Page images
PDF
EPUB

morphia to quiet delirium. Patient took milk,

Tyrotoxicon or Lactotoxine. chiefly, as food, and with relish, even asking EDITOR MEDICAL WORLD:~I was called July for his allowance, and assisting himself from 8, 9. 10, 11 and 12, 1892, to see one or more his bed to stool.

individuals in five different families, who were Third morning after injury, free evacuation sick from eating poisonous cheese. The sympof lower bowel ; little improvement in mind; toms were those of irritant poison-excessive moments of seeming consciousness; sleep better vomiting, purging, dizziness and great prosafter first night ; dicrotic pulse at this time, tration; pulse very feeble, temperature normal which gradually improved under digatalis. . or slightly sub-normal; face somewhat cyan

Fifth evening: Temperature (taken when osed; also great faintness and heat in stomach patient had risen) 102°; pulse 120; reduced (as patients described). again by free application of ice. No further . There was no fatal case, but in case of one movement of bowels. Cathartic given and girl twelve years of age, and one man thirtyrepeated, together with injections.

eight, with heart trouble, the prognosis was Sixth day: First symptoms of intestinal ob- very grave. Several others suffered from nausea struction; bowel very much distended ; tym- and weakness, but did not vomit nor take to panitic; normal temperature; ice removed and their bed. hot applications to the bowel, with missage of Treatment-Powdered opium and calomel turpentine and lard; injections repeated; use (small doses once an hour) dry on the tongue of avena sativa as sedative, and brandy as stim- till vomiting ceased; brandy as needed, hypoulant.

dermic injection of morphine and atropine if From this time on symptoms grew more pain and cramps are excessive. I should say grave; strength steadily failing; circulation wait on the vomiting ; do not check it too and respiration impeded by great pressing up of soon, nor too late. the diaphragm ; mind wandering; cold per- Lincoln. Me.

C. FULLER, M. D. spiration, and clammy skin.

Injections ; Aushing whole of lower bowel ; use of coal oil brought away some thin, dis

Death from Drinking Gasoline. charges. The canula inserted into ascending EDITOR MEDICAL WORLD:- Having just and transverse colon, did not alleviate symp. witnessed a death from the accidental drinking toms ; neither application of battery.

of gasoline, I desire to ask you to answer Such, at end of eighth day; patient's through the columns of your valuable paper if breathing labored; mind not centered, and poisoning from this cause is frequent; and also getting less sleep. Surgical operation at the your many readers to report any cases that may time contemplated, but given up, as symptoms have come under their observation with the grew worse.

symptom produced. Midday of ninth : Collapse threatened, re. On July 5th was hastily summoned to see viving again after some giving way of bowels; a child, 26 months of age, who had drank some slight thin evacuation.

gasoline (quantity unknown). At noon the It was thought a change had come, and for

mother cleaned a dress with it, left the cup the best ; but hiccough and vomiting (not standing, and went to the city, being away all stercoracious) became frequent; a relapse into the afternoon. About 10 o'clock p. m., just a state of exhaustion and total aberration; as the family was retiring, the child discovered gradually sinking and dying morning of tenth the cup and took, perhaps, not more than one day after accident. Bowels moved somewhat or two swallows from it, and immediately freely the last hour. Heart-beat and pulse dropped over in a spasm. The distance being wave lost some moments before death. No only iwo blocks from my office, I arrived on post-mortem.

the scene in fifteen minutes after the fatal Question of importance is—was the compli. cation of bowel trouble from direct injury; I found the little fellow in the arms of his and would any surgical interference have pre

great grand-mother, who informed me that he vailed ?

had just passed away. ( Drs. C. W. Gilbert,

Respiration was entirely suspended, but I at In attendance T. Z. ORFUTT,

once began artificial respiration, and soon the (and BENJ SHIPLEY.

child made an inspiratory effort ; being enGranite, Md.

couraged by this I continued it, changing about with an assistant, and, by the aid of a

hot bath and rubbing with alcohol, in about Tae Toledo Medical and Surgical Reporter says:“The Doctor, in 'The Physician as a Business Man,'

ten minutes succeeded in reestablishing fair not only points out evils, but also suggests reme

respiration. dies.” Price $1. See order blank, page xxii.

