becoming alarmed, returned in a few weeks in a much worse condition, the sloughing having extended deeply into the wrist-joint, a large portion of the articular extremity of the radius, as well as several of the carpal bones, were almost bare. His convulsions were much more frequent as well as increased in severity. On his return to my office I made a careful examination and found extensive caries. The lower ends of the forearm, as well as some of the bones of the carpus, were so soft that I could push a probe into or through them. So I amputated it just below the middle by the circular method. The stump healed kindly, and the convulsions entirely ceased after the operation. Thanks. T. G. STEPHENS, M. D. Sidney, Iowa. Atropia as an Antidote to Carbolic Acid Poisoning. Editor MEDICAL WORLD: Allow me to report a case of poisoning with a teaspoonful of carbolic acid. Patient, G., aged 8, brought to me in a state of profound coma. The father handed me a vial saying: "Wife gave the boy a teaspoonful from that thinking it was cough drops." I immediately recognized Calvert No. 5 carbolic acid er about that strength. The boy's eyeballs were turned upward; pupils contracted; tetanic closure of jaws; a tenacious foamy mucus pouring from nostrils and corners of mouth; skin livid and cold; pulse impreceptible at wrist; respiration sighing; no sensations or motion. The poison had been given only 30 minutes previous. I immediately gave him 30 minims of dilute alcohol under skin, and made an attempt to provoke vomiting by passing a feather into fauces, but could not. Remembering that atropia being a pysiological antidote (Bartholow), I gave him grain under the skin, applied bottles of hot water to extremities, between the legs and the spine, etc. In half an hour the pulse could be felt in the radial artery, mucus diminishing from nostrils. In one hour I again gave him grain atropia under skin. In another half hour the mucus ceased to flow from his nostrils and mouth; pulse better, but he was still insensible and pupils semi-dilated. In half an hour I gave him to minims of ammonia under the skin of the legs, from which he cried out with pain. Having had prepared lime-water I immediately gave him all he would take, perhaps 6 ounces. His skin assumed a scarlet color and pupils dilated. He relapsed into a quiet sleep, body warm and perspiring freely. In an hour he roused up, passed water and vomited freely. In two hours I left him sleeping comfortably. Next day he was up at A Home-made Powder-Blower. Editor MEDICAL WORLD: I desire to present a practical invention for your reader's consideration. I wish the discription, the work of an abler pen than mine. However, as most of the inventions are of such common use I will try to make myself understood. First a powder insufflator that is practical, and at a cost of fifteen cents, that is as good, if not a better device, than those at a cost of two dollars, because it is so very easy to keep clean. It is made from a rubber, fever thermometer case of which every physician has a number laying around the office as useless. Take a case and in the top screw end drill a hole about the size of the mercurial end of a fever thermometer. The other end of case cut square off and roughen, or gouge out so a rubber tube can be attached, then cut the case into at the middle and fit this same piece at the new cut end like a scoop. The expense of fifteen cents will now be incurred for a rubber bulb, unless you have one from an old atomizer; attach this rubber bulb tubing to the notched or gouged end and make the attachment permanent with a fine copper wire or silk thread. And now you are ready for the handle, which is to fit on the other half in such a way that when the two ends (the scoop and the square-cut end) are adjusted they will come together in the middle of the handle-head. The handle should be made from a hard piece of wood about four inches long and six-eights of an inch square, a hole bored through near one end, the size of the case to fit tightly, the handle can now be dressed into desired shape; mine is a round head and a round shaft, The handle should be properly fitted on the square end of case with the drilled hole in as already described. The physician can use as much powder and risk as much force as may please him. This insufflator never gets clogged up and is worth having to handle iodoform in ear cases, to say nothing of its utility in throat diseases. To be convinced of its merit you have only to make one. To use the insufflator, scoop up with the scoop end the powder to be used, properly adjust in the head of handle and shoot at me if you like. H. JNO. TILLOTSON, M.D. Hegewisch, Ill. Vomiting of Pregnancy.