ing entirely. I have seen some marvelous cases of recovery. We have had and still have patients coming here from Florida, Colorado, Arizona, New Mexico and other health resorts, and they almost universally prefer our climate and surroundings to the other places. Unfortunately a number of the sick defer their coming until it is too late. They should not have left comfortable homes in their condition. But one result usually follows-disappointment and death. Others come, remain a short time, not long enough to become acclimated or test the beneficial effects of climate. Many of them also violate all sanitary precautions by exposure and excesses, and then denounce California because her climate would not perform miracles. We have, also, many comfortable small cottages, furnished or unfurnished, for rent; also good lodging and boarding houses; restaurants, first, second and third class hotels, and two well equipped and comfortable hospitals. So persons can be accommodated according to their taste and means. Strangers are welcomed and treated kindly when they show themselves worthy of such treatment. We have few fogs, or cold and damp days; our nights, as a rule, are cool, and strangers going out at night during the winter should wear extra wraps, and have a little fire in their rooms. It is seldom cold enough in San Diego for frost that will freeze the most delicate flower, or make ice. My coal bill for heating purposes last winter, for office and residence was five dollars and sixty cents; this winter up to December 16th, is one dollar and seventy cents-and we manage to be comfortable. Most persons here use coal oil and gas for heating, considering it cheaper and less trouble than coal and wood. The best quality of coal costs from $7.50 to $9 per ton, and wood about the same price per cord. I consider San Diego one of the best health resorts in the country, and the finest all year climate in the world. "The official U. S. Weather Bureau record shows that from 1875 to 1891, 6,205 days, there were 6,006 days of temperature not above 80° nor below 40°. Cold snaps and heated spells are unknown here." Living here is good and cheap. Persons can have all the comforts and conveniences they can

have any place, and many of them that cannot be had elsewhere. Still San Diego is not paradise, altho some persons coming here apparently expect to find perfection in city, climate and people, and then leave sadly disappointed.

San Diego, Cal. P. S. LEISENRING, M.D.

Homing Pigeons as Medical Messengers, or Bulletin Bearers.

Editor MEDICAL WORLD:-For many years I have bred and trained homing pigeons; at first for pleasure and the recreation which the pastime afforded. I believe that every doctor ought to have some hobby to which his tired brain can turn for rest and refreshment. Billiards, cards, the club, bicycling, amateur photography, each have their votaries, and each has some drawback; but the hobby which does not take the doctor away from home, does not hurt his morals, does not make deep inroads into his pocketbook, and does not make him a nuisance to his neighbors, is the one we want for a pastime. want for a pastime. For years I found the breeding of high class fancy pigeons to fill all these requirements; later I began the study of the capacities of homing pigeons; and for the last few years I have utilized them in my practice as messenger boys. I could now almost as well do without my horses as without my birds. When I see a patient in the morning and wish to hear a report in the afternoon, I step out to the carriage, take a bird from the basket underneath the seat, and leave it with the nurse or some member of the family who releases it at the specified hour in the afternoon, bearing a little folded bulletin to me faster than any horse could travel, and without the aid of driver, harness or vehicle. Thus the family gets the benefit of nearly double service, and I the satisfaction that comes from intimate knowledge of my patient's condition. This is only one of the uses to which they are put. I sometimes leave two or three with the lady who expects to be confined, or who is liable to need me suddenly for any purpose, as hemorrhage, heart failure, mania, etc. Every time I return to the stable from driving, I glance into the "trap," which is just within the entrance to their apart

ments, and notice if there is a "letter in the box." The birds never fail me now for my work, but to get them of suitable quality required much effort to procure the best blood. Some are imported from Belgium, where they won many a hotly contested race. Two of them won their last prizes on July 12, 1897, by winning a race flown from Bordeaux, France, to Termonde, in Belgium. I released two 1897 youngsters at Wilkesbarre, Pa., from the train at 2.30 p. m., Nov. 29, 1897, and in the rain; they were home early next morning, a distance of 200 miles. They had never flown a long distance before. I will refer any of your readers to articles of mine on the subject in_the_Cincinnati Medical Journal for July, 1896; also on pages 165 and 318 of vol. 51 of the Medical Record, or will give them any information within my power on the subject if they will inclose a self addressed envelope.

CHAS. L. LANG, M.D.

Meridian, Cayuga Co., N. Y. [Dr. Lang says that he is tired reading the long classic articles in the $5 journals, which take so much time to so little purpose, except for a few specialists. He joins the WORLD "family" to get the advantage of short, practical articles on common, every-day topics.-Ed.]

Puerperal Convulsions Treated with Veratrum.

Her

Editor MEDICAL WORLD:-October 22, 1897, at 8. 30 a. m., I was sent for in haste to see Mrs. M. H., age 20. She was at full term with her first pregnancy. I was away from home and did not receive the word until 10 o'clock a. m. I was told by the messenger that the lady was having convulsions when he started for me, so I hastened to her bedside and found her unconscious. husband reported that she had had seven convulsions and had been unconscious since the first one, which was at 8 o'clock She had not complained of anything that morning except a frontal headache. We were unable to We were unable to get her to swallow anything, so I gave a hypodermic of Norwood's veratrum, mx. I made a digital examination and found that she was in labor, but the cervix was rigid. I gave chloral hyd. per rectum, gr. xxx. In fifteen

a. m.

severe

minutes she had another very hard convulsion. I gave her xx M of veratrum hypodermically. The pulse was very full and bounding. I waited thirty minutes and gave xxv m verat. with 4 gr. morphine and to atropine.

She rested very well until 1 o'clock p. m., when she became restless and another convulsion came on. I gave another hypodermic of veratrum and in a few minutes gave chloral hydrate gr. xxx. per rectum. At 2.30 labor was progressing very nicely. I gave strychnia to support the heart and chloroform to inhale during the pains. She was hard to hold on the bed.

At 3.30 p.m. she gave birth to a living child. I thought the trouble was all over, but not so. At 5.15 p.m. she had another convulsion. I gave veratrum hypodermatically m xx, In twenty-five minutes she had another convulsion, and before I could give another hypodermic she had still another very hard one. As soon as it was over I gave a hypo of veratrum M.xxv and in thirty minutes I repeated it. This brought the pulse down from 130 to 60 per minute. It also produced vomiting and free perspiration. I supported the heart with strychnia and digitaline. She had no more convulsions. She rested very well the rest of the night, and on the following morning she could swallow some. In order to produce free elimination, I gave hyd. chlor. mit. gr. iij in syrup. of rhubarb every two hours until three dozes were given, followed in four hours. by jalap and senna. I also gave, as a. diuretic, potash acetas, gr. xv, digitalis. infusion 3.ij, every two hours until the kidneys acted well.

She regained consciousness in about 48 hours after the first convulsion came on. I put her on a tonic treatment, and she made a rapid recovery.

Bynum, Tex. A. C. SAYLORS, M.D.

Nearly every case has a leading indication, for which cation, for which a leading remedy should be given. Veratrum was the leading remedy indicated in the above case, and the condition of the pulse should have been the guide from the first. In giving veratrum for puerperal convulsions, seek to bring the pulse down to 60 or below, and see that it does not rise above 60. Give it with th s

definite end in view, and don't stop until it is attained. In this way, and in this way only, will you get satisfactory results.-Ed.)

A Peculiar Placenta.

Editor MEDICAL WORLD:-I always find matters of fact of much interest to me in THE WORLD. I always take pleasure in reading short facts. I have no patience to read long articles with but little real merit. Many physicians in widely different portions of our land contributing their mite, makes a journal of interest to all busy practitioners.

Some twenty odd years ago, in my early practice, I attended a labor that progressed with the usual promptness until time for the placenta to separate. Pains were quite severe; no hemorrhage. After waiting some thirty minutes I made an examination. Could not reach any portion of the placenta as in natural cases. Surmising that something was wrong, I introduced my hand into the uterus and found the placenta firmly united to the fundus uteri. Had great difficulty in making a separation, and only then by tearing thru and peeling off by real force. After a time every portion appeared to be loose, and on removing my arm and hand it came away. I took particular notice of the attached portion and to my surprise I found it covered with little hard masses resembling flakes of bone; and on passing the hand over this rough surface it was like moving it over a piece of wet sand paper, so thick were these little particles. I have thought many times of this peculiar case and have not met another like it in over two thousand confinements. The mother made a good recovery, but since that time has developed an ovarian tumor. She has never been pregnant since that confinement.

Woodstock, Conn. JOSEPH SPALDING, M.D.

