« PreviousContinue »
strychnine are of utmost value; ergot in appro- factor in uterine therapeutics. Patients sufferpriate cases; and as an uterine tonic nothing ing from distortions and flexions should be kept better can be recommended than a combination for a length of time under observation, and of aletris farinosa, viburnum prunifolium and should be seen and examined at intervals." viburnum opulus, to which may be added cimi- What benefit is to be derived from such a procifuga, if desirable.
cess of expectancy in the class of ailments In very nervous and hysterical women a which I have been considering, it is not easy capital remedy is bromide of potassium, 3j to to discover.
WM. H. OLSTEN, M.D. water one pint, to be used as an injection at Ephraim, Utah. bedtime, which acts like a charm. It may also be given during the day, if occasion may call for.
Protective Prescription Blanks; Jaborandi in
Erysipelas; Turpentine in Diphtheria; As a sedative suppository in case of pain a
Bromide of Sodium in Tonsilitis; combination of conium and cocaine will gener
Black Oxide of Copper for ally be accepted with thanks. To deplete a
Tapeworm. congestive uterus glycerine tampons are almost a specific, and act very promptly.
Editor MEDICAL WORLD: I have here given only an outline of treat
My last letter, kindly accorded space in your ment, as every case must be treated on its December issue, pages 458 and 459, brought merits. But I wish to say, in conclusion, that me showers of replies from half the States in fortunately the times have passed when the the Union. All asked for and received samphysician with the immaculate shirt front and ples of my prescription blanks, and some have diamond pin, and white cravat and gold-headed already ordered and begun their use.
. I have cane, who is dignity personified, and who, when received many letters approving the idea of he smiled, it was a smile akin to that of one "Personal Professional Protection." This is trying to hide the consciousness of a stomach- a point that I am sure cannot be too strongly ache in the presence of ladies, - I say the time emphasized. has gone by when such a gentleman can pre- I am more firmly anchored than ever in my scribe a little nitre during the day and a Dover's idea of the proper management of the third powder at night for a prolapsus uteri.
stage of labor, not only from more extended Regarding electricity in gynecological prac- personal experience, but by the witness of tice, I will state that its application to the many brothers of from five to forty years' pracuterus, when the displacement is recent and de
tical experience, whose testimony by private pends upon passive congestion, is beneficial, letter accords exactly with the sentiments I and should be employed more frequently. there expressed. I am not at liberty to quote
to them, much as I should like so to do. the Electricity in gynecology should never be attempted by
another trial in the treatment of facial erysipunskillful men, but only by those who are elas, twenty drop doses every two hours, with thoroughly acquainted with all its intricacies aconite in the first stage and calomel purgation. and workings; otherwise disastrous conse- This was my third case, and the result has been quences may result, which may bring the sci- all that could be desired in every one, curing ence of electro-therapy into disrepute. These them quicker and with less trouble than with remarks I have thrown out as a matter of cau- anything else I ever used. Locally, thick abtion to my younger brethren.
sorbent cotton and bandage.
On the subject of the treatment of diphtheV. -FINIS.
ria, let me refer the brothers to pages 404 and I hope I have not failed to establish the two 443, 1888. Don't, I beg of you, let a patient propositions I started out with. I shall be die till you have given this remedy a thorough pleased if I have succeeded in removing some trial, and don't hesitate to push it far beyond of the unfounded prejudice with which the anything there recommended. You may meet mechanical treatment of uterine displacements with a joyful surprise. I have many a time. If and flexions has been, to my mind, so unrea- you try it, let us know with what result. There sonably regarded.
