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bath. I should not expect to meet with "that tired feeling" following the bath in well selected cases. Tried in a case of aching limbs, the pains will generally take their leave during the bath. Frequently an aching head will be relieved and a beginning cold aborted. Indeed, the vapor bath is a valuable aid in practice.

To reduce hyper pyrexia the cold bath is unrivaled, but I think it probable that our contin. ued fevers would neither reach so high a temperature, nor continue so long if the hot vapor bath were used from the beginning of the attack. I have tried this treatment in only two cases of continued fever. One patient was up in two weeks, the other not quite so early, as treatment was delayed a few days. The disease ran a mild course in both cases. Internal antisepsis was used, however. I also recommend the vapor bath as a prophylactic against disease. I like its effects myself, and frequently substitute this for the old fashioned tub bath and sleep well afterwards. But Dr. Dawson wishes a formula for a lotion to be used after the vapor bath. I offer the following:

R. Water of ammonia.

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Those whose skins are harsh and dry may use with good effect a weak ammonia liniment with a base of some bland oil.

If the skin is diseased I would have the patient wash thoroughly in a tub of water as hot as could be borne, both before and after the

vapor bath, when the ointment appropriate to the case should be immediately well rubbed in and the patient put to bed. In these cases it is undesirable to close the pores with cold applications. JOHN F. NEAL, M.D.,

Coperas Cove, Tex.

[We are in hearty accord with the free and intelligent use of heat and of water both hot and cold to re-establish the equilibrium of the circulation and break up a beginning attack of inflammatory or febrile disease.-ED.]

A Plea for Older Remedies.

Editor MEDICAL WORLD:-In the flood of the newer antipyretics, coal tar derivatives, synthetically prepared remedies, it becomes us not to drop the study of the more ancient and, I dare say, more valuable remedies. The preparation I wish more particularly to call the attention of your readers to is aconite-the plain extract of aconite or its alkaloid aconitine. I prefer an accurately prepared fluid extract. As is well known, it is an arterial depressant, lowers the action of the heart and diminishes its beat, affects the sensory nerve strongly, followed by minor action on the motor nerves, in lethal

doses paralyzing the functions of the nervous system, and arrests the heart's action in diastole. It opens the pores of the skin by reducing arterial tension, quiets the lung movement to a marked degree, increases the various secretions of the human economy. As these forces are well marked, its applicability to febrile disease, respiratory affections, and all forms of inflam matory troubles, is self-evident. None of the newer remedies can replace aconite in its prompt. ness of action is certitude of effect, reliability, safety of administration, and last, but not least, reliable preparations can be obtained at small cost, as compared with other febrifuges. In the intoxication of typhoid, coal tar preparations are positively dangerous, and where large quantities of drugs are contra-indicated, aconite acts charmingly, and is the classical preparation to combat fever, keeping the skin moist, increasing buccal secretion, and insisting on prompt kidney action; quieting the usually rebellious heart and respiratory functions, and reducing or at least keeping the temperature in statu quo. In nasal and faucial catarrhs, tonsillitis, fibrinous pneumonia, ephemeral fevers, the disquamative diseases, febrile troubles of infants and children-in fact, in all febrile affections—it is preeminently adapted, and, if properly administered, will delight the user.

Minute doses, fre

Now a caution in its use. quently administered, is the classical method of using it; for adults, an eighth to one drop every half hour is proper dosage; children will usu ally require a one-sixteenth to one quarter of a drop every half hour until effect is obtained, when the tonic may be lengthened. When the heart's action is very much excited, veratrum viride may be combined with it into 1 drop doses, which beneficially heightens its effects. This remedy will bear careful usage and study by the profession, as it has not been having its due from practitioners these latter years. In my practice, after an extensive trial of antifebrine, antipyrine, and other coal-tar preparations, I have found them in sufficient doses to be dangerous, and in smaller doses inoperative, and in the diseases of children almost useless. Another remarkably prompt action for aconite is in the nervous prostration following drunkenness, where it gives brilliant results, quieting the nervous excitement, reducing the buccal dryness, and relieving the offensive headache. In maniacal delirium, as in mania-apotu, gelseminum is to be preferred. Glandorf, Ohio.

DR. A. BORMAM,

Is Acetanilid So Dangerous? Editor MEDICAL WORLD:-In reading the communications from many of your writers we

hear a good deal about the dangers of acetanilid, in causing heart-failure, collapse, etc., and do not recall but one writer coming to the defense of the drug. I have prescribed and dispensed pounds and pounds of it, and have failed to ever see any of the fearful effects we are told it produces; but, on the contrary, have never found anything its equal, in drugs, to quickly reduce fever. It is not only prompt, but in many cases seems curative as well, and will in many cases bring the temperature to normal in a few hours, and it will remain so. I give it in all pyrexias, let the patient be a month old or eighty years, and if the fever is above 104° F. in heavy doses, because it will reduce excessive body-heat more quickly than anything else, except the cold-bath, and I have never seen anything but the most benign effects in all the years I have used it. I sometimes think that surely those that declaim so loudly against it have never used it, or else they would not be so emphatic.

