Send LOOK HERE! DOCTOR! I want you to know my Dosimetric Granules, so I make this special offer. $1.00 and I will forward by return mail a nice nine-vial pocket-case filled as follows: 100 each, aconitine, strych. ars., hyosciamine, digitaline, podophyllin, copper arseniate, codeine, quin, ars. and glonoin. Then if you are not satisfied send it back and get your money. If you become a customer, deduct $1.00 from your first cash order of not less than $10.00.-Yours Fraternally, DR. W. C. ABBOTT, Ravenswood, Chicago, Ill. SEND to John M. Scudder, Medical Publisher, Cincinnati, O., for Eclectic publications. Mention THE MEDICAL WORLD and get 10 per cent. discount. FOR uterine troubles try the direct treatment by Micajah's Uterine Wafers. FOR chart, "Electricity Simplified," address, Geo. O. Robbins, M. D., Waterbury, Conn. TARRANT & Co. import the genuine Hoff's Malt Extract. FOR a tonic under all conditions use "Revivant," by Century Chemical Co., 904 Olive St., St. Louis, Mo. "IN the characteristic and excruciating frontal headache accompanying influenza, I immediately prescribe Antikamnia in five or six grain doses, repeated once in one or two hours, with the happiest results. I have learned to look upon it as almost a specific in counter, acting this form of pain."-D. S. Gardner, M. D. FOR your new spring suit send to Grund & Rodgers 102 S. 10th St., Philadelphia (Near Jefferson Medical College.) B. KEITH & Co., Organic Chemists, 75 William St., New York, N. Y., will send you a valuable Manual for use in your practice. I. PHILLIPS, 14 Marietta St., Atlanta, Ga., will supply all your needs for surgical instruments, cases, &c., at genuine "cut rates." SEND to Nutrolactis Company, World Building, New York, N. Y., for something to stimulate the natural secretion of milk. WRITE to the Hastings Truss Co., 224 S. 9th St., Phila., for trusses, supporters, &c. PRESCRIBE Griffith's Compound Mixture for rheumatism. THE HEALING ART.—Primus-Young Doctor Neale tells me that in his specialty he has never made a misSecundus-What's his specialty-autopsies? ...Cents. ($..... ..) take in diagnosis. NOTE.-We will be responsible for money sent by postoffice order or in registered letter. Send 10 cents extra for registration of each article (except WORLD) if you wish to insure safe delivery. MEDICAL WORLD Visiting List, consists of a handsome leather case and twelve removable sections (price $1.50), and companion Pocket Ledger, indexed and handsomely bound in leather (price 50 cts.). To close out those in which dates are printed 188.. instead of 189.., we will sell for half price. As it is about as easy to write 9 over the 8 and add 2 as it would be to write 2 after 189, the difference is very trifling, and you get a difference of one-half in cost. E. O. THOMPSON, Box 413, Philadelphia, will give you a fit that you will not want to get rid of a neat clothing fit. ANTILUPIA is a new antipyretic, and anodyne. Send to Norwich Pharmacal Co., Norwich, N. Y. BRITISH JUDICIAL DICTA ON DRINK.-The Edinburgh Journal of Jurisprudence says: "Almost every crime has its origin more or less in drinking."—Judge Gurney. "Ninety-nine cases out of every hundred are caused by drink."-Judge Erskine. "If it were not for drink you (jury) and I would have nothing to do."-Judge Pattison. "If all men could be persuaded from the use of intoxicating drinks, the office of judge would be a sinecure"-Judge Alderson. "Three-fourths of the cases of crime have their origin in public houses and beer shops."-Judge Wightman. Intemperance has destroyed large numbers of people, and will, at its present rate of increase, in time destroy the country itself."-Justice Grove. "I can keep no terms with a vice that fills our jails and destroys the comfort of homes and the peace of families, and debases and brutalizes the people of these islands."-Chief Justice Coleridge. To which we might add the recent decision of Lord Young at the Glasgow Circuit, in the case of Eliza Short (whose drunkenness and neglect had resulted in the death of her child), refusing to hold her criminally responsible, because there could not be inferred intention to commit the crime, and refusing to hold her condition, though caused by her own act, sufficient to make her criminally responsible for the death of the child.Clark Bell in Medico-Legal Journal. (CONTINUED OVER NEXT LEAF.) The knowledge that a man can use is the only real knowledge; the only know ledge that has life and growth in it and converts itself into practical power. The The Medical World. Published Monthly, by C. F. Taylor, M. D. C. F. TAYLOR, M. D., EDITORS. Subscription to any part of the United S tes and Canada, ONE DOLLAR per year. To England and the British Colonies, FIVE SHILLINGS per year. Postage free. Single copies, TEN CENTS. These rates must be paid invariably in advance. We cannot always supply back numbers. Should a that from the pharynx or ecchymoses in the sides of the neck, indicate injury of the posterior fossa. Occasionally, also, a quantity of cerebro-spinal fluid will escape. The principal object of this article is to call attention to the necessity for antiseptic measures, to prevent the entrance of germs into the injured portions