Puerperal Eclampsia. EDITOR MEDICAL WORLD:-The case of Dr. Christopher, in THE WORLD of May, page 183, reminds me of a case of eclampsia which I saw recently. I was called to see a lady in the outskirts of the city, and found her in the fifth month of pregnancy, with excessive edema. On my advice she immediately took up her residence with her mother, living only a block from me. She was given baths and the usual treatment for albuminaria, but in a few days she was attacked with convulsions of a most violent character. I wished immediately to empty the womb. but her priestly confessor forbade. Several of the Holy Fathers came to the house, and the result of their consultation was no in terference with the pregnancy. On the third day, after many convulsions and violent delirium in the intervals, a dead fetus was delivered. Many remedies were used, but finally I settled on pilocarpine, keeping her in a condition of extreme perspiration. After the delivery of the fetus there were only a few convulsions. Her mental condition gave me great uneasiness, as I feared a permanent injury to the brain. She finally entirely recovered. C. B. HUTCHINS, M. D. 712 Post Street, San Francisco, Cal. Dropsy of Pregnancy; Convulsions: Delivery and Recovery. EDITOR MEDICAL WORLD:-I was called April 24, 1892, to the bedside of Mrs. S, aged twenty-two, of a sanguine habit. She had a convulsion at two o'clock p. m., and was taken with another one as I entered the front door at three o'clock. Husband told me that she was eight months gone with first pregnancy, had been swelling for six weeks. On examination I found general cellular dropsy, eyes more than half closed and dancing in their sockets. The enormous distension of the abdomen and uɔward pressure of the diaphragm was causing difficult breathing. Anasarca of the lower extremities was great. The abdomen was as firm and tense as a drum head. I bled her copiously-one and a half pounds-and gave hypodermatically, sulphate of morphine, grain 16; tincture veratrum viride, drops 10. I gave no more morphine, but repeated the veratrum viride every hour for three hours. At this time the pulse was counting fifty. She had had two more convulsions before I could get the pulse down to fifty. She remained in a semi-conscious condition eighteen hours. I gave magnesia sulphate to open the bowels, and gave sweet spirits of nitre, nitrate of potash, fluid extract buchu for a diuretic. Dr. S., a physician of good repute, Fluid extract of buchu... Water enough to make pint 1. .ounces I drams 2 ounces I M. Sig.-Tablespoonful every four hours. This acted like a calm in a great storm. She fell into a tranquil sleep and had full watery stools every two or three hours. I was sent for the following day in great haste, the messenger stating that Mrs. S. was having convulsions. On arrival, I found that she had had a convulsion, pulse 130. I bled her one pound, and repeated veratrum viride. She had another convulsion before I could bring the pulse down to fifty. She had passed two gallons of water in the last twenty four hours. Dr. J. M. Skaggs, of Maple Grove, Ky., was called in. No material change in treatment. On May 2, she was entirely relieved of the dropsy, was taking nourishment, and had felt the movements of the fetus the first time for several days. I was called early on the 4th, with Dr. J. M. Skaggs. We found that she had been in labor since 8 o'clock the evening previous. She gave birth to a six months stillborn fetus at six o'clock p. m. There were no symptoms of convulsions during labor. I never tested the urine for albumen. I should like to hear through the columns of THE MEDICAL WORLD from those who have treated similar cases giving this treatment. J. W. SHEMWELL, M. D. Bumpus Mills, Tenn. Fetal Death Caused by Cord Tied Around the Ankle.-Functional Impotence. EDITOR MEDICAL WORLD:--I fear that too many of the readers of your valuable journal are like sponges, absorbing all the good things and giving nothing in return, and as I fear that I might, of a truth, be classed among the number, I'm going to squeeze myself a little and see what may be the result. In the first place I want to say a good word for dosimetry. I have been using the dosimetric granules for nearly two years in my practice and have nothing but the highest praise for their use. They are called arms of precision and rightly named, but let no man think he can pick up the treatment in a sort of hap hazard way, for he vill certainly fail; their proper use and combinations requires much study and experience. April 19, I was called to attend Mrs. G,, age 22, in her first confinement. She said that she had not felt life for about four we ks and feared that her child was dead. There was nothing unusual in the labor, but when the child was born I found the cord wound twice about the ankle of the left leg and tied in a hard single knot. The cord was drawn as tight as the tissue would allow without breaking-so tight, in fact, that the little foot was nearly severed from the leg. By the appearance I should think the child had been dead about a month. I have had two patients come to me within the past year whose cases have troubled me not a little in regard to suitable treatment. I have searched my text books and medical journals in vain for some light on the subject but without any success to speak of, so, thought I would see if any of the many readers of THE WORLD could help me out. I will give the history of but one of the cases at present. Mr. H., age about 24. married, no