is no reasonable doubt but that diphtheria is a If those who so strenuously oppose this sthenic, systemic sepsis, which must be met by therapeutic system had any preferable alterna- powerful internal antisepsis. tive to offer in its stead, there might be some You may as well depend on your pocket less difficulty in understanding their position; handkerchief to cure catarrh as upon local but it is not so. A specimen of the treatment treatment in diphtheria. Local cleanliness is, they recommend is, “time is an important however, commendable in both. I am having
excellent results with benzoate of sodium in the case quoted the doctor's treatment is worthy acute follicular tonsilitis, giving to an adult of the highest commendation. In the use of five to ten grain doses every two hours. Treat ergot I must most certainly stand on the conment adapted to the degree of constitutional servative side. I am anticipating a treat in the disturbance is indicated here as elsewhere; article promised by Dr. Thornton, page 77, usually aconite and calomel, with potassium February WORLD. cloride and tincture ferri chloridi during the Would suggest to Dr. Humphrey, page 83, third stage or that of resolution.
that he examine the urine of his patient, ascerIn the parenchymatous variety tincture acon tain the cause of the leucorrhea, and cure that, ite heroically, ice locally, with calomel purga- stimulate the liver with pil. hydrastis and pod., tion, has done so well by me that I have not and then see if with urine, uterus and liver in sought for anything better.
normal condition the troublesome case is not Many devices have been tried, with more or ended. less success, for ridding the alimentary canal I have recently had a similar case to that of of omniverous man of that lonesome old tape Dr. Astrop, page 84. I believe the doctor's worm. I wish to offer one, and ask the doc- diagnosis is correct, but I think if he had taken tors to try it, suggested to me by a brother the rectal temperature he would have found it M. D., who had first used it successfully on high. Mine, with similar symptoms, was 105 himself, and later in many other cases. I have I gave five grain doses each of quinine and antifound it to be a valuable article, well worthy pyrine every one to two hours, till forty grains your attention; tasteless, harmless and sure so of each had been used. A most profuse sweat far as I have had an opportunity to test its followed, with normal temperature and perfect merits in positive cases.
ease the following morning. The only objections to its use are: (1) That The patient rallied, and eventually made a it must be continued for thirty or forty days, good recovery. For the following forty eight and (2) that the tapeworm is not expelled in hours there was retention of urine, the cathetoto, which is a great disappointment to the ter withdrawing a good quantity, but of rank average patient. What becomes of his majesty odor and deep dark color. During this time or how the drug acts I do not know, but it gets she was as yellow as a Mongolian. there just the same. I refer to the black oxide I followed the antipyretic and anti-malarial of copper. Adult dose, No. 4 capsule, three treatment with sweet spirits of niire and intesor four times daily for a month, or till all tinal eliminations. symptoms disappear.
The pathological condition I believe to be I read with great interest the frequent notes congestion of the liver, caused by the miason the use of sulpho-carbolate of zinc, turpen matic poison, which occludes the excretory tine, sulphite and hyposulphite of soda, hydroduct, and this combination of affairs throws naphthol, listerine, etc., in the treatment of such a quantity of effete material into the diphtheria, typhoid fever, “green diarrhea,” | blood as to produce these alarming symptoms, flatulent dyspepsia, etc., as I am sure it marks and death quickly follows if this antidotal and a step in the right direction. I am using them eliminative treatment be not speedily and daily, and believe as fully in antiseptic medica heroically used. DR. W. C. ABBOTT. tion internally in zymotic diseases as I do in Ravenswood, III. the same applied externally in surgical practice. In the one case we cleanse and apply antisep
Retained Placenta. tics to the internal skin, and in the other to
Editor MEDICAL WORLD: the external, but with the same purpose in There has been so much said on all sides of view; the only difference being that we must this subject, and each writer seems so partial to substitute calomel and the salines in the one his individual views, that I feel some hesitation for the sponge anıl douche in the other, and in offering the record of my humble experience. use non poisonous antiseptics in place of the But we cannot stop to consider the attack of carbolic acid and bichloride, which cannot be the lion when the lamb's blood is flowing, and safely used in sufficient strength to be destruc with an apology for any unlucky or unintentive to the bacteria that infest the alimentary tional blow, I will give as briefly as possible, canal in these affections.
