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tonic tablets, one immediately after meals will Reflex Origin of Pains Resembling servicable.

Chloride of Gold for the Tobacco Habit. One more: Headaches of all forms I treat EDITOR MEDICAL WORLD:~The case outwith caffeine alone, or as follows:

lined by Dr. W. A. Thomas, on page 185 of R Caffeine

.grains iss the May WORLD is probably an example of Phenacetine....

.grains 1-X those reflex pains, well described by Hilton in M. Ft. one powder and repeat as necessary.

his lecture on “Rest and Pain.” In this case Caffeine is a tonic to the heart, and is a reli- the primary irritation is either in the rectum able diuretic.

or in the urethra, most likely the latter. If I like THE WORLD. Would not be without the Doctor will introduce a warmed and oiled its monthly calls. Would that it came weekly. steel sound into his patient's urethra, he will Its suggestions are applicable to the work of find it tight and sore. To treat this condition, the country doctor.

begin with a size which will readily enter into H. H. BARRETT, M. D. his bladder, no matter if it is only No. 1, and Smicksburg, Pa.

remove it immediately if very sore. Repeat

the introduction every seventh day, gradually 'Slow Fever" or a Variety of Enteric Fever. inoreasing the size of the instrument to an Eng.

EDITOR MEDICAL WORLD:-In reply to Dr. lish 14 (using one size say three times before Dean, of Leesburg, Florida, on page 145 of passing to the next). As the soreness dimi. April MEDICAL WORLD, as to “What is it?" nishes, allow the sound to remain longer in the I will say that he has the same name in Florida urethra, slowly increasing the time to twenty as we have in Louisiana, "slow fever,” and a minutes. He must do this with great caution, very improper name for it. The proper name allow plenty of time between the treatments for it should be enteric fever, as its pathologi. for reaction, and rely for the cure more upon cal anatomy is mostly in the intestines. In that reaction than upon what he can do directly regard to etiology it is of malarial origin. with his sound. Extreme gentleness and con. In my experience and opinion the seat of the sideration for the irritated canal are necessary disease is not of the nervous sys'em, and the tor success, but if he makes a healthy mucous pathological condition is not anemia of the membrane, the reflex pain will disappear. spinal cord and nerve centres, at least not in By microscopic examination of the man's this locality. This pathology in my opinion urine, the Doctor will probably find it loaded is not produced by over work, and want of with crystals of calcium oxalate, perhaps some proper assimulation to compensate the waste of phosphate. In the act of urinating these nerve cells that is constantly taking place, but crystals strike the neck of the bladder with by an enteric baccillus of malarial origin, taken thousands of sharp needle points as the liquid into the alimentary canal. My treatment is ball of urine is squeezed through the narrow supportive and antiseptic. We should keep orifice. They also scratch the urethra in their the secretions aroused. I should like to hear passage, keeping the canal irritated and sore. from other brethren.

It is almost impossible to heal the urethral Sibley, La. J. B. GREEN, M. D.

surface with this

splintery mass flowing through [The marked difference of views of Dr.

it several times a day. The cause will pro. Dean and Dr. Green may indicate that they bably be found in the limey drinking waler

, are considering entirely different diseased con

which must be absolutely forbidden until his ditions. If each one would give, in the next

canal is well. Rhubarb, correl, tomatoes and number, a clear account of the disease, the

onions, in any form (even as flavoring) should conditions which favor its development,

be forbidden, because they throw down quanand the treatment to which it most promptly

tities of oxalate of lime in the urine ; also yields, we may get much enlightenment from

strawberries, which often cause a jagged crysit. In that event, we believe that the two

tal; and asparagus, parsley, alcot olic drinks doctors will find themselves nearer together

and spices, which heat the parts chemically than they think.-ED ]

The patient should drink boiled and strained

rain water only, and at least six glasses of it EDITOR MEDICAL WORLD :- A comparison every day, besides what he takes at meals. of the rolumes of The MEDICAL WORLD, which If the crystalline deposit is uric acid, lithia lie now before me, shows the gratifying fact water should be used during the treatment. that the journal is getting better and if possible On the other hand, if the urethra will admit more useful with every year. In fact, I don't a No. 14 English, fully into the bladder withknow of any publication which gives so much out pain or discomfort, and if there is no ulcer in return for the very moderate sub:cription and spasm in the rectum, both structures may price.

be regarded as healthy, and we must take Alle zheny, Pa. A. ZEIGLER, M. D. another view of the case. We must consider

This repre

the nerve centres of the lower dorsal, lumbar A Report of Two Cases in Practice-Croupous and sacral regions, both sympathetic and Pneumonia and General Anasarca. cerebrospinal By pressing firmly with the

EDITOR MEDICAL WORLD :-My first case is thumb down the central line of the back and

one of "coupous pneumonia" in a little girl then on each side of the spine for a breadth

aged eight years, with the following history : I of six inches, the Doctor will probably find a

first saw the patient on the evening of February point where his pressure hurts.

