..grains xv-xx

M. et ft. chart. No iii. Sig. One powder every third hour, to be followed by a dose of castor oil if the bowels do not move freely two or three times If the temperature should be much clevated give one or two ten grain doses of quinine.

If any credit can be given to the experiencc of one who has been eight years in the practice, and has seen from ten to twenty cases each year, it must be acknowledged that it is possible for typhoid fever to be aborted, for I have certainly seen it done time and again, by the above treatment, during the first week or ten days, but never after that time. Should the treatment fail to abort, you have cleaned the bowels of much offending material, and stimu lated the various secretions, such as the bowels, skin, kidneys, liver, etc., and if it be true that the typhoid bacillus makes its ingress into the blood through Peyer's patches, you have done your duty to your patient by making an effort to prevent its introduction, and I know you have done him no harm.

If I don't see the patient until the disease is well developed I never use the calomel, because I believe it would favor both intestinal

hemorrhage and perforation. But I still cling to the antiseptic method, and, after using iodine, carbolic acid, salol, sulphite of sodium, and chlorine gas in solution, my pref. erence is for the sulpho carbolate of zinc, in two to two and one-half grain doses, for an adult, repeated every two or three hours. I have never seen it do any harm, even when long continued; but the temperature will almost invariably fall one or two degrees in twenty-four or forty eight hours after begin ning its use. If tympany is marked I order the bowels bathed with a solution of turpentine and sweet oil, one part of the former to two of the latter, every six hours, covering the abdomen with a flannel cloth after each application. When the tongue is heavily coated and purple edged I give dilute muriatic acid, ten drops with about two grains of quinine for its tonic effect on the heart. But if the tongue is dry and fissured with diamond-shaped patches on it, I give turpentine in emulsion every three hours. Never give stimulants until they are

treatment.

I prefer

needed, and then give them freely. brandy; I am afraid of the coal tar antipyretics; as some one has truly said, about the only good they do "is to let the patient die with a normal temperature." In fact with the continued use of the sulpho-carbolate an antipy. The above is the retic is seldom required. most important medication I use, unless there is some complication that calls for especial As for nourishment, I know of nothing better than a raw egg beaten up in a glass of sweet milk, and of that give about onehalf every two or three hours. I might also add that I have the patient's arms, legs and face sponged with cold water every two or three hours whenever the temperature rises above 1010. With my present opinion, if I should have a case where the temperature should run exceedingly high, I would not hesitate to use the cold bath, unless the heart was very weak. I have never lost but one case of

typhoid in my life, and that from intestinal hemorrhage.

E. T. W. HALL, M. D.

Freemansburgh, W. Va.

[Doctor, we see no reason why you may not add the zinc salt to even your "abortive" treatment with decided advantage. believe that weak heart is no contra indication Also, we to the use of the cold bath, but rather another reason calling for its use. The heart seems to partake in the general tonic effects of the bath. -ED.]

Treatment of So called "Slow Fever." EDITOR MEDICAL WORLD.-I wish to reply to Dr. Speed, of Shirly, Texas. At the commencement of treatment, if the fever runs as high as 102 to 103 or 1032, I usually give three to four gr. doses of acetanilid every two

to four hours to control fever. At the same time

I give about three to four doses of calomel and bicarbinate of soda two to three hours apart to promote the secretion of bile. The formula I

use is as follows:

Hydrarg, chlor. mite...
Sodii bicarb....

Sig. Divide into four powders. three hours.

.grains xii
grains xvi

One every two to

Should they not produce free action of the bowels five or six hours after the last dose is given follow it with castor oil or epsom salts. At any time during the fever, if the bowels become thin and watery, I give sub-nitrate of bismuth and opium, five grains of bismuth and one half grain of opium every two to four hours until checked, usually one to two doses are sufficient. To control the fever after this I use equal parts of acetanilid and salol, two to three grains of each at a dose, every two to four hours. Should the fever run very high I use the

old reliable sponge bath every four to six hours, in connection with the above. Should the acetanilid be too depressing on the heart, I usually add one to one and a half grain of camphor gum to each dose, which will stimulate the heart's action. If the bowels become sore or tender on pres sure, tongue red and dry, spts. of turpentine in ten drop doses every four to six hours has proved successful in my hands. Sulpho-carbolate of zinc is another agent I frequently use as an antiseptic in two grain doses every two to four hours whenever there are typhoid symptoms, which is very often the case.

I never use quinine in my slow fever patients until convalescence has commenced, then only In tonic doses, as it always does harm. As to diet, I generally let the patient have what he wants unless it be of an indigestible character. They don't usually want much of anything. I prefer milk to all other nourishments, and this the patient very often craves. I give them all the lemonade and cold water they want to drink, and have found it in every instance to be refreshing. I have been very successful with the above treatment in what we doctors call slow fever. My patients are usually up and about their daily duties in two to five weeks. And if Dr. Speed will try the plan laid down here I think he will like it.

