I

protean in its character. No other skin disease makes so many changes in appearance, depending on the length of time the disease has existed, the texture of the skin and general health of the patient. From these varying changes, and from location, has arisen a multiplicity of names calculated more to confuse than to enlighten the student.

Since adopting the course I now pursue, nearly every case has readily yielded to persistent treatment. I prescribe an ointment of quinine sulph. gr. x to gr. xv; ferri sulph. gr. x; lanoline 3 i. Quinine is one of our best non-toxic microbicides. By its use we avoid the danger of toxic absorbtion, as is too often the case in using the various mevenvial preparation so highly recommended by some writers. Lanoline, as a base, is preferable to any of the petroleum derivatives, because of its being more readily absorbed by the skin. Any special lesion will require appropriate treatment. If there is severe itching add carbolic acid to the unguent, if there are burning sensations, add camphor or hamamelis; if syphilitic conditions, add plumbi iodidi, etc. Occasionally a case with fermentative conditions may be found when the addition of salicylic acid may be of service. But the main dependence in all cases is the quinine and iron locally. Of course the general conditions want to be looked after. The diet should be bland and easy to digest, the bowels relaxed by some agreeable saline and a diuretic given if necessary.

The ointment should be spread thickly upon a soft cloth. The parts affected thoroughly bathed with some non-irritating soap and water as hot as the patient can comfortably bear, so as to thoroughly macerate and cleanse the surface of all inspissated exudations and scales. As soon as possible after bathing and drying the surface by patting with a soft cloth, the ointment should be applied and thoroughly pressed down to exclude all air. The dressing should not be done more frequently than once each day, and then the diseased surface exposed as little as possible. I shall be pleased to hear from others who may try this method. D. D. ROSE, M.D., Davenport, Iowa.

Carbolic Acid in the Treatment of Carbuncles and Other Affections.

Editor MEDICAL WORLD:-In your Janu. ary issue, I notice an article on "Carbuncles treated by Carbolic Acid Crystals." It reminds me of a case I treated successfully about twelve years ago. In the month of June, 1882, I was called to the house of G. R. B., a man about 50. He had eleven carbuncles on his neck and back, was suffering fearful agony and he

told me he had not slept for six nights and days. He was covered with poultices and he would not allow anybody to come near him or touch him. We were not acquainted with cocaine then and we were not using the sulphide of calcium very much either; but knowing the anesthetic property of carbolic acid, I persuaded him to let me try to relieve his sufferings.

I then injected 4 or 5 drops of pure carbolic acid into eight of the carbuncles (the 3 others had commenced to suppurate), with the happiest results. The pain subsided in a few minutes and the poor fellow went to sleep. I performed the "operation" at 8 P. M., and my patient slept soundly until 6 in the morning. awoke greatly refreshed and the pain never returned. Of the 8 carbuncles injected, 7 aborted; the others went on to suppuration and complete cure followed in two or three weeks.

He

Practical Points In the Use of Water.

Editor MEDICAL WORLD:-Water has a wide therapeutic range in its application to the human body. It's action is remarkably diverse according to its method of application. It is tonic, relaxant, detergent, stimulant, deferves. cent, aperient, diuretic, sudorific. One method of its application has been referred to in THE WORLD recently by Drs. Dawson and Bennett, (See page 133, April WORLD). This method is of great importance too, and it ought to come into more general practice. Dr. Bennet kindly comes to the assistance of Dr. Dawson, detailing his manner of treating the patient after coming out of the vapor bath. The plan is laborious, necessitating "going over" the patient's body half a dozen times. I submit a plan which is both simple and efficacious: Douche the entire body with cold water, the patient himself rub. bing down his body and limbs briskly. Dry rapidly with large towels using all the friction. that is comfortable. If the skin is healthy no lotion will be needed to keep him from "taking cold." The constringing effect of the cold exhil orates the body and increases its power of resistance. Not all cases are suited to the vapor

bath. I should not expect to meet with "that tired feeling" following the bath in well selected cases. Tried in a case of aching limbs, the pains will generally take their leave during the bath. Frequently an aching head will be relieved and a beginning cold aborted. Indeed, the vapor bath is a valuable aid in practice.

To reduce hyper-pyrexia the cold bath is unrivaled, but I think it probable that our continued fevers would neither reach so high a tem. perature, nor continue so long if the hot vapor bath were used from the beginning of the attack. I have tried this treatment in only two cases of continued fever. One patient was up in two weeks, the other not quite so early, as treatment was delayed a few days. The disease ran a mild course in both cases. Internal antisepsis was used, however. I also recommend the vapor bath as a prophylactic against disease. I like its effects myself, and frequently substitute this for the old fashioned tub bath and sleep well afterwards. But Dr. Dawson wishes a formula for a lotion to be used after the vapor bath. I offer the following:

R. Water of ammonia...

Mix.

