Miss R., aged 20, apparently healthy and strong, good sound teeth, no catarrh, functions all performed normally, apparently, has a very offensive breath, sometimes complains of food distressing her. Would like to hear through the columns of your journal as to the cause and treatment in each case. To C. C. C., November WORLD, I wish to say that for years I would at times lie with the soles of my feet against the cold plastered walls of my bed room for "burning feet," and an old lady friend advised me to soak my fect in water, hot as could be borne, with soda bicarbonate in it, which I did, and have always obtained relief. I have often walked in the snow in my bare feet for it. In my case I know it is a neurosis. G. O. FRASER. Randolph, O. Dr. J. Ashworth of Denver, Colorado, reports success in treating typho-malarial fever with sulph. carbolate of sodium and fluid extract of baptisia. He also recommends picrate of amonium for the purpose of reducing the temperature. Editor MEDICAL WORLD: I have a case which I wish to submit to the readers of your valuable Journal. Prof. S. J. Lowe, principal of our schools, age 30, married, parents both living and healthy, about one and one half years ago had what we term here "Dutch measles," -a severe attack but made a good recovery. About one year ago first noticed a pain at the junction of the first and second parts of the sternum upon making certain movements, which seemed at times to be more severe than at others, but has been gradually on the increase, until now it is almost unbearable at times. The pain is greatly increased by pressing his hands together, by pulling on his socks or shoes, or upon reaching after a book while seated at his desk; also upon turning his head to the left, or bending his body backwards. There is no very great pain upon pressure over the sore spot. Upon a careful examination, I can find no lesion of the chest or sternum, no enlargement or tender points. The lungs are sound, he has no cough, no difficulty in breathing or swallowing. Pulse when lying down, 76, and sometimes as low as 50, but upon rising out of bed and standing up runs up to 100 to 120, and upon sitting down drops back to 75 or 80. Has no difficulty of breathing upon exertion, and respirations are not increased upon exercise. Temperature normal. Has mitral regurgitation. Appetite very good. The heart trouble has greatly improved on digitalis and iron since he first came under my care, (about Nov. 1st, 1888.) But the other trouble is still increasing. I find nothing that would lead me to suspect aneurism, or a new growth in the chest. I had thought possibly it might be myalgia or neuralgia, but have treated him for both with no improvement. The pain at times radiates from the sternum to the right side in the shape of a fan, and occasionally to the left side; size of sore spot about as large as a silver dollar. Now, gentlemen, of the profession, what in your opinion is the trouble with the professor? His habits and mode of living are temperate, and he is teaching every day. Garwin, Iowa. DR. M. L. ALLEN. Will some of our brethren give treatment for ulceration (scrofulous) of the superficial lymphatics? H. HOWLAND, M. D. Plattekill, N. Y. Help Wanted. Editor MEDICAL WORLD: 66 Mrs. F., English, aged 38; nervo-bilious temperament, medium height and weight; mother of three children, youngest 12 years of age; never miscarried; no specific" trouble whatever; enjoyed good health previous to last confinement; appetite, as a rule, fair; di-, gestion somewhat tardy; kidneys perform functions according to general condition of patient. After her last confinement she had "weakness," and was treated, and gradually grew worse. Just what that "weakness" was I cannot say; but in short time she was taken with "cramping spells," and became bedridden for several years. After the usual run of doctors, entered hospital. Was benefitted somewhat. Then came courses of medicine by the different doctors again. At times improved; then a siege of complete prostration, caused by the excruciating pains produced by cramps. There seemed to be no help for her, as she employed the very best of physicians of all schools of medicine; but with same result: temporary relief, then return of old complaint. The writer was called to see the patient early last fall. Have watched case since. Made careful examination. Found her in an exhausted condition. She had just had a cramping spell, and her emaciated body was covered with a mild perspiration. The only trouble or evidence of disease that I could find was a retroflexed