of the brain, and the conse. quent formation of an abscess. The ears should be washed clean and packed with some antiseptic cotton, wool, gauze, lint or powder. The naso-pharyngeal passages should be number fail to reach a subscriber, we will supply thoroughly and frequently cleansed and another, if notified before the end of the month. Pay no money to agents for this journal unless pub lisher's receipt is given. ADDRESS ALL COMMUNICATIONS TO Treatment of Fractures at the Base of the Fractures of the base of the skull occur so frequently in children in their romps and plays and not seldom in adults, that the subject is one of considerable importance. A boy hurts his head by a fall, or is struck by a snow ball, base ball, or some other object which is heavy but is not hard enough to produce external signs of injury. After a little bleeding from the nose, mouth or ears, or ecchymosis of the eyelids, the immediate symptoms subside, and the child plays about as usual until, after some days, symptoms of cerebral abscess set in, and the case terminates fatally. Now, what has happened in such a case? The bleeding from the nose indicates that some portion of the floor of the anterior cerebral fossa has been fractured, and blood vessels ruptured. Bleeding from the ear indicates a similar injury of the middle cerebral fossa, and dusted with appropriate powders, or swabbed with strong antiseptic solutions. The nose may also be packed. The general treatment should be the most strict antiphlogistic regimen. The lightest diet for a few days, combined with remedies that increase elimination through the excreting organs; rest must be enjoined, with the head somewhat elevated, with cold applied nearest the seat of injury; circulatory sedatives, as bromides (to relieve the cerebral circulation), aconite and veratrum; sulphide of calcium and phytolacca to prevent suppuration, and a short course of iodide of potassinm at the close of the treatment, if symptoms of inflammatory deposits are present; massage should be employed throughout the course, to encourage venous activity. With such a course of treatment many of these cases will terminate favorably. Advance in Warfare. Prof. Billroth has given an exhaustive address on the improvements in surgical treatment rendered necessary in "the next war" by the increasingly deadly character of the small arms in use in the various armies of Europe. While we admit that it is important that the benefactors of humanity endeavor to keep pace with its enemies in ameliorating the suffering that takes place in warfare, yet it must be re membered that in this matter absolute prevention is worth infinitely more than the most scientific amelioration. Physicians have not, by their scientific training and identification with their profession, lost their identity as men and citizens. As enlightened and humane citizens their whole endeavor should be to depict at all times the cruel and insane folly of war at all the resort to human slaughter to adjust human rights. The higher one rises in the study of that wonderful mechanism, the human body, and that Divine creation, the human intellect, the more he revolts at the wanton recklessness of those who would mutilate the one or forever extinguish the other. us hope that the "next war" will never come; and let us devote our most earnest endeavor to educating public sentiment in favor of universal peace, rather than in contemplating what we shall do in case of war. Let Doctor, look into the beautiful eyes of your own bright little boy and contemplate the possibility that you are carefully bringing him up and educating him to be finally a target for a bullet, fired in some war instigated by political or military officials ambitious for fame or by speculators greedy for gain, with some trifling boundary line dispute, or injury to a crowd of carousing sailors in a foreign port, as a pretext. And yet war can not be waged without somebody's sons, and every volley of musketry slaughters them by the hundreds. While the political economist is mainly concerned about the wanton waste of warfare, we, as physicians and sanitarians, are chiefly concerned regarding the cruel inhumanity of it; and we are recreant to our trust if we do not use our superior education and training, together with our influence in society, to rise and carry our fellow men with us, higher than the passionate domination of sectional and national prejudices. If it be objected that our business is that of treating diseases and injuries, we reply that, while that is our business yet we are also members of society, and that, outside of business activity it is our privilege and duty, as private citizens, to concern ourselves with matters of public welfare. If we do nothing to advance humanity toward a higher plane we will not have wholly justified our existence and the care bestowed upon us in our birth, support and training. How Shall the Physician Dispense his Own Medicines? The picture which most of us cherish in our memory of the old time family physician-the physician of our childhood days-is that of an educated genial gentleman, who brings both cheer and sympathy into the sick room, examines the patient, keeps