Delayed Dentition.

Editor MEDICAL WORLD:

IN THE WORLD for April, page 138, I find a communication from Dr. J. B. Patton on "Delayed Dentition." We admit it to be a physiological process, and everything being equal, it is painless; but how often do we find it otherwise? The Doctor speaks of lancing the gums as cruel; the indiscriminate use of the lancet, I confess, is cruel and does no good; in fact, harm is done if the tooth is delayed, as it then has to overcome the resistance of the cicatrix. But what does he do when he finds the little fellows with convulsions, gums tense and white from strangulation? Does he rely entirely on sedatives and improvement of the blood, until the offending member comes through? When I find the above, my lancet is the first thing I think of, and usually in a day or two the tooth makes its appearance. In but a few instances I have had to lance the same gum more than once. A few years ago I was called to see a child some 12 or 14 months old with convulsions; had several before my arrival; found gum over lower incisors tense and white; went down to the tooth with lancet, gave one dose of bromide of potassium (about ten grs.). In a half hour my little patient was sleeping sweetly and the tooth came through in a day or two. After lancing I always direct the gums rubbed frequently with finger to prevent union. My ideas may be erroneous on the use of the lancet, and, if such should be the case, I am open to conviction.

Lauderdale, Miss.

W. J. STEVENSON.

Hiccough.

Editor MEDICAL WORLD:

I believe that in sweet flag (calamus) we have an agent that will relieve and stop persistent hiccough in almost any case. I have used it in many cases where the spasm was excited from varying causes, and it never has failed me yet. I direct the patient to chew a small piece of the root. I do not claim any curative property; the controlling power was accidently discovered. I have been afflicted from boyhood with attacks of hiccough, coming early in the morning and lasting till night, with intermissions of rest varying from one-half to one hour. These attacks come every six or seven weeks. control each paroxysm by the calamus. Granada, Kan. JOSEPH HAIGH, M. D.

Editor MEDICAL WORLD:

I now

I have been taking THE WORLD for several years, and feast mentally upon its contents as the famished traveler would upon the richest banquet. W. N. MILLER, M. D. 1905 Carson St., Pittsburgh, Pa.

Constipation in Infants.

Editor MEDICAL WORLD:

For his case of constipation in an infant, let Dr. J. W. Wooldrige, of Bowers' Mills, Mo., take a half drachm of reliable tincture of belladonna and an equal quantity of good alcohol; mix them and put one-third of this liquid into a wide-mouthed bottle with an ounce of No. 25 sugar of milk globules, and shake until the liquid is absorbed and the pellets equally moistened; then spread them on a plate and stir them occasionally to prevent them adhering together until thoroughly dry. Repeat the process until all the liquid is used on the same pellets. Then give his patient from six to twelve pellets dissolved in a little water three or four times a day, always remembering that if the dose is too large or too frequently repeated the object will not be attained. Call this irregular, or homeopathy, or what you like; but try it, Dr., and you will be pleased with it, and will find you can relieve your little patients pleasantly, while others are only making matters worse with the different drastic cathartics. Redwood City, Cal. G. T. MASON, M.D.

A Birth Without a Labor Pain.

Editor MEDICAL WORLD:

On Thursday, June 28th, 1888, I was called to see Mrs. F., who was expecting to be confined at any moment, as she thought her "time was up." She complained of her lower extremities feeling cold and numb and a sense of a bearing down weight in the lower part of her bowels, as she described it.

Upon inquiry I found that her membranes had ruptured and waters discharged on the Sunday previous. Thinking that labor was at hand, a midwife was sent for, and upon her arrival she made an examination and said that she thought that labor had commenced, but the woman had no pains whatever. She made all kinds of teas to produce pains, but with no avail. She then came to the conclusion that it was a false alarm and left.

Thursday and made close inquiry concerning As above stated, I was called on the following the case, and then made a digital examination and found the os dilated about three inches in diameter.

Vertex presented and was resting against the pubic arch. I considered the woman's very feeble condition, and with caution and anxiety attempted to bring on labor. I exercised every possible means to bring on labor pains, but all was in vain. I then decided to administer chloroform and deliver with forceps. After the anesthetic was administered, I dilated the os with my fingers and with difficulty applied the

There being no time to lose, I annointed my left hand and arm antiseptically, and gently made for the feet, which I failed to seize, it being impossible to do so on account of their position and the powerful contraction of the uterus. Podalic version now being out of the question without anesthesia, I directed an asistant to externally lift up the body of the child, while I passed my internal hand above and over the head of the child, and my right hand externally over the same.

Making traction and pressure now at the same time, I brought the head down to the pelvic brim and held it there. In a few minutes the uterine contractions drove the head down into the pelvic cavity, so that it could not again get displaced. Now another difficulty presented itself; the crevix at each pain, instead of dilating over the head, was closely hugging the prolapsed arm above it. To remedy this condition I directed the nurse to make firm, steady pressure downwards upon the body of the child, while I passed my index and middle fingers into the cervix and brought the anterior lip of the os over the head and held it there during several pains, when the case passed into the second stage of labor, and shortly after the head was born with the arm at its side. The whole

time between the prolapse of the arm and the birth of child was not over two hours. I subsequently learned that a former attendant in a similar case waited twelve hours after prolapse of arm before securing operative assistance.

The mother and child are well; the former recovered as well as if the labor had been normal. J. G. ATKINSON, M.D.

Oak Hill, N.B., Canada.

Alcohol.

Editor MEDICAL WORLD :

In the MAY number of THE WORLD, a gentleman writes in favor of alcohol as a medicine, and quotes high authority to prove that it is indispensable in typhoid fever, diphtheria, consumption and in all cases where the general system is deranged; that in diphtheria there is more danger in giving too little than too much; that a learned professor would give half the materia medica for this one remedy.

Now, I propose to present positive proof that this is all delusion; that alcohol does not cure, but kills.

June 8th, 1829, I came to this place and commenced the practice of medicine, and have remained till now. I found much sicknesstyphoid fever, dysentery, consumption, diphtheria, colic, etc. I also found alcoholic liquor everywhere; in every house it was kept to use in case of sickness, and they sometimes took a

The sick took it When a doctor was No water was per

little to prevent being sick. to break up the sickness. called he prescribed liquor. mitted, except that, in a few rare cases, they might take a very little after dropping into it a live coal or a little rurn. I had a hard struggle for many years to induce the people to permit. the sick to have water, which is of infinitely more value than all medicine that has been discovered. To this day I am often asked by a patient if he can't have a little water. I never use liquor as medicine, but order the patient to take water freely. There was often a physician called who believed in liquor as a medicine. Then there was a contest between alcohol and water, and water always came out number one.

Typhoid fever.-I will mention a few of the multitude of cases of this disease. In 1865, W. D. R.'s wife and seven children were sick; had no liquor and all lived. one was treated with whiskey and died; seven

In 1868, this disease spread over the town. In one neighborhood there were twenty-two twenty-one were treated without liquor and all cases. One was treated with whiskey and died;

lived.

A young lady in a neighboring town had typhoid fever; she was sick a long time and The two finally pronounced beyond hope. physicians were dismissed and a cold-water she got well and is now a blessing to the world. doctor called. He set aside the brandy, and

Examine thoroughly medical and surgical report of Boston City Hospital, published 1870, in which there is much instruction. From page 275 to 333 is an account of one hundred and fifty-two cases of this disease (typhoid fever), with symptoms and treatment. Eighty-seven had liquor, of whom twenty died; a little more than 22 per cent. Sixty-five took no liquor, and one died; a little more than 1 per cent. I have several times had twenty to thirty with this disease; often four to eight in a family. I have lost eleven patients with typhoid fever. In five of the fatal cases, by request of friends, I had counsel. In every case they advised liquor and I tacitly submitted.

Diphtheria.-Years ago, when it was the fashion to have children, I was frequently called into a neighborhood where the children of several families were down sick. All had a sore throat. In some the fauces were covered or partly covered with a diphtheritic coat. Others had a scarlet-colored rash over the body and limbs. Others had a sore throat without the other symptoms. I took this to be different manifestations of one disease; so they all got the same treatment. I have had some cases, I think, every year of my practice. Of late

years they are few, because children are few. Now the fashion is one or two; then it was ten or twelve. I have lost eight patients with this disease. My neighbor, in an adjoining town, lost forty-two in a few weeks. He used liquor.

Dr. C. B. saw in a paper that a doctor in Ohio saved all his patients with this disease. He wrote to him to learn his practice and received answer that he gave alcoholic liquor and kept them full. The doctor was soon called as counsel to a patient with this disease. He told the attending physician what he had learned from Ohio. They concluded to try it and gave him liquor. He got asleep and never awoke.

Consumption.-Years ago this disease was very prevalent in various parts of the town. There were families that were called consumptive families. I took pains to learn the practice of these families, and found the uniform custom was to take some form of alcoholic liquor when they thought they needed medicine.

A young lady of one of these families resided at my house for a season. She told me that her people took gin and molasses when they took cold. She became convinced that it was best to let liquor alone. Her father, sister and brothers died of consumption. She married, brought up a family, lived to old age and died of appoplexy; at one time she had a cough, and in a violent fit of coughing threw up blood, which spattered the window and side of the room. I was sent for in great haste. A few very small doses of sub-muriate of hydrargyrum stopped the hemorrhage promptly, and in a few days she was well.

About twenty years ago the people, being convinced of the worthlessness of liquor, abolished the town agency, and there has been no liquor for sale in town since. There is also but very little in the houses, and this has almost abolished sickness. There has not been a single case of typhoid fever since 1868, except two imported cases: young men brought home sick. Twenty years respite from typhoid fever and during that time there have been but very few cases of consumption, dysentery or colic. STEPHEN ADAMS, M.D.

West Newfield, Maine.

Alcohol in Therapeutics.

Editor MEDICAL WORLD:

It appears that my hasty contribution to your journal has attracted the attention of at least one of its many readers, who good naturedly differs from me.

If silence implies consent, then I would infer that we are all agreed that Dr. McKinnon is right when he asserts that alcoholic liquors as

sold on the market and prescribed so freely by our profession, are not fit for use, and by the use of them we are the passive victims, no less than the public, of the highest fraud the world has ever known. He who attempts to prove Dr. McKinnon wrong will likely have a very difficult task.

In reply to Dr. Nihart, I wish to say that he is under no more solemn vow, doubtless, to adhere to rational medicine than many others of his brethren. But such a vow does not necessarily impel one to the use of alcohol any more than it does to the use of aconite, veratrum, rhus tox, chloral, etc. I may practice my profession in purity of purpose and charity to my patients, and yet never use either one of the above valuable remedies, and still not be an apostate. And unless it be proven, beyond the question of a doubt, that alcohol is absolutely essential, and has no substitutes, I am at liberty to pass it by, using something else in its stead.

Dr. Flint is good authority for the use of alcohol in the febrile state. But after

carefully examining the extract quoted by Dr. Nihart, I find nothing in it that would lead me to think he (Dr. Flint) considers it sine qua non, dare contradict him; but I will set over against his either as a drug or a food. If he does, I would not views the practical experience of the eminent Dr. B. W. Richardson, which he states in the

following words: "Admit that alcohol reduces fever, reduces oxidation and waste of tissue and, without shortening the course of the disproof would not affect me individually toward ease, acts tentatively as a remedy. Even this other remedies which, in my knowledge are less the employment of alcohol in preference to seductive, less mischievous in the end, and even more effective, because contrasting the results there is nothing I know of in medicine that is of treatment of fevers with and without alcohol, more satisfactory than the treatment of the febrile condition without an alcohol of any kind." (See MED. WORLD, Feb.)

I quote again from Sir Wm. Jenner where, in a very interesting article, he says: "For the last thirty years I have made it the rule of my practice in the treatment of typhoid fever to abstain from giving alcohol if in the case before me I doubted the wisdom of giving it. When in doubt I do not give alcohol in typhoid fever, and when there is a question in my mind of a larger or smaller dose, I, as a rule, prescribe the smaller." How different this from my early training, which was "when in doubt, stimu late," which meant give alcohol; and when in doubt as to quantity give the larger, or, as Dr. Jacobi puts it, fear giving too little rather than too much. But you say Dr. Jenner gives alcohol.

Exactly. But it will be noticed that when in doubt he gives the patient the benefit of the doubt by withholding it, and prefers the smaller to the larger quantity, and says elsewhere that a very large proportion get on without this "sheet anchor" of the average physician in typhoid. While this is not teetotalism, it savors very strongly of it, and the question comes just here, Could Dr. Jenner, and can we do without the smaller quantity? Can we tide the few over? Can we treat the febrile state successfully without any? I assume no right to answer this upon my own authority; but if Drs. Richardson, Davis and others, and the experiments which have been made on a larger scale in hospitals are trustworthy, then I venture to say we can.

Professor Horsley, F.R.S., referring to the London Temperance Hospital, where, since 1873, the experiment as to whether alcohol is essential has been treated to the uttermost, says: "The evidence is perfectly wonderful to those who, like myself, use alcohol occasionally as a drug. The results are wonderful, because so overwhelmingly contradictory to the preconceived idea that alcohol is essential in the practice of medicine."

Dr. Jenner, in the same article, however, says: "The reverse of the rule for alcohol in typhoid I laid down for myself in the treatment of typhus fever." This may be on the principle: The hair of the dog is good for the bite," for were it not for alcohol it is probable that Dr. Jenner, nor the rest of us, would have much, if any, of this ochlesis-crowd poison camp, jail, penitentiary and almshouse fever to treat. But of course this is not the point, that it produces more typhus likely than it cures; but the point is that Dr. Gairdner, who ranked with Murchison and others of like eminence, some years since published the results of the treatment of typhus fever in the hospitals of Glasgow. The statistics comprised nearly 600 cases, and it appeared that the mortality lessened exactly as the dose of alcohol diminished. This is in accord with Dr. Davis' statement that the rate of mortality for general fevers and acute diseases in the general hospitals of Europe and America have increased pari passu with the increase in the quantity of alcoholic drinks consumed in their treatment."

Anything Dr. Jacobi may say relative to our profession ought to carry with it great weight. And yet Dr. S. W. Smith, of New York City, in an article to the Medical Record, shows that while the rate of mortality for diphtheria in that city, for the past five years, has been from 34 to 492 per cent., yet in a series of thirty cases which he treated the rate was 15 per cent. And

in closing his article, he adds: "In all these cases I used neither a grain of quinine, nor a drop of alcohol." Like results, and even better, I've seen reported elsewhere. If any one will examine Dr. Smith's cases, he will find that a large majority of them were naso-pharyngeal. Trousseau has said fifty cases of nasal diphtheria means fifty deaths. But of course the treatment has improved since Trousseau's time. It may be due to the free use of alcohol as Dr. Jacobi advises, but the result of doctor Smith's experiment makes it doubtful at least.

patients at the sanitarium with alcohol, for to Dr. Detwiler may be curing some of his do less than cure would hardly justify him in pronouncing such an encomium upon it in contradistinction to all other drugs. And if he is curing phthisis, is it not probable that the dietetic, hygienic and climatic conditions of the sanitarium have more to do with the cures than the alcohol used? for anybody and any institution can secure alcohol ad libitum, and yet how rare are the cures of this fatal disease. The editor of the Medical Record in an article upon the "Curability of Phthisis" admits that now and then a patient who is in a position to command the least diagnostic skill and therapeutic resources, and under favorable hygienic surrounding, is cured. But asks: "Is there a hospital or dispensary in the whole country which can report cases of consumption, cured? If so, their fortune is an unusual one."

I shall indulge in no more quoted evidence, for the doctor says my "citations amount to but little in the absence of therapeutic and physiological reasons. How about his statement that alcohol" is steadily growing in popularity as a medicine," without the evidence? He may be right. But the lamented Prof. Flint, just before his death, in an address delivered at the first annual meeting of the N. Y. State Medical Association, in speaking of alcohol, said: "At the present time there is considerable diversity of opinion and practice as regards its (alcohol) use among medical practitioners, but the tendency of late years has been to use it with more reserve.” As to the reasons the doctor requires, we may give them some other time, if allowed; although we see no real need of it, for practical experience beats theorizing all the time, and does not need any fine-spun reasoning to corroborate it, although it may be able to produce it. What shall be done with the assertions of Drs. Davis, Richardson, Horsley, Edmunds, Kerr, and a host of others equally eminent in the profession, and the reports that come to us from several institutions? Are they to go for naught? The physicians who use alcohol, and their patients get well,