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quinine and Dover powder. For two days condition. The person may have a small there was loose bowels of a brownish color, unsatisfactory defecation dairy, but in many semi-solid and offensive. I then gave grains 2
thousands of cases, but once or twice weekly. to 4 of acetanilid, with an occasional dose of The greater the constipation and confined conquinine, which reduced the temperature re
fined condition of the intestines, the greater markably. It ranged continually from 100° to danger of tubercular development in the 10372°, always highest in the forenoon. mesenteric glands, commonly called consumpJune uith. I thought there must be some
tion of the bowels. Where the soil is most intermissions, and I put him on the following adapted to developing the germs there will it prescription :
manifest itself more fully. In all such cases R Fowler's sol. arsenic.
there is perceptibly a clammy taste, beginning
..drams i Hydrargyri bichlor..
with a dry cough, possibly hacking occasionTinct, ferri chloridi,
ally, which will by and by develop into the Acidi hydrochloric dil...aa....drams iss regular morning cough. Some cough mostly Potassii chloridi.......
at night on retiring, and towards day-break, Syrup simplex....q.s. ft....... ounces iv
while others cough more as soon as they begin M. Sig.–Teaspoonful four times daily.
to stir from their couches. This terrible When fever came on, a few doses of acetan- annoying and most distressing cough is due to ilide would cause perspiration and control it. the vitiated chyle which is intermingled with He did well, and was able to run about until a venous blood in the right ventricle and thrown few days after the medicine gave out, and into the lungs every moment, ever and anon there was a relapse. The same prescription compelling the lungs to filter and renovate, was given, and is doing well at this time. He
oxygenate and prepare as best possible to be had no untoward symptom except the fever. received by the left ventricle and sent out to Two of his brothers were sick for a few days nourish the body. The great head quarters of only.
this life-giving eurrent—the lungs-is in a conE. I. PERSINGER, M. D. stant dilemma how to get rid of surplus excreCampte, La.
mentitious matter received from the duodenum.
Some possibly passes on into the circulation, Unusual Complications of the Cord.
on its mission of feeding the starving tissues or EDITOR MEDICAL WORLD :-On the 4th the physical system, and more so perhaps inst., after a natural labor, Mrs. C. M., aged because of the sedentary life. The lungs are 19, primipara, was delivered of a male child, seldom if ever expanded fully, and, as a result, 772 pounds. The cord was circled around the but a fractional part of oxygen is inhaled that neck three times, and also loosely knotted should come in contact with the blood in the about three inches from the umbilical attach- lungs. The only way the lung can possibly ment. It measured 4 feet 2 inches (50 inches). eliminate secretions is by exhalation, cough, Quite a long one!
and expectoration, so it will be very readily Thos. B. GRAYSON, M. D. understood that this condition of the system Winkler, Texas.
and circulation cannot go on long before
damage will begin to appear in said organs. A Few Thoughts on Infectious Diseases; Possibly the lungs get on fairly well throwing Tuberculosis in particular.
off surplus secretions for a while, it may be for (CONTINUED.)
months, and in some cases even for years; but
a bronchitis, laryngitis, catarrhal irouble or EDITOR MEDICAL WORLD:-I find that in some air par sage trouble will be the result, due tuberculosis the susceptibility or predisposition, to exhalation. It will be very noticeable now whether inherited or acquired, can be annihi- in the most of cases, the breath is offensive, lated only in cases where the volume of blood said to be due to a foul stomach, but it will has not been reduced by fermentation and almost invariably be found to emanate from the mal-assimilation of food in the intestines. vitiated chyle which has been forced to rely Vitiated chyle diminishes the quantity and upon the lungs to get rid of its death dealing quality of blood, and compels the lungs to composition by exhalation. Even in other throw off secretions that otherwise should pass infectious diseases-scarlet fever, diphtheria, off through the bowels, bladder and skin. and fevers in general—this same condition of Fermentation takes place in the bowels (where the glandular system and engorged alimentary all starchy foods and fat are digested) from a canal will be found. Many attribute the fetid Tetention, and an inability to pass the ilec-cecal breath and coated tongue to be caused by the valve. The colon, especially the ascending stomach or emanating from said organ. This colon, will invariably be found impacted more is a great error, because the clammy taste, or less, and its contents in a dry, decomposed coated tongue, sore throat, deposits of all
kinds, and inflammations of the air passages were avoided. I refer to uncomplicated cases are caused by exhalation from the vitiated of my own and not the cases I saw in consultablood, which is being renovated by the lungs. tion, and after it was too late, and high It will be inferred from what I have said
temperature had done its work and all hope already, and if I am correct in my assertion, had fled. resulting from over twenty years general practice, that the attention of the physician is
I think it best to give my treatment of
infectious diseases as fully as possible, so that I directed to the alimentary canal, the malassimilation of food being the principal cause
may be more clearly understood when I define and beginning of tubercular trouble, from
my plan of treating lung, throat and catarrha!
