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Short stories on the treatment of diseases and experience with new remedies are solicited from the profession for this department; also difficult cases for diagnosis and treat

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Replies-Rheumatism and Meat-Eating. Editor MEDICAL WORLD:-On page 495 Dr. Heard records a very important observation upon the effect of bicycle riding in inducing an attack of cystitis. I do not agree with Bishop Morris, but believe that the bicycle is one of the greatest blessings enjoyed by humanity. But there is no use shutting our eyes to the truth and denying that under some circumstances this machine is productive of harm. Some years ago a fine, hearty youth came to me for complete impotence, for which I could discover no cause but the bicycle. In this, as in Dr. Heard's case, the fault was in the saddle; and it is a pity that the doctor was not a rider himself, since he would then have remedied the matter by prescribing a saddle that suited the young

man.

Dr. Askew describes an interesting case upon page 496. I do not agree with either diagnosis, but believe if the patient were carefully examined there would be found a deficiency in the excretion of urinary solids, and probably some retained fecal masses. Clear out the alimentary canal with a few good doses of castor oil, reinforced by thirty drops of turpentine; then keep them regular by aloetic laxatives, and stimulate the renal function by small doses of caffein valerianate. The woman may require reconstructive tonics, for sometimes the drain of a nursing child causes abnormal nervous manifestations. In fact, you may adopt the diagnosis of hysteria, provided you admit that hysteria is simply an abnormal condition of the nervous system, caused by some physical or mental disorder, to which attention should be directed. The diagnosis of hysteria is otherwise a libel on woman.

Dr. Stringer's case, page 496, is not easy to diagnose from a description, because the symptoms admit of so many different interpretations. There is a hereditary

tendency to asthma, and yet the attacks may be simply due to seeing those of the father, like the mpathetic cough of the mother of a child with whooping-cough. The disordered menstruation is enough to set the whole train of reflexes in motion. The constipation and "torpid liver" is enough to set up the irregularity of menstruation.

Of late years I have found it advisable to adopt a routine in all cases; of beginning treatment by emptying the alimentary canal completely (not easy, in many instances) and then rendering it aseptic by the use of a sulfocarbolate-in this case of lime-and then adding whatever other treatment is indicated. It is remarkable how many need nothing more, or if they do, how much more effective their treatment is when these cardinal indications have first been met.

In Dr. Stringer's case the cold extremities show constipation or debility to be present, perhaps both. Iron and strychnin arseniate, gr. 1-67 each, with macrotin gr. 1-6, every two hours while awake would be my suggestion. When the menstrual period approaches change to sanguinarin, gr. 1-67, and potassium permanganate, gr. 1-6, every two hours until the flow has been established in its normal condition and duration.

Dr. Schafer's exceedingly brief note (page 497) could scarcely refer to anything except a case of scrofula or of syphilis. In what other affections would he have multiple ulcers and exfoliation of bone? Let him give his patient calcium iodid, gr. x, and calcium sulfid gr. j, four to six times a day, with full doses of cod-liver oil and iron iodid; a rich diet, good hygiene, and keep the ulcers clean with antiseptic stimulating dressing such as the sanitas preparations, especially the oil.

Dr. Pennington's case, page 497, is one of those usually termed hydrophobia. It is suggestive that those who have studied hydrophobia most carefully are most doubtful as to its occurrence in man, and those most frequently bitten by dogs rarely have "hydrophobia." In the present instance the disease may have been tetanus, as would seem, from the description, most probable; or septicemia, with pronounced nervous phenomena. The dog was not necessarily affected with any disease, and it was a pity he was killed so soon.

There has recently been some attempt to revive an ancient method of treatment that has long since fallen into undeserved

oblivion. This is the "hunger cure," or fasting. Mark Twain has given a suggestive humorous sketch of his imaginary experience in a German sanatorium, where the physician treated his anorexia by starving him until he ate "chickens in the shell" greedily.

Nowhere in the world is food for all classes so abundant and so cheap as in America. Every laborer expects meat three times a day; every person eats this, even those who do absolutely no work whatever. Is it necessary? The Irish laborer gets meat twice a week, if he is prosperous; otherwise he lives upon potatoes and oatmeal, with garden vegetables, and not too much of them. And yet, look at the muscular development of those men when they first land in America. Take the vast army of uricemics, dyspeptics, catarrhals, rheumatics, auto-toxemics, the obese, plethorics, and very many others, and the first principle of their cure should be to reduce them to the vegetarian regimé and forbid their eating unless hungry, and then only enough to satisfy hunger, not eating to repletion.

