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VOLUME IV. 



1883-1884. 



THE PEORIA 




H 



A PRACTITIONER'S JOURNAL 



THDS, M, McIL'yAINE, ii, M,; M, B,, 

Editor and PuhlishEr, 



oisriB idoi_.i_..a.:e^ r^Ei^ ^A^isrn^uis^. 



PEDRIA, ILL,, 

No, 204 South-JeffErsan Strest, 

1334, 



GONTI^IBUTORS TO VOLUME lY, 



Br. A. B. Allen, Rlinois, 


14-222 


" A. B. Anderson, Nebraska, 


- 165-295-356 


" H. S. Bell, Illinois, - 


151-184 


" J. H. Bencher, Missouri, 


27 


" /. J. Bennett, Wisconsin - 


- 123 


" i?. Boal, lllinnis. 


320 


" W. C. Bowers, Illinois, 


- 121 


" -S. J. Bumstead, Illinois, 


199 


" J. B. Carder, Iowa. - 


174 


" O. W. Carpeiider, Indiana, 


- 126-404 


" F. Cole. Illinois, - - . 


- 339 


" J. F. Corbelt, Wisconsin, 


360 


'■ R. J. Curtiss. Illinois, 


- 457 


" F. Drude, Illinois, 


119 


" J. D. Ebert, Indiana, 


124-358 


" J. S. Geigley, Illinois, 


470 


" C H. B. Gile, Kansas, - 


477 


" J. L. Hamilton, Illinois, 


462 


" J. W. Hensley, Illinois, 


- 322 


" 0. E. Herrick, Michigan, 


41 


" R. F. Henry, Illinois, 


- 204 


" W. S. Higgins, Illinois, - 


174 


" W.O. Henry, Nebraska. 


- 174 


" W. D Hill, Wisconsin, 


158 


" F. L. Hinsdale, Iowa, 


205-354 


" J.M. Hole, Ohio, - 


25 


" JB. J. Law, Illinois, - 


- 207 


" E. L. Larkins, Indiana, 


196 


" T. H. Line, Nebraska, 


107-205 


" L. L. Leeds, Illinois, 


206 


" C. B. Maclay, Illinois, 


262 


" M. S. Marcy, Iliinois, 


360 



Dr. J. T. Mason, Ohio, - - - 419 

" J, P. McClanahan, Illinois, - - 387 

" T,F, McFarland, Illinois, - - 1(» 

" E. L. McKinnie. Illinois, - - 171 

" J. 8. Miller, Illinois, - - 341 

" A. J. Miller, Illinois, . . - 303 

" A. J. Mitchell, Iowa, - - - 26 

" O. N, Murdoch, Wisconsin, - - 205 

" 6r. A. Moxdton, Dakota, - - 206- 

" E.H, Plasch, Illinois, . . - 173 

" J. Richardso7i, Iowa, - - . - 353 

" F. C. Robitison, Illinois, - - 168- 

" A. E. Rodgers, Texas, ... 478 

" E. F. Rolens, Illinois, ... 475 

" O.J. Roskoten, Illinois, - - 160-379 

" R. Roskoten, Illinois, ... 425 

" C. F. Ross, Illinois, - - . - 174 

" Scott, Kansas, .... 203 

" F. J. Shipp, Illinois, - - - 22 

" J. B. Shoemaker, Kansas, - - 183-232 

" J. I. Skelly, Illinois, - - - - 348 

" L, H. Spntding, Illinois - - 317 

" J. T. Stewart, Illinois, - - - 49 

" J. E. Stinson, Texas, - - . 233 

" C. S. Stroud, Iowa, - - - 476 

" S. A. Sxiloff, Pennsylvania, - 206-267 

" H. J. Tillotson, Illinois, - - 219 

" F. C. Vandervort, Illinois, - - 264 

" W. H. Veatch, Illinois, - 19-23-99-139-190 

" Voorhees, - - . . . 203 

" O. B. Will, Illinois, - - 54-393-419 

" W. T. Wright, Kansas, . . . fl, 



TABLE OF CONTENTS--V0L. IV, 



ORIGINAL COMMUNICATIONS. 

Pagb. 

Albuminuria During Pregnancy Boal 320 

Albuminuria Following Scarlet Fever Spalding 317 

Albumni in Urine — Significance of McJlvaiiie 310 

Amnesic Aphasia from Railroad Accident Cole 33& 

Amputation^Dressing Stumps after Skelly 34S 

Anal Fissures and Irritable Ulcers Miller 341 

Annual Address before Adams County Society Drude 119 

Antiseptics in the Practice of Medicine Geigley 57 

Bacteria — Germ Theory of Disease Curtiss 14& 

Battey's Operation for Cystic Disease — Death Will 419' 

Bright's Disease Curtiss 39S 

Bright's Disease — Clinical Use of the Microscope Curtiss 457 

Carbolic Acid in the Treatment of Piles and Fistula, its Origin and Condemnation AUen 14 

Carbolic Acid in the Treatment of Piles Veatch 99 

Carbolic Acid in the Treatment of Piles, Typical Cases Veatch 139 

Carbolic Acid in the Treatment of Piles ^ Hill 158 

Carbolic Acid in the Treatment of Piles — A Reply to Dr. Veatch Allen 222 

Cervix Uteri — Laceration of Bell 151-184 

Cholera Infantum— Causes and Treatment of Shoemaker 183 

Clinical Uses of the Microscope Curtiss 1-64 

Clinical Uses of the Microscope — The Germ Theory of Disease — Bacteria Curtiss 145 

Clinical Uses of the Microscope — Bright's Disease Curtiss 457-398 

Comparative Merits of the Circular Amputation R. Roskoten 425 

Cystic Degeneration of the Ovary — Battey's Operation — Death WiU 419 

Diagnosis and Treatment of Some Diseases of the Rectum — Anal Fissures and Irritable 

Ulcers Miller 341 

Diphtheria ...Tillotson 219 

Dressing Stumps after Amputation Skelly 348 

Extirpation of the Uterus and Ovaries with the Posterior Wall of the Vagina Stewart 49 

Fibrous Contraction of the Pylorus, with Consequent Dilatation of the Stomach — Report 

of Three Cases Miller 303 

General Paralysis of the Insane McFarland 109 

Hepatic Dyspepsia Line 107 

Hydiocele of the Tunica Vaginalis Vandervort 264 

Lacerated Perineum Will 54 

Laceration of the Cervix Uteri Bell 151-184 

Malarial Fever in Children, with Meningeal and Cerebral Complications Anderson 295 

Marasmus — Senile Roskoten 379 

Medical Treatment of Uterine Displaicements Herrick 41 

Methods of Practice Maclay 262 

Microscope — Clinical Uses of « Curtiss 1-64 

Microscope— Clinical Uses of— The Germ Theory of Disease — Bacteria Curtiss 145 

Microscope — Clinical Uses of— Bright's Disease Curtiss 398 

Ovarian Tumors— Diagnosis of Hamilton 462 

Ovary— Cystic Degeneration of the— Battey's Operation— Death Will 419 

Ovariotomy— Report of a Case McClanahan 387 

Oxytocic Remedies Hensley 322 

Piles— Treatment of Veatch 257 

Piles— Corbolic Acid in the Treatment of— A Reply to Dr. Veatch Allen 222 

Piles- Carbolic Acid in the Treatment of Hill 158 

Piles— Carbolic Acid in the Treatment of— Typical Cases Veatch 99-139 

Piles and Fistula — Carbolic Acid in the Treatment of— Its Origin and Condemnation...4Hen 14 

Prematurely Born — Treatment of the Richardson 155 

Scarlet Fever — Albuminuria Following Spalding 317 

Scientific Methods Maclay 103 

Senile Marasmus O.J. Roskoten 379 



iv The Peoria Medical Monthly. 

OrigiHal Commimications — Continued. 

Page. 

Significance of Albumin in Urine Mcllvaine 310 

Spermatorrhoea Geigley 470 

Subinvolution of the Uterus Will 392 

Telescope to Microscope Maday 16 

Uterus— Subinvolution of the Will 392 

Uterine Displacements — Medical Treatment of Herrick 41 

Uterus and Ovaries, with the Posterior Wall of the Vagina— Extirpation of the Stewart 49 

Vomiting of Pregnancy — Persistent only Relieved by Emptying the Uterus Wright 6 

NOTES FROM PRIVATE PRACTICE. 

Abdominal Presentation Veatch 190 

Aneurism of the Gastric Arterioles Stdoff 267 

Anus— Malformation of Rolens 475 

Child Birth— Decided Will Power Manifested in Ebert 358 

Colored Glass for the Headache of Adolescents Higgins 120 

Compression of the Brain Rodgers 478 

Cracked Nipples Bencher 27 

Diphtheria j, Stroud 476 

Diphtheria— Treatment of Ebert 124 

Ergot in Erysipelas Bennett 123 

Felon— How to Cure a Hole 25 

Fi-acture of the Skull with Depression O. J. Roskoten 160 

Headache of Adolescents— Colored Glass for Higgins 120 

Hepatic Colic— Inflammation of Gall Bladder— Perforation— Peritonitis Death Larkins 196 

Intussusception Successfully Treated by Warm Water Injections Veatch 192 

Malarial Fever— Diphtheria— Abortion— Death Anderson 356 

Necrosis of Right Parietal— Post Mortem Hinsdale 354 

Obstetrical Experience Medtcus 479 

Obstinate Constipation of Bowels Cured by Electricity and Massage Shipp 22 

Ovarian Abscess— A Happy Terminus Veatch 23 

Prolapsus Uteri, with Retroversion, Bunn's Supporter ..: :...'Gile 477 

Puerperal Hemorrhage— Secondary Anderson 165 

Remittent Fever During the Puerperal State Richardson 353 

Report of Cases Bowers 121 

Retained Placenta Veatch 19 

Retained Placenta Marcy 21 

Secondary Puerperal Hemorrhage Anderson 165 

Senile Gangrene— Amputation of the Leg— Recovery Mitchell 26 

Shock— Case of Geigley 224 

Spurious Pregnancy, or Pseudocyesis Corbett .360 

CORRESPONDENCE. 

Albumen or Albumin? Prescriptions Maclay 352 

An Attempted Criticism Ebert 202 

Chorea— For Voorhees 330 

Criticism— A Robinson 168 

Critic Corrected Luvois 329 

Correction Repmek 329 

Correction Veatch 330 

Diphtheria ; Robinson 227 

Diphtheria Scott 203 

Dr. Harper Vindicated Findlcy 226 

Ethics Veritas 167-197-230-268-270-324 

Electricity— Uses of Carpender 126 

Irregular Practice will Not Pay A Specialist 127 

Mother's Mark Carpender 404 

New York Letter Will 29 

Prescriptions Repunk 272 

Prescriytion Writing 351 

Quackery — Dr. Curtiss' Articles, etc Carpender 28 

Too Many Medical Colleges Bumstead 199 



Table of Contents. ▼ 

ANSWERS TO QUESTIONS. ^^^^ 

Acute Dysentery B.F.Henry 204 

Acute Dysentery • ^^"« ^^ 

Acute Dysentery HinsdaU 205 

Acute Dysentery Mnrdock 206 

Acute Dysentery 'StttojT 206 

Acute Dysentery i^*''* ^® 

Acute Dysentery Moulton 206 

Acute Dysentery Stinson 233 

Acute Tonsillitis Maxwell 273 

Acute Tonsillitis — Eucalyptus for 

274 
Acute Tonsillitis — Simple Inflammatory 

Follicular Pharyngitis Shoemaker 232 

Nervous Headache— Neuralgia McKinnie 171 

Nervous Headache — Neuralgia Plasch 173 

Nervous Headache— Neuralgia 1^- O. Senry 173 

Nervous Headache — Neuralgia Carder 174 

Nervous Headache • ^''** ^^* 



SOCIETY TRANSACTIONS. 



American Medical Association. 



76^ 



Correction *^ 

DeWitt County Medical Society— Election of Officers ^^ 

Illinois State Medical Society ^ 

Peoria City Medical Association — Discussion on Albuminuria 330 

Discussion on Battey's Operation ■*30 

Discussion on Cerebro Spinal Meningitis ; 433 

Discussion on Circular Amputations *27 

Discussion on Lacerated and Contused Wounds 480^ 

BOOK NOTICES. 

Accidents and Emergencies— What to Do First in 235 

Anal Fistula — New Operation 4°* 

Bright's Disease of the Kidneys 333 

Chemistry— Medical Students' Manual of 235 

Connecticut State Board of Health— Fifth Report 34 

Collective Investigation of Diphtheria 275 

Copp"s Salary List ' 

Digest of Materia Medica & Pharmacy 333 

Dio Lewis' Monthly 235 

Diseases of the Heart *°° 

Drugs and Medicines of North America 4°' 

Faculty of Maryland — Transactions of 235 

Female Hygiene and Female Diseases ^^ 

General Pathological Anatomy 207 

Gonorrhcea- Pathology and Treatment of ^^^ 

Hand Book of Electro- Therapentics 133 

Illinois State Medical Society— Transactions of 334 

Labor Among Premitive Peoples ^3* 

Legal Medicine 

Marine Hospital Service — Report of 275 

Manual of Practical Hygiene 275-406 

Microscope and Its Revelations 34 

Medical Technology — General 276 

Physicians Pocket Record ' 

Practioners' Ready Reference Book 33 

Reprints ^^"^ 

234 



Roller Bandage 

Shakespeare as a Physician . 
Syphilis in New-born Children 



486 
334 



Transactions of Missouri State Medical Society *°' 



40ft 

IIVA OUlgd^ ..••• 

Wounds— Treament of. 



Veterinary, Medicine and Surgery 

284 



vi The Peoria Medical Monthly. 

PERISCOPE AND ABSTRACT. 

Page. 

Abortion— Long Retention of Placenta After 246 

Abscesses of the Necli 247 

Acute Rheumatism 132 

Amputation— Question as to 209 

Anaesthetics 488 

Ansesthetics in Diseases of the Kidneys 212 

Angina Pectoris— Treated by Nitro-GIycerine 86 

Anorexia 210 

Antipyretic Effect of Carbolic Acid 249 

Aphorisms on Ligation for Arterial Hemerchage 411 

Arsenic in Chorea— Large Doses of 210 

Arterial Hemorrhage — Aphorisms on Ligation 411 

Atropia for Earache 175 

Bismuth and Hydrastia for Gonorrhoea : 245 

Boracic Acid 175 

Bright's Disease — Coryza in 447 

Bromide of Potassium in Migraine 444 

Calomel in Diphtheria 210 

Carbolic Acid— Antipyretic effect of. 249 

Child-birth — Temporary Blindness following 446 

Cholera Infantum — Case and Cure of. 91 

Clinical Gynsecological Observations 334 

Cold Abscess of the Tongue 89 

Collodion in Vascular Tumors 209 

Corpyza in Brights Disease .'. 447 

Croton Chloral Hydrate in Facial Neuralgia and Hysteria 211 

Cutaneous Erysipelas from Arnica 244 

Dental Formation in the Nasal Cavity 89 

Diarrhoea — Percussion of the Colon in 85 

Diphtheria 279 

Diphtheria— Calomel in 210 

Diphtheria— Terapentics of 407 

Diphtheria— Treatment of 447 

Diphtheria— Peroxide of Hydrogen in 413 

Does the Materia Medica Afford, etc 280 

Dressing for the Umbilical Cord 287 

Earache — Atropia for , 175 

Eczema 447 

Effects of Internal Administration of Glycerine 90 

Ergot — Use and Abuse of 284 

Extirpation of Uterus for Cancer 130 

Facial Neuralgia— Croton Chloral Hydrate 211 

Fecal Accumulatioh— Fever Dependent upon 87 

Fractures— Treated by Plaster of Paris 362 

FHiruncles— Treatment of 87 

Glycerine -Effects of Internal Administration of 90 

Gonorrhoea— Bismuth and Hydrastia 245 

Gout— Treatment of aa 

Granular Lids — Treatment of _ 208 

Haemophilia — Transfusion in 211 

Hodgkin'.s Disease— Treatment of. 250 

liot Water in Secondary Hemorrhage 284 

How to Examine the Insane 251 

Hypertrophic Nasal Catarrh 445 

Importance of Cleanliness in Surgical Operations 284 

Insane— How to Examine the 251 

Insomnia — Treatment of 250 

Intestinal Catarrh in Children y^f^ 

Iodoform 



442 

Iodoform Ointment in Rheumatism _.. 244 

Kidneys— Anaesthetics in Diseases of. 212 

Local Anaesthesia— Ready Method of. 13, 



Table of Contents. vii 

Abstract and Periscope — Continued. 

Pagk. 

Lympho— Sarcomata, Kern's Clataplasmata in 208 

Malarial Fever— A New Remedy for 132 

Medicated Collodion in Vasular Tumors 209 

Migraine — Bromide of Potassium in 444 

Nitro-Glycerine in Angina Pectoris 86 

Obstruction of the Bowels 282 

Oil of Peppermint in Zoster 215 

Os Uteri Internum 446 

Percussion of the Colon in Diarrhoea 85 

Peroxide of Hydrogen in Diphtheria 413 

Pessaries — Use of • 365 

Plaster of Paris Dressings in Fractures 362 

PluggingtheOs Uteri 413 

Practice of Medicine in China 214 

Prolapse of the Urethra — Case of. 364 

Puritus Ani : 89 

Psoriasis— Treatment of. 369 

Puerperal Hemorrhage 129 

Puerperal State— Remittent Fever During the 283 

Remittent Fever During the Puerperal State 283 

Retention of the Female Catheter 285 

Retention of the Placenta after Abortion 246 

Rheumatism— Iodoform Ointment in 244 

Rheumatism — Acute 132 

Ringworm— Treatment of 91 

Ringworm — Salicylic Acid in 246 

Salicylic Acid in Ringworm 246 

Santonin — How to Give 88 

Secondary Puerperal Hemorrhage 129 

Sick Headache Pencils 489 

Sore Throat in Children 488 

Specialism in Medicine 276 

Talmage on Doctors 213 

Temporary Blindness following Child-birth 446 

Tuberculosis, Produced by Sprayed Sputa • 286 

Typhoid Fever— Treatments of 336 

Ulcer of the upper Lip 212 

Ulcers with Large and Slowly Separating Sloughs — Treatment of 90 

Umbilical Cord — Dressing for the 287 

Urethral Hyperaesthesia 368 

Uterus 130 

Vascular Tumors — Medicated Collodion in 209 

Zoster — Oil of Peppermint in 215 

EDITORIAL DEPARTMENT. 

A Card to the Public • 218 

A Daily MedicalJournal 293 

A Hint to Coutributors 9*> 

A Thief and Fraud 180 

A Word of Explanation 216 

American Pharmacy Abroad 294 

An Inquiry 137 

Another Light Extinguished 373 

Bound Volumes of 1882 181 

Chicago Journal and Examiner on the Illinois State Board of Health 415 

Close of Fourth Volume 490 

Code of Ethics— Peoria Medical Monthly and 288 

Code of Ethics — Homcepaths and the 37 

Code of Ethics — St. Louis Medical Society and the 176 

Code Stand — How Long will the 135 

College Announcements 217 



viii The Peoria Medical Monthly. 

Editorial Department — Continued. 

Page. 

Columbus Medical College— Illinois Board of Health and 92: 

Croton Chloral Mixtures 137 

Crowded Out 96 

Daily Edition 40 

Death of Dr. S. Marion Sims 289 

Died 96 

District Medical Society of Central Illinois 418 

Do Moral Principals Change? 178 

Enterprise in Wood Cuts 293 

Errata 255 

Home Health , 291 

Homoepaths and the Code of Ethics 37 

How Long will the Code Stand? 135 

Illinois Board of Health— Certificates Revoked by the 290 

Illinois Board of Health— Chicago Journal and Examiner on the • 415 

Illinois Board of Health and Columbus Medical College 92 

Illinois Board of Health— Politics in the 416 

In Memoriam 180 

Large Meeting 97 

Louis Pasteur 372 

Maclean vs. Sutton 292 

Make us a Visit 179 

Many Thanks 96 

Married 95-97 

Medical Colleges and Higher Medical Education 448 

Medical Controversy — Personalties in 252 

Medical Journal — The Practioner and His 336 

Medical Profession — Social Influence of the - 370 

More Certificates Revoked by the Illinois Board of Health 290 

More Editors 293 

No Apology 96 

Notes and Comments ....450-455-374-337-480 

Notes and News Items 95-181-253 

Notices 256 

Obituary 95-136 

Peoria Medical Monthly and the Code 288 

Personalities in Medical Controversy, 252 

Physician, The 374 

Physician Himself, The 291 

Play, Fair 136 

Pledge, That 134 

Politics id the Illinois State Board of Health... 416 

Practice For Sale 40 

Practitioner and His Medical Journal, The 336 

Reading Notices : 138-418-456-378-192 

Receipts 39-98-137-182-218-256-455-377-294 

Removal 96 

Renewals 97-181 

Returned 96 

Ricordiana 97 

Social Influence of the Medical Profession 370 

Society Meetings 137 

St. Louis Medical Society and the Code of Ethics 176 

Suspended 293 

Third Edition 97 

Unpleasant 97 

Volume Fourth 86 



?eorik >ie(ii6kl >Iontl|ly. 



«S= Contributions must be short-not to exceed five hundred words.-=®ft 



70L. I. MAY, 1880. NO. 1. 



[For the Peoria Medical Monthly.] 

Fracture of the Neck of the Femur. 



BY J. MURPHY, M. D. 



We have certainly no cause of complaint with regard 
>to the extent of the literature of fractures of the neck ot 
the femur, whatever objections there may be to its quality,^ 
its precision, or its practical bearing on the treatment ot 
formidable and not unfrequent accident. The wordy war- 
fare in which surgical writers have so long indulged with 
reference to it, their lack of unanimity with regard to many 
important points connected with the accident and its treat- 
ment, and the almost universal deformity which it entails, 
indicate that the subject has either not been investigated 
with sufficient painstaking precision, or that a restoration 
of the part to its natural condition is not within the re- 
sources of surgery. ^ ^r, ^. t 
In the limits to which I am confined, 1 regret tHat i 
cannot enter into a consideration, either general or special, 
of the many interesting but unsettled points connected with 
this fracture ; although this regret is somewhat neutralized 
by reflecting on the very trifling advantages of a practical 
character which have been derived from the apparently in- 
terminable warfare that has been waged with reference to 
the diagnosis of the fracture, whether within or without, 
or partly within and partly without the capsule; and 
"whether bony union ever occurs, and how often we may 



Peoria Medical Monthly. 



expect it. These considerations do not, I conceive, involve- 
any questions of an important practical character, and it is 
fortunate that they do not, because while it may be possi- 
ble for an hospital surgeon of large experience and superior 
powers of perception and discrimination to detect the dif- 
ferent fractures, I feel quite certain that the general prac- 
titioner cannot do so, at least in the great majority of cases. 
The different species of the fracture do not present suffi- 
ciently distinct characteristics of a general nature to enable 
an ordinary surgeon to decide definitely respecting, it ; 
while the special symptomology equally fails in conveying 
to the surgeon's mind any definite idea regarding it. Some 
of the special symptoms which are depended on to enable 
us to discriminate between the different fractures will not 
bear rational analysis ; for example, that one relative to the 
diminished arc of a circle described by the trochanter in- 
rotating the femur. Any attempt at rotating the limb in 
those cases is so painful that in many instances very little 
information is to be gained by attempting it, but in those 
cases where rotation can be performed, that rotation will, I 
believe, be found to occur invariably in the axis of the 
shaft of the femur, provided the fracture of the neck is not 
an impacted one. In its natural position in the acetabulum 
the head of the femur serves as a pivot, and enables the 
trochanter to move in a certain segment of a circle; but 
when the neck is fractured the pivotal function of the head 
is lost, and the trochanter being more firmly fixed than the 
fragment of the neck attached to it, the free end of the 
latter performs the segmental circular movement, while the 
trochanter is the pivot by which that movement is accom- 
plished. The principle involved here is so purely mechan- 
ical that it will be readily appreciated, and can be easily 
tested by any one familiar with the most ordinary scientific 
principles. Other special symptoms depended on to prove 
the species of fracture are equally fallacious. 

Again, all the discussions which have occurred with 
reference to the question of a bony or ligamentous union,, 
although of much abstract interest, have really no practical 
bearing on the treatment of the fracture. The character 
of the union is a question which the surgeon treating the 
case should not give a moment's attention to, as the im- 
pression that a bony union is not likely to occur has induced 
a carelessness and slovenliness in the treatment of sucb 
cases which has unquestionably produced thousands of de- 



Peoria 'Medical Monthly. 



formities, many of which could have been avoided. It is 
probably not so important as surgical writers lead us to 
suppose, what the character of the union may be. A firm 
ligamentous union is probably as useful as a bony one. 
During the lifetime of the individual we are not able to 
detect the difierence. In those cases where union of some 
kind has occurred, we cannot detect any motion or flexi- 
bility at the seat of the fracture, in any movement of the 
limb which may be made. All those considerations with 
regard to the position of the fracture or the character of 
the union, and which are of no special importance in the 
treatment, should be merged in the all-absorbing question: 
Can the normal length of the limb in fractures of the neck 
of the femur be preserved ? This should be the pivotal 
idea of the surgeon, and round it all subordinate ideas 
should revolve. The opinions of surgical writers, occasion- 
ally very loosely expressed, that more or less shortening is 
inevitable in this fracture, has deterred the great bulk of 
general practitioners from making any vigorous efforts to 
prevent it, and hence the almost constant deformities which 
we observe in such cases. 

"Why there should be this want of zeal in treating a 
fracture of so much importance it is difficult to determine. 
It cannot be from the abstract apprehension that a useful 
union will not occur, because we find that union does act- 
ually occur almost invariably, notwithstanding our care- 
lessness in frequently not even making an attempt at bring- 
ing the fragments into apposition, or keeping them there. 
It ought not to be from the dread of the possible disagree- 
able effects which continued confinement might exercise, 
because the aged are the most frequent sufierers from this 
accident, and confinement is less irksome and less injurious 
to them than to the young. It should not be from any 
morbid or irrational fear of want of sufficient constitutional 
vigor to promote union, because as I have said union does 
occur, and we find that other fractures in aged persons unite 
quite readily. Besides a large majority of ununited frac- 
tures occur in the young and apparently vigorous. 

None of those causes is, I believe, the true one why 
we lay our patient's limb on a pillow in whatever position 
is most comfortable to him; or put him on a double inclined 
plane, where adequate extension is impossible; or extend- 
ing the limb for two or three weeks by some one of the 
traditional modes of doing so, until the patient begins to 



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lauat, if posible. 

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T governed 

: "_ ' :t„ and 



if ire 'i . ^ 

IraedirT . :: ::~ 



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Peoria Medic-al Monthly. 



flaoas splints should be avoideil. as interfering with the 
capillary circulation. In order to restore the normal length 
of the neck and the natural rotunditv of the trochanter, 
we must make traction in the direction of the axis of the 
neck of such power as will bring the fi^ctnred surfaces in- 
to opposition. This will be best accomplished bypassing a 
firm band round the upper end of the thigh from within 
outwards, by which extension is made, while counter-ex- 
tension is accomplished by another band passed round the 
pelvis in the opposite direction. After the fractured ends 
of the bone have been thu.5 brought into proper position. 
they can be best kept there by placing an unyieLiiiig com- 
press of the requisite thickness between the thighs, close to 
the perineum, retaining this in proper position by strapping 
the two limbs together at the knees and ankles. Firmly 
made and carefully retained in the position indicated, I 
consider this pad an indispensable requisite to the success- 
ful treatment of this fracture. In addition to this, a broad 
bandage should be applied round the pelvis, embracing 
both trochanters. While the object of the compress is to 
prevent the ends of the fracture from over-riding each 
other, the object of the pelvic band is to keep those frac- 
tured ends in close opposition, and thus mcilitate their 
union. This treatment should be continued for a sufficient 
length of time to admit of union being accomplished. The 
time that may be required in such' eases will depend very 
much on the constitutional vigor of the patient and on the 
skill and care exercised by the surareon. It is a ease which. 
more than any other fracture, requires constant watchful- 
ness and devotion on the part of the medical attendant. 

By carrving out this simple method of preserving the 
length ol the limb and that of the neck oi the femur, there 
cannot be much deviation from a natural position of the 
fracture : and union is more likely to occur, and to be of a 
more firm and satisfactory character, and with less danger 
of shortening, than under any other system of treatment 
with which I am acquainted: certainly much more so than 
in the plans of treatment usually pursued and recommend- 
ed by eminent surgeons. The general result oi this frac- 
ture heretofore has been a blot and an opprobrium to our 
profession : and it is therefore the duty of every practitioner 
to observe such cases with critical solicitude, and reflect 
maturely on the causes which in the past have rendered our 
tre^itment of them so unfortunate and unsatisfactory. 

Peoria. April, ISSO. 



Peoria Medical Monthly. 



[For the Peoria Medical Monthly.] 

Xeiirastlienia. 

Read before iJie Decatur Medical Society June 26th, 1879, by 
A. Robertson Small, M. D. 

The term Neurasthenia comes from two Greek words: 
neuron^ meaning a nerve, and asthenia, want of strength, de- 
bility. It is a functional disease of the nervous system — 
that is, the true pathological changes have not yet been dis- 
covered. It is a disease of recent origin, and I believe all 
that has ever been written on the subject has been done 
within the last ten years ; and hence, the literature on the 
subject is scanty and inadequate, and, so far as I can learn, 
none of the recent standard works contain a chapter on the 
subject, with exception of Erb, in the thirteenth volume of 
Ziemssen's Cyclopaedia, to which article, as well as one in 
the New York Medical Journal, by Dr. Geo. M. Beard, and 
one in the Medical and Surgical Reporter, by Dr. W. 0. Still- 
man, I owe much of my information on the subject. 

Neurasthenia, though of recent origin, is by no means 
infrequent in this country. Dr. Beard says : "But in spite 
of its frequency and importance, neurasthenia, although 
long recognized in a vague way among the people and the 
profession under such terms as ' general debility,' ' nervous 
prostration,' 'nervous debility,' 'nervous asthenia,' 'spinal 
weakness,' and more accurately by some of its special 
symptoms and accompaniments, as ' spinal irritation,' ' ner- 
vous dyspepsia,' 'cerebral and spinal hypersemia,' 'irritable 
ovary,' ' irritable uterus,' ' uterine asthenopia ' and ' sexual 
exhaustion,' yet until quite recently no attempt has been 
made to formally introduce it into science, by describing in 
detail all its symptoms and showing their relation to each 
other and to the morbid nervous condition of which they 
are all the results and expressions. My first paper," says 
he, " on this subject, based on the study of thirty cases, was 
prepared in 1868, was read before the New York Medical 
Journal Association, and was published in the Boston 
Medical and Surgical Journal, April 29th, 1869, and subse- 
quently appeared in the first edition of Beard & Rockwell's 
'Electricity.'" 

The above, I believe, is the first paper ever written on 
the subject. Abroad it seems to have received less atten- 
tion than in this country, possibly because it is not so com- 
mon there as here. The term neurasthenia covers all the 
forms of nervous exhaustion, whether the symptoms come 



Peoria Medical Monthly. 



from the brain or spinal cord, though the term cerebras- 
thenia is applied to the former, and myelasthenia to the 
latter. 

We understand by neurasthenia, those conditions of the 
brain or cord, or both, in which marked and unquestion- 
able disturbance of their function exist, for which no con- 
siderable anatomical basis can be found or assumed; a 
disease, therefore, which must at present b,e classed as a 
functional disease. Many of its symptoms, however, resem- 
ble closely the symptoms in the early stages of severe dis- 
ease of the cord, with anatomical lesions, but whether this 
disease may lead to actual organic disease of the cord is 
doubtful, and most authorities believe it does not. I believe,, 
however, that cerebral and spinal anaemias, hyperaemias, 
and irritations, are often only the symptoms of neuras- 
thenia, and that inervation precedes the disturbance of 
circulation. 

ETIOLOGY. 

The predisposition to this affection is most common in 
the male sex, and youth and middle age are most exposed 
to the disease. It is also most apt to occur in delicately bal- 
anced and highly sensitive nervous organizations, and 
among the signs of this are fine soft skin, fine hair, deli- 
cately cut features and tapering extremites. Most sufierers 
come from neuropathic families, in which psychosis, hys- 
teria and other neuroses, are well known guests. The 
higher and most intellectual classes are much more predis- 
posed to the disease than the lower classes. The following 
are some of the direct causes. Flint says : "It proceeds 
from under functional activity of the nervous system, as 
connected with the exercise of the intellectual and emo- 
tional faculties." 

We, as Americans, work too much and play too little; 
and it is this close application to study and the worry of 
business day after day, week after week, and year after year, 
'with little or no relaxation or recreation, that finally tires 
out the nervous system, and it gives out exhausted. Exces- 
sive mental efibrts, as severe and long-continued study — es- 
pecially if not sufficient sleep be taken — are very prolifio 
causes of neurasthenia, and a similar effect is produced by 
violent grief or excessive excitement of the affections and 
passions. But the immediate cause in the great majority^ 
of cases is worry — worry connected with business matters- 



S Peoria Medical Monthly. 

or excited by domestic complications. Man can do an im- 
mense amount of mental work without being injured 
thereby, if he will only keep this element of worry in the 
background. Another frequent and important cause is 
sexual excesses, masturbation begun very young and long- 
continued, inordinate sexual gratification, or even lack of 
the same. Frequently-repeated sexual excitement without 
gratification, in predisposed persons, acts similarly. Ex- 
cesses of less degree, but longer continued, are often at 
fault, and the disease frequently occurs after the honey- 
moon. Excessive bodily eftbrt may also produce the dis- 
ease, as long forced marches, mountain climbing, etc. In- 
sufficient food, or anything that depresses the powers of 
the nervous system, has an influence in the same direction. 
I believe also, that the excessive use of tobacco acts many 
times as a factor in producing the disease by weakening 
the nervous system. We all know its well-known power 
of producing at least one of the symptoms of neurasthenia, 
that of sexual debility. But the disease is most distinct 
when several of the above causes co-exist, as great mental 
and bodily overwork with disturbance of sleep and rest, or 
when, amid great mental exertion, business or domestic 
worry, sexual excesses are indulged in. 

We now conie to the symptoms of neurasthenia. Neu- 
rastlienia is divided into cerebrasthenia or exhaustion of 
the encephalon, and myelasthenia, or spinal exhaustion. 
These condition are sometimes found distinct and separ- 
ate, but usually more or less blended. Their causes are 
usually different, and their treatment differs much. Their 
distinctive difference, however, will be more especially con- 
sidered under the heads of diagnosis and treatment. The condition 
found in these cases is that of an over-worked brain and nervous 
system, and the symptoms such as would naturally arise under such 
a condition. Confusion of thought is one of the earlier symptoms. 
The patient cannot force his mind to think consecutively on any 
one subject, but his ideas will come and go without his having any 
power over them. There may be times when his mind seems clear, 
but soon again, it will be in a state of chaos, and his ideas indis- 
tinct. This condition will be particularly noticed if he attempt to 
^dd up a column of figures. The memory, too, is usually defective, 
though this usually occurs also in all forms of nervous debility, 
whether caused by exhaustion, organic change, or senility. Another 
symptom is hesitancy of speech, arising from confused thought, and 
bad memory, rendering it difficult to form a clear conception of the 
subject under consideration, and hard to summon the necessary 



Peoria Medical Monthly. 9 

words to express it. This symptom is much better marked in some 
cases than others and in some it does not occur at all. Indecision, 
timidity and lack of confidence in ones own judgment are common 
symptoms in this affection. An almost universal symptom is irrit- 
ability of mind, and depression of spirits. The patient is very apt 
to be suspicious of others, and to think that conspiracies are being 
plotted against him, though he can give no valid reason for such 
belief If he be a business man, he is apt to have vague apprehen- 
sions of financial ruin, though there may not be the slightest 
ground for such apprehension. He is apt to take thoughtless acts 
and remarks of friends as personal slights, or possibly insults. He 
is constantly in a worry and fret about something, or brooding over 
his imaginary troubles. He is restless and wanders aimlessly from 
one place to another. He is ill at ease, and usually confused if any 
one is watching him. Insomnia is nearly always present, and some- 
times may even precede the disease itself, when it may act as a 
cause. It is usually not very troublesome, but of a peculiar char- 
acter ; the patient wakes after a few hours sleep with a sense of 
great uneasiness in his limbs, and may not be able to fall asleep 
again for several hours afterwards, and in the morning feels unre- 
freshed and prostrated. He is also inclined to dream a good deal, 
and his dreams are generally of a fi-ightful character and awake 
him in terror. The preceding symptoms, which we have just con- 
sidered, are more particularly connected with the cerebrum, and the 
higher intellectual faculties, and we now come to a diflTerent class, 
embracing the motor apparatus, the sensory department of the 
nervous system, and the glandular organs, and prominent among 
these are languor and a sense of general or local weakness. A 
feeling of general fatigue is very common, but it is apt to come 
and go suddenly ; at one time the patient may feel as strong as a 
giant, and be capable of performing severe labor, and at another as 
weak as a babe, so that the least exertion is a hardship ; and this 
sense of profound exhaustion may come on suddenly without warn- 
ing, in the midst of his labor. 

There is a peculiar leg weakness in many of these cases, associa- 
ted with a certain form of myelasthenia, growing out of sexual 
indulgence, and this feeling of exhaustion is more particularly felt 
in the morning before getting up. They are incapable of walking 
or standing for any length of time, and if they continue long in the 
standing posture it makes them very tired, with % feeling of pain in 
the back, with shooting or tearing pains in the districts of certain 
nerves. If more severe exercise be indulged in, there will be trem- 
bling of the limbs, and this will be more readily produced by un- 
accustomed exercise. Sometimes a strong mental impression will 
produce the same efiect. These same symptoms of exhaustion and 
want of endurance may occur in the arms, but usually not to the 
same extent as in the legs. It is very diflacult for some of these 
patients to write, owing to trembling and unsteadiness of the hand,. 



10 Peoria Medical Monthly. 

especially if the emotions be excited or the mind embarrassed, 
though others can perform the most delicate movements without 
trouble. The sensations are also markedly effected in this disease. 
The patient complains of flashes of heat, and perhaps the next 
moment of cold, which may be in circumscribed spots. The hands 
and feet are often cold. These sensations probably arise from vaso- 
motor disturbances. Creeping and crawling sensations just under 
the skin are often complained of ; abnormal ticklishness is often 
present ; hypersesthesia or ansesthesia, local or general, are some- 
times found ; neuralgia, shifting quickly from one place to another, 
is very common ; often there is a peculiar pain in the muscles of 
the back, appearing when the body is bent forwards or backwards. 
In a large proportion of these cases there are localized points of 
tenderness along the spine, the same as in nervous irritation. The 
patient is very susceptible to cold and sudden changes in the 
weather. Sometimes the nutrition in neurasthenia is good, and the 
patient may present a hearty and even robust appearance, though 
usually the nutrition is more or less impaired, and the patient 
somewhat pale and anaemic. He is often troubled with a nervous 
dyspepsia. Flatulence and oxaluria are often met with, and not 
infrequently constipation. Redness of the face and irritable eye 
frequently occur, the eye being injected and painful, caused by de- 
bility of the vaso-motor nerves allowing too much blood to be car- 
ried to the part ; and probably the same condition exists in the 
brain at times, and perhaps at others a condition of anaemia. 
Sometimes there are sounds in the ears of a roaring character. 
The sense of taste and smell may also be abnormal. The secretions 
are sometimes at fault, as the lachrymal and salivary glands, the 
sudoriferous follicles, the intestines and testes. There is a tendency 
to shed tears, and this when the emotions are only moderately ex- 
cited, and they may flow profusely without the patient knowing 
why. Disturbance of the sexual organs occupy a very prominent 
place among the symptoms of neurasthenia, and they may stand in 
the relation of cause or effect ; thus, impotence not infrequently 
results from nervous debility, and nervous debility from sexual 
excesses. They commonly Jake the form of " irritable weakness," 
the power of erection and of performing the act are lessened, the 
ejaculation takes place prematurely, and a repetition of the act is 
impossible. The indulgence is usually followed by great prostra- 
tion, restlessness, trembling of the limbs, etc. The symptoms are 
usually all worse after the indulgence of the act. 

Impotence may be caused by suppressed secretion of the sperm, 
due to innervation of the glandular structure of the testes, or the 
loss of desire, or both. Spermatorrhoea is not a regular symptom 
of the disease, unless it previously existed, when it may be consid- 
ered a cause. Their recurrence, however, often aggravates the 
trouble, and when genital affections appear as a cause, the recovery 
is likely to be slow, and the prognosis more unfavorable than when 
they occur secondarily. 



Peoria Medical Monthly. 11 



You will notice that the symptoms are almost entirely subjec- 
tive, the objective symptoms being .slight or entirely negative. 
There is no disturbance of motility ; the patient can usually per- 
form the finest and most complicated movements easily and securely, 
can stand on one foot with eyes closed ; yet the power of muscular 
endurance is weakened, and the patient is more or less anaemic. 

Another important feature is the instability of the symptoms. 
They are not local or constant in their character, as in organic 
lesions, but are constantly flitting from one set of symptoms to an- 
other ; to-day the patient may be complaining of one set of symp- 
toms, and as soon as they are subjugated another set springs up. 
[concluded next month.] 



[For the Peoria Medical Monthly.] 

Hydrobroniic Acid. 



One of the most valuable preparations lately introduced 
to the notice of the medical profession is Hydrobromic 
Acid, a pale straw-colored liquid, a combination of bromide 
of potassium and tartaric acid. I regard this acid as one 
of the most efficient remedies we possess in a certain class 
of nervous diseases. It was first brought to the notice of 
the profession by Dr. D. C. Wade, in the Peninsular Medi- 
cal Journal, and recommended highly for its property of 
preventing the headache and ringing in the ears produced 
by the administration of quinine. Given with or immedi- 
ately after each dose, it prevents in a remarkable degree 
these unpleasant symptoms. It is also of especial value in 
nervous and delicate individuals, in preventing the fulness 
felt in the head, induced by the administration of the various 
preparations of iron. Where there is nervous excitement 
induced by excessive indulgence of tea, coffee or alco- 
holic stimulants, nervous exhaustion from prolonged appli- 
cation, prostration induced by excessive venereal indulgence 
and in many hysterical conditions of reflex origin, it has, 
in my hands, yielded excellent results. This acid combines 
readily with many substances ; is a good solvent for sul- 
phate of quinine, with which it may be administered, al- 
though I prefer giving it immediately after each dose. 
The advantage of hydrobromic acid over the bromide of 
potassium is its agreeable taste, for when given in half a 
glass of lemonade, it forms a very pleasant and refreshing 
draught. 

Dr. J. Milner Fothergill, in the Philadelphia Medical 



12 Peoria Medical Monthly. 

Times, December 9th, 1876, says he has used it to allay 
bronchial irritation. His formula is as follows : * 

^ Spts. Chloroform, 20 minims. 
Hydrobrom.ic Acid, y^ ounce. 
Syr. Scillse, 1 ounce. 

Aqua ad., q.s. 2 ounces. 

M. ET SiG.— One or two teaspoonsful tliree times a day. 

The above recipe I have used many times, with very 
gratifying results. The dose of the acid is from half to one- 
drachm, given largely diluted. The formula for the prep- 
aration of hydrobromic acid is as follows : 

Bromide of Potassium, 10 ounces, 6 drachms, 28 grains. 

Dissolve in four pints of water and add 
Tartaric Acid, 13 ounces, 1 drachm, 27 grains. 

Bitartrate of potass, is thrown down as a precipitate, when 
■the clear liquid may be decanted. It is then ready for use. 
This acid, from its pleasant and agreeable taste, is des- 
tined to supersede the use of bromide of potassium as it 
has been heretofore administered, and its combination with 
tartaric acid heightens the action of the bromic salts. It 
has been estimated that half a drachm is equal in efficacy 
to one and a half drachms of the bromide of potassium. 
The medicinal quality of this combination ofiers a wide field 
for investigation, and if it sustains its reputation as a nervous 
sedative, superior in all respects to the bromide, we have 
gained a preparation of no trilling value. 

Peoria, 111. J. S. Miller, M. D. 



Quinia as a Preventive of Scarlet Fever. 

During the late epidemic of scarlet fever in this city, I 
have used quinine to prevent its spread in a family, after 
one member of that family has contracted this disease, and 
in no instance has it attacked any other member of the 
family, unless the attack came on in a day or two after 
commencing the quinia. 

I give two or three grains, three times a day, according 
to the age of the child; then, after four or five days, the 
dose may be lessened; but the administration of the 
quinine must be kept up for three weeks, or until the sick 
members of the family are fully recovered. I have tried 
this practice in a number of cases, and with complete 
success. 

As scarlet fever still prevails in many parts of our 
country, I would like to have physicians try it and inform 
us of their success with it. H. 

Peobia, April, 1880. 



Peoria Medical Monthly. 13 

Providence and Disease. 

In an article under the above title, published in the 
Detroit Lancet for March, 1880, Dr. C. E. Page claims that 
an unregulated and unseasonable diet is a potent factor in 
the causation of many of our most malignant though 
widely dissimilar forms of disease. Of course the form of 
disease being determined by the constitutional predis- 
position of the individual. 

Although it is a well established fact, that a diet, to be 
healthy, must be suited to climate and season, we think the 
ground taken by Dr. Page is somewhat novel and cer- 
tainly worthy the consideration of sanitarians. 

We are too apt to ignore common sense in our search 
after the cause of disease, allowing our imagination too 
much sway, becoming infatuated with dazzling theories, 
when often times the cause sought for, lies plainly before 
us and may be found in what we foolishly considered toa 
commonplace and familiar an origin. 

Dr. Page says : " The excessive or wrongly composed 
diet (too many meals, too much at each, and too hot ; meat, 
pastry, rich cake, greasy biscuits, short cake, coffee, tea, 
chocolate, gravies, spices, pepper, &c.,) that in summer 
proper, in spite of perfect ventilation, when we are virtu- 
ally living out of doors, will cause bilious, slow or yellow 
fevers, cholera or cholera morbus, will, during our artificial 
summer weather in winter — rooms over-heated, doors and 
windows sealed tight and almost entire absence of ventila- 
tion — produce scarlet, typhus and typhoid fevers, diph- 
theria, croup and the like." ^ 



[For the Peoria Medical Monthly.] 

Whooping Cough. 

" Medicus" writes us, to ask the readers of the Peoria 
Medical Monthly, for the best treatment of whooping 
cough: both abortive (if there be any) and palliative. Let 
us hear from our readers. 



Apropos of the metric question : The U. S. nickel five 
cent piece is two centimetres in diameter, and its weight is 
five grammes. Five of them placed in a row will give the 
length of the decimetre, and two of them will weigh a 
decagramme. 



.14 Peoria Medical Monthly. 

[ For the Peoria Medical Monthly.] 

Repeated Tapping- as a Preparatory Measure to Successful 

Ovariotomy. 

The three patients upon whom ovariotomy was per- 
formed in this city during the past year, and all of whom 
recovered, were in the previous two years tapped and the 
fluid withdrawn by the aspirator, ten, fifteen and twenty- 
three times respectively. 

In none of these cases was the operation performed 
until the system of the patient was no longer able to sustain 
the drain upon it, and the operation was imperatively 
demanded. 

Does not this repeated tapping prepare the peritoneum 
for the final operation of extirpation, and render it less 
liable to take on inflammatory action, and septic influence? 

I do not think tapping as dangerous an operation as 
many consider it. I have performed it many times in the 
past few years, and have never yet seen any serious conse- 
quences follow. It is done with but slight inconvenience 
to the patient, and generally she will be up and around the 
house the next day. 

In multilocular tumors but a single puncture need be 
made. I have emptied at least a dozen cysts without 
removing the needle. 

Statistics show that ovariotomy has been more success- 
ful when performed on tumors of many years growth, than 
when more recent. Emmet gives as the reason for this, 
that "a judicious delay enables the peritoneum to become 
more tolerant to irritation and much less liable to inflam- 
mation than it would be were the tumor removed at an 
•early stage of its growth." But may not the tolerance of 
the peritoneum in these cases be found to be due more to 
the repeated tappings than to the mere existence of the 
tumor in the cavity for a variable number of years ? 

Peoria, April, 1880. H. 



Dr. J. Marion Sims reports, in the Medical Record, the 
loss of a patient, 21 hours after the use of the bromide of 
«thyl. The operation (Battey's) was a long one, and the 
woman had for five years, been subject to epileptic attacks. 
Whether the anaesthetic was directly the cause of death, or 
not, does not seem to be clearly settled. We are glad Dr. 
Sims has laid this case before the profession, as it may 
deter many from a too hasty and careless use of this pow- 
erful agent. * 



Peoria Medical Monthly. 15 



Anfesthesia in Liabor. 

In an able and very interesting paper read by Dr. D. M. 
Barr before the Obstetrical Society, of Philadelphia, and 
published in the Surg, and Med. Rey., Dr. Barr offers the 
following combination as an ansesthetic for use in cases of 
labor, the proportions graded according to the relative 
•strength and nature of the ingredients, and the demands of 
the case: 

^ Ether, 3 parts ; 

Chloroform, 1 part ; 

Alcohol, 2 parts. 

In summing up he makes the following points : 

1. The claim of the parturient woman for anaesthesia 
is unequaled by any claim in the wide world. 

2. These claims will not have received a fair response 
iQntil the anaesthetic is as common in the lying-in chamber 
as upon the operating table. 

3. A proper anaesthesia is more directly indicated and 
■more safe in the ordinary obstetric patient than in the surg- 
ical patient, case for case. 

4. We have an anaesthetic mixture, capable of produc- 
ing perfect immunity from suffering, without intoxication, 
without vomiting, without reaction or dangerous sequences. 

5. The babe offers no contra-indication, since its safety 
is not jeopardized. 

6. Labor is not hindered, but rather hastened by the 
anaesthetic. 

7. Anaesthesia offers no contra-indication for the use 
of any medication, which would be indicated in its absence. 



[For the Peoria Medical Monthly.] 

Tooth Aclie Drops. 

The following formula has been tried for a long time 
■and has proven very successful. The writer of this has had 
personal experience of its efl3.cacy and alway carries a small 
phial in his pocket ready for use : 

9; Chloroform (pure). 

Tr. Aconite rad., a. a. 3 drachms ; 
Tr. Capsicum, 1 drachm ; • 

Oil of Cloves, 1 drachm ; 

Camphor, ]4 drachm. 

Mix and apply on cotton to the hollow tooth. ^ 



16 Peoria Medical Monthly. 

Ethyl Bromide, or Hydrobromic Ether. 

In relation to this new anaesthetic, which js now the- 
subject of much discussion among physicians, we take the 
following extracts from an article in the College and Clinical 
Record, Feb. 16th, 1880 : 

" It is not so recent an agent as is generally thought, 
Kobin made known its properties as an anaesthetic in 1837,. 
after having made many experiments with it. 

"Mr. [N'unnely, of Leeds, England, reported some ex- 
periments in 1849, and in 1865 exhibited it to the members 
of the British Medical Society, stating that he was using it 
quite extensively, both in his private practice and in the 
Leeds General Infirmary. 

"Dr. Laurence Turnbull, of Philadelphia, in 1878, seems- 
to have been the first to arouse an interest in it in this- 
country. Since that time it has been tried somewhat exten- 
sively." 

Di\ R. J. Levis reports on its properties and use as- 
follows : 

" The principal physiological characteristics which will 
concern the surgeon are its rapidity of action and the 
quickness of recovery from its effects. So far as observed 
by me, it does not influence the circulation, except some- 
times to produce a slight increase in the rapidity of the 
heart's action. The cerebral ansemia and the fatal syncope 
of cardiac depression, to which chloroform is liable, do 
not appear to threaten. Respiration is but little influenced 
beyond the ordinary characteristics of all anaesthetic sleep. 
* * * ISTausea and vomiting appear to occur less fre- 
quently than after chloroform and ether. * * * Its vapor 
is quite unirritating to the respiratory passages when in- 
haled. * * * General excitement and tendency to- 
struggle occur less frequently than in the early stages of 
ether or chloroform anaesthesia. * * * Recovery from 
its effects is much more rapid. * * * The pupils dilate 
as soon as complete anaesthesia is induced, and as the sen- 
tient state returns they resume their normal condition. 
Anaesthesia is usually effected in from two to three minutes, 
the quantity used varying, with the operation, from one tO' 
eleven fluid drachms. The vapor of bromide of ethyl is 
not inflammable. * * * The ordinary essentials of the 
proper and safe production of anaesthesia are required in 
the use of the bromide of ethyl. Whilst feeling inclined 



Peoria Medical Monthly. \ 17 

to impress caution in regard to the use of so powerful an 
:agent, I am, from a basis of experience, inclined to recom- 
anend its use to the profession." * 



Forced Alimentation. 



An excellent paper on an important and too often over- 
looked theraputic measure,- was read before the New York 
State Medical Society and published in the " Proceedings " 
for March, 1880. Its author, Dr. A. Hutchins, claims that 
the principle of forced feeding is a valuable adjunct in 
resisting certain influences of heredity. He says, " The 
inheritors of certain constitutional taints are notoriously 
light and fickle feeders. The parents themselves uncon- 
scious of the discipline of food, accept their ofl'spring's 
^' weak stomach " as the inevitable. But this weak stomach 
is also an uneducated stomach, with latent possibilities that 
-a cultivated discretion may call into vigorous exercise. 

This digestion, not stimulated by drugs, but exercised 
by materials that possess the elements of nutrition, can 
■enforce a nutrition by which the malign hereditary influ- 
ences may be set aside, and the maturing years be coinci- 
dent with maturing powers of resistance that would be 
unknown to the period of development, ill-trained and ill- 
nourished. 

' Bearing in mind that food is the natural tonic, and that 
■drug tonics are but excitants to the natural tonics, it, at the 
same time, is not to be lost sight of that, during the entire 
period of growth and development, where waste and repair 
go on so rapidly, where accumulation stretches way up 
beyond the region of supply, and that for a long continu- 
ous succession of years, any protracted failure of appetite 
and an inadequacy of food, coincident with a want of 
enthusiasm and buoyancy native to vigorous youth, must 
naturally suggest the most gloomy forebodings. * * * 
* * Aside from all considerations of appetite, notwith- 
standing any weakness of will power, or the multiplied 
obstacles of repulsion, loathing, or seeming impossibilities, 
the first point is to get food of some kind into the stomach 
in such quantities as is possible, and at stated intervals, as a 
stern duty, either in fulfillment of an intelligent apprecia- 
tion of the necessity, or in submissive obedience to infiex- 
Ible orders." 

In carrying out this system Dr. Hutchins suggests : 



18 Peoria Medical Monthly. 

1. The food selected should not require mastication ,- 
possess no special flavor and be capable of being sawllowed 
by a single eflTort. 

2. Solids and semi-solids have, for familiar physiolo- 
gical reasons, preference over liquid foods. 

3. Food must be taken at stated intervals, stretching 
over a long period of each day. It is best practiced eigh- 
teen hours out of the twenty-four. And should be com- 
menced before the patient is out of bed in the morning. 

4. Nitrogenized foods are inappropriate in the early- 
stages of forced feeding. 

5. The free use of water is to be insisted on as a requi- 
site to success. 

6. These measures must be united with all those con- 
ditions which influence free animal action, regular evacua- 
tions, abundant fresh air, judicious exercise and cheerful^ 
occupation. 

We think this subject worthy of the most careful con- 
sideration by physicians, and feel assured that it is a most 
valuable measure in connection with the prevention and< 
treatment of disease. * 



New Method of Using Salicylic Acid. 

Compresses wet with an aqueous solution of the salicy- 
late of soda, 5 per cent., are applied upon painful articula- 
tions. To avoid acidity the liquor is neutralized with a. 
drop or two of ammonia. In two cases the pains were re- 
markably diminished in a short time; one of the patients 
could move his affected joint slightly half an hour after 
the compresses were applied. No great irritation of the 
skin was produced, but slight disquamation took place. 
The salicylate is absorbed quite rapidly, since its presence 
could be demonstrated in the urine in twelve to fifteen 
hours. Many patients cannot tolerate salicylic acid, and' 
refuse to take it; here is a handy means for its employ- 
ment. — Detroit Lancet, March, 1880. 



Dr. Thos. G. Morton has measured the length of the- 
lower limbs of over 800 boys at Girard College, Philadel- 
phia, Pa. He found asymmetry and not symmetry to bfr 
the rule, the difference in length ranging from a fractionj. 
of an inch to an inch. 



Peoria Medical Monthly. 19 

Ovariotomy in Italy. 

A report of the lirst one hundred operations of ovari- 
otomy in Italy was published in the Journal des Sciences 
Medicates for February, 1880. These were performed by 
thirty-four different surgeons. The recoveries were thirty- 
seven ; the deaths sixty-three. Dr. Peruzzi thinks the 
unsatisfactory results are accounted for by the number ot 
different surgeons making the operation, and that results 
are better in the hands of a few specialists, who by practice 
become expert in the operation. — Surg, and Med. Rep.^ 
April, 1880. 

[For the Peoria Medical Monthly.] 

Ergotine as a Topical Application to tlie Eye. 

The excellence of this remedy in some forms of ophthal- 
mia is undoubted, especially when the inflammation is 
intense and accompanied with chimosis. In the proportion 
of thirty grains to the ounce of water, a few drops instilled 
into the eye every three or four hours, at the same time 
applied externally by a cloth saturated with the solution 
and laid over the organ, ergotine gives very satisfactory 
results. The evidence of others as to its efficacy, as well 
as our own experience in its use, leads us to consider this 
a remedy of great value. S. 



Use of Turpentine in Cancer. 

That such a familiar substance as turpentine should be 
found of value in cancer is somewhat surprising. Never- 
theless, Dr. John Clay, of Birmingham, England, relates 
in the Lancet, March 27th, several cases in which Chian 
turpentine, freely administered, thirty or sixty grains a day, 
really seemed to modify favorably the disease as it appeared 
in uterine schirrus and epithelioma. He thinks he can 
safely assert that when the remedy is steadily used for some 
time, it arrests the progress of the disease and relieves the 
pain incidental to the malignant growth. Certainly, if it 
will accomplish this, the discovery will prove one of the 
highest importance in therapeutics. — Medical and Surgical 
Heporier, April 17th. 

Mr. Kelley, Representative from Pennsylvania, intro- 
duced a bill, March 22d, to impose a duty of 10 per cent, 
on quinine. 



20 Peoria Medical Monthly. 

Forceps or Its Alternatives. 

Dr. Barnes read a paper before the London Obstetrical 
Society on the use of forceps, compared with its alterna- 
tives. After fully discussing the objections to the use of 
ergot, its danger, its uncertainty, &c., the conditions which 
demand a resort to the use of forceps or its alternatives, he 
concludes as follows : 

"1. In lingering labor, when the head is in the pelvic 
cavity, the forceps is better than its alternatives. 

2. In lingering labor, when the head is engaged in the 
pelvic brim, and when it is known that the pelvis is well 
formed, the forceps is better than its alternatives. 

3. In lingering labor, when the head is resting on the 
pelvic brim, the liquor amnii discharged, and it is known, 
either by exploring with the hand or by other means, that 
there is no disproportion, or only a slight degree of dispro- 
portion, even although the cervix uteri is not fully dilated, 
the forceps will generally be better than its alternatives. 

4. In proportion as the head is arrested high in the 
pelvis, in the brim, or above the brim, the necessity, the 
utility and safety of the forceps become less frequent. 

5. As a corollary from the preceding proposition, in- 
creasing caution in determining on the use of the forceps 
and greater skill in carrying out the operation are called 
for." S. 



Dr. E. R. Squibbs, of Brooklyn, confesses to hav- 
ing a prejudice against bromide of ethyl, though purely upon 
theoretical grounds. He gave as a chemical rule, that the 
ansesthetics, which are the least dangerous, are those 
which are the most simple, and when decomposed yield 
elements, which, physiologically, are known to be most 
innocuous, as nitrous oxide, &c. The bromide of ethyl, 
which is a loosely molecular article and more easily decom- 
posed than bromides of ordinary bases, contains 73 per 
cent, of the irritant poison, bromine. If then, under cer- 
tain circumstances, this agent becomes discomposed the 73 
per cent, of bromine goes into the system and grave effects 
will be produced, if not soon eliminated. Whereas under 
other circumstances, if it remains as bromide of ethyl it 
may work no harm. — Medical Itecord. * 



The next annual meeting of the Illinois State Medical 
Society will be held at Belleville, Tuesday, May 18th, 1880. 



Peoria Medical Monthly. 21 

MorpMa in Uraemia. 

A writer to the Louisville Medical News says : Of this 
method Prof. Loomis stands an eminent defender, and 
those who havQ listened to his lectures or read his book, 
must have been somewhat impressed with the plausibility 
of his views. Prof. Loomis reasons as follows : The skin 
in patients with acute uraemia loses its excretory action — 
and diaphoresis if induced is not eliminative — nor do the 
bowels respond readily to purgatives. Then, if the system 
is overwhelmed by this uraemic poison, and all the avenues 
of elimination closed, the question is, how can you coun- 
teract the influence of this poison and open again the 
channels of elimination ? 

To diminish reflex sensibility and subdue spasmodic 
muscular paroxysms must be speedily accomplished, for 
either, if continued, will terminate life. Chloroform, here- 
tofore, has been almost a sole remedy, but Prof. Loomis 
believes that so far from being beneficial, it even prejudices 
the chance of ultimate recovery by the changes its inhala- 
tion produces in the blood, which changes hasten rather 
than retard the development of the uraemic toxaemia. It 
also seems to him to be more diflicult to establish diapho- 
resis and diuresis in patients to whom chloroform has been 
given. Chloroform only controls muscular spasm tem- 
porarily, and does not exercise any neutralizing effect on 
the poison. Dr. Loomis says that in morphia he has an 
agent that not only controls muscular spasm, but re-opens 
the avenues of elimination, either by counteracting the 
effects of the uraemic poison on the nerve centers, and thus 
facilitating the action of diaphoretics and diuretics, or itself 
acting as an eliminator. He uses it in cases where the 
premonitory sj^mptoms are most severe, as well as during 
the convulsions. The rules relating to its administrations 
are altogether governed by the convulsions. Sufficient 
quantities should be given to control spasm. Neither the 
condition of the pupil nor the number of respirations afford 
liable guides. Thus, he believes, morphia administered 
hypodermically becomes a powerful eliminator, in which 
belief Dr. Loomis is sustained by weighty corroboration, 
based upon reliable clinical data. 



Always read our advertisements, as we know them to 
be from responsible parties, l^o others will be admitted 
to our pages. 



22 Peoria Medical Monthly. 

[From the Medical Brief, April, 1880.] 

Typho-Malarial Fever. 

Editor Medical Brief: A number of your correspondents 
from this State are asking and giving the treatment of 
typho-malarial fever, so-called. What is typho- malarial 
fever? Some of its early advocates, and indeed those that 
first discovered it, say that said fever ceased to exist as soon 
as the special causation was removed ; that armies closely 
crowded in unhealthy camps were attacked with a fever 
that they (the surgeons) called typho-malarial fever, and 
as soon as the armies were disbanded and allowed to go 
home, where they were better fed and clothed, and their 
location healthier, then said fever became one of the 
things that were. 

I^ow no sane physician will admit that we have any 
disease in this climate which is not more or less compli- 
cated with malaria — that subtle, indescribable, but potent 
poison, common to our climate. "Why not say pneumono- 
malarial fever, or rheumo-malarial fever, when our 
patient has pneumonitis or arthritis ? The fact is, they are 
fighting either aggravated remittent or simple typhoid 
fever. I make quinine in five to ten grain doses, differ- 
entiate for me. If after the use of said remedy, I am 
enabled to note a decided remission, I say then remittent 
fever. If my quinine aggravates symptoms, I drop at once 
to a simple expectant treatment, and call it typhoid fever. 
The treatment of either disease is given, far better than I 
can give it, in any standard text-book. 

J. E. Stinson, M. D. 
Montague, Texas. 



[For the Peoria Medical Monthly.] 

Physicians vs. Drug^gists. 

The difficulties between druggists and doctors seem to 
be nearing a climax, and physicians are eagerly seeking 
relief. Some of the charges against the druggist are but 
too well founded. The use of prescriptions, over and over,^ 
without permission or directions ; the very common habit 
of prescribing for venereal diseases; the use of poor, cheap 
drugs, and the substitution of others for the drugs called 
for in the prescription ; and last, but not least, the enor- 
jnous prices patients are made to pay. The druggist in- 
sists on cash payments, the doctor cannot always do so. 



Peoria Medical Monthly. 23 

hence the druggist often gets all the money, and the doctor 
can go hang for his pay. It will drive physicians to dis- 
pensing their own remedies, as was formerly the custom, 
or to the establishing of co-operative societies by physicians, 
who will buy their own raedicines, employ a competent 
clerk and charge patients only a small advance on cost, as 
has been suggested in several medical journals. * 



Duplicating Prescriptions. 

A recent medical act in Wisconsin reads as follows : 
" If any physician practising medicine in this State, shall 
write or cause to be printed on any prescription the words, 
' No duplicate,' any vender of medicines who shall dupli- 
cate such prescription without the physician's consent, shall 
be subject to a fine often dollars for each offence." 



New Method of Administering- Kousst*. 

One-half ounce of fresh powdered kousso is treated 
with one ounce of hot castor oil, and afterward by two 
ounces of boiling water by displacement, express, and by 
means of the yelk of an Qgg,, combine the two percolates 
into an emulsion, and add forty drops of sulphuric ether, 
flavoring with some aromatic oil. This is to be taken at 
one dose early in the morning, after a previous fast of about 
eighteen hours. The worm is usually expelled dead after 
six to eight hours. — Buffalo Medical and Surgical Journal. 



Cystitis. 

A writer in the Medical News gives the following as a 
very prompt remedy for an inflammatory condition of the 
bladder and painful micturition : 

Acidi Benzoici, 1 drachm. 

Ext. Belladonnae, J^ drachm, 

Ext. Eucalypti Globuli, 2 drachms. 
Mixturoe Amigdal^, 534 ounces. 
Ol. Cinnamoni, 6 drops. 

M. SiG.— A tablespoonful every three hours. 

The mixture is not a very pleasant one to the taste, but 
taken in a half-glass of skim milk it is quite tolerable. 
The diet should be confined as largely as possible to skim 
milk, and the bladder washed out twice a day with a pint 
of lukewarm water, to which has been added two drachms 
of bicarbonate of sodium. 



24 Peoria Medical Monthly. 

Peoria Medical Monthly. 

EDITORS: 

\ 

John Murphy, M. D., J. L. Hamilton, M. D., 

H. Steele, M. D. 



All communications must be addressed to 

Thos. M. MoRvaine, A. M., Publisher, 

229 South- Adams Street, PEOKIA, ILL. 

Notes and Extracts. 

In offering another journal to the profession, we hope 
that it will be found, what it is intended to be, a help to 
the busy practitioner — a practical working journal. Our 
idea of a medical journal is, that the articles should be short 
and to the point, and. of such character that they may 
be of actual benefit in every-day practice. We call the at- 
tention of our readers to the prospectus (printed elsewhere) 
and hope all will give us their assistance in carrying out 
this idea. It will not take you long to contribute a short 
article, and you may help a brother physician out of a very 
hard place. Please take an interest in our work and give 
us something from your experience that will benefit others, 
and you may find something in our pages that will be of 
great help to you. * 

We had expected a contribution from Prof. W. H. 
Byford, of Chicago, for this number of our Monthly, but 
in a letter received. Dr. Byford begs to be excused until 
next time. Dr. Byford is busilj'' engaged in getting ready 
for press a new edition of his work on " Diseases of 
Women." When published this work will mark a new 
epoch in the gynaecological literature of our country. It 
will be the latest and best work on the subject, and coming 
from such a master of the art of teaching, its practical 
nature will render it a necessity to every practitioner. * 



The article on " IsTeurasthenia " will be found to be a 

most able and interesting resume of our present knowledge 

of this disease. It is longer than it was our purpose to 

print, but it will fully repay a perusal. We won't do so 

/again. 



Peoria Medical Monthly. 25 



A Simple Method of Evacuating Small Calculi. 

Dr. Mercier recently demonstrated before the Societe de 
Medicine, an easy and practical means of getting rid of 
small vesical calculi. It consists in making the patient lie 
on his belly, then the calculi fall by their own weight into 
the anterior part of the bladder. The patient is then 
allowed to rise slowly on all fours. He micturates in this- 
position, and the calculi, which have not yet had time to 
return into the cul de sac behind the prostate, are carried 
away in the stream of urine. — Medical Press and Circular. 



A doctor went out west to practice his profession. An 
old friend met him on the street one day and asked him 
how he was succeeding in his business. 

"First rate," he replied, "I've had one case." 

" AVell, what was that ? " , 

" It was a birth," said the doctor. 

" How did you succeed with that? " 

" Well, the old woman died, and the child; but by the 
grace of God, I'll save the old man yet." — Exchange. 



At the Autopsy. — Three medical students met together 
to consult at the sick bed of General X. After 'they go^ 
the General rings for his man-servant : 

" Well, Jaques, you showed those gentlemen out; what 
did they say? " 

"Ah, General, they seemed to differ with each other ; the 
big fat one said they must have a little patience, and at the 
autopsy — whatever that may be — they would find out what 
the matter was." — Exchange. 



Book ]Votice. 



Dr. Robert Roskoten, of this city, has just published an 
historical drama, entitled, "Oarlotta." It is founded on 
the eventful and unfortunate career of Maximillian and 
Carlotta in Mexico. It is finely written, and evinces a 
thorough acquaintance with the subject, as well as an ac- 
curate knowledge of the laws of dramatic unity. This work 
affords abundant proof that a ph3'sician may enjoy a large 
practice and at the same time find opportunity to success- 
fully cultivate a fine literary taste. 



Advertisements. 



ST, Femcis' eenDLEy hospitsl! 

A well-knowa Institution conducted by the 

Sisters of St. Francis. 



Delightfully situated on the bluff, above the city, com- 
manding a magnificent view of city, lake and sur- 
rounding country. The building is very commodious, 
and having been built expressly for the Hospital, has 
all the necessary conveniences and improvements ; 
large rooms, well ventilated, and everything comfort- 
able. 



Physicians in Attendance. 

Physician Dr. Jos. Studer. 

Surgeon Dr. J. T. Stewart. 

Oculist and Aurist Dr. J. Perrin Johnson. 

Any one wishing to retain their own physician can do so. Phy- 
sicians sending their own patients, retain the full benefit of their 
practice. 



Terms of Admission. 

The apartments for patients are private rooms and general wards. 
Elegant private rooms, including attention and medicine, (Doctor's 
attendance at regular rates), are from $7 to $10 per week, according 
to size of room and accommodation required. In the general wards, 
the cost is from $4 to $6 per week. 

MOTHER MARY FRANCIS, 

Superior. 

In answering advertisements mention the Peoria Medical Monthly. 



1 eofik VLedickl \/Loi\tl:\ly 



4®=- Contributions must be short— not to exceed five hundred words.^^ft 

VOL. I. JUNE, 1880. NO. 2. 



[For the Peoria 3Iedical Monthly.] 

Keurastlienia. 

Read, 'before tlie Decatur Medical Society June 26<7i, 1879, by 
A. Robertson Small, M. D. 

( CONCLUDED.) 
COURSE, DURATION AND TERMINATION. 

It usually comes on in a gradual and insidious manner, though 
•sometimes it comes suddenly after some severe or long-continued 
mental exertion, or excesses. The symptoms usually increase 
gradually for weeks ; then they may remain stationary for awhile. 
Sometimes slight transitory improvement occurs, and then, after a 
slight excess, the patient grows worse. 

If proper treatment be adopted, improvement generally occurs, 
but months and years may elai)se before recovery takes place. 
Some are very much benefited by treatment in a few months' time, 
but relapses are likely to occur in all cases, even on exposures of a 
trifling nature. Erb says that '' intercurrent febrile aifections often 
seem to have a favorable influence on the disease and to hasten re- 
covery," but says that he is unable to state whether there are incu- 
rable cases. He says : " I am also in doubt whether the disease can 
pass into any tangible chronic form of spinal disease (myelitis, 
sclerosis, gray degeneration). I have never observed such an event, 
and have never had to modify my diagnosis in the direction indi- 
cated. But only continued experience can decide." While Dr. 
Beard says on this subject, " Some of these cases, under proper and 
persevering treatment, seem to acquire a new constitution. Very 
many of these cases of neurasthenia I have watched not only while 
under treatment, but for months and years. I see every week, in- 
deed almost every day, cases that I treated all the way from five to 
ten years and more ago, and can testify that the results are often 
permanent. They may be sensitive, delicate perhaps, but they are 
well, in working order, and in no need of special medical aid." 



28 Peoria Medical Monthly. 

« 

Pathology. — About the pathology of neurasthenia, if it has a 
pathology, there seems to be but little known. Erb thinks the 
hypothesis of anremia of the cord is very plausible, but then, what 
causes anjemia ? The conditions or anaemia and hypersemia are 
contracted \)j the vaso motor nerves, and, hence, it seems to me 
that ansemia and hypersemia are rather the results of neurasthenia 
than causes of it. Erb also says : *'It seems most natural to recur 
to fine disturbance of nutrition in the cord, such as we are still 
obliged to assume in so many diseases of the nervous system." Dr. 
Stillman says : "A rational explanation appears to be, that it is a 
debility affecting the nerve cells ; that there is a deficiency in vigor 
in the gray matter of the brain and cord. This cell debility arises, 
as is frequently the case elsewhere, from functional over-work, 
which weakens and enfeebles cell life, thereby interfering with the 
power of assimilation and nutrition, and, as a consequence, with the 
capability of performing physiological duty ; hence, the condition 
and symptoms found in neurasthenia. Just as over-drain upon 
physical strength may shatter and permanently weaken the muscu- 
lar system, so great draughts upon nervous energy may produce a 
similar result in the nervous system." Dr. Beard seems to hold to 
nearly the same view. He says, "In regard to the probable path- 
ology of neurasthenia, my view, as expressed in my first paper on 
the subject, is, that there is an impoverishment of the nerve force 
resulting from bad nutrition of the nerve tissue, on the metamor- 
phosis of which the evolution of nerve force depends ; as in anaemia 
there may be a deficiency in quantity, or impairment in quality of 
the blood, so in neurasthenia there is, without question, deficiency 
in quantity or impairment in quality of the nerve tissue ; hence the 
exhaustion, the positive pain, the unsteadiness, the fluctuating char- 
acter of the morbid sensations and phenomena to which the term 
neurasthenia is applied." Dr. Salisbury, of Cleveland, claims to 
be able to diagnosticate a seriously exhausted condition of the 
nervous system by the changed condition of the blood corpuscles, 
his theory being that the red corpuscles are carriers of substances 
that feed the nerves, and he asserts that when these corpuscles are 
not properly laden with food for the nerves, as in the case of 
nerve exhaustion and insanity, the corpuscles exhibit changes that 
the microscope can recognize ; hence an addition to our means of 
diagnosticating nerve impoverishment. Dr. Heintzman, of New 
York, claims to be able to determine, by examination of the blood 
under the microscope, whether the constitution is good or bad, and 
even to tell whether the subject is especially exhausted at the time 
of the examination — as, for example, after a sleepless night. If 
these claims can be verified we may soon have some positive knowl- 
edge on the pathology of this disease. 

Diagnosis. — It is usually easy to distinguish neurasthenia from 
other nervous diseases. The symptoms of neurasthenia are nearly, if 
not all, subjective, while the objective symptoms which belong tO' . 



Original Coimnunications. 29 



organic diseases are lacking. The symptoms of neurasthenia are 
transient, fleeting and recurrent, may iiave one set of symptoms 
to-day, another different set tomorrow, while the symptoms of 
organic disease are fixed and stable. It may readily be distinguished 
from most organic diseases by the absence of the objective symp- 
toms peculiar to them, thus it may be distinguished from locomotor 
ataxia by the absence of lancinating pains, of disturbance of sensi- 
bility ; of tottering when in the dark or when the eyes are closed, 
and by the co-ordinating power not being effected, lleflex activity 
is usually increased in neurasthenia, while, as a rule, it is dimin- 
ished in organic disease of the cord. 

Ansemia is sometimes mistaken for neurasthenia, and may ac- 
company it, though it is not necessarily present. Anaemia is more 
common among females, and usually follows bad nutrition, 
impure air, exhausting discharges, etc., while neurasthenia arises 
from intellectual labor or worry, or emotional or sexual exhaustion. 
It is necessary also to be able to distinguish the two divisions of 
neurasthenia — cerebrasthenia and myelasthenia ; and as Dr. Beard 
describes these differences very concisely and accurately, I cannot 
do better than give you his words. He says : " The symptoms that 
suggest cerebrasthenia are obviously those that are directly or in- 
directly connected with the head, and they may be either physical 
or psychical. Tenderness of the scalp, a feeling of fullness in the 
ears and head, all disorders of the special senses, tenderness of the 
gums, deficient thirst, morbid desire for stimulants and narcotics, 
gaping, yawning, rushes of blood to the head, congestion of con- 
juctiva ; the different forms of morbid fear, mental depression and 
impairment of memory and intellectual control, all indicate that 
the brain is chiefly affected. Certain symptoms, however, — as ex- 
ternal tenderness of the scalp, general or local itching, clamminess 
of the extremities, muscae volitantes, pain and heaviness in the back 
of the head, — may arise from exhaustion in the upper part of the 
spine. The symptoms that suggest myelasthenia, or spinal exhaus- 
tion, are local spasms of muscles, local chills and flashes of heat, 
shooting pains in the limbs, startings on falling to sleep, morbid 
sensations on the bottoms of the feet, as of burning or tenderness, 
vague pains in the feet, podalgia, sexual debility in its various 
phases, pain in the back — any part of it, from the nape of the neck 
to the tip of the coccyx, with or without the accompaniment of 
spinal irritation, — creeping and crawling sensations up and down 
the spine, incontinence of the urine or paresis of the bladder, feel- 
ing of pressure in the chest, with or without ticklishness in that 
region, heaviness and stiffness of the muscles simulating rheuma- 
tism, sensitiveness to cold and changes in the weather, hyperesthe- 
sia of mucous membranes, dryness of the skin or morbid perspira- 
tion, dryness of the joints, and dilated pupils. Some other 
symptoms — as nervous dyspepsia, constipation, flatulence, sick 
headache in all its forms, numbness, hyperasthesia and insomnia, — 



30 Feoria Medical Monthly. 



appear to be common in both f-tates, since they manifest themselves 
when either cerebasthenia or myelasthenia is uppermost." 

Another important point of difference in these two conditions is 
that, in myelasthenia, physical exercise, as standing or walking, or 
even exercise of the arms, is tiresome and disagreeable, and makes 
the patient very soon feel exhausted ; while in cerebrasthenia, long 
and violent physical exercise can often be well borne, and may 
even be desired, while mental exertion, even for a short time, makes 
the patient tired and exhausted. But these two conditions are fre- 
quently combined, and sometimes alternate with each other. 

Prognosis. — The prognosis, as compared with organic nervous 
disease, or as regards life is favorable, though it may take months 
and years to restore the patient to health under the most favorable 
circumstances, and even then he is apt to be nervous and subject to 
a relapse. The prospect, however, of a final recovery depends a 
good deal on the severity of the attack, and the temperament and 
surroundings of the patient. This disease does not seem to involve 
any immediate danger to life, and whether it leads to any severe 
organic disease is doubtful, to say the least. 

We now come to the treatment of the disease, which embraces 
both the hygenic and medicinal. In the first place, all excessive 
claims on the nervous system must be forbidden. The patient must 
have a period of rest from all harmful occupations, and mental 
worry and trouble must be as far as possible removed. If the 
disease has been brought on by business worry or too close applica- 
tion to the same, it would be advisable to take a sea voyage, and 
forget, for a time, his business cares. In short, the causes, if they 
can be ascertained, should be removed entirely. Travel, change of 
scenery, and climate, cheerful and pleasant society are great helps 
in the treatment. The diet must be generous and varied, and 
should include those foods containing most phosphates. Alcohol, 
in moderate amount is allowable, but it should always be taken 
with meals. The patient must work but little and sleep much, 
must go to bed early, and at regular hours and sleep as long as he 
can, for nothing is more beneficial in these cases than plenty of 
good, sound, natural sleep. The sleeping room must be well ven- 
tilated, and the patielit must move about in the open air a good 
deal, but never to the point of exhaustion. In most cases the sex- 
ual act need not be entirely prohibited, but should only be indulged 
in, in great moderation. Sexual excitement without gratification 
must be avoided. 

At this point the distinction between cerebrasthenia and myel- 
asthenia must be considered. In the former physical exercise is 
usually beneficial, such as walking, mountain climbing, skating, 
horseback riding, etc., but in the latter, absolute rest is demanded, 
or, at least only passive exercise should be indulged in according to 
the patient's strength. Riding may be indulged in in moderation, 
but in either case, open air exercise should not be indulged in to 



Original Communications. 31 



the point of actual fatigue or exhaustion. It is of the highest 
importance that the domestic and social life should be cheerful and 
agreeable, with no worry or anxiety. The patient should go as 
much as possible in pleasant and agreeable society, visit theaters, and 
places of amusement, in short, have his mind diverted as much as 
possible from business and worry. A change to the sea coast, or 
mountain air is often desirable. Sea bathing is also useful. 

Erb says : " Of the plans of treatment for the direct relief of 
the disease, the use of a moderate cold-water cure, well graduated 
to the patient's strength and sensitiveness, deserves special mention. 
Rubbing down with partly warmed water, gradually made colder, 
washing of the back, of the feet, and sitz baths are most suitable, 
and usually soon impart an increase of power and vigor. Douches 
and very cold applications should be avoided." 

Salt baths are stimulating and protective against cold. Stillman 
recommends Turkish and Russian baths as being useful, from their 
alterative action, and stimulation of the functions of the skin. He 
also recommends the cold spray or douch, directed against the 
spine, as being useful in rousing up the dormant . energies of the 
nervous system. The galvanic and faradic currents have also been 
applied in these cases with good results. 

Among the medicines which have been found most useful are 
those which more properly come under the head of foods. Thus, 
the phosphates have produced excellent results. Malt, cod liver 
oil, iron, quinine and strichnia are all beneficial. Pills of phos- 
phorous and nux vomica are also useful. Dilute phosphoric acid 
is also used. As a sedative, or to. procure sleep, nothing will equal 
the bromides, or the bromides combined with chloral. Stillman 
recommends a combination of Fowler's solution, bromide of potas- 
sium and nux vomica. Calabar bean and zinc have also been 
used. These remedies must be continued steadily and for a long 
time to gain any noticeable benefit. Any symptomatic indications 
which may arise, such as sleeplessness, pain, spermatorrhoea or in- 
digestion, should be treated with the appropriate remedies. 



[For the Peoria Medical Monthly.] 

Arsenic in I^euralgia. 

One old and tried remedy is worth a thousand of the 
new ones that are thrust upon the profession with the 
sound of trumpets by manufacturers of drugs all over the 
country. This statement is pre-eminently true as to arsenic 
in ordinary neuralgia. Many competitors have risen and 
fallen, many aye now striving to supersede it; still it stands 
above them all, without an equal. Yet it is not fully ap- 
preciated by a large part of the profession, because they do 
not know how to so administer it as to obtain its best ef- 



32 Peoria Medical Monthly. 

fects. To derive the lull benefit of this drug it must be 
given, at first, in small and frequently-repeated doses, grad- 
ually increasing the dose, until the neuralgia is controlled 
or the medicine begins to show its constitutional effects. 

Another point of equal importance is this: Long expe- 
rience has taught me that by combining it with opium a 
much larger quantity will be tolerated by the system than 
would be if given alone. The opium aids it also in con- 
trolling the neuralgia. The following is a formula which 
I have used with great satisfaction for many years : 

^ Fowler's Solution, 3 drachms 

Tiact. Opii, IJ drachms 

Alcohol, l| drachms 
Mix. 

The alcohol, of course, is added to prevent so much of 
the opium in the laudanum from being precipitated. In 
giving this mixture I am in the habit of beginning with 
ten drops in water every three hours, and increasing twa 
or three drops a day until the disease is controlled, or until 
decided constitutional effects of arsenic are produced. It 
is rarely that the neuralgia does not yield before the con- 
stitutional effects of the drug are manifest. In obstinate 
cases I have repeatedly increased the dose in this way until 
fifteen or twenty drops of Fowler's Solution were given 
every three hours with perfect tolerance on the part of the 
system, and generally had the satisfaction of seeing the 
neuralgia yield. 

I do not by any means put this forward as a specific. 
Many cases of neuralgia require other remedies as well,, 
such as iron, quinine, strychnia, etc.; but I do say that I 
have never found any one remedy that will compare with 
it if given as I have indicated. J. T. Stewart, M. D. 

Peoria, III., May, 1880. 



[For the Peoria Medical Monthly.] 

Eclampsia Puerijeriuiii. 



The subject of puerperal convulsions seems to have 
elicited rather more contrariety of opinion among observers 
than most things in the range of professional investigation. 
It doubtless seems reasonable, at first, sight, to look for and 
expect to find a constant set of causes producing a constant 
set of symptoms, upon the general ground of cause and 
effect. But, in the investigation of disease, it would be 
well to remember that nothing is more fallacious. Anaemia 



Original Coimnunications. 33 

of the .brain, from loss of blood, and hyperaemia of the 
nerve centres (the opposite condition), both produce con- 
vulsion ; and when neither condition is present, the same 
phenomenon is observed, on account of reflex movement 
from sources of irritation far removed from the nerve cen- 
t»es. It is plain that eclampsia puerperium presents itself 
to us in at least two forms, as widely separated as the poles, 
in causation and requirements for treatment. One set of 
cases wjll be found associated with general plethora, in 
which cerebral hypereemia is the proximate cause of the 
convulsion. These require the prompt and vigorous em- 
ployment of venesection for their relief. In strong con- 
trast to these is another group, which might very properly 
be styled the nervous or hysterical form. These have their 
origin in reflex nervous action, from the irritable gravid 
uterus, through the nerve centres, and are very properly 
and successfully treated with chloroform, chloral hydrate, 
opium, forced delivery, etc. The "confusion of tongues'^ 
in the literature of this most important subject arises from 
careless analysis of cases, and generalization from insuffi- 
cient data. 

One observer rushes into print with a single case of 
puerperal convulsion, leaving us in total ignorance of any 
condition present save convulsion and pregnancy, and con- 
cludes his report with the declaration that he. shall never 
fear any case of this frightful disorder so long as he has 
chloral hydrate for his "armamentum medicorum." An- 
other, equally obscure in the description of his case, is just 
as positive in excluding everything but the lancet. 

It is true that medicine is not, and cannot ever be, an 
exact science, yet we certainly may expect a higher degree 
of unanimity than this. 

The two sets of cases referred to above are as widely 
separated as the poles in their pathology, and present a fair 
illustration of the worthlessness of generic names as at 
present used in the classification of disease. Puerperal 
convulsion is certainly not a specific disease, but one of 
ever varying conditions, each requiring its own line of 
treatment. Let us leave to the followers of Hahnemann a 
monopoly of the doctrine of " Specifics," and set it down 
that there is no "royal road" in the management of this 
ailment or any other. 

This generalization from insufficient data disfigures our 
medical literature to a lamentable extent, and it is by na 



-34 Peoria Medical Monthly. 

means confined to observers of small experience and ob- 
scure position in the profession. That Bright's disease of 
the kidneys may co-exist with the puerperal state is not 
denied, but when Dr. Carl Braun, of Vienna, advanced the 
theory that albumenuria was almost, if not quite, the only 
cause operating in the production of puerperal convulsion, 
he promulgated a heresy which has done much harm. For- 
tunately the theory has been consigned to that vast museum 
of German medical abstractions, and no one is now alarmed 
at the discovery of albumenous urine in connection with 
the puerperal state. Indeed, it is almost as common as 
morning sickness or discolored areola, and just as little 
regarded. 

Let us have more care in classification of cases and less 
generalization, and we will have more uniformity. " One 
sparrow does not make a summer," nor does one case, or 
even one entire class of cases, establish a general principle. 
It is safe to discard generic names altogether in the inves- 
tigation of diseased conditions, for, as an exponent of 
these, our nomenclature is altogether useless and only cal- 
culated to mislead the inexperienced and unwary. 

S. M. Hamilton, M. D. 

Monmouth, III., May 10, 1880. 



[ For the Peoria Medical Monthly.] 

Cliroiuic Acid on Cancroid Grrowths. 

Editors Monthly: — I had a very critical case under my 
care four years since, which, at the time, caused some talk 
in these parts, and which I think ought to be presented to 
the profession because of its peculiarity, both in appearance 
and success in specific treatment. 

IsTovember 25th, 1875, I was called to see Mrs. R. On 
examination I found a large cauliflower excresence on the 
lower part of the abdomen, about the size of the crown of 
a man's hat, having four or five points that looked like the 
blossoms of that plant. It was covered with a gelatinous 
substance, which discharged from it freely, supposed to be 
about one fiuid ounce per day, and the tumor appeared to 
be increasing daily. 

The history of the case was the following : About six 
years previous Dr. Thomas of ]^ew York, had removed an 
ovarian tumor from her. (It weighed 57 lbs., and she still 
has it preserved). Since the operation she had enjoyed 



Original Cormnunications. 35 

comfortable health to within six months ; at that time she 
was taken with a bilious, malarial fever, and at the begin- 
ning of convalescence this tumor made its appearance. Her 
physician thought it might be a hernia and advised a truss 
or pressure, but it grew rapidly worse. Several eminent 
physicians were consulted, but after vigorous treatment 
they pronounced it malignant and incurable, advising that 
nothing more be done, only careful nursing and bringing 
the mind to a condition of regeneration. 

Having carefully examined the case I determined to 
extirpate the tumor by means of caustics, if possible, hav- 
ing the promise of free co-operation by the family. I 
commenced by applying to the entire surface a saturated 
solution of chromic acid and gave freely of chloral hydrate 
and glycerine. The first application charred the substance 
about half an inch deep. In one week all that appeared 
killed was shaved off with a razor, and I applied another 
dressing as before, with an occasional dressing of chloride 
of zinc instead of the acid. Watching the case carefully 
that the sound tissues were not interfered with, fearing 
perhaps peritonitis might be induced, (which, let me say, 
was happily prevented.) 

About May 12th, I made the last application, and as a 
result in a few days, extracted from the opening a hard 
substance, about the size of a hen's Qgg., extending point 
downwards to the stem of the ovary. After which she 
made a good recovery, and to-day walks our streets as firmly 
and proudly as any lady can. 

I wish to call the attention of the profession to the 
merits of chromic acid in all cases of a cancroid character. 
I do not think in genuine cancer it has any strongly marked 
specific virtues, but I believe in epithelial cancroid tumors, 
wherever found, if properly applied, it will arrest their 
growth. 

In the past ten years I have radically cured many cases 
of so-called cancers, and simply by the judicious use of 
chromic acid. 

I have a case now under treatment — from a lady's womb 
I have taken two, about the size of a good sized hickory 
nut. I applied the acid but twice, two days in succession^ 
and she is rapidly convalescing. Have any of your corres- 
pondents had any experience with this drug ? I would like 
to hear from them. Geo. W. Carpenter, M. D. 

South Bend, Ind., May 10, 1880. 



36 Peoria Medical Monthly. 

[For the Peoria Medical Monthly.] 

ALkaline Treatiuent of Acute Rlieuinatlsm. 

"We regret to observe that for the past few years there 
has been a tendencj to abandon, to a considerable extent, 
the use of alkalies in this disease. This is probabh^ a result 
of two causes: first, a misconception of the action of the 
diiferent alkalies, and their proper mode of administration ; 
secondly, the disposition on the part of the profession to 
experiment with new remedies. The experience of every 
physician who has used the alkaline treatment understand- 
ingly, and the aggregate statistical results of that treat- 
ment, indicate its therapeutic value so unmistakably that 
we should pause and hesitate before abandoning it. Fuller 
treated 439 cases without a death and with only nine car- 
diac complications by alkalines. Contrast this with 246 
cases treated miscellaneously at St. George's Hospital in 
London, in which there were 114 cases of heart aifection; 
or with Libson's, treated on different plans, in which fifty 
per cent, of all the cases had heart complications. 
Furnival had no heart affections in fifty cases treated on 
the alkaline plan, and Chambers, under similar treatment, 
had only nine cardiac complications in 174 cases. Garrod, 
in fifty-one consecutive cases, had no heart difliculty after 
administering alkalies in the manner of Fuller for forty- 
eight hours. Dickenson treated by this method forty-eight 
cases with only a single heart complication, while in 113 
cases otherwise treated, he had 35 heart difficulties. 

Every unprejudiced observer must admit that these 
statistics are positively conclusive; and when the alkaline 
treatment fails, it does so probably from either inefficiency 
or impropriety in its administration. Errors have been 
made in the doses and in the character of the alkalies used. 
The preparations of the two alkalies most frequently used, 
potass, and soda, have very different effects on the system. 
The salts of potass, depress the heart's action in large doses, 
weaken the action of the spinal system of nerves, and pro- 
duce an anaemic condition of the general system, while it 
is known that the salts of soda do not produce any of those 
disagreeable effects. Fuller's treatment takes these con- 
siderations into account, and is both soundly philosophic 
and eminently successful. He administers the neutral salts 



Original Communications. 37 

of both potass, and soda combined, with a proportion of the 
free carbonate of one of them. His prescription is: 

V^ Potass, acetas, 2 scruples, 
Soda bi-carb, \h drachms, 
Aq. Pura, 3 ounces, 

Rendered efFervesceut by the addition of two drachms 
of citric acid. 

This draught is repeated every three hours until alka- 
line urine is produced, the action being usually prompt. If 
alkalinity of the urine does not soon follow this treatment, 
and particularly if any depressing effects are manifested, 
Fuller attributes them to fne retention of too large an 
amount of the alkalies in the sj'stem, and renders the above 
draught aperient by using two scruples of the potassio- 
tartrate of soda instead of the acetate of potass, and tar- 
taric acid instead of citric acid. By this means the excess 
of the potass, salts is eliminated,- the prostrating effects of 
that excess are removed, and the urine becomes speedily 
alkaline. Further, all the comparative statistics that we 
have on the subject show that under the alkaline treatment 
the average duration of the disease is shorter, and the ten- 
dency to relapses less, than under am^ other treatment. 

J. Murphy, M. D. 



[For the Peoria Medical Monthly.] 

A Case of L<acerated Cei'vls: Uteri— Operation— Recoverj. 

Mrs. F. Gr. P., the mother of two children — the elder 
about twelve years of age and the younger about ten 
months old — called at my office October 31st, 1879, with 
the following history and symptoms: 

She enjoyed fair health until the birth of her second 
child, who, at the date of her visit to me, was about three 
months old, except occasional attacks of indigestion, and 
sometimes leucorrhoea. She was attended in her last labor 
by a midwife, and had a very tedious labor ; and since get- 
ting up has had continual trouble with her stomach, for 
which she had consulted several physicians, but without 
relief. Her symptoms were a distressed feeling in the 
«tomach which could not be called a pain, and which she 
described as a "cold feeling." Her distress was aggravated 
after eating. She declared that she could eat no meat, 
butter, in fact nothing but bread, without aggravating her 
distress. She also complained of nausea at times and 
bitter eructations, and said, " I have to spit all the time." 



Peoria Medical Monthly. 



Her flesh was very much reduced, and she was weak and 
exhausted. A very prominent symptom was depression of 
spirits. She was utterly despondent, and had the most 
hopeless and gloomy forebodings. Her bowels were con- 
stipated, and she complained of a profuse leucorrhoea. 

Suspecting that the derangement of the stomach was 
only reflex, and that the uterus was primarily at fault, I 
made an examination, and found the uterus enlarged to 
about four times its normal size, and the cervix lacerated 
on the left side to within about one-eighth of an inch of the 
utero-vaginal junction, and on the right side about half 
that extent. 

jN'ovember 24th, with the assistance of Dr. Chenoweth,, 
of this city, I performed Emmet's operation. The patient 
was placed in Sims's position, anaesthetized, and the uterua 
drawn down as low as possible. I then carefully and 
thoroughly pared the edges, and inserted three silver wira 
sutures on the left side and two on the right, and fastened 
them with perforated shot. She was then put to bed and 
kept quiet until union took place. I ordered the vagina ta 
be washed out thoroughly two or three times a day with 
warm water slightly carbolized. The sutures were removed 
on the eighth day, when we found perfect union had taken 
place, except a small space of about one-fourth of an inch 
in diameter at the lower part of the right side, and this I 
again pared and united with a single silk suture. In five' 
days this was removed, when union was complete through- 
out the whole extent, leaving the cervix as good as ever. 
No rise in temperature or inflammatory symptoms followed 
the operation, and the woman has steadily improved 
ever since, and is now well, and the uterus reduced to 
its normal size. During one week (the fourth after} 
she gained nine pounds in weight. Before the 
operation she was an invalid, unable to work, and confined 
to her bed most of the time. In one month after the ope- 
ration she was able to move about and assist in the house- 
work, and in three months after the operation she was well 
and able to do all of her housework, and has continued so- 
since. A, Robertson Small, M. D. 

Decatur, 111. 



International Sanitary Conference. — The joint res- 
olution, authorizing the President to call an Internationa) 
Sanitary Conference has passed the Senate. 



Original Cominunications. 39 

[For the Peoria Medical Monthly.] 

Wliooping Cough. 

In answer to the inquiry of " Medicus" in the last issue, 
I will give my experience and remedy : 

In the year 1852, I saw an article by Dr. Carson, of 
Montgomery county, Pa,, in the American Journal of Medi- 
cal Sciences^ on the efficacy of belladonna in whooping 
cough. I had a very bad case in hand at that time — one 
child in the family having died, and a second one it seemed 
would die. I began at once to give belladonna as recom- 
mended by Dr. Carson, and in less than one week the 
cough had ceased, and the child made a rapid recovery. 
Since that time I have used belladonna in all bad cases of 
whooping cough, and with uniformly happy results. 

The formula of Dr. Carson was eight grains of the ex- 
tract of belladonna to one ounce of water. Nine drops of 
this contains one-eighth of a grain of the extract. I usu- 
ally' begin with four drops of this, every three hours to a. 
child two years old, and continue till the pupils are dilated 
or the face flushed. If these eflects are not produced the 
Urst day, the dose is to be increased two drops daily until 
they appear or the cough is stopped. Of late years, since 
the bromide of potassium has come into use, I have given 
with the belladonna, a mixture of the elixir bromide of 
potassium with syrup of squills, wild cherry, or some other 
of the expectorant syrups ; believing that the bromide of 
potassium does, to some extent lessen, the liability to con- 
gestion of the brain, which belladonna may produce. 
They may be given together, but I prefer to prepare them 
separately as above given, and drop the belladonna intO' 
the mixture at each dose. In this way the dose can be 
regulated better, and you always know just how much you 
are giving, and can increase or reduce it at your pleasure. 
Always instruct the parents or nurse to stop the belladonna 
when the pupils are much dilated or the face flushed soon 
after taking the medicine. The next day the belladonna 
may be given again, but it is better to begin again with a 
reduced dose. Many cases of whooping cough may be 
greatly benefited by wearing a belladonna plaster on the 
spine, over the lower cervical and first dorsal vertebrae. 
The plaster should be small, so as not to inconvenience the 
child. J. L. H. 



40 Peoria Medical Monthly. 

Boracic Acid in Inflammations of Mucous Membranes. 

At a meetiug of the Baltimore Clinical Society, Dr. J. 
Shelton Hill reported a case of gonorrhoea in which he used 
an injection of boracic acid (half a drachm to four ounces). 
Four days after, the patient was entirely well. He has also 
used it in a primary attack, the dose being increased to ten 
grains to the ounce. This case was cured in one week, 
after having lasted six days. The patient (a letter carrier) 
continued his employment during treatment. He has also 
employed this agent by inhalation in follicular tonsillitis 
with good results and in post nasal catarrh. In a very 
painful cystitis from long standing resilient stricture, the 
injection of an eight grain solution, morning and evening, 
after drawing the urine, gave equally surprising and satis- 
factory results. Astringents of zinc, acetate of lead, 
opium, nitrate of silver, etc., had been used for the cistitis, 
but the patient grew steadily worse, until the employment 
of the boracic acid. The injections were made through a 
small flexible catheter, about a No. 2. The patient had 
suffered intensely, necessitating hypodermic administra- 
tion of anodynes, but after a short time was enabled to 
walk a long distance without distress, — Maryland Medical 
Journal. 



Painless Cure of Internal Hemorrlioids. 

Dr. R. A. Vance of Cincinnati, gives the following 
painless and certain cure of these' troublesome tumors : 
*' The tumor must be completely extruded. This done by 
means of enemata of hot water. Investigate the condition 
of the uppermost tumor ; tind the spot where sensibility is 
least (which is always at the summit), and pass a curved 
needle through the summit, being careful not to go too 
deep, or to bring the needle out too far from where it en- 
tered. By attending to these points the needle is passed 
without pain, yet if passed too deep or carried too far from 
the entrance, not only will pain be excited, but the rectum 
will contract and the tumors return. As soon as the needle 
is passed, tie the ligature into a loop about six inches long ; 
this loop will enable the surgeon to control the movements 
of the whole mass of tumors; next, pass a ligature through 
each of the other tumors, making the thread double, and 
tying them so that there is not more than an inch of loop 
in all. Finally, draw down the upper tumor by means of 



Periscope. 41 

the double thread through it, and tie a knot in the latter 
so close to the tumor that all the setous may be alike in 
length ; then cut off" the superfluous thread and return the 
tumors within the anus. This done, the patient should be 
instructed to keep his bowels freely open, daily, but above 
all to at once assume the recumbent posture should any 
pain develop in the parts. Cases vary widely in the dis- 
position of the seton ; in some this comes away within a 
fortnight, leaving an ulcer that continues open until the 
hemorrhoidal tumor disappears; in others it remains until 
all the pathological products have been absorbed, and- then 
drops out. It is worthy of trial in cases iu which the 
patient cannot abandon his calling during treatment. It 
takes from five to nine weeks to cure an average case by 
this method." — Med. and Surg. Rep.., May, 1880.' 

Medical Societies. 

The Woodford County Medical Society met in El Paso, 
111., May 4th, and was called to order by the president. Dr. 
"W. 0. Ensign. The minutes of the last meeting were read 
and approved. The reports of secretary and treasurer 
were approved. At the afternoon session, Dr. J. S. Whit- 
mire gave a description of several eases of puerperal con- 
vulsions which had come under his notice. The discussion 
on this subject was continued by Drs. Zeller, Rich, Blanch- 
ard, Reynolds, Kinnear, Lichtenberger, Slemmons and Cole. 
Dr. K. E. Rich read a clinical report of thirty-five cases of 
scarlet fever. President Ensign extended the report from 
his own practice. The discussion following was partici- 
pated in by Drs. Zeller, Whitmire, Lichtenberger and 
others. The election of oflicers for the ensuing year re- 
sulted as follows: President, Dr. Chas. T. Lichtenberger; 
Vice-President, Dr. Enoch Blanchard; Secretarv and 
Treasurer, Dr. F. Cole. Drs. J. G. Zeller and C. t! Lich- 
tenberger were appointed delegates to the American Medi- 
cal Association, and Drs. Whitmire, Cole, Slemmons and 
Crawford, delegates to the State Medical Societ3\ After 
appointments for essays and papers for the next meeting, 
the society adjourned. F. Cole, M. D., Sec'y. 



A BILL to regulate the Practice of Medicine in the State 
of Maryland, failed to pass at the late meeting of the legis- 
lature. The West seems to lead the East in such matters, 
as many of the Western States have had such laws in force 
for some years. 



42 Peoria Medical Monthly. 

Transactions of tlie Peoria City Medical Society. 

At a regular meeting of the Peoria City Medical Society, 
Dr. J. T. Stewart offered the following resolutions, which 
were unanimously adopted : 

Whereas, The Peoria Medical Monthly supplies a 
want long felt by the profession of Peoria ; therefore, be it 

Resolved, That we hail with pleasure its advent. 

Resolved, That we tender to its able corps of editors our 
thanks and our best wishes for the success of their lauda- 
ble undertaking. 

Resolved, That we give it our influence, co-operate with 
its editors, and render them all the assistance in our power 
to enable them to make it an honor to the profession and 
a benefit to the country. 



[For the Peoria Medical Monthly.] 

Sick Headache. 



Editors of the Monthly: Will some of the many read- 
ers of the Monthly give me their treatment for sick head- 
ache ? The cases to which I especially refer are those of a 
periodic character — recurring every two or three weeks, 
and continuing from one to three days, causing the patient 
intense suffering, with distressing nausea and vomiting. 

Peoria, 111. " E. A. DuMars, M. D. 



Boracic Acid as an Internal Remedy. 

Considering the well-known antiseptic properties of 
boracic acid, it is curious how little it has been adminis- 
tered as an internal remedy. Its effect in diphtheria, both 
locally and internally, is very marked, and by its use the 
disease is shortened and other members of the family pro- 
tected from infection. From what I know of its power in 
combating the action of disease germs, I cannot help think- 
ing it would materially lessen, not only the intensity, but 
also the duration of the various eruptive fevers. I incline 
to this belief very strongly ; time will show whether it is 
correct or not. Boracic acid is but sparingly soluble in 
cold water; an ounce will only take up about eighteen 
grains, but a drachm of boiling water will dissolve about 
five grains. The dose is from five to fifteen grains. It has 
one particular recommendation, and that is its tasteless- 
ness. — Dr. E. P. Atkinson, in Practitioner. 



Periscope. 43 

To Control Hemorrhage during Hip-Joint Amputa- 
tions. — Dr. Frank Woodbury suggests the following 
plan : " The bowel should be evacuated by a large 
warm water injection previous to the operation. The hand 
being anointed, (with lard or vaseline) and the fingers 
folded into a cone, it is gradually introduced into the rec- 
tum, with its dorsum to the sacrum, until reaching the 
sigmoid flexure, where the hand may be pronated and, as 
the vessels are right under the fingers, the main supply of 
blood to the limb may thus in a few moments be completely 
controlled. With the prior application of the elastic ban- 
dage from the foot to the thigh, this operation may in this 
manner, be rendered almost as bloodless as some of the 
operations of minor surgery." 



Albiiniinviria in Facial Erysipelas. 

" The second point to which I wish to call your atten- 
tion is the condition of the urine. Some years ago I found 
that albuminuria was very constant in erysipelas, and since 
then have tested the renal secretion in every case of 
the disease that came under my notice. I now give you 
this rule : In a case of erysipelas of any marked severity 
— that is, in any except the very lightest cases — you will 
have albuminuria. It is a consequence of the disease, and 
not an accident. It appears when the disease has reached 
its height and is beginning to decline. At this time there 
is a congested state of the kidneys, and the mucous mem- 
brane, like the cutis upon the face is tumefied, and the 
epithelium is exfoliated in sheets, forming epithelial and 
granular casts which may contain a few blood cells. This 
shows an intimate connection between the morbid action 
going on in the kidney and upon the surface. The album- 
inuria is not, as a rule, accompanied by a large number of 
casts ; it was not in the present case. Moreover, from the 
presence of albumen in the urine, and its quantity, you may 
get some idea of the stage of the disease, and some prog- 
nostic indications, for w^hen it exists, we know that the 
disease has reached its height or is declining. It does not 
occur in the first few days. When the albumen is in large 
quantity, it is a grave case, and relapses are more likely to 
happen. Therefore, look out for the kidneys ; if they fail 
to act well, you may have to come to their aid by purga- 
tives, diaphoretics and dry-cupping the loins. — Dr. Da Costa 
in College and Clinical Record. 



44 Peoria Medical Monthly. 

Peoria Medical Monthly. 

EDITORS: 

John Murphy, M. D., J. L. Hamilton, M. D., 

H. Steele, M. D. 



All communications must be addressed to 

Thos. M. McHvaine, A. M., Publisher, 

229 South- Adams Street, FEOKIA, IIjIj, 

Why Is the State LiawForhidcling- Quackery Xot Enforced ? 

" Why are' all honorable physicians forced to comply 
with all the requirements of the law regulating the prac- 
tice of medicine, while quackery is permitted to exist un- 
rebuked and unhindered? What justice is there in a law 
that is not equally binding on all ?" These questions are 
frequently asked, but aTe difficult to answer. We would 
answer them " Yankee like," by asking another: Whose 
fault is it that the law, as it now stands, is not enforced? 
The blame must rest somewhere — either with the State 
Board of Health, with the medical profession as recognized 
by the law, with the law itself, or with the various officera- 
of the law ? We do not think the law is entirely satisfac- 
tory as it now is. It is not wide enough or sufficiently ex- 
plicit to meet the exigencies of every case that may come 
up, but it is a beginning in the right direction, and we hope 
in the near future to see it amended and the weak places 
strengthened. Still, faulty as it may be, it would accom- 
plish much good if it was strictly and impartially enforced. 
The State Board of Health seems very dilatory. Period- 
icity seems to be the law governing its actions. Spasmod- 
ically it breaks out upon some flagrant offenders, but after 
a great splurge goes to sleep again for a six month, having- 
accomplished but little more than an extensive advertising 
of these quacks. As regards the profession, sometimes 
personal feelings prevent that cordial co-operation of physi- 
cians with each other, which is necessary to success in such 
cases, still there are better reasons for their inactivity. 
There is the lack of proper co-operation on the part of the 
proper officers of the law, and the difficulty of getting a 
grand jury, or any kind of a jury, to regard the suit ir^ 



Editorial J^otes and Cormnents. 45 

any other light than that of persecution prompted by per- 
sonal jealousy and instigated by pecuniary motives. The 
matter has been tried in our own city by a physician 
against whom none of these reasons could possibly be 
urged, and whose practice, wholly in the country, was not 
in the least degree interfered with by the traveling " cure- 
all;" yet he, with apparently all-sufficient proof, was barely 
able to get a hearing. It is needless to say nothing was 
done in the case, and all that he received for his honest 
effi)rt to have the laws enforced and to protect the com- 
munity, was personal abuse find villification. The greatest 
opposition, however, to the enforcing of this law comes 
from the public press. Through its agency public opinion 
is to a large extent formed, and we would exempt from 
this charge many papers which either denounce quackery 
wherever found, or at least do not uphold it, but too many 
denounce any attempt at the suppression of quackery 
with a vehemence and abuse that can only come 
from an attack upon the pocket-book. Quacks are 
large advertisers, and these papers are loth to kill 
the goose that lays the golden egg, even though the 
goose be a goose only to them, but a snake to the com- 
munity, doing immense harm and no good. What is to be 
done ? A steady and continued pressure should be kept 
up upon the State Board, and it should be spurred, if nec- 
essary, to its work. Active co-operation on the part of 
every physician and medical society should be cordially 
given to any one brave enough to face the storm of slander 
he will certainly receive. Physicians should, in every hon- 
orable manner, try to counteract the evil influence of the 
press, and by their own influence and a pure example mould 
public sentiment in the right way, and finally the State 
Medical Association should seek to have the law so amend- 
ed as to make it absolutely impartial as well as eminently 
protective of the rights of all, whose interests it is the aim 
of the law to guard. 



Dr. R. S. Sutton of Pittsburgh, Pa., the new lecturer 
on Gynaecology in the Spring Faculty at "Rush," has 
completed his course and returned home. His lectures are 
said to have been very interesting and instructive, and 
" Rush " is said to be congratulated on the acquisition of 
such a man. 



46 Peoria Medical Monthly. 



Substitution of Drugs. 

An instance recently came under our observation which 
served to convince us absolutely, that the reprehensible cus- 
tom some druggists have of substituting drugs other than 
those called for in prescriptions still prevails, and to a 
greater extent than most physicians suppose, though we are 
loth to believe that any reputable druggist would be guilty 
of so contemptible and dishonest an act. 

In the case alluded to, the prescription called for Balsam 
Peru. The patient was told that he might have trouble in 
getting his prescription filled. One druggist frankly ad- 
mitted that he did not have the drug. The next one put 
up the prescription promptly enough, but something arous- 
ing the patient's suspicions, he had the prescription filled 
at a third place. The difference between the two mixtures 
was so apparent, that he used neither, and they were 
brought to us for inspection. It was at once manifest that 
neither contained a particle of Balsam Peru. 

A few such instances in the experience of each physi- 
cian, coupled with some other abuses for which some drug- 
gists are responsible, will eventuate in physicians dispens- 
ing their own remedies. S. 



Opening the Abdominal Cavity. — The operation of 
ovariotomy has done more than enable us to remove the 
ovarian tumor; it has demonstrated the important surgical 
fact, that free incisions can be made into the abdominal 
cavity without that danger from peritonitis which was for- 
merly apprehended. As has been well remarked, the suc- 
cess of this operation has changed the entire surgery of the 
abdomen, and demonstrated the possibility, by this abdom- 
inal section, of removing various tumors of the uterus, 
enlarged mesenteric glands, or tumors connected with the 
mesentery. Intussusception has been successfully treated 
by opening the cavity of the abdomen, and it is probable 
that other acute affections of the abdominal viscera may be 
treated equally successfully. With an atmosphere satura- 
ted with carbolic acid spray, an incision into the abdominal 
cavity is sometimes justifiable, as has been stated by a high 
authority, for the purpose of making or confirming a 
diagnosis. J. M. 



Editorial Xotes and Comments. 47 

We enjoyed a pleasant call from Dr. S. S. Wiltbank, a 
week or two ago, and found him a thoroughly genial gen- 
tleman, and well posted in his business. He left us several 
samples of Wm. Warner & Co.'s goods, among them was 
Quinamine, which we have tried and found to be all that 
he claimed for it. We like the Parvules too, and think the 
idea which led to their manufacture a good one. By this 
means we can administer staple drugs in a pleasant manner, 
and by small doses, frequently given, probably obtain the 
same effects as from larger doses given at greater intervals. 
They will be found especially advantageous in treating dis- 
eases of children. 



