and for the benefit of those who may not have access to the references mentioned, I will give the history and the symptomatology of the case in brief: The patient, an elderly lady of neurotic temperament, had an attack of hemiplegia of the left side of the body about nine years since, from which she made an almost complete recovery, leaving the affected side slightly atrophied. About eight months since, she commenced complaining of pain and tenderness in the sole of the left foot, followed by congestion of the capillary vessels, with very slight edema at the seat of pain. The edematous area was circumscribed, being no more than one half an inch in diameter. The surface was at first of a dusky red color, but later changed to a purple. For several weeks there was a marked rise of temperature in the affected foot, which gradually subsided, and the foot became cold and pale. During the last six months the edematous, purple spots have appeared in different situations, until at present almost the entire foot is affected. pain is constant, with exacerbations and remissions, making the patient's life one of torture. The medical literature at hand is nil as to therapeutic indications in the case. I have relied chiefly on tonics, with sedatives, general and local. Seemed to derive most benefit from valerianate of zinc, but the case does not improve. Will be thankful for suggestions as to treatment from any readers of THE WORLD. Bicknell, Ind. WM. R. JONES, M. D.

The

Intermarriage of Relatives-Veratrum

Viride in Puerperal Convulsions. EDITOR MEDICAL WORLD:-Four years ago the writer proposed marriage to a full cousin. The answer was, "It cannot be; we are cousins." The mountain had to be crossed and it was crossed, and one of the results is a bright lovable girl (of course due allowance being made for a fond father) of nearly two years of age. My conclusions after mature reflection, contrary to the old and popular idea that the offspring of such marriages must of necessity be deficient mentally, morally, physically or all, was that the question of relationship had nothing to do with the matter, but that where there were hereditary tendencies of a similar character, those tendenc es were intensified, especially if they came from the side of common parentage. Dr. Waugh deserves thanks for his article in the October MEDICAL WORLD. It is in strict accordance with the conclusions which I had reached, the subject concerning me personally.

A physician with a hypodermic syringe, some tincture of veratrum viride, some brandy as a menstruum, and a little atropia to correct the depressed respiration, can absolutely control

the convulsions in puerperal eclampsia. Veratrum viride in proper doses is a specific, as it will control the spasm of the arterioles, which is due to irritation of the vaso-motor centers, and the rapid pulse, which depends upon the spasm, and which, in my experience, necessarily accompanies the convulsions.

If the patient is in labor or at full term give chloroform and deliver. If she needs eliminatives, bleed, purge, sweat, etc., judiciously. Some patients with serious kidney lesions will die.

Use strict asepsis to avoid septic troubles which are so prone to complicate convulsions,

Veratrum viride, however, will control the convulsions. I commence with 10 drops of the tincture in a little brandy as a menstruum by hypodermic injection, and if the pulse have not assumed a satisfactory condition in one half hour, repeat in five drop doses as needed. It is useless to attempt to restore consciousness by repeated injections of veratrum viride, its indication being to prevent the convulsions only.

Morphine, chloral and the bromides are of great service to allay the irritation to the vasomotor centers and the general nervous condition. J. C. MCALLISTER, M. D.

Driftwood, Pa.

The Proper Application of Terms, Especially in Malarial Complications. EDITOR MEDICAL WORLD:-I read with much interest the different communications on the subject of malaria, as "I live and move" in it, and was pleased with your remarks on the subject of typho-malaria, having seen so much of it, and hold that the term is as legitimate as that of typhoid to express "like typhus." I meet occasionally a disease which is not purely typhoid or malarial and can be described by no better generic term than that of typho-malarial fever. It begins as ordinary malarial intermit tent or remittent fever and about the close of the first week assumes the form of typhoid as we see it here—i. e., typhoid fever and runs the regular course of typhoid to the close, sometimes, more generally, terminating fatal. ly with repeated copious hemorrhages from the bowels. I suspect that Peyer's glands become the seat of the disease in such cases. Quinine fails us in the latter stages of this disease. I also maintain that it has been well established that two diseases may exist and feed on the human economy at the same time, and the malarial elementgenerated by vegetable decomposition-is first to start, and runs its course more rapidly, when the typhoid element-which is the product of animal decomposition-being slower in de

veloping, is the concomitant and sequel of the two poisons. Granting the correctness of this theory, could we have a more appropriate term or one more in accordance with the etiology or pathology of the diseases in question? I think the great trouble with those who deny the genuineness of the term is that they can not or will not admit that two distinct poisons can exist or do exist and run their course at the same time in the same subject. This has been already demonstrated by army surgeons, who have seen both syphilis and yellow fever or syphilis and remittent, bilious in their active stages in the same subject.

PEARSON CHAPMAN, M. D. Perryman, Harford Co., Md.