children, but very desirous of them, of good physique, a perfect picture of health as far as that goes, came into my office some time ago with the following story:-"Doctor, I am not sick, in fact never had a sick day in my life, but I have a little trouble that annoys me very much and my wife not a little also. The facts are these: in attempting coitus the orgasm occurs too soon, sometimes before the organ is fairly entered; consequently with little satisfaction to myself and none at all as far as my wife is concerned. Can you do anything for such trouble ?" Upon questioning I could elicit no history of masturbation in former years, nor any sexual excesses. There is an occasional nocturnal emission once in two or three weeks when sexual intercourse is not attempted or he is absent from home. I have tried the bromides, ergot, strychnine, belladonna, monobromate of camphor, &c., &c., without any material benefit. I would [These cases are very common, indeed. They depend upon a hyperesthetic condition of some portion of the urethra, or of the genital nerve center in the cord or upon a general nervous hyperesthesia or erethism. Sometimes a short frenum is found to be the cause. The treatment must be patient and protracted. Everything must be done to relieve sexual erethism and tone up the nervous system. Locally, the urethra must be distended by cold steel sounds according to details as given by Gross, and washed with astringent lotions to the prostatic portion, as detailed by Ultzmann. Cold water douches to the back portion of the brain and the spinal cord may be given in the morning followed by brisk rubbing. Prolonged cool sitz baths in a deep tub should be given at night. The sedative treatment by electricity (positive to the lumbar and sacral portions of the spine and negative to peripheral points-thighs, genital organs and over the pubes) should be given regularly. The mind should be trained to avoid salacious thoughts. The diet should be abso lutely plain and unstimulating. In fact, in this very unsatisfactory condition the physician has many things to look for, and should correct one after another until improvement is manifest.-ED.] A Parasite in the Stomach. EDITOR MEDICAL WORLD:-Replying to Dr. Jones, whose article appeared in the April number, I would say that, while I have been very skeptical as to the formation or existence of live creatures in the stomach, agreeing with the subsequent editorial, yet it was my good fortune or misfortune to be an eye-witness to the expulsion of one such creature. I was sent for in haste to Mrs. W., a widow about 25 years of age, who complained of a terrible distress in the stomach. She had been troubled with it for six years, during the last two years growing rapidly worse. She had tried everything and several physicians with no success or relief. The pains were apparently spasmodic. For two or three weeks she would have a terrible gnawing, distressed sensation, with continued desire to eat but no satisfaction came of eating. Then for a week or two it would subside, during which time her appetite was poor. She was languid and had an utter loss of ambition. At the time of my visit she was in spasms. After a careful examination I thought that she was suffering from an irritated condition of the stomach. I administered a drastic evacuant with enemas of glycerine, 2 parts, carbolic acid, 1 part, dis. water (warm), 6 parts, which had a partially good effect, reducing the inflammation and allaying the convulsions, after which sleep for two hours was induced by the administration of a soporific, after which she went under the general treatment, but without effec:. A return of the same distress (as she termed it) .ook place with spasms, lasting for two hours, and sometimes longer. All the while she protested and was positive there was something alive "inside of me." Without saying anything I resolved to give her the benefit of the doubt and subsequently ad ninistered a vermifuge and emetic and watched the case closely In about one hour and a half she began to vomi: and continued so for about half an hour, relenting only a few minutes at a time, exclaiming, Oh, doctor! if I could only get that thing out of my mouth I should feel better," It finally came up into the mouth, and I passed my finger in the mouth and felt something squirming from the throat. I looked and found it to be alive. I unwound it and found that it resembled very much an earth worm, about two and one half inches in length, varying from a quarter to three quarters of an inch in width, with almost innumerable legs or roots, color white, slightly pointed at the head, which was slightly brown. It only lived a short time after being exposed to light and air. The patient began to improve and recovered in a short time, and enjoys good health since. This is the first and only time that I ever witnessed such an expulsion, although much has been claimed. What this was or what it might be called I do not know, I know it was expelled, and I removed it from the mouth, as before described, which dispelled in a measure my skepticism as to the existence of such creatures in the stomach, Perhaps other members of the profession have had similar cases; if so I should De pleased to read what they have to say upcn the subject in the "Physician's Friend;" THE MEDICAL WORLD. Could not get along without it. Valuable Therapeutic Uses of Iodoform.