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the facial nerve, and we yawn.
ousy, or what?
m x1 gr. xxiy
.dr. ij .dr. ij
B Potass. bicarb.,
åā dr. iss
.dr. iss Liq, ammon, acet.
ad oz, viij For one dose, with dr. ss of citric acid in oz. ij of
Two tablespoonfuls with a tablespoonsul of lemon. water, in acute rheumatism.
juice, three times a in " gouty" headac B Lithiæ citrat...
dr. iiss One teaspoonful in hot lemonade, every two hours, in
Tinct. aurantii. muscular rheumatism.
..ad oz, iv
One tablespoonsul, in water, three times a day, la B Ammonii sulphide..
gouly headache. Tinct, aconiti.
.m xij Aq. menth. pip..
B Potass. iodidi. One-fourth part every four hours, in acute rheuma
Potass. bicarb. tism,
Ammon, carb.. & Tinct. guaiaci ammon.
.ad oz. viij
Two tablespoonsuls thrice daily, in rheumatic headAq. cinnamomi.
.ad oz. viij
ache. Two lablespoonfuls every four hours, in chronic rheumatism.
Cold bath, or cold wet pack, in acute rheumatism
R Vin, colchici, .
partes equales. Ol. gaultheriæ, m xx, ter die, in subacute rheuma
Aq. chloroformi.. tism.
Dr. j ter die, in chronic rheumatism. B Liq. arsenicalis..
Osmic acid, me iv (100 per cent. sol.) hypodermi. Potass. iodidi.
cally, in muscular rheumatisın. Syr aurantii
.07. ij One teaspoonful, in water, three times a day, in mus R Chloral hydrat.
.dr. j cular rheumatism.
oz. j & Succi limonis...
Misce. As an ointment, in acute articular rheumaSyr. limonis.
tism. Inf. chiralco.
,ad oz. viij Two tablespoonfuls three times a day, in subacute rheumatism.
Those articles of food which contain the
largest percentage of nitrates are the best buildB Acidi salicylici,
ers of the muscular system ; phosphates are Potass. bicarb..
.åà dr. v
most needed for the nerves and brain; carbonAq. dest..
ates help to form the fat. Dissolve and add
Beans, peas, oats, Tinct, nucis vom..
salmon, eggs, beef, all contain plenty of ni. Sp lavand. co..
. dr. ij
trates; the same foods, and, in addition, codSyr, simplicis.
.ad oz. iv
fish, contain an abundance of phosphates; One teaspoonsul, in water, every three hours, in butter, rice, cabbage, corn, beans, provide the acute rheumatism.
carbonates. Eggs fried in butter, or codfish & Potass. iodidi.
similarly treated, constitute a perfect fleshVin, colchici,
former. Syr. simplicis.
.āä oz. ss Aq. menth. pip..
Hemorrhage from wounds of the scalp is One tallespoonful three times a day, in subacute generally arterial, although it does occur, as a rheumatism.
rule, in jets. It is to be recognized by its color.
Venous hemorrhage from the scalp is of course B Ext. jaborandi A...
darker in color, and indicates injury of the Soda bicarb. Aq. dest
..ad oz. iv
cerebral sinuses. One teaspoonful every three hours, in acute articular rheumatism.
If a little bile be added to human blood,
small, right-angled crystals will soon develop; B Ammon carb...
horse's blood will develop cubes; pig's blood, Vin, colchici,
..dr, ss Tinct. aurantii.
right-angled prisms; sheep's blood, rhomboidal Aq. dest
.ad oz, iss
plates ; chicken's blood, cubes, more or less One teaspoonsul, in Apollinaris water, every four
regular; but the blood of a dog will present hours, in rheumatic headache.
precisely similar crystals to that of a man.
The Current Medical Thought.
Temperature in Jaundice.
In case of jaundice, the bodily temperature ""Knee-Jerk.”
is abnormally low, except in those instances
where jaundice is occasioned or accompanied “ Knee-jerk" is the most familiar and most | by a disease which of necessity begets fever. demonstrable of the tendon reflexes. It is When the liver is performing its functions naeasily tested by hanging the leg of the patient
| turally, much heat must necessarily be generaover the fore-arm of the physician, whose hand
ted by the rapid chemical changes involved in is meanwhile placed on the patient's other knee.
its work; but when these changes are lessened The leg should then be struck smartly with the
or held in abeyance, as occurs in jaundice, the edge of the hand (or with a percussion ham- temperature would fall, and no doubt affect the mer), upon the bare skin. Reflex contraction
whole system in like manner. of the quadriceps extensor muscle will be excited, and the foot will be involuntarily jerked upward. The manoeuvre should be tested on
For Bacchanalians. both legs, as a perceptible difference between | Half a teaspoonful of chloride of ammonium the two sides may indicate some pathological | in a goblet of water will almost immediately condition of the spinal cord. The absence of restore his faculties and powers of locomotion knee-jerk, however, is no posisive sign of dis to a man who is helplessly intoxicated. A ease. Reflex movements may be excited in wineglassful of strong vinegar will have the any sensitive part of the body, as the sole, the same effect, and is frequently resorted to by thigh, the buttock, the scapula, or the abdo drunken soldiers to enable them to return men. Foot-clonus, personal reflex, and tendo steadily to their barracks. achilles reflex are examples of deep tendon reflexes. “Knee-jerk” has been a common source Pain at the tip of the shoulder, so frequentof amusement among young people for years. ly sympathic of peptic disease, is also present
in cases of disease of the pancreas. The other Bones of the Insane.