Theory of Gasoline Poisoning. EDITOR MEDICAL WORLD:-The history of the gasoline poisoning cases, recited in the August and October numbers of THE WORLD, has interested me very much. In Dr. Barnett's case the child must have drunk a large quantity of the gasoline; at least a great deal more than did Dr. Robinson's case. In Dr. Barnett's patient the child, at first seemingly dead, was temporarily restored by artificial respiration and a few minutes later expired while in the act of vomiting. In Dr. Robinson's case, the child became very weak and dark around the eyes afterwards falling asleep; (I rather think the child fell into a semicomatose condition instead of going to sleep). On awakening, the child presented symptoms of impending convulsions which, however, soon passed away. I will now give you my theory in regard to the cases.

Gasoline being quite volatile, it, no doubt, was not only taken into the stomach, but into the lungs also; but here, in a gaseous state. The gasoline probably caused great irritation and congestion of the lungs and of the stomach; hence, this was probably the cause or one of the causes of the hematemesis and hemoptysis. In regard to the cause of the convulsions, I believe them to have been caused by venous stasis in the cerebral vessels, brought about, no doubt, by a depressing or paralyzing action on the heart by the gasoline. The dark appearance around the eyes of Dr. Robinson's patient, as stated by the child's parents, would seem to indicate venous congestion. The treatment, based on the above theory, in my mind, should consist in giving cardiac stimulants, such as digitalis, whisky, strychnine, atropine, etc., and these given preferably by hypodermatic method, especially in urgent cases. In very urgent cases bleeding from the arm would be of service. I think, after the patient has been restored to consciousness, a

saline purge would, no doubt, prove to be of benefit.

To give a summary of my theory:-The gasoline enters the system by the gastrointestinal and respiratory systems, there irritating the parts and causing great congestion; once in the vascular system in sufficient quantity, it depresses the heart, thereby causing venous congestion all over the body and this in the brain producing coma, convulsions and finally death from heart failure. The venous congestion may also stand in the light of a causative agent in producing hematemesis and hemoptysis. A post-mortem examination of such cases would throw much light on the subject. If any of THE WORLD's readers should meet with a case of gasoline poisoning, I would be very much pleased to know how the above treatment answered.

ROBERT R. SAUNDERS, M. D.

Philadelphia, Pa.

Gasoline Poisoning.

EDITOR MEDICAL WORLD;-The cases reported in August and October numbers by Drs. Barnett and Chipman lead me to report my recent experience with such a case.

I was called hurriedly to the residence of the child's parents three miles from my office, messenger stating that the child was very ill, but did not know the trouble. On my arrival, by inquiry I soon learned that Willie H., their four-year old son, had drunk an unknown quantity of gasoline from a bottle. I found the parents very much excited, and as this was my first experience with such cases-child first grandson born to an important family-I felt just a little nervous myself. I saw the child one and a half hours after taking the poison. The mother stated that he turned sick instantly after taking the poison, but in a short time became drowsy and wanted to sleep. would sleep for twelve or fifteen minutes, then he would make loud screams as if he had become suddenly frightened, and showed marked tendency to convulsions.

He

I, like Dr. C., was somewhat at loss for recommended treatment in such cases, but, thinking emesis imperative, at once gave a tablet of apomorphine. The action was prompt, and I am sure half a pint was rejected. I then put him on Peacock's bromides to control nervous symptoms. The child would hold itself in one position, and there was extreme tenderness over the region of the stomach, "blistered inside," as mother suggested. this I prescribed an emulsion of starch. Fever developed on the second day. For this I gave quinine sulph., grains ij every two hours in

For

compound syrup of yerba santa. The child made a good recovery.

I don't claim originality for this treatment, but remembered same suggested in a former number of THE WORLD. Is the treatment correct? What is the toxic principle and what is its antidote ?

Will Dr. Hixon, page 393, October number, try Carlsbad Sprudal salt, teaspoonful in a glass of warm water or tea on rising, or cascara with maltine? The former serves me best. Advise the patient to go to the closet at a regular hour each morning after breakfasting and sit there for not less than one hour; think over it and try to defecate. Use an occasional Use an occasional glycerine suppository. Try this and you will be pleased. J. R. McCown, M. D. Rice's Crossing, Williamson Co., Tex.

A Medical Medley. EDITOR MEDical World:- It seems to me that the doctors should speak out against the bad habit parents and teachers have of hitting children on the head and boxing their ears. I have known deafness to result from boxing children's ears, and I have known "brain fever" to result from hard study in school and for examination. Teachers and parents too often punish children unnecessarily unjustly anyway. Young unmarried women during their menstrual spells are perhaps often too cross for teachers-married women do better.

