lates to their sensory fibres or rather the organ or part to which they are distributed in a highly disturbed and sensitive condition. This, of course, would presuppose the primary disturbance of nutrition to be located within the posterior columns of the cord, but such reasoning is by no means more difficult to explain than anemia or congestion of any other part or organ of the body and is far from phenomenal. However, to suppose that the nerve connection of spinal origin will explain all the observed disturbance in a given case of neurasthenia is likewise impossible and vague in expression. Does a tonsillar inflammation carry with it a full explanation of a case of rheumatism? And yet we believe in such connection.

Motor disturbance is also frequently associated with these cases. In some there are strong tonic contractions of the muscles of the lower extremities, and in others very great weakness or complete paralysis. In some there are occasional clonic spasms simulating chorea. Again, many, of the phenomena of spinal irritation point strongly to the secondary involvement of the sympathetic system. It is thus that the visceral disturbances which form such prominent features are mainly to be explained. While much more of an interesting character might be said along this very fruitful line of research, suffice it to say that in conclusion and basing our opinion on the known facts of the symptoms and progress of a neurasthenic case, we see no serious reason in admitting the condition to be one of irritable spine and especially so where in the light of modern therapeutics we find that rest in bed and proper feeding to be one of the very best modes of treatment for the victims of this disease, whereby a physiologic balance, the all necessary governor to a well poised and properly functionating nervous system, is obtained.

Mifflinburg, Pa.

Strophanthus has been prescribed in several cases of goitre, ten drops of the tincture three times daily, with a rapid reduction in the size of the enlargement, and in

some cases a cure.

RATIONAL APHRODISIAC TREATMENT.

BY W. C. BUCKLEY, M. D.

INCE my first article on the subject of the use of alkaloids in cases of this kind, I have had several requests for a continuance of the paper, and though I am not prepared to speak in a way that the importance and nature of the subject demands, I may nevertheless say a few words. Recent experiment has proved that there remains no doubt that some forms of impotence are easily cured by the use of Yohimbin. It is true that there have been some failures but with more precise and extended observation it will soon become clear concerning which are the types of the complaint it may be expected to benefit, and which are those in which it is useless to prescribe this remedy.

Although Yohimbin has proved itself, in suitable cases, to be a reliable and rational aphrodisiac, free from all danger of creating any unpleasant after effects, it is not yet known whether it has any increasing effect upon the procreative power. Further trial may serve to prove this point. It is reasonable to suppose that it will stimulate the seminiferous tubules. Administration of the remedy in tablet form is most desirable. They are perfectly stable, the usual dose being from one to three (1-12 grain) tablets each day. (See Alk. Clinic Feb., 1903, p. 105. Surg. Clinic,May, 1902, p. 224.)

Dr. F. A. T., of Wisconsin, writes: "I am interested in the uterine tonic as presented by Dr. Abbott, of Chicago, Ill. "When giving the uterine tonic to prevent premature delivery do you give one pill every four hours when continued a long time, say for one or two months or more?" I answer that I usually give one every four or six hours no matter how long they are given. Their tonic effect on the nervous system is what we need in these cases.

"Would you give them in all pregnant women as a preparatory?" I would give them in all cases of this kind unless there is some contraindication to the use of the contained remedies, but this rarely occurs. Nearly all cases of pregnancy in which the

pill is given are made to terminate so easily and naturally that the doctor must look sharply or the nurse or some neighbor may be called to act the part of accoucheur in his stead.

"Would you give them every two hours after labor terminates?" I certainly would as long as the danger lasts and until the after-pains have ceased.

"How about a miscarriage?" In this case they are indicated every three or four hours for at least three or four days.

