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more frequently for chronic morbid conditions bowels in front of a helpless retroverted uterus. of the endometrium. with or without special Fifth, to order the very simplest case a daily functional disorders, than iodized phenoi. He douche of plain or medicated hot water, so employs it by ingestion and injection, without that if retroversion does occur it may not be or following curetting. The drug is antiseptic, rendered hopelessly incurable by adhesions. alterative, astringent, mildly caustic and he- Sixth, to keep the bowels in an easily movable mostatic. Resorcin has proved to be an ad condition so as to avoid forcing the uterus mirable remedy, combined with boracic acid when retroverted still further into the hollow and white vaseline, or incorporated with the of the sacrum. Univ. Med. Magazine. ointment of the oxide of zinc as a salve, to be Ten Families of Drinkers, and Ten of Sober applied to certain skin diseases of the external
Members. generative organs, and to foil smelling, indo DEMME studied ten families of drinkers and lent ulcerations in the puerperal as well as ten families of temperate persons. The direct gynecological conditions. Creolin is an effi- posterity of the ten families of drinkers included cient germicide, and in some respects more fifty-seven children. Of these twenty-five powerful than carbolic acid, more destructive died in the first weeks and months of their to the micro-organisms of various diseases, life, six were idiots, in five children a striking and of suppuration. It is less toxic than car. backwardness of their longitudinal growth was bolic acid, but it is not entirely devoid of tox- observed, five were affected with epilepsy, five icity. Chloride of zinc is valuable for vaginal with inborn diseases. One boy was taken with and endometrial morbid conditions, All ma- chorea and became idiotic. Thus of the lignant diseases of the uterus, for any cause, fifty-seven children of drinkers only ten, or rendering partial or complete hysterectomy 17.5 per cent. showed a normal constitution unjustifiable, are signally improved in general and development. The ten sober families had health, given a prolonged lite and materially sixty-one children, five only dying in the first bettered in all local symptoms by a thorough weeks; four were affected with curable diseases application of the zinc chloride, after sharp of the nervous system; two only presented curretting. He has employed intrauterine inbor defects. The remaining fifty_819 timpons, siturated with a solution (from 25 to per cent. —were normal in their constitution 50 per cent strong) or crayons, equally strong, and development. From this series of investia protection of the vaginal mucous membrane gations wc derive the sad truth that among the being maintained at the same time.-Univ. children of drinkers the prevailing mortality Med. Magazine.
is fearful, that the survivors represent a pitiful
crowd afflicted with unsoundness of mind, The Prevention of Retroversion of the Uterus. idiocy, epilepsy and other disturbances of their Lapthorn Smith (Journal of Gynecology,
nervous syste n, and that only a very small September, 1891) finds that this class of cases
proportion of the descendants grow up as useful is the most pitiful in his practice. At every
members of society.-- Herald of Health. step, at every effort they make, the sensitive
Dr. JOAN W. CORBETT, Cainden, s, C., writes of uterus thumps down upon the sacrum, or, what
“The Physician as a Business Man:” “I bave read, is still worse, in some cases 'pounds the im
and re-read it with a great deal of interest and
profit.'' prisoned ovaries. All this suffering could be saved if accoucheurs would adopt a few simple
The following are some of the hospitals, the for rules. First, to instruct their patients not to
mulæ of which are given in “ The Official Formula
of American Hospitals": lie upon their backs more than for a few min
University Hospital (Philadelphia.) utes, but to turn about freely from side to side, Episcopal Hospital (Philadelphia.) and to lie occasionally on their faces. Sec
Philadelphia Hospital. ond, to give them full liberty to sit up to re
Children's Hospital (Philadelphia.) lieve their bladder and bowels, aud while they
Pennsylvania Âospital (Philadelphia.)
Jefferson College Hospital. are taking their meals. Third, to take care New York Hospital. not to allow the bladder to be distended dur Roosevelt Hospital (N. Y.) ing the first few days, but to order the nurse
Bellevue Hospital (N. Y.) to pass the catheter every eight hours at least.
Charity Hospital (N. Y.)