What is a mad-stone? I was under the impression that it is a bezoan, the intestinal concretion of a ruminant. The common ox when he sheds his hair, licks it of, and a hair ball in his stomach or intestines results. Sooner or later the death of the ox results from the hairball. The whale, likewise, suffers from ambergris. I have seen the fossil coral brionas: træa oblonga from the Jurassic rocks, and hairballs, but never a mad-stone, but would like to investigate one. The instrument must have considerable suction power to adhere as it does to bites of rabid animals or snakes. Some intelligent persons have great faith in mad stone and relate what seem to be facts, of its efficacy.

a

Has any intelligent scientist ever experimented with the mad-stone and published his views? If not, we know nothing reliable about it.

The people out southwest of here call the mephistis concolor (Gray), the "hydrophobia cat," and believe it is the origin of rabies. What conditions are required to impart it I do not know. Persons bitten by the animal seem to die with hydrophobia. Educated people believe in this theory out there. We are led to this belief by the fact that there are regions and counties where there are millions of dogs and no rabies, caused, we think by the "hydro

Sudden Obstruction in the Esophagus.— A Treatment for Cold in the Head. EDITOR MEDICAL WORLD:-H. C., aged seventy-four, a slim, wiry, healthy man, while eating dinner suddenly found himself unable to swallow. He did not feel greatly alarmed, supposing that a morsel of chicken's gizzard, which he had hurriedly swallowed, was the cause and would soon pass away. He continued in this state two days, then sought medical advice. During this time he amused himself in attempting to swallow food, mostly liquids, a mouthful or two of which could be retained several minutes, when it would be regurgitated, a quantity of mucus following, causing a "gagging" for a couple of minutes. The drinking of half a cup of fluid brought on the attempt at vomiting immediately, with the regurgitation of the fluid drunk. Spraying the upper part of the gullet with a four per cent. solution of cocaine did not lessen the vomiting.

The sensation of hunger passed over on the second day. I found him free from all discomfort, except the inability in deglutition and the consequent regurgitation. Careful examination revealed no tumors nor aneurism, nor progressive difficulty in swallowing, nor any abnormality. Spasmodic stricture was closely ruled out by his age, good health, and previous history. As I had no esophageal bougie with me, and the patient anxious to have all the time possible for "nature's relief," a visit was arranged for the following day. In the interim a solution of pure pepsin, two grains, and dilute hydrochloric acid, two drops to the dram, was prescribed every half hour, in water. Twenty hours later I saw the patient, whose cheerful countenance told of the gladness in escaping the esophageal sounding. Two hours previously the obstruction suddenly gave way, and immediately he drank a cup of milk without any difficulty, which he did also in my presence.

There is no doubt that the gristly portion of the chicken's gizzard, imperfectly masticated and hurriedly swallowed, had lodged at one of the narrowest points of the esophageal canal, which is opposite the fourth or fifth dorsal vertebra, where the left bronchus crosses it obliquely downwards and outwards. The narrowest part of the canal, which is only one

inch in diameter, is opposite the cricoid cartilage, and is frequently the position where foreign bodies lodge, the proportion being as seven to two (Allen).

In this case the amount of fluid retained and the patient's sensations pointed to an obstruction further down the canal, four or five inches. Had I had an esophageal bougie with me the point would have been definitely de termined. The use of an acid solution pepsin seemed to me an easy solution of the patient's difficulty.

of

In October WORLD, Dr. D. F. Easton asks for a speedy cure of cold in the head. If he will try the following he will be amply satisfied: Administer tincture aconite, drop one-quarter to one-half; tincture belladonna, drop onehalf to one; tincture gelsemium, drop one, hourly. Administer a saline cathartic. These two remedies will be extremely efficacious. It is a well-known fact that a cold in the head is often "broken up" when a profuse bowel discharge takes place. To those intelligent patients to whom a cocaine atomizer can be entrusted, immediate relief can be given by spraying the nostrils several times daily with a solution of cocaine-a four per cent. or a two per cent.-the latter is the better to give a patient. I do not advise the cocaine spray to people who cannot absolutely follow advice, as the secondary results of a profuse use of cocaine in the nostrils is much worse than the evil sought to be mitigated. The first remedy proposed can be used either in solution or tablet

form.

To "Anxious Observer," for the best treat ment of gonorrheal rheumatism, he will find protiodide of mercury and quinine in large doses the most satisfactory treatment, according to the method outlined by Dr. J. William White, in the International Surgery, vol. 1. Salicylates, alkalies, etc., amount to little in the treatment of this disease. For anchylosis and permanent lesions galvanism and massage, baths, etc., as is of the best use in chronic rheu

matism and would be the most efficacious in chronic gonorrheal rheumatism.

Haverstraw, N. Y.

N, B. BAYLEY, M. D.

Rheumatism and Gout.

EDITOR MEDICAL WORLD:-In looking over the bright pages of your most excellent journal the pleading tones of "An Anxious Observer," arrested my attention.

