speak of nourishment; beef-tea, milk, milkpunch, poached eggs, rice, etc., were given every three hours, day and night, as regularly as medicine. I consider nourishment essential from the begining of the disease.

Dr. P. was compelled to withdraw from the case, owing to a pressure of business. I continued the above treatment, only making a few changes to meet symptoms as they came up. The patient was declared convalescent on the 30th day, and has made a speedy recovery.

Since I took charge of the case, four other members of the family have been stricken down with the same disease, although I made every attempt to prevent its contagiousness by disinfecting stools, bed linen, etc. I followed the above plan of treatment with all cases with the same happy result.

I will state for the benefit of your readers that I have treated 26 cases of typhoid fever, all pretty much on the above plan, with the loss of only one patient, and that case was complicated with facial erysipelas; but before closing, must acknowledge myself indebted to my friend Dr. Clanton for valuable assistance rendered in some of the other cases.

Minor points of treatment, though very important, I have neglected to mention, such as acid baths, twice or three times a week, and changing of the clothing and bed linen every other day, etc. Hope, Texas.

SI YOUNGKIN, M. D.
An Unexpected Babe.
Editor MEDICAL WORLD:

One morning, in the spring of 1883, I was called early to see the wife of a patron. The messenger said she was suffering with pains in the bowels, and was in great distress. I hastened to the bedside and found the woman half through labor; in fact, the peculiar cry of a new-born babe was the first sound I heard on opening the door. In a very short time the placenta came away. In the meantime a few neighboring women had been summoned, fires started, and preparations were soon well under way to care for the new arrival. To one of the women, the mother said, "there isn't a dud made for the baby, for I didn't expect one." This unusual state of affairs excited my curiosity, and I proceeded to elicit from the mother the following almost unbelievable story:

She said she had no idea, at all, that she was in the family way. Ten or eleven months previously she had given birth to a child, as she had done a like time previous to that. So it happened for nearly three years her abdomen was either enlarged or enlarging, and at no time had it had any time to resume the normal condition. It was in a relaxed flabby state, and

so it happened that she did not notice the enlargement which otherwise would have excited suspicion. From the patient's mother I learned that she had had no intimation of such a state of affairs. I am therefore well satisfied that this woman conceived, bore a child to full term, and completed the second stage of labor without ever admitting to herself the possibility of her being in a pregnant condition.

I have never read of a similar case. Maybe some of the WORLD'S readers have. Le Claire, la. J. A. DE ARMOND, M. D. The Opium Habit.

Editor MEDICAL WORLD:

The opium and allied habits are receiving more and more attention at the hands of specialists. In the profession at large there still exists a degree of skepticism in regard to the permanency of the cure of these habits, those, however, who are best qualified to judge are of the emphatic opinion that the habit can be so completely broken up that the patient will have no desire for his former narcotic; and that, too, in a short time without much suffering, if he has the benefit of skilful medical treatment. A few do break the chains that enslave them, after a desperate struggle, by a sheer force of will; but if the attempt is unsuccessful (and it generally is) they are utterly discouraged; so it is desirable in the beginning to give the patient all the advantages which science can afford.

The first condition of success is that the patient shall unreservedly place himself under the care of a competent physician. It is better for him to go to his physician's residence, and become his guest during treatment, than to remain in his own home. He needs at all times to be kept under watchful eyes.

The treatment should begin by rapidly reducing the narcotic. The first day the patient may be allowed one-half or two-thirds his usual quantity. The second day's dose should be onehalf what was taken the first day. The amount used each succeeding day should be less and less for eight or ten days, when the narcotic should be entirely discontinued.

