If this suggestion will be borne in mind and used, you will save many an old man years of suffering.

Dr. Stroud is likely to derive benefit in his case by combining this procedure with the internal use of the fl. ext. of saw palmetto, in twenty to thirty minim doses three or four times

day. I believe if Dr. Bock, p. 153, will adopt this plan, and see that it is faithfully carried out, he will derive great benefit from it. Will any one trying it kindly report through this journal?

"Southern California's" prospective treatment in his next similar case might have a good moral effect on his patient, but I doubt if this course will increase his venereal practice. His own criticism, a few lines above, is probably the correct one-too great a variety in treatment.

Doctor Allen, p. 169: Is not the trouble in the Professor's case accounted for by the heart lesion? Sternal pain is often the only subjective symptom from the near proximity of the laboring heart with the engorged lungs. Your recourse lies in first regulating and controlling the heart-beat, pushing the means taken to the extent of overcoming the dilatation, if there be any, that causes the regurgitation; second, lessening peripheral resistance. For the first digita lin (genuine) pushed strongly; and for the second, baths, friction, and flannel clothing at all seasons of the year. I presume this will be

an old chestnut to the doctor. Am curious to see what others have to say. I get the best effect from the digitalin granules made by the Metric Granule Company, of Chicago. DR. W. C. ABBOTT.

Ravenswood, Ill.

A New Remedy for Vesical Catarrh, Cystitis, Irritable Bladder and Frequent Micturition in the Aged.

Editor MEDICAL WORLD:

In reply to Dr. H. E. Stroud's inquiry, page 159, April, 1889, I recommend him to administer to his father the fluid extract of Sorghum saccharatum or Sorghum vulgare, in teaspoonful doses three to five times daily.

This is the product of the common broomcorn seed, and must not be confounded with broom-top or scoparius.

It is diuretic, sedative, demulcent, and soothing to the irritated urinary organs.

I have been using it a number of years, and have found it very beneficial in cases of irritation and tenesmus, where there is almost constant desire to micturate, but small quantity only is expelled at each effort.

In the aged who are compelled to rise frequently at night to void their urine, it has produced great relief.

The only literature I can refer to on the subject is found in the American Journal of the Medical Sciences, July, 1881, page 164.

The fluid extract can be obtained of Messrs. Sharp & Dohme, Baltimore, Md., list price $1.20 per lb.

In cases of emergency a decoction can be made by boiling two ounces of the bruised seed in a quart of water, down to a pint; strain, and give all during the succeeding twenty-four hours.

I have seen no disagreeable effects from its W. J. CRAIGEN, M.D.

use.

Cumberland, Md.

For Rectal Worms-Treatment of Gonorrhea. Editor MEDICAL WORLD:

In answer to Dr. A. P. Poaps, on page 172, April MEDICAL WORLD: Mix a solution of table salt and water of such proportion that 3ij of the mixture will contain a teaspoonful of salt, and inject in the rectum. Repeat on alternate days three or four times, if necessary; usually twice is sufficient. This has never failed with me. Those worms cannot exist in salt water. The patient should he still after the enema is given, until compelled to go to stool. If this fails, please report, as I never knew it to fail.

IN REPLY TO SOUTHERN CALIFORNIA, PAGE 158, APRIL NUMBER.

The cure of gonorrhea, in some cases, is no trifling matter, as I long ago learned, not from books, but by experience. Such remedies as the doctor describes will often produce just such results, or did for me in my early practice. Any preparation of mercury, sulphate of zinc, nitrate of silver, acetate of lead, or, in fact, any and all astringents too strong, given in the early stage of gonorrhea, will be very likely to result in stricture or orchitis. Many cases thus treated come to me from other M. D.'s. It is far better to do nothing than to use such remedies, especially in the early stage. I have had but one such case as yours out of a large venereal practice in the past year, and that was a case demanding quick work or certain exposure of

his true condition.

