waited about ten minutes. I then laid the tumor open in, three places, and after the subsidence of the swelling, found, to my shameful surprise, that I had opened the gut in just so many places. I then waited for some days and found that there was no trouble in passing feces, and the parts seemed to be healing nicely with the aid of iodiform and borax. I intended to bring the incised parts together with sutures, but finding that the compresses of absorbent cotton were doing all that could be expected, I decided to let the healing go on without any further disturbance.

Mrs. H. is now well and in her third pregnancy. An old physician of forty years practice was called in in my absence, and I never knew of it until my patient was well and discharged, he never discovered the mistake, and thanks to God for it.

Can any one tell me who was the most ignorant? His eyes are good and we are not of the same church.

This dose may be given to infants of a few months, and to children of a year or more in age. Each teaspoonful contains one-fourth of carbolic acid, the active ingredient.

In your "Manual of Treatment" I see Prof. Davis gives carbolic acid in some particular stage of the diarrhea in extremely small doses, the forty-fifth of a grain once in four to eight hours. As a germicide the acid is of no avail in this dose. A pint of bacteria laden fluid in the infant's degestive tract requires the same amount of bi-chloride or carbolic acid to destroy its disease-giving element as does the same fluid in that of the adult, and infinitesimal doses are simply disappointing.

Neither Palmer nor Jacobi mention carbolic acid as a remedy in the treatment of these diseases. Creasote is barely mentioned by Palmer as having been used by some practitioners. One of your correspondents some months ago called attention to it, but gave no particulars of its use.

I always precede this treatment with calomel in doses of three to six grains, divided into

Syr. simp. vel aq. pur. ad. .fl. unc. ij. Misce. Sig. Give a teaspoonful every half hour, or two hours.

The quantity of veratrum may be increased, depending on the height of fever and arterial tension. I generally order a dose every fifteen or thirty minutes for four times, then once an hour until the patient sweats profusely, or the fever is decidedly abated. Under the influence of this combination the tongue moistens and the secretions and excretions become stimulated to throw of the products of destructive combustion. F. A. ALFORD.

Ferndale, Cal.

[Notice that the doctor uses "unc." as the abbreviation for unciam, the Latin for ounce. Our familiar "oz." for ounce is entirely arbitrary, as the letter "z" does not occur in the word, excepting in the Spanish, onza, ounce. -J. J. T.]

Difficult Twin Labor. Editor MEDICAL WORLD:

I

A few months since, I had an obstetrical case which I think was unique in medical literature. Being called to Mrs. McC., I met the midwife at the door, who said it was coming all doubled up, with something between its legs. hasten in, and after a prolonged examination, I discovered that there were two children, one presenting the head, the other presenting the feet with the cord drawn tight up in the crotch, the feet and legs hanging down in the vagina, both children jammed down into the superior strait very tightly. I omitted to say the woman was robust, weighing 180 lbs., and in her 11th pregnancy, pains strong, and with no intermission. I first tried to push one child back and then the other, for the double purpose of finding to which child the cord belonged, and which of course had to be delivered first. This was found to be impossible as the pains were so strong. I commenced the treatment by giving her one-half grain every twenty minutes of tartrate of antimony and potassium, preventing the children in the mean time from advancing by pressure. At the end of

thirty minutes the mother's system began to relax, and I could move first one child and then the other back into the uterus. I found that the cord belonged to the child presenting the head. I just set the footling gentleman up, and on the side of that broad pelvis and held him there until the nausea passed off, which was in a short time. I gave a small dose of morphine; pains soon come on, and the head of the first child soon cleared the brim. I delivered it with the forceps, the woman having been in labor 32 hours; the second soon followed. One child weighed 9 lbs., the other 81⁄2 lbs, and was a complete mermaphrodite externally. Now brothers could this woman have been delivered if there had been a minimum of contraction, or even an ordinary size pelvis (perrias naturalis)? In conclusion, I will say give me tartar emetic to relax the system in all such cases. I. B. GRIMES, M.D.

Mt. Meridian, Ind.

Pulmonary Edema-Prevention of Hepatic Colic.

