As the epidemic of influenza has about passed away, we are compelled to restrict the space allowed for its discussion. Dr. J. O. Robinson, of Bridgeport, Ky., outlines his treatment, in which he gives aconite, gelseminum and belladonna, each according to its special indications, when neuralgia of the fifth pair of nerves is the prominent condition; sulphite of sodium when there is broad, white-coated, teeth, indurated tongue; and muriate of ammonium in nearly all the cases as a drug for general treatment. The doctor condemns the use of very depressing remedies, especially the coal tar antipyretics, antipyrin, phenacetine, acetanilide, antikamnia, etc.

phenomena. The rapid prostration, nervetension, bruised and sore feeling, are the greatest diagnostic features of the disease. Onset with some sudden, vomiting and purging; tongue red; pulse rapid; fever 99° to 101° F.; first vomit stomach's contents, second biliary matter; from bowels, fecal and then mucous discharges.

For the vomiting, dry calomel on the back of the tongue, though if calomel be not indi cated, I find hydrate of chloral or creasote. (beechwood) either to act well in such cases. Onset with others not quite so violent. Tongue heavily coated; bowels constipated, with great pain in the back and neck. With this class there is complaint of great thirst, but temperature runs from 99 to 104 F.; skin dry and hard; kidneys very inactive, urine scanty and high colored, with most. The class of cases with scanty urine are troubled more with bronchial affections during the trouble. With this class I find it very wise to thoroughly arouse the hepatic centre, and lower the temperature with appropriate remedies. Allay

thirst with hot lemonade, followed by this:

of the Body Warm.

EDITOR MEDICAL WORLD:-I wish to present the design illustrated by the accompanying cut.

THE RADIATOR

The pipe is connected with the cylinder, which is placed between the bedclothes, the pipe passing between the foo'board and the tick (if it is the feet to be warmed). A small lamp placed beneath furnishes heat. The cylinder has on one side an open space, ard within, a piece of tin is arranged to distribute the heat. The heat collector or cone has withinit a second cone to prevent the current of air from the moving of the bed - clothes, blowing the 1 m out. I thought of the plan years ago, but only this fall during the very serious illness of my brother, who had several relapses from the nurses allowing the hot lids to cool during the night-did I try the experiment, and it proves so satisfactory that I am sure that others will like it. I have one in use now with one of my patients.

The Medical Evolution. EDITOR MEDICAL WORLD-I can not help writing a few lines in answer to several recent contributors to your valuable journal-they who still advocate the heroic doses of calomel. We are ready to admit that calomel in minute doses is a sedative to the stomach, liver, and intestines, and favors the pouring out of the watery portion of the blood into the intestines. Now it does seem that some of our brother contributors have fallen back a few paces, or have failed to keep abreast of the times. One writer on "typhoid fever" still advocates the use of calomel in fifteen grain doses in his treatment for that disease, and very thoroughfully reminds us that he did observe 4 some ptyalism in a case he was treating. I am dra firm believer in the theory that typhoid fever is produced by a micro-organism and the bacilli find lodgment in the intestinal canal, where it flourishes and produces its peculiar effect. Peyer's glands, and many of the solitary glands are involved, and I believe many of the obstinate abdominal symptoms are aggravated (if not produced) by the irritation following the administration of purgatives.

We do not doubt for a moment that mercury

is an antiseptic, and will, when properly given, accomplish great good. But we look back with horror to the days when typhoid fever was treated with huge doses of calomel, to the time when to have an attack of that disease meant from two to six months confinement for about forty per cent. of the victims, and death to the remaining sixty per cent. Think of giving from fifteen grains to thirty grains of the drug to a case where the Peyer's glands were undergoing a high grade of inflammati n, a time when we want our patient quiet, when we want as little commotion in the intestines as possible.

Now with dosimetric granules we will accom. plish our purpose in a much neater and surer manner than our pioneer brothers ever dreamed of who follow the old plan, and we will have a greater per cent. of live patrons. The pioneers bought their calomel by the pound and gave it freely. I presume because it was so cheap. Do we not secure antisepsis in the intestinal canal with 1-10 grain doses of calomel? I am sure we do. A few of our leaders of the old class, still adhere to the old plan, but the rank and file of the profession have gratefully accepted the wholesome lesson taught us during the last quarter of a century by our homeopathic friends. They taught the people that it was possible to recover from a disease under a treatment that left them a soft palate and an inferior maxillary. We believe it also, though we do not believe in the theory of homeopathy.

We think the time is at hand when the mistaken ideas of our pioneers in the profession of medicine should be covered with a mantle of

charity. Prof. Gross, one of the brightest lights in surgery the world has ever known, made a revolution in his writing, showing what a change could come about during a decade or two even in the science of surgery.

We must keep pace with the age in which we live. Galen, Eberle, Watson and others were all right at the time they worked and taught, but we passed that period. We must now prescribe our medicines as appears the most rational to us, and I believe that means dosimetry. You who do not believe in it will soon be obliged to accept the theory, or you will see your patients gradually slipping away from you and joining in the call for the little granules.

It is a matter that will not reach all in a day or a year. Revolutions do not come with a

rush, peop'e have warning, the ominous growling is heard, the ear quickens at the sound, the mind begins to work and soon the whole soul is thrown into the new channel and a

world is conquered. The "hand writing is

on the wall" and we must fall in line or even

tually be classed as a back number.

ROBT. C. M. LEWIS, M. D.

Centerburg, O.

An Argument Straight to the Point.

EDITOR MEDICAL WORLD.-Tɔ insure financial as well as professional success, the general practitioner of to day must carry and dispense his own medicines; for though there will always be large numbers who will continue to succeed by the usual methods of prescriptionwriting, yet many more will fail, unless they imitate the homeopaths, at least in the manner of dispensing their remedies. Their drugs are always convenient and ready for use and their patients must return to them when they want further treatment, instead of applying to the druggist to refill the prescription. This means another consultation and fee; whereas there is no telling what erratic course a prescription may pursue, bandied about from one to another, benefitting here and injuring there, and surely straying wide of its author's original intention. Now in the elegant form of dosimetric granules, your medicines are conveniently and agreeably carried, in accurate and definite doses, and they only contain that part of the drug which is of actual medicinal service; thus saving o much in bulk that you can stow away in your inside coat po ket a sufficiently extensive and varied selection to meet the wants of a large general practice, and yo ran have your favourite formulæ put up thus ac·

cording to your special order. As all crude parts of the drugs are eliminated by chemical process, and nothing but active principles remain, you are here approaching really accurate medication, and rising a step higher in the direction of the scientific treatment of disease.

By this means also, you can boldly and with safety use the most active agents; for you give dosimetric granules in frequently repeated doses, until the required therapeutic effect is produced, and yet stop sh rt of its toxic action. It is under your absolute control; in the case of children, a matter of paramount importance. This is no new system of therapeutics, Lut a more accurate and therefore a more successful method of administering such drugs or combination of drugs as you think best adopted to the case in hand; it is your own prescription, condensed, deprived of all superfluous ingredients, and presented in a portable, reliable and palatable form. A granule, very little larger han a pin-head, will contain as much alkaloid, say of digitaline, as is contained in an ounce of infusion of digitalis; yet the action of the granule will be the speedier, and the more precise; and moreover you have not to wait for the "middle man," or druggist; for in many instances, loss of time means loss of life. In the case of drugs calling for larger doses, the granules can be given in greater numbers; but the dose of many alkaloids can be represented in a single granule. I am here I am here advocating the administration of medicines in these convenient dosimetric granules, and not the so-called "Dosimetric" school of medecine, with which I have nothing in common. But I do consider these granules a vast improvement on all former methods of administering our remedies, and they provide a legitimate means of widening our financial resources. LOUIS LEWIS, M. D.

36 N. 19th St., Philadelphia

Something More About Dosimetry. EDITOR MEDICAL WORLD.-The question may be asked by practitioners:

What is dosimetry? It is nothing else than the adaptation of the remedy to the strength of the patient and the force of the disease. Thus, to an acute disease, we oppose acute medication; to a chronic case a chronic treatment is applied. A false idea has prevailed in times past, that an acute disease was a sign of strength on the part of the patient, and in order to master the disease, the debilitation of the sufferer was sought and often times the form of the malady was changed from acute to chronic.

The design of dosimetry is to abort the disease that could not be prevented, hence the

"Jugulation" so often referred to by those physicians who have adopted this method of

treatment..

Old Hippocrates held that all diseases have a natural course they must follow, no matter what means the physician employs. The idea surely is erroneous and has been the means of giving the undertakers a good living. Many physicians, even some of great renown have been misled by the idea; this was done in good faith however, under the idea advocated by the Father of Physics, supposing that by eliminating from the system the morbid principles classified under the title of "humors" cures could be effected.

