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dyspnea, burning pain in stomach, etc. In all of these conditions it is the best drug to use, provided that the symptoms and general condition is similar to the effect produced by arsenic.

What we need to make us good prescribers is the study of drugs and their actions on the healthy body. Whether we get it from our materia medica, from personal experience or from other physicians matters little, provided the source is reliable. And we should always notice with particular care the seemingly trifling symptoms. No symptom present in a patient but is worthy of recognition, no matter how trifling it may seem. They all help us to make accurate prescriptions.

I admire the frankness of Dr. Sanders (page 488). How many of us would confess to giving a hypodermic of morphin to a fourteen-months'-old child?

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Easy Road to Mistakes. Editor MEDICAL WORLD:-I have often thought of the ease with which many of us arrive at conclusions respecting the value of remedies, and frequently give our sanction and unqualified approval, adding the words, "It is the remedy in this disease." We thus convey to the reader the idea that our minds have been thoroly convinced of the accuracy of the theory and that practice has demonstrated it to be eminently correct.

Of course, when we treat patients suffering from any disease, our main object is to get them well, and incidentally, if we can, acquire all possible information as to etiology and therapeutics. We are thus repaid for time and money spent, even tho the patient "kicks" on the bills and pays nothing. So, if we don't get money out of any given case, we may gain reputationor a point in knowledge. After the patient has recovered health it will matter little to him by what means recovery was brought about.

But if it does not amount to a great deal to the patient it may amount to a great deal to us, or to the next patient similarly afflicted whether the first patient was treated properly or improperly, that is, whether the patient was benefited by the treatment or got well regardless of the treatment. Of course the treatment may have been all that could be possible and was the factor that made recovery possible. Again it might have been that the patient recovered from both the disease

and the remedies. The patient might have been of strong vitality with a great reserve dynamic force and possibly the drugs gave the vital forces a greater fight to continue life than would have been the case without the drugs. Understanding what we see is important, but to fail to understand may be more important.

We frequently read of the treatment of different diseases according to the individual peculiarities of the writer, the article possibly closing with "I never lost a case.' Of course this is likely all true. I do not think a member of the medical profession would "warp words," yet I believe a physician may have success in treating patients suffering from a given disease with remedies far inferior to other remedies of its class. Just because "none have died " does not necessarily indicate that each case was properly treated, or even that some of them might not have gotten well more quickly without that particular treatment. I might say, as many others have said, that I never lost a case of pneumonia in the thirteen years I have tried to practice medicine, but the general outline of treatment I usually give pneumonia patients to-day differs very materially from my treatment ten years ago, or even five years ago. I certainly believe that had I treated some cases of broncho-pneumonia recently under my care, as I did a few years ago, the patients would have died. Simply because none happened to die under my old treatment, does not satisfy my mind that the treatment was correct. And as I cannot account for results any other way, I might add that it was probably luck.

This reminds me of a case recently reported where three inches of a rubber catheter was broken off in a man's bladder. It remained there for four weeks without causing any disturbance, and at the end of that time it was passed without difficulty. The author adds that should he have a similar case again, he would not feel uneasy, believing the best way would be to leave it alone. The editor made no comment, except "Some men are born lucky."

Here is a conclusion from too little evidence that such treatment or "letting alone" is proper. With the same evidence, one case, I would be more than anxious to have the piece of catheter out of the bladder. If I erred I would err on the safe side.

A physician used a rubber catheter in drawing a man's urine, and when he at

tempted to withdraw the catheter it was broken, and no one knew exactly how much catheter was left in the bladder. After a few days it gave rise to pain and frequent micturition, so that he went to a hospital in Louisville, Ky., and had removed by the lithotrite, 7 inches of the rubber catheter in three parts. No more could be found. The man went home but returned five months later and said he had no trouble of any description with his bladder until four weeks previous, when pain began again and frequent micturition. Examination with a sound revealed a stone, which was removed by the lithotrite, and this contained 3 inches of rubber catheter as a nucleus. It was formed by a phosphatic deposit which altogether weighed 17 drams.

Of course, I do not assume that all such cases would terminate thus, but since such a thing might occur it would be best to remove the broken catheter as early as possible. DR. J. R. LANDERS.

Sidell, Ill.