— Salicylate of Soda for Eczema. EDITOR MEDICAL WORLD:-Allow me to report upon the therapeutical action of two drugs whose action is not generally used in the manner reported. Iodoform internally I have found of inestimable value in the vomiting of La Grippe attended with foul discharges of the feces. In fact, in any disease where the evacuations from the bowels are very offensive it acts like magic. I had been treating a case of typho-malarial fever when the discharges were very offensive. I had given sulpho carbolate of zinc for a week with no improvement; also carbolic acid and iodine, corrosive sublimate, turpentine, mild chloride and thymol had no effect whatever. The condition of things was getting worse all the time. It was upon my own person. I eventually took two grains of iodoform night and morning. Three doses changed the character of the stool so that no more was necessary. My second case was that of a woman whose skin was bronzed with bile pigment, offensive bowels, foul taste in the mouth, emacia:ed, no appetite and suppression of the lacteal fluid. She had been taking acetate of potash with calomel and podophyllin and quinine with no benefit. Three one grain doses changed the character of the secretions. The skin cleared up and general good health ensued with no other treatment. My third case was that of a baby three months old with fermentative diarrhea. It had been taking mercury with chalk and syrup of rhubarb in smal doses. No change occurring for the better I resolved to try iodoform. Two one eighth grain doses night and morning effected a cure without any further treatment. My fourth case was that of a child four months old with fermentative or frothy offensive diarrhea, of two months duration, so the mother reported. Two doses, grain one-eighth each, effected permanent cure. I have used it in fourteen cases in all without a failure to do as reported. My last case was one of pleuro pneumoria with congestion of liver and bowels, attended with vomiting and offensive evacuations from the bowels. I was called in consultation in this case. The case assumed an unfavorable aspect; temperature 1042°F. vomiting persistent, which the attendant physician had attempted to control with hypodermics of morphine. Three twograin doses of iodoform arrested the vomiting, changed the character of the secretions and in three days the patient was convalescing. Iodoform disengages ninety per cent. of its iodine when taken internally; is a sedative to the mucous membrane, an anti-ferment, anti septic and alterative. with sugar of milk. the smell or taste. I give it in powder mixed Patients do not object to More anon. Now for chronic diarrhea: A young man twenty years of age, came to me with chronic diarrhea of two yea's duration, pains in the stomach and bowels, skin dry and harsh, emaciated, urire scanty, tongue red and inflamed, chills in the evening, puise feeble, anemic and generally dilapidated throughout. I immediately put him on iodoform, which changed the character of the discharge in two days. I then put him on a milk diet with salicylate of soda and bismuth and inunctions of quinine, which effected a complete cure in three weeks. This is the only case I have tried of the kind. By the way, I find salicylate of soda one of the finest remedies we possess for the treatment of chronic eczema. It relieves the hyperemic condition of the skin and effects a cure when taken internally when all other remedies have failed with me. I have used it in six cases without a failure. I use a coating of bismuth externally to relieve irritation and itching while the soda is doing its work. I have a few other remedies to report but enough for the present. GEO. H. TREADGOLD, M.D. Port Huron, Mich. Fistula in Ano. EDITOR MEDICAL WORLD:-I sent you a few lines recently on the treatment of fisula (see April, 1892, page 149). I have just had a case which illustrates the treatment. There was an abscess near the rectum, opened early, but would not heal. There was no opening into the gut, but on thoroughly opening the abscess I found nearly one half of the sphincter detached from the outlying tissues. What a temptation to cut the muscle, as it would then certainly heal; but I have been a sufferer for many years from a sphincter cut in 1865, by Dr. Van Buren, of New York. It did not unite and when there is diarrhea it is necessary to remain near a closet or there will be a catastrophe. I stretched the sphincter (not stitched, as is incorrectly printed in the April number), injected the abscess with a strong solution of nitrate of silver, put a plug made of cloth into the rectum, so as to keep the muscle quiet and immovable for 24 hours, and on removing the plug the sphincter had become attached to the adjacent tissues, and the cure was complete. I never cut a sphincter any more, but inject the fistula thoroughly, stretch the muscle and put in a plug large enough to completely distend the muscle. C. B. HUTCHINS, M.D. 712 Post St., San Francisco, Cal. Rectal Worms. EDITOR MEDICAL WORLD:-On page 57 of MEDICAL WORLD, J. W. Ward, M. D., inquires for a destroyer of the parasite. I would say that it is much more difficult to cure females of the parasite than males. The mature parasites frequently desert the rectum and anus of the female and enter her genital tract and lay their ova there to be hatched, and thus if you kill them in the rectum and anus they speedily return from the vagina and vulva to the anus and rectum, and thus the patient is never cured. The way to kill them completely is to kill them in the genital tract as well as in the rectum and anus. I know they emerge from