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Cholera Iafantum.-Treatment From a Dosi- removal of the fermenting material in the alimetric Standpoint,

mentary canal with colon fushing and small

doses of seidlitz salt will go prepare the way ETOR MEDICAL WORLD:~This dread cog

that brucine will again effect a perfect cure. nomen is aptly applied to the various intestinal

If brucine is not at hand, salts of strychnine disturbances occurring in early life, more

may be used, preferably the arseniate, but often during the neated season of the year.

brucine is to be preferred. We have now The various grades of disturbance from simple touched simply upon the causes and treatment diarrhea to choleraic collapse being simply of this condition in the simplest form. As we different degrees of intensity of the same primary have said before, the various phases of choleraic condition.

flux are simply different degrees of intensity of While desiring to deal only with the indica- the same condition. Let the causes continue, tions for treatment, you will pardon me if I wearied nature wavers, helpful compensation refer briefly to the causation of this condition, becomes a pathological condition, the natural upon a clear comprehension of which a rational function of the canal is suspended (over.dismethod of treatment can alone be based. tension causing paresis), bacteria generate, Nimerous things, chief among which are and soon we have a seething mass of intestinal errors in diet and exposure, through the action putridity reeking with odors and teeming with of the sympathetics, bring about a disturbance the vilest poisons. It is no wonder that the of the physiological relation or balance existing mortality is so great. It. is more wonder that between the circulation of the external and the with the incendiary treatment of the past it internal skin. Fortunately, nature is extremely has not been greater. Here is a serious contolerant of abuse, or trouble would arise more dition; there is no time to lose, for unless often than it does. The great law of compen- relief is at once obtained, a life will go out sation under which certain parts are called surely and speedily. What shall we do? Shall upon to perform the work belonging to others we give opiates and astringents to further temporarily in a state of imperfect activity irritate the mucuous surfaces, to lock up this saves serious calamity more often than we are vile mess of abomination while the death apt to suppose ; meanwhile, the forces of sentence of our patient is given in the absorpnature are brought to bear to set the wrong tion that is sure to follow? I hear an echoing right, and if successful all soon goes on as "No!" Good! Now, in the light of systembefore. Here is where the work of the physi. atic therapeutics what shall we do? We will cian comes in, to hold out to nature a helping meet the indications and first give our best hand. How necessary it is that one should not intestinal antiseptics is such doses and freonly clearly comprehend conditions but be quency as is necessary to destroy the multiply. able to select and apply the best means of ing microbes, and thus remove the local irritaassistance. The relation above noted is a tion and stop the septic absorption. veritable physiological see-saw, a cutaneous Arsenite of copper, grain 1 1000, one vaso-constriction or chill means an intestinal granule every fifteen minutes until effect, and vaso-dilatation, while irritating substances in then at longer intervals, one to two hours, is a the alimentary canal bring about the same precious remedy; so also is sulpho.carbolate of condition in a reverse order, and we have a zinc, grain 1.6, used in the same way, but it is choleraic flux, first from external and second probable that none excel, if any equal, calcium from internal causes. Mental emotion may sulphide, grain 1-6, to which the same direcbring about the same order of things, as noted tions will also apply. These three are readily in the effect produced by fear, and should be tolerated by the system, even beyond the classed among external causes. These two amounts required to produce the desired local main points in causation must not be lost effect. Their action peroram may be supple. sight of, as they require entirely different mented by colon flushing of the same in hot means for their removal. In the first, the solution, and if retention of fermenting cause of excitation being removed, the exhibi- residues is suspected, seidlitz salt in small tion of brucine, one or two granules hourly doses should be used, paradoxical as it may along with one of phosphoric acid, will quickly seem. For a child, one or two heaping tea. remove the temporary paresis of the vaso. spoonfuls in halt a glass of cold water may be motors of the intestinal tract, with entire relief given in teaspoonful doses every five or ten to the condition.

minutes to allay thirst, and continued till If the loss of balance is caused by a chill, effect. the use of glonoin, with external warmth, one Now comes the second indication, to stimugranule every fifteen minutes till effect, is the late vitality by every possible means, that the quickest possible way to dissipate internal con paresis of the intestinal vaso motors may be regestion. In the second, abstinence and the lieved and their functions restored as soon as

have followed the above, in children brought from the city, with success in every case.

