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the kidney disease is due to the hepatic. The Original Communications.

only case now occurring to me is when cancer

attacks the liver primarily, and the kidney Port articles on the treatment of diseases and experience with new remedies are solicited from the profession for

secondarily. this department; also difficult cases for diagnosis and In Dr. Cochran's case (page 468) the pus weatment.

may have been in the frontal sinus, or some Articles accepted must be contributed to this journal only. other part of the nasal tract. There are

The editors are not responsible for views expressed by contributors.

scarcely enough data given to show whether Oopy must be received on or before the twelfin of the month

this was so, or where the pus collection was for publication in the next month. Unusid Manuscript located ; and trephining could not be percannot be returned.

formed without previously locating the abscess. Curtainly 4 is excellent discipline for an author to feel that he must say all he has to say in the fewest peo5le words, or

I wish to call attention to the insufficiency of Ats reader is sure to skip them; and in the pluinest possible

the diagnosis of hysteria. It is very nearly a spords, or his reader will certaini isunderstand them Generally, ciso, a dsinright fact jy be told in a plain

meaningless word. A woman may be notoriously way, and we want downright facts at present more than hysterical, but that does not preclude her havsnything else.--RUSKIN.

ing any disease of any sort. I cannot count

the number of consultations to which I have READ. REFLECT. COMPARE, RECORD.

been called, in which we have discovered

plenty of reason for the symptoms. One case Notes and Comments.

of uncontrollable "hysteria" recovered her EDITOR MEDICAL WORLD:- In spite of the self-control promptly when I evacuated a pelvic arguments advanced by Dr. Cook (page 444), abscess for her. Another hysteric girl, who it is pretty certain that the Kansas fever is glared at me from under her bed (hysterotyphoid. In mild cases of typhoid we often mania), returned to her senses next day, when have little or no diarrhea, especially if the her intestines had been unloaded of a fecal diet has been well arranged, and no intestinal collection of several weeks standing. Another, irritants employed. The same may be said of sadder still, quietly remarked to me: “Doctor, ty mpanites and other abdominal symptoms; don't pester me with valerian, but persuade while typhoid often subsides during the third my husband to let me alone for a little while." week. The eruption is sometimes absent, often Is insomnia a disease? No; only a sympso scanty that an inspection of the entire sur- tom, and not even a symptom demanding face of the body is necessary to detect it; an treatment. It is a danger signal, an indication inspection not made once in 1000 cases. It is for the physiologist rather than the therapeutist. not easy for even a practised diagnostician to I am unable to give an opinion as to ihe reladetermine that the spleen is not enlarged ; tive merits of the new hypnotics, because I coma and extreme prostration are only present never have any use for them. My hypodermic in bad cases; while as light cases generally re- pellets of morphine I have not seen for months. cover, it is impossible to say in what condition Even in delirium tremens, what hypnotic can Peyer's glands may have been; though the compare with capsicum and coca? presence of blood in the stools is a fair indica- For enuresis (page 468) try salol, gr. v, at tion of ulceration. But the time has come bedtime. when such discussions should cease, since the Nothing can be done in the way of removmeans for settling the question are accessible. ing the fluid of a hydrocele, except by the A search for the typhoid bacillus with the trocar. For injection after removal, most microscope, and the application of Ehrlich's surgeons employ tincture of iodine.

Levis test to the urine, are within the reach of any advised carbolic acid. physician; and our Kansas brethren ought to For corns, the best remedy is the salicylic avail themselves of these, and decide this in- acid and cannabis plaster. teresting question.

For N. H.'s psoriasis (page 468) I would Dr. Cushman (page 468) asks rather a diffi- use an ointment of chrysophanic acid, resorcin, cult question.-** Have you ever known a aristol or oil of cade, or all in succession; diseased liver to produce a diseased condition applying lanoline with oil of roses to the skin of the kidneys ?" Amyloid disease, syphilis, after the disease has disappeared. tuberculosis or cancer, may affect both organs; Well, our old friend La Grippe has reone not necessarily caused by the other. If appeared in a new guise. It struck my province the outflow of bile be stopped, and reabsorp. (beginning with myself) the latter part of tion occur, with jaundire, the bile is discharged November. Until to-day (December 15) it by the kidneys, and this may cause irritation has been exclusively among the better classes of these organs

Alcohol causes hepatic cir- of my patients; my first case among the handrhosis, and desquamative nephritis later; but workers occurring to-day. There has been there is no special reason for believing that little tendency to pneumonia, but head ache,

bone ache, sore throat, bronchitis, with deep ent are doing well. There was one placenta cough and scanty sputa, a full, soft, compres- and each child had a separate sack and cord. sible pulse, and moderate fever. The pulse

JAMES A. MEEK, M. D. yields at once to small doses of cardiac depres- Bunker Hill, Ind. sants, and reacts quickly and too strongly to stimulation. Quinine has proved valuable to

An Anomalous Fever. a degree that has surprised me, in view of its small value two years ago.

