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lus so closely in appearance that it has often been forms have a rolling, rocking motion from side mistaken for tubercle bacillus in genito-urinary to side, their cilia being likewise in rapid vimicroscopical work.

bratory motion. The preceding being an introduction, we This motion of the forms, and the vibrawill proceed to consider various diseases, or tion of their cilia, are extremely irritating phases of the same and the relationship of to the afflicted person. These forms are to microbe invasion to their manifestation. be found mostly in the thin, watery dis

The first we will consider is that abnormal charge from the nose. They may be discondition or rather one phase of it-known covered in the tears that flow from the eyes. as epidemic influenza, or "la grippe." In not all forms of influenza or "la grippe" Asthmatus Ciliaris.

do we find these organisms. Neither are

they so common in the south as in the north. This is the name given to the forms we However, the writer, while serving on the are about to describe. Kent, in his manual Bureau of Medical Relief, during the epion “British Infusoria,” describes them un- demic of yellow fever in Jacksonville, Fla., der this name. However, I do not find them in 1888, had the opportunity of exhibiting described by Professor Liedy in his great under the microscope, using a one-fifth Gunwork on “Rhizopods” for the United States lack objective, some of these forms as they government.

appeared in the secretions obtained from a Professor Haller, in Zeitschrift für Para- Cuban doctor suffering from influenza.

Treatment. The most efficacious local application we have found for relief are sodium benzoate and thymol, both to be used as errhines.

We have also found menthol an excellent local application. Such internal remedies as tend to eliminate from the body the toxic material, the result of the life history of the asthmatus ciliaris, and tonics to take up the slack.

As a neutralizer of the poison we have found the application of calcium sulfid, gr. 1/6, three pellets to be given every hour, to be all that could be desired.

Gilmore, Fla. A. T. CUZNER, M.D.

Sanatoriums for Inebriety and Narcomania

EDITOR MEDICAL WORLD A good man Asthmatus Ciliaris. (Drawn by A. T. Cuzner, M.D.) writes me, what has become of all the in

ebriate asylums and hospitals in this counsitenkunde, Jena, Prussia, describes them as

try? That is a practical question. follows, and the writer can verify from his

From 1880 to 1890 there were over 150 own experience and the testimony of Dr. gold cure and other specific hospitals, sanaJ. H. Salsbury and that of Prof. John Phin, toriums, homes and asylums for drinking editor of American Journal of Microscopy,

men. That was the acme of that great charthe accuracy of this description.

latan movement, which claimed that it had Infusorial catarrh is purely a parasitic disease

discovered new and absolute remedies for arising from a peculiar organism armed upon one side or at the end, or all round, with cilia.

the cure of spirit and drug neurosis. This organism assumes a variety of shapes and From that time there has been a steady sizes. By watching its development and meta- decline, and now, twenty or more years morphosis under the microscope, it may be seen

after, there are less than thirty institutions to transform itself into many different forms. The most usual shapes appear to be either spher

and homes, including the three-day cures, ical or oval. Each frequently sends out a pro

in operation. boscis, at the end of which is an elongated and Forty years ago there were eight or nine dilated cilium. center of the mass of cilia or at the side or end. hospitals, both scientific and semi-scientific, It may be drawn in, leaving a nipple-like ele

at work in this field. To-day there is about vation, or it may disappear entirely. These the same number or less. Two are State institutions or farm colonies. Three or

fectual. All such patients want institutional more are semi-scientific, using religious and then home treatment. Then the posmeans and methods, and promoting special sibility of cure will be the rule and not the ideas of cures. There are two or three more exception. A very few places now in operathat are strictly scientific with no mysterious tion have proved this fact beyond question. drugs or guaranteed cures.

The great central fact which every phyOn the other hand, there are 150 or more sician should impress upon drink and drug hospitals, surgical and medical, insane asy- takers is, that they must go away and secure lums, homes for mental diseases and sana- first-aid treatment at once. Then they can toriums for nervous cases that have distinct come back and continue under the charge wards for inebriates and drug takers. Some of the family physician, and restoration will of them are more or less crowded with this be sure. There is nothing mysterious about class of patients. All of them advertise this but common-sense use of the means and receive such persons, and it has become and measures, but they must be associated quite a feature of these various institutions with radical change of living and surroundto give aid and help to this class.

ings at the beginning. All practical men in charge of these in- There are more institutions to-day than stitutions complain that these are very dif- ever before in the world, and a greater deficult cases to treat, unless kept by them- mand, and yet they are unspecialized and selves. Their influence is bad on other pa- the old theories that vice and wickedness tients. Inebriates feel that it is a sort of enter into the causation still pervades the a stigma to go to hospitals for the insane, minds of many persons. In all this there and that it implies that they are mentally is evolution and growth, and the direction disturbed, and both the families and friends is unmistakably in favor of small hospitals find serious objections to this kind of treat

and scientific sanatoriums for the exclusive ment. The only feature of this is that such

care of these poor neurotics. institutions can take these patients at lower

T. D. CROTHERS, M.D. rates than exclusively organized hospitals

Hartford, Conn. for drink and drug takers.

