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No.
Boston
Medical Library
Association,
19 BOYLSTON PLACE.
i^
^^ «- — y
I
THE
MEDICAL ERA
MONTHLY JOURNAL OF MEDICINE
/ .-^ — "-^ \
^ SEP 9 18''9 )
CH. GATCHELL, M.D.
- JAMES E. GROSS. M.D.
VOL. VI.
January to December, 1888.
CHICAGO
GROSS & DELBRIDGE
1888.
CONTRIBUTOR^^ TO VOLUME VI.
Bacon, Sara E «4
Banton, W. H 1«
Bartiett; Bevel 243
BaBCom, H. M 234
Beebe, Curtis 201
Bliem, M. J 16, 200
Bowen, G. W 243
Bowie, A. P 49
Champlin, H. D 105, 300, 325
Cheeseman, W. 274
Comstoek, T. Griswold 357
Cowperthwaite, A. C 226
Dunham, J. U
236
Foster, E. N 76
Gentry, W. D 361
Oilman, J. E 266
Gordon, F. "W 203
Hale, E. M 18, 60, 82, 205, 263, 295
Hall, Geo. A 357
Hall, W. H 324
Harbach, C. W 237
Hathaway, W. E 106, 150
Hawkes, W. J 197
Holmes, H. P 107, 136, 293
Johnson, S. D 131
Kaler, W. A 269, 361
Keeler, Elmer 149
''King, Thorokr^ 304, 333
Knoll, W. F 272
Lilienthal, S 214
Lippincott, E 12, 77, 111, 132, 208, 241
Martin, Wm. J 51
McAffee,W. D 195
McKay, Chas. S 325
Mitchell, Clifford
14, 47, 81, 109, 134, 22s, 32 1-, 355
Mitchell, J. S tJs
Miller, H.L -.... 45
Nicbol, Theo 50
Palmer, L. B 260
Parker, A. M 232
Pauly, C. A 302
Pease, F. ' 275
Peck, Geo. B 43
Porter, Phil 130-
Pratt, E. H 101, 264, 296
Proctor, Dr s»i
Shears, G. F 297
Sherry, Henry 259, 303, 361
Smith, W. A 23s
Soiithwoi-th, F. W 1 50
Spiich, A. B 46, 130
Streeter, J. W 19
Taylor, Dr 150
Vilas, C. n I9r»
Vincent, J. A 24o
Waite, Lucy 359
Williams, C. A 202
Williams, E. C 236
INDEX TO VOLUME VI.
A.
'Abdominal Sargery aoe
AbfoeBsea. Treatment of .. 870
Accnnte Dbgnoeie 857
-Acne, Treatment of 348
.Al)>Qmlnor1* 78,104
AlbuminnriA, in Life Tnf nrance 870
Alcohol in Diphtheria K8, 94, 128
.Alezander'a Operation 301
American Inetltnte, TraDPactlonn of, IRH7. 8
Ammonia, Ob8er\'ationa on 86
Anget»thetic8, The Administration of 16
Anatomy 42
Antifebrin, Dangen* of 30
Aiitipyrine 383
Antijiep8i« 316
Apomorphia 18
Applicationp, I^ral 245
Arsenic Cancer 319
B.
Bacteria, Multiplication of 350
Bedside Experiences 336
Beverages for Hot Days 140
Bone, Reimplantation of 377
Boracic Acid In Oonorrhflpa 53
Bottermilk in Nutrition ... 316
C.
Ciesarean Section 119
Cancer, Arsenic 119
Cancer, OperatloDB for 30
Cannabis Indica in Lame Back 'to
Cardiac Legions 275
CaUract Extraction 147
Cerebral Case, A 348
Cerebral Gray Matter 30
China 136
Children and Hygiene 303
Circumcision, Value of 808
Cleaning the Hands. 368
Clinical Eye Cases 196
Clinical Medicine 5, 8
Cocaine Poisoning 281,383
Cotfee Drunkenness 281
Congress of American Physicians and Sur-
geons 880
Coninm for Rectal Pain 379
Convention, Louisville 846
Consumptives 242
Cook County Hospital.. 38, 59, 92, 122, 152, 317
Copaiba Offlcinalis 49
Cremation 266
Carious Items 313,342
Cutaneous Photography 143
D.
Diarrhcea of Children 147
Diet, Recipes for Special 143
Dietetics ^ 313,341
Diphtheria 118
Diphtheria, Alcohol in 15, 133
Diphtheria, Epidemic of 16
Diphtheria. Rhus tox. in 50
Diphtheritic Sore Throat 145
D.— Contiuacd.
Dioacorin in Hepatic Colic 30
Doctor Talks 67, 106
Drinking with Meals 144
Drugs, Some Useful 303
Dyspnoea lH
Dyspnoea, Nitrite of Amyl in 808
DysmenorrhroBa, Galvanism In 149
Dysmenorrhcpa Cured by Galvanism 236
Education, Medical 3, 163
Electricity as a Galactagogue 53
Electricity in Peri-Uterine Inflammation.. 114
Endocervlcitis and Cystitis 388
Emergency Cases, Rules for 148
Epithelioma 281
Ether, Death under 146
Eyes, Care of the 845
F.
Fatal Results from Hypodermic Puncture. 216
Feeding Patients at Night 149
Fever, Nature of 869
Fluo-Silicate of Sodium 977
Fracture of Humerus 46
G.
K.
Kali Cyanlciini 335
I..
Labor, Management of Second Stage 116
Laparotomy in a (;hild .*.. 145
Leprosy 276
Leprosy, Contagion of 288
Locomotor Ataxia 326
Lycopodium 197
Lymphoma, Radical Cure of Malignant 19ft
M.
Malingering 309
Mammary Abscess. Prevention of 58
Materia Medica 8
Marriages by Syphilitics 246
Medical Legislation 240
Meningitis, The Sequehc of Spinal 884
Hfenatruation, Vicarious 869
Mexico for Invalids 60
Morrhnal 2(i8
N.
Nails, Transverse Markings 318
Natmm Muriaticum 197
Nephrorrhaphy, A Case of 189
Nerves, Reuniting of 280
Neurasthenia 888
Neurasthenia In its Protean Aspect 800
Galactagogue 53 O.
Gangrene, Senile 250 obstetric Aphorisms 317
Gaseous Enemata in Diagnosis 244 obstetric Methods 349
Germ Theory 54 obstetrics ... 8, 86
Gestation, Ectopic 869 obstetrics. EVecVricItVVn\"\""\\"™ 819
Glands of Tongue. Enlarirement of 148 ophthalmology 6, 41
Gonorrhiea, Boracic Acid In 53 oxalate of Cerium 295
Gynecology 5, 38 oxyjr,.,, rsoof 218
H.
Ilamamelis 186
Haschisch, A Novel 804, 388
liny Fever, Rhinitis Vasomotoria Periodica
.^ 12, 77, 111.133,308, 241
Ilepar Snlphnris (^alcareum 293
Hernia, Radical Cure of 272
Illp-joint Disease 10
Homceopatby on Trial ,53
Homoeopathy In Relation to Malignant Dis-
eases 68
Human Decadence 335
Hunj^ep. Abnonnal 106
Hydrophobia 110
I.
Incubator, A Baby 319
Infantile Spinal Paralysis 274
Infant-, Care of 141
Infection, Causes of 369
Iodide of Arsenic 105
Iodine for Worm« 335
Inte^tinal ()b*itruction 370
P.
Piedology 7
Pasteur's Method .\ 315
Pathology 43
Pemphigus, A Case of Malignant 131
Personals 29, 61, 94, 124, 155, 223, 285, 348
Perspiration 318
Pharmacy 3
Phimosis in the Female 200
Phthisis, Etiology of 54
Phthisis, Ptomaines in 189
Phthisis Laryngealis 309
Phthisis Pulmonalls 269
Physiology 42
Placenta Praivia 21, 310
Plastic Surgery, Principles of 144
Pregnancy 368
Post-Partum Annoyances 43
Preputial DllaUtion 20
Protest. A. 233
Psychological Medicine 7
Puerperal Eclampsia 214
Pulque In Albuminuria 76
Pulsatilla 136
Pyemia, Chronic 21. 32
INDEX.— Continued.
K.
Roctal Irrigation — 361
Rectam, CUmp Operation for 296
Reflex Disorders from Uterine Derange-
ments 84
Rheamatism 808
Rliue Toxicodendron in Diphtheria 50
S.
Sanitary Science 41
Scarintlna, Aifopia in 861
Sciatica, Three Cases of 51
Society, Illinois Valley 347
Sodium Phosphate, Experience with 834
Splint, Pistol 180
Skin, Parasitic Diseases of 81
Stone in the Bladder 264
Stricture of Urethra, Electrolysis for 20
Strophanihns in Heart Disease 53
Suicide, Remarkable 217
Sunstroke 881
Suppuration 3<*8
Surgical Aphorisms 246
Surgical Case 130
Surgical Notes 842
Surgical Studies 259
Surgery. J- 3, 10
Sub-involution of the Uterus 205
Syncope. Inversion of Patient for 815
Tale of a Tubercle 860
Talipes Equino Varus, Treatment of 297
Tetanus, Alcohol in 369
Thuja and Its Clinical Importance 357
Transactions of the American Institute of
Homojopathy, 1887 3,36,212
Triangular Splint 46
Tuberculosis, Congress for the Study of .. 806
Typhoid Fever 217
Typhoid Fever, Antithermic Treatment... 107
Typhoid Fever, Applications in 837
l\
Umbilical Cord 247
Urinary Organs, Surgery of 282
Urinary Analysis, Relations of, to Diag-
nosis 228
Urine of American Bae^ness Men 855
Urine, Systematic Clinical Examination
of 14,47,81,109,184
Urethra, Caruncles of 871
Urethra, Stricture of 202
Useful Recipes 314,348
Uterine Displacements 19
Uterine Hemorrhage 21
Utcnis, Rupture of 359
Vaginal Medication 8tf
Valedictory Address 101
Ventilation of Beds of the Sick 14K
Vomiting Centre 217
W.
Wounds, Drainage of by the Use of Horse-
hair-. 118
Book Reviews:
Aitkkm; Handbook of Treatment 81
AP09T0LI; New Treatment of Chronic
Metritis 126
Bell; Therapeutics of Diarrhcea 287
Billroth; Diseases of Mammary
Glands 68
Brubaker; Compendof Human Phys-
iology 157
Burnet; Fifty Reasons for Being n
Homoeopath 158
Chrobak; Cyclopedia of Obstetrics
and Gynecology 157
Clark; Diseases of the Heart 157
Cleveland; Salient Materia Medica . 156
Clipton; Therapeutic Changes 158
CowpERTHWAiTE ; Texl-Book of Gyne-
cology '.... 319
Day; More Excellent Way in the Prac-
tice of Medicine 181'
Farrinoton ; Clinical Materia Medica. 81
Fox : Skin Diseases 126, 157
Goss; Practice of Medicine 887
Gowebb: Manual of Diseases of the
Nervous System 156
Hamilton: Manual of MedicalJuris-
prudence 63
Hewitt; Diseases of Women 223
Hirst ; System of Obstetrics 223
Heoar: Hand Book of General and
Operative Gynecology 63
Howe; Excessive Venery 351
Hudson: Manual of Physical Diagno-
sis 31
Hughes: Cyclopedia of Drug Path-
ogenesy 157
Kimball ; Repertory of Gonorrhoea . . . 2-^3
Leaxino: Contributions to the Study
of the Heart and Lungs 127
LlPPiNCOTT; Hay-Fever 819
Mack; Simllia Slmllia Curantur? 127
Mitchell: Practitioner's Guide to
Urinary Analysis .• 63
Morrow ; Atlas of Venereal and Skin
Diseases 156
Otis; Clinical Lessons on Syphilis 225
Perkins: Homoeopathic Therapeuticii
of Rheumatism... 127
ScuDDEB ; Specific Medication 127
Simon: Manual of Chemistry 351
• Southwick; Practical Manual of Gyne-
cology 156
Valentine : 600 Medical Dont*s 31
Watbon: Disinfection and Disinfect-
ants 850
WriTHAUs: Essentials of Chemistry.. 223
Wood; Therapeutics 350
Editorial.
Alcohol 198
Another Moxie 199
Anti-Periodic The Great 298
Bad Lot, A 823
Bartholo w on Homoeopathy 162
Bill, A Propostd 853
Blackest of Crimes 9H
Can You Save Them? S
Colleges, Opening of 289
Coming Physician 161
Cook County Hospital 189
Diphtheria, Alcohol in 1, 85, 66
Doctor, The Young 323
Do Allopaths Practice Homoeopathy? . 33
Do Homoeopaths Practice Homoeop-
athy? 33
Dunglison Demolished 293
Electric Prostration ;i54
Explanation, An 86
"Fatal Illness of Frederick the Noble" 821
Frauds, A Galaxy of 285
Hay Fever 1
Immigration, Evils of Unrestricted 85H
Illinois Homoeopathic Medical Antrocin-
tion 18*)
Increase of the Insane tS
Intestines, Diagnosis of Wounds 168
London's Lattst Horror 354
Many Graceful Compliments 289
Mayhem 99
Medical Education 161
Medical Soc lei les Local 353
Paupers, For the Benefit of Imported- . 97
Prophylactic, An Universal 82i
Still on the Decline 3*J
Thanks! 189
Tuberculosis 891
Verdict, The 65
Woman's Dress 194
Yellow-Fever 194, 858, 29i)
Dietetics '. 349. 381
Opinions Expressed 838 380
Scientific Notes .. 313, 341
SUBGICAL Notes 842, 880
Useful Recipes 314, 343. 881
They Say .... 32, 64. 96, 188, 160, 198, 224. 256.
288, 320, 858, 384
Translations 340, 379
Worth Knowing 310, 389, :J45
News From the Colleges.
Ann Arbor 28,89, 151
Boston 55,121
Chicago, Hahnemann : ... 24,56,344
Chicago, Homoeopathic. 27, 58, 91, 128, 344
Cincinnati 24, 57, 848
Iowa City 85, 56, 152, 344
Minneapolis 26, 57, 91, 121
Philadelphia 26, 55, 90, 120, 346
San Francisco 251, 346
S*t. Louis 85,57,92
\4
i>
SEP 9- I8ft9
\
"I
THE MEDICAL
ERA
YoL. VI.
Chicago, January, 1888.
No. 1.
EDITORS :
CH. GATCHELL, M.D.
JAMES E. GBOSS, M.D.
1888,
The Medical Era greets its numerons read-
ers this year with a change of dress, but with
no change of principles.
While we recognize the fact that every physi-
cian, to whatever school of medicine he may
belong, should, in justice both to himself and
to his patients, become acquainted with every-
thing that pertains to the science and art of
medicine, and while our pages will relSect this
belief, yet the preference will always be given to
matter which is in harmony with the doctrines
of our school.
"We shall permit no one to excel us in our de-
votion to the cause of homoeopathy — including
the Name ! — or in loyalty to its great founder.
And in so doing we deny the pretensions of the
members of that sect — whose arrogance is
equaled only by their ignorance — who assume
to be the exclusive guardians of Hahne-
mann's memory, the only interpreters of his
will, and the sole communicants with him in
the spirit world.
To the mugwumps of our school, who owe so
much to homoeopathy and yet repudiate its
name, we extend our condolence.
To the allopaths, who are trying to enrich
their poverty-stricken therapeutics by filching
from the homoeopathic materia medica, we pre-
sent our compliments, and promise to call
frequent attention to their lack of honesty in
failing to make due acknowledgment.
But to ''regulars " and (ir)regulars alike we
extend a hearty greeting.
HAY FEVER.
He who discovers a method of curing a
disease before considered to be incurable, ren-
ders mankind. a service. For this are we physi-
cians.
In the present number of The Medical Era
appears the first of a series of articles by Dr.
E. LiPPiNCOTT, of Memphis, Tenn., on hay
fever. Dr. Lippincott claims to have cured
every case of the disease — a no inconsiderable
number — that has ever been submitted to him
for treatment. This claim, we think, he will be
able to substantiate.
Those readers of The Medical Era who fol-
low Dr. Lippincott in his description of the
disease and its treatment will, we have confi-
dence, be able to repeat his success.
ALCOHOL IN DIPHTHERIA.
The use of alcohol has banished from our mind
the anxiety which we formerly experienced when
called to diphtheritic cases. — Editor N, Y, Med,
Times,
On another page of this journal will be found
an account of the method of the treatment of
malignant diphtheria by the exclusive use of
alcohol.
The editor who makes the report has em-
ployed the method for a period of fourteen
years, and the strong endorsement which he
gives it should arrest the attention of every
practicing physician in the land. The endorse- ■
ment is in language which is emphatic and uu^
equivocal.
THE MEDICAL ERA.
[Vol. VI. No. 1.
Every candid physician knows that he has no
reliable means of arresting the course of malig-
nant diphtheria, or of saving his patient. Oc-
casionally a case recovers, but the instances are
too few to afiford sufiBcient foundation for the
attendant to claim that the recovery is due to
the result of his efforts.
At intervals we hear claims of the remarkable
success achieved by some physician by means of
a new method of treatment. But all such
methods have been tried by others, and all have
failed.
Chlorate of potash, carbolic acid, bromine,
sulphur, and a thousand and one other things
have enjoyed a brief reputation, but the usual
disappointment has followed their use.
Now a well known physician reports most
extraordinary success in the treatment of this
dread disease by the use of alcohol. True,
alcohol has been used more or less by many
physicians ever since Von Grauvogl first called
attention to its virtues, but not so systematically,
or with such results claimed for it, as in this
instance.
We here quote the editor's language, italiciz-
ing the important words, in order that the pro-
fession may realize the extent of the claims
made for it :
Alcohol, we make bold to say, is the prince of
antiseptics and the most perfect and reliable medi-
cine of which we have any knowledge in diphtheria.
Diluted with equal parts of water and given in
small and repeated doses, the malignant symptoms
of this most fatal malady soon disappear and con-
valescence becomes assured.
If anyone doubts the beneficent influence of
alcohol in these cases of blood disease, a little ex-
perience with it will suffice to assure him.
Since the autumn of 1873 we have treated all
our cases with alcohoL with most gratifying results,
the malignancy of the disease yielding at once to
the correcting power of the drug, thus assuring
recovery. ^
If, in the hands of others, the treatment of
diphtheria by the systematic use of alcohol
"should be followed by such favorable results as
above reported, then this is one of the most im-
portant additions to therapeutics that has been
made in this generation, antiseptic surgery alone
excepted. It is the duty of every practitioner of
medicine to give the treatment a fair trial, un-
less, indeed, he is already acquainted with a
superior and never-failing method, in which
event we most earnestly beg that we may be
informed of the fact by telegraph, at our ex-
pense. (Lac caninum cures must be sent by
mail, fuU postage prepaid.)
CAN YOU SAVE THEM?
In order for a comparison to be just, there
must be some similarity between the things
compared. Much has been said of late concern-
ing the mortality rate in the homoeopathic wards
of Cook County Hospital, of this city. It is
admitted that we are doing well, but some have
asked that we do still better. Let us see if such
a thing is possible.
We give herewith a list of the fatal cases
occurring in the three months from Oct. 1 to
Dec. 31, 1887. We give for each case the con-
dition of the patient, the length of time in
hospital, and the cause of death.
No. 68,645. The police patrol brought in a man,
Sept. 29, in a state of deep coma, and with right
hemiplegia. Diagnosis: cerebral hemorrhage.
The patient never became conscious; died 36 hours
after admission. Autopsy confirmed the diagnosis.
No. 68,598. A man in the last stage of phthisis
pulmonalis was admitted Sept. 26. Both lungs
much degenerated. Died eight days after admis-
sion. Autopsy confirmed the diagnosis.
No. 68,220. A man in the last stage of phthisis
pulmonalis, and with frequent epileptic convulsions,
was admitted Sept 7. Died four days after ad-
mission. Autopsy showed both lungs much de-
generated.
No. 68,737. A man in the last stage of
cirrhosis of the liver, from alcoholism, was admitted
Oct 6. He was much emaciated, and had extreme
ascites. Died twenty-one days after admission.
Autopsy confirmed the diagnosis.
No. 69,134 A man in the last stage of cirrhosis
of the liver, of alcoholic origin, was admitted Oct.
28. There was extreme emaciation, and great
ascites. Died nine days after admission. Diagno-
sis confirmed by autopsy.
No. 69,277. A man in a stupor was brought in
Nov. 4. The stupor rapidly developed into a
deep coma, showing some intra- cranial lesion. In
Jak., 1888.}
EDITORIAL.
absence of preyions history its exact nature was
not determined. Died four days after admission.
Autopsy showed diffuse purulent meningitis.
^ No. 68,986. An old man, with many symptoms
of senile decay, was admitted Oct. 19. He showed
insanity, and the physical signs of fatty infiltration
of the heart Died 27 days after admission. The
autopsy showed immense deposits of fat about the
heart
No. 69,433. Nov. 14, police patrol brought in
a man (no history) in a profound coma; tempera-
ture 105^ F. Died eight hours after admission.
Autopsy showed extensive cerebral meningitis,
much effusion, and cerebral softening.
No. 68,924. A lad of 17 was admitted Oct 16,
in the midst of an attack of acute parenchymatous
nephritis, complicated by diffuse peritonitis. The
case resisted all treatment, and the patient died
twenty days after admission. Diagnosis confirmed
by autopsy.
No. 69,208. A man with chronic organic disease
of the heart, high temperature, and rapidly devel-
oping cerebral symptoms, was admitted Nov. 1.
Sank into a coma, and died four days after admis-
sion. Autopsy showed the cause of death to have
been encephalitis.
No. 69,288. A child two years old was admitted
Nov. 5. It was scrofulous, with hydrocephalic
head, poorly nourished, a severe nasal and bron-
chial catarrh, and a history of a recent attack of
scarlet fever. Capillary bronchitis soon developed,
and it died ten days after admission.
No. 69,676. A man was brought in Nov. 29, in
a state of deep coma; stertorous breathing; mot^r
and sensory right hemiplegia; pupils irregularly
dilated; paralysis of lower sphincters. Diagnosis:
cerebral hemorrhage. The patient never regained
consciousness ; died four days after admission. No
autopsy.
No. 69,704 A Chinaman, literally rotten with
tertiary syphilis, was admitted Dec. 2; was almost
in articulo mortis at time of admission. Died in
four hours.
No. 69,925. A man, reduced almost to a skeleton
from advanced phthisis, was admitted Dec. 12; died
the next day. Diagnosis confirmed by autopsy.
With this record we are willing to compare
results with any other homoeopathic hospital in
the world. We cure everything that is curable.
For the incurable cases we know no remedy. If
there is any homoeopathic physician in the land,
I high or low, rich or poor, who thinks that he
can save any of the cases that result fatally
under the treatment which they now receive in
the homoeopathic wards of the Cook County
Hospital, we most earnestly invite him to come
and make the attempt.
Either accept our invitation^ or keep still !
INSTITUTE TRANSACTIONS.
SYNOPSIS OF TRANSACTIONS OF THE
AMERICAN INSTITUTE OF
HOMCEOPA TH F, 1887,
[Arranged by the Editor of Trk Medical Era.]
GENEBA.L SESSION.
RESOLUTIONS.
Resolved, 1. That the American Institute of
Homoeopathy adheres, as it has always done, to
its object, as declared by its founders in the
first article of its Constitution, namely, ** The
improvement of homoeopathic therapeutics,
and all other departments of medical science."
4. That the still later charge by some of the
profession (the above having been demonstrated
to be untenable), that homoeopathists ** trade
upon a name," is not only a slurring attempt
to check a winning cause, but is a positive
calumny.
6. That the responsibility for the division of
the profession into schools, so far as homoeo-
pathists are concerned, rests upon those who, by
an illiberal and unprof essionul course — refusing
to examine into the doctrines of the new school,
and aspersing and ostracising its followers —
rendered the closer a'ssociation of these latter
a necessity.
Y. That there is no demerit in belonging to a
sect, provided it be engaged in a good cause,
and its methods be tempered with liberality.
BUKEAU ADDRESSES.
PHARMACY.
Various metals in trituration with milk-sugar
become darkened in color, and grow darker and
darker the longer the trituration is continued.
Such is the case with all the metals which have
been triturated.
The darkening is independent of chemical
changes from exposure to air, for it takes place
with the nobler metals, such as Aurum and
Platinum, and chemical analysis fails to show
oxidation even in Stannum and Mercurius.
The color test shows such a remarkable
change in the triturations that there is no ques-
tion of the power of trituration to subdi\dde
small particles.
Mercury and lead exert their most lasting
effects when administered, absorbed and re-
tained in minute chemically undissolved par-
ticles. Those who think that chemical solution
is necessary to medicinal activity are reminded
THE MEDICAL ERA.
[Vol. VI. No. 1.
that the chyle, and even the blood itself are not
pure chemical solutions ; but that they contain
floating solids.
Is it not enough to reduce our drugs to the
fineness of the smallest blood granules ; or, what
is equivalent, to a state of mechanical solubility
or permanent suspensibility ? — L. S.
MEDICAL EDUCATION.
In one college with optional third course we
find the longest average of study. In another
requiring three courses, one-third the students
were graduated with less.
The people have the right to ask that we
educate ourselves in all that concerns the gen-
eral well-being.
It would be better were this Institute, aided
by its Inter-Collegiate Committee, to fix upon
some plan of education that would be acceptable
to all the colleges. It would certainly secure
greater uniformity in education, if not more
thorough medical training, in those destined to
compose our societies and watch over the health
interests of the people.
And, in this connection must be noted a grave
error committed by our schools, in not allowing
old school graduates to have the credit due to
the possession of diplomas from reputable col-
leges. The effect of this illiberal and injudi-
cious policy has been to keep away a large num-
ber of medical men who will be greatly benefited
and who would in turn confer considerable
benefit upon our schools.
Taking things as they are in this country the
inauguration of schools for graduates, in which
clinical instruction predominates, and by which
the many fine hospitals and dispensaries in our
large cities are made doubly useful, is a move
in the right direction, and is to be heartily com-
mended.
It is to be hoped that in our large cities
where there may be, near together, several hos-
pitals and public dispensaries having the
benefits of homoeopathic medication, able and
enterprising teachers and practitioners will com-
bine to furnish the cUnics and demonstrations
necessary to constitute excellent post-graduate
schools.— T. Y. K.
OBSTETRICS.
There is yearly a growing tendency, with
physicians of all schools, to urge a preparatory
treatment during pregnancy. As a result,
many morbid conditions have been recognized
and relieved that formerly attained their fullest
development.
More cures would result from a greater
familiarity with our materia medica by every
obstetrician.
Pregnancy hastens the development of carci-
nomatous growths, and an early resort to the
use of the knife is warranted. The after-treat-
ment is often eminently successful because of
homoeopathic influences. Calendula aids in
securing union by first intention. Hypericum
allays the irritation of an injured nerve. Arsen-
icum, Lachesis and Bhus tox. assist in saving
many a valuable life which otherwise would be
sacrificed.
A woman having perfect health of nerve and
muscle has normal presentations. The preg-
nant woman is not exempt from evidences sup-
posed to be caused by malaria, sometimes
teaching the form known as pernicious fever.
The child may be bom, and suffer from chill
during the first hour.
The fever may return during the second or
third week of the lying-in, assume typhoid type,
and resist all known treatment. — M. J. C.
SURGERY.
The rapid method, so-called, for the treat-
ment of fractures — a full description of which
is impossible here — consists of using splints
and other contrivances until the callus is sufiSc-
iently strong to support the weight of the limb,
when all splints and bandages are removed. It
is claimed that the average duration of this
treatment need not exceed twenty-eight days.
In regard to the surgery of the brain, oper-
ations are now performed for the removal of
foreign bodies, depression of the different tables,
for the cure of epilepsy and other affections,
with increasing good results. The membranes
of the brain are found more tolerant of hand-
ling than has been previously believed.
Operations about the liver, duodenum, stom-
ach and kidneys are becoming more frequent
and successful. The suprapubic operation for
the removal of calculi, almost obsolete, is again
coming into public notice with most excellent
results.
But whilst this is a fact, in regard to surgical
appliances and operations, we have the satisfac-
tion of knowing that the old-time remedies as
prescribed by Hahnemann, for surgical diseases,
and after surgical operations, have stood the
test of time. The question may be properly
asked here, Was Hahnemann a surgeon? I
would say, in one sense he was : in the way of
prescribing for surgical diseases, and an eminent
one ; but as for being an operating surgeon, he
was not, so far as I can ascertain. If he or
Jan., 1888.]
INSTITUTE transactions:
some of his followers had been surgeons and had
made a specialty of surgery, it would have been
to our advantage.
Is surgery, then, so important? I say, yes.
One of our colleagues weU said, at the Interna-
tional meeting in England: Take away from
medicine all the names of great surgeons in Ger-
many, France and England and what is left?
Not speaking vainly as a surgeon, but stating it
as a fact, very little that we know of. Our
students go to the Continent, and come back
like the Argonauts of old, with tales of wondrous
ox>erations, the hke of which would never be
permitted in this, country. Ask them the treat-
ment of typhoid and other diseases, and the
details of medicine for the cure of the sick, and
they look at you with astonishment. It does
seem to me that all men great in the world of
medicine must be shedders of blood.
Twenty years ago our colleges did not even
teach bandaging. Surgery has enabled us to
have hospitals under our exclusive control. — L.
H. W.
CLINICAL MEDICINE.
To Hahnemann and his early followers is
conceded due credit and just praise for self-sacri-
ficing labors, which have given us our law of
cure by the application of which we claim to be
able to relieve suffering and to cure all curable
diseases — curable diseases.
An old family, he says, is a family which
knows about its ancestors ; and where for many
generations there has existed the means to
procure more food and drink than the organism
actually requires. Many of us can remember
when there was, in the minds of many, but one
chronic form of diseased kidney — and that form
inevitably considered fatal — when albuminuria
meant Bright's disease, and Bright's disease
early death. The medical treatment in the past
and now is purely symptomatic. In this line
the advances have all been made by our own
school. Surgeons appear nowadays to take
special pleasure in opening the abdominal walls
mainly for diagnostic purposes.
Albuminuria does not now invariably mean
Bright's disease, and Bright's disease does not
now always mean speedy death. Neither does
the absence of albumin in the urine invariably
exclude Bright's disease. The various forms of
casts in the urine do not nowadays invariably
signify incurable disease of the kidneys.
Prof. Dieulafoy says in relation to Bright's
disease, that the nice points that authors try to
make as to the particular forms of lesion that
exists in any given case, will all fail you at the
bedside ; that, in fact, all the different lesions
are often found in the same kidney. — J. W. D.
GYNECOLOGY.
a
The use of the electric light for diagnostic
purposes is just in its infancy, and it is well for
us to be awake to its coming usefulness.
The use of tents of all kinds, even the elm
tent advocated by Byford, of Chicago, and which
is the least objectionable, has been so uncertain
in results as to cause physicians to look for
more reliable means.
Allow me to say here, while on this part of
my subject, that dilatation is very beneficial in
the treatment of endocervicitis and catarrh of
the endome^ium, not only because of the better
application of surfaces, but from the tonic effects
to the canal of the steel instruments.
Electricity in gynecology, after many fluctu-
ations, has at last become thoroughly established
as a reputable therapeutic agent. It is now
decided to be the best method of treatment of
extra-uterine pregnancy. It is absolutely safe
and certain, and immediate in its effects. This
alone would fix its place as a great remedy. It
relieves ovarian neuralgia and the pain after
laparotomy. It causes absorption of inflamma-
tory products, areolar hjrperplasia and chronic
exudations. It is valuable in subinvolutions
and in intrauterine catarrh. Faradism has a
sphere of cure in simple amenorrhcea ; galvan-
ism, for atonic amenorrhoea.
Right here, on this subject of oophorectomy,
I am pleased to notice that conservative gyne-
cologists themselves are crying out against the
reckless and indiscriminate spaying of women
for every sudden and trivial symptom which
may look towards tubal or ovarian trouble.
Those who will still recklessly insist on this
operation must expect to be condemned.
Laparotomy, in its widest sense, has now
been so successfully employed that we can but
glance at some of the more recent affections for
which it is recommended. Pelvic hsematocele,
pelvic abscess, periuterine abscess, suppurative
peritonitis, both acute and chronic, and even
tubercular peritonitis have each and all been
successfully treated by opening the abdominal
and peritoneal cavities.
In from two to three weeks after labor exam-
ine the cervix. If there is a laceration apply,
after drying the surface, a solution of Argentum
nitricum, one drachm to the ounce. From three
to six applications have healed thoroughly quite
extensive lacerations.
6
THE MEDICAL ERA.
[Vol. VI. No. 1.
It is settled beyond doubt that a lacerated
cervix is a starting-point, and may be a cause
of malignant disease. Radical cure of epithe-
lioma of cervix by early amputation is no ques-
tion at this date. The importance of an early
diagnosis and operation cannot be overestimated.
Where this is done the majority of cases never
recur.
The great and increasing frequency of tubal
disease is shown by the record of cases to
come somewhat largely from the presence of
gonorrhoea, though unsuspected and never
treated. Early discovery and treatment would
prevent much of this. Careful discrimination
and keen analysis of subjective symptoms are
necessary here, as elsewhere, to succeed.
Some of the established uses of hot water in
gynecology may be of interest. Affier laparoto-
mies it is used in washing out the abdominal
cavity. As a hgemostatic it stops the oozing of
blood from small vessels. It lessens shock, after
abdominal section, at 105° to 115° Fahr. It is
valuable after curetting the endometrium, stops
bleeding and contracts vessels. In plastic opera-
tions about the vagina and perineum, done
under a small stream of hot water. Dr. Phillips,
of Boston, one of our honorable members, found
it to remove the blood more rapidly and per-
fectly than could be done by the most skilful
assistant.
Glycerine is absolutely needed for the purpose
of depletion in conditions requiring it.
Martini and Trischler and others have used
with excellent results in uterine diseases, the
Aurum natronatum muriaticum. Indurations,
as well as flexions and displacements, have
yielded to its effects, and inflammations also.
The Peroxide of hydrogen for cleansing the
cervix and canal has no equal. It is also val-
uable as an appUcation in pruritus vulvas.
Methyliodide applied locally to the endo-
metrium or vaginal vault causes an anaes-
thetic action so that a sound can be passed
without pain, an effect similar to a four per
cent solution of Cocaine.
In strong solution and by hypodermic use,
Cocaine has been followed by serious constitu-
tional effects. To overcome this, a plan to
circumscribe the rapid diffusion of the drug into
the general circulation has been found, and the
end attained. A metal ring of suitable size and
shape and properly covered is made to surround
the point of operation, and by pressure check
the circulation to some degree ; it is found best
to inject or apply the Cocaine and wait two
minutes and then apply the circumscribing pres-
sure.
Cocaine is invaluable in vaginismus, pruritus
and hyperaesthesia of vagina, and sore and fis-
sured nipples. In view of how little we have
done to place preventive treatment in a more
advanced and practical position, I feel that we
should all make the prophylaxis of the painful
diseases of women a constant end to be obtained.
And to us who believe in the law of similia, as
applied in therapeutics, this desire to anticipate
and render unnecessary surgical and mechanical
measures in gynecology, comes home with in-
creased force.
Let us, as a body of homoeopathic gynecolo-
gists, lay this course before our eyes as a path to
be followed more and more faithfully until we
elevate the department of medication in gyneco-
logical practice to a higher standard of excellence
and certainty. It is our inheritance, and if we
fail, there is no one in the allopathic branch
even to make the effort.
Naturally, as homoeopathic physicians, we de-
sire to combat the surgical tendency of the times.
How can we do it better than by perfecting our
skill in diagnosis? I believe most thoroughly
that we are able, under the banner of similia, to
prevent, in many instances, a recourse to surgery.
b. P. H.
OPHTHALMOLOGY.
The important questions of asepsis and anti-
sepsis in ophthalmic surgery have been thoroughly
discussed, and a strong tide in their favor seems
to have set in. The main points to be recom-
mended are to have clean hands, and to see that
all surroundings are clean ; to avoid having in-
fected instruments ; to shun old solutions, or those
likely to generate or to contain contaminating
germs. Several deaths following enucleation
have been reported. Death in each case was
accounted for satisfactorily (to the operator).
Meningitis, apoplexy, embolism or blood-poison-
ing, was usually the cause assigned. In a series
of eighteen cases compiled, purulent meningitis
was revealed by the autopsy to be the cause of
death in each case. Infection of the wound is
believed to be the primary cause in all these re-
sults. This .may be avoided by free drainage of
the orbit, disinfection and sterilization.
Nitrite of amyl has been found to be a good
antidote for the loss of consciousness produced
by Cocaine.
A woman cured of Grave's disease had from
youth suffered from a tendency to obstruction of
the nostrils, and later on had a full development
of this formidable disease. A local examination
of the nose disclosed ** marked hyperplasia of the
erectile tissue of the middle and lower turbinated
Jah., 1888.]
INSTITUTE TRANSACTIONS.
bones/' Cauterization of one side, the erectile
body of the right lower turbinated bone, was
followed immediately by a diminution of exoph-
thalmos, and a similar result followed the like
treatment of the other side. Later a complete
cessation of the palpitation took place, and the
cardiac dullness was reduced to normal limits,
according to the reporter.
Boracic acid, in the form of an impalpable
powder, continues to enjoy the high reputation
at first imputed to it. Experience shows that in
a well cleaned ear, Boracic acid, tightly packed
for a few hours, will frequently do more than any
other remedy to cure a certain class of purulent
discharges.
It has been found, by repeated experiment,
that incising of the drum-head in acute hyper-
iemia of the middle ear, so long practiced by
many, is entirely unnecessary, says an author,
except in cases where pain is persistent. — C. H.V.
PiEDOLOGT.
There is no branch of medicine of equal im-
portance, so generally neglected by us as that of
dermatology.
Dunham has told us that this empirical pre-
scribing is the result of our method of studying
disease, regarding it as a natural phenomenon
rather than a condition of the individual.
The most successful of the old-school derma-
tologists to-day base their treatment, not so
much upon the name, as upon the individual.
Dr. Henri Huchard says, "One should not
treat disease, but the patient. There are no lo-
cal maladies, but the malady is localized.*' It
is worthy of comment to read these words from
the pen of old-school dermatologists, who ad-
vise what Hahnemann gave the profession years
before. I am aware that our materia medica, as
arranged, is not well adapted to favor individual
prescribing, for the anatomical order in which
provings a,re arranged gives more prominence to
the same class of objective symptoms, and, by
separating them from their sequences and con-
comitants, obscures the relation of the ofttimes
more important individual 83miptom8. The Cy-
clopedia of Drug Pathogenesy seeks to remove
some of these difficulties by giving us, in con-
densed form, the action of remedies in order of
evolution of symptoms. The advantage of this
system will become more and more apparent to
the physician as he familiarizes himself with the
co-ordination of symptoms under this natural
arrangement.
Of the thirteen colleges reporting to this In-
stitute, only four deem the subject of dermatolo-
gy worthy of mention in their professional as-
signment, or in lecture course.
Empiricism is a confession of ignorance ; edu-
cation is the remedy. — C. D. C.
PSYCHOLOGICAL MEDICINE.
A personal habit is an acquired custom of do-
ing something, either good or bad, until the ten-
dency has become either automatic or impulsive.
All habits which tend to physical disease, may
likewise tend to the disturbance of mental equi-
librium. The habit of too early rising is one of
the saddest and surest means by which insanity
may be acquired.
One of the most striking differences between
civilization and savagery, between the environ-
ments of organized society and the freedom of the
forest, is this enforced habit of too early rising
on the part of the young.
The free and lazy savage gets up when he gets
ready, and rarely or never becomes insane. Af-
ter the habit of waking and rising at five o'clock
in the morning has been formed, under the in-
junctions and threats of unwisely ambitious
parents, it is exceedingly difficult in later life to
overcome it. Even when we are privileged to
sleep later in the morning, through some delec-
table turn in the wheel of fortune, those of us
who have been victims of early rising in youth
are apt to waken at four or five o'clock, and lie
awake a long time before we can again woo
the gentle goddess of sleep. Some farmer boys
have saved themselves from early rising, and
likewise from insanity, by going into the minis-
try, or by entering the medical profession.
A third habit which tends to the production of
insanity, is that of being roused too suddenly
after a long night's sleep. After the brain has
been in an ansemic condition for several hours,
and after the mental processes have been practi-
cally suspended during the entire night, the
resumption of mental activity should be very
gradual.
Another habit which tends to work injury
against the well-being and growth of the young,
and which tends to the production of insanity, is
the premature use of tobacco and alcohol. The
use of stimulants and narcotics by those who are
young and undeveloped is one of the leading
causes which tend to the production of physical
disease and mental unsoundness. Scores of
young men find their way into a lunatic asylum
with the cigarette in one hand and beer bottle in
the other. The Arctic explorer, the athlete, the
pugilist, all eat good food (when they can get it)
and avoid stimulants while undergoing the great-
8
THE MEDICAL ERA.
[Vol. VI. No. 1.
est hardships and taxations upon their mental
and physical powers. Still another habit which
produces insanity is that of immoderate and
prolonged toil. I do not refer so much to the
toils of necessity as I do to those toils of ambition
which combine with the labor and unfortunate
anxiety as to the result. Switzerland is the fair-
est land on earth, but in that country there is ,
one lunatic to every two hundred inhabitants.
The Swiss peasant, through seclusion and pri-
vation and paralyzing hardships, becomes insane
at the rate of one to two hundred. On the other
hand the pampered sons of royalty, the kings of
earth, those who are afforded every comfort and
luxury which the worl(l can bestow, coupled with
those anxieties and worriments which are em-
bodied in the sentiment, ** Uneasy lies the head
that wears a crown," become insane at the rate
of one to sixty. — S. H. T. ,
BUBEAU PBOCEEDINGS.
MATERIA MEDICA AND GENERAL THERAPEUTICS.
Sviject: — Bemedies causing disturbed sleep.
The treatment by drugs of sleeplessness from
functional trouble of the brain is extremely un-
satisfactory from the fact that all the serious
cases require prolonged and stringent hygienic
treatment. Kesults are not to be obtained rap-
icfty, nor must we expect speedy results from the
use of medicines. Recuperation of exhausted
brain cells requires time, and it is nearly always
a very slow process. The eJGFects of treatment
by drugs given in large doses for the purpose of
forcibly suppressing the functional activity of
the brain is always to be condemned, for the
secondary results of the drug action only aggra-
vate the pre-existing disease. The effect of giv-
ing drugs to produce an artificial ansemia of the
brain mass is bound to lead to degeneration of
brain cells, and give rise to serious consequences.
While the Coflfea patient follows a train of
thought clearly and persistently, the Alcohol
patient has a confused thronging of ideas, often
of a grotesque nature.
Cannabis Indica, however, is characterized by
most fanciful imaginings and hallucinations, gen-
erally of a pleasant nature. The patient while
awake really enjoys the florid mental pictures
which are conjured up by the morbid brain cells.
We must deplore and denounce the prevalent
method of hastily prescribing a hypnotic, and so
doing the worst thing for our patient.
Over- worked brain cells, in my experience, can
only be restored by rest. — T. F. A.
Insomnia, when the condition is of compara-
tively recent origin, occurring in business men.
college professors, men of culture, whose brains
are over-active and hypersemic — in these cases
I have found positive benefit from Gelsemium,
third decimal, in pellets three times a day. It is
somewhat of an empirical prescription with me,
but it has done good service where the insomnia
is comparatively recent and due to hyperaemia
rather than to brain exhaustion. I would say
then, give Magnesia phos. for brain exhaustion,
and Gelsemium for the hyperaBmic form of
insomnia.
In drunkards the honors, in my experience,
have been divided between Gelsemium and
Aconite. The latter for cases where there is a
great amount of excitement, with fear and fright-
ful dreams ; the former where the patient is in a
more passive state, with nervousness and errors
of vision. — J. C. M.
Hyperopia necessitates a constant strain
upon the ciliary muscles, which, if continued for
months and years, you can readily see will be
communicated to the brain, thus producing
various nervous disturbances. Therefore, in
obstinate cases of insomnia have the eyes tested
and see if they are not affected. — G. S. N.
I wish to say one word for the poor drunkard,
as I have had many of them to treat. I have
never found a remedy that would equal Cannabis
Indica to produce relief in such cases. (I would
like to add, I always give it often, and low,
equal parts of tincture and alcohol and water.)
—A. M. C.
CLINICAL MEDICINE AND SPECIAL THERAPEUTICS.
Subject: — Diseases of the Kidney and Bladder.
The vast influence of heredity in the produc-
tion of disease has been much underestimated.
For growth and multiplication the parasitic
organism must have a suitable soil.
Therefore, even assuming the germ theory
to be correct, and according it all that is
claimed by its advocates, there must, still be a
predisposition, a susceptibility, a suitable soil,
or there can be no pulmonary phthisis.
Homoeopathy has already on record too many
cases of veritable cures of disease of every phase
and degree of severity, to be overthrown by any
theory, no matter how popular or how well
established it may appear to be. — T. L. K.
From my own personal experience I would
state with some assurance that few men in New
York City reach 60 without some form of
nephritis, and I have examined but one person's
urine over 70 where the chemical, and more
especially the microsopical, warranted my stat-
ing the kidneys to be healthy.
JaVm IffiS.]
INSTITUTE TRANSACTIONS.
d
The higher we climh on the ladder of age, the
more certain are we to find absolute traces of
renal disease.
The changes occurring in the kidney during
old age, and which may be attributed to the uni-
versal degeneration going on, are similar to those
found in the gouty kidney (interstitial nephritis)
with narrowing in some places, and obliteration
in others of the tubules. There is this diflFerence
between the purely gouty kidney and that pre-
senting apparently similar morbid conditions due
to senescence : in the former we are apt to find
an hypertrophied heart ; in the latter its bound-
aries are not increased. And though our knowl-
edge may be somewhat wanting in senile
pathology, we have come to recognize in reality
that if the pathology of childhood countenances
clinical considerations of a special kind, and if
it is indispensable that it should be known from
a practical point of view, then, also, senile studies
present difficulties which cannot be surmounted
except by long experience and a profound ac-
quaintance with its peculiar characteristics.
Among other things it has often been noticed
that the textural changes which old age induces in
the organism sometimes attain such a point that,
the physiological and the pathological states
seem to mingle by an imperceptible transition,
and to be no longer sharply distinguishable.
The three conditions peculiar to age are ath-
eroma, senile kidney (without hypertrophied
heart), and (arthritis deformans) chronic pro-
gressive articular rheumatism. Nodular rheu-
matism, gout, certain arthropathies, and hyper-
trophied prostate gland, are also claimed to be
peculiar to advanced age.
There is a decided tendency after maturity for
the development of a lowly connective tissue
which is eager to seize upon the kidney as one of
its first prey.
In my opinion the impetus to senile changes
often finds its commencement in just such irri-
tating conditions. The uric acid (and possibly
other excrementitious matter of nitrogenized
character, the products of albumin metamor-
phosis) irritates the kidney structures, and starts
up a rank growth of lowly connective tissue, or
packing material, at the expense of the higher
true structures of the kidneys.
Renal epithelia and casts of the tubules are
the only true, infallible e\ddences of kidney des-
truction, as to existence if not as to extent. The
character of the urine tells much ; when it is
copious and of low specific gravity, we have only
too good reason to decide that the injury is
extensive and widespread. Sometimes albumin,
by the grosser tests, is present, but its significance
depends upon its associations.
The most acute and sudden form of renal
disease is undoubtedly that following scarlatina,
and it is in just these that acute dilatation of the
heart occurs most typically.
While granular kidney often terminates in
cerebral hemorrhage (86 times in 117 cases of
apoplexy), the subject of chronic parenchyma-
tous nephritis rarely dies by that means.
The life history of the kidney is one of early
senility, and it runs in this respect with
baldness, grey hair, and the atheromatous aorta.
Senility, as a rule, dates from the seventieth
year. — J. M. 8.
While it is not certain that albumin can be
present in the urine when the system is in abso-
lute health, and all its organs are doing their
work properly, yet, it is certain that albumin can
be present when the kidneys themselves are
healthy. When for any reason a temporary
increase of blood pressure occurs in the kidney,
albumin may be excreted by them.
He would be a rash man indeed who would
venture to assert that Bright's disease existed,
simply because albuminuria was present.
It should never be forgotten that urine con-
taining blood in any quantity appreciable to the
naked eye, is albuminous.
While pus may be present in catarrhal inflam-
mation of the urinary passages without notice-
able constitutional disturbance, yet, so serious
a disease as pyelitis should never be inferred
from its presence unless corroborative consti-
tutional symptoms co-exist. — E. B. H.
Great as has been the increase of our knowl-
edge of the rarer affections of the kidneys during
recent years, the close student will readily
see that further careful clinical study is neces-
sary to develop a better understanding of their
yet undetermined points. — J. S. M.
Chronic cystitis is an affection that is more
frequently due to, and associated with, disease in
some other part of the urinary tract than to an
acute cystitis becoming chronic. A patient suf-
fering from renal calculus will almost certainly
have chronic cystitis.
The prime object of this paper is to call atten-
tion to Chimaphilla as a very reliable remedy in
chronic cystitis. I have witnessed very remark-
able benefit from this drug in two very bad cases
of this trouble.
Chimaphilla, as far as my limited experience
goes, is our best remedy for chronic cystitis, and
unless there are good reasons for doing other-
wise, I would always give it early and make no
change. — W. J. M.
10
THE MEDICAL ERA.
Vol. VL No. 1.
In my examination of the symptomatology of
chronic cases I have found that in the great ma-
jority the mercurials seem to be required. There
is the nocturnal aggravation, easy perspiration
and sensitiveness to the open air, and I have
found in these cases decided benefit from the use
of Protoiodide of mercury.
Where there is more or less reflex bladder
trouble, pain in the sacrum, and hard pressure
in the rectum, but especially the reflex bladder
symptoms, Mercurius corrosivus is the remedy.
When we find, as we often do, a yellow, heavily
furred tongue, with headache, especially of the
right side, pressure on the vertex, and vertigo,
then the Protoiodide of mercury. — T. F. A.
The changes in old age are not identical with
those occurring earlier, say from 40 to 70 years
of age. These latter changes are more of the
inflammatory type, in which elimination of the
acid urates, and products of defective oxidation,
and other toxic substances through the kidneys,
induce a very slow form of inflammation resulting
in the proliferation of connective tissue and sub-
sequent contraction. But in the arterio-sclerotic
kidney we find a general process going on affect-
ing the arteries throughout the entire body.
There is a tendency to sudden death in kidney
troubles, when associated with acute inflamma-
tions.
I do not consider that specific gravity alone is
of great importance in diagnosis, but taken in
connection with the quantity of urine eliminated
in the twenty-four hours, it is of the highest
importance.
The abundant use of pure water is the best
diuretic employed in kidney troubles. — J. M. W.
Nothing short of the microscope can be relied
on in the diagnosis of diseased kidneys. — J. H. C.
SURGERY.
StJyject: — Hip-joint Disease.
The etiology of morbus Coxarius is in a meas-
ure obscure. Authors largely attribute it to
constitutional dyscrasia, a strumous diathesis.
Some pronounce it of traumatic origin.
The symptoms of all stages vary slightly, as
the disease is located in the acetabulum, the
head of the femur, or in the ligamentous structures
surrounding the joint. Limping is one of the
earliest symptoms ; this may be persistent from
the first, or may be intermittent.
Effusion of fluids into the joint during this
stage, by distending the capsular ligament, causes
eversion and rotation of the foot.
Rheumatic deformity has many symptoms in
common with the disease of the hip- joint,
but seldom exists in the young, while morbus
Coxarius is pre-eminently a disease of child-
hood.
The prognosis of hip-joint disease is always
guarded. In uncomplicated cases in the first
stage, or in the early part of the second stage, a
favorable result, with little or no impairment of
the joint, may be predicted. If the disease passes
into the third stage, deformity and anchylosis,
more or less complete, will surely follow.
Anchylosis with deformity, may result in some
cases. — N. 8.
Later observers doubt that the disease arises
in the cartilage, and believe that in most eases
it originates in the bone, and less frequently in
the synovial membrane.
At the hip both pelvic and femoral develop-
ment lie entirely within the joint sack. The
growth here is most rapid, and any over-action,
any inflammatory or other morbid condition
gUdes quickly into a joint disease.
All authorities agree that a case of synovitis
may develop into a perfect case of hip-disease,
but all recognize that this is of rare occurrence-
Tuberculosis as a cause of hip-disease does
not seem to be generally recognized.
In the post-mortem examination of the early
stages of the disease we find the cartilage eroded
and the underlying bone exposed. The neck
may be eaten away or the epiphysis may be
partially or entirely separated from the diaphysis
by the destruction of the epiphysal cartilage.
The head of the bone thus separated may lie
loose in the joint, or it may form firm and per-
manent adhesions to the acetabulum.
There are many diseases which, in their
appearances, as well as in their symptoms,
simulate true inflammation of the hip-joint.
In a very young subject the apparatus must
be constructed regardless of locomotion. For
one of more advanced years it must be con-
structed so as to admit of locomotion.
In the application of sphnts there are four
cardinal principles which must be considered :
immobiHty, extension of the limb, removal of the
weight of the body, and a provision for out-door
exercise.
All splints constructed with the view of remov-
ing the weight of the body from the cotyloid
cavity and at the same time permitting the
patient to have the freedom of the limb, have
been failures. — G. A. H.
I do not beUeve the disease as a rule to be of
scrofulous origin, for in my own experience the
subjects in nine cases out of ten are healthy
children, the disease being occasioned by
traumatism.
Jak. 1S8B.]
INSTITUTE TRANSACTIONS.
11
In these days the opening of the cavity of a
joint is a simple thing in comparison to what it
has been in the past.
In performing resection of the hip-joint, you
place your patient on the sound side. You have
the parts thoroughly scrubbed. You then take
a solution of Bichloride of mercury, one part to
two thousand, and inject it into all the sinuses.
Then pour over the thigh a strong solution of
Iodoform.
The parts must be constantly irrigated during
the operation. There should be both above and
below the site of the operation towels constantly
wet with an antiseptic solution, and these should
be frequently changed.
With the improved methods of mechanical
treatment now at our disposal, there is not the
need of operative treatment there was formerly.
— W. T. H.
During the first stage of the disease when the
pathological changes are not marked, but are
merely those of congestion and subacute inflam-
mation, causing a rigidity of the muscles and
ligaments adjacent to the joint, thereby resulting
in impairment of its functions, the first essential
part of the treatment is rest.
Such remedies as Gale, carb.. Gale, phos..
Gale, iod.. Fluoric acid, Mercurius, Phos., etc.,
are called for. Without special constitutional
condition, and in the average case, one or more
of the following, Bell., Bry., Am., Ehus. t.,
Stramon., Puis.
The remedies most useful in the second stage
are Bell., Rhus, t., Stram., Gale, c. Gale, phos..
Am., Apis.
In suppuration, accompanying the changes of
the third stage, a good and nutritious diet of
easily digested food is essential, such as milk,
essence of beef, God-liver oil, etc., together with
fruits of various kinds.
In some cases where operation is not consid-
ered advisable, either on account of extensive
involvement of the sacrum, coccyx, or pelvic
bones, or where a movable joint is already being
formed by nature, adopt Prof. Billroth's method
of injecting into the sinuses a solution of Glyc-
erine saturated with Iodoform. The cavity or
sinus is filled with the solution and then sealed
up as tight as possible with adhesive plaster.
It will usually stop the suppurative process and
gradually restore it to a healthy condition.
Most cases of joint disease can be brought
under one of two classes, namely, acute and
chronic. The acute diseases are usually trau-
matic, and in relation to the joint structure
begin in the centre and spread to the circumfer-
ence. The chronic are usually constitutional.
and begin in the circumference, that is, in the
bone, and spread later towards the centre of the
joint.
No one who has had experience can belittle
the effects he has had from Stramonium in
quieting the night pains; no one can belittle
the effects he has secured from Belladonna and
Mercurius ; no one can belittle the effects he has
seen produced by Hepar, Hecla lava and Sihcea
in the third stage. — J. H. McG.
What we call white swelling has been found to
be tuberculosis of the joint.
I have the records of sixteen cases operated
upon by homoeopathic surgeons. I had one death
in my lot, and there was one other death ; two
deaths in sixteen patients. — S. B. P.
When the pain is manifest upon the inside of
the thigh and the interior of the knee-joint, the
inflammation is at the base of the cotyloid cavity,
and involves the ligamentum teres. The nerve
filaments which supply the capsules of the liga-
mentum teres are from the accessory branch of
the obturator, and this supplies the internal part
of the knee and knee-cap.
In the same manner, when the anterior por-
tion of the capsules and synovial membrane are
involved, the pain is distributed along the outer
portion of the thigh and to the outside of the
knee, as branches of the same nerve supply both
localities.
When the inflammation is located in the pos-
terior of the hip- joint, the pain is in the popliteal
space and along the calf of the leg, due to the
distribution of the sciatic nerve. — G. A. H.
{To he Continued.)
Other Days. — At the time the Medical Gon-
gress met in Washington, the correspondent of
Louisville, Kentucky, Cawrier Jownal, in that city,
wrote a two-column letter advancing the claims
of homoeopathy, giving a sketch of the life of
Hahnemann, and some interesting facts. We
quote : ** It is not generally known that Lincoln
and his entire Gabinet were homoeopathists.
Payne, on the night when he went to assassinate
Seward, on the night when Wilkes Booth shot
Abraham Lincoln, carried in his hand a little
package that he claimed Dr. Verdi, then and
now a homoeopathic physician, had sent him with
to give to Mr. Seward, and by this means gained
the opportunity to do his ghastly work." Among
the names of those who are treated by homoe-
opathy, given by this correspondent, we notice
those of General McGlellan, Ghief Justice Waite,
James G. Blaine, Jefferson Davis, and many
others of present or past fame. — Recorder.
12
THE MEDICAL ERA.
(Vol. VI. No. 1.
ORIGINAL ARTICLES.
I.
HAY FEVER;
BHINITIS VASO-MOTOBIA PEBIODICA.*
By E. LIPPINCOTT, M.D.
VRVPHI8, TBKN.
Synonyms. — Asthma ^stivum (Summer
Asthma) ; Chortasthma ; Grass Asthma ; Hay
Asthma; Pollen Asthma; Rye Asthma; Asth-
matic Bronchitis ; Summer Bronchitis ; August
Catarrh ; Autumnal Catarrh ; Bostock's Catarrh ;
June Catarrh ; Nervous Catarrh ; Pollen Catarrh ;
Eose Catarrh ; Spasmodic Catarrh ; Catarrhus
^stivus (Summer Catarrh) ; Hay Cold ; June
Cold; Peach Cold; Rose Cold; Yearly Cold;
Gouty Coryza; Idiosyncratic Coryza; Paroxys-
mal Coryza; Dust Fever; Pollen Fever; Rag-
weed Fever ; Rose Fever ; Summer Fever ; Sun
Fever; Glanderoid; Asthmatic Influenza; Pol-
len Poisoning ; Periodic Rhinitis ; Rhinitis Sym-
pathetica ; Rhinitis Vaso-motoria ; Coryza Vaso-
motoria Periodica. French — A sthmu (Vete. Ger-
man — Roggen Asthma; Frilhsoinnierkatarrh.
These numerous synonjmas are objection-
able, for they are misleading as to cause, time
of onset, course and nature of the disease, hav-
ing been intended, obviously, by their various
authors, to indicate either the name of the
writer who first described the disease, the time
or supposed cause of its appearance, the parts
affected, the pathology, mode of manifestation,
or resemblance to other diseases.
The terms " Hay Fever " and " Hay Asthma "
are indisputably misnomers, in that they ex-
press neither the nature nor the cause of the
disease. While pollen from hay, in common
with other kinds of pollen, as well as dust, odors,
fumes, gases, heat, light, etc., may be the excit-
ing cause of the disease, yet many people suffer
from attacks into which neither luiy nor fcrer
enter as a factor, either causative or symp-
tomatic. But the terms have become so firmly
fixed in the popular mind, and so thoroughly
incorporated into the medical literature of the
day, that, for convenience of expression, I shall
hereafter use them in their conventional sense.
My object in presenting the term Rhinitis Vaso-
motoria Periodica, as being the most appropriate,
is not to involve the absurdity of associating a
♦ Copyright 1888.
disease with an impossible cause, but to define
the seat of the lesion, and to demonstrate that
the affection depends upon engorgement and
hyperaesthesia of the nasal mucous membrane,
with which are associated certain reflex nervous
phenomena.
Definition. — Hay fever, so-called, is an an-
nually recurring affection which involves the mu-
cous membranes of the ocular, aural and respira-
tory tracts, depending upon engorgement and
hyperaesthesia of the nasal mucous membrane,
and accompanied by the following sjTuptoms : —
Periodic and spasmodic attacks of acute rhinitis,
rhinorrhoea, itching and irritation of the nose,
eyes, ears, mouth, pharynx, larynx, and bronchi ;
mild or violent attacks of sneezing; copious,
watery discharge from the nares, either bland,
or of an acrid, salty taste, excoriating the nose
and upper lip; redness and swelling of the
nares ; swelling of the submucous tissue of the
nares, with more or less occlusion and some-
times epistaxis ; lachrymation, redness and suffu-
sion of the eyes; swelling of the submucous
tissue and consequent stenosis of the lachrymal
canals and nasal ducts; photophobia; conjunc-
tivitis; sometimes, but rarely, cedema of the
eyelids; chilliness; aching; slight febrile dis-
turbance in some cases ; pressure and heaviness
in the frontal sinuses and forehead, or headache ;
neuralgia; flushed face; hacking, deep, hollow
or wheezing cough ; sleeplessness ; loss of appe-
tite; sensitiveness to cold air, change of tem-
perature, drafts, sunlight, heat, pollen, dust,
smoke, odors, fumes, perfumes, and other ex-
ternal impressions or irritants ; in some instances
papular eruption over the extremities ; burning
sensation in the bronchi and lungs ; bronchial
irritation or bronchial catarrh; tightness of
chest ; difl&cult and wheezy breathing with pro-
longed expiration, and other asthmatic symp-
toms ; more or less cough, followed, at the close
of the attack, by expectoration, the advent of
the cough being generally accompanied by asth-
matic symptoms of more or less severity ; greater
or less impairment of the senses of taste and
smell, together with general discomfort and such
a degree of physical and mental depression as to
render the sufferer unfit for physical or mental
effort; the attacks recurring annually with
almost minute exactness in point of time, last-
ing four to eight weeks, and occurring in most
cases throughout the remaining years of life,
leaving little or no trace of its presence either in
local lesion or systemic disturbance. The spells
of sneezing or cough, with many of the other
symptoms and conditions, are spasmodic, and
[Jan., 1888.
ORIGINAL ARTICLES,
13
appear or are aggravated at certain hours of the
day or night.*
Yarieties. — There are two varieties of this
affection, known as "Kose Cold/* or "June
Catarrh, " and " Hay Fever, " or " Autumnal
Catarrh," both of which to a greater or less
degree, simulate catarrh and asthma in their
manifestations. The first variety occurs in tliis
country, as regards time, from the last week in
April, to June, and corresponds with the " Hay
Fever " of Europe in time of development,
but not in severity of attack, the " Hay Fever "
of Europe being more severe. In rose cold
we rarely have asthmatic complications, but
they are of frequent occurrence in the autumnal
variety. Bose cold disappears spontaneously in
June or July in some cases ; in others it con-
tinues later, or until the appearance of frost,
with only an occasional sneeze or succession of
sneezes, or with the usual hay-fever symptoms
and conditions, with the exception that it is
generally in a milder form than that which
characterizes the autunmal variety. The hay
fever of Europe usually occurs about May 25th,
and rarely continues later than July. The
second or autumnal variety appears from July to
September — generally from August 10th to Sep-
tember 10th — in America. The difference in
the character and severity of the attacks, and
time of appearance of the two varieties, is due to
the season of the year in which the exciting
causes operate or exist, the kind and character
of the irritants, the character of, as well as the
greater or less extent of the abnormal condition
of the nasal cavities — which is the prime cause
— the varied susceptibility and the latitude and
altitude of the residence of its victims. Dr. M.
Hyman, of Boston, doubts the essential identity of
the two varieties, for the reason that the same
exciting causes are not equally operative, and
also because relief is afforded from the rose cold
by a resort to the sea shore ; while the subject
of the autumnal variety must resort elsewhere.
He grants, however, that the objective phe-
nomena are essentially alike, differing only in
severity, and admits that the rose cold often
seems to lead to the later one eventually, only
yielding its victinas when the severer form is de-
veloped.
Although vegetation is earlier in the South
•A young lady whom I treated for rose cold June,
1883, had periodical sneezing spells at midnight that
lasted an hour, with a return of the same in the morn-
ing on rising, of shorter duration and less severity.
With the hay-fever patient it appears on any day,
much like the "Lancashire Folklore" Sunday sneeze:
"Sneeze on Sunday, your safety seek,
"The Devil will have you the whole of the week."
than in the North, the uutumnal variety appears
earlier in the North than in the South. It ap-
pears in Colorado, Minnesota, Wisconsin, Iowa,
Michigan, Northern New York, Vermont, New
Hampshire, Maine and Massachusetts, from the
last week in July to August 5th ; in Connecticut,
and New York, August 10th; In Pennsylvania,
New Jersey, Ohio, Indiana, Illinois, Missouri and
Kansas, August 15th; in Delaware, Maryland,
Virginia and Kentucky, August 20th ; in North.
Carolina, South Carolina, Tennessee and Ark-
ansas, August 25th; in Georgia and Northern
Mississippi, August 28th to September 1st; in
Florida, Alabama, Mississippi, Louisiana and
Texas, September 5th to 10th ; continuing in the
majority of cases until frost or cold weather
checks the inflorescence of plants and maturing
vegetation.
The autumnal variety appears in two forms,
the catarrhal, so-called, and the asthmatic, the
catarrhal often lapsing into or being accompan-
ied by the asthmatic.
Each form is made up of three stages : first, the
stage of development; second, the paroxysmal
stage ; third, the stage of convalescence. The
catarrhal form appears as heretofore described
under the definition of hay fever, the symptoms
varying in diflferent indiriduals. The asthmatic
form is, in addition, constantly accompanied by
more or less dyspnoea and laryngo-bronchial
catarrh. Its asthma is peculiar, in that it gene-
rally occurs most frequently during the day, at
least more frequently than in other forms of
asthma, and varies from slight dyspnoea and
moderate cough, to an intense and distressing
dyspnoea and severe bronchial cough. The hay-
fever victims of America, who are subject to the
autumnal variety, have ^immunity from the
disease in Europe, at the time they would be
affected here. It is claimed by Sajous and a
few other writers that "the affection presents
itself twice in the year, in some individuals,
while in others it either occurs in May or June,
or during the last two weeks of August, or early
in September. " I have never known of a patient
who bad two attacks in one year. This affection
is very rare among young children. Sir Morell
Mackenzie, and one or two other writers, claim
to have seen it as early as the second year of
childhood. Were not this statement made by
men of acknowledged ability there would be
reason to doubt the correctness of the diagnosis.
Geographical Distribution — In this coun-
try the boundaries of the variety denominated
" Rose Cold " have not been defined, but I have
never met with it except in the Southern States,
14
THE MEDICAL ERA.
[Vol, VI. No 1,
Hay fever is found almost everywhere, except
in very cold countries, in elevated regions,
and, in some instances, on islands. Dr. M. Hy-
man's statements with reference to the geo-
graphical distribution of the disease in this
country, are incorrect. He believes that the
autumnal variety does not extend south of the
Ohio Kiver, north of the great lakes, or west of
the Mississippi River. He claims that certain
portions of the country intervening are also ex-
empted, as follows : A section lying north and
east, adjacent to the White Mountains; also
that portion of the state of New York north of
Lake George, and extending west nearly to
Ogdensburg, and the southern tier of counties
from the Catskills, west to the state line ; again,
that portion of the Alleghany mountains south
of the head waters of the Juniata River, to
Covington, Kentucky. He beUeves these boun-
daries to be approximately true, varying with
the season. The extension of the disease be-
yond these limits, northward, is only observed
in seasons of unusual and protracted heat. In
the summer of 1874 the autumnal variety
reached northward beyond Mackinac (its usual
boundary), even to the northern shores of Lake
Superior, a region never before visited by this
disease. It exists in Europe generally, but it is
by far most common in England, where the an-
nual number of cases is supposed to be double
that of any other country.
I.
SYSTEMATIC CHEMICAL EXAMINATION OF
UBINE FOB CLINICAL PURPOSES *
Bt prop. CLIFFORD MITCHELL, A. B., M.D.
CHICAGO.
IT is assumed in tl^s article that the reader is
in possession of some manual of urinary anal-
ysis, such as the author's "Practitioner's
Guide," and that condensation in statement will
therefore neither create confusion, nor occasion
difl&culty.
In the first place, keep in view the data pre-
sented by the following tables, I. and II. :
TABLE I.
Constituents of Nobmaij Ubine.
Con8titi4€nt. Averagt amount in 24 Jioun,
Water 40 to 50 fluid onnces, or 1,200 to 1,500,0. c;
Urea 308.6 to 617.2 grains, or 20 to 40 grams ;
Uric acid 6.17 to 12.34 grains, or 0.4 to 0.8 gram;
Ereatinine 7.7 to 20 grains, or 0.5 to 1.3 gram;
Hlppuric acid 7.7 to 15.4 grains, or 0.5 to 1 gram;
Chlorides 154.3 to 246.8 grains, or 10 to 16 grams;
Earthy phosphates 15.43 to 23.14 grains, or 1 to 1.5 gram;
Alkaline phosphates 30.86 to 61.72 grains, or 2 to 4 grams;
Sulphates 46.29 to 61.72 grains, or 3 to 5 grams.
* OopTTlgbt applied for.
TABLE U.
Physical Ghabagtebibtios of NoBMAii Ubine.
1. Quantity in 24 hours:
Average, 48 fluid ounces; 3 pints; 1500 Cubic cen-
timetres.
Possible normal range: Men, 30-60 fluid ounces;
Children, 17 to 50 fl. oz.; Women, 26 to 45 fl. oz.
2. Color:
Yellow to amber; after drinking, pale; on rising,
dark amber. In young children, but little color.
3. Specific gravity :
Of the 24 hours' urine, 1015 to 1025; after a full
meal, high as 1030; on rising, 1015 to 1025.
4. Solids:
70 grams, or 1080 grains, in 24 hours.
5. Beaction:
Of the 24 hours' urine, slightly acid; after drinking,
neutral; after full meal, neutral or slightly
alkaline.
6. Odor:
Of the 24 hours' urine faintly aromatic.
7. Transparency:
Usually clear when freshly voided; faintly visible
cloud after standing a few hours; sometimes par-
tially opaque when first voided, but later clear,
above, with flocculent mass beneath;* sometimes
turbid on cooling.-f
8. Consistence:
Perfectly fluid like water.
TABLE III.
How TO Examine Ubine as to Chemical and Physioaii
Chabaotebs.
Method of Examination,
Characterittic.
1. Quantity in 24 hours:
Cause patient to collect all urine voided in 24
hours, beginning and ending with an empty
bladder. Measure in cubic centimetres or fluid
ounces and compare results with TabiiE n, 1
(Quantity).
2. Color:
Let ten or fifteen fluid ounces of the 24 hours'
urine settle, and note color of the urine, in the
middle and upper parts of the glass; or Alter
and note color of filtered urine. If colorless to
straw yeUow, it is pale; if yellow to amber, is
normal; if reddish -yellow to brown, is highly
colored. Note any unusual color, as green, dirty
blue, blood-red, intense yellow, brown or black.
3. Specific gravity:
Take the specific gravity of the 24 hours' sample
with a good urinometer, standardized for a tem-
perature of 77^ F., and use a fluted glass jar;
read the figure on the scale from above the fluid.
4. Total amount of solids:
Estimate the quantity of solids from the specific
gravity: multiply the last two figures of the sp.
gr. by HsQser's coefficient, 2.33, and the product
will be approximately the number of grams of
solid matters in every 1,000 C. c. of the marine;
multiply this product by 15i and the new prod-
uct will be the number of grains in every 33.8
fiuid ounces of urine. [Another and more rapid
method is to measure the quantity of urine of 24
hours in fiuid ounces and multiply the number
found by the last two figures of the sp. gr. The
product represents approximately the number
of grains of solids in the whole urine of 24 hours.]
Consult Table II., 4 (Solids).
5. Beaction:
The urine being in a beaker or vessel with a wide
mouth, dip into it a piece of neutral litmus
* A slight Bedlmeiil of earthy nhosphates, cleared by a few drops of
nitric acid, can hardly be regaraed as abnormal.
t Caused by depositioD of urates, which clear on application ofheat.
Jks^ 183R.1
ORIGINAL ARTICLES.
15
paper. Hold the paper in the nrine until it is
saturated; if it turns red, the urine is said to be
aoid; if it turns blue, alkaline; if it does not
change color, it is neutral. In case the neutral
litmus paper cannot be obtained, the ordinary
red and blue papers may be used. Dip into the
urine a slip of red litmus paper, and also, using
the other hand, a slip of blue. Hold the papers
in the urine until they are saturated ; if the blue
paper is reddened, the urine is aoid; if neither
is changed in color, it is neutral.
If the urine is found to be alkaline, allow
the litmus paper used to dry, and notice whether
the blue color remains, or whether the red has
returned. If the blue color remains, the urine
is alkaline from^Ixed alkali; if the red returns,
the urine is alkaline from noUiiiU alkali.
If a piece of bright blue litmus paper is
very quickly turned a marked red in freshly
voided urine there is hyper-acidity of the urine.
6. Odor:
Notice whether the odor be (1) normal (faintly
aromatic), (2) strongly urinous, as in that of
feyers, or (3) fetid and ammoniacal, as in stale
urine.
7. Transparency:
Notice whether the urine deposits a sediment on
standing. If the sediment is plainly Yisible the
urine is abnormal except perhaps in cases of
females, and possibly, when the deposit con-
sists of earthy phosphates or urates. (See
TabIiB n., 7, foot note.)
A slight turbidity or << mucus cloud,'* barely
perceptible, is noticed in all normal urine on
standing for a short time; after the urine has
been voided for some hours a turbidity may
normally be present.
The urine of children four or five days old
is somewhat turbid.
The turbidity seen in urine is due to the
presence of substances, which the water of the
urine cannot dissolye nor keep dissolved, and
which, after long standing, form what is known
as a sediment, that is, ** something which settles
to the bottom."
Urine which is transparent is not necessari-
ly normal. Urine which is very turbid when
freshly voided is abnormal.
8. Consistency:
Observe whether the urine is (a) perfectly fluid
like water, readily flowing through a tube of
very small diameter and dropping easily from
it, in which case its consistence is normal; or,
whether (6) it is thick, <'ropy," and viscid; or,
(c) creamy, forming a jelly-like mass after being
voided.
Notice whether the froth on the surface of
the urine is (a) temporary, in which case it is
normal, or (6) permanent.
ALCOHOL IN DIPHTHEBIA.
[One of the editors of the New York Medical
Times claims to have had extraordinary success
in the treatment of malignant diphtheria by the
exclusive use of Alcohol.
We give below a description of his method of
treatment, and earnestly recommend the readers
of The Medical Era to give it a fair trial in
their practice. We invite those who test the
treatment to keep a careful record of results,
and send them for publication in our columns.]
We have been using pure Alcohol (95 per cent)
diluted in equal parts of water, giving one tea-
spoonful of the mixture every hour or two, according
to the severity of the attack, and duration of the
disease previous to the treatment. The pure
Alcohol is preferable to Whisky or Bum for the
reason that one cannot always be certain as to the
quality of either of the last-named articles. Alcohol
in such small doses being a food as well as a med-
icine — never a stimulant or an excitant of the
pulse, but always a sedative, becalming the pulse
— there need be no hurry as to the administration
of other nutriments. Indeed, it is idle to force
other nourishment on these cases. And as the
poison is gradually and effectively neutralized or
destroyed in the blood as well as in the throat by
the remedy, one has nothing to fear from sudden
collapse, or blood stasis, which so often occurs
under other forms of treatment.
It is interesting to note that Alcohol diluted as
above stated, though about the strength of ordinary
Whisky, at first causes no burning of the diphtheritic
fauces or the mouth. In severe cases of diphtheria
it causes no more irritation of the throat than
water — until the fungoid exudation is dissolved
away. When this effect has been produced, usually
after the lapse of from twenty -four to forty -eight
hours, the alcoholic mixture may be reduced by the
addition of another part of water, and sufficient
Glycerine added to render it palatable, especially in
cases of children.
Other methods of using Alcohol in this grave
disease may sometimes become necessary, for not
infrequently the disease has advanced to a condition
of positive blood-poisoning ere the physician is
called. In such cases we resort to the alcoholic
bath. Where collapse is imminent we wrap the
patient in woolen cloths wrung out of hot Alcohol
and water (equal parts), changing or renewing
them frequently. If swallowing is impeded or
impossible, we give hypodermics of either pure
Alcohol or Brandy, as may seem most expedient, in
thirty minim doses, repeated every hour or two. If
anyone doubts the beneficent influence of Alcohol
in these cases of blood disease, a little experience
with it will suffice to assure him.
It is interesting to note with what facility the
Alcohol dissolves [!] the diphtheritic exudation in
the throat, lowers the temperature and becalms the
pulse, showing its destructive action upon the
germs of the disease which have been absorbed by
the glands and gained access to the blood. This
remedy has been used by us in the treatment of
diphtheria since 1873, during which time no case
of the disease has slipped through our hands except
in one solitary instance, and that case was in
articulo mortis before the remedy was given. The
remedy is also prophylactic to the disease, as we
have found in many instances where it has not
been expedient to quarantine the patient For this
purpose it is only necessary for exposed persons
16
THE MEDICAL ERA.
[Vol. VI. No. 1.
to nse the remedy, diluted as above stated, as a
gargle, and to swallow a little of it three or four
times a day. The ease with which the remedy may
be prepared and administered to children of all ages
is a point of no mean advantage over the painful
and often clumsy methods of the old school.
[We shall expect reports from all who try this
method. — Ed. Eba.]
BEPOBT ON AN EPIDEMIC OF DIPHTHEBIA.
By W. H. BANTON, M.D.
CEDAB falls, IOWA.
DUEING the last eight months diphtheritic
croup has been almost epidemic in the
town. There would be intervals of four to
six weeks between the outbreaks. Mild cases
of pharyngeal diphtheria have accompanied the
trouble, but none, to my knowledge, have been
fatal that were uncomplicated with croup. I
can give no suggestion as to the origin of the
disease. It was not particularly contagious. Usu-
ally one or two in a family sujffered. When called
to a case would find some membrane on the ton-
sils, slight fever, and occasional croupy cough.
Within twenty-four hours breathing would be dif-
ficult, with spell of almost total suffocation.
Patient would live from one to five days. The
oldest that I know of dying was a boy of 14 years ;
the youngest, five months. The majority were
under five years. I had two young women aged
18 and 20 recover from what started out to be
severe cases. Both occurred in families where
children have died from the disease. These pa-
tients coughed the membrane up, and it did not
re-form. They suffered loss of voice for two weeks
following. In patients under seven years of age
recoveries were rare, possibly ten per cent, and
this in mild cases. No severe cases recovered,
no matter what course of treatment was pursued.
The treatment will be of most interest. Steam-
ing with Chlorinated lime-water. Iodine, Brom-
ine, etc. Sprays of solution of Chlorine, Iodine,
Corrosive sublimate, and Eucalyptol ; burning of
tar, turpentine, and sulphur in the room ; hot
and cold applications to the neck; occasional
vomiting. There were cases enough to give all
these methods a thorough trial. Absolutely
no benefit resulted. The remedies used in
cases that recovered were either Merc, binio-
dide, 2x or Merc. cor. 2x, two-grain powders every
hour till physiological eflfects were obtained ; also
five to ten drops of Ph3rtolacca tinct. every two
hours. All the Whisky was given that patients
would take. About all the other remedies used
in croup were given a thorough trial. Tracheoto-
my was performed in a foui'-year-old girl. She
lived three days, the membrane extending to the
bronchial tubes. Again, in a two year-old boy,
the operation added eighteen hours to his life.
Artificial respiration was kept up for five minutes
after the tube was inserted; died of exhaustion.
I could not get permission to operate in any
more cases, and then resorted to intubation.
This was tried in seven cases. Relief was imme-
diate. All died from extension of the membrane
to the lower trachea and bronchial tubes. In two
cases the membrane loosened and came out in
one piece three to five inches long. The tube
came up inside the membrane. In the course of
twelve hours breathing would again become difli-
cult and the tube would not reheve, showing that
the membrane had formed lower down. I used
Waxham*s intubation set. His tubes have an
artificial epiglottis of rubber. This made the
patients cough, and interfered with removing the
intubator, the sliding jaws of the instrument
catching over the rubber. I removed the epi-
glottis, and to protect the tube from falling into
the trachea, I left the fine silk thread attached
and fastened it to the cheek with adhesive plas-
ter. This worked very satisfactorily. I have
much confidence in intubation for sporadic cases
of croup, but when the disease becomes malig-
nant enough to attack adults I have no faith in
saving children with anything.
ON THE ADMINXSTRATION OF
AN2STHSTI08.
BtM. J.BLIEM, M.D.
CHICAGO.
EVEKY day we meet patients whg exhibit the
utmost dread of undergoing ansBsthesia.
In fact, to most people this fear is of far
more concern than the operation itself.
In dealing with these cases the administrator
has need to exercise the greatest tact and skill.
Aside from the natural aversion to being made
artificially unconscious, this dread arises largely
from alarming and unpleasant experiences pre-
viously undergone either by the patients them-
selves, or by their friends. Indeed, so unfortunate
have these experiences often proved, that the vic-
tims have been told that it would never again
be safe for them to take an anaesthetic. Having
dealt with many such patients, I have become
firmly convinced that the trouble is chiefly due,
not to any natural idios^iicracy, but to the man-
ner in which anaesthesia is accomplished.
I consider giving anaesthetics an art, as well
as a science. The administrator must be a man
of quick observation, and keenly aUve to the
Jan., IRSS.]
ORIGINAL ARTICLES.
17
responsibilities of his Huties. In dealing with
the timid and nervous, a bearing of perfect
confidence in his skill, and gentleness in persua-
sion, will go far to reassure and calm the patient.
He must never scold or try to force ; he will only
terrify the more. If he can but gain the com-
plete trust of his patient before he begins, the
battle is half won. A short previous acquaint-
ance is of advantage. I think it cruel to intro-
duce an entire stranger to a nervous patient and
have him proceed with his business. If this
element of fear be not exorcised in the begin-
ning, it will often manifest itself through the
whole period, and make the subject much less
susceptible to the ansesthetic.
The method of procedure is of the greatest
importance. As a rule people do not dread chlo-
roform j?er w, for it acts quickly and pleasantly ;
they are mainly concerned for tlieir hearts. This
nervous apprehension often causes rapid, tumul-
tuous action of the heart and even intermissions.
Do not think that because you find no organic
trouble there is no danger. This class of cases
requires the most skilful application of mental
influence, and very gradual and continous admin-
istration of the anaesthetic. When anaesthesia is
once produced the heart steadies down and be-
haves very well.
Ether, the anaesthetic most commonly used
in this country, is, unlike chloroform, safer, but
extremely disagreeable to most people, both from
its odor and from the sensations it produces.
Here, then, the method pursued may make much
difference to the patient's comfort of mind and
body.
Many and wonderful are the cones devised to
facilitate the administration of ether. But I
would discard them all. I prefer a clean,
moderately heavy towel folded into a cone and
held by a single large shield-pin. How much
more agreeable for each patient to have his own
than to force upon his sensitive nostrils a con-
trivance black with age, saturated with old ether
fumes, and perhaps many times soiled by others'
vomit !
I am strongly in favor of beginning the admin-
istration of ether, or the mixtures often used,
gradually. I cannot conceive of anything more
cruel and even unsafe, than the so-called *' chok-
ing plan" of many authorities — the plan of at
once excluding all air. True, they boast of pro-
ducing anaesthesia in from one to two minutes,
which, of course, is a matter of far more impor-
tance to the ** busy doctor " than the comfort
and safety of his patient, It is the horrible
fright of this choking sensation that ever after
haunts the victim like a cruel nightmare, and
completely unnerves him when confronted by a
repetition.
With extremely nervous patients it is often
necessary to hold the cone so far away as to give
them only a faint inhalation. Gradually bring
it nearer, gently encouraging and calming the
patient, until in a short time he is taking free
inhalations and has had no choking sensations.
Thus the sensitive lining of the air-passages be-
comes gradually accustomed to the foreign vapor.
Should there be any complaint, admit a little air,
and then gradually depress the cone again. This
plan, it is true, takes more time, but you will
win the gratitude of your patient. Let us be
humane, and make the dreadful ordeal of a
surgical operation as easy as possible for our
patients, in all respects.
Full anaesthesia having been produced, it is
now the administrator's duty to continue this
condition with the least possible ammmty and here,
no doubt, lies the cause of many alarming experi-
ences. He becomes interested in the operation,
and before he is aware of it the subject is in
profound narcosis — dangerously near the bor-
der-land of death. Many cases, it would seem,
from my observation, are kept in a state of
asphyxia rather than that of amesthesia — the
result of poor science and poorer skill. If dur-
ing the operation the administrator will only
attend to his own business, those wild alarms
will rarely occur when surgeon and assistants
drop their work and fiercely pull out the tongue,
inject hypodermics and perform artificial respi-
ration, until the patient once more gets all the
oxygen he needs, or is beyond recall.
Right here let me express my great satisfac-
tion with Tait's mixture, used and recommended
by Prof. E. H. Pratt, of ether two-thirds and
chloroform one-third. There are but few cases
where the mixture is contraindicated ; it produces
anaesthesia quickly, is not as a rule disagreeable
to the patient, requires a very small quantity, is
not so liable to produce nausea, and seems to act
very safely. I generally pour over the inside apex
of the cone enough to last until anaesthesia has set
in. This occurs as a rule in about five minutes,
by the gradual method, and the amount required
is perhaps two or three drachms. There is rarely
any choking, struggling, or excitement after that,
anaesthesia is continued with a marvelously small
quantity, and it is only occasionally necessary
entirely to exclude the air.
The objection has been made that Tait's
mixture is impracticable because the two are
of different densities, and so will not mix. Prac-
tically this objection does not hold.
18
THE MEDICAL ERA.
[Vol. VL No. 1.
One word more concerning the reason why
some patients take anaesthetics badly, under any
method. Prof. Pratt's observations, as well as
those of others who have investigated the mat-
ter, convince me that the tension of the sphinc-
ter ani muscles have a co-relation with the respi-
ration. The same observation shows that faulty
respiration under an ansBsthetic is frequently due
to spasm of the sphincters. The patient will do
better if the muscles be moderately stretched with
the speculum. By following the plan which I
have here indicated the dangers and disagreeable
features attending the administration of anaes-
thetics will be reduced to the minimum.
APOMOBPHIA.
By E. M. hale, M.D.
CHICAGO.
THIS alkaloid, prepared from Morphine, is a
snow-white powder, is permanent when dry,
but becomes green when moist. A solution
turns green in a few hours, and finally black. It
was once supposed that this change of color was
attended by loss of its specific drug action, but
recent experiments prove that it is not. It can
be prepared in triturations or in Alcohol. It is
soluble in Alcohol in the proportion of 1 part in
50, therefore the 1st centesimal can be used, and
discs saturated with it, each disc containing
1-100 grain. The hydrochlorate is a salt from
the alkaloid, and is generally preferred. One of
the most remarkable and specific effects of this
drug on man is the power to cause sxidden, pain-
less vomiting. As small a quantity as 1-20
grain injected under the skin, or taken into the
stomach of an adult, will cause vomiting in five
or ten minutes. The vomited matters do not as
a rule contain bile ; syncope often occurs. No
.systematic provings have been made, but Allen
(Encyc. Mat. Med.) gives the symptoms of sev-
eral cases, in which hypodermic injections caused
vomiting, faintness, headache, palpitation of the
heart, cold sweat, salivation, etc. No schema
of its symptoms is given. It seems to contain
all the emetic powers of Opium audits alkaloids.
As to its methods of action : — the vomiting must
be central, or cephalic, such as the vomiting
from Opium is. This would narrow its thera-
peutic sphere to those cases of vomiting due to
cerebral irritation, or from purely nervous
(central) causes — possibly from the remote reflex
irritation. It does not seem to derange the
functions of the stomach for any length of time,
as do Ipecac, Antimony, and other emetics. It
has some similarity to Lobelia and Tobacco, and
possibly Pilocarpine. It does not destroy the
appetite or injure digestion. Dr. Brown (British
Horn. Journal) says he has used it successfully
in those cases when the nausea and vomiting
constitute the disease. The tongue is clean, the
bowels regular, no headache, some appetite, no
pain after eating, but a sudden nausea after eating
or drinking may appear ! He also uses it in sym-
pathetic vomiting, from gall stones, uterine
disease, or neuralgic headache. Dr. Cooper
states that it caused immediate cessation of
vomiting in a case when ** tumors pressed on the
brain." Apomorphine is said not to cause vom-
iting when the vagus is cut, or when the animal
is chloroformed. In my ** Therapeutics of New
Eemedies " I suggested that it would probably
prove useful in sea sickness, or nausea and
vomiting from riding on a railroad, or in a
carriage. It has been found useful in such
cases.
One of the most useful properties of this drug,
is its power to cause sudden and complete
emesis in case of poisoning, or to expel fermenting
or noxious substances from the stomach. For
this purpose inject hypodermatic ally, or give
internally one-fifth or one-fourth of a grain. If
it causes too great depression, give 1-100 grain
of Glonoin, which will quickly restore the patient.
Apomorphia has. been used successfully as an
emetic in children with suffocative catarrh,
when the patient seemed in imminent danger of
strangulation. In yoimg infants 1-25 or 1-50
grain is sufl&cient.
In capillary bronchitis according to Dr.
Fhesburg (TlierapetUic Oazette 1887, Page 657)
is invaluable He does not use it as an emetic,
but as an expectorant. He gives a child one
milligrame (1-60 grain) every one, two or three
hours, (one or two grains of our 3x trit.) He says,
** I have always found it to act very promptly,
producing an easy expectoration of the thick,
tenacious phlegm, which otherwise so often
strangles or chokes the unfortunate little sufferer
in his futile endeavors to rid himself of the
sticky stuff. It produces a watery exudate in
the bronchia and bronchioles, which again thins
the tenacious phlegm. It also, by this transuda-
tion, bathes the inflamed surfaces with a non-
irritating fluid." He thinks it reduces the
hyperemia of the lungs. It does not seem to
occur to him that he is using a homoeopathic
remedy, yet certainly the extreme pathogenetic
effects of Apomorphia would be to cause this
kind of suffocating, mucous fluid, which would
strangle the victim. In several cases of acute
capillary bronchitis, in which I gave the 3x trit.
in 2 gr. doses, it seemed to act much better
Jam., 1888.]
ORIGINAL ARTICLES.
19
than Tartar emetic or Ipecac. In very bad cases
where suffocation was imminent, I should not
hesitate to give an emetic dose (1-20 gr.), giving
Glonoin (1-200 gr.) at the same time.
Dr. Stocquart, of Brussels, has used Apomor-
phia hydrochlorate extensively in certain kinds
of dry cough. The kind of cough in which it
has proved most successful, he says, is a dis-
tressing and frequent hacking, with exceedingly
difficult or with no expectoration. The improve-
ment usually comes in a few days. He gives to
an adult 1-20 grain during the day in small,
frequent doses. I can verify his statement, for
I have found no remedy that acts with greater
satisfaction to my patients in just such coughs.
I prefer to use the 2x dilution in Alcohol, satur-
ating sugar discs or tablets, and giving one every
hour or two.
For children under three years, the 3x acts
efficiently.
UTXBIVE DI8PLA0BMENTS.
By J. W. 8TREETER, M.D.
CHICAGO.
"1 Reported by Q. F. Roberts, from a lecture.]
IN a recent lecture on the treatment of uterine
displacements. Prof. Streeter said :
Proper hygienic treatment is of vast impor-
tance. The clothing should be loose ; the food,
nouMshing ; exercise, as much as she can safely
take. Remember that mental influences have their
effect. When possible, regular hours of rest
should be observed, and this rest should be in the
best position, which is on her face, or semi-prone.
The genu-pectoral posture for five minutes
when she is tired, will give her more rest than
two or three hours in a rocking chair.
Rest at the menstrual period should be en-
joined upon all women, especially girls when
studying hard and going to school. If the blood
which should go to the pelvis at regular intervals
is called to other parts of the body, the womb will
remain undersized, and the genitalia will lack their
normal tone. All women would be benefited by
remamiDg in bed, or assuming the recumbent
posture most of the time, for four days at each
menstrual period during sexual activity.
The bowels and bladder should be evacuated
regularly. This is absolutely necessary in order
to be healthy.
I do not beUeve any medicine will cure a dis-
placement. Use mechanical measures. There is
a pathological condition present which calls for
a particular remedy, and you should prescribe
for the totality of the symptoms.
The postural treatment is important. Teach
the woman how to walk and sit.
After confinement the womb is in a condition
to be easily molded. After the tenth day, if she
will take the genu-pectoral position for fifteen min-
utes three times a day, the uterus will regain
its normal tone and position, in spite of fomer
displacement or anything else. Creeping is also
good, and walking on the hands and feet is bet-
ter than creeping on hands and knees.
As a rule it does not pay to take hot water
injections except at the beginning of acute
mflammation. For an ordmary injection a tem-
perature of 98° or 100° is good. Never let a
woman give herself a cold injection. This is the
injection commonly used to prevent conception.
Chronic metritis is the common result.* Women
forget that spermatozoa may be pickled, as well
as chilled, to death. It would be far better for
them to use acidulated warm water for this pur-
pose.
An astringent injection is good after the womb
is in proper position. Do not have it too strong.
Sitz baths do a great deal of good in pelvic
congestions. They should be taken before going
to bed, the water having a temperature of about
100°. When the cold bath is used for tonic pur-
poses, which is rare, it should not last over
thirty seconds.
Tampons may be used to help keep the womb
in position, the vagina healthy, and as a vehicle
for medicine. When used as medicine-carriers
they should be small ; when to keep womb in
position, larger. The non-absorbent cotton makes
a very good tampon, but I Uke the prepared wool
better.
The tampon should be about one and one-half
inches wide, four inches long and one-half, or
two-thirds inches thick, quilted lengthwise through
the center, with a string which should be left free
at one end for six inches.
Among the most common of wet applications
are Hydrastis, Calendula, solutions of Alum,
Tannin or Borax, and Pinus Canadensis.
In many cases you will find that dry powder
acts better. Powdered lodiform. Alum, Boracic
acid, or Quinine may be blown upon the cervix or
the vaginal wall. After wiping out the vagina,
take a tampon and saturate it with a 1 : 2000
bichloride solution, pass it into the posterior
cul de sac, remove the speculum and then pull
out the tampon. Now introduce speculum, dry
the walls of the vagina, dust on powder or intro-
duce powder on a tampon which should, in either
case, extend the whole lengtli of the vagina.
Emmet*s repositor is the best instrument for
replacing a retroverted uterus.
20
THE MEDICAL ERA.
rVoL. TI. No. 1.
SELECTIONS.
The Danglers of Antifebrin and Antipyrin.
Two articles have recently appeared in the
Hungarian medical journal, Gyogyazat, in which
the profession is warned that Acetanilide, or
Antifebrin, as it is called, though it is not without
value, is an uncertain and indeed a dangerous
antipyretic. Dr. Geza Dulackska finds, after
giving the drug a prolonged trial in the hospital,
that small doses may bring down fever, but that
in some cases even three-grain doses produce
violent sweats, prostration, and hemorrhage or
cyanosis. It does not appear to him to exert
any favorable action on the course of the disease
itself.
Preputial Dilatation.
This operation may well take the place of cir-
cumcision, which is sometimes followed by se-
rious hemorrhage, diphtheritic invasion of the
wound, or partial gangrene.
Eeserve circumcision for those cases alone
(about one in three hundred) in which dilatation
is impracticable. Use a two-bladed dilator
instead of the three blades of Nelaton, intro-
ducing it and slowly expanding the orifice. The
operation is finished by separating the adhesions
with a grooved director, and is followed by daily
massage, in which the gland is alternately exposed
and covered.
Stricture of the Urethra Treated by Electrolysia.
Dr. Robert Newman publishes a synopsis of
his second hundred cases, and gives the following
advantages of the method: (1) Electrolysis is
applicable to all strictures in any part of the
urethra. (2) Electrolysis will pass and enlarge
any stricture, when other instruments or the
skill of surgeons fail, which I have often demon-
strated. (3) It causes no pain or inconvenience.
(4) It is devoid of danger. (5) It is not followed
by hemorrhage, fever, or any other unpleasant
consequences. (6) It relieves at once. (7)
The patient is not detained from attending
his daily work or business, and can earn his
living while under treatment without restraint.
(8) No relapse takes place. — The Epitome.
Dioscorine in Hepatic Colic.
. A judge of one of our highest courts was re-
duced to the verge of tlie grave with frequent
attacks of that excruciating malady, hepatic colic.
He had the best medical advice that Georgia
could give ; he vainly sought distant watering
places and other physicians ; he was a wreck,
gave up his business and lost hope. He was
advised to take the fluid extract of Wild Yam
(Dioscorine) by some one, and never after did he
have an attack. I do not mean that one dose
cured him, but that from the beginning of its use
dated the end of his trouble My success
with the remedy in hepatic colic has been sim-
ply all that I expected, or desired. — Atlanta Med.
and Surg. Jour., — Horn. Record.
Besearches on Electrical Phenomena of Cerebral
Gray Matter.
1. Electrical currents are present in the
gray matter of the convolutions.
2. These currents are increased during the
arrest of functional activity causec} by ansBsthetics
or death. After death the current diminishes
and disappears.
3. In regions of the brain related to a special
function negative variation appears to take place
during functional activity.
4r. The occurrence of negative variation in an
area of the brain assumed to be related to a
special act at the moment of the performance
of the act, affords further evidence of localiza-
tion.
5. These experiments afford some evidence
that areas of brain related to movements of
special muscles are also related to some form of
sensibility in the skin adjacent to those muscles.
— Med. Record.
Operations for Cancer.
1 . Any operation for cancer which does not
completely remove the disease will be fol-
lowed by recurrence.
2. During life the limit of cancerous disease
originating in any part of the uterus cannot be
known ; hence no operative procedure can
guarantee complete removal.
3. In view of this fact, no operation is justi-
fiable which greatly endangers life, provided
other and safer methods are available.
4. Vaginal hysterectomy is more dangerous,
in a certain sense, than the disease against
which it is used; that is, a given number of
patients aflSicted with uterine cancer will live
longer without than with the operation.
5. Other methods of treatment, attended by not
more than one-sixth to one-fourth the mortality
of vaginal hysterectomy, are equally efficient in
ameliorating the symptoms and retarding the
progress of the trouble, and they have been fol-
Jah., 1868.]
SELECTIONS.
21
lowed by as Beemingly good results as regards
recurrence. Hence they should be preferred.
6. Vaginal hysterectomy does not avert or
lessen suffering ; it destroys, and does not save
life. It is, therefore, not an useful but an in-
jurious operation, and as such is unjustifiable.
A Hew Method of Treatixig the Ve^table Parasitic
Diseases of thp Skin.
First, the parasiticide must be applied so as
to reach the bottom of the hair-follicles in f avus,
ringworm of the scalp, and barber's itch. The
reader proposed to apply the medicament to the
diseased part and place over it the positive pole
of an electric battery, and the negative upon
some other part of the body, and induce the
penetration of the solution to the deeper parts by
a well-known law of electric physics. He uses a
battery composed of a large number of small
cells, such as is used for the removal of hairs.
The strength of the current must vary with the
sensitiveness of the parts — five to fifteen cells,
according to the feelings of the patient. Where
there is much hyperemia the current must be
weakened. Cocaine, applied in this way, pro-
duces anaesthesia of the whole scalp. The sur-
face is first to be thoroughly cleansed. Then
saturate the sponge of the positive electrode with
the parasiticide solution and place over the
diseased patch, and the most negative sponge
over the skin of some other part of the body. A
one per cent solution of the bichloride was the
parasiticide employed in the cases reported. He
had only had an opportunity to thus treat three
cases, but all have been so successful as to give
him great confidence in its usefulness. — Dr,
Reynolds.
Placenta Prss^ia.
I was summoned in haste one night to a stout
Grerman primapara. I was at her bedside in less
than five minutes after the messenger had left it.
The blood had already saturated the bed, made
a pool under it, and flowed across the room. It
was still pouring from the vagina, when intro-
ducing the whole hand, I found the os about the
size of a haK-dollar, with the presenting placenta
so firmly adherent all around that it could no-
where be detached, and too thick and firm to be
penetrated by the finger. So, to check the
hemorrhage, I closely applied the palm over the
OS (with the fingers in the posterior cul-de-sac,
as the patient lay supine), while the external
hand over the foetal breech strongly held the
head against the placenta, the lowest part of
which was thus firmly compressed. Hemorrhage
was impossible, and not another ounce of blood
was lost until, after four fatiguing hours of this
steady pressure, the os had so far dilated as to
allow one edge of the placenta to slip out, forced
down by the head, which now of itself com-
pressed the attached portion against the pelvic
wall. Dehvery was spontaneous and speedy;
and the large, thick after-birth showed near its
center a circle some four inches in diameter
much thinned and completely blanched. Both
mother and child did well. — Therapeutic Gazette.
Chronic Pysomia of Dental Origin.
The history of the case is as follows: The
patient, male, good constitution and habits, suf-
fered for the last thirty years from neuralgia,
besides having constantly recurring furuncles
and eruptions in various parts of the body, which
would often for months become running absces-
ses. He experienced burning and itching erup-
tions of hands and feet, which would finally
change to stubborn ulcerations. His bowels
were either stubbornly constipated or exhaust-
ingly loose. He suffered from frequent rigors and
febrile attacks of varying intensity, profuse night-
sweats, retention of urine, serious constriction of
the bowels and urethra. Lancinating pains
darted from the maxilla of right side to bowels,
bladder, limbs, hands and feet, or to whatever
part was locally affected at the time. This lat-
ter peculiarity, together with the discovery of
a little pus exuding from the locality of the wis-
dom-tooth, led to a final correct diagnosis of his
case.
The tooth referred to was extracted, and
a speedy and complete recovery followed. As
other sources leading to pyaemia, and having
their starting-point in the oral cavity, may be
mentioned pyorrhoea alveolaris, alveolar abscess,
abscess of the antrum, and dental caries.
The doctor related ten other cases similar to
the above, which all yielded to the simple remedy
of removing the offending tooth. — Dr, Porre.
Uterine Hemorrhage.
Suppose a woman about fifty years of age,
who has borne children, comes to you with the
statement that at the age of forty-five the menses
ceased, and that she had no discharge of blood
from the vagina from that time until six months
ago, when she again began to lose blood : what
would you suspect ? You should suspect cancer
of the cervix. Why ? Because as a result of
her labors a laceration of the cervix has probably
happened, and carcinoma has developed in the
cleft of the tear. I will venture to say that in
ninety-five out of a hundred cases this diagnosis
would be correct.
22
THE MEDICAL ERA.
[Vol. VL »•. 1.
Suppose, however, that a woman, also about
fifty years old, has not borne children, and that
the menses have not ceased, but have continued
and increased in quantity: what then should
pass through your mind ? You should infer that
the hemorrhage was probably due to one of two
factors — either to a fibroid tumor, which is
the more common, or to a polypus. The fact
that she has not borne children would tend to
eliminate the suspicion of carcinoma ; for it is
exceedingly rare to find cancer of the neck of the
uterus in sterile women. I have, however, seen
this in two instances, one of which, however,
tends to strengthen the rule. This was ^he case
of a lady about sixty years of age, who had a
large fibroid tumor of the womb, which in the
process of enucleation had forced open the os to
the size of a silver -dollar, and was protruding
from it. I wrenched the tumor off and removed
it. Cancer subsequently developed in the cervix,
which had been injured by the long protrusion
of the tumor. The second exception came to my
notice a few months ago. It was that of a mar-
ried lady who, I am sure, has never borne a
child. She had a cancer of the neck of the
womb, from which she died. Carcinoma . will
sometimes attack the fundus of the uterus in
the sterile, but this is also 'very rare. — Dr.
Goodell, in Va. Med. Month. — The Epitatne.
PysBmia.
With Gussenbauer, I will define pysBmia as a
general infective disease, the result of the intro-
duction into the blood of the products of
septic pus; differing from other infectious
diseases by the presence of multiple foci of in-
flammation and suppuration, and attended by
an intermittent form of fever.
The first reliable investigation into the nature
of the disease was made by Koch, who not only
studied the form and natural history of the
germs, but produced pyaemia artificiaUy.
We shall take it for granted that in every case
of pyaemia we are dealing with the presence of
the essential germs (the Streptococcus and the
Staphylococcus), which produce at first a local
suppuration, and secondly, when the disease be-
comes general, implicate the veins. Phlebitis in
connection with pyaemia signifies always the
production of a thrombus at the point of inflam-
mation, and its subsequent dissemination by
embolism. The infection-atHum, or. route by
which the pus-microbes gain entrance into the
system, is usually through a wound — a loss of
surface continuity somewhere which may not be
detected or recognized in every instance, as in
some cases of septicaemia, for the primary wound
may have healed before pyaemia has occurred.
A thrombus starting in a smaU vein in the
immediate vicinity of an infected wound, by its
growth in a central direction, graduaUy invades
larger vessels, and when such is the case the
projecting portion into the free lumen of an
adjacent larger vein may become detached by
the blood-current, and after passing through the
right side of the heart is arrested in the pul-
monary artery, where it causes a sudden isehae-
mia of the lungs and death from asphyxia. The
formation of infarcts in the pulmonary artery is
thus easily explained m pyaemia, but it is more
diflScult to account for the presence of emboli in
more distant organs.
The question presents itself. How are we to
explain the formation of metastatic deposits
beyond the first filter, the lungs, in more distant
parts of the body, as the liver, kidneys, pancreas,
brain, and joints ? It is impossible for the frag-
ment of a thrombus of any considerable size to
pass directly the pulmonary filter, as it is
mechanically arrested in some of the branches
of the pulmonary artery. The embolus under
these circumstances becomes the nucleus for a
new or secondary thrombus, which by extension
through the pulmonary capillaries may reach
directly the systemic circulation, where it serves
as a new focus for the dissemination of the
specific germs and furnishes the material for
systemic emboUsm. The germs in this secon-
dary thrombus have a more ready access into
the general circulation, and by implantation upon
the walls of the capillary vessels initiate a
pathological condition, the same as I have de-
scribed in the vessels at the primary infection-
atrium. I have already informed you that these
so-called metastatic abscesses are not true
abscesses ab initio; their close resemblance to
pus led Virchow to apply the term " puriform"
transformation in contradistinction to " pur-
ulent."
Modern research has come to our assistance
in correctly interpreting the formation of pus in
parts distant from the primary focus of suppura-
tion. A secondary abscess can only occur after
pus-microbes enter the circulation and have
found favorable conditions for locahzation and
reproduction in some distant part.
Whenever antiseptic surgery is practiced tho-
roughly and intelligently, pyaemia seldom if ever
occurs. As the disease can only occur after
suppuration has been established, it is evident
that all measures calculated to prevent suppura-
tion also prevent this disease, and where sup-
puration has occurred, rigid antiseptic treatment
diminishes the danger of pyaemia. — Dr. N. Senn,
in Phil. Med. Times. — Tlie EpitoTne.
Jah., 1888.]
COLLEGE NEWS.
23
NEWS FROM THE COLLEGES.
Ann Arbor.
UNIVERSITY OF MICHIOAN.
Prof. Wood says that, in the second stage of
labor, the application of cloths wrung out of ^hot
water aid materially in the relaxation of the
perineum.
He also recommends, for the same purpose,
the application of Lobelia; using about one
ounce of the fluid extract to one quart of water.
He advises the young practitioner to time
himself, allowing the uterus to rest fifteen or
twenty minutes after the second stage of labor,
before bringing on the third stage; Crede's
method, of course, being employed.
After delivery, if the pulse of your patient is
over 100 do not leave her.
As a rule doctors leave their patients too soon
anyway : remain one hour after a dehvery and
during the first half of that time keep one hand
on the uterus.
The doctor is a warm advocate for the use of
chloroform in labor to deaden pain.
Prof. Obetz says he would not expect to make
a very good living by removing floating cartilages
from the knee-joint by the use of medicines. He
advises the subcutaneous excision operation for
their removal.
In epistaxis, when it becomes necessary to
plug the posterior nares, use a soft rubber cath-
eter with which to draw the cord of the pledget
through. Having passed the catheter into the
anterior nares push it gently along the floor into
the pharynx. Attach to it the cord and bring
it forward.
In compound fractures where the end of the
bone protrudes do not wantonly saw it oflf unless
it is denuded of periosteum.
Teeth loosened by the kick of a horse may be
left in position and will become solid again.
When, because of an injury, the jaws are
bandaged together and the patient is fed through
a tube, remember to cleanse thoroughly and often
the cavity of the mouth to prevent suppurative
processes.
The doctor is partial to the plaster-of-Paris
dressing in treating fractures of all kinds. He
says in cases of compound fracture mark the
openings with pins which point outward and put
on the plaster dressing, allowing each layer to
be pierced by the pins while being put on, and
cut out a piece around each pin afterward, leav-
ing a hole for drainage purposes.
Dr. Yaughan says in aU cases where you find
oedema in a child examine the urine for eviden-
ces of acute parenchymatous nephritis.
If called to a severe case, no matter how se-
vere, if the heart is still beating, begin your
treatment by using a hot- water bath and wrap-
ping the patient quickly in blankets.
The doctor has discovered, recently, the
chemical poison of typhoid fever, and his experi-
ments upon animals are the first in which
have shown a decided rise of temperature.
Dr. Sterling says that an attempt to cure a
case of purulent conjunctivitis with internal
remedies alone is as criminal as to treat a case
of post-partum hemorrhage in the same way.
He recommends the Nitrate of silver locally in
strength proportioned to the severity of the case.
He thinks Argent, nit. as an internal remedy
is indicated homceopathicaUy more frequently
than all others, in the above condition.
All kinds of conjunctivitis are contagious.
Prof. Amdt says : In acute hepatitis, Bryonia
is undoubtedly the most often indicated and
quickest acting remedy in the materia medica.
There is not a remedy able to furnish the
''similimum" to intermittent fever with a ty-
phoid tendency, that Bryonia does.
There is no excuse for alternating remedies, as
commonly practiced. For instance, nobody but
a dunce can be excused for not differentiating
between Aconite and Belladonna, or Bryonia and
Ehus. In vescicular erysipelas you would not
think of employing Bryonia, but Ehus.
In great dryness of the mouth and throat (as
often occurs in a typhoid condition for instance)
under Ehus. you would have no relief from
drinking ; under Bry. you would have relief from
drinking.
The doctor wants to file a protest against the
common practice of calling every sore throat,
which has the formation of a membrane, diph-
theria. It is not only the cause of much un-
called-for anxiety on the part of the friends of
the patients who are not suffering from a malig-
nant or deadly disease, but it is the scTurce of
much indefiniteness, uncertainty and embarass-
men't to the profession.
True diphtheria is a fearful disease and calls
for all the skill and care possible in order to
cure it.
The study of materia medica and the applica-
cation of remedies to disease calls for something
more than the memorizing of certain lists of
symptoms : It needs the use of strong common
sense to explain the presence of such symptoms
from the conditions present, and to select a rem-
edy capable of producing such conditions.
24
THE MEDICAL ERA.
[Vol. VI. No. 1.
The professor thinks Cantharides is the best
antidote for poison ivy, using one drachm of the
tincture to a pint of water, applying it locally.
At the same time use Gantharis or Belladonna
internally.
Chicago.
HAHNEMANN MEDICAL COLLEGE.
Prof. Hall says : Never be alarmed about the
hemorrhage from a scalp wound; sew up and
put on compresses is all that is necessary. In
from 24 to 36 hours the wound will be united
enough so that sutures may be removed.
Prof. Leavitt advises not to use chloroform
until toward the latter part of the second stage
of labor. He also advises the use of the soft-
rubber cathether in all cases when possible, as it
is not nearly so apt to do injury as the ordinary
silver female catheter.
Prof. Hall says : For perineal band in dressing
for fracture of the thigh, or anything of a similar
nature, a piece of rubber hose, about one inch
in diameter, stuffed with cotton, to prevent its
bending too acutely, and covered with a thickness
of muslin, is the best thing for the purpose.
Prof. Bailey says: In uterine displacement,
instead of using a hard rubber pessary at first
to hold the uterus in position, try a tampon of
cotton smeared with cosmoline. Many times it
will not be necessary to use anything else. But
after faithful trial, if this does not do, a hard
rubber pessary may be inserted. In explanation
he said that many times if a hard rubber pes-
sary had been used at first, the tender and in-
flamed parts would have rebelled, and many times
serious results would foUow.
Prof. Gee said, in lecturing on Belladonna, that
many times almost immediate relief from ear-
ache, particularly in children, is had by putting
a few drops of a 2 gr. solution of this drug into
the aJBFected ear.
Prof. Ludlam says : Never use Apis, Lachesis,
or any remedy of this class in dilution, but
employ the triturated potencies. The alcohol
used in the dilution antidotes or destroys the
eifect of all animal poisons.
Prof. L. also says : In employing the vaginal
douche, do not squirt the water in with force, as
is often done ; — let it flow in gently over the
parts, and much better results will be obtained
than as though the water was forced in as from
the hose nozzle of a steam fire-engine.
Prof. Hall never uses Arnica, but Calendula
instead.
Prof. Laning, in making his diagnosis, does
not rule out cancer because there may be absence
of pain.
Prof. Watry gives the following formula for
softening hardened ear wax :
3 . Bi-borate of soda - - - grs. x ;
Glycerine 3S8;
Aqua 5J.
M. Sig. A drop 3 times daily on the hard wax
for two or three days, and then syringe the ear.
Holiday vacation begins Friday night, Decem-
ber 23, lectures commencing again Monday
morning, January 2. The clinics in the hospit^
will be held as usual through the vacation.
Prof. Ludlam says ; when a patient exhibits a
great longing for meat,' and does not seem to
crave much of anything else, diabetes may be
suspected. Always test the urine when this
symptom is found.
Prof. Hall says a few drops of Nitrite of amyl
on cotton in a vial held under the nose of a
patient in collapse from anaesthesia will resusci-
tate him at once.
Cincinnati.
PULTB MEDICAL COLLEGE.
We are often advised by medical societies and
in the journals, that it matters little whether we
feed a child one of the numerous ** infant
foods " of the day, or allow it to nurse the mother.
This is a mistake. There is no substitute for the
breast, — and we are never justified in taking an
infant from the mother except in cases of ex-
treme necessity. When I first took charge of
the orphan asylum (Mt. Auburn) in this city, the
nurse informed me that during certain seasons
of the year the graves in the cemetery were never
covered. Wet-nurses w^ere provided, and we
found that the mortaUty was greatly reduced.
One of the strong arguments in favor of
mother's milk, as against all other foods, is that
the child gets it warm from the glands where it
is secreted. We do not know what chemical
changes take place in milk by alternate cooling
and heating. Certainly there are changes when
the animal heat is lost and artificial heat ap-
plied, and I believe that if we were* to use the
cow's-milk as it comes from the udder, before it
is allowed to cool, it would be more easily digest-
ed, and give us much less trouble.
In cases of slow digestion add a ** pinch" of
salt to the milk. This aids in digesting the
caseine.
As a substitute for mother's-milk, where we
have been obliged to take the child from the
breast, I have long used the following: — one
tablespoonful of granulated pearl barley, pour
on boiling water and boil five minutes. Of this
Jan., 1888.]
COLLEGE NEWS.
25
take three parts, cow's milk one part, sugar-of-
milk, tablespoonful. It has always worked well,
and I still use it.
Acidity is the great enemy of infantile life.
Of all the ihfluences that tend to give us the
large death rate among children, acidity stands
at the head. Rickets is often caused by acidity.
The presence of a surplus of acids dissolve out of
the blood and tissues the bone-making and bone
sustaining salts, thus giving rise to rickets. In
these cases, the development and functional ac-
tivity of the nervous system is so interfered with,
that the organism is not able to appropriate
the phosphate even when it is present. I have
found Cod-liver oil the best remedy, and I believe
that 90 per cent of the cases can be cured by it.
It, in some way, corrects the cellular condition
that prohibits the absorption and appropriation
of the bone salts, and I have found it to work
marvelously weU both in my private practice
and in the asylum. The evidences of improve-
ment in the use of Cod-liver oil are :
1. Cessation of spasms of glottis.
2. Cessation of sweat and sweating about
the head.
8. Child sleeps better, and is not so irritable.
4. Decrease of catarrhal troubles.
'5. Improved digestion and nervous affections
in general.
Remember Cod-Uver oil and Hypophosphite
of lime as remedies in rickets. — Prof. Crank.
When children refuse to take milk on accoimt
of depraved quality, I have found that a dose or
two of Calc. c. given to the mother will cor-
rect the condition of the milk and remove all
trouble.
In cases of croup (simple), give Aconitum if
there is much fever, and when fever subsides
alternate Hepar and Spongia. I have found
these remedies almost infallible.
Prof. Buck, in speaking of the importance of
proper hygiene and care in typhoid fever,
recommends frequent baths with hot water. He
told the class that if he had his choice between all
the drugs in the materia medica and hot water and
a good nurse in the invasive stage of typhoid, he
would take hot water and the nurse every tivie.
Bathe the patient from one to six times per
day. No bad results can come from this in
any case, so long as the temperature keeps up.
The only sure and safe guide in this disease,
either in treating or in diagnosing, is the degree
of heat, the character of fever, and how is this
to be determined without a thermometer ? Nevei*
think of trying to practice medicine without a
clinical thermometer.
St. Louis.
HOMGBOPATHIO MEDICAL COLLEGE.
Dr. Campbell says that if pus is in a cavity,
as for instance the ear, a few drops of Peroxide
of hydrogen introduced into the cavity will loosen
up the pus, and permit it to come away.
That in a case of ophthalmia, with much
itching, the application of a few drops of the fol-
lowing solution will afford relief :
5 Acid boric grs. x ;
Aq. Camph. - - - - 3i;
Aq. boracic. - - - - 3vii;
M. ft. sol.
Also that in gonorrhoeal ophthalmia of one
eye, it is necessary to protect the other eye, but
that there are objections to the plan, adopted by
many, of sealing up the well eye, and he advises
his students, by way of an improvement, to take
a piece of rubber-plaster about three inches
square, cut a circular hole in its centre, and fit
into it a watch glass, the hole being cut to a size
a little smaller than the glass, so as to hold it in
place. Then to apply this over the well eye,
taking care that it is adhering securely to the skin,
except at the outer comer of the eye, leaving a
piece of the muslin on the plaster over that part
to prevent it adhering there ; this will allow the
air to reach the eye. By the use of this plaster
there is full protection, yet the patient is able to
see, and the physician can watch the well eye.
That if the patient's lids are swollen with pus
beneath them, when they are separated by the
attendant, there is danger to the attendant's own
eyes from the pus spurting out, but the physician
or nurse, as the case may be, can guard against
this by wearing a pair of large plain glass spec-
tacles, such as are worn by stone-cutters.
Dr. Parsons says that in cases of irritable
ulcers, when you decide to use an escliarotic, to
destroy the oversensitive nerve filaments, and to
excite a healthy inflammation ; it can be done
painlessly by applying a few drops of a four per
cent solution of Cocaine twenty minutes before
using the escharotic.
Iowa City.
UNIVERSITY OF IOWA.
In speaking of the treatment of pneumonia,
after consolidation has taken place, Prof. Dickin-
son says: Stick to Phosphorus for years, if
necessary.
In diphtheria, when the pulse is regular, but
rapid and compressed, and the patient listless,
languid and weak, with no interest in anything,
Lachesis 30x will seldom fail to cure.
26
THE MEDICAL ERA.
[Vol VL No. 1.
Prof. Cogswell advises giving Asparagus tea
when indicated remedies fail to relieve retention
of urine.
The new Homoeopathic Hospital was recently
deprived of a good case for the clinic by the un-
expected death of the patient shortly before her
arrival. On making a post-mortem, Prof. Gil-
christ found a fibroid (interstitial) tumor of the
uterus, of ten years' standing, with cystic degene-
ration, death occitrring from rupture.
The right ovary was atrophied, and had a
thin-walled cyst ; the right Fallopian tube being
lost in the mass of the tumor ; left ovary larger
and also cystic, and left Fallopian tube having
an impervious stricture. Menstruation contin-
ued without change to the end !
In his lecture on angesthesia. Prof. Gilchrist
strongly urges the necessity for individualization
in selecting anaesthetic agents.
Ether is often given undue preference, as the
dangers from it are remote, and therefore not
easily, traced, while those from chloroform are
immediate. The use of stimulants was con-
demned, as their effect is uncertain. In some a
dangercms depression is produced without the
primary exhilaration, while in others the primary
excitement is as great as in the case of ether.
In others the effects are delayed, and the danger
in the first stage of chloroform unopposed
having the effect of an antidote.
Minneapolifi.
HOMCEOPATHIO MEDICAL COLLEGE.
Prof. Kicker says : We are too apt to con-
sider diarrhoea a disease. Remember it is only
a symptom, and may have to be considered
together with several other symptoms in order to
get a correct picture of the disease. In acute
enteritis the trouble may be caused by organic
or inorganic matter in the water ingested ; and
not only the food, but the drinking-water, should
be carefully looked after.
Indigestion, constipation, and a long list of
ailments are common troubles among a lot of
" hygienic cranks" who are always doctoring,
and who live on wheaten grits, graham, oatmeal
and other indigestible stuff.
Suppurative inflammation of the blood vessels
of the liver may follow surgical operations upon
the rectum, or any region from whence the blood
is carried by the portal vein to the liver. Do
not operate on the rectum unless there is a
good prospect of compensative results ; for rec-
tal operations are not as innocuous as some
surgeons would have us beheve. On the con-
trary they are always attended with danger.
Prof. Wilcox says : It has recently been dis-
covered that Perchloride of mercury is precipi-
tated by contact with blood, thus destroying its
antiseptic properties. This action does not take
place, however, if the Perchloride ' solution be
previously acidulated by the addition of a few
drops of Hydrochloric acid, or a few grains of
Boracic acid.
Fever is the result of poison taken into the
blood, either from within or without; and in
surgical cases it is evidence that decomposition
is taking place in the wound, and that its pro-
ducts are passing into the circulation. This
will be the condition whether the wound have an
offensive odor or not.
Prof. Ripley emphasizes the necessity for great
care in the prevention of ophthalmia neonatorum,
and recommends the use of Boracic acid solu-
tion, 5 gr. to a half tumblerful of water, appUed
by means of soft linen rags, which should not be
used a second time. Bathe the eyes immediately
after birth, and at intervals of 15 to 30 minutes
during the first day or two. The use of soap in
bathing infants is a frequent cause of inflamma-
tions of the eyes, and is very liable to irritate the
skin. I do not find as many cases of diphtheria as
some physicians, and I diagnose more carefully
between diphtheria and follicular tonsillitis.
Unless great care is used, many cases of the lat-
ter disease will be reported to the health office
as diphtheria.
Philadelpliia.
HAHNEMANN MEDICAL COLLEGE.
In his lectures on neuralgia Prof. Goodno
spoke of a general neuralgia which is not found in
the books, and which we fondly denominate
** The neuralgia of Goodno," found mostly in
broken-down women with menstrual difficulties ;
women of an energetic disposition, and who meet
trouble half-way ; it often begins in the uterine
region and then extends to the plexus iu the
neighborhood of the stomach ; it may extend to
the cardiac area, when the most serious symp-
toms are shown, as of sudden, violent pain in
the region of the heart, accompanied or not by
dirturbance of its action. We may then have
symptoms of collapse, but there is an absence of
the pang and dyspnoea that marks the angina
pectoris. This is very dangerous indeed, and
oftener causes death than all other forms.
Prof. Mitchell told of a case of abortion he
attended when a ten weeks old foetus distinctly
kicked while lying in his hand.
Woe betide the man who, the last week in
March, believes that the child can be bom, in a
Jan., 1888.]
COLLEGE NE WS.
27
face presentation, if the chin gets in the hollow
of the sacrum. The Professor says he will tell
such a man that he is "exceedingly and par-
ticularly stupid."
Prof. Mitchell also told us that in differentiat-
ing between hysteria and eclampsia, the hysterical
woman, by not hurting herself shows that she
bosses the convulsion, while in eclampsia there
is no doubt that the convulsion is bqss.
While lecturing on Aconite, Prof. Mohr said :
When you find a child who has two or three at-
tacks of croup in a winter, which at the time
have Aconite symptoms, and recovers from its
administration, give the patient Phosphorus in
between, and so remove the tendency to recur.
He also says : Tht keynote for Hyoscyamus
in typhoid fever is that ** the patients continu-
ally fumble at their genitals."
Dr. Bartlett in his clinic, showed a very in-
teresting case of tremor. A man about 35
years old, with tremor of the left forearm and
hand. The shake was most observed while at
rest, was rythmical and ceased on motion, and
for a few seconds after massage of the arm.
Left pupil was a trifle larger than its fellow.
The man gave a history of having been occu-
pied as a painter until about 18 months ago.
There was no wrist drop or lead-Une on the
gums, nor was there any rigidity of affected
parts, and the man walked with head erect.
The doctor's diagnosis was lead poisoning,
and his 5 • Mercury, with massage as an adju-
vant.
Chicago.
HOMtEOPATHIC MEDICAL OOLLEGE.
Prof. Poster's definition of a metaphysician :
An imaginary doctor treating an imaginary
patient for an imaginary disease with an imag-
inary remedy producing an imaginary effect.
Prof. Foster recommends the following douche
in case of an abortion where there are approach-
ing symptoms of septicflemia :
Good Whisky - - one part.
Water - . - - three parts.
In many cases the power that this douche has
over temperature is truly magical. It is not
only a food and a stimulant, but also prevents
decomposition, and is not a poison. Avoid the
use of CarboUc acid and Corrosive sublimate, for
they are dangerous, as every good physician
should know. Watch the pulse, for it is your
beacon hght.
Prof. Pratt says : You will never see a cancer
of the breast without concomitant uterine symp-
toms.
You will always find trouble at the anus in
epithelioma of the Up.
Prof. Woodward says : You can put it down
that Aconite is no longer indicated in pneumonia
when the alternation of heat and cold has ceased
to exist.
I do not know that .there is another drug in
the whole materia medica that I value so much
as Cina in the treatment of incontinence of urine
in children.
Prof. Foster says : Viburnum perforatum Ix
or 2x, is one of the best remedies I know of for
the general symptoms of threatened miscarriage.
Put a few drops in a tumbler half full of ^ water,
and give a teaspoonf ul every half hour. If the
ovum is not detached, give Viburnum and order
the womq^n to stay in bed three or four days.
Tampon the vagina with a sponge. This tam-
pon may be used at any time during pregnancy,
hefore the taterus w emptied. If the uterus has
discharged it contents, only use it when you are
sure that a dangerous hemorrhage into the
uterine cavity cannot take place.
In the later months of pregnancy it is good
practice after the expulsion of everything, to
wash out the womb. Use warm water with a
little Whisky or Arnica. Pass the rubber tube
without a nozzle, directly into the womb, so the
stream may be large and gentle. If you use
the nozzle, water may get into the Fallopian
tubes, thus causing ovarian colic and salpingitis.
At a recent chemical laboratory exercise a
number of students were performing the ** Marsh
test " for arsenic. As one of them appUed the
Ughted match to the, as he thought, escaping
gas, his apparatus exploded ; but as he had taken
care to wrap a heavy wet cloth about his jar, no
harm was done. Moral: If you would feel
safe while performing this experiment have your
head protected likewise.
A few notes from Prof. Hobart's lectures on
Materia Medica :
In administering iEthusa, I have found small
doses, often repeated, to be of more value than
large doses, given at longer intervals. If this med-
icine is useful in a case of cholera infantum,
the effect wUl be immediate. Use it high.
For ordinary clergyman's-sore-throat you will
find nothing better than Alumina.
In prescribing Apis mel., for eye troubles, use
the 30x ; when for threatened abortion, during
early months, or for irritation of the bladder,
the 6x ; for acute oedema, 3x.
Eemember that the thirst of Arsenic is not
confined to ** little at a time and often." It may
be mvbch and often.
28
THE MEDICAL ERA.
IVoL. VI. No. 1.
When Belladonna is indicated in dysmenor-
rhoea, you will get good results from prescribing
it in one drop doses, four times a day, fox ten
days before the period.
When prescribing Colocjmthis for neuralgias,
use from the 24th to 30th potencies. For colic
you will get better results- from the 3x or 6x. The
2x frequently aggravates.
Prof. Streeter strongly advocates the primary
operation for laceration of the perineum. He
says it is always best to operate when the tear is
over half an inch long. Be satisfied that hem-
orrhage from the womb has ceased, then wash
away all blood clots and thoroughly irrigate with
carbolized water. Pare smoothly the torn sur-
faces, irrigate, then put in the silk suture. If
the tear is back to the sphincter a^i, at least
three stitches will be required. It is not neces-
sary to tie the limbs together. The suture may
be removed on the seventh day. The danger
of sepsis is less than when you do not operate
At a recent clinic Prof. Streeter said it is
proper to dilate the cervix uteri under the fol-
lowing conditions : (1) stenosis ; (2) cicatricial
tissue ; (3) chronic inflammation ; (4) flexions ;
(6) tortuous canal. As a rule gradual dila-
tation with graded steel sounds is best.
In 1828, Dr. Fisher, an allopathic physician,
of Dresden, wrote: "Homceopaths do not bleed,
and God only knows how they arrive at the de-
sired result in those cases where bleeding is the
only mode by which we can expect to save the
patient.'*
Investigation shows that the limit of tempera-
ture at which men can work depends upon the
length of their exposure, the amount of exer-
tion they put forth, their condition, and the
nature of the atmosphere, particularly as to its
degree of moisture. It is stated that men have
been employed on railways at 104° F., in
mines, mider very favorable conditions, at 125°
F., and are said to work occasionally in the
stoke-holes of tropical steamers at 156° F.
Professor Dubois is reported to have estimated
that a temperature of 122° F. can be endured
when the air is as dry as possible, but that even
104° F. is likely to be fatal in an atmosphere
saturated with moisture. It is also considered
certain that men cannot become accustomed to
stand for any considerable time, a higher tem-
perature than from 145° F. to 165° F. ; even
when they keep perfectly still and are in quite
pure air.
COOK COUNTY HOSPITAL.
The old man spoken of in last month's notes
as having cut his throat, has departed this life.
The post mortem confirmed the diagnosis of fatty
accumulation of the heart, over a pound of adi-
pose tissue being found in the pericardial cavity
surrounding a very much atrophied heart.
The use of the pistol-splint in the treatment
of Collets fracture has been attended by uni-
formly good results. No bad effects have ever
been obtained, and all cases recover with abso-
lutely no deformity.
American women are not all becoming sterile.
There is one in the hospital now 37 years old,
married at the age of 23 years, who has had 16
children in 14 years of married life.
Some of the most remarkable effects have
been produced by the hypodermic injection of
from 15 to 20 minims of HvjO. Nervous, hyster-
ical patients quiet down under its influence, and
occasionally on leaving the hospital, ask for a
bottle of ''that medicine that makes them
sleep so well.''
Illustrative of the capacity of the ordinary
country practitioner a case of compound frac-
ture of the leg was admitted recently which had
been treated by a disciple of iEsculapius in a
small Illinois town. Vaseline had been smeared
over the wound, a dirty linen rag laid on that, and
then the leg immersed in a long box filled with
sawdust. When seen the wound was fairly
crawhng with maggots, and the leg in such a
condition that amputation was necessary in order
to save the patient's life.
Warts that had resisted Nitric acid, Carbolic
acid and even Silver nitrate, yielded readily and
kindly to Thuya tr., and thereby gained the good-
will of a nurse for homoeopathy.
Plugging the posterior nares is a very simple
operation to perform in a book, but when a man
gags like a dog with a bone in its throat, and
spits bad whisky and swear- words in the opera-
tor's face, it isn't quite so pleasant.
A severe case of epistaxis was admitted re-
cently. The patient was a man about 50 years
old who had been on a spree for several weeks,
and could give no reason for his ailment. He
had been bleeding for 12 hours. A physician
outside had tried in vain to stop it, and then
recommended him to come to the hospital. A
pledget of cotton a little larger than a grain of
com was removed from the posterior nares, both
nostrils were plugged fore and aft, a hypodermic
injection of Ergot tr. m. xxx given and the hemor-
rhage ceased.
Jam., 1887.1
MISCELLANY.
29
MISCELLANY.
The readers of The Medical Era will observe
that with the present number the journal has
been enlarged and very much improved. The
columns are wider and longer, and, notwithstand-
ing the larger type — which will be grateful to
many eyes — it contains a greater amount of
reading-matter than ever before. With this
number you are getting more for your money.
As we have frequently said in the past, so we
repeat: Others may follow, but The Era will
lead.
Solutions of Corrosive sublimate may be
prepared oflf-hand by always carrying m your
pocket, or bag, an alcoholic solution, a drachm to
the ounce. A teaspoonful to a pint of water
makes a solution about 1 :1000. Sublimate
should not be used with soapy water, as it causes
a greasy white precipitate, or with dirty or bloody
hands, as it "fixes" the dirt, producing indelible
stains.
Urinary Analysis. — In this number of The
Medical Era our readers will find the first of a
series of practical articles by Dr. Clifford Mitch-
ell, author of " Practitioner's Guide to Urinary
Analysis." This article will be followed by
others, forming a series the value of which all
must appreciate.
Cablegram. — London, Oct. 25th. W. R.
Warner & Co., Phila., received highest award
from American Exhibition in London far superi-
ority of their sugar-coated pills and effervescing
salts.
The November Chironian contains a full ac-
count, illustrated, of the proposed new building
of the New York Homoeopathic Medical College.
This school will have the largest, finest, and
most complete building of any homoeopathic
college in the country.
Pepsin is undoubtedly one of the most valua-
ble digestive agents of our materia medica, pro-
vided a good article is used. Robinson's Lime Juice
and Pepsin, (see page x. this number) we can
recommend as such. The fact that the manufac-
turers of this palatable preparation use the pur-
est and best pepsin on the American market, and
that every lot made by them is carefully tested,
before oflFering for sale, is a guarantee to the
physician that he will certainly obtain the good
results he expects from pepsin.
Have used Tongaline for dysmenorrhoea and
found the results thoroughly satisfactory.
Gilead, Lewis Co., Mo. J. P. Frame, M. D.
PERSONALS.
Dr. J. W. Bamsdall is treating many cases at
his new hospital, at Omaha.
Dr. Chas. P. Beaman has located at 163
State St., Chicago, Rooms 65 & 66.
Dr. E. A. Beaumont, of Minneapolis, is just
recovering from an attack of typhoid fever.
Dr. C. J. Pearson has returned from his trip
to California, and resumed practice at 1262 W.
Lake St.
Dr. F. W. South worth, in search of a more
genial climate, has removed from St. Paul to
Tacoma, Wash. Ter.
Dr. W. W. French, of New York, has removed
to Chattanooga, Tenn., and become a partner of
Dr. G. E. Harrison.
Dr. R. A. Harlan, of Warsaw, HI., wants a
successor. Physicians seeking a location should
address him as above.
Dr. A. B. Rockwell, of Wahpeton, Dak., wants
some physician to correspond with him with a
view to taking his practice.
Dr. D. M. Goodwin, of Minneapolis, has been
compelled, on account of ill health, to take a
rest. He is visiting in the East.
Dr. Frank Kraft, of Sylvania, 0., assumes the
editorship of the American Homceopathist, We
congratulate Mr. Chatterton, we welcome Dr. •
Kraft, but at the same time we regret Dr. Under-
wood's retirement from journalism,
Dr. H. W. Champlin, after six years of suc-
cessful practice at Chelsea, Mich., has gone to
New York for hospital advantages. He leaves a
good field at Chelsea, which should be occupied.
Write to H. S. Holmes, Chelsea, Mich., for par-
ticulars.
Hoxnoeopathic Physician Wanted.
There is a good opening in the village of Fair-
child, Wisconsin, for a first-class homoeopathic
physician and surgeon, there being none there at
present. Good territory outside of village. For
particulars, write or apply to J. S. Grave, C. B.
Collins, or N. C. Foster, Fairchild, Wis.
A Ccurd.
To the Editor of the Medical Era:
For the benefit of the profession at large, wiU
you kindly state that William B. Clarke, M. D.,
— formerly my assistant — is no longer holding
any business relations with me, and that I will
in no wise be responsible for any bills he may
make or loans he may endeavor to negotiate.
0. S. Runnels, M.D.
Indianapolis, Nov, 16, 1887.
30
THE MEDICAL ERA.
[Vol. VI. No. 1.
OTJB OOMPLIHENTS.
We refer to the compliments which have
been lavished upon The Medical Era by repre-
sentative physicians in all parts of the country.
They do not make us vain, but will stimulate to
greater eflFort.
I value The Medical Era very highly. — Dr. O.
jS. Runnels.
The Medical Era is one of our brightest journals.
— Dr, Asa. F. Couch.
It always seems as if the last number is the
best — Dr. A, M. Crane.
I enjoy The Medical Era, and gladly remit for
it. — Dr. Millie J. Chapman.
I place The Medical Era among those at the
head of the list — Dr. F. H. Orrne.
The Medical Era is good! good!! — well worth
the money. — Dr. H. A. Houghton.
I like The Medical Era better than any other
journal that I take. — Dr, D, D. Cole.
I am taking four journals and The Medical Era
leads them all! — Dr. J. L. Robinson.
I am glad to remit to the good journal which
you so regularly send. — Dr. I. T. Talbot.
I wish to express my high appreciation of The
Medical Era. — Dr. Julia Holmes Smith.
Send it another year. I can't do without it now.
It is a tip-top journal. — Dr. J. S. Daniels.
1 regard The Medical Era as the best homoeo-
pathic medical journal now published. — Dr. L. D.
Coombs.
The Medical Era is indispensable to the practi-
cal and progressive homoeopathic physician. — Dr.
H. W. Champlin.
I have but one objection to The Medical Era,
and it is a serious one — it does not come often
enough. — Dr. T. M. Triplett.
TAOVriJE.
OwENSBORo, Ky., Dec. 17, 1887.
To The Medical Era:
A student of mine went to church last Sun-
day, and on his return I asked him what the
text was. He said :
** As well as I can remember it was, * All
strictures are caused by indiscretion, and are
profitable for doctoring, for reproof, and correct-
ing unrighteousness. ' "
He had been reading ** Orificial Surgery."
Very Truly,
E. W. Skinner, M. D.
P. S. Send me the Era another year.
Vice VerM.
Some mischievous being,
With evil desire,
From Dr. Pratt's house
Cut the telephone wire.
With the piece taken out,
Reversed end for end,
He filled in the gap,
And spliced it again.
The effect is peculiar,
For now, strange to tell.
When Pratt shouts " Hello ! "
It sounds like, " O ! "
Selah.
Helen. ** Mamma, what is a casus helii? "
Mother, ** My child, never speak of anything
so indelicate I It is the Latin for stomach-ache."
Lady (to drug clerk) — "A two-cent stamp,
please." Clerk (absent minded) — "Yes, madam.
Will you take it with you or have it sent ? "
** And what did the doctor say?"
**He said de chile had a 'tack of erysipelas. "
"Erysiplas ! I alius saiddat chile would hab
trouble wif his ears some day." — Judge.
Friend. — *' Stammer, old boy, I hear you have
purchased a parrot ? "
Stammer. — ** Ye-ye-yeth, and it ith gw-gw-
gweat f-f-fun, you know. I'm t-t-teaching it t-to
t-t-t-talk."
Gihbs. ** So the man was killed at the hotel,
was he?"
Squibbs. **Yes, shot right in the rotunda."
Gibbs. ''Great Scott! No wonder it killed
him. That's a terrible place to hit a man."
DOCTOR : — There are some who have not yet
acknowledged the receipt of bills sent out. To
you these words are addressed. If you do not
wish us to draw, please notify us, telling when
you will remit. If you find an error in your
bill, there is greater reason why you should
write and notify us, in order that the proper
correction may be made.
In ten days after you receive this copy of the
Era, we shall draw on all who have not paid,
but we prefer that you should remit before that
time, or write telling when we may expect pay-
ment. This is not facetious.
Jah., 1888.]
BOOK REVIEWS.
31
BOOK REVIEWS.
A Manual op the Physical Diagnosis of Tho-
racic Diseases. By E. Darwin Hudson,
Jr., A. M., M. D., late Professor of General
Medicine and Diseases of the Chest in
the New York Polyclinic ; Physician to Belle-
vue Hospital, etc. One volume. Octavo.
162 pages. 93 illustrations. Price, $1.50.
New York : Wm. Wood & Co. 1887.
The tendency of modem book-making is to
condensation and systematic arrangement.
This has been admirably carried out in Dr.
Hudson's Manual. There is very little to criti-
cise, but much to commend. For the purpose
expressed in its title, " the physical diagnosis of
thoracic diseases," it is the best work with
which we are acquainted. The illustrations are
abundant and well executed. The descriptions
are clear and concise, without being too brief.
The tables are full and well compiled. The au-
thor, evidently, is not acquainted with Bartlett's
pleximeter, or he would certainly recommend it
in preference to Flint's. But this does not pre-
vent it from being the best book that we have
on the physical diagnosis of chest diseases.
A Complete Hand-book of Treatment : An Al-
phabetical Index of ' Diseases, containing
1000 FormulfiB. By Wm. Aitkin, M. D.
(Edin.) F. E. S. Edited with notes and
additions by A. D. Rockwell, A. M., M. D.
One vol., cloth, 444 pp. Price $2.75.
New York: E. B. Treat.
This is the latest issue of the Medical Classics
Series being published by this well-known house.
It is a reference book compiled from Dr. Aitken's
work on the Science and Practice of Medicine.
The treatment is, we think, a little old-fash-
ioned. It is not abreast of modem therapeutics,
as practiced in America, at any rate.' While
many useful hints might be gathered from its
pages, yet as a guide to treatment it does not
fulfil expectations. Dr. Aitken was more
skilled in the science of medicine than in its art.
600 Medical Dont's : or, the Physician's Utility
Enhanced. By Ferd. C. Valentine, M. D.,
Ex-Surgeon General, Army of Honduras,
etc., New York: G. W. Dillingham. 1887.
This unique book has its place ; or, if not, it
will soon make a place for itself. The title and
arrangement were, obviously, suggested by Mr.
0. Bunce's popular handbook on etiquette.
But Dr. Valentine has shown great originality
in adapting the method to medical topics. He
has made a book which is apt to be read, be-
cause it will entice the reader. And that is a
great virtue in a book. But, in addition, after
having read, the reader will be instructed, and
if he observes one-tenth part of the injunctions
laid down, he will be a wiser and healthier man.
The book is intended for the laity, but the pro-
fessional man may read it with profit.
A (kiiNiCAL Materia Medica. Being a Course of
Lectures delivered at the Hahnemann Med-
ical College, of Philadelphia, by the late E.
A. Farrington, M. D. Revised by S. Lilien-
thal, M. D. With a Memorial Sketch of
the Author, by Aug. KomdcBrfer, M. D.
Philadelphia : Sherman & Co. 1887.
Farrington's Materia Medica differs essen-
tially from most of the works with which the
profession is now familiar. It is, as indicated
by its name, a clinical materia medica.
Dr. Farrington was well known as a teacher,
and this book contains the substance of the lec-
tures which he gave to his class. They read
just as he talked. It is fortunate that, by aid
of the author's manuscript, and of Dr. Bartlett's
phonographic notes, the lectures have been pre-
served. The book will be appreciated not alone
by the students who heard the original lectures
at the Philadelphia college, but by all students
of materia medica. Among the many works on
the subject, this one has its place, a place which
is of no little importance.
The readers of St. Nicholas will discover in the
December number that Mrs. Frances Hodgson
Burnett has created a worthy companion char-
acterto " Little Lord Fauntleroy," in the heroine
of her story, **Sara Crewe; or, What Happened
at Miss Minchin's."
The December Century opens with a frontis-
piece portrait of Lincoln from a photograph made
about the time of his inauguration, which event is
the subject of the present part of the Lincoln
History.
The Christmas number of The Illustrated Lon-
don News, is a real work of art. It contains three
handsome colored lithographs, well worth fram-
ing.
With the number for January, Scribner's Maga-
zine begins auspiciously its second year. The
features of the new year promise to be most
interesting and valuable contributions to liter-
ature, and the publishers' announcement of in-
creased excellence in illustrations is evidently to
be richly fulfilled.
32
THE MEDICAL ERA.
[Vol. VI. No. 1.
THEY SAY
That oil of vitriol is not an oil.
That carbolic acid is not an acid.
That copperas contains no copper.
That a goose may live to be eighty.
That leprosy is absolutely incurable.
That German silver contains no silver.
That a hornet always keeps its end up.
That the life of the elephant is 100 years.
That there are two lepers in Philadelphia
That sulphuric ether contains no sulphur.
That education is the gateway to all reform.
That to conceal the truth is to lie in ambush.
That 16 years is the average life of a monkey.
That tortoises live to be from 100 to 200 years old.
That leprosy is contagious in a very slight degree.
That hair does not grow on the body after death.
That whales are supposed to live a thousand
years.
That the Fijians call a doctor a "carpenter of
death."
That purpuric spots in scarlet fever are of grave
import.
That dirty diatribes have no place in medical
literature.
That a butcher is willing to meat his customers
half-weigh.
That there are 7,732 homoeopathic alumni in
this country.
That a doctor of medicine can practice dentistry
if he wants to.
That swans and ravens sometimes live to be
200 years old.
That the Queen of Corea is not the Empress of
St. Vitus' dance.
That hysteria troubles the doctor more than it
does the patient.
That the homoeopathic colleges graduated 372
students last year.
That what is said about the failure of the potato
crop is mostly rot.
That gunshot fractures sometimes unite as readily
as simple fractures.
That parrots sometimes live to be 200 years old;
100 is not uncommon.
That a girl in Boston has named her cat Santa,
on account of its claws.
That there were 991 matriculates at the homoeo-
pathic colleges last year.
That a western doctor takes a reef in the mesen-
tery with lycopodium 30th.
That oxygen means the " acid-maker," and yet
some acids contain no oxygen.
That one cubic inch of platina black takes up
253,440 cubic inches of oxygen.
That the homoeopathic hospitals of the country
treated 13,862 patients last year.
That conscience is the pulse of reason, and some
people have an awful hard pulse.
That milk charged with carbonic acid gas will
keep an indefinite length of time.
That Dr. Quain left his entire fortune of 1375,-
000 to University College, London.
That a woman should not marry a man that
chews, but choose a man that marries.
That body-lice may be instantly destroyed by
washing the parts with sulphuric ^ther.
That arsenic and antimony are found in the
bright red-colored stockings of commerce.
That leprosy was introduced into the Sandwich
Islands forty years ago by two Chinese coolies.
That in Norway the number of lepers has
decreased fifty per cent in the past twenty years.
That a man who is hanged is generally cool; it
is the one who is guillotined that loses his head.
That 15,000 children are killed annually by the
use of soothing-syrups and similar preparations.
That men and monkeys are the only animals
having eye lashes on both the upper and lower lids.
That the sum of the walls of all the cells con -
tained in a cubic inch of charcoal equals 18 square
feet.
That in Japan lepers, as soon as the disease
shows itself by obscure symptoms, are immediately
isolated.
That Mrs. A. T. Stewart used to pay $32,000 per
year to her doctors, and Mrs. Catherine Wolf paid
$20,000.
That the mortality from labor in China is esti-
mated to be about eight per cent, or 4,000 deaths
annually.
That thirty-four homoeopathic dispensaries last
year treated 142,629 patients, and made 376,886
prescriptions.
That blindness is increasing, owing, it is thought,
to the introduction of contagious diseases of the
eyes by immigrants.
That the gas companies in Chicago are creating
a great deal of trouble; they are getting up a sort
of a gas- trick fever.
That the great and increasing frequency of tubal
disease in women is due to the presence of
gonorrhoea, often unsuspected.
That Lawson Tait says he is well satisfied that
venereal diseases might be stamped out if more
scrupulous attention were given to the toilet of
the genitals.
THE MEDICAL ERA
Vol. VI.
Chicago, February, 1888.
No. 2.
EDITORS :
CH. GATCHELL, M.D.
JAMES E. GROSS, M.D.
DO HOMCEOPATHS PRACTICE HOMCE-
OP A THY?
The paper by Db. Geo. B. Peck, a synopsis
of which we present to 5ur readers, possesses a
peculiar interest. The most striking lesson that
it teaches is a demonstration of the fact — which
The Medical Era has always insisted upon — that
by far the greater part of the practice of homoe-
opathic physicians is consistent homoeopathy.
The loose and empirical methods which some are
fond of believing have penetrated our school, like
a medical dry rot, belong to the few, and not to
the many.
Look at the record : For the relief of after-
pains the vast majority of the 177 physicians
who report, rely upon such remedies as arnica,
Pulsatilla, caulophyllum, chamomilla, bella-
donna, cimicifuga, secale and the like.
Is this allopathic practice ?
For inflamed breasts, the majority rely upon
belladonna, phytolacca, bryonia, and pulsatilla.
Is this allopathic practice ?
For milk-leg the majority use hamamelis,
belladonna, Pulsatilla, bryonia, aconite, arsen-
icum, rhus, apis and the like.
Is this allopathic practice ?
In the entire report, how much can be foimd
of what may be called allopathic practice?
Very litUe indeed ! And what little there is, is in-
dulged in here and there by but a single member
of the profession, and it belongs to the individ-
ual and not to the school.
Thus is the charge which Dr. Bowditch made
the key-note of his famous address, refuted.
Homoeopaths do practice homoeopathy. And as
homoeopaths they are not only entitled to the
name, but to call them by any other would be do-
ing violence to the facts. Here is the conclusion
at which Dr. Feck himself has arrived.
A word concerning an important element in the
value of the statistics I have presented. In them
we find the experience of the rank and file of our
profession ; the proofs of the essential unity of our
school; in that for a given condition the same
remedy is prescribed by the low dilutionist and the
high; that while comparatively a small number oc>
casionally resort to palliative treatment, the vast
majority adhere rigidly to the principles implied in
our name; and that in all instances in which the
nature of any given ailment is clearly non-sorgical
or non-mechanical, deviations from law are scarcely
appreciable.
DO ALLOPATHS PRACTICE HOMCE.
OP A THY ?
No. At least, they do so to such a limited
extent that it is scarcely worth taking into
account.
Look at their records : Not long since a Phil-
adelphia journal of the old school published
reports from one large hospital in that city,
from one in Cincinnati and two in Chicago, giv-
ing the ** Present Method of the Treating Tjrphoid
Fever " in each institution (it is necessary for
an allopath to be particular with his tenses:
present soon becomes paM).
And what of the methods ? In the first place,
as it is easy to surmise, no two were alike,
34
THE MEDICAL ERA.
[Vol. VI. Na S.
Again, it was simply a record of calomel (to
** clean out " the bowels), bromide of potassium,
opium, quinine and antipyrin.
Is this homoeopathic practice ?
If there is any place to which we would be en-
titled to look for a display of homojopathic
practice on the part of our friends, the enemy,
it is in the treatment of cas^s of typhoid fever.
It is a disease of common occurrence, and one in
the treatment of which the homoeopaths have
never been accused of want of success. But we
seek in vain.
Look through old school journals ; read them
by the score, and it is impossible to find among
the many cases reported, of this, or any other
disease, a single one treated according to homoeo-
pathic methods. If the allopaths had absorbed
very much of our practice, ought we not to find
in their journals some indication of it once in
a hundred times ?
The allopaths have acquired a cheap reputa-
tion for having possessed themselves of ** what
little good there is in homoeopathy, " but it is
hard to find in the field of practice evidence that
they have fed upon a single crumb dropped from
our table.
From hospital experience in an institution
where both schools are represented within the
same walls, as well as from observation in pri-
vate practice, the writer has failed to find a
single instance in which an allopath has availed
himself of homoeopathic methods in the treat-
ment of disease. Surely, if very much absorp-
tion had taken place, we ought to see the results !
But the results are not to be found.
Do the members of the old school, then, know
anything about the use of homoeopathic rem-
edies ?
Only this much : Some of them have become
possessed of the knowledge, in a general way,
that Pulsatilla is a good remedy for amenorrhoea.
They give it, and, often, it disappoints them, for,
as every homoeopath knows, it is adapted only to
cases marked by a certain set of symptoms.
When it fails, the allopath is at the end of his
line. He has no knowledge of the virtues of
cimicifuga, sepia, aconite, bryonia, phosphorus,
calcarea, ferrum or graphites in the treatment,
of the condition — remedies which the homoBO-
path would next consult. The allopath does not
know why he gave Pulsatilla, and he does not
know why the Pulsatilla failed.
If this is practicing homoeopathy, then, oc-
casionally, is an allopath guilty of the crime.
What is true of Pulsatilla, in this respect*
may be said of cantharis, ipecac, colocynth,
hepar, and a few other drugs. An occasional
prescription of the kind is made, but it is made
regardless of "indications," and with no knowl-
edge of any other homoeopathic remedy related
to the diseased condition, in case the first one
fails. In a word, the use that they make of what
few homoeopathic remedies they may have become
familiar with, is, like their use of everything
else, purely empirical.
But, it may be asked, do none of them get
farther than this in their knowledge of homoeo-
pathy ?
Yes ; but, when they do so, they muaUy buy a
lot of liomoiopathic books, a case of medicines^ and
become out-and-out homoeopaths. And, moreover,
they generally become the staunchest kind, for
they have had an opportunity to witness the
evils of the old system, and to realize the great
superiority of the new.
In the last forty years — the age of our oldest
college — there have been seven-thousand-and-
odd graduates of homoeopathy in this country.
Of these a great many, of course, have died,
and many others have left the profession. And
yet there are now said to be, in the United
States, more than ten thousand avowed homoeo-
pathic physicians, some estimates putting the
number as high as twelve or fourteen thousand.
At the very lowest calculation there are, then,
six thousand homoeopathic physicians to be ac-
counted for who never graduated at homoeopathic
colleges.
Whence came they?
They represent former allopaths who learned
the ''indications " for Pulsatilla.
Fbb.,1888.]
EDITORIAL.
35
ALCOHOL IN DIPHTHERIA.
Soon after the last number of The Medical
Era was issued, we were informed that Dr. R.
N. TooKBB, Professor of Diseases of Children in
the Chicago Homoeopathic Medical College, of
this city, had for years been teaching to his class
the treatment of diphtheria by the systematic use
of alcohol. In response to a letter of inquiry
addressed to Dr. Tooker, we received a reply
from which we make the following extracts :
The first case of diphtheria in which I used
alcohol in large doses was that of Charley Cow-
an, living then and now at No. 1 Washington
Place (Mrs. Stephens, nurse).
For a week I kept the patient ** boozy " with
whisky toddy. He was then a baby, and is now
a boy nine or ten years of age. The case was a
most malignant one, and I have always attributed
his recovery to the free ujse of stimulants, adminis-
tered regularly by a professional nurse.
I think the regular and systematic manner of
dosage is in every way important. I have often
thought that in the above case, as in others
treated subsequently, there was an unusuaUy
great tolerance of alcohol, and I have questioned
whether this is not always so in subjects of
diphtheria.
My experience certainly teaches me that alco-
hol,, in all forms of administration, is well borne,
and I have seen no ill effects from it in any case.
I have been very chary, however, in giving it in
the form of milk punch or egg nogg, for fear of
gastric disturbance. Pure alcohol, diluted as
recommended in your article quoted from the
editor* of the Medical Times, or in the form of old
whisky, in either case made palatable with hot
water and sugar, is the best form for its admin-
istration. No wines, either imported or domes-
tic, are to be depended upon.
Alcohol, as pure as obtainable, is preferable to
any bibulous compounds, and can be diluted as
desired. It should be used as strong as can be
swallowed, up to fifty per centum, and if em-
ployed with an atomizer, of full strength.
With young childi-en I generally use a Codman
& Shurtleflf steam atomizer, being guided in fre-
quency by the length of time the patient can be
induced to use it.
Referring to the question of to whom is due
the honor of first introducing the treatment of
diphtheria by the systematic use of alcohol, I
desire to say that 1 do not know when I got the
• But, as it turns out, the editor of the M. T, has had
no such ej^perience.
idea, but, for the sake of the school to which I
belong, and in which I have the honor to be a
teacher, I can say that for at least six years, al-
cohol, administered as above, has been taught
and emphasized in the strongest language at my
command, and no intelligent student has gone
out from our college in ignorance of its value.
It must not be imderstood from this that I
consider alcohol to be the iie plus ultra of treat-
ment, or that other remedies are uncalled for.
I never use it, nor advocate its use, to the exclu-
sion of other treatment. Other remedies are of
great value, and some mild cases of diphtheria
may not require alcohol at all:
But in malignant cases of diphtheria I would
swap the entire materia medica for a pint of
good bourbon whisky and an experienced, con-
scientious nurse to administer it regularly.
To the adherents of the germ theory, alcohol
presents itself as the best of all germicides ; to
those who regard the disease as of septic origin,
it is confessedly the best of all antiseptics. It
is at once a food, a stimulant, and a medicine
par excellence, and I am very glad indeed that
you have again called attention to its use.
The valuable testimony thus given by Dr.
Tooker we are glad to be able to add to that
already offered. Those students who have gone
out in past years from Dr. Tookbr's teaching
should have reports to make, and we most earn-
estly invite communications from all who have
tried this method of the treatment of diphtheria.
We are glad to be able to add the testimony
of Dr. S. L. Eaton, of East Orange, N. J. In a
paper read at the last meeting of the New Jer-
sey State Society, Dr. Eaton said :
I have seen a child with diphtheria, who was
apparently moribund, extremities cold, and the
radial pulse imperceptible, revived by the liberal
use of champagne, which was continued in large
quantities for several days, until nature had had
time to cast off the poison and resume its func-
tions without adventitious aid.
On the other hand, in a letter which we have
received from a New York physician, a reliable
authority, the following statement is made :
The general impression here about alcohol, which
has been used quite generally in diphtheria, is
that it is good, but it does not deserve the sweepT
ing recommendation given it
36
THE MEDICAL ERA.
[Vol. VI. No. t
Still, we would urge its trial by phyflicians
throughout the West, only reminding them that
the alcohol should be used energetically and
systematically, and that no results will be con-
clusive except in cases of moXigrumt diphtheria.
AN EXPLANA TION.
The article on the use of "Alcohol in Diphtheria"
should have been credited to a correspondent, and
not to an ** Editor N. Y. Med. Times! "
The above has been received at this oflSce from
the Editors of the journal named.
It is the custom of The Medical Era to give,
freely and unhesitatingly, full credit to all to
whom credit may be due. In this spirit we
credited the Editor of the Tiities with that which
we had every reason to believe belonged to him.
We now, just as freely, give him the benefit of his
disclaimer.
But we wish to file a bill of complaint against
such loose and unusual methods of journalism.
A physician living in Oregon sent a letter ad-
dressed :
^^ Editors New York Medical Times."
The reply began with thet following words :
" We take pleasure in replying to the request of
our esteemed colleague. It is true that the sug-
gestions toe made, in the communication to which
our correspondent refers, were too meagre for prac-
tical use." [Our italics.]
Thus the reply was made with the editorial
•*we" At the end of the article there was no
name, no initial, only an insignificant *, to in-
dicate that it was written by any hand but that
of the editor himself.
Why should a correspondent use the editorial
**we"? Why should he refer to the Oregon doc-
tor as «'our correspondent"? Why should it
not be plainly indicated that it is not the editor
who is speaking ? We give it up.
But in taking leave of the Times and its cor-
respondent, we wish to express our satisfaction
at having become acquainted with another of the
peculiar methods of this peculiar paper.
It is very fitting that a nameless journal should
be edited by anonymous correspondents,
INSTITUTE TRANSACTIONS.
SYNOPSIS OF TRANS^
ACTIONS OF THE AMERICAN
INSTITUTE OF HOMCEOPATHY, 1S87.
[Arraoged by the Editor of The Midical Era.]
The Medical Era has received several letters of
thanks for the Synopsis published in Jannair.
Some requested that the names of the different
writers be given in full in the part that was to fol-
low. With this request we have complied, and
we also give, below, the names of those who were
quoted last month.
SYNOPSIS IN JANUABT ERA.
L. S., Dr. Lewis Sherman;
T. Y. K, Dr. T. Y. Kinne;
M. J. C, Dr. Millie J. Chapman;
L. H. W., Dr. L. H. WiUard;
J. W. D., Dr. J. W. Dowling;
S. P. H., Dr. S. P. Hedges;
C. H. v., Dr. C. H. Vilas;
C. D. C, Dr. C. D. Crank;
S. H. T., Dr. Selden H. Talcott;
T. F. A., Dr. T. F. Allen;
J. C. M., Dr. J. O. Morgan;
G. S. N., Dr. Geo. S. Norton;
A. M. C, Dr. A. M. Gushing;
A. L. E., Dr. A. L. Kennedy;
J. M. S., Dr. J. M. Schley;
E. B. R, E. B. Hooker;
J. S. M., Dr. J. S. MitcheU;
W. J. M., Dr. W. J. Martin;
T. F. A., Dr. T. F. Allen;
J. M. W., {Should have been O. M. D)
Dr. Geo. M. Dillow;
J. H. C, Dr. J. H Carmichael;
N. S., Dr. N. Schneider;
W. L. J., Dr. W. L. Jackson;
G. A. H.,Dr. Geo. A. Hall;
W. T. H, Dr. Wm. Tod Helmuth;
J. E. J., Dr. John E. James;
F. S. F., Dr. Fred. S. Fulton;
J. H. McC, Dr. J. H. McClelland;
G. A. H, Dr. Geo. A. Hall.
Page 4,
4,
4,
5,
5,
7,
7,
8,
8,
8,
8,
8,
8,
9,
9,
9,
9,
10,
10,
10,
10,
10,
10,
11,
11,
11,
11,
11,
(C
((
i(
&(
((
((
«
((
i(
«
u
a
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u
((
((
«
BUREAU PROCEEDINGS.
OBSTETRICS.
Subject: — Important Complications of Gesta-
tion.
The death of the foetus in the earlier months
should not have a moment's consideration when
the life of the mother is at stake.
A case came to my knowledge in this State,
where a physician of greater renown in sanitary
science than as an obstetrician, was called to
Pbb., 188&]
INSTITUTE TRANSACTIONS.
87
attend a case of labor, and pronounced it a case
of deformed -or contracted pelvis, and, sending
for counsel, they performed craniotomy on the
living child and delivered a dead foetus. Within
a year the same woman had a large child bom
alive, and no doctor was called ! This woman
conceived a great contempt for doctors ! — Dr« C.
G. HlOBEE.
At least thirty physicians in every hundred
are called upon to apply mechanical treatment
in some manner to child-bearing women.
Epilepsy works greater damage to gravid
women than to others.
Typhoid fever is, perhaps, the most serious
conlplication of pregnancy under consideration,
if we judge by its mortality in comparison with
that of ordinary cases under skilful homoeo-
pathic treatment.
Scarlatina. — That pregnant women can nurse
persons suffering from this disorder apparently
with impunity is a matter of common observa-
tion.
Puerperal scarlatina, on the contrary, is a
very serious matter.
Measles, when complicated with pregnancy,
is not so innocent a disorder as when not so
attended.
Heart disease seems to be a comparatively
inconsequential complication of pregnancy.
Pneumonia has been observed by nineteen
practitioners. The maternal and the infantile
mortality were alike — 14.28 per cent.
Concerning mothers, I do not wish to be under-
stood as speaking positively, but the chances are
that when suffering from tuberculosis, fully
twenty-five per cent will die during the year
succeeding parturition.
Pregnant women are not so likely to take dis-
ease as others, but ' if it is contracted it is more
likely to prove fatal ; remedies act with prompt-
ness, but the power of the system to react is
diminished. — Dr. Geo. B. Peck.
There is probably no complication of gestation
which arouses greater anxiety in the mind of the
obstetrician than that known as "renal," pre-
supposing, as it does, a true pathological condi-
tion of the kidneys.
Children bom of mothers having albuminuria
are poorly nourished, so that they are puny and
not well developed at birth, and if the disease be
intense, gestation may be interrupted prema-
turely, or the child may be still-bom. The
albummuria of pregnancy, when due to super-
albuminosis, or merely to over-distension of the
blood-vessels of the kidneys, will disappear almost
immediately after delivery.
Glonoine, as a remedy in ursBmic convulsions,
is spoken of as most valuable, sometimes giving
rehef after coma has supervened.
Without being themselves voluntary users of
tobacco, hundreds of delicate wives are victims
to this pernicious habit in others, living and
dying, begetting and bearing children, in an air
laden with the fumes of this vile drug, to the
misery of their own lives and the permanent det-
riment of their offspring. It is little less than
absurd to expect prophylactic remedies to over-
come the influences of such glaring evils, which
should be met and regulated by hygienic care,
on the one hand, and husbandly care on the
other. — Dr. Phcebe J. B. Waite.
Beady-made wardrobes I consider a curse.
A fruit diet, often represented as a safe way to
decrease pains of child-birth, is also conducive to
nervous diseases.
The cases I have seen have resulted from
tight lacing, over-fatigue or close rooms, and
have been relieved by loosening the clothing,
open air, cold water, perfect rest and Moschus
3d. If there is any remedy I give empirically it
is Moschus in all kinds of syncope, as well as in
hysterical paroxysms, nervous asthma and hic-
cough.
When neuralgia is confined to the facial
branches I have found Gelsemium, Ignatia,
Coffea, Spigelia, etc., to relieve.
I have especially found the continued use of
Calcarea carb., say two doses a day for two or
three months, to be marvelously helpful where
pregnancy accompanied pulmonary waste.
Neuralgia of the mammsB is often relieved by
Conium or Phytolacca.
In the vomiting of early pregnancy, lying
with the shoulders low and hips elevated, will
give relief. A linen compress saturated with
French brandy, strapped tightly over the gastric
region with adhesive plaster, acts mechanically
in holding the muscles quiet, and will sometimes
do wonders in these cases. — Dr. Emma V. D.
Pardee.
It is evident that in the old school the popu-
lar measures for such cases in obstetrics are great
quantities of medicine, stimulants, cathartics,
and such like. It has been my experience and
observation that such cases are most always
injured more by the medicine than by the condi-
tion of pregnancy. They treat as a disease what
is not a disease. Some years ago I read in a
little book that a pregnant woman's pulse was
the same • standing, sitting, or lying down. I
have often taken advantage of that, and found
it to be true; that is, the examination of the
38
THE MEDICAL ERA.
[Vol. VI. No. 1
pulse standing, while sitting, and while lying
down, and found that the number of beats was
the same in these three conditions, and I use it
as a sign of diagnosing pregnancy. — Dr. 6. L.
Brown.
One remedy in albuminuria is frequently
called for, and that is Argentum nitricum. I
have given it in those cases where the quantity
of urine seems to be suflScient,. but where the
quantity of albumin is also relatively large.
I have found that Argentum nitricum would
more rapidly diminish the quantity of albumin
than any other remedy that I have used. —
Dr. J. B. G. CusTis.
GYNECOLOGY.
■
As to the application of the vaginal pessary.
We will always meet advocates for and against
its use — some advising, others condemning the
practice, while many praise the instruments.
Owing to the great variety of instruments
known as vaginal pessaries, placed at the dis-
posal of the profession, their application becomes
a problem not unlike that of therapeutics, dis-
tinguished more by actual wealth than by
poverty of material.
The advantage gained in their application far
outweighs all theory or unfortunate results from
their use by the novice.
Like the application of a splint to a fractured
limb, a truss to a hernia, a brace to a spinal
curvature or a case of talipes, so must we accept
the mechanical assistance of a properly adjusted
pessary.
So long as the vagina retains any amount of
contractility it should be our first duty to pre-
serve rather than destroy this property.
The practitioner who is not a mechanic should
not trust himself to the employment of a pessary.
Never introduce a pessary when there is a
metritic inflammation, acute or chronic . Remem-
ber the golden rule in the mechanical treatment
of uterine displacements: Always adjust the
pessary to the patient, not the patient to the
pessary.
Leucorrhoea always destroys the elasticity of
the vaginal tissue, and while almost always
present in a slight degree during the wearing of
a pessary, any increase should be regarded with
suspicion. If the physician appreciates the
mechanical principles underl3ring the action of
all vaginal pessaries in their relation to uterine
displacements, his work is much more easily
performed. If, on the contrary, he **goes at it
regardless," he will not only meet with disap-
pointment, but bring odium upon an instrument
that, if properly employed, is really a benefactor
to the sex.
Dexterity in the manipulation of pessaries can
only be cultivated by practice. There is no gen-
eral rule to follow in their application.
It is a recognized fact throughout the world
that the pressure symptoms, including weight in
the pelvis, sacralgia, bladder and rectal irrita-
tions, difficulty and pain on locomotion, dragging
pain in the hips and hypogastric region, com-
bined or uncombined with systematic effects, are
relieved by a skilful adjustment of pessaries.
While the evidence in our school has been
discouraging as to the curability of uterine dis-
placements by means of pessaries, we must at
least acknowledge their powerful aid as palli-
atives. — Dr. Phil. Porter.
The physician who would ignore the progress
that has been made in gynecological surgery dur-
ing the last few years would be left far behind
in the race for superiority. And he who fails to
recognize and bring to his aid homoeopathic
treatment is certainly doing his patients an injus-
tice and depriving himself of one of the greatest
resources in medicine. The more accurate
pathological knowledge of uterine diseases now
obtainable enables the scientific physician to add
to the objective and constitutional symptoms
the pathological symptoms, and thus have a
complete picture of the disease in view to aid
him in selecting the curative remedy.
Many times the mode of making local appli-
cation does more harm than the medicine does
good. It is a safe rule and one that I have
never seen formulated, that we may use any
means for the relief of our patients in gynecology
which give immediate relief, and which, within
a reasonable time thereafter, show no symptoms
of any unfavorable reaction.
We have the illustrious examples of Hahne-
mann, Jahr, Hempel, and many other eminent
men for the use of local medication in such
cases, and of Helmuth, McDonald, Hughes, Lud-
1am, Comstock, and thousands of others whose
devotion to homoeopathy is beyond question, as
to the benefit to be derived from the combina-
tion of constitutional and local medication and
surgical treatment in diseases of the uterus. —
Dr. C. G. Higbee.
For cleansing the cavity of pus I use the
Peroxide of hydrogen. This requires much
more care in its use, as it is far more liable than
Listerine to produce mischief. — Dr. C. B.
KiNYON.
Among the first in importance is careful and
exact diagnosis. It cannot be reasonably asked
'Fu., 1888.]
INSTITUTE TRANSACTIONS.
39
or expeeted that any credence will be given our
reported successes in any direction unless we
can show that our diagnoses, upon which our
claims must be based, are something more than
guess-work. We must be able to establish,
beyond a reasonable doubf, that the disease or
condition which we have treated and cured had
an actual existence.
When there has been, from parturition or
otherwise, such ilijury to the cervix uteri that
instead of a normal os we find a gaping slit,
especially if the lips are everted and the cervical
endometrium inflamed and eroded, and with
these local evidences are associated various ner-
vous disturbances of greater or less intensity,
which may be and probably are dependent upon
the injury, surgical repair — restoration of the
injured parts to their normal form and rela-.
tions — o£Fers the only means of removing the
•cause of the trouble. Then, the exciting cause
having been removed, the remedies variously
indicated have a chance to effect a cure of the
nervous disturbances.
When epithelioma — especially the proliferat-
ing variety or cauliflower excrescence — can be
discovered in its early or incipient stages, tho-
rough and complete removal of all the diseased
tissue may arrest it and render a cure possible,
which is more than can be claimed, I think,
for any other treatment.
Polypoid growths, which often cause much
^arm, especially through hemorrhage, and which
are so easily removed, should be cut away or
curetted off, and then the remedies to prevent
the further development of such growths have
their fitting place. In the treatment of uterine
displacements, too, surgery should sometimes
be applied. — Dr. L. A. Phillips.
The neck of the womb had of course been
dUated by surgeons and by obstetricians long
before Simpson's time, but nevertheless to that
startling inventor is justly due the immense
credit of showing that the cervical canal of the
non-gravid uterus may be, under certain condi-
tions, safely enlarged.
For purposes of dilatation pure and simple I
have personally abandoned the use of tents alto-
gether. My chief reasons for this practice are,
first, because their action is tedious, involving
many procedures where one would suifice;
second, their use is horribly painful ; third, cel-
lulitis may be indaced, or, if latent, may be
lighted up by them. — Dr. Edward T. Blake.
Embarrassment of any organ, if prolonged,
^irill divert its functions and lead to the expres-
sion of some form of malnutrition.
It is clear that gynecology is a many-sided
art, and that she has the undoubted right to
draft into her employ any force that will best
serve her purpose.
This is therapeutics in the broad and only
true sense, embracing correctly all that pertains
to the art curative, however administered ; lay-
ing claim rightfully to every utilizable fact and
principle of application within the scope of
knowledge.
In the field of pelvic disability there are very
many conditions demanding the assistance of
local treatment which, with all the light before
us, it would be malpractice not to give.
Iodine is a remedy possessing peculiar power
over the absorbents, quickening their functions
and thus reducing hypertrophies and hyperplas-
ias in mucous, connective or granular tissues.
Twenty-nine thirtieths of Iodoform by weight
is Iodine. It possesses the virtues, therefore, of
Iodine to a very great degree. Iodized phenol,
owing to its large percentage of Carbolic acid,
possesses energy of greater value in some cases
than either of the other members of the Iodine
groups.
The general symptoi»8 calling for Hydrastis
are the cachectic state, weak muscular power,
poor digestion, and obstinate constipation. —
Dr. 0. S. Runnels.
The rapid advance lately made in uterine
electro-therapeutics is to be attributed to the
attention paid to the details of the application
of the electric current according to the indica-
tions derived from a careful study of its effect
upon living tissue.
The soothing, anod3aie effect of the Faradic
current is best attained by very frequent interr
ruption of a weak current, the positive electrode
being placed as near as possible to the sensitive
part, whilst the negative is placed a little dis-
tance from it, both being moistened with a warm
saline solution. The positive hardens, almost
inspissates, the tissues when currents are used
of great intensity, hence its application to bleed-
ing surfaces as a hemostatic.
The negative is more applicable when the
resolution of neoplastic growths is desired on
account of its fluidifying effect. — Dr. B. F.
Bbtts.
Many seem to think that it makes no differ-
ence to your patients how you apply your elec-
tricity, but this is certainly as unreasonable as
to suppose that medicines can be used indis-
criminately and your patients cured. I wish to
enter my protest against advising patients to
use the battery indiscriminately. — Dr. J. K.
Warren.
40
THE MEDICAL ERA.
tVoL. VI. No. 8.
What is the first thing to do when you come
face to face with a sick person ? To do no Iiarm.
What is the next ? To do some good.
Intra-uterine treatment may be necessary in
rare cases, and reaUy do good, but it requires an
expert, and one with a great deal of experience,
to use it with safety, and all the time he should
bear in mind that he is "treading upon holy
ground," and before he knows he may do more
harm than good.
The local application of Chromic acid has
caused sudden death, and it is a dangerous rem-
edy.
Now regarding intra-uterine treatment, before
ever resorting to it, it is necessary to make a
careful diagnosis, for we sometimes have cases
where the catarrhal discharge comes from or
extends up into the Fallopian tubes from an
existing salpingitis. If you get these cases, do
not use intra-uterine applications of any kind, for
they will do no good.
A case of salpingitis may yield to appropri-
ate treatment from internal remedies, but pyo-
salpinx will require surgical aid.
The older I grow the less I use pessaries. I
have nearly a bushel of them at home, of all
kinds, ready for adjustment. I never use a stem
pessary. Never ! Never ! !
Surgery has come greatly to our assistance in
gynecological practice; but what I wish to
impress upon you here is that diagnosis of the
case is of the first and greatest importance. I
often see cases of lacerated perinsea, not to men-
tion lacerations of the cervix,. where treatment
has been carried on symptomatically for months,
and no physical examination ever made. Such
cases, when they go into the hands of experts,
are a disgrace to the previous medical attendant.
Operations for the restoration of perineal
ruptures are among the most satisfactory and
successful of any that fall to the lot of the sur-
geon.
The »tampon and Glycerine treatment for
hyperplasia, erosions and ulcerations has been
in use for some years, and has been overdone.
Instead of the tampons saturated with Glycer-
ine, take a tampon of borated cotton and intro-
duce it within the vagina, pushing it against the
OS. This gives the uterus support, acts better
than a pessary, is clean, comfortable and one of
the greatest i^provem;nt8 in modem uterine
therapeutics.
I would like to speak of the curette and uter-
ine sound. They are valuable instruments and
have their places, but do not use them too often.
I use them with great caution, for I candidly
beheve they have done more harm than good.
"Take away all remedies and therapeutic
measures in the materia medica, and leave me
only one to select, and my choice will be hot
water." I think this is sound common sense.
From the most recent studies of Apostoli, in
Paris, we have learned that the Galvanic current
may be utilized as a substitute for the surgeon's
knife in some of the most serious affections the
gynecologist has to treat.
" The coming man," in uterine therapeutics,
is electricity, but it requires patient study in
science as well as in art. — Dr. T. Griswold
COMSTOCK.
The argument in favor of treating the uterus
kindly I most certainly subscribe to. It is a
much abused organ (the uterus), often mal-
treated, overtreated, harshly treated.
But hot water also may do harm by too fre-
quent use, too higji temperature, and by pro-
longing the douche beyond a certain limit. — Dr.
Jane K. Culver.
In the use of hot water, the bulb syringe is
too frequently used, and the use of hot water
with this instrument is an abomination. I never
advise the use of hot water except with the
douche or fountain syringe. — Dr. Albert Clay-
pool.
•
I have seen very severe pains, and even col-
lapse, follow the use of hot water, especially
where a small quantity has been thrown into
the uterus. A very small amount of water
within the uterus may .cause a sudden contrac-
tion of the organ, producing the most intense
agony and pain.
We should never use a nozzle with an orifice
at the point, but one which has orifices around
the sides.
The prolonged use of hot water should be for-
bidden; I mean, months together.
It is a positive shame that women are treated
for so many months, instances of which we all
know, by internal medication alone, without the
physician's knowing what is the matter. — Dr.
0. S. BUNNELS.
The ligaments act mostly as guys to hold the
uterus in its vertical position, and have very little
to do in preventing a prolapse. So long as this
condition exists you can never cure prolapse
with any kind of pessary. In the treatment of
flexions the pessary is an important factor, and
the surgeon who discards it loses a valuable
adjunct. — Dr. N. Schneider.
Too much treatment of this organ has been
the custom in the past. We want more rest for
our women and less treatment. I cannot endorse
the intra-uterine stem pessary, for I have seen
188B.1
INSTITUTE TRANSACTIONS.
41
bad results from it, and would not use it in my
own practice. — Dr. H. Tyler Wilcox.
OPHTHALMOLOGY, OTOLOGY AND LARYNGOLOGY.
Subject : — Tumors of the Eye, Ear and Throat.
Sarcoma of the choroid is a tumor of middle
life, rarely appearing before this period, and
unknown in infancy.
In the second stage, which is the one in which
the patient usually comes to us, symptoms of
glaucoma, or iritis, have appeared.
There is but one remedy — excision — and if
it is done early enough, and the cut end of the
optic nerve presents no evidences of invasion, a
good result may be hoped for.
The causes are yet undetermined, but it is
certain that sarcoma is especially liable to attack
injured eyes or those shriveled from disease. —
Dr. C. H. Vilas.
It is pretty generally acknowledged that opaci-
ties of the lens are due to some disturbance of
its nutrition, the causes of which are numerous
and varied.
Cases of cataract resulting from diabetes and
albuminuria have been known to improve under
treatment directed toward the primary disease.
The old school does not attempt to treat cata-
ract by internal medication, and this id but
another instance where our therapeutic system
serves us where theirs fails, for there is no doubt
that the progress of cataract can be stayed by
the indicated remedy, and even considerable
improvement in vision may follow its exhibition,
though we do not claim to cure opacities of the
lens with medicine. — Dr. B. W. James.
" A large number of cases are to be found in
our literature, in which the internal administra-
tion of a few doses of the properly selected rem-
edy has worked a wonderful cure of cataract, but
the great majority must be taken cum grano sails,
and put aside with the remark, ' Mistaken diag-
nosis.' " — Dr. Geo. 8. Norton.
The remedies most commonly indicated are
Calcarea, Causticum, Magnesia carb., Pulsatilla,
Silicea, Sulphur, Phosphorus. The latter has
several times been attended with good results in
my practice.
I have employed Ghimaphilla in incipient and
progressive cataract with pleasing results, hav-
ing been able to hold the increasing lenticular
opacity in check in quite a number of cases. —
Dr. B. W. James.
The ophthalmoscope is a powerful aid in the
diagnosis of a class of diseases which is daily
becoming more common and assuming greater
prominence in the science of medicine.
Reich found in his collection of 88 cases of
tumors of the brain, confirmed by the post-mor-
tem examinations, either papillitis or atrophy of
the optic nerve in 95.4 per cent, and only 4.5
per cent in which no changes were present.
What changes are to be looked for ? There
are three: — choked disk or papillitis, papillo-
retinitis, and atrophy of the optic nerve.—
Dr. G. S. Norton.
SANITARY SCIENCE,
Subject: — Climatology,
It has not yet been shown affirmatively that
any particular climate or any variety of climates
has been uniformly beneficial in any particular
class of nervous diseases. — Dr. Wm. Owens,
Ocean air at a comparatively short distance
from the shore is practically pure, and this fact
constitutes one great and valuable difference
between ocean and land climate. — Dr. B. W,
James.
There were present at the convention of asth-
matics, in Denver, one hundred and seventeen
persons. Of this number sixty per cent pro-
nounced themselves cured; thirty per cent as
considerably relieved, and the remaining ten per
cent were either relieved on the plains or by
going to still higher mountain countries. — Dr.
A. 8. Everett.
During my residence in Florida I have con-
versed with persons who have traveled and lived
in almost every portion of the globe, and espec-
ially with those who have sought a satisfactory
winter climate, and the universal testimony is
that Florida, considered with reference to cli-
mate, presents more advantages than almost any
other country, and my own observation compels
me to believe that it has an almost perfect win-
ter climate.
The census reports show that Nevada and
Florida have the lowest death rate in consump-
tion.
The State of Florida is so located, between
the Atlantic Ocean and the Gulf of Mexico, that
its entire surface is swept by sea breezes, and
this ocean air, mingled with the atmosphere
from the pine forests, combines to form a per-
fect climate. — Dr. H. K. Stout.
The first duty of our profession is the preven-
tion rather than the cure of disease, by dissem-
inating to the masses proper instruction in right
living, and to demand from our government wise
sanitary laws, both State and National.
We ought to know when to send a patient away
from home, where to send him, and how to send
42
THE MEDICAL ERA.
[Vol. VI. No. 2.
him. The medical attendant at the resort ought
to know how long he should remain, when a
change is necessary, and much other needed
advice in his new home.
It is doubtful if any climate will cure or per-
manently benefit tubercular phthisis in the sec-
ond or last stages. These cases should have
home care, and not be allowed to die away from
home.
In the United States we have as great a diver-
sity of climates as the earth affords; but to
utilize them we must endeavor to individualize.
A dry air, a moist air, a high altitude, a
medium and low altitude, a cold or a warm cli-
mate, each has its special advantages.
Pneumonia is one of the curses of high alti-
tude, probably because it taxes the circulation.
The altitude of immunity from consumption
lessens from the equator to the poles, while the
diminished pressure of the air is the same for
equal elevation, whether at the equator or at the
poles.
Pure aseptic atmosphere and sunlight are the
first requirements for lung disease, whether it be
on the mountain top, sea level or in the valley.
We must not forget that it is a wet soil, rather
than a moist air, which is so injurious to health,
and that to make a place healthy one of the
requisites is to drain the subsoil if it be wet.
Pure air is the life of lung tissue. Both pre-
vention and cure of consumption are due largely
to dry soil, pure air and outdoor exercise.
Dr. Osgood shows that our home statistics
prove the percentage of deaths by consumption
in each State bears an exact proportion to the
greater or lesser number of inhabitants who
follow indoor occupations.
Phthisis among the men who live in the open
air in the Swiss Alps is very rare, while among
the women who are employed indoors it is very
prevalent.
The mineral springs of this country, like its
climates, are legion, and, I fear, are too little
appreciated by us.
The three climates of the earth each impresses
certain peculiarities on the people who inhabit
them, and each has its special classes of dis-
eases.
The mere fact of the pioneer clearing some
virgin soil may effect a change in the network
of isothermal lines which pass over the country.
As forests disappear and drainage increases we
find less malaria, but more typhoid and catarrhal
diseases.
It is disappointing to learn that the eucalpytus
has had no visible effect on the banishment of
malaria from the Boman Gampagna, and | that
whatever has been done in that direction must
be credited to drainage and the ardent rays of
Old Sol.
The climate of any country depends much upon
the amount of simlight it possesses.
The relations of ozone — oxygen in an active
electrical state — to health and disease is an
unsettled question.
The paramount considerations for the promo-
tion of health are an abundance of pure air, sun-
shine and outdoor exercise. Without these no
climate is promotive of health or propitious for
the cure of disease. — Dr. H. E. Beebe.
ANATOMY, PHYSIOLOGY AND PATHOLOGY.
Subject : — Malarial Pathology.
Although it is true that the subject has been
but opened, enough has been conclusively dem-
onstrated to warrant the belief that a constant,
if not causative, factor of malarial fever is the
Plasmodium malarue.
The conclusion drawn by Councilman from
these investigations is that there are in malarial
disease blood changes that render the diagnosis
certain, and, further, that when the plasmodia
are found within the blood cells the disease is
intermittent fever ; when the crescents prepon-
derate it is either malarial cachexia or some
form of remittent fever, and the value of estab-
lishing this conclusion places these among the
most important of recent medical discoveries. —
Dr. F. Park Lewis.
It is universally recognized that there are two
factors at work in producing malaria : an object-
ive or germ element, the result of vegetable
decomposition; and an inner influence called
msceptibUity of the patient.
Malarial diseases have been found in all parts
of the habitable globe between 63° north lati-
tude and S?"" south latitude ; and at all eleva-
tions from the level of the sea, and even below
that point, to an elevation of 9,000 or 10,000
feet.
It will further be observed that in all places
where malarial diseases prevail heat is much
greater during the day, and that the chilliness
of the atmosphere is much greater during the
night than in the surrounding territory. — Dr.
Wm. Owens.
Remittent fever may be mistaken for enteric
or yellow fever. The difference between remit-
tent and enteric fever is generally defined, and a
careful examination of the history of the case
and the symptoms observed, suffice to establish
a correct diagnosis.
1886.]
ORIGINAL ARTICLES.
43
The hsBmatozoa of malarial fever, both as etio-
logical and diagnostic factors, are worthy of
most respectful and careful consideration.
These organisms are considered diagnostic of
malarial fever. The amoeboid, pigmented bodies
within the red corpuscles indicate intermittent
fever ; the crescentic bodies, remittent or mala-
rial cachexia, while the ciliated bodies are not
diagnostic of the type, but of maUgnancy.
But, as I have before remarked, the diagnosis
of malarial fever, as usually seen, is an easy
matter, and the wayfaring man, though a fool,
need not err therein. — Dr. W. H. Dickinson.
Neuralgia of the ophthalmic division of the
trigeminus is of relatively frequent occurrence,
as indeed are neuralgias of aU its branches, of
malarial origin.
V. Arlt describes a pecuhar keratitis which he
saw following intermittents in eight men during
a period of twelve years. The corneal opacity
was cloudy, or uniformly composed of spots and
irregular stripes, with slight ciliary redness. The
patients were sallow and emaciated.
The fact that quinine is so extensively and
universally used in the treatment of malarial
diseases, and that quinine itself has a very pro-
found effect upon the functions of hearing and
vision, partially or completely interrupting both,
either temporarily or permanently, renders it
extremely difficult, in a given case, to determine
whether the loss of function of the special senses
is due to the disease or the remedy.
Weber-Liel has given a very comprehensive
account of one featiure of malarial poisoning
affecting the ear. Speaking of otitis symptom-
atica, he describes a form of inflammation of the
middle ear appearing as a complication of the
acute infectious diseases, or as the only and
local manifestation of an infection, febris recu-
rens. It is distinguished from simple idiopathic
otitis by its peculiar symptoms and protracted
course. The pain is especially severe, and of a
tearing and boring character, and for weeks the
patients pass painful and sleepless nights. After
perforation of the membrana tympani, and the
appearance of the discharge, relieving the ten-
sion and pressure occasioned by the pus, there is
no amelioration of the symptoms, while with
simple idiopathic otitis, perforation of the membrane
and the exit of pm is followed by complete subsidence
of the pain. — Dr. Alfred Wanstall.
During the past few years, " malaria " has
become the fashionable diagnosis for every dis-
ease that affects the human body, from the
crown of the head to the soles of the feet. This,
I believe, has been carried altogether too far. —
Db. Gbo. S. Norton.
ORIGINAL ARTICLES,
POST PABTirU ANNOYABTOXS: A 8TUBT.
Bt GEO. B. PBCK, M. D.
PROVIDKMCS, R. I.
"pxil. PECK read a paper at the last meeting
-^^ of the American Institute of Homoeop-
athy, of which we have made the following
synopsis for the benefit of the readers of The
Medical Era. In answer to' a series of ques-
tions sent out, Dr. Peck received the rephes given
below :
How soon after the birth of the child do you
cut the cord?
1 in three minutes ;
1 *' in due time;"
2 in five minutes ;
2 *' whenever convenient;"
2 *'any time will answer;"
3 in sixteen minutes ;
9 when the child cries ;
10 immediately;
10 soon;
49 when respiration is estabhshed ;
83 when pulsations in the cord have ceased.
What do you do to the uterus before the ex-
pulsion of the placenta ?
15 give it no attention;
42 apply friction or pressure ;
48 keep one hand over it ;
62 give it only ordinary attention.
How soon after removing the child do you
dehver the placenta ?
1 with the child if possible ;
1 when there is frigidity of the cord ;
1 waits five or six hours ;
2 within an hour ;
6 ** don't hurry;"
8 '*soon;"
10 in five minutes ;
11 in thirty minutes ;
12 in ten minutes;
15 in twenty miniites;
18 in fifteen minutes;
25 wait for a pain ;
37 immediately.
* *
What method do you employ in deUvering the
placenta ?
3 leave it to nature ;
9 insert fingers and grasp it ;
82 employ expression ;
101 traction on the cord.
44
THE MEDICAL ERA.
Vol. VI. Ho. S.
To what method do you resort to prevent uterine
relaxation?
1 each gives' Aconite, Chamomilla, Cinna-
monum, Iron perchloride, HamameUs,
Ferrum inuriaticum, Millefolium.
2 give Nux vomica ;
3 give Ipecac ;
3 give China ;
4 give Gimicifuga ;
6 give Belladonna ;
8 give Pulsatilla ;
8 give Arnica ;
12 give Caulophyllum ;
1 5 apply a binder ;
60 give Secale (Ergot) ;
124 friction or pressure by the hand.
I What do you give for the relief of after-pains ? .
2 give Ipecac ;
3 give Ignatia;
3 give Sabina;
3 give Xanthoxylum ;
4 give Opium ;
6 give Bryonia ;
8 give Aconite ;
15 give Viburnum;
16 give Coffea;
17 give Nux vomica ;
18 give Gelsemium;
26 give Secale ;
26 give Gimicifuga;
31 give Belladonna ;
34 give Ghamomilla;
36 give Gaulophyllum ;
37 give Pulsatilla;
66 give Arnica.
The two who give Xanthoxylum are most en-
thusiastic in its praises.
* *
What do you give to the baby before it receives
the breast?
1 gives catnip tea ;
1 gives rice water ;
1 gives crust coffee ;
1 gives bran water ;
1 gives panada- water and milk ;
1 gives milk, cream and water ;
2 give oat-meal gruel ;
3 give condensed milk ;
3 give molasses and water ;
18 give water;
• 19 give cracker water;
19 give cream and water;
42 give milk and water ;
47 give sugared water ;
58 give nothing at all !
What do you give the child when the mother
cannot nurse it ?
2 give rice water ;
3 give goat's milk ;
4 give barley water ;
6 give "gruel";
7 give oat-meal ;
9 give Nestle's food ;
12 give Imperial granum;
12 give Bidge's food;
14 give cream and water;
14 give Mellin's food ;
20 give Horlick's food ;
37 give condensed milk ;
100 give milk and water.
What do you do for inflammation of the breasts ?
For internal medication —
1 each gives Bhus tox., Gale, sulph., Cro-
ton tig., Iodine, Hecla lava and Secale ;
2 give Phosphorus ;
2 give Gale. carb. ;
3 give Ergotin ;
9 give Pulsatilla ;
10 give Bryonia;
11 give Phytolacca ;
18 give Belladonna ;
For external application —
1 each uses vaseline, brandy, lead plaster,
Iodine, hot sweet oil, lard and beeswax,
turpentine in oil, peppermint, cacao but-
ter, Phytolacca cerate, lard compress, " cool-
ing lotions " ; and Hamamelis, Arnica and
Gamphor.
2 resort to strapping ;
2 use Belladonna and Gamphor ;
2 use Amicated oil ;
2 use whisky ;
4 use lard ;
What do you do for caked breast?
For external application —
1 each uses Phosphorus cerate, Amicated
cerate, Dulcamara cerate, Almond oil,
brandy and sweet oil, Ammonia and sweet
oil, alcohol and water, Beeswax, Phos-
phorus in hot water, hot Glycerine, Poke-
root and meal, hot pancakes !
2 each keep the parts warm, "warm ap-
plications," hot whisky, Cacao butter,
Phosphoretted oil ;
3 use Vaseline and alcohol ;
3 use Gosmoline ;
4 " let them alone ; "
4 use alcohol and water ;
4 use Hamamelis ointment ;
5 use Belladonna cerate ;
188B.
ORIGINAL ARTICLES.
45
6
6
7
11
13
14
13
17
32
34
43
83
For
1
2
3
5
7
11
32
35
60
use Bteaming ;
use cold water pack ;
use hot poultices ;
keep the milk drawn ;
use hot fomentations ;
support the breast ;
use Phytolacca cerate ;
use applications of Belladonna ;
use hot lard or hot oil ;
use friction drubbing) ;
use applications of Camphor ;
use the breast-pump.
internal medication —
each uses Dulcamara, Apis, Conium,
Sulphur, Kali hyd., Pulsatilla, Baryta,
Gimicifu|;a and Rhus tox.
each use Hepar sulphuris, Chamomilla,
Veratrum viride, Mercurius, Silicea ;
each use Hamamelis, Arnica, Iodine ;
use Graphites ;
use Phosphorus ;
use Aconite ;
use Belladonna ;
use Bryonia ;
use Phytolacca.
What do you do for cracked nipples ?
For internal medication —
1 each gives Chamomilla, Belladonna, Bryo-
nia, Aconite, Petroleum, Thuja, Nitric
acid, Pulsatilla, Baryta, Hyoscyamus,
(Enanthe, Ars. iod., Quinine, Castor equi.,
Borax, and Merc. corr. ;
3 each give Argentum nit., Phytolacca,
Sepia, Hydrastis, and Arsenicum ;
4 give Phosphorus ;
6 give Hepar sulph. ;
6 give Calc. carb. ;
6 give Silicea;
8 give Lycopodium ;
9 give Calendula ;
13 give Arnica;
22 give Graphites ;
23 give Sulphur.