We invite secretaries of district or county medical 
societies to send us short synoptical reports of their pro- 
ceedings, for publication; also of any interesting papers or 
reports read before the societies. 



We hope our readers will send all items of interest to 
the profession that may come under their notice. Marriage 
and death notices inserted free ; also, change of address 
of physicians. 



Drs. Scott, Capps and McCosh, members of the class of 
1880, Rush Medical College, have died since their gradua- 
tion. 



What They Say of Us. 



" The Peoria Medical Monthly is a new journal pub- 
lished at Peoria, 111. To judge from the first number, 
which contains several original articles of considerable 
interest, besides selections from other journals, it deserves 
the support of the profession." — Medical and Surgical Re- 
porter, May 22, 1880. 

" The Peoria Medical Monthly is the latest addition in 
medical journalism. Its contents are mostly brief, very 
practical and suited to the wants of its subscribers. We 
hope its success will be all that its Editors can desire." — 

JSi. Louis Clinieal Record. 

Thank you, gentlemen, for your kind words and good 
wishes. 



48 Peoria Medical Monthly. 



Ovariotomy by a Traveling Quack. 

The Cincinnati Lancet and Clinic reports a case of 
ovariotomy by quack. The patient had suffered from 
abdominal enlargement for some time, and when this quack 
came along, he pronounced it an ovarian tumor, and per- 
suaded the patient to allow him to remove it, to which she 
consented. An incision was made, but no tumor found — 
only a large deposit of adipose tissue in the walls of the 
abdomen. The wound was sewed up, but the patient died 
in three days. 

Gratuitous Services to Clergymen. — The Allegan 
County, Mich., Medical Society, adopted the following^ 
July 26, 1877 : 

" Resolved., That the custom of giving our professional 
services to clergymen and their families gratuitously is un- 
just to a large class of our patrons, whose incomes are much 
less than the average incomes of theirs, and that we will 
hereafter adopt the practice of charging them the same as 
others." 



Coto Bark in Diarrh(EA. — Dr. G. B. Grandall writes to 
the Therapeutic Gazette for .January, 1880, that he has found 
the following formula successful in a case of diarrhoea with 
tubercular complications : 

Fi. Ex. Coto Bark, 2 ounces, 

Comp. Tr. Cardamon, 2 ounces, 

MucilagB Acacia, \ ounce, 

Syrup, \ ounce, 

Cinnamon water, q. s. ad., 8 ounces, m. 
Sig. — Teaspoonful every three hours. 



"We hope that many physicians will take an active in- 
terest in our work, and show it in two ways — first, by 
sending us a dollar as their subscription ; and secondly, by 
sending us a contribution. Many have already done both^ 
for which we are grateful. 



Always read our advertisements. We admit none of 
questionable character, and physicians are safe in corre- 
sponding with any firm whose card is found in our pages» 



1 eoi^ik JVLedidal JVLontl\ly. 

VOL. I. OCTOBER, 1880. NO. 6. 

[For the Peoria Medical Monthly.] 

Injury of the Head Involving- tlie Brain. 

Having of late had my mind called to this important 
class of injuries, by reading reports of cases of that charac- 
ter in the journals, and having been intensely interested in 
a case in m^^ own practice, I have been induced to present 
the following for the consideration of your readers, which 
may be regarded as an unusual recovery, to say the least of 
it: 

I was hastily summoned January 4, 1872, at 8 o'clock 
p. M,, to visit P. R., aged 20 years, who the messenger said 
had his head sawed completely open at a saw mill ten miles 
in the country. I arrived at the house at 10 p. m. 

The foreman of the mill gave me these facts : " At 5 
p. M. the hands quit work for the week (it being Saturday 
evening), and P. R. was directed to clean out the dust pit 
for an early run on Monday morning. The man went into 
the pit, and in a short time the saw was heard to strike 
something (all the machinery being yet in motion), and on 
looking down saw P. R. lying at the bottom of the pit, with 
his head and face cut open. When immediately under the 
saw" in a stooping position, he had undertaken to straighten 
up, when his head came in contact with the rapidly revolv- 
ing saw, which was four and one half feet in diameter. 
The rapid movement of the saw had dashed the man 
with great violence against the wall of the pit. He was 
quickly dragged out, and to their utter astonishment was 
alive, and manifested consciousness and a determination to 
help himself, and by the assistance of two of his comrades 
he walked to the residence of his brother, a distance of over 
^eighty rods." 



134 Peoria Medical Monthly. 

On examination I found that the first tooth of the qslw 
had punctured the skull at a point one half inch above the 
occipito parietal articulation of the right side, and one and 
one half inches to the right of the superior angle of the- 
occipital bone. The second tooth had struck near the 
sagittal suture in the right parietal bone, one and seven- 
eighths inches from the first, lacerating the scalp on either 
side one and one-half inches, and tearing out the bone one 
and one-fourth inches in width. The third struck the left 
parietal bone, tearing through the sagittal suture to the 
place of the second. The fourth struck near the fronto- 
parietal articulation. The fifth struck through the frontal 
bone over the left orbit. The sixth struck the external 
angular process, and the seventh struck the cheek opposite 
the left angle of the mouth, tearing through the molar- 
bone, the whole of the bone being removed the whole 
length of the cut, being a distance of something over 
thirteen inches, cutting into the brain substance from the 
first to the sixth tooth. • 

The teeth on the saw were ten and four-fifths inches 
apart, so that seventy-five and three-fifths inches of the cut- 
ting surface of the saw had passed through thirteen inches 
of surface on the head. The point at which each tooth had 
struck the head was known by the lacerated flaps of the 
scalp, which were torn back an inch and a half on each side 
of the main wound. When the wound was cleansed of 
hair, blood, bones, dirt, saw-dust and managled brain, it 
measured one and three-fourths inches at the point of its 
greatest depth. The sixth tooth had torn the eye-lids apart 
at the outer angle of the eye, and stripped the supera 
orbital ridge, and lay the covering over the right eye, leav- 
ing the left eye uninjured, but without a covering. 

The hair was removed from the remainder of the head,, 
the wound thoroughly cleansed, the flaps, or the points of 
the lacerated scalp were drawn in contact, and the longest 
points held together* by silk stitches, the head dressed with 
cold water, an opiate ordered and the man left to die. 

On the morning of the 7th, however, I was surprised to 
be recalled to the man, who it was said was rational and 
wanting something to eat. On visiting him I found him 
not only rational and calling for nourishment, but the 
points of the scalp and skin had united and healed by the 
first intention. The wound was not disturbed. After this- 
I saw him every second day until the 21st, when it was- 



Original Communications. 135 

thought safe to dismiss him. His recovery was rapid and 
regular. Very little suppuration took place in any part of 
the wound, and six weeks from the day of injury I found 
him cutting wood in the back yard. 

I observed one feature in this case that I had never had 
an opportunity to observe before, and never have since : In 
dressing the wound it was necessary to make some pressure 
on the brain substance with the sponge, in order to cleanse 
it of the dirt and hair drawn into the wound. And when 
any degree of pressure was made on the brain, the man 
became delirious, and as soon as the pressure was removed 
the delirium as suddenly left him. This was repeatedly 
tried and the attention of the bystanders called to the fact. 

This man was under my observation about one year 
after the accident, and if there was any mental derange- 
ment, or any difference in his mental condition in any way, 
I failed to observe it. 

If this curious case can be of any benefit to any one, the 
readers of the Monthly are welcome to it. 

Carthage, III, Sept. 4, 1880. Wm. H. Veatch, M. D. 



[For the Peoria Medical Monthly.] 

A Tliorn in the Heart. 



The specimen to which you refer, in the college museum, 
was furnished by Dr. J. L. White, of Bloomington, Illinois, 
concerning which he gives the following account : 

" The subject was George Joslyn, age about 7 years, an 
inmate of the Illinois Soldiers' Orphans' Home. Upon the 
occasion of my visit to the institution, Wednesday, July 7, 
I found him in bed, decubitus upon back inclining to the 
left side, left arm pressed tightly against his body, and left 
leg drawn up. Did not take his temperature, but the sur- 
face was about normal heat; pulse 130, jerky. Complained 
of pain in region of the heart and in left arm. Screamed 
when I attempted to move the arm (i. e.) to carry it out 
from the body. Also complained when any attempt was 
made to straighten his leg. Tongue considerably coated. 
Auscultation revealed nothing to my ear abnormal either 
in the heart or lungs, except as to the rythm of the heart. 
I could get no bruit of any kind. Gave a mercurial 
cathartic, to be followed by quinine and Dover's powders 
every three hours. 

Nurse reported that he came to the hospital on the even- 



136 Peoria Medical Monthly. 

ing previous complaining as I had found him, and said " he 
had been getting sick all day." 

July 8, condition much the same as j^esterday ; pulse 
more feeble but complains less of pain ; talks freely and is 
cheerful, still will not permit the arm to be moved. July 
9 was informed in the morning by telephone that he was 
better. Was called to him between 11 and 12, saying that 
he had suddenly taken worse. I found him with surface of 
body congested and bathed in cold perspiration ; counte- 
nance indicating great distress ; pulse scarcely perceptible 
at the wrist ; rolling his head but perfectly rational when 
spoken to ; still kept the arm closely pressed to the side, 
and complained of pain in the chest and arm; leg also kept 
drawn up. Gave stimulants freel}'. Condition remained 
about the same until he died, which was about midnight. 
Autopsy nine hours after death : Surface of body mottled ; 
rigor mortus slight ; upon opening the thorax and abdomen 
all the organs presented a normal appearance ; severed the 
vessels and removed the heart, and was about to dip it in a 
bucket of water, but as I pressed my finger into the 
descending vena cava, I felt some object move before the 
end of my finger. Upon examination I found it to be a 
thorn. Its position was directly across the vena cava, just 
at the entrance of the auricle. 

I found extending from 'the auricle into the ventricle a 
long clot, which I presume originally extended from the 
thorn. I have no theory to ofli'er, only I think at some time 
in the past the thorn entered the body through the skin and 
traveled as we have frequently known of needles traveling, 
to the spot where found." 

The specimen as I have it shows a thorn IJ inches long, 
extending across the vena cava at the entrance of the auri- 
cle, but gives no positive clue as to the source from whence 
it came. It has been suggested that it might have been 
swallowed by the child, and becoming lodged in the oesoph- 
agus worked its way through the walls, and finally into its 
present location. Respectfully yours, 

E. P. MuRDOCK, M. D., 

Chicago, 111. Curator Eush Med. College. 



[For the Peoria Medical Monthly.] 

Cystic Disease of the Oviiin. 

Mrs. Bessie S., aged 19, pale and an?emic, had suffered 
much from painful menstruation. Married September 12, 



Chdginal CoTmnunications. 137 

1876. Last menstrual show four days after marriage, and 
almost from that time suffered greatly from nausea and 
vomiting, beginning in the morning and lasting throughout 
the day. Eight weeks after menstruating, or about the 
16th of November, commenced flowing with all the symp- 
toms of miscarriage, throwing off clots in quantities, expul- 
sive pains, etc. A midwife, a near neighbor, saw her fre- 
quently, probably daily, but did nothing but watch and 
wait. The flow gradually subsided, until about the 25th of 
December, or nearly forty days from tirst attack, another 
excessive flooding came on, this time followed by great 
prostration. Yet I was not called until January 3 ; found 
patient very weak — scarcely able to speak above a whisper. 
Upon examination found abdomen very much enlarged, 
so much so that I began to question whether there had not 
been a miscount, or something else. By the touch found 
the uterus quite large and well down, but os remarkably 
close and undilated. Found no clots in vagina. The dis- 
charges, now pale and colorless, had excoriated the parts, 
so that investigation was intensely painful, and as they 
were gradually lessening, considered the alarm over for the 
present, prescribed gentle stimulants and waited results. 
USText day (the 4th) was sent for in haste. Arriving at the 
bedside found my patient completely exhausted, and the 
bed and clothing completely saturated with blood. Of 
course there was no further time for dallying. Found the 
OS still undilated, even so much as to admit the point of the 
little finger, but bleeding had overcome resistance, and 
dilatation was readily effected ; the index finger could pass 
almost entirely around the immense mass, which led me to 
suspect placenta prsevia, especially as there had been so 
much hemorrhage. Further examination encountered 
adhesions, which I still thought placental, and commenced 
detaching, as I had many an after-birth. Then the question 
was, what had become of the fcBtus ? Dilatation by tins 
time admitted two fingers, which by grasping the mass, and 
by the aid ot a pain, the whole bulk was thrown off alto- 
gether. Finding no umbilicus, and the uterus empty, the 
contents of vessel were the next object of interest, when to 
my surprise found the " deliver}^ " a great hydatidiform 
mole, and nothing else, not the slightest sign of foetus or 
placenta — hydatidiform vesicles, thousands upon thou- 
sands of them, from the size of a millet seed to a malaga 
grape, and much the same shape, rather more elongated. 



138 Peoria Medical Monthly. 

the larger attached to a base membrane and the smaller 
apparently to each other, by long slender necks. Contrac- 
tions followed as in natural labor and flooding ceased. The 
lochia was rather more oftensive than usual for a while. 
Patient somewhat feverish for a day or two, but continued 
to gain strength and improve from that time ; appetite nat- 
ural and digestion good, and iu less than two weeks went 
down regularly to her meals. N"o particular medication 
was used except a few drops of dialyzed iron in a little gin^ 
three or four times daily. 

In less than four months from the mishap reported, the 
lady again became pregnant, went the full time, and was 
delivered of a healthy child, who, the father wrote me (as 
they had removed to a distant city), was the finest boy in 
the country. 

This article might be strung out indefinitely by specu- 
lating as to the cause of such growths. Most of the 
authorities are about as " clear as mud " on the subject. 

One says that " an alteration in the envelopes of the 
ovum, with an enlargement of the chorial villosities, is the 
only origin of the true mole." Another (Leishman) that it 
is " simply an alteration and degeneration of previously 
existing structures." Gierse "is of the opinion that the 
change consists in hypertrophy of the normal structures 
found in the chorian villii, with secondary oedema. "^ 
Another that some specific disease of the blood might likely 
produce morbid changes in the circulating fluid, that would 
lead to the production of vesicular disease of the ovum. 
However that might be, I'm sure that in the case described 
no syphillitie taint existed. 

The point that puzzled me most was why there was so 
much flooding, and at such long intervals, if there was not 
placental attachment and detachment? In twenty-five 
years' practice I never saw a similar case, and if any one 
could give any light or explanation why such things occur,, 
that the average mortal could understand, I for one would 
be under obligations to them. 

Hamilton, 111. "Wm. H. Githens, M. D. 



[For the Peoria Medical Monthly.] 

Case in Practice. 



I was called the night of October 14, 1877, to see a man^ 
aged 35 years. I found him very much excited, trembling 



Original Cormnunications. 139 



violently, pulse quick and jerky; he could not lie still but 
a moment or two at a time ; was seeing very beautiful 
images in the distance, and occasionally would see some- 
thing under the sofa that did not seem to strike him so 
pleasantly — in short, a well marked case of delirium tre- 
mens. I learned that he had been in the habit of drinking 
about two quarts of whisky a day for some time, but had 
left it off entirely about three months previous to this 
attack, and in order to satisfy his appetite for liquor, had 
been using from twelve to sixteen ounces of Sanford's 
Extract of Jamaica Ginger per day. (And just here let me 
state that in Maine it was no uncommon thing for so-called 
reformed drunkards to use Extract of Jamaica Ginger in 
the place of whisky, and I have known of several such cases 
as I here relate following its use.) Some four hours pre- 
vious to my seeing him, he had fallen on the street and was 
said to be intoxicated, but there was no smell of liquor on 
his breath, and he told me afterwards that he had not tasted 
liquor since his "reformation," but had used extract of 
ginger only. 

The treatment was large doses of bromide of potassium, 
which quieted the excitement, and chloral hydrate to pro- 
duce sleep. In two days he was able to attend to business 
again. I attended him afterwards through two similar 
attacks of the same nature, which, however, were caused by 
drinking whisky. 

L. S. Cole, M. D. 



. [For the Peoria Medical Monthly.] 

Scarlet Fever and Diphtheria. 

The intimate relationship existing between these two- 
diseases has frequently developed itself during the recent 
epidemic of scarlet fever in this city. While there is no 
doubt of their being distinct diseases, yet their etiology and 
mode of attack are very similar. Any cause likely to bring 
on an attack of one, will apply with equal force to the other. 

I have seen in the same family, and coexistent, scarlet 
fever and diphtheria. And the same individual may have 
both diseases at the same time. While it is not uncommon 
for diphtheria to be developed in a patient recovering from 
scarlet fever, I have never seen scarlet fever follow directly 
in the course of diphtheria. 

Dr. Thompson, in the Medical Record, August, 1880, irk 



140 Peoria Medical Monthly. 

speaking of the relationship of these two diseases, says : 
^' When the characteristic features of diphtheria occur coin- 
cident with the existence of scarlet fever, in any particular 
case during a scarletinal epidemic, I am inclined to believe 
that the former is to be viewed in. the light of a complica- 
tion rather than as a distinctive disease. The diphtheritic 
invasion, intercurrent with and aggravating an existent 
scarlet fever attack, finds its vulnerable point of seizure in 
eounection with already invaded parts, namely, the organs 
of the throat ; and when this happens, to-wit, the formation 
of a well marked exudative membrane in the fauces, it may 
be said, I think, with all propriety, that the distinguishing 
feature of the one disease is engrafted, as it were, upon the 
other general malady." I have observed, however, that, 
■when both diseases are developed in the same patient and 
are coexistent, the constitutional symptoms are very much 
aggravated, and you usually have what appears to be a hope- 
less case ; yet my experience leads me to conclude that the 
two, coexisting diseases, in some way destroy each other, and 
the course of the two is much shorter, than either one alone, 
especially if it be of a severe nature. This may have 
occurred only incidentally, but I am led to regard the 
engrafting process as not an unfavorable one. If, however, 
the diphtheritic attack is delayed and occurs in the scarlet 
fever patient during the period of convalescence, it is likely 
to be much more serious. One characteristic difterence in 
these diseases is, that one attack of scarlet fever protects 
one against further attacks of the same disease, while in 
diphtheria one attack aftbrds no immunity against the dis- 
ease in the future, but rather predisposes to its return. 

While both diseases are more or less aggravated by the 
lack of proper sanitary condition of cities, scarlet fever is 
probably less so than diphtheria. Both diseases are con- 
sidered contagious, but scarlet fever is more of an infectious 
disease, and, I believe, may be spread through the air in an 
infected district without any direct communication, pro- 
vided the system be in a proper condition for its invasion. 

Diphtheria is quite generally supposed to be caused by 
a " microscopical fungus " that attaches itself to the throat 
and developes rapidly at expense of the animal fluids. 
The disease may be, and doubtless is, spread by the excre- 
tions thrown off from the throat and other dejections of the 
body during the progress of the disease. Some writers on 
■diphtheria claim that a rash often accompanies it. I have 



Original Communications. 141 

never seen anything of the kind in cases unaccompanied 
with some of the cutaneous diseases, and do not believe- 
that diphtheria itself developes any cutaneous eruption. 
These differences mentioned are enough to show that they 
are really separate and distinct diseases, even more unlike 
than scarlet fever or measles, but I think that the develop- 
ment of both at the same time, in the same person, is not 
so greatly to be dreaded than an attack of either in a malig- 
nant form. Such, at least, has been my experience. 
Peoria^ 111. J. L. H. 



^linicdl lectures. 



Lead Poisoninsr. 



BY AUSTIN FLINT, M. D. 

Professor of Principles and Practice of Medicine in Bellevue Hospital Medical 
College, New York. 



I had intended, gentlemen, to bring in several cases, but 
as our time is limited, we shall have to content ourselves 
with presenting but one more. This case opens up a very 
interesting and important subject, namely, the varied effects 
of lead poisoning. They are varied, and unless we have in 
our minds the different effects which are referable to this 
cause, we are sometimes liable to overlook their influence, 
the patient perhaps, in the meantime, continuing to be 
exposed to the poisoning. 

This patient's name is William C, he is forty-six years 
of age, a native of Ireland, and his occupation of late has 
been working in white lead. He works in the manufacture- 
of white lead, and inhales the vapor of it. It has occurred 
to me to meet with a good many cases of poisoning from 
lead, occurring in persons who are engaged in the manu- 
facture of white lead, so that although I do not know all 
the details of the manufacture of it, still I know it involves 
the presence of lead in the atmosphere. It is inhaled. 

He was admitted on the 25th of May. The family his- 
tory has no bearing at all on the patient's disease. He has 
always been a hard working man, and he has been variously 
employed as a sailor, a laborer in iron and sugar works, but 
for the last four months as a laborer in a white lead factory. 
He has led a temperate life. He has never had gout, rheu- 



142 Peoria Medical Monthly. 

matism, syphilis, or malaria, and has usually enjoyed excel- 
lent health. It is not very often that we have presented so 
clear a previous history as this case presents ; in this hos- 
pital, I mean. 

Three weeks ago the patient began to be troubled with 
vague pains in the knees and elbows. Well, now, it is 
pretty common to have patients complain of pain in the 
joints and limbs. We are very apt not to think much about 
it, not to form a ver}^ definite idea about it. Sometimes we 
cannot form a very definite idea ; but there are various half 
neuralgic aflections, as they are termed, where patients 
complain of these vague pains. We should have attention 
directed to other points of inquiry in such cases ; look for 
other evidences of poison by lead. 

He lost his appetite, as patients do when poisoned by 
lead ; he suffered from nausea with occasional emesis. 
That is common. He was constipated, and that is the rule; 
. but, of course, constipation is something common enough. 
He noticed that his urine was below normal in quantity, 
and dark in color. I am not prepared to say of how much 
importance that dark color may be, as indicating poison 
from lead. An examination of the urine was overlooked in 
this case, and it is usually overlooked. My impression is 
that the text books do not give directions for the examina- 
tion of the urine. Indeed, I have reason to know so, that 
is, with regard to many of them, because I have had occa- 
sion to refer to some of them. 

I saw a patient several years ago who had characteristic 
lead paralysis, but lead poisoning had not been suspected ; 
it had not been thought of; still the patient, a child five or 
six years old, had wrist drop. Well, when I saw that I 
spoke to the physician whom I saw in connection with the 
case, and said I thought it was due to lead poisoning. He 
said it had not occurred to his mind. Immediately we 
made inquiry with regard to any exposure to lead, but 
could find no evidence of it. No others had symptoms of 
lead poisoning in the house. I looked for every evidence 
possible, and then it occurred to me to make an examina- 
tion of the urine. I took it to Prof. Doremus, the chemist, 
and his assistant at that time examined it and brought the 
result to me. It was perfectly black, and showed undoubt- 
edly the presence of lead. That it was that led me to look 
into works and see whether directions were generally given 
for the examination of the urine for lead, and I failed to find 



Clinical Lectures. 143 



them. I do not assume to say that there are no books that 
contain it, but it was not contained in the books to which I 
referred, so that in my clinical medicine I asked Dr. Dore- 
mus to give me the details for an examination for lead, and 
introduced it into that work, thinking it might be useful. 
I do not think it is often done in order to obtain evidence 
of lead poisoning. I do not know how frequently we do 
obtain evidence of it, but I know we do in some cases, from 
that case I have just referred to. In regard to that case, we 
finally concluded that the child got lead into the system by 
the use of certain toys, leaden soldiers, which he played 
with a great deal, and which he was accustomed to put into 
his mouth. That seemed to be the only source of lead 
poisoning in that case. 

You will please observe that blue line on this man's 
gums ; the blue line on the gum which we should always 
look for in cases in which we have any ground for suspect- 
ing lead poisoning. It is pretty well marked in this case. 
I suppose it is more likely to be marked in those who 
receive lead into the system by the inhalation of the atmos- 
phere coming in contact with the gums, and there meeting 
with the sulphide of hydrogen. But we get the blue line 
when it is not to be explained in that way ; when a suffi- 
cient amount of the lead comes through the blood to the 
gums to form the characteristic blue line. 

This patient became weakened, and lost considerable 
flesh, but continued to pursue his general vocation, how- 
ever, until May 18, when he discontinued his work, owing 
to exhaustion and general malaise. He suffered from severe 
frontal and occipital cephalalgia, Now, various neuralgic 
affections are due to lead, and when we have a case of per- 
sistent neuralgia, no matter where the neuralgia may be 
situated, we should think of this as a possible or probable 
cause. We do have in some cases, but rarely, a very severe 
cerebral affection, called lead encephalalgia, in which there 
occurs convulsions and coma, and usually a fatal termina- 
tion. It has occurred to me to meet with but one well 
marked example of this effect of lead poison. 

ISTow I come to another point in his history : May 19, 
he was attacked for the first time with intense pain in his 
abdomen, constant in character, but increased in exacerba- 
tion, and situated in the epigastric and the umbilical region. 
At the same time he suffered very severe headache, con- 
striction in the chest, pains in the limbs, anorexia, exhaus- 



144 Peoria Medical Monthly. 

tioD, and great constipation. These symptoms persisted at 
the time of his admission, May 25. l!^ow, here we have a 
group of local symptoms which attended lead colic. It has 
received also a great variety of other names. It is charac- 
terized by pain, usually constant, but increased in exacerba- 
tion, situated, as it is here, in the epigastrium and around 
the umbilicus, not infrequently attended by restriction of 
the abdomen, unaccompanied by tenderness on pressure; 
indeed, pressure sometimes affording relief; and accompa- 
nied by obstinate constipation, and absence of fever. The 
want of tenderness on pressure, the constipation, the absence 
of fever, at once suffice to exclude all the inflammatory 
affections which are liable to give rise to colick}' pain, and 
when we meet with these symptoms, we should at once 
think of lead, and direct our attention at once to the pos- 
sible and probable sources of the introduction of this poi- 
sonous principle into the system. 

On examination he was found to possess a well marked 
blue line upon his gums. Isfothing abnormal was detected 
in any of his thoracic or abdominal organs. His urine was- 
high colored, and had a specific gravit}^ of 1.026; it con- 
tained no albumen. He has had no paralysis. 

Well, now, what is to be done in a case like this ? What 
is the treatment ? Constipation is a symptom which claims- 
attention, but it does not claim as much attention, it seems 
to me, as it has heretofore received. It is the old practice, 
one of the traditional things, that patients with lead colic 
must be purged, the purgation kept up, and that active 
cathartics should be employed, as those of a milder charac- 
ter did not effect the object. Well, constipation is a symp- 
tom which claims attention, of course, but I do not know 
that we produce any marked impression upon the disease 
by overcoming the constipation. We should endeavor to 
secure such an evacuation of the bowels as to prevent any 
inconvenience from that cause. Aside from that I do not 
know that the use of cathartics effects any very important 
object. However, ot course it claims attention. And at 
the same time the pain is to be relieved. If the patient is 
suffering extremely from pain, it is important to relieve it, 
and these objects conflict with each other. We cannot well 
give cathartics and opiates at the same time, as one neutral- 
izes the other. However, we can effect something if we do 
not give our opiates in too large doses. 

This patient, gentlemen, does not belong to my division^ 



Clinical Lectures. 145 



but the treatment has been as follows : He was put upon 
the sulphate of magnesia and the camphoretted tincture of 
opium, of each an ounce, and water added to make a pint, 
and he ^ot of this an ounce every two hours. In addition 
to that he was given the iodide of potassium, ten grains 
three times a day. For the past twenty-five years and more 
we have followed the observations made by a French 
observer, who published a monograph on the subject of 
lead poisoning, and gave a series of cases which seemed to 
show conclusively that the iodide of potassium exerted a 
curative efiect upon this disease in this way ; it formed 
combinations of lead in the tissues, wherever the lead might 
be deposited — for no doubt the eftects are due to the actual 
presence of lead in different tissues, although it has not 
been exactly ascertained as yet in what tissues it especially 
is. But it formed combinations which were soluble, and in 
this way the lead was eliminated through the kidneys. 
And ever since that time this has been the standard remedy 
in the treatment for lead poisoning. Well, with regard to 
the effect of it, I think a good many would state that their 
experience accords with mine, that we do not get such evi- 
dence of its special effect as we were led to suppose we 
should by the above named observations and writings. At 
the same time, it by no means has been shown that it does- 
not have more or less effect in that way, and therefore, 
especially in the absence of any other remedy at the present 
time which accomplishes this object, and this being the 
desirable object, this remedy is given ; and the moment we 
reach the diagnosis that we have to deal with a case of lead 
poisoning, the iodide of potassium comes in as a matter of 
course. 

Well, this patient has been taking ten grains of the 
iodide of potassium three times a day, and it will probably 
be increased in quantity. N'ow, what has been the effect of 
that treatment ? The patient has been in the hospital only 
since May 25. He says his pain has been much relieved. 
It was necessary to resort to the use of croton oil in order 
to make his bowels move, and that proved successful, and 
he says he was relieved by it. Well, there is one great 
comfort in the use of active cathartics, whether they are 
really indicated or not; whether they do any good or not; 
they are very apt to satisfy the mind of the patient. And 
a patient who takes a dose of croton oil is conscious of the 
inconvenience attending a good many evacuations, and is. 



146 Peoria Medical Monthly. 

very apt to think that something is being done, and that 
that something is very likely to be useful. It has a good 
moral efl'ect anyhow. I do not mean to say that that covers 
the whole ground, but sometimes it is not unwise to embrace 
that consideration in prescriptions. 

Well, that is the case, gentlemen ; a well marked case of 
lead poisoning, and it is a case which shows so far the good 
effect of the treatment which has been pursued, and which 
is now being pursued. — Medical and Surgical Be^Joiier. 



§mBca^^. 



Cliian Turpentine. 

The London Lancet of March 27, 1880, contains the 
records of four cases of carcinoma uteri, treated by Chian 
turpentine, with the result of checking bleeding, fetor and 
pain, which were rapidly followed by diminution in the 
size, and finally entire disappearance of the morbid growth. 
The question of accuracy in diagnosis cannot arise when 
Professor John Clay is the observer, but the details of each 
case are fully given. The first patient, aged 52 years, suf- 
fered from scirrhous cancer of the cervix and body of the 
uterus. Hemorrhage was excessive, pain of the back and 
abdomen agonizing, and cancerous cachexia well marked, 
the uterus so extensively destroyed that its cavity readily 
admitted three fingers. Six grains of Chian turpentine, 
with four grains flowers of sulphur, were made into two 
pills, and both administered every four hours during the 
day. No opiates nor lotions used. On the fourth day the 
patientreportedherself greatly relieved from pain, in better 
spirits, but complained of vaginal discharge consisting of 
a dirty white tenacious secretion, without blood or fetor ; 
on the twelfth day this was replaced by a somewhat serous 
fluid. The OS would only admit one finger; the patient's 
general health was improved; medicine well tolerated. In 
the twelfth week " the parts feel ragged, and do not bleed 
on roughly touching them." The other three cases were of 
a similar character, two of much more advanced condition, 
with enormous cancerous tumors ; the treatment resulted in 
all in the same way — steady improvement. In one, on 
account of the size and fungosity of the tumor after diminu- 



Periscope. 147 

tion under the turpentine had commenced, vaginal injec- 
tions were used, in one instance, solution of perchloride of 
iron, in the other arsenical solution, which Mr. Clay 
thought assisted in reducing the growths. Many experi- 
ments were made, in which various remedial agents were 
added to turpentine, and the other varieties of turpentine 
were also tried, but owing to effects upon the digestive or 
other organs which were more or less harmful, preventing 
necessary constancy in use of the medicines, they were all 
■cast aside, excepting the sulphur. In order to administer 
the Chian turpentine in other than pill form, Mr. Clay gives 
the following formula, which is said to be agreeable and 
readily taken for weeks together. An etherial solution of 
the turpentine is prepared by dissolving one ounce of the 
turpentine in two ounces of pure sulphuric ether (anaes- 
thetic) : 

9; Solution of Cliian turpentine, 3^ ounce. 

Solution of tragacanlh, 4 ounces. 

Simple syrup, 1 ounce. 

Flowers of sulphur, 2 scruples. 

Water, q s. ad. 16 ounces. 
Dose, one ounce three times daily. 

The remedy appears to act upon the periphery of the 
growth with great vigor, causing speedy disappearance of 
infiltration, and arrest of the further development of the 
tumor. Pain is promptly arrested, as are the hemorrhages. 
The cicatrization leaves the cervix nodular to the feel, and 
examination through the speculum shows small cicatrical 
depressions. Glandular involvement is prevented, and the 
peculiar cancerous cachexia disappears. The evidence 
adduced by the observer is of the most encouraging charac- 
ter, and the treatment certainly deserves extended careful 
trial. Patience and perseverance on the part of both phy- 
sician and patient are requisite, and the aphorism of Tros- 
seau must not be forgotten, that " chronic diseases require 
chronic remedies." If this agent proves as valuable as 
these cases indicate, in malignant disease of the uterus, may 
vre not expect also good results when the disease affects 
■other organs? — Si. Louis Courier of Medicine. 



Organic Matter in Running- Water. 

On one point chemists agree, viz. : that organic matter 
tends to be eliminated from running water. But when it 
comes to the question of how long the process lasts, there 
is a wide difference of opinion. At the late meeting of the 



148 Peoria Mediccd Monthly. 

Association for the Advancement of Science, a paper was- 
read showing that the organic matter of a peaty water was 
rapidly oxidized in a mountain stream. Here, however^ 
the conditions were unusually favorable. The rapid fall 
and the consequent agitation of the water tended to bring 
the organic particles into intimate and frequent contact 
with the air. It is evident that in a slowly moving stream, 
the oxidation would take place much more slowly. 

Tidy, in his paper on " River Water," (English Chem.. 
Soc. Journal), says that organic matter is rapidly oxidized 
in running water. He says that the waters of the Shannon 
lose more than thirty-eight per cent, of their organic matter 
during a flow of one mile. He also instances a stream in 
the north of England which loses fifty per cent, of its 
organic matter in a flow of four miles. Dr. Frankland, in 
a recent communication to the Chemical Society, the joint 
work of himself and Miss Lucy Halcrow, denies that water 
strongly impregnated with peaty and other organic sub- 
stances, is so rapidly purified. A sample of peaty water 
kept for seventy days in contact with air, and freely 
exposed to the sunlight, but without shaking, lost only six 
per cent, of its organic elements. When the water was- 
violently shaken the results were but little more satisfac- 
tory. The conclusion arrived at by the investigators is that 
peaty matter is oxidized with extreme slowness, and in no 
case in such amounts as the report of Tidy seemed to show. 
In the discussion which followed, particular attention was- 
given to the question, " Can running water be safely used 
for dietetic purposes a few hours or days after it has been 
mixed with sewage?" In discussing this question Dr. 
Frankland took strong grounds against the theory of oxi- 
dation. He said no river in the United Kingdom was long- 
enough to eftect the complete destruction of sewage filtra- 
tion. On the other hand Dr. Tidy asserted that the experi- 
mental proof was good of the rapid oxidation of organic 
matter. 

Fortunately in this country our rivers are longer than in 
England, and hence there is a much better chance to secure 
the destruction of organic matter. It is also not often 
necessary that one town should draw its water supply from 
a stream which has but lately received the sewage of 
another. But the above facts should at least make us more 
careful about the sources of water supply in large cities. 
We may safely adopt a mean of the two extremes stated 



Periscope. 149 

;above, and, while we admit the probability of sewage con- 
tamination, let us not deny the possibility of sewage elimi- 
nation by atmospheric means. It is possible that the citi- 
zens of Peoria may not be altogether wrong when they say 
that the Illinois river at that point is still foul with the filth 
of Chicago; but the Peorians should remember that it is 
much more likely to be foul from the sewage of Peoria. — 
Chicago Medical Review. 

Complete Amaurosis from tlie Use of Salicylate Soda. 

Dr. Francisco Gatti reports, in " Grazetta degli Ospitali," 
a case of sudden and complete amaurosis, which lasted ten 
hours, and was induced by the medicinal use of salicylate 
of soda. The patient, a girl of sixteen, was suffering from 
acute articular rheumatism, for which 12| grains of the 
drug was prescribed every hour during ten hours. After 
taking this amount the articular pains were relieved, but 
the patient was seized with deafness, noises in the ears, and 
•complete blindness. The pupils were widely dilated, and 
the sclerotic and cornea on each side highly sensitive. 
After preception of light had returned, the mydriasis still 
continued. The optholmoscopic examination generally 
gave negative results, l^either the urine nor the saliva 
yielded the characteristic reaction of salicylic acid in pres- 
ence of ferric perchloride. The ocular symptoms lasted in 
all about ten hours, but left no permanent impairment of 
sight. 

External Treatment for Night Sweats. 

Dr. T. H. Currie, of Lebanon, ^. H., writes: 
For over thirty years I have used the following prescrip- 
tion without a single failure in sweats from whatever cause. 
In one case a neighboring physician was poisoned while 
■dressing a mortified finger. He suffered untold misery and 
was drenched with perspiration for a number of days and 
his life despaired of. When I saw him I ordered him to be 
bathed immediately and repeat once in two hours. The 
third application stopped all perspiration, and convales- 
cence commenced at once : 

^ Alcohol, Oj; sulphate of quinine, ^j. M. Wet a 
small sponge with it and bathe the body and limbs, a small 
surface at a time, care being taken not to expose the body 
to a draft of air in doing it. — Mich. Med. News. 



150 Peoria Medical Monthly. 

Pathological Condition of the System Denoted by the Dif- 
ferent Conditions of the Tongue. 



M. J. E. LEGRIS, M. D. 



Editor Medical Brief : In answer to J. K. S., inquir- 
ing in the August number of the Brief for the pathological 
conditions of the system according to the different condi- 
tions of the tongue, I will say that we cannot tell and judge 
in a sure way; nevertheless, on a great many occasions, one 
can guess pretty near right. For the benefit of the doctor 
and the profession in general, I will give an account of my 
studies and observations on the subject. 

Dryness of the tongue is caused by a want of spittle or 
mucous, and indicates a tendency to the deviation of secre- 
tion of the salivary glands, and is generally met with erup- 
tive and continual fever, inflammation of the abdominal 
viscera and of their serous membranes, and in many other 
feverish and acute affections. 

Humidity is regarded as a good symptom, and announces 
in most instances a good condition of the whole system. 

According to its different colors, we also mark the dif- 
ferent changes. When pale, it indicates ansemia, affections 
of the spleen, or some organic disease. Completely red is 
met in the course of exanthem. In gastric and bilious fever 
the redness is limited to the end and the edges of that organ. 

When loaded you will generally have active inflamma- 
tion of the mucous membranes, aft'ections of the brain, and 
of its membranes, and every kind of fever. If the tongue 
is white you must have an active fever, without any inflam- 
mation of the internal organs ; but if loaded with a yellow- 
ish tinge we must suspect a disease of the liver, with reten- 
tion of the bile in the blood. 

When the tongue is firm, narrow, slender, red and dry 
to the end and edges, always some inflammation ; if soft and 
large, pale or white at the same time, debility of the 
whole system in general. We cannot tell much by its 
examination in the morning before eating. 

Let some other tell his exDerience on the subject. 

Natick, R. I., Aug. 3, 1880". —Med. Brief. 



We expect to have a representative at the next semi- 
annual meeting of the Military Tract Med. Society, who- 
will report the proceedings for publication in this journaL 



Periscope. 151 

Misuse of the Iron Preparations. 

In cases of debility, prostration, or loss of appetite, 
preparations of iron, alone or variously combined with bit- 
ter tonics, are seemingly indicated clearly, and are very 
generally used. But in many cases they do harm, either 
from their being administered at a wrong time or because 
they are not tolerated under any form or circumstance. 
The greatest abuse of iron is where it is given for loss of 
appetite or difficult digestion, and when it is given within 
half an hour before eating or within three hours after. We 
have found entirely to our own satisfaction, both by clinical 
observation and by experiment, that iron preparations intro- 
duced into the stomach while digestion is going on either 
hinder or arrest the process. 

We have found the use of iron preparations to produce 
indigestion, feeling of fulness at the epigastrium, and even 
vomiting, when given at the wrong time. 

The tendency both on the part of prescribers and the 
large drug manufacturers is to combine -iron with other 
tonics, so that the markets are flooded with elixirs, syrups, 
and wines of iron and quinine, iron and strychnia, iron, 
strychnia and pepsin, and so on ad wfinitam. The combina- 
tions with pepsin are a shameful waste of this valuable 
medicine, and well calculated to bring it into disrepute. 
None of the others above mentioned should be used for or 
in any gastric derangement, except with due regard to time 
of adijiinistration. The most suitable time to give iron is 
one hour before meals, or four hours afterwards. — Alf. W. 
Perry ^ M. D., in Western Lancet 



Old Sore Lesrs. 



In answer to the inquiry of Dr. A. A. Wolfe, Gossett, 
Illinois, 1 state that twenty years ago the treatment of indo- 
lent ulcers was an opprobrium to the profession. By care 
they could be healed only to break out again. The modern 
and successful treatment is to apply a Martin Elastic 
Bandage in the morning, so soon as the patient is ready to 
get up, and before he puts his foot on the floor. On retir- 
ing remove and wash it. Should there be much discharge 
it is well to apply a dressing of ointment, covered by a com- 
press for the purpose of keeping the bandage clean. The 
application must be neatly and evenly made, and extend 
from the toes above the knee or as much higher as may be 



152 Peoria Medical Monthly. 

Decessary. The bandages can be procured of an^^ width 
and length, and have tapes attached for the purpose of 
securing them. Dr. Martin, of Boston, and Dr. Bulkley, 
of New York, have both written monographs on the sub- 
ject. Even in cases where the elastic stocking has failed to 
afford relief, the elastic bandage will eifect a speedy and 
permanent cure. 

For varicose veins the bandage is the only auxiliary cure. 

Dr. Bulkley claims that eczema of the legs can be cured 
in the same manner. In this I cannot coincide, as I opine 
there was an error in the diagnosis. — Dr. J. H. Egan, in 
Medical Brief. 

Poisoning- by Santonin. 

A native girl, aged 7, an inmate of one of the schools 
conducted under foreign auspices at Kinkiarg, complained 
of symptoms that were interpreted to point to intestinal 
worms. Accordingly, half a teaspoonful of santonin was 
administered in one dose early in the morning. For half 
an hour she appeared quite well, but she then suddenly fell 
down in a tit, became insensible, foamed at the mouth, with 
livid face and stertorous breathing. Fortunately, at this 
moment she vomited freely, and was placed by her attend- 
ants in a warm bath, in which she regained consciousness. 
Dr. Jardine, who records the case, saw her soon afterwards, 
and, on hearing of the dose of santonin, ordered a smart 
purge. The patient was well in the afternoon of the same 
day ; and it is to the timely vomiting that she probably 
owes her life. Santonin, even in small medicinal doses, is 
sometimes capricious in its action, so that care should 
always be taken in its administration. A number of cases 
have from time to time been recorded in various medical 
journals, both home and foreign, where doses of six grains 
and under have been attended with most alarming symp- 
toms. — Br. Med. Jour. 



As has been said by one of eminence in our profession 
(Prof. Parvin) : "If society does treat the medical man 
harshly and unkindly, is it any worse than medical men 
treat each other? Many of the worst things ever said of a 
physician, originally came from a physician's tongue. Soci- 
ety is often the mere whispering gallery, which echoes back 
these utterances. Were we more charitable towards each 
other, we would silence half the reproaches which are 
brought upon the profession." — The Black Arts in Medicine. 



Periscope. 153 



Poisoning- by Iodoform. 



Not much is at present known of the toxic effects of 
iodoform, and considerable interest therefore attaches to 
two cases which have been pubUshed by Oberlander. The 
maximum dose given was 0*8 gramme (12J grains) in a pill. 
The symptoms of poisoning occurred in one case (a woman 
twenty-six years of age) after forty-two grammes of iodo- 
form had been taken in eighty days ; in the other case (a 
woman sixty-nine years of age) after five grammes had been 
taken in the course of seven days. The symptoms produced 
were giddiness, vomiting, and deep sleep, from which the 
patient could be roused with difiiculty. This somnolence 
was interrupted by periods of excitement, each lasting sev- 
eral hours, and was followed by delirium, intense headache, 
sense of impending death, spasmodic contractions of the 
facial muscles, and in the case of the younger patient, 
diplopia. The functions of the other sensory organs were 
not disturbed, and the pupils presented a normal reaction. 
Deep inspirations alternated with apnoea of about a min- 
ute's duration. After five or six days the toxic symptoms 
gradually lessened and passed away. — Lancet. 



Antidote to Carbolic Acid. 

Dr. Senftleben states that sulphuric acid is a good anti- 
dote to carbolic acid, entering into combination with it, and 
forming an innocuous compound. His formula is dilute 
sulphuric acid, 10 grams ; mucilage of gum arable, 200 
grams ; simple syrup, 30 grams. A tablespoonful of this 
mixture to be given every hour. Carbolic acid is unfortu- 
nately so often taken in error, even in spite of its powerful 
odor, that there will be abundant opportunities for testing 
the value of this recommendation. — Louv. Med. News. 



Report of tbe Michigan State Board of Health. 

The regular quarterly meeting of this Board was held at 
Lansing, July 13, 1880. 

Dr. Lyster called the attention of the Board to syphilis, 
a disease to which but little attention was paid by sanitari- 
ans, but which causes much sickness and many deaths in 
this state. He was requested to prepare a paper on this 
subject and present it to the Board at the next meeting. 

The resignation of Dr. H. O. Hitchcock and the appoint- 



154 Peoria Medical Monthly. 

ment of Prof. E. A. Strong were announced. Complimen- 
tary resolutions to Dr. Hitchcock were adopted. 

Drs. Lyster and Baker were appointed as a committee 
to prepare a plan for a board of health in Detroit, and to- 
endeavor to secure its adoption by the city authorities. 

The Board spent considerable time in perfecting the 
details for examining and marking the standing of candi- 
dates in the examination in sanitary science inaugurated 
the following day, and which requires : " The replies on 
each set of topics shall be marked on a 'scale of 10, and an 
average standing of 70 per cent, on all topics shall be 
necessary in order to pass the applicant." One who suc- 
cessfully passes the examination receives a certificate that 
he is considered qualified to act as health officer of any 
township, city, or village in Michigan. 

A paper on " Unsanitary Conditions in Our Public 
Schools," by G. E. Corbin, M. D., of St. Johns, was read. 
The paper consisted of details of overcrowding, bad venti- 
lation, and the sickness resulting therefrom, which came 
under his personal observation. The paper will be pub- 
lished in the report for 1880. 

ADULTERATIONS OF FOODS. 

Dr. Kedzie said he had received a request from gentle- 
men in Chicago to enter upon an investigation of adultera- 
tions of foods, and had replied that the Board had no funds. 
He stated that the adulteration of sugar with glucose was 
increasing rapidly, and was being done more skillfully. 
That adulteration with pure glucose did not endanger 
health, but the sugar was not so sweet. The manufactured 
glucose, however, was unhealthful to take into the stomach, 
because of poisonous substances which are always associated 
with it. Dr. Lyster said a prominent candy dealer had 
informed him that all candies excepting rock-candies were 
composed in part of glucose. Dr. Kedzie said nearly all 
syrups were made from glucose. 

The Board performed a large amount of routine work, 
such as auditing of bills, and adjourned until October 12, 
1880. 



"We call the attention of those of our readers who are 
not subscribera to the prospectus on page 7. There they 
will find what we propose to do, and what is thought by 
the profession of what we have already done. Read page 
7 carefully. 



Therapeutic Jfotes. 



loS 



'^her^fimtiii <^ate^. 



TREATMENT OF BAEBER'S ITCH. 

Brame recommends the follow- 
ing treatment : Shave off the 
hairs or cut them very short ; 
then apply once or twice a week 
an ointment composed of: 

p.' Prepared chalk 10 parts, 
Coal tar 1 to 4 " 

Glycerine 5 " 

Simple cerate 50 " 

ARISTOCRATIC REMEDY FOR ITCH 
Jl Balsam of Peru 1 ounce, 
Benzoic acid 110 grains, 
Oil of cloves 40 drops, 

Alcohol 2}4 drachms. 

Simple cerate 7 " ounces. 

Dissolve the essential oil and 
the benzoic acid in the alcohol 
and mix them with the cerate. 
Lastly add the balsam of Peru. 
It is said to effect a cure in twen- 
ty-four hours. — 31ed. and Surg. 
Eeporter. 

STIMULANT AND FEBRIFUGE. 

The following is in almost con- 
stant use at the New Haven 
(Conn.) General Hospital, as a 
stimulant and febrifuge : 

Jfc Camphorag 1 scruple, 

Ammon. carb. 1 drachm, 

Muc, acacise 1 ounce, 

Aquse 1 pint. M. 

Sig. \ ounce every two hours. 

ITCHING OF THE SCALP. 

Dr. Geo. P. Oliver gives the 
following in the Med, and Surg. 
Eeporter, as effectual for itching 
of the scalp and falling off of the 
hair : 
5fc Hyd. chlorid. mit. 1 scrup., 

Cerat. plumbi subacetat. 2 drs., 
Ung. aquffi rosse 1 oz. 

Apply night and morning. 

FOR OBSTINATE CONSTIPATION 
OR OBSTRUCTION OF THE BOW- 
ELS. 

Dr. S. J. Bumstead says the 
following formulae by Dr. Thor- 
oughgood, is the best thing he 
has ever used in obstinate con- 
stipation, and in cases where in- 
vagination or other serious ob- 
structions of the bowels are feared 
to exist. Dr. B. says his experi- 
ence with it has led to such 



happy results after everything- 
else had failed, that he is inclined 
to believe it " almost a specific:" 
^ Plumbi acetat. 10 grains, 

Ex. belladonnse fl. 1 drachm, 
Aquae 4 ounces. 

M. Teaspoonful doses till the 
effect desired is produced, or un- 
til the physiological effects of 
the belladonna appear, when sus- 
pend for a while and begin again 
after they have passed off. 

CHLORATE OF POTASH IN SCROF- 
ULOUS DISEASES OF THE SKIN, 

Dr. Jno. V. Shoemaker, in the 
Medical Bidletin, says : "I have 
been using the chlorate of pot- 
ash for several years, particularly 
in scrofulous disease of the skin, 
and am glad to add, that in con- 
nection with suitable hygienic 
surroundings and the proper local 
remedies, it has acted with won- 
derful success. I generally give 
from one-half to ten grains of 
the chlorate of potash in pure 
water, three or four times daily. 

If continued internally for any 
length of time, it will increase 
the appetite, change the charac- 
ter of the blood, improve the 
color of the skin, and fatten the 
patient." 

DRESSING FOR BURNS. 

The Canada Journal of Medi- 
cal Science, for September, 1880, 
recommends the following form- 
ula : 
^ Iodoform 1 drachm, 

Spermaceti 1 ounce. 

Extract of conium 2 scruples, 
Carbolic acid 10 drops. M. 

Sig. Spread on some soft mate- 
rial and cover the burned parts. 

FOR ULCERATED STOMATITIS. 

The following local remedy ha& 
been tried for years, and always 
acts like a charm : 



Jfc Pul.kino 
Sodse boras. 
Sach. albfe 



1 drachm, 

1 drachm, 

2 drachms. 



M. Put a small powder in the- 
mouth dry, and allow it to dis- 
solve gradually. 



156 Peoria Medical Monthly. 



]ook r^otict§. 



A Manual of Midwifery for Midwives and Medical Stu- 
dents, by Fancourt Barnes, M. D., with illustrations ; Phil- 
adelphia, Henry C. Lea, 1879; pp. 192, price $1.25. 

We have read this work with interest, as to our mind it is 
•a work whose widest dissemination among midwives is a 
thing greatly to be desired. Without pretension, it is suffi- 
ciently technical to enable a midwife to express herself 
intelligibly to practitioners, yet simple enough for one with 
but modest literary entertainments to comprehend and 
master. With this book in the hands of every midwife in 
the country, and carefully studied, mistakes, deplorable 
and often damnable, on the part of professional midwives, 
.would be less common, and the lives of many infants as 
well as mothers saved yearly. We advise every physician 
to urge midwives of his acquaintance to procure and read 
this truly valuable book. For students it possesses but 
little to recommend it, except as a work for review before 
examination, the treatment of the various complications or 
■diseases incident to the puerperal state being almost 
entirely omitted. 

Official Register of Physicians and Midwives to whom 
certificates have been issued by the Illinois State Board of 
Health, and those who have registered in the county clerks' 
•offices, and those who claim to have practiced in Illinois 
ten years prior to July 1, 1877, but to whom no certificates 
have been issued ; pp. 286. 

We presume this is as complete as it is possible for such 
.a vast undertaking to be made. As a work of reference it 
is invaluable. 

Transactions of the State Medical Society of Arkansas 
at its fifth annual session. Little Rock, Ark., 1880 ; pp. 118. 

A very interesting report from an intelligent and pro- 
gressive body of men, containing a number of papers of 
more than ordinary interest, among which we notice the 
.address of Dr. Dale, president of the society ; "An Account 
of the Yellow Fever at Forest City, Ark., during 1879," by 
Dr. J. B. Cummings ; " Scarletina and its Analogues Diph- 
theria and Membraneous Croup," by C. E. Nash, M. D. 

The publishing house of William Wood & Sons is now 
prosecuting a work that should earn for them the gratitude 



Book iN'otices. 157 



and patronage of every physician in the country. We refer 
to " Wood's Library." In a compact and elegant form, 
and at a wonderfully low price, they present to the medical 
public, each month, a new volume on some important topic. 
We have not space at this time to notice in detail the work& 
whicli are thus put within the reach of every one, and we 
will have to defer the pleasure to succeeding numbers ot" 
this journal. In the meanwhile, however, we would say to 
every reader, subscribe for the year (only $15), and you 
will get what would otherwise cost you at least $50. 

A Contribution to Cerebral Localization, by S. J. Bum- 
stead, M. D., Decatur, 111.; pp. 6. Reprinted from the 
Archives of Medicine, 1879. 

This is an article of more than usual interest, both from 
the nature of the case itself and also from the nicety and 
precision of observation on the part of the author. 

Transactions of the Southern Illinois Medical Associa- 
tion for the year 1880; George O. Rumbold & Co.; paper, 
pp. 92. 

Many state societies do not publish a better or more 
interesting report than this district society. The address 
of the president. Dr. C. W. Dunning, of Cairo, 111., is one of 
the most polished and effective that we have ever read. An 
elaborate paper on the treatment of Postpartum Hemor- 
rhage, by George J. Engelmann, M. D., is also worthy of a 
close reading. 

Among new exchanges we note : 

The International Surgical Record, l!Tew York, weekly,. 
$5.00 per annum. A. Rose, M. D., Editor. 

Canada Medical and Surgical Journal, Montreal. Drs. 
Ross and Molson, Editors. 

The Clinical :N"ews, Philadelphia, weekly. S. M. Miller,. 
M. D., Editor. 

The St. Joseph Medical and Surgical Reporter, St. 
Joseph, Mo. Dr. J. P. Chesney, Editor. 

Chicago Medical Review; Dr. E. C. Dudley, Editor; bi- 
monthly ; Chicago, 111. 

Arkansas Medical Monthly, Little Rock, Ark. Dr. J. J.- 
Jones, Editor. 

The Medical Bulletin, Philadelphia, Pa. Dr. John V. 
Shoemaker, Editor. 



158 Peoria Medical Monthly. 

Peoria Medical Monthly. 

All communications must be addressed to 

Thos. M. Mcllvaine, J.. M., Publisher, 

204 South- Jefferson Street, PEOKIA, ILL. 

J§ditarml ^e^Hrttmnt 



The Treatment of the Insane. 

One of the curses which seems to be entailed upon the 
high degree of civilization that this century has attained, is 
the rapid increase of diseases of the mind; consequently 
one of the most important questions of the day, both to 
physicians and philanthropists, is, how shall we treat our 
insane? 

Without referring to medication, which is foreign to the 
topic we wish to consider here, we ask the question, for 
reflection and thought, and certainlj^ no class of patients 
demands a greater consideration on the part of the commu- 
nity or should enlist warmer sympathies, not only from 
friends but from every one, than the one we call the insane: 
What shall we do with this rapidly growing class of unfor- 
tunates ? 

Shall the already enormous buildings of the various 
state asylums be still further enlarged, bringing still greater 
numbers of insane together under one roof, and adding to 
the duties and responsibilities of those intrusted with their 
welfare ? We think the experience of the past answers 
that this should not be done. That harm does follow, and 
recovery is retarded by the association of a large number 
of unhealthy minds, in a vast penitentiary-like edifice, with 
the restrictions and restraints absolutely necessary in such 
large institutions, is beyond question. This subject has 
received much serious thought both at home and abroad, 
and various plans have been suggested, among which we 
believe the one variously known as the seggregation sys- 
tem, the cottage system, and as the home-like treatment, to 
be the most rational and to offer the best prospects for 
recovery. By limiting the number of patients in an asylum 
the buildings needed will be smaller and more like the one 
the patients are accustomed to ; the number of uneducated 



Editorial Department. 159 

and unsympathizing attendants will be smaller ; patients 
can be allowed a wider freedom and be under less restraint; 
the physician in charge can see his patients more fre- 
quently and have more time to study the peculiarities and 
exigencies of each case, and the influence of even one 
healthy, educated, sympathizing mind in the close commu- 
nication of a home-like life will have an eftect beyond any 
system of medication. 

Unfortunately this plan, having other advantages which 
space forbids here to enumerate, is only possible to a limited 
extent among the poorer classes. The state cannot aflbrd, 
nor would it perhaps be wise, to establish the number of 
separate institutions which this system demands. But 
among the better classes of society, and those who do not 
need to rely upon the charities of the state, this system 
should be understood, and if once understood we feel con- 
fident it would be appreciated. One institution in this state, 
to our knowledge, fully realizes the requirements of this 
home-like system of treatment. We refer to that of Dr. 
McFarland, at Jacksonville, and we wish every physician 
could visit this establishment and understand its workings 
and the aim of its founder. The friends of the insane 
depend largely, if not entirely, upon the family physician 
to recommend a place for treatment, and we feel that it is 
the duty of every physician to know something of such 
institutions, their workings and methods, so that he can 
feel fully assured that what he recommends will be the very 
best thing for his unfortunate patient, and will give it the 
best possible opportunity for a happy recovery. 

The call for advice of this kind may come very unex- 
pectedly, and it behooves every physician to be fully posted, 
so that his advice may be given promptly, without waiting 
to read up or correspond with others as to what they con- 
sider the best asylum. An early removal of many patients 
to an asylum is imperative, and the chances for recovery 
are oftentimes materially decreased by hesitation and delay 
on the part of the medical attendant. 



Up to date 348 have matriculated at Rush for the com- 
ing term. This is 80 more than had matriculated last year 
at the same time. The total number enrolled last year was 
481. This year the number bids fair to exceed 500. The 
college building has had its annual overhauling, and is 
"resplendent with paint and calcimine." 



160 Peoria Medical Monthly. 



We are happy to announce that the November issue of 
this journal will contain an original article from the pen of 
Dr. William Goodell, of Philadelphia, and we will have one 
from Dr. William Pepper for our December number. 
Beginning in November, we hope to publish regularly a 
series of clinical lectures by the most eminent lecturers in 
the West. These will be reported expressly for this jour- 
nal. 

Drs. Kendall and Meacher (Rush, '80), the successful 
candidates at the examination for internes at the Cook 
County Hospital, held September 16, will assume their 
duties October 1. 

Horsford's Acid Phosphate is so well and favorably 
known to the profession as a valuable remedy, that it needs 
no special commendation on our part. We have used it 
and like it. 

Physicians will benefit themselves by reading the adver- 
tisement of S. D, Miller, medical publisher, on pages 2 and' 
3, and will no doubt wish to have the book, which has sO' 
many good features to recommend itself to them. The 
almost unparalleled sale which the work has already 
attained attests its value. 

Any one who has occasion to consult an analytical 
chemist, will do well to call on Mr. F. C. Bourscheidt. He 
pays especial attention to criminal analyses, and we know 
will give satisfaction. 

Physicians needing an office chair for examinations or 
other purposes, will find the chair manufactured by Com- 
stock & Avery to fill every want. Many are in use by phy- 
sicians, and give good satisfaction. 

Married. — At Danville, Ky., September 1, by the Rev. 
Dr. J. Edwards, Samuel 0. Loughridge, M. D., of Peoria, 
III., and Efiie M. Edwards, daughter of the officiating min- 
ister. 

Dr. A. W. Edmiston (Rush, '80) is located at Clinton,. 
111., and has made a fair start towards success. 

If we can accommodate any physician by purchasing 
or ordering any books or instruments, we will be glad tO' 
do so, free of charge. We will select with as much care 
as if buying for ourselves, and can get as low prices as can 
be had anywhere. The goods can be sent C. 0. D. Ad- 
dress the publisher. 



?eorik ]^edickl JVioiithly. 

VOL. I. DECEMBER, 1880. NO. 8. 

^KW^^^ ^ommttnicHtion§. 

[For the Peoria Medical Monthly] 

Dr. Rudolplius Rouse. 

During the past sixteen years, nine members of the 
medical profession have been taken from us by death. 
Two of this number had rounded out the allotted span of 
human life — three score and ten. Four were stricken 
down in the prime of manhood, and in full possession of 
their mental powers. Three were cut off in the morning 
of life, falling victims to the dangers incident to their pro- 
fession, and adding other names to the long list of martyrs 
who have died for humanity. With one or two exceptions 
they w^ere unknown beyond the locality in which they 
labored. They had not acquired a widespread popularity 
or a great name in their profession, but wherever they were 
known they have left grateful remembrances in the 
hearts of the friends to whom their aid was rendered. No 
stone over these graves records their deeds of self-denial 
and heroism. Having worn out health, and sacriiiced life 
in the cause of humanity, they have found that rest from 
their labors which was denied them upon earth. One 
among those who have gone, was widely known as a lead- 
ing and prominent practitioner of this city. His appear- 
ance is yet fresh in our recollection as he lived among us 
seven years ago. Few, if any, of our citizens at that time 
did not know, either personally or by reputation, the late 
Dr. Rudolphus Rouse, the subject of this brief biographical 
sketch. 

Dr. Rouse was born iu Renssalaer county, New York, 
on the 20th of July, 1793. At an early age he commenced 
the study of medicine, and attended a course of lectures in 
the University of Pennsylvania. Near the end of the ses- 



190 Peoria Medical Monthly. 

sion he was attacked with articular rheumatism and was 
obliged to return home. Recovering his health he secured 
a license to practice medicine and surgery in the State of 
ISTew York from the censors of the Renssalaer County Med- 
ical Society. Soon after he was commissioned as assistant 
surgeon in one of the regiments raised by the State of 
New York and accepted by the United States in the war 
with Great Britain in 1812. After serving in that capacity 
for some months he was honorably discharged in Novem- 
ber, 1814. In the winter following he attended a second 
course of lectures in the Pennsylvania University, and 
again near the close of the session was attacked with 
rheumatism and obliged to go home. He subsequently 
practiced his profession in the States of New York and 
New Jersey, daily acquiring that experience which made 
him a popular and able physician. After a practice of a 
few years in the above named states, as well as in the 
cities of New York and Philadelphia, he made a tour 
through the Southern States, and while greatly pleased 
with their climate, soil and productiveness, the curse of 
slavery deterred him from casting his lot there. In 1832 
he visited the three Western States. Struck with admira- 
tion of the beautiful valley of the Illinois, then but sparely 
settled, he determined to make it his future home. In the 
following year he moved with his family to the village, 
now city, of Peoria, where he resided until his death. His 
practice and reputation grew with the growth of the town, 
and there are many still living who speak of him as a 
physician in terms of unqualified praise. In his prime he 
ranked among the most prominent members of the profes- 
sion in the city and surrounding country. He held several 
positions of honor and trust — was president of the first 
Board of Trustees of the town of Peoria; president of the 
Peoria & Oquawka Railroad Company. In 1850 he presided 
at the meeting which founded the Illinois State Medical 
Society — was one of the original members — elected its 
third president, and for many years took a deep interest 
in its prosperity. For a long time he was the presiding 
officer of the Peoria City Medical Society and was always 
prominent and active in its membership. In whatever 
position he was placed he filled it with integrity, ability 
and energy. His principles were keen, his judgment 
good and his powers of discrimination excelled by few. 
For the last two years of his life his strength gradually 



Original Communications. 191 

failed, but he retained his clearness of mind in a remarka- 
ble degree. His attention was almost exclusively directed, 
during the last year of his life, to the erection of a monu- 
ment for his family and a tomb for himself in Springdale 
cemeter3^ When his strength permitted, he daily visited 
the spot and gave directions for the construction of the 
'narrow house in which he expected soon to lie. He fre- 
quently expressed the fear that he would not live to see 
the monument and tomb completed. This seemed to be 
the only object for which he desired to live, and strange as 
it ma,y appear, the one in which he took the greatest inter- 
est. He died April 30, 1873, having suffered for several 
years from chronic catarrh of the bladder and enlargement 
of the prostate gland. The personal appearance of Dr. 
Kouse was neither very striking nor commanding, yet no 
one could see him or be in his company without recogniz- 
ing in him a man of decided traits of character. His 
features were not regular, but were often lighted up by 
emotion of any kind. His countenance was sometimes 
staid and solemn, at times, beaming, particularly when re- 
lating a story or telling a joke, at which he was an adept, 
and of which he was very fond. His head was well 
formed and indicative of intellect. He was social in his 
habits and feelings. His step was slow, deliberate and 
firm, and his manners simple and dignified, but not invaria- 
bly so. Humanity has its infirmities, and to them Dr. 
Rouse w^as no exception. In the earlier part of his life his 
disposition was remarkably placid. As years and disease 
grew upon him he was at times irritable and irascible, ^at 
others genial and gentle. To those who had crossed or 
offended him he was short and curt in his language, 
and under great provocation occasionally rude in his inter- 
course. Beyond these named he exhibited no faults or 
foibles worth mentioning. At all events he and they are 
alike gone, and it would be ungracious and ungenerous to 
recount or remember infirmities over which the grave has 
closed. Of his professional character and reputation, men- 
tion has already been made. It may be truly said that 
no man filled a larger space or was better known in the 
community in which he lived than Dr. Rouse. He be- 
longed to that class of practitioners in a new country 
whose daily life was spent in the hard, rough work inci- 
dent to those early days. Few medical men of the present 
day can form an adequate conception of the dangers, trials 



192 Peoria Medical Monthly. 

and privations of those pioneer doctors. Nearly all were 
intelligent and energetic, and many of them educated men. 
They came in the vigor of youth and manhood to make a 
stern, unfaltering trial of their fortunes — with great labor, 
with much self denial, with slight prospect of pecuniary 
reward, struggling with poverty and with no hope of fame, 
their services were cheerfully rendered to all those who re- ' 
quired them. 

But two of that number besides the writer remain in 
the field, Drs. Frye and Murphy. Nearly, if not quite all, 
the others are dead, and if any survive, they have removed 
to other and distant fields of labor. Living or dead, their 
humble, laborious, useful and self-sacrificing lives challenge 
our admiration. While their sacrifices and labors will 
never be appreciated as they deserve, these pioneers in our 
noble profession, should not be forgotten when they are 
seen no more. It is to be hoped that those who have suc- 
ceeded them, will leave behind as green a memory in the 
hearts of the recipients of their care, as did the subject of 
this sketch and his cotemporaries. 

Peoria, III. Robert Boal, M. D. 



[For the Peoria Medical Monthly.] 

A Case of Pneumo-liydro-Tliorax of traumatic Orig-in. 

BY J. P. ROSS, M. D., 

Prof, of Clinical Medicine and Diseases of the Chest, 
in Rush Medical College. 



J. B., aged 35, a Scotchman, a grain dealer, was admit- 
ted to Cook County Hospital, Oct. 16th, 18 — . We give 
the following history : 

Has always enjoyed good health. On the day previous 
to admission while crossing the street he was struck on the 
back with a pole of an omnibus. The blow knocked him 
down and produced insensibility, which lasted about one 
hour. On returning to consciousness he had a feeling of 
oppression in the stomach. His breathing was interrupted 
and so difficult as to prevent his lying down. He had a 
slight hacking cough accompanied by severe lancinating 
pain in the right side of the chest. 

On admission he was unable to lie down. His counte- 
nance was expressive of severe suflering; pulse 150 and 
small. Respiration 50 and short and imperfect, skin moist, 
tongue furred, short dry cough. Severe pain in right side 



Original Communications. 193 

of chest. Bowels constipated. On inspection only slight 
motion was observed on the right side. There was partial 
obliteration of the intercostal spaces. Percussion revealed 
tympanitic resonance of right side of chest and normal re- 
sonance of the left side. In the erect posture there was 
dullness on the right side below the ninth rib and varying 
according to position of patient. 

On auscultation puerile respiration was found on the 
left side. In the infraclavicular region of the right side 
the breathing and the voice sounds were amphoric. There 
was metallic tinkling behind the nipple and total abstin- 
ence of all sounds below the sixth rib. The succussion 
sound was very distinct. 

The side was bathed with a soothing liniment, and a 
warm poultice was applied. Liq. ammoniac acet. was admin- 
istered internally and rest was secured, with Dover's powder 
at bed time. 

Oct. 19th, four days after the accident, the pain was 
much diminished. Respiration 45 and still labored. Pulse 
124. Patient still unable to lie down. A physical exam- 
ination revealed that the effusion in the pleural cavity had 
increased so that it reached as high as the fourth rib. The 
side was painted with tr. iodine and the poultices contin- 
ued. Patient was given acetate ot pot. 20 grs., and sweet 
epts. nitre one drachm, every four hours. 

On Oct. 26th, eleven days after the accident, the patient 
was able to lie on the aifected side. He complained but 
little of pain and less of dyspnoea. Respiration 40 ; pulse 
140. Ordered iod. of pot., grs. 6, with tr. digitalis, gtts. 
10. Discontinued poultices. 

On Oct. 30th, the effusion was somewhat diminished ; 
dyspnoea less. Continued the treatment. From this time the 
patient improved steadily. The urine became copious and 
the dyspnoea diminished with the decrease of the effusion 
and the proportionate expansion of the lung. The increased 
resonance and the amphoric sounds gradually disappeared. 

On Nov. 29th, six weeks after the accident, there was 
total absence of the amphoric sounds — the effusion was 
completely absorbed. The chest expansion was almost 
normal. The patient was discharged a few days later. 

On Dec. 1st, 18 — , a little over four years after the acci- 
dent, the patient called upon me at which time he was per- 
fectly well. He stated that his health had been perfectly 
good ever since the time he left the hospital, Dec. 20, 18 — . 



194 1 \ Peoria Medical Monthly. 

This case is one of exceeding interest because of the 
unusual cause of the rupture and the rapid progress of the 
recovery from the injury. There was no severe external 
injury to mark the place where the blow was received. A 
slight external bruise was all, and yet the lung was rup- 
tured and the pulmonary pleura torn. 



[For the Peoria Medical Monthly.] 

The Accommodation of tlie Eye and What it Means. 



BY S. J. BUMSTEAD, M.D. 



Knowing from my conversations with physicians who 
possess no special acquaintance with opthalmology that it 
is difficult for them to get a proper understanding of the 
accommodative and refractive affections of the eye, from 
the text books upon these subjects, as also from my own 
experience in acquiring that knowledge, I thought a service 
might possibly be rendered some professional brethren, if I 
gave them an idea of these conditions of the eye in simpler 
language than that in general use by our opthalmological 
authors. From a consideration of the accommodation of 
the eye, we may in successive articles consider in the same 
way presbyopia, hypermetropia, myopia and astigmatism. 

The human eye constitutes of itself an optical system 
which, when of the normal construction, has a certain 
definite refractive power over the rays of light entering it 
from distant objects, or those which in relation to it are sit- 
uated farther than twenty feet. This normally constructed 
eye, in the optical sense, is known among occulists as an 
emmetropic eye, which signifies that when the eye is at rest 
and completely passive, all objects over twenty feet from it 
are distinctly pictured upon its retina. For the present 
purpose we may regard the optical system of the eye as 
having an anterior and posterior focal point, and a nodal 
point. The nodal point in the emmetropic eye is situated 
in the lens, nearer the posterior than the anterior surface, 
and we have principally to concern ourselves now with the 
nodal and the posterior focal points. In this nodal point 
the rays proceeding from the top of an object before the 
eye, pass through and go to the lower part of the image 
upon the retina, and vice versa, placing it there upside 
down, a fact generally well known. This is easily demon- 
strated by allowing a landscape view to pass through a 



Original Cormnunications. 195 

convex lens of short focus, upon a screen placed behind it 
in the focal point. A bi-convex lens has its anterior and 
posterior focal points at the same distances from the centre 
of the lens. Of course the eye is not so simple as a glass 
lens in its optical construction, because we have both the 
anterior and posterior surfaces of the cornea, the aqueous 
humor, the two surfaces of the lens, and lastly the vitreous 
humor, to exercise their distinct and difterent action upon 
the rays of light traversing them. 

And yet for the purpose we have in view it is correct 
enough to say, that these refractive media, taken collect- 
ively, so bend the rays of light that they come to a focus 
and form a perfect image, just 6.7 parisian lines behind the 
nodal point, and which is a little over half an inch, there 
being twelve lines to the inch, and the parisian inch a little 
longer than our own, about one-tenth. For our purpose,^ 
then, we can say tlie eye focuses its rays one-half inch 
behind the lens, and a glass lens of the same power is 
regarded as a strong one. The power the difterent media 
of the eye have in bending the rays over that in air, is called 
the index of refraction, and is as 4 : 3. Then if the emme- 
tropic eye can see distinctly, without efibrt, all objects more 
than twenty feet from it, how and why can it see an object 
when brought within six or eight inches from the eye ? 
This power the human eye possesses, and is called the 
accommodative power, and range of the eye. It is well 
known that rays proceeding from an object within a few 
inches are very divergent, and the lens of the eye in its 
passive state can only bring rays that are parallel to a focus 
upon the retina. Objects situated more than twenty feet 
from the eye send rays of light that are parallel, and such a 
convex lens of one-half inch focal power will bring to a 
perfect image just in the focus of said lens : that is, the 
retina. 

But if the object is brought within twelve inches of the 
eye, no addition having been made to the former optical 
system, the rays will come to the eye so divergent that the 
same focal power will not suffice to bring the image in the 
same place, but the retina would then lie anteriorly to the 
focus; that is, only circles of unfocused rays would fall 
upon it. 

One can demonstrate this truth as follows : Take a con- 
vex lens of three-inch focus, and placing it in a cylinder to 
represent the camera obscura, turn it towards an object in 



196 Peoria Medical Monthly. 

the distance, when if a ground glass is placed three inches 
behind it, the image will be depicted thereon perfectly. So 
soon, however, as the object is brought as near as six or 
eight inches, the image disappears, and it will be necessary 
either to add another convex lens of six or eight inch focus, 
or place the screen farther from the lens, and this latter the 
eye cannot do. 

[TO BE CONTINUED.] 



[ For the Peoria Medical Monthly.] 

A Case of Fracture of the Skull. 

On the afternoon of July 13th, 1880, while standing at 
my office window I saw a policeman make an arrest at a 
saloon immediately opposite, while standing in the door- 
way was the bar-tender, P. M., a young man about twenty- 
five years of age, who was covered with blood. Shortly 
afterwards I was called over to make an examination of 
the man's injuries. I found a slight dent in the cranial 
walls on the vertex, and that there was considerable 
hemorrhage from the right ear. 

The man was fully conscious although presenting a 
dazed appearance and answering questions in an absent 
minded manner. In reply to my inquiries as to the nature 
•of the blow he had received, he said that while interfer- 
ing in a fight he received a blow upon the head from a 
chair. I gave as my opinion that the man was severely 
and dangerously injured. When the blood was washed 
away he went behind the bar to attend to his regular duties, 
which, as I was afterwards informed, he performed for a 
half an hour or more. In the meanwhile another physi- 
cian had been called, and I retired to await developments. 
In less than an hour I was again summoned and responded, 
to find him stretched upon a sofa, breathing stertorously 
and with all the symptoms of a pressure upon the brain. 
I assured the bystanders that there was nothing to be done 
;and that he would die without regaining consciousness, as 
he did, within an hour. On making a jwst mortem examin- 
ation, Dr. Bluthart, the county physician, found a fracture 
of the skull extending from the vertex to the foramen 
magnum at the base. The remarkable feature in the case 
was his ability to attend to his duties as bar-tender for the 
length of time above mentioned, after he had received so 
extensive an injury. 

Chicago, III. F. E. Sherman, M. D. 



Original Communications. 197 

[ For the Peoria Medical Monthly.] 

Mtrite of Arnyl. 

This valuable remedy does not seem to be used as much 
as it is indicated, I have been using it for nearly three 
years and find it almost a, specific in facial neuralgia and 
nervous headache. My mode of administering it is this : 
put four or five drops on a pocket handkerchief and have 
the patient inhale it until the face flushes and the patient 
complains of choking, which is caused by the increased 
pulsation of carotids, then withdraw the amyl. Give the- 
patient one-half grain of morphine and two grains of quin- 
ine, let them lay down an hour and they will almost in- 
variably be cured of the attack and feel grateful. 

S. A. Oren, M. D. 
Mount Auburn, Iowa, Oct. 26, 1880. 



linicnl WectnreB, 



Mutism- -Treatment of the Opium Habit. 



BY WILLIAM PEPPER, M.D. 
[Special Report for the Peoria Medical Monthly.] 

Mutism. — All the rest of this woman's children can talk 
perfectly well except this one. There was no trouble at the 
birth of this girl. She had measles when eighteen months 
old, and whooping cough when two years of age. She was 
not able to make any sound whatever before she was two- 
years old. She tries to read now, but cannot. She can 
count, however, up to twenty-four ; can say mother, faiher, I 
knoio; and repeat all the letters of the alphabet except W. 
She can make plenty of noise when she chooses to, so that 
there is no loss of the sound-producing power; she is not 
tongue-tied. Her tonsils are greatly enlarged, but they do- 
not interfere with her voice. There is no tumor on the 
vocal cords, and they move freely. The difficulty lies in 
the use of articulate speech. She is able to talk much better 
thari she does. The mutism may be due either to a congeni- 
tal defect or to retarded development. I have seen this- 
condition co-existing with very fully developed intellect. 
There is probably retarded development of the centre of 
speech in the brain in this child. Aphasia we usually con^ 



198 ' Peoria Medical Monthly. 

nect with some defect or lesion of the anterior part of the 
left hemisphere, the left fissure of Sylvius and the island of 
Reil. In treating this condition we must be guided (1) by 
the extent of the defect (here the defect is very marked) and 
(2) by the condition of the general health and intellect (here 
it is excellent). There is one form of mutism, where speech 
begins to develop and suddenly comes to a dead stop, and 
a,nother, in which speech begins to develop late, but goes 
on developing. Of these two, the first is the more unfavor- 
able condition. Here the prognosis is favorable. I should 
say that when she is fifteen this girl will speak quite well. 
She must be carefully taught to exercise the function of 
speech, and every effort must be employed to get her to 
practice phonation. There are no drugs needed, except, 
perhaps, the phosphatic salts. Where the mutism is com- 
plete and is accompanied by deafness, the patient cannot, of 
course, be taught to employ vocal sounds. In some cases 
mutism is only dependent upon deafness. 

TREATMENT OF THE OPIUM HABIT. 

Up to four years and three months ago, -this woman was 
in vigorous health, when she became a severe sufferer from 
sciatica. The only thing that gave her relief from her pain 
was morphia, of which she finally became in the habit of 
taking six grains thrice daily. During this prolonged 
course of morphia, her original trouble entirely disappeared. 
"When she came to stop its use, however, every attempt to 
diminish the dose was followed by the most horrible dis- 
tress, 80 that she found it impossible to give up the use of 
the drug, and became a confirmed opium-eater. This is 
just a type of the cases you will meet in practice. The 
quantity of opium which the system maybe brought to bear 
is truly enormous. There was lately in my wards at the 
Philadelphia Hospital, a young girl, who would take as 
much as a pint of laudanum in the course of twenty-four 
hours. 

In the present instance there was culpable carelessness 
on the part of her attending physician. Be always very 
careful how you sanction the use of opiates in chronic cases. 

In an incurable disease opium may be very properly 
administered to produce euthasia, but where the disease is 
curable it is your duty to be exceedingly careful. In this 
case the physician neglected that duty. 

After reaching a certain point it is morally impossible 
to give up the use of opium by force of will. The craving 



Clinical Lectures. 199 



for opium is much more soul enthralling than that for 
strong drink. If the dose is postponed, such a sensation of 
depression and distress, such craving and longing come on, 
that the patient will have the morphia, if he have to sell his 
soul to get it. The general functions of the body gradually 
become accustomed to the regular administration of the 
drug. The bowels, stomach and kidneys perform their 
functions regularly so long as the habit is kept up. 

This woman has been so long an opium eater that she 
comes to us white, emaciated and shattered in body and 
nerves. How are we to break up the habit ? It is useless 
to appeal to the moral sense. We must endeavor to dimin- 
ish the need of the system for the opium. Rest is the first 
item in the cure : keep the patient in bed. If the habit be 
only in its infancy, extensive travel, as a diversion for the 
mind, will often work wonders. See that such patients 
have ample nourishment. If there is any morbid irritation 
of the mucous membrane of the stomach, put them on an 
absolute diet of skimmed milk, beginning with a pint, up 
to two quarts daily. All this while you must progressively 
diminish the amount of opium taken. If the conjoined 
milk- and opium produce constipation you must trj'^ and 
overcome this condition by massage. Have the abdominal 
muscles well kneaded daily. Regular injections of cod- 
liver oil may be given in the morning, followed by cold 
water injections at night, or you may give some vegetable 
laxative. Iron must be administered in large and ascend- 
ing doses. Dialyzed iron is an excellent chalybeate. It 
may be given in doses of from ten drops up to one fluid 
drachm thrice daily. Quinia and strychnia may be com- 
bined with the iron. This patient has been reduced to two 
grains of opium thrice daily, instead of six grains at the 
same interval. She is taking quinia and half a fluid drachm 
of dialyzed iron four times dai]}^ In the course of three 
weeks I have every reason to believe that the habit will be 
entirely broken up. 



Pelvic Abscess. 



BY WM. H. BYFORD, M.D. 
Professor of Gynaecology in Rush Medical College, Chicago, HI. 



[Reported for the Peoria Medical Monthly by a Student.] 

This patient, a widow, is twenty-six years of age. She 
was married at fourteen ; has one child, now nearly eleven 



200 Peoria Medical Monthly. 

years old, and has had four miscarriages. Menstruation, 
which has always been regular and normal up to within a 
short time, began in her twelfth year. While she had never 
been very robust, she enjoyed a fair degree of health until 
three years ago, or after her last miscarriage, which is the 
date she gives us as the beginning of her present difficulty. 
She then began to complain of general symptoms of pelvic 
disease; pain low down in the back; pain over the abdo- 
men, tympanitis, palpitation, frequent micturition, &c., &c., 
and also tells us, that eleven months ago she had what was 
called an attack of inflammatory rheumatism, for which she 
received treatment, and which passed off in a few days. 
This rheumatism was confined to the lower extremities, and 
principally to that of the right side. After the subsidence 
of this rheumatism, which was not accompanied by swell- 
ing, her health has been only fairly good. She has had a 
continuation of the symptoms I have enumerated, but not of 
such a severe character as to prevent her from attending to 
her household duties. 

In September last, she had another attack of rheuma- 
tism of the same character as before, followed, as she says,, 
by typhoid fever. This febrile condition lasted between 
two and three weeks. During and since this last attack in 
September, she has had an aggravation of the pelvic symp- 
toms, with more localized pain in the right side of the pel- 
vis and back, which are very severe, and to relieve which 
morphia in considerable doses has been administered. 
Some time later there was a copious discharge of pus 
through the vagina, and this discharge still continues,, 
though greatly lessened in amount. Now, what has been 
and is the trouble here ? You will have no hesitancy in 
diagnosing a pelvic abscess, and I think I will have no diffi- 
culty in making her previous symptoms harmonize with her 
present condition. The rheumatism from which she suf- 
fered was not rheumatism at all, but was a reflex irritation 
of the nerves leading to the parts aflected, caused by the 
inception, in the first place, of this inflammatory process, 
and during the last attack, to the renewing of this inflam- 
mation and to the other morbid processes preceding suppu- 
ration and the opening of this abscess. There was nO' 
swelling, puffiness or especial tenderness in any of the 
joints which there would have been had the attack been 
rheumatic in character, while the fever accompanying it 
was of a low grade, too low for the usual rheumatic fever. 



Clinical Lectures. 201 



Her trouble dates from her last miscarriage, and there 
is no doubt in my mind, though the patient will not com- 
mit herself, but that force was used, that it was a produced 
miscarriage, brought on probably by a whalebone or some 
such instrument. The symptoms at that time subsided, but 
only to appear in September last ; the trouble, however, 
had materially advanced, and the fever accompanying the 
pain was of considerably greater intensity. She says it was 
called typhoid, but from its course, character and duration, 
together with the sequelae, we know it was purely inflam- 
matory, and was caused by this localized point of inflam- 
mation. This, with the intimate relations existing in the 
pelvis between the nerves of the lower extremity and the 
organs occupying that cavity, will explain the nature of her 
so-called rheumatic attacks. 

Following the miscarriage, which was brought on by 
some violence done to the organs of generation and their 
appendages, she had a localized inflammation which with 
its exudate led by natural and known processes to the forma- 
tion of this abscess. On examination I find, that the abscess 
situated in the right broad ligament, opened into the vagina 
at the most favorable locality, just below the utero-vaginal 
juncture on the right side. The cavity was not entirely 
emptied at the first discharge, and this is usually the case. 
l!»[ow, what shall be the treatment? Were she in a position 
to carry out all my directions, I would first of all insist 
upon complete rest. Since that is impossible for her, as 
boarding-house keeper and doing her own work, to do, I 
will tell her to keep as quiet as she can, and rest as long 
each day as she can find time. ]^ext, I would endeavor to 
lessen the amount of morphia she is obliged to take, by a 
resort to a sitz bath, an hour at a time twice a day. The 
water in this bath should only cover the pelvis and upper 
part of the thighs. In addition to this I will advise copious 
injections of water. You will notice that I do not say hot 
or warm or cold water, and I generally leave that to the 
patient, telling them to use water of that temperature which 
causes no discomfort and aflfbrds the most relief, and this 
they will find out by a few trials. This water for injecting 
may contain a small amount of permanganate of potassium, 
or carbolic acid as a purifier and antiseptic. Further, I will 
place her on the following tonic, which I frequently use and 
find most excellent in these and similar cases : 



202 Peoria Medical Monthly. 



Jpfc Tr. ferri chloridi, 1 ounce. 

Syrupi simp., 3 ounces. 

Potas citras., 1 drachm. 

M. Sig. Take a teaspoonful three times a day. 

The bowels should be kept open, and in these cases, I 
prefer to do this by regulating the diet rather than by medi- 
cines. Graham bread, used exclusively, is often sufficient. 
The diet must be nutritious and good. I shall also pre- 
scribe as an alterative, one grain of blue mass every night, 
which I find useful in cases where there is considerable 
induration, as an induration in the broad ligament. 

For a counterirritant she will use a liniment made of 
equal parts of tinct. iodine and dilute alcohol. This will be 
applied with a camel's hair pencil over the parts aflected. 
In this case the prognosis is not as favorable, for a speedy 
cure, as it would be if she could enjoy complete rest and 
freedom from work of all kinds. Still I think that by doing 
as I have above outlined, she will make a good though 
somewhat tardy recovery. 



Clirysopliaiilc Acid in Diseases of the Skin. 

In ringworm of the scalp, chrysophanic acid is often 
very useful, but it is necessary to use it with considerable 
care, as it has and may produce severe inflammation. Ten 
grains to the ounce of cerate and vaseline is generally suffi- 
ciently strong. Of course it is necessary to use epilation in 
bad cases. One drawback to its use on the scalp is the 
staining of the hairs to a purplish brown color. I think it 
well to mention this fact to patients when stating to them 
the advantage of rapid cure which we are warranted in 
promising from the use of this acid. Ringworm of the 
body is readily cured by an ointment of moderate strength 
rubbed in several times daily. When used upon the trunk 
or extremities, chrysophanic acid will inevitably stain the 
underclothes. To get over this trouble as well as we can, I 
state the fact to patients, and advise them to wear such 
clothes as are well-worn, and to continue their use while 
under treatment, as the time is usually not very long. In 
lichen planus, I have seen some of the most rapid cures 
produced by this agent, but the itching which usually 
accompanies this affection, often necessitates the addition 



Periscope. ' 203 

of some anti-pruritic agent. In other chronic forms of 
lichen this acid may often be used with great benefit. I 
have now under treatment a case of lupus erythematosus, 
which I am sanguine of curing by an ointment of the 
strength of twenty grains of the acid, to the ounce of oint- 
ment. — *S^^. Louis Courier of Medicine. 



How to Eradicate Syphilis. 

A woman infected with syphilis, convicted of prostitu- 
tion, should be spayed, and, not to make any invidious dis- 
tinction on account of sex, everj^ syphilitic or leper, married 
or single, should be interdicted from sexual co-habitation, 
under no less penalty than the deprivation of the procrea- 
tive power. Under existing law, it is optional for married 
syphilitics to live together or separate, but the continuance 
of the marriage relation under such disabilities, should be 
regarded as a crime. — Dr. French in Chicago Med. Rev. 



Chrysoplianic Acid, "Caution." 

Physicians prescribing this remedy should caution their 
patients against the accident of introducing it into their 
e3'es through rubbing them with the fingers. Dilatation of 
the pupil ensues, accompanied with inflammatory itching 
and burning, causing much pain for the time it lasts, though 
the inflammation soon subsides. — Western Lancet. 



Black Silk for Lig-atures. 

Prof. W. H. Pancoast says he uses only black silk for 
ligatures. " It is the purest silk, the iron dye makes it less 
irritating to the flesh, and all the white silk of commerce 
is dyed with lead." — Medical Bulletin. 



Military Triact Medical Association. 

The regular semi-annual meeting of the Military Tract 
Medical Association, was held at Masonic Hall, in Galva, 
III, on Tuesday, J^ov. 9tb, 1880. 



204 Peorico Medical Monthly. 



The president, Dr. H. Judd, of Galesburg, called the 
meeting to order at 10 A. M., and after the transaction of 
some business preliminary to the regular programme, a 
recess was taken until 1:30 P. M. 

At the appointed hour the association was again 
called to order, the president, Dr. Judd, in the chair. On 
motion, the following physicians were elected members of 
the association : Drs. E. Smith, of Viola; C. 0. Smead, of 
Victoria; aod I. N. Wear, of Fandon. Drs. J. P. Johnson 
and 0. B. Will, were present from the Peoria City Medical 
Society. 

Reports of the various committees being in order, Dr, 
A. L. Craig, from that on Practice of Medicine, reported 
two very interesting cases of " puerperal mania," in the 
course of the treatment of which uterine injections of an 
antiseptic character were used. Dr. Nance, of Kewanee, 
objected to the use of uterine injections of any description, 
unless the greatest possible care was exercised to ascertain 
for a certainty, a sufficiently patulous condition of the os 
to admit of a free out-flow, or a double current catheter 
used, to insure a rapid return of the injection. 

Dr. Baldwin, from the committee on surgery, reported 
a case of cancer of the breast — which had been examined 
and discussed by a number of surgeons — with operation for 
its removal by the knife, the wound healing kindly and 
remaining so for several Aveeks or months, to the comfort 
of the patient, the woman subsequently dying from spas- 
modic heart trouble, apparently owing to reflex irritation 
from the application of a caustic preparation to a small 
ulcer which Anally appeared at the side of the cicatrix. 
The report of the case provoked a lively discussion as to 
the advisability of operating for cancer, participated in by 
Drs. Nance, Ingels, Todd and Babcock, of the association, 
and Dr. Johnson, of Peoria. 

Dr. J. F. Todd, from same committee, reported case of 
non-union of flaps after amputation of leg. Discussed by 
Drs. Nance and Ingels. 

Other committees failed to report, and the time was 
occupied in the discussion of various interesting topics. 
Although there were comparatively few present at the meet- 
ing of the association, it was an interesting and profitable 
one. The semi-annual meetings are never so well attended 
as are the regular annual meetings, the next of which will 



Society Transactiojis. 205 

he. held in the city of Galesburg on Tuesday, May 19th, 
1881. The members of the profession in Galva well sus- 
tained their reputation for hospitality, in providing accom- 
modations at their own homes for those in attendance. The 
reporter of the Monthly is thus indebted to Dr. A. C. Bab- 
cock and his estimable wife; and for many favors to the 
efficient secretary of the association, Dr. B. S. Peck. 

Below is appended the programme for the next meet- 
ing, as furnished by the president. W. 

The Military Tract Medical Association will meet at 
Oalesburg, 111., Tuesday, May 10th, 1881, prompt at ten 
o'clock A. M. 

PROGRAMME — ANNUAL MEETING. . 

Practice of Medicine — S. M. Hamilton, H. Nance, H. L. 
Harrington,'E. Smith, S. F. Wear, A. S. Slater. 

Surgery — J. S. Todd, M. Reece, G. L. Corcoran, H. C. 
Hopper, J. P. McClanahan, A. C. Babcock, W. S. Holiday. 

Materia Med. and Thera'peutics — A. E. Baldwin, J. A. 
Mitchell, J. M. McClanahan, E. R. Boardman. 

Obstetrics and Diseases of Children — R. B. Smead, T. A. 
Scott, J. H. Wallace, H. S. Hurd, J. B. Ingels, J. F. Pur- 
<3um, J. Y. Frazier. 

Essayest — M. A. McClelland. 

Neerology — B. S. Peck. 

These committees are earnestly requested to prepare 
themselves, and to be present at this meeting. 

Herbert Judd, Pres't. B. S. Peck, Sec'y. 



Proceecling-s of tlie Jasper Countj (111.) Medical Association 
— November Meeting-. 

S. R. Youngman, M. D., West Liberty, President ; A. 
B. Faller, M.D., Secretary, Newton. 

Meets on the first Friday of each month, at JSTewton. 
Association came to order with the President in the chair. 
Members present, Drs. S. R. Youngman, Z. Allen, N. S. 
Olark, H. S. Hinman, James Piequet, George Shamhart, J. 
H. Maxwell and A. B. Faller. 

The minutes of the October meeting were read and ap- 
proved. 

The Committee on Resolutions reported as follows : 

Your committee upon whom you imposed the duty of 



206 Peoria Medical Monthly. 

drafting suitable resolutions in regard to the admission of 
medical practitioners within the state, would respectfully 
submit the following : 

Whereas, Whilst we cheerfully recognize the great 
good done to the public by the laws passed by a late Legis- 
lature, regulating the practice of medicine within the state, 
and creating a Board of Health, we cannot help noticing 
the insufficiency of these laws, and the limited power for 
good of the Board of Health; and. 

Whereas, A number of medical colleges annually con- 
fer the degree of M.D. upon individuals who are not quali- 
fied to practice medicine ; and 

Whereas, The Board of Health is compelled to recog- 
nize these diplomas, and grant certificates to practice to 
individuals possessing sucVi diplomas, irrespective of their 
qualifications ; therefore be it 

Resolved, That we use our influence with our legislators 
■ to have a law so framed that, after a certain time, no person 
shall be admitted to the practice of medicine, in any of its 
branches, within the state of Illinois, who in addition to a 
diploma granted by a medical college, shall not have been 
submitted to a public examination, held at stated intervals 
by the State Board of Health, or by medical men of recog- 
nized ability and integrity, not connected with any medical 
college, said examination embracing the different branches 
of medicine, viz : Chemistry, anatomy, physiology, pathol- 
ogy, materia medica, and surgery, and also a strict exam- 
ination on all the branches of knowledge which are an 
indispensable prerequisite of a thorough medical education ; 
and be it further 

Resolved, That this preamble and resolution be pre- 
sented to all the regular medical societies wnthin the state, 
and to the State Medical Society, and they be requested to 
give this matter consideration. 

J. Picquet, M.D., \ Committee 
A. B. Faller, M.D., / ^^^^^^^^^-^ 

After considerable discussion on the subject of medical 
education, the foregoing was adopted. 

The Association then adjourned for dinner. 

At 1 p.m. came to order. 

Dr. Maxwell read a paper on a dislocation of the femur 
in an old man, with atheromatous degeneration, in which 
chloroform was used, in the reduction, with no bad results. 
Drs. Shamhart and Clark reported a case of spermatorrhoea. 



Society Transactions. 207 

or prostatorrhoea, in a eunich, the patient having amputated 
the scrotum with all its contents, about fifteen years ago. 
This case was spiritedly discussed. 

The Association then adjourned until the first Friday in 
December. At this meeting Dr. Maxwell will open a dis- 
cussion on pneumonia, and Dr. Allen will contribute a 
paper. 

A. B. Faller, Secretary. 



Illinois State Board of Health. 

At the last meeting of the Illinois State Board of 
Health, the following resolution was adopted : 

Whereas, It is the legal duty of this Board to issue cer- 
tificates to persons presenting diplomas from Medical Col- 
leges in " good standing; " and 

Whereas, It .becomes thus the duty of the Board to 
determine as to the good standing of such Colleges ; and 

Whereas, Complayits are frequently made to this Board 
as to the practice and standing of certain Colleges ; there- 
fore, 

Resolved, That a committee of this Board be appointed 
to report at the next quarterly meeting the requirements 
and characteristics which shall, in the judgment of this 
Board, constitute "good standing" in a Medical College, 
and also the conditions under which this Board will receive 
and hear complaints against the standing of any Medical 
School or College. 

The undersigned having been appointed a Committee 
under the above resolution, respectfully address the mem- 
bers of the profession in this State, asking them to reply to 
the following inquiries : 

1. In the present state of Medical Science and education 
in this country, what preparation is and ought to be 
required for admission to the lectures of a Medical College 
to entitle it to good standing? 

2. On what branches of Medical and Cognate Science 
ought courses of lectures to be provided, and what length 
of course on each to entitle the college to "good standing?" 

3. What requirements as to full attendance, reading and 
quizzes, or other examinations, occasional or final, ought to 
be maintained in such colleges ? 

4. What attendance on lectures, as to time, number of 
terms or courses and intervals between courses, are, and 



208 Peoria Medical Monthly. 

ought to be required by such colleges as conditions of grad- 
uation? 

5. What other conditions of graduation, such as hospital 
practice, or practice under preceptors, attendance on clinics 
and dissections are and ought to be required for graduation? 
An early and full reply will be a favor to the Commit- 
tee, and we hope also to the best interests of Medical 
Science. 

Address reply to Committee State Board of Health, 
Springfield, 111. 

John M. Gregory, Chairman, 
Wm. M. Chambers, 
John H. Rauch. 



DeWitt County Medical Society — In Menioriam. 

At a special meeting of the DeWitt County Medical 
Society, held at the office of Dr. Gc^dbrake, in Clinton, on 
the 11th day of November, 1880, the following preamble 
and resolutions were unanimously adopted : 

Whereas, The great creator and preserver of all things, 
has summoned from our midst our well beloved fellow 
member, Thomas K. Edmiston, M. D.,who died at his resi- 
dence in this city on the 9th inst., after a long and painful 
sickness; be it therefore 

Resolved, That in the death of Dr. Edmiston, our society 
has lost one of her oldest and most zealous members, the 
profession at large a skillful and experienced co-worker in 
the science and art of medicine, the community an honest 
and upright citizen, and his family a kind husband and 
indulgent father. 

Resolved, That we feel a deep and heartfelt sympathy 
with the widow and children of the deceased, and can only 
point them for comfort to Him who doeth all things well. 

Resolved, That this preamble and resolutions be spread 
upon the records of the society, that they be published in 
the Peoria Medical Monthly and our county papers; and 
that an attested copy be furnished the widow of our deceased 
colleague. 

Thos. W. Davis, M. D., ^ 

John Wright, M. D., I Committee. 

Christopher Goodbrake, M. D., j 
C. Goodbrake, Sec'y. J. J, Starkey, Pres't pro tern. 



Therapeutic J^otes. 



209 



"^herHfientk <^ok§. 



NITBITE OF AMYIi FOE HICCOUGH 

Dr. Simon, in the Medical Ex- 
■aminer, states that he instanta- 
neously cured a case of hiccough 
which had lasted twenty-six 
hours, by the inhalation of three 
<lrops of the nitrite of amyl. 

FOR CROUP. 

P Oil stilligia. 

Oil cajiput, a a 1 drachm. 
Oil lobelia. 

Oil lavender, a a }^ drachm. 

Oil cinnamon, 10 gtts. 
Alcohol, 1 oz. M. 

As soon as the croupal cough is 
noticed rub a small quantity on 
the throat ; repeat as often as ne- 
cessar3\ If the case be very ur- 
gent, give one or two drops on 
sugar internally, every hour or 
two. — 3fed. Summary. 

FETID PERSPIRATION OF THE 
FEET. 

J^- Pul. alum, exsiccati. 3 ounces. 

Acid, salicylici, \\A to 3 drachms. 

The patient is directed to bathe 
the feet every morning with 
warm water and soap, and while 
they are yet moist to cause the 
powder to partially adhere ap- 
ply it freely to the whole foot, 
leaving plenty between the toes 
and in the sulci underneath 
them. At first it may be neces- 
sary to apply this twice or more 
times in the day, but in a short 
time once a day will suffice. — 
Med. Record. 

PRURITUS VULVAE. 

j^ Pulv. gummi arable, 2 drachms. 

Peruvian balsam, 1 drachm. 

Oil of almonds, 1}/^ drachms. 

Rose water, 1 ounce. 

M. Apply with a camel's hair 
brush eight or ten times a day to 
the itching parts. This also 
rarely fails to cure sore nipples 
applied hourly for a few days. I 
prefer this to anything else. — Dr. 
Tauszky, in Med. Record. 



TRIGEMINAL NEURALGIA. 

For a neuralgia of the first 
branch of the fifth pair of nerves, 
of six years duration. Dr. Lan- 
derberg used the following with 
perfect results : 
R Aconitise, (Duquesnel's) % grain. 

Glycerinaj, 1 drachm. 

Alcoholis, 1 drachm. 

Aq. menth. pip., 2 ounces. 

M. One tablespoonful three 
times a day. 

OXALATE OF CERIUM IN CHOL- 
ERA INFANTUM. 

This remedy is recommended 
by a writer in the Concours Med- 
icate, to be given in the following 
manner, viz : Four grains divi- 
ded into ten powders for chil- 
dren under two years, one to be 
given every hour; eight grains 
in ten powders, between two and 
ten years; and fifteen grains 
similarly divided, for adults. 

DIPHTHERIA. 

Dr. Edwin Burd of Lisbon, 
Iowa, advises the following, 
which he believes, if given in 
time, will cure all cases of diph- 
theria : 

B Sodse hyposulphis, 8 scruples. 

' Quiniee sulph., 3^ drachm. 

Spts. frumenti, 4 ounces. 

M. For a child five years of 
age one teaspoonful every four 
hours, night and day. 
P Potasspe cbloras., 2 drachms. 2 
Tr. ferri chloridi, 2 drachms. 
Syr. simplicis, 4 ounces. 

M. A teaspoonful every four 
hours, night and day.— iWed. and 
Surg. Rep. 

TINEA CIRCINATA. 
B Argent, nitras (pulv.) 1 scruple. 
' Hydr. oxid. rub., 2 scruples. 

Plumbi iodidi, I drachm. 

Vaseli'nae, a a 2 drachms. 

M. ft. ung. Sig. Rub a piece 
the size of a bean well into the 
diseased surface until it disap- 
pears; repeat night and morning. 
—Med. and Surg. Reporter. 



210 Peoria Medical Monthly. 



]aoh <^otice§. 



A Treatise on Foreign Bodies in Surgical Practice, by 
Alfred Poulet,M.D,, Adjutant Surgeon Major, Inspector of 
the School for Military Medicine at Val-de-Grace ; 2 vols., 
pages, 265 and 320 ; New York, Wm. Wood & Co.; vols. 2 
and 3 of Wood's Library of Standard Medical Authors for 
1880. W. T. Keener, agent, Chicago, 111. 

We cannot indicate the aim and scope of this work bet- 
ter than by copying a few extracts from the preface. The 
author says : " ]^o surgeon has hitherto thought of collect- 
ing in one book all the material which is scattered through- 
out the annals of science concerning the question of foreign 
bodies. However, there are few subjects which are more 
worth}^ of attracting the serious attention of practitioners. 

All those who have been brought in contact in the course 
of their practice with the numberless difficulties produced 
by the presence of foreign bodies, know how uncertain the 
diagnosis often is, how sudden are the symptoms and how 
often the treatment requires skill, address and varied and 
extensive learning." This work is confined to a considera- 
tion of foreign bodies entering the body through the natu- 
ral passages. The author has endeavored to bring this 
hitherto unarranged mass of facts into harmony with gen- 
eral laws, and to suggest the various therapeutic measures 
necessary in each instance. In this we think he has suc- 
ceeded admirably. The general practitioner, but especially 
the surgeon, will read with great pleasure and much profit 
this valuable addition to his library. The addition of a 
large number of cases, illustrative of the various accidents 
mentioned, adds variety and interest to the work. Part 
first treats of foreign bodies in general. Part second of 
those in the intestinal tract, including bodies in the pharynx, 
oesophagus, stomach, intestines and rectum. Part third, 
foreign bodies in the air passages. Part fourth, in the gen- 
ito-urinary organs, including those in the male and female 
organs, urethra, bladder and uterus. Part fifth, in the ear. 
Part sixth, in the nasal fossse. Part seventh, in the glandu- 
lar canal and Wharton's duct. 

The author promises a continuation of the work by con- 
sidering, at a later period, those bodies " which enter the 
economy by ' effraction ' or are fixed to the surface of the 
parts." 



Book Jfotices. 211 



Health and Health Resorts, a hand book of practical 
information, for the use of tourists and invalids, by John 
Wilson, M.D.; cloth, 12 mo.; pp. 286; Porter & Coates, 
.Philadelphia, Pa. 

This little book contains a vast amount of useful infor- 
mation concerning the resorts and baths of Europe. It is 
especially designed for persons who contemplate a visit to 
Europe for their health, and mentions the class of diseases 
most likely to be benefited by a residence at each of these 
places. It will be of great use to the physician also, who is 
frequently called upon to recommend a journey to his 
patients. Both sides of the question are given, and the 
dangers and sufferings so often entailed by expatriation 
upon invalids in search of health, are placed in sharp con- 
trast with the possible good results. 

The style of the writer is easy and graceful, and dry 
details of portions of the book are made interesting by this 
pleasing feature. 

In speaking of the health resorts of our own country, he 
says: "It may be fairly questioned whether our mineral 
springs and sanitary resorts do not possess elements as well 
adapted to the treatment of various forms of disease as any 
of the most famous baths or springs of Europe." In a new 
edition the proof should be more carefully read, and several 
mistakes corrected, especially in the names of places. 

Higher Education of Medical Men, and its Influence on 
the Profession and the Public : An address delivered before 
the American Academy of Medicine, by F. D. Lente, A.M., 
M.D., President of the Society. Published by direction of 
the Society ; pp. 16. 

This is an able plea for the higher education of the med- 
ical profession — recommending a high preliminary exam- 
ination as well as a more thorough course of medical study. 
The author gives us a fact, based upon college statistics, 
that the men who stand highest in college, the best students^ 
rarely study medicine. These prefer law, theology or. mer- 
cantile life, while the poorer students, or those who do not 
graduate at all, adopt medicine as an easy way to make a 
living — that is they can get through a medical college 
more easily than any other. We doubt the entire accuracy 
of this statement, but it has some truth in it. 



■212 Peoria Medical Monthly. 

Peoria Medical Monthly. 

All communications must be addressed to , 

Thos. M. Mcllvaine, A. M., Publisher, 

204 South- Jefiferson Street, PEOBIA, ILL. 

Chicago Letter. 

Chicago, November, 1880. 

As your correspondent had the pleasure of hearing a 
lecture before the Chicago Philosophical Society, delivered 
by Dr. George M. Beard, of " Neurasthenia " fame, and 
more recently the hero of an episode on the Atlantic, which 
does not so redound to his honor, on the subject of " Ameri- 
can Nervousness; its causes and consequences," he thought 
it might be of interest to some of your readers to learn 
something of his appearance and manner, as well as of the 
present stage of his latest invention — American nervous- 
ness. Dr. Beard is slightly above medium height, and of a 
rather slender figure ; shoulders square but with a slight 
stoop ; his gait, as he walked up to the platform with his 
ihands in his pockets, might be characterized as stiff and 
awkward. His face is thin, eyes large and exhibiting a 
tendency to roll up; his voice is not unpleasant, but subject 
to that peculiar modulation common to persons slightly 
deaf, as Dr. B. himself is. His manner, eminently dog- 
matic, is that of a man impressed by the grandeur and 
truth of his cause and a high sense of his own importance. 
He seems to be badly afflicted with the disease of which he 
is the great high priest, although we may be mistaken in 
this, for after a somewhat careful reading of his work and 
attentive hearing of his lecture last night, we are not 
exactly certain what " nervousness " is, and he may not 
have- "it" after all. 

As regards the lecture we think we can safely say, that 
even from the standpoint of his previous productions it was 
below par. It was dogmatic in the last degree, wanting 
in connection and unity. Without defining what he means 
by nervousness, and especially that type he pleases to call 
American, he plunged m medias res and left his audience to 
flounder after him and be content with guessing at his 



Editorial Department. 213 

meaning. Some of the statements were rather large, to say 
the least. He told us : that we are more temperate than 
our ancestors in all things, because our nervous sensitive- 
ness is greater than was theirs, and we cannot, therefore, 
endure what they endured. StilL this increased sensitive- 
ness is not hereditary, but is caused by modern civilization. 
Some of the ancients, the Greeks, for example, were civil- 
ized, but modern civilization is that civilization plus the 
steam power, telegraph, sciences, political anxieties and the 
mental activity of women. Then again our civilization is 
more intense than that of European nations. In Europe 
one man is delegated to bear the burden that rests upon 
the head wearing the crown, while in this country we have 
fifty millions of uncrowned sovereigns. In Europe the 
church does the thinking upon religious matters for the 
people, while here each man must work out his own salva- 
tion with fear and trembling and neurasthenia. Three 
great questions are the potent factors of American nervous- 
ness, viz : Who shall be our next President ? How shall 
we keep from starving? Where shall we go to when we 
die ? The drier climate of the larger portion of the United 
States is also a cause of this disease. Our American women 
are the most beautiful in the world, because the climate and 
the social position accorded to them is highly productive of 
nervous sensitiveness, which in turn is essential to the high- 
est type of female beauty. In ending, however, the lecturer 
gave us a few grains of comfort in the statement that there 
was no danger of the American people becoming emascu- 
lated and destroyed by reason of their nervousness, as its 
increase was overcome by an unprecedentedly rapid growth 
of the people's strength. This is a bare outline of the lec- 
ture, but as full, perhaps, as it deserved. The lecturer was 
criticized and pretty severely handled at the conclusion by 
various members of the society, notably by Dr. Jewell, 
whose well known, close study of nervous disorders gave 
weight to his strictures upon the speaker's statements. The 
lecture is part of a book to be published soon, and then 
those desirous can find out, if they can, just what American 
nervousness is, and they will probably find that they have 
had it all their lives and didn't know it. 

The students and some of the faculty at Rush were con- 
siderably worked up by a long article which appeared in a 
daily paper of large circulation a short time ago. The- 



214 Peoria Medical Monthly. 

writer of the article in question seemed desirous of making 
out that the students at Rush are the worst set of roughs 
and blackguards imaginable, and that some of the Profess- 
ors are not far behind them. The statements are so obvi- 
ously false that they are not worth repeating or denying. 
Their author is probably some budding Esculapius whose 
vanity has been wounded, because he was not offered a 
chair in the Faculty, or perhaps even the presidency of the 
college. It has been your correspondent's privilege to have 
visited many medical schools, both in America and in 
Europe, and he can truthfully say, that the present class at 
Rush will compare favorably in conduct and gentlemanly 
deportment with any class of equal size that ever met in 
any college. 

The Hon. A. E. Bishop, President of the Board of 
Directors of the Central Free Dispensary, Chicago, a trustee 
of Rush Medical College, and an active woi^'ker in many 
charitable and educational causes, died at his residence in 
Chicago, l!^ovember 15th, aged QQ years. 

In company with Bellevue Hospital Medical College, 
The College of Physicians and Surgeons, l^ew York, The 
Medical Department of the University of l^ew York, and 
others of equal standing, Rush Medical College has with- 
drawn from the American Medical College Association. 
These colleges prefer to make their own laws and require- 
ments, and not be made to stand as sponsors for all the 
small colleges springing up all over the West. We would 
not be surprised if the action of these leading schools for- 
bodes the speedy dissolution of the Association. It has, 
however, done good work in the past, and we predict that 
another and stronger association of the best and strongest 
colleges in the land will spring from its ashes. 



Notice to Readers. 

We call the attention of readers to the prospectus on 
page 7, and hope they will read it carefully. We have so 
far done all that we promised, and more. This should give 
us the confidence and support of the profession. The 
amount we ask for a year's subscription is small — you will 
never notice it, and a dollar bill can be enclosed in the let- 
ter. We do not know that a single dollar sent in this way 
has been lost. Put an extra piece of paper around it, and 
be sure that the letter just fits the envelope. 



Editorial Department. 215 

Medical Colleges. , 

The College of Physicians and Surgeons, at Keokuk, 
Iowa, has about 300 students this year. 

The Chicago Medical College has about 175 in attend- 
ance. 

The Medical Department of the Iowa State University 
opened with 180 matriculants. 

The Woman's Medical College, at Chicago, has 80 
matriculants, which is a decided increase over previous 
years. The graduating class of 1880 numbered 10. This 
College is in a very flourishing condition, with all the facili- 
ties necessary for successful competition with the older col- 
leges in the East. It is now in the eleventh year of success- 
ful operation. 