Sudden onsets

(Continued from December.) have been the rule. One gentleman was talk- Editor MEDICAL WORLD :-Referring the ing with a friend, when he suddenly became readers to December World for a typical case, speechless. When I saw him a few hours I will refer here to a few of the many varialater, the pharyngeal mucosa looked as if it tions. A certain percentage of cases run the had been reduced to pulp by some powerful entire course without any other marked symp. corrosive. Local stimulation was employed, toms of disease than a sever. They eat well, and sloughing did not ensue. It was three sleep well, and do not complain of anything days before the man could speak, or swallow but weakness. Another class of cases have a without difficulty. During the last few days persistent diarrhea from first to last. Others intestinal troubles have become manifest. are constipated throughout. In some the While there has been some debility present in diarrhea begins after the fever has left. those suffering with other affections, as well as The alvine discharges in some cases are thin those down with influenza, this has not been and watery; in others they consist of mucus very marked. This is only my individual and blood. Sometimes there is tenderness in experience. The reports of the Health Office

the region of the ileo-cecal valve, sometimes show that the mortality in Philadelphia has not. The onset of the disease is sometimes increased in one week from 410 to 508, and abrupt, but generally slow. I have seen cases that pneumonia caused 79 deaths last week. begin as an intermittent and repeat the chill Thus far I can only say : Beware of over-dosing and fever as many as four times in successive and of cardiac depressants; give quinine freely; days, presenting all the symptoms of an ordin. watch the pulse carefully; do not over-do the ary ague, and have given quinine, but the fever feeding ; be sparing of stimulants; drop the continued. The duration is as uncertain as the "antis” for the present, and use liniments for mode of beginning. Some cases run seven, the cough. Dr. John J. Taylor speaks so some fourteen, some twenty-one days, and perhighly of ammonia that I shall give it more haps longer, but I think there is usually some frequently. Profuse and exhausting, but complication in cases lasting more than twentysalutary, sweating followed the use of small

one days. Relapse is' not uncommon and doses of Dover's, and, for some unknown

usually lasts as long and presents the same reason, the febricide pills. Finally, I cannot symptoms as the first attack. I saw one patient recollect a time when the good influence of a relapse the second time, and with the same cheery face and a hearty, sympathetic voice course of fever each time. I believe cases that appeared to do so much good.

are reported to last six weeks or longer are William F. WAUGH, M. D. simply relapses. Typhoid fever has been known 1725 Arch St., Phila.

to behave in like manner.

The termination is usually by lysis, but not Quadrupulets.

always. I have seen an intermittent follow as EDITOR MEDICAL WORLD:-On the night of

well as precede the continued fever. In fact

the disease at times presents such a variety of November rith, I was called to visit Mrs. Ed. gar George, living three miles south west of symptoms and conditions as to almost lose this place, in her fifth confinement.

On ar

its identity. For a time, after my introducriving, at about 9.30, I was informed by Dr.

tion to the malady, I was by no means certain

whether I had to deal with one or several dis0. Č. Irvin, of El Paso, Texas, who was

eases. visiting the family, and who is a brother-in-law of Mrs. George, that the labor was over and

Etiology.- Be me sowl,” exclaimed Mrs. that FOUR LIVING GIRL BABIES were born, re

Finnegan, “iverything is blamed on the poor

Oirsh now a days. marking also that he didn't think he let any

Wud yez belave it, Pat? get away For a time we had business giving They do be sayin that an Oirishman gave the attention to the mother and four little strangers. People of the sout the yaller sever; a felly by They were all perfectly well-formed, though

the name of Mike Roby.” small, not averaging over three pound each.