Chloride of soda.

Soft water........

....ounce ss dram ij ..ounce xvi

Those whose skins are harsh and dry may use with good effect a weak ammonia liniment with a base of some bland oil.

If the skin is diseased I would have the patient wash thoroughly in a tub of water as hot as could be borne, both before and after the vapor bath, when the ointment appropriate to the case should be immediately well rubbed in and the patient put to bed. In these cases it is undesirable to close the pores with cold applications. JOHN F. NEAL, M.D.,

Coperas Cove, Tex. [We are in hearty accord with the free and intelligent use of heat and of water both hot and cold to re-establish the equilibrium of the circulation and break up a beginning attack of inflammatory or febrile disease.-ED.]

A Plea for Older Remedies.

Editor MEDICAL WORLD:-In the flood of the newer antipyretics, coal tar derivatives, synthetically prepared remedies, it becomes us not to drop the study of the more ancient and, I dare say, more valuable remedies. The preparation I wish more particularly to call the attention of your readers to is aconite-the plain extract of aconite or its alkaloid aconitine. I prefer an accurately prepared fluid extract. As is well known, it is an arterial depressant, lowers the action of the heart and diminishes its beat, affects the sensory nerve strongly, followed by minor action on the motor nerves, in lethal

doses paralyzing the functions of the nervous system, and arrests the heart's action in diastole. It opens the pores of the skin by reducing arterial tension, quiets the lung movement to a marked degree, increases the various secretions of the human economy. As these forces are well marked, its applicability to febrile disease, respiratory affections, and all forms of inflammatory troubles, is self-evident. None of the newer remedies can replace aconite in its promptness of action its certitude of effect, reliability, safety of administration, and last, but not least, reliable preparations can be obtained at small cost, as compared with other febrifuges. In the intoxication of typhoid, coal tar preparations are positively dangerous, and where large quantities of drugs are contra-indicated, aconite acts charmingly, and is the classical preparation to combat fever, keeping the skin moist, increasing buccal secretion, and insisting on prompt kidney action; quieting the usually rebellious heart and respiratory functions, and reducing or at least keeping the temperature in statu quo. In nasal and faucial catarrhs, tonsillitis, fibrinous pneumonia, ephemeral fevers, the disquamative diseases, febrile troubles of infants and children-in fact, in all febrile affections-it is preeminently adapted, and, if properly adminis tered, will delight the user.

Now a caution in its use.

Minute doses, frequently administered, is the classical method of using it; for adults, an eighth to one drop every half hour is proper dosage; children will usually require a one-sixteenth to one-quarter of a drop every half hour until effect is obtained, when the tonic may be lengthened. When the heart's action is very much excited, veratrum viride may be combined with it into 1 drop doses, which beneficially heightens its effects. This remedy will bear careful usage and study by the profession, as it has not been having its due from practitioners these latter years. In my practice, after an extensive trial of antifebrine, antipyrine, and other coal-tar preparations, I have found them in sufficient doses to be dangerous, and in smaller doses inoperative, and in the diseases of children almost useless. Another remarkably prompt action for aconite is in the nervous prostration following drunkenness, where it gives brilliant results, quieting the nervous excitement, reducing the buccal dryness, and relieving the offensive headache. În maniacal delirium, as in mania-apotu, gelseminum is to be preferred. Glandorf, Ohio.

DR. A. BORMAM,

Is Acetanilid So Dangerous? Editor MEDICAL WORLD:-In reading the communications from many of your writers we

hear a good deal about the dangers of acetanilid, in causing heart-failure, collapse, etc., and do not recall but one writer coming to the defense of the drug. I have prescribed and dispensed pounds and pounds of it, and have failed to ever see any of the fearful effects we are told it produces; but, on the contrary, have never found anything its equal, in drugs, to quickly reduce fever. It is not only prompt, but in many cases seems curative as well, and will in many cases bring the temperature to normal in a few hours, and it will remain so. I give it in all pyrexias, let the patient be a month old or eighty years, and if the fever is above 104° F. in heavy doses, because it will reduce excessive body-heat more quickly than anything else, except the cold-bath, and I have never seen anything but the most benign effects in all the years I have used it. I sometimes think that surely those that declaim so loudly against it have never used it, or else they would not be so emphatic.

If any practitioner is being influenced by those pictures of its action, and is not using it, he is discarding one of the promptest remedial agents in the whole materia medica. Imperial, Neb. D. BOSWELL, M.D.,

Medicinal Cure for Cancer. Editor MEDICAL WORLD:-I have treated a melanotic cancer successfully. It is entirely cured, nothing remains but a withered scab, which could be easily removed now, but I set out not to touch the cancer, and have not. I deem it a duty to report the matter, particularly to you, hoping that it may be of benefit to the suffering, knowing that you can bring it to their notice in a few days, which I could not do in a lifetime. I am giving the same treatment to several others, in various stages of disease, two of whom have cancer, and all are improving rapidly. I will give the treatment, and you can make what use of it you think proper.