For external treatment —
1 uses applications consisting of Glycerine,
Glycerine and Cantharis, Glycerine and
Hydrastis, Glycerine, Borax and Hydras-
tis, Glycerine and Hepar sulph., Glycer-
ine and Arnica, Glycerine and Calendula ;
2 each use hot water, cold cream. Cacao
butter ;
3 use Castor oil ;
4 use Tannin ;
6. use gum Benzoin ;
6 use Vaseline;
9 use Cosmoline ;
9 use Borax ;
7 use Graphites cerate ;
11 use Calendula cerate;
16 use Hydrastis cerate ;
14 use Arnica cerate.
A great variety of other applications, too nu-
merous to mention, are made use of by the
remaining male " grannies '* on the list.
What do you do for milk-leg ?
For internal medication —
1 each gives Eupatorium, Eucalyptus, La-
chesis, Urtica urens. Allium cepa, Merc,
bin., Ferrum mur., Collinsonia and
Antimonium crudum ;
2 each give Rhus rad., Phytolacca, Secale,
Lycopodium, Chamomilla, Cimicifuga,
China and Mercurius ;
3 give Veratrum vir. ;
5 give Arnica ;
9 give Apis;
13 give Rhus tox. ;
16 give Arsenicum ;
17 give Aconite ;
17 give Bryonia;
23 give Pulsatilla ;
24 give Belladonna ;
39 give Hamamelis.
For external application —
1 each use Eupatorium, Veratrum, Urtica
urens. Iodine, and Cimicifuga, besides
various domestic preparations ;
2 use Hydrastis ;
2 use Aconite rad. ;
3 use Calendula ;
3 use Arnica ;
8 use Rhus tox. ;
8 use Belladonna ;
10 use Pulsatilla ;
61 use Hamamelis.
Of one hundred and seventy-seven physicians,
sixty-one stated that they had never met with a
case of this disease.
CANNABIS INDIOA IN ULMB BACK.
bt dr. h. l. millbr, m.d.
OTBKOO, MICH.
CANNABIS INDICA has been of enestima-
ble value to me during the past three years
in the treatment of a diseased condition
wherein, previously, I had been powerless for
good. I refer to what is commonly called
*' crick in the back," or **lame back," a peculiar
lameness in the lumbar region which interferes
46
THE MEDICAL ERA.
[Vol. VI. No. %
with stooping, lifting, and often with motion of
any kind. The patient often complains of an
ache, or a sensation as if part of the back were
gone, a condition which is virtually the result of
a strain, and is in no sense to be confounded
with lumbago.
If a patient had come to me three and a half
years ago, complaining of the symptoms de-
scribed above, and asking for relief, I would have
said, ** I can do nothing for you.** To-day I say,
**I can cure you."
In the faU of 1 883 I treated 37 cases of diph-
theria. One of these patients, Mr. B., a man of
robust appearance, light complexion, about 35
years of age, was, about one week after appar-
ent recovery, attacked with nephritis. The
urine was thick, milky, and loaded with albumin.
Cannabis indica 3x was prescribed, and patient
made a rapid recovery.
About three weeks later Mr. B. came into my
office and stated that he had been troubled with
a lame back for about twenty years, and that
my last prescription had cured him. This state-
ment gave me food for thought. My experience
in the treatment of lame back had not been
flattering, and I was willing to experiment with
anything that would seem to offer any encour-
agement.
Bering gives but two symptoms for which Can-
nabis Indica might be prescribed in lame back :
aching in region of the kidneys, and pain across
the spine ; cannot walk erect ; must stoop.
My next patient of this class was Mr. F., a
clergyman, aged 35 ; dark complexion, and ap-
parently in robust health. In fact the only dif-
ficulty he had was a lame back of three years'
standing.
I examined the urine microscopically and
chemically. My patient was in perfect health
with the one exception of the lame back.
I looked for a cause, and supposed I found it
in a peculiar position which he occupied in his
study, sitting tipped back in a low-backed arm
chair, with the feet upon his writing-table (Amer-
ican fashion).
I candidly told Mr. P. of my want of success
in treating this difficulty, and my experience in
the case of Mr. B. Mr. F. was anxious to begin
any treatment which offered a hope of success.
H. Cannabis Indica 3x, five drops three times a
day.
In three weeks my patient reported himself
well, and still remains so, now three years, and
this notwithstanding the fact that he had, accord-
ing to agreement, never departed from his old
habit of position.
I have now a record of 63 cases treated by
this remedial agent, of which 49 were and are
cured.
Of the 49, 41 complained of pain in the back,
of a dull, heavy nature, aggravated by stooping
or lifting ; no tenderness on pressure. With the
exception of six who had hemorrhoids, they
were otherwise in good health.
The remaining eight of the 49 complained of
o<?cipital headache, lame back, palpitation, lan-
guor and debility, and marked tenderness on
pressure over the region of the kidneys. Exam-
ination of the urine gave albumin in various
quantities.
Fourteen cases made little or no improvement
under Cannabis, although some responded.
Marked benefit under treatment by galvanism.
These latter cases were all rheumatic.
In order to test the question of dosage, I gave
at different times to the same patient 30th, 12th
and 3d potencies, as well as the tinctures and
fluid extract. The majority made the most
marked improvement under the use of from five
to eight drops of the tincture. One patient
made a fine recovery under the 30th. This
patient's complaint was of one year's standing.
On reviewing the symptoms, I find that 49 pa-
tients complained of lameness of the back ag-
gravated by motion. Eight of the 49 presented,
in addition, occipital headache ; langour and de-
bility ; marked tenderness on pressure over the
region of the kidneys, and albuminuria. All
these symptoms, except albuminuria, can be
found under the provings of Cannabis Indica.
T&IANGULAB CUSHION SPLINT FOB THJS
TREATMENT OF FBAOTV&B OF
THE HT7MEBXTS.
BY. A. B. SPACH, M. D.
Head Intsbkb, Homcbopathic Dbpt., Cook Coukty Hospital,
Chicago.
THE triangular cushion splint, which I de-
\i8ed two months ago for the treatment of
a case of fracture of the humerus then in
our wards, has now been in use a suflScient length
of time to permit of its merits being fully tested.
The result has been so very satisfactory in all
respects that I now feel full confidence in giving
it to the profession.
First, let me describe its method of construc-
tion.
DIRECTIONS :
Measure from the level of the shoulder to be-
low the elbow on the uninjured arm ; with this
distance, and about four inches wide and half an
PXB., Ifltt.]
ORIGINAL ARTICLES.
47
inch thick, construct two triangular pieces from
some light wood, such as pine. Firmly unite
their bases at right angles. From some strong
material, such as bed-ticking, cut out a square
piece, tack it to the edges of the triangles on one
side, fill the space thus made with horsehair,
cotton, or some light material ; lap over the other
piece of cloth and tack it to the other sides of
the triangle, rounding out the upper and lower
comers, as seen in Figure 1.
Fig. 1.
Measure from within an inch of the axilla to
the bend of the elbow on the uninjured arm.
With this distance, and the bases three inches,
construct a similar and smaller triangular cush-
ion. Stitch this to the larger cushion, with two
lower and two upper draw
loops running between
the two, and through which
the arm is to pass. The
sides of the smaller cushion
are to be at equal distances
from the sides of the larger.
Carefully mold a piece of
Bussian felt or heavy card-
board to the arm, from the
shoulder to the elbow, pad-
ding it with cotton, and
apply it with the roller.
Pass the arm through the
loops in the cushions ; make
the loops tight, fasten the
cushions to the body with
the strap going over the
shoulder, and the one going
round the body, as shown in
Figure 2.
Fig. 2.
The splint, thus constructed (and applied, pos-
sesses the following
ADVANTAGES :
1. Perfect immobility of the shoulder.
2. Perfect immobility of the fragments of the
broken bone.
3. The requisite amount of extension can
easily be made whenever there is shortening.
This is done by padding well the lower border of
the smaller cushion, and securing the forearm
snugly by means of the draw loops.
4. Perfect apposition of broken fragments.
5. It is applicable to fracture at any part of
the humerus.
6. It is Ught and comfortable to the patient.
Its construction is not so formidable a matter
as the description might make it appear. A lit-
tle' material, a Uttle tact, and an hour's time
will serve to complete one in good shape.
I have now used this splint in cases of both
simple and compound fracture of the humerus,
and in every instance with perfect satisfaction.
Among its many merits, its chief one is the
perfect immobility which it secures.
II.
SYSTEMATIC CHBMIOAL EXAMINATION OF
UBIK^ FOB OLINIOAL PUJEtPOSES.
By CLIFFORD MITCHELL, A.B., H.D.
CHICAOO.
I. Notes on Manipulation.
1. Quantity: — To collect the urine of young
children place a clean sponge over the genitals
and fasten the diaper on over it. To measure
the urine of 24 hours, use graduated jars like
those found at the pharmacies.
2. Color : — To determine the color of turbid
urine have recourse to filtration.
In order to filter urine there is need of a funnel,
filter paper and a receiving vessel of some kind.
A filter ring and stand are also very useful.
Funnels for this purpose are of glass, and
those three or four inches in diameter across
the top are of convenient size. Filter paper is
unsized paper, and the best is called Swedish,
and comes in commerce already cut in circular
form ; filters seven and a half inches in diameter
fit well into the funnels above described. The
filter paper recommended by Prof. Fresenius
should be used. In order to fold the filter paper
so as to fit it into the funnel : first fold the cir-
cular paper in two, then turn the right half, say,
over on to the left. In this way a funnel shape is
given to the paper ; now fit it into the funnel and
48
THE MEDICAL ERA.
[Vol. VI. Kow 2.
it is ready for use. When the paper thus folded
has been fitted into the funnel three '< pockets "
can be seen ; the liquid may be poured into any
one of these three ** pockets" except the middle
one. It is often well to wet the paper slightly so
as to fit it better to the funnel, and, for quick
filtrations where the filtered urine only is wanted
the filter paper may be ribbed. At the bed-
side, use small filters one to two inches in diam-
eter folded as above, and inserted without a fun-
nel into a wide mouthed test-tube. Observe the
color of the urine after it has come through the
filter paper.
3. Specific gravity: — Be careful to note whether
your urinometer is standardized to 60'' F., or to
77°. Take the temperature of the urine, using
a chemical thermometer, and warm or cool it to
the temperature to which the urinometer is
standardized. Squibb's urinometer, recommend-
ed by Prof . Tyson, is standardized at 77° P., and
is free from many objections.
4. Solids: — In taking the specific gravity with
a view to estimation of urea or solids, the urine
should first be boiled, filtered while hot, then
cooled to standard temperature, 77° F., with a
Squibb urinometer, or 60° F., if a common instru-
ment is used.
5. Reaction : — Litmus-paper may be procured
in the form of little books, which should be kept
protected from the air. Blue litmus can be turned
red by exposing to action of acid fumes or by
immersing in vinegar and water; in the latter
case dry before using. Eemember that urine on
standing may grow more acid, and finally may
change to alkaline reaction.
II. Tests for Albumin, Peptone, Bile, Sugar.
In general, examine a specimen of the 24
hours' urine. In doubtful cases, examine thfe ur-
ine of each micturition during some one period of
24 hours ; if albumin is sought for, cause the pa-
tient to take as vigorous exercise as is prudent
before voiding urine for examination; women
should take a cleansing injection before voiding
urine for examination, especially if they are
troubled with leucorrhoea.
A. Albumin: — If the amount of albumin is
small, or there is doubt as to its presence, as there
might be in cirrhosis, lardaceous degeneration,
and congested kidney, especially in early stages ;
or, if it be desired to test for small quantities of
albumin in the urine of a patient recovering from
acute nephritis, recourse should be had to a care-
ful and systematic search as follows :
(1). Get the urine perfectly clear; filter
through several papers folded together, and if it
comes through turbid, boil with one-fourth its bulk
of liquor potass® and filter again. If the filtered
urine is still turbid, boil a fresh amount with a
few drops of magnesian fluid (magnesium sul-
phate one part, pure ammonium chloride one
part, pure liquor ammonise one part, distilled
water eight parts) and filter.
(2). Fill a test-tube, preferably a short one,
to the depth of half an inch with the clear fil-
tered urine; hold it somewhat inclined in the left
hand, and with the right, take up by means of
a pipette, preferably roughened at the upper
end, pure colorless nitric acid and allow the lat-
ter to flow down the side of the inclined test-tube
into the urine.
If there is any difficulty in causing the acid to
flow steadily from the pipette, rotate the latter,
covered by the index finger, between the middle
finger and the thumb, as suggested by Dr. Ty-
son. Wait a few moments until the acid has
slowly sunk through the urine, then bring the
tube from the inclined position to the vertical. If
a whitish zone is seen at the juncture of the urine
and acid, albumin is probably present. Set the
tube aside while the next test is being made.
(3). Pour three fluidrachms of the clear fil-
tered urine into a perfectly clean test-tube,
preferably a long, narrow one, and add two drops
of acetic acid to it. Shake well so that the acet-
ic acid may be well diffused throughout the ur-
ine. Take the reaction by pouring a drop or
two on a piece of blue litmus-paper. If the
latter is not turned slightly red, add another
drop of acetic acid, and try again with the litmus-
paper. See that the urine turns blue litmus-
paper slightly red, then holding the tube by the
bottom between the thumb and forefinger, heat
the upper part gradually by boiling. If a whit-
ish turbidity appear where the urine has been
heated, and if moreover a whitish zone was seen
resulting from the cold nitric acid test, (2) albu-
min is present, and nothing further need be done.
(4). When albumin is abundant, tests two and
three will be noticeably successful ; if there is
any doubt read the following :
Bemarks.
1. If a turbidity be obtained with the nitric acid
test, but nothing at all with the heat test applied
to the clear acidified urine, the urine being al-
lowed to stand six hours after the heat test has
been performed before a decision is piade, al-
bumin is absent.
2. If with the nitric acid test we are unable to
see any zone or turbidity, but with the heat test a
turbidity is plainly \dsible, add a few drops of
nitric acid to the urine which hap been boiled,
and if the turbidity disappear albumin is
PxB., 188&]
ORIGINAL ARTICLES.
40
absent. If it does not disappear add np to 15 or
30 drops of nitric acid, and if the turbidity per-
sist, albmnin is present. , [Go back to the test-
tube in which the cold nitric acid test has been
performed, and after it has stood for a time you
will probably in a good light be able to see a few
flakes of albumin. Even if you do not, however,
the heat test now indicates a very small amount
of albumin.]
3. Whether the nitric acid test shows a zone
or not, if the heat test shows nothing at the time
it is performed, but, if after six hours, a turbid-
ity is noticed, supply heat again and if the tur-
bidity disappear, albumin is absent; if it does
not disappear, on boiling, albumin is present.
[Go back as in (2) to the test-tube in which the
cold nitric acid test has been performed.]
4. If, before making the heat test, upon add-
ing acetic acid the urine becomes turbid (as com-
pared with a specimen of the clear filtered urine
to which nothing has been added) and if, after
heating, this turbidity is not increased (seen by
comparing with the same bulk of clear filtered
urine to which the same amount of acetic acid
has been added, but which has not been boiled),
albumin is absent. If the turbidity is increased,
albumin is present. The conditions described in
2, 3 and 4 will not usuaDy cause any trouble. I
lay great stress on the importance of comparing
results, and have seen dozens of students detect
albumin in this way who were unable to see any
change before comparison was made. Moreover,
comparison does away to a great degree with the
necessity of a good light, dark back-ground, etc.,
and thus saves time.
5. If the urine has been boiled with an alkali
to make it clear, it should be carefully neutralized,
by addition of acetic acid, drop by drop, before
the heat test is tried. Add the acetic acid, drop
by drop, taking the reaction by pouring a drop of
urine on red litmus-paper. When the urine
turns neither red litmus-paper blue, nor blue lit-
mus-paper red, it is neutralized. Then add two
drops more, shake well, and, as a matter of pre-
caution, pour a drop on blue litmus-paper, and
if it turn the latter slightly red proceed with the
heat test. If not, add another drop of acetic
acid to the urine, and so on, until the blue Ut-
mus-paper be turned distinctly red. Care must
he taken not to add too mutch acetic acid; freshly
voided urine can generally be filtered clear
through several thicknesses of filter paper, and ef-
fort in this direction should always be made first.
6. Instead of a pipette, my own device, a small
gjiass syringe, may be used, to which a glass tube,
slightl}' tapering, is connected by rubber tubing.
I have found tins superior to the pipette in point
of ease of manipulation. Fill the syringe with the
acid, then inserting the tip of the small glass tube
inside the test-tube held inclined in the left hand,
with the right forefinger gently press on the pis-
ton. The acid will flow out very regularly and
slowly, and a clear-cut, well defined zone is seen,
if albumin be present. The syringe should, of
course, be weU packed and in good order.
A KBGLSCTBD BXMEDY — COPAIBA OFFIC-
INALI8.
By a. p. BOWIE, M.D.,
DMIONTOWN, PA.
[TransacUoos Horn. Med. Soc. of PenneiylvaDia, 1887.]
VARIOUS remedies frequently employed by
old school physicians are, it seems to me,
neglected on that account by practitioners of
our school, and one of these remedies is Copaiba
officinalis. The classical use of this remedy in
gonorrhoea has caused it to be used for this disease
alone almost, and while the doses in which it has
been given are such that new symptoms would
arise — thus furnishing a clue to its further use
— for clinical symptoms have an undoubted
value to those who know how to make use of
such knowledge, not only for furnishing new
indications for remedies, but for confirming
provings.
In an old work by John Armstrong, M.D.,
published in 1826, he calls attention to the use
of Copaiba not only in affections of the urethra,
but in other diseases of mucous membranes.
He says: ** From the remarkable efficacy of
Copaiba in an acute inflammation of one mucous
membrane, we might ask has it a similar power
over a similar affection of every mucous mem-
brane ? And, another proper question to ask, are
the effects of the remedy confined entirely to the
mucous membranes?"
Armstrong mentions the use of the remedy in
croup, trachorrhoea and leucorrhcea.
All writers I have examined agree as to its
having a specific action on mucous membranes,
and some mention its action on the skin.
In Allen's Encyclopaedia over three hundred
symptoms are given, showing that its sphere is
not confined to these parts of the body alone,
although the most marked and characteristic
symptoms are of the skin and mucous mem-
branes. This schema will well repay a careful
study, and I may here remark that those who
have .the Encyclopaedia of Allen and do not read
and study it, I am afraid lose many a thera-
peutic gem which may be found by delving in its
pages.
60
THE MEDICAL ERA.
[Vol, VI. Ko. a.
But the chief object I have in view is to verify
some symptoms of this remedy and report its
efficacy in retention of urine in aged persons.
In old persons (men, I slundd say) who front cold or
other causes cannot urinate, or where there is a
frequent desire to pass water and only a few drops
pass unth much straining — ^frequently with a mucom
discliarge from tlie bowels with much ruiMing and
rolling in the abdomen — no remedy has proved mare
efficacious than Copaiba officinalis; in to^ct I consider
it a specific for this group of symptoms, as I have
used it in at least a dozen cases with entire
relief. Of course the catheter will have to be
used when necessary, and the remedy homoeo-
pathic to the above group of symptoms is Copaiba
in five-drop doses of the first dilution on sugar.
Before using this remedy I must confess m
success with this class of cases was far f
flattering, but now I no more dread the sum
to an old man who cannot pass his waterj
with Copaiba and a flexible catheter I can
speedy relief. When using the catheter I al
apply the pure balsam to the instrument, an
believe it aids in the cure and is far more
soothing than lard or sweet oil.
To relieve the burning and itching at the anus
caused by hemorrhoids I know of no remedy
more efficacious than Copaiba, ten drops of the
balsam to one of Vaseline. I always used the
indicated remedy internally, and the relief
afforded by the external use of the remedy is
marked and permanent. The action of the rem-
edy in urethritis, specific and non-specific, and
bronchitis in old people, has been very satisfac-
tory, and if I succeed in calling the attention of
the Society to a neglected remedy, I shall have
succeeded in the object of this paper.
BHT7S TOXICODENDBON IN DIPHTHERIA
OE THE LIPS.
Bt THOMAS NICHOI^ M.D.,
MONTREAL.
[TranBactions Horn. Med. Soc, of Pennsylvania, 1887.]
ON April 6th, of this year, I was called to
Miss G. D., aet. 10, who was said to be ill with
measles. I found a typical case of the disease
which readily yielded to Aconite, third decimal
trituration, in repeated doses. I was attending
an aged relative in the same house, so I saw
th^girl more frequently than I otherwise would
have done, but she was dismissed quite well on
April 12th.
But on April 19th, I was called to see Miss
6. again, and was told that she had an eruption
on both lips. I went expecting to see an ordi-
nary case of herpes tabialis. I found something
entirely different. Both lips were large, prom-
inent, tender, and of an ashy-gray color, and this
arose from the infiltration beneath the mucous
membrane of an albuminous-looking matter,
behind which was a layer of some dark-colored
fluid which I conjectured to be blood. The face,
especially the forehead, was bluish in hue and
decidedly cool in temperature, and all the features
were drawn and pinched. The submaxillary
glands were greatly swollen, but all the cervical
glands remained normal. The pharynx and
tonsils were clean and not at all inflamed;
and a very faint injection was present which
would not be noticed under ordinary circum-
stances. The pulse was 96, small and thready ;
fiW€)MLtoe^7.3°. The tongue was swollen,
te, and^p^ed with offensive mucus very
odor to' the lips. The patient
^strated. I diagnosed diph-
laving seen a number of cases
Lurmg tne ^p^e^ic which raged in the county
!ft}^<llK)^^t6rio, from 1858 to 1864. I pre-
toxicodendron, sixth decimal tritu-
ration, a small powder in twelve teaspoonfuls of
water, a teaspoonful every hour.
Next day I found that the mucous membrane
of both hps had broken, and they were now
coated with an albuminous membrane mingled
with blood — the latter being thin, watery and
strikingly like plum-juice in color. The lips
were still very large, and the carrion-Uke odor
was very offensive. The submaxillary glands
were larger ; throat still clean. The pulse was
much the same as on the previous day ; tem-
perature 97.5". The tongue was but little
changed, and the only favorable sign was the
somewhat improved strength of the patient and
a slightly increased feeling of well-being. The
face, too, was not quite so bluish. Continued
Rbus toxicodendron, sixth decimal, in the same
manner.
On the third day the lips were smaller and
dryer and of less disagreeable odor. The tongue
was cleaner ; the pulse 84, stronger and firmer ;
temperature, 97.9 "" . The most marked improve-
ment was in the strength, while at the same
time the face was more of the natural pink
and white. The glands were smaller; throat
unchanged. Continued Rhus toxicodendron.
On the fourth day the dark-colored crust on
the lips began to peel off at the edges, revealing
a raw sore which already showed signs of heal-
ing. The tongue was almost normal, the pulse
down to 76, stronger and firmer. The improve-
ment in strength still continued, glands very
small ; throat still clean. From this time the
^KB., 1886.]
ORIGINAL ARTICLES.
51
improYement was very rapid, and on the eighth
day the patient was dismissed.
I was originally guided to the use of Bhus
toxicodendron in this phase of diphtheria by the
symptoms, " the lips aro dry and parched, cov-
ered with a reddish-brown crust, black lips," to
be found in the second volume of Jahr's Symp-
tomen Codex, page 680. I have seen these
indications repeatedly confirmed in cases of Bhus
poisoning, where the lips passed through just
such a morbid process as that which I have en-
deavored to describe.
THBBB 0A8X8 OF SOIATIOA..
Bt WILLIAM J. MARTIN, M.D.
PITTSBUBGH, PA.
[TransactloDB Horn. Med. Soc., of PeDDsylyania, 1867.]
THESE three cases of sciatica, recently
treated, illustrate very forcibly, that in
order to cure our patients we must pre-
scribe for the syviptoms in each individual case,
and not for the disease. Sciatica T/iaj^ 'be cured
by any medicine in the materia medica, but no
one drug in all oar niatena inedica can cure all cases.
True, one, two, three, or a half-dozen remedies
are more frequently indicated than others, but
in choosing our remedy, we must not allow our-
selves to be confined to any limited number of
drugs.
These three cases were cured, one by Arseni-
cum, one by Bhus tox., and one by Colocynth,
yet they were all cases of the same disease.
Mr. McM., a very vigorous old gentleman of
over sixty years of age, has been a healthy man
all his life, he cannot remember of being sick in
bed. When I was called to see him (April 1st),
he had been confined to the house one week
with sciatica (so pronounced by the old school
M. D. who had preceded me in the case). While
no fault could be found with the old school M.
D.'s diagnosis, the patient became dissatisfied
after a week of treatment ; he was getting worse
aU the time, and refused to take more of the
medicine. In examining into this case, I found
that the prominent symptoms were : First, dis-
tinct and well marked and very violent aggrava-
tion every night after midnight. Second, very
restless, tossing about in all positions, he cannot
be kept in bed and cannot sit still in a chair and
cannot walk. Third, marked relief from heat
and hot applications.
Now with these symptoms so prominent, viz. :
periodicity, i. e., the attack coming every
night ; time of aggravation, t. <?., after midnight ;
and the conditions of amelioration, i. e., heat and
hot applications, there could be no question as
to Arsenicum being the indicated homoeopathic
remedy. It was prescribed, the third trituration,
a few grains dissolved in a glass half-fuU of
water, a teaspoonful every half-hour during the
paroxysms and every two hours at other times.
The first night after I prescribed for him, the
attack came a little later, and was shorter and
less severe than before. The remedy was con-
tinued, and the paroxysms continued to grow
lighter and shorter until in eight days from be-
ginning to take the Arsenicum he was entirely
well, and to this date has had no return of the
trouble.
The second case is that of a large, muscular
man aged about forty years, whom I was called to
see June seventeenth. He had in former years
suffered with attacks of sciatica, and knew what
was the matter with him ; but had never had
such a violent attack as this one. The pain
makes him ''yell like an Indian;" his pain is
worse when he is still. Two days ago while he
was feeling some little soreness in the limb — it
was the right one — he walked to a funeral and
back home again, about fourteen miles in all,
and while he kept walking his leg did not hurt
him, but when he got home, he was very tired
and he lay down, then the pain returned and
steadily increased, and when he tried to rise for
the purpose of undressing he could not stand.
His family put in the night applying hot cloths,
which had been sufficient to relieve him in for-
mer attacks, but now only gave him slight tem-
porary reUef .
Next day, in the afternoon, I was called, and
prescribed Bhus in water, a dose every half hour
until relief came. The reasons for selecting
Bhus were: the aggravation when still, the
amelioration by walking — (while he was able to
walk) ; and the cause of this severe attack,
which I took to be from a strain — that he had
started out while suffering in a mild way with
sciatica, and walked so far (with relief while
walking) that he strained himself.
He commenced to take Bhus about four p. m.,
and the following morning at ten, I found him
resting quite easy, — though he had had a hard
night of it ; so the remedy was continued, and
the next day he had very little pain, but was
restless and had a paralyzed feeling in the leg.
The Bhus was continued, and the improvement
continued from day to day, and in six days he
was able to come to the office, and in ten days
he went to his work, which is very heavy labor
in a rolling-mill.
This was one of the nicest cures I have seen
of this troublesome affection, and I feel like ex-
plaining the beautiful results thus : first, I hit
52
THE MEDICAL ERA.
[Vol. VI. Ko. 2.
Upon the right remedy to begin with, and second,
the case had not been spoiled by previous old
school drugging, or by new school drugging
either.
My third case is that of a young married
woman who was a sufferer from sciatica follow-
ing typhoid fever. Her attendant, one of the
regulars, after treating her for many weeks,
finally tells her that it is useless to send for him
every time she has a severe paroxysm, that all
that can be done is for her to take Morphia to
alleviate the pain, that it takes time for the
system to throw off the disease, and that there
has been no medicine found curative in sciatica.
Being told by a friend that I had given him
medicine that cured him of a severe attack of
sciatica, she sent for me.
The prominent symptoms of the case were
these : Sharp drawing pains in the lumbar re-
gion, hip and thigh of the right side, coming at
irregular intervals and of intense severity, ag-
gravated by any motion and only endurable when
lying perfectly stiU with the thigh tightly flexed
on the abdomen ; soreness and lameness follow
the attack. These symptoms all called for
Colocynth, which was prescribed in the third
dilution, ten drops in a goblet half full of water.
This prescription was continued for forty-eight
hours, without any perceptible benefit. Yet
nothing in materia medica was as well indicated
as Colocynth. I observed that she was a little
nervous, verging on the hysterical, and remem-
bering how Dr. J. H. McClelland had told me
some ten years ago, when I had him see a case
with me at our old hospital, — a female patient
of similar disposition, also suffering with sciatica
and to whom I was giving Colocynth 3x, that
many of this class of female patients get along
better when they can taste the medicine, and for
me to give her a few drops of Colocynth tincture
in water, which I did, and she improved rapidly.
So, too, with this patient, when I changed from
Colocynth 3x to Colocynth tincture she improved
steadily and in a few weeks was able to come to
my office. Under the Morphia treatment she
had been confined to the house some three or
four months.
The Colocynth was given thus : six drops in a
glass half full of water, a teaspoonful every two
hours, but during a paroxysm of pain she was to
have a dose every fifteen minutes. The result
was that the paroxysms were shortened and their
frequency diminished until she was well. This
treatment was followed by a few prescriptions of
Pulsatilla 3x, which corrected some menstrual
trouble and cured her of leucorrhcea.
This case was treated last winter, and I have
not heard of her having any return of her
trouble since.
I have used Gnaphalium in sciatica, and cured
more cases with it than with all other remedies
put together. The special indications for its use
are pains of a burning character followed by
numbness in the affected part. I have also suc-
cessfully used Gnaphalium in cases in which the
burning was not present. In one such case the
pain was of a decidedly aching character and
affected the entire length of the limb. It ex-
cited cramps, particularly of the calf muscles.
There were also coated tongue, more or less
headache, indifferent appetite, and constipation.
Nux vomica was given without success. Bryonia
and Sulphur were also prescribed with like re-
sults. Then Gnaphalium was given and cured
the case. — Dr. Peinberton Dudley,
I have also used Gnaphalium in sciatica with
excellent results. A feeling of lameness, inde-
pendent of pain, is a good indication. I have
usually used the tincture or the first dilution of
the drug. — Dr. Axtg. Karndonrfer.
Organized opposition to homoeopathic truth,
although of late years, from motives of policy,
is less pronounced, covertly is as earnest and
active as at any time in our history.
So long as the dominant school refuses to
accept the homceopathic principle as the leading
one in the domain of therapeutics, and places us
and our school under a ban because we hold
such a tenet ; and so long as non-homoeopathists
refuse to teach their own students the benign
truths of homoeopathy, it is incumbent upon us
to hold our position ; to maintain a separate
organized existence ; and, above all, to retain the
distindive name; for, if we give up our name, who,
and what, and where are we ?
The distinctive name is our birthright ; it is
ours by inheritance ; it is ours by conquest ; it
is ours, and ever will be ours, in spite of our-
selves, so long as homoeopathy is known as a
recognized method of cure. — Dr. II. M. Paine.
Our students go to the Continent and come
back like the Argonauts of old, with tales of
wondrous operations, the like of which would
never be permitted in this country. Ask them
the treatment of typhoid and other diseases, or
the details of medicine for the cure of the sick,
and they look at you with astonishment. — Dr.
WiUard.
FSB., 1888.1
SELECTIONS.
53
SELECTIONS.
The Prevention of Munmary Abeoees.
Miall says that when mammary abscess is on
the point of forming, he has frequently seen all
the symptoms disappear in a few hours under
the influence of fomentations with hot water and
Carbonate of ammonia. He uses an ounce of
the Carbonate in a pint of water, and, when solu-
tion is accomplished, the temperature of the fluid
will be hardly too high for fomentation to be
commenced with cloths dipped in the liquid. He
applies them from half an hour to two hours, at
the same time protecting the nipples. He has
often had immediate relief, and seldom requires
more than three applications. — Medical News,
daily until milk is obtained, which rarely fails to
appear after the fourth application. — World's
Med, Review,
. Homoeopathy on Trial.
Take for example the cure of a case of epi-
lepsy, that had some months of skilful allopathic
treatment, without benefit. This cure was ac-
complished by a few doses of less than the one
thousandth of a grain of water hemlock, known
to our materia medica as (Enantlie crocatay and
selected strictly according to the law of similars.
Not another spasm of the complaint occurred
after the medicine was given, while before they
numbered several a day.
Another example. The cure of a case of ma-
rasmus in an infant given up to die by two of our
most skilful old school physicians, the curative
medicine being fooFs parsley — otherwise known
as ^thusa cynapium — in doses less than one
millionth of a grain. — Dr, W. E, Hathaway,
Borado Add in Gonorrhoea.
My experience with Boracic acid and Glycerine
in the treatment of subacute and chronic gonor-
rhoea has been so successful for the past year
that I can confidently say it is almost a specific ;
I have used it in thirty cases, and only in three
did it fail. One of them was a heavy drinker of
spirituous liquors, and the other two had strict-
ures, which it was necessary to treat in the usual
way before the discharge ceased. The mode in
which I use the acid and Glycerine is as follows :
I prepare about two drachms at a time, which
is sufiicient for one seance^ using half a drachm
Boracic acid and one and a half drachms Glycer-
ine ; then, by the use of a soft rubber catheter of
proper size, one which will pass easily the full
length of the urethra, and a hard rubber syringe,
with a nozzle of large enough calibre to allow
the paste to flow freely, I commence injecting
from the prostatic urethra, gradually withdraw-
ing the syringe, and stripping the catheter with
thumb and forefinger, until the full length of the
urethra has been thoroughly saturated. This
is to be repeated every second day. — Med. Rec-
ord.
Electricity a« a (Mtacta^ogue.
In 1884 a patient, in whom the usual medica-
tion for diminished lactation had failed to in-
crease the secretion, was successfully treated
through the application of Faradic electricity.
Since that date Pierron has treated a number of
such cases, and always with complete success.
The mode of operating consists in placing the
positive electrode, having the form of a spherical
cup, over the nipple, while the negative electrode,
terminating in a ball, is placed below the breast ;
in this manner the orifice of the gland is the first
to be excited. Afterwards, the positive electrode
is moved over the entire surface of the gland,
while at the same time the negative electrode is
displaced in such a way that the former will con-
verge toward the latter. The current should not
be strong enough to excite pain. Each applica-
tion should last ten minutes, and be renewed
Btrophanthue in Heart Disease.
Last summer I treated a young lady for a
peculiar organic disease of the heart. The pulse
was very rapid and thready. On auscultating,
I heard a very loud, cooing sound all over the
cardiac region. I say cooing — it was not the
purring sound described in stenosis of the left
auriculo-ventricular opening. Neither was it
like the bellows murmur — there was no blowing
at all. I think this peculiar sound was caused by
constriction.
The heart disease was caused by fright, and
was of some months' duration when I first saw
the patient. I gave Digitalis, Aconite, Spigelia
and Glonoine for fourteen days, without any ap-
parent benefit — trying each medicine a few days.
Then I prescribed Strophanthus Ix, as I had
seen it very highly spoken of in the journals. '
Patient took three drops of Strophanthus Ix,
every four hours, for eight days. I found then
some improvement. A week after, when pre-
scribing again, I found great improvement ; pa-
tient more cheerful and hopeful. The two last
prescriptions, scarcely any cooing sound. After
improvement, the interval between doses was in-
54
THE MEDICAL ERA.
[Vol. VI. No «.
crea8e4, and the dose reduced to one drop of
first decimal. She took Strophanthus over 36
days, and was at least temporarily much bene-
fited.
I am not able to say how permanent the im-
provement may be. I regard Strophanthus as a
very great addition to our heart remedies. Its
sphere, perhaps, lies between Digitalis and Cact.
grand. In my experience, Digitalis is not worth
a great deal in attenuated doses, unless there is
an intermittent pulse.
The diet must be watched, as any indigestion
increases the distress of the patient, and may
cause a fatal issue. Tea and buttered toast are
about the worst diet that can be given, as they
often cause flatulency, which is always distress-
ing. The grains, with cream and milk, when
liked by a patient, will be found suitable diet
in most cases. — Dr. CujnjningSy in the Clinical
Reporter.
Stiologry of Phthisis.
Phillip, of Edinburgh, sums up his views on
the causes of phthisis as follows :
1. In view of the work of Koch, it is impossi-
ble to avoid admitting that a causal relationship
exists between the tubercle bacillus and the
phthisical process.
2. The mere predication of this relationship
is not sufficient in explanation of the clinical facts
and the generally fatal termination of such
cases.
3. The usually received explanations of the
modus niofiendi in phthisis are insufficient.
4. It appears probable that the lethal influ-
ence of the bacillus is due to the production
thereby of certain poisonous products.
6. Clinical and experimental evidence appear
to indicate that the morbid secretions from the
respiratory surfaces afford a good medium for
the growth of the tubercle baciUus and, presum-
ably, for the elaboration of such products.
6. Such a product is separable from the care-
fully selected and prepared sputum.
7. This product is possessed of well-marked
physiological properties, being eminently toxic to
frogs, mice, and other animals.
8. The toxic properties of the product are,
speaking generally, depressant.
9. More particularly they include a marked
depressant influence on the heart.
10. . This depressant influence seems to be
exerted through the medium of cardio-inhibitory
mechanism.
11. The toxic action of the product is more
or less completely opposed by Atropine.
12. The amount of the product which may
be separated appears to bear a distinct relation
to the abundance of the bacillar elements present.
13. Absorption of the poisonous products
most probably occurs by way of the lymphatic
circulation. — Med. Times. — World's Medxml Re-
view.
The Germ Theory as a Subject of Education.
The time is past when it is necessary to dis-
cuss the probability of the ** germ theory " as ex-
plaining infectious diseases. This is no longer a
theory, but as fully demonstrated as most of the
other universally accepted conclusions of science.
No one to-day who is competent to form a judg-
ment from a knowledge of the facts, will doubt
that many infectious diseases are caused by the
growth of microscopic organisms in the body. Of
course, no general proof of the parasitic nature
of all infectious diseases has been adduced, nor is
such general proof possible ; but when the cau-
sal connection between certain specific bacteria
and definite infectious diseases has in many
cases been proved by a demonstration so con-
clusive as to be beyond question, and when such
causal connections have been rendered extreme-
ly probable in many other cases, indeed in
almost every infectious disease, it is only ignor-
ance of the facts that can explain any doubts as
to the very general applicability of the theory. It
is true that many, perhaps a majority of practic-
ing physicians, do not have much sympathy with
the conception of the parasitic nature of infec-
tion, sometimes indeed treating the whole sub-
ject with ridicule. Some are incapable of form-
ing correct judgments, but most of them have
not found the time or inclination to study the sub-
ject enough to know what facts have been
established. At the time when most of the phy-
sicians who are now practicing were pursuing
their studies, the germ theory of disease was
scarcely entertained as a theory, and nowhere ac-
cepted. Only three or four years ago some of
our better medical schools taught their students
that the theory was a wild hypothesis, and des-
tined to be exploded like any other visionary
speculation. It is not surprising therefore, that
they should still refuse to accept a theory which
so revolutionizes the conceptions of disease. But
our leading physicians, including professors in
better medical schools, are now convinced of the
truth of the theory and the great importance of
the subject, and medical papers throughout the
country are giving more and more space to the
subject of bacteriology. — H. W. Conn, in Science.
Fbb., 1888. J
COLLEGE NEWS.
55
NEWS FROM THE COLLEGES.
Pluladelphia.
HAHNEMANN MEDICAL COLLEGE.
'' The moBt contemptible way of committing
suicide is to blow your brains out over a room,
or, worse yet, to jump from a fourth story window
and present a fearfully mangled carcass to your
already horrified friends," is the way Prof. Will-
iamson put it while lecturing on psychology.
" Notice the connection of rectal troubles with
glaucoma'* says Prof. Mohr. " I have several
times observed a proctitis precede manifestations
of this trouble.** He also told us of accidentally
curing a case of prolapsus of the rectum with
Euphrasia while treating the patient for ca-
tarrhal ophthalmia and so, having observed this
relation between the rectum and the eye, thinks
it an additional point for Euphrasia in glaucoma.
The rectal symptom for Euphrasia is : Ina-
bility to sit squarely on a chair ; sits first on one
buttock, and then on the other, never on both at
one time.
Prof. Betts thinks pruritus (local or general)
often the result of stenosis of the cervix, which
by retaining some of the discharges reflexly
causes a neurosis, or possibly may cause a blood
poison, thus producing the itching sensation.
In Prof. C. M. Thomas* first clinic on surgery
this year he performed perineal section for stone
under Cocaine, and the operation was very suc-
cessful, the patient not once calling out and only
towards the latter part, when the Prof, put
his finger in the bladder, did the man make a
wry face.
In our clinics now almost all the minor surgi-
cal operations, especially on adults, are done un-
der the effects of this anaesthetic, a 4 per cent
aqueous solution being used, and almost always
with complete success.
While Prof. Dudley was lecturing on climatol-
ogy he spoke of Southwestern Texas as being the
best place to send the hemorrhagic cases of phthi-
sis and he quoted Dr. Jos. Jones of San Antonio,
Texas, as telling him '< that of 100 cases of phthi-
sis, taken hit or miss, in Philadelphia, and sent
there, 50 per cent will get well.** When Prof . Dud-
ley asked as to what kind of physicians his patients
would find to take care of them there, Dr. Jones
told him they did not need a doctor. And the
Prof, says, in conclusion : '< That is what causes
me to put so much faith in what Dr. Jones says,
as it shows that this place is not, as many of the
so-called health resorts are, merely a place to
send your well-to-do patients, that the resident
physician may collect large fees from them.'*
Prof. Mitchell says that he has found scraped
raw beef, frozen in wafers between lumps of ice,
to be retained on the stomach in case of obsti-
nate vomiting, particularly of pregnancy, when
all else failed.
He also told us that a baby cannot generate
heat, and that if a new-bom infant's tempera-
ture gets sub-normal, it will not do to merely
wrap it up in flannel as we would do with an
older child or adult, but the flannel must pret-
viously be warmed and the child must have
artificial heat.
Boston.
UNIVERSITY SCHOOL OF MEDICINE.
Dr. Ahlbom recommends the hot pack in' cases
of acute nephritis when dropsy is at its height.
This treatment invariably induces perspiration
and almost invariably gives relief. It should be
continued for four hours if necessary, when the
skin, before tense, will be found much relaxed
and the patient brighter. Follow up this treat-
ment until the urine shows a decrease in albumin.
As an auxiliary, Aconite 3x, hourly, will support
the perspiration and materially sustain the
heart's action.
In severe cases of diphtheria, in which there
is very rapid swelling of the throat and the swel-
ling so marked as to obliterate the angle of the
inferior maxillary bone. Dr. J. H. Smith recom-
mends a poultice of rye meal (2 parts) and (1
part) powdered and sifted Phytolacca, mixed in
dry state thoroughly, then stirred with vinegar
over a fij-e. These poultices should be changed
quite often. In 18 hours the swelling will have
subsided. Phytolacca is also often indicated in
these cases internally.
Dr. J. B. Bell, in a recent lecture on the
dressing of wounds, strongly advocated surface
drainage by the use of Glycerine. A compress,
saturated in a solution composed of one-third
Glycerine and two-thirds water, is placed directly
over the stitches. The drainage tube is left suf-
ficiently long not to interfere with the compress.
The Glycerine is found to absorb all oozing from
around the stitches or from the wound before it
begins to heal.
For torpid, indolent, gangrenous ulcers, in
persons of a strumous diathesis, which will not
respond to other remedies. Dr. Jones recommends
a poultice of finely divided soil containing a
goodly amount of clay. Apply in a perfectly dry
state. The antiseptic properties of the soil will
be seen to a remarkable degree.
56
THE MEDICAL ERA.
[Vol, VL No. 2.
Ohicago.
HAHNEMANN MEDICAL COLLEGE.
Prof. Fellows says in the "peA^ vud form of
epilepsy, where the patient has one or more
spasms each day, if breakfast be taken in bed it
seems to ward off the attack for that day. With-
out this precaution, as soon as blood circulates
more freely through the brain, brought on by the
exertion of arising from bed, the fit seems to
come on.
Prof. Hoyne said, in speaking of the eruptive
fevers : Don't make a positive diagnosis of your
case until you see the eruption.
Prof. Hall says that the plaster cast is the
cause of more non-unions and false joints than
any other form of dressing that can be applied to
fractures.
Prof. Ludlam, in a general talk on post-puer-
peral diseases, said that all troubles peculiar to
women in that state are related to either pyssmia
or septicaemia. No matter whether it be pleu-
risy, pneumonia, small-pox, scarlet-fever or
what-not, they all have the same connection.
On the differentiation between the two he
stated as follows :
Sepsis.
1. Comes on or begins
in the first nine days.
8. Begins generally
with a chill, but chill
does not reour.
3. Hilarious; seems to
bedmnk;very drunk and
happy.
4. May expect high
temperature; if highest in
the morning very grave
8ign ; highest in the even-
ing, good sign.
5. No pulse signs that
can be depended upon.
Pyemia.
1. Beginning after the
ninth day.
2. Begins with a ohlU,
and the chiU recurs. The
more severe the chills the
more grave the case.
3. Dull, stnpid; wants
to be let alone ; takes no
interest in anything,
4. Do not alviaya find
high temperature, bnt
find it np in proportion
to the severity of the case.
5. No diagnostic pulse
signs.
He also said, in speaking of the pulse of a
lying-in woman, that when the pulse reached
120 or more look out for peritonitis, endome-
tritis or phthisis pulmonalis.
To differentiate between the first two he gave
the following hints :
Pebitonitis.
Lack of offensive lochia.
Localized pain.
Enbo-hetritis.
Stinking and very of-
fensive lochia.
May or may not have
pain.
Prof. Watry gave the following prescription
for ear-ache caused by acute suppurative inflam-
mation of the middle ear.
B. Ext. Plantago Maj. - - - 3iv;
Tinct. Bell. - - - gtts. xv ;
Tinct. Aconite Bad. - gtts. x ;
Magendie's Sol. Morph. gtts. xx;
Aqua q. s. ad. - - - - |.
M. S. 3 to 6 drops in the ear every 15 min-
utes until relieved.
The final examination begins Feb. 6, and
commencement exercises the 16th. About 75
are coming up for graduation. The incoming
senior class consists of over a hundred mem-
bers.
Iowa Oity.
Prof. Cowperthwaite advises to study carefully
the appearance of the tongue when differentiat-
ing between Podophyllum and Nux vom. in
morning diarrhoea. In Podophyllum the coating
is usually yellowish while in Nux vomica it is
more nearly white — Podophyllum may have a
white coating, but it is thicker than in Nux.
Subinvolution is the type of Lilium tig., and
is one of the newer and best remedies in treat-
ment of female troubles. Its action is much the
same as Sepia, but can be distinguished from it
by the aggravation of symptoms in the afternoon.
Sepia then being ameliorated.
In typhoid fever Arnica should be given a
more prominent place. It is indicated when
the capillaries are relaxed, i, e., when ecchymosis
appears.
Baptisia, if given before suppuration takes
place, is both abortive and curative. A teaspoon-
ful every half hour of the tincture or Ix., in
water.
Opium is called for in the same disease when
the heat of the bed is intolerable.
Colocynth is given first rank in treatment of
Sciatica ; Xanthoxylum and Gnaphalium being
next in order.
The best antidote for Bhus tox. poisoning is
Grindelia robusta, both internally and externally.
Aconite and Belladonna should never be given
in alternation, as it is a ** slip-shod " way of pre-
scribing. Veratrum viride beautifully covers the
middle ground.
The Professor upholds the temperance cause
by advising the graduating class to take with
them, when called in the country on a cold day,
a bottle of coffee instead of whisky, the effects of
the former being sufficiently stimulating and less
injurious.
Prof. Dickinson obtains the best results from
Podophyllum 30x to 200x and even higher in
morning diarrhoea of a serous character.
The higher potencies of Niix vom. are also
better acting than the lower, particularly in old
or chronic cases.
For sore and chapped lips apply equal parts
of tincture of Calendula and Glycerine ; for bums
substitute oil for the Glycerine. It acts like
a charm.
PcB., 1868.]
COLLEGE NEWS.
57
Prof. Gilchrist says : Simple fracture of the
patella should be converted into a compound one
and treated as such.
As a dressing in all wounds and fractures Hy-
pericum is of the highest importance. Calendula
to promote'repair.
For '' loose joints " and lax muscles Brucea is
the indicated remedy.
Prof. Cogswell says that Caulophyllum 2x
given once a day for six or eight weeks prior to
labor, will greatly facilitate it.
There is no more sense in using a vaginal
syringe after labor than after the menstrual flow.
In post partum hemorrhage China 2x should
be given every five minutes. After-pains are
greatly relieved by the application to the parts
of hot bags of salt. Arnica and Gelsemium are
the remedies.
St. LouIb.
HOMGSOPATHIC MEDICAL COLLEOE.
Prof. Schott advises students when they get
a case of scarlet fever, to warn the friends of
the patient against his taking cold, as dropsy may
result. Dropsical symptoms may show them-
selves four weeks after the patient has been dis-
charged as cured.
He also says that in measles one must not
expect the fever to subside as soon as the erup-
tion comes out ; the symptoms increase when it
first appears, and reach their height about the
second day of the eruption.
In a new-bom infant, collapse of the lungs
may follow a chill ; he therefore advises against
bathing the child immediately after -delivery, but,
instead, to rub the child over from head to foot
with sweet oil. Collapse may also be caused by
the band around the child's body being so tight
as to impede the respiration.
MinneapoliB.
HOMCBOPATHIC MEDICAL COLLEGE.
Prof. Hall says : When vertebral caries is sus-
pected, examine by passing a piece of ice along
the spine, or use instead a sponge dipped in cold
water, or one of the electrodes of a battery. The
carious spot will be found more sensitive than
other portions of the spine.
If you wish to make a special examination of
the chest do not be deterred by feelings of deli-
cacy from stripping the patient to the skin. A
thorough chest examination cannot be made
through clothing. Do not be content with ex-
amining a single region, but go carefully over
the whole chest.
Nov. 5th Prof. Higbee removed both ovaries
of a young lady who has suffered several years
from hysterical and neuralgic troubles, causing
great emaciation and loss of strength. She
made a rapid recovery from the operation, the
temperature at no time reaching 101''. At this
date she is recovering health, strength and
avoirdupois. Another patient had a second de-
gree laceration of the perineum of 20 years'
standing, and an irritable condition of the spine,
with other symptoms of coccygodinia. There
was a history of injury to the coccyx from a fall
sustained 8 years ago. Prof. H. diagnosed
necrosis of the bone, and on Jan. 7th removed
it. An examination disclosed two carious spots.
The patient is doing nicely, and will be operated
upon for the laceration when sufficiently recov-
ered from the first operation.
In gynecological practice Prof. H. finds anti-
septic wool far preferable to cotton. The wool
tampons retain their elasticity when wet, while
the cotton becomes hard and unjdelding. The
vegetable fibre of cotton causes much irritation
in some patients, while the animal fibre of wool
proves non-irritant.
Hydrastis stains may be removed from linen
by first washing in cdd water. Hot water fixes
the stain.
Some patients cannot wear tampons saturated
with glycerine. In such cases use olive oil and
melted vaseline, equal parts.
Prof. Leonard finds Lycopodium an excellent
remedy in follicular tonsillitis — not only remov-
ing the disease, but also the tendency to recur-
rence. He thinks the frequent and continued
administration of Belladonna aggravates the
disease, though it is homoeopathic if properly
used.
Gincimiati.
PULTE MEDICAL COLLEGE.
In a recent lecture on ** The Belation between
Ovulation and Menstruation," Prof. Phil. Porter
spoke somewhat as follows :
There seems to be quite a difference of opin-
ion among physiologists as regards the relation
between the phenomena of menstruation and
ovulation. Leopold holds that the periodicity
of menstruation is ** analogous to the rhythm of
the pulse or respiration." Forkiston views it as
a reflex phenomenon, '<the ripening follicle act-
ing as a cause of irritation to the ovarian nerve
supply." He compares it to the erection of the
penis and ejection of semen. Reichert's theory
is that, previous to the discharge of an ovum,
the uterine mucous membrane undergoes a
** sympathetic change " whereby its activity is
58
THE MEDICAL ERA.
[Vol. VI. No. «.
increased, and what is known as the membfana
dediua mefistrucdis is formed, and degenerates,
. provided conception does not take place. In
contradistinction to this view is that of Pfluger,
who regards menstruation as a periodic ** fresh-
ening " of the superficial layers of the mucous
membrane of the uterus, in order to render it
more susceptible for fertilizing the impregnated
ovum.
But is menstruation necessarily dependent
upon ovulation ? We know that ovulation may
occur in those who have never menstruated, e. g,,
in girls who have not reached puberty; and
there are many cases of women becoming preg-
nant in whom the menses never appeared. After
the climacteric, too, ovulation must go on, since
ovarian cysts are so often found. Again, women
whose ovaries have been removed have been
known to menstruate. Must this imply the exist-
tence of a third ovary ? Still further, ovulation
and menstruation may go on at the same time.
There is nothing to prove that ovulation is
periodic, since there is no time during the whole
child-bearing life of woman that she may not con-
ceive, hence the conclusion to be arrived at is
that ovulation goes on continually. The ovary
has certainly a sufficient supply of ova to war-
rant it, and, furthermore, the two phenomena,
menstruation and ovulation, are not dependent
upon each other save that memtrnation proiides
a superabandance of material to be appropriated in
ca^e pregnancy occurs.
Dijsinenorrlioea, — After classifying the various
forms of dysmenorrhoea the Professor stated that
his definition should be, that dysmenorrhoea, pure
and simple, the uterine form, was pain produced
at the menstrual period by the influx of blood to
and within the uterus, where there already existed
a neurotic state. In the so-called forms of
spasmodic dysmenorrhoea we have an irritation
of the nerves of the uterus or of the ovaries,
which will, during menstruation, produce ex-
aggerated contractility of the muscular elements
of these organs, transforming simple contractions
into spasms.
Ovarian dysmenorrhoea, we should remember,
plays an important part in the interesting
and important phenomena of menstruation.
Under the influence of special predispositions
the entire muscular net-work of the bulbar por-
tion of the ovary, which assisted in the dehes-
cence of the mature ovule, may become spas-
modically contracted, hinder the rupture of the *
vescicle and even give rise to follicular or
menstrual ovaritis, distinguished by local pain
and producing sympathetic trouble in neighboring
parts. Also, in ovarian dysmenorrhoea you will
find your patient extremely sensitive to the
touch, but with no tumefaction about the hypo-
gastric region. The same may be said of the
iliac region, except that there may be found a
slight prominence of the part. With ovarian
dysmenorrhoea you will find associated spasmodic
action of the uterus.
Ohicagro.
HOMOBOPATHIC MEDICAL COLLEGE.
Prof. Tooker says : Calendula is a fine remedy
for eczema pustulosum.
The Prof, cautioned the class in regard to the
use of Pulsatilla, which is so potent in controll-
ing the cough in measles. It should not be
given until the rash is well developed.
Although Belladonna is not a sure preventive
of scarlet fever, it should be given early to mod-
ify the symptoms when they appear.
Prof. Foster says: Gentleness, cleanliness
and patience are three important points to be
observed in the use of the obstetric forceps.
** Bags and science " are both very important
to success in the lying-in-room.
Prof. Streeter's chair : Ten rules in regard to
pessaries.
1. The material should be light, hard rubber,
and as small as will answer the purpose.
2. The patient should not be conscious of its
presence after a day or two.
• 3. If it hurts after a few hours it should be
removed. Instruct the patient how to take it
away.
4. All pessaries should be examined within 48
hours after introduction to see if they are per-
forming their mission ; then again three or four
days later.
5. When introducing the lever pessary the
short arm should go in first. Introduce the
pessary about two-thirds of its length, then
push the finger through the ring and depress tlie
short arm so it will pass under the cersax, to ride
into the posterior fornix.
6. Pessaries should be movable in the vagina.
7. As the secretions are somewhat increased,
vaginal injections should be used daily, as long
as necessary.
8. The pessary should not interfere with
coition.
9. To be curative, pessaries should be worn a
long time ; one year, on an average.
10. It should be removed at least once a
month ; after each menstruation.
The professor is a firm behever in the use of
pessaries, and says, if they are not efficacious,
it is the fault of the physician.
Fn.,1888.]
HOSPITAL NOTES.
59
HOSRTAL NOTES.
COOK OOUHTY HOSPITAL.
With the New Year, the Homceopathic Depart-
ment has had extended to it additional privileges
in Cook County Hospital, by being given control
of a share of the patients in Ward 14, the ma-
ternity ward. Hereafter the homoeopathic iw-
Xerneti will have the benefit of practical lessons in
obstetrics. January 6 the first case was assigned,
and Sunday morning a five-pound baby was bom
under homoeopathic auspices. Both mother and
child are doing well.
In one of the wards under the control of the
old school, there was a case of phlegmonous
pharyngitis, with sloughing of the wall of the
internal carotid, followed by rapid and fatal
hemorrhage.
A case of obstinate ulcer of the leg resisted all
treatment. Sawdust was boiled in a 5 per cent
solution of carbolic acid, then soaked for twelve
hours in a solution of Bichloride of Mercury,
1 :5,000. The patient was put to bed, and the
leg buried in the prepared sawdust, in a fracture
box, and the sawdust dressing frequently changed.
The ulcer healed rapidly.
More than a dozen cases of Collets fracture
have been treated in the hospital the last year
with the pistol splint ; without exception, there
has been good union, and no deformity in any
case. The pistol splint had fallen into disfavor
until it was taken up by Dr. Henry Sherry, the
attending surgeon, to whose efforts are due its
present position in the Hospital. It would not
be possible to obtain better results than this
method shows in our wards.
January 7, patient was admitted for cellulitis
of the scalp. A large collection of pus was found
between the pericranium and the skull. The
man had received a scalp wound in the region of
the occiput a few days before, which had been
treated non-antiseptically with the above result.
First-class results have always been obtained
in this Hospital with the following treatment :
1. The scalp is carefully shaved for a con-
siderable distance from the woimd.
2. All shreds and d^hm are thoroughly cleared
away.
3. Hemorrhage is thoroughly controlled. If
this is difficult to accomplish, pass a full
cur\'cd needle, armed with aseptic silk or cat-
gut, through the scalp, under the artery, and
out at the other side, and tie.
4- Thorough irrigation with Mercuric bi-
chloride solution, 1 : 4,000.
5. The edges of the wound are carefully co-
apted with aseptic silk stitches, leaving in a
couple of strands lengthwise of the wound for
drainage.
6. Inject the wound with lodofomi and ether
solution, 1 : 6.
7. Cover with sublimated gauze and secure
with roller bandage.
With this treatment primary union can be
predicted with mathematical certainty.
A fireman recently received a punctured wound
of the calf of the leg by a sharp piece of plate
glass falling upon it. A physician was called,
who covered the wound with a piece of bella-
donna plaster. When brought to the hospital
the leg presented a considerable bulging. The
plaster was torn off, when the blood spurted
freely.
The case was treated in the following manner :
The wound was enlarged, all blood clots cleaned
out, and the hemorrhage controlled. It was irri-
gated by Mercuric bichloride solution, 1 : 4,000 ;
the edges carefully co-apted with aseptic silk
stitches, and covered with sublimated gauze care-
fully secured. Results perfect.
A Swede, 45 years old, about 9 a. m., took
what he declared to be a teaspoonful of mor-
phine, with suicidal intent. He was brought to
the hospital about 11 : 30 p. m. His respirations
were four per minute. He was well pumped out
with the stomach-pump; flagellation and the
Faradic current were applied and kept up for an
hour, when he was able to walk. Atropine gr.
yV was given every four hours till four doses
were given, and the patient kept awake all night
by an attendant constantly at hand. He was'
given his breakfast and allowed to sleep during
the forenoon, and in the afternoon was dis-
charged all right.
The hands and fingers of the surgeon are pre-
pared as follows before touching a wound : First,
they are thoroughly washed and scrubbed with a
brush with soap and water, everything being
thoroughly cleaned from under the nails. Sec-
ondly, they are immersed in a solution of Mer-
curic bichloride, 1 : 1,000, for at least one minute.
Sixteen grains of Mercuric bichloride to a
quart of water make a solution of 1 : 1,000. It
dissolves best in hot water.
"If we put deaths from corrosive sublimate
poisoning on the one side of the balance, and
the deaths from wound infection on the other
side, the latter go down with such a thump that
the former are hurled high in air and scattered
to the winds." — Aform.
60
THE MEDICAL ERA.
[Vol. Vl. No. a.
CORRESPONDENCE.
MEXICO AND CALIFORNIA FOB INVALIDS.
San Erancisoo, Jan. 6, 1887.
Editors of the Medical Era : —
Since yisiting Mexico' and California I believe
it my duty to give my colleagues, the readers of
the Era, the benefit of my observations.
Of old Mexico I will say that I consider the
high valleys in which lies the city of Mexico,
nearly 7,000 feet above the sea, to be one of the
best climates in the world to send patients with
chronic asthma, bronchitis and incipient phthi-
sis. The temperature varies but little all the
year round, ranging from 60° to 80" F. The
only drawback is the poor accommodations, the
lack of any provisions for heating rooms, and
the food and cooking, to which it is difficult for
Americans to become accustomed. No invalid
without plenty of money should be sent there,
for he should have means to surround himself
with the comforts he has at home.
I have visited all the noted places lauded as
health resorts in Southern California, from San
Diego to Monterey on the Pacific Slope, and I
must say that I find no advantages in them over
any town on Lake Michigan. This may appear
incredible when so much has been said in praise
of that section of California. But my reasons
are good. While the air is pure, and sunshiny
days are the rule, there are drawbacks which
offset all. The winds from the Pacific are cold
and raw, and the fogs evening and morning are
penetrating and depressing.
All diseases of the respiratory organs are
common, especially catarrh and bronchitis, and
they are aggravated in invalids from the East,
who do not know how to guard against the de-
ceptive aspects of the weather. The sun shines
very hot in the middle of the day, but if you sit
in the shade, a chill is the result. There is no
such thing as sitting on piazzas or swinging in
hammocks in the evening, or, indeed, the most
of the time during the day. In this respect
California (near the coast) is far inferior to
Florida. If you send invalids' or delicate per-
sons to California, to avoid severe northern win-
ters, advise iviperatively that they remain on the
western dope of tfie mountains.
Here the ocean winds and fogs are arrested
by the Sierras, and the air is warmer and drier.
Such places as San Bernardino, Fresno, and
Yesalia, and others on the western slope are the
best. Do not let patients go without cautioning
them to wear all-wool clothing next the skin day
and night, and avoid the night air — in fact,
all the precautions you would advise in our
northern climate.
San Francisco should be avoided. It has a
climate as bad as Chicago, and old residents tell
me that it is growing colder every year.
HOW ICEDICINE IS PRACTICED BT THE CHINESE.
Chinese therapeutics are beyond the ken of
ordinary mortals. The substances used are
mainly from the animal kingdom, and are in-
describably filthy. They would delight such
persons as Lippe, Swan, and the International-
ists. The general method for the selection of
these remedies is this : The patient, if able, goes
personally to the Joss-House (temple of the
gods). He kneels before the image of the Chinese
Esculapius, the God of Medicine ; he bums some
slips of paper on which are printed prayers,
draws at random from a bundle of slips of bam-
boo, each numbered. He takes the slip to the
Chinese druggist, whose drugs are all numbered,
and receives the drug bearing the corresponding
number. This is the remedy for his disease !
Simple, is it not ? Almost as simple as select-
ing the remedy by one key-note symptom! If
the patient caUs a physician, he consults the
God of Medicine (which is his familiar), and is
handed a slip of bamboo with a magic number
on it.
Some of the Chinese physicians dispense their
own drugs. Some have attained a reputation
beyond their own race, and have accumulated
large fortunes.
Their most popular medicine is a pill whose
components are oxide-of-iron and bone-dust,
and this is valued highly by the Americans who
patronize the Celestial physicians. The reason
is obvious.
E. M. Hale, M. D.
It is said that there are at present between
thirteen and fourteen thousand qualified practi-
tioners practicing homoeopathy in the United
States of America, and it is calculated that if the
proportion of homoeopathic to allopathic prac-
titioners should increase in the same ratio
during the next twenty years as it has in the
last homoepathists will then be in the majority.
The allopathists will then, no doubt, all turn
homoeopathists in a body to escape the unpar-
donable sin of being a ''sect." — Homeopathic
World.
Fkb., 1887.1
MISCELLANY.
61
MISCELLANY.
Otis Clapp & Son, Boston, have favored us
with a beautiful calendar, which will serve to
keep them in mind every day of the year.
Echinacea Angcstifolia is the latest candidate
for favor in the treatment of typhoid fever. The
Eclectics are using it very extensively, and claim
surprising results.
The Pope Mfo. Co., of Boston, who make
almost all the Bicycles that are used in this
country, have sent out a convenient calendar to
grace editorial desks.
We acknowledge the receipt from the Medical
World publishing o£Sce of a very convenient
pocket record for daily practice and accounts.
It is the best in this line that we have yet seen
and must recommend itself at sight.
Pocket Umnaby Test Case. — Look in the
advertising pages for a description of this useful
device. Thousands are in use. It is recom-
mended by Prof. Clifford MitcheU. Send orders
to G. & D. 48 Madison st.
Doliber, Goodale & Co. have sent out a calen-
dar " to furnish by means of the engraver's art,
a beautiful picture, and to remind one of Mel-
lin's Food for Infants and Invalids.** It admir-
ably serves its purpose.
Our exchanges will confer a favor, in making
extracts from our columns, by giving credit to
the — Medical Era. There are several " Eras,"
but only one Medical Era. Some have regarded
this, and some have not.
If You Want a flexible catheter that will never
wear out, and a clinical thermometer that will
never break, drop a postal card to Sardy, Coles &
Co., 96 Maiden Lane, New York, and tell them
that you saw their advertisement in The Medi-
cal Era.
New Lme to Cheyenne.
The new extension of the Burlington Route to
Cheyenne, Wyoming Ter., having been completed,
the C. B. & Q. R. R. is now running a through
sleeping car from Chicago to Cheyenne, via
Omaha, leaving Chicago daily at noon on " The
Burlington's Number One" fast train. For
tickets apply to any coupon ticket agent of its
own or connecting lines, or address Paul Morton,
Genl Pass, and T'ck't Agt., C. B. & Q. R. R.,
Chicago.
PERSONALS.
Dr. W. I. Howard has removed from Stevens
Point, Wis., to Los Angeles, Cal.
Dr. C. M. Dinsmoor, of Omaha, is among the
late arrivals at the Grand Pacific.
Dr. R. N. Tooker has moved into his elegant
new hodse. No. 261 Dearborn Av.
Dr. B. L. Cleveland, of East Saginaw, Mich.,
is among the arrivals at the Palmer House.
Dr. John Fazzard, of Port Orange, Fla., says
there is a good location for a homoeopathic phy-
sician at Daytona, Fla. Write Dr. F. for par-
ticulars.
Dr. E. Lippincott, we regret to say, has been
severely sick for several weeks, suffering from an
attack of pneumonia. At last accounts he was
approaching recovery. The second of his series
of articles on hay fever will appear in March.
Dr. W. E. Hathaway, of Maryville, Tenn., is do-
ing a work, in his own community, similar to that
of the Homoeopathic League, of England. He
has issued a pamphlet for the benefit of his
patients, entitled " Homoeopathy on Trial." It
is calculated to popularize homoeopathy.
IK MEMOBIAV.
The friends of the late A. E. Small, A.M.,
M.D., have issued a memorial which is a fitting
tribute to the memory of this wise and good man.
It is gotten up in exquisite taste, and the con-
tents, consisting of the beautiful sermon dehv-
ered by the Rev. L. P. Mercer, form a whole*
which will be of greater value to his many
friends than would any column of marble or
granite.
Chemical Food is a mixture of Phosphoric
Acid and Phosphates, the value of which physi-
cians seem to have lost sight of to some extent,
in the past few years. "Messrs. R. A. Robinson
& Co., to whose advertisement (on page X) we
refer our readers, have placed upon the market
a much improved form of this compound, "Rob-
inson's Phosphoric Elixir." Its superiority con-
sists in its uniform composition and high degree
of palatabihty.
A deUghtfnl essay by James Bnssell Lowell, on
Walter Savage Landor, is one of the maoy featnies of
the February Century. It is accompanied by a front-
ispiece portrait of Landor, and a collection of his be-
fore unpublished letters.
In the February St. Nicholaa Mary Hallock Foote
has drawn the frontispiece; — two young housekeep-
ers in consultation over "Family Affairs."
62
THE MEDICAL ERA.
[Vol. VI. No. 2.
MORE COMPLIMENTS.
I read and enjoy the Era. — Br, E. E. Pkkett-
Success to the grand Era. — Dr. May Barring-
ton,
I cannot keep house without it. — Dr. E. H.
Sparling.
I cannot do without The Medical Era. — Dr.
L. Paidu.
Many thanks for your good journal. — Dr.
Joseph Jones.
I cannot do without The Medical Era. — Dr.
J. W. BarnsdaU.
I am well pleased with The Medical Era. —
Dr. S. E. Atkinson.
I consider The Medical Era the first and
best. — Dr. C. II. Vielie.
The Medical Era still distances all competi-
tors. — Dr. W. E. Hathaway.
The Medical Era is more helpful to me than
any otlier journal that I take. — Dr. W. S. Lee.
I derive great satisfaction from the pithy
contents of The Medical Era. — Dr. C. E. Ehinger.
The only trouble with The Medical Era is
that it does not come often enough. — Dr. F. C.
Pagan.
I must have Tbm Medical Era, as I find it
both profitable and enjoyable. — Dr. Laura A.
Ballard.
If you want another of the best journals in
the country, just take the Era. — Tli^ Medical
Institute.
The Medical Era is the best — yes, the Best
— of the twelve journals we take. — Dr. J. C.
Kirkpatrick.
I get more practical hints from The Medical
Era than from any other journal I take. — Dr.
II. E. Cross.
Among the five journals I take, The Medical
Era is the only one I read clear through. — Dr.
J. B. CuiUy. •
I consider The Medical Era our very best
medical journal, and I would not like to be
without it. — Dr. Jane H. MiUer.
It is hardly worth while for me to tell you
how more than satisfactory the Era is, and I
will only say. Keep on the same course, uphold-
ing the banner of homoeopathy without conced-
ing an inch to " our friends, the enemy.'* Those
in our ranks who are lacking in spinal stiffness,
and who are willing to surrender the title of
homoeopathy, should be ** counted out, "for they
are not of the stuff of which' the founders of
homoeopathy were made, — Pr, H. R. Sto^t.
He Wanted Help.
He sang with vigor,
He sang it each day.
" I would not live always,
I ask not to stay;"
But when with a fever
And chills taken down
He quickly had in all
The doctors in town
— Boston Courier.
Physician (to patient) — Your case is a very
serious one, sir, and I think a consultation had
better be held.
Patient (too sick to care for anything) — Very
well, doctor ; have as many accomplices as you
like.
The following testimonial from a lady, says an
exchange, has been left at this office, for sale, by
a dealer in patent medicines : *' Dear Doctor, I
will say that, while suffering from a severe back-
ache, I took my purse in my hand and went out
to buy one of your plasters. I met a street-thief
on the comer and was relieved at once. Tou
can use this for what it is worth.'*
A notorious quack residing in Buffalo issues
legions of pamphlets filled with testimonials of
those who have been cured of consumption,
Bright's disease, and other serious maladies.
The editor of a paper in Philadelphia has written
to these patients. Some had gone to a better
world, others were not cured, and the remainder
spoke of him in anything but complimentary
terms.
An Old Friend Prescription — ** No, no, young
man ; there aint nothing wuth spealung of the
matter of you," said old Dr. Sipes to delicate
little Claude De Vere, who was spending a few
weeks amid the rural delights of Sipesville.
" I tell you what you do," said the old doctor,
while Claudie*s blood ran cold: "You slap a
good hot mustard plaster on your back, and one
of slip'ry ellum on your chist. Drink a quart of
red pepper tea bailing hot, when you go to bed,
soak your feet in b'iling water, and take three of
these pills every hour, and one of these quinine
powders every half-hour, with a good smg of
this green mixture between, and a half-a-pint of
this yellerish stuff night and morning. You
keep that up a week, and you'll be a different
man. It'll knock most any disease mortal ipai)
ever come down with." — Puck.
Pbb., 1888.]
BOOK REVIEWS.
63
BOOK REVIEWS.
A Manual of Medical Jurisprudence ; with Spec-
ial Reference to Diseases and Injuries of the
nervous system. By Allen McLane Hamil-
ton, M. D., one of the Consulting Physicians
to the Insane Asylum of New York City, etc.
With illustrations. New York : E. B. Treat.
1S87. (?2.76.)
Of various works on medical jurisprudence
which have been offered to the profession, this
one, we think, is best adapted to the wants of
the student. It is clear and concise, qualities
which should characterize all text-books. The
work is especially valuable in being written with
special reference to diseases and injuries of the
nervous system, a subject which is of great im-
poi-tance from a medico-legal view. The pub-
lisher's work is also to be highly commended, for
E. B. Treat is making a series of books of very
convenient size and shape, and beautifully
bound.
Diseases of the Female Mammary Glands, by
Th. Billroth, M. D., of Vienna, and New
Growths of the Uterus, by A. Gusserow, M.
D., of Berlin. Illustrated. These two works
constitute Vol. IX. of the " Cyclopsedia of
Obstetrics and Gynecology," (12 vols, price
$16.50) issued monthly during 1887. New
York: William Wood & Company. (W.
T. Keener, Chicago).
A Handbook op General and Operative Gynecol-
ogy. Volume 1. By Dr. A. Hegar (Uni-
versity of Freiburg) and Dr. R Kattenbach
(University of Giessen). In two volumes.
This is also Vol. VI. of " A Cyclopsedia of
Obstetrics and Gynecology " (12 vols., price
$16.50), issued monthly during 1887. New
York : William Wood & Company.
These volumes form part of the set for 1887,
issued by this well known house. The value of
the various works is indicated by the names of
the eminent authors, Billroth, Gusseraw, Hegar
and Kattenbach, whose writings are thus pre-
sented to American readers. So much has been
said in our columns regarding those publications
that it is only necessary to call the reader's at-
tention to these new volumes of the series.
The Practitioner's Guide to Urinary Analysis.
By Prof. Clifford Mitchell, A. M.,M. D.
Professor of Chemistry in Chicago Homoe-
opathic College. Second edition; rewrit-
ten and enlarged — Chicago: Gross & Del-
* bridge. 1888. ($1.50.)
The profession is already familiar with Prof.
Mitchell's work, the first edition of which was rap-
idly exhausted. It is only necessary to say that
this is a great improvement on the former edition,
it having been so much enlarged as to make of
it almost another book. No practitioner, who is
not already well-informed, can treat intelligently
cases of disease involving the condition of the ur-
ine without such knowledge as is here given ; and
nowhere else con he find that knowledge so
clearly and yet so fully given, as in Prof Mitch-
ell's book.
The Clinical Reporter. — This new journal,
edited by the faculty of the Homoeopathic Med-
ical College of Missouri, has made its initial
visit. It is very neat in appearance, and con-
tains much good reading. We gladly welcome
it as an exchange, and wish it a long and pros-
perous career. The price ($1.00) should insure
for it a wide reading. Remittances should be
sent to 219 Chestnut street, St. Louis, Mo.
Contempt of Court. — Of all the curious read-
ing that we have enjoyed in sometime, we think
that afforded by a communication from Dr. F.
E. Stewart to the current number of the l)ru,g-
gigt^* Circular certainly caps the climax.
Whenever a physician strays from his own
profession into the intricacies of the law, and
especially of the patent laws of this country, his
feet are on dangerous and slippery ground, no
matter where his head or heart may be. In
the present paper, Dr. Stewart attacks the re-
cent decision of the United States District Court
in the matter of the suit of Battle & Co., against
the Grosses (Daniel W. and Edward Z.) for in-
fringement of their copyright of Bromidia, He
declares the decision is not final or binding, and
advises the Grosses and druggists generally not
to pay any attention to it. Dr. Stewart thus put
himself in contempt of the United States Courts
and advises others to place themselves in the
same foolish and dangerous predicament. The
queer part of the matter, however, is that every
reason which he advances against the validity
and justice of the decision is the strongest possi-
ble argument in its favor, and the reader must be
obtuse indeed not to see that it is so. This view
of it was evidently taken by the editor of the
Circular, who says : " While giving Dr. Stewart's
argument publicity on account of its novelty, we
thmk it proper to remind pharmacists that they
are bound by the decision so long as it is al-
lowed to stand " — which advice is good, sound
sense, like pretty much everything that ema-
nates from the editor of the journal quoted. — St.
Louis M. and S. Jaumal.
64
THE MEDICAL ERA.
(Vol.. VI.- No. t
THEY SAY
That squint is always binocular.
That there is a plethora of medical men.
That a man's temper improves by disuse.
That good nursing is absolutely remedial.
That both dogs and men have summer pants.
That chronic inebriates are practically insane.
That it pays to be good and it's good to be paid-
That a rolling-pin gathers a great^deal of dough.
That conium will relieve neuralgia of the mammsd.
That whisky lowers a man, but raises the devil.
That arsenic will both cause and cure epitheli-
oma.
That New York will not put up with much more
]\)[osi
That cannabis is a prime remedy for ''lame
back."
That xanthoxylum is a good remedy for after-
pains.
That gnaphalium is an excellent remedy for
sciatica.
That glonoine is a good remedy in ursemic con-
vulsions.
That suppurating wounds do not often cause
tetanus.
That better cooking in the army would prevent
desertions.
That there's nothing original now-a-dayq except-
ing original sin.
That there is always albumin in the urine of
new-born babes.
That cina is a good remedy for incontinence of
urine in children.
That an epidemic of cow-pox has been discov-
ered in England.
That it makes a Frenchman mad to have the
German measles.
That the wages of sin is death, but no one ever
applies for the wages.
That a single application of sulphuric ether will
destroy pediculi pubis.
That the Queen of England pays her court phy-
sician $25,000 per year.
That rubbing the skin systematically with lano-
lin will remove wrinkles.
That the heart discharges four ounces of blood
at each ventricular systole.
That "malaria" is the physician's Jersey- jacket
— it fits a great many cases.
That copaiba officinalis is almost a specific for
retention of urine in old men.
That climatology is fast becoming one of the
sisterhood of medical sciences.
That the cornea of pure Egyptians is decidedly
smaller than that of other races.
That wine, women and worry are the most potent
factors in causing general paresis.
That more than one half of a physician's pa-
tients are under seven years of age.
That nameless jourtials are very appropriately
edited by anonymous correspondents.
That moschus is a valuable remedy in syncope,
hysteria, nervous asthma and hiccough.
That an elephant's chest is larger than a man's,
but its trunk is smaller than a woman's.
That you should always adjust the pessary to
the patient, not the patient to the pessary.
*That Leland Stanford has founded a university
in California, and endowed it with $20,000,0(X).
That the students in the surgical clinic may be
very unsympathetic, and yet they are always in
" tiers."
That an application of hot water and carbon-
ate of ammonia will prevent threatened mammary
abscess.
That Sir Morell Mackenzie has already received
$40,000 for attendance on the Crown Prince of
Germany.
That apoplexy of the severe type should be
treated by compression of the carotid of the
affected side.
That it is highly amusing to hear one corre-
spondent refer to another correspondent as " our
correspondent "
That a bald-headed neighbor of ours had a rab-
bit painted on top of his head, so that people
would think a hare was there.
That opera managers say tights are not injuri-
ous, but we saw fellows New Year's night who
were rather the worse for them.
That Caius Julius Cassar was the first one who
described the Caesarean operation, and hence its
name. You may believe this if you want to.
That it's easy enough to be a philosopher; all
one must do is to talk something he doesn't un-
derstand, and that no one else can understand.
That to keep within the limits of dignified as-
surance without falling into the ridiculous rantings
of the boaster, constitutes the supreme talent of the
physician.
That the earth is constantly shrinking at the
rate of two inches a year. This accounts for the
nervous anxiety of some people to possess it before
it becomes any smaller.
That the physician who depends on the grati-
tude of his patient for his fee, is like the traveler
who waited on the bank of the river for it to cease
flowing in order that he might cross.
THE MEDICAL ERA
Vol. VI.
Chicago, March, 1888.
No. 3.
EDITORS :
CH. GATCHELL, M.D.
JAMES £. GBOSS, M.D.
THE VERDICT.
Our English colleagues have scored a great
triumph. In a battle of the types — waged in
the columns of the London Times — they have
come out victorious.
The story is too long to tell in detail. Suffice
it to say, for the information of those American
readers who cannot see it in its original sources,
there has been a long, animated, and heated con-
troversy waged between distinguished members
and friends of both schools, the homoeopaths be-
ing represented by Drs. Dudgeon, Dyce Brown,
J. H. Clarke, Mr. Millican, Major Vaughan
Morgan, and Lord Grimthorpe. Our friends,
the enemy, were represented by Drs. J. C.
BucKNiiiL, R. B. Garter, Thudichijm, Brunton,
G. Johnson, and others.
The contest was short and fierce. The issue
was, as it always is in an unprejudiced court, in
favor of the homoeopaths. Here is the verdict :
The medical controversy which has been raging
for a month or more in the Times was summed up
yesterday in an editorial which leaves the " regu-
lar " doctors aghast The leading journal practi-
cally sides with the homoeopaths against the allo-
paths. Not that it pronounces judgment on either
system, but for the purpose of this controversy it
gives the allopaths the worst of it This attitude
is the more surprising because homoeopathic
doctors are in England a very small minority.
The important correspondence that has lately
appeared in the London Tim£s is the most com-
plete and critical discussion of the merits of
homoeopathy that has ever appeared. All mem-
bers of our school should read it.
THE INCREASE OF THE INSANE.
The physician cannot divorce his interests
from those of the state. His citizenship involves
peculiar responsibilities. He takes little part in
the administration of laws, but he has a large
share in dictating those laws which have for
their purpose the conservation of the public
health. Questions of sewage, of drainage, of
quarantine, of infectious diseases, are referred to
him, and laws are framed according to his
decision.
There is another matter which will soon be-
come of national importance, in which the med-
ical profession should take an active interest.
One or the other political party will undoubted-
ly include in its platform a clause favoring.the re-
striction of foreign immigration into our country ;
not its abolition, but its restriction. This action
will be proposed with a view to the protection of
American labor, and to preventing a further in-
crease in the number of paupers.
But to the physician it has another aspect.
It is a well known fact that the number of the
insane is increasing in a greater ratio than the
number of our population. The various states
are appropriating large sums of money to the
building of asylums to accommodate the men-
tally deranged.
In attempting to account for this too rapid
increase of the insane, our American habits and
customs have been held responsible. It has
been attributed to the great strain under which
we labor, to the intense activity of our business
lives, and to the rapid fluctuation in fortune.
66
THE MEDICAL ERA.
(YoL. YI. Ho. 1
But, as often happens, this explanation does
not explain. A search of asylum records reveals
the fact that the new wards are being filled, not
by Americans, but by foreigners. In other
words, Europe is not only dumping her paupers
on our shores, but she is cleaning out her mad-
houses in order to turn their former occupants
oyer to our tender care. While this is, undoubt-
edly, a great kindness to the patients themselves,
yet it is a species of charity which vdll fail of
appreciation in this country.
The remedy must be found in legislation, and
it is the duty of the members of our profession
to take an active part in shaping public senti-
ment in order to bring about the desired end.
America has long been looked upon as being an
asylum for the oppressed of all nations, but we
draw the line at *' the halt, the lame, and the
blind. " All who are capable of becoming self-
supporting, will here find welcome, but let each
nation care for its own wards — a legacy that
Gk>d has left to mankind everywhere.
ALCOHOL IN DIPHTHERIA.
We are led to refer to this subject again in
order to correct some misapprehensions. We
have received communications from several phy-
sicians making the claim that they have long used
the treatment described, with but indifferent re-
sults. But these men are mistaken in claiming
that they have used the systematic alcoholic
treatment of diphtheria. They have done no such
thing ! The Editor of the Medical Visitor thinks
that he has done so. But he mistakes.
In every instance we have taken pains to in-
terrogate these claimants, and in every instance
they have admitted that their treatment con-
sisted in the occasional use of alcohol in the
atomizer, and an egg-nogg containing a tea-
spoonful of whisky, given several times a day.
a day a child suffering from this disease will
take. He knows, well enough, how such a child
dreads the mere act of swallowing, and will often
struggle against taking even a teaspoonful of
medicine, and that it is considered a great triumph
when a host of anxious friends, as a result of
entreaties, prayers and promises, have induced
the little patient to drink half a glass of milk.
Then they talk of having employed the system-
atic treatment by alcohol because, forsooth, the
child has taken some milk and egg with a little
whisky in it. It is absurd !
Was not the language in the preceding num-
bers of this journal plain enough ? Could Eng-
lish be made to tell the story more distinctly?
We think not. It only remains for those who
wish to put in claims of priority to read the in-
structions again, and read them intelligently.
We are led to give this much space to the
subject, because we wish the method of treat-
ment to be tested by a large number ofphysiciang.
But in making the test, these fundamental prin-
ciples must be observed :
1. Employ only the best quality of alcohol
( not whisky ) properly diluted.
2. For internal administration, dilute about
one-third to one-half; for the atomizer, full
strength.
3. Give the alcohol regularly, systematically
and energetically.
4. Give it to the verge of intoxication.
5. If it cannot be introduced into the system
in one way, then employ another ( the skin will
absorb alcohol ; a child may be rendered intoxi-
cated by putting it into a warm bath of alcohol
and water ).
6. No results will be conclusive which are
not obtained in cases of malignant diphtheria.
Anyone with experience in the treatment of
diphtheria knows how many glasses of egg-nogg
We again urge the trial of this method of the
treatment of malignant diphtheria. It can do no
harm— you cannot cure maUgnant diphtheria
by any method of treatment now at your com-
mand ; you might as well try this one.
Mab., 1888.1
EDITORIAL.
67
xvm.
THE DOCTOR TALKS.
"It does me good, " said the doctor, " to hear
a man give his reasons for the faith that is in
him ; consequently, it does me good to read the
foUowing in the latest number of the Medical
lUeard:
" * P*of . Samuel O. L. Potter, of San Francisco,
giyes, in the Lancet, the following as his reasons
for abandoning homoeopathy. He says: ''I aban-
doned homoeopathy before entering into practice,
because my observation of the reception by homoeo-
paths of Ihr. C. Wesselhoeft's reproving of Oarbo-
vegetabilis, and Dr. Sherman's work in the
'' Mflwaukee Test " of 1879, proved to me that no
Gmdal drug-experimentation, conducted under
scientific safeguards, could meet with any degree of
apjNreciafeion from the majority of that sect. I was
further impressed by finding that ninety-nine out
of every hundred so-called homoeopathic physicians
were in the habit of resorting to regular therapeu-
tics whenever there was any active therapy to be
done.' "
« «
"But, like the average specimen of oleomar-
garine, this thing will not bear analysis. Let
us look at it :
'^ ' I abandoned homoeopathy because of the re-
ception of Dr. Wesselhoeft's reproving of carbo-
vegetabilis. '
" Now, what I want to know is : Why did not
Dr. Wesselhoeft also abandon homoeopathy be-
cause of the reception of his reproving of carbo-
vegetabilis ? Why did not Dr. Wesselhoeft feel
called upon to shake the homoeopathic dust from
his feet and step over into the slough of allo-
pathy? He, certainly, had greater reason for
so doing than did Dr. Potter, for with Dr. Wes-
selhoeft it was somewhat of a personal affair, as
well as a matter of schools. But he did not
* abandon ' anything ; he stuck to his text, and
he has been working on that line ever since, and
doing noble service for the only school of medi-
cine that has any established principles.
" Dr. Wesselhoeft is right ; Dr. Potter is
wrong. "
"Again, Dr. Potter says that he abandoned
homoeopathy because of the reception of Dr.
Lewis Sherman's < Milwaukee Test. ' Still the
question recurs. Why did not Dr. Sherman also
'abandon' something about that time? He
did not do so. He is, to this day, grinding away,
with pestle and mortar, and doing all that he
can to promote the interests of the only school
of medicine that has any claim to being called
rational or scientific.
"As further reason, Dr. Potter says that he
abandoned homoeopathy because he found that
'ninety-nine out of every hundred so-called
homoeopathic physicians resorted to regular
therapeutics whenever there was any active
therapy to be done. '
"This is one of the most astounding state-
ments that man ever made ! In the first place,
it is untrue. In the next place, there is nothing
in this world so * irregular ' as what Dr. Potter
is pleased to call 'regular' therapeutics. It is
a travesty of language to call it so. It is about
as regular as the track of a cyclone — and about
as disastrous."
" But it is untrue. Ninety-nine out of every
hundred homoeopaths do not resort to empirical
methods in the treatment of serious diseases.
In their treatment of dysentery, diarrhoea, Asiat-
ic cholera, syphiUs, pneumonia, typhus, scarla-
tina, rheumatism, peritonitis, pleurisy, menin-
gitis, yellow fever, small-pox, and the other
diseases that cause the greatest mortality in the
human race, the great majority of homoeopaths
adhere closely to the Hahnemannian method, and
with a degree of success greater than 'traditional'
medicine ever attained. On the other hand, in
the treatment of malignant diphtheria, advanced
phthisis, and the like — diseases for which no
school of medicine owns a specific — he resorts
to whatever empirical treatment, in his opinion,
promises best ; and, since the ' traditional '
school has no mortgage on these methods, he
does so without asking permission of his ' aban-
doned ' brethren. It is not necessary. "
"Dr. Potter's letter to the London Lancet
comes at a very inopportune moment; it comes
when all England is aroused by the voice of the
* Thunderer ' in proclaiming the spirit of intol-
erance, bigotry and persecution which still ani-
mates the traditional school in its attitude towards
homoeopathy. It comes at a time when the
people — and, really, they are the ones upon
whom we exercise our art, for whose benefit, or
destruction, medicine exists, and who are most
interested — are least prepared to lend a willing
ear to those who wish to insinuate that all ho-
moeopaths are either * frauds or fools. ' The
* Thunderer ' says that they are not.
" When Dr. Potter abandoned our school, did
anyone go with him ? No ; he went alone.
" That makes three. "
SELAH.
68
THE MEDICAL ERA.
[Vol*. VL HO.S.
HOMCEOPATHY IN ITS RELATION TO MALIG-
NANT DISEASES.
By JOSEPH SIDNEY MITCHELL, M.D.
CHICAttO.
[An address delivered ander the auspices of the Almnnl Associa-
tion of the New York Homoeopathic Medical College.— Beprintfrom
th$ North American Journal of Homceopathy.]
SCANNING the records of the past we find that
all great movements that have marked their
imprint deep on the world's history, have
had much the same general course. Some men-
tal giant boldly leaps away from the dogmatism
and conservatism of the schools and announces
new views. A small following adopt them with
enthusiasm, then there is more extensive recep-
tion, later a quite universal acceptance, to be
followed by apathy on the part of many, deser-
tions by an inconsiderable number, then a revival
in the same or a new form and a deeper hold on
the minds of men than before. This is the epit-
omized history of all the great reforms, the great
parties and the great sects that have held sway
from Moses to Gladstone. That of homoeopathy
is no exception. What physician ever rapidly .
evolved such a wealth of research as that Jupiter
of medicine, Hahnemann? Has the devotion
and enthusiasm of his early adherents ever been
excelled ? It is not strange that we revere this
intellectual leader of our great school. What
grandeur of character he possessed — see how
rare he was even among the most distinguished
apostles of medicine ! In the wonderful breadth
of his knowledge, in the extent of his mental
endowments, in his interest in therapeutic meth-
ods, in that intense personality which quickly
gathered zealous adherents, in his capacity for
boundless work, in his unfaltering devotion to
the reformation of medicine from the errors with
which his sagacious brain saw it involved, he
stands a hero. Shall we not proudly say of him,
**He is our leader and our guide" ? And let us
remember he was no mere iconoclast. As he
remorselessly demolished the images of old phys-
ics he set up more worthy gods for our worship.
How rapidly his tenets spread until those mar-
velous statistics w^e yearly have presented at the
American Institute of Homoeopathy, seem al-
most beyond belief. The lukewarmness that is
inevitable, is manifest in some quarters. Have
we not indeed almost abandoned provings —
and do not some of us hanker too much after
the flesh-pots of Egypt ? Traitors we have had
but few. There are those who would drop the
name and merge us again with the great medical
body politic, where our identity would be lost ;
but there is no ** Ichabod " graven on the brow
of homoeopathy. The revival is to come, and
come it will, with full tide. Heroic souls now
stand in the breach, gather the records of the
past and give them to their followers of to-daj.
We stand on Pisgah heights — we see the Prom-
ised Land — the revival of homoeopathy; we may
not enter there, but those who come after will.
What is your homoeopath ? Is he the sectar-
ian your opponents claim, the exclusive dogma-
tist ? Not at all. Rather is he the one valid
exponent of freedom of medical opinion — the
one physician who alone of all medical men has
no limitation, to whom the whole glory of all
medical truth is open, with no shibboleth that
appals. The pure coin of the realm of scientific
medicine is his wherever he finds it, and he can
detect the counterfeit with almost alsolute cer-
tainty. When with a materia medica, which the
revival will bring, rich in new provings, purged of
the errors and contradictions of the old, he goes
to the new crusade against disease, he will lay
before us trophies far surpassing those yet laid
upon the altar of modem medicine. But, we
are asked. Upon what do you base your hope
for homoeopathy? The fact that therapeutic
methods are to be more cruciaUy tested than ever
before. W^e, who have turned over and over the
history of twenty centuries of traditional medicine
and with keenest interest studied in comparison
the ninety years of homoeopathy, know there is
no crucible too fiery in which to test our methods
and calmly await the result. In the whole range
of medicine, since Charon taught his pupils in
the recesses of a Thessalian grotto, to our day,
we have had little opportunity to study the nat-
ural history of disease. Every tribe has had
some decoction or charm to influence grossly
either the mind or the body, and the educated
physician is prone to interfere with every
morbid state. The metaphysicians boldly
assert that even the most organic of troubles
needs no medicine, and we have some records
that are useful from this new protest of out-
raged constitutions against drugs, this tacit
acknowledgment that even homoeopathy has not
yet demonstrated its power to wholly accomplish
the healing of the nations. A case of peritonitis
steadily going on to fatality under metaphysical
treatment gives us what the medical world has
rarely seen before. It is well for us to get as much
as possible of this natural history of diseased con-
ditions, this tertium canqyarationia of Ameke. We
realize that we have had but little of it hereto-
fore, yet we recognize its paramount value. Our
old school friends, with their expectant methods
and their medical nihilism, are also rendering
aid in determining the relative value of thera-
peutic measures. The more critical observa-
,1888.]
ADDRESS— MITCHELL.
60
tion of the noted sick provokes deeper inqairy
into our treatment and a more rigid criticism.
The conduct of the case of the Crown Prince
bids fair to bring no more laurels to our com-
panions over the water than did that of the
lamented Garfield to the regular profession here.
Note how differently these new conditions are
met by the two schools. The adherents of old
physic hopelessly plunge. After practicing vene-
section 2,000 years they abandon it under the
sway of homoBopathy, but a large quota still
hanker after it, and now and then its use is
gravely urged, and its abandonment deplored.
The life of many of their new drugs is ephem-
eral- Lately, we were to have anti-febriles to
put Aconite, Quinine and other old remedies in
the shade. Fever was to be a thing of the past.
They were all agog recently with Antipyrin, the
best of the group. Yet at the last International
Congress there was none so poor to do it rever-
ence. Does it not strike us that the drug at
once the most valuable and the most steadily
held in esteem through all the mutations of old
physic should have wrought in its use such
havoc to mankind? We do not need to look
back to Bacon, Henle and Sir John Forbes for
remorseless criticisms of the glaring defects and
inconsistencies of allopathy. Very recently H.
C. Wood said: "Yet with a babel of discordant
voices does it celebrate its 2,000 years of experi-
ence."
Lauder Brunton says: **We give medicine
at random with no definite idea of what it will
do."
Jacob Bigelow asserts that: ** It undermined
strength, started new morbid phenomena, and
left more disease than it took away."
Homoeopathy, however, goes right on in its
course. Its early disciples made proving after
proving. That was in the true line. We used
the proved drugs on the sick. It was scientific
medicine. We made simple deductions from
the facts and confirmed the law Hahnemann
gave us. It has never swerved from its alle-
giance to its law or its remedies. We have many
drugs as indisputably established as the Opium
of old physic. Not alone the polychrests, but
also among our new remedies we have Gelsem-
inum, whose specific action upon the paralysis
of small muscles following severe diseases is
uniform. We have Hamamelis and Hydrastis,
whose restorative effect upon diseased mucous
membranes is too well demonstrated to be
doubted. No babel of discordant voices comes
from us. Even the estrangement of the high
dilutionists from the body of the profession has
not been on an issue that impairs our faith in
the value of our drugs, or questions in any
degree the truth of the law of homoeopathy.
Whether tried in public cases under vigilant
scrutiny or compared with the natural history of
disease, it does not fail where failure is not
anticipated. Yet we are not without fault. We
ought to be willing to criticise ourselves as our
opponents do themselves. When we stopped
proving we fell at once from grace, and unless
we return to our colors we may find ourselves in
a slough of despond,' not perhaps as deep as
that of traditional medicine, but certainly fatal
to progress. Homoeopathists should return to
vigorously proving remedies, both old and new.
Whatever our deduction, the demonstrated fact
that such a remedy always produces such symp-
toms helps to establish medicine on a scientific
basis. Even the man who rejects ^imiZia will admit
that this form of experimenting with drugs
affords valuable data. Does not Dr. Brunton say :
'' Before therapeutics can become a science, the
physician must know the action of his drugs"?
The world has to wait centuries for a Galileo
and a Hahnemann — but we have Turners and
Wagners, DeLesseps and Edisons always. This
age demands very radical, even sensational
demonstration. Little stir is made when the
record of homoeopathy in Cook County Hospital
is announced in the most prominent old school
journal in America, the Medical Record. We
have secured a better death rate than can our
allopathic confreres, and the statement is
faithfully made. Note, however, the reason
which it gives. " It does not speak well for the
work of the old school staff," says the Record,
and it is claimed by a correspondent that th«
regulars, ivho have the excltidve assignment, take
all the interesting and bad cases, and leave the
milder ones to the homoeopaths. What charming
naivete — yfheit superb magnanimity — how an-
tagonistic to their usual methods; verily, we
may fear the Greeks bearing gifts !
Four years* hospital service has called espec-
ially to my attention, all the while, the difficulty
of reducing the comparative rate of mortality
between the homoeopaths and allopaths, and
the reason was, that in addition to the better
methods of our old school brethren, despite the
Record, our fatality was mainly from the maUg-
nant diseases. This suggested the choice of the
theme for discussion to-night. In considering
the relations of homoeopathy to maUgnant dis-
eases we may premise that under this head we
include not only those thus usually grouped,
namely: cancer, as one class; acute diseases
70
THE MEDICAL ERA.
(Vox. VL Ka t.
with malignant Bymptoms, such as typhoid
fever, scarlatina, cholera, variola, and diphtheria,
but all those whose tendency is inevitably to
fatality, as phthisis, morbus Brightii, Addison's
and Hodgkin's disease, and pernicious anaemia.
Carcinoma, which stands for one class, does
not, as the records of the Royal Arcanum and
other recent great public societies show, furnish
a fatality equal to that from suicide, yet it
apparently increases. But phthisis, Bright's
disease, and the fevers of the malignant type
give us nearly our whole mortality. Even in
our own city it is shown that about three-
quarters of all deaths are from phthisis. How
grand a field for therapeutics ! I yield to no one
in my admiration for what the late improvements
in abdominal surgery have done for humanity,
but it must be acknowledged they cut but little
figure in reducing the general mortality rate.
The question that specially interests us to-
night, is whether homoeopathy can do anything
more than heretofore to lessen the mortality
from malignant diseases ? Have we any
grounds for believing that our efforts will enable
us to accomplish cures where now they seem
impossible ? This is a matter for the most
earnest, thoughtful consideration. No claim
should be made that cannot be substantiated. In
its discussion it is necessary to review what
homoeopathy has done. First, we assert that it
can be demonstrated that it has had powerful
injQuence upon pronounced morbid conditions of
tissues, hence, it is fair to infer that a closer
study of it may lead to a kowledge of remedies
to reach even the gravest lesions. We have
indeed failed to convince all our opponents of
the value of our system, by our superior results
as shown by statistics, in the treatment of such
diseases as cholera and yellow fever, which are
characterized by great severity and fatality. They
either deny their truth, or dispute the cause, for
recoveries are many under any treatment. The
demonstration is satisfactory to us, and has made
no inconsiderable number of converts from
the ranks of the old school. Homoeopathy has
accomphshed all that the statistics of Grauvogl,
Dake, Ameke and others show, in reducing mor-
tality in the above affections, although such a
candid and broad minded man as Dr. Bowditch
regards them as <' little less than worthless.*'
We are thoroughly convinced ourselves. We
have, moreover, for our support what may be
called the unclaimed stattstics of homoeopathy.
These are not vigorously asserted and defended
as their prominence justifies. Homoeopathy has
wiped out all symptoms of syphiUs, save the
lightest, and absolutely shorn the disease of its
ancient terrors. It has shown that persons who
have been reared under its benign influence aie
rarely subject to inflammatory rheumatism at
any period of life. It has almost obliterated
puerperal fever from the families of our ad-
herents. It has vastly diminished the prevalence
of all the grave lesions, such as phthisis and
Bright's disease, and we may make honorable
mention of the great relative ease and comfort
which it has brought to the patient sick with
acute diseases. Can I better enforce the truth
of this last statement than by an actual in-
cident ? An old school member of a hospital
staff was one night vainly tiying, with best
intent, by means of most active measures to
torture back to comfort an apparently moribund
patient. The trained nurse finally expostulated.
''He will die if I do not interfere," said the
doctor. ** He will die if you continue," was the
calm response. "What would you do?" said
he. ''I would do as the homoeopaths on the
other side do. Leave him to me.*' " I will,'* was
the laconic reply of the doctor. The patient
was soon easier and made a good recovery.
Such actual experiences, it would seem, are often
enough repeated to have convinced the most
skeptical, but, as we have seen, the world still
needs new and sensational proof.
I have an abiding faith in statistics, albeit
they are received with such contumely by some.
At the Fifth Annual Convention of the Bureaus
of Labor, recently held at Madison, Wisconsin,
the Hon. C. C. Bonney said : " Law-makers
would do better work if they had better informa-
tion. Law is sometimes called the science of
human experience. Experience consists of facts.
Statistics are net facts classified. It is only by
study, classification and analysis that the prin-
ciples which give vitality to facts can be
discovered." The only means by which the
results of a wide and varied experience in any
department of life can be collected, classified,
analyzed and studied is that known by the name
of statistics."
At the International Congress at London, Sir
James Paget in his inaugural address said : '< In
thus speaking of the value of careful observation
and record of facts I seem to be in accord with
the officers of aU the sections."
We need the advent of the statistician in
homoeopathic medicine, and he should have for
his work the most superior education and ex-
perience. If we take 100 children of phthisical
parents, we clain that homoeopathy can save a
large percentage from the inroads of the
Mab., 18B&)
ADDRESS— MITCHELL.
71
disease, not alone from hygienic means enforced
in common with our old school friends, but
because of Galcarea carb., Kali carb., Phospho-
rus, Bryonia, etc., given as symptoms indicate.
A long continued and careful observation of cases
treated with and without remedies would be nec-
essary to establish such a claim. Our school is
the one which should, par excellence, undertake
this work. Unfortunately we have no statistics
that help us here, but the combined experience
of our physicians has brought conviction to us
already, and even Dr. Bowditch admits that we
"must rely largely upon the judgment and ex-
perience of those eminent in the profession. "
It is greatly to be lamented that we were nev-
er successful in having homoeopathic life insur-
ance companies on a large scale. I did all I
could to sustain them by failing with each of the
three companies that have been organized. I
don't know that I was the Jonah, but I clung
to them all to the death. May be, if every hom-
oeopath in the land had been as faithful, I would
not now hnnent the loss of statistics, not to men-
tion my unrequited shekels. It ought not to dis-
courage us that neither by statistics or argument
can we convince more men of the tr^th of our
law, for are we not hopelessly divided on every
prominent issue? The fact is that the large
majority of men will not take the time to exam-
ine any great question other than superficially.
How many of us to-day can make out a differ-
ential diagnosis between protection and free
trade, capital and labor, agnosticism and relig-
ion, or socialism and anarchy? All intelligent
men have a good general idea, but is it not like-
ly that many of us would change our views after
a special study of either of these subjects?
Just so with the medical world. The same rou-
tineism that makes it continue venesection for
2,000 years keeps it from investigating homoe-
opathy.
Since, then, the aggregate experience of those
eminent in the profession teaches us that many
a grave pathological condition is a sealed book
to the homoeopath, because the mild but effective
measures early adopted preclude the possibility
of the development later of serious lesions, it is
fair to make a statement that we have dimin-
ished cancer and phthisis largely by preventing
their outbreak. Yet we have shown this is hard
to establish in all minds. Can we make a more
absolute demonstration ? Can we take cases of
phthisis and carcinoma, already existent, and
cure them, so that not only the laity but the
whole profession will be convinced ? Let us ex-
amine the grounds on which we may hope we
can do this.
Carroll Dunham, whose saintship in homoe-
opathy none can deny, gave us the key-note to
the solution of this problem which we have only
to develop.
He says : '' If, then, our science of therapeu-
tics be not capable of adapting itself to, or dove-
tailing with, or making subservient to its use,
any exact related physical science, is not that
fact the condemnation of our therapeutics?
Pathology is the science of functions as modi-
fied by disease, and pathological anatomy the
science of tissues so modified by disease. Using
the word symptom in its largest senile as a mod-
ification of funtstion or tissue, or both, pcaJyoiogy
i$ therefore the science of symptoms.'* How true
this! Can not we all assent? There is the
close connection always between symptoms and
pathological conditions. Indeed it is likely that
the tangled web of pathology will yet be unrav-
eled by symptomatology. Tet Grauvogl says
plainly how uncertain a guide pathology has
been in furnishing us indications for treatment.
Other prominent men in our school have from
time to time inveighed against pathology. Those
who advocate, and those who deride pathology,
simply look on opposite sides of the shield.
Hahnemann denounced in bitter terms the pa-
thology of his day. Tet in chronic diseases he
says : <' The first duty of a homoeopathic physi-
cian, who appreciates the dignity of his character
and the value of human life, is to inquire into
the whole condition of the patient, the cause of
the disease, his mode of life, the nature of his
mind, the tone and character of his sentiments,
his physical constitution and especially the symp-
toms of the disease." Is that mere symptom
hunting? Is any better evidence needed that
he valued pathology in its true relation ?
Again we find that Dunham saw both sides of
the shield, for he further says : "But if divert-
ing pathology from this its legitimate function,
the homoeopathists construct by its aid a theory
of the essential nature of the disease, and a the-
ory of the essential nature of the drug effects,
as that the one or the other depend on a plus or
minus of some blood constituent, or on such or
such a cell change, or on such or such a struct-
ural lesion, and if he draw his indications for
treatment trom such a theory, he introduces in-
to his therapeutics the same element of hypothe-
sis against which Hahnemann protested, and in
so doing he diverges from homoeopathy towards
the blind uncertainty of older therapeutics.'*
If, then, pathology in its wide sense is the
science of symptoms, it is by a study of symp-
toms alone that we can learn the correct pathol-
ogy. Under such a method of observation this
72
THE MEDICAL ERA.
[Vol. VL Ko. S.
branch of medicine ceases to be guess work. No
longer will we have a different view of the path-
ology of a morbid state by each authority, vary-
ing with the fashion of the times, but it will be
as fixed as semeiology. The reason it has here-
tofore failed to be of service to therapeutics is
because it has been worked from the wrong end.
Take pathology as represented by its most true
method of expression, viz., the symptoms, and
it at once becomes an aid to therapeutics.
With these views concerning the relation be-
tween pathology and symptoms let us take a
case of phthisis. We have the same train of
phenomena as in any inflammation, viz., afflux of
blood to the parts, stasis, products of inflamma-
tion with their degenerative changes plus some
unknown factor that renders the train of morbid
processes unamenable in the end to present
methods of treatment. The specific nature/ of
this is as unknown as it was before the bacillus
tuberculosis was discovered. Laennec divined
it, as the geniuses in medicine so often do with
their unerring prescience.
So with carcinoma. In its essential nature it
consists of cells very like the physiological cells,
epithelial and endothelial cells, colorless blood
corpuscles and gland cells. It is merely the
subsequent specific metamorphoses in these that
give rise to disintegration of the part or organ
affected. Is this specific change the same or
different from that which urges the tuberculous
exudation on its destructive career ? Have we
as homoeopaths done our whole duty in inter-
rogating the symptoms of the diseases with a
view to unfolding their pathology and therapeui
tics ? I am a positivist in medicine. Great is
my faith in the vis medicatrix natura, but great
also is my faith in simUia. Did not Hahnemann
announce by study of symptoms that Veratrum,
Cuprum, and Camphor were the homoeopathic
remedies for cholera ? Can we not study symp-
toms of phthisis and carcinoma and reach cures ?
It is because we do not study that we do not
cure. There are more laws in homoeopathy than
we dream of. We must find them. Let us not
allow our old school friends to hit on ways and
means and actually filch from us our good
things. The study of Phosphorus shows us that
it has symptoms adapted to that condition where
commencing exudation has already blocked
many an air vesicle. What follows its use ? Ab-
sorption and resumption of vesicular breathing
over closed areas. Phosphorus causes fatty de-
generation. We have then a pathological expla-
nation of its action. Moreover, there are clearly,
during the period while these pathological
changes are going on, the special symptoms of
Phosphorus. May it not be possible that the
transforming element from the benign to the
malignant, instead of being some vital, chemi-
cal, biological, mechanical process,is merely in
each case some simple aberration, different for
each individual, and when we know it, plainly
enough manifest by the special symptoms ?
Cases of phthisis are similar in their main
pathological features and general symptoms,
yet how unlike in detail. Each one has its own
individuaUty. Cover the patient's face and ed-
ucate yourself day by day with the symptoms,
and you would learn your cases as readily as
by the features. Many homoeopaths have all
along worked at them too much on general prin-
ciples. Pathology studies the disease in its
special details and finds it can make a clear dis-
tinction between the fibrous, tuberculous and
catarrhal forms and recognizes to a certain ex-
tent the fixed. We can go further and offer
special symptoms for each case and individualize
under each form. To illustrate : take two cases
of fibrous phthisis ; while quite similar in. gen-
eral features, one will have a cough, hacking
and mildly irritable ; another will have more
violent paroxysms ; the mental symptoms of one
will be mild melancholia, the other will present
the usual cheerfulness. Thus we draw finer and
finer distinctions all the while. It is just here
our varied symptomatology comes to our aid.
To illustrate further the point just made, we
may cite that a case of phthisis now under treat-
ment had this peculiarity: hemoptysis every
night at two o'clock, waking the patient out of
sound sleep. I found nothing to correspond,
but from analogy gave him China ; the next day
the patient said delightedly, "You have struck
it." There has been no hemorrhage since, and
the patient's condition is vastly improved.
Query : Was the morbid process timely checked ?
Now how certainly may we depend upon this
sjmiptom of periodicity in China to help us in an-
alogous cases. We have established periodicity
as a law of China just as we have that Natrum
mur. will aggravate at eleven and Kali carb. at
three. Doubtless we can go as far with many
of our other remedies. How much further ad-
vanced than our old school confreres we are,
whose clinical therapeutics, according to H. C.
Wood, have established scarcely anything but
these principal facts, that Opium will allay pain
and lull to sleep ; that Quinine will arrest an in-
termittent (sometimes) and that Salts will purge,
Virchow thought, if biology and etiology once
became complete we should have a rational
MAB., 1808.]
ADDRESS— MITCHELL.
78
therapy. But just now biology is under a cloud.
Semmola, at the last International Congress,
ably showed the failure of the microbe, and
Boscoe, at the late meeting of the British Asso-
ciation for the Advancement of Science, said :
"The microscopist must again give way to the
chemist. It is by chemical rather than by biolog-
ical investigations that the causes of disease
will be discovered and the means of removing
them obtained." They have been equally at sea
on etiology. Speaking of the prevalence of ty-
phoid fever in large cities this fall, the Louis-
ville Cinmer-Joimud says: **The cause of the
disease and the source of the disease are as
mysterious as ever." ** It comes from the well
water,*' declares one class of physicians dogmat-
ically ; but, it is as frequently in houses where
no weU water is used. ** It comes from the sew-
er attachments," is the opinion of others, but
the absence of sewer attachments is no safe-
guard, as the experience of many households
show. It is, others think, due to impure milk,
but it invades families who have cows of their
own. It is due to change of chmate, but it
attacks the oldest inhabitant. It is due to over-
work, and yet it attacks idlers ; it is due to men-
tal anxiety, and yet it numbers among its victims
those who never had a careen their lives." This
lack of knowledge must be charged to physicians
themselves; there should be a report of each
case of typhoid fever in which all the circum-
stances should be given. If it were possible to
have such reports cover the past five years we
should know just how much influence water,
air, sewer gas, employment, location, high liv-
ing, poverty, dark cellars, new buildings, new
streets, and other conditions, have in propagat-
ing or perpetuating disease. It would be wise
to have such reports uniform, and to embrace
every fact bearing on the subject. The reports
could be systematized by the health officers in
every city, and in a little while, with this com-
prehensive plan, some trustworthy conclusions
would be reached. From these considerations
we are urged to further investigation. We must
push aside those to whom every new idea is a
h&e noire.
Homoeopathy has laws. It has its cardinal
law upon which it was founded, but the laws of
the adaptation of remedies are still to be given
us. Not only will we have provers, but we will
have laws governing the selection of remedies
from the provings. The harvester gamers the
wheat, but a finer process gives us the snow-
white flour. In the discovery of these laws how
fertile the domain of malignant diseases!
Through their study we can place medicine, and
especially homoeopathic medicine, on a plane
higher than it has yet occupied, with no more
than a year's effort. Suppose every homoeo-
pathic physician would for one year take this
most accurate description of symptoms and phys-
ical signs of d single phthisical patient, keep close
records of each prescription and its results, rea-
sons for giving, etc. Each observer would thus
be in a way a specialist. Then, let these results
be carefully tabulated and studied. What val-
uable information we should secure ! Some of
the reports might be of little value, both from
carelessness of detail and observation, but we
could glean a rich fund of knowledge. If our
previous statements are accepted, we can readi-
ly see the results would be startling. We may
find that the pathology will always be manifest
from the effects of the drugs, for we shall learn
that given effects always sub-tend given morbid
conditions.
It is not a reproach that we cannot now X^ure
the malignant diseases. As reasonably might
we ask the theologian to rid the world at once of
all sin. We may inquire. Are we not already
abreast of the times ? Look at politics, theology,
science, exact, methodical science, and see what
wide differences of opinion, what sects, what dis-
sensions exist. It is only the crank who asks for
perfection before its time. It is urged, as we are
all painfully aware, that medicine has advanced
least of all, in an age when startling invention
succeeds startling invention. Telegraph, tele-
phone, phonograph lead the human brain to
instant conclusions that in the days of Guten-
berg would have taken indefinite time. In the
mental development that this productive envir-
onment generates, every branch of human knowl-
edge forges rapidly ahead. Medicine is not
behind, but to make her perfect as a science
will require yet more than one generation. One
of those doctors "who always go on foot and do
not cover much territory," succeeded a popular
and successful physician in the treatment of a
stubborn, chronic case. He said of his prede-
cessor that he was too busy to have charge of
such a case. There is food for reflection here.
Take any case of severe disease. How much
careful, patient study, involving hours, must be
given it before we have mastered its complete
semeiology. Then the treatment may be quite
quickly determined at first, but to study its re-
sults carefully and note them with exact judg-
ment, require both time and good mental poise.
A lawyer takes hours and days for an opinion
involving property. We take minutes for an
74
THE MEDICAL ERA.
[Vol. VL Ho. S.
opinion involving life. Hospital and private
practice are alike. How difficult it is to secure
full and complete records of even hospital cases.
We may put down what seem to be the salient
points, but many hourly and even minutely
changes are always unrecorded. What would the
proper treatment of a case of phthisis involve ?
We should, to illustrate, make a careful physi-
cal examination; then, having noted residts,
take the rational signs, then prescribe; then
each day, or at least tri-weekly, we should re-
examine to see the physical changes, and take
down changes in symptoms. One man in a hos-
pital could not take over four or five cases a day
and make proper records. A lawyer is well con-
tent to familiarize himself day by day with the
details of a single case until he has mastered it.
Not alone do we require capability on the part
of those who report cases, but honesty and
judicial, unprejudiced minds. Since, then, we
encounter difficulty not alone in obtaining reliable
statistics, but in convincing opponents after we
have secured them, we need data that will hold
undisputed sway. In no domain of medicine
are we more likely to find them than among
malignant diseases.
It may here be noted that at the last German
Congress of Medicine the belief in the curability
of one-fourth of the cases of phthisis was boldly
announced. If such results are attainable by
old-school methods we ought to accomplish yet
more with our superior therapeutics.
Superior as we are, we are yet too overly
charged with routineism. As Bacon says:
** Much iteration, but small addition." To aid
in the selection of our remedies we must break
the bounds of routineism. If we only will, who
doubts the probability of our obtaining before
long the assigning of definite laws for the selec-
tion of the remedy ? If Phosphorus acts best
on the lower lobe of the left lung, depend upon
it there is a reason for it. Our present process,
which fits the remedy to given symptoms, rests
simply upon the -selection of a correspondence.
Pure memorizing, which we all fail in as we
grow older, however active and retentive our
youthful memory may have been, should cer-
tainly not be the only qualification for the old
and experienced practitioner to aid him in the
choice of a therapeutic agent. Homoeopathy,
which, mainly upon this basis, has already
helped to bring medicine nearer the position
held by other sciences, will raise it still higher
when the laws governing the choice are better
defined, as defined they will be. When I hear
homoeopathy decried by its foes, or see it tem-
porarily abandoned by its adherents for the
random medicine of the old school, my indigna-
tion is fervent, and I am only consoled by the
words of Him who said, ** Father, forgive them,
for they know not what they do." Bead the
lamentations of the great lights of orthodox
medicine over the failure of its two thousand
years of therapeutic experience, and ask why we
should turn back. Bather let us with the mar-
velous light which homoeopathy has already
given, further develop it, until we have a dem-
onstration that will convince the most obdurate.
If physiology and pathology, as ordinarily
applied, fail in establishing a therapy, and ho-
moeopathy has furnished us the most scientific
basis for one we have yet had, may it not with a
more complete development accomplish the cure
of both phthisis and cancer ? Grauvogl says :
" Again even pathological anatomy takes upon
itself to decide upon the curability or incurabUity
of pathological exudations for which it has no
right." We have already seen phthisis to be an
inflammation plus the unknown factor. This
unknown factor, this algebraic x, has its eviden-
ces in special symptoms such as lead us to the
idea of incurability, viz : unamenability to med-
icine and steady progress without self -limitations.
But this same homoeopathy, better than any
other therapy, establishes in some of the malig-
nant diseases susceptibility to medicine retarda-
tion, of course, and cures. Why should typhoid
and variola exhaust themselves and phthisis
and cancer continue until the patient is exhaust-
ed? Is it not because of .the condition of the
constitution antecedent? Carefully interrogate
symptoms, tabulate them, and note their logical
results. Then we find that the aversion to la-
bor, melancholic mood, catarrhal tendencies,
neuralgic pains in the chest, and dyspeptic
symptoms are long antecedent to the physical
outbreak. Homoeopathy alone offers remedies
for the cure of all these prodromata.
In the discovery of a guide for remedies we
step aside from the special symptoms of the
disease to the constitutional or concomitant
symptoms — thus Grauvogl suggests for croup,
with its well known phenomena, which may have
few accompanying symptoms. Copper when spas-
modic conditions prevail; Ipecac, Iodine or
Bromine when associated with intermittents and
neuralgias, and Hepar with angina, urticaria,
erysipelas, and felons. Then again to the pa-
tient with chlorosis, with uterine and pulmonary
hemorrhages, phthisis, scrofula, inflammation
of the eyes, diarrhoea, ascarides, etc., Iron-
Chlorosis, with affections of the lamyx and
.1888.1
ADDRESS— MITCHELL.
75
bronchi, Chlorine ; sweating of the feet, Cuprum ;
chlorosis, with melancholy, hysteria, disturb-
ance of the heart and kidneys, discharges from
the ear, Pulsatilla.
Duchenne recommended the Faradic current
for the paralytic form of writer's cramp, and
states that the spasmodic form made it worse.
Nunez found a pneumonia with a miliary erup-
tion, and straightway a more successful treat-
ment. Thus we made our distinctions more and
more definite until a concomitance of special
and general symptoms will always give the
knowledge of the remedy. Homoeopathy shows
that our distinctions need to be so fine that in the
treatment of disease we look to the color of the
hair and eyes, and even the weight of the body.
These facts, and many others that might be quot-
ed, show that the whole secret of successful
treatment hes in the power of differentiation.
Homoeopathy, with its wide range of symptoms,
famishes scope for the most exact differ-
entiation, but it does not always cure. We
must be more than mere symptom-hunters.
Should we not press this differentiation to the
development of the relations of the special
symptoms of each case to its special pathology ?
Our ninety years of homoeopathy has giv-
en us the most scientific materia medica we
have, and ample clinical verification which we
can place against the babel of discordant voi-
ces of the 2,000 years of allopathy. It is for
homoeopathy, with its exact therapy, to still fur-
ther follow out on the same line of study the
treatment of malignant diseases. There is an-
other relation in which homoeopathy can do
more for malignant diseases than it has done
heretofore. We can prove new drugs, and re-
prove old, and establish their applicability to
them. In the treatment of carcinoma, Chloride
of chromium, Chian turpentine, Carbolic acid and
Arsenicum have not received at our hands the
consideration their symptoms and clinical exper-
ience demonstrate they should. Let us do
better than the knife and certain recurrence.
Since Arsenicum in potency has cured epithelio-
ma, may it not, if early used, have power over
other forms?
Note the value of Phosphorus as indicated in
the case of Addison's disease, which I reported
at the meeting of the American Institute at Put-
in-Bay in 1878, and here I venture to add that
not only did the symptoms indicate it, but I was
able to trace the relationship of the disease to
tuberculosis, as one of its many forms — a view
which, I am glad to say, is lately confirmed by
other obBervers.
Calc. jod. will cause separation and extrusion
of a uterine fibroid. Calc. carb. should be writ-
ten in letters of gold in every family where there
is marked scrofulosis, for the silent, constant
improvement it can steadily effect. Scrofulosis
is the child's tuberculosis, and curable in most
instances unless it takes the form of basilar
meningitis, when it assumes the malignant
character.
Few indeed will be the cases of malignant
glandular disease when these or other indicated
remedies have been used as the dyscrasia first
announces itself.
Our minds are so imbued with our ability to
cure in certain directions, and how to rid pa-
tients of their numerous ailments, that we lose
sight of our helplessness in malignant cases of
diphtheria. Even now in the various cities and
towns of our land it is raging with special viru-
lence, and our school has little power over some
of its worst forms. If the claim is true that one
of the most malignant epidemics was cut short
at once by Sulphur, which was specially indicat-
ed by the characteristic symptoms of that par-
ticular epidemic, and that no fatal case occurred
after its use, we are encouraged greatly in the
hope that the similimum may be found for all
forms.
It is well worth the establishment of a medi-
cal commission, able and well paid, to investigate
this matter alone.
Now and then such an experience as this oc-
curs to every physician : A patient of mine with
acne had been to several prominent physicians /
in Chicago and Boston, one, at least, a most /
competent dermatologist. No means had been /'
spared, and the finest talent of both schools^'
homoeopathic and allopathic, had been for montHs
invoked in vain. A Paris physician, I d^ not
know of what school, cured the case with a sin-
gle prescription of some herb. That it, ^as not
a chance result has been attested by stibsequent
success in similar cases. The cure/^Of the acne
in each instance was attended with marked im-
provement in the general health^
Wolff cured writer's cramp in fifteen days by
massage. Every such cure ^ould be thoroughly
sifted and its exact relati^aiti to therapeutics es-
tablished. /
It has been said thsrt semeiology has been ex-
hausted. In no fv^nse, when, as Paget says:
** We are occupiei^with all varieties in all class-
es of men, of ev^jiy age and every occupation, in
all climes an^ in all social states, men singly
and in multitudes, in poverty and in health, in
wise and unwise living, in health and all varieties
/
76
THE MEDICAL ERA.
[Vol.. VI. No. 8.
of disease, and we have to learn the results of
all these conditions of life, while in successive
generations and in minglings of families they
are heaped together, confused, and always chang-
ing. " It has no more been exhausted than has
been the proving of drugs. Never mind the
3,000 symptoms under Sulphur, I can find 3,000
symptoms in diseased conditions to match.
A phthisical patient, with all that the name
implies, weighing only eighty pounds, and in a
far advanced stage of the disease, lately came
on with menorrhagia. Bemember Watson's sign
of the little old woman with the red hood and a
broom as the aura of the epileptic. Show me a
patient and I will, with a little eliciting, show
you a new symptom. What we need is not few-
er symptoms, but more laws governing the re-
lations of these symptoms to the selection of the
remedy. Development in this matter requires
the slow process of mental evolution that obtains
in all sciences. Symptoms are our guide, and
will surely lead us not only to a correct therapy,
but to a correct pathology.
It is matter for regret that the nature of the
subject has made this paper more suggestive
than demonstrative ; but let us, who tenaciously
hold to homoeopathy, still further develop its
provings, interrogate with deepest scrutiny the
symptoms of all diseases, investigate their rela-
tions to pathology, and strive with intense in-
terest for the discovery of new and well defined
laws of administration. When we survey the
field and see what is to be done in semeiology
and therapeutics, and accept that it is in these
very departments that our strength lies, we are
derelict to our duty if we do not labor zealously
and endeavor to bring results that will so affect
our mortality from malignant diseases in a fa-
vorable manner that there will be no one left
who will not rise up and call homoeopathy blessed.
This may mark a new era in medicine. With
the Malthusian doctrine we have nothing to do.
Our business is to save every human life we can.
While we look on with awe at the irresistible
evolution of the race, with Nihilism rampant in
Russia, with Socialism strong in Germany, with
France convulsed with internal dissensions, with
London menaced with those riots, which not
only stir this greatest of aJl cities to its depths,
but strike terror to the heart of the civilized
world, with the bombs of anarchy lately in our
midst, and with the financial anarchist slowly
but surely strangling the life out of thousands
of helpless victims, my spirit rises into the
realms of prophecy, and I see the doctor settling
the whole queston, as with a more subtle and
enlightened therapy than ever before obtained,
he purges our poor human nature from those
physical and moral congestions that are the
mainspring of all our vices.
In our noble work may there be naught but
harmony. Men's minds are not alike. How
stupid they would be if we were all cast in the
same mould ! Let the man of statistical turn
render his aid ; let the imag^ative man arouse
us with his fancies, the philosophic man with
speculations, the acutely observant man furnish
clinical facts, the practical man, instruments,
and the scientific man evolve new laws. Above
all, let us remand to the infernal gods from
whence it came, all vituperation either of each
other or our opponents. Let us take in all un-
til among the 200,000 medical men in the world
there shall be that concord and unity that will
with a single purpose focus our medical knowl-
edge upon a plane within the ken of every ob-
server. May we be so earnest in this study
that the years shall be few before homoeopathy
can say even of the malignant diseases, '< Leave
them to me. "
PULaUE IN ALBUHINUBIA.
By R. N. poster, M.D.
CHICAGO.
ABOrX two months ago a gentleman residing
in this city, who had been imder my care
for diabetes for four years, and whose
diabetes had disappeared, but only to give place to
albuminuria, called my attention to a printed
circular which be had received. The circular
called attention to a preparation of the juice of a
species of Mexican cactus, and recommended the
same modestly as a remedy in Bright's disease.
The juice, which looks and tastes something like a
sample of well-watered and badly spoiled milk,
is put up in great bottles, and is used as a food —
about one-third of a bottle daily. My patient
asked my advice respecting a trial of it in his case.
Inasmuch as his urine now exhibited about seventy-
five per cent of albumen ; as his legs and feet were
enoimously swollen, his abdomen dropsical, his
lungs oedematous, his heart tired, and the toes of
his left foot gangrenous — one toe having sloughed
off entirely ; inasmuch as he could only sleep in a
chair, the recumbent posture being impossible ;
and as he was daily growing worse in every respect,
notwithstanding months of careful treatment ; as a
matter of course I recommended him to try a few
bottles of Pulque.
There was at that time none to be had in this
city, but after some delay a few bottles were ob-
tained from St. Louis by express, and my patient
commenced its use. Immediately, I may say with-
]iA]L,i8e&i
ORIGINAL ARTICLES
77
in twenty-four hours after taking the first drink,
there was an increase in the quantity of urine
passed, and a marked diminution in the quantity
of the albumen. The improvement continued every
day, until at the end of four weeks' use, the albu-
men had fallen to about twenty per cent, with a
corresponding improvement in all other respects,
with the one exception of the oedema of the lower
extremities. This remains unchanged. The sugar
in the urine has not yet reappeared. The patient's
appetite has improved. He sleeps better. His ex-
hausting dyspnoea and cough have ceased. The
improvement, when we consider the advanced stage
of his disease, is worthy of the utmost considera-
tion ; and it is doubtless due to the Pulque.
Seeing the prompt effects of this food in his
ease, I recommended a trial of it by a lady who
two years ago suffered from the albuminuria of
pregnacy in its worst f onn.
The case had progressed before discovery to
oedema of the face and upper extremities, and vio-
lent cephalalgia She was at the eighth month,
and the urine passed was two ounces in twenty-
four hours, and it became literally solid on heat-
ing. Labor was hastened and we escaped with a
slow recovery, but with a chronic albuminuria
which nothing could reduce below about seven per
cent of albumen. Nothing seemed to alter this per
centum. Months of treatment, almost daily obsier-,
vation, many remedies, water, foods, — all failed to
produce the slightest apparent effect Meanwhile,
with the exception of a doubtful cardiac lesion, my
patient was in apparent good health.
Here now was a test- case for Pulque. The urine
was tested. The albumen was still there in the
fixed amount Pulque was taken for one week.
Again the urine was tested. The albumen was
not there.
My third case was that of a lady advanced to
her seventh month in pregnancy. The usual symp-
toms, cephalalgia, dyspnoea, oedema of the face
and upper extremities, extreme restlessness, and
so forth, led to an ei^amination of the urine. It
proved to contain seventy -five per cent of albumen.
After three days use of buttermilk and Pulque, the
albumen was reduced to a mere trace. Suddenly
it increased for two days, then again disappeared,
and has continued for several days to exhibit the
merest trace of its presence. Meanwhile the sug-
gestiTe symptoms above mentioned, have all van-
ished, and tiie woman seems to be in perfect health.
The fourth patient is one under the care of my
colleague, Dr. Geo. F. Washbume. Her condi-
tion was in all respects very similar to that of the
patient just described ; so much so that the same
description will serve for both.
Twenty-four hours after she began using the
Pulqae, the albumen had f aUen off from seventy-
five to ten per cent In two days it had returned
to the larger volume, and further reports are
awaited with interest
These four cases speak for themselves. They
are certainly sufficient to justify a report of pro-
gress. The disease in question is among the most
formidable and least tractable with which we have
to contend.
From the above experience I cordially recom-
mend to the readers of the Era a trial of Pulque
in the albuminuria of pregnacy, of scarlatina, and
of Bright's disease properly so called. For that
matter it ought to be tried in all forms of album-
inuria. If a food has been discovered which can
deliver us from the terrors, and our patients from
the dangers of puerperal eclampsia, it is indeed of
inestimable value. It is too soon to claim this for
Pulque, but I should not feel justified in with-
holding the results of my brief experience, when
by making it public experiment on a wide scale
becomes immediately possible.
n.
BHIiriTIB VA80-M0T0RIA PE&IOBIOA.
BY B. LIPPINOOTT, M.D.
MBXFHI8, TBNN.
History. — This disease was first known or
written of in England, having first made its ap-
pearance there. On page 191 of the second
volume of the " Practice of Physic, *' by William
Cullen, M.D., published in 1793, under the head
of Asthma, he says : " In some persons the fits
are readily excited by external heat, whether of
the weather or of a warm chamber, and par-
ticularly by warm bathing. In such persons fits
are more frequent in summer, and particularly
during dog-days, than at colder seasons."
Judging from the above, Dr. Cullen must have
met with hay asthma in his day. Hay fever
was first written of by Heberden, who made
some remarks which show that he had recog-
nized the affection as distinct from the usual
catarrhal and asthmatic troubles, and unique in
its annual recurrence. He ventured no opinion
concerning its causes, and did not seem to know
anything of its real nature. It was first de-
scribed by Dr. John Bostock, of London, in 1819,
in a paper read before the Medico-Chirurgical
Society of London, in which he described his own
case under the title of, "A Case of the Periodi-
cal Affection of the Eyes and Chest." This gave
origin to the term "Bostock's Catarrh." In
1828 he read a second paper on this subject be-
fore the same society, and gave a more length-
ened account of the disease, paying attention to
special symptoms which distinguish it from
other complaints resembling it. In his second
78
THE MEDICAL ERA.
[Vou VI. Ho. a.
paper the disorder was called **Catarrhu8 iEs-
tivus," or ** Summer Catarrh." He described a
form of the affection corresponding in its main
features with what is now known as **Eose
Cold," or ** June Catarrh." In the nine years
intervening between the two papers, no other
notice of the disease appeared in printed form,
but Bostock had either seen or had received
distinct accounts of eighteen cases in addition
to ten others in which the accounts were less
perfect.
In 1828, Dr. Macculloch mentioned the dis-
ease, and in speaking of its causes, said: ''It
is produced by hot-houses, or green-houses, and
in the public estimation it is particularly
caused by hay fields." In 1829, Mr. W. Gordon
published his "Observations in the Nature,
Cause, and Treatment of Hay Asthma." In
1830 Mr. Augustus Prseter published a short
notice of a case he had seen in Paris, some
years before. Dr. Elliot son noticed the disease
in his lectures in 1831. In 1833, he gave a
fuller account of the malady. In 1839, he men-
tioned pollen as being the probable cause of the
affection.
In 1854, Dr. Phoebus (professor of medicine
at the University of Giessen) gave an analysis
of 300 cases. In the early part of 1859 he sent
out circulars, which were published in various
medical journals in Europe and America, invit-
ing medical men aU over the world to send him
answers to a series of questions so framed as
to embrace every possible kind of information
about the causes, symptoms, and progress of the
disorder, its periods of prevalence, geographical
and ethnological distribution, and its prevention
and treatment. Although this disease is more
prevalent in England and America than in any
other parts of the world, it was to the above
mentioned German author. Dr. Phoebus, that
we are indebted for collecting and putting into
an available form all that was known of hay
fever up to the time of the appearance of his
monograph in 1862. He was not himself a suf-
ferer from the disease.
In 1860, Dr. George Wyld, of London, gives
as the probable cause, ** the pollen of hay float-
ing in the air." In 1865, Dr. Wm. Abbotts
Smith issued a second edition of his ** Observa-
tions on Hay Fever, Hay Asthma, or Summer
Catarrh." In 1866, a fourth edition of the same
work appeared. In 1867, Dr. Wm. Pirrie is-
sued a monograph on ** Hay Asthma, or the
Affection termed Hay Fever." In 1869, Dr.
George Moore issued a monograph on ** Hay
Fever, or Summer Catarrh : its Causes, Symp-
toms, Prevention and Treatment." In 1868 the
distinguished physiologist, Helmholtz, claimed
to have discovered in the nasal secretions of
hay fever patients, certain low vegetable para-
sites — vibriones — to which he ascribed the
origin of the disease. This discovery was after-
wards said to have been confirmed by several
others. On the other hand, other microscopists
of equal reputation have failed to substantiate
the discovery, even with high magnifying powers.
In 1870, Dr. W. C. Roberts published a paper
on **Catarrhus iEstivus, Hay, Rose, or Peach
Cold, or Asthma," in the laJew York Medical Ga-
zette, Oct. 8th, 1870, in which he claims priority
of discovery of, and wished due credit awarded
for, the symptom of excessive coldness of the
end of the nose, which he considers ** as the
pathognomonic one."
In 1872, Dr. Morrill Wyman, of Harvard
University, published a work on "Autumnal
Catarrh," containing a record of eighty-one
cases, and maps giving the boundaries of its dis-
tribution throughout the United States. He
deals with the question of heredity, as well as
the geographic and chorographic relation of the
malady. Although a sufferer from the disease,
he does not seem to have any settled or exact
opinion of the nature of its cause.
In 1873, Dr. George M. Beard, of New York,
published a treatise on ** Hay Fever," or " Sum-
mer Catarrh," and in 1876, published a mono-
graph on the same, in which he attempts to
demonstrate that a large per cent of hay fever
sufferers are of the nervous temperament, and
that the exciting causes are very numerous, and
not limited to pollen, as had previously been
maintained by the majority of writers.
In 1873, Dr. C. H. Blackley, of Manchester,
England, reiterated ElUotson's opinion, that the
affection is caused by pollen^ and demonstrated
by a series of experiments — which began in 1859
— its role as a causative influence in this disease.
In 1880, in his ** Hay Fever, its Causes, Treat-
ment, and Effective Prevention, Experimental
Researches, Second Edition," he has sifted and
re-arranged this mass of evidence after a more
logical method, and collected additional evidence
to substantiate it.
In 1875-76, Dr. Elias J. Marsh, of Paterson,
New Jersey, made experiments on the causes of
hay fever, after the plan pursued by Blackley,
recommended in the first edition of his work.
In 1877, he read an essay, on **Hay Fever, or
Pollen Poisoning," before the New Jersey State
Medical Society. He attributes the cause to
pollen. To him we are indebted for the term
" Rag- weed Fever."
Xab., IMSl]
ORIGINAL ARTICLES.
79
In 1883, Dr. W. H. Daly, of Pittsburg, Penn.,
pablished a treatise, in which he attributed the
cause of the annually recurring attacks of hay
fever "to local chronic disease of the nasal cav-
ities, upon which, the exciting causes act with
eflfect/* adding that '* the parts should be put in
order, and thereby enable them to withstand the
exciting influence of the next recurring crop of
bacteria." Dr. Daly was the first writer to call
the attention of the profession to, and to dem-
onstrate, the relation of hay fever and disease of
the nasal cavities. In the iVe/r York Medical
Journal, May 12th, 1883, Dr. John 0. Roe advo-
cated the same theory, and stated **that hyper-
aasthesia is associated with, or occasioned by, a
diseased condition, either latent or active, of the
naso-pharyngeal mucous membrane," and *'tliat
the removal of the diseased tissue in the nasal
passages removes the susceptibility of the in-
dividual to future attacks of hay fever."
Dr. C. E. Sajous, of Philadelphia -^ unac-
quainted with the papers of Daly and Roe —
published an essay entitled '* Notes on Hay
Fever," in the Medical and Surgical Reporter,
Dec. 22nd, 1883, in which he advanced the
opinion '* that hay fever was due to an idiosyn-
crasy on the part of certain individuals to
become affected by certain emanations ; that
organic alteration of the surface of the nasal
mucous membrane altered its sensibility and
destroyed what morbid irritability might have
attended the nervous filaments distributed over
it," and, furthermore, that ** hypertrophies of
the nasal membrane increased its irritability and
the intensity of the symptoms." In 1885, he
published a monograph on " Hay Fever, and Its
Successful Treatment by Superficial Organic
Alteration of the Nasal Mucous Membrane,"
illustrated with thirteen wood engravings.
Dr. Harrison Allen, of Philadelphia, in an
article in the American Journal of the Medical
Sciences, January, 1884, on the treatment of hay
fever, attributed the disease to permanent or
temporary obstruction of one or both chambers,
and advanced the opinion that by overcoming
this obstruction by the usual methods, a cure
could be effected.
In the New York Medical Record, July 19, 1884,
Dr. J. N. Mackenzie, of Baltimore, suggested
the term **Coryza Vaso-Motoria Periodica,"
on the ground that **the disease is essentially
a coryza, showing, in most cases, a decided
tendency to periodic recurrence, and dependent
upon some functional derangement of the nerve
centres as its predisposing cause."
In 1884, Dr. Morell Mackenzie, of London,
delivered a lecture at the London Hospital Med-
ical College, in which he favors the pollen and
idiosyncratic theories.
etiology.— Dr. C. H. Blackley says : *'The
successful elucidation of the aetiology of disease
is fraught with consequences the value of which
it is scarcely possible to estimate, and it is prin-
cipally on account of its intimate connection
with the physical well-being of mankind, that we
ought to be desirous of laying bare its secrets."
Since 1819, when Bostock first described the
affection, numerous and diversified theories have
been advanced to explain its causes and the
phenomena of its periodicity, among which are :
(1). That it is caused by the lodgment in the
nasal cavities of the pollen of plants, grasses, etc.,
floating in the atmosphere, which, being inhaled,
produce in them a special irritation, which ex-
cites more or less systemic disturbance of other
parts and organs. (2). That it is caused by the
lodgment or development in the nasal cavities
of vibriones, or minute organisms, which induce
the attendant symptoms. (3). That it is a
functional disease of the nervous system — a
neurosis. (4). That it is due to an idiosyn-
crasy, or constitutional diathesis. (5). That
its causes are numerous, among which are
heat, light, dust, dampness, cinders, brimstone
matches, gas, cold winds, drafts of air, the
pollen of plants, grasses, shrubs, trees, etc., the
odor of certain animals, plants, grasses, trees,
vegetables and fruits, fumes, perfumes, and
other emanations. (6). That it is of miasmatic
origin. (7). That is due to local chronic dis-
ease of the nasal cavities, and that — except
when disease of the nasal mucous membrane or
nasal cavities, exists — the alleged exciting
causes are inoperative.
The first, or pollen theory, originated with the
laity of England, from the circumstance that
their annual attacks occurred with the ripening
of grasses and during harvest or hay-making
time. They therefore attributed their attacks to
the influence of pollen : hence the terms, " Hay
Ffever '* and " Hay Asthma " by which it is gen-
erally known there. Dr. Elliotson was the first
writer to use the term " Hay Fever," which has
been attached to it since his day. He was led
to give it the name from the fact that one of his
patients — an agricultural laborer — observed
that his attacks were precipitated by inhaling
the emanations of dried hay. This theory is
still the most popular one, and is sustained by
the majority of writers. The careful experiments
and researches of Dr. C. H. Blackley (second
edition, 1880), conclusively demonstrate that
the pollen of various plants stands as a causa-
tive factor in relation to the annual attacks of
80
THE MEDICAL ERA.
[Vol. yi« No. t.
hay fever, and later experiments of other writers
verify it, but prove that the pollen play's a sec-
ondary p^rt only. Flowers have no charm for
the victim of this disease, for their presence is
often sufficient to excite a paroxysm of sneezing,
coughing and asthma.
That pollen is an undoubted factor in the
causation of hay fever and its appearance on a
specified date is well demonstrated and proven
by Blackley and others, from the fact of the pre-
cision with which some plants ripen annually, as
all botanists know. A removal from the locality
where the irritant exists, to the sea shore,
mountains or a sea voyage, or a change to any
place where the pollen of the special irritant is
not found, gives immunity from the attacks, un-
less the winds should carry the irritant to the
new habitation.
The second theory originated with Helmholtz,
from his discovery of vibriones, or minute organ-
isms, in his own nose ; to their presence he
ascribed the disease from the fact that they
could be found in the secretions from his nose
only when sneezing during his attacks, and not
when free from the disease. Dr. Salisbury, in
1873, discovered an animalcular organism which
he termed Aathmatos cUiaris, and considered it to
be the cause of the disease. This animalcular
theory has a few advocates, which is largely due
to the encouragement received from the sup-
porters of the germ theory. Those that are
blinded by the supposed scientific glare of the
animalcular theory, contend that internal treat-
ment for the relief of hay fever is inefficient,
and, therefore, that it is incurable by any
**pathy " or any means other than by destroying
the parasite. It is difficult to conceive by any
process of reasoning why Sabadilla and other
medicines, administered internally, high or low,
can, and ofttimes do prevent, abort or cure
many cases in those who sneeze in the tor-
ments of hay fever, if their nose and eyes were
paying their briny tribute to the Helmholtzian
parasite. The presence of vibriones in the nasal
secretions can only be accounted for by the
claim that ** decomposing mucus is always popu-
lous with this common infusoria." Dr. Morell
Mackenzie, in his ** Hay Fever, Its ^Etiology and
Treatment, London, 1884," says: **It need
scarcely be said that zealous ' bacteriomaniacs '
have, of course, sought for parasitic germs in
the nasal secretions of those subject to hay
fever; but although bodies resembling pollen-
corpuscles have been found {British Medical
Journal, 1881, Vol. 2, page 18), no specific or-
ganisms have, so far as I am aware, been
detected. It is almost a comfort in these days
to find one disease for which the ubiquitous
bacillus does not appear to be responsible."
The third theory has many advocates. Among
these the late Dr. Geo. M. Beard, of New York,
was one of the earliest and most prominent
In his treatise on ** Hay Fever," or*" Summer
Catarrh," in 1873, and in his monograph on the
same in 1876, he was very pronounced in his
opinions. But he mistook the effect for the
cause, in ascribing the origin of the disease to
the nervous system, for the nervous phenomena
can be more satisfactorily explained as arising
by reflex irritation from the local affection, and
by systemic disturbance. According to Dr.
Beard's theory (the nervous), three conditions
are requisite to the existence of a paroxysm of
hay fever: (a). Abnormally sensitive nerve
centres, (b). A hypersesthetic condition of the
peripheral extremities of the nerves, (c). The
presence of one or more of the vast number
of irritants.
But the disease cannot be of nervous origin,
else why does it appear at a stated month, .day
of the month, and even, in some instances, at a
stated hour of the day, and not at other times
of the year ? There is lio other nervous dis-
ease with which we are acquainted, possessing
this peculiarity. Nervous diseases occur at any
and all seasons.
The fourth theory is incapable of being the
explanation of its annual recurrence at a definite
season and generally on a definite day or hour,
in persons of apparently good health, and free
from any traces of nervous or other disorders at
other times of the year. If we may judge by the
number of writers on hay fever, and other
diseases, who are ever ready to attribute the
causes of disease to an idiosyncrasy, without
further explanation, one would infer that almost
all diseases were inherent in the system. The
term ** idiosyncrasy " is only a convenient ex-
pression to cloak ignorance. The words "con-
stitutional diathesis " would not have so great a
significance in the medical world, if we were
more specific in our investigation of the cause of
disease. If hay fever is due to an idiosyncrasy,
it is not a congenital, inherent, or innate
idiosyncrasy, and, consequently, the disease is
not hereditary. Of the eighty-one cases re-
ported by Wyman, we find only four of the
number whose parents were similarly afflicted,
which precludes the possibility of its hereditary
origin. If hay fever be due. to an idiosyncrasy,
it is only an acquired idiosyncrasy due to the
, effects of some previous diseases. In the true
acceptation of the term, all diseases that are
said to be due to an "idiosyncrasy, "or to " con-
ifAik,iaB.]
ORIGINAL ARTICLES.
81
stitational diathesis,*' are considered as being
congenital : hence these terms are not applicable
to hay fever. The fifth theory includes too much.
Not one of the irritants named bears a causa-
tive relation to the disease. The theory that
light and heat can produce hay fever, is
completely opposed by the fact that sufferers
from the affection are usually relieved, or have
immunity from it, on going out to sea, where
the sun's rays are more powerful than on land.
During the hay fever season dust of all kinds is
composed more or less of various kinds of pollen.
Gas, odors, fumes, and emanations, produce
more or less irritation of the nasal cavities, but
are not sufficient to set up hay fever in one with
a healthy condition of the nasal mucous mem-
brane. To one with a knowledge of the aetiology
and pathology of hay fever, the sixth theory —
promulgated by John R. Kippax, M.D., of
Chicago, in his " Lectures on Fevers." 1884,
page 123, — does not present a single feature
to conmiend consideration, or adoption. If
pollen is a miasm, then another fact is added
to scientific medicine.
m.
•
8TSTS1CATI0 OHBMICAL SXllCIVATION OF
tXRINE FOB OLINIOAL PURPOSES.
BT CLIFFORD MITCHELL, A.B., M.D.
CHICAOO.
ni. Estimation of Quantity of Albumin.
Bough Method of Estimation of Albumin: — Set
the second test-tube — namely, that one in which
the acidified urine has been boiled — aside, and
then note the amount of albumin which has
settled. If the amount is insignificant the loss
of albumin in 24 hours is under 2 grams
(31 grains) ; if moderate, from 6 to 8 grams (93
to 124 grains) ; if considerable, 10 to 12 grams
(155 to 186 grains) ; if very large, about 20
grams (310 grains). Boil daily, using test-tubes
of the same size, the same amount of urine
passed at about the same hour of day, adding
3 drops of acetic acid. Lay the tube aside and
compare results with those of a preceding day.
Rough Method of Estimation of Percentage of
Albumin: — Pill a test-tube two-thirds full of
clear filtered urine and add 20 drops of nitric
acid ; let settle. If the entire fluid is coagulated,
2 to 3 per cent of albumin, by weight, is present ;
if the coagulated albumin reaches half way up
the urine, 1 per cent of albumin is present ; if
one-third the way up, 0.5 per cent; if one-
quarter the way up, 0.25 per cent ; if one- tenth,
0.1 per cent ; if the curved part of the tube is
barely filled with coagulum, 0.05 per cent ;
slight cloudiness merely, less than 0.01 percent.
It is well to perform the operations in a grad-
uated test-tube, as the comparisons can then be
made more accurately, and a record of results
jotted down in a note book from day to day.
A neat method of estimating albumin is that
of Esbach of Paris. The drawbacks to it are
that a specially prepared solution and a specially
made tube must be obtained. The advantages
are ease of application, and indications suffic-
iently exact for clinical purposes. It is a very
popular method with those now using it.
EsbacWs Method: — Dissolve 19 grams (295
grains) of picric acid and 20 grams (310
grains) of pure citric acid (dried in the air) in
800 or 900 cubic centimetres (about xV ^^ rb
of a quart) of cold distilled water. After the
substances have dissolved, add distilled water
enough to make a litre (1.05 quart). The
specially constructed tube has an upper mark,
R, a second mark below it, U, and the figures 7,
6, 5, etc., one above the other, beginning just
below U, and going down to nearly the bottom
of the tube. Fill the tube with urine, which has
been shown to be albuminous, as far as the mark
U. Then add the picric acid solution up to the
mark B. Close the mouth of the tube with the
thumb, and invert a dozen times without shak-
ing. Then close with a rubber cork, and let it
settle for 24 hours. Bead the height of the de-
posited albumgi in figures on the tube. If, for
example, the sediment is as high as the figure 5,
it means that this particular specimen of urine
you are examining contains 5 grams (77 grains)
of albumin to the litre. The graduation of the
instrument, therefore, represents in grams the
quantity of albumin contained in a litre of the
urine under examination. Beckon a gram 15^
grains and a litre a quart. See how many litres
of urine the patient passes in 24 hours, and
multiply this number by the number of grams
in one litre, found by estimating, and the result
is the total amount of albumin the patient is
voiding in 24 hours.
The urine in all cases should be acid. Hence,
if it does not redden blue paper add a few drops
of acetic acid. Urine loaded with albumin may
better be diluted with water, so that the sedi-
ment does not rise above the figure 4. If this
is done by adding an equal amount of water,
then double the result found; if adding two
parts of water to one of urine, multiply the
number of grams (figure on the tube) by three
and so on.
82
THE MEDICAL ERA.
[VoIk VL No. I.
For clinical purposes this method gives at the
end of 24 hours sufficiently accurate data. Ail
operations should be performed on a specimen
of 24 hours' urine and when comparative esti-
mates are made from day to day care should be
taken that the precipitate in each case be
allowed to settle for at least 24 hours. If there
is no great hurry 30 hours in each case is
better. The percentage of albumin is readily
calculated by dividing the amount of grams to
the litre by 10. Thus, if there were found to be
9 grams to the litre in any particular specimen,
9^10=0.9, i. e., nine-tenths of one per cent
would be the percentage.
B. Detection of Bile.
(a) Coloring Matter: — 1. Get a little splinter
of wood from a wooden tooth pick, say, or from
a match and drop it into a test-tube containing
nitric acid to an inch in depth; a very small
fragment of wood will suffice. Then heat the
acid and it will turn yellow. Remove the stick
and proceed then precisely as in testing for
albumin, namely, by causing the yellow acid to
flow down the side of the tube into an equal bulk
of urine. If bile coloring matter be present, at
the juncture will be seen a series of colors from
above downwards, green, blue, violet-red, and
yellow. Green is the most constant and first
color in order ; the violet, shading into red and
yellow, is also most always seen.
Criticism: — The above test is not always
successful. The urine tested should be freshly
voided. If the test fails and presence of bile is
suspected, dip a piece of white filter paper into
the urine and let it dry. If bile coloring matter
not detected by acid be present, the paper will
be colored brown. Try also the following test :
2. Place some tincture of iodine in a test-
tube, and float a few drops of urine on the
surface of it : at the point of contact of the two
fluids, a delicate green color will be seen, if
bile-pigment is present.
(b). BUe-saUs: — 1. Detection: — Dry 30
grains of glucose over the water-bath and, when
cold, drop into half an ounce of strong sulphuric
acid. A delicate straw-colored liquid results,
which will keep for several days in a closely-
stoppered bottle excluded from the light. Place
a fluidrachm of this in a test-tube and float an
equal quantity of urine on its surface ; if bile-
salts are present a purple color will be seen at
the juncture. If the test does not succeed, try
the following: —
2. Detection and approximate estimation : —
To 20 minims of clear filtered urine reduced to
1008 in sp. gr. add 60 minims of test-fluid pre-
pared as follows : —
Pulverized peptone, (S. & M.) gr. xxx ;
Salicylic acid - - - - gr. iv;
Acetic acid (B. P.) - - m. xxx ;
Distilled water to - - fl. oz. viii.
To be filtered repeatedly until transparent.
If bile salts are present in quantity gi^ater
than normal, a distinct milkiness promptly
appears, becoming more intense in a moment or
so. If the bile salts are in normal or less than
normal quantity, there is no immediate turbidity,
but in a short time a slight tinge of milkiness is
seen.
A rough quantitative test may be made by
preparing a standard solution for comparison, as
follows : — to urine of 1008 sp. gr. add equal
parts of the test-fluid and normal urine mixture
of sp. gr. 1008.
Any urine (of sp. gr. 1008 by dilution) 50 or
60 minims of which, when added to 60 minims
of the test solution, are required to bring up
the opacity to that of the standard, does not
contain an excess of bile acids. Dr. Oliver has
prepared a standard table as follows : —
INOREASK OF PKBCRNTAOS.
If' 1 Minim or 2 drops are required. 6,000 times.
"2 "4 •* " 3,000 "
«« 3 « 6 « «< 2,000 "
"4 *« 8 " «• 1,500 •*
" 5 '* 10 ♦* " 1,200 "
" 10 " 20 ** ** 600 "
«' 15 " 30 *« " 400 "
« 20 " 40 " " 300 "
«« 25 «' 50 «* « 240 "
<« 30 ** 60 *' " 100 "
« 35 « 70 a it 83 "
4< 40 «* 80 *• " 66 "
« 45 « 90 <« <« 50 "
An increase over 700 per cent is rarely found
in urine.
This test detects 1 part of bile-salts in 18,000
to 20,000 parts of a solution of common salt.
Dr. Oliver has prepared a test-paper as well.
The precipitate caused by the bile -acids differs
from all others produced with this reagent in
that it is dissolved on addition of a drop or two
of acetic acid, and diminishes, but does not dis-
appear entirely on boiling.
VAGINAL MEDICATION IN DISEASES OF
THE XJTEBUS AND OVARIES.
By E. M. hale, M.D.
OHICAOO.
IT has been ascertained by many trustworthy
experiments, that the vagina and rectum are
capable of absorbing nutritive and medicinal
substances to an extent nearly equaling the
stomach and intestines.
Mab., 1888.]
ORIGINAL ARTICLES.
88
Vaginal alimentation has been thoroughly
tested, and the absorbing powers of that canal
have been proven to equal that of the rectum.
Suppositories containing various animal and
vegetable foods have been used, capsules con-
taining peptonized foods have been infroduced
into the vagina at regular intervals, and it is
asserted by the experimenters that the results
were better than when the same foods were intro-
duced into the rectum.
Moreover, the vagina has many advantages
over the rectum. The necessity of an alvine
evacuation every day ; a tight sphincter ani ; the
presence of hemorrhoids; an irritable rectum,
render the vagina less objectionable, as a recep-
tacle for food or medicine, than the rectum.
The absorbents of the vagina are much nearer
the uterus, ovaries, and other tissues connected
with the genital apparatus, than the stomach.
Physiologically, all medicinal substances ought
to act more promptly on the pelvic organs when
placed in the vagina.
If we take into consideration the fact that each
outlet of the body is an entrance to a tube which
absorbs nutriment, or medicinal forces appropri-
ate to the needs of contiguous organs, it is logical
to suppose then, that the vagina will most readily
absorb and appropriate medicinal agents of
which the uterus and its appendages are in
need. When an organ or tissue is in a patho-
logical state, it craves remedial agents, just as
healthy organs crave their appropriate normal
food and stimuli.
In my gynecological practice, for nearly twenty-
five years, I have practiced applying to the uterus
and vagina the remedy indicated by the symp-
toms and condition of the organs affected. When-
ever I could induce the patient to allow the proper
appUcation of such remedies, or apply them her-
self, I have found the curative process to proceed
much more rapidly then when medicines were
given by the stomach. Some medicines when
applied in the vagina, to the os and cervix, will
act as quickly as when given hypodermatically.
To those not accustomed to observe the action
of medicines applied per vagina, I will say that I
have repeatedly observed the general temperature
to fall 2" in as many hours after the application
to the OS uteri of a tampon wet with Aconite 2x
dil. I have seen severe uterine pain relieved
quickly by the local use of Belladonna 3x dil., and
uterine spasm by the use of Cannabis Indica,
Ergotin, Hammamelis and Sabina. Cinnamon-
nna will arrest chronic hemorrhage as soon or
sooner when topically applied. I have arrested the
violent vomiting of pregnancy, with tampons
moistened with Ipecac, Cocaine, Bromide of soda
and Onosmodium, when they had failed other-
wise. Every gynecologist has observed when ap-
plying Iodine, Carbolic acid, Iodoform, Argentum
nitrate and Mercurial agents, to the os and cervix,
that the woman has complained or observed the
taste of these agents, immediately. I have known
the mouth and tongue to become dry and the
pupils dilate in one minute after the application
of a too strong lotion of Belladonna orAtropiato
the cervix.
Innumerable instances could be mentioned
proving the rapid absorption of medicinal agents
into the [femral system, when placed in the vagina.
By this method we can sooner get the tonic
and haematic effects of Iron, Manganese, Aurum,
Argentum, Hydrastin, Cinchona and Quinine, as
well as Cod liver oil, Cocoa and other nutrients.
Every physician should avail himself of these
facts and apply them in practice. It will greatly
aid his usefulness in alleviating the sufferings of
women subject to disease^ of the reproductive
organs.
It is likely that many who practice gynecology
avail themselves of these facts, but as they do
not publish their observations the field is left open
to charlatans, who have taken advantage of it,
and in consequence the market is being flooded
with nostrums whose utility is doubtful, and
which are not devoid of injurious effects. Many
of these vaginal tablets, balls, suppositories whose
components are not given, contain Opium, Mor-
phine, Cocaine, and other narcotics, which are
liable to cause the Opium habit and other habits,
of great ultimate injury.
Several nostrums which are asserted to be
" perfectly harmless " are capable of causing great
local irritation, as I have often observed. The
absurd and pretentious claims made, that they
are capable of curing all kinds of tumors, can-
cers, displacements, arid other malignant and
structural diseases of the uterus and ovaries,
should be enough to prevent any sensible physi-
cian or layman from resorting to their use.
My experience, in brief, of this topical method
enables me to state that we can only treat suc-
cessfully diseases which are functional, or those
which depend upon anomalies of nutrition.
Acute and chronic inflammation of the vagina,
uterus and ovaries, cellulitis, cervical and vaginal
catarrh, ulceration and erosion, atrophy and hy-
pertrophy, polypoid and incipient fibroid tumors,
commencing ovarian tumors, spasmodic and neu-
ralgic pains, congestion and anaemia and those
local irritations causing reflex sufferings; all
these are amenable to the curative action of rem-
edies when appropriately selected.
84
THE MEDICAL ERA.
[Vol. TI. Ka. t.
Among the medicinal agents which I use most
frequently I will name in order of their value
the following: Hydrastis, Gelsemium, Ergotin,
Ustilago, Belladonna, Pulsatilla, Macrotin, Lil-
ium, Apis, Sepia, Viburnum, Aletris, Aurum,
Iodine, Millifolium, Cinnamonum, etc., which are
absorbed and act upon all the pelvic organs.
Others whose action are purely local, but of
great value, are Bismuth, Calendula, Boracic
acid, lodol. Carbolic acid. Chloral, Cordeia, Tan-
nin, etc.
I have had my happy results from some com-
binations of both classes of remedies, for by com-
bining three or four of those having the widest
range of curative action I have succeeded in curing
many cases presenting unusual and perplexing
complications. Such combinations I hold are not
unscientific, for the uterus and ovaries, with their
contiguous tissues, are capable of appropriating
to their need the various agents, if they are so
combined that they do not destroy each other's
chemical identity or form new compounds.
One example must suffice to illustrate my
meaning. Take the condition known as uterine
enlargment; a soft and flabby condition of its tis-
sues, a condition of erosion and eversion of the
08, with a copious leucorrhoeal discharge. In
such cases a small, slowly dissolving mass made
up of Hydrastis,Cubebs, Boracic acid and Bismuth
will give very prompt and satisfactory results.
These medicines have a very wide range of cura-
tive action, of long duration, and if other morbid
conditions are present (and we seldom find a sin-
gle morbid state existing), other remedies can be
added with decided benefit.
AEFLBZ DISORDERS FAOM XJTEBINB
DERANGEMENT.
Bt SARA E. BACON, ItD.
CHICA'eO.
[Read before the Woman's Medical Society.]
SOMEONE has said that every man's life con-
tains a novel of at least one volume — a
woman's clinical history has filled many.
From the reflex disorders arising from ovarian
and uterine troubles, these small organs — the
most diminutive of all in the female economy,
whose combined weight in their primitive state
does not exceed two ounces — have caused vol-
umes to be printed, sustained medical colleges,
and brought wealth to the specialists.
Before taking up the subject of the evening I
would review the nerve-supply of the pelvic vis-
cera. These are almost entirely under the in-
fluence of the sympathetic nervous system, whiich
comprises a continuous chain of nerve fibres and
ganglionic enlargements, extending from the
head to the coccyx, on both sides of the spinal
column, and which is in constant communication
along its course with branches of the cerebro-
spinal system of nerves. It helps to form plex-
uses on all the principal blood-vessels, and by
this means, controls the involuntary muscular
fibres, of which the arteries, as they decrease in
size, are almost entirely composed.
The sjrmpathetic nerve regulates the vascular
supply to the various tissues and organs, and
the nerve-fibres are often termed "nerves of or-
ganic life," since they regulate the life of tissues
by controlling their blood-supply, while the cere-
bro-spinal nerves are called " nerves of animal
life,'' as they control the acts which are essential
to the life of the individual. The frequent com-
munication between the two systems of nerves
keeps the action of both in perfect accord.
When we consider that .every act which dis-
tinguishes the animated being from the dead
body is dependent upon the influence of the
nerves, and that, without these electric wires the
heart would cease to throb, the lungs no longer
perform their function, that smell, taste, and
expression of hate, love, and joy, which can be
depicted by the same muscles through the action
of the nerves, and that without their aid all
movement would cease, we can then understand
how much of physiological interest must center
about this special study, and how necessary is
the thorough understanding of the distribution
and junction of the component parts of the ner-
vous system.
We might say in a liberal, if not in a literal
sense, that all diseases peculiar to woman depend
upon either menstruation or pregnancy. If the
nervous conditions that control the circulation
are such as to divert the blood from the pelvis
to the brain or elsewhere, just when it is needed
within the ovarian and uterine vessels as a con-
dition of menstruation, the secretion will be
arrested or altered and serious results are sure
to follow.
As it is well known that nervous impressions
in the adult, through the vaso-motor nervous
system, will often cause local derangement in
the circulation of the brain, lungs or the skin, so
the uterine circulation is peculiarly susceptible
to similar influences, as shown in amenorrhoea
and menorrhagia, and also through the placental
circulation. A nervous shock experienced by
the mother produces disturbance in the nutrition
of the foetus, and causes various deformities, and
even utero-amputations have resulted. Also a
18M.]
COLLEGE NEWS.
85
nervous shock may excite prematnre contractions
in a pregnant ntems, and consequent abortion.
Pregnancy, as a physiological crisis, is often
a means of cure for many disorders, such as dys-
menorrhcea, chronic metritis, and prolapsus uteri,
and, as a rule, the diseases of the sensory and
motor nerves which occur during gestation are
self-limited.
The same is true of the incidental affections of
the urinary system, as the development of
Bright's disease, with its accompanying albu-
minuria, ursemia, and tendency to eclampsia. But
often pregnancy is the means of engrafting and
perpetuating disease, which is excited anew
evei^ month by the periodical return of menstru-
ation. It is not strange that under these con-
ditions the conservative powers of nature are
entirely overcome, and uterine cachexia so often
developed. In a reflex way the stomach becomes
irritable, the appetite capricious, and even the
mental and moral spheres are more or less
affected. The ovaries feel this influence to such
a degree that ovulation is in many cases ar-
rested, and no more Graafian follicle^ are rup-
tured during the remaining term of what should
be the child-bearing life of the woman.
The uterus is so delicately poised that it is
more movable than any other organ in the body,
not excepting the eye, and is constantly chang-
ing its position. The act of talking, walking,
breathing, or any muscular effort may move it
in any direction. Deviations of position are im-
portant only when they become permanent, and
create or complicate disease by their effects upon
the uterus.
Menstruation, as I have said, is a powerful
predisponent of uterin^displacement. The uterus
having become the seat of venous engorgement,
its increased weight has borne down upon the
structures that were designed to sustain it, until
they have given away, and the organ has become
displaced.
Its direct pressure upon the anterior sacral
nerves, and also upon the utero-cervical ganglia
of the sympathetic, is sufficient to account for
the temporary paraplegia which sometimes
occurs, and which differs from real paralysis in
being self-limited, for, as soon as the uterus is
lifted up — by rest in the horizontal position on
the part of the patient — the normal circulation
returns and the paralysis disappears. (Such
cases of paralysis are often cured by " mind
healers.")
The same physiological condition explains the
peculiar sensation, as if a portion of the spine
has been removed, faintness, syncope, and after
a frequent recurrence of this displacement the
nervous system has acquired a predisposition to
hysterical complications, and yet these symptoms
are none the less real because we style them
"nervous," and it is only through our knowl-
edge of the functions of the reflex nervous system
that we can explain their existence.
Smce the ovaries and uterus are almost directly
under the influence of the sympathetic nerve,
through the inferior hypogastric and ovarian
plexus, it is not strange that there are so many
reflex disorders when we consider the direct
conmnmication that exists through the circula-
tion between those organs and the lungs, heart,
stomach and brain.
As a consequence of deviations, we have leu-
corrhcea and uterine ulcerations. The uterus
lying low upon the perineum, its friction upon
the posterior vaginal wall causes an abrasion of
its investing epithelium and this may induce and
perpetuate a superficial ulceration of the cervix.
Sometimes the most prominent symptoms are
referred almost exclusively to the bladder and
the physician consulted for kidney trouble when \
the real cause lies in the displaced uterus.
In retroversion the bladder symptoms are
usually less marked than in the anterior displace-
ments, but the intimate union between the neck
of the uterus and bladder makes it almost im-
possible to displace the one without disturbing
the other and it may produce engorgement and
chronic inflammation of the ovaries. The reflex
symptoms are many. The gastric disturbances
are almost never lacking. Occipital headache,
pain in the region of the vertex, and hysterical
symptoms of every kind and description, may
depend upon this and disappear only when the
local cause has been removed.
Uterine ulceration, a few years ago, was the
most familiar disease known to the medical pro-
fession. It was generally thought to be the
essential and fundamental lesion in most of the
diseases of women. But now it is known to be
infrequent. Formerly apphances were brought
to bear upon a lesion which had no existence,
until it was induced by the treatment itself.
The subjective symptoms are really very distress-
ing, and the poor woman nearly a wreck, while
painful menstruation and leucorrhoea are frequent
and troublesome accompaniments. The reflex
symptoms are numerous and varied, and such
patients are apt to be melancholy, and some-
times exhibit strong tendencies to insanity.
But of all diseases that require the greatest
amount of tact and discretion on the part of the
physician, if he would retain his patient, are
86
THE MEDICAL ERA.
[Vol. VL No. 8.
irritable uterus, and spinal irritation, single or
combined. This class of patients travel from
one physician to another. They are usually
nervous, badly nourished, their vital force is low,
and their strength below par. And yet no
lesion of the structure of the uterus can be foimd.
Still the morbid exaltation of uterine sensibility
causes reflex disorders of every conceivable kind,
of which ** hysteria " is the most common.
SOME PKACTICAL OBSEKVATIONS ON
AMMONIA.
By dr. PROCTER.
[Read before the British Homceopathic Congrees, Liverpool, Sept.,
1877. From the Monthly IJ omceopat hie Review J\
PERHAPS there is no dinig in the pharma-
copoeia that can boast of a higher antiquity
than Ammonia. Dating from the time
when it was obtained by distillation of the soil
near the temple of Jupiter Ammon in Egypt, it
has come down to us with a distinguished career
through the middle ages, when it was known as
Spirits of Hartshorn, in consequence of its being
obtained by the dry distillation of horn shavings.
In modem times it is obtained by the ton
from the distillation of coal in the manufacture
of gas. It was known to us only as Sal am-
moniac, i. e.y the Muriate of ammonia, until the
close of the eighteenth century, when Dr. Black
liberated the alkali from its combination with
chlorine, and it was thence known as the volatile
alkali, or Ammonia, simply.
A substance of this kind, possessing such well
marked physical and chemical properties would
naturally be impressed into the service of med-
icine, and accordingly we find remarkable vir-
tues attributed to it in very early times that
have yielded to more moderate estimates in later
ones, but all along it has held a high position as
a stimulant to the heart and circulation, as an
antacid and a gastric cordial, as a diaphoretic
in fever, and as a nervine in spasmodic affec-
tions, etc. In very recent times it has been
studied in respect of its physiological action on
the animal body, and with the result of its hav-
ing been found to possess a very decided action
on the liver, the lungs, the gastro-intestinal
mucous membrane, and on the blood itself. All
these experiments go to confirm the provings
that liave been made by the homoeopathic school,
and give an additional sanction to the results we
had already arrived at, and in some particulars
have added to those results. It^would appear that
Ammonia, after absorption, ceases to exist in
the free form in the blood, and enters into com-
bination with the plasma. It does not escape
by the lungs, as might have been expected, but
is quickly oxidized and eliminated by the kid-
neys as urea in mammals, and as uric acid in
birds.
In his work on insectivorous plants, Dan^^in
refers to his experiments with various salts
upon the digestive action of the glands of the
Drosera rotundifolia. Amongst others he tried
Phosphate of ammonia. Surprised at the smaU-
ness of the quantity that sufficed to induce phys-
iological action, he repeated his experiments
with every possible care against chances of error.
The quantity of Phosphate was lessened grad-
ually until he found that the twenty-millionth of
a grain was sufficient to set up this action. Dar-
win says *' the reader will best realize this degree
of dilution by remembering that five thousand
ounces would more than fill a tliirty-one gallon
cask, and that to this large body of water one
grain of salt was added. Only half a drachm, or
thirty minims, of the solution being poured over
a leaf. Yet this amount sufficed to cause the
inflection of almost every tentacle, and often of
the blade of the leaf." He goes on to say : ** I
am well aware that this statement will appear
incredible to almost every one. Drosera is far
from rivaling the power of the spectroscope, but
it can detect, as shown by the movements of its
leaves, a much smaller quantity of the Phosphate
of ammonia than the most skilful chemist can
of any substance."
Ammonia is a drug with very little organic
specificity. It acts very generally over the whole
system, in this respect resembling soda ; conse-
quently, we find its influence pervading most of
the tissues, and hence its homoeopathic indica-
tions have to be drawn ratjier from the kind of
action than the seat.
Let us see, in the first place, how it afifects
the respiratory tract. Its action as a mucous
irritant is well marked, and presents us with a
picture of acute catarrh and bronchitis, having
the characteristics of great vascular congestion
and thin watery secretion. The obstructed nos-
trils, the irritated throat, the tickling cough are
recognized as guiding symptoms.
Congestion is the key-note of Ammonia ; ca-
tarrh with thin secretion separates it from a host
of catarrhal medicines at once. Besides, the
secretion has no irritant properties, and this
again is a help. The action seems to extend
along the whole tract of the mucous surface. It
is, therefore, eminently a catarrhal medicine,
and you will notice with what a true instinct
this has been generally arrived at.
At the present time Ammonia, in the form of
smelling salts or cigarettes, is in popular use^
188B.1
ORIGINAL ARTICLES.
87
and its Tirtues have been so highly extolled by
Bome that we are assured it only requires the
Ammoniaphone to develop a pure Italian singing
voice. This is claiming too much for it ; but
the truth underlying it all is the fact that Am-
monia is homoeopathically indicated in certain
forms of catarrh, and from my observation it is
very generally indicated and widely useful. In
catarrhal croup I have learned to trust very much
to it, and in bronchitis the Muriate of ammonia
is a remedy of the first order. Our allopathic
friends aj^e not clear as to its indications, some
recommending it when the secretion of mucus is
excessive, others when it is deficient and ought
to be increased, but all agreeing that it is an ex-
pectorant in helping the expulsion of mucus.
The fever accompanying the catarrh is char-
acterized in the case of the Carbonate of am-
monia by little or no chill, but vigorous reaction,
with great vascular turgidity. Such catarrhs
are very common in hot weather and hot climates
from a sudden chiU, and are very common in all
temperatures when the chiU has been received
under circumstances of great vascular excite-
ment, such as the after-dinner cold, which we
are made acquainted with the next morning.
Whilst on this point let me remind you of the
usual course of a cold of this kind. The system is
affected after the manner of a concussion to a train.
The first carriage receives the impact, and this is
transmitted to the next and next until it has
passed the whole length of the train. We begin
with sneezing and nasal catarrh, the irritation
travels downwards to the throat and larynx and
bronchial tubes, perchance setting up pneu-
monia. It passes in the same way down the
cesophagus to the stomach and bowels, maybe
setting up catarrhal jaundice en route, or down
the urinary tract to the bladder, and in mild
cases finishes up with catarrhal rheumatism.
Well, our Ammonia travels over the same
ground, and as we see by our provings, fur-
nishes us with lumbago and other local pains in
the framework of the body. The peculiarity of
its intestinal action is the copious production of
clear mucus. As a glandular medicine, how-
ever, it seems to have little or no action. It is
true the Muriate has been found to be a chola-
gogue, but it seems more probable that such ac-
tion results from the increased vascular activity
in the liver than from any specific stimulation
of the biliary elements. In our provings we see
nothing Uke jaundice, consequently where such
is present specific hepatic remedies are called
for. In gastric catarrh, the Muriate of ammonia
has decidedly a claim upon our consideration, as
its symptoms point very strongly in that direc-
tion. The first decimal trituration is a favorite
dose with me.
It may be remembered that Dr. Stewart wrote
a paper in the Lancet a few years ago, recom-
mending the Muriate in twenty grain doses in
acute hepatic congestion in hot climates. He
had great success with it, but I am not aware
that his practice has been followed to any great
extent. However, recognizing the similarity in
many respects between the action of Ammonia
and that of alcohol on the vascular system, one
may infer by analogy that this practice is likely
to be good, and acting on the hint I have found
the Muriate of ammonia efficacious in hepatic
congestion in persons exposed to heat, such as
cooks and others in this country. Also I have
proved its value in hepatic affections consequent
on the use of alcohol, and I have a strong feel-
ing that is likely to afford help in cirrhosis, and
be disposed to try it in substantial doses in a
future case.
Let us turn to another aspect of the therapeu-
tics of Ammonia. In scarlatina it has had a
considerable reputation in the old school, but
with the usual instability of allopathic medicine
it has passed out of favor, although Binger tells
us that Dr. Peart treated nearly 300 cases with-
out a single death. In our school it stands where
its provings placed it as a remedy for scarlatina
with anginose symptoms, but without cerebral
disturbance and with shght eruption, 'or even
tending to retrocession. The force of the disease
is spent on the throat. The Carbonate of am-
monia is more particularly indicated in scarlat-
ina, just as the Muriate is in catarrh, and as
we shall see presently, the Liquor or Caustic am-
monia is in diphtheria. As illustrating its ac-
tion on the skin, in addition to a scarlet eruption
that has been noticed in a few cases on the upper
part of the body, Hahnemann mentions the
symptoms, "the skin of the palm of the hand
peels off (after four days)." I am able to con-
firm this by an unintentional proving on a pa-
tient. A man for some gastric derangement got
a prescription for Am. carb. Ix trit., to be taken
for a few days. He took it by mistake for about
three weeks, at the end of which time he casu-
ally pointed out to me that the skin of his hands
was peeling off, as after scarlatina. He had had
no illness in the meantime, and I could only put
it down as a pure drug symptom.
The general tendency of the scarlatinal symp-
toms of Ammonia being towards the anginose
type, it is obvious that it would be tested in
diphtheria. Accordingly we find it recommend-
88
THE MEDICAL ERA.
[Vol.. VI. Ko. a.
ed in all our books, but it seems not to have re-
ceived as much attention as it deserves. Its
power over sloughing conditions of the mucous
membrane was strongly borne in upon me some
years ago, when testing the Liquor ammonia
bottle on one occasion in the dark by applying the
stopper to the tongue. I was at once convinced
I had got hold of the Ammonia and in a minute
or two I found the Ammonia had got hold of me,
for it removed a patch of epithelium and left a
sore place behind it for two or three days. The
most remarkable evidence in its favor in the
treatment of diphtheria is given by our colleague,
Dr. Thomas, of Llandudno, formerly of Chester.
He informs me that he has relied upon Ammonia
in diphtheria for the last twenty years, and has
treated some 130 cases with only one death.
His method is to give the Liquor ammonioe f ortior.
of the British Pharmacopoeia in half or quarter
drop doses every two hours until the exudation
is fairly gone; the treatment to be continued
night and day. I am not aware of any body of
evidence in our school to compare with this in
respect of Ammonia, and I trust Dr. Thomas will
publish his cases, with details, so as to enable
us to follow his treatment with the confidence
derived from his experience.
The most striking support of the Ammonia
treatment that I can find in our literature is in a
case mentioned by Eaue, and, although a single
observation, carries with it great weight. The
case was one where there was croupous cough,
which threatened suffocation every minute. The
lower part of the pharynx, as far down as could
be seen, was covered with a white exudation.
The patient was in the greatest agony, frequently'
jumping out of bed and gasping for breath. The
details of the treatment are not given, but it is
merely stated that Ammonia caust., 15 drops to
a glass of water, cured the case (Special Pathol-
ogy, p. 300 ; 2nd Edition). Evidently here was a
condition of diphtheritic croup of a very severe
type, and recovery from a state of extremity like
that by the use of a single remedy is not to be
lightly passed over. For my own part I am dis-
posed to regard the Ammonia treatmient as full
of possible good, and worthy of our most careful
attention.
There is one other practical use of Ammonia
that I would rfefer to, although it cannot be con-
sidered as either homceopathic or allopathic, but
simply as the utilizing of a physiological fact in
medicine. You are aware of the power pos-
sessed by Ammonia to retard the coagulation of
the blood by some solvent action on the fibrine.
Now it occurs to me that if this action can be
applied to the dissolving of emboli, we shall find
a new and important use for Ammonia. In all
such cases we have at present to stand by and
see important organs going to destruction, ow-
ing to obstruction of the circulation, and can do
nothing to save them.
Dr. Moore said that there were great differ-
ences between the action of the two chief prepa-
rations of Ammonia — the Carbonate and the
Muriate. The Muriate, possessing a catarrhal
action on the nose and throat, was suited to more
chronic conditions; while the Carbqpate was
more allied to acute states and to low febrile con-
ditions.
Dr. Brotchie, refering to the lack of distinc-
tion shown in Dr. Procter's paper between the
two salts of Ammonia, said that in the absence
of Dr. Procter he would endeavor to give the
differential diagnosis between them. He had
found the Muriate useful in catarrhal conditions
of the nose ; in tracheitis of young and old people
where there was an accumulation of mucus, a
passive form of the disease in congestion of the
liver, and also in sciatica. In the two latter
conditions, he gave it in material doses, and in
the former in the first decimal trituration. The
Carbonate he had found most reliable when there
was any suppressed eruption, as in measles or
scarlatina. At the same time he gave a warm
bath.
Alcohol in Diphtheria.
The administering of stimulants in diphtheria
is not of recent date, but it is only recently that
they have been used systematically. We find,
in a review of the literature, that the greatest
weight of authority is in favor of them. They
should be commenced earlier in diphtheria than
in other diseases ; in fact, during epidemics of a
malignant type we should commence treatment
with them. If the patient shows failing strength,
pallor, any loss of appetite, we must give them
in large and frequent doses. The only signal we
need obey is that of intoxication. More often is
the error on the side of giving too little than too
much. It is a surprise to see what amount of
brandy a patient with a septic form of diphtheria
will take without any signs of intoxication. J.
Solis Cohen mentions giving brandy to the extent
of one ounce every fifteen minutes for three
hours. Another writer has given twelve ounces
a day to three-year-old children with benefit. —
jyr. Cain, in Medical Register.
The physician should not limit himself as to
the length of time necessary for a cure in any
uterine trouble. In the mildest cases six months
is none too much time. — Dr. Wood.
lan.]
COLLEGE NEWS,
89
NEWS FROM THE COLLEGES.
Ann Arbor.
UNTVERSITT OF MICHIGAN.
In speaking of uterine hemorrhage, Prof.
Wood says that it may be caused by a very small
polypus; by anything that interferes with the
circulation in the pelvic organs ; by albuminuria
with Bright's disease.
To remove polypi, dUate the cervix and scrape
the mucous membrane with a Thomas' dull wire
curette. This will sometimes cure a case of
uterine hemorrhage of long standing.
In speaking of pain, Prof. Obetz says it is
salutary — a cry for help. With an anodyne,
the allopath stills the cry but does not stop the
pathological condition, and his patient may be
lulled into the long, long sleep of death. If,
however, the pain is treated scientifically, the
indicated remedy given, then when the pain is
gone the pathological condition is removed.
In differentiating between neuralgia and in-
flammation the pain will indicate : in neuralgia
it commences suddenly with great intensity and
as suddenly stops. The cure comes when' the
pain stops. In inflammation there is first a ten-
derness, and then a gradual increase in intensity.
It leaves gradually, and is a dangerous symptom
to stop suddenly.
Pain in the back of the neck may indicate in-
flammation of the brain ; in the left shoulder-
blade, heart trouble ; in the right shoulder-blade,
Uver trouble; in the penis, trouble with the
bladder; in the groin, trouble in some pelvic
organ.
In inflammatory fever following an operation,
remove all irritation. If there is tension from
the stitches, cut them at once. Use antiseptic
gauze and cotton in dressing, with Carbolic acid.
Chloride of zinc, Boracic or Salicylic acid, Glyc-
erine, etc., but better still, clear alcohol. If
cold water is used it must be applied continuous-
ly and changed often. Never apply heat if
distasteful to patient, and the same may be said
of cold. In the use of ice be careful not to
freeze the part or produce chilblain.
In making a poultice have it large and thick
enough to keep in the warmth and moisture and
of such material that it will not be hard when
dry. A poultice is useful when tension in a soft
part is very great.
Fever indicates that there is something wrong
about the wound. Be careful to have good
drainage.
Prof. Amdt says in cases where Mercury is
indicated, if there is a rapid destruction of tissue,
Corrosive sublimate is called for every time.
In gleet with a greenish yellow discharge, use
the soluble Mercury. Also in syphilis where the
inguinal glands are affected. It may be thought
of in fevers when there is a yellow sweat and the
pillow stained yellow.
Cyanuret of mercury is useful in tonsilitis
where there is a profuse flow of ropey saliva,
painful deglutition and gray ulcers filled with
yellow pus.
In chronic tonsQitis the Bin-iodide of mercury
is an excellent remedy. The iodides are called
for in chronic nasal catarrh.
Muriatic acid is to be thought of in scarlatina
when the child looks in color like a boiled lobster.
Also in typhoid fever when the patient is so weak
he slips down in the bed and has to be pulled
back to the pillow.
In ulcerations of the throat, a useful local
remedy is found in Nitric acid, from 5 to 20 drops
in an ounce of water.
Nitric acid is a good remedy in albuminuria
where there is a mercurial syphilitic taint. In
syphilitic disease the Mercuries are useful with
light complexioned people and Nitric acid with
dark.
Arsenic may be indicated in iritis and con-
junctivitis. It acts on the mucous membrane of
the inner surface of the eyelids.
Although Kali iodide is better, Mercurius
vivus is often indicated in syphilitic headache.
As children play, so must the symptoms, in all
cases, be taken like blocks and placed together
to form the combination or blockhouse of the
totality of symptoms.
In the treatment of leucsemia or anaemia. Prof.
McLachlan says no good results usually from
the transfusion of blood.
A patient with scabies was directed to take
each evening for two or three days, a bath, using
mild soap. After the bath to apply an ointment,
consisting of half a drachm of Sulphur to an
ounce of lard. Every morning this should be
washed off and all the clothes changed. At the
same time to keep the skin in good condition,
was given Sulphur 3x.
Given in the Ix or 2x, Tartar emetic is an ex-
cellent remedy for lumbago. Continue its use
till slight nausea is produced and when this is
gone give it again.
Boston.
UNIVERSITY SCHOOL OF MEDICINE.
In erosion of the cervix, Dr. Church strongly
recommends the dry treatment of Dr. Engelman,
90
THE MEDICAL ERA.
[ToL TL Ha. Sl
which is as follows : Dust the part thoroughly
with Iodoform, then pack around the cervix with
cotton balls, having first covered each with Iodo-
form and a layer of styptic iron cotton. No
douche or glycerine; with this treatment alone
the erosion will heal.
In cases of chronic nephritis, post scarlatinal,
where there is considerable constipation, Dr. J.
H. Smith recommends lamb broth, prepared as
follows : Chop the lamb fine and add an equal
weight of water; allow it to simmer slowly
for an hour; then bring it to a quick boil,
strain ; then allow it to chill, take ojff the fat and
administer as required. It proves at once nour-
ishing and a good laxative.
Dr. Smith recently produced very happy
results from Borax in a case with the following
symptoms : Inability to sleep ; fainting ; feeling
of continual sinking ; pulse normal, but extrem-
ities icy cold; stitching pains in the thoracic
parietes. The basilar circulation was diagnosed
to be in a state of complete exhaustion. Twelve
hours after giving Borax the extremities were
found to be warm and all symptoms much im-
proved.
In chronic enteritis, where there is much
tenesmus, Dr. Hedenburg recommends injections
of thin starch, or a few drops of Laudanum may
be added. Hot fomentations to the perineum
and left iliac region also give relief.
In gall-stone colic, when the agony is unen-
durable. Dr. Ahlbom advises putting the patient
under the influence of ether ; the muscles relax,
the caliber of the duct enlarges, and the stone may
pass soon ; this stops the vomiting and restless-
ness. Now apply hot compresses until the
patient is relieved. When relief comes it is
absolute.
In cases of absolute nephritis from scarlatinal
poison invading the kidney, the exudation oc-
cluding the ducts, urffimic intoxication following,
and the patient in convulsions, Dr. Ahlbom
swathes the patient in water bandages, fre%h
every half hour, till the kidneys are stimulated.
Faithful changing of the compresses is import-
ant. Aconite, Gantharis, Arsenicum, and Gheli-
donium are good remedies in this connection.
The result of the above in many cases is that the
coma, bloated face and puffed eyelids pass away,
and appetite returns.
PhUadelphia.
HAHNEMANN MEDICAL COLLEGE.
Dr. Gramm called attention to the rapid in-
crease of scabies in seaboard cities, and then gave
the following points to aid in diagnosis : — Usu-
ally the patient, when first coming for advice,
complains of an <' itch and eruption all over the
body, which was first noticed two or three weeks
ago, and has been progressively getting worse ; it
is aggravated at night, and is most noticed on
the^;rar side of the tmst, on the web of the fin-
gers and back of the hand, on genitals, on the
buttocks and in the axilla ; but never on the face"
The lesion is multiform.
As the cause is a parasite, he believes the
proper treatment is to kill it.
He thinks it rather difficult to explain to a
patient that the best way of treating him is to
give him a course of medicine that will change
the soil so that the itch-mite wiU leave of its
own accord, especially if the patient is almost
distracted with the itching. So he prescribes :
l^.Naphthol - - - - 3ij;
Greta prssp. - - - - 3i ;
Adipus |i;
Sapon viridis - - - - |i. M.
To be rubbed well in for three nights in suc-
cession after a good wash with a strong soap.
Gaution — Don't use this too long, or a der-
matitis will be set up as bad or worse than the
itch will cause.
As to remedies, he finds almost everything,
from Aconite to Zincum, at times indicated.
Sulphur is no more a specific for scabies than
any one remedy is for any other complaint.
Dr. Wallace McGeorge, of Woodbury, N. J.,
lectured to us in the preliminary course last
September, and he gave as his experience that
Plantago tr. ^ to water f was the best antidote
to ivy poisoning, if applied within three days.
He extolled it very highly, saying he had never
known it to fail, which, coming from a physician
so long in practice as Dr. McGeorge has been, in
a country town, made quite an impression, espec-
ially on the students from the country, who
have had some experience ii; ivy poisoning. The
doctor also said he found an infusion of Sassafras
root best in cases over three days old.
Prof. G. M. Thomas thinks, in cases of fracture
of the patella, the great attention should be to
the quadriceps femoris, and that the bone will
usually get along first-rate with a plain roller
bandage. He advises early beginning massage
and electricity to the muscles, as there is a
tendency to atrophy, and he tells of a case with
a space of one and a half inches between the
fragments, with almost perfect function, while
many cases with close union have greatiy
impaired function from muscle degeneration.
Prof. Betts treats " night terrors " of children
by giving them an evening meal of bread and
,1888.]
COLLEGE NEWS.
91
milk, and he says ihe remedy is Lycopodium.
For children who are afraid to be alone or to be
in a dark room, he says give Stramonium.
Kinneapolifl.
HOM(EOPATHIG BfEDICAL COLLEGE.
Prof. Matchan cautions us against appl}ring
tar plaster to wounds when the granulations are
red and active. Its sphere of usefulness is con-
fined to sluggish sores which require stimula-
tion.
Piof . Bicker relieves the painful respiration of
pleoritis by the use of adhesive straps on the
affected side to prevent expansion of the chest
wall. The straps should reach a little more
than half way around the body. A frequent
recurrence of pleurisy in the dry form, especially
if at the upper part of the chest, may generally
be regarded as a precursor of phthisis.
Prof. Spaulding reports a case of puerperal
eclampsia, treated by Dr. Geo. E. Dennis,
Lecturer on Sanitary Science, as follows: Pa-
tient 26 years old, six months pregnant. Uremic
convulsions at intervals of about five minutes,
each spasm lasting five or six minutes. Patient
unconscious during the whole time. Hypoder-
mic injections of Apocynum over the kidneys,
and various internal remedies, were used without
effect. At the end of two hours a rectal enema
was given, consisting of Chloroform, 3ss ; Water,
Jij ; Sugar, 1 tablespoonful,
A spasm occurred immediately after the
injection, but there was no further recurrence.
Two days later the lady was delivered of a dead
foetus, the labor being unattended by convulsive
symptoms. There has since been a profuse dis-
charge of albuminous urine, which is gradually
improving under Arsenicum and Merc. cor.
Prof. Beaumont says : The local treatment for
granular conjunctivitis should be such as wiU
promote absorption. The more irritable the
eye, the milder the applications. Hydrastis in
water or Glycerine may be used in almost any
strength. Tannic acid and Glycerine, 15 to 30
gr. solution, prepared under heat, is an excellent
application. Granulations extend so deeply into
other tissues that their removal by the use of
caustics should never be attempted. Avoid using
preparations containing lead, as opacity of the
cornea from lead deposits is liable to follow their
use.
A strange freak of nature was recently discov-
ered in the dissecting-room. The subject is a
middle-aged man who died of tuberculosis. A
double kidney, about eight inches in length, and
of. the usual diameters, extends transversely
across the spine. There are two pelves in the
superior border of the organ, and each portion
seems complete in itself [a horse-shoe kidney].
One ureter passes down anteriorly over the kidney,
the other posteriorly. No dissection has been
made to ascertain whether a direct communi-
cation exists through the connecting portion.
Ohicago.
HOMCEOPATHIG MEDICAL COLLEGE.
Prof. Delamater says : Under no circumstances
should you allow ice or ice-cold water to be
appUed to the head of a child sick with cerebral
meningitis. The Prof, believes a true case of
tubercular meningitis has never been cured.
Prof. Woodward says: For simple, straight,
uncomplicated jaundice use Ghelidonium. Sul-
phur and Galcarea carb. will be of great use in
cases of malignant scarlet fever found in persons
of a scrofulous diathesis.
In choosing between Arsenic and Carbolic acid
for treatment of septic conditions, remember
that the suffering is greater in Arsenic.
Prof. Buffum recommends the following treat-
ment for impacted cerumen: Instill into the
ear two or three times a day a mixture of fluid
Petroleum, 3 drachms; and Sulphuric ether, 1
drachm. As soon as the wax is softened, wash
out with the ear-syringe.
For chronic suppuration of the middle ear, do
not use the syringe, but remove the discharge
with cotton swabs, and, after cleansing, blow in
Boracic acid powder.
Prof. Foster says : The forceps should be used
whenever it is necessary or desirable to hasten
the delivery of the woman after the os is dilated ;
also in every case of retarded labor when the
woman is deliverable. I recommend the Wallace
forceps above all others.
Antisepsis with me means cleanliness and whis-
ky; whisky not for the doctor, but for the pa-
tient.
Treatment for post-partum hemorrhage, in
order of use :
1. One hand outside ;
2. One hand outside and one inside ;
3. Ergot, one to two teaspoonfuls, in water ;
4. Injections of hot water;
5. Injections of cold water, or the introduc-
tion of ice into the womb ;
6. Injection of vinegar, hot or cold.
7. Injection of Persulphate of iron, or Muri-
ated tincture of iron, two drachms to a pint of
water.
Treatment for puerperal convulsions :
1. Give the woman Chloroform, and keep her
under its influence ;
02
THE MEDICAL ERA.
[Vol.. VI. No. ».
2. Deliver her as soon as possible ;
3. If it takes too much Chloroform to quiet
her, administer a hypodermic injection of Mor-
phine, i to f grains ;
4. After administration of Morphine, use Chlo-
roform with caution ;
5. Have a competent person remain by the
patient, at least 24 hours after delivery, ready
to give Chloroform should there be the least
sign of returning spasm.
Prof. Foster reports excellent results from the
use of the Mexican ** Pulque " in the treatment
of albuminuria. Cases that nothing else could
touch have yielded to its use. A pint bottle
should last about three days.
Prof. Beebe recommends the following recipe
for local use in cases of sprains, lameness,
etc. :
5. Camphorated tr. of soap - lii;
Aeon, rad., tr.