"Are they of value in 'change of life?"" Yes, par excellence. Give one every four hours at least. Alternate with one tablet of my uterine sedative, especially if flow is profuse. "Is sterility cured by the uterine tonic?" (B. U. T.) It often is, most certainly. I have had most remarkable results in these cases by the persistent use of this remedy aided by other general tonic treatment. Read the case reported by Dr. E. H. B. in the September number of the Surgical Clinic, 1902, page 1092. Dr. S. also asks the same question. Dr. T. wants to know, "What are the therapeutic properties and the physiological effect of macrotin?" Firstly, macrotin is not cimicifuga. They are both derived from cimicifuga racemosa or macrotys, but macrotin is the better for therapeutic purposes. It is a mild incitant to the nervous system, used successfully in headache of congestion the passive kind; also in rheumatic conditions, and as a uterine tonic. Strychnine increases the tonic effect. The dose of macrotin is one or two granules (gr. 1-6) every four or six hours; it may be repeated as often as required. Macrotin in doses of two grains has induced vertigo and dimness of vision and depression of the circulation.

Macrotin is an important remedy in the treatment of the inflammatory pelvic diseases of women which we meet in every day practice.

Combined with aconite or aconitine there is no remedy that will give quicker relief in cases in which sudden and abrupt suppression of the menses occur from cold. One granule of aconitine (1-500 gr.) with one granule of macrotin (1-6 gr.) every

half hour or hour is generally sufficient to bring on the flow in from four to eight hours. It is important to keep the body warm in order to favor perspiration. The same dose of aconitine, with one pill of the uterine tonic answers the same purpose and better even in more chronic cases, but should be given less frequently, that is from two to three hours until relieved, then less frequently until the desired effect has been obtained. In myalgia or socalled muscular rheumatism the "B. U. T." or the macrotin combined with aconitine in the same form may be successfully administered.

1705 N. 15th St., Philadelphia, Pa.

is a fair conductor when not too moist and is all right during cold weather worn over linen. The writer has begun to recommend linen underwear to his lung, rheumatic and catarrhal patient, advising the wearing of woolen over the linen during winter when the linen should be of heavy grade and the wool of a light weight. In this way of dressing we secure a double and invaluable protection from the elements, because the evaporation from the body's surface is readily eliminated through the porous linen and the wool on the outside allows the skin to breathe as well as affords protection from the outside atmosphere and dampness. In many cases a gauze shirt is sufficient to wear over the linen undershirt, while during the summer a very light weight of linen is preferable.

Tubercular and catarrhal cases do much better by wearing linen alone during the hot

months-light weight- and as soon as the cool nights and mornings begin in the autumn and spring, the writer recommends a light woolen protection over a light weight linen As soon as winter sets in the light weight linen should give way to heavy weight and a heavier woolen substituted for the lighter over-shirt.

It is not necessary for the writer to enter into an argument to prove that linen absorbs moisture much more readily than wool, neither is it necessary to more than intimate that wool should be worn on the outside of the linen to get the best possible protection. Our soldiers should have the benefit of linen underwear as soon as possible. Why they are not wearing linen underwear cannot be understood, while hundreds and thousands of physicians would not be without it. If it is good for the profession, it is good for the army. If it is a good thing to protect the body from the elements, and conducive to the health of you, my brother physician, who is exposed to all kinds of weather, can any one tell why our soldiers are without this great protection? The writer wants the army to have the benefits derived from linen underwear as soon as possible. But, some one says "its too expensive." Suppose it is expensive, is that a sensible reason why our army should be deprived of it? Is any thing too expensive or too good for our soldiers, that will add to their comfort, to their powers of endurance, or that contributes to their health, long life and happiness? Not by any means. Uncle Sam is said to be "rich enough to give us all a farm," so we conclude he is able also to buy all his soldiers a shirt, and the best at that. There are several good reasons why our army and navy should have at the earliest possible moment the wholesome benefits to be derived from linen underwear. Hundreds of officers are wearing it, not because it is a luxury but because it affords greater protection, and because it also contributes to our greatest comfort during the summer months. This is not all that can be said in favor of linen underwear, for it would require too much space in this paper to give all its qualities, and the

reasons why everybody should wear it next to the skin. Some one gave the excuse of expense as a reason why our soldiers are not supplied with it. In answer to this important suggestion it would be well to say emphatically no, and then prove that linen underwear is not more expensive than other kinds, simply because a suit will last from two to four seasons. The writer has been wearing Dr. Deimel's linen for six years with the greatest comfort and satisfaction, both summer and winter. During that period but two or three purchases have been made. Linen wears well and is not expensive in the end.