uterus, with a slight enlargement of right ovary; only slight discharge at intervals from vagina; menses regular. The uterus was replaced, and, I presume, like the other doctors, I commenced a general treatment, with about the same degree of success. There was one peculiar feature I failed to note: that was that, up to the time I took charge of the case, only one doctor had the opportunity of seeing patient have a "cramp," and I was fortunate enough to meet with same opportunity. Patient sitting in chair. The muscles of face twitched and rapidly passed into tonic spasm. Then muscles of arm, then of hand, of thigh, leg, and toes; sometimes all present at same time; or first one, then would skip and operate in distant part of body. After twenty minutes of this torture, the jerking would begin, and her feet, arms, head and body would jerk and snap so that I expected to see her bones give way. Patient conscious and talked rationally whenever muscles of jaw would permit her so to do. The spasm would subside immediately whenever hot water was brought in contact with the muscles afflicted. While she was having the "jerks," two large men tried to hold the offending limb, but failed; and when the strength displayed during attacks is compared with the weak, delicate, emaciated body of patient, it seemed wonderful. I This patient, I will venture, has taken enough drugs in different forms to start a drug-store, and with same degree of effect or relief. know that I tried all drugs that her condition indicated, and then on general plan, with but same effect. At last I placed her At last I placed her upon "Schuerler's tissue remedies," and for the period of six weeks she was free from attacks; but now she is as bad as ever. I would ask, what manner of irritation produces this condition? B. R. LE ROY, M.D. Chagrin Falls, O. Editor MEDICAL WORLD: I wish to ask through your valuable journal treatment and diagnosis of the following case: The patient, an old soldier, has been troubled with spells, beginning by sensation of heat in the heart and extending gradually all over the body, followed by double vision, vertigo, faint and "all gone" feeling, as he expresses it. Although not able to speak or move a muscle, he knows everything that is said and done. While in these spells his pulse is from 40 to 50 per minute. The whole left side becomes so numb that he cannot move it for some time afterwards. Auscultation over the heart; there is a double blowing sound which can be heard at times by parties sitting close by him. He complains at times of a sensation of cold water dropping inside of heart. Also of a pulling and dragging at the heart: this last is not while he has these spells, but between. Until the last year or two he has been able to work. These spells prior to this would be only two or three a year; but since he has been compelled to give up work of all kinds, even read ing will bring them on. He says he is in no pain while in the spells; rather die than live. Father and father's father died of rheumatism of heart, one brother of aortic aneurism, and one brother living that has a heart trouble. The left side of the chest is a little fuller than the other. Digestion rather poor. By spells, especially in summer, has diarrhea. Has been troubled a great deal with diarrhea since in the army. O. L. MAPES, M.D. Mesopotamia, O. Editor MEDICAL World: Somebody tell me what is good for sweating feet? I have two cases on hand now that sweat until they are soaked, and the steam rises from them when shoes and stockings are taken of and smell! The odor is awful. I have tried everything I can think of and failed. Have been tempted sometimes to cut their legs off to see if it would relieve the neighborhood. I want the editor and all the good doctors who read this to send in their best remedies at once. I have also had a few cases that sweat profusely about the genital organs, for which suggestions will be in order. JAMES A. MINICH, M. D. Worthington, Ind. Diagnosis Wanted. Mr. D., age 30, habits regular; general health good, and from healthy parentage. Fifteen years ago he had a severe abscess about the knee, resulting from a large boil improperly treated, which left deep scars above the joint and in the popliteal space. Every spring this abscess would return, and no treatment availed as a preventive. Two years ago he came under my care. I dissected out the popliteal sac, which hastened the recovery from an attack, and the interval was the longest he ever enjoyed. When it did return, however, it came in the fall. He has had two attacks since; but