The jugulation of diseases rests upon the fact that there are in nature agents that cause defervescence without interfering wilh either circulation or nutrition. The dosimetrist adopts for all fevers, that method of treatment adopted by the profession for intermittent fevers, without, however, allowing them to pass from the acute to the chronic state. Thus, typhoid fever, for example, attacked at first with the arseniate of strychnine and quinine, then followed by aconitine, veratrine and digitaline, will succumb to the treatment in less than fifteen days. This result, however, depends much upon the method of exhibiting the drugs. The remedy must not be measured by reason of its quantity, but rather by reason of its quality. Half milligram doses of the active principle of the drug repeated as often as needed, will, as experience has well proven, conquer the disease.

Jugulation then means: cutting the fever short without leaving behind any complications.

Colchester, Conn. ED. CORNET, M. D.

Accidents from Vaginal Injections. EDITOR MEDICAL WORLD:-Replying to M. D. in February WORLD, on "Alarming Symptoms after Vaginal Irrigation" I will say that, in my opinion, the prevention of such accidents can only be accomplished by abandoning indiscriminate vaginal irrigation, which is an unnatural process, to say the least, and its too frequent practice of late is due entirely to the microbe craze which has taken possession of the medical mind. In my long practice I have attended over a thousand obstetric cases, and recall only about a dozen cases in which I thought vaginal washes were needed. Of course external cleanliness and aseptic precautions were enjoined and used, and I have had only two cases of puerperal fever occurring in my practice, which however has been principally in country villages and the country. The first one was caused, I am satisfied, by my having

a number of bad cases of erysipelas on hand when called to attend it-this was long ago, before I had learned the danger. The second was due to a case of erysipelas in the house, in the person of the patient's mother, who had come to be with her daughter in her confine. ment. The fatal termination of these cases impressed me deeply with the idea that no physician, nurse, or other person having been lately in contact with a case of erysipelas should ever enter the lying in room. I have seen only two cases of the accident mentioned by M. D., and they both occurred last year in ladies who said they were in the habit of using vaginal irrigations, by means of a douche bag, hanging on the wall. They were both taken with intense abdominal pain, immediately after the injection, accompanied with a severe rigor, nausea, and vomiting. The locality and nature of the pain led me to believe that a few drops of the water had entered the peritoneal sac, but by what route I am unable to say, especially as one of the ladies was three months pregnant, and, though she suffered severely two or three hours, she did not abort. I gave them granules of hyoscyamine, codeine and digitaline, one of each every fifteen minutes till relieved, and advised them to plug the central hole in the nozzle of the pipe before using it again.

I have known of several sudden deaths in this state caused by this accident, and the opinion of the attending physicians in these cases was that the fluid had penetrated to the peritoneum. This might occur through an empty uterus, via the fallopian tubes, but I do not understand how the accident could happen in a case of pregnancy. But I may be altogether wrong in my opinion and would like to hear an explanation of the accident by some of our learned gynecologists, who have had opportunities of making post mortem examinations in suc cases.

Houston, Texas. W. L. COLEMAN, M. D. [Doctor, what do you think of the probabil. ity that the trouble was uterine colic, caused by the fluid entering the uterine cavity ?-ED.] In a private letter to the editor occurs the following, which we take the liberty of publishing in vindication of the Doctor's views : (See Nov. 1891, WORLD, page 413.)

I suppose I am to blame for selecting my two worst cases to illustrate my dosimetric treatment of Grippe, but I supposed the breth ren would see that my object was to show the power of the method to jugulate the disease in its worst form and thus prevent threatened inflammations and organic lesions. The disease itself seldom kills, but its sequelæ do, and the profession should be willing to adopt any treatment which by cutting it short in its first stage

would save the people from the terrible sequelæ and wrecks which have followed the past epidemic. Three-fourths of my grippe patients last winter did not go to bed at all, or for a few hours only, and took less than a tube of any of the granules I used in its treatment, but I insisted upon their taking six to eight granules of ars. strychnine and quinine a day for several days after their recovery, with the dosimetric trinity at bed time, and thereby saved then from relapse. The disease has been worse here this winter than ever, and I have been very busy, but fortunately have not lost a case yet. We have also had more rheumatism than usual. Last Wednesday week I was taken suddenly with a violent attack of lumbago and was placed hors de combat for nearly fortyeight hours. I had my favorite external remedy applied, a flannel strip saturated with turpentine laid upon the spine and warm iron passed over it for ten or fifteen minutes. This gave me great relief and though you call it polypharmacy, I took salicin, strychnine, hyoscia. mine, aconitine, and digitaline every hour that day. The next day I was able to be out, and my first case was an old lady who had been suffering three days and nights with the same disease, and was not able to move then. The same treatment relieved her so she was able to walk about next day Houston, Tex.