Sooner or later in these cases the patient is nervous by day and sleepless at night. Vomiting and diarrhoea sometimes occur. Neuralgic pains in various parts of the body distress him, while profound exhaustion, bordering on collapse, is experienced. The skilful physician. has it in his power to materially control these conditions. For the nervousness and insomnia the bromides and cannabis indica, given in full doses, are valuable. Chloral is also a powerful agent. Its actions should be critically watched. Vomiting and diarrhoea are usually easily arrested by ordinary measures. Neuralgia yields to the

Strychnia, ammonia, capsicum, arsenic, coca, with wine and brandy, all have a place in the treatment of the opium habit; also, beef tea, chicken broth, eggs, when they are borne by the stomach, and plenty of milk with lime water. To this list may be added, as convalescence advances, some of the bitter tonics, as compound tincture of gentian. Spirituous liSpirituous liquors should only be administered when the danger from collapse is imminent.

The time necessary to break up these habits varies; but in ordinary cases convalescence begins in two weeks, and in from two to four weeks more the patient's health is regained. The period of treatment is brief contrasted with the great benefits resulting from it. The patient improves in flesh, strength, and disposition.

The writer has become very much interested in the subject, and for the purpose of obtaining more information, most earnestly requests all readers having cases to answer the following questions:

A. The manner in which the habit was contracted.

B. The preparation used.

Before medicine can lay claim to a scientific basis, we have much to learn and much more to unlearn.

In time, all the isms and pathies will merge into the simple, but universal and untrammeled | study of medicine; and practitioners and schools of medicine will unhitch all the useless and insignificant "ics" and "thists" from the terminations of their names.

We shall all grow tolerant of each others vagaries and individual opinion, even if they be! sometimes mere whims and baseless caprices. To be a Physician, will be the sole ambition of the future medical student. But that happy day may be nearly as far off as the mythical millenium.

Fungi always cling to dead and dying objects, --never to thrifty living ones.

The medical practitioner of the future, which is a convenient phrase to fall back upon when we want to indulge in a harmless dream of possible utopia-will not be an apologist

appreciation and recognition whenever shown, while stupid ignorance and stolid indolence, dressed up in broadcloth, will not win the highest seats at the feast and the largest rewards of pelf and place.

Nor will the asses of the ilk be formally sustained, tacitly endorsed or officially apologized for, simply because somewhere in the past they wheedled or bought a reputable and recognized school into granting them formal and "lawful” credentials!

Who records, with a flourish of trumpetsand certificates the cases of spontaneous recoveries from various acute and chronic diseases? Their number is legion, their history is nil. They do not appear in the archives of medicine, but they occur constantly, in every community, as a caustic criticism of our boasted knowledge and skill!

NEW YORK.

Treatment of Pneumonia. Editor MEDICAL WORLD:

I have had a good many practical hints from your valuable journal, and think it not amiss to exchange thoughts with my medical brethren; and as pneumonia is a very prevalent disease at this season of the year throughout the country, and often fatal, I will give the treatment which I have found eminently successful, having rarely lost a case for some years past.

If called in the early stages, I at once commence with the tincture of veratrum viride or aconite, from one to three drops every hour, until temperature is reduced and pulse brought near the normal standard, and in this malarious district, a ten grain dose of calomel with a grain or two of podophillin. This also keeps down the temperature. In a day or two I commence with my chloride of ammonium mixture, which is as follows:

Mix. Sig. Tablespoonful every hour or two. In this I sometimes add carb. ammonia. Here we have a defibrinating antiphlogistic and resolvent in the ammonia, a refrigerant and alterative to the mucous membranes, and at the same time organizing agent to the partially discarbonized blood in the chlorate of potassium; in the senega and licorice an expectorant and demulcent, and at the same time a nervous sedative; the chloroform checks the cough and quiets the system. This mixture I continue throughout, giving milk toddy as occasion

requires. Locally I use hot mush poultices to the affected side in the beginning, followed in a day or two with a large blister. I also manage to get from 12 to 15 grains of quinine into the patient during the remission that generally occurs at morning. If called several days after the attack, I commence with the ammonium mixture at once.

