In this way you do not irritate the prostatic urethra, as when a catheter is passed. It prevents, also, the introduction of air and disease germs.

By filling your syringe with the remedy, (the basis of which is glycerine in certain quantities) and forcing all the air out, you can, so to speak, by steady gentle pressure and the co-operation of your patient in contracting and relaxing the compressor urethra muscle, enables him to drink it right into the bladder. You get immediate results and a sure cure in a short time, and thus save taking remedies that are uncertain at best and that many times injure the stomach and kidneys.

It is just as efficient in stricture and chronic urethritis and, in fact, is a revelation in the treatment of such diseases.

S. C. DUMM, M.D., 1499 N. High St., Columbus, O..

Ergot and Quinine in Obstetric Practice.—Delivery of Placenta.-Canker Sore Mouth.-Query. Editor MEDICAL WORLD:-When reading many of the very interesting articles contained in THE WORLD, I often feel inclined to take a part in the discussion. Perhaps the best means of obtaining knowledge would be to ask questions and express no views-allowing others to instruct.

However, to Dr Huntsman's article of "Hour Glass Contraction," page 160, I would say that I was taught by Lusk that such results would at times be obtained by the use of ergot and that we would better rely on the use of qui. nine, which, in ten grain dose, causes uterine contractions, and also braces up the system for the occasion. If needed, friction over the fundus of the womb will often act nicely, and can be used after giving the medicine. There are some cases-and which are of the greatest importance in which we do not get satisfactory results after giving medicines. They are not all primiparæ. Some slight malposition may exist-the head a little large, or the pelvis slightly contracted-but most usually there is uterine inertia-which cases are perhaps the only ones needing medicines-but not the only ones so treated. It is a very common thing in most communities for some physicians to give all cases medicine, whether needed or not, presuming that they have done their duty by giving the patient the benefit of the doubt, in their mind, whether medicine was needed-and in many instances they rush the case to save time-the drug most frequently used being ergot. Some of these cases we would better give a dose of Dover's powders, which will give the patient a rest for a few hours, and relax the resisting

parts, after which the case may proceed nicely. Should dilatation be about completed or you can not have full control of the patient but must complete the labor, then have patient to sit up-walk if she chooses, keep the feet and limbs warm by protecting them. Should patient complain and take to the bed and the pains again become indifferent, have her to kneel by the bed-side or in bed until the head advances well on the perineum, after which the patient can lie down without further trouble. Some patients almost refuse to comply with anything which disturbs the rest they obtain by not having strong pains. I then tell them, it may be necessary to deliver with instruments-which removes their objections. Gravity, obtained by the position, greatly aids to engage the head in the inlet, and the pains are made stronger by a change of position. When called to a case and

on

examination find but little dilatation, pains poor, patient's statement would indicate that she has gone her full time, we proceed to help-or, rather, might say, force the casethrough a tedious labor-should we not think the fruit was not quite ripe enough to pluck?

Some cases do not take quinine well. For this reason I have given ergot, ten minims each hour if needed.

If dilatation is complete I give a large dose. I have had one hour-glass contraction, a part above and part below the contraction-which yielded readily to dilatation with the fingers, after which I have not trusted the use of ergot so much.

I was taught to tie the cord in two places and cut between and wait then for the after-birth. In doing so I always had trouble to remove it. I use one ligature, cut, and allow the placenta to drain off. It shrinks in size and may almost always be found ready to enter the vagina. I pass the index finger above one edge, bring it down, press over the womb with the disengaged hand, and I have no trouble.

Some say gently draw on the cord, which is most apt to bring it down as a parachute-acting like a valve to a force pump, that may favor inversion. Do not think you weaken the mother by loss of blood, as I have heard expressed, as there is no circulation between the mother and the placenta after the child is removed.

Should we give ergot after the birth of child or after the after-birth is removed? If so why and how?

To Dr. Kelley, page 174:-Aqueous ext. hydrastis I find to give good results for canker sores. Apply frequently.

I have a case, young man, age 20, right eye as prominent as in a bad case of exophthalmic goiter.

Seldom pains, and then only when used much. Left eye natural. Pulse 80; heart seldom palpitates and then under excitement only; is easily startled or frightened a little nervous; has suffered some pain about the heart. No enlargment of thyroid. The trouble commenced some two or three years ago. What is it? Give best treatment. W. H. CLOUSE, M.D., Crestline, O.