A Few Dissentient Opinions. Editor MEDICAL WORLD:-Will you permit me to enter a mild protest against the truth of the analogy of introducing smallpox virus or scarlet fever virus into the human system and giving the thirtieth or two hundredth dilutions of drugs? The virus of small-pox or of scarlet fever, according to the best scientific thought of the day, is a living something capable of multiplying a million-fold in a short time and by this growth generating poisons which produce the disease. If we grant that there is some of the drug in a dose of the thirtieth dilution, the amount is exceed ingly small and remains as small while passing thru the system. If it should be said, "Introduce an exceedingly small amount of the ptomains of an infectious disease and it produces the disease, then why should not a like amount of the indicated remedy cure it? there would be analogy but we probably know, or at least should be reasonably sure, that an exceedingly small amount of the ptomain would produce no effect whatever, providing no living germs were present, hence :

Brother Hartson certainly cannot be sure that the rhus tox he gave in the case cited by him in the October WORLD had any effect on the case. He knows that ivy poisoning is self-limiting, and from what was stated it may be concluded that the case had been running some days at least.

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Second, the conditions of rest and pressure on the parts affected are all too lax. Third, he gives no per cent. of cures effected.

I do not know whether he means tannic acid as the basis of his astringent treatment or not; if he does, I fear his per cent. of cures will be small, and if the tannin is used strong enough to hope for a cure, his risks of abscess will be correspondingly increased.

Ten drops of a four per cent. solution of mercuric bichlorid is about the most reliable injection that can be used to produce plastic inflammation sufficient to occlude the hernial sac. In using it, I usually place the finger in the ring so as to close it above, then force the needle from below upwards until the point is distinctly felt beneath. Then I withdraw the needle a little and inject; for some minutes I keep the finger firmly pressed against the ring so as to prevent the possibility of any of the solution passing upwards and into the peritoneal cavity. Abundant effusion fol

How shall we manage the yearly index? That is a question that arises every year. To send it loose and separate enables you to bind it in just as you please, but some complain that it gets lost, and they prefer it bound in with December issue. Many magazines make it a part of December issue, thus curtailing the reading matter just that much, but we have never done this. If we were to put it at close of reading matter, you would have to cut the leaves to separate it. We have concluded this time to bind it in the center, so that if you wish to bind it any place else you can simply take a pocket-knife and loosen the wires, lift out the index entire, then bend the wires back again. Our worthy contemporary, the Philadelphia Medical Journal, has done this, and they say that this plan pleases their subscribers.

lows; a hard, firm mass fills the canal and then if pressure is exerted, it not infrequently happens that the walls adhere and the hernia is cured. May be in a future number Dr. Manley will give his solution so that your readers can compare notes and ideas.

I am now using a four per cent. solution of the bichlorid in fatty tumors. I inject from fifteen to twenty drops. It requires a long needle and should be injected at about three points around the periphery of the fatty mass, and then directly in the center; the needle in each instance driven at least half way into the mass, In my hands, in not a single instance have I known it to fail. First, the mass is hard and firm like a fibroid, then it is gradually absorbed and disappears. I also use the I also use the same injection in goiter and scrofulous glands of neck in any stage except the suppurative. It produces excellent results in syphilitic induration of the glands. I have never tried it in cancer as I do not care to risk the treatment when the ready plaster is so safe and effective.

S. EDWARD MCCULLY, M.D.
Milwaukee, Wis.

"They Twain Shall Become One Flesh." Editor MEDICAL WORLD: -The Scriptures state that in the connubial relation husband and wife become one flesh. This statement is not a metaphor, but the enunciation of a fact. The discovery of the fact that living cells (leucocytes) have the power of locomotion and can pass thru the walls of blood-vessels, thus migrating into the tissues beyond, explains the method by which husband and wife become actually one flesh. When conception occurs, living cells (the spermatozoa) which are a part of the husband and partake of his nature and being, multiply (reproduce by division) and form other cells which develop in such relation to the tissues of the wife that they may, and no doubt do pass into the tissues of the wife by migration from the blood of the fetus into the vessels of the placenta.

In this way the body of the wife absorbs the living and growing elements of the body of the husband, and "they twain become" literally and actually "one flesh." The wife becomes, to a greater or lesser extent, "bone of his bone and flesh of his flesh," as actually as Eve did when developed from a portion of the tissues of Adam's side. (A case where the reproduction was by the method of gemmation

or budding.) Very probably there is also a migration of living cells at other times than during gestation, by means of sexual intercourse, other living cells as well as spermatozoa passing into the tissues of the wife. This migration of living, growing, reproducing leucocytes is a very different thing from the use of animal food. The leucocytes in flesh used as food have been digested and decomposed. They are dead and not living.

