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gave granules of codeine, and, if necessary, Dr. Cline's treatment of dropsy (page 417) morphine. If delirious, I gave granules of may be as successful as it is unique. I treated hyosciamine. Every two hours one granule of two cases six months ago, one of anasarca and arseniate of strychnine and the salicylate of ascites, the other of anasarca. The former as ammonia mixture, so often referred to in The follows: WORLD this season (should now use the sulpho- R Acet potass..
...ounce i carbolate of zinc in alternation continually Tincture of digitalis
..drams iiss throughout the fever). After defervescence Í Fluid extract of Queen of the Meadow
(P. D. & Co.,) continue the arseniate of strychnine, alternated
Fluid extract of corn silk (P. D. & Co ) with hydroferocyonide of quinine and quassine. Equal parts enough to make .. ounces iv The diet is highly important; an exclusive M.Sig: --Shake. Dose one teaspoonful, well diluted, milk diet is the best. Regularly every two
every four hours. hours, I gave a glass of milk, or its equivalent. After I had run all the water out of him, To those to whom it was impossible to admin. (which took about one week), I put him on ister milk I gave broths thickened with arrow cactina pillets, one every one, two, or four root. Stimulants were resorted to in but two hours, as required to control the heart pain,
(Plenty of cold water first, last and all dyspnea and palpitation, conjoined with the the time.
following: One hundred and nineteen years ago, when R Fluid extract of sour wood Dr. Buchanan wrote his then excellent work, Fluid extract of Solidago virgaurea aa blood-letting was in vogue in the treatment of
M. S.-One dose repeat t. i.d. almost all diseases, but to-day the use of the lancet and tape is almost a lost art, and my
He told me yesterday that he considered opinion is that in less than that number of himself permanently cured, which I much years more the use of cathartics amongst the doubt, though he has been free from dropsy careful observers and thinking men in the
some five months. When I commenced treatmedical profession in the treatment of typhoid ment he was water-logged from his toes to his fever will have been banished, and thereby nipples, and had to be propped up in bed to many valuable lives will be saved.
sleep. I think my friend, Dr. W. C. Abbott, does For an experiment I put the other case on not correctly interpret nature's anguish;
sour wood and solidago, with tincture of instead of the small intestines crying because strophanthus until the cellular tissue was emptheir contents are so nasty, they are crying tied; then on cactina pellets. This case did because their mucous membranes are inflamed,
as well as the other. and their tears are what produces the diarrhea.
One thing which I do not understand about Now, instead of increasing the inflammation
the first case was that the diuresis was all diur. with cathartics, soothe with the sulpho carbol
nal no rising at night to evacuate the bladder. ate of zinc, and “flush” the colon with the Dr. Harrington (page 407) voices my opinion chloral solution and relieve their grief.
of Dr. Hurd's cases of anamalous fever both as Albany, Vt. J C. CAMPBELL, M. D. to name and treatment. In the settlement of
new territory, here in the West, fevers are uf Comments on Morphinism.-Cyanosis.- the intermittent and remittent bilious type. As Dropsy.-Continued Fevers of
population becomes more dense, we find a a New Country
transition to enteric complications, and WoodEDITOR MEDICAL WORLD:-1 would suggest ward's misnomer a "typho-malarial,” which in Dr. Emory's case of morphomania (page 427), is typhoid, and should be recognized and as to the amount used, to remember that an treated as such. Here in the Arkansas valley, opium habitue, like one afflicted with syphilis, sixteen years ago, it was the exception to have is always a liar. To tide him over the “pitiable a fever patient in bed longer than from five to condition,” which I presume is caused by seven days. If intermittent, calomel and being deprived of the drug, I would give him quinine sufficed; if remittent, when called to Keith's avena sativa con. tinc. for the attacks a case, you would load your patient up at night of angina, inhalations of amyl nitrite, and do with calomel tamped down with Dover's pownot spare it ; his head will not burst ! In the der, touch him off with salts in the morning, intervals give cactus grandiflora, or cactina feed him on quinine for a week, and discharge pellets.