Ehus. tox., tr. aa - - - 388 ;
Aqua ammonisB fortior - '^\.
Sig. Eub in thoroughly, using plenty of " palm
oil " and elbow grease.
For fractured patella the Professor recom-
mends the straight posterior spUnt, properly
padded, and the bandage so applied as to co-apt
the fragments. Over all put the plaster-of-
Paris cast.
HOSPITAL NOTES.
St. Louis.
HOMCEOPATHIO MEDICAL COLLEGE.
Prof. Schott says: The catarrhal form of
pneumonia is apt to be confounded with capil-
lary bronchitis.
Unless a complete physical examination of
the chest is made, the portion of lung presenting
the signs of catarrhal pneumonia may not be
discovered. He advises that a thorough exam-
ination of the chest be made, both anteriorly
and posteriorly.
He also says that Tartar emetic in low atten-
uations is very apt to aggravate a case of
pneumonia ; so much is this the case that the
old school have realized it, and are becoming
afraid to employ the remedy in this disease,
even in very small doses. He advises against
its use in any potency below the 30th, and him-
self prefei-s considerably higher.
Prof. Goodman warns his students that in
pneumonia, where only one lung is involved, the
physician may have left the patient one day, on
the road to recovery; and on returning, next
day, he may find the patient in a high fever, and
the other lung involved.
OOOK COUNTT HOSPITAL.
A Pullman porter received in a railroad acci-
dent a lacero-contused wound in Scarpa's trian-
gle. The muscles were severed transversely, the
femoral artery and internal saphenous vein just
escaping. The ends of the divided muscles were
sutured with chromic catgut, the wound thor-
oughly inigated with sublimate solution 1 : 4000,
the edges of the wound carefully co-apted with
aseptic silk, iodoform and ether (1 to 6) injected
along the line of the wound and the wound cov-
ered with sublimate gauze and secured with
bandage. The result was primary union and
complete restoration of function of the injured
muscles.
Following is the method of preparing the sub-
limated gauze used in the Hospital : Bichloride
of mercury, one ounce to a gallon of boiling
water. Add 2 per cent of glycerine, as this
helps to hold the Bichloride of mercury in solu-
tion and keep the gauze soft and moist. Into
this solution immerse bleached butter cloth and
let it stand 36 hours ; the vessels to be of wood
or stone, and covered. Remove from the jars
and hang up in a room to dry ; then roll up and
cover with aseptic paper or rubber protective.
A man of about 50 years recently came to the
Hospital for a severe pharyngo-laryngitis. His
respirations were intensely labored. The steam
atomizer was kept constantly going ; the usual
remecties both locally and internally were ad-
ministered, but with indifferent results. But in
about 24 hours after admission oedema of the
glottis set in ; respirations about four per minute ;
the man became cyanosed, and apparently
breathing his last. An unsuccessful attempt
was made to intubate the larynx, the oedema
being too great. The operation of tracheotomy
was hurriedly performed, the incision being made
just above the isthmus of the thyroid gland.
The secretions were cleared away, a tube insert-
ed and artificial respiration performed. The
man was soon restored to consciousness, and
nodded assent as feeling greatly relieved. A
stream of hot, moist atmosphere was kept con-
stantly flowing over the opening of the tube. He
was fed freely with milk and at frequent inter-
vals. Lived five days. Subsequently it was
learned that he contracted syphilis 27 years ago
and was recently treated for some of the tertiary
manifestations. Post mortem revealed gumma-
ta of the liver and a general syphilitic degenera-
tion of all the organs.
.]
CORRESPONDENCE.
98
CORRESPONDENCE,
Chattanooga, Tern., Feb. 16, 1888.
To the Editor:
In your February number I notice the testi-
mony of some of our co-workers as to the use of
alcohol in diphtheria.
Ton also invite other students of Dr. Tooker*s
who have had his instructions upon the matter,
to send in experiences. I am not a student of
his but a graduate of the New York Hom. Med.
College of 1875. I was taught there, and have
read in journals ever since, the good effects de-
rived from alcohol as a gargle in diphtheria. I
have used it with success in some cases, and in
othes had none whatever.
I have never given it as heroically as is re-
ported in your jouma^, so cannot condemn or
extol ; I would consider it as any other drug,
according to symptoms.
I cannot agree with your writer, that " alcohol
is a food," but as one of the most aetive of stim-
ulants, I fully concur with him, and consider it
a very valuable adjunct to our materia medica.
Sincerely,
W. W. French.
Paris, Texas, Feb. 10., 1888.
To the Editor:
The Medical Era editorials of February on
the subject of homoeopaths practicing other meth-
ods than pure homoeopathy, and of allopaths, so
called, the same, has taken such possession of
me that I cannot restrain my pen from adding a
httle practical experience upon the subject, which
is of such importance in refuting the absorption
of "what little good there is in homoeopathy " by
our friends ( ?). As the editor very properly claims :
"They do use our remedies sometimes, but, like
all else, in an empirical manner.'* I know this
to be true, for I have seen many instances of it.
Nine days after delivering a lady patient I was
suddenly called to see the baby, who had taken
cold and was evidently having a mild attack of
bronchitis from which he should have readily
recovered. I could not be found exactly when
wanted, so an "old schooler" went, and I found
him administering Ipecac in the form of syrup,
" with a little lard."
The indications to my eye and questions dis-
tinctly indicated Ipecac, and so the little fellow
was having "what little good there is in homoe-
opathy," though the attendant did not know he
was working upon the grand principle, otherwise
why did he give that child an Ipecac disease upon
the already Ipecac disease, not produced by the
drug?
"What did you think of my child's case?"
was the father's question the next day. " A very
good result," I answered, " if properly treated,
and the Doctor was giving the proper remedy,
but he didn't seem to know it. How is the
child to-day ? " "Dead!"
How is that for "what little good there is in
homoeopathy?" This was in Jan., 1887.
Jan. 28, 1888, I was called in consultation
with the two leading allopaths of a town nearby,
to a case of continued nausea, with occasional
vomiting; woman threatening abortion in the
eighth month ; continued flow of bright red blood ;
spasms occasionally, but retaining consciousness.
The nausea and vomiting being most promi-
nent I turned to the physicians and said,
" Gentlemen, if you have no objections I would
like to stop this with a little Ipecac." Both
responded, "Why, of course. Doctor, the case is
in your hands, but we have but just given Ipecac."
How is this for empiricism, allopathy, homoe-
opathy, or whatever you may call it, and in men
who claim so much, and "what httle good there
is in homoeopathy " ?
I can't help telling here exactly what I said to
them then : "Why, gentlemen, that is the purest
homoeopathy you could use, but you didn't know
it, as you probably prescribed it because Bartho-
low says on page 555 of his Materia Medica, and
that is probably your authority, that : ' It has
long been known that Ipecac, in small doses, has
the power to arrest certain kinds of vomiting.'
But did you ever notice," I continued, "that on
page 554 he says, * Ipecac in large doses pro-
duces this same vomiting.' " .
Now I may be considered rather enthusiastic,
but I couldn't help it, so just invited them to my
oflBce when they wanted to continue homoeopathic
practice homoeopathically. The Era seems to
think our' brothers have not, nor do they, use
any homoeopathy, and if their journals do not
show it, let us take their Bartholow as the crite-
rion, and compare him to Cowperthwaite, if only
on one subject. Ipecac : —
Bartholow says. Ipecac is good — 1st, for acute
indigestion, 2nd, for such symptoms as these:
— Much nausea and ineffectual efforts to vomit ;
a strong sense of epigastric oppression ; 3d, good
for membranous croup, capillary bronchitis,
laryngismus stridulus; 4th, acute or chronic
dysentery or diarrhoea with these symptoms : —
Stools are usually voided with much pain and
straining. The special indication for its use is
the occurrence of greenish stools, containing
mucus and sometimes blood. It is a hemostatic."
Now look at Cowperthwaite in his symptom-
atology : — '^ Distressing nausea and inclination
94
THE MEDICAL ERA.
[Vou VI. No. a.
to vomit with almost all complaints. Gastric
catarrh from indigestion ; distressing feeling as
though the stomach were hanging down ; frequent
stools of greenish mucus; bloody stools;' hemor-
rhage from the uterus ; blood bright red. Vio-
lent constriction at the throat (laryngismus
stridulus); rattling noises in the air passages
during respiration; dyspnoea, etc. Therapeutic
range: — croup, pertussis, bronchial asthma,
hemorrhages from all parts, diarrhoea, etc."
If you can't find homoeopathy in allopathic
journals, if you but look at the text books such
as Binger and Bartholow, it seems to me (who
have been on their side) the principle of similia
is clearly acted upon, though they may not j^rd
their cures in jau/mals.
Just one other case from experience, please.
While surgeon of H. M. Ship "Capulet," andoflf
Yucatan (Mexico), I had occasion to stop a
persistent nausea and vomiting in the cook (an
old sailor). According to my teachings on page
555 of Bartholow, Ipecac was given and the case
cured. What grand principle of cure was that
effected upon ? Was it " contraria contrariis
curantur?"
Now, so far as the old school is concerned (at
least in our district) I think I can show their
" scientific thirst after knowledge " through their
leading representative here, by a little confab
on Masonry and one of his cases, which roused
him as Zch. probably, as a fly kicking the
chrysalis of a butterfly. We talked of Masonry,
and as he is a Knight, I asked why he didn't go
higher, and said I meant to know it all one day.
" That's the difference between us two in several
things; I don't want to know any more of
either." This from one of those who have pos-
sessed themselves of '* what little good there is
in homoeopathy." I must say I'm not surprised
at his answer, nor would I be one day to meet
and ask, "WTience came you, and why here?"
When he shall answer, "From the ancient school
of hereditary know-alls and plagiarists of the
philosophy of eternity, elucidated in the nine-
teenth century, having learned a little < indication '
of Pulsatilla, etc., as prescribed in little pills and
sirup water by our like(ly) brethren. Now he
begs the address of authorities on the same sub-
ject, and I note him down in this way: —
Sharp's Tracts; Hahnemann's Organon; Hol-
comb's Bedside Tests, with no more foding, but
fmthy no more plagiarism^ but patience; no more
Calomel, but cleanliness, no more dosing, but diet,
no more guessing, but genuine, downright, hard
absorption of characteristics as capital, and draw
his 2 per cent per month at the bedside.
B. A. Leaoh, M.D*
Alcohol in Diphtheria.
Providence, B. I., Feb. 25, 1888.
To the Medical Era: —
Should I be limited to a single instrumentality
with which to stay the ravages of diphtheria, that
one would be alcohol. If the use of a second be
permitted it would be Arsenicum album; and if a
third, Hepar sulphuris oalc I care for naught else
in nine cases out of ten. The first is indispensable.
With it available I regard my patient serenely;
without it I would scarcely assxune the charge of
a case. My ordinary method of employment is as
a gargle, immediately before taking nourishment
or medicine, diluted with one or two parts water;
for infants the atomizer sprays the throat with a
mixture of equal parts. No objection is made to
a little reaching the stomacL The desideratum
is a compound sufficiently strong for one to realize
its presence, but not strong enough to bum the
parts.
Geo. B. Peck, M.D.
PERSONALS.
Dr. W. F. Hobart has located at 725 Lincoln
Av. Telephone 3930.
Drs. Orme and Manahan, Atlanta, have dis-
solved partnership. Dr. Orme will continue his
office at 42 N. Forsyth street.
Dr. H. J. Hoppin has removed from Geneseo,
m., to Ventura, California, where he has opened
an institution for the treatment of chronic dis-
eases. His wife, who is also a skilful physician,
will join him.
Dr. E. M. Hale has opened an office in the
Pullman Building, where he will have hours
from 11 to 12, especially for the purpose of
meeting heart-disease patients from out the city.
His son Dr. Albert Hale, will also have hours
there.
OBITTTABT.
On January 31, 1888, of apoplexy. Dr. George
Fellows, of Waukesha, Wis., aged 57 years.
On January 23, 1888, of pneumonia, the well-
known homoeopathic physician. Dr. Adolph
Lippe, of Philadelphia, aged 76 years.
COLLEGB COMMENOEKENTS.
Hahnemann Medical College held its thirty-
eighth annual commencement at the Grand
Opera House, Feb. 16th, and graduated a class
of seventy-eight.
The Chicago Homoeopathic Medical College
held its eleventh annual commencement at the
Chicago Opera House, Feb. 21st, and graduated
a class of forty-seven.
A more extended account will appear in our
next issue.
MISCELLANY.
Ebsbhcb of Fbfsinb (FoinrhiZii ). — A boIu-
tion of the EsBential Organic Ingredient of the
Gastbic Juiox, Extracted Directl; from the Pep-
tic GlandB of the Stomach.
This Essence of Fepsine is highly recommend-
ed where a fluid and agreeable form of pepsine
is desired. It is especially eligible for adminis-
tration to infants in vomiting and indigestion.
It contains but a slight trace of acid, not per-
ceptible to the taste ; whenever tki$ is indicated,
the proper tuidcan be added, and in the amount re-
qaired. The very decided acidity invariably found
in the ordinary wines, elixirs, etc., of pepsine, is
of very questionable ntihty therapeutically. It
is certain that there are cases, eapeci^y of
children, in which acid is not only undesirable,
but positively hurtful.
A teaspoonful just before or after food will be
found to aid digestion and assimilation ; also,
recommended at any time when suffering ttom
indigestion. In the occasional distressing attacks
to which chronic dyspeptics are subject, a few
doses will afford the most happy rehef. Faib-
CHiLD BRoe. & FosTEK, 82 & 84 Fulton St., New
York.
Fob Sale. — First class general practice in
Westera city of 200,000 inhabitants. Going m-
to eye andearexelusively. Price $3,500. This is
a bargain to some pushing man. A young man
can handle it if first class. Address, DOCTOR,
c«re UxDiOAL Era.
Ip yon will writelto Sardy,
Coles & Co., New York, men-
tioning The Medical Era,
they will send you a descrip-
tion of their clinical ther-
mometer that never breaks. It
is self-registering, and accu-
rate. This cut shows exact
size.
The Portable Ox^en Generator is the latest
and most compact thingofitskind in the market.
Write to Gross & Delbridge for descriptive cir-
culars.
Thb Ifarch CetUury wiU contain the story of
"Colonel Bose's Tunnel at Libby Prison," told
l^ one of the one hundred and nine Union offi-
cers who escaped on the night of February 9,
1864. The successful construction of this tun-
nel, dug from a dark comer of the cellar of the
prison, through fifty feet of solid earth — the
only tools being two broken chisels and a wooden
spittoon in which to carry out the dirt — was
one of the most remarkable incidents of the war.
Notwithstanding the large number of Hxfo-
pHOBpmTES on the market, it is quite difficult to
obtain a uniform and reliable Syrup, "Bobin-
bon's " is a highly elegant preparation, and pos-
sesses an advantage over some others, in that it
holds the varions salts, including Iron, Quinine,
and Strychnine, etc., in perfect solution, and is
not liable to the formation of fungous growths.
"I have prescribed Tonqaune with great suc-
cesB in the treatment of Neuralgia and have
never found any remedy equal to it."
R. C. McCamn, M.D., Benton, Miss.
The Pocket Urinary Test-Case
IS recommended by Prof. Clifford
Mitchell. It is the most conven-
ient device of its kind yet offered
to the profession. The contents
of the test vials can be replen*
ished at any drugstore, at slight
cost. There are thousands now
in use, and they give nniversal
satisfaction. It is the cheapest
test-case in the market. You
can determine: The quantity
of urine passed, the color, trans-
parency, reaction, sp.gr., total
solids passed, and the presence
or absence of albumin or sugar.
Write to Gross & Delbridge, if
you want one.
Hew Line to Oheyonn*.
The new extension of the Burlington Boute to
Cheyenne, Wyoming Territory, having been
completed, the C, B. & Q. B. B. is now running
a through sleeping car from Chicago to Chey-
enne, via Omaha, leaving Chic^o daily at noon
on "The Burlington's Number One " fast train.
For tickets apply to any coupon ticket agent of
its own or connecting lines, or address Paul
Morton, Gen'l Pass, and Ticket Agent, C, B. &
Q. B. R, Chicago.
96
THE MEDICAL ERA.
[Vol. VI. Ho. 4
THEY SAY
That praotioe is a field in which tact is the fer-
tilizer.
That phthisis is responsible for one-eighth of all
deaths.
That a prolonged diet of grapes will cnre dys-
pepsia. '
That a homcBopathic college is to be o pened in
Bogota.
That mathematicians seldom snfiPer from disease
of the brain.
That a donkey often does a great deal of
brayin' work.
That over -worked brain cells can only be re-
stored by rest.
That in this country and Canada there are
95,000 doctors.
That in Switzerland there is one Innatic to e^i^ry
200 inhabitants.
That life is short, pat^^iits fastidious, and col-
leagues deceptive.
That general paralysis is not a definite disease,
but a degeneration.
That as sanitary measures increase, low forms
of disease decrease.
That a worm will turn when stepped on, and
so will a barrel- hoop.
That pregnancy hastens the development of
carcinomatous growths.
That many fathers get up with the son, espec-
ially when it has croup.
That alveloz is the latest candidate for favor in
the treatment of cancer.
That anxiety causes more brain disease than any
other cause, except love.
That the common house-fly is an active carrier
of the infection of disease.
That inebriety should be considered a disease
as much as typhoid fever.
That the best plan to rid yourself of a tiresome
patient is to present a bill.
That ballet girls put on airs. Well, do let the
poor things put on something !
That severe cases of brain syphilis follow slight
evidences of secondary trouble.
That granular kidney terminates by cerebral
apoplexy in 75 per cent of cases.
That copaiba officinalis will relieve the pruritus
caused by external hemorrhoids.
That a man has namldd his dog tonic, because
he is mostly bark, steal and whine.
That the patient who pays his attendant is but
exacting; he who does not is a despot
That physicians in Germany sometimes make
professional calls for a fee of ten cents.
That a man of seventy has consumed in his life-
time 80 tons of food — solid and liquid.
That there is some difference between getting
on well in life and etting well on in lif a
That in a fatal case of chronic alcoholism the
post-mortem temperature rose to 110° F.
That morbility reports must form the principal
data for the vital statistics of the future.
That an examination of 1,000 school-children
showed that 708 had errors of refraction.
That in fever the waste of the organism is usual-
ly most marked as regards the adipose tissue.
That in 35 per cent of sterile marriages the dis-
turbance of conception is traceable to the man.
That a man who is constantly airing his knowl-
edge is troubled with a chronic disease of the knows.
That the physician should always appear to be
doing something, especially when he is doing noth-
ing.
That in eclampsia the convulsion bossee the
woman, but in hysteria the woman bosses the con-
vulsion.
That someone has discovered that castor oil can
be very easily taken with beer, but we prefer
pretzels.
That the older a man becomes the harder it is
to pull the wool over his eyes. There s less of it,
you know.
That an Italian gynecologist amputated the
uterine cervix of a patient rendered insensible by a
hypnotic sleep.
That the power of recognizing syphilitic dis-
ease is one of the most valuable gifts which the
physician can possess.
That burning is the only reliable disinfectant of
the discharges from the lung and throat in phthisis,
diphtheria and scarlet fever.
That a physician will be more censured for
failing to perceive and announce a fatal termina-
tion than for losing the patient.
That Colorado has a greater number of physi-
cians in proportion to the number of inhabitants,
than any other state in the Union.
That there is no demerit in belonging to a sect
provided it be engaged in a good cause and its
methods be tempered with liberality.
That aromatic spirits of ammonia, a one or two
drachm dose, is good for sobering up after ''a
drunk.'' It is better not to get drunk.
That a kidney may gradually pass from the
healthy into the chronic condition of wasting and
condensation, without there being any enlargement
at any period of the
THE MEDICAL ERA
Vol. VI.
Chicago, April, 1888.
No. 4.
EDITOKB :
CH. GATCHELL, M.D.
JAMES £. GROSS, M.D.
FOR THE BENEFIT OF IMPORTED
PA UPERS.
The campaign has opened. Politicians are
getting in their fine work.
A circular has been received at this office from
the Georgia State Medical Society, asking us to
petition our representatives in Congress to take
action to remove the tariif duty from all impor-
tation^ of surgical instruments and appliances,
to the end that cheaper ones may be imported
from abroad, and thus be placed within easy
reach of the poor. The plea is urged on the
grounds of "charity" and "humanity."
The plea is a veiy pretty one. But it is as
specious as it is pretty.
In a State whose convict labor system par-
takes of the methods of the inquisition, and
which attempted not long since to pass a law
making it a criminal offense to teach white
and colored children in the same school, it is
calculated to excite suspicion when the rest of
the country is called upon to join it in an act of
"charity." Would it not be well for that charity
to begin at home ?
But the underlying motive in this matter is
not far to seek. It is not one of " humanity " at
all — it is one of politics.
At the present time the two great political
parties of this country are divided on the ques-
tion of the tariff, and from the two factions peti-
tions are pouring into Congress. At this juncture
the Georgia State Medical Society — under the
specioas plea of having a charitable object in
view — calls upon the medical profession of the
United States to aid a certain one of these poli-
tical parties. The question is. Shall we do so ?
The answer is. Most assuredly not !
If this were really a matter of charity, then
we ourselves would have taken action long ago,
without waiting for the suggestion to come from
others. But it is not a matter of charity.
Let us look at it : Supposing it should render
surgical instruments less expensive ? The poor
do not buy surgical instruments. Surgeons
supply themselves with all such necessary ar-
ticles, and we have yet to hear the first complaint
from any surgeon/in the land that good instru-
ments are any too dear at present prices, while
poor ones would be dear at any price. American
cutlery is to-day renowned the world over for
its excellence, and Europe could not supply us
with anything better than we now make our-
selves.
Again, the raw material entering into the
manufacture of any surgical instrument amounts
to but a few cents ; the greater part of the price
represents American labor. Shall we , then, in
order to reduce the price of surgical instru-
ments, patronize the poorly paid labor of Europe
at the expense of American artisans? Not
knowingly !
The next question is. Would the poor be bene-
fited by this species of charity ? Not at all !
The surgical appliances which the poor use
in greatest number are trusses and artificial
limbs. The latter must, in every instance, be
made to measure, which involves their being
made in this country, as a matter of necessity.
Therefore, to place them on the free list would
98
THE MEDICAL ERA.
[Vol. VL No. i
have no effect whatever in reducing their price.
Trusses can be bought anywhere in America for
a dollar and a half. If there are any among
the indigent poor who cannot afiford to pay the
amount, there is not a county in any one of the
United States that would not furnish the instru-
ment without cost and without price.
And this brings us to the vital point of the
whole question.
Among native Americans there are no poor.
At least, they are not so numerous as to demand
a general reduction of the tariff for their benefit.
Among industrious artisans who have come to
this country from abroad, the same may be said.
The abtiskoitseSy asylums and hospitals of the
United States are being filled, not hi/ Amancans, but
by paupers, the mentally deranyed, the diseased and
tlie crippled who are dumped on our shores by the
ship-load by foreiyn Nations.
And now comes the Georgia State Medical
Society and proposes — after Europe has fur-
nished us with ruptured and crippled paupers
— that she shall also furnish us with *• surgical
appliances'* duty-free for these paupers to wear.
Great heavens ! Wliat a proposition !
America already contains too many undesira-
ble exotics ; too many demanding foreign flags on
public buildings; too many anarchists, whose
mission it is to destroy ; too many socialists, to
disturb established order; too many ** strikers,'*
to urge to violent methods ; too many alien pau-
pers, unsound of mind and diseased of body.
These gangrenous ulcers came into our country
duty free. And now we are asked to put Amer-
ican labor into competition with the source of all
this evil !
We respectfully, but firmly, decline. It is
time to call a halt.
THE BLACKEST OF CRIMES!
When a physician becomes a burglar, then
must we blush for our profession.
The confidence reposed by the people in their
medical attendants has long been proverbial.
That confidence is seldom betrayed. But at last
it has received a most violent shock.
The story is this: Dr. Geo. F. W^eed, a phy-
sician over fifty years of age, had long practiced
his profession in Newport, Maine. He had as a
patient an old man by the name of Peter Ben-
nett. Bennett was a miser, and had in a wooden
chest in the room where he slept the sum of
$34,000. This fact he had confided to Dr.
Weed. The doctor soon conceived the idea of
robbing the old man. He engaged the co-oper-
ation of two New York *• crooks." After their
arrival he took advantage of his professional
position to administer to his victim a heavy dose
of opium, and, aided by this, accomplished his
imrpose.
The story is best told in the words of the prin-
cipal witness, one of the doctor's accomplices :
'* On the afternoon of Friday, Dec. 2, between
12 and 2 o'clock, I stood on the sidewalk on Broad-
way, in New York, and a friend approached with
Clarence Whitney, whom I had never seen before.
We were introduced, and then the three of us went
into a saloon near by and had a couple of prinks.
My friend then left us and Whitney and I got a
private room and went into it. Whitney took out
a letter from Newport, Me., and told me of the
small fortune down there that a man could have
if he would pick it up. In twenty minutes I had
agreed to meet him that night and go down East
after the money. That evening at 10 o'clock we
took a train at the Grand Central depot and came
straight through to Newport, arriving there at
5 o'clock in the afternoon. It was then dark
and Whitney alighted upon the depot platform,
while I jumped off on the other side and hid my-
self in a coal shed near the freight tracks. In
about half an hour Whitney came down, found me,
and we went up to the office of Dr. .Weed. There
we found the doctor and we sat down and
made our plans for the robbery in his private office.
We slept there that night on a sofa with his buf-
falo overcoat for a covering. The next morning
he came in early and after a talk he started with
his team for Bennett's home, to 'see if the old man
understood his instructions about taking his opiate.
All three of us passed Sunday afternoon in that
private office. All that I had to eat was a little
lunch of crackers and oysters that the doctor
brought me in his pocket.
" We made our plans for the trip fully, the doc-
tor drawing a plan of the house, showing me evesry-
door, the location of the money, trunk, eta, and
saying that all we would have to do would be to pick
up the money and walk away with it We made
masks out of an old coat lining and got revolvers
in readiness. At 9 o'clock that night we left the
doctor's office for the Bennett place, meeting Wbit-
Apkil, 1888.]
EDITORIAL.
09
ney upon the railroad track half a mile away. When
we reached Bennett's orchard we put on our masks
and then entered the bam and proceeded into the
house, not a door being locked. Whitney was to
dispose of the old man and his wife, the doctor
was to care for the grandson and his wife, while I
was to drag oat the money trunk. I carried the
dark lantern and accidentally threw the rays full
into old Bennett's face. He awoke and sprang up,
while Whitney grappled with hiuL In the struggle
Whitney fired his revolver so close to me that the
powder blinded my eyes and I dropped the lantern;
the doctor became scared and bolted, leaving us in
the room alone. I took the trunk out of the house,
where Whitney and the doctor joined me, we rifled
it and ran. Whitney and I kept together, although
we knew that the doctor had nearly all the money.
We traveled until the morning commenced to break,
and then we plunged into the woods and concealed
ourselves. A cold rain commenced falling and we
crept under some logs for protection, but these
afforded but little. All day we lay in that chilling
place, and at night arose and tramped on. We
counted the money during the day and found that
we together had 14,000, thus leaving about $30,000
in the hands of the doctor. All we had to eat the
first day was a piece of bread Whitney had in his
pocket The second morning we called at a farm-
house and got something to eat, and then we
entered a little woodshed near the country school -
house and slept through the daylight hours. We
rode the most of the distance from that point until
we reached Rumford, where we were arrested."
Here is a plain statement of one of the most
wicked and infamous crimes ever committed. As
compared to it, ordinary burglary is an honor-
able pursuit. The professional burglar takes
his chances of finding valuables, and takes his
chances of discovery. But this doctor gained
his knowl^ge of the existence of treasure by
means of his professional position, and then
made use of his professional privileges in order
to drug his \ictim.
Thus was accomplished the moet vile, despic-
able and dastardly act ever laid at the door of
the medical profession. Pray God it may be
the last !
MAYHEM.
souri adds another to the catalogue of crimes
perpetrated by a physician. Here is the story
in this case :
Spbinofield, Mo., March 14. — Effie Ellis, of St
Louis, lies in agony, with her eyes burned out and
her face scarred with burns from vitriol. She was
an abandoned woman, and had ruined Fenton Cox,
son of Dr. George Cox, the United States pension
examiner of the Springfield district and a promi-
nent man pohtically and in the medical fraternity.
Worked up to a frenzy by the shame of a de-
bauched son, Dr. Cox enticed the girl from St
Louis by means of telegrams signed with his son's
name, and early this morning met her at the
Springfield depot There was but one carriage
there, and the driver hurried her into it with the
assurance that he was sent to her for that purpose.
It was still dark, but as the door closed she saw a
man in the- carriage, who seized her as she at-
tempted to step out She recognized him as Dr.
Cox. The whip was put to the horses, and in a
twinkling they were dashing down the street.
Horrified, she cried to the man for mercy and not
to murder her.
" I'll do worse than kill you — I will disfigure
you for life," was the response, and thereupon he
struck her over the head with a bottle of sulphuric
acid.
The liquid poured down over her head, face and
shoulders, and burned and ate its way into her
flesh, causing intense agony. Her eyes were also
attacked by the burning stuff, and she felt as
though she was being consumed. The doctor
also struck her several severe blows with his fist
Her cries attracted the police and the carriage
was stopped. The girl was taken to Steiger's
Iiotel and physicians called, who found that one
eye was totally destroyed and the other will prob-
ably become sightless. Her face, neck, shoulders,
and chest are scarred with bums, and she is horri-
bly disfigured for life.
But it is not the last.
As if not to be outdone by the East, the West
sends in its record with which to mar the page
of the history of the medical profession. Mis-
In most eases of this kind, the man is as
much at fault as the woman. But in this in-
stance it seems that the girl Ellis, by prolonged
and persistent effort, drew the young boy on to
his ruin. The father's indignation was righteous,
and his provocation great, but his method of re-
venge was both cowardly and despicable. By
trickery he got his victim into his power, and
then in a most brutal manner inflicted bodily
suffering and life-long injury upon a helpless
woman !
Further comment is useless. The profession
needs a new Hippocratic oath, and a penalty
for its violation.
100
THE MEDICAL ERA.
[Vol. VI. No. 4
XIX.
THE DOCTOR TALKS.
"Hello! Where /lave you been all this time?
I haven't seen you for an age."
With these words I greeted the Doctor as I saw
him step from a train at the Union Depot last
Friday.
"Been? I've been spending a few weeks in
New York's genial clime," replied the Doctor.
" After having passed through our usual winter in
Chicago, I concluded that too early a spring would
make me bilious, — it generally does, — so I start-
ed for a place where I could enjoy a few more
weeks of good, old-fashioned winter weather.
With t!iis end in view I packed up a lot of extra-
heavy flannels, took a great fur overcoat, and went
down to New York prepared for the worst. And
the worst came! Before I was half acclimated
they snowed me under with a fiercer blizzard than
Manitoba ever produced. I was perfectly par-
alyzed. And so was the entire city. Why, for
days, New York could neither feed her children
nor bury her dead."
" Just think of it," exclaimed the Doctor; " a
city that ordinarily consumes six hundred and fifty
thousand quarts of milk a day, was left without
enough to fill a nursing- bottle. A mother, with
tears in her eyes and silver in her hand, offered a
dollar for a pint of milk, and was unable to obtain it.
Wet-nurses — those human cows — were offered a
premium of twenty dollars a day to suckle the
children of the rich. One poor mother, tempted
by the golden bribe, left her own babe to the care
of neighbors, while for three days she sold her
breasts to a banker's child. Her own babe sick-
ened and died, and the sixty dollars scarcely paid
funeral expenses."
"Daring those eventful three days there was an
embargo on the transportation of both the quick
and the dead. Not a funeral was held, although
people died at a little above the usual rate. One
undertaker, who started out on Tuesday with a
eoffin containing the body of a child, became inex-
tricably stalled in the drifts that filled the street
from side to side. He took the small coffin from
the hearse and shoved it ahead of him over the
surface of the snow, while he floundered after. At
the nearest house he picked it up, pushed by the
servant who opened the door in answer to his ring,
deposited his burden on two chairs in the front
parlor, and, in spite of the protests of the members
of the family who by this time had gathered in
response to the servant's alarming cries, he an-
nounced that he intended leaving it there, and,
cautioning them to take good care of it, the next
moment he disappeared out of the front door and
was soon lost to sight in a huge snow-bank."
" But as soon as the blockade was raised," con-
tinued the Doctor, after pausing, a moment to take
breath, " there was a grand rush for the ceme-
teries. At one place alone, on Thursday, a hun-
dred and seventy -five men were engaged in digging
and filling graves. From nine in the morning to
six in the evening they had interred one-hundred
and thirty bodies, while forty-two were left over
for the next day. These were not all victims of the
blizzard, understand; they simply represented the
accumulated mortality of half a week."
" As to the business of the doctors, that, like
everything else, was completely suspended. On
that eventful Monday a patient who lived at a
greater distance than next door, never saw a phy*-
sician. To cross the street, even, required a degree
of moral and physical courage which was almost
prohibitory. As a consequence, many patients got
well — and some didn't."
At one of the medical schools, attended largely
by Southerners, the profane poet of the class put
the following lines on the blackboard:
m
SONO OF THE SOUTHBBN STUDENT.
<* < O, land of balmy breeze and lithesome lizzard,
<< < Give us one breath of spring to warm our gizzard;
<' * To melt our corpus from a to izzard,
<< < And free us from this d d infernal blizzard! '
" As for me," concluded the Doctor, '* the next
time I want to indulge in an extra week of winter
weather I shall try the climate of ice-bound far-off
Spitzbergen."
SELAH.
Apbil, 18R8.]
ADDRESS— PR A TT.
101
YAIiBDICTOBY ADD&BSS TO THE CLASS OF
'88 IN THX CHICAaO HOMCBOPATHIC
MEDICAL COLLEGE.
Bt prop. E. H. PRATT, M.D., LL,D.
CHICAQO.
Mr. President, Ladies and Gentlemen, Fel-
low Doctors : In behalf of the Chicago Homcjpo-
pathic Medical College, I rise to congratulate
you upon your arrival at professional majority,
and to speak a few words befitting our last meet-
ing as students and faculty. This is to l)e your
last lecture. The others are all over, and now
comes the peroration of your course.
The occasion is inspiring, and suggests many
an interesting theme. Had I the power to do
justice to my feelings on this occasion, I should
make this final talk both eloquent and instruct-
ive.
You have complied with all the requirements
for graduation, and are here assembled for your
degree and the parting blessing of your alma ma-
ter. Your diplomas are already in your hands,
and now, in wishing you God-speed in your
mission of healing, it is our desire to express
the wish with such intensity of feeling that you
can never forget the benediction.
We are justly proud of the class of '88. The
daily contact occasioned by your medical pil-
grimage with us has enabled us to appreciate
your manly characteristics, and has convinced
us of your fitness for the profession of medicine
and surgery. We have learned to respect you,
to admire you, and to feel an undying interest in
your welfare ; and although at the close of the
present exercises you are to pass from our im-
mediate care, the heart strings that bind you to
us" will never break, but stretch out after you to
the very end of your professional journeyings.
With us this occasion is but an annual celebra-
tion, but we fully realize that to each and every
one of you it is a climax in your lives. You
have dreamed of it, you have hoped for it, you
have struggled for it, and now, amid music and
flowers and friends, you have at last attained it.
It was a worthy object, and worthily have you
achieved it.
Your introduction to the medical profession is
now complete ; but before you leave us, consider
for one brief moment the nature of the obliga-
tion which, in accepting your diplomas, you
assume.
Y'our college is chartered by the state of Illi-
noiSy so that henceforth you are legally qual-
ified for assuming the care of the health and
consequent happiness of whatever patrons may
seek your professional services. Let me assure
you that it is easier to win a diploma than to
do it subsequent justice.
Y'^our chosen vocation has but one true mean-
ing — the preservation of health to those who
possess it, and its restoration to those who have
lost it.
Let drop from your memories all irrelevant
knowledge ; forget theories, forget technicalities,
forget anything and anybody that ceases to be
of service to you, if you choose, but never forget,
as you value your hope in heaven, that your
sole mission from henceforth and forever is to
save mankind from the opposing forces of des-
truction. Questions of emolument, of reputation,
of personal comfort are to be buried beyond the
possibility of resurrection.
In the medical profession at least, nothing
but a complete sacrifice of your life will ever
enable you to find it.
You will be expected to know when people are
sick ( for things are not always as they seem ) ;
you will be supposed to know the cause and na-
ture of that sickness, and to have at command a
remedy for it. Your college has taught you
anatomy, physiology and chemistry ; it has in-
structed you in pathology and diagnosis ; it has
given you the recognized principles and appli-
ances in surgery ; it has schooled you in pallia-
tives and adjuvants to be employed when nec-
essary ; and more than all, it has familiarized
you with the only scientific law of drug action
known at the present time — the law : Like is
cured by like. It has not only taught you the
science of medicine and surgery, but has done
what it could by its practical and extensive hos-
pital and college clinics to aid you in acquiring
the art of healing as well. As a college it has
done its best to thoroughly fit you for your call-
ing.
But there are some things it has not done,
and has not intended to do. It has not pledged
you to any dogma or narrow-minded philosophy.
It has not desired your allegiance to any the-
ories that time may not verify for you. It has
not obligated you to abstain from the employ-
ment of any force or agency that may benefit
your patients. It has not clipped your wings,
and you are at liberty to soar at will into the
vaulting realms of truth. It has taught you
homoeopathy, and your alma mater will feel
disgraced and deeply chagrined if you do not
avail yourselves of the marvelous power of this
wonderful law of drug action.
Hahnemann, with us, gentlemen, is an hon-
ored name, and shines brighter than any other
in the whole history of medicine.
102
THE MEDICAL EkA.
[Vol. VI. No. 4.
Other names are planets and smaller stars, and
when they shine give forth but reflected light.
Hahnemann is a sun, and while time lasts will
never set, for he glows with the fire of eternal
truth.
If you bring disgrace upon that name you
will but disgrace yourselves. May you never be
so disloyal to truth — so dead to your highest
obligations and best interests !
But your diplomas confer upon you the degree
of ** doctors of medicine and surgery." Drug
and medicine are not synonymus terms. Drug
is narrow, limited, mere matter in some form.
Medicine is broad, unlimited, and means anything
that will prevent, cure, or alleviate human suif er-
ing. Think of that, gentlemen, and in the face
of any blinded bigotry, or petty selfishness that
may seek to limit your resources or fetter your
freedom, stand out boldly for your full preroga-
tive.
You may often require all the assistance that
earth and its treasures can lend you ; you will
always need all the forces of heaven you may
be able to enlist to accomplish your work.
Preventive medicine is sadly in need of your
earnest consideration.
Questions of diet, of work, of rest, of clothing,
of climate, and of sanitary science, and still
deeper questions of hfe and faith, will look to
you for their answers. Can you not, beginning
your career in the full possession of the accum-
ulated knowledge of the past, outstrip your pred-
ecessors and return such answers to these ques-
tions as will save the race much of its accus-
tomed misery ?
May'we not hope for you the honor of disclos-
ing the prevention ( for there must be one ) of
diphtheria, typhoid, yellow and scarlet fevers, of
cholera and all the dreaded scourges that pre-
maturely harvest so many human lives ?
Can you not disclose for the benefit of man-
kind, the hidden sources of cancer, consumption
and the other so-called constitutional disorders,
that there may be some escape from their
ravages ?
Preventive medicine is young and ineflBcient ;
let it receive your early and continued attention.
Palliative medicine is but an apology for better
work. Unfortunately, however, our present knowl-
edge is so limited as to render it still useful.
Common humanity moves us to alleviate when
we cannot cure, and we must be ever ready to
comfort the distressed, cheer the down-hearted
and give rest to the weary.
It is sad work ; voices call to you, that you
cannot answer ; looks plead for assistance you
cannot render ; hands stretch out to you that
you cannot grasp.
Many a time will you be thus admonished of
your own insignificance and made to feel how
little a doctor knows and how httle he can do in
a serious battle with disease and death.
There is nothing attractive or satisfying or
encouraging in palliative medicine. It only
smooths the way to the inevitable — it does not
stay it. Morphine, chloral, cocaine, and the
whole list of narcotics and anodynes are a
mournful company of drugs. They are com-
panions of hopeless misery, of despairing afflic-
tion, of professional weakness and incompetency.
Their record is so bad that they ought to be
kept in black bottles witji sealeil stoppers. It
is a misfortune to both patients and doctors
when their use becomes imperative.
But the third department of medicine is more
inviting. In curative medicine you will find abun-
dant opportunity for winning any of the rewards
of either time or eternity to which you may aspire.
The sick and suffering are everywhere crowded
into sanitariums and health-resorts ; taxing the
energies of almost every household ; congregat-
ing in cities and scattering into the country ;
boarding trains and embarking on steamers;
laving in springs and swimming in oceans ; as-
cending mountains and penetrating forests;
chasing up and down the entire world in the
vain effort to escape from themselves.
Every spot on earth where human beings
abide is well supplied with them, and as dealers
in curative medicine your counsel will be fre-
quently sought.
Are all the resources of curative medicine at
your command ? and are you free enough and
fair enough and honest enough to employ what-
ever force or agency or line of treatment the
case demands?
Kemember that the state has selected the
term medicine because of its broad signification ;
and as doctors of medicine under the authority
of the state you must accept your title in all
its comprehensiveness.
You are not graduated as doctors of drugs,
but as doctors of medicine.
The condition of your patient may need rest,
it may need exercise, it may need water, it may
need air, it may need the administration of drugs ;
it often needs the mere stopping of them. It
may need the consolations of a home ; it may
need a sojourn among strangers. It may need
some form of bodily patching, and it may need
the regeneration of a soul.
ApBtL, 1888.]
ADDRESS — PR A TT.
103
Whatever necessary knowledge and training
has not been included in the college curriculum
you are expected to supply. The human body
upon which you are to practice the art of healing
is a wonderfully complex affair.
The animal, vegetable and mineral kingdoms
contribute to its formation. Its particles are
held together by magnetic forces and are con-
stantly vibrated by electrical currents.
The structure, however, is material and tends
to decay. In the language of imagery —
'^Man is bom on a battle field: round him to rend
Or resist the dread powers &e displaces, attend
By the cradle which nature, amidst the Htern shocks.
Which have shattered creation and shapen it rocks,
fie leaps with a wail, into being: And lo!
His own mother — fierce nature herself is his foe.
Her whirlwinds are roused into wrath o*er his head;
'Neath his feet roll her earthquakes; Her solitudes
spread
To daunt him; Her forces dispute his command;
Her snows fall to freeze him; Her sun burns to
brand;
Her seas yawn to gulf him ; Her rocks rise to crush ;
And the hon and leopard allied lurk to rush
On their startled invader."
But that is not all, for while it is true that the
history of the bodily career is a record of one
continued struggle against the disintegrating ele-
ments of time, it is also true that the wind of the
spirit plays no insignificant part in its shaping.
"For when man has tamed nature, asserted his
place
And dominion, behold, he is brought face to face
With a new foe — himself: war is waged within
His own heart; for self-knowledge is knowledge
of sin;
And many have striven, and many in vain.
With the still rebel heart and still baffled brain.
Some have conquered, some died of that conquest,
but all
Have suffered and struggled; and whether he fall,
Or whether he vanquish, still man on the field
Of life's lasting war, may not rest on his shield,
May not lean on his spear till the armed archangel
Sound o'er him the trump of earth's final evangel."
Nobody who has seen fear blanch the face and
start the excretions in a cowardly effort at bodily
annihilation; nobody who has seen love fan
back to a ruddy glow a flame of life almost gone
out; nobody who has seen sorrows and cares
and disappointments check the native buoyancy
of organs; nobody who has seen hope and
realization and good cheer gladden the entire be-
ing with renewed vigor ; nobody who has seen
ambition, greed and false pride and all forms of
8€lf-love lash a body into such superhuman
efforts for the achievement of gratification as to
wear it out, and break it down prematurely;
nobody, in short, who has ever lifted his eyes
from the surface of the earth long enough to
catch even a glimpse of the sky, with its clouds
and shine and storms and calms, can question
for one moment that mind can rend the body or
can heal it; can throw it into discord or vi-
brate it back into harmonious action.
My dear doctors, do not go out to your work
to-morrow with the belief that you can tune the
complex harp of time known as the human body
with material tools alone.
Equip yourselves with all the armamentaria
that matter dan furnish you, but do not forget
that, in addition to this outfit, you must be hope-
ful enough to cheer the discouraged. You must
be brave enough to calm the fearful. You must
be wise enough to instruct the foolish. You must
be good enough to reclaim the bad.
Gentlemen, it is true that if mental forces can
destroy, they can also build up. If they can
become disordered and work bodily mischief, they
can also be readjusted into such harmonious
action as shall materially assist you in the pur-
poses of bodily repair. Let me, however, in this
connection, give you just one word of warning,
that you may not be tempted to give undue
prominence to the action of mind over matter.
The great subject of mental therapeutics is
now and always has beefH in an exceedingly
chaotic state, and for a very good reason. It
has been handled chiefly by a class of so-called
healers, for whom there is but one well fitting
term of designation — spiritual quacks. They
forget that higher forms make use of lower
forms to rest upon.
A butterfly was once a worm. A tree that
furnishes shade and fruit came by way of the
ground. A spiritual being, as it passes on its
way, takes on a material form ; every word by
which we express a spiritual thought has early
in its history been used to express a material
one. These changes are stages of development
and are essential in the revolutions of time, and
never until men who are well grounded in nat-
ural science give their attention to the matter
will there be developed a sufficient knowledge
of spiritual anatomy, physiology and pathology
to place mental therapeutics upon a respectably
scientific footing and render it at all worthy a
place in the curriculum of a medical college.
But even when that time comes, gentlemen, and
mind is duly installed on its proper throne, you
must not expect too much of mental science. It
may, nay, must, do wonders in the prevention of
disease; it will undoubtedly render valuable
104
THE MEDICAL ERA.
[Vol. VL No. 4.
aBsistance in removing disease. But never, until
a tree can live without its roots and an animal
without its food, can mental therapeutics become
adequate to the entire demand for remedial
measures in sickness.
The grand accumulation of medical lore which
the great past has accomplished and to which
you now have access, is not so easily dispensed
with. The indefatigable labors of succeeding
generations of doctors of medicine have not been
in vain, and time cannot build too many, too
lofty or too enduring monuments to the memory
of the departed great in medicine and surgery.
Not a fact in our sciences is unimportant. Not
an item of knowledge is useless. •
Let vandalism attack governments, kingdoms
and all social and political fabrics if it will, for
they can be reconstructed. But let it spare our
schools, our libraries, our sciences, for their loss
would be irreparable, and our health and happi-
ness depend upon them.
My plea is not that you should value these
less, but simply that while you duly appreciate
fair earth and her exhaustless treasures, you
may not entirely ignore the over-arching vault
of heaven.
It takes a combination of spirit and matter to
form a human being ;
It takes a combination of spirit and matter to
develop a human being ;
It takes a combination of spirit and matter to
maintain a human being ;
Why should it not require a combination of
spirit and matter to cure a human being ?
Go out now, gentlemen, into this great broad
field of medicine and labor where ever you will.
Your college has fitted you especially for the
practice of surgery and the prescribing of drugs.
To these branches of medicine most of you will
undoubtedly devote your energies. But in the
pursuit of your specialty strive to remain broad-
ininded enough to recognize and appreciate the
good in all forms of healing.
Graduates of the Class of '88 : there is, per-
vading all nature, a law so universal that the law
of gravity is but a small portion of it. It is the
law of natural selection, of action and reaction ;
the law by which like attracts like.
By this law gold and other minerals arrange
themselves in narrow veins ; by this law plants
alike in kind are congregated in closely huddled
patches; by this law birds and other animals
seek out their fellows and form themselves into
large families ; by this law mankind divides it-
self into nations, communities and organizations
with ties of common interest ; by this law, eye
answers eye, voice responds to voice and heart
speaks back to heart ; by this law, all nature
echoes back to you whatever you give out to her,
be it through work or deed.
Would you wreathe a neighbor's face with
smiles ? Then smile upon it.
Would you rouse a kindly feeling in another?
Warmth from your own heart is sure to ac-
complish it.
Would you stir into activity noble impulses,
manly courage, and all the virtues essential to
the winning of life's best prizes ? You have but
to speak to these qualities in their own language,
and as surely as a tense wire vibrates in
answer to the music of its own pitch, so surely
will every string of the human heart respond in
faithful echo to the voices that call out to it.
In pronouncing the benediction of this faculty
upon you to-day, I feel that I shall but voice the
sentiments of every member of it, when I assure
you that we shall make use of this law in our
future relations with each and every one of you.
We shall call out to your manhood, to your
honesty, to your best loves and highest motives,
and keep on calling until the echoing of these
qualities shall reverberate through your being so
loudly that you will be unable to listen to less
worthy voices.
You must be good ; You must be true ; You
will then be great.
We trust you, we believe in you, we know j'ou
will not disappoint us.
Good-bye, boys, — don't forget us, — we shall
never forget you. Be hard students of life — it
is the only way to prepare properly for that
other examination that in the uncertain future
comes for us all, and introduces us to those other
and grander commencement exercises that mark
the beginning of our life beyond. — Good-bye.
Albuminuria.
We should absolutely give up the idea Btill
current in practice that albuminuria must always
coexist with nephritis. The most frequent cause
of chronic albuminuria is that in which albumin
filters through the kidneys because of defective
assimilation of albuminoids.
We must abandon the idea still held by many,
that we can supply the loss of albumin by a
highly nitrogenous diet, because this can only
increase the albuminuria, the overloading of the
organism with nitrogen only augmenting the
defective assimilation of albuminoids. On the
contrary, as soon as albumin is seen in the urine
we should at once have recourse to a milk diet,
which in a few days is sufiicient to cause the
albumin to disappear, or at least to decrease
considerably. — Med, News.
Apul, 1668.1
ORIGINAL ARTICLES
105
ORIGINAL ARTICLES.
A BTVDTOF THB IODIDE OF ABBXmO.
Bt H. D. CHAHPLIN, A.B., 1I.D.
OLITBLAXO, OHIO.
ARSENICI lODIDUM; Arsenicum iodatum ;
Hydriodas arsenici.
Iodide of arsenic is formed by the com-
bination of Arsenic and Iodine. Its action upon
the human economy is profound and long-last-
ing.
General Characteristics.
In cachexia of malarial, strumous, and scrof-
ulous type, when marked by emaciation, debil-
ity, and general exhaustion ; discharges watery,
excoriating, ill smelling and profuse; glands
generally implicated.
Fains are burning, lancinating in character.
Great restlessness and thirst ; much prostration.
Therapeutics.
Eyt%. Purulent and phlyctenular ophthal-
mia with a thin, acrid, corroding discharge,
which excoriates the surrounding parts; great
burning and restlessness.
Granular conjunctivitis.
Iritis, especially in strumous persons, and
when pain is burning in its character.
Earn. Otorrhcea with fetid corroding dis-
charge.
Otitis media with inflamed lymphatics.
NartH, Acute coryza; thin, watery, acrid
flow, and catarrhal trouble — extends even to
stomach and bowels.
Chronic nasal catarrh, abundant, acrid, burn-
ing discharge, scalding sensation in nose and
throat; subjects are delicate and tuberculous;
old cases, when discharge becomes fetid and
bloody, scabs and pus, and there is lassitude and
prostation.
Hay fever, discharge thin and excoriating, and
patient presents the appearance of being ** played
out."
Ozsena; ichorous discharge, odor foul, and
almost unendurable ; in malignant cases when
constitution shattered.
Ozfiena syphilitica; acts promptly and well.
In epidemics of influenza in the winter months,
where discharge was fluent, watery and mildly
irritating in its character, puiBSness of the face,
patients complained of aching and soreness with
chills and flushes of heat and general used up
condition ; (it has done me yoeman service in
alternation with Gelseminum).
Throat, Chronic larjmgitis — husky voice,
burning in throat, and there is a disposition to
tuberculous deposits.
Malignant diphtheria — profound depression of
all the vital forces.
Croupous diphtheria — great restlessness,
hoarse cough, pulse slow and weak.
Respiratory Organs, Pulmonary phthisis —
soreness in larynx, hoarse racking cough day and
night with profuse purulent expectoration.
Bronchitis — where there is debility associated
with deficient oxidation, cough dry, and glands
are enlarged — all the more indicated in over-
grown young people with weak lungs.
First stages of the croupous form of pneu-
monia when there is a tendency to bronchial and
pulmonary congestions — sensation of weakness
in the chest with oppression, anxiety, burning
stabbmg tearing pains, cough with dyspnoea and
blood-streaked expectoration.
Pleurisy, when exudation has taken place,
acts by improving general constitution.
Heart, Hypertrophy with dilatation — severe
and violent palpitations, anxiety, dry cough and
asthma.
Angina pectoris — with dropsical symptoms,
venous hypersemia, and cyanosis.
In cardiac debility depending upon general
exhaustion.
Bmvels, Chronic diarrhoea of an exhausting
character — stools watery, purulent, fatty, and
scalding the anus to rawness.
Inclination to constantly change position.
Emaciation rapid, although digestion good and
patient eats often and much.
Inanition with enlarged abdominal glands.
Cholera infantum — watery acrid stool, cadav-
erous smelling, and there is every appearance
of an early dissolution.
Tabes mesenterica, and chronic hydrocephalus
— when the tubercular cachexia is present.
Female Genitals. Utertis. Endometritis with
corrosive discharge ; frequent and profuse menses ;
ulceration of os.
Chronic endometritis — with thin, watery, bad
smelling discharge, and patient is liable to have
sores — scirrhus and epithelial cancer of cervix
and OS — parts are indurated and there is a con-
tinual discharge of an acrid, excoriating char-
acter, mitigates suffering and renders life a little
more endurable.
Leucorrhoea corrosive — watery, with too pro-
fuse and frequent menses, generally find an
ulcerated condition of the os-r-as fin accompani-
ment.
106
THE MEDICAL ERA.
[Vol. VI. No. 4.
Hydrops ovarii — burning pain, corroding leu-
corrhoea, mammary glands become atrophied,
strumous constitution.
Male Genitals. Vems, Chancre, where ulcers
are phagadenic and gangrenous with bloody
edges, and acrid, corrosive pus.
Bubo — either simple or specific, when there is
a scrofulous dyscrasia, acts as no other remedy
witk which I am acquainted.
Breast. Scirrhus of the mammaB where there
is debility and a manifest increase in size. En-
largement of glands very marked. Tumor pain-
ful and sensitive to touch, great emaciation,
restlessness and thirst.
Mammary abscess with throbbing pains, great
restlessness and much thirst.
Skin. Abscesses ; discharge corroding, ichor-
ous, and putrid smelling, with great muscular
prostration.
Abscesses of scrofulous type which threaten to
become gangrenous.
Icthyosis — (does all that can be done).
Lupus exedens.
Psoriasis of entire body, and obstinatein char-
acter. (Has done more in my hands than any
other remedy.)
Dermatitis exfoliativa and erythema of the
face — has generally proved curative.
Ulcers of an indolent and irritable type, accom-
panied with an exhausted constitution, burning
lancinating pains, and all the more indicated
when the sore is consequent upon the long con-
tinued abuse of liquor.
Bhod. Pyaemia, septicaemia, or where there
are any indications of it, proves a valuable ad-
junct.
Traumatic, senile, and hospital gangrene.
Joints. Coxalgia, restlessness, emaciation,
rapid exhaustion, diarrhoea which is w^orse at
night.
Synovitis.
ABNOBMAIi HUNGER.
Bt dr. W. E. HATHAWAY,
XABTVILLB, TENN.
A FEW months since I had a patient who
gave me an unusual amount of trouble
and difficulty to find the curative remedy.
The patient was a young lady of highly
nervous organization. She had been, for some
weeks, overburdened with the care of a sick
sister. The most marked symptom was abnor-
mal hunger, that recurred within an hour or two
after eating. If not satisfied, the patient ex-
perienced a gnawing and unbearable agony. A
very moderate amount of food satisfied the
hunger temporarily, but it returned day and
night, waking the patient out of sleep. She had
to provide food by her bedside and take it
through the night, the first thing in the morning;
frequently between meals through the day and
the last thing before retiring for the night.
With this there was considerably accelerated
heart's, action, great general exhaustion and
weakness, anaemia, diarrhoea, irregularity of
the menstrual function, and great nervousness.
Ferrum, Phos., Calc. carb. and Arsenicum all
seemed to do some good, but the hunger
symptom continued. Ars. iod. 6x checked the
diarrhoea ; Calc. carb. 3x improved the concomi-
tant symptom of cold extremities. Ferrum
seemed to steady the heart somewhat — but the
hunger trouble was still intractable. I feared mes-
enteric tuberculosis. The digestion seemed too
active, the secretion of gastric fluid too free. The
mill ground out the grist, so to speak, too quickly,
and unless more was supplied began to grind
upon itself. It really seemed as if the stomach
was threatened with self destruction. I feared
ulceration and final collapse of digestive power.
In this dilemma I bethought me of applying the
homoeopathic law to control the gastric secretion.
I could find no authority for the programme
that, it seemed to me, ought to meet the case ;
but its correctness, according to the law of
homoeopathy, commended it. The 4:X dilution
of Lactic acid and the 2x of Muriatic acid,
fifteen drops of each in half a glass of water, a
teaspoonful every two hours, corrected the
trouble very promptly. After discontinuing
this remedy the trouble returned somewhat, but
again promptly disappeared on the exhibition of
the combined acids, and this time the cure
seems to be complete, for the medicine has
been discontinued several months with no return
of the trouble, and my patient is restored to
health and vigor.
My theory was that the dilution of the acids
would stimulate an alkaline secretion in the
stomach and retard the too intense digestion.
Whether the cure was actually in accordance
with this theory I will leave others to judge;
suffice to say the cure was and is complete and
satisfactory.
Postscript. — A half hour ago I finished the
above brief article and laid it aside. Then I
settled myself in my easy chair and took up a
new journal, the Dietetic Gazette, a sample copy
of which recently came to hand. Glancing over
its pages to see what of interest it might contain
I chanced upon the foUowng :
Hyperacidity of the Stomach. — A number of
more or less important observations have recently
Apbil, 1888.1
ORIGINAL ARTICLES.
107
been made in Germany, France and Bnssia on
hyperacidity and hypersecretion of the gastric
juice. A continnous acid secretion has been de-
scribed by Beichmann and others. This condition
has been called gastrorrhoea acida. It arises
chiefly as a symptom of disease of the nervous
system, such as tabes, in hysteria, and neurasthe-
nia, but occasionally as an independent disease of
the nervous apparatus of secretion brought about
by constant over- irritation in a neurotic subject.
The chief symptom is vomiting, generally at least
once a day, often at night or 'in the early morning,
of a quantity of almost pure gastric juice, un-
mixed with remains of food, but often bile-stained.
It occurs chiefly in young persons or those belovr
middle age, often periodically, without any ap-
parent cause, the patient waking in the night with
heartburn and severe cramping pain in the
stomach, thirst, etc., succeeded shortly by copious
vomiting. There is often headache, restlessness, and
altered expression of the countenance. The at-
tacks may last for twenty-four hours or a few
days, and in some hysterical cases for weeks or
^ months. The acidity of the vomited matter varies
from .8 to .4 per cent in different cases (average
nonnal gastric acidity during digestion --=.2 per
cent.) It digests albumen well, if free from or-
ganic acids, and presents all the characteristics of
almost pure gastric juice. The diagnosis is rend-
ered certain if the stomach be washed out at bed-
time and all traces of food removed, and the fol-
lowing morning a quantity of fluid of the character
described above be found in it. Digestion is often
marked by an increased acidity, by the retention
of starchy matters in the stomach, and by the ab-
sence of all traces of muscular fibre after the food
has remained in the stomach a few hours. There
is usually increased appetite and a frequent crav-
ing sense of hunger, compelling the patient to eat
frequently during the day, and even to rise at
night to satisfy it, increased thirst, heartburn, and
painin the stomach, particularly at night. When
the disease lasts for any length of time there is
wasting and anaemia. The disease is rare, accord-
ing to Beichmann, he having only noticed six cases
amongst several hundred examined with the sound.
Treatment consists in washing out the stomach so
as to free it for a time from its acid contents. Wash-
ing out the stomach with alkaline solutions is also
very beneficial. Solutions of nitrate of silver (1 — 2
in 1000 of water) lessen, in a certain measure, the
hypersecretion. In less pronounced cases, after
several washings out, alkaline saline waters may be
taken in the morning fasting, or solutions of nitrate
of silver (1*2 to l\ grain in 10 drops of water) in
a gelatine capsule. Alkalies are often necessary
daring the night as palliatives. As to diet, dry
food, consisting almost solely of albuminous sub-
stances, such as eggs and meat, which soak up
the excess of gastric juice, is most useful. In
order to quiet thirst, injections of water may be
given j)er rectum*
Compare my hurried description of my
patient's symptoms with this more careful path-
ological exposition, and it must be confessed that
they belong to the same genus. Then, oh then,
shades of Hahnemann ! compare the therapeu-
tics — the clumsy stomach washings — the fre-
quent gagging stomach pump — the rectal in-
jections — the alkaline solutions, the high and
mighty resources of ** regular" and "scientific,**
* * rational " or * * physiological * * medicine —
and what do you think of it ? Is it not really
a wonderful fact, worthy of being blazoned across
the sky in letters of light, that there is a law for
our guidance in therapeutics ? A law which, com-
prehended and obeyed, turns the wisdom of the
wise into foolishness, and out of the mouths of
the very babes of homoBopathy perfects its praise.
THE ANTITHEBMIO TBEATMBNT OF
TYPHOID 7EYEB.
bt dr. p. jousset.
PABIB.
[Cllniqne of the Hospital Salnt-Jacqne. Tranelated from
VArt Medical, by H. P. Holmes, M.D., Sycamore, 111.]
REDUCING the teinperature, treating the
hyperpyrexia, is an illusion which has been
established as a therapeutic method, and
it has given rise to a school which only consid-
ers the hyperpyrexia, and regards it as the
most important feature in typhoid fever. Others,
however, with good reason, look upon it as a
single symptom only. For reducing the tem-
perature they employ either cold water or cer-
tain remedies called antipyretics.
The first method is simple even to naivete ; it
consists in plunging the patient into cold water
as soon as there is an elevation of temperature.
Peter has very appropriately said it was a "fire-
man's therapeutics " {tlierapeiitique de pompier.)
The method has been extolled by Brand ; the
proceeding is simple; the patient is plunged
into a bath at 68"^ six or eight times in twenty-
four hours. There are two errors in this method :
a physiological and a therapeutical error. The
first error is that ** the hyperpyrexia constitutes
the danger, and nearly always is the cause of
death." This error comes from Brand, who
found that a temperature of 107.6'' produced a
vitreous coagulation of the muscular fibre, the
degeneration of Zanker. There are carfes from
Valleix which demonstrate that this degenera-
tion is independent of the heat. Physiological
therapeutics are full of danger. The high tem-
perature alone does not suffice for producing
death, and there have been cases in hysterical
subjects and in spinal disturbances where there
wfts a temperature ^ym above 108° without
108
THE MEDICAL ERA.
[Vol, VI. No. i.
danger of the patient's dying. The high tem-
perature, then, is not the cause, but one of the
expressions of the gravity of the disease (Peter),
and a favorable prognosis may frequently be
given in spite of the hyperpyrexia. The second
error in Brand's method is in the mode of ad-
ministration, which prevents the reaction. All
physicians who believe in hydropathy agree
upon this point, that the central temperature is
neither lowered during the cold bath, nor after
it, so long as the reaction does not occur.
Caulet, physician to the Pyrenees Waters,
said the formula of Brand prevented the cold
baths from exercising their antithermic action
and rendered them oflfensive and dangerous.
Passing to the proved statistics: If Brand's
statistics be consulted the mortality is found to
be wiZ; every patient has recovered ! Ricklin
gives the statistics of the Rodolphi Hospital, in
Vienna, where Brand's method is employed in
all its rigor. These statistics, carried through a
period of seven years, give a mortality of from
15 to 27 per cent.
Labadie-Largrave, in a thesis, gives the sta-
tistics of Schmidt, who gives as an average in
the adult a mortality of 1D.6 per cent. The
statistics of the German army gives only a
small mortality, seven to fifteen per cent (Glen-
ard), while in the French army we have 40.5
per cent. That excessive difference is due as-
suredly to confounding synochal and typhoid
fevers. In Algeria, however, we have only 21
per cent. Brand's method is dangerous and
may produce grave accidents. In patients
treated this way, in fact, we frequently notice
pneumonias, interstitial hemorrhages, and cases
of sudden death.
Cold water in the treatment of fevers had
already been employed by Curie in 1792 and
later by Recamier in 1840; but after another
method which consisted in-producing a reaction
instead of preventing it. Recamier placed the
patient in a bath tub and threw over him five
or six pailfuls of water; he was then carried
to his bed and vigorous frictions were given to
hasten reaction. I have even seen them
prescribe frictions of Croton oil over the whole
body following these cold affusions and one
patient thought to be already dead was cured by
these means.
Cold affusions may be serviceable in certain
grave forms, and by these means you will fre-
quently see the delirium cease and the patient
grow calm. In the insane the douche produces
the same effect. There are then two ways of
employing cold water ; one brutal and unscien-
tific, as Brand's method ; the other milder and
more scientific, based upon the necessity of the
reaction which should follow the cold affusions.
We have here a means which we may be able to
use in certain well indicated cases. The high
temperature is a condition which shows that the
cold water will be well borne; therefore this
mode should not be employed where there is
only a slight elevation of temperature; yon
would not obtain any good results. Cold water
is much better borne where the temperature is
more elevated.
There is still a milder way of employing cold
water. It is in the form of simple spongings,
which may be done without taking the patient
out of his bed. In grave cases I think that the
physician, after having warned the family of the
danger of the case, may employ one of these
last methods. It will not cure the patient, but
the temperature will be lowered and one will
thus have a little respite during which the
remedies may be able to act ; time may be saved
by this means.
A word now on antithermic remedies : The
remedies most frequently employed to this end
are : Sulphate of quinine, Antipyrine, Salicylate
of soda, Phenic acid, Alcohol, etc. These reme-
dies lower the temperature but do not prevent
the progress of the disease. Let us examine the
question a little farther. You may lower the
temperature ; that is all right, but it returns ;
you continue, the disease progresses and the
patient occasionally, if not oftener, dies imder
the treatment. Why is it so? It is because
the antithermics cannot act against the malig-
nancy; then reduce the temperature without
diminishing the danger. It is not the high
temperature but the malignancy which con-
stitutes the danger and the patient is left
to the mercy of the disease while you are
trying to lower the temperature. This is
not a reason for giving up cold water; that
permits a saving of time, as I have said.
The malignancy is characterized by a sort of
derangement of the negative functions. There
are two species of this malignancy: the per-
nicious is that which comes in repeated attacks ;
the other which is continued is, properly speak-
ing, the malignant form. The pernicious at-
tacks have been noticed in pneumonia, pleurisy,
typhoid fever, etc. In the old hospital Saint-
Jacques I have seen cases of typhoid fever as
grave as that of our , patient and yet these
patients were cured; but the malignancy re-
turned in attacks. Now then, we have a means,
I will say almost infallible, of combating the
pernicious intermittent; it is the Sulphate of
quinine.
ktaiu 1S88. 1
ORIGINAL ARTICLES.
109
But there are cases where the malignancy
continues, and against that we are are com-
pletely disarmed. In these grave cases there
are several means which may be employed : cold
water. Arsenic, China, Carbo vegetabilis, Lachesis
and Phosphorus.
Cold water in the form of lotions or afifusions
has a certain action, but it is ephemeral. It is
indicated by the high temperature, ataxia, and
adynamia.
Arsenic is indicated where there is a high
temperature with chilliness of the extremities,
pnlse small and frequent, great thirst, dry
tongue (which is a prominent symptom), anxiety
and excessive restlessness.
Carbo vegetabilis is a remedy for adynamia,
anxiety and collapse. Carbon not being ab-
sorbable, we use it according to the triturations
of oar school. Chnical experience demonstrates
that it is the higher dilutions which act best ;
the twelfth or thirtieth dilutions. You see we
employ the remedies in all potencies and base it
only on experience. China and Sulphate of
quinine are given in large doses, while Carbo
veg. acts better in the small dose.
Lachesis is indicated by a tendency to hem-
orrhages, petechial eruptions, adynamic state,
coUapse, feeble pulse and fainting.
Phosphorus is especially indicated by the
tendency to hemorrhages like the preceding
remedy.
En resume : Cold water — a powerful remedy,
without danger, if used in affusions, may, with
the reaction which it produces, arrest death at
the threshold and give time for action. You will
then use Arsenic or China ; Arsenic if there is
restlesness, China if there is indifference and
sleep wi^th open eyes. Finally Lachesis and
Carbo veg. in the collapse.
In closing this lecture I will say a word
about two patients. The first is in No. 12 of
the large ward.
It is a young chlorotic girl treated with Iron ;
she was doing well enough, when she was taken
with supra-orbital neuralgia. The pain in-
creased from midnight till morning. I had
occasion to again verify the action of Nux
vomica. I gave this remedy in the 12x dilution
and in two or three hours the neuralgia had dis-
appeared. Whenever you have to treat a supra-
orbital neuralgia coming on in the morning, you
may be certain of succeeding with Nux vomica
in a high dilution.
The other patient is a rheumatic who had an
acute attack of rheumatism some two years
ago. She entered the 30th of November with
four or five joints affected and a temperature
varying between 100^ and 102.5. I gave China
sulph. on account of the remittence of the fever.
At the end of a few days the fever had fallen
and the joints were fi:ee. We thought her cured,
when there was a return of the rheumatism in
the side of the shoulder. I gave Bryonia, tinc-
ture, ten drops, and the pain diminished at the
end of two days. The 14th of December the
articulations were in good shape, but the patient
complained of palpitation of the heart ; I gave
Cactus for fear of an endocarditis ; the rheu-
matism has returned. I then returned to Bry-
onia and the patient is well to-day.
As a conclusion to draw from this case of
rheumatism, I would say to you that, whenever
you have given a remedy with good results, it
should be continued for some days after the
amelioration, and not try anything else.
IV.
SYSTEMATIC OHBMICAL BZAMINATION OF
UBINE FOR CLINICAL PUBP0SB8.
By CLIFFORD MITCHELL, A.B., M.D.
CHIOAOO.
C. Detection of Peptones : — Balfe's Test.
Whether or not serum albumin has been
found, take cold Fehling*s solution and cause
fresh amount of urine to trickle down the side
of the test-tube into it. A rosy red color at
juncture indicates the presence of peptones ; a
violet coloration, may be noticed when serum
albumin is present.
(For constitution of Fehling's solution see
next paragraph, Da).
D. Sugar.
Procure Fehling's solution, which is made as
follows : — (a) 34.64 grams of c. p. crystallized
copper sulphate dissolved in moderately warm,
distilled water, and then diluted up to 500 c.c.
with cold, distilled water. Preserve in a stop-
pered flask.
(6.) Dissolve 173 grams of Rochelle salt (in
pure crystals*) in 100 c.c. of caustic soda solu-
tion having a sp. gr. of 1.34. Dilute up to 500
c.c. Preserve in a stoppered bottle. For use,
mix equal volumes of the fluid (a) and (6).
Shake together and there results a dark blue
fluid.
The two solutions may be mixed and kept in
small flasks away from the light. If, however,
the solutions are kept in bottles, it is wise not to
mix until a short time before using.
♦SohucliarcU's is said to be good.
110
THE MEDICAL ERA.
[Vol, VI. No.i
When about to test a sample of urine sus-
pected to contain sugar, remove albumin, if any
be present, by boiling the urine, to which a drop
of acetic acid has been added and filtering. Test
the filtered urine: 1. mix equal amounts of solu-
tions (a) and (fc).
2. Fill a test tube to the depth of three
quarters of an inch with the solution obtained by
mixing in heat, until it begins to boil, remove
from the flame, and quickly add a drop or two
of urine. If, after a second, the mixture sud-
denly turns an intense, opaque, yellow color,
sugar is present and in abundant quantity. An
abundant yellow and red sediment will, in this
case, settle to the bottom of the tube. Where
the amount of sugar is very great, the color of
the precipitate may be brownish red. The
darker the color, the more the sugar.
3. If a few drops of the urine fail to produce
the yellowish precipitate, take a fresh amount of
the solution made as in (1) and boil it. Then add
a little less than an equal amount of the urine,
raise to the boiling point, and remove from the
flame. If the mixture changes to an intense
opaque yellowish-green and a bright yellow de-
posit is slowly precipitated, sugar is present in
small amount.
^. B. It is important to test the Fehling's solu-
tion before rising it, DUute some of it with four
times its buUc of distiUed ivater and boUfor afeiv
seconds. If the solution remains clear it is fit for
usCy otherivise not.
Quantitative Estimation of Sugar.
1. Bough method: Collect urine of 24
hours. Take specific gravity. Multiply last
two figures of the sp. gr. by two and this re-
sult by the number of litres of urine passed in
24 hours. Subtract 50 and the result is
the amount of sugar in grams. Multiply by
15J- to get it to grains. Suppose total amount
of urine in 24 hours be four ^litres ; sp. gr.
1036, (36x2x4)-50 --^ 238 grams of sugar in the
24 hours urine.
2. Approximate method :
(a) Collect the urine of 24 hours, measure
carefully, pour four fluid ounces into an
eight ounce bottle and add a small piece of
yeast, then pour four fluid oimces into another
eight ounce bottle adding no yeast. Set aside
the two bottles in a warm place for 24
hours, then take specific gravity of the urine in
each. It will be found that the one containing
the yeast is of lower specific gravity than the
one without the yeast. Each degree of sp. gr.
lost means one grain of sugar to the fluid ounce
of urine, or 0.2196 gram of sugar to the 100 c.
c. of urine. For example, suppose the patient
voids 150 fluid ounces of urine in 24 hours:
suppose sp. gr. of the urine in the bottle
with yeast to be 1035, in that of the bottle with-
out yeast 1045, then this specimen of urine con-
tains ten grains to the fluid ounce, and 150
fluid ounces there will be 150 x 10 grains or
1,500 grains of sugar passed in the 24
hours. This method of estimation should be
made from time to time in order to ascertain
whether the patient is voiding more and more
sugar or less and less. The same uri-
nometer should always be used and, prefer-
ably, one with a long index, so that the variation
in degrees can be easily read oflf and closely ob-
served. Occasionally it is wise to make an ac-
curate estimation of the percentage of sugar.
(b) Another method of using fermentation
as a means of estimating the quantity of sugar
is the following : Procure at least two of the so-
called fermentation tubes ; shake up ten c.c. of
the diabetic urine with one gram of compressed
yeast and pour into one of the tubes ; do the
same with ten c.c. of normal urine and one gram
of yeast and pour into the other. Allow both
tubes to stand for 20 or 24 hours at ordinary
temperature, and in the diabetic mine carbonic
acid gas will be generated, but not in the normal
urine.
A convenient apparatus for this purpose is
the Einhorn saccharometer ; after the urine and
yeast mixture has been poured into the saccha-
rometer, the latter apparatus is inclined so that
aU the air in the graduated part is replaced by
the fluid and then it is set aside undisturbed at
ordinary temperature for 20 to 24 hours. If
there is sugar in the urine, carbonic acid gas is
generated which collects in the upper part of
the graduated tube displacing the urine. The
graduation shows on the left the percentage of
sugar and on the right the volume of carbonic
acid gas. It is necessary in most cases to dilute
the urine, for the apparatus does not show a
percentage higher than one, and diabetic urine
often contains as much as four per cent of
sugar. If the dilution is made by taking equal
parts urine and water, multiply the percentage
found by two ; if two of water to one of urine, by
three ; if three of water and one of urine,
by four, and so on.
Neuralgia. — Case of malarial neuralgia ; left
side of face ; pain almost unbearable ; came on
at 9 a. m. ; for a month had been growing con-
stantly worse. Gave Eupatorium perf. After
taking the medicine 24 hours the pain ceased,
and the case was permanently cured, there hav-
ing been no return. — Dr. E, Lippincott,
apbil, les&j
ORIGINAL ARTICLES.
Ill
III.
HAY FXVEB :
BHIHITIB VA80-X0T0BIA PERIODICA.
BT B. LIPPINCOTT, M.D.
MBMPHI8, TSNN.
After consideration of these numerous and
conflicting theories, it is but natural to examine
the parts affected for an explanation of its
causes and phenomena, and to ascertain why
the inhalation of this diversified '' invisible
nastiness " (as Tyndall very appropriately terms
it) should produce a common result in persons
subject to the disease. In the examination of
the nasal and naso-pharyngeal cavities of a boy
aged sixteen, to discover the character of a
catarrh about which he consulted me, I found
hypersemia, hyperaesthesia, hypertrophy, the
mucous membrane denuded of its epithelium,
and partial stenosis of the nasal cavities. He
soon thereafter changed his place of residence,
and, as I afterwards learned, had hay fever the
foUowing year. An examination of the nasal
and naso-pharyngeal cavities of any or aU hay
fever victims during the interim of attacks, and
when in apparent good health, will reveal either
hypersemia, hypertrophy, hypertesthesia, ulcer-
ation, exostosis, polypus, deflection of the
septum, stenosis, or other anatomical or patho-
logical conditions or peculiarities, or both com-
bined, with perverted physiological functions,
showing a local structural or functional disease
of these cavities, which constitutes the prime or
latent cause of hay fever. These pathological
pecuharities and perverted physiological func-
tions of the parts — organic changes — are the
result of a neglected or improperly treated
catarrh, catarrhal fever, repeated colds, or other
diseases which leave the mucous membranes
and structures in a sub-acute inflammatory and
hypersensitive condition, and consequently
highly sensitive to the action of pollen, dust,
or other irritants or external influences, and
upon which the exciting causes operate, and
develop the disease in question. The action
of pollen, dust, and other irritants — more espec-
ially pollen and dust — upon the nasal cavities
in developing hay fever is almost universally
conceded, but hay fever has a previously existing
lesion in the nasal cavities, otherwise pollen and
other irritants could not induce an attack : hence
the above-stated cause, a pre-existing diseased
condition of the structures and functions of these
cavities, is the jyredisjjosing cause, and pollen
and other irritants, the exciting cause. Conse-
quently, as exciting causes, they play a secon-
dary role. The fact of this disease being more
prevalent in localities where catarrhal diseases
prevail, goes far to substantiate the above state^^
ment.
The fact that, to the knowledge of the hay
fever sufferer, there are generally no after-effects
remaining from an attack of hay fever, or any
objective or subjective phenomena by which the
physician could discover any lesion other than
the pre-existing local chronic disease, precludes
the possibility of any pollen poisoning — first
mentioned by Dr. Marsh, and generously ac-
cepted by a few others — and demonstrates that
pollen, dust, and other irritants are mechanical
and not toxicological in their effects.
There is no peculiarity of constitution, form,
or condition, observed in those who are subject
to this disease other than the pre-existing nasal
disease, anatomical peculiarities, and consequent
perverted physiological functions mentioned.
The ** individual aptitudes," ** predisposition,"
"individual or special susceptibility," "consti-
tutional peculiarity," "idiosyncrasy or consti-
tutional diathesis," and other synonymous terms
used by various writers as explanatory of the
causes of hay fever, can all be explained by
reference to the pre-disposing cause — the local
chronic disease. The majority of these writers
fail to explain the origin or cause of the special
susceptibility, etc., which they so modestly and
satisfactorily accept. The cause of the deranged
state of the nerve centers, or neurosis, of which
many so assuringly write, is not explained by
any of them. By an explanation we could bet-
ter comprehend their theory of its cause. But
it becomes clear when we consider that the sys-
temic disturbance, such as asthma, the implica-
tion of the eyes, ears, bronchi and lungs, and
the nen'ous phenomena, are the result of the ir-
ritation of the diseased tissues in the nasal
cavities, which is reflected to distant parts and
organs, causing in them a fluctionary hyper-
aemia, produced through the correlating func-
tion of the sympathetic ganglia connecting these
different regions with the nose.
Dr. Daly, in an article on the " Relations of
Hay Asthma and Chronic Naso-Pharyngeal Ca-
tarrh," {Archives of iMryngcfogy , Apr. 1882, vol.
3, p. 57), reports the histories and cure of three
patients, who were sufferers from hay fever and
hay asthma, for six, fifteen and twenty-one
years ; two of which were cases of hypertrophy
of the nasal mucous membrane, and one a case
of polypus ; the cure in each case being obtained
by removing the morbid condition in the nasal
cavities. Dr. F. H. Bosworth, of New York,
112
THE MEDICAL ERA.
IV0L.VL No. 4.
says: **0f the sixty cases of hay fever which I
have personally examined, I have seen none in
which there was not notable obstructive lesion
in the nasal cavities."
Pathology. — The number of hay fever sub-
jects in the United States is probably four times
that of our standing army. Information rela-
tive to this disease is eagerly sought by this vast
army of sufferers if it oflFer a ray of hope of re-
lief or cure. That hay fever — so-called — is a
morbid entity can be demonstrated by an in-
vestigation into and knowledge of its aetiology
and pathology. Sir. Morell Mackenzie, in his
"Hay Fever, its iEtiology and Treatment, 1884:,"
says in relation to the pathology of this disease :
** Hay fever leaves no permanent structural le-
sion behind it, and cannot therefore be said to
have any pathology." But he is wrong. A dis-
ease can have a pathology without leaving a per-
manent structural lesion behind it. As has been,
and will hereafter be shown, hay fever has its le-
sion in the nasal cavities, and conseqently has a
patholog}' : i. «., there is a permanent diseased
condition of the nasal cavities — the result of
other diseases — which, being acted upon by cer-
tain initants, produce the disease.
The want of definite knbwledge in the past
concerning the fetiology and pathology of this
disease has not been from want of patient, care-
ful, and close observation or painstaking re-
search to ascertain its causes, but from the fact
that its presumed causes have been studied in-
dependently, that their relation to the tissues in
the nasal and the naso-pharyngeal cavities have
not been taken into consideration, and that the
diseased condition of these tissues, which render
them susceptible to various influences, has been
entirely overlooked. In the examination of the
various articles and more or less elaborate works
on hay fever, there is no intimation of any inves-
tigation into the objective phenomena of the
nasal or naso-pharyngeal cavities as the existence
of any localized diseased condition or anatomi-
cal peculiarities that might predispose to the
affection, previous to the articles of Drs. Daly,
Roe, Sajous, Harrison, Allen, and J. N. Macken-
zie. Hay fever patients are all alike in present-
ing certain anatomical pecuharities or pathologi-
cal conditions of the nasal cavities, or both
combined, among which are: obstruction by
deflection of the septum, (either congenital, or
acquired by disease or injury), sometimes unusual
prominence of the inferior turbinated bones,
stenosis, or complete closure of one or both
cavities, hypertrophy of the soft parts or bones,
polj'pus, exostosis, or other diseased condition
of these cavities. The tissue covering the
inferior turbinated bones and lower part of the
septum is a highly vascular, erectile tissue, which
is under the control of the vaso-motor nerves,
and is highly sensitive in local impressions, aa
well as to other impressions in other parts of
the body. The effects of a cold in the head, or
of a draft of air striking the body will, in some
instances, cause this tissue to become engorged
and thus occlude one or both nostrils. The en-
gorgement of this tissue as a result of a draft of
air, or sudden chilling of the body, etc., causes
the distressing sensations arising from and ac-
companying a cold in the head. A remaining
engorged, sub-acute inflammatory, or hyper-
sensitive condition of the tissue covering the
nasal cavities — a rhinitis — as a result of the
above operative causes is irritated by the con-
tact of pollen and other irritants, which develop
a rhinorrhoea, and also what is popularly but
erroneously denominated hay fever. An inflamed,
turgescent or hyperaesthetic condition of this
tissue — although slight and not sufficient to cause
any special annoyance, or attract the attention
of the patient — may, through atmospheric and
other influences, increase its susceptibility to
irritation in a marked degree, or result in per-
manent hypertrophy, and consequently nasal
stenosis.
There is an intimate connection between the
nervous supply of the nose, eyes, ears, throat,
bronchi and lungs. The irritation reflected from
tissues of the nasal cavities through the sjrmpa-
thetic nerves to other parts and organs, is the
excitor of the varied and distressing symptoms
and conditions experienced by hay fever victims,
among which are haj' asthma.
If the lesion of hay asthma is traceable to
the nasal cavity, it is reasonable to suppose that
the lesion of other forms of asthma may be
traceable to a diseased condition of this cavity.
Such has been the result of my investigations in
cases of asthma. The importance of an unob-
structed nasal passage, free nasal respiration,
and a healthy condition of the nasal mucous
membrane can only be realized and appreciated
when one attempts to eat, drink, sleep, or talk
with the cavities closed.
Diafjtwgis. — Hay fever may be mistaken for a
cold in the head, catarrh, influenza, catarrhal
fever, ophthalmia, acute bronchitis, or asthma.
In hay fever we have itching of the nose, eyes,
ears, mouth, throat and skin, paroxysmal and
violent sneezing, profuse bland or acrid discliarge
from the nose, occlusion of the nares, an in-
flamed condition of the eyes, headache, fever,
spasmodic cough, asthma, a specific date for its
annual recurrence, which visitations are out of
Ann.., IMB.]
ORIGINAL ARTICLES.
118
the seasons of ordinary colds, catarrh, influenza,
etc. It is of long duration and great severity.
There is no predisposition, as a rule, to other
diseases, and the combination of symptoms and
conditions are not common to any of the above
diseases. A careful study of its symptoms,
fetiology and pathology, will prevent its being
confounded with any other disease.
Prognosis. — The prognosis is favorable. A
removal from the exciting causes gives immunity
from the affection. The catarrhal and asthmatic
conditions seldom, if ever, lead to grave results,
or to permanent organic changes. No matter
how severe the case may be, the symptoms finally
disappear in all but rare instances, and the pa-
tient recovers health in the months of perfect
immunity. It does not appear to shorten life.
It has heretofore been regarded as the most
obstinate and, to a great extent, one of the in-
curable diseases, but the discovery of its lesion
being in the nose has made prognosis favor-
able in all cases, for just so far as we can cure
this pre-existing nasal disease, just so far can we
cure hay fever. The existence of great debility,
pregnancy, pulmonary or bronchial affections,
and grave constitutional difficulties modifies the
prognosis.
Sanitary Resorts, — The only places to which
hay fever victims, as a rule, can resort with
benefit or immunity, are those where vegetation
does not exist, as on the ocean, or where the
seasons are so short vegetation does not ripen,
as in high mountain regions, or on islands, show-
ing conclusively the result of the inhalation of
substances arising from Summer's or Autumn's
growth. Some hay fever subjects are only sus-
ceptible to a special irritant ; these have immun-
ity by removal to a district where this irritant
does not exist, or is not carried by the winds.
The principal and favorite hay fever resorts in
the t-nited States are the White Mountains,
Catskilis, Adirondacks, AUeghanies, Lookout
Mountain, Roane Mountain, the Rocky and
SieiTa Nevada Mountain country. Lake Chau-
tauqua, the shores of Lake Superior, Put-in
Bay, Colorado Springs, Col., Hot Springs, Ark.,
Fire Island, the Island of Mackinaw, Cobl)'s
Island, and Brigantine Beach, New Jersey.
Some of the principal hay fever resorts of
Europe, are : The Highlands of Scotland, the
mountainous districts of Wales, the rocky At-
lantic coast of Ireland, and the mountains of
Switzerland. These hay fever resorts give im-
munity, by virtue of the rare and pure atmos-
phere, wherein pollen, etc., does not exist, and is
not carried or found floating, in contradistinction
to the humid atmosphere of the habitat of the
victim, wherein all the various irritants float,
and other exciting causes operate. A sea voy-
age gives entire immunity from the disease. All
hay fever subjects do not alike receive immunity
from the disease. Dr. J. C. Morgan tells us that
'* Hodrogenoid patients do badly at the sea-shore,
but Long Branch, on the New Jersey coast, has
a special reputation as a sanitary resort for hay
fever subjects, having no upland vegetation,
and being separated from the mainland by five
miles of salt bay." The case of a lady was
brought to my notice, who had been a victim of
hay fever for several years, who visited Hot
Springs, Ark., for three consecutive years, at
about the usual time for the attack, and remained
until the hay fever season was past. She has
had entire immunity from the disease since.
Some physicians claim that there is an element
of the practical in the geographical feature of
the disease in that it enables them to direct their
patients where they may expect to find immunity
from their attacks. So a bomceopathist with a
knowlege of its aetiology, pathology, the proper
local and general measures for removal of the
pathological condition, and the proper simUimum,
there is no necessity for such consolation, or of
making exiles or refugees of hay fever patients.
InsUnctive Self-help in Dyipnoea.
During a paroxysm of asthma or dyspnoea
from other causes, the sufferer leans upon a
table or rests his elbow there. Why ? He seeks
to make his shoulder the fixed point, to assist
respiration, and calls on muscles whose usual
uses are to move the head, to move the chest as
the stemo-cleido-mastoid ; muscles whose duty
it is to raise the arm, as the pectoralis major ;
muscles of the scapula and shoulders, as the
rhomboideus major and minor. Thus he con-
verts, by fixing the head and shoulder, muscles
of volition and ordinary motion of extremities
into temporary muscles of respiration. The
trapezius is also enlisted in the same service.
— Med. World.
In response to the circular from Georgia The
Medical Era has sent to the representatives of
this District in Congress, petitions praying that
the duty on surgical instruments and appliances
may remain as it now is, to the end that Amer-
ican labor may be well paid, that American in-
vention may be stimulated, and that American
surgery and gynecology may in the future, as in
the past, command the admiration of the world.
114
THE MEDICAL ERA.
[Voi»VL No. 4.
SELECTIONS.
A New Treatment by Electricity of Peri-XTterine
Inflammation.
By Q. APOSTOLT, M.D.,
PARIS.
Ever since the year 1882, when I began my
study and treatment of fibroid growths, I have
carried on concurrently similar researches on
uterine inflammation. I believe that my at-
tempt to unravel the pathology and improve the
treatment of this malady has not been fruitless
of new ideas. On this ground I ask some share
of your attention.
Besides what has been made known in my
oral teaching at the CliniqiLe, and by my lectures
at the Practical school of the Faculty of Med-
icine, which have been delivered without inter-
ruption for the last five years, the thesis of my
pupil Dr. Carlet, on the electrical treatment of
fibromata of the uterus, contains reports of
many cases of peri-uterine inflammations, treat-
ed electrically and with success. One case is
especially noticeable, as it was that of a fibrome
complicated with a long-standing chronic form
of phlegmonous inflammation, in which I em-
ployed the vaginal negative puncture.
I also made a communication at the Inter-
national Congress of Copenhagen, in which I
dwelt upon the use of faradization, either alone
or in conjunction with intra-uterine cauteriza-
tions, in these affections.
A year later, 1885, in a paper on peri-uterine
hsematocele treated by galvano-puncture, vagi-
nal, I enlarged upon the important part which
galvano-puncture, applied in my way, is called
upon, in the future, to play in the treatment
either of solid exudations ( chronic cellulitis,
phlegmon and peri-uterine phlegmasia), or of
neoplasms (interstitial myoma, local hypertro-
phies), or of uterine and peri-uterine cysts
( haematomata, extra-uterine foetation, etc. )
In 1886, in my memoir giving an account of
my new treatment of chronic metritis, especially
endometritis, I introduced, incidentally, the sub-
ject of peri-uterine phlegmasia. Notice of the
same kind is also to be found in a note append-
ed to my pamphlet on the use of galvano-punc-
ture in gynecology.
The subject is therefore nearly a novelty, and
in this place I only wish to explain my views
upon the modem question of treatment by elec-
tricity. "*
Notwithstanding the variety of names which
have been given to peri-uterine inflammations,
sometimes fashioned only according to the in-
ventive ingenuity of authors, and sometimes
only indicating the localization, they all mean
pretty much the same thing, except as regards
the point of intensity.
Whether it be caUed a perimetritis, a para-
metritis, a phlegmon or a cellulitis, we have
always to deal with a peri-uterine inflaromation,
either limited to the cellular tissue only, or in-
volving all that is included in the pelvic folds of
the peritoneum. Throughout, the therapeuti-
cal indications are much the same, and it is of
them only that I wish to speak.
I do not fail to see how complex the problem
is, and I am not presumptuous enough to sup-
pose that I have solved it. I only wish to es-
tablish the fact that my operative proceedings
are justified by the general results.
Wishing not to go beyond therapeutical con-
siderations, I make use of the ordinary symp-
tomatic classification, and I accept the division
into the three forms of acute, sub-acute, and
chronic cases.
Although the operative proceedings which
I think necessary require great precaution, I un-
dertake them for two definite objects : first, to
calm down the pain the patient is enduring;
and, secondly, to arrest, if possible, the inflam-
matory action, and to prevent its running on to
suppuration.
I have already, in 1883 and before the Con-
gress at Copenhagen, in 1884, made known the
general lines of my treatment, which may be
thus summed up. I faradize every woman even
when under an acute attack of inflammation,
observing, however, the following practical con-
ditions.
a. I proscribe every faradization that would
cause the least pain, and expressly that of
quantity, engendered by the bobbin with short
and thick wire, b, I use for such cases the
bobbin with long and thin wire, from which I
obtain a current of tension, on account of its
specially anodyne effects, c. I begin with a
simple vaginal application, by means of a laige
bipolar electrode, the point of which is placed
against the inflamed part. d. I only employ a
current easily bearable, so as to cause no suflfer-
ing nor any excitement of the patient, as this
would insure an entire failure of the treatment.
e. All the success of this medication depends
upon making the first sittings sedative, so that
they may serve as a prelude to more active
measures; and the faradization will only be-
come hyposthenic on the double condition of its
low intensity and its long duration. /. Each
sitting should last five, ten, fifteen, twenty or
twenty-five minutes, as may be required, and
APBIL, 1888.1
Miscellany.
115
should not terminate before the patient spon-
taneously declares that she is better and sufiFers
less. g. It is necessary to reinforce what has
been said, by dogmatically averring that no suc-
cess will come out of this treatment unless it be
managed, not only without violence, but with
extreme gentleness. A. There may be one or
two sittings each day, as may be wanted for
lowering the febrile action, allaying pain, and
bringing about what is called the subacute state
of the inflammation, i. Every faradization
should be preceded and followed by a vaginal
irrigation with the sublimate solution, and all
the sounds should be scrupulously disinfected.
II. Tht Subacute Stage. — As soon as the
sound can be introduced into the uterus without
much pain and without danger, I consider this
stage to have set in, and it requires some alter-
ation in the treatment. Intra-uterine medica-
tion is now necessary, its force being increased
gradually. It is here that we can advantageous-
ly combine faradizations with the continuous
current.
a. I recommend, first, bi-uterine faradiza-
tion, because we desire to prolong in the uterus
the same anodyne effect that we sought for in
the vagina. We must therefore faradize the
uterine cavity.
The current must always be that of tension.
The intensity is increased by advancing the bob-
bin, and this must be done as softly as possible,
without any jerking, till we reach the limits of
personal tolerance. Every day the current may
be repeated, until an evident amendment is tak-
ing place and the inflammation is giving way.
This will be the indication for still more decided
action, when we must call to our aid the constant
galvanic current.
h. The use of the intra-uterine galvanic cur-
rent, in small but gradually increasing doses, is
the second part of the treatment which we have
to offer to the patient, with a view to more rapid
progress in the cure, Here the action is purely
chemical, dynamic, and stimulant, and intended
to stop any tendency to suppuration, and to ac-
celerate the absorption of the morbid deposits.
We must begin with short sittings of only
three or four minutes, with an intensity of not
more than twenty to forty milliamp^res. After
a while, both dose and time may be augmented,
and we have no better guide to trust to than the
ease with which the patient can support this
intra-uterine cauterization. The most exact
care must be taken not to transgress any of the
rules I have laid down for the safe performance
of the operation, never omitting the diligent
observance of every antiseptic precaution.
One or two sittings a week may be made, reg-
ulating the intervals by the strength and con-
dition of the patient. Best in bed after each
operation must be enforced.
The early cauterizations should be with the
positive pole, as it occasions less congestion than
the negative. The negative cauterizations, hav-
ing a greater derivative power, must, however,
be brought to bear as soon as we can make out,
by the way in which the action of the positive
pole is tolerated, that they can be aptly and
beneficially employed.
The surgeon must never lose sight of the fact
that, with his patient on the confines of an
acute stage of disease, he is handling a curative
agent which, while capable of rendering great
service, may also, by indiscreet and inexper-
ienced usage, do her grievous mischief.
To sum up this part of the subject : these two
stages of acute and subacute perimetritis are
difficult to overcome and our great effort must
be to get rid of them, and to place the patient
in that chronic state in which our action will be
more clear and definite.
III. The Chronic Stage, — However excusable
a certain amount of timidity and indecision may
be in treating the acute and subacute conditions
of this disease, there is nothing to hold back
the surgeon from following my recommendation
to act boldly, and even heroically, when he
comes to encounter the chronic stage. Here he
must, judiciously but unhesitatingly, push the
intra-uterine galvano-cauterization to its high-
est pitch, and then superpose the vaginal, chem-
ical galvano- punctures, negative and monopolar.
And in order that the inflamed peri-uterine zone
may be directly brought under the influence of
the current, that its full effect may be secured,
and that none of its derivative and resolutionary
force may be utilized. I mean, that puncture
must be made into the diseased part itself. The
whole electric irrigation will then bathe its sub-
stance, and the disintegrating action will more
easily make havoc of the inflammatory exuda-
tion, and insure ita absorption. The negative
galvano-puncture is a therapeutical resource so
full of promise, above all that I can express,
that no exhortation of mine to familiarize your-
selves with it can be too hardly driven home.
In another memoir, on galvano-puncture in
general, I have stated the leading reasons which
induce me to use the negative pole alone as the
therapeutical agent for the purpose we have in
view. I have also laid down the rules for well
doing the operation, have pointed out the dan-
gers, have given every precautionary counsel,
and have left nothing unsaid as to the prepar-
116
THE MEDICAL ERA.
[Vol. VI. No 4.
atory and post-operative care that ought to be
taken.
To make the subject more intelligible, I will
tell you what you may expect to see in a patient
upon whom you have done the operation of
negative jgalvano-puncture. Towards the latter
part of the day you will find that she complains
of some little pain in the body, and she will
most likely have uterine and intestinal colic.
This will cease perhaps before morning, and
keeping her in bed for two or three days there
mil be, within that time, a marked subsidence
of the feeling of distension, and, with that, the
pelvis will be found to be loss blocked up, the
sensibility will not be so acute, and pressure
will be better supported. Of course it is wiser,
especially in bad cases, to maintain the recum-
bent position, so as to give a greater chance of
the absorption of the exudative matter ; but with
the defective accommodation at my clinique, I
have involuntarily had forced upon me a solu-
tion of the question of bedkeeping. If I were
asked whether it were useful, I should answer,
yes. But, as to its being obligatory and indispens-
able, the many recoveries which have taken place
without it enable me to say that it may be dis-
pensed with. And this is one of the recommen-
dations of my system of treatment. We can, in
case of necessity do without a long confinement,
and allow many of the women, I do not say all,
to go through the operations, and yet not much
interrupt their ordinary occupations. I have
had, among the frequenters of my dinique sev-
eral cases of chronic perimetritis, varying in
severity from the simple state of perimetritis to
that of a complication with lateral phlegmon and
general cellulitis, which have been restored to
health under such conditions.
To sum up in a few words the essential parts
of my researches, and the clinical results which
have been worked out from them, I may say :
1. Electricity, in the form of faradic currents
of tension, can, and ought to, be made to calm
the pain at the outset of an acute attack of
perimetritis, and is a sedative of the first im-
portance in abridging the first stage of inflam-
mation.
2. The continued current is a power which
we use in two ways : first, in the form of intra-
uterine chemical galvano-cauterization, to cut
short the acute stage ; second, as vaginal, neg-
ative, galvano-punctures, to get rid of the chron-
ic condition in all its forms and stages.
Is the restoration ad integrum^ complete and
definite, the prevailing result of my treatment ?
I do not pretend that such is the case ; I do
not even expect it ; and I content myself with
offering for trial a method of relief and cure
which I believe to be more speedy than any
other.
Again we may force electricity into our ser-
vice in another way. Given a case of actual
suppuration, or of threatening suppuration, we
have only to use our negative galvano-punctore,
form an eschar, open up a sinus, and direct the
exit of the pus to the nearest point of the vagi-
na. And this we can do at will, when it is
most fit to do it, and in the most convenient
way.
We have, then, in the galvano-puncture, an
effective means of arresting an inflammation,
and of dispersing an inflammatory deposit. Or,
we may use it as a sure and direct way of open-
ing a profound and ready formed collection of
pus. No plan of settling up a vaginal drainage,
controllable as to amount and duration, can b^
more simple : and this we may associate with
any local and antiseptic treatment that may be
desirable, as I have shown elsewhere in relation
with the subject of haematocele.
The subject, of which I have just jotted down
the salient points for your consideration, is new
and undeniably full of interest. You must not
suppose that I think that I have done much for
it, as I may fairly claim to have done for fibro-
mata and endometritis, but what I have seen
and watched with painstaking anxiety is so rich
in clinical results, so fertile in unexpected ther-
apeutical consequences, that I feel I cannot
too earnestly urge you to study the subject
yourselves, and to fathom it to the utmost.
— Brit. M. Jour,, Medical Abstract.
Managoment of the Second Sta^ of Labor.
There are five methods of managing the peri-
neum : 1. Supplying the directing force by press-
ing up the head so as to hold the sub-occiput
under and against the pubic arch. 2. Supple-
menting the resisting force of the perineal centre
by pressing against the advancing head, and
thus gaining time for relaxation above. 3.
Goodell's manoeuvre of pulling forward the deep-
er portions of the perineum, and so diminishing
the tension. 4. Artificial dilation. 5. A
combination or modification of some of these
four methods for the purpose of securing the de-
livery of the head between the pains.
Regarding the practice of obstetrics as an art
of the highest kind, my method, simulating that
of all true artists, is to secure the effect, viz., the
delivery of the child with as little show of art (or
interference) as possible. Hence I object to all
interference on the part of the accoucheur until
AniL. IM8.]
SELECTIONS.
117
something goes wrong. I consider but one ex-
amination per vaginam necessary for the benefit
of the patient in ordinary labor, although I
sometimes make two or three others for my own
benefit, viz., to determine whether or not I may
longer absent myself from the patient's house,
hi the beginning of labor, or as soon after as
called, I determine by palpation over the ab-
dominal walls (and by auscultation if necessary)
whether the child is alive, how it lies, and which
part of it is lowest in the pelvis. Supplementary
to this, I introduce the finger into the vagina,
and by bimanual, or by simple palpation,
through the vaginal and uterine walls, further
assure myself that the ovum maintains normal
relations with the pelvic walls or pelvic brim. I
do not (when acting in the patient's interest) in-
sert my finger in the os or seek for a fontanelle.
I inform myself by merely toucliing the os, of its
condition. My reason for omitting the usual
fingering of the vagina in labor is to avoid irri-
tating the parts, removing the secretions, weak-
ening the membranes, demoralizing the patient,
etc. ; when everything is normal, the labor takes
care of itself without any fingering.
Having informed myself thoroughly of the
history of the case, I await symptons before in-
terfering again.
In primiparous cases, I studiously avoid
teaching the patient how to bear down; in
multiparous ones, I prohibit all bearing down
until the anal and vulval regions are pressed
upon and a sensation of tenesmus is produced.
Excitement is calmed, with as Uttle restraint
as possible, and the chances of a favorable issue
enlarged upon in conversation at the bedside.
I prefer the dorsal position, -yet if the patient
finds herself more comfortable on the side, I do
not object, but take precaution to apply a binder
in all cases in which the abdominal walls are
not firm enough to keep the ovum from sinking
away from the pelvic floor. When the mem-
branes come down and press upon the vulva,
which they nearly always do in my cases (ex-
cept, of course, those abnormal ones in which
they rupture before or near the beginning of the
first stage), I sit down by the patient and wait
patiently for the head. If she be a multipara, I
caution her against hurting herself by attempt-
ing to deUver herself too quickly and make her
promise to stop bearing down, or let out her
breath (or, if she cannot, to cr)* out) whenever I
tell her to do so. If I find her utterly unable to
restrain herself on account of a nervous excitabil-
ity, occasioned by the memory of the fearful time
she had in a previous labor, I give her a little
chloroform with each pain until I get her quieted
down and under control, and convince her that
she can take things a little easier. I seldom
give narcotics and sedatives by the mouth dur-
ing the expulsive stage, as their efiFects last too
long and are apt to be harmful ; and because I
give them earlier whenever I consider them in-
dicated at all. When the membranes protrude
at the vulva, and the head at the same time
pushes back the levator ani and presses upon
the anal region, I do not restrain the bearing-
down efforts unless I find the head coming too
fast. When I find, by the hand or fingers laid,
but not pressed, upon the perineum, that it is
being rapidly distended or dilated, I suppress all
voluntary straining at the acme of each pain,
until the vulva is dilated, and the perineum re-
tracts over the forehead, and the head slips out,
preferably but not necessarily, between pains.
During its passage the body is held up against
the pubic arch, and both the shoulders and hips
are made to pass sloiiiy through the vulva.
When, however, the membranes rupture before
the vulva is two, or two and a half inches in di-
ameter, I often find it necessary to interfere. I
pull down the fourchette a little, just at and only
at the beginning of each pain, in order that the
occiput may ride over it instead of merely dis-
tending the parts below it. After the perineum
becomes somewhat dilated or distended, I lay
the palm of one hand upon the skin behind the
anus (not over it or in front of it), in order to flex
the fcetal head by pressure upon the forehead,
and at the same time keep the sub-occiput
against the pubic arch, and thus secure a pre-
sentation of the smallest diameters at the out-
let. With, at the same time, two or three
fingers of the other hand over the occiput, and
the thumb upon the saggital suture (or else
the thumb over the occiput, etc.) I get com-
plete control of the head, and with control of
the patient's actions, as I have already ex-
plained, am able to secure a very slight but safe
advance with each pain, and a yielding of the
soft parts without tearing. The perineum is
protected rather than supported. This lingering
of the head in the partly dilated vulva is, I am
convinced, not only the safest, but it is the most
natural and least painful method of safe deliv-
ery. The excruciating suflFering connected with
a rapid stretching of the perineum, and the fear
of hurting herself, naturally causes her to
shrink, and perhaps cry out, and thus avoid
advancing the head much until the vulva grad-
ually relaxes, the perineum retracts and the
head slips out. A very common means adopted
by nature for protecting the perineum from
rupture is to throw the patient into a tremor,
118
THE MEDICAL ERA.
[Vol. VI. No. K.
resembling a severe chill, which prevents eflS-
cient voluntary eflforts and prompt delivery, but
saves the perineum. I am convinced that half
the ruptures of the perineum that occur in
young primiparaB and in multiparae are due to
the present universal but unnatural method of
hurrying the patient through her suffering. —
Dr, H, T, Byfordy in Coarier-Reeord. — Archives of
Gymecology,
of Wounds by the Use of Horsehair.
The material may be horsehair, catgut, or
rubber threads. The capillarity of a bundle of
these materials is their chief advantage — an
advantage, however, that is lost if the fluids to
be drained are at all thick. Considerable per-
sonal experience, extending now over about ten
years, leads me quite confidently to commend
again the following method of combined tubular
and capillary drainage. Before the wound is
closed a fenestrated rubber tube, of suitable size,
is placed in the wound, and alongside of it is
laid a mesh of from Ave to ten strands of catgut
or fifteen to thirty strands of horsehair. At the
first dressing, at the end of twenty-four hours,
the rubber tubing is carefully removed, and the
horsehair left in situ. At the second dressing,
on the fifth day, all the horsehair may be re-
moved, or two or three strands left in place, to
be removed at the next dressing, according to
circumstances. The early removal of the tubing
allows the surfaces to fall together, and so pre-
vents the formation of any tubular sinus ; and
if the healing process is rapid, as is generally
the case, fine granulations easily penetrate be-
tween the threads of the horsehair, which thus
offer little obstruction to the union of the sur-
faces, and yet will conduct off any slight amount
of wound-fluids.
The method of removal of the horsehair is im-
portant as a minor detail, but not a little con-
ducive to the speediest healing of the wound.
If removed in mass, the mesh of horsehair may
tear apart, to some extent, the slightly united
surfaces. Accordingly, after separating the
matted thread at both ends of the mesh of hair,
I always remove them singly, and with great
gentleness. This avoids all pain, and, what is
more important, does not in the least disturb any
slender means of union between the surfaces of
the wound. Two or three hairs may be left for
two or three days longer, to drain the slight tempo-
rary sinus left by the removal of the rest of the
mesh, but usually this is a needless precaution.
The horsehair could be introduced, of course,
when the tubing is removed, instead of placing
it in the wound primarily, but this causes mueh
pain, and, worse, it does mechanical violence to
a wound already in the early stages of repair—
a matter always to be deprecated to the utmost.
So careful am I as to this detail that, after sep-
arating the matted hairs, I usually cut off the
projecting threads at one end (excepting the few
I intend to leave in place), so that their stiffness
and the blood coagulated on the projecting ends
shall do no violence to the interior of the wound
while being withdrawn.
I have spoken chiefly of horsehair. If this be
used, it should always be carefully washed with
soap and water, then in turpentine, and, after
thorough disinfection by a sublimate solution,
should be kept in carbolized water till used. Care
must also be taken that all short hairs are elim-
inated from the mesh.
The more absorbable forms of catgut I do not
like, since they swell, soften early, and, being
coarser than horsehair, their capillarity is leas.
The finer, chromic catgut, however, does not
swell, is durable, and answers tolerably well.
But even fine catgut is often harsh and stiff,
and therefore, mechanically, much less well
suited to attain our object than horsehair. — Dr.
Keen, in Medical Record,
Diphtheria.
Dr. C. W. Earle presented the results ot a
study of the causes of diphtheria in locaUties
remote from sewer-gas influence in the less thickly
populated Western States and Territories. He
had received communications from a large num-
ber of physicians widely scattered over this great
region.
His conclusions are briefly summarized as fol-
lows:
1. Diphtheria occurs in the moimtains and
prairies of the great Northwest with the same
malignancy as in the East.
2. And with equal virulence in vicinities remote
from sewers.
3. When once introduced, the residents of
damp sod houses suffer with marked severity.
4. The infection is transported thousands of
miles in some unrecognized vehicle.
5. There is abundant testimony that it follows
the lines of railroads and steamers, making it
imperative to increase the watchfulness and im-
prove the methods of disinfection by railroad and
steamboat companies.
6. The desirability of legal enactments oblig-
ing people of all classes to recognize their res-
ponsibility in regard to the control of contagious
disease.
Aran., 1866.}
SELECTIONS.
119
a.
Siinger thinks that the cause of the greater
American mortality is delay, and only trying the
section when other operations have been unsuc-
cessful. He lays stress on the following :
1. Antiseptic precautions as in other laparot-
omies.
2. The abdominal incision should be made
through the linea alba over the middle of the
fundus, about sixteen centimetres long.
3. It is not advisable to evert the unopened
uterus, as it requires a large incision, except
where the foetus is dead or there are not suffic-
ient assistants.
4. The elastic ligature is not to be used before
the uterus is opened, as it endangers the life of
the child, or may incarcerate parts of the child,
so that it may have to be loosened at a time
when the operator requires his hands for more
important matters.
5. Open the uterus in situ, by a frontal med-
ian incision ; cut through placenta, or push it to
one side ; extract child by the legs ; if head is
caught, extend incision upward, to prevent any
downward laceration of the uterus. At same
time, assistant is to press abdominal walls toward
uterus to prevent prolapse of intestines or flow
of fluid into the abdominal cavity.
6. The danger from hemorrhage is not so great
as is commonly supposed. By pressure on the
inferior segment, and by slight torsion or flexion
of the uterus and broad ligaments, the bleeding
can be much lessened. Do without elastic
ligature if possible.
7. Care must be taken in regard to three points
in suturing: 1. Accurate union of the incised sur-
face of the uterus by numerous sutures, whereby
a broad and close union is obtained. 2. Avoid-
ance of suture-canals in the uterine cavity. 3.
Especially careful union of the serous surfaces.
Silk is preferred to silver wire, because silk can
be absorbed. Excellent results can be obtained
with catgut prepared in oil of juniper, chromic
acid, or mercuric bichloride.
Anenic Cancer.
Mr. Jonathan Hutchinson, after referring to
the fact that Arsenic, when long used, may lead
to the development of soft corns on the palms or
soles, states that, in his belief. Arsenic may also
produce, or at least be an exciting cause of
epithelial cancer. Sir James Paget held the
same view. This will be joyful news to our
homoeopathic brethren. — Medical Record.
▲nli-Hyclrophobia Inoculatioiui.
The fact that individuals who have once
passed through certain infectious diseases, or a
mitigated form of them, are afterward not sus-
ceptible to the infection of these diseases, may
be regarded as a strong evidence of the possibil-
ities of such immunities being obtained by inoc-
ulation with the attenuated viruses of infectious
diseases. While working in this line Pasteur
brought forward the results of his inoculations
against hydrophobia. Both his experiments and
his results have aroused adverse criticism from
those whose ignorance of the subject forbade
any fair discussion of his methods or conclu-
sions, as well as by those who presumably were
competent to sit in judgment upon him ; as a
consequence the profession has been slow to ac-
cept his conclusions.
It would seem however, that the report of the
English Commission appointed by Parhament to
investigate the subject, composed as it was of
the best English observ-ers, must at once put at
rest all doubts. This report is all the more in-
teresting and valuable because it is the first that
has been made by impartial and competent
authority upon Pasteur*s work. The report of
the Commission declares that it is certain that
Pasteur has discovered a method of protection
against hydrophobia comparable to that given
by vaccination against small-pox ; and in their
opinion it is ** difficult to overestimate the im-
portance of the discovery ;" and that while not
every case which he has treated has escaped,
yet a large proportion of cases have been abso-
lutely cured. The report of such a commission
will not only give to Pasteur's researches and
experiments an authority which they have not
before had, but it will also give an impetus to
similar investigations in other directions, for a
method of inoculation is presented by his exper-
iments by which it may be possible to prevent
other diseases in man. — Dr, A, L. Loomis^ in the
Medical Record.
Cod-liver oil as an adjuvant in the treatment
of phthisis is contra-indicated when it produces
eructations or acid stomach. It should be given
only when the patient thrives upon it. Admin-
ister a good, pure oil ; use none of the emulsions.
Alcohol, in the treatment of this disease, is
merely a bridge. For a time it may improve
the appetite and aid digestion, but, in the long
run its action as a tissue destoyer will be felt.
A phthisical patient should live in that climate
in which he feels best.
120
THE MEDICAL ERA.
{Vot. VI. So. 4
NEWS FROM THE COLLEGES.
Philadelphia.
HAHNEMANN MEDICAL COLLEGE.
Prof. Goodno teaches that the pathology of
pulmonary diseases is not nearly so clear as
the books teach, i. e,, that the croupous variety
has a catarrhal element, and the catarrhal like-
wise a croupous addition, and he also says that,
as a rule, a person with a rapid phthisis (who
has not a previously broken down constitution)
has a better chance of recovery than the slowly
developing case.
For the hectic of these acute cases he partic-
ularly recommends the Arseniate of quinine,
from the use of which remedy he reports most
marvelous results, and he speaks highly of the
Iodide of arsenic in hectic of a more chronic
case.
And while on the subject we feel like relating
a case in point : — Early in the term Dr. Sna-
der showed us a man (while demonstrating phys-
ical diagnosis), in whom we found evidence of
phthisis quite marked, and who was so weak
and ansemic as to be scarcely able to walk.
The prognosis given was very grave, and the
patient placed on the Arsenicum jodatum. None
of the students ever expected to see the poor fel-
low again, but what was our surprise, two weeks
ago, at his reappearance for treatment for a
<* cold." He reported a rapid improvement and
had been working all winter. There was such a
change for the better in his appearance that but
few of the men who had taken part in his pre-
vious examination recognized him.
Prof. Mitchell gives the following causes for
dystocia in the first stage of labor.
1. Hypertrophy or disease of the cervix, includ-
ing fibroids, cancers, etc.
2. Cicatricial adhesions.
3. Over-distension of uterus, too large bag of
waters, twins, etc.
4. Adhesion of the membranes around the in-
ternal OS, of which he reports having found sev-
eral cases.
5. Defective, short, cramp-like pains.
6. Premature rupture and en^re drainage of
the amniotic fluid.
7. Thickening of the os from oedema.
8. Spastic annular contraction.
9. Cervix out of the line of the axis of exten-
sion.
10. Deformity of the pelvis or the presenta-
tion of some part of the child that does not
accurately fill the pelvis; as an arm, a leg,
a shoulder, an occiput, posterior, etc.
11. FsBces in the rectum.
Prof. Betts prefers cane sugar to milk sugar
for baby foods and says : — By its use there is
less liability to the formation of lactic acid, it is
sweeter, not so liable to cause constipation, as it
increases the secretion of gastric and intestinal
fluids and last, but by no means least, it is much
cheaper.
Just here he reminded us that Dr. Hering
used to teach that Argent, nit. was the remedy
for children who were suffering from too much
candy.
The following is a case Prof. Mohr cites wliich
I think worthy of quoting.
Woman aet. 77 years, one year ago complained
of a nodule in left breast, stony hard, the nipple
retracted, pain exquisite, lancinating so as to
prevent sleep and cause loss of appetite. She
also complained of vertigo and was given Con-
ium ; under the action of which remedy the ver-
tigo left, but the swelling continued till the size
of a cocoanut, the axillary glands became hard
and as large as an egg, the tumor, which was
diagnosed a scirrhus cancer, then opened and
ulcerated (having a cavity in which you could
put your fist). The discharge was very offensive.
Conium was continued and earth dressing used.
On Dec. 19, the doctor was called for a burning
and itching in the neighborhood of the ulcer of
two days' duration. This spread till it covered all
the space from the shoulder to the ilium and
was diagnosed erysipelas. On account of the
cachexia, inability to eat or drink, (although quite
thirsty) bowels alternately constipated and
diarrhoeic, stools mostly watery, offensive and
excoriating, and the restlessness at night. Arsenic
3x was given.
As the erysipelas disappeared, the axillary
swelling went down and the breast ulceration
gradually healed up and now all appearance of
the cancer is gone, leaving only a cicatrix.
Query : Would it be justifiable to inoculate a
cancer case with erysipelas ?
I must do Prof. Mohr the justice to say that
this query is not his.
Prof. Goodno reports three cases of croupous
pneumonia aborted with Ferr. phos. after develop-
ing the crepitant rale and rust colored sputa. The
disease went no further, but recovered by lysis,
not by crisis, as is usual.
The remedies he suggests for first stage of this
disease are Aconite, Bryonia and Ferr. phos., and
indications are — " You rarely find a case sthenic
enough for Aconite. If there is a pleurisy con-
comitant give Bryonia, otherwise give Ferrum
phos.**
Apbil, 1868.]
COLLEGE NEWS.
121
ICiimeapolii.
HOMCEOPATHIC MEDICAL COLLEOE.
Prof. Bioker says : Bad water, impure air, and
filth will not prodace diphtheria, any more than
they will produce small pox; but thej will harbor
its specific germs, and assist the disease in main-
taining itself in the neighborhood. There is no
question in my mind but the disease is often trans-
mitted by thermometers. The use of this instru-
ment in the mouth is therefore not only disgusting
but dangerous. The internal use of alcohol has
not seemed beneficial in my experience, although
its local use in the form of spray or gargle has
yielded good results. I have obtained better re-
sults from Arsenic than any other remedy. It
suits the epidemic form, with nausea, restlessness,
somnolence, antemia, or septicaemia. For paral-
ysis following diphtheria I have found nothing
equal to Gelsemium. Asthmatic patients do not
die during a paroxysm. Just at the point where
death seems imminent the spasmodic action ceases
and the patient revives. Ipecac probably relieves
more promptly than any other remedy.
Prot Leonard says: When it is desirable to
prolong the life of a dying person until expectt^
friends arrive, or for some other purpose, it may
often be done by frequent small doses of Glonoine.
While a member of the House Staff of Ward's
Island Hospital an excellent opportunity was
afforded me of observing the relative merits of
Carbolic acid and Calendula for surgical dressings.
The surgical wards contained about 150 patients
of all ages, both sexes, and a great variety of ail-
ments. For six months Carbolic acid was used
almost exclusively as a dressing. During the next
six months it was banished from the wards, and
Calendula used in its stead. The results were very
perceptibly better under the Calendula treatment.
Among the many important uses of Arsenic is
the dyspepsia of tobacco chewers — a trouble you
will frequently meet. The tendency toward imbe-
cility in chorea, and in wasting diseases, has been
arrested by the exhibition of Tarantula, and also
^y Agaricus. In using Apis it is well to remember
that it does not act as quickly as other animal poi-
sons.
Prof. Matchan says: In dressing fractures use
splints made to fit the fractured limb, instead of
trying to make the limb fit a patent splint. The
dressings must be varied to suit the peculiarities of
each individual case; and a man who has no me-
chanical ingenuity cannot hope to become a good
surgeon.
In operating for cancer of the breast always re-
move the whole gland, even though the cancer be
smalL If the axillary glands are enlarged they
should also be removed. We can build up the
system, control hemorrhage, and in many ways
modify the symptoms of cancer, but I do not be-
lieve remedies have any effect upon the cancer
poison.
Some very successful surgeons are discarding
extension in the treatment of fractures, and I have
seen perfect results without its use in fracture of
the femur. The fragments being co-apted, the limb
put at rest in a natural and easy position, and
perfectly fitted splints applied, the irritability of
the muscles soon subsides, and there is no indica-
tion for extension.
BoBton.
UNIVERSITY SCHOOL OF MEDICINE.
Prof. J. H. Smith recommends warmly Gilli-
ford's solution of Arsenite of bromine in cases of
diabetes for the removal of sugar from the urine ;
5 to 8 drops three times a day gives excellent
results.
Dr. Smith also uses the following in cases of
agonizing colic from gravel or calculi in the kid-
neys : Dissolve J gr. of Morphia in atablespoon-
ful of coffee and administer ; this will quiet the
patient ; now follow with Lycopodium.
Prof. .Walter Wesselhoefi; for the benefit of the
senior class, recently reported an extremely in-
teresting case of locked twins, which came under
his care in private practice.
The side of the head of the upper child was
locked into the nape of the neck of the first
child, which appeared as a footling presentation.
Delivery of both was effected by application of
forceps to the head of the unborn child. Both
heads flattened suflBciently to admit of success-
ful delivery.
Prof. H. C. Ahlborn in a lecture on pyelitis
gave the follomng : As soon as pyelitis is diag-
nosed from the presence of pus in the urine,
administer Hepar sulph. ; dose : 3 grs. of 2x or
3x every two hours. This will be found to con-
vert the unhealthy to healthy pus. If the secre-
tion of pus is abundant and marked pain in the
' region of the kidney, the patient will be relieved
by a hot bath of eight minutes* duration, followed
by thorough drying of the parts by rubbing.
Copious draughts of equal parts of lime-water
and milk, a quart at a time, if possible, are
excellent, assisting to diminish the discharge of
pus, and washing out the tubuli.
Dr. Alonzo Boothby recently performed a very
difficult operation at the Massachusetts Homoeo-
pathic Hospital. The operation was total extir-
pation of the uterus, and was rendered very dif-
ficult by extensive adhesions to the bladder, the
breaking up of which required much care and
skiU.
122
THE MEDICAL ERA.
LVoL-Vl. No.i
Ohicagro.
HOM(EOPATHIG MEDICAL COLLEGE.
Prof. Mitchell says : The benefit derived from
the use of the pneumatic cabinet in cases of
asthma is but transient. More can be accom-
plished with internal remedies.
Local applications to the chest, often repeated,
and hot as the patient can bear, should be used
in the treatment of pneumonia. Administer
faithfully the indicated remedy.
Prof. Bebee, says the more he uses plaster-
of-Paris bandages in cases of fracture, the more
is he pleased with them. If swelling has not
taken place he applies, at once, the permanent
plaster cast. In case much swelling is present,
he applies a temporary dressing till it is re-
duced.
Treatment for hydrocele : First withdraw the
fluid; then inject 15 minims of 95 per cent
Carbolic, acid. This sets up an inflammation
which heals by first intention, the patient not
necessarily being laid up a day.
The following points are from Prof. Streeter's
lectures.
After the removal of the ovaries, menstruation
may continue. Nature has been forced, afid it
takes a long time for her to overcome the
*' habit."
In treating a puerperal woman, do not allow
her to remain too long in one position. An an-
tiseptic injection should be used once or twice a
day. Guard against contagion by nurse or
physician. No nurse must be had. who has been
near a zymosis. The physician must be ex-
ceptionally careful : nails must be clean, hands
washed in antiseptic solution, the finger lubri-
cated with a disinfectant material, the hair and
beard should be shampooed also. The instru-
ments should be washed in a bichloride of
Mercury solution, 1 : 1000 or 1 : 2000 or in
Carbolic acid, 1 part in 40.
In using an injection do not distend the uterus
with water, but have it so arranged that the
water can escape. A soft rubber catheter by the
side of the nozzle of the syringe is a good way
for drainage. Use from a pint to half a gallon
of water at a time. — Pro/. Streeter.
Ulcers may be touched with a solution of 60
grains of Carbolic acid in an ounce of Glycerine.
HOSPITAL NOTES.
The second annual commencement of the Min-
nesota Homceopathic Medical College will be held
on Monday, April 2, at the First Baptist Church.
Rev. Dr. Burrell will be the orator of the occa-
sion.
COOK COUNTY HOSPITAL.
An old colored woman recently came to the
hospital, claiming to be 103 years of age.
She presented no particular symptoms except
those of senility, but physical examination re-
vealed a nodular mass in the epigastrium. She
died shortly after her admission.
Iti the autopsy, carcinoma of the pylorus with-
out stenosis, and secondary deposits in the liver
were found, also 140 biliary calculi of various
sizes. She did not claim to have been " Wash-
ington's nurse *' ; only to have fed his horse.
The following is the method of treating frac-
tures of the femur in the hospital. The limb is
carefully shaved, and adhesive strips applied to
within an inch of the point of fracture (and held
by a roller bandage), to which three or four bricks
are attached. In this condition and in a blanket
splint the limb remains until the shortening is
overcome, say 36 to 48 hours. Now the limb
is carefully padded with cotton from the foot up
to the body ; two pieces of Bussian felt or heavy
card-board reaching below the knees, one anter-
ior, the other posterior, are firmly bound to the
limb over the point of fracture ; the body is well
padded with cotton. Liston's long splint well
padded is now bound firmly to the body from the
foot to near the axilla. Bandages of plaster-of-
Paris are applied covering the entire limb and
body ; and over this starch bandages. The foot
of the bed is elevated, and extension maintained
with the bricks. In five or six weeks the dress-
ings are removed. Besults always satisfactory.
For fracture of the tibia, fibular, or both, the
plaster-of-Paris cast is always used ; that is, when
there is no shortening in fracture of both bones.
The limb is well padded from the toes to four
inches above the knee, giving the heel and knee
a little extra padding. Over this the roller
bandage is snugly applied and over this two layers
of plaster bandages and one of starch. After
applying the first layer of plaster two strips of
tin, an inch wide and the length of the cast, one
anterior, the other posterior, are then put in
place and held by the second layer of plaster
bandages. These dressings are always comfort-
able to the patient ; no Messing is satisfactory
that is not. These are removed in tliree or four
weeks.
In compound fractures all the debris is care-
fully cleared away and the wound and limb are
well irrigated with bichloride of mercury solution
1 : 4000. Into the wound a solution of Iodoform
and Ether (1 to 6) is injected. The dressing
Apbil, 1888.]
CORRESPONDENCE.
123
consists of sublimated gauze, four layers. Be-
tween these a layer of borated cotton. If the
fracture is of the leg, this dressing is to extend
from the toes to four inches abore the knee.
Over this the plaster cast as above described is
applied. This is to remain from four to five
weeks if no rise of temperature.
Case recently admitted for necrosis of the
bones of the foot. The leg was amputated at
the junction of the middle and lower third. No
fibula was found. The tibia was larger than
normal.
Apomorphia 6x gave relief in a case where
cTerything eaten would immediately come up,
apparently without any effort on the part of the
patient.
Last week three successive autopsies in the
morgue revealed aneurism of the thoracic aorta.
A young woman aged 20 ; never menstruated.
Examination revealed atresia hymenalis. This
was incised and the ostium vaginse dilated by
Dr. Streeter, the attending gynecologist ; about
two quarts of dark blood were discharged. The
patient was douched every six hours with a solu-
tion of Mercuric bichloride, 1 : 8,000 for a week.
She is now convalescent.
CORRESPONDENCE.
In the note in last Era, where it speaks of the
preparation of sublimated gauze, it should read
Mere, bichloride, one dr., instead of one oz.
The Medical Era takes pleasure in making
the announcement that the Board of County Com-
missioners have ordered an increase in the num-
ber of patients to be assigned to the Homoeo-
pathic wards in Cook County Hospital, and also
an addition to our staff of internes.
Dear Editont: —
In the last issue of your journal is a sup-
posed quotation from Dr. Sam. 0. L. Potter,
giving his reasons, for ** abandoning homoeo-
pathy." Is it an acknowledged fact that he
ever adopted homoeopathy ? Is it not generally
beheved that he never was a success as a practi-
tioner in any school ? What evidence has he
left that he ever knew the first principles of our
school ? He saw an opportunity to make a book,
and to sell it was willing to play Jew for a time,
because he thought there was money in it.
Then for a position he was willing to put on his
old coat again — a sort of Carl Schurz man — will
work for the party that will pay him the most
money ! Let him go ! Homeo.
Alcohol in Diphtheria.
Nashville, Tenn., March 22, 1888.
To the Editor of the Med'w^l Era:—
I have been interested in the discussion of the
** Alcohol in Diphtheria " question.
If you will refer to my son, Dr. W. C. Dake's
monograph on diphtheria, you will see that we
have used that article for 20 years and more,
not as ** food," but as niedicine, in that affection.
It cannot be regarded as a' specific, but as a
very important remedy in diphtheria.
Yours very truly,
J. P. Dake, M.D.
Warsaw, N. Y., March 20, 1888.
To ilie Editor oftlie Medical Era: —
It is with great pleasure that I have read the
various articles in your much appreciated jour-'
nal on the use of alcohol in the treatment of
diphtheria. As you have invited reports, I will
briefly relate an experience I had in an epidemic
of malignant diphtheria some eight years ago.
At first I exhibited the usual remedies without
the use of whisky, and I lost about half my
cases. I then began using alcohol as a gargle
and internally, giving two drachms of whisky
once in two hours, with beneficial results but not
good enough to satisfy me. I then increased the
quantity of whisky until I gave an ounce every
half hour. To one family of six, ages from 8 to
20 years, during their sickness I gave them, in
the aggregate, five gallons of whisky. They all
made good recoveries. A young lady about 24
years old came under my care. I gave her one
ounce of whisky, in as much water, every half
hour. One evening I noticed that she was grow-
ing worse; that night she took one ounce of
alcohol in as much water every half hour. In
the morning I found the tide had turned, she
was improving. I continued the alcohol in less
quantity, more diluted. She made a good recov-
ery. The remedies I gave during the last two-
thirds of the epidemic were Mercurius cyanide,
from the 3x to the 30x, Baptisia tr., Arsenicum,
3x and Belladonna 3x. For the gargle I used
one quarter alcohol and three quarters water,
and with this treatment I saved most every one
of my cases. I now carry the use of alcohol to
the verge of intoxication in each case, whether
it be child or an adult.
Fraternally yours,
Chas. C. Curtis, M.D.
124
THE MEDICAL ERA.
[Vol. VI. No. 4.
AUNOUNOBMBNTS.
The American Institute Session.— Preliminary
Notice.
The American Institute of Homoeopathy will
convene in its forty-first session at the Interna-
tional Hotel, Niagara Falls, New York, Monday
evening, June 25th and closing Friday, June 29th.
Hotel accommodations will be ample, and rail-
road rates reduced.
Members having papers should report titles to
appropriate bureau chairman at once. Papers
likely to consume more than fifteen minutes in
reading must be accompanied by an abstract.
Bequests for statistical information sent out by
Dr. T. F. Smith, of New York, should be responded
to without the usual delay.
Each state or inter-state society is entitled to be
represented at the session by two delegates and
one additional delegate for every twenty members;
each county or local society by one delegate; each
hospital, asylum, dispensary and journal one dele-
gate; each college two delegates, to constitute the
Inter-collegiate Committee of the Institute. It
is not necessary that delegates be members of the
Institute, but they are entitled to all the privileges
of membership except voting and eligibility to
office.
The terms of membership are : Initiation fee
$2.00; annual dues 95.00. Blank applications for
membership may be obtained by addressing the
undersigned.
The General Secretary's Circular, including the
entire programme, will be issued some three weeks
prior to the session. Full details will be furnished
to all the homoeopathic journals in time for pub-
lication in their June issues.
Pemberton Dudley, M.D., Gen. Sec.
S. W. Cor. 15th & Master Streets, Philadelphia,
Pa.
The Dakota Homceopathic Medical Association
will meet at Bedfield, Dakota, June 4 and 5,
1888. E. W. Murray, M.D., Secretary.
The Hahnemann Medical Association of Iowa
will meet at Iowa City, May 22, 23 and 24, 1888.
Geo. Boyd, M.D., Secretary, Des Moines, Iowa.
The Nebraska State Homceopathic Medical So-
ciety will meet at Lincoln, May 8, 9 and 10, 1888.
F. W. Winter, M.D., Secretary, Wymore, Neb.
The Western Academy of Homocopathy will meet
in Chicago; May 29, 30 and 31, 1888. C. J. Bur-
ger, M. D., General Secretary, Booneville, Mo.
The Illinois Homceopathic Medical Association
will meet in Chicago, May 15, 16 and 17, 1888.
Curtis M. Beebe, M.D., Secretary, 27 South Ash-
land Ave., Chicago.
The Alumni of the Pulte Medical College held a
reunion at the Gibson House, Cincinnati, Feb. 29,
1888.
PSB80NAL8.
Dr. E. K. Thompson has located at Hutchin-
son, Kas.
Dr. J. W. Streeter has bought a new resi-
dence at the comer of 20th St. and Prairie Av.
Dr. Amy G. Bowen, (Hahnemann, San Fran-
cisco, '87), is attending the New York Polyclinic.
Dr. A. M. Countryman, (Pulte, *81), is attend-
ing the New York Post-Graduate Medical School
and Hospital.
Dr. Florence N. Saltonstall (Hahnemann, San
Francisco, '87), is taking a couree at the New
York Polyclinic.
Dr. C. A. Pauly, (Pulte, '87), is attending a
course at the New Y'ork Post-Graduate Medical
School and Hospital.
Dr. Clifford Mitchell has moved his oflSce and
laboratory to the Bay State Building. Rooms
614 and 615, opposite Central Music Hall.
Dr. E. E. Hale, of Newtonville, Mass., has re-
ceived an appointment to the position of resident
physician in the Massachusetts Homoeopathic
Hospital, Boston.
Dr. William Tod Helmuth entertained the
faculty and graduating class of the N. Y. College
at his elegant residence on Madison Avenue,
Saturday eve., Mar. 24th.
Dr. R. E. Hinman (N. Y. Horn. Med., 'SS), the
retiring editor of the Chironian, will be succeeded
by C. P. Opdyke, '89. The journal has passed
through one of its most successful years.
Dr. G. H. Martin (Boston University, '81), the
predecessor of Dr. F. R. Day, at Honolulu, is
attending a special course at the New York Post-
Graduate Medical School and Hospital. Dr.
Martin has been appointed Professor of Clinical
Medicine in the Hahnemann Medical College,
San Francisco, and will begin his duties at the
opening of that school in May.
The Missouri Institute of Homceopathy will
meet at Kansas City, Mo., April 24, 25, 26, 1888.
Moses T. Runnels, M.D., General Secretary, 8 East
6th St., Kansas City.
The Eastern Ohio Homceopathic Medical Society
will meet at Youngstown, April 18, 1888. A. S.
Hay den, M.D., Secretary, Columbiana, Ohio.
The Homceopathic Medical Society of Wiscon-
sin will meet at Milwaukee, May 23, 24, 1888.
Jos. Lewis, M.D., Secretary.
The twelfth annual meeting of the California
State Homceopathic Medical Society will be held
at the Hahnemann Medical College Building,
San Francisco, May 13th, 1888.
Apbxl, 1868.]
MISCELLANY.
126
Helmuth House.
Helmuth House. — At No. 41 East 12th St.,
New York, is one of .the neatest little hospitals
in this country. Its appointments are perfect,
it is scrupulously neat, and exquisitely antisep-
tic. It may serve as a model for many another
institution. Although this is a private enter-
prise, yet the entire profession should congrat-
ulate Prof. Helmuth on his success.
It is to the credit of our school that its lead-
ing surgeon should be able to show an institu-
tion of a kind that has heretofore been the
peculiar property of the worshippers of tradition.
Prof. Helmuth receives patients from all parts
of the country, and all his rooms are occupied
most of the season. At the present time he has
cases of recto-vaginal fistula, perimetritis, am-
putation of the breast, ovariotomy, nephrectomy,
extrophy of the bladder, varicocele, ovariotomy,
pelvic abscess, lacerated cervix, enlarged pros-
tate, amputation of the tongue, and inguinal
hernia.
Prof Helmuth employs all the antiseptic
methods belonging to modem surgery, and tliis,
together with the surgical skill for which he is
80 well known, gives results which compare
favorably with those of the best institutions in
this country or abroad.
The Laura Franklin Free Hospital for Children.
An institution that is endowed in perpetuity is
in a most enviable condition indeed. But this is
not the only merit enjoyed by the Laura Franklin
Hospital of New York. It possesses a handsome
building, with first-class appointments in all its
parts. It is finished throughout in hardwood, the
wards are light and airy, and furnished with num-
erous cribs, containing many sick children.
The mortality-rate for the first year was but 4.22
per cent, a fact which speaks well for the mode of
treatment which ihey receive. To give a list of
the attending staff would be to name many of New
York's most eminent physicians. Thus it stands
as a memorial to the one for whom it was named,
and as a monument to that system of medicine
which has made so many triumphs in the treatment
of the diseases of children.
A Familiar Nak^. — Few names have become so
familiar to the profession as that of "Lactated
Food, " a preparation of high nutritive value and
easy of assimilation. It contains no cane sugar,
the basis being sugar- of- milk. For the summer
season it offers special advantages, for it will often
solve the important problem of finding a food that
will agree with a sick baby. (See page xvii.)
New York Poet-Graduate Medical School and Hos-
pital.
This institution, now in its sixth year, is the
leading post-graduate school of this country, and,
since its opening, has been resorted to by over
eight hundred physicians, who have taken ad-
vantage of its unusually fine facilities for instruc-
tion. Its hospital facilities are ample, while its
dispensary is overcrowded with cases — many
of them typical — of all forms of disease. The
method of instruction is, in the main, clinical,
though laboratory work and post-mortem dem-
onstrations in pathology and pathological anat-
omy form a part of the course.
The names of those who make up its faculty
are as familiar as household words to the en-
tire medical profession, not only of this country,
but, many of them, of Europe. By their efforts
they are rendering it less and less necessary for
American students to go abroad in order to
avail themselves of the latest and best in medical
science. The representative nature of those who
make up its faculty will be appreciated on read-
ing the following hst :
William A. Hammond, M.D.
D. B. St. John R00B8. M.D.
Frederic R. Sturgia, M.D.
ThoB. E. Satterthwaite, M.D.
Charles L. Dana, M.D.
Andrew H. Smith, M.D.
William Oliver Mof)re. M.D.
Ambrose L. Ranney, M.D.
Bache McB. Emmet, M.D.
Edward Kerishner, M.D., U.S.N.
William U. Porter. M.D.
Geo. Henry Fox, M.D.
Stephen 8. Bon. M.D.
Seneca D. Pow^cil, M.D.
C A. Von Ramdohr, M.D.
Horace T. Hanks, M.D.
Lewis S. Pilcher, M.D.
Clarence C. Rice, M.D.
Chas. Carroll Lee, M.D.
Graeme M. Hammond, M.D.
J. R. Nilsen, M.D.
George B. Fowler, M.D.
Robert Abbe, M.D.
A. M. Phelps, M.D.
Henry D. Chapin, M.D.
A. F. Buchler, M.D.
J. Bf Emerson, M.D.
Whether or not they ever expect to attend, we
advise our readers to send a postal-card asking
for a copy of the latest annual announcement.
Address :
Clarence C. Rice, M.D., Secretary,
224 East 20th St.,
New York City.
G. R. Elliott, M.D.
Francis Valk, M.D.
Chas. H. Brown, M.D.
Wm. M. Lesssynsky, M.D.
William A. Dayton, M.D.
U. B. McCarroll, M.D.
Snmnel Lloyd, M.D.
R. W. Wilcox, M.D.
F. B. Carpenter, M.D.
A. P. Carrier, M.D.
G. G. Van Schalck, M.D.
J. K. Crook, M.D.
Jos. O'Dwyer, M.D«
Chas. K. Briddnn, M.D.
E. B. RamsdelK M.D.
A. P. Dudley, M.D.
Daniel Lewis, M.D.
Robt Bancker Talbot, M.D.
W. A. Shnfelt, M.D.
O. B. Douglas, M.D.
Wendell C. Phillijis, M.D.
H. A. Mandeville. M.D.
H. Draper Speakman, M.D.
G. Dalton Hays. M.D.
H. B. Scott, M.D., U.S.N.
J. H. Girdner, M.D.
Very Beticent.
"And so your dear husband has gone to
heaven ? "
**Well, I can't say positively as to that. He
did not let on where he was going. He was
always a very reticent man."
126
THE MEDICAL ERA.
[Vol. VI. N«.4.
A. Discovery IN Anatomy. — A Boston physician,
Dr. W. S. Bryant, baa discovered the existence of
valves in the portal and mesenteric veins daring
infant life. They disappear as the child grows.
Correction: — in the formula for Esbach's
solution given in Dr. Clifford Mitchell's article in
the last Era (March, 1888,) instead of '* picric
acid, 19 grams," read '* picric acid, 10 grams (155
grains)."
Visiting List. A perpetual Visiting List has
been made by Gross & Delbridge, which is the
best thing in the market. The price is only fifty
cents, and it is worth more than those which sell
for three times the amount.
William Mubrell, M.D., in a lecture delivered at
Westminster Hospital, London, said that the best
Pepsin that he had tested was ^* Fairchild's."
This is valuable and unsolicited testimony.
" Robinson's Lime Juice and Pepsin " is an
excellent remedy in the gastric derangements
particularly prevalent at this season. It is su-
perior as a digestive agent to many other similar
goods. (See page X., this issue).
The Annals of Surgery^ the only English jour-
nal published devoted exclusively to Surgery,
enters now upon its fourth year. Drs. L. S. Pil-
cher of Brooklyn, N. Y., and C. B. Keetley of
London, England, are the chief editors, assisted
by most all the able surgeons of this country as
well as Europe, which is sufficient guarantee of
the literary merits. We bespeak for it the co-
operation of the members of the profession who
are interested in progressive surgery. J. H.
Chambers & Co., St. Louis, Mo., are ilie publishers,
and deserve great credit for undertaking to pro-
duce such an important journal as Annals^ and for
its artistic execution.
The March Century contains several features
of romantic interest. First in uniqueness, per-
haps, is Mr. Kennan's continuation of his revela-
tions in regard to the Russian state prisdhs,
the details of which are remarkable for interest
and bear every evidence of authenticity.
Scribner's for March is a number of unusual
interest. This magazine has attained to a place
equal to any in the country.
D. Appleton & Co. have in press, soon to be
issued. The Applied Anatomy of the Nervous Sys-
tem, by Ambrose L. Ranney, M.D. Profusely
illustrated. Second edition, revised and enlarged.
Also,
The Language of Medicine, by F. R. Campbell,
A.M., M.D., giving the origin, etymology, pronun-
ciation of technical terms found in medicine. Also,
A Text- Book on the Diseases of Women. By
Alexander J. O. Skene, M D. Ulustrated with over
200 fine engravings.
BOOK REVIEWS.
PnoTOGRAPfflc Illustrations of Skin Diseases.
A complete work on Dermatology. Atlas and
Text-book combined, by George Henry Fox,
A.M., M.D., Clinical Professor of Diseases of
the Skin, College of Physicians and Surgeons,
New York. Second edition, enlarged and im-
proved. New York: E. B. Treat. 1888.
It is now eight years since the first edition of
this admirable work was issued, and in that time
it has taken its place as the standard work on
skin diseases. In addition to the text of the
work, which is very full and complete, especial
value is given to it by the photographic illustra-
tions of diseases of the skin. These photographs
bring to the physician's eye, in a most \'ivid
manner, the clinical appearance of the various
skin diseases, aiding greatly in diagnosis.
The work will be complete in twelve monthly
parts, each part consisting of four plates, com-
prising from six to ten cases, printed from the
original photographic negatives, by the artotype
(a new and indelible) process, on the finest qual-
ity of heavy cardboard, 10x12 inches, colored
by hand, giving in each case the characteristic
and life-like effects of the disease. Each plate
will be accompanied by four or more pages of
text.
On a New Treatment of Chronic Metritis.
With Intra-uterine Chemical Galvano-cau-
terizations. By Dr. Georges Apostoli, Mem-
ber of the Society of Medicine of Paris.
Translated by A. Lapthom Smith, B.A.,
M.D. Detroit : Geo. S. Davis. 1888.
The translator of this book went to Paris for
the purpose of placing himself under Apostoli' s
instructions. He says : " t saw results which
were slow in coming and diflicult to obtain by
other methods, follow with almost mathematical
certainty from his treatment. While other
cases, which were being treated successfully, it is
true, but with great risk and danger, and some- ,
times with a high death rate, by means of the ,
knife and curette, were equally amenable to i
Apostoli's gentle, harmless, and nearly always .
painless method."
The profession is already somewhat famUiar
with ApostoU's treatment, but* as yet there has
been no systematic work on the subject. Geo.
S. Davis has, therefore, done good service in
presenting a translation of Apostoli*s work, which
should be owned by every physician who wishes
to become possessed of the latest, and, a^ aceounts
go, the best method of treating clironic diseases
of the womb.
Apul, 1888.]
BOOK REVIEWS.
127
The More Excellent Way in the Practice of
Medicine. By John Glemensen Day, M.D.
(Lond.) London; E. Gould & Son. 1888.
Here is most interesting reading. It is the
old, old story, but told in a delightfully original
mani^r. Dr. Day was a member of the tradi-
tional school, and trained in traditional meth-
ods, with which he became thoroughly disgusted.
A new light flashed on him, and, like the three
wise men, he followed it. That light was similia.
He became a convert to the new method, and is
now confirmed in the faith.
This excellent little work bears a lesson with
it. That lesson is that the true spirit of homoe-
opathy is as active to-day as it was when our own
Holcombe wrote "How I Became a Homoeopath."
And, moreover, Dr. Day's closing words contain
the best answer to Dr. Mack's interrogative title.
Dr. Day concludes by saying — **The stability
of the law is assured, for it rests on the firm
foundation of eternal truth."
Contributions to the Study of the Heart and
Lungs. By James B. Leaming, M.D.,
Emeritus Professor of Diseases of the Chest
and Physical Diagnosis in the New York
PolycUnic. New York: E.B. Treat. 1888.
($2.75.)
While there is much in this work that will
repay perusal, yet, as a whole, it is too frag-
mentary for general use. Dr. Leaming is cap-
able of giving the profession an excellent sys-
tematic treatise, and it would be better had he
done so. The chapter dealing with the bacillus
tuberculosis, especially, should have been rewrit-
ten. The causative relation of the bacillus to
phthisis cannot be so easily disposed of. Dr.
Semmola, at the Washington Congress, was
compeUed to except this when making his sweep-
ing statement regarding the present limits of our
knowledge of the disease-producing agency of
bacteria. The book is good " in spots."
SiMHiiA SiMiLiBus CuRANTUR ? Addressed to the
Medical Profession. By Charles S. Mack,
M.D. Boston and Providence: Otis Clapp
& Son. 1888.
It is hard to see why this book was ever writ-
ten, and still harder to see why it was ever pub-
lished. While it may be true that it is ** better
to debate a question without settling it, than to
settle a question without debate, " yet it is equally
true that it is not worth while to debate a ques-
tion at all (in print) unless one can add some-
thing, be it ever so little, to its elucidation. But
in this our author has failed. He begins no-
whej^ and he ends nowhere. When science bor-
rows the weapons of theology both are reduced
to an absurdity.
Specific Medication and Specific Medicine.
Fourth Revision, with an Appendix and a
Report of Cases Illustrating Specific Medi-
cation. By John M. Scudder, M.D., Pro-
fessor of the Principles and Practice of
Medicine in the Eclectic Medical Institute,
etc. Twelfth Edition. Cincinnati : John
M. Scudder, 1888.
A twelfth edition generally speaks for itself.
But in presenting this book to our readers an
introduction is necessary. The first thing that
strikes us in examining it is the frequency with
which reference is made to homoeopathic reme-
dies. But, unlike the allopaths, Dr. Scudder in
every instance gives due credit. The slight
amount of attention given to many remedies is
noteworthy. Phosphorus, to which Richard
Hughes devotes many pages, is disposed of in
eighteen lines ; the same may be said of Bryonia
and others. But the tendency is all in the right
direction; that is, to specific medication, to
the giving of curative doses, and the avoidance
of heavy drugging and harsh medication.
The Hom(Eopathic Therapeutics of Rheumatism
AND Kindred Diseases. By D. C. Perkins,
M.D. Philadelphia: T. E. Boericke, 1888.
Since Bell wrote his now famous hand-book on
** Diarrhoea and Dysentery," he has had a hunr
dred imitators. It is the same old plan : — The
would-be author chooses his subject, taking some
familiar disease ; he then makes an alphabetical
list of remedies, in number anywhere from one
hundred to three hundred; he then compiles
symptoms from numerous works on materia
•medica, arranges his rubric, makes a repertory,
and, lo ! there is another book. But, ad bono !
Can we be sure that it is always reliable ? Our
author says :
This work, while resulting from the author's
twenty years of constant study, and the treatment
of those complaints termed rheumatic, is neces-
sarily compiled from other sources.
Ah! There's the rub! Are the "other
sources " reliable ? Can our author recommend
Psorinum with any great degree of confidence ?
He frankly admits that ** records of clinical ex-
perience with Bufo are wanting." Can he make
any greater claim for many of the other one
hundred and five remedies represented?
The book, notwithstanding the criticism made,
will doubtless prove very useful, but future
bibliographers should learn that what homoeo-
pathic materia medica most needs is not greater
quantity, but greater accuracy.
128
THE MEDICAL ERA,
[Voi_ VI. No. 4.
THEY SAY
That it blew furiously.
That it snowed vigorously.
That it was a big blizzard.
That the drifts were enormous.
That California is called the " one-lung country. "
That after the fourteenth year one doubles in
weight.
That ffecal anaemia is the latest new name for a
disease.
That the weight of a child to the mother is
about 1:19.13.
That the most rapid growth of one's life is made
in the first year.
That morphine taken by a nursing woman gen-
erally affects her child.
That many men are homeless, but some men
are home less than others.
That no one ever saw a bald-headed consump-
tive, or a bald-headed tramp.
That in New York State the death penalty is to
be administered by electricity.
That the weight of the child generally increases
with the number of pregnancies.
That at full maturity one's weight is about twen-
fy-four times what it was at birth.
That a medical college in the City of Mexico
has had its first woman graduate.
That in the milk- diet treatment of diabetes
only skimmed milk should be used.
That from birth to the age of fourteen one in-
creases in weight about twelve-fold.
That during intrauterine life the foetus increas-
es its weight about one million times.
That one part of saccharin will impart a sweet
taste to over ten thousand parts of water.
That tube- casts cannot be found in alkaline
urine, no matter what renal lesion exists.
That in the early stages of renal cancer, hema-
turia- may be the only noticeable symptom.
That as regards homoeopathy, experience con-
firms the practice; it does not point the way.
That gylcerine makes a good enema to produce
action of the bowels; use two or three teaspoon-
fuls.
That there is now a record of eighty cases of
pneumotony, with forty- three cures and thirty-sev-
en deaths.
That quantitative analysis of the constituents of
urine is far superior to qualitative in the informa-
tion it reveals.
That iodide of potassium taken by a nursing
woman is always found in the urine of her child
within a few hours.
That in hematuria obscure in origin and seem-
ingly causeless some new growth is often at the
bottom of the matter.
That three-quarters of child-bearing women
have a rupture of the perineum of some degree,
one-half of them being slight.
That troublesome attacks of sneezing may some-
times be stopped by smearing the nostrils with vas-
eliue; it often works like a charm.
That in puerperal nephritis calculation of the
total amount of solids in the urine is more impor-
tant than mere testing for albumin.
That a woman had convulsions in whose urine
only one- sixtieth of one per cent (by weight) of
albumin had been found during pregnancy.
That a patient apparently dead, from collapse
following child birth, was resuscitated by a sub-
cutaneous injection of a solution of nitro-glycerina
That the weight of the new- bom child general-
ly decreases for two or three days; it then increases,
and reaches the original weight in five to ten days.
That a boy weighs more than a girl up to the
tenth year or twelfth year, then the girl weighs
more to the fifteenth or sixteenth year, when the
boy again takes the lead.
That one of the squaws belonging to Buffalo
Bill's outfit in London has gone through her ac-
couchement, and produced the first American In-
dian ever bom in England.
That when urine is sometimes clear and normal
but at other times contains pus, occasional block-
ing by a renal calcalus of the ureter which leads
from a diseased kidney is indicated.
That the immediate cause of cholera infantum
is the putrefactive changes which take place in the
stomach and bowels in food not digested, which
changes are often begun outside the body.
That water analyses have been made on English
ships for the past ten years, but water reported
pure and clean chemically has been known to have
produced most violent and fatal epidemics.
That a spider in Decatur, Ga., builds a new web
every morning, and weaves in letters spelling the
day of the week, Sunday, Monday, etc. You can
believe this story or not, just as you please.
That when there is a dangerous condition, in-
volving the kidneys, in pregnant women, the
amount of albuminuria may be very slight, but the
urinary solids will always be found much dimin-
ished.
TBE MEDICAL ERA
Vol. VI.
Chicago, May, 1888.
No. 5.
EDITORS :
CH. GATCHELL, M.D.
JA^IES E. GKOSS, M.D.
THE ILLINOIS HOMOEOPATHIC MED-
ICAL ASSOCIATION.
The coming meeting of this association prom-
ises to be well attended, and to enlist the best
efforts of the representative physicians of the
State. There will be a sufficient number of
carefuUy prepared papers to prove instructive,
and to elicit discussion. The arrangements
for the accommodation of members, and for the
holding of the meetings, are such as to guar-
ant<?e satisfaction. Several features of special
interest have been provided, and we feel justi-
fied in extending to every member of our school
in the State a most earnest invitation to grace
the meeting with his presence.
ANOTHER MOXIE.
A medical meteor has flashed across the sky.
Some designing scamp got up a decoction,
having morphine as its basis, calculated on
being taken to make people " feel good." It
was advertised far and wide as a great tonic
invigorator, and especially recommended as an
antidote for the opium habit.
People drank it, and it did make them *'feel
good." Opium ImhitiU's took it, and found tliat
they could dispense with their former dose, for
this supplied them with precisely the same
thing. Finally, the analytical chemists got
hold of it and made public a report of its con-
stituents, and it was found that the people had
been fed on morphine in considerable quantity.
The bubble burst. No longer are the pax^t*rs
ornamented with pictorial advertisements of
** Scotch Oats Essence," and someone has lost
considerable money.
The lesson which this should, but will not,
convey, is that people should take nothing of
the kind unless they know what it contains,
and in order to do so they should take nothing
that is not prescribed by a (homoeopathic) phy-
sician. Then they will escape drugging of all
kinds. They should remember the story of the
gentleman who was suddenly taken ill at a
hotel. An officious stranger urged the sick
man to take some of "Dr. Balsam's Magic
Tonic." The patient positively declined.
*^ Won't you?" urged the stranger. *<Not
much ! " replied the patient ; **I know what's in
it. I am Dr. Balsam, myself."
COOK COUNTY HOSPITAL.
Brief allusion has been made to the fact that
the Homoeopathic Department of Cook County
Hospital has been granted an increase of pa-
tients and internes. Heretofore, every fourth
surgical, and every fifth medical, obstetric and
gynecological case, was assigned to the homoeo-
paths. Under the new apportionment, one-
fourth of all cases are so assigned. In addition,
we now have four internes instead of three.
The record of the Department is still such as
to create favorable comment.
THANKS !
We- beg leave to extend our most sincere
thanks to the editor of our American SatdUie
for the frantic efforts he is making to help us
edit this journal.
THE MEDICAL ERA.
[Vol. VI. Ko. i.
RECENT INVENTIONS.
POBTBS'S VBST-FOOBBT BUBOICAL CASE.
Editor of the Medical Era : —
Economy of pocket space being an important
factor in a physician's make-up, it is necessary
to condense his appliances and, if possible, em-
ploy only such articles as will meet the demand
and at the same time occupy but little room.
With this in view I had constructed a pocket
surgical case on the lilliputian order which fur-
H IHFBOTED PIBTOI. 8FLINT FOB TBS
TBSATUNT OF OOUiBS' FBAOTUBB.
1HAVE recently improved the pistol splint
for the treatment of Colles' fracture, and it
has been so satisfactory that I here give a
description of it. Its application is so simple
thfft no assistance whatever is required.
Ad ordinary dorsal pistol splint is cut out of
half-inch board, such that its length, including
the curve, is equal to the distance from the
elbow to the tips of the fingers. Measure from
the elbow to the junction of the carpus and
metacarpus. Witb-this distance, an inch tbiek
and an inch and a half wide, a piece is con-
stnicted which is grooved on one of its surfaces
and over one end.
IPortet'sVeM Pocket Sorelol C»ee.]
nishes the practitioner all the instruments ordi-
narily required in "emergency cases." Having
exhibited the case to some of my friends, they
expressed a. desire to have it placed on the
market for sale. Geo. Tiemann & Co., of New
York, were instructed to make a number, and so
well pleased were they with the demand that
they wished to have the case properly placed be-
fore the profession and be permitted to name the
case after myself. The case is only 2^ inches
in length by 1 J in width, with but one fold, thus
furnishing, as Tiemann & Co. state, "the small-
est and most complete surgical pocket case ever
placed on the market." The number of instru-
ments supplied consist of one straight bistoury
(finger knife), one curved, sharp-pointed bistoury
(abscess knife), one pair of beemostatic forceps
(mouse-tooth style), one needle-holder, one pair
of curved scissors, one grooved director, one
jointed silver probe, package of assorted needles
and a card of silk or silver wire sutures. By ex-
amining this list there will be found all the nec-
essary instruments required for cases that are
ordinarily met with in an every-day practice. I
carry the case in a watch pocket, which contains
in addition a clinical thermometer and hypo-
dermic case, thus illustrating how little space is
occupied by the surgical ease.
Detroit, Mich., Respectfully yours,
AjirU 20, 1888. Phil. Porter, M.D.
[Spicfa'i Impioved natol Spllnt.1
This is fastened firmly to the pistol splint,
BO that the ulnar border of the arm will lie in
the groove, and the metacarpus will pass over
the grooved end of the ulnar piece.
Pad the arm well and the ulnar border of the
pistol splint ; apply with the roller, and cover
with starch bandage. In three or four days, cut
the bandage about the fingers, and remove the
dressing entirely in three weeks.
By this method, perfect apposition of the frag-
ments can be obtained, and perfect immobility
maintained.
To the double triangular cushion spbnt for
fracture of the humerus, a description of which
appeared in the February number of The
(Spach'a TT<in|[n1>r CDPhion Splint. J
Meoical Eha, I have added some few improve-
ments, which can be seen in the figure as here
represented.
Mat. 1888.]
ORIGINAL ARTICLES.
131
ORIGINAL ARTICLES.
A 0A8X OF KAIilONANT PBMPHIQX7S; BS-
COVX&Y.
Bt S. D. JOHNSON, M.D.,
rOX LAKl. WIB.
SOMETIME in June, 1881, I was called to Bee
Miss Lillie A., a young lady of 19, who was
in attendance at the Wisconsin Female Col-
lege, of this place. I found her suffering with
acute purulent conjunctivitis. This was soon
controlled by appropriate treatment, but, as this
trouble passed off, there developed upon the ex-
tremities an eruption which I found some trou-
ble in determining whether it was herpes iris or
pemphigus. I, however, diagnosed pemphigus.
It soon almost entirely disappeared, so that al-
though the lady was here a greater part of the
time, I heard no more about it. In December
she went home, and while there blisters devel-
oped on the left foot near the toe^. Her mother
thought she.had chilled her feet and used some
simple measures upon this hypothesis. On Jan.
27th one of the ladies of the college came for a
prescription, saying that Miss Lillie had a cold
and a violent headache. I prescribed some sim-
ple remedies that seemed indicated and received
word in the evening that the patient had ob-
tained some relief. Jan. 28th I was called to
the bedside of the patient. I found temperature
of 104.5^ pulse 120, violeni headache, with
much prostration. Upon examination I found
blebs on the left foot between the toes, and on
the instep of the right foot and ball of the great
toe. These were flat and filled with serum of
alkaline reaction. I prescribed Belladonna 3x
and Bhus tox. 3x in alternation. Jan. 28th,
temperature 103J^ pulse. 106, a. m. ; T. 105,
pulse 120, p. m. Jan. 80th I found the patient
about the same, only there had developed such
a fetor, that I gave Baptisia and Ehus alter-
nately, and used locally Eucalyptus.
Each bleb was promptly opened and dis-
charged and carefully disinfected with solution
Bichloride of mercury, 1 : 2,000. The patient pre-
senting quite alarming symptoms, at the request
of her mother I called Dr. Byron Maclier, of
Portage, Wis., in consultation, who quickly con-
finned my diagnosis of malignant pemphigus.
On account of the great prostration and the
evident septic influence at work, we gave egg-
noggand Quinine, 4 gi-s., every four hours. This
was continued in conjunction with the indicated
remedies for one day, when slight cinchonism
was produced. Then we gave Quinine, 2 grs..
every four hours, with the egg-nogg continued.
After three days the temperature came down and
did not go above 104^, having kept its maximum
at 105. S'' for about one week. But now the
eruption began to spread, the blebs coalescing
until they extended to the knee. We now used
a spray of lime water, carbolized, after the blebs
had been opened, dusting the parts with starch
and oxide of zinc, equal parts. When the parts
became raw and bleeding we used a spray of
Calendula, which was very soothing. The rem-
edies used were Thuja, Arsenicum and Ehus
tox., changing as symptoms or indications for
their use changed.
February 16th the temperature fell to normal
and remained so for ten days, when an abscess
formed on the left foot. This we opened
promptly, and the little fever occasioned by it
quickly subsided and our patient seemed once
more to be in a fair way to recovery.
In about two weeks she suddenly lost the use
of the right leg, the knee became immovable and
the calf of the leg began to swell. The limbs
were entirely denuded of their covering and the
newly formed cuticle was very tender and sen-
sitive. The nails all came off the toes. The
calf continuing to swell, we applied poultices
and endeavored to discuss it, but failing in that
we favored the formation of the abscess that
seemed inevitable, and lanced as early as possi-
ble. This ended the trouble. Since that time
our patient made steady progress and on April
11th she went home. Every vestige of the dis-
ease seemed gone.
This case to me has been a very interesting
one. According to all authorities the prognosis
was unfavorable from the start. The tempera-
ture remained so persistently high and prostra-
tion so great that we seemed almost powerless in
our efforts to relieve. When suppuration ensued
and the temperature ran up, with nausea and
violent headache, I tried Antipyrine with the
happiest result; 15 grs. would usually relieve
the headache and bring the temperature down to
99° every time.
Upon the pathological condition the remedies
having the best influence apparently were Ar-
senicum 3x; Ehus tox. 3x; and Thuya 3x.
Upon the raw surface the spray of Calendula,
following with powder of starch and Oxide of
zinc, were efficient in allaying irritation, keeping
the patient comfortable. The continued use of
Quinine in doses of 2 grains, I feel certain was
one of my greatest allies, keeping the patient
supported when without it she could not have
rallied.
132
THE MEDICAL ERA.
[Vol. VI. No. 5.
IV.
HAY FEVER:
RHINITIS VASO-MOTORIA PERIODICA.
Bv B. LIPPINCOTT, M.D.
M KM PHIS, TKNN.
Treatment. — This disease has heretofore been
considered one of the most difficult and refractory
to deal with and the treatment generally unsat-
isfactory.
Phoebus gives a long list of remedies that have
been unsuccessfully employed to combat it, and
Zuelzer, in Ziemssen's Encyclopedia, after giving
a historj' and description of the disease, dismisses
the consideration of its treatment with the state-
ment that ** treatment is powerless against it."
From the diversified internal medication rec-
ommended by writers of other schools, there is
nothing to offer, on account of the results of the
treatment having been unsatisfactory. It con-
sists mainly of tonics, sedatives, alteratives and
nervines.
With many, a favorite local application has
been to irrigate the nasal cavities with a solu-
tion of Quinine, gr. j, or ij, to water Ij, two, three
or more times daily. This was first recommended
by Helmholtz. It has proved of but little if any
benefit. The good efifect, if any, is attributable
to the solution washing away the ciyr^pxi^ delicti
mechanically, rather than by any parasiticide
action. The various injections and insufflations
recommended have been of no permanent bene-
fit and in many instances have proved injuri-
ous. Sir Morell Mackenzie, (Hay Fever, 1884,
page 22), says: '*I trust very little to lo-
cal measures in the treatment of hay fever, but
when there is profuse secretion with an excessive
tendency to sneeze, the inhalation of strong
Ammonia salts often gives great relief." Many
appliances and devices are recommended for the
comfort of the patient during an attack, but none
of them equal prompt and well directed treat-
ment towards the removal of the cause.
No experiments since those made by Blackley
have been as thorough as his. They were then
comparatively satisfactory from an aetiological
point of view, but did not suggest a successful
plan of treatment.
Homoeopathic literature records but few abso-
lute cures. Leading writers of our school speak
with indifference in relation to its aetiology,
pathology and treatment.
There has been but little concurrence in the
various articles written in relation to treatment.
The internal treatment suggested has been main-
ly empirical, and has depended largely upon the
fanciful doctrine of signatures, especially the in-
dications for the guidance in the choice of the
remedy, which has often been colored to suit
the views of the writer in reference to some fav-
orite remedy or supposed specifiow This lack of
unanimity is attributable to the fact, that, until
recently, the aetiology and pathology have been
but imperfectly understood.
Many cures of hay fever are reported, which,
upon inquiry in after years, it is learned that
the attacks recurred each succeeding year, and,
in many instances, the treatment that once re-
lieved was of no avail in succeeding attacks.
These are not absolute cures, they are only a
partial or temporary cure. An absolute cure
can only be effected by a removal of the prime
cause — chronic nasal disease — which prevents
the susceptibility to the action of pollen and
other irritants, and consequently a recurrence
of attacks. The treatment is necessarily a
varied one, and depends upon the individuality
of each case. It is sometimes of service to use
locally the same remedy that is administered
internally, but generally in a more crude form.
This local remedy is used by inhalation, by hot
or cold sprays, but generally should be apphed
directly to the diseased tissues. It is hardly
necessary to specify the local treatment other
than in a general way. When a polypus is the
cause — as it has been found to be in a few in-
stances — a removal by instruments, electricity,
cauterization either by the galvano-cautery or
acids, or, as has been accomplished in some in-
stances,' by internal medication in connection
with a low dilution or trituration of the same
medicine administered locally. This has been
accomplished by the use of Thuya, Sang, can.,
Teucrium and a few other medicines in cases of
polypus of various parts.
In the Louisville Medical News, Aug. 22, 1885,
page 115, Dr. W. Cheatam, says: " Some few
may be relieved by curing an existing nasal ca-
tarrh."
Among the pathological changes, simple
chronic rhinitis is the condition most common-
ly met with when examining a patient during
the intervals between the attacks, when aU out-
ward manifestations of the disease have disap-
peared.
Those who have once suffered from chronic
rhinitis generally enjoy immunity from common
catarrh. For a removal of chronic rhinitis it
is essential to begin treatment as soon as de-
tected. Prominent among the indicated reme-
dies for this condition are Sang, can.. Bang, nit.,
Mat, 1H8B.1
ORIGINAL ARTICLES.
133
Kali hyd., Kali bich., Cinnabaris, Siuapis nig.,
and some of the mercurial preparations, especially
Merc. prot.
A Vaseline spray, both during the attacks of
hay fever and during the interim of them, is
both soothing and beneficial. It may be neces-
sary during the attacks to use other adjuvants :
i. f., spraying with a weak aqueous solution of
Boracic acid, puncture of the swollen portions
of the membrane with a narrow knife blade,
Cocaine, the galvano-cautery, or, in some in-
stances, acids. In using the knife, galvano-
cantery or acids, we must not be unmindful that
these mechanical and operative measures must
be used with a considerable degree of caution,
as extensive tracts of cicatricial tissue may be-
come the seat of more serious disease than hay
fever. In the Journal of tlie American Medical
As9ociationy Feb. 6, 1886, Dr. S. S. Bishop says :
**The new surgical treatment of hay fever,
which consists of cauterizing the sensitive areas,
is too recent to have afforded permanent results.
Not wishing to prejudice against the operation
those to whom it might prove beneficial, I will-
ingly part company with this phase of the sub-
ject. But I cannot do so with fidelity to the
profession and to this class of patients without
warning them of possible consequences. This
treatment may precipitate paroxysms of verita-
ble asthma. In fact, two applications of the
galvano-cautery, under Cocaine anaBsthesia, have
superinduced true asthma without curing the
hay fever."
With the chronic rhinitis there may exist a
tendency to frequent or permanent turgescence,
hypersesthesia, fluctionary or permanent hj'^per-
trophy, adenoid vegetations, tumors, a deviated
or thickened septum, stenosis, anatomical pecul-
iarities, either congenital or acquired, or other
organic changes. It is useless to attempt a re-
moval of true or permanent hypertrophy by in-
ternal medication. It may aid in some instances,
but the main reliance should be upon the cold
wire or Jar\ds snare, the galvano-caustic snare,
galvano-cautery, or caustic acids, i. e,, Chromic,
Glacial-acetic and Nitric. It is in this hyper-
trophic condition that we are more especially
justified in the use of the galvano-cautery, gal-
vano-caustic snare and caustic acids, but even
then the patient should be under close surveil-
lance that we may be sure of the reduction of
the redundant tissue, and to correct any com-
plication that might ai'ise from the cautious use
of the above measures. Following these opera-
tive procedures, it is generally advisable to use
the Vaseline spray. Nitrous-oxide gas is a con-
venient ansesthetic in using the galvano-cautery.
Chronic hypertrophic nasal catarrh, and hyper-
trophic rhinitis are frequent causes of asthma
and hay asthma. This can be demonstrated by
their removal, when there will be no recurrence
of the asthma.
Adenoid vegetations or adenomata at the
vault of the pharynx can be removed by the
properly selected homoeopathic remedies in con-
junction with proper cleanliness and attention to
diet and hygiene. Where this condition is ex-
tensive, it is essential to resort to operative
measures similar to those in the removal of hy-
pertrophy. The attendant catarrhal condition
should receive prompt attention and constitu-
tional treatment be given with the object of pre-
venting a recurrence of the growths.
The Hydrochlorate of Cocaine is a valuable
adjunct in the treatment of hay fever. A four
per ceftit solution is the strength commonly
used, but it may be used of a varying strength.
It will not cure, but it palliates and temporarily
checks the ravages of the disease by the local
insensibility it produces, and partly by the con-
traction of the capillaries it induces, lessening
the hyperflemia and rendering the mucous mem-
brane temporarily insensible to the action of
pollen and other irritants. It will arrest the
bronchial catarrh and asthma accompanying this
disorder. If used in the early stages, the sneez-
ing stage or in mild cases, where the main or
only feature is sneezing, it checks the disease
temporarily, enables hay fever refugees to re-
main at home and lessens the tendency to com-
plications. Its continued use, whenever any
irritation has been set up, has given many per-
sons almost entire relief from the annoying and
distressing conditions attendant upon the dis-
ease. As a palliative it acts like magic, and for
prompt but transient relief, no other local agent
equals it. Dr. DaCosta has found it useful in
a number of cases. It should be applied be-
fore using the galvano-cautery and other opera-
tive measures. It is used from one to three
times per day, and in extreme cases oftener, but
generally one application a day suflSces. The in-
troduction of Cocaine tablets within the nasal
cavities once or twice a day, is a convenient
mode of using it. Some patients are highly
susceptible to its influence and cannot tolerate
its use, at least only at long inter^^als. Serious
results have attended its use, especially when
used so often that the absorption of a large
quantity has produced physiological and even tox-
ical effects. The manner of using it is by means
of absorbent cotton and cotton-holder on a cam-
134
THE MEDICAL ERA.
[Vol. VI. No. 5.
ers-hair brush ; or a small atomizer, spraying
the entire nasal cavity ; or, by injection of a few
drops into each nostril ; or, by having the patient
in a recumbent position and using a common
dropper, having the patient spit it out should
any get in the mouth or throat. Care should
be taken to have the parts first cleared of mu-
cus, which enables us to get a quicker action
of the drug. It has both a primary and sec-
ondary action. By its primary action we have
ansBsthesia and anaemia, causing total but tran-
sient insensibility and a paleness of the mem-
brane, with some retraction. The secondary
effects are swelling and hypersesthesia of the
parts, even to a greater degree than before its
use, even to the complete closure of the nasal
cavities for hours.
In one case that came under my observation,
a gentleman who was a confinned hay-fever suf-
ferer, whose attacks soon developed into a severe
asthma, kept himself entirely relieved from the
annoying symptoms and asthma by one applica-
tion daily of the Cocaine, or whenever any irri-
tation had been set upon in the nasal cavities.
In giving therapeutic indications it will be
my aim to class the medicines in the order of
their prominence as observed by myself, and by
others that seem to have a true conception of
the therapeutic treatment, and to include there-
after reported cures made by the remedy.
V.
STSTEKATIO OHEICIGAL EZAKINATION OF
XJBINE FOB CLINICAL PUBPOSES.
By CLIFFORD MITCHELL, A.B., M.D.
CBICAGO.
E. Sediment.
Proceed now with the examination of the
sediment; go back to the first portion of the
urine which has been standing so that the sedi-
ment, if any, may settle. Pour off the super-
natant urine very carefully down the side of a
glass rod ; when nearly all the urine has been
poured off from the sediment cease pouring;
save the urine that has been poured off and let
it settle again for microscopic examination.
No. 2. Divide the sediment, if abundant, into
two portions, reserving one portion for microscop-
ical examination, No. 1. [If the sediment is
not abundant proceed at once to the microscop-
ical examination!.
N. B. It is sometimes necessary, especially
when a uric acid sediment is to be looked for, to
collect the urine of separate micturitions, let
settle and observe carefully in how many hours
or minutes the sediment is perceptible.
L. Chemical Examination of the Sediment.
(a) Warm a little of the sediment in a test-
tube, taking care not to boil ; pass the tube to
and fro in the flame of the alcohol lamp ; if the
sediment clears noticeably (shown by comparison
with sediment in another tube not heated) vxnU»
are present. If not, they are not present in
great amoimt.
(hj Look closely at the original sediment in
the glass to see if there are any hroinx specks in
it: look especially in the comers and on the
bottom of the glass, holding it and looking from
below; if such specks, looking like red pepper
grains, are seen, uric acid is present. [I have
known dozens who were unable to see this sedi-
ment with the naked eye even when it was very
abundant].
fcj If the sediment is reddish in color, or
dark, test for blood : take equal parts of spirits
of turpentine and tincture of guaiac, shake well
and cause an equal volume of sediment to flow
down the side of the tube into the mixture ; a
blue coloration at the juncture indicates pres-
ence of blood. [If blood is present, the phos-
phates in urine when precipitated by caustic
potash and gentle heat will appear Uood-rtd in
color]. The test should be made on freshly
voided urine if possible and if unsuccessful the
microscope should by all means be used ; it is in
general, moreover, advisable to use the micro-
scope in order to make the differential diagnosis
between hematuria and hemoglobinuria.
fdj Take a fresh sample of the sediment,
add four or five drops of acetic acid to it, shake
well and compare with the same bulk of sedi-
ment to which just as much distilled water has
been added as was acetic acid. If the sediment
is noticeably cleared by the acetic acid, earthy
phospluites are present. Take a fresh amount of
the sediment to which nothing has been added,
and dip into it a piece of red litmus-paper ; it
should be turned blue if the sediment is in any
abundance. Allow the paper to dry, and if the
blue color persist, calcium phosphate is probably
the chief constituent of the sediment, the urine
being alkaline, from fixed alkali as it is called.
If the blue color disappear when the paper
dries, triple (ammonio-magnesian) phospliate is
the one. (In all cases the microscope should be
used to confirm results.)
2. If the sediment is not wholly urates nor
phosphates, nor both, but there is evidently
something else present, pour some more of it
Hat. 1888.]
ORIGINAL ARTICLES.
135
into a test-tube and add a few drops of liquor
potasBse. If the sediment be originally of a
whitish color, and on addition of the caustic
potash become greenish and glassy, first stringy,
then thicker, till it forms a lump, pus is present.
The stringiness may be perceived by pouring the
mixture from one tube to another, or by trying
to remove by means of the pipette. If the sedi-
ment is dissolved by the caustic alkali, but has
not been by heat, mucus is tlie constituent.
(tJric acid is soluble in liquor potassse but is
not light colored.]
The above directions apply to testing well-
marked and characteristic sediments examined
within a few hours after the urine has been
voided, and before any changes have taken
place. In other words, before the urine becomes
stale. In many cases chemical identification of
a sediment is not easy, and recourse to the mi-
croscope must be had. Note, however, the
following : —
Practical Hints.
1. The urine on standing deposits some little
sediment, but remains generally tlirbid, the tur-
bidity not settling, not even if the urine stand
for days ; the sediment removed by the pipette
does not respond to tests 1 - 2 ; bacteria are present
and the sediment needs use of the microscope for
recognition. [Such urine if tested for albumin
needs magnesian fluid and warming before fil-
tration, otherwise it will not filter clear.] Held
up to the light in a test-tube the urine will be
seen, especially when shaded with the hand, to
become traversed with fine, silky, interlacing
waves.
2. No sediment is noticeable at the end of
a few hours, but a very slight one after twelve
to twenty hours, the urine not being alkaline.
Examine with microscope for calcium oxalate.
[If enough of the sediment can be collected, and
no albumin is present, divide into two parts, add
acetic acid to one and nitric to the other. If
acetic acid have no effect but nitric acid dissolve,
it is possibly calcium oxalate. Verification by
means of microscope not only desirable, but ab-
solutely necessary, as certain forms only of the
oxalate are of of clinical significance.] Keep the
sediment in a cool place, or in a well-stopped
bottle. Urine containing calcium oxalate sedi-
ment will often deposit it on the sides of the
glass, forming numerous fine lines running in
bands. It is often the case that the sediment is
either caught in the mucus cloud, or according
to Tyson the whole of the cloud-like mass so
much resembling mucus is made up of the oxa-
late of lime [proper chemical term, calcium oxa-
late]. When it has settled there will often be
noticed two parts to the sediment : — a soft,
grayish layer on the bottom, and, over this a
whiter, denser layer with a wavy, but well
marked surface.
3. The sediment is abundant enough for
chemical tests and settles within a few hours.
It clears partly with heat, but does not respond
to any other tests.. In this case, after warming,
add liquor potassse, and if it clears noticeably
urates and uric acid both may be present. Verify
with the microscope.
4. If the sediment clear wlwUy on application
of heat, so as to be as clear as the urine itself,
decanted or filtered from the sediment, it is com-
posed of urates and no further chemical tests
need be made.
5. If the sediment with heat has not cleared,
or only partly cleared, and moreover on addition
of acetic acid has cleared only in part, and
farther if it respond to no other of the tests thus
far given, recourse should certainly be had to the
microscope.
6. If the test for pus given in [2] be not suc-
cessful, pus is not necessarily absent. This
test is of value only [a] when the urine is acid
in reaction, and [b] when also the amount of
pus is considerable. When the amount of pus
is inconsiderable even though the urine be acid
in reaction, the test as applied as in [2] will not
give a cohesive lump, but the sediment disap-
pears, and the fluid becomes vitreous and Stringy.
Use as much sediment and as little supernatant
urine as possible.
The chemical test in such case not being
marked in results, many prefer Day's test ; pour
a little tincture of guaiac not freshly made into a
test-tube and let some of the sediment trickle
down into it. If a blue color appear, in course
of a few minutes, pus is present. This test,
however, should be confirmed if possible by mi-
croscopic identification of pus corpuscles.
7. The test for pus given in [2] fails in al-
kaline urine : pus is not necessarily absent ; if •
urine is turbid when freshly voided, clears con*
siderably on standing, and the sediment is
greenish, stringy, tenacious and clings to the
side of the glass, the ropy strings being soluble
in acid, it is pus. Mucus does not form a
similar cohering mass. For verification, test the
urine itself as follows : — fill a test-tube half full
with the urine to be tested, and heat gradually
the upper part of the column of the fluid to
boiling. An increase of the opacity in tlie
portion so heated as compared with the lower
portion not boiled [seen against dark back-
136
THE MEDICAL ERA.
(Vol. VI. No. 5.
grouncr indicates presence of pfis, if this increased
opacity remains after addition of one or two
drops of acetic acid. [Ultzmann.]
8. The sediment does not respond to the
various tests, hut it has heen noticed that the
urin« filters very slowl}': miu^m is present and
the sediment will hecome a thin liquid with
flakes on addition of liquor potassse. If pus is
present at the same time, this test will not be
successful. In this case take a solution of
iodine dissolved in potassium iodide, and add a
little of this to acetic acid, pour the mixture
into the urine and a turbidity will form due to
presence of mucus. This test distinguishes
mucus from pus. Filter urine containing much
mucus and allow the filter to dry, and it' will ap-
pear as if coated with glistening varnish.
9. The urine is albuminous and of acid re-
action : —
The sediment may be very slow in settling ;
do not wait for it to settle, but shake well in a
test-tube, boil and filter. If the filtered urine on
cooling throws down a sediment which in turn
clears on application of heat, the sediment is
urates, at least in part. That which did not dis-
solve on boiling the urine should then be ex-
amined with the microscope. Most albuminous
urines should, however, be examined as to their
sediment with the microscope before the urine
has decomposed, and at any rate before any
chemical operations have been performed on the
entire sediment.
CHINA IN MALIGNANT DISEASES. —
PULSATILLA AND HAMAMELIS
IN EPIDIDYMITIS.
By dr. p. JOUSSET.
PARIS.
[Clloiqne of the IIoBpltal Saint-Jacque. Translated from
VArt Medicaid by H. P. Holmes, M.D., Sycamore, 111.]
IN this clinic I shall speak of the action of
China in malignancy. The pernicious inter-
mittent, whether it exists alone or whether it
occurs as a complication in another disease, is
controlled almost at once by tlie Sulphate of
quinine. It is not the same in the malignant
form, that sort of overthrow of all the symp-
toms in the disease. That malignancy almost
always finds us unprepared. The antithermics
cannot act against that condition. Cold water,
administered, not according to Brand's method,
but according to Curie and llecamier, may be of
8er\'ice. It will not cure the patient, but it will
save time.
Among the remedies there is one, China,
which deserves all our confidence, and it enjoyed
among the old physicians a justly merited repu-
tation. When liroussais arrived, he said that it
was an incendiary remedy, which would only ag-
gravate the fever. China thus fell into desuetude :
to-day it has returned to its place, thanks to
homoeopathy.
We are much inclined to confound China
with Sulphate of quinine ; the antiperiodic action
makes us forget the other symptoms of this
remedy. W^e will recall here only those which
relate to the malignancy with which we are
occupied, they are: Hippocratic face, nose
wasted, eyes cavernous with pale circles around
them, cadaveric, complete indiflference, syncope
with loss of consciousness, then loss of vision ;
lips and finger nails livid, loss of voice and loss
of speech, tongue retracted toward the base,
considerable dyspncea, during sleep one eye is
open and the other- only parti}' closed, with the
eyeballs turned upwards as in death.
This ensemhU of symptoms, so easy to re-
member, indicates China. But remember that
there are conditions so grave that nothing \\ill
do any good ; not even the remedies which ap-
pear to be the best indicated. I should add
that in the homoeopathic school, China has
hardly ever been employed in these grave cases ;
they prefer giving Lachesis or Carbo vegetabiUs.
How^ever, there are some cases of mahgnant
erysipelas where China acts admirably and I
think that it is a reason for trying it in these
malignant cases. It was from reading one of
Jaccoud's clhiics that I was led to employ .China
in erysipelas. That physician declared that he
had treated a considerable number of cases of
erysipelas, more than a hundred, many of which
were excessively grave, with only two deaths,
and that by making the patients take a spoon-
ful of the wine of Quinquinia every hour. I
treated at that time a lady attacked with erysip-
elas following suppurative peha-peritonitis.
The condition of that patient was very grave,
and gave me considerable anxiety. I employed
the wine of Quinquinia and conformed exactly to
the indications given by Jaccoud, and I declare
that to my great surprise the patient was rapidly
relieved and recovered. I was convinced of the
real value of that remedy; it was an experi-
mental fact. It is not necessary to say that I
do not accept the explanation given by Jaccoud,
who pretends to control in a similar manner the
cerebral amemia due to grave erysipelas. I
have searched for the true cause, like a true dis-
ciple of Hahnemann, and I have foimd that
China acted here after the law of similars. I
invent nothing; the old authors have already
Mat, 1888.1
ORIGINAL ARTICLES.
137
recognized that China may produce eczema and
erysipelas. M. Jeudi of Crissac has collected in
his thesis a large number of documents relative
to the eruptions produced by Quinquinia and
Sulphate of quinine. It is principally in the
more or less generalized acute eczema and in
erysipelas that the eruptions produced by this
remedy are reported. Sometimes these erj'sip-
elatous eruptions have been accompanied by an
intense febnle movement and very grave general
symptoms.
We have yet the malignant condition previ-
ously described; finally the characteristic of
Quinquinia is the intermittence in the fever, and
the relation thus to the intermittent action of
erysipelas which proceeds by attacks, with inter-
vals of remittence. You see many of the theo-
retical explanations pale before the law of simi-
lars. We enter here into the positive therapeut-
ics ; China cures erysipelas because it produces
symptoms similar to that disease : dmUi/i sintUi'
has curantur. Whatever that may be, it is a fact
clinically confirmed — China cures erysipelas.
But how should it be used? I have not
thought it best to use the wine of Quinquinia
because it was a preparation not properly dosed>
and which may be unreliable : we should in all
cases and especially in these grave cases know
what we are giving. I have in place of the wine
substituted the alcoholic tincture of Quinquinia,
a uniform preparation and exactly graduated,
and I give this remedy in a dose from two to
five grammes to be taken during the twenty-four
hours.
It will be in order for me to speak of two
patients that we have had in our care, two cases
of surgical erysipelas. You know that erysip-
elas is very much dreaded in the surgical
departments, and causes a great mortality in
the hospital. We have had the pleasure of see-
ing our two patients recover.
The first patient was a young man of 33 years,
a man of letters, who came to the hospital on
account of an inguinal adenitis of the left side.
Our skillful surgeon, M. le Dr. Piedvache, made
a double incision and passed two drainage tubes,
the 16th of November. The patient appeared
to be doing well, when the night of the 24th of
November he was taken with chills and vomit-
ings, and on the morning of the 25th presented a
temperature of 104"^ ; at the same time a slight
redness appeared at the upper part of the thigh.
He was given China in the mother-tincture, five
grammes, and the evening temperature was
down to 102.2''. For two days the temperature
oscUlated between 101.3'' and 102.2^; the fourth
day the temperature had returned to 104°. The
next morning, the temperature being at 99.6°,
there was added to the tincture of China a little
of the Sulphate of quinine, 7^ grains. After
some oscillations in the neighborhood of 100.4"^,
the temperature again returned to 104° the even-
ing of the 8th and 9th days ; (the 2nd and 3rd
of December.) I then prescribed Sulphate of
quinine 75 c. g., and China, mother- tincture,
five grammes. Starting from that time the tem-
perature fell to 99.5° the eleventh day, and the
twelfth day it had fallen below 98.6° to remain
there. The patient was convalescent and left
the hospital entirely cured on the 21st of De-
cember.
This patient presented an excessively grave
general condition, and I was not at all certain
of the termination of the disease. Extreme
weakness, profuse sweats, considerable emaci-
ation and at one time there was diarrhoea ; how-
ever, the erysipelas was arrested above the knee,
after having occupied the left side of the abdo-
men, the groin and the thigh. I think I may
say that China has had a happy influence on
the definite result and has had much to do with
the cure.
The second patient was an old cachectic who
had an old suppuration of the thigh ; he entered
the hospital for an operation for an epithelioma
of the lower lip. M. le Dr. Piedvache thought
that he should open the thigh and produce
drainage before doing anything else, because the
leg was becoming phlegmonous. The wound
was opened, cleansed and drained the 16th of
December; during the night of the 23rd there
were chills and vomitings and the next day
the morning temperature was 104.9°. I pre-
scribed Aconite, mother-tincture, 5 grammes.
The temperature descended to 99.5° the second
day, but returned the third day to 104°. I then
gave the whole of a gramme of Sulphate of qui-
nine and continued China. The fever gradually
diminished and reached 99.1° the evening of the
eighth day. The next day there was another
chill and the temperature went up to 102.2° ;
Sulphate of quinine one gramme during the two
days, and then one-half gramme during the next
two days, and the temperature fell suddenly from
102.5° to 98.6° the thirteenth day. From that
time it has not gone above 99.5°.
I have brought up these two cases to show
you what China can do in grave conditions. I
have thought best in these two cases to associate
Sulphate of quinine on account of the pernicious
intermittent condition ; but China remained the
remedy for the malignancy in the continuous
138
THE MEDICAL ERA.
[Vol. VI. Na 8.
form. En resume , the antithermic medication is
only a form of therapeutics which does not affect
the disease itself. We should not accept that
kind of treatment exclusively; it is an excep-
tional form of treatment, and should only be
used in a very limited number of cases, and then
only for saving time, as I said in speaking of the
lotions and cold aflfusions.
I hope that the homoeopathic physicians \vill
not allow themselves to be carried away by the
brilliancy of that kind of therapeutics. It is so
nice to see a temperature fall from 104'' to
lOO.S'^ by a cold bath or a phenic lavement, that
one is tempted to slide into that easy way of
doing. It does not cure the patient very often,
according to the showing of the most recent
observations. Give up that etiological thera-
peutics. Sulphate of quinine, Phenic acid, etc.,
antithermic and antiparasitic; it is only a
hypothetical method, which may be full of de-
ceptions. Homoeopathists, you have a law and
a guide ; do not leave the right road of positive
therapeutics.
Apropos of a patient who went out some days
ago, I will say a word of blennorrhagic epididy-
mitis. This was a young man of 28 years who,
having a blennorrhagia for the past four months,
was taken with a pain in the right testicle a
fortnight before his entrance into our wards.
He had been treated with frictions of Belladonna
ointment. Iodide of potash, etc., which had not
prevented the development of the epididymitis.
On his entrance, the 18th of December, I pre-
scribed Pulsatilla, mother-tincture, three drops,
then five drops. The 22nd of December, the
swelling had diminished and the pain had
nearly disappeared. The 24th, without any ap-
preciable cause, the testicle became indurated
and painful; I then gave Hamamelis and it
produced a rapid amelioration. The patient,
obliged to return to his work, w^ent out on the
4th of January with a slight induration, a con-
dition which frequently remjiins for quite a long
time.
It was Ricord who gave to that disease the
name of epididymitis ; before that time it was
called orchitis. If the old denomination was
frequently incorrect, the new, it appears to me,
is a little too exclusive ; because, if we do most
frequently have only to diagnose an epididymitis,
which it is true, is in the great majority of
cases, there are sometimes also cases of orchitis.
Whatever that may be, inflammation of the
testicle is a very frequent accident, in the course
of a blennorrhagia. According to Foumier, it
happens once in eight or nine times, and the left
testicle is more frequently attacked than the
right in the proportion of 890 against 534.
Epididymitis is an affection of which numer-
ous explanations have been given. It hardly
ever develops at the commencement of the
blennorrhagia; but principally from the third
to the eighth week. It sometimes attacks those
who have been the most particular in their pre-
cautions, and, on the contrary, it never attacks
certain others, who, in the course of their blen-
norrhagia indulged in all sorts of excesses. There
are then some things in its pathogeny which
are unknown. There are certain individuals
who are certainly predisposed to it, because they
cannot contract a blennorrhagia without its
being followed by an orchitis.
It has also been said that it was caused by
the hot urine settling into the pockets ( sinus poc-
ularis, H ). Valpeau advanced the theory which
has been most generally accepted : the propa-
gation of the inflammation from the urethral
canal to the ejaculatory ducts, from there to the
vas deferens, and, finally, to the epididymis,
where it is retained by a number of folds which
rarely permit it to attack the testicle. But, let
me repeat it for being more exact, if, sometimes
the vas deferens is inflamed, swollen and indu-
rated, and if the propagation in this case
appears evident, there are also cases in which
the vas deferens has absolutely nothing to do
with it. May we not, then, compare orchitis to
those cases of adenitis occasioned bv distant
irritation without the intermediate lymphatics
being inflamed ? The epididymis is attacked be-
cause it is in the line of election of the disease,
the same as the synovial sheaths and the articu-
lations.
There is still another explanation given : that
the affection should be caused by a special mi-
crobe, the gonococcus, which finds an excellent
culture fluid in the epididymis. But if this is
the case, what is the benefit from wearing a sus-
pensory bandage? That cannot in any way
prevent the gonococci from multiplying. At
Lyon, in the Antiquaille, they have cured or-
chitis with a well made suspensory bandage.
The duration of orchitis is from fifteen to
twenty days for the acute period, and several
weeks for the chronic period. Our patient has
left us at the end of twenty days, with a Uttle
induration.
The induration is produced by the obUteration
of the vesicula3 seminales, by the inflammatory
products, granular bodies, leucocytes, fat gran-
ules and even by pus globules. These inflam-
matory deposits are absorbed but slowly, and
Mat, 188BL]
SELECTIONS.
139
there results, in persons attacked with a double
orchitis, a sterility which may be transitory or
definite. I say sterility and not impuissanee ; I
have seen in my experience many individuals
who were perfectly puissant up to that time, but
they had become sterile. It frequently happens
that even when the canals are again permeable
no spermatozoids are formed. Another feature :
m case where a single testicle is attacked, the
other becomes much less fertile. It does not
take on compensatory aQJkion, as happens in the
kidneys, because there, if one organ cann6t fulfill
its functions, the other secretes more actively
and suffices for secreting the urine.
The opposite school have numerous means of
treatment ; leeches, emollients, ice, compression,
hydrocele puncture, freeing the tunica albuginea,
Horrand's suspensory, which allows the patient
to be up and about his work, Langlebert's sus-
pensory, etc. We are not so rich ; for twenty-
five or thirty years we have used Pulsatilla.
This remedy has recently been borrowed from us
by a physician in Saint Malo who has thought
he has made a discovery in pointing out the al-
most marvelous effects of Pulsatilla in orchitis.
There is still another remedy, Hamamelis, which
appears to give good results, but it needs to be
experimented with that its indications may be
clearly fixed. It fails us sometimes. What
then are the characteristics which indicate Pul-
satilla, or when is Hamamelis better indicated ?