I then administered warm water and mild

emetics, under the influence of which a considerable quantity of blood and mucus was ejected from the lungs and stomach. A few minutes later, in the act of vomiting, he expired, notwithstanding that artificial respiration was still kept up. The time that elapsed from the swallowing of the lethal dose to death was about forty minutes. No post mortem was had.

Will some one who has given this subject attention answer the following :

What is the probable effect of gasoline on the mucous membrane of the stomach ; and what would be its effect on the lungs ?

Would the standing of gasoline in an open vessel for a period of eight or nine hours, as in this case, increase its lethal qualities?

As gasoline is now found in almost every household during the summer months, and having myself never heard of a death from drinking it, I have thus fully reported this case, hoping that it may call out a full report on the subject.

B. M. Barnett, M. D. Rosedale, Kansas.

To Prepare Surgical Sponges.--Spasm of Cremaster Muscle.-For Chlorosis-Indolent

Syphilitic Ulcer.-Genital Herpes. EDITOR MEDICAL WORLD:~" Reader" will find the following plan the best for the preparation of sponges. Beat them free from calcar. eous particles, and then immerse them for fifteen minutes in dilute muriatic acid, to dissolve out any remnant of lime which may remain. This solution also bleaches them beautifully. Wash them in cold water, then thoroughly knead with green soap and hot water for five minutes ; rinse again in cold water, then immerse in a five per cent. solution of carbolic acid, in which they should remain until required for use. This process gives a fine, soft sponge, beautifully bleached and thoroughly aseptic.

I would infer from Dr. B. E. Witte's description of his case that he has a case of painful spasmodic contraction of the cremaster muscle, pure and simple, which is probably due to prostatic irritation, as this is the most common cause of this condition. Cure of this prostatic irritation will relieve the condition. This condition is also brought about by nephritic colic, neuralgia of the testicle and sometimes urethral irritation. If all medicinal measures fail to give relief, I would advise excision of muscle as recommended by the late Valentine Mott for obstinate spasm of this muscle.

To Dr. S. C. Cook, I would say that in chlorosis I have found the follɔwing formula of

Blaud's, and so highly lauded by Niemeyer,
particularly efficacious:-
& Pulv, ferri sulph.... ....

Potassii carbonat. puræ...aa...ounces ss
Tragacanthæ......9.8................

Ft. pil. No. xcvi.
Sig.-One to three or four pills three times daily.

« Physician" should continue the use of his iodide of potassium internally in his case of indolent ulcer and as a local dressing. Wash the parts thoroughly with a 1 to 500 bichloride solution, and apply either in the form of a dusting powder or a 50 per cent. ointment, Europhen. I would prefer the dry powder. Herpes progenitalis is very liable to frequent relapses, and as it may arise from various causes the only rational manner to proceed in trying to prevent its recurrence is to isolate the cause and treat accordingly, whether it be from an abnormally long prepuce, gastric or intestinal disturbances, too frequent coitus, etc., etc.

Chas. L. Kerr, M. D. Falls City, Neb. Statement in Regard to the Texas Law Cor

rected. .

EDITOR MEDICAL WORLD:-In your last issue it is stated by a correspondent that the law of Texas requires an examination, and that diplomas “ do not count.” Dr. Kennedy, a resident of Texas, and a friend of mine, wrote to the County Attorney of Dallas County, to know if the last legislature had changed the law from what it was last year. I enclose the reply of the Attorney, which, for the benefit of the misinformed and misinformer, I would suggest that you publish. Information as to the laws governing the practice of medicine in the States should be satisfactorily vouched for before being published.

W. C. UPHAM, M. D.
Washington, D. C.

[The following is the Attorney's letter re. ferred to.-Ed.]

C. T. KENNEDY, M. D._Dear Sir: Yours of the 4th inst. at hand. Will say in reply that under the law no examination will be required of you. The law requires that your diploma shall be recorded with the County Clerk of the county where you practice.

Yours Respectfully,
D. A. WILLIAMS, County Attorney,

per Fouraker.

Dr. W. N. SHERMAN, of Merced, Cal., writes us that they do not have cholera infantum in his part of California, even in bottle fed babies, he having had but one case of the disease in three years.

