progressed; not to say anything of its after result, when the system is left enfeebled from severe attacks.

From the writings of Dr. Goss, of Marietta, Ga., I was induced to try this drug, spigelia; and return him, through the columns of your journal, my grateful thanks for this valuable information. I recommend others to give it a trial. I use the fluid extract (Parke, Davis & Co.), a teaspoonful in warm water, every half hour till relief is afforded; following it the next day with ten minims of cactus grand, three or four times a day, for one or two days, as the case may demand, for an after treatment.

Should I meet in future a case as reported by Dr. Goddard, intimating a fatal termination, spigelia, in combination with ammonia and stimulants, would be the remedies, in conjunction with local applications.

Spigelia we all know to possess destructive properties for tenia and other intestinal worms; does it then follow that it has germicide properties? If we are to look behind the arras cautiously, and ponder over the germ theory, it is still an open question whether it has any relation to angina pectoris. We have a right to think so, when its causation is as yet imperfectly understood, or till such time as a better theory, at all events, can be accepted from facts that will be positively conclusive.

Having given my treatment of this disorder, in which somuch can be accomplished by internal medication, why could not the remedy be used to that end by hypodermic injections? I think the good result one way justifies a trial for it in another. E. MAGUIRE, M. D.

Bloomfield, Cal.

Cactus Grand.

Cactus grandiflorus, or Night Blooming Cereus; part employed, the flowers.

Preparation-Alcholic fluid extracts of the flowers and fleshy stems; dose, 10 to 30 mimims, thrice daily; price, 25 cents per fluid ounce.

Properties. Sedative, diuretic. It is especially useful in functional diseases of the heart, with irregularity of action; palpitation, anginapectoris, cardialgia, rheumatism, valvular dis

ease, etc.

[We give also the following in answer to inquirer:

Saw Palmetto; Sabal serrulata. Preparation. Fluid extract of the fruit; dose, 1⁄2 to 2 fluidrams (p. r. n.); price, 20 cents per fluid ounce.

Properties. Sedative, nutritive and diuretic, and is said to improve digestion. It will allay irritation of the mucous membrane of the throat, nose and larynx.

Llewellyn, corner Sixteenth and Chestnut streets, Philadelphia, kindly furnishes the information. The articles can be had of him at the prices mentioned.-ED.]

Nurse's Sore Mouth-Stammering - Chronic Pharyngitis.

Editor MEDICAL WORLD:

I am with Dr. J. H. Myers, on page 18, January number. This gives a prize to be gained. We could then call for $2.00 instead of $1.00 for consultation, etc.

To Dr. Badger, in November number: nurse's sore mouth readily gives away under the following:

Obstinate Pruritus-Chronic Pharyngitis. Editor MEDICAL WORLD:

To subdue the almost intolerable itching, in a severe case of pruritus genitalia, while internal treatment was being pursued, I tried every known remedy (I believe) without much effect. A 4 per cent. solution of cocaine gave relief for about three hours at a time; other local remedies gave relief for even a shorter time, and after several days' use had no effect whatever. The patient, almost driven to despair, seizing a bottle of bay rum contained in his toilet, and making a wholesale application, as it were, to his surprise found short relief. I ordered a repetition of the article every few hours, gradually reducing the frequency of application. In about four weeks' time the patient has had no return of the itching. The trouble had existed about six months. Internal treatment-arsenic, belladona and strychnia.

L. H. E., of Springfield, Ga., in January WORLD, asks for treatment of chronic pharyngitis. The patient's health being good, be sure that there is no gastric trouble, and use locally nitrate of silver, 40 grains to the ounce of water, cleansing the throat with water before using it. The application should not be too frequent.

THE WORLD is original, clear and suggestive.

JOHN FRANKLIN Mentzer, M.D.

Ephrata, Pa.

Hot Flashes at Menopause. Editor MEDICAL WORLD:

In reply to questions in September number, 1887, page 349, and October number, page 380, in regard to a remedy for those "flashes at the change of life," in addition to the remedies suggested on pages 363 and 364, October number (bromide of sodium and am. tr. valerian"), and page 418, November number (Fowler's sol.), I will state that in these cases, where there is a feeling of suffocation with precordial distress, it is a custom with me to give quebracho, from which relief is generally obtained.

An invalid in my "Home," for treatment during her menopause, suffered at times very greatly with these flashes, accompanied with dyspnea and fright, until she would feel so faint, under their influence, that she must have air or almost swoon.

