This preparation relieves in one minute, as by magic, every headache except a nervous one, when the head is washed or well wetted with it. The quantity of salt, which becomes chloride of ammonia, is sufficient, as the evaporation of the liquid leaves dry salt in the hair, but if the mixture is to be applied on the body a double quantity of salt makes it stronger. The quantity of spirit of camphor is sufficient when used in headache or sponged on the body to cool fever, but if used as an invigorator of the body the amount of spirit of camphor can be augmented or replaced by Cologne water or other perfumed alcohol.

The initial formula, in intelligent hands, will give such remissions in fever, by cooling them rapidly, that remittent or bilious fever can be stopped and cured in less than twentyfour hours, and any fever delirium is prevented or can be stopped at will. It is a specific for the cooling of any kind of fever and all kinds of inflammations.

F. W. Raspail, initiator of the formula and who has caused camphor gum to sell from a few ounces to hundred thousands of pounds, had during his lifetime all the medical faculties against him, because of refusing to accept a diploma as M. D. and keeping his title of chemist. He published a family medical book, denouncing as a murderer any one prescribing mineral poisons as medicine. He declared about 1830 that all human and animal ailments were caused by insects, imperceptible, whom he called acarus, or by cryptogams spores. Microscopes were not what they are now; the name microbe was not invented. He wanted to create a new form of practice based on that theory, that caused him to be called empiric

and his notions turned to ridicule.

To-day many kinds of microbes have been discovered. What do you think his spirit must feel on the Elysian shores?

Bell's, Texas.

DR. P. ROGAY.

DOCTOR-Have you not been wishing to adopt the convenient and most efficient alkaloidal or dosimetric granules in your practice, but hesitated on account of lack of definite knowledge as to how to use them? The new book "Outline of Treatment with Dosimetric Granules" will meet your needs admirably. It is the only book published treating this important subject from the standpoint of the American practicing physician. It meets the difficulties that are encountered at the bedside and in the consulting room. Bound in flexible cloth, small pocket size, 100 pages, price only 50 cents. See order blank on page xxiv.

"Slow Fever" or Enteric Fever-Chronic Malaria-Pyoktannin-Potassium Iodide in Chronic Cough.

EDITOR MEDICAL WORLD:-I have been reading the articles in the MEDICAL WORLD on the subject of "slow fever."

Dr. Green thinks the name "slow fever" is not proper. He says it is of malarial origin, that its seat is in the intestines, that it is caused by a bacillus, taken into the the alimentary canal, and that it is not a disease of the nervous system. Dr. Persinger thinks the above about the correct idea, and reports what he considers a typical case, and gives his treatment.

this fever enteric, we will have clear sailing, and but little need of space in THE WORLD for a discussion, for we will then have the typhoid affection, "slow nervous fever," or enteric fever.

"Now let us reason together." If we call

We should adopt a term which separates the disease from all others and points to a constant feature.

Entero-Mesenteric fever is certainly the most correct term, but as that is too long for convenience, and recognizing the direct connection between the mesenteric glands and the intestines, we shorten the name to plain

"enteric fever.'

Granted that the fever is produced by putrefactive matter, animal, vegetable or fecal, and enters the system through air and water, what is the best treatment?

Murchinson says, "The pilot cannot quell the storm, but by tact, by knowledge, and able assistance, may guide the craft through the storm. No man ever cured a fever."

If these are facts, and I for one do not doubt them, why exhaust the materia medica in a line of treatment for this disease?

By Dr. Persinger's own statement we find he used seventeen distinct drugs and the "various febrile mixtures" besides, for his typical case

of slow fever. This is a treatment that certainly harmonizes with the modern view of enteric fever. In fact I believe that the great majority of such cases need nothing more than milk, subnitrate of bismuth, pepsin, and sulpho-carbolate of zinc.

I have practiced in a malarial district for almost fifteen years but I do not hesitate to say that all of those below four years are enteric, and are not malarial. And further, that I have seen little or no good follow their treatment by quinine alone. I really think that quinine, chlorate of potash, Fowler's solution, etc., are detrimental in these cases. Quinine as a tonic in the later stage is all right, but in the first stage it is all wrong. Ten ounces of good, fresh milk given every two hours, and

suitable doses of the remedies mentioned will do all for the average patient that can be done. Complications are to be treated as they arise.

