the chances of a cure are considerably increased.

Taking into consider

I will say even more. ation the antiseptic and harmless properties of peroxide of hydrogen, the physician who uses it need not fear danger of poisoning by absorption, nor need he trouble himself about the quantity, be it great or small, of the liquid which might accidentally find its way into the stomach. This consideration, then, permits him the use, or even the abuse, of irrigation or gargles which would insure the complete and immediate destruction of the diphtheritic membranes.

Consequently, peroxide of hydrogen will prevent at all times the development and reproduction of these infectious membranes; and it is obvious that all that will be necessary to obtain a prompt cure is a vigilant surveillance. IO W. 4th st., New York City.

Avoid all diphthongs, as entirely unnecessary and cumbersome in language, except in the Latin genitive case ending (a) in nouns of the first declension, in prescriptions.

Avoid using abbreviations, except in formal prescriptions; even here it is best to use the entire word. Haste may be a possible excuse when you are willing to let some poor druggist puzzle over what you mean by "Hy, chl.," but it is gross injustice to submit twenty thousand professional brothers to the same uncertainty, and perhaps it may make your entire contribution worthless on account of a lack of accuracy.

The same reasons make it essential that you should write all technical terms very plainly. The context, or the "sense of the sentence," will often enable the printer to make out the indistinctly written words of

common language, but manifestly the same principle cannot guide him in professional technical terms. If your contribution contains valuable medical information we do not want to throw it away, nor to perform the laborious task of re-writing it, nor to occasion delay by returning it to you for explanation.

Do not sprinkle Latin words in English composition. Plain writers seldom resort to this. "Aged 40" is a great deal better than "et. 40." Those with a thorough classical education are seldom guilty of this interpolation, nor are those who have a sound English training with good medical judgment. It is mostly those whose knowledge of strange tongues is fragmentary

and limited. Stick to your mother tongue. It is now the best language on earth.

We much prefer the use of gr., dr. and oz., rather than gr., 3 and 3. Still, use your choice in regard to that.

After all, it you have a valuable medical fact to contribute to the profession, and feel your inability to write it correctly, do not hesitate to give it your own expression, and we will give it any finishing touches it may aeed, if you will give us room enough between the lines and on the margins to do it, and write on one side only of the paper. Many excellent medical facts are first communicated to the profession by men who are better scientists than linguists.

Original Communications.

Short articles on the treatment of diseases and experience with new remedies are solicited from the profession for this department; also difficult cases for diagnosis and treatment. Articles accepted must be contributed to this journal only. The editors are not responsible for views expressed by conributors.

Unused Manuscript cannot be returned.

Oertainly it is excellent discipline for an author to feel that he aust say all he has to say in the fewest possible words, or his eader is sure to skip them; and in the plainest possible words, or his reader will certainly misunderstand them. Generally, ale, a downright fact may be told in a plain way; and we want townright facts at present more than anything else.-RUSKIN. In these columns, A is frequently used instead of 3.

A Medical Autobiography.

CHAPTER I.

INTRODUCTORY.

Editor MEDICAL WORLD:

This autobiography will contain an accurate portrayal of actual personal experiences from the first day I settled in the practice of medicine to the present moment, and such observations in the actual practice of others as are known to be true, and have a bearing upon the subject matter contained in the story.

If every young man contemplating the study of medicine, could and would read the various chapters of this autobiography, as they appear from month to month in THE MEDICAL WORLD, I venture the prediction that next year's medical classes in the colleges would not be as large as they otherwise would be. Yet I would not have you think that I have made a total failure of the practice of medicine. With becoming modesty I will state that I enjoy the reputation among my fellow practitioners, as well as the laity, of being a I am quite sure my wife would confirm the diagnosis.

hard-worked man.

