A WORLD Subscriber in Europe. One of our old subscribers, Dr. Arthur A. Cottew, late of San Diego, Cal., went to Europe in June, 1913, and has recently returned from the war zone. Unfortunately, on the steamer returning home he fell, fracturing a femur, in consequence of which he is now laid up in New York city. However, he expresses his delight at arriving back in America alive. He writes an interesting account of his trip, and we regret that we cannot spare space for all that he says. The following are brief excerpts here and there from his account. In the first place, he wishes to assure me that his experiences concerning cool weather in Europe were similar to my own. On landing at Southampton he had to buy warm underwear, and many times in the evening he had to wear an overcoat. He traveled in southern Europe and I traveled in northern Europe, yet he says: "In fact, with the exception of a few days in southern Spain, it was never warm, and I have had to go to bed many times to get warm. A banker I know from Montreal told me he shivered in a Canadian overcoat in Scotland while eating dinner with relatives who were saying how comfortable they felt. Temperature just over 50 degrees Fahrenheit." Here I wish to say that in the summer of 1911 it was exceedingly hot all over Europe, even up into England and Scotland. AS WORLD readers know, I was in France, Belgium, Holland, England and Scotland that summer, and the heat was very great in all these places thru July and August and into early September. In Paris I remember that the thermometer was in the nineties, even up to ninetyfive, about every day. In the other countries I did not have the facilities for consulting Fahrenheit records, but I know when it is hot. The summer of 1911 was unusually hot in Europehot summers there are the rare exception, but they are possible. They are more frequently too cool for Americans, as last summer was. Concerning his experiences in the war zone, Dr. Cottew says: "So much has been written of France in the early days of the war that every one's experiences were very similar; dislocation of travel, delayed tourists, waiting and hunting for food of some kind, watching one's baggage and looking at train after train passing full of soldiers going north, and others full of wounded going to the base hospitals. There was an anxious look on every one's face old enough to realize the gravity of the situation. We did not go further than Rouen. I was much interested in the ancient city of Joan of Arc and its beautiful suburbs, up and down the Seine, which, between Paris and Havre, flows thru some beautiful and picturesque country. One of the best ways to see this section is from the deck of one of the river boats en route." "After many delays we got to Havre, thence back to Southampton. In England all the young men were either training or occupied, as one only saw old men, boys or Boy Scouts and women, outside of the few men in military and naval uniforms. Even at the railway stations the absence of young men was at once noticeable. At Liverpool I watched several regiments embark for France. It seemed all too sad to see so many fine specimens of manhood going to be targets for machine guns." "As most of Europe was impossible for travel, we decided to go to Spain, especially as we both speak the language. So bidding good-bye to the war zone we took ship to Gibraltar, and in a few days arrived after a delightful trip, the last day coasting the Spanish seaboard, passing mountains, valleys and towns all in the enchantment that distance lends to the view." The Doctor's description of Gibraltar is very interesting. After remaining there two weeks, the Doctor and his wife took train for Malaga, where, it seems, they spent the winter. This is out of the beaten track of travel, but speaking the native language made it very easy and delightful. Malaga is a beautiful city on the Mediterranean. As beautiful as Southern France, but not frequented by tourists, because, as the Doctor says, "of the lazy indifference of the natives." The authorities do not seem to appreciate the value of their climate, history, scenery, etc., as they make no effort to attract the people there. As they intended to stay some time they rented a flat and kept house. As to domestic servants, he says they hired two pretty Spanish girls "who could neither read nor write, but with lots of horse sense," at $2 per month each. "Everything you need is brought to the door and bargained for. If you can talk to them you pay less than half what a foreigner would. They milk the cow into your own vessel night and morning. Many other interesting things are told by the Doctor of his winter on the southern coast of Spain. He prefers the unbeaten paths of travel, as we all would in a country in which we could speak the language. He took vessel for England again and then all was war again. "No one in that country but avers that England up to the very last tried