When I find a patient who suffers a great deal,
and to whom Pulsatilla has not brought much
relief, I then give Hamamelis, which has acted
very well. Is pain the symptom which indicates
it? Its clinical experience is not yet deter-
mined.
SELECTIONS.
Ptomaines in PhthiBis.
Dr. Philip, of Edinburg, has recently made a
very interesting investigation. He found that
by taking the sputum of a phthisical' subject,
protecting it with great care from contamination
by external agents, and maintaining it for a
short time at the temperature of the body, that
an alkaloid was obtainable by Stas* process,
which was evidently an alkaloid, a ptomaine.
This substance was also detected in the cavities
of phthisical lungs. When this substance was
injected into mammals it produced fever and
progressive emaciation, which proceeded to a
fatal termination, even where the injections were
discontinued. In frogs the same results were
obtained, except that recovery sometimes fol-
lowed.
A Case of Nephrorrapliy for Fixation of a Floating
Kidney.
Bt DeWITT O. WILCOX, M.D.,
OP BUFFALO.
The condition known as floating or movable
kidney is one not infrequently met with. This
organ being held into position by a very consid-
erable layer of loose areolar tissue and having a
movement of its own varying from one-half to
one inch, it is not so surprising that during a
very severe strain or from some outside influ-
ences, it should be torn from its moorings to
such an extent as to be distinctly outlined im-
mediately beneath the abdominal wall. Pa-
tients with such a condition of this gland may
go for years without any apparent distress or in-
convenience, and without any abnormal urinary
symptoms. More frequently, however, the dis-
placed gland is the seat of frequent neuralgic
pains, and produces a dragging feeling when the
patient is wearied.
The operation known as nephrorraphy, con-
sisting of cutting down upon and exposing the
kidney and then stitching it to the edges of the
wound is comparatively recent. Hahn, of Ger-
many, has the credit of first successfully per-
forming it. Other surgeons have followed in the
line — Dunning, Ceccherelli, Weir, Agnew, Es-
march, Gardner, Newman, Stevenson and Jusie
all report successful cases. The following case
came under my own observation in June, 1887.
Sarah W., aet. 24. About nine years ago,
wliile lifting heavily, felt something **give way
in her back." A few weeks after she detected a
distinct tumor in the abdomen a little to the
right and on a level with the umbilicus. She
suffered but little pain, but was worried over its
presence. She consulted a number of physicians
in England where she was then living, but gained
no satisfactory information regarding her trouble.
As time went on she began having pains in
the "tumor" and a heavy, dragging sensation.
There were no urinary symptoms; in fact, the
foregoing history was about all the subjective
symptoms that could l:e elicited.
Upon examination the "tumor" was found to
be somewhat larger than an oidinaiy sized kid-
ney, was quite freely moved and could be crowded
up to the under edge of the liver or pushed down
to the iliac region and even on to the left side ;
it was somewhat painful if squeezed. It was
with some diflficulty forced back into its noimal
position. The diagnosis of floating kidney was
rendered.
140
THE MEDICAL ERA.
IVoL. VI.No.5.
Dr. J. T. Cook saw the case soon after and
upon a thorough examination came to the same
conclusion.
An operation for fixation of the displaced
kidney having been determined on, the patient
was anaesthetized and turned well on her sound
side. The skin was shaved and scrubbed with
bichloride solution. A free incision was then
made midway between the last rib and the crest
of the ilium, extending from the anterior edge
of the quadratus lumborum forward for about
four inches. After controlling all hemorrhage,
the incision was continued through the entire
wall, the hand inserted and the kidney grasped
and brought out to the lips of the wound. Here
it was held with some difficulty, as so long a
time had elapsed since it had been in its natural
place, that it required some stretching of the
tunica adiposa to retain it. After bringing it to
the opening, examining its surface and demon-
strating its blood vessels, there was left no doubt
as to its being a kidney. A heavy catgut suture
was passed through the perirenal fat and each
lip of the incision; this was repeated three
times, till the gland was securely anchored to
the wound.
The remaining portion of the incision was
loosely drawn together and allowed to heal by
granulation. ^It was dressed with the usual an-
tiseptic precautions, and the patient put to bed.
She made an excellent recovery, the tempera-
ture at no time going above 101 l-S"" F. She
is now able to walk quite a distance and do or-
dinary light work.
The gland has kept its position and there is
no pain or dragging, neither have there been
any untoward urinary symptoms.
From all the reports on record which I have
been able to gather, the operation seems to have
been successfully performed a sufficient number
of times to establish it as a justifiable and prac-
tical operation. Yet, according to Eansohotf , but
twenty-two such operations are on record. — An-
nals of Surgery.
Beveragres for Hot Days.
Lemonade, Bussian Tea, Soda Milk, Badminton,
Claret Cup with. Soda-Water.
The feverish thirst of summer days is almost
unquenchable when the liquid we take to relieve
it is unaccompanied by nourishment, for exam-
ple — a cup of tea and a very little bread and
butter or cracker will do more to allay thirst
than three or four cups without. For this rea-
son the egg lemonade that will be such an
attraction at the Chicago soda fountains this
summer is one of the best beverages ever intro-
duced, as well as the most delicious. Many de-
clare that it is not so good when home made and
they are generally right ; this is the reason : The
powerful pressure brought to bear on the lemon
while in the squeezing machine forces out the
oil from the peel as well as the juice, and this is
not done by the ordinary hand-squeezer. The
juice of lemon has little fragrance ; it is the oil
that imparts the delicious flavor to it. Make the
drink in the following way and it will quite equal
that made by professionals :
For egg lemonade, break an egg into a tum-
bler, rub two lumps of sugar on the rind of a
fine lemon, put the sugar into the tumbler,
squeeze the lemon into it with a squeezer, and
half fill the tumbler with ice broken small, fill up
with water, and, with a shaker, shake the whole
vigorously a few seconds, then grate a little
nutmeg over the top.
Simple lemonade is greatly improved by rub-
bing the peel with sugar. WTien made for pa-
tients recovering from fever a far more grateful
drink than strong lemonade is made by using
one lemon to a quart of water, with one lump
of sugar rubbed on the peel, sweeten very Uttle.
This, given in teaspoonfuls, when the mouth
and tongue are parched, is inexpressibly refresh-
ing.
Cold-water tea, or Bussian tea, is usually made
by steeping tea in boiling water in the usual way
and setting it on ice. This gives the astringency
that is pleasant when hot with cream, but to
many tastes very unpleasant when cold. The
better way to make it is easier in hot weather,
and so made iced tea is a positive luxury. Four
hours before you require the tea for use (or over
night, if you choose) put four teaspoonfuls of
tea into a pitcher, pour on it a quart of cold
water, cover, and set it in the ice-box. It does
not sound as if good tea could be made with cold
water, but this is the perfection of cold tea, fra-
grant without the least bitterness and of a beau-
tiful amber clearness. Sweeten as any other
tea. With a little lemon juice and a slice of
lemon floating in each glass this makes the fash-
ionable ** Russian tea.'*
One may long for a glass of soda or be de-
lighted to oflFer it to his heated and weary friends,
but it is quite too much to go to the druggist for
it with the sun high and the thermometer in the
nineties. And yet nothing is more possible or
less expensive than to have the thing always at
hand. In Paris when siphons were first introduced
iced ** siphon water " was the thing to have in the
house. I often wonder that so little use is made
Mat. I88S.]
SELECTIONS.
141
o\ them in this soda-water-loving country except
under a doctor's direction. Half a dozen Hipbons
of plain soda cost 90 cents, perhaps less in large
cities, and if you are known to your druggist you
will not be charged for the loan of the siphons.
Keep them on ice and you have your soda-water
ready. Make and keep bottled a few simple
sirups — vanilla sinip, coflFee sirup, ginger sirup
—and you can have flavored soda at a moment's
notice. In fruit season half fill the glass with
fresh fruit sirup and sugar, fill up from the
siphon, and you have a drink for the gods.
Soda milk is an excellent and nourishing
drink in hot weather, and will remain on the
most delicate stomach when anything but kou-
miss would be rejected, and is simply soda from
the siphon and milk.
Claret cup with soda-water is excellent made
from California wine. Pour a bottle of claret
into a pitcher, and a sliced orange, leaving out
the first and last slice, and a strip of cucumber
peel as long as your finger ; sweeten with sirup,
add, if Uked, a wine-glass of Santa Cruz rum ;
set this in crushed ice, and just before drinking
strain and add the contents of a siphon of soda-
water, stir, and serve at once.
For Badminton, take a bottle of claret, sirup
to tast^, an orange sliced, and a strip of cucum-
ber. Strain after it is well chilled ; then add a
wineglass of curacoa and a siphon of soda — ice
cold, of course — and serve at once. Of all cups,
except champagne, perhaps cider is the best.
For cider cup, pour a quart of cider into a
pitcher, slice an orange into it or three slices of
lemon ; sirup or not, according as the cider is
Bweet or sour, add a glass of sherry and one
of brandy with a pint of crushed strawberries
if in season, otherwise a cup of chopped pine-
apple and a few drops of almond flavoring. If
champagne cider is used let it be iced. Let all
stand till chilled, then strain and add a siphon
of soda. The soda-water must always be used
the last thing, and when there is time to have
the "cup" cold enough without, do not add ice to
it, as if it stands it gets poor. Sweeten all cups
with sirup made thus : Pour boiling water (a
pint) on a pound of white sugar. When dis-
solved bottle for use. The use of sirup prevents
the last of the cup being too sweet.
The Care of lofanta.— Bules for the Managrenient
of InfantB During the Hot Season.
Rule 1. — Bathe the child once a day in tepid
water. If it is feeble, sponge it all over twice
a day with tepid water, or with tepid water and
vinegar. The health of a child depends much
upon its cleanliness.
liuje 2. — Avoid all tight bandaging. Make
the clothing light and cool and so loose that the
child may have free play for its limbs. At
night undress it, sponge it and put on a slip. In
the morning remove the slip, bath the child and
dress it in clean clothes. If this cannot be af-
forded, thoroughly air the day-clothing by hang-
ing it up during the night. Use clean diapers
and change them often. Never dry a soiled one
in the nursery or the sitting-room, and never
use one for a second time without first washing
it.
Rule 3. — The child should sleep by itself in a
cot or a cradle. It should be put to bed at reg-
lar hours, and be early taught to go to sleep
without being nursed in the arms. Without the
advice of a physician never give it any spirits,
cordials, carminatives, soothing sirups, or sleep-
ing-drops. Thousands of children die every
year from the use of these poisons. If the
child frets and does not sleep, it is either hun-
gry or else ill. If ill, it needs a physician.
Never quiet it by candy or cake ; they are com-
mon causes of diarrhoea and of other troubles.
Rule 4. — Give the child plenty of fresh air.
In the cool of the morning and evening send it
out to the shady sides of broad streets, to the
public squares, or to the park. Whenever it
seems to suffer from the heat let it drink freely
of ice water. Keep it out of the room in which
washing or cooking is going on. It is excessive
heat that destroys the lives of young infants.
Rule 5. — Keep your house sweet and clean,
cool and well aired. In very hot weather let
the windows be open day and night. Do your
cooking in the yard, in a shed, in the garret, or
in an upper room. Whitewash the walls every
spring and see that the cellar is clean of all rub-
bish. Let no slops collect to poison the air.
Correct all foul smells by pouring carbolic acid
or quicklime into the sinks and privies. The
former article can be got from the nearest drug-
gist, who will give the needful directions for its
use. Make every effort yourself and urge your
neighbors to keep the gutters of your street or
of your court clean.
Rule 6. — Breast-milk is the only proper food
for infants. If the supply is ample and the
child thrives on it, no other kind of food should
be given while the hot weather lasts. If the
mother has not enough she must not wean the
child, but ftive it, besides the breast, goat*s or
cow's milk, as prepared under rule 8. Nurse
the child once in two or three hours during the
142
THE MEDICAL ERA.
(Vol. VI. No. 6.
\
day and as seldom as possible during the night.
Always remove the child from the breast as soon
as it has fallen asleep. Avoid giving the breast
when you are overfatigued or overheated.
Kule 7. — If, unfortunately, the child must be
brought up by hand, it should be fed on milk
diet alone — that is, warm milk out of a nursing-
bottle, as directed imder rule 8. Goat's milk is
the best, and next to it cow's milk. If the child
thrives on this diet, no other kind of food what-
ever should be given while the hot weather lasts.
x\t all seasons of the year, but especially in
summer, there is no safe substitute for milk if
the infant has not cut its front teeth. Sago, ar-
row root, potatoes, corn-flour, crackers, bread,
every patent food, and every article of diet con-
taining starch cannot, and must not, be de-
pended on as food for very young infants.
Creeping or walking children must not be al-
lowed to pick up unwholesome food.
Eule 8. — Each bottleful of milk should be
sweetened by a small lump of loaf-sugar or by
half a teaspoonful of crushed sugar. If the
milk is know^n to be pure it may have one-fourth
part of hot water added to it ; but, if it is not
known to be pure, no water need be added.
When the heat of the weather is great the milk
may be given quite cold. Be sure that the milk
is unskimmed ; have it as fresh as possible, and
brought very early in the morning. Before us-
ing the pans into which it is to be poured always
scald them with boiling suds. In very hot
weather boil the milk as soon as it comes, and
at once put away the vessels holding it in the
coolest part of the house — upon ice if it can be
aflForded, or down a well. Milk allowed to stand
in a warm room soon spoils and is unfit for food.
Rule 9. — If the milk should disagree, a table-
spoonful of lime-water may be added to each
bottleful. Whenever pure milk cannot be got
try the condensed milk, which often answers ad-
mirably. It is sold by all leading druggists and
grocers, and may be prepared by adding to six
tablespoonfuls of boiling water, without sugar,
one tablespoonful of the milk, according to the
age of the child. Should this disagree, a tea-
spoonful of arrowroot, of sago, or of com starch
to the pint of milk may be cautiously tried. If
milk in any shape cannot be digested, try, for a
few days, pure cream diluted with three-fourths
or four-fifths of water, returning to the milk as
soon as possible.
Rule 10. — The nursing-bottle must be kept
perfectly clean, otherwise the milk will turn sour
and the child will be ill. After each meal it
should be emptied, rinsed out, taken apart, and
the tube, cork, nipple and bottle placed in clean
water or in water to which a little soda has been
added. It is a good plan to have two nursing-
bottles, and to use them by turns.
Rule 11. — Do not wean the child just before
or during hot weather, nor, as a rule, until af-
ter its second summer. If sucking disagrees
with the mother, she must not wean the child,
but feed it in part out of a nursing-bottle on
such food as has been directed. However small
the supply of breast-milk, provided that it
agrees with the child, the mother should care-
fully keep it up against sickness ; it will often
save the life of the child when everjihing else
fails. When the child is over six months old
the mother may save her strength by giving it
one or two meals a day of stale bread and milk,
which should be pressed through a sieve and put
into a nursing-bottle. When from eight months
to one year old it may have also one meal a day
of the yelk of a fresh and rare-boiled egg, or
one of beef or mutton broth into which stale
bread has been crumbled. When older than
this it can have a little meat finely minced;
but, even then, milk should be its principal
food.
BRIEF RULES FOR GASES OF EMERGENCY.
Rule 1. — If the child is suddenly attacked
with vomiting, purging and prostration send for
a doctor at once. In the meantime put the
child for a few minutes in a hot bath, then care-
fully wipe it dry with a warm towel and wrap it
in warm blankets. If its hands and feet are
cold, bottles filled with hot water and wrapped
in flannels should be laid against them.
Rule 2. — A mush poultice, or one made of flax-
seed meal to which one-quarter part of mustard
flour has been added, or flannels wrung out of
hot vinegar and water, should be placed over the
belly.
Rule 3. — Five drops of brandy in a teaspoon-
ful of water may be given every ten or fifteen
minutes, but if the vomiting persists give this
brandy in equal parts of milk and lime-water.
Rule 4:. — If the diarrhoea has just begun, or
if it is caused by improper food, give a tea-
spoonful of a very weak solution of Champhor.
♦ Rule 5. — If the child has been fed partly on
the breast and partly on other food, the mother's
milk alone must now be used. If the child has
been weaned it should have pure milk with lime-
water or weak beef-tea or chicken-water.
Rule fi. — The child should be allowed to
drink cold water freely.
Mat, 1888}
SELECTIONS:
148
Rule 7. — The soiled diapers or the discharges
should be at once removed from the room, l)ut
saved for the physician to examine at his visit.
BECIPES FOR SPECIAL FORMS OF DIET.
For the convenience of mothers the following
recipes for special forms of diet are given :
Boiled Flour or Flour-Ball. — Take one quart
of good flour; tie it up in a pudding-bag so as
to make a firm, solid mass ; put it into a pot of
boiUng water early in the moniing, and let it
boil until bedtime. Then take it out and let it
drj'. In the morning peel oflf from the surface
and throw away the thin rind of dough, and
with a nutmeg grater grate down the hard, dry
mass into a powder. Of this from one to tliree
teaspoonfuls may be used, by first rubbing it
into a paste with a little milk, and finally by
bringing the whole to just the boiling point. It
mast be given through a nursing-bottle.
An excellent food for children who are costive
may be made by using bran meal or unbolted
flour instead of the white flour.
Rice-Water. — Wash four tablespoonfuls of
rice, put it in^o two quarts of water, which boil
down to one quart, and then add sugar and a
little nutmeg. This makes a pleasant drink.
A pint or half a pint of milk added to the
rice-water before it is taken from the fire gives
a nourishing food suitable for cases of diarrhoea.
Sago, tapioca, barley or cracked com can be
prepared in the same manner.
Beef-Tea. — Take on5 pound of juicy, lean
beef — say a piece from the shoulder or the
round — and mince it. Put it, with its juice,
into an eai-then vessel containing a pint of tepid
water, and let the whole stand for one hour.
Then slowly heat it to the boiling point, and let
it boil for three minutes. Strain the liquid
through a colander, and stir in a little salt. If
preferred, a little pepper or allspice may be
added.
Mutton-Tea may be prepared in the same
way. It makes an agreeable change when the
patient has become tired of beef-tea.
Raw Beef for Children. — Take half a pound
of juicy beef, free from any fat ; mince it vei-y
finely, then rub it into a smooth pulp, either in
a mortar or with an ordinary potato-masher,
and press it through a fine sieve. Spread a lit-
tle out upon a plate and sprinkle over it some
salt, or some sugar if the child prefers it. Give
it alone or spread upon a buttered slice of stale
bread. It makes an excellent food for children
with dysentery.
Outaneous Fhotogrraphy Made Easy.
In my own oflBce if diffused sunlight be used on
a bright day, an exposure of thirty to sixty sec-
onds has often been necessary ; but with the new
method equally good pictures may be taken in
the night or in a darkened room in the fraction
of a second. This is brought about by the use
of an artificial light produced by the instantan-
eous combustion of magnesium powder. This
gives a momentary flash of light of surprising
brilliance and amply sufficient for the purpose.
Magnesium by itself will not ignite or burn as
rapidly as when in contact with some more eas-
ily inflammable substance, and I find by experi-
ment that ordinary photographer's pyroxylin, or
gun-cotton, is admirably adapted to the purpose
in view.
The magnesium and cotton are arranged for
use in the following manner : A tuft of cotton
weighing about seven or eight grains is spread out
as a thin layer on any metallic surface, as a
stove-lid or tin plate. Ten or twelve grains of
magnesium powder is next sprinkled evenly over
the cotton.
The patient is then brought into position and
the focus obtained in the usual fiianner. If in the
day time, daylight may be used for focusing, but
if at night or in a darkened room, a candle or
lamp held near the patient vdll answer as well.
The cotton-magnesium is now adjusted or
held by the side of the camera and slightly in ad-
vance of the lens, care being taken not to bring it
within the view angle of the lens. The plate
holder is then affixed to the camera and the slide
withdrawn. The room is then absolutely dark-
ened, and the lens uncapped. All being now ready,
a lighted taper is applied to the cotton. This is
follow^ed by an instant flash which takes the pic-
ture. The lens is capped, the slide of the plate-
holder is returned to its place, and the plate is
ready for development, either by the operator,
if sufliciently skilled, or by a professional pho-
tographer, if desired.
Since my first publication of this instantaneous
flash process, a large number of substitutes for
the cotton-magnesium combination have ap-
peared. These are all in powder form and many
of them contain chloride of potassium as an in-
gredient. Such mixtures are liable to premature
and unexpected explosion and are not to be rec-
ommended when absolute safety is a desideratum.
Care, therefore, should be taken to obtain a mix-
ture entirely free from this objectionable sub-
stance.
144
THE MEDICAL ERA.
[Vol. VL Na 5.
When a full-length figure is to be taken, in
order to show the generalization of an eruption,
I am in the habit of using the photogenic mix-
ture in a pistol cartridge, and firing it from the
weapon in the usual manner. — Piffard; Jour.
Cxbt. Dis, — Tlie Epitome.
Principles of Plastic Surgery.
In an article on plastic surgery, Mr. C. B.
Keetley says :
It will be granted that all parts of the body
are susceptible to septic inoculation, therefore
one of the first rules of plastic surgery should
be : Thoroughly disinfect the parts to be oper-
ated on, the hands of surgeon, assistant and
nurse, the instruments, sponges, ligatures, sut-
ures and dressings.
As a preliminary to the use of such germicides
as sublimate and carbolic acid, a prolonged
washing and scrubbing with the liquid potash
soap of Dr. Duncan, of St. Petersburgh, is. very
useful. This soap has two excellent properties,
(1) it is an extraordinarily powerful solvent of
dirt; (2) it is itself instantly soluble in cold hard
water or antiseptic lotions, so that it may be said
to promptly ** do its business and go about its
business." But, bearing in mind that in plas-
tic surgery one almost always desires union by
the first intention, and that irritants, such as the
stronger germicides, are not favorable to that,
an ideal plastic operation should be aseptic rath-
er than antiseptic. For this reason I generally,
while keeping the instruments in a tray of car-
bolic, dip them into a basin of recently boiled,
not boiling, water before touching the patient
with them. But when they are even temporari-
ly laid down again, it should be either into the
tray or upon acarbolized towel, disposed around
or near the site of the operation. The same
recently boiled, not boiling water, is used as a
douche and for the sponges. Some persons
would prefer boracic lotion. I greatly doubt
whether it has, for these purposes, any advan-
tage over the boiled water. If the operation were
to occupy days, instead of say half an hour, it
would be a different matter.
With regard to ligatures, they should scarcely
ever be used in plastic operation. Temporary
pressure with sponge or forceps almost always
sufiices to check hemorrhage. The boiled water
used at a temperature of about 120^ will assist.
Hare-b"p pins or silver sutures can be often ar-
ranged not only to adjust the parts but also at
the same time to control an obstinate vessel.
The objections are manifest to a number of cat-
gut knots in a wound where perfect antisepsifi
is impossible.
I believe it may be laid down as an axiom
applicable to surgery in general that even with
the aid of antiseptics, the difficulty of obtaining
union in a wound without suppuration increases
geometrically with the length of time a for-
eign body is left imabsorbed in the wound. I
may not be expressing myself properly, but I
mean, for instance, that when in a simple oste-
otomy, even though it be done antiseptically, a
large splinter of bone be chipped off, and left in
8?Vm, suppuration is ten times more likely than
if no such splinter had been made. Very prob-
ably it is the case that, even with carefully ap-
plied antiseptics, a few germs find their way
alive into the wound, but their chance of sur-
viving and multiplying depends mainly upon their
finding or not fiinding some dead or half dead
organic nidus to receive them. It is, therefore,
particularly desirable to keep catgut out of
wounds when complete antisepsis is not only
difficult but often impossible.
As a prophylactic against tedious and trouble-
some hemorrhage, the preference of scissors to
the knife for the division of all structures, ex-
cept occasionally the skin itself, is to be strong-
ly urged. With regard to the skin, in dividing
it, the precision attainable with a sharp scalpel
is advised. — Annals of Surgery.
Drinkingr Water With the Meals.
The Epitoin€y in an abstract of an article by
Dr. Leuf, in the Boston Medical and Surg'ical
Journaly says : Dr. Leuf finds that water drank
freely before meals is beneficial by thinning and
washing out accumulated mucus, increasing the
fullness of the capillaries of the stomach, and
favoring peristalsis of the whole alimentary
tract. The clean hyperaemic mucous mem-
brane is then in excellent condition to receive
food. Moreover, the stomach is distended by
the drink, and its rugae to some extent obliter-
ated. Dr. Leuf has found by repeated vivisec-
tions of animals and post mortem examina-
tions of healthy men who died by violence some
time after meals, that the shape of the stomach
varies with the degree of distension. The
empty stomach, called the "tubular stomach,"
is of small calibre, the mucous membrane
being deeply corrugated or folded, the muscu-
lar coat contracted and thickened. Gaseous
distension, though frequently observed, is not
the rule, nor is it strictly physiological. The
flow of mucus is constant, and is especially
Mat, ins.')
SELECTIONS.
145
noticeable during the intervals between the peri-
ods of digestion. Mucus is normally secreted
daring the night, and the gastric walls in the
morning are covered with a thick, tenacious coat
of this substance. If food enters at this time,
it will be covered with a coating of this tena-
cious mucus, which may for a time hinder diges-
tion. The tubular contracted stomach, with its
puckered mucous lining, always normal in the
moming before breakfast, is not in a condition
to receive food. The mucus it contains inter-
feres with proper digestion, and its firm contrac-
tion is an obstacle to the free circulation of blood
through the vessels. A goblet of water taken
before breakfast, washes out this mucus, partly
distends the stomach, starts peristalsis, and
thus prepares the alimentary canal for the
morning meal. He finds, moreover, that non-
irritating liquids pass directly through the tubu-
lar stomach; they do likewise if the stomach
contains food, and in such cases pass along the
lesser curvature, they neither mingle with the
alimentary bolus, nor impair the action of the
gastric juice on the latter. Cold water should
be given to those who have the power to react,
and hot water to all others. In chronic gastric
diseases, especially catarrh, it is very advantage-
ous to drink warm or hot water before meals,
and salt may be added with additional benefit
in almost all instances.
So-Called Diphtheritic Sore Throat.
The various forms of sore throat which, under
some circumstances and at certain stages, may
be mistaken for diphtheria, are herpetic sore
throat, or herpes pharyngis, common membran-
ous sore throat or ulcero-membranous angina,
and a septic sore throat.
In this vicinity the herpetic variety is by far
the most common, and is the one which will be
considered at this time.
The symptoms vary exceedingly; in some
cases the constitutional, in others the throat
symptoms predominate.
The natural history of a case is as follows :
There is a chill of varying intensity, from a
slight chilly feeling to a ** regular ague shake ;"
this is followed by considerable fever, and almost
invariably the fever is accompanied by a general
malaise, or "bone-aching all over." In nqany
cases the patient will not complain of the throat
during the first day of his sickness, and if it be
inspected at this time, but a slight congestion
will he observed, yet a closer inspection, with
strong light, will reveal slif?ht olovations of
the mucous membrane of one or the other ton-
sil, more rarely the uvula, and most rarely the
palatine arch.
In other cases, however, the throat symptoms
are most marked from the beginning, and the
patient will complain of severe pain in the act
of swallowing, which is usually confined to one
side, and frequently accompanied with earache
on the same side.
In from twelve to twenty-four hours, if the
throat is inspected again, the slight elevations
noted before will have developed into vesicles,
yet, since the vesicles are so easily ruptured
when matured, they are rarely seen, except
when they occur upon the uvula or extend fur-
ther than usual into the mouth.
The bases of these broken vesicles on the ton-
sil now present an ulcerating appearance, or
irregular patches of whitish, grayish, or yel-
lowish membrane, varying in size from that of
a split pea to that of a dime, will be seen.
Occasionally these patches extend to the soft
palate, uvula, and sometimes to the posterior
pharyngeal wall. The membrane is much thin-
ner and of a less dense structure than that of
diphtheria, resembling many times the inner lin-
ing of an eggshell, and may be swabbed off easily,
leaving an eroded surface which may bleed, but
upon which the membrane rarely reforms. The
glands of the neck upon the affected side are
rarely much enlarged, though always tender
upon pressure, even more so than in diphtheria.
Generally upon the second day the other ton-
sil becomes implicated and the deglutition is
extremely difficult. Yet on the third day the
throat trouble is but little complained of, relief
coming very quickly. I have in a few instances
seen small abscesses form in the .tonsil or be-
hind it. These form rapidly and open spontane-
ously in two or three days.
The question of the contagiousness of these
sore throats is in my mind unsettled. I have
seen so many cases apparently spread from one
member of a family to another as almost to lead
me to the belief of their contagious character.
If a diagnosis is impossible at the first or sec-
ond visit, any opinion or decision should be
reserved, but isolation of the patient insisted
upon. — Peoria Med. Monthly.
Laparotomy in a Child One Hour Old.
The child was perfect in every respect, vigor-
ous and healthy, except that the bowels, com-
mencing close to the duodenum, down to the
sigmoid of the colon and onioiituui, with the
mesentery, dragged tliroiigli a small opening in
the umbilicus, and had been developed in a sac
146
THE MEDICAL ERA.
(Vol. VL No. 5.
formed in the umbilical cord. The sac would
have contained about a pound and a half. I
found that it was impossible to return them
through the opening without enlarging it, and
then when I commenced to enlarge the opening
I found that the abdominal cavity was so con-
tracted from the absence of the bowels being
developed in it that it would not contain them
without enlarging it. I therefore made an open-
ing, commencing in the umbilicus, running up
two inches, and then began stretclnng the walls
of the abdomen with my fingers ; then catching
portions of the bowels and forcing them down
into the cavity, while assistants, with hooks
passed through the cut edges of the walls of the
abdomen, held them firmly up. In about twenty
minutes I succeeded in forcing them in and clos-
ing the wound with five sutures and ligatures to
the cord close up to the natural skin. The op-
eration was performed October 2, 1887, without
chloroform or an anaesthetic of any kind, and as
far as any visible signs were manifested by the
child in struggling, crying, shock or pulse, that
it was suffering pain, there was none to be seen.
For all that you could see the child might have
been enjoying the operation hugely, nor has
there been the least unpleasant symptom since.
I gave it a small teaspoonful of castor oil to be
sure and get an operation from the bowels, which
operated freely. I have given five or six doses
of one-third of a drop of Tincture opii. The
child sleeps and nurses well, the stitches are out
and the cord is separating nicely. How long after
birth before the nerves of sensation are brought
into action ? They were certainly not in action
when I performed this operation. — Jom, Am.
Med. Assoc. .
A Death During, and a Death Before the Admin-
istration of Ether.
By D. hays AGNEW» M.D.
On the 3d of August, 1887, I was called to
visit, by appointment, Mr. E. D., set. forty-five,
at his hotel in Philadelphia, for the purpose of
removing two ulcerating hemorrhoids, which had
resisted the ordinary means of treatment for
several months, and were causing the patient
great discomfort. Dr. White was asked to ac-
company me and administer the ether. There
were no ascei-tainable reasons why an anaes-
thetic should not be given, as neither the heart
nor the kidneys were diseased, and the patient
appeared to be in good health. Only one
year previous I had divided and stretched the
sphincter aui of Mr. 1). for fissure, administer-
ing the ether myself, and after anesthesia,
entrusting the agent to a friend of the patient,
who was present, for the brief time required for
the operation. About six ounces were taken this
time.
At the time of the last operation nothing oc-
curred during the early stage of the inhalation,
other than is witnessed every day when ether is
exhibited. In the course of fifteen minutes the
patient, though rigid, was placed across the
bed. One of the tumors was dragged down,
transfixed, and ligated with a double ligature.
When about to seize the second, the breathing,
which had been strong and free, suddenly ceased.
The operation was immediately suspended and
the usual methods of resuscitation instituted.
These consisted in examining the tliroat for the
probable presence of some obstructing cause,
dragging the tongue forward, the use of artificial
respiration, flaggelating the surface with the
end of a wet towel, ammonia to the nose, par-
tial inversion of the patient, and, finally, the
passage of the electro-galvanic current through
the phrenic nerves. Notwithstanding these
measures were persisted in for at least three-
quarters of an hour, during twenty-five minutes
of which time the pulsations of the heart could
be recognized, not a single effort of natural res-
piration occurred. The man was dead.
The post-mortem made by Ur. Formad
revealed complete collapse of the lungs, marked
traces of an old meningitis, attributed to a
former sunstroke, and what satisfactorily ex-
plained the sudden termination of life, the
rupture of a calcified vessel in the fioor of the
fourth ventricle, the recognized physiological
center of respiration ; all the vessels comprising
the circle of Willis were in a similar state of
atheromatous degeneration. It was evident,
therefore, that the increased vascular tension
of these cerebral vessels, caused by the ether,
determined the lesion, a result which might
have followed any unusual excitement, mental
or physical. The heart and kidneys were
healthy.
The question naturally occurs : Could this sad
disaster have been prevented? Certainly, in
view of all the circumstances, it could not. 1st,
The ether was that known as Squibb's. The
can contained eight ounces ; two ounces re-
mained in the vessel ; two ounces, it is fair to
suppose, had been retained in the folds of the
towel, leaving four ounces, or, at most, less
than five ounces which had been inhaled. 2d.
There was a sufficient admixture of atmos-
pheric air with the respired vapor as the an-
Mat, 188».1
SELECTIONS.
147
aesthetic was administered from an ordinary
towel folded into a cone and with an opening at
the apex. 3d. The position of the adminis-
trator, Dr. White, that of reclining alongside of
the patient, with the face of the patient in full
view, would have enabled him to detect at once
any signs of approaching danger, which, from
his long experience in giving anaesthetics, would
have been quickly recognized; and, last, the
impossibility of being able to ascertain, during
life, the state of the blood-vessels of the brain
disclosed by the autopsy, and rendered very im-
probable in a man of forty-five years of age.
I was called to one of our suburban towns to
see a case of strangulated hernia. The patient
was a female about seventy years of age. THie
intestine had been incarcerated for three days.
Her pulse was quite good, and there was no
sign of collapse. I noticed the pupils were
much contracted, no doubt from the opium
which had been administered. I directed her
medical attendant to place the patient properly
in bed, and prepare a cone for giving the anaes-
thetic, while I made my preparation for the
operation. This was done. In a few minutes I
was ready to proceed, and then told the doctor
to give the ether. While reaching for the bottle,
and before removing the cork, the patient gave a
sudden convulsive movement, at the same time
ejecting a large amount of stercoraceous mat-
ter from the stomach, and expired in a moment.
Had the etherization been commenced, or the
operation begun, before the death of the woman,
the fatal result would have been charged to
either the anaesthetic or to the knife. — VhU,
Med. Neu'8.
The Simplest Method of Cataract-Extraction.
He had had an experience of 5,019 extrac-
tions since the beginning of his ophthalmological
practice in 1855. He had not invented any new
instrument. With the progress of antisepsis and
anaesthesia, there was less need than formerly of
dexterity of manipulation. He regarded cleanli-
ness and disinfection as clearly identical. He
avoided the use of carbolic acid on account of its
irritant effect. Preparatory to the operation, he
washes the whole face of the patient, then instils
a few drops of cocaine. Immediately before
operating, he washes the everted eyelids with a
three per cent solution of boracic acid. The
operation may be done without a speculum. The
only instruments necessary are a Graefe knife,
and simple forceps to fix the eyeball. The cut
is made downward, and the same knife is used
to lacerate the capsule through the intact pupil.
Fixation should be abandoned when the patient
is restless. Deliver the lens by gentle stroking,
then remove the speculum, and rub the closed
eyelids over the cornea, and wash again with the
same solution of boracic acid. Then a light
compress is put on, and retained by means of a
strip of adhesive plaster, passing from temple to
temple. The plaster should not be allowed to
remain longer than four days, on account of its
irritant effect upon the skin. In high degrees
of atheroma it is better to do an iridectomy, as
there may be a resulting leucoma. In such cases
Dr. M. does the combined operation, making the
iridectomy upward. In another form of corneal
extraction he uses a lance shaped knife to make
the incision and open the capsule. Here he fixes
the eye at the lower margin of the cornea. The
iris seldom protrudes, and if it does, cut it oif .
In this form of extraction, if traumatic cases be
eliminated, there is scarcely any bad result. He
spoke of modifications in procedure, where the
cataract has a hard, large nucleus, and of the
necessity for an iridectomy where a foreign body
was in the lens, to guard against its being brushed
off by the iris during extraction and left in the
eye. — Dr. Mooren, of Diisseldorf.
The Green Diarrhoea of Children.
Another alleged* triumph of the microbe is
brought to light through the researches of M.
Hayem and his assistant, Lesage, who affirm
that this industrious creature is the cause of
the green stools of children. These investi-
gators assert that for the first twenty to twenty-
five days after birth, diarrhcea occurring in chil-
dren is apt to be bilious in nature, but such a
form of diarrhoea becomes more and more rare
up to the age of six months. After this time if
the discharges are examined in cases of green
diarrhoea, an innumerable number of pathogenic
bacilli will be found, to such an extent that to
their presence is due the peculiar mucus char-
acter of these stools ; while the coloration is due
not to the bile-pigments, which are entirely ab-
sent, but to a peculiar pigment secreted by the
bacilli themselves, and which may be repro-
duced in artificial cultivations of the microbes.
It would, therefore, seem clear that because the
passages in a case of diarrhoea are green it is
not warrantable to speak of them as bilious,
since in many cases bile-pigments will be en-
tirely wanting in cases of green diarrhoea.
Further than this, it would seem that this form
of specific diarrhoea is contagious, and may be
148
THE MEDICAL ERA.
[Vol.. VI. No. 5.
produced in different animals by the induction of
the bacilli through various means. While it
is claimed, however, that there is a certain
amount of probability' in the contagion of the
disease, of course it does not imply that dys-
peptic troubles are without influence on the
development of this form of diarrhoea, since it
is readily conceivable that indigestion, by pre-
paring the soil, may favor the production of this
bacillus. Hayem and Lesage have found the
greatest success in the treatment of this form of
diarrhoea by the administration of a two per cent
solution of Lactic acid in teaspoonful doses.
Of course, in this form, as in other forms of
diarrhoea, the diet must be regulated. Care
must be taken to employ disinfection of the
stools to prevent the spread of the aflfection, and
by proper care it is claimed by these means the
mortality of this microbic form of diarrhoea may
be reduced to a minimum. — 'Tfierap, Gaz,
Ventilation of the Beds of the Sick.
In the Cambridge (Mass.) Hospital there is an
arrangement for the ventilatian of the beds not
generally known ; it is so effective that I wish to
describe it. Beneath each bed is a ventilating
tube of about eight inches in diameter, fifty
square inches area, leading directly through the
floor to a foul-air tank, beneath which it com-
municates with the main ventilating chimney.
About 2,000 cubic feet of air an hour is thus
drawn from beneath each bed. This ventilating
tube is connected with the bed above by a four-
inch pipe of tinned plate, with a proper cover
and joints, which passes around the side or
foot of the bed and into it beneath the clothing.
This pipe is lengthened with one of the same
size of pasteboard or other substance, a non-
conductor of heat, reaching to any part of the
bed. By this simple means foul air is removed
as fast as formed, the bed kept free from odor,
and the patient's body is no longer surrounded
with contaminating gases. As the air presses
inward through the porous bed-clothing none
escapes into the ward. Further, a two-inch
flexible pipe is adjusted to that just described,
and slipped over the hollow handle of the bed-
pan when in use, carrying off odor from that
also. In the same hospital similar means con-
nect the beds in the private wards with the
chimney of an ordinary fire-place, up which the
pipe reaches about four feet to insure a good
draught with a moderate tire ; the pai*t in the
chimney is of black iron. The advantages of
such an arrangement in eases of sloughs, foul
ulcers, cancers, and in fevers with frequent
fpBcal dejections, are obvious. It may be sup-
posed that the passage of air through the bed
would cool it too much. Practically it does not;
probably the quantity of air passing is about
the same as in beds ordinarily at the same tem-
perature of the room, but in a different direction.
— A^. y. MedwalJournaL — Am. Med. Dig,
Enlargement of the Glands at the Base of tlie
Tongue.
Dr. J. M. Schley calls attention to a condition
which, he thinks, is often overlooked. He
describes it as follows :
A young singer applied at my clinic for treat-
ment. She was thin of form, nervous, and anx-
ious about her condition and voice. Her main
support was by singing. On careful physical
examination nothing was discovered bej^ond an
insuflicient mitral valve. She was not hysterical,
neither had she ever had an attack of hysteria.
The nasal fossae were healthy, the naso-pharyn-
geal space slightly hyperaemic, posterior wall of
pharynx healthy, larynx normal. She com-
plained of fullness in the pharvTix, a desire to
swallow something in the pharynx at times caus-
ing pain, always causing discomfort, a stiffness( *?)
of the tongue, and an impossibility to gauge or
modulate her voice as she was accustomed to do.
She located her trouble correctly — as I found
afterwards — at the base of the tongue, for, after
satisfying myself of the general healthy state
and appearance of the surrounding tissues, my
examination was directed to the papillae. Here
I found congestion, enlargement, and sensitive-
ness to the touch.
This patient was very persistent in her attend-
ance, and after three or four months' treatment
with a stronij Lugol solution she has been nearly
entirely relieved. Apis met. Ix, Lachesis Ox,
and Mercurius dulc. llx were the medicines
administered seriatim.
This was the first case of the kind I had
noticed, the glandular tissue being markedly
enlarged, reddened, overlapping the epiglottis in
its center and on its sides. I thought I hfl,d
noticed or perhaps could define a new malady
from this person's novel condition, but found ou
looking over recent literature that similar states
had been observed and written upon. There is
no doubt that such pathological conditions are
mistaken often for others. I believe homoeo-
pathic treatment will cure these congestions and
hypertrophies often without local treatment or
cauterization. — 1\ ((' i5?. luvestUiaJtor,
Mat. 18«8. I
CORRESPONDENCE.
149
Feeding* Patients During the Night.
The exclusive ingestion of food by day is insuf-
ficient for the body in disease, and it becomes
necessary, then, to feed the patient at night also.
The manner in which it is to be taken, and the
amount, are questions which may not be estab-
lished by general law. Each case has its own
requirements. Patients themselves do not often
know how much thev are reduced, as inanition
sometimes progresses very slowly, for instance,
in chronic phthisis ; here, too, appetite becomes
Uunted. It is only by direct experimentation,
thus, upon each case, that the time, amount,
and frequency of food can be established. Yet
it may be stated, in general terms, that the most
appropriate time is between nine and ten in the
evening and one and three in the morning.
The character of the food is to be determined
according to circumstances ; it should be, in gen-
eral, easily digestible food. Alcohol and cod-liver
oil may be of great utility at times.
The diseases which call for this supervision as
to night food are, beside the acute and chronic,
hemorrhages, bronchorrhceas, suppurations,
diarrlueas, diabetic conditions, convalescence
after exhausting diseases, inanition after nervous
diseases, long continued hysterias, hypochondri-
ases, and other mental conditions; also in
mental overwork, premature senility, inanition
consecutive to chronic gastric catarrh, profuse
sweatings, physical exhaustion, infantile atrophy,
dropsies, etc.
/ Inanition often occurs so insidiously that the
J patient himself is not aware of it. A most par-
I ticularly valuable symptom indicative of its
/ invasion is sleeplessness, in combat with which
\ alcohol is a remedy, not to be underestimated,
i I* is certainly true that some reduced patients
' are more or less somnolent ; these patients, too,
require nocturnal food. — Af«s«. Med, Jam.
CORRESPONDENCE.
^
Qalvanism in DyBmenorrhoea.
Have experienced many beneficial results from
the use of galvanism in the cure of dysmenor-
rhcea. The greater number of cases, as found in
ordinary practice, can be very much relieved by
electricity, and many of them permanently cured.
Whatever the condition of the endometrium,
which fails to allow the free flow of the blood
into the cavity of the uterus, thus causing dis-
tension and pressure with pain of greater or
less severity, the free and steady flow of the
galvanic current through the uterine organs is
most efficacious in relieving this congestion and
preventing pain. — Med. Index,
Homoeopathy in the East.
Danbury, Conn., April 20, 1888.
To the Editor of tlie Medical Era: —
Having just returned from the Commence-
ment Exercises of the New York Homoeopathic
Medical College and Free Hospital held on the
13th inst., in Chickering Hall, followed the
same evening at Delmonico's by the most enthu-
siastic meeting of the Alumni Association it has
been my privilege to attend, I feel anxious that
our western brothers may know just what a
" l>oom ** we are having and may be encouraged
thereby.
The keynote of all the speeches was that
homoeopathy, with a large H, has come to stay.
From every quarter came reports of new
victories for those who uphold the banner
of Hahnemann, but for New York City will be
reserved the honor of making the year of 1888
one of rare achievement in the progress of
homoeopathy on this continent.
Our college has long since outgrown its pres-
ent quarters and those ha\'ing its interests most
at heart have planned for such a building as
would place it on a plane with any school of
medicine, old or new, in the United States, and
there is every prospect now that soon these
plans will be consummated.
Y^'our readers have probably all read of the
Grand Homoeopathic Fair held the first week of
April under the personal supervision of some of
the most prominent society ladies of New York
City. The result was that $1(),0()0 were handed
over to the trustees as an aid to the building
fund.
Sixteen lots have already been purchased and
paid for and over a dozen beds endowed with
subscriptions of $5,000 each.
One gentleman has promised to build and
equip a free surgical hospital whose appoint-
ments shall be second to none in the world.
There will also be a free maternity hospital
and training school for nurses in connection
with the hospital and dispensary departments.
In short, we shall soon have in our metropolis
a college where everything is taught that is of
value in the relief and cure of the sick or
wounded, and founded on the granite rock discov-
ered by Hahnemann.
E. Elmer Keeler, M.D.
150
THE MEDICAL ERA.
[Vou VI. No. 5.
Intestinal Gas.
Dr. Taylor, of Concord, Mass., asks for sug-
gestions for a remedy for the following ease :
Male, aged 60, has for the past twenty-five
years suffered from accumulations of gas in the
intestines; he has been prescribed for in all
parts of the world and by all sorts of practition-
ers, with only temporary relief. He is of spare
habit, nearly six feet high, and weighs but 130
pounds. He has canine appetite most of the
time, but is temperate in all things, especially
in diet, yet most of the time he is bloated with
gas, which at times passes freely ; it is generally
inodorous, but at times has a sulphurous smell.
When the gas is passed freely his spirits are
good, and he has abundant energy. But when
the gas is incarcerated, there is great depression,
loss of memory, and life is a burden to him.
The case has so far resisted treatment, and
those having had similar cases to treat are re-
quested to give Dr. Taylor the benefit of their
experience.
A General Abandonment.
In the last number of The Medical Era I read
the following sentence, quoted from Dr. Samuel
0. L. Potter, of San Francisco. He says : ** I
abandoned homoeopathy before entering into prac-
tice, " etc. That was enough. On the same prin-
ciples I want to hold myself up to the admiring
gaze of mankind as a reformed inebriate, and I
want to tell you it takes a great deal of confi-
dence to sustain a man in 'such a position. To
be sure I never drank a glass of liquor of any
sort in my life. No! I abandoned it before I
began, but what I don't know of the holy terrors
of delirium tremens would fill a book.
But I did some more abandoning. I once
listened to a few medical lectures, by some very
learned and honorable gentlemen who knew all
about homoeopathy, and who gave me such a
description of it, that I was led to abandon it
wholly and utterly. To be sure, I didn't know
any more about it than Dr. Potter does of
** Symmes Hole " at the north pole, but I aban-
doned it with a vengeance, and I verily thought
any body else was a fool who didn't do likewise.
After a time I fell sick. The wisest of those
fellows who had taught me to abandon homoe-
opathy tried to cure me. They prescribed big
bottles full of nauseous stuflF, which I faithfully
took for a year or more and got worse all the
time. There loomed up before me the prospect
of what seemed to me a very premature aban-
donment of this life and my wife and babies.
Things were getting very serious. More than
once I discussed with my wife the veritable prob-
ability of an early demise, and the *•' valley of
the shadow of death " was not a cheerful prom-
enade I can assure you. Then it chanced, or
Providence ordered — I fell in with Dr. Eaton, of
Cincinnati, who in a few moments of casual con-
versation learned of my condition, and volun-
tarily prescribed for me, and gave me a small
vial of medicine. • In less than two weeks I was
well — restored to health — and I have never
had a return of the same difficulty. It was my
first practical and real knowledge of homoj-
opathy.
I knew something, both theoreticaUy and prac-
tically, of allopathy, but had never attempted nor
intended to practice medicine in any form. But
I abandoned allopathy then and there — at once
and forever, as a system of medicine, and opened
my eyes wide to discover the merits and princi-
ples of homoeopathy, which had given me such
signal help. Sickness and the sight of death, all
too near for comfortable contemplation, may not
yet have spoken in a personal manner with Dr.
Potter. When they do, and when homoeopathy
offers to remove the spectres — the reception of
Dr. Wesselhoeft's reproving of Carbo veg. may
not seem to be such a very important matter after
all. There's still a chance for Dr. Potter to do
some very lively abandoning. Yours,
W. E. Hathaway.
For Consultation.
Tacoma, W. T., Feb. 20, 18S8.
Editor of TIte Medical Era : —
The following is a case for consultation and
advice : Mr. G. — , jet. 28, mamed ; Nervo-bil-
ious temperament ; consulted me on 13th inst.
and presented the following : Two years previous-
ly had been a tinner and in his rambles about
Poi-tland, Ore., in the evenings, had made the
acquaintance of a member of the demi monde
fraternity from whom he contracted the gonor-
rhoea. Was treated allopathically by injections.
— (strong.) — Discharge stopped but appeared
again. Was then treated by another allopath,
who said he could cure him, but would have to
give him strong injections. Did so and discharge
stopped. Never had any further trouble, but
shortly after he went into office work and in con-
nection with a malarial attack, for which he
took heroic doses of Quinine, he acquired a ** con-
stipated habit." Sometimes the concretioDs
would have to be removed by instrumental means,
they became so impacted. Little circular mac-
Mat, 1888.1
COLLEGE NEWS.
151
ulffi now appeared on the body in different
places about the size of a small pea, dark-brown
in color, more especially on shoulders and lower
abdomen. He was again treated by regulars ( ?)
with washes and salves, and lotions externally,
and Iodide of potash, Iodoform, Sarsaparilla, etc.,
internally with little or no benefit. Thinking con-
finement was operating against him, he took the
road and is now traveling. His health improved
considerably and the maculae disappeared except
a few scattering ones, but he does not feel well.
In his own language ** feels as if in need of a
tonic." Has no appetite. Feels weak and ** run
down." Sleeps well; circulation fair; bowels
move naturally, (keeps them ** open " by fruits,)
urine, specific gravity 10:30, slightly alkaline.
Normal in quantity. In appearence he is dark
sallow and thin, always feels better at night —
worse during day. After an hour's questioning
could not get a guiding symptom, so gave him
"on general principles" Fe et Strychina 3x. At
10 p. m. he took a dose (about 1^ grs.) and at
12 p. m. I was called to go and see him. I found
him just recovering from a veritable Strychnia
convulsion. Said he felt the medicine a few
minutes after he took it. I ordered it discon-
tinued and next day he called at the office and
I gave him Fe et China 3x with instructions to
call and see me in a week.
He had been treating with both schools and
says he always feels worse under homoeopathic
treatment, but still wants to try it again. It is
evident that he is very susceptible to the action
of medicines.
I am a young practitioner and would like to
do the best for my patient. I have had several
of these ** discouraged " cases from other M.D.'s
which I have treated with the most gratifying
results, but this one puzzles me. Please give
me a diagnosis and outline of treatment and
oblige,
Yours fraternally,
F. W. SOUTHWORTH, M.D.
NEWS FROM THE COLLEGES.
Ann Arbor.
UNIVERSITY OF MICHIGAN.
Abscess in the Brain. — On Aug. 1, a child was
admitted into St. Vincent's Hospital, Sydney,
Bufifering from symptoms of cerebral abscess.
Dr. W. Odillo Maher, who at a previous opera-
tion had removed part of the frontal bone, passed a
knife nearly two inches into the brain, and strik-
ing the abscess, let out about two ounces of pus.
The child made a good recovery, and is now walk-
ing about, apparently perfectly sane and well.
In speaking of ameiioirhoea. Prof. Wood says
to treat the imtunt and not the amenorrhoea.
Never use remedies to hasten menstruation.
There is suoh an intimate relation between the
lungs and the organs of generation that if one
region is diseased both are likely to cause
trouble.
Where Ferrumis used in treatment of suppres-
sion of menses it should be in very small doses.
Pareira brava is a too much neglected rem-
edy in the treatment of cystitis, especially in the
chrome form, with dysuria and urging to mic-
turition; ammoniacal urine with thick, white
viscid mucus or deposit of r»3d sand.
Prof. McLachlan says Mercury follows Aco-
nite and Belladonna well in the treatment of
perinephritis. In the mild form Mercurius sol.,
but la er Mercurius corr. In old cases with
hectic fever, Arseniate of quinine 3x.
Hot fon.-entations of Hamamelis, 1 part to 2 of
water, applied continually to the back, is a use-
ful remedy in congestion of the kidneys.
Prof. Amdt recommends Aurum in the treat-
ment of chronic nasal catarrh, in scrofulous
persons, especially where there is a mercurial or
syphilitic taint. It is also useful in prolapse
and induration of the uterus, in syphilitic
iritis when the bones of the orbit are involved
and in syphilitic eruptions.
In the treatment of ophthalmia and granulated
lids a local application of Silver nitrate, 15 or
20 grs. to the ounce of water.
In the acute and early stages of gonoiThcea
Argentum nit. is useful.
Cantharis is not used as often as it deserves to
be in the treatment of pleurisy. It is especially
useful in cases for which Aconite was formerly
prescribed.
Plumbum is useful in intestinal obstruction
or hernia, but in the treatment of such cases the
physician should depend more on his surgical
knowledge than on his materia medic-i.
Speaking of skin grafting, Prof. Obetz says :
Always take the grafts from the person to be
operated on, for fear of some constitutional dis-
ease. The bits of skin need be no larger than
half a grain of rice. Place them about a quar-
ter of an inch from the edge of the sore, which
must be a perfect healing one, covered with
granulations and surrounded with live, healthy
skin.
152
THE MEDICAL ERA.
[Vol. VI. No. \
Nitrate of silver is useful to tease or irritate
a weak wound, but for destroying a malignant
growth it is not good.
Never apply grease to an ulcer. It gets foul,
and dirt collects with it so that the result is
generally a chronic alcer. If the sore is a
healthy, healing one, apply nothing but a water
dressing.
To desicate a weak ulcer use sugar or Quinine.
In the treatment of an indolent ulcer the fol-
lowing outline was given: Correct the position
to help the veins ; give physiological rest ; apply
pressure with bandage or adhesive straps and
keep very clean ; give nourishing diet, and treat
the constitutional condition. The indicated
remedy, alone, will not cure a chronic ulcer.
In washing a wound with carbolized water be
careful not to have the solution too strong, or
it will dissolve the clots of blood plugging the
capillaries, and prolong the hemorrhage.
In redressing a wound, change every piece of
dressing except the macintosh, which should be
thoroughly cleansed. Dryness is the fundamental
rule of success.
Iowa City.
STATE UNIVERSITY.
Prof. Cowperthwaite has often impressed on
the students not to become ** routine pre-
scribers," but to closely differentiate between
remedies. Ipecac, he says, is too often given
where Iris versicolor would be the similimum.
Nausea and vomiting accompanied with head-
ache, is not a case for Ipecac, but for Iris.
Lobelia is often useful in pneumonia and
capillary bronchitis. Make a cornmeal poultice,
on which sprinkle Lobelia, and then cover with
gauze ; moisten with hot water, and wrap around
the affected part. In pneumonia Capsicum
should be added. In erysipelas and in poison-
ing from Rhus tox., the parts should be painted
^vith Lobeha tincture.
Prof. Cogswell recommends the use of whisky
in coUc of children, if Aeon, or other remedies
fail — three or four drops in a spoonful of warm
water often brings prompt relief.
Tendency to chafing or soreness in groins or
axilla is promptly relieved by powdered Mag-
nesium sprinkled over the siu'face.
Always avoid lancing the gums in teething
children, as inflammation will set up and a cica-
trix result. It is much better to rub the gums
with the thumb nail or a piece of charcoal.
Yerat. vir. 2x should be given early.
Cook County Hospital Kotes.
SUicea 3x gave prompt relief in a case of chron-
ic rheumatic arthritis of both knees, after all
other remedies had failed, the trouble subsiding
at once. The joints were swollen and painful,
especially on motion, and had been so for over
three months.
NapMialiyi 2x cured a case of gonorrhoea of
two months* standing; dose every two hours.
The trouble subsided entirely after one week's
treatment with the above remedy. No injections
were used whatever.
A German was brought to the hospital by his
friends, none of whom could give an intelligent
account of his case. They finally managed to
say that something had been injected into the
patient's arm by a physician who bad been
called in, and who, supposing the patient about
to die, sent him to the Hospital. He was appar-
ently suffering intense pain about the epigastri-
um. Some remedies were administered and
fomentations as hot as could be borne apphed.
In three hours the patient's respirations had
fallen to seven per minute, the pupils con-
tracted to the size of a pin-head, and the skin
had assumed a dark, blue tinge, all of which
clearly indicated narcotism from an over-dose
of Morphine. Atropine gr. 1-120 was adminis-
tered every half hour until the respirations had
risen to sixteen per minute, and six doses given.
The faradic current and flagellation were em-
ployed. The trouble subsided in about eight
hours. Muriatic acid in drop doses was admin-
istered every two hours for a few days, when the
patient was discharged all right.
A German, stepping on a rusty nail, ran it
quite a distance into his great toe. A week
later he was admitted to the Hospital with teta-
nus and died in twelve hours.
If one desires a speedy action of drugs swal-
lowed, as if given hypodermically, they should
be given in hot water. One-half of the dose will
suffice if given hot, as it is quickly absorbed from
the stomach and the force of the drug thrown
upon the system at once. — P. and S. Investiga-
tor.
Lactated Food. — A regular size package of
iLactatedFood will be sent, charges paid, to any
physician who is not yet acquainted with its
tnerits. It is a cooked and pre-digested food.
Wells, Richardson & Co., Burlington, Vt,
Mat. 1888.]
ANNO UNCEMENTS.
153
SOCIETY MEETINGS.
THE THOtTT-THI&D ANNUAL M£ETINa OF
THB ILLINOIS HOM(EOPATHI0 MBB-
IGAL ASSOCIATION.
To be Held at Central Kusic Hall. Chicagro, Illmoia,
Commencing Tuesday, May 15, at 10 o'clock
a. m., and Continuing^ Three Bays.
Hkadqiartsrs:— At the Sherman Uoatie, at rodnced ratoH to mem-
bers of the AfiiM)ciation.
OFFICERS FOn 1888.
President : C. B. Kinyon, M.I)., Rock Island.
Vice-Pr€*sidents : Geo. A. Hall, M.I)., ChicafT[o;
F. W. Gordon, M.l)., Sterlinrr; H. P. Skiles,
M.D., Chicago.
Secretar>': Curtis M. Beel)e, ^f.D., Chicago.
Treasurer: A. A. Whipple, M.I)., Quincy.
ORDER OF BUSINESS.
The Association will hold two sessions daily,
from \) oVlock a. m. to 12 m., and from 2 o'clock
to 5 p. m.
Tuesday, May 1.5. — Morning Session.
The Association will he called to order at 10
a.m., hy the President, C. B. Kinyon, M.D., who
>^ill deliver the Annual Address. Suhjeet : Sug-
gestions Regarding the Short-comings and Mis-
conceptions in Medical Education.
Appointment by the President of an Auditing
Committee.
Appointment of a Committee on the Presi-
dent's Address.
Reports of Standing Committees.
Next in order will he the Report of the
[Only the namen of thoee members of boreaiix an* given who
hare alieady handed in the 8ubj<ct« of their papers J
Bureau of Medical Le(jutatwn, JnnsiYnulowe and
Education.
J. A. Vincent, M.D., Springfield, Chairman.
Bureau of Obstetrics.
L. C. Grosvenor, M.I)., Chaimian; Suhjeet:
Infant Hygiene, an illustrated paper.
A.A.Whipple, M.I)., Quincy; Subject: Ob-
stetrical Emergencies.
R. N. Foster, M.I)., Chicago; Subject: Man-
agement of the Breast.
Bureau of Ophthalmology and Otoloffij.
F. H. Foster, M.D., Chicago, Chairman.
C. H. Vilas, M.D., Chicago; Subject: Clinical
Eye Cases.
J. H. Buffuiu, M.I)., Chicago; Subject: Eye
Headaches.
/
Tuesday, May 15. — Afternoon Session.
Bureau of Materia Medica.
W. J. Hawkes, M.D., Chicago, Chairman.
W. S. Gee, M.I)., Chicago; Subject: A Study
of Belladonna and Calcarea Carb.
Bureau of Path)log\f, Physiology and Histology.
M. J. Bleim, M.D., Chicago; Chairman; Sub-
ject : The Liver as an Eliminator of Poisons.
Bureau of Diseases of Womeji.
R. Ludlam, M.I)., Chicago, Chairman.
Curtis M. Beebfe, M.I)., Chicago; Subject:
Alexander's Operation.
M. J. Bleim, M.D., Chicago; Subject: Phi-
mosis in the Female.
Julia R. Lowe, M.D., Chicago; Subject: The
Medical Aspect of the Method of Delsarte.
E. S. Bailey, M.D., Chicago; Subject; Dia-
betic Vulvitis.
Wednesday, May 10. — Morning Session.
Bureau of Clinical Medicijie.
C. E. Ehinger, M.D., Chicago; Subject: Top-
ical Treatment in Diseases of Throat and Lungs.
Cliflford Mitchell, M.D., Chicago; Subject:
Relation of Urinary Analysis to Diagnosis.
Ch. Gatchell, M.D., Chicago; Subject: In-
testinal Inertia.
W\ W. M. Davison, M. D., Chicago; Subject:
Diabetes Mellitus.
WV.DNESDAY, May 10. — Afternoon Session.
Bureau of Neuivhgy, Psychology and Ekctrology.
N. B. Delamater, M.I)., Chicago; Chairman.
Chas. Koier, M.D., Chicago; Subject: Teta-
nus Complicating Erysipelas.
Bureau of Surgery.
Henry Sherry, M.D., Chicago; Chairman;
Subject: The Treatment of Fractures of the
Femur.
E. H. Pratt, M.D., Chicago; Subject: Stone
in the Bladder.
W. F. Knoll, M.D., Chicago; Subject: A Sim-
ple Operation for the Radical Cure of Hernia.
H. P. Skiles, M.D., Chicago; Subject: Ori-
ficial Work in Children.
A. B. Spach, M.D., Chicago; Subject: Treat-
ment of Simple and Compound Fractures.
Evening Session, Address by Prof. J. D.Buck,
M.I)., Cincinnati, **The Coming Physician."
154
THE MEDICAL ERA.
(Vol. VI. No 5.
Thursday, May 17. — Morning Session..
Bureau, of Diseases of Children.
F. W. Gordon, M.D., Sterling, Chairman;
Subject : Children and Hygiene.
E. N. Tooker, M.D., Chicago ; Subject : Post
Diphtheritic Paralysis.
Ch. Gatchell, M.D., Chicago ; Subject : Intes-
tinal Activity.
Belle Shotwell, M.D., Peoria ; Subject : The
Responsibility of the Family Physician.
M. Huston, M.D., Dwight; Subject: Hemor-
rhagic Scarlatina.
Btireau of Anatomy,
C. E. Lanning, M.D., Chicago; Chairman.
Bureau of Sanitary Science and Hygiene.
J. E. Gilman, M.D., Chicago, Chairman; Sub-
ject: Cremation.
L. C. Grosvenor, M.D., Chicago; Subject:
Preventive Medicine.
Thursday, May 16. — Afternoon Session.
Bureau of Phartnacy,
Jas. E. Gross, M.D., Chicago ; Chairman.
Bureau of Medical Literature.
S. Leavitt, M.D., Chicago; Chairman.
Bureau of Necrology and Statistics.
L. C. Grosvenor, M.D., Chicago.
Election of Officers for the ensuing year.
Appointment of Committees and of Delegates
to other Societies.
Selection of time and place of next meeting.
Adjournment.
Curtis M. Beebe, M.D., Secretary,
23 South Ashland Av., Chicago, 111.
The Twenty-second Annual Meeting of the In-
diana Institute of Homoeopathy will be held at
Indianapolis, May 16 and 17, 1888.
The Homoeopathic Medical Society of the
[State of Wisconsin will meet at the Plankinton
House, Milwaukee, May 23 and 24, 1888.
Joseph Lewis, Jr., Sec y.
w
The Texas State Homoeopathic Medical Society
will hold its fifth annual meeting at Dallas,
Texas, May 1 and 2, 1 888.
W. F. Thatcher, M.D., Secretary.
The twentieth annual meeting of the Homoeo-
pathic Medical Society of the State of Kansas,
will be held at Wichita, May 2 and 3, 1888.
P. DiEDERicH, President,
J. F. Elliott, Secretary.
Chattanooga.
\ At an adjourned meeting of the Homoeopathic
Physicians, of Chattanooga, Tenn., held Wednes-
day evening, April 11, 1888, a permanent
organization was formed with Dr. E. H. Price as
President, Dr. W. W. French, Vice-President, and
Dr. G. E. Harrison, Secretary and Treasurer.
They are to have regular meetings on the first
Wednesday evening, 8 o'clock, of every month,
when papers, cases and other matter pertaining
to the good of the profession will be read and
discussed. The name of the society is **The
Chattanooga Homoeopathic Medical Society."
G. E. Harrison, Sec'y.
The Western Academy.
The Western Academy of Homoeopathy will
hold its Fourteenth Annual Uniting at Chicago,
May 29, 30, 81, 1888.
OFFICERS.
President, J. M. Crawford, M.D., Cincinnati,
0. ; Vice President, W. H. Caine, M.D., Still-
water, Minn.; Gen'l Secretary, C. J. Burger, M.
D., Boonville, Mo. ; Prov. Secretary, E. T. Allen,
M.D., Omaha, Neb.; Treasurer, G. W. Foote,
M.I)., Galesburg, 111.
C. J. Burger, M.D., Secretaiy,
Booneville, Mo.
Kansas City Hospital College of Uedicine.
This institution, after having run for six
years, now comes out as a Homoeopathic Col-
lege, under the deanship of our well-known
friend, Dr. F. F. Casseday. The faculty prom-
ises to do work of which homoeopathy will never
be asliamed. Our school has made remarkable
grow-th in the Southwest in the past ten years,
and the presence of this college in the metrop-
olis of the region will strengthen it materially.
All that is wanted is for the faculty to do ** good
work, *' and put their standard high. Then no
one can complain.
The 10th annual meeting of the Homoeopathic
Medical Society of the State of Michigan con-
venes in the city of Ionia, May 15 and 10, 1888.
K. B. House, M.D., Secretary.
The Association of American Medical Editors,
which meets at Cincinnati May 7, will discuss :
1. Is the multiplicity of medical journals an
advantage to the profession? 2. How far do
medical journals distributed by drug houses in-
terfere with regular medical journalism ?
May. 18W.1
MISCELLANY.
155
PEKSONALS.
Dr. F. B. Home has moved from Keota, la.,
to Beloit, Kan.
Dr. E. H. Pratt will sail for Europe on the
S. S. Gallia, May 8.
Dr. A. B. Norton has moved his office to 152
W. 34th street, New York.
Dr. Wells LeFevre has moved to (H»5 W.
Monroe. Telephone 7102.
Dr. A. B. Spach has opened an office at 6310
Wentworth Av., Englewood.
Dr. C. B. Rockwell, formerly of Wahpeton,
Dakota, has moved to Hyde Park.
Dr. and Mrs. C. B. Kinyon celebrated their
tin wedding, at Princeton, 111., April 24th.
Dr. J. S. Mitchell has moved to his new resi-
dence, 2954 Prairie Av. Telephone 8102.
Dr. F. H. Boynton has removed to 34 West
32d street, New York. Hours : 8 :30 to 1 :00,
Dr. R. M. Skinner, of Owenboro, Ky., lost his
office fixtures, medicines, books and instruments
by fire, April 20.
Dr. Wm. B. Van Lennep has purchased the
Uaknernannian Montldify and Dr. Pemberton
Dudley retires from the field of journalism.
Dr. Clarence C. Bartlett, the new editor of
our able contemporary, the Hahnetnannian
Monthly, will please accept a cordial greeting.
Dr. Henry Sherry states, in reply to a query
contained in The Medical Era of April, that
twice in his experience has he inoculated lupus
of the nose with erysipelas, with remarkably
beneficial results.
FACSTI2B.
He Believes In It.
The editor of our American SateUUe froths at
the mouth in declaiming about a ** specific."
He knows perfectly well that no one has spoken
of a specific except himself, and he has intro-
duced it either for the purpose of falsifying the
issue, or through mental inaptitude.
Prof. E. H. Bartley, M.D., of Long Island
Hospital College, recommends **The Practition-
er's Guide to Urinary Analysis " as the best book
in the market for the practitioner, owing to the
vast amount of information it contains upon the
clinical significance of the urine. He thinks
that the author has succeeded admirably in con-
densing the large amount of material at com-
mand. Prof. Bartley is himself a chemist and
author of no little note, his work on ** Medical
Chemistiy " behig used at Harvard and other
colleges.
Mr. Cranky. Then you do believe in the
mind cure. Dr. Pillsbury?
Dr. PiUshury. Well, yes, occasionally, if
the patient is sent to the asylum in time. — Ex.
It Didn't Stote.
He. — The paper says that old Mr. Ferguson
was buried yesterday.
Site. — 0, is old Mr. Ferguson dead ?
He. — Well, as to that the paper doesn't
state. It simply says that he was buried yes-
terday. — Ex.
I
Wakeful Too Late.
Jligrflns. — They say that since Gagley failed
he's been troubled dreadfully by insomnia.
Wiggins — Just like him. He never was
wide awake at the right time. — Life.
A Comminuted Fracture.
Patient. — Do you think my leg is badly
fractured, doctor?
Doctor. — Bad? Why, man, it's beautiful —
beautiful ! The bone is broken in not less than
thirty places ! — Life.
He Forgrot Something.
Doctor. — I will leave you this medicine to
take after each meal.
Mike. — And will yez be koind enough to
lave the meal, too, dochtor ? — Tul-Bits.
Duly Dead.
" As a matter of course the first witness sworn
was a doctor. Coroners begin at the beginning
by first proving that the deceased is duly dead —
not only apparently, but scientifically, and
therefore legally, dead." — Edward EggUston, in
Harper's.
The Doctor Thought so, too.
" I believe Bath would do me good," said an
old lady to her physician. *' They say they are
excellent springs." **The very place I was
about to suggest," said the doctor, **and I will
give you a letter to a very clever friend of mine
there. Dr. Davis." So the old lady went, but on
her way thither she thought she would have a
peep at w^hat her doctor had said about her case.
She opened the letter and read, <* Dear Davis:
Keep the old lady three weeks and send her
back."— Med. World.
150
THE MEDICAL ERA.
[Vol. VI. No. 5.
BOOK REVIEWS.
A Manual of Diseases of the Nervous System.
By W. K Gowers, M.D., F.R.C.P. Amer-
ican edition. With 341 illustrations. Large
8vo. Pp. 1857. Philadelphia: P. Blakes-
ton, Son & Co. 1888. (§6.50).
So rapid have been the advances in knowledge
of diseases of the nervous system, that works a
few years old are already out of date. The pro-
fession is, therefore, fortunate in having pre-
sented to it a recent work on the subject b}' so
distinguished an authority as Dr. Gowers.
In his preface he says, ** I have endeavored to
present to the reader ^he lessons taught by ob-
servation rather than the details of the cases
observed — to subordinate, so far as possible,
theory to fact, the speculative to the practical,
and to employ hypothesis only where it is indis-
pensable for the proper grasping of facts." In
accordance with this expressed plan, we have
here a systematic treatise on all diseases which
affect the brain and spinal cord. Beginning
with the anatomy of the nervous system, followed
by its physiology, the structure is reared from a
foundation of first principles. The author's
style is clear, without being dogmatic. Occa-
sionally he presents hypotheses, but only for
purposes of elucidation.
P. Blakeston, Son & Co. have put the book
in neat and substantial shape, after the manner
so characteristic of that excellent house.
A Practical Manual of GvNiEcoLOGY. By G.
E. Southwick, M.D., Assistant Professor of
Obstetrics in the Boston University School
of Medicine ; L. M. Rotunda Hospitals,
Dublin. Boston: Otis Clapp & Son. 1888.
Among other signs of the healthy growth of
our school is the production of works in the
various special departments of medicine. This
is gradually giving to homa^opathy a literature
of its own. It is true, in the matter of the
operative treatment of those diseased conditions
demanding it, we must di'aw upon the literature
of the old school, and we must learn from them.
But, having once mastered the subject, then a
member of our own school can put the matter
belonging to it into better shape for the use of
practitioners of homoeopathy. He must do this,
of course, by giving attention to homoeopathic
therapeutics, as related to the diseased condi-
tions described.
Dr. Southwick, in an effort of this kind in the
line of gynecology, presents us with a work in
which he shows a perfect familiarity with the
subject, and intelligent and painstaking care in
its preparation. His descriptions of operative
procedures are clear and understandable, so
that any intelligent practitioner should be able
to **go and do likewise." The therapeutics are
well chosen and well given, an excellent plan
being the frequent reference to original sources.
On the whole, the work is to be highly com-
mended, the chief regret being that it does not
cover a larger field. Dr. Southwick, however,
has well earned a place among the brotherhood
of authors.
Salient Materia Medioa and Therapeutics.
By C. L. Cleveland, A.M., M.D. Lecturer
on Materia Medica in the Homoeopathic
Hospital College, Cleveland, 0. Philadel-
phia: F. E. Boericke. 1888.
**More or less dissatisfaction exists with our
Materia Medica on all sides." These are the
opening words of our author's preface.
The question which at once suggests itself is.
Is the present work calculated to do away with
this dissatisfaction ?
If at all, it must be to a ^^ry limited extent,
for its scope is itself very limited. It consists
in gi\dng, for each of a hundred and ninety-
seven remedies, the temperament, location and
nature, objective, causal, general characteristic,
aggravation, amelioration, therapeutic range, and
administration. The author's effort consists in
his having selected from the materia medica
the indications belonging to the above-named
headings, and put them in ** salient" form.
To call it a work on ** therapeutics " is a mis-
nomer. Simply enumerating the diseases in
W'hich remedies are used, and adding a clinical
index, does not make of a book a work on thera-
peutics.
Dr. Cleveland has only inserted another win-
dow in the edifice ; he has not opened a door.
Atlas of Venereal and Skin Diseases. By
Prince A. Morrow, A.M., M.D., CUnical
Professor of Venereal Diseases, formerly
Clinical Lecturer on Dermatology in the
University of the City of New York : Sur-
geon to Charity Hospital, etc. With Contri-
butions of Original Illustrations from many
Eminent Dermatologists. New York :
Wm. Wood & Co., 1888. (Chicago, W. T.
Keener.)
The atlas which Wm. Wood & Co. are mak-
ing, is one of the most elaborate works on skin
diseases ever published in this country. The
text is all by Dr. Morrow, who, in addition to
the plates contributed from his own remarkable
Mat, 1888.]
BOOK REVIEWS.
157
collection, will write the treatise on skin and
venereal diseases. The illustrations are con-
tributed by many dermatologists, among whom
may be mentioned : Dr. J. Hutchinson, of Lon-
don ; Profs. A. Foumier and A. Hardy ; and Drs.
Bicord, Cullerrier, Besnier, and Vidal, of Paris ;
Prof. Leloir, of Lille ; Dr. P. A. Morrow, of New
York; Dr. E. L. Keyes, of New York; Dr. Fess-
enden N. Otis, of New York ; Dr. J. Nevins Hyde,
of Chicago; Dr. Henry G. Piflfard, of New
York, and others.
Particular attention is given to the common
forms of skin diseases, and included in it are
the eruptive fevers, as rubeola, scarlatina, ery-
sipelas, variola, varicella- vaccinia, etc. The
complete work will contain seventy-five superbly
colored plates, executed in true chromo-litho-
graphic style, exquisitely printed in flesh tints
and colors, containing several hundred figures,
many life size, together with descriptive text for
each plate, and from sixteen to twenty folios of
practical treatise on venereal and skin diseases.
Especial care has been taken to bring the ther-
apeutical part of the work fully up to the latest
advances made in this department.
A CoirPEND OF Human Physiology. Especially
Adapted for the Use of Medical Students.
By Albert P. Bnibaker, A.M., M.D. Fourth
edition. Revised and enlarged. With illus-
trations. Philadelphia: P. Blakeston, Son
k Co. 1888.
This is No. 4 in 'the series of ** Quiz Com-
pends " now so well known to the profession. It
contains, in a condensed form, the main facts
belonging to the science of physiology, and may
well serve as a '* remembrancer" to the prac-
titioner, as well as a guide to the student. The
table of physiological constants is very useful.
Photographic Illustrations of Skin Diseases.
An Atlas and Text-book Combined, . by
George Henry Fox, A.M., M.D., Clinical
Professor of Diseases of the Skin, College
of Physicians and Surgeons, New York';
Professor of Diseases of the Skin, New
York Post-Graduate Medical School and
Hospital, etc. Second series. Nearly 100
cases from life. New Yoik: E. B. Treat.
1888.
Parts 3 and 4 of this excellent work are now
on our desk. They cover eczema in seven
varieties, and also sycosis, trichophytosis, der-
matitis and psoriasis. The illustrations are life-
Uke and natural. The text is such as it must
be when prepared by Prof. Fox. We can but
repeat our former recommendation for all stu-
dents and practitioners of medicine who desire
to perfect their knowledge of diseases of the skin,
to possess themselves of this valuable work.
Cyclop-i-idia of Obstetrics and Gynecoiiogy.
(12 vols., price $1().50.) Volume V., con-
taining Gynecological Diagnosis; General
Gynecological Therapeusis, by R. Chrobak,
M.D., Professor of Gynecology at the Uni-
versity of Vienna ; and, Electricity in Gyne-
cology and Obstetrics, by Egbert H. Grandin,
M.D., Obstetric Surgeon to the New York
Maternity Hospital. With one hundred
and sixty fine wood engravings. New York :
William Wood & Company.
This cyclopeedia, of which we have just received
Vols, v., VIII., XI. and XIL, is fulfilling expec-
tations. It gives very fully all that pertains to
the subjects of obstetrics and gynecology at the
present day, in a series of handy volumes, and
at a remarkably low price.
Lectures on Diseases of the Heart. Deliv-
ered at the College of Physicians and Sur-
geons, New York. By Alonzo Clark, M.D.,
LL.D. New York: E. B. Treat. 1887.
This book we can commend to a careful read-
ing. The ** lecture " style, in literature, is not a
favorite, and too often the facts are buried be-
neath a mass of verbiage. But Dr. Clark's
lectures are free from this objection, and much
can be learned from their careful perusal.
A Cyclopedia of Drug Pathogenesy. Edited by
Eichard Hughes, M.D. ; J. P. Dake, M.D.
Part VI. Chromium — Conium. London
and New York. 1887.
Part VI. of this admirable work contains the
pathogeneses of twenty drugs, from Chromium
to Conium, and is an earnest of the work which
is being done by the indefatigable laborers who
have undertaken the task.
Odium Medicum and Hom(Eopathy. Reprint from
the London Times. "With additions. Lon-
don : The Hom. Pub. Co. 1888.
We have already called attention to the com-
ing of this book, which is a reprint of the great
controversy which recently appeared in the col-
umns of the Times. No physician of our school
should fail to read it. Price 40 cts.
Alden's Manifold Cyclopedia of Knowledge
AND Lan(juage. Vol. I. A to America. New
Y(u-k: John B. Aldon. 18S7.
This neat volume — so Innidv and so well
printed — covers ground which has been occu-
158
THE MEDICAL ERA.
[Vol. VI. No. 6.
pied by much more pretentious works. It seems
to be the perfection of the publisher's art. If
any reader wishes a first-class cyclopedia at an
exceedingly moderate price, we advise him, we
urge him, to write to John B. Alden, and call
for specimen pages of his Manifold Cyclopedia.
Fifty Reasons for Being a Homoeopath : Given
by J. Compton Burnett, M.D. London :
The Hom. Pub. Co. 1888.
To Dr. Burnett, of *' -^, Finsburi/ Circus, Ixm-
don, E. C," belongs the credit of having given
UH one of the most readable little books of the
year. Who would have thought of such a thing ?
A quarrel at dinner, a spicy correspondence, and
a detailed account of fifty triumphs with medi-
cine administered by a devotee of Hahnemann !
It really slwxdd. " convince a stone."
The story is this : Dr. Burnett was at dinner
with a *' fresh " young allopath, who was loaded
with all the usual prejudices and false opinions
regarding homceopaths and homoeopathy. In
reply to his arrogant conceit and reasonless un-
belief. Dr. B. impulsively exclaimed that he
could give him '' fifty good reasons for being a
homoeopath." The young doctor demanded the
literal fulfilment of the pledge. Dr. B. is as
good as his word, and the result is this little
book, which may be read not only with interest,
but with instruction.
But the quarrel and the correspondence?
Were they fiction or fact ? We decide for the
latter — they are too real to be the work of the
imagination, even of Dr. Burnett.
Therapeutic Changes in General Medicine Dur-
ing THE Victorian Era. Their meaning and
Lessons for Homoeopaths. By Arthur C.
Clifton, M.D.
After too long a delay, we now perform the
pleasant task of calling the attention of our
readers to Dr. Clifton^s able paper, which con-
stituted the Presidential address at the British
Homoeopathic Congress, held at Liverpool, Sep-
tember 22, 1887. In 'it Dr. Clifton traces the
changes which have occurred in medicine for
the past fifty years. It leads, finally, as every
homoeopath must know, to the position which
our school occupies to-day in the world of medi-
cine. And, as giving an idea of what this posi-
tion is, and of what it must become, we cite
what we look upon as being the most important
passage in Dr. Clifton's address. In speaking
of the work which is being done by Richard
Hughes and others towards putting the honiopo-
pathic materia mediea on a scientific basis, he
says :
This, as you know, is being carried on with
earnestness by those workers in America and this
country who are preparing and have already given
us a large instalment of what is styled ^^A Cyclo-
pcedia of Drug Pathogejiesy, " unrivalled alike in
the excellence of its spirit and execution; and the
fact that the correct' picture which it presents of
drug action, and which makes it serve for different
therapeutic methods, will further commend it to
all scientific men whose eyes are nndimmed by
bigotry, and it will thus form a link between oar-
selves and the rest of the profession.
In addition to this, you are aware, we have in
hand " The Cypher Repertory, ^^ which is being
push^ forward with commendable zeal, and which
is a very needful complement to the former works,
and a valuable addition to our armory.
Then, too, we have one volume of monographs
on aconitum, crotalus, digitalis, kali bichixmiicum^
nux vomica, and plumbum, by the late Dr. Black
and Drs. Dry sd ale. Dudgeon, and Hay ward. These
monographs, under the name of ^^ Materia Mediea
Physiological and Applied," are a perfect model
of what such work should be, and a volume which
we may feel proud to put before any medical
scientist.
In all these we have an instalment and an earn-
est of other works that will speedily follow, if
those who profess a belief in homoeopathy do bat
rise to its true dignity and requirements, and are
not content with being mere sunflowers or seekers
after comfort and ease.
Bound the laborers in this field of knowledge we
must rally with all our enthusiasm. These works
will and must be the supreme monuments of our
science and our faith. Other things may occupy
our hands, other aspects of the batUe may present
themselves, but we must ever remember that this is
the citadel of our camp, the chef d^oeuvre of our lit-
erature.
Mr. George Kennan will tell in the May Century
how he came to go to Siberia on the Cen^wry expedi-
tion.
The People's Health Journal is doing a good
tvork in popularizing homoeopathy. Physicians
would do well to introduce it into the families in
which they practice. Write to the pubhsher for a
sample copy.
Scribner's Magazine, beginning with the April
number, will contain a series of interesting articles
on the railways of the United States.
The North American Journal of Homceopathy
will be sent on trial for three months gratis, to
any one sending their address to 152 West 34tb
Street, New York, and mentioning The Medical
Era.
Kit, ims.]
MISCELLANY.
15»
MISCELLANY.
Beautiful Chemical Preparation.
A BDow white mass of Caffeine, the active princi-
ple of coffee ( 200 pounds and of great value), is
now on exhibition in the window of William R.
Warner & Co., 1228 Market street This beautiful
crystallization represents ten tons of coffee, and is
used as an ingredient in the preparation of Bromo
Soda, prescribed for the cure of headaches, mi-
graine, nervousness, sea sickness, etc. — Phila-
de Iph ia In qu irer.
Battle's Bromidia is a clean and palatable com-
pound of approved hypnotic principles. The pro-
portion of bromide of potassium in it* composition,
to the chloral, could well be doubled for most of
the purposes for which such a hypnotic combina-
tion is indicated. The directions accompanying
this excellent hypnotic combination suggests a
criticism. The injunction to not exceed three or
four of the doses indicated in twenty -four hours,
and to administer preferably during the evening,
or night-time, would avoid many of the evil results
which follow the injudicious use of this and all
similar narcotics. — Editor Alienist and Nenrolo-
gist
Have used Tongaline extensively during an
epidemic of Dengue or Break- Bone Fever, where I
had an opportunity to test it very thoroughly, and
I securecl much more successful results from it
than from the ordinary treatment, consisting of
Pot. iod., Vini colchici., Acid salicyl., Quin. sulph.,
etc. In every instance Tongaline fully sustained
the high character with which it is presented to
the profession, and only deserves to be well known
in order to be thoroughly appreciated. A. M. Sit-
TUBR, M.D., Bowmanstown, Carbon Co., Pa.
The use of prepared food for invalids and young
lildren has become a recognized necessity the
rorld over. The preparation which most closely
sembles mother's milk is confessedly the best
food for nursing babes, and the preparation which
is most grateful and nourishing to the delicate
'organism of the invalid or convalescent is destined
to win the favor and confidence of the medical
' profession. Mellin's food has long since been
found to meet these requirements .
The preparations of " Hypophosphites," " Coca,"
"Pepsin," etc, made by "Messrs. R. A. Bobinson &
Co.," are endorsed by many prominent physicians.
We recommend a careful perusal of the advertise-
ment of this well known manufacturing house.
(See page X.)
A GOOD liomcpopathie physician will find an
opening at Keota, la., where he can step into a
fine practice.
Alden^B Manifold Cyclopedia.
The Manifold Cyclopedia will be much more
than a "Cyclopedia of Universal Knowledge;" it
will embody also a dictionary of the English lan-
guage, including every word which has just claim
to a place in the language. How often you have
consulted Appleton's or Chamber's, or Johnson's
cyclopedia and failed to find the title you were
looking for — then you consulted Webster's Una-
bridged and were successful; the word belonged
to the dictionary rather than to the cyclopedia. Or
you have consulted Webster and found little more
than a mere definition of the word — you must go
to the cyclopedia for details of knowledge. Or,
more probable than either of the foregoing suppo-
sitions, you do not own either a first-class cyclo-
pedia or a first- class dictionary, or only one of the
two, because of their prohibitory cost, so you
" consult your imagination," and " go hungry " for
lack of the few lines of print that would satisfy
you. In the Manifold Cyclopedia you will find a
survey of all knowledge which is illustrated by the
English language.
The Manifold Cyclopedia is meant for " the
millions," and its price iis made, as a matter of
course, very low; per volume, in cloth, 50 cents;
half morocco, 65 cents; postage, per volume, 10
cents. John B. Alden, publisher, 393 Pearl St.,
New York.
Novel in name, form, purpose and method is
The Novelist, Alden's new weekly magazine of
American fiction.
Terms, 11.00 a year, at which rate it will give
over 2,(K)0 pages, equal to from eight to twelve
ordinarv American dollar novels.
A specimen copy of The Novelist sent free
on request. Address, John B. Alden, Publisher,
393 Pearl St., Now York, P. O. Box 1227.
J. H. Bates, the well-known advertising agent
of New York, moved April 20 into new quarters
in the Potter Building, 38 Park Row. He does
the largest business of its kind in the United
States. He has no lists to push, no space to
fill, but does a straight and legitimate business,
which is of advantage both to advertiser and
publisher.
«
New Line to Cheyenne.
The new extension of the Burlington Eoute
to Cheyenne, Wyoming Territory, having been
completed, the C, B. & Q. B. E. is now running
a through sleeping car from Chicago to Chey-
enne, via Omaha, leaving Chicago daily at noon
on the ** Burlington Number One" fast train.
For tickets apply to any coupon ticket agent of
its own or connecting lines, or address Paul
Morton, Genl Pass, and Ticket Agent, C, B. &
Q. K. R., Chicago.
160
THE MEDICAL ERA.
[Vol. VI. No. 5.
THEY SAY
That battons can be made of blood.
That genius invents ; talent applies.
That hairy persons are strong is a fallacy.
That Chicago has eleven medical colleges.
That the colleges should teach medical ethics.
That plants in the sick-room are not injurious.
That you should never pick a quarrel before it
is ripe.
That the entire French nation suflFer from con
stipation.
That the ingestion of hot food is a cause of gas-
tric ulcer.
That a gold fish will out-live three generations
of horses.
That an ounce of silence is worth a pound of
explanation.
•That it takes a snake thirty days to digest a
square meal.
That a boy in Marlette, Mich., died from eating
two nutmegs.
That total abstainers are longer lived than mod-
erate drinkers.
That the latest opprobrious epithet is to call a
man a microbe.
That saccharin is two hundred and fifty times
sweeter than sugar.
That in bearded women there is a want of sex-
ual differentiation.
That a man weighing \ 54 pounds contains 77
pounds of oxygen.
That gonorrhoea is the most prolific cause of
sterility in the male.
That excessive hair upon the legs indicates
weakness and debility.
That it is a foolish notion that impotency is apt
to follow tonsillotomy.
That medicine is the noblest of professions, but
the meanest of trades.
That an undertaker told us business was good,
and he had dead loads of it.
That a drowning man catches at straws, and so
does the man who is thirsty.
That the older we grow the more we find out
how little other people know.
That perspiration is always freer on the right
side of the body than on the left.
That poverty lessens increase of weight, and
affects girls more than it does boys. V
That the ingestion of cold substances lossous thf
irritability of a diseased stomach. ^
\
That the training of children should begin a
hundred years before they are bom.
That the French equivalent for the " tear- blank-
et tree^* is arhre couvert des larmes!
That in making chicken salad out of veal, you
should put in very few of the feathers.
That it softens the pain of making a mistake to
be the first to find it out.
That the man who sits on a bent pin rises sud-
denly and speaks briefly to the point.
That profuse, and sometimes fatal, hemorrhage
in rare instances follows tonsillotomy.
That it is better to be the proprietor of a liver
remedy than to be the conqueror of a city.
That there are thirty-five thousand different
kinds of "patent medicines" on the market
That the fetus is in part nourished by the liq-
uor amnii, which is a fluid rich in albumin.
That drugs given in hot water will have as
speedy action as when given hypodermically.
That if anyone needs the copyright-bill, it's the
editor; copy wrong is what wears his life out.
That there is a mind cure college in Vermont
that confers the degree of M.D. ( mind doctor).
That the man who took up his residence in
Chicago became tired, and has set it down again.
That genuine butter has a higher specific grav-
ity than the spurious articles now on the market.
That a Philadelphia doctor was fined one hun-
dred dollars for failing to report a case of leprosy.
That photography will detect the spots of com-
ing small -pox before they are visible to the human
eye.
That another doctor, by mistake, gave morphine
when he intended giving quinine, with the usual
result.
That a lady on the North Side has named her
baby Fort, so that she can get her husband to
hold it.
That a man does well enough in this world to
hold his own, without trying to hold what belongs
to others.
That drainage of the lioman marshes has re-
duced the death-rate of the Italian army by sixty-
six per cent.
That the best way to prevent the pollution of
drinking water is to keep the whisky bottle locked
up in a closet.
That proper or improper nourishment during
:he first year of life may affect the future weight
md stature of the adult.
THE MEDICAL EM
Vol. VI.
Chicago, June, 1888.
No. 6.
EDITORS :
CH. GATCHELL, M.D.
JAMES E. GBOSS, M.D.
MEDICAL EDUCATION.
There is one fact alone that renders it impera-
tive that there shall be some cheek to the too rapid
production of doctors now going on. This fact
is that the physicians of the United States are
multiplying at the rate of five per cent per annum,
while the population of the country at large is
increasing at the rate of less than two per cent.
It is time to call a halt !
There are many more arguments that might be
urged, with all of which the profession is famil-
iar, but the one above-stated places the situation
in such a startling light that it should be suffic-
ient. This rapid rate of increase is taking place
in a country which akeady has one physician to
every 520 persons I
Politics is so notoriously corrupt that many
good men — through a mistaken notion of what
constitutes consistency — avoid contact with it
as they would with an unclean thing. Blind
adherence to church dogma is something now al-
most unknown. But in spite of the witticisms
and flings of a Moli^re — which were better
deserved in his day than they are in ours — the
medical profession has enjoyed, on the part of
the people, a high degree of confidence and
esteem.
This confidence the profession must retain ;
bat in order to do so the profession must re-
form.
Primarily, the fault lies with preceptors.
Preceptors furnish to the colleges the raw
material out of which the superfluous doctors
are made. And, too often, the material is fear-
fully " raw." Talent which would be better
employed in turning sod or grooming horses, is
diverted to medical channels. In this way are
the ranks of the profession crowded, and its tone
lowered.
Half the reform would be accomplished if pre-
ceptors would discourage where they now en-
courage.
Secondarily, the fault hes with the coUeges.
Of the one hundred and eighteen medical col-
leges in the United States, there are few whose
main ambition, and whose every effort, each
succeeding year, is not to attract ''the largest
class in our history." The commercial spirit is
rampant, and bids are made for students.
Thus do the very men who are in a position
to see most clearly the evils of the present sys-
tem, take the most active part in perpetuating it.
This subject is to-day a live issue. All signs
point in that direction. The Illinois state law
did much to advance the cause of reform. Min-
nesota has gone even further than her sister
state. The president of the American Medical
Association, at its recent meeting, devoted much
attention to it. Dr. J. M. Crawford, before the
Western Academy, dealt with it in an interest-
ing and unique paper, and Dr. C. B. Kinyon,
whose address may be read in this issue, pre-
sents the subject in an able manner.
Reform is necessary. It has already begun.
But the profession can do much to accelerate it.
" THE COMING PHYSICIANS
The coming physician will not depend on outward
signs alone for the diagnosis of disease, nor on drugs
alone for its cure.
This is the key-note of the very interesting
address which the Illinois State Homoeopathic
Medical Association had the pleasure of listen-
ing to, from Prop. J. D. Buck, M.D., of Cincin-
nati. He sketched the ideal physician, and the
ideal life.
162
THE MEDICAL ERA.
[Vol. VI. No. 6.
Nature is dual : the objective world meets the
subjective, and there consciousness dwells. Only
the subjective world is stable — all else is phe-
nomenal. Man develops in the direction of good-
ness and beauty and truth, in proportion as he
draws inspiration from the spiritual part of his
being. A world unexplored lies within the sound
of our voices. In it lies all truth yet undis-
covered. Ideas, types, all that is persistent and
enduring, comes from this shadowy land. All this
will be the possession of the coming physician
if he build wisely and well.
The sketch of the ideal physician given by the
able lecturer, was beautiful to contemplate, and
enticing in its beauty. That all will some day
realize it, there can be no doubt, though to many
of us it is still a long way off.
But, as has been said by one who ever dwelt
** on the heights," and whose permanent abode
is now among the stars, ''though not always
possible to attain, it is good to strive for."
THE DIAGNOSIS OF WOUNDS OF THE
INTESTINJES.
A noteworthy paper was presented at the re-
cent meeting of the American Medical Associa-
tion, by Dr. N. Senn, of Milwaukee.
Every experienced surgeon knows how difficult
it is, at times, to discover penetrating wounds of
the walls of the intestines. Often it requires
much tedious handling of the intestines, which is
both injurious, and, if the wound be very small,
disappointing in its results. Dr. Senn, by a.
series of experiments on dogs, has demonstrated
the fact that the smallest penetrating wound
may be detected and quickly located simply by
injecting the bowels, per rectum, with hydrogen
gas. The gas escapes at the point of puncture,
and thus reveals the presence and location of
the wound. If there be several openings, in
different parts of the bowels, all are quickly lo-
cated by this method.
The gas is unirritating and innocuous, and is
rapidly absorbed from serous cavities or con-
nective tissue. A rubber bag, holding two gal-
lons of the gas, is all that is necessary for the
operation. The gas should be slowly injected.
With a pressure of less than two pounds it
passes the ileo-caecal valves. For wounds of
the stomach the gas must be introduced through
the CBsophagus, as it does not readily pass the
pylorus.
One curious feature of Dr. Senn's experi-
ments was to show that, when a dog has been
well /'charged," the hydrogen may be ignited at
the animal's nose, or at the point of puncture,
where it will bum like a gas-jet.
Not alone by this, his latest, discovery, but by
much other work of a highly important charac-
ter. Dr. Senn has vindicated the claims of his
friends to being the most original and progres-
sive of American surgeons.
DR. BARTHOLOW ON HOMOEOPATHY.
With the regularity of the seasons the Ameri-
can Medical Association holds its annual meet-
ings. And with the regularity of the seasons
some member tickles the fancy of his fellows
by pointing to the decline and fall of homoe-
opathy.
This year it fell to the lot of Dr. Bobertb
Bartholow to draw the veil over the eyes of his
associates. Said he :
A snrpriBing amount of ignorance stiU exists in the
latter part of the nineteenth century, and people still
think that the therapeutic art is based on some 'ism or
'pathy. On the continent of Europe homoeopathy is
nearly extinct, but here it still lives, being held up by
social influences and by misrepresentations on the part
of its advocates.
American physicians of anti-homoeopathic
proclivities generally point to some place about
five thousand miles from home when they
wish to tell of the extinction of homoeopathy.
Had Dr. Bartholow been in London during the
month of Januar}% and read the London Times^
he would not be so sure that homoeopathy is ex-
tinct in the East.
iVKM, 1888.]
K/N VON— ADDRESS.
163
In order that homoeopathy shall be no longer
upheld by "social influences and misrepresenta-
tions," Dr. Bartholow says that —
Tlie remedy for this which regular medicine has to
oiler, is to improve its art. The science of therapeu-
tics should be made more certaiu. A true knowledge
of drug action is not widely enough diffused.
The audacity of this man is refreshingly cool.
After consigning homoeopathy to oblivion, he
proposes to render his own school fit to take its
place — how ?
By adopting the very method which has vxade
homodopathy wliat it is!
He proposes to render ** the science of thera-
peutics more certain '' and to widely diffuse ** a
true knowledge of drug action."
That is precisely what Hahnemann did ninety
years ago, and what all homoeopaths have
labored for, from that day to this !
Dr. Bartholow is behind the times.
INAUGURAL ADDRESS.
'^HomGeopathy," the speaker maintained, ''has noth-
ing to do with* the progress of modern scientific med-
icine. The true therapeutic action of drugs is one of
antagonism/'
Dr. Bartholow doth protest too much. If
homoeopathy were the miserable, dying, fraud-
ulent thing that he would have us believe, it
should not be worthy so much attention on the
part of the distinguished Chairman of the sec-
tion on General Medicine of the American Medi-
cal Association. The fact that he gives it so
much attention, arouses the suspicion that he
is simply talking in order to convince himself.
But, as a fault-finder, our critic is not partial.
Speaking of the members of his own school, he
says —
The acquisition of a true knowledge of drug action
is greatly hindered by the mass of old prejudices
which still cling to the science of therapeutics, and,
like the barnacles on the huU of a ship, impede its pro-
gress.
After Dr. Bartholow has, by implication, thus
designated the members of his own school as a
lot of "barnacles" who cherish "a mass of old
prejudices," we homoeopaths have no right to
complain. We can only agree that, for once, he
has spoken the truth.
IKAT7GUBAI< ADDRESS.
Delivered by Prest. 0. B.
Kinyon, M.D^ of Bock Island,
111., before the Illlnoia State Homos-
opathic Medical Aasociation, at its Thirty-
third Annual Meeting, Ohicago, May 16, 1888.
SUBJECT :
and
Stiggestions Regarding the Short-comings
Misconceptions in Medical Education,
Ladies and Gentlemen, Members of the
Illinois State Homceopathic Medical Associa-
tion: — This Association has the largest mem-
bership of any society in our school except the
American Institute. The honors and respon-
sibilities of the presiding officer are correspond-
ingly great.
It has been my earnest endeavor to fully com-
prehend the situation. My appreciation of
your kindness in placing me here will be made
manifest by the candor of this address, and by
my constant effort to deal fairly with you on
every question. That the highest measure of
success may attend our conference, the sympathy
and hearty co-operation of every member is
solicited.
A generation has come and gone since the
birth of our organization. Individuals perish,
but society is perpetual.
And as the completed cycle of another year
brings us again together, I can add, with pro-
found gratitude, that, so far as I am able to
learn, death has not invaded our ranks during
the last twelve months.
In the preparation of the few thoughts I shall
offer at this time, it has been my deliberate pur-
pose to break the rules made almost sacred by
long custom. Therefore I shall not give a
review of the progress of medicine, or a review
of our work as a society, but instead beg leave
to offer a few suggestions, disjointed though they
be, regarding the short-comings and misconcep-
tions in medical education.
The time was when all healers, of whatever
**ism*' or **pathy," considered the practice of
medicine nothing more or less than an art.
The time now is when there are two distinct
classes in the medical profession. The one, and
I fear the larger class, still cling to the notion
that the study and practice of medicine is but
an art. The other class, by no means small in
numbers^ and constantly increasing, believes
164
THE MEDICAL ERA.
[Vol. VI. No. 6.
with equal zeal, that the study and practice of
medicine is a science as well as an art. The
former class study passing phenomena, but
ignore the cause that produces them. They
admit law but ignore the Law-giver. They
worship the form without the substance.
This is, without doubt, very largely the cause
of the bigotry and scepticism in the medical pro-
fession, as we see it to-day. It is universally
true, that mere blind faith in existing facts,
without studying the factors and forces which
enter into their causation, tends to develop and
establish in the mind a state of intolerance tow-
ard all who may see fit to question established
conclusions. Do not understand from this that
I would give less study to nature's laws ; rather
would I study them more, but in a different
manner, and with a different spirit.
All nature is governed by law, and it is by a
correct study of the laws governing all things
about us that we are led to "look through
nature up to nature's God." Furthermore, the
mind is as much subject to law as the body.
The reign of law is over all.
The law which controls the muscular con-
tractions of the body, stands at the very fountain
of all we do. It is equally true that the law
which controls the action of the brain, stands as
the origin of all we think.
My ideal of the true physician is one who
devotes all there is in him and of him, to the
service of humanity, and the service of the great
Law-giver, which is really the science of human-
ity.
When these two classes of the medical profes-
sion shall be one in sentiment ; when they shall
stand on the same footing ; when they shaU be
recognized as one and inseparable, then shall be
brought to pass the saying that is written :
" Mercy and truth are met together,
Bighteousness and peace have kissed each
other."
Each understanding the other's language,
both bowing reverently before the God of law,
their blended voices will unite in tuneful har-
mony through all time to come. No work is so
near the great beating, throbbing, pulsating
heart of humanity as that of the physician.
Hence it is true that the medical profession has
within its own keeping not only its own destiny,
but to a great extent, the correct molding of our
civilization as well, and with the proper train-
ing, with a thorough preparation of our individ-
ual members, we can do much to hasten, " this
consummation most devoutly to be wished."
By a thorough preparation I mean a well-
grounded understanding of aU that pertains to,
or is, in any way, dependent upon, or connected
with, the work of making lighter the burdens of
mankind.
We should enter with profound reverence the
study of medicine, for in its practical workings it
makes no distinction of race or creed, but binds
up the wounds and relieves the pains of the
afflicted of all nations ; of the rich and the poor, the
ruled and the ruler, Christian and pagan, friend
and foe alike. With an object so noble and
beneficent in its nature, it is our bounden duty
to be found searching in every field of nature
and in every department of human knowledge
for the accomplishment of an object so grand as
lessening the burden of human suffering. In
the faithful prosecution of this work, let us ever
bear in mind that the laws which govern
throughout all the domain of nature are each
" distinct like the billows," yet, " one like the
sea." Distinct in their separate jurisdictions,
they yet constitute one great whole, acting
together harmoniously for the common good.
Each independent of the other in its own
sphere, but, as in all physical life :
'^ All are but part^ of one stupendous whole,
Whose body nature is, and God the souL"
Thus we see that man is a world in himself.
He combines within himself the greatest num-
ber of elementary substances, the most numer-
ous organs and varied functions, so attuned to
harmonious action as to illustrate the operation
of every law in physics, every known force in
nature, and every step in the development of
living matter, from the simple aggregation of
protoplasm, constituting the germinal cell, to the
full grown man.
He is also placed in appreciable and import-
ant relations with material objects, and imma-
terial forces existing in the world in which he
lives. Hence a complete study of the living
man, in health and disease, involves a thorough
study, not only of his structure and functions,
but more t)r less of every element and force
entering into the earth, the air, and the water
with which he stands in constant relation.
As every thing about us exists for, and when
properly understood, is conducive to, man's best
good, it is the duty of the medical profession to
make plain these relations. The medical sci-
ence of to-day, therefore, embraces not only a
knowledge of the living man, but also of such
facts, principles, and materials, from every
other department of human knowledge, as may
JfJVB.188S.)
KIN YON— ADDRESS.
165
increase our resources for preventing or reliey-
iog suffering and prolonging life.
If all this is true, the whole system of medi-
cal education in this country is radically wrong,
or at least very incomplete.
Throughout all these generations we have
been teaching our medical students how best to
get a living ; instead of teaching them how best
to live, how best to teach others to help them-
selves.
Tou say that this is a rushing, pushing, com-
peting, utilitarian age, and in doing as we haVe
done we are but in keeping with the forces about
us. All of which I grant ; but, it is because of
these very tendencies, and because I feel that
the medical profession is one of the most power-
ful forces to check them, that I have spoken
these plain words.
Society, with aU its attendant machinery, is in
a great measure but the arrangement of man.
The study of theology and of law, the necessity
for all the crafts and trades, all forms of busi-
ness, are largely but the invention of man —
are necessitated by conditions which man him-
self has imposed.
Not so with the science and art of medicine.
It- is co-existent with man himself. It is but
the necessary outcome of man's existence, and
this necessity is only intensified by man's arti-
ficial and perverted methods of living.
Thus it is, as I have already said, that we have
a closer relation to the very heart of humanity
than any other class. This very relation throws
upon us added responsibility.
In all seriousness I would ask, can we — is it
possible in the very nature of things — to
properly prepare ourselves for this work in two,
or even three years ? The question would seem
to answer itself with an emphatic No. Yet it is
a fact that until very recently the most of the
profession took less time than two years.
This was true with no preliminary education
at all ; and even now the preliminary training is
far too low.
In the beginning of his career the student
seems to forget, or lose sight of the fact, that he
was called to be a man before he was called to
be a physician. Manhood is little thought of.
All his energy is bent on acquiring the ability to
hold his own, in the rush for gain, in this one
line of work.
All thought is for to-day. It is this continual
hammering away at one lii^ of work, this con-
stant thought on one subject, that narrows the
vision and dwarfs the intellect.
Give us men in the medical colleges with
larger culture, more fully developed powers of
mind, more diversified talents, and it will follow
of necessity that we will have ere long a profes-
sion that will take care of the health of the world
better, that wiU be true to itself and its mission.
What we want as students, is men whose minds
and bodies have been harmoniously developed,
and there is surely no better way to meet this
want than by the proper instruction in childhood
and youth, of what is known as " industrial
education.'* This system is little understood,
and I can in no way make its comprehension
more easy than by giving you the ideas, not the
exact words, of Dr. W. M. Butler, Pres. of New
York Training College for teachers, for work in
" industrial schools."
Industrial education is not technical educa-
tion ; it is not the preparation for trades. It is
a term invented to signify an education in which
mental training, through the hand and the eye,
occupies its proper place beside mental training
through the memory and the other means of ap-
proach to the mind. Mental training through
the hand and the eye, is generally known as
manual training, which term is only satisfactory
in case its proper signification is understood.
This manual training is graded instruction,
the object of which is to develop the pupil's power
of expression. No piece of knowledge is really
our own until we can express or apply it.
Mere memorized knowledge is parrot knowl-
edge; it is mentally indigestible and innutri-
tions. It is the pastry of the intellect. Well
enough, perhaps, if taken in proper quantities, and
at the proper time, but very unsatisfactory and
unwholesome as a steady diet.
Industrial education takes the powers of
expression, delineation, and construction, and
trains them together with the other faculties.
Thus the sense of form, of proportion, of ac-
curacy, and of truth, is developed as is possible
in no other way.
The judgment and the executive faculty, the
most important of all our powers in the practical
work of life, are provided for and trained in the
scheme of industrial education. It is claimed
for industrial education, properly organized and
administered, that it is a system that trains all the
mental faculties, and each at the proper time
and in the proper proportion. It gives us no ab-
normal or mechanical memories, without judg-
ment or executive ability, no hunched backs
without arms or legs. Every faculty is consid-
ered, every power is taken into account. The
166
THE MEDICAL ERA.
[Vol. VI. No, 0.
conditions of the nineteenth century are kept in
mind, and the ideally educated man i& not held
to be the mediaeval recluse, or the eighteenth
century English gentleman.
It also affords a pleasant and healthful alter-
nation of exercise from faculty to faculty. No
noe is over- strained, and none are allowed to be-
come atrophied and die. Muscular exertion is
called in to supplement and relieve mental ac-
tivity.
Does some one ask : What has all this to do
with medical education? The answer is: —
That it is of interest to us as friends of educa-
tional and scientific progress, but it has also a
direct bearing on medical education, and the
work of the physician.
With such a foundation a more useful and en-
during superstructure can be built than would
otherwise be possible. But more important than
all, it enables the young man to decide for him-
self, or us for him, as to whether he is suited for
the work, as to whether he is fitted for the work ;
both of which are essential to success in any
calling, and especially in that of the study and
practice of medicine. In other words, with such
a development it is easier to tell of what sort of
stuff the candidates are made.
After this development of mind and body,
what is the best course for the student to follow ?
I can bring my ideas before you in no better
way than by giving you an outline of the work
done in some of our best preparatory schools.
In outlining this work I have consulted the
catalogues of Johns Hopkins University, of Bal-
timore, Md., and of Cornell University, of.
Ithaca, N. Y. While neither of these schools
has a medical department, they both have
special courses designed for those who intend to
study medicine. Both require two years' work in
this course, but before any one can enter even
upon this preparatory work, he must pass a more
thorough and rigid examinatian than is required
by any medical school in this country, save the
** Boston University School of Medicine," which,
by the way, is homoeopathic.
The required examination is as follows: —
Thorough examination in arithmetic and alge-
bra. Three books of Euclid; plain trigonom-
etrj' and use of logarithms ; thorough examina-
tion in the "History of the English Language,"
and in the language itself ; also written composi-
tion criticised in every particular. Latin: —
Four books of Caesar, with a good "knowledge of
grammar ; also from the sixth book of Virgil's
iEneid. A good knowledge of Greek, or can sub-
stitute French and German for it. Of course,
graduates from good colleges are not required to
pass this examination, but they are strict in
their classification as to what constitutes a good
college.
Another point of especial value in these two
schools is this : If the student is found to be
deficient in any particular, as regards a liberal
education, he is advised and helped to make up
those deficiencies. Thai is, they help to develop
the whole man as nature designed him, instead of
crashing out aU individiudity in a/^cotdancs uMh cast-
iren rides.
However, the principal work of these two years
is in physics, chemistry and biology. In these
branches the work is very thorough indeed, and
any one after such a drill is better equipped for
the study and practice of medicine and surgery
than he could possibly be without it.
The work in the biological laboratory is es-
pecially valuable. They here begin with unicel-
lular organisms, then through the fungi and
flowering plants to the animal kingdom.
Next comes embryology and histology, vrith
the consequent differentiation and specialization
of function as seen in the higher animals.
Prom this the student is easily led to com-
parative osteology and comparative anatomy,
to comparative physiology and morphology.
All this is accompanied with an immense amount
of practical laboratory work in all these
branches.
With such a preparation, the student is qual-
ified to comprehend and grasp the study of med-
icine. The study of the classics tends to de-
velop and strengthen the analytical powers, the
very powers so useful, in fact, so essential, to
the successful practitioner.
While the laboratory drill has familiarized
him with the necessary manipulations to such
an extent that when he enters the medical col-
lege he can understand and profit by the lec-
tures without much outside study, he is thereby
able to give more time to practical clinical work.
As a result, he goes through without cramming,
and comes out with good health and a well-
developed mind, and is ready for the every-day
work of life, with some show of success. It is
not thus with the majority of medical students,
neither is it thus with the majority of medical
colleges.
I have seen, and so have you, students eager
to take down every word of the lecturer, for they
had no ability to comprehend what he Was say-
ing, and their only ^hope was to write it down.
What they failed to write down was never util-
ized by them.
Jvirv, isn.]
KrN YON— ADDRESS.
167
It does not seem to dawn upon them that the
average medical teacher tells but a small frac-
tion of what he knows, but instead they seem to
think that he tells it all, and if they can only
write down and commit it to memory, their
knowledge will be complete.
As a result of such a belief, the student re-
writes his notes, and as near as possible com-
mits them to memory, and is thus able to pass
his examination. Yet many of the words and
phrases that he hears, and even writes, are as
Greek to him — mere parrot talk. How quickly
this pernicious custom would be broken up if
the students were compelled to pass their final
examination before a board having no connec-
tion with the college faculties !
During the entire college course, his efiForts
are for the diploma rather than an education.
After he has obtained the coveted prize, we see
him but an automaton, with no adequate con-
ception of how to go to work. This is largely
the fault of the teachers in our American col-
leges, and of the methods employed.
They fill the student with a lot of isolated
facts, and he has no idea how to classify them.
They teach facts instead of principles. In other
words, consider medicine an art^ rather than
a 9citnjce.
Principles, correct principles, are what should
be taught. Being well grounded in the princi-
ples, circumstances will suggest the facts and
the course to pursue.
Let us have mom teaching of principles in the
schools and less cramming with details, or,
rather, let the course be extended so there will be
time for both principals and details to be taught.
Generally the student is left to form his own
theory regarding the principles of medicine, if
he thinks at all. As a result, these theories are
usually incorrect. It takes as long, and is much
harder to unlearn, to eradicate false ideas, than
to become master of the true ideas.
Having said this much about the preliminary
training, let us give a little attention to the act-
ual work done in the medical colleges, and call
to mind some short-comings.
Sometiine during the year '87, I read an ex-
cellent article on the advantages to be gained
from the establishment of a chair of '' institutes
of medicine," in our colleges. I was indeed well
pleased with the sentiments expressed. You can
imagine my surprise when, in conversation with
the author, a very short time after I had read
his article, I heard him say of a lecturer on the
" institutes of medicine " in one of our best col-
leges, that the " Doctor was one of the best ed-
ucated, and most scientific men in this country,
yet they could not keep him, because he told too
much, was too thorough ; he taught principles too
much. The students could not comprehend him,
and there was not time for such thorough work."
If such things are true, and I state them from
personal knowledge, and not from hearsay, where,
I would ask, is the incentive to prepare our-
selves for better work, for grander achievements,
either as practitioners or teachers ? But I am
glad I can add, and from personal knowledge
also, that such customs are not universal. That
they are too frequently tme, none can deny.
That they ought never to be true, all will admit.
Now, what is the remedy ? The colleges are by
no means altogether at fault. If the profession
of America had its proper ideals, and rigidly ad-
hered to them, it would not be two years before
there could not be found a college giving such
instruction. The most of the colleges would
gladly do better, and the medical profession of
this country is responsible, to a great extent, for
the fact that such things are possible. The
remedies for the case where the teacher knew too
much are, ( 1 ) Students whose brains have been
properly developed, so that they can comprehend
such teaching ; ( 2 ) Longer time for study and
longer college course.
Just think of it for a moment. Who among
you would care to trust your life, or the lives
and health of your family, in the hands of one
who could not understand or comprehend a med-
ical lecture, however deep or scientific it might
be?
Surely if one cannot comprehend what is told
him, he is not capable of unraveling the mys-
teries of disease and restoring to health, or rath-
er, of assisting nature, to restore the lost health.
There is one branch of medical education
which is very much neglected by the profession
and the colleges. I am sorry that truth compels
me to state that it is almost entirely ignored by
this society. To be sure, it has been assigned a
place on our programme, but always on the last
half of the last day of the session. It is not,
nor ever has been put on by the order of rota-
tion, as have the other bureaus. I know from
personal knowledge of several papers prepared
with great care for this bureau, but there either
was not time or disposition to have them read,
even by title.
I refer especially to ** sanitary science," but as
I desire to speak of the work of " state boards of
health, "I have thought best to put what I have
to say under the head of " state medicine." In
view of the fact that there is no unison between
168
THE MEDICAL ERA.
[Vol. VL No. 6.
authorities of different countries, or even be-
tween authorities of the same country, as to what
is meant by ** state medicine," it will be best for
me to make plain what I intend to cover by the
term. It is my purpose to speak of it as includ-
ing both ** preventive medicine" and ''medical
jurisprudence."
The complicated conditions of this nineteenth
century civilization demand a larger knowledge
of hygiene, to hold in check some of the ever in-
creasing tendencies of greed, and the suicidal
tendencies of ambition, to elevate and give
greater significance to the responsibilities of cit-
izenship, and to establish more securely the
idea of international brotherhood.
Crown Prince Rudolph, of Austria, in his ad-
dress before the " International Congress of Hy-
giene," at Vienna, in October, '87, used these
words : ** The most precious capital of the
state, and of society in general, is the man.
Every single life represents a positive value. To
maintain that life and preserve it intact, so far
as the unalterable limit of life, is, not only the
dictate of humanity, but should be the duty of all
commonwealths in their self-interests !"
Such sentiments as these are being recog-
nized by the powers that be, and each year our
modem civilization is demanding more notice
of preventive medicine.
Each year the medical profession is being
weighed in the balance by public opinion, as to
our attitude on sanitary matters, and it will be
a veritable day of wrath when we are found
wanting.
As a matter of fact the time is upon us when
we must either lead or be led. Which shall
it be?
But the fault is not all with the physicians.
Many times when an individual physician, by
his forethought and candor, averts some disas-
ter threatening a family or a community, his ser-
vices are not recognized, in fact, his motives are
often impugned by the very ones he has ben-
efited.
You are all familiar with the causes and de-
tails of the terrible scourge of typhoid fever at
Plymouth, Pa.
That epidemic cost $67,000, in direct outlay.
The loss of earnings was over $30,000. But
who will attempt to measure the distress inci-
dent to the twelve hundred cases 'of sickness,
and tbe loss to the families and the state, grow-
ing out of one hundred and fourteen deaths ?
Prompt and intelligent action on the part of
the medical attendant of the first case would
have averted all that calamity.
True, the people would never have known how
much he had done for them, would not have
given him proper credit, perhaps not even rec-
ognized his good work ; but when a man comes
to settle with himself and his Maker, where
would he prefer to be, with the one who indif-
ferently or ignorantly allowed the seeds of that
scourge to be sown under his very eyes, or with
the one who, unseen and single handed, throt-
tled the monster at its birth and daved the
people ?
Just a word about *' state boards of health."
Many of them try to do too much. In their
zeal they are led not only to exceed their duty
but their rights. When they do this they nec-
essarily fail to accomplish what they undertake,
and each failure weakens their influence with the
people, the profession, and the legislative bodies.
Let the state boards of health demonstrate
the laws of life and of health, of disease and its
prevention. Let the legislator crystallize such
knowledge into laws for the protection of the
people and give the boards the power to execute
those laws, after they have been correctly inter-
preted by the proper authority. If the legislator
fails to pass such laws, when their necessity has
been made plain, let the responsibility rest with
him.
With this understanding the profession ought
to stand by the boards. If it does not it will
be left behind.
In order to bring clearly before your minds the
future possibilities of this work, I have thought
best to make a comparison between the work
done by the sanitary commission, during oar
civil war, and the work to be done by the san-
itarian of the present day. As we proceed with
this comparison you will note the obstacles met
by them, and the methods whereby they were
overcome. I shall also try to make plain some
of the obstacles met to-day, and point out how
they may best be overcome.
In mediation between the rigor of military ad-
ministration and the comforts of household life
and affection for the 2,700,000 men sent to the
field, more than half of them under twenty-four
years of age, the sanitary commission found its
opportunity.
A few whole-souled men, men able to lift their
minds above all prejudice, were not slow to
seize the opportunity, but from the very outset,
the medical bureau of the army doggedly op-
posed any and all plans proposed by these men.
Feeling the justice of their cause, and having
the courage of their convictions, they appealed
to President Lincoln and the Secretary of War.
JUKK, 1888.]
KIN YON— ADDRESS,
169
At the same time they appealed to the pnblio
for sympathy and aid. In those days of excite-
ment it did not take the public long to tell what
it thought, and soon a strong feeling was mani-
fested in favor of the commission. President
Lincoln saw the drift, and knowing full well that
the Gx>yernment, in its hour of trial, could ill
afford to alienate the good will of any of its citi-
zens, urged upon the medical bureau the need of
the sanitary commission.
At last he persuaded them to endure the exist-
ence of the commission, provided it had no
official position, or authority to make any recom-
mendations whatever to the War Department.
It was also not to receive any financial aid from
the Government.
Is this the first instance of intolerance on the
part of the " regular profession?**
With this understanding the Secretary of War
did not appointy but simply authorized a few men
.to act as such commission, and they could add
to their numbers if they found any one willing
to join them. Thus the commission came into
being, and it was not long in starting out on its
mission. From the outset it kept in mind its
two-fold purpose, viz., prevention and rehef.
In the begmning and throughout its existence
the commission had this motto : '' The Govern-
ment is the soldier's richest, ablest and most
constant friend." In this way no one was an-
tagonized.
Because of the obsolete traditions and obstruct-
ive punctiliousness of the medical bureau, and
after they had created a public sentiment ap-
proving their work, the commission secured, by
an act of Congress, early in '62, the right and
privilege of pursuing, unmolested by the medical
bureau, their heaven-bom mission of mercy.
This secured, they began at once to develop a
system of work designed to meet the exigencies
of war. So untiring and successful were their
efforts that they were ably represented at 600 of
the 700 battles of the war.
At the close of the first eighteen months of
their work we find their expenses for hospital
transport alone were over $12,000 a month, and
up to this time they had received but $158,501.
Just at this crisis they received, from Califor-
nia alone, a draft for $100,000, followed two
weeks later by a like amount. This was suffic-
ient to arouse the whole country, so that in the
two and a half remaining years of the war, they
received and judiciously expended over $25,000,-
000.
Of course, in those days this nation lived as
much in two and one-half years as it lives in
fifty years of peace, therefore the ** sanitary
commission," did a marvelous work, unprece-
dented in extent, but the demand for prevention
is as imperative to-day as then, and it must and
will by some one be met.
Let us draw some lessons from the above brief
and imperfect history.
Now, as then, there exists a need. There still
is opposition to be met and overcome, and as
then, the public must be educated.
Now, as then, there is need of laws. Now, as
then, existing laws and authority must not be an-
tagonized, but instead, correct laws enacted and
properly interpreted and executed.
In speaking of laws I want to be distinctly
understood as meaning sanitary laws. W^e
already have too much legislation regarding the
practice of medicine. It would be better for us,
better for all, were there not a law in any state
in this Union relating to the rights of physicians
to practice.
Boards of health, state and national, might
profit by the record of the sanitary commission
if they would. They ought to be admonished by
it to keep within their legitimate sphere, viz.,
suggesting and executing laws having for their
only object the health and weU-being of the
people, and not taking the liberty of either mak-
ing or interpreting laws.
All legislation for the benefit of the medical
profession alone is class legislation, and the
genius of our American institutions is such that
all class legislation is looked upon with suspicion
by our citizens.
The law-making powers of this country have
the right to set the standard of medical educa-
tion. They have the right to say that all who
desire a certificate from the authorized schools
must measure up to such a standard. They
have the right to say to all intending to practice
medicine that, if you wish to enjoy the protec-
tion of this country in collecting your fees, you
must, in the preparation for your work, meet all
of the established requirements. But they have
not the right to say to any one, you cannot prac-
tice medicine at all. Nor have they the right to
say to the people, you must employ a certain
man to doctor you, and not a certain other man.
In so doing they would be infringing upon one
of our inalienable rights as citizens of this free
Republic.
Neither are such laws necessary, for if any
one is not allowed to charge for his services, and
is not protected in the collection of his fees, he
will soon change his line of work for something
more lucrative. The only way in which tJie state
170
THE MEDICAL ERA.
[Vol. VL No. 6.
can establish and maintain a proper standard of
jnedical education is by a complete separation of ths
teacJdng and the examining corps. In all I have
said, I have made no reference to ** isms " or
*' pathies '' in medicine. While yielding to no one
the palm for belief in, or devotion to, the great
law of ** similia," I yet believe that it is not all of
the science and practice of medicine. And the
science of medicine itself is but a fragment of the
far greater science which has for its subject the
physical well-being of manliind.
It is the imperative duty of all physicians to
so prepare for the work of their chosen calling,
and so faithfully to prosecute that work with
unbiased judgment, that they will be able to see
and grasp the truth ; for truth, like the rising
sun, is first perceived by those whose minds soar
above the intellectual horizon of their day, but,
sooner or later, its life-giving influence is felt by
all mankind, by all alike. If we each do the
best that in us lies, if each is but true to himself,
" It will follow, as the night the day,
We cannot then be false to any man."
With such a record, while we sojourn in thia
island of time, it will be well with us when we
reach the mainland of eternity.
ORIGINAL ARTICLES.
THE BBMEDIES FOB STrB-HrVOLXTTION OF
THE UTEBUS.
By E. M. hale , M.D.
CHICAGO.
[Read before the Bareau of Obetetrici at the meeting of the Illi-
nois State U moeopathic Medical Society. May 16tb, 1888.]
BY sub-involution of the uterus I mean that
condition first described by Dr. Simpson as
obtaining after labor, which consists in a
failure on the part of the muscular structure of
that organ to contract, in a proper time, to its
normal size. I also mean that similar condi-
tion, recently described by Dr. Mary Putnam
Jacobi, as occurring after each menstruation,
which, she alleges, is the chief cause of chronic
uterine disorders. The two principal patholog-
ical conditions in such cases are (a) an atonic or
paretic condition of the uterine muscular tissues,
and (fc) a similar condition of the coats of the
uterine blood vessels. The two conditions are
not always present at the same time. The one
may exist without the other. This must be
remembered when selecting remedies.
The chief medicines for sub-involution of the
uterus, so far as my investigations go, are
Secale comutum, Ustilagomaidis, Phoradendron,
Hydrastis Canadensis, Caulophyllum, Sabina,
Thuya, Gossypium, Cinnamon and Hamamelis.
Secale (Ergot) undoubtedly heads the list.
Its action on the uterus is well known. It
causes a continuous contraction of the muscular
fibres of the parenchyma of the uterus, and also
the muscular coats of its blood vessels. If a
large dose is given soon after labor, the uterus
firmly contracts and the contraction is painful.
If clots are present in the uterus, they are
expelled as a rule, but this rule is subject to
exceptions. The most recent axiom of obstet-
rics is "Never give Ergot when there is any-
thing in the uterus, " i. e., wholly within its
cavity. Why ? Because the contraction includes
those of the cervix as well as the body, and any
foreign body is more likely to be retained than
expelled. But if a clot, placenta or foetus is
partly in and partly out, extruding, then Ergot
will expel it. This is an important fact to bear-
in mind.
Some interesting experiments have lately
been made by Drs. Fowler and Heman, of Lon-
don, relating to the influence of Ergot in involu-
tions of the uterus after labor. Sixty-eight
patients were given a single dose of Ergot after
labor (thirty drops fl. ext.). Fifty-eight were
given nfteen drops three times a day for four-
teen days after labor. They found that in the
cases treated by the continued administration of
Ergot, the uterus diminished in size more
rapidly than in those in which one dose only
was given. No perceptible diminution in the
amount of lochia was observed.
Dr. Bexall reported one hundred patients
treated by Ergot. He reports that the routine
use of Ergot (fifteen drops three times a day for
three days) makes no difference in the time
at which the lochia cease, but that it tends
to prevent the formation of clots, hastens
their expulsion, and diminishes the frequency,
duration and intensity of the after-pains. Dr.
Dahin reported a series of careful experiments,
but they did not present as good a showing for
Ergot. Out of one hundred and three cases
where only one dose of Ergot was given directly
after labor, sixty-four had after-pains and four-
teen passed clots. When Ergot was given for
three days, fifty-one cases out of ninety had
after-pains, and twenty-two passed clots ; so
that these cases had fewer after-pains but passed
more clots. The first series of cases passed
clots up to the tenth day; the second series
passed no clots after the sixth day.
It seems that the continuous use of Ergot, by
JUMB, 1888.1
ORIGINAL ARTICLES.
171
keeping up a chronic state of contraction, instead
of allowing normal alternate contraction and
relaxation, would tend to favor retention of
clots, and prevent the normal process of involu-
tion. In discussing this report, Br. Heman said
that Dr. Fowler*s better results were due to the
fact that he kept up the use of Ergot for four-
teen days, instead of three. There may be
some benefit from the continuous use of Ergot
for the longer period. But I imagine we should
select our cases. In primiparsB the use of
Ergot for three days would do better than multi-
parsB, for after first labors there are no after-
pains, and the uterus normally contracts covJtxa"
woudy, while in multipara the contractions are
intermittent.
In the latter, the use of some other remedy,
Caulophyllum or Phoradendron, would be more
scientific. This has been my experience, and I
am surprised that no mention is made of this
fact by the above experimenters. Healthy pri-
miparsB rarely suffer from sub-involution. They
only get it when they have had some uterine disor-
der for years before their confinement. In post-
menstrual sub-involution I consider it very
valuable, but it must be indicated by its physio-
logical action. The cases which call for Ergot
are those in which the menses are too profuse
and too frequent, or regular, but too long lasting.
The menorrhagia is ke,.t up by a paresis of the
muscular structures of the uterus, but the uterus
is not as a whole engorged ; on the contrary, it
is pale and flabby, soft and enlarged. In these
cases the Ergot should be commenced on the
fifth day of the flow and used for a week in doses
of five to ten drops of the fluid extract or " nor-
mal liquid." In these cases we require a con-
tinuous contraction. If the whole uterus is
congested I prefer Sabina or Hamamelis, if it
is venous, and Cinnamon or Hydrastis, if it is
arterial. If the menses are scanty and pale,
Conium or Graphitis are better indicated.
Ustilago maidiSf "corn-sweet," while possess-
ing general properties similar to "rye-sweet,"
or Secale, differs in one important respect. Its
action on the spinal cord, vascular system, and
skin, is essentially the same as Secale, but its
action on the uterus is not. Ustilago causes
regidar intermittent contractions of the uterus, in-
stead of the continvom contraction characteristic
of Ergot. A large amount of testimony in sup-
port of this assertion has been reported from all
schools of practice. Were it not for this we
might well doubt if there was such a difference
in the two Ergots. Ustilago, then, will be in-
dicated just where Secale is not; namely, in
multipara, where we do not desire to cause tonic
contraction of the uterus after labor, and where
we wish to indicate closely nature's processes.
Those who have used it in obstetric practice pre-
fer it to Ergot, for it does not cause hour-glass
contraction or endanger the life of the child
when given just before the completion of labor ;
nor does it leave the uterus in a relaxed condi-
tion with a tendency to hemorrhage. In most
cases of sub-involution, especially in multiparaB
or women with very profuse and frequent men-
struation, it is superior to Ergot. It resembles
Caulophyllum in this one characteristic of reg-
ular intermittent uterine contractions. I usually
give a full dose, half a dram of a good fluid
extract, just as the head is escaping from the
vagina. It acts in thirty or thirty-five minutes
very uniformly, and expels the placenta in
due time. When I desire to prevent sub-involu-
tion, fifteen drops are prescribed four times a
day for a week or ten days after confinement. I
have never carefully noted the effect of this
treatment on the duration of the lochia, but I
have observed that it was less in quantity and
freer from clots than in cases where no medicine
was given. Some physicians have reported
that Ustilago failed as an oxytoxic in their
hands. This was probably owing to the prep-
aration used. A simple alcoholic tincture . does
not represent the whole power of the drug;
a fluid extract is better. If the fungus is col-
lected just as the spores are ripe, and used in a
dry state, the results will be good. If the ripe
spores are triturated with sugar-of-milk, the first
decimal trituration will be active, but it must be
kept dry and closely corked. Of this prepara-
tion twenty to forty grains at a dose is sufficient
in cases of sub-involution or menorrhagia.
Phoradendron is the name given by botanists
to the American Mistletoe. It is nearly identi-
cal with the BioGum Album or English Mistletoe.
The latter has long been used in England and
on the Continent by midwives and veterinary
surgeons for retention of the placenta and uter-
ine hemorrhage. It has recently been taken
up by regular physicians, especially in Germany,
and used as an accelerator of labor, in uterine
hemorrhage, and menorrhagia. In the South-
em states the Mistletoe has a medical history
of similar uses. Dr. Long, of Louisville, Ken-
tucky, was the first to bring it into regular prac-
tice. A notice of its uses in labor will be found
in the last edition of my " New Remedies." Since
that time there has appeared in all schools
some considerable clinical experience which
goes to show that it acts in a manner similar to
172
THE MEDICAL ERA.
[Vox^VL Ho. e.
Ustilago and Gossypium. All observers agree
that when given in labor for deficient or absent
pains, it causes intermitting uterine contrac-
tions simulating the normal ; that in retention
of the placenta it aids in expelling it ; that in
undue hemorrhage or profuse lochia, it restrains
it. I do not know of any record of its use in
preventing sub-involution. My own unpublished
experience is limited to two cases. One, of a
case of miscarriage, at the fourth month, in a
multipara. Her uterus was very large and flab-
by. After removing the contents, there con-
tinued to be considerable hemorrhage of a pas-
sive nature. The cavity of the uterus measured
four and a half inches five days after. Under
the use of Phoradendron in ten drop doses
every four hours for two weeks, the uterus meas-
ured three inches and all discharge had ceased.
The other case was a woman after her sixth
confinement. A week after confinement the
uterus was readily felt, reaching half way to the
umbilicus. It felt heavy and was very open,
with a profuse bloody, mucous discharge. Sa-
bina and Ergot had seemed inefficient. After
two weeks use of the Mistletoe, fifteen drops every
four hours', the uterus was reduced to nearly its
normal size and all discharge had ceased.
( To be Concluded. )
OBSTETBICAL EMEBGENCIES.
By a. a. WraPPLE, M.D.
QUINCT, ILL.
[Read before the Illinois State Homoeopathic Medical Association.]
IN obstetrical practice emergencies frequently
arise calling for prompt and intelligent action.
Complications often occur, endangering the
life of both mother and child, which can easily
be averted or overcome by a skillful accoucheur.
In the hands of an incompetent physician or
average midwife, such cases oft^n terminate
fatally to the child, and too often the mother's life
is in peril, or lost by incompetent midwifery.
Many times I have been called to assist at
the eleventh hour, delivering a dead baby with
forceps which could easily have been saved by
their timely application.
Soon after crossing the threshold of profes-
sional life, it was my pleasure to go eight or ten
miles, one cold, dark night, over Western New
York hills, to aid a woman in her thirteenth con-
finement.
The twelve preceding ones had been normal.
On this occasion she had been in labor seventy-
two hours, attended by three midwives, before a
physician was summoned.
On arriving at the house I found the lady
worn out with the protracted labor, and appar-
ently bloodless, having had profuse hemorrhage
during the first stage on account of a partial
placenta prsevia. On examination I found pre-
senting a hand, and a prolapsed and pulseless
cord.
It had originally been a shoulder presentation,
right cephalo-iliac anterior position.
The child was dead, the mother exhausted.
It was not a pleasant condition of things to
confront a young physician, with no professional
aid at hand, and a stranger in the community.
I endeavored to bring down the feet, but
at first failed. I then gave chloroform and suc-
ceeded.
The lady made a good recovery.
Post partum hemorrhage. This will not very
often become an emergency if the third stage of
labor has been properly managed.
I once listened an hour to a lecture on this
subject. The learned professor expatiated upon
the causes, symptoms, classifications and various
degrees of hemorrhage, the diagnosis, prognosis
and treatment, yet the most practical and use-
ful of all the means at hand, the one most likely
to be prompt and effectual in such an emergency,
was omitted, or so thoroughly obscured by the
profundity of therapeutic means, that the stu-
dent, who had, as yet, no experience of his own,
would fail to comprehend it.
Suppose you are attending a lady in confine-
ment. The child is bom, the placenta removed,
the mother resting comfortably, and you step
into the next room to wrap the cord in cotton
before the nurse puts on the bandage. Some
one calls to you that Mrs. B is fainting.
You step to the bedside and find her uncon-
scious, face pallid, depression of pulse, abdomen
wonderfully distended and an appalling flow of
blood, saturating the bed and deluging floor.
In this emergency what shall we do ? Will you
apply that remedy which is homoeopathic to the
totality of the symptoms in the case ? Will you
give Ergot or brandy in unsparing doses ? Will
you use cold or hot water injections, or pieces of
ice in the vagina ? Will you inject hot water
into the uterus? It has been said "there is
little or no danger connected with the operation,
and it has been found a most efficient means for
controlling uterine hemorrhage."
Possibly you will think best to suppress the
supply of blood to the pelvic viscera by compress-
ing the abdominal aorta, or ligating the thighs.
r
Jnm, IMS.]
ORIGINAL ARTICLES.
173
The above, and many other medicines and
measures are recommended.
If you hesitate the woman \irill die. What
will you do ?
Grasp her distended abdomen with your hand and
squeeze it.
Knead the uterine fundus untU it contracts.
The indications are to induce contractions of
the uterus, by which alone we expect to sup-
press the hemorrhage. The hand is the indi-
cated remedy, and covers the totality of the
symptoms in this particular case.
Puerperal eclampsia constitutes an emergency
which the physician may at any moment be
called to meet, and demands from him entire
self control and presence of mind. In these
alarming conditions homoeopathic remedies prop-
erly selected and administered, are far better
than the large doses, the debilitating or stupefy-
ing means used by physicians of the old school.
I am sorry to say that many homoeopaths do not
seem to believe this.
As I am writing this r journal comes, contain-
ing the report of acase of eclampsia, treated by
a member of this association, and a teacher in
a homoeopathic college, with one-fourth grain
doses of Morphia by hypodermic injection in
alternation with ninety-grain doses of Chloral
hydrate, pumped into the rectum (and by the way,
that shows how necessary it is to have pockets
in the rectum), and, mirabUe-dictu ! the patient
recovered.
People never die because they are not given
medicine enough, but often for want of the right
kind.
If, after the administration of a well-selected
remedy, convulsion should not be relieved, and the
patient is past the seventh month, induce arti-
ficial delivery as soon as possible.
Not long ago I was called to see a woman '< in
fits." She was in convulsion as I entered the
room. Paroxysms recurred every thirty or
forty minutes sin-je early morning, now seven
o'clock in the evening.
A physician had been in attendance all day,
bat had not learned that the woman was preg-
nant.
She had been married eight months, and
menstruated regularly. I saw as I entered the
room she was dropsical. My first impression
was, pregnancy with albuminuria.
On examination I found her about seven
months along, with no signs of commencing labor.
I administered a remedy which was seemingly
indicated, but without waiting to know its action,
proceeded to induce artificial labor, delivering a
very small but living child at nine o'clock in the
evening. There were but two paroxysms after I
saw her, one while making the first examination,
the other one hour after delivery.
STRONG M0THEB8 WITH WEAK CHILDREN
vs. WEAK MOTHERS WITH STRONG
CHILDREN.
Br C. A. WEIRICK, M.D.,
MARBKILLKSf ILL.
[Read before the Illinoie State Homoeopathic Medical ABSOclation.]
SOMETIMES there are expressions, common
to many people, that are founded on facts,
which, if recognized^ would prove of great
value to science, and more especially is this true
in the science of medicine.
The substance of two of these common say-
ings, heard from two classes of nursing mothers,
is, first, "I do not understand how my baby is
so well and plump, while I feel so poorly;" and,
second, ** I do not understand why my baby is
peevish and sickly, when I not only feel well, but
am well and strong." The fact is, the mother
of the first class converts so much of the food
she takes into nutritious milk that the baby is
plump and the mother lean ; that is, the latter
becomes a mere machine for manufacturing food
into milk, and, therefore, not appropriating
nourishment to her own use, becomes feeble.
In the second class the reverse is true, viz..
The mother absorbs to her own bodily use the
nutritive elements of food, and hence the baby
is deprived of a proper supply of nourishment.
There are several practical deductions that I
have drawn from this observation, to one or two
of which I wish to call attention.
First, that this tendency to supply an undue
amount of nourishment to the child may exist,
not only during lactation, but also during preg-
nancy, and, as a result, the mother becomes so
prostrated as either to endanger her life or pro-
duce premature delivery,
I will give briefly, from memory, the history
of three cases of mothers under middle age,
showing this condition.
Case one. Pregnant four times. During first
pregnancy she was languid, pale and emaciated,
with a fair appetite. The child was bom after
a short, easy labor, at the beginning of the ninth
month. The mother suffered so much front ex-
haustion that she was unable to sit up for four
weeks, and the child was weaned. There was
extreme exhaustion during second and third
pregnancies ; the former terminated at the end
174
THE MEDICAL ERA.
(Vol. VI. Ko. «.
of the sixth month in the birth of a child which
hved two days ; the latter, in abortion in three
months. The symptoms of prostration began
so early in the fourth that I feared a repetition
of the unfavorable results of previous pregnan-
cies. Thinking of strong babies and weak
mothers, and believing that the same condition
could exist before delivery, practical application
was made of the thought, by using means to
strengthen the mother. The results were that
the baby was born at full term, and the mother
felt so well that she wanted to sit up in three
days.
Second case. Was pregnant four times. I
know nothing of the history of the first one.
The mother, during second and third pregnan-
cies, was languid and troubled with excessive
nausea, and was delivered, both times, at six
months, of children well developed at that stage.
The same symptoms that occurred in previous
condition were early manifested in fourth preg-
nancy, and suggested a similar termination.
The same object was sought and obtained as in
case one. The excessive nausea and languor
were relieved, and the case went to fuU term
with a quick and pleasant recovery from labor.
Case three. During latter half of first preg-
nancy she was weak, had heart-burn, sore
mouth, nausea and frequent sensations of faint-
ness. The child, which was large and plump,
was bom about two weeks before expected time.
Mother felt poorly during lactation, but the child
was strong and active. The symptoms of the
second pregnancy were similar to those of the
first, except that they began earlier and were
more severe. Labor, as before, came earlier
than was expected. The symptoms of prostra-
tion in third pregnancy began earlier than in
second. At the end of second month her face
was pale, cheeks hollow, mouth sore, severe
heart-bum, pulse very rapid, and while away
from home, after slight exertion, she fainted, re-
maining unconscious nearly half an hour, not-
withstanding the efforts of a physician and her
friends to revive her. The prostration was
earlier and greater in the second than in the
first pregnancy, and so much earlier and more
pronounced in third than second, that I believed
something ought to be done to relieve her, or
the termination of the case might be serious.
In previous similar, though less severe condi-
tions, I was not skillful enough to reheve her ;
but believing now that if some means could be
found that would enable her to appropriate
some of the food taken to her own bodily use
she might be relieved, I adopted this plan. She
soon regained strength, felt well, gained flesh,
muscles became firm and elastic, appetite good,
food retained, the anxious, tired, sick expression
of face gave way to one of cheerfulness and
health. Instead of labor beginning, as in pre-
vious pregnancies, before the expected time, this
one occurred about two weeks later.
It also seems to me by reason of this fact that
when the mother is constantly strong and well
during lactation, but the baby, during the same
period, is as steadily iU, it is right, in carefully
selected cases, to wean the child. I have seen
children with such mothers, suffering in hot
summer weather from lack of nutrition and fre-
quently recurring attacks of gastro-enteric irri-
tation, rapidly recover after weaning. The
mother, in such cases, evidently appropriated so
much of the ingesta to herself, that the mUk
was deficient in the elements necessary to keep
the chUd up to a healthy standard. Harmful
food should not be fed to a child, even if it be
mother's milk.
V.
HAY EEVBB;
BHINITIS VASO-MOTOBIA PEBIODICA.
By B. LIPPINCOTT, M.D.
memphis, trkn.
Therapeutic Indications.
Nsiphthalin. — Dr. Von Grauvogl discovered
by provings on the healthy, and confirmed by
clinical experiments, the use of this remedy in
emphysema pulmonum. He claims that " the
violent asthmatic attacks are ameliorated im-
mediately, and soon disappear entirely." He
gives it two or three times a day, and not often-
er than every two hours. He recommends that
"the administration should be interrupted oc-
casionally, for eight days, but as soon as the
improvement ceases, or a return occurs, the
Maphthalin must be taken as before." He also
claims that '' beneficial results arise not only in
the usual chronic emphysema, with bronchial
catarrh, which exists in the lungs of buglers, but
also in the emphysema, in consequence of the
so-called bronchial asthma, without bronchial
catarrh, which arises from abnormal innervation
of the vagus."
This remedy is applicable to more cases of
hay fever, and to more forms of it, and better
results are obtained from its use in all stages,
than from any other drug. As a prophylac-
tic, a dose of the 2x, or 3x trituration, either in
Jnirs, I8SS.]
ORIGINAL ARTICLES.
175
powder or tablet, if given three times a day, will,
in many — though not in all — instances, give
immunity from an attack. It is in those cases
in which previous attacks have been slight, that
it will prevent an onset of the disease. In rose-
cold I have never given any other remedy, and
have cured every case, though the number is
not great.
On May 6th, 1885, I received the following
note from Mrs. C — : "I am in torture with
rose fever ; great irritation of the lining mem-
brane of nostrils and lips, with constant run-
ning of water from the nose, with feeling of
having inhaled pepper. Constant sneezing.
Eyes inflamed and painful. Entire head hot
and inclined to ache« Send something to re-
lieve me." I prescribed Naphthalin, 2x trit.,
every hour. On May 8th, the patient called at
my office for more medicine, and wanted to know
what that medicine was that gave her so much
relief. She said she had had rose fever every
year for twelve years, and had been treated by a
number of physicians with buthttle relief at any
time, until she had taken treatment from me.
On May 11th she caUed again. She said she
was cured, but, as she was going out of the city,
she wanted another prescription of the same
medicine to take with her to use in case of a re-
turn. On May 29th she called at my office
again ; she had had no return of the disease.
( Reported in Anverican Homoeopathist, Vol. II,
Dec. 1885, page 354.)
I had not seen'this patient again, until March
1888, when I learned there had been no recur-
rence of the attacks.
I first prescribed this medicine in 1879, in a
case of hay fever which I had failed to relieve
with other medicines. The Ix trit. was given
every four hours. Four powders cured, -and gave
immunity from its recurrence. In 1880, six
powders gave a like result. In 1881, there was
no attack. In 1882, the patient changed his oc-
cupation, which required constant traveling. He
had a recurrence of the disease. The same
medicine, 2x trit., cured in a few days and there
has been no recurrence since.
In the June issue of the U. S. Medical Investi-
gator, Vol. XXI., 1885, page 299, 1 introduced to
the profession the use of this medicine in hay
fever, and related the coincidence that led to its
use. Since that time, I have had the gratifica-
tion of having many physicians bear testimony
to its successful use.
In the following August issue of the same
journal. Dr. W. C. D , Oakfield, Wis., in
relating his ''experience with Naphthalin, " says :
"I have a case of hay fever here in which Naph-
thalin, 2x trit., did a splendid thing. A lady
who has been troubled for the last eight years,
had found no relief. I gave her five powders and
she reported herself cured, something different
than she is used to, as she now sleeps all night
and feels splendid. ''
In the following October issue, Dr. W. Wad-
dell, Wauseon, Ohio, reports fine results from
the use of Naphthalin 2x trit., in hay fever, giv-
ing five two-grain powders, which cured every
case, where he had tried other remedies and
failed.
In the December issue. Dr. 0. P. Barden, Tio-
ga, Penn., says : ** Dr. B. F. Grant, of Bath, New
York, who was a sufferer from hay fever, received
prompt relief from Naphthalin Ix or 3x trit. "
In the October issue of the SoutJiern Journal
of Honuwpathy, Vol. V., 1885, page 87, 1 reported
the cure of a case of acute catarrh with Naph-
thalin when other remedies had failed.
Next in order was the testimony of the vener-
able Dr. A. E. Small, in his '* Systematic Treatise
on ilie Practice of Medicine^ '* 1886, page 775, in
the following words :
" Naphthalin in hay fever. We have had
some delightful experience in the use of this
remedy in hay asthma the present season ; sev-
eral cases were relieved or cured in the course
of one week, with the 2x trit. "
Besides these, others have testified to its ef&ca-
cy ^y personal letters, chnical cullings, and
through the journals, but the best testimony of
all comes from Dr. F. F. Laird, Utica, New
York, in an article on ** Naphthalin, ** read be-
fore the Homoeopathic Medical Society of the
State of New York, Feb. 15th, 1888, and pub-
lished in the North American Journal of Ilomcd-
opathy, March, 1888. The portion of it under
''Respiratory Organs," relating to hay fever, I
herewith copy :
1. ''Hay Fever, — For this obstinate malady
it is facile princeps. Dr. Small and many others
in the homoeopathic ranks have here testified to
its wonderful efficacy. * It almost never fails, *
is an assertion to which the writer can truth-
fully and emphatically add his verdict. While
it seems to benefit all cases of this strange neuro-
sis, (?) it is especially adapted to patients who
experience more or less asthmatic symptoms. I
may safely say that Naphthalin isto " hay asthma **
what Aconite is to synochial fever, as near a specific
as anything in medicine can be,
''During this summer and fall I have treated
eighteen cases of hay fever with this di*ug alone,
176
THE MEDICAL ERA.
[Vol, VI. No. ft.
and with the most satisfactory results. Two
cases deserve to be quoted as exhibiting the typi-
cal patient.
*'Ca8e i. — E. L., aged 46, nervo-bilious tem-
perament, has suffered for nineteen years with
hay fever, which put in an appearance regularly
on the 14:th of August. It began with dull fron-
tal headache and sense of malaise, followed in
from 24 to 48 hours by fluent coryza, excessive
sneezing, injection of conjunctivae and most un-
bearable itchixig of the eyelids. During the first
week this condition gradually increased until
the nose, eyelids, and, in fact, the whole face,
became so swollen as to resemble the counte-
nance of Sullivan's antagonist after a prize fight.
During the second week, the inevitable asthma
added to his misery. Night after night he suf-
fered from as ^intense dyspnoea as I ever wit-
nessed, the lips and even the finger nails becom-
ing blue ; while all through the day his wheezing
breathing could be easily heard in an adjoining
room. Ipecac, Arsenicum, Kali iod., Sabadilla,
Aralia, were all faithfully tried, together With
many other remedies of less note. Hypodermic
injections of Morphia and Atropia gave him his
ordy relief in the paroxysms of asthma. A trip
to the White Mountains put an end to the trouble
for 1886. During last winter my attention was
first called to Naphthalin, and immediately the
above case came to my mind as most appro-
priate for its use. On August Ist of this year I
began giving one tablet of the 2x trituration three
times a day, to test its powers as a prophylac-
tic. August 14th passed without any sign of
hay fever far the first time in nineteen years. I
seem to hear the skeptic suggest that ' He
wouldn't have had it any way ! * So the patient
began to think. He therefore stopped using the
drug for a week, and on came his hay fever. On
resuming the remedy the symptoms at once
subsided.
" This fact illustrates a point which I wish to
thoroughly impress upon your minds, namely,
the necessity of continuing tlie use of the drug diiring
the whole time that the disease generally lasts. Like
quinine in malaria it prevents its manifestations
tuithaut stamping out its cause.
** Case 2. — F. W. T., clergyman, at about 50,
lymphatic temperament, a victim to hay asthma
for 14 years, was frequently compelled to give
up his pastorate for several weeks and seek the
mountains for relief. This year he came to me
in June to know if anything could be done in
the way of prevention, his old enemy having
just commenced operations. He had but recent-
ly moved to the city in the hope of avoiding this
pest. Naphthalin 2x was administered, and m
twenty-four Iwurs he was perfectly free from his
trouble, and has so continued up to the present zmt-
ing.
'*In cases presenting marked tumefaction of eye-
lids and nose, ivith very excoriating lachrymation and
coryza, Naphthalin cerate locally is a valuable
adjunct to the treatment ; while in marked ir-
ritability of the throat and in the asthma, the
application of a two per cent spray will be found
very useful. "
I have also learned that to get beneficial re-
sults from the use of Naphthalin, .it must be
continued at longer or shorter intervals during
the hay fever season, and its use continued there-
after in many cases, for the purpose of removing
the chronic rhinitis, which it has done for me in
a few instances. I do not think that, " Like
Quinine in malaria, it prevents its manifestations
without stamping out its cause, " but, that it
frequently stamps out the cause. If it does not
do so entirely while taken during the hay fever
season — for the exciting cause is present, ever
ready to renew the attack — it will accomplish
the desired purpose in some cases by its contin-
ued use thereafter, when it should be given in a
higher attenuation.
From the clinical use of Naphthalin I am led
to believe it to be a left-sided remedy, and its
action more pronounced in the left than in the
right lung. In Naphthalin, we have a sovereign
remedy in emphysema, asthma, hay asthma,
hay fever, acute and possibly chronic catarrh,
and I believe in chronic rhinitis. It should be
well proved. We should not forget that true
hypertrophy and other organic changes and an-
atomical peculiarities preclude the possibility of
a cure by internal medication until these are
corrected by operative procedures.
Illinois took the initiative, in providing a law
governing the practi&e of medicine, which has
had a beneficial and far-reaching effect. Min-
nesota bids fair to out-rival the example set by
her sister state. The Minneapolis Homoeo-
pathic College has gone out of existence. With it,
also, have dissapeared the Minnesota Hospital
College, and the St. Paul Medical College. Here-
after all medical teaching will be done in the
department of Medicine and Surgery of the Min-
nesota State University, which is made up of a
College of Medicine and Surgery, a College of
Homoeopathic Medicine and Surgery, and a Col-
lege of Dentistry.
JUBB, lg8B.l
SOCIETY REPORTS.
177
SOCIETY REPORTS.
ILLINOIS STATE HOK(EOPATHIO MEDIO AL
ASSOOIATION.
THIRTY-THIRD ANNUAL MEETING,
Hdd at Central Mmic HaU, Chicago , lU., May
15, 16 it 17, 1888.
TUESDAY, MAY 15tH. FIB8T DAY.
The meeting was called to order, President
Kinyon, M.D., of Bock Island, in the chair, who
said:
Gentlemen of The Illinois Homoeopathic Med-
ical Association, we will now begin our thirty-
third annual session. The meeting will be
opened with prayer by the Rev. Dr. Patton.
The Rev. Dr. Patton offered the following
prayer :
" Almighty God, our Heavenly Father, we look
to Thee with profound gratitude, thanking Thee
that Thou art the author of our being ; thanking
Thee that Thou hast made us, as Thou hast, with
such iniinite possibilities in our nature; but we re-
member that our immortal nature is not only a
gift of God, but also our physical nature. We
thank Thee that we are living in these days when
it is impossible for the moral principle in man to
have proper scope and development without com-
ing forward with the physical groundwork of our
being. We bless Thee that in all the divine call-
ings which came to man, one of the highest and
holiest is that which takes care of the physical na-
tora We pray that Thy blessings may rest to-day
on this convention of physicians and surgeons who
have come together to discuss grave questions per-
taining to the nature of man. We pray Thee that
they themselves may be conscious of their high
calling and that they may realize the glory and
dignity of this broad and deepening profession
which is covering the earth with its knowledge and
culture. We pray Thee that this convention may
be blessed with Thy presence and that the delib-
erations of this day may result in enlarging the
bounds of truth, and in stimulating deeper re-
searches in the great questions of physical life.
We ask Thee to (fc guide that we may be earnest
in our deliberations after truth and be conscious
that God labors with those who labor and seek
after His truths. We ask this in the name of
Jesus Christ, our Lord. Amen. "
Dr. L. Pratt, of Wheaton, moved that the
President postpone his address until eleven
o'clock, Wednesday morning.
The motion was seconded by Dr. H. P. Skiles,
of Chicago, and carried.
The appointment of an auditing committee
being next in order, the President appointed as
such committee Dr. H. P. Skiles, of Chicago, Dr.
M. J. Hill, of Sterling, and Dr. J. B. Dunham,
of Winona.
The President appointed as a committee on
the President's address, Dr. L. C. Grosvenor, of
Chicago, Dr. F. W. Gordon, of Sterling, and
Dr. M. C. Sturtevant, of Morris.
MISCELLANEOUS BUSINESS.
Dr. Charles Gatchell, of Chicago, moved that
the President appoint a committee of three on
resolutions, to whom should be referred all res-
olutions coming before the meeting.
The motion being duly seconded, was carried.
The President appointed as such committee
Dr. Charles Gatchell, of Chicago, Dr. G. P.
Shears, of Chicago, and Dr. M. J. Hill, of
Sterling.
Dr. G. F. Shears, of Chicago, oflFered the fol-
lowing resolution : '' Resolved that each bureau
be called at the time indicated upon the printed
programme, and that no other bureau shall oc-
cupy the time of the bureau called, unless that
bureau has completed its business." •
The resolution being duly seconded, was re-
ferred to committee on resolutions.
The chairman of committee on resolutions
reported that the committee had given the reso-
lution careful consideration, and recommended
that it be adopted by the association.
BUREAU OF OBSTETRICS.
Dr. L. C. Grosvenor, chairman, read to the
society a paper by Dr. C. A. Weirick, of Mar-
seilles, entitled :
" Strong Mothers with Weak Children, vs..
Weak Mothers with Strong Children."
Dr. A. A. Whipple, of Quincy, read a paper
entitled " Obstetrical Emergencies."
Dr. L. C. Grosvenor, of Chicago, spoke on the
subject of Infant Hygiene. His remarks were
so replete with object illustrations that it is im-
possible to reproduce them on paper.
The President announced that the papers read
before the society were now open for discussion.
Dr. Adam Miller: — Mr. President: I have
listened with great attention to all these papers,
and to remarks of Dr. Grosvenor, and they con-
tain material of more importance than young
doctors would give them, perhaps, by a careless
listening. It is striking at a point that will re-
178
THE MEDICAL ERA.
[Vol. VI. No. 6L
suit in more good to the mother and the child
than those who have had no experience in these
matters can have any possible conception of.
If we expect to see mothers and children hap-
py and healthy, a great deal of attention must
be paid to the matter of lactation. A great
many mothers, for want of proper diet and for
want of proper attention on the part of the phy-
sician, will throw themselves into a state of ner-
vous excitement that will injure the child, and
the mother's milk will become unhealthy.
Dr. Gatchell: — Mr. President : Bob IngersoU
has said that the education of the child should
begin a hundred years before it is bom. I think
we may well apply that to its education in other
respects — its constitution and physical being.
In this connection I think the central idea in
Dr. Weirick's paper is one that will bear discus-
sion, and that is, the suggestion that the well-
being of the child should be considered while it
is yet in the womb.
In the next paper. Dr. Whipple made one
point in an epigrammatic manner, to the effect
that the indicated remedy in post partum hem-
orrhage, is the human hand. I would beg leave
to suggest the addition of another hand, and
say, two human hands. There should be not
only the left hand on the abdomen and over
the uterus, but also the other hand in the uterus,
to turn out the clot, and the instructions would
be complete.
Dr. Wm. J. Hawkes : — Mr. President : I want
to say one word in endorsement of the state-
ment expressed by the paper, and by Dr. Miller,
and that is in regard to the paramount impor-
tance of letting the pregnant woman have her
own way. A woman under the circumstances
should receive special care and attention, not
only for her own sake, but especially for the
baby's sake.
A mother can make a child's disposition just
as she will. She can make its health ( barring
heredity ), what she will, by being happy herself.
That woman should be furnished with what she
wants; she should come and go just as she
chooses. There is no one thing that will so ben-
efit the child as that the pregnant woman should
have her own way in that particular. I have
seen instances in families so markedly proving
the truth that, theoretically, it does not need to
be sustained. It is one we all notice so often,
that the first children are comparatively feeble,
some cranky, some cross, and some irritable,
and the later children, having the same parents,
will be happy, healthy and good, while the first
is bad. It is simply because after marriage the"
comers are being knocked off. Nobody marries
his ideal. Nobody's ideal ever comes up in
reality, and consequently during the first year of
married life the husband and wife are becoming
acquainted with each other; they are getting
used to one another's tempers ; they are getting
accustomed to disappointment that inevitably
comes, which is a result of importance to the
child. I have known so many families where
this is the case, where the first child was as ugly
as possible and the next or other children be of
as good disposition as you would want, and all
owing, I think, to that one fact. I agree with
Dr. Whipple most emphatically in regard to the
homoeopathic remedy of the human hand being
the proper one.
Dr. H. P. Holmes, of Sycamore : — Mr. Pres-
ident : I would like to say a word in favor of
Dr. Grosvenor's baby-suits. I first met Dr.
Grosvenor at our American Institute at Sara-
toga, two years ago, and I can say that he ha«
been the means of giving me a great deal of
practice. At the time I met him I was getting
rather discouraged, rather disgusted over my
obstetrical practice, and looked upon it as tedi-
ous ; but when I saw his baby-suits and heard
his talk before the American Institute, I became
filled with new ideas. The Doctor very kindly
gave me a set of patterns, and being about that
time in need of those things, we commenced
using them in our own family; and I com-
menced putting them among our families at
Sycamore, and it was perfectly astonishing to
see the enthusiasm that the prospective mothers
have over them to-day. In the ordinary family,
where they have baby clothes all made, I would
see them discard them almost at once and make
new ones. In fact, I have had several lectures
from prospective fathers as to incurring the ex-
pense of getting up the new suits. I was a little
surprised to see the way the gentlemen and some
of the ladies handled the clothes here as they
were exhibited to them, and it i8 that very same
spirit which is governing our mothers, and which
has governed our grandmothers. When they
were handed to them they ^ould hand them
right on to the next without looking at them.
Now any one can take these suits and put their
hands right in the sleeves there, and you will
find what a delicate little mouse nest the baby
has to he in, and you can take those suits and
put them on the baby in just about a minute,
which saves the young mother the work of using
pins and bandages. You take one of Dr. Grosve-
nor's baby-suits and simply tie the string
JiniB,1888.]
SOCIETY REPORTS.
179
around the neck and it is all done. Another
thing that the Doctor left out, and I wish to say
that young doctors, those who wish to make a
reputation, should pay particular attention
to this, and that is, the baby's oil bath. I will
guarantee to take any baby from the time it
is bom and in fifteen minutes have it washed
and dressed. The young doctors should them-
selves dress the baby ; it is no trouble at all,
and you will lose nothing by it. While you are
watching the mother, after the birth, watching
for the post parfcum hemorrhage, you can dress
the baby, and it is always done right there.
Don't trust it to the nurse, but do it yourself,
and you will have a reputation in that family by
that more than any one thing you could do. I
am very thankful to the Doctor for the good he
has done me. Take these patterns with you
whenever you are engaged for a confinement,
and give the mother the same lecture and it will
pay. They will always be thankful for it.
Dr. J. B. Dunham, of Winona: — Mr. Presi-
dent: I had occasion to meet Dr. Grosvenor
two or three years ago, when he kindly gave me
a lecture on baby suits, and I took a set of pat-
terns home, not having any use for them myself,
being a widower ; but I found others who had,
and I introduced them into the families, and
took the trouble and went to the expense of re-
printing a little pamphlet which he kindly gave
me, written more expressly for mothers, and
handed that around ; and I must say that for
real, genuine comfort those little baby suits gave
me more satisfaction in obstetrical practice than
anything that I have ever had to do in that
way. Regarding the bandage, I have had two
patients in the last three months of infantile
hernia occurring in little boys, that was directly
traceable to an improper bandage. The first
thing I did upon being called — they were then
still bandaging him — was to remove the band-
age at once in both cases, and had the mother
apply, as best she could, each time a bandage of
cotton, and those children are both improving
and promise to recover. The first thing we did
in endeavoring to cure them was to remove the
bandage, and I am satisfied that in those cases
that was the direct cause of the trouble.
Mrs. Dr. A. A. Whipple, of Quincy: — Mr.
President, ladies and gentlemen: I should be
glad if I am permitted to say a word on this
subject of bUby-suits. I am not a physician,
but I am the wife of a physician and the daugh-
ter of a physician, and I am a mother, and I am
particularly interested in this question of baby-
suits. Dr. Grosvenor says not to put socks on
the baby. What shall we do with the little feet ?
The dresses are short, the skirts are short, what
shall we do ?
Dr. Grosvenor : — That does not apply after
the short clothes' come on.
Mrs. Whipple: — There are no clothes on the
little feet, and if the feet are cold they will have
colic immediately. What shall we do ? There
is another question: they tell us to let the
mothers, during gestation, have every thing they
want, have their own way ; but is that possible ?
Go when they wish and come when they wish.
How can we do this ? When we have so much
put upon our shoulders, as upon the shoulders
of the wives, it is very hard to tell us to do so.
A great many people come to me and speak of
their troubles, and how can I recommend them ?
What can I say to them ? Their husbands say,
" Oh, my wife is so fretful I can't do anything,
with her." What shall we do? The babies must
be cared for, they are not able to have servants,
not able to have all the necessaries they wish,
and what shall we do? I think perhaps the
education of the mothers should not only be dis-
cussed, but the education of the fathers and the
physicians. (Applause).
Dr. Grosvenor : — My friend Dr. Hawkes, in
giving his advice about letting mothers have
their own way, made some very good points, and
especially in regard to the husband taking pains
to see that the wife's wishes are consulted, and
that she has what she wants during gestation.
And I can say that all the care and attention
you can bestow upon a wife during that period
will come back a hundred fold in their good
health. My friend has alluded to what Bob In-
gersoll said in regard to the education of child-
ren. Dr. Williams says that all diseases are
curable and that some of them have to be begun
back 200 years, so you see he seems to have the
same idea. Now I want to say one word in an-
swer to what was said in regard to the hernia.
I say, in nine cases out of ten it is a perfectly
easy matter to cure umbilical hernia. I have
discarded bandages, and I have had no ruptured
babies.
Dr. W. A. Smith, of Winona : — Mr. President :
I raised a colicky baby. I remember in Joliet
I spoke about it, and I asked the doctors there
if they had any prescription that would cure the
colic, and we undertook to cure our baby ac-
cording to some method, and I had my friend
Dr. Dunham with me, and I think he and I
almost exhausted the homoeopathic materia
medica and that baby still thrived and squalled
and grew, and grew and squalled and thrived.
180
THE MEDICAL ERA.
[Vol. VI. No. fl
and I don't know whether I raised the baby or
the baby raised me. (Applause). And it is still
a question in my mind. Now then, if we ever
raise another, we shall unquestionably use Dr.
Grosvenor's baby suits. It is comfortable and
it is easy and labor-saving for the mother, but
for mercy's sake, gentlemen, if you have any
prescriptions for the colic that are sure to work,
let me have them before I leave.
TUESDAY, MAY 15tH, 2 o'CLOCK P. M.
The convention was called to order by Presi-
dent Kinyon in the chair.
The President appointed Dr. W. F. Hobart
secretary pro tem., in the absence of Dr. Curtis
M. Beebe, Secretary.
BUREAU OF OPHTHALMOLOGY AND OTOLOGY.
Dr. J. H. Baflfum read a paper entitled ** Eye
Headaches."
Dr. C. H. Vilas, of Chicago, read a paper en-
titled " Clinical Eye Cases."
The President announced that the papers read
under this bureau were now open for discussion.
Dr. C. H. Vilas : — Mr. President : I was very
much interested in Dr. Buffum's paper, because
it is a subject which has attracted a great deal
of attention from ophthalmologists.
I might say a word supplemental, that the
Doctor did not speak of, viz., about operators.
There have been a great many operations per-
formed for insufi&ciency of all or either of these
muscles, and it is not infrequent at all for spec-
ialists to see persons who have been operated
upon for insufficiency of the internal recti. It
is right here that I would like to emphasize this
point, and that is, that it is almost always un-
necessary to operate for these troubles, as our
remedies render such a proceeding imnecessary.
The remedies that should be administered, and
which have been well tried, are Argentum nitri-
cum andGelsemium. To these might be added
a third, Causticum. These three remedies have
done a great deal in the way of relieving insuffic-
iency of the internal recti and the ciliary mus-
cle, and should be well tried before any operative
proceeding is thought of.
The President : I will appoint Dr. C. H. Vilas
as Chairman of the Bureau of Ophthalmology
and Otology for next year.
BUREAU OF PATHOLOGY, PHYSIOLOGY AND HISTOLOGY.
Chairman, Dr. M. J. Bleim : — Mr. President :
Dr. F. 0. Pease, of Morgan Park, read a paper
on ** Cardiac Lesions and Their Relations to
Wasting and Chronic Diseases."
Dr. M. J. Bleim, of Chicago : — Mr. President :
There are quite a number of cases in which
heart disease and lung disease exist in the same
patient, and in which with careful tracing of the
history, the heart trouble is found to be the pri-
mary trouble, there perhaps being a predisposi-
tion, and consequently a subsequent development
of lung diseases. The fact that the Doctor
mentioned, that so many cases of heart disease,
from a close physical examination, in the ab-
sence of subjective symptoms, is interesting, and
the paper that was presented by Dr. Ehinger at
the last meeting, upon the fact that many cases
exist for years and years without giving rise to
any disturbance of the fmictions of the heart or
circulation, so that now the prognosis of heart
troubles is not nearly so grave as it used to be ;
the fact that traces of heart disease can go on
for twenty or thirty years without giving rise to
any disturbance of the functions, shows the ne-
cessity for an early diagnosis. If we can dis-
cover the original heart trouble, before this
secondary lung trouble, we will certainly do a
great deal to prevent lung diseases.
BUREAU OF DISEASES OF WOMEN.
Dr. S. p. Hedges, of Chicago, chairman.
Dr. M. J. Bleim, of Chicago, read a paper en-
titled " Phimosis in the Female."
Dr. S. P. Hedges : I have a short paper here
to which I will invite your attention for a few
moments. It is in regard to special remedies in
ovarian diseases, a question which has been con-
siderably in my mind during the last year, and
since my attendance upon the American Insti-
tute, and talking with some of the students upon
materia medica. This paper has some argu-
ments for the development of our materia med-
ica by physicians, as we go along in our work.
And I suggest that the members of the con-
vention observe the different drugs used, and in
this way particularly to make an exact materia
medica for us which will be scientific, and which
will demand a close adhesion of all medical men,
and this will be done by gathering up and saving
these records, and thereby have a materia med-
ica upon which we can depend.
Dr. Geo. A. Hall, of Chicago : — Mr. President :
Let me ask a question, more for my own in-
formation than for the instruction of others.
My friend. Dr. Hedges, has read us a paper which
I am a little bit in doubt to know* where it be-
longs, in the bureau of materia medica, or oph-
thalmology and otology, or in the waste basket ,
I cannot tell. There are some good points there,
but by some of the Doctor's statements I don't
JUMB, 18B8.1
SOCIETY REPORTS.
181
know exactly what he means. He says his at-
tention to Iodine was first attracted by local ap-
plication, that it seemed to relieve those pains
which arise in ovarian irritation. Now, if we
are to make our observations in regard to mate-
ria medica from the effects of local applications,
or where local applications are made simply
with the administration of remedies, it strikes
me that we have very little grounds for placing
that in our materia medica, and I would like to
ask the Doctor where the local application was
made and under what circumstances, and wheth-
er those pains were absolutely the result of ova-
rian irritation or rectal disease, or what they
might be, is the question. When we come to
compare our materia medica, and when we come
to prove it and prop it up by our own experi-
ence, I feel that we shall have a prop much
weightier than the materia medica itself. I do
believe in. local, applications myself, and I use
them frequently, but I have never yet made
them without studying the materia medica by
the very symptoms relieved by local application.
I don't believe that we always get the same re-
sult from the internal application of a remedy
as the local application of it. I understand the
physiological effect is very different. We do hot
intend that it shall be applied in the same man-
ner under the same circumstances, but there is
a good idea there, and I think many times that
if men would stop and recognize what they see
in their own practice, and then undertake to ex-
plain that to themselves satisfactorily, we vnU
readily recognize the great fact that there is one
place in our materia medica, and one failing,
which must be filled sooner or later. It is a
fact that in studying the symptoms it is not only
necessary for us to recognize the fact that a cer-
tain remedy produces a certain symptom, or that
a certain symptom can be exhibited under the in-
fluence of certain remedies, but we must study
the fact that certain remedies act upon certain
tissues and certain organs. One remedy may
spend its force upon the mucous membrane, the
next upon the nervous centers, and so on. Then
there is another trouble in our making a careful
observation to know what is reflex and what is
direct. I think the field is too extensive. It
certainly involves too much interest to the pro-
fession for us at any one meeting to settle the
question, but suggestions thrown out will lead to
other inquiry, and if the doctor will answer the
questions which I have asked simply, it will aid
me at least in making further investigation.
Dr. Hedges: I see that Dr. Hall misunder-
stood my paper ; it was this : I noticed that the
Iodine applied to the cervix and endometrium,
relieved ovarian pain which I had otherwise
failed to relieve. I had never had my atten-
tion drawn to Iodine as a remedy for ovaran pain.
It was simply not that I looked upon it as bolster-
ing up the materia medica, or necessary to that,
but I had my attention first drawn to it in that
way, and hence I began to look it up, and found,
to my surprise, that Iodine, of which I was
ignorant at that time, had these symptoms.
Then I said to myself, perhaps it would relieve
symptoms of that kind in cases not under local
treatment, if I had those symptoms to deal with.
So when I found I had those symptoms, in cases
which were not under local treatment and in
local application, I turned over to my Iodine and
I found that I had verified the symptoms, and
have cured those symptoms ; so I believe in the
local application of it to uterine troubles, and
yet I agree entirely with Dr. Hall, that we are to
be very careful in what we observe from the
effects of those remedies locally, for their
physiological effect is different locally from what
it is when given internally. I think that meets
that point.
Dr. Hall : I understood that you were giving
a remedy at the same time you were making the
local application.
Dr. Hedges : No. My point was that I ob-
served those symptoms were relieved while I
used it in one case, brought my attention to it
in another case. That is, it disappeared while
I was using it. I know the local application of
certain remedies has an effect similar to that
when given internally, and in this case it brought
my attention to it, and so, on using it, I verified
that symptom with the materia medica.
Dr. W. J. Hawkes: — Mr. President: The
action is precisely the same, but the symptoms
come by the drug being applied to the surface ;
it is sometimes a raw surface, and it is absorbed
into the system and it goes to the nerve centers
just the same. I think Dr. Hall is in error
when he states, or seems to imply, that one
drug (all other than chemical, I mean — given
as medicine), that one drug will go to one dis-
tinct center, and so on. The action is on the
nerve centers governing those points. All these
symptoms are brought back fipm the nerve cen-
ters, then the nervous system is the governing
power of the individual, so when the nervous
system is really the individual, the tissues are
aU under its control, and the action will be pre-
cisely the same, excepting in the chemical and
mechanical results.
182
THE MEDICAL ERA.
(Vou VI. Wo. 6L
Dr. Hall : I would like to ask if you finally
proved the remedies by making application ?
Dr. Hawkes : You apply Belladonna and you
will get the effects of Belladonna in other parts
of the body just the same as if it were given
internally.
Dr. Hall : I wanted you to admit that fact in
public, because we have had some discussion
about it before.
Dr. Hedges : I have said that drugs could
be proved by using them locally, hypodermic-
ally, or rubbing them on the surface. You can
explain this with Castor oil ; it is not that the
Castor oil goes to the bowels and stimulates
them, it goes to the nervous center controlling
the bowels. Now I heard a statement made to-
day, about what was contained in one of the al-
lopathic journals as to what caused the cholera
symptoms; that it was the irritation of the
virus irritating the intestines, and any good
pathologist knows it is the vaso motor nei-ve
centers, relaxation of the capillaries, that causes
the motory inaction, giving us the results of
cholera. That is the same principle precisely ;
we go back to the nerve centers for all our re-
sults, drug and medicinal.
Dr. T. 8. Hoyne: In iihis connection it is
only necessary to call attention to one or two
remedies. You can get the influence of certain
drugs by rubbing them in the hands. Take the
application of Mercurial ointment, and if you
rub that in the skin pretty well the patient has
salivation just as certain as if he took the drug
internally.
Dr. H. P. Holmes, of Sycamore : — Mr. Presi-
dent : It seems to me that this is but another
proof of the law of our school. We are taught
by Samuel Hahnneman that it is not necessary
to use local application for the treatment of dis-
eased conditions, and the Doctor has proved this
satisfactorily to my mind ; I should like to know
by what 'pathy he was taught to apply Iodine to
an inflamed cervix, and furthermore, if by that
local application he blundered upon the idea
that it would cure the ovary, and finally found
out what had never been proved before this doc-
tor found it, that Iodine would cure the ovarian
condition. Now, if the Doctor had studied his
materia medica and gone carefully to work and
found a constiUitional remedy, that remedy
which had become applicable to the symptoms,
I don't think he would have been obliged to use
the Iodine as a local application.
Dr. Hawkes : I would like to speak a word
in regard to a fundamental error of the gentle-
man (Dr. Knoll) who has just spoken, that be-
cause a drug does not produce a disease, there-
fore it cannot cure that disease. It is not neces-
sary that a drug should produce a disease in
order that that remedy should cure the disease.
That is absurd — perfectly absurd. Suppose that
I have a remedy that will produce ganglion, or
produce anything. It does not follow because
we have no remedy to produce that, that we have
no remedy that will cure it. That is fundamen-
tal.
Dr. Curtis M. Beebe read an article entitled
** Alexander's Operation."
The chairman appointed Dr. S. P. Hedges
Chairman of the Bureau of the Diseases of Women
for the 'next year.
Dr. E. M. Hale, of Chicago, read a paper en-
titled **The Bemedies for Sub-involution of the
Uterus."
Dr. W. H. Hall, of Havana, read an article
entitled ** Some Experience with Sodium Phos-
phate."
Dr. W. J. Hawkes, of Chicago, read a paper
entitled, " A Study of Jjycopodium and Natmm
Muriaticum. "
On motion the discussion of this bureau was
left open until the next session at 9 o'clock A.
Mr, May 16th. Adjourned. .
WEDNESDAY MAY 16tH, 9 o'cLOCK A. M.
Meeting convened ; the President in the chair.
BOARD OF CENSOBS.
The chairman of the Board of Censors read to
the meeting the following applications : Dr. C.
D. Warden, Carthage, Illinois ; W. A. Boyd, of
Rockford, Illinois, and J. W. Walker, of Wash-
ington, Illinois.
It was moved that the apphcations be received,
and the members elected. The motion being
duly seconded, it was carried.
The further discussion of the Bureau of
Materia Medica, left open at the last session,
was now resumed.
Dr. A. A. Whipple : In regard to Dr. Hawkes*
paper, I would like to say a word simply in con-
firmation. He gave the characteristic indications
of a good many remedies for intermittent fever.
There came to my mind one particular case.
About a year ago there was a patient that I was
called to see, suffering with what might be called
superciliary neuralgia over the right eye. I tried
several remedies. Every day it would come on
about eleven o'clock, and it would last all fore-
noon and in the evening and late at night, when
he would go to sleep, and in the morning it would
JnifB. 1868. J
SOCIETY REPORTS.
188
be gone. Then just about eleven o'clock again
it would come on, and I tried two or three
remedies, but with no success. There was
very severe pain, and its intermittent char-
acter led me to use Natrum muriaticum, and
the neuralgia never came again. Natrum
will do that every time when we get the right
indications, and the time of day, eleven o'clock,
is characteristic. I remember also one other
case of intermittent fever that the time of
aggravation was not the characteristic indication,
but the fever blisters about the mouth, and that
was really the only indication that I could get ;
still Natrum proved to be the remedy.
Dr. Curtis M. Beebe, of Chicago : — Mr. Presi-
dent : In discussing the remedies for sub-involu-
tion yesterday, Dr. Hale discussed the homoeo-
pathic remedies as remedies alone — as med-
icines. It seems to me that there has been
opened to us within the last two or three years,
a new field in the study of sub-involution. Elec-
tricity has come to our aid, the most valuable of
all remedies in the treatment of sub-involution ;
but in order that electricity or any remedy shall
do its work, many things must be righted. Sub-
involution is often dependent upon laceration of
the perineum or uterus, and that must first be
corrected before we can expect to have perfect
results from remedies or electricity. Alexander's
operation, of which I spoke yesterday, will cor-
rect retroversion and retroflexion dependent
upon sub-involution, while after the operation
rapid changes take place within the uterus, ow-
ing to more perfect circulation of blood, and the
uterus decreases rapidly in size and weight.
So I think we must consider many things in
studying the subject of sub-involution, and after
the case has been put in a surgically good con-
dition, then electricity and remedies are appli-
cable. But I believe, without using the surgical
means which are at hand in the correcting of
these disorders, that we get very little result from
remedies.
Dr. W. J. Hawkes : — Mr. President : I have a
little more to say, especially on the paper of Dr.
Hale. It is rather a discouraging paper to
homoeopaths, especially coming from one who
has occupied so prominent a position in homoe-
opathy, and treating as it did, the remedies, and
the drugs, and the doses in anything but a
homoeopathic way. There was no encourage-
ment for a homoeopathic practitioner in the
paper. There were a good many fundamental
errors in the paper, one of which is that it is
necessary to give drugs in drug doses to prevent
disease, or prevent sub-involution, or prevent
after-pains, and prevent a great many diseases
so-called. I have practiced twenty-two years,
and I have had a great many obstetrical cases,
and never yet have had to resort to any of these
extraordinary measures, and I think if physi-
cians would more strictly adhere to the homoeo-
pathic law in keeping the patient well, there
would not be any of this necessity, or fancied
necessity, of acting in this absurd way to pre-
vent what they should have prevented by keep-
ing the patient well.
Another point, that is, the giving of Ergot.
He said one good thing which I will give him
credit for, that you should never give Ergot
while there was any foreign body in the uterus.
It has been a habit in some hospitals, homoeo-
pathic or allopathic, of giving Ergot after every
labor, all of which is not only unnecessary, but
harmful. The process of labor is a natural
process. The reduction of the womb to its nat-
ural size after labor is a natural process, and
goes on in a natural way. Dr. Hale said that
you should give Ergot in moderate doses — from
fifteen drops to two or three drams, moderate
doses, when there was nothing inside the uterus,
in order to bring it down to its normal size.
Now it seems perfectly absurd to me, and un-
natural, unphysiological and illogical to drug
your patient to finish up a natural process. And
the giving of Ergot to cause contraction of the
uterus after labor to prevent hemorrhage is cal-
culated to produce the result which it is here
intended to avoid, because the action of the
Ergot is stimulation of the uterus, and you are
more liable to have hemorrhage than if the
Ergot had not been used. I say, I have prac-
ticed twenty-two years and I have never lost a
case of labor, and I think it is because I have
had good luck and adhered strictly to the homoeo-
pathic law — kept my patients well before they
had labor.
Dr. L. Pratt, of Wheaton: — Mr. President:
I think Dr. Hawkes' remarks are practical and
fully within the scope of homoeopathic law. I do
not see the propriety of men of common sense ad-
ministering a drug whose action upon the system
is powerful and poisonous upon the supposition
that certain morbid diseases may result. I
think it is a perfectly ridiculous idea. I have
practiced about forty-five years and have had
some obstetrical cases, and I never resorted to
any such means, giving drugs or anything of
that kind, and I have the reputation among my
patients of being about as lucky as any one. • I
tell you this idea of wanting to do something to
guard against something that may not happen
184
THE MEDICAL ERA.
[Vol. VL No. S.
does not meet with my approval, and I hope
our practitioners will have more common sense.
Dr. C. N. Hazelton, of Morrison: — The idea
of Dr. Hale's paper, I think he made, a distinc-
tion between primiparsB and multiparas, and
especially recommended it in multiparas, giving
his reason. I beheve sometimes that material
doses of Ergot have helped me out. I might
have got out with high dilutions, occasional
doses ; I might, but I was afraid I wouldn't. As
I said before, if we do this and if we think it is
the best way (we do think so if we do it) we had
better get up and confess it ; if it is the wrong
way, we should learn the better. There is cer-
tainly a difference of opinion, whether to give
homceopathic remedies in attenuated doses
strictly or occasionally in material doses.
The chair appointed as Chairman for the
Bureau of Materia Medica for the next year, Dr.
F. W. Gordon, of Sterling, Illinois.
BUREAU OF CLINICAL MEDICINE.
Dr. C. A. Williams, of Chicago, read a paper
entitled " Uruthocele as a Cause of Albuminuria
and Nephritis."
Dr. Charles Gatchell, of Chicago, read a pa-
per entitled '< Intestinal Inertia."
Dr. J. B. Dickinson, of Galva, Illinois, read a
paper entitled "A Case of Abscess of the
Chest."
Dr. J. B. Dunham, of Winona, Illinois, read a
paper entitled ** Death-bed Scenes."
Dr. C. W. Harback, of Lockport, Illinois, read
a paper entitled *' Topical Applications in the
Treatment of Typhoid Fever."
Dr. T. S. Hoyne, of Chicago, read a paper on
the " Treatment of Syphilis in Infants."
Dr. J. S. Mitchell, of Chicago, read a paper
entitled "Pneumonia," after which he said: —
Dr. Mitchell: This is one of the first cases
that I had with cardiac trouble. The second
was the case of my own father, who, after double
pneumonia, developed mitral regurgitant lesion,
which occurred at the age of 74. He died at
the age of 80, of cardiac trouble, the result un-
doubtedly of impairment of the heart at this
time. The fourth case is the one which I men-
tioned, in which instance, following cardiac le-
sion, was the mitral regurgitation. Outside of
this, which is comparatively rare, the prognosis
in pneumonia is almost uniformly favorable.
Begarding the treatment, I have nothing new to
remark. My experience, both in the past epi-
deinic and through all the years of my practice,
has been so almost uniformly favorable with the
usual homoeopathic remedies that I have seen
no occasion to seek for anything further. I use
as an adjuvant a poultice of flaxseed, or, where
it can readily be procured, which is still better,
I use the spongio-pilene, which holds moisture
much better than a flaxseed poultice.
Dr. H. M. Bascom moved that the further
papers and the discussion *of the same go over
until the afternoon. Motion being seconded,
was carried.
BOARD OF CENSORS.
The Board of Censors reported the following
applicants for membership: Dr. J. D. Craig,
Dr. Wells LeFevre, of Chicago; Dr. C. S.Owen,
of Wheaton, Illinois. On motion, the above-
named applicants were elected members of the
Association.
At 11 : 30 the President delivered his address,
entitled, ** Suggestions Regarding the Shortcom-
ings and Misconceptions in Medical Education."
It was moved that Prof. Buck, of Cincinnati,
be granted the privileges of a member of this
Association. Motion being seconded, was car-
ried. Adjourned to 2 o'clock P. M.
2 o'clock p. m.
The chairman announced at the opening of
the afternoon session that the papers already
read are now before the Association for discus-
sion.
Dr. Craig, of Chicago : I wish to say a few
words in regard to the application of water in
typhoid fever. There are two principles on
which water will act, and it don't make any dif-
ference whether it is applied one way or the oth-
er, in a poultice, or how it is used ; it is moisture
in the poultice, and it will have a very beneficial
effect. One of the objects that we have is to
equalize the circulation. That, of course, must
be done by frequent application. If a part is
cold, then a hot application should be used, and
if hot, a cold. Sometimes, in cases of inflam-
mation, the inflammation can be reduced much
more quickly by hot and cold applications al-
ternately. There is one thing about using water,
it does not interfere with remedies at all, so we
can use it at any time.
Dr. H. M. Bascom, of Ottawa, read a paper
entitled ** Sequel® of Spinal Meningitis."
Dr. Clifford Mitchell, of Chicago, read a pa-
per entitled "The Relation of Urinary Analysis
to Diagnosis."
The President announced that the discussion
of papers read would now be taken up.
Dr. H. B. Fellows of Chicago : Mr. President :
In regard to Dr. Dunham's paper, I would like
Juan, 18BB.J
SOCIETY REPORTS.
185
to Bay a word. The first thing that struck me
in that paper was the way the disease came on,
that is, it came on gradually. Now, in all of
the diseases that begin abruptly in the brain you
will find a disturbance of the circulation. Those
that commence with some other degeneration,
will come on more slowly. If this was embolism,
it would have had an abrupt beginning, but be-
ginning very slowly and increasing gradually,
coming on regularly from stage to stage, would
seem to throw it off this catalogue^ But if it
commences by some degenerative process, or some
foreign growth, its beginning might be slow. If
a tumor forms in the brain and does not disturb
the circulation in the earlier stages, the symp-
toms are sometimes very slow in approaching. In
this case we found the symptoms being nausea and
vomiting, with headache ; there was also in this
stage some defective vision. This would locate the
difficulty in the back part of the brain, behind
the motor region, probably somewhere in the
occipital region behind the quadrigeminal bodies.
If this had been in the cortex, we should prob-
ably have been able to trace it to some disturb-
ance of the circulation — thrombus, embolus, or
something of that kind, but the symptoms, as far
as that is concerned, do not show it.
In the case that Dr. Dunham reports, I do
not know enough about the history to judge ac-
curately of it. But it is one of those interesting
cases that I am glad has been brought up here,
because a thorough understanding in the begin-
ning wiU keep us from making a prognosis that
is too favorable. Syphilitic tumors, when taken
early, can in many cases be cured with the
proper use of Iodide of potassium, and other
drugs. But you want to be quite liberal with
the dose in order to get the effect. You must
cause absorption of the tumor as rapidly as you
can, or it will destroy the brain tissue.
Dr. W. A. Smith : What doses do you use ?
Dr. Fellows : I commence with two or five
grains, and increase it according as the stom-
ach will bear, three times a day. I should use
Iodide of potassium, or Iodide of sodium, which
perhaps does not irritate the stomach as much,
and you can grade it up to 30, 40 or 60 grains
in doses, if necessary. Remember, you have
got to destroy that tumor rapidly, or it de-
stroys the brain tissue, so if you are not partic-
ular in this respect you may be two months in
caring what might be cured in two weeks, by
absorbing the tumor rapidly.
Dr. Dunham: I will say, in regard to this
case, that there was no specific taint.
Dr. W. Danforth, of Milwaukee: — Mr. Presi-
dent : I do not remember exactly the order in which
the papers were read. As they were presented,
there were several points that came to me, and
I thought I would like to summarize very briefly
my experience in the matter. There is no doc-
tor, I think, whom I respect and revere more
than Dr. Mitchell. There was one thing that he
said, however, which I want to negative by so
much authority and experience as I have bad,
and that was the idea of jacketing and poul-
ticing the lungs in pneumonia. I don't believe
in it, and don't practice it, for the reason that
it kills, in my opinion, in many cases ; it never
helps any case.
Very recently, in Milwaukee, there has been
an epidemic of pneumonia, and there has been
nearly 25 per cent of mortality among the "reg-
ular '' doctors, and about 3 to 5 per cent among
the homoeopaths. I am stating now the facts —
nearly, very nearly. I believe that the mortal-
ity among the dominant school in their practice
is caused by jacketing the lungs heavily with
flaxseed poultices, and using narcotics. Narcot-
ics are prejudicial and ought not to be given.
Occasionally it may be necessary to stop pain
with narcotics, but it is a dangerous practice.
Does a poultice always kill? No. There is
many a patient who is strong enough to outlive
doctor and poultice.
Pneumonia I believe to be a self-limiting dis-
ease, with a tendency to recovery. I never poul-
tice, for the reason that it keeps in the heat.
It doesn't necessarily kiU, but if the chances are
pretty nearly even it inclines the patient toward
the grave. I jacket mine with soda water, be-
cause I believe 'it opens the pores of the skin
and affords an escape for the heat. I assume
that the lungs are hot ; there is an increase of
the temperature, and in order to get rid of that
I give Aconite, and jacket my patient with soda
water. If there is a state of collapse when I
first call, as there may be sometimes from severe
congestion, I put mustard leaves all over the
chest and keep them on an hour or two ; then I
take off the mustard and put on my jacket, four
or five thicknesses of muslin, that I saturate
with soda water. I change the jacket two or
three times in twenty-four hours ; keep my pa-
tient sweating. I believe pneumonia to be a
self-limited disease tending to recovery. You
will lose scarcely any patients if you treat them
in this way.
The criticism on Dr. Hoyne's paper is that
there was so much of it I could not take it
all in. He had 1,411 symptoms that I counted,
180
THE MEDICAL ERA.
[Vol. VI. Ho. t.
and he had 704 remedies, and every one was
good and all important.
In the paper that was read by Dr. Williams,
" Stricture of the Urethra as the Cause of Al-
buminuria and Nephritis," the point that oc-
curred to me was, that the case had been
treated by many physicians for a long time
without discovering that there was any strict-
ure of the urethra. Dr. Williams discovered
the stricture, dilated it, and in so doing was
instrumental in inaugurating a cure. The
treatment was supplemented by remedies, and
the case terminated in recovery. I believe that
it teaches us a lesson not to overlook local
conditions.
Fourth, ** Abscess of the Chest," by Dr.
Dickinson. That was a case of traumatic ab-
scess. In injuring the lungs you may have
an abscess; and if so, it should be emptied,
and if you don't puncture it, it will puncture
itself. There was a time when the doctors
thought there was pus there, and yet they
both stood by and put on a poultice and
watched the case until it discharged by itself.
I think that it would be better, if the pus is
believed to be present, to puncture the chest.
I am glad that this case resulted favorably,
but many a case of malpractice grows out of
the neglect of duty under the circumstances,
and I think if I were in that condition myself
and there was pus believed to be present in
the chest, and my doctor did not puncture it,
and I lost my life by it, I should want my
friends to sue for damages ; and so I mention
it because it devolves upon the attendant the
responsibility, if it is believed pus is present, to
puncture, or get somebody to do it for him.
That is better than to wait.
The chair appointed as Chairman of this bu-
reau for the next year Dr. J. B. Dunham, of
Winona.
BUBEAU OF MEDICAL LEGISLATION, JURISPRUDENCE
AND EDUCATION.
Dr. J. A. Vincent, of Springfield, read a paper
on the " Status, Progress and Future Need of
Medical Legislation."
On motion of Dr. Smith, of Winona, being
duly seconded, the report was adopted.
The President appointed as a committee on
this bureau for the coming year; Chairman,
Dr. J. A. Vincent, of Springfield ; Dr. N. B. Camp-
bell, of Joliet ; Dr. E. N. Foster, of Chicago ; Dr.
Charles Gatchell, of Chicago ; Dr. G. R. Woosley,
of Normal ; Dr. W. P. McAffee, of Rockford ; Dr.
A. A. Whipple, of Quincy ; and D. P. Marsh, of
Bloomington.
BUREAU OF NEUROLOGY, PSYCHOLOGY AND ELEC-
TROLOGY.
Dr. E. C. Williams, of Chicago, read a paper
entitled "Use of Galvanism in Dysmenorrhoea."
Dr. Anna L. Parker, of Chicago, read a paper
entitled " Neurasthenia."
Dr. H. B. Fellows presented a patient suflFer-
ing from that somewhat rare disease called
Myxoedema.
There is no case reported cured. It is a case
I am very much interested in, not only on ac-
count of its being peculiar, but as showing that
it may affect children as well as adults. This
is the only case of the kind, I think, on record.