the results and conclusions of my obsterical I like Dr. Peck's ideas, pages 67-8 of the Feb- practice on this point. I have ever been a ruary WORLD, except regarding such wholesale critical observer of all the indications and use of ergot. Ergot is a valuable drug, and promptings of nature, offering with a trembling may well be called par excellence in its place; hand any interference with her laws. I have but that place, I believe, is most certainly not leaned heavily upon the " Vis Medicatrix Nathe stomach of every parturient woman. In tura," and have cautiously guided the hand
of help, even when found necessary, with fear that all things necessary are in readiness to reand trembling.
ceive the new-comer. Then I watch closely It is true that most of our teachers and the pulse and the patient, and when the second nearly all our text-books advise to wait some stage has fully developed, I make a thorough time after the child is born before proceeding examination for the exact presentation. Havto terminate the labor by the removal of the ing satisfied myself on this point, I await paplacenta, and during the first few years of my tiently the approach of third stage. Then I expractice I was disposed to obedience to this amine again the condition of the parts to see if high authority, but during that time I discov any assistance is necessary. This done, I watch ered that the less the delay in taking the pla the progress closely, and guard against any accenta after the delivery of the child, the less cident in the exit. Having delivered the child, was the trouble or difficulty attending this duty. I proceed at once to tie the cord (under cover, Being encouraged, therefore, by such prompt as I never expose the mother for this purpose). ings, I gradually lost sight of first precepts and The connection severed, I hand the child to got into the habit of taking the placenta as nurse, and having cleansed my hands, immedisoon as I had delivered the child to the nurse. ately proceed to take the placenta. I always I have never had but one case of retained pla deliver on the back, and take the right side of centa, so called, and that during my early the patient (if left-handed the side would be practice, and if I ever had hour-glass contrac reversed). Then taking hold of the cord with tion it was after I had finished my work and the left hand (under cover), and winding had no occasion or desire to go hunting for it. around the fingers in order to hold it firmly, I Perhaps if some of our tardy brethren would introduce the first fingers of the right hand give more plausible theory for this half hour's into the vagina, following the cord. If found delay, it might be the means of developing the in the vagina I make firm traction with the left subject more fully. We know that the process hand and with the assistance of the right at of labor is an effort of nature to relieve this once draw it forth. If, however, I do not find long suffering organ of its mighty burden, and the placenta outside uterus, I make no stop, but that the act is not complete until the entire follɔw up with the whole hand to its lodgement. contents have been removed. If, therefore, If un tached from the walls of the organ, I in her crowning effort she has delivered the proceed to separate it, and having the cord in major part of her load, but has, perchance, not my left hand, use all necessary traction force expelled the minor portion, are we to conclude to enable me with the right to bring it forth that this was intended as a second act of the before the prison door is closed upon this undrama ? I take it that her mission is to ac welcome retainer. Then removing all memcomplish the whole work in the one act; but if branes and turning out the clots as thoroughly she may sometimes fail to this extent, then if as possible, I put a dry cloth to the vulva, and we are to be of any service at all it is our duty proceed to put on the abdominal bandage and to go to her assistance. I think the whole work let the mother rest. I then remain for a half is generally completed in one effort, as I usually or three-quarters of an hour to watch for post find after the child is delivered the placenta partum hemorrhage, which has but seldom oclying loosely in the vagina, and when retained curred, and then was promptly checked by the in whole or in part within the uterus, I have introduction of lumps of ice and 3 ss to 3 i always found a stronger disposition to hemor doses of fluid ext. of ergot repeated in 15 min. rhage until it has been removed. Some say As stated, I have never had but one case of wait for more pains to expel the placenta, but do retained placenta, and then it was when I was we get them? After-pains are common we inclined, like some others, to grant half an know, but without regard to the presence or absence of the placenta, for we find them as I have yet to witness hour-glass contractions. common and fully as strong after its delivery as I have never used forceps but once, and then in before. I think we should all understand that a case of consultation where the patient, a these are now, not expulsive pains, but the young and robust woman, had been kept in natural and necessary contractions of the organ labor for four days by her physician, of 20 and its stretched and strained ligaments to re years practice, because the presentation had gain their normal size and proper location. I not been corrected at the proper time. would follow this subject further, but not wish I use ergot without hesitation in all stages ing to encroach too much upon your space, I
when called for, and never had cause to regret. must conclude with my usual plan of proce It is a faithful servant and seldom disappoints, dure.
if used judiciously. I have had in my number When entering the birth chamber, after as of deliveries, which I think is a fair average, certaining that the labor is at hand, I first see one case of imperforate anus, upon which I
operated, and the subject-a boy-is living today, well and hearty. I have not much use for anesthetics in labor, and no terror of convulsions. Granite, Md. T. Z. OFFUTT, M. D.