him convalescent. Another fact as to the Dr. Meigs' plan of treatment of cyanosis change in fevers here; our river bottoms are neonatorum, as mentioned by Dr. Dix, (page from one to four miles wide, with a sandy sub420), will not avail in all cases, as I know by soil, and the people use drive-wells; that is, experience, but I will confess that I do not know they bore a hole in the ground with a threeof anything better.
inch auger down to the sand or gravel, drive
down a hollow iron tube, put on a pump-stock, him to strip back the prepuce every evening and and go to pumping. One half day's work wash thoroughly with warm water and soap, gives a well from twelve to thirty feet in depth. and to cease all internal medication, as well as No dirt or trash can get into such a well. Out dilatation with bougies. on the uplands they use open dug wells about As the patient lived at a distance I told him four feet in diameter, walled with stone-a to come in again in a month. A month later veritable catch all for crickets, toads, snakes, I received a letter from him, stating that he and rabbits. Now, as to the origin of typhoid, had had but one seminal emission since seeing in my medical career, dating from 1874, I me, that he could retain his urine five or six have never seen or treated a case of typhoid in hours during the day, and all of the night. the valley. They have always been on the up- He also stated that the dribbling after urinaland, where open wells are used ; and in every tion had ceased, that he had no trouble in instance where I have prevailed upon them to starting the stream, and that he felt entirely clear out their wells, the debris has been crick- well. ets, toads, snakes and rabbits, some or all of I send you above for publication in The these. I have come to the conclusion that ty- World, thinking it may interest some of its phoid does not originate spontaneously, but
I would like to hear through that it is the digestion and maceration of septic The World from some of the other members animal matter carried into the digestive tract of the medical profession if they know of any by polluted drinking water, that causes it. I instance where retained smegma has caused also believe that once started in this way, the such a train of symptoms. dejections of a typhoid patient, by being care- Cincinnati, Ohio. R. P. KING, M. D. lessly thrown out on the ground, can be carried to well-water and thus perpetuate the poison. Injury to Cervical Region of the Spine. Our typhoid fevers occur in dry years, when -Pulsating Abdominal Tumors.-Quinine wells are low, and the sources of infection con
Pills.-Treating Nasal Catarrh. centrated.
- Formula for Lumbago. Mulvane, Kan. W. K. HARRIS, M, D.
EDITOR MEDICAL WORLD : About six
months ago I was summoned in haste to the Reflex Genital Irritation.
country to attend a Mr. L., some 68 years of EDITOR MEDIGAL WORLD : About two age, who, in descending a flight of stairs leadmonths ago I was consulted by Mr. J., aged ing from his barn floor to the feeding room, twenty.one, who had, for the last two years, had suddenly lost his balance and fallen, strikbeen troubled with frequent seminal emissions, ing his head on the floor some 8 or 10 feet two or three per week, also troubled with too below. In falling, about half-way down, his frequent micturition, sometimes every two or head struck the side of a manger and glanced three hours during the day and once at night; therefrom to the floor below, where he was at other times only three or four times during found by his son a few minutes after, crowded the day and not at all during the night. There in between stairs and manger, head flexed on was a dribbling after urination, especially if chest and for the time insensible. He soon he coughed violentiy or bent over suddenly. regained consciousness, however, and was The stream of urine was somewhat twisted and carried to his home, where, on arriving, I the water did not start readily. He has never found him sitting up in a chair, head flexed on had gonorrhea or practiced self abuse. He has chest, totally unable to move it in any direcbeen treated by several different physicians tion or to assume the recumbent position. He but without success.
complained of numbness in the left arm and One physician suspecting stricture, tried side, and of so much pain in the top of his gradual dilatation by means of soft bougies. head that I feared injury to the skull, but, on He claimed that there was an obstruction about examination, I found nothing more than a five inches from the meatus. Upon examination severe bruise of the scalp. I now found, howI found a rather diminutive penis. The prepuce ever, his most serious injury to be in the cervi. adhered to the glands slightly, but I pushed it cal region opposite the third or fourth cervical back without much difficulty, and found the vertebra, where a distinct swelling or prominsulcus completely filled with smegma, which ence appeared, hard and unyielding on preswas with difficulty removed. I told him that sure, and from which the patient complained the filthy condition of the prepuce was probably of sharp shooting pains, radiating to the side the reflex cause of all his trouble ; but to quiet and top of the head. I gave him an anodyne, his fears of stricture I passed a full sized steel ordered him kept quiet and hot application of sound easily into the bladder, showing that lea water applied to the back of the neck and the deep obstruction was spasmodic. I told left.