If any practitioner is being influenced by those pictures of its action, and is not using it, he is discarding one of the promptest remedial agents in the whole materia medica. Imperial, Neb. D. BOSWELL, M.D.,

Medicinal Cure for Cancer. Editor MEDICAL WORLD:-I have treated a melanotic cancer successfully. It is entirely cured, nothing remains but a withered scab, which could be easily removed now, but I set out not to touch the cancer, and have not. I deem it a duty to report the matter, particularly to you, hoping that it may be of benefit to the suffering, knowing that you can bring it to their notice in a few days, which I could not do in a lifetime. I am giving the same treatment to several others, in various stages of disease, two of whom have cancer, and all are improving rapidly. I will give the treatment, and you can make what use of it you think proper.

Last February I was treating a wart on my hand, by dieting, and gr. doses of calcium sulphide, which wart gradually disappeared; also a corn on my foot, which had been there for thirty years or more, the only one I was ever troubled with. I also took aconite and podophyllin granules, as I felt the need of them once in awhile during the time of treatment. Seeing the success on the wart, I asked one of my neighbors (Jno. L. Holder, now of Sherman Heights, Tenn.), who was suffering with a mulatto colored cancer, in the secondary stage, if he would let me try an experiment, and related to him my success with the wart. He agreed, and took at once! gr. calcium sulphide, gr. aconite, gr. podophyllin, his bowels being costive. The dose of calcium sulphide was re

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peated 3 times a day; the aconite and podophyllin when needed. We took exact measurement of the cancer. It was about the size of a silver quarter, and looked angry and defiant. At the end of forty-eight hours the pain had subsided, at the end of fourteen days it was only half the former size, and appeared to be withered. At the end of three weeks it was still smaller, and seemed pinched and dry, and at the end of five weeks from the time of taking the first dose of calcium sulphide, nothing remained of it but a dry scab. The inflammation in the flesh around the cancer subsided within three days from the first, and the costiveness, which dated more than a year back, was greatly relieved, and my friend is delighted. Others being treated report the pain to be relieved, which indicates that the growth of the cancer is arrested. Mr. Holder's father died with the same species of cancer some years ago, and I have no doubt he was infected from his father. The matter of diet is, I think, very important. Alcoholic liquors, coffee, pork, onions, pepper, horse radish, turnips, radishes, pickles, vinegar, rich puddings, cake and mince pies are to be excluded from the bill of fare, and a light diet used. Eat beef, mutton, game, fresh fish sparingly but eat enough. Common vegetables may be used freely such as beans, peas, cabbage, lettuce, greens, bread and butter, or biscuits made with milk and baking powder, not shortened, fresh and canned fruits, dried fruits, sugar, butter milk, sweet milk, rice, hominy, corn meal mush, potatoes, cambric tea, or "store tea," etc. So far as my observation goes, cancer yields to treatment more readily than common warts. WM. H. BURGESS, Chattanooga, Tenn.

Authority to Practice.

Editor MEDICAL WORLD:-Much is being written about the regulation of the practice of medicine in the different States, and there are many who advocate the examination of each applicant for practice before he is licensed. While it should ever be the aim of every medical man to lend a helping hand to the advancement of the medical profession, still I think the medical laws of some of our States are working a great injustice to those old war horses who have graduated years ago, and have become gray in the profession. There are many physicians in country practice to day who, when they graduated, could have passed the examina tions of the State Boards, but years of hard, practical work has kept them from keeping up with all the new ideas that are being advanced. They learned theory at school; they have since learned the practical part, to the neglect of the

theoretical. A graduate of medicine who has been in continuous practice for ten years should be allowed to practice anywhere in this free country.

I believe that the best way to regulate the practice of medicine so that a physician who is qualified in one State will be in all, is for Congress to add another member to the cabinetthat of Secretary of Health. I would give the Secretary of Health power to appoint a United, States Board of Health, and to this Board of Health I would give the power to regulate the practice of medicine in the United States. I would have this Board appoint non-interested examiners for all medical schools that required a four years' course of study, and to those who received the degree of M.D., and who passed the Board of Health examination, I would give a license to practice medicine in the United States, and that no State be allowed to admit any one to practice except licensed physicians and those already in practice. I would also authorize this Board to license all graduates who have taken a three years' course in medicine, and all those who have been in practice ten years since graduation. This license would be presented to the State Board in the State in which the physician desired to practice, and they, upon his proving his rightful ownership and paying required fees, would be granted a State certificate. I would revoke this license when the holder was convicted of unprofessional conduct, drunkenness and the like. In this way I believe the profession of medicine could be regulated satisfactorily to all-the old, because they would be recognized, and the new could be regulated to suit the profession, since all schools would be expected to comply with Board of Health rules or be shut out from examinations, and thus from practicing medicine. Doniphan, Neb. T. H. LINE, M.D.,

Professor Hirst's Pelvimeter.