Treatment of Varicose Ulcers. Editor MEDICAL WORLD :
Recent mention in this journal of the unsuccessful treatment of varicose ulcers induces me to note a method which has been successful in very obstinate cases, in my practice, when others failed. B Bismuth. Sub-nit...
.3 ss to · Iodoform
·gr x to xx Cosmoline,
31 Add “ listerine ”—which is an efficient compound to cover the odor of the iodoform, as well as being otherwise useful—a sufficient quantity. Mix, spread on soft cloth and apply to the ulcer, after cleansing it with carbolic or castile soap and water, and renew it night and morning.
To support the weakened bloodvessels, I prefer a flannel bandage to anything I have ever used.
Cut on the bias, from a good piece of white flannel, bandages three inches in width, and make them long enough to cover the parts needing support, which is usually only as far as the knee.
Two bandages, at least, should be made to begin with, as a clean one should be put on every morning, and one may be washed and ironed daily while the other is in use.
In applying the bandages, make the turns around the foot tightest, and gradually lessen the tension as passed up till, at the top, it is just tight enough to keep it from slipping down, and lap sufficiently to cover the surface well
As the proper application of the bandage is one of the most important and particular parts of the treatment, the patient should be carefully taught how to put it on, and the necessity of keeping it in order.
If flannel is not well borne next the skin, cheese cloth, or some other light fabric, may be placed between them.
The bandages need only be worn during the day, or while the patient is up; but should not be left off entirely for some time after the ulcer is healed.
The ointment should be used continuously till the healing process is complete.
The flannel bandage is sufficiently elastic to give comfortable and efficient support and, put on as I have directed, the greatest compressi will be where it is most required, below the ulcer. Air readily passes through the meshes of the cloth, and aids in the cure.
The objections I have to elastic stockings are that they commonly fit tightest over the calf of the leg, above the ulcer. They should produce the greatest compression below the ulcer, where the circulation is most sluggish, and the blood stagnates.
Rubber bandages, though most effectual as. regards support, are objectionable because, being impervious to air, they keep the leg too warm, and are often uncomfortable and sometimes unbearable to the patient.
As regards constitutional treatment, the following will suit the majority of cases, though each one is an individual study, and will require the particular remedies indicated, to produce the best results.
I have found hamamelis and collinsonia especially useful, and they should be combined with a laxative when constipation exists, as it does in most cases.
A very common prescription with me is :
A blood purifier is generally required, and none have given me more satisfactory results than the preparation of Eli Lilly & Co., “ Succus Alterans," and, where the iodide of potassium is desired, “Syrup of Trifolium" compound of Parke, Davis & Co.'s manufacture, in doses of one-half to one teaspoonful of either, three times daily.
When much pain is complained of, as a local application, the following prescription will give relief, and probably is as useful as any: B Alum pulv..... Tinct. opium..
.āā zj Distillate of hamamelis..