But

A century and a half ago, Benjamin Franklin found the world believing that alcoholic drinks were a necessity to health. Everybody believed this. They wanted to believe it. The early total abstainers ran as good a chance of being tarred and feathered as the early abolitionists. Franklin proved that a man could do more and better work on water than on alcohol, that the porter could carry his burdens better on Adam's ale than on his own special brew. Slowly, unwillingly, public opinion has come up to Franklin's position, and few now hold to the necessity for alcohol, even in treating disease.

It seems to me quite probable that the same history will be repeated as to meateating. The fine health of vegetarians is not exceptional. The Chinese and Jap, anese porters do good work on a diet of rice. The degeneracy of the Hindoo is attributable to his admixture of dark blood, the climate and his peculiar religious tenets rather than to his vegetarian diet. Take him out of his environment and transplant him to a healthier soil, and see how he thrives, like the famous prince, Dhuleep Singh, who is now the foremost cricketer of England.

The undoubted connection of cancer with excessive meat-eating is another argument in favor of vegetarianism. Of all the theories so far advanced to account

Some Thoughts in Regard to Typhoid Fever. Editor MEDICAL WORLD:-Some people think that all cases of typhoid fever die, hence all cases of fever that get well are not typhoid, but something else-bilious fever, slow fever, typho-malarial fever or malarial fever. They can't, or at least don't, understand the difference between a typical case of typhoid, that has been neglected and allowed, or even actually aided, to run its course, and one that naturally tends to run a milder course influenced by treatment, both hygienic and medicinal. Everybody, both of the doctors and laity, is familiar with the fact that some cases of measles are mild while others are severe; some cases of whoopingcough mild, some severe; some cases of diphtheria the same way and so on with pneumonia, scarlet fever, mumps and even consumption, as well as many other diseases. The condition of the system, the idiosyncrasy of the patient, the condition of the alimentary canal, the kind of food the patient eats the first days of the attack, the kind of labor the patient is engaged in when he comes down with the fever,-all of these, and perhaps some other factors, have much to do with the course of the disease.

To illustrate the difference to patients and other people, I call their attention to a crop of corn that was planted early in good, rich soil and cultivated by a farmer who understands his business and attends to it, and then to one that was planted later on a poor hillside and cultivated by a fellow who is really very good in theory but very poor when it comes to practice. In one the stalk is large and the color is dark, the ears are long and heavy; the stalk of the other is small, the blade is yellow and sickly and the ear is a "nubbin " or none at all. Would a man who had never seen a crop of corn grow recognize the two crops as being from the same kind of seed? I think not.

Even doctors often make the mistake of calling the mild cases typho-malarial fever in the same family, where there has recently been or is perhaps at the same time a typical case of typhoid. They are all typhoid fever, usually, else the same germ -seed-produces more than one disease.

If typhoid fever is caused by a definite bacillus, that of Eberth, why is it that some years there will be a great deal of fever and of course a great many germs, and then the following year, and perhaps for several years, there will be little or no

fever? Most likely it is because the following year there are no germs,—in the same way that in some years we will have "armies" of cut-worms or caterpillars or grasshoppers or of other insects, and then for a few years there will perhaps be fewer than common. We cannot explain why, but I suppose none will deny that it is a fact. And thus it is perhaps with the typhoid bacillus. Another reason why there may be only a few cases in the year following an epidemic, is because possibly all the cases that were not "immunes" might have had the disease during the epidemic.

Why is it that, tho not confined to any season, typhoid prevails with greater frequency in the fall? If the water becomes infected, in the fall when the water is usually low, a given number of germs would make a greater number to a given quantity of water and thus make the chances of swallowing one or one million greater. Thus, if a well which in the spring held one hundred barrels of water, in the fall held only one barrel, and at each time had one hundred germs, a man drinking from it would stand one hundred chances to one of contracting the fever in the fall over that in the spring. In the spring, if they were evenly diffused thruout the water, he would only get one by drinking a barrel, while in the fall, by drinking the same amount, he would get one hundred. Another reason might be because of flies, which are so prone to go from the fecal discharges to water and might thus cause more trouble in the fall when water is scarcer, infecting springs or even waterbuckets. G. G. THORNTON, M. D.

Gravel Switch, Ky.

Homeopathy and Typhoid Fever. Editor MEDICAL WORLD: I like THE WORLD because it seems to be a kind of go-as-you- please journal; that is, the writers are allowed to express themselves freely, and then the other fellow is allowed to criticise without making THE WORLD responsible. I hope, therefore, you will not frown upon the criticisms of a homeopath, for, while I practice straight homeopathy, I take all sorts of journals and have studied both systems.

Hardly a journal comes to me but what has something to say about the wonderful advance in the science of medicine. If I can gather from all of these journals a definition of the science of medicine, it would be "a few known facts and a great many theories." What amuses me in the