The editorial in the September WORLD on "chronic malaria" meets my view exactly. I wish every physician in the malarial districts could read it. It would not only benefit them, but perhaps be the means of benefiting some of their patients. I have seen many patients who have reached the stage, so aptly described by the editor, still trying to round up on quinine; the stomach revolting, the gastric catarrh enough to make life a burden, and the quinine only adding fuel to the flames.

Dr. Marlette on page 305, asks for information regarding the use of pyoktannin in gonorrhea. I have had some experience in the New York hospitals. It was used then only as an experiment, and I followed in the same line. Pyoktannin may be filling a long-felt want in the profession, but it is quite clear to my mind that it is not wanted in gonorrhea. That it will kill the gonococci there is little doubt, but how about the patient? I have used it in a solution of from four to eight grains to a pint of water. Dr. Willy Meyer, of New York, recommends the eight grain solution, but you will have a hard time to find your patient when you are ready to use it the second time, for he will get away if possible.

I would advise Dr. Marlette to use something better and safer. Try the bichloride of of mercury solution, one to 4,000. It is colorless, easily prepared, and its use is unattended with uneasiness to the patient. Pyoktannin is one of the aniline dyes, and stains everything it touches.

If Dr. Smith (Page 305) has not used potassium iodide in the case of chronic cough, I think he would do well to try it in onegrain doses with a small quantity of some of the anodynes, (Hoffman's anodyne is my favorite) in simple syrup as a vehicle.

R. C. M. LEWIS, M. D.

Centerburg, Ohio.

Intense Uterine Pain After Delivery and After Using The Douche.

EDITOR MEDICAL WORLD:-At times I get bothered in some of my cases, and would like to have the opinions of those who have had similar cases.

Some time since I attended a patient, forty years of age, in confinement. All went well until the third day when, owing to a door swinging open, and letting in a cold draft of air on her, she was five hours afterward stricken with excruciating pains in the womb. I could hear her two hundred yards away from the house uttering one scream after another.

Having had experience in such sudden attacks

of pain, I gave her sixty drops of laudanum immediately, applied hot water compresses over the region of the womb, and repeated the laudanum in half an hour. At the end of about an hour she went to sleep and awoke in three or four hours, refreshed, free from pain. and exhibiting no symptoms of narcotism.

Shortly afterward I ordered a hot douche and glycerine and tannin suppositories, for a patient suffering from subinvolution of the uterus three weeks after confinement.

The second time she used the douche, she w seized with violent pains in the womb, closely resembling those of the previous case. The same treatment gave about the same results An old doctor, who arrived after the attack was over, pronounced it a case of uterine colic.

A few weeks afterward I was called to see a woman suffering similar uterine pain, three days after her confinement. She had in addition suppression of urine, fever, and tendernes over the lower part of the abdomen. I ordered salts and laudanum in full doses and covered the tender region with cloths soaked in a lotion composed of fifty grains of chloral hydrate and eight ounces of water.

After her bowels had been moved freely, gave her ten drops of laudanum every half-hour for five hours and covered the abdomen with warm mush poultices. Two days later she was as well as before the attack.

These three cases apparently differ only as to the fever and tenderness present in the last. Pathologically what was the difference betwee:

them?

There was no distention of the womb by air in any of them, nor was there any more than usual hardness of the womb. Case number three was a mild attack of peritonitis, ne doubt.

I have seen perhaps a dozen cases, similar to the above three but varying more or lessin severity. BEN. H. BRODNAX, M. D. Brodnax, La. Epistaxis-Warning Symptom of Puerperal Convulsions.

EDITOR MEDICAL WORLD:-I can offer no theory for the value of nitro-hydrochlorid acid in epistaxis, but, having used it for over twenty-five years, I can attest to its value in these recurrent cases so frequently met with.