to make peace. The country was utterly unprepared for war, and France and Russia were both caught napping." *** "An officer belonging to headquarters told me that of the 165,000 men sent out first by England, about 500 remain." Forgettable Things. Has some one played a scurvy trick? Forget it. Has some one soaked you with a brick? Forget it. Don't let the memory endure; a scheme of vengeance will not cure a single sore, you may be sure-forget it. Forget Has some one used your name in vain? it. Don't call upon him to explain; forget it. If you are straight and good and true, it boots not what men say of you; don't fuss, or pause the rag to chew-forget it. Your wife has got a nagging tongue? Forget it. You thought her smooth when she was young; forget it. She's had enough of work and care to sour the temper of a bear; what if she hits you with a chair? Forget it. The kids kick up a beastly noise? Forget it. You cannot read for girls and boys? Forget it. Some day they'll leave the old home shack, and then you'll wish that they were back, to make the floors and rafters crackforget it. You have a toothache in your ear? For get it. You've half a mind to shed a tear? Forget it. For brooding over grief or pain but puts the fantods in your brain, and shows you are not safe or sane; forget it.-WALT MASON, in Phila. Evening Bulletin. THE PRESCRIPTION PAGE. Fever. EDITOR MEDICAL WORLD:-I am sending to you my favorite prescription (for any fever, no matter what the cause may be). I have successfully used this for more than fifteen years. I have never in all my practise found anything to equal this in fevers. No better than this one has ever been produced. You have to exercise your judgment in giving to your patient. Some time in giving a little too much of the mixture, it will cause purple or blue tint under the gums, skin, finger nails and lips and sometimes splotches on other parts of the body, being the aniline tinge that becomes isolated from the substance of the acetanilid and is thus deposited in the blood. A small glass of whiskey or alcohol or a few swallows of strong black coffee will soon remove the cause. R Po. acetanilid Cit. caffiein Salol Bicarb. soda Po. gum acacia Mix and add Alcohol Essence orange or lemon Syr. simple Aqua, q. s... M. Sig.:-Shake and give teaspoonful every 1, 2, 3 or 4 hours, or as needed when there is fever. The above dose is for an adult. I give in proportion to children according to age. I rarely ever dispense more than a 2-ounce vial, which, in the majority of cases with fever, is quite sufficient. I also add coloring of some kind to give it a nice appearance. For grip the above prescription cannot be excelled. I generally give a teaspoonful to an adult every 2 to 4 hours. CILTON C. MATTHEWS, M.D. Como, Texas. Mix and make into 40 pills. Three or four daily in the treatment of St. Vitus' dance, neuralgia or other nervous disorders. Urticaria-A Lotion For. Dr. Coughlin finds that the itching may be greatly relieved with the use of the following lotion: R Phenol Glycerin. Hot water:. Flatulent Colic in Infants. Leonard Williams accredits the following pre scription to Widerhofer: R Tincture of cascarilla.. Simple syrup. Water, ad..... In X m j-ij 3 ijss 3 ij M. Sig. One teaspoonful every two hours. Jour. Med. Soc. N. J. R Calcined magnesia... Gastric Vertigo. .0.3 gram 0.03 gram Prepared chalk, Sodium bicarbonate, āā........0.2 gram Powdered belladonna root......0.02 gram M. ft. pulv. To be taken immediately after each meal.-DR. ROBIN, in Riforma Medica. MONTHLY CLINIC Please notice that our CLINIC department is not used to "boost" proprietary remedies, almanac fashion. THE MEDICAL WORLD has no interests other than to give to the medical profession the greatest amount of honest service possible. It has absolutely no interests in any proprietary preparation nor any medical supply house. Only such queries will be publisht as are likely to interest and instruct many others as well as the one asking help. No charge is made for this service to our subscribers. However, those who wish an immediate and personal reply by mail may obtain the same by inclosing two dollars to the Editor of this department, DR. A. L. RUSSELL, MIDWAY, WASHINGTON Co., Pa. This is really a consultation in the interest of the patient, and should be charged to the patient-two dollars being a very moderate consultation fee. The Doctor agrees to give full, careful and immediate attention to such consultations. We reserve the right to publish in this department any such consultations that may be interesting and helpful to our readers. Name and address will be withheld if requested; but anonymous communications will receive no attention. Come freely for help, but read up as fully as you can before coming to us. Pruritus Vulvæ. EDITOR MEDICAL WORLD:-I have a very troublesome case of pruritus vulvæ that has exhausted all the remedies at my command. The woman is about 40, well nourished, weighs 