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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( 
&( 
(( 
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« 

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i( 

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u 
a 

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« 



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 m