About That Case.

Editor MEDICAL WORLD:-I wish to notice Dr. Waugh's comments (May No., page 154), on the case of typhoid fever which I reported in the April No., page 124. I have been waiting hoping that others might offer something in regard to it.

As Dr. Waugh, in reporting a cure of a case of typhoid fever complicated with rheumatism, does not say anything about excessively high temperature nor other malignant symptoms, we do not know as to the parallelism of his case and mine.

I reported my case as one of unusual malignancy and not to particularly call attention to therapeutic measures; but will say to Dr. Waugh, who supposes that the phenomena observed in my case was due to the lack of sufficient intestinal antisepsis, that that was one of the main lines of treatment followed, and was pushed to the extent of markedly deodorizing the feces. Anti-rheumatic treatment was also used.

The doctor's suggestion would mean that the lack of antiseptic treatment would account, in not only my case but others, for the hyperpyrexia and other malignant symptoms. I could hardly agree with him in this, for the majority of cases of typhoid fever would recover and be attended by no unusual symptoms if not a dose of any medicine were given, and the treatment consisted of nothing but good nursing and bathing. If this be true in the majority of cases there must be something else to account for anomalous ones.

In the case I reported tympanites would have been a more prominent symptom if great putrefactive changes were going on under insufficient antisepsis and to the extent of causing the train of symptoms observed.

If Dr. Waugh or some one else had suggested the idea of septicemia, secondarily, from the absorption of ulcerative products, as the cause of the chills and excessive fever, I would not have controverted the point, though I think the most plausible hypothesis to be that the fever was metastatic in tendency and involved the meninges.

Add one dram of this solution to six ounces of clear, warm, distilled water, and thoroughly cleanse the cavity as needed.

This, however, would not avail of much if the lachrymo-nasal duct is affected with a chronic catarrhal inflammation. The lachrymal sac is a reservoir of the fluid secreted by the conjunctiva, and if this fluid is infe ted with the streptococcus pyogenes, as we have good reason to believe in this case, I would advise you, firstly, to slit the canaliculus and pass the indicated probes, cleanse the nasal duct, and thus restore the normal calibre of the lachrymo-nasal duct. If pus is present, it is well to remember that a solution of 1-1000 of pyoktanin is a very successful remedy to use. Then follow with the compound bromine solution mentioned above,

of proper dilution, and you will certainly cure. your case.

To Dr. Wm. F. Small, page 219, I would say, apply locally in full strength the bromine comp. sol. to the malignant ulcer of mouth.

To Dr. R. T. Story, page 219: It is well to remember that the clitoris is the most sensitive spot in the growing female organism, and is one of the frequent causes of masturbation. Carefully examine if the hood of the clitoris is adherent; if so, free it, and do not forget that rectal trouble is frequently found in the young

even in the babe. Doctor, if you have not already read Dr. Robert T. Morris' "Is evolution trying to do away with the clitoris?" send for it.

Would also say to Dr. J. Forman Pineo, page 218, that if he will carefully examine the nervous patient's rectum, and correct the probable rectal pathology, the general nervous enemia and laryngeal manifestations will speedily correct themselves. For years I have been highly interested and instructed in the clinical experience meetings as presented to us monthly in THE MEDICAL WORLD, and may give further evidence of my high appreciation of your jour. nal and its management in the future. Marion, Ohio.

Dr. A. RHU,

Every number also contains editorial and original articles of merit.

I notice an article in your last issue claiming extraordinary results in the treatment of diphtheria with gunpowder. I have to remark that there seems to be as many different treatments of this terrible malady as there are varieties and modifications of the disease. I have had considerable experience with diphtheria, and I firmly believe that cases do occur in which all treatment is powerless. I have seen cases so rapid in their march that death has occurred within the first twenty-four hours. I have seen a case under the best modern treatment in which the membrane persisted in remaining in the throat for twenty eight days, followed by paralysis and loss of vision, ending afterwards in perfect recovery, and I have seen several patients, under the same judicious treatment,

ease.