Our esteemed friend of the St. Joseph Medical and Sur- 
gical Reporter, \& somewhat worked up over a letter received 
from Philadelphia, Pa., offering to furnish him, for a con- 
sideration, with reports of lectures and other material for 
his journal. He says : " he now catches a glimpse, for the 
first time, of the character of the e.nterjmse of some of our 
brothers of the pen and scissors," and that this gives a 
chance to reiterate the declaration that his " is a Western 
journal, to be made up of Wester7i materials, foe Western 
men, and in the interests of Western medicine." 

This is all well enough, but we think that even Western 
men would sometimes be glad to read a lecture from such 
men as Levis, Gross, Agnew, Morton, &c., and that it would 
be a mark of enterprise on the part of our friend to furnish his 
readers with some original matter from Eastern men. It 
won't do to draw the line between Eastern and Western 
medicine too closely, for the majority of Western practition- 
ers were educated in the East, and can, perhaps, discriminate 
as to what they wish to read, as well as our friend. 

Of course we do not think that the " pecuniary ques- 
tion" had anything to do with the refusal of the offer. We 
are sure that our friend is sincere in his efforts to exclude 
everything Eastern, yet it is strange that while his " clip- 
pings " are almost entirely made up from Eastern journals, 
he should refuse to admit original articles by Eastern men 
in his journal — but such is life. 



216 Peoria Medical Monthly. 

We give below the addresses of several members of the- 
class of '80 of Rush : 

Dr. J. D. Camerer, Kinmundv, 111. 

Dr. W. F. Howe, Brooklyn, Wis. 

Dr. M. H. McGrath, Kickapoo, Peoria County, 111. 

Dr. C. T. Dripps, Staunton, Macoupin County, 111. 

Dr. J. A. Robinson, 428 W. Washington St., Chicago, IlL 

Dr. E. P. Murdock, 133 S. Halstead St., Chicago, III. 

Dr. J. T. Dicus, Streator, 111. 

Dr. John H. Mannon, Kewanee, Henry County, 111. 

Dr. John C. S'ichols, Kewanee, Henry County, 111. 

Dr. M. I. Powers, formerly of Parkersburg, Butler Co.,. 
Iowa, has removed to Independence, Iowa. 

Samples of Staufer's hard-rubber uterine instruments 
and supporters can be seen at the office of this journal. 

If we can accommodate any physician by purchasing 
or ordering any books or instruments, we will be glad to 
do so, free of charge. We will select with as much care 
as if buying for ourselves, and can get as low prices as can 
be had anywhere. The goods can be sent C. O. D. Ad- 
dress the publisher. 

At a late meeting of the Medico-Legal Society, of 
Philadelphia, the following resolutions and amendment 
were adopted : 

'■'•Resolved, That physicians, when writing a prescription,, 
which they do not wish renewed, should write on the bot- 
tom of such prescription, 'do not renew,' and also inform^ 
the patient of the fact in every case. 

Amended; And on the other hand the druggist will 
either write or print on the label upon the bottle or pack- 
age, 'not to be renewed unless by a written order of the 
doctor.'" — Medical and Surgical Reporter. 



One of the most ludicrous typographical errors lately 
reported was from the substitution of a "d" for the final 
" 1 " in chill. A gentleman on making a trip East left his 
wife in her usual good health, and was surprised in a few 
days at the receipt of a telegram announcing her serious 
illness. He telegraphed the family doctor for particulars,, 
and received in reply the following : " Mrs. B. has had a 
child. If we can prevent her having another to-day she- 
will do well." — Western Lancet. 



The Peoria 
MEDICAL MONTHLY. 



Vol. IV. MAY, 1883. No. 1. 



©j:igitt»I C^ommuttiationisi. 



Art. I.— The Clinical Uses of the Microscope. By Dr. Romaine J. Curtiss, 
Joliet, 111. Continued. 

THE GEJIM THEORY OF DISEASE. 

In a previous article the writer endeavored to give an 
outline of the principles upon w^hich the microscope is 
made, and the reasons why objective lenses are good, bad, 
or indifferent. 

As a further introduction to the subject of the clinical 
uses of the microscope, it is necessary to reviev^^ the status 
of the germ theory of disease, and show the relations of 
germs to disease, so far as proven, and also to learn what 
part the microscope has taken in the evolution of the sci- 
ence of contagion and infection. 

So far as anything is known about living infections, as 
discovered by the microscope, there are grounds for a divi- 
of contagium vivum into two great classes — and we may say 
that these two classes are (1) the parasites, which are highly 
organized like trichinae — Echinnococci and Cysticerci, and 
other worms and insects ; and (2) the other class is com- 
posed of those most simple undifferentiated forms of life 
called, collectively, bacteria. 

In relation to these two classes of infection the micro- 



2 The Peoria Medical Monthly. 

scope has been only the agent of discovery, and has been 
no further than this the agent or means of proof that par- 
asites of any kind ever cause disease. The discovery, how- 
ever, of parasites led to the proof that they do cause dis- 
ease, and had it not been for the miscroscope the disease of 
trichinosis, as well as the other infectious diseases of highly 
organized parasites, would yet be ascribed to "Providence" 
or "error of nutrition." 

When parasites were first discovered in diseased tis- 
sues: for instance, when trichinae was discovered in muscles 
of dead people, and the acari in the skin, the presumption 
was that the parasites caused the disease which they ac- 
companied; but, as the simple fact of discovery of parasites 
in suspicious localities could prove nothing against them, 
the presumption that they caused disease was soon met by 
a denial, and it became necessary to furnish the proof. 

In fact, with very few exceptions, in every special kind 
of living infection, when the parasites were first discovered^ 
people would say: "T he disease causes the parasite." When 
this ground became untenable they would say : " Then the 
parasite is an accompaniment of the disease only " — a sort 
of coincidence or companion piece, but in no wise the cause 
of the disease, because the origin of disease is a perversion 
of nutrition, and " perversion " or " error " is an entity, or 
ghost, and is unconditioned, and does not require an ante- 
cedent for its existence. 

In general and in special, then, the nature of infection 
had to be proven, first, that it was not the product of dis- 
ease ; second, that it was not simply a coincidence ; and, 
third, that it really was the tangible, living, natural cause 
of disease. 

Trichinae were of course discovered by the microscope. 
The incidents of the discovery were after this fashion : A 
physician discovered in certain subjects for dissection, or 
in jpost mortem, that the muscles were filled with little 
pieces of chalk. That doctor meditated much on the char- 
acter of the error of nutrition of muscles which should 
result in the development of pieces of chalk. After a time 
another physician, looking through his microscope at these 



Original Communications. ^ 

pieces of chalk, seeking for more errors, found a little worm 
coiled up in the middle of the piece of chalk. Of course^ 
the microscope could prove nothing further than the worm 
was there in the chalk, and the chalk occupied a primitive 
fasciculus of the muscle, and that a very thin, small slice- 
of muscle literally had " millions in it." 

Obviously some other method of proof than the raicror 
scope had to be employed to demonstrate that the disease- 
did not cause the chalk and worm by error of nutrition,, 
and that the worm was not a simple coincidence of the 
trichinosis, but that the worm was living infection, and 
caused the sickness and death of people whose muscles it 
inhabited. 

The human mind is very tenacious of old ideas. The 
older a man grows the more unplastic his brain becomes, 
and the more difficult is it to plow new roads through his 
brain tissue ; or, to speak in more metaphysical terms, the 
more difficult is it for him to build up in his mind new as- 
sociations between ideas. 

Looking back over the history of the world in its steps 
of evolutionary development from primitive man to the 
civilization of the present, and noting the creeds, dogmas,, 
and persecutions, by dungeons, and bonfires, and excom- 
munications, and transportations, we conclude that the two 
principal ethical and mental functions of the human being 
have always been to cling to his own opinions, and make 
everybody else believe as he did. The truth is that the 
more dogmatic an opinion is the more difficult it is to get- 
rid of it. People have been trained a little too much in the 
practice of accepting opinions on faith, or by personal au- 
thority, and then holding to the faith for the sake of ap- 
pearing to be consistent. People will be consistent, at 
least some people try to, even if they have to deceive them- 
selves by a lie in order to do so. This rule of conduct and 
thought is now only taught by theologians and politicians. 
It is even to-day quite a reproach for any man who " turns 
his coat " in politics, or lets go his grip on the faith of some 
particular church long enough to catch hold of some other 
church. Such people are always subjected to the reproacli 
of inconsistency. 



4 The Peoria Medical Monthly. 

But in the matters of science inconsistency has a very- 
different meaning. The test of faith in science is not faith, 
or personal authority ; the test of faith in science is verifi- 
cation by experiment. Hence in matters of science which 
are going through the process of this sort of proof the opin- 
ion and belief of the man whose mind is subject only to 
proofs by verification, will undergo as many shades of con- 
viction as there are corresponding shades of evidence in 
the process of development of the complete proof by ex- 
periment. 

Now the man who believes all through his life as John 
Oalvin did, because he began to believe this way while he 
w^as young and wants to be consistent, can't be criticised, 
very much, and it may be an easy thing for him to do. 
Consistency of this sort is very easy to drill into the mind. 
It is very likely a good thing for the leaders of the Repub- 
lican, or any other party, if a man consistently remains 
with a single party all through his life, and if his sons con- 
sistently follow his political convictions. The party lead- 
ers will never reproach him for vascillating conduct or 
mental inconsistency. They wdll commend him and say : 
^' Behold a man who knows his own mind ! " 

Not many years ago a physician looking through a 
microscope saw the very minutest forms of life in saliva 
from the mouth, and matter taken from a decayed tooth. 
The discovery caused considerable curiosity at the time, 
and just now we are in the very ihidsi: of the experimental 
verifications w^hich are apparently developing the proof 
that these minute forms of life, or bacteria, are the cause 
of the zymotic diseases. 

This history of the development of the science of bac- 
teria will fully show the classical '' inconsistency " of the 
human mind. Bacteria and their spores men foufid every- 
where. The dust of the air was found to be composed of 
the spores of bacteria, and bacteria were found in fact to 
occupy all dead organic matter and all living matter. In 
fact nothing of material character on the earth's surface 
has ever been found which does not contain inside or on 
its surface the spores or germs of bacteria, or the bacteria 
themselves. 



Original Communications. 5 

When people first discovered these micro-organisms 
there was no thought that they had anything to do with 
disease, for the reason that the alleged causes of disease 
were dogmatic, and people could not consistently change 
their opinion. 

After a time Dr. Bastian made a very singular discov- 
ery with his microscope. He found that any organic mat- 
ter which was fermenting, or decaying, or putrefying, con- 
tained countless numbers of micro-organisms. Bastian 
made a series of experiments by which the proof appeared 
to be conclusive that putrefaction and fermentation of or- 
ganic substances caused the formation or creation of these 
living things. 

These experiments were repeated all over the world 
l3y many men of science who verified them, and believed 
accordingly, and there was induced a general law to cover 
this ground of experimental science which proved that 
dead organic matter when fermenting or putrefying caused 
life, and the new law was called heterogenesis. In a short 
time the discovery was made that diseased tissues, and the 
secretions and excretions of sick people contained these 
same kinds of micro-organisms, and the conclusion was 
that putrefaction, fermentation and disease all gave birth 
to life in the shape of bacteria. The literature of sponta- 
neous generation fifteen years ago was very interesting 
reading. 

The next development and differentiation of the sci- 
ence of life and fermentation and disease was made by 
Tyndale. This gentleman is pre-eminently a man whose 
mind is alive to the meaning of a scientific verification. 
He has probably inconsistently changed his mind on sci- 
entific projects more than any other man I know of — for he 
is capable of changing his opinions as the proofs change. 

It is due to the experiments of Tyndale that the doc- 
trine of heterogenesis was overthrown. Tyndale proved 
that putrefaction and fermentation did not cause life, 
or the creation of bacteria, but that the reverse of this is 
true — that bacteria are the cause of putrefaction and of 
fermentation. 

When these proofs were published a great many people 



6 The Peoria Medical Monthly. 

were obliged to change their minds, no matter how incon- 
sistent such a change might appear. To-day heterogenesis 
is never heard of, and even Dr. Bastian is convinced that 
bacteria cause fermentation and putrefaction, which belief 
is just opposite to what he did believe. 

At the present time the same kind of investigation 
which Tyndale carried on in the study of fermentation is 
being carried on in disease. People generally have got 
over the belief that disease can create life. The greater 
part of the medical world now think either that bacteria, 
are coincidences of disease or cause disease. Doctors gen- 
erally are scientific in their methods of thought. As a rule 
the man who thinks that bacteria in no case cause disease 
is deficient in data upon which to found his opinion. Very 
likely he has just read Bastian's early writings, or his mind 
was made up years and years ago on all such points, per- 
haps according to the theory of Liebig, and he is too old^ 
or too consistent to change his mind by reason of the ver- 
ifications of experiment. 

To investigate the things in disease which are too small 
to be seen by the eye, two things are needed. The first one 
is a good microscope and the second is a plastic brain and 
scientific methods of thinking. A man must prepare him- 
self with these preliminaries before he can satisfactorily 
study the facts which present themselves to his senses only 
through microscopic vision and scientific experiment. 

All the microscopes in the world could never aid sci- 
ence if a man could not change his opinion. The only con- 
sistency of mind required in science is a consistent change 
of opinion subject to experimental proof. A narrow vision 
and a dogmatic mind have caused the greater part of the 
cruelty of men to the higher animals in this world, and 
such conditions are the father and mother of ignorance. 

{To he Continued.) 



Akt. II. — Persistent Vomiting of Pregnancy, Only Relieved by Emptying- 
the Uterus. By W. T. Weight, M. D., Winfield, Kansas. 

I have long been impressed that much valuable in- 
formation has been lost to the profession by negligence of 
medical men to report cases of special interest. 



Original Communications. 7 

It frequently happens that we are called to manage 
and treat cases that our text-books fail in affording any 
information, of either the disease or its treatment. 

Occasionally there is something unique in individual 
cases of disease having a well defined history and a stereo- 
typed treatment that constitutes exceptions to the general 
rule in etiology, symptomatology, therapeutics and general 
management. If a record were kept of these exceptional 
cases, noting especially the points of divergence from the 
disease in its general history, and the treatment the 
divergent conditions necessitate — with a rationale for, and 
<the results ot treatment— it would not only be entertain- 
ing, but exceedingly instructive. To many a physician 
such information would be like reinforcements to a half- 
vanquished army, and a star of hope to many a cheerless 
patient. 

Hoping my experience may be of some benefit to 
others, I submit a full report of a case, certainly unique in 
many particulars, and necessitating a treatment somewhat 
out of the ordiuary formula. 

Mrs. A. aged 24 years, two and one-half years married, 
menstruated the last days of May, 1882. About the middle 
of July she began to suffer from slight nausea, especially 
of mornings. About this time I was consulted as to the 
cause of the nausea, and other unpleasant manifestations. 
Being assured she was pregnant, both husband and wife 
were pleasantly reconciled to the situation of things, it 
being the first time she had been pregnant. Nothing un- 
usual occurred till July 30th, when she was taken with 
extreme nausea. 

July 30, 5 p. M.— Mr. A. reported wife as being very 
sick, vomiting every few minutes — had retained nothing 
that had been taken into the stomach that day. Pre- 
scribed : 

5 Aqua calcis. 
Sig. Dessertspoonful everj two or three hours, given in sweet milk. 

Also prescribed : 

5 Morphia acetatis, 4 grains. 

Aqua menth piperit, 3 ounces. 

M. Sig. Teaspoonful once in three or four hours. 

Mustard drafts ordered over epigastrium. 



8 The Peoria Medical Monthly. 

July 31, 9 A. M. — Case reported no better. Had not re- 
tained a single dose of medicine. In fact, everything taken 
into the stomach was immediately ejected ; not even a drop 
of water was retained. Prescribed the following mixture : 

B Ingluvin, 
Pepsin, 

Lactopeptin, aa. 2 draehms. 

Glycerine, 

Aqua cinnamon, aa. f. 2 ounces. 

M. Sig. Teaspoonful every three hours. 

Also, 

3 Hydrarg mild chlor., 4 grains. 

Accacia pulv, 

Sach. alb., aa. 10 grains. 

M. Chart No. 16. Sig. One every hour until vomiting ceased. Solutioij. 
of morphia continued. 

August 1, 9 A. M. — Case reported, condition unchanged. 
Ordered treatment continued, with addition of the free 
use of ice. 

August 2, visit, 9 a. m. — Condition unchanged. Had 
retained neither medicine, food or drink — even bits of ice, 
exceedingly grateful to the patient, were ejected instantly. 
Complains of a burning distress in the stomach, and a con- 
stant flow of saliva, to her great annoyance. The saliva 
flowed so profusely as to completely saturate a handker- 
chief in a few minutes, and seriously disturb her sleep. 
Pulse, 100. 

August 3, visit, 9 a. m. — Had rejected everything taken 
into the stomach. Her appearance anxious and haggard. 
Pulse, 105. Ordered previous prescriptions abandoned, and 
directed the following : 

^ Oxalate of cerium, 1 drachm. 

Chart No. 6. Sig. One every three hours. 

August 3, 9 p. M. — Condition of stomach unchanged. 
Pulse, 108. 

I now determined on a radical change ot tactics. I 
forbid all attempts to nourish or give medicine by the 
stomach. Ordered four ounces beef essence per rectum 
every four hours, day and night. Gave her one-fourth 
grain of morph. sulph. hypodermically. Allowed bits of 
ice, as inclination dictated. 

August 4, 9 A. M. — Had not vomited from 10 o'clock in 
the evening until 2 o'clock in the morning, during which 
time she slept two hours' uninterrupted sleep. Has been 



Original Communications. ^ 

vomiting every few minutes since 2 o'clock. Pulse, 110. 
Complains of burning pain and throbbing in epigastrium. 
Aortic pulsations inordinate, a condition of which she is 
painfully conscious. Has taken nothing into the stomach 
excepting bits of ice, which are ejected quick as swallowed. 
Nervous system becoming seriously disturbed — facial ex- 
pression anxious and wearied. Fourth of a grain of morph. 
sulph. hypodermically. 

August 4, 9 p. M. — Stomach remained quiet four hours 
after the morphine injection, during which time she had 
occasional naps of quiet sleep. Retching and vomiting re- 
turned about 2 o'clock. Says she has had a bad day. Pulse, 
112. Third of a grain of morphia hypodermically. Four 
or five blisters, size of a twenty-five cent coin, directed 
over the stomach, dilated external os sufiiciently to admit 
end of index finger. Saturated a piece of lint with oint- 
ment belladonna, applied in contact with the os. Nourish- 
ment maintained exclusively by soup injections per 
rectum. 

August 5, 9 A. M. — Pulse, 112. Passably comfortable,, 
until middle ot the night, since which time she has been 
extremely restless. One-third grain morphia hypodermic- 
ally. I found one-third of a grain of morphia injected into 
the arm would arrest the vomiting about four hours, if she 
took nothing into the stomach. I instructed Mr. A. in the 
use of the instrument, and had one-third of a grain in- 
jected in the arm every four hours. 

August 6, 9 A. M. — Pulse, 114. Extremely nervous. 
Symptoms of exhaustion apparent. 

August 6, 9 p. M. — Pulse, 114. No improvement. The 
whole contour of the patient bespeaks anxiety for the near 
future. 

August 7, 9 A. M. — Pulse, 115. Flushed cheeks, hacking 
cough, shrunken features, an anxious, wistful expression, 
with intolerance of light and noise, and frequent sighings, 
made up the spectre with which I was confronted. She 
looked inquiringly into my face, and half chidingly re- 
marked : "You are not discouraged, are you, doctor? 
Only let me know what you want me to do, and I will da 



10 The Peoria Medical Monthly. 

my part. Just stand by me, and whatever you think ought 
to be done, do it. I have v^ill enough to go through this 
and get w^ell." It was the wish of both husband and wife 
to save the child, if possible. I delayed the more potent 
means of relieving the mother, hoping te save both. I now 
submitted to patient and her husband the necessity of 
looking wholly to her safety, which had already been too 
long compromised. I passed a uterine sound into cavity of 
the uterus. Hypodermic injections half grain every four 
hours. 

August 8, 9 A. M. — Pulse, 116. Hectic flush, a distress- 
ing dyspnoea, intolerance of light and sound more marked, 
nervous system seriously disturbed. Hypodermic injec- 
tions gave but slight relief. 

August 8, 9 p. M. — Had a bad day. Introduced sound, 
made sure of perforating foetal cyst. Continued hypoder- 
mic injections. 

August 9, 9 A. M. — Pulse, 120. Condition worse in 
every respect. No indication of uterine contractions. In- 
troduced sponge tent. 

August 9, 9 p. M. — Pulse, 122. No improvement in any 
respect. Removed sponge tent. Ordered dessertspoonful 
of whisky with soup injections. 

August 10, 8 A. M. — Pulse, 124. Had a restless night. 
Almost constant nausea and retching. Confined entirely 
to a horizontal position, syncope attending every effort to 
raise up. Introduced the sound into uterine cavity. Gave 
one grain of morph. sulph. per hypodermic syringe. 

August 11, 10 A. M. — Pulse, 125. No improvement. 
Uterus had not responded in any degree to previous 
manipulations. Introduced sponge tent. Ordered table- 
spoonful of whisky, with the beef soup, four ounces of 
which has been given every three hours, day and night. 

, August 11, 8 p. M. — Pulse, 125. Removed sponge tent. 
Ordered two drachm doses fl. ext. ergot every two hours, 
given per rectum. Gave the last morph. injection at 8 
o'clock, evening of the 10th. 

August 12, 9 A. M. — Pulse, 140. Has been vomiting 
almost incessantly since the disuse of the morphine injec- 



Original Communications. 11 

tions. Condition this morning simply desperate. She was 
a fleshy woman ; now the skin hangs loose on her limbs, 
eyes deeply sunken in her head, a markedly pinched 
appearance of her features, respirations forty to the min- 
ute, pulse rapid and indistinct, surface hot and dry, ex- 
treme dyspnoea, restless throwing about of the limbs, gen- 
eral tremor, limbs especially. Her nervous system has 
suffered fearfully for the last four or five days. A flash of 
light in her room would set her vomiting instantly. The 
windows were kept blinded. The light of a lamp was in- 
tolerable, causing instant vomiting. The least noise had 
the same effect. The organs of special sense seemed mor- 
bidly acute. Rustling of the grass by persons walking 
through the yard, on several occasions, brought on a severe 
paroxysm of vomiting. 

This report would be incomplete in one important 
feature, should I omit to state that during this whole sick- 
ness not one sound of complaint ever escaped her lips — 
not so much as an expression suggestive of impatience, or 
in any degree fretful. While by her bed-side yesterday, 
the husband having stepped into the kitchen, she said to 
me : " I wish you would sj)eak hopefully to Mr. A. He is 
feeling real discouraged." I asked how she was feeling. 
She answered, with emphasis : "I am going to get well ; 
just stand by me." Entering her room this morning, she 
evidently read my feelings, and if she read them correctly, 
she certainly read her obituary, but she said : " Doctor, 
you are not going to let me die, are you ? I can live one 
more day ; do your best." My plan was matured by the 
time her last words were spoken. I enjoined her to " Hold 
the Fort," etc. 

It was evident by this time that the vomiting would 
not cease until the uterus was emptied or the woman dead. 

In addition to the use of the sound and sponge tents, I 
had given her two ounces fl. ext. ergot, per rectum, with- 
out exciting the uterus in the least degree perceptible. It 
seemed totally irresponsive to all ordinary means of exci- 
tation. I proceeded at once to carry out what I believed 
would be a successful expedient, wondering I had not 



12 The Peoria Medical Monthly. 

thought of it before. I introduced the smallest tube of 
Molesworth's dilator, dilated to its greatest capacity. Then 
the next size; so on, until I deemed the dilitation sufficient. 
I then brought a Gaiflfe's Battery into requisition, introduc- 
ing one pole into the mouth of uterus ; applied the other 
over the fundus — turning on a constant current for half a 
minute, during which time I could feel, through the atten- 
uated abdominal walls, a firm contraction of the uterus ; 
broke the current for five minutes ; applied again, simu- 
lating the natural process of labor pains. I gradually 
lengthened the time of electric application to one minute. 
In less than two hours I had the pleasure of seeing both 
foetus and placenta expelled, without the loss of an ounce 
of blood. The abortion was completed about 9 o'clock, p.m. 
Pulse, 150. Patient hopeful but fearfully prostrate. Beef 
soup continued every three hours, with addition of one 
ounce of whisky. Directed after three or four hours rest a 
teaspoonful of beef tea oceasionally, per stomach. 

August 13, 8 A. M. — Pulse, 160. Had slept a little dur- 
ing the night ; vomited frequently ; had kept nothing on 
the stomach. Beef soup and whisky continued. Grave half 
grain morphine hypodermically. 2 o'clock, p.m. — Had rest- 
ed well; pulse, 140; had taken small amount of cream, beef 
tea and ice water, and retained them. 9 o'clock, p. m. — 
Pulse, 180. Had no vomiting through the day — had taken 
some nourishment, all of which was retained. Soup and 
whisky continued. 

August 14, 9 a.m. — Pulse, 125; rested fairly well through 
the night. Called for food this morning which was relished 
and retained. 9 p. m. — Pulse, 120 ; some relish for food,, 
which was taken in small quantities and retained. 

August 15, 9 a. m. — Pulse, 115 ; rested well through th& 
night ; discontinued alimentation, per rectum. Directed 
concentrated fluid diet in small quantities, per oris. She^ 
had no more trouble with her stomach; convalescence slow 
but progressed uninterruptedly to complete recovery. 

Analysis of this case presents to my mind three im- 
portant considerations : 

First: — Alimentation per rectum. It will be noted that 
nothing whatever was retained on the stomach for fifteen 



Original Communications. 13 

days. And it is quite uncertain that anything had been 
retained, for three days at least, previous to her coming 
regularly under my care; making eighteen days that noth- 
ing, not so much as a sup of water, was retained in the 
stomach. She certainly would have succumbed from sheer 
exhaustion but for regular and persistent alimentation, per 
rectum. 

We cannot too strongly emphasize the importance of 
sustaining the patient by alimentation per rectum in all 
similar cases. I am quite sure it was one of the essential 
means of saving this patient's life. 

The second' consideration is the importance of psycho- 
logical therapeusis as a factor in the treatment of all cases 
of severe sickness, especially in cases where the energies 
of the system are long taxed. This thought has not re- 
ceived the«^ttention from the profession that its importance 
demands. 

Without doubt all the agencies employed would have' 
failed in the results of this case had it not been for a fixed 
will cherishing every resource of hope, with absolute trust 
in her attendant, never questioning but the very best 
thing possible would be done for her under every circum- 
stance. 

The pui-pose of will to get well — hope inspiring a ready 
obedience to every injunction — a perfect trust that all that 
could would be done for her. were potent elements sustain- 
ing her through those long weary days and nights of suf- 
fering. 

To maintain in a patient this state of mind should en- 
gage every honorable means at the command of the physi- 
cian. This skill in saving life is largely a measure of his- 
ability to turn psycological forces to therapeutic ends. 

Third consideration : Important as the first and sec- 
ond considerations are. they cannot alone sei've the patient 
always. In this case the uterus was absolutely iiTesponsive- 
to all ordinary means of excitation. It was evident the 
patient would find no relief until the uterus was emptied. 
To find a means of exciting uteiine contractions was the 



14 The Peoria Medical Monthly. 

desidemtiim. T found in this case the electric current, 
•used as already described, an efficient agent to institute 
sufficient contractions to expel the contents of the uterus, 
and I believe a measurable sruarantv against hemorrhasje. 



Art. III. — Carbolic Acid in the Treatment of Pile? and Fistnla : Its Origin 
and Condemnation. By A. B. Allen, M. D., .JerseTville, 111. 

I find a growing tendency among physicians to the 
iDelief that carbolic acid injected into the pile tumor will 
radically cure and entirely remove them, and that it 
amounts to almost a specific in fistula. Xow for the ben- 
efit of the rising generation of young physicians, as well as 
to save the poor victims of hemorrhoids unnecessary suffer- 
ing, I will discuss concisely the history of this objectionable 
remedy. A few years ago Prot. Edmund Andrews, of Chi- 
cago, wrote a pamphlet on its use in the treatment of piles, 
and in his summing up does not severely condemn or even 
tacitly commend, but leaves the subject open for un- 
thoughtful men to experiment with a hope of success. I 
see where Gill reports two or three cases treated by car- 
bolic acid in the Chester Penitentiary were successful, the 
report is meagre, no note of the pain or leno;th of time un- 
der treatment, or of any cases where it was a failure. An- 
drews gave as the originator of the treatment one Mitchell, 
an Illinois man, who sold the recipe to many ph3'sicians 
throughout the state. He then i^roceeds to give what he 
no doubt honestly believes to be all the literature extant 
upon the subject. Xone. however, antedating Mitch- 
ell, and only back to 1S71. when, in point of fact, in about 
1861 or 1S62 the popular writer, Crace Calvert, published 
the whole process (that Mitchell sold as a secret) in the 
London Lancet as an extract from a paper read before the 
meeting of the Lancashire and Cheshire branch of the 
British Medical Association. On the use of carbolic acid as 
a remedial agent, among other therapeutic properties, he 
says : '' Hemorrhoids : The action of carbolic acid is mainly 
to corrugate and therefore to obliterate the sack of the 
pile : it coagulates the contents, which may be squeezed 
out. and by corrugation it empties the pile, by which the two 



Original Communications. 15 

surfaces are brouglit into contact and the sack is thus ob- 
literated." While I admire the business tact of Andrews' 
man Mitchell in duping the illiterate physicians of this 
state, I do most heartily despise his knavery. Xow let us 
see what the experience of specialists have been in its use 
as a remedial agent in this specific disease. Mr. Ailing- 
ham, surgeon to St. Mark's Hospital for fistula and other 
diseases of the rectum, says : " I have read in American 
pamphlets that the injection of carbolic acid into internal 
piles for the purpose of effecting radical cures is very com- 
monly practiced in America, a so-called secret remedy. 
This treatment is strongly advocated by Dr. Cook, of the 
Kentucky School of medicine, who obligingly sent me this 
essay upon the subject." 

After carefully reading Dr. Cook's pamphlet, I did not 
feel quite satisfied he had made out a good case for the car- 
bolic acid treatment. In fact, he only relates the history of 
two persons on whom he had performed injections, etc. 
Again, he Says : "Many American surgeons who came to 
see the practice at St. Mark's, have repudiated the treat- 
ment in sound terms, and call it uncertain and dangerous."" 
Dr. Matthews, of Louisville, has kindly sent me his pam- 
phlet, (read before the Kentucky State Medical Society in 
1S7S), and in that paper he endeavors to show that the in- 
jection of the acid into a pile is painful and inetficient, and 
that death is to be feared [a) from peritonitis; (b) from em- 
bolism, (c) from pyaemia. He adds : *' for my own part. 1 
am much inclined to agree with the opinions of Dr. Mat- 
thews. I tried the injection plan on some few cases, but 
the result was much pain : more inflammation than was 
desirable, a lengthy treatment, and the result doubtful: cer- 
tainly not a radical cure." '"All attempts to destroy vascu- 
lar growths by causing a coagulation of blood or inflamma- 
tion in them, while they are not shut off from the general 
circulation, must be fraught with danger. You can have 
no guarantee that the coagulum may not break down, and 
minute particles of dead tissue find their way into the 
vascular or lymphatic systems, and result in embolism or 
pyaemia, or both. Perchloride of pure sulphate of iron and 



16 The Peoria Medical Monthly. 

ergot act in the same manner as carbolic acid, but a similar 
danger awaits them, and this, I submit, outweighs the ad- 
vantages they are said to offer." In conclusion, I will say 
I have met over one hundred cases that had been treated 
by some one of the above methods before coming to me. 
The universal verdict has been that it is very painful, and 
I am certain ineffectual, and a large proportion of them cer- 
tainly very much debilitated, either from the therapeutical 
effects of the drug, or from the excruciating pain they had 
undergone. 



Akt. IV.— From Telescope to Microscope. By C. B. Maclay, A. M., M. D.^ 
Delevan, 111. 

Of course it is a great stride, but the science of medi- 
cine is capable of taking just such a stride; and certainly 
it is a matter of supreme satisfaction to know we are 
masters of the entire field. It is better, as a rule, to look 
at home, anyway, and to know a little well than to scatter 
your thoughts with your vision all over the depths of space. 
It is a glorious privilege, however, in the midst of concen- 
trated rays to be permitted to hold old fogy views and,, 
when our more youthful and enthusiastic brethren find a 
grand specific or unfold the germ and revel in the society 
of baccilli or cystierici, to pursue the even tenor of our 
way, going on in the beaten path to success, if not to fame.. 
When the Listeric cloud rises before our vision, and the 
great men of the profession are enveloped in its glamour, 
how we chuckle as results most satisfactory are attained 
minus the nickel-plated atomizer! But to be serious, it is 
a good thing to be allowed to entertain one's own theory 
and to go on prescribing after one's own prepossessions. 
The idea that in all degenerative changes microscopic liv- 
ing beings might be discovered is a very old one, even cele- 
brated by the poets of olden time as undoubtedly true, for 
do we not read : 

" Little fleas have lesser fleas, 

And they even less to bite 'em ; 
And these have yet much smaller fleas, 
And so, ad infinitum ! " 



Original Communications. 17 

Science, then, may not shake out her feathers and ex- 
claim, " Great is Diana of the Ephesians ! " when she dis- 
covers the sportive bacilli, for the poet has gone far beyond 
her. The germ theory in some form does seem reasonable; 
yea, may be conceded to be very near the truth, but that 
contagious or septic matter is organic or vital and creates 
disease by preying upon living tissues and transforming 
them into tuberculous or other forms is not as easily re- 
ceived by the perceptive faculties as the supposition that 
inorganic poisonous matter, with which these bacilli, for 
example, are intimately related, acts chemically upon the 
tissue, where it has by some means found lodgment from 
impaired vitality or loss of organic power to excrete. That 
decaying substances should immediately furnish a fruitful 
field for the operations of animalcules need hardly be 
spoken of, nor that the atmosphere undoubtedly is full of 
germs. The poison of spiders, bees, snakes, as well as that 
of some vegetable, is undoubtedly of a chemical character 
and transforms the tissues by chemical action. True, it 
has been noticed that even the fluids of some plants, like 
animal blood, have microscopic discs, showing tendency to 
a peculiar motion, and thus might arise a belief that poisons 
are atomic in structure ; and, in fact, it would not be hard, 
under the present scientific regime, to make the world be- 
lieve that every thing is life, and that all changes of every 
■description are simply, to us, new methods and new forms 
of vital energy ! 

But however we may philosophise, it is pretty evident 
that disease is simply a condition, an abnormal condition 
•of the economy of any part thereof, resulting from contin- 
ued interference by some agent or influence with the vital 
processes. Living forms of various dimensions and qual- 
ities seem to come and go with impunity to the system for 
the most part, and only when detained or caged give rise 
to diseased action. It is true, however, that very many 
.systems are able to tolerate the presence of foreign bodies 
of a vennicula character, for many years. The organs that 
have to do with excretory processes, when we give them a 
fair chance, seem sufficiently reliable, and it is wonderful 



18 The Peoria Medical Monthly. 

how much impure air can be breathed, and unwholesome 
food eaten, and nauseous water drank with impunity, if a 
sufficient amount of exercise in the open country air can be 
daily taken. Nature has not left us a prey to invisible en- 
emies, nor need we fear them morally or physically if we 
observe nature's methods. Amongst scientific physicians 
there is not enough of physical practice. There is too 
much disposition to attempt a sudden restoration. Quacks, 
as they always operate in the popular direction, have no 
doubt disgusted the profession and prevented many from 
endorsing and acting on really wholesome plans. Enor- 
mous doses of medicine, inducing violent cathartic, diuretic^ 
sudorific or emetic effects, or the administration of power- 
fully sedative mixtures too often are given to minister to 
the prejudices of bystanders or in forge tfulness of the " vis 
medicatrix naturae." It shall be a glad day for mankind 
when food medicines shall come to the front and the physi- 
cian is more concerned about nutrition than excretion. 

One very great benefit the discussion of the germ theory 
must bring, and that is, the prescription ot remedies that 
have an anti-morbific effect, and are more or less cleansing,, 
purifying, deodorizing, such as the fruit acids, the hydro- 
chlorate ammonia, chloride of sodium, chlorate of potassa,. 
nitrate of potassa, permanganate of potassa, glycerin, tar- 
taric acid, bitartrate of potassa, salicylic acid and thew^hole 
cinchona family. In this catalogue we must not forget our 
old friend, the sulphate of magnesia, to be received, not in 
the old fashioned dose, one, two or four tablespoonsful, but 
by the thimbleful, and that well diluted and made palata- 
ble by some agreeable admixture. Also, in the mortal fear 
of Hahnemannism or negative practice, too often excellent 
permanent results are lost. Habit, the reiteration of the 
same act, or periodicity, as is so often met with in the ab- 
normal operations of the body, may be overcome by a 
knock-down dose, but experience proves the gradual return 
to a natural condition more likely to be permanent and 
complete. When the ancients turned their feeble glasses 
to the heavens, they imagined they could read of impend- 
ing disaster to man's body ; now when the moderns bring 



Notes from Private Practice. 19 

their excretions to the ppwerful microscope, they think 
they find the disaster has happened. In either case the 
body was or is the subject. It shall be well if no more 
mistakes are made in observation now than were made 
then. 



§oU$ |rom irivate iractire. 



Akt. I —Retained Placenta. By Wm. H. Veatch, M. D., Carthage, 111. 

In twenty-seven years experience, it has never fallen 
to my lot to meet a case of so strange a nature as the one 
herein delineated. 

On the 23d of March last, I was called to attend Mrs. J., 
aged 34 years, the mother of five children. Had been con- 
fined seven and a half months before with her last child; 
has never miscarried; never had a premature labor; has 
never had any difficulty in her confinements, or getting up 
after; was always out of bed by the tenth day, and had re- 
sumed her household duties within two weeks. 

Says the doctor had considerable trouble in obtaining 
the after-birth, but by strong efforts and considerable de- 
lay, it suddenly gave way while he was pulling on the cord, 
and felt as if it had torn loose, but did not give her any 
pain, and the doctor remarked with a smile of satisfaction, 
" there, you are through." 

She suffered no after-pain, nor did she flow as much as 
usual. After two or three weeks, she began suffering with 
pain in the back, or rather in the hips or coupling, and she 
was told by her physician that it was on account of her too 
early rising from her bed, and her hard work too early after 
confinement. 

At the end of four and a half months of misery in the 
back and general poor health, with a sensation of fullness 
in the abdomen, and a tendency to bearing down when she 
went to stool, she " came unwell," as she expresses it, and 
has fiowed continuously ever since. She has taken medi- 
cine from several physicians and has been ordered to her 
bed, and retained the recumbant position for weeks at a 



'20 The Peoria Medical Monthly. 

time, but " no doctor" has ever examined the womb since 
she was confined. 

The abdomen has been tender all the time, and fre- 
quent flushes of fever, lasting from two to twenty-four 
hours, would come on and disappear without treatment. I 
found her much exhausted and extremely nervous. A pale, 
trembling tongue, and without pulse in the radial artery. 
A digital examination per vaginum, revealed that the uterus 
was much too large, extremely tender to the touch, and the 
cervix so irritable that the slightest touch produced extreme 
rigidity. 

I ordered stimulants internally, and dry heat to the ab- 
domen and extremities, and the following powder every 
four hours: ferri. sub. sulph. grs. 3, with morphia, sulph. 
grs. i. 

After following this plan for about forty-eight hours, 
the flowing ceased, and in a few hours labor pains came on 
,and I was summoned to her bed side. 

A great change had taken place in the appearance of 
the patient. The pulse was full, the face was flushed, and 
a warm, free perspiration covered the whole surface. A 
digital examination per vaginum, revealed a large, fleshy 
mass protruding from the uterus, and filling the vagina 
almost to the vulva. Two fingers clasped the mass, and 
slight traction brought it away. My first impression was, 
that it was a mole, but on a more thorough I found it to be 
n placenta, almost entire. The cord had been severed from' 
its central attachment, taking with it a portion of the pla- 
<?enta, lacerating the covering membranes, and leaving the 
foetal surface partly denuded. The maternal surface was 
fresh, and had the appearance of recent detachment from 
the uterus. There was no putrid odor emanating from the 
mass, and no coagula followed. She had no farther pain 
and no farther hemorrhage. I did not see her again, but 
was informed that she made a good recovery. 

The peculiar features in this case are, — 

1st. That she had no hemorrhage for four and a half 
months. 



Notes from Private Practice. 21 

2nd. The length of time the placenta was retained 
after the birth of the child, seven and a half months. 

3d. That the uterus did not take oh action to get rid 
of the foreign body within its cavity. 

4th. That when the flow began it was only passive, 
but continuous. 

5th. The absence of putrefaction of the retained sec- 
ondines. 

6th. The entire absence of septicaemia. 

7th. Last, but not least; that such a case could have 
escaped the notice of a medical man, who had ever seen or 
handled a placenta, and that such consummate quackery can 
be tolerated in the State of Illinois. That our law makers 
cannot see the fallacy of allowing such ignoramuses to con- 
tinue this quackery in the face of as intelligent a State 
Board of Health as has ever been placed at the head of a 
great and growing state, simply because they happened to 
have been practicing their quackery ten years before the 
law took effect. 

In all my experience I have not met so novel a case, 
and one exhibiting such consummate quackery. 



Art. II.— Retained Placenta. By M. S. Marcy, M. D. Princeville, 111. 

On April 14 I was called five and one-half miles in the 
country to attend Mrs. R., age 37, plethoric, prirapara. 
Pound she had given birth to a child about four hours pre- 
vious. Child was small, eight months, and lived a few 
moments after birth. Patient had had no pain since the 
child was born, and but very little hemorrhage. I made 
a digital examination at once, and found the placenta could 
not be removed without trouble. I administered chloro- 
form and directed the husband to continue the anesthetic, 
while I attempted to remove the placenta. After annoint- 
ing my hand and forearm and sprinkling the same with 
iodo^rm, I introduced my hand into the womb and found 
an "hour-glass" contraction, with the placenta just beyond 
and firmly attached to the fundus. I tried in vain for two 
hours to dilate the stricture. Notwithstanding the patient 



22 The Peoria Medical Monthly. 

was fully under the influence of the anesthetic, the stric- 
ture would not yield. I put her on opium in sufiicient 
doses to control pain and inflammation, ordered vaginal 
injections of hot water and iodoform every three hours, hot 
fomentations over abdomen, era^ot in one-half teaspoon- 
ful doses every three hours, and cinchonidia in 5-grain 
doses mixed with 5-grain doses of iodoform, to try and 
prepare her system to meet that dread enemy, septicsemia. 
April 15 found patient complaining of general pain and 
soreness over abdomen. Continued same treatment. She 
remained in about the same condition until April 17, when 
she had a " hard chill," as the messenger stated. Called 
Dr. Charles in consultation, and after giving her an anes- 
thetic, he attempted to remove the placenta, but only suc- 
ceeded in removing a few small pieces. Continued same 
treatment. April 18 found patient worse ; had had an- 
other chill, was very restless, lips purple, anxious expres- 
sion, felt suffocated, and had every symptom of septicaemia. 
We decided to stop the opium and substitute whisky, which 
we gave her in tablespoonful doses every half hour. She 
began to improve at once, and next morning found her 
decidedly better. Continued the whisky every half hour 
for forty-eight hours with no signs of intoxication ; then 
lengthened the intervals. April 18, five days after con- 
finement, the placenta came away very much decomposed. 
The patient then made a rapid recovery. 

My object in reporting this case is to influence other 
physicians to try the whisky treatment in septicaemia from 
whatever cause. 



Akt. III. — Case of Obstinate Constipation of Bowels Cured by Electricity and 
3Iassage. By F. J. Shipp, M. D., Petersburg, 111. 

, Mr. W., age 65, is quite an active man for his years ; 
has been troubled with obstinate and persistent constipa- 
tion for the last twenty-five years, not having any desire to 
go to stool, unless a purgative had been taken, and has 
tried almost everything coming in this class of remedies. 
He consulted me March 10th. I then commenced giving 



Notes from Private Practice. 23 

him treatment with electricity and massage combined. 
First used the galvanic current, from four to eight cells, 
from five to fifteen minutes each treatment, negative elec- 
trode on abdomen, commencing at the ascending portion 
of the colon and following up the track. I then gave mas- 
sage in same way. Four weeks later, and for the first time 
in many years (without having taken a purgative), he had 
desire to go to stool, attended the call, and was surprised 
to have an evacuation of the bowels, and has continued the 
same each day for the last three«weeks. The patient thinks 
he is cured, but will continue treatment the same as above 
for a few w^eeks longer. During the first four weeks of my 
treatment, I gave the patient the improved compound 
cathartic pills, three at night. 



Akt. IV.— a Happy Terminus of an Ovarian Abcess. By W. H. Veatch, 
M. D., Carthage, 111. 

Mrs. B. was married in January, 1882, at the age of 
thirty-five years. I was consulted on the 26th day of March 
following, and found her with the following train of symp- 
toms: Headache, sharp pain in the region of the heart or 
pericardium, heavy aching pain in the region ot the right 
ovary, extreme irritation of the stomach, vomiting bilious 
matter, obstinate constipation of the bowels, alternate 
chills and flushes of heat, pulse small and quite rapid, no 
appetite, but on the contrary there was a thorough disgust 
for food, and with all, extremely nervous. 

Her menses had been regular up to the time of her 
marriage, but had failed to appear the first period after 
that event. She had been troubled with a sore place in her 
side for several years, and whenever anything was ailing 
her, that side never failed to present its claims for a share 
of attention. That her physician had always expressed a 
great anxiety about her side, but had never told her why 
he was anxious, or explained the nature of her trouble to 
her. 

On examination, I found a tumefied condition of the 
right ovary, with extreme tenderness and hardness of that 
organ. ^ 



'24 The Peoria Medical Monthly. 

Her treatment consisted of febrifuges, anti periodics 
and nervines, with extensive counter irritation over the 
enlarged ovary. 

In a fev^ days her husband informed me that she was 
doing well, but that the ovary was yet tender. 

The counter irritation was continued, and I heard no 
more from her until sometime in May, her husband in- 
formed me that the menses had returned and she was feel- 
ing quite well. 

She was now able to attend to her household duties 
which were very burdensome, for she had the care of the 
milk from ten cows, and the butter all to care for. 

On the 15th of August I was again summoned and saw 
her. The same train of symptoms were present as in 
March before, except a more pronounced fever of a typho- 
malarial type, was present. She had failed to menstruate 
in June and July, and it had almost reached her period in 
August. The treatment enforced was almost the same as 
in March, with the addition of antiseptics. 

I feared she was pregnant, although few of the ordinary 
symptoms were present. I attended her until the 9th of 
September, before I considered her condition was safe to 
leave without active treatment. 

At this time the tumefied ovary was at least 3A inches 
in diameter. I had began to think seriously of ovariotomy 
as soon as the hot weather was over, but the tenderness 
began to abate and the hardness subside, and she got better. 

On the 10th of December I was consulted by her hus- 
band in regard to a swelling of the external genitals on the 
right side, and a pulpy feeling tumor protruding from the 
vulva. I could not determine as to its nature from what 
he said, and told him I had better see her. He said he 
would consult her and let me know on the morrow. I heard 
no more from her for several days, when he informed me 
that on his return she said " the thing had bursted," and 
had discharged a great amount of pus. This gave great 
relief. 

We were fully satisfied before this that she was preg- 
nant, and that we must look for her confinement in March- 



Notes from Private Prpctice. 25^ 

In January, another discharge of pus took place, and 
a^ain in February, at each period the discharge continuing 
several days. After this, there was no more discharge and 
no more pain in the side, or swellmg of the vulva. I now 
began to prepare her for her confinement. I greatly feared 
that the sack of pus was gathering in some other situa- 
tion, and would give her trouble in her parturition. 

On the 20th of March, however, she was delivered of a 
healthy female child. The labor being natural and of or- 
dinary duration. On the 4th of April she left her room,, 
and on the 15th, she visited a sick neighbor lady a mile 
away, and at this writing, April 21st, she is attending her 
household duties, and feeding her child as if nothing 
had happened her. She feels no more tenderness in the 
region of the right ovary, and claims that she is well. 



Art. v.— How to Cure a Felon. By J. M. Hole, M. D., Salem, Ohio. 

We have seen in various medical journals at different 
times, how to cure felons. We have never seen our cure 
published, and we will give anybody fifty dollars who will 
try our cure and it fails. Well, so far so good. Now for 
the cure : 

Take common salt, roast it on a hot stove until all the 
chlorine gas is thrown off, or it is all dry as you can make 
it. Take a teaspoon ful, and also a teaspoonful of pulv'd 
Castile soap, add a teaspoonful of Venice turpentine, mix. 
them well into a poultice and apply to the felon. If you 
have ten felons at once, make as many poultices. Renew 
this poultice twice a day. In four or five days your felon 
will, if not opened before your poultice is first put on, 
present a hole down to the bone where the pent up matter 
was before your poultice brought it out. If the felon has. 
been cut open, or opened itself, or is about to take off the 
finger to the first joint, no matter, put on your poultice, it 
will stop it right there, and in time your finger will get 
well, even if one of the first bones is gone. Of course, it. 
will not restore the lost bone, but it will get well soon.. 
Try it. 



26 The Peoria Medical Monthly. 

Akt. VI. — Senile Gangrene — Aminitation of Leg: Recovery. By A. J. 

Mitchell, M. D., Wheeler's Grove, Iowa. 

On November 23, 1882, 1 was called to see a Mr. Henry 
Clinton, Irish, aged 64, farmer, single. Found him suffer- 
ing from "felon on thumb ; thought it started from wound 
of sand burr." Found thumb gangrenous ; bone dead. 
Amputated same next day. Put him on tonics and iodide 
potassia with syr. iodide iron, having first moved bowels. 
A few days after above operation called again and found 
other thumb swollen, painful, and with dark purple spots 
on palm, or surface. Made two free incisions, poulticed 
wel'l, and parts healed readily. By this time had diagnosed 
senile gangrene. Continued above treatment. 

About February 9, 1883, was called again. This time 
right foot was the part affected ; whole foot swollen, skin 
tight and glazed, dark red. Used poultices, fomentations, 
etc., locally, with elevated position of foot, but all to no 
purpose — for foot in a few days gave signs of formation of 
pus. Opened freely, having as many as twelve openings at 
a time. Patient now on port wine, quinine and iron, four 
times a day, with the following bitter tonic : 

5 Tr. gentian co., 
Tr. cinchonia co., 

Syr. simplex, each 2 ounces. 

Tr. ginger, 2 drachms. 

Spts. frumenti, 10 ounces. 

M. Sig. A tablespoonful four times per day. 

This treatment was continued throughout. 

Foot becoming gangrenous, on February 26 amputated 
leg at above the junction of middle with lower third 
Anterior flap being little else than skin ,and very poorly 
supplied with blood, soon sloughed. On March 4 ampu- 
tated thigh about four inches above knee, by lateral flap 
method. For three days wound gave appearance of unit- 
ing by first intention ; indeed, upper one-third did so over 
end of bone, but the middle third of wound (from before 
backward, taking thigh in upright position) soon showed a 
spot the size of a silver quarter, which turned black, be- 
came very ofi'ensive to smell, and sloughed off. This 
opened cavity in stump about two. and one-half inches 
long, with sides widely separated, and about two inches 
deep, lined by a tough white membrane. Cleaned wound 



Notes from Private Practice. 27 

thoroughly. After treatment was cleanliness. Injections 
into wound of carbolized wash, strapping to bring sides of 
cavity together, aiid dressing of carbolized cosmoline ; good 
diet, and above treatment internally. Patient now able to 
go on crutches; wound entirely healed. Complains of 
swelling in other foot in evening. Said by his neighbors 
to look better than he has for a year back. 

Patient a farmer, batching, does his own cooking ; said 
to do without having clothing washed, very miserly and 
has been living so in his present place of abode for the 
past twelve years. 

In performing the above operations the only help I 
had was my father, who administered the chloroform, and 
the man with whom Clinton was stopping, who acted as 
my assistant. 

Art. VII.— Cracked Nipples. By J. H. Bexcher, Athens, Clark County, Mo. 

Permit me to occupy a small space in your valuable 
journal in relating the best treatment for cracked nipples 
that I have ever tried. This condition had bothered me a 
great deal until I concluded that the local application of 
the sub-nitrate of bismuth might be of benefit. I prepared 
it as follows: 

Bismuth ,sub nit., 2 drachms. 

Vaselini, 1 ounce. M 

8ig. Apply to the nipple each time after the child has 
nursed, and cover with a soft cloth. The ointment should 
be washed off before applying the child again to the breast. 
This remedy may not be anything new to many of your 
readers, but it may help some who have never tried it. 
With me the results have been perfectly satisfactory. 

Complaint has often been made that grapes grown in 
the vicinity of gas-works possess the disagreeable odor and 
taste of gas-tar, and it has been supposed the fruit absorbed 
this volatile substance from the air. Recent investigations 
prove, however, that the odor and flavor of the grapes are 
due to the fact that the sap of the vine absorbs them from 
the soil. If disagreeable odors may tlius find their w^ay 
into the grape, why, by a similar artificial process, may not 
grapes and, indeed, other fruit, be possibly flavored to suit 
the taste, however varied and whimsical ? 



28 The Peoria Medical Monthly. 



South Bend, Ind., April 21, 1883. 
Editor Peoria Medical Monthly: 

Let me say through your paper that I like the article 
by Dr. Allen on quackery, simply because he has come to 
the same conclusion in twenty-three years that I have 
reached in thirty-five years, viz., the educated business 
quack is very apt to do business when the ethical scholar 
will sit in a lonesome office. The fault, I think, is not so 
much the man's as the ethics of the profession. Let the 
profession adopt as an article of ethics the principle that 
its members may put forth their merits before the public 
as other business men do, and ignorant quackery would 
not be able to compete with them. But while the ethical 
man with merit is sleeping in his office, the uneducated 
and small merit is being advertised all over the country, 
and the masses are being solicited for patronage, and it is 
given simply because asked for, and though not the best 
qualified at first, exiDcrience makes the expert, and success 
in every way follows. I can but think the profession are 
doing an injury to its best talent and the public at large by 
their restrictive ethics. There must and will come a 
change. Physicians ot recent graduation and aspiring men 
will sooner or later break away in such numbers as to 
broaden the ethical code to suit the necessities, or a new 
national society will be formed, with liberal ideas to suit 
the times; not, perhaps, in my day, but yet I hope to see 
the day when a man educated and well qualified for any 
specialty can so advertise his merits as to command public 
patronage and yet hold the respect a.nd esteem of his breth- 
ren. 

I also feel pleased with the article on microscopy, and 
hope Dr. Curtis will give the subject such an airing as will 
cause the profession to wake uj) to the importance of the 
subject. When I attended lectures a microscope was not 
thought of, and I feel my ignorance to-day, and must con- 
fess that I feel too old to commence regularly, yet I have 
strong desire to see and know the little fellows that make. 



Correspondence. 2^ 

such strong claims for my body and those of my patients, 
that we have been thus far unable to resist their claims, 
I feel somehow they are to be respected like Bucher's hill 
that he constructed in imitation of a mountain. Perhaps 
when we become better acquainted with those strange be- 
ings, with strange names, we may be able to persuade them 
to let us enjoy these bodies a little longer. And if they 
won't be persuaded we will make them unfit for their food, 
even. 

I hope the doctor will tell us where they come from^ 
so we can destroy their nests, eggs and all. I believe it 
can yet be done, and our science will have the semblance 
of a science at least when it shall be done. 

In closing, let me say I like your paper very much. Of 
course some things don't agree with my antiquated and 
heterodox notions, but I like it all the better for that, for 
if you and your contributors did not tell me some things 
different from my belief and opinions, I would stop the 
paper at once. My experience teaches me every few days 
some of my ignorance. So I know there is a chance to 
learn. Send on your paper, I will not forget to send your 
dollar soon. Yours, etc., 

Geo. W. Carpender, M. D. 



New York, April 14, 1883, 

Editor Peoria Medical Monthly: 

In my last I noticed briefly and in a general way some 
matters of professional interest in this city, and will now 
take the liberty to particularize somewhat as to professional 
institutions, methods and men, as I happen to view them. 
As my attention is being devoted mostly to investigations 
in a single branch of the healing art, what I have to say 
will, as a matter of course, lean for the most part in that 
direction. The subject of gynecology is an interesting and 
important one, and anything in regard to it seldom falls- 
upon unwilling ears: 

I wish in the first place to say a few words in regard 
to the hospital and dispensary accommodations here. It 



30 ^ The Peoria Medical Monthly. 

really seems as though, taking all grades together, they are 
almost innumerable. Many are supported by city and 
county funds, such as Bellevue, Charity, Maternity, Ward's 
Island, Smallpox, and other hospitals, and the dispensaries 
connected with them. Then there are numerous hospitals 
and dispensaries solely for purposes of charity, sustained 
by societies of different orders, systematic contributions, 
bequests and the like ; such for instance as Mount Sinai, 
supported by the Jewish population of New York, New 
York Hospital, Woman's Hospital, the German Hospital, 
etc. Then again there are a number of strictly private hos- 
pitals for pay patients, such as those of Dr. T. G. Thomas 
and Dr. Emmett. 

Of course those institutions under the management of 
the Board of Public Charities and Correction (subject as it 
is to the changes of political fortune), are not the models 
of excellence that they might be, but have connected 
with them medical men of the highest standing, who 
make the best showing possible under the circumstances. 
Bellevue presents a nice appearance from the river, 
but its interior, with its narrow passage-ways, open 
wood -work, uneven masonry and low ceilings, creates 
any but a favorable impression upon the visitor. Charity 
Hospital presents much the same condition, and one ex- 
periences a noticeable feeling of relief at departure from 
within its massive walls. How different with those insti- 
tutions of a semi-private character, such as Mount Sinai 
and the Woman's Hospital. The former is located well 
Tip in the city, on Sixty -sixth street, and presents an 
appearance of wealth and refined management both out- 
side and in ; broad corridors, high ceilings, well lighted 
and well ventilated wards, etc. So with the Woman's 
Hospital, founded I believe by J. Marion Sims. It has one 
whole block of ground devoted to its uses, and consists of 
two large building of several stories each, separated from 
each other by about seventy-five feet of space, in which is 
located the steam-heating and other apparatus. The yard 
level is about a dozen feet above that of the sidewalk or 
streets, and the whole presents about as good hygienic ad- 



Correspondence. 31 

vantages as one could well imagine in the midst of a great 
city. The interior of the bailding presents large, roomy- 
halls and stair-cases, high ceilings and well appointed apart- 
ments for patients, nurse training, etc. The strictly pri- 
vate hospitals are of course strictly in keeping with the de- 
mands of the class that patronizes them. 

The institution furnishing, in my experience, the most 
abundant clinical material, is the German Dispensary, at 
65 St. Mark's Place. In point of diagnostic advantages the 
student in gynecology will find it unsurpassed, on account 
of the very great abundance of constantly increasing ma- 
terial, and the fact that only two persons are admitted as 
student assistants at one time, thus giving every opportu- 
nity for close personal examination of every kind of case. 
This clinic is under Drs. Garrigues and Kucher. The dis- 
pensary has recently received bequests to the amount of 
a couple of hundred thousand dollars, and will no doubt 
ere long burst into bloom as a fully equipped hospital. 
One of the best gynecological clinics in the city is that of 
Dr. Paul F. Munde, given at the Polyclinic Medical School. 
Only eight members of the class are admitted to the clinic 
room at one time. The students are permitted to exam- 
ine each case in turn. The Professor then questions each 
one as to the diagnosis, prognosis and treatment, corrects 
errors and explains the nature of the case and its treat- 
ment. His explanations are always very full and explicit. 
Dr. Munde is one of the most energetic, hardest worked 
men I ever saw. He took hold of the American Journal of 
Obstetrics when it was practically begging for lite, and has 
succeeded in making it a power in the land, even to the 
extent of silencing its competitor, and his work on minor 
surgical gynecology is a marvel of fullness and accuracy to 
be the production of one so young in years. I might, in 
this connection, remark that Dr. Munde told me a few 
days ago that he was engaged on a revision of his work 
above mentioned, which would in time appear as a publi- 
cation separate from the library of medical authors. The 
latter I esteem as a sensible idea. One dislikes to be 



32 The Peoria Medical Monthly. 

obliged to purchase half a dozen undesirable works in 
order to secure one desirable one, 

I have had the pleasure of attending many operative 
clinics, at the several hospitals. The general plan of pro- 
cedure is about the same in each. Many operations are 
performed here for the relief or cure of prolapsus uteri, by 
resection of the vaginal wall and restoration of the peri- 
neal body. I saw in the woman's hospital operations for 
the lacerated cervix, in which the laceration was apparently 
so slight that I would never have dreamed of an operation 
being desirable, let alone necessary. But I was informed 
by Drs. Emmett and Lee, that numerous patients, who en- 
ter the hospital suffering from anaemia, backache, and all 
the distressing symptoms with which physicians are so 
familiar, after being operated upon for the removal of 
cicatricial plugs, from the angles of a lacerated cervix, re- 
cover their health and become stout and hearty. It seemed 
to me incredible, but the hospital statistics prevented an 
expression of opinion. I never was in an institution where 
there seemed to be as much genuine gentlemanly feeling 
and professional courtesy, on the part of both internes and 
attending medical men, as in the Woman's Hospital. It i& 
a pleasure to visit amongst them. 

Two days ago I saw", in the service of Dr. Garrigues, at 
Maternity Hospital, the only case of vaginal and uterine 
diptheria in a puerperal woman that ever fell under my 
notice. The labia, vagina and cervix uteri were all com- 
pletely covered with exudations. The treatment there 
adopted, with the most favorable results, consists in the lo- 
cal application of solution of chloride of zinc, one to one 
of water, by means of a hair pencil, and injections into the 
uterus of the same drug, in the proportion of one to twelve 
of water, with the addition of a few drops of hydro chloric 
acid to promote solution. Diphtheria is said to be one of 
the most fatal maladies to which puerperal women in 
hospitals are subject, and as cases occasionally occur in 
private practice which are mistaken for other affections, it 
is well to keep in mind the possibility of this disease, and 
any remedy which has proven worthy of confidence in 



Book Notices. 33 

other hands. I find, however, that my time is up for this 
evening, and as I have already dravp^n this letter to undue 
proportions, will close for the present. 

0. B. Will, M. D. 



t00fe §Oti«lSI. 



TLe Practitioner's Ready Reference Book. A Handy Guide in Office and 
Bedside Practice. By Richard J. Doxjnglison, A. M., M. D. Third Edition, 
Thoroughly Revised and Enlarged. Cloth; 8 vo., pp. 530; P. Blakiston, Son 
& Co., Philadelphia. Price, |3.50. 

The aim of the author, as expressed in the preface to 
the first edition, was to provide information of a purely 
practical character in a compact and tangible shape for 
ready reference. With this end in view he collected an 
immense number of facts, hints and suggestions, which are 
of use to every practitioner, but which he may not be able 
to lay his hands on when wanted. The work is divided 
into four general sections : First, general information, 
under which we find paragraphs on weights and measures, 
covering twenty pages ; solubility of medicines in various 
liquids, abbreviations, comparison of thermometric scales, 
and reference tables of weights, measurements and specific 
gravity. 

The second section is Therapeutic and Practical Hints. 
Under this we find the Hippocratic oath, rules for the 
practitioner, medical etiquette, doses of medicine, doses for 
children, doses of remedies in general, for hypodermic use, 
for inhalation, for gargles, suppositories, enemata, etc.; 
baths and how to medicate them, hints as to prescribing, 
hygienic and therapeutic treatment of infants, tables of 
differential diagnosis, obstetric memoranda, examination 
of the urine, poisoning and antidotes, to prevent the spread 
of diseases, how to use the hypoderniic syringe, battery, 
thermometer, etc. ; suggestions for nursing ; to prepare 
stained sections of animal tissues, etc., etc. 

Section third is on Dietetic Preparations and Precepts. 

Section fourth is How to Conduct a Postmortem Ex- 
amination. 



B4 The Peoria Medical Monthly. 

The above is but a brief outline of the contents of 
this work, which we feel confident will be found one of the 
most useful and practical ever placed upon the physician's 
table. 

The Microscope and Its Revelations. By William B. Carpenter. C. B., M. 
D., L.L. D., etc. Sixth Edition ; Illustrated by 26 plates and 500 wood en- 
gravings; 8 vo. ; cloth ; pp. 387. New York: Wm. Wood & Co. 

The publishers of Wood's Library of Standard Medi- 
cal Authors, have certainly placed their subscribers under 
renewed obligations to thena, in including in their series 
this valuable work on microscopy. We say valuable, not 
because we are able to judge of the work and its merits 
from our own knowledge of the subject, but it must have 
* value, else six editions would not have been called for; and 
because the name of its author is sufficient f o stamp it as 
worthy a place in any library. 

The author has intended this as a manual of micro- 
scopy, therefore he has begun at first principles and gives 
everything necessary to a complete understanding of the 
uses of the instrument, by any person of ordinary ability. 

Fifth Annual Report of the State Board of Health, of the State of Connecti- 
cut, for the year ending Nov. 30, 1882. Printed by order of the Legisla- 
ture. 8 vo. ; cloth ; pp. 458. From the Secretary of the Boa-rd, Dr. C. W. 
CSianiberlain. 

The Health Board of Connecticut is certainly to be 
congratulated upon having presented such a report. It is 
one of the most complete and interesting that we have 
ever seen, and will compare favorably with any published. 
The report shows an earnest appreciation, on the part of 
the members and officers of the Board, of the necessity of 
advanced sanitation and the education of the medical pro- 
fession and the people in the laws of hygiene. 

Besides the usual general reports, the volume contains 
several papers of great hygienic value. Among which may 
be noted: Hatting, as affecting the health of Operatives; 
Protective Inoculation; Impure Ice; Some of the Organic 
Impurities found in Drinking Water; Transmission of Dis- 
ease by Milk; Microscopical Examination of Potable 
Waters; Epidemic Intermittent Fevers; How can we es- 
cape Insanity; and some others. 



Book Notices. 3^ 

pamphlets and reprints. || 

Clinical Notes on Opium Addiction. By J. B. Mattison, 
M. D.; Brooklyn, N. Y. To be had of the author. 

Hand Book of Medical Electricity. By A. M. Rosebrugh, 
M. D., Toronto. Paper. 16mo., pp. 54. 

The Best Method of Treating Operative Wounds. By 
Henry 0. Marcey, A. M. M. D., etc. Paper. 16mo., pp. 16, 
Reprint from Med. Gazette. 

Otitis Media Purulenta. By Dudley S. Reynolds, M. 
D. 12mo., pp. 8. Paper. Reprint from Med. and Surg, 
Reporter. 

Death from Lightning. By Thomas H. Hammond, M. 
D. : pp. 4. Reprint from St. Louis Med. and Surg. Journal 

The Pathology and Morbid Anatomy of Tubercle. By 
N. Senn, M. D., Milwaukee, Wis. 8vo. Paper ; pp. 33. 
Reprint from translations of the State Medical Society of 
Wisconsin. 

The Opium Habit :' Its Successful Treatment by the 
Avena Sativa. By E. H. M. Sell, A. M. M. D. 8vo. Paper ; 
pp. 32. To be had of the author, 222 West 21st street, New 
York City. 

Seventh Biennial Report, of the Board of State Com- 
missioners of Public Charities of the State of Illinois. F. 
H. Wines, Sec'y- Paper; 8 vo.; pp. 140. 

Secondary Batteries and the so-called Storage of Elec- 
tricity. By Roswell Park, A.M., M.D. 8 vo.; paper; pp. 16, 
Reprint from the Med. Jrl. and Examiner, Chicago. 



The following resolution was recently adopted by the 
Illinois State Board of Health : ''Resolved, That under the 
recent decision of the Supreme Court of the State of New 
York declaring the charter of the United States Medical 
College of New York null and void, this board can no 
longer legally recognize the diplomas of that institution. 



Peoria Medical Monthly. 



THOS. M. McILVAINE, A. M., M. D., 

Editor and Publisher, 

204 South- JeflFerson Street. - . - - PEOBIA. ILIi, 

***The Editor is not responslbie for the statements or opinions of contributors. 

***Short original articles are invited from any reader, whether a snbscaiber or not. 

***If extra copies are desired by a contributor, the number must be specifled when 
the article is sent in to the Editor. 

*** All exchanges, books for review, and communications must be addressed to th 
Editor and Publisher. 

***The publication day of this journal Is on or about the 15th of each month 

♦**To subscribers! A pencil mark at this place indicates that the time of your sub- 
ficription has expired, and that a prompt renewal is urgently requested. 



C^^itorial §t^nxtmtnt 



Volume IV. 

With this number begins the fourth year of publica- 
tion of this journal, and we wish at this time to again 
thank those who have taken so much interest in our work 
in the past, and bespeak for the future a kindly continua- 
tion of their assistance. 

It was long ago predicted that this publication would 
Ibe a failure, and that it would hardly reach a second year, 
certainly not a third. But such has not been the case, and 
The Peoria Medical Monthly begins its fourth year with 
greater encouragement than ever before. Its circulation 
is no longer local or sectional, but national, and its readers 
are beginning to appreciate it as a medium for putting on 
record the results of their experience. 

Perhaps one reason of our success may be found in the 
fact, that we were content to wait. We did not set our 
aim too high, and when a thousand subscribers did not 
send Id their names during the first year, we shut our teeth 
hard and determined to wait for the results of the second 
and third years, resolving to do our best and feeling confi- 
dent that success would come with time, and it did. 



Editorial Department. 37 

Homoeopaths and the Code of Ethics. 

The ball which was set in motion by the New York 
State Society has, as our readers well know, not yet 
stopped rolling, and it is entirely beyond the power of 
those who gave it the first impulse, to check or guide its 
course, however much some of the clearer-headed of their 
number might wish so to do. One legitimate and natural 
result of the movement to amend the Code of Ethics in 
any other than the proper way, has come to the surface in 
Chicago within the past few days. 

In the Chicago Times of Saturday, May 5, 1883, will 
be found an article headed '' Medical Ethics; The Code to 
be Abolished," etc., from which we make the following 
extracts : 

"The homoeopathic physicians of Cfiicago are prepar- 
ing to meet the question which is soon to cause an up- 
heaval of excitement along the ranks of the medical pro- 
fession, now that the time is drawing near for the meeting 
of the American Medical Association, which comes off in 
June next at Cleveland. Last night there was a secret 
meeting of a number of homoeopathic physicians at the 
Sherman House, to talk over the bist plan to be pursued 
to abolish the medical Code of Ethics which prohibits the 
so-called regular practitioners from consulting with a 
homoeopathist." 

Following this is a brief account of the recent " row " 
in the New York Academy of Medicine, which resulted in 
the defeat of the liberals. It then continues : 

" The liberals issued a call upon the members of the 
medical profession throughout the country to unite with 
them 'in freeing the profession from a stigma it has borne 
quite long enough.' The object of the meeting last night 
was to see whether it would not be well to bring this issue 
to a focus here in Chicago. The fact that noted old-school 
doctors in New York have cut aloof from the old code and 
started this liberal movement, which they ask shall be 
taken hold of all over the country, was gratifying to those 
present last night, and it was decided to start the ball in 
motion here, and prepare for a meeting which wall secure 



^^ The Peoria Medical Monthly. 

the sense of the medical profession in Chicago on the sub- 
ject of removing all barriers which exist in the codes of 
national societies, whereby one set of practitioners refuse to 
consult with those of another." 

We suppose the "call issued to the profession through- 
out the country " was sent principally to homoeopaths, since 
we xiave not heard of any regular physician having received 
it, and it is eminently proper that the New York liberals 
should call upon the homoeopaths to assist in breaking 
down the barriers against dogma in science. We are glad 
that this movement has come to the light, and we hope it 
will be remembered by every one who attends either the 
several State Societies or the American Medical Association. 



t 
Please Stand Corrected. 



The St. Jfiseph Medical Herald, in noticing the receipt 
of the first number of the Home Health, says: "The journal 
IS intended to be a sort of a medico-literary journal, family 
hygienist, etc. We have our doubts as to the propriety of 
its mission, but if any one can make it a success it is Dr. 
Mcllvame, and we hope that he will." 

Now dear brethren, don't you know that, if you have 
any doubts as to the propriety of the mission of Home 
Health, you should not wish for its success, but should 
frown it down— set down on it as hard as you possibly can? 
If you think it is to be a family medical journal, or a quack 
concern of that kind, you ought to discountenance it in 
every way you can. But we are happy to inform you that 
such is not to be, at least while we have anything to say 
about it. 

It is our intention to make it a purely sanitary journal^ 
and one that will be read in the family and by all the mem- 
bers of each family. To do this, to induce people to read 
it, it would not do at all to make it too scientific at the 
start. There is no subject upon which the people need 
more instruction than that of physiology, sanitation and 
hygiene; but there are plenty of text-books upon these sub- 
jects. Why don't they read them and be instructed? Sim- 



Editorial Department. 39 

ply because these books are too technical and scientific; 
they scare their would-be readers by their title pages. 

Our object is to put this knowledge into a more simple 
and pleasing form, and thus secure its wider dissemination. 
Again, Home Health is not to take the physician's place in 
any manner; but it will aid him in his labors, and we be- 
lieve it will be to his interest to assist in its spread. That 
the people want something of this kind is evinced by the 
wide spread and immense circulation of trashy family med- 
ical journals, printed with some other view than the honest 
instruction of their readers; this being true, is it not a duty 
for any one who can, to give the people that which is above 
and better and more scientific? We hope we have answered 
some objections which we knew might be raised against 
our new journal, and those who have misunderstood our 
aims will please stand corrected. 



Receipts. 

To save the time and expense requisite for sending a 
formal receipt to subscribers, we have for some months 
past adopted the plan of printing in this place the names 
of those from whom money has been received during the 
preceding month. Those remitting will please note 
whether their names are included in the lists, and if they 
are not will notify us by card : 

Illinois — Drs. T. A. Scott, J. N. Speed, M. A. Bentley, J. A. Har- 
yQj, C. T. F. Stringer, E. H. Plasch, A. B. Allen, B. C. Smith, H. L. 
Pratt, John Wilson, W. W. Adams, A. Stillwell, R. C. Poos, C. C. Allen, 
George Bratton, D. S. Jenks, W. Wilson, John Cole, H. Gulick, J. L. 
Brown, Elizabeth S. Norred, John TenBrook, Silas Hubbard, E. T.Wood, 
(2 years), W. D. Caldwell, W. N. Cline, C. L. Hatfield, D. C.VanStavern, 

H. J. Tillotson, Brannon, W. J. & C. Chenoweth, C. Park, W. H. 

Githens, W. S. Hendricks, B. F. Farley, C. M. Miller, F. G. Steever, S. 
K. Page, Thomas Temple, J. E. Charles, A. L. Norris, E. F. Cleveland, 
Julius Gunther, Thos. A, Horine, G. P. Ransom, J. R. Chatham, W. H" 
Veatch, C. T. Dripps, Wm. Becker, Robert Boal, E. H. Keith, H. M" 
Boldt, F. p. Eldridge, M. F. Rolens, A. R. Small, J. S. Blankenship, L. 
E. Keeley, F. J. Shipp, A. W. Green, W. P. Eraser, Thos. Killough. 

Iowa — Drs. L. N. Singer, A. White, Jas. T. Youngman, N. Udell, 
B. H. Reynolds, John North, (2 years), W. T. Cobb, T. B. McWilliams, 



40 The Peoria Medical Monthly. 

William Dickey, D. W. Eobinson, W. H. H. Gable, C. M. Martin, J. C. 
Lovejoy, J. C. Marietta, E. J. Yager, S. A. Cooper, VanZandt & Grifl5th, 
C. L. "Warner, N. S. Craig, A. L. Brooks, A. Watkins, W. C. Cummings, 
A. J. Mitchell, W. F. Graham, Z. E. Funk, H. C. Hull, C. C. Ferrell, 
J. D. Elliott, G. T. Nelson. 

Nebraska — Drs. C. Schenck, Thos. H. Line, J. Hoover. 

Minnesota — Drs. H, G. Murdock, W. H. Smith, R. L. Moore, J. 
W. Thompson, A. W. Hill. 

Ohio— Dr. H. L. Baker. 

Dakota — Drs, P. J. Wood, A. V. Benedict. 

Kentucky — Drs. S. D. Winters, Duncan & Douglas, S. F. Canter, 
H. D. Crosby. 

Kansas — Drs. G. E. Knickerbocker, R. L. Hoffmeier. 

Persia — Dr. E. W. Alexander. 

Wisconsin — Drs. Fred C. Werner, D. K. Freeman, W. Hanna, H. 
C. Giles, C. D. Eckley, W. G. Kemper, Ed. Puchner, M. H. Fisk. 

Maryland — Dr. J. I. T. Long. 

Michigan — State University Library, (2 years). 

Colorado — Drs. C. B. Richmond, (2 years), Alexander Rixa. 

Indiana — Drs. J. H. Arburn, E. L. Larkins, E. Walker. 

Missouri — Drs. J. H. Bencher, J. J. Jones. 



Eemember that subscribers to the Peoria Medical 
Monthly will receive Home Health for half price, or only 
$1 a year. We are gratified to find that the medical pro- 
fession is taking so much interest in our sanitary publi- 
cation. 

During the session of the Illinois State Medical So- 
ciety, to be held in Peoria May 15, 16 and 17, there will be 
issued a daily edition of this journal, to consist of about 
twenty pages, with cover. This edition will contain a full 
report of the proceedings of the Society, reports, ofiicers, 
committees, etc., besides being a complete hand-book of 
the city for the use of our visitors. 

For Sale. — Physician^s property, consisting of residence, office, etc., 
at a railroad station in Central Illinois. Ten miles by wagon road and 
seven miles by railroad from Jacksonville, Illinois. Practice estab- 
lished twelve years, by the present owner. No opposition. Address, or 
apply to. Dr. T. A. Wakely, 

Sinclair, Morgan Co., 111. 



[DAILY EDITION.] 



The Peoria 
MEDICAL MONTHLY. 



TUESDAY, MAY 15, 1883. 



Illinois State Medical Society. 



OFFICERS FOR THE YEAR 1882-3. 

President — A. T. Darrah, Tolono. 
First Vice-President — L. G. Thompson, Lacon. 
Second Vice-President — W. A. Byrd, Quincy. 
Treasurer — J. H. Hollister, Chicago. 
Permanent Secretary — S. J. Jones, Chicago. 
Assistant Secretary — Thos. M. Mcllvaine, Peoria. 

MEMBERS OF JUDICIAL COUNCIL. 

One Year— Robert Boal, Peoria ; E. R. Willard, Wil- 
mington ; A. T. Darrah, Tolono. 

Two Years — C. Truesdale, Rock, Island ; C. Gdodbrake, 
Clinton ; A. K. Van Horn, Jerseyville. 

Three Years— E. Ingals, Chicago ; F. B. Haller, Vanda- 
lia ; Wm. Hill, Bloomington. 

STANDING COMMITTEES. 

Practice of Medicine — N. S. Davis, Chicago; B. M.Grif- 
fith, Springfield; J. F. Todd, Chicago. 

Surgery — J. E. Owens, Chicago; J. T. Stewart, Peoria; 
M. Reece, Abington. 



2 The Peoria Medical Monthly. 

Obstetrics — E. L. Herriot, Jacksonville; G. W. Jones, 
Danville; E. A. Ingersoll, Canton. 

Gynecology — David Prince, Jacksonville; C. Chenowith, 
Decatur; E. S. Norred, Lincoln. 

Ophthalmology and Otology — S. J. Jones, Chicago; J. 
P. Johnson, Peoria; J. G. McKinney, Barry. 

Drugs and Medicines — T. J. Pitner, Jacksonville; Her- 
bert Judd, Galesburg. 

Necrolog}'^ — E. Ingalls, Chicago; William Hill, Bloom- 
ington; Washington West, Belleville. 

SPECIAL COMMITTEES. 

Simple Renal Catarrh — I. N. Danforth, Chicago. 

On the practicability and desirability of separting the 
work of teaching in medicine and licensing to practice — 
D. S. Booth, Sparta; E. P. Cook, Mendota; M. A. McClellan, 
Knoxville. 

The diagnostic peculiarities of malignant growths — 
Christian Fenger, Chicago. 

Analysis of a certain class of remedies, concerning 
which physicians are not positive as to their therapeutic 
value — W. L. Ransom, Roscoe. 

COMMITTEE OF ARRANGEMENTS. 

J. Murphy, Chairman; A. S. Adams, J. H. Reeder, J. P. 
Johnson, J. T. Stewart, T. M. Mcllvaine, ex-officio. 



Peoria and Its Surroundings. 

It is not our intention to boast of the size, beauty or 
wealth of this city, but to give sufficient information to 
enable our visitors to ii:ore thoroughly enjoy themselves 
while here. 

Peoria is now the second city in the state ; the direc- 
tory canvass for 1883 has just been completed giving, 18,- 
000 names, which by the usual methods of computation 
would make our present population about 54,000. 

The principal business interests of Peoria are, the man- 
ufacture of highwines and glucose, the grain trade (about 
30,000,000 bushels of grain are handled here annually), the 



1 



Daily Edition. 3 

wholesale drug, grocery, dry goods, boots and shoes and 
hardware business, and the manufacture of agricultural 
implements. Ten lines of railroads center here, and two 
more will enter during the present year. 

To so describe the city as to enable a stranger to locate 
all points of possible interest without further aid, would 
require more space than is at our disposal for that purpose, 
but we will outline the " lay of the land " as clearly as pos- 
sible. 

The river, just at the city, runs nearly east and west, 
(at least near enough to follow), and the principal streets 
run parallel and at right angles to it. The city below 
the bluff occupies an irregular plateau, trom a half to one 
mile in width, and extending along the river about four 
and a half miles. Water street faces the river front. In 
its upper part we find the immense building of the Peoria 
Grape Sugar Refinery, seven stories in height, further down 
the Stove Works covering half a block. A few blocks below 
is found the elegant new Union Depot, just completed, 
some 460 feet in length, and just below that the immense 
freight house over 600 feet long. Below this point Water 
street is nearly covered by tracks, between which and the 
river are found the distilleries which have made Peoria 
famous throughout the world. Here, too, are immense 
grain elevators, "A" and "B", "Advance", "Union", etc., 
with a combined capacity of over 2,000,000 bushels of grain. 
Should time permit we would advise such of our visitors as 
have the inclination, to visit this part of the city. Here 
he will find distilleries using 6,000 bushels of corn each 
daily, and paying from $18,000 to $20,000 daily internal 
revenue. In this connection it might be of interest to state 
that this city pays to the internal revenue nearly $15,000,- 
000 every year, or more than that paid by any state in the 
Union excepting Illinois. 

Next above water street comes Washington. On the 
upper part (near Main) are the banks and wholesale houses ; 
further down stands the Chamber of Commerce (visitors 
admitted " on 'change " by introduction of a member) ; be- 
yond this and extending west to the city limits are found 
manufactories of various kinds. 



4 The Peoria Medical Monthly. 

Higher up one street comes Adams street, extending' 
from the Water Works above to the city limits below, the 
full length of the city, or about five miles, traversed 
throughout its full extent by street cars. This is the retail 
street of Peoria, and on clear days presents a busy sight. 
The Court House faces on this street, and tw^o blocks below 
is found the new Masonic Temple, nearing completion. 
The number of fine business blocks on this street, either 
just finished or still in process of erection, will give the 
stranger some idea of Peoria's rapid growth. 

Above Adams comes Jeff'erson, Madison, Monroe and 
Perry streets. On Jefferson will be found the Public Li- 
brary, Postoffice, New Hotel and Peoria Club House. 

These streets all run parallel with the river. Of those 
running at right angles to it, Main street is the most im- 
portant. It divides with Adams street the retail trade of 
the city, and is solidly built up for many blocks. 

Rouse's Hall, the place of meeting, is on Main street, 
near the corner of Jefferson, and just opposite the Library 
block. 

The new government building is to be built on Main 
street ; it will cost about $250,000, but will not be finished 
for several years yet, as the excavation has only just been 
begun. 

The Opera House is on Hamilton street, or the one 
next east to Main. The Congregational Church is a fine 
stone edifice on Hamilton, two blocks from the New Hotel. 

Many of the finest residences are found along the face 
of the bluff. The Main street line of horse cars go up the 
west bluff, and a short walk on Bluff street will give the 
finest view of the city to be had from any single point. 

A drive of four miles to Prospect Hill will richly repay 
any one who delights in fine scenery. The view from 
Mount Prospect has been declared to be one of the finest 
that can be found in the state. 

Springdale Cemetery will be found worthy of a visit. 



Daily Edition. 5 

Exhibit Notes. 

In the smaller hall, to the ri^ht of the main auditorium 
at Rouse's Hall, will be found the exhibit of drugs, chem- 
icals, pharmaceutical preparations, instruments, batteries, 
etc., which will be of interest to physicians. 

W. S. Merrell Chemical Co., of Cincinnati, have the 
same display here that will reiDresent their house at Cleve- 
land, in charge of Mr. Clark. 

Parke, Davis & Co., of Detroit, have a large exhibit of 
their goods in charge of Dr. Thackery. 

John Wyeth & Bro., of Philadelphia, have a small but 
elegantly arranged display of their well know specialties, 
ill charge of Mr. Ross. 

McKesson & Robbins, of New York, exhibit a line of 
their pills and some of their rarer alkaloids, Mr. Evans rep- 
resenting their house. 

Dr. Mcintosh, of Chicago, the well known inventor of 
electric batteries, is here with a full display of his special- 
ties, including microscopes, solar microscopes, batteries, 
etc., etc. 

Mr. Williams represents the Trommer Extract of Malt 
Co., of Fremont, Ohio. He gives some simple tests to show 
the superiority of his goods over those of other manufac- 
turers. 

Allaire, Woodward & Co., manufacturing pharmacists 
of this city, do not have any regular display of their prod- 
ucts, but offer a cordial invitation to every physician to 
visit their laboratory and look around for themselves. The 
entrance to their establishment is at 110 Main street. 

M. W. Shultz & Co., of this city, dealers in surgical in- 
struments and physician's supplies, desire all members to 
make their store (118 North Adams street, opposite the 
main entrance to the Court House) headquarters while in 
the city. This firm has an elegant store, filled with a full 
line of instruments, drugs, and everything needed by the 
physician. They desire to call especial attention to their 



6 The Peoria Medical Monthly. 

office cases, designed for the use of physicians who dispense 
their own medicines. 

Doctors and mackerel have this in common, that they 
are seldom caught out of their own schools. 



Arrangements have been made with the various rail- 
roads running into Peoria, to return delegates and mem- 
bers at reduced rates. All who have paid full fare coming 
to this city, will receive return tickets at one-third rates. 
In order to secure this reduction each person must have a 
certificate to that effect, signed by the Secretary of the 
Committee of Arrangements, Dr. Mcllvaine, who can be 
found at the secretary's desk in the hall. 



The hotel accommodations of Peoria are, we are sorry 
to say, proverbially poor. We were promised that the new 
hotel would ^e finished and ready for guests by the time of 
this meeting, but were disappointed. We have made ar- 
rangements to have as many visitors as cannot be accom- 
modated at hotels, entertained by citizens at private houses. 
The reception committee, of which Drs. Hamilton, DuMars, 
Boal, Jones, W. A. Johnson and Charles are members, will 
be at the hall this morning to provide places for our guests. 



From all sources of information, we have reasons for 
believing that this meeting will be the largest ever held by 
the State society. We would not be surprised should four 
hundred register as members during this week. 



The members of the 33d Annual Meeting of the Illinois 
State Medical Society can feel assured of a heartj^ welcome 
on the part of the citizens of Peoria. Our people take an 
active interest in strangers a.nd always try to make them 
feel as much at home as possible. 



To-morrow morning we will give a full report of 
to-day's proceedings, list of members and delegates pres- 
ent, and so far as can be ascertained, where each are enter- 
tained ; a programme for the succeeding days, and every- 



Daily Edition. • 7 

thing that a physician may want to know about the meet- 
ing, A full time card of all the railroads will be given in 
each issue. 



Many physicians take considerable interest in secret so- 
cieties. For their benefit we give in to-day's issue a list of 
such organizations and times of meeting. 



Weather permitting, the Peoria City Medical Society 
will entertain their guests by a carriage drive through the 
city and over the bluffs, on Wednesday afternoon at 4 
o'clock. In the evening a promenade reception will be 
held at Rouse's Hall, to which a large number of citizens 
have been invited, and a general social good time is ex- 
pected. 

The hospital resources of Peoria are, St. Francis' Brad- 
ley Hospital, and the Cottage Hospital. St. Francis' Hos- 
pital is situated on the East Bluff about one mile from the 
Court House. It is a commodious brick structure, contain- 
ing about forty beds for patients, and is in charge of the 
Sisters of St. Francis, a well known charitable order. Cot- 
tage Hospital is in charge of a board of citizens, both gen- 
tlemen and ladies. It is situated on the corner of Second 
and Fisher streets, and has accommodations for twenty 
patients. The Monroe street cars pass the door. Both 
hospitals are attended by staffs of well known physicians 
and surgeons of the city, and will compare favorably with 
similar institutions in any city of this size. Members of 
the State Society will be cordially welcomed at either 
place, and shown around. 



Visitors should not leave the city without visiting the 
Grand Opera House. Its interior decorations are beautiful, 
and are not excelled by those of any opera house or theater 
in the West. 



This is our first attempt at publishing a daily, and we 
hope any errors will be kindly overlooked by our friends. 



8 The Peoria Medical Monthly. 

We will do our best to make this edition both interesting 
and profitable to our guests. ^ 



The dismal success of an attempted evening session at 
Quincy last year, will, we hope, deter any attempt from 
being made here to hold night sessions. Two long sessions 
during the day are sufficient to tire the members, and the 
evenings should be devoted to recreation. 



The Peoria Club House, adjoining the New Hotel build- 
ing, was for some years the home of the famous Robert G. 
Ingersoll. The building then stood on the corner, and was 
moved when the hotel was started. 



Societies. 

MASONIC — BLUE LODGES. 

Peoria Lodge No. 15, meets last Monday of each month. 
Temple Lodge No. 46, meets last Wednesday of each month. 
Illinois Lodge No. 263, meets second and fourth Tuesdays. 
Schiller (German) Lodge No. 335, meets last Friday of each month. 

CHAPTER. 

Peoria Chapter No. 7, meets first Thursday of each month. 

COMMANDEHY. 

, Peoria Cpmmandery No. 3, meets first and third Fridays. 

ANCIENT AND ACCEPTED SCOTTISH RITES. 

Central City Grand Lodge of Perfection, meets first Thursday of 
each month. 

Peoria Obuncil, Princes of Jerusalem, meets second Monday of each 
month. ' 

Peoria Chapter of Rose Croix, meets third Monday each alternate 
month. 

Peoria Consistory, meets fourth Monday of February, May, August 
ancl November. 

KNIGHTS OF PYTHIAS. 

Calanthe Lodge No. 47, regular convention every Tuesday evening. 

ODD FELLOAVS. 

Columbia Lodge No. 27, meets every Tuesday evening. 
Fort Clark Lodge No. 109, meets every Monday evening. 
Weistern Lodge' No. 295, meets every Thursday evening. 



[DAILY EDITION.] 



I 



The Peoria 
MEDICAL MONTHLY. 



WEDNESDAY, MAY 16, 1883. 



Transactions of the Thirty-third Annual Meeting- of the Illinois 
State Medical Society. 

First Day, May 15, 1883. 

MORNING SESSION. 

The meeting was called to order in Rouse's Hall, 
Peoria, 111., at 10 o'clock a. m.. by the President, Dr. A. T. 
Darrah, of Blooraington, 111. 

After prayer, offered by Rev. J. C. Bruce, the Chair- 
man of the Committee of Arrangements, Dr. John Murphy, 
of Peoria, made a brief but very appropriate address of 
welcome, to which Dr. Wm. Hill, of Bloomington, re- 
sponded on behalf of the Society. 

Dr. Murphy then read the report of the Committee of 
Arrangements, which was adopted. 

A telegram from. Dr. H. H. Mayard, a delegate from 
the Iowa State Society, expressing his regrets at not being 
able to be present, was read by the Secretary. 

Dr. W. L. Ransom, of Rockford, a special committee 
on " The analysis of a certain class of remedies, concerning 
which x)hysicians are not positive as to their therapeutic 
value," reported progress, and at his own request was con- 
tinued another year. 



2 The Peoria Medical Monthly. 

The time for the report of the Committee on Practice 
of Medicine was set for 2 o'clock this afternoon. The re- 
port on Surgery to follow. 

The report on Obstetrics was set for Wednesday morn- 
ing. The report on Drugs and Medicines to follow. 

The report on Gynecology was set to follow the re- 
port on Surgery. 

The report on Ophthalmology and Otology to follow 
that on Drugs and Medicines. 

The Committee on Necrology was set to report this 
evening at 7 o'clock. 

The special committee on the "Practicability and de- 
sirability of separating the work of teaching in medicine 
and licensing to practice," was set for this evening. 

The report of Dr. Walter Hay on the " Commitment of 
the Insane," was ordered to follow the above in regular 
order. 

The following titles of volunteer papers were handed 
to the Secretary, and the time for their reading was set 
for Wednesday, at 2 o'clock p. m. : 

Report of Epidemics of Marshall County. By Dr. L. Gl. 
Thompson, of Lacon. 

Case of Deformity, etc. By Dr. B. F. Crummer, Warren. 

Cause and Prophylaxis of Infantile Diarrhoea. By Dr. 
John Murphy, Peoria. 

The World Progresses. By Dr. J. S. Whitmire, Meta- 
mora. 

The President then read his annual address, which was 
listened to with great interest, although its length was con- 
siderable. 

The Society then adjourned to meet at 1.40 p. m. 

AFTERNOON SESSION. 

Dr. N. S. Davis read the report of the Chairman of the 
Committee on Practice of Medicine. 

Following this Dr. B. M. Griffiths of Springfield, and 
Dr. J. F. Todd of Chicago, members of the same committee, 
read supplementary reports. 

The above reports were, on motion, received. 



Daily Edition. 3 

Discussion on the subjects presented in the papers was 
participated in by Drs. S. C. Plummer of Rock Island, J. P. 
Walker of Mason City, and B. F. Crummer of Warren. 

Dr. J. R. Wells of Geneseo, made the motion, which 
was carried, that Dr. N. S. Davis give his views on Vene- 
section in Pneumonia. 

This was done by Dr. Davis to general satisfaction. 



List of Deleg-ates Registered. 

Dr. T. J. Pitner, Jacksonville, Morgan County Medical 
Society. «* 

N. S. Davis, Chicago, Chicago Medical Society. 

Ira R. Wells, Geneseo, Iowa and Illinois Central Dis- 
trict Medical Society. 

David S. Booth, Sparta, Southern Illinois Medical 
Society. 

A. Wetmore, Waterloo, Southern Illinois Medical 
Society. 

John L. Hamilton, Peoria, Peoria City Medical Asso- 
ciation. 

J. E. ('harles, Peoria, Peoria City Medical Association. 

H. Judd, Galesburg, Military Tract Medical Society. 

R. Park, Chicago, Chicago Medical Society. 

J. Cozad, Reynolds, Iowa and Illinois Central District 
Medical Society. 

A. K. Van Horn, Jersey ville, Jersey County Medical 
Society. 

G. W. Nesbitt, Sycamore, De Kalb County Medical 
Society. 

C. Goodbrake, Clinton, DeWitt County Medical Society. 

C. Armstrong, CarroUton, Medical and Surgical Society 
of Western Illinois. 

A. J. Mcintosh, Allendale, Wabash County Medical 
Society. 

S. L. B. Blacke, Tonica, North Central Illinois Medical 
Society. 

W. L. Downey, Wenona, North Central Illinois Medi- 
cal Society. 



4 The Peoria Medical Monthly. 

Dr. F. Cole, El Paso, North Central Illinois Medical Society. 

R. A. DuMars, Peoria, Peoria City Medical Association. 

L. H. Spalding, Peoria, Peoria City Medical Associa- 
tion. 

Joseph Studer, Peoria, Peoria City Medical Associa- 
tion. 
•G. M. Kellogg, Carthage, Hancock County Medical 
Society. 

0. J. Roskoten, Peoria, Peoria City Medical Associa- 
tion. 

J. A. Robinson, Chicago, Chicago Medical Society. 

E. T. Goble, Earlville, Notth Central Illinois Medical 
Association. 

T. M, Cullimore, Concord, Morgan County Medical 
Society. 

G. W. Albin, Neoga, Esculapian Medical Society of the 
Wabash Valley. 

J. T. Brady, Cooperstovvn. Brown County Medical As- 
sociation. 

C. Barlow, Eaton, Crawford County Medical Society. 

J. F. McKenzie, Leroy, McLean County Medical Society. 

B. H. Harris, Groveland, Tazewell County Medical 
Society. 

H. Steele, Peoria, Peoria City Medical Association. 

M. Reece, Abingdon, Military Tract Medical Society. 

E. F. Purdum, Abingdon, Military Tract Medical Society. 

S. K. Crawford, Monmouth, Military Tract Medical 
Society. 

W. H. Heller, Abingdon, Military Tract Medical Society. 

J. M. Heller, Abingdon, Military Tract Medical Society. 

G. L. Corcoran, Brimfield, Military Tract Medical 
Society. 

N. Holton, Smithville, Peoria City Medical Association. 

N. A. Byrd, Quincy, Adams County Medical Society. 

M. F. Bassett, Quincy, Adams County Medical Society. 

J. S. Whitmire, Metamora, Woodford County Medical 
Society. 

J. W. Whitmire, Metamora, Woodford County Medical 
Society. 



Daily Edition. 5 

Dr. A. F. Rooney, Quincy, Adams County Medical Society. 

M. Rooney, Quincy, Adams County Medical Society. 

Hugh Marshall, Monmouth, Military Tract Medical 
Society. 

Thomas Temple, Cameron, Military Tract Medical 
Society. 

W. G. Piersol, Hermon, Military Tract Medical Society. 

N. Holmes, San Jose, Brainard District Medical So- 
ciety. 

Katharine Miller, Lincoln, Brainard District Medical 
Society. 

C. V. Rockwell, Taylorville, District Medical Society of 

Central Illinois. 
Lucinda H. Corr, Carlinville, Macoupin County Society 
for Medical Improvement. 

E. H. Thurston, Chicago, Chicago Medical Society. 
W. P. Verity, Chicago, Chicago Medical Society. 

R. C. Charlton, Pekin, Tazewell County Medical Society. 
S. W. Jones, Catlin, Vermillion County Society. 
N. J. Hall, Fairfield, Wayne County Medical Society. 
A. M. Drew, Weldon, DeWitt County Medical Society. 

D. E. Thomas, Lacon, North Central Medical Associa- 

tion. 

C. T. Reber, Shelby ville. District Medical Society Cen- 
tral Illinois. 

W. H. McNary, Martinsville, Esculapian Society Wa- 
bash Valley. 

W. S. Holliday, Monmouth, Military Tract Medical 
Society. 

Warren Hunter, Hampton, Iowa and Illinois Central 
District Medical Society. 

F. Jennie Shipp, Petersburg, Brainard District Medi- 
cal Society. 

N. S. Read, Chandlerville, Morgan County Medical 

Society. 
A. S. Craig, Aledo, Military Tract Medical Society. 
C. F. Smith, Danforth, Central Illinois Medical Society. 
David Prince, Jacksonville, Morgan County Medical 

Society. 



6 The Peoria Medical Monthly. 

List of Physicians Registered as Permanent Members. 

Drs. S. J. Jones, Chicago. 
0. B. Will, Peoria. 
S. C. Plummer, Rock Island. 
John H. Ranch, Springfield. 
Robert Boal, Peoria. 
John E. Owens, Chicago. 
John F. Todd, Chicago. 
Walter Hay, Chicago. 
G. W. Jones, Danville. 
G. H. Tebo, Mount Sterling. 

D. S. Jenks, Piano. 
Wm. Hill, Bloomington. 
John Wright, Clinton. 

E. L. Herriott, Jacksonville. 
Ellen Ingersoll, Canton. 

B. F.> Crnmmer, Warren. 
R. E. Rich, Wenona. 

J. T. Stewart, Peoria. 

C. C. Allen, Chillicothe. 
L. G. Thompson, Lacon. 

J. T. Barnes, Bloomington. 

A. T. Darrah, Bloomington. 

C. Truesdale, Rock Island. 
John Murphy, Peoria. 

J. P. Johnson, Peoria. 
T. M. Mcllvaine, Peoria. 
W. T. Kirk, Atlanta. 
J. P. Walker, Mason City. 
L. L. Leeds, Lincoln. 
Anna S. Adams, Peoria. 
Robert Roskoten, Peoria. 
W. H. McNary, Martinsville. 
W. W. Baxter, Mt. Sterling. 

D. T. Douglas, Colfax. 

B. M. Griffith, Springfield. 

C. H. Norred, Lincoln. 
Elizabeth H. Norred, Lincoln. 



Daily Edition, 



Dr. R. W. Crothers, Delevan. 
E. Holderness, Chenoa. 
J. H. Stewart, Exeter. 
G. W. Cox, Clayton. 



Dr. J. H. Rauch, Secretary of the Illinois State Board of 
Health, is here, and will give to those who have not already 
received them, a copy of the Second, Third and Fourth An- 
nual Reports of the Board, and their other publications. 
This report is a valuable one, and a copy should be secured 
and read by every physician in this state. 



Dr. Robert Roskoten, of this city, is the author of a 
drama entitled " Carlotta ", which has received high praise 
from competent critics. A few copies may be found in the 
Exhibit room, for sale at the nominal price of $1.00. 



J. H. Chambers & Co., Publishers, St. Louis, are repre- 
sented in the Exhibit room. They publish the Courier of 
Medicine and the Weekly Review, both excellent medical 
periodicals. Besides these, they publish some very valua- 
ble books which will well repay inspection. 



Members who have not secured places of entertain- 
ment will please make the tact known to the Chairman of 
the Reception Committee, Dr. J. L. Hamilton, or any 
member of the Peoria City Medical Society. 



The Military Tract Medical Society is quite well 
represented, about a dozen having already registered from 
that Society. 



The Illinois State Society is to be congratulated on 
having as a member the Nestor of American medicine. Dr. 



8 The Peoria Medical Monthly. 

N. S. Davis, whose wise counsels are always of value. A 
meeting would not be complete without his presence. We 
are pleased to see that he is in good health. 



Delegates will please call on Dr. Mcllvaine for any 
information respecting return tickets. 



Dr. L. G. Thompson has presented us with a fine speci- 
men of renal calculus taken from the kidney of a cow. It 
is certainly a very curious specimen, and well worthy of 
inspection. 



The registration up to six o'clock yesterday showed a 
very large attendance. 



Visitors should not forget to visit Allaire, Woodward 
& Co.'s Laboratory, and M. W. Schultz & Co.'s Physicians' 
Supply House. 



Dr. Darrah is receiving much praise for the dignity 
and urbanity with which he presides. 



We desire to correct the reading of the advertisement 
ol Geo. C. Frye. Mr. Trefethen desires to call particular 
attention to the emulsion of cod-liver oil made by his house; 
also to the granular salicylic acid. The emulsion is stated 
to be the best in the market. Warranted not to rancify. 
Call at Mr. Trefethen's exhibit and examine his goods. 



To-morrow's edition of The Peoria Medical Monthly 
will contain a full report of last night's session, together 
with to-day's proceedings. 



For Sale. — Office and residence on South Adams street, Peoria. 
Has been occupied by the undersigned for many years. Reason for sel- 
ling, am about to remove to California on account of ill health. Inquire 
of Dr. Jos. Studer. 



[DAILY EDITION.] 



The Peoria 
MEDICAL MONTHLY. 



THURSDAY, MAY 17, 1883. 



Transactions of the Thirty-third Annual Meeting- of the Illinois 
State Medical Society. 

THIRD SESSION — TUESDAY EVENING. 

Society called to order by the President. 

Report of Dr. W. Hill of Bloomington, from the Com- 
mittee on Necrology, was read and received. 

Dr. Booth then read his report from the special com- 
mittee on Medical Education. 

A paper from the same committee, by Dr. M. A. Mc- 
Clelland, Knoxville, was read by Dr. Mcllvaine. 

Dr. S. J. Jones made some remarks on the subject of 
the reports, after which the papers were relerred to the 
Pul)lication Committee. 

Dr. Walter Hay then read his report from the Commit- 
tee on the Commitment of the Insane. 

On motion the committee was continued for two years. 

Dr. W. Hill of Bloomington, moved that a committee 
of three be appointed to report on the Relations of the 
State Board ot Health to the Public. Motiorj carried. 

The chair appointed Dr. Hill,|Dr. Cook, of Mendota, Dr. 
Booth, of Sparta, and Dr. Verity, of Chicago, was given 
time for a sliort volunteer paper to follow Report on Sur- 
gery. 



2 The Peoria Medical Monthly. 

The Report of Committee on Surgery was set for Wed- 
nesday, 9 o'clock, A. M. 

At 9:45 a motion to adjourn was carried. 

FOURTH SESSion — WEDNESDAY MORNING. 

After some preliminary business, Dr. J. E. Owens read 
his report on Surgery. 

Dr. J. E. Stewart, of Peoria, made a report from the 
same committee. 

Dr. Verity made a short report on and exhibition of a 
new apparatus tor applying plaster casts. 

Dr. Prince, of Jacksonville, followed, showing an appa- 
ratus for the distension of the bowel. 

Dr. J, S. Whitmire showed a new truss for hernia. 

Dr. N. Holton read a short paper on dislocation of the 
left kidney. 

Dr. Crummer, of Warren, read a report on a case of 
deformity from effects of nerve injury. 

At 11 o'clock A. M. a recess of ten minutes was taken, 
to appoint a nominating committee. 

Committee on Nominations : Tazewell, B. H. Harris ; 
Woodford, F. Cole ; Knox, H. Judd ; Warren, W. S. Halli- 
day; DeWitt, John Wright; Putnam, J. M. Co wen; Bureau, 

F. C. Robinson; Marshall, K. E. Rich; Cumberland, G. W. 
Albin; Logan, C. H. Norred; Sangamon, B. N. Griffith; Ma- 
coupin, L. H. Corr; Jersey, A. K. Van Horn; Christian, C. 
V. Rockwell; Morgan, T. M. Cullimore; Fulton, Ellen Inger- 
soll; McDonough, P. H. Garretson; Edgar, C. S. Laughlin 
Adams, M. F. Bassett; Mason, M. H. Alderson; Cook, N. S 
Davis; Jo Daviess, B. F. Crummer; La Salle, S. L. B. Blacke 
Greene, C. Armstrong; Vermilion, G. W. Jones; Monroe 
A. Wetmore; Scott, J. H. Stewart; Kendall, D. S. Jenks 
Moultrie, A. A. Williams; Macon, A. C. Chenoweth; Hancock 

G. N. Kellogg; Rock Island, S. C. Plummer; Henry, Ira R 
Wells; Crawford, C. Barlow; Wabash, A. J. Mcintosh; Cass 
M. S. Read; DeKalb, G. W. Nesbitt; Schuyler, H. Davis 
Randolph, D. S. Booth; Peoria, John Murphy; Mercer, A. L 
Craig; Madison, E. W. Fiegenbaum; Shelby, C. T. Reber 
Menard, F. J. Shipp; Iroquois, C. F. Smith; Clarke, J. Mc 
Nary; Calhoun, L. Harriott. 



Daily Edition. 3 

Re-convened at 11:15. 

A motion was carried that all exhibits be removed 
from the rear of the hall. 

The Secretary read several letters and telegrams from 
absent members. 

The report of the Comii:ittee on Surgery was discussed 
by Dr. W. A. Byrd, of Quincy, after which it was referred 
to the Publication Committee. 

Dr. E. S. Norred, of Lincoln, next read a paper from 
the Committee on Gynecology. 

The Society adjourned at 12.30 to meet at 2 o'clock 
p. M. 

AFTERNOON SESSION — WEDNESDAY AFTERNOON. 

The Society met at the appointed hour. 

Dr. Cook, of Mendota, moved that the motion to ex- 
clude exhibitors from the rear of the hall be reconsidered. 
Carried. 

The report of the Committee on the Relations of the 
State Board of Health was read by Dr. Hill, adopted, and a 
copy ordered sent to the Legislature. 

Report of special committee on recommendations in 
President's address : 

Whereas, The Illinois State Medical Association take 
much interest in urging and promoting the formation of 
the State Board of Health, and the results of its work since 
its organization fully justifies the expectations of its friends, 
in protecting the people from professional ignorance and 
imposition, from epidemic diseases and various other causes 
prejudicial to life, and the promotion of a higher standard 
of medical education, thus placing Illinois in the front rank 
in this respect among her sister states. This result is 
largely due to the personal sacrifices of the members of the 
board, the appropriations made by the state having never 
been sufficient to carry out the duties imposed upon the 
board by law. Therefore, be it 

Resolved, That in the opinion of this society it is the 
duty of the legislature of this state, to make such appro- 
priations as will enable the board to carry out the impor- 
tant duties assigned it, by the acts creating the State Board 
of Health and the act to regulate the practice of medicine. 



4 The Peoria Medical Monthly. 

Resolved, That a copy of this preamble and resolution 
be sent to members of the legislature now in session. 

William Hill, 

D. S. Booth, 

E. S. Cook. 

An invitation from the Staff of St. Francis' Hospital to 
visit their institution, was read. 

Dr. Prince, of Jacksonville, and Dr. Chenoweth, of De- 
catur, then read papers from the Committe on Grynecology. 

Dr. N. S. Davis then read the report of the Treasurer. 
Adopted and referred to the Publication Committee. 

The report of the Nominating Committee was read and 
adopted. 

REPORT OF NOMINATING COMMITTEE. 

The committee was organized by electing Dr. N. S. 
Davis Chairman : G. W. Jones Secretary. 

The following is the report of the c'ouimitte : 
Mr. President and Members of the State Society. 

Your Nominating Committee have the honor of pre- 
senting the following names of gentlemen as suitable for 
officers, and recommend their selection for the positions to 
which they are severally assigned for the ensuing year : 

President — Prof. Edmond Andrews, Chicago. 

First Vice President — ^David S. Booth, Sparta. 

Second Vice President — G^o. W. Nesbitt, Sycamore. 

Treasurer — Walter Hay, Chicago. 

Secretary — D. J. Jones, Chicago. 

Members of the Judicial Council for three years — 
Robert Boal, Peoria ; Herbert Judtl, Galesburg ; L. G. 
Thompsou, Lacon. 

Committee on Practical Medicine — J. C. Frye, Peoria ; 
J. W. Hensley, Yates City ; N. S. Pi-eed, Chandlerville. 

Surgery — Roswell Park, Chicago ; D. S. Booth, Sparta ; 
J. D. Whitley, Petersburg. 

Obstetrics— S. R. Crawford,Monmouth ; Ellen A. In- 
gersoll. Canton ; C. Du Hadway, Jersey ville. 

Gynecology — W. S. Caldwell, Freeport : L. H. Corr, 
Carlinville ; A. F. Rooney, Quincy. 

Ophthalmology and Otology— J. P. Johnson, Peoria ; 
Robert Tilley, Chicago ; P. H. Garrettson, Macomb. 

SPECIAL COMMITTEES. 

J. V. Black, Jacksonville, on Oral Surgery. 
Dr. Christian Fenger, Chicago, continued for another 
year. 



Daily Edition. 5 

W. Gr. Ransom, Roscoe, continued. 

C. Truesclale, Rock Island, on Tetanus. 
M. F. Bassett, Quincy, on Vaccination. 

J. P. Mathews, Carlinville, on Diseases of Children. 
A. Wetmore, Waterloo, on Physiology. 

COMMITTEE ON ARRANGEMENTS. 

D. W. Graham, Chicago ; Chas. Gilman Smith, Chicago; 
R. C. Hamil, Chicago; H. A. Johnson, Chicago; E. Ingals, 
Chicago. 

Very respectfully submitted, 

N. S. Davis, President. 
Geo. Wheeler Jones, Secy. 

A report on Epidemics in Marshall County was read by 
Dr. L. G. Thompson, of Lacon. 

The report of the Committee on Drugs and Medicine 
was read by Dr. T. J. Pitner, of Jacksonville, and H. Judd, 
of Galesburg. 



Additional List of Perniaiieiit Memljers and I>elegates 

Present. 

DELEGATES. 

Dr. A. J. Miller, Paris, Esculapian Society Wabash Valley. 

Lee Smith, Bloomington, McLean County Medical So- 
ciety. 

J. P. Matthews, Carlinville, Macoupin County Society. 

H. Parkhurst, Danvers, McLean County Medical Society 

R. W. Gillett, Danville, Vermillion County Medical 
Society. 

E. W. Fiegenbaum, Edwardsville, Madison County 
Medical Society. 
' C. A. Bolinger, Oakford, Brain ard District Medical 
Society. 

A. R. Reynolds, Chicago, Chicago Medical Society. 

M. H. Alderson, Bath, Brainard District Medical So- 
ciety. 

T. F. Worrell, Bloomington, McLean County Medical 
Society. 

Robert Tilley, Chicago, Chicago Medical Society. 

M. D. Hull, Arrowsmith, McLean County Medical So- 
ciety. 

W. S. Hendricks, Ferris, Hancock County Medical So- 
ciety. 

D.W. Aldrich, Galesburg, Knox County Medical Society. 



6 The Peoria Medical Monthly. 

Dr. W. Wilson, London Mills, Military Tract Medical So- 
ciety. 

W. M. Dunlap, Secor, Woodford County Medical Society. 

J. M. Cowden, Rock Island, Iowa and Illinois Central 
Medical Society, 

J. A. Walker, Mason City, Brainard District Medical 
Society. 

H. H. Long, Orion, Iowa and Illinois Central District 
Medical Society. 

P. W. Mendenhall, Ceorgetown, Vermilion County 
Medical Society. 

M. T. Bolsley, Danville, Vermillion County Medical 
Society. 

C. Chenoweth, Decatur, District Medical Society of 

Central Illinois. 