On returning next day I found him where I I use a steam atomizer ten minutes night and left him and in much the same conditiou, ex- morning with the following: cept that the numbness had disappeared, but
R. Acidi carbolici crystal ....grains xv the pains were still severe and aggravated on
grains xxiv slighest movement of head or attempt to move Pot .. iodidi,
grains lxxx the jaws. His temperature was 99.50. The Glycerini swelling on the back of the neck had subsided Aqua destil......9. s. ad.....ounce xvi a little, but I now saw that the injury was of a At the same time internally: very serious nature and did not give a very
R. Pot. iodidi,
.. drachm ij flattering prognosis of the case to the family.
Liq. pot, ars.
... drachm j But now some six months have elapsed and Syr, sarsaparillæ comp. .....ounce iv the old gentleman is still living under sympto- M. Sig.–Teaspoonful in water after meals. matic treatment and the important element, Or in mild and receni cases : time. He has regained to some extent the use R, Menthol..
.grains x-xx of his head and jaws, can be in bed with his Albolene
..ounce j head well raised on pillows, can move his head Spray in atomizer three times daily. to a fair degree back and forth and rotate it The use of the steamer should be continued somewhat. His appetite and general health
from one to four months, according to the are fairly good, but the prominence on the severity of the case, and gives best results in back of the neck still remains clear and dis
summer seasons, on account of freedom from tinct, and will remain, for it is a long one and, fresh chills. in my opinion, is caused by a dislocation for
Try it and keep your patients from falling wards of perhaps the third cervicial vertebra. into the hands of the quack. What say you, brother M. D's?
To the doctor who had trouble in comI was somewhat surprised at the number of pounding his lumbago liniment, if he will cures of abdominal aneurism lately appearing, have the druggist put it up in the following and what I would say in regard to the same order: Tincture of iodine, ammonia water, has been said by Dr. Waugh. I had a case
collodion; it will not solidify afterwards, some time ago in a woman of thirty of a pulsa- though it will become colorless in a few hours, ting tumor about two inches above and to the
which does not affect its virtue. Success to left of the umbilicus, with pulsations synchron
THE WORLD, with its regular monthly clinic. ous with the heart beat, shortness of breath and other aneurismal symptoms that disap
Prospect, Pa. J. B. THOMPSON, M. D. peared very promptly under treatment for in
Ulcer on the Leg. digestion. Since then patients troubled this way have complained to me frequently of what
EDITOR MEDICAL WORLD:-In December they call a beating in the stomach. But don't
World, page 468, N. H. desires a “ first-class be alarmed; cases of abdominal aneurism must
treatment" for a sore leg. of necessity be a rather rare occurrence, and
I will simply say that I once had a sore leg in diagnosis here it is well often to apply a line
on a man sixty five or seventy-five years of age. of Longfellow that “Things are not what they My treatment was as follows:
I ordered six leeches every other day to the How many of the brethren give quinine in
affected part, and in the mean time, cleansed sugar coated pills, so convenient, you know,
the parts well with castile soap and warm water. or gelatine capsules? I have done it, but don't
I gave as an alterative, podophylin, sufficient do it now in fevers. True, a gelatine capsule
to insure a free discharge from the bowels each will dissolve very readily in the mouth or in
day; also iodide of potassium, five grains three the secretion of a stomach free from fever; but
times a day; and in three months the sore in fever, where you want their effect most, the
healed and troubled no more. solvent power of the stomach is not equal to Freedom, N. H. A. W. HOBBS, M. D. the task, and three times out of five you will find them in the stoois as they were taken. If
Labor Complicated with Hydrocephalus. you don't believe it try yourself and see.