I am forcibly reminded of the difference between rheumatism and gout, as described by a very eminent physician who suffered with the latter. He said, "Put your finger in a vice, screw it up just as tight as you could possibly bear it, let it be, and that represents rheumatism, then give the vice one more turn and that is gout.'

In a case of 3 years standing of gonorrheal rheumatism, after the patient had been treated by more then one physician, the joints of the foot and toes having become anchylosed, he was cured by saturating him with potassium iodide and keeping the liver active, by giving small doses of calomel, frequently repeated, for some weeks at a time. Treatment continued for three months, after which the swelling subsided, and in a few months the joints partially resumed their former usefulness, and to-day the patient works fairly well, and has not a symptom of the malady with the exception of slight contraction of the extensor brevis digitorum and partial stiffness of the tarso-metatarsal joints, not sufficient to cause any trouble in working. The stiffness is promoted by the contracted tendons. In connection with the treatment, which was not resorted to till all acute inflammatory symptoms had long since subsided, and the disease had become chronic, passive motion was cautiously employed, accompanied by gentle friction for an hour at a time, twice or three times daily, especially at night.

If these suggestions relieve the case in question one iota, should he give it a trial, my labor will not have been in vain in reporting the case.

The last number of your excellent journal, like its former issues, is running over with practical knowledge for the busy practitioner. May its shadow never grow less.

wishes.

Lexington, N. C.

Best

DR. WILL B. CRAWFORD.

EDITOR MEDICAL WORLD:-I would like to advise "Anxious Observer" to give two (2) grains of iodide of potassium in half a glass or so of hop tea, or tincture of hops, every four hours.

Simple, isn't it? Try it. Therapeutic reasons will be given and full particulars if wanted. (Jeff. Coll. '67.) CHARLES A. BAKER. N. W. cor. 16th and Clearfield Street, Philadelphia.

Shake bottle. Dose, two teaspoonfuls in glass of water as indicated.

In fifteen years' active practice I have used this treatment all the time and have never seen a case hesitate to make a very rapid recovery. The only objection I have to it is that there is no money in it for the doctor, as one visit usually settles the business. Stimulants may be used if treatment should seem to depress too much.

.6

One-hundred and twenty grains of Sulphonal (Bayer)" was given to a male adult in nine (9) hours. This man was suffering from subacute cerebritis with some development of maniacal symptoms. This large dosage was administered in milk, the first dose at 6 P. M. and the last at 3 A. M. which caused only fair rest during the night with some depression of heart and lungs the day following as evidenced by cyanosis and muscular relaxation, though not marked until afternoon, when symptoms yielded promptly to a liberal amount of brandy and milk, he resting much better on the succeeding night than when the drug was given. I will say that I do not advise such heroic treatment and in this case gave no such orders, but as he had shown some pretty positive maniacal manifestations, in which attendants were unable to control him for a time, they took it upon themselves to see that he had enough to produce quiet, they having several 30 grain doses at hand. Patient had been confined to his bed for several weeks and was weak except when the wild symptoms came on, which had not been often.

Lebanon, Ind. W. A. DORMAN, M. D.

Arsenite of Copper Defended. EDITOR MEDICAL WORLD:-In October number I notice that Dr. McMahon, in reply to Dr. Patterson's interrogatories in regard to arsenite of copper, condemns in a most unqualified manner this favorite remedy. The doctor considers the remedy a worthless drug-fit for nothing whatever. Well, I am very inuch surprised at such a sweeping denunciation of so useful a remedy. I have been using arsenite of copper for a year or two, and I am not often disappointed in it. I use it freely in diarrhea, dysentery, cholera morbus, colic, flatulence, summer diarrhea, etc. It rarely fails to give relief in my hands. I give a little larger dose than the one usually recommended. I give about one two-thousandeth of a grain (0) to adults and about to little children every half hour until three or four doses are taken, then gradually lengthen the interval between doses. A friend of mine, Dr. Brockway, of Livingston, Ala., told me recently that he had a patient who had suffered a long time with chronic diarrhea, and after trying a number of approved remedies, with no good results, he tried arsenite of copper, in dose of grains (one tablet) three times a day. It had a most happy effect, and the patient was soon relieved. I have given the remedy to horses with colic with the happiest results. A tablet was given every twenty minutes. Will some one give me a good remedy or treatment for hay fever? I have it every fall, and it is very annoying. J. HUGGINS, M. D.

New Berne, Ala.

Bernhardt's Balm.

EDITOR MEDICAL WORLD:-In your September number you gave Bernhardt's balm, copied from the Formulary. Madame Sara Bernhardt is not the author of the compound, as it was published some years before she was born. But, with her known intelligence, she has selected one of the best formulas among the therapeutics of the world. She is not the only one who uses it, as great quantities are used every year in this and other countries. That compound is simply the Eau Sedative, published by F. V. Raspail in 1835, in three strengths for the use, respectively, with chil