The assimilization of the wife to the husband is a fact of common observation. Husbands and wives, after years of married life, come to resemble each other in looks and disposition. The fact that they grow to resemble each other in looks shows that there is a physical change; that the resemblance is not entirely due to association. Certain facts observed in comparative embryology and in pathology are explained by the above considerations. Among such may be mentioned the syphilitic infection of the mother thru the fetus; the resemblance of the children of a second husband to the first husband, as has occasionally been observed; the fact that mares bred to the ass and subsequently bred with their own species are apt to produce foals with asinine features; the fact that the retention of the semen, as in natural, normal sexual intercourse, is essential to healthy connubial relations.

The interesting biologic fact to which I call attention, that the wife" becomes one flesh" with the husband, has an important bearing on sexual relations. It adds new interest to the connubial relation emphasizing its sacredness, as well as throwing new light on the abomination of promiscuous sexual intercourse.

DAVID P. JACKSON, M. D.

New Bedford, Pa.

Gall-Stones and Biliary Colic. Editor MEDICAL WORLD:-In a case of gall stones which gave me a great deal of trouble, I administered a mercurial cathartic and then put the patient upon silver nitrate combined with extract of belladonna, with the result that there was no return of the colic and the patient made a complete recovery.

Bismuth salicylate after meals is recommended. Anent this, a friend of mine was greatly annoyed by gall-stones, hepatic colic or gastralgia, and on going to Texas for his health, consulted an aged physician of eminence, who put him on some kind of salt which was to be taken three times a

day in hot water, a teaspoonful at a dose. He got out of the medicine and was again a great sufferer from his old complaint; but not having the formula and being unable to obtain it he was in a bad way, as nothing else appeared of any avail. After trying for a long while with my help and failing to ascertain what the prescription contained, he finally obtained from the Texas druggist some of the powder (but not the prescription) and had it analyzed and sent me the result. What do you suppose it was? Rochelle salts simply-nothing more! He now takes it and pronounces it the same in taste, appearance and action as the original prescription.

These rambling thoughts may help some struggling brother. Arcadia, La.

J. ATKINSON, M. D.

Use of Pneumatics in Locomotor Ataxia. Editor MEDICAL WORLD:-Long ago I promised an article on the use of pneumatics, or the result of their application in treating locomotor ataxia. All cases here referred to were hard old "chronics." Case I was due to traumatism of most severe type; Case II was the acknowledged result of fast living; Case III was due to syphilis, for which six years' constant medication had been necessary to eradicate the specific disease germ; Case IV arose after a hard attack of gonorrhea, the patient being subject to congestion of the lumbar nerves whenever a cold was taken, even tho a light one.

For obvious reasons I will omit the ages of these patients, trusting it will suffice to state that their ages varied from thirty-five to sixty years and the periods of affliction in the spinal nerves from six to thirty years. In habits one was in no sense addicted to drink or to the use of tobacco; one drank some occasionally; one was a heavy drinker, yet rarely drunk, and one often "full." One had little or nothing to do with women at any time; one had been a little "rapid" in his youth; one was a great man for women, and another never had sense enough to know when to let go.

Many other cases might be cited, but these will suffice for present purposes and avoid the possibility of offending

any.

CASE I.-Under pneumatic or vacuum treatment three years and three months, was cured of all ataxic symptoms.

CASE II.-Was freed of all ataxic pains

and restored to active business, from tak ing one hundred and six treatments. Case III.-Received about forty treatments without appreciable benefit, drinking and having intercourse (sexual), despite all remonstrances made by me, even bragging to me of five successful attempts in a single night.

CASE IV. Had been under constant treatment five years and out of business six months when he came to me for examination. Diagnosis: Chronic locomotor ataxia in last stage; chronic general hyperesthesia of superficial and many deep nerves; kidneys inactive; bladder partially paralyzed; practically impotent, having an unsatisfactory erection about every two weeks or a month, oftener the latter; sight badly impaired and unable to walk at all in the dark; could not close eyes and keep his feet at any time; bowels in fair action; would often spend ten to fourteen hours in a vain attempt to empty his bladder. Was injured in accident and rendered bed fast. After the twenty-eighth treatment and before seen again by me, he had failed a great deal, both legs becoming edematous to the knees, edema starting from the feet. After retaking case I gave him about 600 treatments upon the spine and legs.