To relieve this, quebracho was given in doses of 30 drops, with complete relief of the dyspnea, lowering the respirations and pulse to normal; and not only the thoracic symptoms, but also the hot flashes would most happily disappear. I do not recommend quebracho as a

specific in all cases of climacteric flushes, as the remedy occasionally fails; but, as a rule, in these cases, where there is a feeling of suffocation, I consider this remedy of great value.

These flushes" are greatly increased to a more unbearable degree by emotional excitement, hot rooms, hot drinks, over-eating, constipation, etc. In these cases, directing the. patient to guard against all the passions of the mind that may agitate it—as grief, anger, uneasiness, and harrassing cares, with relaxation from mental strain, and a proper regimen, may do much toward warding off those disagreeable attacks. J. V. BOWER, M.D.

Malotte Park, Ind.

Hyperesthesia.

Editor MEDICAL WORLD:

Dr. H. J. Rowe, January number, page 33, reports a very interesting and, I imagine, a very rare case. Perhaps a brief history of a somewhat similar one may possibly throw some light on Dr. Rowe's case. Years ago, I treated a small male child, nine months old, for hyperesthesia, without the slightest clue as to cause, except that the child had a very large head. To touch this little fellow any place, with the tip of the finger, as lightly as possible, from the crown of the head to the end of the great toe, was immediately followed by the most violent convulsions. This little touch-me-not appeared all right as long as he was let alone; but to touch him was like fire to a little magazine.

Repeated injections of laudanum in small quantity of starch and water, after a few hours, entirely subdued this exalted state of sensibility; and, to-day, my patient is a full grown,

robust man.

What Is It? Editor MEDICAL WORLD:

Mrs. B., aged 46, family history good, presented herself, in the summer of 1885, with the following symptoms: Tonic spasms of muscles of face and neck, those of neck most marked. The spasms affect both sides; most often the right. The head is drawn almost down to the shoulders during the attack. The spasms occur every two or three days, and last from a few minutes to one or two hours. There is dimness of vision, tremor of upper eyelidsnystogmic oscillation-paroxysmal headache, and some gastric derangement. At long intervals the patient has for years been subject to an

uncontrolable chattering of teeth. There is no paralysis, no hyperesthesia, no double vision, no difficulty in speech, no tremor, ex cept as mentioned. The pupils are normal; no menstrual derangement. She was put on barium chloride, hyoscyamus and electricity, and after a few weeks treatment was discharged improved, but not cured. The attacks became light and far between. After two years the patient presented herself with the same symptoms, and others added. The spasms affect both arms, chest, and abdomen (?). During attack the arm is extended, never flexed, and is perfectly rigid. The spasms last from one to four hours, though there may be light attacks of shorter duration. They occur sometimes several times in the twenty-four hours. During severe attacks the eyelids are closed, but not spasmodically. There is difficulty in speech and in respiration; weakness after the attacks. There is loss memory, tremor of upper eyelids; but not constant. There is never loss of consciousThe dimness of vision is not worse than two years ago. There is no paralysis, no wasting, no hyperesthesia, no marked tremor, no spasms of lower limbs, no trouble with bladder or rectum. Taste, smell and hearing are normal. No feeling of constriction around waist, and pupils normal. No ophthalmoscopic examination has been made. The patient has some vague premonitory symptoms of the attacks. Seat of headache in the top of the head. The patient is able to do light housework between attacks. Now, editor and readers, what is it? Is it sclerosis? A. C. AMUNDSON, M.D. Cambridge, Wis.

ness.

Diagnosis Wanted.

Editor MEDICAL WORLD:

In ordering your journal, which is to me quite the most indispensable of medical journals, I wish also to add the statement of a case of disease of the rectum, which I believe to be catarrh of the lower bowel. It has been in progress about four years. The patient, sixtynine years of age, is of large frame, and formerly very portly. Since the disease came on his weight has decreased from 275 pounds to about 210 pounds. Appetite still good, but strength failing. From the lower bowel there is from five to twenty times a day a discharge of a bloody, serous fluid, sometimes only very slightly colored or tinged with blood-only one or two tablespoonfuls at one time. The discharges are accompanied with no pain; at least, pain, if any, is very slight. There appears to be, about two inches from the anus, a surface of mucous membrane slightly abraded about eight or ten lines in length. I have endeavored to diagnose

cancer, but cannot, as, after so long a time has elapsed without pain, we can, I believe, safely exclude any malignant growth. Any suggestion as to a diagnosis and treatment by my professional brethren will be gratefully received. Chicago, Ill. WM. C. DERBY, M. D.

