THE TREATMENT OF PNEUMONIA

The types of pneumonia are so varied in their manifestations due to age, climate, heredity and other conditions that there can be no fixed treatment that will fit all cases. One of the most essential things at the very outset is that of making the patient comfortable and his environment cheerful and hopeful. Nearly all are agreed upon the efficacy of the mustard poultice employed in the incipiency of the disease. It relieves pain and favors nerve and vasomotor sedation. The cantharides paste in some inexplicable manner gives good results, especially in cases of tardy resolution.

The skin should be kept well cleansed. The skin is our greatest emunctory and grease or anything else that retards its activity throws more work upon the other eliminants. Frequent spongings with diluted vinegar or alcohol are of great value.

Usually the absorption of toxins from the alimentary is a strong factor. Intestinal elimination and disinfection should therefore be efficient. Every gland and secretion should be spurred into activity, for pneumonia is much more a general than a local disease. We do not believe there is one physician in a hundred who does not give calomel in generous doses at the very beginning. As an auxiliary eliminant salines are more efficacious than any other drug. The patient should also be induced to take plenty of water, either pure water or in the form of lemonade. An abúndance of water favors renal and intestinal excretion as well as diluting toxic matter that is not so promptly eliminated.

As a general rule remedies and measures which favor dermal relaxation give better results than the application of cold. Quinine to the point of cinchonization is a choice treatment with some physicians, but we are inclined to believe that the untoward effects of the treatment sometimes more than offsets the benign results obtained. Aconite or aconitine is our choice vasomotor sedative and veratrine is a near relative. These remedies find an indication in the beginning of the disease in sthenic individuals. Many prefer to fortify these drugs with digitalis or digitalin. Strychnine is a remedy that is so often wrongly employed in this disease and might be compared to applying the lash to a runaway horse. Feebleness of pulse accom

panied by depression is an indication for strychnine.

Cough syrups are not conservative. Small doses of codeine or Dover powder may at times be needed for the cough and to produce rest. The old-fashioned treatment for pneumonia was to start the patient off with ten grains of Dover powder and ten grains of calomel. Many will agree that it is not bad treatment even today. Emetin acts very nicely in controlling the cough and producing mild sedation. Carbonate of ammonia was at one time supposed to exert a liquefying effect upon the blood. It has an unquestioned effect in loosening the mucous secretions. It is also a useful stimulant and quick in action when the breathing is embarrassed. The room should also be saturated with the fumes of ammonia, which seem to soften the air and make breathing easier. The patient's position should be changed frequently in order to obviate hypostatic congestion.

Food should be nutritious and easily assimilated, and so far as practicable should be given at regular intervals. Keep the patient in a prone position with his head not too high. Keep up thorough elimination with cleanliness internally and externally. These are simply the editor's suggestions based on personal experience, and not a learned dissertation. Let us have the personal experience of others.

THE PRICE OF DRUGS

Bromide of potassium has advanced from 40 cents a pound to four dollars a pound. Many other drugs have advanced in like proportion. The price of many things is almost prohibitive and scarce at that. Ergot, quinine, santonin, carbolic acid and all anodyne and sedative drugs have gone soaring. The high cost of drugs works a hardship to doctors who dispense. What can be done about it? Perhaps nothing. Do not dispense in larger quantities than necessary and write a few more prescriptions.

Dr. David I. Macht in a recent number of the Johns Hopkins Bulletin seems to have demonstrated that the best treatment of carbolic acid poisoning is lavage with sodium sulphate, although it is by no means a certain antidote. -The Lancet-Clinic.

LAITY DOCTORS

They are not numerous in large cities, but are much in evidence in small communities.

They are solicitors for the welfare of the ailing! Their prescriptions for the sick are as varied and potent as those of the most learned and experienced of physicians. They are nosy! Then they know a good doctor, and who is the best one. There may be some doubt among physicians as to the learning and skill of his colleagues; but the "eagle eye and massive brain" of the laity doctor is unerring! They may not be skilled in differentiation, but a little defect like that doesn't stump them when it comes to advising treatment of any disease. Their thought tanks are the repository of potential remedies which never fail! If you have a serious case of sickness on your hands, be sure to shut them out!

THE DOCTOR AS A PATIENT

The sick doctor usually makes a poor patient. His knowledge of symptoms introspectively applied is inclined to keep him constantly in "hot water." He cannot forego his self-scrutiny and he worries and wonders whether the right thing is being done for him. The man who is really sick, whether he be physician or layman, is hardly in the right attitude of mind to know what is altogether best for him. So, doctor, if you are so unfortunate as to become really sick, take this tip from those who have traveled the road before you. Rest your case with a reliable physician and nurse and stop your self-analysis. Let somebody else count your pulse and take your temperature. It is folly to attempt the role of physician and patient both at the same time.