A. N. Williams, Sullivan, Moultrie County Medical 
Society. 

W. H. K. King, Mt. Sterling, Browit County Medical 
Society. 

Lizzie White, Mt. Sterling, Brown County Medical 
Society. 

Cephas Park, Oquawka, Military Tract Medical Society. 

P. G. Manley, Keensburg, Wabash County Medical So- 
ciety. 

E. H. Graves, Tremont, Tazewell County Medical So- 

ciety. 

D. Warren Miller, Gilman, Central Illinois Medical 

Society. 
J. Little, Bloomington, McLean County Medical Society. 

E. M. Patton, Rockford, Winnebago County Medical 

Society. 
L. H. Montgomery, Chicago, Chicago Medical Society. 

PERMANENT MEMBERS. 

Drs. L. D. Dunn, Moline. 

A. F. Burnham, Ashland. 
J. M. Cowan, Hennepin. 
J. S. Miller, Peoria. 
W. 0. Ensign, Rutland. 
J. H. Reeder, Lacon. 
R. A. Chapman, El Paso. 
P. H. Garrettson, Macomb. 
J. W. Spear, Mason City. 
A. M. Sargent, Lincoln. 

F. L. Matthews, Springfield. 
J. L. Connelly, Harristown. 

F. C. Robinson, Wyanet. 
Geo. A. Zeller, Spring Bay. 



Daily Edition. 7 

This being onr last issue, we wish to extend to our 
visitors our hearty thanks for the many expressions of good 
will toward this publication which have come to our ears. 
Owing to the great press of other and more important 
society business, we have not been able to make this daily 
edition as interesting as it should have been had we not 
been otherwise engaged, but we have done what we could 
to add to the pleasure, of our guests by furnishing them 
with such information as we thought would be useful. 

Many visitors have honored us with their names as 
subscribers to our Medical Monthly, and we hope the list 
will be still further increased. We have now hy far the 
largest circulation of any medical journal published in the 
State. 

Hoping that to-day's session will be pleasant and pro- 
fitable, we say good-bye to each one, and express a hope 
that we may all meet in Chicago next year. 



The Managing Director and Superintendent of the 
Peoria Grape Sugar Refinery extended a cordial invitation 
to any and all members of the Society to visit the Refinery, 
where they would be welcomed and shown over the build- 
ing. Mr. E. B. Stewart, the Superintendent, is well known 
in Chicago as a chemist and microscopist, and we need not 
say will spare no pains to make the visit pleasant. 



Several of the exhibits have been removed to the 
Peoria House, where they cannot bother some of the severe 
members of the Society. 



Parke, Davis & Co. 

The exhibit of Messrs. Parke, Davis & Co., is attracting 
universal attention, and in its selection and arrangement 
show that this firm have considered fully the necessities of 
the practitioner. They display their goods in regular gra- 
dation, from the crude material to the finished preparation, 
in the most attractive form, and Dr. Thackeray, their rep- 
resentative, gives all information required, and distributes 
their samples with a liberality which has always character- 
ized this house. 



8 The Peoria Medical Monthly. 

John Wyetli & Co., Manufacturing Chemists of Philadelphia. 

This well known firm make a small and very elegant 
display of a few of their leading specialties, consisting of 
elixirs, syrups, fluid extracts, Lawton's absorbent cotton, 
compound hypodermic tablets, and Fehling's test. They 
also show the impalpable powder of boracic acid, which is 
now so largely used by the medical profession at liome and 
abroad. 

McKesson & Rohhins. 

The beautiful ovoid pills, introduced by McKesson & 
Robbins, of New York, and displayed by Mr. Wm. J. Evans, 
have received a general approval. Nearly all the physi- 
cians have registered on their visitor s list and received a 
neat, desirable pocket case of samples. 



Geo. C. Frye. 

We would call attention to the exhibit of Frye's special- 
ties, and advise all members of the Association not to leave 
the hall without supplying themselves with a case of sam- 
ples, and also one of the elegant surgical instruments. Cat- 
alogues distributed by Mr. A. J. Terfethen, who is represent- 
ing Geo. C. Frye, manufacturing chemist, Portland, Me. 



Wm. S. Merrell Chemical Co. 

The Wm. 8. Merrell Chemical Co. in their large exhibit, are con- 
spicuous for the rare freedom from deposit of undissolved material in 
their fluid extracts. As practiced by them for years, and as now earnestly 
advocated by such authorities as Dr. Bartholow, Dr. Squibb, Profs. Attfield 
and Holmes, of England, and many others of equal note, this house re- 
cognize the necessity of preserving volatile substances in a large number 
of the most valuable American and foreign drugs, and to that end pre- 
serve many in strong alcohol from the hour they are gathered, and to 
serve the same end they import direct from Dresden a number of fluid 
preparations of such standard drugs as Aconite, Hyoscyamus, &c., which 
are prepared from undried materials, and which are found in the practice 
of many of the members of the Illinois State Medical Society, to be un- 
surpassed for purity, uniformity and reliability. 



For Sale. — Office and residence on South Adams street, Peoria. 
Has been occupied by the undersigned for many years. Reason for sel- 
ling, am about to remove to California on account of ill health. Incpiire 
of Dr. Jos. Studer. 



The Peoria 
MEDICAL MONTHLY. 



Vol. IV. JUNE, 1883. No. 2. 



(Di^iflittal C^ammutttatiottisi. 



Art. I— The Mechanical Treatment of Uterine Displacements. A Paper read 
before the Grand Rapids City Medical Society. By O. E. Herrick, M. D., 
54 Monroe street, Grand Rapids, Mich. 

No subject has so taxed the ingenuity of medical men 
or been the theme of so many essays and papers, as that of 
uterine diseases and displacements. Wide apart as their 
theories have been, their treatment and pathology has been 
even more conflicting if possible. Notwithstanding these 
differences of professional opinion, the science of gynecol- 
ogy has moved more rapidly forward towards perfection 
since Dr. Hodge i a vented his uterine pessary, and the in- 
struments devised have become each year nearer to the 
class of instruments known as those of precision. The 
name of Dr. Hodge will always be remembered and men- 
tioned with veneration by the profession, along with other 
great discoverers in medicine ; but his, like other discov- 
eries, should be improved upon as the science of medicine 
moves onward. There has been, ever since Dr. Hodge's 
time, a class of physicians who denounced anything like 
instrumental interference in the treatment of the different 
displacements of the uterus, but so have there been physi- 
cians who denounced vaccination and all other new things 
introduced into the science of medicine ; but that class of 



42 The Peoria Medical Monthly. 

men have been gradually left behind or forced to join the 
rapid moving ranks ot the seekers after knowledge, until 
now the man who does not use some form of mechanical 
device in his treatment of uterine disease is indeed a vara 
avis in the profession, while all teachers of gynecology urge 
the judicious use of pessaries as one of the chief means of 
treatment of those troublesome diseases. Unquestionably 
there are a few physicians yet who stoutly oppose pessaries in 
any form and will continue to treat their patients, who are 
af&icted with displacements, in the future as in the past^ 
with tonics, recumbent position and upon the expectant 
plan generally, maintaining their belief in the efficacy of 
such a plan in the face of the success of their less obstinate 
brother practitioners who treat their patients after modern 
means and notions, even after they see their patients, whom 
they have assiduously plied for years with expectant treat- 
ment, recover under the use of modern measures, they still 
persist that all pessaries do absolute harm, instead of good. 
It is often the boast of those who object to pessaries, that 
" displacement of the uterus seldom cause much harm or 
inconvenience, and that they have known women to go 
about with the os-tinca protruding through the labia for 
many years and yet do all the work for a large family." I 
have heard men of fairly good judgment make just that 
kind of an argument against the use of mechanical sup- 
ports. I do not doubt the statement that they have known 
such cases, for many women do go about and do their work 
in just that condition, but no one but the suffering woman 
herself knows of the untold miseries and the wearied ex- 
istence of such a condition. What a boon a properly ad- 
justed pessary would be to such a woman is never known, 
until she falls into the hands of some practitioner familiar 
with the benefits and application of mechanical supports ; 
then she asks herself why she was not relieved by her fam- 
ily physician, and the query does not redound to his profes- 
sional credit. 

It is a well known fact that all of our most noted and 
successful gynecologists both use and recommend their 
students to use, some kind of mechanical support in the 



Original Communications. 4B 

treatment of uterine displacements, only stipulating that 
they shall make themselves familiar with the mechanics of 
the instrument and the individual abnormity of each case; 
if these tw^o last conditions are not observed, failure must 
surely result, where only success should be obtained. 

Dr. J. Marion Sims said, before the section on Obstet- 
rics and Diseases of Women, at the Detroit Meeting of the 
American Medical Association : "I insist that if gentlemen 
will adapt the instrument properly, it will prove of great 
service. Where failures occur, it is the physician who fails, 
and not the principles of the instrument. Changes must 
occur in the uterus from time to time, and it is only by ex- 
perience, diligent study and research we are able always to 
meet the individualities of a case." Truer w^ords were 
never spoken on the subject of the application of pessaries, 
and if physicians could always have them in mind when 
about to adjust a support to a displaced uterus, failures 
would be of very rare exceptions, and the science of gyne- 
cology would be the gainer. 

Having for a number of years been very closely con- 
nected with the manufacture of pessaries, I have had un- 
usual opportunity for observing physicians' knowledge of 
pessaries and their uses, as I receive and answer hundreds 
of letters upon the subject every year. These observations 
have shown me that large numbers of the profession are 
entirely ignorant of any practical knowledge of the appli- 
cation of pessaries ; much the larger number, however, 
(thanks to modern teachings upon the subject), understood 
the adapting of mechanical supports to the cases in hand. 
Still, there are too many physicians who buy an instrument 
and adjust it without regard to either length, width, size of 
ring, length of vagina, size of uterine neck, or in fact kind 
of displacement the patient is afilicted with ; without stop- 
ping to see whether it conforms with the natural curvatures 
of the vagina, or the axis of uterus and vagina, they intro- 
duce it themselves or let the patient do so in some instances, 
when she is left to remove it or wear it to the end of her 
days. Some physicians write to me detailing their patient's 
symptoms, as told to them by the patient, never having 



44 The Peoria Medical Monthly. 

made an examination per vagina themselves, and upon 
such information ask me to send them an instrument such 
as I think suitable for the case. It is this slip-shod manner 
of adjusting pessaries that helps largely to bring them into 
disrepute. No woman should be left to adjust a pessary or 
uterine support of any kind herself; neither should she re- 
move it herself; far better that none should be used than 
applied without any regard to its fitness for a given case. 
I consider it just as essential to the ultimate recovery of 
the patient, in any displacement of the uterus, to have a 
properly adjusted pessary, as that a proper splint should be 
ajDplied to a fractured bone ; and after a pessary is intro- 
duced it should receive nearly as much attention. 

What would be thought of a surgeon who adjusted a 
splint to his patient's thigh, and then paid no further atten- 
tion to the case? And yet this is exactly the situation with 
a large number of physicians who adjust pessaries, the pa- 
tient in many instances is not even instructed to use daily 
injections of .soap and water, a precaution which should 
always be observed as a matter of cleanliness. In my 
opinion physicians should, if they treat such cases at all, 
treat them to cure the difficulty, and not merely to palliate 
the symptoms. If there is a deformity in the shape of an 
enlarged and weakened vagina from rupture, either partial 
or complete, during child-birth, or from any other cause, 
(for I believe the vagina to be the principal support of the 
uterus) an operation should be performed to reduce it to its 
normal size ; then a proper fitting pessary introduced to 
keep the displaced organ in position until the vagina heals 
and is able to sustain the weight and give the support na- 
ture intended it should. After that is accomplished the 
instrument may. be removed, when the uterus will usually 
remain in place. 

The causes of uterine displacements are so va- 
ried, that it is impossible to point out any one to be 
guarded against to the disregard of others. The most pro- 
lific cause, however, is I believe, to be found in an enlarged 
and weakened vagina. When we consider the anatomy of 
that canal, and notice that external to the mucous mem- 



Original Communications. 45 

brane its walls are composed of fibro-cellular tissue, the mus- 
cular fibres of which, in their normal state, are contracted 
sufficiently strong to throw the mucous membrane into nu- 
merous transverse folds, and which can be contracted at 
the will of its owner, it is very easy to see that anything 
which tends to weaken these walls, or prevent them from , 
being contracted at will, is liable to be followed by descent 
of the uterus, there being nothing to support it from the 
bottom ; consequently, from force of gravity, it descends, 
putting all its ligaments upon the stretch, and causing all 
those distressing symptoms usually met with in cases of 
uterine displacements. I believe that procidentia uteri is 
nearly always preceded by relaxation and dilatation of the 
vaginal walls, either froni child-birth, long continued leu- 
corrhoea, or excessive coitus; or, as in one case which came 
under my observation, where the vagina had been occupied 
for several years by a large fibroid, which distended and 
destroyed the contractibility of the muscular fibres of the 
vagina, so that after the tumor had been removed the vag- 
inal walls did not recover their tonicity. I have rarely seen 
a case of uterine prolapsus without a corresponding weak 
and dilated vagina, and if inquiries are pressed close enough 
we will usually find, in most such cases, some of the above 
mentioned causes to account for the displaced uterus and 
dilated vagina, excepting, of course, such accidental causes 
as the accumulation of liquid in the abdominal cavity, or a 
voluminous, ovarian or other tumor, which may displace 
the organ downward, from the pressure from above, in 
w^hich case the vagina may be natural. In view of this, 
we should be governed by the abnormal condition of the 
vagina, as well as by the kind of uterine. displacement, in 
our selection of a pessary, and choose one which least dis- 
turbs and dilates that canal. A pessary should conform, as 
nearly as possible, to the natural curvatures of the vagina, 
and should be long enough to get as much of its leverage 
as possible ; if it is a pessary sustained in its position by 
outside attachments it should reach the whole leiigth of 
the vagina and protrude, at least one-half inch, so the out- 
side attachments, whether they are elastic straps, rubber 



46 The Peoria Medical Monthly. 

tubes or metal springs, shall not infringe upon the labia or 
entangle the hair upon those parts ; if it is an intra vaginal 
pessary, without external attachments, it should be as long 
as possible, without coming in contact with the horizontal 
ramus of the pubis just above the arch ; it should be long, 
for the purpose of getting as much vaginal leverage as pos- 
sible ; a short pessary that does not get vaginal leverage is 
of no more use than a cotton pledget, and only holds the 
uterus up by distending the vagina, thus causing as much, 
or more, mischief than it remedies ; on the other hand, an 
intra vaginal pessary should not be too long, and never 
long enough to infringe upon the urethra, neither should it 
ever he adjusted so as to 7'est against the horizontal ramus of 
the pubis; that practice is the most pernicious ever thought 
of by the profession, and fortunately there are very few 
advocates of it at the present day. If a pessary is long 
enough to rest against the pubis and be retained in that 
position, it must be wedged in sufficiently tight to not only 
cause intense pain, but to set up inflammation, and if left 
any length of time sloughing will surely follow, and there 
are a number of instances where perforation of the urethra 
has resulted from a pessary so adjusted ; fortunately, it is 
pretty difficult to adjust a pessary so that it will stay in 
that position. An intra vaginal pessary should simply float 
in the pelvis, and be as narrow as consistent with the size 
of the uterus and vagina. The objection to all intra vagi- 
nal pessaries is their liability to abuse, and it is this form 
of pessary that has been misapplied sufficiently to cause all 
the professional distrust which attaches to mechanical sup- 
ports. In the hands of the inventor of each of these, per- 
haps there is little danger of their being misapplied, but it 
is impossible for any one else to understand the inventor's 
intent in some of the intricate shapes of the numberless 
instruments of this class. Quite naturally I prefer a pes- 
sary with an external support, and, aside from my close 
connection with one form of such an instrument, I believe 
they are less liable to be misapplied, and not open to the 
many objections to be urged against intra vaginal supports. 
Each form of uterine support has some commendable 



Original Communications. 47 

features, as well perhaps as some objectionable ones. In 
the cup and stem variety, the principal objection I think is 
in the tact that the uterus fits down into it so closely that 
all air is excluded from the cup, the uterine tissue project- 
ing through the 'little holes in the bottom intended for the 
exit of the secretions, thus hermetically sealing the end of 
the uterus in the cup, and effectually preventing the es- 
cape of its secretions; from this cause is undoubtedly due 
the ulceration which almost invariably follows their use if 
worn any length of time without removal. Another cause 
of this ulceration and irritation is perhaps to be found in 
the fact that the uterus rests its weight upon the extreme 
end of the os, which moistened in secretion constantly 
chafes and rubs against the hard material of which most 
such cups are made. Cups and stems are only useful in 
prolapse, no matter how they are shaped, for the reason 
that no leverage is exerted upon the uterus, as the only 
force applied is upward ; if a cup with an extended lip is 
used, the force is simply applied at the end of the os and to 
the posterior cul-de-sac, and only prevents the uterus from 
tipping farther over, but does not exert a particle of force 
toivards the bladder, and if it could do so, instead of reduc- 
ing the displacement to the normal position, it would only 
produce anteflexion of the organ, for the reason that the 
OS is held firmly in the bottom of the cup instead of being 
allowed to go backward toward the hollow of the sacrum 
as the body goes forward towards the bladder. This will 
be seen w^hen it is remembered that the axis of the vagina 
is from about one inch below the arch of the pubis to a 
point just below the promintory of the sacrum, and not in 
a direct line with the body. If one of these instruments 
is forced upwards high enough, the uterus will simply tip 
over the extended lip instead of being pushed forward — a 
thing often seen where patients have worn a cup and stem 
pessary for some time, thus causing a flexion instead of a 
version. A cup and stem instrument is chiefly useful in 
slight and recent cases of simple prolapse, where it is per- 
haps only necessary for a support to be worn for a brief 
period. 

There is another class of external and internal sup- 



48 The Peoria Medical Monthly. 

ports combined, which may be grouped under the head of 
loop and ring pessaries attached to a stem; and to this 
class belongs Cutter's, Thomas' and my own. Dr. Cutter's 
as you all know is an oblong loop, the wide end of which 
is intended to support the body of the uferus in version, 
and the narrow end is still wide enough to allow the uter- 
ine neck to glide backwards as the fundus is forced for- 
wards, the stem in the vagina acting as the long arm of 
the lever. This instrument is constructed upon a proper 
principle, and the greatest fault I see in it is in the parts 
intended to make pressure, being made of hard material, 
thus endangering the soft structures with which it comes 
in contact, and perhaps another is its being attached to 
outside belt by a spring instead of being hung upon elastic 
straps or cords. Dr. Thomas' instrument is constructed 
upon a similar plan except one variety, which is a hard 
rubber ring mounted upon a stem; the ring being in this 
variety the fulcrum, and the stem the lever, which in turn 
is held in place by a spring attached to a belt which goes 
around the body. This instrument is, I think, the best he 
has given us, and the only objection is the same as to Cut- 
ter's, i. e., the hard material of which it is made and the 
spring instead of elastic supports external. 

Perhaps in explaining how my own pessary prevents 
versions, I may be pardoned for quoting from my pamphlet 
intended for those of the profession who use my instru- 
ments. "This instrument prevents version and flexion on 
account of its being a complete lever; the elastic ring fits 
up close around the uterus at its neck, where it acts as a 
fulcrum, on account of its elasticity, while the tempered 
silver wire stem reaches the whole length of the vagina 
and acts as the long arm of a lever with its protruding end 
held fast by the rubber tubes passing through the small 
ring at the end of the stem." The stem of this instrument 
admits of bending to fit vaginae of different axis and dif- 
ferent shapes, as any instrument must be to be of service 
in treating different kinds of displacements and patients, 
and unlike some others of its class, the portion coming in 
contact with the delicate membrane of the uterus, is of 



Original Communications. 49 

soft instead of hard rubber, and can be worn for any length 
of time without producing either soreness or chafing of the 
parts. It is also elastic and keeps up a strong but gentle 
force upon the organ whenever there is a tendency for it 
to become displaced. One thing I do not want to forget 
before closing this already lengthy paper, and that is the 
preparation of the patient to wear a pessary of any kind. 
Before a pessary is adjusted the patient should either use 
daily astringent injections, or the medical attendant should 
apply himself pledgets of cotton saturated with some such 
material as tannic acid and glycerine each day for four or 
five days before adjusting the pessary. The patient should 
also use large injections of hot water. If each one who 
applies pessaries or supporters will observe this plan, they 
will have much less complaint for the first few days of the 
instrument causing pain and discomfort, for the reason 
that a displaced uterus is usually a tender and irritable one, 
and that tenderness should be subdued -before anything is. 
applied to remedy the displacement. 



Art. II. Extirpation of the Uterus and Ovaries with the Posterior Wall 
of the Vagina.— Recovery. A Paper read before the Illinois State Medi- 
cal Society at Peoria. 111., May 16, '83. By J. T. Stewart, M. D., Peoria, IlL 

Mrs. C , aged 35, of German birth, from Peru, 111., 

the mother of five children, was admitted to St. Francis 
Hospital May 23, 1882. 

She was suffering from extreme procidentia — the 
uterus and bladder protruding half way to her knees. Her 
constitution was good, but she was in an irritable condi- 
tion and very despondent. I put her on general treatment 
to allay this irritation and build her up, until June 12th. 
At this time I operated on her for narrowing the vagina. 
The operation was a partial success. It retained the uterus 
in situation four months. It then burst through. 

In the early part pf February last she returned to the 
hospital, the procidentia even worse than before. The 
neck of the womb was enormously enlarged, measuring 
about three inches in diameter, and the entire surface in a 
state of ulceration. 



50 The Peoria Medical Monthly. 

As I said before, she was the mother of five children, 
aged respectively 15, 12, 10 and 6 years. She had a miscar- 
riage four years ago at four months. 

After the birth of the second child the womb j)rolai3sed, 
protruding outside the body; was in this condition most of 
the time until after the birth of the last child, when it 
came down and remained in a state of procidentia contin- 
ually. Therefore, according to her account, she had this 
procidentia twelve years, and for the last six years contin- 
uously. It probably resulted from a laceration of the per- 
ineum during her second confinement. 

After the trouble first began she bore three children. 
It is hardly credible that she should become pregnant 
while the womb was protruding continuously, but that is 
her statement, and that she miscarried at four months. 

Seeing that she could be benefitted by no operation ex- 
cept the removal of the whole organ, I so informed her, 
and laid before her the full extent of the danger of the 
operation. She said she would rather die than live in the 
condition she was then in, and insisted on my doing it. I 
therefore prepared for it and on the 13th of February per- 
formed it. 

The operation was ably assisted by Drs. J. P. Johnson, 
J. Murphy, J. Studer, members of the hospital staff, and 
witnessed by a number of the most prominent physicians 
of the city. 

The patient being etherized, the first step consisted in 
drawing the mass well downwards and forward and mak- 
ing a transverse incision on the posterior part through the 
mucous membrane, a little below the junction of the 
cervix and the body of the womb, then a longitudinal in- 
cision to near the rectum. 

The uterus was then siezed by the fundus and drawn 
downwards and forward through this opening. The uterus 
w^ith its appendages were thus fully exposed. On one side 
a ligature was placed just outside the ovary. The ligament 
was divided inside the ligature, and the broad ligament 
divided to the uterus between the ovary and the round lig- 
ament, leaving the ovary still attached to the uterus. A 



Original Communications. 51 

ligature was next placed around the round ligament near 
the uterus, and another embracing the rest of the broad 
ligament the same distance from the uterus — perhaps half 
an inch. These parts were then divided. The other side 
was treated the same way. 

The next step was to separate the bladder from the 
nterus. Here was the great difficulty of the operation and 
it was very great. The whole posterior part of the blad- 
der had become firmly adhered, not only so, but it had 
lapped round and adhered to at least two-thirds of the cir- 
cumference of the womb. A sound was introduced as a 
guide and dissection began. By the exercise of extreme 
care and by long perseverence this was accomplished with- 
out wounding the bladder. The uterus was then severed 
from its attachments to the vagina. 

The posterior wall of the vagina being thickened and 
prolapsed, was removed by the scissors. It was then found 
that at the upper part where the uterus was separated from 
its vaginal attachment, the peritoneum was loosened for 
quite a distance. This was secured by three stitches. 

The bladder was then replaced a wad of absorbant 
cotton, placed over the vulva; some cotton wadding placed 
over the abdomen, which were kept in place by a bandage. 

This completed the operation, which occupied an hour 
and ten minutes. 

By this time the patient was in an extremely exhaust- 
ed condition. She was put to bed, warm blankets applied 
to her, plenty of fresh air admitted and as soon as she 
could swallow stimulants given freely. She revived in an 
hour or two and began to suffer pain, when an opiate was 
administered. 

The posterior wall of the vagina was removed for two 
reasons. One was because it was greatly thickened and 
prolapsed. The other was to give a fresh surface for the 
bladder to rest upon. 

The posterior surface of the bladder in removing it 
from the womb was denuded; the posterior surface of the 
vagina was denuded. In lying on her back these two raw 
surfaces fell together and adhered, thus making a firm floor 



52 The Peoria Medical Monthly. 

to support the intestines. And of course the whole poste- 
rior surface of the bladder being adhered to the posterior 
surface of the vagina prevented it from prolapsing. 

There was no need to close the external parts. By- 
leaving that open it gave better drainage and there could 
be no possible o))ject in closing it. The external parts are 
now natural. From the outside it is about an inch to the 
adhesion in the centre. On each side it is about an inch 
and a half. The adhesion is perfect and complete, closing 
the whole passage. No catheter was left in the bladder 
and it was not necessary. The urine was very easily drawn 
off. I instructed one of the sisters how to do it, and she 
drew it off four times in twenty-four hours tor about two 
weeks, after which time she passed it herself without diflS- 
culty, I may say here that the secretion of urine was co- 
pious all the time. 

I now give from notes which were taken at the time 
an outline of the progress and treatment of the case. 

The operation was done on the afternoon of February 
13, 1883. 

February 14th. Fully recovered from the shock of the 
operation. No fever and not much pain; continued cotton 
to abdomen; applied absorbant cotton to vulva with two 
thicknesses of lint, moistened with cai:bolized water over 
it. The dressing secured by a T bandage. One-fourth 
grain of opium every four hours. 

15th. Patient resting well and feeling comfortable. 
Respiration normal; pulse 110; temperature 102^; skin 
moist. Continue opium, one-half grain every four hours. 
Dressing same. 

16th. Pulse 118; temperature 102; great thirst. Con- 
tinue opium and dressing same as yesterday. 

17th. Pulse 80, very weak; temperature 98|; pain and 
tympanitis; vomited occasionally through the night. One 
grain opium pill every four hours; drop doses of Fowler's 
solution every three hours. Gave powdered ice to quench 
thirst, which was intense. 

18th. Pulse 100, w^eak; temperature 98; vomiting 
ceased; diarrhoea. Continue opium; continue ice. Gave 
Liebig's extract beef and brandy. 



Original Communications. 53 

19th. Pulse 80; temperature 98|; thirst intense; se- 
vere pain in abdomen by spells; tympanitis continued; 
ordered one grain opium every two hours. Arnica flower 
poultices to abdomen. Beef extract continued, champagne 
given in place of brandy. Ice continued ad libitum. 

20th. Pulse 80; temperature 98^. Great tympanitis 
and pain. Opium, beef extract and champagne continued,, 
also the following mixture; 

5 Fennel seed, 2 drachms, 

Manna, 3^ ounce. 

Magnesia carb., 'Z drachms. 

Tinct. assafcetida, 3^ ounce. 

Barley water, 10 ounces. 

Mix. S. Tablespoonful every three hours. 

Injection into the bowels of mistura assafoetida and 
spts. turpentine. 

21st. Pulse 90; temperature normal; little pain; tym- 
panitis increased. Gave an injection of castor oil and tur- 
pentine in soapsuds; it passed off without effect. 

22d. Had a restless night. Temperature normal; 
pulse 100; tympanitis slightly reduced; pain increased. 
Gave one-quarter grain morphia hypodermically. Continue 
opium pills. Applied turpentine to abdomen, to be fol- 
lowed by mercurial ointment. A dessert-spoonful of the 
following mixture every three hours: 

^ Spts. turpentine, 3^ ounce. 

01. sweet almonds, 3^ ounces. 

01. anice, 4 drops. 

Aq. anesi, 2 ounces. 

Pulv. acacia q s. to make an emulsion. 

Beef tea and champagne given freely. 

23d. Pulse 90; temperature normal; tympanitis still 
great; some pain; repeat hypodermic injection of mor- 
phine; continue emulsion; apply turpentine again followed 
by mercurial ointment. 

24th. Decidedly better. Temperature normal; pulse 
90; tympanitis less; pain less; suppuration healthy. I will 
say here that tepid carbolized injections were used daily ta 
cleanse the wound until it healed. Continue treatment as^ 
before. 

25th. Much the same as yesterday. The intense 
thirst which had been persistent from the beginning, now 
abating; for this ice has been allowed freely, which is still 
very grateful. 



54 The Peoria Medical Monthly. 

26th. Still improving. Stop mercurial ointment, and 
apply cotton over abdomen. Emulsion once in four hours; 
opium at night. 

27th. Progressing favorably. Bowels regular, as they 
have been most of the time. Stop emulsion. Quinine ten 
grains during the day, and opium at night. 

Suffice it to say that from this time on, with the ex- 
ception of three or four daj^s in the latter part of the third 
week, during which she had a rather severe diarrhoea, with 
an almost total cessation of the action of the liver, she im- 
proved steadily and very satisfactorily. At the end of five 
weeks she could set up a little. In seven weeks she could 
easily walk across the room alone, and in two months after 
the operation she was perfectly well. A few days later she 
was allowed to go home. That is about a month ago. She 
says in a letter she wrote a few days since, that she is as 
well as she ever was in her life. 

The drainage tube was not much used in this case for 
the reason it was not necessary. 



Art. III. — Lacerated Perineum. Operation with Entire Success. By O. B, 

Will, M. D., Peoria, 111. 

Aside from constituting an addition to the literature of 
simple perineal laceration, the following case presents a 
couple of noteworthy features, in the extent of the wound, 
and its closure at a single operation. 

Mrs. C. A., a native of Sweden, 23 years of age, mar- 
ried, mother of one child, and of good general health, was 
admitted to Cottage Hospital, May 1st, 1S83. The history 
of the case disclosed the fact that four and one-half months 
previous to her admission she fell in labor with her first 
child, and at the end of twenty-six hours was delivered 
with instruments, the delivery resulting in a complete lac- 
eration of the perineum, and a portion of the recto-vaginal 
septum. The presentation I understand to have been nor- 
mal. The child was still-born. The rent was closed at the 
time by the introduction of silk sutures, but the parts failed 
to unite. 



Original Communications. 55 

An examination, after the woman's admission to the 
hospital, revealed a laceration of the peritieum, involving 
the rectal sphincters, and extending^ up the recto-vaginal 
septum to the extent of an inch or more, rendering the 
patient quite unable to retain her foeces, no matter what 
the consistency, and her condition pitiable in the extreme. 
There was no laceration of the cervix uteri, no prolapsus, 
no reflex nervous disturbances. There was no evidence of 
cellulitic inflammation, uterine or other trouble of a con- 
tra-indicating character, and an immediate attempt at 
closure was decided upon. 

The day following, assisted by Drs. Hamilton, Stout, 
Mcllvaine, Steele, Roskoten, and R. A. Kerr, I proceeded to 
close the rent in both recto-vaginal septum and perineum 
at one and the same time. 

The patient was etherized and placed on her back on 
the operating table, the hips drawn well down to the edge 
and the thighs flexed upon the abdomen. With assistants 
keeping the parts as tense as possible, I proceeded to de- 
nude the cicatrized portion with the scissors, taking off the 
cicatricial tissue in strips, thoroughly, and extending the 
denudation into the posterior vaginal mucous membrane to 
the extent of half an inch above the upper end of the recto- 
vaginal rent, gradually curving its anterior margins from 
thence downward and forward to what was intended to 
constitute the posterior commissure of the vulva. Some 
difficulty w^as experienced in denuding the margins of the 
rent in the septum, on account of the rolling out of the 
rectal mucous membrane over the surface to be pared. No 
considerable hemorrhage resulted, at all events not more 
than could be satisfactorily controlled by applications of 
hot water. The instruments and sponges used were all 
previously immersed in a solution of carbolic acid. 

When completed, the denuded surface closely resem- 
bled, in general outline, the shape represented in the works 
of Emmett, and others, in illustration of similar operations. 
Seven silver wire sutures, No. 25, were then introduced 
through the medium of the straight lancet pointed needle 
of Dr. Lee, chosen with reference to its fineness, so as to 



56 The Peoria Medical Monthly. 

force the wire tightly in its track. The first was entered on 
the left side at a point on a level with the posterior margin 
of the anus, three eighths of an inch from the line of the 
denudation, carried upward through the tissues to a point 
just above the upper angle of the rent in the septum, where 
it was for convenience sake made to immerge. Being re- 
introduced at the point of immergance it was carried down 
the right side and brought out at the point corresponding 
with that of its entrance. Four of the sutures were thus 
carried upward and transversely through the substance of 
recto-vaginal septum, passing betw^een the rectal and vagi- 
nal surfaces and at equi-distant points between the upper 
end of the rent and one-eight inch above the denuded sur- 
face on the posterior vaginal wall. The others were in- 
serted at equi-distant points on one side, and after having 
been carried through the tissues to a point on the vaginal 
surface directly upward, one-eighth inch above the denuded 
plane, were carried over to the opposite side and made to 
traverse the same course through that, so that when 
tightened the corresponding surfaces would be brought in 
contact throughout their entire extent. 

The parts were adjusted by first tightening the poste- 
rior wire, by simple twisting, without the intervention of 
quills or shot. While tightening the first suture the rectal 
mucous membrane was kept out of the way and the proper 
position of the anus maintained by an assistant pressing 
the posterior wall of the rectum firmly back with the 
handle of a tenaculum. The remaining sutures were 
tightened in succession from back to front, like the first, 
and the ends of all secured in the usual manner. The pa- 
tient was put to bed with her legs bound together, and the 
nurse admonished to keep her on her side and not allow 
her to change from one to the other without assistance. Two 
grains of quinine, with a small quantity of morphia, were 
administered every four hours for the first twenty-four 
hours, and the quinine alone four times a day for the next 
two days thereafter. A liquid diet was maintained for two 
weeks. The temperature arose on the third day to 101.5-10 
and then gradually declined to normal. 



Original Communications. 57 

An attempt was made to keep the bowels open from 
the first, but a movement was not obtained for a week, at 
which time considerable diflBculty was experienced in soft- 
ening the faecal accumulation and preventing separation of 
the parts. The former, however, was accomplished by fre- 
quent injections of warm water, allowed to return through 
a catheter. The urine was drawn from two to three times 
a day, for a week or more, and the vagina syringed out 
daily with carbolized water. 

The sutures were all removed on the eighth day, and 
union found to have taken place throughout the whole ex- 
tent, with the exception of a slight fistulous opening at the 
entrance of the second suture which is, at present writing, 
entirely closed. The vagina is in good shape, the perineal 
body firm, and no difficulty whatever experienced in con- 
trolling the evacuations of faeces or gas. 



Abt. IV.— Antiseptics in the Practice of Medicine. Read before the Brainard 
District Medical Society, April 26, 1883. By J. S. Geigley, M. D., of Lewis- 
town, 111., and ordered to be published in the Peoria Medical Monthly by 
a vote of the Society. 

In the last few years there has been much discussion 
in the medical world on the germ theory of disease, and 
the profession have been considerably divided in their ideas 
on the subject, but according to the latest authorities it is 
now no longer a theory, but a practical demonstration, and 
has been "proven" (as our homoeopathic brethren would 
say) by the results obtained through treatment directed to 
that end. 

As is well known the first to apply the theory of prac- 
tice, or rather the practice to the theory, was Joseph Lis- 
ter, of Edinburgh, and as he was a surgeon, of course he 
applied his ideas of the germ theory to surgery. His de- 
ductions were simple enough, viz.: that the trouble to be 
apprehended after all surgical operations, was decomposi- 
tion taking place in the wound; and, as the eminent 
French scientist, M. Pasteur, says, decomposition is a spe- 
cies of fermentation, and that fermentation is due to an 
organized germ floating in the atmosphere, which coming 



58 The Peoria Medical Monthly. 

in contact with certain substances favorable for reproduc- 
tion, multiply; this multiplication constituting the process 
known as fermentation. 

Now Mr. Lister reasoned thus: if these atmospheric 
germs could be kept from a wound by a system of dress- 
ings, or could be rendered inert before reaching a wound, 
he could prevent many of the unpleasant results that fol- 
low surgical operations. 

He found that there were many substances that were 
destructive to the lower forms of animal life, the most 
common of which were creosote, benzine and carbolic or 
phenic acid. He chose carbolic acid on account of its 
cheapness, its ready mixability and its cleanliness; besides 
it had a local anaesthetic effect on raw surfaces. 

His idea was to thoroughly impregnate the atmosphere 
with the antiseptic, by means of an atomizing aparatus, 
before a breach of surface was made, to keep up this con- 
dition of things until all hemorrhage was controlled, the 
wound closed, and dressings applied. 

His system of dressing was calculated to maintain 
asepsis by filtering the atmosphere through cotton wool, 
impregnated with an antiseptic, and which constituted a 
part of his dressing. 

These dressings would seem complicated to one accus- 
tomed to the ordinary water dressing, but in reality they 
are very simple. They consist of : first, a piece of oiled 
silk or sheet of gutta-percha, dipped in a solution of car- 
bolic acid, and placed next to the wound as a protection 
against the too irritating influence of the antiseptic in the 
outer dressings ; next comes a layer of Mcintosh cloth, 
carbolized ; next, cotton wool rendered aseptic ; and last, 
the final protective of oiled silk. He also employed drain- 
age tubes to drain away the discharges which would neces- 
sarily take place in the wound, and would otherwise cause 
trouble by distending the parts, and making tension on the 
sutures. But these discharges were not allowed to get be- 
yond the dressings, or where the outside atmosphere could 
reach them, until it had uudergone filtration and been de- 
prived of its fermentative germs. Thus they were kept 



Original Communications. 59 

entirely free and unirritating, and the process of repair 
could go on, and the dressings would not have to be re- 
moved until continuity had been wholly or nearly restored. 

In order to make the antiseptic process complete in all 
its details and have nothing in the wound that might cause 
future separation, Mr. Lister would secure bleeding-vessel^ 
by acupuncture, torsion, and by means of the carbolized 
catgut ligature, cutting both ends short near the knot, and 
leaving the remainder to be absorbed. He also used me- 
talic sutures to close the wound, as they created no irrita- 
tion and could be left in situ for any length of time. 

There are many other details of the antiseptic system 
that I have not mentioned, for I have merely attempted to 
outline the subject, and not go into details ; but there is 
one thing I forgot to mention, and that is the rigid cleanli- 
ness insisted upon by Mr. Lister, for he maintained that a 
dirty hand or knife would spoil all the rest of the proceed- 
ure. Every instrument used about the patient, every as- 
sistant, as well as their clothing, must be thoroughly clean 
and rendered aseptic before begining the operation. 

When every detail of the system has been carried outy 
Mr. Lister says "he can leave his patient, feeling that he 
is absolutely secure against the various risks of pyaemia^ 
erysipelas, hospital gangrene, necrosis, osteomyelitis or ex- 
haustion, from profuse suppuration." 

When the details of the antiseptic system were made 
known to the profession, with the result Mr. Lister had ob- 
tained through its use, most of the prominent surgeons 
throughout this country and Europe, adopted it at once. 
Many were enthusiastic, expecting and obtaining grand re- 
sults ; others condemned it, saying the process was entirely 
too complicated, that their results were no better, if as 
good, as under the old plan of treatment; while some went 
so far as to say that the system was positively injurious, 
Keith, of Edinburgh, for instance, claims to have lost sev- 
eral ovariotomy cases, who died with every symptom of 
carbolic acid poisoning which, he says, was caused by 
the use of the spray ; perhaps such was the case, for in his 
report he states that he used in a one ten solution of car- 



60 The Peoria Medical Monthly. 

bolic acid ; and, as the average duration of the operation 
must have been two hours, we may safely suppose that the 
spray was playing on the exposed peritoneum from an hour 
to an hour and a half, giving abundant time for that rapid 
absorbing surface to take up enough of the acid to poison 
the patient. But was this the fault of the antiseptic sys- 
tem, or the fault of the operator? We can poison a person 
by giving him an overdose of almost anything. 

.Again, it has been asserted by some that the good re- 
sults obtained by the use of the antiseptic system, was by 
cleanliness enforced by its use. I shall endeavor to show 
that this is not the case. 

Some time ago I heard an eminent member of the pro- 
fession speaking of the management of the different hos- 
pitals of Europe. He alluded to one in Germany which he 
visited in the summer of '81. The resident physician of 
the institution informed the gentleman that for forty years 
the mortality after surgical operations had been so great, 
that from amputations alone it had run from 18 to 20 per 
cent. ; that a season never passed without their having an 
epidemic of traumatic erysipelas, and everything had been 
done to render the sanitary condition of the institution as 
good as might be. In '76 or '77, they had adopted the an- 
tiseptic system. Since that time there had not been a sin- 
gle case of traumatic erysipelas in the hospital ;* that the 
mortality, after amputations, had fallen to about 3 percent. 
Could these results have been due wholly to the cleanliness 
•or the antiseptic system ? 

In abdominal surgery Listerism has given results that 
are certainly brilliant, notwithstanding the assertions of 
Keith, Lawson, Tait and others, to the contrary, for these 
gentlemen, although not following out the details of Lis- 
ter's plan, do not lose sight once of his main principles, viz: 
cleanliness and thorough drainage ; this, together with the 
care they exercise in the selection of their cases, has much 
to do with their great success in ovariotomy. 

Another branch of surgery which has only been de- 
Teloped since the advent of Listerism, and which is in re- 
ality an outgrowth of that plan of treatment, is operations 



Original Communications. 61 

about the joints. We do not hesitate now to open a syno- 
vial cavity, to remove an osteophite, or a loose cartilage, for 
we fully expect repair to take place, with unimpaired func- 
tion to the articulation. 

We can also cite the recent successes in bone surgery. 
Fenger, of Chicago, a short time ago, reported a number of 
cases of osteotomy, for the correction of the deformity con- 
sequent to faulty union in " Pott's fracture," all of which 
were successful. 

Mr. Lister has lately been obtaining bony union in 
fracture of the patella, a thing never before accomplished. 
His plan is to expose the bone by incision, and coaptate the 
fragments by means of stout silver wires ; he then carries 
out his plan of treatment. He has treated a number of 
cases successfully. 

Many other triumphs of the antiseptic system in sur- 
gery could be cited, but the limit of a short paper will not 
admit of it. My object in recounting the foregoing well- 
known facts, is this : If antisepsis has done so much for 
surgery, could not its sphere of usefulness be greatly en- 
larged by applying it to general medicine ? There is 
scarcely a day but which the general practitioner could 
apply the principles of antisepsis to certain of his cases, 
with benefit to the patient and credit to himself. 

I do not mean pure, unadulterated Listerism, when I 
say antisepsis, for he himself has dropped many of the de- 
tails that he once claimed to be indispensable to the suc- 
cessful practice of his plan, neither does it matter what 
particular antiseptic we use. Carbolic acid is objected to, 
by many, on account of its disagreeable odor ; the same 
may be said of iodoform — which is an excellent antiseptic, 
being used almost exclusively by the German and French 
schools. If it be used in ointment, however, the odor can 
be effectually disguised by the addition of a few drops of 
the oil of anise. Benzoic- and boracio acids are both ex- 
cellent antiseptics, and are free from odor, but they are 
very insoluble in water, without the addition of an alkali, 
which is undesirable. 

Thymol, or thymifc, acid is at present a very popular 



62 The Peokia Medical Monthly. 

antiseptic. It has all the advantages of the above-men- 
tioned drugs, while few of their disadvantages. But, what- 
ever agent we use, it should combine these qualities : it 
should be of agreeable odor; unirritating to the tissue; not 
toxic when used in any quantity or strength ; perfectly 
miscible with w^ater in any proportion ; and above all, de- 
structive to low forms of animal life. A convenient method 
of testing the relative merits of different antiseptics would 
be to suspend a small piece of beef in bottles containing 
solutions of the drugs, keeping them in an even tempera- 
ture, of about 85 to 90 deg, Fahr.; also a piece in plain wa- 
ter. This would show the time it took for decomposition 
to take place in each. 

I have been using a preparation, for the last four or 
five months, that is prepared by Messrs. Tompkins & Stand- 
ard, pharmacists, of this town. It is an elegant prepara- 
tion, combining all the advantages enumerated above. It 
is a colorless liquid, very much resembling the preparation 
known as Listerine. The composition of it is about this r 
to each fl. oz. there are 2 grs. each ot benzoic and boracic 
acid, an equivilent of each of the antiseptict oils of thyme, 
eucalyptus and gaultheria. The preparation can be used 
full strength on a raw surface, without in anyway interfer- 
ing with primary union. I have used it in two cases of 
amputation with the most flattering results. Irrigating the 
raw surfaces thoroughly before putting up the flaps. In one, 
the stump was entirely healed on the eighth day. When 
the dressings were removed there was no sign of pus, and 
only a slight exudation of serum. In the other case the sub- 
ject was not good, suftering from scrofulosis and being ad- 
dicted to the use of spirits ; but, notwithstanding, the 
wound healed by granulation. There was comparatively 
little suppuration, and the stump was sound in three weeks 
from the time of the operation. 

A compound, comminuted fracture of the olecranon pro- 
cess of the ulna, in which I removed nearly a dozen pieces 
of the bone through the opening over the process, and in 
which the synovial fluid had escaped, 1 treated by syring- 
ing the cavity with a half and half solution of the antisep- 



Original Communications. 63 

tic every day, tenting the wound with strips of lint and 
iodoform ointment. Contrary to my expectations, the pa- 
tient recovered, with scarcely any impediment to the func- 
tion of the joint. 

I also use it in obstetrical cases. Always sponging the 
soft parts with a half and half solution after delivery, and 
after the second day giving daily injections of a one in five 
solution of the antiseptic. I feel almost certain that I 
saved one patient from puerperal septicaemia by its use. 
It was the first case of the kind I used it on. On the 7th 
day after delivery the patient had a chill ; I was sent for, 
and found the temperature 104 deg. in the axilla, and the 
pulse about 140. I was informed, by the midwife, that she 
had had considerable trouble in getting the uterus to con- 
tract after delivery. I determined to wash out the uterus- 
This I did by means of a Hodge's stomach tube and syphon 
apparatus, using a half and half solution of the antiseptic. 
Quite a quantity of decomposed blood clots came away, and 
inside of an hour the temperature fell to 101 deg.; pulse, to 
about 108 or 110. Putting the patient on quinia, in good 
doses, and daily vaginal injections, 1 to 5 sol., she recovered 
without further accident. 

In ulceration of the os uteri, I have found no better 
application than the antiseptic in question, used full 
strength, through a speculum, once or twice a week, with 
daily injections of one to five solution of the same. 

In ozoena, or chronic nasal catarrh, a one in four solu- 
tion, used with a douche, has a good influence on the offen- 
sive discharge attending those troubles. 

Now, as to the internal use of antiseptics. I think their 
field of usefulness is just as large in that direction as in any 
other. I have made use of the preparation, before referred 
to, in certain forms of dyspepsia, especially that form in 
which the fats and starches that undergo fermentation. A 
half to a teaspoonful given after meals will prevent fer- 
mentation ; or, if given after the fermentation process has 
begun, will relieve that disagreeable sensation of fullness 
complained of by so many patients. Although not a cura- 
tive measure in these cases, it relieves the most disagreea- 
ble symptoms — while curative measures may be adopted. 



64 



The Peoria Medical Monthly. 



But I believe that the widest degree of usefulness, in 
the internal administration of antiseptics, will be found in 
the exhausting summer diarrhoeas of children, especially 
those forms where the discharges are of an acid and ir- 
ritating nature, and where there is tympanitis, due to the 
fermentation, taking place in the intestines, antiseptics ad- 
ministered in such cases will, I believe, be attended with 
the most happy results ; not only from the effect they will 
have on the fermentation process, but from their topical 
effect on the inflamed mucous membrane. 

It would be superfluous for me to go on enumerating 
the diseases to which antiseptics are applicable; and I will 
say, in conclusion, that I believe antiseptics to hold the 
same position toward rational medicine and surgery, that 
proper sewerage does to a city. By their use we not only 
expect to modify and cure disease, but also to prevent the 
same. 



Abt. v.— The Clinical Uses of the Microscope. The Germ Theory of Disease. 

By Dr. Romaine J. Cuktiss, Joliet, 111. Continued. 




Fig. 1.— Trichinae Spiralis. 




.^27 



^ 



'^ 



Fig. 2. — Echinnococus Hooks. 



Fig. 3. — Cysticercus Hooks. 



THE MIGRATORY PARASITES. 



The trichinae spiralis, and the booklets of the echinno- 
cocus and cysticercus, are the microscopical objects which 
afford the means of diagnosis of very important diseases. 
These objects, when discovered during the progress of dis- 



Original Communications. 65 

ease, are verifications of the nature of the disease, what- 
ever may be the signs of other character or the symptoms 
of disease. In the diseases, then, which are caused by these 
three parasites, trichnae, and the larvae of taenia solium, 
and taenia echinnococus, the microscope is an instrument 
of exact diagnosis, to the extent that if these objects are 
seen, the diagnosis is certain; but the disease and parasites 
may be present in the body and the physician fail to find 
them. 

There are two methods of making microscopical inves- 
tigation of trichinosis disease ; one may be termed direct 
and the other indirect. The first method consists in an in- 
spection of the muscular tissue of the person who is be- 
lieved to have the disease. The muscle for, inspection is 
obtained by incision — cutting out a piece of muscle, or, pre- 
ferably, by the subcutaneous method, by use of Duchenne's 
trocar, or Middledorpflf's harpoon. If a suspected muscle 
is inspected in this manner in a living person, and trichinae 
are found by the microscope, the diagnosis is positive, no 
matter what the other signs and symptoms or the history 
of the case may be. 

The indirect method of making a microscopical diag- 
nosis of trichinosis, consists in an inspection of the meat 
which a trichinosed or diseased person is known to have 
partaken of. If the meat is found to contain trichinae, and 
patient is known to have eaten of the meat, and is sick 
with signs and symptoms like trichinosis, the diagnosis is 
reasonably certain the sickness is caused by this parasite. 

In addition to these microscopical methods the sexually 
developed trichinae some times pass from the bowels. This 
method of inspection, however, is impractical, for the rea- 
son that intestinal trichinae are usually few in number, 
comparatively, and rarely pass off until they are dead and 
the mischief they can do, by breeding migratory trichinae, 
is done. If, however, intestinal trichinae are found in the 
discharges from the bowels, the diagnosis of the trichinosis 
is positive ; and this method of diagnosis is only possible 
by aid of the microscope. 



66 The Peoria Medical Monthly. 

natural history. 

These worms are classified according to their location 
in the body which they inhabit, as muscle and intestinal 
trichinag. The difference between the two, physically, are 
that the muscle trichinae is undeveloped, while the intesti- 
nal worm is developed sexually. 

The history of the development of the worm is that 
the muscle trichinae, lying encapsuled in the muscles of 
pork or most any other kind of meat, are eaten by another 
animal, generally the human animal. When the muscle- 
worm thus gets into the intestines of the eater, it rapidly 
develops sexually. There are males and females. In seven 
days from the date of entrance of the muscle trichinae into 
the intestines the worm is developed and the first young 
are born, and begin the process of migrating to the mus- 
cles. Just the route taken by these newly-born migratory 
trichinae is not known, but the destination is the muscle. 
Having reached the muscles, the immigrant forces itself 
into a primitive fasiculus of the muscle, and causes more 
or less disintegration, or metamorphosis of tissue of the 
muscle. The worm increases somewhat in size, and finally 
curls up into a spiral shape, and remains there alive in a 
sort of hybernating condition, waiting for some animal to 
swallow him along with the muscle ; or, if it must be so, 
to live in the muscle of the man as long as the man lives, 
or even longer, and finally go with his dead body to the 
grave. 

TRICHINOSIS. 

The signs and symptoms of the disease, whatever they 
may be, are caused by the pressure and action of the para- 
sites in the muscles. The general signs and symptoms are 
pain in the muscles and increased temperature of the body, 
which characters must be reconciled with the action of the 
parasites. The changes brought about in the muscles may 
be expressed in the most general terms as a metamorphosis 
of tissue. The worm attacks the primitive fibres ; it con- 
sumes the muscular tissue, and occupies the place where 
once was living, acting muscle, just in the same sense that 
a mouse, which has eaten his way into a cheese and lives 



Original Communications. 67 

there, occupies the place once occupied by unconsumed 
cheese. In the action of parasites acting upon living struc- 
ture, two forces are at work— the force which represents 
the parasite, and the force which represents the resistance 
of the living animal to this parasitic action. The resultant 
of these two forces determines the limitation of the dis- 
ease, or the death of the patient; and the resullant also de- 
termines the character of the metamorphosis of tissue. 
There is no question but the resistance of the vital forces 
to the action of muscle-worms, has had much to do in de- 
termining that feature of the natural history of the parasites, 
• which is, that they are unable to reach full development, 
sexually, in the muscles; and taking the evolutionist's view 
of it, this fact has had much to do with the development of 
the worm up to its present anatomy, natural history, and 
functions. 

The metamorphosis of tissue in the muscles, consists 
(1) of direct loss of muscular substance ; (2) a cavity con- 
taining the worm; (3) the development of "muscle nuclei," 
and (4) sooner or later a disposition of lime salts around 
the worm which encased it more or less firmly. 

The question of temperature, in an animal body, can 
only be understood on the basis of estimation furnished by 
that of correllation of force, and that the animal body is 
simply a machine. There is no other way to explain or 
understand it. Machines are made for, and their function 
is, to transform force. They transfer heat into motion, oi- 
other forms of motion into other forms of motion. If ex- 
tra friction is put into a machine, as a steam engine, which 
is used to transform heat into work, the process of this 
transformation is interfered with, and part of the force 
which ought to go into work, is converted into heat again, 
and the temperature of the machine is raised. 

The action of the parasites, upon the body, is to cause 
more or less local pain, as a consequence of metamorphosis 
of tissue, and to create a friction which raises the temper- 
ature of the body. There appear to be more or less definite 
rules regarding the manifestation of these phenomena. The 
heat is proportionate to the destruction of tissue, and, as a 



8 The Peoria Medical Monthly. 

rule, the destruction of tissue depends upon the number of 
parasites. If the number of parasites is sufficient, when 
the muscles are invaded by trichinse, the temperature curve 
is very like that of typhoid. The general law governing 
parasitic action, whether in trichinosis, consumption, or 
splenic fever, or other zymoses, is that there is pain and in- 
crease of temperature, depending upon metamorphosis of 
tissue, caused by the parasite. 

{To he Continued.) 



Mtitx^ %vm%uXxtim. 



Proceedings of the Thirty-third Annual Meeting of the 
Illinois State Medical Society. 

. . First Day, May 15, 1883. 

MORNING SESSION. 

The meeting was called to order in Rouse's Hall, 
Peoria, 111., at 10 o'clock a. m., by the President, Dr. A. T. 
Darrah, of Bloomington 111. 

After prayer, offered by Rev. J. C. Bruce, the Chair- 
man of the Committee of Arrangements, Dr. John Murphy 
of Peoria, made the following address of welcome: 

M7\ President, and Members of the State Medical Society: 

I hope I will be pardoned for remarking that we 
Peorians are very proud of the beautiful site which a be- 
nificent nature has provided us with to build our city on, 
proud of the destiny which we are vain enough to believe 
is in store for it, and proud of the successful enterprise of 
our citizens; but we are never more proud than when the 
Illinois State Medical Society holds its annual meeting in 
Peoria, dignifying our city by its presence, and conferring 
an honor on the profession here which is warmly and duly 
appreciated. 

More than a decade has elapsed since your last meet- 
ing in Peoria, a period pregnant w^ith the progress of ideas 
in our profession fully as philosophic in its development, 
and as practical and useful in its character aS that of any 
epoch which preceded it, with names as eminent probably 
as those which have adorned any similar interregnum, 
with discoveries reflecting honor and credit on the great 
dead of that time, as well as on the illustrious living. 



Society Transactions. 69 

During the tedious years which have elapsed since you 
last assembled here, a few seats in this society at that time 
meritoriously filled, are now vacant, a few niches in the 
temple of fame at that time empty are now worthily occu- 
pied; but it is a matter of congratulation that during this 
long interval the hand of time has dealt so leniently with 
the members of this society, and I am happy to see before 
me to-day so many faces with which on the occasion of 
your last meeting here I became familiar. 

Without however further infringing on your valuable 
time, permit me in the name of the profession of Peoria 
and its vicinity and the citizens generally, to extend to you 
a hearty and hospitable welcome to our city, and to ex- 
press the hope that your sojourn among us will contribute 
to your enjoyment, and neutralize to a certain extent at 
least the onerous and exhausting labors of the session on 
which you are about to enter. 

Dr. Wm. Hill, of Bloomington, responded on behalf of 
the Society. Dr. Murphy then read the report of the Com- 
mittee of Arrangement, which was adopted. 

A telegram from Dr. H. H. Mayard, a delegate from 
the Iowa State Society, expressing his regrets at not being 
able to be present, was read by the Secretary. 

Dr. W. L. Ransom, of Rockford, a special committee 
on "The analysis of a certain class of remedies, concerning 
which physicians are not positive as to their therapeutic 
value," reported progress, and at his own request was con- 
tinued another year. 

The time for the report of the Committee on Practice 
of Medicine was set for 2 o'clock this afternoon. The re- 
port on Surgery to follow. 

The report on Obstetrics was set for Wednesday morn- 
ing. The report on Drugs and Medicines to follow. 

The report on Gynecology was set to follow the report 
on Surgery, 

The report on Ophthalmology and Otology to follow 
that on Drugs and Medicines. 

The Committee on Necrology was set to report thi& 
evening at 7 o'clock. 

The special committee on the '' Practicability and de- 
sirability of separating the work of teaching in medicine 
and licensing to practice," was set for this evening. 

The report of Dr. Walter Hay on the " Commitment of 
the Insane," was ordered to follow the above in regular 
order. 

The following titles of volunteer papers were handed 



70 The Peoria Medical Monthly. 

to the Secretary, and the time for their reading was set for 
Wednesday, at 2 o'clock p. m. 

Report of Epidemics of Marshall County in 1882. By 
Dr. L. Gr. Thompson, of Lacon. 

Case of Deformity, etc. By Dr. B. F. Crummer^ Warren. 

Cause and Prophylaxis of Intantile Diarrhoea. By Dr. 
John Murphy, Peoria. 

The World Progresses. By Dr. J. S. Whitmire, Meta- 
mora. 

The President then read his annual address, which was 
listened to with great interest, although its length was con- 
siderable! 

The Society then adjourned to meet at 1:40 p. m. 

AFTERNOON SESSION. 

Dr. N. S. Davis read the report of the Chairman of the 
Committee on Practice of Medicine. 

Following this Dr. B. N. Griffiths, of Springfield, and 
Dr. J. F. Todd, of Chicago, members of the same commit- 
tee, read supplementary reports. 

The above reports were, on motion, received. 

Discussion on the subjects presented in the papers was 
participated in by Drs. C. S. Plummer, of Rock Island, J. P. 
Walker, of Mason (>ity, and B. F. Crummer, of Warren. 

Dr. J. R. Wells, of Geneseo, made the motion, which 
was carried, that Dr. N. S. Davis give his views on Vene- 
section in Pneumonia. 

This was done by Dr. Davis to general satisfaction. 

THIRD SESSION — TUESDAY EVENING. 

Society called to order by the President. 

Report of Dr. W. Hill, of Bloomington, from the Com- 
mittee on Necrology, was read and received. 

Dr. Booth then read his report from the special com- 
mittee on Medical Education. 

A paper from the same committee, by Dr. M. A. Mc- ' 
Clelland, Knoxville, was read by Dr. Mcllvaine. ' 

Dr. S. J. Jones made some remarks on the subject of j 
the reports, after which the papers were referred to the i 
Publication Committee. 

Dr. Walter Hay then read his report from the Commit- 
tee on the Commitment of the Insane. ^ 

On motion the committee was continued for two years. 

Dr. W. Hill, of Bloomington, moved that a committee 
of three be appointed to report on the Relations of the 
State Board of Health to the Public. Motion carried. 



Society Transactions. 71 

The chair appointed Dr. Hill, Dr. Cook, of Mendota, Dr. 
Booth, of Sparta. Dr. Verity, of Chicago, was given time 
for a short volunteer paper to follow Report on Surgery. 

The Report of Committee on Surgery was set for Wed- 
nesday, 9 o'clock, A. M. 

At 9:45 a motion to adjourn was carried. 

FOURTH SESSION — WEDNESDAY MORNING. 

After some preliminary business, Dr. J. E. Owens read 
his report on Surgery. 

Dr. J. T. Stewart, of Peoria, made a report from the 
same committee. 

Dr. Verity made a short report on and exhibition of a 
new apparatus for applying plaster casts. 

Dr. Prince, of Jacksonville, followed, showing an appa- 
ratus for the distension of the bowel. 

Dr. J. S Whitmire showed a new truss for hernia. 

Dr. N. Holton read a short paper on dislocation of the 
left kidney. 

Dr. Crummer, of Warren, read a report on a case of 
deformity from the effects of nerve injury. 

At 11 o'clock, A. M., a recess of ten minutes was taken, 
to appoint a nominating committee. 

Committee on Nominations : Tazewell, B. H. Harris ; 
Woodford, F. Cole ; Knox, H. Judd ; Warren, W. S. Holli- 
day; DeWitt, John Wright; Putnam, J. M. Co wen; Bureau, 

F. C. Robinson; Marshall, E. K. Rich; Cumberland, G. W. 
Albin; Logan, C. H. Norred"; Sangamon, B.K Griffith; Ma- 
coupin, L. H. Corr; Jersey, A. K. Van Horn; Christian, C. 
V. Rockwell; Morgan, T. M. Cullimore; Fulton, Ellen Inger- 
soll; McDonough, P. H. Garretson; Edgar, C. S. Laughlin; 
Adams, M. F. Bassett; Mason, M. H. Anderson; Cook, N. S. 
Davis; JoDaviess, B. F. Crummer; LaSalle, S. L. B. Blacke; 
Greene, C. Armstrong; Vermilion, G. W. Jones; Monroe, 
A. Wetmore; Scott, J. H. Stewart; Kendall, D. S. Jenks; 
Moultrie, A. A.Williams; Macon, C. Chenoweth; Hancock, 

G. N. Kellogg; Rock Island, S. C. Plummer; Henry, Ira R. 
Wells; Crawford, C. Barlow; Wabash, A. J. Mcintosh; Cass, 
N. S. Read; DeKalb, G. W. Nesbitt; Schuyler, H. Davis; 
Randolph, D. S. Booth; Peoria, John Murphy; Mercer, A. L. 
Craig; Madison, E. W. Fiegenbaum; Shelby, C. T. Reber; 
Menard, F. J. Shipp; Iroquois, C. F. Smith; Clarke, J. Mc- 
Nary; Calhoun, L. Herriott. 

Re-convened at 11:15. 

A motion was carried that all exhibits be removed 
from the rear of the hall. 



72 The Peoria Medical Monthly. 

The Secretary read several letters and telegrams from 
absent members. 

The report of the Committee on Surgery was discussed 
by Dr. W. A. Byrd, of Quincy, after which it was referred 
to the Publication Committee. 

Dr. E. S. Norred, of Lincoln, next read a paper from 
the Committee on Gynecology. 

The Society adjourned at 12.30 to meet at 2 o'clock 
p. M. 

FIFTH SESSION — WEDNESDAY AFTERNOON. 

The Society met at the appointed hour. 

Dr. Cook, of Mendota, moved that the motion to ex- 
clude exhibitors from the rear of the hall be reconsidered. 
Carried. 

The report of the Committee on the Relations of the 
State Board of Health was read by Dr. Hill, adopted, and a 
copy ordered sent to the Legislature. 

Report of special committee on recommendations in 
President's address : 

Whereas, The Illinois State Medical Association take 
much interest in urging and promoting the formation of 
the State Board of Health, and the results of its work since 
its organization fully justifies the expectations of its friends, 
in protecting the people from professional ignorance and 
imposition, from epidemic diseases and various other causes 
prejudicial to life, and the promotion of a higher standard 
of medical education, thus placing Illinois in the front rank 
in this respect among her sister states. This result is 
largely due to the personal sacrifices of the members of the 
board, the appropriations made by the state having never 
been sufficient to carry out the duties imposed upon the 
board by law. Therefore, be it 

Resolved, That in the opinion of this society it is the 
duty of the legislature of this state, to make such appro- 
priations as will enable the board to carry out the impor- 
tant duties assigned it, by the acts creating the State Board 
of Health and the act to regulate the practice of medicine. 

Resolved, That a copy of this preamble and resolution 
be sent to members of the legislature now in session. 

William Hill, 

D. S. Booth, 

E. P. Cook. 

An invitation from the Staff of St. Francis' Hospital to 
visit their institution, was read. 



Society Transactions. 73 

Dr. Prince, of Jacksonville, Dr. Chenoweth, of Decatur, 
and Dr. E. S. Norred, of Lincoln, then read papers from 
the Committe on Gynecology. 

Dr. N. S. Davis then read the report and resignation of 
the Treasurer, Dr. J. H. Hollister, v^hich was received and 
referred to the Publication Committee. 

The report of the Nominating Committee was read and 
adopted. 

REPORT OF NOMINATING COMMITTEE. 

The committee was organized by electing Dr. N. S. 
Davis Chairman : G. W. Jones Secretary. 

The following is the report of the committe : 
Mr. President and Members of the State Society/. 

Your Nominating Committee have the honor of pre- 
senting the following names of gentlemen as suitable for 
ofiicers, and recommend their selection for the positions to 
which they are severally assigned for the ensuing year : 

President — Prof. Edmond Andrews, Chicago. 

First Vice President — David S. Booth, Sparta. 

Second Vice President — Geo. W. Nesbitt, Sycamore. 

Treasurer — Walter Hay, Chicago. 

Secretaiy — S. J. Jones, Chicago. 

Members of the Judicial Council for three years — 
Robert Boal, Peoria ; Herbert Judd, Galesburg ; L. G. 
Thompson, Lacon. 

Committee on Practical Medicine — J. C. Frye, Peoria ; 
J. W. Hensley, Yates City : N. S. Reed, Chandlerville. 

Surgery— Ros well Park, Chicago ; D. S. Booth, Sparta ; 
J. D. Whitley, Petersburg. 

Obstetrics — S. R. Crawford,Monmoutli ; Ellen A. In- 
gersoll. Canton ; C. Du Hadway, Jerseyville. 

Gynecology — W. S. Caldwell, Freeport : L. H. Corr, 
Carlinville ; A. F. Rooney, Quincy. 

Ophthalmology and Otology— J. P. Johnson, Peoria ; 
Robert Tilley, Chicago ; P. H. Garrettson, Macomb. 

SPECIAL COMMITTEES. 

J. V. Black, Jacksonville, on Oral Surgery. 
Christian Fenger, Chicago, continued for another 
year. 

W. G. Ransom, Roscoe, continued. 

C. Truesdale, Rock Island, on Tetanus. 

M. F. Bassett, Quincy, on Vaccination. 

J. P. Mathews, Carlinville. on Diseases of Children, 

A. Wetmore, Waterloo, on Physiology. 



74 The Peoria Medical Monthly. 

committee on arrangements. 

D. W. Graham, Chicago ; Chas. Gilman Smith, Chicago; 
R. C. Hamil, Chicago; H. A. Johnson, Chicago; E. Ingals, 
Chicago. 

Very respectfully submitted, 

N. S. Davis, President. 
Geo. Wheeler Jones, Secy. 

A report on Epidemics in Marshall County was read by 
Dr. L. G. Thompson, of Lacon. 

Dr. Pitner, of Jacksonville, of the Committee on 
Drugs and Medicine^, presented a long paper, containing 
many points of interest even to persons not practitioners, 
upon the subject assigned to the committee. After speak- 
ing of the improvements in pharmacy, he proceeded to 
consider the improved methods of administering medicines. 
He mentioned in particular the value of the use of single 
medicines, asserting that the change in this regard shows 
decided progress in the profession, for in this way only can 
a thorough knowledge of therapeutic agents be obtained. 
He also dwelt upon the value of small doses of active med- 
icines frequently repeated. He regarded this as the best 
way of administering medicines, although it is not equally 
applicable to all agents. 

Dr. Judd, of Galesburg, of same committee, reported 
most unfavorably on the vaunted specific action of phenic 
acid. After some further miscellaneous business the soci- 
ety adjourned. 

At adjournment the delegates were invited to a car- 
riage drive through the city. In the evening a promenade 
reception and collation was given by the citizens of Peoria 
in honor of their guests. A large number of citizens were 
present and everybody enjoyed themselves. 

THURSDAY MORNING — SIXTH SESSION. 

Dr. Herriott, of Jacksonville, presented the report of 
the Committee on Obstetrics, and was followed in a supple- 
mental paper by Dr. Ellen Tngersoll, of Canton. Dr. Jones, 
of Danville, gave an exposition of a difficult case in prac- 
tice, which was listened to with considerable interest. 

Dr. Jones, of Chicago, gave the report of the Commit- 
tee on Ophthalmology and Otology. 

Dr. McKinney, from the same committee, read a paper, 
in which he briefly considered double sight and ulceration 
ot the cornea. 

SEVENTH SESSION — THURSDAY AFTERNOON. 

At the afternoon session Dr. John Murphy, of this city, 



Society Transactions. 75 

read a special paper entitled: "Some Enquiries Relating 
to the Causes and Prophylaxis of Infantile Diarrhoea." He 
pronounced malaria the overshadowing factor in the pro- 
duction of diarrhoea. When he came to Peoria, thirty-five 
years ago, the river and creek bottoms and even the prai- 
ries were saturated with malaria. At that time diarrhoea 
among children was as fatal in one place as another, but 
as the land began to be cultivated the malaria was dissi- 
pated, and the disease has now almost entirely disappeared. 
It is not so frequent nor fatal now on bottom lands which 
have been cleared and drained. In short it will be found 
that summer complaint and diarrhoea are only prevalent 
where the atmosphere is miasmatic. Quinine has been 
supposed to be the great panacea for infantile diarrhoea, 
but after the disease has become established it only aggra- 
vates it and produces no therapeutic effects. 

Dr. Reber, of Shelbyville, read a paper upon Septicae- 
mia arising from Nasal or Post-nasal Irritation, forming 
symptoms similiar to those in acute pneumonia. 

A paper upon " The Epidemics in Marshall County in. 
1882," was read by L. G. Thompson, of Lacon. 

Dr. Ranch, of the State Board of Health, addressed the 
convention concerning proposed legislation now before the 
Legislature. He read the bill which had been offered look- 
ing to the expurgation of quackery by forbidding the ad- 
vertising of the treatment of diseases in any other way 
than is usually done by reputable physicians, also forbidding 
the advertising of all appliances used for immoral purposes. 
He declared that the bill had created considerable excite- 
ment among the quacks, who were using every effort to 
defeat it and to have the appropriation of the State Board 
cut down. He also read a proposed amendment to the 
medical practice art, intended to rid the state of itinerant 
venders. In commenting upon it, he urged a more thor- 
ough co-operation of the medical men of the state with the 
Board of Health, in order to secure a more satisfactory en- 
forcement of the medical practice act and the proper regis- 
tration of births and deaths. He moved that a committee 
of one from each county be appointed with that end in 
view, and the motion was carried, the committee to be ap- 
pointed at the President's convenience. 

Dr. G. Wheeler Jones, of the committee to whom had 
been referred the matter of the practicability and advisi- 
bility of preparing biographical sketches of the society, 
reported in favor of so doing, and recommending that the 
work be confined to sketches of deceased members. A 



76 The Peoria Medical Monthly. 

plan of preparing the volume was suggested, Dr. J. H. Hol- 
lister to act as its editor-in-chief, the volume of sketches to 
be re-edited every five years. The report was adopted and 
the recommendations concurred in. 

Dr. N. S. Davis, of Chicago, referred to the difficulty at- 
tending the securing of reliable reports as to the prevalence 
of disease, and the need of getting a more positive knowl- 
edge concerning the causes and circumstances inducing 
disease in Illinois. He offered a resolution that a special 
committee of three be appointed to furnish each member 
of the society a circular letter, requesting him 'to give a 
report upon all acute diseases coming under his care ; also 
that one member in each topographical district be appoint- 
ed to report concerning the meteorological conditions of 
the atmosphere, with especial reference to the active agents 
at work, as ozone, etc. The resolution was adopted. 

A telegram was read from the Missouri State Medical 
Society, stating the time for holding its annual meeting had 
b>een changed to the second Tuesday in May, and that dele- 
gates had been appointed to the next meeting of the Illi- 
nois Society. 

After returning votes of thanks to the physicians and 
citizens of Peoria, the railroads of the state and the local 
press, for courtesies extended them, the convention ad- 
journed, to meet next May in Chicago. 



Thirty-Fourth Annual Session of the American Medical 
Association. 

Space will not permit of even an outline of the entire 
proceedings at Cleveland, but we will give some of the most 
important features of the meeting. 

In his presidential address. Dr. Atlee gave a graphic 
description of his early medical life, going back sixty-five 
years, with reminiscenes of his instructors, Drs. Wistar, 
Coxe, Chapman, Physick and Parish. In referring to the 
Code of Ethics, Dr. Atlee spoke as follows : 

Above all things, ever strive to maintain the honor and dignity of 
the profession. Let no selfish or mercenary consideration deter you from 
observing the laws laid do^Yn in our noble Code of Medical Ethics. Cul- 
tivate friendly relations with your local medical brethren, more partic- 
ularly the younger-; and regulate your intercourse with all men in such a 
way as to cast no stain upon the honor of the profession, which is in your 
keeping. 



I 



Society Transactions. 77 

In my day, previous to the establishment of medical societies through- 
out the country, and organization of the American Medical Association, 
:and the general adoption of the Code of Ethics, I saw many disastrous 
effects from the want of brotherly consideration and kindness. The med- 
ical men of that day were often in difficulties, patients would be takea 
from one physician to another without ceremony ; and so great was the 
jealousy existing between them, that for more than twenty years after my 
graduation, it was impossible to form a medical society in my native city 
and country, because there were so many aspirants for the honors. Here 
let me speak oSsome of the difficulties I had to encounter in my early 
professional life. Instead of being taken by the hand by the older phy- 
sician, every obstacle was thrown in my path — consultations were refused* 
and the treatment of my patients unfavorably criticized. 

By the establishment of the medical societies and the adoption of the 
Code of Ethics, a wonderful change has been affected. We now feel it 
our duty to sustain our younger brethren, to treat them with courtesy and 
kindness, to save them from their errors, and encourage them in all their 
good work. Had the adoption of the Code of Ethics no other result than 
this, it would have been an invaluable blessing to the profession. But it 
has accomplished more. It has put the seal of condemnation upon all 
"isms," aiad developed an esprit de corps that has enlarged the boundaries 
of our science, and greatly increased the usefulness and social standing of 
the profession. 

Dr. W. H. Byford, of Chicago, read an admirable paper 
•on Chronic Intero-pelvic Inflammation, before the section 
on Obstetrics and Diseases of Women. The following is an 
outline of his paper, and his inferences from it : 

The term parametritis and perimetritis is erroneously supposed by 
many to include the whole subject of intero-pelvic inflammation. These 
terms are misleading because, as now often used, they present to the mind 
the idea that all cases of inflammation not confined to the uterus, must 
belong to one or the other of them. Actual observation teaches the im- 
portant fact that perimetritis and parametritis usually exist together and 
are usually complicated with inflammation of the- uterus, and not infre- 
quently the ovaries and fallopian tubes are involved; the obvious conditions 
of chronic parametritis, are first suppuration, or chronic pelvic abscess, lo- 
cated more frequently, but not always, in the broad ligament, the conse- 
quence of cellutitis. The chronic pelvic abscess is generally the sequel of 
acute inflammation and attains chronicity from the imperfect evacuation 
of the pus after acute inflammation has terminated in suppuration. The 
remedy in such cases is found in surgery and consists in making a more 
direct outlet through the vagina large enough to at once completely evac- 
uate the pus and enable the surgeon to dense arid disinfect the cavity. 



78 The Peoria Medical Monthly. 

Here the Doctor cited several cases. In closing he said : As the main 
object I had in view in writing this paper was to caution my associates 
against the danger of converting a chronic pelvic inflammation into a dis- 
astrous acute form, I desire to give a summary of suggestions and infer-- 
ences drawn from it. 

First. The sometimes terrible efiects of examinations or operations 
in the pelvis do not often, if ever, take place, when there is not a percepti- 
ble predisposing inflammation. 

Second. The inflammation may be so slight as to be easily overlooked. 

Third. It may be an original condition ; the sequence of an acute 
attack long gone by ; or it may be the product of some immediately pre- 
vious examination or operation, the effects of which have not subsided. 

Fourth. To avoid the dangers of acute inflammation, we should, in 
making a first examination for pelvic disease, conduct it in such a way as 
not to give the patient much pain, and when she complains of much pain 
and suffering, desist, at the sacrifice of complete diagnosis. 

Fifth. Complaints of much tenderness to the touch, or the use of 
instruments, especially in parous women, is sufficiently diagnostic of in- 
flammation upon which to base treatment for that condition. 

Sixth. If, with such tenderness, a thorough examination or opera- 
tion is imperative, it should be done under profound anesthesia. There 
is no question in my mind that much less danger of ill effects is incurred 
in making examinations or operations, on susceptible subjects, under the- 
free use of anesthetics. 

Seventh. Examinations or operations should not be repeated until 
the effects of the first have entirely passed off*. 

Eighth. As chronic parametritis is a frequent complication of most 
of the morbid conditions of the uterus it should be always suspected, and 
its diagnosis be carefully considered in all cases of metritis. 

Ninth. When chronic parametritis is present it should be the chief,, 
if not exclusive, object of treatment until removed. 

Tenth. It is not safe to use the sound, sponge tent, or intra-uterine 
stem, when their is perimetric inflammation. 

Eleventh. It is especially dangerous to replace a displaced uterus, 
when it is bound down by inflammatory adhesion, by any means which 
will overcome its fixedness by force. 

Twelfth. All local treatment of the uterus must be conducted with 
the greatest care in all cases where the complication is present. 

We regret that we cannot give a full abstract of Dr. 
Albert L. Gihon's paper on "Medical Education the Funda- 
mental Fact in Medical Ethics," read before the section in 
State Medicine. It was a most caustic arraignment of the 
scholarship which is allowed to receive diplomas, replete 






Society Transactions. 79 

with facts which must cause a blush upon the cheek of 
every physician who has the honor of his profession at 
heart. His whole paper was an able plea for a higher edu- 
cation, which alone can retain to the profession its honored 
position. 

The feature of the section in Surgery and Anatomy 
was a paper by Dr. S. D. Gross, of Philadelphia, on the 
" Value of Early Operations in Morbid Growths, especially 
Malignant." From it we take the following extracts : 

The value of early surgical interference in morbid growths, especially 
the malignant, has long been recognized by writers and teachers, but un- 
less I greatly err, it has not been discussed with that degree of force and 
emphasis to which its intrinsic merits entitle it. I therefore propose lay- 
ing the matter before you, if possible, in a stronger, if not also in a clearer 
light than any in which it has hitherto been presented, and in this wise 
bring it more fully under your notice for elaborate and dispassionate con- 
sideration. The great reason for the removal of tumors in the early 
stages of their development, must be thus stated: 1. — The less risk of 
shock and hemorrhage. 2. — The more effectual riddance of the diseased 
structure. 3. — The diminished probability of septicsemia or blood-poison- 
ing. 4. — The avoidance of unsightly scars. And 5. — The less risk of a 
recurrence of the morbid action, either at the seat of the operation or in 
other parts of the body. These propositions are so self-evident that any 
formal discussion of them seems to be out of place; nevertheless, it may 
be well to call special attention to a few points in order to impress them 
more fully upon your mind. 

The fact is now generally, if not universally, admitted, that all mor- 
bid growths or tumors, whether benign or malignant, are of local origin. 
That the constitution, in certain conditions, as when from any cause the 
general health is more or less seriously impaired, may predispose to such 
formations, is not improbable, but that a neoplasm can be developed in 
any organ or structure of the body of a perfectly sound person, without 
some local cause, is what no enlightened pathologist of the present day 
believes or teaches. There is unquestionably occasionally a«hereditary 
tendency to the development of morbid growths, both benign and malig- 
nant. We see this tendency, sometimes in a remarkable degree, displayed 
in warts and sebaceous cysts. , * * * =^ =^ 

I state, as another incontrovertible proposition, that all morbid 
growths, tumors, or neoplasms are the product of perverted nutrition, in 
which the comparatively few cells native to the part are replaced by col- 
onies of young cells, of the latter of which the new product is essentially 
composed. 



80 The Peoria Medical Monthly. 

All morbid growths are developed, directly or indirectly, under the 
influence of inflammatory action, the result of external injury, or as is 
more frequently the case, of some mechanical obstruction, causing, in the 
first instance, congestion of the part, and this, in turn, incited action and 
inflammation, both leading sooner or later to abnormal cell-growth, cell- 
formation, or cell-development. It is in this way, and in this way alone, 
that we can satisfactorily explain those morbid growths, both benign and 
malignant, which, as the phrase goes, arise without any assignable cause. 
One of the most simple of all tumors, the sebaceous, is formed under the 
irritating influence of its own natural secretions, retained by the closure 
of its natural outlet. Obstruction of a lacteal duct is, there is no doubt, 
a frequent starting-point of scirrhus of the mammary gland. There is 
not a surgeon of any experience anywhere who has not occasionally met 
with cases of carcinoma which were due, directly or indirectly, to the ef- 
fects of local injury. 

In speaking of the value of early and correct diagnosis 
he made the following just and proper criticism : 

It is in vain to conceal from ourselves the fact that there are com- 
paratively few reliable, ready, or trustworthy diagnosticians. Diagnosis 
is a high art, and it is not saying too much that the profession, as a body> 
are not sufficiently familiar with it to render it all times, or even in a 
minority of cases, properly available at the bedside. It is, of all the arts 
in our profession, the one which demands the greatest amount of refined 
culture, experience, and tact ; not culture, experience, and tact of 
an ordinary type, but of the highest possible type. Founded essentially 
upon a thorough knowledge of pathological anatomy, a branch of science 
little cultivated in any of our schools, and totally neglected in most, it is 
not surprising that the art of diagnosis should be so little understood by 
the generality of practitioners, and so many errors committed in the ex- 
amination of morbid growths. If there is any one thing in the organiza- 
tion of our medical colleges more culpable, I had almost said more crim- 
inal, than any other, it is the exclusion from their curriculums of the 
study of pathological anatomy. Just in proportion as our knowledge of 
morbid structure is positive, accurate and comprehensive will be the 
probabilit}* that we shall become skilled diagnosticians, and conversely. 
Hence, so long as this state of things exists, we shall look in vain for any 
marked improvement in this direction, and what is true in this respect is 
true alike of city and country practitioners, standing, as they do, upon 
the same unfortunate platform. * * * * 

In all operations undertaken for the removal of neoplasms of what- 
ever nature, the golden rule is to perform the work as thoroughly as pos- 
sible. If this cannot be done, it is better in many cases, if indeed not in all, 
not to meddle with the growth at all, as such interference often only tends 



Society Transactions. 81 

to light up increased activity, not only in the abnormal structures them- 
selves, but in the surrounding ones. In carcinoma, the knife, as already re- 
peatedly stated, cannot be employed too early. The longer it is withheld 
the greater will be the probability, not of relapse, properly so-called, but 
of some of the cancer cells being left behind, buried out of sight, and 
thus serving as new centers of morbid action. All secondary develop- 
ments, as enlarged and indurated lymphatic glands, should of course be 
removed in immediate succession. All sarcomatus neoplasms, are, as a 
rule, dangerous formations, however early subjected to the knife, not so 
much on account of any inherent tendency to recurrence after extirpation, 
as from their liability to attack other parts of the body from causes simi- 
lar to those which gave rise to the primary disease. The worst of all the 
sarcomas is the round-celled. Any rapidly growing tumor is, as a law, a 
bad subject for successful surgical interference. * * * 

All benign growths of rapid development cannot be extirpated too 
soon. Let us, for example, take a cystic tumor of the ovary. No one 
will deny that a neoplasm of this kind of small bulk can be removed 
more easily and with less risk to life than a large one, or one of long 
standing. In the former case there will probably be no adhesions, and 
little or no danger of hemorrhage or shock ; a comparatively small inci- 
sion will be required to expose the mass, and the resulting peritonitis will 
be restricted within the healthy limits, the limits of repair. In ovarian 
cysts of large size, the reverse of all this is usually the case; there is also 
apt to be greater shock and greater liability of blood-poisoning. Similar 
remarks are applicable to chondromas, fibromas and osteomas ; operated 
upon early in their progress, their removal is generally easily effected 
with little or no risk to life; allowed to remain until they have attained a 
large bulk, the troubles and dangers of operative interference are aug- 
mented a hundred-fold. Nothing more happily illustrates the truth of the 
old adage, "A stitch in time saves nine." * * * 

What should be the rule of action of the surgeon in cases in which, 
as for instance, in carcinoma of the breast, in which, perhaps, several op- 
erations have already been performed, there is a large ulcerated surface, 
attended with excessive pain and a large quantity of the foulest discharge, 
poisoning the very atmosphere which the sufferer is obliged every moment 
to inhale ? Surely no sensible and humane practitioner would hesitate in 
such a condition to do the rational thing to be done — to sweep away the 
whole mass of the disease, so far as it is accessible with the knife, and then 
treat the wound and system upon general principles. Such a procedure 
is the only feasible one of relieving pain, of moderating suppuration, and 
of making the patient temporarily comparatively comfortable. Death 
under such circumstances is generally hailed as a welcome visitor. * * 

What I have here said respecting early surgical interference in ma- 
lignant and other morbid growths applies with equal force to many other 



82 The Peoria Medical Monthly. 

surgical affections, as well as to diseases in general. Thus an abscess, if 
not opened early and freely, is sure to cause serious destruction of tissue, 
to say nothing of the concomitant pain and other distress. A small stone 
is more easily crushed or extracted than a large one, while the risk 
to life is incomparably less, inasmuch as there is less danger from shock 
and hemorrhage, laceration of structure, urinary infiltration, pelvic cellu-. 
titis, peritonitis pyaemia or ursemic poisoning. Besides, the longer a stone 
remains in the bladder and the more it increases in size, the greater will 
be the chance of its causing serious disease of the bladder and of its de- 
pendencies. ******* 

Dr. Chas. W. Earle, of Chicago, read a short paper be- 
fore the section on Diseases of Children, on 

" CEPHALHEMATOMA IN THE NEW BORN." 

Cephalhsematoma, the speaker said, is a soft, elastic, fluctuating tu- 
mor, generally painless, and situated upon one of the cranial bones. It 
takes place, it seems to me, with somewhat greater frequency than the lit- 
erature of the subject would lead us to suppose. I have already seen four 
cases in twelve years' practice. Contrary to the experience of other ob- 
servers, all four cases have taken place upon the left parietal bones. It 
is stated by some writers that in the great majority of cases, indeed, in 
almost all, the tumors have been upon the right parietal bone, inasmuch 
as it is this bone that is exposed to the pressure of the rigid os uteri in the 
greatest number of deliveries. This tumor has not, in the cases that 
have occurred in my practice, made its appearance immediately after 
birth. Some three or four days have usually elapsed before my attention 
has been called to the difiiculty. It has in a few cases been noticed upon 
both of the parietal bones, although this has not occurred in my practice. 
When the tumor is first noticed it is a soft and painless enlargement. In 
the course of a few days a firm bone ridge is usually noticed surrounding 
the base of the tumor. The seat of the difficulty, he said, is between the 
bone-proper and the periosteum, and the enlargement is caused by the 
rupture of a blood vessel in this position, and the bony ring is simply 
bony material thrown out from the periosteum to repair this injury. This 
ridge, or bony ring, does not contract evenly in all directions, and little 
hard projections will spring forward from this ridge, showing that the de- 
posits of osseous material does not take place evenly in all directions. As 
the process of repair goes on, the tumor loses its soft, fluctuating feeling, 
and in the course of a few weeks nothing can be detected but a slight 
want of symmetry in the two parietal bones. 

The most important question connected with the subject, the speaker 
said, was its diagnosis, and it appeared to him that there were four diffi- 
culties with which it was likely to be confounded, namely: caput succedse- 
neum, congenital encephalolocele or hernia cerebrum, erectile tumors and 



Society Transanctions. 83 

crania tabes. To show the distinction between these four difficulties and 
the one under discussion the speaker said the caput succedseneum is an 
cedematus condition, and it does not fluctuate, being only a difficulty of 
the scalp, cellular tissues, and blood vessels; congenital encephalolocele 
never occurs, with a possible exception, on the cranial bones; a vascular 
tumor has sometimes the same boggy feeling noticed in caput succedseneum, 
but it has no bony ridge; crania tabes is the soft places found upon the 
■cranial bones in rickety children. 

As to the treatment of this difficulty, the speaker said the best method 
to be pursued was a judicious letting alone, nature, in a great majority of 
•cases, being able to efiect a cure without the aid of the medical art. 

In the general session of Wednesday, Dr. N. S. Davis 
read the report of the committe on the proposed journal of 
the associp.tion, introducing resolutions which make the 
journal an established fact. These were almost unani- 
mously adopted, and Dr. Davis was declared to be the edi- 
tor of the new journal. It is said that the first number 
will appear early in July. 

In the afternoon Dr. Jno. Morris, of Maryland, read a pa- 
per before the section of Obstetrics, with the following title: 

" What Means can be Judiciously Used to Shorten the Term and 
Lesson the Hours of Labor," of which the following is a brief abstract : 
In describing lingering labor he divided it into three stages; first, when 
the head remains high up; second, when it has descended into the pelvic 
cavity, but the parts are tense and undilatable; and third, when the child 
inhinges with perineum. He explained the procedure to be used on all 
these conditions, and at what time to employ them. These procedures 
were, detaching the members around the cervix with the finger in the first 
stage, dilating with the pulpy part of the finger and stretching it cau- 
tiously during each pain. Forcible external compression, pushing the 
cervix over the occiput; the administration of opium or ergot, but never in 
first cases, and finally chloroform. These means all failing, the only al- 
ternative is the forceps. The doctor further said that if the means he 
suggested were employed, laceration of the os and perineum, those betes 
noir of modern medical literature, would be obviated, and post-partum 
hemorrhages, that greatest of all complications in labor, would be pre- 
vented. 

Dr. T, N. Reynolds, of Detroit, read an interesting 
paper before the section on Practical Medicine, on 

" The Alimentary Canal in Bronchitis and Phthisis." Dr. Reynolds 
said the abnormal condition of the alimentary canal and portal and lac- 



84 The Peoria Medical Monthly. 

teal systems was often the predisposing cause of both acute and chronic 
affections in all parts of the respiratory apparatus. Speaking only of 
bronchitis and phthisis, acute tracheo-bronchitis was often caused by ex- 
cess in the dietary elimination with proportionately incomplete waste. In 
view of this fact, in such cases the treatment should be prompt evacuation 
of the bowels and restriction of the diet to a light liquid form. 

Necessary quiet and warmth of the surface should be maintained, but 
the atmosphere of the room should not be too warm. The cathartic, hot 
drinks and a warm surface produced a revulsion of nervous energy from 
the inflamed part to the bowels, kidneys and skin. He deprecated the use 
of ordinary cough mixtures to the use of this more rational treatment. 
Morphine, quinine, aconite and veratrum viridie were the more usually 
appropriate remedies in the first stage, but did not equal the treatment 
without drugs to which he referred. Derangement of the primse and se- 
cundse was still more causative of chronic bronchitis, and treatment should 
have reference to this fact. When purulent, quinine was the best remedy 
in connection with the management pertaining to ingestion and elimina- 
tion. It was not wise to press stimulants and strong nourishment when 
not readily digested. Clothing should be sufficient, but not excessive; a 
.common mistake was wearing too much on the chest. He had a few times 
seen striking improvement in expectoration in those going about, from re- 
moving two or three extra undershirts and a chamois leather lung protec- 
tor. Physical exercise, involving free use of the lungs, restored wonder- 
fully their normal elasticity after an attack. It dissipated thickening and 
adhesions, just as continued free motion dissipated the thickening and ad- 
hesions from around a recently inflamed joint. Catarrhal fibroid phthisis 
most frequently was the result of neglected chronic bronchitis, and should 
be treated in much the same way, not by cod liver oil or any other sup- 
posed specific alone, especially if they interfered with indigestion; but 
quinine was useful in lowering temperature and lessening the secretion of 
pus, and the patient should cultivate an outdoor life, with plenty of physi- 
cal exercise and wholesome mental occupation. Under this regime diges- 
tion and tissue building soon went on properly, cavities often healed, and 
recovery became complete. Any region free from malaria or unwhole- 
some emanations, with a temperature permitting constant outdoor life, 
would answer for a resort. 

During the general session on Thursday morning, a 

communication was read from the St. Louis Medical Society, in which it 
was stated that an association can only be ruled by laws made by itself. 
Grood laws, under some conditions of circumstances, become oppressive 
under others. In the past thirty-four years so many changes have oc- 
curred, the code has accomplished all it was designed it should, but at 
present many of its features are obsolete, and not adapted to their wants 



Periscope. 85 

The necessity of an early revision is very apparent, is loudly called for in 
all parts of the country, and it cannot be repressed much longer. The 
American Medical Association can alone order the revision. States soci- 
eties can only ask for such revision. The excitement and evil conse- 
quences of a schism can be easily averted now and fraternal feeling re- 
stored. The paper, therefore, asked that a committee consisting of one 
member from each State be appointed to take into consideration the ad- 
visability of revision and report thereon at the session in 1884, and that 
the committee be empowered 

TO PREPARE A NEW CODE OF ETHICS. 

When the resolution was read a motion to table it was immediately 
made, and being put to the house was carried by a considerable majority. 
About three-fourths of those present seemed to oppose a revision. 

Dr. W. F. Peck, of Davenport, la., as chairman of the section on 
surgery and anatomy, presented his reports of what had been acomplished 
in these departments of science during the past year. The paper was a- 
most elaborate review of the advancement in surgical knowledge not only 
in this country but throughout the world. It was one of the most care- 
fully prepared papers read during the entire session. 

The Committee on Nominations presented their report through Dr. 
Eugene Grissom, of North Carolina. Dr. Austin Flint, sr., was announced 
for president, which created great applause; first vice-president, Dr. R. A. 
Kinlock, South Carolina; second vice-president, T. B. Lester, Missouri; 
third vice-president, A. L. Gihon, United States Navy; fourth vice-presi- 
dent, S. C. Gordon, Maine; treasurer, Richard J. Dunglison, Philadelphia; 
librarian, C. H. A. Kleinschmidt, Washington, D. C. They favored Wash- 
ington, D. C, as their next place of meeting and the first Tuesday in May 
as the time of meeting. Dr. A. Y. T. Garnet, of Washington, was selected 
as chairman of the committee of arrangements, and Dr. D. W. Prentis, 
of Washington, secretary. 



Percussion of tlie Colon in Diarrhoea. 

Diarrhoea depending upon fecal accumulations in the 
lower bowel {diarrhoea parodoxa) is a well known condi- 
tion, the treatment of which by laxatives is of long-recog- 
nized utility. The diagnosis, however, between this form 
of diarrhoea and that other whose location is, more strictly 
speaking, in the small intestine, has often presented con- 
siderable difficulty. In an article upon this subject, in the 
Deutsche Medlcinische Wocheschrinft of February 14, 1883, 



86 The Peoria Medical Monthly. 

Dr. Goedicke advocates the systematic practice of abdom- 
inal percussion in all cases of diarrhoea. He was led to 
adopt the practice in this wise: Several years before, when 
a young army surgeon, his suspicions were often aroused 
Idj the number of soldiers coming to him with the com- 
plaint of diarrhoea. In order to detect the malingerers, 
he made use of percussion of the colon, reasoning that in 
genuine diarrhoea the descending colon should be empty, 
and therefore give a tympanitic percussion note. He was 
surprised, therefore, to find that the contrary was usually 
the case. In most of the men in whom diarrhoea actually 
existed, as was ascertained from the reports of the infirm- 
ary orderlies, the percussion note of the descending col- 
on was dull. The investigations now undertaken led him 
to the following conclusions: 1. In a healthy individual, 
with normal movements, if we percuss the colon, we shall 
find that the left iliac fossa usually gives a flatter note 
than the right. 2. In patients suffering from diarrhoea the 
greater dullness may be on either side, but is usually, in 
otherwise healthy persons, on the left. 3. The same con- 
dition obtains in children. 4. Whenever there is tender- 
ness on pressure, it is found on the same side as the greater 
dullness. 5. The term "dullness" is to be understood as 
relative and not necessarily absolute, for the percussion 
note on both sides may be actually tympanitic if the colon 
be distended with gas. The author asserts that by far the 
more common form of diarrhoea is that excited by fecal 
accumulation in the large intestine. It is this variety that 
is characterized by increased relative dullness in the left 
iliac fossa, and in which opiates and astringent remedies 
are contra-indicated. In the other form of diarrhoea the 
trouble is in the upper bowel, and here the percussion note 
upon the right side is more dull, or less tympanitic, than 
that on the left. It is in these cases that the ordinary di- 
arrhoea medicines find their application. Dr. Goedicke 
concludes by urging the practice of abdominal percussion 
in every case of diarrhaea, where possible (it is always pos- 
sible in children, and it is in children that the knowledge 
of the true nature of the trouble is of the greatest impor- 
tance). And he states his conviction that the more general 
this practice becomes, the less frequently will opium be 
■employed in the treatment of diarrhoea. — Medical Record. 



i 



Angina Pectoris Successfully Treated witli Nitro-Glycerine. 

Dr. Jacob Frank, of Buftalo, N. Y., relates the history of 
a married woman, aged thirty-one, mother of three healthy 



Periscope. 87 

children, who had for six years suffered intensely from at- 
tacks of angina pectoris. Dr. Frank does not say whether 
there was any organic heart trouble. She was treated with 
morphine and various other remedies, but without success. 
Dr. Frank at first applied the faradic current over the 
pneumogastric, and got relief. During the next attack, 
however, this failed. The patient was then put upon nitro- 
glycerine, mj. of the one per cent, solution gradually in- 
creased to /»vj., t. i. d.; then decreased. The patient has 
had no further attack. Dr. Frank writes: "During the 
course of this treatment a rather curious phenorr: ^on oc- 
curred. After she had been taking this nitro-glycerine for 
about six weeks, aphthae broke out on the tongue, mouth 
and fauces. The medicine was stopped, and these ulcers 
treated with borax, etc., after which the treatment was 
again resumed." Dr. Frank gives the usual explanation of 
the curative action ot the drug. — Medical Record. 



Fever Dependent Upon Fecal Accumnlation. 

A rise of temperature is often observed in women after 
childbirth or ovariotomy, which subsides after a free move- 
ment of the bowels. In addition to the fever there are fre- 
quently symptoms of peritoneal irritation— pain or pressure, 
meteorism, elevation of the diaphragm, cyanosis and rapid 
pulse. To explain these symptoms, Dr. Kustner instituted 
a series of observations upon women after ovariotomy 
(Zeitschrift fur klin. Medicin. vol. v.) He found that the 
temperature rose when the fecal matters had passed into 
and extended the rectum. By reason of increased peri- 
stalsis and from direct pressure of the distended rectum, 
the wounded surfaces were disturbed and a resorption ot 
the secretions induced. This gave rise to fever. Perhaps 
also the retained fgeces caused a more rapid decomposition 
of the secretions. The same explanation will answer for 
similar conditions in the puerperal state, and the author as- 
serts that peri-uterine exudations are often due to the same 
cause. — Medical Record. 



Treatment of Furuncles. 

It is well known to-day that the matter ot furuncles is 
inoculable spontaneously, and it is considered that this 
spontaneous inoculation is encouraged by the softening of 
the epidermis from the employment of the poultice so often 



88 The Peoria Medical Monthly. 

used in this affection. The primitive boil becomes thus the 
point of departure for secondary ones, which manifest them- 
selves in the neighborhood. To prevent this inconvenience, 
M. Labbe had the idea of employing successively for the 
dressing of furuncles a solution of chloral or phenic acid, 
but he perceived that this dressing, which was undoubtedly 
antiseptic, did not hinder the softening of the epidermis; 
it was thus he had recourse to collodion, a layer of which 
he placed around the furuncle. The result answered to his 
expectations, for no secondary evil appeared. M. Pasteur 
discovered the microbe of the furuncle, which he found sit- 
uated at the summit of the pustule. However, it will be 
borne in mind that secondary evils do not always depend 
on auto-inoculation, but often are the result . of a diathesis 
at present not well understood.— iferf/ca/ Press and Circular. 



How to Give Santonin. 

Lewin finds fault with all the usual methods ot admin- 
istering santonin. According to him it should be given in 
its least soluble forni, /. e., in that form in which it will be 
the least readily absorbed, as the effect desired is not a gen- 
eral, but a local one. An oily solution of santonin under- 
goes according to his experiments performed on animals, 
not the slightest absorption in the stomach, so that under 
no circumstance is any trace found in the urine. Almost 
any kind of oil may be employed, cocoa-nut oil, olive oil, 
cod-liver oil, or castor-oil. He recommends that three 
grains of santonin be mixed with two ounces of oil and 
given in four doses. He thinks that a useful addition to the 
above would be that of an oil contained in santonica, the 
oleum cinse aether., for the reason that all ethereal oils have 
been shown to act as poison on the lower forms of animal 
life. 



Treatment of Gout. 

Dr. N. S. Davis, of Chicago, recommends forty drops of 
an equal mixture of the acetated tincture of opium and. 
wine of colchicum seeds to control acute paroxysms of gout. 
This dose may be repeated in an hour if necessary. Often- 
times, one or two doses will abort what threatens to be a 
very severe attack. When the j^aroxysm is under control 
the same remedies may be continued in smaller doses, three 
or four times daily, if any gout remains. We have used 
this remedy, and can add our indorsement to this distin- 
guished recommendation. — Medical and Surgical Be^wrter 



li 



Periscope. 89 



Cold Abscess of tlie Tongue. 



A woman, thirty-five years of age, presented herself 
with a swelling upon the right side of the tongue. The tu- 
mor was the size of a walnut, soft and fluctuating, and not 
painful on pressure or manipulation. It had appeared,with- 
out any known cause, four months previously, had attained 
its present size in about a* month, and then remained sta- 
tionary. The patient's general health was excellent. Dr. 
De Brun incised the tumor, which gave exit to a quantity 
of thin pus. The sac was dissected "away and the wound 
closed with sutures. Union was complete in a few days. — 
Le France Medicale, No- 14, 1883. 



Dental Formation in the Nasal Cavity. 

Dr. Max Schaeffer relates the tollowing case in the 
Deutsche Med. Wochenschrift, No. 2, 1883: A gentleman had 
for some time experienced a slight obstruction in one nos- 
tril. Examination revealed the presence of a hard, round- 
ish, movable body, which was attached to the floor of the 
nostril about one inch from the anterior opening. It was 
removed by the snare, and was found to be a perfectly 
formed canine tooth, a little over an inch in length. The 
anterior portion was covered with enamel, and its little root 
presented a layer of cartilage. There was no bony alveola. 
The patient had all his teeth. 



Pruritus Ani. 



Pruritus ani, says the New York Medical Record, often 
proves a most annoying and obstinate symptom, persistently 
refusing to yield to our therapeutic endeavors. It is, there- 
fore, very comforting to be assured that we have, in two 
well-known drugs, two equally efficient specifics. Thus, Dr. 
Steele, of Denver, (Lancet and Clinic), has found quinia sul- 
phate, rubbed up with only sufficient lard to hold it to- 
gether, a never-failing specific in this affection. He uses it 
in both pruritus ani and vulvae. The nearer you get to the 
full strength of the quinine, the more efficacious will it 
prove; and some other physician is similarly confident 
about the local application of Peru balsam Hence, we are 
told, there need be no uiore itching about the anus, and 
medicine has achieved a new triumph. Selah ! — Gaillard''s 
Medical Journal. 



90 The Peoria Medical Monthly. 

Effects of the Internal Administration of Glycerine. 

Dr. Tisne speaks highly of glycerine as a therapeutic 
agent internally administered. He states (Gazette des Hop- 
itaux, March 17, 1883), that it causes no irritation to the : 
mucous membrane of the digestive tract beyond exhibiting 
a slightly increased peristaltic movement. It exerts a bene- 
ficial effect upon nutrition, increasing the v^eight and palli- 
ating many of the distressing symptoms in phthisis, such li 
as loss of appetite, diarrhoea, night-sweats, and insomnia, j 
Its action upon the liver is manifested by an increase in li 
size of the organ and by a more abundant flow of bile. Ii> i 
has a diuretic effect and increases the excretion of urea, . 
the chlorides, and the phosphates. The alkalinity of the | 
urine is diminished, and if any pus be present in this fluid 
it is greatly lessened in amount. 



Treatment of Ulcers with Larg^e and Slowly Separating Cen- 
tral Sloughs, 

The following is;, as far as I am aware, a new method 
of treating these ulcers, although possibly the same idea, 
may have occurred to others as well as to myself. In these 
ulcers the slough frequently remains as a hard, white mass, . 
very slow and tedious in separating from the subjacent tis- 
sue. There being no possibility of healing whilst this mass 
remains, its rapid removal becomes a matter of some im- 
portance. Finding that the ordinary methods of treatment 
were slow in effecting separation of the slough, I was led 
to try the effect of pepsine as a dressing. I have now used 
it in some half-dozen cases, and with the most satisfactory 
results. Within a week it dissolves the slough, and leaves 
a granulating surface, very amenable to further treatment. 
My method of using it is to apply a lotion to the ulcer con- 
taining pepsine wine, mixed in varying strengths, but usu- 
ally half pepsine and half water, with a little tr. of laven- 
der to improve its appearance. — B. A. Whitelegge, M. D., 
Resident Medical Office — Medical Press. 

Dr. Fred S. Dennis succeeds the late Professor Van 
Buren in the Chair of Surgery at Bellevue Hospital Medi- 
cal College. Dr. Dennis is one of the youngest men ever 
appointed to fill so important a chair. His age is stated to 
be about thirty-four years. 

"Have you ever tried the faith cure?" asked a long- 
haired, sallow stranger, addressing a gentleman in the 
street car. " I have," was the reply. " Do you believe m 
it ?" "I do." " May I ask, then, of what you were cured?" 
"Certainly ; I was cured of my faith." 



Periscope. 91 

Tlie Cause and Cure of Cholera Infantum. 

Dr. A. E. Walker, of Mount Liberty, Ohio, sends us 
some judicious criticisms upon ''Henoch's Lecture on Chol- 
era Infantum," published in "Wood's Library of Standard 
Medical Authors, for 1882."' Dr. Walker believes that hipjb 
temperature is not given its proper importance as a cause 
of disease. "One other fault that I find with his lecture is- 
that his cases of cholera infantum appear to have assumed 
a chronic form (figuratively speaking). He says that v^hen 
we are called to see a patient suffering an attack of cholera 
infantum on the second or third day of the disease, we can 
administer such remedies as he indicates. Now, in this 
part of the world (it may be entirely different in Berlin) a 
physician is scarcely ever called upon the second or third 
day after the attack has begun, unless it is for the mother 
of the babe who is suffering from nervous shock caused by 
the sudden death of her child. As I understand cholera 
infantum, it is very sudden in its onset and the majority of 
cases die within thirty-six hours if left to the curative 
efforts of nature." 

Dr. Walker thinks that Henoch's treatment would be 
valueless in a vast majority of cases. He recommends in 
the place of it, the plan adopted by Profs. D. N. Kinsman 
and Pooley, of Columbus, Ohio. These gentlemen com- 
mend injections of ice-water, cold compresses to abdomen, 
and in addition to this Dr. Pooley advises the use of sub. 
nit. bismuth in the following doses: he takes enough bis- 
muth to make a tolerable thick cream, using aqua dist. as 
the vehicle; of this he gives from one-half to one tea- 
spoonful about every four hours, until choleriform discharg- 
es ceases. 

Dr. Walker writes: "This plan of treatment, I believe,^ 
is destined to become the treatment par excellence in cases 
of cholera infantum. — Mass. Eclectic Med. Jour. 



Treatment of Ring-worm. 

The treatment of ringworm. Dr. Simon says (British 
Medical Journal), should be thorough and vigorous, so long 
as the black spot or stumpy hair remains, and when neces- 
sary constitutional remedies should be given. In recent 
cases local applications of sulphurous acid and glycerine,, 
and carbolic acid pomade are useful; epilation is also- 
frequently necessary. In chronic cases oleate of mercury 
and croton oil properly applied will generally effect a 
cure. 



THE 



Peoria Medical Monthly. 



THOS. M. MelLVAINE, A. M., M. D., 

Editor and Publisher, 

204 South-Jefferson Street, .... PEOKIA. ILL. 

***The Editor is not responsible for the statements or opinions of contributors. 

***Short original articles are invited from any reader, whether a subscjiber or not. 

***If extra copies are desired by a contributor, the number must be specified when 
the article is sent in to the Editor. 

#♦* All exchanges, books for review, and communications must be addressed to th 
Editor and Publisher. 

***The publication day of this journal is on or about the loth of each month 

***To subscribers! A pencil mark at this place indicates that the time of your sub- 
Bcription has expired, and that a prompt renewal is urgently requested. 



(^^ttofial §t\mx\mt\\X, 

The Illinois State Board of Health and the Columbus Med- 
ical Collegre. 

The June number of the Chicago Medical Journal and 
Examiner contains an item with the following caption: "Is 
it true? Has the Illinois State Board of Health Uncondi- 
tionally Surrendered to Columbus Medical College?" The 
incitement to these queries is claimed to be their affirma- 
tive announcement by Gaillard's Medical Weekly, founded 
upon the allegations (1) that in October, 1882, "the Secre- 
tary of the Illinois Board of Health requested a formal n 
communication from the West Virginia State Board ofj 
Health, giving its action respecting the Columbus Medical 
Oollege;" (2) that "meantime a nephew of Dr. J. W. Ham- 
ilton, the owner of Columbus Medical College, had become 
Governor of the State of Illinois;" (3) that "the Illinois 
State Board of Health has not sustained the West Virginia 
Board," but " by default it recognizes the college which 
granted a diploma to a man after three weeks' attendance 
upon a lecture course." If these allegations are true they 
fully justify the Journal and Examiner in its further com- 
ments, as follows: "Is this a stand that promises a higher 
medical education? Is this the Board which is to sweep 



Editorial Department. 9B 

Illinois free from uneducated doctors? Is three weeks' 
lecture attendance sufficient to constitute a regular medi- 
cal course? Alas, the times! the customs! It looks as if 
the owner of Columbus Medical College fixed his nephew, 
the Governor of Illinois, so that the Illinois State Board 
dared not to peep against Columbus Medical College,'" etc., 
etc. 

This matter has seemed to us of sufficient importance, 
now that it has received the dignity of a quasi endorse- 
ment by so influential a journal as our Chicago contempo- 
rary, to warrant an examination of the record as to the 
facts, in the belief that, as usual, there were two sides to 
the question. It is found, as a result of such examination, 

1. That it is true that "the Secretary of the Illinois 
Board of Health requested a formal communication from 
the West Virginia State Board of Health, giving its action 
respecting the Columbus Medical College "—and that such 
request was occasioned by appeals from the West Virginia 
Board to the Illinois Board, that the latter body should 
sustain the former in its action with regard to the Colum- 
bus Medical College. It further appears of record that, on 
receipt of the formal communication requested, the Illi- 
nois Board invited the representatives of the Columbus 
Medical College to be present at the next meeting of the 
Board to make such answer as they deemed proper to said 
formal communication. 

2. That this meeting of the Illinois Board was held 
on the 11th and 12th of January, 1S83, and that whatever 
action was taken with reference to the Columbus Medical 
College, by the Illinois Board, was taken during those two 
days. Hence it is not true that, in the " meantime a neph- 
ew of Dr. J. W. Hamilton, the owner of Columbus Medical 
College, had become Governor of the State of Illinois," — 
the records in the office of the Secretary of State showing 
that Shelby M. Cullom was Governor of Illinois on the 
11th and 12th of January, 1883, and so continued until the 
6th of February following, a period of over three weeks 
after the meeting at which it is alleged .John M. Hamilton 
was " fixed " as Governor, in the interest of his uncle's col- 
lege in Ohio. 



94 The Peoria Medical Monthly. 

3. That if we read the text of the Medical Practice 
Act correctly, the Illinois Board has, if anything, exceeded 
its legal authority in its effort to sustain the West Virginia 
Board, as a matter of comity between kindred organiza- 
tions, and in what it, doubtless, considered the best inter- 
ests of the public welfare. Under the law the action of 
the Board upon the question of recognition of a given 
medical college, maj be taken only upon presentation of a 
diploma from such college, actually offered as the basis for 
claiming a certificate entitling the owner to practice medi- 
cine in Illinois. No such diploma was offered — no such 
application was made; and the Board would have had no 
authority or justification for saying in advance what it 
would or would not do in the absence of such diploma and 
application. 

The Board may, however, define what constitutes the 
"good standing" of medical colleges, and it is the diplomas 
of such only — i. e., medical colleges in good standing — 
which it is called upon to recognize. This definition, 
formulated after careful study and investigation, is duly 
set forth in its schedule of minimum requirements; and is 
in itself a sufficient answer to the somewhat hysterical 
queries we have quoted concerning " a higher medical edu- 
cation," and "a three weeks' lecture attendance." 