Another protection or preventive that our soldiers should have the benefit of, and that is the privilege of carrying quinine with them as they may need it at any time. Quinine ranks next to calomel as a preventive medicine. There are seasons of the year when quinine (four to six grains) should be taken every morning on awaking, especially if the soldier is camping in a malarious district, low, flat or damp ground.

A

In fact it will do no harm whatever to take four to six grains every morning tor months. Quinine is a far better stimulant and preventive medicine than alcohol. dose of quinine will give resisting power to the body for half a day and longer, while whiskey or brandy loses its stimulating ef fect every thirty minutes to an hour. The alcohol ruins the stomach if continued, while four to six grains of quinine will do no harm when taken for a long period, rather a benefit in every way. Men of average size and vitality should take four to five grains, and larger men from six to eight grains. In forty-five minutes the physiological effect is acquired, the heart pumps the blood faster, and the friction in the blood vessels is greater, as a result more coloric is generated, a stimulation or buoyancy is experienced more or less perceptible; in fact it makes one feel good, taking away the tired feeling that lingers with many persons. until the volume of blood has been enlarged by breakfast. The resisting power of the body is much less after midnight, until food has been taken than any other time during

the twenty-four hours. Therefore, the suggestion that quinine be taken in the morning. In case of wet, cold, disagreeable weather, or if the soldier has taken cold, he should take two doses of quinine daily. The second dose should be taken in the after

noon.

1623 15th St. N. W. Washington, D. C.

ABORTION-HEMORRHAGE.

BY J. S. LEACHMAN, M. D.

OT long since one evening just about dark, a gentleman came to my place and stated he was passing a dug-out about eight miles west, and that a Mr. J. ran out and told him that he thought his wife was dying and asked him to go for a doctor, and outside of this he could find out nothing.

was

I had just come in on a broncho and not being used to much horseback riding I dreaded the trip but hastened away to the place. On arriving I met Mr. J. at the door and he told me it was a case of flooding and he had given his wife one-half teaspoonful of fld. ext. ergot, yet she was cramping badly and once in a while fainted away, yet she was far better than when he sent for me. I went in and oh, what a stench, even her breath had that peculiar smell that sometimes we come in contact with in the lyingin chamber. I found the heart action quite feeble. She was inclined to faint, complaining of a desperate cramp in the uterine region and said it seemed as though she was turning inside out. I made a digital examination and found the uterus low down in the pelvis and hard as rock. I gave her an injection (hypodermic) of mor, phine and in a short time some heart tablets which contained digitalis, cactus and glonoin, and as she seemed cold almost as a corpse, ordered hot irons to feet. In a short time she warmed up and on the second hypodermic injection of a one-fourth grain of morphine she became easy. I had her watched the balance of the night and she rested quite well the rest of the night. In the morning she told me she had miscarried three weeks before and that she soon get up

and had been feeling quite well until a few hours before I was called, and that she got up on a little box to hang up some garment and the box turned over and she fell and it set her to flooding, and she took the ergot and that it checked the flow but cramped her almost to death. I told her I would go back home and get my curette and see what was inside the womb, which I did, and I took away quite a putrid mass resembling the placenta and shreds of membrane with quite a handful of clotted blood. I used a gallon or two of hot carbolized water and thoroughly washed out the uterine cavity. But I forgot to say while I was at home she had quite a rigor and when I got back the fever was up to 104 degrees F. I gave then the following:

M. Sig.-A teaspoonful every hour to control the fever,and every three hours 2 grains of calomel combined with 4 grains potassium chlorate, and after the fifth dose castor oil and spirits of turpentine to work the medicine off, with lard and turpentine applied locally all over the abdomen, also ordered hot carbolized water as an injection once each day. The calomel acted nicely, carrying off quite an amount of bilious matter and her fever came down and she had another rigor and rise of temperature,so her husband said, and her head hurt her badly. I sent her a few antifebrin powders and also some one grain tablets of calomel (as he said she was sick at stomach) to be given each hour in alternation till headache subsided and fever came down, then to discontinue the antifebrin, but keep on with the calomel tablets until they acted or begun to act and then give the castor oil and ten to fifteen drops of turpentine and also tr. echinacea in twenty drop doses every six hours and report to me when necessary. The medicines acted well and no report was sent in, and the next I heard of the lady she had applied for our public school. The director told me she was looking well. I only made two visits.

I think this case would have died had I

not removed and cleaned out the nutrid matter from the uterus,and I think that the other part of the treatment eradicated the poison that had already contaminated the system, and to tell the truth, I have great faith in Lloyd's echinacea or the Echifolta and would be at a loss to treat a case of blood poison without it. This lady was about 25 years old, has one child four years old. She is rather small, weight 105 pounds and of a nervous temperament.

Higley, Okla. Ter.

THE RATIONAL TREATMENT FOR

TUBERCULOSIS.

BY L. G. DOANE, M. D.

HE Deutschen Medicinische Vochenschrift publishes a synopsis of a lecture which Professor von Behring, of Marburg, delivered before the German Naturalists' Congress, at Cassel. Professor von Behring does not believe that tuberculosis can be inherited or contracted epidermically by an adult. He asserts, however, that a decisive factor in the spread of tuberculosis is the nourishing of infants with milk taken from cows suffering from that disease.

"The human infant, like the young of all animals, lacks the digestive apparatus and protective organs which in the case of grown persons prevent the germs from entering into the tissue. As a consequence, he contends that young children should be nourished with milk free from the germs of tuberculosis.

"Professor von Behring's efforts are being directed toward the substitution of sanatoriums and a system of inoculation for consumption hospitals. He is firmly convinced that, like animals, human beings can be rendered immune by inoculation with tuberculosis toxin obtained from cows. The professor, however, distinctly says that his experiments to obtain a perfect toxin are not completed."

There is probably no topic in which the community in general is more interested than in the prevention and cure of pulmonary consumption.

The general fatality of the disease is greater than any other, fully ten per cent. of all deaths being attributable to it. Its prevalence is also in due proportion.

When viewed from a matter of fact standpoint this is bad enough, but still there is no reason why we should not look at the actual situation fairly and squarely in order to meet more intelligently and practically the issues at stake. Very encouraging efforts are being made in such directions, and the common sense basis of them as given by experts deserves the widest possible discussion.

The grand principle aimed at is to place the possible cure within the reach of all. In keeping with such intention the public is being educated in the proper direction of purely hygienic treatment. Fresh air, sunlight and plain, nutritious food are easily obtainable even by the comparatively poor

man.

It is high time that the individual as such should have a show and the over-dreaded bacillus come in on a second class ticket. Since the useless scare concerning the universal danger of infection by this veritably omnipresent microbe too little attention has been paid to the more fundamental doctrines of prevention and cure.

The newly found bug is as much a part of creation as the human being, and has come to stay in spite of the defiantly belligerent manifestoes of health boards. If it could speak in its own behalf it would say that, far from being an intruder in the animal economy, it is a specially invited guest. The susceptible person is, after all, the only one that offers it a welcome. Thus it happens that only a small proportion of all that must be some time or other exposed to infection become victims to the disease.

The bacillus is the theory, but evidently the patient himself must be the fact. The higher purpose should be to make the man strong enough to throw off the disease, no matter what its source. The same rule should apply with equal force to the susceptible person, however exposed. In both instances the germ would be as seed on the rock.

In New York City we have a "lung block." The air is foul here and sunlight