diseases (tuberculosis). I have good reason which throat, lung, and catarrhal disesses
for believing from the results derived from my develope. Especially have I found it so in diphtheria, scarlet fever, and fevers generally. Saved from premature graves, correcting their
treatment that 75 to 85 per cert. could be in acute infectious diseases I have invariably predisposition to consumption to such an extent found that removing the contents of the bowels
that they might live to die of some other cause. from the chyliferous vessels reduced the temperature at once, and that acting upon the
Dr. Brobst, of Lehigh Co., Penna., who glandular system with proper medications, in
visited me in consultation with a very interest connection with Alushing the bowels with hot
ing caze a few weeks ago, told me that while water, entirely removed the original source or
he was spending eight months in Europe, at cause of the malady, that is, provided it is Vienna, I think, he learned that my mineral done before this condition of the alimentary
treatment for tuberculosis gave the best re
sults. canal has produced tissue change, lesions, etc.,
This gives me encouragement to conby a high temperature. The retained feculent
tinue in its development. matter surely generates the heat and is the Washington, D. C. N. B. SHADE. fuel which must be burned up (consumed), or fatal results necessarily follow, unless nature ALUM used to whiten bread is detrimental comes to the patient's relief by diarrhea. to digestion, in that it renders phosphates in
If this takes place soon enough the patient soluble.--Homan in the Medical Fortnightly. may pull through, but in danger of sequela to follow; a result of the decomposing, ferment.
IF I see an ulcer on the inside of the leg ! ing feces lying too long in contact with the
suspect varicose veins, if on the outside I susmucous surfaces of the bowels, especially the chyliferous vessels.
pect syphilis.-Gregory, lb. I refer now to all acute infectious diseases. I think I should be allowed to say what has been upon my mind for a long
Test Questions. time in regard to my experience with infectious 1. What is the most useful, practical, safest, timediseases. Before I arrived at the knowledge I saving and money-saving form for a prescription blank? have attained, I had lost four cases of scarlet
See "The Physician as a Business Man," pages lig
and 120. fever, three of typhoid fever, one of pneumonia, 2. Illustrate the difference between the doctor and none of diphtheria, small pox and erysipelas, the merchant from the stand-point of public charity, two of child-bed fever, and none for the last See pages 18 and 19. ten or twelve years. The first seventeen years
3. How do physicians' charities help the large capiof my practice was in McConnelsburg, Pa. I
talists, and what is the logical remedy? See pages 27,
28 and 29. lived in the county seat, and practiced all over
4. What is the basis of the pbysician's fee? See the county from twenty to thirty-five miles
pages 30 and 43 to 47. around, I had hundreds of cases of typhoid 5. What are average reasonable fees for differen: fever, scarlet fever, diphtheria, erysipelas,
services? See pages 71 to 75. pneumonia, and thirteen cases of small pox,
6. How should physicians' Sunday work be re.
garded ? See page 75. eight of which were of a malignant confluent
7. How do medical fees compare with those of other variety and all in one family. (They were all professions ? See pages 80 to 82. terribly marked, because my directions were 8. What is the most practical bill form ? See page 88 not carried out in protecting the face.) My 9. What do you think of cooperative efforts at co! success in the treatment of these diseases led
lecting accounts ? See pages 104 to 110.