the rectum for I have seen them emerge, and I know they enter the vulva and vagina because good authority informs us that they have been seen there. I even believe they travel from one person to another and thus infect persons who sleep with the affected. I have tried lime water enemas and find them of no value. I have tried enemas of very bitter infusions and find that they will destroy the worms. An ointment of calomel will speedily kill them or any other parasites which infest the rectum and anus, or vulva and vagina. When the pruritis ani or vulvæ is not caused by the worms it is usually caused by microscopic parasites, and whatever means are used to kill them, the best preventive of their return is to use injections of tepid water once per day for two or three weeks. Indeed, the injections of tepid water alone, as aforesaid, would drive away the parasites, for they revel in septic matter, and cleanliness would make the parts no home for the parasites. The worms frequently cause hemorrhoids, and occasionally cause spasms and convulsions in in the young. Hudson, Ill. SILAS HUBBARD, M.D. Two Strange Cases. EDITOR MEDICAL WORLD - During the thirty-five years of my professional life in various countries many strange things have passed under my observation. But I have lain dormant for the last few years as far as writing communications for medical journals is concerned, but have decided to arouse myself and mention two cases that may be strange to some if interesting to none. In Denver, Colo., in 1883, I attended Mrs. B., age 27, first child, in a severe and protracted labor. The child (boy) was born with every vital organ perfect. The head was the size of an ordinary goose egg. Length from top of head to sole of foot, eight inches. Weight eight ounces. It lived on milk from a spoon fifty-three days and died from natural causes. The strangeness in this infinitesimal specimen of humanity was that it did not increase in weight and length from its birth until it died, when it could only be compared to a Liliputian skeleton. Is there such another birth recorded in any medical journal in this country? Another case. Seventeen years ago I was invited to attend Mrs. R. in confiement, age 22, first child, Eight hours in natural labor, child, a boy of average weight, well developed and healthy. One hour after birth of the child, whilst putting the placenta into the chamber under the side of the bed, I noticed adhering to the same a closed sack about the size of my two hands, but I paid no special attention to it until an hour afterwards, when about to retire, I bethought me to see what the little sack contained, and in breaking it open I found a living girl baby, weight five pounds, which soon grew fat and as large as her little brother. Both lived to the age of seven months, grew rapidly, and in perfect health, when both were stricken down at the same time with pneumonia and died within an hour of each other. S. M. HASLEA, M.D. Albuquerque, New Mexico. Suggestions in Regard to Cerebro-Spinal EDITOR MEDICAL WORLD:-We have just passed through an epidemic of cerebro-spinal meningitis, in which eighteen patients out of twenty-seven died. For good articles on the subject I would refer THE WORLD'S readers to Pepper's System of Medicine, Vol. 1, Hare's System of Therapeutics, Vol. 2, and Reference Handbook of Medical Sciences, Vol. 2. I merely wish to give my views in regard to etiology and treatment, for I believe the disease is caused by a specific poison found in moldy bread stuffs, either from moldy grain converted into flour, or bread, crackers, etc., rendered moldy by being kept in a damp place. I am satisfied that I traced three of my cases to moldy crackers, and that the disease was caused among soldiers by the moldy hard tack that they ate. Grocers ought to keep crackers in a dry place, for they are usually made from inferior flour and very liable to mold. Nearly all of the cases that recovered were given large doses of opium, and had bags of ice water applied to the back of the neck. I was able to reduce fever and relieve pain by means of the ice bag, which can be filled and emptied without moving the patient, by attaching a syringe. The sick room should be darkened, very quiet, and the patient moved as little as pos Acetanilid for Hypersecretion of Milk. EDITOR MEDICAL WORLD:-Noticing in the May MEDICAL WORLD the request of Dr. Rogers for unfailing method of drying up the milk," I would suggest the trial of acetanilid. This remedy has proved most satisfactory in my practice, having twenty recorded cases in which it was given fair trial. Administration: -two to five grains every two hours, guarded (if necessary) by stimulants to avoid depression. Acetanilid has undoubtedly been used for the same purpose by other members of the profession, but having no recollection of seeing it suggested for such purpose I offer it for trial and discussion. FRANCIS E. THORNTON, M. D. North Parma, N. Y. Some Tried Methods of Treatment. EDITOR MEDICAL WORLD:-I modestly offer to the readers of THE MEDICAL WORLD a few of my favorite formulas. They have always given me good results. For chronic inflammation of the bladder and irritation of the mucous membrane take R Fluid extract of corn silk......ounces iv Mix. Dose, teaspoonful, t. i. d. One of the best combinations in our materia medica. As a general tonic the following is always to be relied upon, in malnutrition, when the nerves are crying for food, and manifest this state by low vitality, imperfect enervation, |