Long Island College Hospital (Brooklyn.) Fourth, to abandon the use of the obstetric
City Hospital of Boston. binder until involution is complete and the Mass. General Hospital (Boston.) patient is up, with the uterus anteverted, when Chicago Marine Hospital, and many others. she can recover her figure, if she is foolish The book is a neat, cloth-bound volume of 971 enough to wish it, with much less damage by
pages, and the price is only $1.00. It is worth meet
times the price, and should be in every physician's tight lacing and forcing down the bowels be.
library. Published by THE MEDICAL WORLD. Order hind the uterus instead of squeezing down the when you send your subscription for '92.
astioles on the treatment of diseases and experienon with now remedies are solicited from the profession for this department; also difficult cases for diagnosis and
eatment utlolos accepted must be contributed to this journal only.
The editors are not responsible for views expressed by
contributors. Oupy must be received on or before the twelfth of the month
Jor publication in the next month. Unud Manuscript
quonot be returned. Certainly is excellent discipline for an author to feel that he
must say all he has to say in the fewest pc ble words, or Au reader is sure to skip them, and in the piutnest possible worde, or his reader will certain isunderstand them. Generally, also, a downright faci jy be told in a plain way; and we want downright facts at present more than anything else.-RUSKIN.
READ. REFLECT. COMPARE. RECORD.
Notes and Comments. EDITOR MEDICAL WORLD.—What sort of nerve tonic do your correspondents take? They seem ful: of "vim," bright as new dollars, and overflowing with good ideas this month. We felt that way once, but that was in the long ago, before La Grippe swooped down upon us. Now at the termination of a death-grapple with him, we feel like going off ant burying ourselves for a month 'till we have gotten a little rested. And that is what we ought to do. After a period of unusual activity, when the powers of mind and body have been taxed to their utmost capacity, and the strain has been kept up for months, there should come a period of hebetude, a rest, as complete as possible, to be continued until nature has recuperated her forces and there comes a longing to be back at one's work. It is a sad thing when a man has lost the capability of resting and enjoyment. Many do; and find that all their acquisitions have turned to dust and ashes, be cause they have forgotten to preserve the faculty of enjoying life. Perhaps these thoughts are inspired by the fact that ! have at present so many medical men applying to me for treat. ment. It is so easy to see that, after the hard work was over, they should have betaken them selves to some quiet resort, at the seashore or in the mountains, whichever offers the greatest change from the usual conditions under which they live. Please don't ask me if I have done so. We doctors rarely take our own advice. and I really have not time just now. Relics of the epidemic still on hand, bills to collect, arrears of neglected work to pull up, etc., etc. • What fools we doctors be."
Dr. Ward (page 57) wants a cure for asca rides. This is noi so simple a matter as it looks. The usual remedies are lime-water and tincture of iron, injected into the rectum; but sometimes these fail. I had one case in which
I used glycerine, but without effect. Naphthol has been pronounced effect::al. I would advise a trial of local remedies systematically, until one is found that will destroy the worms an'l yet not injure the rectum. Very cold water; very salty water; acids; alkalies; chioro oim solution; coal-oil; liquid vaseline; each to be tried cautiously, increasing the strength until the limit of toleration is reached. In the meantime a steady course of iron, quinine or mercury, whichever is indicated, should not be neglected.
M. D. (page 58,) has had an unfortunate case. When injections are thrown into the vagina, they sometimes are thrown directly into the uterine cavity; when sudden and alarming symptoms may ensue. This is what has occurred in M. D's. case. It is best to employ for vaginal irrigation an apparatus like that of the Knap Company, with a shield to close the vaginal mouth and a tube just long enough to carry the stream into the vagina; and this tube should have the openings at the side and not at the end. A still better way is not tr. use the injections at all, but clean the vagina by the use of a soft springe on a handle, like a large probang.
Dr. Dodge has mentioned some very curious cases (page 61,) but he does not tell us of those in which his prognostications were not realized. Many of us have doubtless had such impressions in regard to our patients for which we could not satisfactorily account. Sometimes they come true; and it is not surprising that a doctor who has practised since 1854 should be able to recollect a number o: such curious coincidences. But he forgets the others, because they made no impression upon his brain. I was once engaged to attend two sisters in confixement. Tie first was a bad case, fully expected to die; but she did very well. Then there occurred a little disagreement between us; I very unreasonably expecting to be paid in something more current than blarney, the consequence was, that a few days before he second confinement was due, I left the house remarking as I went out. “I brought good luck into this house, and if luck goes away with me it will not be surprising.” Within a week the second mother and her child lay dead in their offin. This was a case in which no difficulty was expected.