Of course its action is too slow for use while the bleeding is going on, when the usual means will have to be employed; its value is to prevent recurrence, and it has to be used for weeks or months; and I have never found it fail to do good.

The dose is minims xv t. d. in a glass of water after meals.

Epigastric pain going and coming in the

latter months of pregnancy is almost sure to be followed by convulsions unless the patient is put at once on the proper regimen and properly treated.

Neuralgia of the fifth pair of nerves is also to be looked upon as a dangerous symptom under the same circumstances.

It may be a "chestnut" to say that in such cases, if albumen be present in the urine, an absolute skim-milk diet is imperative. B.

The Atmospheric Tractor and Uterine
Safety Tube.

EDITOR MEDICAL WORLD:-Dr. J. C. Campbell's estimate of my Atmospheric Tractor "that it will supersede the forceps in all but the most severe cases" (October WORLD, page 381) is in the main correct. I have been using the Tractor now for about two years, and in that time I have been compelled to resort to the forceps in only three cases, one of which was a face presentation, another a forehead presentation, and the third was one of an unusually large head (154 inches in circumference) the mother being a primipara. My Uterine Safety Tube is, however, of equal if not greater value than the Tractor. It renders the labor safe, by enabling the physician to lessen the internal pressure so that it cannot reach the danger point. It also lessens the pain and exhaustion hitherto incidental to "labor" and shortens its duration.

The principles upon which it is based seem novel to many practitioners, but progress in any science means the adoption of novel ideas, and the abandonment or modification of views previously held.

Theoretical objections have been and can be urged against the Uterine Safety Tube, but they ought to fall flat when confronted by the immediate benefit obtained from it.

All of my patients are now delivered in from 30 to 90 minutes after the os uteri is dilated to 2 inches, if multipara and in from 1 to 3 hours if primipara. Formerly the same stage ran from 2 to 10 hours and occasionally

, and the pain and exhaustion were often very great. Now they suffer but little and are so little exhausted that they want to sit up on the third or fourth day.

The children are bright and healthy, and their prospects of attaining healthy maturity are considerably greater than if they had been exposed to the uncontrolled intra-uterine pressure, or to inordinate forceps pressure. Even in abnormal cases requiring severe operations, the Uterine Safety Tube will be a valuable adjuvant in warding off danger while the necessary measures are being considered, or arranged.

In cases in which the forceps must be em

ployed, the simultaneous use of the Uterine Safety Tube will reduce to a minimum the amount of extractive force required. Without the tube the force employed must be great enough to overcome both the resistance of the tissues and the pressure of the air against the fetal head. With the tube, the air pressure is equalized, and the resistance of the tissues is the only force to be overcome. In the third case referred to I did not exert more than five pounds of force in delivering that large healthy child. If the Uterine Safety Tube had not been in position, I would have been compelled to exert much greater force. P. MCCAHEY, M. D., 1413 South 10th Street, Phila., Pa.

Uterine Tumors Removed by a new Process.

In a

EDITOR MEDICAL WOR D:-Every progressive physician is ever on th alert to investigate and adopt any new and successful method of treating disease, provided the evidence is sufficient for such endorsement by him. concise way I wish to call the attention of the profession to a method for the treatment of various uterine tumors which promises, so far as my experience goes, to be better and safer than any other that has ever been made known to the medical profession. The method I speak of is carried into effect by the use of an invention of Dr. J. H. Woodward, of Seward, Neb., in the form of an "Electric Hypodermic Syringe." The electric current is passed through the tumor by introducing the needle of the syringe into it, and connecting the syringe to the negative post of a galvanic battery; the needle in this relation to the battery and the tumor constitutes it the negative pole and the tumor the electrolyte. the circuit is closed by applying a large dispersing electrode to the abdomen, I inject thirty to forty minims of the solution of electro-negative iodine, or ergotine with the syringe into the tumor. The dual action of the active electro-negative needle in the tumor and the electrified iodine separate the elements of the tumor, and the morbid mass melts away phenomenally by the power of these two electronegative forces. I have given this work of treatment a fair test in one of the worst cases of fibroid tumors I ever saw, and with better results than it was thought possible to get from the nature of the case. While the patient is under the treatment, antiseptics and constitutional remedies are not to be overlooked. In this I have only attempted to bring what I consider the merits of this new and wonderful invention to the notice of the members of the medical profession, for an investigation and

After

trial of it in the removal of uterine tumors. W. S. TOWNSEND, M. D. Seward, Neb. County Physician. [The Doctor has simply used the needle of the hypodermic syringe as a needle electrode. Being hollow, it allows the injection of the iodine into the mass of the tumor in addition to its electrolytic action.

