made the cut herewith presented, which, of course, represents accurately the appearance and extent of the disease as it appeared when first seen by me, showing how the disease had progressed along the arm upward from the handHæmorrhagic infarctions, oedema and induration had occurred, (with a large indolent ulcer having ragged, undermined edges and irregular in outline, still showing the place of infection) while pain, itching, high temperature and rapid pulse were the leading symptoms manifested by the patient.

The treatment adopted was : First, free incisions, liberating the sanious matter; and second, applying absorbent cotton in considerable quantities, retained with a roller bandage, and constantly kept saturated with

R

fzxvj

Misce. (The time honored aqua phagadenica or lotio flava.)

Internally she was ordered to take:

R

Potassii iodidi

Elixir gentianæ, et
Tincturæ ferri chloridi

M. Sig. Teaspoonful before meals three times daily.

5iv

fzviij

This treatment was continued until February 16, when the case presented herself at the office, and all had healed nicely, with the exception of the ulcer. The internal medicine now being discontinued, the yellow wash was ordered to be continued, and in two weeks more the case was discharged cured. It may not be out of place to mention that the case, despite my urgent advice to the contrary, attended to her household duties without any interruption during the treatment.

HOSPITAL NOTES.

HYPERTROPHY OF ANTERIOR LIP OF CERVIX.-Prof. Adams recently exhibited to the class of the University an elongated and hypertrophied anterior lip of the cervix which occurred in a case of Dr. Himoe, of this city. The anterior lip was so greatly hypertrophied as to project outside of the vulva, and had become a source of great annoyance from friction with the thighs. The patient was removed to All Saints' Hospital and the growth cut away, restoring the os to its natural size and shape.

A COMPLICATED CASE.-At the German Hospital Prof. Jones presented, at a clinic of the University Medical College, a case that had been the subject

of typhoid fever; the typhoid state was followed by empyema, for which the chest was opened (after repeated aspirations) and the cavity repeatedly washed out. After the suppurative pleuritis had been relieved abscess of the liver developed; after evacuation of the abscess, general anasarca came on. Just as recovery seemed probable the patient suddenly became insane, probably from formation of abscess of the brain; as this could not be located by the symptoms present, no operation was thought advisable.

METHOZYN IN DIABETES.-Prof. Lanphear has a case at the East Side Dispensary in which the polyuria failed to yield to all ordinary methods. Ten grains of methozyn (antipyrine) given morning and evening immediately reduced the amount of urine excreted in twenty-four hours from twenty-four pints to four pints, and the amount has continued low for a considerable time under its constant use.

for one day.

About once a week the drug should be discontinued

A CATARACTOUS FAMILY.-At the University clinic Prof. Tiffany removed cataracts from a man aged forty and from two of his children. The tendency to the development of cataract in certain families was thus happily illustrated. The Michel dressing was applied instead of the old dark-room process of after-treatment, and excellent results obtained.

WIRING BONES.-Prof. Lewis not long since operated in three cases at the Wabash Hospital in old, ununited fractures; one was of the humerus, one of the radius and one of the ulna. In each instance the incision was made large enough to easily manipulate the fragments when exposed; the fractured surfaces were freshened and brought together, held in contact with silver wire passed through holes drilled in each extremity, the wound cleansed and brought together with silk and dressed antiseptically. Union of the soft parts was immediate, and the bones have united nicely.

AN ELIGIBLE IRON MIXTURE.-An iron mixture that is borne well by even the most delicate stomach is thus dispensed at the East Side Free Dispensary :

Misce.

Sig. Dessertspoonful one hour after meals.-The object in giving the iron one hour after meals is that at that time the tannic acid taken at meals in tea, coffee, etc., has passed from the stomach, and the iron does not thus combine with it to form an insoluble tannate of iron, from which no benefit could possibly be derived.

FOR NEURALGIA.-Prof. Lanphear prescribed for a distressing case of neuralgia:

R Sodii salicylatis
Olei gaultheriæ
Syrupi simplicis

zij gtt.xx

f3j

Misce. Sig. Teaspoonful every two or three hours.-In cases of neuralgia not due to anæmia he finds this much better than narcotic agents, because it often relieves just as promptly and it is followed by no bad after-effects.