The above treatment will cure nine-tenths of the cases. Of course I vary the treatment according to the condition of the patient, idiosyncrasies and complications. No one prescription can be invariably followed; we cannot practice physic successfully by prescriptions from books in all cases, but must be varied according to the judgment of the practitioner. Ergot has -- been highly lauded, and I think it very useful in congestion of the lungs; but it cannot take the place of other remedies in active inflammation of these organs.. Port Conway, Va. Death of Child in Utero. What Was the Cause? Editor MEDICAL WORLD:

W. N. JETT, M. D.

I am young in the practice of medicine, and wish to gain all the light I can from the experience of others. Therefore I make the following report and ask you, Mr. Editor, or some of the experienced readers of THE WORLD to give their opinion.

I was called to see Mrs. F, July 20th, 1884. I found her in the eighth month of pregnancy, with general anasarca, this condition being the reason of my being called. I learned that her age was 24, pregnant for the first time; the urine I found very heavily loaded with albumen.

I showed a specimen of the urine to an old practitioner, and his opinion was that the mother was in a critical condition and that the child would be still-born. I treated the woman with tonics and diuretics. Had no difficulty in reducing the anasarca and removing the appearance of albumen from the urine. For two weeks previous to delivery no movement was felt, and on August 26th, I delivered her of a still-born child, shoulder presentation. Ishould judge that the child had been dead for a week or more, as the cuticle readily come off, and the bones of the skull were dislocated and movable one upon another. There was no unpleasant odor to the waters, and absolutely no hemorrhage from the womb. Woman made a good recovery.

On November 18th, 1885, I was called again. Found t'e woman in labor at eight months, as she claimed, pains irregular and in front. Made a digital examination; found that the mucous plug had been discharged; could insert my finger into the os, which was soft; the

neck of the womb was not much shortened and the internal os did not seem to be open, and the pain did not affect the womb; at least I could not perceive any change in the condition during pain and in the absence of pain. So, after waiting for two or three hours, I made a second examination. No change; pain dying away; I left. In one week was called again, and delivered the woman of a dead child, shoulder presentation; child had apparently been dead for a number of days.

This time there was no anasarca and no appearance of albumen during the course of gestation. The woman had been very well; had taken no medicine; had no hard work, and had taken every precaution that there might not be a repetition of 1884. There was no movement from the 18th to the 25th: On the 18th I could have taken my oath that the head presented. What I want to know is the cause of death in the second case, and the management that would have been instituted on the 18th, by those more experienced than I. I know what I would have done had I known what the result would be in one week. But. after the thief has stolen the horse we know very well what we would have done, had we known there was a thief preparing to steal the horse; but how was I to know of the thief?

If this, in your mind, is worthy of discussion, please reply in THE MEDICAL WORLD. Alton, Maine.

A. H. T.

[Any taint of syphilis or tuberculosis in family? If so, treatment for these conditions should be begun in early pregnancy and be continued throughout. Did the bag of waters break prematurely? Had you been able to fore see the death of the child on the 18th, how could you have prevented it except by inducing labor at once?—Ed.]

An Obstinate Case of Sciatica. Editor MEDICAL WORLD:

On the 12th of February I was called to see Mr. J. P. G., age 48, who previous to this attack had enjoyed exceptionably good health. On questioning him I learned that in his attempting to carry a stick of wood into the house he was suddenly stricken with a sharp intense pain in the lumbar region, and fell prostrate to the ground. In this position he was forced by the pain to remain till assisted in the house by his family.

then in less time than it takes to write these lines it will shift to the region of the knee.

tum.

In the way of local treatment I have used poultices, liniments, counter-irritants ad infiniInternally, morphiæ sulph., per orem and hypodermically in the region of the nerve, salicylic acid and salicylate of soda and potass iodide, with no material benefit.

For the last ten days his attacks have become periodical; coming on between the hours of nine and twelve at night. For this state of affairs I have given quinia sulph. heroically, and still he is not much better. Perhaps when some of my professional brothers read the above array of drugs they will wonder why he is not dead, instead of having any hopes of recovery. I will add that each drug was given a fair trial and discontinued before another was tried.