-Constipation. Editor MEDICAL WORLD: On page 83 of the February WORLD Dr. C. Allan asks: What would you do for a case of sick stomach of pregnancy?" He seems to have exhausted the "routine" and failed to get the desired relief. If his experience proves to be like mine, he will find in the hydrochlorate of cocaine the remedy which will give prompt relief. Rub up one grain of the remedy with ten grains of wheat flour and divide into ten powders. Give one powder dry on tongue every hour until relieved. Dr. Gentry, page 82, will find Warner's parvules of aloin to give him perfect satisfaction in his or any other obstinate case of constipation. I find very much in THE WORLD columns practical value. Brookings, D. T. C. W. HIGGINS. For Sick Stomach of Pregnancy. Editor MEDICAL WORLD: In reply to Dr. Allan, of Winchester, Ky., I would say, that in the "sick stomach of pregnancy," when prolonged and intractable as his case seems to be, I would search for uterine displacement. He will probably find retroversions of that organ. The knee-chest position will enable him to rectify malposition, when the untoward symptoms will speedily clear away. Only superinduced troubles will then need treatment. JOHN F. NEAL, M. D. Coperas Cove, Texas. Nausea of Pregnancy. Editor MEDICAL WORLD: Dr. Allan, of Winchester, Ky., asks in February number for reliable remedy for nausea of pregnancy. I will give briefly my own experience and convictions derived therefrom. There is no specific drug at all. Those which the doctor mentions are appropriate and will relieve mild cases; the severe ones drugs will affect very little-probably the use of morphia hypodermically, and the chloral per rectum, are most effective as palliatives. I have tried blistering the spine over dorsal vertebra as recommended some time since in THE WORLD. It is no good in severe cases; it will relieve some of the milder ones, but drugs will also help those. Of late I treat these cases as follows, viz.: After a few days' trial of the approved remedies, and possibly a blister over spine, with no marked improvement, I use the speculum, and invariably find the os patulous, the cervix inflamed, angry-looking and eroded, and very likely studded with enlarged follicles. These should be pricked, and the parts, after being well dried, thoroughly painted over with some caustic. I prefer a mixture recommended by Goodell, of pure carbolic acid, iodine and chloral, carrying it some little distance up into the cervical canal. Insert a large, firm tampon of absorbent wool and cotton well rolled in boracic acid. This relieves most even of the obstinate cases, and if needed can be applied again at end of a week. Theoretically, applications of cocaine to the cervix ought to at least relieve, and I believe they would do so; but they would need to be so frequently renewed as to make their use inconvenient. I think the above treatment founded upon a rational pathology. The vomiting of pregnancy is a reflex phenomenon, owing to irritation of nerves of cervix from increased development of the organ incident to conception. This occurs, as a rule, in all cases more or less; and when this new process is grafted upon an already diseased condition we get an excessive reaction. In short, always look to the vomiting during pregnancy. cervix in cases of obstinate and prolonged Ludlow, Vt. W. N. BRYANT, M. D. Antifebrine in Pneumonia. Editor MEDICAL WORLD: Dr. L. G. Walker, on page 84, MEDICAL WORLD, February number, asks for experience of antifebrine in pneumonia. I have used it in four cases this spring, with good results in all. Had thirteen cases last spring. Used quinine, carbonate of ammonia, veratrum viride, aconite, and lost five cases. Used this spring antifebrine, carbonate of ammonia; had four cases, and lost none. I shall hereafter use antifebrine. Temperature ran as high as 104°. Smother the flame and the fire goes out is my own axiom. DR. P. BRISCOE. Port Republic, Md. Incompatibility of Antifebrine and Sweet Spirits of Nitre. Editor MEDICAL WORLD: Having occasion lately to prescribe an antipyretic for a lady, aged thirty-nine years, who had a high grade of malarial fever, I gave antifebrine, 6 grains; spts. nitre, small teaspoonful, and in a few moments was confronted with very alarming symptoms: wild delirium with a terrible sense of suffocation, etc. Was it caused by the above combination of remedies? Are they incompatible, I would like to know? Bradford, Ark. J. G. ALLEN, M.D. [Yes, the two remedies are incompatible therapeutically.