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of light compelled me to give it proper attention. I first fixed it to use upon a Cleveland student lamp. I removed the top and bottom of lantern, also the handles (it would be well to leave handles on), turned the shade from before the glass, soldered in a piece of nickelplated copper for a reflector, and it was ready to use. By adjusting it over the lamp chimney and behind one of the chimney fenders, it proved to be the proper height to get the full size of the flame. I used it in this manner for some time, when my student lamp was exchanged for a large library lamp with double wicks, and the question at once confronted me how to use the police lantern concentrator of rays. The question was quickly solved to my satisfaction, however, for it was an improved combination. All I had to do was to remove the lamp chimney, set the concentrator on inside the fenders same as a chimney, then the chimney exactly fit inside the top of lantern, and the concentrator of light was complete, with no effort on my part, and at no expense and more satisfactory than ever. I now use the concentrator on any medium size lamp, the patron furnishing lamp, oil, and chimney at their homes. The concentrator can be slipped into any coat pocket or wrapped with paper and carried in the bottom of the buggy. It will aid in securing a powerful light, provided the doctor calculates it so as to get flame directly in rear of the lens, and a good reflector in back of the flame chamber. If the doctor has not a police lantern at hand, any tinsmith can make a proper frame, and the hardware store will fur nish the glass lens.

Hegewisch, Ill. H. JOHN TILLOTSON, M.D.

Illuminating Gas for Respiratory DiseasesGonorrheal Rheumatism.

Editor MEDICAL WORLD:.

In some of the journals lately I have seen advised the use of inhaling remedies to destroy the microbe of consumption.

For some time I have sent my patients suffering from incipient phthisis to the gas-house in this city to inhale the gas, as in hooping-cough. The result has surprised me. The cough disappeared in a short time.

I have also used the same remedy in the influenza, with a cough, hanging on for two or three months in many cases. I am convinced that it aids very much in curing the cough. As you like short communications I won't speculate.

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Business-like Collections.

Editor MEDICAL WORLD:

I do you only justice in saying that you have given me in medical literature the best value for my money I ever received.

I wish country doctors would generally adopt my plan of collecting bills, namely, promptly present them every first of January, April, July and October, and have back-bone enough to obtain cash or note on interest. I get one or the other every time, or there is a thoroughly good reason why not. I never try to keep friends with the class who can but will not pay, but, on the contrary, I sit down on them flatfooted. By these means I find I can live, while my professional neighbor, who may know more. than I do, is (at least sometimes) compelled to

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On Dec. 22d, 1886, I was called to see Clara Hall, a colored woman, supposed to be in labor. On making inquiry I found that she was the mother of one child thirteen years old. Had never aborted. On making a digital examination I found the os quite high up-in fact, it was almost impossible to reach it at all. dilatation whatever. The womb was contracting tolerably hard, but the pains were very far apart. I diagnosed labor in the first stage, but could not make out the presenting part. I would remark here that the woman was very fleshy, and that I could not make out the position of the child by palpation. I do not remember whether I felt the child move or not. The labor being very slow, I left for home with instructions to call me if the pains became faster. I called to see her again twelve hours later and found that the pains had ceased. I

The best remedy I have found for gonorrheal did not make any further examination, but told rheumatism is:

the husband that he could call for me when the

pains came on again.

One week from the time of the first call the husband told me that his wife had her sickness slightly, but no pains. The discharge continued for about one month, but no pains. I called to see her several times, but made no digital examination. The patient said she had not felt the child move since the night she was first taken sick.

The discharge per vaginam was slightly fetid at this time. I came to the conclusion that the child was dead, and I insisted on making an effort to bring on labor; but the patient objected. Still I commenced to give ergot, and kept it up several days; but it had no effect, except to stop the hemorrhage. The patient said that she felt well, and was able to do all her work. I saw the patient often for the next twelve months, as she was living on my farm. She seemed to be in good health, able to do farm work most of the year, and menstrated regularly after the first seven months. Her abdomen was about as large as it was at the time of expected comfinement. Menses became more scanty each month, and had ceased entirely by the eighteenth month, Jure, 1888. The patient now began to complain of pains at irregular intervals, sometimes quite severe and very much like labor pains.

I gave ergot with the hope of increasing the pains, but it had no effect. 1 had to give morphia to get any relief. The patient was in bed about half the time for the next three months. She had lost considerable flesh, the womb v y hard and reached about two inches above the umbilicus. Intermittent pain most all the time.