170, had 2 children, youngest 14, no vaginal discharge of any consequence, but is of high nervous tempera ment. I cannot detect any difference in the skin at any particular spot, but around the hairs along the labia there is a sort of dryness, but no scales. She will scratch the skin till the blood appears; then get relief. Can you suggest anything that may possibly give relief and stop the itch? There are no evidences of any parasitic disease. For Pittsburgh, Pa. C. LEROI THOMPSON, M.D. [Vulvar pruritus is often intractable, and_as often yields to very simple medication. years we have been accustomed to test the vaginal secretion with litmus-if found very acid, we prescribe some alkaline douche such as a sodium bicarbonate or borax solution; if strongly alkaline, we often use diluted vinegar, making sure that it is of vegetable extraction. Then, too, we have frequently cured such cases as yours by injections into the vagina twice daily of corrosive sublimate solution, 1 to 3000. Of course, other physicians had failed on the case because they had not used it on account of their being "no (perceptible) discharge"; don't trust your eye as to existence of irritating discharge in minute amount. . An The compound resorcin ointment will generally alleviate all such cases, and cure many. Oleate of cocain is efficient in allaying the itching, and this is often tantamount to a cure. Antipyrin, internally, is usually efficient in cases complicated by "nerves." A saturated solution of alum, in water, is often successful in these cases. aqueous solution of silver nitrate, 20 grains to the ounce, painted frequently over the affected parts seldom fails to produce satisfactory results. A dram of ichthyol to the ounce of vaselin is another of our favorite remedies in this condition. Perhaps we have given you some suggestion along a line you have not yet tried, and we feel sure some of the above will give you the boon of a cure, for we have not failed on a case, so far; but. we admit, we have often had to "change the medicin."—ED.] Papulo-Vesicular Eruption. EDITOR MEDICAL WORLD:-I have a case which is causing me considerable trouble and would like to have some information from you or some of THE WORLD readers. The history of the case in part is as follows, taken December 16, 1914: Mrs. A. R., age 30, married; occupation housewife, nothing in family history more than her mother suffers some from rheumatism. Patient has had mumps, whooping cough, malarial fever seven years ago. Menstruated at 16 years of age; never regular, go from 4 to 6 weeks. Married at 20, gave birth to 5 children; ages from 1 to 9 years. One miscarriage eight years ago. Had puerperal sepsis at birth of last child. Was confined to bed for eight or ten weeks following. Menses have always been very painful, generally constipated, and at time history was taken suffered some dyspnea, some wheezing and often had to get up at night to breathe, but not been troubled from that any during 1915. Patient well nourished in December when first seen. At that time her chief complaint was an eruption (papulo-vesicular) on both hands and wrists. Skin was very dry and rough, cracked in many places. Inside of fingers was very dry and cracked. Could not sleep at night for the intense itching. The eruption has since disappeared from wrists and thought to be doing nicely till about 6 weeks ago it reappeared on arms above the elbows. No trouble below on the forearm. Eruption very red, more vesicular and when scratched or rubbed during sleep, as she does Would often, makes large, raw, ulcerated areas. say that a urinalysis was made. Urin was somewhat cloudy. Sp. gr. 1020; reaction, alkaline; sugar and albumin negative. Patient is at present convalescing from an attack of typho-malarial fever, during which time all signs of eruption disappeared, but during the course of that attack a turpentine emulsion was used and eruption returned in a more aggravated form than ever, seemingly. Have tried various forms of applications for the intense itching. Any of which contains any acid at all makes conditions worse. Have never found anything to relieve itching in the least, only a mixture of resorcin and milk of bismuth. If you can furnish me any light on this case, would certainly appreciate same. Sycamore, Ga. W. A. HARRISON, M.D. zoinated oxid of zinc ointment, covered with chamois skin and a bandage. This should be renewed twice in the twenty-four hours, the old ointment being removed by cotton dipped in warmed glycerin-avoid allowing water coming in contact with affected area during treatment.ED.] Epithelioma of Nose and Cheeks. Has DEAR DOCTOR TAYLOR:-I would like some help in the following case from you and "the family. Lady, age 68. Knits socks for a living. skin cancer for 15 years affecting the whole of the nose. It has spread out on each side for one-half inch; is also under each eye, affecting the inner canthus and also between the eyebrows. Eyes