Dr. Cheeseman, of Joliet, read a paper on ** In-
fantile Paralysis."
Dr. Julia Holmes Smith, of Chicago : I list-
ened very attentively to the paper of Dr. Parker,
and was very much interested in it because it
suggested a line of thought which I had taken
up myself. The point of my remarks will be
against the fashion of prescribing rest for every
thing. I am glad to hear Dr. Parker prescribe
change of environment and work. In this civil-
ization of ours, the civilization that gives girls
so little to do and men so much, we have really
to expect neurasthenic women, and they are the
people who make the largest doctor bills, and
so I shall have to ask the doctors to practice a
great deal of self-denial if they carry out the
suggestion that I take the hberty of making this
afternoon, from a woman's standpoint.
It seems to me that we have gone in the line
of operation and rest and massage and electric-
ity just about far enough. It is quite time now
to stop putting women, who have nothing the
world the matter with them, to bed for days and
weeks and wait for the doctor to come every
day, at whatever price he chooses to charge, and
at the end of several months, saying, " Now, I
have done all I possibly can ;" and at the end
of another month, ** There is only one thing
more needed for complete recovery, and that is.
to take the Servia or Etruria, and go to Earope
and spend the summer."
Oh, it is a beautiful prescription, but I think
we ought to begin right here to preach the doe-
trine of work, and work that will pay. Not a
little fashionable practice on the piano, or tak-
ing Delsarte lessons and singing lessons. Not
that kind of work, but work which will pay for
the girl herself; encourage the girl that she
may do something for herself ; if she has a genius
JUMB, 1888.]
SOCIETY REPORTS.
187
for hoasekeeping let her throw her energies in
that direction, something for which she will get
money for her services ; if she has a genius for
book-keeping, train her in that direction. If by
chance she is fool enough to go into the medical
profession, train her for that, but let her have
work at all hazards. She comes to us and says,
" Oh, I don't feel well this morning ; I am so
dreadfully tired. It doesn't seem as though I
could carry my clothes." Nine times out of ten
she is lazy. Now have the courage to follow
your convictions and say right up and down to
her, *' My dear young woman, there is nothing
in the world the matter with you ; go right to
work and do something for somebody besides
yourself and you will be a great deal stronger
and happier. (Applause).
BOARD OF censors' REPORT.
The Board of Censors reported the following
applications for membership : Dr. S. L. Smith;
Dr. Charles D. Eich; Dr. T. E. Roberts; Dr. W.
S. White ; Dr. W. G. WUlard ; Dr. W. P. Pack-
ard.
It was moved that the applications be re-
ceived, and the applicants made members of the
society.
Dr. R. N. Foster, of Chicago: — Mr. Presi-
dent: I would like to add something to the
suggestions that have already been made ; the
excellent ones made by Dr. Parker in her able
paper, and those made again by Dr. Smith. I
would like to add one or two more suggestions
as to the possibility of doing something for the
unfortunate victims of neurasthenia. Neuras-
thenia is sometimes the result of faulty educa-
tion, sometimes the result of faulty surround-
ings, sometimes the result of faulty habits, and
sometimes the result of downright, honest over-
work — honest, but mistaken overwork.
I think in cases of pseudo-neurasthenia, rath-
er than the genuine article, that Dr. Smith's
prescription covers the ground pretty well. It
is true that worry is one of the most fruitful
sources of that disease, and I think that monot-
ony of life and pursuit is perhaps the next.
We all see a good deal of the disease manifested
among men who lead active and exciting lives as
business men, men whose fortunes depend every
day upon the whims of the market, upon whose
hands hang great responsibilities all the time,
and who live continually a life with this strain
put upon it, never have a moment's relief ex-
cept during the time they sleep, and even that
time interfered with by the presence of the bur-
den.
Again, I think that not only monotony, worry
in these cases, but a simple monotony of do-
mestic-life with women, burdened down, kept in
a state something like perpetual bondage with
small, petty, although very important, very annoy-
ing, very worrying and very trying details — care
of children and family, and church sociables, and
society and charity organizations, and so on —
monotonous things which they are expected to
carry along all through their lives — I believe a
great many of them will become neurasthenics by
that, more by the simple monotony of life than
anything else. Now, I want to add, I say, a
little possible cure for some of these cases. It
is the rule now to send some of the victims
across the water to Europe; if we can't send
them to Europe we advise them to go fishing, or
we send them to the Rocky Mountains. Now,
that is a good thing, for the simple reason that
we have relieved a great many that way. We
have taken away the cause of this perpetual ex-
haustion. But I think there is a more serious
cure than that, and a more lasting one involved,
and to illustrate my meaning, I will report a
case. A very intelligent gentleman was an-
nounced to give a paper at a private residence
in Chicago not long ago, where a number of
persons were invited to meet at the house of a
lady of considerable literary ability, to hear a
paper from a gentleman on a subject involving
rather a high literary criticism. The company
assembled and the literary paper was read. It
was a paper of extreme merit. In conversation
with the author afterwards (the paper, I might
say, was on Browning — we have all heard of
Browning) in conversation with the gentleman
we found that he had been a man of business ;
that from the time he was thirty-six years of
age his time was spent between his bedroom
and his office, and that he conducted a very
large business in Chicago — successful business,
and by the time he had reached thirty-six he
had gained the whole world and had lost his
own health entirely. He was complete master,
financially, of the situation, but was left without
any capacity to enjoy, or even push his business
negotiations any further. Now, this man took
a very new and a very unusual course. He went
and entered himself as a student at Harvard
University. He spent four or five years there,
applied himself deliberately to the study of the
higher studies, such as are taught at the univer-
sities. He entered the law school and graduated
from the law shool. He then went to Con-
cord School of Philosophy and he spent some
time there and he subsequently emerged as
188
THE MEDICAL ERA.
[Vol. VT. No. «.
one of the most brilliant literary men of our
country; a man of rare capacity, a man of
genius. I said to him, <<Now you can go
back to business again." '< Not only can I go
back to business again, but I can transact
business as I never could before, and engage
in all matters as I never could before, for I never
could place a meaning upon business as busi-
ness, and my whole life and my whole knowl-
edge was developed, and I am healthy in conse-
quence of this course of study.'* And I would
suggest further that there is probably a good
deal of neurasthenia on the Board of Trade in
this city, and among men of that character of
life, and I have no doubt that a course of Har-
vard would do any of them good. A great many
men have reached that period of life in Chicago
— Board of Trade men, worthy men, wealthy
men, men connected with the largest business
interests, have commenced without more than a
mere common school education, have reached
that period where they begin to feel that they
know it all, but they haven't got it all, and so
they proceed to try to get more and to know less
continually. The result is, invariably, in cases
of those men, a moral and intellectual deteriora-
tion which no man can escape who applies him-
self simply to the pursuits of business, money-
getting, and so on. It is utterly impossible to
avoid it. It is impossible to avoid the deteriora-
tion that comes of that. The consequence is
the physically nervous man breaks down, and
with apparently all the success in the world
within his ^asp, he goes to pieces a total wreck,
affected with neurasthenia. And so you tell a
man to go fishing and it strikes him that a few
days' fishing is nothing at all compared with the
magnitude of his business affairs ; but if you tell
such a man to go to Harvard until he is culti-
vated, it will open to his view a new sphere of
life. Say to him " You have rather overdone
the one part, now you can take a four or five
years' vacation and go and cultivate the other
with equal care and persistency." He may do it
with equal success, and I can tell you a great
many of them would return like this gentleman
I have spoken of ; would return men of greatly
increased capacity, greatly increased social
value, greatly increased intellectual power, and,
in fact, increased in value in every way, and
with restored health, because I think the exer-
cise of all the faculties is the most important
element in the maintenance of both physical
and intellectual health, the cultivation of busi-
ness and the cultivation of the higher affairs
equably. I believe by this simple evolution of
the higher intellectual faculties, more and better
results can be obtained, results that cannot be
obtained and maintained except by bringing out
of these deeper and higher latent powers of the
spirit.
Dr. Dela^iater : The question is asked of this
bureau in regard to the use of the galvanic cur-
rent, galvanism for the cure of urethral strict-
ure. The error is in using a strong current
when that produces actual cauterization.
Dr. Danforth: Beturning to the question of
electrolysis, I would like to add one thing. Dr.
Delamater did not tell us which current to use
to the stricture. The negative to the stricture
always. The negative, because it dilates ; the
positive contracts. It will always cure. Con-
tinue the current about five minutes. One or
two times is sufficient.
The President : I hold in my hand a greeting
from the Minnesota State Medical Society, which
says they " send us greeting and bid us God-
speed in our work." A motion will be in order
to authorize the Secretary or the Committee on
Besolutions to respond in a suitable manner.
Dr. Mitchell : I move that the Secretary re-
spond in some fitting terms.
Motion being duly seconded, was carried.
BUREAU OF SURGERY.
Dr. Curtis M. Beebe, of Chicago : — Mr. Pres-
ident : I move that the by-laws be suspended in
the bureau of surgery, and that the discussion
take place after each paper is read.
Motion being duly seconded, was carried.
Dr. Geo. A. Hall, of Chicago, read a paper
entitled, "The Importance of an Accurate Di-
agnosis and Careful Observation of Patholog-
ical Changes in Various Forms of Disease,
Viewed from a Surgical Stand-point."
The President : Discussions upon Dr. Hall's
paper are in order.
Dr. G. F. Shears, of Chicago : I want to em-
phasize a point which Dr. Hall has made in
his paper in regard to the detriment that may
arise from escharotics in the treatment of malig-
nant growths. I believe, from my observation,
that many times, by means of escharotics, tlie
character of these ailments has been changed,
and they have become malignant.
I saw, some time ago, a tumor in a small
child, on the lip, which appeared to be a sim-
ple lupus, and so far as any one could tell
from observation or from history, the cluld
was born with this little tumor upon its lip.
It was nothing but a lupus. I advised the
parents that it be removed, and it could liave
JuMB, 18B8.1
SOCIETY REPORTS.
189
been done without any deformity of the lip.
They, however, were induced by some of their
neighbors to have a plaster applied, some es-
charotic plaster placed on the tumor; and it
began to eat its way, and the tumor began to
enlarge, and instead of the treatment decreas-
ing the size of the tumor and removing it, by
the time it had removed a certain portion, it be-
came much more enlarged and extended. After
it had invaded fully one-half of the lip, the pa-
tient was brought to me and an operation was
made of removing that portion of the lip by
a " B " incision, and the part healed readily, and
so far (two years having now elapsed) there has
been no return of the trouble. I believe, if that
plaster had been applied and continued, the
whole lip would have been destroyed and it would
have become very maUgnant.
Some five years ago there came to me two
cases of epithelioma of the lip. In both of these
cases I advised removal, and in only one of them
did I have the opportunity of doing so. I did
not promise that the tumor would not return,
inasmuch as it had invaded the glands. I be-
lieve I was correct, for I have since operated up-
on the case twice. The last operation was a
short time ago, removing a small nodule. The
patient's health was good and the deformity was
very slight. In the other case the patient was
sent to a hospital in the vicinity, and had a
plaster applied which removed the growth from
the lip, but by the time the growth was removed
the submaxillary gland had increased to a large
size. The plaster was applied to this, but it was
not effective. The patient died before the en-
tire trouble was removed. I see no reason why
the second case should not have progressed as
favorably as the first one. By careful attention
and removal as fast as the nodule appeared, the
patient's life might have been extended for five,
six, or possibly ten years. I saw this man upon
whom I operated, a short time ago, and he says
he has sufficient lip any way, and that if it is re-
moved each time the growth appears, he will
be able to live until natural causes carry him
oflF.
Dr. C. A. Williams, of Chicago : — Mr. Presi-
dent : I can give you one instance in the use of
escharotics and the knife in the same patient.
About one year ago I was in the office of another
physician. The case was that of a woman aged
60. There was a small iudurated mass in the
comer of the lip ; it was discharging a very fetid
fluid ; the submaxillary gland was engaged and
he had been applying plaster to it. Instead of
becoming any better, it gradually grew worse and
was spreading. There was a similar nodule on the
nose, on the comer of the nose, and he wanted
to know what to do about it. I told him at that
time that I thought it was best that it be re-
moved by the knife. He said he had never used
a knife in that locality, and didn't like to doit. I
told him I would remove it, and he gained the
lady's consent to have the nodule in the lip re-
moved, but he thought he could cure the one on
the nostril by the use of the plaster. So I removed
the nodule on the lip by a <<B" shaped incision, and
dressed the wound, and it has healed very nicely.
I saw the patient some few months ago and there
was a nice clean scar on the hp, but the one on
the nose had gradually increased until it has in-
volved fully one-third of the nostril, and has ex-
tended to the cheek, but she refuses to have any
operation performed, and remains in that way
at the present time.
Dr. Golwell : I should like to ask a question
of Dr. Hall, and that is, whether he puts all
escharotics in that category as being injurious,
Arsenicum as well ? I have seen and read works
that fiave reported very favorably upon it.
Dr. Geo. A. Hall : I would place all escharot-
ics in the same list. I do not say that they
have not been employed in some cases to the
apparent benefit of a certain morbid growth, as
well as to an ulcerated surface followed by
natural granulation and recovery. But I
claim this, that in such cases cure would have
been more prompt and great suffering would
have been saved, and economy in the way of tis-
sue would have been promoted, by using the
knife. Again, in all such forms where we apply
an escharotic, we have no opportunity of closing
up the wound until it is healed ; then a second
operation has become necessary. But in
operating with a knife where such growths are
removed, it is, in plastic surgery, within the
plane of the surgeon to remove such deform-
ity and make such treatment as will make a
respectable nose out of a part of a cheek, or
he can borrow a portion of the Up of some
neighbor, and make a very decent nose out of
it, but you can't do that with escharotics.
The President announced the following
CHAIBMEN OF BUBEAUS.
Materia Medica — Dr. F. W. Gordon, of Ster-
ling.
Medical Legislation — Dr. J. A. Vincent, of
Springfield.
Obstetrics — Dr. A. A. Whipple, of Quincy.
Ophthalmology — Dr. C. H. Vilas, of Chicago.
Pathology and Histology — Dr. F. O. Pease, of
Morgan Park.
190
THE MEDICAL ERA.
(Vol. VI. No. «.
Diseases of Women — Dr. S. P. Hedges, of
Chicago.
Neurology — Dr. H. B. Fellows, of Chicago.
Surgery — Dr. W. F. Knoll, of Chicago.
Diseases of Children — Dr. M. J. Hill, of Ster-
ling.
Sanitary Science — Dr. C. W. Harback, of Lock-
port.
Pharmacy — Dr. J. E. Gross, of Chicago.
Medical Literature — Dr. H. P. Holmes, of Sy-
camore.
Necrology — Dr. T. S. Hoyne, of Chicago.
The election resulted in the choice "of the follow-
ing
officers:
President: Ch. Gatchell, M.D., of Chicago.
Ist Vice-President: F. W. Gordon, M.D., of
Sterling; 2nd Vice-President, W. A. Smith, M.D.,
of Winona; 3rd Vice-President, H. E. Stansbury,
M.D., of Chicago.
Secretary: A. B. Spach, M.D., of Englewood.
Treasurer: A. A. Whipple, M.D., of Quincy.
Chairman Board of Censors: L. Pratt, M.D., of
Wheaton.
Bockford, Quincy and Sterling came up a"^ con-
testants for the next place of meeting. The bal-
loting resulted in the choice of the latter place.
The convention then adjourned, to meet again in
May, 1889.
Sterlingr, 111.
Sterling, Illinois, the place which has been
chosen for the next meeting of the Illinois State
Homoeopathic Medical Association, is in Whiteside
County, 110 miles due west of Chicago, and twen-
ty-five miles from the Mississippi river. It is
reached by both the C. & N.-W. By. and the C, B.
& Q. It is finely situated on the Bock Biver,
and with Bock Falls, on the opposite bank, forms
a beautiful city of ten thousand inhabitants. It is
well provided with all the conveniences of modem
city life, contains many handsome buildings, ele-
gant residences, and its people enjoy a well-de-
served reputation for intelligence and culture, and
a generous hospitality.
Among its hotels, the Gait House is the chief,
and has a capacity for one hundred and fifty guests.
TheAcademy of Music is one of the finest provin-
cial halls in the state. Sterling is the home of
Dr. F. W. Gordon, vice-president of the Associa-
tion, as well as of Dr. M. J. HiU, and several other
well-known physicians of our school.
Sterling is supplied with some of the best news-
papers in the state. The Sterling Gazette pub-
lishes a daily and a weekly edition. There are also
the Sterling Standard, the Eock River Express,
and, across the river, the Rock Falls News.
The members of the Association may be assured
that they have made a fortunate choice in selecting
Sterling as the place of their next annual meeting.
WESTE&N ACADEK7 OF HOMCBOPATHT.
FOURTEENTH ANNUAL CONTENTION,
Held at the Grand Pacific Hotel, Chicago, May 29,
30 and 81, 1888.
The president, J. M. Crawford, M.D., of Cin-
cinnati, called the meeting to order at 2 P. M.,
May 29. The Academy adjourned at 5 P. M.,
May 31.
The three days* session was marked less by
great achievements, than by an evident deter-
mination on the part of those present to put the
Academy in such a position that it shall accom-
plish far more in the futur^.
The papers were not numerous, but, consider-
ing the amount of material presented, the dis-
cussions were well sustained, and the final ver-
dict was, that the convention had been both en-
joyable and profitable.
Papers were read by the following members :
P. S. Hoyne, M.D., of Chicago ; H. P. Phillips,
M.D., of St. Louis ; D. W. Williams, M.D., of
Omaha; J. D. Buck, M.D., of Cincinnati; E. F.
Storke, M.D., of Milwaukee; T. C. Duncan,
M.D., Geo. A. Hall, M.D., and Chas. Gatchell,
M.D., of Chicago.
Wednesday afternoon was devoted to a car-
riage ride through Chicago's parks and boule-
vards, an entertainment which was arranged by
Dr. Geo. A. Hall.
On Wednesday evening, an audience which
filled the room listened to the president's ad-
dress. Dr. Crawford took for his subject " The
Preliminary Education of Medical Students,"
and presented it in a manner which was both
novel, interesting and instructive, and elicited
much applause.
The important business of the session con-
sisted in abolishing the annual dues of $S, and
in the adoption of the following resolutions,
which had been prepared by a committee ap-
pointed for the purpose, consisting of the presi-
dent, Drs. Vilas, Caine, Storke, and GatcheU.
RESOLUTIONS.
1. That, as suggested in the president's ad-
dress, one person be appointed by the president,
in each place suggested by any member of the
Academy, containing a homoeopathic physician,
whose duty it shall be to procure new mem-
bers, and otherwise to advance the interests of
the Academy.
2. That the chairman of each bureau select
from among the members of such bureau at
least one person who shall prepare a practical
essay on some assigned subject, which subject
JUKS, 1888.]
MISCELLANY.
191
shall be discussed by members of the bureau,
previously designated ; after which the discus-
sion shall become general.
3. That the time and place of meeting of
the Academy shall be the last Wednesday in
August of each year.
4. That the local physicians in the city
where the meeting is held shall not be expected
to go to expense in providing any excursions,
banquets, or other entertainment.
The president appointed the following as
chairmen of bureaus :
Legislation and Statistics, H. B. Skiles, M.D.,
of Chicago.
Pharmacy, A. H. Schott, M.D., of Troy, 111.
Sanitary Science, E. F. Storke, M.D., of Mil-
waukee.
Nervous and Mental Diseases, Ghas. Gatchell,
M.D., of Chicago.
Ophthalmology and Otology, J. L. Beaumont,
M.D., of Minneapolis.
Surgery, G. F. Shears, M.D., of Chicago.
Pathology, E. C. Cole, of Chicago.
Paedology, A. P. Bowman, M.D., of Des
Moines, Iowa.
Gynecology, H. C. Baker, M.D., of Kansas
City, Mo.
Obstetrics, G. H. ParseU, M.D., of Omaha.
Materia Mediea, W. H. Pettit, M.D., of Cedar
Falls, Iowa.
Clinical Medicine, J. D. Buck, M.D., of Cin-
cinnati.
The election resulted in the choice of the fol-
lowing
OFFICERS :
President, T. S. Hoyne, M.D., of Chicago.
Vice-President, W. A. Paul, M.D., of Bock
'. Island.
Secretary, C. J. Burger, M.D., of Boone-
/ ville, Mo.
I Treasurer, G. W. Foote, M.D., of Gales-
' burg, ni.
Bock Island, 111., was chosen as the next place
of meeting.
A circular-letter from the Secretary of the Ameri-
can Institute, together with other matter that has
be -n crowded out of its reading pages by our extend-
ed society reports, will be found on business page XV.
OBITXrABY.
We regret the necessity of having to announce
to death of Mrs. Frances A. Bowling, wife of Dr.
J. W. Dowling, of New York. After a lingering
illness, Mrs. Dowling died May lOth, in her 47th
year. We extend to Dr. Dowling the assurance
of our most sincere condolence.
Home and School for Backward and Weak-
Minded QirlB.
The profession of Chicago will be glad to know
that an institution of 'this character has been
opened. Rev. A. K. Parker, D.D., 635 Adams
street, and A. W. Woodward, M.D., 130 South
Ashland avenue, have permitted their names to be
used as references. Physicians knowing of chil-
dren who would be benefited by systematic train-
ing may safely refer the parents to this school.
Address 155 Irving avenue.
Aldbn's Manifold Cyclopedia . The second vol-
ume of this work, now on our table, even better
than the first, fulfills the promises of the publish-
er's prospectus. It is a really handsome volume
of 040 pages, half morocco binding, large type,
profusely illustrated, and yet sold for the price of
05 cents ; cloth binding only 50 cents — postage
1 1 cents extra. Large discounts even from these
prices are allowed to early subscribers. It is to be
issued in about thirty volumes. The publisher
sends specimen pages free to any applicant. John
B. Alden, Publisher, 393 Pearl St, New York, or
Lakeside Building, Chicago.
The Phosphates of Iron, Soda, Lime and Potash,
dissolved in an excess of Phosphoric Acid, is a
valuable combination to prescribe in nervous ex-
haustion, general debility, etc. Robinson's Phos-
phoric Elixir is an elegant solution of these chemi-
cals. (See page X.)
The good results of the use of Lactated Food as
a substitute for mother's milk, may be seen in the \
picture of little Amy Cox, which speaks for itself. \
Any physician will receive this handsome picture
who will send his address to Wells, Richardson & /
Co. , Burlington, Vt.
The North American Journal of Homceopathy
will be sent on trial for three months gratis, to
any one sending their address to 152 West 34th
Street, New York, and mentioning The Medical
Era.
New Line to Oheyenne.
The new extension of the Burlington Route
to Cheyenne, Wyoming Territory, having been
completed, the C, B. & Q. R. R. is now running
a through sleeping car from Chicago to Chey-
enne, via Omaha, leaving Chicago daily at noon
on the "Burlington Number One" fast train.
For tickets apply to any coupon ticket agent of
its own or connecting lines, or address Paul
Morton, Gen'l Pass, and Ticket Agent, C, B. &
Q. R. R., Chicago.
192
THE MEDICAL ERA.
IVOL. VI. No. 6
THEY SAY
That the meeting was well attended.
That the president presided with dignity.
That the surgical bureau wants more time.
That the hall was well suited to the purpose.
That the baby- clothes excited much interest
That the adjournment was rather precipitate.
That the powder folding machine was very
" cute."
That the hall would have looked bare without
the ladies.
That some of the discussions were Hvely — and
some were not
That a fish in the milk is strong circumstantial
evidence.
That life is not a mouthful, that a man should
gulp it down whole.
That you can trust the cat when the buttermilk
is on the top shelf.
That iodoform is the best thing to stop serous
oozing from wounds.
That the average opium eater does not live to be
more than forty -five.
That you should never try to carry two water-
melons* under one arm.
That lacerations of the cervix are most often the
result of tedious labors.
That God never had a house of prayer, but
Satan had a chapel there.
That acute lobar pneumonia leaves the lung
uninjured after recovery.
That the perspiration is more concentrated on
the right side of the body.
That you must not pull on the cord until the
placenta is felt in the vagina.
That syphilis is a much more serious disease in
early life than it is in the aged.
That of all the lower animals the leech shows
the greatest attachment for man.
That primary acute pleurisy is not fatal unless
it is accompanied by pericarditis.
That people who get into the social swim are
often drowned before they get out
That about fifteen thousand doctors wrote books
and articles on medical subjects last year.
That a doctor in a Pennsylvania town reports
an unusual " prevlence of tyford fever."
That skin diseases frequently penetrate deeper
than the skin, and their study is deeper still.
That premature baldness is not always heredit-
ary, but frequently due to neglected dandruff.
That a red-headed boy explained by saying that
when he had the scarlet fever the disease settled in
his hair.
That the animal parasitic diseases cannot always
be diagnosticated by observing the presence of the
parasite.
That the reason some men can't make both ends
meet is because they are engaged in making one
end drink.
That fatal bronchitis in persons between 10 and
60 years of age is either capillary or secondary
to tubercle.
That the skin presents sixteen square feet of
exposed surface, and is liable to constant irritation
from without
That electricity is very good for illuminating
purposes, but for killing people it can't hold a can-
dle to a coal-oil can.
That there is little use trying to cure a mor-
phine habittiS unless the patient himself earnestly
desires to be cured.
That a Georgia farmer made $ 100 from an acre
of watermelons, and the nearest doctor made $200
from the same acre.
TitAT non-volatile substances dissolved or sus-
pended in water are not absorbed by the akin to
any appreciable extent
That a fish should never be permitted to lie
when it can be hung conveniently. The same may
be said of the fisherman.
That the majority of oases of eczema display no
vesicles; when present, the vesicles are generally
small and quickly broken.
That during chloroform ansasthesia the amount
of oxygen in the blood diminishes, while the
amount of carbonic acid increases.
That gelsemium may be characterized by call-
ing it the remedy of the four L.'s — lightheaded-
ness, languor, lassitude and listlessness.
That th& morphine habit, in the majority of
cases, is the result of its having been adminis-
tered medicinally during some illness.
That the obstetrician who does not inspect the
perineum after labor has no lacerations, but he
is the hand-maid to the gynecologist
That convulsions occurring first after the thir-
teenth year, and usually^ epileptiform in charac-
ter, point to a possible cerebral tumor.
That the easiest way to detect the morphine
habit is to give a hypodermic injection of mor-
phine to the suspected victim, and watch the ef-
fect
THE MEDICAL ERA
Vol. VI.
Chicago, July, 1888.
No. 7.
EDITOBS :
CH. OATCHELL, M.D.
JAMES E. GROSS, M.D.
ALCOHOL.
The spirit of evil !
It has justly been called the <' Great Degen-
erator." In its presence connective tissue con-
tracts, and organs shrink. The stomach, the
kidneys, the hver, and even the brain, all suc-
cumb to its destructive influence. The liver
resents its presence by taking on a density
almost cartilaginous. The kidneys partly sus-
pend their functions. The lungs, when inflamed,
invite a grave prognosis.
All this it does, and more.^ Its sphere of
action is limited, its redeeming qualities are few.
In cases of collapse, and when the vital powers
are low, as a temporary stimulant there is
nothing that will supplant it. But in the treat-
ment of chronic disease it has no place, and in
health its effects are more than deleterious —
they are often ruinous. Not only orthographic-
ally, but Uterally, an intoxicated man is a poi-
soned man.
It is almost a work of supererogation to dilate
upon the evils wrought by this crownless king.
They are well known to every school-boy. The
subject is old, trite and familiar; one concern-
ing which every man may be a teacher, and
hence find none to teach. But re.ference to it
calls for no apology, and will not until man's
emancipation is complete, and children are in-
sored against an undeserved inheritance.
Our object now is to remind physicians of the
relation which they bear to the matter, and
of the duty of the hour. In many instances
the direct responsibility for the formation of the
vicious habit rests upon the medical man. But
in the reformation which is in progress, and
which had its birth nearly a century ago^ he can
do more than avoid the errors of the past — he
can take new ground for the future. It devolves
upon him to make known to the people the true
nature of this subtle poison ; to teach them, from
the point of view of physiology, that the virtues
that alcohol has been supposed to possess, are
all vices ; that it does not strengthen, but en-
feebles ; that it does not .aid digestion, but re-
tards it ; it does not add warmth, but extracts
heat ; it does not build up, but tears down ; it
does not fatten, but bloats ; it does not generate,
but degenerates.
With these sins, and with many others, is it
justly charged.
It is peculiarly the province of the physician
to make this known. The physical well-being
of the race is in his keeping. Let him do his
duty!
But in so doing, let him not forget that re-
forms are not accomplished in a day ; that edu-
cation must precede legislation; that man's
appetite cannot be controlled by statute. Let
him not shirk his task, which must be one of
years, by hoping to shift it upon the shoulders
of the executive, expecting it to be accomplished
in a week. Let him help to mold public sen-
timent — a force more potent than martial
law. The one is for a day ; the other is for all
time.
Be not misled by blind enthusiasts.
194
THE MEDICAL ERA.
[Vol. VI. No. 7.
YELLOW-FEVER.
Another microbe has gone.
For several years the profession has been
made acquainted with the claims of a certain
Dr. DoMiNGos Freirb, of Eio Janiero, who
announced that he had discovered the specific
microbe of yellow-fever. He claimed, more-
over, that by a system which he had devised,
those who were subjected to inoculation with
the germ were rendered innocuous to the dis-
ease.
The Government of the United States made
an appropriation for the purpose of having the
matter investigated. Dr. Geo. M. Sternberg
— whose eminent fitness for the task all will
recognize — was appointed for the mission.
The results are decidedly negative.
Dr. Freire said there was a microbe.
Dr. Sternberg failed to find it.
Dr. Freire said that of 6,524 persons whom
he had inoculated, only eight contracted the
disease.
Dr. Sternberg found that out of a certain
forty-four people who had been inoculated,
twenty-two took the disease, and nine died.
Thus is another microbe disposed of.
The over-zealous friends of the doctrine of the
germ-origin of specific diseases are apt to do the
cause more harm than good in the estimation
of the profession at large.
There are several facts that have been abso-
lutely demonstrated : There is a specific bacil-
lus of tuberculosis, and a specific bacillus of
anthrax, and these bacilli bear causative rela-
tions to the diseases named. There is also a
bacillus which bears a constant relation —
whether causative or not is not knoMTi — to
Asiatic cholera. This much has been demon-
strated and is capable of demonstration over
and over again. Even the conservative Sem-
MOLA freely admits it. But beyond this there is
as yet no positive knowledge.
Those who accuse the friends of this doctrine
of more than this, are simply indulging in that
pastime which is called setting up a man of
straw in order to knock it down.
WOMAN'S DRESS.
If men should dress as women do, the extinc-
tion of the race would soon begin. Without
adequate protection for the lower limbs, and
with their feet encased in kid, they would, in
harsh weather, become the victims of rheum-
atism, pneumonia, and other diseases resulting
from exposure to wet and cold. With stays
tightly fastened about the waist, constricting all
the abdominal organs and impedmg the motion
of the lower ribs, they would suffer far more
from disease of the imprisoned parts. With
bungling skirts hanging about their legs, they
would be unable to perform three-quarters of
the work which now is theirs.
That all these dire disasters are not now
visited upon woman, is due to the fact that her
mode of life calls for less exposure, and her
occupations for less activity. Were the condi-
tions of the sexes reversed, the fashion of- cloth-
ing might be exchanged.
If woman would compete with man in the
fields which hav6 long been his — a movement
which, to a great extent, will some day be
accomplished — she must first reform her dress.
She must so clothe herself that she may with-
stand the vicissitudes of weather, and enjoy a
freedom of motion now denied.
But this is enough to justify the claim that
there are diseases which are caiLsed by the introduc-
ikm of (jernis into the system.
But this should be done without a sacrifice of
either grace or beauty. And it may be accom-
plished by adopting the Turkish costume, which
permits freedom of motion for body and limbs,
and at the same time presents an apparel which
for grace of design has never been equaled. It
affords an opportunity for the display of colors,
and for adornment with laces or jewels, to excite
the admiration of man and the envy of woman.
It answers every demand, whether of utility or
of beauty.
But woman's first emancipation must be from
the thralldom of unsuitable dress.
JULT, 1888.]
ORIGINAL ARTICLES.
195
ORIGINAL ARTICLES.
RADICAIi CUBS 07 MALIGNANT LYM-
PHOMA BY 8TATI0 BLXOTBIOITY.
Bt W. D. McAFF£B, M.D.
BOCKrORD, VUU
[Read before the Illinois Stole Homceopathic Medical ABSociatton.]
IMBUED with no desire for self-aggrandize-
ment, but with a sense of obligation to my
associates, I will relate my experience with
static electricity. Let me say right here that
the machine I am using was invented and made
by P. Atkinson, of Chicago, and is first-class in
every particular, generating a strong, even cur-
rent, and if kept clean is but little affected by
atmospheric changes. During the one and a
half years I have used it I have had hundreds
of cases and given several thousand treatments,
and in some cases the success has been extraor-
dinary ; more has been accomplished with this
machine in my hands than I ever obtained with
the old style of battery during a practice of a
quarter of a century.
If I may be permitted, I would like to preface
the consideration of the subject of my paper with
a brief mention and results of treatment of some
disabilities that daily present themselves. In a
few cases the indicated homoeopathic remedy
was given. In the. majority of them I gave no
medical treatment.
In amenorrhoea, notably among the younger
class, scores of patients have been restored and
regularity established. In rheumatism and
neuralgia, great relief has been obtained, and
some cures have resulted. When, from poor
circulation, the feet are habitually cold, spark-
ing them a few times will permanently warm
them. In a number of cases it has proved a
valuable hypnotic. It has completely cured
several cases of chorea. Has been beneficial in
ec^ma. It has relieved the soreness in corns
and bunions. It has aborted felons. It has
removed the stinging pain that is so intolerable
in the nerve of the toes from wearing narrow
shoes. It has been beneficial in spinal irrita-
tion, paraplegia, muscular atrophy, enlargement
of the joints, hypereemia of the liver, constipa-
tion and hysteralgia.
About the first of last October, David C, a
man of strong habit, about fifty years of age, by
occupation a machinist, came to me for treat-
naent for malignant lymphoma of the right cer-
vical region. The extent of the growths would
fill the triangular space made by the anterior
portion of the trapezius and stemo-cleido-mas-
toid muscles. One of the tumors extended over
the clavicle about the middle third ; another at
the junction of the clavicle with the sternum.
This triangle was a nodulated mass of tumors
of varying sizes, some being very large. They
were evidently of both the hard and soft varie-
ties, as observed by Virchow and Langhans.
Two were soft; the others were hard. These
growths were quite noticeable about the first of
May. Their development was rapid, so that in
six months they occupied the whole of the region
specified. So intractable and unyielding were
they that to turn the head to the right was an
impossibility. This was a great inconvenience
in obtaining rest.
This man came to me in a very despondent
mood, as well he might, for he had read some-
thing of the nature of his case. He was reduced
by worry and the painful fact haunting him
that a fatal termination awaited him in the near
future, for he had been treated by other physi-
cians of this city in the conventional way, and
no other prognosis was given than that the
growths would cause his death.
I began giving him daily treatments, applying
the spray direct to the tumors, bringing the
pointed electrode so immediately in contact with
the skin as to cause a frying sensation, nearer
than the sparking distance. He had a month's
daily treatment, then every alternate day for
two months. Improvement was observable after
ten treatments. He took no remedy but Galca-
rea iodide for one month. About this time two
of the tumors showed signs of suppuration, and
very soon they began discharging freely. These
two surfaces I was compelled to lay open freely
with the knife. The wounds were kept cleansed
and dressed with Calendula, and they gradually
healed. At the same time all the remaining
growths remained hard, but gradually lost their
grip, diminished and disappeared, so that at the
end of four months this abnormal regional anat-
omy would not be recognized. The patient
gained fifteen pounds, and being of a strong,
muscular build, lost but few days of labor.
It may be said this experience is limited.
Very true ; but I would undertake the next case
with full confidence that I could master it, such
is my faith in static electricity. I regret I did
not take a photograph before and after treat-
ment.
I think this is one of the most remarkable
cases, as well as one of the most remarkable
cures, on record, and my patient is one of the
happiest beings in Bockford.
106
THE MEDICAL ERA.
[VoL,VL Ko. 7.
GLINIOAIi ETS 0A8BS.
Bt C. H. VILAS, M.D.
cniCAao.
[Read before the Illinois Homoeopathic Medical AsaoclaUon at Chi-
cago, 1888.]
MR. D., aged about sixty years, came to be
operated on for cataract. His left eye was
the most affected in vision, and exami-
nation revealed nothing abnormal beyond the
opacity of the lens.
The operation selected was a modified Von
GrflBfe, and was done without special complica-
tion. Anaesthesia was produced locally with
Cocaine. After the operation was completed ( it
is essential that the operation be well done), the
eye-lids were closed with gentle stroking and
sealed. The patient went to bed, and remained
until the next afternoon, about twenty-four
hours. No darkening of the room was advised,
and during the afternoon the sun shone directly
into the room. The corneal incision healed
speedily, and in a week's time the patient went
about, care being taken that no sudden or strain-
ing movements were indulged in. Vision was
excellent, and so remained.
Mrs. C, aged about fifty-five years, was oper-
ated on by me for senile cataract. One eye had
been lost by a cataract operation, and this was
the ''last chance," and consequently a matter of
great importance to her. The same procedures
were gone through with and a sinjilar result
obtained.
I have narrated these cases, freed of all tech-
nicalities and unnecessary details, to comment
on them and the deviations from ordinary meth-
ods of treatment.
A short time ago the exposure of eyes oper-
ated on for senile cataract to ordinary daylight,
to say nothing of strong sun-light, would have
been regarded as fatal to the recovery of vision.
Ten years ago, when I was in Vienna, we were
only allowed to see cataract patients in rooms
so thoroughly darkened that it was almost im-
possible, to go about even when the eyes had
become accustomed to the darkness. A shaded
candle was used to inspect the eye, and the
greatest care was taken that no light harmed
the eye. Such treatment I had followed for
years. Six years ago the same treatment ob-
tained in Vienna. I am told it does now.
In Paris, substantially the same was carried
out in Prof. Galezowski's clinic, though less
stress was laid on extreme darkness. I was
told the same care was used in DeWecker's
and others', but I was unable to verify the report.
In London, at the Royal London Ophthaknic
Hospital, Moorfields, the same general treatment
was pursued, but the room was considered suffic-
iently dark when the wooden blinds were closed.
In all these great centers especial care was
taken to bandage the eye also. In Vienna the
long flannel roller was used ; in Paris a similar
one ; in London a modified Liebreich. In the
German centers the patients were kept in bed
four days to a week, when they were allowed to
be up and about the darkened room.
Such in general, and especially as applied to
the light, was the treatment everywhere. I do
not recite or dwell on the treatment otherwise,
because in this paper I am only concerned in
the questions of light and bandage.
A few years ago it occun^ed to several almost
simultaneously that there was no reason why
light should be harmful to an eye operated on
which was otherwise healthy. An accident after
a cataract operation at the Hahnemann Hospital
in this city whereby the eye of a patient was
exposed to direct sunlight, .convinced me that
extreme care was not essential to success, and
after reading the experience of others as well as
conversing with some of them, I decided on try-
ing the effect of no bandage and full light .in
such cases as promised a successful issue.
In suitable cases, that is, those uncomplicated
with other troubles, no harm to the eye has fol-
lowed from a free exposure to light, and I am
sure much benefit to the patient. The relief to
the latter can hardly be understood by those who
do not have to deal with such eases. Under the
old flap operation the recumbent motionless
posture was imperative for many days ; four to
twelve might be said to be the extremes, and the
greatest of care as to any expulsive effort. Von
Graefe shortened and modified this by his clas-
sical operation, but insisted on the bandaging.
If any one will carefully experiment on animal
eyes set in an ophthalmic mask, he will readily
see that on the proper section of the eye materi-
ally depends the probability of a speedy union.
If the section be made in the plane so carefully
detailed and explained by Von GrsBfe, the severed
parts will lie in exact apposition ; if in a faulty
plane, only m. juxtaposition, and union cannot
be had primarily except pressure is applied to
hold the lips of the wound together. But if
the wound is in a proper plane, nothing is re-
quired after the expulsion of the cataract to
close the lips of the wound, they spontaneously
closing. If, then, they are allowed to so remain,
union is immediate.
Examining the structure of the tarsal car-
tilage,* it will readily be seen to be a perfect
JcrLT« 188R.1
ORIGINAL ARTICLES.
197
splint for the holding of the parts already in
apposition. No one could shape a piece of felt
or pasteboard so accurately, for it fits all de-
fects as well as perfections of the curvature of the
individual eye. Nothing is required to effect its
use as a splint, except to close the lid and relax
the pressure. These points are accomplished
by fastening the closed lid with a piece of soft
plaster; diachylon is too coarse, preferably a
piece of gold-beater's skin.
In my opinion no advance in ophthalmic sur-
gery has so contributed to the comfort and ease
of both patient and operator, as this one. - That
it is not applicable to diseased eyes is true, and
that it will not always be available, may also be
admitted. Experience and judgment cannot be
laid aside or become valueless, no matter what
progress is made in an art.
A STUDY OF liTOOPODIUM AND NATRXTM
MTTBIATIOTTM.
Bt W. J. HAWRBS, M.D.
CBICAOO.
[ Bead before tlie Illinois SUte Homoeopatbic Medical Association.]
THESE two valuable remedies, while very
dissimilar in many respects, are alike in
several marked particulars. Both are re-
garded as practically inert as medicinal agents
in the crude state and in the very low potencies,
and are consequently relegated as medicines to
the state of << innocuous desuetude " by all allo-
pathic, and the vast majority of homoeopathic
physicians.
Each has its special field of action, in which,
as a curative agent, it has no equal. While
each finds frequent work in other fields than its
own, in no other is its action so prompt and so
often needed. Both are highly regarded by all
physicians who use the 30th and higher poten-
cies, and who know and heed the value of the
teachings of Hahnemann, Hering, Lippe, Guern-
sey and Dunham. Both alike are left out of the
memory and case of those who have little knowl-
edge of, and confidence in, the action of dynam-
ized drugs, for both agents are practically use-
less in preparations lower than the 30th. There
are reliable authorities who claim that in the 6th
and 12th potencies they develop active curative
action. I never use lower than the 30th of these
remedies, and more often the 200th or 1 m.
Both are unimpeachable witnesses, proving the
truth of the dynamization theory of Hahne-
mann.
Lycopodium — Common Club Moss. The Na-
tional Dispensatory, the old-school album of all
drugs, has little to say of the mediciiial uses
of this ( in our hands ) powerful curative agent.
It is only to base use that this indispensable
medicine is put by the arrogant medical *' sci-
ence " of the dominant school.
The field of its usefulness, known to us, and
discovered through the instrumentality of the
homoeopathic law, embraces especially the diges-
tive and urinary organs. Diseases of the heart
and lungs, and those of a rheumatic nature, are
often controlled in a most remarkable manner
by this remedy. It is noticeable that in all in-
stances where it is indicated, some evidences of
derangement of the urinary and digestive func-
tions will be found to exist, of the former by
pains in the renal region, difficulty of urination,
frequent desire to urinate, reddish, sandy
sediment in the urine, etc. Of the latter by
borborygmus, distension of the stomach, with
sense of satiety after eating but very little, con-
stipation, shooting pains in the abdomen, coated
tongue, etc.
Many other remedies have symptoms similar
to those mentioned ; and are more or less useful
in these troubles. Nux vomica, Arsenicum, Pul-
satilla and a number of others have many of
these general symptoms. But there must be
one or more symptoms in each to distinguish
it from all others; else were some remedies
redundant, as filling the space fitted to another.
There are such distinguishing symptoms. In
addition to the symptoms already given for Ly-
copodium, there are others peculiarly character-
istic of this remedy : — viz., Ist, the patient, .
no matter what ails him, is invariably worse
from about four o'clock in the afternoon until
late bedtime. He will attend to his daily duties
in comparative comfort and with reasonable
strength until about that hour, when almost
suddenly his " strength gives out,*' and he be-
comes unaccountably worse in every way. He
usually attaches no significance to the circum-
stance and attributes it to his becoming tired
towards the close of the day. I regard this as
one of the most valuable and reliable symptoms
of this or any other remedy. I have learned to
rely upon it implicitly. It is more often to me
the " key-note " to the " Club-moss " time than
any other symptom. It also frequently aids in
making a diagnosis ; for nine times in ten, when
that four-o'clock-aggravation is voluntarily men-
tioned by the patient, there will be found kidney
trouble also. The period of aggravation is not
always limited to the hours between "four and
eight o'clock p. m." of the books. In some se-
vere cases it begins as early as three o'clock,
and continues as late as midnight. .
198
THE MEDICAL ERA.
[Vol. VI. No. T,
2d. The sense of satiety and fullness after
eating only a mouthful, although beginning with .
a good appetite, is very characteristic of this as
a remedy for the dyspeptic patient ( or any other
patient for that matter). This is the distin-
guishing stomach symptom of Lycopodium, as
the sense of weight and distress an hour or two
after eating is of that other great dyspeptic rem-
edy, Nux vomica ; or as the disgust for fat or
greasy food is for Pulsatilla ; or as the burning
and thirst for, with intolerance of cold water, is
for Arsenicum.
3d. The pain in the back which is greatly
aggravated by retaining the urine after the de-
sire to void it, has been experienced, and the
marked relief from pain after urinating when
this symptom is supplemented by ** red sand"
in the vessel, Lycopodium will relieve the pa-
tient.
Here again it may be advantageously com-
pared with its great co-worker in so many fields
— Nux vomica — ^whi'jh also has back-ache, kid-
ney troubles, sand in the urine, etc. But the
Nux sand is predominantly whitish in color, the
back-ache is not markedly aggravated nor re-
lieved by retention or passing of urine respec-
tively, and has its period of aggravation between
two and four o'clock in the morning.
I would here emphasize the valuable truth in
symptomatology and therapeutics, that when the
period of aggravation of a remedy is well defined,
there is no more valuable or reliable guiding
symptoms in its pathogenesis. And this is
especially true of these two remedies ; hIso of
Natrum muriaticum, Rhus tox., Arsenicum, La-
chesis, Kali carb, etc.
When the following group of symptoms are
manifested in any patient sufifering from what-
ever ailment, Lycopodium may be implicitly
depended upon to initiate improvement, provided,
always, that the 30th or higher potency be used,
to- wit: — In kidney affections, red sand in the
urine, back-ache in renal region aggravated be-
fore, and relieved after passing urine. In respir-
atory troubles, ** fan-like motion of the wings of
the nose. "
In derangement of digestion, sense of fullness
and satiety after eating but little, rumbling of
gas especially in the upper left side of the abdo-
men, pain shooting across the lower portion of
the abdomen from right to left, and in all
affections a general aggravation between four
and eight o'clock in the afternoon.
From many marked cases I will detail two of
recent occurrence by way of illustration of the
value of the symptom '* aggravation between
four and eight p. m.," as an index to this remedy
in desperate cases.
Com ^o. i. Male, aged about forty years.
I was called on by the patient's wife about ten
o'clock in the evening, when she asked me to
visit her husband in consultation with the phy-
sician who had been attending him for two
weeks. She said the trouble was rheumatism,
and it was seriously threatening the heart. I
could not go that evening, but agreed to meet
the other doctor at ten o'clock next morning.
About five o'clock next morning a messenger
came hurriedly, and begged me to come at once,
as <<the physician had given the patient up, had
left the house, and he was surely dying. "
I found that the gravity of the situation had
not been exaggerated. He could scarcely breathe ;
his heart was beating feebly at the rate of
tweiity-five to the tnimUe! He complained of
great pain in the left chest, especially in the car-
diac region. His countenance expressed the ut-
most distress and anxiety ; face pale, sallow and
looking like death.
How much blame for the patient's desperate
condition was to be charged to the account of
the drugs administered during the period since
the heart had been threatened, it was not easy
to determine. But they had doubtless had much
to do in causing the slowness and feebleness of
the heart's action, as the pain and apprehen-
sion caused by rheumatic or neuralgic attacks
in the cardiac region tend rather to accelerate
than retard the rapidity of its action.
No doubt, large and increasing doses of drugs
having direct action on the heart nerves, had
been given, in addition to the Salicylic acid and
its compound, used in all such cases by the
old school. But the physician who had had
charge of the patient having deserted his post,
the facts in this regard could not be learned.
In therapeutically diagnosticating the case,
grave diflBculties presented themselves. The
patient himself could do no more for me than
to reiterate feebly between gasps, with his hand
to his heart, ** The pain here ! " The impossi-
bility of distinguishing as to which of the then
existing symptoms were those of the disease and
which were those of the drugs, made them a
poor dependence for a prescription.
I concluded the best plan to adopt would be
to go back to the beginning and ascertain, if
possible, what symptoms had presented them-
selves before drugging had been begun. He
had the good fortune to have a very intelligent
wife, and persistent questioning and intelligent
replying developed that he had been troubled on
JuiiT, ISgS.]
ORIGINAL ARTICLES.
199
account of bis kidneys for some time before be
bad taken to bis bed, baving bad pain in bis
back, irritability of tbe bladder, evidenced by
frequent desire to urinate; tbat a deposit of
''red sand" was frequently to be found in tbe
vessel ; and tbat all tbrougb bis illness be bad
been invariably worse from about four o'clock in
tbe afternoon till well into tbe nigbt. Tbis lat-
ter symptom was tbe first drawn out, and was
told in response to the question : << Is tbere any
time in tbe twenty-four bours tbat be bas seemed
worse tban at otber times, otber tbings being
equal?'* Tbis bint suggested inquiries as to tbe
urinary symptoms, witb tbe result as given, and
to observe bis countenance more closely by tbe
aid of more ligbt (be wanted tbe room darkened),
wben tbe peculiar "fan-like" motion of tbe oLt
nasi was plainly to be seen. Tbere were also
tbe severe flying pains about tbe beart, causing
tbe patient to press bis band tbere, dread to
move or be moved. Tbis latter symptom I bave
repeatedly verified as belonging to the condition
Lycopodium will cure.
Here was as good a picture of a remedy as
could be expected in such a clouded case. Lyco-
podium was prepared in water, with instructions
tbat it be given every half hour until some indi-
cation of improvement should be seen, when the
interval was to be lengthened. I left, promising
to call again after breakfast, which I did at ten
o'clock, and found my patient fast asleep ! His
pulse had increased to fifty-five beats per min-
ute, and there was every indication of substan-
tial improvement. His wife insisted that the
improvement became apparent in fifteen minutes
after be had swallowed the first dose of medi-
cine. Tbe patient did not wake while I was in
the house during tbis visit. It was the first
quiet sleep be had had in a week. His wife
could scarcely be convinced that he had not
been given an opiate. I left witb directions that
the medicine should be given every two hours
after awaking. Galled again at one p. m. and
found tbe patient awake and comparatively com-
fortable. Pulse ninety. Discontinued medi-
cine and substituted placebo.
On calling about eight in the evening, found
him still better, and the danger point apparently
passed. Improvement was steady and uninter-
rupted till in three weeks he was able to walk
out a little way. Bheumatism in his shoulders
persisted for a while, but finally yielded to Bry-
onia.
During the first week of my attendance upon
him he bad no appetite and a coated tongue.
He took no food but a Uttle milk in boUing
water, and drank warm lemonade. I find it
best in all such cases to forbid food, until the
patient longs for some simple, wholesome food,
and eats it with a relish. Such food, imder
such conditions, will refresh and strengthen the
patient. If forced upon him before he is thus
ready for it, it will weaken rather than strength-
en him.
Case No, 2, Male, aged 30. I was called to see
him a week ago, after he had been sick two
weeks, under the care of an old- school physi-
cian, with rheumatism in the left hip and the
sacro-iliac symphysis of that side. He had not
been able to sleep for several nights on account
of the severity of the pain, and extreme restless-
ness. Tongue heavily coated a yellowish white ;
great thirst for acid drinks ; no appetite ; face
sallow. The extreme restlessness, being obliged
to change his position veiy often, worse at
night, etc., suggested Rhus tox., which was given
in potencies varying from the highest to the low-
est, for forty-eight hours, without any relief
whatever. In cases so violent as this, and where
there is so much suffering, the proper remedy
will act and bring relief in a few hours at most ;
and I became satisfied Bhus was not tbe remedy
for this case.
A more careful examination discovered tbe
fact that, while he was worse at night, he began
to experience an aggravation of all bis symp-
toms about four p. m. This bad been the case
from the beginning. Examination of the urine
showed a copious, mealy, pinkish sediment in
the vessel ; be said he bad great trouble in pass-
ing water, with urging frequent. He had no
appetite, but craved lemonade and acid drinks.
His suffering had been so extreme for so long,
with loss of sleep, etc., he and his friends were
desperate ; so was I, almost. The pain was ex-
treme ; as severe as in aggravated cases of sci-
atica, so tbat the patient lamented continually.
His friends and he begged for something to relieve
the pain ; he must have rest the next night. I
promised them he should have, and determined
to do that which I do not do once in a year —
resort to anodynes if he was not relieved in a
measure by night. I gave him Lycopodium
about ten a. m. of the third day of my care of
him. I sent my partner in the evening with in-
structions to give him the simplest anodyne
should he not be a little better. The doctor re-
ported next morning that the patient became
easier about noon, and was comparatively free
from pain when he called ; so he gave him noth-
ing. Next morning I found him smiling and
comfortable, having slept several hours during
200
THE MEDICAL ERA.
[Vol. VI. No. 7.
the night. He told me he could feel that " qui-
eting medicine*' xvarkl
He has had sac. lac. for three days and is
free from pain, able to sit up, calls for food,
sleeps nearly all night, and is evidently on the
way to speedy recovery.
PHIMOSIS IN THE FEMALE.
Bt M. J. BLEIM, M.D.
CHlCAaO-
[Read before the Illinois State noinoeopathic Medical APBOciation.]
THE clitoris is a miniature penis. In its
general structure it corresponds to the
male organ. The two cruri arising from
the pubic rami unite to form the body, which
lies concealed in the depression between the up-
per extremities of the labia majoris. The body
terminates in a bulb of oval shape, and about the
size of a small split .bean. This is the glam
clUcridis, and is the only part exposed to view.
It lies in the apex of that triangular space called
the vestibulum and, like its male type, is covered
by a prepuce or foreskin. This prepuce is
formed by the labia minores. Each labia
divides at its upper extremity into an upper and
a lower fold ; the upper parts blend with «ach
other over the glans, thus forming for it a hood-
like covering. The under parts unite beneath.^
the glans, and are attached to its base, forming
a sort of frenum. Around the base of the glans,
where it joins the body of the clitoris, runs, a
groove, corresponding to the similar groove in
the male organ. If this description be sufficiently
clear its resemblance to a miniature penis can
plainly be seen.
Proportionate to its size and apparent place in
the sexual function has been the attention be-
stowed upon the clitoris, and indeed, the range
of diseases to which it is liable is extremely
limited. When we mention hypertrophy, vene-
real productions and cancerous aflFections we have
already exhausted the list given in text-books.
And yet there is one condition, extremely com-
mon, and in many cases undoubtedly prolific of
local and reflex disturbances, which I have never
seen mentioned in any of the familiar text-books
and works of reference. What one might find
by searching the musty records of the past, if one
had access and time, I cannot pretend to say.
The condition to which I refer is similar to that
so well known in the male, called phbnom.
If we will examine a normal clitoris we shall
see that the hood or prepuce is perfectly free
from the glans, and can be retracted without
difficulty, so as to expose the whole glans and
the groove at its base. In many cases (and
these are abnormal) it is impossible to do this,
because the prepuce is adherent to the surface of
the glans. Sometimes only the tip can be ex-
posed, but more often the adhesion exists only
over the distal half. You will find it almost im-
possible to break up this adhesion Without the
aid of an anaesthetic, and it is best done as a part
of complete orificial work ; even Cocaine fails
often to overcome this sensitiveness sufficiently.
On peeling back the prepuce we usually find
smegma confined in the groove and the affected
surfaces highly inflamed and irritable.
More rarely than the simple adhesion we find
the prepuce tense or shortened laterally, thus
binding down and pressing upon the glans. To
correct this condition it is necessary to incise the
hood up the center or to stretch it. If large, it
may be advisable to take stitches, and, if too
redundant, even to amputate a portion of the
prepuce.
And now, a word as to the effects produced by
this female phimosis. That it may exist in
many women without ever giving rise to any
local or reflex disturbances I do not deny. That
it may prove a possible cause of such troubles
I affirm ; and as a known abnormal condition
its correction is always justifiable. The princi-
pal local irritation which I have observed is
sexual excitation. Who knows but what this
condition may not in many cases be the direct
cause of masturbation ? That it keeps up a con-
stant irritation of the sexual function, whose
craving for satisfaction ends in masturbation, I
am positive. A fine illustrative case was the
one which first led my attention to this matter.
While assisting my friend, Dr. Wells LeFevre,
in performing an operation upon a young woman,
I noticed a very marked tension of the prepuce,
plainly pressing upon and binding down the
glans. I called his attention to it, and we dis-
cussed the propriety of correcting the condition.
But in view of our ignorance, we decided to
wait. The girl improved in many ways, but
finally told the doctor what she had never con-
fessed to him before — that she was troubled
with excessive sexual excitement, which at timed
became so intense as to lead to masturbation ;
she was a good girl and this trouble mortified
her terribly. Thereupon the doctor incised the
prepuce and broke up the adhesion. The relief
was instantaneous and to us a revelation. It
resulted in the immediate disappearance of all
sexual irritation and of masturbation. The Ger-
mans, with their penchant for curing all ills
\\ith the knife, have indeed practised ampnta-
JlTLT, 1888.1
ORIGINAL ARTICLES
201
tion of the clitoris for that vile habit. This is,
however, a very radict^l thing to do, and the suc-
cess has been so iudififerent that the procedure
is not well established. In those cases where
relief has been obtained by this measure, I am
of the opinion that the exciting cause was a
local one and could have been cured by attend-
ing to the condition of the prepuce, as well as to
all the lower orifices. In unsuccessful cases we
must seek for the exciting causes in the higher
mental and moral spheres.
Aside from local irritation, this condition of
phimosis may certainly operate by way of reflex
disturbances, keeping up an irritation of the
whole nervous system and a consequent drain
upon it. In short, may we not look for the same
range of effects as have already so well been de-
termined in the male sex ? May we not hope to
find here an additional key to the source of
some obscure nervous disturbances in young
girls and women ?
AIiEXANDEB*8 OPEBATIOK.
Br CURTIS M. BEBBE, M.D.,
CHICAGO.
[Read before the Illinois State HonKcopatblc Medical Association.]
ALEXANDER'S operation consists in short-
ening the round ligaments of the uterus.
The patient should be prepared as follows :
The day before the operation she should be
bathed with soap and water and sponged with a
solution of Bichloride of mercury 1 : 4,000 ; the
lower abdomen and mons veneris shaven and
sponged with Bichloride of mercury 1 : 4,000.
Give the patient some Castor oil the night
before, an enema of 23 of Glycerine three
hours before the operation, and a hot vaginal
douche of 1 : 6,000 Bichloride solution. Towels
saturated in 1 : 1,000 Bichloride solution should
be so arranged over the thighs and abdomen
that prepared objects will not touch unprepared.
The hands of all persons touching prepared
objects must be scrubbed in 1 : 1,000 Bicliloride
solation.
Find the landmarks to the external abdominal
ling — r namely, the spine of the pubes and the
ligament of Poupart above these, and at their
point of union is the external opening of the
inguinal canal, the external abdominal ring.
Cat through the abdominal wall parallel with
the upper border of Poupart's ligament, the in-
cision, one and one-half inches in length, hav-
ing its center over the external abdominal ring.
Cut directly through the several layers of
fascise to the ring and the aponeurosis of the
external oblique muscle. The depression corre-
sponding to the ring may be easily felt.
All of the tissues down to the aponeurosis,
throughout the whole length of the incision,
should be divided and drawn aside by retractors.
The wound should be kept almost constantly ir-
rigated. All of the structures, emerging from
the ring should now be raised on the blunt hook.
They consist of the round ligament, fascia, and
the inguinal branch of the ilio-inguinal nerve.
The nerve lying upon the other structures is
caught up, drawn out and cut off.
Dense fascia firmly unites the round ligament
to the pillars of the ring, and its extremity is
united with the areolar tissue over the crest of
the pubes.
Clip with scissors the fascia at the border of
the pillars of the ring, and thus free the hga-
ment at the opening ; passing the tip of the fin-
ger into the canal above, below, and at the side
of the ligament, and thus separating the liga-
ment from the canal, to which it is firmly
united.
When this is done completely the ligament is
free, can be readily pulled out, and is said to
**run." Stopping the hemorrhage and packing
the wound with Bichloride gauze, proceed in the
same way on the other side until that ligament
also "runs."
An assistant should now raise the uterus
with an Emmett*s repositor and place an Albert
Smith's pessary in position. Now draw the lig-
aments out as far as possible and have them
held firmly while the sutures are applied.
Use silk-worm gut for sutures and pass them
through the pillars of the ring, including two-
thirds of the substance of the ligament. The
ligatures should be drawn very lightly. Use
as many as four sutures to each ligament.
When the sutures are perfectly applied, cut ofif
the ligament half an inch from the opening, and
suture this end firmly to the tissues over the
pubic crest. Irrigate thoroughly. Inject sev-
eral drachms of Carbolic acid 1 : 100 solution
into the canal.
Pass a small drainage tube into the canal, so
as to secui-e free vent for the bloody serum thrown
out during the first forty-eight hours. Co-apt
the skin as perfectly as possible with silk- worm
gut sutures, irrigate, dust with Iodoform, then
spread a strip of Lister's protective over the line
of the sutures. Place a large handful of mussed-
up Bichloride gauze over the protective, and
over that a layer of Bichloride cotton two inches
thick. Then comes the T bandage. The urine
should be drawn with a catheter.
202
THE MEDICAL ERA.
[Vou VI, No. 7.
In twenty-four hoars the dressing should be
changed. In twenty-four hours more, remove
the drainage tubes and dress as thoroughly as
before.
This dressing may remain ten days, when the
stitches may be removed.
The patient should remain in bed one month.
The pessary should be worn six months.
The operation is useful in procidentia, retro-
version and flexion, and possibly extreme cases
of anteflexion.
Examining the position of the womb upon the
cadaver after making taut the round ligament,
it is found to be straightened and lying ante-
verted, very close to anterior abdominal wall.
In order that the operation be successful,
other measures may be necessary — amputation
of an hypertrophied cervix, uniting a lacerated
cervix or perineum, or correcting a prolapse of.
the anterior or posterior vaginal wall.
With these additional precautions, when the
necessity for them exists, I believe that Alexan-
der's operation offers the best and most perfect
cure of retroversion and procidentia.
8TRL0TUBB OF THE UBETHBA AS A OAUSE
OF ALBUMINURIA.
Bt C. a. WILLIAMS. M.D.
CUICAOO.
[Read before the Illinois Homoeopathic Medicul Aesociatlon.]
IN May, 1887, I was called to see a lady from
Kansas who gave the following history :
She became pregnant in Sept., 1884, and
felt perfectly well till Feb., 1885. On the
15th, she strained herself by some unusual
exertion. That night a discharge of blood came
from the vagina, and continued for three weeks.
Soon after the discharge stopped oedema set in,
and a sediment in the urine. Feb. 19, she was
delivered of a dead child. This was followed by
unconsciousness for twenty-four hours, probably
of uraemic origin. There was retention of urine
for several days. This was followed by a condi-
tion of involuntary urination, which lasted for
months. Occasionally there was great pain on
urination. Also a constant dribbling, notwith-
standing the bladder felt full, so that she would
sit on the vessel for hours. The urine was
albuminous. There was a burning and gnawing
pain in the urethra.
When I first saw this patient she was emaci-
ated, pale, with an anxious, painful expression.
Tongue coated, appetite poor, bowels loose, face
puffy, and some swelling of the feet. She could
sit up but a short time, and with difficulty
walked across the room. Questioning elicited
the fact that no one of her advisers had made
an examination either of the urethra or the
bladder, ascribing the trouble in these organs
to the albuminuria. On introducing the sound,
I found at the neck of the bladder a stricture
of the urethra and external to the stricture
an enlargement, or pouch, which contained
about half a teaspoonful of urine. At the seat
of the stricture the walls were thickened and the
canal so closed that a small probe was passed
with great difficulty.
The stricture was nearly half an inch in length,
and the thickened walls prevented the complete
closure of the canal, accounting for the constant
dribbling of the urine and distressing tenesmus
of the neck of bladder. By careful and contin-
ued efforts, using various sized probes, I was
enabled to pass a No. 5 sound, and finally a
small-sized catheter.
The bladder was about the size of a very small
orange, and with the capacity of perhaps one
teaspoonfuL The internal surface was granu-
lated and the slightest touch of the sound or
even the soft catheter was followed by a profuse
discharge of blood. There was no time that
the urine was not discolored. The enlarged
canal made but little change. The agony of
using the sounds when passing the lU'ethrocele
was intolerable. Considering this the aggravate
ing cause, and believing that its removal, thus
enabling us to get rid of the stale, acrid urine
that was retained in this receptacle, would add
much to our means of relief, I called Dr.
Streeter in consultation as to the advisability of
slitting up the canal, after Emmet*s plan, re-
moving the superabundance of tissue.
After a careful examination. Dr. Streeter con-
firmed my diagnosis, describing the urethrocele
as one-half inch across and three-quarters iacli
in length, sufficient to hold three-quarters to a
drachm of urine. Dr. Streeter suggested, in-
stead of using the knife, that the stricture be
rapidly and forcibly broken up by passing grad-
uated sounds until the whole canal i^aa
enlarged to a uniform size with that portion
containing the urethrocele. This was done at
once, passing from a No. 5 up to a No. 24
sound. This I continued at intervals of two,
three and four days, for three or four weeks,
and had the satisfaction of seeing the urethro-
cele gradually fade away and the canal become
uniform in size.
The patient could now at times retain the
urine for half an hour, and the capacity of the
Jttlx, 18B8.]
ORIGINAL ARTICLES.
203
bladder had increased to one-third of an ounce.
She was directed to use all efforts to retain the
urine as long as possible. As soon as a suffic-
ient quantity of urine was obtained an analysis
was made and found to contain a large amount
of albumin, blood corpuscles, pus, tube-carts
and broken down epithelium, establishing be-
yond all doubt the implication of the kidneys.
There was no way to get at the amount of urine
voided in twenty-four hours, but there was every
evidence that the amount was far below the
normal quantity. The diarrhoea continued in
spite of thorough medication and careful atten-
tion to diet. An examination of the rectum
revealed a contracted sphincter and sensitive
papillae. These were removed, and tlie sphinc-
ter stretched, and was followed by rapid relief
from the diarrhoea. Her general condition be-
gan to improve in a marked manner, and she was
enabled to take some out-door exercise. Injec-
tions into the bladder of a saturated solution of
Potassa chlorate was used every day for some
weeks, and the amount of blood was greatly
diminished, and often the urine was voided
without being discolored. Boracic acid was
now substituted for the Potassa, one drachm
to the ou[Qce of water. The capacity of the
bladder gradually increased, and on her depart-
ure for home, Aug. 7th, 1887, was nearly one
ounce, allowing her to retain it nearly an hour.
She has continued under treatment to the pres-
ent time, sending at regular intervals samples
of urine for examination.
The first measurement made after the incon-
tinence ceased^ showed six ounces secreted in
twenty-four hours. This gradually increased
until at the present time she is passing thirty
to forty ounces per diem. The albumin also
gradually decreased until now there is no trace
of it whatever. She now writes as follows:
April 11, 1888. **As my medicine is nearly
gone, I write you again. I believe the bladder
is steadily increasing in size as I can now retain
nearly three ounces at a time. The urine never
looks bloody, and does not dribble away at all
any more. And I generally wake during the
night in time to get up, although 1 sleep real
well. I pass from two to two and a half pints
every day. Some articles of food, as onions
and buttermilk, affect my bowels some, although
ihey are quite well as a rule."
Two points were learned in this case that are
worthy of our consideration. First, that from
stricture of the urethra we may have cystitis
followed by contraction of the bladder, and as
the results of the obstruction to the discharge of
the urine, sympathetic inflammation of the kid-
neys, resulting in albuminous and real nephritis
with structural change in the kidney itself.
Second, The general stimulating effect produced
through stretching the constricted orifice of the
body, resulted in this case in the removal of not
only the stricture, but so toned the walls of the
urethrocele as to obhterate that most trouble-
some and, in many cases, incurable condition
by the ordinary surgical measures. Thip paper
would be incomplete without mentioning some
of the therapeutics in the case. Many different
remedies were used, as the conditions seemed to
indicate, but only from two did I get any
marked results: Mercurius corrosivus, and
Millifolium. These were used a greater part of
the time, and when discontinued their absence
was noticed very soon.
OHILDBSN AND HYGIENE.
By p. W. GORDON, M.D.
BTBKLINO, ILL.
[Kcad before the Illinois State Ilonueopathlc Medical Ai<Bocialioii. ]
IN presenting a few thoughts on this subject,
it is with the hope that I may stimulate fur-
ther research in this important field, and to do
what I can to impress upon the minds of all, that
in order to have vigorous and well-balanced men
and women, we must have healthy and well
trained children. Such a desirable state of
things can only be possible by a due observance
of nature's laws.
Ordinarily our first duty toward the new-bom
babe is tying and severing the cord. This
should not be done too soon, especially if there
is strong pulsation, as that indicates that the
pulmonary* circulation is not fully established.
My experience teaches that nurses are often
inclined to adjust the waistbands much tighter
than they should, thereby inducing great discom-
fort, indigestion, colic, and a lack of general
development.
It is barbarous thus to cause needless suffer-
ing, to say nothing of the permanent injuries
that are liable to follow.
The only natural food for infants is obtained
from the mother's breast. This rule should in-
variably be followed, if possible, unless the health
of the mother forbids. Where organic disease
exists to any considerable extent, especially of
the respiratory organs, nursing should not be
permitted. Another difficulty frequently met
with is the tendency with many to protract the
nursing period far beyond the demands of health
204
THE MEDICAL ERA.
IVOL. VI. No. 7.
and to the injury of both mother and child.
Various excuses are given for this, such as,
"Her teeth are so slow in coming;" and, **She
won't eat anything at the table," etc. But I am
forced to conclude that the real cause often is
the false impression that they are, for the time
at least, insured against future pregnancies. An-
other reason for nursing, and one which I think
is rarely considered, is that, being a natural
process, it materially aids in the speedy and com-
plete restoration of the entire generative tract.
Where there is a manifest lack of nourishment
at the breast, cow's milk, properly diluted, may
be given, but only in sufficient quantity to make
good the deficiency.
Wet-nursing is perhaps the next most natural
method to be employed, although it has some
serious objections. The greatest is, perhaps, the
risk of communicating disease in some form or
other to the child. The nurse should be closely
examined. To retain their places they may, and
sometimes do, resort to feeding the child clan-
destinely, and if the little one is sleepless or
colicky, may resort to drugs.
The next most available and natural means of
nourishing a child is with cow's milk. Untold
and meritorious efforts have been put forth to
supply something better and more nearly allied
to that of the mother, but without success.
Says an eminent English authority: "Even
Baron Liebig has followed the lead, with a * Food
for Infants,' wherein ounces and quarter grains
figure closely, and which, after all, is not nearly
so close an imitation of human milk as is made
by the addition to fresh cow's milk of half its
bulk of soft water, in each pint of which has
been mixed a heaped-upteaspoonful of powdered
sugar-of-milk, and a pinch of phosphate of lime."
That " infant foods" serve an excellent pur-
pose, and can not easily be dispensed with, I
freely admit ; but that it is possible to substitute
any article whatever that milk in some form does
not largely enter into, that will prove more nu-
tritious and beneficial to infants generally, I
positively deny. My experience teaches that
there is a wide-spread disposition now-a-days
on the part of mothers to find something that
will wholly take the place of milk, even in the
diet of healthy children. Such a course can
only lead to disaster and should be emphatic-
ally discountenanced by the medical fraternity;
I recall to mind one striking illustration that
came under my care. A child had long been fed
upon this and that watery and comparatively
innutritions compound, until it became a mere
skeleton and wa9 thought by the parents to be
well advanced in phthisis pulmonalis. I was
called in to give an opinion, and, if possible, to
suggest some way out of the difficulty. After a
close examination and thorough inquiry as to
diet, I concluded that proper alimentation was
all the case demanded, and so informed them.
Suitable preparations of milk were at once sub-
stituted, and the child was speedily restored to
health.
Guerin's experiments with fat puppies is con-
firmatory of the position above taken. By re-
moving half the puppies and placing them on a
meat diet he found a speedy arrest of develop-
ment, and that those allowed to continue a milk
diet far outstripped them.
For children between the periods of infancy
and puberty, some recommend, and with good
reason, I think, four meals a day. The tempera-
ture of the food when taken is an important
thing to be considered, and one which I am in-
clined to think has been sadly neglected. It
has been demonstrated that food taken into
the stomach much above the temperature of the
body retards digestion and tends to crack the
enamel of the teeth. This adds another to the
many serious objections to the use of tea and
coffee as ordinarily practiced. They belong to
the domain of medicine ; are not naturally de-
manded by the healthy organism. Neither are
intoxicants of any kind — and they certainly
cannot be said to be nutritious.
Precepts on health are among the oldest in
the world. We have only to adopt and rigidly
adhere to the old Mosaic laws to insure the
greatest freedom from disease, viz. : " Scrupulous
attention to cleanliness, isolation of the sick,
and extreme care in the use of wholesome arti-
cles of food and drink. "
Slight errors in diet, improper ventilation, lack
of out-door exercise, loss of sleep, etc., that
would not be felt for a time, will, if persisted in,
bring serious and often fatal results. Ansell^s
mortuary statistics for England tell us that in
the worst parts of the large cities not more than
ten per cent of the children live over five years,
while among the peerage ninety per cent may
be living at that age. They also tell us that
one-half the deaths of all ages among the poor
of large cities occur under five years.
Such statements are startling, and demand
our strictest attention. It is evident that not
more skillful surgeons or more kind and atten-
tive physicians are demanded, but a thorough
sanitary reform, a common-sense application of
the principles of hygiene. Such a course, and
only such, will bring success.
JuiiT, 18H8. 1
ORIGINAL ARTICLES.
205
It is plainly the province and the duty of the
medical profession to stand as a unit on all
needed improvements in this direction. We
should use our influence towards the enactment
of more wholesome laws — laws prohibiting the
violation of every condition of right living. We
should promote a public spirit that will no more
quickly tolerate the density of population, filth
and wretchedness, as now met with in our large
cities, than it would tolerate a slaughter-house
in the same localities. Laws that will throttle
for all time that parent of disease and crime,
that curse of curses of the nineteenth century,
that has hitherto been so carefully guarded and
protected. Laws are demanded that will effect-
ually prohibit marriage among such as are hope-
lessly suffering from diseases inherited or
acquired that are calculated to entail weakness
and suffering upon their offspring.
All will readily admit the pernicious and last-
ing effects of the use of tobacco, especially on
the young; yet the spirit of indifference that
pervades almost every community in regard to
its use is truly amazing. However, when we
consider the millions on millions who know its
effects, and who should set a better example,
who are deliberately and persistently destroying
their health and manhood by a slow process of
poisoning, it is not so amazing after all. I
think it is not misrepresenting this great mass
of humanity to say that such a course is not
pursued in after years by more than one-fifth
from actual preference, and a feeling that it is
beneficial, but because they are slaves to the
self-conceit and indiscretions of youth and early
manhood. The same is true also in regard to
intoxicants.
By such means, and such alone, can long life
and freedom from disease be secured. None
will dispute the assertion that to pursue such
a course would well-nigh stamp out for all
time epidemics of every description. What a
relief to the ever-watchful and anxious mother
to know that her promising babe is almost cer-
tain to escape the majority of ills and dreaded
epidemics now so prevalent. Were such laws
to be enacted, enforced, and personally adhered •
to, who can calculate the added vigor to youth
and manhood, and consequent ability to with-
stand diseases of every description that would
thus be secured. It would indeed be to future
generations what compound interest is to the
capitalist. That a condition of things so rad-
ical and yet so desirable can be brought about
in the near future is not to be expected, but that
it will b^ brought about, sooner or later, I firmly
believe. •
I have thus briefly alluded to what every
thinking person must admit are living issues,
now rising up before us in immense proportions,
and demanding our immediate attention.
Permit me again to urge the necessity of con-
stantly agitating this matter before our school
boards, boards of health, common councils, legis-
lators, and wherever an opportunity presents,
until it can at least be said of us, we have kept
pace with the fatherland.
THE REMEDIES FOB BUB-INVOLUTION OF
THE UTEBUS.
{Continued from June number.)
By E. M. hale, M.D.
CHICAGO.
[Read before the Bnrean of Obstetric* at the meeting of the ItU-
noie S'ate HomiBopathic Medical Society, May 16th, 1888.]
HYDRASTIS CANADENSIS, an indigenous
medicine, has been long known in this
country as a tonic and an alterative to
mucous membranes. It was shown by Ruther-
ford to have some action on the liver, and was
classed by eclectics as a " uterine tonic," but no
tangible proof was shown that it had any specific
action on the uterus until the German Professor
Schatz demonstrated that it had the power of
contracting the blood-vessels of that organ. He
found that in animals it also caused contractions
of the uterine muscles, and supposed that it acted
similarly on the uterus of women, but later in-
vestigations by Schatz and others have shown
that it does not contract the human uterus.
This narrows the sphere of action of Hydrastis
to its power of. contracting the uterine blood-
vessels. In this it differs from all other drugs
ha\dng an action on the uterus. It is believed
to act on the arterioles and arterial capillaries,
similarly to the action of Hamamelis on the
veins. The brilliant success obtained by the
use of Hydrastis in the treatment of uterine
fibroids and other uterine neoplasms, is due to
the power which it possesses of shutting off the
nutrition supplied by the arteries.
I do not think that the action of Hydrastis on
the arteries of the uterus is local only. It doubt-
less acts similarly on all arteries, but especially
on those of mucous membranes, on the liver,
mammary glands, and intestines. It may pos-
sibly act similarly on the blood-vessels of the
lungs and brain.
206
THE MEDICAL ERA.
[Vol.. VL No 7.
Much has yet to be learned concerning the
physiological action of this unique remedy. It
is known to gynecologists and obstetricians that
a contracted uterus may bleed profusely, and
that a uterus may be the seat of violent con-
tractions and yet fail to*gain normal involution.
Muscular contraction of the uterus may occur
without real contraction of its blood-vessels. In
a large proportion of cases of sub-involution,
uterine hemorrhages, dysmenorrhoea, and even
amenorrhoea, the trouble may be caused by a
paretic condition of the uterine blood-vessels
alone. It is in such cases that Hydrastis is the
specific remedy. A uterus may be congested
with blood to such an extent as to cause either
of the above named conditions. It is not an
(hctiive congestion, but a blood-stasis, in which
the coats of the arteries are relaxed and paretic.
I believe this condition to be secondary y because
in the experiments with Hydrastis made by
European observers, it has been observed that
the primary effects of large toxic doses, were ac-
tive congestion, followed later by arterial relax-
ation. Also that from smaller doses, arterial
contraction occurred. In accordance with the
law of simUia, minute doses are indicated only
in anaemia of organs and tissues, while material
doses are called for by the opposite conditions.
Tlie distinctive pathological state of the uterus
in sub-involution is passive stasis. The arteries
are surcharged with blood which is not rapidly
taken up by the veins. This causes an abnor-
mal growth of connective tissue, and, if not ar-
rested, induces areolar hyperplasia. Now, if
after menstruation, miscarriage or labor, the
uterus remains large, heavy, and engorged, not-
withstanding the presence of muscular contrac-
tions, with or without pain, there is Hydrastis
fully indicated. Its use should be commenced
as soon as we detect the abnormal condition, or
sooner, if we know that sub-involution or chronic
blood stasis has previously existed. It has
been established by numerous observations based
on clinical experience, that the efficient dose is
from twenty to forty drops of a strong tincture
or fluid extract, repeated thrice in twenty-four
hours ; or, if the active principles of Hydrastis
are used, a proportional dose. Schatz and
others find that the Phosphate of hydrastin
possesses similar properties. ( By Hydrastis is
meant the combined Berberine and Hydrastin).
The dose of this preparatioti is from one to
three grains.
If the white alkaloid is used, (Muriate of hy-
drastia) the dose is from one-tenth to one grain,
three or four times daily. This latter prepara-
tion is now made in a colorless solution, the
dose of which is from ten to thirty drops. It is
devoid of any unpleasant, bitter taste, and is
tolerated by the most irritable stomach. One
great superiority possessed by this medicine over
all others I have mentioned, is its tonic and re-
storative properties. It aids digestion and as-
similation of food; increases the tone of the
muscular system, regulates the bowels and the
secretions. I believe it is indicated in the ma-
jority of cases of uterine sub-involution from
any cause.
Caubphyllum has been • extensively used in
this country as a partus-accelerator. It seems
to cause uterine pains closely simulating labor
pains. But there is.no recorded testimony that
it causes jmnfid contractions. On the contrary,
it is a very popular remedy for uterine pains of
a crampy or spasmodic nature, and has been
successfully used for dysmenorrhoea, painful
labors, false pains preceding labor, and after-
pains. If such an anomaly were possible, it
would seem that this drug causes, in large doses,
uterine contraction destitute of pain. I have
even used it successfully in allaying the uterine
pains caused by Ergot. The testimony in favor
of its power of preventing violent painful labor
is sufficient to make us believe it. This med-
icine ought to be an excellent remedy, not only
to prevent sub-involution, but in its treatment
where existing. I cannot find any report of
cases proving this assertion, but in several cases
where I have given it before and after confine-
ment, I believe it has prevented excessive lochia,
and shortened the period of involution. These
patients already had enlargement of the uterus
from sub-involution after previous labors. The
enlargement seemed to be less after its use. I
would not advise the use of the tincture, for it
is nauseous and acrid, even in small doses of
ten to twenty drops. The attenuations are use-
less in such cases. Gaulophyllin can be given
in trituration. The Ix or 2x is sometimes quite
sufficient, or it can be. prescribed in sugar-coated
granules of fractions of a grain, three or four
times a day.
Leontine, the recently discovered alkaloid or
glucoside of Caulophyllum, is a very active and
elegant preparation. It is about eight times as
potent as Gaulophyllin, and the 2x or 3x tritu-
rations are very effective. Lloyd's solution of
Leontine is about the same as the first centesi-
mal. The dose is five to fifteen drops three or
four times a day. It has been tried by many
gynecologists and obstetricians and found to
equal Ergot in causing expulsive contractions of
July, 1888.]
ORIGINAL ARTICLES.
207
the atems, but without pain. Perfectly normal
labor pains are slight when compared with ab-
normal pains. It has proved useful in chronic
passive hemorrhages from the uterus — menor-
rhagia — too frequent and profuse menses, and
amenorrhoea.
Gossypmm, It is singular that so much has
been asserted of the abortifacient and parturient
powers of the cotton-root, and yet so little really
known. No systematic experiments have been
made to ascertain if it will cause uterine con-
tractions in the unimpregnated or gravid uterus
in animals or women. All that we know of it is
purely empirical, except a fragmentary proving
by Dr. Williamson, of our school, and in that
proving the uterine symptoms are almost nU,
It is asserted that it will hasten labor by caus-
ing more efficient pain, and arrest uterine hem-
orrhage due to laxity of its tissues; that the
expulsive efforts are not as painful as those of
Ergot, and that it will arrest excessive lochia.
Now, if it will do all this, it will be an addi-
tion to our means of treating sub-involution of
the uterus. ' All that I personally know of Gos-
sypium is, that in large doses it rather decreases
than increases the menstrual flow, that it is
beneficial in after-pains, with normal or abnor-
mal lochia, and that the uterus seems to con-
tract better after labor if it is administered in
moderate doses (fifteen or twenty drops three or
four times a day for a few weeks after labor).
I never found it to cause uterine pain, nor do
I know of a single authenticated case where it
has caused miscarriage or premature labor. We
must have more definite knowledge of its power
before we can use it with precision.
Sabina has, from the earliest times in medi-
cine, been considered a potent uterine drug.
There is no doubt but it will cause abortion at
any date of pregnancy if large doses are given,
but, at the same time, it is one of the most in-
jurious drugs known, if prescribed in toxic doses.
It is pretty well established that it causes active
arterial congestion of the uterus (primarily) and
passive venous stasis (secondarily). During its
primary effect very painful uterine contractions
occur, often attended by acute inflammation.
During its secondary effects, the uterine blood-
vessels are in a state of atony, and the uterus is
enlarged, a pathological condition closely simu-
lating some cases of sub-involution, especially
those which are post-menstrual or obtain after
abortions. It is therefore better indicated in
these than in post-parturient cases. The cura-
tive dose Ues in the Ix or 2x dilutions.
There are several drugs analogous to Sabina,
both botanically and pathogenetically. Among
these are Thuja, Terebinth, Pinus Canadensis
and Abies. Under certain circumstances each
may be indicated in sub-involution. Turpentine
is far more valuable in such cases than is sup-
posed, and Thuja, if indicated, is as potent in
preventing and treating this condition as any
drug in the whole materia medica.
Cinnairwn is another drug which is not suffic-
iently appreciated. It ranks with Hamamelis.
But the former is to arterial hemorrhage what
the latter is to venous, while Hydrastis stands
midway between. These three form a trio which
we cannot do without. They do not cause con-
traction of the uterine muscles, their action be-
ing only on the coats of the uterine arteries.
Perhaps Kali bromatum, Erigeron, Trillium
and Millefoil belong to the same class. I think
they do.
In conclusion, I have a few words to say re-
garding the doses I have advised ; not in the
way of an apology, but in explanation. Uterine
sub-involution is never a primary affection. The
primary condition which antedates it is always
active congestion. Now, none of the medicines
above treated can cause, primarily , sub-involution,
but they all cause, in large toxic doses, the active
uterine congestion or inflammation, which ends
in chronic vascular stasis with hyperplasia of tis-
sues. The deduction is, that all the drugs re-
commended above are secondarily indicated in
that condition, and the dose must be larger than
if they were primarily indicated. Were I con-
sidering acute congestion or inflammation of the
uterus, I would advise minute doses of the same
drugs, with a sincere belief, based on experience,
that such doses are curative. In prescribing
material doses of medicines for symptoms and
conditions which simulate their secondary ef-
fects, we expect to set up physiological effects,
which, to a certain degree, resemble the primary
acute symptoms. I have often been astonished
at the inanity of intelligent men who think to set
up physiological effects with infinitesimal doses.
I have known some physicians to prescribe Secale
thirtieth for the purpose of causing uterine con-
tractions in hemorrhage or absent labor-pains.
As well might we prescribe Ipecac thirtieth to
caVfSe emesis.
Until such utterly absurd notions are aban-
doned, they cannot expect anything but ridicule
from scientific men of all schools. The law of
similia is a grand therapeutic law, but we must
not misunderstand or pervert it.
(Concluded,)
208
THE MEDICAL ERA.
(Vol. VL No. 7,
VI.
HAT FEVSB:
RHINITIS VASO-HOTORIA PERIODICA.
By E. LIPPINCOTT, M.D.
mbmphis, tbnn.
Therapeutic Indications.
Sabadilla. — This medicine has been recom-
mended by some writers as a prophylactic, and
some cures have been reported from its use, but
I have failed to learn whether any of the cures
were permanent. Dr. Small ^ays that ** Dr. E.
M. Hale has succeeded in aborting several cases
of hay fever with Sabadilla.''
It is of excellent service in relieving excessive
sneezing, fluent coryza and lachrymation.
Its therapeutic indications are : Great irrita-
tion and itching of the pituitary membrane, with
violent paroxysms of sneezing; copious coryza
and lachrymation; lachrymation when in the
open air ; when looking at a bright light ; when
coughing or yawning ; frontal headache ; redness
of the margins of the eyelids; dryness of the
mouth without thirst ; dry, spasmodic cough ;
cough worse on lying down; sensitiveness to
cool air; agitated, unrefreshing sleep. Dr.
Bayes has used it with marked success.
Dr. Hawkes (Clinupic, Vol. I, 1880, page 95),
reports the cure of a case of rose cold of three or
four years' duration, with Sabadilla 200 in about
three days, with the following symptoms:
** Burning stinging in the bridge of the nose,
with a full, distended feeling ; complete obstruc-
tion of the nose, so that he could breathe only
with his mouth open ; much sneezing, with pro-
fuse discharge of a bland, watery, very thin
mucus ; persistent, almost voluptuous itching and
tingling of the alse nasi at their junction with the
lips; sneezing much worse indoors than outside;
breathing much easier outdoors ; better in every
way outdoors ; nose swollen and red ; eyes watery
and weak looking. Commenced improving next
morning after taking medicine." In reply to
my letter of inquiry of Sept. 21st, 1887, Dr.
Hawkes said : "In the case of rose cold referred
to, there was no return of the symptoms, to the
best of my knowledge and recollection,"
Arsenicum iodatus— This remedy has been
recommended as a prophylactic. The prophy-
lactic power of a drug lies in its ability to so
affect the organism as to render it proof against
contagion, or to remove a pre-existing diseased
condition, and predisposing cause, and render
it innocuous to an exciting influence. No remedy
up to the present time, has been so much in
general favor with the profession as this one.
Dr. £. M. Hale considers it to be the nearest to a
specific for hay fever that we now possess. It is
indicated in cases in which there is a malarial
cachexia; in persons of a pale, delicate complex-
ion, prone to glandular enlargements; itching
and irritation in the mouth, eyes, ears, nose and
throat; burning sensation in the nose and
throat; excessive sneezing; fluent coryza, the
discharge being thin and acrid, the acridity be-
ing pronounced; chilliness; flushes of heat;
pufiiness of the face and eyelids ; eyes and nose
red; rawness and dryness of throat, with
hoarseness and asthmatic breathing, the diffi-
cult breathing being worse in the morning after
meals, and after midnight ; prostration ; thirst.
Dr. Blackley, (** Hay Fever," second edition,
1880, page 252), says: **0f all the remedies I
have had an opportunity of testing, I must give
the palm to the Iodide of arsenic for its prophy-
lactic properties in the early stage of hay fever,
both in my own case and in those of other pa-
tients."
In a personal letter, Dr. 0. P. Barden, of
Tioga, Pa., reports good results with this reme-
dy, in the treatment of several patients who had
previously suffered from hay fever for two or
three months each season. The indications for
his guidance were as heretofore given. He says :
" I find Arsenicum iodide an excellent remedy
for catarrhal troubles."
Kali hydriodlcura. — Frequent sneezing, flu-
ent, acrid coryza ; rawness and burning in the
nasal and respiratory passages; swelling and
redness of the nose ; aching pain and throbbing
in the frontal sinus ; general aching ; corrosive
lachrymation ; purulent discharge from the eyes,
with swelling or cedema of the eyelids ; oppres-
sion of breathing; hoarseness; violent, suflFo-
cative cough ; profuse, white, frothy or stringy
expectoration; choking sensation on awaking;
wheezing breathing.
Dr. J. H. Lowrey, Neola, Iowa, reported to
me, about two years ago, the following case:
" Incessant sneezing for an hour or more every
morning on rising ; aching, heavy, pressing pain
between the eyes ; lachrymation when sneezing ;
at night the nose became stopped up ; it feels
sore to the touch. This trouble had appeared
two years consecutively at the same date. Kali
hydriodicum Ix trit., one powder every four
hours, cured in a week, and there was no yearly
return of the attacks."
In the New York Medical Gazette^ October 8th,
1870, W. C. Roberts, M.D., vice-president New
JCLT, 1888.]
ORIGINAL ARTICLES.
209
York Academy of Medicine, says : * ' If there were
any truth in the similia siniilihm doctrine, and
any virtue in infinitesimal doses, Hydriodate of
potash ought certainly to prove efficacious ; for
once in my life, and only that once, I saw it
produce in a man as bad a * crying cold ' as I
ever had at any period of my autumnal catarrh. "
Aralia racemosa — The venerable S. A.
Jones, M.D., proved this remedy on liimself, and
to him are we principally indebted for our knowl-
edge of its pathogenetic effects. He is a sufferer
from asthma, and a paroxysm came on after
taking the remedy, but he claims it was very
different from his usual attacks, in that it re-
sembled hay fever. In this complaint and sim-
ilar suffocative coughs, Dr. Jones has found it
very beneficial. He relates a case of hay asthma
cured by this remedy, in which the characteris-
tic symptoms were : Yearly attacks of suffoca-
tive catarrh, with extreme sensitiveness to a
draught, the least current of air causing a violent
fit of sneezing, accompanied by a copious, wa-
tery, acrid discharge from nostrils and posterior
nares. Head felt stupefied from great loss of
fluid, of a watery, transparent character, of an
acrid, salty taste, excoriating the nostrils, pos-
terior nares, and fauces. Waking at night with
terribly impeded breathing, which necessitated
immediate rising, with inability to lie down un-
ti^nearly morning. During this time, sneezing,
spitting, and blowing his nose would keep him
busy. Bending forward, elbows on knees, eased
the asthma very soon. Walking up stairs pro-
duced an aggravation. Inspiration was more
difficult than expiration. When the coryza
wotild cease, the whole trouble would settle on
the lungs, producing an intense dyspnoea. To-
wards the end of the attack a dry, wheezing
cough would set in, continuing, until with the
sputa, there were ejected yellow, thread-like pieces
of tough mucus, looking as if they had been
dislodged from the bronchial tubes. Aralia ten
drops, three times a day, cured in three days.
For a more full description and knowledge of
the action of this remedy the reader is referred
to " Eough Notes on Aralia Racemosa," by S. A.
Jones, M.D., North American Journal of Hothos-
apathy, November, 1872.
Alliam eepa. — Sneezing; profuse, bland,
thoagh sometimes acrid coryza, commencing in
the left, afterwards extending to the right nostril ;
discharge of white mucus ; itching and burning
in the nares ; lachrymation, with itching of the
eyelids and redness of the conjunctivae ; nasal
respiration impaired and sometimes abolished ;
headache ; photophobia ; sleep disturbed ; appe-
tite impaired ; violent laryngeal cough, worse in
the evening and in a warm room.
While there are no reported cures by this
remedy, yet it is often valuable as an intercur-
rent remedy for the coryza and sneezing.
Sanguinaria Canadensis. — Frequent sneez-
ing, aggravated by odors ; copious, watery, acrid
coryza, causing burning and rawness of the
pituitary membrane, with loss of smell or per-
verted smell ; pain in the frontal sinuses ; (head-
ache, arising from the back of the neck, coming
forward to forehead and right side of head) ; op-,
pression, pain, and soreness in the upper part of
the chest, or on the right side of the chest, with
difficult, wheezing breathing; severe dyspnoea;
hay asthma; wheezing, whistling, hacking or
dry cough, sometimes followed by diarrhoea,
which relieves the cough ; cough worse at night ;
burning dryness of the mouth and throat, not
relieved by drinking; offensive sputa; all the
symptoms worse on the rigdt side.
In the U. S. Medical Investigator, (Vol. xviii.,
1883, page 185), Dr. Winterbum says; ** San-
guinaria has an important influence on the nasal
mucous membrane. I have seen it cure a num-
ber of fluent coryzas. It seems to act best in cases
which affect particularly the right nostril^ and
are accompanied by much sneezing. Such cases
often yield quickly to inhalation, through the
nose, of the dust arising from shaking a small
quantity of Sanguinaria in a bottle ; the inhala-
tion to be repeated at intei-vals of three or four
hours.
** Periodic coryzas of all sorts, from rose cold
to autumnal catarrh, if possessing the charac-
teristic conditions for Sanguinaria, will be cured
by it.
** It may be merely a coincidence, but I have
never been able to cure polypi in the left nostril
with Sanguinaria. There is a peculiar right-
sidedness running through the pathogenesis of
this remedy and its analogue, Chelidonium.'*
Sangninaria nitrat*'. — Our knowledge of the
indications and conditions for the use of this
medicine is, as yet, somewhat limited. Its action
is similar to that of Sanguinaria Canadensis. It
is claimed that it acts upon the hypertrophied
tissue in the naso-pharyngeal regions better than
any other remedy.
In catarrhal sore throat, Dr. Winterbum re-
commends its use in the form of a spray. He
also reports (U. S. Medical Inve8tigator,Yol, xviii.,
1883, page 186) the cure of "a mucous polypus,
adherent to the septal membrane, nearly filling
the arch of the passage, and hanging downward
into the posterior nares." The patient was giv-
210
THE MEDICAL ERA.
[Vol, VL No. 7.
en << an ounce of the Nitrate of sanguinaria, first
decimal trituration, in a two-ounce bottle, with
orders to shake the bottle and snuff the dust
thoroughly up the right nostril every three
hours. The effect was slow, but in the end most
gratifying. In two months the polypus haJ en-
tirely disappeared, and the nasal membrane was
healthy and has remained so." .
Arsenicum album. — This remedy is recom-
mended by some hay fever writers as a prophy-
lactic. Symptomatically, it is frequently indi-
cated for sneezing; fluent, acrid, excoriating
coryza ; thirst for small draughts of water, and
often; corrosive lachrymation ; redness of the
conjunctivae; photophobia; burning sensations
in the nose, eyes, throat and chest; anxiety;
restlessness ; prostration ; asthmatic oppression
of the chest, with great dyspnoea ; wants doors
and windows open, or jumps up suddenly at
night and runs to the door or window for more
air ; or grasps hold of something ; or sits up in
bed, resting the head upon the hands, with the
elbows resting upon the knees ; short, hacking
cough with pain in the upper part of the right
lung ; worse after midnight, from the least bod*
ily exertion, or from a change of weather ; men-
tal depression. Dr. J. E. James, of Philadelphia,
says: **I believe we have its (hay fever) rem-
edy in Arsenicum 2nd or 3rd. It has in my
hand effectually cured several €ases. *'
Because of the presence of the specific irri-
tant or exciting cause during the hay fever sea-
son, Arsenicum album and other symptomat-
ically indicated remedies do not always avail
without the removal of the predisposing cause.
Stfcta palmonarla. — Violent and incessant
sneezing ; severe coryza ; hot, irritating, watery
mucus is discharged; afterwards it becomes
thick, bloody, green, or yellow, followed by dry-
ness of the mucous membrane ; the fluent coryza
dries quickly on a handkerchief ; the secretions
dry rapidly, forming scabs difficult to dislodge ;
excessive dryness of the nasal mucous mem-
brane ; dryness of the throat, worse at night ;
tickling in the bronchi and larynx, with racking
cough, worse on inspiration; burning in the
eyes; conjunctivitis; severe frontal headache
with a sensation of fullness in the frontal si-
nuses.
Arum trlphyllnm. — Frequent sneezing;
fluent coryza; nose obstructed, compelled to
breathe through the mouth ; coryza acrid, ex-
coriating nose and upper lip; must have the head
elevated in order to sleep ; much itching of the
eyelids, and inner canthi ; aversion to a bright
light ; desire to go in the open air unless the
sun shines brightly ; chilliness ; heat of face and
head ; constriction of the throat ; saliva acrid ;
burning in the mouth and throat ; soreness and
burning sensation in the lungs ; frequent tick-
ling cough, with mucus expectoration; asth-
matic paroxysms.
Ipeeacuanha. — Is sometimes useful in the
sneezing stage, but it is more prominently indi-
cated in the asthmatic. The chest S3rmptom8
are the ones calling for its use. Long-continued,
exhausting fits of coughing, with suffocative
spells ; gasps for air at an open window ; the
dyspnoea is intense ; constriction of the throat
and chest ; constant, choking, asthmatic cough,
with rattling of mucus ; wheezing, nausea and
vomiting ; loss of breath on the least motion ;
face pale; chilliness increased by external
warmth ; in the later stages there is profuse
mucus expectoration.
Kali bichromicnm. — Is better adapted to
the removal of the prime cause than to the dis-
ease itself, though Dr. James Kitchen and others
have used it with much benefit in hay asthma,
especially when the quantity of mucus in the
bronchial tubes is not as great as it appears
to be, the expectoration being tough and
stringy ; burning of the mucous membrane from
the nose to the throat; headache in frontal
sinuses or over the left supra-orbital ridge;
fluent, acrid coryza; hoarseness; wheezing, ^r
sharp ringing cough, excited by eating or drink-
ing ; pinching pain across the bridge of the nose
relieved by hard pressure ; plugs of green mu>
cus in the nose ; loss of smell.
Euphorbium offleiualis. — The main sphere
of this medicine is for the cough. It has done
me good service in some cases of hay fever, but I
have not made any cures, or learned of any
made by its use. Its indications are: — sneez-
ing ; chilliness and heat alternating ; inflamed
eyelids, glued together at night or in the morn-
ing ; dryness of the mouth and throat ; oppres-
sion of the chest; weakness and general
prostration ; worse from draught of air or dust ;
dry, deep, hollow cough, almost constant day
and night, with irritation of the larynx, accom-
panied by stitches which seems to proceed from
the pit of the stomach to both sides of tlie
chest.
Grindelia robusta. — The use of this remedy
is as yet empirical. I have used it but very
little and with no satisfactory results in hay
fever or hay asthma. It has been found to
produce '< a suspension of respiration " which
awakened the prover from sleep. There is
accumulation of tenacious mucus in the bronch-
JUX.T. 188a]
ORIGINAL ARTICLES.
211
ial tubes, with difficult expectoration; oppres-
Bion of breathing and asthma.
Ambrosia artemislalolia. — If the hair of
the dog is good for the bite, then this remedy,
according to the exclusive pollen theorists,
should be/adfe princeps. The published symp-
toms are similar to those of hay fever, as given
in the materia medica.
Nqx Tomiea. — The use of the remedy in
hay fever was written of as early as 1852, in
the North American Journal of Homoeopathy^ vol.
2, page 395. The indications for its use are: —
sneezing; profuse fluent coryza; nose stopped
up at night and dry, but fluent coryza during
the day ; eyes itch and bum ; dull frontal head-
ache ; loss of appetite ; bad taste in the mouth
mornings ; chilliness and heat alternately, espec-
ially morning and evening; heat of the head
and face; constipation; hemorrhoids; in the
asthmatic form, with the occurrence of violent
paroxysms of coughing in the evem'ng after
lying down, and especially if the expectoration
is absent or scanty and tenacious.
Gelsemiam sempervirens. — Often gives re-
lief at the time of the premonitory symptoms.
It is of excellent service in the outset of a cold
in the head. There is sneezing, tingling and
obstruction of the nose ; fluent coryza ; watery
corrosive discharge; pain in the back of the
head ; sneezing in the morning on first getting
up; profuse lachrymation. Drs. Lippe and
Hale give as its key-note, "violent sneezing in
the morning." There are no reported cures by
its use, and as a curative agent it has proven to
be more theoretical than practical.
Hercnrlns sol. Habn.; Merearins dalels;
Mercurins snblimatis corrosiyus and Merea-
rins protoiodatns. — Frequent sneezing, with
swelling, redness and soreness of the nose ; acrid,
excoriating discharge ; pains in the head, face,
ears, teeth and extremities ; violent, racking, un-
ceasing cough, worse at night; chilliness with
slight fever ; tongue heavily furred ; profuse non-
alleviating sweat ; burning in the posterior nares ;
mucus of an unpleasant odor; aching, itching
and burning of the eyes, chiefly in open air;
lachrymation, glueing the eyelids together;
thirst ; heat is uncomfortable, but patient cannot
bear cold air. Mercurius protoiodatus is the
one generally preferred, on account of its marked
action in diseases of the nose and throat, and
because of its being more suitable to the condi-
tions that cause hay-fever.
Aurum metallleum and Mnriaticnm.—
Itching of the nose; constant sneezing, fluent
coryzsk or stoppage of the nose ; the eyes become
involved by itching and photophobia ; especially
worse in sunlight; sneezing worse from effects
of sunlight; the nose and eye symptoms are
worse in the morning, better from midnight to
morning ; morning asthma ; face blue ; palpita-
tion of the heart; suffocative attacks, with
spasmodic constriction of the chest. Several
writers have reported good results from its use,
but no absolute cures have been reported.
Natrum nmrlaticnm. — Sneezing, worse
when undressing at night, or on rising in the
morning ; excoriating, watery discharge from the
nose, with sensation of squirming in right nos-
tril as of a small worm there ; bland discharge
from the eyes ; they smart when reading ; smell
acute. Dr. Hawkes, {Clinique, Vol. I, 1880,
page 94), reports the cure of a case of hay fever
of eighteen years' standing with Natr. mur. 200,
a powder every night for four nights. The his-
tory of the case showed that asthma supervened
upon the suppression of a severe attack of fever
and ague with large doses of Quinine. There
was no history of asthma in the family. The
chills were tertian and appeared at 10 A.M.,
but under the influence of Quinine came irregu-
larly. The lips and around her mouth were so
thickly covered with fever blisters that she could
not eat, speak, or use her mouth in any way
without great difficulty and pain. There was a
marked desire for salt. The examination of the
patient elicited: ''Constant and distressing
sneezing and coughing ; nose ' stuffed ' or * run-
ning ' all the time ; cannot lie down from 8 P.M.
to 5 A.M., on account of distressing dyspnoea;
sits up and smokes Saltpeter and Stramonium
all the night in order to get breath ; cough dis-
tressing and constant; great soreness in the
chest ; appetite poor ; much headache ; cannot
be in a room where dusting or sweeping is going
on ; cannot walk in the street when dust is fly-
ing; the least dust of any kind distresses her
and makes her gasp for breath. Her worst
time is during the month of November. This
had been her condition during the fall month
for eighteen years. She left home for relief
nearly every season. Sometimes she experi-
enced partial relief; other times none. She
8tiU desires a great quantity of salt with her food.
The doctor concluded <' that the cause of the
' hay fever ' was the maltreatment of the inter-
mittent fever eighteen years ago, and that the
remedy indicated for the patient while suffering
with that disorder was the one indicated in the
present condition," and that **the symptoms
indicating the remedy were: The time of the
chill, 10 A.M.; the profuse eruption of fever
212
THE MEDICAL ERA.
(Vol. VL No. 7.
blisters, and especially the craving far saU, which
was still present." The prescription was given
Sept. 7th, 1879, and on Sept. 29th, 1879, the
patient reported, ** entirely free of all former
symptoms of her old enemy and cured. "
The doctor claims that *'this case tends to
prove the truth, that hay fever is as amenable
to treatment by the indicated remedy as are
other diseases." Being desirous of knowing the
uUinmUim of the treatment in this case, I wrote
Dr. H. Sept. 2l8t, 1887, and received the fol-
lowing, dated Sept. 29th, 1887. ** In reply will
say tliat the case of hay fever reported as cured
with Natr, inur, 200, remained well for that sea-
son ; but that she was ill again the next season
with the old trouble, although not quite so
severely as on former occasions. Natntm mur.
did her no good the second season, and the
patient was so discouraged, she did not give me
an opportunity of trying further for the remedy.
This was the only satisfactory case of this
annoying disease I have had. As a rule they
do not give us an opportunity, being, as they
are, under the impression that there is no relief
from it, except change of climate. My view of
it is that the predisposing cause of these cases
is psoric, and that they are to be treated homoe-
opathically, just as we treat all others, accord-
ing to the totality of the symptoms."
We have in the above reported cure, not a
permanent cure, but a palliation or cure of the
existing attack, and no prevention of future
attacks. With a true conception of the aetiology
and pathology of hay fever, Dr. Hawke's views
and treatment will change. A strict reliance
upon symptomatology alone, in the treatment of
hay fever, will cause many failures. The above
is a fair illustration of some of the reported
cures, and about the purport of the replies to
inquiries concerning reported cures and the
theories of the causes of the disease.
Calcarea carbonica. — Dr. W. S. Gee,
[Ilonweopathic Physician, Vol. IV, 1884, page 355),
reports the cure of a case of hay fever, of ten
years* duration, with Calcarea carh, mm. In
reply to my letter of inquiry, he says: **The
case reported in the Homoeopathic Physician is
mine. The disease returned the next year, but
not so hard. I have treated others with relief,
but in the main they are unsatisfactory to deal
with. I believe the ** psoric" miasm is at the
base in every case, and must receive treatment
as for any chronic disease." Comment is
unnecessary.
Lobelia inflata. — Hay asthma. The attack
is preceded by a prickling, nettle-like sensation
all over ; little or no cough.
MoschuR. — Hay asthma in persons of a
nervous, irritable, or hypochondriac tempera-
ment ; violent constriction of the throat, without
cough ; can't sleep during the whole night.
Palmo yalpis. — Von Grauvogl used a first
centesimal trituration as a remedy in an old
subject suffering with asthma humidum, and
met with brilliant success. — {Arndts" System of
Medicine, Vol. I, page 315.)
The venerable S. A. Jones, M.D., [American
Observer, Vol. II, 1874, page 032), gives some
valuable hints, as well as the results of his expe-
rience and that of others, in the use of this
medicine. This article and the reported cure
are well worth reading, but too long to report
here.
Camphor. — ** First cent, trit., has been fol-
lowed for some hours after each dose by decided
amelioration. — (W. H. Holcombe, U. S. M. and
S. J., Vol. VIII, page 180.)
PBOCEEDIKGS OF THE ILLINOIS STATS
HOMCEOPATHIO MEDICAL ASSOCIATION.
[The following^ web crowded oul of the last ieene of Thb Mkdigal
Era.]
BUREAU OF SURGERY.
Thursday, May 17th, 1888. 9 o'clock a. m.
Dr. Geo. F. Shears, of Chicago, read a paper
entitled, ** The Treatment of Congenital Talipes
Equino Varus."
Dr. W. F. Knoll, of ^Chicago, read a paper en-
titled, «* A Method for the Radical Cure of Her-
nia.
f>
Dr. H. P. Skiles, of Chicago, read a paper en-
titled, ** Orificial Work in Children."
Dr. W. 0. Cheeseman, of Joliet, Illinois, read
a paper on ** Anchylosis."
BOARD OF CENSORS.
The Board reported the following applicants :
Dr. A. B. Spach, of Chicago ; Dr. Helen M. Hef-
fron, of Washington Heights. It was moved
that the report of the Board of Censors be ac-
cepted, and that applicants be elected members
of the society.
The motion, being duly seconded, was carried.
Dr. A. B. Spach, of Englewood, read a paper
entitled, "The Treatment of Fractures of the
Upper Extremity."
Dr. W. D. McAffee, of Rockford, Illinois, read
a paper entitled, '* A Radical Cure of Mahgnant
Lymphoma by Static Electricity."
Dr. M. J. Bleim, of Chicago, read a paper, to
take the place of a paper to have been read by
JUI.T, 1888.]
PROCEEDINGS.
213
Dr. E. H. Pratt, of Chicago, entitled, " Stone
in the Bladder."
Dr. Henry Sherry, of Chicago, read a paper on
** Fracture of the Skull."
It was moved and seconded that the discussion
of the Bureau of Surgery be closed at 11 o'clock.
DISCUSSION.
Dr. Henry Sherry : — Mr. President : I want
to say a word about the Bureau of Surgery. It
may be that the members of this Bureau want
to crowd the other department. But the fact
of it is, that so far as homoeopathy is concerned
in this city, it depends upon the fact that some
of its men have done good surgical work. Now,
there is not enough attention paid to the depart-
ment of surgery. Every year the Bureau of
Surgery has been crowded to the wall, and the
time has been taken up in the discussion of lit-
tle details, local applications and so on, that
are entirely out of place, it seems to me, and I
object to this. What I object to most emphat-
ically, as Chairman of this Bureau, is to being
crowded out in the amount of time. We are to
be limited now to 11 o'clock. We were crowded
out of our time yesterday afternoon, and I wish
to go on record as emphatically opposing the
motion that has been made.
The President : The discussion commences,
I believe, on Dr. Shears* paper.
Dr. Sherry : I consider Dr. Shears' paper a
very classic one, and I trust it will receive the
attention from the medical profession which it
properly deserves. It is well prepared, — and it
requires time to present and prepare a paper of
that kind. I know this from personal experi-
ence in the matter.
Dr. Geo. P. Shears : I would like to say a
word about Dr. Knoll's paper, a simple opera-
tion for the radical cure of hernia. I would say
that I made that operation, although I did not
know that the Doctor had originated it himself ;
but it is one that seems to me very desirable ; it
is a simple one, and it strikes at the root of the
matter ; it brings together the columns and gives
them union. Those cases in which I have made
operation have not been severe cases, have not
been bad cases of hernia; but they have been
ones in which we desire radical cure, and in
about one-half of the cases good results have been
obtained. I have seen a number of Dr. Hall's
operations. He has operated many times in a
way very similiar to that described by Dr.
Enoll, and, I think, with probably a favorable re-
sult in 50 to 75 per cent of the cases.
Dr. Henry Sherry: — Mr. President: I don't
see anything original in the method that has
been described by Dr. Knoll. I have operated
in that way, with but slight variation, in a
number of casejf, for several years past.
BUREAU OF DISEASES OF CHILDREN.
Dr. R. N. Tooker, of Chicago, read a paper en-
titled, ** Post Diphtheritic Paralysis."
Dr. M. J. Hill, of Sterling, read a paper en-
titled, ** Thoughts."
Dr. F. W. Gordon, of Sterling, read a paper
entitled, ** Children and Hygiene."
BOARD OF CENSORS.
The Board of Censors reported the following
applicants : Dr. C. T. Bassett, of Chicago, and
Dr. K. B. Touser, of Chicago.
It was moved that the report be accepted,
and the applicants elected members of the
society.
The motion, being duly seconded, was carried.
It was moved that the discussion of the papers
now before the society be continued until com-
pleted, and that no recess be taken.
The motion, being duly seconded, was carried.
REPORT OF COMMITTEE.
Dr. L. C. Grosvenor, of Chicago, Chairman of
the Committee on the President's Address, made
the following report :
The Committee on President's Address would
respectfully submit the following report : .
We hereby express our admiration and.hearty
approval of the able and exhaustive manner in
which the various subjects were presented. We
believe it highly important that early and wise
action be taken to carry into effect the various
suggestions therein contained. To the end that
the rank and file of the profession be abreast of
the times in these matters, we would recommend
that 2,000 copies be printed for gratuitous dis-
tribution among the profession.
L. C. Grosvenor, Chairman; F. W. Gordon
and M. C. Sturtevant.
Dr. L. C. Grosvenor : — Mr. President : I would
like to say a word about this resolution,
and on behalf of those who have the President's
address in hand. Those who heard the address
were delighted with the manner in which the
various subjects were handled, but the subject
of medical education was one of such great im-
portance to us who are interested in building up
and maintaining the character of the medical
214
THE MEDICAL ERA.
(VouVI. No. 7.
profession, felt that the suggestion was of unusal
value, and we feel that if in the selection of our
students to send to medical colleges, we take
men of character, men of culture, and men of
refinement, just as far as we cai), and discourage
those who are illiterate, we will do a great deal
to elevate the character of the profession. The sug-
gestion seems very prudent and very wise. And
it seems very desirable that the largest number
should be men of character, men of reputation,
and men of scholarly habits.
Dr. G. E. Lanning, of Chicago, read a paper
entitled, < 'Anatomy in its Belation to the Practice
of Medicine."
It was moved that the paper be referred to
the committee on publication.
The motion, being duly seconded, was carried.
Dr. Henry Sherry : — Mr. President : I would
like to make a motion, and that is that the Bu-
reau of Anatomy be united with the Bureau of
Surgery.
The President : You will have to put that in
the form of a resolution.
Dr. Gatchell, of Chicago : — Mr. President : I
believe I can solve the problem that has come
before the society, by introducing a resolution
which I hold in my hand. The committee on
resolutions has had this under consideration,
they report it favorably, and recommend its
adoption by the Association. The resolution is
as follows :
Eesolved, That the President appoint each year
a committee of three, who shall be called "Com-
mittee of Finance and Management,'^ and whose
duty shall consist in the incurring of necessary
expenses, auditing bills, having general super-
vision over the plan of the circular, and arrang-
ing such other business connected with the As-
sociation as shall not directly come under the
supervision of the Secretary or Treasurer.
It was moved that the resolution be received
and adopted.
The motion, being duly seconded, was carried.
The Chairman appointed as such committee
Dr. G. F. Shears, Chairman ; Dr. W. H.,Steams,
and Dr. H. M. Bascom, associates.
BUREAU OP SANITARY SCIENCE AND HYGIENE.
Dr. J. E. Gilman, of Chicago, read a paper
entitled, ** Cremation.**
After the election of officers the Society ad-
journed.
A sixty per cent solution of Lactic acid, for
topical 'application, is the best remedy for
tuberculosis of the larynx.
SELECTIONS.
The Treatment of Puerperal Eclampsia.
Bt s. lilibntuall, m.d.
What a blessing it would be for the world at
large, and especially for the medical profession,
be they allopaths, so-called homoeopaths or
members of the I. H. A., if they would learn that
the essence of homoeopathy consists in the prin-
ciple of similarity, and that the infinitesimal
dose is only a corollary which allows here and
there exceptions and that a large, even a so-
called toxic dose, may be perfectly homoeopathic
to the case in hand. When Yeit and Buehle,
men well known by their labors, assert that of
seventy cases they lost only two, and even these
on account of severe morbus Brightii, we may
find it worth while to follow their treatment and
save our patient. The soporous and cyanotic
state of the patient is the keynote, and we know
full well that Opium produces a soporous and
cyanotic state. How well Yeit individualizes
his narcosis ! He does not want a chloroform
narcosis, he repudiates injections of Hydrate of
chloral per anum or hypodermically and insists
on Morphia pure and simple, with or without
the hot bath and pack, according to circum-
stances. Our own limited experience is cer-
tainly in his favor. We witnessed several cases
where chloroform and the A. C. E. mixture failed
to be of the least benefit, and we saw one woman
die undelivered, though four physicians were in
consultation. Never will I forget the case where,
in post partum convulsions, the father, a cele-
brated New York physician, gave up all hopes
of seeing his daughter recover ; in sheer despair
I put two grains of Morphia in one tumbler and
ten grains of Quinine in another one ; every five
minutes I administered alternately a dessert-
spoonful, and the woman recovered in spite of
the bad prognosis of the father and the other
physicians, and till we know a better method to
battle with this dreadful disease, let us remem-
ber Veit and his successful treatment. MacK^
nachf aher macKs reckt nach and do not mind the
largeness of the dose.
Farrington, in his "Clinical Materia Medica,"
teaches us that in Opium convulsions the face is
dark-red and bloated, and that it is the remedy
for sudden effects of emotions ; retention of
urine is another hint, and the more the case
approaches a kind of stupor, the more will Opi-
um be the remedy ; keeping in mind, how many
women dread their approaching confinement,
how often they predict even a fatal issue ; their
nervous system is certainly in a high state of
JuiT, ISBBl]
SELECTIONS.
215
excitement and convulsions follow, too often
with the dreaded fatal result. Let us also look
at the renal affection, whose origin we also know
to be not only in the brain, but close to the con-
vulsiye center, and certainly Yeit's treatment to
hold down by force this over- wrought nervous
center till equilibrium is established, has com-
mon sense in its favor, and scientific researches
give us the clue to its action.
Guernsey , in his '< Obstetrics, "page 423, gives
the following indications for Opium : Sopor, with
stertorous respiration ; the stertorous respiration
continues constantly from one spasm to the next,
and so on ; incoherent wandering and convulsive
rigidity of the body, with redness, swelling and
heat of the face ; hot perspiration and insensible
pupils ; suppression of the pains of labor (too
often from a sudden emotional cause) may have
been the proximate cause.
Belladonna, Gelsemium and Yeratrum viride
are a trio, certainly not to be neglected in the
study of that unexpected complication, and we
acknowledge our indebtedness to the tincture of
Gelsemium in a case of urfemic post partum
convulsions. It may be probably all wrong to
put one remedy and one treatment ahead of all
others, but not every physician is a master of
our materia medica, and where there is so much
danger in delay, especially the young practi-
tioner, far distant from his alma mater and pre-
ceptors, will look more hopeful with a treatment
which promises success. The symptoms are so
clear, that where we have cold sweat, pale face
and partial consciousness, nobody would think
of Opium. For hysterical and anemic convul-
sions, which, though they look dangerous, are
not so in reality, we have not only a host of
remedies, but time enough to study up the case
and select the drug accordingly. The word
'< convulsion or eclampsia *' need not frighten us ;
but whoever has treated true puerperal eclamp-
sia during labor or post partum, knows the dan-
ger and the fatality which attends them. In
strict individualization is our only safety. —
Hahnemannian Monthly.
iBvenlon and Suspension of the Patient for Syn-
cope.
Dr. J. J. Ghisolm, of Baltimore, relates his
experience in four cases of sudden arrest of
respiratory functions of the heart's action during
chloroform narcosis, in aU of which life was
restored by inversion and suspension of the pa-
tient. He says: —
** I feel assured that most of these patients
would have died had they been left in the recum-
bent posture, regardless of what may have been
done otherwise for the restoration. Fanning,
fresh air, water-splashing, spanking, whisky or
ether injections, electricity, artificial respiration
— all of them the remedies which physicians rely
upon — go for very little, provided the patient be
left supine. General experience, unfortunately,
has too often shown this. In my experience
with chloroform, in cases of suspended anima-
tion, all of these means for resuscitation are use-
less, provided the patient be bung up by the feet
without any loss of time, so that blood may flow
to the anasmic head and heart, and stimulate
the nerve-centers before the vital spark goes
altogether out. A fire cannot be rekindled by
adding fuel if there be no live coals in the grate.
Fortunately, suspension of the body needs no
preparation or apparatus for its immediate
application. It only needs vigilance on the part
of the operator. Should fright make him forget
his duty, then precious minutes are lost in try-
ing useless remedies, and these precious minutes
can never be recalled.
"The lesson which I would impress upon every-
one who uses chloroform, sulphuric ether^ or the
bromide of ethyl for general anaesthetic purposes
is, that prompt suspermon, tuith the head down, is
the remedy for suspended animation suddenly
coming on during acquired narcosis."
Pasteur^s Method of Xxterminating Babbits.
The offer of M. Pasteur to exterminate rab-
bits in some of the English colonies and the sen-
timental objection to his method, is fresh in the
minds of all. His plan was to utilize the infec-
tious and deadly action of chicken cholera
poison upon rabbits to rid certain localities of
the pests.
Mme. Pommery put at M. Pasteur's disposal
an enclosure of eighteen acres, the ground of
which was completely riddled by the burrows of
rabbits. The workmen estimated that more
than 1,000 rabbits came out each day to eat
from the boxes of provender furnished them.
December 23d, M. Loir sprinkled their food with
a fresh culture of the microbe of chicken chol-
era. In a very few minutes the repast was de-
voured. The results were as follows : Mme.
Pommery writes that on the next morning nine
dead rabbits were counted outside the burrows.
The second day the enclosure was not visited.
The third day thirteen more dead ones were
counted and not a single living rabbit was to be
seen. Careful watching on subsequent days
proved the annihilation of the entire lot. Some
burrows were opened and anywhere from two to
five dead animals foimd in each. — L' Union Med.
n
216
THE MEDICAL ERA.
IVoL. VI. No. 7.
Antisepsis.
Dr. Wm. Tod Helmut h says : **I always use
the Staffordshire knot in ligating the pedicle af-
ter ovariotomy. The silk I employ is carefully
prepared by the manufacturer and then soaked
in an antiseptic solution. On two occasions,
however, I used the ordinary silk without any
preparation, except washing it in clean water,
and applied it around the pedicle. One was the
removal of the ovaries for fibroids and the other
an ovarian cyst of the right side. Now, it may
be a coincidence, yet these are the only cases in
which I have had sloughing of the pedicle. The
sloughing was extensive, so much so that the
knots came oflf and injections spurted out from
the abdominal cavity. All the other cases did
well where the antiseptically prepared ligatures
were used. This is the antisepsis I believe in.
** I believe that you are apt to poison your pa-
tient with washing out the abdominal cavity with
Bichloride of mercury and other solutions. It
certainly does harm in many cases and I do not
use them. But in saying this I do not mean to
imply that I never use them in the treatment of
other wounds, because I do. In open wounds
or operations I flush the part with the antisep-
tic to remove the debris of bone and other mate-
rials which may collect during the operation. I
spoke only of the serous substances of the abdo-
men, where, for some time, I have used nothing
but hot water. In the cases where the Bichlo-
ride is used, it is not a constant irrigation, but
an occasional washing to keep the parts in good
condition. I do not fill the wound full of Iodo-
form or other substances and leave them there,
but sprinkle the substance over the closed wound
before the application of the air-tight dressing.
'* I have never seen trouble from the applica-
tion of the Bichloride to wounds other than of
serous surfaces." — P. and S. Invest
Exploratory Puncture With the Hypodermic Needle
Followed by Fatal Results.
Dr. H. M. Biggs quite recently made an au-
topsy and found pneumothorax due, he thought,
to perforation with the hypodermic needle. A
physician introduced a hypodermic needle on
each side for diagnostic purposes. The follow-
ing morning the patient, about 40 years old, was
found dead in his bed. The left lung was the
seat of extensive interstitial inflammation, with
tubercular foci, and occupying certainly not
more than half the space usually occupied by it.
The heart was drawn considerably to the left.
The right lung had collapsed and lay against
the spinal column and to the left of the median
line. The chest cavity was full of air. The
right lung was found to be very emphysematous,
and when it was inflated under water a pin-hole
perforation was discovered at its lower border.
Nothing of a pathological nature was found
about the perforation and there was nothing fur-
ther abnormal in the lung, except a few very
small tubercular nodules. There was not the
slightest trace of inflammation in either the pa-
rietal or the visceral pleura on the right side.
Dr. Thacher saw a similar case a few mouths
ago. Pulmonary symptoms developed, and, in
order to settle the diagnosis between broncho-
pneumonia and pleurisy, the hypodermic needle
was inserted on both sides. Witliin two or three
hours intense dyspncBa developed and the child
soon died. Both lungs were collapsed and a
puncture was found through the lower edge of
both at the site where the physician said he had
introduced the hypodermic needle. There was
a slight amount of broncho-pneumonia. — New
York Mediccd Journal,
Sour Milk and Buttermilk in the Nutrition of In-
valids and Others.
As the result of an extensive exx)erience in
rural practice, Dr. Demuth extols sour and
buttermilk as cheap, effective and easily assim-
ilable nutritive agents. Both are easily digested
on account of the finely divided condition of the
casein and the presence of acids. For infants,
the following is especially recommended : one
quart of buttermilk boiled with one tablespoon-
ful of wheat flour to the consistency of thin
pap.
Buttermilk is useful in all cases where a milk-
cure is indicated, and is particularly to be
recommended in consumption. Sour milk has
shown itself valuable in scrofulosis, neuras-
thenia, hypochondriasis, in convalescence, in
diseases of the organs of respiration and deg-
lutition, chronic catarrh of the air passages,
nervous disturbances following excessive or
exclusive meat diet, dropsy, albuminuria, and
Bright's disease. It is also useful in diabetes
mellitus. Both forms of milk are efiicacious in
chronic metallic poisoning, and inflammatory
and febrile conditions, especially in typhoid
fever. They are contra-indicated in all ulcer-
ous processes in the alimentary tract — a fact
not always considered in ulcer of the stomach,
ulcerating cancer, and tuberculous ulceration of
the intestines — and dilated stomach. — Med, d
Sur. Reporter. — Am. Med. Dig.
JUI.T, t88B.J
SELECTIONS.
217
Obstetric Aphorisms.
NeTer fail to inspect the perineum after labor.
If it is torn, have the moral courage to commu-
nicate the fact to your patient, and then put it
up immediately. The obstetrician who does
not inspect the perineum after labor, has no lac-
erations ; but he is the hand-maid to the gyne-
cologist.
Don't knead the uterus immediately after the
birth of the child ; by so doing you favor hem-
orrhage rather than prevent it.
Don't attempt to deliver the placenta imme-
diately after the birth of the child unless there
is some urgent necessity for so doing, as for in-
stance, post partum hemorrhage.
When the uterus makes an attempt to expel
the placenta, assist the effort by grasping the
fundus in the hand, and gently pressing it down-
ward and backward.
Don't pull on the cord until the placenta can
be felt in the vagina.
After the placenta is expelled, pass your fin-
gers gently into the vagina and up to the cervix,
and if portions of the membranes are caught in
its grasp, gently loosen and bring them away.
Always inspect the placenta after delivery to
see that no part of it has been left in the uterus.
-^ /nd. Med. Jour.
The Yomitmtjr Centre.
Professor Fremas, (Lancet) who has been in-
vestigating the subject of vomiting, finds that in
dogs and cats, section of the medulla at the
level of fourth ventricle does not prevent the in-
duction of vomiting by hypodermic injections of
Apomorphia. By touching different parts of the
medulla with a weak solution of Apomorphia, so
as to induce vomiting, he was able to localize
with tolerable precision, the situation and ex-
tent of the vomiting centre, which, he says, lies
in a small space before and behind the calamus,
and in the deeper layers of the medulla. He be-
lieves that the absence of vomiting, which is
observed in ruminants, rodents, and some other
class of animals, is due to the absence in them
of a vomiting centre, or to the very rudimentary
condition in which it exists. In a rabbit on which
he tried in every way to induce vomiting, no
signs of gastric movement of that nature could
be detected. — Canada Lancet,
In a patient who had been addicted to the use
of Cocaine and Morphine, nearly 600 scars were
actually counted on his trunk and limbs made
by the hypodermic needle. All of these had
been made within the last year, and most of them
by his physician*
A Remarkable Suicide.
A man had dined alone with his wife on the
evening in question and subsequently was seated
with her in the drawing-room, where, as the lady
was playing to him on the piano, he destroyed
himself in a manner at once unusual and terri-
ble. Heating a thin brass poker to redness in
the fire, he forced it several times into the abdo-
men, no less than four wounds so inflicted being
found on the body. The unfortunate wife's at-
tention was speedily called to her husband's
condition by the cries involuntarily excited by
his intense sufferings, and on witnessing the dis-
tressing nature of the cause which gave rise to
them, the poor lady immediately fainted and
was found in this condition by the servants at-
tracted to the room by the man's groans. Af-
ter some hours of intense suffering the unhappy
suicide succumbed to the injuries he had in-
flicted on himself. Such a mode of suicide is
almost unique in the history of medical juris-
prudence.
The Western Drugcfiat tells the following, illus-
trative of the power of mind over body : " Late-
ly a man was taken to a Buffalo hospital, suffer-
ing intense pain. He told the doctors he had
swallowed his gold plate containing four teeth.
Hourly he grew worse. After being in the hos-
pital four days, it was decided that it would be
necessary to remove the foreign body by an
operation. At last his sufferings so diminished
that a little steak was given him. As soon as
the patient had swallowed a mouthful he
writhed in agony. So great was the increase of
his sufferings that he declared he would die if
an operation were not performed instantly. He
described minutely the sensation experienced by
the slipping down his throat. Then, placing his
hand upon his stomach, he groaned forth, ''I
feel it right here. Doctor." So great was his ago-
ny that the attendants could scarcely keep him
in bed. But just as the surgeon was about to
commence, a telegram was handed the patient.
It read: * Found teeth under bed, come home.'
The suffering man got up, dressed and paid his
bill. He could not understand what made the
nurses and doctors laugh."
Typhoid Fever.
At the meeting of the Michigan State Board
of Health held at Lansing, Professor Vaughan
reported a successful experiment of product in a
oat of a disease similar to typhoid fever in the
human family, by the use of the germs found in
the water used by the 300 victims of the scourge
at Iron Mountain, Michigan.
218
THE MEDICAL ERA.
[Vol. VI. No. 7,
The Use of Oz3r?en.
Oxygen will be found to be of service in the
following classes of cases :
First. — Those in which, from some obstruc-
tion in the air passages, an insufficient supply of
oxygen is allowed to enter the lungs, as in croup,
constriction of the larynx or trachea, asthma,
accumulation of mucus in trachea or bronchi
during coma or severe bronchitis.
Second. — Where the lung is consolidated,
either by pneumonia or tubercular deposit, or in
a state of atelectasis, or compressed by pleuritic
accumulation, so that only a portion of the lung
is pervious to air.
Third. — Cases of blood poisoning, as by
opium, chloroform, uremia, etc.
Fourth. — Cases of anemia, as auxiliary to ap-
propriate internal medication.
Fifth. — Gases where it is desired to stimulate
the capillary circulation, whether of the skin, as
in certain skin diseases, and indolent ulcers, or
of the intestines when ulcerated, as in dysentery
and typhoid fever.
Thus we see that in a large proportion of
cases oxygen may be of service, and it would, no
doubt, be much more frequently used if we had
some convenient mode of generating and admin-
istering it. — Medical Times,
The Perspiration.
The perspiration is more concentrated on the
right side of the body ; this observation is in ac-
cordance with that of Beinhardt ; it would be
interesting to know whether the opposite was the
case in the left-handed. The palm of the hand
sweats four times more than the skin of the
chest, and the cheeks one and a half times as
much. There is a slow increase in the sweat in
the afternoon, especially obvious from 8 to 12
o'clock at night. After midnight there is a dim-
inution. Feeding has but little influence on this
function. Elevation of the surrounding tempera-
ture increases the perspiration, and variations of
the hygrometric state of the atmosphere have an
immense influence on the function. The quan-
tity of water evaporated in a quarter of an hour
from, a cutaneous surface 25 centimeters square,
in a normal individual, is about 1.76 of a
gramme. In infants the quantity is generally
less than in adults. The weight of the body
and sex have no influence on the perspiration. —
Lancet.
Transverse Marking of the Nails as an Indication
of Previous Disecwe.
After showing to his class a case of acute
pneumonia of the apex going on to abscess. Dr.
Longstreth continued: It is interesting to watch
the history of the case as recorded upon the fin-
ger nails. When I look at this patient's nails,
I see on each of them a distinct ridge, showing
that the portion of the nail which has grown
since the acute attack is much thinned out. The
nails show that this disease came on acutely, as
would occur in a pneumonia, and that the soft-
ening has resulted from this and not from a
tubercular process. This is the only element
which gives us any hope in this case.
Here is another man in whom an acute double
pneumonia occurred a few weeks ago. You see
on his finger nails the ridge showing the acute-
ness of the attack. This is quite distinct, and
is seen on all of the nails. These marks are
very interesting and tell us a perfectly straight
story. They will remain for at least two years.
If a person tells you that he has broken his arm
within eighteen months, you will see the ridges
on the nails of the hand of the affected side,
whDe they will be absent on those of the other
side. If you are told that a patient has had
typhoid fever, look at his nails, and if the state-
ment is correct, you will find the ridges. The
more acute the illness, the sharper will be the
ridge. When the illness comes on, the nutri-
tion of the body, including that of the nail,
ceases. We all know about the hair falling out
after a disease like typhoid fever. It only be-
gins to fall after the growth has recommenced
and the hair is coming up out of the follicle.
The nail is a much more enduring evidence
of disease. If there has been an acute rheuma-
tism coming on within a few hours, with a
temperature of 104° or 105°, the nail will be
cut down sharply. I have seen nails looking as
though they had been cut across. In typhoid
fever, where the disease comes on gradually, there
is not such a sharp cutting out of the nail. There
will rather be an area of thinning, which will
not be seen until the nail grows beyond the
white mark at its base. I first observed this
condition in my own finger nails, in 1870. I
had at that time relapsing fever, which, &8 you
know, is an affection in which there is one week
of fever, then a week without fever, followed, by
a return of the fever for another week, and so
on, indefinitely. When I was recovering, I saw
that all my nails had white lines across them.
— The Epitome.
Jvi«T, 188B.]
SELECTIONS.
219
A Baby-Inoabator.
We are again indebted to a Frenchman for a
clever contrivance, of which we spoke some time
since. M. Tamier has invented a baby-incuba-
tor, which he calls a conveiise, in which the the-
ories about preserving life in premature children
are reduced to a practical accomplishment. This
suggestion for promoting and extending viability
has been current for some time, but has gener-
aUy been regarded as more clever than practica-
ble. Few supposed that baby-incubators would
ever become a factor in obstetrical work; but
that they are fast becoming so is evident from
the fact that they are already largely used
abroad, and are rapidly coming into use in our
own hospitals. By means of the Tamier con-
r^use, the viability of premature children has
been carried back nearly to the sixth month. It
is not a very complicated machine, either — a
simple incubator with a glass lid, the interior
being supplied with heat and moisture. The
child is kept in the machine except when it is
being washed and fed, when it is kept in a room
where the atmosphere and temperature are the
same as that of the incubator. A stomach-tube,
in the shape of a rubber urethral catheter, is
used to accomplish feeding, which consists in
the allowance of eight grammes of the best milk
available given hourly to a very small child.
The whole process is so simple that, in the ab-
sence of M. Tamier's conveme, a suitable incu-
bator could almost be contrived, while we doubt
not that the old egg-incubators, of which so
many have been abandoned because of the diffi-
ciilty of caring for motherless chicks after hatch-
ing, might well be devoted to this higher use.
— Medical Register.
Electricity in Obstetrics.
It is incumbent upon every physician to avail
himself of all the resources of his art to save his
patient; but if, after faithfully applying all
remedies at his command, death snatches his
victim, then the physician will have the proud
satisfaction of knowing that, as far as he is con-
cerned, he has faithfully performed his duty.
February 16, I was called to see a patient
who, as her husband informed me, was bleeding
to death. She had been taken suddenly, an
hoar before the messenger arrived, with pains,
and soon afterwards with hemorrhage. On the
way, he remarked to me that his wife was forty
years of age and the mother of ten children, and
at present in the sixth month of her pregnancy.
Upon my arrival at his house I felt very much
dismayed. The blood was trickling through the
bed and upon the floor. I injected a strong so-
lution of Ergotin, hypodermically, at once, made
a quick examination, ruptured the membranes,
and found a foot presentation. I delivered im-
mediately and felt the placenta already detached.
I now proceeded to give my patient a teaspoon-
f ul of fluid extract of Ergot and a small teacupful
of strong cider vinegar, hoping the worst had
been bridged over. But as there is a calm be-
fore the rage of a storm, so it was with my case.
A few minutes after delivery, the feeble con-
tractions ceased entirely and the dreaded hem-
orrhage reappeared worse than ever. Ergot,
ice, injections of hot water and Iodine, the ad-
ministration of strong vinegar, and everything
else was tried in succession, but still the hem-
orrhage continued. The patient complained now
of dimness of vision and a feeling of f aintness —
symptoms which warn us of an approaching
crisis. I passed in quick review before my mind
the possible resources on hand, and, fortunately,
I bethought myself of electricity. Pressing with
both hands upon the abdominal aoriia, I sent to my
office, which was not very far oflF, for my battery
(a Oaiffe ). I now applied one pole upon the sa-
crum, the other over the fundus, and gave my
patient the benefit of the strongest current. In
a few minutes I felt contractions at the fundus,
gradually spreading forward. I continued with
slight intervals for nearly an hour. The uterus
was firmly contracted; the hemorrhage had
gradually lessened, and after awhile ceased en-
tirely. While using the current I still continued
pressure upon the aorta. I think it was quite
unnecessary, yet I wanted to be on the safe side,
as this was my first experience with electricity
in a case of this kind. It is needless to say
that, by these means only, my patient was
saved, and that at present she has nearly re-
covered from the effects of the loss of blood.
— Medical Register, — The Epitome,
The Scholar in Medicixie.
Dr. Asa F. Couch vouches for the authenticity
of the following letter, which he received from
a doctor who wanted counsel :
deer Dock — ^i have a pashunt whos physical
sines shows that the windpipe has ulserated off
and his lunges hav drop down into his stumick
i have given hym everry thin without efeckt her
fathur is welthy honable and iniluenshal as he
is member of assembly and god nose i don't
want to loos hym what shall i do ans by retun
male. Yours frat.
220
THE MEDICAL ERA.
LVOL. VI. Na
ILLINOIS HOMGBOPATHIC MEDICAL ASSOCIA-
TION.
PRELIMINARY ANNOUNCEMENT.
To THE Members of tbs. Illinois Homceopathic
Medical Association : — In accordance with the
custom of our Association, the President has in-
structed me to make the following preliminary
announcement :
The thirty-fourth annual meeting of the As-
sociation will be held in the city of Sterling, 111.,
in the month of May, 1889, at a date yet to be
determined by the Executive Committee.
At the last meeting, held at Central Music
Hall, Chicago, May 15, 16, 17, 1888, the follow-
ing resolution was adopted :
Resolved, That the President appoint each year
a committee of three, who shall be called ^* Com-
mittee of Finance and Management," and whose
duty shall consist in the incurring of necessary
expenses, auditing bills, having general supervis-
ion over the plan of the circular, and arranging
such other business connected with the Associa-
tion as shall not directly come under the super-
vision of the Secretary or Treasurer.
The committee for the current year consists
of G. P. Shears, M.D., Chairman ; W. H. Steams,
M.D., and H. M. Bascom, M.D., associates.
Following is a list of Chairmen of Bureaus :
J. A. Vincent, M.D., of Springfield, — Medical
Legislation, Jurisprudence and Education ;
A. A. Whipple, M.D., of Quincy, — Obstetrics ;
C. W. Harback, M.D., of Lockport, — Sani-
tary Science and Hygiene ;
C. H. Vilas, M.D., of Chicago, — Ophthal-
mology and Otology ;
F. W. Gordon, M.D., of Sterling, — Materia
Medica ;
F. 0. Pease, M.D., of Morgan Park, — Pathol-
ogy, Physiology and Histology ;
S. P. Hedges, M.D., of Chicago, — Diseases of
Women ;
J. B. Dunham, M.D., of Wenona, — Clinical
Medicine ;
H. B. Fellows, M.D., of Chicago, — Neurology
and Psychology ;
W. F. Knoll, M.D., of Chicago, — Surgery.
M. J. Hill, M.D., of Sterling, — Diseases of
Children ;
T. S. Hoyne, M.D., of Chicago, — Necrology
and Statistics.
It is urged that all chairmen give early at-
tention to the work of their respective bureaus,
to the end that no hasty reports shall be made
at the last moment before the meeting of the As-
sociation.
All correspondence should be directed to the
Secretary.
A. B. Spach, M.D., Secretary.,
6310 Wentworth Av.,
Chicago, 111.
The TsEATBfENT OF Ulcebs. — An article appeared
in the London Medical Record, for December 15,
1887, giving interesting details of the treatment of
ulcers by phosphoric acid, as shown by the experi-
ence of Dr. Grossich. By this method of treat-
ment, he used a ton per cent solution of pure
phosphoric acid in distilled water. The ulcer is
covered with a bit of lint dipped in this solution,
and the dressing renewed three or four times a
day. The patient for the first few minutes feels a
slight burning sensation, but this soon passes, and
within twenty -four or thirty- six hours the ulcer
cleans and looks better. Inflammation or eczema
of the surrounding parts disappears, and all pru>
ritus ceases. The ulcer cicatrizes rapidly, and the
cicatrix is firm and healthy.
KoUischer treated tubercular affections of the
joints with injections of the phosphate of lime,
with great success. Dr. Grossich has also had
good results with this treatment, and cites some
very interesting successful cases.
The treatment by the solution of phosphoric
acid was further employed in a case of tuberculous
abscess of eight months' duration, and also a case
of eczema marginatum which had lasted more than
a year, and good results followed.
The above suggests the superiority of Horsford's
Acid Phosphate as a substitute for the phosphoric
acid.
The effective acidity of this preparation is about
the same as the ten per cent solution of phos-
phoric acid which is prescribed in the above treat-
ment, and it may therefore be justifiably employed
by the profession in the treatment of disorders of
this character. It has the advantage of containing
the phosphates in solution, notably the phosphate
of lime. It follows, then, that all cases that re-
quire the phosphoric acid treatment can be more
advantageously treated by Horsford's Acid Phos-
phate, and the suggestion is hereby commended to
the profession.
Old Lady (to grocer) — " My daughter is quite
an invalid, sir, and wants some nice fresh eggs."
Grocer — ''Yes, ma'am. (To boy): James,
show this lady those invalid eggs." — The Epoch.
Jni.T, 1888^
MISCELLANY.
221
MISCELLANY.
Kew York.
The commencement exercises of the N. T.
Homoeopathic Medical College and Hospital was
held in Chickering Hall, New York City, on the
afternoon of Friday, April 13, a large audience,
mnsic and a fine class making the occasion a brilliant
one. The Dean, Prof. Allen, made the opening ad-
dress, in which he spoke of the flattering prospects
of the College. Hon. Bufus B. Cowing, and Bev.
Dr. Bowles also made admirable speeches. The
prizes were presented by Prof. Malcolm Leal,
President of the Faculty. Forty -eight members
composed the graduating class.
The work on the new college and hospital
buildings will be commenced during the month of
May. It is expected that the i;}ew college building
will be ready for occupancy at the opening of the
session of 1880.
The next meeting of the American Institute
of HoMCBOPATHY will be held at Lake Minnetonka,
Minn., in June, 1889.
Ohio.
The Homoeopathic Medical Society of Ohio met
at Delaware, O., May 8 and 9. Officers for ensuing
year :
C. K Walton, MD., President ; C. L. Cleveland,
M.D., First Vice-President ; Frances J. Derby,
M.D., Second Vice-President ; Frank Kraft, M.D.,
Secretary ; H. Pomeroy, M,D., Treasurer ; C. D.
Crank, M.D., Assistant Secretary ; H. E. Beebe,
M.D., Chairman Board of Censors.
Meet at Cincinnati, O., second Tuesday in May,
1889.
Kentucky.
The Homoeopathic Medical Society of Kentucky
met at Frankfort on the 16th and 17th of May,
with an unusually large number of physicians in
attendance. The papers read were thoughtful, and
a credit to the authors and to homoeopathy in gen-
eral.
The following officers were elected : President,
Dr. C. P. Meredith; Vice President, Dr. H. C.
Kehoe ; Corresponding Secretary, Dr. Howard
Crutcher ; Recording Secretary, Dr. A. C. Jones ;
Treasurer, Dr. J. A. Vansant.
The next meeting will be held at Louisville in
May, 1889. All papers and communications should
be addressed to Howard Crutcher, M.D.,
Corresponding Secretary,
Louisyille.
It Makes a Difference.
« It's mighty easy ordering when you please
Infusi sennw capiat uncitia tree;
It's mighty different when you quiEickle down
Your own three ounces of the liquid brown.
Pilula, pulviSf — pleasant words enough,
When other throats receive the shocking stuff;
But oh, what flattery can disguise the groan
That meets the gulp which sends it through your
own!"
Nuz and Sulphur.
The following treatment has been suggested
for Dr. Southworth's case, May number, page
160.
Nux vom., 30x, a dose at bed-time for two weeks.
This to be followed, if necessary, with one dose of
Sulphur 200 or higher, then to wait patiently for
clear-cut indications of some remedy before pre-
scribing again.
The few symptoms given in Dr. Taylor's case,
page 150, are not sufficient for a homcBopathic
prescription. C.
Wm. B. Warner & Co., have issued a notice
to physicians denouncing certain reports which
have been circulated to the effect that they were
connected with the firm of H. H. Warner & Co.,
of Rochester, who make the so-called '* Safe "
remedies. Wm. R. Warner & Go's, goods are
pure pharmaceutical preparations, made for the
profession only.
The uncertain strength of Coca leaves makes
this drug very unreliable, unless a preparation
is used which we knoiv to be made from a good
leaf. *' Robinson's Wine Coca" is prepared by
percolating assayed Coca Leaves with Malaga
Wine, and has always been found entirely sat-
isfactory.
Lactated Food has shown itself to be a reli-
able preparation as a food for infants during the
summer months. It contains no starch or cane
sugar, and possesses the highest value in nutri,
ents.
Dr. Eustace Smith, of London, physician to
the Children's Hospital, and author of "Wast-
ing Diseases of Infants and Children, " says :
** Mellin's Food is by far the best of any with
which I am acquainted. It seems to agree
equally well with children, whether they are
healthy or diseased. "
Nestle's Food requires no milk in its prepa-
ration, and is very effective in the prevention of
cholera infantum. It is especially suitable for
infants in hot weather.
Atkinson's Battery for the production of
Static Electricity, can be had at Gross & Del-
bridge's, 48 Madison St.
222
THE MEDICAL ERA.
[Vot. ▼!. H*.7.
PERSONALS.
Dr. W. F. Hobart has located at Gross Park,
HI., corner Wood and Melrose Streets.
Dr. A. B. Spach has been appointed Demonstra-
tor of Anatomy in the Chicago Homoeopathic Med-
ical College.
Dr. T. H. Williams has located at Plymouth,
Wis.
Drs. C. M. and L. C. Koier have moved their
office to the north-west corner West Division
and Milwaukee Ave., Rooms 8 and 9.
Dr. James E. Lilienthal has his office with his
father, Dr. S. Lilienthal, at 1316 Van Ness Ave.,
San Francisco.
El celebre doctor Hale tambien estuvo en esta
Capital ; el Instituto tuvo la pena de no poder
darle la bienvenida y de no verse honrado con
su presencia, debido al corto tiempo de su per-
manencia entre nosotros. — ha Refornva Medico.
Rbininoer — Traver. Dr. E. E. Reininger and
Miss Nettie Traver, both of Chicago, were mar-
ried June 12th. At home Thursdays after June
27th, 1093 Taylor St.
Eden Musee. — At the Eden Musee, which
was opened Friday, June 15th, one of the most
natural groups in the entire exhibit is that of d
father holding a child on his lap, and a physi-
cian standing by feeling the little one*s pulse.
It is well worth a visit.
For Sale. — Residence and business in a beau-
tiful summer resort town in Michigan. Address
" M.D.," care of Medical Era.
Patterns. — In answer to several correspon-
dents, we take pleasure in informing them that
the ** Gertrude Patterns" can be obtained by
sending $1.00 to Dr. L. C. Grosvenor, 185
Lincoln Ave., Chicago, Illinois.
George Eennan's Siberian paper in the July
Century will be called **The Steppes of the
Irtish," and it will include an account of a long
ride in an out-of-the-way part of Siberia, among
the Kirghis and the Tartars.
Not for Sale, but Given Away. — A first-class
general practice in a town of 2,000 inhabitants
in Western 111. No competition. Homoeopathy
well established.
This is a rare chance for some pushing man.
Good reasons given for leaving. Call on or
address, Coburn Badoley, M.D.,
Astoria, Fulton Co., 111.
A Great Popular Cyclopedu. — The third vol-
ume of Alden's Manifold Cyclopedia, a marvel of
condensed information, covers the alphabet between
the titles Artemisia and Baptisia. There seems to
be little doubt that it will prove to be the great
popular Cyclopedia for the next score of years, at
least. The embodiment of an Unabridged Dic-
tionary of Language and a complete Cyclopedia of
Universal Knowledge in one work, in large type,
with thousands of illustrations, and all for a price
less than people have been used to paying for a
dictionary alone, is not only a novelty in plan, but,
to the ordinary book-buyer, the fact is hardly less
than astounding.
The publisher, John B. Alden, 393 Pearl St,
New York, or Clark and Adams Sts., Chicago, will
send specimen pages free to any applicant, or a
specimen volume (which may be returned if not
wanted) in cloth for 50c., or half Morocco, 65c.;
postage 10c. extra. The set of thirty volumes is
offered at considerably reduced prices to early sub-
scribers.
It Brings the Funeral.
FaWi Ciirist — " Why don't they try the faith
cure on General Sheridan?"
Skeptic — "I suppose the principal objection
is that where the faith cure is tried the funeral
follows so quickly after the complete recovery."
— Texas Siftings.
Scribner's for July has the usual variety for
summer reading, and St. Nicholas maintains it-s
superiority over all other magazines for the
young.
Foreman. — **In what column shall I put the
account of the man who fell and broke his back-
bone?"
Editor. — (Busy writing a leader) <* Spinal
column, of course."
New Line to Cheyenne.
The new extension of the Burlington Route
to Cheyenne, Wyoming Territory, having been
completed, the C, B. & Q. B. B. is now running
a through sleeping car from Chicago to Chey-
enne, via Omaha, leaving Chicago daily at noon
on the "Burlington Number One" fast train.
For tickets apply to any coupon ticket agent of
its own or connecting lines, or address Paul
Morton, Gen*l Pass, and Ticket Agent, C, B. &
Q. E. R., Chicago.
Thb North American Journal of Homceopatht
will be sent on trial fur tbree months gratis, to any one
sending their adilress to 152 West 3ith Street, Kew
York, and mentioning Ths MEDiCAii Era.
JuLT, 188B.]
BOOK REVIEWS.
223
BOOK REVIEWS.
A System op Obstetrics. By American Au-
thors. Edited by Barton Cooke Hirst, M.D.,
Associated Professor of Obstetrics in the
UniveVsity of Pennsylvania. Volume I.
Illustrated with a Colored Plate and 309
Engravings on Wood. Philadelphia: Lea
Brothers & Co. 1888.
This is the first volume of a work which the
well-known house whose imprint it bears is is-
suing as a companion to Mann's '* American
System of Gynecology. ** Like the latter, it is a
composite treatise, each separate subject being
prepared by some author whose study and ex-
perience has especially fitted him for the task.
Those who are represented in the present vol-
ume are Drs. S. C. Busey, Geo. J. Engelmann,
Barton Cooke Hirst, W. W. Jaggard, H. Newell
Martin, Theophilus H. Parvin, R. A.F. Penrose,
and J. C. Reeve.
This volume carries the reader through the
usual preliminary chapters, through the con-
duct of normal labor, the dystocia, the use of
anesthetics in labor, and anomalies of the forces
in labor.
This system must take its place among the
standard works on obstetrics. It is the only
composite systematic treatise on the subject
ever published in America, and will be welcomed
by all American physicians.
A Repertory of Gonorrhoea, with the Con-
comitant Symptoms of the Genital and
Urinary Organs. Compiled by Samuel A.
Kimball, M.D., I.H.A. Boston: Published
for the L H. A., by Otis Clapp & Son. 1888.
There was much good paper spoiled when
this book was printed. If the pages had all
been left blank, it would make an excellent note
book, either for pencil or ink. As it is, proba-
bly the best purpose to which it can be put is to
use it as a scrap-book.
Essentials op Chemistry and Toxicology. For
the Use of Students in Medicine. By R. A.
Witthaus, A.M., M.D., Professor of Chem-
istry and Physics in the University of New
York, etc. Second edition. New York:
William Wood & Company. 1888.
This work is written in the question and an-
swer style throughout. It is well adapted to the
student's use, either for class-room purposes, or
preparatory to an examination. It is clear,
concise and exact.
Practical Clinical Lessons on Syphilis and the
Gbnito-Urinary Diseases. By Fessenden
N. Otis, M.D., Clinical Professor of Genito-
urinary Diseases in the College of Physi-
cians and Surgeons, New York. Second
Student's Edition. New York : G. P. Put-
nam's Sons. 1888.
No American physician is better qualified
than the author of this volume to write on the
subjects involved. His experience as a teacher
and as a clinician has been very great, and he
has long been looked upon as an authority in
his specialty.
Prof. Otis' well-known views regarding the
nature of the syphilitic virus, first promulgated
in 1868, are here given in full. In the matter
of treatment, he is conservative and " rational."
Mercury, in small doses, he looks upon as the
"specific." He 46precates the use of injections
in the inflammatory stage of gonorrhoea, and
gives in chapter xliii. his method of treatment,
which must appeal to the good sense and judg-
ment of all.
Those who have to treat **the venereal"
will find this book a valuable aid.
The Pathology, Diagnosis and Treatment of
THE Diseases op Women. By Graily Hewitt,
M.D., London, F.R.C.P., Professor of Mid-
•wifery and Diseases of Women, University
College, and Obstetric Physician to the
Hospital. A new American from the
Fourth Revised and Enlarged English Edi-
tion. Edited by H. Marion Sims, M.D.
E. B. Treat, Publisher, 771 Broadway,
N. Y. 1888.
These volumes constitute the 7th, 8th and
9th in the series of medical classics published
by E. B. Treat, of New York. At the present
time, when numerous works on gynecology are
being given to the profession, it is well that the
great English specialist should be represented.
The author, in the preface, says : " Ten years
have elapsed since the last edition of this work
was published. What I have gained from ob-
servation and experience during these ten years
has been here faithfully and truly set down.
The greater part of this new edition has been
rewritten." Dr. Sims has given the work a
thorough revision, freely criticising, and com-
menting on the author's views, and making
many valuable additions in the text and illustra-
tions.
224
THE MEDICAL ERA,
[Vol. 71. W©. T.
THEY SAY
That hanger is neyer delicate.
That alcohol is the great degenerator.
That many dishes bring many diseases.
That death is not horrible to the djing.
That man's great enemy is his stomach.
That there are 150 lepers in this country.
That the proper pronunciation is 6C-ze-ma.
That a glutton digs his grave with his teeth.
That typhoid fever is absolutely preventable.
That adults never have ringworm of the scalp.
That syphilis in the young is a serious disease.
That syphilis of old age is a very slight affec-
tion.
That eczema is not properly pronounced ec-
2;e-ma.
That acne is not cured in a day, nor pemphigus
in a week.
That it is no compliment to call a man ^' poor,
hut honest."
That lupus is a specific disease, and is not due
to syphilis.
That eggs can go through a process of true in-
flammation.
•
That papular syphilis is not " syphilitic psoria-
sis.*'
That woman's first reform should be in her own
attire.
That the prudent man will not be misled by
blind enthusiasts.
That it is not a crime to express one's thoughts,
but sometimes it is very imprudent.
That now-a-days a man never gets drunk; he
simply " over-estimates his capacity,"
That for every death from small-pox in the last
thirty years, there have been six from scarlet
fever.
That for the last thirty years, for every death
from cholera, there have been twenty-two from
typhoid fever.
That one of the greatest causes of trouble in
this world is the habit some people have of talk-
ing faster than they think.
That a woman in Kentucky has a circular hole
in one of her eyelids, through which she can see
when both her eyes are closed.
That the Chinese suffer but rarely from typhoid
fever, because their universal custom of tea- drink-
ing prevents their taking unboiled water.
That there is a club in New York composed en-
tirely of men who have organic heart disease; they
have named it " The Sudden Death Club. "
That there are 60,000,000 people in the United
States, and 90,000 doctors, while in Russia there
are 100,000,000 people, and only 5,000 doctors.
That saccharin is two hundred and fifty times
sweeter than sugar, and we know a girl who is two
hundred and fifty times sweeter than saccharin.
That it is bad enough for a small boy to throw a
banana peel on to the sidewalk, but it is worse for
a banana peel to throw a large man on to the side-
walk.
That cancer is a cusease of the most highly civ-
ilized, the most cultured, the wealthy, and of local-
ities which are the most salubrious. It is not
hereditary.
That our ofSce boy wants to know why it is that
men always have their clothing made to button
from left to right, while women button theirs from
right to left.
That an old plantation darkey treated fracture
of the femur with alum and resin, given internally
— << alum to draw de pieces togedder, an' rosin to
sodder 'em. "
That children bom of morphine-eating mothers
are practically morphia-eaters, and suffer for want
of the drug with which they were supplied during
intra- uterine life.
That rational treatment for trismus and tetanus
neonatorum is the preventive one, and this, in the
light of recent discoveries, seems to consist in an
antiseptic treatment of Uie umbilical cord and
navel.
That Alexander's operation of shortening the
round ligaments, it is now generally conceded, is
not efficient in cases of prolapse, unless supple-
mented by the usual operations on the va^na
and cervix.
That coma from alcoholism is best treated by
subcutaneous injections of ammonia, a mixture of
one part ammonia with two to six parts water.
Under this treatment a comatose patient will some-
times recover consciousness in a few minute&
That woman's dress
Will harm her less
Than drinking wine or gin;
But man's desire
For liquid fire
Will make a corpse of him.
THE MEDICAL EM
Vol. Y1.
Chicago, August, 1888.
No. 8.
EDITOBS :
CH. GATCHELL, M.D.
JAMES E. GROSS, M.D.
A GALAXY OF FRAUDS.
There are frauds innumerable, but the most
damnable fraud of all is that which, in the
guise of innocence, conceals a sting. To rob a
man of money can sometimes be gracefully
done, but to deliberately rob him of his power
of self-control requires the vices of a vulture and
the depravity of a procuress.
She who offers "Vita Nuova " to a devitalized
public is one of these. To those who are trying
to free themselves from the use of intoxicants
she promises relief, and then draws their bonds
the tighter. She tells them that they may
overcome their craving for alcohol by drinking
the draught whibh she prepares — and then she
prepares a draught of alcohol !
The nostrum which has been so extensively
advertised under the name of **Vita Nuova," by
a certain Mrs. Harriet Hubbard Ayeb, is
nothing more or less than port wine. Hence,
we are presented with the spectacle of a man
who may have been addicted to the use of strong
drink, forming the resolution that he will never
touch another drop. He grasps at everything
which will aid him in his effort. He reads that
"Vita Nuova is positively free from alcohol, and
is a sure specific for the alcohol habit."
He buys, he drinks, and thus is his old appe-
tite strengthened and his resolution weakened.
By a base fraud and a miserable lie Mrs.
Ater thus secures another victim.
It has already been told how a man who is
known to the world of infamy by the name of
Dr. H. N. Kane has emulated the example of
the " Vita Nuova " woman by offering as a cure
for the morphine habit, more morphine. It is
estimated that each teaspoonful of his " Scotch
Oats Essence " contains one-eighth of a grain of
the sulphate of morphine. This he advertises
as an antidote for the effects of morphine, and
the cure of the morphine habit.
Justice will not be done until this fiend is
closely confined, and until Mrs. Ayer is com-
pelled to devote herself strictly to the prepara-
tion of "Madame Becamier's Cream Balm."
Of a less harmful, though equally deceitful
record, is the history of " Moxie." The story
has all the interest of an oriental tale and all
the truth of a campaign lie.
The circular which accompanies each bottle
of this wonderful tonic purports to tell how a
certain Lieut. Moxie — somebody's "dear old
friend" — inherited a large fortune from his
father and the consumption from his mother.
While hunting for health in South America —
that land of impotent missionaries — Lieut.
Moxie made a discovery destined to " shake the
country more than telephones or telegraphs,"
to say nothing of earthquakes, and such trifling
terrestrial disturbances. The discovery which
he made was of a new species of "greens."
After having despatched a bale of the "greens "
to a doctor in Lowell, Mass., the lieutenant
went to Lower CaUfomia and very obligingly
died.
But, though Moxie is dead, '* Moode*' stil
lives. The Lowell doctor immortalized the
226
THE MEDICAL ERA.
[VouVL No. 8.
name of his "dear old friend'* by wrapping it
about each bottle of the beverage. Then he
"gave it to the world." He promised that it
would cure insanity, blindness, dipsomania,
headaches, softening of the brain, loss of man-
hood, and other ills too numerous to mention.
Like the old-fashioned almanac, he relates sev-
eral cases of wonderful cures. One was of an
old lady with " apparent progressive paralysis;"
another was of an old lady with "the utmost
nervous exhaustion." But, most wonderful of
all, it cured an editor who had " a tendency to
mix ideas." For this, blessed be " Moxie !"
INSTITUTE ADDRESS.
But a new light is thrown upon the subject of
"Moxie" when it is known that the stuff is
nothing but flavored water ; that the few simple
ingredients of which it is composed may be
found in any drug store in the land; that no
"greens" ever came in a bale from South
America, and Lieut. Moxib is a dead myth.
The whole thing is a fraud, a delusion and a
snare. The circular is a miserable catch-penny
contrivance, bom of the author's imagination.
The wonder is that the public could be so easily
gulled by the gauzy fish-story which it tells.
But the further wonder is that any reputable
physician should have lent his name to such
a fraud. In his circular Dr. Thompson says —
** I do not like to advertise like a quack, but my
friends say I must give it to the world."
And then the circular concludes with a letter
which endorses Dr. Thompson, and leaves the
impression on the mind of the reader that
the writer is the "friend" who said that the
doctor "must give it to the world."
Dr. Thompson has been very clever in shifting
the responsibility of the whole affair upon the
shoulders of his friends, one of whom is dead,
and one living.
A century has not added wisdom to the dom-
inant school of medicine, — Cowperthwaite,
EXTRACTS FBOK THE ADDRESS OF THE
PRESIDENT OF THE AKERIGAK IHSTI-
TT7TE OF HOMCBOPATHY, 1888.
We present to our readers the following ex-
tracts from the presidential address of Prof. A.
C. CowPERTHWAiTB, M.D., delivered at the recent
meeting of the Amencan Institute.
THE PROGRESS OF HOM(EOPATHT.
The progress of homcBopathy during the past
year has been all that could have been desired.
From every quarter of our own land comes the
most cheering intelligence, and from other lands
where barriers exist against medical freedom such
as we of this free and enlightened country know
nothing of, from these lands comes the welcome
news that homoeopathy is becoming slowly but
surely established in spite of barriers and in
spite of a spirit of intolerance and persecution
only surpassed by that with which Hahnemann
contended in the early days of our system. Es-
pecially have our brethren in Great Britain rea-
son to be encouraged. The outcome of the cele-
brated discussion carried on through the colums
of the London Times on " Odium Medicum and
Homoeopathy" is gratifying to every homoe-
opathist. It proves a fact that was long since
established, namely, that whenever homoeopa-
thy or any of the interests pertaining to it are
brought before the bar of pubUc opinion, it never
suffers.
THE opinion of HOLMES.
It is said that Dr. Holmes still adheres to the
statement made so many years ago, and that,
too, notwithstanding he cannot have helped ob-
serving the unparalleled advancement of homoB-
opathy during all this period of time. At the
time Dr. Holmes made this statement there was
not a single homoeopathic college in existence.
Now there are 14, with about 1,200 matriculates
annually and over 400 graduates, their alumni
already numbering over 8,000. At that time
there were but a few hundred practitioners in
this country, — now there are nearly 12,000.
Then there were no homoeopathic hospitals — ^now
there are 60 with nearly 6,000 beds. Then we
had but one or two journals devoted to the in-
terests of homoeopathy, — now we have 25. Then
we had but half a dozen societies, including the
American Institute of Homoeopathy, which had
been recently organized, — now we have over 150
Afr«nST, 1888^]
INSTITUTE ADDRESS.
227
societies. Then only one or two small pharma-
cies were required to supply the demands of the
profession, — now there are 33 strictly homoeo-
pathic pharmacies, some of tliem doing an im-
mense business, while thousands of drug stores
have miniature homoeopathic pharmacies estab-
lished in connection with their regular business,
— and I must say, in my own opinion, much to
the injury of homoeopathy.
THE MISTAKES OF BARTHOLOW.
In the " Address of Medicine," delivered at
the recent meeting of the American Medical As-
sociation by Dr. Roberts Bartholow, that gentle-
man, after abusing the press for its '* flippant"
attitude toward the medical profession, proceeds
to berate homoeopathic practitioners for publish-
ing statistics that he claims are << fictitious,"
and which, he says, have "placed legitimate
medicine in a false position, and discredited its
practice to a most serious extent." He then re-
fers to a certain pamphlet written by a physician
" who had been a professor in the faculty of Iowa
University," which contains " the usual tirade
against allopathy, its past errors and its present
uncertainties," but, according to Dr. Bartholow,
" its really elBfective part consisted in statistics
made up out of whole cloth." I have never seen
this remarkable pamphlet, nor am I prepared to
deny that it contains false statistics. I desire,
however, in justice to the State University of
Iowa, to make the statement that the gentleman
mentioned was once a student in that institution,
and for one year held a nominal position as as-
sistant to one of the professors ; but he was never
professor, and such a claim was entirely fraudu-
lent. If, therefore, he would assu^ie a fraudu-
lent title for trade purposes, it is not unlikely
that he might for the same purposes manufacture
false statistics. If he did do so, as Dr. Bar-
tholow*s investigation would seem to prove,
it is no fault of the homoeopathic profession at
large, and only goes to show the gentleman's
ignorance of facts, as he could have readily pro-
cured authentic and reliable statistics to have
proven his point, namely, the superiority of
homoeopathic over allopathic therapeutics.
THE INDIFFERENCE OF HOMCEOPATHS.
A private letter, just received from the chair-
man of the Bureau of Materia Medica, contains
these words : " It is very discouraging to find so
few men willing to work on clinical medicine,
therapeutics and materia medica. "
As I contemplate the attitude of some mem-
bers of our profession, I feel that there is a
growing disposition to neglect the essential feat-
ures of homoeopathy, and with scalpel and
microscope in hand to follow close in the rear of
the old school, searching for the nature and
causes of disease. I would not for a moment
discourage scientific investigation in every de-
partment pertaining to medicine, but I would
make that entirely secondary to the develop-
ment and perfecting of our materia medica, with-
out which we might as well surrender our
distinctive title, and allow to perish all the prin-
ciples and truths which Hahnemann and his
followers have cherished, and which have brought
so much of nealth and happiness to the world.
THE RELIABILITY OF DRUGS.
Again, since the days of that notable abortion,
** the Milwaukee test, " there has been a dispo-
sition on the part of some to spend their time in
searching for and publishing to the world alleged
discrepancies in homoeopathic pharmacology..
The microscope is brought to bear upon our
drugs and the vehicles in which they are pre-
pared, and the world is informed that the former
do not exist beyond the limit of certain attenu-
tions, and that the latter are possessed of im-
purities which may more than overbalance and
destroy the infinitesimal quantities of the ma-
terial drug which they are said to contain. May
the oft-invoked shades of Hahnemann rest upon
us, that now, after three-fourths of a century of
the successful use of these very attenuations,
prepared in precisely the same character of
medium, that wonderful little instrument called
the microscope should discover for us that we
have been deceived, and that the preparations
which have performed such wonders for us at the
bedside were nothing, or at least anything ex-
cept what we supposed them to be. Can we
expect anything else than righteous criticism
from the old school when they are permitted to
quote such arguments against us from those of
our own household? How soon will we learn
that drug power in disease is not to be measured
by scruples and drachms, any more than are the
imponderable essences of disease itself, and even
if they were, has microscopic science reached
the limit of its development ? Is it not possible
that succeeding years will afford inventions that
will go still farther in detecting the infinites-
imal in nature than has yet been done ? Let us
bear in mind these questions and forget not the
wonderful achievements of homoeopathy as
proven by clinical rather than microscopical
tests.
228
THE MEDICAL ERA.
[VouVI. No. 8,
MEDICAL EDUCATION.
I would urgently recommend that at this ses-
Bion a resolution be adopted setting forth that
on and after the year 1890, the American In-
stitute of Homoeopathy will not recognize the
diplomas of any college requiring for graduation
less than an attendance upon three courses of
lectures of at least six months each. And I
would further recommend that the inter-col-
legiate committee of the Institute be requested
to hold a special meeting at such a time and
place as they may agree upon, not in connec-
tion with the meetings of the Institute, at which
time they shall formulate and adopt some gen-
eral and uniform system of medical education
more comprehensive and rigid in its character
than that now existing, including the following
minimum requirements :
( 1 ). A good preliminary education, includ-
ing some knowledge of the classics.
( 2 ). A four years' course of study.
( 3 ). Attendance upon three full courses of
lectures of at least six months each.
The said committee to report their action to
the Institute at its annual meeting in 1889, and
after such report has been adopted by the Insti-
tute, any college that refuses to adopt the same,
or, having agreed to adopt it, fails to uniformly
adhere to its requirements, to be excluded from
the Institute, its diplomas not recognized, and
no representation allowed in the inter-collegiate
committee.
PUBLISH THE PAPERS.
In the first place I can see no valid argument
why the publication of papers should be prohib-
ited before they have appeared in the ** Trans-
actions." I cannot see that such publications
would in any manner whatever injure the Insti-
tute or detract from the value of the "Transac-
tions." But I can see why these papers while
they are fresli ought to be given to the public,
who, with the profession, are especially and di-
rectly interested in the results of so important
a gathering as that of the American Institute of
Homoeopathy. I consider it impossible for us
to give the members of the press too wide a
liberty in the publication of our proceedings,
including the papers which are here presented
and discussed. We encourage our members to
prepare and present papers, which are of great
interest to the profession-at-large, but these
papers, if published, of which there is no cer-
tainty, do not appear until late in the year, by
which time they have grown stale and lost much
of their interest. I would, therefore, recommend
that section 9 of the by-laws be arnended, strikr
ing out the words ** which have been previously
published," or as occurring immediately after
the word "transactions, " and that the Institute
allow the publication of any part or all of the
papers and discussions at any time after their
presentation, provided that no papers are re-
moved from the custody of the secretary for that
purpose. This will permit authors to furnish
extra copies of their respective papers for publi-
cation outside of the "Transactions" and will,
in my opinion, result in harm to no one, but in
much good to the Institute and to the cause of
homoeopathy in general.
ORIGINAL ARTICLES.
BELATIOX OF TXBINABY ANALYSIS TO
DIAGNOSIS.
By CLIFFORD MITCHELL. M.D.
CHICAGO.
[Read before the nUnois Homoeopathic Medical AsBoclation.]
THE part played by analysis of the urine in
diagnosis is important, but not necessarily
leading. In many cases it is purely sub-
ordinate and dependent upon the history of the
case for its value. It is unjust, therefore, to
expect the whole story of the disorder to be told
by the urine. For example, suppose the urine
of a patient is nearly or quite normal, is he
therefore in perfect health ? It would take too
much time to answer this question by enumera-
tion of disorders, some very serious, in which
the urine may give no hint whatever of the con-
dition of affairs : in hydro-nephrosis and some-
times in renal calculus the urine may be clear
and normal.
On the other hand, when the urine doc* show
variations from the standard of health, every
effort should be made by means of systematic,
methodical, and repeated examinations to ascer-
tain the significance of the changes. Occasional
** testing," so-called, of a few drops of urine, will
not tell the whole story. It is seldom possible
to obtain accurate information of the pathologi-
cal condition except after several complete
examinations of the twenty-four hours* urine,
which must be collected and measured with
scnipulous care. In cases where this is impos-
sible, the morning urine can almost always be
obtained, and should be used. I feel, however,
that I am groping in the dark unless I know the
total quantity in twenty-four hours ; for this I
make every endeavor. Next, in routine order,
the specific gravity should be taken ; from it the
solids approximately estimated, and then by spec-
AuGVar, 18B6.]
ORIGINAL ARTICLES.
229
ial chemical process the total quantity of urea
ascertained. The quantity of the latter may be
very much decreased and yet no signs of uraemia
exhibited by the patient until the convulsions-
come on ''without warning," as we often read
or hear, when really there was warning enough
in the urine.
In chronic diseases of the kidney, collection of
the twenty-four hours' quantity, estimation of
solids and urea (and sometimes of phosphoric
acid, as when cirrhosis is suspected) should be
made whenever practicable. When in the course
of these diseases the total urea falls to fifteen
grammes there is cause for anxiety; when to
ten, for alarm; when to five, for mourning.
After the solids and urea have been determined,
microscopic examination of the sediment should
be made. I say "after," because it is always
possible to determine the presence and quantity
of solids and urea, while sometimes it is impos-
sible to discover the presence of tube-casts, as,
for example, in alkaline urine, sometimes in
bloody urine.
Sediments should be stained with carmine
before being examined with the microscope. My
routine method is to pass the sediment through
three stages of collection, as follows : First, let
the urine settle in its bottle ; second, pour off the
supernatant urine and let the sediment settle
again in a Y-shaped glass provided with a lip ;
third, pour off supernatant urine again and pour
the sediment into a tapering glass tube provided
with a glass stop-cock. Lastly, add two drops
of carmine solution to the sediment, now dense
and of small volume, and l0t stand until a layer
of urine is distinctly visible above the sediment.
Keep the tube corked and in as cool a place as
possible. Staining the sediment reveals casts,
hyaline, epithelial, etc., which might otherwise
escape unnoticed. Moreover, mucus casts are
not stained and cannot be mistaken if this
method is used, for hyaline casts. Fungi, which
sometimes string themselves out to look like
easts to the inexperienced, do not take the stain,
but genuine renal tube casts and epithelia read-
ily become stained and are then easily identi-
fied. Finally, if albumin is present, estimate
the quantity, which may be done approximately,
and in general note whether it is very abundant,
moderately abundant, or small in quantity. In
turbid urine clarification with liquor potass®,
filtration, and cautious neutralization is posi-
tively necessary when small quantities of albu-
min are to be looked for, as in cirrhosis of the
kidney*
In such cases, after the urine has been clari-
'fied, filtered, and neutralized, the ordinary acid
or heat tests will reveal albumin plainly enough.
My method of performing the operation is to add
to the turbid urine (which cannot be filtered
clear) one-fourth its volume of liquor potassse,
heat, and then filter, letting it run through
into a small beaker. A small tumbler, like a
whisky glass, answers the purpose full well.
Then wet a slip of blue litmus and paste it on
the inside of the glass and as far below the level
of the urine as possible. Next add acetic acid,
a drop at a time, stirring well after each drop.
Stop adding acetic acid the moment the blue lit-
mus shows a tint of red. Then test the urine
for albumin in the ordinary way.
This method is particularly adapted to the
detection of albumin in alkaline or stale urine,
for it is well known that urine containing bacte-
ria is difficult to filter, and the turbidity masks
the ordinary coagulum of albumin when the lat-
ter is present in small quantities.
After the total quantity in twenty-four hours
has been measured, the solids and urea estimat-
ed, microscopic examination of the stained sed-
iment made and albumin detected and esti-
mated, attention should next be paid, especially
if the condition of the urine suggests it, to the
history and symptom^ of the case, every effort
being made to ferret out such conditions as
would suggest kidney disease. In order to make
the examination of the patient systematically, I
pursue the following course :
Inquire, (a) Age, sex and weight of patient ?
(fc) History ? (Ascertain particularly whether
there has been previous acute nephritis ; ask for
history of alcoholism, gout, lead poisoning, apo-
plexy, syphilis, phthisis, scrofula, chronic sup-
purative processes).
(c) General condition ?
(1) Head, — Observe appearance of face ; note
if features are v^ffv ^^d 'pallH or whether the
skin is zaS^ofw and cachectic in hue, or cyanotic. If
headache^ ascertain particularly whether it be
occipital and extending to back of the neck. Note
disturbances of hearing or vision, insomnia, mental
depression, and hypoclumdria. Inquire for pres-
ence ot epistaais,
(2) Chest. — Notice whether the patient is suf-
fering (or has suffered) firom dyspnwa; whether
the area of cardiac dullness is increased or whether
there are signs of cardiac changes in general.
(3) Abdomen. — Inquire for gastro-intestinal
symptoms, nausea, vomiting, flatulent dyspepsia,
diarrlwea; look for enlargement of liver or spleen;
note any symptoms connected with the urinary
230
THE MEDICAL ERA.
(Vol. VI. No. 8.
argansy as total number of micturitions at night
if any, pain (on voiding urine) whether absent,
renal colic, clots of blood voided, etc., etc.
(4) Notice whether the ptdae is Imrd, resistant,
rolling like a cord, or sniaUy conipressihle, rapid.
Observe whether the larger veins are prominent,
especially over the abdomen and lower extremi-
ties.
(5) Dropsy. — If there is or has been dropsy,
where first noticed, and whether general or con-
fined to special localities.
(6) Miscellaneous. — Inquire for muscular
weakness, lassitude, vertigo, loss of sexual desire.
Ascertain whether there have been convulsions,
coma, or other symptoms of uraemia.
The weiglit of the patient must be known in
order that the total amount of urea which he
ought to void in health may be calculated. For
those of average weight about S^ grains of urea
to the pound should be voided. A man of 150
pounds then should void about 500 grains of
urea normally, or say thirty- five grammes on an
average.
The real value of examinations of the urine
taken in connection with the general examina-
tion of the patient, may be seen from the follow-
ing cases.
I. Man, 45, 160 pounds, history of gout;
condition: well preserved, occipital headache,
several micturitions at night, recent flatulent
dyspepsia, no dropsy. Came to have urine ex-
amined because noticed that he voided more
urine than usual, and was vaguely apprehensive
of "weakness of the bladder." Repeated col-
lections of the twenty-four hours' urine showed
it to be increasedin quantity, 6n an average above
1,500 C. P., and sometimes as high as 2,900
C. P. Clear and paler than normal. Solids dim-
inished, urea averaging only 20 grammes, ought
to be 35 or over. Albumin found in small quan-
tify, varying from l-20th to 1-lOth of one per
cent by weight. Casts doubtful. In one speci-
men I thought I saw a very slender hyaline cast
faintly stained, but the sediment was very scanty
even when concentrated. But from the history,
condition, and age of patient, coupled with al-
buminuria and decreased solids, I decided the
case to be one of cirrJwsis qftlve kidney. Repeated
examinations of the urine showed that the re-
duction in solids was constant. It must be re-
membered that there is sometimes in this dis-
order a pre-aUmminuric stage in which case, albu-
min being absent, the physician may be lulled
into feelings of security from which, however, an
attack of uraemia may suddenly arouse him, for,
as is well known, uraemic accidents are more
common in this form of Bright's disease than
in any other. I have made at least once the
diagnosis of cirrhosis of the kidney when no al-
bumin could be found, basing my opinion on the
increase in quantity of the twenty-four hours'
urine, more urine voided at night than during the
day, reduced solids, in the patient a recent flatu-
lent dyspepsia, age oyer 40, general condition
good, but attacks of occipital headache frequent.
It is not improbable 'that the urine of such a pa-
tient would be pronounced ** all right" by many
a life-insurance examiner, just as on the other
hand a man with an albuminuria purely func-
tional is sometimes rejected in his application.
Case II. Man, 20, 145 pounds, history indefi-
nite, and nothing of importance elicited save
had had scarlet-fever when a child. Features
somewhat pallid, but general health good, except
indigestion at times. Reason for having his
urine examined, **had been told by physician he
had Bright 's disease." Repeated examination
of his urine by me showed nothing abnormal
except occasional presence of albumin, some-
times as much as l-20th of one per cent by
weight. Urea and solids sometimes slightly re-
duced, but averaging normal. Made the diag-
nosis of functional albumhmria due to digestive
disturbances. Patient eventually went to the
country, and after an out-of-door life for three
months the albumin disappeared. Returned to
city, became somewhat dyspeptic and the albu-
min reappeared at times. There was no pus or
blood in the urine at any time.
,1 should say at this point that there is record
of a man who voided slightly albuminous urine
for twenty years with impunity.
It is hardly worth while to take up your time
with accounts of cases of typical kidney diseases,
especially those when the albuminuria is heavy,
the dropsy marked and the tube casts abundant
and found with half an eye. Yet it is possible
to find urine in character somewhat puzzUng
when the general history of the case will be
necessary in making the differential diagnosis.
Thus in advanced cases of cyanotic imluration of
the kidney we find albumin casts, and in the
patient dropsy, urine reduced in quantity and
of high sp. gr., urates and uric acid in the sedi-
ment. The earlier stages of chronic parenchy-
matous nephritis may offer a similar condition of
affairs, but repeated examinations will generally
show a diminution in urea, and at times very
heavy percentages of albumin, J to 1 per cent by
weight, whereas, in cyanotic induration, the
amount of albumin is always small, but a few
tenths of one per cent at most. An important
AUGDBT, 1888.)
ORIGINAL ARTICLES.
231
point in the dififerential diagnosis is that in
chronic nephritis oedema is usually noticed before
heart complications, whereas cyanotic indura-
tion is an affection depending on lesions of the
heart.
When no form of Bright's disease is evidently
present, but there is something the matter with
the urine, as shown by presence of pus or blood,
then look for signs of renal calcidm, more espec-
ially in absence of signs of cystitis, and the
mine is acid and solids nearly or quite normal.
Cases of renal calculus are perplexing to the one
examining urine, and much injustice may be
done to the physician who examines the urine
and reports nothing abnormal. It is not always
that renal calculus betrays its presence in the
urine. If a patient comes to me with pain in
the groin down the spermatic cord, inner side of
thigh, or persistent pain in lower extremities, or
in heel or foot, I am very unwilling to give an
opinion until I have examined the urine several
times at long intervals, for the pain may be re-
jlected rencd pain due to calculus, and the utmost
vigilance should be observed in looking for pus,
blood, jagged uric acid crystals or dumb-bell cal-
cium oxalate. Patient search will sometimes,
though not always, be rewarded, but an attack of
renal colic is a great help in the diagnosis!
Beale states that the dumb-bell crystals of cal-
cium oxalate may be regarded as minute calculi.
In addition to this, let me say, the ordinary octa-
hedral crystals of calcium oxalate and no dumb-
bells at all were found by me in one case in
which eventually a small mulberry calculus was
passed.
Leaving the kidneys and turning to diabetes,
I think it is well to distinguish glycosuria, in
which the sugar varies very greatly in amount
and disappears, from true diabetes mellitus, in
which the percentage of sugar is more or less
fixed. I regard the former as curable by diet
and remedies. A very serious chance for error
here, however, is that mild cases of true diabetes
may suddenly become severe and rapidly fatal,
as is well known, and cases which in the start
were curable glycosurias, through neglect may
run on into true diabetes. The distinction be-
tween glycosuria and mild diabetes is sometimes
difficult, and the greatest care should be observed
in the prognosis. I am inclined to think that a
case in which there is but little sugar, the latter
disappearing when strict diet is observed, but
returning at once when the diet is relaxed, and
in a young person, is more likely to be true dia-
betes mellitus than one in which at times there
may be considerable sugar not affected by diet,
greatly fluctuating in quantity, and especially in
an elderly person. There is a chance in the
latter case for clever prescribing.
I have lastly to speak of the urine in nervous
disorders, an4 an opportunity is to be found here
for close distinctions between so-called ** urinary
disorders " and nervous diseases. Dr. Delama-
ter is a believer in the value of examination of
the urine in nervous diseases ; he is in the habit
of looking for calcium oxalate in the freshly
voided urine of cases when degeneration of the
brain is suspected. It is at least doubtful whether
oxaluria, phosphaturia, and lithuria are to
be deemed separate disorders. They are, in some
cases at least, concomitants of nervous diseases.
Fothergill calls a certain class of patients " neu-
rotics with disturbances of digestion and lithae-
mia." In such cases concentrated urine with
sediments of urates and uric acid is found.
"Whenever a patient comes to me with so-called
neurasthenia, nervous prostration or exhaustion,
** malaria,'* general worthlessness, inability to
do any thing or make any exertion, indolence,
laziness, even though habits are good ; patient
irritable, fretful, peevish and discontented with
those around him, but rarely finds fault with
himself or is hypochondriacal; may rise at
night to void urine, which latter is high-colored
and deposits a sediment frequently reddish in
color; constipation, drowsiness, headache, rest-
lessness at night — I examine the urine for sedi-
ments of urates and uric acid, especially in pa-
tients who lead sedentary lives, spending their
time mostly in offices or at home, and taking
little exercise ; who drive or ride in street-cars,
but soldem walk. (According to one theory now
advanced, uric acid is a substance irritating to
the kidneys, and continued elimination of it
leads to Bright's disease. Even if there is no
sediment in the urine, the total amount of uric
acid ought to be estimated.)
If, on the other hand, the urine be normal in
quantity and specific gravity, but pale green in
color, micturition frequent and urgent though no
great quantity of urine be voided ; burning sen-
sation across loins, with feeling of tightness and
dragging around the abdomen, shooting and
burning pains in the lower limbs, twitchings of
the muscles ; feelings of numbness, deadness, and
coldness in different parts of the body ; patient
generally amiable to those around him, but is
himself filled with gloom and forebodings, and
excessively hypochondriacal; bowels irregular;
nervous dyspepsia. — ^the urine is to be examined
microscopically every day for at least a week,
for sediments of calcium oxalate ; look particu-
232
THE MEDICAL EkA,
(Vol, VI. No. S.
larly in morning urine voided on rising. If
dumb-bell crystals of calcium oxalate be found,
the condition may lead to renal calculus. (Diag-
noses of incipient locomotor ataxy and -of syphi-
litic disease of the spinal cord have been made
in cases where the condition was relieved when
the patient voided a small concretion of calcium
oxalate.)
Lastly, where there is a diabetes, but no sugar,
it is necessary to distinguish 'between diabetes,
insipidus and phosphatic diabetes. In the
latter, which is a rare disease, we find great
emaciation; aching rheumatic pains in loins
and pelvic regions; dry, harsh skin, with
tendency to boils, and ravenous appetite ; pos-
sibly cataract ; polyuria or normal quantity of
urine, with high sp. gr.
Estimate the total quantity of phosphoric acid
(using uranium nitrate solution), and thus dif-
ferentiate phosphatic diabetes from diabetes in-
sipidus and azoturia.
Excessive elimination of phosphoric acid,
associated with nervous derangements, or with
phthisis, is a difficult disorder to control ; prog-
nosis unfavorable. Excessive elimination of
phosphoric acid running a course like saccha-
rine diabetes, but without sugar or alternating
with saccharine diabetes, is more easily man-
aged ; prognosis more favorable. A sediment of
earthy phosphates in the wine is not necessarily of
any clinical significance whatet'er, unless the total
amount of phosj^lioric acid in tlie urine is increased.
This can be ascertained by quantitative analysis
only.
In diabetes insipidus, on the other hand, we
find noteworthy increase in the amount of
urine voided, such as five to ten pints a day,
and, especially in children, with possible debil-
ity, languor, loss of weight, neuralgic and rheu-
matic pains, moderate degree of thirst ; urine
often of pale green color. Note whether the con-
siderable discharge is more or less intermittent,
as in hydro-nephrosis, or persistent, as in diabetes
insipidiks, (If the latter, distinguish from dia-
betes mellitus by testing for sugar.) If the
former, and especially in female disorders, ex-
amine for evidences of hydro-nephrosis, looking
for enlargement of the kidney, etc.
Diabetes insipidus may be either hydrwia, in-
crease in water without increase of solids, or
azoturia., increase of water and urea, the distinc-
tion being easily made by the repeated estima-
tions of urea.
What we need is fewer papers and more
cussions. — Coivperthwaite.
dis-
NBVAASTHSiriA.
Bt a. M. PARKER, M.D.
CHICAGO.
[Read before the Illinois Homoeopathic Medical ABaoclatloD.]
THE limitations of human knowledge, Often
painfully apparent to the physician, are
never more baffling than when he is called
upon to treat a patient whose nervous system is
bankrupt. The difficulty to be met exists in
the fact that vitality itself is an unknown
factor.
So long as nervous energy is generated as
fast as it is expended, the equilibrium of health
is maintained.
The loss of this equilibrium, and, consequently,
of health of the nervous system, may be due
either to excessive waste or deficient production
of nervous energy.
In the first instance, the prescription is rest,
change of scene, generous diet, etc., aided by
such remedial agents as may from time to time
be indicated. But, if the organism generates
little vital energy, if the trouble is in the very
springs of life, the picture is a gloomy one. In-
stead of the pink tint of health, the skin is pale
or Ballow. The tongue is pallid, or worse still,
presents a purplish hue. The extremities are
cold, the muscles soft and toneless. The great
force pump that should, with vigor, send the
blood through the vessels, beats faintly. The
arterial system is toneless, and feebly seconds
the wavering action of the heart. The respira-
tory muscles imperfectly perform their office,
and all the important functions of life share in
the general impoverishment.
The system has lost its subtle power of recup-
eration.
Best, so far from restoring the lost tone, seems
to increase the sluggishness of mind and body.
Medicine gives only temporary relief, and food
cannot build up structures that have lost the
power of assimilation. Man cannot live by bread
alone.
You may heap brick and mortar upon a build-
ing site until it is buried, but the hand of the
builder only can make of them a house. You
may supply the unfortunate victim of neuras-
thenia with good food and pure air — these are
th§ materials out of wliich to build strong nerves ;
but the builder, the architect, the spirit within,
how shall we restore its lost power?
Clearly, by devising some stimulant exactly
fitted to the case in hand, by which to touch the
mysterious sources of nervous energy.
^UOQBT, IBBBh]
ORIGINAL ARTICLES.
288
By stimulant I do not mean the pemicioas ir-
ritants that have so long masqueraded as tonics,
nor the vile narcotic that taints the atmosphere
of our cities, and even, in some instances, makes
the husband and father a very upas tree planted
in the midst of the home garden, withering and
dwarfing all beneath its branches.
A stimulant is any influence that will increase
the vital energy, and is as often spiritual or
mental as medical.
Leaving the medication of these cases to abler
hands, I wish to speak briefly of accessory treat-
ment, which has been of great service in some
apparently hopeless cases.
Miss P., aged 27, had never been strong, and
for ten years had been gradually failing in
health. She had been a school-teacher, but
could no longer endure the confinement of the
school-room.
She h^d suffered much at the hands of physi-
cians, who, failing to find other evidence of
disease, and making much of the fact that men-
struation as well as all the other physiological
processes, was feeble and insufficient, had pre-
scribed many drugs and much local treatment
for the long-suffering reproductive organs. . This
patient had a good appetite and fair digestion,
the only hope in her case.
She presented one peculiar symptom: even
in summer she was troubled with cold feet dur-
ing exercise, and could only get these extrem-
ities warm by lying down.
Acting upon this hint, I prescribed what the
sanitarian people call hot and cold to the spine ;
alternating hot compresses with the application
of ice, and vigorous friction. The improvement
was prompt and gave rise to hopes of a complete
restoration to health, but after a few weeks the
case became stationary again. Evidently, the
cause of the decline was still operating, and
must be sought outside of the patient's organ-
ism: in her home and its association, or in
her interior spiritual body, out of which all phys-
ical ills are believed by some persons to pro-
ceed.
My researches disclosed a sad history of re-
pression and grief in childhood. The mother a
slave, the father a gloomy bigot, a hard task-
master and a devotee of tobacco. The ill health
consequent upon these depressing influences
had prevented her marriage, and disqualified
her for business, thus deepening morbid im-
pression.
This was the situation in Sept., 1886. Through
the interposition of a sister she was removed to
a cheerful home, where she wa^ Able to mak^
herself useful. Suitable remedies were prescribed
at various times during the ensuing year with
good effect, and in September, 1887, Miss P. took
up the burden of life bravely and hopefully, and
reports herself well.
I give this as a typical case, a case which
medicine alone would never have reached. And
I think we, as physicians, should go further than
defective ventilation and sewer-gas poisoning in
our search for the causes of disease.
Let us, one and all, remember that however
rapid and substantial may have been the growth
of homoeopathy in the past, we are now only at
the dawn of its period of true prosperity. —
Cowperthwaite,
A PBOTEST.
Will the Editor of The Medical Era grant one
of its interested readers space to say a few
words regarding Dr. Julia Smith's remarks on
neurasthenia? If the Doctor is correctly re-
ported in the June Era, her observations on
neurasthenia cast reproach upon a class of in-
valids whose sufferings are as real, if not so
fatal, as those of other diseases.
The command, '*go right i6 work" may be
applicable to what Dr. Foster callB the *'pseu-
do " cases; that it is applicable to "nine cases
out of ten," or even to the majority of cases, is
not so easily demonstrated.
When a mother works year in and year out to
the limit of her endurance, with the added men-
tal strain of trying to make one dollar do the
work of two, fading and losing strength year by
year, till finally she goes to pieces '* all of a sud-
den," like the deacon's " one boss shay," adding
one more to the large army of neurasthenics, I
protest it is not a change of work nor a scolding
from the Doctor that she needs, but rest first and
last, with kind words and cheerful companion-
ship.
When a devoted, self-sacrificing daughter un-
dertakes to act the part of nurse to an invalid
mother, to do the family washing, walk two
miles night and morning to and from school,
and to study so faithfully as to rank first in her
class, at last breaking down after graduation
' and becoming a semi-invalid for years, I again
protest that rest, pure and simple, is the pana-
cea, and not work.
When a school girl crowds the work of two
years into one, that she may the sooner fit her-
self to support an infirm father and mother, and
in the attainment of mental gains experiences a
234
THE MEDICAL ERA.
[Vol. VI. No. 8.
physical loss of strength and endurance, I doubt
the wisdom of the physician who would dismiss
her with the order — "go to work,"
Again; when a teacher works to the point
not only of exhaustion, but of fainting, while at
her duties, and soon develops the long train of
symptoms characteristic of neurasthenia, I
would question the propriety of ordering her to
work.