The Journal and Examiner'' s " hope that in some man- 
ner the whole affair may be shown to be a myth, and that 
the Board will sustain the action of the West Virginia 
Board," must be gratified by the foregoing, at least to the 
extent of satisfying it that there is no foundation for the 
graveness of the charge — namely, that a Governor of 
Illinois had violated the dignity of his office by attempting 
to intimidate or unworthily influence the action of his 
appointees; or that such appointees had so far forgotten 
their responsibilities to the public and the profession as to 
yield to such intimidation or influence. We are happy to 
believe that neither the late nor the present Governor 
could be capable of the former; and the record of the 
State Board of Health, during the six years of its existence, 
is certainly a sufiicient refutation of the latter. 



Editorial Department. 95 

Obituary. 

Died. — At her residence in Peoria, 111., Friday morning, 
June 15th, Mrs. Christina Walker Boal, wife of Dr. Robert 
Boal, aged 73 years. 

Mrs. Boal was born in Philadelphia, Pa., April 30, 1810. 
When she was quite young her parents removed to Ohio. 
In May, 1831, she was married to Dr. Boal at Reading, 
Ohio, where they resided until 1836, when they removed to 
Lacon, 111. In 1865 they removed to Peoria, which place 
has since then been their home. Mrs. Boal was a lady of 
excellent qualities, who made friends on all sides. Pos- 
sessed of brilliant conversational powers and gifted with a 
happy disposition, she was a cherished friend and a general 
favorite. She was also gifted with high literary talent 
which was made manifest by many graceful contributions 
to the press. For years her contributions were to be seen 
in the Philadelphia Saturday Evening Post, the Ladies' 
Friend, Graham's Magazine and local papers. While her 
husband was a member of the State Senate, she wrote a 
series of letters for the Chicago Tribune under the title, 
" Springfield as Seen by a Lady." These attracted wide 
attention and for a long time their authorship was a secret. 
Many of her original letters were copied into English pe- 
riodicals as well as translated into a number of German, 
French and other foreign magazines. 

Mrs. Boal was the mother of three children, who sur- 
vive her — Charles T., of the wholesale store of Saxton, 
Cribben & Co., Chicago; James St. Clair, asssistant prose- 
cuting attorney for the Northern District of Illinois, and 
Clara B., widow of the late Col. Greenberry L. Fort, of 
Lacon. 

Dr. Boal has the warmest sympathies of his friends in 
this his greatest affliction. 



Notes and News Items. 

Married. — At the residence of the bride's uncle in 
Warrensburg, 111., May 29, 1883, Dr. W. L. Leforgee (Rush 
'81) to Miss Jessie F. Drake. Dr. and Mrs. Leforgee have 
removed to Decatur, 111., where the Dr. will engage in the 
practice of his profession. 



96 The Peoria Medical Monthly. 

The Monthly begs to express the sentiments of many- 
friends, in wishing the young couple happiness and long 
life to enjoy it. 

Returned. — Dr. W. T. McLean (Rush '81) has returned 
to Maroa, 111., where he will resume the practice of medi- 
cine. 

Died.— We are pained to hear of the death of Dr. F. 
AV. Bullock, of Vermilionville, 111., (Rush 76) on March 
31st. Cause of death, inflammation of the brain. 

Removal. — Prof. W. E. Quine has resigned his chair in 
the Chicago Medical College, and has accepted the chair of 
Practice of Medicine in the College of Physicians and Sur- 
geons, Chicago. 

No Apology. — We offer no apology for the tardiness of 
this number of the Monthly. The large amount of mate- 
rial sent in has necessitated a corresponding increase in 
the number of our pages, which must be our apology. 

Crowded Out. — Notes from Private Practice, Corres- 
pondence and Book Notices have been omitted this 
month to allow of reports of the American and Illinois 
Medical Societies. 

Many Thanks. — We are deeply indebted to our friends 
for the increasing interest shown in the Monthly, by the 
large number of articles, reports of cases, etc., sent in for 
publication in its pages. We only wish we could afford to 
print 80 or 100 pages each month, but our low subscription 
price forbids. Publishers of other journals are growling 
at us already for the large size of the Monthly and its low 
price, but we can not help it. We promised long ago to 
give our readers just as much as we had money to pay for, 
and we have done it. 

A Hint to Contributors. — Owing to the amount of 
original matter sent us, some of it is forced to lay over to 
succeeding issues. That we may give every one an equal 
chance, will our contributors please "boil down" and con- 
dense their articles as much as possible. We do not mean 
to be so " brief" as to be worthless, but be as brief as pos- 
sible. 



Editorial Department. 97 

Renewals.— Some two weeks ago we mailed renewal 
blanks to those whose subscriptions had expired, and we 
have been almost literally overwhelmed at the promptness 
of response on the part of our friends. We never before 
believed that the Monthly was so popular, but this proves 
it. Thanks gentlemen, thanks! 

Large Meeting. — Contrary to general expectation 
the Cleveland meeting of the American Medical Society 
was one of the largest ever held. We counted 996 names 
on the official registration list. 

Unpleasant. — We notice in the Cleveland daily papers 
that there was not entire unanimity of purpose and feeling 
among the members of the Committee of Arrangements. 
Some of the most prominent members of that committee 
even came to blows — to their own disgrace and the dis- 
grace of the profession. 

Married. — A card upon our table reads as follows: 
" Aaron W. Edmiston, Maria D. Jones. Married, Tuesday 
evening, June 12. Clinton, Illinois." The gentleman 
referred to is our friend Dr. Edmiston, (Rush '80) and we 
hasten to offer to himself and bride our heartiest congrat- 
ulations. 

Third Edition. — So great has been the success of Dr. 
D.W. Cathell's book, "The Physician Himself," that a third 
edition has been demanded. A physician of nearly forty 
year's successful practice said to us only yesterday, " It is 
one of the most interesting books I ever read, and shows a 
profound common sense on the part of its author. Every 
young doctor should read it again and again." Send for a 
copy and you will never regret it. The publisher's address 
is Cushings & Bailey, 262 W. Baltimore St., Baltimore, Md. 
Price, $1.25. 

RicoRDiANA.— An old pupil of Ricord recently gave us 
a pleasant account of the famous master, and some of his 
peculiarities. One hon mot will bear repeating; he said du- 
ring a lecture, " Messieurs, le vaqin c'est le pivot de le societe." 
The similarity in the words is so alike that translation is 
unnecessary. 



98 The Peoria Medical Monthly. 

Receipts. 

To save the time and expense requisite for sending a 
formal receipt to subscribers, we have for some months 
past adopted the plan of printing in this place the names 
of those from whom money has been received during the 
preceding month. Those remitting will please note 
whether their names are included in the lists, and if they 
are not will notify us by card: 

Illinois.— Drs. W. A. Byrd, W. I. Cottel, A. K. VanHorn, W. A. 
Johnston, T. M. Cullimore, M. Rooney, W. W. Baxter, J. L. C'onnelly, 
M. F. Bassett, J. A. Bolinger, Geo. A. Zeller, P. H. Garrettson, C. Bar- 
low, E. P. Cook, J. T. Bradbury, W. P. Fraser, H. M. Harrison, O. P. 
Crane, P. H. Liebrock, Wm. Dongall, W. A. Gordon, C C. Allen, F. C. 
Robinson, Ellen Ingersoll, L. G. Thompson, F. M. Gamble (2 years), J. 
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Dorn, W. H. Jones, W. E. Guthrie, H. Knapperberger, J. W. Hensley, 
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O. Gratton, J. W. Waters, O. J. Roskoten. 

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ald, G. T. Nelson, L. B. Allen," E. H. Harris, D. W. Wright, Maxwell & 
Bowman, W. J. Saunders, W. H. Hunt, Jos. A. Treat, F. M. Powell, J. 
N. East, L. L. Dexter, Geo. McCulloch (2 years), W. S. Bransom. 

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Wisconsin.— Drs. F. E. Walbridge, M. H. Fisk, G. H. Haddy, J. 
M. Lewis, A. A. Maurer, Francis Pinch. 

Ohio. — Drs. H. L. Baker, Clarke Chemical Works. 

Indiana. — Dr. E. Walker. 

Kentucky. — Drs. J. D. Crosby, W. W Lambuth. 

Utah.— Dr. W. H. Behle. 

Colorado. — Dr. Jno. Eisner. 

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Pennsylvania. — Dr. S. A. Suloff. 

Minnesota.— Dr. T. C. Clark. 

Arkansas. — Dr. J. R. Brewer. 



The Peoria 
MEDICAL MONTHLY. 



Vol. IV. JULY, 1883. No. 3. 



©rtgiual (^^ommuttiationisi. 



Art. I.— Carbolic Acid in the Treatment of Piles. By Wm. H. Veatch, M. D., 
Carthage, 111. 

In the May number of The Medical Monthly I find 
an article by A. B. Allen, M. D., of Jerseyville, 111., on the 
above subject; and in addition to my caption he adds: 
"Its Origin and Condemnation;" in which he takes occa- 
sion to very severely criticise this mode of treating piles, 
and in passing gives Prof. Andrews a back-handed stroke, 
as if he had slightly deviated from the standard of ethics. 

He says : "A few years ago Prof. Edmond Andrews, 
of Chicago, wrote a pamphlet on its (carbolic acid) use in 
the treatment of piles, and in his summing up does not 
severely condemn, or even tacitly commend, but leaves the 
subject open for unthoughtful men to experiment with a 
hope of success." 

Now, while Prof. Andrews is perfectly competent to 
speak for himself, and needs no such scribbler as me to de- 
fend what he may say or do in matters of surgery, yet I 
feel that the article does Prof. Andrews^ great injustice. I 
happen to have Andrews' article before me, and I read it 
through quite different glasses from those of Dr. Allen. I 
will quote from Andrews' article that your readers may 
see for themselves that the subject is not left as wide open 
as Dr. Allen's article would intimate. In the fourth and 



100 The Peoria Medical Monthly. 

last section of Prof. Andrews' "summing up" he very 
clearly and distinctly indorses the plan of "hypodermic 
injection of carbolic acid in the treatment of piles" in the 
following concise language : "I predict that for the treat- 
ment of internal piles, this will remain as a valuable and 
'permanent improvement in surge?y, and ivill he as safe as the 
ligature, hut it must he remernhered that neither this, nor any 
other plan is exempt from serious danger when 'practiced hg 
ignorant men." (The italics are mine.) 

If this emphatic endorsement of the plan, based upon 
the history of thirty-three hundred cases, can be called 
"leaving the subject open for unthoughtful men to ex- 
periment with a hope of success," then I have to say that 
no authority is worth anything to us, and we had as well 
close our text-books and call in our subscriptions to medi- 
cal journals, and launch out on the broad ocean of experi- 
ment without mariner or compass. 

I have said that Prof. Andrews is abundantly able to 
defend his own article ; so, having made this slight correc- 
tion, I will pass to the consideration of the objectionable 
points urged by Dr. Allen. He quotes largely from Mr. 
Allingham, of St. Marks Hospital, and criticises Dr. Cook's 
pamphlet without a quotation. He also refers to Dr. 
Matthews, of Louisville, and says : " He endeavors to show 
that the injunction of the acid into a pile is painful and 
inefficient, and that death is to be feared (a) from periton- 
itis (b) from embolism (c) from pysemia." Allingham, he 
says, is much inclined to agree with the opinion of 
Matthews : " That he had tried the injection plan on some 
few patients, but the result was much pain ; more inflam- 
mation than was desirable ; a lengthy treatment and the 
result doubtful ; certainly not a radical cure." He further 
quotes from Allingham : "All attempts to destroy vascu- 
lar growths by causing a coagulation of blood or inflam- 
mation in them while they are not shut off from the 
general circulation, must be fraught with danger. You 
can have no guarantee that the coagulum may not break 
down, and minute particles of dead tissue find its way into 
the vascular or lymphatic systems, and result in embolism 



Oeiginal Communications. 101 

or pyaemia, or both. * « * And this, I submit, 
outweighs the advantages they are said to offer." 

In concluding his article the doctor says he has met 
over one hundred cases who had been treated in this way 
before coming to him, and the universal verdict has been 
that it is very painful, and he is sure very ineffectual. 

I wish to say a word in reference to the much dreaded 
" embolism " the doctor lays so much stress upon, and try 
if I may, to quiet the tears of that school of physicians 
who cry "Wolf!" when there is no wolf, and who start 
back in amazement at imaginary twilight ghosts ; and 
who disturb the sleep of the camp by the constant picket 
firing when the enemy is only an old rotten stump with 
fox-fire which the light of day dispels. So this cry of "em- 
bolism " of coagula in the vascular circulation, pyaemia 
from an imaginary cause, and peritonitis, when the whole 
tissue between the lower rectum and the peritonaeum must 
suffer before the inflammatory places can reach that mem- 
brane. I say a few facts and a little "thought " will serve 
to set him all right. 

Did any man ever see a hemorrhoidal tumor, either 
external or internal, where the very trouble the doctor sa 
much dreads is not entirely and effectually obviated by the 
very cause of the disease itself ? Allow me to ask, what is 
the cause of hemorrhoids? Evidently an obstruction in 
the heii'.orrhoidal vein which prevents the blood from 
passing back into the vascular circulation. If the blood, 
while fluid, cannot pass back into the circulation, how, let 
me ask, can it get there in a coagulated state ? But he 
says : " When the coagulum is broken up, then small par- 
ticles of dead tissue find their way into the vascular and 
lymphat systems and result in 'embolism' or pyaemia, or 
both." I say again, please explain how they get there, or 
if you cannot do this, hunt up all the records of the many 
tens of thousands of cases, and see if you can find one re- 
liable record of "embolism," pyaemia, or peritonitis, from 
injections of true hemorrhoidal tumors. I doubt if there 
was ever a case of embolism from the injection of any sub- 
stance into a hemorrhoidal tumor. In fact, I believe it to 



102 The Peoria Medical Monthly. 

be an impossibility for such a result to follow, and until 
the doctor or some of his school can show how the thing is 
done, I must beg to dissent. 

Some of the doctors, "unthoughtful," and, I will add? 
unperceiving men, may have injected a fold of the rectum 
in prolapsus ani, and danger, or even death, may have 
occurred from the causes the doctor enumerates, but never 
such a result from a hemorrhoidal injection. 

Many people claim to have piles, and when we come 
to examine them, we find a wrinkled and relaxed rectum, 
which folds down over the external sphincter ani when at 
stool and gives them much annoyance, which, if we should 
be so " unthoughtful " as to try an experiment by injecting 
those folds, we may get trouble on our hands. I here say 
with Prof. Andrews : '' This nor any other plan is exempt 
from danger when practiced by ignorant men." In my 
opinion all the trouble which has ever been experienced in 
this plan of treatment has arisen from throwing a coagu- 
lable substance into the rectal circulation, and not into a 
stagnant pool of blood as we have in piles. 

I have no doubt but that inflammation could be pro- 
duced in the rectum, wiiich might be communicated to the 
peritonium by throwing a large quantity of carbolic acid 
into the tissues about the rectum, but "thoughtful" men 
will never do that but once. So if we become fearful of 
inflammation, we had better use our thoughts a little and 
reduce the strength of our solution. 

I wish to say here that I was one of the doctors, "un- 
thoughtful men," when, about nine years ago, an itinerant 
pile doctor strode into my office with a bottle of carbolized 
olive oil in his hand, and proposed to sell me the bottle for 
fifty dollars, with full instructions to use it. He w^as a 
man who understood the nature of piles, and evidently 
thought he had struck one who knew but little. And in 
his anxiety to make a trade he explained the action of the 
remedy, and proposed to demonstrate his theory on a case 
which happened to come into the office for treatment. 
The patient being willing he operated there and then. The 
pile being recent, and only one external tumor, in ten days 



Original Communications. 103 

there was not a vestige of the pile remaining. Of course, 
I was not nnthoughtful enough to pay him fifty dollars for 
ten cents' worth of carbolized oil, and having seen the 
simple operation I told him I could not purchase. So he 
went his way, with the happy thought : " Well, you don't 
know what the mixture is, and if you do, you don't know 
what proportion or how often to use it." When I saw the 
result of this case I was not nnthoughtful enough to allow 
the next case to pass without treatment. I revolved all 
those ponderous imaginary objections, such as inflamma- 
tion, embolism, etc., over and over again in my mind, won- 
dering what would become of me if I, through my " un- 
thoughtfulness," should make a misstroke and kill some 
poor unfortunate subject of miseiy ; yet the complete suc- 
cess of every case I treated emboldened me to persevere in 
well doing. 

Not a few cases have been treated by me, both of ex- 
ternal and internal piles, and but a single case has ever set 
up a plea of inefiiciency, and that man was scared out by 
the professional cry of danger ahead. 

I do not propose to publish certificates ot success, but 
if the doctor or any of his school of doubters cannot take 
my report of cases as evidence of the success of the plan 
of treatment, and will write me direct, I will refer them to 
names of men who have been cured by this plan, who will 
give them the facts in their own cases. The limits of this 
paper (already too long) will not allow me to recite many 
cases, but I promise you I will give typical ones. 

• {Continuation of Typical Cases in Augvst Number.) 



Art. II.— Scientific 3Iethods. By C. B. Maclay, A. M., M. D., Delavan, 111. 

While men, who are called scientists, rightfully assume 
it to be the correct thing to allow no creed, dogma or 
opinion to fetter them in their search for truth, yet it is 
certainly very unbecoming for them to turn aside for the 
purpose of castigating enemies, or to throw reproach upon 
the character or belief of any class of respectal»]e, not to 
say intelligent, persons. It is with regret that I read in 
the leading article of The Monthly for May these words: 



104 The Peoria Medical Monthly. 

" People will be consistent, at least some people try to be, 
even if they have to deceive themselves hy a lie in order to 
do so. This rule of conduct and thought is now only 
taught by theologians and politicians." It is surely enough 
to call attention to this statement to refute it in its entire 
scope. The theologians of the day of any branch of the 
church need no one to take up arms in their defence. 
Again, the writer says: "Now the man who believes all 
through his life as John Calvin did, because he began to 
believe this way while he was young and wants to be con- 
sistent, can't be criticised very much, and it may be an 
easy thing for him to do." Of course, taken alone, this 
sentence may be allowed to pass without challenge, but if 
written in the spirit of the above quotation is very censur- 
able. John Calvin, as a scholar or as a thinker, has not 
yet found a superior on this globe, and, with all due defer- 
ence, the men who misrepresent him and decry him are 
mere pigmies in intellect in comparison. Now let us not 
become so enamored with our own attainments as to try to 
discredit any man. True scientific method is to pursue the 
even tenor of our way; to seek to know, to leave no stone 
unturned, and when ten thousand facts have been obtained 
to sit and string them to one's fancy. What if one ob- 
server makes a monkey of his progenitor, is it right for 
another to grow angry with his logic? By no means, al- 
though he may be allowed the privilege of thinking it 
rough on the theorist's grandmother. As to the greatly- 
vaunted theory of evolution, it may be emphatically de- 
clared to be wholly an assumption built on probabilities. 
The gradations found in the vegetable kingdom, then in 
the animal, have always been the wonder and admiration 
of mankind, and although tireless seekers after knowledge 
have brought to light millions of most interesting facts, 
yet the theory is no more dignified nor conclusive than a 
theological dogma. It is unscientific to object to dogma, 
or to creed, for what is a dogma but the expression of con- 
sent to a theory by the intellect? What is a creed but the 
mere acknowledgement of what a man believes to be either 
proven or self-evident? Methods of observation may be 



Original Communications. 105 

numerous, and even totally opposite in character, and yet 
truly scientific; nevertheless the effect of discovery be mis- 
leading. Men who are following in the wake of Darwin 
dwell with great unction on the metamorphoses of insect 
and reptile forms, setting forth these wonderful changes as 
illustrations of the evolution theory, while Darwin never 
proposed any such proofs, knowing well the unscientific 
nature of all such examples. And why? Because these 
are in the ordinary course of nature, operating round and 
round in a continuous circle. While the development or 
evolution idea is that of changes " occuring at long inter- 
vals and upon a very few of any given species." 

Now the method of observation may be truly scientific 
— color, form, size, endowments, habitat accurately noted, 
and yet the mere claim that at some period a certain 
change did occur, and another and another at very, very 
long intervals in very opposite directions, till at last an 
animal of the horse kind, with several prongs to each leg, 
drops two and carries one to the convenience, the great 
convenience, of his brother man, who, in like manner, has 
dropped an inconvenient tail, elongated his lower hands, 
and swapped a snug coat of weather-proof hair for a mis- 
fit by the tailor! Yes, this mere claim is no more scientific 
than that of the doctor's student who, seeing a saddle 
under the patient's bed, concluded the sick man had eaten 
a horse. Indeed, Darwin, close observer as he was, proves 
himself deficient, logically, and, as Carlyle declared, was a 
man of inferior brain power. Tyndale and Huxley, alive 
as they are to gather facts from all quarters, and clear and 
forcible as is their style, the very moment they begin to 
theorize are as apt to fly in the face of logic as to be led by 
its teachings. The fact is, everybody loves theory, and 
medicine has suffered as much from this weakness of 
human nature as any other department of knowledge. 
The methods pursued to ascertain the action of remedies 
on the human system have been very unscientific. How 
many physicians of long experience are not willing to say 
frankly that they have been mistaken over and over again 
as to the action of remedies or the nature of disease? Our 



106 The Peoria Medical Monthly. 

medical literature is weighted heavily with most defective 
reasoning, and how little can we depend on the conclu- 
sions that are set before us even by eminent men. 

A new remedy is introduced to our notice. Dr. A. has 
given it in various doses. Improvement has been noted. 
Rapid restoration to health. He has tried the remedy in 
various diseases and in all with marked benefit. -Dr. B. 
follows with about the same results. Next comes Dr. C, 
D., E., F. and G. with the same report. But now Dr. H. 
doubts, and accordingly presents a list of failures. About 
this time Dr. A. reconsiders ; alas, too soon the vaunted 
remedy is relegated to the shades where it will sleep till 
some future ambitious M. D. shall restore it to favor, and 
clothe it with world-wide renown. One swallow does not 
make a spring, nor does one nor fifty trials prove the 
worth of any remedy. Right here mention may be made 
of that disgust that fills the soul of the sincere physician, 
driving him almost from his profession when he sees how 
many there are that accept the situation, and decide to 
ply their business in a wholly empyrical way. Grandly 
written prescriptions, that would pass muster before any 
bench of professors, have so much power over the purse of 
the community that too often the simple remedy is super- 
ceded to the manifest discomfort, if not injury, of the un- 
suspecting patient. The scientific method is surely the 
simplest, the most direct and most effective. We need not 
care, then, how little favor our plan obtains, nor how con- 
temptuously it may be regarded by more pretentious prac- 
titioners, if it shall only meet the indications. Many of 
the household practices in case of disease are as truly 
scientific as any others. True, if asked the modus operandi 
no learned answer might be given, and yet ease and 
restoration to a normal condition come all the same. It is 
true science to know that heat or cold, pressure or motion, 
may relieve pain and bring about the desired end. Of 
course, it is a further advance in science to know what has 
occurred or is occurring in the tissues or parts concerned. 
But there is a point where science must meekly and pru- 
dently keep her mouth closed. 



Original Communications. 107 

Scientific methods apply to intellectual problems just 
as truly as to material facts. The scientific nescientist or 
agnostics, by striving to bring torth a class of definitions 
that harness science to material touch or vision, think to 
prove that " He that made the ear cannot hear, or that he 
that made the eye cannot see, or that He that taught man 
knowledge does not know," and thus ignore the unanswer- 
able argument from design, but they are not scientific in 
this course, since we do know without demonstration, and 
do perceive how things must be and are, by mental process 
only. Neptune's place in the heavens was long known by 
the purturbations of Uranus, and mapped before he was 
found or seen by mortal eye ; so it is just as truly scientific 
to find God's place in the universe by the evidences of de- 
sign and by that revelation of himself that is corroborated 
by human history and by man's own mental and moral 
experience. What the so-called science of medicine needs 
is both exact observation and logical inference. Here it is 
that the secret of some common uneducated men's success 
and highly educated men's failure -is readily learned. 
Common sense is worth more than high education so- 
called, since that may be no education at all, but a garner- 
ing of knowledge that may or may not be of use to the 
learner, but common sense is the sure foundation, desirable 
of itself, but affording support for all that can be built 
upon it, or itself the right material to be drawn out or 
educated to any extent. As disease is discovered to be the 
sequel of breathing impure air, eating improper food, taking 
too little or too much exercise, thinking too intently, 
maintaining a cramped position for too long a time, ex- 
posure to heat or cold of intense degree, or indulging in 
too much sleep or too long wakefulness, or being sur- 
rounded by a too dry or too moist atmosphere, the methods 
of cure will be more and more easily recognized, and the 
bonds that have held practitioners to arbitrary routines 
will dissolve away. 

Art. III.— Hepatic D^ppepsia. By Thomas H. Line, M. D., Marquette, Neb. 

This is an affection of which you have patients of all 
ages, both old and young. They complain of not being 



108 The Peoria Medical Monthly. 

able to sleep well at night, and on arising in the morning 
they complain of pain in the temples, and a burning sen- 
sation in the stomach. These symptoms go on increasing 
gradually, until they begin to feel sick at the stomach at a 
time varying from half an hour to an hour after eating, 
and with this feeling there will be regurgitation of sour 
matter into the mouth, and very often vomiting; some- 
times, however, they cannot vomit, but there is a constant 
nausea and retching. There will be in connection with 
these symptoms a peculiar sensation in the bowels. They 
will tell you that it acts as though something was biting 
them, and occasionally ask if it is not worms working in 
their bowels, or " running around " as they say. This sen- 
sation occurs about the navel and is accompanied by fre- 
quent flashes of heat and cold alternately; occasionally a 
chill occurs. 

We have now brought form and symptoms which 
point to several distinct functional disturbances, all of 
which belong primarily to a functional disturbance of the 
liver, and latterly those belonging to a functional distur- 
bance of the stomach. Most of the symptoms can how- 
ever be referred to a disorder of the liver. It is probable 
that this derangement of the liver is due to the fact that 
not a sufficient quantity of bile is furnished for purposes 
for which it is needed. This may be due to the liver's ina- 
bility to produce enough bile, or it may be due to obstruc- 
tion of the gall ducts, thus preventing its being eliminated. 
I am inclined to believe that the latter is the cause of the 
cases that came under my observation. Hard water or 
strong lime water seem to be predisposing causes. To 
relieve these symptoms is a question that will sometimes 
trouble the best of us. As a lule they have been taking 
all kinds of patent medicines, and only when they are un- 
able to stand it any longer, they apply to you for treat- 
ment. Some will tell you to put them on iron, quinia, or 
some other tonic. I think a treatment of this kind will 
almost invariably fail. The treatment should be directed 
mainly to the liver, which is the cause of the symptoms in 



Original Communications. 109 

other parts of the body, and so in the first place I put them 
on such a treatment as follows: 

5 Podophylin, one-fifth grain. 

Hydrarg bicblorid, one-tenth grain. 

Ext. coiocynth comp., three-quarter grain. 
Ft. Capsule No. 1. 

I give one of these capsules in the above proportion 
three times a day, and gradually lessen the number as the 
symptoms improve. The diet should be composed princi- 
pally of animal broths and meat. Then it is well to ad- 
vise them to wash themselves all over every morning with 
cold water and rub dry with a rough towel. This with 
fresh out-door exercise will generally bring them out all 
right. 



Art. IV.— General Paralysis of the Insane. By T. Fletcher McFarland, 
M. D., Jacksonville, 111. Read before the Medical Society of Morgan 
County, 111. 

Of the various types of insanity, the one w^hich forms 
the subject of this essay, presents to the student of mental 
disease one of the most interesting of the many varieties 
of mind ruin, which may be brought to his notice. 

The term, mind ruin, is used in this connection, for 
like many another morbid condition, while it presents to 
the clinical observer a most enchanting field, to the prac- 
tical physician, to the mind diseased, it is discouraging in 
the extreme. 

Hence, while imperfectly treating of this form of men- 
tal "death in life," it must be said at the outset that we 
possess no antidote designed for its cure, our only resource 
being to summon the meagre assistance which a progres- 
sive science can afford, and which, alas, only serves to 
smooth the pathway to the grave. 

The persons selected for this afflictive visitation, are 
in a large majority of cases, confined to the male sex, and 
these in the flush of active life, or about the time it has 
reached the meridian. 

A word as to the character of these men : Generally 
speaking, they are not the drones of the social and busi- 



110 The Peoria Medical Monthly. 

ness hive — on the contrary, they are those who make of 
themselves the moving spirits in useful undertakings. 

If a railway is to be chartered and constructed, or, 
indeed, if anything designed tor the good of the commu- 
nity in which they reside is to be done, it is usually the 
men who are instrumental in the establishing of these who 
oftenest fall victims to the disease. 

Hence, it is no wonder that if a practicing physician, 
or even an insanity specialist, should, in the incipiency of 
the malady have any misgivings as to such a man's sanity 
that the expression of such doubts had best not be uttered; 
for it is extremely probable that they would meet with the 
incredulous, if not indignant remonstrance of those who 
would consider them as being intended to interfere with 
the rights of a useful and therefore valuable citizen. 

Like most other forms of mental disease, this variety 
does not, in its incipiency, come before the disc^ning eye 
of the practicing physician. And, although a man's rela- 
tives i^erceive in him a more devoted application to busi- 
ness, yet, naturally enough, instead of having the remotest 
conception of what is really the matter, they will hold him 
up as an example of business energy, and as an instance of 
what industry can do for a self-made man ; for it is notice- 
able that he will at this juncture subject all his physical 
and mental powers to the consummation of his hopes in 
life. 

Now, as has been intimated, it would not be at this 
time a very agreeable topic for a physician to as much as 
to hint to this man's friends that insanity may be in pros- 
pective, but afterwards, when the disease is unmistakably 
apparent, some of these same friends will confidently 
assert, in speaking of this period, that they knew some- 
thing was wrong all along. 

A man's acts during this epoch may eventually become 
of medico-legal importance ; for he is now apt to be seized 
with a desire for speculation, often borrowing more capital 
for the purpose of enlarging the sphere of his business 
operations, resulting generally in disaster to his estate; 
although it would be a difficult matter for an expert 



Original Communications. Ill 

witness to establish the fact of insanity in this connection 
to the comprehension of an average jury. 

Among the number of instances in my mind, is that of 

the late J D. C , Esq., of St. Louis, a man of fortune, 

who died a few years since in the Butler Hospital for the 
Insane, at Providence, R. I. Mr. C. invested largely in a 
Missouri lead mine, which proved worthless. He was. 
afterwards adjudged insane, and his heirs endeavored to re- 
sist the collection of certain notes given by him at this 
particular epoch of his disease. But the courts sustained 
the claims of his creditors, because his representatives 
were unable to prove the existence of his insanity either 
prior to, or at the time these notes were executed. 

It may be noticed in passing that the man is apt to 
involve himself in suits of various kinds, such as libel^ 
slander, etc., and if unmarried, he may have a breach of 
promise case upon his hands ; and it is needless to say, he 
proves a rich bonanza to our friends of the legal profession. 

A little further on, we may observe certain inconsist- 
encies of moral conduct incompatible with his previous 
course of life, for his habits now become irregular, he is 
sometimes seen under the influence of liquor, and as you 
pass the door of some drinking saloon you may see him 
standing in the midst of a crowd of loafers, himself enlarg- 
ing upon his business schemes, and his actions in various 
ways are a source of anxiety to his true friends. 

He is prone to become the prey of human vampires of 
both sexes, and the Levites of social life soon show their 
customary propensity to defame a falling man ; and unless 
his help-mate be more than ordinarily affectionate and dis- 
cerning, his actions may, for certain obvious reasons^ 
become her plea for a divorce from the wifely relation. 

There are, however, some lingering virtues which are 
apt to assert themselves at the commencement and to con- 
tinue far into the course of the malady. For the man is 
usually of a generous disposition, apparently possessed of 
} a manly candor for which his friends endeavor to condone 
I his errors by the remark, "he is his own worst enemy." 



112 The Peoria Medical Monthly. 

I now approach the second act of this mournful drama. 
Between the symptoms already so imperfectly described, 
■and those soon to be mentioned, there is a boundary line, 
faint, it is true, at its commencement, but readily discerni- 
ble to one who has long been familiar with the insane ; 
for delusions of a marked character in time appear upon 
the scene and they are of an exceedingly exalted and hope- 
ful tone. 

In that form of insanity, known as melancholia, the 
patient is forever looking upon the dark side of life. He 
is apt to be of a suicidal tendency, and his long drawn face, 
so disagreeable to the genial young doctors of our asylums, 
is a perpetual reminder of his imagined woes ; moreover, 
he thinks that he has committed some of the most awful 
unpardonable sins, and is often found in some corner read- 
ing the Bible as a penance for the same. 

Now, the case is far different with these general para- 
lytics, for up to a certain period there are more agreeable 
features connected with their care than with those of any 
other class. For life to them is full of hope and joy ; they 
are, therefore, before the occurrence of the third stage, or 
that of dementia, pleasant companions, despite the tact of 
their possessing a certain vanity of imagined power ; which, 
as will be seen, is the main ideational characteristic of 
these cases. 

It may have been inferred that the man's views in re- 
lation to his business affairs have been of a marked, ener- 
getic and ambitious character ; but at the commencement 
of this, the second stage, his ideas take upon themselves a 
more fantastic shape. 

He in time projects the most stupendous schemes of 
power and grandeur ; for there is seemingly nothing be- 
yond his ability to accomplish. 

He thinks that he is now possessed of great wealth, 
consisting of gold mines in Colorado, factories in New; 
England, immense farms in Illinois and Iowa, as well asj 
plantations in Georgia and the Carolinas. 

He therefore proposes to transport the city of Chicago 
to the Atlantic seaboard, and thus hasten the time when; 



Okiginal Communications. 113 

-the Metropolis of the West shall become the rival of both 
l^ew York and Boston ; also to tunnel the Rocky Moun- 
tains, bridge the Pacific Ocean, and possiblj^ to construct 
lines of railway to the moon. And thus the sad fact dawns 
upon his friends that he who once was the pride of the 
-community is now a madman whose proper place is within 
the sheltering arms of an institution for the insane. 

Here, if stationery be furnished him, he will write 
whole reams ot orders to his imagined mercantile agents 
-all over the world ; or, he may adorn his clothing with 
^aily colored rags attached to pieces of tin, for these are 
to him badges of honor and distinction, representing the 
orders of Bath or the Garter, and they are worn with all 
the dignity of a Marlborough or a Wellington. 

We notice that our patient, in referring to these delu- 
sions, will, during the course of their recital appear to 
forget certain words, especially the names of persons and 
things, and we have that condition known to medical men 
.as aphasia. 

In regard to the important matters of sleep and appe- 
tite, we do not in these cases have that cause for anxiety 
that we have for those who are exhausting themselves in 
the throes of either acute or typho-mania ; although in the 
third stage, or that of dementia, the appetite, which is then 
apt to be voracious, is, for a reason to be hereafter ex- 
j)lained, a source of grave apprehension. 

As the derangements of intellectuality have been de- 
scribed, we will return to the commencement of this stage 
and briefly allude to certain symptoms which then arise, 
and which are connected with the phenomenon of volun- 
tary motion and to some extent that of excito-motor 
action. 

We generally observe first in this coniiection a diffi- 
culty in the pronunciation of certain w^ords, especially of 
the consonants, more noticeable when under the influence 
of excitement the patient attempts to talk quickly. From 
this, we infer that the muscles engaged in the movements 
of the tongue are being slowly paralyzed. 



114 The Peoria Medical Monthly. 

There very soon is made manifest an impairment in. 
the performance of locomotion ; for the patient will, in 
walking, drag one limb behind the other, and there is also- 
a loss of co-ordinating power similar to what is seen in 
progressive-locomotor-ataxia. 

It will be remembered that the act of deglutition is 
performed jointly through the agency of voluntary motion 
and excito-motor action. But a most important complica- 
tion arises from the fact that the treacherous paralysis has 
not only involved the glosso-pharyngeal system of muscles^ 
but also those of that normally faithful sentinel known as 
the epiglottis as well. 

As a result of this, the muscles of the pharynx do not 
properly fulfill their function, i. e., that of propelling food 
towards the sesophagus past the rhima glottidis, which is 
not in these cases guarded by the epiglottis in a proper 
manner, and as a consequence fatal asphyxia sometimes 
results owing to the entrance of particles of food into the 
air passage ; and the danger of this is rendered more obvi- 
ous during the stage of dementia by the patient's habits of 
gluttony, which at that time are generally manifested. 

Attacks of violent mania sometimes terminating in 
either coma or epileptical convulsions may occur during 
this stage, or else the latter may happen without being^ 
preceded by excitement. 

Either one of these is to be looked upon by the physi- 
cian with serious misgivings as to the final outcome. 

Especially may this be said in relation to their occur- 
rence during the stage now to be described, or that of 
dementia. 

It was amid the ruins of the capital, said Gibbon, that 
I conceived the idea of writing a history of the empire. 
And it is now that subjects are at hand ready for the por- 
trayal, that the essayist would make a feeble attempt to 
picture the scene of mental darkness which in the stage of 
dementia overshadows a once noble intellect. May the de- 
scription appear too sombre? if so, it is simply an illustra- 
tion of the sinking of mind which has been the fate of 
many a once useful and valued man. 



Original Communications. 115 

Either one or all of the symptoms of paralysis now 
increase in their intensity, for we may notice complete 
hemiplegia, or else we find that the act of deglutition is 
fraught with the utmost danger to life. The few mumbled 
utterances of the paralyzed voice only serve to render the 
mental vacuity more apparent, and that countenance 
which once beamed in the light of an intelligent man- 
hood becomes a complete blank. 

A little further on and we observe that the merchant 
who, in the second stage, imagined that the goods of his 
world-extensive trafiic were borne by the wings of com- 
merce o'er every sea, and who then entertained the casual 
visitor, is now wrapt in a silence as of the grave, and it is 
by the portals of the tomb alone that he will be delivered 
from the awful thraldom. 

The immediate tendency towards death is manifested 
either by successive paroxysms of epileptical convulsions, 
or else the occurrence of sudden or gradual appearing co- 
ma, from which the patient does not emerge, and as he has 
been so long indifferent to this life's surroundings, so now 
is he soon freed from one of its most terrible afflictions. 

In the tabulated statements of the assigned causes of 
insanity, as sent out from our State Insane Asylums, one 
will find quite an array of worldly ills which are set forth 
as being changeable for the affliction. 

For certain reasons, however, these statements are not 
altogether reliable. From these alone we can come to no 
accurate decision in regard to the matter of cause, and we 
must, perforce, look deeper than these, for a solution of the 
■question. If the family history of the most of these cases 
of general paralysis could be ascertained, there would, it 
is believed, be found evidences of impaired mental organi- 
zation either in the direct or collateral line of blood rela- 
tionship. 

Dipsomania, or inherited drunkenness, the various 
forms of insanity, together with epilepsy, are all related to 
«ach other, and we need not be surprised to find the off- 
spring of those thus afflicted inheriting either the identical 
misfortune of their progenitors or one of the others that 
have been named. 



116 The Peoria Medical Monthly. 

If, then, in a man inclined to mental obliquity by he- 
reditary predisposition, there come on that perturbation 
arising from the haste to become wealthy, together with 
the cares of an expensive family, and more especially if 
we observe in such a man a course of life whose tendency 
is to lower the vital tone, we may find such circumstances 
as may render the overthrow of reason simply a question 
of time. 

Whatever view one may take as to the origin of the 
human mind, there can be no question but that it is by 
means of the brain centres that its action is made mani- 
fest; and it has been from the results of post-mortem ex- 
aminations of these, which have been reported by the 
medical stafi" of the New York State Lunatic Asylum, at 
Utica, that rich fruits have already rewarded the patient 
investigation of this department of pathological anatomy- 

From this source as well as the published reports of 
public instructions for the insane in this country and also 
in Grreat Britain, there has been established the fact in 
these cases of general paralysis of the insane of a paren- 
chymal inflammation of the cortical substance of the cere- 
bral hemisphers. 

It is to the aid of the microscope, as shown in photo- 
microphy, that we may look for important developments 
in this field of morbid brain anatomy, and when that 
instrument shall have fulfilled the task which it has so aus- 
piciously begun, science will have gained one of her bright- 
est garlands. 

In relation to the diagnosis of general paralysis of the 
insane from other forms of mental disease, it may be 
claimed that when the delusions of exaltation are accom- 
panied by the signs of paralysis, we may know the exact 
character of the demon with which we have to deal. 

In the absence of these, however, it is the safest course- 
for the physician to preserve a silence as to any misgiv- 
ings that he may have in regard to his patient's type of! 
insanity, a caution especially applicable by reason of the* 
fatal termination of these cases. ^ 

I 



Original Communications. 117 

"Abandon all hope ye who enter here," may well be 
said of all unmistakable cases of general paralysis of the 
insane, for in the language of an eminent mind specialist,, 
there is here no such thing as recovery, and as well may a. 
human hand by its uplifting, attempt to stop the going 
down of this day's sun, as for the physician to annul the 
decree of Death, the irrevocable seal of which has been 
placed upon its victim. 

It must be remembered that we have here a lesion of 
the brain centres; and while some other forms of mental 
disease whose termination in recovery substantiates the 
favorable prognosis of the physician, based upon the opin- 
ion that these centres have not suffered from degeneration, 
yet in these cases there is no such ground for hope; and it 
is the duty of the physician to candidly inform the most 
discreet of the friends of. his patient at the instant para- 
lytic symptoms are manifested that there is no prospect of 
recovery. 

The average duration of the disease may be stated to 
be about two years; although, of course, in individual 
cases, there are wide variations from this estimate; and in 
those few cases seen by the essayist in man past the prime 
of life, the progress towards dissolution was rapid. 

It has long been the opinion of the humble essayist, 
that certain forms of mental disease, especially puerperal 
mania, and even some cases of mild melancholia, may be 
treated by an intelligent practicing physician, in the well 
ordered home surroundings of some patients, as skilfully" 
as the same could be done in the most elaborately equipped 
institution for the insane. 

But this observation can in no wise apply to the case& 
which have been under consideration; and it is safe to say 
that there is not one family in five hundred that can prop- 
erly care for a general paralytic, especially when the 
afflicted one is the family head, as is generally the case. 

In many cases of acute mania, melancholia, and even 
typho-mania, we often perceive the most satisfactory re- 
sults following the use of valuable drugs designed to pro- 
mote sleep, and in melancholia, especially, some of the 
preparations of opium subserve a good purpose. 



118 The Peoria Medical Monthly. 

In these general paralytics, however, we are not gen- 
erally apprehensive in regard to the matter of sleep, for 
this is as we could desire. The only time when we find it 
necessary to administer hypnotics is during the attacks of 
violent mania, which have been mentioned; and recogniz- 
ing the palliating effect of a night of comparative rest, we 
may at bed-time, administer the hydrate of chloral, in do- 
^es not to exceed thirty grains. 

In regard to the matter of appetite, we are not unfa- 
Torably concerned; indeed, we find it necessary during the 
stage of dementia, to check any gluttony which may man- 
ifest itself, for we know not when the pharyngeal muscles 
may utterly fail during the act of deglutition, an accident 
liable to result fatally from asphyxia. 

Our most dangerous foes are the seizures of coma, and 
the paroxysms of epileptical convulsions. These are to be 
looked upon with an innate sense of dread whenever they 
occur, for it is by means of these, that the tendency to- 
wards death is manifested. 

For the convulsions, nothing can be done except what 
every efficient hospital nurse is supposed to understand. 

In regard to coma, it must be understood that these 
cases admit of no depletion, although it is advisable to 
■evacuate the rectum by means of an enema. 

We find it necessary here to administer stimulants, 
preferably the spiritus frumenti, together with the applica- 
tion of heat to the extremities; and while we should at all 
times be hopeful, yet we must be prepared to find these 
measures in vain. 

In concluding this manifestly imperfect essay, it is to 
be regretted, that the type of cases which have been here 
presented, could not have that happy termination in recov- 
ery seen in some other forms of mental disease. 

But it may not be improper for the essayist to state 
that one of his principal reasons for submitting this paper 
to the consideration of the Morgan County Medical Society, 
w^as to illustrate one of those dramas of insanity which 
have been for years enacted before his vision, and which 
has numbered so many of the most worthy and useful m^n 
of the West, amongst its victims. 



Original Communications. 119 

Art. v.— Annual Address of the President of the Adams County, Illinois, 
Medical Society. By F. Drude, M. D., Quincy, 111. 

Gentlemen : Before leaving the position of honor to 
which your partiality has twice elected me, it becomes my 
constitutional duty to address you. Allow me, then, to 
tender to you my heartfelt thanks for your good will and 
the fraternal feeling exhibited during the whole period of 
my oflBce term. 

At my advanced age I consider myselt one of the 
veterans who have placed themselves upon the retired list, 
watching with unabated interest every progress in our 
science, whether real or imaginary. During the long 
period of forty years we are oftentimes led to believe 
" truth to he a liarj' inasmuch as doctrines and theories, 
which were once considered true and stable, are now 
doubted or thrown aside by new discoveries, and consid- 
ered as false and erroneous. 

The true advance of the medical science for the benefit 
of mankind is, however, rather slow ; the road to it is 
obstructed with hindrances, which are difficult to over- 
come and conquer. Still, many obscurities remain riddles 
unsolved, which makes us repeat the old saying of Albert 
Haller ; " Into the very nature of things no created spirit 
will ever penetrate." 

It should be the duty of every member of this Society 
to contribute his share to make our meetings more inter- 
esting and profitable. More essays should be read and 
topics discussed, than has been done. 

There is another subject to which I would like to call 
your attention. You will recollect that about two years 
ago this Society, by resolution, placed a purse of twenty- 
five dollars into the hands of the law firm of Carter & 
Govert (the latter the prosecuting attorney) for the pur- 
pose of protecting the legitimate practitioner in the execu- 
tion of his avocation. Now, I ask you, what equivalent 
have we received for it? Has this firm ever done the 
least to earn this fee ? I know that in order to earn 
twenty-five dollars I have to work a little harder than 
to do nothing at all. And yet we all know that there are 



120 The Peoeia Medical Monthly. 

such men as Bacher, residing at present on South Fifth 
street, between Maine and Jersey, who practice without a 
shadow of legality and have done so for three or four 
years. There was also a committee appointed by this 
Societj^ whose duty it is to watch such men and bring 
their acts to the attention of the Grand Jury. There is 
this famous Indian doctor, who does an immense amount 
of running. 

There is still another topic on which I desire to dwell 
a moment. The by-laws require that " The Censors shall 
inquire into the character, standing and eligibility of the 
candidate, and report in writing at a subsequent regular 
meeting." Now, it strikes me that this part of their duty 
is not always strictly adhered to. Candidates sometimes 
apply for membership who have such offensive and quar- 
relsome dispositions or disreputable characters, that it is 
not desirable for any Society to admit them, and Avhen 
once admitted it is rather troublesome, if not impossible, 
to get rid of them again. One word of warning ought to 
be sufficient for future guidance. 



%tsXt% |rom ^xmU "^xuXm, 



Art. I.— Colored Glass for the Headache of Adolescents. By W. S. Higgens, 
M. D.. Rantoul, 111. 

The theory that mental exertion is the onltj cause for 
the peculiar kind of headache met with so often in children 
between the ages of ten and seventeen; noticed more by 
those who go to school, in fact is more prevalent among 
scholars, does not hold good in practice. 

At the age when the economy is developing reproduc- 
tive powers, all physicians know the nerves are incapaci- 
tated for hard and continued exertion, and that thousands 
are now dragging out a miserable existence for indiscre- 
tions at that important period of life. Admitting sleep to 
be a specific for over mental exertion and that patients are 
better in the morning, does not prove that mental irrita- 
tion alone is the cause. If it did, the patients could not 



Notes from Private Practice. 121 

study better dark cloudy days than bright clear ones, nor 
could they continue to prosecute their studies while wear- 
ing colored glasses, or study longer on colored paper. 

Be the cause what it may some persons cannot look on 
white or hlack without producing pain in the frontal and 
parietal portions of the head. 

I had one patient over 50 years of age who never 
could sew on black cloth nor look on a paper to read 15 
minutes without producing the most agonizing pain, fre- 
quently caused vomiting, and never suspected the cause 
until after the colored glasses were w^orn six years ago; 
who was taken out of school at the age of 14 because of this 
same pain, yet while wearing the smoked glass could read 
and sew as well as anyone. Her youngest boy, 13 years of 
age, while going to school would complain of excruciating 
pain in the frontal and parietal portion of the head. The 
mother's experience, care and anxiety for her boy led her 
to seek some aid if possible, as she never got relief until I 
prescribed the colored glass. The boy would not go to 
school and wear the spectacles, but could study at home by 
wearing the colored glasses, and when the glasses were re- 
moved suddenly in a bright light severe pain was produced, 
and he ivas always better in the morning. 

I have frequently tried him with colored paper, which 
was a great improvement — he could study much longer 
without pain. And since then I have invariably found the 
smoked glass a decided benefit in all such loatients. 
Would it not be well to recommend school books printed 
on colored paper. 

Art. ir.— Report of Cases. By W. C. Bowers, M. D., Danville, 111. 

On the eve of June 4, 1883, 1 was called to see a child 
thirteen months old, nervo-sanguinous temperament, had 
been in good health and well nourished up to late illness; 
had been weaned but a short time. 

The room was large and airy, un plastered, and in a 
newly built house on a hill. 

The child a few days before had a saline cathartic with 
some bromides to control some meningeal irritation, which 
threatened to become troublesome. 



122 The Peoria Medical Monthly. 

I found some tense, swollen, red gums, which I lanced, 
producing immediate relief. The child was weak, not car- 
ing for food, having three or four somewhat offensive 
5tool^ per day and slight fever. Hydrochloric acid dilute 
^vas prescribed in two to four drop doses every two hours. 
Some abatement of symptoms for a day, but gradually in- 
creasing depression, with five or six very offensive stools, 
eame on* with slight pain before operations. 

9 Tinct. op., 20 drops. 

Tinct. op. camph., 1% drachms. 
Creosotum, 2 drops. 

Syr. simp. gs. ad, 3^ ounce. 
M. S. One teaspoonful every two hours until stools less offensive and 
less frequent. 

Quinia with the acid, and port wine and milk, beef tea, 
3tc., ad libitum. Rapid improvement and final recovery. 

2d Case. — On eve of June 14, 1883, I was called to see 
Sve-year-old daughter of a coal miner; nervo-sanguinous 
temperament. House low, but on a hill and well drained 
md airy. The room was very clean and comfortably fur- 
lished. Child was lying on the bed in an atitude of nat- 
iral rest, half-open, inexpressive eyes. She was hard to 
irouse and would awaken terrified at objects which she 
jeemed to see in different parts of the room, and immedi- 
itely drop listlessly back into a state of stupor. Skin 
ntensely hot all over the body. 

Pulse 144, respiration 25 and arythmic. She said, " I 
lurt here, and here and here," meaning all over. 

No tumor or tenderness was found in any part of body. 
Pupils slightly dilated; cheeks alternately flushed and pale. 
Heart and lungs normal. Tongue centrally coated, red 
3dges and glazed. Urine passed frequently, but plenty. 
N'o movement of bowels for twenty-four hours, and then a 
small dry stool. Vomiting whenever anything swallow^ed. 

The child showed oppression, but no depression. A his- 
:ory of pertussis and measles, but only slight cough 
remained, and child had lately enjoyed good health. 

I concluded some ingesta was at the bottom of these 
profound symptoms. 

To get the bowels open was the thing, but to keep the 
physic down was the main point. 



Notes from Private Practice. 123 

5 Hydrarg. Chlor. mil., 1 grain. 
Sodae bicarb., 30 grains. 

Sacch. alb., q. s. 

M. Fiat chart, 8. S. One every three-quarter hours. 

Aconite tinct. one drop every three-fourths of an hour. 

Slight effervescence from stomach on giving first pow- 
der, but no more vomiting. Abatement of fever with rest 
until morning. Salts were tried and vomited. John Wy- 
eth & Bros.' comp. (compressed) cathartic pills were given, 
one at 7 and one at 12. No stools; so the following: 

5 Fl. ext. sennae,, i^ ounce. 

Sodae sulphas, 1 drachm. 

Syr. simp., J^ ounce. 

Aq. menth. pip., 1 ounce. 

M. S. Two teaspoonfuls every three hours till freely purged. 

After a number of doses free catharsis came on with 
complete abatement of symptoms. 

One pill, above mentioned, was vomited, and the other 
one came away in a stool, both in as good shape as Jonah 
was. 

The stools were composed mostly of young gooseber- 
ries and currants. 

What I wish to notice is that we might in children 
think there was not much the matter when there are not 
very expressive symptoms, while the child is very ill; and 
again when there are profound symptoms regard the ill- 
ness dangerous, when there is only general oppression. 

We learned something about pills too. 

Hoping some points of interest may be gleaned from 
these cases, I submit this report. 



Akt. III.— Ergot in Erysipelas. By I. J. Bennett, M. D., Fort Atkinson,. 
Wis. 

A short time since, what proved to be a very obstinate 
case of erysipelas came under my care, and under the sup- 
position that my experience may be of benefit sometime to 
a small number of your readers, I will submit a short his- 
tory of the same. 

Mr. , aged 33, strong, robust, active habits and 

strictly temperate, presented himself, suffering with ery- 
sipelas affecting whole of right side of face and neck, also 



[24 The Peoria Medical Monthly. 

3oth thighs, scrotum, penis and perineum, the principal 
energy of the disease seeming to be centered upon the 
scrotum, which was enormously swollen, as was also the 
penis, but to a much less extent ; right side of face was 
much swollen and right eye nearly closed. The irritation 
it times was so great patient could not be quiet a moment 
n any position, and his nights were rendered almost en- 
tirely sleepless thereby. For the space of ten days I tried 
ill the usual means of medication, both internal and ex- 
ternal, with no visible improvement, except a few moments 
at a time, as first one and then another local application 
v\^ould allay the terrible burning. At this juncture the 
skin upon the scrotum began to exfoliate freely, and think- 
ing the disease had about expended itself, I simply kept 
the parts thoroughly dressed with cosmoline, changing the 
dressing every two to four hours, as seemed proper, and 
the intensity of the inflammation seemed to subside some- 
what ; but by the fourth day a second exfoliation began, 
and all the symptoms returned with renewed violence, 
swelling markedly increased, and skin of scrotum looked 
livid in nearly every part, with here and there a red, raw 
looking surface. Just now the property of ergot to pro- 
duce capillary contraction came to my mind, and acting 
upon it I at once a]Dplied Tilden & Co.'s fl. ex. ergot 1 ounce, 
aqua pura 15 ounces, and caused the inflamed parts to be 
freely and frequently bathed with the solution and left 
uncovered to the free action of the air. In two hours my 
patient was resting easy, and in a short time fell asleep 
and slept for several hours, when there was marked im- 
provement in the color of skin and diminution of swelling. 
All the symptous went on improving from that time, and 
in three days discharged patient well. 

I should be pleased to hear from any of our brother 
practitioners in relation to the subject, as I believe it will 
prove to be of genuine usefulness. 



Art. IV.— Treatment of Diphtheria. By J. D. Ebert, M. D., Dundee, Ind. 

I wish to give to my co-readers of the very wel- 
come visitor, The Peoria Medical Monthly, the best 



Notes from Private Practice. 125 

treatment for that terrible disease known as diphtheria, in 
all of its forms, regardless of age or sex. In doing this, I 
do not wish to be considered soi-cUstant or dogmatical. 
With my father's notes and same treatment, which covers 
about twenty-four years of the past, in that time meeting 
with several epidemics of diphtheria in all its grades, and 
also my own practice of the past five years, we both using 
the same treatment, we have not in that time, with hun- 
dreds of cases and some which had under various other 
treatments despaired of life and seemed that no treatment 
could possibly reach them, but our notes show that we 
have had no unpleasant results ; all recovered. The treat- 
ment has stood the test and deserves confidence and a 
trial, as the written standard scientific treatment meets 
■with far too a large a mortality to be unquestionably the 
l)est. Here is the treatment, in short, which of course 
should be/egulated according to age, etc. But whatever 
you do, leave off your quinine until the sloughing has 
ceased : 

5 Hyclrg. cum. creta, 18 grains. 
Pul. gum camphor, 12 grains. 
Dover powder, 20 grains. 

M. Divide in six powders, one to be given every two hours. 

Also tr. of sanguinaria can. in ten to fifteen drop doses 
ri^ht along every two hours for several days or until 
sloughing has subsided. Repeat powders as often as to not 
bring on ptyalism. If kidneys suspend action, give large 
doses spt. nitre. 

For sloughing, I care not what amount, kind or color, 
use a bit of soft sponge as a swab with a pretty strong 
solution of the sul. of cop. three times per day. The chlor. 
©f potassium as an adjunct in a solution may be gargled 
occasionally. Turpentine may be used externally, if de- 
sired. We rely on the powders and swab, persistently 
but cautiously administered. This treatment is suggestive 
©f itself to every medical man's mind, of its value as a 
powerful alterative, effects upon the entire secretive and 
excretive power of the system which is so wonderfully sus- 
pended, a peculiar condition which affords a rich soil for 
the microcociic animalculse. 



126 The Peoria Medical Monthly. 

Not wishing to tax the patience of the reader, I will 
not enter further into the vast field, pathologically, of this 
fearful malady, diphtheria, at this time. 



(^cxxtw^^ftia. 



Uses of Electricity. 

South Bend, May 13, 1883. 
Editor Peoria Medical Monthly: 

Dear Sir: I have been very much interested in read- 
ing the article by W. T. Wright, M. D., and wondered while 
reading the first part of the article why he did not resort 
to electricity, but finally when almost in articiilo mortis, as 
a dernier resort, it was used, and with success. Had he 
made use of electricity at first there would in all probabil- 
ity have been no need of the painful and dangerous dila- 
tation, tents, etc. I have been in the use of electricity 
both internal and external to the womb. I use it as the 
drinker uses whisky to warm when too cold, or to cool 
when too hot. I use it when the menses are too profuse, 
or where there is hemorrhage, and where there is suppres- 
sion in anaemia, or hyperaemia, and find it hardly ever fails. 
It is a great regulator of nerve force, and hence helps 
muscular function. Had the doctor used it seven days 
sooner, or three days sooner, he undoubtedly would have 
saved much suffering and anxiety ; and I believe if he had 
used it to the womb inside and outside every alternate day 
from the start, he would have arrested the vomiting and 
saved the child. In all my acquaintance I have yet to 
find any who are as heroic in the use of that agent, in that 
direction, as I have been. And when I relate what I have 
done, I am often asked, "How dare you?" I dare because 
I am not afraid. If 1 want to produce abortion, I do it 
with electricity. If I wish to prevent abortion, I do it 
with electricity. But as an abortive it has no equal. If 
you hit the foetus with a strong current from a Faradic 
battery it will destroy its life, and if you apply it to the 



Correspondence. 127 

great uterine muscle it will cause contraction. If you 
apply it to the nerves of the cervix the dilatation v^ill 
almost invariably attain, especially when there is a foreign 
substance in the womb. I hope the doctor's article will 
wake up your readers to a more scientific use of that much 
neglected agent. And, by the way, what is the reason I 
find so little said in any of our journals about the use of 
external appliance in therapeutics. I find so few writers 
giving an expression of electricity, massage baths, hot air^ 
vapor, medicated, etc. Is it because they are not being 
much used ? 

I find my success in the treatment of chronic cases 
largely to depend upon the use of electricity, baths, etc. 
I cure hundreds of cases every year by the use of bath 
cabinets, sold in this city by E. E. Hackney, and a battery 
with induction coils of the finest wire that can be insu- 
lated of copper. I could not get along without them, and 
would not try. Electricity, as attenuated by fin© wire and 
interrupted by short armature, acts more like nourish- 
ment than stimulant. 

The battery, or batteries rather, I am using are of my 
own improvising, and do me better than any I have previ- 
ously used. 

In conclusion, let me give a case irrelevant to the 
above subject. Mr. Black brought to me a child eleven 
months old, about six months since. It had what the doc- 
tor called a cancer and wished to extirpate it with a knife.. 
He had treated seven weeks with caustic, etc. I pro- 
nounced it an undurated sublingual gland. Applied to it 
sat. sol. of chromic acid. In two weeks it was cured. The- 
point I wish to make in this report is, don't use the knife 
too much, but use something that will cause a deep slough 
on all such tumors, and you will find less cancers and 
quicker cures. G. W. Carpender, M. D. 



Irregular Practice Will Not Pay. 

Des Moines, Iowa, June 9, 1883. 
Editor Peoria Medical Monthly: 

Having recently read some interesting remarks on the- 



128 The Peoria Medical Monthly. 

subject of quackery, I will lay before you some extracts 
from a letter just received from a medical friend, who has 
done extensive advertising during the five years just 
passed. He is a clever operator (operative surgery being 
his specialty) and would have been an ornament to his 
profession had he confined himself to legitimate practice. 
I may add that his feelings in the matter are simply the 
re-echo of my own, and that if I now enjoyed the respect, 
honor, confidence and love of the people and the profession 
that once was mine, I should certainly never seek fame 
and fortune by self-laudation through printer's ink. The 
following are my friend's remarks, and it is hoped they 
may be of value to many impatient doctors, who may 
think there is money and honor in this kind of a life : 

My Dear Doctor : Your letter reached me some days 
since, but I am out on a tramp, and have been quite busy. 
As you are aware, I have been making trips through Kan- 
sas for more than a year, and am making a reputation in 
this country. I have been doing good straight work all 
through the Western country with the view of ultimately 
locating in Kansas City or St. Joe, where I could reap the 
benefit of my advertising and work. * * * If I could 
become connected with some reputable medical college 
would prefer it to any surgical institute or advertising con- 
cern in the world. You appreciate the fact as fully as I 
do, that the advertising doctor-is under the ban of public 
disapprobation continually, and must ever be so. We may 
flatter ourselves that we are exhibiting a spirit of inde- 
pendence ; but after all it is not, to me at least, satisfac- 
tory. Now, please do not understand me as unholding the 
old orthodox code of ethics; the day for that is passed 
among thinkers in the profession, but I simply believe that 
a straightforward course in connection with a liberal, 
educated and progressive body of men will do more to ad- 
vance the science of medicine and elevate us to a higher 
standard, personally, than can be attained by any method 
of self-lauding or advertising by means other than that 
which_ surely comes from the actual accomplishment of 
scientific work. Year by year people are seeing more 
clearly that the greatest humbugs on earth are to be found 
among medical advertisers. You are well aware that the 
majoritij^ of medical men who advertise are ignorant of the 
most primary principles of scientific medicine; and those of 
us who have received a medical training, find it hard to 



Periscope. 129 

•convince the laity that we are better than any other 
advertising doctor. And then again, financially, I doubt 
much if, in the end, we are gainers by this method. Our 
enormous expenses necessitate an enormous income ; but 
at the end of the year, when the grand balance is struck, 
my own experience has been to find myself behind those 
of my friends who located in good towns and attended 
strictly to a legitimate business. After five years of quite 
extensive advertising, I find myself no better off, finan- 
cially, than when commencing. I have gained a world of 
valuable experience, perhaps not to be otherwise obtained 
in the same length of time, but this is all. I am not dead 
to the fact that I am a poor manager ; but am convinced 
that my experience does not differ from many others. 
Being into it, I am painfully aware of the difficulties that 

prevent one from getting out, but believe I shall try. 
****** * *** 

If you deem the experience of two advertising physi- 
cians of middle age advantageous to your readers, you may 
publish the letter — physicians whose professional experi- 
ence and attainments are certainly not below the average. 
Any aspiring young man, who has the spirit of philan- 
thropy within him, will succeed if he acts naturally and 
does not allow his vanity to harden him against his better 
nature. Kindness to the poor, fidelity to all, encourage- 
ment to the weak, should be his motto, and the only 
advertisements he needs if he keeps himself bright and 
well posted. A cold dignity will ruin one's prospects, even 
if it be adorned by brilliant scholarship. These are the 
conclusions that we have arrived at after fifteen years of 
close observation. Intelligence is becoming too generally 
prevalent to be easily daunted by the assumption of 
dignity. Yours respectfully, " Specialist." 



Secondary Puerperal Hemorrhage. 

Dr. Paul F. Munde read a very valuable paper on this 
subject before the New York Academy of Medicine {Medi- 
cal Record, January 27, 1883). He refers principally to the 
fact that alarming uterine hemorrhage may occur as late 
as several weeks after confinement, and concluded his 



130 The Peoria Medical Monthly. 

paper by making reference to the means of preventing 
these hemorrhages, both primary and secondary. The fol- 
lowing rules were given for the management of the third 
stage of labor and the early puerperal state: 

1. Always keep the hand on the fundus uteri from the 
moment the head appears at the vulva until the placenta 
is expelled. 

2. Do not hasten the expulsion of the placenta too 
much. 

3. Always watch the uterus with the hand, using 
gentle friction occasionally, for at least one hour. 

4. Always give ergot by the mouth immediately after 
the birth of the child. If chloroform has been given, or if 
the labor has been unusually tedious, give ergot hypoder- 
mically, injecting a syringefull of the fluid extract to the 
depth of one inch near the umbilicus. 

5. If the uterus shows a reluctance to remain con- 
tracted, rub the fundus gently with a piece of ice, or insert 
a cone-shaped piece into the cavity. 

6. Always mako sure by palpation and percussion 
that the uterus contains no coaguli. 

7. Apply the child to the breast early. 

8. Apply an equally tight binder, and, if there be 
tendency to hemorrhage, a pad should be placed over the 
fundus to secure its steady compression. 

9. If there be laceration of the cervix or vagina^ 
future oozing may be checked by mild astringent injec- 
tions, or, if need be, by applications through the speculum. 
Immediate suture for laceration of the cervix appeared to 
him to be rarely feasable. 

10. Do not allow the lying-in-woman to leave her bed 
before the tenth day. 

11. See that the bladder is empty, and is not interfer- 
ing with uterine contraction. 

12. See that the nozzle of the syringe is not intro- 
duced too far, and that too much force is not used in giving 
the customary cleansing injection. 



Total Extirpation of the Uterus Through the VagpLna 
for Cancer. 

This operation continues to be frequently performed, 
especially in Clermany. It seems to have almost entirely 
displaced Freund's abdominal operation. At last year's 
German Medical Congress of Physicians at Eisenach, 01s- 
hausen reported that he had performed total extirpation of 
the uterus twenty-three times. Of these, three were not 



Periscope. 131 

completed; one on account of rectal, and two on account 
of vesical adhesions. One case had a vesico-vaginal fistula 
as a sequel, and another an intestino-vaginal fistula. Of 
the remaining twenty cases six died. In nineteen there 
was carcinoma of the cervix; in three, sarcoma of the 
body of the uterus. In one case the operation was per- 
formed on account of myoma of the posterior wall of the 
cervix. Of the survivors of the operation, in three the 
diseases reappeared, and of these two died. In the last ten 
he had employed the elastic ligature exclusively, with car- 
bolic acid irrigation, drainage tube in Douglas' i^ouch, and 
iodoform gauze. At the same meeting, Martin reported 
that he had made thirty-one operations, in five of which 
all the diseased tissue could not be removed; of the twenty- 
six others four died. His method was to commence by 
opening the posterior vaginal cul de sac, and then to ligate 
the tissues to be divided, thus avoiding loss of blood. He 
employs drainage. He admitted that, as regards the re- 
turn of the disease, the operation was not successful. Of 
all his cases only one remained a year and a half free from 
the disease. At the same meeting, Keyelmann stated that 
he had never seen a case of permanent cure of carcinoma 
obtained by extirpation. He therefore thought it ought to 
be reserved tor cases of adenoma. Olshausen, Yiet, Rinecker 
and Martin were, however, opposed to this view, as they 
have all seen cases in which long continued or permanent 
relief has been maintained. The experience of Martin as 
just given, scarcely warrants the assertion on his part. — 
Canada Medical and Surgical Journal. 



A Ready Method of Obtaining- Local Antestliesia. 

Dr. Cheize, in Jour, de Med. ef de Chi): Pratique, says 
among the difficulties which surgeons in this country 
frequently encounter, and must promptly overcome, is the 
paucity of surgical instruments and appliances. The want 
of a Richardson atomizer I had recently to supply in the 
following manner : 

A young girl presented herself with inverted toe nails 
and solicited an immediate operation, i. e., extirpation. I 
imbibed with ether a piece of cotton wadding of the size 
of five francs, and placed it upon the big toe, and with a 
common hand bellows I blew on it for a few minutes, until 
complete evaporation had taken place. I saturated the 
cotton wadding a second time, and again manipulated the 
bellows. In less than five minutes antesthesia was com- 
plete. I extirpated the ingrown nail, and applied to the 



132 The Peoria Medical Monthly. 

matrix the actual cautery without the patient experiencing 
the least pain. I had to exhibit the extirpated nail in 
order to prove to her that the operation was performed. 
This is an anaesthetizing apparatus of the greatest sim- 
plicity, and within the reach of any one. Is it new ? I do 
not know. It is certainly very simple. Country practi- 
tioners may find it of great value.— S^. Louis Medical and 
Surgical Journal. 



A New Remedy for Malarial Fever. 

Dr. Carlo Magliere speaks very highly of a remedy 
which has been in popular use in some parts of this coun- 
try for some time. It is a decoction of lemons. He had 
his attention drawn to it while visiting another section of 
his country, and after experimenting with it was aston- 
ished at its beneficial effects in all sorts of malarial fever. 
He reports some truly remarkable cures effected by it. 
He recommends the decoction made of the fresh lemon, 
cut into slices and boiled in a new earthen pot. It is to be 
given four hours before the fever. He gives the results 
arrived at with this decoction as follows, and urges further 
experiments to be made : 1. The decoction of lemons in 
malarial affections gives results equal to and better than 
quinine. 2. It is not only active when quinine is active, 
but even after the latter drug ceases to be active. 3. It is 
not less active in chronic malarial affections. 4. It does 
not present any of the disadvantageous effects of quinine. 
5. Its administration is possible also in catarrhal condi- 
tions of the digestive tract. 6. Its cheapness renders it 
eminently popular. — Courier of Medicine. 



Acute Kheuniatism, 



Dr. J. M. Granville advises no local applications ex- 
cept loose cotton wool covered with light flannel ; no oil 
silk or other vapor proof material. He prescribes the 
following : 

5 Tr. aconiti (P. B.) 12 minims. 

Ammonia sulphide 16 " 

Aq. menth. virid. dist., 6 ounces. 
M. Sig. One-fourth part every four hours, or in severe cases every three 
hours. 

The sulphide of ammonia decomposes very easily, and 
therefore'no more than four doses should be prescribed at 
one time. — British Medical Journal. 



Book Notices. 133 



Hand-Book of Electro-Therapeutics. By Dk. Wilhelm Erb, Professor in the 
University of Leipsig. Translated by L. Putzel, M. D.. etc. With 39 TS'ood 
cuts; S vo., pp. 366. Wm. Wood ^Sc Co., Xew York. 

Dr. Erb has long been recognized as one of the most 
advanced electro-therapeutists of Glermany, and this work 
from his pen will be eagerly received by those who have 
read translations and abstracts of his numerous shorter 
papers on this important subject. Electro-therapeutics 
will be of benefit to a physician in proportion as he uses 
it intelligently, and with a thorough understanding of the 
results he seeks to attain. Too much of the electrical 
treatment that patients receive is given in response to the 
demands of the patient, and is given in a slip-shod sort of 
a way, without much hope on the part of the physician 
that good will result, because he does not thoroughly 
understand what he is driving at. A careful study of this 
w^ork of Dr. Erb will place the reader in possession of most 
of the facts that are established in this branch of medicine. 
Electricity will not cure everything, but certainly is a 
valuable adjunct to the treatment of many obstinate 
affections. 

Labor Amon^ Primitive Peoples. Shoeing the Development of the Obstetric 
Science of To-day from the Natural and Instructive Customs of all Races, 
Civilized and Savage, Past and Present. By Geo. J. Englemann, A. M. M. 
D., etc. Second edition; revised, enlarged and re-arranged; 59 illustra- 
tions; 8 vo. cloth, pp. 227. J. H. Chambers & Co., St. Louis, Mo. 

No medical work lately published shows so much 
careful and laborious study and investigation as does this 
uniqe monograph of Dr. Englemann. As a scientific curi- 
osity it will fully repay a careful reading, and the lessons 
it teaches will be of service to every accoucheur in his 
daily practice. The author has searched the whole world 
to gather facts for his purpose, and has certainly exhausted 
the subject. The cuts are generally well executed and add 
much to the interest of the text. 



TECE 



Peoria Medical Monthly. 



THOS. M. McILVAINE, A. M., M. D., 

Editor and Publisher, 

^04 South-Jefferson Street, .... PEORIA. ILL. 

***The Editor is not responsibie for the statements or opinions of contributors. 

***Short original articles are Invited from any reader, whether a subscjiber or not. 

***If extra copies are desired by a contributor, the number must be specified when 
the article Is sent In to the Editor. 

*** All exchanges, books for review, and communications must be addressed to th 
Editor and Publisher. 

***The publication day of this iournal is on or about the loth of each month 

***To subscribers! A pencil mark at this place indicates that the time of your sub- 
scription has expired, and that a prompt renewal is urgently requested. 



(^(litofial Sieirat'tm^ttt. 



That Pledge. 

Since the adjournment of the American Medical 
Society at Cleveland there has been some pretty vigorous 
^'kicking " indulged in about the pledge with which every 
member or delegate was confronted before registration. 
Considerable indignation was expressed at the time, but 
very few took time to think the matter over sufficiently to 
-arrive at the conclusion that it was entirely optional with 
each whether it be signed or not. We have seen it stated 
several times that those who refused to sign it were de- 
barred from participation in the meetings. Such, however, 
was not the case ; we know of instances where members 
refused to sign it, and on reference to the judicial council, 
they received their credentials. Many signed it under 
verbal protest, and it is from these that the "kicking" 
now comes ; they are willing to kick themselves because 
they signed it when it was not necessary. 

The whole thing was an insult to the members of the 
association. Especially to those who had previously 
attended. It looked very much like applying the gag to 
keep the mouths of any opponents to the code closed. It 
certainly gained no friends for the code party, and really 
^alienated many who were not previously opposed to it. 



Editorial Department. 135 

How Long Wm the Code Stand ? 

Those of our readers who are also readers of any of 
the New York journals, especially the weeklies, will by 
this time have become heartily tired ot the question of 
code or no code ; to these we must apologize for again re- 
ferring to the subject, yet we cannot refrain from penning 
our dissent to the decision of the American Medical Asso- 
ciation refusing to take any steps looking towards a 
revision of the existing code of ethics of that body. The 
petition of the St. Louis Medical Society was eminently 
proper, and we believe should have been adopted, but in- 
stead of being allowed discussion, it was promptly tabled, 
although by not a very heavy majority. 

We believe we voice the sentiments of a full majority 
•of the reputable, regular profession in this country to-day, 
in saying that the code of ethics can and ought to be so re- 
vised as to be made a living law instead of the dead letter 
it now is. Many who talk the loudest in its favor, are the 
most flagrant offenders against its spirit ; such will always 
vote against a revision, for in its stilted language and 
antiquated and sometimes ambiguous construction they 
can always be able to escape the penalty of its violation, 
and to themselves, at least, excuse their wrong-doing. 

But this is not the strongest argument that can be 
brought to bear in favor of a revision. The medical pro- 
fession is undoubtedly a strong one, but it is not as strong 
as public opinion, and to this stronger law it should make 
some concessions in self-defense. We opposed the action 
of the New York State Medical Society on the same 
grounds that we would oppose any act of rebellion on the 
part of any integral part of a general organization : the 
change of laws to govern the whole should come from the 
parent body, but when it is generally conceded by a ma- 
jority of the members of the regular profession in this 
country that a change might be made in ethical law which 
would tend to prevent further rebellion on the part of 
other societies, and to heal the breach already existing, it 
-seems to us that the members constituting the American 



136 The Peoeia Medical Monthly. 

Medical Association at Cleveland made a grave mistake in 
refusing to permit a discussion on the present code of 
ethics. 



Obituary. 

Died.— At Decatur, III, July 11, 1883, Dr. Walker L. 

Leforgee, aged 23 years, 8 months and 13 days. 

The first item under our notes for June was the an- 
nouncement of the marriage of Dr. Leforgee ; now it 
becomes our sad duty to record his death. Dr. Leforgee 
was born in Macon Co., 111., and resided in Decatur the 
greater part of his life. As a student with Drs. W. J. & C. 
Chenoweth, he applied himself with earnestness and zea-1, 
winning the confidence and esteem of his preceptors and 
acquaintances. After four years of medical study, includ- 
ing three fall courses at Rush, he received his diploma 
from that college in Februarj^, 1881. After practicing a 
year at Hammond, 111,, he removed to Warrensburg, where 
he remained until about one month ago, at which time he 
returned to Decatur. 

On the day of his marriage, May 29, 1883, he was 
stricken with paralysis, but from this attack he recovered 
in a few days, and entered with accustomed vigor into a 
promising practice. On July 4th he was again stricken 
down, and lived just one week. 

In college the industry of Dr. Leforgee was the subject 
of constant remark by all the students, and he was looked 
upon as one of the brightest men of his class. We remem- 
ber his prompt answers in every '• quiz," and the eager, 
though rather boyish face, with which he watched every 
utterance of the lecturer. To the bereaved parents, and 
terribly bereaved young widow, we wish to offer our hearti- 
est and most tender sympathies. 



Play Fair. 

We respectfully ask that the Medical Record give this 
journal due credit for original articles copied. In our June 
issue we gave a very interesting case of " Extirpation of 
the Uterus," a paper read before the Illinois State Medical 



mi 



Editorial Department. 137 

Society, and of which we have the original manuscript as 
read. A week or two later the Record printed the same 
article (though with heading somewhat changed) as an 
original article. The St. Louis Beview also published the 
same article after ours was in print. This is by no means 
the first time that articles have been copied from this jour- 
nal without credit being given, and we are about tired of 
it. It is neither honorable nor honest. 



All Inquiry. 

Dr. Hill, of Westfield,»Wis., wishes to know the best 
remedies for frontal and nervous headaches. Also, a good 
treatment for neuralgia, besides the use of opiates ; and a 
wash for the scalp for dandruff. If any of our readers will 
give Dr. H. the benefit of their experience and research, 
either through the pages of this journal or by private com- 
munication, we know it will be* appreciated. We would 
prefer that it should be sent to us for publication that all 
may be benefited thereby. 



Society Meetings. 

The semi-annual meeting of the Military Tract Medi- 
cal Society will be held at Galesburg, 111., Tuesday, No- 
vember 6th, 1SS3. The committee are making special 
efforts to have a large and interesting programme. 



Crotoii-Chloral Mixture. 



Professor Liebreich, who introduced butyl chloral, less 
correctly but more commonly called croton-chloral, into 
medical practice as a remedy in neuralgia of the fifth pair 
of nerves, and in the headache which affects anaemic women, 
prefers the following formula for its administration : 

5 Croton-chloral, 5 to 10 parts. 

Glycerin, 20 " 

Distilled water, 130 
M. Teaspoonful doses of the mixture will contain two to four grains of 
croton-chloral. — JVtto Remedies. 



Receipts. 

To save the time and expense requisite for sending a 
formal receipt to subscribers, we have for some months 



138 The Peoeia Medical Monthly. 

past adopted the plan of printing in this place the names 
of those from whom money has been received during the 
preceding month. Those remitting will please note 
whether their names are included in the lists, and if they 
are not will notify us by card: 

Illinois — Drs. H. Herrell, Jno. Eiser, H. N. Whitacre, H. Davis, 
G. W. Prewett, J. M. Wilson, J. S. Miller, L. W. Carter, E.E. Reynolds, 
L. Gillett, P. A. Rosenberger, J. B. Miller, S. F. Bennett, E. G. Davis, 
H. S. Hinman, A. S. Core, J. J. Reaburn, I. Carson Smith. 

Iowa — Drs E. S. Edwards, Hugh Jenkins, E. J. Chapman, W. D. 
McC'onnaughey, R. W. Selby, E. H. Keables (2 years). 

Wisconsin— Drs. J. F. Corbett, J. C. Wright, I. J. Bennett, F. H. 
McNeel. 

Indiana — Dr. S. Hunt. 

California — Dr. Jos. Kurtz. 

Nebraska — Dr. F. A. Long. 

Tennessee — Dr. F. F. Porter. 

Missouri — Dr. Wm. W. Moore. 

Texas — Dr. Edward L. Sessions, 

Michigan — Drs. Hugo Erichson, A. Garwood. 

Washington, D. C. — Library Surg. Genl's Office. 

Oregon — Dr. Ralph Leonard. 

Dakota— Drs. A. F. Bryan, G. AV. Nuckols. 



Reading- Notices. 



Celerina. — Dr. W. B. Hazzard, of St. Louis, Mo., contributed an 
article to the June " Brief" in which he considers separately the con- 
stituents of celerina, viz: coca, viburnum and celery. He states that 
coca is indicated in all functional affections in which it is a desideratum 
to prevent waste of muscular or nervous tissue. Viburnum has the 
power of reducing hypersesthesia and reflex excitability. Celery pos- 
sessess strong powers as a diuretic, controlling irritability of the bladder, 
and is beneficial to nervous headaches. It is also valuable in sleepless- 
ness and as a stomachic tonic. After considering each ingredient thus 
separately, he concludes that Celerina is a combination that is worthy of 
the confidence of the profession. The cases reported by Dr. H. as having 
been treated by Celerina include several of a very severe character, in- 
pluding one of marked nervous exhaustion, consequent on prolonged 
masturbation, and one of melancholia, have rapidly recovered under the 
use of this agent. Further reports of cases treated by it Avill be of inter- 
est and value to the whole profession. 



The Peoria 
MEDICAL MONTHLY. 



Vol. IV. AUGUST, 1883. No. 4. 



CDriginal C$0mmuttlati0tt$. 



Art. I — Carbolic Acid in the Treatment of Piles— Typical Cases. By Wm. 
H. Veatch, M. D., Carthage, 111. 

(Concluded.) 

Case 1. E. L., age 65 years, a farmer, had suffered 
from piles for over twenty years. Says he is compelled to 
put the tumors back a number of times daily. He post- 
pones the evacuation of his bov^els until bed time, so he 
■can lay down immediately and put the piles up. When he 
rides to town he always retires to some excluded spot and 
puts them up before presenting himself on the streets. 

On examination, I found a small external tumor as 
large as a filbert. Passing the finger into the rectum I 
found two tumors of the internal vein, the one on the right 
side about as large as an English walnut and the other 
about half that size. He also suffered from enlarged pros- 
tate. 

September 13, 1880, 1 injected the external tumor with 
eight drops of a mixture of equal parts of carbolic acid, 
glycerine and water. He was surprised when I told him I 
was through for that time, and wanted to know what I had 
done, as he had felt no pain. He sat and chatted with me 
for an hour, and said he was more comfortable than usual, 
but there was a sensation of fullness and a slight itching 
about the anus. 

September 30 I injected the same tumor, and also the 
larger internal one. 



140 The Peoria Medical Monthly. 

October 21. The internal tumor is all gone. A large 
fold of the skin and mucous membrane lay in the situation 
of the tumor. The internal one had been reduced to one- 
half its former size, and the man says he has been per- 
fectly comfortable ; has been engaged in work that he has 
not been able to perform for fifteen years. He had taken 
from the ground and put into the cellar twenty-five bush- 
els of potatoes in one day, and did not stop once to put up 
his piles. At this date I injected both the internal tumors. 

November 6. In reply to my inquiry, he said, "I am 
well ; have not had so much comfort in twenty years." On 
examination I found only a slight induration in the situ- 
ation of the former internal tumors. I threw a small 
quantity of the fluid into the indurations and told him 
he would require no further treatment. 

November 20. To-day I find no vestige of the piles 
left. He says the only inconvenience he experiences is 
that he finds it a little difiicult at times to control the 
sphincter ani when gases generate in the bowels. This 
patient is under observation every week, and always re- 
sponds to my inquiry, "Jam wellJ^ 

Case 2. October 20, 1880. Mr. J. W. N., age 36 years, 
a printer, had been afilicted with piles for fifteen years, but 
they had never "got him down" before. I found the man 
lying on his back on the floor, with his hips elevated and 
his feet over a chair. Says that is the only position in 
which he can have any ease. Putting him on his knees- 
and elbows I found seven external tumors of a dark purple 
color, one of which was as large as a hulled walnut, and 
the smallest was about the size of a filbert. They were all 
quite tense and elastic under the touch, but slight hand- 
ling gave him no pain. When the hypodermic needle 
pierced them, a sanguino-purulent matter issued from all 
except the smallest, and the piercing of this one was the 
only one at»which he showed signs of pain. I injected all 
seven with a one-third solution of carbolic acid, and applied 
a pledget of cotton saturated with the same solution over 
the tumors, and allowed him to resume the position he was 
in when I first saw him. I gave him ten-grain doses of 



i 



Original Communications. 141 

chlor. hydrat. every three hours, which was sufficient ta 
induce sleep. 

November 6. Two of the tumors are gone, all th& 
others look shriveled. No tenderness to complain of, na 
more pus escaping, and they give him but little trouble at 
stool. I injected the five remaining tumors, after which 
he takes no medicine. He is walking about town 

November 19. The tumors are all gone. There is a 
loose wrinkled condition of the skin about the anus. T 
touch the parts with a brush dipped in the carbolic solu- 
tion, and give him a small sponge and instruct him to 
apply the solution once a day until I see him. 

January 5, 1881. The patient says he is well ; has no 
more trouble in any way. 

In a letter written from Kansas, in reply to an in- 
quiry concerning his condition, he says, "October 9, 1882. 
— I wish to state that I have not had the least symptom 
of piles since your treatment nearly two years ago." I will 
say that this was the worst case of external piles 1 have 
ever witnessed. 

Case 3. December 30, 1881. Mr. W. B., age 32, a law- 
yer, had been complaining more or less of piles for a year 
or more. Has been under the treatment of his family phy- 
sician all summer and so far this winter, but so far it has 
only proven palliative. I found three internal tumors, one 
as large as a hickory nut, the others smaller. I injected 
the larger one. He complained of sharp pain at first, but 
after a few minutes he was comfortable. He sat in the 
office an hour, and said he felt a fullness about the rectum 
and some itching. The next day he reported that he got 
little sleep the night before on account of sharp darting 
pains through the parts. He went to his office, however, 
and was on duty all day. 

January 5, 1882. Found the tumor slightly ulcerated, 
I injected both the smaller tumors and allowed the first to 
go without treatment of any kind. The introduction of 
the speculum caused sharp pain, and when I injected the 
tumors he complained of sick stomach and vertigo, but 
arose from the table as soon as the speculum was with- 



142 The Peoria Medical Monthly. 

drawn and walked across the room and took a drink of 
water, after which he went into the reception room. In 
about thirty minutes he said all unpleasant feelings had 
left him. He returned to his office and attended to his 
professional duties for the day. 

January 26. Found only a slight induration in the 
situation of the former piles. I touched them with the 
brush dipped in carbolic solution, after which he reported 
himself well. 

This case has been under observation almost every day 
since, and I hear no complaint. 

Case 4. December 17, ISSl. Mr. A. J. L., age 28, a 
railroad agent, had suffered two years, at times, with inter- 
nal piles. " Had been treated almost every way," but said 
he was worse now than ever. Six months ago had been 
treated by an itinerent "pile doctor," by the hypodermic 
plan. Got better ; thought he was well; paid his $50 and 
doctor passed on. It had returned, and he wanted a guar- 
antee of cure. 

On examination I found an indurated spot on the 
anterior wall of the rectum, and a tumor as large as a fil- 
bert on the right side. He was a very nervous man, and 
had the strongest resisting sphincter ani I have ever at- 
tempted to dilate. The introduction of the finger gave 
him great pain, and when the speculum was dilated he be- 
came frantic. On being assured that the operation and 
pain would only be momentary, he nerved himself for the 
task, but when the instrument was withdrawn I found 
that he had fainted. The solution used was equal parts of 
carbolic acid and water. In ten minutes he was up and 
laughed about his being so easily hurt. 

A few days later he said there was a slight discharge 
of pus, but after that he said he had no more trouble. This 
man is still under observation, and remains well. 

Case 5. October 6, 1881. Mr. L. S. S., age 30 years, a 
grocer; a very active and energetic business man; acts as 
purchaser, salesman and book-keeper ; handles a good 
amount of heavy goods, such as sugar, salt and lime, has 
been troubled with piles at times for two or three years. 



Original Communications. 143 

Had been treated by two physicians with washes and oint- 
ments. Had used all the patent nostrums with but tem- 
porary relief. Now they are so bad that he must suspend 
business. 

On examination I found a large external tumor, as 
large as half of a hen's heg, and very much the shape. The 
fluid used was one-third carbolic acid. He suffered with 
sharp pinching pains in the tumor for about twelve hours, 
but resumed his books the next day. One week later he 
said he was well and needed no further treatment. I see 
this man every day. He is indeed well. 

Case 6. February 16, 1881. Mr. W. W., age 30, a stock 
drover. Piles is hereditary in his family. His father had 
been cured by the hypodermic plan in the hands of an itin- 
erent pile doctor. Has been suifering a little as long as he 
can remember, and now something must be done. 

I found three small external tumors. The largest did 
not exceed the size of a filbert and the smallest about the 
size of a pea. I opened the sphincter and found two small 
oval tumors about a half inch in diameter. I treated the 
external ones first, all of which I injected at once. This 
patient is extremely nervous and tender, and complains 
bitterly of the sticking of the needle, but as soon as I said 
" That is all " he rolled off of the table, and before I had 
my instruments out of my hands he was off for the train 
and went two hundred miles to his home. 

March 13. The tumors have shrunken to about one- 
half their former size. Another injection was given to all 
the internal ones, and he was off p.gain. Time passed, and 
I heard no more of him until December 27, nine and a half 
months from the last treatment. Said his business was 
such that he could not get away, and was very desirous 
that I should set a price and sell my secret to his family 
physician and allow him to be treated at home. I in- 
formed him that I had no secret to dispose of ; that all I 
knew of this plan was before the profession, and had been 
for a number of years, for all to use if he saw fit to do so. 
He expressed great surprise that his doctor had not found 
it out. 



144 The Peoria Medical Monthly. 

At this date the external tumors are all gone, but they 
have left folds of skin, hard and indurated, around the 
anus. I now inject the two internal tumors, which have 
somewhat enlarged, but are not so tense. With the tenac- 
ulum and scissors I remove the folds of loose skin around 
the anus. A little sub. sulp. ferri., applied on a piece of 
cotton, stopped the hemorrhage, and he went his way. 

January 7, 1883. The tumors are smaller, bat have 
not shrunken as rapidly as is common for such ones to do. 
The solution, however, has not been quite as strong as 
common. 

January 16. Another injection. But little improve- 
ment since the last treatment. Complains of desperate 
itching in the parts. Prescribe bis. sub. nit. 1 dr., morph. 
sulph. 5 grs., cosmoline 1 oz. — M. Sig. Apply as the case 
may require. Wash freely every day. 

February 9. Tumors all gone. Slight induration at 
the site of the former tumors. Touched them with the 
brush dipped in carbolic solution. 

February 22. Touched the indurations again. 

March 10. Indurations all gone. A slight eczema 
about the anus. Add plumbi acetate to the ointment. 

May 3. Itching about subdued, no pain, rests easy 
and bowels regular. 

May 22. A letter informs me that he is perfectly satis- 
fied with the result of the treatment. He is well. 

Many other cases might be presented, but space ad- 
monishes me to desist, or the publisher will consign me to 
the waste basket. 

In the past nine years I have treated many cases as 
severe as the ones reported, and I wish to say for the 
benefit of my extremely fearful brethren, that I have never 
seen a case of either peritonitis, embolism or pyaemia fol- 
low the treatment of any case; neither have I seen serious 
supuration or ulceration result from treatment. 

The universal testimony has been that they have suf- 
fered more from the piles in their inflammatory stage than 
they have suffered from the treatment. 



Oeiginal Communications. 145 

If these facts and cases are worth anything to the pro- 
fession, or can in any way help in removing the extreme 
prejudice existing in the minds of some of my professional 
brethren against this plan of treatment, or curing piles 
(I use the word curing in its broadest sense, and I know 
whereof I speak), my object in adding this paper to the 
mass of literature on this subject now before the profession 
will have been fully accomplished. 



Art. II.— The Clinical Uses of the Microscope— The Germ Theory of Dis- 
ease — Bacteria. By Romaine J. Curtiss, M. D., Joliet, 111. 

The present age is living in the fulfillment of the 
prophecy that the least shall be the greatest. Just now 
the notoriety that bacteria are having in relation to human 
attention and human life is excelled by no other living 
things. 

Not to know all about bacteria, to-day, in their rela- 
tion to disease, and as they appear in the microscope, and 
the methods of their destruction by preventive medicine, 
or the antiseptic treatment, is almost equivalent to know- 
nothingism in medicine. Bacteria have taken the place of 
endless and transcendant dogma in pathology and thera- 
peutics. They are the living cause in medicine, occupying 
the place where has been, all the way down through the 
medical ages, (1) ignorance, (2) superstition, (8) dogma, (4) 
the unknown cause of the solid, the humoral, and cellular 
pathologies. 

The relation of bacteria to disease, and its discovery, 
has made medicine a science. Before this time the skep- 
tics, critics and believers, alike, have always denied that 
mediciue was a science. The system Avas composed of em- 
pirical and dogmatic precepts, and had no scientific founda- 
tion because the antecedent of pathology was unknown. 

Our text books to-day, even the very latest and most 
voluminous, are simply observations of symptoms and 
signs, and the records of experimental dabblings with anti- 
dotes to symptoms and signs ; and obviously unscientific, 
because knowledge of a symptom, without a knowledge of 
its cause, is not science, and treatment of a symptom with- 



146 The Peoria Medical Monthly. 

out treatment of its cause, is only the beginning of experi- 
mental medicine, and is unscientific because the antece- 
dent of the signs and symptoms — the cause of the sickness 
— is unknown and untreated, and perishes by the law of 
the self-limitation of disease. 

From these facts what wonder is it that medicine is 
filled with impositions, pathies and quackeries ? The 
whole object of medicine has been to antidote symptoms 
and not remove causes, and it appears to be rather sufii- 
ciently proven that most anything can antidote symptoms, 
from venesection to milk, sugar, or water packs, or capsi- 
cum, or electricity, or imagination, or hocus-pocus, saints' 
bones, or prayers, and that so far as practical results go, 
and have gone, that the pathies stand on equal ground. 
They all furnish antidotes for symptoms, while the disease 
gets well itself by the peaceful and undisturbed euthanasia 
of the unsuspected cause. 

Bacteria are simple cells. Morphologically their 
structural differentiations are very slight, if any. They 
have no chlorophyl. In shape they are either spherical or 
oblong, or cylindrical, or spiral, and they reproduce them- 
selves by two methods — the method by fission and the 
method by formation of spores. The bacteria are supposed 
to be structurally composed (1) of a cellulose envelope, 
chemically composed of hydrocarbonaceous substance, 
which envelope ha» very great resistance to the action of 
alkalies and acids. The envelope contains a highly refrac- 
tive, colorless protoplasm, in which oily looking globules 
are sometimes seen. The minute, spherical bacteria (mi- 
crococci) have a molecular motion called Brownien move- 
ment, which motion is also observed in small objects, or 
molecules of inorganic matter. The larger baeteria have 
a more differentiated motion, owing to their possession of 
flagella or cilia, which certainly act as means of propelling 
the bacteria through fluids, and a person watching bacte- 
ria through a microscope will be struck with the likeness 
of their movements to voluntary motion in animals. 

There are, perhaps, a dozen classifications of bacteria, 
but the one in general use is that of Cohn. By almost 



Original Communications. 147 

common consent bacteria are classed, first, under the vege- 
table kingdom. They somewhat resemble algae and fungi, 
and in some things they resemble animal life. Haeckle, 
therefore, classifies them under a new kingdom, which he 
calls Protista. The basis of classification appears to have 
been 'primarily dependent upon the shape, and what little 
could be learned of the physiology of the bacteria. Lat- 
terly the basis of classification is taking the shape of our 
knowledge of the action of these organisms upon the dead 
and living organic matter in the production of fermenta- 
tion, putrefaction, and disease. It is being learned that 
the bacteria which have the same structural appearance, 
differ most remarkably in their physiological action, and 
somewhat in relation to their chemical and color reactions, 
and a classification based upon their structural microscopic 
appearance does not classify or distinguish them. 

Cohn first divides the bacteria into four tribes. This 
tribal classification is based entirely upon the microscop- 
ical shape of the organisms and their resemblance in form 
to some other familiar shape. The tribes are divided into 
genera, and these into many species, the basis of the two 
latter classifications being a mixture of anatomy and 
physiology, and relations to other living and dead matter. 

The outlines of Cohn's classification can be concisely 
expressed as follows : 

f TRIBES. { GENERA. 

Micrococus Chromogenes. 
,-, M. Zymogenes. 

( M. Pathogenes. 

( Bacterium Termo. 
3. Micro-bacteria \ B. Lineola. 
Bacteria <j' ( B. Catenula. 

i Bacillus Subtilus, 
3. Desmo-bacteria ■] B. Anthrax. 



I Vibrio 
4. Spiro-bacteria -| Spirillum 



( B. Tuberculosis. 

( Vibrio, 
-j Spirillum. 
( Spirochsetaj. 



148 



The Peoria Medical Monthly. 




(1) Sphero-bacteria {M. Vaccinae). 

(2) Micro-bacteria {B. Termo). 



(3) Desmo-bacteria {B. Vina). 

(4) Spiro-bacteria {Sp. Volutans). 



The bacteria, like most other living things, present 
some external forms of social life. They aggregate into 
forms of certain rather definite characters, as veils, chains, 
svs^arms, tomla, zooglea, etc. 



Q 





Swarm of V. Serpens. 
Zooglea [Microcci). 






f3) " Rosary Chain " [M. Urea). 
(4) Zooglea B. Lineola. 



The larger bacteria can be seen in outline with low 
power objectives, but their structure, spores, cilia or flag- 
ella, require the wide angle objective and considerable 
amplification. The examination of urine for M. Urea, and 
of fermenting fluids for M. Zymogenes, and of putrefying 
fluids for B. Termo and B. Lineola, require an objective of 
180 deg. ang. ap. The amplification can be carried out to 
the degree desired by eye pieces. Certain of the bacteria, 
however, cannot be seen at all, until they are stained with 
aniline color. 

The spherical bacteria are recognized by their small 
size and spherical shape. When they are observed alive 

The above illustrations are reproduced from the Microscopical Journal. 



I 



Oeiginal Communications. 149 

and at work, they are always in motion, the motion being 
a simple to and fro movement, called Brownien motion, 
and resembling molecular motion. They are not known 
to have cilia or flagella, and the motion is probably the 
primary sample of action and reaction between the ego 
and the environment. 

All spherical bacteria are called Micrococci, or Micro- 
coccus, is the genus of all species of Sphero-bacteria. There 
are three groups of the Micrococcus species. The first are 
called M. Chrotnogenes, because they contain different col- 
ored pigments and can be recognized by their chemical re- 
action, and by spectroscopic analysis, on account of the 
color substance which they contain. 

It appears to be characteristic of these colored bacteria 
that they develop mostly in cooked food. If potatoes, or 
meat, or eggs are cooked, and exposed to air a day or two, 
these colored bacteria will appear in them. There are 
eight or ten kinds of colored sphero-bacteria, being of 
different sizes and all colors from yellow to violet. 

The M. Zijmogenes are so-called because they cause 
fermentation of different kinds. The variety having the 
greatest interest is the M. Urea, which causes the ammo- 
niacal fermentation of urine, when urine becomes ammo- 
niacal, in the bladder or out of it ; the cause is always the 
presence of this form of sphero-bactei'ia. 

The M. Pathogenes are so called because they are capa- 
ble of producing disease. There are several kinds or 
species of these sphero-bacteria, and they are called after 
the diseases which they are supposed to cause, as M. Vac- 
cines and another species, which is very like it, but acts 
differently and causes small-pox. Cohn regards these two 
kinds as being different varieties of the same species. 
According to modern nycology, one kind would be regarded 
as an attenuation or dilution of the more severe type. 
Septic poisons, causing septicsemge, puerperal fever, 
pyemia, and abscesses, constitute so many other varieties 
of sphero-bacteria. 

The Micro-bacteria are the rod bacteria. They are 
composed of cylindrical cells, have flagella, and conse- 



150 The Peoria Medical Monthly. 

quently spontaneous movement, if there is such a thing a& 
spontaneous movement, which is doubtful. The genus 
under which the different species are grouped is Bacte- 
rium, a very unfortunate name for the word in a generic 
sense, ought not to occur in a general sense, and then 
again in a more special sense. The principle species are 
B. Tenno, B. Lineola, B. Puncfum., B. Catenula. Other 
species constitute the acetic and lactic acid ferments. 
There are other kinds which cause the putrefaction of 
milk and pus, and give them a blue color. 

The B. Termo and B. Lineola are the agents of putre- 
faction. The B. Termo is usually first in the field of putre- 
faction, whether the field be sewage or dead men, and is 
followed, after a few days, by other species and varieties. 
If B. Termo and similar species can be kept out of dead 
organic matter by cold, or heat, or antiseptics, the organic 
matter, whether waste products, or food products, will 
never putrefy. People preserve their dead and their food 
by various processes which interfere with the activity of 
the micro-bacteria. 

The Desmo-bacteria are composed of elongated cylin- 
drical cells. If they are well supplied with oxygen their 
movements are very active. The desmo-bacteria are called 
bacilli, and the genus under which the different species are 
grouped is called Bacillus. The principal species of Bacil- 
lus are B. Suhtilis, the hay bacillus, B. Anthrax and B. 
Tuberculosis. 

The B. Suhtilis is the butyric acid ferment. It exists 
in rennet and pepsin. It can support a temperature of 
105 deg., and live without free oxygen, but when deprived 
of oxygen it lives a short time and devotes its expiring en- 
ergies to the formation of numerous spores, which are each 
capable of developing into new bacilli. 

The B. Anthrax is the cause of splenic fever or an- 
thrax, or charbon, or malignant pustulo. 

The B. Tuberculosis is the agent of consumption, and 
since the discovery of Dr. Koch, is the well known cause of 
death of one-seventh of the people born in civilized coun- 
tries. 



Oeiginal Communications. 151 

Certain of the bacteria present spirals or curves m 
their shape. Some of them have only one curve, others 
have several. This fact forms the basis of classification of 
the spiro-bacteria. There are three genera, the Vibrio, the 
Spirillum, and the Spirochcetce. 

The Vibrios are of tw^o species, the V. Rugula and V. 
Serpefis. These species move through fluids as a serpent 
sw^ims through the water, the only difference betw^een them 
being that V. Rugula has only one spiral or curve, whila 
V. Serpens has several. 

The V. Rugula is found in deposits upon the teeth, and 
was, perhaps, the first bacterial form ever seen, for Stewen- 
boeck first discovered them in the human mouth. 

The distinguishing characteristic of the various^ 
species of the genera Spirillum is that they resemble a 
cork screw. When they move they do not travel as a ser- 
pent swims, for the reason that their curves or spirals are 
not flexible, but they move through fluids just as a cork 
screw goes into a cork. There are two species of the 
Spirillum, the Sp. Undula and the Sp. Volutous. The latter 
is the giant among bacteria, and seen with others, looks 
like a whale among the minnows. It is found in sea water 
and occasionally in organic infusions. 

The genera Spirocluetce resemble a spiral wire springs 
perhaps the curved spirals are closer together than in other 
kinds. They are very rare birds, and there are several 
species. The species which has gained the greatest noto- 
riety is the Sp. Obermieri, who found them in the blood of 
persons with relapsing fever. 



Art. III.— Laceration of the Cervix Uteri. By H. S. Bell, M. D., Paris, 111. 
Read before the ^sculapian Society of the Wabash Valley at Charleston,. 
111., May 30, 1883. 

It has only been a few years since this accident in 
parturition was recognized as an abiding source of irrita- 
tion. It had always been considered possible, but only a 
very few writers spoke of it as a probable cause of disease. 
In 1862, twenty years ago, Emmet accidentally recognized 
the importance of the lesion, and at once devised a surgical 



152 The Peoria Medical Monthly. 

operation for its relief. Notwithstanding a score of years 
have elapsed since the first case was described and success- 
fully operated upon, it is only within the last five years the 
profession have come squarely to discuss and act upon this 
innovation. 

And even yet there is a great lack of harmony in the 
views expressed on this subject. Many good and true men 
have been convinced by Emmet of the existence and im- 
portance of this accident, and have published papers setting 
forth the nature, pathology, and necessity for its relief. 
There are many good observers, however, who do not in- 
dorse the operation, but think it much overrated and too 
much practiced. This adverse opinion is held by European 
gynaecologists almost entirely. In America the feeling is 
almost unanimously favorable to the operation, especially 
among our leading surgeons. In our country districts the 
difference of opinion is considerable, and is to be consid- 
ered a matter of course, as it is the experience of all things 
new. The gauntlet through which this new operation has 
almost passed, is, in fact, the crucible by which all ques- 
tions of importance are tried ; and thus impulsive progress 
is checked, which of itself is sometimes more disastrous 
than the routine of a thousand years. But to our mind 
this operation deserves a high place in the practice of 
gynaecology. When a married lady comes to us with an 
account of poor health since the birth of her child, or since 
the occurrence of an abortion, and describes an ever con- 
sciousness of pelvis, back and thighs, and of her inability 
to do the things with ease which previously were of choice 
and pleasure, and gives an experience of profuse and fre- 
quent menstruation and intervals filled in with an equally 
tormenting leucorrhea, and added yet to these, and proba- 
bly worse still, perverted and painful nervous manifesta- 
tions, such as irritability of temper, despondency and its 
fertile field of evil forebodings, hysteria, melancholia, and 
the ten thousand different sensations of pain, heat, flush- 
ings, throbbings, palpitations and hyperasthesias by any 
other name you might kindly suggest. With this very 
common suggestive history, we request an examination, 



Original Communications. 153 

and often find a large red eroded os uteri, the long styled 
"''ulceration of the mouth of the womb." This patch of 
erosion may be quite extensive, covering the whole face of 
an apparently enlarged os, or it may be but a small blush 
not larger than a nickel. This examination must be con- 
ducted with patient in lett semi-prone position with Sim's 
speculum. With small tenacula we seize both anterior 
and posterior lips of the os and endeavor to approximate 
the everted lips by bringing the engaged points of the 
tenacula in apposition, and if this succeeds, in turning in 
from the right the angry looking surfaces which before 
were presented to view, and also reduces the apparently 
enlarged os to one of normal size, we at once have re- 
vealed to us, by this simple but pathognomonic diagnostic 
principle, laceration of the cervix uteri ; and that Emmet's 
operation will most probably relieve all the symptoms of 
which this poor suffering woman complains, and convert 
this offensive looking, foully secreting cervix to a pale, 
pink, smooth looking, non-bleeding surface — the exact 
counterpart of a virgin os uteri. 

It was formerly the practice to treat these erosions 
{ulceration so-called) with caustics, especially nitrate of 
silver, fuming nitric acid, acid nitrate of mercury and the 
actual cautery. The success following this line of practice 
was often gratifying for a little time, but it was found that 
these cases were prone to relapse in a few months, and 
were therefore visiting one doctor after another in the vain 
hope of finding relief. 

Now, if we recognize these cases as non-healed lacer- 
ated cervices, and then, after duly preparing the patients, 
proceed to restore the original form by a painless, plastic 
operation, we at one grand and final cou]) de grace relieve 
these women of a mal-condition which can generally be 
treated successfully in no other way. 

The beauties and fascinations of this practice have 
only to be seen to be appreciated. To the doctor who has 
had poor confiding women, too true to his character and 
reputation to discharge him for his constant and repeated 
failures to relieve them, sees them relieved in a few months 



154 The Peoria Medical Monthly. 

of permanent sources of physical pain and mental distress,, 
by this simple operation, to him the satisfaction of know- 
ing " 'tis well done " and done for good is beyond the power 
of pen to portray. 

This operation, so productive of good, is not unlike- 
most other operations in surgery, in the fact that it is 
liable to be done in many cases not requiring it. And this- 
very question of deciding in any given case as to the 
advisability of operating, is of the greatest importance and 
responsibility. Here it is that the judgment of the practi- 
tioner is to be mostly exercised. We should ask ourselves 
ever so candidly, is this operation necessary for the health, 
and comfort of this patient ? The mere fact that we diag- 
nose a laceration is not a sufficient reason for the opera- 
tion. We have seen quite a number of patients with un- 
doubted lacerations of the cervix, but in whom no serious 
or special symptoms were present. Some of these patients 
presented well marked lacerations, but the everted lips 
were well covered with sound mucous membrane or un- 
broken cicatrices. There were none of those reflex nervous- 
disturbances by which many poor women are sorely tor- 
mented. There are also some cases where there is but- 
little erosion and no marked constitutional derangement- 
To operate in this class of cases would be inexcusable reck- 
lessness. 

The cases upon which we should operate are those who- 
are obviously and unmistakably suffering trom poor healthy, 
and are disqualified by reason of the laceration from dis- 
charging the duties incumbent upon them as wives^ 
mothers and housekeepers. Those women who are anaemic,, 
neuralgic and dyspeptic, without any discoverable cause,, 
after patient and diligent inquiry, should be examined with 
reference to this injury, and if found to exist, this opera- 
tion should be done, and they are almost invariably re- 
stored to good health by it. It would seem, from the above 
description of the cases not requiring, and of those need- 
ing, the operation, that no very great power of discrimina- 
tion would be brought to bear in deciding the point ; but 
discrimination in medicine is everything, and it is much 



i 



Original Communications. 155 

easier to classify cases on paper than in practice, hence so 
many plausible writings. The subject of diseases of the 
female generative organs is so much like that of diseases 
of the mind that it is often no easy task to tell where the 
plane between health and disease begins to depart or de- 
scend. 

{Concluded in September Number.) 



Art. IV.— Treatment of the Prematurely Born. By Joshua Richardson, 
M. D., Moravia, Iowa. 

It seems to be tacitly admitted by many in the profes- 
sion that to do more than give merely a few general direc- 
tions as to the management of prematurely or feebly born 
infants, would be time thrown away, and hence too often 
the little stranger is left alone, as it were, to his fate, to 
struggle alone for a few hours against the common enemy 
and then succumb, when, perhaps, a steady and intelligent 
perseverance on the part of the doctor and attendants 
would have been crowned with success. 

And as human life is always worth striving for, no 
pains should be spared to keep alive the vital spark until 
nature becomes strong enough to support her own. I think 
one of the proudest moments of my life was when I had 
become assured that my efforts at saving a feeble six and a 
half month's child, had been attended with success. 

Sometimes it is too sadly true that our efforts are 
coldly seconded by those who should be most anxious for 
the infant's life. But as ours is not a profession to pander 
to the convenience of society in such matters, such cases, 
when they come, must not deter us from our duty. Turn- 
ing to our statistics, the conclusion, especially to the young 
practitioner is, it must be admitted, not at all satisfactory; 
yet great though the mortality may be in these cases, un- 
doubtedly very many could be saved to our population that 
now die, provided the medical attendant could be always 
made to understand that in the majority of these cases he 
needs nothing but what almost any family can furnish 
toward resuscitating and invigorating the life of the child. 

Presupposing that the attendant is conversant with all 
the first attentions to the infant, we will pass without 



156 The Peoria Medical Monthly. 

comment to the secondary, but no less important duty of 
perfecting and maintaining the newly begun functions of 
separate existence. Let us take a typical case — one in 
which breathing has become established, however imper- 
fectly it may be: The foramen ovale and ductus arteriosus 
yet imperfectly closed, as indicated by the cyanosed hue of 
the skin, are probably more or less mourning respirations; 
the breathing spasmodic and irregular, and the child too 
weak to nurse, and rapidly growing cold; all of which 
symptoms terminate soon in death unless relieved. 

My first directions in these cases are to order a warm 
bath of fresh cow's milk, sugar and water, in same propor- 
tion as if to feed the child, as indeed it is to serve not only 
the purpose of warming the child and indirectly aiding the 
respiratory functions, but also serves directly as food, suffi- 
cient being absorbed through its delicate skin to nourish it 
in a ten or fifteen minute's bath, to amply supply its first 
needs, though not a drop be taken by the mouth. Until it 
becomes thoroughly warm these baths must be repeated at 
short intervals and the physician should personally super- 
intend this; seeing that the bath is kept at the proper tem- 
perature, ^. e., about 98 degrees and also fresh. In the in- 
tervals have the child swathing in something soft, as ken- 
ter flannel, as that is usually the most convenient material 
usually to be had. Do not allow it to be dressed until it 
gains sufficient strength for this ceremonious operation, as 
the more it is handled the more it is wearied. Between 
times of bathing still further supply heat by means of the 
hot water jugs and hot bricks, etc., as generally recom- 
mended in the text books. And while operating the milk 
baths, if the lungs and trachea seem much clogged with 
phlegm, may give a drop or two of spirits ammonia in a 
little water, in addition to the nurses simples for this 
trouble. So soon as wrapped up, if cyanosis be complicating 
the case, lay the child on its right side with its head and 
body elevated about 40 degrees, as we thus help to correct 
the circulation and close the foetal ducts. 

If these measures be carried out under the guidance 
ot a skillful physician, I have no doubt that most satisfac- - 



i' 



Oeiginal Communications. 157 

tory results will often reward him for his labors. In no 
case I think need alcoholic stimulants be used; in fact 
many a little life is sacrificed by their use. 

In these premature and feeble deliveries the condition 
of the mother's milk must also be carefully looked after; 
as whatever be the character of her food, such will be the 
quality of her milk. Strong coffee or tea, and bacon and 
beans, and all such food must be strictly regulated into 
their proper proportion and strength, or all our gratifying 
success of the first few days may very probably be turned 
into defeat. 



Art. v.— The Predetermination of Sex. By Silas Hubbard, M. D., Hud- 
son, 111. 