Warm applications and morphine gave some relief. About this time, Nov. 15th, 1888, a very offensive discharge began to pass from the vagina. I made a digital examination; also examined with the speculum. Found the os high up and very hard, somewhat enlarged. I tried to pass a small probe, but could not do so. I was still of the opinion that it was a retained fetus, and advised an operation, either to dilate the cervix or abdominal section, but the patient would not consent. I tried most everything to relieve pain, as morphine made her sick at the stomach, but would finally have to return to morphine.

Feb. 1st, 1889, the patient in bed all the time; able to get but little sleep on account of the pain; getting weaker every day; but little appetite; stomach very irritable.

Feb. 5th, I called on Dr. S-, of Austin. After pruducing complete anesthesia with chloroform, Dr. S-introduced a modification of Sims' speculum and found the cervix very hard unyielding. After considerable time and using mcderate force, Dr. S-succeeded in passing a probe through the cervix. Withdrawing that, he introduced a dilator and tried

to dilate the cervix; but the process was very slow, as the parts would scarcely yield at all. However, after considerable delay and manipulation, he finally succeeded in introducing a large urethral sound, which he rotated with very little trouble.

There was no discharge from the womb whatever, no fetor on examining the sound, not more than two drachms of blood lost from the forcible dilatation.

Dr. S. diagnosed fibroids and suggested a course of treatment. I was still not convinced, but said little about it, as I had no way to prove that I was correct. Patient bore the chloroform well, but suffered with nausea afterwards very much. She became very restless about midnight, but did not complain of much pain. She died rather suddenly at 2 o'clock A. M., after making an effort to get up.

At 8 o'clock A. M., I made a post-mortem examination. On opening the abdomen I found the abdominal walls attached to the anterior portion of the uterus, and with considerable difficulty succeeded in separating it there from. There was also inflammatory adhesion between the fundus and the small intestines. There was about a pint of bloody water in the peritoneal cavity. I finally succeeded in detaching the womb from its surroundings. Some of the adhesions were very tough, almost like cartilage. The womb was about as large as a half gallon jug, and in some places very thin. I could plainly feel the cranial bones inside. I placed the womb on a table, and, on opening it, I found an eight or nine months' fetus, very much decayed.

The fetor was terrible. The flesh was entirely gone from the bones of the cranium and also from the large bones. The skin and flesh on the posterior part of the trunk was still intact.

The breech of the child was presenting at the cervix. On introducing a small probe at the external os, and passing it upwards, I found that it did not enter the uterine cavity at all, but penetrated the cervix very near the internal os, and entered the abdominal cavity through a rather ragged opening, showing very plainly the reason why we had not detected any fetor the day before. It also explained why the sound rotated so easily. This opening was to the left of the womb. Of course the bloody water, spoken of before, came from the parts lacerated by the sound. I did not examine the ovaries or tubes, as I had no help, and the fetor was so bad that I was anxious to get through. I sent the uterus to Dr. S. for examination.

I have very few remarks to make in regard to the case. I have been able to find but little

literature on the subject. I know that a few very eminent men have had the same accident happen to them that we had in this case; that is, the penetration of the abdominal cavity. The cervix was so tough that I do not think we could have ever succeeded in dilating it sufficiently to remove the fetus per vaginam.

The only way, in my opinion, that the child could have been removed at all, would have been by Cesarian section, and even then I am satisfied that, if the patient had not died under the operation, she would have died from septic poisoning in a very short time.

Likely our treatment hastened her death, but she could have lived but a short time anyway. W. A. ELLISON, M.D.

Manchac, Texas.

Fatal Case of Mumps.

Editor MEDICAL WORLD:

April 20th, I was summoned to see one Mrs. Way, aged 84, and found her afflicted with catarrhal fever. The catarrhal inflammation did not extend beyond the bronchial tubes, and by the tenth day the patient was convalescing very nicely. However, on this day, my atten tion was directed to a pain, complained of during deglutition, in the region of the angle of the jaw. On examination I found the lower part of the left parotid gland tender to the touch, and slightly swollen, and the next day the entire gland was inflamed, and the right one slightly so, and very tender to the touch. I now concluded that my patient had the mumps, regardless of her extreme old age. Suffice to say, that there were no untoward symptoms more than usually occur with this disease, and by the fifth day the inflammation appeared to be subsiding, and the patient doing extremely

well.

But on the morning of the sixth day, I was sent for in a hurry, the messenger informing me that the patient was supposed to be much worse, and on my arrival at the place I found the patient with the following symptoms: stupor, stertorous respirations, jactation, etc. She could swallow liquids when aroused from the stupor. But in spite of all we could do to relieve her she succumbed to the disease, and died at four o'clock next morning. Deeming this a case of mumps with metastasis to the brain, occuring in this extremely aged person, I thought it might prove interesting to the readers of your valuable journal.