Why did I say it? I do not know. Idle words, suddenly occurring, in a moment of anger, and regietted the instant they were uttered. Nevertheless, they were repeated far and near, and for years I enjoyed the doubtrul reputation of a wizard, a dangerous man to offend! The death was a pure coincidence, as were Dr. Dodge's cases, and the man who
puts faith in such things as of the supernatural, The quite natural cunfounding of these two would better place himself under the care of different diseases so often noticed in an eye an expert in mental affections.
clinic, is the apology for this article. Without William F. WAUGH, M. D. any claim to originality, but with some expe1725 Arch St., Philadelphia.
rience in this direction, I will state, briefly,
some of tho:e differential diagnostic points be: Differential Diagnosis Between Glaucoma
tween the two, which can be appreciated by and Senile Cataract.
all: EDITOR MEDICAL WORLD :-During my reg
I. Hardness of the eyeball. Let the physi. ular course in ophthalmology at the University
cian put one finger of each hand upon a pair of Michigan, under Prof. Frothingham, and
of healthy eyes, the lids being closed, altermore especially during a post-graduate course
nately palpating, as when testing for pus in in the same branch under Prof. Carrow, my
an abscess. Now transfer the fingers to the attention was often drawn to the lack of care
suspected eyes and note the difference in tenin diagnosing between glaucoma and senile
sion. Any hardness above normal, points to cataract, found among the profession generally.
glaucoma. Scenes were often piteously sad during the
II. Pain. Cataracts, as a rule develop University Hospital clinics. Patients came
without pain. Glaucoma, as a rule, causes from a long distance, supposing they had cata
pain, often of a very severe character. When ract. Their eye trouble had been so diagnosed
the patient complains of a dull aching across by the family physician. They had been bid. the forehead and through the eyeball, the den to wait until the imagined cataract became physician may well suspect glaucoma, but ripe. During the ill advised waiting, the when the distress is at all extreme, he may be precious days and hours were wasted, in which almost sure of it. helo could have been given, and when, finally. 111. Opacity of the cornea. A hazy, ground the patient presented himself for an operation. glass appearance, denotes glaucoma. he could only be told that help is impossible.
diminossible IV. Anesthesia of the cornea. This is an And so, with disappointed hopes and sightless easily tested glaucomatous condition. eyes, he took his long journey homeward. only V. Large and lortuous episcleral veins also to pour curses upon his well-meaning physi.
vsi. characterize glaucoma.
C cian. Often have I heard that faithful teacher,
VI. A shallow anterior chamber, the iris Dr. Flemming Carrow, say to his clinical
being discolored, and, together with the lens, pupils these golden words: “I will not con- pu:
on pushed forward into it, imports glaucoma. sent to the graduation of any student who can.
1. VII. A large and immovable pupil warns of not diagnose between glaucoma and senile
glaucoma. cataract. These facts lead me to think a brief
VIII. Color of the opacity. In cataract paper on this subject may do good, and be
the lens is white, yellowish white or grayish. useful to the busy doctor. I know the subject
In glaucoma the hue is greenish. Indeed, the is found in books, but books are expensive,
meaning of the word glaucoma is green, so and in many cases their need is not felt, nor constantly
constantly is this color a symptom. does the practice seem to demand them.
IX. Subjective appearances. In glaucoma "When well established, it (glaucoma) is the patient often complains of halos or colored often mistaken in old persous for senile cata- rings around candles and lamps when lighted. ract, especially because the lens of old age has These are not observed in cataract cases, a smoky hue. This explanation of failing though scintillations and phosphenes are some sight is considered adequate, and a resort to times seen; but these are easily distinguished skilled advice is discouraged. Under this mis from the rainbow appearance above alluded to. take, the patient is told to wait until the sup- I remember a patient, a woman, in Dr. Carposed cataract shall be ripe before going for row's clinic at the University Hospital, who relief, while the delay is simply affording time said she saw spiders, large and small, in a for total loss of chances of recovery.”-Noyes great number, hanging from the ceiliog of her on the Eye, page 506.