Diagnosis Wanted.

Editor MEDICAL WORLD:

THE WORLD I prize more highly than any other medical journal I have ever taken. Will you diagnose and give treatment for a case as follows: Married lady, aged 23, had one abortion about the sixth week of pregnacy, two years ago, after which time her menstrual discharges were irregular for about one year, having one every two or three weeks, flowing profusely for one week at each menstrual period, causing anemia, and very much emaciation. Her menstrual discharges became regular about one year ago. She has improved in general health, has gained in flesh considerably, is feeling as well as ever, with the exception of a pain in the right arm, which she has had over a year, about three inches below the shoulder joint, slightly in front of the deltoid muscle and toward the chest. There is very little soreness. No pain or suffering during the day. At night the pain begins, and will continue by spells through the night. It is with great difficulty that she can move her arm, unless assisted by the other hand. After rising in the morning and moving the arm a few times, it will feel comparatively well through the day, unless strained by work. She then feels the pain and soreness for a short time. This difficulty has existed more than one year, and I have blistered, used iodine externally, and have given the usual remedies for rheumatism and neuralgia. Hope you will not let this pass unnoticed, as I am very anxious to relieve the trouble. Would be glad to hear from your readers in regard to it. Do you think her periods have anything to do with the pain? J. B. H. CUSHMAN, M. D. East Charleston, Vt.

Electro-Therapeutical Department.

Cases, questions or views upon electricity in medicine are invited.

It requires more intelligence, study and experience to be a successful electrician than to be an orninary prescriber. There must be that delicately skillful touch and manipulation, that mental vision of the parts under treatment and the condition to be corrected, which can only be acquired by a thorough study of pathology and patient daily experiment with the current. Many men satisfy themselves with giving the patient an electrode in each hand, turning on the current, and letting the patient endure it until the prescribed time has expired, then fondly imagine that they have exhausted the last resources of science and "given the patient electricity." There ought to be a law against such men owning a battery. If any benefit is to be derived from electricity, it must be as carefully and intelligently administered medicines.

Treatment of Neuralgia.

as

The Faradic current will very frequently cure a neuralgia at one sitting of from twenty to thirty minutes. Not that every one, however roughly or carelessly he may apply it, can secure such favorable results. In our own experience the following method has been uniformly successful:

First. Place the so-called positive pole over the painful spot, sponge-covered electrode, sponge moistened with warm salt water.

Second. Place the other pole at some adjacent healthy part, a little below the positive and opposite to it, preferably at some point along the spinal column. Thus, if the neuralgia is in the head and the face, place the negative over the lower cervical vertebræ; if of the abdominal viscera, over the lower dorsal vertebræ, or down towards the coccyx; suit the strength of the current to the location, that it may not be painful; very light over the head and face, and sufficiently strong over the viscera. Give stationary application to the painful spot, and manipulate all around from that as a centre towards the other pole. Some practitioners claim that for this application the negative

electrode should be attached to a cord twice the length of the other.

The galvanic current is also used to treat neuralgias; positive pole to the affected parts, and negative on some opposite healthy part.

A person who is subject to recurring neuralgias should receive the general tonic treatment. until the system is sufficiently toned up to resist the neuralgic tendency.

In our next we shall speak of the treatment of rheumatic affections.

Retirement of Prof. Seiler.

The readers of THE MEDICAL WORLD, who have had the pleasure of enjoying Prof. Carl Seiler's articles on the technique of the electric battery, during the year 1887, will regret to learn of his retirement from this department, with the December, 1887, number, caused by his rapidly increasing professional duties, in addition to his work as a thorough teacher and an active society worker. The professor's thoroughness and skill in his chosen specialty, Laryngology, his extensive researches in the subject of electricity, as well as his uniform courtesy to his fellow members of the medical profession, have all won for him an enviable professional distinction. We congratulate him upon his well-merited success.

This department will hereafter be conducted by the regular staff of THE MEDICAL WORLD.