Results: Eye-sight so improved, glasses seldom used for any purposes. Got out on crutches in a few months, walking length of house and back to his bed several times daily by some one simply tightly gripping his arm. Desire to micturate satisfied promptly or within five to ten minutes. Body and limbs usually warm. Circulation started up all over the patient. Sufficient life and sensibility restored to spinal cord and roots so that nux vomica, sixth potency, yields toxic symptoms after third dose of six pellets each under repeated trials. From tenth dorsal vertebra down, at one time, the nerves all seemed dead to all feeling, the heaviest vacuum being possible with the largest cups, 6 x 10 inches, applied lengthwise up and down the spine. Now, a cup 4x6 inches can not be borne with more than 70 per cent. of former vacuum and only for a much shorter time of application.

During period of treatment there have been liver, stomach and splenic disturbances and swelling of glands, all controlled by the vacuum as being due to congestions.

In this case materia medica has been exhausted, with the result that one remedy alone yields any satisfaction. And that?

odid of strontium as an alterative. I am ratching its use in two other cases, both ositively syphilitic. Patient is continung under the vacuum and iodid of stronium, and gaining.

Inasmuch as the channels of circulation ave been reopened and the sensibility of he cord and nerves so fully re-establisht, t seems reasonable to believe this "absoutely incurable case will recover. It is ny opinion that he should now do so, accidents excepted.

In three of the foregoing cases, serum or serum and fibrin were given off under the vacuum in those places where deep irritation was noticed: One a few drops of serum only; one some five ounces of serum and fibrin, and one fully one quart of serum and fibrin. One felt no tenderness resulting from taking off the serum and fibrin in largest quantity, while another felt great soreness or tenderness. Usually there is no tenderness whatever in the fleshy tissues, and this one case is the exception in over fifty such, one of whom gave off fifty-two ounces of serum and fibrin, as much as one ounce at one time, from beneath a 4 x6 cup, the fibrin forming a triangular-shaped, amber-colored mass, as much as of an inch in the deepest part, half an inch wide and two inches in length.

My experience is that 5 per cent. of old chronic cases have more or less tissue clogged with this lifeless material. When found in locomotor ataxia and other forms of paralysis, the walls of the veins in various sections are found to be collapsed and the inner walls adhered, tho in one instance in mind I found the vein adhesions without the serum. In locomotor ataxia due to traumatism, coagulated blood will be found in the veins surrounding the spine the spinal veins and no other form of treatment will ever remove these clots and make health possible to such patients, and then only by skilful application. WILLARD CYRIL FRANCIS,

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in the abdomen, nausea and vomiting almost every morning. The child has also itching in the nose, and when asleep he grinds his teeth, and has a difficulty in breathing. (2) The oxyuris vermicularis, found living in the large intestine, causes itching in the anus. In girls, they may enter into the vagina and cause vaginitis, or leucorrhea.

The occurrence of these symptoms can easily be understood by physicians to relate to worms, even tho they do not see the patient. H. ROSAHNSKY, M. D.

Brooklyn, N. Y.

Should Doctors Dispense Their Own Medicines? Editor MEDICAL WORLD:-I read your journal with much interest, and find it filled with good, practical thought, and, best of all, not averse to anything that is good, regardless of school or 'pathy.

I have much interest in the matter of the doctor dispensing his own remedies. I think he certainly has a right to keep them to himself, disposing of them only to fellow-practitioners when such have need for them.

Prescription-writing is only giving away the doctor's acquired information, which he has paid for in money and hard study. I have known, and know to-day, druggists who use the doctor's prescriptions to knock him out of a fee and to kill his business. They actually put up the doctor's private formulas and put them on the counter to sell to cure this and that.

I am now facing an evil, the result of long prescription files, from an old druggist in San Antonio, Tex., who has gathered his prescriptions and formulated them into medicines which he puts into every drug store in the city and every country store, thus doing all possible to kill the practice of the doctors who supported him in the past. I have learned to keep my medicines and pill-boxes, with my name and office printed, and my prescription vials with labels printed the same, so that if good results I get the reference and not my druggists or some other fellow who cares naught for the doctor. Prescription-writing makes a doctor of every druggist. Nearly every druggist now is a practitioner, and robs the doctor of many dollars. Keep your remedies, record their proven good, and the doctors will be bettered.

DR. L. V. WEATHERS. Bracken, Comal county, Tex.

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