the last one was the mildest he ever had. But long-continued suppuration has taken place so often that nothing is left but ligament, sinews, and the cavity extending deeply underneath the biceps. At times there is fluctuation under the patella, but the pus escapes at the other openings. He has been under the care of several eminent doctors, who disagree in diagnosis and treatment. Some would treat for rheumatism, others for acute synovitis; others thought it due to scrofula; still others to caries of the bone. But, despite all the treatment, suppuration would ensue. What is the cause? and can there be any real cure except by amputation? Doonsville, S. C. J. R. CARNELL, M.D. I have a patient, a man, native of Holland, age 50 years, light complexion, medium height, weight 140 lbs., has enjoyed good health up to about 12 years ago, at which time he complained with a pain in his neck, right side. There is no enlargements of the lymphatics on either side. He has not had syphilis. The pain is spasmodic and sharp, lancinating in character, which becomes so great that he has loss of consciousness, and falls down wherever he is. He had an incision about four or five inches long made along the sterno-cleido mastoid muscle, but nothing abnormal could be found. has been to all the medical colleges of Cleveland and has not derived any benefit; also been to Europe with same result-no better. He has taken all the bromides, strychniæ, antirheumatics, iron, cod liver oil, etc., and is no better. He Now, gentlemen of the medical fraternity, hoping that from this meager description you will please advise me as regards treatment and your opinion as regards its nature, any advice will be kindly received. THE MEDICAL WORLD is the best of journals. Cleveland, O. Editor MEDICAL WORLD: C. BAKER, M. D. Would you or any one of the medical fraternity please help me in the following cases: Case First.-Mrs., aged 47, married, 3 children, was for years a dyspeptic; last June was taken sick with acute gastro intestinal catarrh, vomited often, and had a diarrhea, but before this disease came on she had trouble with the menses, being then in the period of change of life. The patient once menstruated in that time, in the latter part of July, and not since. I carried my patient safely through these diseases, but now we are troubled with one of the sequellæ, viz.: dropsy. I have removed the greater part of this; in the lower extremities there is very little if any, but the face, especially the upper eye lids were very edematous, still somewhat so and the eyes are very painful. I have had the patient on pulv. jalapa composita, fluid extract of scoparius, elaterium, and equal parts of digitalis, nitre and jaborandi, and pills made of pill. hydrag, pulv. scilla and pulv. digitalis ãã xxx grs. made into 30 pills. Supported the constitution with tonics and iron in some form, and for the eyes I have given her a preparation of potass. iodidi. aud small doses of Fowler's solution. This helped her eyes considerably but still they are not what I would like them to be. Now if any one can advise me by letter or through the columns of THE WORLD, I shall be grateful and give credit to whom credit is due. [Doctor, suppose you examine the urine and make other investigations for disease of the kidneys.-ED.] Case Second.-Mrs. H- —, aged 44, married, one child, is corpulent, has had a weak stomach for years, and also has a gastro-hepatic catarrh. In the morning upon rising she spits whole mouthfuls of bile, at times she gets bilious, complains of shortness of breath, a choking sensation, and of a dull pain in the right side up to the axilla, and across the breast to the sternum. This pain is nearly constant and is not exaggerated upon lying down. The tongue is coated white. This pain is what worries her most, and is there whether she is bilious or not; she eats pretty well, and her bowels nove nearly every day. I should like to hear from some of the brethren in regard to this case, especially for something to take and keep away that pain as I am anxious to do her all the good that can be done. [Doctor, you probably have a case of chronic duodenal catarrh, with consequent hepatic obstruction, and will derive benefit from leptandrin podophyllum and phosphate of sodium in small doses, repeated just sufficiently often not to produce catharsis -ED] Case Third.