DR. W. L. WORTHINGTON.

Dowling, Ark.

Retention of Urine.-Novel Method of
Relieving.

EDITOR MEDICAL WORLD:-In cases where a catheter can not be introduced, or where the physician has no instrument, as is the case in country practice, occasionally, I have found the following expedient positively effective: Stand the patient, if possible, but seat him if you are obliged to, and pour hot water from a pitcher upon the abdomen, above the pubic bone, letting the water flow down and off the end of the penis, into a receptacle below. In a very few minutes the water will flow freely, even if the patient be unconscious or delirious.

In cases of organic stricture, of course, no results would be secured. Ferndale, Cal.

F. A. ALFORD, M. D.

Medical Laws in Kansas.

EDITOR MEDICAL WORLD:-In response to your request in February number of THE WORLD, will say that the law regulating the practice of medicine in Kansas is as follows:

"That it shall be unlawful for any person within the limit of the State of Kansas, who has not attended two full cour-es of instruction and graduated in some respectable school of medicine of the United States, or of some for. eign country, or who can not produce a certificate of qualification from some State or county medical society, and is not a person of good moral character, to practice medicine in any of its departments, for reward or compensation, for any sick person within the State of Kansas, Provided, That in all cases, where any person has been continually engaged in the practice of medicine for a period of ten years or more, he shall be considered to have complied with the provisions of this act, and that where persons have been in continuous practice of medicine for five years or more, shall be allowed two years in which to comply with such provisions. (Laws 1870 ch. '76 78 91.) Section two provides penalty for violation."

Owing to the good judgment and loyalty to the principles of American liberty, of the profession and laity of our State, even this law is not enforced. Rushton, Kas.

S. C. Cook, M. D.

[The highest liberty is to be found in the obedience to just laws for the general welfare. -ED.]

Quebracho in Lung Diseases.

EDITOR MEDICAL WORLD:-My attention has lately been called to the use of fl. ex. quebracho in pneumonia, where there is rapid breathing, and a deficiency of oxygen in the blood, or where either exists alone. I have used it in the rapid respiration of pneumonia, and find that the patient breathes from ten to twenty times less each minute. It also slows and strengthens the heart and deepens the res pirations. So far as my observation and reading goes it is safe in the usual doses. Davis and Co. will send a monogram on the remedy to any one requesting it, and if the medicine will do what is claimed for it in asthma, bronchitis, phthisis, pneumonia, etc., it is something unique and very useful. probably works either through enabling the red corpuscles to assimulate more oxygen, or by stimulating the respiratory muscles.

Park,

It

Now, when there is so much lung and throat disease, every doctor should be posted on its action, and I am of the opinion that very few

We

Medical Fire Insurance. EDITOR MEDICAL WORLD:-I notice in the last issue of THE WORLD that several of our professional brethren have lately been burnt out. This suggests to me the idea that it would be a nice thing for us to band ourselves together and insure ourselves against loss by fire. could have a mutual fire insurance company on the assessment plan, whereby many of us would save money, and many others the value of their property. We could limit membership to the members of the medical profession, and have insurance at a very low cost. many are willing to go into such a scheme? Let me hear from all that are willing to take hold.

Aurora, Neb.

How

T. H. LINE, M. D. [There are several mutual benefit organizations giving assessment life insurance among physicians at different places in this cou try. ED.]

Saccharine for Alkaline Urine.

EDITOR MEDICAL WORLD.-In February WORLD, (page 69), W. K. H. wishes to know the best tre tment to render alkaline urine acid. I will state that I have had perfect success in three cases with five grain doses of saccharine in capsule four times daily. I saw this in a medical journal some years since. It is perhaps proper to state that all my patients were suffering with irritable urethra the result of gonnorrhea, and complained bitterly of a bur: ing sensation while voiding urine, and a short while afterward. The urine was to all appearances normal, but upon testing proved to be intensely alkaline. After urination, blood would invariably pass, from a few drops to a teaspoonful. In each case the urine was rendered acid in from twenty-four to forty eight hours, and the symptoms subsided. Landesdale, Miss. S. A. SCRUGGS, M. D.

Abscess Containing Hairs.

EDITOR MEDICAL WORLD :-I would like to name J. W. Ward's case, reported in the February number. The disease is not very com mon. I would also tell him how the hairs get there.

The disease is called Pilo nidal sinus, "pilus hair," "nidus nest," meaning a bunch of hair in a nest, and a sinus leading to it.