Medical Advice in the Market.

on which to advance. Send a bill as follows: EDITOR MEDICAL WORLD :-In Tuly number. Owen Goodmother, . Dr. S. N. Smith, replying to Dr. Kilpatrick,

To I. R. Wakeup, M. D., Dr. makes some pertinent remarks on our - Stock

To consultation on case of Sarah Jane having in Trade," meaning our medical knowledge. taken cold, C., I see no other way than for the medical pro. If not, Why not? The people should learn fession, in this matter to move right up in soon that medical practice is business also. line with the legal profession. The reason a

In rendering accounts, physicians might physician's advice is not as readily and as learn

learn from a Toledo mechanic. richly paid for as that of the lawyer is because,

A manufacturing firm of that city were ope through the commercial ligor of lawyers and day nopplussed by the sudden cessation of the business laxity of physicians. the public motion in their engine. It had come to a have imbibed the notion that law is business, dead stand. A mechanic and that medicine is an incarnate beneficence sent for, who, alter three hours trial, failed to with prodigious bowels (of compassion) and start it. As the operators were all idle in with no stomach to speak of, always bestowing consequence, another machinist, the maker of matei ial good, itself the while subsisting mainly the engine, was hastily summoned. With three on south wind. I said ours must move up smart raps of a mallet at a certain point, he abreast of the sister profession. A move, how.

instantly recalled the sinewy giant to life, and ever, is not sufficient. It will require at least

all went on as before. In due time, this adept a seven days' march to bring us in line.

in mechanics and common sense forwarded to An actual incident in point.-John Moore,

the house a bill with his services thus specificsitting in the reading room of hotel, revising a

ally defined : lease he has just made for a tenant. At the Tomechanical adjustment of engine, $ 1.00 moment, passing out, is Lawyer H. When To use of my expert knowledge which opposite Moore, the latter hands the paper to alone made success possible, . 2400 H., saying, “How is that for a lease?" H. takes the document, scans it for perhaps one

Total,

. . $25 00 minute, and replies, “All right, Moore; as Respect for your valuable space constrains good as though I had done it myself," and me to close. I shall never attempt to practice passes on. At the expiration of about ten save under the stimulo-tonic influence of The days, H.s' office boy calls on Moore with this MEDICAL WORLD. It is the best medical paper little bill :

I ever saw. John Moore,

J. A. Mowris, M. D. To H. & H., Attorneys. Dr. Lafeyette, N. Y. To consultation concerning lease, $10. Moore, being too prudent to hesitate, boy

Slow Fever. retires with a "saw buck."

EDITOR MEDICAL WORLD:--In The MED.CAL Now, Doctor (any one of ten thousand) con- WORLD of July, page 258, I think Dr. Green's trast this service and its returns with yours, idea about slow fever," is as nearly correct when on that drizzly evening last winter, as as that of any who have given an account of it. . you were still three miles from your cozy I have just had a typical case. home, expectant family and warm supper, your M. P., age 12, white, anemic character, progress was arrested by a shout from Mrs. family history good. On May 25th, my first Goodmother, "Doctor! now don't get out, visit. I found he had been complaining for a but I have been wanting to see you so bad week or so, and in hed three days. No symp. about Sarah Jane, who took cold when she tom except abnormal temperature and a slight hadent oughter." Making no reference to the headache. He had been given fifteen grains of balance of fifteen dollars long overdue for your quinine daily, which only caused much services in the fever case, for full twenty nervousness. I gave him a cathartic, comminutes she held you in the storm, plying you posed of aloin, jalap, podophyllin, hyesciawith questions, and drawing out your "stock mus, nux vomica, and capsicum, and a granule in trade," promised to bring the patient to of pilocarpine every 15 minutes, with one of your office on the following morning for treat aconitine every two hours. 26th. Bowels ment, which she never did, dismissed you moved well, but no perspiration or abatement without thanks, and went directly to the of fever. I then gave various febrile mixtures corner grocery, and paid two dollars cash for for several days. No change. Then I gave four Alcock plasters and one bottle Ayer's chlorate of potash and carbolic acid. It caused Cherry “ Pictorial,” all for Sarah Jane. so much nausea that it was discontinued, and

Now, here, Doctor, you have a good case I gave a few powders of calomel, acetanilid,

quinine and Dover powder. For two days there was loose bowels of a brownish 'color, semi.solid and offensive. I then gave grains 2 to 4 of acetanilid, with an occasional dose of quinine, which reduced the temperature remarkably. It ranged continually from 1000 to 10372°, always highest in the forenoon.