When I entered the profession I located in the city in which I now live, renting a respectlocality. Everything of a material value, exable looking house in what I considered a fair cept one small box containing my medical library, and a larger one, about the size of an ordinary trunk, together with my good wife, myself, and a driver, came on a light two horse platform spring wagon. The load was not a heavy one, either. Having arrived, I purchased a ton of coal, a small kitchen stove, two small, cheap ingrain carpets, a very little second hand furniture, and paid one month's rent in advance. In a couple of days I put out my sign and announced myself ready for business. I was then practically penniless, and did not know a single individual in the city. I didn't have anything.

Perhaps a brief account of my library, instruments, office fixtures, etc., may not prove en

tirely uninteresting. By actual count I had nineteen volumes in my medical library. Four of these were not of much account in practice; the remaining fifteen volumes were standard authorities, however. My instruments consisted of the necessary articles for urinary analysis, a pair of pocket scales, and a small pocket instrument case. My office, only one room, did not have a carpet or mat upon the floor, yet was pleasant and cheerful nevertheless. During the first two months my office desk consisted of a dry-goods box, covered with some material my wife happened to have. My "library" stood in one corner of the room, the case being an improvised one. Three or four second hand chairs were distributed about the room. Do you ask why I didn't have better furniture and more of it? Simply because I had nothing with which to purchase it. My medical dip ona, an academical diploma, and three certificates of special training from the University from which I graduated, hung upon the walls. I might add, by way of parenthesis, that our dining-room table, for a short time, was a twin sister to my office desk, and for a long time our kitchen table was first cousin to both.

I did not keep a horse, yet was not weary from walking, although doing all my visiting in that way.

Thus located, without one solitary friend, or even acquaintance; without the kindly assistance of an older physician to send me stray patients or even poor business, and withont anything in the world, and my wife and myself being obliged to eat three times a day, and sitting whole days in my office with nothing to do, I commenced the battle of life.

In the next chapter I will tell you about my first call, and the amount of business and collections the first two months.

[TO BE CONTINUED.]

Answers to Inquiries.

Editor MEDICAL WORLD:

On page 458 Dr. Kendrick describes a case which looks to me like one of tuberculous disease of the bones forming the ankle joint. If this surmise be correct, an earlier operation might have prevented systemic infection. But is Dr. Kendrick certain that there was no de posit of tubercle in the lungs previous to the appearance of the disease at the ankle? Doubtless, at the time the operation was performed, nothing else would have answered; but less radical measures might have done well if used earlier. In one case of caries of the tarsus, I used Villate's solution with perfect success. hope Dr. Kendrick will not look on these re

I

marks as critical. They are not so intended. I know very well that in dealing with patients who are not overly intelligent, there is frequently very great difficulty in persuading them to submit to operations at the proper time.

I am getting a little bolder in the use of the sulpho carbolates, giving from two grains every two hours to ten grains. In this case I use the soda salt, fearing that so large an amount of zinc may have some undesirable effect, whereas the soda has none but what we are familiar with. In a case of tubercular diarrhea I am now giving ten grains of the zinc sulpho-carbolate every four hours, and there has been no evidence of irritation or any unpleasant effects whatever.

Dr. Layton's suggestion is a valuable one. There are many medicinal springs in this counbecause their virtues are not known. In Europe try equal to any in Europe; but of little value the various waters are prescribed by physicians drug-store. That the same is not done here is with as much certainty as the contents of a golden stream diverted from Carlsbad and Ems our own fault. We might just as well have the

to our own fountains, if we took the trouble to ascertain the real value of our waters and prelong as we leave it to the owners of the springs, sent them properly to the profession. But as who claim that they will cure everything from corns to leprosy, we need not look for a change.

If I were "Delta," I would be very well satisfied that my case of progressive muscular atrophy was improving at all, and would not be in a hurry to alter my treatment.

Dr. Foster will not obtain a very efficient remedy for granulated lids until he has removed the lashes which cause the irritation of the cor

paroxysms, as he describes them, bear some resemblance to asthma. Dyspnea is very common in feeble heart from any cause, in Bright's disease, and in chronic bronchitis and emphysema. In any case I should give the tincture of digitalis and quebracho until the patient is better, and would then substitute strophanthus for the foxglove. But an examination of the heart and lungs would make prescribing an easier task.