Woodstock, Va. W. S. CLINE, M.D.

possible. On this, the first indication having been met, success or failure depends. Here again we have brucine, the salts of strychnine and phosphoric acid, precious remedies and sure to win if the case has not been so long

been so long neglected that exhausted nature cannot respond. Brucine and phosphoric acid, one of each together every one-half hour, for a child of foir to ten. The same in divided doses for an infant (dissolve in boiled water and sweeten slightly), or the salts of strychnine if, by the urgency of the case, a more powerful stimulant is demanded, will soon restore this lost vitality upon which all other symptoms defend. A rapid fatality is thus summarily arrested, and we have left but a simple case of slight fever, malaise and depression, which will quickly be overcome by continuation of the remedies with which we have met the two indications, in less frequent and alternate doses, and suitable food and care. If, from the extreme virulence of the case, it is suspected that the intestinal nerves will not respond to excito-motors given by the mouth, the same should be used by hypodermic injection, repeated every half hour till some indication of returning energy is noted, when their exhibition per oram may be depended upon. I would not say that astringen's are never indicated, but remedies which do not act on the vitality are at best uncertain ones. If indicated, use them. If pain demands the use of opiates use morphine, and stop when you have got enough. "Be sure you are right then go ahead." In extreme collapse the two indications may be met simultaneously by a judicious combination of the above named remedies. Should they be rejected by emesis, resort at once to hypodermics of the excito motors, give one granule of camphor-monobromate to dissolve on the tongue every ten minutes till relief, and then return at once to the remedies necessary to meet the first indication. The great variety of empyrical discoveries go for naught in the light of therapeutic certainty.

Dr. W. C. ABBOTT. Rave nswood, Chicago, Ill..

JOSEPH SPALDING, M. D., formerly of West La Fayette. Ind.. now practising in Woodstock, Ct., writes:-“ Cholera of infants, that dreaded summer disease, is the cause of more deaths in this lind than are produced by any other affection to which milk-using children are liable. Its causes are, first, sour and imperfectly digested milk, then a putrid change, causing pain, inflammation, and offensive dis. charges, and consequent lower vitality. Now is the time for the physician to do his good work Remove all offensive contents from the bowels by liberal cathartics, and, as far as possible, use those that are non-irritant. At the same time use heavy calcined magnesia, with small doses of hydrarg. cum creta, and use but little food but plenty of pure water. Use fresh cream mixed with water and magnesia. Lime water is too uncertain, and astringents are a curse. Sweet oil as a laxative usually does well by relieving the irritation of the mucous surface and also acts in a very pleasant way, as it diminishes the frequency of the discharges. Be sure to taste for your self any oil used by children, and if you find that a half-te aspoonful makes your throat feel like it was full of nettles, you would better not give it to the child, as every dose of rancid oil | will increase the a.ready serious condition of your patient.

This treatment I have found in the early stages of cholera infantum to be of the greate.t benefit in my hands. I have had an experience of twenty-five years in the most sultry malarial regions of the Certral States, and can rely on this simple treatment with the greatest confidence, and but a very little fatality. I have recommended the mothers to keep magnesia at hand in summer, and get pure olive oil to use on the first symptoms of sour stomach. Women who were careful to follow directions rarely ever had any trouble with summer diarrhea.

Dr. Spalding says that in the latter stages of summer diarrhea, where all remedies seem to be of little benefit, he has seen rapid improve. ment begin upon the use of a tea made of Mullein leaves, and mixed with a small quantity of cream and given to the child.

Hints on Treatment of Cholera Infantum.

EDITOR MEDICAL WORLD: -My usual manner of treating cholera infantum is to give minute doses of corrosive sublimate, if li zer is terpid, then either arsenate copper, or alol and bismuth tɔ control the bowels. One great factor is to cover the bowels with several fold; of flannel, or to wear a long flannel shirt below the hips. Morning and evening have the child carefully carried and hauled in carriage in order to get as much fresh air as possible. I

MY DEAR DOCTOR TAYLOR:-I have used TH MEDICAL WORLD visiting list and ledger the past two years and find them more satisfactory than any I have yet seen.

Very truly, 528 Fifth ave., New York. E. CUMMINGS.

Price only $1.00 for the complete set. Address this office. See order blank, page 238.]

