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THE MEDICAL WORLD.

The knowledge that a man can use is the only real knowledge; the only knowledge that has life and growth in it and converts itself into practical power. The rest hangs like dust about the brain, or dries like raindrops of the stones.—FROUDĖ.

The Medical World.

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We wish to call the attention of our readers to the importance of recognizing this condition early and correcting it. Many cases of convulsions and other reflex nervous disturbances in male infants can be traced to a contracted and adherent prepuce, and at once disappear upon a correction of the defect. But more important than this is the fact that many cases of nervous irritability, hardly recognized as a distinct pathological condition, and hence not usually treated at all, are due to the constant irritation of an imprisoned glans, and the accumulation of smegma behind the corona. This constant irritation, kept up until, in after years, the boy reduces it himself, exerts a very deleterious influence upon his health. It renders him nervous, timid, more liable to incontinence of urine, and to contract vile habits at puberty. It lowers the general tone and vitality of the individual.

Remove this condition, and you soon have

a happy, sweet-tempered child.

The teeth are usually the scape-goat for this state of affairs, whether guilty or not. Do not lance the gums until you have carefully examined for other causes of irritability.

How shall the phimosis be reduced? The old Mosaic operation of circumcision is an excellent hygienic procedure, but is rather a delicate operation, and always a bloody one.

Prof. Stewart, of the Medico-Chirurgical College, Philadelphia, has devised an ingenious instrument, called Stewart's Preputial Dilator, by which the contracted fore-skin is gently dilated and can then be stripped back, washed and anointed with cosmoline, the whole operation seldom bringing a drop of blood. It then requires close attention on the part of the mother for a few days, washing and anointing it, to prevent it from contracting and adhering again. We think this is the best operation in the hands of the general practitioner.

When should it be performed? From one week to twenty years of age, as soon as the condition is clearly diagnosed. The sooner, the more easily it is performed and the better the results.

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"how few and inexpensive articles can we get along with and still do good work?" welcome this sentiment, because it makes antiseptic surgery possible under any and all circumstances. While the dry antiseptic dressing, undisturbed until healing has taken place, is best where it can be applied, yet we know that it is possible to do good surgical work without it.

Chloride of ammonium, in solution of an ounce to a pint and a half of water, with a slight addition of alcohol, makes an ideal lotion in all kinds of surgical operations, cuts, crushes, lacerations, etc. The chloride of ammonium, besides being antiseptic, has the power of stimulating organic cells to action, so that apparently dead tissue is stimulated to contraction by it as by galvanism. Try this on the heart of a chicken, rabbit or fish, and you will see the demonstration. By this means bad crushes may often be successfully treated that would otherwise require amputation or result in death of the part; also a constant lotion of this mixture will often restore parts in which gangrene is actually threatening.

A solution of the hyposulphite of sodium, one to two ounces to the pint, has proven a very efficient surgical lotion in our hands; as much so, in fact, as we could wish.

As lotions from the plant world, tincture of calendula stands easily at the head, with a reliable preparation of arnica next. They are much more expensive, however, and, we think, not a bit better than those above suggested.

For a powder to be used in the dry dressing we prefer oxide of zinc, thoroughly triturated with one part of corrosive sublimate to one thousand, instead of iodoform. This makes a pleasant agreeable and safe dressing, and is not open to the many objections of smell, poisonous absorption, etc., which we meet in the use of iodoform. We think the process of surgical dressing is destined to be progressively simplified during the next year or two.

J. J. T.

Prophylaxis in Chloroform Anesthesia. There are certain anesthetics which are dangerous by reason of their action upon the heart. It has long been recognized as proper to precede the administration by a dose of

some cardiac stimulant, as morphine, brandy or digitalis, to guard the heart. We would suggest one other important procedure-reduction of the quantity and fluidity of the blood. This may be done by a strictly dry diet for several days preceding the occasion, or, when there is not time enough for that, the induction of gentle diuresis, diaphoresis and hydragogue catharsis for a day or two preceding. Of course this plan is adapted only to premeditated operations, and not to cases of injury requiring immediate surgical attention. J. J. T. .