Dr. Vaughn ought to give us some more data before we can intelligently advise him. Insomnia is not a disease, but a symptom of very many diseases. As a rule, it depends on cerebral anemia or hyperemia; in one case demanding a cup of hot beef-tea at bed-time, at another a dose of hydrobromic acid at bedtime or a cathartic after dinner. The symptoms given may coincide with plethora, when low, dry diet, exercise and nitrate of potassium will do more good than the bromides. If there is anemia, however, the best remedy is a compound of iron, quinine, strychnine and the phosphates. But there may be local disease of the uterus, heart or kidneys to modify or nullify the above general rules.

When a pin has been swallowed, give plenty of bread and a little opium to cause constipa. tion, and examine the stools until the pin passes.

Locomotor ataxy curable? Yes; I had a recovery under the use of strychnine. Carter had two recoveries under oxide of silver. One of these cases had been pronounced incurable by Prof. Samuel D. Gross.

I will conclude this letter by wishing the great WORLD family a very happy New Year! hoping that the coming year will see them all enjoying health and prosperity, and obeying the injunction to increase and multiply, for Friend Taylor's benefit, and their own as well. W. F. WAUGH.

Successful Treatment of Hemorrhoids. Editor MEDICAL WORLD:

We recognize two forms of hemorrhoids, viz., the external and the internal, although these two forms of the painful and troublesome affec tion are often so blended that each partakes of the nature of the other.

Of the external typical hemorrhoid we shall say but little; they are usually hardened, congested, mucous, or muco-cutaneous excrescences, easily reached, and readily remedied; and as the same line of treatment suffices for their removal, as for the internal form, a mere acknowledgement of the usual classification is sufficient.

We understand that the internal hemorrhoid

depends for its origin upon an obstructed circulation in the superior hemorrhoidal veins; but what the cause of such obstruction may be is a matter for discussion.

M. Verneuil claims to have discovered that where these veins perforate the wall of the rectum they pass through a sort of muscular button-hole, which are not surrounded by any protective fibrous tissue, and therefore have the power of contracting and causing a condition of stasis and congestion in these veins which constitutes the starting point in the formation of internal piles.

Whether this state of stasis and congestion is really caused by the contraction of such muscular button-holes, or whether it arises from an engorgement of the portal system as a primary factor, we shall not attempt to decide; in fact we care less for the etiology of this troublesome affection, and more to find a method of treatment which shall give prompt and efficient relief.

For the past two or three years the advertiscrowded with matter devoted to the advocacy ing space in our medical journals has been of the Brinkerhoff, Rorick, or other alleged systems for treating hemorrhoids.

Like an innumerable number of other mushroom productions of the day, whose chief merit has been the cash paid the printer for honest labor, they are falling into disrepute; physicians have squandered money upon these so-called systems to be met with disappointments in therapeutic results.

It has been insisted so strenuously by the fathers of the profession that topical treatment was of no avail, or at the best only palliative, that I hesitated for months to acknowledge that perhaps these wise ones might have been mistaken, and that it was really within the bounds of possibility to relieve and radically cure hemorrhoids without the use of the knife, ligature, or other surgical procedure.

There is in this city a gentleman, F. W. Stuart, who is preparing for professional use an ointment, which, for the cure of this trouble. some affliction, has no equal, as far as my experience reaches; one of the principal ingredients of this ointment is a semi-solid extract of petroselinum sativum, which is made by Mr. Stuart himself by a peculiar process. Any physician who will take the trouble of writing to Mr. Stuart will be furnished with a sample box of this ointment, and the exact formula and method for compounding the same.