I will say to the brother, "Never use any medicine the first two to four days, after the discharge appears. Use only warm water frequently injected with a P.P. vulcanized syringe (use no glass syringe). Use the injection immediately after urinating, so as to avoid carrying the virus further up the canal. Give at the commencement a laxative of any bland cathartic, if necessary, to keep the bowels loose. After

M. Sig. After passing urine to wash out the canal, inject a full P.P. syringe of the medicine, holding it n the penis three to four minutes. Use three times a day.

If more than one bottle is required, fill the bottle each time after the first one is gone, just the same, only use 3ij of the pinus canadensis ; order plenty of nourishment, no intoxicating drinks, avoiding all excesses, and you will have no cases of orchitis, or stricture, and last, but not least, make no failures, nor will even need to blister the penis.

The above course, properly followed out will soon give you venereal cases from a distance as well as in your city. If Southern California sees fit to write me, giving me his correct name and address, I will give him my unfailing management of syphilis. Fairbury, Neb.

I. HUMPHREY, M. D.

The Ideal Laxative.

Editor MEDICAL WORLD:

Dr. J. H. Myers, of Lewiston, Penna., on page 161, April number, asks "What combination of medicines will make a liquid cathartic, a teaspoonful to contain a dose for a man, pleasant to the taste, that will operate without griping and be cheap enough for poor people to keep on hand in place of pills ?"

I can give a splendid one that I have tried for over a year, and have written it fifty times for others.

Take one-half pound of figs, one-half pound of prunes and one half ounce of senna leaves. Put the senna leaves in a quart of water, and boil 15 minutes covered. Then strain and add two teacupfuls of white sugar, cut up the figs and prunes and add them, then boil the whole until the fruit is soft-perhaps a half hour. Take a teaspoonful after each meal. If the bowels are obstinate take a thorough cathartic first, and this will keep them regular. This is a gentle laxative, but will keep them as regular as clock work. Keep on ice in summer time to keep from souring.

Shelbyville, Ind. MRS. G. H. DUNN.

Gonorrhea.-Sweating Feet.

Editor MEDICAL WORLD:

On page 158, nymphæ cdoratæ should be the powdered root. Tr. of celery seed" is It should not commonly found in drug stores.

be prepared by digesting two ounces of seed to one pint diluted alcohol.

3 xii. M. S. One-half fluid ounce before meals and at bedtime.

Editor MEDICAL WORLD:

I was amused at the communication that appeared in the April number of THE MEDICAL WORLD, under the heading, "Gonorrhea, a Failure."

Evidently the doctor lost sight of one of the most important principles of surgery in treating his patient.

He had inflammation of the mucous membrane; no matter if it was specific.

The first indication, in any inflammation, is put the part or member as much at rest as may be, the second, apply something soothing, and the third, time.

The first move the doctor made upon the disease would probably have been curative, if persisted in, had he left off that part of the treatment which might be termed strategic, viz., copaiba, spts. nitre, etc., internally.

But when he commenced beating about with the wind, using first one remedy, and then another, he was awfully "at sea" without a compass, and it is not to be wondered at that he should run upon the rocks.

The doctor will do well to try the following plan of treatment, when he again has a patient, instead of confining him to his bed and blistering his penis:

Editor MEDICAL WORLD:

In reply to Southern California" of April No., p.p. 158-9, I think he made the first mistake in the strength of his bichloride solution. The solution he used is, and it would have been better to have used a ʊʊʊ in

water

as warm as could be borne, in the mist stage, as the efficacy of injections in the first stage is due not to the drug, but to the soothing effect of the hot water. Saline diuretics and purgatives are of immense value in this stage, as are a bland diet and rest. It is certainly a mistake on the part of the doctor to use any vigorous treatment in the first stage of gonorrhea, although he may be importuned by his patient to cut the disease short. If we attempt to do so we will only lengthen the time of the disease, besides causing our patients a vast amount of suffering, as in the case of "Southern California." I know it is hard to resist the frantic appeals of our patients, especially if they be married men, but we must not let our sympathies run away with our judgment, which is often the case, as it probably was in our brother's. I never used the balsam copaiba mixture, and consequently cannot speak either favorably or unfavorably of it, but I do know something of nitrate of silver, and do not hesitate to condemn it in the first and second stages of gonorrhea. It is a dangerous. remedy when the mucous membrane is in condition for it to attack, which condition is favorable in the first and second stages, and a urethra which has been attacked by it may well feel proud if it comes off without a stricture.

