Sig.fss every second hour, till headache or deafness becomes a prominent symptom; then give the same dose every fourth hour.

It is not necessary to make any remarks on the salicylic treatments, but I think the combinations herein set forth sufficiently commendable to attract notice, as the salt seems to diffuse itself more quickly and efficiently through the system when given in the mendereri menstruum.

THE MISTURA ALBA,

Of the Adelaide Hospital, given in cases of gastric ulcer, and as a night calmative in phthisis, is a very agreeable and happy combination:

Sig. One every second hour, till pain is relieved. As a preventative he gave one t. i. d. for a day or two before the menses appeared.

Mr. Nixon, Surgeon to Mercer's Hospital, was very successful in the treatment of

SCIATICA.

This was his treatment:

R Vini colchici,

Liq. donovani.

Kali iodidi

.āā.... f3 ij 3 ij

Decoct. sarsæ co......q. s. ad.....fz viij

M. f. mist.

Sig. f3 ss in one-third glass of water, after meals.

Externally, he counter-irritated the lumbar spine, as well as along the course of the sciatic

nerve.

He used what he called the pigmentum iodi:

B

Linimenti iodi (B. P.),

Tincturæ iodi,..

M. f. pigmentum

.āā....f zij

Sig.—Apply till skin becomes black, once a week.

I have seen the most gratifying results under his care and treatment, and in the few cases I have had the opportunity of treating in hic modo this treatment has been successful every time; and I can say that in one case of ten years' standing it completely cured, but the patient was under treatment for over two months before we gained this end. To cure chronic sciatica, however, "it takes chronic time," and if we can prescribe any remedy, with a reasonable hope of success in these cases, it is well.

Remark here that the dose given was fifteen grains of the soluble iron salt. As a rule, cases of anemic amenorrhea are the subjects of habitual constipation. Indeed, we might say it is almost an invariable concomitant, the general system being in a state of torpor. Now, under the influence of the dose named, the bowels become regular, and sometimes become relaxed in the beginning. Undoubtedly, this is due to excess of the salt, causing mechanical diarrhea; but soon the system becomes adapted to the dose by a more perfect absorption and assimilation. I have seen cases under his care responding promptly to this treatment where other means had failed.

In the same class of cases as the preceding, Dr. Charles F. Knight, of Mercer's Hospital, used to prescribe this pill:

"To Distinguished Physicians." Editor MEDICAL WORLD:

I am pleased that the idea of having something in the dress of the physician to reveal his profession has met such a wide-spread interest, and I cheerfully accept the commission to receive suggestions as to the character of the designation to be adopted.

Quite a number of letters have been received and they will all receive due consideration. Those who may have pronounced or helpful ideas on the subject, please address me here. I. H. STEARNS, M.D.

16 Federal St., Lynn, Mass.

Purples.

Editor MEDICAL WORLD:

Mr. A., aged 46, farmer, widower, came to me January 10th, 1888, for treatment for purples. Four weeks before he had a slight attack of "German" measles, and ten days later he had a slight attack of malarial fever. It was a cold day when he came, and his face looked almost exactly like it had been painted with iodine. Ten minutes by the fire removed every trace of the purple. He then informed me that when he was out in the cold a short time he would turn almost black, but he had no trouble at all while he remained in a warm room. He complained of no pain at all except numbness. A few days treatment with tincture of iron and chlorate of potassium and quinine prevented a return of the purples, even when he was exposed to cold. C. KENDRICK, M.S. M.D. Corinth, Miss.

Information Wanted. Editor MEDICAL WORLD:

I am a great sufferer from lumbago and sciatica, and, as I have tried everything I have seen recommended in the way of liniments, counter-irritants, electricity, and internal remedies by the dozen, and have never received any permanent benefit, I ask my brother M.D's for advice in any way they may see fit to give it, but especially in regard to a location where rheumatism is not prevalent. I think if I could find a warm, dry, even temperature I would not be troubled much, as I am much worse in cold, damp weather.

Arlington, Kans.

JAS. W. HANAN, M. D.

A Suggestion.

Editor MEDICAL WORLD:

I wish to suggest that when a brother answers a question propounded in a previous number of THE WORLD, he begin his reply by giving the page of the inquiry, as well as the inquirer's name or initials, thus enabling the brotherhood to readily review the description of case. We are all interested, and by doing this we will save each other loss of time in searching for the inquiry, which is often difficult to find. Dr. Waugh sets a good example; let's follow it. By all means, change the symbol 3 to 4.