WEAK HEART.—In a case of weak and feeble heart Prof. Jones prescribed small doses of atropine, saying that in certain cases it is the best thing at our command to restore the heart to its normal action. There was no murmur to be heard; he remarked that in cases of suspected heart-murmur the patient may be made to walk quickly up and down stairs; the exertion will bring out the latent murmur if there be one.

TOBACCO AND EYE-SIGHT.—In operating upon a case of extreme pannus due to long-continued self-treatment with irritants, Prof. Tiffany called attention to the pernicious habit of people's putting irritating "eye-waters," oils, etc., into the eye upon the slightest provocation, and the duty of the physician to do all in his power to correct this abuse. He insisted upon the patient's ceasing entirely the use of tobacco, as it is a great irritant to the eye, and in subjects particularly susceptible to its influence it may cause amaurosis. In inflammatory troubles of the eye cessation of the use of tobacco is of great importance in successful treatment.

EPITHELIOMA OF GUMS.-Prof. Van Eman recently operated at St. Joseph's hospital for epithelioma of the gums. The incision was made in the median line through the upper lip and, dividing, passed up on each side of the nose. The entire soft palate, the superior maxillary bone up to a point that left but a small portion of the antrum of Highmore, (cutting just below the exit of the fifth nerve) and a portion of the pterygoid processes, were removed. There was considerable hæmorrhage, but after a time it ceased, the wound was cleansed and dressed antiseptically. The wound in the lips united by first intention, the temperature never rose above 99° F., and the patient recovered with no bad symptoms and can eat soft food very well, breathe comfortably and even talk in a way that is nearly as distinct as one affected with cleft palate.

CORRESPONDENCE.

THOSE CASES OF OBSTETRICS.

DEAR DOCTOR LANPHEAR :-My attention has been called to a somewhat lengthy inquiry," relative to my report and notes on 1,000 obstetrical cases, in the July number of the "KANSAS CITY MEDICAL INDEX," which appears in the "Kansas City Medical Record," September issue. The "inquiry" bears all the evidence in itself that any rational mind needs to be convinced that a spirit of envy or malice prompted its production. Who has ever heard of, or has ever been acquainted with, a well-educated, cultured and respectable gentleman, within the medical profession or out of it, who would allow himself of being guilty of writing anything, especially any reference in regard to the veracity of a fellow brother, to which he should be afraid or ashamed to place his signature? Therefore, with all due respect to "age and experience," ethics and decency, allow me to say fearlessly and truly, that I do not know, nor have I been able to ascertain, (not even through a personal demand to the editor of "The Kansas City Medical Record," Dr. Fulton) who the author of

said " Inquiry" is; but whoever he may be who found it necessary for his own "conscience sake" to assume the fictitious name of "Age andExperience," no title is more justly in place, here, than coward.

But,

"A fool is nauseous, but a coward worse,"

"Immodest words admit of no defense,

For want of decency is a want of sense.”

I desire to take off the silver-hue from the editor's, Dr. Fulton's, answers to said "Inquiry," which are uncalled for, and largely incorrect, and endeavor to reveal the golden truth, for the benefit of those of the profession who may be interested in truthfulness and correctness in reports of cases.

1st.—I will prepare a careful copy in tabulated, statistical form, of all my cases reported, giving names of mothers, residence, date of birth, sex of child, presentation, complications, etc. The cases of consultation I will give similarly, with the name of each accoucheur in attendance; and forward the same to any medical journal that will publish the same, thus giving an opportunity for any one to make due inquiry, direct, and learn the truth.

2d.—I will submit to a committee of three or more fair-minded, well-educated gentlemen (as medical editors) to be selected by a disinterested party to be agreed upon, any statement hereinbefore or hereinafter made in this article by me. That said committee shall have authority and be requested to duly inquire into the nature of any and all matters brought before them on both sides, and their decision shall be final and so appear in print. Furthermore, I will pay one-half of the expenses of the investigation myself.