die within fourteen days of the onset. I have used neither charcoal nor saltpetre in the disFor constitutional treatment, I pin my faith on tincture of iron, sulphurous acid, chlorate of potash, poke root, urpentine, quinine, brandy,carbonate of ammonia and the solution of acetate of ammonia, compatibly combined in different mixtures according to indications; for local treatment, I rely on potassium bromide, potassium chlorate and tincture of iron, and on salicylic acid, borax and glycerine gargles. Tincture of iodine and salicylic acid crystals are good applications locally to the membrane. Sprays of peroxide of hydrogen are excellent; so, also, is carbolic acid solution. Baker's yeast, as a gargle, has done me good service. The atmosphere of the room should be moist and antiseptic, made so by steam from lime water and the evolution of chlorine and sulphurous acid gases. phurous acid gases. But with all these and other excellent means, too numerous to mention, intelligently used, we must be prepared to lose

cases.

In catarrhal diseases of the urinary organs with difficult micturition, no matter what the cause, I have had excellent results from the use of sanmetto in teaspoonful doses four times daily, alternated with a teaspoonful of acetate of ammonia solution in plenty of water, into which ten drops of tincture of iron are dropped just before taking.

In a recent case of inflammation of the stomach with obstinate vomiting, I succeeded in turning it to a favorable issue by applying a large fly blister over the stomach, injecting per rectum eighty drops tincture of opium in starch water, directing the patient to swallow small pieces of ice every few moments, and by the administration of the following:

R. Acid hydrocyan, dil. (P. B.)..................dram i
Bismuth subnit

Tr, calumbæ..... Aquæ q. s. ad..

.dram ii

.ounce- iv

M. Sig.-Teaspoonful every 4 hours, well shaken before taken.

In your May number Dr. Grinnell says, "I believe more injury has been done by the internal use of chlorate of potash, than all the good it has ever accomplished." Now, I must add my opinion from a long experience. In the treatment of anemia I have found, that a solution of five grains of chlorate of potash in plenty of water, into which ten drops of tincture of iron have been dropped, and taken immediately after meals has done me more service than any other remedies whatever. The proper use of this drug in suitable cases is commendable.

I notice a reported cure of a case of genuine phthisis, as a result of treatment with codliver oil, iron, beechwood creosote, and atropine pills,

of which Dr. R. J. Thompson, Ky., June WORLD page 218 writes making inquiry, was first practiced by Dr. Horace Green, of N. Y.

It consisted in injecting into the lungs or bronchi, (as the case demanded) through a rubber tube, one dram of a solution of argent. nit., forty grains to the ounce of water. I have in my possession the article written by Dr. Green in 1855, giving illustrative cases. wonder why a treatment which promised so much, and is the most rational of any, has fal len into disuse.

I

The doctor claimed that it was absolutely safe, although such men as Erichsen, Trousseau, Hall and others claimed that it was impossible to pass a sponge probang wet with the caustic solution, beyond the vocal cords. However, Dr. Green passed it many times without harm. The operation was performed several times in the presence of Sims, Parker, Bowditch, Sayre and Minor. The doctor will find the article in Trans. of State Med Soc., of N. Y., 1855, p. 244. Also in Braithwaite's Retrospect, Vol. xxxii p. 60.

The case of Dr. Pineo, Chester, Novia Scotia, Can., in my opinion is stricture of esophagusbut whether spasmodic or organic, of course, I cannot say positively. However, I would pass a bougie occasionally, feed through the stomach tube, apply belladonna ointment to the neck, and give anti-hysterical treatment, keep bowels open, give asafetida, valerian, etc., etc. If organic, or from pressure on esophagus from some growth or aneurism, any late work on surgery will inform you of the best course to pursue. J. T. BARNETT, M.D.,

A Secret Cure for Cancer,

Editor MEDICAL WORLD:-I enclose a letter for you to dispose of as you see fit It is being advertised very heavily in California by Dr. Chamlee, formerly of Lone Oak, Texas. I am personally acquainted with one man who had a cancer taken off him several years ago by this method, he says. Now it is returning, and he wants me to treat him in the near future. I wish the remedy tried, and the results, pro or con., published in THE MEDICAL WORLD.

I send this, believing that everything that is of benefit to humanity should be published.

M. D. M.

[We give below an exact reproduction of the method of treatme t, as it appears on an old and worn copy enclosed with the doctor's letter. In the first formula, galangal and sanguinaria are doubtless intended. Practically the same treatment has previously appeared in THE WORLD.-ED.]

R for Cancer.