In the anatomy of everyone just on the lower end of the spinal column, there is a decided depression. In some it is very great, forming a sort of a pocket. You will generally find a small tuft of hair growing in the centre. Nov, from growing more fleshy, covering up the hairs, setting up itritation, I think constant

uncleanliness, together with the hairs, is sufficient to cause inflammation covering up the hairs; in fact, the pocket is destroyed or covered entirely over, leaving the hairs in the bottom. They might remain stationary, or move about as in Dr. Ward's case, but the trouble never gets entirely well till the hairs are removed.

Really, I have never seen the trouble mentioned in the books. Have seen only a few cases; I think it does not often form an abscess, and surely is not generally understood. Fairmont, Minn.

H. N. RICE, M. D.

Rectal Worms.

EDITOR MEDICAL WORLD:-I see, in the February number of THE MEDICAL WORLD, that Dr. J. W. Ward wishes to learn a cure for rectal worms. As I have succeeded in curing, among others, a case that for months resisted all methods of treatment, and that had begun in early childhood, I will give him my experience, in the hope that it will prove equally successfully with his patients.

The case was that of a young girl, age fifteen years, who had been troubled with them ever since she can remember.

She came to me for relief about two years ago, as they had become so numerous as to seriously undermine her health.

After trying all of the remedies I could think of, or read of, I found that the fluid extract of spigelia and senna would remove them for a t me, but that they would invariably return. I then combined with the spigelia and senna, a method essentially the same as that mentioned by Dr. W. N. King, in a later number (October, 1890) of THE MEDICAL WORLD, viz.; an injection at bedtime of an ounce of a saturated solution (aqueous) of the best socatrine aloes. But this is not all, nor do I think the principal part, of a treatment for the permanent cure of this disease.

On looking up what the different authorities on the subject had to say, I found under the heading, "Thread Worms," in Quain's Medical Dictionary, that the ova may be swallowed by ingesting them with the uncleaned fruit and vegetable, to which the eggs have become adherent; but undoubtedly the most common way in which the disease is prolonged, if not at least contracted, is by swallowing fresh germs, conveyed directly to the mouth by the hands of the patient.

The distressing sensations of heat, irritation and itching, within and about the genito-urinary passages, will cause the sufferer to handle the parts while asleep, if at no other time, thus causing the ova to become lodged on the hands and more especially under the nails.

Hence, in addition to the remedies prescribed, whatever they may be (and I have found the treatment mentioned above the best of all), and without which, any or all remedies give only temporary relief, strict attention should be paid to the diet and regimen. The avoidance of green fruit, and local washings daily, should be insisted on. The nails should especially be kept very short, and very clean, and the habit many people have of biting them. should be discontinued.

My patient has, since adopting the above line of treatment, never had any return of the symptoms, and if the treatment had been con. tinued as in the beginning, she would, in the same length of time, have had many returns of the unwelcome visitors I consider the injection alone insufficient, as many of the worms are situated beyond its reach. Grantfork, Ill.

E. B. YOST, M. D.

For Rectal Worms. EDITOR MEDICAL WORLD:-Dr. J. W. Ward asks for rectal worm remedy, and offers $10, which I do not require, but for the benefit of MEDICAL WORLD readers I give a treatment that has proved successful with me when all else has failed.

R

Chloride of sodium....

Distilled water....

drams ii

.....

.. pint i Slg.-Inject half at night and the remainder in the morning (warm), immediately followed with brisk purgation of sulphate of magnesia.

Repeat this every second day for six days.

If Dr. Ward will insert in the next issue of THE MEDICAL WORLD a formula for a beforedinner plll, an appetizing tonic that can be used for three months without constipating or other than a good effect on the blood and system generally, he will oblige me very much. I use several tonic pill formulas, but not one is entirely to my satisfaction.

St. Augustine, Fla. T. J. SMITH, M. D. Oinment for Rectal Worms and Hemorrhoids.

EDITOR MEDICAL WORLD.-Seeing a call in your interesting journal for a cure for rectal worms, I hereby inclose you a prescription which has proved perfectly satifactory in my hands:

EDITOR MEDICAL WORLD:-In answer to F. D. Badger, M. D., page 34, January WORLD, say that he will find relief to his ten-year-old boy with diabetes by giving him three to five drop doses of Fowler's solution of arsenic three times a day, and if his discharge of water is excessive, give one drop of carbolic acid, c. p., in a glass of tepid water three times a day. Arsenic arrests the development of glysogen in the liver, thus removing the cause of the trouble, and gives prompt relief with strict diet.

Success to THE WORLD, whose character by force of brains has given to it a great momen

tum.

ALEXANDER G. Lane, M. D. Albuquerque, New Mexico.

Calomel for Pruritus.-Carbolic Acid for Cholera Infantum and Abscess of Lung.