his own counsel, and carefully measures out the powders or other forms of medication suitable to the case. This age of differentiation and division of labor has wrought much change in the old time picture, and the dispensing druggist now does most of this work, and the physician knows altogether too little about the agents with which he combats disease. This change was mainly effected by reason of the growing multiplicity of remedial agents, and the additional skill required to prepare acceptable mixtures and other compound preparations. However, the wheel has taken another turn, and we find ourselves again on the eve of a general practice among physicians to carry and dispense their own medicines. We quote from a contemporary an exhaustive article on this subject on another page. Yet the cycle has not been on a horizontal plane, but on a spiral, as the road climbs the mountain, or as all evolution proceeds, and the physician while again at the point of dispensing, does so on a higher plane, and, instead of powders, infusions, etc. dispenses granules, tablets and other forms containing only the active principles of the crude drugs. We believe that this method will enable the physician to make a more substantial success in life. Hygienic Precautions against Infection. To escape malarial and typhoid fevers in miasmatic climates, the following directions are suggested: 1. Drink no water that has not been thor oughly boiled or otherwise disinfected. 2. Avoid exposure to the out-door air from sunset until an hour after sunrise. 3. If such exposure is necessary let it be entered upon with nourishing food in the stomach and warm clothing on. 4. Keep a small fire in the house at night but, being insoluble, is not itself absorbed, and morning. and hence is entirely non-toxic. The Bacillus of Influenza. Dr. R. Pfeiffer, Chief of the Scientific Section of the Berlin Institute for Infectious Diseases. has reported to the scientific world the undoubted discovery and complete identification of a bacillus, found only in cases of influenza, and always present in such cases. He recommends thorough disinfection of the sputa of influenza patients as a prophylactic measure. At about the same time, Dr. S. Kitasato, of Berlin also succceded in making culture of the influenza bacillus on glycerine agar. Dr. P. Canon, also of Berlin, has isolated the same bacillus from the fresh blood of influenza patients. Inasmuch as the disease behaves, clinically, exactly like a disease of germ origin, it is not at all surprising that a particular germ should be identified with it. In connection with this it is interesting to note that Dr. Goldschmidt, of the island of Madeira, has recently observed that persons recently successfully vaccinated for small-pcx are also protected against influenza for a considerable period of time. THE folly of naming a drug by its supposed therapeutical application-as "antifebrine," "antifebrine," cardiene," etc., has found another practical illustration in the drug which was called "orexin," because it was thought that it was thought that it would stimulate the appetite under any and all circumstances. Dr. W. Brunner, in the Gazette Lekasska, after recording failure after failure with it, recommends that the drug be dropped entirely from the list of reliable medical remedies. A New Dressing Powder. A sub-gallate of bismuth, which, in other countries, has been known by the extremely unscientific name of "Dermatol," has now been under observation long enough to unable us to judge fairly of its merits. It is a fine, insoluble, yellow powder, not decomposed by the action of light and air, odorless, moderately antiseptic, siightly astringent, having great power to absorb discharges, Its principal use is as a dusting powder on ulcers, eczemas, burns, and wounds, where iodoform has generally been considered applicable. The venereal surgeon will also find it of service in chancroids and other troubles, as will also the gynecologist as an application to the os, cervix, vagina and vulva. The physician will use his judgment in incorporating with it a small quantity of a more active germicidal agent, or stronger stimulating agent in the cases specially requiring either of these qualities. WHO has not been impressed with the fact that much time relatively is unnecessarily spent in the study of the anatomy of the osseous and muscular systems, while visceral anatomy is almost neglected? The principle lifework of the physician is in dealing with the viscera of the cranial, thoracic, abdominal and pelvic cavities. So little does he have to do with the "levers and pulleys" of the body that he generally forgets the origin and insertion of all but the most important muscles, and even the names of most of them, in a very few years after leaving college. And yet, as a student his chief pride was in being able to rattle them off glibly without a mistake, and to it he devoted much time and labor. To be most thoroughly prepared for his important work, the young physician should know, first, normal visceral anatomy, second, pathological visceral anatomy, and third, what time is left may be devoted to the extremities. And Did you never, when you had a