-Mr. K— aged 30, has had gonorrhea for nine months, and has been treated by five or six M. D.'s. I have been treating him for the last two months and have done him some good but he is far from being cured. He has a discharge yellow, thick and ropy, then some days there is very little discharge. He takes good care in diet and takes no stimulants. He had steel bougies passed before he came to me, without any good whatever. He passes a good stream of water. The seat of pain is far back. I have given him different preparations without much good being done. If you, or any one can give me a good prescription for this patient I should be ever so much obliged. If there is any one that wishes to communicate through letter, I should be glad to hear in regard to either one of the three cases stated. What is the best thing to do for facial neuralgia in pregnant women? Egypt, Pa. H. D. LEH, M. D. [Doctor, we think that the hydrastis, boroglyceride, etc. mixture, which we have published twice in THE WORLD, will cure your case.-ED.] Scaly Eruption. Editor MEDICAL WORLD: I have a patient, a young man, single, thirty years of age, temperate, who has a scaly tetter of about sixteen years' standing. Has general dryness of the skin, but no constitutional disturbance, and no specific history. The eruptions are somewhat circular, covering the body and limbs, but not on the hands, feet or face. some on the scalp. There is no secretion, and no severe pruritis. Epidermal scabs are throwm off in abundance. He had external treatment with no success. What can I do with the case? Valcourt, Quebec, Canada. D. DESNOYERS, M. D. [Doctor, we recommend the following oint Editor MEDICAL WORLD: Please give me a prescription for the permament cure of rectum worms. They are from 4 to in. long and continually bother my patient. I have tried almost everything: injections of all kinds and medicines internally. The best was hydrag. sub chloride with colocynth in powders. They seem to be located in the rectum about 8 to 12 inches up and crawl out at the anus. I have tried all the anthelmintics, but they only give temporary relief. The MEDICAL WORLD is the best paper printed and you can always count me a subscriber. Los Angeles, Cal. A. P. POAPS, M. D. Acid. boric... Glycerini. Acid. carbolic. Aquæ destillat. ..āā p. ij ..P. iv ..p. j. .......p. xxx M. Sig. One to three pills daily at meals. -The most popular antiseptic dressing for open wounds, in Paris, is said by the chief pharmacist of one of the hospitals to be made as follows (N. Y. Medical Abstract):--R. Iodoform.. Olei eucalypti. Paraffin. Vaseline.. .2% gm. ..20 gm. 50 gm. ..50 gm. M. It is convenient to handle, and may be used as an ap plication to ulcers and also as an emergency dressing. -Dr. Loomis, of New York, suggests the following formula for a pill for gout: R. Extract. colchici., acetic., Extract. aloes, Ipecac. pulv., To be taken every four hours until purgation occurs. These pills may be carried about and employed at the first sign of an attack; they will often abort it. (Minn. Medical Journal, Feb., 1889.) -To blister the skin quickly, Medical Record, February 16th, 1889, suggests the following plan: Into a watch glass, pill box, or any similar small receptacle, pour ten drops of concentrated water of ammonia (aqua ammoniæ fortior); cover the liquid with a bit of linen or a little cotton-wool, and at once apply the cup upon the skin where the blister is required. Press so that the vapor is confined to the inside of the vessel. A red circle will directly be observed outside, when it will be certain vesication has taken place. Half a minute or so is all the time required to obtain the result. The blister may be dressed in the usual manner of dealing with a blister from cantharides. Acetic acid, concentrated, applied to the skin will also in a few minutes produce vesication. In such cases evaporation should be prevented by some suitable covering. Bibulous paper lightly wetted with a little of the ethereal extract of cantharides, instantly applied to the skin and covered with a piece of adhesive plaster, will answer for the same purpose. Dr. H. C. Woods says the following formula known as Dewee's Emmenagogue Mixture, he relies upon almost exclusively in the treatment of simple atonic amenorrhea. The amount of iron should be as the anemia, of alces as the state of the bowels, of cantharides as the susceptibility of the urinary organs: B Tincturæ ferri chloridi.. Tincturæ cantharidis... Tincturæ aloes... .3 iiij. .3 j. Tincturæ guaiaci ammoniatæ.., ... iss. Sig: Tablespoonful three times a day.-Medical Waif. Antiseptic Paste for Ulcers. L'Union Medicale of May 19, 1888, gives. the following formula for an antiseptic paste: This paste is especially adapted to the treat ment of Ulcers.-Medical News. |