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Notes and Queries.

NOTE ON THYROID EXTRACT.-One who has followed the history of the use of drugs of animal origin must thereby have acquired skepticism. The clinical results which have followed the administration of thyroid extract, however, in myxedematous and allied cases would seem to be sufficiently established and pronounced to justify absolute belief in the potency of this substance as a therapeutic agent. Nevertheless, in his recent very elaborate rescearch, Dr. Cunningham believes that he has demonstrated that the symptoms of thyroidism, so-called, are not produced by any substance which exists originally in the thyroid gland, but that they are the outconie of toxins, ptomains, or other poisonous organic principles, which are the result of post-mortem changes in the gland; and he further affirms that while these extracts hasten the death of the dog that has suffered complete thyroidectomy, even feeding such an animal on the fresh thyroid gland fails to put aside sensibly the fatal issue; statements apparently founded upon good experimental evidence and which certainly tend to befog what we had supposed to be clear knowledge.

Under such circumstances I hesitate very much even to report clinical facts bearing upon the subject; nevertheless, four recent cases seem to me to be worthy of being noted, although the happenings may have been coincidences. In these four cases the exhibition of thyroid extract has been followed by violent outbreak of gouty or rheumatic symptoms, not existent at the time at which the drug was given. In one of these cases the patient never had had rheumatic symptoms before to her knowledge. In a second case, that of Mrs. D., the patient was of distinctly gouty tendency, had had from time to time gouty attaeks, but was free from any lithemic or arthritic symptoms when I first unsuspectingly gave her thyroid extract for obesity. In about ten days or two weeks she had a violent outbreak, confining her to bed. She was taken off the thyroid, put on appropriate treatment, and rather rapidly convalesced. An antilithemic diet was insisted upon and maintained. April 1oth or 11th she began again to take five grains of thyroid extract three times a day, being at that time in greatly improved health and without evidences of diathesis. To-day, April 20th, her sister reports at the office that Mrs. D. is in bed, with great pain and swelling in the ankles as before. Miss M., another case, was a young lady, about sixteen years of age. She had once in her life suffered from slight rheumatic symptoms. She came under treatment for recently developed goitre, dermographia, and various nervous symptoms. About February 22d, she was put upon nine grains a day of extract of thyroid, increased about March ist to fifteen grains, and decreased March 7th to six grains. March 11th she had a severe rheu

matic outbreak. The thyroid extract was withdrawn, a simple tonic given; the rheumatism rapidly disappeared. On March 22d she was again put on thyroid extract, which was followed in about ten days by a return of the rheumatic symptoms.

My object in reporting these cases is not to claim that the extract of thyroid was the cause of the rheumatic symptoms, but simply to call the attention of the profession to the subject, so that careful observation may be made upon a wider scale. --H. C. Wood in Philadelphia Medical Journal.

HISTORIC DEATHBEDS.-One of the penalties of greatness in these days is the intrusion of the newspaper reporter into almost every circumstance of private life. It is of course inevitable that princes and potentates and politicians should live ever in the public eye, but it is surely hard that they should also have to die, as it were, before the footlights. The deathbed should be unprofaned by the prying of a foolish or morbid curiosity; even those who have lived most in the public ways that public manners breed have a right that the curtain should let fall silently on the last scene of all. Medical details of a historic case may legitimately be given in the proper place and in the proper way, but they are altogether out of place in ordinary newspapers. How can it interest the public to be informed that a dying statesman presents the symptom known as Cheyne-Stokes respiration? That relatives and friends should strive to piece into some semblance of meaning the stray words which fall from the beloved lips before they are closed forever is natural. But that other watchers at the bedside should gather up the mutterings of delirium and permit them to find their way into the press is much to be regretted. We are willing to admit that the position of those who are called upon to attend the sick or dying bed of a person of national eminence is often one of great difficulty. On the one side there is the natural desire of the public, as represented by the press, to obtain authentic information, and on the other, the obligation of reticence which is laid upon every one who enters the sick-room, and not least upon the medical advisers. It is by no means easy for a medical man to maintain perfect reticence when reporters lie in wait for him at every corner. A casual word may be expanded into an interview, and even a look may be translated into a statement of opinion. In regard to the incidents which have led to these remarks being made, some excuse may perhaps be found for indiscretions in the free communications made by some members of the dead statesman's family. We do not feel called upon to attempt to apportion exactly the responsibility for the indiscreet publicity which has been permitted with regard to the last hours of Mr. Gladstone, but we would venture to express the strong opinion that when the supreme moment approaches a man is entitled to the sympathetic protection of those around him. Neither his relations and friends, nor his spiritual and medical advisers, have any right to let the public hear his cry of agony, or to repeat words muttered in the apathy of approaching dissolution. Certain French

words believed to have been uttered by the dying statesman have been twisted by a foreign newspaper unfriendly to this country into affording apparent ground for conclusions as to Mr. Gladstone's opinions which are tantamount almost to a charge of want of patriotism. We repeat, we do not feel called upon to apportion the exact ineasure of blame that should rest on any particular individual for the disclosures which have called forth many criticisms not only throughout the medical profession, but among the educated public. Whatever others may think it permissible or expedient to do in regard to the privacy of the deathbed, the duty of the medical man is clearly expressed in the words of the Hippocratic oath: "Whatever in connection with my professional practice, or not in connection with it, I see or hear in the life of men, which ought not to be spoken of abroad, I will not divulge, as reckoning that all such should be kept secret.British Medical Journal

