appear as before. This had been her condition for eight weeks, except that there was sometimes a rest of the movements for hours. I prescribed antipyretics and cathartics pro re nota, pepsin, bismuth and charcoal for tympanites, and four drops of turpentine every three hours. Next day I invited another physician to see this case with me, and we found that catharsis had taken place, fever almost gone, tumor size of fetal head, pains less and patient much better. We continued the treatment, with the addition of assafetida enema three times daily, and quinine. In a week the woman recovered so that she had no fever, could eat with relish, and was strong enough to walk about the country to visit her friends and relatives. She then passed from my observation. In October following she was sick, almost as before, and went to the Charity Hospital in New Orleans, remaining there from October 29, to November 19, 1896, and was discharged as improved. She died Feb. 19, 1897. Dr. Geo. H. Jones, assisted by myself, held an autopsy five hours after death. It revealed: Lungs Flabby and weak looking. Heart: Considerably enlarged, with much water in pericardium, and fatty degeneration. Stomach Small patches of ulcers. Small Intestines: Inflamed about twelve inches from stomach, three inches in length in several places, and fourteen inches in length in another; containing a large quantity of water, as the woman drank eight glasses of water an hour before death. Tumor Cheesy in consistency, nodular, eight inches long, three wide and one and a half antero-posteriorly, situated posterior to stomach and attached to stomach, spinal cord, liver and small intestines. Peculiar movements were due to contraction and relaxation of intestines, causing gas to be confined and then liberated. DR. R. W. SEAY. Lutcher, St. James Parish, La. [It is well known that phantom or intermittent tumors are caused by gas being temporarily confined in a small portion of the intestine. In the above duty of the "scavengers" of the system not to permit an accumulation of this worn-out matter; but they can only act under the direction of the nervous sys If the nervous force is deficient, the elimination of this poison is in the same measure arrested. The causes of this nervous deficiency are unwarrantable exhaustion and insufficient sustenance. These co-operate; the exhaustion, by physical or mental overwork, robs the digestive and assimilative organs of the power to prepare and appropriate nutritious food. Thus the blood is impoverished, and the brain and nervous system are starved. A third coefficient cause now enters to oppress the tired and hungry brain. The "auto intoxicants" not being duly removed, poison the whole nervous system. Thus is it robbed, starved and poisoned. This condition is typically illustrated in the uninterrupted progress of typhoid fever, which is declared and admitted to be a zymotic, or filth disease. It is caused by the accumulation of the debris of the animal tissues. In the course of an unarrested case a specific bacillus is developed as a sequence of this accumulation, in which it finds its true culture food, in which it thrives. Doubtless it is ever with us, waiting for the culture medium for its development. A widespread and unfounded hypothetical error prevails, maintaining that this bacillus is the cause; while clearly it is a sequence provided by nature to further digest and render less harmful these retained poisons. How unwilling we often are to recognize our best friends! It is further claimed by the "hypothetics" that typhoid fever is generally induced by the inception of this bacillus thru water or milk taken into the stomach. I take exception to this theory and present another. A sufficient abundance of water is required to wash away these auto-intoxicants. If the water is for any cause unpalatable, it will not be taken in sufficient quantity to do this work; the result is apparent. Milk is no proper substitute for water, and it is not likely to be taken in sufficient quantity to do the work of washing the "inside of the cup and platter." No; it is what is not drank, because of its unpalatability, or neglect of a plain requirement, that nature becomes overburdened with these auto-intoxicants. This is well illustrated in the recent plague in India, and those of Arabia, where, after a protracted drought, attended with great scarcity of wholesome water, pestilence breaks out. The great importance of external cleanliness in relation to health is generally recognized; the greater importance of internal cleanliness has not yet been duly appreciated. Having thus briefly defined the almost universal cause of disease, and that it is not peculiar to typhoid fever, the next step is to inquire the way by which it may be avoided, or removed. We must retrace our steps; take rest for the robbery, digestible food for starvation, and a capable detergent to remove the accumulated debris which induces the symptoms of disease. Rest is always in order; it is the most apt and timely of all remedies. Often the matter of nutrition must be waived temporarily, that the work of elimination of the autointoxicants may qualify the way for nutrition; then will the subject demand food, which should be supplied, but not in the form of milk, which is often indigestible by those in health and always by those who are sick. Liquid-peptonoids, Horlick's malted milk, bovinine, etc., are much to be preferred. ་་ Lastly, what shall we use as a detergent? How shall we wake up the stupid scavengers" and set them to work? Again, taking typhoid fever as the type, let us inquire what has been proven the sine qua non in the prevention and arrest of that dread disease for the past eightyfive years? It is simply mercury. This peculiar power has never been found in any other drug. It is moreover, a most efficient antiseptic. It is presented to us in two general forms or classes; in the pure metallic form, by trituration with other substances by which it may be protected from oxidation; also in a great variety of chemical combinations, calomel being most extensively used. This marvelous detergent power resides in either form. What then should determine our choice? The question of safety. In the pure protected metallic form eighty-five years experience has demonstrated its absolute safety from all liability to mercurial-poisoning. I hardly Quiz Department. need to allude to the hazard of all the chemical forms, included among which should be the blue-mass and the graypowder when not freshly prepared, as exposure to the air oxidizes the finely The great number of requests for private answers, for the divided metal, converting it into a poison. In a protected metallic form it is capable of all the virtues credited to that much abused drug in any form, and is as safe as the simplest herb. Forty-five years' experience with it in typhoid fever has resulted in an average duration of but eleven days, a death rate under one per cent., with no relapses and no second case at or about the same time in the same house-all evidence of infection being abolished by the early and persistent use of this protected form of mercury. In conclusion, there is hardly a conceivable disturbance of the human organism that is not likely to result in some measure of detention of this inevitable debris; surgical injuries of every kind and degree, the puerperal state, both before and after its culmination, burns and frosts and colds. How unlimited then is the field for usefulness of this imperial drug when shorn of its risks and hazards No study in therapeutics is of greater value, and none other will so richly repay the careful and conscientious student. MOSES W. KIDDER, M.D. Lincoln, Mass. DR. J. W. C. SMITH, of Benton, Miss, writes that he has nine bound volumes of THe World, but will hereafter use our binders and do the binding himself, as the cost is so much less and does as well. Another advantage is that you put each WORLD in the binder as soon as it comes, so that they are always preserved in their regular order, and do not get soiled, torn, scattered or lost, and at the end of the year your volume is bound and ready for the library. [See Order Blank on page xx,-ED.] DR. A. H. FREEMAN, of Briensburg, Ky., writes: I cannot do without THE WORLD. It is one of my standbys. Keep up your "Monthly Talks," for they are along the right line and full of thought for the thinking physician. DR. W. G. HARRIS, of Lakota, Tex., writes: Give us as much of your "Monthly Talks as you possibly can. There is more good hard sense in them than in anything I ever read. DR. F. H. FORSHEE, McGrawville, N. Y., writes: I admire you for your method of stopping when "the order is filled," so to speak, until you have another order. If any one thing makes me hot it is to have a paper keep coming and finally have them send in a bill. Stick to your text and we will stick by you. Questions are solicited for this column. Communications not accompanied by the proper name and address of the writer (not necessarily for publication) will not be noticed. information and benefit of the writer, makes it neces sary for us to charge a fee for the time required. Thi fee will be from one to five dollars, according to the amount of research and writing required. Hysteria. Editor MEDICAL WORLD:-I have on hand a case of long standing which has puzzled me much. If you and your readers will diagnose and prescribe for it you will relieve me of much anxiety and a patient of much misery. The patient is a married lady, 26 years old, has one living child and has had several miscarriages. Was seized with eclampsia after the birth of her first child (the one now living), but not since. Yet she is the victim of some very peculiar symptoms. We have a history of constipation of a very persistent character, with headache intense and almost remediless. This is of several years standing. There are some prodromal symptoms to these attacks of which we shall presently speak, of which the chief is a marked dizziness or vertigo during 12 to 24 hours preceding each paroxysm. The following are the symptoms: Pain in the precardial region accompanied by a sense of constriction and suffocation. Breathing is suspended from one-half to one minute. These attacks come on with a state of partial unconsciousness, so that the patient fails to recognize her physician or friends. The nervous system is put on a tremendous strain; a whisper, the rustle of a paper or the touching of a hand will bring on an attack in which her face becomes deadly pale, pulse small and frequent and surface cold. Pains shoot across the chest, upward under the sternum and into the left arm. Patient will wring her hands in greatest agony, saying: "You can't feel it; you don't know anything about it, do you?" This occurs as she is coming out of a paroxysm or state of breathlessness. When the attack is over the pulse comes up, the surface gets warm, there is eructation of gas, sometimes vomiting, and uniformly a quantity of pale watery urine is passed at the close of an attack. The last attack was on the night (always come at night) of March 1st. She had been free from the attacks for a longer period than usual, about six or eight months. Previously they had occurred every three or four weeks. This last attack was the worst we have seen her in. When first seen she talked freely and rationally, complained of having had a feeling of dizziness all day long and of being hot and having an intense headache. I took her temperature and found it normal, and this is the last thing she remembers. I called upon her to drink a potion that I had mixed for her. She did not respond. I touched her arm, when with a convulsive movement she sprang up, clutching at her throat and gasping for breath-not gasping either, for the power to breathe seemed to be paralyzed. The tongue is paralyzed even after consciousness is restored. Complains of roaring sounds in the head. A peculiar feature about this particular attack is that there are points of tenderness along the spinal column (this is the only attack in which I have noticed this); very tender to the touch. Marked thruout the dorsal and lumbar regions. Any information or