I have not seen Mike Roby (microbe) in One of them, however, only lived about five

these parts but he is likely here. hours. The remaining three and mother at pres- Age.--It does not often attack either the old

of age.

or very young. My youngest patient was three composition, besides the ill effects of bad venand my oldest fifty-five years old.

tilation. I have seen large families live in a Sex.--It attacks either sex equally, but is house of this kind that only contained two more fatal to girls from sixteen to twenty years small rooms.

I am sure the disease has de.

creased in frequency seventy-five per cent since Physical condition - It seems to specially the sod house has disappeared. attack persons of previous good health. All Whether the disease is malarial or typhoid, my fatal cases were of this class. Young,

or a mixture of both, or whether it is caused strong, robust, the very picture of health, yet by a poison different from either, I can not they fall soonest. Pregnancy offers no obstacle

say. I will say, however, that the most comto the disease, as I have seen often. I treated mon manifestation of malarial poisoning, ague, one case where the woman was confined during is not seen here at all. I have never seen, the progress of the disease ; but the puerperal

either, a well-marked case of remittent fever. condition did not seem to affect the course of

If it is typhoid it must arise in many cases de. the disease in any way,

The patient made a

novo, for I have seen many cases, isolated, far gocd recovery in the usual time. The babe

from public thoroughfares and miles from any did not contract the disease. I have never

other cases, where there is not the slightest susnoticed any tendency to abortion from the picion of a contagious origin. disease.

Bushton, Kan. Climatic conditions. --The only particular

S. C. Cook, M. D. point that I have noticed is, that the disease is [This most excellent, almost classical, demuch more prevalent and also severer in very scription of this disease, including treatment, hot, dry years. In 1879, at Ellinwood, Kansas, will be concluded in next issue.-E..] the disease was extremely fatal, some cases proving fatal in the first week. In 1887 a very

Cold Abscess of Neck. extensive epidemic prevailed in western Kan.

EDITOR MEDICAL WORLD:--Je sie W. H., a sas. In both these years the vegetation was

full-Llood Sioux female, aged 17, presented killed in July by the hot winds, and the weather

herself at the dispensary July 29, 1891, with was extremely hot and dry until late in the

a swelling on the right side of her neck fall. Neither moisture nor drouth seems to

immediately over the sterno-cleido-mastoid have any effect except when accompanied by muscle and about midway of its length. It was heat. But the disease is by no means always

about as large as a lemon, and on palpation epidemic. I have frequently seen isolated cases,

revealed fluid contents. I diagnosed cold as well as epidemics confined to certain small

abscess of tuberculous origin, and made a neighborhoods or villages.

small puncture with a bistoury. On the escape Season. -The disease almost always occurs

of the pus the tumor had completely disapin the last six months of the year, and it seems fair to presume that the conditions prevailing peared, leaving at its site only a bunch of

shriveled integument. I then washed out the during that part of the season have some in.

sac with a solution of chlorinated soda and fluence in its production, although we see the

carbolic acid, and applied a compress, susdisease under widely different climatic condi

tained by a roller bandage about the neck. tions.

This was repeated three times a day for a Sanitary conditions. The disease has de.

week, when it was observed that the sac had creased in frequency and severity in exact ratio to the improved sanitary conditions. In

closed entirely, and the wound of puncture

healed. There has been no return of the abthe newer parts of the State, where people live in sod houses, small and badly ventilated, the

sress. Now had she not applied for treatment,

but allowed the abscess to take its own disease is much oftener seen than in the older

course, it would have have finally opened parts, where the people are better housed. For

itself, and degenerated into a large ulcer, the benefit of those living in the East that are

which would have lasted her for years, prob. not acquainted with the sod house, I will describe one. It is built of sod cut into squares

ably, and by constitutional infection possibly destroyed her.

These cold abscesses are very of convenient size, and about two inches thick,

common among the Sioux, and this seems to and laid up into walls from two to three feet

be the best treatment of them. thick and five to six feet high, and is covered

2. T. DANIEL, M. D. by the same material supported on posts or

Cheyenne River, U. S. Indian Agency, poles, or sometimes boards or brush. The

South Dak. whole structure is composed of vegetable matter and dirt, and usually rots down in a few

The Physician should be a good business man. Get years. The inhabitants thus live in an atmo

our new book and resolve to be guided by its rules and sphere laden with the products of vegetable de- suggestions during the coming year.

A Case of the Keeley Treatment.

Extract cinchona comp. fluid. ..ounce iij
Extiact coca fluid..

..ounce j EDITOR MEDICAL WORLD:-I have a case

Glycerine.