I would have used for the second stage the solution of bichloride, which was used in the first stage, to render the discharge antiseptic, and would have relieved the pain and encouraged the discharge by having the penis held in hot water, which I see was done in this case. I never allow my patients to follow the habit of putting cotton over the meatus and holding it there by means of the foreskin, but I have them make a poke out of muslin and fasten it by means of tape sewed to the open end and passed around the body, and at the bottom of this poke some absorbent cotton is placed to catch the discharge. This is better than having a rag wrapped around the penis and held there by means of a string tied tightly around the root of that organ, thus obstructing its circulation.

In the third stage, or when the discharge has lessened and assumed a mucopurulent form, is the time I use astringents, and nitrate of silver' gr. 1⁄2 - gr. j to the oz. is as good as anything else, and in some cases it has succeeded where other preparations have failed. But there is no one remedy to be recommended above all others. Every physician has his favorite, and I presume all have done good work and all have failed. I have found that the less you handle an inflamed mucous membrane the better will it be for it, and its unhappy master, and, although I do not doubt that the doctor in this case has treated more cases of gonorrhea than I have, yet I cannot help, inasmuch as he invites it, to criticise his treatment in that he did too much, especially in the first and second stages. I know some patients will say, "Well, doctor, if you can't do more than you are doing now, I will go to some one who can;" but you had better let them go and let the other man have the elephant on his shoulders. You will not lose anything by it-you will be the gainer.

The next case you have, doctor, put him to bed, but do not blister his penis, or you will have an elephant on each shoulder. I bli-tered a penis once; the man was married he is now single; and my wife was almost a wit so was his.

I have not gone into the pathology of this disease, as you all know the pathology of an inflamed mucous membrane, and when the treatment of gonorrhea becomes based on its pathology, it will be handled with gloves, and not be burned with caustic injections, for which it can never become tolerant. Then strictures, the result of destruction of the mucous mem brane by caustics, will become a thing of the past dark ages, and homes once more the abode of angels.

Newark, O. W. B. MIDDLETON, M.D.

This I have the patient inject and retain as he did with No. 1, until cured; it is important to instruct the patient how to use the syringe in a proper manner. Fill the syringe about onehalf full, push the piston forward until the solution reaches the mouth of the syringe; it is then introduced within the mouth of the penis, the solution is forced gently but firmly as far as the disease extends. Remove the syringe, and, by gentle pressure on the mouth of the penus, retain the solution.

Gonorrhea being a local disease, needs but little internal treatment. The successful doctor will meet indications and overcome them as they may arise. D. W. MCCARTHY, M. D.

Removal of Placenta. Editor MEDICAL WORLD:

I have been somewhat pleased and interested concerning the discussions that have taken place in THE WORLD, and more especially concerning the third stage of labor.

We all know the old adage about doctors disagreeing, and they all seem to have an opinion of their own on the subject, and they are not afraid to let that opinion be published.

Last Friday morning I was called in haste to see Mrs. H., and found she had gotten through the first and second stages of labor alone.

They had been waiting for nature to complete the third, but had been waiting in vain, so sent for help. When I reached there I found her panting and gasping for breath; in fact, all the symptoms of post partum hemorrhage.

I hastened to work, for here moments were precious, for a young mother's life hung in the balance. Pains she was having, but no progress.

The proper remedies were given, and a quick examination showed a womb that was partly full of blood and placenta. I introduced my hand gently, removed the clots, and at the same time a pain came, and, grasping the placenta, I removed everything and bleeding stopped. The mother said, "I feel so comfortable now. I stayed with her until danger was past, and then left, to continue my work, happy with the thought that I had heard the calls of nature, answered her, and assisted her to save another precious life.