If any of your readers will give me a few hints in the next issue of THE WORLD, or by letter, how to cure my patient, I shall consider myself under lasting obligations.

Will the editor of THE WORLD, or some one in possession of the information, tell me the chemical constituents of the much vaunted antipyritics, thalline, kairin and antipyrin? Every medical journal I pick up now has something to say about them.

Wise, Ark.

S. H. SINGLETON, M. D. [Write to Messrs. Lutz & Movius, 15 Warren street, New York, for all information concerning kairin, antipyrin, etc.-ED.]

Inward Dislocation of Radius and Ulna at
Elbow.

Editor MEDICAL WORLD:

In your January number I noticed an article by Dr. W. W. Hester, of Anna, Ill., on "Inward Dislocation of Ulna and Radius at Elbow." Thinking it would be of interest to the gentleman to hear of other similar cases, I refer him to an article on the subject which appeared in The Weekly Medical Review, of Nov. 28th, 1885, page 431, in which seven (7) cases are mentioned. LOUIS HAUCK, M. D. 1903 Lafayette Ave., St. Louis, Mo.

[The following is the article above referred to.-ED.]

at

Dislocation of Radius and Ulna Inward
at Elbow.

BY LOUIS HAUCK, M. D., ST. LOUIS, MO. P. Burns, aged 13, was brought to our office noon on the seventh of September. A half-hour previous, while playing, he slipped on a banana peel and fell. Striking on the point of his right elbow and turning on this as a pivot he struck his right cheek and forehead.

On examination I found the external condyle prominent, olecranon lying over internal epicondyle, and the head of the radius on the

trochlea, where it could be felt rotating. A depression existed between the olecranon and external condyle. Passive flexion and extension were very limited; pronation and supination possible but very painful. Reduction was easily accomplished by drawing on flexed forearm in a line with the humerous, and pushing the olecranon outward, while the humerus was being firmly held by an assistant. Immediately after reduction the severe pain disappeared, and extension and flexion, pronation and supination were almost perfect, but painful. The radius had returned to its normal position.

The treatment consisted in immobilization of the elbow by means of a posterior felt splint fastened with crinoline bandages.

Sept. 11, four days after the injury, I removed dressing and found extensive ecchymosis and some swelling, some tenderness over the joints and several bullæ on forearm.

On Sept. 21 I removed splint and placed the arm in a sling. Liniment was ordered to be rubbed into the arm about the joint twice a day.

I did not see case again until I sent for him a month after and found him still carrying the arm in the sling, although I told him to carry it there for one week only, and then to let me see him again.

The result is almost perfect, there being only a slight impediment to full flexion and extension. He is able to shovel coal and do other hard work without inconvenience.

This is a rare accident, as only five cases, according to Prof. Hamilton, have been recorded. A sixth case was reported by Prof. T. F. Prewitt, of this city. Of these two were mistaken for fracture, and in one no attempt was made at reduction; in the other an attempt was made five weeks after the accident, but failed; one Malgaigne failed to reduce, though recent; one was easily reduced immediately after the accident, and two were reduced with great difficulty after five and fifteen days respectively.

Vaccination.

Editor MEDICAL WORLD:

With regard to Dr. Palmer's difficulty of not having vaccine virus to "take" upon himself, I will say that I am still without ever having the virus to "take," and I have passed through three epidemics of small-pox.

For the benefit of all my medical friends I will give him my treatment of my own family while I am attending those who have the disease. I make it a rule immediately upon my discovery of having on hand a case of either varioloid or small-pox, to immediately vaccinate all my

family and myself. So far I have been successful in warding it off in my own family. I had one singular case in the town I practiced in. The mother called me in to vaccinate the whole family, mother, baby and three boys. One boy, Frank, was last operated on. Next day in passing the house the mother called me in to see how they were all doing. Of course there is little to be seen in that time, you will say. So I thought; but Frank's.arm was inflamed, and the two scars were weeping pus terribly, and the scars were as large as pennies and at least a quarter of an inch in thickness. In less than two months the mother took varioloid and also the baby; but Frank had confluent small-pox. Now my impression was in regard to Frank that as he had such a large amount of pus secreted and thrown off, he would be likely not to have a severe attack, if any. The rest of the family, except those mentioned above, escaped entirely. 1126 S. 10th St., Phila.