...ounce ) which I think will interest the many readers of Water.

..ounce j THE MEDICAL WORID, both on account of its M. Sig.–Take a teaspoonful every two hours when rarity and as relating to the latest craze-- the

awake. And the following hypodermic injection every

four hours ; I 10 grain of the chloride of gold and soKeeley morphine treatment.

dium and 1.40 grain of the nitrate of strychnine, Miss G., aged 30, a morphine habitue, began This will produce the same symptoms and the home treatment by Leslie E. Keeley, with

same results as the Keeley cure, the "bichloride of gold,'' about two months

H. E. WHITSEY, M.D. ago. She was using about to grains of morph

Spring Creek, Pa. ine a day at the time. From the first of the treatment she began to complain of her failing

The Effects of Coffee. health and came to me for remedies, which I

EDITOR MedicAL World:_ The effects of refused to give while she was taking the treat

coffee or the influence of coffee on the growth ment. She took two bottles, about 20 ounces,

of organism in the human system is very great. of the remedy in the time, losing about 20

Prof. Carl Luderitz made a careful series of pounds in weight. During the last two weeks experiments in which he determined the influshe was taking the remedy I was away

from

ence of coffee infusions of different strength, home. On the evening of my return, Nov. 20th, I was again called to see her. I found (varying from 10 to 20 per cent ) upon the her very weak-much emaciated and her skin growth of various forms of pathogenic and a perfect yellow. The conjunctivæ were very freshly roasted and ground, this was covered

non-pathogenic micro-organisms. The coffee was yellow—so much so that I could plainly notice with boiling water, the infusion thus prepared it 20 feet away. She was much constipated

was placed in a closed flask in a water bath for and was passing immense quantities of urine,

about ten minutes, it was then filtered.

This perfectly black and very bad smelling, but infusion was used in part for making gelatine, which caused no pain on passing. She had no and in part direcily.

He found that the deappetite and was generally in a very weak and structive power of coffee upon various microbes bad condition. I at once credited the condition to the "bichloride of gold” and at once all died in a longer or shorter period. In one

was very great. He found that the organisms vetoed that remedy. The patient was put on series of experiment anthrax bacilli were de. the following prescription :

stroyed in three hours, cholera bacilli in four R Calomel....

grains v hours, erysipelas streptococci in one day, &c., Pulv. podophyllin.

..grains x

&c. The antiseptic effects of coffee do not M. Sig:-One powder at bedtime, repeated every depend on the caffeine, as some suppose, but on second night.

the empyreumatic oils developed by roasting. I also gave tablespoonful doses of syr tri- Prof. Luderitz's observations have been confolium comp., three times a day and wine glassfirmed by Profs. Wees, Oppler, Rabateau and doses of infusion of buchu twice a day.

others. Hence these observations may be At this date (Dec. 3rd) the patient is doing considered reliable. If infusions of coffee finely, the jaundice has almost entirely disap. have such marked deletericus action upon peared, the urine is clear and natural and the pathogenic organisms, and especially upon some patient is on the high road to recovery, but is forms which are the cause of epidemic types still using the morphine in slightly reduced of diseases, it is certainly a valuable agent for doses. I am satisfied that two weeks treatment the restriction of these, and may be used as a more of the Keeley business would have called drink instead of water, when there is any susfor an undertaker. The World is the best picion as to the contamination of water; especmedical journal in the universe.

ially is this true in cases of epidemics of tyWM. JOHNSTON, M.D. phoid fever, cholera, erysipelas, scarlet fever, Williams, Arizona.

and the various types of malarial severs, which

are transmitted almost entirely through the Keeley Cure.

medium of food and drink. Numerous exper. EDITOR MEDICAL WORLD :_Seeing several iments have also been made with infissions of requests in The World for the Keeley cure for coffee upon living animals, such as dogs, &c., drunkenness, I will give you what I believe to

in order to ascertain the effects of coffee on the come very close to it:

organs of digestion, circulation, respiration, B Sodio-auric chloride..

&c. These experiments demonstrated tha

.grain xij Ammonium chloride.

grain vj

coffee was a very valuable agent in assisting Strychnine nitrate..

..grain ;

the digestion of food; it quickened the diges. Atropine, ...