CHARLES W. MUSGROVE, M.D.

Austinville, Penn.

Obstetrical Statistics.

Editor Medical World :

There has, of late, been considerable discussion in your journal regarding the treatment of the placenta, and it is only by testimony from various sources that the truth on any subject is reached, as discussions on practical points in our art enable us the more certainly to grasp the subject in its fulness. It is these practical discussions of matters of every day practice that prove of the greatest benefit to the major number of the great army of physicians. The practical usually is so frequently overshadowed by the theoretical, that it is a boon to the greater number of us, who are the followers, to be able to find these points of every day work practically discussed.

In my practice there has not been a very abundant harvest of obstetrical cases; for you will find in many places in California that laymen consider themselves, in many instances, sufficiently expert to manage lying in cases themselves. But, such as my practice has furbrazen-faced, add my mite of testimony. Of nished I may, I hope, without seeming too the fifty-five cases of which I have record, the following is a brief resumé: Of these, all but four were vertex presentation. Of these, twenty were in first position; eleven in the into second; five in the fourth position, three second position; one in third position, rotating of these rotating into first position; eight vertorily diagnosed. tex cases, in which position was not satisfacOne of my recorded cases was transverse, vertex left, right hand and arm presenting. Two breech casts, knees presenting. One of the vertex cases was complicated with descent of funis; but, fortunately, this was replaced quite easily by using two fingers of the right hand, the head immediately descending, and the child saved. I had one case of twins, and in five cases labor terminated before I arrived upon the scene of action.

Of all my cases, there were five in which the child was still-born. One of these was transvis of the mother was contracted, the fetus deverse presentation; another, in which the pellivered by p dalic version, but died before this presentation was the third confinement of this was accomplished. patient, both previous children having been finement, I had the pleasure of delivering the A year later, in her fourth conpatient of a fine, healthy girl this being a breech case-for which I received their heart

The case of transverse

still-born.

felt thanks and three cords of live oak wood.

In the three remaining still-born cases, one of which was a breech presentation, it was a

difficult matter for me to determine the exact cause; but in two I found the forceps necessary, and it required about all my strength to extract the fetus in both of these cases.

In all my practice the forceps have been resorted to in but five cases, and in two of these, as just stated, the children were still born.

Of these fifty-five cases which I have recorded, the children were males in twenty six cases; females, twenty-five; of the remaining number no record is before me regarding this point.

In but two cases was there any hemorrhage of serious import, and these both were controlled without any dire results by use of the alum plug, retained for a few moments until the action of ergot administered brought about firm uterine contraction. My practice regarding the treatment of the placenta is to remove it as soon as the cord is tied and severed, unless, perhaps, a few moments rest is granted the mother just for a "breathing spell; " and usually the interval from the birth of child to the moment I sever the cord is sufficient for this, for I almost invariably wait for the cessation of funic pulsation before the liga ture is applied. After this is done, I proceed to remove the placenta by what might be terme a combination of Crede's method and extraction-manipulation of fundus over ab domen with left hand, and slight traction on cord with right, and when the uterus is relieved the first and second fingers of the right hand are used to hook out the mass.

Following this it is my usual practice to administer a drachm of the fluid extract of rgot. This drug I very seldom employ at a period prior to this, for in most cases I find it is un necessary.

Among my cases I have had three in which puerperal fever was plainly manife ted, due to pelvic cellulitis. One patient was confined in bed for about six weeks, but recovered perfectly, and a year later was delivered of a fine, healthy child. In another case the cellulitis was quite severe, resulting in complete rigidity of the uterus from the accumulation of a mass of lymph in Douglas' cul de sac. This case, in the course of four or five months, was as well as ever, apparently. The third, in three weeks from confinement, was on her feet, but did not gain her usual health for two or three

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While on the fire do not burn it; boil it

If there has occurred an almost complete slowly till it becomes a dark brown color; re

cessation of uterine contractions during labor, I sometimes administer a half drachm of the drug, if there is no direct obstacle to the advancing head. I never had but one case where it seemed hour-glass contraction" was present, and that case was one in which a drachm of ergot had been given to hasten labor. However, it was overcome by introducing the hand, shaping the fingers as a cone, and steady upward pressure through the os, maintained for a few moments.