EDITOR MEDICAL WORLD:-In the DecemHow many of the brethren are satisfied with ber number I see a communication from Dr. J. their results in the treatment of chronic nasal G. Knox, (page 463) which calls to mind two catarrh? Few, no doubt. But I think that cases of hydrocephalus of the fetus which octhe greater part of cases under forty years of curred in my practice some time ago. In the age ought to be cured and that without de- first, a woman of some forty two or forty-three stroying a good stomach while doing it. True, years of age, who had given birth to eleven it takes perseverance on the part of the patient, children, all of them fully developed and but if he don't follow it up, don't take his case. sound, called me to attend her in the early
morning. I found the breech presenting and large compresses, pressure with the fingers, &c.,
Carnot, Pa- WM. H. McGEEHON, M.D.
Hemorrhage from the Cord.-Hematuria. and delight there was a great gush of water and the child was born, my assistant taking an
EDITOR MEDICAL WORLD:-Let me ask involuntary movement backward against the
“Doctor" (page 422) if he is sure of the wall of the room.
source of the hemorrhage in his case ? In the The mother, after suffering from a little sep- evening of January 26th, I was summoned tic trouble, made a good recovery and, after
across the street, in haste, to attend Mrs. C., about two years, I attended her in another con
who was delivered, within thirty minutes, of a finement, when she was delivered of a good, nine-pound boy. The loss of blood during the sound boy baby.
third stage was so great that symptoms of colThe next one was the mother of two fine
lapse followed, from which she recovered healthy children. When I was called to attend slowly by usual treatment and constant care her I found a breech presentation.
As she during the night. My attention was called the seemed in good condition and, not finding any
next morning to a severe hemorrhage from the reason for the delay of affairs, I suspected hy. cord. Upon examination I found the child's drocephalus and, as soon as possible after body bandage, dressing of the cord, and the upper was born, ruptured the coverings of the head, part of the diaper wet through with bright blood. which, fortunately, were very thin. The
Knowing that, on account of the condition of woman got up well and in due time I attended
the mother, I had tied the cord in haste, and her again, when she was delivered of a fully thought that the knot had slipped, I tied it developed healthy child. Two cases, both again. After securing the cord the hemormothers healthy, both breech presentation, both shage continued wish increasing amount, when had previously and have subsequently had
I made a close examination of the cord, penis healthy children. I have classed them in the
and anus, and was still at a loss to know its
source. same category as dropsy of the funis and spine, bright, but as the case continued the amount
At first the color of the stain was
bright. January 31 the child was too weak
and feeble, extremities cold. I had given
large doses of ergotine, tincture of the chloride EDITOR MEDICAL WORLD:- Articles in Dec. of iron and tincture of opium without benefit. WORLD prompt me to write the following: The last hemorrhage had gone through its
On March 18th, 1887, I attended Mrs. S., diaper, clothing and thirteen thicknesses of a in her sixth confinement, which was quite an folded sheet. I then gave three drops of oil ordinary one. The child was a vigorous boy, of erigeron every three hours. Marked im- . weighing 8 or 9 pounds. There was no hemor- provement followed during the night, with rhage from the cord at any time, and before I very little stain to the urine the next day, and discontinued my visits, I was informed that much less in quantity. February ist I col. the cord had come off, and it was all right. lected a few drops of urine by placing a small On March 30th, just twelve days after the vial over the penis and doing it up in the woma!'s confinement, a messenger came for diaper. Examination showed it to be nearly me, saying the child was bleeding. I went out limpid and acid; by microscope numerous in haste and found profuse hemorrhage from blood corpuscles and a variety of epithelium the umbilicus. Saturating a bunch of cotton and some water. In a few days the oil was in Monsel's solution, I pressed it down on the discontinued, when the amount of urine insource of the hemorrhage. Afterwards I tried creased to normal. A rapid improvement fol
lowed and the baby was entered at the fair for
around my hands, that I may have an units beauty. In this case the penis had been
doubted purchase. I want my hands and directed upwards, and the urine and hemor- ligature dry that there be no slipping. In case rhage had reached the dressings of the cord,
the ligature is not the best, and well tied, two so no one could tell its source.
ligatures are safer than one. Edinboro, Pa. F. G. GREENFIELD, M.D.