It is doubtless due to the petroselinum that this ointment posse-ses such soothing, alterative, and healing properties; and that these properties are resident in the drug is, I think,

evinced by the fact that the semi-solid extract of which I have spoken, properly diluted with water, forms one of the best applications for post-nasal catarrh, pharyngitis, etc., etc. I use about one part of the extract to fifteen of water and direct it to be inhaled through a bent glass inhaling tube two or three times a day, or used as a gargle, as the case may be. I have, for something over three years, used the ointment extensively, and have yet to know of the first case where it has not afforded prompt and efficient relief. For internal piles I prescribed it in P. D. & Co.'s rectal capsule suppositories. One of these capsules filled with the ointment and introduced into the rectum allows the medicament to come in direct and prolonged contact with the affected part. Morphia, cocaine, tannic acid, etc., etc., can be added if circumstances seem to demand; but this will seldom be found necessary.

When the hemorrhoids protrude extensively and are of an intensely congested appearance, I exhaust them of their blood as far as possible by a double-acting hemorrhoidal syringe, and then inject them with Stuart's extract diluted with warm water, without withdrawing the needle, using the ointment as a subsequent dressing.

It is surprising how rapidly even aggravated cases will improve under this treatment, fortyeight hours often sufficing for complete relief, as I have experienced in my own case.

May it not be a fact that the direct action of this ointment is upon the muscular fibres of the button-holes described by M Verneuil, relaxing them, and permitting the circulation in the hemorrhoidal veins to be restored to its normal condition?

In conclusion, I would say to my professional brethren, do not invest from $35 to $150 in the purchase of any so called system for treating hemorrhoids (the majority of which are simply a renewal of the old and exploded idea of injecting the pile tumor with a solution of carbolic acid), but write to Fred W. Stuart, Oswego, N. Y., and get a sample box of this ointment, together with the formula from which it is made, try it thoroughly and beccme convinced, as I have done, that it is the remedy par excel lence for the alleviation and cure of hemorrhoids.

Oswego, N. Y. H. L. WILDER, M. D. Uterine Displacements and Flexions-Their Mechanical and Clinical Treatment. Editor MEDICAL WORLD:

1. PRELIMINARY REMARKS. A few preliminary remarks are necessary before entering upon this subject properly, inasmuch as professional opinion is still divided

upon this much vexed question; but there are indications that it has undergone a great change. Gynecologists are still far from being agreed, even as to the exact nature of the mechanical treatment to be employed in this large, important and interesting class of cases. I think there are two extremes of opinion as to the clinical importance of uterine displacements and distortions. According to the one, these conditions are always the active or potential source of grave local and general troubles, and should therefore be at once brought under treatment, mainly of a local and mechanical character. According to the other extreme the conditions in question are to be regarded simply as the passive local expression of troubles to be looked for and treated elsewhere, either in ovarian irritation or in disordered states of the general health. It is greatly to be regretted that not only have opinions in regard to these questions been too extreme, but sentiment, if not personal feeling, has too evidently prevailed in their expression.

Displacements and flexions of the uterus are in no sense obscure, much less speculative in character; they are purely physical conditions, even more capable of recognition than the fractures and dislocations of surgical experience; and their relief and cure by the judicious use of appropriate mechanical appliances are as capable of demonstration as any in the whole domain of medicine. I have had a continuous experience of the mechanical treatment of this class of ailments, and I am more and more convinced that it is the only efficient means, when confirmed, for their relief and cure. I readily will admit that in incompetent, perhaps in unscrupulous hands, their employment has often been unnecessary, dangerous, mischievous and sometimes fatal; but I yet maintain that these are accidental and preventable abuses, and do not in the slightest degree affect a sound principle of the treat

ment.

I will now proceed to state that my thesis resolves itself naturally into a question of pathology and a question of therapeutics.

Therefore I shall establish my subject in two propositions:

I. In some women certain well-defined groups of local symptoms, and evidently related constitutional disturbances, are found associated with certain flexions and displacements of the womb as the only recognizable organic exciting cause.

II. In appropriate cases, local suffering and constitutional disturbance subside on reduction of the displacement or flexion, and the retention, for a longer or shorter period, of the

womb in its normal attitude and axis by mechanical appliances is followed by permanent relief and cure.