Electricity in Labor. Editor MEDICAL WORLD:

I was called, Nov. 9th, to Mrs. S., who was said to be in labor. The patient, a small, spare woman, already the mother of six chilExamination: os soft and dilated, two inches in dren, had been having pains for twelve hours. diameter; pains feeble. Gave tablespoonful of paregoric, expecting usual results; rapid dilatation of os; pains stopped, to set in again next night; paregoric again, same result; third night pains set in. No paregoric, pains continued all night with no result. Gave drachm fl. ext. ergot; in an hour pains. ceased entirely. The patient was getting tired and worn out, the os was not sufficiently dilated to put on forceps, craniotomy would be bad practice. I determined to use electricity. Placed one pole of a Faradic battery on each side in front of the fundus. This induced uterine contractions of the upper segment, but did not push down the

head. Placed a vaginal electrode against cervix and the other pole to fundus; no better results. Then we placed one pole to the sacrum, retaining the other to the fundus. This effectually aroused the uterus and contractions became frequent and strong; while I used the current about ten minutes the uterus dilated rapidly. The second and third stages of labor were completed by one pain; that is, as soon as the head passed the os, the head, body and after-birth were expelled by one pain. The labor was complete in less than one hour after the first application of the electricity. In a practice of twenty years this is the third time I have seen the os close up after a dilatation of two inches in diameter. In one case the bag of waters broke, both remained closed for a month and completed normal labor at full term. This lady was about eight and a half months gone, which may account for the peculiar behavior of the uterus on this occcasion.

Kinston, N. C.

H. O. HYATT, M. D.

Electricity in Diseases of Women. Editor MEDICAL WORLD:

I have been well pleased with last year's WORLD, SO will try it farther.

I was much pleased with your ideas on electrical treatment in diseases of women, as advanced in your review of Goodell, December issue. I am very favorably impressed with the value of electricity in this department. Dr. George Engelmann, of St. Louis, demonstrated its value to me in his clinic in the Post Graduate School, and since that time in my own practice it has deserved the high opinion I then formed of it. I have not found it necessary to have all of the machinery recommended in order to use

electricity with benefit. A good battery, good electrodes, everything kept clean, in good condition, good fluid often renewed; then the woman's own sensations as a guide and a reasonable amount of common sense, I believe, are the essential requisites for ordinary practical application of Electricity in Diseases of Women. Granada, Kansas. JOSEPH HAIGH, M.D.

Reviews of Some Works on Electro-
Therapeutics.

The subject of electricity in the treatment of disease is engaging the.attention of the regular medical profession more and more every year. The uniformly successful results of many specialists in the use of this agent has led other thoughtful men to inquire "why may not I do the same?" In response to many inquiries as to what is the best work on the medical applications of electricity, we propose to

review a few of the best known works on the subject.

Electricity being such a subtle agent, which cannot be seen, and, until lately could not even be measured, we have many and various, and sometimes amusing theories as to the manner of its action. Of these we care but little, at least until they are capable of more exact demonstration; the main point desired is accurate direction for its application in the treatment of disease.

"Medical Electricity: A Practical Treatise on the Application of Electricity to Medicine and Surgery.' By Roberts Bartholow, A.M., M.D., LL.D., 304 pages. Cloth, $2.50. Lea Brothers & Co., Phila,

This work, prepared in 1881, is now in its third edition, with revisión to date. It is a work of moderate utility on the subject, showing the results of the investigations of a learned and conscientious man, yet one who is not an electric specialist. It is less a work embodying his own practical experience, than one of skillful compilation by one who has almost unlimited resources for knowing the views of others, and of knowing the work done in the great hospitals of the world.

After 94 pages devoted to electro-physics, 30 pages to researches in electro-physiology, he gives us two chapters on electro-diagnosis. Then begins the part of the work relating to electro-therapeutics. We have electricity in spasm and in cramp, in paralysis, in pain, in anesthesias and analgesias, in vaso-motor and trophic neuroses, in constitutional diseases, and in

local diseases. All this in less than one hundred pages. Then follows one chapter on electrolysis, one on medical electric lighting and cautery, and two on thermo-electricity. and application of electricity, rather than One gets encouragement to the further study specific directions for precedure, in this work. Still, however, it is not totally devoid of the latter. The anatominal guides accompanying the text are the best we have seen.

"Practical Suggestions Respecting the Varieties of Electrical Currents, and the Uses of Electricity in Medicine." By A. L. Ranney, M.D., 167 pages, illustrated, cloth, D. Appleton & Co., 123 and 125 Bond St., New York.

This is a very useful hand-book. We especially admire the concise and clear language, of which Prof. Ranney is master. The principles are laid down in a systematic manner. Electrodiagnosis is well given. Still, the specific directions are so meager that one must be a skilled electrician already to be able to use them with confidence. The anatomical illustrations of motor points are very valuable.