I have often seen the floor and furniture, and even the clothing sprinkled with carbolic acid, or some other deception, while the air in the room was loaded with carbonic acid from

lack of ventillation. There can be no objection to the usual disinfectants, provided they are not relied on to the neglect of good ventillation.

Now, brethren, what is this disease? Is it typhoid or malarial, or some other disease? I hope some one or more of the many able physicians throughout the West, having an opportunity, will study the disease post mortem, and report through THE WORLD for the benefit of the profession.

Note: Since writing my first article, which was written for the November number, but was mailed too late, I have had the pleasure of reading Dr. Herrington's article in November WORLD. Perhaps the Doctor will favor me with a more detailed account of the post mortem appearance. Bushton, Kansas. S. C. Cook, M. D.

Grip Wrecks.

EDITOR MEDICAL WORLD:-Early in the winter of 1889, dispatches from European countries filled the daily journals with accounts of an epidemic disorder, which went by the name of Russian "La Grippe." The laity of this country at first was very little interested, considering the reports of the disease very much exaggerated and the fatality connected with the influenza not alarming; also feeling a sense of security, with the old Atlantic and her briny breezes rolling between us and the plaguestricken continent.

For a short space of time, we stood in the role of disinterested spectators, and to read the somewhat heartless, but amusing comments of the lay press, it appeared as if we, to some extent, enjoyed the plight of our neighbors across the sea.

To a great number of people on this side, including a few physicians, the novelty of the name "La Grippe" under which the fashionable foreigner sailed, was something unheard of before. But "La Grippe," like a rumor, spread with a rapidity that was unexpected. From the land of the Czar it took Horace Greeley's advice, to go west, and like a prairie fire it swept everything before it-Germany, Austria, France et. al.-when a cablegram announced one morning, that the Prince of Wales was confined to his room with the prevailing epidemic. That settled it. Immediately upon receipt of the news the fad-feeding snobs of New York and Boston all sneezed, and the distinguished guest was introduced into the upper circles as quite a lah-da-dah affair. But our

aristocratic friends could not get a corner o the truly democratic little microbe that, like a dense black fog, came surging over the ocean, a few days afterwards. It came "en masse, bidding defiance to all quarantine precaution, Castle Garden regulations or revenue officers.

"La Grippe" has been with us long enough. to take out first papers to establish citizenship, having been endemic ever since its advent to our shores, and at intervals becoming epidemic, especially at the approach of the annual aniversary of its first coming, and the inquiry is now made, with a good deal of anxiety by those who treated the subject with levity, has it come to stay? That is the question that prompts the writing of this article, and it is not so much directed or intended for the profession, who, it is supposed, knows as much about the subject as the writer, but to give the people at large a few historical facts, concerning epidemics, and let them form conclusions for themselves; and I notice with some satisfaction that, of late, there is no class of literature in which the public is more interested, than the medical journals.

When the epidemic first made its advent into this country, the newspapers, with praiseworthy zeal, undertook to inform the suffering people all about the new disease, as it was termed, and the name "La Grippe" having a foreign sound, they concluded that it certainly must be of very recent origin. Influenza has been a familiar term to most people and had become a house hold word, but the word "Grip," as it was called, after a short intimacy, seemed to make them lose all sight of it.

The name La Grippe is nothing very recent. It was applied to the same catarrhal epidemic years ago and, while not very expressive, from its French derivation it means to seize, applying it in the sense that the disease caught the man, and not the man the disease.

The Italian term, "Influenza," comes from the theory that planetary Influenza (influence) had something to do with the disorder. Wilson, in his work entitled the "Continued Fever" says,

there are numerous accounts of earlier epidemics resembling it, and it is undoubtedly referred to by Hypocrates, in describing an outbreak in the Athenian army in Sicily, (415, B. C.) but the writings of classical antiquity have not been very exact in its description." As early as the ninth century, several epidemics of like nature have occurred at irregular intervals with a lapse of one or two centuries intervening, varied by two or more outbreaks in the same century.

The epidemic of 1557 started in Asia, spread over all Europe, crossed the Atlantic to America, and circumnavigated the globe; the fatality attending it was great.

From 1658 to 1675 Europe was again visited by a double epidemic that was well described and recorded by Sydenham and Willis in the "Annals of Epidemics." About this time the disease began to be known as Influenza, as the Influenza of the stars suggested itself to the physicians of that date, to explain the wide prevalence and sudden appearance. Willis

writes, "that about the last of April, 1658, a sudden distemper arose, as if sent by some blast of the stars, and many thousand people fell sick together."

From 1837 to 1857 a continuous epidemic condition prevailed, being unusually severe in London in 1847-48, and the report of the Registrar-General shows that in the few weeks that the disease was at its height, five thousand persons died in excess of the average mortality.