But THE MEDICAL WORLD, the visitor that I find myself looking forward to welcome each month, came that night, and reading the discussion concerning the third stage of labor, my jaw fell. I had done wrong to-day. I ought to have sat down and watched nature finish her work, if it had been twenty four hours doing it; but it would not have succeeded in this case, for the mother never would have lived for the work to be accomplished.

Brother physicians, did I do right? I am young yet, and if I am not doing right I shall be doing a lot of mischief before I am called to strike work, if I l ve. The mother is doing well under the treatment. I believe we are only nature's assistants, but we must be quick to hear her calls and hasten to her help. I never have left the placenta alone for one hour before I found the reason for its not coming along, and if it needs my help it gets it, and yet I never had bad results from the practice.

I never had a patient that did not get up quickly from childbirth. I don't assist in the third stage of labor for the comfort of myself, but for my patient; for I find that if I wait for any length of time that the mother is suffering

both in body and mind, for she well knows something is wrong and her life is not safe until all is right.

With my left hand I always follow the contraction of the womb in last pain of the second stage of labor, and know where the placenta is, and there act accordingly. As a general thing it lays in the mouth of the womb, for with the finger you can move it a little to one side, and in moving you excite a pain and all is over, and you save your patient much pain in body as well as distress of mind.

I never have seen bad results from quick removal of placenta, but have seen hour-glass contractions and post partum hemorrhage by not being at the bed-side at the end of the second stage to help in the completion of the third stage. F. D. Badger, M.D. Coventry, Vt.

Quiz Column.

Questions are solicited for this Column. Communications not accompanied by the proper name and address of the writer (not necessarily for publication). will not be noticed

The great number of requests for private answers, for the information and benefit of the writer, makes it necessary for us to charge fee for the time required. This fee will be from one to five dollars, according to the amount of research and writing required.

Tonsils and Virility.

The only responses to our suggestion in April WORLD, giving cases, contradict the theory there mentioned. This agrees with our own observations.

Dr. J. G. Snyder, of Osborne, Kan., asks advice in a ca e as follows: "Patient when he goes to sleep cannot be aroused unless smothered with a pillow, or something to cover the entire face, although he will arouse, if left to himself. He will converse intelligently when asleep."

In the October, 1888, WORLD, page 362, is a short article on a drink for chronic diarrhea. To the directions must be added: for each dose boil a sufficient quantity of the powder with water to make a cupful of the preparation cf the consistency of rich chocolate.

Correction.

In the December, 1888, WORLD, page 438, the first prescription in the second column is incomplete. The quantity of fluid extract of hydrastis should be fl. oz. j. At the last should be: Aquæ rosæ, q. s. ad. fl. oz. iij.

Naphthol Hypertrophied Tonsils. Editor MEDICAL WORLD:

Would like to know dose of beta-naphthol,

and uses.

What is best treatment for hypertrophied tonsil, where knife, etc., are objected to? Patient, aged 6, healthy, good parentage.

Avonmore, Pa. W. FREDERICK, M. D.

[Beta-naphthol is used in parasitic skin diseases, locally, in a combination of from one per cent. to ten per cent. with vaseline, lanoline, lard, oils, ether or alcohol. It should not be applied too freely over a very large surface, as it is diffusible and has caused toxic symptoms.

For hypertrophied tonsil the best of all remedies is the electro-cautery.

Excision or astringent gargles are next to be thought of. Of the latter there are many favorites, including sulphate of zinc, hydrastis, tannic acid and vegetable extracts containing it, etc. Bartholow recommends the injection of tincture of iodine into the substance of the gland. -ED.]

Strophantus.

Editor MEDICAL WORLD: Can you give in your journal anything in regard to the therapeutics of strophantus ? H. D. CHAMPLIN, M.D. 103 Jennings ave., Cleveland, Onio.

[The literature regarding strophantus is, as yet, quite meager. It is used as a substitute for digitalis in cardiac weakness from various causes. Its advantage over digitalis is claimed to be that it does not contract the arterioles, while it hastens the venous circulation—a most important aid to an over-taxed heart. It may be termed mainly a "symptomatic" drug. It is claimed to have no cumulative effects.-ED.]