WE notice in an eclectic medical journal that the hospital of Springfield, Ohio, is to be under the administration, during alternate years, of the physicians and of the eclectic physicians of that city, that the two modes of practice may be observed and compared. We heartily approve of this, as we think that the absolute truth can be better brought out by this means than by all the discussions in the universe. We believe that there is much merit in both methods of practice, and that they are yearly coming closer and closer together by the influence of sensible men of each system, who are selecting the best out of the other, until, finally, there will be no difference at all -nor will there be any distinctive title other than physician or doctor.

DOCTOR, you owe it to yourself and to your family, as well as to your profession, that you send out your bills regularly, and collect closely from all those who are able to pay, and to strictly refuse further attention to those who are able to pay but neglect or decline to do so.

A great many have failed to notice the announcement in January WORLD, page 38, that the price of the Red Cross M. D. Badge was necessarily advanced to $2.co, as their cost is much greater than we at first thought.

We are pleased to see that those who are ordering them are men who can bring the best of credentials, men of spirit, who approve an idea upon their own independent judgement. County medical societies are adopting it officially, and gradually it is becoming the modest insignia of friendly recognition among the bet

ter class of medical men.

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The Naval Medical Examining Board Is now in session at the U. S. Naval Hospital, Philadelphia, for the examination of candidates for admission into the Medical Corps of the Navy as assistant surgeons. The Board will remain in Philadelphia until the 31st of March, 1889. After the 1st of April, 1889, the Board will hold its sessions at the Naval Hospital, Brooklyn, N. Y. There are fourteen vacancies in the grade of assistant surgeon. Further information may be obtained by addressing the President of the Examining Board.

J. MILLS BROWNE, Surgeon General U. S. Navy.

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The Current Medical Thought.

Nerve Impulses.

"All day long, and every day, multitudinous afferent impulses, from eye, and ear, and skin, and muscle, and other tissues and organs, are streaming into our nervous system, and did each afferent impulse issue as its correlative motor impulse, our life would be a prolonged convulsion.

As it is, by checks and counter-checks of cerebral and spinal activities, all these impulses are drilled and marshalled and kept on hand in orderly array till a movement is called for; and thus we are able to execute at will the most complex bodily maneuvers, knowing only why, and unconscious or but dimly conscious how we carry them out."

PROF. RANNEY.

Vertigo from Constipation.

BY B. W. RICHARDSON, M. D., F. R. S.,
Of London, England.

Persons who are accustomed to have a regular action of the bowels every morning are usually affected with giddiness or vertigo, or with a sense of faintness, if the natural habit be, by any accident, omitted. The reason is a very simple one, and is purely mechanical. The regular habit causes the rectum to be loaded with feces, and when the rectum is loaded there is pressure on the surrounding veins. But, as I have shown by direct experiment, the cerebro spinal fluid finds its way into the venous circulation by the inferior vena cava and the common iliac veins. When, therefore, there is pressure, causing impediment to the venous circulation in the pelvis, there is at once an interference with the process of escape of the cerebro spinal fluid, and pressure upon the whole of the cord, up to the cerebrum itself.

The form of constipation here referred to is in the rectum, and must not be confounded with constipation due to accumulation or inaction in the colon. Vertigo with constipation, and with the patient connecting the uneasy cerebral symptoms with the constipation, is an indication that the rectum is loaded, and that relief will follow from a brisk aloetic purge. The Asclepiad.

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TREMONT, Pa.

Dear DOCTOR TAYLOR.-I received the Visiting List and am very much pleased with it. With the many works of the kind in the market, it seems strange now that no one ever conceived this style before. I think it is as nearly perfection as one can get. I have been using one kind or another for thirty-eight years, and this beats them all. Yours Truly, Jos. W. BIRD.

