Fourth-The use of the vaginal tampon in ing present, was unanimously elected to honcertain uterine disorders of position and for orary membership on motion of Dr. Dewees. compression and support in certain effects Dr. Steadman read a paper on a case of obfollowing pelvic inflammations. Answer, in stetrics viz., "Right Occipito-Posterior Prethe correction of versions or flexions, special sentation." After being discussed by Drs. care must be observed in packing the vagina, Adams, Dewees, W. S. Harvey and Daugherty, that the pressure or support shall be equal in it was referred to the committee on publicaall directions. tion.

Motion by Dr. Guibor that the discussion Dr. G. A. Wall of Topeka, gave the society Some Nervous Pheof papers be deferred till the evening session, a volunteer paper on and that we hear read all papers first, and dis- nomena Depending on Faulty Action of the cuss them later, as time allowed. Receiving Ocular Muscles and their Treatment," and a second and carried.

Kansas Medical Journal. avocation, revealed the fact that minute quan

25 Cents. Subscription may begin at any time. The safest mode of remitttance is by bank check or postal money order drawn to the order of the undersigned. When neither is accessible, remittances may be made at the risk of the publishers, by forwarding in REGISTERED LETTER. Address Kansas Medical Journal,

Editor-in-Chief:

723 Kansas Avenue.

J. E. MINNEY, A. M., M. D., Topeka, Kas.

Assistants:

W. L SCHENCK, M. D., Osage City, Kas.
S. G. STEWART, M, D., Topeka Kansas.
Associate Editors:

W. D. BIDWELL, M. D., Leavenworth.

W. F. SAWHILL, M. D., Concordia.

T. W. PEERS, M. D., Topeka.

TOPEKA, KANSAS, AUGUST, 1890.

tities of albumen were still present.

He speaks of its use in stomach affections, the principal symptoms being eructations and vomiting. In cholera infantum the stomach may often be quieted by interdicting everything else and using a few drops of fresh icecold buttermilk at intervals, ranging in length according to the severity of the case.

We have used buttermilk in our practice since the fall of 1881, as a therapeutic agent, food or drink we hardly know which. When an acid was craved by the patient and lemons were not on hand, fresh cool buttermilk was ordered with the instruction to begin with a tablespoonful, in case of an adult, every hour and gradually increase the quantity to a gill W. A. PHILLIPS, M. D., Salina. every two or three hours, unless some untoward symptoms developed, such as nausea, colicky pains, diarrhoea, &c. In the autumn of '81, we had a typhoid fever patient who could retain neither food nor medicine. (Typho-malarial?) It was the second week of his sickness, there was rather severe bowel complication with hemorrhage, irritable stomach This is the title of a paper by Stanley M. and he was in a semi-comatose condition. Ward, M. D., of Scranton, Pa., in the June When aroused he would call for buttermilk. number of the Therapeutic Gazette. He re- It was the twelfth day of his sickness and lates a case of Bright's Disease reported by Dr. death seemed inevitable unless something Henry D. White, in which no alleviation was could be done to quiet the irritable stomach, brought about by the ordinary remedies. The nourish the patient and satisfy the craving patient finally by her own solicitation, was (and as we thought abnormal,) appetite. Sweet given buttermilk, the use of which was follow-milk, pure, and prepared in various ways, toed by the happiest results.

Some Therapeutic Uses of Buttermilk.

Another case is related in which on several occasions the urine under heat and acid was almost solid in the test tube. The ordinary drugs failed to give any relief. The patient began taking buttermilk, two quarts a day. Its effect being markedly favorable, the quantity was increased, and from this time the chief reliance was put on this agent and the patient finally used from six to eight gallons a week.

gether with various foods, and slops, (beef tea, &c.,) had been tried and were repulsive to the patient before and after taking-disagreed with him. In our extremity we directed that a tablespoonful of buttermilk be given every fifteen minutes until we called again in an hour At the expiration of that time no unfavorablę symptoms having developed the quantity of milk was quadrupled and given every halfhour until another call was made in four hours. At this visit the patient was much refreshed, rested better and there was less of the

Diminution in the quantity of urine passed, constipation and headache followed invariably low muttering delerium. During the afterif the supply of buttermilk became exhausted; and, finally, an examination of the urine, made one year and nine months after the first observation, the patient during a great part of this time having been engaged in his usual

part of the night the nurse on watch went to sleep and the buttermilk in the quart cup, was left in reach of the patient and he took advantage of the occasion and drank what remained, fully one pint at once with good re

1

patient was given chloroform and ether equal parts. Assisted by the physicians named I enlarged the wound by making an obtuse angle toward the pubic symphysis and the ensiform cartilage, thus avoiding the epigastric and circumflex arteries, and found the ball had gone slightly downward and to the right, striking the ascending colon and imbedding itself in the internal iliacus, opposite the lower lumbar vertebra. There were four wounds in the colon.

