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Under this head we endeavor to present a Condensed Summary of Practical Medicine, drawn from the best and most reliable sources, thus saving our readers much labor in winnowing out from the chaff, medical grains of real value.
PROPHYLACTIC CIRCUMCISION. be slipped under and peel the two mucous
surfaces of the glans and prepuce apart, During twenty years of active practice clear the corona, clear out the smegma in in general medicine and surgery it has the sulcus, apply a lubricant, and instruct been my experience to have seen many the mother to retract daily for a spell. It fads and fancies of our profession arise, is astonishing how many cases of phimosis flourish for a time, and then fade away. and apparently redundant foreskin yield to Crede's method of placental expulsion was this treatment. I most emphatically oppose so thoroughly ingrained in the students of the custom of indiscriminate circumcision, my time, and later, that any expression of and I contend that many, many cases supcriticism of the practice branded one as posedly fit for no other treatment than ciruninformed. In the passage of years I cumcision can be better treated by the have seen many cases of hemorrhage that method outlined above. in my secret mind I attributed to the too
The two main arguments advanced for hasty removal of the secundines. At this
the routine practice of circumcision are time an expression of that opinion does not
that the prepuce causes reflex irritation arouse professional contempt.
and that venereal diseases are the more I have been awaiting a sensible attitude
easily acquired where the foreskin exists. of our brethren in the matter of circum
A freely gliding foreskin never irritates. cision, but by the journals I judge that the
Venereal infection is acquired as readily acme of that fad has not been reached. I
by an abraded surface uncovered as by one wish to be numbered among the pioneers
covered. I further contend that an exwho protest against the indiscriminate circumcision of male infants. In my experi
posed gland is more likely to be irritated
than a covered one; furthermore, the proence it has not been usual to find in the
tected nerve terminals are a help to the new-born prepuces that could be retracted
longer preservation of potency. I could easily. Following the teaching I had received I had circumcised prepuces seem
enlarge on the unsightly deformities that
have come under my observation from this ingly redundant and non-retractible in the
practice of circumcision, but I am only new-born up to some years ago. Then, on
pleading for a common-sense stand by phyone occasion, upon preparing to remove
sicians on this fad of clipping foreskins. the foreskin, I fortunately discovered a pneumonia which delayed the operation, and I did not see the child until some
[The above was scissored by us from a months after. On re-examining the pa
recent number of the Medical Record. It tient I found the same apparent condition, was communicated to that journal by Dr. but upon producing stiffening I slipped the J. C. Farmer, of San Francisco, and it is foreskin over and thereafter advised doing
so eminently practical, and shows such so daily and applying a sterile lubricant. Since that time I do not circumcise, if
good common sense, that we have deemed there is a free flow of urine, until the child it worthy of reproduction here. Read it is a year old, and I have found very few carefully, think it over, and see if you do cases that did not yield to a gentle separa- not agree with us as to its practical worth. tion of the foreskin from the glans, and
If you do not agree with the arguments after that a free slipping back of the hood. I apply cocaine to the parts, retract as far
presented, let us have your own views for as possible, slip a probe under the sluce, or
publication in THE SUMMARY columns. when necessary nick an opening for it to Ed.).
Notes and Queries
For this Department we cordially invite Questions, Comments and Criticisms on all Topics of interest to the Physician in his daily work for relief of the sick, thus making Summary a valuable medium of communication between the medical profession.
Correspondents will give their names and addresses, but initials will only be printed when desired.
The queries in this issue awaits the Answers which our intelligent readers may be pleased to contribute for publication in our next.
A SEVERE CASE OF HEMETEMESIS, tion was asked by me, but owing to the
indigent circumstances of the family, the WITH RECOVERY.