BOILS

Every general practitioner is likely to treat boils in a routine manner. Sulphide of calcium to the point of systemic saturation is orthodox medication. A good many prefer to give nitro-muriatic acid in ten or fifteendrop doses, well diluted after meals. Nothing is gained by incising a boil too soon. In fact, incision is contra-indicated because it increases the inflammation. There may also be added infections. The time-honored custom of letting the suppuration soften and point before evacuating is still good treatment.

NO AGREEMENT

When the medical practice becomes exact, i. e., as to therapeutics, there will not be such confusion and diversity of opinions as to the appropriate means of cure. Take for example, pneumonia: No two physicians pursue the same line of treatment. Then, appendicitis: One will apply ice to the appendix, and another applications as hot as can be borne. One is about as successful as the other, and the latter decidedly more comfortable.

There is confusion about rheumatism; rheumatism, non-inflammatory, is called "neuritis,' neuralgia, etc. One claims it is caused by germs, and another accepts the Haig theory of uricacidemia. The antacid treatment seems to give as good results as any.

Then in tuberculosis, one will saturate the patient with cod liver oil and hypophosphites, while others will freely give creosote, guaiacol, and metabolized oil. So it goes.

CORRECTIONS

In Dr. Terry's article, November Summary, page 262, the first paragraph in right-hand column, should begin as follows: "In septic peritonitis, beginning by using 15 minims with bicarbonate of soda to one quart of sterilized water, increasing the strength to 3ss, which was more successful than the peroxide," etc. Better take your pencil in hand and make the corrections in your copy of the Journal at Also in the last paragraph of the same article, insert "diluted" between the words "solution" and "that."

once.

THE HISTORY OF "BETTY," THE ALLI-
GATOR GIRL; A CASE OF MATERNAL
IMPRESSION OR PRENATAL STAMP-
ING OF HUMAN OFFSPRING; OR
POSSIBLE ICHTHYOSIS, OR
FISH-SKIN DISEASE

BY F. GRIFFITH, M.D.

Last January, 1915, the writer was in St. Augustine, Florida, and visiting a traveling tent show on the outskirts of the town, encountered amongst the collection of freaks a cow with an extra hind quarter, hoof, leg, functionating milk-bag and udders swung from the top of the back; beside the cow in the stall was a six-months old heifer calf identically adorned as the mother. The writer offers no word to decide whether or no the cow was maternally impressed or whether the showman believed in suggestion to enhance the reliability of his prize showing in the next booth, "Betty" described as the "alligator girl." Betty, a young human female shown with her mother who acted as a lecturer, informed the auditors gathered about her stand that the exhibit was her daughter; the fourth child of seven, all healthy and well; that the girl was born in southern Georgia, twenty-four years ago; that she neither walked nor talked but crawls or must be carried; that she shed her skin twice a year, and preferred a diet of raw meat or fish. Finally that she was exhibited and styled the only living alligator girl because the girl's skin from the crown of the head to the soles of her feet was plated and closely resembled an alligator's hide. That the plating was real and the resemblance most like the writer can bear out after careful, close and extended and continued inspection and palpation of this young woman. The mother stated that during the seventh month of her pregnancy, while crossing a single log foot

reasons.

During speak of ichthyosis, or so-called fishskin disease, but never saw a case to his knowledge if the present instance is to be considered and discarding the mother's circus story as being concocted for commercial Therefore does the medical profession accept the idea of the possibility of maternal impress to mark the child in utero. Is such explanation too easy for our ponderous science to accept? The writer knows a lady this present day, wife of a New York lawyer, who can show a three-quarter sized gray rat outline mapping across her abdomen. The story goes that her mother lying in bed in the last month of pregnancy was terrified by having a rat leap on her bed and race across her body over the bed covers. Every country doctor can tell a maternal impress story to make the city doctor scoff, but my own present opinion is that maternal impress is possible.

New York, N. Y,

DOES IT PAY?—IS THE MEDICAL MAN'S SKIRTS CLEAR IN THE CONSUMMATION OF THIS ACT?

By J. A. De ARMAND, M.D.

I note this item in the daily press: "The State of Indiana with the concurrence of the Supreme Lodge of the Knights and Ladies of Honor changed that organization from a mutual to a legal reserve basis, throwing practically the entire excess cost entailed, it is said, on members who are more than 60 years old.

*

**The ratio of increase may be judged from that on a policy of $2,000 held by a member. The monthly payment on this policy was formerly $7.10 per month; under the schedule it will be $21.70 per month and the member who reaches 91 years will be required to pay $144.90 per month on a policy of $2,000."

The above excerpt tells a story that will carry terror to many an aching, faithful heart. It means everything to many a man who had hoped to put want and poverty out of the reach of loved ones when he is done with this mortal world. To the man of 70 whose earning power has rapidly declined in the last few years, it means snapping the last cord that remains to what he has, may be paid oh so many assessments in the idle hope that here was a really dependable hope and a safe refuge.