Bichloride of Mercury Spray for Cholera In.

fantum.-Kakodylic Acid Again. EDITOR MEDICAL WORLD:-I would suggest the following treatment for "infantile diar. rhea," "infantile indigestion," or " cholera infantum," as being rational and effectual. Sop all nourishmeut. Give a weak solution of soda bicarb (dram i to a glass of water), teaspoonful every ten minutes. Keep the body and extremities warm, if necessary, using mustard water baths.

Make a I to 1000 solution of bichloride of mercury, and with a hand spray, douche or atomizer spray the child's mouth and throat every hour. It is astonishing how quickly this treatment will often change for the better an apparently hopeless case of this kind. Enough of the mercurial solution passes down the esophagus to arrest fermentation, and de. stroy micro-organisms. I suppose there may be danger of producing mercurial poisoning. I have not seen it occur. I wouldn't recommend this or any treatment for a blockhead to try. Infantile indigestion is one of the diseases that require skilful management.

"A NEW THERAPEUTIC AGENT.” I saw an article in The WORLD relative to the use of “ kakodylic acid." While I would not wish to detract anything from Dr. Lewis' fame in introducing a new remedy, I have to say that twenty-four years ago while a medical studert at Hanover, N. H., Prof. Edward Phelps, Professor of Theory and Practice, called our attention to its use as a remedy in tuberculosis, and in my graduating thesis I loyally advocated it, thereby making myself "solid” with Prof. Phelps at examination for degree. It therefore seems that Dr. Lewis' "new remedy” is really an old one resurrected. None the worse or better for that, however.

Let me say just one word in clo ing in com mendation of THE MEDICAL WORLD. So handy, you know, you can pick it up and in a minute get more than a dollar's worth out of it. I hope to take it as long as the lamp holds out to burn." .

Charles C. Pike, M. D. Peabody, Mass.

Although there is not another physician in this city that I know that uses the method altogether as I do, I must confess that under this treatment I have been more successful than under the former treatment. Children will always take the medicine, and better results will follow. Let me relate an illustrative case :

On the 15th of April, 1891, I was called tu see a child, William K., 2 years old, who lived about eight miles from my office, of which the parents had given up all hopes. They had employed another physician before I was called. When I saw the child I thought it must die. The case was cholera infantum of the worst type. The pulse was 155, temperature 105, and the child was vomiting every hour, with great prostration, and passing discharges every half hour of the most offensive character. The lips were of a bluish tinge, tongue darkly coated, and eyes apparently set, taking no notice of anything around it.

As is the custom with most physicians using this kind of medicine, I carry the medicine in my pocket with me. I gave the child one granule of narceine, one of hyoscyamine, one of aconitine, one-half milligramme each, every half hour. I saw the child eight hours after, and the vomiting had ceased, and the child was more quiet. I then ordered for the bowels one-half teaspoonful of seidlitz salt to remove any obstruction that might be in the bowel. Six hours after I ordered one granule of sulphocarbolate of zinc, 1-6 gr., one of brucine, and one of arseniate of strychnine every two hours, to keep up the tone of the system and to check the bowels. The next day I saw the child about 8 o'clock, and the pulse was 120, temperature 102, no running off of the bowels, no vomiting, flesh moist, tongue in good condition. I ordered one granule of aconitine, 12 milligramme, and one of arseniate of strichnine, and one of hydroferrocyanate of quinine every hour, and ordered the child to be given Mellen's food.

On the next day I found the child looking better, pulse normal, temperature 101, tongue looking well, flesh moist, and the child I pronounced well.

So much for the Dosimetric Medicine. I am of the opinion that there is no need of losing so many children as most physicians have lost within the last twenty years.

TURNER TORREY, M. D. 708 11th St., South East, Washington, D. C.

Treatment With Granules. EDITOR MEDICAL WORLD:- I have been a practicing physician for 20 years according to the regular school, and am now nearly 70 years old. About two years ago I thought I would try the new method of treatment advo. cated by Burggraeve, who recommended the active principles of medicine in small, frequently repeated doses, and called it the Dosimetric system.

The Medical Bulletin, Phila., says:-“ Dr. Taylor has given the profession a book of great value. (The Physician as a Business Man.] He shows how much doctors neglect the business part of their work. It points out, in very many ways, how money can be made and saved." See order blank, page 238.

Quiz Department.

haste to save the patient from dying from

hemorrhage. Soon after the patient got up Questions are solicited for this Column Coinmunications:

her mouth got sore, and in spite of all that has not accompanied by the proper name and address of the been done for it, it steadily grows worse. writer (not necessarily for publication), will not be noticed.