Nutrition.

Editor MEDICAL WORLD:-I like the suggestions of the Editor, for each member of the WORLD "family" to make a definite study of one subject for the whole year. For 1898 I have chosen the subject of Nutrition. When we look over the field of remedies, nearly the whole list is directed to the correction of

some violation of the laws of nourishment. The digestive ferments, the remedies for rheumatism, the remedies for eczemas, the blood purifiers, the antiseptics and cleansers all point in one direction, disordered digestion. Let us strive to make a reform in diet. Who of the brethren can give the best breakfast, dinner and supper, to be eaten when well? For my own part I am tired of the dosing business. I believe we will do more good to our patients than now if we would begin to tell them how to live, what to eat and how to prepare it.

Ness City, Kan. DR. T. HANKINS. [The dietary is only the beginning of the study of nutrition. The ideal dietary for one might not be at all suitable for another. It varies with age, habits, season, surroundings, condition, etc.-ED.] The Injection Treatment for the Relief and Cure of Hernia.

Editor MEDICAL WORLD:-My previous article on this subject, published in the November, 1897, issue of THE MEDICAL WORLD, appears to have met with approval, for during that month forty-three physicians wrote me for further information concerning the treatment, and I am still receiving such letters. I could not possibly answer the questions individually, so I will endeavor to answer all in a general way and will base this article on the inquiries received

Dr. Heaton, of Boston, is supposed to have been the originator of this method of treatment, but several other men are now filling the mails with circulars claiming that honor. He published the only book on the subject that I have ever seen. In that work he has thoroly covered the ground and introduced plates explaining the essential features, which can only be properly illustrated in that

recommend it; at least in the quantities he advises.

The questions asked in some of the letters convince me that the writers had not studied the anatomy of the parts sufficiently to undertake to give the treatment.

Unfortunately, I do not know of any medical institution where this method of treatment is taught, but it is so valuable and acceptable to the masses who prefer to depend simply on a truss for relief, unless they know of a mild treatment, that it will not be long before the medical colleges will recognize its advantages and give it the position it deserves.

A few physicians wrote me that they had tried the treatment on a patient or two with more or less success. I was discouraged even after I had treated a number of patients, altho I had exceptional opportunities to see it performed before giving the treatment; but by continual practice and study, I am now successful where I formerly failed, and can now practically tell what can be accomplished as soon as I examine the hernia.

The injection treatment has been injured more by the companies or physicians that advertise "no cure, no pay," than by any other cause. As their object is a mercenary one, impossibilities are frequently promised as a greater inducement to secure patients; but payment is required before a sufficient time has elapsed to determine definitely what the final results will be.

Several of the physicians asked if I treated hernia on the principle, "no cure, no pay." I do not. All cases are not able to dispense with a light support of some kind, and it is generally those, who cause the physician the most trouble. I treat hernia on the same basis as any other affection, and always aim to effect a cure if possible.

The following are Dr. Heaton's directions simplified: The hernia, and if possible the sac, should be returned into the abdominal cavity, with the patient in the recumbent position. Invaginate fore-finger in

find the external the scrotum and

ring then with the left forefinger press perpendicularly upon the stegument directly over the ring,(with sufficient force to, if possible,

enter the ring. Push the cord to one side, then with the syringe (I use an ordinary hypodermic syringe with a 11⁄2 inch needle) in the right hand, penetrate with the needle at the point of the left finger, and have the needle follow the canal, depositing the fluid along the entire canal.

It is difficult to follow his instructions in some cases, and I prefer to the left forefinger in the and crotum hate push the finger well into the external ring from below; Leeping the finger in that position, run the needle along the finger as a guide, having the syringe in the right hand.

For the direct variety, deposit the fluid on border or over ring, depending on size of opening. So important is it to wear a proper support of some kind during treatment and for months thereafter, that I keep a special stock of trusses on hand and apply them myself.

In my opinion, why so many fail to secure satisfactory results is due to the failure of the operator to deposit the fluid at the right spot.

As a large percentage of the direct hernias were at first indirect, it is necessary to locate the internal ring, not from the anatomy alone but in each individual

case.

Dr. Heaton's idea was to simply produce a tendinous irritation; but D War ren advised producing a local inflamma tion (without suppuration). My opinion is that a good tendinous irritation is the best in most cases.