While there is not much satisfaction in having the "Grip," there is some comfort in the fact that the mortality connected with the present visitation in the acute stages is far less than in the previous epidemics, and "Grip"stricken humanity ought to appreciate the fact that the physician of to day is better equipped to combat the disease than those were forty years ago. Medicine as a science has always had a slow growth; it has not kept abreast with collateral sciences and from the very nature of things it can not hope to become exact. But, without being accused of egotism, we can safely say that we have had something to do in checking the death rate. Chemistry has come to the rescue with healing drugs within the last decade, that were unknown in therapeutics a few years ago. Path-finders in the profession at work with the microscope have thrown some light on the subject, and when this present epidemic becomes a matter of history the physicians that struggled with it can report progress, and it is to be hoped that we can find some measure to hasten the departure of our unwelcome guest, but from what we know of the disease by previous visitations, its habits and history, we can expect that, like a fire, it will burn so long as it can find suitable conditions favorable to its existence. We may look for it to gradually decline, and probably this generation will not see a return of the scourge.

With this prophecy we will go back to our text "Grip Wrecks." Every physician, from the city practitioner to the country doctor, has become familiar with all of the various forms and types which the disease assumes, for there is not a tissue of the body that is exempt. The old adage that "Variety is the spice of life" would be a malquotation so far as Grip is concerned, as, in one sense there is variety, but it is the very gall of life.

During the winter of 1890, nearly seventy

five per cent. of all the cases a physician was called to attend was Grip, and no two members in the one family presented the same symptoms. One case would take on the form of catarrhal fever with high range of temperature, others with pleuritic pains, bronchitis and, ending up with pneumonia, with fatal results a very common form of the disease, the victims being mostly young people or aged subjects. But man, in the strength and prime of his noonday, would be seized with a slight chill, complain of vertigo, a racking headache, an atrocious pain in the small of the back, referring it generally to across the kidneys, or the "coupling" as they would say, accompanied with a soreness of the muscles and bones that made it difficult to move. This mode of seizure, the nervous type of the disease, in some localities was mostly confined to vigorous adults, from 35 to 60 years of age, and, as far as our observations went, a large proportion of males. So sudden would it down a victim that in former epidemics, where it took on the nervous type, the French gave it the name of "Horion" because the victim went down as if struck with a blow on the neck with a sand bag. The symptoms were not as severe in all cases of this form of the disease; in some there was only a dizziness with slight malaise, the patient continuing his every day occupation, not admitting that there was anything the matter, but taking advantage of the opportunity as an excuse to take his own prescription-whiskey and quinine, in the proportion of several whiskeys to a minimum of quinine. This type of "Grip" seldom proved fatal in the acute stages, but it is from this source that the "Grip Wrecks" come of which we will speak further on. The shattered wreck it leaves of the cerebro-spinal system, makes it the most to be dreaded of all forms, not from the immediate, but from the remote results that surely but slowly follow.

There is occasionally a form that has been quite common in some sections, that did not show its character on the early arrival, characterized by rapid pus formation in the bony cavities, the mastoid cells or the antrum of Highmore. The French people, who seem to have the right to name the different characters under which "Grip" masquerades, have named this type of the disease "Tac" or in the English "Rot." In some cases an inflammation of the middle ear is apt to occur, "otitis media," which is always serious, sometimes dangerous, the tympanum giving away to allow the escape of pus, leaving the patient in a wrecked condition as to hearing, if not permanently deaf. Autopsies held on subjects known to have had "La Grippe" and supposed to have fully recovered and died suddenly,

show structural changes in the medulla and spinal cord, with pent up pus in the bony vertebral cylinder, which condition is very analogous to the formation of pus in the mastoid cells and antrum of the face.

Our State and private insane asylums are rapidly filling up from this source. The country is strewed with mental "Grip Wrecks," which will remain with us as a sad reminder after the disease has taken its final departure.

There is another class of "Grip Wrecks" from which the advertising vampire has already commenced to reap a rich harvest. There are quite a number of instances where the sexual functions have been temporarily interrupted and in some cases permanently.

Physicians as well as the public will be glad to see the Russian "La Grippe" fade away, and when it has gone the medical men will have plenty of material among the wrecks it left in its trail to study over for years to come.

It is true the death rate from yellow fever was greater in proportion to numbers that were stricken, but yellow fever recognized boundaries. "La Grippe" is universal, and when the battle is over and the death roll made up, "La Grippe" will number more victims than cholera, small pox, and yellow fever combined. A great many people looked on the approaching epidemic, two years ago, before it fully got here, as a Freuch comedy for Puck" to cartoon, and a good opportunity to "guy" the doctors over. But it can be regarded more in the light of a world-wide tragedy.