The tongue and throat are a good deal swollen. The great number of requests for private answers, for the The membrane looks like it had been scalded,

information and benefit of the writer, makes it necessary for us to charge a fee for the time required. This

and is covered at times with white patches. fee will be from one to five dollars, according to the amount of research and writing required.

The sorenes; extends to the stomach. She is

not troubled with nausea, but has obstinate EDITOR MEDICAL WORLD:-Will some of diarrhea at times, also severe pain in the front your readers in Michigan inform me by letter, part of the head. Her mouth is getting so bad or through the columns of The WORLD, of the now that she can hardly eat anything. Jaws regulating the practice of medicine and Patient is a member of my family, and any pharmacy in that state ?

help will be very gratefully received. Brandon, Florida. E. D. LOING, M. D.

"SUBSCRIBER."

We have received several requests for an A CORRESPONDENT wishes to know from article giving an authentic history and descrip. some one of experience, of the practical tion of the mad stone," with a correct results from the use of pilocarpine or jaborandi account of its supposed effects in the preven- for prematurely gray hair. Three special tion of hydrophobia. If any of our readers questions are asked: wish to respond with such an article, we shall 1. Would its use affect the nervous system take pleasure in publishing it.

unfavorably, where nerves are weak, and the

heart subject to nervous palpitation ? EDITOR MEDICAL WORLD:-For three years I 2. What dose and how long continued have enjoyed your bright and entertaining would you advise ? columns, and have gleaned valuable informa- 3. Would its use be unfavorable to mother tion there from that have more than once come or child in nursing? to hand in times of emergency and distress, when occasion for consultation of office litera.

· Nymphomania. ture was out of the question.

EDITOR MEDICAL WORLD:I write to ask I want advice and treatment from your a little help in treatment of a patient that ingenious contributors in the following case:- occupies an interesting position of enor nous A lady, multipara, aged 58, whom I treated dimensions in my mind. My patient is a lady six years ago for erosion of cervix, accompanied aged 32 years, of large physical dimensions, by & jerking of the voluntary muscles of the weighing 196 pounds, and possessed of an limb. I relieved the erosion and she passed absolutely irresistible and insatiable sexual from my hands until a few days since, when I desire. She will have from 10 to 12 sexual was consulted by her husband in regard to this embraces daily. which do not seem in the jerking, which has ameliorated somewhat, but least to relieve her amorous desires. yet remains with such persistency as to keep This deplorable state of aftairs dates back to her awake at night to a great extent. I am a miscarriage tha: occurred about the last of inclined to the opinion that her trouble is a last December. The fetus came away without localized chorea, caused probably by u:erine any unusual accompaniment, but the afterreflex. I have made no examination of late, birth was adherent, and I prepared to try to and cannot state her condition in that respect. deliver with my placental fo.ceps. When all She has suffered since the birth of last child, was in readiness to enter the uterine cavity in which was twenty years ago. Jerking is móré quest of the now foreign body, my patient annoying and persistent at night. Any infor- took the position that the further conduct of mation through The WORLD or by private the case should be entrusted to dame nature, letter will be gratefully received.

and I was obliged to acquiesce in this decision. Milner, Ga. . A. M. SPEED, M. D. The retention continued until within a few

hours of two weeks after discharge of the child, EDITOR MEDICAL WORLD :-I would like and then came away in the midst of an exceeddiagnosis and treatment in following case : ingly copious and truly alarming hemorrhage.

Mrs. B., aged 34, had a miscarriage at 3 This hemorrhage was so extensive as to threaten months term, three years ago. The case was the lady's life. But she rallied in an amaz. managed by an old mid-wife, who didn't know ingly hopeful manner, with every prospect of that a three months fetus had a placenta till it a return of her customary good health and was gouged out ten days after the miscarriage strength. After a reasonable measure of by a physician who had been called in great strength had been gained, symptoms of exist.

ing nymphomania began to manifest themselves, and have continued to more abundantly declare themselves until the present time, with every prospect of added continued growth, if not by some means checked. She seems to be given to gloomy and foreboding imagination and meditation. Is more or less despondent, easily excited to expression of tears and petulant; has some headache, but as a rule eats and sleeps usually well. There seems to be no evidence of general or special sexual derangement, she is regular and normal in cata menia, with no possible mal-demonstration, sive the one which furnishes the headline caption of this article. The fetus was between two and three months, and when it came away the pelvic quarters were greatly decomposed. No evidence of decay exis.ed in placenta when it was thrown off. Anything I have done with view to amelioration of existing sexual mania has proved wholly futile; and, as the case is one of absorbing interest, because of certain existing contingencies, which I do not feel at liberty to explain at the present, I supplicate assistance from some of the competent members of the great family of THE WORLD's readers. Have the goodness, my dear friends, to lend aid in this my hour of absolute need.