rooms, and so real was her delusion that she It may be proper to say here, though briefly, attempted to sweep them down, and her failthat glaucoma is a very serious and peculiar ure to do so led her to consult the family phy disease of the eye ball, whose special charac sician, who diagnosed cataract with the too teristic is a greater or less hardening of the common result--waiting for the imaginary globe, accompanied in many cases with opacity cataract to ripen until the time for help had of the crystalline lens. Senile cataract, on the gone forever. other hand, is an opacity of the lens without X Contraction of the field of vision. This necessarily any other abnormal condition. can be roughly estimated by placing a bit of white paper on the end of a long lead pencil, the other eye is becoming affected, but she and then holding it in various positions, note can still see fairly well with the worst eye. She the result. This can be compared with the lost the sense of smell after a severe attack of field of a normal eye. In glaucoma, as a rule, the grippe, but that is now returning with the the contraction begins on the nasal side, finally use of a mild galvanic current, the negative extending over the whole field.
pole being used for about five minutes each We umit appearances discovered by the oph- day up the nose. thalmoscope as too complicated for the pur Cleveland, O. D. WALLACE MASON, M. D. pose of this present paper. To those who can use that beautiful instrument, this article may Treatment of Ulcers by the Use of Tin Plates. be useless, while to those who can not, the symptoms revealed by it would be of no avail
EDITOR MEDICAL WORLD:-In the Philawhatsoever.
delphia Medical News for December 13th, All of the diagnostic yoints above mentioned 1890, Dr. E. R. Moras very strongly urged will not be found in the same person, but the use of tin plates in the treatment of indowhenever one of them exists. the physician lent and varicose ulcers of the leg. The remay well pause and study the case long and sults obtained by him from this novel and carefully before he advises any course, much
rather ingenious method were, to say the least, less a thoughtless one, which may result in gratifying. total blindness to his patient, and in just cen
Since the doctor's article appeared, I have sure to himself.
had ample opportunity to test the efficacy of BELINO ADDISON BROWN, M. D.
the tin-plate treatment, and can fully and un. 201 Grand Avenue,
reservedly endorse all that was said for it. As Milwaukee, Wisconsin.
it would be a waste of time and space to enumerate the number of indolent and varicose
ulcers successfully treated by me by the tin Muscular Cramps.-Cataract.
plate method, I will report one case only; it EDITOR MEDICAL WORLD:-In reply to Dr. being the worst and most hopeless of all that R. L. Burns, in the February WORLD, asking have yet come under my observation. advice in the treatment of a man "who has Mrs. M., aged fifty-five, a stout though not been suffering with cramping of the muscles of very strong woman, came under my care some the chest for the last ten years," I would say months ago. She had two large callous ulcers, that I had a patient last summer, a young.wo. co existing with varicose veins, on the left leg, man, twenty-three years of age, who had suf- measuring 3/4 by 234 inches, and 2 by 12 fered from cramping of the limbs for four inches respectively. The larger ulcer was two years. She had tried many physicians with inches above the outer malleolus, and the other no relief. I gave her general treatment with three inches above the inner malleolus. Both Paradic electricity and thorough massage to presented a dirty scooped out appearance, dis. the limbs for two weeks. She reported that charging freely at times, and always more or she had no more cramps, although they had less painful. been almost a nightly occurrence before.
Completely surrounding both ulcers was an I have at present a woman, aged sixty, under elevated zone of dense, hardened tissue, while treatment, who has had cramping frequently, the parts immediately around the sores were but principally at night, in the right arm and edematous and excessively tender. Indeed, leg. This condition always comes on with her the entire limb frequently pained the patient in connection with indigestion. I am giving so much that it had become necessary to ad. her similar treatment, and improving her di. minister opiates to alleviate the pain, and se. gestion by carefully regulating the food, and cure rest at night. This patient had been toning up the stomach. She reports “much treated by many physicians, and had tried albetter." She has been a sufferer for many most all kinds of treatment for a period of years.