FRANK L. BROCKETT, M. D.

find nothing left but a dried, shriveled portion of the skin. The child has made a good recovery. Now the peculiarity of this case is the age of the child. The mother has had rheumatism. I would say I confined the mother, she being a primipara, 38 years of age, labor tedious; used instruments; convalescence was rapid and good. Now, am I mistaken in my diagnosis? Has any reader of THE WORLD had a similar case? I have never met a case in so young a patient.

Rogers City, Mich.

E. ERSKINE, M. D.

aa ounce j M. et div in chart. no. 45. Sig. One every two or three hours to relieve muscular soreness, etc. A teaspoonful of spirits ammonia aromatic to relieve prostration.

I use aqua camphora with a few minims of carbolic acid with post nasal syringe twice daily.

Valentine, N. B. J. C. DWYER, D. M.

To Mask the Odor of Iodoform. EDITOR MEDICAL WORLD.-Among your official formulæ of American Hospitals, page 160, I find "Ointment. of iodof. and bals. of Peru."Having had considerable experience with these two drugs, trying to cover the iodoform, I would, for chemical reasons, never combine the two, as myroxylon is incompatible with iodoform, setting free iodine. To cover iodoform I use naphthalin, 1 to 9.

CHAS. A. GRAEBER, M. D. 31 Hobart St., Meriden Ct,

THE Medical and Surgical Reporter, Phila., says of "The Physician as a Business Man :"-"The subject is one which seems to be all but utterly neglected, and there can be no question about the enormous amount of good that would accrue to the profession if many of the suggestions offered were earnestly carried out. * * * This book can be read with profit, especially by those who have just entered, or are about to enter, the profession."

KEEP your journals in a MEDICAL WORLD binder.

Dosimetry Defended. EDITOR MEDICAL WORLD:--Our last monthly clinic came to me while myself a sufferer from rheumatic fever. I had plenty of time to think but that was all. Now among my first efforts I wish to say a few words in support of my position as taken in previous issues of this iournal and held to criticism in your January number.

There is no doubt but Dr. Ensign p. 21, means me. Speak right out the next time Doctor, don't hesitate to pin your placard to the post for which it is intended. I take no positions that have not been fully assured by abundant clinical fact during years of experience along this line. In regard to the use of calcium sulphide in scarlet fever as I appear in the November number I am justly dealt with-I wrote such abominably poor copy that the much abused printer had to do what he could with it and my idea got lost in dots and

dashes before it came into his hands. This is the last idea: give calcium sulphide one or two granules according to age and apparent severity of the onset, along with aconitine every fifteen or twenty minutes till the body exhales its characteristic odor indicating saturation (this will take only from one to four hours) and then continue in sufficient dose and frequency to sustain this condition "till the climax of the eruptive stage is passed." In regard to the use of the other remedies mentioned, we simply claim a neater form and a surer means of producing the same results that have been aimed at all along with Galenical preparations. My patients enjoy a sugar coated granule of arseniate of strychnine much better than they do three to ten drops of nux vomica in a drink of water, and I think Dr. Ensign's would if he should only give them a chance. I have tried both. I have seen many a case that started out with all the furor so well known, temperature 103 to 104 degrees, tremors etc, etc., that under this antidotal treatment only developed a slight eruption on the chest and flexor surfaces, to the terror of the family who had previous old fashioned experiences, to be followed by smiles later and praises of my treatment of the case. Dr. Ensign says "you cannot jugulate a continued fever with dosimetry or anything else" and then goes on to claim for cases so reported an error in diagnosis. Now, gentlemen, let us be fair with one another; let us give educated physicians the credit of possessing the ability to diagnose correctly ordinary pathological conditions without a post mortem, even if we are not able to see the cases ourselves to verify their statements.

Dr. Ensign admits not to have tried the method or the means in this form and yet

brands the whole thing as folly. In regard to turpentine in diphtheria, abundant authority can be cited in later works to verify my claim even if a rich experience with this remedy, personally, had not proven to me its inestimable value in many cases.-"There are more things in heaven and earth, Horatio, than are dreamed of in your philosophy."

Your liberal conclusions, Mr. Editor, are well worthy the attention of every one of the readers of THE MEDICAL WORLD who does take the position of "The dog in the manger" in regard to the improvement in our methods and means of alleviating the sufferings of humanity. Now to the above let no offense be taken, as none is intended. Written words lack the personality of speech and often lead to wrong conclusions. I believe what I have said will be, as intended, for the good of all, Will the brothers kindly stand up and speak, saying a word pro or con the seidlitz salt in typhoid fever, at the same time? DR. W. C. ABBOTT. Ravenswood, Chicago, Illinois.

[We wish to exonerate Dr. Abbott from the charge of poor copy which he makes against himself. The article was not in time to allow deliberate proof-reading. The doctor's copy is always a perfect model--written plainly with wide space between words and lines. joices both editor and printer.--ED.]