Dr. Walling, formerly editor of the electrotherapeutic department of this journal, first called our attention and that of the profession to the fact that iodine and allied substances, being electro-negative, are repelled by the negative and attracted to the positive pole; that hence they may be introduced into the system, by the negative pole, and, gravitating towards the positive pole, will be generally disseminated throughout the intervening tissues. The reverse is true of electro positive bodies, alkalies generally being included in that category. Dr. Walling promises us a paper soon upon this interesting subject-the chemistry of cataphoresis.-Ed.]

Treatment for Chronic Corporeal Endometritis.

EDITOR MEDICAL WORLD:-In answer to Dr. H.'s case, in October WORLD, of chronic corporeal endometritis, I would suggest a treatment that I have successfully used in similar cases. First, I suggest Hayden's viburnum comp., in dessertspoonful doses, four to five times daily, which will relieve the leucorrheal discharge and aid wonderfully in returning the menstrual flow. In connection with the above I frequently use the following prescription with good results (alternately): R. Hydrarg. bichloridi................. ...grain i Tr. ferri chloridi............................ ounce i Acidi hydrochlor........ ............................................ounce ss Sol. chloridi arseniosi...................... dram i Syr. zingiber, q. s. ad .........Ounces vi

M. S.-Teaspoonful three times a day after meals in

The Genu-Pectoral Position. EDITOR MEDICAL WORLD:-My experience in obstetrical practice calling for the genu pectoral position having been very much larger than the ordinary allotment of professional life, I will crave your indulgence for a time, while I give it to you in detail, promising you, in return, to be as brief as the exigencies of the subject will admit. The most astonishing thing to me is that so little has been written upon the subject. Except to briefly mention it in connection with procidentia of the funis, I am unable to find any thing about it in ou: modern text-books on the subject of obstetrics.

True, the position has been mentioned by some of our older authors, namely, Derenter, Smellie, and Bard, who wrote in the early part of the 18th century, but only in connection with podalic version.

Dr. T. Gaillard Thomas, of New York, employed the postural method in procidentia of the funis, for its restoration and retention.

To him belongs the honor of the first recorded cases of the kind, and any person that will employ the method in prolapsus of the co'd need never fail.

On the other hand, to Dr. Edwin R. Maxson belongs the distinguished honor of first employing and recommending the genu-pectoral position in cephalic version. Although Dr. Maxon's first case was purely accidental, it being a transverse presentation, with the arm in the vagina and the cord prolapsed; he put the woman in the genu-pectoral position for the purpose of reducing the cord as recom mended by Dr. Thomas.

After the cord was replaced, and the woman turned upon her back, he was very much surprised to find that the fetal position had changed to that of a vertex presentation, which was already engaging the superior strait.

His conclusions of the highly gratifying results were, that the posture in which the woman had been placed, and by the aid of very slight manipulation upon his part, the change in the presenting part had been brought about. This case occurred in Jan., 1863.

In speaking of the above mentioned case, he observes that; "I did not take to myself any credit for the correction of the presentation in this case, as it was accidental and unexpected. I treasured up the facts, however, in my mind, as well as recorded them in my note book, from which I now draw the main facts, being determined, if possible, to turn it to account some time, which I did in the following case. On the 6th day of February following, the husband of the lady came about ten o'clock at night, saying that his wife was in labor, and asked my attendance; but as I had been up for two or three nights, I advised

him to call a friend, with whom I had consulted in the case of the prolapsed cord, saying to him, that should any difficulty arise, I would see her with him. To this he assented.