often inflamed. Necrosis of tissues has caused quite deep depressions under eyes and at the root of the nose. Scabs over, comes off, etc. The drawing, burning, crawling, knife-like pain night and day makes rest and sleep about impossible. The end of the nose has sloughed off. She says when she blows her nose air will sometimes come out at the corner of the right eye. Of course, there is anemia, nervousness, loss of flesh and appetite, constipation, etc. Her future is most gloomy, indeed. What can I do for her? I would like to relieve this poor woman's suffering. MICHIGAN. [If you can arrange to have her placed in the care of an x-ray specialist, he may be able to give her much relief, and to temporarily check the extension of the process. It is hardly likely, considering the time elapsed since the inception of the disease, that a cure could be hoped for. Outside of this, there is nothing in our armamentarium which promises any relief except the old reliable morphin, which will have to be given in large and constantly increasing dosage to control the pain.-ED.] Who Has Treated Burns? EDITOR MEDICAL WORLD:-Will you please inform me whether or not you have an index of all medico-legal cases that have been noted in THE WORLD? If so, will you tell me how I can secure data on cases dealing with malpractise suits in case of burns, other than X-ray burns. Have been sued for bad results (contractures) following treatment of a burn on the hand of a child seventeen months old. Any help you can give me in citing similar cases will be greatly appreciated. If you are willing to publish this letter in THE WORLD, possibly some of the WORLD "family" will be able to cite me to similar cases. I gave the child scientific treatment for two months following the burn, including aseptic management, rubber gloves, sterile instruments and dressings, skin grafting, splints, and so forth, until entirely healed, with no infection thruout and directed patient to report in case of further contractures, but failed to do so for nearly two years, and now comes back on me for damages for malpractise. Charlevoix, Mich. ALLAN M. WILKINSON. [We have no special index that you inquire about. All such cases printed in THE WORLD are indexed in the yearly index found in December of each year. Contractures following burns are due to scar tissue formation as a result of skin destruction and not due to treatment. We hope "the family" will come to your aid and supply you with all the information you need.-ED.] Intestinal Atony. DEAR DR. TAYLOR:-I am writing to you in regard to myself, and if there is anything you think you can do for me I would be more than glad. I will try to give you my symptoms as nearly as I can, and then you diagnose and prescribe. First, my liver is sluggish or clogged. My No pain tongue badly coated while constipated. in stomach whatever. Pain in lower part of my back, between my hips. I am weak; appetite, moderate. I feel lifeless. I am fifty years old. Menses sometimes. Miss five or six weeks. I have been in this condition nearly a year, and of course get weaker still. I am up all the time. No swelling anywhere. The last physician that examined me pronounced my case catarrh of stomach and liver. He has been giving me nux and pepsin and sodium phosfate, with little improvement. Have been told my kidneys are affected. I do not know what causes the pain in my back. Ga. PHYSICIAN'S WIDOW. [You appreciate, of course, that you are in the menopause, and will never again be regular in your menstrual flow. We cannot, at this distance, decide as to whether or not there may be any kidney involvement; but any capable physician, by examination of the urin, can positively determine as to this. Pay no attention to any doctor who tells you: "You have kidney disease" yet who makes no urinary examination. We take all the more interest in your case because of your being a doctor's widow, and we want to help you all we can. You do not mention "hot flashes" or nervous attacks-these are almost constant accompaniments of the "change of life." If you have them, we will let you know how to get relief from them. Have your druggist procure for you some veracolate tablets. Take one before meals and on retiring; or, if this is not sufficient to stimulate that lazy liver, take two before meals. We would continue the nux vomica in full dosage, but think you will do as well without the sodium phosfate. Pepsin may help some, and we would prefer taking it in the form of the elixir lactated pepsin, 80 grains to the ounce, using 2 teaspoonfuls in a little water before meals.