ETOR MEDICAL WORLD:-Not long ago I saw in THE WORLD directions to use an ointment of eighty grains calomel to vaseline an ounce, in itching of the anus; that has been worth dollars to me. But in its use I found the vaseline very irritating in the same condi tion of the vulva; so I tried dry calomel dusted on, brushing away all surplus. This is perfect, so I could have informed Dr. Musgrove, of Washington, had I noticed his request.

Cholera Infantum is absolutely demolished this past five years by hypodermic of carbolic acid; and I now can record a case of abscess of lung, of between three and five months development, cured in the same way.

You know I object to these cases being called consumption. That is a misnomer and fraud. Did you ever see a crop of boils following a fever? Of course. Well, tell me the difference. A boil, being superficial, can be treated differently. Abscess of lung (boil) cannot be similarly treated, hence runs a chronic course. I am well aware that pathology, the theme of educated physicians, is an attractive subject; but I can change all the pathological conditions of this trouble by a dose of carbolic acid, if it has not already made too great invasion of tissue.

Hemlock City, Mich. D. S. RINEHART.

Umbilical Hemorrhage.

EDITOR MEDICAL WORLD:--In reply to Wm. H. McGeehan, M. D., Jan., 1892, page 26, I would say that after twenty-eight years active practice, I know of but one reliable remedy, namely: Forcibly grasp the abdominal wall, including the umbilicus, and pass a steel needle beneath the two umbilical arteries, and then apply the figure of 8 suture.

Jackson, Cal. E. B. ROBERTSON, M. D.

Dr. G. T. Prince, of Whiteside, Tenn., recommends waiting until pulsations in the cord have ceased before ligating, and the use of twisted silk material for ligature. The Doctor also asks readers for their best treatment for gonorrhea. We would suggest to the Doctor that he will find many excellent articles on the subject if he will consult back numbers of THE WORLD.

Obstetrical Experience.-Corrosive Sublimate Poisoning.

EDITOR MEDICAL WORLD:-I delivered a woman at full term who had had great pain for two months or so in the region of the left Ovary. The placenta not coming away I passed my hand into the uterus and found a pocket on the left side. It seemed to me to be a dilated tube with a tear in it. Part of the placenta protruded through the tear. When I pulled my hand out there was not a drop of blood on it, although I had swept it over the entire inside of the uterus. The woman made a good recovery.

Last Sunday, while I was attending a case of confinement, a colored woman across the street bit off, chewed up and swallowed one-third of a corrosive sublimate tablet, containing seven and a half grains of the poison. It must have been five minutes before I got there, and she had already thrown up a part of her breakfast, eaten only a few moments before. The remains of the tablet was shown me. She was making a great fuss and said her stomach was

on fire. Seeing some raw eggs I broke two and made her drink the whites down, and follow it with a glass of milk. Then I gave her In this way sulphate of zinc and more milk.

I filled and emptied her stomach three times, and then gave her two big doses of castor oil, which happened to be at hand. The second dose was not thrown up. Her bowels moved once before she took the oil. For a short time there was no perceptible pulse at the wrist, and for a long time it was very feeble. At this time she is doing well, but is salivated badly. C. E. BRYANT, M. D.

1122 16th St., Denver, Col.

Was it Typhoid Fever? EDITOR MEDICAL WORLD:-Mr. -~- a school teacher, age twenty-one years, had for several months suffered with a naso-pharyngeal catarrh, with, perhaps, a sub-acute bronchitis, and upon the slightest exposure, would cough incessantly, a dry pharyngeal cough. When taking expectorants he would expectorate very abundantly, a tough, sero-mucous, stringy fluid, but after a day or two, or more, the expectoration became muco-purulent. His general health became somewhat impaired, and though his appetite remained fairly good, he became anemic and generally debilitated.

Ten days ago he applied to me for medicine. I found his temperature 103° F., .pulse 110 to 115, appetite good, no cough. He had had no chill or chilly sensations. He thought that his fever must. have been much higher the previous night, as he had felt very hot. This being a malarial section, I prescribed quinine in four grain doses every two hours, with strict instructions to take to bed and remain there until the fever was broken, and to take the quinine till thoroughly cinchonized. He took three doses that afternoon, and concluding that he would get all right anyway, stopped. taught school all the following day without taking medicine, and his fever again went up very high that night; with severe headache, and general aching in joints and back, expectorating freely as usual, but had no cough.

He

Believing that he had contracted the ever tedious and often obscure "La Grippe," I thought, as he would take no quinine, that I would try the ammonium salts and camphor, with salicylic acid to reduce the temperature. He took two or three doses and refused to take more. I then returned to the quinine, as he agreed to take that now, and directed "four grains every two hours. It affected the temperature but little, nor did it produce but slight cinchonism within the twenty-four hours following. His morning temperature was always low, but in the afternoon and night it

"