[Reported especially for THE MEDICAL WORLD.]

The new pelvimeter contrived by Professor Barton Cooke Hirst, of the Univ., of Pa., entirely does away with the possibility of error in pelvic measurement, due to variations in the conjugate, symphyseal angle, and theheight of the symphysis.

The instrument measures accurately(1) The thickness of the symphysis. (2) The conjugate, plus the thickness of the symphysis.

(3) The distance between the outer edge of the symphysis and the promontory of the sa

crum.

The fatal error of the old Bandelocque mea

surements in the symphyseot my case referred to in last issue caused Dr. Hirst to construct this instrument.

The measurements are taken in the lithotomy position. Tip A is placed firmly against the middle line of the promontory of the sacrum. Tip B is brought to the proper position in the symphysis, and the arm secured fast. Measur ing between the tips, we have the true conjugate plus the thickness of the symphysis. The latter is found as in Fig. 2. Deducting this thickness, we have an accurate conjugate measurement.

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Oxide of Zinc for the Morphine Habit. Editor MEDICAL WORLD:-I had a patient whom I was treating for the morphine habit. So I went to Dr. Waugh's book on Dosimetric Treatment, and looked over his list of drugs used in the treatment of the morphine habit and selected oxide of zinc as being the most likely to be successful, and put my patient on it, but, as he knew something of drugs, I told him of my hopes in the matter, which may have had an influence in the way of suggestion, as the hypnotists would say. However that may be, it was successful, and if it is not the drug Dr. Waugh referred to in his recent letter in THE WORLD, then I have discovered another, which, if used in doses of from 2 to 6 grs. every 3 hours with some capsicum and a minute quantity, say from theto of a grain of ipecac to prevent nausea, will be found of wonderful benefit in quitting the use of morphine.

Spanish Camp, Tex. Dr. C. B. PALMER,

Treatment of the Opium Habit.

Editor MEDICAL WORLD:-I see that the formula of B. M. Woolley's cure for the opium habit is wanted.

I send you what I believe it is, and I think any doctor can cure the opium habit without much trouble. Several years ago I had a patient that took Woolley's treatment and was cured. The first thing that the doctor did was to get the exact dose of opium that the patient took, and how often during the twenty-four hours.

His direction to his patients was not to take opium or anything that contained opium while they took his medicine.

That convinced me that it was nothing but morphine in water colored with lavender.

Let each teaspoonful contain the exact dose the patient takes at a dose, and prescribe about four or six ounces at a time. Reduce the dose gradually, as a new bottle is prescribed, until the patient gets no morphine.

He makes his patients believe that they are not taking opium, and that is the secret in treating a case.

I saw another case where the remedy failed on account of the patient finding out the secret. WM. C. STIRLING, M.D.,

Sulphur Springs, Tex.

The Opium Habit.

Editor MEDICAL WORLD:-I have written at the opium habit several times, but never a full account of this dreadful disease. I have concluded to do this now, partly on account of

hundreds of letters asking for it, partly because no book I have seen gives a satisfactory account of it, and finally because I learn that several physicians, themselves morphinomaniacs, are trying to convince people that the habit is harmless. The fable of the fox that had lost his tail is appropriate. I would no more take the word of a habitue than 1 would that of a sexual pervert or a maniac, that they were right and the world wrong. In this I will also announce the name of the new remedy, when I describe the

treatment.

The opium habit, long prevalent in Asia, was rarely known in Christendom until within recent times. It is becoming of increasing frequency. The reasons for this are to be found in the conditions of modern life, and consist of the causative factors of suicide and insanity. As the demands on the human intellect increase, as the struggle for existence grows sterner, the minds that give way under the strain, or seek assistance from outside sources, must necessarily increase. It is the price we pay for our modern civilization-one example of the law of compensations.

An enormous impetus has been given to the use of morphine by the introduction of the hypodermic syringe. He has much to answer for who teaches his patient the use of this instrument. When the charms of morphine have been once experienced, it is easy to find an excuse for a repetition of the dose. A doctor who first took opium for diarrhea, used to take a cathartic at night to give him an excuse for a dose of opium in the morning. Behind such paltry refuges of lies will poor human nature seek to hide its weakness!

ETIOLOGY.

It is certain that all persons are not equally liable to become morphine habitues. To many the effects of the drug are disagreeable; to others, singularly attractive. Conditions predisposing to narcomania are: the nervous temperament, hysteria, neurasthenia, uterine pain, neuropathy, with pains, as in ataxia, neuralgia,

etc.