-Ed.] For Vomiting of Pregnancy. Editor MEDICAL WORLD: C. Allan, Winchester, Ky., wants a remedy for vomiting of pregnancy. I will give him my specific-cocaine. I say specific, for it has been in my hands curing every case where I have used it, and have used it after all other remedies, such as ingluvin, oxalate of cerium, bismuth, carbolic acid, arsenic, iodine, etc., had failed. I give gr. 4 every three or four hours during the day, keeping the patient in bed, if possible. T. R. MASON, M. D. Sugar Grove, Ohio. Salicin in Malarial Neuralgia. Editor MEDICAL WORLD: I recently had a case of malarial hemicrania or "brow ague," paroxysms occurring daily, and most excruciating. I tried antipyrine in 15 to 20 grain doses, and large doses of quinine with morphia, with only partial relief. After five days I gave salicin, grs. 15 every four hours, and afterwards three or four times a day, with prompt and permanent relief; no paroxysm occurring after beginning its administration. I think salicin in large doses very useful in all neuralgias of a malarial or rheumatic origin, and would recommend a trial of its merits by the numerous WORLD readers. C. R. ROGERS, M.D. Newark Valley, N. Y. Ergot in Obstetrics. Editor MEDICAL WORLD: What I shall have to say in reference to this subject will not be in defense of the indiscriminate use of ergot, as a remedy free from danger, nor to call in question the honesty of those whose extreme views pro and con have recently found way into current medical literature: but rather to find the golden mean between the two extremes. At a meeting of a neighboring medical society, which I had the pleasure of attending about a year ago, a gentleman in high standing in the medical profession, while discussing the subject of lacerated cervix, made the assertion, that a majority of lacerations were due to the use of ergot in labor, and in view of the great amount of suffering entailed on women from this cause, he thought it would be a blessing if its use could be entirely prohibited by law. Now comes a disertation in THE MEDICAL WORLD, Feb., 1889, page 67, by J. F. Lock, M. D., in which he says: "I never have attended a lying-in woman without administering ergot. I gave it, however, only as follows: when the os is well dilated, head presented, and a decided lack of expulsive pains." These are extreme views, that when written or spoken in public, go out on the sea of thought to bear an influence. It must occur to the reader that brother Lock has had a very pecular experience in the practice of obstetrics, since he has had not a single case in ten years' active pratice, that was not characterized by "a decided lack of expulsive pains." Read it over again, and see if this is not a logical conclusion. We are apt to get into the ruts of our own wheels. What we often take for lack of expulsive pains is only preparatory labor. The time has not arrived for expulsive effort. preparatory stage of labor in which the head, or presenting portion of the child, is made to press upon and dilate the circular fibers of the os, by the aid of the bag of waters, and to descend into the pelvic cavity and escape from the mouth of the womb, occupies very different lengths of time in different individuals, and may be characterized by widely subjective symptoms, according to temperament, physical condition, etc. The On Jan. The following case in illustration. 11th, I was called to see Mrs. R., aged 38 yrs.; low in stature, muscular, normal development of maternal organs and pelvis; mother of five children. She had been sick at the stomach, with occasional vomiting, and pain in epigastric region for twenty-four hours. I knew she was nearing the close of gestation, and I questioned her closely as to the possibility of approaching labor. She said she had no symptoms of it; no bearing down, no pain in region of womb, no backache. The pain in stomach was not unlike gastralgia from other causes. I gave 5 grs. of sub. nit. bis. in an aqueous solution of cocain; in about fifteen minutes the pain and sickness had ceased. I remained with my patient's family for dinner; perhaps an hour. I was about leaving, since she was resting so well. I had gone out with my case in hand, when an elderly lady called me back. Very suddenly uterine pains came on, which she recognized at once. I returned and without delay made a vaginal examination, and found the head resting in the pelvic strait; womb perfectly dilated and well receded back of head. There were four or five expulsive pains, and the child was born. It was of good size, well developed and perfectly healthy. The mother made a good recovery. There was a moderate