These are not fancy sketches, created from the
writer's imagination, but are flesh-and-blood
illustrations of the pernicious results that ensue
from working daily to the limit of one's strength,
and particularly of following, without respite,
work that involves mental strain.
An additional proof of the inadvisability of
spurring to work a person with a tired-out
nervous system is given by the victims of
the "mind cure," "Christian science," or "met-
aphysical cure." It has been the writer's mel-
ancholy privilege to watch the career of several
nervously debilitated invalids, who, with the
desperation bom of despair, turned to this
means of cure as a last hope. Taught to believe
themselves well, and to act accordingly, they
ignored rest, resumed former duties and went
about trying "to do good," only to relapse after
awhile into a. condition worse than the one they
sought to cure.
As to the much discussed fashionable suflFerer,
who is sick because she has nothing else to do,
or because it is the mode to be nervously pros-
trated, there seems little hope for her, if such a
creature really exists.
Girded by an armor of steel and whalebones
(by courtesy called corset), her arms encased in
tight-fitting sleeves that pinion those useful
members to her sides, loaded down with jet and
heavy draperies, the whole load of which she
attempts to carry with a smiling face as she
wabbles about on high-heeled French opera-toed
shoes, no wonder she says : "I am so dreadfully
tired! It doesn't seem as though I could car-
ry my clothes." Poor thing, no doubt she is
tired, and always will be while so hampered by
the follies of fashionable dressing. Even for her
a change of clothing would seem quite as advis-
able as the "go-to- work" prescription.
After all has been said we trust the Doctor did
not mean all that her words implied, but a sense
of justice softened by pity impels the expression of
these thoughts in behalf of the often-misunder-
stood, much-abused and sometimes ridiculed
unfortunates — tb^ victims of neurasthenia.
Jab.
THE SEaUBUB OF SPINAL MENINaiTIS.
By H. M. BASCO^. M.D.,
OTTAWA, ILIi.
[Read before the IllinoiB HonuBopaLhic Medical Anfloclation.]
THE local signs of inflammation are (1) pain,
(2) redness, (3) heat and (4) swelling.
The local products of inflammation are
(1) serum, (2) fibrinous exudation and (3) pus.
The sequel® of inflammation are many, both
local and general.
It is not my purpose to discuss the causes of
meningeal inflammation in either epidemic or
spoVadic form, but in this line of thought let us
confine ourselves to its results.
After the study of several severe cases of men-
ingitis and the best authorities I can obtain, I
have come to the unwelcome conclusion that all
cases of spinal meningitis that recover are fol-
lowed by some sequelae. It may seem a broad
statement to make, but it is my firm conviction
that no case recovers as well as before the at-
tack.
To bear out this opinion, we find Dr. Hart
says (in Amdt's System of Medicine, Vol. II.,
page 618) : " Even when life is preserved, which
is rarely the case, the patient never fully recov-
ers, but remains more or less emaciated, anaes-
thetic and paralyzed."
The reason is, therefore, obvious : no inflam-
mation can exist within the vertebral canal
which does not exist at the expense of the cord,
due to the swelling and thickening of its sur-
rounding membranes. If the bony canal wiU
not yield, the cord must. The very pressure ar-
rests the functions of the cord almost as com-
pletely as though a ligature had been drawn
around it.
(1). Paralysis, then, is the first result, and
the most common to be looked for. It may ex-
ist soon after the inflammation begins, but rarely
during the first week. In degree, it varies
according to the amount of thickening of the
membranes, the amount of fibrinous exudation,
the length of time the acute inflammation is
present, and whether resolution occurs by ab-
sorption or the formation of pus. Should the
inflammation be chiefly cerebral, or extending
only slightly into the cervical region, there could
exist only a hemiplegia, but more frequently
there occurs a complete encirchng of the cord
and a paraplegia is the result.
It became my duty, a few years ago, to pro-
sect the spinal cord of a lady who hkd had com-
plete paraplegia for six years following menin-
gitis. I found the cord pressed upon by the
August, 1888.1
ORIGINAL ARTICLES.
285
thickened membranes for a space of three or
four inches, but within the ninth dorsal vertebra
it was strangulated, cut down to less than one-
third its size by a band about one-fourth of an
inch in breadth.
Here was a condition that resolution could
not be sufficient to remove. Pus did not form ;
there was no place to "pocket;" the vertebra
were sound; truly "a living death.''
(2). The second most frequent result of men-
ingitis is spinal curvature, and this may not
develop for a year or eighteen months after ap-
parent convalescence. It is a question yet to
be determined which form of spinal curvature is
most frequently the result of meningeal injQam-
mation. In the cases where the inflammation
extends to the vertebra proper, causing soften-
ing and necrosis of the body of the vertebra, the
antero-posterior curvature, or Pott's disease,
would certainly result. My belief is that most
cases succumb before such a diagnosis could be
definitely determined. Therefore the most fre-
quent form of deformity foimd following menin-
gitis will be the lateral curvature, by Dr. Lewis
Sayre called "rotary-lateral curvature."
Do not be in a hurry io get patients out of
bed who are recovering from meningitis. They
will distort or twist themselves in some unnat-
ural shape to get the spinal column at rest.
"Half the deformities are the result of want of
energy, want of hfe enough to sit up straight."
Again, paralysis of one of the lower extremi-
ties, followed by arrest of development, or short-
ening, giving an unequal support to the pelvis,
increases the tendency to lateral curvature.
Illustrative Case : Miss N. suffered a severe
attack of spinal meningitis, with a high inflam-
matory condition for a week or ten days, fol-
lowed by a slow convalescence of two months.
One year later there developed a lateral curva-
ture of the spine. To obtain a comfortable po-
sition during and after convalescence, a strained
position was assumed, resulting in a deformity
which took another year, with a suitably adjust-
ed corset, extension, frequent gymnastics, rub-
bing and development of the muscles of the
short side to overcome.
( 3). The last sequela I shall mention, but the
most frequent — for it occurs to a greater or less
degree with every patient — is the efifect on the
nervous system. To declare such a patient
moody is to express it very mildly. In propor-
tion to the ansBsthesia below the seat of former
inflammation, there is hyperesthesia above.
It would take the pen of the most fluent
writer to portray in words, together with the
brush of a noted artist, aided by the scenic effect
of the imagination, to depict all that a shattered
nervous system may and does suffer — all the
shades of development, from a simple hysteria
to a mad delirium.
Treatment. —
(1). The treatment of the first sequela, pa-
ralysis, is frequently unsatisfactory. The early
application of electricity, following the acute
congestion, is highly beneficial. The two reme-
dies to be considered are Bryonia and Terebinth.
I care not whether the Bryonia is administered
from the leading symptom of " aggravation by
motion," or if it be given for its supreme power
as an absorbent of fibrinous exudation, the re-
sults will be equally beneficial.
(2). The treatment of the second condition,
spinal curvature — must be rational, whether
caused by disease or accident. This is a con-
dition to be treated in a very different manner
from the first sequela. Active measures must be
used, extension and healthy muscular devel-
opment. The extension being obtained, let it be
maintained by some mechanical device ; let na-
ture be supported. There is no better device
than the plaster-of-Paris corset, properly ap-
plied. (I speak advisedly, having added two
years of experience to the matter since troub-
ling the Society with the subject on a former
occasion. )
(3). The treatment of the nervous condi-
tion is as diversified as the number of cases
treated. Gelsemium has been most frequently
indicated in the cases that have come under my
care. Hyoscyamus and Stramonium are equally
called for. Bhus tox. has been useful. Bella-
donna, Ignatia and Pulsatilla, occasionally in-
dicated, have proved unsatisfactory in these
ottses. I anticipate that Haschisch wiU prove
beneficial, but there seems to be some difficulty
in obtaining a thoroughly reliable preparation.
A somewhat ludicrous statement is made by
Dr. Bartholow to the effect that in "a consider-
able town" in the West, a homoeopathic pamph-
let "was sent to every householder," and that, as
a consequence "a legitimate practice was in a
short time completely destroyed and every reg-
ular physician reduced to extremity." — Cow-
perthwaite.
286
THE MEDICAL ERA.
[Vol VL No. &
BYBKBVOBAHCEA OUBBD BT GALVANISX.
BtE. C. WILLIAMS, M.D.,
OHIOAOO.
[Read before the IllinolB Homoeopathic Medical Aseoclation.]
MISS C, aged 26, began menstruating at the
age of thirteen. Menses were regular and
normal until the age of 21. At that time,
during her menstrual period, she was out boat-
ing and was capsized. The cold bath stopped
the flow. From this time she began having
trouble with the menses. They were irregular,
and accompanied by the most intense pain, and
mental disturbances. I saw her for the first
time about a year ago. At intervals for four
years previous, she had been under the care of
physicians for longer or shorter periods, but
with absolutely no benefit. Examination re-
vealed a highly inflamed cervix, very sensitive,
and bleeding at the slightest touch.
The vagina was also very sensitive. For two
hours before the flow appeared she suffered the
most intense pain in the region of the uterus
(which was not relieved from two to four hours
after flow appeared), intense headache, and al-
most a mania. For two years she had not had
a period without taking opiates as soon as the
pain began. Knowing that she had taken all
medicines which could possibly be of benefit, I
did not give her any, but asked them to call me
at the time of the next menstrual period.
Being called at that time I found her suffer-
ing as usual, and I applied the galvanic current,
placing the positive pole over the region of the
uterus and the negative at about the second
lumbar vertebra. The current was mild and
was continued twenty minutes, at the end of
which time she was asleep. She slept for six
hours, and awoke suffering comparatively little
pain.
After the cessation of the flow, I gave her th j
galvanic current twice a "week until the next
menstrual period, which came on in four weeks.
At this pain was not so great. However, I pro-
ceeded as at the former period, and after it. With
this treatment, and this alone for three months,
the patient was discharged as cured. I saw her
but a day or so ago, and she told me that she
had had no pain since during her menstrual
periods.
I fear that we have in the past failed to ap-
preciate the influence of the press, .and the
mighty power that it is capable of exercising in
belialf of this Institute and the interests here
represented. — Cowperthwaite,
BBDSIDB BXPBBIBirOBB.
By J. B. DUNHAM, M.D.
WBNOHA, ILL.
LRead before the lUlnoiB Homoeopathic Medical Aaeoclatlon.]
JUDGING others by myself, the general prac-
titioner, if young, is frequently meeting un-
familiar cases. The following are reported
-with the hope that the experienced may not
be wearied, and the inexperienced may be bene-
fited, not by the bare report, but by light thrown
upon obscure points, by those who may be suffic-
iently interested.
Clyde, aged 4 months, at the time of birth,
and for two months after, appeared healthy.
From this date he did not thrive. Having my
attention called to this, I ordered cow's-milk
added to his diet, as the mother's milk seemed
poor in quality. Slight improvement was notice-
able for a short time.
May 7th. I found slight fever, features some-
what pinched, as in an infant poorly nourished.
Bowels regular ; urine normal in quantity. A
difficulty in breathing showed itself by his nurs-
ing for a few seconds and then letting go the
nipple for the purpose of getting his breath.
There was no appearance of coryza. Diagnosis
reserved. The difficulty of breathing grew in
intensity until in a few days it was never absent.
A slight swelling was present at this time, the
left side of the throat, externally. The most
careful examination failed to detect any localized
tumor about the affected region.
Desiring counsel, my colleague. Dr. W. A.
Smith, was called. He diagnosticated ** laryn-
gismus stridulous." I demurred; but when
asked, "If not that, what is it?" I failed to
reply.
Believing, as I did, that the impeded inspira-
tory act was caused by an obstruction not spas-
modic, though during the earlier days of the
disease it was much less when sleeping, though
absent, I had given Apis, Phosphorus, Calcarea
carb., Hepar sulph., Mercurius sol., wdth indif-
ferent success. Together we now selected reme-
dies, among which were Cuprum, Ignatia, G-el-
semium, Verat. alb., no improvement following,
and T. B. Hood, M.D., Prof, of Theory and Prac-
tice, Howard University, Washington City, being
in town, he was requested and very kindly con-
sented to call with us. He dissented from my
colleague's diagnosis. The query, What is it?
elicited the opinion that tissues about the glottis
were in a hypersBmic condition, sufficient to
cause obstruction of the larynx, malnutrition.
AUQUBT, I888.7
ORIGINAL ARTICLES.
287
based upon a scrofulous diathesis, being the real
cause of all the trouble.
Prognosis: death.
The condition of our patient grew more hope-
less from hour to hour. With the advent of a
commencing stupor, I gave Opium 3x in drop
doses every half hour, to be continued until I re-
turned from seeing another patient, if' it did not
die before that time. On returning and seating
myself at the side of cot, the patient seeming a
little brighter, without any special object, but
more from sympathy at seeing my patient chok-
ing to death, I gathered the integument and un-
derlying tissues of the submaxillary region be-
tween my thumb and forefinger, and drew them
forward toward the point of the chin. No sooner
done than to my amazement respiration was nat-
ural.
This position of the parts was maintained for
some eighteen hours, when, the child becoming
very restless, he was* raised up and suddenly
vomited a large amount of pure, inoffensive pus.
Respiration was at once perfectly free and he
made a rapid recovery.
Mrs. A., aged 38. Nervous temperament.
Cessation of flow occurred Oct. 16, 1887. Within
a few weeks occasional nausea and vomiting ap-
peared. Peculiar mental disturbances were
noticed bj; her husband, but considered of but
slight moment, as previous pregnancies had been
attended by similar symptoms. After two weeks
of intense suffering of a character detailed later,
I was called Feb. 3, 1888, and found her suffer-
ing most intense pains in the head, accompanied
by a peculiar vertigo that obliged her to have
some one hold her head whenever she attempted
to rise from her couch. Bowels regular ; urine
normal in amount. Neither sugar nor albumin
were present. Ipecac 3x quickly controlled the
nausea and vomiting. For the pains in the head,
that seemed of a neuralgic character, I prescribed
Belladonna, Nux, Colocynth, Arsenicum alb.,
with indifferent success. Questioning her diag-
nosis, a digital examination was made and He-
gar's sign looked for. The examination tended to
confirm the correctness of her opinion. Mental
disturbances continued to increase, as evidenced
by inability to remember past occurrences of the
day ; would recall with an effort a past event and
laugh at her inability to **keep things straight."
Listlessness. She could scarcely sleep at all at
night, but would be overtaken with an irresist-
ible dirowsiness early in the evening. Opium Ix
relieved this, and under the influence of Cim. and
Zinc 1 5x, later 6x, she seemed to improve. Rested
better and finally came to sleep quite well. No
improvement, however, was noticed in her mental
condition, rather the opposite. Having waited
until she was five months pregnant, if at all, I
again made an examination ai)^ was enabled to
confirm my growing suspicion that pregnancy did
not exist. Dr. Coutant of LaSalle was called as
counsel. He confirmed my opinion of the non-
existence of pregnancy, supplementing it with an
unfavorable prognosis. Prior to his call 1 had
prescribed Cim. and Puis, in alternation, to assist
in .re-establishing the flow. He advised its con-
tinuance until time the flow should appear was
past.
Upon Tuesday morning, April 17, 1888, fol-
lowing our later consultation, about 1 o'clock our
patient rose to attend to a call of nature ; was up
and down until 5 o'clock. She seemed to have
lost all power of reasoning. At 5 a. m. she sank
into a heavy stupor from which she could not
be aroused. Death occurred at 10 a..m. The
cessation of respiration was the only evidence, for
surely death could never come more quietly than
in this case.
The great need of reform in medical educa-
tion is too apparent to require argument. —
Cawperthwdde.
TOPICAL APPLICATIONS IK THE TBEAT-
UBKT OP TYPHOID PBVEB.
By C. W. HARBACH, M.D.
LOCKPOBT, ILIi.
[Read before the Illinois Homoeopathic Medical Association.]
DUKING the last few years I have seen much
that has been written in regard to the
causes of typhoid fever and the various
modes of treatment. These treatments have, so
far as I have been able to learn, been confined
to internal medication and sustaining the pa-
tient with proper food and nourishment. Noth-
ing has been said about the benefits to be de-
rived from the use of topical applications;
therefore, it will be my purpose to mention for
your consideration a few of the means from
which I have derived no small amount of good.
Typhoid fever is now universally admitted to
be a disease in which but little can be done to
cut short the time in which it is destined to
prey upon the system. It is our duty, therefore,
to use every known means to guide the patient
to as favorable recovery as possible. Knowing
that aU diseases, where there is any marked
lesion, recover best in a uniform temperature,
and that it is well nigh impossible to secure
238
THE MEDICAL ERA.
[Vol. VL No. 8.
this, especially with untrained nurses, in a cli-
mate as variable as ours ; and believing, as I do,
that many lives are sacrificed each year from
thejbowels beco^iing chilled during the course
of the disease, I was led to the use of some
form of covering for the abdomen. A uniform
temperature was the first great desideratum.
How was this to be obtained ? Hot water and
hot dry cloths were both tried and found to an-
swer admirably, but in a disease covering so long
a period, and in the hands of the inexperienced,
they A\ ere likely to do more harm than good.
Poultices were next tried and found to answer
the case as fully as could be expected. These
poultices are best made frotn com or flax meal
mixed with enough boiling water to make them
of sufl&cient consistency to spread readily with-
out being too thin to remain in place. It is my
practice to have two sacks, each about fourteen
inches square, made of thin muslin. These
sacks are left opened at one comer for the pur-
pose of filling and can readily be fastened with
a few stitches after filling. Take one of these
sacks and put enough of the poultice into it to
make it about half an inch thick. Spread it out
smooth and place it upon the abdomen as hot
as can be borne by the patient without too much
pain, and leave it there until it has become
somewhat cooled, when it should be replaced by
the other, which has been prepared in a similar
manner. Care should be exercised that they are
not too hot and do not> remain until they are
cold. Such medicines as one may desire can be
used in the poultice, but I have derived the
most benefit from the addition of a little Turpen-
tine, the amount being varied according to the
case. Due caution should be taken that there
is not an excess of Turpentine, causing the skin
to become to much irritated. Some burning of
the urine may be caused by the Turpentine, but
only when it is in excess, and will soon pass off
when the quantity is reduced. A poultice may
be used several times by warming, but as soon
as it becomes in the least sour it should be dis-
carded for a fresh one, no matter if it has been
used but once.
These applications should be continued faith-
fully so long as the disease is progressing, and
until the patient has become thoroughly conval-
escent, when the abdomen should be covered
with a flannel band reaching entirely around
the body. These bands should be made of at
least two thicknesses of flannel, so cut as to fit
snugly around the body, covering the entire low-
er part of the abdomen. It is well to have two
of these bands, one to be worn by day and the
other at night, so long as the least tenderness
remains. The bowels by these means aire kept
at a uniform temperature and all danger from
sudden changes is averted. We gpt the benefit
of the heat as a stimulant towards recovery, be-
sides aiding the bowels in the passing of faecal
matter over the denuded surfaces. Such inter-
nal medication as each individual case may re-
quire must be used, as well as great care in the
selection of the proper food, both as to quantity
and quality. During the last eight years, since
adopting above mode of treatment, it has been
my good fortune to bring every case of typhoid
fever coming under my care to a favorable re-
covery, and that not because I had not severe
cases to treat.
The International Medical Congress practic-
ally accepted the theory of the bacterial origin
of disease without opposition. — Cowperthtraite.
ENDOCEBVIOITIS AND CYSTITIS.
By WILSON A. SMITB, M.D.
WI2V0NA» ILL.
[Read before the Illinois Homcoopathic Medical Aesodation.]
IN reporting the following case I am aware
that but Uttle that is new is presented, but I
hope that, if any discussion should follow,
something may be gleaned that will aid at an-
other time in procuring a more speedily success-
ful result than was accomplished.
Mrs. B., aged 30, always had good health
until the birth of her last child, about seven
years ago. Her labor was rapid and normal
and no unpleasant symptoms presented
themselves until about one year after; when
menstruation was re-established, she suffered a
great deal of pain. Thinking it might be noth-
ing unusual, she did not consult her family
physician until after the fourth month, when
each recurring period seemed to be worse than
its predecessor. The pain was more severe, the
flow was continued longer, and there was len-
corrhea between the menses. The flow was
dark, clotted, thick and offensive. At that time
she consulted her physician and he advised an
examination. Being very timid, she refused,
and requested him to prescribe for her, when, if
she received no benefit, she would submit to
local treatment if he still deemed it necessary.
The usual prescription of Quinine and Iron as
a tonic, with rectal injections of Opium at the
menstrual period, was recommended. For a
few months this appeared to help, but after
AueuBT, 1688.]
ORIGINAL ARTICLES.
239
awhile it lost its effect and the patient submitted
to a local examination. This was in 1882. The
physician diagnosticated the case as one of ul-
ceration, and promised a cure in a short time,
two or three months. • For four months she had
the ulcer cauterized, each time the doctor telling
her she was improving.
At that time, instead of being improved, she
was worse. She then complained of bearing-
down pains, back-ache, the leucorrhea more pro-
fuse, burning of the urethra before, during and
after the menstrual period. She had become
nervous, her head ached every day, her bowels
were constipated, appetite capricious, and men-
struation occurred every three weeks. Think-
ing the physician then in attendance did not
fully understand her condition, she changed to
another regular ( ? ) physician, and he, too, saw
ulcers, added to which was a case of urethritis.
She was under his treatment for nearly thirteen
weeks when, becoming disheartened and dis-
gusted, she ceased to take treatment, and con-
cluding she could not get well, abandoned every
effort for rehef.
And now comes the interesting part of the
story. One night in 1884 she was taken with
cramps in the abdomen which were so severe as
to be unbearable, and her husband came after me,
her last physician being out of town. No doubt,
like the old skipper, they ran for any port in a
storm. A few doses of Colocynth, with hot ap-
plications of bran, relieved her in about an hour,
and I went home. When the menstrual period
ceased, her husband came for me to call at his
house and see if anything could be done to help
the patient.
I made an examination and found not a sin-
gle indication of any ulcer, and concluded that
none existed save in the fertile brains of the for-
mer physicians, who had treated her with lunar
caustic and nitric acid. But these conditions I
did find : The cervix was enlarged, the os open,
the lips swollen, tender to the touch, consider-
able leucorrhceal discharge, while in the os was a
piece of mucus resembling gelatine, as near as it
can be described. The introduction of the sound
did not produce much pain and was not followed
by blood. This, according to Dr. Heywood Smith,
is indicative that the body of the womb has not
been invaded by the disease. Her nervousness
still continued. She was full of neuralgic pains,
boming, cutting in character. The urine was
frequently hot, scalding, not only at the men-
strual period, but at other times. Sometimes
there was nausea, but she did not vomit.
The case was diagnosticated as endocervicitis,
and was treated locally and internally. The
remedies mostly employed were Apis, Rhus,
Nux, Sepia and Pulsatilla, as indicated. The
local treatment consisted of applying tampons
of glycerine, medicated with the medicine the
patient was taking internally, twice a week, scar-
ifying the cervix once a week, and Iodine to the
cervix once a week for a few weeks, by means of
the tampons invented by Dr. Danforth, and ex-
hibited at our Peoria meeting in '85. In a little
over six months the cervix was cured, but the
urinary difl&culty continued. Examination of
the urethra revealed no abnormal condition and
treatment was directed to the bladder. The
urine was offensive, and of a low specific gravity.
Gantharis and Apis were the principal remedies
used. The bladder was washed out with fluid Hy-
drastis one dram to water four ounces, but the only
injection which was found to be of any benefit
was Besorcin. This was used- once a day, gen-
erally at night on retiring. I used it in this
manner : First the bladder was washed out with
warm water very slightly carbolized ; then added
to one-half pint of warm water three grains of
Resorcin, injected slowly, allowed it to remain a
few minutes, disconnected the syringe from the
catheter, withdrew the fluid. Sometimes there
will be a little smarting, but not to amount to
anything, and but little, if any more, than would
come from the use of warm water. The tem-
perature of the water should be 100° F.
The patient was under treatment for nearly
two years before she was cured. She is very
comfortable now, except when she takes cold,
when she has flight return of the urinary diffi-
culty. Prof. Winckel recommends other injec-
tions, which I will try, should the difficulty return,
and not yield to Besorcin. In a case so long
continuing one is tempted to try everything.
The diet of the patient was watched and her
feet and abdomen kept warm. She is pregnant
now, and I am quite anxious to know how the
termination of her present condition will affect
her.
Is it not time for us once more to appreciate
the fact that it is the duty of this great organ-
ization to lend its influence to the propagation
of the essential truths of homoeopathy, those
truths which have made homoeopathy an ac-
cepted power in the medical world, leaving the
collateral branches for secondary consideration ?
— ^ Cowperthwaite.
240
THE MEDICAL ERA.
(Tot. VI. K©. 8.
MEDICAL LBQISLATIOK AND BDUOATION.
By J. A. VINCENT, M.D.
BPRINOriELV, ILL.
[A Report made to the Illlnoie Homoeopathic Medical Association at
Its meeting Id Chicago, May, 1888.]
THERE is littte to say on the subject of
medical legislation. In this State the
present status seems to be satisfactory to
all schools of medicine. The last legislature
passed some amendments to the medical prac-
tice act, strengthening some weak points that
experience had taught were necessary to give
greater effect to the law, and to drive from the
State certain disreputable street peddlers and
showmen traveling under the guise of " Indian *
Doctors." I am pleased to say that the amend-
ed law has proved to be very efficient, and the
State is now almost entirely free from these
traveling impostors.-
During the last session of the legislature there
were some bills introduced amending the
** Pharmacy Act," that, had they become a law,
might have embarrassed and interfered with all
physicians who dispense their own medicines.
I presented to the committee having those bills
in charge the full force and effect of such a law,
the hardships, inconvenience and detriment,
not only to our school, but to all physicians in
the State who might wish to dispense their own
medicines. The result was all that could be
desired. The bills were never reported back to
the house, and thus the matter ended.
MEDICAL EDUCATION.
There seems to be an increased interest on
the subject of medical education. Legislative
bodies, physicians and medical colleges (that is,
many of them) are considering as to the best
means of raising the standard. On that, as on
all other important questions, there is a differ-
ence of opinion. Some colleges have extended
the requirements for graduation to three terms
of six months each. In some of the states the
legislatures have enacted laws entirely ignoring
medical colleges and their diplomas, requiring
all physicians to pass an examination before a
" state board of examiners." In this State, the
state board plan has some advocates, and is be-
ing agitated to some extent by physicians and
medical journals. The matter will probably be
brought before the next session of the legisla-
ture. In case it is, we shall be on the alert to
protect our interests and see that we have fair
play. As a school of medicine, we care not
how high the standard of medical education is
raised. All we ask is an equal and proper rep-
resentation on the board. We then accept the
issue and are willing to abide by the result.
mSAKE ASYLUM.
There is a prospect that in the near future
there will be one or more asylums for the insane
built in this State. Our financial and numerical
ajtrength entitles us to the medical control of one
of them. The question arises. Shall we make
the effort ? To obtain it would require a strag-
gle ; a long, strong, stubborn, united fight would
be necessary. Should the Association think
best to do so, some action should be taken to
bring influence to bear all over the State, Oth-
erwise we cannot expect to succeed.
STATE BOARD OF HEALTH.
Our state Board of Health has been and is
doing good work. Their general management
has been commendable. The rights of all
schools have been recognized, and no attempt
has been made to curtail the privileges of le-
gitimate practitioners. We should, however,
have an additional member on the board.
There is no good reason why the homoeopathic
physicians of this state should not have another
representative, and many reasons why they
should. I will mention two of them: The
board, under its present organization, contains
four allopaths, one layman, one eclectic and
one homoeopath, and when we take into con-
sideration the fact that the patrons of homoeo-
pathic physicians pay one-third of the entire
taxes of the state, it is very evident that, ac-
cording to the genius of American institutions, we
should have at least two of the seven members
of the board. We would then have on the
board three allopaths, two homoeopaths, one ec-
lectic, and one layman, a proper distribution,
and so constituted that no one school would
have a majority. If the Association considers
this matter of sufficient importance, I would
suggest that suitable action be taken looking to
this result at the proper time.
I now wish to return my sincere thanks to
the members of this . Association for the re-
peated compliment of an appointment to this
position. I consider it no mean honor to hold
the chairmanship of the "Bureau of Medical
Legislation, Jurisprudence and Education/*
The repeated appointment is to me satis-
factory evidence that I have, in some measure,
at least, discharged the important duties to your
satisfaction.
AueutT. 1888. J
ORIGINAL ARTICLES.
241
VII.
BHINinS VASO-MOTORIA PEBIODIOA.
Bt e. lifpincott, m.d.
Therapeutic Indications.
SambncDS nigra. — When the degree of
dyspnoea is greater than that of Ipec, and
the cough less ; extreme anxiety ; face purple ;
asphyxia seems imminent; loud sibilant rftles
accompany the dyspnoea ; free perspiration ; the
patient seems to sleep into the trouble.
Hippomanes mancinella. — Dr. B. W.
James, (C7. S. Medical Investigator^ Vol. IV.,
1876, page 424), says: **I have seen rapid
improvement follow the use of it, especially
where the attacks occur at night. We previ-
ously used Arsenicum in these cases.''
Sulphur. — Sneezing on awakening in the
morning, or on lying down at night. It is most
useful where there are occasional attacks of
urticaria, and in that form of hay fever where
asthma is the special feature from the com-
mencement of the attack. Profuse perspiration
after the fits of sneezing or coughing; oppression
of breathing between the paroxysms; sibilant
dyspnoea ; bluish lips ; expectoration of a tena-
cious bronchial mucus; burning sensation in
the larynx and trachea; violent paroxysms of
coughing in the evening after lying down ; con-
stipation; hemorrhoids; skin affections.
Laehesis. — Long paroxysms of sneezing;
profuse, acrid, coryza, causing excoriation,
swelling, and redness of the nose ; lachrymation
with conjunctiva injected; violent, tickling,
irritative cough, as if a hair was in the throat ;
constriction of the throat and lungs ; oppression
of breathing with pain in the lungs ; sensitive-
ness of the larynx with a feeling of suffocation
when touched ; dyspnoea worse after sleep at
night, after eating and after a nap in the day-
time ; prostration.
Dr. W. H. Holcombe has obtained brilliant
palliative results with this remedy at the 2,000th
attenuation.
AconitniQ radix. — This medicine is recom-
mended by many writers, but mainly at the
onset of the malady, or for febrile disturbance ;
chilliness, or creeping chills; aching; profuse
watery coryza ; nervousness ; restlessness ; anx-
iety ; coryza. suppressed, followed by headache,
or fullness of the head, heat in the nasal cav-
ities, with frequent paroxysms of sneezing ; dry,
violent, racking cough, with stitches in the
chest ; photophobia, with a feeling as of sand in
the eyes ; luemoptysis.
Eaphrasla officinalis. — Frequent sneezing;
profuse coryza arid lachrymation ; discharge of
white mucus from the nose ; severe itching and
burning at the margins of the eyelids, with
swelling and glueing of the edges ; photophobia ;
dry, tickling cough ; dyspnoea*. It is indicated
when the force of the disease is concentrated on
the eyes.
Drosera rotandifolia. — When the cough
accompanying this disease assumes a distinctly
paroxysmal character, as if it partook of the
nature of whooping cough.
Tartar emetic. — Sneezing ; stoppage of nose
alternating with fluid discharge ; loose rattling
cough, rattling of mucus, with little or no ex-
pectoration; oppression of breathing; nausea;
aching in the muscles and joints ; loss of taste
and smell.
Palsatilla. — Sneezing; coryza fluid or dry,
or the discharge is of considerable consistence,
thick, yellow, or green, and sometimes offen-
sive; there is an alternate stoppage and dis-
charge ; discharge more copious in the open air ;
loss of taste and smell; abundant catarrhal
expectoration; chilliness; vertigo; prostration;
palpitation of the heart ; aversion to milk and
fat food.
Teacrinm marum veram. — <<The eyes look
as if one had been weeping, with smarting in
the canthi and redness of the conjunctiva.
Bedness and puflSness of the upper eyelids.
Profuse smarting tears in the open air. Fine
ringing in right ear when blowing the nose,
squeaking as if air was forced through mucus.
Tingling (itching) in the nose. Stinging, lan-
cinating pain in the upper part of the nasal
cavity. Frequent sneezing, with tingling in the
nose without coryza (or followed by coryza). Sen-
sation in one nostril as if it were half stopped."
— A. L. Fisher f M.D., U. S. Medical Investigator,
Vol. XII., 1880, page 187.
Sinapis nigra. — The venerable J. P. Dake,
M.D., Nashville, Tenn., suggested to me the use
of the ethereal oil of Sinapis nigra, by inhala-
tion, to relieve the sneezing and check the
abundant coryza. He informed me that he had
found it of great service in cases of acute coryza.
His plan of use is to saturate a bottle of pellets
and inhale from them.
C. A. Groves, M.D., {North American Journal
of Homoeopathy, Vol. XXIX., 1880-81, page 630),
says : " Dr. Butler, of Montclair, New Jersey,
has relieved a number of cases with Sinapis
nigra, and recommends the remedy."
Natrum arsenieosum. — ''This prompt and
most searching medicine can go far in the cure
242
THE MEDICAL ERA.
[Vol. VI. No. 8.
of the predisposing cause of this poisoning ( ?).
Besides the burning which iS so characteristic
of this disease, it has scores of other symptoms
which show it to be favorable to many cases."
— J. E. Jones, Af.P., Medical Advance, Vol..
XVIIL, 1887, page 564.
Cuprum aceticum. — *'If persevered with,
cures many a case. Its nightly aggravation,
burning excoriation, violent cough in paroxysms,
fears of suffocation, burning pains, tough te-
nacious phlegm, etc." — J. E. Jones, M.D., Med-
ical Advance, Vol. XVIII., 1887, page 564.
Ammonium bromide. — ''In cases where
the usual attendant symptoms are accompanied
with a violent tickling cough. It also has
more than a mere palliation ; there is a chang-
ing of the diathesis." (?) — J. E. Jones, M.D,,
Medical Advance, Vol. XVIII., 1887, page 564.
Kali bromidum. — Dr. C. H. Blackley, says :
** Bromide of j>otus8xmn had some influence in
delaying the attacks, but it was very feeble."
Iodide of mercury cum Iodide of potas-
sium. — Dr. C. H. Blackley says : ** This drug
seemed, so far as I could judge by the few trials
I had an opportunity of giving it, to promise
excellent results ; but as these results cannot be
considered a sufficient test of its value, it will not
be well to speak too confidently of it. "
Ailanthus glandulosa. — Copious, thin, ichor-
ous, bloody discharge from the nose.
Ammonium muriaticum. — ''Burning in the
eyes, and lachrymation at night. Bawness and
soreness in the fauces. Is obliged to clear the
throat frequently. Burning in s:inaU spots in the
chest. Itching in the larynx. Dyspncea on
moving and when lying." — Kippax on Fevers,
1884, page 131.
Asarum Europeum. — " Fluent discharge
with deafness. Sensation as if the ears were
plugged up with something." — Kippax on Fevers,
1884, page 132.
Bovista. — "Is specially indicated when the
patient complains of fullness at the epigastrium ;
has to leave the clothing loose. The low dilu-
tions are apt to aggravate, but the high act
well. If you give the tincture in water, keep
away from the patient till he forgets how much
suffering it caused. — Advice from experience."
— Transactions Massachusetts Homoeopathic Medi-
cal Society, 1871 to 1877, Vol. IV., page 574.
Badiaga. — "Spasmodic cough, with sneez-
ing and lachrymation. Yellow viscid mucus
flies from the mouth and nostrils during the
paroxysm." — Kippax on Fevers, 1884, page
132.
Belladonna. — Is useful as an intereorrent
remedy for the complication of neuralgia of
right temple and eye; photophobia; wants to
sleep and cannot; soreness of throat; flushed
face.
Carbol ic acid* — Coryza ; lachrymation ;
short, dry cough; dyspnoea; inability to lie
down.
Cyclamen Enropeum. — "When there is a
great deal of sneezing, with rheumatic pains in
the ears and head. Loss of smell." — Kippax
on Fevers, 1884, page 132.
Cuprum metallicum. — Where the asthmat-
ic attacks are sudden, or in the purely nervous
asthma ; respiration spasmodic ; complicated
with cramps and convulsive twitchings.
Hepar sulphnris calcarea. — "A tight
cough with elevation of the shoulders with
each inspiration." — Transactions Massachusetts
llomoiopathic Medical Society, 1871 to 1877, Vol.
IV., page 574.
Opium. — Dr. C. H. Blackley, (Hay Fever,
Second edition, 1880, page 274), says : " Opium
is a remedy that often does good service in the
asthmatic form of hay fever when paroxysms of
suffocation come on during sleep, and when
these are apt to be followed by violent fits of
dry, racking' cough that are relieved for a time
by drinking a glass of water." He advises the
first decimal attenuation.
Bumex crispus. — Violent and rapid sneez-
ing ; fluent coryza, with painful irritation in the
nostrils ; dryness of the posterior nares ; violent,
dry, periodical and paroxysmal cough with sore-
ness therefrom behind the sternum.
There are other remedies recommended for
use in this disease, but the provings of none of
them point to their homceopathicity from a
symptomatic standpoint. Some of them might
be useful as intercurrent remedies for complica-
tions which arise.
{Concluded,)
In closing its columns to the Odium Medicum
discussion the London Times administers to the
allopaths a stinging and well-deserved rebuke —
one which would have been equally appropriate
at any time in the history of the past in connec-
tion with old-school antagonism towards homoe-
opathy. — Couperthwaite.
AueueT, 1888.1
ORIGINAL ARTICLES.
248
A OB&BBBAL 0A8B TAXATBD UNDER DIF-
FICULTIES.
Bt G. W. BOWEN, M.D.
TOBT WAimi, IITD.
A PHYSICIAN aged 60, from severe expos-
ure several cold nights in the winter of
1886, contracted pneumonia. He still
went to his office and worked for two days ; was
then confined to the house for three days, then
went to his office for two days, though suffering
with severe pain in his right ear and neck.
The next day, February 13, he was taken with
violent vertigo, and was unconscious for five or
six days.
He was treated by an allopathic physician,
who gave him Morphine and Bromide of potassa.
I took charge of the case on the 25th of Febru-
ary, and the patient then had a discharge from the
right ear which was found to come from inflam-
mation of the middle ear. The discharge was
pretty free and not offensive. He ^was very
weak, could eat but very little; all secretions
deficient ; could not hear a clock tick unless it
was placed against his head. Gould neither taste
or smeU anything. He gained strength quite
fast, so much so that he was carried to his
office the first day of March and went there every
day, yet was not able to sit up more than a few
hours at a time; could not walk very safely,
turn round suddenly or look up.
His latent energy or will power seemed to
keep him up. I consulted many physicians, so-
liciting aid, but all said my patient must give
up business, rest, or go West. This he could
not do.
A Chicago physician seemed to be sangume
he could help him, and gave him Gels, in some
form, and some special brand of California wine,
and prescribed a fruit diet. This plan of treat-
ment was followed nearly one month, when my
patient got so weak he could scarcely walk or
attend to any business at all. The vertigo was
not any better. I then had my patient take
one-fourth of a grain of pure Arsenious acid a
day for four days. This gave him energy, vitality
and vigor, so he could work and eat again, es-
pecially meat, to sustain his strength. Last
May, (1887), Dr. Haynes, of Indianapolis, gave
him Agaricus muse. 10,000, which he took for
one month in July.
Last May his wife was taken sick, and in car-
ing for her he lost nearly twenty nights' sleep,
never going to bed but one night in that time.
I supposed it would surely kill him, but he stood
the strain surprisingly weU, except in losing
twenty pounds in weight. Not much worse otljer-
wise.
The Agaricus muse, made no perceptible
change in his condition.
He is now able to do considerable mental
work, but cannot bear much exertion, as it will
invariably make him more dizzy. Vertigo is»
constant, even on turning in bed. His hearing,
taste and smell are only partially restored^ and
he can neither walk in the dark or look up.
That nature has so far been the chief restorer,
I am ready to admit, and that her efforts have
been retarded is not to be doubted, since he has
done so much work ; and at times it seemed as if
he went beyond human endurance by the loss
of sleep, and in taking such hard rides in the
country at night, sometimes to the extent of
thirty or forty miles even last winter.
That the brain was involved is unmistakably
evident by the nerves affected, as shown by the
loss of hearing, taste and smell.
This slow and gradual return of function
evinces a partial restoration ; but will, or can
there be a complete recovery ? is with me a ques-
tion of grave importance.
He still continues to live and toil as if uncon-
scious of his apparent danger, and I must say I
see no difference in his mental capacity ; only in
his physical.
He drinks coffee and uses tobacco moderately.
I have tried many medicines, in high and low
. attenuations,, and have seen but little effect. I
think that Belladonna, Silicia and Phosphorus
have had some effect.
WhxJt will help him'?
Dr. Bartholow himself surreptitiously appro-
priated material from homoeopathic sources for
the purpose of compiling a creditable work on
materia medica and therapeutics, and without
which his labors would have been in vain.
— Cowperthwaite.
OOLOBADO FOR 0ONSUMPTIVE8.
By REVBL BARTLETT, M.D.
BOUIiDBB. COL. .
MUCH has already been written, and much
is known about Colorado as a health
resort for those suffering from diseases
of the throat and lungs, but there is yet one
thing to be learned by those sufferers that
should be known before they leave their homes,
instead of it being left for them to find out by
bitter experience after coming thousands of
miles at great expense.
244
THE MEDICAL ERA.
[Vol. VI. No. a
A ten years' experience in the profession in
this State convinces me, as it must every con-
scientious observer, that while it is the climate
par excellence for those suffering from, or predis'
posed to pulmonary and throat diseases, yet it
is not all cases that can be benefited ; and it is
•right here that I want to make my ** point:'*
The discrimination between the cases that can he
cured by a residence Ivere and those that cannot.
Our climate has cured thousands in the past
and has health in store for millions in the
future, but, powerful as it is for good, these
blessings cannot be bestowed indiscriminately,
but must be prescribed only after a thorough
understanding of all the patient's needs and
conditions.
To know whom to send here and when to send
them requires much more study than is usually
given to so important a question, and if we
measure the consideration given in some
cases, by the results to the patient, we can
truthfully say that the physician who gave the
advice was lamentably ignorant of the condi-
tions present, or of the conditions that this
climate will alleviate and cure. Many invalids
are sent here by physicians who ought never to
have left home, the result of which is that
many more are led to remain at home, who
ought to come and who, if they should come,
would be restored to health.
How many physicians are there who send
their consumptive and asthmatic patients here,
who have never given one hour's thought to the
question: '*In what stages and conditions of
these diseases will a changb of climate cure or
alleviate ? " If there were fewer, I feel sure so
many mistakes would not be made; patients
would not be sent here to die before they reach
their destination, or before they have been in the
State twentv-four hours.
For their own reputation I should think the
physicians would, at least, make their prognosis
sufficiently correct to justify them in laying the
blame to the climate, for the early death,
and not have their patients die before they get
here.
It will seem to some who may read this that
my strictures on the physicians are unjust, but
if they could witness the results of this mis-
taken advice, they would be convinced of the
truth of my statements.
One has only to look into the daily papers
here and he can all too often see an item similar
to this: "Mr. A. B., a consumptive, died at
the hotel last evening, having arrived from
the East the day before." Is it the physician's
fault ? Generally it is. Very few invalids come
here without the advice of a physician.
Can it be helped ? is the important question.
I believe it can.
Most physicians here, who have had much
experience with this class of cases, can tell
whether this climate will alleviate a given case
or whether it y^ill aggravate that case.
If those who send patients here cannot tell,
then it is time they gave the subject some study,
and not send their patients here to die away
from the care and comforts of friends and
home.
If I have offered no proof that this climate will
and does cure consumption, it is not that proof
is not abundant, but the only object of this
article is to draw the attention of physicians to
the fact that too many suffering from pulmo-
nary diseases are sent here to die, and too many
are kept at home t.o die, who could be sent here
to live.
Oaseous Enenxata in the Diagnosis of Perforation
of the Intestines.
Before the Ohio State Medical Society Dr. R.
H. Reed performed a series of experiments illus-
trating Dr. N. Senn's recent discoveries.
The first experiment consisted in etherizing a
dog, and, by rectal injections of hydrogen gas,
showing that this gas can be passed the entire
length of the alimentary canal and be burned at
the end of a stomach tube inserted into the dog's
stomach.
The second experiment consisted in etherizing
another dog, opening the abdominal walls, and
making a perforated wound of the intestines,
which were again replaced in the abdominal
cavity, and by rectal injections of hydrogen gas
it was shown that the gas escaped at the perfo-
ration of the intestine into the peritoneal cavity,
and from there through a glass tube inserted in-
to the abdominal wound, from which it was
readily burned.
He then took the same dog and made a resec-
tion of the intestine, and united the upper and
lower ends of the same by the rubber ring
method.
The third experiment consisted in etherizing
another dog, after which the dog was shot
through the abdomen, and then by applying the
hydrogen-gas test, demonstrated positively that
the bullet perforated the intestine ; he then re-
paired the wounded intestine by Prof. Senn's
decalcified bone-plate method.
A08UBT« tSBBt]
SELECTIONS,
245
SELECTIONS.
ICarria^es by Syphilitics.
Dr. Morrow in a paper on the duration of the
Bjphilogenic capacity in relation to marriage, pre-
sents the following conclusions:
1. The facts of everyday observation show that
there is nothing constant in contagion, nothing
certain in heredity. Many men marry with a
syphilis in full activity of secondary manifestations,
and never infect their wives or transmit the disease
to their children.
2. The modem division of syphilis into second-
ary and tertiary period, based upon anatomical
forms and processes, does not furnish a safe cri-
terion for determining the contagious character of
the lesions.
3. The completion of the second stage does not
always mark the definite disappearance of the viru-
lent principle; clinical experience shows the late
lesions are exceptionally, but none the less certain-
ly, the source of contagion.
4. The contagious activity of syphilis and its
susceptibility of hereditary contagion cease after
the third or fourth year as a rule, yet observations
show that the qualities sometimes continue in force
much longer, and may be manifest in the fifth and
sixth year and even later.
5. The aptitude of syphilitic parents to procre-
ate diseased children may persist after the cessa-
tion of all specific manifestations.
6. The precise date when the syphilitic organ-
ism reaches the limit of its contagious or trans-
missive power does not admit of mathematical ex-
pression.
7. This limit probably varies in different cases,
and many circumstances contribute to advance or
defer it
8. The type of the syphilis, the constitutional
peculiarities of the patient, the character of the
treatment, the presence or absence of certain con-
ditions which are recognized as factors of gravity
in syphilis, all exert a modifying influence.
9. All these elements should be considered in
deciding upon the advisability of a syphilitic man
to marriage. Each case must be studied upon its
individual merits.
10. The direct paternal transmission of syphilis
without preliminary infection of the mother, may
be classed among the most conclusively established
facts of medical science.
11. It is, therefore, a dangerous doctrine to
teach that the sole risks a syphilitic man intro-
duces in marriage consist in the contagious acci-
dents he may bear upon his own person.
12. The arbitrary designation of a limit of three
or at the most four years as perfectly safe for a
syphilitic man to marry, with or without treatment,
and irrespective of the actual existence of specific
lesions, is unwarranted by science or the teachings
of experience. — Horn. News.
The Oare of the Byes.
At the sanitary convention held at Ann Arbor,
Mich., not long ago. Dr. C. J. Lundy, of Detroit,
read a paper on *' Hygiene in Relation to the Eye,"
which should have the widest circulation, especially
among teachers and school officers. A fruitful
source of eye troubles is shown to be the excessive
strain upon the muscles and nerves of the eyes due
to faulty educational methods, the ill- planned and
insufficient lighting of school rooms, poor ink and
fine print in school books, and other causes which
education might correct.
In conclusion. Dr. Lundy lays down the follow-
ing rules for the better care of the eyes:
1. Avoid reading and study by poor light.
2. Light should come from the side, and not
from the back or from the front.
8. Do not read or study while suffering great
bodily fatigue or during recovery from illness.
4. Do not read while lying down.
5. Do not use the eyes too long at a time for
near work, but give them occasional periods of
rest.
6. Beading and study should be done systemat-
ically.
7. During study avoid the stooping position, or
whatever tends to produce congestion of the head
and face.
8. Select well-printed books.
9. Correct errors of refraction with proper
glasses.
10. Avoid bad hygienic conditions and the use
of alcohol and tobacco.
11. Take sufficient exercise in the open air.
12. Let the physical keep pace with the mental
culture, for asthenopia is most usually observed in
those who are lacking in physical development.
It is not for us, but for our children's chil-
dren, and future generations, to fully realize
the magnitude of the work which we are now
carrying forward, and it is only for them to
appreciate its full fruition. — Coivperthivaite.
Local ApplicatioxiB.
Until recently all my local applications had been
in the crude form as tinctures or effusions, but I
was led to try local applications of the lower po-
tencies through a recommendation to that effect in
Guernsey's Obstetrics. The results have been so
good as to induce me to go further in this direc-
tion, and besides, the logic of the position is irre-
sistible: If the effective, penetrating force of
drugs is heightened in activity by potentization,
the necessity for the use of such potencies exter-
nally is greater, if that be possible, than the same
internally.
I will now endeavor to give, as concisely as pos-
sible, a list of remedies, with their homoeopathic
usefulness externally, with the understood proviso
246
THE MEDICAL ERA.
[Vol. VL Wo. &
throughout, that other symptoms mnst agree, and
that the topical application of a drug must be sap-
plementary to its internal use, not substitutive.
Acetic acid. — Burns and scalds. Stings and
bites of animals, even rabid.
After bruises and sprains, when dry heat fol-
lows.
YiNEOAR. — Apply freely to lips and nostrils in
cases of prolonged unconsciousness from all an-
sesthetic vapors, and for subsequent drowsiness,
dizziness, headache, etc.
Aconite. — Burns from alkalies.
Apply compress wet with potency to forehead
in cases of sunstroke from direct exposure. Eye
wash in inflammation from foreign bodies, cold and
suppressed gonorrhoea. Enema for ascarides; also
after each stool in infantile chopped- spinach diar-
rhoea. As a surgical dressing in grave cases of in-
jury with internal congestions (C. Hg).
^SGULus. — Anal and hemorrhoidal troubles, as
enema, wash or unguentum.
Agnus castus. — Sometimes indicated in bruises
and wounds, sprains, dislocations, and strains from
overlifting.
Prevents excoriation from walking. Wash for
itching ulcers.
Ammonia gabb. — Rhus poisoning. Insect stings.
Anagabdium. — Bhus poisoning.
Abnica. — The first application to be made in all
cases of traumatism ; for this purpose an infusion
of the flowers, made at the time, will be found most
generally useful; the injured part may be im-
mersed in a pail or pan of tepid water colored with
the infusion. In cases of central concussion, use
freely as a wash or douche, or even a bath.
After evacuation of cold abscess, burrowing pus,
etc., inject watery solution to prevent further sup-
puration and septicaemia, varicose and painful
ulcers, small painful boils, painful corns, insect
stings, and bites of rabid or angry animals.
Absenic. — Old ulcers, carbuncles, open cancers
with agonizing burning pain; a trituration in water
or applied dry to the part may give considerable
relief and supplement the internal action of the
drug very satisfactorily.
Belladonna is frequently applied to boils indis-
criminately. Should be used only when indicated,
and then a potency will be found more efficacious
than the tincture.
Calendula. — Injuries with destruction of tissue;
wounds made by machinery; in lacerated perineum
it is invaluable, as with Arnica; keep the flowers
on hand and make a fresh infusion when needed.
Canthabis — In burns of the first degree, before
blisters have formed, painting with a low potency
will give immediate relief and prevent the bullae
rising. In more severe burns and scalds use higher
ix)tency in water, as a soothing and healing dress-
ing. Said to have removed freckles, but this can-
not be vouched for.
Staphisagbia. — Mechanical injuries from sharp
cutting instruments, hence after surgical opera-
tions.
Tebebinthina. — Burns and scalds of second de-
gree.
Ubtica ubens. — Burns, involving only the skin.
Much burning, accompanied by itching. — Horn,,
News
All papers whose authors are not present
should be read by title and referred, unless their
reading is requested by two-thirds of the mem-
bers present at the sectional meeting at which
such papers are presented. Also a limited
amount of time should be allowed for the dis-
cussion of each paper immediately after it has
been read. — Cowpertkwavie,
Surgical AphoriBms.
In reducing the principal dislocations, the
method known as the Manipulatory . should be
practiced.
1. Diagnosis and Reduction of the Hip joint,
(a.) If the great toe of the injured leg rests
on the tarsal bones of the opposite foot, and you
have preternatural immobility, the head of the
femur is on the dorsum of the ilium.
To reduce it by manipulation, grasp the leg
with one hand and the thigh with the other; flex
the leg upon the thigh and the thigh upon the ab-
domen; carry the leg upward, over the opposite
leg, until it meets with resistance; now rotate the
thigh inwards; continue to move the leg in the
way it will go the easiest, upwards and outwards;
then bring it down alongside of the other leg.
Thus the leg in its course has traveled in an ob-
long circle
( 6. ) If the great toe of the injured leg rests
on the root of the great toe of the opposite foot,
and there is preternatural immobility, the head of
the femur is resting in the ischiatic notch.
To reduce it, grasp the leg as in the former case,
and manipulate in every respect as in the former,
except in a lesser degree, so thai the circle will be
less, and the joint will be reduced.
(c. ) If the foot is in extreme abduction, stand-
ing almost at right angles with the body, and you
have preternatural immobility and half an inch
shortening, the head of the bone will be found on
the pubis.
To reduce it, grasp the leg with one hand and
the thigh with the other, flexing the leg on the
thigh and the thigh on the abdomen, carrying the
leg up in an abducted position. A little caro must
be exercised in rotating in this case. As the head
of the bone is liable to slip over the spine of the
pubis and hang there, the thigh should first be
rotated slightly outwards, then extension made;
after this, and while extension is kept up, rotate
AuauVT, 1888.]
SELECTIONS.
247
inwards. Now oarry the knee upwards and in-
wards; then, sweeping the circle, bring it down
alongside the opposite leg.
(d. ) If the foot is abducted standing in front
of the body, the leg elongated, and -there is immo-
bility, the head of the bone is in the foramen
thjroideum.
lieduce it by grasping as in the former case and
carrying the leg up; rotate the thigh inwards, and
sweep around the circle the same as above, only in
a lesser degree. Thus the manipulatory method
is fully carried out.
2. Dislocations of the Shoulder-joint. — First
find out where the head of the bone is resting.
If the head of the humerus is in the axilla, fol-
low up in their order the following instructions:
First, flex the elbow at right angles; second,
carry the elbow out from the body and up, so that
the shoulder will form another right angle. Now,
with one hand on the acromion process and the
other holding the humerus at the elbow, use exten-
sion and counter-extension to dislodge the head of
the bone; now sweep the arm in detour, upwards
and forwards, describing a circle, and bringing it
down by the side of the body.
If the head of the humerus is under the clavicle,
or under the corocoid process, observe the follow-
ing particulars:
Use extension and counter-extension, first, in the
line in which you find the axis of the humerus.
Secondly, raise the arm at right angles with the
body, the elbow flexed; third, make the detour in
ail respects as in the former.
If the head of the bone is under the spine of the
scapula, use extension and counter-extension first,
then raise the arm, then make the detour from
before up and backwards. «
3. Fractures, — In treating fractured bones of
the forearm, never use plaster-of-Paris bandage
without an underlying splint, as the broken bones
will surely be drawn together, and the arm
.maimed. .
To keep the bones of the forearm apart, two flat
splints, rvider than the arm, should be used.
In fractures of the radius, between the insertion
of the biceps and the pronator-radii-teres muscles,
the hand should be supined — the splints turned at
right angles, to fix the elbow; the splints wider than
the arm, to keep the bones apart; and the hand
sapined, to obtain the proper rotatory adjustment.
Xn fractures of the radius near the wrist, or in
its lower half, the hand is better semi-proned; the
splints should reach only to the roots of the fin-
gers; farther than this impedes the movement of
the fingers and leaves them stifT, as the tendons
l>econie tied down by adhesions.
Xn fractures of the femur there is usually over-
lapping of the fragments, and shortening is the re-
sist.
Means of extension and counter-extension may
often be dispensed with by flexing the leg. An in-
clined or a double-inclined plane is often sufficient.
If you use a weight and pulley extension, see that
the weight is not too heavy. Measure every third
day, so that the weight may be reduced.
A fracture just below the minor trochanter re-
quires a greater inclination than wheuo broken in
the middle of the shaft, a lesser inclination in
the middle of the shaft, and then again a greater
at the base of the condyles at the knee.
A fracture of the condyles, when there is split-
ting into the knee-joint, should be set in the
straight position. •
4. Hip-joint Disease. — When called to examine
a patient with pain in the knee, and you are una-
ble to find a local lesion, you may suspicion hip-
joint disease. If you do not find in the hip evident
objective symptoms, you should carefully examine
the back for vertebral disease.
Apparent elongation of the leg in hip-joint
marks the second stage of the disease, and appar-
ent shortening marks the third stage; these should
not be interpreted as dislocations. In the first
stage of hip- joint, rest in the recumbent posture is
the treatment In the second and third stages an
extending apparatus should be worn, and the pa-
tient allowed the open air.
5. Ulcers. — In the examination of an ulcer look
for the direct excitant. This may be local or con-
stitutional.
If the ulcer is on any part of the body above the
knee, unless in case of a burn or other traumatic
cause, you are led to suspicion a constitutional
cause. If below the knee, and on the posterior
aspect, look for constitutional cause, unless it is
traumatic.
Ulcers are prevented from healing by fetid dis-
charges, by uncleanliness, by the leg being too
dependent, and by the indurated state of the limb.
To cure, you must correct these. Rest, elevation
and antiseptics are suggested. The day of oint-
ments has passed away.
Don't scrub an ulcer. Don't grease an ulcer.
Don't allow it to become filthy. Don't allow the
limb to hang down; or if you cannot avoid this,
use a bandage as a means of compression.
6. Amputations. — In amputating a finger, do
not sacrifice the length to follow any special form.
Leave the stump as long as possible. Make your
flap from the anterior portion, so the cicatrix will
rest posteriorly. Preserve the tendinous insertions
where it is possible.
In removing the metacarpal bones, preserve the
breadth of the hand if possible.
If the periosteum remains, and the parts are
crowded together, the new formation is likely to
crowd upon the nerves and give rise to painful
sensations.
In crushing accidents, save as much of the hand
and fingers as possible. The most useless part is
better than an artificial hand.
248
THE MEDICAL ERA,
[Vol. VI. Ha a
III oonfcractions of the fiagers, a sub-oataneons
divieion of the fibres may be saffioient to correct
the deformity. A Y-shaped flap, with the apex
looking towards the wrist, affords a good incision,
BO that when stitched, after the straightening of
the finger, the incision will present the shape of a
Y, which allows an elongation of the palmar
fascia.
7. Tumors, — In the extirpation of benign tu-
mors, I secure union by first intention by sprink-
ling the parts well with the impalpable powder of
Baracic acid, and» covering with cade gauze. I use
the Boracic acid with impunity, rubbing it into the
raw surfaces; it never poisons, and does not inter-
fere with primary union. — Dr, Yuunkin^in Am.
Med. Jour.
It is a duty that we owe to ourselves as well
as to the country, to use all our efforts to ad-
vance the standard of medical education, and
thus make the diplomas of an American college
equal to those of q,ny other country in the
world. — Cowperthwaite.
Treatment of Acne.
As every ordinary suppuration must be re-
garded as due to the invasion of pus microbes,
80 the clinical picture of acne divides itself into
two essentially distinct sections. These are, the
process of follicular obstruction and of the form-
ation of comedones, and the process of suppura-
tion in the follicle. Comedones are often erron-
eously separated from acne ; their sole cause is
the abnormally firm coherence of the homy
layer on portions of the skin provided with lanu-
go hairs. Whether this change in the homy
layer is duo to a partial anaemia of the skin, or
to the presence of special organisms, is not
known. The second part of the process, the
suppuration of the follicle, takes place only in
those plugged glands within which pus microbes
have entered before their closure, and which
have been subjected subsequently to irritation
(mechanical, eczematous, or from Tar, Chrysaro-
bin, Iodine or Bromine), which has facilitated
the intrusion of the pus microbes into the follic-
ular waUs. Thus the treatment of acne has to
fulfill two chief indications — to loosen the cor-
neous layer and to destroy the microbes. The
horny layer can be best removed slowly by means
of Sulphur and Resorcin, while the hypereemia
associated with all efforts at reducing comifica-
tion is lessened by the application of Oxide of
zinc. Eesorcin has this advantage over Sulphur,
that Corrosive sublimate, the best agent for de-
stroying micro-organisms, can be combined with
it ; Carbolic acid, on the other hand, goes best
with Sulphur. Twice or thrice a week the whole
surface should be gently scraped, the pustules
punctured, and the comedones pressed out. The
effect of treatment should be observed at frequent
intervals. Every acne patient must wash with
soap, and employ water as hot as he can bear,
in order to soften the horny layer. — Dr. Unna.
From the evidences before us we are forced
to xsonclude that however great is the progress
being made by the dominant school of medicine
in the auxiliary sciences, its therapeutics is still
struggling in the dark. — Cowperthwaite.
Treatment of Oompound Fractures.
I believe that all compound fractures should
be at once cut down upon for the purpose of
thoroughly disinfecting and cleansing the wound ;
also to remove all detached spicul89 of bone and
any foreign body that might have been carried
into the wound by the fractured bone.
At this stage of the operation, if the fracture
is found to be oblique, or near the joint, it
should be wired, as it is essential for repair to
keep the bones and injured soft parts absolutely
at rest, and it would be found difficult or quite
impossible to do so without securing the frac-
tured bones by wiring. By securing absolute
rest of the bones, the reparative process is not
interfered with, and a compound will be con-
verted into a simple fracture in a single week.
The size of the external wound should not be
considered.
These cases of small wounds are often attend-
ed with the greatest amount of injury to bones
and soft parts, and will frequently develop the
most serious symptoms of wound infection, fol-
lowed by septicaemia and its consequences.
I cannot too strongly protest against the'
method of "sealing these small wounds with
adhesive plaster," and trusting the case to the
chances' of nature. It is as irrational and un-
scientific as to plaster a punctured wound,
trusting that there is no sliver in the flesh. If
the bone has been driven through the skin, and
has come in contact with infection, which is
abundant in the clothing, the wound will quite
likely become infected, and our duty as surgeons
is quite clearly defined. — Post Grad. — Am. Med.
Digest.
The evidences of progess in the domain of
biology, physiology, pathology, and etiology are
abundant, which, together with surgery and ob-
stetrics, seem to be obtaining a much greater
degree of perfection. — Cowperthwaite.
August, 18B6.1
SELECTION^.
249
Olwtdtric Xetliodi in Prague.
Before examining a woman in labor, the nails
are cut and cleaned and the hands and arms
scrubbed with soap and water and a brush.
This is followed by irrigation with Corrosive sub-
limate solution (1 to 1000), and the hands are
held in a basin of Sublimate solution (1 to 1000)
for a minute or so. Instruments are allowed to
remain half an hou{ in Carbolic acid water after
being used. Catheters are boiled half an hour
in a 5 per cent Carbolic acid solution and
cleaned internally with a brush. The catheters
are specially made, the eye being double and
going directly through the catheter, and the
portion above the eye being filled in with lead,
allowing no crevice for the collection of dirt.
The external genitals are carefully washed with
Carbolic acid solution, before the catheter is
passed, to remove mucus which might be carried
into the bladder before it. Cystitis seldom
occurs, and then only when the catheter is not
clean. Hypodermic needles are heated in the
flame of the gas, and before giving an injection
the skin is washed. Small instruments, such
as dressing forceps, are also held in the gas
flame.
The following antiseptic precautions are
adopted with regard to the patients: Upon
their entering the hospital and before the first
examination is made the vagina is irrigated with
. Corrosive sublimate solution (1 to 2000). Pa-
tients are not irrigated daily unless they have
some abnormal secretion, such as leucorrhoea.
Upon the beginning of labor the vagina is irri-
gated before the first examination. The irriga-
tion is not repeated during the course of the
labor unless a number of students have exam-
ined the case, and the patient has fever or
hemorrhage, or there is an indication for the use
of instruments.
After the birth of the child the external gen-
itals alone are washed, and the vagina is not
irrigated in normal cases. When, however, any
considerable laceration of its structure has taken
place or instruments have been used, irrigation
is employed. The uterus is never washed unless
it has been operated upon, as in applying the
forceps with the child high up, or in perforation
or craniotomy.
The uterus is never washed with Bichloride,
GarboUc acid solution being always used in the
strength of 3 per cent for prophylaxis, or, when
infection is present, 4 to 5 per cent.
After every uterine irrigation two Iodoform
suppositories are introduced into the uterus.
All wounds of the genital passages are sewed up
and dressed with Iodoform.
After the birth of the child and before the
placenta has come away the vulva is covered
with a sheet of cotton soaked in Chlorine water,
which is left till soiled, and then replaced by a
fresh one. This is changed every two hours at
first, and afterward three times a day. Before
the birth the genitals are washed with soap and
Sublimate solution. During the puerperal state
the external genitals are washed with Sublimate,
the vagina is not irrigated while patient is doing
well.
Foul smelling lochia, a discharge too profuse in
quantity, and the continuance of blood in the flow
for a longer time than normal, are considered
indications for irrigating the vagina either with
Carbolic acid or Corrosive sublimate solution.
The Sublimate is never used when the patient is
excessively anaemic or is suffering from kidney
disease or diarrhoea. When the discharge is
normal in character but profuse in quantity, an
astringent — either Alum or Acetate of lead — is
used as an injection. The uterus is never
washed out without an indication, as, for exam-
ple, if the patient has fever or endometritis, or
the membranes or placenta are retained. Car-
bolic acid solution from 3 to 4 per cent is made
use of in such cases.
In examining a patient with septiceemia, if,
upon the introduction of the speculum, any por-
tions of the vagina are found covered with diph-
theritic deposit, the vagina is first irrigated, and
then the patches of exudate are touched with
tincture of Iodine. When everything has been
made clean, so that nothing septic can be intro-
duced into the uterus, the organ is thoroughly
examined.
The rooms for puerperal cases, each one con-
taining six beds, are washed once in ten days
with soap and water and Hypochlorite of lime
solution. Woven wire springs are used on the
beds, and the mattresses are taken out of doors,
beaten, and aired. In the lying-in room the
beds are changed daily. In septic cases the
rooms are washed as usual, and, in addition, a
spray of Carbolic acid is used with the atomizer.
The bedsteads are put into a room and exposed
to a high temperature, the mattresses are beaten
and aired, and, if discharges have soaked
through the rubber cloth with which each bed is
protected, the mattress is burned. — If. F. Med.
Journal.
Treatment of the Umbilical Oord.
If the ligature be thin, it is liable to cut
through the walls of the blood vessels premat-
urely ; if too thick, it may not suflBce to comjjress
them satisfactorily. It ought to be applied at a
250
THE MEDICAL ERA.
[Vol. VI. No. 8.
distance of from one and a half to two and a half
inches from the abdominal wall. Not nearer, in
order to avoid the effect of the immense muscular
power of the umbilical arteries inside the ab-
dominal cavity. A second ligature is placed
about an inch from the first, and the cord cut
between them. It is a good rule, which must
surely be adhered to in every case of thick cord,
to apply an additional ligature between the first
and the abdominal wall, to avoid hemorrhage
from the insufiiciently compressed arteries, which
may take place after the cord has commenced to
shrink. The abdominal end of the cord is then
wrapped up in a dry and soft piece of linen, lint,
or cotton, placed on the left side of the abdomen,
and fastened, by means of a soft flannel bandage,
which is wide enough to cover the larger part of
the chest and all of the abdomen, so as not to
slip.
In wrapping up the end of the cord no oil
must be used. Warmth and dryness favor
mummification ; moisture and exclusion of air,
gangrene. This holds good also for the cord
when it is separated from the living baby by an
additional ligature, and in the dead. Thus, the
former forensic axiom, that a dry cord proved
life, which prevailed for decades after Macke
had demonstrated its fallacy as early as 1853, is
absolutely worthless. Thus, fatty substances,
and moisture of any kind, must be avoided as
much as possible. Powdered Sub-nitrate of bis-
muth or Oxide of zinc, or Iodoform, or Salicylic
acid, one part with ten parts of starch, may be
dusted round the insertion of the cord and over
the stump daily. The latter application is not
necessarily useless (from the point of view of
antisepsis), for the separation of the cord is a
gradual one, and not uniform through the whole
thickness of the amnion and the three blood
vessels.
The size of sore stump and the rapidity or
slowness of cicatrization depend upon the thick-
ness of the cord, the intensity of the line of de-
marcation, and the reactive inflammation. The
latter are most marked in vigorous infants. As
a rule, the surface is dry a few days after the
falling of the cord, and cicatrization complete
within twelve or fifteen days after birth. This
normal process is, however, disturbed by care-
less handling, local irritation, and infectious in*
fluences. In these cases there is a serous or
purulent secretion, and cicatrization may be de-
ferred for many weeks. Under these circum-
stances local treatment is required. Carbolic
acid ought to be avoided, for the newly bom in-
fant is easily influenced by its poisonous proper-
ties. Solutions of Lead, Zine, or Alum answer
quite well. As before, however, I recommend the
powders of Zinc oxide. Bismuth sub-nitrate. Alum
with starch, Salicylic acid with starch, or Iodo-
form. Such measures will always prove helpful ;
to omit them in times of erysipelas or diphtheria is
unpardonable. Perchloride of iron, or Sub-sul-
phate of iron, must not be used. Under the
hard coagulation formed by its application over
the whole wound secretions will accumulate, can-
not escape, are absorbed, and produce sepsis. I
have seen babies die from applications of iron to
the umbilical stump, as I know of women dying
for the same reason when the hemorrhages from
their uteri or from the lacerated vaginae were
maltreated in the same manner. — Archxvts of
Pediatrics.
Moist Heat After Operations for Senile Gangrene.
Dr. Heuel gives at considerable length the
history of a case treated by the method indicated.
The heat was applied by means of a thick, warm
carbolized poultice, which in turn was covered
with a piece of oiled muslin and a woolen shawl,
the object being to retain the heat of the poul-
tice as long as possible. Fresh poultices were
ordered to be applied every hour, night and day.
He concludes as follows :
1st. In an enfeebled subject the healing pro-
cess is greatly assisted by artificially supplying
moist heat to the part, thereby stimulating the
capillary circulation from the outset. I think if
I had used the poultice as above described im-
mediately after my Lisfranc's amputation, pri-
mary union would have resulted instead of phag-
edena.
2d. In enfeebled subjects we can assist nature
in nourishing skin grafts by stimulating the
local capillary circulation through the agency of
moist heat.
3d. Skin grafts should be one-eighth by one-
half inch, if not larger, and should be applied
freshly cut, directly to the freshened and bleed-
ing surface of the wound, thus making use of
the fibrin of the blood to secure the grafts in po-
sition. — TJie Epitome.
The old school has never been able or willing
to meet homoeopathy upon the fair ground of
open and honest discussion, but has invariably
resorted to a travesty of arguments, only such
as prejudice, ignorance, or malice might suggest.
— Cowperthwaite.
AUGX78T, 1888.]
COLLEGE NEWS.
251
A Bub-committee of the American Medical
Association on the subject of infant feeding
offers the following as useful rules: 1. In the
case of infants deprived of breast-milk the arti-
ficial substitute should correspond as nearly as
possible to human milk. 2. Cow's milk corres-
ponds to breast-milk in most respects, but its
easeine should be broken up, so as not to coagu-
late in large masses in the stomach. A portion
of milk should be first peptonized and then
added to fresh milk. 3. Eaw starch is inadmis-
sible, and the practice of adding it to fresh milk
is wrong. Fully digested food for either adults
or infants is bad for the digestive organs. 4.
All nursing bottles should be boiled several times
a day in order to destroy the germs of decom-
position. Desiccated (partly peptonized) milk
is often a convenient and efficient substitute for
mother's milk.
'* The conditions formulated by the Committee
on Infants' Foods at the American Medical
Association are approximated more nearly by
Camrick's Food than by any other with which
we are familiar." Editorial note in PhiUtdelphia
Medical Times, June 1, 1888.
The records of the International Medical Con-
gress are filled with the results of more or less
valuable experiments and discoveries in the
realms of the various sciences auxiliary to med-
icine, but materia medica and therapeutics fills
but a small niche in its literature. — Cowper-
thwaite.
Rapidity of the Multiplication of Bacteria. •
Small as they are, bacteria are by no means
insignificant. Like aphides and other small
insect-pests, they possess the power of multiply-
ing with great rapidity, but they far exceed their
most active competitors in this respect. Cohn
has calculated that a species undergoing fission
once an hour — which is not too high an
estimate for some species — under favorable cir-
cumstances might count nearly seventeen mil-
lion offspring at the end of twenty-four hours,
while in about a week the number could be
represented only by the use of fifty-one figures,
so that it is practically meaningless to the ordi-
nary mind ; but to give some means of compari-
son he calculates the space that these micro-
scopic beings would occupy if each were about
twice the size of that which I have spoken of,
and finds that in five days the progeny of a
single cell, if all survived and were equally pro-
lific, would occupy nine hundred and twenty-
eight million cubic miles, the volume of the
ocean. Of course their reproduction is checked
greatly by unfavorable conditions and by their
enemies, but what wonder if the germs of pu-
trefaction and disease are well-nigh omnipres-
ent?
Though bacteria are exceedingly minute and
simple beings, we have seen that their power of
multiplication, if unchecked, is incomprehens-
ibly great. Their influence on higher organisms
is also entirely disproportionate to their size.
Containing no assimilating pigment, they resem-
ble other fungi, as well as animals, in being de-
pendent upon organic matter for their nutrition ;
hence they must live either as saprophytes,
utilizing the substance of dead animals or
plants, or as parasites, obtaining their food from
living beings, — often at the expense of the
health or life of the latter. — Medical Register,
Our labors are not ended, nor can we hope to
lay our armor by so long as medical intolerance
and bigotry prevail and prevent the full accept-
ance of those truths for the promulgation of
which we are so earnestly striving. — Cowper-
thwaite.
COLLEGE NEWS.
San FranciBco.
HAHNEMANN MEDICAL COLLEGE DISPENSARY.
Mrs. C, aged 80, 'came to the dispensary
complaining of oedema of the feet, which condi-
tion Lycopodium 6x relieved temporarily. The
patient returned some time later with the condi-
tion very much aggravated. The tension had
become so great that the skin had broken, and
the water oozed from the right leg so that for
the space of four inches above the ankle was a
raw, excoriated surface. The heart was exam-
ined and an aortic stenotic and regurgitant mur-
mur was found, and an aneurism in the supra-
clavicular space. Under Apocynum 0, 6 drops
in a half glass of water, the urine, which was very
scanty, inci^ased in quantity, the drowsiness
and apathy, which were marked, diminished.
Thirst and restlessness and other symptoms of
Arsenic developed, for which Apocynum was
changed to Arsenic 6x. The right leg, upon
which was the large area of excoriation, had ap-
plications of Calendula and was carefully band-
262
THE MEDICAL ERA.
[Vol. VL No. «.
aged. At present the condition of the patient is
as follows : The oedema of the extremities has
diminished in a marked degree, the excoriation,
is almost healed, and the patient's general con-
dition is much improved, appetite and sleep
good. The case is instructive, as showing how
the remedy, when properly indicated, will ame-
liorate an apparently hopeless condition and sus-
tain a patient in a comfortable condition, though
suffering with a serious organic lesion.
Phosphorus 6x, in continuous daily doses for
months, in case of incipient senile cataract, has
cleared up the eyes in a remarkable degree, the
patient reporting that he could now see ** just as
well as ever."
A similar case, bearing a history of traumat-
ism, the patient having so nearly lost his sight
as to be led to the dispensary, has, under Phos-
phorus 6x, improved so greatly that the man
expects to go to work again soon. His face
fairly beams as he comes into the dispensary.
An interesting case of uterine polypi, protrud-
ing from the os, and causing dysmenorrhoea, ac-
companied by the characteristic Sanguinaria
headache, has been greatly relieved by that
remedj^ the polypi being already diminished to
one-fourth size when first examined.
Also a case of fibro-myoma is being reduced
under Calc. iod. 6x.
Calc. phos. 30, in small girl's constant morn-
ing headache, frequently attended with nausea
and vomiting, cured promptly.
Viola tricolor in one prescription cured a
case of thick incrustations on scalp, matting the
hair with a sticky, ill-smelling exudate.
CORRESPONDENCE.
San Francisco, July 16, 1888.
Editor Medical Era:
I am glad to see the allusion to woman's dress
in your editorial column. I hope to see all
medical journals unite in impressing upon the
physician his duty to his patient in that she
should J)e properly instructed as to the harmful-
ness of her present methods of dress. Mme.
Jenness Miller's Dress is a step in the right
direction, and the magazine should be recom-
mended to our patients. I. V. Stambach.
many in this region, and makes life a burden
to its victims. But both correspondents men-
tioned remedies which had already been used in
the case.
Will not some colleague who has been called
upon to treat a similar case, and who has done
so successfully, give his experience to
Your obedient servant,
Dr. Taylor.
Concord, Mass.
Homoeopathic Medical Society of the State of New
York.
Rochester, N. Y., July 24, 1888.
The semi-annual meeting of the Homoeopath-
ic Medical Society of the State of New Y'ork will
be held in Syracuse, September 11 and 12. The
prospects for an enjoyable and profitable meet-
ing are most exceUent.
The president, Wm. Tod Helmuth, M.D., of
New York City, will preside, and a large attend-
ance is confidently expected. Particulars will
be given in the circular, which will be issued
about September 1.
Herbert M. Daypoot, Secretary.
Intestinal Gas.
Editor Medical Era: — I received but two
communications from your section in regard to
the treatment of this malady, which afiiicts so
Chicago, July 3, 1888.
Editors Medical Era : — The unreliability of
newspaper reports is well understood, though
they usually have some foundation in fact. The
following appeared in a recent issue of the Sun-
day Herald:
A Oud of Tobacco for Group.
Although Dr. S. Leavitt, Professor of Hahne>
mann College, does not use tobacco in any form,
he is never without a small package of fine cut in
his pocket, and the reason of it is this: A gentle-
man of the doctor's acquaintance told him how he
had saved his child's life after all the doctors had
given her up. She had membranous croup, and
while the mother, from sheer exhaustion, had lain
down for a few moment's rest, the father sat by
the child. . The hard, difficult breathing of the
little one, growing fainter and fainter as the throat
clogged up, was torture to the father. Everything
in the way of emetics had been used, but withont
effect, but suddenly an idea struck the nearly dis-
tracted father. He remembered how deathly sick
he was the first time he chewed tobacco, and hav-
ing a cud in his mouth, without thinking twice he
opened the child's mouth and placed the tobacco
in. The father knew it was a desperate act, and
he waited in terrible suspense for the result. It
AueuflT, 18B6.]
CORRESPONDENCE.
258
came, and quicker than be oould have hoped
There was a sudden oonvalsive movement and the
poor little thing was nearly doubled for an instant,
and seemed to writhe in agony when, throwing
herself forward, there shot from her throat a chunk
of almost solid phlegm at least two inches long
and baying through it a passage no larger than a
small lead pencil. After a few minutes of retch-
ing the little one lay quietly back and slept calmly
and sweetly, and the next day was playing around
the bouse with all her wonted yim. Dr. Leayitt
remarked that it was a tough remedy, but said he
would always carry tobacco hereafter, and he
does.
Fearing that the foregoing has met the eyes
of some of my homoeopathic brethren, I want to
say that I do not carry tobacco, I never knew it
to be administered in croup, and have no idea
why my loyalty to homoeopathic principles
should be sa lightly spoken of.
Truly yours,
Sheldon Lbavitt, M.D.
The Southem Field.
Edhiors of The Medical Era :
I am frequently the recipient of letters from
physicians in various parts of the country, mak-
ing inquiries as to the Southern field of practice.
These inquiries embrace a very wide range — in-
cluding almost everything, from the effect of the
climate on an enlarged tonsil to the result ob-
tained from a high potency administered to a
sick negro — and I have concluded to give The
Era some general observations, which, in my
humble opinion, will be found truthful and ac-
curate.
The Southern people, whilst provincial and
conservative, asre as free from bigotry and pre-
judice as any people known to current history,
and if conservative, are as quick to investigate
and adopt a new method of practice as its merits
will warrant. They are not as enterprising as
they might be in some things, and devote a
good many hours to narrating anecdotes of Clay
and Jackson, that might be utilized in a thous-
and ways for the promotion of their material in-
terests.
But the South of to-day is not the ante-bellum
South any more than the Chicago river is like
the stream flowing by Louisville, and the man
who comes here will find us at work, digging
coal, making pig-iron, boring for natural gas,
fitretching electric wires, and otherwise keeping
ourselves out of mischief and the penitentiary
by aiding in the material development of the
country.
There is a strong, even aggressive, homoeo-
pathic sentiment among the more enUghtened cir-
cles in Kentucky and elsewhere in the South, and
this sentiment can be readily crystallized by sub-
stantial, upright men. Homoeopathy is stronger
in rural localities in Kentucky than it is in Illi-
nois, outside of Chicago, but we have no hospitals
or dispensaries in our cities, and but one jour-
nal — a great big team all by itself, let me re-
mark — in the entire southern country. Homoeo-
pathic physicians were not numerous in this
Commonwealth a dozen years ago, but to-day,
according to a pubKshed list, we have more than
a hundred, pretty evenly divided over the State
according to population. The success of many
men in the State has been extremely gratifying
both to themselves and to the friends of homoe-
opathy everywhere.
We have a live State Society, which meets
next year at Louisville, and to which all good
homoeopaths are cordiaUy invited to send papers
jand to be present in person.
As to climate, the State is comparatively free
from sudden changes, and from extremes of
temperature and winds. There is said to be
malaria (whatever that may mean) in some parts
of the State. Throat troubles seem to do well
here and consumption is by no means a Ken-
tucky disease. The mercury did not even reach
last winter.
Some one breaks the silence by asking, "What
about collections ? " Well, we ccXkct down here
once in a while, send out and receipt bills just
like they do in Paris and London, and manage
to get along pretty well after all. Seriously I do
not know that there is any difference between
collections here and collections elsewhere under
similar conditions. Some physicians render bills
every month, whilst others collect quarterly.
The Southern people are nothing if not sym-
pathetic and sociable, and the northerner coming
among them to practice homoeopathy will find
strong personal influences always at work in his
favor. The friends of homoeopathic practice
seem to take a larger share of personal interest in
its success than people take elsewhere.
In conclusion. Dr. B. is reminded that the
South is, Uke the West, an integral part of the
reunited and indissoluble Union, that the stars
and stripes wave gloriously over the land of the
cypress and the palmetto, and that the bright
light of similia is rapidly breaking upon the dark
places and deep shadows of a land once blighted
by what curses and hindrances I need not men-
tion. Howard Crutcher.
Louisville, July, 1888.
254
THE MEDICAL ERA.
[Vol. VL No. 8.
MISCELLANY.
Minnesota.
All medical schools of the state have been
merged into a department of the State University.
There are fourteen homoeopathic professors and
thirty-two allopathic, all of whom give their ser-
vices for five years without remuneration. Anat-
omy, chemistry and physiology are taught in com-
mon. The dean of the entire faculty is a " regu-
lar."
Mistake in Practice.
A correspondent of the Medical World makes
the following confession :
I was called on May 2l8t, to Mrs. H., aged
forty-five years, twelve hours after delivery of
her second child. I found her suflFering the
most excruciating pain from prolapsus ani, but
my mistake was in diagnosing it external hem-
orrhoids. The congestion was very great and
the parts were livid. I applied a four per cent
solution of Cocaine and waited about ten min-
utes. I then laid the tumor open in three places,
and after the subsidence of the swelling, found,
to my shameful surprise, that I had opened the
gut in just so many places. I then waited for
some days and found that. there was no trouble
in passing feces, and the parts seemed to be
healing nicely with the aid of Iodoform and Borax.
I intended to bring the incised parts together
with sutures, but finding that the compresses of
absorbent cotton were doing all that could be
expected, I decided to let the healing go on with-
out any further distuibance.
Mrs. H. is now well and in her third preg-
nancy. An old physician of forty years' practice
was called in, in my absence, and I never knew of
it until my patient was well and discharged. He
never discovered the mistake, and thanks to
God for it.
Can any one tell me who was the most ignor-
ant ? His eyes are good and we are not of the
same church.
Publications of the Massachusetts Homce-
oPATHic Medical Society. 1887.
This neat volume contains a record of the
transactions of the society for two meetings — an
annual and a semi-annual. In it there is much
good reading. Many of the articles have already
appeared in the pages of the New England Med-
ical Gazette.
PE&SONALB.
Dr. A. K. Crawford has returned from Cali-
fornia to resume practice in Chicago.
Dr. C. G. Fellows, of Waukesha, Wis., has
gone to Europe to spend a year in study in
Paris- and Vienna.
Dr. P. F. Casseday, of Kansas City, is regis-
tered "at the Palmer House.
Dr.- J. W. Coyner, of Peoria, has gone to
Europe to spend a year. He will attend the
hospitals of London and Edinburgh.
Dr. Ji F. Beaumont, of Minneapolis, has been
appointed by the regents to the Chair of Oph-
thalmology in the University Homoeopathic Col-
lege.
Dr. W. D. Gentry, of Kansas City, has in
preparation a "Concordance Repertory," which
is highly spoken of by those who have exam-
ined it. Dr. G. will send a descriptive circular
to all who send him their address.
Moxie. — This famous "tonic" is composed
of a solution containing checkerberry, glucose,
sodium carb., sassafrass, gentian and quassia, a
compound which is advertised as a decoction of
** South American greens ! "
The Latest Reports of Pasteur's Antirabic
Inoculations. — In 1887 there were 306 persons
living in the Department of the Seine who pre-
sented themselves for treatment at the Institute.
Among them only two died. Among 44 persons
bitten by mad dogs, and not treated by inocula-
tion, 7 died. — Medical Record, May 6, 1888.
A plant has been discovered in India which
possesses the singular property of destroying the
taste of sweetness. After chewing the leaves
sugar placed on the tongue conveys no more
sense of sweetness than grains of sand. It also
has the property of destroying the power of enjoy-
ing a cigar, and even masks the bitter taste of
quinine.
OBITUABY.
Died, at Marseilles, lU., July 20, of laryngeal
phthisis, Mrs. C. A. Weirick, wife of Dr. C. A.
Weirick, a devoted mother, a loving wife, a true
woman. Having kno^vn her from early child-
hood, we can justly pay tribute to her memory.
'* B,"
Au«D8T, 1888.]
SPECIAL NOTICES.
255
SPECIAL NOTICES.
Special Ooune in Oriflcial Surgery.
Prof. E. H. Pratt, M.D., will give his second
annual. practitioner*s course of lectures on
Orificial Surgery, commencing Sept. 10, 1888.
For terms and other particulars address 56
Central Music Hall, Chicago, 111.
St. Nicholas for August contains its usual
variety of reading for the young.
Have beep using Tongaline for two or three
years with the most happy results and find it
has excelled any other remedy for the cure of
muscular rheumatism. — J. M. Jones, M.D.,
Newport, Ark.
Please Note — Nestle's Milk Food ia the only
TRUE milk food which is perfectly digestible
without the addition of any foreign ferment or
other substance, furnishing a compkte, safe and
nourishing diet, prepared unth water only.
Attention is called to the institution which
has been opened by Drs. Waite and Poaslee, at
6306 Jefferson Av., Hyde Park. Physicians
having appropriate cases would do well to send
them to the Chicago Gynecological Institute.
See the notice on page VI., of this journal.
The July Century has for a frontispiece a por-
trait of Pastear and his granddaughter \ff the cel-
ebrated French painter, Bonnat This picture is
printed in connection with a timely article of
** Disease Germs, and How to Combat Them," a
foot-note to which article gives a brief sketch on
Pasteur's interesting career.
In prescribing the products of manufacturing'
pharmacists, we should be guided to a great
extent by the business standing of the manufac-
turers. No other house in the South or West
has a better reputation for strict integrity than
the firm of R. A. Robinson & Co., Louisville,
Ky. We do not hesitate to recommend the
pioeparations advertised by them on page X, of
this issue.
Ijactated Food with Cream. — Lactated Pood
may be prepared with cream as follows : Take
three teaspoonfuls of Lactated Food wet up into
a thin paste with cold water, To this add one-
fourth pint of hot water ; boil five minutes, then
add one-fourth pint each of mUk and cream.
To this may be added any flavor the taste of the
patient may desire, or any stimulants that the
physician may direct.
LiOOK Hebe! The Medical Counselor fob three
MONTHS FREE. Send name and address to *< Medical
Counselor Publishing Co.," Ann Arbor, Mich.
Pieliminary Announcement.
In Press. "A Text-Book of Gynecology," by
Prof. A. C. Cowperthwaite, M.D., of Iowa Uni-
versity, is now in press, by Gross & Delbridge,
and will soon be issued. It will be a large work
of 900 pages, profusely illustrated, and contain-
ing the latest that is known to science in con-
nection with the subject of which it treats.
The subject of the homoeopathic therapeutics
of the diseases of women has received especial
care, and the entire work is such as the profes-
sion has a right to expect from the eminent
author and teacher who has already given it a
standard text-book of materia medica.
Just Published.
Fourth Edition of Physiological Materia
Medica, by W. H. Burt, M.D. One hundred and
seventeen pages of new matter have been added,
including the new anaesthetic. Cocaine, and the
most thorough clinical index ever combined with
a materia medica, giving not only all the reme-
dies written up in the text, but all the important
ones known to the profession, with more adju-
vants than can be found in any work on practice
in any school of medicine. Gross & Delbridge,
Publishers.
What is a " soluble carbohydrate f " the reader
asks impatiently. He ought to have been told in
his college course; but it was nobody's duty to tell
him, as no examiner would ever ask him such a
question. The lecturer on physiology describes to
him the act of digestion, and tells him how the
saliva converts insoluble starch into soluble grape
sugar in order that it may pass through the wall
of the alimentary canal. But what he has to do
when the saliva is scanty and inert is not yet the
business of any teacher. He has that to find out
for himself — if he can. The first person who
recognized the importance of converting insoluble
starch into a soluble maltose was M. Mellin with
his " non-farinaceous food." — Fothergill
Bui-lingrton Boute,
VESTIBULE TRAINS.
"The Burlington's No. 1" fast train, leaving
Chicago at 1 p. m. daily for Omaha, Lincoln,
Cheyenne and Denver, and arriving at Denver at
9:10 p. m. the next evening, in now a solid vesti-
bule train for the entire distance between Chicago
and Denver.
The Burlington's "Fast Trains" to Kansas
City, St. Paul, and Minneapolis will also be vesti-
bule trains at an early date.
256
THE MEDICAL ERA.
[Vol. VI. Wo. 8.
THEY SAY
That whalebone is not a bone.
That the tuberose is not a rose.
That sealing wax contains no wax.
That he laughs best who laughs first.
That paper on the wall is a put up job.
That there is arrest for the weary tramp.
That the Asiatic cholera is raging in Chili.
That antipyrin is not as harmless as a dove.
That you should never read in front of a lamp.
That it's all in your eye — the vitreous humor.
That the worst of mad men is a saint run mad.
That what is well done is not always done well.
That children have more need of models than of
critics.
That it's a nod thing to see a man asleep in
church.
That you should pay as you go, but don't go
till you pay.
That hens are the lay members of the barn-yard
congregation.
That the best hair dressing is a small quantity
of a bland oil.
That he who rules must humor full as much as
he commands.
That there are seven hundred medical societies
in this country.
That the only thing that is really what it's cracked
up to be, is ice.
That more than 60,000 eggs were found in a
shad, all in a roe.
That there never was a wedding that went off
without a " hitch."
That Turkish baths are not baths, and did not
originate in Turkey.
That a century has not added to the wisdom of
the dominant school.
That most of the " news of the weak " is re-
ported by physicians.
That Burgundy pitch is not pitch, and does not
come from Burgundy.
That what the Institute needs is fewer papers
and more discussions.
That an undertaker is a brave man; he faces
death almost every day.
That damp clothing should be turned inside
out when hung up to dry.
That the newest thing under the son is a patch
on the seat of his trousers.
That what goes down is sure to come up, if it's
accompanied by an emetic.
That when a medical man has nothing else to do,
he writes a paper on phthisis.
That it is best to let the light fall from above
obliquely over the left shoulder.
That paste diamonds are so called because peo-
ple sometimes get stuck on them.
That peroxide of hydrogen' is the basis of al
preparations for bleaching tJie hair. *
That the matter of educational reform cannot
be left altogether with college faculties.
That they intend to tear down the post office in
order to find the letter that never came.
That no one knows the exact size of the lion's
share, but generally it is all he can get.
That you should stop using your eyes the mo-
ment there is an inclination to rub them.
That the South African diamond fields last year
yielded gems valued at over $20,000,000.
That men sometimes suffer from " morning sick-
ness " when their wives become pregnant.
That any fool can ask a conundrum, but it takes
a wise man to refrain from answering it.
That patients with hypertrophy of the heart
should be put on a non-stimulating diet.
That the out- put of whisky is going to be lim-
ited, but ihe in-put will be as lively as ever.
That the man who was asked to stop a minute,
said thbt he could not arrest the flight of tima
That the medical student whose girl went back
on him said she was afflicted with *' heart failure."
That the diplomas of American colleges should
be made equal to those of any other country in the
world.
That the moment you are instinctively prompted
to rub your eyes that moment you should stop
using them.
That the royal house of Spain suffered from
hereditary madness for over two centuries, wl\en
it became extinct.
That one-half of all the drugs imported into the
United State? is consumed in the manufacture of
patent medicines.
That man need never die except from accident
or his own disobedience of hygienic rules, or in-
herited infirmities.
That in the United States the ratio of medical
men to the population exceeds that of any other
country in the world.
That it is the most heinous of sins for a physi-
cian to take advantage of his professional privi-
leges in order to perpetrate a crime.
THE MEDICAL ERA
Vol. VI.
Chicago, SEPTE^reER, 1888.
No. 9.
EDITORS :
CH. GATCHELL, M.D.
JAMES E. GROSS, M.D.
THE EVILS OF UNRESTRICTED
IMMIGRATION.
One of our enterprising Chicago daily papers
recently sent a woman reporter into many of
the city's factories and workshops in order
that she might investigate the condition of the
working girls. The story that is told is pitiful.
It was found that in most of the places visited
" labor is a bondage, the laborer a slave, and
blood cheaper than needles and thread."
The reporter found a child of 15 working
nine hours a day in order to earn 16 cents; an-
other girl, of 17, earned 80 cents a week, working
from 7 : 30 in the morning to 5 :30 in the even"
iiig ; a young woman engaged in making bustles
received $3 a week — 60 cents a day ; in another
shop wages ranged from $1 to $3 a week; in
another district there were ** hundreds of grown
women who toiled from morning until night in
the •* slop-shops" for $2 and $3 a week. In
reply to questions one young girl said :
'' I work ten hours a day, and make from $4 to f 5
a week."
** What does your board cost ? "
** With washing Inciuded, $3 a week."
«* How mnch do yon pay for car fare ? *'
** At least 60 cents a week."
*^ That leaves at the outside figure but $1.40 for fifty-
nine hours' work, or less than 25 cents a day.
So much for the question of wages.
The places in which these poor creatures toil
are, many of them, unfit for human habitation.
They are described as being adjacent to, or sur-
rounded by "garbage boxes reeking with filth;"
** festering ponds of water;*' ** masses of filth;"
" stench and miasm ;" ** stifling stench, with rot-
ten and broken flooring, through which pene-
trate infernal odors from a stable."
Many of the workshops are poorly lighted, to
the ruin of the eye sight of the workers, while the
air is often poisonous for want of proper ven-
tilation. The girls are required to wash in dirty
water, to dry their hands on their under-clothing,
and to " wait in line " before crowded water-
closets, the condition of which is filthy in the
extreme.
As to comfort, there is none, and every law
of health is violated. There are girls with
"stooped shoulders and prematurely aged
faces;" some were "crowded along a line of
tables so as to be obliged to take short stitches ;"
and competing with " delicate young girls" are
"half a dozen old women, all wearing specta-
cles, and ranging from 50 to 60 years of age."
And what of their employers ?
A similar review of the articles has enabled
us to select from the names of those who are
the girls' task-masters, a list which reads like
this : — Koh, Kohn, Spitz, Stein, Strauss, Olson,
Guthman, Wampold, Karasick, Beifeld, Schles-
inger, Rothschild, Goldstein, Lowenstein, Zim-
merman and Kuppenheimer.
It is true, there are some names which are
easier for an American to pronounce, but the
above ^largely predominate.
The evil thus held up to public view is a great
one, and it cries for a' remedy. Many sugges-
tions have been made, but the right one has not
been insisted upon.
It rests in a restricted immigration.
268
THE MEDICAL ERA.
[Vol. VL No. t.
Who are the workers that are thus competing
with each other at starvation wages ?
Almost all of them are foreigners !
Nell Nelson, the reporter, says that at one
shop:
<*A great many of the girls were Irish, but the
Swedes and Germans were numerous."
At another place :
** At 12:45 o'clock the hands began to arrive from
lunch, first a young Pole, then a Russian, then a Ger-
man Jew."
At another :
** All are Poles but two, and they are Germans."
At still another :
*< Most of the girls were Swedes, and unable to
spea&aword of English."
A review of the entire series of articles shows
that, for the most part, these underpaid laborers
are Irish, Bohemians, Hungarians, Poles, Rus-
sians, Jews, Swedes and Germans.
From the evidence thus adduced, is it not
clear that the situation, for the most part, is
one of foreigners grinding foreigners ? Is it a
fault of American institutions ? Is it to be ex-
pected that this country can supply remunera-
tive employment for the surplus labor of the en-
tire world ? Has it anything to do with high
tariff or low tariff, protection or free trade, as
claimed by some ?
Not at all, unless it be due to free trade in
cheap labor.
If this view be correct, then the remedy lies
in a restricted immigration. The surplus pop-
ulation of the Old World should not be allowed
to pour into this country faster than its natural
development justifies.
But, to the medical man, this quest ion pre-
sents still another aspect, which it is well to keep
in mind.
The last general census of the United States
revealed the fact that the increase of the insane
is out of all proportion to the increase of the
population. At first this was attributed to
causes purely domestic, but it was not long be-
fore the true reason was revealed. The great
increase was found to come entirely from the
ranks of recently arrived foreigners. There are
cantons in Switzerland and towns in Italy, Po-
land, Bussia, Germany, Austria and France
that ship many of their indigent and feeble-
minded to the United States.
These all contribute to the population of our
insane-asylums. It is well known that worry,
more than work, will drive to madness. Thus
the laborers in Chicago shops, who wear their
soul-cases out in struggling for a bare existence,
and who can but worry over the future, must and
do supply numerous recruits for our hospitals,
alms-houses and insane-asylums.
In the interest of humanity the unfortu-
nates who are already with us should be well
cared for, but the swelling tide should be
stopped, for America cannot be made the world's
refuge or the world's asylum.
There is a limit, and it has been reached.
THE YELLOW-FEVER.
According to the latest advices received at
this writing the yellow-fever is now epidemic in
Jacksonville, Fla., and the situation is rapidly
becoming worse. There is still the warm month
of September to go through.
For the twenty-four hours of August thirti-
eth, thirty-four new cases were reported to the
board of health. For the same time, four
deaths were reported. The disease seems to
spread in the direction of the prevailing winds,
and it is assuming a more and more violent
type.
Such an epidemic as this seems only to em-
phasize the fact of the utter powerlessness of
the physician. Medical science has not yet
placed in his hands a weapon with which he can
successfully contend against the contagion.
Too often he himself falls a victim to the vellow
scourge.
If the disease is ever controlled, it must be by
preventive rather than by curative measures.
Hence efforts would better be directed toward
discovering some means of prophylaxis, whether
it be in sanitation or inoculation.
Meanwhile, one can only battle against it,
and pray for an early frost.
SaPT.,1888.]
ORIGINAL ARTICLES.
259
ORIGINAL ARTICLES.
SXEJLETOK 8KET0HES POB 8X7BGICAL
8TITDIE8.
bt henry sherry, m.d.
CHlCAeO.
THESE outline hints are for students, and
particularly junior medical students.
The method is one I follow in my private
studies and in my clinical lectures. It elimin-
ates the purely theoretical, leaving the bare
facts. And Buskin, you know, says that what
we need is - downright facts."
As an illustrative example, I will take, this
time, the simple subject of an ulcer. Now,
nearly every subject can be studied under the
following heads: 1. Derivation, or etymology.
2. Synonyms. 3. Definition. 4. Etiology.
5. Pathology. 6. Symptoms, or anatomical
characteristics. 7. Varieties. 8. Treatment.
Derivation : Greek, ** Ulcus " — A sore.
Syfionym : Sore.
Definition : A solution of continuity of the soft
parts, that show no tendency to heal.
BUoU>,y:{'^'op^^l:
Pathology :
' 1. Irritation.
2. Hypersemia.
3. Serum.
4. White corpuscles.
5. Fibrin and albumen.
Symptoms
■ii;
Surface.
Edges.
Surroundings.
Phaobdsnio.
.,... i '■ «^-^'- 1 ^: Not'^^g.
Varieties:
2. Specific.
Again we make the following subdivision of
the
1. Tonic.
y cm-healing : -
1. Inflamed.
2. Irritable.
3. Phagedenic.
2. At nic
■\i.
Chronic.
Indolent.
Callous.
1. Constitutional
Treatment : -«
■li;
Medicine.
Diet.
Hygiene.
2. Local
■t
Application.
Operation
( 1. Ci
. ^ 2. Di
(3. G]
Curetting.
Dissectiug
Grafting,
Now, your first need is a medical dictionary, in
which you can learn the meaning of words,
thereby insuring a positive knowledgie, rather
than the hap-hazard, not-sure-about-it method
that is so frequently followed.
Having done this, we will pass to the sub-
heads under Etiology, which we find to be idio-
pathic and traumatic. Now the idiopathic
eauses are those which arise from some condi-
tion within the system, such as some constitu-
tional disease, while the traumatic causes are
such as arise from conditions without the sys-
tem, such as bruises, burns, chemical irritants,
etc.
Under Pathology, the various sub-heads indi-
cate the pathological changes through which an
ulcer passes. Of course you can readily under-
stand that in order thoroughly to comprehend
this part you will need to familiarize yourself
with histology. True, you may be able to recog-
nize a condition clinically, without being able to
do so pathologically.
In gaining a knowledge of the condition from
the symptoms as presented by the anatomical
characteristics, your attention will naturally be
first directed to the (a) surface of the ulcer ; next
the (b) edges; and lastly to the (c) surrounding
parts.
Out of the etiology, pathology and symptom-
atology you formulate a diagnosis ; that is, name
the condition. Or, as happens in the condi-
tion we are discussing, name the varieties.
By the sub-head "specific," is to be under-
stood ulcers that are the result of constitutional
diseases, their various forms being the same
as under the sub-head " simple," which is to be
understood as embodying conditions not due to
constitutional diseases.
You wiD, doubtless, readily understand the
various classifications given under the head of
"Treatment," barring, possibly, the operative
processes, which are curetting or scraping, dis-
secting out the ulcer and uniting the healthy
edges by sutures, and sponge grafting, or skin
grafting.
I have ignored "Prognosis," because it is in
many diseases represented by the words " favor-
able," "unfavorable," "doubtful," and what is
favorable to-day may be doubtful to-morrow.
So that of itself it is only a conclusion arrived
at after due consideration of the facts in a
case of which it is not a factor,
B616 Stanton Ave,
260
THE MEDICAL ERA.
[Vol, VI. No. A.
THE TAI^ OF A TUBERCLE.
By LYMAN R. PALMER, M.D.
vnmBAPoLxs.
ONCE upon a time a certain king of fin-
gland called his counselors about him to
solve a problem. '* If you place a fish
in a basin already full of water, why does the
vessel not overflow by the addition of the fish's
bulk?" There were some honest souls who
really couldn't tell ; but a great mathematician
appeared before the king and kindly explained
by demonstrating how this strange thing could
be. The common people were, no doubt, very
proud of their scientific neighbor, but the king,
with a curious look on his face, ordered a ba-
sin of water to be placed before him, and the
friends and admirers of the wise man hastened
to put a fish in it as soon as possible ; then
stood with hurried breath and anxious eye to
await the result. The squirming creature com-
menced to glide about to explore his odd little
home, when lo! the water began to overflow
the sid^s of the dish, flooding the table and
trickling drop by drop down on the marble
floor.
One by one the people slipped silently away,
for the king had gone, and there, with drooping
form and downcast eyes, stood the great math-
ema'tician alone — alone with his theory and the
silent fish.
There probably does not exist a specialist of
diseases of the lungs who does not claim cures
of cases of consumption. Sometimes he makes
these mighty cures according to his own
theories ; sometimes he borrows a theory from
some one else, but in either case a theory he
must and will have. These borrowed theories,
by the way, are much to be preferred, for when
the budding spring-time brings a brand new
theory along with Easter bonnets, it can be
adopted without a blush. While, on the other
hand, if the shabby old thing belonged to the
doctor himself , there would be plain common
people who do not appreciate style, and they
might comment unpleasantly on the extrava-
gance of a bright new theory every spring and
fall.
In placing a few of these theories in review,
our object is not to detract one whit from the
lustre of the noble men who claim them, but
rather to call attention to our old friend ** the
tubercle," who, up to the present time, has been
an object of much odium and reproach.
A gentleman by the name of Laennec once
published a theory to the effect "that phthisis
was tubercular, the result of a new growth in the
lungs, and the subsequent degeneration of that
growth and the surrounding lung tissue."
This theory settled the matter for some little
time, when Virchow, the great physiologist,
proved ** that cheesy masses followed pneumonic
troubles, where the tuberculous struma had
nothing to do with it. "
Next, Robert Koch, the indefatigable scien-
tist, found a little shiny thing in tubercles he
called the bacillus tuberculosis, and claimed
it was the father of our old friend **the tuber-
cle."
Now, from this date we can safely say hos-
tilities had fairly commenced, for Prof. Koch
proposed to kill these germs with an appropri-
ate antiseptic.
Sir Joseph Lister had been claiming all
along, and rightly, too, that the antiseptic was
mightier than the sword, for while the sword
had slain its thousands, disease germs had
killed their tens of thousands.
Carbolic acid is a nice, cheap antiseptic, and
when the English had their late military ex-
cursion in Egypt the surgeons used Carbolic
acid exclusively, for, you see, under this ad-
ministration all disease was caused by germs,
all germs were squelched by antiseptics, and
** all went merry as a marriage bell."
Scientists were delighted, and why shouldn't
they be ! Medicine had scored a point at last.
Poets wrote lines in honor of Carbolic acid, and
-=- the soldiers kept on dying.
France, recognizing her supremacy in medi-
cine as well as millinery, now came to the front
with an antiseptic that was good for something,
and the originator. Dr. Declat, a refined, schol-
arly gentleman, came over and dined with us in
America, and gave our young men and maidens
an opportunity to air their French.
And the great men of our land prescribed his
Phenic acid and said it was good, and they per-
formed many cures — and then they dropped
it. One might reasonably suppose that if Dr.
Declat kept up the standard of his Phenic acid
and the bacteria held out, these doctors would
not have wearied in well-doing ; but they did,
and all because some industrious German hinted
that Phenic acid was not so very strong after
all, but that Mercury was better, for they tried
it on some germs they were raising in a culture-
fluid. Boiling these germs in water often
killed them, too ; but who wants to boil a pa-
tient in order to cure his diseases 9
So, while Sir Joseph Lister's antiseptic
dressings, in the name of cleanliness, revolu-
Sept., 1888.]
ORIGINAL ARTICLES.
201
tionized surgery, the best that could be done
for a consumptive was to glare at the bacteri-
um through a miscroscope and talk to the pa-
tient about culture-fluids and what science was
liable to do for this country.
Dr. Bergeon, of Lyons, France, cured cases
of consumption with enemas of carbonic acid
gas and sulphuretted hydrogen, and his admir-
ers added nourishing injections in the rectum,
and many cases got along nicely in spite of the
fact that there was more nourishment than
theory in this treatment. But a theory was
what the doctors craved, so they told the sick
people they must not use the gas machines any
more.
On the well-authenticated saying that " it
takes a rogue to catch a rogue,'' an ofiScer of
justice, known as a Bacterium ternw, was sent
prospecting about in the bodies of unhappy
patients with positive orders to kill, destroy and
utterly annihilate that wicked rascal the baciUus
tubercidcms, which was causing so much misery
and trouble. This pigmy has afforded a de-
lightful recreation to scientific minds, but failed
to amuse the patient, and when the latter hinted
that his heart's desire was to get well, and that
this massacre of germs failed to help his cough,
the great doctors arose as one man and told him
he ought to be grateful that he was no worse.
For everyone knows that the physician who
prescribes for a patient and makes him no worse
is a great man — indeed, we may say, a very
great man !
Now, between the ebb and flow of these tides
of scientific thought, the people who had the
legacy of consumption thrust upon them had to
work out their own salvation — and the odd part
of it is that they succeeded pretty well, for the
object of their search was not scientific renown,
but health, and they found it in improving the
nutrition.
"All roads lead to Rome," and these pilgrims
after health sought very unscientific paths, but
it was a path they were in, for the beaten
track showed that other feet had been there be-
fore them. Imagine them, then, milking cows
and riding ponies and absorbing a strength and
consolation from these rural pastimes that a
compound oxygen apparatus can never give.
The maker of a pneumatic cabinet once told
me that its effects were greatly enhanced by
using it out in the country rather than in a city
office, although the plan was impracticable with
most patients ; they came to be cured, not to
cure themselves.
Speaking of ponies reminds me of a story
told by Dr. Hatch, of Minnesota. In the early
history of that state it was made the resort for
allthelungcases in the country, and one day the
doctor received a message informing him that
the junior partner of a New York firm, stationed
at Calcutta, and who was dying with consump-
tion, was on his way to the land of the Sioux,
and would shortly call on the doctor. In due
time he arrived ; a tall, gaunt, spectral being he
was, too, and the doctor told him about an ex-
ploring party that was about to start, overland,
for Montana. Enthusiasm seized the patient,
and he bought a wall-eyed pony and announced
his intention of joining the party. The pony
was very small and the invalid was very tall,
but this was a case where office fixtures didn't
bring the business, so the cavalcade set out. In
an hour the poor fellow fainted away and was
carried in the wagon. On his recovery he dog-
gedly remounted the pony and after awhile
fainted again. He prayed for death, and kept
on trying to ride that pony.
Two months later the doctor was startled to
see a rough, powerful looking man ride up to
his office door, and, dismounting from a wall-
eyed pony, stalk in with anything but the air of
a sick man. After introducing himself as the
invalid who started on the Montana trip, the
delighted doctor invited him to stop all night.
This he refused to do unless the Doctor allowed
him to sleep in the bam, which he did. The
next morning he mounted the same old pony
and actually rode to New York City. What a
sight that pair must have been, ambling serenely
up Broadway ! To the best of my knowledge
that gentleman is now, twenty years later, do-
ing business in Calcutta.
The lesson to be learned from this little story
is this : Riding a pony gave lung development,
muscular exercise, and animal magnetism to
this gentleman. Another thing : he didn't come
to a healthful climate to sit around and be
cured — he was willing to cure himself; and
again, this exercise was taken in pure air, not
in a vitiated atmosphere. A hunter will grow
lugged under an exposure that would kill the
same man if incurred in a city.
But, to resume our argument in behalf of our
old friend ** the tubercle."
Every once in a while these pilgrims seeking
nutrition were startled to see a sweet-faced gi 1
among them who was bom in the country and
who milked cows before she was old enough to
carry the pail of milk to the house. Surely, she
262
THE MEDICAL ERA:
[Vol. VI. No. ».
ought to escape the scourge ! Ask her mother.
Before that baby came ** she arose while it was
yet night and ministered unto her household."
She washed, ironed, baked, mended, cooked
meals for harvest hands and made soft soap.
Her husband read the RvaraX New Yorker for
recreation while she rested herself washing up
the milk pans. If this farmer's wife spent all
her strength in toil, where was baby's vitality to
come from ? The poor little thing grew up try-
ing to " help mother," and now here she is with
brilliant eyes and hollow cheeks among the band
of pilgrims.
Some of these pilgrims fall out of the ranks,
or, perhaps, never fall in for the reason of their
physical disability to ride these ponies that are
cantering along the path to nutrition. If they
are questioned you will find some too weak to
ride ; others are troubled with a diarrhoea which
annoys them. And here and there are those
who suffer from a rectal fistula, and the best
authority in the neighborhood is united in de-
claring that if the fistula is cured the lungs will
get worse.
Every once in a while you will meet a pilgrim
who is turning back, for he says that his stomach
is BO bad, and the diarrhoea annoys him so fre-
quently, that he has concluded not to attempt
traveling toward nutrition at all, but thinks he
had better lie down and die. If you will sit by
his bedside that night with his hot hand in yours,
probably you will notice that the cough is very
tight and it is only after a great deal of exertion
that some frothy mucus is expectorated. All
this means fever, and a dry, inflamed mucous
surface. By and by the hand grows cooler and
he sleeps quietly — along toward morning he
coughs again, but the fever is gone and large
quantities of soft, putrid matter come up into
his mouth. The poor fellow is so sleepy he
swallows it very often, and so the morning's
sun shines full on a pale, tired man, with half
a gill of tubercle pus in his stomach. By and
bye his old mother comes in with a cheery face
and a nice breakfast she has cooked herself,
just the things he used to like when he was a
boy, and the invalid proceeds to mix eggs and
broiled steak together with the tubercle pus,
and the result is diarrhoea from lack of assimi-
lation.
Pity that the good doctor could not have re-
membered that Dn DeClat's '^lodo-phenique,"
or any other good antiseptic syrup used to help
these things, and instead of galloping off after
another theory, have some compassion on a
stomach which could not hold its breakfast ; for
a little of the syrup given half an hour before
meals used to wash the stomach out and give
the meals a chance to digest.
As you walk out by the road-side and sit down
on a stump to think about these things, a shadow
falls across the way and there before you is an-
other unhappy pilgrim, staggering along, leading
his pony after him. It may be you are bold
enough to ask him why he does not ride his pony
and enjoy himself instead of stumbling about in
that irresolute way. He will tell you that he
cannot ride, or, indeed, do any thing successfully
except to sweat and groan. For this unfortu-
nate, besides the old story of bad lungs, irritable
stomach, and night sweats, tells you he has a
rectal fistula, and the doctor is afraid to treat
it, for that would make the lungs worse and kill
him sure.
Suppose you invite the good doctor to insert a
probe into the fistulous opening and measure the
distance from the external surface to the point
of entrance into the rectum. Then give him ah
examining speculum and tell him to introduce
it into the rectum just that distance and tell you
what he sees. If he is a nice, honest man he
will probably tell you he doesn't see a thing.
Wipe off the mucous surface with a pledget of
cotton and call his attention to a small, thread-
like groove leading from the internal fistulous
opening to a raw, bleeding spot as large, per-
haps, as a twenty-cent piece. The excited doc-
tor declares it is ulcerated, and while seated on
the wood-pile back of the kitchen you chat with
the doctor about his case. He grows very in-
dignant that his alma mater never taught him,
what now he clearly sees, that a fistula is the
drain to some ulcer which has eaten its way
down below the mucous surface and chosen the
easiest channel of exit. Now, the matter is
plain, that if the drain is obliterated the prod-
uct of the ulcer is necessarily absorbed, and if
that product, as in this case, is tuberculous,
necessarily the system is vitiated and the lung
trouble increased. As the doctor continues to
say harsh things about medical colleges in gen-
eral and his own in particular, possibly you had
better cheer him with the story of the man who
went fishing and bought five cents worth of lit-
tle worms of a briny son of the deep who was in
the worm business. The fish did not bite very
well and the gentleman laid it to the bait ; said
the worms were too small. The indignant worm-
merchant retorted, " How big a worm do you
expect to get for five cents, anyhow ? Do you
suppose you will have a sea-serpent ? "
Sbft., 1868:}
ORIGINAL ARTICLES.
263
My dear fellow, if yon will insist on attend-
ing some five-cent medical school you must not
expect a diploma from Edinburgh !
You say these professors should know more.
But if they knew more they would not be teach-
ing in such a school. As Dr. Babb, of Cincin-
nati, said about his hired girl, <'If she knew
more, she wouldn't be a hired girl."
The experience of another may lead him into
a different channel, but my own judgment in
these cases teaches me to treat the stomach and
intestinal canal first, and the lungs last. Sup-
pose, for instance, the office door opens and a
young than enters, sits down, and commences
to tell his little story. He is eighteen years old ;
been sick two years ; mother just died with con-
sumption ; has been in the pineries ; has been
out on a farm ; found it lonesome ; has a bad
diarrhoea ; seventeen passages a day ; no appe-
tite; temperature 103^^; pulse 132; weight
105 pounds; very weak; sweats profusely at
night ; feet swell ; examination made by a pro-
fessor of microscopy shows tuberculous infiltra-
tion of the lungs ; also, the epithelium is dis-
charged in strips, showing rapid disintegration
of the structure ; patient has frequent hemor-
rhages.
The rectum is highly inflamed, and the upper
one-fifth of the gut shows five ulcers, the largest
the size of a five-cent piece ; the smallest the
size of the head of a pin. The ulcers are not
sensitive — a peculiar feature of the ulcerations
of a consumptive, in which it is analogous to
syphilitic ulceration. In the ulcerations pres-
ent in an old soldier, for instance, with chronic
diarrhoea, the ulcer is peculiarly sensitive.
The patient's first question is, "Can you help
me ? " Take the boy right out to the nearest
livery-stable, and tell him to ride to some given
point and back on a horse. His condition when
he returns gives you an accurate estimate of his
real strength. Next put the patient on the table
and use an electro-thermal conductor in the
rectum. No matter how labored the breathing
may be, it is relieved by the heat in that situa-
tion. Dr. Hamilton, of Michigan, was the first
to call attention to the fact that the lack of co-
ordination between the respiratioij and the heart
in a consumptive is adjusted by heat in the
rectum (I have no theory in the matter. That
I leave for Dr. Hamilton to explain for himself,
which he is thoroughly capable of doing). Next,
we dress the ulcers with Beech tar cerate. Dr.
Porter, of Michigan, prefers Carbolic acid, but
my experience with consumptives does not allow
me to agrefe with him. Next, I order a syrup
of Beech tar, a tablespoonful one half hour be-
fore meals. Next, in this particular case, I ad-
vise inhalations of the volatile antiseptic made
of Beech tar.
My reason for chnging to Beech tar so closely
in these cases is because that drug is the only
antiseptic that has given me satisfaction in con-
sumption. The element Creasote in smoke
cures a ham, preserves it, and I obtain the same
effect on a tuberculous lesion. Next I persuade
the boy's father to buy a pony, and the patient
is to ride every day on horseback. No matter
if he cannot go forty rods — ride! Last, but
not least, in the name of the immortal Hahne-
mann, while all we have done so far is purely lo-
cal, like washing out a wound, we now prescribe
Sulphur, high, dose once a week, for the dys-
crasia which produces the original trouble.
lu examining a re ctum in these cases it is ut-
terly useless to use anything but a long open-
end speculum. The long Hamilton speculum
is my preference, although the Young speculum
also has an open end and is valued very highly,
and, by the way, when a speculum is introduced,
say two inches, and stops short, take it out,
treat the patient a few days with heat and elec-
tricity, and then proceed with the examination.
The mucous lining was too dry.
In conclusion, I will say that our dear friend,
the tubercle, has benefited the human race in
that it has stimulated thought and developed
research as no other disease has done before or
since, and honor is always due a formidable foe,
and such an one these conflicting theories cer-
tainly indicate are found in "the tubercle.*'
MOBRHUOL.
bt e. m. hale. m.d.
CHICAGO.
THIS substance contains the medicinal prin-
ciples residing in cod-liver oil, extracted
by alcohol at 90 °. The alcohol becomes
colored, and yields, on evaporation, an amber-
brown, bitter, aromatic liquid, partially crystal-
lizing at the ordinary temperature, and con-
taining combinations of Iodine, Bromine,
Phosphorus, Phosphoric acid. Salts of Lime aild
Magnesia, Sulphur, biliary and fatty acids.
The oil thus treated becomes inodorous and
tasteless, and resembles any animal oil. The
curative action of cod-liver oil, therefore, depends
on the Morrhuol. The oil given without this ex-
tract m^y fatten, but only as butter, cream, bacon,
or any pure oil does. If the reader will refer to
the article on *' Oleum Jecoris," in my ** Thera-
264
THE MEDICAL ERA.
[Vol. VI. No. 9.
peutics of New Remedies," published nearly ten
years ago, he will see that I then expressed the
opinion that in the constituents of the .oil we
should find the real curative properties. I
wrote:
** The fact of the presence, in cod-liver oil, of
some of the ' antipsorics,' in minute quanti-
ties, gives it its real value in certain diseases of
a chronic character. It cures the same class of
diseases for which we prescribe Iodine, Bromine,
Phosphorus, Calcarea and Sulphur. Many ex-
periments, made with great care, prove that no
other oil has the same curative action. They
may fatten, but the disease goes on unchecked,"
etc.
In that paper I gave a list of idiseases and
conditions which had been treated successfully
by cod-liver oil. All those diseases were due to
a scrofulous or strumous diathesis.
It has been observed that all the hrown oils,
i. e,, those richest in Morrhuol, were the most
efficient. The light oils, those which had been
purified, were more fattening agents, but did not
cure.
M. Chapoteaut, in 1884, initiated a research
having the following leading idea (previously
enunciated by me in 1878) : ** Would it be pos-
sible to replace cod-liver oil or modify it in
such a manner as to remove its disadvantages
and to retain its advantages?" "Is the oil
a * food ' as regards its fatty matter, but a
' specific remedial agent ' as regards its active
principle ? " Morrhuol he found represents twen-
ty-five times its weight of cod-liver oil. In
other words, one dram of Morrhuol represents
twenty-five drams of the oil. I think it could
be reduced still further. It is now put up in
capsules, each containing four grains. It is a
thick, brownish, sticky mass, of a taste com-
bining all of its constituents.
It is my opinion that this substance couli
be prepared in triturations, up to the sixth,
and in that form would show its specific cura-
tive effects as well, if not better, than in the
crude substance ; but this remains to be tested
in practice, which I hope will soon be done.
In a i)amplilet recently published are given
a great many typical cases, in which the cap-
sules were prescribed, and the results were
very gratifying.
I subjoin a list of the diseases and condi-
tions in which Morrhuol was found curative:
Incipient tuberculosis, chronic bronchial ca-
tarrh, scrofula in children, phthisis in the first
and second stages, swelling and suppuration
of glands, etc.
Even in these large doses, it never deranges
the stomach or causes nausea and vomiting ; on
the contrary, the appetite increases, digestion
improves, and the bowels become regular, even
when obstinate constipation is present. Its ef-
fects soon manifest themselves in the improve-
ment of the general health. In fact, we have
all the improvement ever observed in those cases
where cod-liver oil has had its most happy influ-
ence.
Prof. Germain See thus sums up his observa-
tions :
1st. An improvement in the appetite and
regularity of the digestive functions.
2nd. Increase of weight and firmness of
flesh.
3rd. Increase of urea in the urine.
4th. Diminution of the cough.
I would suggest its use in all cases of ansB-
mia in scrofulous children or adults, in chronic
rheumatism and gout, and even in chronic
malarial poisoning. If the administration of
Morrhuol does not fatten by improving digestion
and assimilation, we can aid its action by giv-
ing cream, butter, bacon, malt, and other fat-
tening agents which have no repulsive taste or
odor.
A CASE OF STONE IN THE BI<ADDER.
By E. H. PRATT, M.D.
(Reported by M. J. Bliem, M.D.)
CUICAOO.
[Read before the Illinois Homceopathic Medical AseociatioD.]
BOTH the literature and the operation per-
taining to stone in the bladder are classical,
dating back to Hippocrates, from whom all
things medical fiow. I mention the old father
simply to begin right, for to begin short of him
would amount to medical mendacity. It may
be thought that to say anything on this ancient
subject is superfluous and demands an apology.
This apology must be found in the fact that
the case before us presents several unusual and
interesrting features.
The patient, an old and prominent citizen of
a neighboring city, is 70 years of age. About
eight months f^o he came to Prof. Pratt with
the following history: For several years he
had been unable to pass water without the aid
of a catheter. The urine was alkaline in reac-
tion and, on standing, deposited pus to the depth
of a third. There was constant pain in the re-
gion of the bladder, and in the head of the penis.
Indeed, this organ was considerably enlarged
from the constant handling to ease the pain.
Sbit., 1688.1
ORIGINAL ARTICLES.
265
Latterly the necessity for using the catheter be-
came more and more frequent, so that half an
hour was an average interval. An enlarged
prostate had been diagnosed and the inability to
urinate attributed to that. He also suffered
greatly from constipation, succeeding in reliev-
ing the rectum only by digital aid. Upon exam-
ination the prostate was indeed found enor-
mously enlarged and a severe hemorrhoidal con-
dition in the rectum. No difficulty was met in
passing even the largest sound, nor could any
.stone be detected either by the searcher or the
sound. With still a suspicion of stone, it was
decided only to clear up the rectal condition.
As a result of this work, the patient gained in
general health and spirits, his constipation was
somewhat relieved, and the prostate for a time
reduced in size. He was weaned from the use
of Opium suppositories, but did not mend in the
matter of passing water, though able to retain a
longer time. After four months of improvement
he came to a halt, when all the old symptoms
reappeared with redoubled force, and it became
apparent that something must speedily be done
to save the old gentleman's life. Twice again
was the bladder sounded, with the same negative
result. The pain was becoming excessive, the
calls to draw urine so frequent as to disturb all
rest or sleep, the urine was fetid with pus and
blood, and phosphatic gravel was frequently
passed. There was no evidence, however, of
any kidney trouble. With only symptoms to
guide, the bold decision to cut into the bladder
was made, and Mr. T*s consent obtained. This
decision was made in the face of the classical
and fundamental rule never to cut for stone un-
less it be first detected by the sound, and that,
too, must be accomplished at the time of the
operation ; if not successful, the operation must
be postponed. In view of the severe catarrhal
condition, the proposed section might be justi-
fied as a relief and mode of cure for that. The
inability to urinate was due, as we have seen,
not to any obstacle offered by the enlarged pros-
tate, but to the atonic condition of the bladder
walls. When atony is the result of vesical
catarrh simply, the authorities do not recom-
mend an incision and drainage as a means of
cure. Therefore, the main justification for the
operation must still be found in the large hope
of finding a stone.
The question now to decide was, which form
of the operation to choose — perineal or supra-
pubic. Lithotrity was ruled out from the very
nature of the case. It was decided to perform
the lateral perineal section. In these days, when
it is entirely the fashionable thing to do the high
operation, I suppose this will be considered woe-
fully beliind the times, and a demand be made
uiijfti us for a '* reason of the faith that is in
us.'* Briefly, then, in view of the catarrhal con-
dition and our ignorance of the size of the sup-
posed stone, the principal thing to provide for
was such drainage as could be long continued
and as would thoroughly drain the base of the
bla^dp.r. The perineal section best answered
the' conditions and was therefore chosen.
With plenty of assistants then, and all prep-
arations for a thorcnighly aseptic operation, the
task was begun. It was my lot to hold the post
of honor, i.e., the staff. With knife in hand, the
doctor was ready to proceed, when, holding the
staff firmly upright, I suddenly felt a grating
agslifist it. A slight movement to the left, when
a^ticA — again a duk — and with joyful assur-
ance the surgeon addressed himself anew to
his now most hopeful work. The incision was
quickly made, but so enormous was the prostate
that the operator was unable to reach the blad-
der with his finger. After considerable search-
ing with the forceps he finally grasped the stone,
lying high up on the left side, in a nest of its
own. On account of its size and encysted con-
dition it required no little manipulation to ex-
tract the prize. When held up to our admiring
gaze it appeared the size and shape -of a me-
dium sized hen's-egg. The bladder was now
washed out and a shirted canula, packed with
styptic cotton, inserted. The patient endured
the operation very well, with no signs of shock.
Our object in the after-treatment was (1 ) to
wash out the bladder, and (2) to continue drain-
age until the bladder was well restored to its
normal condition; our criterion to determine
the time for allowing the wound to heal was the
acid reaction of the urine. Upon this point val-
uable light was thrown by Eeginald Harrison's
recent lectures upon " Some Points in Urinary
Surgery." A silver male catheter, vrith the
curve cut off and closed at the end, was kept in
the bladder ; the enormous size of the prostate
can be estimated when I state that it was nec-
essary to insert the tube to a distance of 6.7
inches before it reached the bladder. A long
rubber tube was attached to the outer end of the
catheter, thus conducting the urine into a vessel
under the bed. Twice a day the bladder and the
wound were washed out through the tube with
a warm solution of Boracic acid and Hydrastis.
(To a pint of warm water, a tablespoonful of
powdered Boracic acid, and a teaspoonful of
fluid extract of Hydrastis.) After the first few
266
THE MEDICAL ERA.
[Vol. VL No. ft.
days, when the acute swelling had sabsided, and
it was therefore easier to pass a rubber tube, the
silver tube was replaced by a soft catheter, to
which the long tube was again attached, through
an intervening short glass tube. This was
more comfortable to the patient, admitted of
freer movement on his part, and kept him per-
fectly dry.
A most remarkable feature of the case was
his steady and rapid progress to recovery. There
never was a shadow of fever, no back-set in any
direction. This must be attributed largely to
the patient's natural hardy cofistitution and his
life-long temperate habits. Blood and pus
rapidly disappeared from the urine, and in three
weeks from the day of operation its reaction
was acid. The tube was now withdrawn and
the wound began rapidly to heal. The interesting
point now was to see whether the bladder had
suflSciently recovered its tone to expel the urine.
Within 24: hours of the removal of the tube
drainage was so far checked as to cause a col-
lection of urine in the bladder. This naturally
caused some distress, and the patient twice in-
sisted upon using the catheter. Then he was
dissuaded long enough to allow the bladder to
suddenly (and to the patient's astonishment)
give a pretty exhibition of a miniature geyser
act. From that time on to this day he has
passed water naturally, and he can now go two
and one-half hours. In four weeks from the
operation he went home. It is now six weeks,
and the perineal wound is almost healed ; only
occasionally a few drops pass, but it bids fair to
be entirely closed by the time of this reading.
(The prostate is largely diminished.) The patient
is well and highly gratified with his fortunate
deliverance, but begs to be excused from laying
any more of that class of eggs.
To recapitulate, the value and interest of this
case seem to me to lie in the following points.
1st. The advanced age of the patient — 70
years — and the remarkable and unbroken speed
of his recovery ; statistics show one chance in
four for that age.
2nd. The enormous size of the prostate
gland.
3rd. In the failure to discover the' stone by
sounding, due to its peculiar location. I attrib-
ute the contact of the staff with the stone to the
straight and long form of its beak ; it chanced
to be of just the right form and in the right
position to strike the stone in its unusual loca-
tion.
4th. As involving the essential point of
rightly choosing between the two modes of op-
eration. The result showed the wisdom of do-
ing the low operation.
5th. And finally, as illustrating the rule by
which to determine the time for ending drain-
age — namely, the acid reaction of the urine.
OBEBKATION.
Bt J. E. OILMAN, M.D.
CHICAGO.
[Read before the Illinois Homoeopathic Medical Aeooclatlon.]
AMONG the ancients sanitary science was
undeveloped. The Romans were the
most advanced sanitarians of any of the
people of remote times, and many of their sani-
tary regulations and customs are worthy of
consideration even in this day.
Beligious belief and the superstitious observ-
ances of a nation from that time to the present
have largely controlled the disposal of the dead,
and to this fact may undoubtedly be ascribed
the change from the Roman and Grecian prac-
tice of cremation to the horrors of the heaped
up masses of corruption in and about the chapels
and churches of the Christians.
The early Christians had such a firm belief
in the resurrection of the material body, that the
depositing of the body in the ground seemed to
offer to the unreasoning people a security for all
time. Added to this belief was a superstitious
faith in the efficacy of sacred relics, and we can
readily understand the great desire exhibited
that the mortal remains might be placed in as
close proximity as possible to the altars of the
sanctuaries. As time rolled on and the popula-
tion increased, these burial places were filled to
the utmost, and before corruption had fairly
done its work, often the occupant of a grave
was disturbed by a new-comer, who in turn was
displaced or crowded by succeeding tenants.
The earth was saturated to overflowing with the
products of decay and the vaults and receptacles
of the dead in the churches have been found "to
be converted into cisterns in which the floating
coffins '* jostled against one another.
It is almost incredible the extent to which
this practice was carried, and the investigations
instituted by the English parliament and the
records of different parishes present a chapter
of horrors that reads like a nightmare. *'In
London, in some of the poorer districts, the soil of
the churchyards was raised two, three, or even
four feet within a few years, and in the imme-
diate neighborhood of such cemeteries epidemic
diseases were both more common and more fatal.
SiPT., 1868.1
ORIGINAL ARTICLES.
237
Within thirty years there had been interred
more than 1,500,000 bodies in a space not ex-
ceeding three hundred and eighteen acres/*
In London there are about 100,000 deaths
annually, and these bodies are buried in surface
soil around London, so that in a generation of
thirty years three millions are interred near to
the dwellings of the living. Sir Spencer Wells
says: "It takes twenty years for a body to resolve
itself into its original elements, and London has
therefore always two millions of bodies beneath
its feet and at its doors undergoing harmful de-
cay and occasioning danger to the living by the
pollution of the water supply and the atmos-
pheric germinations of disease.''
"You Arabs," said one of the Northmen in
Bussia to Ahmed Ibn Forzlau, ** are fools. You
take the man whom you most have loved and
honored and put him down in the earth where
vermin and worms devour him. We, on the
contrary, bum him up in a twinkling, and he
goes straight to Paradise." No form of disposal
of the dead can become common or be accepted
by a civilized and educated people that lacks the
semblance of complete respect and reverence for
the earthly garments of the departed spirit.
The personality of the individual still lingers
about the cold clay, and a rough movement or a
rude touch shocks the sensibilities of the be-
reaved friends and hurts the living with an ex-
quisite pain. To cremation as it was originally
performed there might be urged many reason-
able objections. The funeral pyre failed to
completely incinerate the remains in all cases ;
and if this were the only method offered, that in-
herent esthetic sentiment of reverence with
which we invest the dead would be wounded too
deeply to admit of its general adoption. But
in its place suppose a suitable building were
erected where such mortuary rites or funeral
services as were desired should be performed ?
The friends and attendants are sheltered from
the inclemency of the weather ajid relieved from
dangerous exposure. " The body, placed upon
a catafalque and covered with a pall, descends
upon an elevator noiselessly to the cremating
chamber. When the door of the retort is
opened the inrushing air cools it from a white
to a red heat and the whole interior is filled
with a rosy light that is fascinating to the eye.
The body, clad as for burial, is reverently laid in
a crib, which is covered with a clean white sheet
soaked in alum. The crib is then placed in the
retort. The sheet retains its original position
and conceals the form until nothing but the
bones are left, and these gently crumble into
dust as under the touch of an invisible agent.
The process might be caUed etherealization of
the body. There is nothing repulsive or painful
about it ; nothing remaining but a few pounds of
clean, pure, pearly ashes, which are taken out and
put in an urn of terra-cotta, marble or some
other suitable material and placed in a niche in
the columbarium, buried or delivered to the
friends to be disposed of as they may de-
sire." No flame touches the body; it is the
action of incandescent air alone. ** There
is no noise or smoke, no repulsive sight or
smell, nothing that could offend the most fas-
tidious, all the products of combustion being
rendered innocuous and odorless, before liber-
ated in air." This is a process of purification
of the body, and the mind can at least dwell
upon its details without loathing, while -the im-
agination may invest it with symbolic imagery.
Disease germs and those poisons generated in
rapid progression are at once blotted out, re-
maining no longer to pollute the earth and air,
while, on the contrary, if the earth receives the
body, "what is sown in corruption will be raised
in corruption, as an avenging ghost at many a
sick-bed side." And this suppositious form of
incineration is not a baseless fancy, it is already
realized.
There are several forms of cremating furnaces
even now constructed that accomplish all this
as described. Sir Henry Thompson, of En-
gland, says : "A powerful reverberatory furnace
will reduce a body of more than average size
and weight, leaving only a few white and fragile
portions of earthy material, in less than an
hour."
Brunetti, professor of pathological anatomy
of the University of Padua, exhibited at the
Vienna exposition some examples of the process
of cremation. With his furnace and method
the whole process of the incineration of a human
adult body occupied three and a half hours.
The ashes and bone earth weighed about three
and three-fourths pounds. They were pearly white
and were contained in a glass box about twelve
inches long by eight inches wide and eight
inches deep. The quantity of wood required to
effect absolute and complete incineration may
be estimated from its weight, about one hundred
and fifty pounds. Its cost was one florin and
twenty kreutzers, about sixty cents, and this
leads to the subject of cost and cremation
viewed in its economic aspect.
The expense of an average funeral to a famDy
in very moderate circumstances will not fall
short of one hundred and fifty dollars, and the
268
THE MEDICAL ERA.
[Vol. VL No. 9.
usual amount will considerably exceed this sum.
Custom rules, and the outlay is an onerous tax
upon the slender resources of the majority of
people. To exhibit fuir regard and honor for
the dead many poor people impoverish them-
selves and enter into expenditures that must be
followed by pinching economies and deprivation
of many things actually necessary for comfort.
Among that class in society least able to aflford
it the funeral services and rites demanded by
popular usage are most lavish, and the remark
made by a poor woman whose husband was
being conveyed to the burial-ground, expresses
the feeling which excites this outlay: **Poor
Mike would be a proud and happy man this day,
could he but see what an illigant funeral he's
havin'. ** The cost represents the respect that
the family possessed for the deceased member,
and the slurring remarks and ill-concealed
sneers if moderation is observed -are insur-
mountable obstacles to reform in this direction.
Rev. Mr. Benglass, of New York, says : " Apart
from the burial lot and the tombstone and the
expense of carriages, the average cost of a
funeral among the lower middle classes in and
about New York is not far from one hundred and
fifty dollars. The average cost of lots in Wood-
lawn and Greenwood, each containing space for
six graves, is about four hundred and fifty dol-
lars, or seventy-five dollars a grave. The cost
of single graves in the public lot is twenty-five
dollars each. The cost of a moderate head-stone
and foot- stone and their erection will add seventy-
five dollars more, making a total of two hundred
and fifty or three hundred dollars. These three
hundred dollars, more or less, have to be paid in
advance by the poor, to raise which they alone
know what sacrifices must be made. On the
other hand, apart from carriage hire, which we
may assume to be about the same in either case,
the cost of cremation decorously performed,
including the case in which the body is carried
to the crematory, should not exceed forty dollars,
while the cost of the terra-cotta urn of classic
pattern, the most tasteful and appropriate pos-
sible, could not exceed five dollars. Add ten
dollars for a niche in the columbarium, in which
the urn may find a permanent resting-place, in
case the friends should not wish to take it to
their homes, and still another five dollars for an
inscribed tablet under the niche, and we have
sixty dollars as against four or five times that
sum for earth burial."
The increasing number of crematories is an
indication of the growing interest that is being
taken in the subject. In Italy, England, Ger-
many, Denmark, France, and other European
countries, cremation societies have been formed,
and large numbers of scientists and prominent
men have enrolled themselves as advocates of
this method of disposing of the dead.
There is one haunting fear that has been ex-
perienced by every one, and by some it is so
vividly present as to be a source of great mental
anxiety — that is, the dread of being buried
alive. That at the present day this can scarcely
happen is true, but the instances of its occur-
rence are sufiiciently numerous to make the
subject one that deserves notice. After the
body is placed in the burial casket, and the
coffin firmly closed, no further opportunity for
discovery of any indication of life remains,
and during the continuance of an active epi-
demic disease of a virulent type the short period
of time that must necessarily elapse between
the death and burial renders the chance on
verification of death less certain, especially if,
as in the case of cholera, there is such a condi-
tion of collapse and semblance of the phenomena
of dissolution as we know may occur. If life
still remains, the unhappy victim may be re-
turning to the full consciousness of the horrible
fate (the most awful condition the mind can
conceive) while the earth is being cast back into
the half filled grave, and, bound down and stifled
in the close prison, can make no move or sound
to attract attention and avoid the appalling
sequel. Death in the incandescent air would
be merciful as compared with this, while the
chances for such death would be materially
lessened. The body, up to the period of actual
entry to the chamber, would be in condition to
make a demonstration if life was not yet extinct.
And with the first contact with the heated air
the effect would be revivifying and even then the
destruction might be avoided. Certainly, if in
any way a method of determining the existence
of any remaining spark of vitality can be de-
vised, cremation offers a better opportunity than
interment to avert the impending destruction.
After all, talk and reason as we may, the great
obstacle in the way of an immediate adoption
of the practice of cremation is hereditary habits
and sentiment. It remains, then, for us to cul-
tivate the sentiment favorable to incineration,
and gradually habit will succumb to its often
repeated usage.
Among wild tribes and nations, where crema-
tion is the form used, local traditions and beliefs
crown and beautify the mortuary act with a
symbolic imagery that appeals to all the innate
poesy and superstition of the untutored mind.
SMm 1888.]
ORIGINAL ARTICLES.
269
And among civilized nations also this sentiment
and play of imagination must needs be centered
about the crematory act to make it a common
proceeding. The actual mechanism of the work
must be so gilded and idealized that the
afflicted mourners receive a sad comfort in the
significance of the symbolic dismemberment of
the body.
What more can be said. The interests of sani-
tation and purity demand this clean method of
purification in the place of a process which
offends all sense of delicacy, and destroys all
sentiment concerning the actual condition of
the deceased. '^By just so much as ashes are
purer than putrescence, is cremation a purer
method than earth burial, and one aroimd which
a free and healthy sentiment can entwine
itself." The imagination receives no rude shock
as the elements receive into their embrace the
mortal remains through its baptism and purifi-
cation. As the winter's snow dissolves into im-
palpable vapor under the light and warmth of
the summer sun, so man's body, cold in the icy
grasp of death, melts away in the incandescent
air, and resumes its elemental form and its
duties in nature's economies without the inter-
mediate horrors of decay. Pure in spirit man
enters the world, and the elements receive back
the body purified by this agency, and freed
from the long process of contamination, and the
body, bathed in the halo of the rosy light, re-
enters its primal form surrounded by all the
gorgeous magnificence of the departing day.
THEBAPBXTTICS OF PHTHISIS PULMONALIS.
By W. a. KALBR, M.D.,
OHICAOO.
TRead before the Illinois HomoeoDatliic Medical Ass^ociatloo.l
THE therapeutics of phthisis is a subject of
such vast importance that I feel no apol-
ogy is needed for any contribution to it,
whether it be new and startling, or only a sum-
ming up of the knowledge we possess.
I only intend in this paper to formulate the
therapeutical measures that have been found by
a pretty extensive experience to be most efficient
in the treatment of phthisis pulmonalis, and to
review briefly some of the late measures that
have been proposed, tested and found wanting.
Clinical experience has long since demon-
strated that of most importance in the treat-
ment of this disease are such measures as pro-
mote the general nutrition. The environments
of the patient should be as pleasant as circum-
stances will permit. Undoubtedly a change of
residence to a locality where the atmosphere is
less humid and where the thermic and baromet-
ric changes are less sudden and severe is often
beneficial and in some instances is thought to
be exceedingly so ; but phthisis is indigenous to
all climates and countries, and patients who are
not able, for want of means, or from other causes,
to make the change, tod live comfortably, may
probably do as well to remain where they have
the comforts of an established homeland are
surrounded by their friends. But whether the
patient remains at home or goes abroad there
are certain hygienic measures which are of
prime importance and should be rigidly
enforced : Exercise should be persistently but
judiciously taken, and should be of a kind that
is pleasant and practical, varied to suit the
changing strength and conditions of the patient,
but stopping short of fatigue. Bathing is of no
less importance than exercise, not only for
cleanliness, but to keep the skin in a healthy
condition, promote the peripheral circulation
and thereby put the body in the best possible
condition to resist the ill effects of cold and
atmospheric changes.
In the early stage of the disease, while the
patient still has sufficient vital powers to react,
the cold sponge bath taken in the morning
immediately upon rising, and followed by thor-
ough friction, is very grateful and beneficial;
when it cannot be borne, a bath should be
taken later in the day, but as cool as the condi-
tion of the patient will permit, and repeated as
often as the judgment of the physician may
dictate. Day and night, and all seasons of the
year, the apartments of the patient should be
kept at a comfortable temperature, and thor-
oughly ventilated. Ventilation is very import-
ant, especially if another person occupies the
same apartment, since it is known that phthisis
is in a certain degree contagious.
The clothing should be of wool, especially the
underwear, and sufficient in quantity to ensure
comfort and protection from changes in the
temperature of the atmosphere. As a rule, the
instinct of the patient will lead him to dress
comfortably if he is able, unless he is a devotee
to society and cares more for fashion than
health.
The diet should be generous and varied within
the limits of prudence to suit the caprices of the
appetite, but should always be nutritious and
easily digestible. The fats and hydrocarbons
270
THE MEDICAL ERA,
[Vox*. VL No. 9.
(starch and sugar, and especially, if there is
.much wasting and a high temperature, alcohol,
preferably in the form of whisky) should form
a prominent part of the diet. Undoubtedly
cod-liver oil is the most assimilable of the fats,
and much of its unfortunately disagreeable
taste may be disguised by combining it with
lime-water or some other alkaline solution in the
form of an emulsion, or by adding a little
whisky or some vegetable bitter, as Hydrastis
or Wild cherry. ' •
Great care should be exercised to keep the
stomach and bowels in the best condition and to
maintain the digestive powers. The extract of
Malt is not only a nutritious article of diet,
but by virtue of the diastase which it contains
assists in the process of digestion by converting
starch into glucose ; it is especially to be recom-
mended in those forms of dyspepsia where
starchy articles of food disagree; it may be
taken alone or combined with the cod-liver oil.
The syrup of the hypophosphites introduced by
Dr. Churchill, of Paris, a few years ago, as a
food and a medicine has been extensively tested,
but now generally discarded as worthless.
Among the therapeutic measures that have
been proposed in the last few years may be
mentioned live mjection of cavities with medicated
fluids; a few cases of improvement following
this operation have been reported, but the
results have not been sufficient to warrant its
adoption as a practical therapeutic measure.
Since Koch's discovery of the baciUus tuhercib-
lasts, scientists have been trying to find some-
thing that will destroy the bacillus and not the
patient, but no specific for phthisis has yet been
discovered. The Declat phenic-acid treatment
had its day and is now one of the things of the
past. In septic conditions of the system, due to
the absorption of putrid matter from the soften-
ing tubercular masses, it is undoubtedly of some
value, but it do^s not arrest the progress of the
disease or prevent the further formation of tu-
bercle. Later, the treatment introduced by
Bergeon by enemata of carbonic-acid gas
charged with sulphuretted hydrogen has been
pretty extensively tried, but is now generally
discarded ; like phenic acid, it is useful only in
septic conditions and fails to reach the seat of
the badUiiSy or at any rate fails to reach it in
sufficient quantity to destroy the baciUus or pre-
vent its making further progress. Twelve cases
were treated by this method in the Illinois State
Penitentiary Hospital last summer, faithfully
and persistently, but with no better result than
to relieve some of the symptoms due to septic
poisoning.
Pneumatic differentiation, or the breathing of
an atmosphere of different density than that
surrounding the body, has been in vogue for a
number of years, but has been more extensively
used lately since the introduction of the pneu-
matic cabinet. I have never used it, but from
the reports of those who have, I think it is use-
ful only as a means of developing the respiratory
muscles by exercise, and expanding the lungs to
their fullest capacity. I cannot see how it can
have any direct effect on the disease process or
its cause. In March of the present year Dr.
W. Leonard Braddon contributed an article to
the London Lancet, on Oil of Peppermint as an
antiseptic and as a remedy in phthisis and
diphtheria, in which he reports improvement in
several cases of phthisis treated with inhala-
tions of the oil. He leaves no doubt as to its
antiseptic property, and on account of its vol-
atility it ought to prove useful as an inhalation
in phthisis ; at any rate, as it is harmless to the
higher forms of life, it may be used with impu-
nity and should be given a thorough trial. The
chief therapeutic resources of our brethren of
the old school are, besides what I have already
enumerated, for the general condition. Iron
(where there is no hflemoptysis) and the vege-
table tonics. Fpr special symptoms, palliatives
such as —
For insomnia and night cough : Ex. Hyos-
cyamus, Chloral hydrate. Bromide of potash, or
as a last resort some preparation of Opium,
For the fever : Quhiine or Antipyrin.
For night sweats: Atropia and the astrin-
gents, chief of which for this purpose is Tannic
acid.
For hsBmoptysis : Ergot, Morphine.
For the dyspepsia, such remedies as are used
in other cases of dyspepsia.
For diarrhoea : Astringents and Opium.
For pharyngitis: local treatment with Co-
caine, Nitrate of silver, etc.
For to relieve the pain and distress, which in
some instances is so severe at the last. Mor-
phine.
I have not often had to resort to any of these
palliatives except the last.
MEDICAL TREATMENT PROPER.
If I could have but one remedy in the treat-
ment of phthisis in all its stages from beginning
to end, I would unhesitatingly choose Calcarea
carl)onica, and if I am not mistaken this is the
SxPT., 1886.1
ORIGINAL ARTICLES.
271
verdict of all homoeopathists who have had
extensive experience with this disease. It is the
most useful remedy, as recommended by Dr.
Hughes, in that pretnbercular stage which is
characterized by dyspepsia, with (sometimes)
acid vomiting; inability to digest fats, oils and
sugar; defective nutrition and consequent
emaciation and general failure of the vital
powers. Here it will restore the appetite, and
improve digestion and assimilation, even when
it has no perceptible effect in preventing the
formation of tubercle, and it has entirely cured
many Buch cases of dyspepsia, but whether they
were really pretubercular or not, that is, whether
they would have developed as tubercular cases
if left alone, or not, it is impossible to say. In
that other class of cases in which the invasion
of the disease is marked by slight but persistent
cough, often dry and spasmodic, and sometimes
followed by vomiting without nausea, and
languor, and slight hectic fever are present,
Drosera may do more good, or if there is also a
persistent, rapid pulse, dyspnoea on exertion, and
the vomiting is preceded by nausea and made
worse by eating and drinking, Arsenicum is indi-
cated, but even in these cases Calcarea carb.
will improve the general condition.
When the case is confirmed and tubercular
deposits have actually formed, as shown by
physical examination, we have various indica-
tions to meet, and I will divide the rest of the
subject accordingly.
Cough : Worse at night. Hyoscyamus, Lobelia
or C(Hiium ; spasmodic and followed by vomiting
without nausea, Drosera. I habitually use this
remedy in the mother tincture, but when it fails
I find the 3x acts well.
Fever : Calcarea carb. ; Baptisia ; the latter
is, but the former is not, strictly speaking, an
antipyretic. Calcarea carb. is indicated by the
general condition, where with the fever there is
copious perspiration, especially at night, copious
purulent expectoration, anorexia and general
weakness.
Clinical experience confirms every day what
Dr. Mitchell wrote years ago of the value of
Baptisia. He speaks of having seen it ** reduce
the pulse from 120 or 130 to 80 or 70, change
a steep temperative curve to one comparatively
smooth" and therewith ** reduce profuse puru-
lent expectoration almost to nothing, and almost
banish cough."
Night Sweats: If the Calcarea and Bap-
tisia given for fever do not control the night
sweats, Sambucus or Jaborandiwill, in nearly all
cases. I used to resort to Atropine, but I found
several persons so extremely susceptible to its
iniiuence that a one-grain powder of the 3x
would throw them into a wild delirium which
would last for several hours. I do not use it
now.
Dyspepsia : Will usually yield to a carefully
prepared diet adapted to the condition of the
digestive powers, and the remedies prescribed for
the general condition. As adjuvants, Pepsine,
Hydrochloric acid and extract of Malt, are
almost indispensable in hsemoptysis.
HiBMOPTYsis: There is but little immediate
danger, and the best thing to administer during
the hemorrhage is a spoonful of common salt in
a little water, or let the patient swallow small
pieces of ice. After the attack he should be put
to bed and kept quiet, and given Aconite 3x
every hour for the first twelve or twenty-four
hours ; after that, any remedy his condition calls
for.
Diarrhcea : When it is not due to extension
of the disease to the bowels may be cured by
any remedy that would cure a similar diarrhoea
in any other patient ; usually Arsenicum is suffi-
cient, but when it is due to tubercular disease of
the bowels, I have never found any remedy
that would do any good except Opium and the
astringents, and they only afford temporary
relief. In some cases during the last hours pre-
ceding death the patient is in an agony of pain
which is augmented by frequent spells of cough-
ing ; in such cases I believe it is not only humane,
but that it actually prolongs life to administer
Morphine in sufficient doses to procure rest.
Before I close I want to say a few words on
the oft-discussed potency question.
Most remedies act well in the low potencies
and I scarcely ever go above the 3x in any ex-
cept two or three, but I have never seen any
effects from Calcarea carb. in the 3x, and never
any but ill effects from Arsenicum in the 3x in
phthisis. Since I commenced using the latter
remedy in the 30x I have not found it necessary
to resort to any other potency. Calcarea carb.
has served me best in the 30th and 200th, but I
have seen the 1000th do wonders where the 3x
had failed.
It would be well always to bear in mind the
precept taught by Jousset, viz. : " that where a
remedy has been carefully selected, it should
not be hastily changed, but the proper attenua-
tion for the particular case should be sought for
without regard to our prejudice."
272
THE MEDICAL ERA.
[Vol.. VL KoL ».
A METHOD FOK THE RADICAL OXTBE OF
HE&NIA.
By WALTER F. KNOLL, M.D.
CHICAGO.
[Read before the Illinois Homoeopathic Medical AsBoclation.]
EVERY one knows what a hernia is. It is as
common in surgery as catarrh is in medi-
cine, and, like the latter, it may be the
most mild or the most severe and fatal disease.
It is generally approximately estimated that
twelve per cent of the adult human family are
Buffering with some form of hernia.
Why it is so, can be explained by the first
half-dozen victims any one may choose to con-
sult. Perhaps hernia is in the family and has
been as far back as memory and records go,
and hence fifty per cent of the male members of
the families have paid penance to this inherited
weakness. Some were by nature strong and
perfect, but, while in an unnatural position, or
under a powerful impulse, have made a sudden
and violent effort and have severed the strong
cords which made them healthful beings. Some
are born so, and never get over it. Nature
stopped her work too soon and has left an incom-
plete creature. While still others have been the
target of external forces too severe for the tis-
sues to resist without injury and permanent le-
sion.
That hernia may exist from a variety of
causes we all know and can easily demonstrate,
but what is the best thing to do with each one
as we meet them in their varied forms, none of
us are always able to answer wisely and proper-
ly. I shall give my treatment, and by so doing
hope to elicit the methods you use, and by com-
paring our ideas and opinions develop something
which will be of practical value and of perma-
nent use. There are some cases, I frankly con-
fess, with which I do but little, while there are
others in which I attempt to repair with surgical
means all the damage the patient has sustained
or the defects he has endured.
In congenital hernia, for the first few years,
in reducible hernia, in tuberculous and syphilit-
ic subjects, who are and will be in easy reach
of physicians and instrument-makers, a properly
fitting truss is usually sufficient. In irreducible
hernia, in old and decrepit people who have a
large amount of adipose tissue, I do little or
nothing until symptoms develop which demand
radical measures. In all other subjects, with,
perhaps, a few exceptions, I advise a so-called
radical operation, one which in its details at first
was peculiar to myself.
The idea of a radical operation is not a new
one by any means, for simultaneous with the
birth of surgery as a science there were methods
described and practiced by the old masters, and
in every century since then some modified form
of the same has been advocated by their disci-
ples and followers. Even when the majority of
surgical work was still done by barbers and itin-
erant specialists there were some among them
who devoted themselves exclusively to the cure
of hernia. Dishonesty and deception were then,
as alas ! too often now, partners in the profession,
and while these men pretended only to operate
for hernia, they also castrated their helpless
dupes. Their method was the same as the vet-
erinarians use now-a-days on the lower animals,
and as this was the limit of their knowledge,
their hope of success lay in its practice.
So numerous and pestiferous had these men
become in some of the large cities where they
were wont to practice their art that the i)eople
finally rose up and had laws enacted which ban-
ished them from their midst. But when surgical
ideas had crystallized into a science which was
supported by more worthy men, a modified
method found favor with the people. It was
Jamerius and liogerius who recommended the
exposing of the sack by a long incision, pushing
back the bowels and tying off all of the sack
which could be pulled out and dividing the parts
below with the cautery. In a later period the
famous Guido claimed to have discovered the
ne plus vkra in the **Jilum aureum" or gold
thread. It was applied by a series of twists on
the neck of the sack as his predecessors applied
the linen thread, and with the same object ; but,
for reasons which he does not give, he regarded
his discovery vastly superior to any thing pre-
viously in use. The Arabians used the cautery
instead of ligatures, and besides cauterizing the
sack they also applied the same remedy to the
pillars of the ring and parts about.
Their object was to form a cicatrix which
would be large and firm enough to forever close
the opening. In many cases their success was
remarkable, and even to this day it is not for-
gotten by their descendants. Instead of the cau-
tery, in some countries it was the custom to
apply strong escharotics, as mineral acids, with
the object of exciting inflammation, suppuration
and finally cicatrization. The subcutaneous
injection of astringents and escharotics into the
ring for the purpose of exciting adhesive inflam-
mation is a process which was peculiar to our
time, and among its advocates were found such
Skpt., 18SB.]
ORIGINAL ARTICLES.
278
men as Velpeau, Biglow, Pancoast, Schroyer and
Hilton. Bat what a few years ago was so full
of promise and had so many ardent followers, is
now consigned to occupy a few lines in the his-
tory of surgery. About twenty years ago Prof.
J. R. Wood, of New York, conceived the idea of
taking a wooden plug the size and shape of the
finger and with it push all the tissues over the
ring into it, "so-called invagination," and allow-
ing them to remain until adhesions had taken
place. A little later Prof. John Wood, of Lon-
don, accomplished almost the same thing by a
different method. He divided the skin over the
hernia and dissected it off for a considerable
distance beyond the ring. With the index finger
the subcutaneous tissues were invaginated and
fastened in this position by a series of 'looped
stitches which included the pillars of the ring
and the invaginated tissue. This latter is still
the standard operation in most of our text-books
and has at the present time the greatest follow-
ing. Antiseptics, however, have made it possible
to go beyond the apparent daring of Prof. John
Wood.
We need not stop with simple division of the
skin, but can divide all, even to the peritoneum,
and close the wound, with a degree of certainty
that no fatal injury has been inflicted. Another
reason of our advance is the unanimity among
anatomists and surgeons as to the mechanical
part the different abdominal layers play in hold-
ing the organs in the cavity. I will quote a part
of Prof. John Wood's definition of hernia as
given in the encyclopedia, and by what I have
already said of him you will see that his treat-
ment is not wholly in keeping with his anatom-
ical definition. He says, in the more restricted
and xmusual sense it, ri?., hernia, means a pro-
trusion of some abdominal viscus through the
abdominal wall, beneath the integument and fas-
cia. Most frequently the opening is constituted
by the enlargement of a natural aperture be-
tween the muscles and fasciae. Now the ancients
believed the lesion in hernia to be a stretching
and sacculation of the peritoneum and their
treatment was directed wholly to the removal of
this sack and the reunion of the peritoneum at
the point of separation. Prof. Wood does not
believe this, yet in his treatment he does not
consistently carry out his ideas of plastic and
reparative surgery as practiced in the other
parts of the body. If a patient comes to him
with a divided hehx of long standing, he refresh-
ens the edges of the severed parts, co-apts them
with stitches and secures union, and in the end
has an ear as strong and almost as perfect as
nature first made it. Why not apply this same
principle in treating hernia ? Invaginating the
superimposed tissue does not always excite ad-
hesive inflammation, nor does it by any means
unite the fibers and tissues that have been sep-
arated. About twelve years ago Czerny cut down,
stitched the walls of the ring together with cat-
gut and afterwards closed the remainder of the
wound. His results in many cases were perfect,
•but the failures were too numerous to give it any
prominence or lasting fame. It was while delib-
erating upon Czerny's operation, about five
years ago, that I began to make a series of ex-
perimental operations upon cases requiring her-
niotomy for strangulation. The functions of
the different abdominal layers were settled then
as now and the simple question hinged upon the
best method of closing or diminishing this open-
ing between the fascia and muscles. Muscles
and fascia are tissues which are easily united if
their edges are properly refreshed and held in
co-aptation for the necessary length of time.
This was so well demonstrated in the first cases,
as well as at other times and places, that I felt
assured in advising it in all operable cases. The
details which were carried out are as follows:
The parts over a large area were shaved and
perfectly cleansed with soap and solutions. The
skin and different layers were divided as in herni-
otomy until the sack was full in view. This was
then pushed back into the abdomen and held
there with the index finger of left hand. With
a probe-pointed bistourj^ or Simon's uterine cu-
rette the free edge of the hernial ring was thor-
oughly refreshed. When every point where union
was expected had been thus prepared and the
hemorrhage checked and the wound cleansed, it
was closed with No. 24 silver wire.
The whole thickness of abdominal wall was
included in each stitch, and to avert injury to the
spermatic cord or vessels, the index finger re-
mained in the ring constantly, protecting the
vessels and directing the needle in and out of
the walls. The stitches were put in close to-
gether, no more than one-fourth of an inch apart,
and the wires drawn tensely before twisting, so
as to form a short angle in the intra-abdominal
point for the purpose of co-apting the parts and
holding them firmly together. The wound was
dressed as in herniotomy and allowed to remain
so for twelve to fourteen days, when, as a rule,
complete union had taken place. The wires
were then removed and the parts redressed with
bandages firmly applied and the patient kept in
a recumbent position for another fourteen days.
At the end of this time a truss was applied and
274
THE MEDICAL ERA.
[Vol. VI. No. «.
the patient allowed an increasing amount of ex-
ercise from day to day. Four months was found
to be the necessary length of time to complete a
cure under favorable circumstances. These, in
the main, are the details of the principles applied,
and the results in the cases so far treated are
most satisfactory. There was but one failure in
a primary operation and that was in a patient
who had been injected three times with Quercus
alba, and I failed to remove all of the encysted
bark, but on a second trial the patient was com-
pletely cured.
Several of my friends who have seen me oper-
ate or who have been informed of the method
and have given it a trial, have equally good re-
poiiis to offer. Whether I shall always be as
successful in the future as in the past and
whether those who may try it in the future shall
be as successful as those who have tried it in the
past, time only can answer. The principle is a
correct one and I hope that the members of this
Association will give it careful thought and
trial and in a year hence condemn or endorse it,
as their judgment and experience may dictate.
INFANTILE SPINAL PARALYSIS.
By W. O. CHKESEMAN. M.D.
jolibt, ill.
[Read before the Illinois fiomceopalhic Medical AaBOciatlon.]
SYNONYMS. — 1. Atrophic Infantile Paraly-
sis. 2. Polio Myelitis x^nterior Acuta. 3.
Essential Paralysis of Children.
History. — We find occasional allusions to
this disease in medical literature as far back as
the latter part of the last century, but the first
accurate description is by Drs. Kennedy and
Heine in 1836 and *40. Since Heine's publicQr
tion of his classical memoirs, a number of ob-
servers have studied this disease. Different
writers give it a different term, viz. : Heine and
Myer called it infantile spinal paralysis ; Gall
called it paralysis during dentition ; by Eilliet,
Barthez, Vogl, Eulenberg, Vallieux, Brummiche,
Laborde and Niemeyer it was called atrophic
paralysis of children. Ducherme and Echerer-
ria named it fatty atrophic paralysis of infants.
By Eeynolds it was called paralysis with wast-
ing of muscles. Bouchut added the term myo-
genetic paralysis. Hammond calls it organic
infantile paralysis, and by others it is called
idiopathic and congestive infantile paralysis.
Causes. — The etiology of this affection is
very obscure. Age is the only influence which
can be said to be a positive factor in its produc-
tion, as it attacks both sexes indiscriminately
between the ages of two months and four years.
By some writers it was attributed to dentition,
but more careful observation shows that no di-
rect causal relation can be traced. It is proba-
ble that the early age and dentition act indi-
rectly by inducing a susceptibility to the disease.
Sex seems to have no influence in its production
and it is as frequent among the children of
the rich as among the ill-fed poor. West at-
tributes it to the local action of cold; Ham-
mond, to lying on damp ground. It has occurred
during convalescence from measles, scarlatina,
typhoid fever, rheumatism and chorea. By
some, injuries to the spine are supposed to have
caused it. One thing is certain ; it seems to be
the grand source of club-feet, shriveled, half-
dead limbs, and other sad deformities affecting
children.
The paralysis is usually partial, single mus-
cles or groups of muscles only being affected.
The muscles most frequently attacked are the
muscles of the anterior part of the leg, forming
the extensors of the toes, and the flexors of the
foot, extensors and supinators of the hand, these
muscles being always affected together; ex-
tensors of the leg, and with them generally the
muscles of the foot. When single muscles are
affected, those most likely to suffer are the ex-
tensor longus digitorum of the toes, the tibialis
anticus, the deltoid and stefno-mastoid.
Pathological Anatomy. — The early changes
are medullary hypeiaemia, vascular exudation,
and inflammatory softening. Microscopic ex-
amination reveals an inflammatory softening of
the anterior horns of the gray matter. Among
other constant lesions are atrophic degeneration
of the multipolar ganglion cells and the anterior
nerve roots. The changes noted as occurring in
the cord are usually limited to the dorsal, lum-
bar and cervical regions. As a result of the
changes in the trophic center and the nerve de-
generation of the muscular fibres supplied, there
ensue changes in the bones and joints, leading
to deformities.
The deformities produced by infantile paraly-
sis are talipes equinus, equinus valgus, equinus
varus, and calcaneo valgus is found with equino
valgus of the other limb.
Symptoms. — Onset usually sudden, with an
attack of mild fever of a few days' duration^ on
recovery from which it is noticed the child is
paralyzed ; or the child may be put to bed, and
in the morning is found to be paralyzed.
SkpTm 1888.]
ORIGINAL ARTICLES
276
The paralysis may affect both arms and both
legs, the legs alone, or only one of the foar ex-
tremities. It may, but very rarely, be a hemi-
plegia. The bladder and rectnm are not affect-
ed, nor can anaesthesia or nambness be detected.
3?he temperature of the paralyzed limb is low
and the appearance cyanosed.
After a few days there is a sUght improve-
ment in the paralyzed parts, although the mus-
cles show a rapid wasting, which is progressive
until all muscular tissue is gone.
The reflex movements are impaired or abol-
ished. The electro-contractility by the Faradic
current is abolished in the paralyzed parts.
Diagnosis. — Hemiplegia from acute cerebral
affections in children can be distinguished from
infantile "paralysis by the disorders of intelli-
*gence and the special senses, and the persever-
ance of the normal electro-contractility. Pa-
ralysis of myelitis occurs in older persons, and
is associated with disturbances of the genito-
urinary organs and bed-sores.
Pseudo-muscular hypertrophy, with paraly-
sis, begins gradually, becoming progressively
worse with increase in the size of the limbs.
Hip-joint Disease. — (1). The child bears
all of its weight on the healthy limb. (2).
Turns the foot of the affected side inward when
walking, and stands with the toes of that foot
resting on the dorsum of the foot of the healthy
side. (3). Increase of pain on striking the
head of the femur against the acetabulum by a
blow on the hip. (4). The fixed pain in the
knee of the affected side. (5). Increased
temperature of the affected side. (6). Short-
ening of the limb. (7). Absence of the gluteal
fold of that side.
Prognosis. — The duration of the disease is
variable. It may pass off in a few days, or
even hours, but it is more likely to occupy
several weeks or months in recovery.
If the paralyzed muscles retain their electro-
contractility and electro-sensibility, and so show
that they have not passed into a state of fatty
degeneration, there is great hope of recovery,
even if years have elapsed since the first attack.
Treatment. — Massage, shampooing, move-
ments of various kinds. Faradism to the par-
alyzed muscles.
Remedies. — Aconite, Belladonna, Gelsemium,
Nux vom.. Plumbum.
The treatment of deformities resulting from
infantile paralysis should be a judicious combi-
nation of surgery and mechanical appliances.
Case. — Leo S. Age four. Eight months pre-
vious commenced to have trouble with the right
leg. There was no history of fever. The onset
was sudden ; the child was out playing ; came
in and complained of its foot at first ; not much
attention was paid to it, but the parents noticed
that the leg was growing smaller. An old-school
physician was called in, and the child has had
several of that school since.
Examination reveals the leg atrophied its
whole extent. The toes are drawn down, and
the paralysis is probably confined to the flexor
longus digitorum.
The appetite is normal, bowels regular, sleep
good. Bemedies : Nux vom., followed by Plum-
bum. Faradism and massage. This case is
slightly improved.
OABDIAO LESIONS AND THBIB BBLATIOIT
TO WASTING AND OHBONIO
DISBASBS.
Bt F. O. PEASB, M.D.,
VOROAN PABK, ILL.
[Read before the IHlnoiB Homoeopathic Medical AsBOciation.]
IT was my privilege, a year ago, to present a
paper with a similar title, with the clinical
history of two cases. The object of this
paper is briefly to reiterate the position then
taken, viz. : That valvular or structural disease
of the heart may be, and often is, primary to
many of the diseases we are called upon to treat,
especially those graver forms which insidiously
assail the systemic or vegetative spheres, and
whose presence in the body are usually consid-
ered, and too often are, incurable. If the cause
or primary lesion is not recognized, or is over-
looked, owing to a too superficial study of the
pathological conditions, the disease steadily ad-
vances, and our patient dies, simply because we
do not direct our treatment against the primary
cause.
Another object of this paper is to call atten-
tion to the importance of systematic physical
examination, and to suggest that physical diag-
noses should be more generally and practically
understood by the mass of physicians.
The authorities, some of them, teach that
valvular or organic heart lesions give immunity
from phthisis. Foster says: "Wherever the
valve mischief is, and whatever its nature, it
robs the arterial circulation and enriches the
venous. In front of the lesion is less blood ;
behind it there is more.'* And further he says :
''Over-fullness and stasis in venous, and less-
ened arterial circulation, results in various as-
sociated visceral disorders and complications."
282
THE MEDICAL ERA.
[Vol. VI. No. 9.
cases, he found, in eighteen, anorexia; in six-
teen, disturbances of sleep ; in sixteen, trembling
of the lips and tongue ; in twelve, leucorrhea ;
in eleven, gastralgia ; in ten, dyspepsia ; in t£9i,
neuralgia of various forms ; in eight, cephalal-
gia ; in four, vertigo a»d convulsive attacks ; in
four, obstinate constipation ; and in three, con-
stipation and diarrhoea alternating. The evil
effects of cofifee are especially observable in chil-
dren. The coffee drunkard is described as thin,
pinched features, pale, wrinkled face, and a gray-
ish-yellow complexion. The pulse is weak, fre-
quent and compressible. The sleep is troubled
with anxious dreams.
No doubt, coffee does, on the whole, far more
good than evil. But it is important that the
medical profession constantly bear in mind the
evils that it is able to produce under favorable
circumstances. In a general way, it may be
said that indoor brain- workers do not bear cof-
fee as well as outdoor muscle-workers. Persons
of nervous temperament bear coffee badly. —
Am, Lancet — Tlie Epitome,
Sux^ery of the Uxinary Org^ans.
Mr. Harrison, in his lectures before the Med-
ical Society of London, objects to the term ureth-
ral fever, as misleading, inasmuch as it seems
to connect the symptoms with the precise part
rather than the process by which they are pro-
duced. He proposes the term " urine fever," as
it is produced by the presence of urine in a recent
wound, and is probably due to the absorption of
some poisonous compound, such as an alkaloid,
which is derived either from urine or tissue or
wound decomposition, or all combined. This he
bases on the following : 1. The presence of urine
in relation with a recent wound is necessary for
the production of urine fever. 2. The mere con-
tact of urine with a wound is not suflScient for
its production. 3. The retention of fresh urine
within the area of a recent wound is almost in-
variably followed by its development in a greater
or less degree. 4. Where urine is placed under
such circumstances as last mentioned, the liabil-
ity to urine fever is greatly diminished when it
is sterilized by local or general means. 5. The
retention of fresh urine, blood, and the debris of
damaged tissue in the confines of a recent
wound for a certain time, at a tempera-
ture of about 100'^ F., could hardly be pos-
sible without chemical changes taking place in
the constituents referred to. 6. The common
origin for urine fever is rendered probable by
the uniformity of symptoms attending it, which
are identical, whether following a surgical oper-
ation or an accidental wound. Certain drugs,
by their elimination through the urine, such as
Quinine, seem to render it less capable of excit-
ing this fever.
Strictures of the urethra he holds to be due to
inflammatory exudation thrown out to resist
leakage of some of the constituents of the urine
through the mucous membrane of the urethra,
where from any reason the epithelium is dam-
aged so as to render the canal not urine-tight.
Among his reasons for believing this are the
secondary implication of the mucous membrane
in the stricture-forming process, the density and
contractility of the plastic exudation, the char-
acter of the cicatrix produced in the healing of a
recent wound constantly submitted to the action
of more or less pent-up urine, and the form in
which the stricture tissue is deposited. After
rupture of the urethra, formation of a stricture
can, he maintains, be prevented by performing
perineal section and preventing the infection of
the wound with urine.
Regarding the prostate, he considers it the
muscular retentive apparatus of the male blad-
' der, and that its intermittent glandular action is
subservient to this continuous physical action.
Its fibers are spread out like a funnel, with the
apex downward, forming a strong support for
the bladder. In the adult man an exceptional
degree of pressure is made upon the outlet of
the bladder, as the perpendicular axis of the
"urine pressure " falls directly upon the outlet,
and not partly on the pubic bone, as in the fe-
male. Where there are no such physical func-
tions to perform, as in extroversion of the blad-
der, the prostate as a muscle exists only in a
rudimentary form, though the sexual sense m.ay
be normal. Hypertrophy first appears for a dis-
tinctly conservative object. Projecting nodules
he considers structural upheavings of a frequent-
ly contracting muscular ring developing in the
line of least resistance, and assuming a more
lowly organized form than that which was in the
first instance developed. To prevent prostatic
hypertrophy, and the complications arising from
it, care should be systematically taken to pre-
serve the muscular power of the bladder, and to
aid it artificially when necessity arises. The
timely use of the catheter he warmly commends
as warding off changes which unfortunately do
not always cease when they have become pre-
cisely compensatory.
Eecurrence after litholapaxy he places at one
in seven. This is the weak point of the opera-
tion. He ascribes this largely to the condition
of the bladder, which is often in a state of chronic
Skpt., I88S.]
SELECTIONS.
283
inflammation, predisposing to the deposit of
phosphates. As in such cases the calculus is
the result rather than the cause of the trouble,
he advocates their treatment by lateral lithoto-
my and drainage of the bladder, with careful
cleansing of from four to ten weeks, in order to
restore the mucous membrane to a healthy con-
dition. — jV.F. Medical Journal. — A^n. Med. Digest.
The Oontag^n of LeproBy.
The necessity and demand for the segregation
of lepers from the rest of the community grow
out of the belief that it is capable of communi-
cation from the body of the afflicted one to those
who may come into more or less intimate con-
tact with him. Science has not yet been able
to determine the exact limits of the contagion of
this disease. There are still those who profess
a disbelief in the spread of leprosy by contagion
(using this word in its broad sense), but it is
safe to say that no physician who has had expe-
rience with the disease, leprosy, and has studied
its history in this country, has been able to oiBfer
any other satisfactory explanation of its spread
amongst the people of these islands ; and as a*
fact, to-day, the medical profession in the Ha-
waiian Islands are, I believe, unanimous in the
beUef that leprosy is a communicable disease,
and that every leper is a possible source of con-
tagion to all who may come into more or less
intimate contact with him. — Report of Hawaiian
Board of Health.
Poisoning by Antipyrina
For a severe headache, of a nervous charac-
ter, in a lady — Mrs. H. — of about twenty-five
years of age, and otherwise healthy, I prescribjed
two powders (ten grains each) of Antipyrine, one
to be taken an hour after the first, if needed.
She took one about 9 : 30 P. M., and in two or
three minutes she began to experience a " snap-
ping " in her head, along with an itching and
burning in the mouth and throat, particularly in
the roof of the mouth. This feeling also extend-
ed to the eyes, nose and ears, and became so
violent that she involuntarily thrust her fingers
into her mouth and ears to seek relief. The
" snapping " in the head increased in intensity
until she became almost frantic, and ran up and
down the room screaming, partially losing con-
trol of herself, and apprehending acute insanity.
Sneezing soon commenced and became extremely
violent, the act being repeated at least fifty
times, while the nose and eyes were running a
very copious, watery fluid. The turgescence of
the mucous membrane was so extreme that she
could not breathe through the nostrils for sev-
eral hours ; indeed, not until the next day. Fol-
lowing all this, there was a stupid, tormenting
feeling, with swelling of the nose and eyes, till,
exhausted, she finally fell asleep. This sleep
was troubled and tiresome, but the headache
proper was relieved. The most violent part of
the process continued for only about ten min-
utes, but recovery was not perfect till the next
day. — Dr. Peters in Med. Register.
Injection of Cocaine into the Urethra Followed by
Death.
Dr. Henry J. Simes adds another case to the
list of deaths reported following the use of Co-
caine. The patient, cet. twenty-one, suffered
from a urethral stricture and a small fistula
leading from the urethra and opening through
the perineum. The man was placed upon the
operating-table, one drachm of a twenty per cent
solution of Muriate of cocaine was introduced
into his urethra, by means of a long-nozzled
urethral syringe which passed about four inches
into the canal. The instrument had scarcely
been taken out of the urethra when the patient
made a foolish remark, the muscles of his mouth
began to twitch, the eyes staring, pupils dilated,
frothing at the mouth, face much congested, res-
piration interfered with, and ending in a violent
epileptiform convulsion, lasting for some sec-
onds. These convulsions were continued with
increasing violence several times a minute, the
whole muscular system taking part in the spasms,
requiring considerable force to keep him from
falling off the table. The action of the heart
was not much interfered with, and. appeared only
to be secondarily affected. It was the respiratory
action that seemed first to fail, and then the
heart's" action became irregular and slow. The
breathing was gradually more and more inter-
fered with ; the face, in fact, the entire surface
of the body, became deeply cyanosed, the pulse
slow, and at the end of twenty minutes from the
first convulsion had ceased to beat. The man
was dead.
Post-mortem showed no lesion of importance,
but maried congestion of the brain, lungs and
liver. — Medical Neivs.
The Annals op Surgery, published by J. H.
Chambers & Co., St. Louis, is the only journal
in this country devoted strictly to surgery. The
editors are L. S. Pilcher, of New York, and C.
B. Keetley, of London.
284
THE MEDICAL ERA.
[Vol. VI. Ko. 9.
CORRESPONDENCE.
Colorado for Consumptives.
To tJie Editor of tJie Medical Era,- —
In calling the attention of the profession at
large to the unwise practice of many physicians
of sending phthisical patients indiscriminately
to Colorado, would it not have been an import-
ant addition to Dr. Bartlett's article in the last
Era for him to have classified, as nearly as his
extended experience and observation would en-
able, those who should and should not be sent
there ? We have been taught mainly that those
who suffer from hsemoptysis should not be sent
there, but South possibly.
Personal observation and experience has
taught me the unreliability of statistics in regard
to climate and health resorts issued by the va-
rious bureaux of different states and territories,
they being usually "constructed" to further
emigration into their boundaries, so that a let-
ter from Dr. B. in regard to the mean atmos-
pheric conditions of Colorado, which his resi-
dence there would enable him to fully set forth,
with a classified list of such patients who are
** eligible " or not for residence in the state, as
suggested above, would be very acceptable " to
those who sit in darkness " regarding that much
lauded health resort.
Dr. E. M. Hale, in Feb., 1888, number of the
Era, gives his impressions of Mexico and Cali-
fornia for invalids, especially consumptives,
from the true standpoint — that of a physician;
and Dr. Bartlett, from actual residence for so
many years in Colorado, should consider it his
duty to his professional brethren to give them
the benefit of his observations in regard thereto,
for if we err in advising Colorado as a resort
for our consumptive patients, it is because we
know so little of the state or climate, and that
little is unreliable for reasons before stated.
F. W. SOUTHWORTH, M.D.
Taavna, W. T.
Southern California.
* Pomona, CaL, July 23, 1888.
Editors of The Medical Era :
No doubt the readers of the Era remember an
article on ''Mexico and California for Invalids,"
by E. M. Hale, M.D., of Chicago. If not, look
over your back numbers and you will find it in
February, 1888, on page 60.
Now, no one can make a short visit to this
country and understand its peculiarities and ad-
vantages. One has to live here some time be-
fore being competent to advise invalids on
locality. You can find any kind of climate here
you wish, and no one is better qualified to select
the locality for the invalid than the resident
physician. The Eastern physician sends his
patient to California for help, and not under-
standing the variety of climate found here, con-
demns the whole Pacific coast because his pa-
tient is not benefited. Whereas, if the invalid
had been instructed to consult a local physician
he might have been benefited. How often have
I seen certain chronic cases plant themselves in
a locality not favorable to their disease and
gradually fail till death relieved them of their
troubles, while the same class of cases, upon
consulting a responsible physician and going to
the proper place, invariably got well.
Certain cases, such as the debilitated scrofu-
lous persons, and some forms of catarrhal and
bronchial troubles, are benefited at the sea
shore, while the neuropathic, hysterical and car-
diac troubles are only aggravated.
Our tubercular friend (and with this class we
• are always well supplied) should invariably seek
the higher altitudes. But, on the contrary, the
consumptives come here (generally in the last
stage of the disease) and remain in the valleys,
house themselves up, take very little exercise in
the open air, and in a few months are sent back
"in a box."
I have practiced in several localities in the
East, and nowhere have I found a climate so
congenial to the invalid as the state of Califor-
nia, providing this adaptation to locality is prop-
erly considered.
. 1 will close with a practical hint to those who
send invalids here. Convince your patient that
he has something to do after he gets here, es-
pecially the consumptive. He should lead an
active, out-of-door life, so far as his strength
permits. So many come here and sit down with
folded hands and wait for climate to heal their
diseases. Such invalids die.
Explain to them why they should invest a lit-
tle money in good advice from a responsible
physician here on the proper locality for their
case.' Sheldon Fitch Davis, M.D.
/ The place of meeting of the Southern Homoe-
opathic Medical Association has been changed
From Nashville, Tenn., to Louisville, Ky. A
large attendance is expected. Time: October
110-12, 1888.
Sbtt., 188B ]
CORRESPONDENCE.
285
PEBSOKALS.
Dr. Thos. PhiUips has moved from Austin,
Minn., to Waterloo, la.
Dr. A. P. Sumner, of Boston, has gone to
Germany to remain eighteen months.
Dr. Selden H. Talcott, President- elect of the
American Institute, has gone on a voyage to
Europe.
Drs. Lippincott and Landis, of Memphis, have
dissolved partnership. Dr. Lippincott con-
tinues business at the old stand.
Dr. Harold Wilson has moved from Ann
Arbor to 100 Miami Avenue, Detroit, where he
will devote himself exclusively to tlie treatment
of diseases of the eye and ear.
Dr. F. R. Day, of Honolulu, has favored us
with a copy of the biennial report of the presi-
dent of the board of health to the legislature of
the Hawaiian Kingdom.
Look Here ! The Medical Coumelor for three
MONTHS FREE. Send name and address to
" Medical Counselor Publishing Co.," Ann Ar-
bor, Mich.
I have used Tongaline in the treatment of
neuralgias and forms of rheumatism and rheu-
matic gout since 1883, and cannot speak in too
high terms of its efficacy. — Pr, R. Thombs, M.D.,
SupL Colorado State Insane Asylum, Pueblo, Colo.
<' I gave Lactated Food to a miserable speci-
tmen of an infant. I am pleased to write you
ithat it began to improve in a few days, and
^ow, without taking any medicine, is a j&ne,
{healthy child. I will add that it has had no
lother food." — Dr. J. R. Ilolcombe.
A FINE suburban practice for sale, ten-room
cottage, horse and phaeton, with or ^^ithout of-
fice furniture ; a bargain. One-half down, bal-
ance in seven years. Address,
The Medical Era,
48 Madison Street, Chicago.
A correspondent sends us a newspaper clip-
ping containing the foUowhig :
A grand jarj in Kentucky indicts homcBOpathists for
giYing liquor to their patients.
FiiBMiNGSBUBo, Ky., August 18. — Indictments werjB
found against Dr. P. A. Gordon, homceopathic physi-
cian, for prescribing and furnishing liquor to his pa-
tients, the prohibitionists holding that whisky is not
recognized in the homoeopathic pharmacopoeia.
We will venture the opinion that there was an
allopathic doctor on the Flemingsburg grand
jury.
Wanted : — A successor to a fine paying prac-
tice in the largest city in Dakota. Ten years
estabhshed. A fine chance to make money from
the start. Price very low. Reason for selling,
price and full particulars by calling on or ad-
dressing Dr. a. L. Marcy,
Sioux FaUs, Dakota.
The attention of our readers is called to the
advertisement of Messrs. R. A. Robinson & Co.,
which appears on page X. of this issue.
This house is one of long standing, and enjoys
a reputation of the highest character.
The preparations referred to, we recommend
specially to the notice of Practitioners.
ClaM in Orificial Surgery.
To THE Members of the Medical Pro-
fession : — A Class in Orificial Surgery will be
held at the Chicago Homoeopathic Medical Col-
lege, beginning September 10, at ten o'clock,
A. M. The entire week will be spent in a thor-
ough discussion and complete illustration of the
orificial philosophy in all its details.
A lecture of an hour or more will be given
every morning, to be immediately followed by a
clinic of several hours' duration. Clinical ma-
terial is abundant, and cases will be selected
with a view to illustrate, in the best manner
possible, every variety and complication of ori-
ficial work.
Not only the operations, but the after-treat-
ment of cases, which is of extreme importance,
will be outlined.
Lacerations of the cervix and perineum will
be repaired ; hymena will be removed ; the most
successful methods of controlling uterine dis-
placements and diseases will be illustrated. The
proper treatment of the clitoris and the prepuce
will be.shown, and in rectal work there will be
abundant opportunity for watching and person-
ally assisting in the removal of pockets and pa-
pillae, in the treatment of ulcers, fissures, fistulae
and hemorrhoids, and in the modified clamp
operation for the complete removal of the pile-
bearing inch, where the tissue is sufficiently
redundant to require it. There is no part of
this work that does not require illustration to be
fully understood and appreciated. Most of it
can be done by any practitioner of medicine and
surgery who deserves the title.
Obstinate cases of asthma, bronchitis, mala-
ria, liver and stomach troubles, constipation, di-
arrhoea, neuralgia, nervous prostration, head-
aches, spinal irritation, insomnia, paralysis^
286
THE MEDICAL ERA.
[Vol. VI. No. 9
dropsy, insanity, acne, eczema, etc., etc., to
which this work is a godsend, are so common in
every physician's experience that a very general
interest has been aroused in the orificial philos-
ophy and treatment. It is impossible to enter-
tain visiting doctors singly with any justice to
the doctors, to the work, or to myself. I there-
fore earnestly request that all those who med-
itate visiting Chicago for the purpose of master-
ing the problems which the work involves will be
kind enough to join this class instead of coming
at other seasons.
The course is designed for practitioners rather
than for under-graduates. The latter, however,
will be permitted to attend.
The fee for the course will be $25.00, payable
in advance.
Fraternally,
E. H. Pratt, M.D., LL.D.,
A Card.
In a spirit of fairness to all concerned, we
offered to Dr. Thompson the use of our columns in
order to explain his theory of the action of '*Moxie,"
and its mode of preparation. But in this connection
we must also state that we have in no wise been
moved by talk about "challenging" and "fight-
ing," or implied threats of any kind, and prefer to
consider that it was indulged in in a Pickwickian
sense. We are sure that we can trust to the intel-
ligence of our readers to form ' opinions, unin-
fluenced by us.
In a communication to The Medical Era, regard-
ing " Moxie," Dr. Thompson says :
" I have nothing to conceal aside from the mode
of preparing it in fixed solution or artificial diges-
tion without injury to it aS a nerve food.
" In contests, with counterfeiters, before the U.S.
courts, we were met by pur opponents with the
plea that we were not entitled to the protection of
the law. In all these suits 143 witnesses were
employed by lis, 28 cases of old. helpless paralysis
and nervous wrecks from abuse and over work were
present to testify that they were recovered by
Moxie when other resources failed. Then the facts
of our successful digestion of the albuminoids
and the theory of their adaptation to the wants of
the nervous system and their positive complete
fixed solution proved by evaporation. The theory
of this adaptation is as follows :
" 1st. The nerves and brain are the seat of ani-
mal life and the generation of force and strength
for the muscles and intellectual faculties.
"2d. The great authors of works on chemistry,
Anatomy and Physiology find that the nerve
centres are loaded with 17 per cent of albumen,
slight traces of the salts and 71 per cent of water
and gelatine.
" 3d. That the nerve fillaments of the brain are
independent organs in themselves, small tubes
filled with the al>ove, covered with very delicate
porous membranes and are but 1-14000 of an inch
in diameter, while a blood corpuscle is from
1-2400 to 1-3000 of an inch in size.
" This precludes any possibility of the introduc-
tion of blood into the nerve substance. It also
assures us of the fact that the only food used by the
nerves is the basic nutrition, albumen. That the
structure of the nerves and capillaries also proves
that all the albumen reaching the nerve centres to
generate life and animal force, must be dissolved,
without injury, to the consistence of water before
it can pass by the law of exosmosis and endos-
mosis through the coats of the capillary blood
vessels and the delicate porous membrane covering
the nerve fillaments into the nerve centre for use.
"It was long since an accepted fact among
scientific men that the nerves besides generating
animal force, also control or govern the functions
of the organs of the body, when there is force or
strength enough in the nerves to keep up a normal
function we were in good health, otherwise, ilL
" It is also known to be a fact that in persons who
die from exhaustion or insanity, there are positive
evidences of malnutrition of the brain and nervous
system. Also a want of proper functional strength
in the organs governing imbibition tfnd exhalation.
" If the stomach's functions are governed by the
nervous system, how can it digest the only food
for the nerves to a proper consistence for their
possible absorption after their force has been half
destroyed by overwork, worry or abuse? It is
now an accepted fact that nervousness and the
terrible tired feeling exists from malnutrition of
the nerves, and it is because natural digestive force
cannot furnish fuel enough for the ordinary wants
of the system under such circumstancea How
can medicine as stimulants help starvation ?
" Chemical science has not yet been able to make
a complete digestion of the albuminoids. The
moxie plant is loaded with albuminoids and another
element that antidotes alcohol. From the fact
that I have been able to restore paralysis and old
nervous wrecks with the moxie albuminoids
through my newly discovered process of artificial
digestion, and not being able to discover any
medicinal or alterative effect from large quantities
of the moxie except solid substantial strength to
the nerves, I have called it a nerve food. The
moxie alone is tasteless as starch. It is flavored to
make it palatable. It will not help paralysis
caused by the mechanical pressure of fluids effused
around the trunk of a nerve. I farther believe it is
a food because women tell me it gives a remarkable
support, has no reaction like a stimulant, and does
not lose its effect from long use. This is moxie
and the reason for its mode of preparation. Of
com'se'it must be taken constantly if people con-
stantly abuse or overwork themselves, or it might
as well hot be taken at aU. A. Thompson, M.D."
SipTm 1689.]
BOOK REVIEWS.
287
BOOK REVIEWS.
The Practice of Medicine ; or, the Specific Art
of Healing. By I. J. M. Goes, A.M., M.D.,
Professor of the Practice of Medicine in the
Georgia Eclectic College of Medicine and
Surgery, Author of '*The American Prac-
tice ;" ** Materia Medica, Pharmacology and
Therapeutics." Chicago: W. T. Keener.
1888.
Dr. Goss' work on practice shows to what a
great extent the eclectics are using homoeopathic
medicines homoeopathically. Aconite, bryonia,
I'hus tox., Pulsatilla and many other polychrests
are as frequently mentioned as are bromides,
Iodides, laxatives or cathartics. Much of the
treatment is thus of a conservative kind, and a
great improvement on the older methods.
The departments of pathology and diagnosis
are in the main correct, though not so thorough
in detail as would seem desirable in a work of
its pretensions. But eclectic physicians who wiU
be guided by the .treatment recommended will
find themselves becoming more and more of
homoeopaths. Mr. W. T. Keener, the enter-
prising publisher, deserves to have his efforts
recognized by large sales.
The Homceopathic Therapeutics of Diarrhgsa,
Dysentery, Cholera, Choleiu Morbus and
Cholera Infantum. By James B-. Bell, M.D.
Third edition. Philadelphia: F. E. Boe-
ricke. 1888.
This excellent work needs no introduction to
our readers. It is one which is hard for a
homoeopathic physician to get along without.
This volume is an enlarged edition of our old
friend, ''Bell on Diarrhoea and Dysentery," and
is worthy of the confidence which is always
reposed in an old friend.
Pboceedinos and Papers of the Homoeopathic
Medical Society of the State of Kansas.
Sixteenth to Twentieth Annual Meetings.
1888.
This neat volume contains the reports of pro-
ceedings of the society for five successive meet-
ings, and it makes a very creditable showing.
The Kansas physicians are to be congratulated
on having such an excellent record of their past
hi8tor5^
But the most striking paper is the very unique
and interesting address of President Diederich,
delivered at the last meeting, entitled **A Hom-
oeopathic Decalogue." It abounds in clever hits,
in good advice, and in good sense. Dr. Diederich
shows himself to be a good homoeopathist, and
yet liberal enough to suit the highest and the
lowest alike.
To be appreciated. Dr. Diederich's address
must be read. Its extreme originality is refresh-
ing. We suspect that the enterprise shown in
the publication of this volume is in great meas-
ure due to the energy of the retiring president.
Prelixninary Announcement.
The valuable series of articles on Hay Fever, by
Dr. E. Lippincott, of Memphis, Tenn., will soon be
issued in book form by Gross & Delbridge, pub;
lisbors. Orders may now be sent in.
A Great Popular Cyclopedia. — The fourth vol-
ume of Alden's Manifold Cyclopedia, a marvel of
condensed information, fulfills the promise of
those which have preceded. The publisher, John
B. Alden, 893 Pearl St., New York, or Clark and
Adams Sts., Chicago, will send specimen pages free
to any applicant, or a specimen volume ( which may
be returned if not wanted) in cloth for 50c. or
half morocco, 65c.; postage 10c. extra. The set
of thirty volumes is offered at considerably re-
duced prices to early subscribers.
For Sale. — A $1,600 residence and an ex-
tensive practice for only $1,500. Reason for
selling is on account of the altitude. My family
can't live here. Fpr further particulars call on
or address P. I. Cromwell, M.D., Sterling, Lo-
gan County, Col.
. The North American Journal of Homceopathy
will come to you for three months, gratis, on re-
ceipt of your name and address.
The Century for September contains a contin-
uation of Geo. Kennan's articles 6n Siberia.
St. Nicholas is the favorite magazine for the
young.
Scribner's for September is an interesting
number and profusely illustrated.
Burling^n Route.
VESTIBULE TRAINS.
**The Burlington's No. 1" fast train, leaving
Chicago at 1 P. M. daily for Omaha, Lincoln,
Cheyenne and Denver, and arriving at Denver
at 9:10 A. M. the next evening, is now a solid
vestibule train for the entire distance between
Chicago and Denver.
The Burlington's **Fast Trains" to Kansas
City, St. Paul and Minneapolis will also be ves-
tibule trains at an early date.