symptoms include a deep aching pain below the In many cases of insanity, the osseous struc centre of the epigastrium, radiating through to tures undergo certain pathological changes, the back, chest-walls, and left lumbar region. which render them peculiarly liable to fracture on the application of very moderate force-a When the muscles of the orbit are paralyzed, degree of force in no way commensurate with
without any apparent local trouble in the eye or the effects produced. This condition espe.
brain, rheumatism will be the most likely cause, cially affects the ribs; and attendants on luna
| or else some lesion of the spinal cord. tics are open to charges of unnecessary violence, when the patients may have received their injuries through the unnatural brittleness
An enema of a strong infusion of green tea of their own bones a condition known as
has acted antidotally in a case of opium poisonosteomalacia.
Frequent doses of antipyrine often change Talipes and Spina Bifida.
the color of the blood to a rich chocolateTalipes calcaneus in infants is commonly | brown. found associated with spina bifida. When the foot is drawn up permanently towards the fore
The Danger in Medical Abbreviations. part of the leg, with great prominence of the We doubt whether many practitioners of heel, a tumor constituting spina bifida may be medicine who are accustomed to write prelooked for in the lumbar spine. Club-foot is scriptions daily realize the danger their patients also frequently thus associated.
run through abbreviated formulas. Some physicians affect an extreme brevity, as if it inti
mated their superior familiarity with the maThe hysterical paralysis of the bladder, which teria medica One of the best we ever knew is not infrequently met with in young females, always wrote out fully the names of the drugs generally yields to the administration of ergot in a clear hand, and took time to do it. How and strychnine ; say half a drachm of liquid many sick persons have been poisoned by excuextract and five or six minims of liquor strych sable mistakes on the part of the druggists in niæ (P. B.) in chloroform water, three times a deciphering prescriptions it would be difficult day. Of course the catheter is sometimes, but to say, and the many jokes said to have been not always, required.
practised on drug clerks whereby meaningless
scrawl was translated into a bottle of some com Dr. Mathews on the Treatment of Hemorrhoids. pound, have a basis in fact. From an exchange the following list is taken, Association, Dr. Joseph M. Mathews, Professor
At the last meeting of the American Medical which shows how some common modes of ab
of Surgery and Diseases of the Rectum in the breviating may be interpreted to mean severally Kentucky School of Medicine, Louisville, read from two to five different things, some poison
interesting paper on the above subject. He ous :
thinks that hemorrhoids is a disease of middle May mean Acidum Hy life, and that they seldom affect children and Acid. Hydroc. drochloricum, or Acidum
old people. He also thinks that there is no Hydro cyanicam.
anatomical basis for the classification of hemorAcontine.
rhoids into venous, arterial, capillary, etc. As Aconit. Aconiti Radix.
to treatment, he was opposed to carbolic injec(Aconiti Folia.
tions from the start, and he gives the conclusions Ammonia (alkali.)
of Dr. Andrews against this method, although Ammon. Ammoniac (gum-resin.)
he does not seem to have tried them himself.
It is true that there has been some bad effects Aqua Chlori
from this method; but it is now claimed by Aqua Chloroformi.
some of the later writers that these all arise from May often be read Aqua Aq. Fontis.
the use of too strong a solution of the acid, and Fortis.
that with the use of a solution of from seven to Chloride of Calcium. Calc. Chlor.
fifteen per cent. the method is perfectly safe. Chlorinated Lime.
Dr. Mathews also opposes dilation of the Chlorine.
sphincter, claiming that it is impossible to Chlor. Chloroform.
remove or cure a well-developed hemorrhoid in Chloral.
Above all other methods he favors Emp. Lytharg (lead plas.
ligation, and his remarks upon this method are ter, old name.)
well worthy of quotation in full. Emp. Lyt.
Emp. Lyttae (blistering “The Ligature.-Certainly, of all known plaster.)
methods, the ligature stands preëminent as an
operation for internal hemorrhoids. It has (Extractum Colchici. Ext. Col. Extractum Colocynthidis.
stood the test of years in the hands of the most
eminent surgeons. To-day it is the most popuCalomel.
lar method. Easy of execution, free of danger, Hyd. Chlor. Corrosive Sublimate. Chloral Hydrate.
and rapid in its results, it can but command
the attention of all who are interested in this Hydrargyrum (mercury.) operation. To the principle involved in the Hydras (hydrate.)
use of the ligature all are agreed, but the method Hydrochloras (hydro of application is to a certain degree disputed. Hydr. chlorate.)
The method, as practiced by Mr. Allingham, Hydrocyanas (hydro is to dissect the hemorrhoidal tumor away from cyanate.)
its attachments, and then to surround the Hydriodas (hydriodate.)
remainder, at its base, with a tight silk ligature. Ammonia Mixture.