2. PATHOLOGY (UTERINE).

Nothing in uterine pathology is more remarkable, and often inexplicable than the varying amount of pain and distress which such conditions involve in different patients. A slight disturbance of uterine equilibrium will produce continuous suffering in woman, while extreme forms in another will be borne with comparative impunity. This pathological anomaly is often adduced in triumph by the opponents of mechanical treatment. But it is equally well known that in other morbid states phenomenal parallels are observed. In every disease different patients react differently to the same exciting cause, and this is more evident when the latter is physical in nature and local in action. Some woman will have constitutional disturbances to an extreme degree without suffering; in others a slight lesion will give rise to intense local suffering and great general sympathy. In others, again, the symptoms are either entirely local or altogether general in character. There can be no disturbance of uterine equilibrium without more or less interference with the vascular and nervous supplies of the organ, and through them with its secretory apparatus. Hence arise congestion, leading to inflammation, morbid sensibility and pain from pressure on the nerve filaments, and excessive and perverted glandular secretion, as the direct physi

cal results of this disturbance. The clinical importance of these conditions cannot be overlooked as immediate factors in the causation of a variety of functional derangements; and if not corrected, ultimately, sooner or later they induce changes of structure of a grave character. Women who are the subjects of uterine distortions and dislocation suffer more or less from disturbance or interruption of the two great distinguishing functions of their sex.

"Menstrual irregularities and sterility are usually present, and are in most instances the subjective conditions which attract the attention of the patient and lead her to seek professional advice, which results in the recognition of the disability.

Paulus Egineta recognized distortions of the uterus first and their effect in producing sterility, and suggested coitus a posteriore as a possible means of overcoming the difficulty as regards conception.

With respect to the immediate causation of all forms of flexion and version of the uterus, it must be borne in mind that, in addition to stretching or relaxation of the proper liga

ments of the uterus, the supporting power, or rather function of the vagina and its attachments has been more or less reduced, so that there is always at the same time a certain amount of uterine procidence or displacement downwards. The importance of this pathogenetic relation has as yet not been sufficiently recognized. In fact, there can be no shortening of the vaginal tube from whatever cause, and consequent subsidence of the uterus within the pelvis, without a disturbance of uterine equilibrium to a certain and usually corresponding degree. There is, then, an essential relation between procidentia and version of uterus, and this relation at once and satisfactorily explains the beneficial action of purely vaginal supports to some extent in all such cases, and, it may be, completely in slighter WM. H. OLSTEN, M. D.

forms.

Ephraim, Utah.

(To be continued.)

Case of Extra Uterine Pregnancy. Editor MEDICAL WORLD:

I was called to Mrs. H., age 22 years, pregnant two months, having had wo abortions before and one natural labor.

On the 19th of November (Sunday morning) she arose well, ate a very hearty breakfast, and was about and in good spirits until 10 A. M., when, like a flash, she was suddenly seized with an excruciating pain in her pubic region, and soon fainted. I arrived there at 12 A. M.,

having had five miles to go, when I found her condition as follows: Death like pallor of the face, lips cyanosed, pulse nearly imperceptible, extremities cold, extreme thirst. On asking her husband how the attack came on, he said with chills, and vomiting and pain. Having made an examination per vaginam I found the os firmly contracted. I then came to the conclusion that I had a case of extra uterine pregnancy (possibly tubal) with rupture, and the fetus escaping into the peritoneal cavity with a concealed hemorrhage. The patient lingered until 4 P. M.

The only thing I regret to mention is that I was refused a post-mortem examination, the husband saying it was always against her wish that she should be opened after her death. JOHN P. HILLEGASS, M. D.

Pennsburg, Pa.

The companion to the visiting list is a handsome, indexed book, arranged as a ledger of monthly halances and index of accounts. The two sets of books form a very complete and handy system of bookkeeping. The price of the entire set is $2.00, aud if not found satisfactory after three months' use, the money will be refunded on the return of the books.-American Medical

Journal.