case of urgent importance on hand, involving some perplexity, carefully study it up just previous to your next visit, and evolve just the exact prescription you were going to issue? then didn't you, when you reached the bedside, just as carefully study the patient and reject, one after another, the remedies on which you were going to rely so confidently? And didn't you finally write an entirely different prescription, much simpler, perhaps most likely consisting of only a single remedy-or even leave something out of your pocket case? Thus it will mostly always be with the best physicians 82 -those with whom study and practice go along together until they depart to solve the mysteries of the great beyond. "When Doctors Disagree." UNDER this caption the Philadelphia Ledger gives some sensible remarks, suggested by the directly contradictory evidence given by, medical men called as expert witnesses in reThere are two ideas cent important cases. suggested for remedy. The first is a modification of the law to the end that the expert shall be paid only from public funds, and that he shall be questioned only by the judge trying the case, the opposing lawyers being allowed only to make written suggestions to the judge. The second remedy proposed is a very important one-that the physician should not allow himself to be placed in the attitude of a friend or a servant of either client, but should be recognized only as an an assistant of tre court to ascertain the exact and impartial truth. It certainly is discouraging to see men posing as high authority in science exhibiting as much zeal as the lawyers themselves in their It is un. advocacy of their client's cause. worthy the elevated plane in morality and honor which scientific physicians should occupy and which they generally do occupy. We suggest this as an appropriate topic for consideration by our various medical associations. Compression of the Carotid for Convulsions. Dr. Leopold Roheim, of Budapesth, Hungar, treats convulsions of all kinds by compressing the carotid artery with the index and second fingers, between the larynx and the sterno cleido-mastoid muscle, backward toward the spine, as recommended by Trousseau and Blaud. The compression is maintained until the convulsions cease, and is again em. ployed if slight seizures recur, until they are finally completely subdued. He explains the results by considering that the sympathetic nerve fibres, lying in close relation to the artery, are compressed with it, thus allaying the excitability of the brain. THE New England Medical Monthly says of "The Physician as a Business Man:"-"It is quite evident from a careful perusal of the volume that the author understands his subject thoroughly, and has written a book of such value that it should be in the hand of every doctor who strives for success. Current Medical Thought. What are Satisfactory Results in Cases of A committee consisting of Drs. Stephen Smith, of New York; D. Hayes Agnew, of Philadelphia; David W. Cheever, cf Boston; D. W. Yandell, of Louisville; Charles T. Parkes, of Chicago: P. S. Connnor, of Cincinnati; Charles B. Nancrede, of Ann Arbor; and Hunter McGuire of Richmond; appointed by the American Surgical Association, after thorough investigation, reported the following conclusions: "A satisfactory result has been obtained in the treatment of fracture of the shaft of the femur when (1) firm bony union exists; (2) the long axis of the lower fragment is either directly continuous with that of the upper frag. ment or the axes are on nearly parallel lines, thus preventing angular deformity; (3) the anterior surface of the lower fragment maintains nearly its normal relation to the plane of the upper fragment, thus preventing undue deviation of the foot from its normal position ; (4) the length of the limb is either exactly equal to that of its fellow, or the degree of shortening falls within the limits found to exist within 90 per cent. of healthy limbs, viz., from one-eighth of an inch to one inch; (5) lameness, if present, is not due to more than one inch of shortening; (6) the conditions attending the treatment prevent other results than those attained. One year is fixed upon as a reasonable period after the cessation of treatment for a final decision in regard to restoration of function. A limp, or lameness, does not necessarily indicate an unsatisfactory result. It has been observed that many persons have a normal variation in the lengths of their limbs, in some of the cases as much as an inch, who show no signs of lameness. It is also found after fracture that, by tilting the pelvis, some patients will compensate for considerable shortening, and show no limp in their gait, while, others, with much less shortening, will show decided lameness. Of course, reference is had only to it simple fractures of the shaft of the bone; would be obviously impossible to lay down any rule for the infinite variety of complications which may occur under other condi tions.'' These conclusions, emanating from such high authority, are of the utmost importance when we consider the number of suits for malpractice based upon alleged ill results in the treatment of fractures of the femur. |