Editor MEDICAL WORLD:

I am inclined to think acute pulmonary edema was the cause of death in Dr. Frank D. Kinsley's case of pneumonia, page 147, April WORLD. If seen in time, prompt venesection is probably the most effective treatment, unless contraindicated by dilatation of the heart or great feebleness of pulse and cyanosis. To Dr. T. Powell, page 158, April WORLD, I would suggest the persistent use of phosphate of soda as a prevention for attacks of hepatic colic as recommended by Prof. Bartholow. Give from 1 to 41 before each meal for several months. By preventing inspissation of the bile and crystallization of cholesterin it frequently greatly lessens the number of attacks. It is also very necessary to get the patient to abstain as much as possible from the use of starches, sweets and fats. Milk, eggs, animal broths, broiled or raw beef-steak, oysters, white fish, etc., are suitable articles of diet.

Clarksville, Tenn.

C. ALLAN BROWN, M.D.,

Two Cases.

Editor MEDICAL WORLD:

Patient, Mr. F., aged 45, light complexion, medium in size, farmer, became ill about eighteen months ago, but not enough to stop him from work. He tells me that all summer, when he would stop moving about, his bowels would pain him something like colic, so he would be compelled to move on or sit down. His appetite was good, bowels regular, digestion perfect. In December, 1887, he consulted me. I found his bowels tender upon

pressure, with slight jaundice. I commenced treatment with calomel, with some benefit. His symptoms since have been as follows: He has gradually lost flesh; his bowels have grown worse, so that every third or fourth day they would pain pretty severely, and he would have three or four stools in twenty-four hours, which consisted of pus and mucus. His urine is loaded with urates. I never saw more in my life. There was some tenderness over region of bladder, which all left under treatment, but he is just gradually going down. He looks today as if there was not an ounce of blood in his body. His face is clear and of a pearly cast, though his appetite is still good. There is no phthisis in his family history, neither is there any membranous enteritis. I have given him every known remedy, without any good results whatever.

Also, I have a little girl, four years old, who is troubled with small blisters or vesicles on the inner surface of the labia majori which made their appearance when she was only two weeks old. They do not itch, but accumulate until they get so thick that they cause her to complain of being sore. I can cure them up, but they soon return. I would like something that will make a radical cure.

Woodland, Iowa.

A. C. REYNOLDS, M. D.

Alcoholic Hysteria.

Editor MEDICAL WORLD:

Says

J. B., aged 62, weight 178, complexion dark, drinks liquor daily, and is the subject of chronic bronchitis; family history clear from nervous troubles. He states that seventeen years ago he had the cholera in Nashville, Tenn., but denies any previous specific infection. After recovering from the attack of cholera he was an invalid for three years, his weight during that period being ninety pounds. Up to nine years ago he had fits nearly every month. Since that time he had only two, about two months apart. he is conscious of his surroundings when having them, and knows when they are coming on by a pinching sensation, followed by numbness, notably on left side, commencing at his toes. and ascending gradually to his chest, when a struggle for breath ensues, which he says is relieved by someone forcibly pounding his breast. Sometimes, he states, these spells are avoided by walking until the pinching sensation leaves him. I was called to see him at 2 P.M., February 10, found him sitting in a chair quite rational. I was informed that a fit had just left him, being the third one previous to my visit. In a few minutes he straightened himself in his chair, extending his head, body and lower limbs

to their utmost, the arms twisting inward, frothing at mouth, face congested, eyelids closed, pupils somewhat dilated. In two or three minutes he recovered and had a coughing spell, and remarked that he knew what was going on; suffered no pain at any time, but could not get his breath. He laughed, seemed in good spirits, and was very talkative. I prescribed bromide sodium, gelsemium, and sticta. While in the act of laughing he was again attacked as before, soon recovered, apparently all right. Pulse 90, breathing somewhat accelerated. I left him and returned within an hour. Was informed that he had visited an adjoining saloon in my absence and had procured a drink of whiskey, and on returning had another spell. I ordered the bromide mixture continued every two or three hours until quiet. He was prostrated for several days, but has not had a return of the trouble since. Urine not examined. Can any member of THE WORLD'S medical society give a diagnosis of the case? Was it alcoholic hysteria? or is the disease a sequel of the cholera?

Please give me the formula for compounding the syrup of phenate of ammonia.

Bloomington, Ind. JOHN E. HARRIS, M.D.

sion. In a future revision of the "Manual" it will be duly noticed. We had never had opportunity of trying the remedy in hiccough attending peritonitis; and as the anodyne is a nervous stimulant, would not expect it to do much good, even if Dr. Putnam succeeded in getting the genuine Hoffman's anodyne. It is very difficult to obtain on account of the scarcity of pure ethereal oil. The cases in which alone we used it were simply nervous. In our own case the affection came on without apparent cause, and lasted forty eight hours before being relieved by the anodyne.

