success. Have cured cases of twenty-five years, standing, using as much as three drams per week. Ripley, Tenn. C. LAWSON JOHNSON. such conditions as orchitis, goiter, etc. In the treatment of boils and carbuncles I have never known a failure. I have produced relaxation so intense that the patient said that he could not walk 50 feet without sitting down to rest, and on taking the medicin away he was strong again in twenty-four hours. T. B. HAMMER, M.D. Des Moines, Iowa. Anesthesia. Editor MEDICAL WORLD:-A pin prick in cap of can will give a fine continuous stream. After patient is under put a string of gauze in mouth to draw off mucus and saliva. New York. W. CLARKSON WAGGONER, M.D. Cardiac Palpitation of Gastric Origin. EDITOR MEDICAL WORLD:-I recently had a case of cardiac palpitation of gastric origin in a young woman, five months pregnant, nullipara, which lasted from 10 o'clock at night until 7 the next morning, the average pulse rate being 215 per minute. The case resisted ordinary remedies, even morphin, until after a large dose of soda bicarbonate, of which she had already had a considerable quantity, the rhythm suddenly adjusted itself, and the attack was over. I have not been able to go very deeply into the literature of these disturbances, but neither I, nor anyone with whom I have discust the case, have seen an attack persisting that long. Altho emetics are, as a general thing, not indorsed in the treatment of these conditions, on account of the danger of seriously depressing the heart, yet I felt justified in provoking emesis by the use of mustard, but with disappointing results. I believe this case is unique from the length of the attack. I have seen it persist for several hours in a robust young man, and have seen several attacks in the course of one day occurring in a woman with poor compensation; but for it to last nine hours when due, as far as could be determined, to gastric irritability, is out of the ordinary. Marysville, Wash. J. D. THOMPSON. A Medical Insurance Fee Bill. EDITOR MEDICAL WORLD:-Here's a new onefor me. Treated an employee of a papermill on November 29th for severe infection of hand, incising same under ethyl chlorid on December 1st, with subsequent surgical dressings for following three days at my office. Sent him bill, itemized as follows: Office Calls with Surgical Dressings, Nov. 29, Dec. 1, 2, 3, 4, at $2.. $10 Incision of Infected Wound under Ethyl Chlorid, etc.. 5 a Answers to Queries. EDITOR MEDICAL WORLD:—I have been a subscriber of The World for some time, and enjoy your journal very much; in fact, don't see how I could get along without it now. Locomotor Ataxia. Anent a few articles in the February issue, I would like to say a few words: First, as to Dr. M. L. Dalton's query of Dr. Burton's locomotor ataxia treatment (page 78), will say I have his literature and don't see why most any of “the family" can't do nearly as well as he claims. According to my limited experience and that of some of my acquaintances I believe mercury salicylate hypodermically to give nearly, if not quite, as good results as he claims, and I would not hesitate to guess this to be his treatment; that is, if he gets as good results as he claims. Home Treatment of Narcotism. The Towns treatment for narcotics given in answer to Dr. J. C. O'Dwyer's query (page 74) is all right for hospital use, as your editorial states, but this is not of much benefit to the general practician. I have modified the treatment by adding glycerin and simple elixir to the belladonnaxanthoxylin-hyoscyamus mixture and also adding avena sativa, passion flower, Jamaica dogwood and compound tincture of cinchona and gradually reducing the morphin in the mixture, thus making a home treatment out of same with the very best of success. There is no use for it to be further declared that this condition cannot be cured in the home, as an authority on same wrote me since I have been so treating it with the very best of $15 The company employing him sent my bill to the Royal Indemnity Co., 84 William Street, New York, from whom today I receive a letter requesting me “to amend it (bill) in regard to the two-dollar charge for office visit.” They further state that they "enclose schedule of medical fees generally accepted by the Compensation Commission for medical attention in compensation cases." * You will note that one dollar is the amount allowed for each office call." The fee schedule inclosed is printed, "Approved by Medical Society of State of New York, by Alexander Lambert, M.D., Chairman Workman's Compensation Committee, for the Committee. Approved by the New York Claim Association, by W. L. Gahagan and Geo. C. Taft." I am inclosing herewith the schedule, and you may note with joy for yourself some of the generous fees mentioned. In the case of the patient I treated, the actual work took over 25 minutes each time, to say nothing of sterilization of instruments, material for surgical dressings, and time and care while hand was soakt in antiseptic solution, nearly an hour in all. My reply to them: returning bill respectfully declining to comply with your request, as the fee is a fair one and will stand. My lowest fee for office work is $1, and this for an ordinary medical call without extra work or medicins. Mr. S.'s wound required nearly an hour to dress, and the charge is not exorbitant. The Compen. sation Committee you mention has no jurisdiction over my fees, nor am I a member of the Medical Society of the State of New York. If both are willing to stand for cheapened work, they can, but I don't. My bill is against the U- Company, and I should prefer your corresponding thru them in order that they may know what a cheapskate company they are insuring with." Further details when they occur, but I wanted to get this to you early, so that you may take the matter up in The World at once. One would think we are to work at a reduced fee because the companies favor us by permitting their workmen to be injured. It is to laugh-or is it? RALSTON REED, M.D. Morristown, N. J. [The following is the schedule.-Ed.] A Medical Insurance Fee Bill 105 Total limit for full sub sequent treatment. Flat rate, including first operation and full treatment. Separate charges for all subsequent treat- Operation only. Total limit for full sub sequent treatment. Operation only. Separate charges for all subsequent treat- SPECIAL OPERATIONS: Home Office Home Office AMPUTATIONS: Hip. Thigh. Foot Leg. Shoulder joint.. Arm, forearm or hand.. Metatarsal or metacar pal—one.. Metatarsal or metacar pal-two or more... Finger or toe. ... Fingers or toes-two or more. 1 50.00 40.00 20 10 25 15 1 50.00' 40.00 50.00 40.00 15 5 1 1 50.00 40.00 10.00 5.00 10 15 15 15 15 1 1 1 1.50 1.50 1.50 1.50 15.00 10.00 40.00 25.00 10.00 5.00 Trephining of skull.. matic peritonitis. Fixation or suturing of kidney. Laparotomy for rupture or wound of bladder.. Laparotomy for rupture or wound of liver. Laparotomy for rupture or wound of spleen.. Laparotomy for rupture or wound of stomach, Laparotomy for circum scribed aneurisrn... Trephining bone abscess, Caries or necrosis, re moval of .. wall.. ing of. tetanus or hydropho- ceed $25. or excision. Ligating important ar teries (separate opera tion). Ligating small arteries (separate operation)... Hernia, reduction by taxis and applying truss (subsequent treatment none). Herniotomy. Enucleation of eyeball.. FRACTURES: 25.00 10.00 15 1.50 Upper arm. both bones (shaft). Colles' both bones.. pal. bones or plating.... 1 లాలో 50.50MNUTAN 8308813 5.00 50.00 35.00 40.00 25.00 15 15 1.50 1.50 5 5 10 15 15 10 30 10 10 20 15 10 25% extra. ! 1.50 3 i 1.50 1.50 1.50 1.50 1.50 1.50 1.50 1.50 10 1.50 1.50 1.50 1 1 1 1 SPRAINS: 50% extra. Shoulder. Elbow. Wrist. Hip. Knee. Ankle. All other joints. DISLOCATIONS: Minor operations, repair of small wounds, including suturing and dressing.. Repair of large wounds requiring extensiv guturing and dressing... Abscess, incision. Laminectomy (special operation).. Paracen tesis, thoracicis or pericardii (special operation). Rupture of tendon,large, small, 3.00 2.00 4.50 1.50 2.00 1.50 1 BOINCINONEN 1 1 1 1 1 1 1 1 1 16 5.00 1.50 5.00 1.50 2.50 1.50 1 GENERAL ITEMS: (I hereby agree to abide by the above schedule for all services rendered by me in connection with the New York Workmen's Compensation Law.) (Signed).. M. D. Flat rate, including first aid, operation and full treat ment. $10.00 2.00 to 5.00 50 This........day of 191.... (Address).. Approved by Medical Society of the State of New York, by Alexander Lambert, M. D., Chairman Workmen's Compensation Committee, for the Committee. Approved by New York Claim Association, by W. L. Gahagan and Geo. C. Taft. (A synopsis of this schedule was printed in January WORLD, page 25. As stated there, it is a movement intended to put charges for the treatment of injured workmen on a collectible basis and is only operativ in New York State until July 1st, next. The fee bill of the physicians of Herkimer County, New York, is also printed in January WORLD, pages 23 to 25.-ED.) Assisting at operation, major.. minor. Mileage beyond city limits, per mile one way only... Examination in lunacy, including written re 50.00 port and one day's attendance in Court or before Commission. Subsequent Court or Commission attendance per day.. Urinalysis, when specially requested. Complete physical examination and report by other than attending physician. Autopsy, complete with written report.. attending but not performing. Microscopic and chemical analysis of organs. Testimony in Court or before Commission as to simple fact or injury. 25.00 3.00 10.00 5.00 15.00 to 25.00 2.00 5.00 3.00 each 5.00 ORDINARY ITEMS: First aid Subsequent treatment, office $2.00 $1.00 1.00 1.00 1.00 1.00 Ordinary day visit at house, including antiseptic dressing when necessary, Ordinary day visit at hospital, includ ing antiseptic dressing when neces 3ary Ordinary office treatment, including antiseptic dressing when necessary, Visit, including antiseptic dressing and necessary operative procedures in ordinary cases of incisions, punc tures, lacerations or contusions. Night visit, 9 p.m. to 7 a.m.. Formal detailed report by attending physician at special request of in surance carrier.. First attention at office, including operativ procedure and dressing of ordinary wounds. Removal of ordianry foreign body from conjunctiva, at office.. Removal of foreign body from cornea 2.00 1.00 1.00 1.50 1.00 1.00 1.00 Cages not specifically included in this schedule are to be treated on basis of day and night visits, except where special treatment is necessary. In that event, the facts (if not an emergency case) are to be submitted to the insurance carrier and arrangements made with it for such additional or special treatment. Treatments shall not exceed sixty days (as provided by the law, section 13) from date of injury, except upon special arrangement with insurance carrier. These fees have been established with the understanding that they include, in all cases, ordinary dressings and anesthetics, etc., for the proper treatment of each case, and that they will be supplied by the attending physician. It is also understood that the strictest aseptic precautions will be observed in accordance with approved methods of surgery. It is understood that itemized bills shall be rendered immediately after treatment ceases, or in any event, at the expiration of sixty days from date of injury. Such bills are to be itemized, showing date of each visit, dressing or operation, and charge for same. Reports relativ to condition of injured employees under treatment shall be made when requested, without extra charge. This Schedule, except a3 to general items, contains three systems, any one of which may be followed by the physician according to circumstances. I. Column A shall apply when the same physician operates and also gives subsequent treatment. II Columns B and C when one physician operates and another gives subsequent treatment. III. Columns B, C and D when one physician operates and another gives subsequent treatment. Charges for each visit to be on the basis of column D, total not to exceed column C. Physical vs. Medical Methods of Treatment. Axiom-"The whole is greater than any of its parts.' Editor MEDICAL WORLD :-Our topic might at first seem to suggest that there was a controversy or contest between what have been designated “physical” methods of treating diseases, as contrasted with the internal administration or external application of what have come to be known as "drugs" or "inedicins." Nothing could be farther from the truth, tho the advocates of various methods of treatment may divide themselves, or be divided, into hostil canps. As well discuss "boots 2's. gloves," or “hats is. coats." These are all parts of wearing apparel, all very desirable and useful, if not absolutely necessary; yet neither can perform the functions of the others. The preference for one or another all depends on your problem, on what you want to accomplish. And results-just plain, everyday, unqualified and unanalyzed results—will not settle this imagined dispute. The proponents and enthusiastic practicians of every new healing cult will point to an array of unmistakable cures of undoubted actual disease, as proof of the correctness of their theory of disease, its cause and treatment. But they lose sight of or disregard the fact that practically every method of treating disease that has ever come across the horizon is fortified with identically the same evidence to sustain and maintain its claim for recognition. Conversely, there is no method of treating disease that has not failed to cure the patient-allopathic drugging, homeopathic medication, eclectic dosing, osteopathic manipulation, chiropractic adjustment, electrotherapy, psychotherapy, hydrotherapy, spondylotherapy and every other therapy and method has, each of them, many cures to its credit, and plenty of failures—to the disgust of its devotees. Why, then, these contradictory facts, at once so convincing and confusing ? First of all, we may as well recognize the fact that here and there occur certain cases of certain diseases that are simply incurable by any known means. But largely this situation is due to the fact that the various practicians insist upon putting square remedies into round ailments--insist upon making the disease fit the treatment to which they are committed, rather than suiting the treatment to the trouble to be corrected-have sought to make the right thing in the correct manner at the the ear-trumpet do the duty of the eyeglass. psychologic moment. Bearing in mind the fact The microscope reveals bacteria and the minute that the human body is an intricately complicated structure of matter, but the astronomer finds the machine, and also a most wonderful chemical telescope more useful in scanning the heavens; laboratory, is it not possible, yes probable, that each is an invaluable optical aid to vision, but among both “physicalists” and “medicalists" there serviceable only in the particular field of investi- are too many who are at once idolators and gation to which it is adapted-neither can sup- iconoclasts, to whom “our” method is always plant the other, nor can one be said to be superior right, and the “other” invariably and necessarily to the other. wrong? JAY H. Radley, M.D. The incontrovertible fact that practically every 112 West 71st St., New York City. method, system or school of healing has both cured and failed to cure positivly disproves the existence of any one cause of disease—the corol Osteopaths Not Recognized in Red Cross Work. lary of which is that there likewise cannot be any one effectiv method of healing for all cases Editor MEDICAL WORLD :-At the bottom of of all diseases. page 50, tirst column, in the February, 1915, In the relief of suffering and the cure of dis- MEDICAL World, I note the statement regarding ease I have successfully prescribed medicin, osteopaths and Christian scientists remaining at utilized electric energy, directed psychic forces, home during the war. This is certainly an unfair administered osteopathic manipulation, employed statement, and I feel that if you know the situachiropractic adjustment, etc. Had I been chained tion more fully you will realize why this is the to "medical” methods I should perhaps have case as regards osteopaths. drugged some unfortunate whose spine needed I organized a Red Cross Field Corps in Brookadjustment—and failed to cure; had I depended lyn, N. Y., a few years ago and spent a good deal upon osteopathic treatment when there was some of time and money attempting to prenare the chemical discord in the bodily metabolism that members in army hospital corps drill and have required nutritiv or correctiv agents; or had I them equipt and ready for service in war or placed reliance upon the electric current to an emergencies. I was informed that even if I ortagonize, antidote or neutralize circulating toxins ganized the detachments up to the strength of in the body, my patient would have found his a column, that I could not have command as I way to some other doctor-or to the undertaker. had no "M.D.” degree. I was informed that it No, "physical” methods are not versus "medi- was the degree and not the qualifications that cal" methods. Whence, then, the supposed rivalry? counted. First is the fact that for ages the only treat An osteopath tried to gather medical and other ment known was medical; and we of to-day, supplies for relief work during the floods in Ohio possest, if not obsest, by the accumulating heri about a year and a half ago. He found that the tage of generations. find it hard to question Red Cross organization refused to recognize him Solomon's assumed finality that "there is nothing as a physician and would not accept his assistnew under the sun”-tho we have no reason for ance, allowing the local medical physicians to get presuming that wireless telephony, aviation and all the credit for the relief work. a few other commonplaces of to-day were fa Now, Doctor, if an osteopathic physician should miliar to that polygamous potentate. Physical offer his service as a physician and surgeon in the methods of treating disease are new-sone newer present war as other doctors have done, would he than others-and they are unquestionably, even not be accepted as possibly an interne or even tho limitedly, successful, when discriminatingly an orderly or litter bearer? I am certain that he and skilfully employeri in properly selected cases, could not be recognized as a surgeon, even tho and where indicated: but. like medical methods, surgery and hospital work are taught in the they also fail when relied upon in unsuitable cases osteopathic colleges, and an examination in suror when bunglingly administered. gery is required of osteopathic applicants for Further, most of the “physical" methods of examination in New York and some other states. treatment that have been proposed or are now How do you know that some osteopathic phy sicians have not offered their services and had being propagated have been exploited in such them refused again? I am certain that the obabsurdly and ridiculously extravagant fashion as stacles which are usually thrown in the way of to instantly discredit them with people of education, poise and judgment. In ludicrously muti progress by many medical organizations when it lated English, the exponents of each new method comes to new methods of practise which are not have sought to garb and have championed their "regular,” would successfully deter the acceptpet scheme as a panacea. Having become pos ance of osteopaths as physicians and surgeons for sest of, or rather by, a nondescript bug, they war service. If it was selfishness, as your paper states, you have set themselves tip as entomologists of sur would not find osteopathic free clinics in many passing and superlativ knowledge. Insisting that the link which they have forged-granting its cities and other charitable work of that kind car ried on by the osteopathic profession. And, inquestioned value and extended utility-is the again. when attempts to establish these free whole chain. all that has been previously learnt clinics have been made, medical organizations of the structure. functions and ailments of the have again many times retarded the work and human body is but junk to be thrown into the then claimed that the osteopathic profession will discard. And everybody who has treated, or not do charitable work. now treats, any disease by any other than their Middletown, N. Y. JOSEPH FERGUSON, D.O. one method must hear the label “idiot" or "knave"--or both. In the healing art, as in every other field of EDITOR JEDICAL WORLD :-Inclosed check for $6. Chalk me up for eight years, and oblige. human activity, the key to success is in doing 1311 S. 29th St., Omaha, Neb. F. II. FOWIER. (6 Neuritis, Arthritis Deformans and Paralysis Pioneers in Surgery. Editor MEDICAL WORLD:-Allow me to say, you Editor MEDICAL WORLD:—By request, I wish to are, so far as I am concerned, privileged to have offer some additional data upon the subject of your own opinion on politics, religion and the neuritis, arthritis deformans and paralysis agitans. human slaughter house in civilized and ChristianThis refers to the letters on these subjects by Dr. ized Europe. Occasionally one of the brothers Charles M. Collins, Dr. M. J. Carey, Dr. J. I. T. crawls in with a dogmatic pen dipt in the acid ink Long and Dr. H. F. Hudson, upon pages 27, 28 and of skepticism-Dr. Reycraft, on page 57, Febru29 of the January, 1915, WORLD. Certainly in ary World. I think we owe a great deal to the view of the newer medical electricity, our treat pioneers, e. g., Ephraim McDowell in abdominal ment methods of the diseases mentioned have surgery; S. D. Gross before his death was experiradically changed, and reference to recent authori- menting with intestinal surgery; Nicholas Senn tativ works and articles upon the subject will was his pupil and assistant. Afterward Senn pubconfirm this view. lisht a book on the subject. Gross is unknown to I would refer you to my monograf entitled many of the younger men. Ben. Franklin was "Newer Methods in the Treatment of Neuritis," the beginner in electric work, and the present genin the volume of "International Clinics" for eration is reaping the benefit. Laennec was the December, 1913 (publisht by the J. B. Lippincott daddy of the stethoscope. Wonder if in Dr. ReyCompany, Philadelphia), volume iv, 23d series. craft's 1,000 laparotomies he met with ptosis of In the Journal of Advanced Therapeutics for any abdominal organ. Thos. L. GETTLE. November, ,1913, pages 432 et seq., will be found Paris, Va. an article by the writer upon “Deforming Arthritis and Intestinal Stasis.' Provision for Physicians' Pay in Louisiana. For recent data upon paralysis agitans I would Dear DR. TAYLOR:-In regard to your article refer you to the recent work upon "Ionic Medica in February WORLD, on Legal Provision for tion," by Lewis Jones, publisht by P. Blakiston's Physicians' Pay," will state that here in Louisiana Son & Co., 1012 Walnut St., Philadelphia, 1914. we have a law giving a physician the right to $15 Also to Prof. Le Duc's address before the British Medical Association on “Ionization of the Brain on a man's crop, regardless of other debts. I think, tho, that this fact is not very well known for its improved nutrition that will be found in by the profession. C. A. GARDINER, M.D. the London Lancet for March 22, 1913. Sunset, La. A. B. HIRSH, M.D. 22 S. 21st St., Philadelphia. Ferrous carbonate, in powder or in ointment, is an excellent dressing for chronic ulcers, especially Rheumatism, Not Neuritis. those of the leg, and even when syphilitic in origin. Editor MEDICAL WORLD:-If Dr. Collins (pages It is a good cicatrizant. The cavity is filled with 27 and 28, January World) will call his case the powder, and lint and bandage applied. When crusts form, they are removed by oil of sweet rheumatism he will agree with my experience with almonds, applied with a camel's hair brush. In the same trouble. I had it two years ago so I could not lift my right hand to the top of my stubborn and inveterate cases, one may rub the base of the ulcer with lunar caustic and then with head, and have had it again this winter. As he a piece of metallic zinc shaved till the surface is says, salicylates do no good, but if he will take bright; thus the acid nitrate of zinc is formed, and Lloyds' macrotys and their bryonia 5 or 6 minims of each four times a day, and follow it up, he may granulations stimulated, when it is then drest with the ferrous carbonate. The acid nitrate of zinc be benefited. It is all that has done any good for application is painful, but efficient. He has practised seventeen years; I have practised nearly forty-one, am 70 years old, never had The Carvers. a tooth extracted, none decayed, have not been We used to call it gripes, when we had stomach trouble, and all our inward pipes would ache and bend us double. sick in bed for forty-five years, do not use tobacco It was a common ill that caused no awe or wonder, and granny's or liquors in any form, do not chew gum; know simple skill full soon would knock it under. The poor men how to swear, but don't do it; eat anything anyone in their cots, the rich man in his castle, were often tied in knots, and with the gripes would wrastle. A dose of home eats, but cheese; drink a small cup of coffee two made dope would quell the dire upheaval, restoring faith and or three times a day. hope, displacing pain and evil. But now the doctor comesI may some day write a little of my experiences his science sure a blight is!-he looks and haws and hums, for the World. and cries, “Appendicitis!”. He promptly spoils your peace, I. S. BOLES. and makes your courage mizzle, as from his old valise he takes Shellsburg, Iowa. a saw and chisel, a cleaver and some dirks, and how the patient hollers, when he removes one's works, and charges ninety dollars! The docs are done with pills, in this and other nations; no matter what your ills, they call for "operations." Lumbago Warren, in American Journal Medical Sciences, in our backs, the jaundice and hay fever, demand the saw and axe, the hatchet and the cleaver. The druggist's trade is calls attention to a source of confusion in diagnosis poor, and soon he will be starving; the doctor's only cure, of tumors of the female breast. If the breast be these modern days, is carving.-WALT Mason, in Philadelphia pincht between the thumb and fingers, it doubles Bulletin. upon itself more or less, and a sensation is im Editor MEDICAL WORLD :-The best evidence of parted as if a tumor is present when there is really my appreciation of THE WORLD is the fact that I no tumor. He advises that after removal of the have paid my money for it for a long number of clothing, the examiner stand behind the woman, years: while recognizing its value purely and palpate the breast with rigid fingers. In this medical journal, I do not hesitate to say that the method of examination, the gland proper is readily "Monthly Talks" are more than worth the moner; while not always a greeing with the editor, the subdistinguisht as an almost impalpable mass of very jects make one think, and it is only by agitation soft consistency, and any new growth is readily will the social questions that are admittedly so much distinguisht by its bulk or hardness. out of line with justice be rightly settled. L. C. CHENOWETH. a me. as |
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