June uith. I thought there must be some intermissions, and I put him on the following prescription : B Fowler's sol. arsenic............drams i

Hydrargyri bichlor..............grains i
Tinct, ferri chloridi..
Acidi hydrochloric dil...aa.... drams iss
Potassii chloridi................drams ij

Syrup simplex....q.s. ft....... ounces iv
M. Sig.-Teaspoonful four times daily.

When fever came on, a few doses of acetanilide would cause perspiration and control it. He did well, and was able to run about until a few days after the medicine gave out, and there was a relapse. The same prescription was given, and is doing well at this time. He had no untoward symptom except the fever. Two of his brothers were sick for a few days only.

E. I. PERSINGER, M. D. Campte, La.

Unusual Complications of the Cord. EDITOR MEDICAL WORLD :-On the 4th inst., after a natural labor, Mrs. C. M., aged 19, primipara, was delivered of a male child, 772 pounds. The cord was circled around the neck three times, and also loosely knotted about three inches from the umbilical attachment. It measured 4 feet 2 inches (50 inches). Quite a long one!

Thos. B. GRAYSON, M. D. Winkler, Texas.

condition. The person may have a small unsatisfactory defecation dairy, but in many thousands of cases, but once or twice weekly. The greater the constipation and confined confined condition of the intestines, the greater danger of tubercular development in the mesenteric glands, commonly called consumption of the bowels. Where the soil is most adapted to developing the germs there will it manifest itself more fully. In all such cases there is perceptibly a clammy taste, beginning with a dry cough, possibly hacking occasionally, which will by and by develop into the regular morning cough. Some cough mostly at night on retiring, and towards day. break, while others cough more as soon as they begin to stir from their couches. This terrible annoying and most distressing cough is due to the vitiated chyle which is intermingled with venous blood in the right ventricle and thrown into the lungs every moment, ever and anon compelling the lungs to filter and renovate, oxygenate and prepare as best possible to be received by the left ventricle and sent out to nourish the body. The great head quarters of this life-giving eurrent_ihe lungs— is in a constant dilemma how to get rid of surplus excrementitious matter received from the duodenum. Some possibly passes on into the circulation, on its mission of feeding the starving tissues or the physical system, and more so perhaps because of the sedentary life. The lungs are seldom if ever expanded fully, and, as a result, but a fractional part of oxygen is inhaled that should come in contact with the blood in the lungs. The only way the lung can possibly eliminate secretions is by exhalation, cough, and expectoration, so it will be very readily understood that this condition of the system and circulation cannot go on long before damage will begin to appear in said organs. Possibly the lungs get on fairly well throwing off surplus secretions for a while, it may be for months, and in some cases even for years; but a bronchitis, laryngitis, catarrhal irouble or some air par sage trouble will be the result, due to exhalation. It will be very noticeable now in the most of cases, the breath is offensive, said to be due to a foul stomach, but it will almost invariably be found to emanate from the vitiated chyle which has been forced to rely upon the lungs to get rid of its death dealing composition by exhalation. Even in other infectious diseases-scarlet fever, diphtheria, and fevers in general—this same condition of the glandular system and engorged alimentary canal will be found. Many attribute the fetid breath and coated tongue to be caused by the stomach or emanating from said organ. This is a great error, because the clammy taste, coated tongue, sore throat, deposits of all

A Few Thoughts on Infectious Diseases ;

Tuberculosis in Particular.

(CONTINUED.) EDITOR MEDICAL WORLD :-I find that in tuberculosis the susceptibility or predisposition, whether inherited or acquired, can be annihilated only in cases where the volume of blood has not been reduced by fermentation and mal-assimilation of food in the intestines. Vitiated chyle diminishes the quantity and quality of blood, and compels the lungs to throw off secretions that otherwise should pass off through the bowels, bladder and skin. Fermentation takes place in the bowels (where all starchy foods and fat are digested) from a retention, and an ipability to pass the ilec-cecal valve. The colon, especially the ascending colon, will invariably be found impacted more or less, and its contents in a dry, decomposed

were avoided. I refer to uncomplicated cases of my own and not the cases I saw in consulta: tion, and after it was too late, and high temperature had done its work and all hope had Aed.