Muscular Rheumatism.

Editor MEDICAL WORLD:

I have a case that I would like to lay before the readers of THE MEDICAL WORLD. Harry Hays, aged seven years, was out at play with his fellows last fall, when he suddenly cried out that he could not walk for the pain in his right knee. He had to be assisted home. In an hour I was called in to see what was wrong with the boy. His mother said that he could not walk, and that he took on terribly with pain in his knee. I found on examining his knee that it was swollen quite full, the swelling extended from two inches above the knee-joint

down half way to his foot. I diagnosed subacute rheumatism, and gave tinct. aconite to bathe the part with, and directed to keep on warm poultices. Made poultices out of plantain leaves wilted in warm water. Gave him one drop of tinct. aconite every four hours and a half, and also gave a powder composed of two grains of calomel and two grains of pulv. salol. Next morning I called to see how the boy was, and found him up and feeling quite well. His knee did not pain him any. His physic had operated well, and he said that he was well. I told him to keep quiet that day, and left for my office. The next day I was called in to see the boy again; his left knee had become as painful as the right had been. I ordered tinct. aconite to bathe the parts with and apply the leaves as the day before. Gave tinct. guaiac and sweet spirits nitre equal parts, six to eight drops every four hours. Next morning the boy had not rallied as well as the first time, but was much easier than on the previous night. By night the boy said that he was quite well. Next day he complained of the right fore-arm. The next day it was well, but the left arm was as bad as the right had been. The next day the left arm was well, but on the back of his head was swollen and painful. Next day it was on top of head as painful as the back. The next, it moved to the forehead, and disap peared from top of head, and so it skipped

from one place to another. It went up along his back, shoulders, breast and abdomen. At last it affected his stomach. I tried the alkaline treatment with quinia, but when stomach was affected by it I gave bromide of potassium and fluid ext. ergot with quinia. In a few days he was better and convalesced well, and was well and hearty until the last of the winter, when he became affected as before. It swelled up here and there as before. This time I ordered tinct. guaiac, fluid ext. ergot with quinia, with once in four days a powder of calomel and sub-nitrate of bismuth to clear out

the bowels. He was sick some ten days, began to convalesce, and was well in a week or two, so that he returned to school. It never appeared in two places at the same time. Now, what I would like to have the readers say is, What was the matter with the boy? I called Imuscular rheumatism; was I right or not? Linesville, Pa. DR. J. O. KENT.

Diphtheria.

tor MEDICAL WORLD:

We have had something of an epidemic of htheria in this section during the past six Paths, during which time I have never been thout one or more cases. At present I have convalescents and nine suffering with the Beaded disease, eight of whom are in the same st. I have lost only two of my cases in six months, one an infant, fractious and unanageable, and one dying when first seen. following is my treatment :

Local: Poultices of bran or hops, kept and moist in a steamer over a pot of boilgwater into which I pour half a teaspoonful pure carbolic acid every three hours.

Steam the throat by inhaling the steam from vessel containing hops, vinegar and lime

water kept b›iling for five minutes out of each hour.

Spray the throat with a hand atomizer containing the following solution, warmed : R Potass, permang.

Potass. chlor.. Aquæ calcis,

.gr. x .gr. xx

..Zviii M.-Throw the spray directly against the surface coated with membrane every one or two hours, day and night.

Gargle often with equal parts of vinegar, and very hot water.

Constitutional: Every two hours give brandy according to age. Milk, half a cupful to a or whiskey; a teaspoonful to a tablespoonful, cupful. Egg, beaten up with milk, sugar and hot water. Beef tea, half a cupful. Rice, well boiled. Farinaceous articles of diet made up with milk. Medicine:

Infantile Diarrhea.

Editor MEDICAL WORLD:

I have found the following one of the very best prescriptions in the diarrhea of children:

Calomelanos..

Pulv. Doveri.

Cretæ prep.

Pulv. zingiberis..

āā grs. 2

..grs. 30 .grs. 6.

M. Sig. Divide into twelve powders. One every two, three, four or six hours p. r. n., and continue at intervals till discharges become natural. Atlanta, Ga. STAINBACK WILSON, M.D.

Neuralgia. Editor MEDICAL WORLD:

I will give THE WORLD the best neuralgia remedy known, in my opinion. A trial will convince anyone of its superior merits: