wanted the case. I said "I can do nothing for you, and it is my opinion no one else can. I do not think you will live four months." He sent for another physician, and I lost track of him for between one and two months. At the expiration of this time I went into a grocery store to do some trading, where I found him apparently improved in health. As I went in he pointed me out to a half-dozen standing around as the doctor who did not know every thing. He went on with his tirade about doctors in general and me in particular, until I could stand it no longer. I said "Gentlemen, I did say that Mr. D. would not live four months, and I want you to write down what I now say. Mr. D. will not be alive six weeks from to-day." About a month after this he sent for me and apologized for what he had said in the store, and in a few days died.

I have simply stated facts and shall defer giving any explanation of the whys and wherefores until scientists tell us what life and matter are, and their proper relationship with each other, which will be in the far distant sweet bye and bye.

W. C. DODGE, M. D.

Mount Dora, Florida [Dr. Dodge is a graduate of Jefferson Medical College, Philadelphia, of the class of 1864.-ED.]

Treatment of Typhoid Fever.

EDITOR MEDICAL WORLD:-In your December issue is an article written by Dr. J. R. Etter on the abortive treatment of typhoid fever, saying that in sixteen years practice he had not one case of developed typhoid fever in his own families. He also states that typhoid is very prevalent in his community, and seems to place the entire credit of his own success to calomel. How different his experience is to mine. I have in the last seven years treated about one hundred cases of typhoid and typhoid malarial fever. My plan of treatment has been about as follows:

I invariably begin with about six grains of calomel in three doses of two grains each, to be given two hours apart, this to be followed in from six to eight hours by a full dose of oil and turpentine. I often repeat this as often as twice; then I leave calomel off for good, for by this time I have aroused the secretions pretty well and have my case pretty well shaped up. I almost invariably administer from ten to fifteen grains of quinine during the morning remission, relying on bismuth subnitrate five grains every four hours, alternated with tincture of iodine, drops two, and carbolic acid, drop one. With antifebrine and bathing I hold the temperature as rear normal as possible. However, for the past summer, dur

ing which time I treated twenty typhoid cases, I have been using sulpho-carbolate of zinc, with much happier results. This is the general outline of my treatment. I have had all my cases to go through the full term, and have had the honor of seeing all my patients recover but one, and in that one the parents injudiciously administered a course of calomel and santonine without my authority or knowledge, and the little fellow died in about twenty-four hours thereafter.

Dr. Etter says that they take it for granted that they are going to have a case of typhoid fever, &c., which we do, and I follow his line of treatment for three or four days, and it continues all the same. I attribute my success greatly to the calomel, followed by the antiseptics, iodine and carbolic acid. They almost all recover in from twenty to twenty six days.

Gann, Tenn. T. N. COCHRAN, M. D.

Mercury in Typhoid Fever.

EDITOR MEDICAL WORLD.-I must say that I am very much interested in some of the articles in the December number of THE WORLD, more especially the articles on typhoid fever. I cannot agree with Dr. J. R. Etter as to his theory of typhoid fever, as he implies in his article that typhoid fever is not a germ disease, or, in other words, a disease of itself, but rather a neglected case of remittent fever a theory which has long since been exploded in the progress that pathology has made of late years. I cannot agree with him as to his ability to abort typhoid fever either, but am prepared to admit that his mercurial treatment may lessen the gravity of the disease and, perhaps, in 14 to 21 days the fever may subside without having attained any very great degree of severity. While giving the doctor credit for his article and his desire to benefit his brother practitioners by his experience, I am compelled to say that he has been exceedingly fortunate in the class of cases he has been called on to treat. I am very much pleased with Dr. O'Neal Mendenhall's article on mercury in typhoid fever, and see that his experience in his cases has been very much like my

own.

I have come to the conclusion that mercury is one of the principal remedies in this disease. My rule is that as soon as I am able to make my diagnosis of typhoid, I give for an adult about fifteen grains of mercury in the form of calomel, and give all through the course of the disease about one or two grains during the twenty-four hours, with salol in five grain doses four or five times a day, using no antipy. retics except warm water with soda, with which I have my patients sponged frequently.

I keep everything about the room as aseptic as possible, changing the sheets and clothing at least every other day, using liquid food. I prefer Carnrick's or Mellin's with milk, etc. With the above plan as thus briefly stated I have been very fortunate, and have noticed in several cases in which the patients complained of their gums being a little sore, and gave a slight metallic smell, that the fever never ran very high, and that I had no unpleasant effects from the mercury. As a matter of course I use a mouth wash, and generally in from fourteen to twenty-one days my patients are clear of fever and have made a good recovery. I should like to hear more upon this subject.

I have now a case, Mrs. J., who was feeling quite badly for a couple of weeks before I saw her. She stated that every morning she had a slight chill, headache all the time, and disturbed sleep. When I first saw her her temperature registered 103.5 degrees, pulse 110. She was restless and uneasy. I gave twelve grains of calomel in eight capsules with five grains of salol. The next morning she said she had rested well, temperature 1012, pulse 96. Continued the calomel, using a mouth wash, and from that time to this her fever has never been above 100 degrees. She says that she feels able to get up and go about her work, but I find that she has a little fever (99.5 degrees, pulse, 84,) and this is about as low as I am able to keep it: I expect in the course of a few days to report her convalescent. I forgot to state that upon the third day she was slightly ptyalized.

Now, my reasons for giving mercury are, that ist, it cleans out the "Augean stable better than anything else, without much danger from prostration; 2nd, it is our best antiseptic and 3d, when its physiological effects are obtained the bowels are so thoroughly aseptic that it is impossible for reinfection to take place and the disease runs a short course without high fever; generally it does not last over fourteen to twenty-one days and the

patient is not much reduced in flesh and strength. I will add that I give my patients their food as regularly as their medicine, and believe that much of the success in the treatment of this disease will be found due to a

properly regulated diet and proper hygienic surroundings.

J. M. APPLEWHITE, M. D.

Corvallis, Oregon.

DR. J. R. LYTLE, Rankin, Ill., writes:-"Dear

Doctor-I have just read, with much pleasure,

"The Physician as a Business Man,' and wish to express my appreciation. I have been particularly interested in what you say about keeping accounts."

Typhoid vs. Bilious Fever.-Cupric Arsenite.

EDITOR MEDICAL WORLD:-Dr. J. R. Etter has an article in December WORLD on the prevention of typhoid fever, in which he very graphically describes the method of aborting the disease by calomel. As I have had no experience with the method I may not be in a position to criticise, but his views on the cause, symptoms, etc., of the disease, are at total variance with the accepted and recognized opinions of all the authorities I have read. Be it remembered that I am actuated by the kindliest of feelings in my remarks, recognizing that magnanimity ever invites and holds sway over the true physician, no matter how different our opinions may be. He says that, "All cases have symptoms in common with bilious or malarial fever," implying, I infer, that cases may commence as bilious fever and develop into typhoid, which they will never do unless the specific microbes of typhoid enter the system. We can, with just as much reasoning, say that every case of measles commences as scarlatina and vice versa.

Another cause advanced by the doctor would give the disease an auto-infectious origin (which I think is extremely doubtful) for he says that "it is only after the system becomes poisoned by reabsorption of the material that shonld be thrown off by the bowels, kidneys and skin that the symptoms peculiar to typhoid fever are developed."

Now, I suppose that all physicians who have had any experience with typhoid fever cases, especially where malaria is prevalent, has recognized a mixed type of the disease, one or the other predominating according to the podisease has been denominated typho-malarial tency of their specific elements: hence the fever, and the admixture of symptoms belong. ing to both diseases in the same case are frequently met, at least such has been my experience in malarial regions. But the slow, insidious development of typhoid, the gradual rise of temperature, the abdominal and other symptoms, are sufficiently striking (in uncomplicated cases) to prevent confounding with bilious fever. Bnt I do not wish to undervalue the doctor's treatment, for I think any man may justly feel proud, and certainly deserves the highest encomiums of this age, both lay and professional, who has "practiced medicine sixteen years in a community where typhoid fever is the rage every year, and has never had a developed case."

I have read several articles in the journals of late on cupric arsenite in diarrhea, both pro and con, but my experience with the remedy will not allow me to condemn it as entirely useless. On the contrary, I have employed it

in some cases with the happiest results, after chalk mixture, catechu, bismuth, opium and other astringents had failed. Just exactly the kind of cases to which it is adapted I believe no one can tell. The great beauty about the remedy is that if some benefit is not obtained in one or, at the most, two hours with its use, you would just as well abandon it, so very little time is lost to ourselves or patients. LAWRENCE B. YOUNG, M. D.

Rolesville, N. C.

Typhoid Fever -Gall Stones. EDITOR MEDICAL WORLD:-In the communications of THE WORLD I find a great many good things and a few that conflict with my experience. I believe this to be due to the variation of diseases and symptoms under various climatic conditions. For instance, disease in California differs greatly in many respects from the same disease in the eastern and middle states. I want to speak of typhoid fever. I was taught to regard cathartics in this disease as dangerous, but I do not believe it now, providing the proper one (calomel) is used. What more ratioral treatment could one wish? The patient becomes poisoned with the bacilli and their ptomaines, and the calomel destroys the offen. sive germs and carries them away, leaving the bowels in a condition to heal.

Why not get the removal of the offensive contents, the healing and cleansing effect, the germicidal effect, the antipyretic effect, the antiseptic effect, all with one remedy, given by the mouth, instead of the flushing with one and antiseptics the other. When the good effects of an occasional dose of calomel, are obtained then follow with the salicylates and sulphocarbolates, so as preserve these good results. When I first used this remedy it was empirical -the pathogenic germs were undiscovered; to-day its use is rational and we know why and how it is good. I was pleased with Dr. Waugh's suggestion, "to use the microscope, and cease the discussions." I hardly see how one can practice inteligently without the constant use of the microscope.

I read with particular interest any treatment refering to gall stones, having treated it in near relatives and my own family. I can not agree with Drs. Mays and Bloom, for sweet oil in my hands has been ineffectual, possibly due to the fact that my cases do not usualy retain it, the stomach rejecting everything, There is not the same character of stone in all cases. In some (generally stout, obese subjects) we have a small white smooth gravel from the size of a pin head to that of a hazelnut, but in inherited lithiasis we have large

pieces of inspissated bile and cholestrum passing away, one to six during an attack, often but one, which sometimes consumes 6 to 24 hours in passing. These are dark, semi solid balls, which mould themselves to the size of the ducts, but when retained in the gall bladder becomes crystallized and hard. have specimens of both these varieties. The sufferers from this form of the malady are always thin, nervous people, and the trouble is evidently produced by what Professor Dujardin Beaumetz, calls a "disassimilation of the nervous system." The only effectual means of relief, in my hands, has been morphine and atropine, and sometimes, chloroform for the paroxysms and phosphate of soda, ox gall, nux, cascara etc., during intervals.

Merced, Cal. W. N. SHERMAN, M. D.

A Case of Opium Habit Cured by "Concentrated Tincture of Avena Sativa."

EDITOR MEDICAL WORLD:-Believing that a report of the following case will be of interest to many readers of THE MEDICAL WORLD, I feel it my duty to report it for the benefit of such.

P. F., M. D., of Boston, Mass., wrote me on March 1st, 1891, giving me the following history:

"I am 60 years of age. Have been an opium eater since 1865. I have used an ounce of gum opium every week during the past year. I took it as a last resort for chronic diarrhea—the result of malarial poison in my system. On January 28, 1891, I by chance, saw your name in a pamphlet of B. Keith & Co's, giving your experience with their "concentrated tincture avena sativa" in opium addiction. I began its use in 15 drop doses, increasing the dose as you directed. I also made 32 powders of opium, graded from my full dose down to grain 1, and took one each day at bedtime only. I have taken five bottles of the avena up to this date. I am obliged to take now at bedtime, 1-16 grain. of morphine on account of spasmodic twitchings of right arm and leg. Am weaning oft from the avena. I have no desire for any larger dose of opiates, but am troubled at night with frequent yawning and sneezing. I sleep nicely every other night, but no sleep during the night between. My memory and general health are very much improved. My eye sight is so much improved that I have quit my glasses. I thought you could tell me what to do to kill the after effects of the infernal opium. If you can you will confer a lasting favor upon a brother physician. * * * *""

I immediately answered him in substance, as follows. Stop your 1-16 grain of morphine immediately, and instead of weaning yourself

from the avena, increase the dose to one teaspoonful and gradually to two teaspoonfuls if necessary, every two hours. Use no other remedy for your nervous system. Time enough to stop the avena when all abnormal symptoms due to the opium have ceased. Please report

results.

On March 22nd, 1891, he wrote me again as follows:

"Your letter was duly received, and contents noted and approved. After writing you, I dropped the small dose of morphine and have not taken any since. On receipt of your letter I began the avena as you directed, and am still taking it but in diminished doses. I still have that inveterate yawning, stretching and sleepless nights. The subsultus tendinum is nearly all gone. * * * * Otherwise I feel splendidly and am gaining in flesh and spirits. I feel 20 years younger. I will now give you the effects of B. Keith & Co's. concentrated tincture avena sativa in my case. It has cured me of chronic cystitis completely, and wholly removed all the old pains in both kidneys, all abnormal conditions of urine, and also restored my sexual powers to their olden time activity. It has also removed all chronic rheumatism from my joints, and the enlargements have almost entirely disappeared. *

I append a few extracts from a letter received from him, dated July 16th, 1891.

"I have not taken one particle either in powder or liquid form, of opium since my last letter to you in March. I am feeling perfectly well except from symptoms produced by valvular heart disease, which I have had since 1864. I weigh 226 pounds and am on the gain. The cure was wholly due to "B. Keith & Co's. concentrated tincture avena sativa." It took 15 bottles to perform a cure in my case of over 20 years standing. I am a new man all over. My memory has returned as fresh as in youth. I have cured several cases since, but not as long standing as my own. * * * *""

Also from a letter dated October 8th, 1891. "Dear Doctor:-Your note of inquiry just received. Yes, I am perfectly free from the use of opium in all its forms. And in fact, take nothing of the sort whatever. I am 21 once more. I have recovered all my old vitality with the exception of the heart disease before referred to. I have no desire for the old stimulant, and am as free as a newly born child. * * * *"

Now the above report given me by P. F., M. D., of his own case, speaks for itself, and proves that the opium habit can be cured, and, too, by a remedy within the reach of every physician. Of course, his battle is not ended, for if he should carelessly administer to himself for any cause whatever, a single dose of the

drug, he would undoubtedly become again a slave to its subtle power. This condition of the system will undoubtedly last for a eonsiderable length of time. Nevertheless, his case cannot be counted anything but a cure. Myerstown, Pa. A. W. COTTRELL, M. D.

Facial Erysipelas.

AN ADDENDUM TO MY LETTER OF SEVERAL WEEKS AGO.

EDITOR MEDICAL WORLD:-The rhus tox and belladonna treatment, as lauded by Dr. Cook, of Lake Shore Villa, Utah, in THE MEDICAL WORLD of 1880, page 37, proved to be as ineffectual as the jaborandi. If I mistake not, in my former letter I reported the medicine as having the disease in check, but much to my disappointment, the eruption continued for a week or more, notwithstanding that the medicine was administered faithfully all this time.

After the expiration of about two weeks the disease spent itself, uninfluenced apparently by anything I used internally or externally.

A remnant of the ailment was left on the wing of the nose and upper lip. This locality seems to be a rendezvous for the infection. The parts during the entire fall, thus far, have been in an inflamed and swollen condition, and subject to a violent, at times, burning and stinging sensation. From its hiding place here, upon the least provocation, it sallys forth over the entire face. Exposure to a cold driving wind, provoking a free flow of mucus from the nose, necessitating use of handkerchief invariably excites an attack.

Five days ago, after exposure to a cold, bleak driving wind, the whole face was involved. The inflammation ran high. The eyes were completely closed in the morning from the inflammation and swelling of lids. This is, he says, one of the worst attacks he has ever had and has followed close on the other reported in my former letter. He is taking rhus tox and belladonna internally and 20 per cent. icthyol ointment locally. The inflammation and redness is subsiding, but about as rapidly as when other and no treatment at all was used.

Will you, or some of your many contributors, please suggest something effectual to prevent the frequent relapses--in short something to cure? J. D. NICODEMUS.

Walkersville, Md.

THE Weekly Medical Review, St. Louis, says of "The Physician as a Business Man," "There is no doubt in our mind that many physicians will find in this rules of procedure which, if followed out, will lead to pecuniary remuneration such as they have not been in the habit of experiencing."

Quiz Department.

Questions are solicited for this Column. Communications not accompanied by the proper name and address of the writer (not necessarily for publication), will not be noticed. The great number of requests for private answers, for the information and benefit of the writer, makes it necessary for us to charge a fee for the time required. This fee will be from one to five dollars, according to the amount of research and writing required.

Corrections.

IN Dr. O. W. Braymer's article, page 29, January, 1892, thirteenth line from the beginning, "one third part tincture of belladonna" should read "one third drop tincture of belladonna."

EDITOR MEDICAL WORLD:-In my prescription on page 16 of January issue, pulv. podophyllum is meant, not the resin, podophyllin. The resin was not given by me in that case, but the fresh powdered may apple or mandrake. W. M. JOHNSTON, M. D.

Williams, Arizona. EDITOR MEDICAL WORLD :-The readers will please turn to Page 443 Dec. No., article, "Anomalous Fever" and draw a mark through the last word in the 9th line and write on margin the word Malaise. Malaria is hardly classed as a symptom of any disease. Bushton, Kans.

S. C. Cook, M. D.

WE have many letters of inquiry asking for a statement of the medical practice law in the different states. We are not able to give the required information for the very good reason that legislatures are constantly tinkering with the laws in their respective states. Our readers will be under obligation to correspondents who will promptly inform them, through these columns, of any important changes made in the medical laws of any state. Preference wlll be given to those letters which state the subject most clearly and concisely.

DR. OWEN BUCKLAND, of San Francisco, Cal., very sensibly writes as follows:-"Í often feel tempted to give a few cases from my practice with the hope that they might benefit some one. I have gathered so much useful information from the pages of the WORLD that I feel as if I ought to try to give something in return, as I do not consider that the mere payment of subscription in any but the smallest way compensates for what I receive.

This is a very true statement of the duty of a phician towards his fellow practitioners. A journal may well be compared to a medical society. One does not fulfill his entire duty by merely paying his dues.

WHITE PINE as an ingredient for cough mixtures was fully discussed in THE WORLD, 1887, page 467, 1888, page 476 and 1889, pages 166 and 197.

We have written to the "Germicide Journal," 59 E. 9th Street, New York, R. R. Russell, M. D., editor, and have entirely failed to get any response, either in regard to the journal itself or the books and medicines said to be put out by the concern. Hence, the only information we can give our readers, in response to inquiries about the concern, is that it evidently doesn't want medical journals to know too much about it.

We have been in receipt, lately, of so many requests to publish letters from doctors, stating that they had lost their house, furniture, library and instruments by fire, and soliciting financial aid from members of the profession, that we wish to state that this is not properly within the province of THE MEDICAL WORLD. We have not the opportunity of investigating the merits of such cases, being, as they all are, so remote from us. In view of the frequency of such claims we would advise all physicians to guard against the probability of such disaster by carrying adequate insurance upon their buildings, furniture, library and instruments, as other business men do.

EDITOR MEDICAL WORLD:-I should like to ask advice of my brother practitioners in the following case: Woman, aged thirty-five, who ever since her last confinement, two years ago, complains of an almost constant pain, as she expresses it, in the lower end of the back bone, so much so that she cannot sleep well at night. Lying on her back makes it worse. She describes it as an aching and sometimes a throbbing. Digital examination per vagina and rectum reveals nothing. Any advice by letter or through THE WORLD will be appreciated.

Vernonia, Oregon. C. H NEWTH, M.D.

EDITOR MEDICAL WORLD:-Again I come to you, or any of THE WORLD's readers, who are further advanced than myself for advice in the following case:

Mrs. W., aged forty-one, is the mother of five children, the youngest of which is three months old, and has always nursed the breast, and suffers from constipation so much that enemas of soap suds are necessary to produce an evacuation; otherwise apparently healthy. The mother is suffering from cardiac dropsy, which has become quite general, with dyspnea, palpitation and fainting spells, on slight exer