Among my first cases I find notes regarding the result to perineum and its treatment. In twelve cases the perineum was sutured with from one to three sutures. But as it has been

my almost invariable practice to apply sutures even in slight lacerations beyond the fourchette, it is safe to say that in a great majority of cases the suture has been used immediately after placenta was removed and clots turned out.

move from the fire and add one drachm of camphor when it is nearly cold. This is a wonderful salve for burns, scalds, scrofulous, fistulous and all other ulcers. Spread on linen and renew daily.

If the brother gives this a trial, I think he will have just what he wants.

Menno, Mifflin Co., Pa.

T. S. PYLE, M. D.

Cure of Paralysis and Atrophy by Vacuum. Editor, MEDICAL WORLD:

On page 167 of April World, Dr. Craver, of Bryan, Ohio, asks advice of your readers in regard to a case of partial paralysis and loss of sensation of both hands. If the doctor will make a tin tube sufficiently large to insert the arm up to the elbow-rubber band around top about three inches wide-bottom closed with

small tube in the bottom end to receive a small rubber hose, which is attached to an air pump, and exhaust the air, producing partial vacuum, the blood will be drawn into the arm and hand. Then use friction with his hands after taking them out of the receiver. By this means he will soon build up the wasted tissue and strengthen the nerves, and have the satisfaction of saving his patient, happy, with two useful hands.

I have restored paralyzed arms from lead poisoning, and built up wasted limbs in this manner. In 1869 I cured a badly frozen foot, which was cold and of a bluish purple color, with no sensation in the foot, in this manner. (Several doctors, including a surgeon, recommended amputation as the only means of relief.) I also cup with the air pump.

I see on advertising page xvi. that Dr. Conner, of Labette City, Kansas, advertises a physician's cane as something new. I have had a cane like his (except hollow handle) made of hard rubber, holding 16 bottles, which I have used more or less for thirty years. I simply mention this to remind the doctor that "there is nothing new under the sun."

W. R. GODFREY, M. D.

Michigan City, Ind.

Enlarged Prostate.

Editor MEDICAL WORLD:

In the April number of your valuable journal, Dr. David Bock (page 153), and Dr. H. E. Stroud (page 159), ask for advice for enlarged prostate.

I would say to both that during the last ten years I have had no difficulty in treating this troublesome condition successfully. My treat

ment consists of two remedies only, but they have been sufficient in all cases.

The firt is carbonate of lithia, given in 2 to 4 grain doses. If cystitis is present as a complication, no attention need be given to it, for the lithia will cure it just as surely and more speedily than any other remedy in the Materia Medica. No anodyne can rieve he distress of cystitis as quickly as can f

My second remedy in this troublesome dition, i. e., enlarged prostate, is queen of the meadow. This I usually give in the form of an infusion, about half a pint for a dose. In about 15 minutes the patient will be able to pass the urine without any difficulty. I have also used the tincture with satisfactory results. Were I forced to confine myself to either one of these two remedies it would be impossible for me to decide which I would prefer. Both have done their work promptly, and when prescribing them the patient's idiosyncrasies decide which

I will use. If, for example, I fancy the patient has no confidence in small doses, he will get infusion of queen of the meadow. While, on the other hand, if he object to large doses, he gets the lithia.

In conclusion, I desire to say that, were it not for the fact that your space is too valuable, I could quote over one hundred cases from my case book wherein the two remedies cured. C. A. WALTERS, M.D. III Milton street, Brooklyn, E. D.

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Sig. One every 3 or 4 hours, or as needed to keep the patient completly under the influence of the opium for 6 or 8 days, taking care to never let the patient get up, or to exert himself in any way during this timekeep dry heat to the rectum and perineum (not warm but hot), give no medicines per stomach, do not draw the urine or use the catheter for any purpose.

I have had the best of success with this treatment, after all other treatment had failed. I was called to treat a professional brother some 3 months ago who was suffering very much with prostatitis, and who had used all the medicines mentioned by Dr. Stroud, including the opium suppositories, but had failed to keep up the treatment as it should be. After 9 days' treatment, the Dr. was able to attend his office business, and has had no trouble since. If Dr. Stroud should try this treatment, and give it a thorough test, I would like to hear from him through THE WORLD. WM. HALL, M. D. Wichita, Kan.

Enlarged Prostate.

ICAL WORLD:

I send this, not as a solution to Dr. Stroud's puzzle, but simply as a suggestion to the brothers. In the early stage of a similar case I offer the plan advocated by the late lamented A. B. Palmer, of the University of Michigan:

"When difficulty is experienced in passing water from this cause, as the stream starts let the meatus be tightly compressed laterally, preventing the exit of urine, when the same, pressed strongly from behind, will stretch the urethra, so that the remainder of the act can be accomplished with comparative ease."

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