My report embraces the time from May 9, 1875 to May 1st, 1888. During this period I have attended over twelve hundred cases of labor, as stated in the said report, wherein I included none but cases attended during the three stages of labor. Thus it will be seen that over two hundred have been attended but partially, i. e., the last stage of labor had passed or was at hand upon arrival.

I attended one hundred and thirteen cases while a student, prior to receiving the degree of M. D., at the University of Pennsylvania, as evidenced by my thesis on "Means of Lessening the Sufferings of Parturition," which received special honor at commencement.

As to myself, I am coming thirty-five years of age; commenced practice of medicine in March, 1877; never had any difficulty with my confreres in Pennsylvania, or elsewhere, except a few here in Salina. I probably have had my full share of troubles and trials, but their source is confined to two relatives, and whatever has been said of me has no other basis for it than the malicious hatred of James F. Dumn, of Fleetwood, Pa., who is married to my sister, and who has done everything in his power to execute his sworn purpose to do me all undeserved harm, since the will of my deceased father has been admitted to probate, by the provisions of which, my sister, (J. F. Dumn's wife) will receive her share of our father's estate only upon condition that she survives him. My mother and myself were named executors in said will, but refused to act counter to the provisions thereof-hence the animus. This same man, Dumn, caused years ago, the publication of libelous matter concerning me, and in suits of libel, in courts of justice, I not only absolutely vindicated myself but had full reparation made to me by the publishers. Having honorably vindicated my

self and not wishing to suffer the continuous persecutions of J. F. Dumn, I concluded to go beyond his immediate reach; consequently, I left a practice worth from $8,000 to $10,000 yearly to me, and located in Salina, Kansas, where lived no less than forty families from my Pennsylvania home, and whose friendship and support I always have had. This same man, Dumn, immediately followed me with infamous letters addressed to several physicians and other citizens of this city. The physicians, despite the appeals of my friends here, were the only persons taking any recognition thereof, and at once became vigorous assailants. As a result therefrom I allowed myself to give vent to a momentary impulse of resentment and permitted an account of myself to be published in the secular papers of this city, but in only one issue. A sign, as stated, was hung out for three weeks; before and after this I defy any one to bring proof of my having advertised or otherwise been guilty of violation of the code of ethics, except in a pamphlet, which was a concise statement of the merits and principles of an abdominal-spinal-shoulder-brace, an invention of my own, but which contained nothing relative to skill, etc., concerning myself. I have never been rejected from the local medical society of this district or any other, as stated in the Record. I made application for membership in the Kansas State Society last May, and there was only one person preferring charges against me and he was unable to bring up anything but what I have just mentioned (and this is the only irregularity of my life, while a period of two years intervened since that time). The matter was referred to a judicial committee composed of Drs. Bell, Cochrane, Hannawalt, Lane and Baker, who advised me to lay over my application one year, which was agreed to. The address written by me - by request to be delivered at the state society's meeting referred to, was the only article ever tendered by me to the editor of the Kansas City Medical Record for publication, and his reason assigned at the time was, "It is too long," but the same address has been published in an eastern journal, The Medical Register, of Philadelphia, in three parts.

If I am "read out," or ostracised to a great degree by the regular profession in this locality, surely I know it not, for within the past eighteen months I have been in consultation with Dr. Sweitzer, Dr. Collins, Dr. Browne, Dr. Winterbottom, of the city of Salina, Dr. Bradley, of Assaria and Brookville, Dr. Crawford, of Assaria, Dr. Sawtell, of Gypsum City, Dr. Sanders, of Niles, and Dr. Campbell, formerly of Salina, now professor in one of the medical colleges of St. Joseph, Mo.--all regular graduates and gentlemen. The only animosity that has been manifested towards me was by simply two physicians out of twenty-six physicians (of all schools), in this city and county; of these two, one has extended to me the right hand of fellowship, with a mutual pledge to "bury the hatchet," while the other one has continued in increasing degrees in. his works of denunciation about me.

In conclusion let me ask: When may we expect to see the day that editors and professional men will give evidence of having received

"Adversity's sweet milk-philosophy,"

and labor, mindful of the great truth, that in the sight of God no man is perfect? From the day when Adam was driven forth from the garden of Eden to the present moment the pages of recorded history, either sacred or profane, are