I. R. S.

A Further Word on Oxygen Treatment and Oxygen Charlatans.

BY SAMUEL S. WALLIAN, A. M., M. D. Editor MEDICAL World:

It is said that every genuine coin has its counterfeit, and every true bank note its spurious imitation. Whether this be true or not, it certainly is true, in medical practice, that every novel or unusual method of treatment is more or less counterfeited and dragged into the mire by mercenary quacks and charlatans. Electricity is a notable example. Legitimate as it is, and in a class of cases absolutely essential and the only effective agent, it has been degraded by blatant emipircism until many intelligent members of the profession are yet foregoing its use through prejudice and disgust.

The use of oxygen in some of its many forms and combinations has been steadily growing in favor with the profession for the past ten years or more, and is now being used by a large number of physicians, some of them very eminent practitioners, scattered all over this country and Europe.

The arguments in behalf of the rational nature and curative potency of the agent are plausible, easily understood, even by laymen, and hence the advocacy of the "treatment" opens a wide field for the empiric and the charlatan.

A glance at the daily and weekly press, especially the religious journals, will convince the observer that this field is being thoroughly worked. The giant of all the tribe of quacks in the oxygen line has his castle in a neighboring city-and no mean castle is it! The mail are loaded with pamphlets and periodicals, printed in fine style with profuse display of wood cuts and lithographs-not forgetting the inevitable

"genuine certificates" without number.

Nor are semi-professional indorsements, from members of the profession in "good and regular standing," wanting to give a glamour of genuineness and worth to these specious and shystering claims. Thus encouraged, these cormorants have built up a business of fairly gigantic proportions. They have waxed fat and wealthy until now they are able to kick with arrogance.

The disgraceful and humiliating feature of the matter is that not a few physicians who really are aware that the claims of unscrupulous advertisers, that they are possessed of secret processes and a knowledge of new combinations of oxygen, of methods for magnetizing" the gases and lethean waters they dole out, are notoriously fraudulent and without the slightest foundation. in logic or chemistry; and yet they give their bogus wares a tacit endorsement by either procuring them for their patients as temperizing placebos, or encouraging their sale by acquiescence to their use as "probably harmless."

From time to time analyses of these nostrums have been published and some faint attempts at "exposures" have been made; but it must be confessed that the profession has taken no active measures to warn the public of the bare-faced imposition that is being practiced upon it.

Now to the facts:

Most of these advertisers name their "secret" preparation compound oxygen.' Some call it simply, "The Oxygen Treatment." As to their nature, all are about alike; and it ought to be unnecessary to repeat to intelligent physicians that none of them contain any free oxygen, beyond the inconsiderable quantity always found in common water. They consist generally of weak aqueous solutions of nitrates of lead and ammonium, some adding also chlorate of potash. The clew that these solutions are "the chemical solutions in which we have been able, after long and carefully conducted experiments, to hold this magnetized (!) substance," etc, is the quintessence of bosh. The exercise of a grain of chemical common sense will forever set at rest any doubt as to whether possibly there might not be some virtue, some undeveloped "secret," behind all this pretensious nonsense.

Let the medical press generally take up this matter, publish far and wide the analyses of this specious trash, formulæ for manufacturing the same, and by a concerted action at least shame reputable physicians from giving their semisanction to this notorious and wide-spread quackery.

Thus, if the following does not so closely imitate the mixture called " Compound Oxy-. gen," and sold to credulous invalids or their doting friends at from $12 to $15 per bottle,