London, O. J. W. SWAR'IZ, M. D.

EDITOR MEDICAL WORLD :-Can you give me any information regarding the treatment of varicocele by hypodermic injection of ergo tine or hamancelis beneath, or among the veins? Is it curative? Is it attended with danger, or does it necessarily compel the patient operated upon to take to bed ? I have seen an occasional reference to such treatment in journals but have not been able to find any book giving information on the subject.

John M SMYTHE, M.D. Washington, D. Č.

EDITOR MEDICAL WORLD:-Can you give the formula for making s veet powders, sweet calomel, hydrargarum, sacharatum, as it is known by all these names? It is manufactured A Noblesville, this state, and is sold to only one druggist in a town, at $8 per pound. It is claimed that it will not salivate, it matters not how much acid is swallowed after a dose of the sweet calomel.

Clay City, Ind. JOE. FOREMAN, M. D.

Dr. M. J. KENYON, of Decatur, Neb., asks for the 0. E. Miller patented treatment for hernia. Can any of our readers give it?

A. E. WESSEL, M. D., of Brooklyn, Iowa, asks for the composition of " Eureka Hair Restorative," made at Grinnell, Iowa

EDITOR MEDICAL WORLD:--A few days ago a long, loose jointed, lank individual came into my office, wishing a tooth extracted. After the operation, which, by the way, was a very easy one, he asked me my charge. I replied, fifty cents." "What!” he cried, "fifty cents pii “Certainly; that is the regular charge." As he reluctantly laid the money on my table, he said, “I'll just be dog goned if that don't beat gosh! (or words to that effect). Why, Dr. M. pulled a tooth for me last fall and he upset the chair and dragged me all over the floor, and he charged me only fifty cents." Fact.

I would ask the readers of THE MEDICAL WORLD if any of them knew of a fat person having a tape worm ? Bromfield, Neb. C. E. BROWNE, M D.

Glycerine for Accelerating Labor. For the induction of premature labor, and also for facilitating labor at term Pelzer, in Centralól fur Gynak., (translated for Brit. Med. Jour.) recommends the injection of one hundred cubic centimeters (about 373 ounces) of pure sterilized glycerine, between the uter. ine wall and the membranes, under strict antiseptic and air-excluding precautions.

Test Questions 1. What is the most useful, practical, safest, timesaving and money-saving form for a prescription blank? See “The Physician as a Business, Man," pages 119 and 120.

2. Illustrate the difference between the doctor and the merchant from the stand-point of public charity, See pages 18 and 19.

3. How do physicians' charities help the large capi. talists, and what is the logical remedy ? See pages 27, 28 and 29.

4. What is the basis of the pbysician's fee? See pages 30 and 43 to 47.

5. What are average reasonable fees for different services ? See pages 71 to 75.

6. How should physicians' Sunday work be re. garded ? See page 75.

7. How do medical fees compare with those of other professions? See pages 80 to 82.

8. What is the most practical bill form ? See page 88.

9. What do you think of cooperative efforts at col. lecting accounts ? See pages 104 to 110.

10. What kind of account-books are most practical for physicians' uses? See pages 122 to 127.

11. How can the building association help the doctor? See page 128.

12. What obstetrical fee is charged by the profession in different parts of this country? See pages 48, 49, 55, 57, 63, 65, 68, 69, 72.

Price of "The Physician as a Business Man" is only $1.00. See order blank on page 238.

EDITOR MEDICAL WORLD :-The physician as a busi. ness man received and read at our sitting. It contains good, practical, common sense advice, and would do what it claims if lived up to. It was al vays my belief that a physician owed as much to his own family as to the community in general. Yours respectfully, Chester, Vt.

F. P. EMERSON, M. D. Price $1. Address this office. See order blank, p. 238.

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