Dr. Carrington advises adding guaiacol mj to the formula given in my previous article.

I have used some of the proprietary fluids with gratifying success, and even prefer them to any others. My only objection to them is, the formula is a secret. I like to know what I am using.

*

Only those who know or have suffered the annoyance, torture and misery some hernias cause, can fully appreciate the great benefit the injection treatment has been to humanity; and when its efficacy

* [Later: I was somewhat disappointed at the Doctor's high estimate of the value of the secret fluids, and have had a talk with him about the matter. We do not believe in secrets in medicine. Our constant effort is to give all the information possible to the profession. In next issue, the Doctor (who is also opposed to secrets), promises to tell us all he knows about the various fluids for injection in hernia, with the best formulas known to him.-Ed.]

becomes generally known, those afflicted will no longer dread the possibility of having to wear a severe and uncomfortable truss the remainder of their lives.

C. FLETCHER SOUDER, M.D. 1607 Arch St., Phila., Pa.

A Post Mortem.

Editor MEDICAL WORLD:-Your Dec. WORLD reminds me of an experience some years since. A stout, rugged man, not feeling well, took treatment and felt better, but about three weeks later took to the bed. Not improving, counsel was called. In the absence of the regular attendant I was called in haste one day, as the family thought him dying. After making the patient more comfortable I withdrew. A few days later he had retention of urine and the attendant drew his water. A few hours later a pool of blood was discovered under the bed. Investigation revealed a bed saturated with blood. The penis was tied up to check the hemorrhage. In due time the patient "passed over to the great majority." A post mortem was held and an invitation to be present was extended to me, of which I availed my self. The consultant said that he expected to find serious disease of the liver, as there had been a great amount of pain in the legs which he attributed to disease of the liver. (By the way, let me say that I considered the consultant a very competent physician.) The stomach was found eroded at the pyloric extremity. It was thought that this was quite recent and possibly might have been caused by chloral, possibly after death. The liver, heart, lungs and spleen were found in a normal condition. The bowels were normal, but were adherent to the pelvis, and a stricture existed with a caliber that would barely admit a lead pencil. The adhesion was conjectured to have been of six months standing at least, as there were no signs of recent inflammation. So far as any one of the doctors knew, there was no history of bowel trouble. The consultant asked if we should pursue the investigation. I asked if in his opinion we had found sufficient evidence of disease to account for the man's sickness and death. He replied, "No." I agreed with him. The attendant thought we had. I advised an

examination of the brain and spine that we might locate and know what the primary lesion was, if possible. The attendant objected, as he was in a hurry to get away. A certificate of death was made out, "Cerebro-spinal meningitis.” I asked the consultant how he diagnosed it as such without examining the brain or spine, when during life the symptoms were so obscure as to not cause a suspicion of any such a disease. His reply was, cerebro-spinal meningitis with obscure symptoms. In a conversation afterwards with a very intimate friend of the consultant he expressed great surprise at the diagnosis when the brain and spine were not examined. He could not see how they knew it to be meningitis without an examination, when there were no symptoms during life. I always looked upon this as a case of diagnosis by exclusion "with a vengeance." Yet I do not look upon the post mortem as being of no benefit, for the patient's brother-in-law was taken sick inside of two months presenting the same symptoms. The consultant attended him and he recovered. I feel sure with the last case the consultant knew what was not the matter with the patient, even tho he might not have known just what was.

Filley, Neb. S. J. SMITH, M.D.

[Why was not the genito-urinary tract, the source of that dreadful hemorrhage, examined? The slow and gradual taking down, the aching limbs, the bowel disturbance, and the fact that the brother-in-law was afterwards similarly affected, suggests the possibility of ty phoid "with obscure symptoms."—Ed.]

An Autopsy.

Editor MEDICAL WORLD:-Mrs. J. C., aged 68, farmer's widow. Was taken sick on Saturday with severe pain under sternum at the 4th to 6th rib, radiating to left shoulder and arm, back of neck and head; vomiting, mostly mucous; pulse and temperature normal, the former of good volume and quality. Some tenderness over lower border of liver. Diagnosis, hepatic colic. Gave hypodermic of morph. and inhalation of chloroform, which relieved her in the course of two hours so she could lie down; unable to do so before. Several 4 gr. doses morphia were given during