For the first few years in special practice I did Mist, Ammon. Mixture of Ammoniac
the operation after this plan. I then modified (gum resin.)
it for these reasons : 1. It was misleading to Hydrate of Potash
teach students after this fashion, because there Potass. Hyd. (caustic potassa.)
was much danger in their dividing the artery Hydriodate of Potash which supplied the tumor. 2. There was more (iodide of potassium.)
cutting than was necessary. -Phrenological Journal.
“The modification consisted in running a delicate knife around the base of the pile, simply
going through the integument. This saves any The habitual use of macaroni is said to be a
deep cut, and, at the same time, removes all cause of acne.
superfluous skin, or external piles. Indeed,
there are many cases of internal hemorrhoids The uvula is only found in men and monkeys. which require no cutting at all. This point is
not sufficiently brought out in the books. I Pepsin helps to destroy tape-worm by diges allude to the large internal piles which have no tion.
complication as mentioned here, viz. : super
fluous flesh, or external piles. These require benefit in these operations. In the removal of only to be brought in sight, ligated and returned external piles much benefit is derived from into the bowel. Much stress is laid upon the throwing the solution under the growth. In degree of tightness that should be accorded the the operation for internal piles I have found it ligature; some saying apply it loosely, others of little value. advising it to be drawn tightly. I am sure that “Antiseptics. Unfortunately, strict antithe tighter a ligature is drawn, the quicker and sepsis cannot be practiced in these operations. more effectual will be the cure. A point is Fortunately, it is not as necessary as when made in suggesting the kind of material to be operating elsewhere. I am in the habit, howused in the ligature. Many preser silk.
ever, in all these operations, of having strict in the habit of using the stoutest linen thread, surgical cleanliness as regards both the person such as is used by saddlers or shoemakers. The ; and instruments. If any cutting is done, the twist of silk, or other material, I am sure, has parts are dusted freely with iodoform, and the nothing to do with it, as some seem to think it gauze of the same applied over the wound. has. The kind of knot to be tied is spoken of, “Results.--As the caption of this paper Mr. Allingham remarking that he ties the knot intimates, I have operated about one thousand three times. Twice is quite sufficient, and the times for hemorrhoids by the ligature. I have surgical knot has no advantages over the com never had to operate the second time upon the mon hard knot. All internal piles existing same patient for the affection. Have never had should be ligated at the same sitting, and all an unnatural contraction around the anus as the returned into the rectum. The greatest care result of the operation, nor had ulceration or should be taken in cutting off the tumors after stricture to result. I have had in this time one ligating It is much best to leave the whole case of tetanus, which I believe to have been mass, rather than to have one ligature slip after superinduced by a debauch, the patient having returning the tumors into the bowel. The : been drunk for several days before the operation. presence of the mass in the gut cannot result in 'The tumors protruded, strangulated and mortiany harm; the ligature is between it and the fied, hence the operation. He recovered from circulation. As a rule, then, it should not be the tetanus under the bromide treatment. Have cut off. A number who have written upon this . had one case of secondary hemorrhage occuring subject say that the bowels should be confined on the third day. The rectum was plugged and for from five to seven days, and a light liquid the bleeding stopped. Also one dangerous case diet enjoined. Certainly this is a mistake, for of hemorrhage which occurred one hour after two reasons : 1. In this length of time the feces operation was done, in consequence of the slipwill become hardened and impacted. 2. These ping of the ligature, the pile having been cut patients generally require all the nourishment
The patient was pulseless and cold when they can get. When following this advice I
but the artery was quickly secured and have had as much, or more, trouble result from tied, and he made a good recovery. I have impaction, than from the original operation: never had a single death result from the operaMy habit is to purge the patient the day of the tion, and but few untoward symptoms." operation, and to give an aperient on the second day after the operation, and each succeeding day thereafter, until the patient is discharged. A poisoned finger is an example of erythema, Consequently a full diet is prescribed if required. and frequently occurs to cooks, poulterers, and When operating under an anesthetic, I always the performers of post-mortem examinations. divulse the sphincters, more especially if any The member becomes swollen and inflamed in cutting is done. This prevents the contracting the neighborhood of the puncture, and red of the muscles, hence obviates much pain when lines spreading up the arm represent infamed infiamed.
lymphatic vessels, leading to the glands in the
axilla, which will also be probably enlarged. "Anesthetics.--It is often asked if the opera
Whitlow affects the distal phalanx of the finger, tion for internal hemorrhoids can be done
and is accompanied by the formation of pus without the use of anesthetics. If the sphincter and loosening of the nail. If there is no evimust be divulsed because of the complication of dence of pus near the surface, the inflammation fissure, ulceration, or what not; or if any cut
is in the periosteum, and the symptoms will be ting is to be done, then an anesthetic is abso
1 more acute. lutely necessary. If internal hemorrhoids exist without any such complication, and protrude well in response to the bearing down effort, Stricture of the esophagus causes no real difthen an anesthetic is not necessary. It is often ficulty in swallowing ; but the food persistentsuggested that cocaine could be used with ly regurgitates into the mouth.