Last February I was treating a wart on my hand, by dieting, and gr. doses of calcium sulphide, which wart gradually disappeared; also a corn on my foot, which had been there for thirty years or more, the only one I was ever troubled with. I also took aconite and podophyllin granules, as I felt the need of them once in awhile during the time of treatment. Seeing the success on the wart, I asked one of my neighbors (Jno. L. Holder, now of Sherman Heights, Tenn.), who was suffering with a mulatto colored cancer, in the secondary stage, if he would let me try an experiment, and related to him my success with the wart. He agreed, and took at once gr. calcium sulphide, gr. aconite, gr. podophyllin, his bowels being costive. The dose of calcium sulphide was re

peated 3 times a day; the aconite and podophyllin when needed. We took exact measurement of the cancer. It was about the size of a silver quarter, and looked angry and defiant. At the end of forty-eight hours the pain had subsided, at the end of fourteen days it was only half the former size, and appeared to be withered. At the end of three weeks it was still smaller, and seemed pinched and dry, and at the end of five weeks from the time of taking the first dose of calcium sulphide, nothing remained of it but a dry scab. The inflammation in the flesh around the cancer subsided within three days from the first, and the costiveness, which dated more than a year back, was greatly relieved, and my friend is delighted. Others being treated report the pain to be relieved, which indicates that the growth of the cancer is arrested. Mr. Holder's father died with the same species of cancer some years ago, and I have no doubt he was infected from his father. The matter of diet is, I think, very important. Alcoholic liquors, coffee, pork, onions, pepper, horse radish, turnips, radishes, pickles, vinegar, rich puddings, cake and mince pies are to be excluded from the bill of fare, and a light diet used. Eat beef, mutton, game, fresh fish sparingly but eat enough. Common vegetables may be used freely such as beans, peas, cabbage, lettuce, greens, bread and butter, or biscuits made with milk and baking powder, not shortened, fresh and canned fruits, dried fruits, sugar, butter milk, sweet milk, rice, hominy, corn meal mush, potatoes, cambric tea, or "store tea," etc. So far as my observation goes, cancer yields to treatment more readily than common warts. WM. H. BURGESS, Chattanooga, Tenn.

Authority to Practice.

Editor MEDICAL WORLD:-Much is being written about the regulation of the practice of medicine in the different States, and there are many who advocate the examination of each applicant for practice before he is licensed. While it should ever be the aim of every medical man to lend a helping hand to the advancement of the medical profession, still I think the medical laws of some of our States are working a great injustice to those old war-horses who have graduated years ago, and have become gray in the profession. There are many physicians in country practice to-day who, when they graduated, could have passed the examina tions of the State Boards, but years of hard, practical work has kept them from keeping up with all the new ideas that are being advanced. They learned theory at school; they have since learned the practical part, to the neglect of the

theoretical. A graduate of medicine who has been in continuous practice for ten years should be allowed to practice anywhere in this free country.

I believe that the best way to regulate the practice of medicine so that a physician who is qualified in one State will be in all, is for Congress to add another member to the cabinetthat of Secretary of Health. I would give the Secretary of Health power to appoint a United States Board of Health, and to this Board of Health I would give the power to regulate the practice of medicine in the United States. I would have this Board appoint non-interested examiners for all medical schools that required a four years' course of study, and to those who received the degree of M.D., and who passed the Board of Health examination, I would give a license to practice medicine in the United States, and that no State be allowed to admit any one to practice except licensed physicians and those already in practice. I would also authorize this Board to license all graduates who have taken a three years' course in medicine, and all those who have been in practice ten years since graduation. This license would be presented to the State Board in the State in which the physician desired to practice, and they, upon his proving his rightful ownership and paying required fees, would be granted a State certificate. I would revoke this license when the holder was convicted of unprofessional conduct, drunkenness and the like. In this way I believe the profession of medicine could be regulated satisfactorily to all-the old, because they would be recognized, and the new could be regulated to suit the profession, since all schools would be expected to comply with Board of Health rules or be shut out from examinations, and thus from practicing medicine. Doniphan, Neb. T. H. LINE, M.D.,

Professor Hirst's Pelvimeter.

[Reported especially for THE MEDICAL WORLD.]

The new pelvimeter contrived by Professor Barton Cooke Hirst, of the Univ., of Pa., entirely does away with the possibility of error in pelvic measurement, due to variations in the conjugate, symphyseal angle, and theheight of the symphysis.