man did not wish to incur the additional
debt. The woman continued in this low Editor Medical Summary:
state of vitality four days. Supposing that This case happened to fall to me very
there had been quite a destruction of tissue recently. The woman was a frail little to account for all this blood, I looked for body of about thirty-five, having a family
an inflammatory action, and this I knew of half a dozen children, the last just
the woman could not well combat with so weaned. She had not had a return of her
little blood. The temperature during that menses. When I entered the room I saw
time wavered between 100 and 102. If she was as pale as paper and her lips were
it had gone to 103 or 104 I am of the as white as her skin. Hemorrhage sug
opinion that death would have immediately gested itself to me at once. No history of
followed. But in this case the unexpected hemorrhage concealed or otherwise was
happened, and she became slightly conelicited. I thought of ectopic gestation and valescent on about the fourth or fifth day. a ruptured ovum, but found no evidence Notwithstanding the low state of vitality, pointing particularly toward it. There
she retained a certain amount of nourishwere slight elevation of temperature, ex
ment and stimulants, which greatly aided treme weakness, pulse of 120 per minute,
nature's other recuperative measures. The weak and thready, and in keeping there
nourishment consisted of eggnogg, beef tea, with there was a feeble heart whose first chicken broth and milk, and later butterbeat was almost absent. Strychnine, dig- milk. Codeine and other sedatives were italine, and diffusible stimulants were pre
given until the danger of a recurrent atscribed. The next morning all these symp
tack of emesis seemed past, and after that were multiplied several times. The the bowels were kept open with calomel features were like marble and she seemed
and Abbott's saline laxative, alternating almost exsanguinated. The heart and cir- occasionally with castor oil. Calomel and
. culation were still feebler, and the pros
soda in one-grain doses were well tolerated tration was extreme.
The raising of the
after the immediate danger seemed past. even slightly produced fainting. The
The most interesting phase of this case, husband showed me, after my brief exami- from my point of view, is that the woman
a wash-pan half full of blood and mucus which she had thrown up during the
W. T. MARRS, M. D. night. The emesis was followed by faint- Peoria Heights, Illinois. ing and prostration. The blood was thickly clotted, and looked to be between a pint a quart of it. The next night an
RAKE “UP” OLD ASHES. attack of vomiting occurred, and about the same amount of blood was again ejected. I do not know where it could
Editor Medical Summary: have all come from, she being very ane
Some of the old remedies discarded to begin with. The prognosis looked as the best after all, and do better work. I
anything could be, and a consulta- had a case of the old-time itch (scabies).
and gave this formula, and had such happy "the mind runs the body," especially in results that I give it for what it is worth :- such cases : R Sulphurated potassa ......3iij.
☆ Ol. terebinthinæ, Ung. hydrarg. nitrat.,
M. Sig.-Twenty drops after meals and M. Ft. ung.
bedtime on lump sugar, slowly dissolved Sig.-Rub in well the last thing at night
in the mouth or in a little sweetened water. and first thing in the morning wash
It can be employed as a liniment with off, after morning's application,
good results, and it has been of great serv“Grandpa's” common wonder soap. It is
ice to me for years. I have used an oldso full of potassium carbonate and com
fashioned teniacide for years with good remon tar, that it kills the parasite or itch
sults, and as it is a little unusual, many mite.
of you have not been familiar with it. The salve perfumed with a little oil of
Give the patient weakened doses of Epsom bergamot is not objectionable, and does
salts, in strong lemonade, for two days quick work. Where a lotion is indicated
previous to taking the antidote, and a light
slop diet. The magnesia and lemonade use this, and you will find it effective:
will take away the mucus protection from Acid salicylic,
the worm, and have your patient take a Potassium bicarb. .....āā. 3vj.
pint of kershaw or crooked neck squash Aqua dest.
.q. s. Zviij.
seed pounded up in a strong mortar, with M. Ft. lotio.
enough water to make a light emulsion, Sig.–Use three or four times a day on
and strain through cheese cloth. Take onepoints that itch, and wash off once a day half, and in one hour the rest; three hours with soft soap or the bar soap mentioned.