10. What kind of account-books are most practical me to what I have discovered in the successful
for physicians' uses? See pages 122 to 127. treatment of tuberculosis. I should have said 11. How can the building association help the docthat I have had no sequelæ follow during the tor? See page 128. last ten years of my practice in insectious dis- 12. What obstetrical fee is charged by the profession eases, for the simple reason that I removed
in different parts of this country? See pages 48, 49, the cause that produced a high temperature,
55. 57, 63, 65, 68, 69, 72.
Price of «The Physician as a Business Man" is only and as a result tissue change, lesions, etc., $1.00. See order blank on page xx.
EDITOR MEDICAL WORLD:-Will some of The
World readers who have used Pyoktannin in Questions are solicited for this Column. Communications
the treatment of gonorrhea please give their not accompanied by the proper name and address of the experience and formula? writer (not necessarily for publication), will not be noticed
C. E. MARLETTE, M. D. The great number of requests for private answers, for the Gordonsville, Ala.
information and benefit of the writer, makes it necess ary for us to charge a fee for the time required. This fee will be from one to five dollars, according to the
EDITOR MEDICAL WORLD :-Will some of amount of research and writing required.
your writers answer the following questions reEditor MEDICAL WORLD:—Will some of garding the arsenite of copper? I find satisfac. your readers in Washington inform me through tion in its use, but the combined experiences of the columns of The World of the laws regulat. others will be helpful. ing the practice of medicine and pharmacy in What are the symptoms or indications for that State ?
its use? WASHINGTON. What is the dosage, and how often repeated?
What results must be looked for? EDITOR MEDICAL WORLD :-Have a patient When decrease the dosage and suspend its 85 years of age, who has constant sensation of
use? burning of the feet. Has had it for six years. How does it affect the stools as regard color, Feet are always cold, but the burning sensation consistency and frequency? always present. Have tried chloroform,
DR, G, W. S. PATTERSON. aconite, belladonna, and cocaine, but without Demorest, Ga. benefit. Would be glad to have the sugges. tions of any who have had successful experience
EDITOR MEDICAL WORLD: -My patient, a in similar cases. No cause can be ascertained. woman, age 45, has had some cough during
J. W. S. the past two su amers. She has been under
a physicians care for six months; her general EDITOR MEDICAL WORLD:-If any vs the health is improved, but there is no relief from readers of The World have any explanations the cough. Her present condition is as folfor the following, I should like to hear them : lows: She has very little cough but she ex
In July 1887 I was called to attend a young pectorates about every five minutes; has some lady who had taken, with suicidal intent, catarrh, but the most of the expectorated matnearly two ounces of Paris green.
ter comes from the bronchial tubes. What She had vomited freely, and beyond giving will cure or relieve ? or attempting to give an antidote of dialysed Please also give treatment for spasmodic iron, I did nothing, from the fact that she croup. Tesisted, and very effectually, everything that Reed's Corners, N. Y. S. J. SMITH, M. D. was done for her.
Twenty-four hours after taking the poison EDITOR MEDICAL WORLD:-I would inquire she vomited a piece of hard Paris green as of your readers who live in a malarious region, large as a walnut, and covered with mucous. what remedy or combination of remedies they Why was not sufficient poison absorbed to
have found to be the most successful in the kill the girl? She recovered without any treatment of malarial fever3, especially when inconvenience.
quinine alone fails or disagrees with the Mt. Kisco, N. Y.
F. A. AUGUR.
Also, what is found to be the best mode of EDITOR MEDICAL WORLD :-I would like administering quinine, that is, in regard to some of the readers of The World to give the dose, time of giving, and whether in solid or best and most successful treatment for sciatica. liquid form, in malarial fever? I find it very stubborn to cure; have tried a
W. J. HAINES, M. D. number of methods of treatment, including West Farmington, Ohio. electricity, but find it very difficult to cut short the disease.
EDITOR MEDICAL WORLD:-I have a patient, J C. BELL, M. D. an infant four months old, suffering with hydroTeeterville, Norfolk Co., Ontario
cephalous. I have been using iodide of potas
sium and mercury, with some apparent benefit. EDITOR MEDICAL WORLD:
your Will you or some of the brethren please give readers inform me what is meant by the me the proper treatment of it. I also have a "Keeley barber pole" injection? It is said to case—a lady fifty years old, mother of family, knock a man higher than Gilroy's kite. stout, who complains of a dead or numb feeling Chicago.