Purcell, Ind. Ter.

D. D. HALSHAD, M. D.

THE MEDICAL WORLD VISITING LIST, 1888.-A handy book, with removable tablets for each month in the year. The most practical list we have seen. Physicians may also use the accompanying ledger to advantage.-Int Med, and Surg. Synop.

Collecting Problem.

F. A. LONG, M D., MADISON, NEB. Editor MEDICAL WORLD:

How to collect is a question asked by several physicians through THE WORLD. I think it is a fact that most professional men lack business qualifications and business training.

I think the first thing necessary to enable a physician to collect his just dues, is to make up his mind that there is a business side to the practice of medicine. Having made up his mind to this, let him do as merchants

do: make a point of sending statements regularly. People will soon learn that doctors also need and want money, and at the same time they will find out that sinall bills are easier to pay than larger ones. The doctor will soon find out who the dead-beats are, and persistent 'dunning" will scare them away to his neighbor across the street, perhaps. I enclose a statement (my own contrivance), small, simple and pointed, the use of which gives excellent results. results. It is adapted, of course, to a country practice.

Cerebro-Spinal Meningitis and its treatment. Editor MEDICAL WORLD:

It was in 1872 that I first met with cerebrospinal meningitis, and I would say that the disease baffled all the skill that I could command. I was then practicing medicine some 12 miles east of this place (Louisville, Miss). It was about the last of January, or first of The weather February. was exceedingly changeable, a great deal of sleet and rain, with a rise and fall of the temperature, generally every 24 hours.

I was called to see Mr. Ts family, consisting of himself, wife and six or seven children. Two of his children were first taken sick, and died very quickly. The next that were to meet their fate were Mr. and Mrs. T., and then two more of the children were called to cross over the dark river. In the meantime several renters or tenants, both white and black, were visited by the destroying angel. I called in two other physicians, and we did all that we could, but death was in the land and it appeared that the blood was not on the door.

SYMPTOMS.

In giving the symptoms I can not do better than quote "Dickson's Elements of Medicine," with the addition of some symptoms that I will italicize. "It usually invades with a chill, succeeded by great febrile excitement, the headache being intense from the first, with severe pain down the back, and in the limbs. The countenance often flushed, expresses surprise, or wildness and terror; there is vertigo; the pupils of the eyes are generally dilated; sometimes, however, they are contracted, and, it is affirmed, may be in opposite states, one dilated and the other contracted. The patient is very restless, moaning or uttering plaintive cries; the breathing, at first hurried, soon becomes slow and oppressed, and even stertorous; the speech thick and inarticulate.

After an uncertain, but brief peroid, tetanoid spasms come on, being readily excited; there is hyperesthisia, with muscular rigidity. Opis. thotonos is the usual form, but it is sometimes pleurothotonos or emprosthotonos. Tympanitis and constipation are present, with palsy of

the bladder and lower extremities.

In the last stage there is coma; the tongue is dark and dry, with sordes on mouth and teeth; the bladder is distended, and a constant stillicidium of urine, and involuntary fecal discharges take place." FIRST STAGE-Tongue dark in centre and red around the edges, great pain in one finger or toe, engorgement of the lungs after 6 or 8 hours.

The following I find from my note book, the treatment adopted: Calomel, Dover's pow

ders and quinine, with spirits of turpentine applied to the neck with a sponge, and a flannel cloth over the neck, and ironed in with a flat iron, as warm as the patient could bear it. In several cases I tried the actual cautery to the neck and spine without any effect.

The above was about the treatment we used. The last case attacked was a negro man, whose about those symptoms were enumerated above. My experience was that the treatment we had used was worse than nothing, as all the preceding cases had been fatal. I concluded I would give him one dose and risk the consequences. I therefore gave him 60 grains of calomel. This was at night and I did not see my patient until next morning, when, to my surprise, I found him a great deal better. He was free from pain, could use his head, and had but little fever. The next day I gave quinine in 10 grain doses, every 6 hours, and discharged the case, his recovery being rapid. I have met with a few sporadic cases since, and have relieved my patients in every case.

When called to a case of cerebro-spinal meningitis of an adult, I commence treatment by giving calomel (20 grains) in a teaspoonful of balsam copaiba, with 30 drops of tincture of gelsemium, and repeat the dose in 21⁄2 hours, giving quinine in 10 grain doses, commencing at 4 o'clock in the morning, every 2 hours until I have given 30 grains. The fever is generally lower from 4 to 8 o'clock in the morning. If fever should rise, I give 20 drops of tincture of gelsemium every 1 hours, also copaiba every 6 hours. If the lungs are engorged, I apply a fly plaster over each lung, let it draw well, and then apply a mush poultice to the blistered surface. If the patient is restless give some Dover's powders until sleep is produced.