after take two tablespoonfuls of castor oil, I never believed much in internal medi- or one dram of comp. jalap powder, and cation, as the ravages of the parasite is six drams of sulphate of magnesia in half truly a local affair. Of course, the clothing a glass of water. You get the head every should be changed often and strict cleanli- time. The kershaw seed can be gotten at ness observed in every way. Where it is any seed store, and you can often get the imperative that you make a rapid cure, squash at the grocery store. Did you ever use a 90-per-cent. solution of liquid acid
notice, you men of the profession, that all carbolic with glycerin, and antidote it lo- anthelmintics act on the great sympathetic cally at once with pure alcohol; as it most chain of nerves, and the majority dilated often presents itself on hands, forearms, the pupil. Santonin, spigelia marilandica, and lower extremities, you can do this or pink root, one of our most efficient easily and with safety. Oftentimes those
preparations for the annoying lumbricutaneous diseases are overtreated, and a coides, will cause light delirium and a very troublesome irritation produced by dilated pupil : Santonin, pelletierin, all the agent employed to treat and control it. of them, and kousso. The kershaw-squash I give you a prescription as old as the hills, does it in some cases to marked degree. but very popular with the laity after they Pumpkin seed is good in some cases, but have used it. It is indicated in subacute too mild in many. In writing a practical rheumatism and bottled-up uric acid, article for a journal, one digresses and gets where we have unhealthy deposits and in- way out in the stream, and in a future filtration in the muscles, and the toxins article I will stick to the text and try to cannot get in the general circulation, and draw from the cortical cells of my brain a where we have a false metabolism, if you few thoughts that will amuse and perhaps can use the term. In septic prostatitis or edify. Some that are willing to recognize when we have hypertrophy of that gland, that a man of forty years' experience has it certainly does effective work, and then a few good cards up his sleeve yet, and is we have a strong and potent psychical ef- willing to play them for the benefit of those fect, as the terebinthinate odor is so marked that are willing to absorb. the patient thinks the goods go right
A. V. Banes, M. D. through to the diseased surface. Verily, St. Joseph, Mo.
learned it himself from Chiron, the centaur,
and afterward instructed his friend, PatroEditor Medical Summary:
lus, in it, who did not disdain to exercise
the art in healing the wound of Eurypilus. We learn from “Rollins' Ancient His
This wound he healed by the application tory":
of a certain root, which immediately as"In early times the origin of physic, the suaged the pain and stopped the bleeding. beginning of which, as of all other arts Botany, or that part of physic which treats and sciences, were very rude and imper- of herbs and plants, was very much known, fect, Herodatus, and after him, Strabo, and almost the only branch of the science observe, that it was a general custom used in those early times. Virgil, speakamong the Babylonians to expose the sick ing of a celebrated physician who was into passers by in order to learn of them structed in his art by Apollo himself, seems whether they had ever been afflicted with to confine that profession to the knowledge a like distemper, and by what remedies of simples. It was nature herself that they had been cured.” From hence several offered these innocent and salutary remepeople have pretended that physic is noth- dies, and seemed to invite mankind to make ing else but a conjectural and experimental use of them. Their gardens, fields, and science, entirely resulting from observa- woods supplied them gratuitously with an tions made upon the nature of different infinite plenty and variety. As yet no use diseases, and of such things as are con- had been made of minerals, treacles, and ducive to and prejudicial to health. It other compositions since discovered by must be confessed that experience will go a closer and more inquisitive researches into great way; but that alone is not sufficient. nature. Pliny says that physic, which had The famous Hippocrates made great use
been brought by Aesculapius into great of it in his practice, but he did not entirely reputation about the time of the Trojan rely on it. The custom in those days was war, was soon after neglected and lost, and for all persons who had been sick and were in a manner buried in darkness till the time cured, to put up a tablet in the temple of of the Peloponnesian war, when it was Aesculapius, wherein they gave an account revived by Hippocrates and restored to its of the remedies that had restored them to ancient honor and credit.
This may be That celebrated physician caused true with respect to Greece, but in Persia all these inscriptions and memorials to be we find it to have been always cultivated copied, and derived great advantage from and constantly held in great reputation. them. Physic was, even in the time of the The great Cyrus, as is observed by XenTrojan war, in great use and esteem. ophon, never failed to take a certain numAesculapius, who flourished at that time, ber of excellent physicians along with him is reckoned the inventor of the art, and in the army, rewarding them very liberally had even then brought it to great perfec- and treating them with particular regard. tion by his knowledge of botany and chirur- He further remarks that in this Cyrus gical operations; for in those days these only followed a custom that had been anseveral branches were not separated from
ciently established among their generals, one another, but were all included under and he also informs us that the younger profession.