In the meantime, many men are selling specific drugs and remedies to physicians

Symposium on Circumcision. for home treatment. Others are advertis- In discussing the subject circumcision we ing boldly the special remedies they use, may not all be discussing the same operaand when tested the failure is attributed to tion. As foreskins differ, so will the operalack of skill and appointments.

tions differ. Let us all get a proper foundaOne thing is certain: the number of drink tion for our discussion, each one of us statand drug takers is larger to-day than it ing exactly what we mean by the word ever has been before. There is no doubt “circumcision.” Strictly speaking, it means that it extends into the thousands, and the "cutting around." That might mean cutting problems of treatment have not attained the foreskin loose by a circular incision the scientific prominence they deserve. where it is merely adherent to the glans, and What is needed to-day is special homes and in this case little or none of the foreskin may small hospitals, practically houses of refuge, be removed. Where the foreskin is so conwhere active men and women can retire, stricted at the extremity that it leaves only have the alcohol and drugs removed, and a very small ostium, probably a half inch of the mind and body built up, and receive a skin and a half inch of mucous membrane species of education on how to take care of is removed by the operation. Perhaps in themselves in the future. Psychic treat- many other cases, for various reasons, much ment should also be applied in the most more dermal tissue is removed. effectual way.

It is quite possible that surgeons get into A number of large cities are already pre- the habit of removing too much of the preparing to establish, or have started farm puce in their surgical operation. Only so colonies for the special care of the indigent, much should be removed as is necessary to giving them scientific treatment according meet the indication. It may be that it is to the conditions. New York has such a much more easy to remove a large section colony in operation. Cleveland has a similar of the foreskin than a small one. It may be project, and wherever these have been tried less difficult to secure a good cosmetic and in a small way they have proved most ef- surgical result by removing nearly all the




foreskin than by removing only the portion after constipation, etc. It is well to reindicated in each case. But that does not member that the same condition is to be constitute a sufficient reason for an exten- found with girls, and the loosening of the sive operation. The operation should be foreskin over the clitoris will usually reveal made to fit the condition, not the condition a number of hard concretions. to fit the operation. As to the ritual opera

Why is it that the percentage of gonortion, we do not know the extent of the tissue rhea is a great deal smaller amongst the removed. Please state, in succeeding com- Jews? The reason is that many a Gentile munications, to what sort of an operation seeking satisfaction among prostitutes for you refer. This, we think, will clarify the his imaginary excess of passion carries home situation and permit all our readers to get under his foreskin enough germs, even after a thoro comprehension of your views and the usual unsatisfactory prophylactic measavoid all misunderstanding-Ed.

ures used in such places, to give him a good

start in venereal diseases. Benefits of Circumcision.

If the physician would examine some of EDITOR MEDICAL WORLD:-You explain the babies that are nervous and not thriving in a note to Dr. E. W. Feige's article in the well, he would find most of the boys had a September WORLD that Dr. Reed, in his long foreskin with a very small opening, essay on “Circumcision Should be Abol- while the girls had an adherent clitoris with ished,” only meant circumcision done by solid concretions underneath. The circumrabbis and such like. I would take it that cision of such children would save the meant any circumcision done without proper doctor much annoyance, the mother a great antiseptic precautions. Possibly that is deal of worry, and the child a great deal what he did mean, but Dr. Reed surely made of suffering now and in after years. If a it appear in his article in the August issue doctor has such a tender heart that he canas if he meant that circumcision of any kind not hurt a child in order to benefit him, let should be stopped from a humane stand- him refer the mother to some one else; but point.

he should not denounce and ridicule a treatI fully agree with Dr. Feige. The re- ment that has saved thousands of individuals sult of circumcision is usually wonderful. from the most terrible suffering, physically, It not only reduces the irritability of the mentally and morally, and that has saved child's penis, but also the so-called passion and would save thousands of unhappy wives

, of which so many married men are so ex- from separation and the divorce. tremely proud, to the detriment of their

Elgin, Neb. L. W. WUESTHOFF, M.D. wives and their married life. Many youth

[The above writer misconstrues our note ful rapes could be prevented, many separa- to which he refers. We distinctly stated in tions and divorces also, and many an un- that note (page 352 of September WORLD) happy marriage improved if this unnatural

that Dr. Pass referred to the operation perpassion was cut down by a timely circum

formed by rabbis.-ED.) cision.