amount of hemorrhage, post-partum, placenta expelled in fifteen minutes. No ergot. This was an interesting case to me. We have all had cases in which the preparatory stage of labor was very annoying to us, and very painful to our patients; cutting pains in the back and abdomen. When this condition exists unreasonably long in a nervous women, it is well to interpose for rest. I would never give ergot to hurry such a case. Better annoint the os with belladonna, which, while it relives nervous irritation, will relax the rigid circular fibres of the os, and afford a period of refreshing rest. When labor comes on again with the os well dilated, and excessive nervous irritation under control, your patient will thank you for relief. During a practice of thirteen years, I can recall but a few cases of inertia; in these cases I used ergot in 15 to 20 drop doses every thirty minutes, well diluted with water. It acted specifically, and I was not disappointed. It is well not to carry its use too far, nor to give it in large doses. Very violent contractions are dangerous to both mother and child. They may cause the arrest of the fetal circulation, or rupture of the womb. Contractions under ergot are tetanic and rarely cease till the contents of the womb are expelled. (Biddle.) Other dangers are, when there is apparent inertia, with os well dilated, but resting between the head and the brim of the pelvis, if large doses are given it may cause the circular fibres of the os to contract simultaneously with the longitudinal fibres of the fundus, and so powerfully as to impede deliverly and cause laceration of the cervix. I have no doubt that many lacerated cervices are due to this cause, and to the administration of ergot in the first stage of labor, together with retained placentas, hour-glass contractions, etc. Ergot is, in a sense, a specific remedy-valuable, indispensable-let us all study its physiological and pathological effects, and therpeutical uses, and learn to use it only when really indicated. Crittenden, Ind. L. A. SIMMON. Retained Placenta. Editor MEDICAL WORLD: After reading the articles in THE MEDICAL WORLD on retained and adherent placenta, I feel compelled to add a little to the testimony contained therein. My grandfather practiced medicine 25 years. My father is in active practice, and has been for 35 years; and he has two brothers who have been in practice the last 35 years. I have been practicing but 7 years. Now the total of this represents 137 years of practice-without boasting I may say active practice--in our family. Without elaboration it is safe to say that we have attended thousands of confinement cases. Never have we forcibly removed the placenta, and never have we lost a lying-in patient from complication of the third stage of labor, where the placenta was retained. I have known cases where the placenta was retained, adhering in the uterus 48 hours; and in my own practice have known 36 hours to elapse before the placenta was expelled; but have known of no injury from retention, either of sepsis or exsanguination. When tension on the cord, with pressure and friction over the fundus of uterus causes other than expulsive pains, I relinquish my attempts at assisting nature, unless there is active hemorrhage; when I continue pressure and friction until I have means within my reach for alternating hot and cold applications, using the cold only for revulsive effect, when needed. These means are necessary while waiting for the hemostatic remedies to act. I had a confinement case a year ago, the recovery of which was the poorest I ever had. The lady was delicate and anemic, the presentation of the breech, and the child weighed, when born, ten and one-half pounds. delivery the lady was chilly and numb, and the placenta was retained. After I remained with her several hours, hoping she would get through, giving a little ergot occasionally to bring about placental expulsion without avail. Getting an unusual amount of light I found her hands were becoming purple ; a condition that I could not account for, and after giving brandy, which she vomited, told her husband the case was not progressing as I wished, and perhaps we had best have counsel. I said nothing to alarm the lady, but before counsel arrived she said her hands were purple from knitting-yarn! The lady was very comfortable when my "counsel" arrived and I acquainted him with the circumstances. With no consultation he began looking over her; called for some sweet oil, and before I was aware of his intentions he was tearing away the placenta. Her suffering was worse than during parturition. He was