I prefer absorbent cotton for dressing the
cord, as it hastens dessication by absorption, Umbilical Hemorrhage.
and prevents the introduction of bacteria, and
thereby serves to avert certain diseases of the Editor MEDICAL World:-I have had three umbilicus. cases of hemorrhage from the cord, after ligat- As to the time of ligating after delivery, ing in the usual way. One proved fatal, the some recommend to wait till pulsation ceases other two recovered. These cases led me to in the cord, that the child may receive an a study of its causes, and a series of experi- abundant supply of blood. I believe this ments to determine a safe method of ligating recommendation to be based on a false hypothand dressing the cord to preyent the possibil. esis, and to be misleading.
This brings up ity of leakage.
another point in the “Doctor's” case,
He An established rule of surgery is, that in states that “The placenta was pumping blood ligating an a:tery, the ligature should be drawn into the child's circulation for some time.” sufficiently tight to divide the internal and mid- Let us see-during the last throes of labor, dle coats of the vessel, leaving only the tough, when the child is being expelled from the womb elastic outer coat in its grasp. There is then and through the pelvis, the anatomical relation imme liate retraction, and contraction of the between the uterus and placenta is broken up internal tunics, wrich favors the formation by forcible contractions. Immediately after of a clot. In ligating veins, the walls or coats delivery of the child, the placenta will be are not divided, but corrugated. The umbili. found resting over the os, protruding, or cal cord consists of two small arteries and one wholly expelled into the vagina--except in large vein, imbedded in a dense elastic gela. cases of morbid adhesion. tinous substance, surrounded by a tough mem- If this beso, there can be no further relation branous sheath-a reflection of the amnion between the circulation of the mother and and chorion. Tying all these tissues is a some child. The pumping process goes the other what different operation from tying a single, way. To convince yourself of this fact, cut isolated vessel, and requires a greater degree the cord while it is yet pulsating and observe of force to divide the internal coats of the the venous blood flow in jets from the umbilarteries.
ical arteries at each pulsation of the fetal heart. I am satisfied that the cause of hemorrhage Notice the placental end of the cord, and see in “Doctor's" case, (page 422, Nov. WORLD) the blood flow without pressure till the small was not contraction of the cord where ligated, quantity contained in the blood vessels is as he reported, but that the ligature was not drained away. sufficiently strong and tightly drawn to divide The child should evidently receive our atthe internal tunics of the arteries, leaving tention till breathing is well established. First, them patulous in the presence of all these it should be placed on its right side for obvious tissues. This I judge to be the cause of hem- reasons, have its whole body exposed to the air, orrhage in two of my cases. In the other case mouth and nose well cleaned and free from the hemorrhage occurred after separation of obstructions, when a moment's attention should the cord, and was due to antecedent blood be given to the mother, to ascertain the possichanges, evidenced by the development of bilities of hemorrhage, twins, &c., and if purpura hemorrhagica.
nothing contravenes we may safely proceed to Authors classify hemorrhage occurring under tie the cord without regard to pulsation. the above conditions as being due to careless As to what the result might be if the cord ligation, but fail to point out the peculiar en- be not tied at all, those who practice that vironments of the vessels to be ligated, and the method can best answer. I am satisfied that necessity of an extra strong ligature tightly hemorrhage will not occur in the majority of drawn, From the moment the cord is cut till cases; but to appreciate the possibility of its complete dessication there is loss of substance occasional occurrence, and the necessity of a by exosmosis, which favors loosening of the safeguard in all cases, is but to refer to its ligature; hence the importance that it should primal causes, viz.: the hemorrhagic diathesis, include only the denser tissues of the cord and enlargement and imperfect closure of the accesblood vessels in its grasp.
sory blood vessels, inhibition of the function I now use a linen
cord the size of ordinary of that part of the nervous system that influwraping twine. I want it long enough to wrap ences collapse and maintains closure of the