I think it best to give my treatment of infectious diseases as fully as possible, so that I may be more clearly understood when I define my plan of treating lung, throat and catarrha! diseases (tuberculosis). I have good reason for believing from the results derived from my treatment that 75 to 85 per cent. could be saved from premature graves, correcting their predisposition to consumption to such an extent that they might live to die of some other cause.

Dr. Brobst, of Lehigh Co., Penna., who visited me in consultation with a very interesting caje a few weeks ago, told me that while he was spending eight months in Europe, at Vienna, I think, he learned that my mines al treatment for tuberculosis gave the best results. This gives me encouragement to continue in its development.

Washington, D. C. N. B. SHADE.

ALUM used to whiten bread is detrimental to digestion, in that it renders phosphates in: soluble.--Homan in The Medical Fortnightly.

kinds, and inflammations of the air passages are caused by exhalation from the vitiated blood, which is being renovated by the lungs. It will be inferred from what I have said already, and if I am correct in my assertion, resulting from over twenty years general practice, that the attention of the physician is directed to the alimentary canal, the malassimilation of food being the principal cause and beginning of tubercular trouble, from which throat, lung, and catarrhal diseases develope. Especially have I found it so in diphtheria, scarlet fever, and fevers generally. in acute infectious diseases I have invariably found that removing the contents of ihe bowels from the chyliferous vessels reduced the temperature at once, and that acting upon the glandular system with proper medications, in connection with Aushing the bowels with hot water, entirely removed the original source or cause of the malady, that is, provided it is done before this condition of the alimentary canal has produced tissue change, lesions, etc., by a high temperature. The retained feculent matter surely generates the heat and is the fuel which must be burned up (consumed), or fatal results necessarily follow, unless nature comes to the patient's relief by diarrhea.

If this takes place soon enough the patient may pull through, but in danger of sequela to follow; a result of the decomposing, ferment. ing feces lying too long in contact with the mucous surfaces of the bowels, especially the chyliferous vessels. I refer now to all acute infectious diseases. I think I should be allowed to say what has been upon my mind for a long time in regard to my experience with infectious diseases. Before I arrived at the knowledge I have attained, I had lost four cases of scarlet fever, three of typhoid fever, one of pneumonia, none of diphtheria, small pox and erysipelas, two of child-bed fever, and none for the last ten or twelve years. The first seventeen years of my practice was in McConnelsburg, Pa. I lived in the county seat, and practiced all over the county from twenty to thirty-five miles around, I had hundreds of cases of typhoid fever, scarlet fever, diphtheria, erysipelas, pneumonia, and thirteen cases of small pox, eight of which were of a malignant confluent variety and all in one family. (They were all terribly marked, because my directions were not carried out in protecting the face.) My success in the treatment of these diseases led me to what I have discovered in the successful treatment of tuberculosis. I should have said that I have had no sequelæ follow during the last ten years of my practice in infectious diseases, for the simple reason that I removed the cause that produced a high temperature, and as a result tissue change, lesions, etc.,

[blocks in formation]

See pages 18 and 19.

3. How do physicians' charities help the large cap. talists, and what is the logical remedy? See pages 27, 28 and 29.

4. What is the basis of the physician's fee? See pages 30 and 43 to 47.

5. What are average reasonable fees for different services ? See pages 71 to 75.

6. How should physicians' Sunday work be re. garded ? See page 75.

7. How do medical fees compare with those of other professions ? See pages 80 to 82.

8. What is the most practical bill form ? See page 88.

9. What do you think of cooperative efforts at co! lecting accounts ? See pages 104 to 110.

10. What kind of account-books are most practical for physicians' uses? See pages 122 to 127.

11. How can the building association help the doctor? See page 128.

12. What obstetrical fee is charged by the profession in an in different parts of this country ? See pages 48, 49, 55. 57, 63, 65, 68, 69, 72.

Price of the Physician as a Business Man" is only $1.00. See order blank on page xx.

« PreviousContinue »