By giving the balsam copaiba at the commencement of the disease we have no trouble with the urinary organs.

Louisville, Miss.

Dr. A. S. KIRK.

examination I found the womb to be practically without a neck, it having, by dilation from above, become a part of the body, and by attenuation reduced almost to the thickness of a membrane. The finger passed the external os as if a hole in this membrane, and reached easily a tumor, apparently the size of a large hickory-nut, situated on the right side, at the junction of the body with the neck. I concluded to try the ergotine treatment, with a view to its strangulation or its spontaneous enucleation. This treatment was kept up at intervals, with more or less effect in controlling and lessening the discharge, for two years. The ergotine was given sometimes by the mouth for a week or two in succession; also occasionally by injection per rectum, and by direct application to the womb by saturating prepared cotton with ergotine in glycerine.

This course gave promise of success for many months; but finally began evidently to aggravate the hemorrhage, but was persisted in until the discharge became alarming, and called for immediate and most active measures for arresting it. I then took a new departure, and resorted to a gelatine intra-uterine pencil coated with persulphate of iron. Not having any of these pencils prepared with the iron, I took one of Mitchel's morphine and zinc pencils, and washed it down in warm water to such a size that, when rolled in the persulphate powder until well covered with a coat of it, it could be passed through the applicator into the womb. This very promptly arrested the hemorrhage. I contiuued to introduce these pencils every three or four days, with the effect of not only keeping my patient entirely free from hemorrhage, but of constantly diminishing the size of the tumor by the sloughing from its surface, due to the escharotic effect of the iron, after each application. The tumor diminished, the neck gradually developed and thickened, and the os regained its natural feel to the touch. During this treatment I watched until I discovered the recurrence of the menstrual period, and then only used pencils when the discharge was too profuse or too long continued. The patient was discharged, and for nearly three years has menstruated regularly and naturally. T. M. HARRIS, M.D.

Ritchie C. H., W. Va.

What is the Cause of the Headache? Editor MEDICAL WORLD:

Mrs. H., aged fifty-four, slender form, says that she has never had any good health excepting during pregnancy. She has been pregnant fifteen times, and has ten living children, the youngest being ten years old. She has not menstruated for the last eight years.

She has been a sufferer with piles for thirty years, more or less, but since the menstruation ceased the hemorrhoids have been more aggravated. She has great loss of blood after each action of the bowels, sometimes as much as one-half pint. She would then have to lie down for several hours. She is quite nervous at times, the least excitement producing pain in the back and palpitation of the heart, the pain running from the lower end of the spinal column to the top of the head, and is greater where the occiput and parietal bones come together at the top. She suffers more after lying down at night. She says it is not like any other headache she has had, but says it is an indescribable, uneasy feeling. She says it keeps her from resting well at night. The skin is thickened over the region of the pain. Her bowels are constipated, but move regularly under the influence of small doses of cascara sagrada. On examination per rectum I found hemorrhoidal tumors and an ulcer. I have treated the tumors by injecting carbolic acid into them. They are better, but she still has occasional small hemorrhages. I have treated this case on general principles for anemia and nervous debility, though iron in any form always aggravates the piles. She would now be enjoying a tolerable degree of health if it were not for this headache. What causes it, and what is the remedy?

THE MEDICAL WORLD is the best friend I know of for the man who wants to keep abreast with the times in the healing art.

Wilderville, Texas.

W. C. HEDRICK, M. D.

Colored "Inserts."

Editor MEDICAL WORLD:

I recently stopped my subscription to a highly valued journal, edited by one of the most talented and brilliant medical men in New England, because the journal came to me with colored advertising pages inserted in the body of the work. The distinguished editor is an ornament to a dignified profession, and I am sure is fully cognizant of the respect due it, and why he permitted this desecration I do not understand. We surely would object if our standard text-books were thus marred by the manufacturer of therapeutic agencies, who cheekily assumes to dictate to us how and wherewithal we shall treat our patients; and, as our journals are fully as important and valuable as our text-books, I, for one, propose to object to this advertising dodge, which is becoming too common. The mercenary spirit which, lost to all respect for the proprieties and for the studious reader, rudely thrusts his glaring sheets under our very noses perhaps in