288
THE MEDICAL ERA,
[Vol- VI. N©, ».
THEY SAY
That amyl nitrite is highly explosive.
That eternal vigilance is the price of
That the bomb is dynamitier than the sword.
That ether- tippling is becoming a prevalent vice.
That absinthe- drinking is becoming quite com-
mon.
That a case of leprosy has been reported in St.
Louis.
That amyl nitrite by inhalation is an antidote to
atropia.
That there will be a great waste of 'rah material
until November.
That a poisonous alkaloid has been discovered
in the expired air.
That the Arizona Indians call iodoform the
" chancre medicine."
That the existence of a "heat center" in the
brain has been discovered.
That a quarter of the population of London gets
gratuitous medical advice.
That birds have the greatest temperature, rang-
ing from 105° F. to 110° F.
That the greatest infant industry this summer is
scratching the prickly heat.
That the right cerebral hemisphere averages
greater in weight than the left.
That a little plumbago from an ordinary lead-
pencil will cure a creaking hinge.
That a diet of milk makes a large quantity of
fecal matter, and also constipates.
That many physicians persist in writing per
orem or per oram instead of per os.
That it is not surprising that an alma mater
should give her students a diplo-ma.
That assimilation is a process of endosmosis,
dissimulation is a process of exosmosis.
That the new-born children of opium- eating
mothers will die unless given the drug.
That body lice may be instantly destroyed by
washing the parts with sulphuric ether.
That a film of oil no more than the joikViyij of an
inch will prevent waves from breaking.
That the Seven Sutherland Sisters' celebrated
hair tonic consists of bay rum and salt.
That a corneii player who cannot attend the
band meeting should send a subs-to-toot.
That it didn't hurt the baby to fall into the cis-
tern, because it contained soft water, you know.
That a great many people who are crazy to get
into the social swim are drowned before they get
out.
That an American dentist has just been fined in
Berlin for putting the word "doctor" on his cards.
That the reason Mohammed refused to go to the
mountains was because the hotel rates were so
high.
That in cholera the temperature may fall as low
as 80° F., and in tetanus it may rise as high as
122° F.
That a pause between one respiration and the
next indicates a pharyngitis and differentiates it
from croup.
That fatal bronchitis in persons between ten and
sixty years of age, is either capillary or secondary
to tubercle.
That the American Medical Association no longer
requires applicants for memberships to sign the
code of ethics.
That there are many doctors in the poorer parts
of London who will see a patient, prescribe, and
supply medicine at twelve cents a visit.
That it is almost impossible to construct a tele-
graph line in some parts of Africa; monkeys cliznb
the wires in such numbers as to break them down.
That it is hard to tell whether it is the pretty
girl that makes the white dress look cool, or the
white dress that makes the cool girl look prettv.
Which is it?
That the bacillus of tetanus produces a peculiar
ptomaine, which has been named tetanina It is
probable that the disease is due to the action of
this ptomaine.
That 113° F. would prove fatal on account of
the disturbance of the nutritive process. 75° F.
would prove fatal on account of the excessive dim-
inution of heat.
That not more than five persons out of a thou-
sand who have used opium hal^tually for more
than six months can ever free themselves from the
trammels of the drug.
That a man put some chlorate of potassium and
friction matches in his pocket. By the time they
had settled their little difficulties he required sur-
gical treatment for a burn.
That flesh which is to be examined for trichinae,
should first be subjected to the action of pepsin in
acidulated water; the meat becoming peptonized
the trichinae are more easily distinguished.
That the ghost of a boy who died of eating too
much watermelon haunts the melon-patch of a
Georgia farmer, and at night it can be heard to
cry and groan with the colic. It is supposed to be
a case of " cholera-in-phantom. "
THE MEDICAL EM
Vol. VI.
Chicago, October, 1888.
No. 10.
EDITORS :
CH. GATCHELL, M.D.
JAMES £. GBOSS, M.D.
THE OPENING OF THE COLLEGES.
When this number of The Medical Era
reaches its subscribers, fourteen hf>moeopathic
medical colleges will have begun the winter's
work, with an aggregate of about twelve hun-
dred students in attendance.
There is one college each located in Boston,
Philadelphia, Cleveland, Cincinnati, Ann Arbor,
Minneapolis, St. Louis, Iowa City, t^^ansas City
and San Francisco, with two in New York and
two in Chicago. They are all well-established
and prosperous, and three are state institutions.
And yet there are those among our friends, the
enemy, who say that " homoeopathy is dying
out " !
MANY GRACEFUL COMPLIMENTS.
To pay a compliment, and do it well, requires
great delicacy and a rare tact.
The numerous compliments which were show-
ered upon homoeopaths by several members of
the Kentucky State Medical Society, at its recent
meeting, give evidence that the gentlemen com-
X)osing that body are not wanting in the accom-
plishments of polite society. Really, they were
BO profuse in their praises, and so much inclined
to return to the subject again and again, as to
give rise to the suspicion that, in an excess of
good feeling, they intended to flatter us beyond
our deserts.
One member ** admired the wisdom and fore-
thought " of those who formulated the code of
ethics, which would not allow a "regular" to
consult with a " homoeopathic practitioner,"
This delicate compliment, so undeserved by
us, fell from the lips of the distinguished presi-
dent of the society, thus having the sanction of
him who was highest in authority.
Another doctor found fault with the Governor
of the state because he appointed "two little-
pill men on the State Board of Health, which
board was called into existence by the So-
ciety.**
This glowing tribute to our worth came from
a Lebanon member, who re-enforced his remarks
with some further comments of a like tenor.
Surely, homoeopaths,, had there been any within
hearing, must have felt a growing pride, for
while the president had called us " practition-
ers," this member made such an extended excur-
sion into the realms of flattery as to speak of us
as " little-pill men,*' and to insinuate that ho-
moeopaths have no right to any position within
the gift of his excellency, the Governor.
But, if these two members were unnecessarily
civil, the next one who spoke indulged in re-
marks which showed, really, an excess of kind-
ness and good feeling. It is said that —
<< Homceopatliy received its jast deserts at his hands,
and he likened its treatment to the hair of the dog to
cure the bite of the same. When he saw one of these
gentlemen swinging his shingle to the breeze, he felt
like exclaiming, in the language of the sheriff, * God
save the commonwealth! ' He thought they were mur-
derers, and worse than murderers. The murderer was
honest in his profession, and did not pretend to be a
doctor, and was liable for consequences. He thought
every homoeopath should be hung till he was dead
three times."
What an excess of kindness is here ! From
compliments we have come to flattery — flattery
of the crassest kind. The president called us
"practitioners;** the Lebanon doctor, "little-
pill men,** but here is one who, out of the abun-
dance of his heart speaketh with his mouth, and
290
THE MEDICAL ERA.
[Vol. Vi. No. 10.
bestows upon us the distinguishing title of
"murderers.** Was ever any set of men more
highly flattered ?
As we go further into the history of this re-
markable meeting, it is possible to discern the
source of all the good feeling expressed. After
homoeopaths had been consigned to the tender
mercies of the hangman, the members proceeded
to settle a few little difficulties among them-
selves. The record says : .
<« The discussion was followed by a very intemperate
exhibition of medical politics. When the report of the
nominating committee was brought in. there was war
almost to the knife. The president felt affronted at the
unprecedented action of the society in rejecting tke
nominations of the committee, which was of his own
creation.
•* Dr. Yundell, in a very bitter speech, in which he
accused members of holding office above that which was
higher than honor [!J, offered his resignation.
*< Dr. Bailey offered his resignation as first vice-pres-
ident. Accepted.
<'Dr. Cecil offered his resignation.
<< Several gentlemen rose to a question of privilege,
some acrimonious remarks were made, and matters
began to look fiery —
'* When some member called for the resumption of
the order of the day.
«' The trouble dates back to feuds for which Ken-
tucky is SQ noted, and has grown into fights between
college faculties. Louisville has three times as many
coUeges as she can stand, hence this bitter rivalry and
disgraceful quarreling."
These are the men who undertook to bestow
upon homoeopaths so many graceful little com-
pliments. But we feel that we can, without any
sacrifice of modesty, accept them from those
who, among themselves, indulge in "bitter
speeches," "acrimonious remarks,** and "dis-
graceful quarreling.**
In thanking our Kentucky friends for their
kind consideration, there is only one other com-
ment which suggests itself :
For a homoeopath to be hanged, is rough;
but for a homoeopath to be hanged "till he is
dead three times," is most decidedly tough!
THE YELLOW-FEVER.
It is just ten years since Memphis was visited
by the scourge which is now devastating Jackson-
ville, and history is repeating itself.
new victims each day, while *the death-list is
steadily growing. The city is being deserted as
fast as refuge can be found, and those left be-
hind are in a deplorable condition. Scattering
cases have appeared at various places in the
South, and there has been an outbreak among
a party of refugees that fled to the mountains
of North Carolina. The fever has also claimed
one distinguished victim in New York City.
At the time of the Memphis epidemic, and
during its height. Congress appointed a National
Board of Health, composed of some of the most
able sanitarians and medical men in the country.
Their action was prompt and decisive, and when
the disease reappeared the following year it was
quickly suppressed and a second panic pre-
vented.
Had this Board had a continued existence
the present epidemic might have been averted,
for it is now known that there were warnings of
its approach many months ago. But there was no
such body of able men ready to deal with it. The
efficient Board of ten years ago — a body made
up of sanitarians who in point of scientific at-
tainments and in record of work actually done
have never had their superiors — was wiped out
of existence through political influen<jps, and
superseded by a political bureau — the marine
hospital service — which has demonstrated its
inefficiency in the present' in stance.
There should be another National Board of
Health, non-partisan in its character, and com-
posed of men who are selected because recom-
mended by their scientific attainments and
knowledge of hygiene and sanitation. It is the
duty of Congress to re-establish the former board,
or some similar body of men, and to give money
freely to the execution of sanitary measures
before an epidemic appears.
During the month of September the fever has
rapidly increased, finding a large number of
Our government has spent more money in
the investigation ^of the diseases of the hog than
of those which afflict mankind.
Meanwhile, Jacksonville is still suffering.
OpT.« 1888.]
EDITORIAL.
291
ABOUT TUBERCULOSIS.
It is only within the past ten years that we
have gained an intimate knowledge of the na-
ture of the most destructive disease that afifects
mankind.
At the recent Congress for the Study of Tuber-
culosis, held at Paris, many facts which have
been developed within the period named, were
for the first time formulated. Doubtless some
of the statements made still need verification,
but in the main we may accept the conclusions
arrived at.
this means, acquire tuberculosis, is because more
are not susceptible.
The eommunicability of tuberculosis — which
by some has long been recognized as a fact —
was reafiSrmed. But it is generally agreed that
the conditions of contagion must be favorable.
The individual must be '' susceptible " — there
must be a proper ** soil '* to receive the specific
germs.
This is the old question of "constitution," of
'' diathesis," stated in another way. What was
formerly conjecture, is now almost a demonstra-
tion.
One of the most important, though by no
means one of the newest, subjects discussed was
the acquirement of tuberculosis through the me-
dium of the milk or flesh of tuberculous animals.
Dr. H. C. Clapp, of Boston, in his "Is Con-
sumption Contagious ? ** has dealt with this ques-
tion so intelligently and in so thorough a man-
ner, that little remains to be said. But until
the entire profession appreciates its importance,
and until the people are taught to give practical
heed to its lessons, continued agitation is de-
manded.
Under the most favorable conditions, the con-
tagion of consumption may, doubtless, through
the medium. of the atmosphere, be taken into
the system by inhalation. But this, while pos-
sible, must be of rare occurrence. Probably, in
the majority of cases, the vehicle of transporta-
tion is the milk or flesh of tuberculous animals.
In our large cities there is probably very little
milk — consisting, as it does, of the mixed milk
of mjiny cows — which does not at times contain
tubercle bacilli. That more people do not, by
The bacilli of tuberculosis cannot, it is be*
lieved, pass from the blood of the mother to the
blood of the child, since they cannot traverse the
placenta. At any rate, Koch, Weigebt and Jahni
have all presented negative evidence on the sub-
ject. Hence a tuberculous woman may bear a child
entirely free from tuberculosis. If this be true,
then heredity plays but a secondary r6le in the
causation of the disease. But the child can in-
herit the " vice of constitution," the "diathe-
sis," which renders it susceptible, and thus it
succumbs to the first invasion of the system by
tubercular matter, whether conveyed through
the medium of the mother^s milk, cow's milk, or
other food.
According to M. Van Hersten, of Brussels,
tuberculosis is found in cows in the proportion
of four in the hundred ; among calves not more
than one in six or eight hundred is affected*
This fact would seem to lend probability to the
view above expressed.
Cadeac and Mallet, as the result of experi-
ments, satisfied themselves that the inhalation
of air containing tubercle bacilli is not produc-
tive of tuberculosis unless the animal is already
suffering from bronchitis. They claim that the
presence of a catarrhal secretion in the acini
and bronchioles is essential to the settlement
and growth of the bacilli. If this be true, then
it is in a line with the old theory of Niemeyer,
which he promulgated many years before Kooh
demonstrated the specific bacillus.
Experiments in the line of preventive inocu-
lation all gave negative evidence. Nor is it to
be expected that the result should be otherwise.
Consumption presents no points of resemblance
to those diseases — such as small-pox and an-
thrax — which have been shown to be controlled
by such prophylactic measures.
In the matter of therapeutics, the Congress
was barren of results. Not a new remedy was
named, npr ^ pew line of treatment suggested.
292
THE MEDICAL ERA.
[Vol, VI. No. 10.
But even this is far more creditable than it
would have been had they offered to a waiting
profession a number of impracticable and disap-
pointing methods, which would but follow the
Bergeon apparatus to the lumber-room.
The specific character of the bacillus tuber-
culosis, and its causative relation to the diseased
process is now questioned by no one who is well
informed. Even the sceptical Semmola was
compelled to make an exception of this, when
warning others against the over-confident bac-
teriologists.
The one practical act of the Congress was the
passing of a resolution to the effect that, in their
opinion, all animals affected in any degree with
tuberculosis should be seized and condemned as
unfit for food.
In the light of present knowledge the carrying
out of the sentiment which this resolution ex-
presses would result in great good to mankind.
It points out the chief, if not the only, practicable
method of prophylaxis against consumption now
at our command.
The result of the labors of this Congress seems
to justify a remark which we find in ** Robert Els-
mere:'* — ** There never was so little original
genius in Paris, and there never was so much
good work being done."
THE GREAT ANTI-PERIODIC'
•* Doctor, my former physician told me to take qui-
nine, and within a short period I took sixty- eight
5-grain pills, but felt no effects whatever. Isn't *that
a Uttle singular ? "
This question was addressed to us by a man
whom we were recently called upon to treat for
a malarial fever. Our reply was that, every-
thing considered, it was not at all singular.
Here was a man who had taken three hundred
and forty grains of quinine, with no perceptible
effect ! Nine years ago, such a thing could not
be, but now that the country is deluged with
cheap and adulterated quinine, it may be taken
with as much impunity as so much salt.
The reason for this is that the doors of this
country are open to the world to Alter with this
product of the bark, and the manufacturers of
the world, competing with each other, are not
slow to take advantage of it. Adulteration, the
child of close and enormous competition, has
done the rest.
In 1879 the price of quinine in our markets
was $3.18 per ounce; at present it is about 80
cents per ounce. In 1879 all tariff was removed
from quinine, and since that time it has entered
duty free.
There are those who claim that it was the re-
moval of the duty that lowered the price of the
drug. But let us see if this is true : *
Down to the year 1879 the world's only source
of supply of cinchona bark was Peru. It grew
in a wild state; no means were adopted to pre-
serve the trees, and the forests were rapidly be-
ing depleted. Anticipating an ultimate failure
of the Peruvian bark, the Dutch in Java, and
the English in India and Ceylon, had, years be-
fore, begun its cultivation. The experiments
proved a success, and in the early eighties the
new supply began to come into the market. Im-
mediately the price of quinine began to fall, and
there has since been a steady decline, keeping
pace with the yearly increasing supply of the
bark, which is now far greater than ever before
in the world's history. Moreover, the percent-
age of sulphate of quinine which can be extract-
ed from the cultivated bark, is five times greater
than that which the wild article supplied.
This is what has reduced the price of quinine,
the world over, and the removal Of the tariff
duty in America had no more to do with it than
did the death of the Siamese twins.
There are many facts which could be cited to
substantiate this statement, but they are of
greater interest to the political economist than
to the physician. It is sufficient for us to know
that the American manufacturer has been
swamped by the product of the low-priced labor
of Italy, Germany and England, and that the
goods offered -are of an inferior quality.
Oct., *888.]
ORIGINAL ARTICLES.
298
Meanwhile, the oonsumption of quinine has
enormoasly increased, but the " shakes " are as
common as ever.
ORIGINAL ARTICLES.
DUNOLISON DEMOLISHED.
The following item was published just four-
teen days ago in a Pittsburg paper :
Miss Margaret L. Crampton, M.D., has
jast been appointed a delegate to the
Pennsylvania Homos opathio Medical So-
ciety. She is the first woman in the
United States to be chosen as a delegate
to a medical convention. She wiU read
a paper on ** Polio-MyeUtis Anterior
Acnta."
A few days later the same^item, slightly cor-
rupted, appeared in a Chicago paper. It wound
up by saying —
She will read a pap^r on << Polio- Myel-
itis, Anterior, Acute."
The next Monday morning an Omaha editor
got hold of it, and it showed up in his paper
still a little the worse for the wear. It stated
that —
She WiU read a paper on <' Polio, My el, it
is anteri or acute.'*
With the aid of a pair of crutches the item is
still wandering westward, and by the time it
reaches "the Coast" the editors will have Dr.
Crampton reading a paper on '* Sapdio, why it
is better than soap,'' and its best friends will not
be able to recognize it. When the secular press
gets to wrestling with a medical term, Dungli-
son is fearfully slaughtered.
But is sh^ the first woman delegate, anyhow ?
Dr. Abernethy was once consulted by a gen-
tleman laboring under intense mental anxiety,
almost bordering on insanity. On questioning
him, he found that his malady was induced by
close study, and advised him to abandon every-
thing and seek repose, and especially to take
frequent opportunities of seeing and hearing the
famous Grimaldi, a noted clown and player who
was convulsing London with his jokes and an-
tics. To his surprise the patient exclaimed :
"Alas, Doctor, I am Grimaldi! "
Written expressly for THE MEDICAL ERA.
HEPAB SULPHUBIS OALCABSUM.
. Bt H. p. holmes, M.D..
8YCAM0BV, ILL.
THIS peculiar preparation, which is a stand-
ing proof of the wonderful experimentative
research of Hahnemann, is used to-day only
by the homoeopathic school. The allopathic tend-
ency to imitate and appropriate has shown itself
in the spurious preparation known in our school
as Hepar sulphuris kalinum. This latter
preparation, the only one named in the United
States Dispensatory, we are especially warned
by Carroll Dunham not to use, for it has been
discovered, in the course of experiments, that
the sulphur in the compound is soluble. Our
preparation of Hepar sulphur is not mentioned
in the United States Dispensatory, which gives
us reason to state that we are the only ones who
possess and use this remedy. The radical ^
difference in the two drugs may be appreciated
when we know that Hepar sulphuris calpareum
is prepared from equal parts of the fiowers-
of-sulphur and calcined oyster-sheUs ; while
Hepar sulphuris kalinum (the Hepar sulphur of
allopathy) is prepared from one part of sulphur
and two parts of carbonate of potassium.
The more one uses a remedy the greater
knowledge he acquires of its sphere of action,
and at the same time the more he is inclined
to make a hobby of it, providing it fulfills its
general indications. It is only by general use
of a remedy, and by the wide experience of
many physicians, that we can thoroughly learn
its action ; and when the result of that wide
experience is gathered together, its judicious
abridgement will indicate the certain and
reliable use of the remedy. In this article I
will present my own ideas of the uses of Hepar
sulphur, in as practical a manner as possible.
We are taught that Hepar sulphur is the
great remedy in suppuration. Very few, how-
ever, understand it to be one of the grandest
remedies to prevent suppuration. Dr. Helmuth,
in his work on surgery, quotes in a foot-note,
page 61 : — " Sometimes under its use the
suppurative process is rapidly followed by
absorption, and the abscess disappears without
being opened.'* On the first page of Lilienthal's
Therapeutics we read: — **If there arises on
any internal or external part a painful, red, in-
flamed swelling, . . . Hepar will often disperse
the whole swelling and keep off suppuration/'
294
THE MEDICAL ERA.
[Vol. VI. No. 10.
This experience I have verified so many times
that I am led to regard Hepar sulphur as an
anti-suppurative. In incipient adenitis it works
wonders, and stands second to few remedies in
its ability to promote resolution without suppu-
ration. For enlarged cervical glands I rely
chiefly upon Hepar and Iodine. In my opinion
it always acts as an anti-suppurative. While
the key-note of its use seems to be '* suppura-
tion," I believe it is its tendency to prevent
supp]iration and bring about a healthy tissue
action, that makes it so useful. The two great
health-producers are vital force and the circula-
tion ; consequently, whatever adds to, or de-
tracts from, these two agents, acts correspond-
ingly as a tissue-changer. Hepar sulphur may
be said to release an unusual amount of vital
energy, and this, and not the remedy itself,
brings about the healing process. We see this
well illustrated in its action following mercurial
treatment ; its antidotal action frees the system
from the pernicious effects of the Mercury, and
the released vital force carries the healing
action on untrammeled.
A pi^actice with me that has become almost
routine, is, in the treatment of ulcerated sore
throats where the mercurial preparations are
used, to suspend the Mercury and substitute
Hepar sulphur as soon as I find that improve-
ment has begun. My reason for this is that I
consider Mercurius a powerful and long-acting
remedy, productive of many evil results after
its desired action has been accomplished. In
such cases all that we hope to accomplish is to
remove the affection for which the remedy was
prescribed. As soon as this healing action is
well under way, nature will accomplish the rest,
and the Hepar will prevent the Mercury from
doing more than is required of it. This
practice with me has been productive of such
good results that I can advise anyone to follow
a dose of Mercury by Hepar sulphur.
Hepar sulphur finds its main sphere of action
in the scrofulous subject. For enlarged glands,
eczema, intertrigo, and suppurating affections
attended by a discharge of thick, yellow pus, it
stands first and foremost. There are few cases
of eczema capitis that will not yield to Hepar
or Graphites, and these remedies work well in
alternation, or used in periods, first one and then
the other. I do not wish to be understood as
advising the alternation of these two remedies,
for it is not good homoeopathic practice ; but I
wish to be honest enough to say that they have
done for me most excellent work, in alternation,
in days when my medical qualifications were
not such as to enable me in every case to
prescribe the simiUa off-hand. For eczema of
the body and eiLtremities it has not satisfied me
so well, and I am willing to attribute the result
to routine prescribing, and not to careful in-
dividualization of the remedy.
The most familiar key-note of Hepar sul-
phuris is : — '< Sensation as if a fish-bone or a
splinter were stioking in the throat." This
symptom might well have a broader meaning,
and read: ''a pricking sensation in the affe'jted
part." It matters not what the affection may
be ; the pricking sensation, as if there were a
sliver in the affected part, is a sufficient invita-
tion to study Hepar. Not only in sore throat
does this symptom become valuable, but also in
felons, abscesses, hemorrhoids (here, in contra-
distinction to iBsoulus, where the sensation is
as of sharpened sticks in the rectum), pneu-
monia, pleurisy, rheumatism, and, in fa«t,
in any affection in which the symptom
appears. As proof of this, I will cite Allen's
Encyclopaadia, in which over fifty symptoms are
given containing the words ''sticking" or
** pricking." Many physicians will bear witness
of the efficacy of Hepar in removing so-called
** fish-bones " from the throat, and a similar
condition is apparent in felons. The majority of
patients appearing for treatment for felons have
thought there was a sliver in the affected part,
and have made pretty strict search for the
offending object. Had Hepar been administered
when the patient first began the search for the
** sliver " the trouble would, most likely, have been
Warded off. Confirmatory of this AUen gives,
'* Stitches in one finger, as from needles."
Among the mental symptoms, we find an
irritability equal to and similar to that of
Chamomilla. Peevish, irritable, fretful; quick,
hasty speech; peevish about trifles. This
irritabihty may come largely from another con-
dition which is a key-note of the remedy: —
** great sensitiveness to the slightest touch."
The patient is not only sensitive to touch, but
also to the slightest draft of air ; sensitive to
everything.
This remedy, so useful in suppuration, is
also one of the polychrests in rheumatism. If
anyone wishes to see its many indications in
this disease, I would call his attention to that
excellent work on " Eheumatism and Kindred
Diseases, " by Dr. D. C. Perkins. The excessive
irritability and sensibility ; the great sensitive-
ness to the slightest touch or draft of air ; the
great heaviness of the limbs and the affected
parts ; red, hot swelling of the joints of hands
Oct., 1888. J
ORIGINAL ARTICLES.
2d5
and fingers, and last, but not least, the previous
treatment of the case by Mercury or the Iodide
of x>otassium, are the leading indications for
Hepar sulphur.
In croup, either spasmodic or true, it is of
the greatest service. Where the cough has the
rough, sawing sound, but with more or less of a
loose rattling, it wiU do good work. It forms
one of the five celebrated croup powders of
Boenninghausen ; viz : 1 and 2, Aconite 200th ;
3 and 5, Hepar sulphur 200th; 4, Spongia
200th. Hahnemann says in his << Lesser Writ-
ings:" — "The symptoms of croup are to be
found in the pure materia medica among
83rmptoms produced by burnt sponge and Hepar
siilphuris ; and see ! these two alternately, and
in the smaUest dose, cure this frightful disease
of children, as I first discovered."
In the 3ummer diarrhoeas, when the patient
smells sour; when the first thing noticed on
entering the sick-room is the sour smell from
the patient, there are few remedies so likely to
be indicated as Hepar sulphur. The same hint
in regard toHhe previous use of Mercury applies
as well here as in any other case. I will not go
farther in its indications in diarrhoea, as all
have the materia medica to refer to.
For conjunctivitis where there is a profuse,
yellow discharge, sticking the lids together, and
the eyes very sensitive to contact or light, it
will do good work. In many cases of ophthal-
mia neonatorum, where the above symptoms are
prominent, it will prove a reliable remedy.
I have a case of chronic pelvic peritonitis
which derives more benefit from Hepar sulphur
than any other remedy, even though others
seem better indicated. When from over-exer-
tion, riding, or a long walk, the sensitiveness
of the peritoneal membrane appears, there is
nothing soothes like Hepar sulphur.
In my experience the lower potencies act best,
and also in frequently repeated doses. I have
used it in the third decimal, the sixth, twelfth,
thifltieth, two hundredth and one thousandth,
and my preference is for the third. While
others may g^t a satisfactory action from giv-
ing a single dose high, it has always failed to
act as well for me if used above the third or
sixth trituration. I have also come to the con-
clusion that alcoholic dilutions do not act as
well as the triturations. My practice is to use
two-grain powders, repeated as often as is con-
sidered necessary, and that has often been as
often as every hour for a greater or less length
of time. Carroll Dunham says of it : ** Some
physicians use the third only of Hepar sulphuris
who use higher potencies of other drugs."
Hahnemann speaks of giving ten grains of
Hepar sulphur in twenty-four hours to a young
man who had taken large quantities of Calomel
for a gonorrhoea. He afterwards gave the same
patient three grains of this remedy every hour,
with the best results, and then adds : '< I leave
every thinking man to draw his own inference
from this striking case. "
THE THEBAPEUTICS OF OXALATE OF
CERIUM. ^
BtB. M.HALE. >I.D.
CBICAOO.
THE extension of the therapeutics of this drug
is one of the curiosities of medical science.
It was introduced to the profession by Dr.
J. Y. Simpson, as a remedy for the vomiting of
pregnancy. I do not know what lead Dr.
Simpson to its selection, for he was certainly the
first to use it in any way. He designated it '< a
sedative tonic, resembling in some degree, the
Salts of silver and Bismuth." He not only found
it useful in the vomiting of pregnancy, but in
many cases of vomiting from uterine irritation ;
also in << pyrosis, hysterical emesis, and various
dyspeptic conditions of the stomach — especially
atonic dyspepsia."
The clinical experience with this drug in the
above disorders, has been in many cases brilliant
and surprising, relieving serious cases when all
other remedies failed. There being no *' proving "
on record, the exact symptoms calling for its use
cannot be given. My own experience shows
that while it will arrest the vomiting, even of
bloody matters, and the painful, empty retching,
the nausea generally remains.
The deduction I have drawn from this fact, is
that its chief power is on the spasmodic element
in the vomiting pisocess. It appears to me to
act more upon the motor, than on the sensory
nerve of the stomach. It is of some value in
the vomiting of children — from reflex, intestinal
or cerebral irritation. Several physicians have
found that in doses of 5 grains, in children, it
has some decided ** narcotic " effects, which
would show that it has some sedative action on
the brain.
The next step in the evolution of Cerium is its
use in whooping-cough. Several physicians
found it to have decided palliative effects in the
spasmodic stages. It changed the whoop, or
spasm of the glottis, to an ordinary cough.
This ought to have led to its use in idiopathic
spasm of the glottis in children and hysterical
women, but I find no record of such use.
296
THE MEDICAL ERA.
[Vol. VI. No. 10.
Recently several papers have appeared re-
commending its use in all severe, shaking, spas-
modic coughs, those of .a nervous or reflex origin,
and in chronic bronchitis and laryngitis.
,Now, in cough, or in vomiting, it is evident
that it is the spasmodic element which is most
under the control of Cerium.
Theoretically it ought to be useful in spasm
of the stomach and intestines. Dose, 1 or 2 gr.,
crude, or Ix to 3x.
A new use of this drug is to relieve the pain
in 4ysmenorrhoea. The discovery of its value in
this disorder was due to a mere accident. Dr.
Chambers, in the Medical Record, writes that he
was applied to by a young lady of fine physique,
in perfect health. Not wishing to give her Mor-
phine, thinking that ** a little pain would do
her less harm than a dose of Morphine," he gave
her four powders of 6 grs. each of Oxalate of
cerium **as a placebo," one to be taken every
hour till the pain was relieved. To his surprise
he learned from the lady that three powders had
given her entire relief. Acting on this experience
Dr. Chambers says he has given it in many cases
with excellent success. He says he cannot state
exactly what form of dysmenorrhoea it cures, but
adds : " It is in that kind, however, frequently
occurring in fleshy and robust women, with
scanty discharge, in which the pain comes on
before the flow, or at its commencement, is spas-
modic or colicky, accompanied by a feeling of
tenesmus, and is relieved when the flow is
thoroughly established." He says he does not
remember a failure when given for the above
symptoms. The dose he finds most useful is 5
grs. every hour till relieved. He cautions us to
use only the pure drug.
65 Twenty- SBCOND Stbeet.
THE MODIFIED CLAMP OPERATION FOB THE
REMOVAL OF REDUNDANT TISSUE
OF THE LOWER RECTUM.
Bt E. H. PRATT, M.D.
CHICAGO.
IN The Medical Era for August, 1887, was
an article by the present writer on '* A New
Operation for the Treatment of Hemor-
rhoids." It was a description and commendation
of Whitehead's process, but at the close of it is
the following prophetic language :
"It is possible that a combination of the
clamp and the present operation may shorten
the process, and make it less bloody; and
although it is as yet untried, I can think of two
ways of accomplishing this purpose. The first
is by clamping half of the anus at a time and
applying the stitches behind the clamp before it
is removed. The crushed ridge is then to be
amputated and the stitches secured, after which
the other half may be dealt with in a similar
manner.
'' The second suggestion is to include the
entire anus in a single grip of the clamp, being
careful not to apply the clamp as closely as in
an ordinary clamp operation. After removing
the clamp and severing the crushed ridge, I can
conceive no difficulty in matching the mucous
membrane to the skin by sutures."
A year has now gone by, and the operation,
which at that time was merely suggested, has
been so thoroughly tested and has passed into
such general use, owing to the simplicity of the
process and the uniformly satisfactory results
obtained, that there is little doubt now of its
passing into the history of surgery and occupy-
ing a place in the list of standard operations.
This fact is now pretty well known, as the
operation has been pretty generally adopted, but
a more careful account of its details may be of
use to some, and will constitute the future report
promised in the original article.
The operation is for the relief of cases which
present at the anus a large mass (constant or
occasional) of prolapsed, redundant and con-
gested tissues, and has for its object the com-
plete removal of the mass without loss of time
or blood and the covering of the wounded surface
by mucous membrane.
As the first method suggested has been so
eminently happy in its results, I have never
tried the second, and have heard of no one who
has. Hence, my report will be confined to the
former.
The patient having been anaesthetized and
placed on his back, with the thighs flexed on
the abdomen and hips elevated on a pillow, the
sphincters are thoroughly stretched, the degree
of stretching being until they show no tendency
to immediate contraction. Artery-forceps^ are
now employed to seize the protruding portions
destined for removal, the entire ring being well
everted by their aid.
By examining the prolapsed ring a decision
will easily be reached whether it will require
dividing in two, three, or, possibly four places.
After a bistoury has accomplished this, one of
the, segments is to be seized with two or three
pairs of forceps and held straight while the
clamp is being applied. The choked tissues are
now to be clipped away, so as not to interfere
with the subsequent work. Straight needles,
threaded with good-sized cat-gut, are now passed
Oct., 1868.1
ORIGINAL ARTICLES.
297
through the secured segment, about one-quarter
of an inch apart and one-quarter of an inch from
the clamp, the ends being held apart by an
assistant. The clamp is, now removed, the
crushed ridge seized with forceps and cut off
with scissors. No hemorrhage of consequence
should follow. The stitches should now be tied.
The other segments are to be treated in a like
manner until the circuit of the anus is made.
A few places will now be found needing addi-
tional sutures, which are to be applied in such
a manner to co-apt the skin and mucous mem-
brane neatly at every point. The wound may
be dressed antiseptically or treated with moist
or dry, hot or cold dressings, as the surgeon
prefers.
Occasionally some slight pain and soreness
results for a day or two, but not usually so severe
as to require a local anodyne.
The part will require no further attention if
the work is well done, as healing takes place by
first intention, and no contraction follows.
This operation seems to me to be so admirably
adapted to its purpose as to admit of little
improvement. A week in bed is the usual time
needed for complete repair.
So much for prolapsus with redundant tissues.
But there is another condition that calls for
attention in which invention is still needed. It
is where there is a varicose condition of the whole
ring of anastomosing veins at the lower margin
of the anus, without either prolapsus or redun-
dancy of the other tissues. To remedy this
trouble there are two methods, either of which
would be practicable, but, since they are as yet
untried, so far as I am aware, experience must
determine the choice between them. One method
is the suggestion of Dr. G. S. Eldridge, of
' Chicago, and the other is my own. Dr. Eldridge
proposes sub-mucous ligation with silk, by
sections.
The other process involves the separation of
the mucous membrane from the skin, as in
Whitehead's operation, except to a less extent,
the paring off of the enlarged veins from the
under surface of the mucous membrane with a
pair of scissors, and the subsequent replacing
of the mucous membrane and sewing it to the
skin with cat-gut. These cases often resist cure
by simple dilatation of the anus, by ointments,
internal medication and by injection, and call
for radical measures. It seems as if one of the
methods proposed would meet the requirements
of such a case.
The following cut illustrates a new clamp
which I have just had constructed for use in
cases presenting one or more large isolated in-
ternal piles, piles which are too lai^e to exsect
with scissors and too long to permit of treatment
by the injection method with safety. The bowel
is to be dilated, the pile is to be seized with one
or more artery-forceps and raised from its bed,
and the clamp is to be applied longitudinally.
The choked tissue is to be snipped away and cat-
gut ligatures are to be applied behind the clamp,
the clamp removed, and the ligatures tied, as in
the modified clamp operation just described. In
some cases this can be done without a speculum,
but the tissues are so easily torn that it is safer
to use one, especially where the pile is under the
prostate gland. The final appearance of the
wound is of one or more fine, nicely co-apted
seams, extending up and down the bowel. This
clamp has already been used, and gives satis-
faction.
56 Centbaij Music Hai<Ij.
THE TREATMENT OF CONGENITAL TALIPES
EaUINO YABUS.
Bt o. f. shears, m.d.
CHICAOO.
[Read before the Illinois Homceopathlc Medical Association.] *
IN looking over the works in my library on gen-
eral surgery — Gross, Helmuth, Agnew,
Heath, Hamilton, Wyeth and others — I
was surprised at the uniformity with which these
authorities limit their remarks on the oper-
ative treatment of club-foot to the division of
tendons in the medium and severe cases of de-
formity, and to the possible efficacy of tenotomy
in the extreme cases. In none of these is ref-
erence made to the necessity of dividing other
structures than the tendons and fascia, while it
is certain, from recent observations, that the lig-
aments play a part second to no other structure
in the maintenance of the deformity, and that
their division is as important, in severe cases, as
that of any of the tissues named.
Again, some of these authorities adopt the
plan of simultaneous division of all the tendons
implicated, while others divide only a part at one
sitting ; some advocate the plan of immediate
restoration of the foot to its normal position,
after tenotomy, while others believe several days
298
THE MEDICAL ERA.
[Vol. VL No. 10.
should elapse between the operation and the
straightening of the foot. No one but Wyeth
places any stress upon plaster-of-Paris, the
agent which, in my experience, is the most val-
uable of all the mechanical appliances. It is
this lack of appreciation, on the part of the au-
thors mentioned, of the part taken by the liga-
ments in the maintenance of deformity and of
the value of syndesmotomy, as well as this vari-
ance in the after-treatment, that has led me to
bring the subject before this Society.
Equino-varus is of many grades, from the
very light to the very severe, and the anatomy
of the deformity is equally variable. In general,
it consists of an extension of the ankle and in-
version of the foot. This latter is a complicated
change, a rotation of the calcaneum inward, and
an inversion of that part of the foot beyond the
medeo-tarsal articulation. The foot, in its nor-
mal position, is held in place and its arch main-
tained by the binding together of its tarsal, met-
atarsal and phalangeal bones by ligaments and
by the sustaining power of muscles and tendons.
Any chauge in position of these bones, such as
occurs in talipes, means a changed relation of
both ligaments and tendons. The action of the
tendo- Achilles in extending the foot and produc-
ing or maintaining the equinus, is well recog-
nized, and the action of the tibialis anticus, pos-
ticus, flexor longus digitorum, flexor longus polli-
cis, adductor poUicis, and plantar fascia, in pro-
ducing or maintaining the inversion, is equally
well recognized, but that the ligaments uniting
these bones are equally at fault, and then- divis-
ion as certainly demanded, is not so widely
taught.
My attention was first called to this subject
some three years ago, while treating a severe
case of club-foot. I had divided all the ten-
dons, but still the foot could not be restored to
the desired position, the point of resistance be-
ing at the mid-tarsal articulation. As a last re-
sort I turned the knife toward the bone and cut
down until it seemed to enter the joint, when all
resistance to restoration gave away. I believed
that I had divided the ligaments. This proced-
ure I continued to practice, more or less thor-
oughly, but never having had an opportunity to
verify my conclusions by dissection of a taliped-
ic foot, I did not feel sure of them until I read
the record of Dr. Parker's experiments, dissec-
tions and conclusions as published in his recent
monograph.
According to Dr. Parker, after all the muscles
had been removed from a talipedic foot, he could
not restore it to its natural position without us-
ing greater force than is warranted in a living
foot, while in the fellow foot, which was equally
deformed, after the dividing of the tarsal hga-
ments reduction be(\9.me easy, even when the
muscles remained m situ. The value of this dis-
covery I have frequently verified.
A brief consideration of the changes in the tal-
ipedic foot will enable us to determine more
plainly the ligaments at fault. As said before, the
inversion of the foot takes place at the mid-tar-
sal joint, the movement of the foot at the ankle
being limited to that of extension. The medeo-
tarsal joint is formed by the articulation of the
calcaneus with the cuboid and the astragalus
with the scaphoid. As in varus, the contrac-
tion is on the inner side of the foot ; the liga-
ments of the astragalus and scaphoid are the
ones that are at fault in a majority of cases of
inversion of the foot.
In addition to the astragalo-scaphoid liga-
ments proper, the bones are still further united
by fibres from the anterior ligaments, and by
fibrous expansions of the tendons of the ante-
rior and posterior tibial muscles. These form
bands of great strength, and nothing but their
division will permit of complete restoration of
the foot in severe or neglected cases.
The extension of the foot depends largely upon
the contraction of the tendo- Achilles, but besides
this, in severe cases, the posterior ligament of
the ankle-joint is shortened, so that its division
is necessary in the complete extending of the
foot.
Accepting, then, these conclusions as to the
structures entering into the maintenance of this
deformity, how is the foot to be treated ? The
remarks in the opening of this paper indicate
my faith in tenotomy. While certain of the sim-
ple, uncomplicated cases may be successfully
treated by mechanical appliances, in a great
majority of cases tenotomy is absolutely neces-
sary to a rapid and successful cure.
During the past few years I have seen many
cases in which, after long and tedious efforts,
the deformity was not overcome, and the child,
having passed the most propitious time for cor-
rection of the deformity, was then obliged to
submit to the usual operation. There should be
no objections to tenotomy, for, when skillfuUy
done, there is no possible danger. The opera-
tion should be made as early as possible. If the
child is strong and hearty the third or fourth
week is not too early, but if weak and puny all
interference may be postponed until several
months later. In every instance the operation
should be made and the foot in position by the
Oct., 1888.1
ORIGINAL ARTICLES,
299
time the child begins to put his weight upon his
foot.
The manner of dividing the tendons is des-
cribed in every work on surgery, but of the lig-
aments little is said. I will, therefore, take the
liberty of giving some directions. The astragalo-
scaphoid ligament is the most important, and is
most easily divided by entering the tenotome,
held vertically with the edge forward, in front of
the internal malleolus, tlie blade being passed
between the structures to be divided and the skin.
The knife is then turned toward the ligaments
and gradually made to cut its way down until
the tarsal bones are reached. The calcaneo-cu-
boid ligament may be divided in a like manner,
the knife being entered as nearly as possible over
the calcaneo-cuboid articulation on the outer sur-
face of the foot. ,
The posterior ligament of the ankle may be
divided by passing a spear-shaped tenotome ver-
tically through the ten^o-Achilles, just above
the prominence of the calcaneus. The knife is
then turned flatwise and made to enter the cap-
sule at about its center. By putting the ankle
on the stretch and turning the knife first to one
side and then to the other, as much may be cut
as necessary to straighten the foot. .
Most of our authorities advise the plan of di-
viding the muscles and fascia, producing the in-
version of the foot, and after two or three weeks'
treatment, then to divide the tendo- Achilles, be-
lieving that by maintaining the immobility of
the astragalus and calcaneus the inversion of the
foot can be more easily overcome. While this
seems to be the view of many of the writers, I
believe the more prominent orthopedic surgeons
do not follow it. My plan has been to make
multiple tenotomies and divide all constricting
bands at the first operation.
In connection with this subject, as to whether
a part or all of the constricting bands should be
divided at the same time, comes the question :
Is it best to place the foot in its deformed posi-
tion and wait for some days until a plastic effu-
sion has connected the divided ends of tendons,
and then begin gradually to stretch the newly-
formed tissue ? Or is it better immediately to
place the foot in as nearly a perfect position as
possible ? The fear of the older operators, that
immediate restoration, necessitating, as it does,
a wide separation of divided structures, might
result in non-union, has not been verified by re-
sults experimentally or in practice, and it is
more than probable that the constant interfer-
ence with the process of repair resulting from
the old plan of constantly stretching newly-
formed tissue, was more injurious than the more
pronounced treatment at the time of the opera-
tion. No matter how wide the separation, plastic
effusion and blood in the sheath of the tendon
will quickly prepare the way for uniting the di-
vided structures.
Having divided all constricting bands and re-
stored the foot as nearly as possible to its nor-
mal position, how is it to be so retained? Fol-
lowing the advice of the older authorities, most
of our text-books advise the use of carved wood
splints, of tractable metal splints, of adhesive
plaster, and of Scarpa's shoe, and yet none of
them, in my experience, is to be compared with
the plaster-of-Paris cast. In Scarpa's shoe, and
the various metal splints, the pressure must of
necessity be more or less localized, the strain
coming more on certain points than on others,
and as a result ulceration occurs. The frequent
application of adhesive-plaster to a sensitive,
delicate skin, is soon followed by irritation, while
the elasticity of the skin makes the maintenance
of the desired position almost impossible. Plas-
ter-of-Paris, on the other hand, does not have
fixed points of pressure, but may be so applied
as to bear equally on the entire area of the foot,
thus doing away with the sores and ulcerations,
and at the same time maintaining the foot for
any length of time in the position placed, a re-
sult not to be obtained by any other mechanical
appliance. The fact of its cheapness is not to
be ignored, especially in hospital practice.
Before the plaster bandage is applied, a soft,
well-fitting woolen stocking may be put on ; or,
if this is not at hand, a soft bandage may be ap-
plied from the toes to the knees. The toes should
be left free in order to observe any possible ob^
struction to the circulation of the foot.
One of the great objections to plaster-of-Paris
is its diflSculty of removal. This may be obvia-
ted in part by the method of application. The
following little wrinkle, as Dr. Ludlam would
say, I have frequently adopted with satisfaction
to myself : After placing a single layer of the
bandage about the foot and leg, bring successive
layers up almost to the median line, and then
turn back, and so continue until sufficient thick-
ness is obtained. By this means the strength
of the cast is maintained, while the single layer
dol^^l the center admits of easy division. The
bandage may be allowed to remain for from one
week to one month, according to the circumstan-
ces of the case. If the foot, after the operation,,
has been restored to normal position, and the
bandage is simply used to retain it in this posi-
tion, the bandage may be allowed to remain for
one month ; whereas, if still more extension is
demanded, at the end of one week the bandage
300
THE MEDICAL ERA.
IVoL VL No. la
may be removed, the foot placed in a better po-
sition, and the bandage reapplied.
As soon as the foot is in normal position, the
plaster-of-Paris may be discarded and a properly-
fitting shoe, with braces, applied. These braces
should reach above the knee, and if there is any
turning in of the limb, they may extend to a pelvic
band. The child should be under supervision
for two or three years, and in the meantime
massage and friction should be daily practiced.
The following table gives the results in eleven
cases of club-feet treated by me according to the
plan suggested in this paper. As will be seen by
the record, seven of them were perfect results,
three were nearly perfect, and in one the foot re-
mained curved, although the sole of the foot
could be placed upon the ground. Of the three
cases marked nearly perfect, all the children
were over three years of age, and the least per-
fect one was in a child of six years. Less trouble
was had with the old cases of double talipes than
in the single, possibly because the child with
both feet deformed walked but little compared
with the cases of single talipes.
Designation.
Age.
Character
of Deformity.
No. of
Operations.
Resnlte.
Operations.
James R
August S
Charlotte M
JuUus Y
8 months.
6 months.
1 year.
3 years.
1 year.
6 years.
6 years.
6 months.
13 months.
3 years.
4 years.
Double.
Double.
Double.
Single.
Single.
Double.
Single.
Double.
Double.
Double.
Single.
1
1
1
a
1
3
3
1
1
1
2
Perfect.
Perfect.
Perfect.
Perfect.
Nearly perfect.
Perfect.
Walks on sole of foot. )
( Nearly perfect. J
Perfect.
Perfect.
Nearly perfect.
Nearly perfect.
Tenotomy.
Tenotomy.
Tenotomy. Syndesmotomy.
Tenotomy. Syndesmotomy.
Patrick F
Adam H
Tenotomy. Syndesmotomy.
Tenotomy. Syndesmotomy.
Mamie B
Tenotomy. Syndesmotomy.
Tenotomy.
Tenotomy.
Tenotomy. Syndesmotomy.
Maggie B
Jennie R
NelUe R
Reiley
Tenotomy. Syndesmotomy.
3130 Indiana Avenue.
NEUBASTHENIA IN ITS PROTEAN ASPECT.
Bt H. D. CHAMPLIN, A.B., M.D.,
CLKVBLAND, OHIO.
NEURASTHENIA is a condition of nervous
exhaustion, or prostration of the whole or
some part of the nervous system, due to
deficieiit nutrition of the parts. Ocular and
microscopical examination fail to find any gross
lesion of the spinal cord or brain. It even
occurs without general ansemia or any apparent
disturbance of the vital functions.
The cause may be traced to excessive func-
tional activity of some part of the nervous
system; the emotional, intellectual, or reproduc-
tive. The disease, or condition, is real, although
careful investigation fails to find any organic
lesion. It may be manifested in a variety of
ways; its symptoms depend upon the type
which exists — cerebral or spinal exhaustion —
and also upon special idiosyncrasies belonging
to the patient.
No two cases exhibit identical manifestations
of nervous depression.
A neurasthenic is not a person with a nervous
system prone to break down, but one whose
nervous system, from some cause, is actually
broken down, and who has become an invalid,
and is incapacitated from performing the or-
dinary duties of life ; such persons complain of
languor, general weakness, mental depression,
loss of sleep, and loss of all energy in the
pursuit of business or pleasure. The causes
which largely bring about such a deplorable state
are many and varied ; shock, overwork, mental
strain, prolonged grief, irregularity as regards
meals, sleep and rest ; bad habits, viz. : sexual
errors, immoderate use of tobacco, abuse of
alcohol, chloral, morphine and drugs of that
kind.
The nervous centres are starved and the im-
poverishment is so great that nutrition fails
to supply the demand.
The symptoms divide themselves into those
proceeding from cerebral and spinal exhaus-
tion. Some patients who suffer from the first-
named manifest its eflfects. in the voice — it
becomes faint and toneless ; others in mental
disturbance, stomach difficulties, insomnia, skin
disturbances, disturbed heart's action, and so on
throughout the entire human organism.
When we consider the fact that by means of
the brain and spinal marrow, and the nerves
which unite them to the diflFerent parts of the
body, we are enabled to smell, taste, hear, and
perform voluntary muscular actions, any ap-
parently discordant facts which arise may be
easily reconciled. By means of our nerves the
digestive processes go on, the heart beats, the
blood-vessels contract and dilate, and every
Oct., 1888.]
ORIGINAL ARTICLES.
301
process pertaining to life is automatically
regulated without our knowledge or control, and
it is easy to understand how a debility of the
nerve-cells and fibres can disturb any particular
one or all of the special functions. One patient
may suffer from sexual exhaustion, another
from nervous dyspepsia, a third from insomnia,
and so on.
The symptoms of most importance in cerebral
neurasthenia (brain exaustion), and those
present to a greater or lesser degree in every
case, are, insomnia, intense activity of the mind
during waking hours, mental irritability, and
inability to concentrate the mind on tasks of
the simplest nature — the mind wanders con-
tinually from the subject in hand ; also, we find
spasmodic jer kings and movements of the whole
body, or a single member, just as the patient
is falling into a doze, and constantly recurring.
There are morbid fears of various kinds, which
generally indicate sexual exhaustion, among
which may be mentioned anthrophobia — fear of
mingling with men ; gynsephobia, fear of women —
panthaphobia, fear of everything, and so on ad
infinUum.
In addition, we find among the symptoms :
vertigo; dilatation of the pupils; pain and
weight at the vertex of the head; tenderness
of the scalp, general or partial; muscad vol-
itantes; tinnitus aurium; flushings of the
face ; dryness of the skin and mucous mem-
branes ; trembling of head and limbs ; excessive
perspiration; numbness in the limbs; blanch-
ing of the hairi hopelessness; pains in the
head ; abnormal and imaginary impressions of
smell and taste.
The symptoms in many (^ses are but the
manifestations of weakness. The brain-cells
are feeble or uncertain in their action; in-
capable of performing their offices ; not diseased,
but liable to be sooner or later.
Spinal neurasthenia (spinal exhaustion),
myelasthenia, signifies an exhausted state of
the cells which go to make up the spinal cord.
The spinal cord is about the size of an
ordinary lead-pencil, and is sixteen inches in
length, composed of millions of nerve-cells and
distinct bundles of nerves ; some of these nerves
pass through to the brain above, others are
united to the spinal cells, and pass no farther.
This organ is under the control of the brain,
but is capable of exerting, under certain circum-
stances, control over all its acts, which are
termed ''reflex,'' because to a greater or less
extent independent of the will.
It serves also to conduct to the brain percep-
tions of pain, touch, and motor impulses sent
out from the brain-cells to the muscles of the
body and limbs. Therefore, when the cells of
the spinal cord become exhausted, the symptoms
differ in a marked manner from those of cere-
bral exhaustion. The following may be men-
tioned as among the chief manifestations :
Tenderness on pressure of the spine in its
whole length, or in spots, accompanied or not
by spinal irritation; attacks of palpitation of
the heart; an extremely rapid or slow pulse,
which fluctuates widely during periods of ex-
citement or fatigue; muscular twitchings in
one or a group of muscles; cramps of the
limbs, especially at night; general or local
pruritus, always worse at night on retiring;
abnormal sensations of heat in the skin of
the body or limbs; excessive perspiration on
the slightest cause; irritability of the breast,
ovaries, and uterus in women ; in men frequent
seminal emissions ; weakness of the rectum and
bladder ; local disturbances of innervation and
circulation; highly sensitive to cold, and
especially to changes in the weather ; disturb-
ances of the digestive functions, viz. : nervous
dyspepsia, etc.
The distinction between the two forms of ex-
haustion cannot be made in every case, because
various combinations of the two are encountered
in the same individual.
Neurasthenia in all its forms occurs in the
male between the ages of fifteen and sixty, the
active sexual period. In the female, between
the ages of ten and forty-five ; after the meno-
pause the liability ceases.
The aged, children, and infants are singularly
exempt from neurasthenia.
The treatment should tend to procure com-
plete rest from worry and exertion of all kinds,
hence the temporary relinquishing of business
or duties is advisable, until rest sufficient for
recuperation has been obtained ; then return to
the usual vocations, which must be carried on
in moderation ; let them observe the old Spanish
maxim, /e«tina knte.
Bad habits, if any exist, must be corrected,
masturbation in particular.
Invigorate the whole system and take meas-
ures to that effect. Out-of-door life, sponge-
baths, salt-baths, sea bathing, nutritious and
generous diet, tonics, cod-liver oil, fats and
oils as freely as they can be borne. That fats
are an important auxiliary in general nutrition
there can be no doubt.
Electricity (either current, galvanic or faradic ;
either pole, anode or cathode, upwards on the
spine) and massage play an important part in
restoring lost nervous energy.
802
THE MEDICAL ERA.
[Vol. VI. No. 10.
In cases of nervous dyspepsia or weak
stomach, feed often, small quantities at a time,
and after each meal give a powder of pepsine.
(I use the old-fashioned chicken gizzard tritu-
rated with sugar-of-milk.) When the stomach
is incapable of performing its functions, resort
to rectal and vaginal alimentation.
When anaemia is present, give Iron in the
form of the Ferrum phos. or the sub-carbon-
ate, three times a day.
A change to a tropical or hot climate often
brings about good results.
All other plans failing, isolation, complete
rest, over-feeding, massage, as practiced by S.
Weir Mitchell, will speedily bring about a reac-
tion.
The drugs which have proved useful in these
cases are. Borax, Gelseminum, Belladonna,
Tarantula, Ledum, Mercurius sol.. Digitalis,
Secale com., Gonium, Zinc sulph., Cannabis
Indica, Sulphur.
As a tonic I have given Arsenicum album,
2x trit.. Strychnin sulph., 3x trit., eqml parts , a
powder twice a day, and have gotten results I
could not when given singly or in alternation.
The intense pruritm so often present can be
relieved by frequent sponging in water in which
Borax, Bicarb, of soda. Carbolic acid (10 per
cent). Chloroform, and Muriate of cocaine (4
per cent), have been placed.
The insomnia yields more quickly to the in-
dicated remedy than to the use of hypnotics (a
lazy and slovenly habit).
Alcoholic stimulants should be avoided as
much as possible ; from the relief they give, the
patient is apt to form the habif of using them
constantly.
SOME DIAGNOSTIC POINTS BETWEEN NEURASTHENIA
AND ANEMIA.
Neurasthenia.
Barely appears in scrof-
ulous, rheumatic, or tu-
bercular subjects. Is
limited to the middle
period of life.
Is not dependent on
any organic disease. No
cardiac murmur or nec-
essary pallor.
May lead to hysteria,
but hysteria is a distinct
condition.
The menstrual func
tions are not as a rule de-
ranged.
Prognosis usually good;
majority of cases get well.
105 Jennings Atbnub.
AncBtnia.
Generally appears in
scrofulous, rheumatic or
tubercnlar subjects.
Found at all periods of
Ufe.
Often dependent on or-
ganic disease. Cardiac
murmur and pallor always
present.
Hysteria is not a dis-
tinct condition.
The fnenstrual functions
are almost always de-
ranged .
Prognosis depends
largely upon cause pro-
ducing it.
A GLANCE AT ABDOMINAL SUBOEBT.
By C. A. PAULY, M.D.,
CIRCIMNATI, O.
THERE is a tendency on the part of the sur-
geon of to-day — probably more with the
Bo-called ** regular" than the homceopath,
to resort to the use of the knife in the treatment
of disease of the uterus and its appendages
before giving internal medication proper atten-
tion and time to show its beneficent and cura-
tive eflfects.
The surgeon who has performed the largest
number of laparotomies, hysterectomies, trache-
lorraphies and perineorraphies with the small-
est mortality, is greatly admired by his aspir-
ing colleagues. He goes into the medical
societies, or before a class of medical students,
buoyed with the feeling of success, and reports
the number of successful laparotomies he has
performed, but says very little about the per-
manent cures he has made, because the results
of many of these operations are very unsatis-
factory. Nevertheless, the operative plan is
considered the only cure.
I have witnessed a number of these opera-
tions, and have looked on some of them in
perfect amazement, and wondered why surgical
interference should be resorted to, when proper
internal medication and rest would restore the
patient to health. I heard an eminent gynecol-
ogist state to his class several days after per-
forming Tait*s operation (removing the ovaries)
to relieve the sufferings of the climacteric period :
** Gentlcnien, I feel perfectly Satisfied with the
antiseptic precautions and the manner in which
we performed Tait's operation on Tuesday, but
I regret to announce our patient is dead. This
is the first case of Tait's operation I have ever
lost, yet I do not think I wiD ever perform it
again. This lady was a great sufferer, but she
would have soon passed the climacteric, and by
the use of medicines might have been made
comfortable the rest of her life."
More attention to internal medication and the
proper selection of remedies will be gratifying,
and oftener lead to success in the treatment of
these cases than by the use of the knife.
The ambition for surgical fame is too great
and the aspiring surgeon thinks he must go
with the crowd. Hence he rushes into abdominal
surgery with a lack of proper consideration and
study of the malady he has to deal with. His
time is spent in looking up surgical procedures
instead of looking up the medicinal curatives.
The shghtest enlargement of an ovary, or the
presentation of a small tumor in the abdominal
Oct., 18RSj9
ORIGINAL ARTICLES.
303
cavity, in the opinion of these enthusiasts, re-
quires its removal. There is no other cure. A few
ban^s of adhesions binding down the uterus ne-
cessitates opening the abdomen, breaking up the
adhesions and liberating the uterus, k slight
laceration of the cervix, with protrusion of its
mucous membrane is considered an excellent
case for trachelorraphy. Cystocele, often said
to be the cause of cystitis or catarrh of the
bladder, calls for calorrhaphy. In like manner
I might write of many of the capital operations
that are constantly being performed by our
eastern surgeons and by many in the West.
The surgeon of the " regular " school, for
want of knowledge of internal medication, is
obliged to resort to surgical measures in the
treatment of diseases of the uterus and its
appendages, or let them alone, and many times it
would be better if he would let them alone. The
homoeopathic surgeon has at his command a
materia medica full of drug provings, and a law
of cure — yet he is liable to become enthusiastic
over the reports and writings of his allopathic
friends and induced to resort to the use of the
knife without carefully considering and applying
internal medication under the law of sin;iilars.
Seventh and Mound Stbbsts.
80MB T78BFUL DBU08.
By henry sherry, M.D.
OBICAGO.
VERATRUM VIRIDB.
THE special value of Veratrum viride to me
is in diseases of the respiratory organs, and
in convulsions. As showing its wonderful
power, let me illustrate by two cases :
Case I. My friend and colleague, Dr. Eeeler,
sent for me one night to assist him in the case
of a young woman who had already been in con-
vulsions for twelve hours. I made a diagnosis
of hystero-epilepsy, and suggested Morphine hy-
podermically, and Chloroform inhalations. Mor-
phine had practically no control of the condition,
and Chloroform relieved only during anaesthesia.
After several hours' trial of these drugs. Dr. K.
suggested Veratrum viride up to the point of
nausea. The result was magical ; the convul-
sions ceased and were kept under control by
minimized doses.
Case II. Little Dot, two and one-half years
old, came down with a severe attack of capillary
bronchitis. Pulse 120, temperature 103° P. I
treated the case to the best of my ability. Aco-
nite, Tartar emetic, Belladonna, Phosphorous,
Bryonia, linseed-meal poultices to the chest,
etc. But the patient grew worse, and I seemed
to have no control of the disease. It finally
seemed my painful duty to inform the parents
that I did not believe the baby would live twelve
hours. The pulse was now 140, temperature
104*^ F. With many misgivings I determined to
try Veratrum in doses sufScient to produce a
physiological effect. I therefore ordered Nor-
wood's tincture in one-half drop doses every
half hour till the pulse dropped to 100 and the
temperature to 99° F. Four doses were given,
when the child vomited large quantities of mu-
cus streaked with blood. The pulse was now 96.
Brandy as a stimulant was given, and the Vera-
trum continued in one-half drop doses every two
hours. The little fellow recovered, much to my
surprise, for if ever a case seemed hopeless to
me, this one certainly did. I use Veratrum now
far more frequently than Aconite, and with
better results.
GERANIUM.
In hemorrhages this drug has no equal. Ham-
amelis. Ipecac, Sabina, etc., cannot compare
with it. I have used it in hemorrhages of ty-
phoid, uterine hemorrhages, vesical hemor-
rhages, and it has never failed me, Herein lies
its usefulness — hemorrhages only. No dynam-
ized dose, however. It may have other uses, but
this is sufficient to crown it. In cuts and bruises,
Calendula is good, but Geranium is better.
Therapeutically it is an astringent, its chem-
ical constituents being galhc and tannic acids.
3616 Stanton Avenue.
In the early diagnosis of pulmonary phthisis,
mensuration of the chest is of great importance.
When the circumference of the thorax at the
level of the axilla is less than twenty-seven
inches, that at the xiphoid cartilage not more
than thirty-one inches, and the distance between
the two nipples but seven inches, the probability
of pulmonary phthisis is very great. Further
presumptive signs are an absence of a clear per-
cussion-note, inspiratory nlles, altered respira-
tory rhythm, with prolonged inspiration and
forced expiration, a dry and paroxysmal cough
followed by a moist one; occasional aphonia,
and dyspnoea on exertion. The thermometer
is a valuble aid ; in a doubtful case an evening
rise to 102° or 103° F. is a pretty sure indica-
tion of tubercular disease. — Af . Espina y Capo.
THE MEDICAL ERA,
[Voi-.Vl. No. 10.
LSCHISCH.
A NOVEL.
I Thobouj Kiho.
CHAPTER I.
HELENE.
HAD Mrs. Hard; been told that she would
some day adopt a daughter, she would
have received the suggestion with a smile
of incredulity, if with qo stronger expression of
unbelief. Her skepticism, moreover, would
have been prophetic, had not circumstances
combined to bring about the very thing which
she considered such a remote possibility.
It happened in this -wise: In her younger
days — when her name was still Louise Bel-
mont — she was sent by her parents to a school
not far from New York. There she bad as
room-mate a girl whose home in the city was
almost in sight of her own, and yet who, after
the fashion of metropolitan life, had been until
that time unknown to her. These two formed for
each other a warm friendship, which continued
long after their return to their city homes, and
after marriage bad, in a measure, separated
their lives.
This school-girl friend, having acted as Mrs.
Hardy's bridesmaid, several years later herself
became a bride and the mistress of a happy
home. This, however, she was not destined
long to bless. In the third year of her married
life a daughter came to her mother-arms, and
when the child was almost six years old, by a
series of calamities which crashed upon each
other in quick succession, first father, then
home, and finally mother, were lost to tlie little
one, and she was left a homeless orphan.
[It is with much miaglving, and with many apolo-
gieB, tbat the e<ti tor -in -chief of The Medical Era
oSere to its readers a work ol flctioa from his own pen.
He hopes, ainee the ssbject treated of Is one which is
related to medicine, that "Haachisch" may prove to
be of sufQcient interest to warrant its appearance in
these colnmns. — Ch. G.]
The sympathy which had been with the
mother through all her trials now went out to
the child, and it was arranged that Helene
should come to Mrs. Hardy and remain at her
husband's hotel, where the family resided, ontO
relatives living in the far West should take her
to their own fireside.
Thus week after week passed, and the child,
growing fonder of her temporary home, began
to live in dread of the summons which should
remove her from it ; but, as the weeks length-
ened into months, the dread of change gave
place to a feeling of vague uncertainty, lest,
should her friends fail to come for her, she
might be left altogether homeless. This feel-
ing, however, was carefully hidden in the little
breast, and was fast merging into a sense of
chQdish despondency, when chance, accident —
call it what you will — revealed it, one day, to
Mrs. Hardy.
Helene had been playing with other children
in the house, but had quietly withdrawn, and
for a time stood watching them as, hy the side
of their mothers, they reveled in their gamea.
Suddenly she turned and ran down the long
hall-way to Mrs. Hardy's room. There she
found her. Bushing to her side and holding up
her little hands in earnest appeal, she cried
with trembling voice :
"All the little girls have mammas but me!
Won't you be my mamma ? "
Instantly Mrs. Hardy caught the child to her
arms and covered her face with tears and kisses,
exclaiming :
"Yes, my darling, you shall never want a
mother while I live t "
Touched to the heart, the little one nestled
more closely to her breast, and sobbed until she
slept.
The twilight deepened into darkness, and still
holding the sleeping child, Mrs. Hardy sat in
the quiet room, now faintly illumined hy the
checkered light which the street-lamps threw
upon the high ceiling, until her husband
entered. It required but a short consultation
on their part to decide that the impulsive prom-
ise so given should be fulfilled in fact.
The distant relatives readily relinquished all
claim to the child they had never seen, and thus
Helene's temporary abode became her perma-
nent home.
It was now twelve years since this decision
had been made, and in all that time Mrs. Hardy
had never regretted her-aet.
Oct.. 1888.]
HASCHISCH.
805
It was early decided that Helene should
retain her own family name; and, as further
act of loyalty to her dead ^end, Mrs. Hardy
took pains, as anniversaries returned, that the
child's memory of her mother should he kept
fresh. Advantage was taken, also, of the sav-
ing of a remnant from her father's shattered
estate — a mere trifle though it was — to en-
courage in her a spirit of independence and
self-reliance.
Thus Helene grew to girlhood. In person,
although she was not beautiful, yet she was
very handsome. Her eyes were large and ex-
pressive, her complexion fair, with the tint of
the rose in her cheeks ; and her blonde hair fell
unconfined in half-careless waves to her neck.
Even when young she carried herself with a
grace which denoted a spirit far more mature
than her years, while her voice had in it a
tender undertone, which revealed a nature
deeply sympathetic.
But the chance which had given Helene a
new home, and made her the recipient of every
favor which wealth can bestow, was destiaed to
weave into her life certain elements of misfor-
tune which almost made of it a tragedy.
CHAPTER II.
** TH^ BELMONT.
»>
THE hotel which had thus early become
Helene's home was not one of those busy
houses so numerous down-town in the
neighborhood of the Squares, where a moving
mass of people take up their daily changing
residence, but a quiet famOy hotel on one of
those streets with a numerical name which cross
the city a little below the reservoir. When he
lai& its foundations Mr. Hardy had decide^d to
give to the house the name which his wife bore
before she assumed his own, and hence the let-
ters cut in stone over its principal doorway
announce to all who pass beneath that they arfe
about to enter " The Belmont."
The building itself is of substantial brick.
From the iron balconies which cling to its
waUs a glance to the eastward affords a view
into Fifth Avenue, with its moving procession
of white 'busses and black carriages. To the
westward one's eye travels across busy Broad-
way, over the stilted track whose airy trains go
flashing by, over ships and over water, to the
distant Jersey shore with its high banks of invit-
ing green.
Mr. Hardy belonged to an old New York fam-
ily, whose name at one time had many repre-
sentatives, but, by a strange fatality, daughter
after daughter was bom to it when prayers went
up for sons. But one of these prayers received
answer, and thus it was that the owner of << The
Belmont" became in time the sole surviving
male member of the line.
.The chief desire of Mr. Hardy's life had long
been to revive the family name — so near ex-
tinction in himself — and to place it on such a
basis that it would stand in little danger of suf-
fering flnal decay. In this ambition fortune
so far favored him as to bless his union with
two sons, both of whom gave promise of doing
honor to their long line of ancestors.
Austin, the elder of these, in early manhood
showed such aptitude for business that he was
sent, by the house in whose employ he had
spent several years, to represent important
interests which their growing trade demanded
in a South African port. But the same busi-
ness tact and spirit of enterprise which had
gained for him the confidence of his employers,
soon deprived them of his services. After he
had been at his new station one year, he made
a fortunate investment which resulted in his
acquiring a third interest in one of the richest
of African diamond mines. Of this mine he
assumed the superintendence, and thus his field
of labor was early transferred from the count-
ing-house at Cape Town to the management of
important interests in the interior.
Kenneth, the younger, was more inclined to
study than to commercial pursuits. But a cer-
tain delicacy of constitution soon making it
apparent that whatever calling he followed must
be of a nature which should offer him an active
life, he adopted the profession of civil engineer-
ing. In order that a successful pursuit of his
studies might be conjoined with a change of
climate, which his health seemed to demand, he
was sent to Paris for a three years' course at
VEcole Centrale.
Mr. and Mrs. Hardy would have felt very
keenly the absence of their sons but for the
presence of Helene, who, realizing the peculi-
arity of her position, gave to her foster parents
all of a daughter's love, with even more than a
daughter's devotion, while she, in turn, received
from them every consideration which their own
children enjoyed.
The two boys, on their part, had shown
Helene greater partiality than brothers are
accustomed to bestow upon their sisters. .But,
shortly after her advent into the family, the
demands of school had called them from home,
and thereafter it was only at holiday times that
306
THE MEDICAL ERA.
[VouVL No. 10.
brief visits permitted their generous rivalry in
her affections.
From the day when, as a child, she had en-
tered her new home, her position had secured
to her all the privileges of an only daughter.
But, some two years prior to the events of our
story, she had gladly shared her place with a
new-comer who had a similar claim upon the
family affections.
Mr. Hardy, at this time, had been appointed
the legal guardian of his youngest sister's
orphaned child — a daughter of one of those
numerous daughters whose continued coming
had so long threatened the extinction of the
Hardy name. Thus Dora Macy came to make
her home in her guardian's family, until she
should herself assume control of the property
to be held in trust during the term of her
minority.
Between Helene Evarts and Dora Macy there
was soon formed one of those intimacies that
make up so large a part of young girlhood.
But at the time when our story takes up the
thread of this family history, a great change
and a deep sorrow had come to the little house-
hold at " The Belmont."
Helene was now nineteen. Austin was still
in far-off Africa. Kenneth, in the previous
spring, had returned from his three years' resi-
dence in Paris. The summer had come, and
had brought with it a dread disease which, the
year before^ had burst its Indian barriers and
pursued its silent march over Europe. After
resting awhile on the shores of the Mediterra-
nean, it crossed the Atlantic and spread its
black pall over the American metropolis.
Mr. Hardy, on the eve of his preparations to
seek a safe retreat in the mountains for himself
and his family, fell one of its first victims.
The ever unwelcome visitor that touched him
with its skeleton finger never left hearts more
sorely tried than those which mourned his loss.
Kenneth was almost inconsolable in his sorrow,
and words are useless to tell the grief which the
widow hugged to her heart.
After all the offices incident to their sad loss
had been performed, the family left the city for
the mountain retreat whose cool air and inviting
shade the father had hoped to enjoy with them.
There the early days of their mourning were
passed.
As summer faded into autumn, the first frosts
drove to the southward the terrible scourge
which the hot and sultry months had fostered,
and the city began to fill with hordes of return-
ing fugitives.
The rumble of heavily-laden carts in the
streets succeeded the sound of toiling hearses
dragged by tired« horses. Crapes disappeared
from door-knobs, and dravm blinds were again
thrown open to admit the sun. Even the places
of amusement opened wide their doors, and
crowds of merry people passed their brilliant
portals, smiling and chatting as though death
were but a fiction and life a holiday.
Thus the memories of the dead were left to
be worn in the hearts of those who suffered.
(TO BC CO NTIKUED.)
TUBEBGT7LOSI8.
CONGRESS FOR THE STUDY OF TUBERCULOSIS.
Htld in Paris, July, 1888.
[^he following excerptfi are taken from the epecial report of the Con-
greee made for The Medical Becard.—Eo. Bba.]
A large proportion of sufferers from phthisis
acquire the infection from eating tuberculous
meat. — M. BtUel.
The subjects of pulmonary phthisis innoculate
themselves by swallowing the infectious sputa
raised into the throat from the lungs. — M,
Petresco.
Domestic fowls are frequently the subjects of
tuberculosis, the disease often involving the ab-
dominal organs. Pate-de-foie-gras is sometimes
almost a pure culture of tubercle bacilli. — M.
Moide.
One case of tuberculosis of the cervix uteri
occurred in a woman who had no pulmonary
or intestinal trouble, and it was probable that
the infection occurred during coitus. — M.
Cornil. ^
There are two forms of tuberculosis of the
liver, excluding miliary tuberculosis, viz., a
tubercular infiltration or caseous hepatitis ; and
& cavernous ulceration, or tubercular abscess of
the liver. — M. Lannelongtte.
One of the most important facts that has been
established by experiment is that the tubercle
bacillus may penetrate the unbroken mucous
membrane. This has been shown in the case
of the lungs and of the intestinal tract. — Af.
ComU,
In the hospital treatment of tuberculous
patients, there should be small pavilions,
thorough disinfection of the wards and of all
objects used by the patients, and the nurses
should be themselves strong and healthy, and
above thirty years of age. — M . Oiorgieri.
Oct. , 18B8L )
ORIGINAL ARTICLES.
807
All cow's-milk should be boiled before being
given to infants. *In view of the fact that it
is difficult to recognize mammary tuberculosis
in cows, it is safe to look upon all raw milk with
suspicion, and to render it innocuous by boiling
before giving it to infants. — M . Nocard.
In the case of fifty-three individuals suffering
from pulmonary tuberculosis, careful inquiry
into their antecedents revealed the fact that
there had been tuberculosis in one hundred and
eighty-one of the near or remote relatives. — Af .
Ricochon.
In nine experiments on guinea-pigs there was
no instance of the transmission of the disease
from the dam to her young. Hereditary tuber-
culosis, therefore, if it exists at all, is of very
rare occurrence. The young which were suckled
by the dam became tuberci^Jous as a rule. — Af.
Oabier.
The early diagnosis of phthisis in cattle is
not difficult. It is characterized from the first
by tumefaction of the retropharyngeal glands ;
the inspiratory movements are irregular ; a harsh
friction sound is heard on auscultation; the
cough is s^ort, provoked by sharp percussion
on the thoracic parieties. — M. Orissonnanche.
It is necessary to proclaim tuberculosis in
animals a contagious disease. Bacilli do not
long retain their virulence in muscular tissue,
but a certain number existing in the flesh at
the time of the killing of the animal would re-
tain their vitality in the dead meat, and be
capable of infecting those who ate it. — M .
Arloing.
In the tubercular arthritis of children, open
widely the diseased articulation with the thermo-
cautery, scrape away all the infected parts,
whether bone, cartilage or synovial fringes, and
provide for subsequent irrigation. Becurrence
of the disease is frequent, but after two or
three operations a definite cure results. — Af.
Renard.
Pieces of tuberculous tissue were placed in
the bottom of a flask in which was maintained
a stream of running water of a temperature of
about 60° F. It was found that micro-organ-
isms were still active at the end of six weeks. In
stagnant water the virulence was preserved for
seventeen or eighteen weeks. — Af. Arhing.
Tuberculosis occurring in infants under two
years of age differs markedly from the same
disease in older children and adults. In babies
it tends less to become localized, but assumes
more of the characteristics of a general disease,
the symptoms being chiefly fever and emacia-
tion. More children acquire than inherit tu-
berculosis, the source of infection being the
food. — Af. Landouzy.
One of the earliest symptoms of mammary
tuberculosis in the cow is tumefaction in the
gland, which may exist a long time before any
changes are observed in the milk. The swelling
l^ter becomes indurated, and then the milk be-
comes yellowish, and contains fibrinous flocculi.
The milk of all tuberculous cows is not capable
of carrying the infection, but only when the
mammary gland is affected. — M. Bany.
The chickens belonging to a certain family,
one member of which was suffering from pul-
monary tuberculosis, were found to be almost
all diseased. M. Gagny found that the sick man
was in the habit of walking in the garden, and
it had been noticed that the chickens eagerly
seized upon the matter expectorated by him.
The chickens had tuberculosis of the liver, and
it was found necessary to sacrifice the entire
flock. — M. Cagny.
The tubercle bacillus enters more easily
through the digestive than through the respira-
tory apparatus; hence the great part which
alimentation plays in the production of the dis-
ease in children. There are three incontestible
facts now known. to all, viz.: 1. The virulence
of the flesh of tuberculous animals. 2. The
predisposition of man to tuberculosis. 3. The
easy entrance of microbes through the alimen-
tary canal. — Af. Butel.
Notwithstanding the fact that the inhabitants
of Asia Minor live much in the open air, under
the best hygienic conditions, tuberculosis is very
prevalent; ten per cent of all patients suffer
from this disease. The natives recognize the
contagious nature of the malady, and always
destroy the articles used by the sick. The fre-
quency of the disease was attributed to the use
of the milk and raw flesh of tuberculous
animals. — M, Robinson.
It is not uncommon to see, in children be-
tween the a^es of one and thirteen years, num-
bers of small, round, movable tumors just be-
neath the skin, chiefly in the region of the neck.
This generalized glandular hypertrophy
\vhich recalled, but was easily distinguished
from — the syphilitic adenopathy, was always
dependent upon tuberculosis, and those affected
with it were at least potentially, if not actually,
phthisical. — Af. Le^raux.
308
THE MEDICAL ERA.
[Vou VI. No. 10.
SELECTIONS.
Bheumatiain.
The surroundings of a patient suflfering from
rheumatism are a matter of no httle importance.
Free ventilation should be secured, but without
draughts, and the temperature kept between 68"^
and 70° Fah. The patient should be clothed in
flannel and lie between woolen blankets. His
covering should be light. An excess of bed-cloth-
ing will add to the pain in the inflamed joints,
and unnecessarily increase the sweating. It
should be a studied effort to spare him any
painful movements possible, and every ministra-
tion should be gentleness itself. Milk, with selt-
zer water or lime water, pre-eminently meets
the requirements as the principal article of diet,
during the active period of the disease. If this
proves insufficient, or is not well borne, then
other light and concentrated food can be ad-
ministered. Some authorities insist that animal
food and alcohol are contra-indicated during the
height of the fever. The latter should certainly
be prohibited, as a rule, but the patient's diet
need not be so much restricted as in other high-
ly febrile disorders. Those who are habituated
to the use of stimulants should not be entirely
deprived of them. — Bost. Jomnial of Health,
Value of CircuxnciBion.
A boy at, nine had been troubled for several
weeks with lameness and pain in the thigh. Five
months of rest in bed with an extension appa-
ratus did not ameliorate his condition. Observ-
ing the length and contracted aspect of the boy*s
prepuce (unaccompanied by inflammation or
lesion of any kind), M. Eeverdin recalled certain
cases of unexpected cures of various painful af-
fections following circumcision, and decided to
practice the operation in this case. Cure was
effected in three days, the disquieting symptoms
disappeared as if by magic, and, though a year
has elapsed, none of them has returned. The
author then referred to the great tendency of
young children to urinate during an examination
of the coxo-femoral articulation. Also to cases
of the cure of incontinence of urine through cir-
cumcision, as showing a certain interdependence
or sympathy between the bladder, prepuce and
coxo-femoral articulation. In the author's prac-
tice, circumcision produced a notable ameliora-
tion in the psychic condition of a young man
who had been hypochondriacal and had made
an attempt at suicide. In other cases circum-
cision had unquestionably effected the cure of
epilepsy. Paralysis, St. Vitus' dance and other
nervous troubles have been cured by circum-
cision, and if with these we consider the num-
ber of lesions actually caused by phimosis we
may well ask why circumcision is not more prac-
ticed. With proper antiseptic precautions the
only danger to be feared is hemorrhage in cases
of hemophilia. A few instances of death have
occurred under this condition, and the possibili-
ties of such a result were fully recognized by the
ancient Jews, who made a law that if two sons
in the same family shall die from the effects of
circumcision, the third shall not be subjected to
the operation. — J, de Med.
Nitrite of Amyl in Dyspnoea.
I had a patient with Bright's disease, who
suffered most agonizing paroxysms of dyspnoea
— they were simply terrific, notwithstanding
the use of ordinary measures. There was no
asthma whatever. On the recurrence of an at-
tack I gave three drops of Nitrite of amyl in a
teaspoonful of brandy, without expecting much
result, but simply as a dernier ressort. The re-
sult was simply miraculous ! It was almost in-
stantaneous. From a sense of impending suf-
focation, the patient began to breathe perfectly
free in less than five minutes. This relief lasted
for upwards of twelve hours, when the same
quantity was repeated on the recurrence of an-
other attack, with the same result, and without
increasing the dose. The Nitrite was given on
every recurring attack, until the attacks finally
disappeared, and for several days the patient
has had no dyspnoea whatever. The original
disease, however, is unaffected by the Nitrite.
Now, while I am free to admit that one swal-
low doesn't make a summer, and while I know
that this remedy is not especially recommended
for the dyspnoea of Bright's disease, still, I have
seen enough of its effects in this case to make
me wish that I could tell my experience to the
whole profession at once. — Dr, Ward, in Medi-
cal Register,
Tuberculosis of the mouth is comparatively
rare, especially when we consider the large ex-
tent of surface of this cavity, and its unusual
degree of exposure to the action of micro-organ-
isms. The immunity of the buccal structures is
due, in all probability, to the great number and
variety of micro-organisms in this cavity, which,
by their continual growth, prevent the develop-
ment to any undue extent of any one kind. —
M. Valude,
Oct., 188&]
SELECTIONS.
309
Ourioofl Case of Malingering.
Early in April I was asked by a friend to see
a servant girl who was stated to have a ''dead
tumor " in the cheek, and a similar one growing
on the other side. One surgeon had advised
their removal ; another had regarded the case
as hopeless. The patient was twenty years of
age, apparently ' in excellent health, and she
showed great reluctance to being examined. The
left cheek was distended over a firm, rounded
tumor the size of a large Tangerine orange. It
was not fixed firmly to the jaw, and the cheek
appeared to move over it. " It has been grow-
ing for three years." The right cheek was sim-
ilarly affected, the swelling being the size of a
large walnut. On everting the lip I saw a grey
surface like a slough, but traversed with threads.
The finger in the mouth then confirmed the sus-
picion that these '* tumors " were foreign bodies
between the cheeks and the jaws. With forceps
I removed two balls, the larger of which, in the
left cheek, was with some difficulty extracted
through the mouth. The cheeks then hung down
in flaccid folds. The second lower molar on the
lef f side was displaced inwards, and its buccal
fang was exposed almost to the tip. The lining
of the cheeks was pale in color and thickened.
The " balls " consisted of strips of calico very
tightly sewn together with black thread. I have
been unable to discover any motive for this cu-
rious freak, and in this it is on a par with many
of the practices of hysterical girls. — Lancet.
Phthisis Laryngeaiis.
Local treatment. Although relief rather than
cure has to be expected from this, yet I think it
is important and should be used oftener than it
is at present. Soothing inhalations, as steam
alone, steam with Eucalyptus or Pine oil, are
very good to allay the irritation, or extract of
Hops, or extract of Conium with a little Carbon-
ate of soda form a very soothing spray. Greater
benefit is got from the laryngeal brush. This
must be used with great care. Harm is done by
making a wild dash at the lar^'nx, and then
jerking the handle of the brush about in the hope
of applying a medicament to the part which is
diseased, while the patient gasps and gags.
Steady and very careful manipulation is required.
With a good light and reflector and the laryn-
geal mirror held steadily in the left hand, and
the image of the larynx plainly seen in the mir-
ror, the brush must be passed back steadily but
not too slowly, otherwise the patient becomes
weary and cannot retain his position. The point
of th^ brush must be seen (in the mirror at the
back of the throat) to pass over the epiglottis,
and then the handle must be raised without
pushing the brush any further back in the throat.
This manipulation causes the end of the brush
to descend behind the epiglottis into the larynx.
The point of the brush must be kept in view un-
til it reaches the part to which the application
is to be made. When the point of the brush is
not seen, it must be withdrawn and again intro-
duced. The application must be made to the
diseased part only, and not to the sound tissues
around. Krause, at the laryngological subsec-
tion of the meeting of the German physicians at
Berlin, in September, 1886, said: ** Ulcers on
the posterior laryngeal wall are curable by Lac-
tic acid, if there is not too much marasmus,
which is a contrary indication. No tubercular
ulcer can resist cicatrization by application of
Lactic acid made by a practiced hand. The pain
or even a certain amount of spasm resulting
from the treatment is no contra-indication. "
Schrotter, of Vienna, and Fraeubel have corrob-
orated this. Hering, of Warsaw, has made this
subject a special study, and on the same occa-
sion read papers on '* The Curability of Tuber-
cular Laryngeal Ulcers, and on their treatment,"
and said that '* he had seen eight unquestionable
cases which prove the curability of tubercular
ulcers. He had also seen cures of such ulcers
without medication. The ulcers were on the
true and false ligaments, arytenoid mucous mem-
brane and epiglottis. Their tubercular nature
was certain from the contemporaneous affection
of the lungs and presence of bacilli. In three
cases the cure lasted respectively nine, two and
one year, and in five cases from half to three
years. The larynx cured, the lung is amelio-
rated, the voice becomes better, and general im-
provement results.*'
Lennox Browne also narrates a case where he
has cured tubercular ulcer of the pharynx, when
he first scraped the surface and then applied
Lactic acid, and improvement occurred and
weight was gained. This has also been obtained
in many other cases. I have myself treated a
case of ulceration of the inter-arytenoid mucous
membrane which was diagnosed by Prof. Schwitz-
ler, in Vienna, as commencing phthisis, with
Lactic acid and Iodoform insufllation, and the
case improved, and when she was dismissed the
ulceration- was healed and the cough and hoarse-
ness greatly relieved. I have also treated and
watched the treatment of several other cases of
early tubercular ulceration in the larynx, and
great improvement has been obtained. — Dr.
Hayward, in Month. Hanioiopathic Review.
810
THE MEDICAL ERA.
IVoL. VI. No. 10.
Tnatment of Placenta Pnwia.
I. Let the patient pass water, or draw it off
with the catheter, apply a binder to the abdo-
men and keep it tense, to assist in the expulsion
of the foetus as the contractions of the uterus
go on.
II. Detach the placenta and try to force one
finger above the placental attachment.
III. Puncture the membranes as soon as it
can be done with safety.
IV. Introduce the tampon — either Braun's
colpeurynter, or Iodoform gauze or candlewick-
ing.
V. The most eflScient treatment of all is, forc-
ibly dilating the cervix with either Barnes' dila-
tors or Molesworth's, or, best of all, Allen's uter-
ine dilator, attached to his surgical pump. (This
surgical pump should be in the armamentarium
of every obstetrist.)
YI. Ergot, as a medicine to excite contractile
pains, may be thought of, and, if positively indi-
cated, may be promptly administered.
VII. Certain other remedies might be men-
tioned. Ipecac, Gossypium, Hamamelis. Di-
lute Sulphuric acid and Borax may be called for
in post-partum hemorrhage and should not be
forgotten.
Last, but not least, vinegar should not be for-
gotten — it is one of the best hemostatics that
we possess, and has proved to be most excellent
in many cases of post-partum hemorrhage.
Many practitioners use it locally, but it is still
more efficacious when used internally. It may
be given in cases of shock, from flooding, in
doses of half a wineglassful, and repeated. — Dr.
Comstock, in Clinical Reporter,
WORTH KNOWING.
Saved Himself but Killed His Wife. — A
chemist named Maximy, at Arzew, Algeria, lived
on bad terms with his wife. The other day dur-
ing dinner Mme. Maximy put some Aconite in
a bottle of wine while her husband's back was
turned and calmly awaited results. The chem-
ist took two or three glasses of the stuff, and no
sooner had he done so than he felt violent qualms
in his " interior." Immediately suspecting the
real state of affairs, he took up the wine that re-
mained in the bottle and subjected it to a rough
examination. Finding his suspicions confirmed
he went for a revolver and with it shot his wife
dead as she still sat at the table. The poison
in the meantime had not done its work, for M.
Maximy, thanks to his professional knowledge
and experience, was able to treat himself medi-
cinally, took efficient antidotes, and is now al-
most recovered.
Lanolin is said to possess remarkable pene-
trating powers, but it is doubtful if it has in this
respect any superiority over lard.
Vaseline has very little penetrative power,
and is occasionally irritative to €ome skins. But
it has the advantage of never becoming rancid.
Typhus fever is most dangerous to persons
who have passed their fiftieth or sixtieth year ;
less so to infants and those between thirty and.
forty-five ; and least dangerous to children about
five and to young adults.
Cerebral Abseess. — If we suspect abscess or
non-inflammatory softening of the brain, and
the pupils should be dilated, it is a sign that^the
region of the brain is involved from which the
fibres spring enervating the iris.
Paralysis of the insane is quite often an-
nounced by the difference in the size of the pupils
for some time prior to the appearance of any
nervous symptoms. There is no doubt that pu-
pillary difference with paralysis of accommoda-
tion in the same eye is a prodromal symptom*of
the mental condition that develops later.
A Cough of Reflex Origin.— A man came to
the clinic suffering with a paroxysmal and long-
continued cough. Nothing wrong could be de-
tected in the lungs ; upon continuing the exami-
nation a plug of cerumen was found in the ear,
and its removal ended the cough.
Chloroform Narcosis.— The play of the pu-
pil is an important test of approaching danger
in chloroform narcosis. As long as the pupil
contracts simultaneously, when the eye is
opened, there is none ; as soon as the contrac-
tion is wanting, there is, and the further admin-
istration has to be stopped.
A displacement of the nterns, according to
Emmet, should never be corrected simply on its
own account, nor until the cause has been clear-
ly ascertained; nor should a pessary be em-
ployed without a clear understanding as to what
is to be accomplished by its use, beyond merely
changing the degree of version.
The classification of insanity which has
been in vogue for some years, and which has
been adopted by most authorities, is mania, mel-
ancholia, dementia, and general paresis. Each
of these has its own peculiar manifestations and
symptoms. The most prominent characteristic
of the insane is the alteration of the natural af-
fections: usually those most dear to them l)o-
come objects of dislike.
Oct., 1888.]
WORTH KNOWING.
811
Opimn habitues in nearly all instances com-
mence the habit because of a painful disorder of
the body or mind. The drug is very commonly
first prescribed by a physician who fails too
often to place sufficient safeguards around its
use, and to warn the patient against its dangers.
Granting a painful physical necessity, and the
daily or semi-daily use of the drug for weeks or
months, and there are very few who can with-
stand its power.
Peroxide of hydrogen is a most valuable
agent in the treatment of diphtheria, ozsena, and
in all cases of cancerous ulceration and of sup-
puration or necrosis. It is employed in a solu-
tion containing 0.5 to three per cent, using
most frequently, however, a strength of one per
cent, diluting the commercial " ten volume "
peroxide with two or three times its volume of
water. Of its value in clearing away and effec-
tually deodorizing the decomposing exudate in
cases of diphtheria it is superior to any other
known application.
Many cases of acne seem to be due to some
nervous derangement produced by causes other
than indigestion, but are not understood. These
are the most obstinate to treat. In all cases
observe whether a cause can be assigned or not ;
the pus in each individual acne should be given
free exit with a small knife, such as is used in
cataract operations. A spray of rhigolene for a
few minutes, say two or three, wiU anaesthetize
the skin to such an extent that the operation
will be painless. Immediately after these pus
cups are opened the hot water should be applied
in the manner before stated.
Treatment of Barns. — M. Nikolsky reports
great success in treating bums of the first and
second degree with bandages made with the fol-
lowing solution :
Tannin,
Alcohol (95 per cent.) aa 4 grammee.
Bectified sidpburic ether 30 *<
The bandages are renewed two or three times
daily. After the evaporation of the ether, a
fine, brilliant film of tannin remains and pr(>
duces a prompt alleviation of the pain and in-
flammation. The healing is much more rapid
than under the influence of collodion and other
remedies usually employed. The first bandage
should be preceded by washing with some anti-
septic solution. The blisters should be opened
so as to allow the serum to flow away. The de-
nuded portions of epidermis are at first dusted
with a fine powder of iodoform and then wrapped
in the etherized tannin. — Med, lieffister.
Antagonism of Poisons. — The property
alleged to be possessed by certain poisons of
counteracting the action of others has been sub.-
mitted to experimental test, and the results are
suggestive of the necessity for caution in accept-
ing some statements that have been made upon
this subject. It is found that animals succumbed
to the effects of a mixture of morphine and atro-
pine long before the ascertained fatal dose of either
Jrug separately had been reached, and the same
observation was made with mixtures of atropine
and quinine, or quinine and morphine.
Bone Transplantation. — Skin grafting has
long and successfully been resorted to, but now
the transplanting of bone is looming up. Dr.
Weir, of New York, trephined the skull for the
cure of epilepsy, the opening being about two
and a half by three inches, then replaced the
bone removed, and in about seven weeks after
the operation all the wounds had healed save
one ; the bones were felt to be solid and pain-
less. In another instance, a boy, aged three
years, with necrosis of the entire diaphysis of
the humerus, had the sequestrum removed, but
the periosteum failed to develop bone. The sur-
geon at different times introduced into the arm
pieces of bone, broken very small, taken from
the tibia of children in rectifying incurvations.
The engrafted pieces of bone grew, and in the
course of fourteen months from the time of the
first transplantation the boy had a functional
humerus.
Disinfection by Heat. — In a report by the
medical officer of the local government board of
health, London, reference is made with a view
to ascertain the degree of dry heat necessary to
kill the germs of disease well known to be infec-
tious. The bacilli of splenic fever, for instance,
were killed by exposure for five minutes in a
dry heat varying from 212 to 218 degrees. P.,
but their spores did not yield to two hours at
220 degrees ; one hour at 245 and four hours at
220 degrees achieved the result. Some very re-
markable practical instances are given of the
difficulty with which dry heat penetrates such
articles as bedding, blankets and pillows ; thus,
a thermometer enveloped in a roll of flannel
placed in a hot air bath at 212 degrees, only
registered 130 at the end of one hour. Numer-
ous experiments demonstrate that steam at or
above 212 degrees possesses a very much greater
power of penetration and disinfection than dry
heat ; moistening the air of the heated chamber
also materially reduces the time required for
disinfection.
812
THE MEDICAL ERA.
[Vol. VI. No 10.
DIETETICS.
• Sugar should be rigidly excluded from the
food of children suffering from intestinal dis-
ease.
The addition of salt to milk used as food
for infants and children, serves as an excitant
to glandular secretion and facilitates digestion.
As a rule, raw starch is inadmissable in the
diet of young infants, because the digestive
powers of the infant are rarely sufficiently active
to convert crude starch into a soluble form.
Salt in Beer. — A certain quantity of chlo-
ride of sodium is a normal constituent of all
beers, but more may be added by the brewer,
either to increase the thirst of the one who
drinks, or to conceal some objectionable taste.
Spealcing roughly, a quart of oysters con-
tains, on the average, about the same quantity
of actual nutritive substance as a quart of milk,
or a pound of very lean beef, or a pound and a
half of fresh codfish, or two-thirds of a pound of
bread.
The casein of cow's milk, according to Dr.
Eustace Smith, as the rule, traverses the in-
fant's alimentary tract and may be found un-
changed in the fecal discharges. It is, there-
fore, a constant source of irritation, and often
gives rise to diarrhoea and entero-colitis.
It is nearly six centuries since Eobert Bruce
sent into England his army of twenty thousand
men with no provisions except a bag of oatmeal
for each warrior ; but the herculean feats which
were performed and undergone by his hardy
followers suggest that there must be considerable
nutriment in that plain, simple food.
Although coflfee does on the whole far more
good than evil, it is important to bear in mind
the evils that it is able to produce under favor-
ing circumstances. In a general way it may be
said that indoor brain-workers do not bear coffee
as well as outdoor muscle-workers. Persons of
nervous temperament bear coflfee badly.
The genuine Mocha coffee comes only from
the province of Yemen, a province of Arabia,
north of the Gulf of Aden, of which Mocha is
the principal place on the sea coast. No coffee
is grown in Mocha. Something over 10,000
tons of coffee are anually exported from Mocha,
but no small part of it is not the product of
Yemen, but is grown in the East Indies and sent
to Mocha, whence it is reshipped.
Prof. DaCosta states that the treatment of
hypertrophy of the heart is always the same.
Decrease diet, but do not starve, as that may
increase the trouble. Place the patient on non-
stimulating food — milk and vegetables, but no
meat ; avoid tea and coffee and use cocoa ; also
avoid active exercise.
What is required hy persons acutely sick ?
That depends upon the temperature. If there
be pyrexia present, it is not only useless to give
albuminoid matters, as no histogenesis goes on,
but there is the positive risk of adding to the
waste and excrementitious matters floating in
the blood. Soluble carbo-hydrates and blood-
salts are what is required.
A person may be acutely ill, as in bron-
chitis, for instance, with but a very trifling rise
of temperature, and then milk is not contra-
indicated. In such cases milk which has been
well boiled is excellent. The advantages of such
boiling are twofold. (1) It destroys disease-
germs, and (2) the curd is small and flocculent,
and there is no risk of that firm curd which is
fraught with so much danger, especially in
typhoid fever.
Milk jelly is made as follows : Heat one
quart of milk with one pound of sugar, and when
the sugar is dissolved continue the heat, at a
boiling temperature, for about ten minutes.
Now cool it well, and then add, zhwly stirring, a
solution of one ounce of gelatin in a cupful of
water. Next add the juice of three or four
lemons and three wineglassfuls of wine, brandy,
or other liquor. Set the glasses containing the
mixture in a cold place, so that the contents may
gelatinize. It is necessary to have the milk
quite cold before the other ingredients are added,
as it would otherwise curdle.
How to Eat a 8oft;-boiled Egg.— The very
nicest way of eating a soft-boiled egg is from
the shell. Place the small end of the egg into
an egg cup, or you may stand it in a small nap-
kin ring. The large or butt end of the egg should
have the shell removed from it ; then if you take
a\vay a small piece of the white you have ample
room for salt, pepper and a small piece of but-
ter, which may be mixed with the egg without
difficulty. Long-handled porcelain teaspoons
are the nicest and only proper things to
serve with boiled eggs. Soft-boiled eggs may
also be eaten from a heated egg-glass ; the egg
being opened carefully and turned into the glass.
Salt, black pepper and butter are the proper
seasonings. — Tahle-Talk,
Oct., 1088.1
SCIENTIFIC NOTES.
313
SCIENTIFIC NOTES.
CURIOUS ITEMS.
A Yibratorf Theory of Scent.— Prof. Le-
clerc, writing in Cosmos, maintains that odors
are dne, not to the emanations, as such, of so-
called odoriferous bodies, but to the vibratory
movement among such emanations, due to
processes of oxidation. Scent, on this theory,
is analogous to sound.
The Actinic Ray. — Prof. Sachs, the celebra-
ted German botanist, has discovered that the
ultra-violet and invisible rays of the solar
spectrum especially promote the development of
flowers, the growth of which is exceedingly
feeble when the rays are suppressed, although
that of the other parts of the plant is very
luxuriant.
Kelatiye Talue of Illuminators.— Investi-
gations concerning the effects of different forms
of artificial illumination on the health have
shown that the tallow candle is the most un-
wholesome agent and the electric light the best.
The incandescent electric light produces only
^ about 1.3 % as much heat as the tallow candle,
while it gives out no carbonic acid or water.
One gas-jet in a room is said to vitiate the air
as much as six persons.
A Universal Solvent. — /rwi gives an inter-
esting account of what it calls the universal sol-
vent, and which, it declares, though long known
to modem chemistry, has only just been sepa-
rated, and cannot even now be retained in its
isolated state, simply because it destroys every-
thing. This fury of the chemical world, it
goes on to say, is the element fluorine. It ex-
ists peacefully in company with calcium in
fluorspar, and also in a few other compounds ;
but when isolated, it is a rabid gas that nothing
can resist. It combines with all metals explo-
sively. When they are already combined with
some other non-metallic element, it tears
them from it and takes them to itself. In
uniting with sodium, potassium, calcium, mag-
nesium, and aluminum the metals become
heated even to redness by the fervor of its em-
brace. Iron filings, slightly warmed, burst into
brilliant scintillations when exposed to it. Man-
ganese does the same. Even the noble metals,
which at melting heat proudly resist the fascina-
tions of oxygen, succumb to this chemical siren.
At a moderate temperature glass is devoured at
once, and water ceases to be water by contact
with this gas.
Gincrer-Drinking. — pr. Taylor, of Concord,
Mass., says that he has a patient who has twice
been on the verge of delirium tremens from ex-
cessive drinking of Sanford's ginger, • taking
thirty bottles in as many days. This is a habit
which is said to be on the increase, especially
among women.
An Infant with Two Mouths.— Lendon
describes an infant born with two mouths,
separated by a fleshy partition extending from
the lips to the fauces, where they open into a
common pharyngeal cavity. Faint indications
could be seen of separate chins and lower lips,
but there was no well-defined sulcus.
A family at Versailles, France, consisting
of the parents and two children, were poisoned
with conium, which had been used instead of
parsley in a dish of vegetables. The patients,
being dangerously sick, were taken to the hos-
pital for treatment, and recovered. A variety
of conium much resembling parsley grows in all
the back yards and gardens in Versailles.
Manicures first bathe the hand a long time
in hot water, then with scissors and knives clean
and cut the nails, remove the superfluous skin
about the onyx, then polish the nails with buck-
skin and fine powder, washing the hand again
in hot water with soap. After drying, the nails
are polished with a fine brush and are finally
rubbed with a rosy unguent to give them a shell
pink.
Among the relics of prehistoric man of the
neolithic and bronze ages are certain skulls
which are perforated in one or more places. In
one single collection there are not less than a
hundred and sixty-seven examples ; and we find
them scattered all over the earth, in the caves
of Europe, as well as the mounds of North
America and the ancient graves of the Peru-
vians.
A ^^ female medical Htndent," in a '' con-
fidential " communication to the Journal de Med-
ecine de Paris, strikes what she calls the " geni-
tal balance-sheet " of her sex in this way ; " in-
difference, which may be easily overcome, dur-
ing the inter-menstnial period; strong desires
and marked sexual appetite at the commence-
ment of menstruation ; disgust, repulsion during
the last days of the catamenia from the moment
the sanguineous discharge is fully established
and abundant." — N. Y. Med, Times.
314
THE MEDICAL ERA,
[Vol. VI. No. 10.
USEFUL RECIPES.
Iodoform.
The favorite method of disguising the odor of
iodoform is to mix it with some very finely-
powdered roasted coffee.
To Bemove Nitrate-of-Silver Stains.
Dip the fingers into a strong solution of cupric
chloride. In ahout a minute the silver will be
converted into chloride, and may then be
washed oflf with hyposulphite-of-soda solution.
Preservation of Urine.
A six-per-mille solution of chloroform is
found to effectively prevent the growth of micro-
organisms in urine, and it can be employed for
keeping pathological liquids, and for the storage
of anatomical preparations.
Solutions of Corrosive Sublimate.
A neat and convenient way to handle corro-
sive sublimate for making antiseptic solutions
is to dissolve 15 grs. in f 3 j of alcohol, which,
added to a quart of water makes 1-1000 and un-
dergoes no chemical change if used imme-
diately.
Increasing the Antiseptic Powers of Iodoform.
Solutions of iodoform in ether and alcohol
have greater antiseptic properties than the pow-
dered drug, owing to the production of free
iodine. The following solution is an an excel-
lent antiseptic, and much superior to the ethereal
one : Iodoform, one part ; ether, two parts ;
alcohol, eight parts.
A T.iTtmg for Oistems.
A simple method of keeping cistern- water as
soft as possible is to rub parafSne on the dry
walls and bottom of the cistern, and melt it
into the cement with a hot iron. Cisterns, when
plastered with pure Portland cement, generally
give satisfaction.
Shellac Splints.
Making splints out of thick woolen cloth and
strong alcoholic solution of shellac is done
by brushing the shellac over the cloth, plac-
ing several pieces together and passing a
hot iron over them. These splints are stiff
enough for ordinary uses, can be softened by
hot water, so as to permit them to be molded
to the parts, and can be cut in any shape.
A MoppOT fbr Bats.
Soak one or more newspapers, knead them
into a pulp, dip the pulp into a suitable solution
of oxalic acid. While wet, force the pulp into
any crevice or hole made by mice or rats.
Besult — a disgusted retreat, with sore snouts
and feet, on the part of the would-be in-
truders.
To Get Bid of Bed-Bugs.
Bore a large number of holes in a small
block of wood, with a gimlet. Place such a
block under the mattress of each cot in the hos-
pital. The bugs wiU take up their abode in the
gimlet-holes, and at intervals the block can be
plunged into a basin of boiling water. By this
method hospital beds may be entirely freed from
these pests, if the walls do not harbor them.
For Chapped Hands.
The Awerican Drii^^t recommends the follow-
ing formula: White wax, 5 xiv., spermaceti, 3
iij., cocoa butter, S ix., castor oil, S ix., oil of
benne, S vi. Melt and mix ; then add glycerine,
3 ij. Perfume as desired.
This makes quite a nice preparation. Petro-
latum is used instead of the oil of benne (sesame
oil) by some, and is considered an improve-
ment.
Cement for Bottles.
A new cement for bottles containing very
volatile liquids, which is easily prepared and ap-
plied, and which is said to prevent the escape of
the most volatile liquids, is composed simply of
very finely ground litharge and glycerine ; and
it is merely painted around the joint between
the bottle and the cork or stopper. It quickly
dries, and becomes extremely hard, but can be
easily scraped off with a knife when it is neces-
sary to open the bottle.
Porcelain Shot.
Under this name small white globule? of por-
celain are made in Munich. They are made to
take the place of ordinary lead shot used for
cleaning wine and medicine bottles, as porcelain
is entirely free from the objection of producing
lead contamination, which is often the result
when ordinary shot is used. Their hardness and
rough surface producing, when shaken, greater
friction, adapt the porcelain shot well for quickly
cleaning dirty and greasy bottles, a)id as they are
not acted upon by acids or alkalies, almost any
liquid can be used.
Oct., 1888). J
NEWS OF THE MONTH.
315
NEWS OF THE MONTH.
Cincinnati has a new crematory constructed
with all the modern improvements.
The Nebraska State Medical Society has
prepared a bill relating to the formation of a
State Board of Health, which it will ask the leg-
islature to pass.
Cheese-poisoning. — There have been many
eases this season in Ohio. The symptoms are
vomiting) gastralgia and violent purging. The
toxic agent is probably tyrotoxicon.
Aconite in Soda Water. — A druggist in a Con-
necticut town by mistake put tincture of aconite
into a glass of soda-water, instead of the proper
fruit syrup, and thereby caused the death of two
boys who drank the soda.
Dr. H. R. Stout, of Jacksonville, Fla., so
widely and favorably known to the profession,
early in the epidemic passed through a severe
attack of yellow-fever. We extend to Dr. Stout
our heartiest congratulations on his recovery.
At Duluth, Minn., Gabriel Marillo died re-
cently as the result of a singular accident.
While working on the street he was struck full
in the face by a stream of water from a hydrant ;
his false teeth were knocked down his throat and
he choked to death.
New Pavilions for Cook County Hospital. —
The executive board of the Commissioners for
Cook County have recommended the erection of
two new pavilions on the hospital grounds, one
for contagious diseases and one to serve as a
detaining hospital for the insane.
At Greenville, Pa., Miss Nellie Williamson,
while returning home from prayer-meeting
Wednesday evening, became greatly amused at
some occurrence and indulged in a violent fit of
laughter, during which a blood vessel bursted,
causing instantaneous death.
Life was Extinct. — At Dover, Del., a man
fell across the railroad track in such a position
that the wheels of an entire freight train passed
across his neck. The local paper, in describing
the accident, adds, very unnecessarily, "when
the body was discovered life was extinct."
Base-ball pitchers have killed five men and se-
riously injured six others this year with their swift-
ly thrown balls. The latest victim is Henry Zicke-
meyer, of Tiflin, Ohio, who was instantly killed
Aug. 30. He was struck by a ball over the re-
gion of the heart, and dropped dead instantly.
The Second Annual Report of the British
Homoeopathic League makes a most encouraging
showing. There has been a great increase in
the membership, and letters are coming from
members of the Boyal College of Physicians
asking to be referred to the standard works on
homoeopathy.
The Connecting Line. — The learned chim-
panzee, known as "Mr. Crowley," that lately
died in New York, has been ** posted." The
brain showed that the pyramidal tract was de-
ficient in development, while the convolutions in
the region of Broca's speech centre were almost
entirely wanting.
Miss Mary Crawford died in a ball-room at
Delray, Mich. An examination revealed the fact
that she had died from tight lacing, the stays in
her corsets having been drawn so tightly that
her flesh lay in folds beneath, so that the exer-
tion of dancing caused the bursting of a blood-
vessel.
A Pharmacist's Fatal Mistake. — A dispatch,
of Sept. 9, reports that Julius H. Eichberg,
pharmacist at the Cincinnati Hospital, who has
been there eight years, and filled 200,000 pre-
scriptions, caused the death of a patient yester-
day by his first mistake in putting deadly poi-
son in a prescription.
Bitten by a Bear. — Dr. William Knight, pro-
fessor of anatomy at the Ohio Dental College,
had his arm nearly eaten off by a black bear at
the Cincinnati zoological garden last week. He
had thrust his hand through the bars of the cage
to give the bear some peanuts, when the brute
seized his wrist with his teeth and bit the hand
almost off.
Would Not Believe Him. — While testifying in
a suit. Dr. J. J. Cole, of Indianapolis, offered to
reveal certain secrets told him by the woman
while he was her medical attendant. Judge
Taylor, before whom the case was tried, said
that he " would not believe a physician under
oath who would reveal a confidential communi-
cation received from a patient while acting in a
professional capacity."
Hahnemann Medical College and Hospital. —
This old and well-known college opened its
winter's course for 1888-'89, on the evening of
September 18th. Profs. D. S. Smith, R. Lud-
1am, and C. E. Laning, delivered addresses to
the large class that was assembled in the am-
phitheatre. After the " feast of reason," a ban-
quet was indulged in in the large dining-room of
the hospital.
816
THE MEDICAL ERA.
[Vol. VI. No. 10.
Chicago Homceopathic Medical College. —
On the evening of Sept. 18th the Chicago Hom-
oeopathic Medical College began its thirteenth
annual session with a large class, and an inter-
ested audience. The address of the evening
was delivered by Prof. C. M. Beebe, which was
followed by music by the glee club, and short
speeches by different members of the faculty.
**Bill Nye," the famous wit,. acted as brevet-
umpire in a game of base-ball between the "reg-
ular" and homoeopathic doctors of Minneapolis,
one day last week. He says that **the common
error seemed to be the same as that made in the
Garfield case — an incorrect diagnosis as to the
course and location of the ball."
Detecting a Malingerer. — A prisoner in the
Joliet penitentiary who feigned paralysis, resist-
ed every effort which was made to detect his
malingering, even to the running of pins into
his legs while asleep. As a final test the fellow
was put under the influence of ether, and then
rolled off from the cot on which he was lying
on to the floor. As he came out from the ether
he jumped up on the legs he had not used for
months, danced around like mad, and wanted
to ** lick " the crowd.
The Bodies Got Mixed. — At Corydon, Eng.,
a burial scandal of a remarkable nature occurred
last week. A man died in the infirmary the
same day as a woman, and the former was to be
buried by the parish and the latter by relatives.
By inexplicable bungling the bodies got mixed,
with the result- that the woman was put into the
man's coffin, and the man into the woman's.
The mourning relatives of the latter followed the
wrong body to the cemetery. The mistake tran-
spired after the funerals, and the bodies were
exhumed and transferred.
Drove His Head Into a Mule. — A singular
accident occurred in a mine at Wilkesbarre, Pa.,
Sept. 9. Joseph Richards, a boy fourteen years
old, was driving a mule in the Murray shaft. A
train of five loaded cars ran away and struck
the boy with such force that his head was driv-
en entirely into the mule's abdomen. His
shoulder was broken and he was otherwise in-
jured. When the horrified miners discovered
the boy's condition they endeavored to extricate
him, and found the united strength of two men
necessary. The boy's head penetrated the ab-
dominal walls and entered the mule's stomach,
killing the animal instantly. The boy suffered
from fracture of the base of the skull, and sur-
vived the mule by about an hour.
A Georgia girl is cutting teeth at the age of
nineteen, and they are not wisdom teeth, either,
but a pair of front ones which had been missing
from birth, and which she had just engaged a
dentist to supply when nature stepped in and
spoiled the doctor's job.
Orifioul Surgery. — The physicians who
were in attendance on Prof. Pratt's class held
a very interesting meeting at Central Music
Hall, on the evening of September 13th. The
object of the meeting was to discuss, among
themselves, the subject of orificial surgery, and
to relate their experience in its practice during
the past year. The meeting was presided over
by Dr.E.M. McAffee, of Clinton, la., as chair-
man, with Dr. C. C. Edson, of Rock Falls,
111., as secretary. A full report of the pro-
ceedings, together with a report of Prof. Pratt's
lectures, will be published soon by a committee
appointed for the purpose. Those who were
present were Drs. W. A. Foster, Curran, Dl. ;
R. L. Stow, Pleasant Hill, 0.-; J. K. Elms,
Traverse City, Mich. ; M. S. Rice, Aurora, Dl. ;
W. D. Lusk, Battle Creek, Mich. ; M. J. Hill,
Sterling, 111.; W. E. Green, Little Rock, Ark.;
J. C. Daily, Fort Smith, Ark. ; Laura A. Bal-
lard, San Francisco, Cal. ; W. E. Newton, Lig-
onier, Ind. ; R. Wilson Carr, Sedalia, Mo. ; T. H.
Trine, Chicago ; C. JI. Kaetel, Maysville, Wis. ;
Wm. Webster, Dayton, Ohio; A. Mitchell,
Ripon, Wis. ; J. M. Dart, Salt Lake City, Utah ;
M. D. Youngman, Atlantic City, N. J. ; I. Sax,
Crete, 111. ; G. H. McLin, Huntington, Ind. ; M.
M. Dodge, Albert Lea, Minn. ; G. A. Coming,
Hampton, Iowa ; T. W. Roberts, Winona, Minn. ;
E. Cross, Lake View, 111. ; J. W. Taylor, Craw-
fordsville, Ind. ; W. W. Gould, Rochelle, HI. ; J.
P. Madison, Cynthiana, Ky. ; J. N. Prinn, Han-
nibal, Mo. ; J. H. Drake, Mt. Pleasant, la. ; H.
W. Osbom, Cleveland, Ohio ; C. C. Edeon, Rock
Falls, 111. ; W. E Pritchard, Bushnell, 111. ; H.
A. Haley, Champaign, 111. ; S. T. Edgar, Zanes-
ville, Ohio; S. W. Beall, Columbus, Ohio;
J. E. Behrenburg, St. Louis, Mo. ; E. A. Water-
man, Indianapolis, Ind. ; J. F. Steyner, Olean,
N. Y. ; J. D. Boyd, Rockford, lU. ; J. S. Fahne-
stock, Laporte, Lid. ; W. A. Stone, Providence, R.
I. ; P. S.Replogle, Champaign, 111. ; C. A. Pauly,
Cincinnati, Ohio; E. H. Parker, Eau Claire,
Wis.; J. J. Whitfield, Grand Rapids, Mich.;
Laura A. Edwards, Hastings, Neb. ; N. M. Col-
lins, Rochester, N. Y. ; R. F. Hayes, Freeport,
111. ; A. L. Monroe, Louisville, Ky. ; E. W. Vietz,
Plymouth, Ind., and G. A. Ross, Ft. Wayne,
Ind.
OoT., 1888.]
HOSPITAL NOTES.
317
HOSPITAL NOTES.
Ckx)k County
Two cases recently admitted to the "other
side," as we call it, gave full proof of the efficacy
of Dr. Senn's method of diagnosis in penetra-
ting gun-shot wounds of the abdomen. The
course pursued is as follows :
Hydrogen is generated by the action of dilute
Hydrochloric acid upon zinc, the gas being col-
lected in a rubber receiving-bag. To this bag a
rubber tube is attached for insertion in the pa-
tient's rectum. As the gas is expressed from
the bag it distends the intestines, passes upward
and makes its exit from the mouth, where it
may be ignited, provided the intestines are in-
tact. If, however, the gastro-intestinal canal is
perforated at any point, the hydrogen escapes
into the peritoneal cavity, and may be ignited by
introducing the end of a small glass tube into
the external wound, and applying a candle to
the open end.
Case I. A bullet entered just beside the um-
bilicus, in a position where intestinal perforation
would seem almost inevitable. On rectal infla-
tion with hydrogen gas, the intestines gradually
distended until the gas escaped from the oeso-
phageal tube, and was there ignited. No flame
followed the application of a match to the tube
inserted into the abdominal wound.
The man died a week later from septic peri-
tonitis following an abscess in the track of the
bullet. Post-mortem showed no'intestinal per-
foration.
Case U. A young negro was shot in almost
exactly the same location as case I.
Very soon after the accident, inflation was
commenced. Bloody fluid and gaseous bubbles
appeared in the glass tube inserted in the exter-
nal wound. Blue flame appeared on applying a
lighted candle.
Laparotomy was immediately performed by
Dr. Fenger, and eighteen perforations of the
small intestines discovered.
The hydrogen was still further utilized in as-
certaining the exact location of the perforations ;
as the hydrogen was turned on it bubbled through
the lacerations, which were immediately sutured,
and the process repeated until all had been
found. This proceeding alone saved much time
and search.
The above cases illustrate well the value of
this method. Both external wounds were in the
same location. In tha one case, non-interfer-
ence gave the greatest chance for life, in the
other, laparotomy was the man's only hope.
Senn's method alone afforded the means to de-
cide the proper line of procedure.
Not long since a newly-arrived immigrant —
one of Bismarck's subjects, unable to speak a
word of English — wandered into the Hospital.
The man was taken to the proper apartment,
undressed, given a thorough bath,'then taken to
a ward and put to bed. After remaining there
several hours he was waited upon by the attend-
ing physician, who, after making a cursory and
fruitless examination, asked the man what was
the matter with him.
"Nichts," replied the German.
** Then why did you come here ? "
"To look around and see what kind of hospi-
tals you have in this country," said he, in Ger-
man.
"Then why did you let. them bathe you and
put you to bed?"
"Because," replied the man, "I thought that
was the American way of receiving visitors."
The patient was discharged and marked in
the books as a case of " complete recovery."
XALEVALA.
The Great Epic of the Times.
Prof. J. M. Crawford, M.D., of Cincinnati, is
just now receiving a great deal of attention from
the literary critics of the country, he being the
first to translate the £alevala into English.
This great epic is over three thousand years old,
and yet was never reduced to writing in any
language till within the last half century. Two
physicians, Dr. Topelius and Dr. Seurot, visit-
ing the Finns in their dwellings, gathered the
fragments which for nearly thirty centuries had
been preserved by oral tradition. In 1835 the
fii'st edition appeared, and now another physi-
cian, in the midst of a busy practice and ardu-
ous college work, is the first to produce an Eng-
lish translation of this great epic. This poem
has an additional interest to English readers, as
it was the source from which Longfellow drew
the framework and meter of his Hiawatha.
The work is elegantly gotten up and issued in
two volumes by John B. Alden & Co., of New
York.
OBITUARY.
At Bichmond, Ind., August 10th, the venerable
Dr. 0. P. Baer, in the seventy-second year of
his age.
Maria W. Porter, M.D., at her home in Daven-
port, Iowa, on Saturday evening, Sept. 8th,
1888, aged 65 years.
Died, September 6th, 1888, Dr. William Von
Gottschalk, of Providence, E. I., in the sixty-
eighth year of his age.
318
THE MEDICAL ERA.
[Vol. VI. No. 10.
FACETI/E.
SPECIAL NOTICES.
The Doctor's Slate.
A gt>od prescription for dyspepsia,
three times a day.
To be taken
** For every evil under the sun,
*< There is a remedy or there is none ;
<' If there is one, try and find it,
" If there. isn't, never mind it."
Never Mind the Biafirnosis.
Doctor. — ''My diagnosis causes me great un-
easiness, sir. It is — "
Patient, — **0, hang your diagnosis! All I
want to know is, what's the matter with my
liver."
A Slight Resemblance.
Patient, — **Well, doctor, what do you call
it?"
Doctor, — " Progressive paralysis."
Patient's Wife, — "Is it anything like progres-
sive euchre, doctor?"
Good Advice.
** Now, Doctor," said he, as he joined the
medical gentleman in the street, ** in the ease of
a man who can't sleep at night, what would you
advise ? "
'* I would advise him to sl6ep in the day-
time. " — lAfe.
Secundum Artem.
Doctor, — "My poor man, you are dangerously
ill. Is there any word you want sent to your
friends ? "
Patient, — " Am I really so ill? "
Doctor. — "Alas, I can oflfer you no hope ! "
Patient, — " Very well, then, nurse, telephone
for another doctor." — Ex.
Lung Troubla
Brown. — " You don't look well lately, Robin-
son.
»>
Robinson, — " No ; I can't sleep at night on
account of lung trouble."
Brown. — "Nonsense; your lungs are all
right ! "
Rcbinson. — " Yes, mine are ; the trouble is
with the baby's.
Important Convention of the Southern Homoeopathic
Association.
The Southern Homoeopathic Association will
meet in Louisville, October 10. This will be by
far the most important meeting of that school
of medicine ever held in the South. Dr. H. R.
Stout will be present and deliver a lecture on
the subject of " Yellow-Fever."
Prof. Buck, dean of the Pulte Medical College
of Cincinnati, will give an address on live topics
in medicine.
Besides these they expect Profs. Hale and
Pratt, of Chicago; Runnels, of Indianapolis,
who is private physician to Gen. Benjamin Har-
rison ; Dake, of Nashville ; W. H. Holcombe, of
New Orleans, and the Kentucky state delegation
en masse.
Reduced rates have been obtained from the
Louisville & Nashville, the Louisville, New
Albany & Chicago, and the Ohio & Mississippi
Railroads. Certificates must be obtained from
ticket agent at starting point, which, when
countersigned by the General Secretary at Louis-
ville, will entitle members to reduced rates
homeward.
A. L. Monroe, M.D. ^ Local
Howard Crutcher, M.D. > Reception
Charles W. Taylor, M.D. S Committee.
Laotated Food comes to the front with a speci-
men of three prize babies, raised on this favorite
aliment when no other food would agree. A cabi-
net photograph of the " triplets " will be sent to
anyone who will write to Wells, Richardson & Co.,
Burlington, Yi, and mention the Era in the re-
quest.
Monon Route to I«ouisviUa
From Chicago to Louisville the Monon Route
ofiPers superior accominodations. Leave Chicago
at 8:30 p. m., arrive in Louis vOle 6:30 a, m. City
ticket office, 73 Clark St. Depot, Dearborn Sta-
tion, Polk St., near State.
Burlingrton Route.
Vestibule Trains. — " The Burlington's No. 1 "
fast train, leaving Chicago at 1 p. m. daily for
Omaha, Lincoln, Cheyenne and Denver, and arriv-
ing at Denver at 9:10 p. m. the next evening, is
now a solid vestibule train for the entire distance
between Chicago and Denver.
The Burlington's " Fast Tl-ains " to Kansas City,
St. Paul, and Minneapolis will also be vestibuled
trains at an early date.
.>^ »>
MbdioaIj Btudbnts can have the Era for fl a year.
Oct.. 1888.]
BOOK REVIEWS.
319
BOOK REVIEWS.
Text-Book of Gynecology Desioned fob the
Student and General Practitioner, by
A. C. Cowperthwaite, M.D., Ph.D., LL.D.,
Professor of Materia Medica and Dis-
eases of Women in the Homoeopathic
Medical Department of the University of
Iowa ; President of the American Institute
of HomcBopathy ; Author of A Text-Book
of Materia Medica,'' '^ Insanity in its
Medico-legal Belations," etc., etc. Chi-
cago. Gross & Delbridge. 1888.
We open this book with great expectations,
and yet not without some misgivings. The
former, because one who has attained to Prof.
Cowperthwaite's eminence as an author and
teacher, cannot afford to give an ill-considered
work to the profession ; the latter, lest he might
have done so. But misgivings soon vanish as
we find ourselves absorbed in reading the pages
of a work beautifully written and systematically
arranged, covering the entire field of gynecology,
and making up a text-book far superior to any-
thing before possessed by our school and, equal,
we think, to the standard works of the old
school.
There has long been in our school a demand
for a good, reliable and practical work on the
diseases of women, and we are free to admit
that Prof. Cowperthwaite has succeeded most
admirably in his efforts to supply the want, a
fact which, we are sure, the profession will be
quick to recognize.
The first chapter is devoted to a brief study
of the anatomy of the female genital organs.
This is followed by a chapter on the general
etiology of gynecological diseases, which three
chapters are devoted to examination and diag-
nosis. This important subject is treated in a
most exhaustive and practical manner, and is
illustrated by cuts of the various instruments
used, and diagrams representing the methods to
be employed. These chapters are alone wor*h
the price of the book, and will prove of ines-
timable value to the student. Chapter Y. in-
troduces the consideration of the various g3me-
cological diseases in systematic order, beginning
with diseases of the vulva and ending with dis-
eases of the pelvic peritoneum and cellular
tissues. Then follow disorders of menstruation,
leucorrhoea, chlorosis, hysteria, sterility and
extra-uterine gestation, the last four chapters
of the book being devoted to a consideration of
the diseases of the mammary glands, a very
important subject, not heretofore included in
the works on gynecology. Each subject is
systematically arranged under the respective
headings of synonyms, definition, pathology,
etiology, symptoms, diagnosis, prognosis and
treatment. The pathology of the various dis-
eases is briefly given, but includes all that is re-
quired by the student and general practitioner,
and is fully up to date, embracing the most
recent ideas of modem pathologists. Medical,
local and surgical methods of treatment are
given.
The homoeopathic therapeutics which the au-
thor has introduced, will prove to be a valuable
feature of the book. For adequate reasons,
which are stated in the preface, this department
is not as elaborate as might be, but will, doubt-
less, serve the purpose intended.
As a whole the book will commend itself at
once to any student of medicine and every
practitioner. It is admirably well written, con-
cise, systematic and complete, and, withal, pro-
fusely illustrated, containing 215 illustrations.
It makes a book of 550 pages. The typograph-
ical exQcution and binding are the best that can
be put into the making of a book.
Prof. Cowperthwaite is to be congratulated ;
and so is the profession.
Hay Fever ; or Rhinitis Vaso-Motoria Periodica
AND ITS Radical Cure. By £. Lippincott,
M.D., Member of the American Institute
of Homoeopathy; Southern Homoeopathic
Medical Association ; American Public
Health Association; American Obstetrical
Association. Chicago. Gross & Delbridge.
1888. ($1.25.)
Physicians having cases of hay fever to treat
must possess themselves of this book. It is a
careful and systematic treatise on the subject,
and, withal, eminently practical. Dr. Lippin-
cott holds the view that hay fever is caused by
the irritation of a previously-diseased nasal
mucous membrane, and that treatment be
directed to this part. He claims for himself
abundant and gratifying success, by the use of
the methods described. The homoeopathic
therapeutics are particularly full, making it
altogether the best work on the subject of which
we are possessed.
The fifth Tulnme of the Manitold Cyclopedia, which hae Jaet been
fmbliehed, more than BDStalns the good reputation of the previoas
BBues, being, especially, more fall in Its vocabolary, and the entire
workmanship, both lltt^rary and mechanical, apparently being of a
higher grade. The publisher will send specimen pages free to any
applicant, or specimen volumes may be ordered and returned if not
wanted. J. hn B. Alden, Publisher, 898 Pearl Street, New York; 818
CUrk Street, Chicago.
320
THE MEDICAL ERA.
(Vol. VI. No. 10.
THEY SAY
That the urethra is a rifled passage.
That the big toe has now had its innings.
That it was not a case of leprosy, after all.
That a doctor mast understand all tongues.
That it is bad practice to forget what you never
knew.
That it is the female mosquito that does the
biting.
That an assurance company must have lots of
cheek.
That 35 years is the average age at which most
suicides occur.
That marriage is a trust for the protection of
infant industries.
That the best way to get a head is to go to
raising cabbages.
«
That the small boy is now gathering the home-
groan apple crop.
That there is nothing more misleading than fig-
ures, except facts.
That you should shut your mouth — and breathe
' through your nose.
That he who sells himself for nothing generally
gets all he is worth.
That the word "drug" only applies to medi-
cines in their crude form.
That the best way to get even with some men is
to pay what you owe them.
That the luckiest man of all is the one who
keeps school in hot weather.
That a cat makes most noise when everything is
still — everything but the cat.
That one-seventh of the deaths of the human
race are due to tubercular disease.
That by swearing you may convince yourself,
but you can't convince the other fellow.
That gonorrhoeal rheumatism attacks by prefer-
ence the temporo-maxillary articulations.
That a babe in the house is a well spring of
pleasure; but twins — twins are a deluge.
That a doctor always remembers kindly his first
patient, but never chips in for the monument.
That you should pay heed to the idle rumor,
lest the idle roomer forget to pay heed to you.
That sometimes people are killed by kindness,
but the mortality this summer has been very
light.
That the predisposition of man to tuberculosis
has doubled sincethe beginning of the present
century.
That the bilious and sanguine temperaments are
best for long life, the nervous and lymphatic the
worst.
That embolism involving directly only the ex-
tra-ganglionic portions of the cerebrum does not
cause coma.
That there is a tide in the affairs of men which,
if not skilfully dodged at the proper moment,
drowns them.
That the hardest sinner to convert is the one
who spends half his time in sinning and the other
half in repenting.
That lying with the shoulders low and the hips
elevated has given relief in some cases of the vom-
iting of pregnancy.
That man possesses a lung capacity which is
nearly one-fourth larger than the actual necessities
of life at sea-level demand.
That chloroform as an ansBsthetic is dangerous
when there is organic disease of the heart, or in
persons addicted to whisky.
That when it storms it is best to be on dry land;
but when it storms the land isn't dry, and it puz-
zles one to know where to go.
That a little boy carried a written order to a
Lewiston druggist calling for *' Ipecac enough to
throw up a four-year-old girl."
That according to the bulletins all great men
continue to improve until the improvement is
stopped by the death of the patient.
That there is a doctor down in Missouri whose
name is Gall. There is a position waiting for him
on the o. s. staff of cook co. hospital.
That false pains may come on at any time dur>
ing pregnancy, and cannot be told from true pains,
except that the former are relieved by opiunL
That a physician who drank some sheep's blood
said that, with his eyes shut he would have sup-
posed that he was drinking milk fresh from the
cow.
That "tympanitis" means one thing, and "tym-
panites " another, and there is no justification for
using these words indiscriminately, the one for the
other.
That a boy who was sent to the doctor's, came
home in high glee and said that the doctor told
him there was nothing the matter with him bat
" mental imbecility."
That a petrified man has been found in Minne-
sota. It is supposed to be the doctor vrho fell
" stone dead " when told that the American Insti-
tute would come west next year.
TEE MEDICAL ERA
Vol. VI.
Chicago, November, 1888.
No. 11.
EDITORS :
CH. GATCHELL, M.D.
JAMES E. GROSS, M.D.
''THE FATAL ILLNESS OF FREDE^
RICK THE NOBLEr
Sir Morell Mackenzie has spoken.
No such severe arraignment of one set of
physicians by another physician high in author-
ity has ever before been made.
Dr. Mackenzie, ivith gloveless hands, dissects
the case with anatomical detail. He weighs no
words, and softens none. He spares neither
invective nor sarcasm. He prefers against his
German colleagues charges which are not short
of crass ignorance and criminal malpractice.
There is an amount of circumstantiality in the
telling which lends to it a strong air of proba-
bility.
From the first he distrusted those whom he
found in charge. Gerhardt, he says, had given
"some attention to diseases of the throat."
Von Bergmann he had never seen mentioned in
laryngological literature **save as a somewhat
unfortunate operator in a few cases of disease
of the larynx." Tobold had grown to be " Kttle
more than a nominis umbra.*' He says :
I confess that I felt some surprise that among those
with whom I was invited to take counsel in a case of
such importance there was not at least one of the lead-
ing German specialists in throat diseases.
But these are mild indictments. He goes
further. He intimates that Gerhardt's treat-
ment of the case by galvano-cautery, making
an application once a day for a fortnight, may
have been the active agent in rendering the
growth malignant. His language is plain :
Prof. Gerhardt himself tells us that at an early
period of his connection with the case he suspected
that the affection was malignant. This makes the
manner in which he proceeded to deal with it simply
incomprehensible, except on the supposition that his
anxiety made him reckless. It is certain that if the
growth was not malignant from the first Gerhardt, by
his unmerciful use of the galvano-cautery, went the
surest way to work to make it so.
Bramann is criticised for making the trache-
otomy incision out of the median line, and for
inserting a large and clumsy canula, the lower
end of which impinged upon the posterior wall
of the trachea, causing irritation, inflammation,
and destruction of tissue, so that —
Greater destruction was probably occasioned in
three weeks by ill-fitting tracheotomy- tubes than
would have occurred in a year had the illustrious pa-
tient not been subjected to such injudicious treatment.
Von Bergmann does not escape Mackenzie's
lance. The description of the effort on the part
of the former to insert a tracheotomy-tube, is
certainly amazing. According to the account
he almost strangled the illustrious patient in
three unsuccessful attempts to insert the tube,
each time forcing it into a false passage which
he had created in the cellular tissue of the neck
in front of the trachea. Not until he had,
for some unexplained reason, plunged his finger
into the wound, did he desist from his efforts.
A cellular abscess is claimed to have followed
this unskilful manipulation, which Mackenzie
calls "the death-warrant of the Emperor,"
for —
"LiitoT on, a further source of irritation was supplied
by the trickUng into the windpipe of pus from the
abscess caused by Prof. Von Bergmann's blundering
efforts to make force supply the place of skill in intro-
ducing a canula.
322
THE MEDICAL ERA.
[Vol, VI- No. 11.
So the story goes, in all its grim detail. It
is without precedent in medical history. It is
in ill-temper ; it is malevolent. Mackenzie cer-
tainly exhibits an excess of controversial zeal.
But, it must be remembered, the provocation
was great. While the Emperor lived, Macken-
zie was maligned, insulted, persecuted, and even
threatened with personal violence. No sooner
was the autopsy held than he was dismissed
like a lackey, and publicly accused by his antag-
onists of having hastened the patient's death.
If he had not resented these savage attacks he
would not be an Englishman.
Of the merits of the case, it is hard to judge.
Although the story bears the impress of truth,
both sides should be heard before judgment is
formed. Probably no physician was ever before
placed in so delicate and exacting a position
as was Mackenzie during the Emperor's illness,
and probably none ever bore himself so well.
His skill, no one will question. His tact was of
an equally high order. To what extent he may
have been governed in his course by state rea-
sons, the world, probably, will never know.
Thus is initiated what promises to be a most
bitter international medical war. The lines are
drawn, and the battle wages.
The victim lies in his grave.
A^ UNIVERSAL PROPHYLACTIC.
It is impossible that the man who has not had
a professional education should understand the
problems of medicine. As well might a baker
pretend to understand Blackstone. When out-
siders invade the field of medicine, it is gener-
ally to display their ignorance.
Even Edison, the "wizard," so expert in his
own department of science, fails to show a com-
prehension of the subject when he approaches
that of the prophylaxis of disease. If we are to
believe the papers, he has recently been giving
some attention to the matter of the suppression
of yellow-fever, which he would accomplish by
killing the germs by means jof gasoline or caus-
tic soda. Now, while it is true that caustic
soda will destroy any animal organism, and a
gasoline bath is fatal to life, yet, like the old
lady's recipe for Indian pudding, it would be
necessary for Mr. Edison first to " catch his
germs." And this is not so easy a matter.
Mr. Edison expresses the belief that " the
fever microbes are parasites that crawl along the
ground." The bare suggestion of an atom
smaller than a blood-corpuscle — possibly no
more than the five-thousandth of an inch in di-
ameter — " crawling along the ground," must
be amusing to the practical bacteriologist!
How far the creature would crawl in the course
of an afternoon, deponent saith not.
Mr. Edison should understand that bac-
teria are not potato-bugs, and sprinkling the
streets with gasoline would probably cause
greater consternation among the voting popula-
tion of a village than it would among the mi-
crobes.
But what is the use of seeking for a remedy
that is already found ? No city in the land need
be visited. by the fever if it will observe the sim-
ple precautions which are familiar to every weU-
educated physician — cleanliness, as secured by
proper sanitation. Dr. J. P. Dake, in a letter
to the Nashville American, in criticising the local
board of health for refusing to harbor refugees,
expresses the opinion that Nashville could, with
impunity, receive all who might come without
infected luggage. Louisville very hospitably
threw wide her doors, and Dr. Lippincott, of
Memphis, writes us —
We have not had, and wiU not have, any yellow-lever
here this year, or at any future time. The eanitary
condition of the city is such that it can never originate
here, and, if brought, it would not spread.
The lesson is learned. With yellow-fever, as
with so many other diseases, filth is the nidus
from which it springs, and cleanliness is abso-
lutely prophylactic.
Meanwhile, a kindly frost has raised the
siege.
Nov., 1888.1
EDITORIAL.
823
" THE YOUNG DOGTORr
A fresh young doctor, like a fresh young
rooster, is apt to overestimate his capacity.
There is no sight in all nature so calculated
to increase one's confidence in the ability of the
race to take care of itself, as to see some young
sprig of medicine try to puff himself out so as to
appear as important as he feels. To him, age
is a mark of imbecility, and experience teaches
faulty lessons.
The laity, as well as the profession, under-
stand this, but nowhere have we seen it so aptly
"taken off" as in that most excellent of novels
*^ Robert Elsmere,^' where the gifted authoress
describes the diphtheria epidemic, in which the
Rector and his wife labored so hard. Mrs. Ward
says:
The Rector's ohiof help and support aU through had
been old Dr. Meyrick ; but now tlie old gentleman was
laid up with rheumatism, and the duties of attending
the sick fell to his son. This son was nominally his
father's jimior partner, but as he was, besides, a young
and brilliant M.D., fresh from a great hospital, and his
father was just a poor old ^.eneral- practitioner, with
only forty year's experience to recommend him, it will
easily be imagined that the subordination was purely
nominal.
The young doctor's superlative presumption,
as always, annoyed not only his poor old father
— who first made the boy, and then made him
a doctor — but all others were subjected to the
irritation of his manner, for it is related that —
The Rector was always sorry to see the young doctor
come. His attainments, of course, were useful, but his
cocksureness was irritating, and his manner abomina-
ble. When the old doctor was able to get about again,
he gave the sick ones an infinity of patient watching,
and amused the Rector by the cautious hostility he
would allow himself every now and then toward his
son's new-fangled devices.
That medicine, as a science, has made great
advances in the past forty years, expresses what
we all know. The young man who leaves col-
lege to-day carries with him a vast amount of
exact knowledge which is of comparatively recent
discovery. He certainly has the advantage of
the medical Bourbon who, since he went to
school, has learned nothing, and forgotten
nothing. But experience, to those who are cap-
able of learning, is an excellent teacher, and the
fledgling who assumes to know more than his
father, must simply be written down a ** cad,"
A BAD LGT.
As so often happens, it is the " reporter " who
is responsible for the error of statement con-
tained in the notice of Dr. Crumpton's appoint-
ment as a delegate to the Pennsylvania State
Society, to which we called attention in last
month*s Era. We have received the following
official letter from Dr. Crumpton, in which she
very modestly renounces all claim to having
been the "first woman delegate, "and places the
responsibility where it is generally found to rest
— on the ** reporter."
AiiiiEGHENY, Pa., Oct. 2, 1888.
Editor of The Medical Era:
In your current issue I find an editorial article which
amuses and interests me very much. For the last two
weeks my time has been taken up in writing to paper h
and journals stating that I am 710/ the first woman del-
egate to a medical convention, and asking the editors
to correct the statement; not being true, I do not wish
such an item circulated in connection with my name,
nor do I wish to be a first anything, least of all a first-
class impostor, as the papers seem to make me out. I
had no idea that my poor little paper would be the sub-
ject of so much commotion, and I shall be only too
glad if you will correct the mistake in the next issue
of the Era.
If we have any drug in the pharmacopoeia that will
silence reporters, we ought to use it very freely.
Very truly,
Margaret L. Crumpton, M.D.
26 Sherman Avenue.
STILL ON THE DECLINE.
We find the following item in a late num-
ber of the Medical Record :
A New HosPiTAii. — The papers announce, with much
fiourish, the completion of a new homoeopathic ho<^pi-
tal at Detroit, Mich., at a cost of $100,600. The sum
mentioned does not go far in hospital building and
maintenance. It is unfortunate, however, that even
such an amount should be wasted in giving support to
a dogma already practically extinct in intelligent com-
munities.
We were beginning to feel very disconsolate
over this piece of news, when we picked up an
Eastern paper containing the following para-
graph :
A New College. — It is announced that another
allopathic medical college is soon to be opened in
Brooklyn, N. Y. It takes considerable money to run
such an institution decently, and it is a pity to waste
it in supporting an empirical system of medicine
which, as is well known, is being abandoned by the
best and most intelligent class of citizei^s in every city
in the country.
Now we feel better!
324
THE MEDICAL ERA.
[Vol. VI. No. 11.
ORIGINAL ARTICLES.
SOME EXPERIENCE WITH SODIUM
PHOSPHATE.
By W. H. hall, M.D.
HAVANA, ILL.
[Read before the Illinois Homoeopathic Medical ABBociation.]
AFTER the manner of the great law of evo-
lution is our materia medica unfolded
and fixed in the memory, to be drawn
upon as circumstances require.
Schiissler says: ''Through the presence of
Sodium phosphate, lactic acid is decomposed
into carbonic acid and water. The Sodium
phosphate fixes or absorbs carbonic acid and
carries it to the lungs for exhalation."
The same author recommends it for all ail-
ments in which there are symptoms of acidity,
and as lactic acid seems necessary to the life of
intestinal worms, the remedy is recommended
for the destruction of these annoying parasites.
Either on account of improper selection of the
remedy, or carelessness of the patient, many
cases of indigestion do not improve as we would
like, and it calls to mind the diflficulty, many
times, of obtaining satisfactory results in that
other protean malady, hysteria, and suggests the
idea of the probable, or, rather, possible rela-
tionship between some of these cases.
We are often appealed to for the relief of pain
coming on an hour or two after eating, burning
in the stomach, eructations of gas and sour
fluid. The patients often tell us that it makes no
difference what they eat or how it is eaten ; the
trouble comes as regularly as the meal. Such
cases go the rounds of doctor shops and nos-
trums, and kill time during the interval taking
Sodium bicarbonate. For the symptoms men-
tioned above I am now in the habit of prescrib-
ing Sodium phosphate 3x, a small powder in a
swallow of water before each meal, and with a
certainty of success that I did not have with
other remedies.
Recently a man of means, one retired from
business, called on me for relief from very
troublesome burning in the stomach after eat-
ing, and continuing almost to the next meal-
time. He also had pain developing one or two
hours after meals. His external appearancp
was that of a healthy man. The tongue had
a light gray coating, no bad taste in the mouth,
no fullness or tenderness about the hypochon-
drium or epigastrium, bowels regular and stools
normal. No thirst or fever. EBs chief annoy-
ance was the burning, which sometimes kept
him awake at night. He received Sodium phos-
phate and immediately began to improve.
The next time I saw him he said : '* The med-
icine is doing its work ; the burning has ceased,
and it was not the result of faith, for I came to
you at the solicitation of friends, and without
hope."
This is only one case of a number where So-
dium phosphate has in like maimer succeeded.
Last winter a child (its father a druggist)
fourteen months old had typhoid fever, after
which it suffered with indigestion. Everything
soured in the stomach, the breath smelled
sour, it vomited curdled milk and sour-smell-
ing fluids, had green stool, alternating with
constipation ; was troubled with colic ; had white-
coated tongue and was white around the
mouth ; was fretful, cross and restless at night.
After several fruitless efforts with other med-
icines and considerable loss of time, the entire
trouble was readily removed and the child
restored to perfect health by the use of Sodium
phosphate.
I have treated two cases of pin- worms, with
itching of the anus, with perfect success. In
both cases the Sodium phosphate 6x was used,
a powder night and morning. In one case all
symptoms disappeared in a week. In the other
the itching was less annoying after one day's
treatment, and entirely disappeared by the sec-
ond night. Both cases were treated over a year
ago, and have not manifested any symptoms
of a relapse since.
The Sodium phosphate was continued two
weeks in each case. The twelve tissue reme-
dies are not likely to displace the entire materia
medica, but will evidently become valuable aids.
NOTE ON KATiI CTANICUM.
By CLIFFORD MITCHELL, M.D.
CHXCAOO.
THERE is a muddle in regard to nomen-
clature which threatens to become as in-
volved as the celebrated "Nathaniel-
Daniel or Daniel-Nathanier* case in Pickwick.
There is a substance which has been used by
Dr. Adams, of Toronto, and also by Dr. Tyrrell,
of the same city, in cases of carcinoma with
marked effect in several ways as they show. In
an article in the Homoeopathic Recorder their ex-
perience with the drug is fully related. They
call it Kali cyanicum, and give its formula as
ECNO, and its familiar name as the CjRnate of
potassium. As the substance may have a "great
future " (like most all drugs that we hear of), it
may be well to understand its chenucal constitu-*
Not., 1888.]
ORIGINAL ARTICLES.
326
tion. In the same article in which Dr. Tyrrell
describes its use he alludes to a drug used by
Petroz, which cured a cancerous ulcer of the
tongue. Now the drug used by Petroz was not
the Cyanote of potassium, but the CyanicJ^, as the
editor of the Recorder shows in a note at the end
of the article. In order to understand fully the
chemical diflferences between the Cyanw^ of po-
tassium and the Cyanaf^ of potassium, together
with the synonyms of each, I have arranged the
following table :
POTASSIUM CYA^ ATE.
Ternary compound
made by oxidizing Potas-
sium cyanide by heating
the latter with oxides, as
those of metals.
Formula, K(CN)0 or
KCy 0—81.
Potassii cyanas.
POTASSIUM CYANIDE.
Binary compound made
by heating 8 parts Potas-
sium ferrocyanide with 3
of Potassium carbonate.
Formula, K(CN) or K-
Cy-»65.
U. S- Pharmacopoeia
name : Potassii cyan!-
dum.
French names: Gyanure
de potassium, Hydrocy-
anure de potassiiuu.
German names: Kali-
umcyanid or Cyankalium.
English homoeopathic
name: Kali cyanatum.
Properties: Transpar-
ent, colorless cubes if
crystallized from fusion,
or anhydrous, octahedrous
and cub o- octahedrous
from aqueous solution.
Fhi8es at dull red heat. In.
odorous except when
moist. Strongly alkaline.
Bitter taste.
Confusion, if any, arises from the fact that the
Cyanwfe is termed by homoeopaths Kali cyanatum.
If, however, the CyanaYe be termed in homoeo-
pathic medicine Kali cyemicum they may thus be
distinguished from one another. In the same
way homoeopaths call Potassium chlorate, KaU
chloTicum; but Potassium bromwfe. Kali brom-
atum. Practically, it is difficult to obtain Potas-
sium cyanide which does not contain Potassium
cyanate as an impurity.
70 State Stbest.
Cyanate de] potassium
Ralium cy an icum .
Kali cyanicum.
Properties: Small col-
orless laminae and needles
like Potassium chlorate.
Fuses much below red
heat. Inodorous. Tastes
like nitre.
IODINE FOB WORMS.
By CIIAS. S. McKAY, M.D.
lowell, mich.
LAST month I was called to attend a child
about three years old, suffering from a
severe cold. Noticing a discoloration on
the child's chin, I inquired its cause. The
mother explained that about four days before
the child had found a bottle of Iodine (tr.) and
enjoyed a taste. The mother said further that
the next day the child passed several large,
round worms, the largest nearly five inches long.
I had at that time on my hands a child about
four years old, who had all the worm symptoms
in the calendar. The worms seemed to enjoy
Santonine in every form, from 6x to crude drug.
The day after hearing the above from the mother
of the child that had taken the Iodine by mistake,
I put one-half dram tincture of Iodine into a
two-dram vial and filled it up with water, and
ordered it given in three-drop doses every three
hours. To the satisfaction of all, the next day
the child passed several round worms similar to
those passed by the first babe. Another thing
that happened was, the child had been "cank-
ered " seemingly throughout the extent of the
digestive and intestinal mucous membranes, but
after taking the Iodine and passing the worms,
this entirely disappeared.
HUMAN DECADENOE.
Bt H. D. CHAMPLIN, A.B., M D.
CLEVBLAND, OHIO.
THERE is not one person in ten who thinks
of, or seems to care for, his health until he
loses it.
The most absurd excuse for neglect of duty to
one's self is that he cannot always be looking
after his health ; in other words, he has not the
moral power to abstain from excesses that
weaken the body and shorten life as surely as
night follows day.
The old Roman idea of manliness was a sound
mind in a sound body. Physiologists recognize
the existence of two sources of strength in the
constitution ; one is called the force in use, and
the other the reserved force, and the conserva-
tion of these forces is the desired end to be at-
tained. The great thing in regulating and ben-
efiting human life is not to find out new things,
but to make the best of old things — to live ac-
cording to nature and the will of nature's God.
And certainly the high pressure that the major-
ity of the present generation are putting upon
themselves, the strain of over-work, and «rim-
inal abuse of their stomachs and organs gener-
ally, shows a disposition to live according to no
law.
Dr. John Brown, of Edinburgh, tells the fol-
lowing story in one of his books : " One day on
my return to the office I asked the servant if any
person had called, and was told that some one
had. ' Who was it ? ' ' Oh ! it's the Uttle gen-
tlemen that aye rins when lie walks.' " So it is
with this age and people, and one wishes they
would walk more and *' rin " less.
A man can walk farther and longer than he
can run, and it is poor saving to get out of
breath.
326
THE MEDICAL ERA.
[VOL.VL No. 11.
The man of seventy, well preserved mentally
and physically, with ten children and as many
grandchildren, is of more value to the com-
munity than twenty men who die at thirty, and,
it is to be hoped, unmarried. More than half
the bad effects of over- work might be prevented
by a little plain knowledge, attention, and judi-
cious use of good sense on the part of the family
physician. Educate your patients in regard to
themselves; make them acquainted with the
fact that they have a stomach, and define its lo-
cation (few, very few, seem to have a correct
idea as to where it is). Explain the fact that
it is the laboratory in which the most wonderful
chemical processes constantly go on ; that what-'
ever goes into it is at once acted upon chemically,
and the nutritious and wholesome portions go to
build up and strengthen the system. Improper
food, improper hours of eating, liquor-drinking
and tobacco-using put an extra amount of work
and fatigue upon it in the effort to sustain life.
What a man habitually eats and drinks has
much to do with the condition of mind and
body.
Matthew Prior has these stout old lines :
*< The plainest man alive may tell ye
The seat of empire is the belly :
Froifi thence are sent ont those supplies
Which make us either stout or wise.
The strength of every other member
Is founded on your stomach timber ;
The qualms or raptures of your blood
Rise in projTortion to your food.
Your stomach makes your fabric roll
Just as the bias rules the bowl.
That great Achilles might employ
The strength designed to ruin Troy,
He dined on lion's marrow, spread
On toasts of ammunition bread;
But by his mother sent away
Amongst the Thracian girls to play,
Eifeminate he sat and quiet,
Strange product of a cheese-cake diet.
Observe the various operations
Of food and drink in several nations.
Was ever Tartar fierce or cruel
Upon the strength of water gruel ?
But who shall stand his rage and force
If first he rides, then eats his horse ?
Salads and eggs and lighter fare
Turn the Italian spark's guitar,
And, if I take Dan Gongreve right,
Pudding and beef make Britons fight."
105 Jennings Avenue.
CLINICAL LECTURE.
Reported bj Wm. Wta<tford.
liOCOMOTOB ATAXIA.
We may now consider the bacillus as the
cause of tuberculosis. I believe that tubercular
lesions are sometimes curable, as, for example,
tubercular meningitis. I believe the danger in
such cases lies not so much in the presence
of bacilli as in the presence of septicaemia,
which is so apt to be present. — Th\ San%om,
By CH. GATCHELL, M.D.
CttlCAOO.
[A clinical lecture delivered at the Cook County Hospital, Chicago,
October 4th, 1888.]
GENTLEMEN: The first case that I shall
offer for your instruction presents the
most common form of chronic disease of
the spinal cord with which that organ is affected.
It is variously called progressive locomotor ataxia,
posterkyr spinal sclerosis, and tabes dorsalis.
The disease consists of primary degeneration
of the sensory nervous system, involving both
the spinal cord and the peripheral nerves, char-
acterized by muscular incoordination, by peculiar
pains, and by the loss of certain reflexes.
As regards its etiology, it is far more frequent
in men than in women, in the proportion of ten
to one. Heredity has but a slight influence. It
is a disease of middle life, the greater number
of cases occurring between the ages of twenty
and forty. Traumatism is responsible for some
cases, maybe one in ten. But the cause that is
more pronounced than any other one, is syphilis.
Some authorities put tins, as a predisposing
cause, as high as ninety per centum. If we place
it at one-half of all cases, it is a very safe esti-
mate. When it occurs secondary to syphilis it
generally makes its appearance four or five years
after the initial disease. It is not strictly a se-
quel of syphilis, but, rather, a degeneration to
which syphilis predisposes the system. The
character of the degeneration is unlike syphilitic
lesions.
I will first, in this patient, demonstrate a few
symptoms which characterize the disease, then
explain its pathology, and afterwards attempt to
account for the symptoms according to the le-
sions found. This man's tabetic history dates
back one year. It is a case in which trauma-
tism has been the exciting cause. About one
year ago he was sitting on the edge of a wharf,
and at the approach of a steamer he was thrown
violently to the deck of the wharf, and probably
suffered concussion of the spine. From that
time he dates the first symptoms of the disease.
He soon suffered from severe pains and other
sensations extending down the left side, involv-
ing the thigh as far as the knee. It is only
about six weeks ago that the ataxic symptoms
made their appearance. At the present time
these are very prominent. Observe his gait. As
he returns from walking across the floor notice
Not., 1888.]
CLINICAL LECTURE.
327
the maimer in which he puts his feet down.
This is called the ataxic gait. The heel comes
down first, then the front of the foot, so that
there is a sort of double sound as each foot
strikes the floor. The patient does that in order
to secure a firm foundation upon which to rest
the feet at each step. Again, you will notice,
he spreads the feet as he walks ; that is to gain
a wide base of support. The peculiar gait has
been called the gressua gaUinaceiis, or the ** cock-
walk," in contradistinction to the gressm vaccinas,
or the '* cow-walk," which is found in paraplegia.
Paralytics will drag their feet and scrape the
inside of the feet and toes in walking, while the
tabetic patient throws the heel down first. It
used to be said by the old authorities that the
diagnosis between a case of tabes and one of
paraplegia could be made simply by having the
shoes that the patient wore brought to the doc-
tor's office. If the shoe was worn down at the
back of the heel, it was tabes ; if on the inner
side of the sole, it was a case of paraplegia.
This, however, is rather fanciful, gentlemen,
and I would not advise you to depend upon it
as a discriminating symptom in this disease.
As the patient stands with his feet close to-
gether and his eyes closed, he sways to and fro,
and without the support which I render he
would fall, and yet there is full power of the
muscles. Now, seated in a chair, as he extends
his leg it requires all my strength to bend the
knee. Thus, notwithstanding the interference
with locomotion, his muscular power is not even
diminished.
In tabes the degeneration usually begins in
the postero-external column, the column of Bur-
dach, as you have heard it called, though I
prefer names that are descriptive rather than
names that immortalize the discoverer. The de-
generation, then, as I have before said, begins
generally in the postero-external column of the
cord in the lumbar region. It may extend to
the dorsal and cervical regions, to the medulla,
across the floor of the fourth ventricle, and even
into the aqueduct of Sylvius.
The nature of this change gives to the disease
one of its names — spinal sclerosis, a hardening.
The process is simply this : In its normal state
the posterior column of the cord is made up of
white nervous tissue — an axis-cylinder sur-
rounded by the white substance of Schwann.
The nerve-fibres, thus composed, are bound to-
gether by connective tissue, or neuroglia. In
primary degeneration of the spinal cord, first
the white substance of Schwann undergoes gran-
ulo-fatty degeneration; the greater portion of
it degenerates into fat ; this finds its way into
the lymph- spaces of the vessels, and is carried
off. At the same time there is a corresponding
hyperplasia of connective tissue. This is the
histological process involved in primary degen-
eration of the cord. The peripheral sensory
nerves in any part of the body may undergo a
similar degeneration.
Now, gentlemen, I will try to account, so far
as it is possible in the present state of our
knowledge, for the symptoms of the disease,
taking the pathological changes as a basis. In
the first place, one of the earliest and most con-
stant symptoms of the disease is pain. The pain
may occur in any part, from the head to the
feet. In many cases — and it is true in the case
of this patient — it consists of sharp, shooting,
Ughtning-like pains, which are often mistaken
for neuralgia. At other times the pains will be
of a character resembling rheumatism. Some-
times the pains are of such severity that in ex-
treme instances they have driven the patient
to suicide in order to escape from the unendur-
able torment. In addition to the pains there
may be other disturbances of sensation — formi-
cation, '*like ants crawling over the parts;"
creeping pains ; burning pains, and almost any
variety to which the human sensory system is
subject. We can only account for these pains
by supposing that they are due to molecular
changes which take place in the process of de-
generation of the sensory nerves. Temperature-
sense may be lost in some cases, and the tactile
sense in others. Loss of sensation — cutaneous
anaesthesia — is common. Also, there is delayed
conduction, so that the prick of a pin may not
be felt for several seconds after the skin is
pierced.
Among the symptoms belonging to the head,
we often find a severe cephalalgia. There are,
moreover, important eye symptoms. In about ten
per centum of all cases there is atrophy of the
optic nerve, which is simply another instance of
degeneration of a peripheral sensory nerve, in
this instance it being a nerve of special sense.
Always examine with the ophthalmoscope your
cases of tabes. The retina will appear grayish
in color, which is due to destruction of the capil-
laries. In some cases the peripheral limitation
of vision will have made considerable progress
before the patient discovers that there is any
defect. Of course, such a degeneration, if not
arrested, must finally result in total blindness.
One of the prominent symptoms of this disease
— though it occurs also in paretic dementia and
in disseminated sclerosis — is the Argyll-Robert-
son pupil, which consists of a loss of contraction
of the pupil to light, while the contraction to ac-
328
THE MEDICAL ERA.
[Vol. VI. No. 11.
commodation still persists. This is an instance
of the loss of a reflex act, for the contraction of
the pupil to light is reflex, while contraction to
accommodation is a voluntary act. This state-
ment calls for some explanation.
When light strikes the retina, an impulse is
conveyed along the optic nerve to the anterior
pair of the quadrigeminate bodies, and thence to
the centre for contraction, in the front part of
the floor of the aqueduct of Sylvius, where a
motor impulse is reflected along the third nerve
to the circular fibres of the iris, causing pupilla-
ry contraction. A destruction of one link in the
chain abolishes the reflex act. In this instance
it is supposed to be due to degeneration of the
centre for contraction, in the floor of the aque-
duct.
On the other hand, when, by a voluntary act,
we converge the eyes for near vision, by an
"associated movement" the ciliary muscles are
also brought into action, and the pupils contract.
This occurs because there are nerve-fibres con-
necting the ciUary motor centre, in the hind
part of the floor of the third ventricle, with the
centre of the motor-oculi, in the front part of
the floor of the Sylvian aqueduct. Thus it is
that this power may be retained, while the re-
flex act is lost. In rare cases, the power of con-
traction for accommodation is also lost.
Another symptom belonging to the eye is a
condition of myosisj permanent contraction of
the pupils. There is also, sometimes, ptosis,
and, even, paralysis of the external ocular mus-
cles. When this occurs it forms an exception to
the rule that only sensory nerves are aflfected in
tabes. The motor paralysis is accounted for by
the degeneration of the nerve-centres presiding
over these muscles. The teeth of tabetic sub-
jects sometimes undergo great decay ; in extreme
cases they drop out, from trophic changes which
take place in the alveolar processes. There is
sometimes spasm of the larynx, which much re-
sembles laryngismm stt^idulus.
There is one important symptom belonging to
the stomach ; it is what is called the gastric crisis
— a persistent, uncontrollable vomiting, some-
times accompanied by nausea and pain, some-
times not. It will persist for hours, or even
days, and then cease, only to recur at some fu-
ture time. The gastric crisis is supposed to be
due to degeneration in the floor of the fourth
ventricle in the region of origin of the pneumo-
gastric nerve.
There are other crises, as they are termed.
There will be a rectal crisis : severe pains in the
rectum, tenesmus, and sensation as if there
were a foreign body present. Sometimes there
will be occasional attacks of diarrhoea, consid-
ered to be the intestinal crisis of the disease,
though usually there is obstinate constipation.
Belonging to the bladder, there will be reten-
tion of urine, but it is entirely diflFerent from that
which occurs in paraplegia, where the bladder is
paralyzed and unable to expel its contents. In
this disease residual urine remains after each
expulsive effort, because intelligence of its pres-
ence is not conveyed to the spinal cord, owing to
impaired sensibility.
In the sexual apparatus symptoms of irrita-
tion will present themselves, manifested by saty-
riasis, and later, in almost all cases, there is
complete impotence. This you know is another
loss of a reflex act.
Among the -trophic changes there are diseases
of the joints, which have been so well described
by Charcot. These joint changes consist of an
erosion of the articular cartilages and wasting of
the articular surfaces of the bones.
Among other trophic changes, there is the
perforating ulcer of the foot, an indolent ulcer
that resists all treatment, and sometimes makes
amputation necessary. There are vaso-motor
changes, revealed in oedema of the ankles.
I now come to consider a symptom of the dis-
ease which is the most important of all, because
it is more constant than any other, and often
determines the diagnosis — loss of the patellar-
tendon reflex, or, as it is better to term it, the
knee-jerk. In the case of this patient, the knee-
jerk is absent, indicating that there is a break
somewhere in the reflex arc.
While the kncj-jerk is considered to be a re-
flex act, yet there are some who do not subscribe
to the doctrine. There is a peculiarity in the
production of the knee-jerk to which I will call
your attention. As I produce it in this other
patient, who is suffering from lateral spinal
sclerosis, and in whom the knee-jerk is much
exaggerated, you will notice that the action of
the leg follows very quickly upon the stroke of
the patellar-tendon. The space of time between
the stroke and the jerk, is scarcely appreciable.
Now, according to all the knowledge that we
possess regarding the rate at which nervous im-
pulses are transmitted along the course of nerves,
it should require about twelve-hundredths of a
second for this circuit to be made, and yet, as a
matter of fact, it occurs in about two-hundredths
of a second, making a difference of one-tenth of
a second. And because of this one-tenth of a-
second the entire scientific world of medicine is
in a state of suspense, uncertain whether or not
to call the knee-jerk a reflex act.
Nov., 1888.]
CLINICAL LECTURE.
329
Those who favor the view that it is not a re-
flex, attempt to account for it by supposing that
there is in all muscles what thev call a mwscU-
tanuSy and that when the stroke is made upon
the patellar-tendon there is, as it were, a sort of
explosion of force in the quadratus-femoris mus-
cle, and hence the prompt response. But the
chief objection to this explanation is that it is
based upon only a theory — a very unsubstan-
tial foundation. Notwithstanding the seeming
anomaly, as regards time, in the production of
the knee-jerk, the weight of opinion is to-day in
favor of its being a retiex act.
In attempting to elicit the knee-jerk, be care-
ful to guard against all sources of error. If there
is not a prompt response to the ordinary
method, have the patient sit on a table with the
legs over-hanging. Then have him hook his
fingers together, and pull hard while you strike
the patellar-tendon, a little to the inside of the
knee. As the patient thus pulls on his fingers
the knee-jerk is ** re-enforced, "and often reveals
itself when other methods fail to develop it. If
you should succeed in your efforts, then you need
seek no further for signs of tabes, for of all
symptoms, this is the one which is most con-
spicuous by its absence.
Tabes dorsalis is essentially a chronic disease,
lasting sometimes for twenty or thirty years. In
its course there may be numerous periods of re-
mission and exacerbation, so that you are never
certain whether or not apparent improvement is
the result of your treatment. The fatal result
— which comes in almost all cases — is due
generally to some intercurrent malady, often
some disease of the kidneys. Though the prog-
nosis is so grave, yet a few recoveries have been
known, and, this being so, every patient is en-
titled to have his case looked upon, and treated,
as if it were to be the next which would show a
favorable termination.
This is the disease in which nerve-stretching
was at one time so widely practiced, but the re-
sults have not been such as to recommend it,
and it has fallen into a deserved state of *' in-
nocuous desuetude."
Unfortunately, there is no established line
of treatment for this disease. An anti-syphil-
itic treatment, consisting of the employment
of Mercury and the Iodide of potash, has
seemed to do good in some cases with a his-
tory of antecedent specific disease, but the
results are very variable, and not to be depended
upon. Dr. Bichard Hughes reports the cure of
a case, in its early stages, by the use of Bella-
donna. Zincum sulphuricum has some testi-
mony in its favor. Dr. Hughes speaks highly,
also, of the virtues of Picric acid in controlling
the symptoms of sexual irritation. Probably
more uniform results have followed the use of
Argentum nitricimi than of any other one reme-
dy, and this and Arsenicum should be given a
trial in all cases. This patient, who has been
suffering so severely from the gastric crisis re-
ceived for several days Apomorphia, which at
first seemed to give much relief, but later there
was a renewed accession of the trouble.
I show you here three cases, all suffering from
locomotor ataxia. This man presents a clear
case, ha\4ng many of the characteristic symp-
toms of the disease — muscular incoordination,
absence of the knee-jerk, and the lightning-like
pains.
This woman entered the hospital to be treated
for what appeared to be rheumatism. But, prov-
ing to be unusually obstinate for a case of rheu-
matism, a more critical examination was made,
and it was discovered that the knee-jerk was
absent, that there was a very slight want of co-
ordination, and that she was suffering from some
of the sensory symptoms of tabes.
Here is still another woman, who came to the
hospital with an attack of vomiting from which
she had been unable to obtain relief. After
entering the hospital we treated her with Ipecac,
Iris, Tabacum, and various other remedies
seemingly indicated, but all to no purpose. The
vomiting, indeed, became worse, and finally bile
and lilood followed the more innocent ejecta that
had preceded. Then it was that my suspicions
first became aroused. I had the woman sit on
the edge of the bed, and tested for the knee-
jerk. It was absent. The uncontrollable vom-
iting, then, was the gastric crisis of a case of
tabes. .She also gave a history of severe light-
ning-like pains in the feet, especially in the
great toes. Thus it became easy to make a
positive diagnosis, which time has only served
to confirm.
These two cases afford useful clinical lessons.
Their histories teach you that in every case of
supposed rheumatism, neuralgia, or vomiting —
to which I might add various other symptoms
— you should always test for the knee-jerk. If
you find it to be absent, then look for other
symptoms of locomotor ataxia, and often you
will be able to make a clear diagnosis in a seem-
ingly obscure case.
A morbific agent may produce widely different
results, varying with the locality of its acti\4ty.
— Dr. Atkinson.
330
THE MEDICAL ERA.
[Vol.. VI. No. 11.
SOCIETY PROCEEDINGS.
CONGRESS OF AMERICAN PHYSICIANS
AND SURGEONS.
FvrtA Tri-ennial Meeting, held in WaMtigton, D. C,
Sept. 18-25, 1888.
FThe following excerpts of the ProceedingB of the Congress are
taken from the full report published by ihe Medical Record. — Ed.
Era.1
I believe the localization of cortical centres
of sensation to be still an open question. — Dr,
Starr.
In a large number of cases of nasal surgery,
dangerous blood-poisoning has resulted. — Dr.
Rice.
The differential diagnosis of extra-uterine
foetation is simply impossible, unless made
inside the abdominal cavity. — Dr. Price.
The benefits of climatic treatment depend,
first, upon choosing the proper climate, and,
second, upon the proper regulation of the life.
— Dr. Piatt.
One of the difficulties of producing an aseptic
atmosphere is, that what will destroy one mi-
cro-organism will not destroy another. — Dr.
Johnson.
The large number of micro-organisms found
in dwelling-houses would lead us to infer that
infectious diseases are usually, if not always,
contracted in dwelling-houses. — Dr.WhiMaker.
A« large percentage of laryngeal complications
are not tuberculous, while in other cases tuber-
cular infiltration appears in the larynx before
the lungs are involved. — Dr. Ohsgotv.
Intubation had been done as a precautionary
measure in many cases in which tracheotomy
would not have been thought of. Some of the
good results of intubation are to be a'ttributed
to this fact. — Dr. Mudd.
By senile coxitis I understand a rheumatoid
affection of the hip-joint occurring in old people,
and characterized by pain, stiffness, muscular
spasm, and disability; one never showing a
tendency to suppuration. — Dr. Taylor.
Benal disease prevails most where the heat
for the greater part of the year might be called
temperate. Change of climate in chronic
Bright's disease is of great value, and is, per-
haps, as important as in consumption. — Dr.
Wilson.
The rate of consumption, especially scrofu-
lous, among Indians is high and is increasing,
which may be accounted for by the change of
life among those who have given up their wild
life and are living on reservations. Scrofula is
common among these people. — Dr. Rice.
The writer cited experiments on Indian, Chi-
nese and civilized women, to show that costal
respiration is not, as is generally supposed, pe-
culiar to women, but is the result of the tight
clothing worn by most civilized women. The
normal respiration of women differs but little
from that of men who lead sedentary lives. — Dr.
Martin.
The aspirator should never be used in pelvic
abscess unless for diagnosis. It is never cura-
tive. I believe in washing out with corrosive
sublimate. I would hesitate to use a solution
1 : 1,000. In many cases it is not safe to wait
till a distinct tumor is formed, and open into
the vagina. — Dr. Parrish.
Our present knowledge justifies the statement
that both the csecum and appendix may be the
starting-point of an inflammation spreading to
the peritoneum or to the peritoneum and cellular
tissue of the iliac fossa, constituting a compli-
cated lesion which for convenience sake we may
call " perityphlitis."— Dr. BuU.
To Dr. Mott belongs the credit of being the
first to show that atrophy is a true active
dystrophy and not a mere passive change. By
cutting of the cauda equina he demonstrated an
atrophy of the femur. The whole of its inner
surface was lined with osteoclasts. — Dr. Hors-
ley.
Impetigo, furunculosis, and sycosis have been
found to be produced by the invasion of staphy-
lococcus pyogenes aureus et albus. The differ-
ences in these diseases depending upon the
depth to which the bacterium penetrates, and to
the varying anatomical structure. — Dr. Atkin-
son.
In one thousand ovariotomies I left the sec-
ond ovary in a number of women, and these
women bore two hundred and twenty-eight chil-
dren and only two of the women died. If these
second ovaries had been removed these two hun-
dred and twenty-eight children would not have
been bom. — Sir Spencer WeUs.
The consensus of opinion, as Expressed by the
leading surgeons of New York City, within the
past two or three years, is to the effect that the
best possible results in elbow- joint injuries are
obtained by perfect immobilization after the
part has been placed in normal position. — Dr.
GUmey.
In my opinion the presence of dark red,
round, or irregularly shaped flat papules which
show no tendency to become vesicles, justify
N«T., 1888.1
SOCIETY PROCEEDINGS.
881
the diagnosis of a licheilbid eruption, but not of
the disease lichen planus. For that diagnosis
the clinical symptoms must correspond to those
of undoubted cases. — Dr. Robinson,
In regard to the recurrence of epilepsy in
operations performed for the relief of this affec-
tion, I consider that Ihe recurrence is due to
incomplete operation. In those cases in which
I have removed not only the lesion, but the sur-
rounding brain-substance for at least one centi-
metre, there has been.no re turn. — Dr.Ferrier.
Hysterical symptoms occurr in a great many
cases of organic disease. But functional
troubles are really due in great pai-t to impair-
ment of the nervous system. I saw a case of
tremor lately, following mild lead-poisoning,
where two or three applications of hypnotism
removed the tremor. — Dr. Zenner.
So far no one has been able to show that the
supposed bacilhis of syphilis is the specific
bacillus. That it is a specific disease cannot be
doubted ; that it is due to a microbe cannot be
doubted, but to establish this positively, experi-
menters must do what Koch did before he
announced the specific origin of tuberculosis. —
Dr. Senn.
The question of what and how many brain-
tumors are operable has been best answered by
White. He found, in one hundred brain-
tumors met with in the dead-room of Guy*s
Hospital, that only nine could have been
removed — one tuberculous nodule, four sar-
comas, two undetermined tumors, one cyst, and
one myxoma. — Dr. Park.
The primary purpose of the drum-membrane
is protection ; transmission of sound waves is a
secondary purpose, and made necessary by the
existence of the protective membrane. The
membrana tympani exists for the protection of
the tissues of the middle ear from the desicat-
ing influence of tke atmosphere, and the rigidity
that would therefrom ensue. — Dr. Rlcliey.
It is sometimes hard to discriminate between
malingering and actual suffering. People
injured are followed up by runners for lawyers
and by them impressed with the dangerous
nature of their injuries. Then the slow pro-
cesses of law force them to remain in a condi-
tion of ill-health. They cannot afford to get
well for fear of a suit for conspiracy. This
develops in the patients a psychical condition
worse than hysteria. — Dr. Gray.
Laparotomy in peritonitis is the only justi-
fiable treatment in the puerperal form, and
especially in peritojiitis fifter perforation pf iur
testine ; it is almost sure to be followed by the
recovery of the patient. In tubercular periton-
itis it is especially successful. Seeing that the
only alternative is death, I think the operation
should in all cases be tried. — Dr. Montgoniery.
I have gone over the brain to find what parts
are accessible to surgical interference. We are
able to strip up the longitudinal and lateral
sinuses to a considerable extent. The dura
mater may be separated for a considerable dis-
tance from the bone. I have been able to raise
up the frontal lobes so as to see the anterior
clinoid processes, and to feel the foramen mag-
num. — D)'. Weir.
Clinically flat-foot is an affection which, in
the majority of cases, occurs independent of
local or constitutional disease. The direct
cause is overweight or overwork for feet sub-
jected to mechanical disadvantages. Being es-
sentially a dislocation, it should be treated as
other dislocations, by reposition and retention
in the normal position until by exercise and
avoidance of faulty position the muscles may
regain their normal strength. — Dr. Whihnan.
Surgical interference is not justifiable and
should not be instituted in cases of typhoid
fever, in which perforation occurs when the in-
fection process is at its height. In mild cases
of the disease in which the pyrexia has not been
of high grade, and in which perforation occurs
at tlie end of the third week, or later, when the
stage of convalescence is fully pronounced,
laparotomy may be performed. — Dr. BuU.
We must, as it seems to me, regard Bright*s
disease as a constitutional disease, in which the
repair and waste in all the tissues of the body
are imperfectly carried on, and in one way or
anotlier the kidney changes are expressive of
other visceral and arterial changes, which, com-
bined with the kidney lesion, make up the clin-
ical and pathological history of the disease. —
Dr. fjoomis.
In disseminated forms of tuberculosis the
climatic treatment is often of benefit. No one
climate is beneficial to all cases ; some improve
most on the seashore, others most in the moun-
tains. Sunshine, however, is always beneficial,
and over-crowding should be avoided. Sun-
shine, plenty of fresh air, and purity of ihe
atmosphere, are the important elements in clir
mate for the treatment of phthisical cases. — Dr.
Brmii.
Many cutaneous affections are thus seen to
have a varying etiology, and the dependence of
skin-lesions upon disease of th^ central nervous
332
THE MEDICAL ERA.
[Vol. VI. No. 11.
system and of the viscera is abundantly evident ;
but until pathology discovers whether the influ-
ences are constant and what is their exact na-
ture, we cannot expect that diseases will be con-
sidered so much what they are, as what they
appear to be. — Dr. At]dns(m.
Patients often present themselves for treat-
ment for headaches, occipital in character or
often like real migraine. These and other
paresthesias of the head are often attribut-
able to uraemia in a pre-albuminuric stage of
Bright's disease. In such cases there is, as a
rule, increased arterial tension and active heart.
Casts are often discernible in the urine, but
albumin rarely. There are generally symptoms
of indigestion. — Jyt, Seguin.
In puerperal eclampsia, he advocated strongly
the immediate induction of premature labor so
as to take the pressure ofiF the renal veins,
which causes uraemia, which in turn causes the
damage to the brain. As soon as we know that
the urine is loaded with albumin, he thought
that further delay was dangerous. We ought
not to wait until the last, when even a breath
of air would bring on a convulsion, but start at
the beginning, when interference is without
danger. — Dr, Lapthom Smith,
The most common cause of pelvic abscess is
pyosalpynx, as held by Lawson Tait; or even
the forcing of catarrhal secretion out of the dis-
tant end of the Fallopian tube into the perito-
neal cavity. He cited several cases where it had
been undiagnosed for years, and where on open-
ing the abdomen he had found large abscesses.
Symptoms: Fever, emaciation, rigors and
night-sweats. The aspirator will often make
the diagnosis certain. Prognosis is good, pro-
vided it is not tubercular. The pus must be
evacuated and the abscess-cavity kept clean.
In pyosalpynx the abdomen must be opened. —
Dr. Cushing,
Bickets, although a constitutional disease,
dependent upon mal-assimilation and mal-nu-
trition, yet exhibits its worst phases in deform-
ities of the bones. The deformities are due to
the relative preponderance of organic tissues in
the bones, and the failure of the formative car-
tilage cells to produce true osseous cells. Dur-
ing this stage of softening many portions of the
skeleton become disturbed, and when earthy
salts are again deposited sclerosis results, and
the faulty portions are permanently fixed.
Anterior tibial curves are among the most fre-
quent. — Dr, WWard.
The influence of the use of the telephone on
hearing power I believe to be bad, because the
very low intensity of the sounds, as demon-
strated by experiments, necessitates a very fa-
tiguing effort on the part of the ear, which
places it in a condition in which it is especially
liable to injury from the shocks of the metallic
sounds of high intensity liable to be heard at
any time through making or breaking the cir-
cuit. — Dr. Blake.
One case of goitre treated by electrolysis is
reported in which the tumor not only grew
smaller during the treatment but continued to
do so after its cessation, until it has now prac-
tically disappeared. The author's experience
with electrolysis in fibromata, vascular naevi,
and epithelial and papillary neoplasms strongly
corroborates that of others. He is led to ascribe
this continued effect to a modification of vital
activity impressed upon the tissues by the elec-
trolytic current. — Dr. Atkinson.
My experience is that there are present in the
nose, heat, moisture, foreign matter, extract
from air containing numberless germs, and, in
fact, every condition to favor decomposition and
the infection of any cut surface. Tissues, in
swelling after operating, -block up the nose, in-
terfering with drainage and enclosing small
fragments of soft or bony tissue that are almost
certain to decompose ; tissue also partly severed
and still hanging to wound ; excessive bleeding
also tempts one to pack the nostril, which, along
with use of Persulphate of iron is almost certain
to show septic symptoms in from eight to
twenty-four hpurs. — Dr. Rice.
The author read an excellent paper descrip-
tive of a new and safe method of overcoming
laryngeal obstruction. The ingenious instrument
he presented is so designed as to render most of
these unfortunate complications impossible,
while operating with greater ease and rapidity.
Thin silver blades are introduced through the
crico-thyroid membrane and passed between the
vocal cords. These are separated by pressing
together the two short external extremities,
which are at right-angles to the rest of the
blade and united to each other by a hinge where
they rest in the wound. Pressing the outer ends
together separates the inner blades between the
vocal cords. — Dr. Holden.
In the use of plaster-of-Paris dressings for the
knee my experience is that the better the fit se-
cured by the plaster dressing, and the longer
kept uninterruptedly applied, the greater was
Mo*., IM.]
HASCHISCH.
the disappointment at not findiag the ex-
pected anchylosis ; in other words, the riinge of
motion was increased by the prolonged fixation.
Whatever aucliyloaia occure in a joint which
has been subjected to immobilization occurs by
reason not of immobilization but of the nature
and intensity of the inflammation, and of the
inefficiency of the apparatus employed. — Dr^
Gibitey,
In cerebral surgery we practice simply the or-
dinary rules of surgery. In cutting out the
bone, a one- inch trephine should be first used to
determine the thickness of the skull. The sur-
gical engine may then be used to out almost
through the portion of bone to be removed. The
bone may then be removed with strong forceps.
The dura mater should be hrst separated. If
nothing is found and the operation is an explo-
ratory one, the dura mater should be opened. If
we propose to use faradism for the recognition of
certain areas, it is important that the ordinary
antiseptic solutions should not be applied to the
brain, for they tend to prevent the response to
the electric current. — I)r. Ferrier.
The nucleated red corpuscle of the marrow
in the adult is derived from a colorless nucleated
cell found in the marrow, and shows the same
characteristics, with the exception that it con-
tains no hfemoglobin. This cell multiplies by
direct division, and hfemoglobin becomes devel-
oped in the cell-substance of its offspring, form-
ing thus the nucleated red corpuscle. These are
also capable of reduplication by indirect division
as long as the nucleus shows a reticular struct-
ure, but when this is lost, and the nucleus stains
deeply and uniformly with methyl green, it is no
longer capable of karyokinesis. Its nucleus is
then excluded, and there is left a non-nucleated
red corpuscle, which later becomes a bi-concave
red corpuscle of the circulation. — Dr. HoweU.
The author believed that in the unsatisfactory
state of the treatment of Pott's disease, it would
be well to judge of the efficiency of mechanical
treatment by the impression made by the appa-
ratus on the skin covering the projection. He
thought the object of treatment was threefold :
to fix the diseased bones, to transfer pressure
from the bodies to the processes, and to reduce
the deformity. If the skin near the summit of
the projection becomes thickened and callous,
which it does without discomfort if the pressure
is carefully increased from time to time, it is to
be considered that the apparatus is acting as it
ought to, and when the greatest pressure is
made compatible with the integrity and comfort
of the skin, the apparatus has reached the limit
of its efficiency. — Dr. Jvdson.
SOHISOH.
Thorold Kiho.
CHAPTER III.
AITKR FIVE YEARS.
IT was early in November. "The Belmont"
had its full quota of guests, and its inmates
had settled down to their old-time routine.
One evening, shortly before dusk, a servant-maid
entered one of its handsomely-furnished apart-
ments, ushering in a gentleman with the words :
"This way, if you please, sir. What name
shall I give, sir? "
"You may deliver this," said he, extending
toward her a card.
But, instead of depositing the card on the sil-
ver tray which the girl held toward him, he
quickly returned it to his pocket, and added :
" No, stop a moment ! Tell your mistress that
a gentleman whom she has long been expecting,
wishes to see her. Do you understand ? "
" Yes, sir," replied the girl, as she departed
on her errand.
Quickly turning, the young man's glance
swept the room, and paused only when it lighted
on a portrait of Mr. Hardy, which hung above
the mantel. Stepping before it, he regarded it
long and earnestly. He stood erect, his hands
clasped before him, with fingers tightly inter-
locked, while their oecaHionally increased pres-
sure, accompanied by a long-drawn sigh, gave
evidence that he was stirred by deep emotion.
He was a little above medium height, with a
fully-rounded, muscular form. The lower part
of his face was hidden by a full beard, and even
his lips wer« shut from view by a heavy, over-
hanging mustache. His head was set on broad
shoulders, and his deep chest indicated robust
health, the possession of which his swarthy com-
plexion helped to confirm.
For several minutes he stood before the pic-
ture ; then, with a sigh, he left it, crossed to a
window and looked out. Suddenly, on hearing
approaching footsteps, he turned and glanced
toward the door.
384
THE MEDICAL ERA.
[Vol. Vl No. 11.
At this moment a young girl entered, clad in
hat and ulster, having evidently come from the
street. A roll of music which she carried in her
hand sh^ tossed lightly upon a sofa. Hum-
ming softly to herself, she proceeded to draw off
her jgloves, when, glancing tip, slie discovered
that she was not alone.
*' O, pardon me ! I was not aware a stranger
"was present!'* she exclaimed, and turned to
withdraw.
** Helene ! Don't .you remember me ? " eried
the other, advancing toward her.
The girl drew back, and for an instant gazed
at him intently; then, rushing to him, in her
surprise she could scarcely articulate.
**0, Austin, is it you? I am so glad! We
have all been longing for you — it was so hard
with you away ! And — and — '' but her voice
broke with emotion, and she could say no
more.
For a moment Austin himself was silent, and
his own eyes filled with tears. But soon regain-
ing his composure sufficiently to speak, he said
tenderly :
"I know, dear, how hard it must have been,
and I have so longed to be with you — with you
all. And my poor mother, how is she ? How
does she bear it?"
**0, better than we dared hope, at one time.
And she, too, is so longing to see you ! But we
did not expect you to-day — if we had, we
should certainly have been at the boat."
" Yes, I know you would ! But that is my fault
— I made an earlier start — I was so anxious to
reach home ! Will mother be here soon, do you
think?"
** Yes, but all the sooner if she knows it is
you ! I will go and find her at once."
" But I have already sent a message by the
maid."
" 0, she will never find her ! Let me go — I
shall not be long."
" But you will return, too ? "
" Yes, presently, after mother has had a short
visit with you."
And so saying, Helene turned to leave the
room. As she did so, a figure appeared in the
door-way through which she was about to make
her exit. It was that of a man of about Austin's
age, but as unlike him as it was possible for
another to be. He was slightly taller, but his
thin and spare-built frame gave him the appear-
ance of greater height than he really possessed.
His eyes were small, piercing and restless — of
no determinate color, but, chameleon-like, ap-
peared to change in different lights. They were
surmounted by a pair off heaVy eye-brows which
the flexibility of his features permitted him to
draw down so as almost to hide his eyes from
view, or to raise high on his forehead. The
former position was the one which they habitu-
ally assumed. His temples were hollow, bis
cheek-bones high, his nose narrow, and his chin
eharp. He was clean-shaven, with the 'excep-
tion of a narrow line of mustache whose tightly-
twisted ends showed the action of nervous fin-
ders. His lips defined a mouth which would
have been his only redeeming feature had it not
been wanting in that breadth which goes with a
generous nature*
As the stranger displayed no disposition to
retire when his presence was observed, Helene,
half-turning, said :
** Mr. Hardy will doubtless be pleased to meet
one who comes from the same part of the world
which has so long been his home. Mr. Hardy,
this is Mr. Arnold, of Cape Town," she conclud-
ed, as she quickly left the room.
The person who was introduced under this
name, advanced with a tread which was like
that of the panther tribe — the ball of the foot
was first extended in an exploratory manner, as
though searching for a convenient spot upon
which to plant itself. This found, the heel was
then permitted to touch the ground, and the
weight of the body was slowly shifted from the
foot in the rear to the one newly-planted, with an
air of security which the previous deliberation
seemed to justify.
Austin, who was about to extend his hand, on
hearing the stranger's name pronounced, started
back in surprise.
"What! Philip Arnold of Cape Town?" he
exclaimed.
The other now showed as great astonishment
as Austin displayed, and he, too, involuntarily
started back.
**You have the advantage of me, sir!" said
he.
**I knew that you were somewhere in this part
of the world," continued Austin, as though the
other had not spoken, '* but I never expected to
find you under this roof ! "
** May I ask, sir, why you take such a lively
interest in my whereabouts ? "
Now for the first time seeming to talk to Ar-
nold, and not to apostrophize, Austin spoke in
more direct and lower tones.
*'I do so because I have a mission to per-
form."
*'I know of no reason why I should be inter-
ested in your missions, sir."
Kov.. 1888.]
HASCHISCH.
835
** Possibly ; but there is reason for my taking
an interest in yours."
** A matter which gives me little concern."
" Philip Arnold, " said Austin, earnestly, **it
is useless for us to spar in empty words. We
shall soon be interrupted, and this interview
must terminate, but I desire that it shall be re-
sumed at the earliest possible moment."
" An honor which I must beg leave to decline
until I am informed of its necessity," said Ar-
nold, with an appearance of indifference which
was only belied by a nervous twitching of his
long fingers.
*'You can quickly hear all that I have to
say," said Austin, speaking rapidly and incisive-
ly. ** Listen! One year ago, in South Africa,
Horace Crane, formerly of this city, died and
left an only child — a little girl of six years.
You, as his legal adviser and his trusted friend,
administered his estate, which, in passing
through your hands, in some way dwindled to
an insignificant sum, and his child was left al-
most penniless. A small amount of real-estate
which he had in this country you are here to
administer, but valuable securities which he was
supposed to possess, disappeared at the time of
his death. Search for these papers has been
unavailing, and was long ago abandoned."
During this rapid recital Arnold stood almost
transfixed. What emotion he may have felt
was carefully concealed; even his fingers had
stopped their nervous twitching, for their ends
were now tightly pressed into his palms. When
he again spoke, it was in a voice which showed
that its owner had taken many lessons in the
art of self-control.
"And how does that concern me?"
** Those securities are still in existence."
" If you know that, why do you not produce
them ? "
** Because there is but one man in the world
who knows where they are secreted — "
** And that man — "
**Is yourself! "
" It is false ! " hissed Arnold, now for the first
time permitting his agitation to come to the sur-
face.
*' That it is not false, I am prepared to con-
vince you."
**But I decline to hold any further intercourse
with you, sir," said Arnold, drawing toward the
door.
** Hark ! " exclaimed Austin, advancing a step.
** Someone comes. You must go, but I desire
you to meet me in this room again to-night,
after all others have retired. I shall be here ;
you may do as you think best.
With gliding step the one passed out at the
open door, while the other turned, crossed the
room, and again gazed out of the window upon
the street below.
CHAPTER IV.
A MAN OF ACTION.
AUSTIN HARDY belonged to the world of
action. He had made some failures in the
course of his life, but they were few com-
pared to the number and magnitude of his suc-
cesses. Though still young, yet the opportunity
which a new country affords had enabled him to
accomplish more than most men do, even after
long lives of toil. Although to others his actions
might at times appear to be hasty, yet every
undertaking was preceded by a period of calm
deliberation. But, once having determined upon
a course, he then pursued it with a directness of
purpose which commanded success in spite of
all obstacles which might oppose. He was fear-
less, courageous, and once convinced that he was
right, accomplished his object by direct force
where others might resort to diplomacy — a
word of whose meaning he was ignorant. He
never used a bent pin when there were a dozen
straight ones in the cushion.
This was his method in business, and it was
his method in all other relations of life. He
hated wrong, and would fight for the right, if he
had it to do, according to this same principle of
action.
Austin had stood at the window but a few
moments when the servant who first ushered
him appeared at the door.
** Mrs. Hardy is here, sir," said the girl.
Austin turned quickly. A rustle of drapery,
a quick step, and mother and son were clasped
in each other's arms.
Let us leave them during the moments of
their first greeting — leave them to ask and to
answer the thousand questions which are to
b'ridge the gap of their long separation. The
story of the sickness and death of husband and
father must be recounted in broken voice, and
the weary hours passed since then told with
many sighs. Thus the stream of life which di-
verged years before, comes together again like
a river parted by an island.
** How long the time seems, Austin, since you
left us, five years ago!" exclaimed Mrs.
Hardy.
**Yes, five long years!" repeated Austin.
**But I have been so lonesome — Tso entirely
without friends — that it has seemed even longer
336
THE MEDICAL ERA.
[Vol. VI. Nouli.
than that ! I have often wished that Kenneth
were with me."
** 0, to that I could never have consented ! "
**No — ^and though I should have enjoyed
immensely having him with me, I never expected
it," rejilied Austin.
**It was hard enough, in your absence," con-
tinued Mrs. Hardy, ** to let him go even as far
as Paris, and I consented only because his health
Beemed to demand the change-."
** I ahi so glad to know that h^ is fully re-
stored!"
** Yes ; his residence abroad has worked won-
ders for hini \ But for the pictures which you
have seen, you would scarcely recognize him."
**I wish that I might have an opportunity to
try," said Austin. ** He has not yet learned of
my arrival, has he ? "
** No, not yet, or he would have been here be-
fore this time. He will soon come, however,"
said Mrs. Hardy, glancing at her watch, ** for I
sent a message to him before I came in."
"Helene I have already seen," continued
Austin. '' How beautiful a woman she has
grown to be ! But w^here is cousin Dora ? She
has not left you, I hope ? "
''0, no ! Although she is now of age, and has
control of her own property, she still prefers
making this her home. She is out for the day,
but will return before dark. You know that we
had no warning of your coming."
**That was entirely my own fault," said Aus-
tin, ** for not having cabled you from London."
**And you must have left the Cape much
sooner than you expected ? "
** Yes, I did. And on the voyage I took ad-
vantage of every opportunity to gain a day, for
I was impatient of delay."
" And you will not leave me again, I hope? "
" Only temporarily ! You know that for sev-
eral years I have contemplated returning to
New Y'ork to engage in business, and I had
already begun negotiations for the sale of my
interest in the mine a month before receiving
the news of father's death. With the excepti6n
of one matter — which can receive attention at
some future time — I completed the sale as
hastily as possible, and at once set out for home,
where I now expect to remain."
The mother did not reply, but her satisfaction
expressed itself in a gentle pressure of the hand
which clasped her own.
*' You have written me so often of late," she
said, after a short pause, **of something you
intended confiding to me as soon as we should
meet."
**Yes, something that I preferred to tell rather
than to write. Have you never suspected what
it is?" asked Austin, full of his own conscious-
. ness of the subject.
* * No. Why should I ? You have never given
me the slightest hint."
** That is true, and I should not have ex-
pected it. But I shall not be long in telling
you," he began.
** Listen!" suddenly exclaimed Mrs. Hardy.
*' Someone comes. It must be your brother."
At this moment Kenneth hastily entered, as
Austin sprang to his feet. Then each drew back
a step and glanced into the other's eyes, when,
without a word, the distance between them van-
ished and they embraced — not as girls em-
brace, but awkwardly, as men do, chest to chest,
with arms obliquely crossed.
When their first greetings were over they
seated themselves, and the three had much to
say to each other.
While there was some family likeness between
these brothers, with that the resemblance
ceased, and further comparison would be a
matter of contrasts. Kenneth was of medium
stature and of nervous organization, though
with just enough of the sanguine in his tem-
perament to rescue his features from being too
sharp, and his disposition from being too angu-
lar. His hair was dark and curly, his com-
plexion clear and florid. He, too, was bearded,
though not so heavily as his brother. His
nervous organization made him quick and viva-
cious in manner, though the sanguine element
permitted that repose which goes with a hope-
ful disposition. Unlike his brother, who was
more practical, Kenneth was full of sentiment.
Yet, while his mind ran rather to the abstract,
still, in all that he did he was so methodical
that none of his energies were lost, and thus he
accompUshed more than would be expected of
one of his nature.