H. at times, tingling of hands and fingers. This
occasionally amounts to pain. Otherwise she enemata than to use the more indirect and is in excellent health. What is it, and what uncertain course of the entire digestive tract. ought to be done for it.
Our method then is as follows: After a Sicily Island, La. J. D. USHER, M.D. dysenteric passage, place the patient on the
right side, and, by means of a fountain syringe, EDITOR MEDICAL WORLD:- The idea of
or other syringe which gives a continuous, devoting a number occasionally (I add as often
gentle stream, and does not throw water in as possible) to a special subject is an excellent
forcible jets, let flow into the colon from two one. Could you not obtain from some of your
to four quarts of water, which has been very contributors, specialists in diseases of infants,
weakly salted, and is as hot has can be comfort practical hints on the dosage of medicines ad.
ably borne. When that has been relained as ministered to that very delicate and interesting
long as possible, perhaps as long as five minutes, class of patients.
and has been expelled, charge the syringe again Hahnville, La. DELPHIN BIENVEAU, M.D.
with a half pint of water, in which has been dissolved five grains each of chloral and sul.
pho-carbolate of zinc, and let it flow into the DR. N. STUART MCKENZIE, Faireville, Iowa,
rectum, to be retained, the patient keeping the asks for recommendation of a good medical recumbent position. college. We wrote him, recommending the
This entire procedure is to be repeated after University of Pa , Phila., and Rush Medical
each dysenteric passage. College, Chicago, but the letter was returned
With some patients the amount of water to us marked “ No such post office in the State mentioned will not be borne without great pain. of Iowa.”
As pain should not be caused, of course you THE MEDICAL World is the best journal I take.
will use your judgment as to the amount to be Have been a subscriber from the first year.
used, according to the case. Also, in the case West Farmington, O. W. J. HAINE, M. D.
of childrer', the amount of water used would be proportionate to their size. So, as to the
amount of chloral and zinc required in the Current Medical Thought. second part of the treatment; a good general
rule would be one grain of each for each year The Treatment of Acute Dysentery.
of the child's age up to five.
In regard to the second, or medicated injec (Editorial from The MEDICAL WORLD of tion, we have only mentioned the lotion that August, 1891.)
we prefer to use. Any other mild and soothOur only apology for introducing into these ing astringent-sulphate of zinc, alum, acetate pages an article giving specific directions for of lead, or in the country a decoction of white the treatment of disease is the necessity we oak bark, or whatever you prefer, will do fairly feel for emphasizing the importance of a line well, only that it be mild and unirritating. In of treatment which seems to us to be greatly fact, in the great majority of cases the second overlooked in the numerous articles which ap- part of the treatment may be omitted entirely, pear at this season of the year, regarding this one or two thorough flushings with the hot salt very common disease. Foremost among single water proving sufficient to cure. remedies administered for the cure of dysentery This treatment does not preclude the use of stand sulphate of magnesia and other salines, any systemic treatment preferred by the physo long used as to be considered standard or sician. However, we believe that in very fer classical treatment. This succeeds well and cases will he feel the necessity of giving any quickly with that large class of cases of simple medicine, except to correct malarial or other catarrhal dysentery, which tend to recover in a coincident affection of the system. The flashfew days even without treatment. Another ing, if thoroughly done, seems to answer the favorite treatment with a large class of practi. double purpose of removing all irritating matter tioners is the repeated administration of large and arousing the bilary and other secretions
. doses of ipecacuanha. With this treatment This treatment is original with us only in the remarkable success has been achieved.
minor details, the general principles having But our object in writing this is to call the been advocated occasionally for many years. attention of our readers to a treatment which It seems to be one of those good things that although too often overlooked, is at once are allowed to fall into disuse. We are rery rational in theory and successful in practice. desirous of placing before our readers the te
The local treatment of a localized inflamma- sults of this treatment in those severe dyse tion is always rational if the inflamed area can teries of the malarial regions. We should be be reached. So it seems more logical to apply pleased to hear the results from any who give remedies directly to the inflamed colon by it a thorough, faithful trial.-J. J. T.