.grain 4 tion and in a way increased the demand for food. This should be well born in mind by antiseptic properties will preserve the teeth those who live in a hot and malarial climate. from decay, if used daily. The experiments also demonstrated that coffee Igo, Shasta Co., Cal. H. SCHAFER, M.D. aided the blood to take up more nourishment than it would without it. It also quickened

Fatal Pulmonary Emboli. the circulation of the blood and of respiration,

Editor MEDICAL WORLD:~Mrs. R. expected and a rise in the temperature of the body was

to be confined about November ist.

She was perceptible.

the mother of two children. Both confineApart from the above experiments, it is well

ments had been normal and easy. Youngest to mention that coffee is also stimulating and refreshing, and that this quality is due to the

child one year old, girl; oldest three years, caffeine it contains. Coffee contains also be boy. October 2nd I was called to attend the sides caffeine, sugar, fat, acids, casein, &c. It boy in what proved to be a severe case of ty

His life lay as in a balance for is also a neutral stimulant of the highest order. phoid fever. But if carried to excess it will produce wakeful. nearly two weeks. His mother was his constant ness, debility, irregular pulse, injury to the watcher and the mental strain told severely on heart and spinal functions, &c. But coffee is

her. October 29 I made my last visit to the a sovereign remedy in tiding over nervousness

boy, he being convalescent, in emergencies. In order to derive the good

November 6th I was called to see the mother effects from infusions oi coffee, it is of the ut

and found her with a temperature of 103°. I most importance to know how to prepare a good diagnosed the case as one of typhoid fever. infusion. The first step towards it, is the

The temperature stood 102° morning ; 103° roasting of the coffee bean. This should be evening from that time on.

November 10th, done at home within twenty four hours of being

about 6 a. m., labor began. I found her temused. The roasting is a too delicate an opera

perature 102°; pain, slight; vertex presenta tion to be left to the grocer or merchant, who

tion; os soft and dilating. About noon the

membranes ruptured. invariably subjects it to a too severe fire. They

Expulsive pains came burn it either dark brown or black, charring

on at once and continued. The head de it to the core, and thereby deprive it of its scended, entered the pelvis and the occiput aroma, and render it intensely bitter.

The presented at the vulva, slightly distending ihe coffee bean, in its natural state is sweet and perineum, when suddenly she turned purple in contains, as above stated, sugar, &c. To re

the face and was in a state of collapse. I intain this quality it should only be roasted to stantly applied the forceps, which were in an amber brown. Coffee infusion made from

readiness, and quickly and easily delivered her beans thus roasted possesses an exquisite flavor

of a still born child. I gave the lady several and should be drank without sugar and cream.

hypodermic injections of whiskey and by shakThe following is a good way to prepare a

ing and dashing cold water in her face, general

friction and other approprlate measures we good fresh cup of coffee :

established respiration again. I then gave a Take two or three ounces of fine ground cof- hypodermic of strychnine sulph. 1-25 gr., fee, pour upon this one pint of boiling water.

morphine /4 gr., atropine sulph. 1.75 gr. She This makes a first class beverage or drink. To improved shortly and swallowed at intervals avoid bitterness, don't boil the coffee. The whiskey and strong coffee, taking in all about following is also a good way. Pui two or three

four ounces of whiskey and one cup of coffee. ounces of fine ground coffee in a granitized The radial pulse could not be felt for a time, kettle and pour a pint of cold water on it and

but gradually returned; it was small, threadlet rest over night. Heat it next morning to like, very rapid and difficult to count. Respira just the boiling point, set it back to prevent

tion was also rapid and difficult and her lips further ebulition. The strength is extracted, still remained purple. The placenta was exits aroma is preserved.

pelled, the patient losing scarcely any blood and Whoever drinks this coffee during the day, the uterus could be felt firmly contracted. In will render his system proof in a great measure about thirty minutes from the first attack she against typhoid fever, cholera, erysipelas, had another exactly like the first, which remalarial and other fevers.

fused to yield to the same methods and in a A cup of hot coffee should be drunk before few minutes she had a tonic spasm with slight venturing into the morning air. Fine ground opisthotonos and died. coffee burnt on hot coals will disinfect the sick She had no symptoms at any time of kidney room. Coffee infusion is also a healthful sub- trouble. There was no rupture of the uterus; stitute for tooth powders, and a most excellent neither did she take any ergot. mouth and tooth wash. The mouth and teeth I would invite comment on this case from should be rinsed with it after each meal. Its the brethren of THE WORLD,

W. B.

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