Above all, Kenneth was quick to the point of
impetuosity. Like a woman, he arrived at con-
clusions by that process of rapid reasoning
called intuition. And, as a rule, his intuitions
were correct. But, as reasoning is sometimes
false, through fault of premise or of process, so
intuitions may now and then be wrong. When
he was right, however, his quick decision and
rapid action gave him an impetus which soon
placed him many steps in advance. On the
other hand, when he was wrong, his impetuosi-
ty precipitated disaster so suddenly that he "was
never able to escape the crash which followed.
But on such occasions his ingenuity would soon
:4ov., 18^8.]
HASCHISCH,
887
come to his rescue, and enable lilm to recover
lost ground by the adoption of new expedients,
with which he seemed to be ever ready.
The conversation in which mother and sons
were engaged had taken a practical turn.
**You understood that after your father's
death," Mrs. Hardy was saying, **I decided to
make no attempt to keep this immense house
myself, and therefore I leased it to Mr. Howard,
who for more than three years had been its
manager. I reserved only this suite of rooms
for ourselves ; but, as we now have company,
you shall have a room in the hall-way above."
** Company?" asked Austin.
" Yes. Helene's former school-mate, Madge
Irving, is making her home with us while her
father is in Mexico, where he will be detained
for another year. And Gordon Wright, who used
to live here, is back on a visit as Kenneth's
guest."
"Is that the Wright who was in the engineer
service?"
"Yes. It was he who first suggested that his
profession would be a good one for Kenneth to
adopt. But he is out of business now, and al-
most distracted over the misfortune which led to
the loss of his position."
"Why! — is it so serious?" asked Austin.
"Yes, it is very serious, indeed! " spoke up
Kenneth. "On the completion of the New York
and Chicago Railway, in the construction of
which he was engaged, he accepted a position in
the company's service, and became one of its
most efficient officers. But one day last winter,
on leaving his office to go to lunch, he failed to
close the door of the safe, and in his absence a
sneak-thief, as is supposed, entered and ab-
stracted a package containing twenty thousand
dollars in bank-notes. Poor Gordon, who re-
turned in less than thirty minutes, was almost
wild when the loss was reported to him."
"And has no clue to the thief ever been
found," asked Austin.
" None whatever ! Diligent search was made,,
and descriptions of some of the bills — which
were new, and their numbers known — were
advertised far and wide, but without result."
"But they do not suspect him, do they?"
" 0, no ! " was the quick reply. " But since
the loss was the result of his carelessness, the
company felt called upon to demand his resig-
nation."
"Poor fellow!" exclaimed Austin. "I do
not wonder that he is distressed ! "
" He might be reinstated in his former posi-
tion," continued Kenneth, " if he could make
good the loss, but this he will never be able to
do. He has become extremely melancholy over
the matter, and almost a monomaniac on the
subject of large sums of money. Mr. Arnold
says that he never knew anyone to be so
strangely affected."
"And what makes the affair doubly sad,"
broke in Mrs. Hardy, "is that he is engaged to
Madge, and they were to have been married as
soon as her father returns. The marriage, how-
ever, is now indefinitely postponed — he fears,
forever, although she refuses to share this gloomy
view."
"Just like a woman!" exclaimed Austin.
Then turning to his brother, he asked : " What
Mr. Arnold is it of whom you speak, Kenneth?"
" 0, it is a Mr. Philip Arnold, of Cape Town,"
answered Kenneth. " He came to the city last
December, and has been stopping here ever
since. Having lived in South Africa, we had
hoped that he might be able to tell us something
of you, but he says that he never met you, and
had not even heard your name. Do you know
him?"
"I never met him there," replied Austin, " for
in the last four years all my time has been spent
up at the mines, while he was at' the Town, it
seems."
"Yes, he practiced law there for several
years."
" Does he intend remaining here much longer,
do you know?"
"He said but yesterday," answered Kenneth,
"that the business which had brought him —
some legal affair in connection with the settle-
ment of an estate — was almost concluded, and
that he may leave at any moment.'*
Again the conversation turned to the subject
of Austin's experience in diamond mining, and
an appointment was made for the evening, when
all were to be asked to meet him, and to see
some rich specimens which he had brought with
him.
The three now separated to dress for dinner,
and Kenneth conducted his brother to his room.
Before leaving each other the two brothers en-
tered into further conversation, Kenneth the
while sitting by and watching Austin as he ex-
tracted articles necessary to his toilet from a
much disordered valise. Kenneth was trying to
accustom his eyes to his brother's altered ap-
pearance. He did not realize that time had
wrought as great a change in himself. We never
do. Others may grow old, but eternal youth is
ours I
\
(to bb contintjbd. )
838
TH£ MEDICAL ERA.
[Vol. VI. So. 11.
OPINIONS EXPRESSED.
I do not believe in the old saying that a sick
pregnancy is a safe one. — Br, Graiiy Hemitt,
The best specialists are those who for many
years have been general practitioners. — Dr.
Vander Veer.
In my opinion, the disease from which the
Emperor Frederick III. died was cancer. — Sir
MoreU Mackenzie.
A morbific agent may produce widely differ-
ent results, varying with the locality of its activ-
ity. — Dr. I. E. Atkinson.
At the present day there is no physiological
ground for believing that the healthy kidney
secretes albumin at all. — Dr. Pye-Smith.
Many pelvic abscesses — four out of five —
occurring within a year or two after delivery, are
due to salpingitis or ovaritis. — Dr. W. GUI Wylie.
The physician should watch every patient in
confinement until the third stage is ended, and
the uterus found to be well contracted. — Dr.
T. O. Comstock.
The operative surgery of our time has
annulled pain, arrested hemorrhage, averted
septic absorption, but it has not prevented shock.
— Dr. D. W. Cheever.
Certain it is that disease of the heart is more
common than formerly, or, that physicians
failed to recognize the malady when it existed. —
Dr. J. W. Doivling.
In tlie study of materia medica the best pro-
gress is made by the philosopher and not by the
memorizer, who exercises an humbler mental
attribute. — Dr. A. L. Monroe.
No one has the right to dogmatize in med-
icine, which is still an inexact science, in which
nearly every fact is open to more than one in-
terpretation. — Sir MoreU Mackenzie.
In advanced life the mind retains its vigor
after the decline of the body has begun. There-
fore, if the body be properly taken care of, much
mental work of a high order may be done. —
Dr. A. L. Loomis.
It heems to me that the effects of phimosis
in the male are analogous to those resulting
from lacerated cervix in the female, and, like
them, are manifested by certain reflex nervous
disturbances. — Dr. Sidney F. Wilcox.
The determination of the functions of the
brain will in time lead to the successful treat-
ment by surgery of some of the most distressing
ailments of mankind. There is a great future
for cerebral surgery. — Dr. David Ferrier.
Doctrines and practices in favor to-day,
may be modified or superseded to-morrow. The
lapse of five years takes the bloom off the best
text-books, and in ten years they are discarded
or have to be rewritten. — Dr. W. H. Taylor.
It Is no longer justifiable to describe lupus
as lupus. Dermatologists must drop the name
and call it by what it is — a localized tuberculo-
sis of the skin. The identity of lupus with tu-
berculosis has been definitely established. — Dr.
Senn.
The timidity with which the surgeon for-
merly approached the abdominal cavity was
remarkable; the boldness with which we now
attack the lesions of this cavity is almost appall-
ing, but the success is correspondingly gratify-
ing. — Dr. W. W. Keen.
I believe the time will come when the physi-
cian who neglects to take proper precautions to
prevent the infection of healthy persons by con-
sumptives will be considered as guilty as one
who exposes his patient to small-pox without
vacoination. — Dr. A. H. Smith.
There is more apathy than there should be
about the ravages of pulmonary consumption,
which are more formidable than even the epi-
demics of the middle ages, and we should take
proper precautions against the spread of the
disease. — Dr. C. M. Wilson.
The profession is divided into two classes —
those who know how to use pessaries, and those
who do not. He who always throws pessaries
aside should not be allowed to practice. One
who does not know how to use them, should be
shunned. — Dr. T. GaUlard lluymas.
No one operation in surgery is applicable to
all cases. When we hear a man say that he
treats all his cases of fracture in such-a-way, all
his cases of stone in such-a-way, and all his
cases of prostatic disease in such-a-way, we may
be sure that he is a man of very limited experi-
ence, or of very limited resources. — Dr. Arthur
Durham.
Laparotomy is done too often, and with in-
sufficient grounds, but this is no reason why the
operation should be condemned. Through all
history all advances have had unworthy advo-
cates. Vaccination, anaesthesia, and ovarioto-
my have been subjected to great animadversions
and misrepresentations, and yet have prevailed.
Thus it shall be with laparotomy. — Dr. W. H.
Taylor.
Mackenzie, with his vast experience, could
never have doubted the diagnosis of cancer. If
he behaved in such a way as to imply that he
Nov., 1868.]
WORTH KNOWINC.
380
had some doubt in the matter, that could only
be owing to outside pressure or motives of hu-
manity. The known want of fallibility in med-
ical diagnosis is almost the sole ray of hope to
unfortunate incurables. Falsehood in such cases
becotnes a moral act. -^ BUlroth,
Patients woa-ld often fare better if, in ..place
oif rushing off to a specialist when some particu-
lar oifgan is manifestly affected, they would con-
fide themselves to the care of a good all-around
general practitioner, who would not concentrate
all his attention on one organ, but would take
into consideration the whole morbid state of
which the local disease is only a partial mani-
festation. — Dr. li. E, Dudgeon.
£rgot and the forceps in natural labor are,
no doubt, too frequently resorted to by the
practitioner, for the sole purpose of hurrying a
natural parturition. The opprobrium conveyed
in the vile designation ** meddlesome midwifery "
is often justly earned by practitioners whose
hurry to get away from a case leads to the
untimely and uncalled-for use of this, the most
valuable instrument in the obstetrician's arma-
mentarium. — Dr. Wm. C. Ricliardson.
The enviable position which homoeopathy has
attained, its elevation in the estimation of many
of the old school, from quackery to a recognized
system of medicine, and Hahnemann from a
quack to a great reformer, has not, in my opin-
ion, been accomplished by controversy, vituper-
ation or dogmatism. Knowledge is the power
which has and will accomplish the wider dis-
semination of the law of cure, and will maintain
it when established. — Dr. Wm. Tod Helminth.
A distinguished protessor of physiology in a
German university asked me, not long ago:
" What becomes of the young men from your
country who work in our medical laboratories ?
Wliile here they do good work and show an apt-
itude and capacity for scientific investigation,
certainly not less than our native students. But
after their return to America we hear no more
of them." I was obliged to explain to him that
the facilities and encouragement for carrying on
scientific investigations in the medical institu-
tions of this country are in general very meager,
and that one great impetus to such work is
almost wholly lacking here, namely, the assur-
ance, or even likelihood, that good scientific
work will pave the way to' an academic career.
*'When America does wake up to the neces-
sity of these things," he replied, ''then let
Europe look to its laurels.*' — Prof. Wm. H.
Welch.
WORTH KN&WING.
Reftal injections %t the vapor of ether in
lead colic, have proved very satisfactory,
calming th« spasmodic state and rendering the
action of purgatives less irritating. A case is
mentioned in which the vapor of fifteen grains •
of ether sufficed to produce such results.
Dr. Underwoudy the customs medical officer
at Kiu-Kiang, attributes the comparative im-
munity of the Chinese in that region from
typhoid fever — notwithstanding that most of
the factors favoring the disease are present in
abundance — to the fact that " cold, unboiled
water is rarely or never used when tea can be
had." The explanation is siniple: A boiUng
temperature destroys the typhoid poison.
Having investigated sixty-three cases of ex-
cessive use of tobacco, Decaisne finds forty-nine
to be over 50 years of age. In thirty-seven
cases the smokers pursued the habit fasting,
and in these vertigo was present, especially in
the morning. Sometimes the vertiginous symp-
toms have been confounded with those due to
cerebral congestion, and even to heart disease.
Injections of ether subcutaneously appeared to
stop the vertigo in a few minutes.
Physicians agree that the poison conveyed
by human teeth is one of the most annoying
that they have to deal with. One of them
writes to the Medical Register : " I have under my
attention severe and most complicated cases of
blood poisoning, in which the patient had but
shghtly abraded the hand in the course of a
fight by striking the knuckles against the teeth
of his opponent. I have known hands thus
poisoned only saved from amputation by the ap-
plication of all the resources of science.
Gaffeism. — Dr. Guelliot has published twen-
ty-three cases of chronic caffeism. Of these cases
seventeen were women.
He gives as the characteristics of caffeism:
anorexia, disturbance of sleep, trembling of the
lips and tongue, attacks of gastralgia, different
kinds of neuralgia, dyspepsia, and leucorrhoea,
often profuse. In the twenty-three cases, he
found in eighteen anorexia ; in sixteen, disturb-
ance of sleep ; in sixteen, trembling of the lips
and tongue ; in twelve, leucorrhoea ; in eleven,
gastralgia ; in ten, dyspepsia ; in ten, neuralgia
of various forms ; in eight, cephalalgia ; in four,
vertigo and convulsive attacks ; in four, obsti-
nate constipation; and in three, constipation
and diarrhoea alternating.
340
THE MED/CAL ERA.
[Vol. VI. No. U
TRANSLATIONS.
Made ezprcBsly for The Medical Era.
The persistence of the virus of hydropho-
bia in cadavers has been experimentally proved
by Galtier, for he succeeded in inoculating
healthy animals with the brain substance of
' a rabid dog, which had been buried for several
weeks, and producing hydrophobia in the course
of fourteen days. — Journ. de Pharm. et de Chim.
lodoform-wickine: affords better drainage
than the strips of iodoform-gauze. This can be
proved experimentally, and practical experience
confirms it. Among other uses, it is recom-
mended in tamponing the uterine cavity after
enucleation of fibroids, and also in endometri-
tis. In order to introduce it into the cavity of
the uterus a pair of forceps is used, the blades
of which are smooth, bent at the end, and run-
ning conically to a point from handle to extrem-
ity. — Schmidt's Jahrbilcher.
Nenroplastic. — In the course of an operation
for necrosis of the humerus, Landerer divided
the radial nerve. A complete paralysis of the
parts supplied by this nerve followed. Some-
time afterwards Landerer proceeded to a further
operation in order to re-unite the ends of the
severed nerve, but found that they could not be
.brought together. He pl^iced between the sev-
ered ends a piece of fresh rabbit-nerve, secured
it in place by sutures, and closed the wound.
In a comparatively short time the conductivity
of the nerve could be demonstrated, and finally
reached a very satisfactory degree. Landerer is
of the opinion that the piece of interposed rab-
bit-nerve became united to the severed ends of
the radial in a relatively short time, and as-
sumed the functions of the original nerve. —
Schmidt's JahrbiicJier, 1888.
Helleboreiii as a local ansesthotic has been
found by Vittario and Elvidio to be very effica-
cious. Of an aqueous solution containing in each
drop 0.0005 g. of this glycoside, three to four
drops injected into the conjunctival sac of a rab-
bit or dog are sufficient to produce, after ten
minutes, complete anaesthesia of the cornea,
lasting about half an hour, while the surround-
ing parts remain perfectly sensitive. Even if
helleborein is somewhat to be preferred to co-
caine, yet its frequent employment, according to
the opinion of the authors, would be prevented
by its extremely poisonous character. Lasting
changes and disagreeable secondary effects, as
irritation of the eye, which are to be feared in
the use of erythrophlsein, have not yet been
observed in the employment of helleborein. —
Annali di Chim. e. Farrmcd. Marzo, 1888, 159.
Destruction of the Teeth in Clarionet-play-
ers. — Dr. P. Reformatskij has had opportunity
to examine musicians in the Bussian army to
demonstrate that clarionet-playing has a de-
cided influence on the destruction of the middle
incisor teeth of the upper jaw. First the enamel
is^ubbed oflF, then the dentine and finally a typi-
cal process of caries of the teeth appears,
which sometimes leads to the teeth falling out.
A distinct thickening of the mucous membrane,
sometimes with traumatic changes, may be no-
ticed upon the upper lip. The development of
the morbid process is the more rapid the higher
the tones of the instrument are. — Wratsch, St.
Petersburg, XXXI.
Poisoninic by Illuminating 6as.— Bruneau
gives a monograph on poisoning by illuminating
gas. The poisonous constituents of illuminating
gas are : 1. CO, which forms 5 to 13 per cent of
illuminating gas ; 2. as a result of Bruneau's
own earlier investigations, propylene. The re-
maining constituents, hydro-carbons, have
shown themselves innocuous. The most fre-
quent and dangerous mode of penetration of gas
into the living-rooms is that from the main in
the street. In the bursting of a gas-pipe large
quantities of gas penetrate into tlie earih, ex-
tending great distances, passing up into the
ground-floor of the house, which has been proved
by numerous examples. This danger is there-
fore so great because the gas becomes odorless
by its infiltration through the earth, and thus its
entrance into the roorns is not noticeable. It is
only in winter that the gas gains entrance into
the houses in this manner, as the surface is
frozen and the heat attracts the gas out of the
earth.
The symptoms of poisoning by illuminating
gas are the same as those of carbon-monoxide ;
therefore the diagnosis, the medico-legal proofs
and the therapeutics are the same. As pro-
phylaxis, care should be taken to lay the
pipes in proper places. Although to the present
time, with the best of gas-fitting, seven per cent
and over of gas is lost in the ground. Of im-
portance are the positions of the syphons, in
order that the water which collects in the pipes
may be pumped out. A simple syphon-tube
opening freely into the ground should not be at-
tached to the pipe, for in case it does not con-
tain water the gas pours out freely. On the
contrary, the syphon-tube must lead into an air-
tight vessel from which a pump-tube ought to
open on the free surface of the ground. Also in
lighting the gas in the houses certain precau-
tions must be taken, which every gas company
should furnish. — Ann. de Hyg, XVIII, 8.
Nov., 188&]
SCIENTIFIC NOTES.
341
DIETETICS.
SCIENTIFIC NOTES.
Sick Headache. — The headache of indigestion,
accompanied by scotoma, or scintillations and
dazzlings of light before the eyes, is always due
to acidity and evolution of gases in the stomach.
In all fcTCrs ; in inflammatory conditions ; in
the acute gastric upsets which occur with deli-
cate children and phthisical patients ; in all gas-
tric diseases ; and in those conditions of gastric
catarrh which follow upon obstruction in the
pulnionary circulation, whether due to disease
in the heart or lungs, liquid food containing a
sufficiency of carbo-hydrates in soluble form is
essential to life.
Tea and Teeth.— In the cities of the United
States, where tea is consumed in much smaller
quantities than in this country (England), the
teeth decay more rapidly than with us. The
climate, the many indigestible articles of diet,
the extreme nerve- tension of the Americans, and
other causes affecting the nervine and general
health of that great people, tend to induce a
dyspeptic condition which always seemed to me
to be largely responsible for their premature
dental decay.
That a healthy cow allowed to feed on rich
meadow grass, and in the evening carefully
housed, cared for and given a diet of meal and
hay, will yield a rich, creamy milk is evident ;
and that such milk is pure and healthful is cer-
tain. On the other hand, it is equally plain that
an unhealthy cow, fed on distillery swill or
brewery refuse, and improperly housed and
cared for, will yield a thin milk without nourish-
ing qualities. It is also well known that cows
with certain diseases, such as tuberculosis and
anthrax, give a milk that is positively dangerous.
The body wastes in pyrexial disease, and
often the lamp of life goes out for want of fuel.
If no food be given, the sufferer sinks of inani-
tion. If food be given which requires digestion
when the digestive ferments are inert, the suf-
ferer dies of starvation just the same. Death
from hunger is the hard lot of each. Yes, and
myriads perish annually ; succumb to this hor-
rible fate, with loving friends around them, anx-
ious to be of service and grudging no expense,
while the medical man looks on complacently,
and assures them that ** everything is being
done," unconscious of the abominable falsehood
he is uttering. The solemn farce goes on in
hundreds of households annually without a scin-
tilla of suspicion being aroused as to the true
state of affairs. It is something worse than hom-
icide by misadventure. — FothergiiO,.
A New Method of Medication.— Medicine
may be introduced into the human system by
electricity. The electrodes of a battery are
saturated with the medicine and applied locally
to the skin. Experiments show that there is an
actual absorption of the medicine into the sys-
tem.
The Origin of Petroleum.— Professor Me-
delejef has advanced the theory that petroleum
is of mineral origin, and that its production is
going on and may continue almost indefinitely.
He has succeeded in making it artificially by a
similar process to that which he believes is go-
ing on in the earth ; and experts find it impos-
sible to distinguish between the natural and the
manufactured article.
The new light which microscopic investiga-
tion throws on a seemingly insignificant matter
is again illustrated by the results obtained in
examining the matter which untidy people allow
to collect under the finger-nails. Thirteen
assistants in a hospital were subjects of the ex-
periment. The matter from the finger-nails of
each individual was placed in a proper culture
medium. In every case except one were col-
onies of microbes obtained.
Gircalation of the Blood in the Eye.—
" At Professor Hirschberg*s clinic, in Berlin,"
writes a correspondent of the Kama^ Medical In-
dex, " my attention was called to the fact that
the circulation of blood in the blood-vessels of
the cornea affected with pannus can be seen. If
one could not see this in America, it might
almost be worth a trip across the ocean. By
the aid of a strong lens one sees the circulation
here almost as well as in the web of a frog's
foot or in a fish's tail."
The Human Breath.— Professor Brown-
Sequard has recently been making experiments
to determine whether the human breath was
capable of producing any poisonous effects.
From the condensed watery vapor of the expired
air he obtained a poisonous liquid, which, when
injected under the skin of rabbits, produced
almost immediate death. He ascertained that
this poison was an alkaloid, and not a microbe.
The rabbits thus injected died without convul-
sions, the heart and large blood-vessels being en-
gorged with blood. Brown-Sequard considers it
fully proved that the expired air both of man
and animals, contains a volatile poisonous
principle which is much more deleterious than
carbonic acid.
842
THE MEDICAL ERA.
[Vol. VI. No. n.
SURGICAL NOTES.
CURIOUS ITEMS.
Gases of internal intestinal obstrnction
should be considered in the same light as cases
of strangulated hernia. Operation should be
performed as soon as the diagnosis is made. —
Dt, Senn. »
AnsBSthetics should not be used in cases of
tracheotomy, provided proper assistants can be
secured. The operation is not accompanied
with much pain. By avoiding the anaesthetic
many of the risks of the operation are avoided.
— Dr. Cheever.
The supra-pubic operation for stone is
to be performed only in exceptional cases. These
are classified as follows : 1. In those cases of
stricture in which the obstruction cannot be
overcome in time to relieve the patient of great
suflFering. 2. In cases' of prostatic obstruction.
3. In cases of tumors of the bladder which
would interfere with the lateral operation. 4.
In cases where the stone is too hard or too large
to be removed either by lithotrity or by lateral
lithotomy. — Dr. Hingston.
When and Where Can One Trephine With
Safety? — The safest rule is first to apply the
trephine over those areas which do not overlie
large vascular channels. Afterward, the open-
ing may be extended in any direction, and to
any required extent. The greatest hesitation is
with regard to opening one of the sinuses. Two
dangers attend such an accident : one, fatal air
embolism, the other, profuse hemorrhage. The
former danger is almost a theoretical one, and
the other may be overcome by plugging the
sinus or closing the wound with a fine needle and
suture. — Dr. Park.
In order to diminish shocli : 1, Wait for re-
action; 2, never neglect to calm the mental
shock by a cheerful word and personal presence ;
3, give alcohol a quarter of an hour before an-
aesthetics; 4, make the anaesthesia short; 5,
operate as rapidly as possible; 6, as short
dressing as possible; 7, avoid chilling of the
patient.
To promote reaction after operation: 1, Per-
sistently and carefully apply dry heat; 2,
liquid nourishment combined with a stimulant
and a little laudanum by enema; 3, subcutan-
eous injection of brandy ; 4, aromatic spirits of
ammonia by the mouth; 5, black coffee and
brandy, the stimulent par excellence when it
can be retained by the stomach ; 0, quiet — a
more than horizontal position ; sleep — assurance
that all is over and doing well. — Dr. Clieever.
Pittsburg has a chemist who is urging that
all dead bodies, whether human or otherwise, be
saved from the grave and from the crematory
and be either ground -up for purposes of fer-
tilization or be placed in gas retorts and con-
verted into illuminating gas, water, ammonia,
tar and animal charcoal. Subsequent distilla-
tion will yield aniline colors, carbolic acid, am-
monia sulphate, and possibly an antipyretic
alkaloidr
Tn Alabama, a black negro girl about eigh-
teen years old has given birth to twins at seven
months, one of which is as " black as the ace
of spades," and the other as white as any white
child her medical attendant ever saw. This is
as puzzling as the case recently reported, in
which a beautiful young woman with a tinge of
negro blood so slight as to be imperceptible,
married an unsuspecting white gentleman, and
in due time presented him with a black baby.
Professor Richard A. Proctor came to
the conclusion that a man whose stature is not
up to the average can increase his height if he
cares to. He said : " I think we may fairly
conclude from the evidence, imperfect though it
is, that stature may be increased by judiciously
selected food, and probably that lime should in
one form or another be given in increased quan-
tity in the food where growth is to be en-
couraged."
Menstruation in a Child Three Tears Old. —
Dr. Komfield describes a case of menstruation
in a child three years old. The child, which
was addicted to onanism, had on April 5 a
hemorrhage from the genitalia, which dimin-
ished at noon, and had disappeared* the next
morning. An injury — an abraded spot or any
other source of the bleeding — was certainly
not present. Bleeding recurred regularly at
the beginning of May, June, July, at precisely
the very time at which the mother menstru-
ated.
A Curious Treatment for Hydrophobia. —
A correspondent of the Scientific American says
that he recently met a gentleman of high educa-
tional attainments, who stated that, in six years*
residence in the East Indies, he had known of
three severe cases of hydrophobia, and that
each case was permanently cured. The means
used was to take the patient to a pool or stream
of water, plunge him in and allow him to
just about drown and then resuscitate hiiu. In
each case, as l)efore stated, a permanent cure
was effected.
Not., 18m.]
COLLEGE NEWS.
343
USEFUL RECIPES.
COLLEGE NEWS.
BingwonxiB.
Dissolve salicylic acid in collodion and apply
it to ringworms once a day. A very few appli-
cations will remove them.
For Dandruff.
A boracie acid soap, containing five per cent
of boracie acid, is said to be excellent for dand-
ruff of the scalp, and it leaves the skin unin-
jured.
Salicylic Acid.
The only fixed oil with which salicylic acid
will readily mix, is castor-oil. A two-per-cent
solution should be used as an application to the
skin.
Iiead in Hair Bestorers.
A large majority of hair restorers contain lead,
and should never be used. The lead may be
detected by adding a solution of iodide of pot-
ash to the ** restorer, " when a yellow fluid, iodide
of lead, will be formed.
To Bemove the Odor of Benzine.
The disagreeable odor of benzine can be re-
moved by shaking repeatedly with plumbate of
soda, made by dissolving oxide of lead in caustic
soda, and rectifying. Simply shaking with
charcoal and filtering will partially remove the
odor.
A New Disinfecting Compound.
Oils of rosemary, lavender, and thyme, in the
proportions of ien, two, and two-and-one-half
parts respectively, are mixed with nitric acid
in the proportion of thirty to one-and-one-half.
The bottle should be shaken before using, and a
sponge saturated with the compound left to dif-
fuse by evaporation. The vapor of this com-
pound possesses extraordinary properties in
controlling the oddrs and effluvia of offensive
and infectious disorders, and for purifying the
air of the sick-room.
Test for Drinking- Water.
When in any hotel or summer-resort there
occurs a single case of typhoid fever or diphthe-
ria, test the drinking-water, or have it done at
once. A few cents will buy an ounce of satur-
ated solution of permanganate of potash at a
chemist's. If when a drop of this solution is
added to a tumbler of water its color changes to
broim, it is unfit to drink ; if it remains clear,
or slightly rose-colored after an hour, it is,
broadly Speaking, safe. — Pacific Record.
CINCINNATI.
PULTE MEDICAL COLLEGE.
Prof. Crawford: — ** You cannot depend on
the statements of your patients that they are
sick." He illustrated the point from cases of
hysteria and hypochondriasis, and in the clinic
showed from a case which proved to be locomo-
tor ataxia, the danger of being misled by a
wrong interpretation of symptoms which the
patient will give.
Prof. Hartshorn stated that in cases of hem-
orrhagic diathesis he had used with good results
Hamamelis tincture, two teaspoonfuls in a half
glass of water ; also, Phosphorus, but especially
Calomel Ix, 1 gr. given every two hours till we
have the physiological action.
Prof. Loimsbury: — "The indicated remedy
is the best tonic, and when we use a remedy
which is not such we may possibly tone them
up to a diseased condition.
'< As an antidote to mercurialization one of
the best remedies I have used is Nitric acid. I
generally use the 30x, and have known it to
reproduce the salivation.
'* Muriatic acid is useful in chronic congestion
and inflammation of the liver, applied externally
as a compress |- 3 to a quart of water, giving
great relief."
Prof. Lounsbury also called the attention of
the class to Rapou's work on typhoid fever, from
which he had obtained the following practical
hints in the treatment and diet of his cases,
which by ten years' experience he had found to
be of the most valuable assistance :
Take a glass of urine each evening and morn-
ing and set in a still place and leave till next
visit, in order to examine the light mist which
forms in the upper part of the urine. At
first the urine is turbid and whitish; then,
as the disease progresses, it becomes clearer,
with only a light cloud floating near the top
which, as the disease progresses favorably,
descends till the urine is clear above and below,
while the middle is cloudy, opaline and perfect-
ly defined.
In proportion as the cloud descends, so may
we argue that the disease approaches a favorable
crisis.
As soon as this enurema has touched bottom
it changes its nature and is transformed into a
sandy deposit of a reddish gray of which a part
attaches to the sides of the vessel. This is a
signal of approaching recovery, and we may re-
assure the anxious friends.
344
THE MEDICAL ERA.
[Vol.. VI. No. n.
The deposit increaseB, becomes very abun-
dant, and is now composed of a rosy powder de-
posited upon a thick mucous bottom. Here is
a positive indication for giving the patient food,
broths, light porridges, etc., or right here his
strength may sink. When the deposit again
becomes purely sandy and begins to diminish,
the cure is assured and we should without loss
of time prescribe tonic alimentation, as roast
meats, wine and water, nourishing porridges,
etc. ; if not, we arrest reaction at its most favor-
able moment, and bring on a tardy, dangerous
convalescence.
If at any time in the case the deposit rises
higher from the bottom and leaves it, this is
positive indication of a change for the worse,
and heavy feeding should suspended and the
cause of change determined. These hints only
hold good in the pure type of typhoid, uncom-
pUcated by malaria.
CHICAGO.
HAHNEMANN MEDICAL COLLEGE.
Prof. Vilas, in speaking of acute glaucoma,
says : "Its symptoms often resemble those of
bilious colic. So, when called to a case in which
there is violent vomiting with severe headache
and the eye-sight obscured, always think of acute
glaucoma."
Prof. Ludlam, in speaking of uterine cancer,
said ; " When you hasre a free flow of pus, you
are farthest removed from carcinoma."
Prof. Hawkes says : *' If in a case of diphtheria
the child loses its voice, you are safe in making
a fatal prognosis ; " and he has never known
one to recover when such was the case.
Prof. Ho3me says : " In diagnosticating sec-
ondary syphilis, if the eruptions are found upon
the extremities of only one side, or they itch,
they are not syphilitic."
It is Prof. Laning*s experience that in dia-
betes mellitus, when the patient is much ema-
ciated and very restless, if he can be induced
to eat some thoroughly cooked fat of a porter-
house steak, it will prove very beneficial. The
reason is that the nerves are largely nourished
by the glycerized phosphates.
Prof. Hawkes considers Bhus tox. the most
uncertain remedy in the materia medica in re-
gard to the potency ; so he frequntly prescribes
a high and low potency in alternation.
Prof. Shears has noticed a " crackling feel "
in a number of cases of abdominal coUoma.
This is a diagnostic feature not mentioned in
text-books.
In physical diagnosis, Prof. Arnulpliy says
that if we find a diminished arterial pressure,
with increased venous pressure, the condition
Prof. Laning says : '' If a patient complains
of a flushing of the face every evening toward
bed-time, it is indicative of hepatic derange-
ment."
IOWA CITY.
STATE UNIVERSITY.
• i • I
Prof. Dickinson says that in all cases of acute
rheumatism the heart should be examined fre-
quently for signs of inflammatory action. The
fatality of the case is almost always due to
coincident disease of the heart. One attack
renders the person liable to future attacks.
Prof. Gilchrist tells us that every contagious
disease contains some form of bacteria, which is
of value simply as diagnostic factors.
Relaxation of the limbs indicates great bodily
prostration.
The body bent forward indicates abdominal
injury.
The body bent backwards or to either side in-
dicates spinal injury.
Hemiplegia indicates brain lesion.
A pinched appearance of face shows that there
is hemorrhage.
A frowning look indicates pelvic trouble, and
expansion of nostrils, lung trouble.
Prof. Cogswell checks excessive flow at the
menopause by drop doses of Erigeron Canaden-
sis. Uterine spasms at this time are controlled
by Actea racemosa.
Prof. Cowperthwaite says : '* Medicines which
have a similar origin should rarely follow each
other. Go into some other kingdom for a rem-
edy. Compare your remedy ^th the disease,
and, if they correspond, apply.
" The scientific mode of treatment is to give
one remedy at a time. Lachesis never produces
inflammation ; it is from first to last an irritant.
The aggravation after sleep is of very great im-
portance."
CHIOAGd.
CHICAGO HOM(EOPATHIC MEDICAL COLLEGE.
Prof. J. S. Mitchell says: Calcarea carb.
should be written in letters of gold in every
family where there is a tendency towards scrof-
ula. No other remedy will be found so valuable
in the treatment of children of strumous
habit.
Probably one out of every five persons is
affected to a certain degree with follicular
pharyngitis. Upon careful examination, en-
larged foUicles will be found where their pres-
ence was, perhaps, unsuspected. Besides the
usual treatment by remedies administered in-
ternally, it may be necessary to touch the en-
larged follicles with Chromic acid or a solution
iJov., 1888.1
COLLEGE NEWS.
345
brash. Be careful to touch only the part af-
fected.
Chronic hypertrophy of the tonsils may be
cured without the extirpation of these bodies, by
proper internal and local treatment. Give
Iodine 30x, in the early stages, Mercurius bin-
iode, etc., in suppurative stage, and Baryta
carb. if the surface is hard and indurated. For
local application use Iodine tinct., or solution of
Silver nitrate.
Prof. Woodward says : Zinc is the soverign
remedy in paralysis arising from structural
lesions in the spinal cord.
Cuprum will be found a most valuable remedy
in cases of scarlet fever, where there is angino-
sis. Belladonna is often administered ineffec-
tually, when Cuprum would relieve quickly.
Prof. Tooker : I make the statement that you
can regulate the bowels of infants by the use of
proper foods, and you will rarely, if ever, have to
resort to medicines if you understand feeding.
If the mother's milk is insufficient in quan-
tity, supplement it by the use of some good
artificial food, but let the child continue to
nurse. Allow no cold food or drink to be taken
into the babe's stomach.
The idea prevalent in some minds, that the
nursing mother should not partake of fruits,
cabbage, etc., on account of their acidity, is a
fallacy, as none of these acids enter into the
milk as such, but are converted into alkalies
during the process of digestion.
The Faradic current may usually be depended
on to restore milk to a breast from which it has
been driven by fright, or other mental shock,
but will not psove efficacious where there has
not been a supply of milk.
An interesting case was recently presented in
Prof. Knoll's clinic. The patient, a German
woman, had suffered intensely during the past
four years, with pains of excruciating character
in the upper portion of the abdomen, and at the
time she came under Prof. Knoll's notice, there
was what appeared to be the opening of an ab-
eess at the umbilicus, from which there was a
slight discharge. A probe passed in at the um-
bilical opening, and directed toward the right
hypochondrium, penetrated to a depth of four
inches, where it encountered a solid obstruction.
An operation was decided upon, and the patient
being ansBsthetized, an incision four inches in
length was made, beginning at the umbilicus,
and being directed upwards and outwards. A
sinus was found, leading from the umbilicus to
a cyst which had formed near the gall-bladder,
and this cyst was literally packed with gall-
stones. When these were removed, it was dis-
covered that there were several still remaining
in the gall-bladder, from which the others had
escaped into the cyst. These were also removed,
the wound carefully dressed, and the patient is
making a good recovery. The stones varied
from one-eighth to one-half an inch in diame-
ter, and were one hundred and thirty in num:
ber.
HAHNEMANN MEDICAL COLLEGE.
At one of our recent medical clinics Prof.
Goodno presented a lady between 60 and 70
years of age, suffering from typhoid pneumonia.
Shortly after her admission to the hospital
there was a rapid elevation of the temperature,
the pulse weak, great prostration, muttering
delirium, picking at the bed-clothes, inconti-
nence of urine and involuntary stool, brown
tongue with red tip and edges, rust-colored
sputum. An examination of the chest revealed
dry, crepitant rfdes.
Ill this case, Dr. Goodno said that old Dr.
Bering's ** three legs of pneumonia " were pres-
ent, viz. : rapid elevation of temperature with a
weak pulse, great prostration, and rust-colored
sputum. He said that typhoid pneumonia was
not typhoid fever and pneumonia as the public
generally suppose, b\it simply pneumonia with
a typhoid state, the latter meaning a certain
group of symptoms depending on a certain con-
dition of the system.
A thorough examination of the entire chest
should not be made every time the physician
sees his patient, as death, in this disease, is due
to heart failure, and on this account the patient
should be kept as quiet as possible. It is suffic-
ient to examine the heart only.
I cite another case of a man, middle-aged,
who, during the last week of August, 1886, was
seized with an attack of hay-fever, which sub-
sequently developed into asthma. This contin-
ued until the first or second week of October of
the same year, when it disappeared. He was
under allopathic treatment, but with no success.
During the corresponding period of 1887 it
appeared again, and under the same treatment
received no relief. About Sept. 1st of this year
the affection broke out for the third time, so he
concluded to try homoeopathy. Dr. Snader, who
first saw the case, elicited symptoms from him,
the very first of which was ** itching of the
upper eye-lids." This, with other symptoms,
led him to prescribe Arsenicum 2x, as the doctor
said he remembers having made a proving of
Fowler's solution, and this was one of the most
prominent symptoms. The remedy seemed to
act like a charm. The patient returned in a
346
THE MEDICAL ERA.
[Vol. VI. No. 11.
few days, feeling like a new man, the dyspnoea
having entirely disappeared, and according to
his own language, he rested better at night
than he had at any time for the last two
years.
SOCIETY REPORTS.
NOTES FROM THE LOITISVILLB OOlTVSirTION.
SAN FBANCISOO.
HAHNEMANN HOSPITAL GOLLEOE.
Professor Eckel strongly advises inhalations
of Lactic acid, ten to twenty drops in an atom-
izer, in croup. If there be great opposition on
the part of the child, or in the case of a very
young child, put a tent or sheet over the bed,
thus confining the fumes which the child must
breathe. It is also recommended in diphtheria,
when the disease attacks the larynx.
Professor Lilienthal reminds us that although
Lachesis is strongly the left-sided remedy in
throat troubles, especially when going from left
to right, we are also to remember Sabadilla,
which has similar symptoms, only it is better
from warm drinks, while Lachesis is worse fiom
warm drinks.
Also, that we should not always fly to Bhus
tox. in rheumatism — if worse at night and from
damp, wet weather; better from warmth and
motion — for Lycopodium has similar symptoms,
and is too often neglected.
Professor Boericke says, that with proper
care, bottle-fed babies never need have colic.
Later, I saw an illustration of his method, twins
that at three months had never had colic. The
child is given the bottle with the tube tied in a
loose knot to prevent suckling too fast. At short
intervals the bottle is taken away, the child is
taken up into a sitting position, the back gently
rubbed ; sometimes the child is slightly jolted,
and up comes a bubble of wind, and the baby
lies down happy to continue the bottle. This is
repeated several times before the bottle is emp-
tied. He claims that this rule, carried out
among his patients, never fails. The child is
compelled to nurse slowly with the knot in the
tube, and soon learns to assist the rubbing with
voluntary efforts to bring up the wind.
Professor Boericke finds the greatest success
with sterilized milk, thus eliminating any fer-
menting germs the milk probably contains. As
soon as the milk-man has made his morning
visit, put the milk in small unlettered bottles
having perfectly tight-fitting corks. Fill the
bottles full of milk, put them, uncorked, in a
vessel of water and boil twenty minutes ; cork
then and there, and the milk wiU keep for a
week sweet and pure. Patients going overland
can sterilize milk enough for the journey.
NEW OFFICERS.
President : — Dr. W. E. Green, Little Rock,
Ark.
First Vice-President: — Dr. Walter Bailey,
Jr., New Orleans.
Recording Secretary: — Dr. E. Lippincott,
Memphis, Tenn.
Corresponding Secretary : — Dr. Howard Cmt-
cher, Louisville.
Treasurer: — Dr. Ghas. W. Taylor, Louis-
ville.
PERSONALS.
Drs. Buck, McDermott, Walton and Eaton
represented Cincinnati.
Dr. W. B. Morgan, of St. Louis, reported a
steady growth of homoeopathy in that city.
Dr. M. M. Eaton: — *' Homoeopathy is more
popular in the South than many people sus-
pect."
Dr. E. Lippincott, of Memphis, telegraphed
to Dr. Crutcher: ** Bring the meeting here next
year, and, cost what it may, I will see that it is
a success.''
Dr. E. H. Pratt: — **Fear weakens a man;
anything that weakens a man lessens his powers
of resistance; therefore, fear may render him
more liable to an attack of yellow-fever."
Dr. J. D. Buck : — ** We must have something
practical in materia medica. The student must
learn a few key-notes of each remedy, and avoid
the great mass of rubbish going the rounds
under the misleading title of 'materia med-
ica.
Dr. J. H. Henry: — **Give Arnica before sur-
gical work and you will have cause for congratula-
tion. Begin several days before an operation, and
give the remedy in small doses. I have used it
in this way for several years, and I know where-
of I speak."
Dr, Howard Crutcher, the very efficient Cor-
responding Secretary, made things lively, as he
is wont to do. On the last day of the session
he read a very interesting paper on ** Anaesthet-
ics," the timely nature of which was indicated
by the discussion which it elicited.
Dr. C. E. Fisher opened the public meeting
Wednesday evening with a twenty-minute speech
forty minutes long, in the course of which he
gave the audience some facts and figures regard-
ing homoeopathy, that they will not soon forget.
K'ovMiaflS.J
SOCIETY REPORTS.
847
Dr. Fisher, moreover, was paid the well-deserved
and distinguished compliment of being named
by the Convention as its candidate for member
of the proposed National Board of Health which
will be organized by the Government should
Senator Call's bill become a law. The Medical
Era congratulates the Doctor on this mark of
confidence and esteem reposed in him by his
colleagues.
Dr. Geo. M. Ockford: — '*The growth of the
absinthe habit among the intellectual classes,
the increase in the number of victims of Opium
and Cocaine habits, are serious questions, and
well worthy the attention of physicians. By the
avoidance of the careless use of anodynes and
narcotics much of the evil can be averted, for it
is an undeniable fact that the careless prescrip-
tions of physicians are in many instances re-
sponsible for the mental and physical wrecks
due to these pernicious habits."
NOTES.
Eighteen new members were admitted during
the session.
An obstetrician present at the meeting ac-
knowledged to having much trouble in delivering
in cases of breech presentation. Dr. Monroe
asked him why he did not use a special delivery
stamp.
One man in the convention was married at
four o'clock in the morning ; another was never
at a medical meeting before ; and still another
declared that he had "treated forty-one cases of
corns with the 200th potency of Saccharum lac-
tis without a single death."
Tait's Mixture seems to be par excellence the
ansesthetic. In its use we escape the dryness
of mucous membranes, the congestion of the
brain and the lung, trying and exhausting stage
of excitement found with ether alone, and we
equally escape the extreme cardiac sedation and
cerebral ansemia that we all so fear with chloro-
form. In short, it seems to accent the advan-
tages of both drugs and to reduce their disad-
vantages. — Dr. A. L. Monroe.
[Ths Mbdical Era would have been glad to publish
a full report of the Louisville meeting, but it does not
wish to trespass upon territory which rightfully be-
longs to the accomplished editor of the Southern Jour-
nal ofHomcRopathy, Dr. C. E. Fisher, who. by his intel-
ligent efforts and his zeal has succeeded in doing what,
we believe, no other physician in the United States
could have done— -he has suocessfuUy established a
flrst-class medical journal in the far-off Lone Star
State, under difficulties which would have appalled
anyone less able and less energetic. We bespeak for
Dr. Fisher the support of the entire profession, North
and South.]
ILLINOIS VALLEY HOMCEOPATHIC MEDICAL
. SOCIETY.
This new society was organized July 12, 1888,
at La Salle, 111., by the following-named phy-
sicians :
G. P. Coutant, of La Salle; F. Duncan and
Dr. English, of Mendota; A. H. Hatton, of
Peru; 0. B. Stannard, of Earlville; Charles
Stewart, of Streator ; W. A. Smith, of Wenona ;
H. M. Bascom, of Ottawa; C. A. Weirick, of
Marseilles; J.G. Waggoner, of Minonk, and J.
B. Dunham, of Wenona.
It was decided, on motion, to hold regular
semi-annual meetings the second Thursday of
October and April, of each year, each session
being from 12 m. to 4 p.m.
At the first regular meeting papers were read
by Drs. A^ H. Hatton, W. A. Smith and J. B.
Dunham. The papers were all clinical in char-
acter. Seven cases of permanent cures made
by the single remedy, in various potencies, were
reported.
It was the expression of all present that
many times, in chronic and sub-acute cases we
prescribe too hastily. The patient had better
be given a placebo, and required to return sev-
eral times, if need be, and have the same re-
peated, until the physician has so studied the
case that he can give the single remedy with
assurance of benefit.
At the close of the discussion of the papers,
the chair appointed the following chairmen of
bureaus, to prepare papers for the next meet-
ing:
Women and Children; H. M. Bascom, M.D.,
Ottawa.
Theory and Practice and Materia Medica ; W.
A. Smith, M.D., Wenona.
Surgery; G. F. Coutant, M.D., La Salle.
Volunteer papers are especially requested.*
The work of the first regular meeting was quite
satisfactory. The meeting occurring the second
Thursday, in April, 1889, will be one of special
interest. J. B. Dunham, M.D., Sec.
Wenona, lU., Oct. 13, 1888.
The air of different localities varies a great
deal in the number of micro-organisms, the air
of cities containing more than that of the coun-
try. The air at sea, at the distance of a little
over a hundred miles, is absolutely free from
micro-organisms except in the presence of a
land-breeze. — Dr. Wkittaker.
348
THE MEDICAL ERA.
[VouVL No. 11.
FACETI/E.
PERSONALS.
Insomnia.
A somewhat weather-beaten tramp being
asked what was the matter with his coat, replied :
** Insomnia; it hasn't had a nap in ten years."
Rather Tougrh.
It is rather tough on a doctor's son to be
named William and have to sneak through the
elysium of youth under the opprobrious title of
"the doctor's Bill."
Only a dueetion of Time.
'* Doctor, how is Banker Jones'? I heard that
he was very sick."
'* He has joined the innumerable caravan," said
the physician, solemnly.
** What ! You don't mean to say that Jones
has skipped to Canada ? Well ! well ! " — A^ F.
Sun. *
Not in Gray.
A daily paper, in reporting a fight, quotes one
of the parties as saying :
*' Simmons did not shoot me in the hallAvay ; he shot
me in the saloon, without any provocation."
A careful search of ** Gray's Anatomy, Des-
criptive and Surgical," fails to reveal any parts
of the human system named ** hallway" and
** saloon."
In Anticipation.
Dickie. — **What are you running for, Bob-
bie?"
Bobbie. — **The doctor."
D^c^-^€.— - Who's sick ? "
iMii^.— "Nobody."
Dickie. — ''Then what do you want of the
doctor?"
Bobbie. — ** To-day's my birthday, and I'm
going to have chicken and pickled oysters and
lemonade and jelly and ice-cream and cake and
sandwiches for dinner and ma wants me to tell
the doctor to call around this evenin'."
In the Wrong Pew.
James Payn, the novelist, is editor of the
ComhiU Magazine, London. Next door to his
oflSce a medical journal has its sanctum. One
day Mr. Payn's door was cautiously opened and
a pale-faced, long-haired individual entered. "I
have brought a little thing about sarcoma and
carcinoma," said the \4sitor. ** Very sorry, sir,"
said Payn, politely, ** but we have all the poetry
we want." *' This isn't poetry ! " exclaimed the
visitor. *' It is an essay on two varieties of tu-
mor." ** Oh, I beg your pardon," said Payn,
**I thought they were a pair of Italian lovers."
The long-haired man was a well-known medical
professor who had entered the wrong office.
Dr. a. H. Wales, of Lanark, III., has begun
his duties as interne in Cook County Hospital.
Dr. E. L. Smith, of Bellefontaine, 0., is tak-
ing a course at the New York Post-Graduate
School.
Dr. W. G. Willard, whose term of service as
interne in Cook County Hospital expired October
1st., is indulging in a hunting trip in Iowa.
Dr. J. B. Dunham, of Wenona, chairman of
the Bureau of Clinical Medicine, Illinois Hom-
oeopathic Medical Association, desires each
member of the bureau to prepare a paper on
clinical medicine.
Dr. D. S. Smith, who enjoys the distinction
of being president of the Tippecanoe Club, of
Chicago, in a very graceful and effective speech
introduced the club to Gen. Harrison, on the oc-
casion of its recent visit to Indianapolis.
Dr. W. a. Dunn, formerly of Wabash, Ind.,
after having spent two years in the hospitals of
Vienna, has located in Chicago. He conducts
the throat and nose clinics at Hahnemann Hos-
pital.
Dr. F. H. Lutze, of Cheshire, N. Y., is in-
formed that the drug referred to is the Geranium
maculatum. A full account may be found in
an article by Dr. Shoemaker, in Chicago Medical
Journal and Examiner, 1887.
Dr. Wm. H. Harrison, a homoeopathic physi-
cian of Baton Rouge, La., is a cousin of Gen.
Benjamin Harrison, of Indiana. Dr. H. is the
republican candidate for Congress in his dis-
trict.
Drs. Albert Pick and P. Prttchard, of 82
E. Brookline Street, Boston, Mass., have favored
the Era with the very interesting translations
from foreign journals to be found on page 340.
This wUl become a regular feature of the jour-
nal, and one which, we have no doubt, will be
appreciated by our many readers.
Dr. Wm. D. Gentry, of Kansas City, has sent
out a circular containing specimen pages of the
<* Concordance Repertory" which he has pre-
pared, and a blank calling for subscriptions.
Dr. Gentry should have the support of the pro-
fession in the excellent work that he has under-
taken, and we hope that his appeal will meet
with a liberal response. He is making the best-
arranged repertory possessed by our school.
Not.. 1888,]
MISCELLANY.
349
Dr. Euo. a. Guilbert, of Jackson, Miss., has
stuck loyally to his post. Sept. 27 he received
the following telegram : —
You are authorized to work as member of American
Bed Gross in yellow-fever at Jackson. CiiABA Babton.
Dr. Guilbert has shown himself fully worthy
of the trust reposed in him.
Dr. B. B. Weaver, demonstrator of anatomy
at the Hahnemann Medical College, Philadel-
phia, has finished a piece of work which has
occupied his close attention for six months. It
is a complete expose of all the nerves of
the human body, exactly in the position they
occupy during life. Some idea can be formed
of the labor involved when it is remembered
that the human body contains upward of a
million nerves of various sorts. Dr. Weaver,
who lately traveled in Europe, was struck with
the want of some specimen of anatomy showing
the nerves only. Procuring the body of a col-
ored woman who had died in an emacit^ted con-
dition, Dr. Weaver, working ten hours a day for
upward of six months, and chiseling the bones
away piece by piece, managed to get what he
wanted. The figure pinned to a black-board in a
polished frame looked at a distance like a deli-
cate drawing in white of the nerves of the human
figure. A close inspection, however, reveals the
fact that the delicate lines were really nerves,
some as delicate and as fine as silk. The
dura mater of the skull and backbone are re-
tained, and also the eyes. The nerves of the
spinal cord are so fine and so close together
that a fine needle had to be used to separate
them.
SPECIAL NOTICE.
Every friend of homoeopathy in Chicago, at
the coming election, will see to it that the name
of the Hon. Aaron J. Miksch is on the ticket
that he deposits. Mr. Miksch, who is at the
present time a member of the Board of County
Commissioners, has been re-nominated. He has
rendered Cook County valuable service, he is now
thoroughly familiar with public business, and
should be re-elected by an increased majority.
He is a homoeopath, **from the ground up," and
is the especial champion of our cause on the
Board. Let every physician vote for him, and
influence as many of his patients as possible to
do likewise.
At the same time do not forget that Commis-
sioners Philo E. Dodge and D. B. Scully are
equally well worthy the support of every mem-
ber of our school.
NEWS OF THE MONTH.
The corner stone for the new building of the
New York Homoeopathic Medical College was
laid October 22nd.
W. F. Daly, the actor and sporting man, is
dying of blood poisoning from a wound in the
hand received by striking a man in the teeth.
■
The German physicians who have been so
severely criticized in Sir Morell Mackenzie's
book, have threatened to bring suit for libel.
At Racine, Wis., several people who attended
a **wake" were fatally poisoned by drinking
some embalming fluid, left by the undertaker,
which they mistook for beer.
Boards of Health in Ohio. — By a new law
in Ohio, a board of health is to be established in
every city or village containing more than 600
inhabitants.
The Board of Eeoents of the University of
^Michigan decided at their last meeting that the
clinical department of the medical school should
not be removed to Detroit.
In Oakland, Cal., there is an undertaker's
shop with a large sign which says, ** Bodies
Embalmed,** while next door is another man's
sign which reads, "Spirits Rectified."
The sensation of the month is the publication
of Sir Morell Mackenzie's book, giving an ac-
count of his connection with the case of the late
Frederick HI., of Germany. Seventy-five thous-
and copies were ordered by the trade.
Th/R Medical Visitor is publishing a continued
story in the shape of a **List of Ph3^sicians."
Unfortunately the stuff has all been published
before, and is about as correct as a last year's
almanac, and about as readable as yesterday's
paper.
At Hudson, Wis, a man bought a box of san-
tonin worm-lozenges, each lozenge containing
one-half grain of santonin. Within a period of
three hours he gave three lozenges to a two-year-
old child, and it died the next day as the result
of santonin poisoning.
In a tenement-house in Buffalo, N. Y., twelve
cases of small-pox were discovered the other
day, none of which had been reported to the
authorities or received any medical attention
whatever. The patients were all recovering in
a highly irregular and unprofessional man-
ner.
350
THE MEDICAL ERA.
[Vol. VI. No. 11.
It js said that the cause of the hatred of the
English which William II., of Germany, enter-
tains, dates from the moment of his birth. His
mother, in her first accoiicheTnent, demanded the
services of an English physican. The one who
attended her, by an unskilful manipulation of
the forceps, injured the child's arm so that it
has ever since been atrophied. This physical
defect he has felt very keenly all his life, and it
has given rise, on his part, to a prejudice against
everything and everybody English, even to his
own mother.
Autopsy of Emperor Frederick. — A full re-
port of the post-mortem examination upon the
body of the late Emperor Frederick has been
published. The microscopic changes are sum-
marized as follows : Cancerous destruction of the
larynx, with secondary disease of a rather large
lymphatic gland at the lower part of the left
side of the neck, and a cutaneous nodule on the
right side near the wound. ^Esophagus unaffect-
ed. Inflammatory destruction of the upper por-
tion of the windpipe and the neighboring partfik
Numerous bronchiectases, with putrid contents.
Near these, broncho-pneumonic suppurating
gangrenous patches.
Hospital Experience. — ** You don't know what
a nature a fellow gets, not only lifter being a
soldier a while, but after living in the sights and
influences of the camps and the wounded — a na-
ture he never experienced before. The stars and
stripes, the tune of Yankee Doodle, and many
other similar things, I have seen bring tears
on some men's cheeks, and others turn pale with
emotion. I have a little flag (it belonged to one
of our cavalry regiments), presented to me by
one of the wounded ; it was taken by the Secesh
in a fight, and rescued by our men in a bloody
skiimish following. It cost three men's lives to
get back that four-by-three flag — to tear it from
the breast of a dead rebel — for tJie name of
getting their little ' rag ' back again. The man
that soured it was very badly wounded, and
they le? him keep it. I was with him a good
deal ; he wanted to give me some keepsake, he
said, — he didn't expect to live, — so he gave
me that flag. The best of it all is, dear M.,
there isn't a regiment, cavalry or infantry, that
wouldn't do the like, on the like occasion." —
Walt Whitman in October Century.
BOOK REVIEWS.
Experiments performed during the past sum-
mer had enabled him to prove that the convul-
sions of so-called Jacksonian epilepsy were solely
due to the cortex, and not at all dependent upon
the spinal cord or upon the bulbar spinal sys-
tem. — Dr, Ferrier.
Therapeutics: Its Principles and Practice.
By H. C. Wood, M.D., LL.D., Professor of
Materia Medica and Therapeutics in the
University of Pennsylvania. A Work on
Medical Agencies, Drugs and Poisons, with
Especial Reference to the Relation between
Physiology and Clinical Medicine. Sev-
enth Edition, Rearranged, Rewritten and
Enlarged. Philadelphia: J. B. Lippin-
cott Company. 1888.
This is the seventh edition of **A Treatise on
Therapeutics," by H. C. Wood, M.D., a book
which has long been a standard work of refer-
ence for the profession. In the present edition
much has been added, and the entire matter
has been rearranged. In the first part remedies
which are not drugs are treated of, dietetics,
metallo-therapy, massage, and other remedial
measures being considered, and also the general
treatment of bodily states, such as exhaustion,
obesity, and lithiasis. The most valuable part
of the work, however, is that which is devoted
to the physiological action of drugs, which is
very fuU, and forms a source of information
which is indispensable to every student of ma-
teria medica.
The J. B. Lippincott Company have done their
usual good work in the matter of printing and
binding.
Disinfection and Disinfectants: Their Appli-
cation and Use in the Prevention and
Treatment of Disease, and in Public and
Private Sanitation. By the Committee on
Disinfectants, Appointed by the American
Public Health Association. Concord, N.
H.: 1888.
We have here the best work on the subject of
disinfectants ever published in this country, if
not in the English language. The distinguished
physicians composing the committee gave to the
work their best efforts, and they have succeeded
in making a valuable contribution to science.
Much of the work is entirely original, and that
which is not has been so carefully considered
that all may be taken as authoritative. The
book comes very opportunely, when the subject
of which it treats forms an important part of the
physician's education at the present day. It is
a handsomely bound volume of two hundred and
sixty-five pages. Sent on receipt of price, by
Irving A. Watson, M.D., Secretary American
Public Health Association, Concord, N. H.
Not., 1888.]
BOOK REVIEWS.
351
Excessive Venbry, Masturbation and Conti-
nence. Their Etiology, Pathology and
Treatment, Including Diseases Resulting
Therefrom. By Joseph W. Howe, M.D.,
late Professor of Clinical Surgery in Belle-
vue Hospital Medical College. Second Edi-
tion, Revised. New York: E. B. Treat,
1888.
There are various works on the subject of
which this one treats. None of them, perhaps,
goes over the ground more thoroughly than Dr.
Howe's book. Scarcely any feature of it is neg-
lected. It is well written and instructive. But
it is really amusing to see that the author — like
many other authors — has been beguiled by
some of Dr. Hammond's pretty fables, especially
the one that tells about the man who was accus-
tomed to have a heavy-weight girl, with her
boot-heel on his bare chest, whirled around like
a spinning-top, ''till his flesh was torn and
bleeding," after which " our hero rubs his in-
jured spots with his naked hands, and his
bruises, scars and ecchymoses almost entirely
disappear within a very few minutes." This is
a good story to tell the marines, but it has no
place in a work that lays claim to being scien-
tific. In other respects the book is very well
written.
Manual of Chemistry, by W. Simon, M.D.,
Ph.D., Professor of Chemistry and Toxicol-
ogy in the College of Physicians and Sur-
geons ; Professor of Chemistry and Analyt-
ical Chemistry in the Maryland College of
Pharmacy, Baltimore, Md. 8vo., pages
479, with forty-four illustrations and seven
colored plates. Philadelphia. Lea Brothers
& Co., 1888.
A handsomer volume than the second edition
of Professor Simon's notable work has seldom
graced the shelves of the physician's library. In
typography, illustrations, and colored plates,
there is little to be desired. The author is for-
tunate in his publishers. The Medical Era,
in reviewing the first edition, has called atten-
tion to the superlative excellence of the book as
a text-book for medical students, as regards
not only inorganic chemistry, but organic also.
The chapters on animal chemistry are thorough
and interesting. Urinary analysis is treated in
a masterly manner, and is a feature of the work.
The manual has undergone extensive revision,
and is now seventy-five pages longer than at
first, bringing it up to the latest investigations
and discoveries of interest to the physician.
Few can realize, until they have taught from it,
what a monument of useful, orderly and consci-
entious labor Professor Simon has raised. That
a second edition follows so closely on the first
shows how well the author has succeeded in
presenting what the profession particularly needs
in the study of chemistry. C. M.
Lactated Food. — It is to be prescribed in
cases of malnutrition, when the little patients
are poorly nourished. Its base is sugar of milk,
and it contains no starch.
Thb October Century closes the thirty- six th voliunc
and 18th year of that periodical. The frontispiece of
the number is a portrait of the late Emma Lazarus, the
Jewish poet of New York; and in the body of the maga-
zine appears a sympathetic study of the genius and
personality of this most interesting woman.
The Sixth volume of Alden's Manifold Cyclopedia
extends from Bravo to Calville, its 635 nicely printed
pages including 120 illustrations. Along with its
manifold number of words and topics treated briefly,
there are many extended articles, as for instance,
Brazil, seven pages; Breecb Loading Guns, eleven
pages; Bridge, eleven pages; British Museum, ten
pages; Brooklyn, five pages; Buddhism, fifteen pages;
and California, sixteen pages. The Cyclopedia well
deserves the enthusiastic commendation it is receiviog
from all sides; it is certainly the Cyclopedia for pop-
ular use. The publisher sends specimen pages free to
any applicant, or specimen volimies, which may be
returned if not wanted, for 60 cents for cloth binding,
75 cents for half Morocco, postpaid; the better binding
is particularly commended. John B. Alden, Pub-
lisher, 393 Pearl Street, New York, 218 Chirk Street,
Chicago.
There is a preparation that is called ** Carnrick*s
Food," which I have used. It consists of equal parts of
dried milk which has been digested with pancreatine,
and of wheat-starch, which has been converted by
dry heat into dextrine. I have reason to know that
this food is well made. — Dr. O, B, Fowler, N. Y.
A. W. FuRBEB. M.D., L.K.C.S , says: " I have for a
long time had a patient under my care for disease of
the teeth, and although my operations progressed fav-
orably, I had many diflftculties to contend with. The
whole of my patient's teeth appeared to have a syphil-
itic taint, with increased flow of saliva, amounting to
chronic salivation. lodia having come under my no-
tice, I was inclined to give it a trial, and with the addi-
tion of a small proportion of liq. hydrarg. bi-clilor.,
taken daily before meals for a time — the salivation be-
came normal, the mucous membrane assumed a more
healthy state and the teeth generally looked like com-
ing back to their original color.
80 Fortress Boad, London, N. W.
Burlington Boute.
Vestibule Trains. ''The Burlington's No. 1" fast
train, leaving Chicago at 1 P. M. daily for Omaha, Lin-
coln, Cheyenne and Denver, and arriving at Denver at
9:10 A. M. the next evening, is now a solid vestibule
train for the entire distance between Chicago and
Denver.
The Burlington's ** Fast Trains" to Kansas City, St.
Paul and Minneapolis will also be vestibule trains at
an early date.
352
THE MEDICAL ERA.
[Vol. VL No. 11.
THEY SAY
That nothing dries sooner than tears.
That a doctor's bill is a debt of honor.
That flies are common carriers of contagion.
That blood will tell, and so will watered milk.
That doctors are not always as wise as they
look.
That chalk is never used as an adulterant of
milk.
That the lungs of a dog are the seat of his
pants.
That Job was the first doctor — he had pa-
tience.
That in the silent watches of the night there is
no tick.
That some men are like rivers — little head, big
mouth.
That peppermint water will relieve pruritus
pudendi.
That convicts never have the courage of their
convictions.
That hysteria is a bedevilment of the entire ner-
vous system.
That poetry runs in the blood — in the poetical
vein, you know.
That all men are more or less insane, especially
the other fellow.
That iodoform is Billroth's favorite antiseptic in
surgical practice.
That micro-organisms cannot pass through the
healthy placenta.
That blood deprived of its red corpuscles is
regarded as lymph.
That a good man gone wrong is generally a bad
man just found out.
That water is a solvent of more substances than
any other one fluid.
That acute diseases, following upon chronic, are
the most dangerous.
That the wise man is known by the company
that he keeps out of.
That bile itself taken internally, is the most
powerful cholagogue.
That speech is silver, silence is golden, and
laughter often ironical.
That a kleptomaniac is a person who suffers
from fits of abstraction.
That it's called the " funny bone" because it is
the point of the humerus.
That in a life-time of eighty-four years the heart
beats 2,869,776,000 times.
That atrophy of the muscles of the thigh follows
synovitis of the knee joint.
That in Massachusetts it is forbidden by law to
give chloroform to a patient.
. That two members of the royal family of Bava-
ria have graduated in medicine.
That at last the allopaths have discovered the
therapeutic virtues of lycopodium.
That the proportion of tuberculous cattle brought
to Paris is about six in the thousand.
That the weight of medical opinion is in favor
of the view that leprosy is contagious.
That the physician who values his time and
advice is the man who is best appreciated.
That for solid comfort, next to a clear con-
science nothing equals an easy pair of boots.
That the mother of Henry VIII. was only 13
years old when she gave birth to the future king.
That there is a colony of Poles in Connecticut,
and they are going into the business of raising
polo-cats.
That there is a doctor in Kentucky whose name
is Bowel; it is proposed to make him Secretary of
the Interior.
That a forced expiration with a sibilus denotes
an access of asthma, and excludes both croup and
capillary bronchitis.
That summer complaint loses its epidemic char-
acter as soon as the minimal daily temperature
remains below 60° F.
That the government has spent more money for
the purpose of investigating the diseases of hogs,
than the diseases which afflict mankind.
That crystallized aconitine is the most violent
poison known, the two-hundredth part of a grain
endangering the life of the person taking it.
That there isn't much difference between the
front teeth, but there is a voi deferens between
the epididymus and the base of the prostate.
That a well developed natural bust is handsomer
in the nursery with a future president at it, than
in the parlor or ball-room with a modem dude gaz-
ing at its fictitious substitute.
That a medical journal in New York has pub-
lished a list of " Great American Phvsicians." The
list covers a page and a half. Now, if it would
publish a list of physicians who think they are
great, it would have to buy an extra ton of paper
and run the press night and day.
THE MEDICAL ERA
Vol. VI.
Chicaoo, December, 1888.
No. 12.
BBITOBS:
CH. GATCHELL, M.D.
JAMES E. GB088, M.D.
A PROPOSED BILL.
Frank S. Billinos, director of the Patho-
Biological Laboratory of the State University of
Nebraska, has sent to this office the text of a
proposed bill providing for the establishment of
a laboratory at Washington which shall be sup-
ported and controlled by the National govern-
ment. He submits the draft of the bill for con-
sideration, and caUs for suggestions.
"world-accredited " ? • Opinions might differ on
the subject. The language of the bill leaves op-
portunity for the exercise of arbitrary powef .
We beg leave to submit the following :
It is proposed that the "general supervision
and control of said patho-biological laboratory
shall be in the hands of the surgeon-general of
the marine hospital service."
We most respectfully submit that the present
surgeon-general of the marine hospital service
has not made for himseU such an enviable rep-
utation in dealing with the present epidemic of
yellow-fever in this country as to recommend
him for the enlarged duties which the pro-
posed position would involve. His management
— or mismanagement — of the epidemic is in
strong contrast to the very efficient work which
was done by the National Board of Health in
1878. The officer named probably has sufficient
to tax his powers in the position which he at
present occupies.
The proposed bill, furthermore, provides that
the " directors of the institutes named shall be
graduates from a thoroughly organized and
world-accredited medical school,'* etc.
This is altogether too indefinite. Who is to
be the judge as to whether the school is
Supposing, for instance, that a graduate of a
homoeopathic college should make application
for the position ? The surgeon-general of the
marine hospital service might decide that the
doctor's altna mater was not "world-accredited,"
whatever that may mean.
The homoeopathic graduate might fulfill every
other condition except this one, and then be
arbitrarily excluded. Such an occurrence is
possible, for homoeopaths can, at times, answer
very stringent requirements. It is a matter of
history, right here in Chicago, that for three
years a well-known Philadelphia firm offered
very expensive microscopes to that graduate who
should stand the best examination in micros-
copy. The microscopes were competed for by
graduates of every one of the seven medical col-
leges in Chicago, and, in addition, by graduates
of the Chicago University. And it is also a mat-
ter of history that for two successive years the
prize was carried off by graduates of a homoeo-
pathic college.
Hence, it would be well so to alter the pro-
posed bill as to prevent all possibility of unjust
discrimination in favor of any one school of
medicine, for we are quite sure that it cannot
pass in its present shape.
All of which is most respectfully submitted.
LOCAL MEDICAL SOCIETIES.
In the November issue of this journal will be
found a report of the meeting of the Illinois
Valley Homoeopathic Medical Society. We re-
fer to it at the present time in order to suggest
854
THE MEDICAL ERA.
[Vol. VI. Ko. 12.
that physicians in other parts of the state should
follow the example of those who have organized
this society.
The advantages of such local organizations
scarcely need enumeration. The meetings afford
an opportunity for interchange of views, and
for a closer acquaintance among neighboring
physicians. The experience gained in preparing
papers will be an aid rather than a hindrance
to the annual contribution to be made to the
State Association. We commend the action of
the physicians of the Illinois Valley to the con-
sideration of the entire profession.
ELECTRIC PROSTRATION.
New conditions develop new diseases.
The " railway spine " has taken its place in
medical nomenclature, and the "caisson dis-
ease " has also been recognized. Now a third
has been added to the list in a condition which
has received the name of "electric prostration."
This is a disorder that affects those who work
under strong electric lights. After an exposure
of one or two hours the workers have a painful
sensation in the throat, face and temples, the
skin becomes of a coppery-red color, there is ir-
ritation of the eyes, with profuse lachrymation,
lasting forty-eight hours. After five days there
is desquamation of the discolored skin.
These symptoms do not follow exposure to the
ordinary Edison light, but to one of excessive
strength, such as is used in electric furnaces for
the quick heating of metals. Some mitigation
of the symptoms may be procured by tlie use of
dark-colored glasses, but not entire immunity.
The effects seem to follow exposure not to the
heat, which is not great, but to the intensely
brilliant light.
Thus has a new industry created a new dis-
ease, for which the profession will be called
upon to find a remedy.
From a review of one hundred and thirty-
seven cases of cortical lesion I find a complete
identity of the motor and sensory cortical areas.
A deeper lesion is apparently more common
where there is anaesthesia. — Dr. C. L, Dana,
LONDON'S LATEST HORROR.
The devilish fiend is at work again.
In ninety-three days the mysterious murderer
who haunts the streets of Whitechapel has
killed and butchered nine of his unholy victims.
The latest case is a fair sample of the pre-
vious ones. As usual, the victim was a woman-
of-the-town. Her body was mutilated almost
beyond recognition. The head was severed
from the trunk and placed beneath one of the
arms. The nose and ears were cut off. The
skin was torn from forehead and cheeks. The
breasts were sliced off and laid upon the table.
The body was disemboweled, and the intestines,
heart and liver placed beside the breasts in
their peculiar resting-place. From her thighs
great pieces of flesh had been stripped and
strewed upon the floor, while all surrounding
objects were smeared with blood. The uterus
had been removed and carried away.
To the present time the murderer has eluded
the utmost vigilance of the police. No one sees
him coming or going, though he works in crowd-
ed streets.
Such reasonless butchery and such cunning
mark the work as being extraordinary in the
history of houiicides. It is removed from the
catalogue of crime, and placed in that of in-
sanity. No creature of sound mind is engaged
in it. Neither is the man a monster; he is
simply insane, and as liarmless as a child ex-
cept to his peculiar victims.
It is most likely that the assassin is an epi-
leptic, rather than a monomaniac. As **Mr.
Hyde," he imagines that his mission is to kill;
at other times he may mingle with his fellow
men as the harmless " Dr. Jekyll."
But, in whatever guise he walks, his appre-
hension will be a source of relief to a peculiar
class of London's citizens.
It is not too early to begin the preparation of
papers for the next meeting of the Illinois Hom-
(copathic Medical Association.
Dsa, 1888.]
ORIGINAL ARTICLES.
855
ORIGINAL ARTICLES.
THE UBINS OF AMEBIC AN BUSINESS MEN.
By CLIFFORD MITCflELL, M.D.
CUiCAOO.
MAN'S inhumanity to his kidneys makes
countless millions mouni. This reflec-
tion has come over me after examining
the urine of many men too actively engaged in
business. Now, the stomach and bowels, when
abused, make themselves felt. They " turn
again and rend you." But the kidneys hide
their grief from vulgar gaze and pine away
and die. Signs of sorrow may at times, never-
theless, be detected by those familiar with the
character and constitution of the long-suffering
kidney.
I cannot fail to recognize certain points of re-
semblance in the various specimens which have
come under my observation. The urine of the
over-worked and over-fed American business
man usually shows in the beginning, before any
renal disease is actually present, the following
characteristics:
The total quantity of urine for the twenty-four
hours is greatly reduced, sometimes to half the
normal quantity. The color is usually, there-
fore, darker than normal, and there is an abun-
dant sediment in which urates, uric acid, and often
calcitim oxalate may be seen with the microscope.
The urine being diminished in quantity and the
acidity relatively increased, the urates and uric
acid cannot be held in solution as they ought to
be. Estimation of the total quantity of urea will
almost invariably show this substance to be
diminished to a figure considerably below normal.*
My method of examination of such urine is,
first, to cause the urine of twenty-four hours to
be collected and brought to me. I measure it
in an accurately graduated jar. Next, the total
solids are calculated and compared with the
normal range, 55 to 75 grammes. Next, tbe
total urea is estimated by the hypobromite pro-
cess and compared with the normal range, 20 to
40 grammes. But I ascertain what would proba-
bly be the normal urea figure for each particu-
lar patient by multiplying his weight in pounds
by the proper co-efficient. As I have often
shown, 3^ grains to the pound is about the nor-
mal average for those between 120 and 160
pounds. In cases where the acidity of the urine
* The p^rcenfage ot nnti mtiy be normal, or even higher than nor-
mal, ana care is very necepnary in theee canes to distlngnish between
the percentage and the total quantity. See my article, " Fallacies in
Urinary Analysis/' iu the JlahnemanrUan of Jaly, 1888.
is very noticeable, I estimate this by the vol-
umetric method, and from time to time repeat
the operation to observe the effect of diet and
treatment.
Testing the urine with delicate teats, for
albumin and sugar, and examining the sediment
for crystalline constituents must next be done.
Perceptible traces of albumin and sugar I oc-
casionally find in the urine of hyper-active bus-
iness men, but in many cases both these con-
stituents are as yet absent. I say " as yet,"
for sometimes, if all warnings are unheeded,
one or the other of these imwelcome visitors in
time, may make its appearance. I regard
persistent decrease in both fluids and solids of
the urine of great significance in those who eat
heartily and exercise little. It is not necessary
that either albumin or sugar be present ; there
is enough trouble without them. WJien a man
of average weight voids da'dy no more urea than we
find in tlie urine of a delicate woman or a bed-ridden
2)atient, it is time to cry "halt." As a rule,
however, the man himself will be vaguely con-
scious that "something is the matter with him,"
though the kidney is never suspected of being
at fault.
I have found that these patients with dimin-
ished urea and crystalline sediments have all
sorts of aches and pains. Headache is a very
common concomitant. Sleeplessness is an-
other. If I could have my own way I would
estimate the urea in the urine of every patient
in the country suffering from insomnia or rest-
less, unrefreshing sleep. Professor Dowling, in
his paper on Lithaemia, has commented on the
same thing. Not all insomnia is due to lith-
aemia, but many cases, apparently hopeless,
could be helped were the condition properly un-
derstood. Much bromide of potash would yet
rest peacefully in the pharmacist's bottles un-
disturbed by apostles of palliative treatment.
When among the various persistent aches and
pains Ifackache is felt, then the patient rushes in
terror to the nearest doctor and has his urine
" analyzed." Now is the time to put the enemy
to flight, but often, unfortunately, because for-
sooth, albumin and sugar are absent, theijatient
is told that "nothing is the matter with his
urine."
A number of cases taken directly from my
own records will now be quoted as illustrations.
Bear in mind the following data :
Average normal quantity of urine, 1200 to
1500 cubic centimetres.
Average range of solids, 55 to 75 grammes.
856
THE MEDICAL ERA.
tVoL.VL No. ».
((
it
Average range of urea, 20 to 40 grammes ac-
cording to weight.
Case 1. — Weight of patient, 160 pounds.
Total urine in 24 hours, 1050 cubic centi-
metres.
Total solids, 38 grammes.
T'otal urea, 19 grammes.
Albumin, trace.
Deficiencies : In total urine nearly 200 c.c.
from minimum normal average; in solids, 17
grammes from minimum normal; in urea, 1
gramme from minimum normal. But the pa-
tient's weight being 160 pounds he should void
34 grammes of urea, therefore the deficiency in
this particular case was really 15 grammes.
Three estimations of the urine from the same
patient, taken at different times, showed about
the same condition.
Case 2. — Patient has numerous slight ail-
ments. Says '* cold is his worst enemy."
Total urine, first day, 793 c.c.
" second ** 708 c.c.
" third " 546 c.c.
Sediment contains jagged crystals of uric
acid.
In this case only about one-third the normal
quantity of urine was voided for three consecu-
tive days. Patient said that as a rule he did
not void much urine. (Urea not estimated. )
Case 3. — Total quantity in 24 hours, 945
cubic centimetres
Total solids, 53 grammes.
Urea not estimated. In this case the reduc-
tion in fluid was greater than that of the solids.
The sediment contained dH khids of calcium oxal-
ate crystals: spherical, oval, dumb-bell and octa-
hedral. In three months' treatment consider-
able improvement, 24 hours' urine just doubled
and the calcium oxalate scanty.
Case 4. — Elderly gentleman who has led a
busy life and taken little air, exercise or recrea-
tion.
Total urine in 24 hours but 530 cubic centi-
metres. Solids, 32 grammes. Urea, onhj 9
(framrnes. [Later repoi-ts from this case would
indicate appearance of albumin, and from what I
can learn he is now suffering from a well pro-
nounced kidney lesion.]
Case 5. — Very intelligent gentleman, univers-
ity graduate, who for several years has had a
noteworthy sediment of urates and uric acid.
Specific quantity of morning urine, 1040. No
sugar, but loaded with urates and free uric acid.
[No estimates made the first time, but some
weeks later 24 hours' urine was obtained.]
Total urine only 500 c.c.
Total solids, 32 grammes.
The patient was greatly helped by reduction
of meat in his diet. After a week's total ab-
stinence from meat no uric acid could be seen
with the naked eye in his urine, while before this
for several years he had noticed it con-
stantly.*
Case 6. — Case sent by Dr. N. B. Delamater.
History of close confinement at business. Vari-
ous painp complained of : in occiput, and lower
end of spinal cord ; drawing, contracting pains
in left leg. General feeling of tension.
Total urine, 738 cubic centimetres.
Total solids, 52 grammes.
Total urea, 24 grammes.
Case 7. — No history obtainable by me other
than the usual story of close confinement at
business.
Total urine, 870 c. c.
Total solids, 54 grammes.
Total urea, 24 grammes.
Urine of a rich color and contains sediment
of urates and calcium oxalate.
Case 8. — Weight of patient, 200 pounds.
Total urine, 974 c. c.
Total solids, 58 grammes.
Total urea, 27 grammes.
(Should expect 38 grammes.)
This specimen showed a distinct case of al-
bumin.
Case 9. — Typical pase of defective oxidation.
Patient fleshy and indisposed to exercise.
Total urine, 679 c. c.
Total solids, 28^ grammes.
Total urea, llj^ grammes.
Albumin distinct. No casts. Sediment
amorphous phosphates.
After three months' treatment :
Total urine, 1652 c. c.
Total solids, 72 grammes.
Total urea, 28 grammes.
Albumin, faint trace only.
Case 10. — Patient, young man and tolerably
active, but eats very heartily ; especially given
to meat diet. Eats meat freely three times a
day. Complains of dull aching pains in the
back in region of sacrum.
Total urine, 738 c. c.
Total solids, 37 grammes.
Total urea, 23 grammes.
Sediment : free uric acid, urates, calcium ox-
alate, (octahedral crystals).
Of these ten cases all were on their feet, and
most of them actively engaged in business at the
time the examinations were made.
♦Tt has been argued that meat Itself is not bo bad in theftc case*, but
when assoeiaUd tpifh too great a quantity of other food \t is bat im-
perfectly oxidized in the body.
Dko., 1888.]
ORIGINAL ARTICLES.
357
THUJA OGOIDSNTAIilS AND ITS CLINICAL
IMPOBTANCS.
Bt T GRI3W0LD COMSTOCK, M.A., M.D.. Ph.D.
ST. Loai8.
THQJA, commonly known as arbor vit8B,
and white cedar, grows in swampy grounds
in Pennsylvania, and may be seen flour-
ishing among the plants and shrubs that are so
much admired in Shaw's boulevards in St.
Louis. It is a remedy but little used by the
old school, and we are indebted to Hahnemann
for a knowledge of its virtues. The older physi-
cians of our school have used it for sycosis or
condylomatous £ig-warts. These sycotic ex-
crescences have not been well defined. They
appear after gonorrhoea, and are not to be
regarded as syphilitic ; they occasionally develop
to a large size, and in two instances that came
under my observation they were like a large
sponge, completely enveloping the penis. In
the form of true condylomata, they are found
particularly about the anus, and when located
here they are undoubtedly sequelsB of syphilis.
Sycosis, or fig-warts, as they appear upon the
penis or vulva, usually disappear after appli-
cations of fluid extract of Thuja ; but, if they
are multiple, and disseminated, they should
first be excised and then Thuja should be
applied. Occasionally, these fig-warts are very
refractory and liable to recur.
The recent provings of Thuja confirm Hahne-
mann's statement that it acts particularly upon
the skin, genito-urinary organs and anus.
Internally, it is useful for blenorrhoea, and
refractory gonorrhoea. Locally, it is excellent
in phagedena of the penis the result of hard
chancre. The phagedena should be dusted
twice daily with Aquila alba, ancT then dressed
with Thuja. When the phagedena is intensely
painful, as is frequently the case, the pain
should be allayed by applying Cocaine. In
senile gangrene affecting the big-toe of old
persons. Thuja is the best application that I
know of to allay the horrible smell usually
attending it, and it undoubtedly possesses spe-
cific properties in staying this deadly disease.
In epithelioma it is worthy of trial, and I have
already used it in three very suspicious cases
with satisfactory results. In uterine cancer it
seems to allay the fetor, and certainly has a
sanitary influence in perhaps holding the dis-
ease in check. In pruritus ani I have found it
better than any other remedy that I have ever
tried. In making such a positive statement it
may be well to add, that I have heretofore used
and recommended for this purpose Hydro-naph-
tholy which is reliable as an anti-pruritic in
most cases, but it occasionally fails ; when this
is the case I resort to Thuja, and it seems to
act better than Hydro-naphthol. When Thuja
is applied to a bad case of pruritis ani, at first
it greatly aggravates the itching, and this
aggravation lasts from five minutes to hal^ an
hour, when the greatest relief will follow. To
effect a cure of refractory cases of this distress-
ing trouble, it is my custom to employ the gal-
vanic current (the cathode being applied to the
anus), once daUy, and then apply a dressing of
borated cotton saturated with Thuja. Some
seven to ten cells of Mcintosh's battery may be
used. In pruritus vulvae, the same treatment
may be employed with good effect, alternating
applications of Thuja with Hydro-naphthol.
in carbuncle, Thuja will be found useful
when applied locally and is better than Carbolic
acid for this purpose. In rheumatic affections
after gonorrhoea, in some cases, it seems to be
specific when given internally. In the very
worst forms of ozoep^, it allays the foul odor,
and it is recommended as a gargle for bad
breath. In malignant diphtheria, from what
we know of it in other affections, I should be
disposed (theoretically) to apply it locally, that
is to say, if Peroxide of hydrogen failed to
relieve and allay the fetor accompanying this
dreaded disease.
409 N. Grand Ave.
(Beers* HotbIi.)
THE IMPORTANCE OF AN ACCURATE DI-
AGNOSIS AND CAREFUL OBSERVATION
OF PATHOLOGICAL CHANGES IN
VARIOU0 FORMS OF DISEASE,
VIEWED FROM A SURGI-
CAL STANDPOINT.
Bt GBO. a. hall, M.D.
OBIOAOO.
[Read before the Uliools Homceopathic Medical Asaoclation.]
THE full import of this subject is appre-
ciated only by the surgeon. It is in this
depaiiiment of practice that we are com-
pelled to deal with the unfortunate who have
been misguided, and not permitted to know the
nature, progress, or probable termination of
their ailments. The natural dread of a surgical
operation makes the patient a willing listener to
ill-considered advice, and thus, lulled into a state
of indifference, he drifts along until more threat-
ening symptoms appear, and then he is rushed
off to the surgeon for consultation.
Nearly all surgical diseases, in their first
stages, are treated by the general practitioner,
and for this reason I desire to stimulate a more
earnest determination on the part of the pro-
fession to make themselves familiar with ad-
vanced views of surgical pathology and the more
858
THE MEDICAL ERA.
[Vol. VI. No. 18.
modem methods of diagnosis. Should the case
be an exceptional one, or should it present fea-
tures which he does not imderstand, consultation
and advice should be sought from those who
have had a larger experience. Such a course,
generally adopted by the profession, would
greatly diminish the mortality of surgical opera-
tions. It is with this thought in view that I
pi'esent a few typical cases to illustrate the dan-
ger and risk of faulty diagnosis and unfortunate
treatment in the early history of morbid
growths.
Case 1. Mr. A, <^t. 21, while in Washington
Territory, had what he supposed to be a wart
just behind the ear, at the base of the mastoid
process. An English physician residing in his
neighborhood assured him it could be cured
without pain or danger. It was ligated with a
piece of sewing-silk and caustic was applied
to the stump. But it refused to heal, it rap-
idly enlarged, and assumed an angry appear-
ance. Three months later he returned to his
home in this state. The tumor at this time
had grown to the size of a hen*s-egg, was of a
very dark, livid color, and extended deep into
the surrounding tissue. Several surgeons ad-
vised its immediate removal, but the father,
having heard flattering accounts of a cancer-
doctor near by, took his son to him for treat-
ment. The ** doctor'' assured him of its safe
removal by plasters, and the fiendish work be-
gan. Six weeks after the first application of
plasters I saw the patient, who then had an
eschar three and one-half inches in vertical
diameter by three and three-quarters trans-
versely. It extended down deeply into the inner
triangle of the neck.
My opinion was asked, and I expressed great
astonishment at his reckless daring in applying
plasters to this vascular locality. One week
later I was summoned in great haste and found
that the external jugular vein had been literally
eaten oflF by the caustic plaster, and the patient
was in an exsanguine condition as a result of
hemorrhage. In this extreme condition the free
use of milk-punch was resorted to, and when
the circulation was sufiiciently restored to war-
rant the use of ether I removed the diseased tis-
sue which remained, together with the parotid
gland and the cervical plexus of lymphatics,
which had become involved. The disease had
apparently progressed faster than the destruc-
tion of the tissue by the plasters. The patient
survived the operation only a few hours, sink-
ing rapidly after the discontinuance of the ether,
despite all efforts for his restoration.
Case 2. Miss K., (bL 16, had for several
years an excrescence on the tarso-metatarsal
articulation of the third toe. She suffered but
little inconvenience except from the chafing of
the shoe. In the spring of 1886*it was stepped
upon by a colt. By the next year it was as
large as a dove's egg, and was operated upon by
the family physician. For a while the wound
seemed to heal, then a dark spot appeared, and
soon it developed into a large fungous growth.
In a few months after this operation the case
came Under my charge. The tumor was then a
cauliflower excrescence, oval in shape, and about
four and one-half inches in diameter. The dis-
charge was eanious and Tery oflfensive. The
limb was amputated at the middle third of the
leg. The inguinal glands, both deep and super-
ficial, were greatly indurated, extending down
into the pelvic cavity. The stiimp healed quite
readily and the patient returned home to meet
the inevitable, which is sure to come.
Case 3. Mr. T., czt, 62, had a warty excres-
cence just in front of the lobe of the ear. It
very soon became fissured, and he was treated
for two years with various plasters anv4 lotions.
An ulcer formed at the margin of the upper bor-
der of the ear, which gradually involved the
whole external ear and extended down the ramus
of the inferior maxillary to the angle, and then
obliquely down and back of the ear for about
two inches. It also extended upward and back-
ward to the insertion of the stemo-cleido-mas-
toid muscle. It had refused to heal under all
fornrs of treatment. When he came under my
care I operated at once. The entire mass of
ulcerated surface was removed down to healthy
tissue, including, at the same time, a great por-
tion of the axternal ear. The auditory canal
was curetted to the middle ear. The wound
was dressed for two months with tar plaster, and
the result was decidedly satisfactory.
Case 4. Mrs. H., cet. 43, had for some time
observed a hard spot near the center of the calf
of the left leg. For two years it caused no par-
ticular inconvenience other than sharp, lancin-
atiYig pains, which seemed to "shoot up and
down the limb." An unfortunate blow, exciting
inflammatory action, was the beginning of more
rapid growth. Her physician assured her that
there was no danger and that he certainly could
cure it with remedies, and hence no local appli-
cations were made. For thirteen months she
followed his advice strictly, with a rapid increase
of the growth as a result.
In January last she returned to this city and
was placed in the hands of one of our best pre-
Die, 1888.1
ORIGINAL ARTICLES.
359
scribers. At this time, however, the tumor was
quite large and more painful. In vain did the
doctor endeavor to arrest this morbid process
by judicious prescribing. Last March I was
called to see the case. The limb at this time
was flexed upon the thigh and the thigh upon
the body. A large fungous mass involved the
entire muscular portion of the calf of the leg,
dipping down to the bone. The pain had now
become so severe that the patient found no relief
day or night. She had marked cachexia and
other evidences of rapid constitutional involve-
ment. To save her life I advised amputation,
and the limb was removed just below the inser-
tion of the ligamentum patellfe.
In the case of tumors or morbid growths, it
may be quite diflBcult, in their early history, for
even the most experienced to declare positively
as to their nature. It is, therefore, a safe pro-
cedure for the general practitioner, whose atten-
tion may be called to a nodule in the breast or
an excrescence on the surface, to note carefully
its progress and avoid all irritating applications
until he is convinced that its removal is impos-
sible by remedial measures. Then he should
advise its removal by the knife at once. Some
may ask if escharotics must always be avoided.
To this I would give an aflSrmative answer. I
have never seen a case of mprbid growth or
malignant ulcer that could not be removed by
the knife with greater safety, attended by less
pain and followed by better results, than by
the use of escharotics and plasters. It is unfor-
tunate that patients, through fear or prejudice,
exercise their own choice and resort to the caus-
tic applications. In such cases, however, the
patient assumes the responsibility and the phy-
sician is free from any censure.
In addition to the above arguments, it can be
said that in removing growths from the face or
exposed portions of the body by means of the
knife, we avoid the frightful cicatrization and
deformities caused by plasters and other forms
of escharotics. The plaster will destroy, but it
will not restore. The clean incision will remove
the disease and restore the parts without serious
deformity.
In the case of accident or traumatism, espec-
ially those involving the joints and osseous struct-
ure, the necessity of accurate diagnosis cannot
be questioned. It is in this class of injuries that
we find our largest number of malpractice suits,
hence the greater need of observation, experi-
ence and consultation. When these considera-
tions are kept in mind by the profession, many
valuable lives will be saved and a better record
will be made by surgeons.
3400 PBAIBIS ATEKtJS.
RX7PTUBE OF THE UTEBUS IK THE 7IBST
STAGE OF LABOK.
[CaKe from notes taken in the Clinic d' Accouchmect, Paris, Ser-
vice of Prof. Pujol. J
By LUCY WAITK. M.D.
CHICAGO.
CASE 14. — The patient was thirty-four years
old, in her fourth pregnancy. There was
a history of hard labors, two being instru-
mental deliveries. Nothing remarkable in the
present pregnancy, and labor progressed natur-
ally, although slowly, until about half an hour
before rupture took place. The pains increased
in severity without any corresponding advance
in labor, the patient became weak and exhaust-
ed, and showed signs of sinking. The head was
still high, the os not fully dilated, and before
the course of treatment was decided upon, the
rupture occurred. The face became deathly
pale, the pulse small and weak, the skin was
covered with a cold perspiration, and the nausea
and vomiting were most distressing. The foetus
had escaped only partially into the abdominal
cavity, and an attempt was made to deliver by
the forceps through the vagina. This failing,
and the symptoms becoming every minute more
alarming, it was decided to proceed without
delay to gastrotomy, but before the operation
could be begun the patient died suddenly, sup-
posedly from internal hemorrhage.
Remarks, by tlie First Assistant, Dr. Loviot : —
This is, without doubt, the gravest accident the
accoucheur is called upon to meet. Fortunate-
ly it is a very rare occurrence. Statistics vary
greatly according to different authors ; one, an
English writer^ making it as high as one in
about nine hundred and fifty cases, others only
one in three thousand.
For convenience of diagnosis and treatment
we adopt the following division: (a) rupture
during pregnancy; (b) rupture during parturi-
tion. The causes of rupture during pregnancy
may be classed as predisposing and determining.
The most frequent of the former are, old lesions,
the result of former labors ; tumors of uterus ;
and abnormal thinness or thickness of the uter-
ine walls. Under the determining causes may
be classed all those of traumatic origin, external
or internal. Some authors class under traumat-
ic, those caused by the convulsive movements
of the foetus, but as this alone can never cause
a rupture without a predisposing cause, it be-
longs, more properly, under the first division.
The symptoms vary according to the period of
pregnancy, but in general they are as follows :
In the prodromal stage a general feeling of dis-
tress, more or less abdominal pain, and fever
360
THE MEDICAL ERA.
[Vol. VI. No. «.
This period is followed by the second, with in-
tense, sudden pain, a sensation as of something
tearing in the abdomen, and a cracking sound
which is plainly heard, chill and violent trem-
bling, followed by a cold sweat, with either hem-
orrhage per vulva or internal hemorrhage, and
persistent vomiting. If the rupture takes place
in the later months of pregnancy the foetus
may be felt in the abdominal cavity. If it is
dead it remains there as a foreign body. This
condition may continue for hours, or even days,
and the woman die from peritonitis, or septi-
caemia, or death may result immediately from
internal hemorrhage. The treatment is the
same as for rupture during parturition, so far
as possible, and will be given under that di-
vision.
Rupture during labor may take place in any
of the three stages. As determining causes are:
a prolonged labor, the immoderate and inoppor-
tune use of Ergot, forced introduction of the
hand, and clumsy application of the forceps or
cephalotribe. The rupture usually takes place
in the lower segment of the uterus, as the
muscular tissue is there thinner and put more
on the stretch. The body of the uterus has
sometimes been torn completely from the neck.
The general symptoms are the same as in rup-
ture during pregnancy, with additional symp-
toms according to the period of labor. If in
the first period, we have complete cessation of
the pains, closure of the orifice which had
previously been gradually expanding; and, if
the child has escaped from the uterine cavity, a
large tumor on the one side and the contracted
uterus on the other.
It is often impossible to diagnosticate an ap-
proaching rupture. After the rupture has oc-
curred the signs are unmistakable.
TreatTnent. — There is probably no one sub-
ject in obstetrics in regard to which physicians
differ so widely as the treatment in a case of
rupture of the uterus during parturition. We
divide the treatment into — first, preventive;
second, obstetrical ; third, after-treatment.
The preventive treatment consists in stand-
ing guard over any abnormal conditions which
may favor a rupture. If the walls of the uterus
are abnormally thin and very much distended
with liquor amnii, it is well to make a small
puncture and draw off a very little of the fluid.
If there is a decided disproportion between
pelvis and foetus, craniotomy should be per-
formed early.
The obstetrical treatment will depend upon
the following conditions : first, if the child still
remains in the uterus ; second, if the child has
passed partly into the peritoneal cavity, and
third, if it is completely outside of the uterine
cavity.
If the child remains in place, it is self-evi-
dent that the first duty of the physician is the
extraction, either by forceps or by version, ac-
cording to the presentation and degree of en-
gagement. If there is an unavoidable obstacle
to the delivery by forceps or version, and the
child is dead, craniotomy is the proper opera-
tion beyond a doubt. But if the child lives,
and, as the life of the mother is already a
doubtful question, gastrotomy should be pre-
ferred to craniotomy, and the life of the child
saved.
In the second case, where the foetus has
passed partly into the peritoneal cavity, an at-
tempt should be made to deliver through the
parturient canal ; if this fails, Gsesarean section
is the last resort.
In the third case, where the foetus has es-
caped entirely into the peritoneal cavity, opin-
ions differ as to the most advisable operation.
Bandl, Schroeder and other German authors
say that an att<empt to deliver the foetus through
the natural canal should always be made, as
being less dangerous than the opening of the
abdominal cavity. The English and American
obstetricians however, take the opposite ground,
maintaining that in every case of uterine rup-
ture where the foetus has escaped wholly or in
part into the abdominal cavity, gastrotomy
offers the best chance of saving the mother. As
the uterus is already torn and the peritoneum
opened, the only additional danger is the open-
ing of the abdominal parietes, which offers an
opportunity of sponging out the abdominal
cavity and removing blood-clots, as in ovariot-
omy. The last method of treatment, the ex-
pectant plan, means sure death to both mother
and child. The after-treatment' consists in
seeking to prevent peritonitis and septicaemia,
and keeping up the strength of the patient" by
suitable nourishment.
5306 Jefferson Avenue.
1. It is physiologically proven that the ner-
vous system directly affects general nutrition.
2. Various lesions are the immediate result of
previous ner\'e disease. 3. In various cases the
lesions are not preceded by circulatory disturb-
ance. 4. No known vaso-motor condition is
capable of causing many of these lesions. 5.
Therefore it is absurd to attribute changes to
preceding vaso-motor changes. — I)r. Wood,
Dsc, 188S.]
ORIGINAL ARTICLES.
861
ST7N8TBOKB.
Bt w. a. kaler, h.d.
JOLIET, XLIi.
NOT satisfied with the results of customary
treatment of sunstroke, I determined to
try Jaborandi in physiological doses, on
account of its power to produce perspiration and
lower the temperature. I soon had an opportu-
nity.
June 21, '88, H. W. T., No. 8896, fell out of
line on the march from the cell-house to the
working-shop, after dinner, and was Ufted up
and carried to the hospital. At 1 p. m. he was '
semi-conscious ; could give his name and answer
questions; spoke sharply, then relapsed into
stupor. Skin very dry and hot ; pulse hard and
wiry, and 144 to the minute; temperature 103'';
pupils normal.
Gave 20 minims fl. ex. Jaborandi in a tea-
spoonful of warm water, and applied ice-bags to
the head and over the carotid arteries.
1:15 p. M. — SUghtly delirious; moaned and
called for water, and pressed his hands to his
head and chest; considerable flow of saliva;
skin still dry.
10 minims fl. ex. Jaborandi in a little water.
1:30 P.M. — Pulse 120; temperature 102°;
skin slightly moist; condition otherwise un-
changed.
1 : 45 p. M. — Removed the ice-bags and gave
15 minims fl. ex. Jaborandi in water.
2 : 30 p. M. — Pulse 108 ; temperature 100 5-
10°; skin moist.
4 p. M. — Pulse 96 ; temperature 99°.
5 : 30 p. M. — Mind clear ; skin rather dry ;
ate a little hot milk and bread.
5^. Aconite nap. 2x every hour.
6 : 30 p. M. — Temperature 98 5-10°. Com-
plained of slight pain in the chest.
June 22, 7 a. m. — Pulse 66 ; temperature
98 1-10° ; slept well and ate fair breakfast.
Discharged from the hospital, but relieved
from duty until June 23, when he resumed
work.
This was a mild case, but recovery was so
prompt that, if I had had another, I should
have followed the same treatment. Fortunately
the weather turned cool and no more cases
occurred.
If another case of sunstroke is presented I
shall use the Hydrochlorate of pilocarpin, which
acts more promptly and can be given by sub-
cutaneous injection. This is a consideration
when the patient is unconscious.*
IiiiiiKOis State Penitentiary.
ATBOPIA AS A PBOPHYIiACTIC FOB SCAR-
LATINA.
Br W. D. GENTRY, M.D.
XAH8A8 CITT, MO.
WHILE physician to the Children's Home
in this city three years ago, when there
were about fifty children in the institu-
tion, a child just from Ohio was received, and
three days afterwards was taken sick with scar-
latina. I did not recognize the disease until
the next day, when she was removed to an
isolated room. The following day two other
children were taken down, and that night two
others. As soon as I discovered the character
of the disease I mixed two or three grains of the
second potency of Atropine in a tumbler of
water and had all the children in the institu-
tion take a teaspoonful every three hours for
two days. This put an end to the disease in
the house. I have since used the Atropine as
a preventative in families where the disease
occurred and no child or person who took the
medicine had the disease. I regard it as a cer-
tain preventative and far better than the Bella-
donna.
RECTAL IBBIGATION.
By henry SHBRRY« M.D.
CHICAGO.
MOIST heat is a recognized agent in the
treatment of hypersemic and inflamed
tissues, as witness the every-day use
of hot poultices and fomentations, as well as
the more modem method of applying heat by
the use of rubber tubing as a coil for the knee-
joint and as a mat for the abdomen.
Having several cases of simple prostitis with
ulceration and mucorrhoea, and believing that
the best method of treating them would be by
the use of continuous hot water irrigation, I
had devised and made for me a rectal irrigator,
by Hausmann, McComb & Dunn, of this city.
It consists of a perforated hard-rubber cylinder,
through which the water is discharged into the
cavity of the rectum. Within this larger cylin-
der is a smaller one, through which the excess
of flow is drained off.
The arrows in the cut show the inflow and
outflow of the fluid.
3616 Stanton Avenue.
THE MEDICAL ERA.
5CHISCH.
?HOR0LD KlNn.
CHAPTER V.
THE PBICE OF HONOR.
AMONG those who were gathered in Mrs.
Hardy's parlor on the eveiiing of Austin's
arrival were three with whom the reader
is not yet acquainted.
Madge Irving, one of those, was a strikingly
handsome girl. Although a blonde, she was
gifted with that rare combination of light hair
and dark ejes which nature occasionally be-
stows upon her favorites. Her lips, when part-
ed, displayed rows of perfect teeth ; when closed,
their firm compression emphasized the presence
in her character of the element of strong deter-
mination. Her perfect self-poiae and ease of
action revealed a conscious power which her
regular features and expressive face helped to
confirm.
Although the element of strength in her char-
acter was so pronounced, yet her limited expe-
rience in the affaire of the world had, thus far,
permitted but light demand to be made upon it.
It had served its chief purpose in preserving her
naturalness while surrounded by those condi-
tions which are supposed to be fatal to such a
result in one who is young, beautiful, and the
only daughter of an indulgent father.
Between this girl and her friend Helene
Evarts tliere waa sufficient likeness to permit a
mutual understanding, which formed the basis
of a congenial friendship. On the other band,
there were sufficient contrasts of character to en-
able the one to understand the other a little
better than she understood herself, and thus to
strengthen their bond of union by making them
mutually considerate. Helene, though capable
of deeper feeling, was less aggressive than
Madge. Madge would be quick to resent an in-
jury, but would almost as quickly forgive, and
soon forget ; Helene would be slow to forgive,
and would never foiget.
Dora Macy sat near Helene, resting her arm
on the latter's chair. An artist would have
placed her in that position for the sake of the
contrast — a blonde and a brunette. Dora had
dark eyes, dark and curly hair, and a face ex-
pressive of intelligence rather than of beauty.
In appearance and manner, the ordinary ob-
server would have called her indifferent ; those
who knew her better, interesting ; while she be-
came charming only to those who had learned
to love her.
Dora had always been regarded as being
" peculiar." For the sake of indulgence in her
tastes, which were inclined to the literary, she
had neglected many of those accomplishments
which " society " demands. In a word, she
was non-conventional: therein lay her pecul-
iarity.
Gordon Wright, the man upon whom Madge
bad bestowed her affections, and to whom she
was betrothed, sat next to her. Although his
countenance showed plain marks of the depres-
sing emotions under which he labored, it also
revealed the face of a man who, under all ordi-
nary circumstances, had perfect command of
himself. His smooth-shaven face was naturally
round and full, though now, as the effect of
many anxious days and sleepless nights, his
cheeks were hollow and his gray eyes slightly
sunken.
Austin had finished his narrative, and all
had gathered closely about the table in the
center of the room to examine the promised dis-
play.
Opening his coat, and taking from about his
waist a wide leather belt which, he said, he was
accustomed to wear beneath all his clothing,
Austin laid it upon the table and produced from
one of the many pockets in its margin a small
parcel, from which he removed a rubber band,
and then several layers of soft and softer paper.
This process was repeated until there appeared
two rolls of cotton which, when separated, re-
vealed a mass of sparkling stones, almost daz-
zling in their splendor, as they threw back,
scattered in a thousand rainbow hues, the bril-
liant light of the chandelier.
At the sight, all uttered exclamations of sur-
prise, and the ladies could not have bent over
the wrappings with more eager interest had
their careful unfolding brought to light a nest of
httle babies.
Some of the larger stones had distinct his-
tories, and even the dates of their finding,
like the discovery of continents, were matters of
record. All these items Austin carefully de-
tailed.
Dbc, 1888.]
HASCHISCH.
863
While those^ who were gathered about the
table in Mrs. Hardy's parlors were absorbed in
the examination of the freshly-opened parcel,
there was, for a moment, another presence ih
the room.
First a foot was extended, as though quietly
feeling its way. After the foot was duly placed
it was surmounted by the body and form of a
man who, evidently, did not expect to find him-
self in so numerous a company, for, unobserved,
he quickly withdrew, as quietly as he had
entered.
But after this form had disappeared from the
room, the little upright line of light which
showed through the narrow crack where the
door hinged against the jamb, was for several
minutes eclipsed. Had those about the table
been less intent in their examination of the pre-
cious stones they might have observed through
this crack, almost six feet above the floor, a
flashing jewel which sparkled even as the dia-
monds did.
Austin now took from another pocket in the
belt a parcel, which, when opened, revealed a
number of dull, uninteresting stones, which one
might almost expect to pass unnoticed on a
pebbly beach.
" The diamonds which I have already shown
you," said he, ** I sent to London last winter to
be cut; but these," he explained, "are dia-
monds ' in the rough,' just as they come from
the mine."
" And were all these beautiful gems cut from
such rough-looking stones ? " asked Dora.
" Yes, " replied Austin ; " just as a sculptor
may carve a graceful statue from an awkward
block of marble."
" Eeally?" asked Helene, as though seeking
further confirmation. ** How interesting that
is ! " she added, as she took up the largest one
and examined it closely.
** But now please tell us, Mr. Hardy,*' said
Madge, " which is the finest diamond of them
all?"
"That, like the choicest wine at the feast, I
have reserved until the last," replied Austin,
proceeding to take from a narrow pocket in the
belt a parcel smaller than the others. As he
was removing its wrappings, he added: ** I had
intended leaving all these at the bank on my
arrival in the city, but when I left the custom-
house it was too late by an hour. Hence, you
see, it is only to an accident that you owe this
display to-night."
At length he brought to view a sparkling
brilliant.
" Here it is," said he; ** the largest diamond
ever taken from our mine ! "
" 0, how beautiful ! " cried Helene, whose
exclamation was echoed by all. "How it spark-
les ! Let me take it in my hand, please?"
Helene received it, and placed it against the
third finger of her left hand, as though it were
an immense setting in a ring.
Madge, in turn, extended her hand to receive
it.
'* May I take it? 0, what a magnificent
stone! What is its value, Mr. Hardy, ex-
pressed in paltry dollars ? "
** An offer of twenty thousand has been de-
clined. Some day I expect to sell it for more
than that."
At this moment Madge placed the gem in the
hand of Gordon, who sat next to her.
" See, Gordon," said she, *'it's nothing but a
stone."
"Nothing but a stone!" repeated Gordon.
" Nothing but a stone ! And yet it may hold
the price of a man's honor."
Extending his outstretched palm, and avert-
ing his head, he cried, excitedly:
" Take it away ! Eiches that are not ours
only mock us ! 0, take it — it bums my hand ! "
Madge quickly took the diamond, while Ken-
neth arose from his seat and stepped to Gor-
don's side.
"Come, Gordon," said he, gently, "I fear
you are not well to-night. Let me go to your
room with you ? "
At this Gordon arose and put his hand to his
forehead.
" 0, yes, I am perfectly well — only a sudden
headache — that's all. But I will go. Good
night ! " And, accompanied by Kenneth, he
left the room just as the line of light in the crack
of the door passed from eclipse.
When the two had disappeared, Madge in a
voice trembling with emotion, cried :
"It is all my fault ! How could I have been
so thoughtless ! "
Mrs. Hardy made a kind but ineffectual effort
to comfort the distressed girl, while Helene and
Dora, whose quicker instincts divined the use-
lessness of such an attempt, after a few words
gently led her from the room. They knew that
Madge would find relief only in tears.
A
CHAPTER VI.
"THEN SHED YOUR TEARS FOR ME."
S soon as the young ladies had gone Austin
liastily gathered up the diamonds which
had been the exciting cause of the unhappy
864
THE MEDICAL ERA.
[Vol. VL No. 11.
incident, and, restoring them to the belt, placed
the latter beneath his tightly buttoned coat.
" I am very sorry," said he, ** that the even-
ing should have terminated so unfortunately for
Gordon and Madge."
<* Yes, but no one could have foreseen it," said
Mrs. Hardy. ** However, its effects, I think,
will not be permanent."
" I hope so, sincerely, for it is plain that
Gordon's present burden is all that he can
bear."
**Yes, and more than he deserves. Poor
fellow ! he tries hard to rally from his depres-
sion ! "
"With that girl to encourage him, he should
meet with greater success," remarked Austin.
** Yes, I quite agree with you ; although it is
a view of the subject which would be more apt
to occur to you than to me," said his mother,
smiling.
"You will be still more inclined, mother, to
understand my appreciation of the sentiment in
the case, when you learn what I had begun to
tell you this evening."
"Ah!" exclaimed Mrs. Hardy, in evident
surprise, " I had not suspected that it was of
that nature ! "
" Did you not?" said Austin, as though en-
joying keeping her in ignorance of the main
point as long as possible. " Then you shall
have the mystery solved."
Austin began his disclosure by stating a
truism, which, though as old as the race, he no
doubt thought that he was formulating for the
first time.
"I believe^" said he, "that no man goes
through life— whatever the end may be —
without at some time feeling that the love of
some good woman is necessary to the comple-
tion of his happiness."
"Yes," assented Mrs. Hardy.
"At least that has been my experience," he
continued; " and the feeling has grown until it
has become the one thought of my existence.
Five years ago, when I went thousands of
miles from home, I carried with me an image
which had already impressed itself on my life,
and from that day to this it has been constantly
with me. My return to my native land was
first prompted by its memory, which I found it
impossible longer to resist."
Mrs. Hardy listened with expectant attention,
seeming to study a figure in the carpet. As
Austin paused she looked up into his face
with evident pride, and yet with that apprehen-
sive sense of coming loss and divided affections
which a mother, under such circumstances, in-
stinctively feels.
" She is a fortunate being, Austin, who has
awakened such feelings in your breast. Go on ;
tell me more of her."
" There is little more to tell," continued Aus-
tin, speaking rapidly and earnestly. " In child-
hood I was jealous of her every glance not
mine. When she was still very young I left
home, but, unknown to anyone — even to her-
self — I have loved her all these years with a
love which time and distance have served only
to intensify. I return to find that she has
blossomed into a beautiful womanhood, of which
this image," said he, taking from his pocket a
picture, " is but the bud of promise."
Mrs. Hardy glanced an instant at the card
which was placed in her hand, then dropped it
suddenly and looked up at her son with an ex-
pression of mingled pain and solicitude.
" Helene ! " she cried.
"Mother! What is it? "gasped Austin, al-
most in an agony of suspense.
Mrs. Hardy extended her arms and rested
her tightly clasped hands upon her knee. Not
trusting herself to look up again, she only
groaned in anguish :
" 0, my poor boy ! "
"Mother, tell me!" cried Austin, becoming
more and more excited.
Still she was silent.
"Helene is mine, and no man on earth shall
take her from me ! " cried Austin.
Mrs. Hardy could but clench her hands more
tightly. But, as soon as she could summon
strength to speak, her words struggled for utter-
ance as she slowly said :
"I know not for which my tears should flow,
for you — or — your brother Kenneth ! "
" Kenneth ! " cried Austin, starting to his
feet.
For a few moments he panted with quickly-
drawn breath, while his muscles played convul-
sively under the sway of the mingled emotions
which filled his breast. Then slowly sinking
into his chair, he bowed his head upon the table
and buried his face in his hands, as he said, in
a choking voice :
" Then, mother, shed your tears for me ! "
Mrs. Hardy waited for the storm to subside
before attempting to offer consolation or sym-
Dxc, 1888.]
HASCHISCH.
365
pathy. Then kneeling at bis side, with one arm
over his shoulder, she whispered, tenderly :
" My dear boy, my heart bleeds for you, but
I know not what to say ! "
The privacy of the conversation which had
thus been passing between mother and son had,
so far as they knew, been undisturbed. And it
would have been well if no part of it had fallen
on other ears than theirs. But Kenneth, after
having spent some time with Gordon, at the lat-
ter's urgent request left him in order to rejoin
the company in the room below. As he ap-
proached the door of the parlor in the lower
hall -way he heard the voices of his mother and
brother within. Something in their tones which
seemed to betray unusual excitement led him to
quicken his steps, and he was almost across the
threshold when he heard from his brother's lips
words which went to his heart like a knife:
'' Helene is mine, and no man on earth slutU take
her from me!**
Almost stunned by the sudden blow which
these words conveyed, he checked himself, and
for a moment listened. There came from his
mother no word of explanation or of remon-
strance. A sense of faintness came over him,
and fearing lest he should be noticed, and his
agitation observed, he slowly withdrew, partially
supporting himself along the wall, and made his
way to his own room, which was not far dis-
tant.
Austin and his mother, unconscious of the
silent scene which had been enacted so near by,
for a long time remained too deeply moved to
speak.
Finally, raising himself slightly, Austin re-
turned the caress which accompanied his
mother's last words, and said, in a husky voice :
"0, mother, there is nothing you can say to
comfort me ! Were it anyone else in the world,
I would contest the prize, and let her heart de-
cide between him and me. But I will not take
the chance of wrecking my brother's happiness
in a blind attempt to assure my own ! "
Mrs. Hardy did not reply. She only shed
tears of sympathy for her suffering boy.
"Mother, I am calmer now," said Austin.
"Tell me about it."
" The story is soon told," replied his mother.
" Kenneth has always been very fond of Helene,
and on his return from Paris for his first sum-
mer vacatioBi he told her his hopes ; but she,
without an absolute negative, deferred her
answer. The next year the subject was re-
opened, but she seemed more reluctant than
before. Last spring, however, having finished
his course and returned home permanently, he
won from her a consenting answer. This oc-
curred shortly before your father's illness, and
amidst the many events which followed little
has been said on the subject.
" Once, only, Kenneth let fall a remark which
led me to suspect that he might have some mis-
givings in his mind. I was not certain, and
may have inferred too much, but I took pains
to say what I could to allay any apprehensions
that he may have felt.
" Helene, it is true, gave reluctant consent,
and for a long time was unusually reserved. I
myself did not understand it at first, but, on
consideration, I have become convinced that it
was due to the promptings of her own sensitive
nature. Knowing the peculiar position which
she occupies in our family, and knowing that
Kenneth's association with her is the result of
what she considers to be kindness on the part of
your father and myself, she feared lest he should
make a mistake which would some day cause
them both deep and permanent regret.
" Helene is, I think, just beginning to out-
grow this feeling, though I am satisfied that she
has all the time been sure of her own heart ;
while Kenneth, more impatient than she, and
with no such motive for restraint, shows plainly
that it is the one thought of his life. He asked
that he might be the first to inform you on your
arrival, and it is for this reason that the subject
has not been mentioned before."
After this long recital Austin was silent for
several minutes. Finally he said, more calmly :
"Mother, Kenneth must never know my feel-
ings."
" No, he never shall," replied Mrs. Hardy.
" And in order that he may not, I must leave
here immediately."
Mrs. Hardy did not speak. Her emotion ex-
pressed itself in a sudden look of alarm.
" It will not be for long, mother," said Aus-
tin, understanding the cause of her anxiety.
" Sooner or later I must have returned to the
Cape, and now it is best that I should go at
once.
>>
"0, no, Austin, you will not leave me so soon,
after all these years of absence?"
"I mmt go, mother! I could not endure the
trial which every day and hour would bring.
But you should not grieve, for I shall soon re-
turn and, away from here, make a new home for
you and myself."
366
THE MEDICAL ERA.
[Vol. VI. No. W.
Being partially reassured by these words,
Mrs. Hardy clasped Austin's hand in both her
own, and said :
** You will surely come back to me soon?''
**Yes, very soon," repeated Austin. **But
meanwhile, mother," he continued, ** you must
hasten this marriage, for it must take place be-
fore my return."
**But this sudden departure? No one will
understand! What can I say?"
"Leave that to me," he replied. ** I will ex-
plain it as best I can."
At Austin's request his mother obtained for
him pen and ink from a cabinet near at hand.
Seating himself at the table, he endorsed his
name on a paper which he took from a book in
his pocket. This he handed to his mother.
** There is a draft for two thousand pounds.
Give it to Kenneth — not on his wedding-day,
but as soon as I am gone."
Mrs. Hardy took the narrow ^trip of paper
with trembling fingers.
" Tell him," added Austin, " that I said he
must devote it to that object on which his life is
bent."
After a long conversation which followed, the
mother and son bade each other good-night, and
parted, she to carry with her all the burden of
a son's grief, as only a mother can.
From the time when, with tireless patience
and tender words, she soothes her weeping child
and kisses his wounded finger, to the day when
the bearded man, yet still " her boy," comes
with wounded heart, a mother lives again in her
children. No sacrifice is too great for her love,
no cry is too faint for her ear, and though in
time of trouble all else fail, there is safe refuge
in a mother's love !
But only those who have ever felt that sense
of utter desolation, who have known what it is
to be bowed down with despair, can measure the
grief of him who suffered ! If it were not that
added endurance comes with increase of sorrow,
he would have sunk under his heavy burden of
grief.
For a long time Austin sat motionless, his
head bowed upon his arm, which rested on the
table. Once, only, he raised himself wearily,
took up the picture which lay upon the table
and returned it to his pocket, as though the bur-
den which he must bear for years could thus be
lightly buried.
A
CHAPTER VII.
A COMPLETE SURRENDER.
USTIN had no sooner restored the picture
to his pocket, and again bowed his head
across the threshold of the room and took a po-
sition on the carpet. This foot was soon fol-
lowed by another, and above them both arose
the body and form of a man, who, for a few
moments, silently contemplated the bowed fig-
ure before him.
Finally — feeling another presence in the
room — Austin slowly raised his head, and, as
though not comprehending its meaning, said
dejectedly :
"WeU, sir?"
**I have come," said the figure, "to give you
an opportunity to state, as briefly as possible,
the nature of your business with me."
Austin drew his hand across his eyes, and
looked again at the man who stood before
him.
**0, it is you, is it?" said he, slowly.
** I repeat, sir," said the figure, ** that I have
come in order that you may state, as briefly as
possible, the nature of your business with
me.
Gradually the light returned to Austin's eyes.
He now leaned slightly forward, and said, more
earnestly :
** The brevity of our interview, Mr. Arnold,
is to be determined more by yourself than by
me.
" I do not so consider it."
" I have already informed you that my only
desire is that you should restore to the child of
Horace Crane the property which is hers."
Arnold made no reply.
**Have you nothing to say?" asked Austin.
•* My only answer is, that I do not recognize
your authority to call me to account in any
matter whatsoever."
** Is that final?"
**Itis — except that I will consent to state,
for your information, that I have no knowledge
of any such property as that of which you
speak. And that ends it ! " said he, moving
toward the door.
** Not yet ! " said Austin, with a gesture of
restraint.
Taking from his vest-pocket a ring, he ex-
tended it to the other's view.
** Perhaps you will let this convince you that
I am right ! "
Philip Arnold was not sufficiently master of
himself to restrain a slight start at the sight of
this. But the exclamation which involuntarily
rose to his lips was changed to a hiss as it
passed his teeth, while, instead of speaking, he
curled his lips into a smile, and vainly tried to
assume an air of indifference:
Austin was quick to detect every change of
feature.
Dscm 1888.]
HASCHISCH.
367
Arnold was silent.
" You compel me," continued Austin, ** to
repeat the entire story connected with this ring,
the main features of which will not be strange
to your ears.'*
Still the other was silent.
'*You will speak, I think, when I tell you
that , four months ago, at the Eencliff Diamond
Mine, South Africa, the breaking of a piece of
machinery wounded several men, one of whom,
John Temple, died in my arms. When he
knew that he had but a few hours to live, he
told me that a lawyer, named Philip Arnold, in
settling the affairs of Horace Crane, deceased,
conceived the idea of robbing the estate of a
large number of valuable bonds. But in order
to accomplish this it was necessary for him to
gain the co-operation of one John Temple, a
former clerk of Crane's, and the only one be-
sides himself who had definite knowledge of
their existence.
"This he succeeded in doing, and the two
divided the spoils on the solemn agreement that
each should secrete his portion for a period of
five years, when, it was thought, they might be
brought forth and converted without danger of
exciting suspicion. This was done, and, as a
pledge of mutual good faith, two rings were
made and worn.
"This ring which I have in my hand," said
Austin, holding it to his eyes for a moment,
and then again directing his gaze at Arnold,
'* has a curious setting. It consists of a mot-
tled blue stone — one-half of a broken pebble.
There is but one other ring in* the world which
is the exact counterpart of this one — whose
settling will fit to this as a sea-sheU fits its mate
— and that ring is now on the first finger of
your left hand ! " concluded Austin, pointing in
that direction.
"That is false — it is false as hell!" cried
Arnold, now throwing oflF all restraint.
"If you are an innocent man you will permit
me to put your ring to the test," said Austin,
extending toward Arnold the ring which he held
in his own hand.
" You have no right to make any such re-
quest, sir ! "
"And do you decline to grant it?"
"Most emphatically! " replied Arnold, again
moving toward the door.
" Stop ! " cried Austin, quickly. " I make a
final demand. Will you take that pen and
write, stating where those papers may be
found?"
" Never! " replied Arnold, thus surprised in-
to betraying himself in his answer, while his
eyes flashed fire and his lips were tightly com-
pressed.
"As you please," said Austin, coolly, moving
to a part of the room which cut off the other's
retreat by the door, and reaching toward a but-
ton in the wall, the pressing of which would
summon an attendant from the office. "John
Temple, before revealing to me the hiding-place
of his share of the spoils, extracted from me a
promise that I would take no measures to have
you punished, providing you would do likewise.
But, on your refusal, I am left to pursue what-
ever course I choose. I have in my possession
sufficient evidence on which to have you arrested
this night and held for trial. Defy me, and I
shall turn you over to the authorities in less than
five minutes. Do as I demand, and, on my
promise to a dying man, you go free. Which
shall it be?"
If Philip Arnold was a villain, he was no fool
— except as all villains are fools. With folded
arms and contracted brows he stood motionless
for some minutes, seeming to gaze into vacan-
cy.
Possessed of an amount of shrewdness and
cunning which honest men are never called
upon to employ, when dealing with honest men,
his very shrewdness taught him how far he
could go in his daring schemes, while his cun-
ning helped him to disarm suspicion when its
continuance might involve him in deeper danger.
He knew, too, well enough, that the man with
whom he now had to deal was determined, cour-
ageous, and not to be turned from his purpose
by any wiles which he might employ.
For these reasons, and, it may be, for others,
Arnold yielded with a readiness and grace which
astonished even the man who knew that he had
put him on the defensive and driven him to ex-
tremities.
" You might as well have the bonds," said
he, suddenly looking up.
"Very well! " said Austin, with equal readi-
ness. " Now take that paper and write these
words :
" Valuable papers, the rightful property of Alice
Crane, only child of Horace Crane, deceased, may
be found "
Arnold seated himself at the table and wrote
rapidly, at Austin's dictation.
" Now finish it, and sign," said Austin.
Arnold wrote a few words more, and then
handed the paper to Austin, without a twitch
868
THE MEDICAL ERA.
(Vol. VI. No. VL
of his fingers or a movement of the muscles of
his face. Austin read :
*** in Cape Town Cemetery, buried in her
father* 8 coffin,*
" I see ! '* he exclaimed. " The night before
the funeral you secreted them in the metallic
casket which contained the body ? "
" That is not hard to guess ! ** said Arnold,
bitterly.
" No," repeated Austin, looking at him as an
intending purchaser might view a horse, ** that
is not hard to guess ! "
" And now I presume that you are content?"
said Arnold, rising.
** Not yet!" replied Austin, quickly. **I
have no means of knowing that those papers
are still in the place designated. I learn that
it is announced that at any moment you may
set out for the Cape? "
**WeU?"
<' On the next steamer I shall start for there
myself; nothing is more natural than that we
should travel in company. When that property
is finally in my possession, you may consider
this affair settled."
" You are over-particular ! " said Arnold,
testily. " It is true, however, that I am about
to leave New York, and if you choose to take
passage by the same boat I know of nothing to
prevent."
"Very well! On that understanding we will
now part," said Austin, waving his hand as
though in dismissal.
Arnold left the room without a word, while
Austin seated himself at the table which a few
moments before the other had occupied, and
taking from his pocket a small memorandum-
book, he spent some time writing in its
pages.
Finally he arose, turned out the gas, and
sought his own room through the dimly-lighted
halls and stair- ways.
rin order to devote all the pages of the Era to articles on medicine,
it 18 decided to discontinue the publication of '* HaBchisrh^^ with this
isfine. We apprehend that few will be diiMtppointed. In cane there
should be any such, we make the following offer: On receipt of 25
centH the complete work, handsomely printed and bound, will be ^nt
to all who mav order it. This price —which is one-half that charged
by the publishers, Brcntano Bros., New York — is obtained onlv by
special arrangement, and is bare cost to us, while the postage is bo
much extra expense, which we will bear.
I^est some evil-minded persons may accuse as of having begun the
publication of ** Hasi'hiscD^Mvith this end in view, we wish at the
present time to enter ii plea of " Not guilty.** It was our original In-
tention to continue its publication until completed, but considerins:
that this would require nalf-a-dozen of the Bra^s pages each month
for a year tn come, we have concluded to devote the space to its legit-
imate object — articles on the science and practice of medicine. We
trust that this course will be satisfactory to all concerned.— Ed.]
SELECTIONS.
Suppuration.
Suppuration justly claims a high interest for
us. Pus, it appears, is only formed in the pres-
ence of certain minute organisms, but more re-
cent research makes it probable that not the
organisms themselves but their products —
ptomaines — are the agents which bring about
suppuration in the tissues. In the absence of
ptomaines, it would appear that pyogenic micro-
organisms are incapable of exciting suppura-
tion. — Dr, Atkinson,
Pregnancy and Operative Surgery.
1. Pregnancy is a physiological condition
and does not contra-indicate a surgical opera-
tion.
2. During pregnancy temporary strain may
be exerted on some organ, 6.^.,.kidney, inducing
impairment of function.
3. A surgical operation upon a pregnant
woman is to be conducted so as to avoid induc-
ing abortion, in itself a serious accident.
4. The main cause of abortion after opera-
tion is sepsis.
5. The probability of sepsis after operation
is increased if the patient is suffering from dis-
ease, either temporary or chronic.
6. Abortion may result from operation —
shock, perhaps. — Dr. Cheever,
OleaniDg the Hands.
Dr. Yagel Eisleben says that he has noticed
that coppersmiths, tinsmiths, etc., whose hands
become covered with dirt from working in oxides
and acids, which cannot be removed by ordin-
ary means, first rub their hands with warm oil,
and then, when this has thoroughly penetrated,
with powdered borax. Subsequent washing
with soap and water makes the hands perfectly
clean. He advises those who have to use car-
bolic acid to go through the process above des-
cribed first, and claims that in this way (1) dis-
infection is more thorough; (2) the hands are
made purer than it is possible to make them by
soap alone ; (3) the hands remain soft and free
from rough epidermic scales, and the odor of
carbolic acid^s destroyed ; (4) the uncomfortable
anaesthesia of the hands, after washing with
carbolic acid, is avoided. — Dmg Cir, — CUmcal
Reporter.
Die, 1888.1
SELECTIONS.
369
The Nature of Fever.
The word fever is often used as if it only
meant a rise of temperature above the normal,
while clinical experience shows that there may
be an increased metabolism without a rise of
temperature. The temperature of the body de-
pends on the relation of the heat production to
the heat dissipation. In fever there is a gen-
eral increase of metabolism, but this increased
waste is often accompanied by a lower temper-
ature, the heat production being masked by the
increased heat dissipation. In advanced ty-
phoid not infrequently a sudden fall of temper-
ature is seen. This is no sign, however, that
heat has ceased to be produced; it is much
more probable that it has been rapidly thrown
off. If by fever is meant an alteration of tissue
metabolism, we may have fever with high or
with low temperature. — Dr. //. C Wood,
Treatment of Ectopic Gestation.
1. In every form of ectopic gestation,* prior to
the fourth month, the destruction of life by
electricity (Faradic current).
2. Between the fourth and sixth months, de-
struction of life by electricity, and some weeks
later laparotomy.
3. In rupture, immediute laparotomy, with
removal of sac, contents, and the effused blood.
4. In cases that have passed the sixth month,
wait until viability is well established, and per-
form laparotomy, observing every precaution
that separation of the placenta does not occur ;
close the sac above, or down through the vagi-
na.
5. In case of death of foetus, it should be re-
moved by laparotomy a few weeks later.
6. Where the foetus has become macerated
and abscess has formed, its sinus should be en-
larged, and the foetal residuum removed. — I>t.
Dandridge.
The Causes of Infectious Diseases.
Consider for a moment the immense progress
which has been made during the last few years
in our knowledge of the causation of infectious
diseases, those most terrible scourges of man-
kind. Who could have foreseen that the little
vegetable organisms which were studied over
fifty years ago so minutely by Bhrenberg were
destined to become so important to the physician
and surgeon. Among them to-day we recognize
the specific causes of tuberculosis, of leprosy, of
Asiatic cholera, of typhoid fever, of relapsing
fever, of malaria, of erysipelas, of traumatic in-
fections, and of a number of other diseases of
human beings and of animals. Even the chem-
ical substances by the production of which these
microscopic organisms poison the system have
in some instances been isolated in a crystalline
form. Some time ago a work on lock-jaw was
introduced by the legend, Causa dbscara^ vis no-
tissima est. To-day we can say that there is no
disease the cause of which is better understood,
for we know not only the living germ which pro-
duces traumatic tetanus, but also the habitat of
this germ and the chemical substance by the
production of which its destructive agency is
effected.— Pro/. Wm. H. Welch.
Menstrual Bleeding from a Laparotomy Scar.
At a recent meeting of the Kiey Obstetrical
and Gynecological Society, Prof. George E.Bein,
showed a menstruating woman from whom he
had about three years before removed a cyst of
the right ovary, weighing thirty-seven pounds,
fixing the pedicle in the abdominal wound.
The patient soon recovered and . the wound
healed, but at one part of the scar there
remained a diminutive slough, which fell off
just before the beginning of menstruation, its
separation being followed by a constant flow of
blood from the denuded surface during the
whole catamenial period. The phenomenon had
regularly recurred monthly ever since. As a
rule, the scar begins to bleed somewhat earlier
than the uterine flow makes its appearance.
The menstrual blood from the cicatrix has a
characteristic odor. It is difficult to explain
such an occurrence. Possibly a Fallopian tube
or one of the uterine-comua had been stitched
together with the pedicle into the abdominal
wound. However, Prof. Rein hopes soon to
ascertain the nature of this interesting and rare
case^ since the patient must undergo a second
laparotomy for disease of the left ovary. —
British Med. Jour. — Med. Reg.
Alcohol in the Treatment of Tetanus.
In practice, I have found that alcoholic stupe-
faction answered a two-fold purpose, being much
better in its effects than opiates and anaesthetics,
besides being much more permanent than either,
and, at the same time, stimulating the circula-
tion and calling up the adipose reserves until a
sufficient quantity of the most nutritious ele-
ments of food could be brought to bear upon the
case.
870
THE MEDICAL ERA.
[Vol. VI. No. 12.
To be successful, alcohol must be given early
in the attack, and in a quantity sufficient to
produce sound sleep. It should be continued as
the patient rouses from his lethargy, and from
that time on until the paroxysms are subdued.
At a late period in the disease, it will be found
next to impossible to produce such an impression
upon the system of the patient. In a very
marked case, of a male adult of large size, I
gave in a half-hour after the attack eight ounces
of good brandy, producing profound sleep within
a half-hour ; and I gave repeated smaller doses
as often as he awakened — using one quart, or
thirty-two ounces, in the first twenty-four hours,
with a gradual reduction of the force of the
spasm. I followed this with a similar quantity
during the next twenty-four hours, when the
spasms entirely subsided. I then allowed my
patient to return to consciousness, and, with
milk-punch, beef-essence, strong barley-water,
and oatmeal gruel, the patient was restored to
health and vigor.
I will here add, that in this case no other
remedies were used or required. — Dr. Leake, in
Med. Register.
A New Method of Treating Abacesses.
As soon as I am satisfied that pus has formed,
I plunge into the cavity a large-size aspirating
needle and attach it to an Allen surgical pump,
and by turning the crank, remove all that is
possible of the contents of the sac. I then take
a 20 volume solution of Peroxide of hydrogen.
To this I add an equal volume of water and, by
reversing the motion of the handle of the pump,
without withdrawing the needle, I inject the
cavity till it is moderately distended only. Al-
most immediately I find that the distension be-
comes greater and greater until I am satisfied
that the medicament has reached every nook
and comer. Then I simply turn the pressure
off from the rolls of the instrument at the back
of the pump, the accumulated gas which has
been given off rushes out through the tube,
carrying with it a considerable quantity of
debris. I tighten the rolls again and, continu-
ing the motion of the instiiiment in the same
direction, I extract every particle that is left,
and repeat the procedure as before. At the
second washing with the Peroxide I notice that I
do not get nearly so much distention,and when the
screw at the back is loosened for the second time
but little of the gas and fluid comes away. After
this comes off I am sure that I have a perfectly
clean cavity. Now I take the solution of bichlor-
ide, Ito 2,500, and again inject and withdraw two
or three times. I am confident that I have a
perfect aseptic cavity. At this stage the needle
is removed, and I place over the whole integu-
ment overlying the abscess a smooth, even pad
of iodoform gauze. I bind it firmly and neatly
in place by an abundance of bichloride gauze
bandage.
This dressing I invariably leave in place from
four to ten days, when I always find a complete
closure of the cavity, perfect adhesion of its
waUs, and not a trace of the abscess left. The
patients are simply delighted that no knife is
used, and but very little pain produced, no
after-dressings required, no salves, solutions or
ointments, no washings or daily dressings. —
Dr. Wile, in Jour. Am. Med. Assoc.
The Relatioxi of Albuxuinuria to Life Insaranee.
No system of life insurance is perfect which
does not include those who are apparently
healthy and those who are not. Certain appli-
cants presenting themselves for examination for
life insurance are wrongfully rejected, because of
the presence of albumin in the urine. Of the
various terms used to indicate the particular
form of albuminuria under consideration, I
give a decided preference to the term " func-
tional." Two illustrative cases, which I con-
sider " safe risks " for life insurance companies,
I will mention. One of the histories is that of
a young man, who has been under the observa-
tion of many physicians, among them Dr.
Stewart, of Edinburg, the various observations
extending over several years. The other a less
favorable family history and an older man
In both there was final disappearance of al-
bumin.
I believe that there are certain conditions which,
if observed by competent and skilful examiners
(if it were always possible to get such), would
enable the companies to save these risks. These
conditions are: 1. The applicant must in all
other respects present the signs of good health.
2. The albuminuria must be unaccompanied by
tube-casts, however perfect may be the health
in other respects ; albumin and tube-casts con-
joined always meaning structural changes. 3.
The specific gravity of the urine, that is the
*< real " specific gravity (that of the quantity for
the twenty-four hours), should not be lower than
1.015-1.025. Great care must be taken to
secure the "real" specific gravity, as it would
be unfair to reject the candidate on account of
the specific gravity of a single specimen. 4.
The signs of hypertrophy of the left ventricle,
and the existence of high vascular tension as-
Dbo., 1888.]
SELECTIONS.
371
Bociated with albumin, would exclude the candi-
date. 5. The age of the applicant is a highly
important consideration. It is doubtful whether
any person forty years of age with functional
albuminuria should be accepted, unless at least
he has been long under the observation of a
competent and conscientious examiner. 6. The
presence of true gout in any case should decide
against the person, because gout is always,
sooner or later, followed by interstitial nephritis.
FinaUy, retinal changes such as are associated
with nephritis, should exclude the applicant.
In conclusion, I do not claim, of course, that
we are in a position to put these conditions in
operation, but I believe, as we are enabled grad-
ually to secure the desired education and train-
ing in medical examiners, the applications of
these conditions will be possible. The absence
of the albumin from the urine passed on rising
in the morning is an important aid in the diag-
nosis of functional albuminuria, but not an es-
sential one. — Dr, Janies R, Tyson, in Medical
Record.
Carundes and Vascular Tumors of the Urethra.
Among the many affections of women that
the busy practitioner is called upon to treat,
there is one special lesion that is particularly
distressing, and requires no little skill and ex-
perience to successfully manage. The affection
that we refer to is caruncles of the urethra. If
a female coiuplains to her medical attendant
that she has cutting pains during micturition,
that continue to be even more intense after
urinating, it is the duty of the practitioner to
examine carefully into the special particulars of
the case. We have seen in our practice females
thus affected with what they defined as "stran-
gury," who had suffered for a long time, and
had been attended by practitioners for months
without relief, and upon inquiry from the pa-
tients, they stated that no physical examination
was ever made as to their exact condition. A
practitioner when he is attending a female
should always try to find out just what is the
matter, or his therapeutics may not be fol-
lowed by any good result.
At the mouth of the urethra, or a few lines
back of the orifice within the canal, most usu-
ally upon its floor, these vascular proliferations
have their seat, being made up of inflamed cap-
illaries and bundles of distended blood vessels
in connective tissue. These vessels at the ori-
fice and within the urethra, being overfiJiled with
blood and inflamed, have been compared to
rectal hemorrhoids, and the similarity certainly
holds good. These vascular growths proliferate
and enlarge, and with time become more and
more sensitive, and through reflex irritation
derange the general health of the victim, affect-
ing more especially the nervous system. When
a practitioner is called to such a case, and finds
upon examination the appearance of a vascu-
larity, caused by inflamed vessels at the meatus
or within the urethra, if the pain from them is
unbearable, he can at once make up his mind
that he has something troublesome to deal with.
To relieve the pain will call forth all the
resources of his art, and to effect a cure of them
they must be removed by excising them with
small scissors, or destroying them by a potential
cautery. These tumors occur usually among
married women who have borne children, but
this rule has exceptions. We have met with
cases in young women where vascular excres-
cences come after an attack of severe and pro-
tracted gonorrhoea, as a result of urethritis, and
the possibility of such a cause it is well to bear
in mind. These tumors are called by authors
neoplasms, and classified as papillary, polypoid
and angiomas. Some of them that are exceed-
ingly painful appear as small points, varying in
size from a coffee-bean to a tumor as large as a
small chestnut, in some cases even larger.
They are single or multiple, and in one case
that we have treated, they extended back in the
urethra for more than one inch. Although
apparently insignificant, they are attended with
more pain and distress than almost anything
else that the physician is ever called to treat.
TreatmerU. — As a preliminary to treatment,
the physician should carefully examine the
meatus and dilate the urethra, to find out just
where the pain seems to be located. Experience
seems to show that the pain may come from a
small point or tubercle upon the edge of the
orifice or within the urethra.
We may find upon examination just within
the urethra, what seems to be a little tumor the
size of a flaxseed or coffee-bean, made up of
blood vessels, constitutiirg a vascular enlarge-
ment, and at this point there is great sensitive-
ness and pain. Urethral caruncles are exceed-
ingly difficult to isolate, and it is recommended
that the patient be placed upon her back, with
her limbs supported in a gynapod or leg-
braces; but in the absence of this practical
apparatus, place her in the left semiprone posi-
tion of Sims. Now apply a 10 per cent solution
of Cocaine by saturating a piece of cotton with
the Cocaine, which insert against the meatus and
within the urethra. Next dilate the vagina
372
THE MEDICAL ERA.
[Vol* VI. No. ^SL
with Bozeman's Bpeculum, which instrument of
all others is the best for this operation. Next
comes the dilatation of the urethra, and for this
purpose we have tried a variety of urethral
specula, but the ingenious practitioner can
select two long hair pins and bend them at right-
angles, and use them as retractors for the
urethra, and they are about as satisfactory as
any of the expensive specula recommended by
gynecologists. Those practitioners who have
the nasal speculum of Frankel, can utilize it as
a urethral speculum and dilator, and it will be
found to be quite handy for this purpose. With
a good assistant to hold the wire retractors, or
by the use of the Frankel nasal speculum with-
out an assistant, the surgeon can excise the
caruncles, or apply either Paquelin's cautery, or
the galvano-cautery, as he may decide. In our
experience we have found Paquelin's cautery
quite as good, and more practical, than the
expensive galvano-cautery. To dilate the
female urethra satisfactorily, requires no little
skill and experience, and to see the exact situ-
ation of the carunculflB or vascular points, will
require a good light, and in the absence of that,
the electric illuminating lamp will be found very
useful, so that the exact locality of the carimcles
can be determined.
Removing these tumors by excision or cauter-
ization is usually effectual, but occasionally they
are very refractory, and the operation must be
repeated. No treatment is successful until the
neoplasms are completely destroyed. After the
application of the cautery, apply a little Iodo-
form dusted over the seat of the lesion, and
cover the meatus with borated cotton. A case
in point of this kind we treated recently, in a
widow, at. 34, who had been troubled some nine
months, and was complaining of great suffering
when urinating. Upon examination, a vascular
tumoc was diagnosticated, situated at the
meatus, and its ramifications extended up the
urethra four lines or more, and was the cause
of her distress, which had seriously affected her
general health, as she began to have symptoms
of chronic hysteria. She had lost in weight,
had no appetite, was anaemic, and had fever
that was intermitting, and which she insisted
upon as being ** malaria.**
For this state of things (already lasting nine
months), she had been taking tonics and ner-
vines, had used locally Cocaine, Laudanum,
Witch hazel, etc., as ordered by her physician,
who had never made any physical examination
of the patient. I treated this case by excising
the vascular tumor, then applied Carbolic acid,
and dressed it with Iodoform. Great relief fol-
lowed this treatment, but some pain was stiU
felt during urination, and a complete cure had
not yet been effected. As the patient had a
great- fear of any thermal-cautery, and would
not allow me to use it, I next touched the meat-
us with glacial acetic acid, and immediately
after with fuming nitric acid, and then dusted it
with Iodoform. Notwithstanding this she stated
to me that she felt at times as if she was being
** pierced with sharp wires," after urinating. I
then made an application of a solution of
chromic acid, (grs. 100 to the ounce of water),
but after this treatment some twinges of pain
would be still felt at times. As the sensitive-
ness at the meatus was so persistent I finally
succeeded in inducing her to allow me to try
Paquelin's thermo-cautery. I should have pre-
viously stated that these caruncles are fre-
quently so sensitive that they cannot be exam-
ined without giving great pain, and for this
reason I always apply a 10 per cent solution of
Cocaine to them before I introduce a urethral
speculum, and this usually greatly mitigates the
pain, so that the suffering from the operation
(whether we excise them or cauterize them) is
greatly alleviated. In this case, I resolved to
touch the remains of what was the caruncle
with Paquelin's caustic, and I did it, and entirely
destroyed the roots of the growth, and then
dusted it with what we call in Vienna, **^gwifa
ciiba,'' which is the classical synonym for Mer-
curius dulcis, or dd Calomel.
After this treatment she had no mdre pain,
but her general condition of neurosis and anae-
mic hysteria required appropriate treatment,
viz., Ferrum phosph., Cimicifuga, Zincum
phosph., etc., and the cure was terminated by
sending her to the Rockbridge Alum Springs in
Virginia, where, after a sojourn of some three
months, her health was perfectly restored. Re-
currence of the local difficulty is not infrequent
in these cases, and such patients require to be
under the observation of the physician for a
year at least. Two other cases that I treated
where the growth was not very much developed,
I cured by the application at first of tinct. Thuja
occidentalis, and afterwards of Chromic acid
solution. In each case I repeated the Chromic
acid application some three different times. Af-
ter excising these caruncles or applying the po-
tential caustic to them, I dust them with either
" Aquila alba " or Iodoform, and if there is much
soreness left, I apply tinct. Benzoin comp.(Friar's
balsam).
Regarding the consequences of vascular
growths, I have already stated tl\at they occa-
sion so much distress, that the women thus af-
Bbo., 1888.1
SELECTIONS.
878
flicted are, to say the least, hysterical. The
pains that they set up during and after micturi-
tion, produce great reflex disturbances. In one
instance that I observed in the case of an old
lady, (Bt, seventy years, who had several carun-
cles within the urethra, she would manifest such
symptoms of irritation, from the severity of the
pains, that I was seriously fearful that she
might lose her reason and require to be sent to a
retreat. After excising the tumors (they were
small and multiple), she soon made a complete
recovery, and all of her nervous and mental dis-
turbances subsided. These vascular neoplasms
are said by authors to have caused epileptic
paroxysms, paraplegia, vaginismus, and reflex
difficulties in the rectum.
Remwie of Treatment. — It has been stated that
Thuja occidentalis tinct. given internally . and
applied locally has cured these diflSculties. I
have seen the good effects of Thuja in condylo-
mata, and it was supposed that it would be
equally effective in caruncles, but I have not
proved this clinically ; still, I think it may be
valuable in such cases. Hahnemann recom-
mended Thuja for condylomata, more than fifty
years ago ; and we notice in recent foreign, as
well as home medical journals, that its virtues
in this respect have been rediscovered, and are
just becoming known.
Other Local Remedial Agents. — Glacial acetic
acid. Chromic acid. Carbolic acid. Iodoform, Nitric
acid, Nitrate of silver. Friar's balsam. Oil of
witch hazel, and Cocaine, are all beneficial, and
may be selected as required.
Removal by Excision ami Cauterization. — When-
ever these little tumors can be well seen in the
speculum, it is best to seize them with a tenac-
ulum, and excise them by means of small scis-
sors, and finish by touching them with Carbolic
acid. In some cases there will be troublesome
bleeding after they have been excised, but such
an accident is rare if Cocaine has been applied
just before operating, as the Cocaine contracts
all the tissues, and in our experience greatly
lessens the tendency to hemorrhage. Exceptions
may occur, as we have found in one case ; and
it is well to be prepared for such an accident,
and have within reach a solution of the Per-
chloride of iron as a hemostatic to staunch the
hemorrhage, if it should happen to be trouble-
some.
The general condition of the patient must be
looked after, and if symptoms of anaemia be
present, proper constitutional remedies must be
given. The urine should be examined, and if
anything abnormal is found, the proper treat-
ment for this condition is to be given. I have
heard of one case where glycosuria was a com-
plication, and possibly a cause of a vascular ex-
crescence, as the patient was reported to have
suffered for a long time with itching meatus,
and after frequent and repeated scratching, a
vascular growth appeared.
Itching of the genitals, as is well known, is
frequently a sequence of sugar in the urine. —
Dr. T, Griswold Comstocky in Medical Summary.
The Doctor RESPONSiBiiE. — A prominent busi-
ness man of Kansas City, Mr. C. E. Bennett,
brought suit for divorce to-day against his wife,
a leading society woman, alleging that she has
become an habitual drunkard and has been ex-
pelled from Scott's Sanitarium, the St. James
Hotel, and other public places, for drunkenness.
Mrs. Bennett acknowledges the truth of the
charges, and says that she contracted the love
for liquor by taking it at first as a medicine, pre-
scribed by her physician.
Singular Suit Against a Doctor. — Dr. Sam-
uel C. Vanderpoele, Jr., a popular New York phy-
sician, has a singular lawsuit on his hands. Two
weeks ago he diagnosed the illness of a little
daughter of Charles Dawson, of Syracuse, N. Y.,
who was spending some time with his family at
the Larkins House, Watch Hill, L. I., as scarlet
fever. Mr. Larkins, the proprietor, relying on
the diagnosis of another physician, denied that
the child was suffering from the disease, and
the Dawson family remained at the hotel. The
other guests, hearing of Dr. Vanderpoele's diag-
nosis, left the place. Mr. Larkins immediately
brought suit in Ehode Island against Dr. Van-
derpoele for $12,000 damages. Dr. Vanderpoele
says that his diagnosis was correct, and that he
has been sustained by the board of health of
Westerly, L. I., and some prominent physicians.
Dr. Vanderpoele intends fighting the suit to the
bitter end. He says he was subjected to great
personal inconvenience by the action of Mr. Lar-
kins, who, as soon as he brought the suit, had
an order issued for Dr. Vanderpoele's arrest.
The sheriff arrived at the Watch Hill House^ a
rival establishment, where the physician was
staying, and proceeded to execute the order. Bail
was fixed at a large figure, but several of the
cottagers offered at once to go on the doctor's
bond. The sheriff, however, Dr. Vanderpoele
says, made paltry objections to each of them,
and stated that he intended to lock the doctor
up, but satisfactory bail was finally furnished.
Dr. Vanderpoele declares he will in turn sue the
hotel man for damages.
374
THE MEDICAL ERA.
[Vol. VI. No. 13.
COLLEGE NEWS.
NEW YORK.
HOM(EOPATHIG MEDICAL COLLEOE AND HOSPITAL.
In a recent lecture on materia medica, by
Prof. Allen, he called the attention of the stu-
dents to the valuable properties of Arsenic in
controlling the night- sweats of phthisis.
While Mercury is valuable, perhaps, as a
prophylactic in syphilis, it bears little relation
to the disease, as a rule, and cases are rare
that it cures ; possibly it may be applicable to
some forms of ulcers, and to the pains in the
extremities at night, but these pains are much
more frequently indicated in Asafoetida.
In comparing Asafoetida in this connection
with Stillingia, he gives the differential features
to be that in Asafoetida the pains are located in
some particular spot, such as the tibia, or the
skull ; while in Stillingia the pains are found
shooting through the whole course of the limbs.
Prof. Allen also asked the students to make
note of the fact, that whereas he had for years
taught that lodum was a left-sided remedy in
affections of the upper lobes of the lung, his
more recent observations had led him to be-
lieve that it is as useful on the right side as
upon the left, provided the other indications for
the drug are present.
In speaking of the despondency and melan-
cholia with suicidal intent of Aurum, as given in
the materia medica, he says that it does not
really apply to cases of suicidal mania, but that
its sphere of usefulness is in cases of syphilis
where patients threaten suicide, but never com-
mit it, and that real suicidal mania is more
often cured by Arsenic.
Prof. Moffat gives the key-note for Stramo-
nium in spasmodic asthma to be the shrill, high-
pitched voice.
He also recommends Ranunculus bulbosus in
very appreciable doses of the tincture as being
valuable in cases of delirium tremens.
BOSTON.
UNIVERSITY SCHOOL OF MEDICINE.
Sciatic pains occurring night after night and
not relieved by the usual remedies, may some-
times be cured by cupping over the course of the
nerve.
Sleep and rest may be given to a raving man-
iac by placing a roller towel wrung out of mus-
tard and water, around the abdomen, and cover-
ing with a flannel, thus relieving brain pressnre.
This will relieve when Chloral, Morphine and
other medicines will not.
In treatment of ringworm an application of
Gantharides will often effect a cure after other
methods have failed, but hay fever has been
known to follow the suppression of the ring-
worm.
In the treatment of epilepsy a powder of Cal-
oarea phos. or Calcarea carb. every night is very
beneficial, also Cuprum acet. 6x, when there
is fine subsultus, especially at the wrist. Epi-
lepsy is as incurable as cancer, although cures
of each have been reported. The epileptic can
be steered and in a great measure be controlled,
and life made more endurable by the right use
of the Bromides, which as yet have no substi-
tutes.
A key-note for the use of Lachesis in diph-
theria is the beginning of the attack with violent
neuralgic pains in the side of the head.
In diphtheria a spray of glycerin and water
in proportion of one to seven is one of the best
agents for arresting decomposition, and is very
grateful to the patient. — Dr. J. Heber Smith.
High temperature in child-bed, continuing for
10 or 15 days, between 101" and 103°; the
patient is weak, but has no pain or tenderness
on pressure ; lochia is normal and there are no
tangible signs on which to base a diagnosis of
any local trouble. What is the cause ? There
may be a point of inflammation situated any-
where in the system, as in the lung, liver, etc.,
which at this time may become active and through
the changes which occur in the blood-supply
after the birth of the child, continue for some
time, although an elevation of temperature
may occur at any time from trivial causes, such
as constipation, errors of diet, mental emotion,
and we should not attribute a continuous high
temperature to these conditions. — Dr. Walter
Wesselhceft.
CHICAGO.
CHICAGO HOMCEOPATHIC COLLEOE.
Prof. Buffum says : Aconite is usually sup-
posed to be indicated only in acute conditions,
but it will be found a very valuable remedy in
the treatment of chronic granulation of the eye-
lids.
In treating injuries of the eye, especially if
the conjunctiva is destroyed, there should l>e,
during the first twenty-four hours, a constant
application of cold, either by means of crushed
ice or ice-water, in order to reduce the inflam-
matory process to a minimum.
Dbc, 1888.]
COLLEGE NEWS.
875
In post-diphtheritic paralysis of the ciliary
muscle, causing loss of power of accommoda-
tion, Gelsemium rarely fails to effect a cure.
An eye containing a foreign body which has
destroyed sight, should be removed, since it
will sooner or later result in the destruction of
the other eye unless this is done.
Prof. Foster, in speaking of the disorders of
pregnancy, says: The pregnant woman may
eat anything that she desires which the stomach
does not reject. That food is best for the in-
dividual which the stomach craves and will re-
tain, providing experience does not contra-indi-
cate it.
Galcarea phos. is almost an infallible remedy
for excessive accumulation of gas in the stom-
ach.
Constipation during pregnancy is very diffi-
cult to manage. The best results are obtained
by proper diet. It cannot be cured by the use
of purgative drugs.
There is a species of Mexican cactus the juice
of which is called pulque, and used by the
natives as a beverage. This is of rare value in
the albuminuria of pregnancy, and will, if used
freely, promptly, decidedly, and continuously,
reduce the quantity of albumin in the urine. It
is a food rather than a medicine, and will be
found highly nutritious as well as medicinal in
its effect.
Prof. J. S. Mitchell : Phthisis is sometimes
preceded by a long season of hoarseness ; there-
fore, always be on your guard in any case of
chronic hoarseness that you may be called upon
to treat.
For the hypertrophic form of chronic laryn-
gitis, Arsenicum is the remedy where there is
burning dryness of the mucous membrane,
fetid expectorations, and a disposition to irrita-
bility. Hepar sulphur, if there is a lumpy sen-
sation with tickling, and the expectoration is
thick, profuse, muco-purulent, or even bloody.
Hepar sulphur has really a specific affinity
for the larynx, and is to be thought of in chronic
affections of that organ. In case of singers,
whose voices have become impaired by the
thickening of the vocal cords, and the secretion
of tough, stringy mucus, the use of Hepar will
be attended with the happiest results. You
may confidently tell your patient that it will
not only relieve the catarrhal condition, but
that the voice will actually be improved, so as
to be capable of a greater range than before.
You should be elastic in your treatment. If
you feel sure that you have selected the proper
remedy, and still your patient does not improve
as you expected, change the potency, and in the
majority of cases, the result will be gratifying
both to yourself and to your patient.
Prof. Knoll: In treating ulcerative sinuses,
such as fistula in ano, it is usually best to slit
it up with a bistoury, remove all ulcerated tissue,
stitch the edges of the wound together, and you
will, in the majority of cases, obtain union by
first intention.
There is nothing that is so effective in cur-
ing goitre as a reliable preparation of Iodide of
lime.
Prof. Delamater: In the treatment of epi-
lepsy, you should obtain a full and complete his-
tory of your patient, carefully noting every
symptom, then select a drug which covers more
than 75 percent of the symptoms presented,
and administer it for three or four months.
During this time you may have occasion to
change the potency, but stick to your remedy.
IOWA CITY.
STATE UNIVERSITY.
Prof. Cowperthwaite says: One dram of
Cantharis to one pint of bay rum makes an ex-
cellent wash for the head when there are scales
on the scalp and enormous quantities of dand-
ruff.
No remedy equals Sepia for chronic leucor-
rhoea.
Ammonium carb. should be used oftener to
break up a cold where there is acrid coryza
during the day and the nose stopped up at
night.
Antimonium tart, is of great benefit in mem-
branous croup. Two grains of the crude drug
in a glass of water, a teaspoonful given at fre-
quent intervals for several doses, is followed by
great improvement. This is also the remedy in
hepatization of the lungs.
Prof. C. reports a case of fibroid tumor of the
uterus cured by the internal administration of
Ustilago and Secale.
CHICAQO.
HAHNEMANN MEDICAL GOLLEOE.
Prof. Ludlam says : A large share of ovarian
troubles date back to an attack of the mumps.
Alumina is most often called for in constipa-
tion accompanying right-sided ovaritis ; Collin-
sonia if with left-sided.
Lacerations of the cervix often exist for
years without serious results, but if left until
the climacteric the chances are forty to one
that the woman will have cancer.
876
THE MEDICAL ERA.
[Vol. VI. No. 12.
In corrosive ulceration of the cervix if Cal-
carea carb. and Hydrastis do not stimulate
healthy granulation, the chances are one hun-
dred to one that the trouble is either cancerous
or syphilitic.
If the urea in twenty-four hours amounts to
180 grs., and there is any abdominal involve-
ment, it is very certain to be cancerous.
In cases of prolapsus ani Prof. Leavitt rec-
ommends . that ' the seat for the passage of the
stool should be elevated, and in very severe
cases the patient should be in a recumbent posi-
tion.
Prof. Amulphy says: The pathology of the
coronary arteries is the pathology of angina-
pectoris and fatty degeneration.
Prof. Bailey says: The tendency of the cervix
to bleed if touched with the soimd, is often the
forerunner of cancerous growths. In cases of
daily hemorrhage he recommends the applica-
tion of vinegar as a styptic.
He says that at the present time the work of
the gynecologist and neurologist go side by
side, as the functional disturbances are so close-
ly dependent upon neurotic conditions.
Prof. Vilas says that Chinese silk is best for
eye operations ; that water containing an excess
of lime should not be applied to the eyes, but
that by the addition of an equal quantity of
milk it may be rendered suitable for use, as
the lactic acid unites with the lime-salts to form
the insoluble lactate of lime.
Prof. Hawkes says that in scarlet fever, when
the symptoms seem to call for Belladonna, but
Belladonna does not relieve, Baptisia often cures,
especially if the throat is darker than the char-
acteristic Belladonna throat.
Prof. Amulphy says that mistakes are often
made in locating the ribs and intercostal spaces
by number, but if it is remembered that the
ridge of the sternum is opposite the second rib,
this mistake can always be avoided.
Prof. Crawford says that a typhoid patient
well nursed is half cured.
In diabetes, if the burning extends downward,
look out for diarrhoea, and Arsenicum is the
remedy.
If the patient is so weak that he can scarcely
stand, but does not feel his weakness while sit-
ting or lying, Arsenicum is indicated.
ST. Loxns.
HOMCEOPATHIC MEDICAL COLLEGE.
Prof. Schott says : In the artificial feeding of
infants do not use brown sugar to sweeten the
milk whey, as it will produce thrush ; neither
will " A " sugar answer. The best to use is the
prescription sugar-of-milk, 110-120 grs. to the
pint of whey, or about half the quantity of loaf
sugar.
Tears, as a rule, are not secreted until the
third month. If there is a cessation of the
flow of tears in a violent disturbance of the
system, it would be an unfavorable symptom,
and favorable on the reappearance of lachryma-
tion.
Prof. Beed says: In tonsilitis, Belladonna
has been given ; now that pus has formed give
Hepar sulph. ; later, we have the throat filled
up, threatening suffocation, rune give Mercurius
V. or sol., and your case is cured. This is not
to be a routine treatment. These three rem-
edies follow each other in the order given, and
you know the symptoms calling for their exhibi-
tion.
Belladonna may be indicated in the initial
stage of typhoid fever — high, raging fever,
coming on with great suddenness ; abdomen dis-
tended, throbbing carotids, hot skin, fairly
burning the hands, from which skin a steam
arises. The last objective symptom belongs to
Belladonna alone.
Prof. Campbell's treatment of blepharitis
marginalis is both local and constitutional ; at
times constitutional only. The first is scrupu-
hits cleanliness ; then, to protect the eyes from
the air, and to soften and remove the scabs he
uses the following :
H.Pulv. Boracis, - - grs. ii. to iv. ;
Petrol, albi. - - - ,?i.
M. ft. ungt. ; sig., on lid edges once or
twice daily.
In bad cases, with raw edges pencil
with —
^, Arg. nit. - - grs. ii. to iv ;
Aqua destil. - - - fl5i.
M.ft. sol.
And then apply this ointment —
U . Hydrag. ox. flav. - gr. ii. to iv ;
Petrolati albi, - - - ,?i.
M. ft. ungt. ; sig., on lid edges once or
twice daily.
In the internal treatment one of these rem-
edies will probably be indicated : Ai)is, Argen-
tum nit., Arsenicum alb., Calcarea, Graphites,
Hepar sulph., Mercurius, Pulsatilla, Staphy-
sagria, Silicea, Sulphur, Thuja.
To protect the eyes from the light, use the
smoked glasses. If the blepharitis has been
caused by an optical anomaly, that must be
corrected by the use of proper glasses.
Prof. Luyties says : In the application of an
ice-bag to the head, move it about frequently in
order to prevent freezing of the parts.
DbC, 186R.]
WORTH KNOWING.
377
WORTH KNOWING.
In the human species one great fact is lost
sight of too frequently. It is, tiuit the teeth once
bniU ttj), are biiilt up forever ! Therefore, it fol-
lows that it is vise to attend to the original
building. — T>r. Thayer, in Med, Counselor,
Absinthe, the favorite intoxicant of the
French, is almost always manufactured with
alcohols of industry, ill-rectified, rendered green
by the addition of the sulphate of copper, and
saturated with resin, so as to give it the beauti-
ful greenish-white precipitate produced by pour-
ing water on it, and which drinkers so much
admire.
The lesion of exophthalmic goitre Benedikt
places in the medulla oblongata, Eichorst in the
grand sympathetic and Filehne in the restiform
body, while Charcot considers it as a general
neurosis allied to hysteria, and others believe it
to be specially related to chlorosis or anaemia.
Its whereabouts is uncertain.
Treatment of Gonorrhcea with Iodoform.—
Dr. Paul Thiery recommends injections of finely
powdered iodoform suspended in sweet-almond
oil in gonorrhoea. He cites six cases which were
cured in less than two weeks with about seven-
teen injections. Aside from its antiseptic prop-
erties, the injections of iodoform greatly relieved
the pain of the disease.
Professor Ranke, of Munich, said that when
he first went to that city, thirty years ago, ty-
phoid fever was of frequent occurrence, but with
the sanitary improvements which had since been
carried out, this disease had almost entirely
disappeared. On the other hand, diphtheria had
not been appreciably lessened, so that drainage
seemed to have no influence on this disease.
Erythrasma. — This name is applied to red-,
dish-brown scaly patches found on the inner
surface of the thigh, where the scrotum comes
in contact with it, and on the corresponding
surface of the scrotum. This affection seems
allied to intertrigo, but differs from it in that
inflammation is no necessary part of the dis-
ease, and also in the constant presence of para-
sitic fungi or bacteria.
At the onset of a papular eruption it is often
difficult to decide whether the case is one of
measles or of small-pox. The following method
is a certain means of determining by which of
these diseases the eruption is produced: If,
upon stretching a portion of the skin, the papulse
become impalpable to the touch, the eruption is
caused by measles ; if, on the contrary, the pa-
pulae are still felt when the skin is drawn out,
the eruption is the result of small-pox.
Koch has shown, in his studies of the com-
ma-bacillus of cholera, that they are destroyed
by the lactic acid of the normal gastric juice,
and that it is when the activity of this physio-
logical safeguard is interfered with or destroyed,
that the bacilli pass unharmed into the intes-
tines, to multiply and produce the characteristic
disturbance there. The effect of lactic acid upon
these microbes, suggests the acids as a class of
germicides, the study of which promises inform-
ation of the most practical value. — Medical News.
Praritns Ani. — Much has been written of
late concerning the treatment of pruritis ani. I
desire to add my own suggestion. The best
remedy I have ever found is the galvanic cur-
rent. The quantity required need not exceed
five milliamperes ; the time of application, five
minutes. The relief is immediate, and the ap-
plication once or twice daily is quickly curative.
The anode is placed over the perineum or base
of the scrotum and the cathode against the
sphincter ani, or, if required, within its grasp,
bringing all the pruritic surfaces between the
poles. — Dr, Sittton, in M. and S, Reporter.
The Earliest Symptoms of Inherited Syphi-
lis. — Attention is particularly called to fissures
of the lip, especially the upper lip. Parrot re-
gards such as unmistakable signs of hereditary
syphilis. It certainly forms a very frequent and
early manifestation. The very earliest fissures
on the upper lip are generally two, placed sym-
metrically on either side of the central portion.
Relatively nearer are fissures on the lower lip.
When such do occur there is usually only one,
and that in the centre of the lip ; but afterward
others may occur, and uniting, form ulcers.
They are very painful, difficult to heal, and leave
white scars, which are very persistent.
In the diagnosis of simulated diseases in
children, attention should be given to two points :
The physician should be on his guard whenever
the little patient's tale of his illness is too mo-
notonous. One who is really ill tells a different
story from day to day, his pain and his feelings
being modified by passing circumstances. The
malingerer, on the other hand, has his story
learned by heart, and repeats it always without
any modifications. Another thing that should
excite suspicion in the physician's mind is the
long duration of the simulated malady, and a
want of proportion between the physical signs
and the degree of pain or discomfort of which
the child complains.
378
THE MEDICAL ERA.
[Vol. VL Na 12.
Bergmann has shown that abscess of the
brain has but one result — death, and that the
surgeon's knife offers the only relief. So far as
we know, there is no such thing as idiopathic
abscess of the brain; it is always the result of
some external wound of the head, or some ex-
tension from diseased surrounding bone. The
only exceptions to this statement are to be found
in the case of pyaemia or tuberculous abscess. —
lyr. Parks.
Haman teeth begin to form in the dental
groove as early as the sixth week of gestation,
and they keep on forming for the next twenty
years. These growing, forming teeth should he fed
in the mother, child, youth and nian ! Why teeth
are strong and able to resist decay is because of
the liberal deposit of the lime-salts in and
amidst the interstices of the tooth protoplasma.
No man can build himself a house without stone,
brick, cement, mortar, iron, wood and materials
that enter into such construction. Neither can
one build up good and serviceable teeth without
material things, the inorganic salts, out of
which to build with. — Dr, lluiyer, in Med,
Counselor.
Remarkable Success with Tetanus.— In a
paper read before the British Medical Associa-
tion, Dr. Meldon, of Dublin, invited the mem-
bers to test a plan of treatment which in his
hands has been singularly successful, and he
placed on record the results of treatment with
different drugs in 937 acute cases collected by
him. In his first case, twenty years ago, he di-
vided the nerve with only temporary relief,
since which time he had tried in succession
Calabar bean, Indian hemp, curare, quinine, al-
cohol, and opium, with an invariably fatal result.
Some years since, he tried a combination of
hyoscyamus, belladonna, and conium, in a bad
case, which recovered under that method, and,
subsequently, several other cases, with satisfac-
tory results ; of seventeen cases, in which these
drugs were administered, he had thirteen recov-
eries and four deaths.
Influence of Attitude on the Pulse. — Ac-
cording as the vis a tergo changes in unison
with our position, the pulse rate varies, whether
we sit, stand or lie down. Such at least is the
case in health. The knowledge of this fact is of
practical value in the examination for life insur-
ance. Any emotion, especially in nervous per-
sons, will at once increase the frequency of the
pulse, and to determine whether in a candidate
for life insurance the frequency of the pulse is
due to a transient cause or to disease, all that
the physician has to do is to let the applicant
lie down for a few minutes, when the pulse will
at once become slower and assume its normal
rate, provided there is no lesion of any kind pro-
ducing the increased frequency, for then the
pulse will remain the same as when standing.
Hypertrophy of the heart induces greater rapid-
ity, not influenced by position.
The cause of death in hyperpyrexia is claimed
to be as follows : Dr. H. Vincent, of Paris, re-
views the various theories hitherto offered, and
shows that they are all equally untenable, and
then proposes one of his own, which seems to
him to be more reasonable and more in accord
with the known facts. He has studied carefully
the various symptoms, on the part of the circu-
lation, the secretions, the respiration, etc., pre-
sented by those dying of hyperpyrexia, and also
the lesions found post-moi-tem, and concludes
that death is due to an auto-intoxication caused
by an accumulation in the blood of various
waste products. The excessive temperature
causes increased waste of the tissues, and also
interferes with the speedy elimination of the
poisonous products resulting therefrom. The
poisons accumulate in the blood and act upon
the central nervous system, more especially
upon the respiratory centres. Death results,
therefore, from an arrest of the respiratory
functions.
Suppuration is rare in gouty subjects.
When ulceration of the skin follows the forma-
tion of tophi on the fingers or external ear, the
process is a dry one, and not attended with the
formation of pus. In patients of a gouty diathe-
sis, who have commencing pulmonary phthisis,
the author has also observed that expectoration
is very scanty or absent, showing that there is
little or no pus-formation. It would seem,
therefore, that urates and uric acid are antago-
nistic to the pyogenic micro-organisms. Now,
ordinarily, when the tubercular bacillus attacks
the organs of an individual, it opens the way
for the microbes of suppuration, which crowd
into the open door, and establish the suppura-
tive process which saps the life of the individual.
It is to this pus-formation that a great part of
the evil effects of the tubercular process is to be
attributed, and if this is prevented, as it is in
gouty patients, the tubercular bacillus has to
struggle for an existence, and is not potent for
harm. Such is the explanation offered by M.
Molliere, of Lyons, of the immunity from tuber-
cular troubles enjoyed by gouty subjects. It is
ingenious, and, as far as it goes, satisfactory.
DKr., 1888.1
TRANSLA TIONS.
379
TRANSLATIONS.
Translated expressly for The Medical Era by Albert B Plek and
P. Prttchard, Boston.
Bluish-blaek colorations of the skin from
gun-powder may be removed by washing the
skin with a wash of ammonium bihydrojodicum
and aqua destillata (equal parts). The red
spots left by this wash may be removed by di-
luted hydrochloric acid. — Zeitschr. fur Tlierapie.
lodoform-coUodion has a better action on
the human skin than the tincture of iodine.
The following is the formula :
li. CoUod. elastic - - - 10.0.
Iodoform, - - - i.o.
The collodion is especially elastic and effica-
cious if to 100 parts of collodion 2 parts of cas-
tor oil be added. — Monatsheftefur prakt. Dermatol.
On the Technlqae of Ergotin-Injections.—
According to Dr. Engelmann, the disagreeable
symptoms sometimes seen as an accompani-
ment of ergotin injections (contrary to Bumm*s
view), may be avoided by using a pure ergotin.
The solution of ergotin decomposes, in spite of
any antiseptic which may be added, in the
course of a few hours. Therefore, it must be
prepared shortly before the injection. Then the
procedure is entirely painless, whatever con-
centration may be used. — Dr. Engelmann,
Schmidt's JahHmcher.
Palpation of the Vterns and the Ovaries.—
In order to make the uterus and ovaries acces-
sible in difficult cases, UUmann adds a new
method to those of Simon. The bladder is
emptied and a colpeurynter is introduced into
the rectum ; then, with one hand pressing upon
the abdomen, and with the finger of the other
hand placed in the vagina, the hand upon the
abdomen presses the uterus, together with its
appendages, which have been placed in a posi-
tion of increased flexion, anteriorly by the col-
peurynter, towards the finger in the vagina.
Thus one may succeed in palpating the anterior
and the posterior surfaces of the uterus as well
as its ligaments and the ovaries with great ac-
curacy. — Dr. UUmann, Vienna, Schmidt's Jahr-
Imcher.
Birth of Triplets. — The case in question
was that of a multipara in her third confine-
ment. At her first confinement she was deliv-
ered of a well- developed pair of twins; then
followed an abortion at two months. Of the
triplets one was extracted in the breech position,
the second in the cranial position by Kristeller's
method. Both foetuses, a boy and girl, were
well developed and had been carried through the
full period of gestation; the third foetus was
bom with the membranes intact, and in the
place of liquor amnii there were only two spoon-
fuls of a slimy fluid. This foetus was very bad-
ly developed ; it was a female, small and atro-
phied, and died on the third day. The faulty
development of the third foetua is traced by the
writer to the extremely small amount, res-
pectively, to the concentration, of the liquor
amnii, and he claims to see in his observation
a confirmation of Ott's view, that the liquor am-
nii serves exclusively for the nutrition of the
child, while the umbilical cord and placenta
only act as respiratory organs. — Dr. Y. Balin,
Odessa; Cent. Gynack.
Photogr»phin|?the Eye.— In order to pho-
tograph the eye the so-called ** flash-powder,"
invented by Goedicke & Miethe, of Berlin, con-
sisting of magnesium and saltpeter, is used;
according to Cohn the amount which may be
held upon the point of the smallest knife, is suf-
ficient. This is to be held at a distance of SO-
TO mm. from the eye, which, without smoke or
dazzling, is sufficient to produce enough light for
momentarily photographing the eye. The light
is developed so quickly that the pupil has no time
to contract. Therefore, one is able to measure
exactly the width of the pupil in the dark.
Until now this method was used to get an exact
picture of pupillary membranes and colobomata
of the iris. Cohn found the breadth of the pupil
in the dark 8 to 9 mm. ; and Du Bois-Reymond
10 mm., with the breadth of the cornea 13 mm.
It is yet undecided whether by this manner one
may be able also to correctly photograph the pos-
terior portion of the eye, the papilla of the optic
nerve, etc. — Du Bois-Heymond, in Schmidt's
Jahrhucher, Aug. 1888.
The Induction of Premature Labor.
There are three methods of inducing prema-
ture labor, viz. : By medicines acting through
the general system, such as ergot ; sympathetic
methods, such as irritating the breasts; and
methods applied directly to the uterus, such as
galvanism. Tampons to the cervix are useful
in placenta praevia ; hot- water injections to the
vagina, but they are uncertain; tents and
Barnes' bags, good ; injection of water between
the membrane and the uterus; but the best
method is the introduction of an elastic bougie
which is left in the uterus. — Dr. Stanton.
380
THE MEDICAL ERA.
[Vol. VI. No. «.
OPINIONS EXPRESSED.
SURGICAL NOTES.
It is a great mistake to be men of one method,
especially in surgery. — J>r, Arthur Durliam.
There are few dermatologists who do not
admit the identity of lupus and tuberculosis. —
Dr. Heuntzinan,
In my opinion the nearest we can come to a
definition of insanity, is that it is a diseased
. condition of the brain, which to a certain extent
impairs the intellect and the will. — Dr, J. C.
Markoe.
The power and quality of the voice depends
not so much on the trembling of the vocal cords
as on the sympathetic vibration of the air in the
resonance chambers above and below the larynx.
— Dr, Martin.
I think caruncles of the urethra to be of
great clinical importance, and if other practi-
tioners have the same trouble that I formerly
had to cure them, they will welcome a remedy.
— Dr. Coimtock.
I understand ^* materia medica ^' to embrace
all the substances that are known to produce
deleterious effects upon the human organism,
and which by virtue of these effects may be ap-
plied to the cure of disease. — Dr. T. F. Allen.
A subject demanding careful attention is the
inability of mothers to nurse their children.
The number of such defective mothers reaches
the enormous per cent of forty with us ; much of
this is due to faulty methods of dress and life. —
Dr. W. H. Tayhr.
In those diseases in which the specific cause
has been isolated, cultivated outside of the hu-
man body, and in which the injection of this
culture produces identical lesions, we have posi-
tive proof that the disease is due to specific
germs. — Dr. N. Senn.
I can no more accept the alcohols as food
than I can either chloroform or ether, or methyl-
al. That they produce a temporary excite-
ment is true; but, as their general action is
quickly to reduce animal heat, I cannot see how
they can supply animal force. I see clearly
how they reduce animal power, and can show a
reason for using them in order to stop physical
pain or to stupefy mental pain ; but that they
give strength — i. e., that they support materi-
al for construction of fine tissue or throw force
into tissues supplied by other material — must
be an error as solemn as it is wide-spread. —
Dr. B. W. Richardson.
A careful search of current medical litera-
ture reveals but four cases of surgical interfer-
ence in perforating typhoid ulcer, in all of which
a fatal result occurred. — Dr. BM.
Fifty per cent of cases of nasal disease
operated on have same temperature. Erysipe-
las is comparatively common after operations
in nasal cavities. — Dr. Rice.
The researches of Senn have shown that
complete extirpation of -the pancreas is invari-
ably followed by death, while partial excision
is a feasible operation. — Dr. BtM.
In most of my cases of intubation where the
patient survived I found it necessary to resort
to tracheotomy ; patients have recovered after
tracheotomy where intubation has proved un-
successful. — Dr. Mudd.
Many abscesses, four out of five, occurring
within a year or two after delivery, are due to
salpingitis or ovaritis, and our best proof is from
those who have opened the abdomen. — Dr.
Wylie.
Ulcers of the leg are usually first poulticed
if sloughy, and, when clean, a dry powder dress-
ing of bismuth, boracic acid, iodoform or calomel
is used under the bandage from the toes up,
with elevation of the affected extremity. Should
granulations be protuberant, they are strapped
with the ordinary basket-strapping of surgeon's-
plaster.
Sutures. — After abundant trial and compar-
ison, the conclusion is arrived at by Gerster
that, as a rule, the interrupted suture is in
every way preferable to the continuous one.
The chief advantage claimed for the continuous
suture — namely, the saving of time — is illu-
sory. As regards safety in holding, and exacti-
tude of adaptation, the interrupted suture has
no peer.
Spread of Abscesses. — Gerster states very
pertinently that the notion that the law of grav-
ity alone regulates the spread of abscesses is an
erroneous one, as it is w^ell known that many
forms of suppuration extend in a diametrically
opposite direction to the force of gravity. The
local spread is prescribed by the direction of the
loose connective-tissue planes separating and
connecting the different organs, and is mainly
influenced by hydrostatic law. Perforation
always takes place where resistance is the
least.
Dbo., 1888.3
DIE TE TICS— RECIPES.
381
DIETETICS.
USEFUL RECIPES.
When you giye condensed milk for any
length of time to a child, it is apt to become
rickety. — Dr. Jacobi.
80 far as known at present; the milk of tuber-
culous cows is free from tubercle-bacilli unless
there exists tubercular disease of the udder.
Well cooked food is of great importance to
the aged; it should be simple and easily
digested. — Dr. Loomis.
People talk of using the milk of one cow in
order to have an unvarying quality. Why, the
woman's own milk itself varies every day and
every hour. — Dr. Fowler.
When persons speak of the amount of meat
used in the preparation of the beef tea given to a
certain person who has joined the majority,
they do not know What pernicious nonsense they
are talking — pernicious because misleading.
The food value of the beef tea depends upon
what is added to it. — FothergiU.
A pint of warm water taken on an empty
stomach in the morning, is the safest and surest
of all remedies for habitual constipation. It
dissolves the fecal matter and stimulates peris-
taltic action, thereby giving a normal action
without pain. If the tongue is coated, squeeze
a lemon into the water and drink without sweet-
ening.
An excessive meat diet will sometimes bring
on hypochondriasis, and in this condition the
ordinary rules for nervous invalids are to be
changed. Hypochondriacs must be fed largely
upon vegetable food, which distends the colon
and causes it to empty itself. When hypochon-
driasis is brought on by a meat diet, it is cured
by porridge and green vegetables.
It is a mistake to suppose that because milk
is a liquid food it is at the same time a drink
which is capable of satisfying the thirst of
infants. Although milk appeases hunger, it
makes thirst more intense after it has remained
some time in the stomach and digestion of it
has begun. It is thirst which causes healthy,
breast-nourished infants to cry for long periods
of time in many instances. There are many
cases of indigestion duet o weakness or insuffic-
iency of the child's gastric juice which would
be greatly benefited or even cured if the child
were allowed an occasional drink of water.
TTrticaria.
A mixture of chloroform and alcohol, equal
parts, applied locally, will quickly relieve almost
every case of urticaria.
The Best Parasiticide.
Lice and other parasites are removed from
the hair quicker and better by a decoction of
quassia, to which a little borax and glycerine
have been added, than by almost any other
known means.
Cracked Nipples.
Treat cracked nipples by covering the fissures
with India rubber or caoutchouc dissolved in
chloroform. This forms a pellicle which pro-
tects the nipples against the contact of the in-
fantile saliva.
To Sterilize Instruments.
Wash the instruments after use in cold water,
place them in a water-bath, boil them for five
minutes, wipe with a sterilized cloth, and place
away for use. No one disinfecting fluid will
destroy all microbes, but none can withstand a
temperature of 212^ F.
Preservation of Flowers.
Inclose the flowers, with a little burnt lime,
in a tube hermetically sealed. In a few days all
the oxygen of the air will have disappeared^ the
lime will take up some of the moisture of the
flowers and portions of the carbonic acid, so
that the plant soon exists in pure nitrogen.
To Preserve Brain Specimens.
A brain, or any part of it, is first hardened
by any of the current methods, such as chrome
salt solutions, alcohol, or chloride of zinc, then
dehydrated thoroughly in alcohol, and subse-
quently placed for three days in a saturated
solution of Japanese wax in chloroform. This
wax is a concrete oil obtained from a Japanese
tree. The specimen is then placed for three
days longer in melted Japanese wax, kept in a
molten state over a water-bath. It may then
be removed, drained, and allowed to dry. It
now suffers no change from exposure to the
atmosphere; and may be used for demonstration
of the coarser morphology, and perhaps even of
the finer. Some specimens presented had been
in service for two years.
882
THE MEDICAL ERA.
[Vol. VI. No. 11.
NEWS OF THE MONTH.
Two young women in Buffalo, who graduated
in medicine last spring, have bought out a drug-
store, and are successfully running it.
Worcester, Mass., Nov. 2. — Mrs. Frank A.
Degroot, of Milbury, gave birth to four girl
babies this afternoon. Mother and children
ajre all doing nicely, but the father is badly
broken up.
At the comer of Thirty-third and Laurel
streets, Chicago, Oct. 16, the police found in an
old clay pit, a soap-box containing the dead
bodies of five babies. It is supposed that some
midwife could, if she would, explain what is
now a mystery.
Pittsburg, Pa., Sept. 18. — A few weeks ago
Miss Ever Pemberthy, of Canton, 0., who is
wealthy and well educated, came to Pittsburg
to obtain practical knowledge as a nurse. While
in one of the hospitals here she witnessed a
surgical operation which affected her mind.
She continued to grow worse until to-day, when
she was sent home a raving maniac.
In a recent case the Supreme Court of Ohio
decided that the druggist is liable for negligence
in putting up medicines. In the case in dispute
the druggist was asked for '* oil of sweet
almonds," in place of which he carelessly gave
the **oil of bitter almonds." As a resiUt, the
person who took the oil died. Though his clerk
made the mistake, the court held the druggist
responsible. — Med, Register.
" A Correction. — The Boston Medical and Sur-
gical Journal, from which an extract was quoted
by The Medical Record bearing on the composition
of several artificial foods, publishes a correction
based upon the analyses of Professors Elwyn Wal-
ler and A. A. Breneman regarding Keed & Carn-
rick's soluble food, to the effect that 88.20 per
cent of the albuminoids which it contains are in
soluble form, that no ' hard unchanging particles of
casein ' were found, that the casein is partially ren-
dered soluble by the action of the digestive fer-
ment. That the proportion of albuminoids in
Liquid Peptonoids is limited only by the quantity
which can be kept unchanged in solution, that six-
teen per cent of alcohol is necessary to prevent
decomposition of the albuminoids, and that no
greater than three per cent of these can be held
in solution in this liquid. We publish the correc-
tion from the same source as the original quota-
tion as an act of justice to all concerned, regret-
ting that we, in common with our Boston contem-
porary, were in ' any manner misled by what
appeared to be a well -authenticated official report."
— The Medical Record, Oct 13, JHSS.
PEBSOVALS.
Dr. Albert Claypool, of Toledo, 0., has ad-
ded another succesful case of ovariotomy to his
list.
Dr. B. F. Bailey, of Lincoln, Neb., announces
the removal of his office to the S.-W. comer L
and 14th streets. •
Dr. C. S. Mack, formerly of Boston, has lo-
cated at the N.-W. comer 57th street and Lake
avenue, Hyde Park.
Mrs. Harrison, wife of Gen. Benjamin Harri-
son, of Indiana, during the residence of her
husband in Washington was one of the directors
of the National Homoeopathic Hospital, and is
an earnest friend of homceopathy.
** Dr.*' Thompson, the " Moxie '* man, will prob-
ably require a long course of his nerve medicine
A Boston woman whom he is alleged to have
slandered from motives of jealousy, has recov-
ered against him a verdict of $30,000 damages.
— Chicago Tribune.
Dr. Clifford Mitchell will contribute to the
pages of the Era a series of original articles on
the urine, based on the results of numerous ob-
servations, and illustrated by cases from prac-
tice. The first one of the series appears in the
present issue.
Dr. John C. King, of Banning, CaL, takes ex-
ceptions to Dr. Hale's strictures on the climate
of California. He sayB that the coast towns are
totally unfit for consumptives, being subject to
fogs and malaria, but the towns " on the eastern
slope, at altitudes of from 2,000 to 3,000 feet
enjoy the best climate in the world."
In January there will be issued from the press
of A. L. Chatterton & Co., New York, a new pub-
lication entitled The Journal of Ophthalmology,
Otology, and Laryngology. It will be edited by
Geo. S. Norton, M.D., assisted by Chas. Deady,
M.D. The editors have undertaken the work with
enthusiasm, and are determined to make the journal
of the highest practical value to all interested in the
eye, ear, or throat. To Bccomplish this the im-
mense mass of material found at the N. Y. Ophthal-
mological Hospital will be fully utilized, in addi-
tion to which there will be articles by prominent
authorities throughout the country. The journal
will be particularly devoted to original articles upon
the three specialties. This will probably be the
only journal in our school devoted to these sub-
jects, and special attention will be given to the
development of homoeopathic therapeutics and
the clinical verifications of old and new remedies.
The publication will appear quarterly, and consist
of about 400 pages at $3.00 per year. Those de-
siring full sets will do well to advise the publisher
at an early date.
Dbcm 1888.]
MISCELLANY.
883
Otis Clapp & Son have prepared their visiting
list and prescription record, which is as neat and
convenient as ever. It is ** perpetual " in ar-
rangement, and contains many new features.
The regular winter visits of the Chironian are
always received at this office with great pleas-
ure. It is a journal from which those who are
ripe in the profession may learn many useful
lessons.
A NEW alkaloid, oxypropylenediizoamylamine,
is said to induce epileptic fits. Would it not be
well to make a proving of its name on some
medical student, and thus establish its homoeo-
pathicity ?
Lactated Food has been so long in use by
the profession that its virtues have become well
known. Not only can it be used in the heat of
summer, but at all seasons when it is desired
to improve the nutrition.
There comes to our table a new candidate
for favor which is very appropriately named
Tlie Medical Student, published by the students
of the B. U. S. M., with H. Warren Johnson,
M.D. ('88), as managing editor. We give the
new journal a cordial welcome, and feel sure
that it will fulfill the promise made in its open-
ing editorial.
Physicians who change their locations, or who
know of removals, deaths, or changes of any
kind on the part of others, should send the intel-
ligence on a postal card to Dr. T. S. Hoyne, ed-
itor of the Medical Visito)-, in order that the list
which he publishes may be correct to date. It
is the best list in the United States, being cor-
rected monthly.
Literary Note. 728 is the record in num-
bers of the articles printed during 1888 in
the Archives of Gympcohxjif on the special sub-
jects of its title. It is the aim of the editors to
publish all current thought in these departments
of medical knowledge. The publishers, Leon-
ard & Co., 141 Broadway, New York, do not
send sample copies, but if you are not pleased
with the first number it may be returned and
the order erased. Subscription $3.00 per annum.
Payment is not asked till end of the year.
BUfiSCBIBB NOW.
New subscribers to The Medical Era are invited
to send in their names (accompanied by the
price of subscription) at as early a date as pos-
sible. Many have already responded, and ex-
pressed their opinions at the same time. The
general tenor of the remarks may be gathered
from the specimens which we give below :
Yours is a practical journal — just what I
want. — Dr. E. W. Boardman.
Having for the first time seen your journal, I
am so well pleased with it that I enclose price
of subscription. — Dr. A, N. Logan.
I am very much pleased with the Era. I
think it the best journal I have seen yet. Add
my name to your subscription list. — Dr. 0. A.
Bemis.
I enjoyed reading the Era very much — more
than any other journal I ever saw. I like its
snap and independence, and besides that it is
bright and newsy. Consider me a permanent
subscriber. — Dr. A. F. Goodrich.
Dr. Thompson Admits His 7oUy.
Boston, Mass., Oct. 30 — Dr. Thompson, of Lowell,
publicly admits his folly in his connection with the
actress, Mrs. Beale, who just secured $30 000 damiiKes
from him, but says he acted from the kiudness of his
hoart. — Chicago Tribune.
*' Diseases of the Kidneys, CiiixiCALiiY Gonsid-
BBED," Is the title of a new work by Dr. Clifford Mitch-
ell) now in press.
From Philadelphia comes the Medical Institute, very
mnch improved in appearance, and having quite the
character of an adult medical journal. It has our
best wishes for a long and prosperous future.
Scribner^a Magazine is the popular favorite. The
railroad articles have largely increased its circulation.
The November Century begins the thirty- seventh
volume and nineteenth year of the magazine ; and the
number is mad^ notable by the beginning of several
new series, or magazine *' features."
Dr. Charles H. Merz, the house physician to Univer-
sity Hospital at Cleveland, Ohio, Apri 126 th, 1887, said :
I have made use of Fapine for some time past, both in
hospital and private practice, and find it a most agi'ee-
able substitute for Morphine and Opium. It is the
anodyne par ejccellence.
The Seventh volume of Alden's Manifold Cyclopedia
is equal to those which have preceded. It well deserves
the praise which it receives on all hands, being the
best there is for popular use. The handy size of the
volumes recommends it. Send for specimen pages to
John B. Alden, Publisher, 393 Pearl street, N. Y., or
218 Clark street, Chicago.
Burlington Route.
Vestibule Trains. *• The Burlington's No. 1''
fast train, leaving Chicago at 1 P. M. daily for
Omaha, Lincoln, Cheyenne and Denver, and
arriving at Denver at 9 : 10 A. M. the next eve-
ning, is now a solid vestibule train for the en-
tire distance between Chicago and Denver.
The Burlington's ** Fast Trains " to Kansas
City, St. Paul and Minneapolis will also be ves-
tibule trains at an early date.
384
THE MEDICAL ERA.
(Vol,. VI. No. 13.
THEY SAY
That ci lost boy is a waif from home.
That the soul of pathology is etiology.
That Cork has a large floating population.
That bread riots are generally led by loafers.
That nothing can be aseptic unless it is clean.
That he who steals a doctor's purse steals trash.
That the tax-collector always comes in due time.
That conceit, like any other seat, must be sat
on.
That it's easy enough for a gunboat to shoot the
rapids.
That a sunstroke is insolation, and freezing is
iceolation.
That it's always the other fellow who sees the
sea-serpent.
That there is no kind of septic infection that is
nofc parasitic.
That things will become smoother if you do
your level best.
That the man who was stoned to death was
rocked to sleep.
That only one person in 10,000,000 who travels
by rail is killed.
That doctors often kill themselves in trying to
cure other people.
That the man with nasal catarrh says there's
always rheum at the top.
That a wink is as good as a written prescription
to an intelligent druggist.
That when a robin loses its mate, it takes a
birdsigh view of the case.
That in China there is a temple containing an
idol that weeps tears, idol tears.
That the doctors intend getting up a trust —
trust to luck to get their bills paid.
That after the Christians are fairly civilized, we
are in favor of attacking the heathen.
That people are always talking against the tele-
phone, and yet it's a very useful affair.
That a Danish newspaper is called Hamlet be-
cause it is one of the prints of Denmark.
That the Sultan of Morocco discharged forty of
his cooks because they spoiled the broth.
That there's many a slip 'twixt the cup and the
lip, so it's safer to drink out of the bottle.
That in Boston the neck of the chicken is called
Napoleon — it's the bony- part, you know.
That the man who invented alcohol died nine
hundred years ago, but his spirit still lives.
That there are few dermatologists who do not
admit the identity of lupus and tuberculosis.
That we are liable to make mistakes, but it's
always the other fellow who makes blunders.
That "cat-gut" ligatures are not made of the
gut of the cat at all, but from sheep's intestines.
That a man at the college wants to know if rais-
ing the tariff on wool will affect the price of flan-
nel cakes.
That when you are burned out, you generally
get the insurance, but when you are fired out —
good bye!
That a book on the diseases of convalescence
would be one of the most valuable that a physician
could write.
That in China physicians receive about six
cents a visit The Chinese know pretty well what
a thing is worth.
That in sixty- three per cent of cases in which
pregnant women are attacked with typhoid fever,
abortion follows.
That mares matched with zebras will subse-
quently, when mated with horses, produce colts
which are striped.
That two rival undertakers got into a row at
a funeral the other day, but finally decided to
bury their differences.
That a Connecticut man spent forty years try-
ing to invent a compressible head, then gave it up
and in two days invented an elastic hat.
That there is a Sioux Indian in Dakota whose
name is Big-Head. What a splendid professor he
would make for one of our medical colleges!
That the first stage of labor is under the influ-
ence of the sympathetic, while the second stage is
under the influence of the eerebro- spinal system.
That the teeth of the present generation are
more fragile, and more subject to decay than the
teeth of those who composed the population fifty
years ago.
That the clothing of patients suffering fron*
scarlet fever, folded up and put away in drawers
without disinfection, can retain their dangerous
properties for years.
That a woman in Michigan went to sleep with a
big water-melon rind tied over her face to improve'
her complexion; a burglar who entered her room
and saw her, fainted away, and was picked up
next morning in a dying condition.
llBy<h^
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