Rectal Injections in Dysentery.
38° or 40° C. If in addition a more stimulatFrom an excellent article by Dr. Rosenau, in
ing and astringent action is looked for, the the New Orleans Med. and Surg. Journal, water may be given cool or iced. June, 1892, we clip some extracts:
As a cleanser and antiseptic, peroxide of It is important to note that much of the hydrogen has advantages not possessed by
other articles of its class. It is not poisonous, juccess of treatment depends upon the care and horoughness with which the method is carried
seems not to irritate, dissolves pus and secre
tions and has antiseptic properties. It has put. This was well illustrated in a case of sub. cute amebic dysentery in the wards of the given good results in from 10 to 25 per cent.
solutions. Marine Hospital at New Orleans last January. njections of one pint of a ten per cent. solution
Salicylate of soda, 2 to 4 per cent., has of peroxide of hydrogen were given through an
When a decided astringen! is wanted in ordinary hand-bulb syringe once daily. This vas continued almost a month. Improvement
cases of large and repeating hemorrhage, alum n all the symptoms followed, but no decided
in from 2 to 4 per cent. solutions ha; been
found to act promptly. mpression was made on the case until large
The results in some cases of chronic dysennjections were administered, high up, thoro
tery are most gratifying. The following is an ghly flushing out the lower bowel.
eloquent witness of what may be accomplished After several trials, I have settled upon the
in long standing cases which have shown themollowing plan of procedure. No claim of selves proof against medication by the mouth. riginality is made :
In this connection, it is well to observe that The patient lies on his left side, thighs “thickening of the mucous and sub-mucous lexed, hips elevated. An ordinary soft coat in chronic dysentery is due partially to abber catheter is passed its full length into the infiltration with new cells and partly to new ectum. The fluid is delivered from a fountain formation of connective tissue. There is, howyringe, held from two to four feet above the ever, less tendency to the development of new ody of the patient. The finger on the deliver- fibrillated connective tissue in chronic dysenng tube acts as a governor to the amount of tery than in the chronic inflammation of most uid which is allowed to flow. The lowering mucous membranes ; hence, complete recovery I raising of the reservoir determines the is possible after long duration of the disease." mount of pressure.
It is remarkable how long a time these If the fluid is injected slowly, no pain is chronic discharges may continue and be comaused_except the feeling of weight and patible with working health. ension in the abdomen. Sometimes patients It is proper to state that much of the success omplain of colicky pains about the umbilicus, of the treatment in these chronic cases depends hich pass away after a few moments interrup. on the absolute rest in bed and the careful on of the flow.
regimen which is insisted upon. If there is much tenderness about the anus That injections alone will not always cure od rectum, a cocaine suppository may be was demonstrated in the case of a negro iven ten minutes before the introduction of steamboatman who was allowed to be up and le rectal tube.
about during the treatment. A cure was not The amount which different patients are effected until the rest treatment was combined ble to retain varies considerable. Adults with the local applications. sually hold four or five pints with difficulty. An exclusive milk diet is preferred; the milk 1 some severe cases, where the patient's is peptonized when it is considered necessary. rength is exhausted and the parts are relaxed, If there is exhaustion or much weakness a je injection will run out alongside of the generous diet must be allowed. The hygienic ctal tube at the same time that it is being surroundings should be the best obtainable. orced in. In such cases I have used the In the grave or gangrenous form of the disingest rectal tube and continued the injection ease, injections are only palliative in their atil the return flow is as clear as the Auid effect, and great care must be exercised lest the njected.
thinned bowel wall be ruptured. The relief afforded is prompt and decided, The dysenteries of moderate intensity are sting from two to fourteen hours after the the last class of cases to be considered. Here lema, the time lengthening as the case pro- the results are uniformly good, as observed in tesses favorably.
the sporadic cases common to this country. The solutions which have proven useful in The injections cause an almost immediate cesy hands are the following:
sation of straining and blood in the dejecta. Sterile water is efficient, especially in the The evacuations remain fluid for a few days, bilder cases. It is best given warm, about when they resume their normal consistence