Small Doses.

It re

EDITOR MEDICAL WORLD:-A short article on page 1 of Jan. WORLD on "The Good Effect of Small Doses calls to mind my own

experience.

A lady with a rather weak stomach and a severe cough had been vomiting for several hours when I saw her. I took a grain of tartar emltic in 12 teaspoonfuls of warm water, gave a teaspoonful and repeated it in 15 minutes; she went to sleep, slept all night and got up free from both troubles in the morning. I take 1-2 ounce of acetanilide and the same bulk of glycerine, warm it till it becomes a clear solution (about 150 degrees) in a wide mouth vial. When it cools it solidifies and looks very like very pure carbolic acid crystals. Of this I give, every half hour or every fifteen or twenty minutes, what will stick on the front of a pen knife, about a drop. This, with me, produces all the good effects of a three to five grain dose, given every hour or two hours, besides, it is very pleasant to take, and the patient does not know what it is.

On the same line is the arsenite of copper in most forms of acid diarrhea, one fivehundredth or one one-thousandth of a grain

Abscess Caused by Presence of Hairs. EDITOR MEDICAL WORLD:-I would like to report the following case to your readers. Mr. F., aged 40, general condition good, had, as he says, a 66 a big boil" near the anus, about thirteen years ago, which broke and discharged freely, remained open for several weeks before healing, and thereafter was always more or less sore, and would, at times, "break and run" occasionally. About one year ago he had the measles, and was complaining of his sore, so I examined it with silver probe. Ifound a small opening, about two inches to the left, and a little above the anus. The probe passed downward and forward to the depth of two inches but did not communicate with the rectum. A little pus and bloody water escaped, when it healed and gave but little inconvenience until about two weeks ago, when he said something must be done, as it troubled him a great deal. An examination elicited symptoms of an abscess as before. So I concluded to open early and deep, I passed the point of a bistory in at the old opening site, to the depth of two thirds of an inch, followed the direction the probe had taken before, then cut out. Imagine my surprise to find about a half a dozen hairs on the point of the bistory. The wound bled freely. When it had stopped, I removed hairs to the number of eighty in all, dressed the wound with the usual precautions, which is now doing well. The hairs were about one inch in length, and I think had been there all these years. But how did they come there?

I will pay $10.00 to any brother who will send me a cure for rectal worms. The case is that of a lady, 30 years old, who has been. troubled since she was a child. Have tried all the usual methods.

Grand View, S. D. J. W. WARD, M.D.

THE Toledo Medical and Surgical Reporter says:“The Doctor, in 'The Physician as a Business Man,' not only points out evils, but also suggests remedies."

Acetanilide.

EDITOR MEDICAL WORLD:-Much has been written by various authors on the use of acetanilide, and my experience agrees so closely with that of Dr. Ely's, as given on page 14, January number, that I feel constrained to add my morsel, hoping that some one may be benefitted thereby. During the epidemic of La Grippe, I found various lung complications, with high fever, and acetanilide was my sheet anchor, combined with quinine, chiefly, or any other combination which seemed to be demanded. I have not used it in typhoid, cr very extensively among children, but in dysmenorrhea in young or old I give it in five grain doses, to be repeated in three hours, and rarely a third powder is taken. In the neuralgic form, with those splitting headaches, it has done me best service. I have also used it with most gratifying results in the varied forms of sick headache, where the bilious vomiting is a characteristic feature. It seems to act as a sedative to the stomach, and also stops the headache. I remember one very severe case of this kind in a young lady, who had been a victim and great sufferer from the old-fashioned bilious sick headache, occurring periodically every month. While she was suffering a severe attack I was called and at once administered five grains of acetanilide, and repeated it in two hours. At the end of six hours she reported feeling nicely, and has never had sick headache to any extent since. I also have a few patients of a similar kind who are constantly calling for my headache powders, and they invariably get acetanilide, and with good satisfaction. I was also driven to its use in a case of irritable bladder, where the usual remedies had failed to relieve, and after resorting to i's use had the pleasure of seeing my patient get better. I find it very useful in controlling the paroxysms of asthma, and, by an eight or ten grain dose at bedtime, giving the patient a good night's rest. To "straighten up a drunk," as is the familiar term here, I find that it relieves the "cerebral congestion," quiets the nerves, settles the stomach, stops the headache, and induces sleep, all of which the patient comes around and thanks me for next day, and promises to pay the bill. I consider it a sedative fully equal to the bromides, if not superior. As an analgesic it is second only to morphine, and I may say here that since I have been using it freely that I very rarely use opiates in any form, for the reason that I have never noticed any ill after effects following its use. As an antipyretic it certainly takes the lead of the list in my opinion, especially in bronchitis, pneumonia, and rheumatism, of which we get a good share in this locality. I find it neces