suggestions will be thankfully received. DR. M. G. PRICE. treatment in the following case: A Tubular Lymphangitis. Editor MEDICAL WORLD:-I was called some days ago to see a Mrs. P. A. B., who had, five or six days previously, while handling a piece of new tin, accidentally cut a gash across the metacarpo-phalan Mosheim, Tenn. [The diagnosis of this case is easy-geal joint of index finger. hysteria. It is strange, Doctor, that you did not recognize it. Many of the symptoms, the large quantity of pale urine, for example, point plainly and directly to hysteria. Your report is not a model one. The first part of it reads as tho the headache and other symptoms were constant. Then it develops that these are present during comparatively infrequent paroxysms. Read up fully on hysteria and master this subject, even if it takes you a year to do it. You will find excellent treatment for this trouble in past numbers of this magazine. Practice on reporting cases. Keep a report on hand for some time before sending it, during which time read it over every few days and have others to read it, so that you can finally make it a clear, logical and concise presentation of the case.-ED.] Learned on my arrival that the cut readily healed and occasioned little thought; but the end was not yet. On the night of the sixth day, Mrs. B. was awakened by acute pain in cut joint., Pretty soon she was well, shaken by a rousing chill, much fever immediately ensuing. Headache, backache and aching limbs combined to increase her discomfort. comfort. Restlessness was not wanting. Stomach Trouble. Editor MEDICAL WORLD :-I write to ask the profession for diagnosis and Examination of joint discovered considerable swelling, redness and a gaping wound. Two very distinct, pink-colored lines ran parallel from wrist, inner aspect of forearm, to elbow. Synovitis, erysipelas, septicemia, presented themselves for consideration. Leaving the diagnosis to the future, I prescribed as follows: Internally, every 4th hour, Kenyon's fever tablet; two hours after each dose, 2 gr. quinine pill. Locally, Campho-phenique powder, thrice daily, covered with flaxseed meal poultice. This treatment was ordered con tinued till patient was seen again. I then left, feeling, however, some doubt as to wisdom of treatment. Improvement followed rapidly, leaving no cause for complaint as to treatment. Patient was soon well. Neglected to state, first dose was a saline purgative. Wound was superficial. My object in this report relates to diagnosis. What was the trouble and proper treatment? Mr. Editor and brethren, please speak out. All may not be teachers, but all may be students; and it is to the latter class only that I can claim to belong. In conclusion, would be glad to learn the composition of "Neuralgicide," put up by the Mason Chemical Co., Philadelphia, and also what the profession thinks of Protonuclein. Allen, Md. J. I. T. LONG, M. D. [Diagnosis, tubular lymphangitis, caused by absorption of poison from the wound. Treatment, satisfactory in results, and not open to special criticism. -Ed.] Dear Editor:-Will you or some one tell me in next issue what can be done for the itching caused by deposit of bile under the skin in jaundice? I have tried pilocarpin. W. H. JUDSON, Danielson, Conn. Rheumatoid Arthritis. Dear Editor :-For two years my wife has suffered with rheumatoid arthritis. We have used all the drug treatment I ever saw recommended. Seven different physicians besides myself have treated her case without any permanent benefit. Last July I sent her to Hot Springs, Ark., with the hope of getting relief. She remained there five and a half months, but came home no better. She is now an invalid. Can walk but very little and remains in her room most all the time. Salicylates do her the most good, and for the last two months she has not suffered so much pain. I hope you will publish this, and if any of your large family of physicians can suggest any remedy either by letter or thru your magazine, I will feel very grateful. Would especially like to hear from the Editor and Dr. Waugh. R. S. MARTIN, M.D. [The Doctor does not seem to have tried the hot air treatment, which is now decidedly the most promising treatment for this stubborn and distressing malady. Several mentions of this treatment have been made of late in these pages which the Doctor seems to have overlooked. After thoro trial of the hot air treatment, please report.-Ed.] Spasms Caused by Holding the Breath. Editor MEDICAL WORLD:-I wish to report a case that is somewhat peculiar to me. A child, 18 months old, ever since birth, when hurt or mad, holds its breath. When about a year old, when holding its breath, it was seized with a convulsion. Since that time it has had some 4 or 5 convulsions when holding its breath. Is the convulsion due altogether to the holding of the breath? and if so, is there any treatment I can put the child on that will benefit it? Let me hear from the editor and readers of THE WORLD on this case, as the parents are very uneasy about the child. Marcella, Ark. A. J. CASEY. If the child were older, a little wholesome discipline with a firm hand would be indicated. At its present age, careful management with a view to avoid hurts or anger seems to be the most rational and promising course.-Ed.] Editor MEDICAL WORLD-I take the liberty as an old subscriber to ask information in regard to a case. My brother, aged 39 years, general health not good, bowels naturally constipated, complexion and hair dark; within a few weeks there has appeared on left side of face light colored spots. Could I hear thru THE WORLD as to cause and treatment? Could we hear from Dr. Waugh? Buffalo, N. Y. OLD SUBSCRIBER. Who Owns the Prescription? Editor MEDICAL WORLD:-Will you kindly inform me thru THE WORLD as to the ownership of the physician's prescriptions and the right to refill, etc.? Glenwood, Minn. L. B. REMICK, M.D. [This has been a much discussed question. Some patients believe that they buy the prescription. Druggists keep the original on file for their protection, and most of them do not scruple to refill |