Somebody, maybe of the Josh Billings type, said that he did not take a great deal of stock in the conversion of a man who had got too old to be devilish. My conversion, was, I admit, too long in coming to be of great service, but if I can sound a warning even now that will şave some poor fellow mortal from the clutches I will be satisfied. Nearly forty years ago I began the practice of medicine in a small town. About that time an order called the A. O. U. W., took that village much as the measles and other epidemics enveloped it. The most natural thing in the world made me the medical examiner. The strong point with that company was its cheapness. I made out an examination paper as long as the moral law and got the munificent fee of one dollar for it. That is, most of the time, but as I now recall it, I many times got the promise of the dollar only. There was the usual urinary examination, and the usual list of questions to be answered. Reliable insurance companies seldom offered to pay less than three or five times as much for a great deal more business work without half the rubbish.

I do not need to tell readers of The Summary what became of the order as it then existed. In later years the C. of H., the W. O. W., and I know not how many dozens of other companies or orders have either squeezed out deserving members or have fallen by the wayside and from the ashes have sprung new fly-by-night orders too good to be true and surely too weak to last.

Does it occur to the reader that the medical order has always and everywhere a constant stand-in with this sort of dishonesty? There is always a medical man close up at the top. The young medic is an easy prey because he has plenty of time, has the need of social opportunities such as these orders offer and of course, he will fall. It rarely occurs to him that he is working for a measly pittance without reason. If he has not the right sort of stuff in his make-up he becomes a humdrum examiner who is not wanted by the reliable insurance company whose business is worth while. I fell for it, and so have thousands of other doctors fallen. A very little bit of careful thought would have told me as it tells you that without a careful, conscientious examination of the applicants, no insurance company is sure to last over night. The reliable safe company of today asks its examiner for a pen picture of the applicant, and

it never thinks of asking you as a parting shot "if you were in the business would you insure the applicant."

I am not a disbeliever in life insurance; in fact, I believe that the wise man of the future, when his daughter's hand is sought in marriage will ask the happy man to exhibit a policy in a good, reliable company and a disposition to keep it above water.

Cheap insurance is not cheap insurance because it is not good insurance. It is not sure. It starts out with the idea of furnishing something for less than it is worth, less than the markets of the world say it is worth. It is semi-social-just enough to blind the applicant to the real defects and in the end the cloven hoof shows up and this always at a time when real insurance cannot be had at a rate commensurate with the earning powers of the applicant.

It is in the power and should be everlastingly to the credit of the medical profession, that examinations should be charged for at established rates. Then there would be an end to the never-failing efforts to include in the lodge a weak-lunged man with a beautiful tenor voice, or a woman whose value consists in the ability to lacerate a hesitating tune out of a rickety organ.

To the young practitioner, let there be no mistake in your course in putting principle before temporary gain. There is really nothing in any of the dollar-a-head insurance; you know it is largely temporary or has been such heretofore, and can't be put on the right road any too soon. Be a power in discrediting any plan that has only a temporary and surein-the-end failure in store. Insurance is like other articles of commerce-it costs something to maintain and when some enthusiast proposes to furnish it at less than cost, do not be a party to advancing the scheme when neither riches nor glory can come as a reward for your part in the scheme that sidetracks dishonesty too closely for your lasting reputation. Davenport, Iowa.

Hyper- or hypo-activity of the thyroid may be compensated by the eliminative or reciprocal organs within certain bounds; varying with individuals, beyond which it results in disturbance of nervous, nutritional and metabolic equilibrium.-W. L. Crosthwait, Texas Med. Journal.

THE TREATMENT OF DISEASE WITH ELECTRICAL CURRENTS

BY ZACHARIAH GARTON JONES, Ph.B., M.D., LL.B.M.E.

A prelude to this article was published in the Wisconsin Medical Recorder, in October, November, December, 1914. (A copy of which will be sent upon request.) In that paper I gave a short description of the different forms of electrical currents that are used in medicine, and endeavored to bring out some of the points relative to the commercial uses of this phenomena as well as its general usefulness in the treatment of disease. My object in this paper will be to carry the subject further in its medical phase and to cite a few more cases that have come under my observation which will, I believe, be read with interest by those interested in the welfare of his fellowman, and especially by those who are seeking the more modern means of relieving the aches and pains of suffering mankind.

A little more than ten years ago, I went forth into the field of medical practice armed with the crude and common every-day weapons used by man in his battle against death and disease. I trusted to medicines and the knife to bring me fame, but frequently I came across a suffering client for which medicines were useless and the knife contra-indicated them; death alone stood out as the ultimate goal.

It appeared to me that something more ought to be done, but I had exhausted all the means that had been given me and was left helpless. I had done all that I knew to do, and had left only the discouraging news, that the future contained but little or even that death itself was only a matter of a short time.

All the older methods of treatment are rapidly being replaced by the newer ones, especially the various physical therapeutic forces, because we obtain results, not by producing artificial symptoms to take the place of the symptoms of which the patient complains, as is the case so frequently when medicines are used, but by bringing about a healthy normal condition of the tissues and organs, by supplying them with natural forces with which to combat the cause of the disease.

As an illustration, a patient will experience a sensation of pain, and for relief will take a dose of medicine-say morphine-he may get relief, but how is it brought about? He simply