sults. The amount was gradually increased ide of Mercury, shaved and at daylight the and the fifth day after he began the use of the buttermilk he drank one gallon, and continued to drink a gallon a day for the next ten days. While he gained but little if any weight, he was much better every other way. Owing to the excessive work put upon the kidneys and lack of nourishment in the buttermilk a few tablespoonfuls of cream was added on the fifth day with a view of decreasing the quantity of fluid and increasing its nutritive value. Four tablespoonfuls of cream mixed with The first was a cut, half an inch in length one quart of buttermilk and the milk given through its muscular coat, an inch and a half as before, produced nausea and anorexia. The below an opening through the bowel, an inch cream was withheld and the buttermilk by the below, another, and half an inch farther down next day was relished and agreed with the and nearly opposite the ileo-cœcal valve a patient. After a number of days one, and then fourth, all in the central line of the colon. two tablespoonfuls of cream were added to Smoothed their edges and closed them with the buttermilk and it was tolerated, finally continued sutures. Sponged the cavity, the one-half pint a day was given and the quanti- hemorrhage being inconsiderable, and washed ty of buttermilk was reduced to one half gallon it out with a warm 1-3000 solution of bia day. He relied upon this fluid food for about chloride, wiped it dry, closed the external six weeks until complete recovery, although wound with three deep and several superhe was tempted with and given food of various ficial stitches, dusted well with iodoform kinds, he retained a relish for buttermilk.

The buttermilk craze is on, and while the physician must not loose his head, it is a safe rule to utilize agents within the reach of all, both as a food and a medicine when they meet the indications, and never despise the day of small things, and the use common of things.

Gun-Shot Wound of the Intestines.

put on a few long adhesive straps to give support, dressed with absorbent cotton satur, ated with solution of bi-chloride, one to two thousand, covered with a coating of oakum and applied a broad roller bandage, having left a drainage tube in the lower angle of the abdominal opening. In three-quarters of an hour we removed him from the table with less shock than when the operation was commenced, the primary shock being partly due to the circumstances of the injury.

Was called at 3 a. m. June 23, 1890, to see a tramp about 32 years of age, sanguine temThe anesthetic caused slight emesis. One perament, well developed and in good health, and one-half grains of morphine were given who had been shot two hours before while to prevent restlessness and pain and to splint burglarizing the house of a citizen. Counten- the bowels, conceding that opiates prevent ance anxious, pulse small and frequent, and functional activity and the removal of effete breathing labored. After receiving the wound matter, I think in such cases their advantages he ran a square and a half and fell, saying he out-weigh the objections. Absolute quiet and was "done for." Found a bullet hole three diet with small quantities of water to allay inches to the right and a little below the umbili- thirst were directed. Our hospital was the cus. Gave him a drink of whisky and a grain town hall and our patient a would-be robber of morphine, and decided upon an exploratory and murderer, who with a pal had fired six incision to ascertain what injury the ball had balls into the bed where a citizen and his wife done and make such repair the case permitted. were sleeping, and the millions came to stare Sent for Drs. Heller, Brown and Artz, who and to talk as may be supposed, not very concurred in the decision. The abdomen sympathetically. At bed time gave morphine was washed with a 1-1000 solution of bi-chlor- and atropia hypodermically.

June 24-Temperature normal, pulse 98. Directed an ounce of milk three times a day, dressings kept moist with solution of bi-chloride and morphine as necessary to secure ease and rest.

p. m., showed the sutures in the gut had disJune 25-Temperature normal, pulse 100, appeared, and the wounds all open; all parts continued, the directions of the previous day. of the peritoneum deeply inflamed with slight The weather being extremely hot, the hottest adhesions uniting the small intestines to each for years at this season of the year, the patient other and to the peritoneal lining of the cavirefused all covering and demanded frequent ty. The ball was lodged in the interual iliacus, sponging with ice water. When his demand two inches below the crest of the ilium, where was not gratified he would ask for a drink, it would have been cared for. take a mouthful and spit it over his body and Though the wound was kept covered with this day after day. Without entering into a absorbent cotton, made aseptic, a "city hall," daily account of the case the patient did well open to the multitude, for a hospital; a city until the 27th when a sympathetic citizen government that desires the death of the pagave him a glass of beer, which was followed tient, and a total absence of pure surroundby severe vomiting, relieved by rectal feeding ings, are not the conditions that insure sucof two ounces of milk every six hours and an cess after grave operations. occasional dose of chloroform.

We think this case demonstrates, from its

W. L. S.

On the 28th there being no discharge, re- rapid and perfect union, from the absence of moved drainage tube and found the remainder discharge through the drainage tube, and of of the opening through the abdominal wall fever, dying on the thirteenth day from septic had closed without suppuration, and the indi- contamination, that with proper surroundings cations were that those in the bowel were in four gun-shot wounds in the intestines are not the same condition. The tympanites though incompatible with recovery, and warrants the conclusions of the best abdominal surgeons, considerable was never excessive. The temthat in such cases we should know what we perature never above 99° and the pulse had have and do what we can, and that cleanliness not risen above 110 per minute. During the is godliness." night of the 29th the nurse gave him on his own account a bottle of beer. On the 30th the vomiting was persistent and when quieted by chloroform there was frequent regurgitation of bile which was spit out without an effort at vomiting. On the 30th the pulse was up to 120, with temperature normal. Directed large enemata of castile soap suds, turpentine been much extolled. The formula is : and oil or glycerine every six hours. Small quantities of extract of beef and milk by mouth.