1st. Take strong hop tea, use corn meal and make a poultice, and apply over night, which is merely to cleanse the part.

2d. Make a plaster as follows: Gallenger pulv. Sanguinary " red, аа i ounce Chloride zinc, . iij drams xl grs. Pulverize thoroughly, add water to make a thick paste, spread on a linen cloth, apply; let it remain 24 hours, remove, and apply 2, 3 or 4 times, according to size and nature of cancer. You must be governed by the appearance of cancer. Now the cancer is killed, and will drop out from 4 to 6 or 8 days, and needs no assistance, and will drop out itself.

You then make a salve as follows:
Mutton suet,

Beeswax,

Eng. Resin, aa, lb. or less if you wish. Melt them together; while cooling add oil spike. 1 ounce. spike. 1 ounce. Spread on a linen cloth, apply

Editor MEDICAL WORLD:-Permit me to report the following case of "heavy weight."

Mrs. Harris E. Mason, age 35, No. 85 Literary St., this City, whom it has been my pleasure to attend since marriage, was on May 12th, delivered of a fine boy, weighing 18 lbs., being her seventh. Mrs. M. weighs but 100 lbs. at her best, is of Scotch parents, herself a native of Canada. Mr. M. is a native of this city, an ordinary sized man.

Child and mother at this date well.

C. M. CHALFANT, M.D., 414 Pearl St., Cleveland, O.

The Attitude of Railroad Authorities Toward the Medical Profession.

Editor MEDICAL WORLD :-You ask for in

formation in regard to the payment of physicians by railroad companies in case of accidents. I live on the line of the Boston and Maine Railroad, and have been called in cases of accidents. Sometimes I have been paid by the party injured; at other times by the road. The last case of accident I attended was in the night, and though the passenger was at fault, yet I sent my bill to the railroad authorities, at the

anemia is usually present. The lymphatic glands have been found inflamed, or suppurating; the heart muscle pale and sclerosed (Lewinstein), or hypertrophied; twice it was fatty (Hirschfeld). The cells of the spinal cord present tissue faction, vacuolation and granular degeneration.

When the drug has been discontinued the tissues gradually resume their normal function; rapidly and fully if the habit be of short duration, slowly and imperfectly as it has continued longer. The nerves resume their functions almost violently, and when relieved of the longcontinued benumbing influence of the drug, they become hyperesthetic, their abnormal sensitiveness causing acute distress. The same reaction is often noted in relation to other vital functions. As the symptoms of dementia supervene, with obliteration of the moral sense, the chances of complete recovery are lessened. Patients who have been treated by the Keeley people are especially difficult to handle, as they seem to be often devoid of shame, and to look on themselves as irresponsible freaks of the most interesting description. Prolonged restraint, for at least a year after the cure, is frequently required to render it permanent in such cases. But even if the case be far advanced, a permanent cure may be obtained, provided the patient's means permit him a period of rest, or light occupation, and a sufficient motive exists to keep him from falling back. The possessor of a wife and children is a more hopeful case than the bachelor, especially if the latter be supported by a mother, and not traine to suprort himself. It is astonishing that men of brains, of talent, or even genius, so frequently fall under the morphine thralldom. In the majority of cases, some true chord will be found to vibrate in harmony with duty. Depravity is rarely so complete, self-indulgent imbecitity so deeply seated, but that motives may be found that will arouse the latent spark of manhood and induce the patient to make an effort to break his chains, if properly helped.

The efforts at cure and other incidents may

at once, without question.

Wakefield, Mass. D. S. COLES, M.D.,

The Morphine Disease.

Second Paper.

Editor MEDICAL WORLD:-In the earlier stages few and trifling lesions of the nervous system have been found. It is at all times difficult to tell what is due to the morphine and what to intercurrent or pre existent disease. Hyperemia of the brain, lungs, liver, kidneys aud bowels have been described; with apoplexies, ecchymoses, etc. Cerebral

these its duration is variable. Some run quickly through the stages, while in others the progress is slow. Death is often due to intercurrent disease; the opium habitue being peculiarly liable to die of epidemics, cholera, typhoid, etc. Surgical operations result badly with them, and tuberculosis is especially frequent. Death is frequently due to an over-dose, taken from chagrin or with suicidal intent.

A frequent cause of relapse into the habit is the recurrence of that imperative sense of need, of which we have spoken. During the first year