21st, 1892. She had had a chili the previous sents an irritated (congested) nerve centre day, and the family, thinking nothing serious, which lies beneath. If no sensitive spots are delayed calling for my services for twenty-four evident run a mild current of galvanism (the hours. When first seen by me, she had a temKidder mixed current is the best) from the perature of 104% F., pulse 160; respiration effected foot to the back. Having located

panting. There was dullness over the middle them, treat the sore points and the adjacent and lower lobes of the right lung, but I could spinal centres with the negative pole for five

detect no rales on auscultation. The family or ten minutes, or run a current from each

history of this case was not a flattering one for foot to the back for five minutes. Do this

the ultimate recovery of my frail little anemic every third day, and as the case is not very

patient. She was the only child of a dead chronic, relief will be seen in several treat- mother-her mother dying of consumption men's and cure in some weeks. Try five elec- when the child was but an infant. All of her tric treatments tentatively anyway,

mother's side of the house show a tuberculous If it were my patient, I would also give taint. All of her father's side also, as her Thus, third dilution, or colocynth. or agaricus father and his younger brother are the only tincture, quarter drop 'hree times daily. relics that are left of a family of five. If no sore spots can be elicited and if there

Tuberculosis on one side of the house is bad is no improvement from five applications of electricity, the Doctor must trace bar k to the

enough; but when we have it doubled and higher nerve centres in the brain; but I have

twisted on both sides, we have a monster, in

deed already given enough suppositious treatment. Let me hear from him again, as he may have to

Bessie H., our patient in question, was one

of these unfortunate ones—a child of tubercugo no further than the urethra. I would request Dr. W.O. Hawkinson, of

losis parents. She had suffered with a chronic

bronchitis for several munths previous to the Roanoke , (May WORLD) to try a treatment for the tobacco habit which proved succecsful

present attack, and was in general ill health; with a professional friend.

pale, blue-eyed, anemic, and a dear lover of It is the homæo

common salt, a characteristic often noticeable. pathic first trituration of aurum muriaticum,

in this class of patients. So fond was she of three grains nie ht and morning. In his case

salt, that she would steal it out and carry it to tobacco was injurious to his heart. He had

bed with her to eat through sleeping hours. often tried to give up his after dinner cigar, but the longing and sense of “want" always

The following is my treatment of the case : brought him back. This time he stopped

I ordered a stimulating liniment to be rub. smoking and began the aurum. In a few

bed over the entire right chest. I then enweeks he realized that the longing had disap- veloped the chest in cotton batting dressing, peared and it has not since returned. After

and gave half drop of tincture of aconite every six weeks use, the gold was discontinued.

txo hours to control the temperature and pulse.

I ordered milk diet, generally hot, every two Geo F. LAIDLAW, M, D. 137 West 41st Street, New York, N. Y.

hours. In twelve hours the patient made some

little improvement; temperature 104, pulse A PHYSICIAN of Texas, who does not give 156, respiration 48. his nam , offers the following information :.

In about eight hours after the above observa. "The case described by Dr. W. A. Thomas,

tion was made, I was called to see the patient in May number, is very common among the

in haste. She was bleeding from the nose and caval y troops in North French Africa, Alge

the family had become much alarmed. When ria, and so rebellious to cure that officers, even

I saw tne patient her nose was bleeding but privates, who have the means, immediately very little. I believed that some hemorrhage obtain furlough for the hot sulphur sprig at

from her nose would be bene ac ial to her lung, Aix les-Caines. Savoy, France, where massage

and did not feel inc'ind to check it premaand hot baths effect a cure, in all cases, in

turely, but taking into consideration the child's from four to twelve days. The hot springs of anemia and the family's fears. I ordered five Arkansas will do the same."

minims of fluid extract of ergiit in addition 10

aconite every two hours to equalize the circuKoep your journals in a MEDICAL WORLD binder. lation and control hemorrhage. The epistaxis was controled for twelve hours, when I was magots. I ordered all abrasions of the surface called in haste again to find my little patient washed in a weak carbolized solution. I gave bleeding from both nose and lungs and satu- him a decoction of carya alba, or the outer rated in blood. I had with me some lemons bạrk of “shag bark” hickory. I gave him and a post nasal syringe, and I used lemon water in no other form with but one or two exjuice freely with but temporary results.