July 1-Small doses of calomel were given and enemata continued, with no results.

July 2-Slight suppuration of wound which had been kept covered with cotton wet with the bi-chloride solution.

July 3-Suppuration marked and walls of the wound rapidly breaking down. Only hope that adhesion may have occurred between the abdominal walls and colon, and an artificial anus. Bowels freely moved.

NEW REMEDY FOR PEDICULI PUBIS.-—The

treatment of pediculi pubis by the usual blue ointment has so many inconveniences with its disagreeable application and its toxic aftereffects, that the use of the well-known antiparasitic action of salicylic acid has of late

R.

Salicylic acid,
Aromatic vinegar,

2 to 3 parts.

25 parts. Alcohol, (eighty per cent.) 72 parts.

The parts are to be rubbed with a piece of flannel wet with the mixture. One application is usually sufficient. Sulpho-calcine is also excellent in this trouble as well as innocent of any irritation in its application.

INJECTION FOR GONORRHOEA. -A new specific for gonorrhoea is a one per cent. solution of creosote in decoction of hamamelis combined with boric acid. It is claimed that this

July 4, all union in wound destroyed and will destroy the gonococci in two hours.

Summer Heat a Cause of Disease in Infants. mild attacks, that are not thought to be serious or even worthy of calling the physicians' attention to are, in the hot weather, the beginning of the more serious intestinal troubles and ought not to be neglected. Prevention should be our aim and cannot be attained while those having the care of infants are ignorant.

S. G. S.

With the heat of summer we have a large increase of patients of the infant class. Is there anything in the high temperature of the atmosphere causative of the summer diseases of children? We think there is, but if we examine our patients and thoroughly sift the evidence, we will be forced to the conclusion that the cases where the cause is due to high DR. F. F. DICKMAN, in the July number of temperature alone, are very few. We have the Catalogue, publishes a paper he read benot space to consider the effects of heat alone fore the Bourbon County (Kans.) Medical Soon the child. Suffice it to say, under the in-ciety, in which he makes some statements fluence of heat there is great relaxation of the founded upon original research and the literavascular system and arrest of glandular action ture on the subject, that are worth careful due to the depressent effect on the vaso-mo- consideration. The subject of his paper was, tors, blood changes take place, the red cor-"The History of Injuries, and Their Imporpuscles are rapidly destroyed. Blood drawn tance in Surgical Diagnosis, Especially its during an attack of thermic fever shows crenation of the red corpuscles, and that the white corpuscles are not present in proper proportion. These conditions are present in varying degrees, owing to the extent of the exposure and the strength of the child, but when infants are in health having good care, good food, good sanitary surroundings, there is but little danger from the summer heat of this latitude.

Bearing in the Differential Diagnosis Between the Different Portions of the Body, with a special consideration of the so-called Concussion of the Brain and Spinal Cord, and Compression, Studied from an Anatomical and Physiological Standpoint." In summing the matter up he says:

I.

That concussion of the spinal cord never does nor can take place.

2. The moment actual lesion occurs conBut with the weaklings, the bottle-fed, those cussion is excluded, and I find that all autopfed on adult food, with bad sanitary surround-sies on record for supposed concussion have ings, bad care, uncleanliness, etc., these fur shown actual lesion. nish the vast majority of the victims of summer heat.

Physicians must be teachers, and they usually perform their duties with credit, but there are a large number of mothers and nurses having the care of babies, who do not know how to fulfill their responsible position, and must be taught the details. It should not be thought beneath the dignity of the physician to patiently instruct those having the care of the little ones, even by practical demonstration, how the babe should be clothed, how to sterilize the milk, how to clean a bottle used by baby, and many other little details which, if neglected, seal the fate of the infant.

Physicians should impress on the mother the danger of overfeeding. Warn them not to neglect the slight catarrhal diarrhoeas. These are curable by simply clearing out the intestinal tract and limiting the food. These

3. All symptoms that are as a rule ascribed to concussion are such as interfere with conduction, or, as in my case, a lesion of the sym pathetic system.

Dr. Dickman also refers to a paper read by B. A. Watson, M. D., at Nashville, in which the writer relates a number of experiments on dogs, and pointed to what Dr. D. had already done, and finally says: "Having completed our study on the so-called 'concussions of the spinal cord,' from an anatomical and experimental standpoint, I am thoroughly convinced that neither pathological lesions, nor even functional disturbances, are ever produced in this center, in a healthy cord, without the application of a very great force. It is foolishly absurd to presume that these morbid conditions can have their origin in a slight jar, wrench, or even the application of a moderate concussive force, etc."