thirty years without relief. Indeed, the ulcers In return I would like to ask the advice of had never been entirely healed up, and this the brethren if any one can give me a system woman told me when I was called in that she of treatment that will retard or prevent the hardly thought anything could be done for her growth of cataract on the eye after it has once limb, but at the earnest solicitation of her huscommenced. I am aware that the books say: band and family she submitted to treatment. "The treatment of cataract is entirely opera- The first step in the treatment of this pretive, no kind of medication being of any use." viously incurable case was the application, for The patient is a woman, aged forty-seven, in several days, of flax seed meal poultices, for fairly good health. The difficulty has been the purpose of softening the dense indurated noticed on one eye for over a year and now tissue surrounding the ulcers, after which they
were depressed to the level of the sores by again fainted, and vomited a still larger amount means of adhesive strips varied with each of dark clotted blood. I was then summoned dressing. Two pieces of sheet tin were then and found her in an extremely collapsed con. cut with a common shears, sufficiently large to dition. I injected, hypodermically, a tenth cover each sore and one-eighth inch of the ad- grain of ergotin, ordered ice to the epigastrium, jacent skin. The plates, with two pieces of and ice to swallow. The following night she rubber tissue protective the same size, were had another hematemesis, more profuse than then placed in a 1 to 1000 corrosive sublimate any previous, filling a large wash bowl twosolution for five minutes, and, in the interim, thirds full; (this, of course was partly due to the sores well washed with the same solution. melted ice and gastric juice, but contained a
Having made all the parts perfectly antisep- large number of clots.) More ergot was in. tic, the tin plates were next applied smoothlyjected, and also morphia one-eighth grain, to with the rubber tissue protective underneath quiet nausea, continued at intervals of four the plates, and next to the sores respectively, hours. Rectal feeding was employed. Pal. the plates being secured by means of adhesive pation revealed a localized tenderness, slightly strips. Corrosive sublimate gauze was placed to the right of epigastrium, and downwards ; over the plate dressing, and the whole kept in considerable pain was complained of in this position by a roller bandage, applied from the location, also. When the stomach seemed toes to the knee. In six days the entire dress full, and just before a hemorrhage, there ing was removed, and the ulcers, on inspection, would be pronounced epigastric pulsation. At showed signs of beginning activity. The this point she was given a quarter grain nitrate edema being gone, and the pain in the limb, of silver pill, twice a day. She continued imso much complained of before, had entirely proving for three days, but Friday night abated. At the end of eight more days the vomited more blood, not so great in quantity, dressing was again renewed, and both ulcers but brighter and fresher looking. After the had then lost their excavated appearance, and last hematemesis she complained of a choking presented a healthy, even, granulating surface. sensation, for which I allowed her a little cold
The same dressings were subsequently re. water. She immediately vomited a large and newed every week or ten days and, by the lively round worm, measuring ten inches in sixth week both ulcers were completely healed. length. She was at once put on an emulsion This patient now wears a stout silk elastic of turpentine, half a diam at a do e, followed stocking, and can do all her own house work in twenty-four hours by a full dose of castor with ease and comfort, the limb not causing oil, but no more worms were obtained. Her her any pain in the least.
recovery was rapid and uneventful. The prompt and gratifying results obtained Undoubtedly this was a case of simple gas. in this case, which had successfully resisted tric ulcer caused, or aggravated, by the paranearly all other forms of treatment for many site, which, when the cause was removed, re: years, is but a tithe of what can be accom- covered. I have been unable to find any rel. plished by the proper and judicious use of the erence to intestinal worms as a cause for gastin plate in all chronic indolent and varicose tric ulcer, and the case is of interest in that ulcers, wherever may be their site.
respect, as well as to find worms in a patient L. Frank SIEGLER, M. D. of her age. New Kingston, Penna.
F. S. PARSONS, M, D.
1438 Dorchester Ave., Boston, Mass. Hematemesis Caused by Parasite. Editor MEDICAL WORLD:--The following
Hydracetine for Psoriasis.-Nitrate of Strychcase may be of interest to some of the readers
nine for Alcoholism. of THE WORLD:
Editor MEDICAL WORLD:- For the inforMrs. B., age twenty five years, widow six mation of the many readers of your valuable months, but not pregnant ; at time of sickness journal, I send you the fillowing as showing had been a cook in small family four months. the wonderful curative effect of hydracetine She had been complaining of dyspeptic symp. in psoriasis. This disease is one of the toms, with considerable epigastric pain, for most stubborn and persistent of the infiammawhich she had been treated by a lady physi. tory diseases of the skin, and will often resist cian of this city, for three weeks prior.
the best directed treatment; and many times, While visiting a lady friend one Sunday as the physician is congratulating himself on afternoon, she suddenly fainted, and on rally. being master of the situation, in his treatment ing vomited a large quantity of clotted blood. of this disease, his patient has a relapse. HavShe was at once gotten to bed, where she re- ing four cases under treatment last summer, mained until morning, when on rising she and noticing in THE WORLD that Guttman, of