About two o'clock in the morning I was called again by the husband, saying the Doctor would like to see me, as there was trouble. The Doctor informed me that he had a shoulder presentation. I examined the patient, and found as he had stated.

"On a little reflection, during which I called to my mind the case of malposition with prolapsed cord, which I had so recently corrected by position, I suggested the possibility of correcting the presentation in this case by position and manipulation, to which the Doctor readily assented, saying it could do no harm, but thought it would not be successful. But feeling, as I did, a special responsibility in the case, on account of having been previously consulted by the lady, I resolved with the Doctor's consent to make the effort, which I did in the following manner: I had her get on her knees on bed quilts and pillows placed in the center of the bed, to the height of about eighteen inches, her chest and face lying flat upon the bed, fetching the back at an angle with it of about forty-five degrees, the knees being a little apart. I then passed my hands -being smeared well with lard-in the vagina, and with scarcely an effort, and without the least complaint or evidence of uneasiness upon the part of the patient, crowd d back, and, of course, down, in her position, the shoulders, and slipping my hand between the brim of the pelvis, and the fetal head, I spread out my fingers and brought or directed it during a pain to the superior strait, and then retaining the grasp, we had her turn her hips down carefully upon the bed, when after a pain or two, the head engaged in the superior strait, and we had a perfectly natural presentation, without having used the least violence, or apparently caused any pain or uneasiness to the patient, and all accomplished, I should judge, within five or ten minutes. Labor terminated favorably in a few hours, the patient giving birth to a ten pound boy, and alive and well.'

The above report I have taken from the Philadelphia system of obstetrics, by Joseph S. Longshore, published in 1866. It will be seen that what Dr. Maxon calls the "posture treatment" has made easy an operation that in certain presentations is always difficult, and some times impossible, and that it has avoided the hideous operation of embryotomy, which, barring an occasional spontaneous version, would have been in many instances the only alternative under the circumstances.

To those that have never attempted the operation, it will be a wonderful surprise to see

the ease with which the hand is passed into the vagina and uterus in this position.

In a general practice of over twenty-one years I have met with eleven cases of transverse presentations, seven of which I readily succeeded in converting to a vertex presentation by the knee chest position and gentle manipulation. Hence I believe that I have a right to pass judgment upon the utility and general practicability of the great advantages to be derived from a thorough adoption of the genupectoral position in those cases.

66

There is scarcely anything so alarming to the young and inexperienced, as to suddenly find some other part aside from the fetal head presenting. His desire to leave the room becomes almost uncontrollable. In other words, he wishes he wasn't in it." I have been there and know whereof I speak. How well I remember the first shoulder presentation I ever met with. It was nearly twenty years ago, and it is as fresh in my memory as though it was but yesterday. On my first examination I could feel no presenting part, so likewise on my second, two or three hours afterwards.

After waiting for some considerable time, and finding the pains increasing in both severity and frequency, I made a third examination, and was not a little perplexed in not being able to determine the presenting part.

At this juncture, my partner, Dr. Thomas, who since has joined the vast majority, chanced to pass by. I hailed him and invited him to see the patient. With an examination, he assured me that it was a knee presenting, and that all would be well, and after giving me some cheering advice, and the patient some comforting words, took his departure. He had not long been gone, until, during one of those terrible throes of labor, an arm was expelled and occupied the vagina. I was almost panic stricken, and sent a messenger in all possible haste for the doctor to come and assist me. He was soon by my side, the distance being less than two miles, and I ventured to suggest to him, though an elderly gentleman, Dr. Maxson's method of procedure. He had never before heard of it, and had not the least confidence in it in the world, and proceeded at once to the administration of chloroform and delivery by version.

In January, 1879, I was called in consultation by my friend, Dr. Farley, to see a lady then in her second confinement. The Doctor told me that he was undecided as to what the presentation was. I made an examination, and was myself in doubt, the presenting part being high and almost out of reach. I suggested the propriety of allowing it go on undisturbed, until the presenting part could be determined. This was about nine o'clock in the evening,