Griesheim, Pfluger and Dr. G. Born have recently put 
themselves to immense labor and care in artificially im-- 
pregnating frog spawn by applying to it the semen of frogs 
in full rut, etc., under a great variety of circumstances, to 
discover if the sex can be predetermined. Their experi- 
ments proved nothing in favor of predetermination so far 
as they could see. If they had proceeded according to my 
theories, published in the Buffalo Medical Journal of 1855, 
viz: applied the frog sperm to the eggs while they were 
quite recently developed, they might have possibly proved 
that a great proportion of them developed into males, and 
vice versa if they had applied the sperm to very mature ova 
they might have possibly proved that a great proportion 
of them developed into females. However, unconsciously 
to themselves, they did produce a shade of argument in 
favor of my theories, viz: those eggs which they artifi- 
cially impregnated with frog sperm became mostly females, 
while the sexes were about equal of those frogs which 
were generated in the natural w^ay without interference ; 
and the shade of argument is this, that probably in their in- 
terference they selected very mature eggs, and thus they 
mostly developed into females ; while when left to them- 
selves the males would be very sure not to neglect the 
females in the beginning of rut, and thus a larger number 
of new ova were impregnated and consequently a larger 



158 The Peoeia Medical Monthly. 

number of males were produced ; somewhat on the princi- 
ple that when a bull herds with a flock of cows a greater 
number of male calves are produced than when he is kept 
in confinement and the cows are frequently brought to 
him when they are far advanced in heat. 

I was the first to publish that the impregnation of new 
ova produced males and the impregnation of old ova pro- 
duced females ; but thirteen years after this, as related by 
JN'apley, certain men experimented to prove that the new 
ova w^hen impregnated became females and the old ova 
became males, thus reversing the order I had taught, I do 
not care which they undertake to prove, providing they 
give the true facts in the case. 

Just as I penned this, 1 picked up a book published by 
J. H. Kellogg, M. D., in 1S81, in which he says : "More re- 
cently another German physician has advanced the theory 
that the sex may be controlled at will by observing the 
time of fecundation. He asserts that when fecundation 
occurs shortly after menstruation, the result will be a 
female ; but if impregnation occurs later in the month, 
and prior to three or four days preceding the next men- 
strual period, a male will almost certainly be produced. 
This theory was proposed by Prof. Thury, of the Academy 
of Geneva, who claims to have thoroughly tested it in a 
great variety of ways, and always with an affirmative re- 
sult. Dr. Heitzman, of 'New York, an instructor in patho- 
logical histology and an eminent physiologist, informs 
us that he has thoroughly tested this theory, and finds it 
to be entirely reliable. There are numerous facts which 
seem to corroborate the truth of this theory, and future in- 
vestigations may give to it the dignity of an established 
physiological fact." 

I would say that I was the first to publish the above 
theories with facts to prove them true, which can be found 
in the Buffalo Medical Journal of 1855. 



Art. VI.— Carbolic Acid ia the Treiitment of Piles. By H. D. Hill, M. D., 
Weslfield, Wis. 

There has been considerable said for and against the 
injection of carbolic acid into hemorrhoidal tumors, either 



Ml 



Original Communications. 159 

external or internal. I have treated several cases in this 
way by use of carbolic acid, with a cure iu every case. I 
will note but one, it being a typical case: 

A young man 25 years of age came into my office one 
evening, looking as though he had lost every friend he had. 
He asked me if I could cure piles. I told him yes. He 
said he had had them for over six years; had been treated 
by seven doctors, and they had all told him they could 
cure him, but any more than temporary relief, he had never 
been much benefitted, but he said he would give me a trial. 
I told him to come back the following morning, 

I might here mention that the patient had been unable 
to get about for several days, and unable to follow his 
trade for some weeks. He had no appetite; was becoming 
emaciated, and bowels very costive, and really thought he 
was going to die. The following morning he came to my 
office again. T examined him and found five tumors about 
the size of a hazelnut, very hard and sensative to touch, 
I injected a few drops of a 10 per cent, solution into two 
of the tumors, and he went home. 

The next week I treated the remaining three. At the 
end of one month he came back to my office, looking very 
much better, and he said he felt nothing of the trouble, 

only that it itched like h . He said he was feeling 

better than he had in years. I examined him and found 
no trace of piles. The skin around the anus looked a little 
red where he had scratched himself, that was all. I rubbed 
a little salicylic acid around the part and he thought then 

it did itch and burn like h sure enough for a while. 

I examined him about one year after and no trace ot 
his trouble was to be seen. 

1 think that this injection of carbolic acid and olive 
oil the very 5esf and as well, a safe treatment. 

This case is only one of several that I have treated 
satisfactorily to myself and my patients, as a c/.Te is all 
that is necessary no matter what does it, so long as no injury 
is done in other ways. 

Let us hear from others on this subject. 



160 The Peoria Medical Monthly. 



Art. I.— Fracture of Skull, With Depression. By O. J. Roskoten, M. D., 
Peoria, 111. 

On May 19, H, S., an upholsterer in this city, missing 
his footing, fell down an elevator way. In his descent 
head foremost his forehead struck a projecting brick, 
breaking bone and brick. On examination Drs. R. Rosko- 
ten, J. L. Hamilton and 0. J. Roskoten found him insensi- 
ble, with a large transverse wound at the middle of the 
forehead, from which blood and brain substance were 
slowly oozing. By the finger a comminuted depressed 
fracture was detected, the line of the fracture extending as 
far as the finger would reach. The frontal sinus being 
very spacious, the tip of the finger entered it readily, while 
the edges of its anterior and posterior walls could be 
plainly felt. The fragment was depressed nearly one- 
fourth of an inch beyond the posterior wall of the sinus, 
readily accounting for the symptoms of compression pres- 
ent. The most marked of these were the profound stupor, 
slow stertorous breathing, flopping of the alae nasi, the 
full, slow pulse (60 per minute), dilated pupils and general 
warmth of the surface. Patient could not be roused by 
loud speaking, but fifteen minutes later slowly turned over 
on his side to vomit, after which he relapsed into his 
former condition. There was no external hemorrhage 
from nose or ears, nor a discharge of any clear liquid, nor 
paralysis of limbs, hence apparently no fracture at the 
base of the skull. 

The upper eyelids were almost black from sanguine- 
ous effusion, the lower to a lesser degree. Patient was re- 
moved to his boarding house, where, in the afternoon, I 
made the operation to raise the bone, Dr. R. Roskoten 
assisting. The wound was enlarged sufficiently to 
expose the whole extent of the fracture, making the length 
of wound, plus incision, 4i inches. The depressed bone 
was of an irregularly quadrangular .shape, 3^ inches long 
by 2 inches in width, the lower line running transversely 
across the forehead one inch above the root of the nose. 
Along its four edges there were a large number of small 



Notes from Private Practice. 161 

fragmeDts, the whole being so tightly wedged together that 
difficulty was experienced in loosening and extracting 
them. This done, it was found that the fracture of the 
inner table was more extensive than that of the outer 
table (the fracture extending above the frontal sinus), the 
former, however, not being much splintered. I could, 
therefore, not apply the elevator until after I had chiseled 
away one-sixth to one-fifth of an inch of the margin of 
the undepressed bone for some distance. After removing 
some more*lmall spicula, the bone was raised to its natu- 
ral level without any further difficulty. I took the pre- 
caution to clean out the frontal sinus (which was filled 
with blood) by the atomizer. The bone had been entirely 
stripped of its pericranium, the shreds of which were re- 
placed as smoothly as possible, and the wound closed with 
silk sutures after thorough cleansing with carbolized 
water. Patient was now transferred to his bed, and com- 
presses of ice water constantly applied. Being addressed, 
he now readily answered. Pulse, 80 ; temperature, nor- 
mal. Gave a mercurial laxative, to be followed by two 
teaspoonfuls of Epsom salts. Lemonade, if thirsty. 

When seen, three hours later, pulse 90 ; temperature^ 
99^. Still later, his extremities became cold, and hot baths 
were necessary. 

May 20, 9 a. m. Vomited blood twice during the night ; 
some cough ; breath olfensive ; fever was high till 3 a. m., 
when it gradually declined. Urine passed involuntarily ; 
restless and requiring restraint towards morning. Pieces 
of ice are now substituted for the compresses, and another 
dose Epsom salts administered. In the evening was more 
quiet; pulse, 100; temperature, 99|; responds readily; 
tongue protruded quickly ; pupils of equal size ; breath 
very offensive. Wound healing by first intention. 

May 21. Fetor of breath excessive. Left some Lister- 
ine, diluted with equal parts of water, to be taken in tea- 
spoon doses hourly. Mucous in throat interfering with 
respiration; pulse weak, 110 per minute; surface cool. 
Administered liq. ammon. aromat, which excited a cough, 
dislodging mucous, restoring respiration and reviving 



162 The Peoria Medical Monthly, 

patient. Sweats profusely; urine and fseces passed into 
bed. Cleanliness being sadly neglected and surroundings 
unfavorable in his boarding house, patient was now car- 
ried to the (yity Hospital (three blocks distant) on a 
stretcher, no unfavorable results occurring. Eyelids greatly 
swollen, perfectly black, for which warm applications of 
diluted tincture of arnica were made. Evening, pulse, 
110; temperature, 100^. 

May 23. Last stitches removed ; no trace of discharge 
from the wound up to date; temperature, 100 ; pulse, 112. 
Fetor of breath nearly disappeared. Aromatic wine, 
diluted with twelve parts of water, is now applied to the 
eyelids. Patient with difficulty induced to take nourish- 
ment of a liquid form. Bladder becoming paralyzed ; for. 
one and one-half weeks after this date required daily use 
of catheter. Bowels distended, but not yielding to large 
doses of salines and other cathartics. 

May 24. Cold water to forehead instead of ice. Eyes 
improving. 

May 25. Lies perfectly still, with eyes closed. Now 
drinks milk ; pulse, 100 ; temperature, nearly natural. 

May 26. Pulse, 120 ; weak ; no increase in tempera- 
ture. R. Spts. ammon. aromat. 

May 27. Vision good, but does not recognize ordinary 
objects, like a watch. 

May 29. Pulse, 96 ; temperature, normal. No paraly- 
sis, except bladder and bowels ; all applications to head 
discontinued. Wound healed by first intention, except at 
two small points. 

May 31. Read a few lines when requested. 

June 2. Pulse, 88. R. Decoct, cinchona. 

June 3. For the first time in nearly two weeks has 
passed urine voluntarily. 

June 5. All evacuations into bed ; this continued 
until July % in spite of all medication. Pulse, 90. 

June 6. Emaciation very great. Yesterday patient 
suddenly regained his memory, which had previously failed 
him absolutely. Out of mere curiosity I inquired of him 
the date, to which question he promptly replied : " This 



Notes from Private Practice. 16^ 

is the 21st of May." There was more sense in the answer 
than I thought at first. The last date that was fixed in 
his mind was the 19th of May (the day of the accident). 
I said that his memory returned yesterday ; it was quite 
natural, therefore, that he should take yesterday to be the 
20th and to-day the 21st of the month. He was greatly 
astonished on seeing to-day's date in a newspaper. 

June 9. Pulse, 84 ; temperature, natural. R. 15 grs. 
citrate of iron and quinine daily. 

June 13. Pulse, 76. Bowels and bladder still emptied 
into bed daily. 

June 15. Mental dullness marked (rainy day). Bowels 
evacuated on floor of room ; diarrhoea 

June 17th. Dulness continues; keeps bed; forehead 
cool; pale exuberant granulations at angles of wound 
touched with nitrate silver; large dose of salts. 

June 18th. Mild delirium at times; when aroused is 
clear, but speedily relapses. Thinks he is in Germany. 
Pulse 80. R. 10 grains jalap, and cold compresses to head. 

June 21st. Walks around the room; is again quite 
intelligent. Ordered him to spend an hour daily in open 
air. 

June 25th. Improving rapidly since the 21st. Com- 
plains of constant but slight headache. 

June 30th. R. Pill — strychnine 1-30 grain; one pill 
four times daily, with a view to restoring tone of bowel 
and bladder; all other remedies had failed. 

July 2d. Faeces retained. 

July 5th. No more trouble with bowel or bladder. 

By request spends the greater part of the day in the 
hospital garden, but prefers to lie on bed. Wound per- 
fectly healed. Appetite good. Talks rationally about 
plans for the future. Patient being still too weak to earn 
his living, he was granted permission to remain at the hos- 
pital for another month, at the end of which time it is 
thought, he will be able to resume his work. He is now 
able to do little chores about the hospital. 

There are several points of interest connected with the 
case. One of them is the origin of the large amount of 



164 The Peoria Medical Monthly. 

blood vomited the night after the accident. I could not 
diagnose a fracture of any of the fossae at the base of the 
skull, hence it would appear most rational to conclude that 
the blood, after filling up the frontal sinus, had found its 
way along the infundibulum, through the anterior ethmoi- 
dal cells into the middle meatus of the nose and thence 
into the throat and stomach. There was sufficient time 
for this to occur, as the operation was made a number ot 
hours after the accident. On the other hand, examining 
patient's chest the following day, on account of his cough, 
I found on percussion upper part of middle lobe, right 
lung, almost flat (in fact S. had been under treatment for 
consumption at the hospital some months previously), 
while a few weeks later, resonance was nearly normal or 
slightly tympanitic. It is quite possible, I think, that the 
shock of the fall may have caused the rupture of an eroded 
vessel in a pulmonary cavity, the blood being then raised 
by acts of coughing, and swallowed. This theory would 
also account for the frightful odor of his breath commenc- 
ing the . day after the accident, when putrefaction had 
begun in the contents of the bursted cavity. It is also cor- 
roborated by one of the attendants having seen "matter" 
with the blood, and by the fact that the cough, which had 
troubled him for months, stopped almost immediately after 
the supposed discharge of the cavity. 

Another point of interest is the partial paralysis of 
the bowel, and the complete paralysis of the bladder, com- 
ing on a few days after the accident, lasting a couple of 
weeks, and then changing into incontinence, or paralysis of 
the sphincters. I here call attention to the prompt action 
of strychnia on this condition in this case. I believe that 
these conditions were results of concussion of the spinal 
cord, sustained in the fall. 

Lastly, the above case again shows how tolerant the 
brain is of injury of at least its frontal lobes, and that in 
every case of depressed fracture, however unpromising, or 
even of fracture without depression, but with positive 
symptoms of compression, operative treatment should be 
instituted in the hope of saving a life otherwise forfeited. 



Notes from Private Practice. 165 

Art. II. — A Case of Secondary Puerperal Hemorrhage. By A. B. Anderson, 
M. D., Pawnee City, Neb. 

I relate the following case as being the first that has 
occurred in my practice of six years. 

On the evening of June — , 1883, I was called to attend 
Mrs. A. in her second confinement. On arriving, however, 
I discovered that the little stranger had preceded me by a 
half hour or so. The attendants reported everything in 
good shape and everybody comfortable. I inquired about 
the placenta and was informed that it had come away all 
right, and without any assistance from the attendants. 1 
examined over the uterus, found the contraction good, and 
slight after pains. 1 then examined the placenta, found it 
entire, and as the patient seemed to be doing so admirably, 
I simply rested for a short time and took my departure. 

I heard nothing more from the case until two weeks 
and three days afterward, when I was hastily summoned 
about 3 o'clock in the afternoon to attend this patient for 
"severe flooding." I hurried to the place, a distance of four 
miles, and found it even worse than I had anticipated. 
The nurse said the woman had been doing splendidly until 
about 10 o'clock of the preceeding day. I learned that she 
had remained in bed for a week after her confinement. 
She then got up and was around about the house until 
taken ill this morning. She was feeling so well the day 
before that she washed a very few of the baby's clothes. 
She got up feeling as well as usual the next morning, but 
about 10 o'clock begun to be "unwell." When I entered 
the room she was lying upon her back, looking very pale, 
complaining of dizziness, great weakness, and yawning 
every few minutes. 

I found a large quantity of clots in the bed around her 
and the blood still pouring from the womb. 1 immediately 
gave one-half drachm fluid extract of ergot and one-half 
drachm of brandy, called for cotton batting, in the 
mean time making pressure over the womb through the 
abdominal walls. The mouth of the womb contained no 
clots, though the vagina was pretty well filled with them. 
These I cleared away, introduced pledgets of cotton until 



166 The Peoria Medical Monthly. 

the vagina was well packed. At the end of fifteen min- 
utes, she not rallying, I repeated the brandy and ergot. 
But in a little time pulse disappeared from the wrist, with 
every symptom ot alarming prostration. I raised the foot 
of the bed about ten inches above the floor, this with the 
pillows removed from head and shoulders, left that part of 
the body quite dependent. In a short time she began to 
rally and soon could speak, but still yawning and color 
bloodless. Repeated brandy and ergot frequently. In a 
short time she again began to sink, which seemed to me 
^would certainly be the last. On examining the tampon 
carefully, (I had kept my fingers against it to hold it firmly 
in position), I made up my mind there was still a leak, 
and that the blood was making its way slowly beside the 
wedge in the vagina. 

I resolved on syringing the vagina and uterus, if pos- 
sible, with hot water; accordingly had the attendant pre- 
pare water and syringe while I removed the tampon. This 
removed I found the hemorrhage only partially controlled. 
Though not so free as formerly, was still sufficient to soon 
deplete to an irremediable extent. On a careful examina- 
tion of OS, concluded that it was not sufiiciently dilated to- 
admit nozzle of syringe and give a free exit to the syringed 
fluid. I directed a stream of this water, as hot as could be 
borne, against the neck and os. This was kept up about 
five minutes, adding hot water to basin as its contents 
cooled. After using this injection I again introduced a 
tampon firm and tight, and renewed my efforts at external 
and internal stimulation, which were soon effectual to the 
extent of bringing about that degree of force to the circu- 
lation that completely kept down the former alarming 
symptoms of exhaustion. I remained all night with the 
patient ; in the morning removed the tampon, when there 
was no hemorrhage and none at all afterward. . Patient 
passed no clots of any note and made a good recovery in 
two or three weeks. 

I have had a number of serious cases of post partum 
hemorrhage, several cases of excessive flooding in early 
abortions, but in none of these was the prostration more 



Correspondence. 167 

alarming or the danger of fatal bleeding apparently 
greater. The points of special interest to me in this case? 
are: 

1. Delayed or secondary post partum hemorrhage. 

2. The kind of exercise that brought on the attack — 
washing. 

3. The hemorrhage not .coming on until eighteen 
hours after the exercise or work was done. 

4. The profuse and so nearly fatal character of the. 
hemorrhage. 

5. The means used to arrest it — ergot tampon, intra> 
vaginal (not intra uterine) injections of hot water. 



(S>i^vvH\iom\tnct. 



Medical Ethics. 

Editor Peoria Medical Moyithly: 

The question of medical ethics is assuming some 
prominence at the present time. An exchange of views, 
might be of value, if truth only is sought ; not factious- 
criticism, nor dictation, but a candid canvass of its merits- 
If any State has a right to be heard on this question, surely 
Illinois. Her legislation was a new departure. She was- 
the first to recognize the rights of minorities. She incor- 
porated in her Board of Health (which is being largely 
imitated) three elements, approximating as nearly as pos- 
sible to their representative strength, viz: the regular,, 
homeopathic and eclectic. 

It was a magnanimous concession for the old school,- 
steeped and saturated with an inveterate hostility, but it- 
was a graceful and becoming act on the part of the others 
to accept an apparently subordinate position. The act 
culminated and crystalized into law. 

Prejudice and bigotry have gradually given way, and 
most have had the manliness to remain silent. Its opera- 
tions have proved salutary. 

The people appreciate its benefits, and so far as I can? 
learn, those who represent the minority on the Board have= 
been as true friends and given as cordial support as any. 



168 The Peoria Medical Monthly. 

The interests of genuine legitimate medicine have been 
advanced, and to-day Illinois stands at the front in success- 
ful and reformatory medical legislation. 

Now, Mr. Editor, as times are dull, crops short, health 
good, and some leisure thrown on our hands, why not 
quietly and peaceably discuss some of the mooted points, 
the pros and cons? the reason for to be. 

If the code was built only as .a staging to put up the 
superstructure and build the character of the profession, 
need it continue? Is it so linked and attached to the 
main building, that its removal would threaten its down- 
fall ? Must it remain as a monument of our disability, 
evidence of our want of cohesion, humanity and good 
sense ? 

The children of Israel were forty years in the wilder- 
ness and fed on manna, but when they crossed the Jordan 
the manna was withdrawn ; possibly w^e have not reached 
the land of promise and emerged from the wilderness, and 
require this juvenile diet a while longer. If, however, the 
code has fulfilled its destiny, why should it survive its use- 
fulness ? Why not pronounce a few feeling and eloquent 
eulogies over its remains, and bury it. 

Seriously, there is a diversity of opinion, and the 
National Association seem inclined to smother any utter- 
ance on the matter ; to snub even legitimate discussion. 
Our Missouri delegate could tell us something about it. 
If we have no right of discussion or petition, what next ? 

Veritas. 



A Criticism. 

Wyanet, III., July, 1883. 
Editor Medical Monthly : 

In the July number of the Peoria Medical Monthly 
is an article from the pen of J. D. Ebert on the treatment 
of diphtheria, which deserves a passing notice. I congrat- 
ulate the doctor upon his great success if he has found a , 
treatment which removes all fear of this dread malady 
diphtheria, and parents no more need suffer their little 
ones to choke to death by membranous exudation in the 



Correspondence. 169 

throats, or pass to the unknown through the agency of 
blood poisoning. If true how unfortunate for us this arti- 
cle slumbered in the brain of the writer during last fall 
and winter, when thirty of our loved children in Wyanet 
were summoned to pass the dark valley of death, borne 
hence by an epidemic of this terrible disease, diphtheria. 

No benefactor of the race is greater than one who 
saves life, and every unselfish physician who through the 
journals or press gives the results of his discoveries and 
knowledge, thereby benefitting his fellow man and prolong- 
ing life, should be crowned with laurels of honor, commen- 
surate with the good they accomplish in relieving suffering 
humanity. 

The fortune of any physician is secured when he can 
truthfully say that he has found a treatment for diphtheria 
which knows no failures, and if I had been the lucky dis- 
-coverer of such a panacea I should make it a s])ecialUj and 
travel from epidemic to epidemic, from home to home, 
restoring the stricken ones to health and hope again, and 
thus bring joy and happiness into what would be otherwise 
sorrowing homes. 

What are the thoughts presented in this paper, and 
how far will they stand the test of practical experience? 

The doctor has been in practice five years, his father 
twenty-four years, and both using the same treatment in 
hundreds of cases, afiirm that they have had no unpleasant 
results — all recovered. Such assertions savors of quackery, 
and the doctors have either never treated hundreds of 
cases of diphtheria without losing a patient, or they have 
been dishonest enough to turn their fatal cases over to 
other physi'cians, by whom their deaths were reported. 

A physician in a neighboring town once told me that 
he had done $3,500 worth of business without losing a 
patient, and I learned it was his invariable custom, if he 
believed his patient would die, to tell the friends to call 
an6ther doctor. A physician may be ignorant, yet should 
be honest enough to tell the truth, and when he writes 
that he has cured '' hundreds of cases of diphtheria by san- 
guinaria, mercury, camphor, Dover's powder, and swabbing 



170 The Peoria Medical Monthly. 

the throat three times a day with sulphate of copper, with- 
out a failure," we must conclude the age of humbug still 
exists, and the nature and pathology of diphtheria imper- 
fectly understood. 

During a practice of more than twenty years, I have 
passed through several epidemics of diphtheria, beside 
treating many isolated cases, and this fact is noted, that in 
some cases membranous exudations and blood poisoning 
occur so early in the disease that the little ones are soon 
beyond restoration by any known formula. Dr. Ebert's 
"treatment" notwithstanding. 

Ever since this disease has been known under its pres-^ 
ent name, it has been the bane of childhood life, annually 
destroying thousands of our race, as well in the mansions 
of the wealthy as in the humble homes of poverty. The 
cause, pathology and treatment of diphtheria have been 
the subjects of much scientific research, microscopical 
investigation and clinical study by the best men of our 
profession, and the conclusions reached show that it is a 
constitutional blood disease, and no specific has yet been 
discovered; and he who would treat it most successfully 
uses such remedies known to destroy bacterian or micro- 
coccic germs, upon which this disease is supposed to 
depend. These zymotic germs multiply in the blood, and 
acting as a ferment unfits it for carrying on the vital pro- 
cesses of life, destroying assimulation and nutrition, caus- 
ing albuminous urine, spontaneous hemorrhage, great mus- 
cular prostration, and despite all treatment, death 
sometimes closes the scene, except among the "hundreds 
of cases " treated by Dr. E. and his pa. 

From the known action of the drugs used by the doc- 
tor can we reasonably expect they will stand the test of 
clinical use and prove to be deserving the confidence of the 
profession? I think not. Can we tell our patients that 
we have at last found a sure antidote to the mortality of 
this disease, so much dreaded in every community? Can 
we with a few powders, a vial of sanguinaria and a solution 
of cupri sulphas in our cases, remove all anxious solicitude 



Questions and Answers. 171 

of parents, and assure them that their children will be 
restored to health and no unpleasant results follow their 
illness? 

Can we adopt his views of sloughing, and say we don't 
care what amount, kind or color it is, a soft sponge or swab 
ivith a solution of blue vitrol will remove every trace of 
this dread malady? In fine, can we afford to discard well 
approved remedies, such as quinine, tincture of iron, po- 
tassium chlorate, sulpho-carbolate of soda, carbolic and 
sulphurous acids, for such a medley as this, at the same 
time believe it to be the best treatment known for diph- 
theria? 

The answer to these queries suggests itself to every 
intelligent reader, admonishing him to prove all things and 
hold fast to that which is good. 

When I commenced this criticism it was my intention 
to write of an epidemic of diphtheria which broke out in 
our public school last September, and continued through 
the winter of '82 and '83, but as the article is already too 
long, I will reserve it for another paper, in which I will 
give the supposed cause and the results of treatment by 
the physicians employed in this epidemic, soliciting free 
criticism by the medical profession. 

F. C. Robinson, M. D. 



i^m$\\m% Mfi ^nmv%. 



Frontal and Nervous Headaches— Neiiralg-ia—Dandruflf. 

Herewith we give some communications which have 
been received, in answer to Dr. A. W. Hill's request in our 
July number. We will gladly give space to any question 
and answers thereto which we think will be of general 
interest, and would be pleased to have this form a regular 
department in our journal. 

Viola, Mercer Co., III., July 20, 1883. 
Editor Peoria Medical Monthly: 

Tour journal for July contains the request of Dr. Hill 
of Wisconsin, "for the best remedies for nervous head- 



172 The Peoria Medical Monthly. 

aches;" also treatment for neuralgia. If the headaches 
arise from an exhausted condition of the nervous system,, 
it follows as a truth that needs no demonstration, that the 
treatment must be almost diametrically opposite to that 
exhibited when the headaches are dependent on some irri- 
tation of the nervous system. 

For a purely nervous headache, dependent on some irri- 
tation, I have found the following a useful formula: 

9 Zinci oxide, 30 grains. 

Lactopeptine, 40 grains. 

M. DiTide into ten powders. One three times daily after meals. 

Also, 

5 Potassi bromide. 

Ammonia bromide, 2 drachms. 

Tr. belladonna, 2 drachms. 

Aqua menth pip. ad g. s., 4 ounces. 
Mix. Sig. Desertspoonful every four to six hours as needed. 

Now I do not pretend to think that the above are abso- 
lutely the "best" in the whole range of remedies, but they 
have proven satisfactory in my hands. Neither will they 
cure- every case, for in many cases headaches are obstinate,, 
and become the opprobria of medical art. 

Headaches depending on exhaustion, the patient being 
anaemic, require nerve tonics, of which strychnine and 
phosphorus stand at the head of the list; irorf, also, being 
quite admissable. 

Isee by a late number of the Medical Record that aco- 
nitia is most heartily endorsed by Prof. Shrady, of this 
country, and also by Prof. Gubler, of Germany, as the rem- 
edy for neuralgia, but it must be remembered that such a 
powerful alkaloid must be used with extreme caution — one 
fourth of a milligramme (about tttVcto ir of a grain) every 
three hours, being the dose as given by Drijardin, Beau- 
metz; but I doubt whether, at the present time, with the 
bitter war waging on "codes" and "ethics," the "regulars'^ 
would ever assent to such infinitessimal doses as that. 

For a local affection in facial neuralgia the following 
has never failed me: 

Q Carbolic acid c p. 

Tr. iodine co. «a, 1 drachm. 

Glycerine, 6 drachms. 

Mix. Apply with brush to aflfected part. 

I am indebted to Dr. C. Truesdale, of Rock Island, for 
the above formula, to whom I desire to return thanks. 

For internal exhibition, when opiates are not desired,, 
the following is a favorite: 

9 Tr. belladonna. 

Tr. Gelsemium, cui, }4. A^id ounce. 
Mix. Twenty drops every two or three hours. 



Questions and Answers. 173 

Now I do not want anyone to assume that I believe 
these are the best, for doubtless many of my brethren ot 
the profession know better ones, but so long as their 
secrets are locked up in their own breasts, of what avail is 
their knowledge and experience to others. Too many phy- 
sicians are like the horse leech's daughter, crying " give,"^ 
"give," themselves never contributing to the store of facts 
as proven by experience or research. 

Dr. E. L. McKinnie. 

Eleroy, III., July 24, 1883. 
Editor Medical Monthly: 

In answer to the inquiry of Dr. Hill, of Westfield? 
Wis., I would advise the doctor to try iodide of potassium 
in frontal headache, as given in No. 12, Vol. II, of the 
Peoria Medical Monthly. In nervous headache I think 
the bromide of potassium is the most valuable remedy. 

In the treatment of neuralgia I suggest that the doc- 
tor try croton chloral,* as recommended in a recent lecture 
at the Bellevue Hospital Medical College, by Prof. A. A. 
Smith, that is in small and frequent repeated doses. The 
professor says, "Allow^ me to suggest what I consider a bet- 
ter mode of administering the drug (croton chloral), that 
is, to give a grain of it, prepared as you please, either in 
liquid or pill form, every half hour until the neuralgia 
symptoms are relieved." Then I should advise the doctor 
to correct disorders of the stomach by the use of simple 
bitters, as gentian, etc., after which I should improve the 
tone of the nervous system by the use of such remedies a& 
iron, strychnine, phosphorus, cod liver oil, etc., as indicated. 

Dr. E. H. Plasch. 

Pawnee City, Neb*, July 26, 1883. 
Editor Peoria Medical Monthly: 

In reply to the inquiry of Dr. Hill as to the best treat- 
ment for frontal and nervous headaches, allow me to sug- 
gest the following : If possible, ascertain the cause, which 
may be malaria, a catarrhal condition of the frontal sin- 
ures, constipation of the bowels, or derangement of the 
stomach from a torpid liver, and hence the internal treat- 
ment must be governed accordingly. For the immediate 
relief of the pain 1 know of nothing better than a liniment 
of chloroform 2^ ounces, tr. of aconite root, tr. of gel- 
semium and tr. of opium, each A ounce, with which a 
flannel cloth is saturated and pressed firmly over the seat 

* A formula for a croton-chloral mixture is given on page 137 of this journal for July, 
1883.— Editoe. 



174 The Peoria Medical Monthly. 

of pain until a severe burning is felt, then remove it and 
reapply in a few minutes, unless the pain has vanished, 
v\rhich in a large proportion of cases it will do, if the appli- 
cation be made when first the pain appears. The above 
may be used successfully in some cases of neuralgia also. 
I will add a word of caution, and that is, if applied too 
long the preparation will blister. 

I will ask Dr. H. to give the above a fair trial and 
report. Yours, W. 0. Henry. 

Brooklyn, Iowa, July 31, 1S83. 
Editor Peoria Medical Monthlij: 

I notice in your last number an inquiry from Dr. Hill, 
of Westfield, Wis., for remedies for nervous headaches 
and neuralgia. For nervous headache, and especially ner- 
vous sick headache, I have found the following prescrip- 
tion of great value : 

R F. E. celery. 

F. E. guarana aa. 1 ounce. 
Simple elixir, 6 ounces 

M. Sig. A teaspoonful ; repeat the dose, if necessary, in six hours. 

For facial neuralgia, the 2 gr. pill of iodoformi et ferri, 
1 to 3 pills every eight hours, is the best remedy I have 
ever used. 

Yours respectfully, J. B. Carder. 

Matteson, ni, July 24, 1SS3. 
Editor Peoria Medical MonthUj: 

In reply to inquiry of Dr. Hill would say : The doctor 
will, no doubt, find the remedies for neuralgia and head- 
aches far more numerous and varied than the causes, 
though many, of these affections, the treatment of which 
is often unsatisfactory to both patient and doctor. How- 
ever, I think he will find the following an excellent pre- 
paration for the hair and for removing the dandruff : 

R Amnion carb., 2 drachms. 

Sod. boras., 4 drachms. 

Tr. couth., 1 drachm. 

Glycerina, }-^ ounce. 

Spts. myrcisB, 1 pint. 
M. and filter. Apply about three times a ^veek, rubbing well and with 
regular use of brush. 

Alcohol may be used in place of bay rum. May use 
sufficient water for solution of salts. 

Very respectfully, C. F. Eoss. 

Acute Dysentery.— Dr. D. L. Russell, of Prairie City, 
111., wishes some of our readers to give him their treatment 
of acute dysentery. We hope his request will be complied 
with for the next issue. 



Periscope. 175 

Atropia for Ear-Ache. 

The Boston Journal of Chemistry says that Dr. A. D. 
Williams recommends its use as follows : The solution is 
to be simply dropped into the painful ear, and allowed to 
remain there from ten to fifteen minutes. Then it is made 
to run out by turning the head over, then being wiped 
with a dry rag. The solution may be warmed to prevent 
shock. From three to five drops should be used at a time. 
•The strength of the solution must vary according to the 
strength of the child. Under three years one grain to the 
ounce, and over ten years four grains to the ounce of water. 
In adults almost any strength may be used. All ages will 
bear a stronger solution in the ear than in the eye. The 
application should be repeated as often as may be neces- 
sary. Usually a few applications will stop the pain. In 
acute suppurative inflammation of the middle ear and 
acute inflammation of the external meatus, atropia will 
•only slightly palliate the suffering, but in the recurring 
nocturnal ear-aches of children it is practically a specific. 
— Medical and Surgical Reporter. 



Boracic Acid. 



Edmund Dana, Jr., states, that while cold water and 
alcohol hold in solution only eighteen grains of this acid 
to the fluid ounce, hot water dissolves eighty grains, but on 
cooling all but eighteen grains precipitates. Hot glycerine 
on the other hand dissolves one hundred and eighty grains, 
and retsAns the whole amount on cooling. The acid is not 
soluble in parafline, wax, vaseline, oil or spermaceti. Vase- 
line, cold or hot, does not affect it, but does readily unite 
with boracic glycerine at a high temperature and remains 
permanent in cooling. He suggests the following formulae 
as a substitute for the mixtures of vaseline and boracic 
acid, which he thinks are simply mechanical and some- 
times irritating, on account of the action of the undis- 
solved crystals upon the ulcerated surfaces : 

Glycerite of Boracic Acid. 

5 Acid boracic, 3 drachm. 

Glycerina;, 1 ounce. 

M. Dissolve the acid in glycerine suspended in a hot water basin until 
dissolved. 

Acid Boracic Ointment. 

^ Acid boraeic glycerit, 2 ounces. 
Cere albse, 2 " 

Vaselinse, 12 " 

M. Mix the was and vaseline together, and while hot add the glycerine 
-slowly with constant stirring while cooling.— Druggists' Circular. 



THIHl 



Peoria Medical Monthly, 



THOS. M. MelLVAINE, A. M., M. D., 

Editor and Publislier, 

204 South- Jefferson Street, .... PEORIA. ILIi; 

***The Editor is not responsible for the statements or opinions of contributors. • 
***Sliort original articles are invited from any reader, whether a subscjiber or not^ 
*»*If extra copies are desired by a contributor, the number must be specified when 

the article is sent in to the Editor. 

**« All exchanges, boolis for review, and communications must be addressed to th 

Editor and Publisher. 

***The publication day of this journal Is on or about the 15th of each month 

»**To subscribers! A pencil mark at this place Indicates that the time of your sub- 

Bcripiion has expired, and that a prompt renewal is urgently requested. 



®tUt0fial geprtmtttt. 



The St. Louis Medical Society and the Code of Ethics. 

We have received the following, v\rith a request for its 
publication : 

On June 23d, 1883, Dr. Atwood introduced the following, which 
was adopted by the St. Louis Medical Society, after some considerable 
discussion : 

Whereas, At the recent session of the American Medical Associa- 
tion, a preamble and resolution were offered for the consideration of said 
Association, purporting to represent the sense of the St. Louis Medical 
Society upon the propriety of preparing a new code of ethics, or altering 
and changing the existing code in accordance with the prese#it relations 
of the profession, and 

Whereas, In said preamble the assertion is made that, " the code 
has accomplished all it was designed it should, but at present many of 
its features are obsolete and not adapted to our wants. The necessity of 
an early revision is very apparent, is loudly called for in all parts of our 
land, and cannot be repressed much longer. * * * The time has 
come Avhen the loud and very. soon universal call will have to be 
heeded ;" and, 

Whereas, The St. Louis Medical Society did not instruct, "That 
the committee be authorized to prepare a code of ethics which in their 
view will meet the wishes of the profession, and submit the same to the 
meeting of 1884 ;" therefore. 

Resolved, That the St. Louis Medical Society distinctly repudiates 
the statements contained in said preamble, and again expresses its fealty 
to the existing code of ethics as a time honored and most suitable funda- 
mental law of the profession, and specially deprecates any action calcu- 
lated to reflect upon its loyalty to those principles which have heretofore 
secured immunity from the machination of schismatics within or enemies 
without. A. H. Ohmann-Dumesnil, M. D., Rec. Sec. 



Editorial Department. 177 

•In the official report of the meeting of the American 
Medical Association at Cleveland, we find the following : 
"Dr. S. Pollak, of Missouri, presented the following: The 
St. Louis Medical Society requested me to make a motion 
to the following effect." Then followed the preamble and 
two resolutions offered at that time, with which our read- 
ers are doubtless familiar. The first resolution we will, 
however, reprint ; the second appears in the third " Where- 
as" of the above communication. 

The first reads as follows : ^^ Resolved, That the Ameri- 
can Medical Society be respectfully requested to appoint a 
committee of one member from each State for the purpose 
of taking into consideration the propriety and advisability 
of a revision of the code of ethics of the American Medical 
Association, and to report at the meeting of 1884." 

The record further states, " it was laid on the table by 
a large majority." Our object in calling attention to this 
matter, is to ask: 'If Dr. Pollak misrepresented the St. 
Louis Society, why do not these later resolutions state the 
fact, and if he did should he not be reprimanded ? The 
statement is made that a "preamble and resolution 
* * * purporting to represent the sense of the St. Louis 
Medical Society," but it does not deny the truthfulness of 
Dr. Pollak. It is not affirmed that Dr. Pollak was not re- 
quested to offer a preamble and resolution. It does not 
repudiate the first resolution offered by Dr. Pollak, but 
only the last. It tacitly admits that the first resolution 
w^as the sense of the St. Louis Medical Society, yet it " dis- 
tinctly repudiates the statements contained in said pre- 
amble aud again expresses its fealty to the existing code of 
ethics as a time honored and most suitable fundamental 
law of the profession," etc. 

We confess that the more we try to unravel the mean- 
ing of these last resolutions the more we are bewildered, 
and shall jump at a solution. It looks to us as though the 
St. Louis Society thought something like this : The sub- 
ject of the code of ethics will be brought up at the Cleve- 
land meeting ; we believe that a majority of the medical 
profession are in favor of some action being taken with 



178 The Peoria Medical Monthly. 

reference to its revision ; New York took the wrong course, 
we will take the right one, and convince the medical world 
that the city at the end of the big bridge is the center of 
medical wisdom. From this reasoning emanated at least 
the sense of the preamble and the first resolution offered by 
Dr. Pollak. But it was "laid on the table by a large ma- 
jority," the bubble bursted, they were snubbed, their great 
plans came to naught, and they thought the medical world 
was laughing at them. Immediately after the Cleveland 
meeting, on June 23d, the above apology and whine was 
adopted ("after some considerable discussion") and noio 
the medical world does laugh. 

We believe the St. Louis Medical Society was right in 
the first place (at least Dr. Pollak was right), but they have 
spoiled it all by this foolish move. If they thought they 
were right, why did they not stick to it, and we are satis- 
fied that a full majority of the regular medical profession 
would have applauded and sanctioned their action. But 
the opportunity is lost, and St. Louis will wait another de- 
cade or two before appearing again as the champion of 
medical or ethical progress. Poor St. Louis. 



Do Moral Principles Change? 

This is the heading of an editorial in the second num- 
her of the journal of the American Medical Association, 
and as a matter of course is a defence of the code of ethics, 
and a denial that any change could be made to improve it. 

The article begins by asking the questions : ^' Are 
they (moral principles) subject to the Darwinian law of 
evolution ? Has time rendered the declaration of the 
decalogue obsolete ?" 

The burden of what follows is to prove that " they " as 
expressed in the code "do not change." It seems to us 
that this is assuming for the authors of the code an infalli- 
bility, that to many might seem sacriligious ; to compare 
the code of ethics with the decalogue is going further than 
we thought Dr. Davis, with his well known and honored 
religious sentiments, would even dare to go. To argue 



Editoeial Department. 17^ 

that since time has not called for a revision of the " Ten 
Commandments," there is a like reason that the code shall 
stand forever unchanged and unchangeable, is to claim for 
the creation of mortal minds an equality with the Deity. 

If it could be proven that the code, as originally writ- 
ten, was an inspiration, the doctor's argument might hold, 
but until that is done, there will certainly be found those 
who think it might be improved upon. 

When a statute becomes a dead letter before the eyes 
of the law, by reason of natural changes in the habits, cus- 
toms and progress of a people, no one will deny that it 
should either be repealed or modified to meet the new con- 
ditions which have arisen. 

And this, we think, is the opinion held by a great 
number of those who still stand by the code. The consti- 
tution of the United States was not perfected at the time 
it was written ; indeed, it was at variance with the Decla- 
ration of Independence until the XIV amendment was 
added, yet would Dr. Davis say that the adding of that 
amendment was wrong, and would he have prevented its 
adoption had he had power, or was the wisdom of the 
doctors who drew up the code superior to that of the 
statesmen who wrote the constitution ? Times have so 
changed that the constitution needed amendment (in that 
particular amounting to revision), and it is only to the con- 
stitution or some such product of mortal skill can the 
code of ethics be compared, and not with the decalogue. 
If Dr. Davis can prove that its authors were infallible, then 
we may join with him in believing that the code canno^.be 
improved. 



Make Us a Visit. 
The Peoria Fair will be held from September 4 to 14,, 
and the low excursion rates that will be offered by the;, 
various railroads centering in this city, will make it possi- 
ble for many to visit our city and note its improvement. 
The Fair itself will, we have no hesitation in saying, rival 
any State Fair ever held in Illinois. The premiums oflered 
amount to over $17,000, and vigorous efforts are being 



180 The Peoeia Medical Monthly. 

made to have an immense exhibit of everything that is of 
interest to every one. The race track has been altered and 
improved, so that it is now one of the best in the west, and 
the purses offered for speed will bring some of the fastest 
horses in the country. President Arthur has signified his 
desire to visit Peoria, and as the time for his return from 
his western trip coincides with the time for the Fair, it is 
most probable that he will be here. Occasions of this kind 
afford opportunity for relaxation from business, and we 
hope many of our friends will find time to pay our city a 
visit. We will be glad to see as many such as may vi*t 
us, and hope that they will consider our office head- 
quarters. 



A Tliief and Fraud. 

We have received from Drs. Geiger and Hoyt, of the 
St. Joseph Medical Herald, a card warning the profession 
against a deaf mute named R. L. Douglass, who is receiv- 
ing subscriptions for various medical journals. They 
denouce him as a thief, a fraud and an impostor. 

This fellow Douglass paid us a visit a month or two 
ago, and desired to act as agent for this journal, but having 
noticed in the St. Joe Herald a warning against him, we 
turned to it and showed it to him. He took it cooly, 
and for a reply handed us a letter from Drs. Geiger and 
Hoyt, in which they wrote favorably of him, and endorsed 
him. That letter was dated in March, '83, and we confess, 
staggered us not a little. Why, in warning the profession 
against this man, they did not state that he had a letter 
from them, and give reasons why they denounce him, is a 
conundrum. Still his actions are suspicious, and we did 
not make any arrangements with him, nor have we heard 
from him since. We hope none of our readers will be 
duped by him. Pass him on. 



In Memoriani. 

At the monthly meeting of the DeWitt ('ounty Medi- 
cal Society, held at the court house in Clinton on the 10th 



Editorial Department. 181 

day of July, 1883, the following preamble and resolutions 
were unanimously adopted: 

Whereas, this society is called upon to mourn the loss 
of one of its most active members in the death of Dr. 
John J. Starkey, who died at his home in Waynesville, on 
the 18th day of June, after a most painful illness of many 
days; be it therefore 

Resolved, that in the death of Dr. Starkey this society 
has lost one of its most zealous co-workers in the science 
and practice of medicine; the community an honest and 
upright citizen, and a skillful and humane physician; and 
his family a kind husband and indulgent father. 

Resolved, that we tender our heartfelt sympathy to the 
family of our deceased fellow member in this their hour of 
affliction. 

Resolved, that this preamble and resolutions be spread 
upon the records of the society, and that copies be fur- 
nished our city papers and the Peoria Medical Monthly 
for publication. 

J. J. Lake, M. D., President. 

C. Goodbrake, M. D., Secretary. 



Bound Volumes of 1882. 

We have a number of Vols. II and III on hand, which 
we offer at but a small advance over the cost of binding. 
They are bound in library style, cloth, with leather backs 
and tips, and we will send them post paid for $1.00 each to 
new subscribers. 

For $3.00 we will send a bound volume for either 1881 
or 1882, give credit for a year's subscription to this journal, 
and also send our Sanitary Journal for one year. This 
offer is worth $5.00, but we will make it for $3.00 cash in 
advance. 

Renewals. 

Those knowing themselves to be in arrears on their 
subscriptions will confer a great favor on the publisher by 
remitting at once. The money is needed for the journal, 
and should be paid promptly. Everyone who owes us will 
please consider this a personal communication. 

Notes and News Items. 

Alienist and NEUROLoaisT.— This standard publication 
comes to us for July with 190 pages of first-class matter. 



182 The Peoria Medical Monthly. 

The leading article* is Dr. Hughes' paper on "The Simula- 
tion of Insanity by the Insane/' which was read before the 
International Medical Congress in 1876. Dr. Spitzka has- 
an article on the Guiteau case in reply to Dr. J. J. Elwell ; 
Dr. D. R. Brower has an article on Concealed Insanity ; 
besides these there are a number of valuable original arti- 
cles, as well "as selected reading matter. This journal is 
certainly the most valuable to the general practitioner of 
any of the special journals. 

A Correction. — We wish to correct a statement made 
in the Medical Bulletin for August, to the effect that Dr. 
Roswell Park, of Chicago, was elected chairman of the 
surgical section of the American Medical Association for 
1884. The chairman of that section for 1884 is Dr. Charles 
T. Parkes, of Chicago, Professor ot Anatomy in Rush Medi- 
cal College. 

A Change. — Dr. Roswell Park, editor in Chicago of the 
Medical Review, and Lecturer on Surgery in the Spring 
Faculty at Rush College, has been called to the Chair of 
Surgery in the Medical Department of the University of 
Buffalo, N. Y. This is a high compliment to Dr. Park, and 
the young surgeons of the country as well. Dr. P. has our- 
congratulations. 

Receipts. — Owing to the press of other matter, the re- 
ceipts for July have been crowded out this month, but will 
appear in our September number. The receipt of this 
journal for the next month after the money has been sent 
is evidence to the sender that his money is in safe hands.. 

Vacation. — Many of our city doctors are taking a rest. 
Dr. Murphy is in Minnesota, Drs. Stewart and Roskoten in 
New York, Dr. Johnson in Nebraska, and Dr. Martin in 
Iowa. This is good evidence that Peoria is a very healthy 
city. Those remaining at home have but little to do. 

A New Editor. — Dr. H. A. Cottell, of Louisville, suc- 
ceeds Dr. L. S. McMurtry as co-editor with Dr. L. P. Yan- 
dell, of the Louisville Medical News. Dr. C. was formerly 
an editor of that journal, and is consequently no novice. 



The Peoria 
MEDICAL MONTHLY. 



Vol, IV. SEPTEMBER. 1883. No. 5, 



(Original d^ommuuiationisi. 



Art. I. — The Causes and Treatment of Cholera Infantum. By J. B. Shoe- 
MAKER, M. D., Andover, Kansas. 

Among the numerous influences attributed as causing 
cholera infantum, by many writers, we find the following 
as the chief and most important. 

We have as a cause residence in an atmosphere of 
poisonous vapors, and more especially those arising from 
decomposing animal and- vegetable matter. Atmospheric 
changes, caused by heat, and the accompanying influences 
existing in the atmosphere of tenement houses, basements, 
overcrowding and domiciliary uncleanliness, indigestible 
and irritating, carelessly and improperly prepared food, 
and acid and indigegtible fruits, all have their tendency in 
producing a severe attack of cholera infantum. 

Dentition is found among the class producing the dis- 
ease, and a great many writers claim for it a direct cause ; 
but I cannot believe such doctrine, for we have infants 
cutting teeth in the winter months, but we fail to find 
cholera infantum existing at this season of the year. 

I believe the chief and most important causes to be 
malarial influences, and the great activity and the rapid 
development of the intestinal follicles, at the age we find 
jfchis disease existing. 

In regard to the treatment of this fatal and common 



184 The Peoria Medical Monthly. 

disease, the short time we have must be improved, and I 
find the greatest good in the following mixture : 

9 Hydrarg cbloiidi mitis, 3^ grain. 

Pulv. ipecacuanha, 2 grains. 

Bismuth sub. nit., 4 grains. 

Mix, and divide in charts No. 4. Sig. One to be given every three hours in-' 
a teaspoonful of milk. 

Three hours after last dose of above mixture, admin- 
ister one teaspoonful of castor oil. This treatment changes 
the choleriform discharges, till iYi a few hours they become 
natural, of proper consistency and color. Opiates and 
astringents may now be administered, according to condi- 
tion and the discretion of physician. 

I administer as a tonic the following mixture, after the^ 
discharges begin to appear more natural. 

5 Quinia sulph.. 12 grains. 

Sulphuric acid dil., J^ drachm. 

Tr. gentian, % ounce. 

Tr. ferri chloridi % drachm. 

Syrup simplex q. s. for 2 ounce mixture. 
Mix, and give one-half of a teaspoonful everj^ three hours. 

The dose for each preparation above|is for an infant- 
nine months old. 

This line of treatment is excellent, if properly carried 
out, and one with which I have been very successful in my 
practice. 



Art. II.— Laceration of the Cenix Uteri. By H. S. Bell, M. D., Paris, 111. 
Eead before the ^sculapian Society of the Wabash Valley at Charleston,. 
111., May 30, 1883. Concluded. 

.Having decided to operate, we should prepare the 
patient by improving her general health and overcoming 
the erosion and any tenderness we may find about the 
uterus or its appendages. 

We generally find these women as sorely in need of 
constitutional treatment as of local applications. All the 
indications should be met, such as gastro-intestinal derange- 
ments, anaemia, and the various reflex neuroses, by which 
these patients are afllicted. The remedies which will 
improve these patients or relieve the conditions mentioned^ 
are the plain, simple, old-fashioned bitter tonics with chal- 
ybeate preparations and small doses of sulphate of magne- 
sia, to correct torpidity of liver and bowels. We find irt 



Original Communications. IBS' 

not a few cases chronic cellulitis complicating the lacera- 
tion. This and the erosion should be relieved before set- 
ting the day for the operation; more especially should the 
cellulitis be overcome. It is chiefly these cases, where 
there is still a smouldering fire beneath the surface, that 
light up such sei;ious conflagrations. Emmet strongly 
insists on attending well to these cases before any opera- 
tive interference is begun. Those only who have been un- 
mindful of this advice can appreciate the force of the 
caution. If the operation is done when there is any ten- 
derness or soreness present in the tissues in or about the 
uterus, you are quite likely to have a violent acute cellu- 
litis follow immediately with all of its evils, the greatest of 
which is pelvic abscess — a condition much more distressing 
than that for which you seek to relieve your patient, and 
not unfrequently of fatal termination. 

The preparitory treatmeut is directed to the relief of 
the chronic cellulitis and the cure of the erosion, and con- 
sists in vaginal irrigations of hot water night and morning^ 
succeeded each time with the introduction of cotton plugs 
saturated with pure glycerine, and the application once a 
week of Churchill's tincture of iodine to the eroded os and 
cervical canal. 

The hot water injections should be given with a David- 
son's syringe, or any syringe constructed upon the same 
principle. Each injection should be continued fifteen or 
twenty minutes, thus using two or three gallons of hot 
water, which should be kept at as high a temperature as 
can be borne by the hand throughout the entire time of 
giving the injection. The position of the patient should 
be supine, with the hips raised by means of folded blankets 
three or four inches higher than the shoulders. This posi- 
tion can be taken crosswise upon a bed, the hips drawn to 
the edge of the bed, either foot supported upon a chair at 
either side. The water as it escapes the vulva can be 
conducted by a small piece of oil cloth to a foot tub on the 
floor. It is almost unnecessary to say that these injections 
can not be administered by the patient, but it requires a 
strong good friend to squeeze the ball of the syringe. 



186 The Peoria Medical Monthly. 

It is important to be careful and emphatic in your 
directions regarding the details of the hot water injec- 
tions; even then you will sometimes fail to impress your 
advice upon your clients. We have more than once been 
surprised and provoked at the failure of patients to com- 
prehend our instructions. The rationale of these irriga- 
tions is to distend the vagina with hot water, and so long 
as the syringe is worked the vagina is a pool of hot water, 
and not only the vagina, but the uterus is submerged in 
the hot bath; the tissues aad vessels of the whole pelvis 
are stimulated by the hot water, and the successive jets 
add a still further stimulus by the little shocks thus ryth- 
matically produced. You can readily understand that if 
these injections were given by the patient herself, sitting 
upright over a vessel, the water would escape the vagina 
the moment it left the nozzle of the syringe; and those 
l)eneficial results above referred to would not be realized. 

The cotton plugs should be of absorbent cotton and 
rolled into solid cylindrical rods not greater than three- 
fourths of an inch in diameter, nor more than an inch in 
length; these should be secured by a cord and soaked in 
pure glycerine and carried up by dressing forceps against 
the OS, and placed transversly in the vagina, and left until 
the moment of administering next injection. These cotton 
pessaries serve a double purpose — that of supporting the 
womb, thus allowing the broad ligaments to resume their 
normal position and recover their proper tonicity. The 
glycerine acts powerfully upon the congested tissues, un- 
loading them of their water-logged condition, as proved by 
the vefy profuse flow of serum which follows for some 
liours after introducing the cotton plugs. 

Churchill's tincture of iodine 

IJ Iodine crys., 75 grains. 

Iodide potash, 90 grains. 

Alcohol, 1 ounce.' M. 

Is the best local application we can make to the eroded 
and tender surfaces of the cervical canal. It is a powerful 
stimulant to the tissues and vessels, especially contracting 
the dilated veins and lax fibres of the uterus. It should 
mot only be applied to the os and cervical canal, but fre- 



Original Communications. 187 

■quently over the entire vaginal surface, and into the cavity 
of the womb. These applications are only to be made in 
the cervical canal and v^omb by means of a little instru- 
ment known to gynaecologists as an applicator, which con- 
sists of a delicate, flattened silver probe with a spiral slide 
by which you are enabled to withdraw the probe through 
the slide, leaving the little twist of cotton saturated with 
the iodine in the cavity of the womb. 

After having treated your patient after manner out- 
lined about two or three mo»ths, more or less, as necessity 
requires, or until all tenderness or soreness is relieved and 
the erosion is healed, you have her in excellent condition 
for the operation. 

The operation is quite simple in design, but rather 
tedious in detail, owing to location of the uterus. 

The. cervix can in many cases be brought down to the 
vulvar outlet by very gentle and gradual traction with a 
tenaculum or volcella forceps, and wmen this can be safely 
done the operation is of quite easy execution. The temp- 
tation to thus bring the cervix down is so natural, the 
young operator is occasionally made to regret yielding to 
the seduction, as this draging on the broad ligaments is the 
source of greatest danger where there has been a previous 
attack of cellulitis. The broad ligaments, at least one of 
them, usually the left one, is contracted and indurated, and 
the traction is exerted upon this already crippled support 
which is particularly predisposed to acute inflammation. 

But when we can by the most careful and gradual 
traction bring the cervix to the vulva, we have overcome 
all the obstacles to a tedious operation. In these happy 
cases, after administering ether, we put the patient in the 
lithotomy position; a leg being held under the -arm of 
assistants at each side of the table, each of these two 
assistants still having an arm free to assist in the operation. 
Where this position is chosen in preference to the left 
semi-prone position, we use a flattened perineal retractor 
< Jackson's), instead of Sim's speculum. 

The retractor is introduced and given to the free hand 
of one of the gentlemen in charge of the legs, and the os 



188 The Peoria Medical Monthly. 

is then seized with small volsella forceps and ever so grad- 
ually pulled down to the vulva; these forceps are then 
given in charge of the opposite gentleman. The operator 
now leisurely observes the scene, approximating the lips, 
mentally noting the relation the parts are to occupy to 
each other after the operation, deciding where to begin the 
paring process and how deep, the angle or joint to which 
the laceration originally extended is to be carried. Now 
with small tenaculum we hook up the tissue at the point 
where we wish to begin the denudation, while with scis- 
sors slightly curved on the flat we trim or freshen the flaps, 
all the while keeping the strip held by tenaculum on the 
stretch, even from the point of beginning down to the 
angle and back on opposite lip to point corresponding 
with place of beginning. We might by way of- parenthesis 
add, this is easier said than done. The flaps should be 
made broad and smooth, so when they are brought together 
there will be opportunity tor a firm line of union in the 
repaired cervix. 

Silver wire is preferable to any other material for clos- 
ing the laceration. We generally use three or four sutures 
on either side, about three-eighths of an inch apart, and 
begin passing them from the angle, or above downwards. 
The needle should be from three-fourths of an inch to one 
inch long, very slightly curved at the point and round in 
its shaft. This should be threaded with a loop of silk eight 
or ten inches long with a half knot, drawn near the eye of 
the needle, so the wire may be drawn through the flaps by 
hooking it in the loop of silk. The point at which the 
needle should be entered is about one-fourth of an inch 
from the edge of the denuded surface, and this should be 
hooked up with tenaculum, and needle firmly held in 
needle forceps started through the flap at this point. We 
bring the needle out just within the inner edge of the 
pared lip, and its point should be steadied and guided by 
the blunt hook; also counter pressure is to be made against 
the needle with this same instrument. After passing 
through posterior flap in manner just described, we enter 
needle at the edge of denuded surface on anterior flap, at 



Original Communications. 189 

point exactly corresponding to point of exit of needle on 
posterior flap, and pass through, bring it out one-fourth of 
an inch from external edge of freshened surface, aiding the 
point of the needle, as soon as its point is seen, by counter 
pressure with the blunt hook. The wire which has been 
cut in pieces eight or ten inches long, and one end bent 
back for one inch, flat upon itself, is hooked in the loop of 
silk thread and pulled through. After passing all the wires 
in this manner, we prepare them for twisting. This con- 
sists in shouldering them, or after drawing upon them 
until the flaps are nicely coapted, we bend them flat upon 
the cervix at their points of entrance and exit, and again 
bending them at a right angle over the exact line of pro- 
posed union. The wire shield is now held firmly at this 
angle, and with twisting forceps holding the wire properly 
in the shield, we twist the wire to this last angle made in 
shouldering. If the wire is twisted too tightly, the parts 
thus strangulated turn white for want of capillary circula- 
tion. We should be contented with a nice adjustment of 
the flaps, as the tissues will swell slightly, and the wires 
frequently cut out if we are not very careful in twisting 
them. The wires are twisted in the reverse order to that 
in which they were passed, /. e., the last wire passed is the 
first to be secured. Each wire suture is cut off within half 
inch of the cervix and bent over flat upon the latter. The 
patient is put to bed and required to remain there ten or 
twelve days. The sutures are usually removed on the 
eighth day. 

We might conclude this paper with the report of five 
cases upon whom we have done this operation, but we 
have now reached the limits of a modest paper, and besides 
the details of cases are often both tiresome and uninteres- 
ting. SuflBce it to say, the object sought in each case was 
accomplished, i. e., the closure of the laceration and the 
relief of the symptoms which arose from the injury. All 
did well immediately after the operation. In the last case 
the lady did well for fourteen days, at which time her men- 
struation came on, and by advice she took to her bed, and 
it being in the winter season, her room became too warm 



190 The Peoria Medical Monthly. 

l^y reason of bad management of a new and too large base- 
burner stove. After becoming uncomfortably warm, she 
had the blankets removed from her bed, and a door opening 
from the room into a long narrow hall was thrown open, 
and soon a violent chill followed with great pain in the 
pelvis. Acute cellulitis at once supervened, and resulted 
in a pelvic abscess which discharged spontaneously through 
the rectum in three weeks from date of first chill. The 
abscess emptied itself in two or three days, when she rap- 
idly recovered, but she still has some pain in pelvis, due to 
induration in site of old abscess. 



giottjsi |rom grlvafe graftire. 



Art. I; — Abdominal Presentation. By W^m. H. Veatch, M. D., Carthage, 111. 

Many practitioners of extensive experience are dis- 
posed to doubt the correctness of the statements of those 
who report cases of this extraordinary feature in obstet- 
rical practice, and we are disposed to pass such reports by 
with the casual remark, that in many years' experience no 
such case has fallen under their notice. , 

My obstetrical experience has been as varied, perhaps, 
as most country practitioners, and the case reported below 
is the only one of the kind I have ever met. I took notes 
of the case at the time, and having since seen the report 
of cases of this character in the American Journal of Medi- 
cal Science of January, 1888, taken from the Lojidon Medi- 
cal Record of November 15, 1882, I am prompted to report 
this case. 

In cases where the head is in one, and the breech in 
the other, iliac region, and the abdomen of the foetus is 
directly over the mouth of the womb, may be termed 
abdominal presentations, notwithstanding the hands or 
feet or both may be the first thing the accoucheur's hand 
comes in contact with when he passes his fingers into the 
uterus. 

We have hand and feet presentations of an entirely 
different character to those where the hands and feet are 



Notes from Private Practice. 191 

folded on the abdomen and the child transverse ; and were 
it not for the hands or feet, or both, the abdomen of the 
child would be the first thing the finger of the accoucheur 
would touch. Such was the case I am reporting. 

November 7, 1882, 1 was called from the polls, where I 
had just deposited my ballot, to go several miles in the 
country. The man was in great haste and urged me to be 
as quick as possible, as he feared something was wrong 
with his wife. 

When I arrived I found the woman pale and extremely 
nervous, fearing some great calamity would befall her, and 
when asked why she was so fearful, she could only answer 
that she had not felt right for a long time ; but could give 
no definite reason for her belief, nor describe any peculiar 
feeling, except thal^ she felt a kind of sinking whenever a 
pain came on, and that she could not stand many more such 
pains, as they certainly would kill her. The membranes 
had ruptured and the water had passed off an hour before 
my arrival, but the child had made no advance whatever. 

An examination snowed the os uteri to be well dilated, 
and the soft parts very much relaxed, and an abundant 
flow of mucous, but the index finger was too short to reach 
anything within the uterus. Two fingers were then used, 
and by pressing with more force than is usually necessary 
to be made, 1 found, first, a hand, which lay directly in 
contact with an elastic, pulpy-feeling substance. A little 
further exploration and a foot was found a little further 
back and something to the right of the median line. Still 
exploring around the inner surface of the uterus the other 
hand and foot were found, and with very little effort they 
were all brought together. In the manipulation necessary 
to bring the hands and feet together, the umbilical cord 
was felt, a loop of which was inclined to prolapse. Now,, 
having satisfied myself as to the exact position of the child 
in utero, I hooked the index finger of the left hand around 
the right foot of the child, and with very slight traction 
brought the foot down through the vulva, and with mj 
right hand pressing upward in the right iliac region of the 
woman, the turning was at once completed. During this> 



192 The Peoria Medical Monthly. 

time she had three of those sickening, sinking pains, but 
now that the foetus was in a position to be delivered the 
woman became courageous and the contractions natural, 
with a tendency on her part to bear down. Slight trac- 
tion on the foot appeared to strengthen the contractions of 
the uterus, so that in a few minutes the child was expelled. 
It presented a very dark purple appearance, and being par- 
tially asphyxied, I severed the cord before tying it, and 
allowed as much as two drachms of blood to flow before 
tying. This started the general circulation, which had 
been temporarily interrupted, and the child began to cry 
lustily. The cord was now tied, and my attention turned 
to the mother. 

On placing my hand on the abdomen I was surprised 
to find that it contained another child. Passing the fingers 
again into the womb, I found a head presenting with the 
vertex to the right. Contractions of the uterus soon came 
on and a few efforts expelled the child. 

The placenta was double, the gords being attached 
about three inches apart. 

Thus, in less than one hour from the time I entered 
the house, I had performed the usually difficult feat of 
turning one child and delivering both children and the 
placenta. 

The first child was a female and the second a male, 
each weighing about seven pounds. Nothing unusual fol- 
lowen this case. The woman had a good getting up and 
the children are now doing well. 

If there is anything in this case worth publishing, your 
readers are welcome to it. 



Abt. II.— Intusp'isception Successfully Treated by Warm Water Injections. 

By Wm. H. Veatch, M. D., Carthage, 111. 

Mr. A. C. S., aged 40, a grocer, has suffered about 
twenty years from chronic diarrhoea, which he contracted 
while in the United States service. 

He had been troubled for several days with indiges- 
tion, sickness of the stomach, looseness of the bowels, dis- 
gust lor food, nervousness, and general lassitude. 



Notes from Private Practice. 193 

June 7, 1883, he complained of chills and flushes of 
heat with pain in the bowels. At 7 p. m. he took a full 
dose of "sulphate of magnesia, and at bedtime a dose of 
morphine, issued by his brother, who is a druggist. He 
suffered so much during the night, his family thought best 
to consult me in the morning. 

June 8, 7 A. M. I found him in great pain, particularly^ 
about the region of the ilio-coecal valve. Fearing a hernia 
I examined as closely as I could, but found nothing to 
confirm my suspicions. He said his bowels had moved 
slightly twice during the night, but only increased instead 
of relieving the pain. He had vomited several times, and 
the ejected matter tasted as though it had decayed in his 
stomach. His pulse was fluctuating from 80 to 110 per 
minute. I gave him the following : 

R Chloral hydrat. 

Pot. brom., aa 2 drachms. 

Aqua dist. 

Syr. tolu, aa 1 ounce. 

M. Big. Teaspoonful every two hours. 

And as soon as the stomach would retain them to 
give four pills comp. cath. imp. U. S. P., with sinapisms to 
the abdomen, to be followed by fomentation. 

7 p. M. Had vomited several times and thought the 
pills had been thrown up. No action from the bowels, but 
the chloral had kept him partially easy during the day, 
but now he is suflering intensely. Another attack of 
vomiting came on and the matter ejected was dark and 
grainy, having the odor of an evacuation from the bowels. 
The surface became cold, the countenance anxious, and he 
had the appearance of collapse, his pulse being a mere 
thread and very rapid. Tenderness over the bowels not so 
great, but deep seated pain greater. A lump could be felt 
at the ilio-coecal valve, not as hard as one might expect 
from accumulation of fecal matter, so the physicial and 
constitutional signs both pointed to intussusception of the 
ilium through the valve into the coecum. I gave larger 
doses of chlor. hyd., and elevated the hips and threw a 
large quantity of warm solution of soap into the bowels. 
This caused great pain and the exhaustion was so great as 
to require stimulants. When the water passed from the 



194 The Peoria Medical Monthly. 

bowels it brought with it some fecal matter, but did not 
relieve the pain in the bowels. As soon as he recovered 
somewhat from the effects of the enema, I filled the bowels 
full again, with instructions to retain it as long as possible. 
In addition to the chloral I gave him one-fourth of a grain 
of morphine by the skin. This induced sleep, and he re- 
tained the enema through the night. 

9th, 7 A. M. Says he is more comfortable this morning, 
but that terribly filthy taste in his mouth keeps him con- 
stantly sick, so that everything he takes into the stomach 
comes up again. I order him to swallow small lumps of 
ice. I again fill the bowels with water and signs of col- 
lapse follow. The water is passed oft', bringing a small 
quantity of fecal matter with it. Again I throw three 
quarts of water into the bowels, which is retained until the 
next visit. Morphine is again thrown into the skin. He 
takes nothing but ice into the stomach. 

10th. 6 A. M. Has rested well, except at intervals,, 
when he was restless and nervous. He takes a little fiuid 
nourishment, which ig rejected in a few minutes. Gave 
him two grain doses of quinine every two hours which he 
retained until evening, when he had a severe vomiting 
attack, throwing up a large amount of fecal matter. 

6 p. M. Is very much prostrated,' pulse 120, very feeble. 
The countenance is anxious, the features are pinched and 
drawn, a clammy moisture on the surface, great restless- 
ness, general soreness over the abdomen, with a hard lump 
two or three inches long on the right side, extending up 
from the ilio-coecal valve. I now turn the patient on the 
left side, elevate his hips, then slowly inject three quarts 
of water. When he said he could retain no more, I turned 
him on the right side and manipulated the course of the 
colon to run the water with as much force as possible 
against the point of obstruction. After about thirty min- ' 
utes I inserted the muzzle of the syringe and injected two 
quarts more water. In turning him on his back he made 
great complaint, turning ashy pale and becoming almost 
helpless and senseless. After a few^ minutes he whispered 
to me that something had given way, and laid his hand 



Notes from Private Practice. 195 

over the obstructed bowels. His iDulse was almost imper- 
ceptible and the surface was cold. I gave him brandy and 
ginger, and then helped him up, when the bowels moved 
copiously. After about thirty minutes the pulse came up 
and the perspiration became warm. I gave another dose 
of morphine by the skin, and threw three quarts of w^ater 
into the bowels, and ordered the quantity of-ice taken into 
the stomach reduced, and left him for the night. 

11th, 6 A. M. Has rested well through the night. Skin 
soft; pulse 70 per minute and full. Has retained the three 
quarts of water through the night, and think he will 
pass it off soon. I order some eggnog and leave him for 
the day. 

9 p. M. No action of the bowels; surface warm: pulse 
70 and full; only complains of pain on pressure over the 
region of the obstruction. After the injection of two 
quarts of water he has a copious discharge of fecal matter. 
I fill the bowels again and leave him for the night. 

12th, 6 A. M. Feels much better; has taken eggnog 
several times; pulse 70 and full. Urine, which has been 
hard to start, is now easy and free. 

9 p. M. Has been restless for a few hours; feels sick at 
the stomach; pulse 85, rather small. Bowels tender and 
slightly tympanitic. Gave him injection and a large stool 
followed. He says he can feel the matter pass that sore 
spot. A large amount of gas escaped from the bowels for 
the first time. 

13th, 6 A. M. Pulse 70, full, regular and soft. Rested 
well through the night; tongue pale, but dry. Urine free, 
but slow to start — strongly acid. Continue fluid nourish- 
ment. 

6 p. M. Has spent a comfortable day. Thinks he can 
sleep to-night without morphine. Bowels move freely 
after injection. 

14th, 7 A. M. Feels still better; strength slowly gain- 
ing; pulse normal; urine free, less acid and paler; still 
troubled with thirst. Appetite improving. 

After this time he steadily improves, until by the 22d 
he is able to be up. His bowels are moved each evening 



196 The Peoria Medical Monthly. 

by injection, and then he retains three or four pints of 
water for the next twenty-four hours. There is yet sore- 
ness over the ilio-coecal valve, and his strength comes 
slowly. 

28th. Is able to ride out and transact some business. 

29th. Called to see him again. His side yesterday 
w^as too much for him. Soreness in the region of the old 
obstruction. No appetite; bowels moving freely by the use 
of water enema. Order sinapisms and fomentations again, 
and prescribe quinea iron and strychnse. 

30th. Pulse full; stomach sick, and on the side of the 
former obstruction there is a large lump about four inches 
in length by two in width, extending upward from the ilio- 
coecal juncture. I enjoin perfect quiet and continue coun- 
ter irritation. 

July 1st. Is better to-day. Takes a short ride in the 
carriage, but finds that it makes him very tired and after 
going two blocks he returns. 

July 2d. Remains in doors, but is up; feels better. 

From this date he has steadily gained and is now in 
his store again. 



Art. III.— Case of Hepatic Colic— Inflammation of Gall Bladder— Perfora- 
tion— Peritonitis — Death. By E. L. Larkins, M. 1)., Staunton, Ind. 

On the morning of August 11, 1883, 1 was called to see 
a patient, a boy of delicate constitution, aged about nine 
years. 

The parents gave me the following history : Four 
days previously the patient was suddenly seized with 
severe pain in the right hypochondrium, of a paroxysmal 
character, vomiting at first of the contents of the stomach, 
and subsequently of thin mucous, streaked with blood. 
The patient had rigors, followed by fever of a remittent 
character. On the second day of illness there appeared, 
they said, at the inner margin of the right rectus muscle, 
just below the ribs, a tumor a little larger than a hen's 
egg, which could be traced upward to the liver. This, they 
told me, continued to increase in size until some time in 
the night previous to my being sent for, when it entirely 



Correspondence. 197 

■disappeared. Following the disappearance of the tumor 
ihere appeared great prostration with, in a few hours, 
j-apid swelling of the abdomen. 

When I arrived I found the patient in articulo mortis, 
body bathed in a cold perspiration, extremities cool, pulse 
180, temperature 101, respiration short and irregular, mind 
'dear, and complained of pain when the abdomen was 
touched. I informed the parents of the near approach of 
dissolution, my prognosis being verified, as the boy died in 
^bout four hours. 

The gall bladder must evidently have been perforated, 
and the contents escaping into the abdominal cavity, set 
up violent peritonitis, which was speedily fatal. 



(^tsxxt%\)mU\\u, 



Medical Ethics. 

Editor Peoria Medical Monthly: 

Resuming the question of ethics, we venture to sub- 
mit a few general principles which seem to underlie the 
whole matter. Ethics, strictly speaking, implies morals; 
so says Webster and Worcester, while Herbert Spencer, 
who treats the question exhaustively, arrives at the same 
conclusion, only measured by the elements, the social and 
provincial customs which surround it. If good conduct, 
pure morality, is what the code demands, why not use the 
golden rule which is familiar to all? Why should the med- 
ical profession specially require more morals than any 
other? Why should we make ourselves obnoxious by a 
stricter code than governs others ? The presumption 
would arise that we need more moral bearing; that the 
moral fibre is too lax; that we should fortify and strengthen 
this organic debility, this constitutional weakness. 

The friends of the code seem determined to exhaust 
all resources in its defense: 

1st. It was demanded by the peculiar exigencies, the 
€rude condition, the unsettled opinions, and wide dissimi- 
larity both of views and practice. 



198 The Peoria Medical Monthly. 

2d. The code commends itself by its age; its learned 
and venerable founders ; its amiable simplicity and elas- 
ticity. 

3d. By its club features; its union-league proclivities;, 
its monopolizing possibilities, and its cast and guild dis- 
tinctions. 

4th. By its utility as a citadel, as well as a base of 
supplies; its hospital accommodations for invalids, veterans 
and superannuates. 

5th. Its intrinsic excellence; guarding, protecting and 
nourishing blue blood; holding aloft the banner of victory,, 
inscribed " In hoc signo vinces" 

Well, the list is formidable, and has some grains of 
truth, though more of policy. A sham would hardly have 
survived this long. (Yet homeopathy is not dead yet). 
Doubtless most will concede it has exerted some good by 
its simple ideal; but does the medical practice of to-day 
need such a code to be driven into the heart of the profes- 
sion, like a stake in the ground, to hold the character of 
the profession erect? The world has had prophets; it has 
had miracles. In great emergencies men have arisen to 
meet them; but has there been any such crisis in the his- 
tory of medicine as to demand an iron-clad code? and such 
an one that its own framers dare not modify, restate or 
annul ! 

Autocratic Russia or some African or Chinese manda- 
rin might put the shackles on and defy liberty, but an 
organized body of freemen, under a republican form of 
government, should submit to no such dictation. 

Just here allow me to copy verbatim the action of the 
American Medical Association at its last session, as printed 
in the New York Medical Gazette. Speaking of the code in 
a "communication" from the St. Louis Medical Society,. 
closes as follows: "The necessity of an early revision is 
very apparent, is loudly called for in all parts of the 
country, and it cannot be repressed much longer. The 
American Medical Association can alone order the revision; 
state societies can only ask for such revision. The excite- 
ment and evil consequences of a schism can be easily 



Correspondence. 199 

•averted now and fraternal feeling restored. The paper 
therefore asked that a committee consisting of one mem- 
ber from each state be appointed to take into consideration 
the advisability of revision, and report thereon at the ses- 
sion in 1884, and that the committee be empowered to pre- 
2)are a new code of ethics. When the resolution was read, 
a motion to table it was immediately made, and being put 
to the house was carried by a considerable majority." 

Emanating from a society, the peer of any represented 
in the association, could any thing have been more com- 
pletely stated, more deferential? and to the point in asking 
simply consideration and the advisabiliti/ of a change ? It 
was strictly parliamentary, courteous and reasonable. 
How was it treated? Spurned, gagged, kicked out as un- 
ceremoniously and rudely as a burglar or dead beat would 
be on a wedding occasion. Delegate Pollock I presume 
will give them the " Course of Time " in a new edition, 
which may be as entertaining as his distinguished name- 
sake; indeed he, has given his home traducers a. vigorous 
punch, by publishing a naked copy of their instructions 
without note or comment. Such manifestations of moral 
heroism as the St. Louis society have exhibited are not 
particularly exhilirating these " dog days." 

We do not like to see a man* cringe when some boss 
cracks his whip, but to see an apparent majority of an old 
organization cringe and squeal is both mortifying and 
ludicrous. 

If the American Medical Association is the legitimate 

outgrowth of the code, (as some insinuate) and the above 

a fair sample of its manliness and results, let the curtain 

drop! Enough! 

Veritas. 



Too Mauy Medical Colleges. 

Decatur, III., Aug. 23, 1883. 
JEditor Peoria Medical Monthly: 

We learn with considerable dismay that Quincy has at 
length blossomed into a full fledged medical college, and 
no doubt another "long felt want" is about to be supplied. 



200 The Peoeia Medical Monthly. 

N*o doubt the opportunities thus created for several enter- 
prising physicians of that burg to advertise themselves in 
strict accordance with the Code of Ethics of the American 
Medical Association, proved too tempting to be resisted. 
Then, too, the well known paucity of physicians in every 
city and hamlet in the west still further justifies the wis- 
dom of the Quincy doctors, and the profession an4 the 
public will owe them a debt of gratitude it will scarcely 
be able to pay. 

But we Decatur physicians wish these gentlemen to 
understand, that while they have stolen a march upon us, 
we do not propose to allow them this field to themselves. 

We have long recognized the great need of the pro- 
fession for an extended course of study and greater facili- 
ties, and while we may be a little slow in getting things in 
shape, we shall not be very far behind. Our announce- 
ment is not quite ready, though we hope to have all our 
arrangements completed in time for the winter term in 
October, and in the meantime take this opportunity to la/ 
before the profession some of the advantages medical 
students will be able to derive from the new methods of 
the Central Illinois Grand Medical University. A few ex- 
tracts from our forthcoming prospectus will give your 
readers an idea of our aims, etc., and we expect them to 
rally round our standard in a lively manner. I have not 
as yet examined the Quincy prospectus, and cannot there- 
fore be certain as to our fees for the full term. But inas- 
much as they will probably put their price low, say $5.00, 
ours will only be $2.50,' which almost any enterprising 
youth may become possessed of, and for board and wash- 
ing may obtain plenty of work in this city of check-rowers, 
inasmuch as most of our lectures will be given in the even- 
ing to accommodate this class of students so desirable to 
the profession. We only hope that Peoria will not imme- 
diately enter the lists with another institution of medical 
learning, for though greatly in demand, we would then 
come uncomfortably close to the limit in this portion of 
the state. Therefore we say to Peoria, hands off for a year 
or two, gentlemen. 



Correspondence. 201 

The following extracts referred to explain themselves : 

"For some time we have been convinced that the 
obstacles thrown around the pathway to the medical pro- 
fession by designing men are altogether too numerous, 
and it shall be our endeavor to do what we can to fill the 
decimated ranks of the profession, and in this way help to 
hold up the hands, enlarge the sphere of usefulness, etc., 
of those who have already chosen this noble profession. 
We believe it cannot be successfully controverted that 
where members of our profession are most numerous, there 
the health of the community is in the best state of preser- 
vation. This being an undisputed fact, we shall labor for 
the good of mankind, by so decreasing mortality, in filling 
the ranks of our profession, until we may see in every city 
and hamlet throughout this glorious republic of ours, one 
physician to every one hundred inhabitants." 

And again the following : 

" Hitherto it has seemed a necessity for medical stu- 
dents to attend two full courses of lectures before being 
permitted to graduate. But such is the state of perfection 
of our university, that by the aid of our grand, back-action 
and double geared educating machine, invented by a prom- 
inent member of our faculty, and made expressly for us, 
' we will be enabled to impart just four times the instruc- 
tion in the same period of time that any other institution 
has heretofore been able to do. In this way we will be 
able to turn out medical gentlemen with the profoundest 
knowledge of science in six months, one full course of lec- 
tures, and which we confidently believe has up to this time 
never been accomplished." 

Inasmuch as the writer expects to fill three of the 
twenty-eight chairs in the university, modesty forbids any 
further enumeration of its advantages at this time. I 
would only say in conclusion that arrangements have been 
perfected by which our diplomas will be ranked as No. one, 
by the State Board of Health. 

S, J. BUMSTEAD, M. D. 



202 The Peoria Medical Monthly. 

An Attempted Criticism. 

Dundee, Ind., August, 1SS3. 

Editor Peoria Medical Monthhj: 

The August number contains a criticism from the pen 
of Dr. F. C. Robinson, of Wyanet, III, upon a paper found 
in the July issue from the pen of J. D. Ebert, on " The 
Treatment of Diphtheria," etc. 

Now, the doctor being so very sapient, using quite a 
quantity of medico dictum, as though he occupied the posi- 
tion of Apollo in denouncing my paper, I feel it again to be 
my duty, in justice to my paper on "The Treatment of 
Diphtheria," which Dr. R. so ironically assailed with his 
very thin-spun and far-f^ched objections in what he desig- 
nates criticism, to say a few^ things with reference to his 
paper, hoping, if possible, thereby to disabuse the Dr. R.'s 
very imaginary brain. 

Now, doctor, I want to say that the treatment found in 
my article upon diphtheria, as directed (not separately, as 
would seem to suit your notions as per criticism), is just 
what can Save your little patients from " your great un- 
known." If the treatment, as a whole, appears, through 
your scientific spectacles, to be a medley, it is a very good 
one, doctor, at least; one, when used aright while patient 
is in reach of any remedies, that will abort the necessity of 
running, as the Dr. R. suggested, or of making a death re- 
port. I want to say to my brother critic, in all candor, 
that if called to a case of diphtheria, and my stated drugs 
not in hand, I should, to save trouble, do firstly my run- 
ning; for my experience with any other treatment corrob- 
orates Dr. R.'s death statement in his paper; a statement, 
however, speaks loudly for itself, that critic is dissatisfied 
with his own treatment and success in diphtheritic troubles- 
Consistency says, don't throw away the old until you have 
a better new. And to be a universal philanthropist, 
medicinally, in this age would necessitate the writer to use 
a cogenice pen, clothed with coercive authority, which 
spoils a large amount of critic's imaginary philanthropy. 

While I am a lover of true scientific research, and 
ready to hail with great applause every truthful deduction 



Correspondence. 203 

therefrom obtained, I think, we should likewise accept facts 
w^hich have been demonstrated to us by actual experience. 
While eminent men, with the microscope, have given us 
many and rich facts to read and contemplate concerning 
the world's minutiae, etc., they have not been so eminently 
successful in giving to us the treatment in par excellence. 
If to take the safe side for the welfare of our patients, re- 
gardless of popularity, using our best judgment and com- 
mon sense, as the case might indicate, is " quackery," do, 
Dr. R., let us have more of it, if it will save our patients, 
and not go on, a corps perdu, as though we scientifically 
stood poised at point, ne plus ultra, for yet we may, Dr. 
Robinson, live to see, as it w^ere, true science knock the 
bottom out of a pet theory, as it has often been the case in 
the past. 

In conclusion, let me say, that I submitted my paper 
in the July number, feeling it to be a duty I richly owed to 
the readers and contributors of The Medical Monthly to 
add my mite of !'act, ad rem to the great treasure which the 
theory and practice of medicine has in store, which I rever- 
ence and honor. To critic I want to say, I do not object to 
fair criticism, actuated not by an obvious vindictive spirit, 
but with a true motive for good and truth. We should all 
be searchers for truth that will save us from the " great 
unknown." Whatever Dr. R. has in store on diphtheria, 
or any other topic, let us have it. If I should criticise, I 
will promise to do it fairly. This article is already too 
long. I close. . J. D. Ebert, M. D. 



Diphtheria. 

White Rock, Kan., Aug. 27, 1883. 
Editor Peoria Medical Monthly: 

In the August number of The Peoria Medical 
Monthly I notice that some one has found a sure cure for 
diphtheria. He certainly should receive the congratula- 
tions of the infantile world. 

I have never found the great elixir, but I have been 
"thinking for the past year I would say a w^ord or two on 



204 The Peoria ^fEDicAL Monthly. 

the treatment of diphtheria. The pathology, we presume^ 
every one who treats it understands. I use a solution of — 

5 Hydrate ot chloral, 2 drms. 

Spts. lav. comp., 1 drm. 

Glycerine, water, each 1 oz. ' 

M. S. One teaspoonful every two to three hours as an anodine and antiseptic 

In conjunction with — 

5 Mur., tr. iron, 3^ oz. 

Chlorate potass., pulv., 1 drm. 
Syr. simp. gs. ad., 2 ozs. 

M. S. One teaspoonful every two to three hours. 

I always move the bowels with calomel in the starts 
but some of my patients have passed the dark valley. 



(^ttesitionis Mil ^nmm. 



Acute Dysentery. 

Princeville, 111., Aug. 12, 1883. 
Editor Peoria Medical Monthly: 

In reply to the request of Dr. D. L. Russell, of Prairie- 
City, 111., I will say that my treatment of ticute dysentery 
is about as lollows: 

iSTear the onset of the disease, if there have been no 
feculent stools for some time, an evacuant is given; the 
sulphate of magnesia or soda and potassa tartrate is pre- 
ferred. Subnitrate of bismuth is used from the commence- 
ment in ten-grain doses every two or three hours, or com- 
bined, as follows: 

R Fl. ext. belladonna, 1 drachm. 

Subnitrate of bismuth, 2 drachms. 
Elixir cinchonia, 2 ounces. 

M. Ft. solution. S. Teaspoonful every half hour until pains are relieved. 

If not relieved soon after commencing the above, I us& 
in the form of enema : 

R Bismuth sub. nit., J^ drachm. 

Amylum, 1 " scruple. 

Sul. morphia, i^' to }4. grain. ' 

Dissolved in about three ounces of hot water and use when cold 

The same is repeated as often as necessary to control 
the disease. If the system is charged with malaria I give 
sul. quinine or sul. cinchonidia in full doses. 

R. F. Henry, M. D. 

Marquette, Neb., Aug. 25, 1883. 
Editor Peoria Medical Mothhj: 

Haying had a good many cases of acute dysentery to 
treat this summer, in reply to Dr. D. L. Russell's inquiry I 



Questions and Answers. 205 

would state that the treatment with which I had the most 
success was as follows : 

I begin my treatment by giving — 

5 Blue mass, 10 grains. 

Powdered capsicum, 30 grains. 
Make this into eight pills and give two every four hours. 

After the patient is purged freely I give : 

5 Pulv. opii., 3 grains. 

Pulv. camphor, 3 grains. 

Pulv. ipecac, 3 grains. 

Quinia suiph., 12 grains. 

You can make this into twelve pills, or twelve pow- 
ders, as you like, and give one after each move until the 
bowels are properly regulated. Under this treatment, out 
of between forty and fifty cases, I have not had a failure 
yet. T. H. Line, M. D. 

Toledo, Iowa, Aug. 23, 1883. 
Editor Peoria Medical Monthly: 

In reply to Dr. Russell's inquiry I would recommend . 
the following for acute dysentery : 

R Magnesii sulphatis, 2 ounces. 

Ac. arom. sulph., 2 drachms. 

Aqua pura q. s. ad, 8 ounces. 

M. Sig. 3^ ounce every three hours, until it operates. 

Also, 

5 Opii pulv. 

Plumbi acetas, aa 10 grains. 

Fiat pulv. 
Sig. One powder every three hours half way between the preceding. 

I have found the above to give good results in all 
cases where tried. Frank L. Hinsdale, M. D. 

Superior, Wis., Aug. 24, 1883. 
Editor Peoria Medical Monthly : 

Please find enclosed $1.00, which place to my credit. 
Your journal is becoming more attractive every issue. 
The introduction of the "Question and Answer" system 
will be valuable, but will be likely to demand an increase 
in number of pages ere long. 

In reply to inquiry of Dr. D. L. Russell, of Prairie City, 
111., I would suggest the following as applicable to a large 
per cent of cases, and that which has served me better 
than any one combination of remedies I have ever tried: 

;^ Sal. epsom, 4 drachms. 

Tr. opii., 1 ounce. 

Fl. ex. ergota^, 1 ounce. 
Aqua camphora, 2 ounces. 
M. Sig. A teaspoouful every four hours. 

I frequently supplement the above with an injection 
of a strong infusion of tea (2 ounces) injected cold, with 



206 The Peoria Medical Monthly. 

instructions to retain, twice daily. Absolute quiet is en- 
joined and proper dietary. If there is present much tenes- 
mus, the addition of fl. ex. belladonna 5 drops, to the 
injection will be an advantage. 

0. N. MuRDOCK, M. D. 

Patterson, Juniata Co., Pa., Aug., 18S3. 
Editor Peoria Medical Monthly: 

Dr. Russell, of Prairie City, 111., asks for treatment of 
dysentery. Last year we had an epidemic in our town, 
and I had marked success from the following drugs: 

I find turpentine of great importance, as it is anti- 
phlogistic and increases the absorbing power of the intes- 
tines. Likewise I use hydrochloric acid and bismuth, S. 
N., dissolved in water to make a creamy liquid, and opium 
to make the patient rest and keep him quiet. 

I would make a request that writers give therapeutical 
action of drugs mentioned. I would ask of the profession 
of follicular pharyngitis. S. A. Suloff, M. D. 

Lincoln, III., Aug., 1883. 
Editor Peoria Medical Monthly: 

In answer to the query of Dr. D. L. Russell as to the 
l)est treatment of dysentery, I will give the following, 
w^hich I have satisfactorily used in several cases: 

To thoroughly clear the intestinal track I give a large 
dose of oleum ricini and glycerine. After thorough evacu- 
ation of the bowels, I give — 

R Pulv. ipecac, ex. opii., 5 to 10 grains. 

Subnitrate bismuth, 15 grains. 
Every three hours. 

With injections of hot water containing a little glycer- 
ine after each operation, using the water as hot as can well 
be borne. L. L. Leeds, M. D. 

EsTELLiNE, Dak., Sept. 14, 1883. 
Editor Peoria Medical Monthly: 

I notice in your last number an inquiry from Dr. Rus- 
sell, of Prairie City, 111., for remedies for acute dysentery. 
My remedies are the following, and may be of use to some: 
Sodge et pat. tart, in teaspoonful doses every two hours till 
it acts on the bowels, then give — 

R Bismuth subnit., 10 grains. 

Sodse bicarb., 10 grains. 
Tr. opii. camp., }4. drachm. 

Aquae purse, i| drachm. Mix. 

every four hours. If fever exists, give tr. gelsemium, 10 
drops, to an adult every four hours. 

Will ask Dr. R. to give the above a trial and report. 

G. A. MouLTON, M. D. 



Book Notices. 207 



Nervous Headache. 



Fountain Green, III., Aug., 1883. 
Editor Peoria Medical Monthly/: 

I have been very much interested in your journal from 
the very first number, and read it with increasing pleasure 
and profit. I trust the suggestions on " Headaches " v^ill 
do us all good. In some cases of nervous headaches that 
do not yield to any ordinary treatment, the inhalation of a 
few drops of nitrate of amyl seems to act as almost a spe- 
cific, especially in those of a neuralgiac character. As its 
physiological action is understood by all, it is not neces- 
sary for me to give it. R. J. Law, M. D. 



§00fe iotiasi. 



A Text-Book of General Pathological Anatomy and Pathogenesis. Br 

Er>"st ZiEGiiER, Professor of Pathological Anatomy in the University of 
Tuebingen. Translated and edited for English students by Donald Mac- 
Alister, M. a., M. B., etc. 8 vo., cloth; 370 pp. New York: Wm. Wood 
& Co., 1883. 
i 

This volume is complete in itself, although it forms 
the first part of Prof. Zeigler's great work, and will be fol- 
lowed by a second part on "Special Pathological 
Anatomy." We have been exceedingly well pleased with 
our reading of this book, and believe it to be the most 
modern on the subject, incorporating as it does, the most 
recent discoveries and advances in this rapidly growing 
branch of medical science. Pathology affords greater in- 
centive to work than does clinical medicine, and promises 
larger rewards. The observer of to-day is not more acute 
in vision or mental perception than was his predecessor of 
a hundred years, hence for elegant and accurate clinical 
histories of disease and clinical descriptions we go back to 
the writers of fifty, seventy-five and one hundred years 
ago ; but not so with our pathology, what is latest is 
best in a general sense, since our advantages and means . 
for progress are better every day. The use of the micro- 
scope has advanced pathology more in the last five years 
than it had advanced in the previous century, and we 
believe and hope that the coming decade will witness and 



208 The Peoria Medical Monthly. 

confirm discoveries far greater in value than are to-day 
even dreamed of. 

Dr. Ziegler follows Foerster to some extent, but so 
does he follow and quote largely from Yirchow, Klebs, 
Cohnheim, Rindfleisch, and the best authorities on the 
subject. The section on parasites is full and interesting, 
and covers over one-third of the volume. The translator 
has done his work creditably, and his notes and emenda- 
tions are generally to the point and good. 

It was certainly a wise idea for Messrs. Wood & Co. to 
include such a book in their Library of Medical Authors, 
thus putting it in the hands of thousands, many of whom 
would not buy a separate work on pathology, but having it 
they are bound to read; and from this book they cannot 
fail to be interested and instructed. 



Kern's Cataplasniata in tlie Treatment of Liympho-Sarcomata. 

The Medical Record (Sept. 15, 1883) gives the substance 
of a lecture by Prof. Busch, of Bonn, in the use of these 
poultices. The cataplasms are composed of one part mus- 
tard flour to five parts of black soap, the whole being en- 
closed in a gauze bag and applied daily over the tumor for 
four or five hours, or longer. A very intense irritation, 
amounting almost to an erysipelas, is produced. The sar- 
comatous tumors, if fresh, soften and disappear. Dr. Busch 
relates a case treated in this manner, in which it was used 
as a last resort, and in which he scarcely hoped that it 
would be ot benefit. But the continued use of the poultice 
tor four weeks effected a cure. 



Treatment of Granular Lids. 

Dr. Arnoux claims to have met with great success in 
the treatment of granular lids by the following simple 
method: The lid is everted and wiped dry with a piece of 
blotting paper. The granulations are then touched very 
lightly with a crystal of sulphate of copper, and immedi- 
ately after a smooth cylinder of zinc is passed over them. 
Then the conjunctiva is carefully dried again, and, as far 
as possible, the impalpable black powder, which remains 



Periscope. 209 

after the operation, is removed. The lid is then replaced, 
but not allowed to touch the ball of the ej^e for a minute 
or two. No subsequent cold applications are necessary, as 
there is little reaction if the operation be delicately per- 
formed. — Gazetta Medica di Roma, Medical Becord. 



Question as to Amputation. 

Mr. Wm. S. Savory, F. R. S., in a short paper remarks 
that in perhaps no case is the judgment of the surgeon 
more severely taxed than when he is called on to decide a 
question of amputation in an injury to a limb. Mr. Savory 
says, in endeavoring to form a judgment in such cases, one 
has to consider, first of all, whether the injury is greater 
than the operation for its removal. If the injury be 
greater, then of course amputation should not be thought 
of. Secondly, it operation be decided on, is the chance of 
recovery from the operation so much greater as to cover 
the risk from the second shock which the operation would 
necessarily cause? It was formerly held that less risk to 
life is incurred by operating immediately after the injury 
than at a remote period; but Mr. Savory thinks the opinion 
on this question has gradually changed, owing to the differ- 
ent experience civil surgeons have had from military, who 
always advocated primary amputations. In attempting to 
save a limb we should consider " whether it is worth while, 
for the prospect of such future use in the limb that might 
remain to him, for a man to run, in order to preserve it, 
any additional risk of his life, and if so, to what extent? 
With regard to secondary amputations he says: "Second- 
ary amputations are more favorable than primary, ones 
when there is a choice of time — that is, when we can afford 
to wait till the temperature and other signs of general dis- 
turbance have subsided ; but second arj^ amputations are 
less favorable than primary if the operation is forced upon 
us at a period in the case when a degree of fever still pre- 
vails. Herein, too, lies the difference in the prospect be- 
tween secondary amputation after injury and amputation 
in disease, for in the latter case there is almost always a 
choice of time. — Quarterly Epitome. 



Medicated Collodion in Vascular Tumors. 

Dr. Fiorani has treated several cases of telangiectasis 
successfully by the external applications of corrosive sub- 
limate in collodion (three parts in twenty). He applies 
four layers of the substance over the tumors, and a little 



210 The Peoria Medical Monthly. 

beyond, with a camel's hair brush. On the fourth day the 
edges are a little raised, and then a second application of 
four layers is made. This is repeated every four days until 
the swollen edges have become depressed. After the crust 
falls off the surface is seen to be somewhat sunken and of 
a pinkish color, which gradually changes to a normal hue. 
The procedure is entirely painless. It is to be employed 
only where the angioma is raised but a line or two above 
the surface. — Quarterly Epitome. 



Large Doses of Arsenic in Chorea. 

James Sawyer, M. D., in the course of a clinical lecture 
delivered in Queen's Hospital, Birmingham, exhibited a girl 
ten years old who, in being treated for subacute general 
chorea, had taken " Fowler's solution," in doses increasing 
from five to thirty-five minims, thrice daily. Not till then 
did toxic efforts occur, and the chorea ceased. After entire 
suspension of the drug for two days, it was continued for a 
time in doses of fifteen minims, and the chorea did not 
occur. The doctor said: "You may cautiously increase 
the dose of liquid arsenicalis, far beyond the limits of the 
text-books, with the best results in chorea." — Quarterly 
Epitome. 



Anorexia. 

M. Huchard recommends the following stomachic for 
persons who suffer from debility, with loss of appetite: 

* Tinct. cardamomi, 1 drachm. 

Tinct. anisi, 1 drachm. 

Tinct. aurantii corticus. 
Tinct. gentinse. 

Aqua; menth. pip, aa 2% ounces. 

Aquae, ad 3 ounces. 

M. Sig. Teaspoonful between meals. 



Calomel in Diphtheria. 

Dr. Charles S. Miller reports a case of diphtheria in 
which the breathing was very much embarrassed by the 
membrane. Calomel in ten-grain doses every hour, until 
twelve doses were given, was followed by prompt recovery^ 
the membrane being thrown off and showing no tendency 
to re-form. Neither catharsis nor emesis followed these 
apparently heroic doses. The case seems strongly corrob- 
orative of the claims made by Dr. Reiter in a recent num- 
ber of Squibb's Ephemeris. Dr. Reiter, however, recom- 



Periscope. 211 

mended the calomel in the same size doses before the 
membrane appeared, and to prevent its formation, having 
little or no faith in this treatment after the patch had 
formed. We should be very much pleased to receive any 
report on the use of calomel as above. Dr. Reiter's claims 
for the drug employed in this manner are too positive to 
be allowed to pass without subjecting it to a trial. — Quar- 
terly Epitome. 



Facial ]S^euralgia and Hysteria— Crotoii-Chloral Hydrate. 

For some time past I have used with special efficacy 
croton-chloral hydrate in nearly all the cases which have 
recently come under my observation of facial neuralgia 
(some seventeen in all), and my experience in successfully 
treating the affection by means of the drug have led me to 
give the results of my observation to the profession. I 
generally prescribe a full dose in this class of cases : 

9 Croton-chloral hydrate, 2 drachms. 
Glj'cerine, 2 ounces. 

Aqua fontana, q. s., 4 ounces. 

M. Fiat solutio. Sig. One drachm ter. in die. 

In ordinary cases I give a teaspoonful three times a 
day. If the symptoms are quite urgent, I give a teaspoon- 
ful every two hours until the pain is relieved. In hysteria, 
especially when convulsions come on, it is specially valu- 
able. My opinion is that the drug in small doses produces 
first anaesthesia of the head before the rest of the body is 
affected. In large doses the hypnotic effect is marvelous. 
Suffice it to say, its beneficial value is to be seen in all 
painful affections of the head. In just such cases I have 
observed its efficacy as a therapeutic and remedial agent. 
Permit me to add, its primary action is clearly marked in 
producing anaesthesia of the head, and only after this does 
its influence extend to the organs of the body. Finally, i1:s 
true value can only be weighed, not by ordinary experi- 
ence, but by the general verdict of the profession. — Dr. C. 
J. Fox, U. S. A., in Edinburgh Med. Jour. 



Transfusion in Hseniopliilia. 

In the transactions of the Minnesota State Medical 
Society, Dr. Dedolp publishes a decidedly interesting case 
of haemophilia. The patient was attacked with agina ton- 
silaris on both sides, and was nearly suffocated when first 
seen. The doctor incised the tonsils, which commenced 
bleeding at once and continued to do so. for three days. 



212 The Peoria Medical Monthly. 

Circumligation was performed, but as soon as the lighted 
masses came away the bleeding recurred. The patient's 
history, as well as that of his family, pointed to a hemor- 
rhagic diathesis. On the twelfth day, the patient was so 
exhaused that transfusion became necessary. None of 
the family would give the blood. Accordingly the carotid 
of a sheep was opened and the blood passed into the man's 
basilar vein. No force was used beyond the pumping 
power of the sheep's heart. The bleeding stopped at once, 
when about eight ounces of blood had been transfused, and 
not a drop of blood was lost from that time forward. The 
patient made a full recovery. — Chicago Medical Review. 



Ulcer of tlie Upper Ldp, 

This man, present at the Surgical Clinic, Harvard 
University, has upon his upper lip an ulcer, with ragged, 
hard edges. It has been there for six or seven months. 
He has also had for the past six months venereal sores 
upon his privates, which have not healed yet. These sores, 
however, seem to be ante-dated by that upon the lip. The 
question in this case is whether the man has a primary 
specific sore upon the lip, or whether the ulcer is degener- 
ating epithelial growth. The patient himself ascribes the 
sore to irritation from a pipe, aggravated by neglect. I 
can detect no enlarged glands in the neck, and there ap- 
pears to be no soreness on either side. ^ 

It is important to decide on the nature of this sore 
within a few weeks for the sake of the treatment. The 
man says he has taken no medicine. We will, therefore, 
put him at once upon a course of mercurials, and follow it 
up vigorously for three or four weeks, either alone or in 
connection with the iodide. If by that time the sore has 
not begun to heal, it should be excised. — Boston Medical and 
Surgical Journal. 



Anaesthetics in Diseases of the Kidneys. 

Dr. Laurence Turnbull dwells upon the great impor- 
tance of attention to the condition of the kidneys and ex- 
amination of the urine when an anaesthetic is to be admin- 
istered. Many deaths, unaccountable otherwise, are due 
to this cause. In diseases of the kidneys, the blood being 
loaded with urea, ansesthetics almost invariably produce 
coma and death. He enumerates a considerable number 
of deaths from ether and hydrobromic ether, but very few 
from chloroform. Norris has reported two cases of death 



Periscope. 213 

supervening unexpectedly from sulphuric ether after opera- 
tions for cataract. Both recovered consciousness, but died 
comatose, one in a few hours, the other after eighteen 
days ; no organic lesion was found post-mortem except 
Bright's disease. Cases have also been reported by Emmet, 
Hunt and Montgomery, verified by post-mortem examina- 
tion. The kidneys are the active agents in eliminating 
ether from the blood, and if they are unable to perform 
this office, and if the skin is cold, moist and inactive, death 
will supervene by accumulation of mucous in the lungs, or 
congestion of the brain, in true Bright's disease of the 
kidneys. — Medical and Surgical Reporter. 



Talniasre on Doctors. 



Encourage all physicians. You thank him when he 
brings you up out of an awful crisis of disease ; but do 
you thank him tor treating the incipient stages of disease 
so skillfully that you do not sink as far down as an awful 
crisis ? There is much cheap and heartless wit about the 
physician, but get sick and how quickly you send for him. 
Some say doctors are of more harm than good, and there 
is a book written, entitled, " Every Man His Own Doctor." 
That author ought to write one more book and entitle it, 
" Every Man His Own Undertaker." Do you think physi- 
cians are hard-hearted because thej'' see so much pain ? 
Ah, no ! The most eminent surgeon of the last generation 
in New York came into the clinical department of the 
New York Medical College when there was a severe opera- 
tion to be performed upon a little child. The great sur- 
geon said to the students gathered around : "Gentlemen, 
there are surgeons here who can do this just as well as I 
can. You will excuse me, therefore, if I retire. I cannot en- 
dure the sight of suffering as well as I once could." There 
are so many trials, so many interruptions, so many exhaus- 
tions in a physician's life, that I rejoice he gets so many 
encouragements. Before him open all circles of society. 
He is welcomed in cot and mansion. Children shout when 
they see his gig coming, and old men, recognizing his step, 
look up and say, "Doctor, is that you?" He stands 
between our families and the grave, fighting back the dis- 
orders that troop up from their encampments by the cold 
river. No one ever hears such hearty thanks as the doctor. 
Under God he makes the blind see. the deaf hear, the lame 
walk. The path of such is strewed with the benedictions 
of those whom they have befriended. Perhaps there was 



214 The Peoria Medical Monthly. 

in our house an evil hour of foreboding. We thought that 
all hope was gone. The doctor came four times that day. 
The children put aside their toys. We walked on tip-toe 
and whispered, and at every sound said, '' hush !" How 
loud the clock ticked, and, with all our care, the banister 
creaked. The doctor stayed all night and concentrated all 
his skill. At last the restlessness of the sufferer subsided 
into a sweet, calm slumber, and the doctor looked around 
to us and whispered : " The crisis is passed." Whert 
propped up with pillows the sick one sat in the easy chair, 
and through the lattice the soft south wind tried hard to 
blow a rose-leaf into the shaded, cheek ; and we were all 
glad, and each of the children brought a violet or clover- 
top from the lawn to the lap of the convalescent, and little^ 
Bertha stood on a high chair with the brush smoothing her 
mother's hair, and it was decided that the restored one 
might soon ride out for a mile or two, pur house was bright 
again. And, as we helped our medical adviser into the 
gig, we saw not that the step was broken or his horse 
sprung in the knees. For the first time in our life we real- 
ized what doctors are worth. In some of our minds among 
the tenderest of all memories is that of the old family 
physician. — Clin. Brief and San. News. 



The Practice of Medicine in China. 

It is singular what sameness exists in quackery in- 
different parts of the world — how nearly the advertising 
quack falls into the same methods everywhere. A letter 
from a gentleman traveling in China, addressed to the 
Medical Neics, has this picture of Chinese quackery : 

"It is amusing, and not a little interesting to a for- 
eigner, to witness a Chinese doctor examining a patient. 
The scientific gentleman takes very few minutes to make 
a diagnosis ; for it is of some moment to him that he recog- 
nize, so to speak, at a glance where the disease exists with 
his patient, otherwise his reputation might suffer. 

" The doctor looks at the invalid through his glasses — 
no Chinaman can be adjudged intelligent or learned by his 
countrymen unless he wears spectacles, and the larger they 
are the more important and respectable the practitioner is 
presumed to be — and at once demands where the trouble 
is, and immediately after the sufferer has indicated the 
seat of difficulty the learned gentleman exclaims, 'Oh, yes ! 
I knew it was just there,' and he then examines both 
radial pulses, first the right and then the lef£, and con- 



Periscope. 215 

firms the diagnosis by stating tliat the pulse of the side 
aflected beats so differently from that on the sound side. 
This settles the matter in the opinion of patient and phy- 
sician, and without further ado the treatment is advised 
and put into practice. 

" In the great majority of cases the foregoing is the 
entire routine of examination. Any additional rational or 
physical exploration is rarely observed. The Chinese prac- 
titioner resorts to measures to make known his fame and 
medicmes which bring vividly to mind the modes of pro- 
cedure taken by certain itinerant doctors in this land of 
freedom. He selects a prominent part of the city or town 
for his office, puts out his conspicuous sign and promises in 
the most public positions, has one or more sedan chairs — 
corresponding to our carriages— with gaudily dressed car- 
riers, and employs men to run about the principal streets 
to attract as much attention and cause as much commo- 
tion as possible. When not engaged in his office, he has 
his servants carry him at the top of their speed through 
the crowded thoroughfares, it being an important part of 
their function to ask or demand that all passers get out of 
the way for the famous doctor, Wing Lung, who cures all 
manner of diseases, is in great haste to see a dying man 
whose life he has promised to save. And it is a portion of 
their usual programme to have a body of retainers rush 
about the town demanding if anyone has seen the mighty 
doctor. Wing Lung, as he is wanted at once — " here, there, 
everywhere !" One point in their practice is worthy of 
consideration; when they are actually called to see or pre- 
scribe for a patient, and not on dress-parade business, it is 
an invariable rule to obtain the usual fee before acting. 
Pay in advance for all advice is a cardinal point which is 
not overlooked, no matter what the circumstances." 



Oil of Peppermint in Zoster. 

Dr. Meredith says that he has found the oleum menthse 
pip more effective than any other form of anodyne applica- 
tion he has tried in allaying the neuralgic pains so often 
piteously complained of in cases of herpes zoster. He 
has painted the oil over the eruption when it was out in 
a fresh florid condition, and with great relief to the patient. 
— Medical Becord. 



THE 



Peoria Medical Monthly, 



THOS. M. McILVAINE, A. M., M. D., 

Editor and Publisher, 

204 South-JefTerson Street. .... PEORIA. ILL. 

*«*The Editor is not responsible for the statements or opinions of contributors. 

***Short original articles are invited from any reader, whether a subscriber or not. 

***If extra copies are desired by a contributor, the number must be specified When 
the article is sent in to the Editor. 

*** All exchanges, books for review, and communications must be addressed to th 
Editor and Publisher. 

***The publication day of this journal is on or about the 15th of each month. 

***To subscribers! A pencil mark at this place indicates that the time of your sub- 
scription has expired, and that a prompt renewal is urgently requested. 



C^^itonal g^pytmtttt. 



A Word of Explanation. 

A short time since we addressed a circular to the sub- 
scribers of this journal, asking a little personal assistance 
in favor of our sanitary journal, entitled Home Health. 
Our reasons could not all be ^iven in the space ot a short 
circular, and as we do not wish it to be considered as a 
begging circular in any sense, we wi§h to add a few words 
of explanation. In the first place, we believe that a jour- 
nal of this character is needed, both as a means of instruct- 
ing the people in many things concerning which they are 
lamentably ignorant, and as affording a medium of com- 
munication between the profession and the laity. As it is 
now, the daily press affords the only source through which 
the profession can communicate with the public. And 
even when this means is made use of, there are always 
those who accuse the writer of such an article of trying to 
advertise himself. There are few physicians but who 
would be only too glad, had their patients and families 
some sensible, intelligent ideas upon the subject of medi- 
cine, but especially nursing, care of the sick, etc., etc. To 
give an opportunity for this communication with and in- 
struction of the public, we started our new journal. It is 
perhaps known to most of our readers that we are not 



Editorial Department. 217 

regularly in the publishing business, and do not desire to 
go into it ; our practice takes much of our time, and we 
cannot afford to give that up for a business that is so little 
rumunerative. The low prices that we have placed upon 
our journals barely pay expenses, and we cannot afford to 
employ a large number of agents to introduce them. Hence 
we ask our friends to send us the names of such persons in 
their localties as would be most likely to accept an agency 
and canvass for Home Health. We will give such persons 
all the profits and more for their trouble, or will give 
premiums for clubs of from two up to ten names. For a 
journal like Home Health at the reduced rate of $1, it 
will be no trouble for any boy or girl to get from five to 
twenty names among their friends and obtain a watch or 
make money. The trouble we have experienced is in 
getting the names of possible agents or possible subscrib- 
ers. Any one sending us the names of agents will do us a 
personal favor, and we will be happy to reciprocate in any 
way possible. We had not intended to say much about 
Home Health in this journal, and shall probably not refer 
to it again. Home Health will be sent with this journal 
at the low rate of $1.50 for both. 



GoUesre Announceiiients. 



The usual fall shower of announcements, red covers, 
yellow backs, blue backs, and every other color, has come, 
and that part of our office devoted to their preservation 
looks as if a section of a rain-bow had broken in it. Many 
of them are fully illustrated in the style of almanacs and 
most of them are full of promises that are impossible to be 
fulfilled. The latest is the Medical Department of the 
University of Niagara, which is, of course, devoted to a 
higher education and a four years' course. The section of 
the code of ethics forbidding advertising, is certainly a 
dead letter so far as many medical college professors are 
concerned. But if the plain M. D. should attempt to make 
himself known in a similar way he would be promptly 
brought to a severe account. " So wags the world away.'^ 



218 The Peoeia Medical Monthly. 

A Card to tlie Public. 