Iceptions. gave ergot in half dram doses every half hour, In three days time my patient could walk also tincture of iron ; but in spite of all the about the room. The dropsy rapidly disap hemorrhage continued to an alarming extent. peared. I then put him on DaCosta's heart I had no tannic acid with me; but as soon as tonic, and his recovery was complete. I also I could procure it I gave it by insufflation and used a dusting powder of compound talc povper orem until the hemorrhage was controlled ; der and tanin to the scrotum and legs, which but before the hemorrhage was controlled the did much for temporary relief of the patient

. most remarkable part of this case transpired. I report this case because I think it a remarkDuring an effort to vomit, while the blood

able cure in a man of seventy-nine, whether was running profusely, the child became

it be permanent or not. The treatment is choked, and reached her fingers into her harmless, and an efficient and justifiable one. throat to relieve the obstruction, pulling out I believe that I am the pioneer of this treattwo repeated handfuls of fibreus exudation in

ment. filtrated with air. This exudation represented I know that dropsy is not a disease per se, complete moulds of the bronchia and its rami

but an urgent and dangerous symptom, and in fications, and, in its fresh state would represent "carya alba" I believe that we have the drug in area almost the lobe of a lung in a child of to combat safely and effectually this symptom. her lung capacity.

I would like to have report of your trial in I presented this specimen to the Ky. Med. these cases by private mail, and I will report Society, May 4th, 1892, after the reading of collective investigation to this journal. Simon i lexner's essay on croupous pneumonia (read by Prof. Ouchterlony.)


Bridgeport, Ky. The specimen is now in the museum of the pathological department of the Hospital College of Medicine, Louisville, Ky., and as soon as a

Response to Queries. microscopical examination is made, I will re- EDITOR MEDICAL WORLD: "Obstetric Export it to this journal.

perience,” (Dr. Price, page 134, April number As to my patient, she made a good recovery. MEDICAL WORLD), the less manipulation of a After the loss of so much blood and expectora- rigid os uteri in midwifery the better. An tion of casts, her temperature fell to 97 F., administration of ergot, even after it has passed with almost collapse. Hut bottles of water over the head is dangerous, as it is liable to were placed around her. She was fed ani cause the uterine contracture to be transverse, stimulated until reaction was established, and which, instead of expelling the contents of the in four days afterwards convalescence was fully organ, clings for the time more tightly to the established. The expectoration was frothy fetus. Veratrum viride, often administered, a and scanty until the expectoration of the casts, few drops in brandy and water, will cause a when it was grumous directly afterwards, then rigid os to relax. Chloroform administered streaked with blood, then normal. The patient judiciously, if not contra-indicated, will cause has not at present, nor has she had since con- relaxation. A plethoric patient will bear the valescence was established, any bad symptoms loss of half a pint of blood from the arm and of any kind.

She has a good appetite, and the relaxation of the os uteri will soon follow. is cheerful, bright and happy.

Morphine judiciously administered, will often Case and. Mindesh Peyton, aged seventy- have the same effect. If you had succeeded nine, white, was sent to the Franklin Co. In- at the time with the forceps, the uterus would firmary, May 2, 1892, I saw him May 3rd. have been ruptured; vou did right to give the He was dropsical all over; he could not walk morphine, in my judgment, but not the ergot. or lie down; his breathing was short and la To “Inquirer,” (page 151) I would say let bored; his mind wandering; his scrotum was the young people marry." so dropsical that his penis was lost in its own To W S. Richardson, MD., Williamsport, folds ; urination was difficult and scalding; Md., for acne rosacea, I would say, give the his rectum was raw, his legs were red, watery parties proto-iodide of mercury 1.6 grain daily and raw. He had not had a change of cloth- every alternate week for a month. Locally use ing for fourteen weeks before coming to the bi chloride of mercury in solution 2 to 1000 infirmary. Those who washed and dressed over surface every other night on retiring. him stated that his clothing was infected with Grand Island, Neb. C. T. PoE, M.D.



ters, clean the ulcer; apply daily hydrogen EDITOR MEDICAL WORLD:-Permit me to

peroxide and use nitrate of silver occasreply to some queries in the April number.

sionally. Dr. Ed. H. Bowling, Luster, N. C. Your

J. T. BARNETT, M. D. case was certainly intussus ception. You should Hardinsburg, Ind. have urged a post mortem. Dr. J. Francis Cronin, Tampa, Fla.