-ED.] Blood Pressure at Different Ages. EDITOR MEDICAL WORLD:-Will you kindly answer me the following questions: The normal systolic blood pressure, maximum and minimum, in health (mm.). The normal diastolic blood pressure, maximum and minimum, in health (mm.). What effect would chronic Bright's have on the blood pressure? The above blood pressure for an adult. [It is now commonly understood that blood pressure readings are taken with a cuff 4% to 5 inches in width-the width of the cuff makes a difference in the reading-and then follow the rule of Faught, promulgated in 1909: "Consider the normal average systolic pressure at age twenty to be 120 mm. Hg., then for each year of life above this add 1⁄2 mm. to 120.” “Thus at age 60 the average systolic (normal) blood pressure would be 145 mm. Hg., and this estimate adheres closely to figures given by Woley, Janeway, and others' ("Blood Pressure," Faught, page 62). Brunton states that the normal pressure in children between eight and fourteen years is 90 mm.; in youth from fifteen to twenty-one, 100 to 120. Krehl and Cook give from 75 to 90 mm. as the normal systolic pressure during the first years of life. Women are generally presumed to be about 10 mm. below males in blood pressure readings, and a variation of 15 mm. above or below the normal point is not considered as having any special indication. It is to be remembered that the following factors influence the readings in health: Age, sex, time of day, size and temperament of individual, digestion, muscular development, fatigue or mental worry. Janeway believes, from examination of 200 cases, that the diastolic pressure is from 25 to 40 mm. below the systolic pressure in the normal individual. This holds good only during repose, for posture, exertion, etc., affect the two pressures unequally. Chronic nephritis has no influence upon blood pressure except as generalized arteriosclerosis complicates matters. You would enjoy the book above mentioned, publisht by W. B. Saunders Company, Philadelphia, Pa., at $3; also "Heart Disease, Blood Pressure, and The Nauheim-Schott Treatment," Bishop, publisht by E. B. Treat & Co., New York, N. Y., at $3; and "The Clinical Study of Blood Pressure," Janeway, publisht by D. Appleton & Co., New York, N. Y., at $3.-ED.] Books on Chronic Diseases. EDITOR MEDICAL WORLD:-I want an up-to-date work on chronic diseases. Where can I get it? Lamar, Mo. A. B. STONE. [We have no knowledge of any book which we think would fill your ideas. It is our impression you will do much better to procure small late books on whatever subjects you have in mind, getting one book on each subject. If you write E. B. Treat & Co., New York, N. Y., and ask for literature on their clinical treatises, we think you will find an attractive line, embracing diseases of metabolism and nutrition; nephritis; colitis; gout; obesity; new aspects of diabetes; angina pectoris; bradycardia and tachycardia; dyspnea and cyanosis, etc. Each subject in one small, convenient volume. W. B. Saunders Company, Philadelphia, Pa.; P. Blakiston's Son & Co., Philadelphia, Pa.; and Paul B. Hoeber, New York, N. Y., will also be glad to send you lists of excellent books on the subjects you wish to look up. This plan we suggest, we are convinced, will prove much more satisfactory to you than to attempt to use a single volume.-ED.] Pain and Nodules in Bone. DEAR DR. TAYLOR:-A case recently came under my observation that seems quite obscure as to diagnosis. It is as follows: Jno. W., aged 39, male, single. Four years ago tubercle bacilli were found in sputum, but no indications of tuberculosis at present. No history of specific trouble. Wassermann test negative. He complains of severe osteocopic pains in tibia, radiating down to ankle and instep, exaggerated at night or when exercising to excess. Slight swelling, but no pain on pressure. No fever or discoloration. No history of traumatism that he can recollect. Several small nodules are felt along spine of tibia. This pain has been present for past four years. Mercurials and iodids of no avail. I suggested acupuncture or counter-irritants with systemic tonics, as hypophosphites, etc. I would be pleased to have your opinion on the subject; likewise members of "the family." Leavenworth, Kan. H. FRANKLYN FITZGERALD. [We suggest that you write to Dr. John K. Scudder, Cincinnati, Ohio, for eclectic books. One of the books on the subject that would probably interest you is entitled “Specific Diagnosis and Specific Medication," by Dr. J. W. Fyfe, 784 pages, $5. For the second book, we think you will find satisfactory the following: "Instead of Wild Oats," by Dr. W. S. Hall, 62 pages, 25 cents, net. Fleming H. Revell Co., New York City. If this does not cover the subject, they have a series of books, some of which will answer your purpose.-ED.] Dog Fat for Tuberculosis. EDITOR MEDICAL WORLD:-I send a clipping from the Memphis Commercial Appeal, April 30th, for what there is in it. What comments, if any? Gold Dust, Tenn. P. B. KILPATRICK, M.Ď. [The clipping contained a letter to the editor o the Commercial Appeal in which the writer of the letter related an "old man's tale," who asserted that he knew two young men in the last stages of tuberculosis that were cured by eating the meat and fat of a fat, plump dog. In THE WORLD for |