The instrument measures accurately(1) The thickness of the symphysis.

(2) The conjugate, plus the thickness of the symphysis.

(3) The distance between the outer edge of the symphysis and the promontory of the sa

crum.

The fatal error of the old Bandelocque mea

surements in the symphyseotr my case referred to in last issue caused Dr. Hirst to construct this instrument.

The measurements are taken in the lithotomy position. Tip A is placed firmly against the middle line of the promontory of the sacrum. Tip B is brought to the proper position in the symphysis, and the arm secured fast. Measuring between the tips, we have the true conjugate plus the thickness of the symphysis. The latter is found as in Fig. 2. Deducting this thickness, we have an accurate conjugate measurement.

Oxide of Zinc for the Morphine Habit. Editor MEDICAL WORLD:-I had a patient whom I was treating for the morphine habit. So I went to Dr. Waugh's book on Dosimetric Treatment, and looked over his list of drugs used in the treatment of the morphine habit and selected oxide of zinc as being the most likely to be successful, and put my patient on it, but, as he knew something of drugs, I told him of my hopes in the matter, which may have had an influence in the way of suggestion, as the hypnotists would say. However that may be, it was successful, and if it is not the drug Dr. Waugh referred to in his recent letter in THE WORLD, then I have discovered another, which, if used in doses of from 2 to 6 grs. every 3 hours with some capsicum and a minute quantity, say from the to of a grain of ipecac to prevent nausea, will be found of wonderful benefit in quitting the use of morphine. Spanish Camp, Tex. Dr. C. B. PALMER,

Treatment of the Opium Habit.

Editor MEDICAL WORLD:-I see that the formula of B. M. Woolley's cure for the opium habit is wanted.

I send you what I believe it is, and I think any doctor can cure the opium habit without much trouble. Several years ago I had a patient that took Woolley's treatment and was cured. The first thing that the doctor did was to get the exact dose of opium that the patient took, and how often during the twenty-four hours.

His direction to his patients was not to take opium or anything that contained opium while they took his medicine.

That convinced me that it was nothing but morphine in water colored with lavender.

Let each teaspoonful contain the exact dose the patient takes at a dose, and prescribe about four or six ounces at a time. Reduce the dose gradually, as a new bottle is prescribed, until the patient gets no morphine.

He makes his patients believe that they are not taking opium, and that is the secret in treating a case.

I saw another case where the remedy failed on account of the patient finding out the secret. WM. C. STIRLING, M.D.,

Sulphur Springs, Tex.

The Opium Habit.

Editor MEDICAL WORLD:-I have written at the opium habit several times, but never a full account of this dreadful disease. I have concluded to do this now, partly on account of

hundreds of letters asking for it, partly because no book I have seen gives a satisfactory account of it, and finally because I learn that several physicians, themselves morphinomaniacs, are trying to convince people that the habit is harmless. The fable of the fox that had lost his tail is appropriate. I would no more take the word of a habitue than 1 would that of a sexual pervert or a maniac, that they were right and the world wrong. In this I will also announce the name of the new remedy, when I describe the treatment.

The opium habit, long prevalent in Asia, was rarely known in Christendom until within recent times. It is becoming of increasing frequency. The reasons for this are to be found in the conditions of modern life, and consist of the causative factors of suicide and insanity. As the demands on the human intellect increase, as the struggle for existence grows sterner, the minds that give way under the strain, or seek assistance from outside sources, must necessarily increase. It is the price we pay for our modern civilization-one example of the law of compensations.

An enormous impetus has been given to the use of morphine by the introduction of the hy podermic syringe. He has much to answer for who teaches his patient the use of this instrument. When the charms of morphine have been once experienced, it is easy to find an excuse for a repetition of the dose. A doctor who first took opium for diarrhea, used to take a cathartic at night to give him an excuse for a dose of opium in the morning. Behind such paltry refuges of lies will poor human nature seek to hide its weakness!

ETIOLOGY.

It is certain that all persons are not equally liable to become morphine habitues. To many the effects of the drug are disagreeable; to others, singularly attractive. Conditions predisposing to narcomania are: the nervous temperament, hysteria, neurasthenia, uterine pain, neuropathy, with pains, as in ataxia, neuralgia,

etc.

Above all, is the production of euphoria: when this has been experienced, morphine should never again be given that person. Narcotics are also taken to drown remorse or despair; to enable the user to accomplish tasks otherwise beyond his power; to banish care; from idleness, vice, morbid curiosity, bad example; to increase the sexual vigor or the conversational powers. The greatest number is said to be supplied by those who handle drugsphysicians, druggists, nurses, students and their relatives. This, however, may be due to the fact that these classes supply the larger part of