We have just received from Bloomfield, Iowa, a 
•^' dodger," or street hand-bill, which reads as follows : 

" Dr. J. E. Harper, A. M., M. D., Professor of Diseases 
of the Eye and Ear in the College of Physicians and Sur- 
geons of Chicago, expects to visit me next Saturday to re- 
main a few days. I would be pleased to meet all who 
have any diseased eyes or ears at my office durinsj his stay 
here. Respectfully, J. B. Findlet." 

The style of the hand-bill cannot be reproduced here, 
as sotne of the letters are two inches in length. If this 
kind of advertising is all right, we would be glad to know 
it. For information, w^e call upon the State Boards of 
Iowa and Illinois. 



Receipts. 

Illinois — Drs. H. S. Hinmau, J. Carson Smith, Thos. D. Wash- 
burn, W. D. Porter, J. E. Buudy, Thos. F. McFarLand, A. C Albright, 

C. E. Harnsberger, J. M. Ausley, P. L. Dieftenbacher, A. G. Humphrey, 

D. F. Rupp, E. Smith, M. J. Jones, A. W. H. Keen, Weis & Tice, S. J. 
Eumstead, James Henrj^ J. A. Walker, J. P. Walker, John Fahrner. 

Wisconsin— Drs. H. R. McComb, A. Edwards, O. K". Murdock. 

Iowa— Drs. N. D. McConnaughey, R. AV. Selby, J. W. Cox, C. S. 
■Shepard. 

Indiana— Drs. J. M. Adams, D. F. Martin, S. C. Newlon. 

Tennessee — Dr. T. J. Reid. 

Kansas— Drs. J. B. Shoemaker, J. T. Stover. 

Kentucky — Dr. R. J. Howard. 

Oregon — Dr. John T. Grimm.. 

Pennsylvania — Dr. W. C. Park. 



' Dr. W. H. Byford, Prof. Gynjecoloiry, Rush Medical College, 
President and Prof. Obstetrics Woman's Hosjiital Medical College, Chi- 
"Cago, 111., says: ''We have tried the lodia prepared by Battle & Co. 
It is a useful preparation and fulfils our expectations. 



The Peoria 
MEDICAL MONTHLY. 



Vol.. IV. OCTOBER. 1883. No. 6. 



©vigiual (J^ommuiuationsi. 



Art. I.— Diphtheria. By H. Jxo. Tillotson, M. D., Wallingford, 111. 

Forty years a^o Bretonneau of Tours gave his name 
to this fearful disease. The idea has in some way becouie 
popular that diphtheria is a comparatively modern disease. 
The contrary is true. It was known to the Egyptians when 
in bondage as putrid sore throat. It can be found accu- 
rately described in medical works a hundred years old. It 
was epidemic in France in 1855; also in America, in the 
Eastern States, in 1857. Many of our greatest men and 
women have died of diphtheria. It is claimed that George 
Washington, also Stephanie the beautiful, Queen of Por- 
tugal, were victims of this disease. The disease has been 
the same for ages, but its names have been many. In the 
year 1859 it received great scientific attention, and was 
christened diphtheria. Its real cause has not as yet been 
determined. The disease prevails mostly in limited bounds, 
generated in particular persons by breathing impure air, 
such as comes from damp, dirty cellars, sinks, kitchen 
offal, composts, banking up houses with manure heaps, and 
other sources of filth. One attack of the disease affords no 
immunity against a second. On the contrary, it renders a 
person more susceptible. It is diffused by actual contact, 
but greatest by a peculiar miasm or epidemic tendency. 
The seventy of contagtou depends upon the source of the 



220 The Peoria Medical Monthly. 

specific poison 'and the predisposition of the individual. 
Diphtheria contracted from one person to another is more 
malignant than when generated in the system by local 
causes. The causes of diphtheria are living things, vegeta- 
ble and animal — the bacteria and micrococci and others 
— but just how they are the cause is a debatable question. 
They might be thought of as atom maggots or animal culae 
but for the fact they are said to be of a vegetable life or 
origin. Why not these bacteria, animal life, from vegetable 
origin? The vegetable receives its nourishment directly 
from the soil and atmosphere. In its turn the vegetable 
supports animal life and growth. Is it not possible that by 
decomposition or fermentation of vegetable matter that 
animal bacteria are originated and hatched? It is said 
they feed for a time upon the debris of decay and become 
saturated with poison, and hence cause disease. That 
bacteria cause diphtheria by their presence, as trichinee do 
in pork disease, or are poison carriers which adhere to or 
passes from them, is a microscopic scientific problem not 
solved. Though evidence has been adduced in favor of the 
hypothesis of their presence, many new facts must be dis- 
covered to prove it. Prof. Beale, who was knighted for his 
attainments in microscopy and medicine, states that simple 
bacteria pass by thousands into the stomach whenever we 
swallow, and that it is the same with all animals. Every 
vegetable and leaf harbors hundreds of millions, in air and 
water. So small are they that they coald exist within us 
in the blood and pass freely into the substance of every 
organ, and that there is probably not a part of the body a 
quarter of an inch in diameter where germs are not found. 
So it is still an open question whether infective disease 
originates from some special kind of poison carrying bac- 
teria or from particles wholly independent of all such 
organism. 

The most datigerous form of bacteria, the micrococcus, 
looks, when magnified about eight hundred times, like the 
head of a small pin. They multiply and grow upon any 
open sore. When self or artificially planted, they give us 
greatest trouble upon mucous membrane, of tongue, inner 



Original Communications. 221 

cheek, throat, and severe cases nose bronchial tubes, etc., 
where they are to be seen in splotches of a whitish, yellow- 
ish, ashy color. They propagate with amazing rapidity, 
making whole plantations of splotches in a few hours. 
They attack and forage upon any person not in vigorous 
health. Besides false membrane, or mucous membrane, we 
have the distinguishing symptoms of excessive debility, 
foul breath, neuralgic pain in legs and back, sometimes 
nausea or vomiting, palpitation, vertigo, diarrhoea, difficult 
urination, chilliness, irritability, etc. 

TREATMENT. 

I do not add any new remedies to the long list already 
in use, but a new combination of old remedies which is at 
once a local and constitutional treatment. The medicines 
should be thoroughly mixed, and for dispensing it is most 
convenient to use large-mouthed bottles (such as quinia). 

5 Tr. ferri chlori, 2 drachms. 

Potassa clilor., pu., 3 " 

Alum exiccatum, pu., 7 " 

Potassa nitrate, pu., 6 " 

Sulphur sublimatuui', 

Carbo. ligni, aa. 1 " 

Mel. (strained), 16 ounces. 

M. Sig. Teaspoonful every hour until bowels move freely, then every 
two or four hours teaspoonful. Allow no drink for ten or fifteen minutes after 
giving medicine. We allow the patient a bountiful supply of hot milk, relig- 
iously avoiding these most innocent articles, beef tea, chicken broth, etc., while 
true as steel to all laws of hj^giene. 

After diphtheritic patches have disappeared, give 
quinia and hyposulphate soda for tonic effect. I think the 
remedies are incombatible with alkaloids and their carbon- 
ates. They are disinfectant, anti-spasmodic, curative, germ- 
cide, diaphoretic, diuretic, anti-periodic and anti-pyretic. I 
have given these remedies a thorough trial for two years, 
and have given the prescription to physicians in Indiana 
and this State, who have, by reports, given me great en- 
couragement. I do not believe it is a specific. I am con- 
vinced, however, and sustained in the conviction by others, 
that the treatment will cure nine out of ten with a cer- 
tainty, in proportion as it is early adopted. When diph- 
theria is known to be about, it is no time for hair-splitting 
points upon hepetic tonsillitis and follicular tonsillitis, or 



222 The Peokia Medical Monthly. 

any other kind of sore throat. These cases should have the 
benefit of every doubt. 

The remedies and combination may look so simple to 
some that they may be loth to give trial. The Syrian 
would have been willing to do some " great thing " to cure 
himself had the prophet bidden him. But he was without 
faith to believe that help waited for him in the familiar 
stream close by his own door. I apprehend that whoever 
gives it a trial will have no cause for regret. I here leave 
the treatment for your consideration, for your action, and, 
I hope, for further report of abler pens than mine. 



Art. ir.— Carbolic Acid in the Treatment of Piles. Bt A. B. Allen, M. D., 
Jerseyville, 111. A reply to Dr. Veatcli. 

''Me Pede Herculutn." 

Dr. Wm. H. Veatch says: "I wish to say here that I 
was one of the doctors — "unthoughtful men" — when about 
nine years ago an itinerant pile doctor strode into my office 
with a bottle of carbolized olive oil in his hand and pro- 
posed to sell me the bottle for fifty dollars, with full in- 
structions to use it. He was a man who understood the 
nature of piles, and evidently thought he had struck one 
who knew but little; but in his anxiety to make a trade he 
explained the action of the remedy and proposed to dem- 
onstrate his theory on a case which happened to come into 
the office for treatment. The patient being willing he op- 
erated there and then. The pile being recent and only one 
external tumor, in ten days there was not a vestige of the 
pile remaining. 

Of course I was not unthoughtful enough to pay him fifty 
dollars for ten cents' worth of carbolized oil, and haven't 
seen the simple operation. I told him I would not pur- 
chase, so he went his way with the happy thought, "Well, 
you don't know what the mixture is, and if you do you 
don't know what proportion or how often to use it." When 
I saw the result of this case I was not unthoughtful enough 
to allow the next case to pass without treatment. I re- 
volved' all those ponderous imaginary objections such as 
inflamation, embolism, etc., over and over again in my 



Oeiginal Communications. 223 

mind, wondering what would become of me if I, through 
my ''unthoughtfulness," should make a mistake and kill 
some poor, unfortunate subject of misery, yet the complete 
success of every case I treated emboldened me to "perse- 
vere in well-doing." 

The above is a virtual acknowledgment of the gentle- 
man's ignorance in medical literature. Nine years ago by 
stealth he obtained from an itinerant pile doctor this val- 
uable remedy that he has been using with fear and trem- 
bling ever since, as a specific in his practice, having never 
heard of its use, and possibly the drug prior to the angel 
visit of this wandering bright and shining light in the gal- 
axy of medical stars, he appears upon the horizon of this 
man's heretofore tranquil intellectual sky as a comet of 
wonderous brilliancy in the understanding of the nature of 
piles, and like a sagacious hero he stealthily plucks one 
shining quill from the tail of this bright orb to adorn his 
skill. And "do good by stealth and blush to find it fame." 
I am sorry my expression (illiterate doctors) falls upon Dr. 
Yeatch's sore toe; sorry because of the evident pain it has 
given him. How he must have suffered in the monstrous 
throe that gave birth to the brilliant paragraph that forms 
the caption of this criticism. And I am satisfied the high 
opinion the doctor has of the traveling pile doctor's remedy 
will strike the majority of physicians, especially those who 
have tried it as unwarranted. As far as our individual 
knowledge extends we have never tried it, and those who 
have subjected it to the most thorough trial are those who 
most roundly condemn it as a dangerous and painful opera- 
tion, and one which should be discarded from legitimate 
surgery. In view of this fact Dr. Veatch is certainly to be 
congratulated upon the success which has attended it in his 
hands, but we would admonish him not to be over-confident 
but to be on the alert for accidents which are very likely to 
happen, and which may be of such a nature as will some- 
what cool his extravagant opinion as expressed iu his twin 
papers on the subject. 



224 The Peoeia Medical Monthly. 



Art. I.— Case of Shock. By J. S. Geigley, M. D., Lewiston, 111. 

August 14, 1883, was called to see C. H., farmer, aged 
35, who, while sitting in his barn door after eating his din- 
ner, was kicked by a horse. He was sitting with his back 
to the animal and about three feet from his heels, just far 
enough to receive the full force of the kick, which was de- 
livered with one foot. The hoof struck about two or three 
inches to the left of the spine, and one to two inches below 
the lower angle of the scapula. The man was thrown for- 
ward several feet by the blow and was entirely unconscious 
when picked up. The accident occurred about 1 p. m., and 
I saw the patient some two hours afterward. He had been 
removed to the house, which was some distance from the 
barn; was in a semi-conscious condition, but could be 
roused sufficiently to answer some questions. On inspection 
the patient presented the following appearance: The sur- 
face was perfectly bloodless, cadaveric looking in fact, and 
covered with small beads of perspiration, eyelids about half 
open with eyes rolled back, lower jaw dropped on the 
breast, respiratory movements were scarcely distinguish- 
able, patient would now and then give utterance to a pro- 
longed but very feeble moan. The pulse at the wrist was 
so weak that it could not be counted; by placing the ear to 
the chest, however, I found the pulsations to be about 160 
per minute, but very feeble and irregular. The surface 
was perfectly cold to the touch. On taking the tempera- 
ture (which I did with great care several times) the ther- 
mometer registered but 94 deg., each time. 

On examining the point ot injury noticed considerable 
swelling and ecclymosis. The patient being very spare the 
ribs could be easily counted, but owing to the swelling at 
the point of injury 1 could not make out the amount of 
depression that existed, but by placing one finger on the 
sternal and another on the vertebral end of the rib, distinct 
crepitation could be distinguished in the ninth and tenth 
rib, and 1 thought the eleventh rib, but as to the last I was 



Notes from Private Practice. 225 

not positive. I made careful examination for evidence of 
internal hemorrhage but could find none. I therefore con- 
cluded that my patient was simply suffering from shocks 
but taking into consideration the fearfully low temperature 
and complete collapse of my patient, I gave a gloomy prog- 
nosis and proceeded to do what I could for an apparantly 
hopeless case. I had the patient placed in as comfortable 
a position as possible and applied heat to the surface by 
means of hot irons and jugs of hot water; gave internally 
desertspoonful of brandy with a half drop of fl. ex. digitalis 
every fifteen minutes. As the patient commenced to com- 
plain of pain before I left the house. I gave him ^ gr. of 
morphia hypodermically. 

August 15. Found patient vomiting and craving water 
incessantly, but as soon as he would take a swallow it 
would come back as if he had a stricture of the sesophagus; 
the friends informed me that they had given the brandy 
and digitalis mixture for several hours during the night 
until the patient went to sleep, and slept for about an hour, 
when he awoke vomiting. I gave him another hypodermic^ 
put a strong mustard plaster over the stomach, and gave 
him a powder containing 5 gr. bismuth subnit. and 1 gr. 
Dovers powder, which controlled the vomiting. Instead of 
giving him water to drink I ordered milk 3 parts, lime 
water 1 part; this seemed to agree nicely. At this visit the 
thermometer registered 95 deg., being a rise of 1 deg. 
during the night, but the pulse and general condition re- 
mained unchanged. I ordered the heat to be still kept up^ 
and if the patient's condition remained unchanged by noon 
to add brandy to the milk and lime water. 

August 16, Found patient much improved; tempera- 
ture 99i deg., pulse 105; friend informed me that reaction 
had set in about 5 o'clock the previous evening; he had 
slept fairly well during the night, and had taken some 
nourishment at breakfast. The patient now complained of 
great pain at the injured point, which was aggravated by 
taking a deep inspiration. Prescribed tr. aconite rad. in 
drop doses every hour with an occasional dose of morphia. 

August 17. Found patient improved in every respect. 



226 The Peoria Medical Monthly. 

except the soreness. The temperature was normal, appetite 
lair, bowels had moved naturally, in fact the patient was 
recovering rapidly, and from that time on there was not an 
unfavorable symptom, and three weeks after the accident 
the patient was at work. 

Now the points of interest in this case are these: 1, 
the extent and duration of the shock; 2, the comparative 
slight injury that produced it (the termination of the case, 
showing that -there could not have been more than slight 
concussion of the internal organs), and 3, the recovery of 
the patient after such a degree of shock. Most authorities 
agree that the prognosis in shock is unfavorable if the tem- 
perature falls below 95| deg., and- especially if the depres- 
sion is maintained for any length of time. Now in this 
case the temperature was below this point for nearly thirty 
hours, and to make sure my thermometer was not mislead- 
ing me I took the temperature at different parts of the 
body repeatedly. I also tested the instrument on myself 
and some of the bystanders, so there could be no mistake. 



CBJarrieisirattdijttre. 



Dr. Harper Vindicated. 

Bloomfield, Iowa, Oct. 3, 1883. 
Editor Peoria Medical Monthly: 

I notice in your journal the publication of a hand-bill 
issued by me, announcing that Dr. J. E. Harper, of the 
College of Physicians and Surgeons of Chicago, would visit 
me for a few days, and inviting all of my patrons to meet 
me at my office during the doctor's stay with me. 

Dr. Harper was in no way instrumental in preparing 
or circulating this hand-bill; he is innocent in deed and 
in intent; he knew nothing whatever of its publication 
until it appeared in The Peoria Medical Monthly. What- 
ever blame attaches to the issuing of that hand-bill should 
be placed where it rightfully belongs— at my door. I am 
the responsible party, and it is but justice to Dr. Harper to 
say so. During the time I was a student under Dr. Har- 



Correspondence. 227 

per I formed for him a warm personal attachment, in addi- 
tion to a high regard for his professional skill; and I 
frequently invited him, through a friendly correspondence, 
to make myself and family a social visit. And when he 
named the day he was to come I, of my own will, caused a 
hand-bill to be issued and distributed. My object was to 
have as many as possible of my patrons to run in, that my 
teacher might see what I have done, and am now doing. 
The means I employed may be condemned, but my motives 
were good. As Dr. Harper came to Bloomfield on a social 
visit, and not on a professional visit, he should be excul- 
pated from any and all blame that may attach to my indi- 
vidual action. That justice may be meted out properly, I 
trust you will do me the favor to publish this article. 
Yours for the right, 

J. B. FiNDLEY. 



Dyphtheria. 

Wyanet, III., Oct. 1883. 
Editor Peoria Medical Motithly: 

In your September number is. an article from the pen 
of Dr. J. B. Ebert, of Dundee, Ind., upon my criticism of 
Dr. E's treatment ot diphtheria. The irate doctor has not 
answered a single point in my criticism, and, all broken up 
and disconsolate, indulges in personalities which fair and 
honest inquiry does not merit, and is unworthy of special 
notice. Personal controversies through medical journals 
are detrimental to a truthful investigation of any subject 
and uninteresting to professional men who desire to ameli- 
orate human suffering, therefore I will proceed to give my 
views of the cause and my treatment in an epidemic of 
diphtheria that commenced September 7 and continued 
during the winter and spring of '82 and '83. Our public 
school commenced August 30, 1882, and the first case of 
diphtheria was taken ill on the 7th, a child in another fam- 
ily on the 8th, and within the following week half a dozen 
families, widely separated, had one or more children down 
with this terrible disease. This outbreak occurring in 
homes surrounded by excellent hygienic influences led me 



^28 The Peoria Medical Monthly. 

to suspect some common origin; and the school house, 
yard, and well were examined. In searching for a cause 
we observed the first cases attached in each family were 
pupils attending school, and those only ill who had freely 
drank from the school well, which was sixteen feet deep and 
forty-three feet from the privy vault. This vault was dug 
into, and the well through a vein ot sand, and through this 
I had reason to believe communications had been made by 
the heavy rains in June, and the hypersaturated condition 
of the soil had surcharged the well with poisonous vege- 
table or animal matter. The water was unpleasant in taste 
and odor and not examined microscopically. These facts 
being communicated to the school board they ordered the 
school closed, a new well dug, the old one filled up, the 
privy vault disinfected, yet withall were unable to stamp 
■out the dread malady, and twenty-six of our loved ones 
passed to the unknown, w^hile a few miles away, in Indiana, 
lives o;?e who has treated ^^ hundreds of cases with no unfavor- 
•able results; all recovered.^' 

I cannot give the total number of cases attributed to 
this epidemic or the treatment employed by the two other 
physicians in Wyanet, although five cases were in the care 
of Princeton physicians, with a mortality list of three. 

My notes show thirty-three cases treated, with one 
death from blood poisoning, and one from a drachm of 
spirits of ammonia given by mistake when the child had 
nearly recovered from the disease. My treatment has 
proven so successful in so large a majority of cases (about 
95 per cent.), that I am encouraged to give it somewhat in 
•detail for the benefit of my critic and younger practitioners 
who may deign to give it a trial and report their success 
thereon. There is no disease requiring more thorough and 
energetic treatment in the early stages than diphtheria, 
and if you get no control of it in five days or a week at 
most, dangerous laryngeal complications may supervene, or 
blood poisoning leave your patient where the wicked cease 
from troubling and the weary are at rest. My prescrip- 
tions are varied, according to age and stage of disease, and 
are as follows; 



Correspondence. 229 

IJ Sulplio carbolate soda, 1 draclim. 

Glycerine 1 ounce. 

Aqua dis. 1 ounce. M. 

Grive a teaspoonful eveiy hour or every half hour; iu 
bad cases alternating with five grains chlorate potassium 
in a tablespoonful of water, with five to ten drops tine, gel- 
semium if fever is above 101 deg., and in twenty-four hours 
substitute the following for the chlorate: 



Tine, ferri chloridi, 


2 drachms. 


Potassium chlorate, 


2 drachms. 


Hydrochloric acid dilute, 


i< drachm. 


Glycerine, 


5 " drachms. 


Syrup simple, 


4 drachms. 


Aqua, 


11^ ounces. 



M. 

Give a teaspoonful every two or three hours with one 
grain of quinine in pill or powder, alternatins: with the 
sulpho carbolate of soda, which is continued until patient 
is out of danger, and at the same time using as a local 
application in the throat with a swab, the following: 

5 Sulphurous acid 3-4 drachms. 

Sulphur, 2 drachms. 

Glycerine, 6 drachms. 

Aqua, 2 ounces. 

M. Apply every one, two, or three hours. 

If the throat is coated with a heavy diphtheretic deposit 
use quinine upon a swab wet with glycerine, and if offen- 
sive gargle with a five per cent, solution of carbolic acid 
and water. Equal parts of kerosene, turpentine and tine, 
of camphor, a,s a counter irritant, upon the outside of throat, 
and all the nutritious food your patients can be induced to 
take, with stimulants ad libitum. 1 further urge the neces- 
sity of keeping the pores of the skin open by hot sheet 
packs, corn sweats, or frequent bathing, and always pre- 
scribe for the children in every family where the disease 
exists, and have found subsequent cases (should they occur) 
more mild and seldom dangerous. 

Without claiming entire originality in my treatment 
I believe it has saved many little ones in this epidemic, 
while other treatment has given a death loss of thirty per 
€ent. 

In conclusion will say that impure water causes more 
diphtheria than all other causes combined, and it is the 
duty of every physician, school board, or health officer to 
frequently examine public wells and the sources of all 



230 The Peoria Medical Monthly. 

water supply, that this, the most dreaded of all infantile 
ills, may not find a lodgment in our midst. 

F. C. Robinson, M. D. 



Medical Ethics. 

Editor Peoria Medical Monihhj: 

In my previous article illusion was made to some of 
the causes marshalled to sustain the code and prevent an 
untimely dissolution. 

The first (the emergency which called it into being) is 
certainly obsolete; never since medicine has had a history 
have there been such uniform and accepted foundations as 
at the present; never such homogeneousness and liberality, * 
each drawing from the common stock; the vegetable, min- 
eral and animal kingdom alike ministering to all, and 
hygiene asserting a supremacy, conceded by all. 

Remove the prefixes of regular Jiomoeopathic and eledic, 
and the shrewdest Philadelphia lawyer, or expert, could 
not detect the pathy or ism which controls or exists in 
ordinary practice. The fewest patients, no matter how 
long sick, could tell you by their treatment, or by an in- 
spection of the prescriptions sent to the drug house, what 
school, system or sect their doctor belonged to. And no 
wonder, for the same drug store supplies all the schools, 
the same elementary branches are required by all, and if 
the calves should cease to be branded, or the animal 
" roused up " of the State or National Association, a short 
time would elapse before the best mother would not know 
her own child. True, there might be Herefords, Durhams 
and Jerseys, but the fence being leveled they would be- 
come so mixed as to lose their identity, and many would 
think all had improved by the apparent catastrophe. 

Jacob, by his advanced views in gynecology, came 
near missing his father-in-law, got his ill-will, and at last 
had to divide with his rustic and less cultured brother. 
Now if the code had the opportunities he had, and could 
select from the medical family only the well-developed and • 
best blood, and engender the ring-streaked and spotted for 



COREESPONDENCE. 231 

its special iierd, the public might appreciate its efforts, but 
so long as nature is so impartial in her gifts, and the regu- 
lars have founded so many scrubs, the probability of sus- 
taining a medical aristocracy seems very problematical. 
Millionaires are exceptional where the stock is heavily 
watered. 

Second. Age is a factor which has large claims in 
certain directions. The advanced age of a horse adds very 
little to his value. 

The protracted existence of an idea founded on a wrong 
basis works harm. The caste education of India and China 
has been a serious barrier to advancement. 
The proof of time is a crucial test. 

Hardly an organic law of the State, or the consummate 
wisdom of our best statesmen in founding a national code, 
but what has required amendment or modification. Even 
theologists, with a revealed code as a basis, are unable to 
voice its sentiment, and give a formula which meets the 
sanction of the learned, or the demands of the time and 
age. Draco made a savage code which held sway and dis- 
graced humanity for a long time. It accomplished good, 
even, but the time came for it to die. 

The Hippocratic oath, which some of the code de- 
fenders allude to with great respect, is extinct. Serfdom 
and slavery exist only where there is dense ignorance and 
barbarism. The grand old pioneers who founded our med- 
ical code acted wisely and formulated axioms which have 
passed into truisms. It bore some good fruit and met an 
apparent want, but that want has ceased to exist. No 
homoeopathic or electic cyclone has struck it, but its utility 
is exhausted. Some honestly believe dissolution has set in 
and disinfectants should be administered. Some believe 
in its resurrection, but the thing is not immortal (only the 
work of men's hands). Why deify and worship it? A live 
dog is better than a dead lion. Of its simplicity and elas- 
ticity we need not speak; but one feature running through 
it has always seemed to me uncalled for, gratuitous, if not 
mischievous. I refer to the attempt to instruct the public 
on the duties they owe the profession. The public do not 



232 The Peoria Medical Monthly. 

■ask us to instruct them. Why volunteer our services in 
this direction? It is hardly modest, and somewhat preten- 
tious. The average judgment of the people is about as 
good as the average of the profession. If we would listen 
more to their opinion we might be materially benefitted- 
What do they say about the profession, its consultations, 
code and caste prejudices? Consult the New York Tribmie, 
or any national paper. Is it complimentary? No! All 
that relates to the duties of the public towards us I think 
better left unsaid. Its club features, monopolizing and 
guild tendencies, and other intrinsic excellencies, we re- 
serve for another article. Veritas. 



(^nt^tion mA '^nmm. 



Follicular PliarjTigitis. 

Andover, Kan., Oct. 5, 1SS3. 
iEditor Peoria Medical Montldy : 

I notice in your last number of your valuable journal 
a question asked by some professional brother in regard to 
the best treatment for follicular pharyngitis. In answer to 
his query I give the following satisfactory formula. 

The first thing is to attend to the condition of the 
bowels, and if confined give saline laxatives as needed, and 
counter-irritation over seat of inflammation. For counter- 
irritation use the following: 

R Resin cerate, 6 ounces. 
01. turpentine, 3€ Pi°t. 

Tr. aconite, Rx. 3^ ounce. 

Chloroform, 1 ounce. 

Mix and apply over the seat of inflammation several times through day and 
night. 

Another and one deserving great recommendation is a 
piece of fat salt pork, cut thin as possible, and stitched on 
muslin and applied to the throat. Pv. camphora may be 
sprinkled upon the pork; also to increase its efficacy. 

For internal topical applications I find the following 
to prove satisfactory when used as directed: 

R Tannic acid, 2 drachms. 

Iodoform, 20 grains. M. 

And use upon the parts by means of the insufflator, and care 
must be taken in selecting and using the instrument in 



Questions and Answers. 233 

this disease. A glycerite of tannic acid and iodoform, as 
the following, is excellent: 



Tannic acid, 


2 ounces. 


Iodoform, 


120 grains. 


Glycerine pura, 


K pint. 



M. 

And apply to the throat with camel's hair brush, according 
to circumstances. 

Or either of the following may be used, according to 
the fancy of the doctor: 

IJ Quina sulph., 24 grains. 

Cupri, 32 grains. 
Acidi sulphurici arom, 1 drachm. 

Aqua pura, 16 ounces. 
Fiat mistura et signa. 
Tablespoonful four times a day as a gargle. 

Or— 

3 Infus cinchon, 8 ounces. 

Mellis desp. 2 ounces. 

Acidi muriatici, 12 drops. 
Fiat gar gargarysma. 

This may be repeated several times daily. 

Could insert many more, but leave space for some 
•other brother, as this is the most interesting part of our 
valuable journal. J. B. Shoemaker, M. D. 



Acute Dysentery. 

Montague, Texas, Oct. 3, 1883. 
Editor Peoyna Medical Monthly: 

Some suggestions regarding acute dysentery to Dr. D. 
L. Russell, in September number, have induced me to con- 
tribute my mite to the general fund. Now the text books 
give us a general outline of treatment for acute dysentery, 
let its causation be what it may, and I think the treatment 
might be divided into two heads. 1st. To evacuate the 
bowel by some purgative, say calomel if malarial, alter- 
nated with quinine ; or, if simple torpidity of the upper 
bowel produces the congestion, a simple saline purgative 
will cover the ground. 2d. To check the bowels and to re- 
lieve the irritable condition of the lower bowel and rectum. 

This indication is best met by sub. nit. bismuth and an 
opiate, and to come at once to the suggestion which in- 
duced me to send in this article, viz., the injection of cold 
water (iced if possible) after each injection, you may use 
either cold water or cold water with tinct. opii., and if it is 
used persistently I can assure you your tormina and tenes- 
mus, the great aggravator of an already highly inflamed 
and, consequently, irritable gut, will be relieved and your 
case of dysentery cured. I have used these cold water in- 



234 The Peoria Medical Monthly. 

jections for two or three years and they have proven of 
very great value to me, when used early enough in the 
attack. But, unlike Dr. J. D. Ebert, of diphtheria notoriety, 
I occasionally find a case nothing will relieve. Dr. Ebert's 
knowledge of the wonderful curative power of cupri sulph. 
pulvis dorcri, etc., in diphtheria, is only equalled by his very 
peculiar article in September number. Every doctor, how- 
ever, knows what can emanate from an egotistical physi- 
cian who finds a specific for such a disease as diphtheria 
among remedies the world has known for centuries. 

J. E. Stinson, M. D. 



i0ofe §mm. 



The Treatment of Wounds. Its Principles and Practice, General and SpeciaL 

By Lewis S. Pilcher, A. M., M. D., Member New York Surgical Society. 
With 116 wood engrivings, 8 vc, cloth; 392 pp. New York: Wm. Wood 
& Co. 

This is the August number of Wood's library, and but 
adds to the reputation for practical usefulness which the 
series holds among the profession. The subject of wounds 
and their treatment seems to be treated in a very concise 
and practical manner, and leaves little to be wished for. 

Antisepsis receives careful consideration and is well 
handled, and is fully up to the times. The volume will be 
a welcome visitor to the physicians' book table, and will be 
frequently referred to. 

The Roller Bandage. By William Barton Hopkins, M. D. With 73 illus- 
trations, 12 mo., cloth ; 95 pp. Philadelphia: J. B. Lippincott & Co. 

This is one of the most useful and practical little books 
that we have seen for some time, and fitly accompanies the 
volume noticed above. It should be in the hands of every 
student. The illustrations are good and add much to its 
value. "Each bandage was applied to a living model, and 
whenever the roller pursued a course, which the author 
has found in his association with students was the cause of 
any uncertainty, it was at once photographed. From these 
photographs accurate drawings were made by the artist."^ 



■ Book Notices. 235 

We heartily commend it, especially to our younger 
readers. 

"What to do First in Accidents and Emergencies. A Manual explainiug the 
Treatment of Surgical and other Injuries in the absence of the Physician. 
By Chakles W. Dulles, M. D. Second edition. ' Revised and enlarged, 
with new illustrations, 12 mo , cloth.; 118 pp. Philadelpeia : P. Blakiston, 
Son& Co. 

This is one of the best of a class of semi-medical 
' Tjooks for general reading that has been brought to our 
notice. Books of this kind, if written by conscientious, 
reputable, medical men, do no harm to the profession, but 
on the contrary, do much good, and should be regarded as 
valuable aids. In an emergency much valuable time is 
lost before the physician can possibly reach the patient, 
! through ignorance of friends and bystanders, of what to 
do. The object of this book is to correct this ignorance, 
and it is well calculated for the purpose. 

The Medical Student's Manual of Chemistry, By R. A. Witthaus, A. M. M. 
•D., Professor of Chemistry and Toxicology in the University of Buffalo, 
etc., etc., etc., 8 vo., cloth ; 370 pp. New York : Wm. Wood & Co. 

Received too late for special notice. 

"Transactions of the Medical and Chirurgical Faculty of tlie State of Mary- 
land, at its 85th Annual Session, held at Baltimore, April, 1883. 8 

vo., paper; 302 pp. Press of Isaac Friedenwald. 

An especial feature of this volume is the annual ad- 
>dress of Dr. John S. Billings, of the army medical corps, on 
Medical Bibliagraphy. The whole contents of the volume 
^re interesting and valuable. 

The volume deserves better of the Faculty, however, 
than a paper cover. 

Fifth Annual Report of the State Board of Health of Kentucky, 1883. 
8 vo. 260 pp. ; paper. 

Dio Lewis's Monthly. Vol. I, No. 3. 110 pp. $2.50 per annum. Dio Lewis, 
Editor. Frank Seaman, 68-71 Bible House, New York, Publisher. 

A very attractive and invitiug looking publication. 
Its aim is to spread sanitary and hygienic principles among 
the people. Dr. Lewis is a vigorous and pleasing writer, 
and, as a matter of course, his journal is tinted with his 
own peculiar ideas and style, but it is none the worse for 
that. 



236 The Peoria Medical Monthly. 



Treatments of Typhoid Fever. 

BY W. F. A. KEMP, M. D. 
A paper read before the Balto. Med. Association. 

The use of the word typhoid, as applied to febrile- 
states, has made the application of the word somewhat 
ambiguous. In the paper presented this evening we do- 
not use the word in the sense of an adjective, meaning 
thereby a febrile state of adynamic or low type, but in the 
substantive form as applicable to that condition of febrile 
movement, which runs a definite -course, displaying symp- 
toms indicative of deep constitutional origin or grave con- 
stitutional infection. That the fever runs a prescribed 
course can scarcely be denied. The time of its duration 
seems to vary within extended limits; the mean duration 
of the Parisian cases observed by Louis in 1839 and '40 was- 
19.6 days; Dr. Jackson, in Philadelphia, gave 22 days;. 
Jenner, in London, 21 to 30 days. The generally accepted 
average for the febrile state in typhoid fever may be ap- 
proximated by allowing three weeks as the time of the 
fever before convalescence may fairly be expected to set 
in. This represents the average, for it is well known that, 
secondary local lesions may greatly protract the disease. 

After the profession began inquiring into the identity 
or non-identity of typhus and typhoid fevers, many views 
began to receive adherents, as they from time to time were 
established from either post-mortem appearances, clinical, 
signs or theoretical induction. 

Prost, in 1804, first laid the foundation that turned the 
attention of pathologists to research that has led to such 
definite results. He found in more than 150 dissections 
inflammation with or without ulceration of the mucous- 
membrane of the intestines. 

Broussais, 1816, was of the same opinion in the main 
that Prost held; Prost held that the seat of the disease was- 
in the mucous membrane of the intestine. Broussais re- 
garded it as useless to distinguish between the ulcerations 
found in the glands of intestine, and inflammation else- 
where in the digestive tract. He (B.) believed the symp- 
toms were due to inflammation — gastroenterite — and upon 
this urged copious depletion. 

To Louis, in 1829, is accorded the praise of first having- 
given a complete and connected view of the symptoms as- ' 
well as the post-mortem lesions in the fever common in. j 
Paris. 



Periscope. 237 

English physicians especially were unable to accept- 
these views, because they were unable in many post- 
mortems to discover the diseased Peyerian patches,, 
although difference in symptoms detailed regarding the 
fevers of France and England were not then so o.bvious. 
Hence originated two opinions; the first based upon post- 
mortem destruction, the anatomical sign of Louis, the 
other based upon subjective symptoms, because these ob- 
servers were unable to discover the anatomical signs upon 
which the Parisian school laid great stress; the belief began 
to gain ground that there were two diseases which were 
indifferently named typhus and typhoid fever; that one 
prevailed in Paris and the other in England, in Germany 
and elsewhere, being more or less mixed up with the Par- 
isian fever, as measles may be with scarlet fever. Loui& 
subsequently subscribed to this view (1841). 

The Academie de Medicine formally proposed the ques-- 
tion (1835) "What are the analogies and the differences be- 
tween typhus and typhoid fevers ?" Great interest was 
aroused in the solution of this query; numerous parts of 
the world furnished men who, going to Paris, studied the 
disease, and in 1836 Drs. Gerhard and Pennock, of Philadel- 
phia, in a systematic treatise, were the first to indicate 
these differences, it having been already determined by 
Jackson and Gerhard that the fever described by Louis 
under the name of typhoid fever existed in America, and 
presented there the same assemblage and development of 
symptoms, and the same post-mortem lesions, as the Paris- 
ian fever. Lombard, of Geneva, (1836) visiting London,, 
was convinced that two different fevers had been con- 
founded together. Dr. Perry, (1835) was the first to dem- 
onstrate the complete difference of the two eruptions. 
This was published in the Edinburgh Medical and Surgical 
Journal for 1840 (Aitkin). And so it continued, until in 
our day, the search is now made by pathologists for the 
specific materies morbi; drainage, ventilation, everything 
with which the disease has or might have been connected, 
has undergone examination, and there is found a bacillus 
in the spleen and blood of typhoid patients. Maragliano, of 
Genoa, asserts that "at the height of the disease these 
organisms were found both isolated and grouped. These 
organisms almost exclusively consisted of spherical bodies 
which have a delicate contour, and appear to be homoge- 
neous. Some are mobile. During convalescence these 
micro-organisms lessen in number in both splenic and sys- 
temic blood. When quinine was given to the patients in 



238 The Peoria Medical Monthly. 

large doses the organisms either disappeared from the 
blood, or were present in it only in small number. The 
blood used for examination was obtained of patients, from 
spleen, by hypodermic syringe, and from the systemic cir- 
culation at the tip of finger. The blood from both the 
finger and spleen was treated by the method of fractional 
culture, and a large number of rods were obtained, similar 
to those seen in fresh blood onh^ they were of greater 
length, at least some of them." He bases these opinions 
on fifteen cases carefully examined by himself. He avoids, 
however, the expression of any opinion as to their relation 
to the disease. {Med. Neivs, Nov. 25, 1SS2). 

The chief objects of the physician in treating typhoid 
fever should be to reduce excessive temperature, subdue 
vascular excitement if these be in excess, to restrain diar- 
rhoea, to stimulate the nervous system when necessaiy, to 
insure free renal activity and to influence the elimination 
of the growth from intestinal glands. 

To accomplish these ends, special plans of treatment 
are advocated by some, others prefer to simply treat dan- 
gerous or excessive symptoms as they arise. To strictly 
confine the remarks one desires to make on the treatment 
of typhoid fever to any plan is difficult, because it matters 
not wdiat the plan under discussion is, the by-paths of in- 
quiry are numerous and tempting; therefore the rather 
rambling form of statement wdiich appears before you at 
this time must ask your indulgence. The restraining of 
preternatural heat seems to be of the utmost importance; 
those who advocate the so-called antipyretic plan especially 
lay stress upon this. Says one, reviewing Dr. Cayley's 
Croonian lecture on the treatment of typhoid fever. "It 
is a plea to the profession to return to the former philoso- 
phy in respect to fevers, viz., that something must be done 
to modify the febrile process itself. It is a claim put for- 
ward in behalf of some specific plan of treatment for fever, 
or rather the high temperature, in opposition to the ra- 
tional or expectant method. Dr. Cayley applies two prin- 
ciples to the test of the success of thi§ mode ol treatment. 
First, wdiether it appears to relieve the urgent symptoms 
and to exercise a favorable infiuence on the course of the 
disease. Secondly, the test of statistics on the general rate 
of mortality. The result of the test seems favorable, but 
to insure good results the principle underlying the treat- 
ment must be carefully observed through the w^hole course 
of the disease. The temperature must be kept below^ a 
moderate fever heat (102.2 deg. F.) from the beginning to 



Periscope. 239 

terminatoii of the attack. This is to be effected by cold 
water applications, preferably the bath, supplemented by 
administration of drugs, notably quinine, salicylate of soda_, 
and digitalis. The temperature of bath may vary from 65 
deg. to 70 deg. F.; its duration, varied according to the 
patient's condition and effect produced, probably from ten 
to twenty minutes. It is to be repeated as often as the 
temperature rises to the limit (102.2 F.) 

Whilst exerting unquestionably a favorable influence ' 
on the general febrile symptoms, it does not affect unfavor- 
ably any of the special symptoms of typhoid, not excepting 
even the pneumatic or renal complication. A jDlan of 
treatment which is shown to reduce mortality from 16 to 
7.4 per cent. (Brand) certainly has everything almost to 
recommend its further trial and adoption." 

Dr. Rothe {Amer. Jour. Med. Sciences, p. 557, Oct., 1880) 
claiming for an antiseptic treatment of typhus abdominalis 
most excellent results, writes thus: ''From the middle of 
August to the end of October, twenty-five cases were ob- 
served; of these he treated the first six by a method which 
he had employed for some years, and which always yielded 
satisfactory results. This consisted, during the first days 
of the disease, of hourly doses of infusion of digitalis (1 in 
100), with aconite and tincture of iodine until a distinct 
effect on pulse was produced. With this he used perma- 
nent cold wrappings, quinine, or, according to circumstan- 
ces, salicylic acid in large doses; and, in cases of necessity, 
that is when the temperature remained over 104 deg. F., 
cold baths. Of these six one died— a girl set. 15— compli- 
cated with double pneumonia. The remaining cases were 
somewhat protracted, four to six weeks elapsing before 
convalescence was established. 

He claims far better results for an antiseptic, antipy- 
retic treatment, consisting of the administration of tmc. 
iodine and carbolic acid, according to necessity, with the 
addition of digitalis. His claims are given in these words: 
" The tongue assumed in none of the observed cases that 
dry, brown, hard and crusty surface which is usually a con- 
stant svmptom in severe cases; and the gastric symptoms 
subsided at the latest in the beginning of the second week, 
being followed by moderate appetite and a i -elmg of com- 
fort. The effect on the fever seems to take place sooner or 
later, between two and ten days, according to the intensity 
of the general symptoms." He takes from one to two 
grammes each of carbolic acid, rectified spirits and the 
tine, of iodine, to 120 grammes of water; of this mixture 



240 The Peoria Medical Monthly. 

the dose is one tablespoonful every hour, so that after two 
or three weeks' uninterrupted administration, tonic symp- 
toms always occurred. Quinine was not given in any case. 
Of the nineteen cases none terminated fatally. The cold 
wrappings were continued, in all cases for a few days, un- 
til temperature did not exceed 102.2 degs. F. permanently. 

" The advocates of the antipyretic treatment claim 
that under its use not only is the mortality greatly re- 
duced, but that the entire appearance and bearing of 
patients is such that the old picture of a typhoid fever 
patient is no longer to be seen, and that the disease has 
lost a great part of its terrors." Liebermeister informs us 
that in the hospital at Basle there were treated upon the 
expectant plan, between 1843 and 1864, 1,718 cases of 
typhoid fever; of these 469, or 27.3 per cent., proved fatal. 
From 1865 to September, 1866, there were treated under an 
antipyretic plan 982 patients ; of these 159, or 16.2 per 
cent., died. 

Between September, 1866, and 1872, there were treated 
by the antipjrretic plan systematically carried out 1,121 
cases; of these 92 or 8.2 per cent died. After the elimina- 
tion of certain errors he maintains that the mortality will 
not exceed 10 per cent. 

In the hospital at Kiel, the mortality under the anti- 
pyretic plan, as pursued by the Jurgensen, was 3.1 per cent.; 
that under the expectant i^lan, between 1850 and 1861, was 
15.4 per cent. 

In the Military Hospital at Stettin, under the antisep- 
tic plan, it was 4 per cent.; under the expectant plan 25.6 
per cent. 

Dr. Church, commenting upon the treatment of typhoid 
fever in St. Bartholomew's Hospital, remarks that the plan 
of treatment adopted there was generally expectant, and 
that the death-rate had fluctuated from 5.88 per centf in 
1860 to 31.11 per cent, in 1869, the whole mortality for 
twenty years being at a rate of 15.72 per cent. (Am. Jour. 
Med. ScL, Oct., 1882, p. 519). 

To these figures add the 7.4 per cent, of Brandt and we 
have from these sources, for antipyretic, an average mor- 
tality of 7.78 per cent., for the expectant 20.04 per cent. 

The systematic administration of certain drugs is a 
mode of treatment that some advocate. 

Dr. William Pepper advocates the administration of 
nitrate of silver in doses of 1-8 or 1-4 grain, usually in pill 
form, three or four times a day; if constipation exist com- 
bine with the silver belladonna; if looseness of bowels a 
small amount of opium. This plan of treatment has been 



Periscope. 241 

in vogue for no little time, for we read that Trousseau 
gives as much as one grain at a dose, combined with soap 
pill, every three or four hours; and Dr. Tweedie says of 
nitrate of silver: '' I have prescribed it extensively in 
enteric fever, and continued its use for a considerable time, 
and have never witnessed any approach to discoloration of 
skin." I regret that I can find no tabular statement of 
cases thus treated. 

Iodine has its advocates; some prefer iodid. potass., or 
a compound of iodine; others prefer Lugol's solution of 
tincture. 

Liebermeister, after using iodine in more than 200 
cases, d^es not speak very flatteringly of the results ob- 
tained, whilst Roberts Bartholow exalts its virtues, espe- 
cially when combined with carbolic acid. He prefers two 
drops tine, iodine with one drop carbolic acid, in this re- 
spect offering a treatment very similar to that of Rothe^ 
before referred to. 

Calomel has its adherents, at least mercury in some 
form, though its applicability seems to be limited to that 
period of the disease anterior to the ninth or twelfth day. 
The effect of blue pill on secretions is not overlooked by 
many, and they contend that it not only favorably influ- 
ences the course of the disease, but that it tends to shorten 
its duration. The effect of a mild mercurial purgative in 
lessening temperature, can be verified by many observers. 

Dr. James C. Wilson gives this table comparing the re- 
sults of treatment by iodine, calomel and non-specifically: 

Per Cent. 
Cases. Died. Mortality. 

By Iodine. 22'J 25 10.9 

By Calomel, 210 19 8.8 

]Son-Specifically, o35 47 13.2 

(Wilson OH Cont. Fever, p. 229). 

Owing to the hyper-alkalinity of the blood in con- 
tinued fever, some rely upon the administration of mineral 
acids, and trust entirely to them, except in the presence of 
symptoms which demand active and prompt measures. 
Many endorse the opinion of Dr. Flint when he suggests 
that the acids enter always into the treatment, inasmuch 
as they in nowise conflict with other therapeutic measures. 

The expectant or rational treatment of typhoid fever 
is very generally employed amongst us at the present time. 
Notwithstanding the diminished mortality claimed by the 
advocates of the antipyretic plan, its introduction has not 
been accomplished in Baltimore; certainly I am not aware 
of the fact if it is adopted in any of our hospitals or m 
private practice. 



242 The Peoria Medical Monthly. 

This plan of treatment calls for confidence on the part 
of the physician in his ability to meet the symptoms as 
they arise; for the disease being of definite duration, the 
sufferer must be assisted to pass through the successive 
stages of the fever before he regains his health. There are 
' no by-ways b}^ which he can escape from the course this 
disease must run. Great attention to the little things of 
medicine is required; the careful nursing, the well-regu- 
lated diet, cleanliness of bed and person, ventilation, all 
must receive a large share of attention. 

There are many who, with Jenner, hold the opinion:. 
*'If medicinal, in addition to hygienic, treatment is re- 
quired, it is because special symptoms, by their severity, 
tend directly or- indirectly to give an unfavorable course 
to the disease." 

"My experience," says Jenner, "has impressed me 
with the conviction that that man will be most successful 
in treating typhoid fever who watches its progress, not 
only with the most skilled and intelligent, but also with 
the most constant care, and gives unceasing attention to 
little things, and who, when jDrescribing an active remedy, 
weighs with the greatest accuracy the good intended to be 
effected against the evil the prescription may inflict, and 
then, if the possible evil be death, and the probable good 
short of the saving of life, holds his hand." 

The especial symptoms calling for medication are to 
be treated on common therapeutic principles. To begin 
the enumeration of them before this association would be 
unnecessaiy, also time would prohibit our entering upon 
anything like a detailed, accurate or satisfactory considera- 
tion of them. 

Before closing, however, it may not be amiss to state 
that, so far as I can see, the antipyretic plan of treatment 
can never be successfully carried out in private practice; 
occasionally we may find those able to procure an intelli- 
gent nurse capable of carrying out all the minutiae of the 
plan, for the watching of the temperature is as essential 
as the application of the cold affusion, pack, compress, 
sponging or bath, to the success of the treatment. 

The plan of treatment most generally adopted amongst 
us may be styled modified antipyretic, for the application 
of the sponging is in very common use. 

I think I am not alone in stating that quinine does not 
alwaj^s answer our expectations in reducing temperature. 
Salicylic acid, or some of* its salts, are objectionable to 
some stomachs; and again it at times acts as too great a 
depressor to the heart. 



Periscope. 243' 

The rules governing the administration of digitalis 
seem to be just the opposite of what would apply to or- 
ganic cardiac disease. In short, no disease requires more 
cautious medication. 

The diet enters largely into the consideration of treat- 
ment. Fluids should be given liberally; some say without 
stint. Milk is useful as nourishment and answers well to 
quench thirst; it may take the place of water, in a measure, 
but water should not be wholly withheld. Some prefer the 
mineral waters; some prefer water to be temperature of 
room, others iced; but at least fluids should be freely used, 
though care must be observed not to overload the stomach, 
therefore the amount at each time should be moderate. 

The place alcohol occupies in the diet or treatment of 
eteric fever is a subject sutticient to occupy one evening's 
discussion, yet I cannot refrain from protesting against 
that indiscriminate use of wines or stronger liquors that 
finds a place in the early treatment of the disease; from 
my opportunities to observe the benefits of its administra- 
tion, 1 unhesitatingly testify that wines and liquors in the 
vast majority of cases are uncalled for until the second 
week of the fever, and only then when the cardiac, or 
rather arterial pressure, is greatly diminished. As long as 
the pulse remains below 100 beats per minute, alcohol in 
any form is hardly ever indicated. The bulk and force of 
the pulse must be our guides; if they weaken more alcohol 
is needed. If restlessness supervene on the administration 
of stimulants, careful watching will very often convince us 
that less alcohol is needed. I have seen too large an al- 
lowance of wine prevent rather than induce sleep. 

Finally, it appears from the statistics presented in this 
paper, that the antipyretic treatment of typhoid fever gives 
a mortality within ten per cent (according to Liebermeis- 
ter, allowing for errors, etc., it will not exceed ten per 
cent.); the treatment by iodine a mortality of 10.9 per 
cent.; the treatment by a mild, judicious mercurial course, 
a mortality of 8.8 j)er cent, whilst a treatment non-specific 
in character yields 13.2 per cent, a mortality much less 
than the mortuary rate we were able to obtain for the ex- 
pectant plan which was 20.04 per cent. 

The plan pursued by Rothe of carbolic acid and iodine, 
with or without digitalis, was successful in the nineteen 
cases upon which he used the treatment, in not having one 
death against it, yet as he observes, the number of cases 
as yet so treated is too small to speak with the assurance 
that can only be had on further trial. 



244 The Peoria Medical Monthly. 

I have endeavored in presenting the treatment of ty- 
phoid fever, to avoid its symptomatic treatment though in- 
teresting and prolific in suggestions; I have contented, 
myself to produce the results of treatment, commenting on 
the methods only enough to make clear the plan producing 
the result that followed its mention. The many defects of 
this paper are easily seen. The limited and interrupted 
time at my disposal must atone, in a measure, for the mea- 
greness of statistics presented for your consideration. — 
Maryland Med. Jour. 



Cutaneous Erysipelas from Arnica. 

J. R., having a dislocated shoulder, used tincture of 
arnica upon his shoulder and arm. After a few applica- 
tions a violent inflammatory action set in, which had every 
characteristic of a cutaneous erysipelas. I had some hes- 
itancy in pronouncing it to be erysipelas, from the fact that 
I had not read of erysipelas from the use of arnica. I, 
however, ordered the arnica discontinued, and treated the 
case for erysipelas with satisfactory results. 

Shortly after noticing this case, my attention was 
called to an abstract in the Journal of Cutaneous and Vene- 
real Diseases, hova the U Union Medicale, re^OYting a sim- 
ilar case from the clinic of M. Laissus. The reporter cites 
authority which notes the irritating effect of arnica upon 
the skin, but has only found one author, Reddock, who has 
mentioned it as producing erysipelas. This authoritative 
report, coincident with my own case, leaves no doubt in 
my mind but that tincture of arnica is capable of, and fre- 
quently does cause, cutaneous erysipelas. 

The subject is of interest, and by careful observation, 
I doubt not but many cases might be discovered which will 
add to the literature of the subject.— /bV. Joseph Med. Her- 
ald. 



Iodoform Ointment. 



In the various reports upon the uses of iodoform, I 
have tailed to notice the use of iodoform ointmen^t in rheu- 
matism. For the past two years I have used this ointment, 
and having received such highly satisfactory results, feel it 
my duty to make mention thereof. In acute articular 
rheumatism, a local application which will relieve the lan- 
cinating pain and at the same time exert a curative effect 
upon the disease is greatly indicated. This local agent I 
have found in iodoform ointment. The usual prescription 
that I make is from forty to sixty grains of iodoform to 



Periscope. 245 

one ounce of vaseline, rubbed up well, and to be applied 
with friction every four or five hours. After several appli- 
cations a marked relief may be noticed. A few drops of 
oil ot clove or wintergreen rubbed into the ointment will 
mask the odor sufficiently.^;S'^. Joseph Med. Herald. 



Bismutli and Hydrastia in Gonorrhcea. 

Since the introduction of bismuth and hydrastia by 
one of our manufacturers, I have given it a trial in several 
cases. The instructions for the use of the preparations as 
an injection are one part to four parts of water. This I 
have found to be too strong, the best results being where I 
have used one drachm to four ounces. The following is the 
report from two cases: 

Case 1. — The patient suffered from a chronic gonor- 
rhoea, had had a discharge for about nine weeks. I placed 
him upon the following prescription: 



^ F. E. cubebse, 


1 ounce. 


Tr. ferri chlor, 


2 drachms. 


Spts. nitr, 


1 ounce. 


Syrupi, ad 


4 ounces. 


Dessertspoonful ter die. 





M. 8. 

With this I prescribed an injection of bismuth and hy- 
drastia one drachm to rose water four ounces. 

Four days later he reported the discharge disappeared. 
I, however, ordered him to continue the injection morning 
and night for a week, when he left it off altogether, and 
had no return of the malady. 

Case 2. — Was an acute attack of gonorrhoea. I placed 
him for four days upon the following prescription: 

5 Liquor potassse, 1 drachm. 

Mucilage acacise, 1 ounce. 

01. gaultherise, ss drachm. 

Syrupi, ad 4 ounces. 
M. S. Tablespoonful ter die. 

After the expiration of four days I prescribed the fol- 
lowing injection, to be used from four to six times daily: 

3 Bismuthi et hydrastige, 1 ounce, 

Aquse rosse, 8 drachms. 

M. S. As directed. 

The discharge diminished slightly with this treatment, 
but did not cease. I then concluded to try the remedy 
still weaker, and made the prescription two tlrachms to 
eight ounces. With this prescription the discharge stead- 
ily decreased, and in four or five days ceased entirely. 
After the cessation of the discharge I ordered the injection 
to be continued twice a day for about a week, and believe 



246 The Peoria Medical Monthly. 

this a wise precaution to take with all injections. I have- 
used the preparation in a number of other cases, and am 
well pleased with the results. — St. Joseph Medical Heralds 



Salicylic Acid in Ringworm. 

In a number of cases of ringworm which I have 
treated lately I have had excellent results from an oint- 
ment of salicylic acid. In two chronic cases of two or 
three years' standing, the rapid disappearance of the dis- 
ease was astonishing. In acute cases an ointment consist- 
ing of five grains of salicylic acid to one ounce of vaseline, 
has been the most satisfactory^ proportion. In cases of 
longer standing from ten to fifteen grains may be used. If 
used too strong it produces quite an inflammation and con- 
siderable discomfort. I had never seen it recommended, 
but was led to its use by its anti-parasitic properties. Its 
simplicity is in its favor, and a fair trial, I think, will give 
satisfactory results. — St. Joseph Med. Herald. 



%Mx)X(t §e^Mmtnt, 



CONDUCTED BY DR. 0. B. WILL, PEORIA, ILL. 



Long- Retention of tlie Placenta After Abortion. 

A subject of considerable interest to general practi- 
tioners is brought to mind by Dr. S. L. Jepson, of Wheeling, 
West Virginia, in the American Journal of Obstetrics for 
October. The doctor cites a couple of cases of long-re- 
tained placenta, after abortion, one for 115 and the other 
for 66 days. In both cases the patients had regained, in 
great measure, their usual health, with the exception, after 
a time, of occasional bleedings, and finally profuse hemor- 
rhages, which led to an artificial dilatation of the uteri and 
the discovery of the placentae firmly adherent to the 
uterine surfaces. The adherent organs were detached with 
much diflSculty, presenting a healthy condition, and re- 
covery of health followed in both instances. The editor,. 
Dr. Munde, adds in a foot note — the following: "The de- 
terioration of health, firm attachment of the placenta, and 
final necessity for removing it instrumentally, in both these 
cases, seem to us the best corroborative evidence in favor 
of immediate removal of the placenta after every abortion. 
That the placenta was firmly attached in these two cases 
was fortunate, as the decomposition of a partly detached 



Abstract Department. 247 

portioD would probably have soon produced septic infec- 
tion." 

In this connection the writer desires to state that a 
couple of years since he had under his observation a case 
in which the placenta was retained for a period of forty- 
eight days after an abortion at three months. The patient 
and her friends insisted at the time that the "after-birth 
and everything" had come away, although a search was 
made where the vessels had been emptied, without satis- 
factory result. The patient, however, became free from 
pain, bleeding ceased, and for a month she went about her 
household duties as usual. At the end of that time, how- 
ever, profuse hemorrhages came on, continued with vary- 
ing severity for a week or two, when, under the use of 
ergot and the faradic current, the mass came away, pre- 
senting little it any evidence of decomposition. The pro- 
gress of the case though was not very encouraging for 
some time, the patient suffering from repeated bleedings, 
and pelvic weakness and distress for three months or more, 
after which her condition began to improve and she finally 
regained her health. 

The histories of such cases undoubtedly indicate the 
necessity for careful investigation in all instances of abor- 
tion, in order to be fully satisfied that no cause remains for 
future trouble. 



Abscesses of the Neck, 

In the American Jour, of the Med. Scioices for October 
there is a very interesting article- by John M. Lidell, A. M., 
M. D., of New York, upon " certain abscesses of the neck 
which may cause sudden death, and how to treat them 
with success." The writer gives a detailed history of sev- 
eral fatal and non-fatal cases, in illustration, and one espec- 
ially of the former class, in which death ensued in a few 
hours subsequent to examination from asphyxia due to 
spasm of the glottis from irritation of the recurrent' laryn- 
geal nerve by the accumulation of matter, no specially 
distressing symptoms being presented up to within a few 
minutes of death. 

Examples of very sudden death from abscesses in this 
region are numerous, and Dr. Lidell urges upon the pro- 
fession the necessity for a painstaking diagnosis and prompt 
relief by an early evacuation of the pus. He considers 
that the rules governing the management of abscesses in 
general are not applicable to those occurring in the neck. 
The peculiar character and arrangement of the structures 



248 The Peoria Medical Monthly. 

of the cervical region render gatherings there unusually 
damaging and uncertain in eft'ect. The numerous layers 
of dense fascia, and muscular structures with the inter- 
vening cellular tissue, determine the tendency of matter to 
burrow downwards and, latterly, literally dissecting the 
parts from each other, and with little probability of dis- 
charge without the aid of a surgeon. Death in these cases 
frequently occurs when least anticipated, through asphyxia 
from involvement of nerve, causing spasm of glottis, or 
from gradual encroachment by excessive accumulation. 
In discussing a fatal case given in illustration, the writer 
continues: "It is quite possible that I had myself unwit- 
tingly aided to hasten the occurrence of this unhappy ter- 
mination of the case by applying that very moderate 
degree of pressure to the swelling which it was necessary 
to use in order to determine the nature thereof, for such 
an application of force would manifestly promote in a cor- 
responding degree the purulent diffusion just described. I 
make particular mention of this point because the calami- 
tous result of this case clearly shows that whenever the 
surgeon has to examine cervical abscesses of a similar char- 
acter he must always be prepared to lay them open and 
discharge their contents on the spot, whether any symp- 
toms of impending suffocation be already present or not." 
And further: " Enough has been said to clearly show that 
the earlier all deep-seated abscesses of the neck are laid 
open and evacuated the better for both patient and sur- 
geon. And wheresoever, in such cases, the abscess may 
form, the plan of treatment is always the same. As soon 
as fluctuation is discovered the surgeon must proceed with- 
out delay to discharge the matter by making suitable in- 
cision in order that the abscess may not spread downward 
into the cavity, nor burst into any part essential to life; 
nor suddenly cause death by asphyxia." 

In this connection the writer mentions retropharyngeal 
and tonsillar abscesses as closely akin to deep-seated cer- 
vical abscesses in general, and requiring often times equally 
prompt treatment. 

In speaking of hemorrhage occasionally following the 
opening of an abscess, he says: " It is not improbable that 
in some, perhaps in most, of the cases in which the punc- 
turing of a tonsillary abscess is said to have been attended 
with a fatal or a very dangerous hemorrhage, the loss of 
blood has in reality been caused by an erosion of the 
tunics of the bleeding vessel effected by the abscess itself, 
•and not by any wound of the tunics inflicted by the sur- 



Abstea^t Department. 249 

geon's knife." He deprecates the use of the lancet in the 
careless manner described by a writer in Holmes' Surgery, 
and thinks that the recommendation to "plunge the instru- 
ment rapidly and boldly through the different tissues" 
should not be followed in the case of abscesses of the neck, 
but, on the contrary, a careful dissection be made to reach 
the most dependent part of the collection, without running 
the risk of injury to vital parts, if possible to avoid it. 



Antipyretic Effect of Carbolic Acid. 

'A paper by Dr. John S. Lynch {Trans. Med. and Chir- 
ifrgical Faculty of Maryland) calls attention to the effect 
of this agent in lowering temperature. In his earlier ex- 
periments he gave but three drops of the liquid acid, and 
gradually increased to four and five drops every two or 
three hours. From this dose he has never seen any toxic 
symptoms arise. 

Latterly he is in the habit of combining five drops of 
the tincture of aconite root to each dose, and this he gives 
in all cases of fever attended with a frequent pulse. His 
formula is as follows: 

5 Acid carbolic, 1 drachm. 

Tr. aconite rad., % drachm. 

Glycerine, q. s. ad., \% ounces. M. 

Large teaspoonful every two, three, or four hours, according to the temper- 
ature. 

He considers this combination the most certain anti- 
pyretic with which he is acquainted, except the cold bath. 
In those cases in which quinine fails to control the temper- 
ature, carbolic acid is most effectual and reliable. 

" In enteric or typhoid fever, it seems especially appli- 
cable. Not only does it keep down the temperature nearly 
to the normal, but it seems to prevent the diarrhoea and 
tympanites, deprives the foecal discharges of the foetid 
smell so charactertistic, and, most important of all, pre- 
vents entirely the secondary fever which so often protracts 
the disease through many weeks and finally destroys the 
life ot the patient through sheer exhaustion." 

In septic fevers the acid is considered far superior in 
certainty and energy to quinine. The paper concludes with 
the following paragraph: 

The absence of disagreeable taste, the greater cheap- 
ness, and the entire absence of irritating effect upon the 
stomach and other organs of digestion, and its equal cer- 
tainty of effect, give to this remedy infinite advantages 
over quinine. While the latter drug is extremely nauseous 



250 The Peoria Medical Monthly. 

and almost sure sooner or later to excite nausea and anor- 
exia, and sometimes diarrhoea, carbolic acid on the con- 
trary cures nausea when present, never excites it when ab- 
sent, promotes appetite and digestion, and by its antiseptic 
action prevents foecal decomposition, and the sopor^mic or 
stercoraBmic fevers which so often complicate and increase 
the danger from all diseases attended with a protracted el- 
evation of temperature." 



The Treatment of Hodg-kin's Disease. 

After detailing some cases in the American Practitioner, 
Dr. J. C. Mackenzie thus concludes: 

" The treatment in these cases which 1 have reported 
seems to have been quite ineffectual. Such has been the 
result generally, for, though under certain plans of medi- 
cation, cases have recovered, yet these same means em- 
ployed by other physicians have been found utterly useless. 
In estimating the value of any line of treatment in this 
affection, it should be recollected that in some cases, even 
when under no treatment, there will be protracted periods 
when the pathological process seems to be quiescent, and 
there may be improvement, as indicated by diminution in 
the size of the glands and a better condition of nutrition of 
the body generally, but after a time the disease resumes 
its course and the patients succumb; so that before any 
favorable conclusion can be arrived at as to the beneficial 
influence of any course of management, the case should 
have been under observation for some length of time. We 
may therefore conclude that while some cases of cure have 
been reported under the action of phosphorus, arsenic, 
iodine, various mineral baths, etc., these are isolated cases, 
and in the vast majority of patients afflicted with this dis- 
ease, the progress is steadily toward a fatal termination, 
uninfluenced by the various measures adopted for their re- 
lief." 



The Treatment of Insomnia. 

Dr. Thomas Legare, of Charleston, read a paper on this 
subject before the South Carolina Medical Association, at 
its last session (Transactions), which concludes as follows: 

First. Retire early to bed; two hours' sound sleep be- 
fore midnight are of more benefit to the body than double 
the number of hours in the day. 

Second. Eat little, and always some hours before go- 
ing to bed; cold food only should be taken for supper. 



m 



Abstract Department. 251 

Third. The cares and burdens of the mind must be 
put aside; none should be carried to bed with us. Never 
read or study m bed. 

Fourth. Our bed-chamber should contain pure, sound 
air, and should be roomy and high if possible, and the win- 
dows should be always kept open, except in the night time. 

Fifth. When in bed, endeavor to lie horizontally, with 
the head slightly raised. If there is any forced or con- 
strained posture, making the body form an angle, circula- 
tion in the stomach is checked, and a free and uninter- 
rupted circulation of the blood is defeated. 

Sixth. It is improper to have a light burning in the 
bed-chamber during the night; our senses should not be 
acted upon by external impressions. 

Lastly. Endeavor to sleep not less than six, nor more 
than eight hours in the twenty-four; and we would en- 
dorse the well-known motto — 

"To go early to bed, and eai'ly to rise, 

Will make a man healthy, wealthy and wise." 



How to Examine the Insane. 

In the Amer. Journal of Neurology and Psychiatry for 
May, 1883, Dr. E. C. Spitzka concludes an article on this 
subject with the following wise advice: 

" In his demeanor toward all patients, the examiner 
should be gentle, yet firm. He will find the skill of a 
cross-examining lawyer or of a detective very useful, par- 
ticularly in his inquiries of members of the family in 
whose statements the truth is sometimes difficult to win- 
now from the fancies of the laity; but his behavior should 
never approach that of the members of either of these pro- 
fessions. There is a popular delusion that the human eye 
has an influence over the insane similar to that claimed 
for the same organ over wild animals; a delusion that the 
writer has known the insane themselves to ridicule, and 
which he who attempts to utilize will learn to recognize 
the absurdity of at the first attempt. An overbeanng, 
haughty demeanor, a patronizing, condescending air, and 
fidgetiness, are all equally to be deprecated, because they 
will all equally tend to defeat the purposes of an inquiry. 
He who has the characteristics necessary to constitute a 
member of a learned profession will require no stage effects 
to aid in the accomplishment of a serious inquiry; he 
needs but to act perfectly naturally, that is, with earnest- 
ness and scientific purpose." 



rrnE 



Peoria Medical Monthly. 



THOS. M. MelLVAINE, A. M., M. D., 

Editor and Publisher, 

a04 South-Jefferson Street, .... PEORIA, ILL. 

*»*The Editor is not responsible for the statements or opinions of contributors 

***Short original articles are invited from any reader, whether a subscriber or not. 

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the article is sent in to the Editor. 

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***To subscribers ! A pencil mark at this place indicates that the time of your s ub- 
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^^it0rial gtprtmetjt. 



Personalities in Medical Controversy. 

The disagreements between physicians have afforded a 
fruitful theme for many a pungent paragraph in the secu- 
lar press, and many anecdotes are passed from mouth to 
mouth, amusing, it is true, but none the less disgraceful. 
Doctors differ, and it is easy to account|for differences in 
opinion, but when these differences are- so bitterly carried 
out,^even to the point of making personal enemies, it is 
time to call a halt. Without doubt the alliterative ex- 
pression '' Doctors do differ," and the other, "When doctors 
disagree who shall decide?" have had as great an influence 
as any other in causing the medical profession to be re- 
garded with contumely by a large class of people.^; In the 
heat of a discussion many expressions may be excused, but 
when the controversy is carried on through the medium of 
the medical press " such things ought not to be." 

Every man has a right to his opinions and a right to 
be heard, if his opinions are erroneous, his errors should 
be pointed out, and his argument refuted, but it is not ar- 
gument to ridicule and deride an opponent. A discussion 
on the subject of Diphtheria has been running through 
several numbers of this journal and it well illustrates our 
meaning. If differences in the consultation room have such 



Editorial Department. 25^ 

disastrous effect upon the standing of the profession, how 
much more would printed animosities tend to lower its es- 
timation in the eyes of any who might chance to read 
them. We propose to give every man a fair, impartial 
hearing in our pages, but we must ask our correspondents 
to be more fair towards each other than some of them 
have been in the past. 



Notes aud News Items. 

Doctors seem to have a hard time of it lately. There 
is seldom an issue of the large daily papers that does not 
contain a notice that Dr. Somebody has been killed, or shot 
at, or poisoned or killed, or shot at or poisoned somebody 
else; or has been arrested for malpractice, or suicided. 
The reason for this is, we suppose, the practical application 
of the law of the survival of the fittest. Doctors are be- 
coming so numerous that something has to be done. 

We learn through a friend of the death of Dr. Ph. D» 
Shunk, of Ulysses, Neb., Sept. 27, 1883. Dr. S. was a grad- 
uate of Rush Medical College, and was held in high esteem 
by all acquaintances. The cause of death was "billions 
fever." 

We have received cards for the wedding of our very 
good friend, Dr. R. A. Kerr, (Rush '81) now located at Dun- 
lap, 111. The bride is Miss Grant, of French Grove, 111.^ 
and the happy event is set for Tuesday evening, Oct. 16,. 
1883. We have always thought that a doctor deserved all 
the good things that kind fortune can bestow, and are 
pleased that friend Kerr is about to get the best of all good 
things — a good wife. May equal fortune follow them both 
through a long and happy life. 

The Saturday Evening Call, of this city, and one of the 
best family papers we know of anywhere, has announced 
that after the expiration of existing contracts, no more 
patent medicine advertisements will be received upon any 
terms. This action of a secular paper should cause a blush 
on the faces of the editors of religious papers whose col- 
umns are filled with ihese alluring snares for the deception. 



■^54 The Peoeia Medical Monthly. 

of the sick and afflicted. We are glad the Call has taken 
this step, and hope that its circulation will show such a 
Tapid increase that others will be induced to follow. 

The Atlantic Journal of Medicine is the latest "new 
medical journal" to reach our desk. It is published at 
Richmond, Va., and is edited and published by Drs. Stover 
and Houston. No. I contains 76 pages. It is monthly, 
and the price is $3.00 in advance. 

We hope it will meet with abundant success. 

The Journal of the American Medical Association has a 
department called medical progress. So far all right, but 
we beg to ask whether there is no progress made in Amer- 
ica in the healing art? We are led to ask this question 
from the fact that in the last number (Oct. 6} the medical 
progress department contains eleven articles, and of these 
eleven, all — no more, no less — are taken from foreign sour- 
ces, British, German, French, but nothing from America. 
Is there nothing in the Record, News, Boston Med. Journal, 
Reporter, Lancet and Clinic, Courier, and a large number of 
our first-class journals that is worthy to be 'placed under 
the heading of medical progress, or is this progress con- 
fined to the old world? 

Dr. J. W. Chamberlin (Rush, '82) writes us from Lon- 
-don, where he is attending the Royal London Ophthalmic 
Hospital. He intends remaining there for six or eight 
months, after which he will go to Vienna and Berlin. He 
is in good health and spirits, and is much pleased with the 
advantages found in London for the pursuit of the study of 
his specialty. 

The unpleasant delay in mailing the September num- 
ber of this journal was occasioned by the non-arrival of 
our cover paper from the factory. We waited as long as 
possible, and finally had to substitute another color. We 
dislike to change the outward appearance of the journal, 
.so waited longer, perhaps, than we should have done. 

We have a number of Vols. 11 and III, bound in a good 
library style, which we will send, post^pard, to subscribers, 
for the nominal sum of $1.00 eaah— a very little more than 



I 



Editorial Department. 255 

the cost of binding. New subscribers can also be accom- 
modated as long as the stock lasts. Please send in your 
orders soon. 

Under the head of Correspondence appears a letter ex- 
honorating Dr. J. E. Harper from any charge of breach of 
medical ethics which might be based upon the " Hand-bill " 
printed in our September issue. Dr. Harper affirms that he 
did not know of the existence of the " dodger " until he saw 
it in this Journal, and we believe him. We are pleased to 
be thus able to refute any attacks upon Dr. H.'s profes- 
sional character, a«d hope that J. B. Findley will have 
sufficient wisdom given him before he receives his diploma 
to cause him in the future to refrain from even ignorantly 
doing anything unprofessional or unkind. Had he been 
Dr. Harper's most bitter enemy he could not have done him 
a greater injury in the eyes of the reputable medical pro- 
fession. 

It has been suggested by a friend that the subject of 
Acute Tonsillitis be taken as the question for our Novem- 
ber number. The time of the year in which attacks of this 
unpleasant disease are most to be met with, is at hand, and 
we are sure that practical suggestions from a large number 
of correspondents will j^rove interesting and valuable. By 
all means let us have a full reply. Several replies on Fol- 
licular Phanyngitis have been received too late for this 
number. 

The death ot Dr. Charles H. Crane, Surgeon-General U. S. 
A., was announced a day or two ago. We have not yet 
seen any particulars. 

Quite a number of renewals have become due in the 
last few months. Notices have not yet been sent out, but 
we hope that anyone knowing himself indebted to this 
journal will remember that printers' bills wust he paid, — 
and govern himself accordingly. 



Errata. 

A mistake was made in the article of Dr. F. L. Hins- 
dale ( Sept. number^ page 205) which should be corrected. 



256 The Peoria Medical Monthly. 

although it is obvious. The iDrescription of opium and 
lead should be made into ten powders instead of one, as 
might be inferred from the " Fiat pulv." 

The mistake is our own, and Dr. H. should not be held 
accountable for it. 



Receipts. 

Ohio — Drs. M. M. Benschoter, W. M. Lucas, Frank Scott 

Indiana— Drs. S. H. Brittain, Jos. H. Omo. E. W. DePew, J. G. 
Stuart & Son, D, J. Shurley, M. L. Humston. 

Arkansas — Drs. J. O. A. Sullivan, A. S.«Gibbs, A. J. Marberry,. 
Thos, Stevenson, G. Norsworthy, R. M. Osborn. 

Texas — Drs. G. L. Roberts, E. Mussina, J. N. DeVine. 

Iowa — Drs. J. O. Mote, G. M. Ellis, G. N. Skinner (two years). 

Illinois— Drs. C. True, H. W. Newett, H. J. Rice. 

Wisconsin — Drs. J. J. Sherman, J. G. Meacbam. 



For Sale. 



Physician's property in Manito, 111., a thriving village on Wabash 
railway ; population about 450 ; agricultural district ; good school and 
churches. Property consists of two lots, good house, six rooms, good 
barn and necessary outbuildings, and full variety of small fruits. Prac-^ 
tice amounts to from S2,500 to S3,500 per atiUum. Cause for selling, 
health requires change of climate. Price $1,700. "Address, J. R. Mc- 
Cluggage, Manito, 111. 

Dr. McAkthur's Compound Syrup of Hypophisphites is receiving 
the highest commendation of prominent physicians who have used it. 
The care with which it is prepared and the purity of the ingredients 
doubtless contribute to this result. 

Celerina is a combination of drugs which meets all the require- 
ments of a first-class prescription ; it is efficient, agreeable and safe, I 
have used it in two cases of neurasthenia, with highly satisfactory results, 
and shall give it still further trial. H. A. Cottell, M. D., 

Demonstrator of Anatomy, IMicroscopy, and Medical Chemistry^ 
University of Louisville, Medical Department. 

# 

in a recent number of the Obstetric Gazette George J. Engleman, 
M. D., says : " In a sick-room, especially the lying-in chamber, Listerine 
answers a most excellent purpose as a disinfectant, purifying the atmos- 
phere and removing the offensive odor without substituting one almost 
equally disagreeable, as is the case with many of the remedies in use. 
As a mouth-wash, properly diluted, it is reliable and agreeable ; diluted 
with water or glycerine it speedily corrects certain fermentative forms of 
uidigestion, and is of more or less service in the catarrhal conditions of 
all mucous membranes. 



The Peoria 
MEDICAL MONTHLY. 



Vol. IV. NOVEMBER, 1883. No. 7. 



©rigiual a^ommuttiatian^. 



Ant I.— The Treatment cf Piles. By Wm. H. Vbatch, M. D., Carthage, 111. 

Since the publication of my articles on this subject in 
the July and August numbers of the Monthly, I have been 
xjompletely overwhelmed with letters from members of the 
profession — representing ten states — asking for more light 
-on the subject of the treatment of piles. These missiles 
were so numerous that I found t-o answer them personally 
would be too great a tax on my time, so I concluded to 
answer them all through the columns of the Monthly. 

I have received no communication taking issue with 
my theory or plan of treatment, but in the October number 
of the Monthly Dr. Allen, of Jersey ville, who opened such 
a vigorous bombardment of our works in May last, and who 
claimed to have routed the whole camp of the hypodermic 
army, has been heard from again. This time he shows no 
disposition to renew the battle, according to the estab- 
lished rules of honorable warfare, but has undertaken the 
bushwhacking plan. 

■ His article is really amusing, and at the same time 
supremely ridiculous. What he is pleased to call his " criti- 
cism " causes much such feelings as were aroused in the 
"bosom of a young lass whose passionate lover stood before 
lier with hands clasped and eyes glistening with emotion, 
liis whole frame trembling, as he said: "Susanner, only 



258 The Peoria Medical Monthly. 

think! I have soared around like a lone trochilus, flitting- 
from flower to flower, from sweet to sweet, and at last have 
presented myself before a blushing rose, from which I hope 
to draw my life-Ion/;]^ sustenance. If I could but convince 
you that you are my only teraphine I would assume the 
pinions of the oriental zephyrs of the bereal pole, and 
pluck the last feather from the sheltering wing ot the noble 
bird of personal liberty, as he sits perched on the topmost 
branch of the magnificent gum tree from which I draw my 
daily subsistance." 

" Susanner, to gain one smile from your ruby lips, and 
realize that the firmamental azure of your lustrous orbs is 
fixed on so insignificant a thing as me, I would pass through 
flood and flame, and even penetrate pandemonium. Yes, I 

would shed would shed w-o-u-l-d — s-h-e-d " 

" Never mind the wood-shed," said she, " go on with your 
pretty talk." 

The doctor, in his extreme anxiety to make a " point," 
pretends to quote me, and in the twenty-eighth line he 
quotes he makes only twenty-two mutilations in wording 
and punctuation, putting periods in the middle of sentences 
and supplying the w^ord "haven't" for "having" and 
"would" for "could," and many other mutilations un- 
worthy fair and honest disputation. 

One is reminded of the lines of Swift: 

" A strong dilemma in a desperate case, 
To act witli infamy, or quit the place." 

The principal interrogatories of these many corres- 
pondents asking for information on this subject may be 
found below, with my answers attached to each. If I have 
overlooked none, they appear in the following order: 

Question. What is your mode of examination in piles? 

Answer. ICconfine myself to two principal modes of 
examination. 1st. The knee-breast position of the patient,, 
placed on a table two by six feet, well cushioned. My 
stand is taken on the left side of the patient. Pressing the 
nates apart will reveal any external tumors which exist; 
or the finger may be introduced through the sphincter ani 
to explore for internal tumors. 2d. I place the patient oa 
the table, on the left side, the limbs flexed on the body, the 



Original Communications. >^^ 

right limb being drawn higher than the left, with the knee 
resting on the table; then make the examination as before. 

Q. Do you regard internal and external piles of the 
same nature, and requiring the same treatment? 

A. Yes, Piles originate from a common cause; i.e.^ 
obstruction of the hemorrhoidal veins, therefore they are 
of the same nature and may be cured by the same treat- 
ment. 

Q. What make of syringe do you use? 

A. The ordinary hypodermic syringe of Tiemann & 
Co. is the one I have always used. 

Q. How do you manage the needle? At what point 
do you deposit the remedy, at the apex, center or base of 
the tumor? 

A. The management of the needle is an easy matter 
when your patient is in proper position and the tumors 
properly exposed. Use due caution in filling the syringe; 
see that no air is left in the barrel; insinuate the needle 
gently into the tumor at any point from which you can 
most easily reach the sack, or center ot the tumor. I have 
sometimes thought I have had better results from deposit- 
ing the remedy at the base of the tumors, but in so doing 
I am aware that I risk depositing the fluid in the cellular 
tissue beyond the hemorrhoidal tumor, or in an unob- 
structed vessel beyond the limits of the tumor. In such an 
event I can easily see how we might realize Dr. Allen's 
fears of embolism. The safest plan, therefore, is to pierce 
the tumor at its apex or center. 

Q. What is the strength of your solution? 

A. I have used all strengths, from equal parts of car- 
bolic acid and water (See report of Typical Case No. 4 in 
August number of Monthly) to that of only five per cent, 
of acid, and have had good results from all; but as a rule I 
use a twenty-five per cent, solution. Patients will bear 
this strength as a rule without complaining. 

Q. Do you use any other than carbolic acid solution 
in the treatment of piles? 

A. Yes; I have used tr. iodine, sol. sub. sulph. ferri^ 
tr. ferri chlor. sol. plumbi acetat, sol. zinci sulph. and sim- 



-^0 The Peoria Medical Monthly. 

pie cold water. Anything that will coagulate the blood. 
Several of the above act more promptly in that way than 
carbolic acid, but my experience is in favor of the acid on 
account of the readiness with which absorption takes place 
after its use. A little alcohol thrown into the tumor after 
the coagulum has formed will assist absorption. 

Q. What is the exact formula which you have found 
most suitable, and least painful in the treatment of both 
internal and external piles? 

A. 

Acid carbolic. 

Glycerini aa. 1 fi; ounce. 

Morphinae sulph. 8 grains. 

AquEB dist. 2 1. ounces. 

M. Sig. Inject from five to ten drops into each tumor once in two weeks. 

Q. Do you inject more than one tumor at each treat- 
ment? 

A. In nervous persons, who are easily hurt, and com- 
plain of very slight causes of pain, I inject but one at a 
time. But frequently I inject all at once, if there are half a 
dozen, (as in case*]S[o. 2 in report of typical cases.) 

Q. What is the difference in pain in internal and ex- 
ternal piles? 

A. External tumors are always much more painful 
■ under the operation, and are much longer being absorbed. 

Q. Do you ever have ulceration follow the injection 
of carbolic acid. 

A. Occasionally tumors suppurate and discharge con- 
siderable quantities of pus, just as they frequently do with- 
out an operation of any kind; but these pus sacks usually 
granulate and heal with but little difficulty. 

Q. How long does it take to cure a case of piles, 
either internal or external? 

A. I give great latitude in this regard. They have 
run all the way from five days to five months. A great 
deal depends on the length of time the tumors have existed. 

Q. Do the tumors ever return after being cured by 
your plan? 

A. No. When the tumor is once cured the vein at 
that point is obliterated and cannot fill again; but obliter- 
ating the vein at one point will not prevent a tumor from 
forming in any other part of the vein. 



Original Communications. 261 

Q. What length of time do patients suffer after treat- 
ment? 

A. This depends in a great degree on the condition of 
the tumor, the sensitiveness of the patient, and the strength 
of the solution used. Ordinarily the first twelve hours puts 
an end to the pain, i. e., the pain consequent upon the treat- 
ment. 

Q. What instruments are necessary for the successful 
examination and treatment of piles? 

A. The finger and the eye are all you want for an ex- 
amination of any case. A two-valve speculum, a tenacu- 
lum and scissors, a camel's hair pencil and a sponge are all 
the instruments you will require, beside your syringe to 
treat any case of true hemorrhoids. 

Q. Can you cure piles and allow your patient to go 
about their ordinary work? 

A. I can now call to mind only two cases who went 
to bed in consequence of the treatment. Almost all say 
that the pain of treatment is not to be compared to the 
pain they have suffered during the inflammatory stage of 
the recently filled tumors. 

These are the principal questions I have been able 
to cull from the mass of letters I have received, and 
I have to regret that my space will not allow me to enter 
more fully into the discussion of the various topics pre- 
sented by my correspondents. 

Now I will say to one and all, that the disease is to be 
treated as all other diseases must be, by the expenditure of 
a good proportion of common sense, and if one does not 
understand it he had better keep hands off. Always re- 
member Prof. Andrews' admonition, "This nor no other 
plan is exempt from danger when practiced by ignorant 
men." 

First, understand the nature of the parts diseased. 
Second, understand the disease you are attempting to cure. 
Third, understand the nature of the remedy you are mak- 
ing use of; and fourth, understand how to apply them. 
With these simple rules in view one can scarcely do harm. 



262 The Peoria Medical Monthly. 

Art. II.— Methods of Practice. By C B. Maclay, M. D., Delavan, 111. 

The remark is often made that such and such a pre^ 
scription, or such and such a mode of treatment, is empiric 
cal. It is also often said, with great lamentation, that- 
medicine is not a science, and we are requested to brandish 
the microscope, apply the thermometer, conduct our analy- 
sis, and hurry up the cakes generally to completion of some 
grand discover}^, that demonstration may result, and diag- 
nosis, prognosis and treatment may be as exact as the mul- 
tiplication table. We forget that this has already been 
accomplished by our little-pill brethren with such success 
that if a regular can furnish the diagnosis, they can " simi- 
lia" him to a dead certainty. People will doubt, however, 
and shut their eyes to the proofs. To some of us it seems 
unnecessary to absolutely know how or why certain changes 
occur, or to be able without fail to bring about any desired 
condition, in order to believe that medicine, so-called, is a 
science. When we have discovered that a certain material 
used in a remedial way, or a certain method has been ob- 
served, and the results have been decidedly beneficial, we 
may truly declare our treatment to have been scientific. 
The mathematics are not a science, simply because they 
deal in exact methods and sure results or manifest demon- 
strations. The natural sciences are truly named, and yet 
the causes or forces at work, whose results are evident, may 
remain entirely unknown. We hear men say that when 
medicine becomes a science such and such a method of 
treatment shall be pursued, and the results shall be certain 
and the consequences uniform. Surely these hopes are 
illusory, and the predictions shall prove altogether unsatis- 
factory. When we have made ourselves thorough anatom- 
ists and physiologists, we doubtless more clearly than ever 
shall see what innumerable modifications consist in the 
human constitution. As in the ever-changing vegetable 
constructions, so in all mineral tissues there is endless var- 
iation of fibre and form as to quality and quantity, giving 
rise to special endowments, and we soon come to recognize 
in the dominion of the nervous system or systems that tha 
variety of temperaments is without number. As to any 



Original Communications. 263 

aJbsolute body, every graiu of solid or drop of liquid added 
•gives new form and new quality, so it can not be otherwise 
but impossible to draw any schedule, or lay down any arbi- 
trary rule, by which to prescribe any supposed remedy. 
When it is discovered that a certain substance has certain 
therapeutic qualities, and acts with uniformity on one's 
own system, we can not rush out and administer the same 
to others with implicit confidence, but must expect ever- 
varying results, due mainly to diversity of nerve endow- 
ment. What does the practitioner do in this dilemma? Of 
course there must be some experiment, but he soon learns 
to classify, and, wide-awake to the peculiarities of manner, 
form and feature, he is ready to modify as demand requires. 
He perceives the folly of concocting compounds for general 
use, and in his office repose no reservoirs of some "favorite 
prescription." Indeed, the man of observation studies and 
learns to know the peculiarities of his patients as readily 
as the artist the diversity of natural forms and color. Ap- 
parently trifling appearances have a great significance for 
him, and what might pass unnoticed by friends, prove reli- 
able guides in diagnosis and treatment. The man of quick 
perception is likely to be a man of prompt action and ample 
resources. The learned prescription, or abstruse formula, 
or techinal ponderous phrase, cuts a very small figure in his 
make-up. The men who are so loud in calling for mathe- 
matical demonstration are those who generally "load for 
bear," or at least use the shot-gun prescription. When the 
icteric tinge prevails, blue mass; when the tongue is dry, 
calomel. This is what is called science, for the reason that 
immediate results can be foretold! Anxious relatives want 
to see a change, or to know that the medicine did "what 
the doctor said it would." But doctors differ, and they 
shall always do so, for the very good reason that, as no two 
pairs of eyes see exactly alike, so no two minds think ex- 
actly alike. Different conclusions may be drawn from the 
same premises and yet be both in a measure correct. The 
great objection to many consultations lies in the fact that 
if the opinions agree as to diagnosis, they differ as to treat- 
ment, and if the first physician called wishes to retain his 
hold he must superintend another man's method, or the 



264 The Peoria Medical Monthly. 

second man after forming what he esteems a correct judg- 
ment, must be content to endorse the other's plans. In a 
consultation it very seldom happens that the results are 
satisfactory unless one or the other party yields entirely. 
Too often consultations are made a theater for the glory of 
the consultants and bode little good to the patient. Yet 
when there can be a free and unreserved comparison of 
viev7S, a consultation is not a bad thing. It is a pity tliat 
personal ambition is too apt to mar the harmony betv^een 
or at least restrain confidential intercourse of practitioners. 
Medical etiquette is a good thing to talk about, but it is to 
be feared very seldom observed in the spirit, and Hot very 
often in the letter. There are very good reasons for this 
state of affairs, since the annual floods of our medical 
schools are transforming M. D.'s into bread winners. But 
to return. Among many methods one must be the best, 
and he the lucky man that pursues it, very often it is the 
simplest, the very simplest, and a good deal of fortitude is 
required to persevere in its use and reach ultimate success. 
Perhaps the practitioner may feel sorry when he looks 
through the well-filled shelves of the drug store and seeing 
so many articles whose fame pervades the earth, realizes 
his neglect of these vaunted remedies; he consoles himself 
however, with the thought that he has saved so much for 
others who pursue the longer and the more honored way. 
As he drives through woodland or prairie, he is not greatly 
distressed if antimony, mercury, scammony, aloes, gam- 
boge, etc., drop from his dog cart, if the bottles that remain 
bear upon their labels such significant terms as sulphate, 
hydrochlorate, bromide, hydrate, etc., etc. Happy the man 
whose methods of practice are designed to closely imitate 
the operations of nature— to allay undue excitement, to an- 
tidote poisonous ingesta, to stimulate depraved organs, and 
above all to furnish medicinal food for impoverished tis- 
sues. 

Art. III. — Hydrocele of the Tunica Vaginalis. By F. C. Vandkrvort, M. D., 
Eutland, La Salle County, 111. 

It is a true dropsy of the tunica vaginalis. This is a 
common affection, occurring at almost any age, and fre- 



fl 



Original Communications. 26& 

quently causes the surgeon considerable trouble, And not 
unfrequently 4ihe loss of a customer before he is successful 
in effecting a radical cure. It frequently occurs without 
any appreciable cause. It is some times congenital, or it 
may follow a blow upon the testis or from an orchitis. The 
tunica vaginalis is a serous membrane forming a closed 
sac, consisting of a parietal and visceral layer. In health 
this membrane secretes and absorbs a sufficient amount of 
serum to keep the surfaces frictionless, the equilibrinm 
being perfect. In this disease there is a loss of this bal- 
ance, and there is over-secretion and the sac becomes dis- 
tended with the serous fluid. It usually ma^es a large^ 
burdensome tumor, causing great annoyance to the patient. 
The size varies from that of a hen's e^g to a cocoanut. The 
tumor may be confounded w^ith orchitis, epididymitis, or 
cancer of the testicle. The shape in hydrocele is pyratorm 
and pointed at the top, and of an elastic feeling. Hold the 
tumor between you and a candle and you find it is translu- 
cent, with the testicle near the posterior wall. Operation 
is desired to relieve the bulk; also to relieve the extreme 
pressure upon the testicle which is liable to become atro- 
phied. The object of treatment is to relieve the pressure^ 
and to re-establish the lost equilibrium between secretion 
and absorption. The first is generally accomplished by 
tapping with a trochar and canula, and the latter by creat- 
ing sufficient inflammation to cause absorption and secre- 
tion to balance, or sometimes by causing obliteration ot 
the sac by a higher degree of inflammation. The latter is 
not the best result, and is not the result to seek for. Tap- 
ping is formed by grasping the tumor in the left hand and 
plunging the trochar into the sac with the other, at the 
junction of the middle and lower third, directing the point 
of the instrument directly backwards at first and then up- 
wards as soon as it penetrates the sac, withdrawing the 
stylet and allowing the canula to remain. This inflamma- 
tion is caused by the injection of a drachm or two of the 
tincture of iodine or pure alcohol through the canula, the 
latter being found a better injection than the former. 
There is another method common now for curing the by- 



"266 The Peoeia Medical Monthly. 

drocele witjiout tapping, and that is by using a hypodermic 
syringe. Insert the needle and draw out tljie piston and 
allow the barrel to jBll, then unscrew the barrel, allowing 
the needle to remain in, and empty the barrel by pushing 
in the piston. Screw it on to the needle and withdraw the 
piston once more, and proceed as before until you have re- 
duced the amount of fluid one-eighth or more, and then re- 
verse the operation and inject into the sac several syringe 
barrelsful of either tine, iodine or alcohol, the latter by 
preference. This is a simple though tedious operation and 
should be thoroughly tried until you are convinced it will 
not cure. Next try the evacuation and injection plan. I 
have found "alcohol to cure when strong tine, of iodine 
would utterly fail. This operation is not serious and causes 
the patient a little pain and transient sickness at the stom- 
ach'. I have operated on a young man in my office and 
allowed him to drive home, three miles, after the opera- 
tion. There was considerable soreness and swelling for a 
day or two, but after that he went about his farm work, 
finding himself cured in a week. My patience and his were 
sorely tried before we accomplished the desired result. I 
operated on him several times by each method, and finally 
succeeded by tapping, and injecting the sac with one 
drachm of pure alcohol, after repeated failures with the 
tine, of iodine. There is another method of operating that 
may be resorted to after all other methods have failed, but 
not until strapping the testicle with adhesive straps has 
been tried and your skill tried in that difficult operation; 
and that is the insertion of a small seton, allowing it to re- 
main two days, or until sufficient inflammation is estab- 
lished. Then the seton must be withdrawn and the inflam- 
mation treated on general principles to keep it from run- 
ning too high. This is a sure method of cure, but not to 
be resorted to until the other more mild operations have 
been thoroughly tried and found wanting. Hydrocele in 
infants may be cured by the use of evaporating lotions, as 
muriate of ammonia, alcohol and water. In old or feeble 
men it is best not to resort to a radical cure, but simply re- 
sort to tapping as a palliative measure. 



Notes from Private Practice. 267 



Abt. I.— a Case of Aneurism of the Gastric Arterioles. By S. A. Sulofp, M. D., 
Patterson, Pa. 

Miss Rhetta Todd consulted me on Dec. 30, complain- 
ing of a severe pain in her left side under the seventh rib. 
The bowels bein^ constipated, I prescribed a laxative with 
a simple alterative. She returned to her work, which was 
saleswoman in a fancy store, and the pain continued. The 
third day she felt a heavy weight in her side, and all of a 
sudden spit up a mouthful of veinous blood. She came 
home, feeling weak and sick at her stomach. I was called 
in and prescribed malots of iron, fl. ext. ergot, and a laxa- 
tive. During the night she vomited a small quantity of 
blood and passed clotted blood by the bowels. The next 
day she again returned to her work, and felt well the fore- 
part of the day, but afternoon began to experience a gurg- 
ling sensation at the seat of pain. I was sent for, and I 
could distinctly hear the gurgling from the opposite side of 
the room. She vomited blood twice during the evening. 
The hemorrhage now becoming arterial, vomiting nothing 
but clear blood and gastric juice. I called Dr. Thos. A. 
Elder into consultation, and after consulting me gave her 
emulsion of turpentine with Monsels sol., w^hich controlled 
the hemorrhage for the time, but on the day following it 
returned more violently than ever, with large quantities 
passed by the bowels. We used counter-irritation, and all 
the hgemostatics with no avail, only to find our patient 
growing weaker at each hemorrhage. Supporting with 
condensed food and stimulants we just merely kept our 
patient above death's door for eighteen days, she nearly 
bleeding to death on several occasions. On one occasion 
when I was out of town she began bleeding, and several 
doctors were called in. This time she bled until her radial 
pulse was extinct. When I returned we put on a fly blister 
over the stomach and continued Monsels sol., ergot and 
turpentine. After this she bled but little, and soon re- 
gained her normal condition. Were it portal conjestion it 
would not have been so large in quantity nor would we 
have had bright arterial blood. 



268 The Peoria Medical Monthly. 



!Ethics. 

Editor Peoria Medical Monthly: 

If you had not slightly confused my last manuscript^ 
and managed to get the " animal roused up,^^ in place of 
saying as you should at the '^annual round-up" of the state, 
etc., your Texas readers would have understood the case 
and I should not have appeared in so belligerent an atti- 
tude. But to resume the topic under discussion. T\iq cluh 
features of the code are sufficiently manifest; the most su- 
perficial observer has been impressed with this fact. Like 
the church, and secret orders which ramify society, how 
many enter to secure respectability and enjoy its social 
and pecuniary benefits; how many ignorant, incompetent 
and unworthy men seek the regular fold, not from a sense 
of fitness, conviction of its excellence, or love of the same, 
but for protection, professional aid, commanding position, 
and a citadel of defense; how jealous and vociferous they 
become for their rights; how ready to pounce upon the lax 
or more liberal, who are overtaken by* any indiscretion, or 
infringe on the letter of the code without violating its spirit; 
how easily they overlook the culpable transgressions of 
those eminent in the profession, while the slightest peca- 
dillo of mediocrity is attacked with venomous vigor. These 
are painful facts, but written all over the history of the 
profession, from the commercial centers to the rural dis- 
tricts and the frontier. Look, again, at our local and state 
organizations; the former are especially open to this criti- 
cism. A few dictate too often extreme measures, and fos- 
ter the more ultra views in regard to the code and disci- 
pline. I might add that the National Association is not 
entirely exempt from this censorious spirit. I call to mind 
an incident in the centennial year, when the " guys " at- 
tempted to bar the entrance of an Illinois delegate, because 
forsooth the M. D. and professor was robed in calico. T" 
need not go into further statistics, which would neither be 
agreeable nor complimentary; the physician who has not 
encountered it is certainly exceptional. 



Correspondence. • 269" 

Its 7nonopoUzing characteristics are equally apparent; 
every one who enters an organization, every one who sub- 
scribes to the medical code becomes a member of a close 
corporation; he gives away certain personal liberties ex- 
pecting to receive a corresponding gain; of course it is his 
right and inivilegeif he so elect; but like the Apostle Paul 
in regard to marriage, it is better perhaps to remain un- 
trarameled rather than become a slave to a code, an idea,, 
or a woman. Now, many felt the halter draw at the late 
convention at Cleveland, when they were unexpectedly 
called to reaflQrm and sign the code before being allowed 
to participate and take part in the proceedings. Who dic- 
tated that little maneuvre? No public vote had been taken; 
no by-law or resolution prescribed it. What boss or clique 
ordered it? How many signed it with a mental reserva- 
tion; how few could raise their right hand and affirm they 
had not been guilty of its violation? Did it produce a 
change of heart and action? Not muchlif! Does any one 
suppose the medical profession has reached that high moral 
plane, above all other corporate bodies and organizations, 
that a modest autograph to an ethical formula will absolve 
them from all their medical sins, and place them in a pe- 
rennial Eden, above suspicion? Nay! Compulsory obedi- 
ence is a doubtful remedy. Was it not a puerile way of 
improving their morals? It certainly strikes the common 
mind as futile, undignified and senseless. Compulsory 
friendship or fellowship is apt to be attended with a good 
deal of friction; it may be the normal condition in torrid 
regions, but it is not suited to this climate. The recent ac- 
tion of the New York Academy of Medicine displays some 
of those disagreeable possibilities which surround the code. 
The finest propositions are tabled, and caucuses are engi- 
neered and packed with all the skill and science of the 
most approved pot-house politician or unscrupulous dema- 
gogue. If the high-toned and honorable professors and 
nestors of the profession in the meridian-blaze of our most, 
cultured metropolis boldly and defiantly transgress the 
* spirit of the code, and resort to quirks and quibbles to se- 
cure a base victory and dishonorable success, it is no won- 






270 The Peoria Medical Monthly. 

der they become a stench and offense to the nostrils of a 
well-regulated nose. 

Already the mutterings of the storm are heard, and 
the code and anti-code partisans are high up in decimal 
fractions working out the numerals, which show how the 
unknown quantity, 4=§. 

Tt reminds me of Auld Lang Syne when the precocious 
urchin played "Heads I win, tails you lose;" and they 
threaten now to become as badly demoralized as the young 
man who did not succeed in thrashing his rival, but vow^ed 
he would make faces at his sister. If such are the intrinsic 
excellencies of the code, and such the proud prototypes who 
champion its virtues, the sooner it achieves a Napoleonic 
defeat the better; then in the quiet of the stilly night you 
4iiay listen for the sad dirge — 

It sleeps its last sleep, 



It has fought its last battle ; 
No sound shall awake it 
. To glory again. 



Veritas. 



Medical Ethics. 

Salem, Ohio, October, 1883. 
Editor Peoria Medical Monthly: 

Allow me to congratulate Veritas through your excel- 
lent journal, for his very sensible, yet fair and honest show- 
ing of the "code" ethics. To my mind he says just the 
thing in relation to the medical code. Age and experience 
in all the avenues of life, moral or religious, as well as sci- 
entific, must have convinced the most secular if they are 
honest, the great improvements in every one. The minis- 
ter in the rendition of scripture to his parishoners dares not 
regale them with " hell fire " punishments as they did in 
the time of Galen. The telegraph and telephone are in the 
sense claimed by the code. Its innovators, railroads, steam 
plows, threshers, and the thousand other utilized machin- 
ery could be as justly condemned for want of age. No, no; 
the argument to me is so absurd I cannot for a moment re- 
gard it worthy of the intelligence of the age. We, it is 
true, have a few old " mossbacks " who are very charry of 
any infringements upon what their fathers set up. They 



Correspondence. 271 

are like the man who carried his wheat to the mill on horse 
back, the wheat in one end of the bag, a stone in the other 
end to balance over the horse, simply because his father 
before him did. So, reverence for age you see. 

I was called some time ago in consultation some 30 
miles, to a family I had formerly attended professionally. 
They did not know what my system of practice was; hence 
the physician in attendance supposed me to be a "regular" 
or allopath, as he was. We held a consultation all very 
agreeable and satisfactory. I suggested remedies that he 
had not tried, saying his remedies were of the class long 
known and ought to be successful, yet I had been using lat- 
terly in such cases such and such medicines, with very 
gratifying results. He said of course his remedies were 
not relieving the lady, and as I had been called to see the 
case, he would freely consent to my suggestions as to the 
remedies, but he had not in his kit the medicine nor did he 
remember the dose. I told him I could furnish him with 
both, which I did, and the patient was at once put upon 
their use, which fortunately for both of us had the desired 
result in a few days. The doctor, when I was about to bid 
him good-by, said he was very glad I had come to see the 
lady with him, and should attend faithfully to the new 
treatment, for if she did not now get along the family, he 
was afraid, would either call in one of the eclectic or hom- 
eopathic quacks of the town, and he could not nor he 
would not, under any circumstances, counsel with them, 
as he, like all true physicians, adhered to that good old 
American medical code, and in no case ought it to be vio- 
lated. I told him my pathy was "cure" in all cases, 
^'code or no code." If catnip tea cured the patient that 
was science; if chloride of gold killed the patient that was 
quackery. 

Oh, yes; so it would seem. But to think such men as 
A. or B. dare to start up a system of medicine right in the 
face of long ages of practice, and then I to have to coun- 
tenance such practice and lower the standard of medicine. 
' I never will. I am 60 years old. I have lived too long 
Tinder the old flag of regular to contempl-ate any such 



272 The Peoria Medical Monthly. 

change. Before I got entirely through with him he became 
a listener. I prescribed for his own case, asthma, another 
new remedy, not regular nor official, yet some time after 
he reported well pleased with its effect. Thus you see this 
M. D., took anything from me because he supposed me al- 
lopathic, but for an eclectic or homeopathic to tell of it 
would have sickened him. However, he had the pleasure 
of finding out I was one of the quacks. Kindly yours, 

Jas. M. Hole, M. D. 



Prescriptions. 

Kewanee, Wis., Oct. 24, 1883. 
Editor Peoria Medical Monthly : 

In one of the numbers of The Peoria Medical 
Monthly I find thirteen prescriptions, in eight of which 
mistakes are made, either in the miscellaneous use of Latin 
or English in the same prescription, in Latin endings or in 
spelling. In an article on diphtheria appears the follow- 
ing: 

9 Tr. ferri chlori, 2 drachms. 

Potassa chlor. pu. 3 drachms. 

Alum exiccutum, pu. 7 drachms. 

Potassa nitrate, pu. 6 drachms. 
Sulphur sublimatum, 

Carbo ligni, aa. 1 drachm. 

Mel. (strained). 16 ounces. M. Sig. 

Teaspoonful every hour until bowels move freely, then 
every two or four hours, teaspoonful. Allow no drink for 
ten or fifteen minutes after giving medicine. We allow 
the patient a bountiful supply of hot milk, religiously 
avoiding these most innocent articles, beef tea, chicken 
broth, etc., while true as steel to all laws of hygiene." 

Not a line of the prescription proper is written as it 
should be. The first line is Latin, but wrongly spelled, 
the second, English, or Latin in the wrong case; the third, 
misspelled and in the wrong case; the fourth, English; the 
fifth, English and Latin, and in the wrong cases; the sixth, 
Latin abbreviated; the seventh, Latm and English. The 
directions are rather too long, both for the patient to read 
and understand, and for the druggist to copy. 

In an article written for a journal that is read by so- 



Questions and Answers. 273 

many physicians, more care should be taken in writing 
correctly, either in» Latin: 

5 Tinctnrai ferri chloridi, 2 drachms. 
Potassii cliloratis, (pulvis), 3 drachms. 

Alumini exsiccati, 7 drachms. 

Potassii nitratis, 6 drachms. 
Sulphuris sublimati. 

Carbon is ligni, aa. 1 drachm. 

Mellis (lespunnati, 16 ounces. M. S. 

Or Latin abbreviated — 

R Tr. fer. chlorid, 2 drachms. 
Potas. chloral, (pulv.) 3 drachms. 

Alum, oxsic. (pulv.) 7 drachms. 

Potas. iiitrat. 6 drachms. 
Carbo. ligni. 

Sulph. subl. aa. 1 drachm. 

Mel. desp. 16 ounces. M. S. 

Or, in plain English, take of — 

Tincture of iron, 2 drams. 

Powdered chlorate of potassa, 3 drams. 

Powdered dried alum, 7 drams. 

Powdered nitrate of potassa, 6 drams. 

Sublimed sulphur. 

Charcoal, of each, 1 dram. 

Strained honey, 16 ounces. M. Sig. 

On another page I find the following: 

R Sulphurous acid, f?:| drachm. 

Sulphur, 2 drachms. 

Glycerine, 6 ' drachms. 

Aqua, 2 ounces. M. S. 

Why not say " water " instead of " aqua " (or rather 
aquae) and be correct. 

Let us have correct prescriptions, at least in our jour- 
nals. Repmek. 



* Acute Tousillitis. 

Newton, III., Oct. 24, 1883. " 
Editor Peoria Medical Monthly: 

I see in the October number of your journal the sub- 
ject of acute tonsillitis has been suggested as the subject 
for the November number. Acute tonsillitis is frequently 
met with in this locality in the late fall and winter months, 
and its frequent cause bad ventilation. 

The disease is usually ushered in by a chill, followed 
by fever. If seen in the first twenty-four hours I give the 
following prescription : 

5 Tr. guaiaci, 4 drachms. 

Spt. nit. dul., 6 drachms. 
Tr. aconiti r., 8 drops. 
Syr. aurant, q. s., 2 ounces. 
M. Sig. Teaspoonful every two or three hours. 



274 The Peoeia Medical Monthly. 

If the case is seen later, I have found the sodium salicy- 
late an excellent remedy. This treatment has been very 
satisfactory to me. So much so that I often tell my 
patients, positively it will cure you. 

J. H. Maxwell, M. D. 



Eucalyptus in tlie Treatment of Acute Tonsillitis. 

For some time past I have been using eucalyptus in 
cases of quinsy with very gratifying results. Dilute one 
drachm of the fluid extract with one ounce of warm water,, 
and use as a gargle or spray every twenty minutes. The 
water must be as warm as the patient can bear it. 

It has been my good fortune to see all the cases so 
treated recover speedily, without suppuration. No other 
remedy was used, except in one instance, I prescribed 
quinine. 

It has occurred to me that, owing to its antiseptic 
properties and its special action on the respiratory tract,, 
eucalyptus would be an excellent local application in diph- 
theria, either used as above or to medicate vapor for in- 
halation. — Atlantic Jour, of Med. 



Simple Inflammatory Tonsillitis. 

Dr. ^. Solis Cohen treats this affection by a modifica- 
tion of the guaiac treatment, which consists in the use, as 
a gargle, of a mixture known in the House Pharmacopoeia 
of the Philadelphia Polyclinic as the Gargarysma Guaiaci 
Composita. Two fluidrachms each of the ammoniated tinc- 
ture of guaiac and the compound tincture of cinchona are 
mixed with six fluidrachms of clarified honey, and shaken 
together until the sides of the containing vessel are well 
greased. A solution consisting of eighty grains of chlorate 
of potassum in sufficient water to make four fluid-ounces 
is then gradually added, the shaking being continued. If 
this is carefully done secundum artem, a not unpleasant 
mixture w^ill be produced. Without due care, however, the 
resin will be precipitated. The patient is directed to gargle 
with this mixture freely and frequently, at intervals of 
from one-half to three hours. In some cases a saline car- 
thartic is first administered. Should any of the guaiac 
mixture be swallowed it is considered rather beneficial 
than otherwise, and in some cases it is advised to swallow 
some of it. Relief is usually experienced in a few hours. — 
St. Louis Courier of Medicine, Oct., 1883. 



Book Notices. 275" 



Annual Report of the Surpervising Sui'geon-General of the Marine Hospital'. 
Service of the United States for the Fiscal Year 1883. Government 
Printing Office, Washington, D. C. 

The first part of this volume of 406 pages is taken up- 
by the regular report of Dr. Hamilton. The second part is 
more interesting to the general medical reader, as it is 
made up of selected cases from hospital practice. The 
third part is filled with " Reports of Fatal Cases, with 
Autopsies." The last part consists of a history of the yel- 
low fever epidemic of 1882. As a whole, the reporjb is an 
advance upon previous reports from the same office, and is 
of more interest and value to the general practitioner. Dr. 
Hamilton seems to have his work well in hand, and is an 
active and efficient officer. We predict still further im- 
provements in future years. 

A Manual of Practical Hygiene. By Edmund A. Parkes, M. D., R. F. S., late- 
Professor of Military Hygiene in the Army Medical School; Emeritus Pro- 
fessor of Clinical Medicine in University College, London, etc. Edited by 
F. S. B. Francais De Chaumont, M. D., F. R. S., Fellow of the Royal College- 
of Surgeons of Edinburg, etc., etc. Sixth edition ; with an appendix, giving 
the American Practice in Matters Relating to Hygiene, prepared by and 
under the supervision ot Frederick N. Owen, Civil and Sanitary Engineer.. 
Vol. I. Cloth, 8 vo ; 368 pp New York : Wm. Wood & Co., 1883. 

Subscribers to Wood's Library of Medical Authors will 
be highly pleased with the addition to it of Dr. Parkes' 
justly famous work on hygiene. By means of new editions- 
it has been kept fully up to the times, and abreast with 
progress of the sciences of preservation of health. It 
should be in the hands of every practitioner of medicine. 

The Collective Investigation of Diphtheria, as Conducted by the Therapeutic 
Gazette, with Editorial Summary. By J. J. Mtjlheron, M. D., Detroit,. 
Mich. Geo. S. Davis, Publisher. Boards, $1.25. Cloth, $1.00. Paper, 75c. 