Above all, is the production of euphoria: when this has been experienced, morphine should never again be given that person. Narcotics are also taken to drown remorse or despair; to enable the user to accomplish tasks otherwise beyond his power; to banish care; from idleness, vice, morbid curiosity, bad example; to increase the sexual vigor or the conversational powers. The greatest number is said to be supplied by those who handle drugsphysicians, druggists, nurses, students and their relatives. This, however, may be due to the fact that these classes supply the larger part of

those who apply for cur, as the statistics are based on the reports of sanatoria. It may be that these classes, conscious of their danger, are more likely than others to seek to escape.

CLASSIFICATION.

The habitual takers of narcotics may be divided into several classes. Regnier classifies them as justifiable consumers and morphinomaniacs. The first group comprises those who are subject to incurable disease - cancer, tuberculosis, etc., who employ morphine solely to render conscious existence endurable. Morphinoma niacs are they who take the drug to secure the pleasurable sensation denominated euphoria. A large number in this class claim to be in the former, as they first took the drug to relieve the pangs of disease that has since passed off-as rheumatism, or that is not, as they claim, incurable. Sometimes narcotics are taken to ward off attacks of periodic dipsomania, or to replace the habitual use of alcohol.

All these are to be distinguished from those whose feebleness impels them to seek in morphine a shelter from all unpleasant sensations, and from the rude jars of a hurrying, struggling world; still more from those in whom morphinism is but one expression of a defective organiization, inherited from a neurotic ancestry. This disease we should denominate the narcotic habit, rather than morphinomania, for chloral, cocaine, chloroform, and alchohol habitues in terchange their drugs readily-representing simply varieties of a single neuro-psychic malady-Narcomania. The dipsomaniac, "cured" by some secret process, returns to his home quite comfortable with the morphine habit; while the morphinomaniac rids himself of this drug by substituting codeine, chloral, cocaine or cannabis indica. The real disease remains uncured the dependence upon narcotics. Those who employ morphine from Lecessity may long continue to obtain relief from the ordinary medicinal dose, but morphinomaniacs push the doses up as rapidly as they are able, the tolerance increasing with the rise. Regnier believes that this is because larger doses are required for the production of euphoria, but I think this is a mistake. Every patient I have questioned has acknowledged that he increased the dose because he wanted more of the pleasure. Indeed, there is sometimes a remarkable sensitiveness to the action of morphine in habitues, and I have produced euphoria with grain, in a man who had been taking 15 grains daily only ten days before.

CLINICAL HISTORY.

Regnier pictures the genesis of morphinomania as follows: Take a hysteric, to whom

morphine has been given to arrest the paroxysm. The sense of calm is accompanied by a comfortable consciousness of well being, of peculiar super-activity. She is alert, her memory quick, her wit keen. Tasks previously fatiguing become easy. Good humor pervades her, the cares are forgotten, she is optimistic, her face is rosier, the eyes bright, the pulse and respiration stronger. But when the morphine is discon tinued she finds herself possessed by a strange malaise, oppression, inquietude, even anguish. The mind is dull, sluggish, weighed down by a sense of powerlessness. Yawns, coughing fits, irritate her; icy sweats appear, with palpitations The pulse may become very feeble, and she languishes, incapable of exertion, pale and meager, or red and cyanotic, assailed by pains over the whole body, chilled, trembling, knowing not to what to attribute her malady, and anxious as to its outcome. Let her then have an opiate, and like magic the symptoms disappear, and warmth and gayety pervade her being. Every pang is gone, and health, strength, imagination, power to work, return on the instant. But, sooner than at first, this magic state passes away, and the malaise returns more pronounced, more accentuated than before. But now she comprehends the true nature of the malady, she recognizes the imperious need for morphine, and after a brief resistance she demands the drug. This sense of need, intense, imperious, irresistible constitutes morphinomania. From this day her life is divided into two periods, distinctly alternated-the state of euphoria from morphine, the state of ned when the effects of the dose are spent, the former lessening its duration unless the doses are increased in size or in frequency. Insomnia furnishes ano: her excuse for increasing the daily dose, and in time every excuse is seized upon for augmenting it. As this is done, the symp toms of intoxication ensue, and these may frighten the victim into moderation; but the reappearance of that dreadful need drives her back to it. If she be resolute enough to attempt a stoppage, the frightful suffering and the terrifying symptoms arising force the patient back to the drug, and only result in inspiring her with such a dread of discontinuing it that she can hardly be persuaded to resort to legitimate

treatment.

Sometimes, if the habit has not had time to rivet its hold, the victim may break his bonds, but generally he fails. Some who succeed remain free for months, when some emergency arises for which opium is taken, and a single duse is enough for that dreadful need to reappear in all its force, and in a very short time the habit is re-established, and the second stage of

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