As a man's brain is excited by an erection, whether timely or untimely, a little child's

Circumcision Must be Encouraged. brain, with its unstable nervous system,

EDITOR MEDICAL WORLD :- I should like should and surely does undergo similar and

to say that Dr. A. P. Reed, of Boston, Mass., more lasting reactions. I am certain that is not a bit right in his decision in abolishmany a maniac, epileptic, or pervert could ing circumcision. The causes upon which

, be prevented if circumcised in earliest youth, he built his decision are not at all convincbecause it is the sympathetic reaction on the ing. undeveloped brain-cells of the infant that Dr. Reed says, in August World, that does the harm—a great deal more than a some people confessed to him of having dislittle masturbation during adolescence. Cir- comfort from clothing friction; others have cumcision will not prevent a boy altogether

a feeling of wanting to pull the prepuce from masturbating.

forward and unconsciously do it to relieve Bedwetting can always be cured by a cir- exposure of glans. But what should Dr. cumcision. Of course, the usual measures Reed say of the 300,000,000 of circumcised have to be employed in conjunction, such Moslems and the other millions of circumas forbidding the use of large quantities of cised Israelites? Perhaps they are not huwater before going to bed, and looking man. Do they all suffer? I have ten


brothers besides myself, and never heard a lieve it should be resorted to except in cases complaint of any of them. Yes, it is a re- where nature has been too lavish and there ligious rite, but it was made to be a religious is a decided superabundance of foreskin. In

a rite after a good sanitary thought—that of the large majority of cases merely dilating cleanliness and comfort. As a doctor in the prepuce is all that is required. medicin, I should like to say that prepuces I would like to ask why was the male sex are merely pouches of filthy microbes. But provided with such an appendage? As a perhaps Dr. Reed will say prepuces should general rule, nature does not make many be left alone as Nature made them. We mistakes. Everything is created for some will answer him, so beards, nails, hair, and purpose. Take, for instance, the clitoris in moustaches should be left alone as Nature the female. Why did nature protect it with made them. In my opinion, "they" are "all" a partial covering or hood? Because it is dirty.

a highly sensitive organ and needed a coverA case or two, or even ten in a doctor's ing to prevent friction from clothing, etc. clinic, are not a sufficient proof of the un- The prepuce is intended to act as a prousefulness of an operation.

tector to the delicate and sensitive glans What Dr. Reed should have said and penis. The argument that it allows shall would have settled the question, is that cir- I say filth to accumulate beneath it in the cumcision ought to be made early in child- form of smegma, etc., is not sufficient reahood, so when children grow they would get son for its removal. Any person who has accustomed to clothing friction.

not sense enough to keep the parts clean, ABDUL-Aziz Ramzy, M.D. which can be so easily done, should be sent Sinbellawain, Egypt.

to a reformatory. The penis is something

that is not hid away and forgotten, but is Circumcision and Masturbation. handled more or less every day; so there is EDITOR MEDICAL WORLD: In his letter no excuse for uncleanness. on “Circumcision and Masturbation" in the It is one of the strange things so far as October World, Dr. Wm. J. Robinson says my observation goes, and I have practised he is convinced “that the prepuce is one of medicin nearly fifty years, that the elongated the great factors in causing masturbation prepuce has been much more common durin boys.” Now, as it happens, my observa- ing the last twenty years than previous to tion and experience would show to the con- that time. There are ailments or diseases, trary; that an exposed glans, thru the un- also, that have become far more common covering of a sensitive part, subjecting it during the last decade, such as appendicitis to direct friction from the clothing, is quite and ovaritis. Has the modern way of living as much a cause of masturbation as any brought about these changed conditions ? prepuce can be. In the case of some mas

Sciatica. turbators the act itself, long continued, seems to practically circumcise the person

I was much interested in Dr. J. C. Dreinasmuch as the glans thus becomes more or

her's article in October World on cupping less exposed permanently, and with me,

for sciatica. That is a method of treatthese cases are very obstinate as far as cur

ment that I think has fallen too much into ing or stopping the masturbation is con

disuse. I remember relieving the pain in cerned, a fact I attribute to this very thing

a case of pleurisy before the cup was re

moved and without a return. It has been of glans exposure. In these instances there seems a congestion that gives a constant many years since I have made use of cupcondition of erotomania or eroticism. ping.

A. Noxon, M.D. Boston, Mass. A. P. REED, M.D.

Toronto, Canada. Circumcision Useful in Selected Cases.

C. F. Taylor, M.D., Editor of the Medical

World, Philadelphia, U. S. A. Editor MEDICAL World :—There has

Dear Doctor :-Of course, I received your letter, been a number of articles publisht in The including bill, and the journals in time. I am now

enjoying reading the journals; and am just feeling MEDICAL World from time to time upon that I am in U. S. A. discussing matters of the the subject of circumcision. There is an profession with the American doctors. Many thanks

for THE WORLD, old saying that truth, or, in other words,

You were asking if I were an American for my the right thing, is between two extremes. easy writing, or an Egyptian for my strange name. I do not pretend to say that circumcision Yes, as you last mentioned, an Egyptian ; obtained

my medical education in America. is unnecessary in all cases, but I do not be

Sinbellawain, Egypt. ABDUL-Aziz Ramzy, M.D.

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