This book contains the views of over one hundred 
practitioners upon the subject of diphtheria. We do not. 
believe that anything new has been elicited or that any 
definite conclusions have been arrived at. The conflict of 
opinion may tend to confuse rather than instruct; still, 
here are plenty of diverse opinions, and the reader can taka- 



276 The Peoria Medical Monthly. 

his choice. The opinions of a numerical majority will 
hardly be held sufficient to decide any scientific problem. 

€opp's U. S. Salary List and Civil Service Rules. By Henky N. Copp, Wasli- 
ington, D. C. 

It purports to give all the government salaries, but the 
first salary we looked for was omitted. A book may give 
much information, but if it fails on just the point it is ex- 
pected to give, our opinion of it is shaken. 

Manual of Greneral Medical Technology, Including Prescription Writing. By 

Edward Curtis, A. M., M. D., Professor of Materia Medica and Therapeu- 
tics, College of Physicians and Surgeons, etc. ^Tew York : Wm. Wood & 
Co., 1883. 33 mo. ; pp. 234. 

The book seems to be carefully written and is of value. 
'Students will find it of benefit, as too little attention is 
paid to prescription writing in a majority of our colleges. 

The Physicians' Daily Pocket Record, Comprising a Visiting List, Many Use- 
ful Memoranda, Tables, etc. By S. W. Butler, M. D. ; 18th year. Edited 
by D. G. Bristou, M. D., Philadelphia, Pa., 1883. 

An old friend that will be welcomed by thousands of 
physicians. 

One of the most beautiful papers for children we have 
ever seen, and one that seems best adapted to healthful 
training of young minds, is " The Pansy," edited by Mrs. 
G. R. Alden, and published weekly by D. Lathrop & Co., 
of Boston, at seventy-five cents a year. The text is good 
and the illustrations fine. Doctors, why not make this a 
Christmas gift to one of your little curly heads? We in- 
tend to do it. 



'^Mmti §t\mvtnm\t. 



conducted by DE. 0. B. WILL, PEORIA, ILL, 



Specialism in Medicine. 

The Aflantk Jotfrnal of Medicine for October contains 
an address on the above subject, delivered by Dr. Paul F. 
Munde, of New York, as an introductory before the medi- 
cal class of Dartmouth College. 

In the course of his remarks Dr. Munde enumerates 



Abstract Department. 277 

the causes which led to the growth of specialties in medi- 
cine as they now exist. Of course we have space for only 
the merest synopsis of these showings, but enough, per- 
haps, to give o-ur readers the main points. He claims as 
causes: 

"1. The increase in scope and depth of medical science, 
which rendered it absolutely impossible for one mind to 
grasp and master all, or even the larger part of the knowl- 
edge which now seems essential to a thoroughly educated 
physician. 

"2. The general tendency of science and art during 
each successive decade of this century to subdivision of 
thought and labor. 

'' 3. The progress in physical science which resulted in 
the improvement of old instruments, such as the micros- 
cope, and the invention of new appliances for the diagnosis 
and treatment of diseases of certain hitherto inaccessible 
portions of the body. 

" But there are other reasons," says Dr. Munde, after 
elaborating the above, '' than these scientific ones why 
specialisn should have been born and developed to its 
present state of perfection. There are more practical rea- 
sons why specialists should exist. .One of these is: 

" 4. The amount of time required to study and treat 
cases such as usually come under the observation of spe- 
cialists, and the necessity for possessing office and other 
conveniences, complicated instruments and apparatus, per- 
haps trained assistants, etc., which general practitioners 
cannot afford to have nor become dexterous in using. ■' * 
* * Further: 

"5. The general practitioner himself is, to a certain 
extent, a cause of the rise of specialism. This on account 
of his habit of calling in consultation and sending patients 
to such of his medical brethren as happened to become 
known for proficiency in the cure of some particular..dis- 
ease or class of diseases. * 

"The laity themselves began to call for specialists, 
who, they found, cured them more rapidly, if somewhat 
more expensively, than their old family physician; and 
further: 

" 7. The specialist, by not being compelled to spend 
his time in the never-ceasing round of general practice, and 
by confining his professional labors to certain hours, is able 
to spare leisure to keep himself thoroughly conversant 
with the literature of the day in his specialty and out of it. 
Thus he is enabled to work out the results of his experience 
in the shape of new theories, remedies and methods to the 



278 The Peoria Medical Monthly. 

glory of the common mother, the whole science of medi- 
cine. 

" 8. In difficult, serious and doubtful cases, one of the 
greatest comforts the attending physician can have is that 
of a consultation with a brother practitioner," * « * * 
and necessarily the most desirable would be a specialist in 
the necessary department — the most valuable and useful 
to physician and patient. 

After remarking that a proper regard for the interest 
and feelings of the attending physician should always guide 
the consultant in his words and actions, and that he should 
ever remember the honor of his profession and the eti- 
quette of the specialist, Dr. Munde proceeds to summarize 
briefly the disadvantages of this modern system, in that 
the natural tendency of the specialist is to become " one- 
sided," to forget that there is somethmg else in medicine 
besides his own specialty, and that the human body has 
other organs than those to which he devotes his' attention;, 
to become a " routinist," looking upon the organs treated 
by him as entirely separate and disconnected from the rest 
of the body, and apparently forget that " the same blood 
courses through the entire system, and the same center 
supplies the nerves to every organ, and the same skin 
covers the whole body." 

After contending that every practitioner is in a cer- 
tain respect a routinist, Dr. Munde mentions the curious 
fact that many who glory in calling themselves " general 
practitioners," and deprecate the insinuations of being 
specialists, have made their reputation by success in treat- 
ing some one affliction, or as authors of some work on a 
special disease, and calls attention to the injunction to 
every specialist to be first a physician for the whole body 
before he thinks of becoming the guardian for a single por- 
tion of it. 

After some very interesting considerations relative to 
the ways of becoming a reliable specialist, and ifche much 
vexed question of physicians advertising, the doctor con- 
cludes his address with the following paragraphic sum- 
mary, in answer to the question, " Is specialism an advance 
in medical science?" 

" If the specialist has gone through the course of spe- 
cial training already described preparatory to entering 
upon the study and practice of his specialty; if he remem- 
bers the interdependence of all organs and parts of the body, 
the one under his special care not excepted, as a cardinal 
principle in his practice; if he is sufficiently conscientious 
to confess the absence of disease belonging to his specialty 



Abstract Department. 279 

in a given case, and then unhesitatingly refers the patient 
to some other practitioner to whose sphere the case more 
properly belongs; if he is sufficiently liberal to admit his 
own fallibility and the possibility of a general practitioner 
having an intelligent perception even of a special case; 
and, finally, if he works on dilligently in his specialty and 
endeavors by a faithful publication of his experience to 
elevate and further science and benefit mankind — if he 
does all these things, which would naturally be expected 
of every honorable physician, then certainly the institution 
of specialism in medicine is an advance, the importance of 
which cannot be overestimated." 



Diphtheria. 

The following extract is from a clinical lecture on 
*■' Diptheria and Its Treatment," delivered by J. M. Keating, 
M. D., one of the attending obstetricians to Philadelphia 
Hospital, and reported by Dr. W. H. Morrison for the Med- 
ical News: 

"To review this subject we have noted that micrococci 
are associated with diphtheria; that inoculation of these 
matters will produce the disease; that they are found at 
that point where the diphtheritic process is found in the 
greatest intensity; and lastly, that certain solutions will 
kill or paralyze these micrococci and prevent their growth, 

" Let us now study a form of treatment based upon 
these views. We divide our treatment into the constitu- 
tional and the local. For the former we rely on hourly 
administration of liquid food in small quantities, such as 
beef juice, wine-whey, milk, frozen beef tea, or ice cream, 
albumen water, or peptonized food by the bowel; also, 
stimulants, fresh vegetable acids, koumyss; and drugs, as 
quinine, strychnine, etc. We must pay a special attention 
to the circulation, as heart death may occur in two ways: 
First, syncope from fatty degeneration of the cardiac 
muscle, and sudden death occuring even during conval- 
escence. This requires absolute quiet in bed, digitalis and 
strychnine. Second, heart clot, which is most insidious in 
its formation, and w^hich, I believe, may be due to the 
rapidly accumulating micrococci, which can possibly be pre- 
vented by free stimulation, chlorine and the chlorides, both 
internally and by inhalation, and fresh air. The local 
treatment has these objects in view, namely, the destruc- 
tion of the diphtheritic poison or germ, the prevention of 
putridity of the false membrane, and the allaying of the 
inflammation ot the mucous membrane itself. It is neces- 



280 The Peoria Medical Monthly. 

sary for the latter indication to keep the air moist, either 
by the slakina^ of lime, to which may be added the vapor 
of chloride of lime; vaporizing the throat by means of an 
atomizer, to which may be added opium or hyosciamus in 
some form, and applying moisture to the throat without, 
either with a wet cravat covered with oil silk or a light 
poultice surrounding the neck. For the treatment of diph- 
theria I would recommend astringent local applications, as, 
for instance, the perchloride of iron, believing that the 
disease is originally a local affection. I would not waste 
time in using carbolic acid alone, for I believe that in such 
cases, at the onset, it is of questionable use. An excellent 
local application, which should be used daily by the physi- 
cian, applied thoroughly to the whole mucous membrane 
of the fauces, is: 

5 Tiuc. iodini, 1 fl.-drachm. 

Acid carbol, 10 grains. 
Tine, lerri perchlor., 1 fl.-drachm. 
Glycerins, ad. 1 fi.-oiince. 

The use of the carbolic acid being to prevent decom- 
position of the membrane. Between times I have used a 
gargle of salicylic acid and claret. Common salt, I have 
uo doubt, would be of great service, and probably the pop- 
ular opiuion so favorable to chloride of sodium and sulphur 
will be found to be based upon a very solid foundation. 
You know that calomel and soda, in small and frequently 
repeated doses, placed dry upon the tongue, has many up- 
holders, and probably its local action is a very important 
one, as much so as the constitutional one, in rendering the 
membrane aplastic. Labarraque's solution would be cer- 
tainly indicated, and possibly the very valuable Platts' 
chlorides would serve the same good purpose." 



Does the Materia Medica Afford An Unobjectionable *Ijaxative 

Remedy ? 

To answering the above question Dr. F. C. Herr, of 
Philadelphia, devotes a carefully x^repared article pub- 
lished in a late number of tlie Med. and Surg. Beporter. He 
thinks that the long sought treasure has been found at 
last, in Cascara Cordial, appropriates nearly the whole 
article in extolling its merits, and makes his laudation 
read very like a veritable patent medicine " puff." We 
opine, however, that the writer will find many medical 
men whose experience leads them to differ in opinion from 
him, and think that cascara is a decidedly uncertain 



Abstract Department. 281 

remedy, and the syrup spoken of principally useful as a 
vehicle for the administration of more potent drugs. We 
give some extracts, as tollows: 

" Let us see whether pharmacy has not met the de- 
mand of the medical profession for a certain, palatable,, 
painless cathartic remedy. We think it has. In that ele- 
gant preparation made by Parke, Davis & Co., known as 
" Cascara Cordial," the most fastidious doctor or patient 
can find just what they want. It pleases the taste, pro- 
duces gentle and salutary action of the bowels, is free from 
the property of griping, and is devoid of any injurious 
secondary action. In that type of cases where muscular 
atony is the factor in the production of constipation, relief 
is speedily effected with Cascara Cordial, and its continued 
use will produce permanent cure. 

" Cascara Cordial meets the double indication of rheu- 
barb and gentian in a manner more satisfactory than the 
agents themselves, as the tonic astringent and resin-bear- 
ing principles of cascara-sagrada in the highest degree im- 
part tone and vital force to the alimentary canal, while at 
the same time nutrition is improved, and all the forces of 
the economy invigorated. This can easily be demon- 
strated by experimentation upon one's self — as I have done 
frequently. Its action is so gently stimulating that it be- 
comes almost grateful in its effect. Not only as a remedy 
for constipation — especially chronic — is it servicable, but 
it is invaluable as a vehicle for the administration of other 
and less palatable drugs. Many officinal preparations are 
used almost exclusively for such a purpose. The com- 
pound liquorice mixture, the aromatic elixir of liquorice, 
the comp. syrup of sarsaparilla, etc., etc., are pleasant and 
agreeable adjuncts for the administration of many reme- 
dies, but not one of them is worthy to hold a place by the 
side of Cascara Cordial. It is more agreeable in flavor than 
any of the preparations mentioned, and has such decided 
medicinal qualities of its own that I do not much doubt it 
will, in time, largely supplant them in this use. I cannot 
now name a disease in which Cascara Cordial w^ould be 
contra-indicated. On the other hand, its salutary action 
on the gastro-intestinal secretions in morbid conditions of 
whatever character, its healthful action in promoting 
digestion, stimulating absorption, and improving nutrition 
generally, marks it for great favor at the hands of the 
medical profession. 

" If I were asked to name another preparation equally 
effective and palatable, I should answer that it does not 



282 The Peoria Medical Monthly. 

exist. The physician can assuredly be content with Cas- 
cara Cordial, as its medicinal uses and varied utility and 
elegance of composition mark it for great favor." 



Obstruction of tlie Bowels. 

In the Med. and Surg. Beporter for October 20th Dr. 
Isaac N. Snively, of Waynesboro, Pa., reports a very instruc- 
tive case of obstruction of the bowels in the person of a 
maiden lady fifty years of age, in which life was prolonged 
forty-three days by nutritive enema. The doctor was called 
to see the case on November 5, 1881, and describes the 
symptoms as follows: 

"Was suffering from great pain in her stomach and 
upper bowels since the previous day. She informed me 
she first felt an unnatural sensation in this region on the 
16th of October. Since then she had several attacks of 
cholera morbus, and pyrosis came on regularly every morn- 
ing at four o'clock. On Friday evening, the 4th of Novem- 
ber, she ate fried oysters and a few dates. This morning 
she had what she considered a free movement of the 
bowels, but pain continued all day in the epigastric region. 
I ordered sinapisms over the painful parts, which was fol- 
lowed by warm fermentations, which were continued all 
day. Anodynes and anti-spasmodics were also prescribed. 
The case continued to grow worse, with much vomiting of 
stercoraceous and other matter, pain, and all the evidences 
of bowel obstruction. Consultations were held with promi- 
nent medical men from time to time, and every means, 
almost, known to the profession were adopted without any 
permanent advantage. The patient lingered with almost 
constant pain, except when relieved by hypodermic injec- 
tions of morphia, for a period of torty-three days, being 
sustained during that time by enemas of beef tea, quinine 
and brandy. The lady died on December 17th, and an 
autopsy was held four hours after death. The result we 
give in Dr. Snively's own words: "Great emaciation — al- 
most total absence of fat. Small petechial or ecchymosed 
spots nearly all over the surface of her body. Mesentery 
and omentum very much atrophied. We find the obstruc- 
tion in the ileum, eighteen inches above the ileocascal 
valve, a mass of hard substance of gritty material, remind- 
ing me of clay and sand mixed and let harden — wedge- 
shaped and of the size of a hen's egg. This matter is very 
hard; almost like stone. Gangrene and ulceration of this 
portion of the bowel has commenced, but no perforation as 



Abstract Department. 

yet has taken place. We took a fine saw and opened it, 
and found as a nucleus of this mass of hard material some 
date seeds." 



Remittent JFever During- tlie Puerperal State. 

Apropos of the discussion relative to the existence ot 
remittent fever during the puerperal state, and the liability 
of confounding it with true puerperal fever. Dr. A. Cordes, 
of Geneva, reports the following case, with comments, to 
the Journal of Obstetrics: 

" Mrs. H., lY. para, was delivered by me by version — a 
very easy one, lasting only ten minutes — on June 30th last, 
at half-past five a. m. Delivery of the placenta normal. 
Being obliged to leave town for an urgent ovariotomy at a 
great distance, I gave up my patient to a medical friend. 

" When returning, on July 7th, I heard that she had 
offensive lochia and high fever every second day, in the 
a,fternoon, since the second day after her confinement. As 
she sucked her child, I was afraid to give her quinine, but, 
seeing the fever coming again, with chill, hot skin, per- 
spiration, and the aconite not acting well, I decided to put 
her on this remedy, forbidding to give the breast less than 
eight hours after taking the quinine. 

" The first dose, twenty-five centigrams, prevented the 
fever on the 11th; it come only on the 12th, very attenu- 
ated, after a second dose of quinine. 

" 12th — Slight fever at night, ivithoid chill. 

"She never had nausea or vomiting. Since then Mrs. 
H. went on better and better, except that she remained 
weaker than after her preceding confinements. 

" Now I believe this was a true case of remittent fever, 
not of puerperal character. During the intervals Mrs. H. 
was all right, except weakness; the fever was of a very 
genuine periodical character; the milk did not stop; the 
abdomen was never very tender; the fever was cutr short 
by quinine. The lochia was offensive for several days, it is 
true, but I never found, nor did my assistant, any decom- 
posing clot in the uterus. The cause I found in some fresh 
excavations in the neighboring garden. This being the 
first time Mrs. H. had remittent fever, I think her delivery 
disposed her to absorb the miasms from the earth which 
had before been under a water closet." 



The following points are gleaned from the transactions 



284 The Peoria Medical Monthly. 

of the American Gynecological Association, as reported for 
the Americcm Journal of Obstetrics: 

Dr. Sutton, of Pittsburg, in a paper on 
The Importance of Cleanliness in Surgical Opera- 
tions, takes occasion to show up in all its aspects the ever 
fruitful theme of Listerism, and- concludes that the essen- 
tials of Listers method can be summed up in one word, 
viz., cleanliness, and those present seemed to mostly con- 
cur with him in that opinion. The antiseptic spray would 
seem to be a necessity in old hospitals and under circum- 
stances which tend to foster septic ^erms, but generally it 
is not necessary if the ordinary rules of cleanliness are ob- 
served. Injurious effects are often produced by the use of 
too much carbolic acid, and its poisonous influences some- 
times mistaken for septicemia. "M. Lawson Tait uses 
absolutely no carbolic acid about his operations. All he 
Qses is boiling water. The only man standing by the side 
of Tait is Bantock, who has also abandoned carbolic acid 
entirely; and Dr. Emmet suggests that Mr. Savage has also 
abandoned it.'' The use of 

Hot Water in Secondary Hemorrhage was considered 
by Dr. Albert H. Smith, of Philadelphia. This gentleman 
is impressed with the idea that the specific action of hot 
water in controlling hemorrhage has not been as fuWy 
appreciated as it should be. He uses it to control hemor- 
rhages occurring with pregnancy; considers it one of the 
most efficient agents at our command for controlling post- 
partum hemorrhage, and advises its use as a prophylactic 
against hemorrhage in every case of labor, and also against 
local absorption. He wishes to direct special attention to 
the use of hot water as a hemostatic in surgical operations, 
particularly pelvic, and believes that in secondary hemor- 
rhage occurring after such operations, from opening of 
large vessels, we have in the hot water douche a means for 
its control. During the discussion of Dr. Smith's paper 
Dr. Wm. Groodell advocated the use of hot vinegar and 
water as better than the water alone, and Dr. Barker, of 
New York, thought that we needed yet an answer to the 
question, " What hemostatic can be employed which will 
arrest hemorrhage at once, and act more rapidly than hot 
water ?" in those cases in which it is necessary that the 
hemorrhage be stopped at once. The general opinion as to 
the usual efficiency of hot water in cases of hemorrhage, 
was decidedly favorable. Dr. Engelmann's paper on the 

Use and Abuse of Ergot, was a denunciation of the 
use of that " dangerous drug " in the treatment of any con- 



^■ft. 



Abstract Department. 285 

dition of the gravid uterus, and a claim that its use be abso- 
lutely restricted to the uon-pregnant womb 

In the discussion following, while its absolute prohibi- 
tXl^^n^n^^^• ^^^^f ^ted, the majority considered its use 
+?.. w r universal, and that unless the greatest precau- 
tion be taken to give it only in the quantity and' at the 

altogeTheT '*' ""'^ ^""^ better be dispensed with 

Retention of the Female Catheter. 

Referring to tlie frequent accidental retentions of the 
temale catheter, Malcolm McLean, M. D, of New York, has 
the tollowing to say on the subject in the American Journal 
of Obstetrics for October. " Those who have practiced cath- 
eterization with the ordinary silver catheter, must have- 
observed that it IS exceedingly liable to become engaged 
somehow, in the neck of the bladder or vesical end of the 
urethra. In attempting to withdraw the instrument it 
seems to be, and is, grasped more firmly, and considerable 
torce would be required to overcome it. In a certain num- 
ber ot cases relaxation takes place and the catheter is re- 
l^sed so that it may be removed without violence, if the 
patient s attention is attracted to some other matter. 
. In other cases relaxation never takes place, but the 
instrument is held in a firm, elastic grasp, which cannot be 
overcome without violence to the mucous membrane, un- 
less the proper means be taken to release it. * * * 
Once forced into the instrument, the tissue swells and be- 
comes fixed, so that laceration is almost sure to follow any 
considerable traction or twisting of the metal tube. Fis- 
sures of the bladder and urethra are doubtless sometimes^ 
produced m this manner, and urethritis is a frequent sequel 
to careless catheterization. 

"The faulty shape, size and location of the openings in- 
the ordinary silver instrument contribute largely to the ac- 
cident m both varieties. In the first class, the neck of the 
bladder gets spasmodically contracted around the portion 
of the catheter which is very much diminished in calibre- 
by the location, etc., of the eyelets ; while in the second 
class the mucous membrane gets forced through one or both 
openings. 

"The well-known method of having the catheter made 
with numerous small round openings is generally a safe- 
guard against the accident we are considering. And if we 
are careful to shut off the flow of urine with the finger over 



286 The Peoria Medical Monthly. 

the externa] extremity of the instrument, just before we 
begin to remove it, we will seldom be troubled. 

"But the accident may happen to any of us, and then 
what is the best course to pursue? There is a simple 
method by which we may always succeed in disengaging 
the parts concerned in retaining the catheter, and it will 
not fail if properly carried out. 

"Placing the nozzle of almost any syringe against the 
extremity of the catheter and injecting a small quantity 
of cold water, will drive out the mucous membrane, so that 
the instrument will readily slip out at the same instant. 
Forcing air into the canal will not do, and should not be 
used as a substitute for water." 

We have never used the cold water injections, but 
have of late years avoided the difficulty referred to by the 
use of the soft rubber catheter, which is just about as read- 
ily introduced, and in our experience gives no trouble. 



Tubercnlosis as Produced by Sprayed Sputa. 

. Dr. Louis D. Brose, of Evansville, Ind., reported to the 
Medical Society of the Mississippi Valley a series of experi- 
ments on the infectiousness of tuberculosis. We take the 
following conclusions from this paper as published in the 
Medical Becord: He writes: " Under these circumstances 
I feel justified in presenting the following conclusions: 

" First. That tuberculosis may follow the inhalation • 
of air-carrying particles of sputa from phthisical patients. 

"Second. The breath and saliva of consumptive per- 
sons, being thus contaminated, are liable to originate, 
either through kissing or by direct inhalation through close 
contact, the same disease in a healthy person; the greater 
the concentration of the breath inhaled the greater the 
danger. 

" Third. Since the same sputa in animals killed under 
ten days produced no disease, and since the healthy brain 
of other animals produced no disease, in cats even when 
under observation for a period longer than twenty days, 
while true tuberculosis always followed (in five of my own 
cases) the inhalation of tuberculous sputa in animals be- 
tween eighteen and thirty days after the first spraying, I 
feel warranted in inferring that in the last instance there 
was something specific in the inhaled spray requiring cer- 
tain development before originating the infectious disease, 
tuberculosis. That it was alone the tubercle bacillus of Koch 



Abstract Department. 287 

I have not claimed. My own opinion regarding the origin 
of tuberculosis, formed from this research and a no incon- 
siderable clinical experience with the disease, is that, like 
diphtheria, it is ordinarily determined by certain peculiari- 
ties and susceptibilities in individuals, together with the 
presence of a specific principle. Now when a person who 
has this peculiarity of weak lungs, or, in other words, one 
in whom bronchial and catarrhal troubles are easily ex- 
cited, has superadded the infection of tuberculosis, let it be 
in a minimum amount, we have arising true consumption 
running through its various stages. Even healthy persons 
can thus be infected when the specific matter is inhaled in 
large quantities, just as the poison in other infectious dis- 
eases will certainly produce these same diseases when in- 
oculated in concentrated quantities in persons who would 
otherwise escape. The reason why we have acute dissem- 
inated miliary tuberculosis in one case, and catarrhal 
phthisis in another, will depend upon the susceptibility of 
the individual to catarrhal cell-proliferation and whether 
the specific principle was superadded to an already exist- 
ing catarrh, in which case the specific principle would re- 
produce itself easiest at the seat of tissue necrobiosis. If, 
on the contrary, there existed a proclivity against catarrhal 
processes, and the person was infected with a concentrated 
dose, so to speak, of the specific principle ot tubercle, there 
might arise a disseminated miliary tuberculosis. 



Dressing- for tlie Umbilical Cord. 

W. D. Babcock, of Evansville, Ind., recommends {Amer. 
.Jour. Ohstet.) the use ot absorbent cotton as a dressing for 
the umbilical cord. Its use was suggested by a lady who 
saw it in his satchel, and he has since found it very effi- 
cient for that purpose. He says: "I have quite a pad of 
the cotton placed around the cord, without grease of any 
. kind, and do not allow it to be disturbed at all. In from 
three to four days the cord comes off, leaving the naval in 
the best condition. I have not had in a single case the 
slightest irritation or redness, nor granulations. I hope 
those who have not will give it a trial. It will, in a num- 
ber of cases, especially when you have awkward nurses, I 
think, prevent umbilical hernia. It prevents pulling on 
the cord, which is apt to occur when cloth is used. It gives 
equal and gentle pressure, and keeps the parts sweet and 
-clean. There was not the slightest odor in any case," 



TTiE 



Peoria Medical Monthly. 



THOS. M. McILVAINE, A. M., M. D., 

Editor and PublisJier, 

204 South-Jefferson Street, ... - PEOKIA. IIiI<. 

***The Editor is not responsible for the statements or opinions of contributors 

***Short original articles are Invited from any reader, whether a subscriber or not. 

***If extra copies are desired by a contributor, the number must be specified when 
the article is sent in to the Editor. 

**« All exchanges, books for review, and communications must be addressed to the 
Editor and Publisher. 

***The publication day of this journal is on or about the 15th of each month. 

***To subscribers ! A pencil mark at this place indicates that the time of your sub- 
scription has expired, and that a prompt renewal is urgently requested. 



MxUxi&X Jfjrartmettt. 



The Peoria Medical Monthly and the Code. 

Within the past six months we have received a great 
many letters from professional gentlemen asking for the 
position of this journal on the " code question." These in- 
quiries are easily and can be briefly answered: 

1st. If a man has subscribed to the rules governing 
any society he is bound by his honor to live up to those 
rules so long as he retains his membership, but he does not 
give up his right to criticise those rules, and work to amend 
them if he believes they are not accomplishing the pur- 
poses for which they were originally intended. 

2d. If any physician has serious, conscientious objec- 
tions to the existing code of ethics he should sever his con- 
nection with any society of which he may be a member 
that has incorporated the code in its constitution and rules, 
provided he is not able to effect a modification to suit his 
views. 

3d. Every regular practitioner of medicine is supposed 
to be a man of general education, and is therefore capable 
of forming his own standard ot right and wrong, and is 
entitled to an expression of his views upon any ethical 
subject. 



Editorial Department. 289 

4th. Believing as stated in the foregoing, The Peoria 
Medical Monthly will uphold the code of medical ethics 
of the American Medical Association so long as its editor 
shall retain his connection with that body. Yet the pages 
of this journal may consistently contain articles criticising 
the code, or even directly in opposition to it. We believe 
in perfect freedom of discussion, and will invite it in our 
pages, either upon medical or ethical topics. 



Death of Dr. James Marion Sims. 

In the death of Dr. Sims the medical profession of 
America has lost one of its most brilliant adornments, and 
the world a great and good man. Few medical men have 
occupied a more conspicuous position in the general world, 
and none have excelled the deceased in the dignity, honor 
and uprightness with which he acquitted himself in his 
sphere. 

Dr. Sims was born in Lancaster District, S. C, January 
25th, 1883, and died at his residence in New York city on 
Tuesday morning, November 13th, 1883. After graduating 
from the South Carolina (College in 1832 he entered Jeffer- 
son Medical College and received his degree in 1835. 

He practiced in Montgomery, Ala., from 1836 until 
1853, in which year he removed to New York. Although 
■diseases of women soon became a subject of special study, 
he att^ed considerable skill in general surgery. He per- 
fected the operation for the cure of vesico-vaginal fistula 
while in Montgomery, and there laid the foundation of his 
future successful career as a gynecologist. It was there, 
too, in 1845, that he invented the speculum that bears his 
name and that has worked such a change in gynecology. 

After his removal to New York, where he soon built 
up a large and lucrative practice, he was instrumental in 
establishing the pioneer hospital for women in this country, 
if not in the world. 

In Europe Dr. Sims was accorded greater honors than 
he received at home. Many governments bestowed upon 
him flattering evidences of their appreciation of his labors, 



290 The Peoria Medical Monthly. 

and his civil decorations were quite numerous. In 1870 h& 
was appointed Surgeon-in-Chief of the Anglo- American 
Ambulance Corps during the Franco-Prussian war, and 
much of its valuable services were ascribed to his energy 
and skill. 

Dr. Sims did not write many books, but what he did 
write, as contributions to medical journals, was always 
well received by the profession throughout the world. 
During the past few years he resided most of the time 
abroad, visiting th'is country during the autumn months, 
and it was just on the eve of his departure for his Italian 
home that death took him to his last rest. 



More Certificates of Practice Revoked hy the Illinois State 

Board of Health. 

The Illinois State Board of Health continues a vigor- 
ous warfare against itinerent " cure alls." At a late special 
meeting of the Board charges were brought against Drs. 
Smith and Jones, which consisted " not only in the claim 
that they were itinerent physicians, that they went from 
place to place soliciting custom, but that they were asso- 
ciated with notorious quacks and medical montebanks, or 
worse. Smith being employed by ' K. & K.,' a firm of typi- 
cal charlatans having their headquarters in Detroit." After 
considering the charges and discussing the cases, t^e Board 
ordered the revocation of their certificates. Since this 
action of the Board we learn through the daily press that 
Smith has brought suit against Dr. Rauch, Secretary of the 
Board, for $50,000 damages. He alleges that his crime 
only consisted in his advertising his presence in Peoria,, 
where he had gone to attend a medical convention. Re- 
diculous! There has been no medical convention held in 
Peoria since May last. His presence in Peoria was made 
known by extensive newspaper advertismg and by means 
of large circulars extolling the skill, etc., of the Detroit 
Medical and Surgical Institute of " K. & K.," in which in- 
stitution Smith claimed to hold the position of Vice-Presi- 
dent and Surgeon-in-Chief. He is a graduate of a Chicago 



I 



Editorial Department." 291 

Homoeopathic College, and only graduated two years ago. 
If our memory serves us right, a representative of " K. & 
K." is now doing this state free service in one of the peni- 
tentiaries. Smith boasts that he will return to Peoria in a 
short time; if he comes back he can be assured of a warm, 
it not a hearty, reception. Of course, his suit against Dr. 
Ranch will prove a mere game of bluff. 



Home Health. 

Lack of time necessary for its proper management has 
forced us to give up the publication of our sanitary journal. 
The Medical Monthly has grown to such an extent that it 
has become fully enough for any one man to attend to, and 
with the two journals there was danger of both suffering. 
Still we are happy to state that Home Health has gone 
into good hands, and although under another name the aim 
and interests of the original will be preserved. J. H. 
Chambers & Co., of St. Louis, Mo., will issue on January 1, 
1884, and thereafter a new publication, called "Chambers' 
Monthly," of which Home Health will form an important 
department. Dr. Curtiss w^ill continue as editor of that de- 
partment, and we feel confident that it will become the 
most interesting and valuable department in the "Monthly." 
Subscribers to Home Health will receive "Chambers' 
Monthly " for the unexpired term of their subscription. 
The new monthly will be a 96 paged, double column, large 
octavo journal, fully illustrated, and published at $3.00. 
We will have more to say of it hereafter. 



The Physician Himself. 

We have already several times referred to this very 
interesting work of Dr. Cathell, but feel it a privilege ta 
again call the attention of our readers to it. 

We do not exaggerate when we say it is impossible to 
begin it without reading it through, and it is among the 
few medical books that can be read daily with both 
pleasure and profit. It teaches medical ethics better than. 



292 The Peoria Medical Monthly. 

a thousand formal codes could ever do. As we wrote over 
a year ago, " Any who may purchase the work through our 
recommendation will thank us for bringing it to their 
notice." Dr. Cathell's address may be found elsewhere in 
this issue. 



Notes and Comments. 



Professor Donald Maclean, of Michigan, falls foul of 
K. Stansbury Sutton, M. D., of Pittsburg, over what he con- 
siders an attack on his veracity, and treats the readers of 
the Detroit Lancet to a protest in his own vigorous lan- 
guage. He writes: " The bombastic egotism and sciolistic 
phraseolgy of Dr. Sutton's paper merely make him redicu- 
lous." Further: '' The gratuitous insult amounts to mali- 
cious libel," and then turning upon the editor of the Lancet, 
continues: "That you, sir, should have lent your columns 
to the promulgation of such a vile slander without in the 
first place making for your oum sake some slight efforts to 
arrive at the facts passes my comprehension." The fact 
that Dr. Maclean lately won a libel suit for $50,000 against 
the Detroit Neivs may give great significance to the words 
he has italicised above. The trouble is about an article by 
Dr. Sutton in the Obstetric Gazette, in which he says: "I 
was long abroad and had access to everything, and I do not 
speak as did a certain Michigan professor of surgery when 
he began his report of a number of ovariotomies by saying, 
'Since my visit to Dr. Keith.' When I began to read his 
report I supposed he had seen Keith operate, but when I 
asked my friend. Dr. Keith, how long he had visited him, 
he replied, ' He did not see me operate, but spent an hour 
or two talking in the room here with me.' " Dr. Maclean 
supposed himself to be the Michigan professor of surgery, 
and retorts that he did see Keith operate several times, and 
assisted him in an ovariotomy, and then follows the above 
quotations. Dr. Sutton replies that " at present he has no 
reply to make to Dr. Maclean, but later he may be able to 
furnish conclusive proof of the statement." It takes a long 
needle to prick the epidermis of the Pittsburg gentleman, 



Editorial Depaetment. , 293 

"but we will bet on the Michigan professor of surgery with 
his "catling," as the Medical Age calls it. 

The St. Louis Medical and Surgical Journal has added 
Drs. Keber, of St. Louis; Christopher, of St. Joseph; At- 
wood, of St. Louis; Byrd, of Quincy, 111.; and Prince, of 
Jacksonville, 111., to its editorial corps. The time is not 
far distant when every physician in the country will be 
either an editor or a professor. 

With its December issue the Pittsburgh Medical Journal 
will suspend publication. Its senior editor is going to 
Europe, and there is not enough brains left in the city to 
run it in his absence. Is that the reason, or is it because 
•delinquent subscribers won't pay up? 

A DAILY medical journal has been started in Paris and 
all the journals are wondering at it. That's nothing new. 
Why, a daily medical journal was started in Peoria and 
run successfully for three days. Now don't look to Paris 
again tor medical novelties. 

The New England Medical Monthly gives in its Novem- 
l)er issue a cut ot Dr. W. A. Hammond. It is certainly not 
Tery flattering to the doctor's good looks, but still can be 
accepted as a sample of push and enterprise on the part of 
Bro. Wile. 

Dr. John Warren used to lecture on anatomy three 
hours at a stretch. Dr. Holmes confesses that his own 
students sometimes went to sleep, and his allotted time 
was less than an hour. Rather rough on Dr. Holmes. 

The brain of Carey, the '' Informer," weighed sixty- 
ihree ounces, and yet he wasn't smart enough to " get the 
■drop " on O'Donnell. We will probably hear the weight of 
O'Donnell's brain in a few months. 

Dr. Oliver Wendell Holmes calls the dissecting room 
the " Anthropotomic laboratory." The word probably only 
applies to Boston. 



294 The Peoria Medical Monthly. 

Receipts. 

Illinois. — Drs G. \. Oamerer, M. L. Brown, A. F. Campen, J. N. 
Niglas, F. Cole, W. H. Weirich. S. D. Culbertson, H. Schaefer, N. S. 
Tucker, E. W. Gray, R. I. Law, L. L. Leeds, R. W. Bower, A. F. Hand, 
H. Judd, C. D. Henton, J. L. Hoaver, W. R. Nash, S. S. Clayberg, W. 
H. Byford, I. D. Camerer, D. B. Jewell, E. L. Emerson, P. A. La Bar- 
riere, W. C. Boyington, G. W. Downey, O. P. Paulding, N. Hatton, V. 
B. Corey, H. N. Baldwin (2 years), H. C. Coffey, W. Zindel, J. P. John- 
son, F. M. Skinner, J. B. Carver, G. W. Dunlap, L. B. Martin, W. D. 
Nelson, I. H. Reeder (2 years), Anna S. Adams. 

Indiana.— Drs. W. B. Squire, W. C Chafee, W. B. Harris, J. 8. 
Sparks. 

Michigan. — State University Library. 

Ohio.— Drs. G. W. Swimley, S. W. Mercer, D. McElwee, J. W. 
Hoff. 

Minnesota. — Dr. T. Kirk. 

Wisconsin. — Drs. James Oettiker, J. N. Boyd, F. Pinch, W. A. 
Reed (2 years). 

Arkansas. — Drs. W. H. H. Caldwell, M. Y. Harston. 

Iowa. — Drs. F. T. Searles, M. I. Powers, D. W. Jackson. 

Texas.— J. W. Daniel. 

Dakota. — Drs. J. L. Otterman, D. M. Slemmons. 

Missouri. — Dr. A. V. Banes. 

Nebraska. — Dr. H. Reader. * 

Tennessee. — Dr. W. A. H. Coop. 



American Pharmacy Abroad. 



The aggressiveness of American enterprise received a very striking- 
illustration at the late International Pharmaceutical Exhibition held at 
Vienna, in the display of products from the laboratory of our energetic 
countrymen, Messrs. Parke, Davis & Co., of Detroit, Michigan. We 
notice in the reports as published in the domestic journals, and from the 
special correspondence of foreign journals, that the display, while excit- 
ing much interest from its scientific features, attracted more than ordi- 
nary notice from its artistic beauty and finish, among the non-professional 
visitors. This lay interest was, doubtless, largely due to the special 
attention given the display by the Emperor and the Archduke Karl Lud- 
wig. These royal visitors manifested unusual interest in this exhibition 
of American taste, and took occasion to especially compliment the firm, 
through its representative, on its enterprise and skill. We congratulate 
Messrs. Parke, Davis & Co. on this distinguished recognition of the 
artistic excellence of their laboratory products. Their intrinsic worth 
needs no commendation from us ; this has long been conceded by the 
profession. The gold medal awarded them by the Vienna Exhibition is 
but an endorsement of the esteem in which this scientific commercial- 
house is held in this country, where it is best known. 



The Peoria 
MEDICAL MONTHLY. 



VoK IV. DECEIIBER, 1883. No. 8. 



Original d^ommmuatiott^: 



Art. I.— Malarial Fever in Children, with Meningeal and Cerehral Com- 
plications. By a. B. Anderson, M. D., Pawnee City, Nebraska. 

In the present iDaper I propose giving first some cases 
of the above named fever, v^ith marked meningeal and 
cerebral complication, leaving others to judge whether 
these complications were of a congestive or inflammatory 
nature. Following the report I shall raise some inquiries 
which, to my mind, seem important and relevant, and sup- 
plement the whole with my own ideas of the pathology 
and treatment of these cases. Let me say first, that I have 
not selected these cases simply because they recovered, and 
that I have any specific for this disease, but rather because 
the fact that they did recover gives me the better oppor- 
tunity for following the cases in detail through the entire 
course of the disease. 

Case I. Female, aged 6. Was taken during the month 
of September, 1881; not suddenly, but had been sick for 
two days with mild fever before I was called. On my 
second visit I found an evening temperature of 104 deg.; 
pulse 130; child not delirious, but nervous and inclined to 
drowsiness; tongue coated brown; bowels torpid.* I had 
diagnosed malarial fever and prescribed mercurial purga- 
tives — gelsemium, aconite and cinchonidia. The next day 
there was a remission in the morning, but toward evening 
the temperature again reached 104 deg. Patient more 



k 



296 The Peoria Medical Monthly. 

stupid than on previous days. Treatment continued. The- 
drowsiness continued and increased to stupor, to that ex- 
tent that she could not be roused by calling or shaking, or 
in any way made to respond. On making my- usual morn- 
ing visit about this time, my attention was called to a 
peculiar shriek or crying out about every one or two 
minutes. Between these cries the patient made no noise, 
but was restless, tossing the head from side to side on the 
pillow, breathing regular, but sometimes almost stertorous; 
pulse 120, and intermittent. At this date my partner. Dr. 
Henry, at my request saw the case and pronounced it a 
complication of meningitis, with malarial fever, in which 
opinion I concurred. The symptoms after this date I take 
from memory, and will, of course, give only those that 
were impressed on my mind by their intensity, and by 
their distressing effect on friends, as well as the attending 
physician. Suffice it to say, that for two long weeks, day 
in and day out, there was restlessness, delirium, high tem- 
perature, irregular pulse, insomnia, crying suddenly out, 
throwing the hands, constantly rolling the head from side 
to side, strabismus, making up a group ot symptom? that, 
to my mind, at that time almost precluded a possibility of 
recovery. T do not mean to say that all of these symptoms 
continued through all this time, but during this time they 
all occurred, and were more or less persistent. Conval- 
escence was established very slowly; delirium and rational 
symptoms alternating, before the mind seemed at all under- 
proper control. During this stage occurred purulent dis- 
charge from the ears and abscess behind the lower maxil- 
lary. Duration, from the beginning of the attack until, 
convalescence, four weeks. 

Case II. Female, aged 2 1-2 years. When I was called 
to see this case the child had been sick for four weeks with 
continued malarial fever, while from the reports given me 
by the pitrents I judge had partially recovered and then re- 
lapsed into an intermittent form. The immediate cause of 
my being called was a convulsion, which occurred at the 
height of a paroxysm of fever. I found the child in a 
semi-unconscious state, eyes rolled back and symptoms of 



Oeiginal Communications. 297 

general nervousness. My first remedies were directed ta 
the nervous condition, as I was fearful of a second convul- 
sion, which seemed imminent. As the child had already 
been treated with large^ doses ot cinchonidia, as was shown 
by the powders present, I deemed it unwise to administer 
any more of that drug. I was at a loss to get something 
with which to replace it, the condition of the brain at this 
time, in my opinion, forbidding the use of any remedy 
whose tendency would be to at all increase cerebral excite- 
ment. I had already put the little fellow upon veratrum 
viridi, gelsemium and belladona. I left a prescription 
containing pot. iodid. 2 grs., ergot fl. ext. 2 drops. Fowler's 
solution 1 drop to each dose, which I ordered repeated 
every six hours. The child had one slight convulsion after 
I left on this my first visit, but none afterward. The 
sequer proved that the intermittent paroxysm did not re- 
turn. While there was some continued febrile action, a 
paroxysm did not occur. However, the cerebral symptoms 
did not improve. The coma continued for some time. 
Strabismus following, and at times evident blindness ex- 
isted. At times the appetite voracious, the next few hours 
refusing all food and drink. Sometimes she would call for 
a drink and on it being brought would push the cup away. 
Various up^ and downs occurred, and it was not until three 
weeks from the time I began to treat her that I could say 
she was really better. By this time she was greatly ema- 
ciated. Purulent discharge from the ears followed in this 
case, and from what I learned of the case since I think 
there was paralysis of the lower limbs. The family re- 
moved from the neighborhood as soon as the child was 
able to be moved, and before she had time to require the 
use of her limbs. She had improved very much, gained in 
flesh rapidly, but six months later I heard that she had not 
yet walked. 

Case III. Female, aged eighteen months. This child 
had been somewhat irritable for some days prior to being 
taken down sick. Parents thought the child teething. Or- 
dinarily she was very fond of being drawn about in a little 
wagon. During the week previous to her coming down 



.'298 The Peoria Medical Monthly. 

sick, the parents noticed that she would cry when taken 
to ride in the little wagon. She would ask to be allowed 
to ride, but as soon as they would start with her she would 
bfegin to cry, and they would have to take her out. She 
was taken suddenly sick, so far as the acute symptoms were 
concerned, with high fever, bowels constipated, and was 
-also inclined to be stupid. I saw her the next day. The 
parents had given several doses of rhubarb and some castor 
oil, but without effect. On my arrival I found a tempera- 
ture of 104 deg., pulse 130; drowsy, — would open her eyes 
when called, but immediately closed them again, without 
seeming to take any notice. She was very nervous. I 
used an injection, with some effect. Gave calomel and 
rhubarb for the bowels; also gave bro. pot., veratrum and 
cinchona alkaloid. For the next four days the symptoms 
did not materially change. Temperature 102^ in the morn- 
ing, and would run up to 103A or 104 during the day. After 
four or five days she would open her eyes without being 
spoken to, but would not hold them open. During the lat- 
ter part of the second week she seemed partially conscious. 
Eyes would follow those about the crib. Up to this time, 
everything that was put into her mouth was greedily swal- 
lowed, as readily as if it had been the best of food to a 
strong child, — the bitter just as readily as the .sweet, and 
without a single wry face. When she first opened her eyes 
so they could be observed, the right eye was very much 
turned toward the nose. During the fourth week this be- 
come straight, and the left eye turned as much inward. 
The bowels were very hard to move throughout the attack. 
The temperature gradually declined toward the close of 
the third week, and continued only at intervals afterwards. 
The pulse was very frequent from the beginning of the at- 
tack until the close of the third week; after this it did not 
exceed 120, and was frequently at lOS. During the fourth 
iveek, child was more wakeful; skin very dry; temperature 
from 100 to 101. Takes milk punch every three hours; 
also pot. iodid. ergot and gelsemium. Three gr. doses of 
chloral, repeated in two or three hours, to give rest at night. 
INow utters shrill, sharp cries every few moments. Con- 



Original Communications. 299 

«tantly throws. the right hand, and with it rubs the nose 
and eyes. The left arm is stiff; will yield to efforts to ex- 
tend or flex, but not readily. 

Wednesday: Slept eight hours during the last twenty- 
four. Sudden flushes of the face, lasting but a moment, 
and then face assumes the same pale aspect. No fever this 
morning, but during the afternoon the temperature reaches 
101 deg. Yery restless all day, constantly crying out with 
that distressing shrill cry. I gave chloral and bromide of 
potassium with but little effect. Toward evening gave tine. 
opii. deod. 5 drops. As a result the child slept four or five 
hours during the ensuing night. 

Thursday morning: Very restless; eyes rolled back. 
Had given bromidia 10 drops, and in half an hour 5 drops, 
with very little effect. Bowels moved without using the 
syringe. Now gave fl. ext. gelsem. 1-2 drop, -fl. ext. bella- 
doiia 1-12 drop, tine, veratrum vir. 1-12 drop every half hour 
for two hours. At the end of that time the child had be- 
come more quiet, and I ordered the same repeated every 
hour when awake. 

7:00 p. M. Found the child very restless, had slept but 
little during the afternoon, and when not asleep constantly 
tossing herself, rubbing the nose and, as near as I can de- 
scribe it, yelping every minute. Gave same dose as above 
and repeated it in half an hour. At eight o'clock babe was 
asleep; pulse 108 and feeble; breathing regular and easy; 
temperature slightly above the normal. 

Friday: Condition much theifeame; temperature nor- 
mal; child crying out as before, but voice very feeble, 
scarcely audible; constantly putting out the tongue and 
working the jaws as if heaving; tongue coated white. Gave 
same portion of gelsemium alone every three hours. There 
is no effect of the drug upon the eyes. 

Saturday: Child is making no noise but constantly 
•opening and shutting the mouth, as if attempting to make 
the same cry as heretofore. Slept seven or eight hours 
during the past twenty-four. Takes milk, with a prepared 
food, "Imperial Granum," every three hours, also stim- 
ulant. 

Sabbath: Condition unchanged since yesterday. 



300 The Peoeia Medical Monthly. 

Monday: Voice is stronger, and cry somewhat differ- 
ent — more of a whiny cry. Hands are going all the time^ 
rubbing eyes and nose, and running the fingers into the^ 
mouth and biting them until they are ready to bleed. Eyes- 
are very dull. You may put the finger upon the eyeball 
without producing any involuntary movements of the lids.. 

Tuesday: Condition unchanged. 

Wednesday: Appearance of patient better. Eyes fol- 
low the cup of food, and the head will slightly turn as the 
mother moves around the crib. Pulse some stronger. 
Bowels have not moved for forty-eight hours. Have been 
giving 5 grains of rhei every six hours for the past twenty- 
four. Used injections with slight effect. Bowels full but 
not hard or sensitive. Ordered three drops of chlor. ano- 
dyne every two hours to procure rest. 

Thursday: Child is evidently better; improvement 
apparent to all; slept greater part of last night, and not 
fretting when awoke this morning. Pulse 102 and good 
volume. Large operation from the bowels after giving two 
doses of Husband's magnesia. 

Friday: Had a very restless night. Three drops of 
chlor. anodyne every three hours failed to bring sleep. On 
my arrival, as the child was very restless, throwing itself 
from side to side as much as its feeble strength would 
allow, I gave 4 grains of chloral with 5 grains of potas. 
bromidi. Waited one hour. No effect being manifested, 
I then gave 5 drops of deod. tine. opii. with same quantity 
of Jamaica dogwood. I§ thirty minutes child was asleep. 

Saturday: Slept considerably last night. Eyes look 
heavy and dull this morning. Temperature lOlJ deg. at 
4: 00 p. M., and child very restless. Gave potas. bromidi 5 
grains, with gelsem. 1-2 drop, and belladona 1-6 drop, every 
hour. If this does not procure rest in three or four hours- 
they are to give 3 drops of chlor. anodyne, which was done,, 
and the patient had a pretty good night. 

Sabbath: Appearance better. Eyes look intelligent 
and follow the mother about the crib. 

Monday: Called early. Had no sleep through the- 
night. Chlor. anodyne failed. This morning child is con- 



1 



Original Communications, 301 

stantly chattering, as if talking to itself. Takes food read- 
ily. Does not look wearied, though it had not slept a wink 
for forty-eight hours. I gave, this morning, 5 grains ot 
chloral hydrate with 10 drops of paregoric, and in half an 
hour repeated the dose; in another half hour, as there was 
no effect, repeated it again. The result of this was, that it 
slept perhaps half the time until the next morning, when 
it seemed as wakeful and talkative as ever. The improve- 
ment from this time on was gradual, but apparent, from 
day to day, and the greatest difficulty was to procure sleep 
and to get the bowels to move. For the former, the prepar- 
ation last named seemed to do the best, namely: chloral 
and paregoric. A change was occasionally made, as had 
been before, to some other anodyne, but whatever was 
used had to be given in large doses to produce any effect. 

A resume of the symptoms and treatment of this case 
will better place it before our minds in order to make sat- 
isfactory conclusions: 

Taking up the febrile condition, we find a very high 
temperature, with slight morning remissions, continuing 
into the third week; then a gradual decline, and final sub- 
sidence about the end of the fourth week. In regard to the 
nervous symptoms, we have drowsiness, then complete 
stupor, bronchial rales, (a symptom not mentioned in the 
report, but which was present on my first visit, and con- 
tinued three days, subsiding without any expectoration or 
even cough,) general nervousness, strabismus, crying out, 
insomnia. Bowels constipated throughout the attack, only 
once distended and tympanitic, several times boat-shaped, 
most of the time flacid. Pulse first frequent,— 130 to 140, — 
then slow,— once below 100; continued at 108 for several 
days, when there was considerable fever. Sudden and 
transcient flushing of the face observed at intervals during 
three successive days. Now, while none of these symptoms,, 
taken alone, are said to be pathognomonic of cerebral fever, 
yet, in this last case, they form a group which, to my mind, 
needs only to be confirmed by an autopsy to make more 
conclusive that actual cerebritis did exist. But since the 
patient recovered, and the conclusive evidence thus denied^ 



302 The Peoria Medical Monthly. 

are we to conclude that that dread and so generally fatal 
disease, cerebral fever, did not exist? 

As to the treatment, we will give that which was fol- 
lowed in the last case mentioned as a type of our treatment 
of such cases, which can be given in few words. In most 
of these cases, as we find them in this locality, malaria is 
present in a marked degree, and must be met. In children 
generally, and especially where there is much nervousness, 
I am decidedly in favor of using the sulphate of cinchona, 
or the cinchona alkaloid, as less liable to provoke cerebral 
or meningeal irritation. As for the arterial sedatives, I 
prefer veratrum viridi or gelsemium, unless there are special 
indications for the use of aconite. When the brain or 
meninges become involved, as indicated by the symptoms 
already mentioned, I rely upon the effect^of iodide of pot- 
assium and ergot, and it is a matter of note the quantity 
of iodide these little patients will bear without producing 
the usual symptoms of iodism. As an alterative in adults, 
we give 5 grains of the iodide three times a day, increasing 
the dose, perhaps, as needed. In these little patients we 
give 2 grains, with 2 drops of fl. ext. ergot, every three 
hours, which in twenty-four hours reaches the usual quan- 
tity for adults in the same time. I will not attempt, in this 
paper, which is already too long, to enter into a discussion 
of the modus operandi of these two drugs, which, to my 
mind, are the important ones in these cases. In chloral 
hydrate we have a most valuable aid to our other remedies 
for procuring rest. This I combine with the bromide of 
pot., and disguise the disagreeable taste of this salty and 
pungent combination by the addition of a little elix. lico- 
rice. Belladona comes in frequently in these cases, but I 
give it in very small doses — say 1-12 of a drop to a child 
two years of age; in the latter stage of the disease, more as 
a heart stimulant than for its calmative effect. Blistering 
behind the ears, or on the back of the neck, according as 
the symptoms point to cerebral or spinal predominance, is 
a measure that I think should not be forgotten, and, unless 
there is good grounds for dispensing with it, should be em- 
ployed. Now, while I do not claim anything new in dis- 



Original Communications. 308 

covery or application, I must say that I have succeeded in 
many of these cases by the judicious application of these 
remedies, even bej^ond my own expectations; and if I have, 
in this imperfect paper, added even a mite to the available 
resources by which the lives of our children, and the child- 
ren of our patrons, — the first unspeakably dear to us, be- 
cause they are a part of our very selves; the second also 
dear to us, because they are children, innocent and love- 
able, and awaken in every parent's heart a tender chord of 
sympathy when they are suffering, — I shall be satisfied. If 
I shall, by this means, awaken in the minds of my co- 
laborers a greater interest, — a more intense, dilligent and 
determined search for the truth, — a greater interest and a 
more, careful study of this most important branch of medi- 
cal practice, diseases of children, I shall be amply rewarded. 

4 

Art. II.— a Report of Three Cases of Fibrous Contraction of the Pylorus, 
with Consequent Dilatation of the Stomach. A paper read before the 
^sculapian Society of the Wabash Valley at its thirty-seventh annual meet- 
ing, at Paris, Illinois. By A. J. Miller, M. D., Parjs, Edgar County, 111. 

My apology for reporting the following cases is the 
sparseness of our literature on this subject, owing, most 
probably, to the somewhat rare occurrence of the disease. 
But as three cases have fallen under my notice within the 
past five years, two of which I had charge of for the last 
six months previous to their disease, and in all of which a 
;post mortem examination was had, either revealing or con- 
firming the true diagnosis: 

Case I. Allen Buckler, aged 52, was a farmer and re- 
sided five miles from Paris. Sometime in the spring of 
1876 he applied to Dr. H. L. Obetz, a homeopathic physi- 
cian, for what seemed to be a slight attack of indigestion; 
but he gradually grew worse, and at the close of a year was 
induced to present himself to a convocation of homeopathic 
physicians then being held in Terre Haute, Indiana, where, 
after a careful examination, the savants of that body de- 
cided that he had cancer of his stomach. Early in the 
spring of 1878 he came under my care, at which time it 



304 The Peoria Medical Monthly. 

was evident he had dilatation of his stomach, from obstruc- 
tion of some part of the alimentary canal below that 
viscus; but as to the exact nature and location of the ob- 
struction I had about as vague conceptions as the profes- 
sion at present seem to have of the ultimate causes that 
are brought to bear in the production of the disease in 
question. 

At the time I took charge of him his bowels were ob- 
stinately constipated, and he complained of an almost con- 
stant burning, gnawing pain in the stomach, with sour 
eructations, which, when it was full, he described as being 
^distressing m the extreme. ' He vomited, as a rule, but 
once in twenty-tour hours, and this took place about two 
or three o'clock in the afternoon. After vomiting from 
one to two gallons of a grumous matter, mixed with more 
or less particles of undigested food, he wouliihave a few 
hours of comparative repose, during which time he w^ould 
frequently become very hungry, and the too free indul- 
gence of this craving for food seemed to be a prolific source 
ot his suffering. He was considerably emaciated and 
gradually grew more and more so, evincing by this fact, 
and his constant loss of strength, unmistakable signs of in- 
anition. I treated him for a while with laxatives, salicylate 
of soda, pepsin, wine and lactate of iron, together with a 
diet restricted mainly to animal broths, eggs and milk. 
But he so often broke over these restrictions that I soon 
abandoned all efforts in that direction. For a month pre- 
vious to his decease, which took place on the first of 
August, then-e was nothing whatever passed through his 
bowels. In this case I made no efforts at rectal alimenta- 
tion, as I saw no prospect whatever of his ultimate re- 
covery. 

On the 2d day of August, assisted by four or five mem- 
bers of the profession from our city, I made a post mortem 
examination of the body, with the following results: 
Stomach dilated to at least three times its normal capacity, 
with greatly attenuated walls. About an inch and a half 
of the pyloric extremity was contracted so as barely to ad- 
mit the passage of a crow-quill. 



Oeiginal Communications, 305 

Here is a section embracing the constricted portion, 
"which has been slit up, on account ot tlie canal being tor- 
tuous from unequal contraction. There seems to have 
been no proliferation of new tissue, but a simple contrac- 
tion and condensing of the existing fibrous tissue surround- 
ing the part; nor was there the slightest evidence of any 
inflammatory action. The immediate cause, doubtless, of 
death, was inanition. What the remote cause was, which 
produced the pathological condition herein described, no 
man at present is permitted to know; nor are we in posses- 
sion of any known remedy or course of treatment for either 
its prevention or cure. The other organs of the body, as 
far as examined, were seemingly in a healthy condition. 

Case II. Jacob Harding, aged 80, was a prominent cit- 
izen of Paris for many years. He had always enjoyed 
good health until sometime in the fall of 1882, at which 
time he became troubled with symptoms of indigestion; 
his bowels were obstinately constipated, and he was almost 
constantly affected with a peculiar sense of gnawing and 
burning in his stomach, and these symptoms were more or 
less accompanied by nausea, anorexia and vomiting, 
together with frequent eructations of gas, and more or less 
tenderness and pain in the region of the pylorus and along 
the lower border of the liver. He came under my care on 
the 6th day of December last, with symptoms as above de- 
scribed. His temperature was slightly above normal, and 
his pulse about 80, with considerable thirst. After moving 
his bowels, which had been locked up for eight or nine 
days, I put him on Nichol's Elixir of Calisaya, iron and bis- 
muth,— dose, a dessertspoonful after meals. To each dose 
of this was added the 1-32 of a grain of strychnia, and, to 
arrest the excessive fermentation of the contents of his 
stomach, I gave him from 3 to 4 grains of salicylate of 
soda, three or four times a day. Under this treatment he 
seemed to improve for a short time. Several other reme- 
dies were tried in his case. Jensen's pensin, in 2A-grain 
doses, was tried, after taking albuminous food. But little 
benefit was obtained from this, or anythiug else. His 
strength gradually failed, and the stomach became so irrit- 



306 The Peoria Medical Monthly. 

able that he absolutely refused to take nourishment by the 
mouth any longer, and there was left but one alternative 
to perpetuate his existence any longer, and that was rectal 
alimenation. The nutriments used were milk and concen- 
trated animal broths. These, by means of a stomach tube 
and a Davidson's syringe, were thrown quite high up into 
the bowels. For about ten days the nutriment so given 
seemed to be digested, and his stomach became much 
quieter; but after this the bowels would no longer retain 
the enemata for a sufficient length of time for digestion to 
take place, although tincture of opium was combined with 
the nutrients. All efforts to nourish were now given up, 
and the patient allowed small bits of ice to allay thirst. 
Morphine was hypodermically used in small quantities, to 
procure sleep. He did not vomit often, but the quantity 
was large, ranging from one to two gallons at a time. The 
matters vomited during the last week of his life were floc- 
culent, and of a dark green color, and almost odorless. 
He died on the 11th of March. A post mortem was obtained, 
and on the following day, assisted by several of the physi- 
cians of our town, the body was examined with the follow- 
ing results: Stomach enormously distended, and its walls 
attenuated, but otherwise healthy, except at its pyloric ex- 
tremity, three or four inches of which showed obvious signs 
of inflammation. The fibrous tissue surrounding it was 
greatly contracted. The right lobe of the liver was also 
enlarged, and its lower border firmly adherent to the pyl- 
orous and first part of the duodonum. All the surrounding 
tissues showed signs of inflammation, being more or less 
indurated, and of a dark red color. The calibre of the dis- 
eased section was greatly reduced, but not occluded. The 
remainder of the alimentary canal was healthy. The stom- 
ach had in it a gallon or more of the same kind of fluid he 
had been vomiting for a week previous to his death. 

Case HI. Mrs. C. H. Fenton, daughter of Col. Thomas 
Harris, of this city, aged 26 years. I first saw her on the 
27th of last September, the day on which she died, in con- 
sultation with Dr. John TenBrook. She had been suffering 
for several days with persistent pain in the lower part of 



Original Communications. 307 

the bowels; her pulse was quick and feeble, and she had 
tonic spasm of her upper extremities and of the glottis, — 
the latter of which made her breathing distressingly labor- 
ious, and this lasted until overcome by the relaxation of 
death. The history of the case, as obtained from the fam- 
ily, is as follows: Some three and a half years ago she be- 
gan to have symptoms of indigestion, which gradually 
grew more and more aggravated. She not only had all the 
symptoms described in the preceding cases, but in addition 
to these, when the paroxysms were severe, she had tonic 
spasm, as above referred to; but whether the larynx was 
usually involved or not, I am unable to state. Her appe- 
tite at times was voracious, but whether indulged in or not, 
the vomiting in time came; but refraining made it less fre- 
quent. A number of physicians were consulted with refer- 
ence to her case, but they were all in doubt as to the true 
nature of her ailment, — some of them not even venturing 
an opinion in the case; nor was there any appreciable ben- 
fit resulted from any plan of treatment adopted during her 
entire illness, except of a tempoi iry character. She died,. 
as before stated, on the 27th of [September, and, at the re- 
quest of Dr. TenBrook, a post mortem was granted, and on 
the following afternoon the body was examined, with the 
following results: Her stomach, as in the other cases, was 
enormously dilated, over-riding the transverse colon and 
reaching to the pubic arch. Its walls were also greatly at- 
tenuated, but there were no other signs of diseased action,, 
except at the pyloric extremity, where a fibrous band about 
an inch in width encircled it, closing the outlet until its 
lumen was only a few lines in diameter. The chest was 
not opened,, nor was the liver examined. A section of the 
transverse colon about five inches in length was entirely 
dead, all its coats being dry, but they had not lost their in- 
tegrity. There was no shading off of the diseased action,, 
but up to a line on either side the dead and living tissues 
were joined. This dead portion of intestine was filled with, 
fecal matter, but nat to distention, nor were its contents 
either hard or dry, so that its lodgment was most probably 
due. to loss of peristaltic action in the necrosed gut, and not 



308 The Peoria Medical Monthly. 

the cause of its death. What the true cause was, is to me 
an unsolved mystery. It was certainly not due to pressure. 
Whether this local death began in the peripheral nerves, or 
in the extreme blood-vessels that are dependent upon the 
former for their functional power, we cannot tell, and could 
we determine this fact, the cause would be none the less 
obscure. The general failure of nutrition was undoubtedly 
one of the strong predisposing causes. 

Of these three cases, the first and third were non-in- 
flammatory. The obstruction in the second case was 
clearly due to an inflammatory action, and it may fairly be 
doubted whether it ought to be ranked in the same cate- 
gory with the other two. This inflammatory action most 
probably had its origin in the liver. 

" Stenosis, constriction, and obstruction of the pyloric 
orifice," says Reynolds, " are comparatively rare, independ- 
ently of obstructions from cancers and other tumors of the 
mucous membrane, or from cicatrices resulting from the 
healing of ulcers, or sometimes from the eff'ects of corrosive 
poisons. Pyloric stenosis may, however, result from the 
induration of the submucous tissue which may affect the 
stomach throughout, or may be limited to the pyloric ring 
— occasionally it results from hypertrophy of the muscular 
coats which may be limited to the pylorus, or it may aftect 
the stomach throughout. Obstruction may arise from 
pressure upon the pyloric orifice, or first part of the duode- 
num, by tumors originating externally to the organ. The 
most common of these are cancerous growths in the pan- 
creas, in the lymphatics of the small omentum and in the 
liver. The symptoms of this affection are essentially those 
resulting from obstruction to the passage of food from the 
stomach, though varied by those of the other diseases in 
which the obstruction has its origin. Vomiting is the most 
distinct and prominent of these. Its appearance is not 
necessarily indicative of absolute closure of the pylorus, 
for Bamberger has observed it to occur in cases where the 
orifice would still admit of the passage of the little finger. 
Its character and time of appearance, however, greatly de- 
pend upon subsequent changes in the stomach, and espe- 



Original Communicatiqns. 309 

cially on the degree of dilatation which the organ under- 
goes. 

" Paralysis of the muscular coat, limited to the pyloric 
portion, has been known to cause secondary dilatation of 
the stomach. Also, obstruction of the duodenum, or even 
of the upper portion of the jejunum, has been followed by ■ 
the same result." The excessive use of vegetable food has 
been thought by Dr. Hodgkin to cause the disease in ques- 
tion. Omental hernias, by causing dislocation and drag- 
ging of the stomach, may, says Bamberger, produce the 
disease. The first cause of dilatation would seem to be the 
obstruction to the onward march of the food, producing an 
almost continuous over-distention, and consequently a con- 
tinuous strain on the muscles of the stomach, which, says 
Neimeyer, induces myOjoathic palsy in them. One of the 
most distressing results of this forced retention of food in 
the stomach, is the production of fermentative changes, 
from whence arises that burning, gnawing sensation which 
is always present. And this fermentative process also gives 
rise to an almost unbearable nervousness that tends to the 
production of misanthropy. For further particulars re- 
specting the etiology, pathology, symptomatology and diag- 
nosis of this distressing malady, I will refer you to Rey- 
nold's System of Medicine, as it contains more on the sub- 
ject than any. work, except Ziemssen's Cyclopedia, with 
which I am acquainted. Many of the older works are en- 
tirely silent on the subject. 

The treatment of cases of obstruction of the pylorus, 
says Reynolds, can only be of a palliative nature. The 
main indication is the administration of food in small 
•quantities, and at frequently repeated intervals. It is also 
of extreme importance that the food given should be of 
such a nature that it can undergo its chief metamorphosis 
by the process of gastric digestion. Hence, protein sub- 
stances, beef-tea,j)owdered meat, or, possibly, meat already 
-digested, as suggested by Drs. Marcet and Pavy, should 
form the chief articles of diet. All articles of diet contain- 
ing starch, should, on account of their causing fermenta- 
tion, be avoided. The use of pepsin and hydrochloric acid 



310 The Peoria Medical Monthly. 

with the food, for obvious reasons, is indicated, although 
fermentation may be greatly controlled by the judicious 
use of salicylate of soda or the alkaline sulphites. Strych- 
nine, and the use of the battery, would seem to be indicated^ 
as they tend to impart tone to the stomach in its half par- 
alyzed condition. But the remedy first introduced by 
Kussmaul, and so highly lauded by Niemeyer and Fother- 
gill, especially for dilatation, whether produced by obstruc- 
tion or not, is the use of the stomach-pump. Says Nie- 
meyer: Even the first application of the pump generally 
gives the patient such relief, that, so far from dreading its 
repetition, he will clamorously beg for it. After the stom- 
ach is emptied, says Kussmaul, it should be washed out 
with vichy water or sulphurous acid. Other antiseptics 
will answer the same purpose, provided they are of such 
kind and strength as may be safely introduced into the 
stomach. 



Aet. III. The Significance of Albumin in Urine. Read before the Peoria 
City Medical Society, Dec. 4, 1883. By Thos. M. McIlvaine, M. D., Peoria, 
111. 

The discovery of albumin in the urine of any person, 
whether the urine be that of a patient, or an applicant for 
life-insurance, or a physician or student studying normal 
fluids, is, to say the least, an alarming one, and it behooves 
us to become well acquainted with the true significance of 
that which, in this connection, may well be called "matter 
in the wrong place.*' 

In choosing this subject to open the discussion this 
evening, it was not my intention to consider in any detail 
that disease in which albuminous urine is so important a 
diagnostic factor — Bright's disease of the kidney, but simply 
to call attention to the probable causes of this abnormal 
condition, and its varying significance, whether physiolog- 
ical or pathological, and endeavor to arrive at some practi- 
cal conclusions that may be of service to us as general 
practitioners of medicine. 

The short time allotted me for the preparation of this 
paper must be my apology for its fragmentary character. 



m 



Original Communications. 311 

To attain the object of my paper, it will be necessary 
to revert to so much of the minute anatomy of the kidney 
as will serve to make plain the terms I shall frequently 
use. "For the purpose of the physician, the kidney may 
be divided into three parts. It consists, first, of a compli- 
cation of tubes, which, with the malpighian bodies in con- 
nection with them, aro the sources of its secretion, and are 
the essential elements of the gland. Secondly, these struc- 
tures are bound togetlier with a delicate web of sparsely 
nucleated fibrous tissue. This surrounds and supports 
every tube and every malpighian body. Thirdly, the gland 
is abundantly supplied with blood-vessels, which lie with 
the fibrous tissue between the tubes."* 

1 shall, however, go somewhat deeper into the micros- 
copical anatomy of the organ. 

The malpighian body consists of a glomerulus or tuft 
of blood-vessels floating in a sac, known as Bowman's cap- 
sule. Both the tuft and the interior of the capsule are 
lined with connective tissue, covered by flat epithelial cells. 
As the principal function of the tuft is to permit of the ab- 
straction of the watery portions of the urine, the capsule 
has an outlet which is the beginning of the uriniferous 
tubule. The portions of the tubule with which we are con- 
cerned, are the proximal convolution, the descending limb 
of the loop, Henle's loop proper, the ascending limb of the 
loop, and the distal convolution of the tubule. After pass- 
ing through this winding channel, the urine unites with 
that from similar sources, and flows towards the pelvis of 
the kidney. 

The epithelia of the tubules differ materially from 
those of the glomerulus, being composed of a clouded mass 
of nucleated protoplasm, loosely attached to the basement 
membrane. This epithelial lining of the tubules rests upon 
endothelia, covering the basement membrane of the 
tubule.f 

That the urine of persons suffering from dropsy would 
coagulate with heat, was noticed as early as 1770, by Coto- 
gno, but until the appearance of Dr. Bright's " Report of 

* " Albuminuria."— Dicfcj/ijon, p. 1, el seq. t Bright's Disease— Millard, p. 6, et seq. 



312 The Peoria Medical Monthly. 

Medical Cases," in 1827, no definite idea was had as to its 
close connection with renal disorders. 

Dr. Bright considered albuminous urine as pathogno- 
monic ot the renal disease he described, and which justly 
bears his name, and from that day to this it has been looked 
upon by a large majority of medical men as indicative of 
one of the gravest diseases to which man is liable. To con- 
sider whether these fears are, in all cases, well founded, and 
what the real significance of this unnatural condition is, 
comprises the object of my paper. 

In order to examine the subject methodically, I shall 
ask the following questions in regular order, and attempt 
to answer them from the best authorities that I have been 
able to consult: 

1st. What are the sources of albuminous urine? By 
albuminous urine I mean renal albumin, as distinguished 
from albumin entering the urine external to the kidney, as 
from blenorrhoea, deep vaginitis, cystitis, and blood in the 
ureters, bladder, and elsewhere. 

Time will not permit of even the shortest resmne of all 
the theories as to the parts of the kidney involved in its 
secretion or extraction. Mention of some of the most im- 
portant of these theories may, however, be of interest. 

Hydraemia, or a thinned condition of the blood, was 
one of the earliest, and Canstadt and Prout were its especial 
upholders. They argued that, as the blood was abnormally 
thinned, its liquid constituents might pass out by mechani- 
cal filtration; but the experiments of Stokvis and others 
disproved this completely. 

Again, it was held that a portion at least of the albu- 
min might have passed into the urimiterous tubules from 
the vessels in the connective tissue around them. Yet, in 
order to do this, the albumin would have to pass through 
the walls of the blood-vessels, the structureless basement 
membrane, and the endothelial growth which replaces the 
lost tubular epithelia, — that is, through three layers, each 
of different structure, a fact which renders this source ex- 
tremely improbable, if not absolutely impossible. It is now 
generally agreed upon by the latest and best authorities 



Original Communications. 31B 

that it is within Bowman's capsule tlfat albumin is ex-^ 
tracted or secreted. * 

My second question is one much more difficult of 
answer. 

2d. What are the causes of albuminous urme? 

Passing over the subject of physiological urine for the 
present, it may be broadly stated to depend upon patho- 
logical conditions, or, in other words, "some abnormal con- 
dition of the circulatory process of the kidneys." This 
abnormal condition may be produced by many direct 
causes, as the irritant poisons, heart affections, various 
fevers, as typhoid and yellow fevers, specific affections, as 
scarletina and cholera, diseases of the nervous system, as 
mania, and affections of the spinal cord, lead poisoning, 
pregnancy, and many others exclusive of nephritis.f 

Apart from these direct and known causes, an in- 
creased blood pressure in the vessels has been held as the 
principle factor in its connection. Others have asserted 
that the loss of the epithelial lining of the secreting tubes 
gives easy passage to the albuminous fluids. 

Dr. Dickinson^ combines these theories in his work on 
" Albuminuria," and adds a thiilr influence, that of a larda- 
ceous change in blood and vessels which permits of the 
transudation of the liquor sanguinous. 

Bartels insists strongly upon the theory of congestion 
and epithelial loss or change. He says: " The overflow or 
passage of serum albumin from the Mood vessels into the renal 
tubes will in every instance be proportioned either to an existing 
abnormal blood pressure or to an altered state of the walls of 
the vessels, or to a combination of both these causes acting to- 
gether"^ Admitting the fact that albumin transudes ani- 
mal membranes with difficulty unless a high pressure be 
attained, he argues that the increased pressure may stretch 
the walls of the vessels and consequently enlarge the pores. 
To quote: "It may chance that the cells which form the 
covering of the capillary coils loosen and separate from 
each other under the strain to which the glomerulus is sub- 



*Bright's Disease— Millard— p. 49. f Significance of albumin as a symptom.— Ellis. |Albu- 
minuria, page 12. IZiemsson's Cyclopaedia— YoX. XV., page 40. 



*314 The Peoria Medical Monthly. 

jected and admit cfr pores or passages forming in the epi- 
thelial network." It will • be noticed that he attributes 
everything to mechanical force, and little or nothing to 
.structural or functional change. 

Against the theory of increased blood pressure may be 
adduced the experiments and conclusions of Overbeck, 
Goll, Stokvis, Ludwig, Paschutin, and latest, Dr. Walter 
Mendelshon, of New York, all of which go to show that in- 
creased pressure results in a diminution or absence of 
albumin. If it is granted that increased pressure causes a 
diminished velocity in the vessels of the tufts, the explana- 
tion becomes easier and more rational. That the glome- 
Tulal epithelium is peculiarly sensitive to anaemia has been 
proved by many authorities, and that a diminished velocity 
•does produce this condition in the cells cannot be denied; 
hence we do not need to look farther for a sufficient cause 
of albumin in the urine than this deoxygenated condition 
of the blood causing anaemia of the cells, and thus produc- 
ing partial or complete loss of their functions, one of which 
is to prevent the transudation of the serum albumin. This 
view is held by Charcot, Nussbaum, Overbeck, Heidenhaim 
and Millard, and is, I think, the most reasonable one yet 
advanced. 

In view, however, of many observations and some ex- 
periments, it is necessary to account for the presence of 
albumin in urine by another direct cause, namely, the in- 
fluence of the nervous system. Histologists and patholo- 
gists have given but little attention to the subject, and it 
is usually dismissed, in even the most elaborate works, 
with a paragraph, at best a page. 

Dr. Halbrook found that large numbers of nerve fibres 
accompany the arteries, producing reticula around the ves- 
sels and the tubules. A delicate plexus is found within 
the basement membrane and sending filements through the 
cement substance of the epithelia and interconnecting the 
•epithelia. It could not be demonstrated that nerve fibril- 
lae entered the interior of the epithelia, but it is reasonable 
±0 suppose that sach is the case.* 

* Microscopical Morphology — Heitzmann—p. 748. Bright's Disease— JftUard — p. 28. 



Original Communications. 315 

The experiments of Dr. Mendelshon* on the renal 
circulation during fevers, bear evidence to prove the influ- 
ence of the nervous system. He finds: 

1. "That in dogs with fever the kidney undergoes a 
diminution in its bulk. 

2. "This diminution is due to a contraction of the walls 
of the blood vessels. 

3. "It is constant and progressive, being proportionate 
to the intensity of the fever. 

4. "That it is, in all probability, the result of a nervous 
stimulus originating in the central nervous system from 
the irritation of abnormally hot blood circulating there." 

I grant that this is but meagre evidence, but I believe 

it to be in the right direction and will be further substan- 
tiated. 

No one claims that in every case in which albumin is 
found in the urine evidences of pathological changes are 
found in the kidney. There may be the transudation of 
even a large amount of albumin without a change to 
account for it, just as we find grave cases of nephritis in 
which there is no sign of any albumin whatever. 

Numerous cases are on record where this has been 
known and observed for years. I will merely give the out- 
lines of a case that has come to my notice. My reason for 
not giving this case in detail is, that the case will in a 
short time be reported at full length by the patient him- 
self. 

Dr. , professor in a medical college, while making 

various tests before his students, used some of his own 
urine to show negative results in normal urine, was much 
alarmed to find a large amount of albumin in it. Careful 
chemical tests confirmed its presence, while microscopical 
examination failed to reveal any casts. He was in usual 
health at the time; had no symptoms of renal disease what- 
ever. The amount of albumin found was one-third by 
bulk. It is now three years or more since this was first 
noticed, in which time the quantity of albumin has some- 
ivhat lessened. Still he is in perfect health, and has gained 

* American Journal of Medical Sciences, 1883. 



316 The Peoeia Medical Monthly. 

somewhat in flesh. Says he is positive that he has no 
renal disease. 

Another case somewhat similar, but not so striking, 
has also come to my notice. Dr. D., while attending his 
last course of lectures, discovered albumin (about 1-12) in 
his urine. No other symptoms of renal disease presented 
themselves. He entered into active practice, enjoying 
usual health, and considers himself a perfectly well man 
to-day. 

In each of these cases the cause was attributed to over 
mental exertion, and this theory is not without other con- 
firmatory observations. " Chateaubourg found that the 
urine of forty-six out of fifty pupils at one of the govern- 
ment schools who were hard at work preparing for exam- 
inations, or ninety-two per cent., contained albumin.""^ 

I must now pass on to consider briefly the existence of 
physiological albuminuria. It was suggested by Gubler, in 
1865, that albumin existed in the urine of well persons. 
Ultzman, J. Vogel, and Saundby report cases confirmatory 
of this condition. Millard states he has frequently detected 
albumin in the urine where no evidences of deranged 
health existed. Capitan and Chateaubourg have recently 
published a series of experiments which furnish almost in- 
disputable proofs of the compatibility of various degrees of 
albuminuria with perfect health. Space will not permit of 
more than a mention of these interesting observations. 

In ninety-eight healthy soldiers, under the most favor- 
able circumstances of rest and diet, albumin was found in 
the urine of forty-four. Again, out of ninety-four the urine 
of seventy-six (or 82 per cent.) showed degrees of albu- 
minuria. 

The urine of eighty-eight was examined after two 
hours' severe exercise in the hot sun, and seventy cases (or 
87.5 per cent.) showed the presence of albumin. 

This subject of physiological albuminuria is one of con- 
siderable practical importance, and should always be re- 
membered where an examination of urine is made. 

But my paper is already too long for the time allotted 

* Bright' s Disease — Millard — page 42, et seq. 



Original Communications. 317 

me, and I will close by deducing some conclusions from 
what I have so rapidly passed over. Some of my conclu- 
sions may seem trite and commonplace, but it is well to 
keep even common things fresh in our minds. 

1st. Albuminous urine is not alw^ays a sign of renal 
disease. 

2d. The presence of even a considerable quantity of 
albumin in the urine is not incompatible with general good 
health. 

3d. The nervous system plays an important part in 
the causation of albuminous urine. By nervous system I 
mean the central or cerebral system. 

4th. The microscope is of far greater importance in 
the diagnosis of nephritis than the chemical examination 
of the urine, and should always be resorted to. 

5th. In testing the urine of applicants for life insur- 
ance, the discovery of albumin should lead to careful and 
repeated tests at various times and under various condi- 
tions (excepting, of course, those cases in which renal dis- 
ease is, from other signs and symptoms, unmistakably 
present). In case no other sign, either physical or micro- 
scopical, of nephritis exists, it would be only justice to the 
applicant to advise him to withhold his application for a 
time,* as the rejection of his application (which would 
surely follow) would debar him from all future participa- 
tion in life insurance, even though the albuminuria should 
prove to be only transcient or physiological. 



Akt. IV.— Note on Albuminuria Following Scarlet Fever. A Paper read 
before the Peoria City Medical Society, Dec. 4th, 1883. By L. H. Spalding, 
M. D., Peoria, 111. 

The most common, as well as the most dreaded and 
alarming of the sequelia of scarlet fever, is scarlatinous 
nephritis, or the appearance of albumin in the urine. This 
condition may follow other diseases, when a high tempera- 
ture has been observed, but more than four-fifths of all 
cases of albuminuria occurring in children, can be traced 
to the effects of scarlatina. To within a very few years, 



318 The Peoria Medical Monthly. 

the cause of this trouble being so frequently found follow- 
ing scarlet fever, has been attributed to the direct action 
of the scarlatinous poison on the kidneys, or to the efiects 
of "cold" or exposure during convalesence. I extract a 
few quotations from well-known authors, to show this 
point: Dr. J. Lewis Smith says: " Scarlatinous nephritis, 
with consequent uremia, is due to the direct effect of the 
scarlatinous poison on the kidneys. * * * ^ common 
exciting cause is exposure to vicissitudes of temperature 
or currents of air, by which the surface is chilled, and 
cutaneous transpiration checked, at the time the old epi- 
dermis is being detached." Dr. J. Francis Condis says: 
"The dropsical effusion, often attended by albuminous 
urine, and in some with a diseased condition of the kidneys, 
is usually produced by imprudent exposure to cold. The 
influence of cold is probably more general than that of ne- 
phritis, — it is, in many cases, both the cause of the dropsy 
and the nephritic disease." Dr. Chas. West says: "That 
cold and interruption ot the cutaneous function favor the 
occurrence of dropsy after scarlatina, is a fact supported by 
universal testimony." Tanner and Ellis take about the 
same view. Prof. Edward Henoch, of the University of 
Berlin, says: "I do not agree with the view that it is due 
to 'cold' or 'suppressed perspiration;' it is much more 
probable that the unknown virus of scarlatina exercises its 
specific influence on the kidneys, which may even be man- 
ifested during the first few days." The following is from 
the article of Dr. Wm. Roberts, on Bright's disease, in Rey- 
nolds' System of Medicine: "Dr. Johnson contends that 
the defective action of the skin causes certain deleterious 
matters to accumulate in the blood, and that the burden of 
their elimination is thrown on the kidneys, to their injury; 
but it must be remembered that suppressed cutaneous 
transpiration ushers in a multitude of inflammatory and 
febrile conditions without inducing renal disease. It is 
impossible to predict — when a person has taken cold — what 
organ will be affected, — whether the pleura, the lung-tissue, 
the bronchial tubes, or the kidneys, or some other organ or 
part of the body. No special relation between suppressed 



Original Communications. 319 

cutaneous secretion and the genesis of renal disease can 
therefore be said to exist." 

These few quotations will serve to show the almost 
universally accepted views of the profession as to the etiol- 
ogy of albuminous nephritis, to within the last two or 
three years. There can be no doubt but that the patholog- 
ical condition in Bright's disease, and nephritis, following 
the zymotic diseases, is the same. Logically, then, there 
should be a common causation; and the various conditions 
under which we find albuminous urine may be called the 
pre-disposing causes, and the actual or primary cause still 
lies beyond. Prof. Semmola, of Naples, Italy, was perhaps 
the first to direct attention to the influence of food and the 
condition of the blood in all cases of nephritis accompanied 
by albuminuria; and in a paper read recently before the 
Paris Academy of Medicine, he set forth his views at full 
length. His opinions were supported by numerous experi- 
ments and profound research, extending through many 
years, and have elicited the support of a number of the 
most eminent physicians. 

The influence of diet in these troubles was what first 
called his attention to the matter, and the conclusions 
arrived at and based on these investigations are: That the 
kidneys play only a secondary part in albuminuria, and the 
true pathological condition consisted in a want of combus- 
tion or assimilation of the albuminoids of the blood. That 
owing to some unperceived change in the system, or some 
unknown influence on the assimilability ot the albumin- 
oids, they cease to exercise their function in nutrition, and 
become morbid material to be thrown out of the circula- 
tion by the emunctories of the body. If the increase of 
albumin in the blood exceeds the elimination, the kidneys, 
being the chief depurents, are overtaxed. They can take 
care of a small quantity of this material without harm or 
injury, but from any cause should the quantity rapidly in- 
crease, as from suppression of the functions of the skin, the 
renal filter becomes clogged, and hyperaemia, the first stage 
of nephritic trouble, sets in, followed by the other stages 
unless the kidneys are relieved. Of course this theory has 
no application to mechanical albuminuria, as from pres- 



320 The Peoeia Medical Monthly. 

sure, alcoholism, lead poisoning, etc., and does not explain 
where the large quantities of albumin excreted by the kid- 
neys in these cases come from; for it is acknowledged that 
the kidneys in an inflamed state, or irritated by pressure or 
a poison, will in many instances excrete albumin when 
there is no increase or change in the albuminoids of the 
blood. It has long been known that a prudent dietary 
regimen, rigidlj^ adhered to, in incipient cases of albumin- 
uria, will usually result in a speedy cure. Histological and 
pathological truths amount to nothing if they do not lead 
to practical clinical results. In this case we have long 
been familiar with the importance of dietary measures in 
the treatment of albuminuria, but did not understand its 
full physiological bearing until it was brought to light by 
the researches of Prof. Semmola. The profession, there- 
fore, owes him a debt of gratitude in furnishing the most 
plausible and reasonable theory, that leads to the most 
practical and successful treatment of this much dreaded 
disease, as well as prophylactic against its occurrence. As 
pertinent to this last remark, I cannot do better than 
quote, in conclusion, from a lecture delivered at the Vienna 
Poliklinik by Prof. Monti, and published in the New York 
Medical Journal, of Nov. 10, 1883. In presenting a case of 
scarlet fever he said: '' It has been my experience that all 
children who take solid food too soon have renal complica- 
tions, as shown by the appearance of albuminuria, dropsy, 
etc. No meat should be allowed before the fourth week. 
After the fourth week this danger is passed. The ordinary 
idea that the use of cold baths, or the so-called 'taking 
cold ' from the patient's getting up too soon, is the cause of 
kidney trouble after scarlatina is erroneous. It is only 
caused by the premature use of a meat diet; give nothing 
but soup and milk. Attend strictly to the diet, as this is of 
vital importance. Little medication is needed in simple 
cases. This is the only treatment. You will never see 
dropsy in simple cases under this treatment." 



Art. v.— Note on Albuminuria During- Pregnancy. Read before the Peoria 
Medical Society, Dec. 4th, 1883. By Robert Boal, M. D., Peoria, 111. 

Albumin in the urine of pregnant women derives its 



Original Communications. 321 

:significance from the generally received opinion that it 
plays an important part as a factor in the production of one 
of the most grave and appalling ailments to which the preg- 
nant woman is liable — eclampsia, or puerperal convulsion. 
JThat the presence ot albumin in the urine of pregnant 
women is always significant of danger admits of doubt. In 
some individuals it may exist in considerable quantity and 
cause no appreciable ill effect. In others a small quantity, 
as low as 4 per cent., may be attended with serious and 
sometimes fatal results. Why it should be so has never re- 
ceived a satisfactory explanation. A great amount of labor 
has been bestowed upon the subject, and the results arrived 
at are by no means conclusive. This much we know, how- 
ever, that albumin has been almost invariably found in the 
cases of eclampsia, and the conclusion, as I think justly 
reached, that its presence causes it. It has been main- 
tained by some that it is only in pregnant women suffering 
from Bright's disease, in some one of its forms, that eclamp- 
sia occurs. This position has one great fault — it is not 
true. Some reliable statistics have shown that eclampsia 
does not always occur in women suffering from Bright's 
disease. About 60 per cent, is said to be the proportion. 
All writers and observers, however, agree that the relation 
between the attacks of eclampsia, and the altered secretion 
of the kidneys, is well marked. The discharge of urine is 
scanty, and to a greater or less degree albuminous before 
and during the paroxysms. A decrease in the quantity of 
albumin, and an increase of the urine, results in either a 
mitigation of the violence and frequency of the attacks or 
their entire cessation, showing conclusively the grave sig- 
nificance of albuminous urine in pregnant women. It is 
not the design of this brief addendum to the paper of the 
evening to consider the cause of albuminous urine in preg- 
nancy, whether it arises from mechanical pressure, caus- 
ing an insufficiency in the secretion of the kidneys, or that 
enlarged oedematous appearance which is alleged by some 
to be peculiar to the kidneys of pregnancy, showing the 
:signs of inflammation and differing in its frequency and 
progress from both acute and chronic nephritis, but only 



322 The Peoria Medical Monthly. 

to advert to its significance when present in the urine of 
pregnancy. 

The prognosis in the albuminuria of pregnancy is un- 
certain as to its course, frequency and duration. In some 
its effects are manifested during gestation, in others at the 
time of parturition, and again, after delivery. In the lat- 
ter, it is doubtful v^hether albuminuria or a vaso-motor 
reflex neurosis is the morbific agent. While the presence 
of albumin in the urine of pregnancy may, in some in- 
stances, prove innocuous, it should always be regarded as a 
grave complication, and significant of danger, either pre- 
vious to or during delivery. In all cases of pregnancy 
where there is dullness of vision, pain in the head, oedema 
of eyelids, face and extremities, prompt and efficient meas- 
ures should be adopted to ward off the impending danger. 
All pregnant women, especially pnmaparae, should be care- 
fully watched after the fifth month, and upon the first 
appearance of one of these danger signals we should en- 
deavor to avert the threatened disaster, or, failing in that, 
afford all the shelter in our power from the coming storm. 
From a neglect of the proper prophylactic and remedial 
means for the removal of the albuminous urine in pregnant 
women, many have been lost who otherwise might have 
been saved. It is clearly the duty on the part of all en- 
trusted with the health and lives of the best and fairest 
part of creation to guard them from the approach of dan- 
ger, as well as to administer to them when it comes. 



Art. VI.— Oxytocic Remedies. By J. W. Hensley, M. D., Yates City, Knox 
County, 111. 

Was called November 14th inst., at 2 o'clock a. m., to 
attend Mrs. J. (a multip.), in her accouchment. Found 
her suffering with irregular, rather spasmodic, contractions 
of the uterus, with flying pains in various parts of the 
body, manifesting a good deal of irritability. 

This patient had frequently consulted me during this 
latter pregnancy, and had been in a semi-helpless condi- 
tion most of the time; was very prone to neuralgia and 



Original Communications. 32 3t 

generally of a complaining habit, so I anticipated, .a -perr 
plexing case. Found os partially dilated and not oyer 
rigid. Ordered spiced teas and hot pediluvia. : ; - 

At noon there was no appreciable advancement in the 
labor. Gave morphise sulph. 1-3 gr. Pains did not in- 
crease under the stimulating effects of this drug, but rather 
subsided under its sedative action. 

At 6 p. M. case much the same, except a little more 
fatigued. Gave fl. ext. ergotae 1 drachm ; repeated dose in 
twenty minutes. No result from this oxytocic except in- 
creased cramping in lower limbs and more general rest- 
lessness. ■-. : 

The case was powerless per se, and one of the main. 
causes was an over-distended uterus, with an excess of 
liquor amnii. This I could not well evacuate, because no 
pouch or bag of water presented. No hopes were enter- 
tained by myself- that matters would change without either 
artificially induced vis a tergo or vis afrontis. 

To aid the former, administered qninise sulph. 15 grains, 
mixed thoroughly with elix. tarax comp., ^ fl. oz. In 
twenty minutes the oxytocic effect of the quinine was 
truly wonderful, all flying neuralgic pains vanished as if hj 
magic, and regular uterine contractions set in. By external 
expressio foetus during the pains, I was soon enabled to 
rupture the membranes and let off a very great quantity of 
amniotic fluid, after which the delivery was soon accom- 
plished. 

Now, I do not report this case as being anything extra- 
ordinary within itself, but because much has been said of 
late about the power of quinine to produce uterine contrac- . 
tions, and the testimony has generally been anti. It has 
been my practice for several years to give quinine freely in 
cases of powerless labor, where the want of power was due 
to atony alone, and it has seldom disappointed me in its 
results. 

Let those who claim that this drug has no bearing on 
the gravid womb, test it a little farther before declaring it 
inert. Especially is it the remed^j par excellency in cases of 
abortion w^here there is a retained placenta. Now yoa 



324 The Peoria Medical Monthly. 

often meet with these cases, which are not only perplexing, 
but actually dangerous. They are often accompanied with, 
chills, and the person is nervous and uneasy. Please give 
30 or 50 grains of quinine, in 6 or 10 grain doses, every five 
hours, and you will almost always arouse the uterus to ex- 
pel its contents; and then please tell me if it be not oxyto- 
cic, under certain circumstances? 

It depends very materially upon the condition of the 
parturient whether ergot, quinine, opium, cinnamon or 
galvanism will best act as a parturifacient. You may call 
them oxytocic, or not, my experience teaches me that each 
and all of these means will, under certain circumstances, 
produce, or more especially increase, uterine contractions, 
and that each and all will usually fail to produce an abor- 
tion, or bring on a premature delivery. Ergot of Rye has, 
perhaps, a greater specific action on the uterine muscular 
fiber than any other known agent; yet, there are many 
sage practitioners of medicine who regard ergot as totally 
inert for such purposes. This diversity of opinion, I am 
persuaded, arises more from a lack of understanding of 
terms, — or rather, from a different application of terms, — 
than from the powers of the agencies employed. If we un- 
derstand an oxytocic to be any means that tends to pro- 
mote contraction of the uterine walls during parturition, 
than we have many oxytocics; but if it must be an actual 
specific, — one that will as surely produce this result as 
atropia will dilate the pupil of the eye, — then we have no 
oxytocics. 



(E&vvt^l^m&tna, 



No. 5.— Ethics.— Present Status. 

( CONCLUSION.) 

Editor Peoria Medical Monthhj : 

There are three divisions on the code among the active 
members of the profession, viz: In favor of the present 
code, in favor of a modified code, and those in favor of no 
€ode. Which of the three are in a majority would be dif- 



Correspondence. 325 

-ficult to decide, nor does it matter; each party are equally 
sincere, and the most ultra as anxious for the purity, excel- 
lence and high character of the profession as the extremest 
■code man. It is only the choice of means to secure the 
end which divides them. 

Because the National Association affirms certain posi- 
tions, does not make them essential or obligatory. They 
are merely an advisory body, without power to enforce 
obedience. The utmost they can do is to prohibit acces- 
sions, or deny membership to those who refuse to subscribe 
to its dictate. They are neither a medical Sanhedrem or a 
Congress. They are not a representative body in the sense 
"the State societies are; nor have they any control over the 
State societies. No one will say they are authorized to 
Toice the sentiment of seventy thousand regular physicians. 
State societies do not represent more than one-tenth of the 
regular physicians in the State, and they are not in a 
condition to usurp authority or attempt coercion. Many 
counties have no society, but plenty of regular physicians, 
a-nd by no means dwarfs; but they are beyond the reach of 
discipline, — they are a law unto themselves. How will the 
code discussion affect this unorganized mass? Much as it 
did the man whose partner had the fight with the bear — 
-"■ Didn't care which whipped." 

Twenty years ago I was a strong code man. Ten years 
ago I was convinced it would be better if modified. If it 
would create harmony and uniformity, I would accept it 
now; but I believe it will remain a disturbing element and 
a bone of contention. Too much heat is already generated. 
The boss element is quite conspicuous. The national body 
is inclined to be arbitrary and dictatorial. Suppression is 
not the remedy. If fair, open, dispassionate discussion is 
not tolerated, the organization goes to pieces, and we must 
commence de novo. 

There is no use breaking all the lances, exhausting the 
ammunition and bursting the Krupp guns. The scattered 
forces must be collected; the knowledge gained by mis- 
takes must be utilized, and reconstruction instituted. A 
change of base, as well as tactics, is indicated. We need 



326 The Peoria Medical Monthly. 

not call a Pierson, a Hufelund, a Speacer, or other foreign 
solon; we can select from our own resources counsellors 
"to the manor born." 

Were I allowed to contribute ray humble mite to the 
bill of fare, or whisper in the ear of the committee on the 
declaration ot first principles, I would say: Please not men- 
tion code. What then, you say? Just this: Let all the 
essentials of the code be taught by the preceptor, in his 
office. Let this be repeated and emphasized in the lecture 
room. Let it be spread among the primary elements in 
the works on Practice, and let it be reiterated by the Pro- 
fessor of Theory and Practice, or of Jurisprudence. Liter- 
ally, ethics lies in the domain of morals; but an analysis of 
the medical ethics divulges the merest atom of morals, but 
an immense amount of etiquette. "Etiquette," says a re- 
cent English writer in Chambers' Journal, " is the code of 
rules by which great people keep lesser ones in proper re- 
spect." Well — yes; thatmay do lor John Bull; but brother 
Jonathan has withdrawn from that partnership, and ceased 
to administer on that bankrupt stock. 

The code was evidently drafted for juniors, and those 
of a juvenile type; some contributor has informed us that 
Dr. Pierson concocted it for a son. I confess I am not par- 
tial to English ethics or etiquette. Professional dogmatism 
and injustice have no better exponents than the English. 
{See London Lancet, 1845, p. 476.) Esteeming ourselves as 
a great medical brotherhood, — an old aristocratic family, if 
you please,— whose lineage remains untarnished and un- 
broken, whose prestige and position are unchallenged, — 
does it not betray a little foolishness, when, in the presence 
of our neighbors and near kindred, we attempt to creater 
laws and rules to control, restrain and discipline members 
of our own family? Is not that family best governed that 
has the fewest rules? The unwritten family code meets all 
its wants. It is humiliating to be told that we are such a 
set of boors we need constant discipline to restrain rude- 
ness, encourage courtesy, and develop manhood. Why 
trumpet our deformities, and expose to public gaze the 
weakness and besetting sin of the medical family, whett 



Correspondence. 327 

our clerical brethren have just as large a mote in their eye, 
and our legal cousins an extraordinary large beam in 
theirs? I confess it is anything but exhilerating to pack 
around such burdens as we have imposed upon ourselves, 
and invite special attention and sympathy to our decrepid 
and helpless condition. 

To-day a steam powder passed my office, dragging a 
loaded wagon. The roads were heavy, and for half a mile 
it had come on an up grade. Puffing and whistling it 
went merrily on with its ponderous weight, moving and 
turning in any direction with as much apparent ease as a 
light buggy. I could but admire its freedom and independ- 
ence. That a stately engine, with its boiler and water 
tank, should seek its destination on a common road, 
unaided by horse or mule power, was something of a nov- 
elty, possibly an innovation. It certainly had discarded 
the railroad code; it was not running on a cast-iron groove, 
and was evidently working under a new dispensation. But 
then it had no brains, like the National Association, and 
was less likely to make mistakes. 

But I was still more impressed a few days since. A 
young man passed down street with a vigorous stride, car- 
rying his head-one side and the opposite shoulder much 
elevated. He was suffering from latteral curvature, con- 
tracted years ago, now firmly anchylosed. His intelli- 
gence was undenied, but his deformity irredeemable; but a 
few years since Dr. Sayers would have entirely recon- 
structed him. Shall I say the thought struck me that the 
code is producing a decided curvature; that the medical 
backbone is distorted ; that the danger of anchylosis 
threatens, and unless help comes speedily permanent de- 
formity will ensue. 

Is it not do false postulate that the best American prac- 
titioners will run off the track, and wreck the train, and 
smash things indiscriminately, unless clogged by a code? 

In conclusion, as long as the code is distasteful and re- 
pugnant to many, — and a modified or compromise code is 
not likely to meet a harmonious approval, — why not cull 
all its real excellencies and essentials and have them 



328 The Peoria Medical Monthly. 

taught, as I have suggested, by the preceptor, the text 
booi:, or the Professor of Theory and Practice, or of Juris- 
prudence? . 

In the matter of quackery, I would be glad to see a 
robust and comprehehensive definition brought forward? 
and promulgated by each State Society. My own convic- 
tion is, drop entirely " the duties of the public to the pro- 
fession." Let them learn that as they do their duties to^ 
the tailor and butchei . 

In regard to consultations I would say, make no re- 
strictions. An intelligent regular, who cannot select ap- 
propriate counsel, should be esteemed non-compos. 

If we wish to retain the name and character of a 
liheral profession, let us cease to be so conspicuoHsly intol- 
erent and withdraw our claims to infallibility. The word 
change need not throw us into spasms. Why, that grand 
old organization. Episcopacy, spent weeks in revising their 
code, and even changed the "Book of Prayer." Even that 
centennarian on the Andover hills is not free from suspi- 
cion. Yes! Puritanism itself is not the bigoted child it 
was, and King James' version has an authorized substi- 
tute. Stagnation is not a normal condition, even for med- 
cal codes. If we are a mere petrifaction, seeking notoriety 
as a fossil, why not sell out to Barnum, betore the pall of 
oblivion cover us, as it has the Cardiff Giant? Seriously, 
we are drifting into danger and peril. New soundings 
must be taken, new charts made, the coast line better de- 
fined, or the proud old ship and gallant crew will be 
wrecked. 

I have barely touched on some of the more salient 
points in this discussion, — sufficiently, perhaps, to indicate 
something of a divergence in opinion. I believe in the 
progress of medicine; I believe in the National Associa- 
tion, — unstinted honors and laurels to those who have 
borne the burdens and conquered the huge obstacles in 
its way. Acclamations of "well done" should resound far 
and wide through the profession for such unselfish and per- 
sistent devotion as have been exhibited by N. S. Davis^, 



Correspondence. 329 

Sam'l Gross and Austin Flint; but a false step, at a critical 
time, may destroy the labor ot years. Veritas. 



A Critic Corrected. 

Wyanet, III., December, 1883. 
Editor Peoria Medical Monthly: 

In the November number of The Peoria Medical 
Monthly is an article by " Repmek " upon the writing of 
prescriptions, in which he says, " In eight out of thirteen, 
mistakes are made either in the miscellaneous use of Latin, 
or English, in Latin endings, or in spelling," and then he 
proceeds to criticise two of them, and closes by saying: 
" Let us have correct prescriptions, at least in our journals." 
In the first prescription "Repmek" says not a line is 
written as it should be, and then he proceeds to tell us how 
it should be written in full Latin, Latin abbreviated, and 
then in what he calls plain English, making the same mis- 
takes he attempts to correct. He writes tincturai for tinc- 
tura, exseccatl for exseccatuni, niellis desjninnati for mel despn- 
matimi, and tincture of iron where it should be tincture of 
chloride of iron. In the second prescription He writes " sul- 
phurous acid f drachm, when the original reads "3-4 
drachms." The dash between numerals means to, and 
shows the quantity may be varied according to age of 
patient or judgment of physician. " Repmek " asks, " why 
not say water, instead of aqua, and be correct?" If critic 
will look on pages 193-200 National Dispensatory, he- will 
find that aqua is water, and in no case is the plural aqu(B 
used except where medicated waters are designated, which 
in this instance would have been incorrect, and not accord- 
ing to common usage. Luvois. 



Correction. 

Kewaunee, Wis., Dec. 6, 1884. 
Editor Peoria Medical Monthly: 

In the November number, page 273, third line, should 
be tinctune instead of tincturai', twelfth line should be 
^otas. chlorat. instead of chloral. Will you please make a. 
notice of that in your next? Repmek. 



^^^ The Peoria Medical Monthly. 

■ ' A Correction. 

Editor Peoria Medical Monthly: 

In my article on the treatment of piles, in the Novem- 
oer nlimber of The Monthly, a very grave mistake occurs 
in answering the question: "What is the exact formula 
you have found most suitable and least painful in the 
treatment of both internal and external piles?" 

The compositor makes me say: 

. , 5 Acid carbolic, 

Glycerine, aa. 1 fl. ounce. 

• ; Morphinae sulph., 8 grains. 

Aqua dist., 2 fl. ounces. 

M. Sig. Inject from five to ten drops into each tumor, once in two weeks. 

I used drachms instead of ounces. As published, v^e 
would only get a homoeopathic dose of morphine. 

Please correct, and oblige, Wm. H. Veatch. 



For Chorea. 

• ' ' ■ Mason, Ohio, Dec. 10, 1883. 

Editor Peoria Medical Mo7ithly : 

I have used the following prescription very successfully 
in treating chorea: 

5 Liq. potassii arsenitis, 1 drachm. 

Ext. Physostig. fl. 2 drachms. 

Alcoholis dil. 2 ounces. 

■3A.. Sig. One teaspoonful three times daily, after meals. 

S. R. Voorhees, M. D. 



Jiorim? iransiartionisi. 



Transactions of Peoria City Medical Society. 

Pursuant to adjournment, the society met in regular 
session at the National Hotel, Dec. 7, the President, H. 
Steele, in the chair. The minutes of the previous meeting 
were read and approved. 

The Board of Censors reported favorably on the appli- 
cations of Drs. J. Furry and M. Whiting, and they were 
elected to membership in the society. Application of Dr. 
€o,uch referred to Board of Censors, to report at subsequent 
meeting. 

The report of the Committee on the Practice of Medi- 
vcide was received in the shape of a paper by Dr. T. M. 



Society Transactions. BSl 

Hcllvaine, on the " Significance of Albumin in the Urine," 
and short correlative papers by Drs. Boal, Spalding and 
Hamilton, on the subjects, respectively, of " Albuminuria in 
Pregnancy," "Albuminuria Following the Acute Infectious 
Diseases of children," [the above are printed in this num- 
ber of The Monthly] and "Notes on the Treatment of 
Bright's Disease." 

The following is a brief synopsis of the expressed 
opinions of the members of the society in the discussion of 
the above mentioned report: 

Dr. J. Murphy was convinced that at least fifty per cent. 
of urine in health contains more or less albumin ; it is only 
a symptom of various conditions. He considered albu- 
minuria proper a hopelessly incurable disease. We can 
send our patients to other climates, etc., for relief, but not 
cure. Doctors make a mistake in not informing such 
patients that they cannot recover. Better do so, and re- • 
tain the confidence of the public as well. 

Dr. J. P. Johnson said: The presence of albumin in the 
urine seems to signify but little, generally speaking; but 
sometimes means much with some persons. In ninety-nine 
cases out of a hundred, accompanied with dropsy, patient 
will die. In his opinion the difficulty or condition origin- 
ates in trouble with transpiration, causing a diffusion of 
-albumin through the blood, its elimination causing disease 
of the kidneys. Has no doubt that in scarlet fever the sub- 
stance is removed by rapid elimination through the skin. 
Treatment in all these cases should be, directed to gaining 
activity of the skin. Use water abundantly, internally and 
-externally. 

Dr. J. T. Stuart said: One would think that there are 
many remedies for albuminuria. In almost every form of 
disease albumin is found in the urine. It is only a symptom 
oi disease, at the best, and sometimes not that. It may be 
produced by almost any disease. To treat the disease or 
condition rationally, we must see what this symptom in- 
dicates in a particular case. All the circumstances must 
be taken together in making up a diagnosis. We must 
group the symptoms to make them of importance. 

Dr. J. S. Miller thought albuminuria only occasionally 



332 The Peoria Medical Monthly. 

a symptom of any importance. Do not always find it in^ 
Bright's disease. Do not find it in the contracted kidney 
of Bright's disease. Most reasons given for the presence of 
albumin are speculative. In pregnancy the woman has a 
double duty to perform; the kidney has a double duty to 
perform. They become over-taxed. Albumin is more fre- 
quently found in primipara, caused often by tight lacing;, 
nephritis mostly present. Rest is the prime factor in treat- 
ment. Probably best remedy for eclampsia is benzoic 
acid. 

Dr. Anna Adams expressed the opinion that a much- 
larger per cent, of unmarried pregnant women suffer from 
albuminuria and eclampsia, as shown by the report of one- 
of the Boston hospitals; the presumption with her being 
that the peculiar mental state accompanying a condition 
of pregnancy in the unmarried had something to do with, 
the matter. 

Dr. H. C. Young considered albuminuria an uncertain 
symptom. He would not like to trust to benzoic acid in 
treatment of puerperal eclampsia. Main hold veratria or- 
morphia, as symptoms pointed. 

Dr. R. Roskoten thought the microscope a necessity 
under such circumstances, but admitted that he could do- 
better with it after the patieut was dead; that is the 
trouble, — can't cure it. Albuminuria sometimes comes on 
without fever. Comes from lack of equilibrium between 
ex. OS. and endosmosis. It will come after scarlet fever 
when greatest care is taken. Increase of diuresis does not 
<3ure. Albuminuria comes after disquamation. 

Dr. W. A. Johnson said that while studying practical 
chemistry he examined his own urine, and found it to be 
one-fifth albumin, although in health, and in a week it had 
all disappeared. 

Dr. Will said, in relation to the subject of albuminuria 
in puerperal eclampsia, that he had personally examined 
the urine in three successive cases of convulsions, and in 
only one of them was any albumin present. In two ot the 
cases the examination was made the day following the at- 
tack, and in the other on the second day after. 



Book Notices. 333 

Dr. Mcllvaine closed the discussion of the subject by- 
saying that he did not like the use of the word albumin- 
uria in the sense in which many used it. He preferred 
" nephritis." Albumin is not poison in itselt ; never pro- 
duces nephritis. As to treatment, in acute disease, with 
blocking up of tubules, diuretics come into play; water 
the best diuretic, and plenty of it. 

0. B. Will, Sec'y. 

A Treatise on Bri^ht's Disease of tlie Kidneys, Its Pathology, Diagnosis and 
Treatment. With Chapters on the Anatomy of the Kidney, Albuminuria, 
and the Urinary Secretion. By Henry B. Millard, M. D., A.M. 8vo.;. 
cloth ; beveled edges. Pages 246. New York : Wm. Wood & Co., 1883. 

The only claim the author makes for this work is, that 
it gives the result of nearly twenty-six years of hospital 
and private practice, and of several years study in the 
laboratory. 

Modesty is one of the most attractive traits of an 
author, and certainly Dr. Millard possesses it in a high de- 
gree. Having produced a work that we consider one of 
the most practical ever written upon this abstruse subject, 
he places it before the medical public without brag or 
bluster, and simply desires that it may add to the knowl- 
edge of the subject to which it treats. This feature adds 
much to the pleasure of the reader. 

Space will not permit of an exhaustive review of this 
work, but we will say that Dr. Millard has added much to 
the existing fund of knowledge, especially in the minute 
anatomy of the kidney. The whole work is characterized 
by a clearness and plainness that will make it a favorite 
with every reader. We commend it to our readers as the 
best work on the subject with which we are acquainted. 
It is as nearly an ideal medical work as any we have ever 
seen, for it combines all the essentials. 

A Digest of Materia Medica and Pharmacy, Forming a Complete Pharmaco^ 
pceia for the Use of Physicians, Druggists and Students. By Albert Mer- 
rill, M. D., Professor of Chemistry, Pharmacy and Toxicology in the 
American Medical College, St. Louis, Mo., etc. Large 8vo.; cloth, with 
leather back and tips; 512 pages. Philadelphia: P. Blakiston, Son & Co.v 
1883. Price $4.00.. 

" The object of the writer of the following pages is^ 



334 The Peoria Medical Monthly. 

briefly stated, to present a condensed statement of such 
essential facts pertaining to each drug therein described as 
will form the ground work for their rational employment 
in the treatment of diseases." The above quotation from 
the author's preface tersely states the character of the 
book. The drugs described belong to the pharmacopcsias, 
of all schools of medicine, and from this fact alone the 
book is of great value. The regular physician sees some 
reference to a drug used by the electrics, but cannot find 
it described in any book in his library; he may wish to try 
it, but cannot learn anything definite about its uses, prop- 
erties or dose. If he has this book it will give the required 
information, and hence will find it of practical service. As 
a reference book of materia medica it seems to cover the 
whole ground. 

A Treatise on Syphilis in New Born Children and Infants at the Bresist. Bt 

P. DiDAY. Translated by G. Whitley, M. D., with Notes and an Appendix 
by F. R. Sturgis, M. D. 8vo.; cloth. Pages, 310. New York : Wm. Wood 
& Co., 1883. 

This is a reprint of