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3. Their introduction is followed by intense butyric reaction, most marked after hydrochloric acid.

4. Larger quantities of the acids produce a considerable effusion of bile into the stomach.

5. They stimulate, very actively, the secretion of pepsin, but have no more influence upon the secretion of hydrochloric acid than so much distilled water would have.

6. Their long continued administration is followed by marked diminution of the secretion of hydrochloric acid.

7. Even in large quantities hydrochloric acid produces no gastric disturbances. On the contrary, a continued administration of the acid is attended with a feeling of well-being.

8. The difference in the effect between acids and the alkaline salts on the gastric functions consists in the fact that the alkaline salts dissolve the mucus and decrease the secretion of pepsin, while the acids precipitate the mucus and increase the secretion of pepsin. The disappearance of the alkaline salts from the stomach is followed by a decided increase of the hydrochloric acid secretion. This does not occur, or only to a slight degree, in the case of acids. Both the acids and salts, in large quantities in continued use, have the same effect in lowering the activity, and finally in destroying the function of the glands secreting hydrochloric acid.

Experiments with the introduction of carbonic acid into the stomach, either in gaseous form or dissolved in water, show that this acid has the property of stimulating the peptic and acid functions of the stomach, and in that way increases its digestive power.-N. Y. Med. Journal, Jan. 19, 1889.

To Remove Tattoo Marks.

Tattoo marks may be entirely obliterated by pricking each spot with a needle until it bleeds, then injecting a solution of tannin, and finally cauterizing with nitrate of silver. The mark is effaced in about four weeks, after passing through many shades of color, like the slow disappearance of a "black eye.'

Curious Facts Regarding Various Liquors.

Glycerine and succinic acid are constantly. present in all wines in varying proportions. Fusel oil is found in low class whiskey and brandy, especially in those prepared from pota

toes and beets. It is a most deleterious and objectionable product of fermentation, and has to be removed by rectification with sulphuric, muriatic, or nitric acid. This process causes the formation of acetic ether and acetate of amyl, giving a pleasant, "fruity" flavor to the spirit; whereas, fusel oil is pungent and penetrating, causes gagging and nausea, and injures the coats of the stomach. The best spirits are made from rye, wheat, or barley, or a combination of these. Rum is made from molasses, or from the sugar cane direct. Pelargonic ether and essence of pineapple are used as flavoring ingredients. An inferior brandy is made in Germany from potatoes, and sold as cognac. It contains much fusel oil. Good spirits are also distilled from old wines in France and Spain. They produce the best brandies: and the residue of these old wines left over after distillation contains sufficient glycerine to be utilized for other purposes.

Bloodless Treatment of Ingrowing Nail. Dr. Patin recommends the following procedure for removal of ingrowing toe-nail, which he has employed with excellent results in all of his cases. After thorough cleansing of the nail, a solution of gutta percha 10 parts, in 80 parts of chloroform, is applied with a brush to the interstices between the nail and the granulations. This is repeated several times on the first day, and subsequently at longer intervals. By exercise of care and patience it will be found that the nail is gradually lifted from the underlying parts, and can then be removed without pain with the scissors. If a properly fitting shoe is worn no recurrences need be apprehended. The solution applied in this manner exerts a double effect, the chloroform is anesthetic, and the gutta-percha acts mechanically, forcing its way between the granulations and the nail, and finally liberating it from its abnormal position. -Gaz. des Hopitaux.-The Clinical Reporter.

Jaborandi.

In an article in the Medical and Surgical Reporter, Dr. J. B. Carrell, of Hatboro, Pa., recites the value of this drug in a variety of diseases. He says, "In the early stages of pneumonia-that is, in the congestive stagecharacterized by sudden rise of temperature, throbbing pulse, dryness of skin, hurried and difficult respiration, chilliness, etc., I will put

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