Treatment of Epilepsy. need not expect much from internal remedies,

EDITOR MEDICAL WORLD:-I have noticed for your case of varicose veins. Some authors

quite a number of requests for treatment of recommend injecting ergot or witch hazel

epilepsy. When not caused by injury to the along side of the vessels, at the same time giv- brain, I have had good success with the following witch hazel internally; I have had no

ing :experience with the plan of treatment. I

R Tincture of digitalis.... ...drams ij generally advise an elastic stocking, where they

Fowler's sol....

..drams ij will not consent to having the vessels oblitera

Tincture of nux vomica.. ... drams; ted by passing hair-lip pins under the vessels, Fluid extract ergot (Squibbs)..ounces ijss and applying the twisted suture.

Bromide of potassium, sat, sol., Dr. C. P. Hubbard, Lovell, Me. 6- Bottled

9, s. ad..

ounces viij

Mix. Sig.–Give drams j in a wineglass of water Electricity" (2) is a small, wide-mouthed

three times a day. bottle containing a sponge, in one side a piece of zinc, in other a piece of copper ; a piece of

I think Dr. J. W. Slack's patient would be copper wire run through all; the sponge is helped by the following :then saturated with oil of mustard. You can

R Tincture of nux vomica..

drams ss

Fowler's sol. manufacture all the bottled electricity you Fluid extract dandelion.

ounces j want. You will not need the zinc and cop

Ammonia muriate (C. P.)......drams iv per.

Water.......q.s. ad.......... ounces iv Dr. Richardson, Williamsport, Md. I have Mix well. Sig.-Give drams j in water three times been successful in curing most of my cases of

a day before meals. acne rosacea by keeping bowels open, and I am always glad to

see your valuable using locally the following:

journal. R. Sulphur precip.

...dramsj ss

Topeka, Kan. H. K. TEFFT, M, D.
Pulv. tragacanthæ.

...grains xx
Spt, camphoræ
...fluid drams ij

Test Questions.
Liq. calcis .......9. s. ad. fluid ounces jv

1. What is the most useful, practical, safest, timeM. S.-Apply twice a day with leather or camel's hair brush.

saving and money-saving form for a prescription blank ?

See “The Physician as a Business Man," pages 119. Dr. JM. Mackie, Portage La Prairie, Ont. and 120. I think your diagnosis is correct. Try Fow- 2. Illustrate the difference between the doctor and ler's Solution of Arsenic. If no improvement,

the merchant from the stand-point of public charity, then try hyoscyamus and nitrate of silver. Dr. See pages 18 and 19. J W. Black's case requires similar treatment.

3. How do physicians' charities help the large capiThere is, in my opinion, ulceration in connec

talists, and what is the logical remedy ? See pages 27,

28 and 29. tion with the gastric catarrh. Dr. S. B. Bennett, Fairview, Ill. I will sug

4. What is the basis of the physician's fee? See

pages 30 and 43 to 47. ges; some remedies that will influence the

5. What are average reasonable fees for different disease (exophthalmic goitre) as much as any services? See pages 71 to 75. remedies now in use. It will require time and 6. How should physicians' Sunday work be repatience. Give digitalis, scutellaria and ergot garded ?

See page 75. in combination. The object being to so regu- 7. How do medical fees compare with those of other late the heart's action, as to lessen the excit- professions ? See pages 80 to 82. ability of vessels and reduce the flow of blood 8. What is the most practical bill form ? See page 88. through them more nearly to the natural 9. What do you think of cooperative efforts at col. standard. Establish menstrual flow if suppres

lecting accounts? See pages 104 to 110. sed. Regulate diet and see to it that the

10. What kind of account-books are most practical hygienic surroundings are good.

for physicians' uses? See pages 122 to 127. Use electricity also. Faradization of the

11. How can the building association help the doc

tor? See page 128. sympathetic, one electrode to the sympathetic

12. What obstetrical fee is charged by the profession in the neck, the other to the cervical vertebræ.

in different parts of this country ? See pages 48, 49, Charcot employs galvanism to precordial re

55, 57, 63, 65, 68, 69, 72. gion.