SYMPHYSIOTOMY FOR DYSTOCIA DUE TO A LARGE FETUS.-Lepage (Ann. de Gynéc. et d'Obstét., March, 1898,) in an article on eight cases in which symphysiotomy was performed, specially refers to one instance in which the pelvis was normal, and yet the operation was required on account of the large size of the fetus. The mother, a two-para, aged twenty-eight, had in her first confinement been delivered with difficulty, and by forceps, of a large dead-born infant. In the present pregnancy the uterus was larger than normal, and palpation revealed a large, hard fetal head above the brim. There were frequent and severe pains; the head presented, O. D. P., but did not engage, and dilatation went on slowly. The fetus was alive. Symphysiotomy was performed, the parts were held apart with Farabeuf's écarteur, and the head was brought down to the vulva, the écarteur being removed at this stage and the pubic bones approximated. Natural efforts expelled the child, which was with some difficulty resuscitated. It was a male, and weighed 5,200 g. (over ten lbs.), while the occipito-mental diameter of the head measured 14.9 cm. (nearly six inches). There was marked ossification of the cranial bones, and the promontory mark was on the right parietal boss. The puerperium was satisfactory.-Ibid.

THE GERMAN HOSPITAL, of San Francisco has opened its doors to the Red Cross Society for the care of sick soldiers. The San Francisco branch of the Red Cross has raised over $30,000.Medical Record.

DR. MAYROGENIS, of Athens, is said to be the last survivor of the Greek war of independence. He was born in 1798, and was one of the first to rise against the Turks in 1821.-Ibid.

DR. EDWARD JACKSON has resigned his chair of diseases of the eye in the Philadelphia Polyclinic, and has been elected emeritus professor.

DR. ALFRED Stengel will from October, 1898, have editorial charge of the American Journal of the Medical Sciences.

Special Notices.

SYPHILIS.—When a patient presents himself for treatmeat he should be placed upon the following recipe (which fully meets all indications) until the symptoms disappear, his appetite is improved, and a general feeling of vigor and activity exists. Hydrarg. bichlor., 2 grains, iodia 6 ounces. M. Sig: One teaspoonful after each meal.

Iodia is prepared by Battle & Co., St. Louis, and contains extracts from the green roots of stillingia, helonia, saxifraga, and menispermum. Each fluid drachm also contains five grain iod. potass. and three grains phosphate of iron. The tendency of the profession is too much toward discarding every thing but mercury. I have often seen mercury alone or combined with iod. potass. fail to heal secondary ulcerations, which speedily disappear when combiued with vegetable alteratives. It is therefore best to have the good effects of the only three reliable remedies at once, viz., mercury, iodide, and vegetable alteratives (which is obtained in the above prescription). Lectures on venereal diseases by W. F. Glenn, M. D., clinical professor of genito-urinary and venereal diseases, medical depatrment Vanderbilt University.-Southern Practitioner, May, 1898.

MORE ROOM NECESSARY.—The Chicago Eye, Ear Nose, and Throat College, after one year's existence, has been compelled on account of its large attendance to seek more room. The attendance has increased to so great an extent during the past few inonths that the Board of Directors saw that it would be necessary in order to maintain the high standard of teaching adopted by the school to have more room. Fortunately at this time a large space on the same floor has been vacated and has be immediately leased by the college. The acquisition of this space will make it possible to teach at least three times the present number. It is the intention of the directors of the college to make this the foremost school of its kind in this country, and with the new space and great additions made to the present equipment will undoubtedly make it so. Write secretary for catalogue.

J. B. DANIEL: Dear Sir-I have tried your Passiflora Incarnata on myself for nervous irritability with very gratifying results. It seems to be all that is claimed for it. I shall continue to use it myself when necessary, and prescribe it for my patients where it is indicated. I shall in future get my supplies from your agents in New York City.

Respectfully, 94 Varick Street, New York City, May 27, 1897.

EDWARD MCGUIRE. SANMETTO IN Cystitis, PROSTATITIS, AND IRRITABLE BLADDER.-I have been using Sanmetto in my practice for two or three years. I have used it in a good many cases of cystitis and in all cases of irritable bladder, with the most gratifying results. Arlington, Ky.


Ex. Pres't. So. Western Kentucky Med, Assoc. LABOR SAVING: The American Medical Publishers' Association is prepared to furnish carefully revised lists, set by the Mergenthaler Linotype Machine, as follows:

List No. I contains the name and address of all reputable advertisers in the United States who use medical and pharmaceutical publications, including many new customers just entering the field. In book form, 50 cents.

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Certainly it is excellent discipline for an author to feel that he must say all he has to say in the fewest possible words, or his reader is sure to skip them; and in the plainest possible words, or his reader will certainly misunderstand them. Generally, also, a downright fact may be told in a plain way; and we want downright facts at present more than any thing else. --RUSKIN.

Original Articles.


Author of "A Pilgrimage, or the Sunshine and Shadows of the Physician."

“When true hearts are withered,

And fond ones are flown,
Oh! who would inhabit

This bleak world alone?" -Moore.

Sophocles says: "What good man is not his own friend?” Young states that a foe to God was ne'er true friend to man; some sinister intent taints all he does. Dryden says: “Want gives us to know the flatterer from the friend."

om the friend." The Bard of Avon makes Cassius say: " A friend should bear his friend's infirmities." Webster's definition of a friend is, “One who entertains for another such sentiments of esteem, respect, and affection, that he seeks his society and welfarema well-wisher."

Egotism, hatred, avarice, intemperance, immorality and infidelity are at enmity with professional friendship. Any member must purge himself of these evil genië before he knocks at the door of professional friendship for recognition and admittance. To have professional friends we must be worthy of them. All physicians should be friends,promoters of each other's welfare, success, and happiness. All gentlemen who are members of our noble profession will be friends. Friendship is founded on confidence, confidence on integrity, and without integrity there can be no friendship. It is the duty of the physician in his daily *Delivered before the Lincoln County, Kentucky, Medical Society, at Hustonville, Ky., September, 1897.

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