W. L. COLEMAN, M. D.

Notes from Practice -Tonsillitis.-La Grippe. -Herpes Zoster.-Palatable Prescribing.

EDITOR MEDICAL WORLD:-Let my fellow readers of THE WORLD dissolve three to five grains of nitrate of sanguinaria in three ounces of syrup or water for a gargle in quinsy every two to four hours, and they will use no other remedy. I have not had a case to suppurate in the last five years under its use. It is especially convenient for the country doctor, as it takes up but little space in his medicine case.

One of the best treatments for grippe to relieve the tired feeling and the oppressive head ache is ten grain doses of sodium benzoate every four hours, followed by a teaspoonful of whiskey in hot water.

In herpes zoster I use with gratifying success a coating of collodion over the vesicles, which gives immediate relief.

To disguise the taste of quinine, I add the following, which children take without much complaint:

Death From Heart Clot. EDITOR MEDICAL WORLD:-Several years since, when practicing in Northern Ohio, I was hastily summoned to attend Wm. Leeland, who was said to be suffering from a very severe and sudden attack of pain in the stomach. Upon investigation I found him to be afflicted with gastric neuralgia. The patient was a man of twenty-four years of age, weight about 200 pounds; of most excellent, symmetrical physique, with every external evidence of superior physical health. From a brief history I found that he had been engaged during the morning in making repairs in a plank road, and on coming by a whiskey hell, he had imbibed several drinks of rot-gut whiskey. The pain came almost immediately upon him, and was indescribably severe. I thought to relieve without recourse to opiates, but with no apparent alleviating result. Having some sulphate of morphine in my pocket I resorted to administration of that for relief. Gave him dose after dose with only apparent temporary relief, perhaps of from ten to twenty minutes duration, when he would scream for more morphine. My sympathy unsettled my judg ment and by 7 p. m. I had given him more or less of from 15 to 20 grains, with no apparent permanent effect. Had no hypodermic syringe or I would have certainly used it. At that

time I concluded at all events to cease the use of the drug and went home. Returned at nine and found him agonized as before. Upcn careful examination I could find no evidence of narcotic poisoning. I picked up my chloroform and gave him a few inhalations, and only a few, under the influence of which he dropped right away into a sleep. He may have slept twenty minutes and upon awaken. ing found his pain all gone, and chatted pleasantly with his companions, who had gathered during the evening to sympathize and see him die, saying, in course of his remarks, that he felt splendidly. In a short time he fell again. into a comfortable slumber. At one a m. I made a critical examination of his apparent

state and, fearing to awaken him for fear of the return of the awful pain, I turned to the boys and told them I would go home, and for them to keep a silent watch upon William, and if any thing occurred in which I could be of possible service to let me know, and home I went. I truly thought our patient would in all human probability awaken up o. k. before or in the morning. Without any apparent change he continued in the same state until 3 a. m., when he gave a gasp, and death claimed his spirit. At the post mortem, which was conducted by a very efficient man, a demonstrator of anatomy in a medical college, we found dilatation of the stomach, the transverse diameter being four inches in excess of normal, and numerous ulcers of the mucous membrane. Also anti-mortem heart clot. The verdict was that he was attacked and suffered from gastric neuralgia, which passed to the heart, producing a clot which ultimately eventuated in death. The autopsy was made as public as possible, being held in the largest room of a farm house, where the neighbors and friends had assembled to attend the funeral obsequies. I requested Dr. M-to tell the truth, the whole truth, and nothing but the truth, publicly, as we proceeded step by step through the process of investigation. Two doctors who had treated

him more or less at different times for the same trouble, had openly declared that he would probably die in one of those attacks. He had had similar attacks more or less from the time he was ten years of age. Friendly comment and criticism on treatment and results is invited from some of THE WORLD'S family of readers. An explanation given Mr. Thorp, Mr. Leeland's employer, by a physician, a cousin of the deceased, was that our patient had constriction of the pyloric orifice of the stomach and, as a result, the morphine was retained in the stomach, but upon reception of chloroform relaxation of the tissues resulted, and the morphine then passed into his system, producing narcosis and consequent death. London, O.

J. W. SWARTZ, M. D.

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