Price of “The Physician as a Business Man" is only For ulceration of rectum, dilate the sphinc- $1.00. See order blank on page xx.

Comments on Articles in June “ World." what sluggish.

He says he passes 10 to 15 at EDITOR MEDICAL WORLD: I have been

every stool, sometimes about one-half the stool “leeching ” long enough; been drawing from is composed of these segments. When I put the pages of The WORLD without returning them in dilute alcohol they contracted to about anything. In 1887, Dr. Murray, of Suffolk, one half their original length. Each joint has Va , and Dr. Benj Edson, of Brooklyn, N. Y., a small tubercle on the side, something like the had an argument on cholera infantum. After

tape-worm. Each piece is three or four times reading their arguments, I decided that neither as long as a joint of the original worm. was correct. Surely if the cause was well The man has always had good health, exceptunde stood they would not differ so widely. ing that he had typhoid fever about six years I started in the dark, as it were, at that time ago, from which he seemed to recover Until and called it a “germ.” Dr. Coggin, Keener, after we got the worm he could call to mind Ala , has about my thoughts on the subject, in that he would have “slight pain about the his summary on page 212, June No. Instead bowels, but did not amount to much." of “poor nourishment” I say heat and im- My wife says " she wishes I'd stop taking proper nourishment.

I prefer corrosive sub- THE WORLD" because its hard work to get me limate for the treatment, as it is the best to meals, and no hoeing done in the garden antiseptic known. I give i 100 to i 50 grain. until I get through reading it. This destroys the cause. Now soothe the irri

Harper, Kan. J. H. MEDARIS, M. D. tation they have caused. This I do by pulv. acaciæ ad. libitum. Now supply the watery

Imperfectly Developed Child, elements of the blood by giving water. What

EDITOR MEDICAL WORLD :- Dr. W. R. else do you need ? Dr. Marshall, on page 212, " hathes and

Pennington's article in your last issue suggests swathes in a decoction of hickory leaves," but

a case which I attended some time ago. don't know why. We can't find hickory leaves

Was called to see Mrs. B., a multipara.

Made an examination and found that labor was here. I gue-s buffalo grass will do as well, as it was the water taken into the system through hour she gave birth to a full term, well

progressing normally. In the course of an the skin. He did not say cold or hot. I

nourished child, weighing 10 lbs. There was would suppose warm, as this will relax the

an absence of the anus, and male and female capillary blood vessels, and the water will be more readily absorbed If Dr. West, on page

external sexual organs. It lived about twenty

hours. 214, would leave out his lead and starch in his recial injections, it would be more effective.

D. G. SHARPE, M. D. Nor can I see why he gives sulphate of quinine

Cassopolis, Mich. and tannic acid together, as they form an insol. uble tannate.

Was it Hydrophobia ?-The Madstone. I like the granules, but Dr. Hate and Dr. EDITOR MEDICAL WORLD :-In auswer to Campbell, on page 214, placed the little rifle

your request in the June number of The bullets in "double action Winchester," and WORLD, I send the following case and comfired so fast we could not see which hit the munication : mark

May 31, 1892, I was called at 1 a. m. to see I would say to Dr. Browne, page 219, yes. a man aged 23. The messenger said that his I have 26 feet of the gentleman in a bottle, arm was hurt and, supposing it to be a surgical taken from a man well nourished, red faced, no case, I took my emergency grip and went, symptoms; complained of nothing until one through an awful storm, about six squares. On evening he was going home tro o his place of arrival, I found the patient perfectly nude, business he felt an uneasiness about the anus. held on the bed by six strong men, the father, He stopped in his barn and found several brothers, and two others. joints hanging out. I proceeded to remove I found that another messenger had been him (the worm) by the chloroform route. The sent out, as the one that came for me had been patient was not careful to save all discharges, hunting for a physician about an hour. Another so I can't say that we got the head. Some physician had arrived a few minutes before, months alter he begins to pass segments i to and as the patient would take no medicine per 1/2 inches long (no two pieces connected to- orem, had gone home for his hypodermic, and gether), 14 inch wide, which have power of he being the physician to the chloride of moving along, and can elevate head end for gold institute here, and supposing it to be a one fourth their length from the paper on case of what Mrs. Partington calls “ delirius which he had them He says they moved tremendous," also went for some of his “ gold about rapidly. When I saw them about one hour after they were passed, they were some- Upon learning of his having been called, I



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