J. D. ELY, M. D.
I read the discussions in The MEDICAL WORLD two or three years ago, on the value of ergot in pneumonia, and resolved to try it as soon as possible. I have used it in a great many cases and with most satisfactory results. early experience with it, I noted some failures which puzzled me not a little. Why it should act like a charm in some cases and be worse than useless in others, I could not at first make out. My experience has taught me that in this section of country the lobar or croupous forms are speedily controlled by it, while in that form where the bronchi are principally affected, it is of no use. During last month (January)
I had more cases of pneumonia in children than twitching and winking, the victim would go I remember having ever had in the same length through when trying to talk, or rather trying of time in my practice of nearly twenty-one to start, they would be convinced it is purely years.
nervous. I had him read aloud with the teeth In only one case had I to make more than tightly closed, and applied galvanism (3 cells four visits. In that case the parents wished a McIntosh battery), to reach over nerves of consultation and the consulting physician re- phonation as near as possible. I also put the fused to allow its use, though he could give no patient through a drill. There certainly was good reason for so doing. Some of my cases an improvement. I also observed he could when first visited had a temperature of 104° swear without trouble, even when it would be and over, with pulse up to 175, and one was impossible for him to use nearly identical words. delirious. All recovered promptly, except the I also found the stammering was more or less one where ergot was discontinued, and his case periodical, and when health was very good the lasted double the time. My treatment is as speech was better, and that the mind controlled follows: For a young child, fl. ext. ergot x to it to a great extent; when things were agreeable xx inin. For an adult, one drachm every one, and surroundings pleasant, speech was better. two or four hours, according to urgency. I also Also that sometimes he could say anything give aconite (saturated tincture) 5 to 10 drops alone, but if I looked him in the face that in a goblet of water; sig., a teaspoonful every settled it. five minutes until pulse reduced, then only I hope to have further opportunity of using every hour or so. I also reduce temperature some of these means so kindly suggested. For by antifebrine iij gr. doses as required. Ipecac my part I am convinced that the trouble is in onegr. doses (with hydrargyrum cum creta nervous. Fear of stammering is a great cause. I if costive) every four hours for an adult; bro- think nearly every case could be cured. I have mide soda or potassium with spts. nitr. eth. to a good deal of faith in the block between the procure rest and keep kidneys active. Mustard teeth. One writer advises it between the inand linseed poultices to the chest. Had I cisors. Another advises it between the molars. time I could cite a number of cases where this I also have great faith in the physiological course has been followed by most happy effects of the battery. Also would not hypnorecoveries.
tism or animal magnetism succeed? I see hysI have a case on hand just now which I will terical patients have been ordered to cease havtry to report in next month's issue to illustrate ing spasms with success. If it would work in the course of the disease under this treatment. these cases, why not in stammering? I wish Stirling, Ark. C. S. HAMILTON. some one would test it.
Mr. E. J. E. Thorpe contributes an article Various Remedies for Stammering. on page 327 well worth referring to.
I will conclude by saying I have had a numEditor Medical WORLD:
ber of letters from physicians and others offer. Last year I wrote asking the household for a
ing a sure cure for sums varying from $5.00 to remedy for stammering or stuttering. I left $50.00, I could not help thinking how mermy former home hurriedly, and in the excite
cenary when the brotherhood is contributing ment and rush of getting settled and business
Their experience and discoveries for the benefit and professional cares, neglected so far to thank of suffering humanity, those whose name is those who so very kindly gave me their advice. legion are seeking to enrich themselves by others' As I received several suggestions by mail, I here
misfortunes. It would be well if such would with give the means offered in the hope that they remember we brought nothing into this world may be of service to some member of the and will take nothing out. brotherhood.
H. E. STROUD, M. D. Dr. J. H. Medaris thinks it a nervous trouble Oceanside, Cal. and gives strychnia. Dr. S. H. Singleton recommends holding a piece of soft wood or
Peculiar Ravages of Syphilis; Report of Dr. pebble between the incisor teeth, biting suffi
Stephens' Case. ciently to steady the jaw. Mr. B. E. Sedberry recommends the same thing, only holding the Editor MEDICAL WORLD: block between the molar teeth to steady the jaw. In the October number of your valuable
Slow and distinct articulation was advised by journal, page 391, I asked for diagnosis and all. The case I had didn't remain in my loca- treatment, for which I received an excellent retion long enough to give much chance of effect- sponse from Prof. Waugh in the November ing a cure. If those who doubt the trouble number, page 415. About the time I wrote being nervous could have seen the contortions, the patient passed from under my care ; but,