Cyrus acted in the same manner. The two sons of Aesculapius, Podalirius It must, nevertheless, be acknowledged, and Machaon, who commanded a certain that it was Hippocrates who carried this number of troops at the seige of Troy, science to the highest perfection. And
no less excellent physicians than though it be certain that several improvebrave officers, and rendered as much service
discoveries have been in the Grecian army by their skill in medi- made since that time, yet is he still looked cine as they did by their courage and con- upon by the ablest physicians as the first duct in their military capacity. Nor did
and chief master of that art; and as the Achilles, himself, nor even Alexander the person whose writings ought to be the Great in aftertimes think the knowledge
chief study of those who would distinguish of this science improper for a general or
themselves in that profession. beneath his dignity. On the contrary, he Men thus qualified, who, to the study of
the most celebrated physicians, as well The physiologic action of brucine resemancient as modern, as also to the knowl- bles that of strychnine, but the former is edge they have acquired of the virtues much less powerful. Various writers have of simples, the principles of natural philos- pronounced the difference as great as i to ophy, and the constitution and contexture 6, or even 20. Bouchardat denied that any of the human body, have added a long such difference existed, and in America practice and experience, together with their brucine is considered equal to one-half or own serious reflections; such men, in a one-quarter the strength of strychnine. well ordered state, deserve to be highly The therapeutic effects of the two are rewarded and distinguished, as the Holy closely analogous, both being applicable in Spirit itself signifies to us in the Sacred the whole line of paretic maladies, torWritings :
pidity, and atony of the whole body or of "The skill of the physician shall lift up
any special member or organ. In such his head; and in the sight of great men,
conditions as occurring in young children,
, he shall be in admiration,” since all their
brucine is preferable to strychnine. Laura labors, lucubrations, and watchings are
counsels the milder remedy in atony of devoted to the people's health, which, of
the gastro-intestinal musculature, in tymall human blessings, is the dearest and most panites disordering digestion and giving valuable. And yet, this blessing is what
rise to diarrhea or to constipation, or to an mankind is the least careful to preserve.
alternation of the two. This is a common They not only destroy it by riot and ex- and at times a perilous condition with incess, but through a blind credulity, they fants. Tympanites sometimes embarrasses foolishly intrust it to persons of no credit both respiration and circulation. or experience, who impose upon them by Laura found brucine especially effective their impudence and presumption, or se
in the treatment of the paralyses of induce them by their flattering assurances of fancy as manifested among the poor chilinfallible cure.”
dren of the Children's Hospital. The cures There were, it seems, mountebanks in
thus obtained, he adds, were no secret those days. We have them in every com
among the physicians and the benefactors munity; not that they are ignorant and
of this institution. devoid of medical education, but that they
Brucine suits the young and the feeble. make promises they know they cannot
It increases the force of expectoration, fameet, and covertly decry the merits of some
cilitates respiration, digestion, and defeother brother's capabilities and treatment,
cation; it aids in the generative act withas compared to their own superior attain
out endangering collapse and syncope like ments and skill. Of all men, they are the
the direct aphrodisiacs (Burggraeve). It most contemptible and dishonorable.
is preferable to the latter also, as it has D. L. FIELD, M. D.
not their well-known (to the laity) repuJeffersonville, Ind.
tation, a source of the gravest peril and occasionally a cause of death when these
drugs are taken ignorantly or injudiciously. BRUCINE.
Laura, who had a large and happy experience with brucine, placed the dose at
two to three times that of strychnine. Editor Medical Summary:
Something is to be credited to individual This alkaloid is found in varying pro- susceptibility also. Taking the granule of portions in nux vomica, ignatia amara, an- 1-134 grain, he advises as a mean daily gustura, and in general throughout the dose 12 to 20 granules for adults, 5 to 10 family of Loganiace. The process for its for children, in acute cases. In chronic extraction is simple and well known. It maladies adults may take 6 to 10 granules is more soluble in hot than in cold water. daily, children 2 to 4. The remedy should It forms crystallizable, soluble salts. The be suspended occasionally for a week out brucine of the shops is almost always of each month, or for every sixth day. In inixed with strychnine, and the variations cases of long standing it is well to begin in relative strength assigned to brucine with one granule four times a day for may be attributed to this fact.
adults, adding one daily dose every alter