an old practitioner, while I was young. He had friends there, and it was my first call. I waited -to-day I should kick him out. Following this brutality was phlegmasia dolens, first in left leg and then in right, accompanied with hemiplegia of right side, and Her life 3 ij 3 ij .q. s. 3 viij a discharge of pus from the uterus. was dispaired of for many days, and I was a constant visitor there for six weeks. She can never be strong again. This is all the discomforture I have ever suffered from an adhering placenta, other than that of waiting-for I never leave such cases without waiting a couple of hours after delivery and leave with them full directions regarding precautions against hemorrhage; precautions which they were never called upon to use. Dr. Meachem, in February WORLD, expresses my opinion. "If we can trust nature with our patient through the whole period of gestation. to the delivery of the child, truly we can a half hour or hour longer." Nobly spoken, doctor, we are only nature's assistants at the best, and child bearing is a natural phenomenon. P. L. TEMPLETON, M. D. Glover, Vt. Poisoning.-Warning from a Layman. Editor MEDICal World: I would like to call the attention of the agricultural people through the medical fraternity to the danger there is in handling poison in a dry state for the purpose of poisoning the potatobeetle, and other pests. The writer used it somewhat several years ago, and after using London Purple one windy day was taken with an attack of vomiting, caused, doubtless, by inhaling the poison. Since that time I have known of others being affected in the same way. Now I do not understand the action of poisons fully on the system, but think that a careless use and inhalation of them by persons, as they cannot be expelled by vomiting, might lead to chronic ailments that would baffle medical skill. Lockwood, N. Y. Editor MEDICAL WORLD: J. H. ANDRE. Is there any cure for enlarged prostate in a man fifty-six years old? DAVID BOCK, M.D. Hygiene, Boulder Co., Col. Winter Eczema. Editor MEDICAL WORLD: In reply to Dr. C. P. Hubbard in the March number of THE MEDICAL WORLD, would diag nose the complaint you refer to as "prairie itch, " winter eczema, mange. It has become more prevelant in this country in the last two years. I have had a varied experience with remedies. I first began with sulphur ointment, which proved very unsatisfactory; then I resorted to naphthaline chalk and sulphur ointment. This gave relief to about two-thirds of my patients suffering with this intolerable itch B Liquor carbonis detergens. S. Sponge on the body as required to allay the itching. Renfrew, Pa. R. L. PATTERSON, M.D. [Doctor, the United States Dispensatory does not give liquor carbonis detergens. What is it? -ED.] Surgical Dressings-Ingrowing Toe Nails-Hemorrhoids-Whooping Cough-Gastralgia. Editor MEDICAL WORLD: In your list of surgical dressings I would add the red wash : Zinc sulphate, ten grains. Compound spirits lavender, one ounce. as a lotion in dressing cuts, lacerations, bruises, etc. I have found nothing else so generally useful. Burns, sprains and inflamed swelling, a lotion of one ounce of bicarbonate soda to a pint of water is my favorite lotion, and is very effective; or liquid preparations of opium may be added, covering the dressing with oiled silk. As a dry dressing in indolent ulcers, subnitrate of bismuth I prefer to all others. The application of moist heat is better attained by frequently changed ordinary pancakes made of size and shape to suit and sprinkled, if need be, with ginger, mustard or pepper. Ingrowing toe nails can be much more readily and painlessly removed by wrapping the toe in lint saturated with the soda solution, and thoroughly covering with oiled silk, for twentyfour hours before the operation. The best stimulating salve I know of is balsam Peru 3j, resin cerate 3j. For gall stones I would add to Dr. Ziebold's phos. soda prescription a teaspoonful of fluid extract of chiananthus three times a day, decreasing dose if found too active. The most successful treatment of hemorrhoids is to cure them by administering tincture of horse chestnut, twenty-drop doses in water every three hours. It has cured many bad cases in my hands, and I am satisfied will cure all if the patient will persevere; it takes a long time in many cases, but is very sure. Whooping cough. Somewhere I saw it stated that antipyrine would cut this disease short. I have tried it in six cases, and am sure that the severity of the paroxysms was notably lessened and the duration of the disease shortened. I dissolved sixteen grains in four ounces of water, |