CRITICAL COMMENTS. Editor Medical Summary: According to Dr. Osler, a man has no excuse for living after sixty years. Newspapers made fun of the doctor, who expressed an opinion which was his right. It is to be hoped that the doctor will live long and continue his useful life, and by so doing demonstrate the falsity of his own theory. Many able men have done so in the past, and their work has been excellent. A man is often at his best at sixty, especially in the professions, where experience is a factor we think of value. Two aphorisms should be written in letters of gold, and placed before the public, to wit: "Old men for council, young men for action." "A woman is as old as she looks; a man is as old as he feels." The Indians often kill off their old men and women, the civilized man protects and supports them. Dr. Osler would chloroform them after sixty years of age. I wonder if any good would be accomplished if he were taken seriously? Let the old men and women live, even if they do but little good. They may be "has beens" and "back numbers" and "antiques," but they can give the youngsters much advice of value. "Young men think old men are fools; Old men know young men are fools." "Experidentia docet," and who has it? The old man and woman. Every creature of God is of value to the world. This is a world where the moments fly, Where once, when the day has flown Let us, then, while here below, We hope to occupy one day. MILTON A. WILLMENT, M.D. Editor Medical Summary: I have been favored with a number of "peppery" letters, which lack depth, but giving full measure in length, anent, my communication replying to my friend Doctor Servoss' article. Replying generally, and particularly for the benefit of my correspondents, would simply state that when a writer publicly airs his views, he invites and expects criticism, lack of this recognition, from an author's standpoint, is too painful to contemplate. When a man seeks oblivion he does not rush into print, though frequently his literary efforts may produce the opposite of his desire. No sane mortal claims to enjoy a monopoly of wisdom, yet much depends on the manner in which words are employed "It is the tone that makes the music." And when I criticized and contradicted it did not necessarily imply opposition. "To contradict means sometimes to knock at a door, in order to know whether there is anybody at home." It is sometimes used to draw forth and to examine the weight of a man's opinion or arguments, as general propositions, without modification, often lead to very erroneous conclusions. Several letters which I have received from Doctor Servoss leads to a better understanding, and appreciation of his abilities, and demonstrate that we only differ in unimportant non-essentials, that is, regarding what has been published heretofore. Some of my correspondents lack that politeness and consideration which is due from one gentleman to another, and which mitigates the asperities in the discussion of differences. My remarks concerning country physicians seem to arouse much irritability, but I feel no resentment beyond that which is justified by the occasion. And getting down to cold facts, the conditions that obtain passeth all understanding. I am temporarily residing in a community, fifteen miles distant from the nearest town, and if I hire an auto or rig to take me there and back, the prices fluctuate between $6 and $7. When any of the residents here send to that town for a physician, he responds, using his own vehicle, and supplies medicine and charges $4 for the round trip. Comparison of the rates afford a true indication of the importance of the individuals involved. A teamster's services are rated higher. Incidentally. and ethically the worst is yet to come. The natives are less loyal to a physician than to their grocer, and having about six practitioners to choose from, they invariably call three or four in each important case. When physician No. 2 arrives, he wants to know whay that damn fool No. I was sent for, and when No. 3 arrives he throws out of doors the medicine left by Nos. 1 and 2, and if the patient is still living when No. 4 arrives, in the parlance of the village, "There is something doing." The residents are accustomed to those professional shindys, and take the doctors at their own valuation, and when conditions permit carry the seriously ill to the Philadelphia hospitals. Perhaps this sort of blackguardism is not carried on elsewhere, but the fact that it obtains here, and that I can prove it, justifies my previously-declared opinion. You will say that things are just as bad in the city, and therein you will, paradoxically be both right and wrong. Competition exists probably to a greater degree in the city, the struggle for existence is severer, but the sword-play is keener. and the methods are more refined. The raised eyebrow; the eloquent silence when a confrere is criticized: subservience to the minister; wire pulling for a hospital appointment; social maneuvering and struggling for recognition may be intense, but is politely performed, and the rewards depend on the strugglers' adaptability, resourcefulness, and primarily on the quality of his epidermis. Of course the country practitioner's prototpye also exists in the city, but instead of displaying a coarse, brutal uncouthness, his method is usually a determination to inveigle the gullible, and with that in view fills his office with the most fearsome articles of furniture, laying every branch of medical sience under tribute for decorative and hypnotic purposes. The writer recently called on a professor, and in his waiting-room, hanging on the wall, were six different photographs, signed by the donors, and each inscribed with a tribute to the skill of their dear doctor, and on the table were several hundred reprints of an article he had written years before, and the table was decorated with a frame containing a card on which was printed a request to take one. This man is a member of eight medical societies, and a visiting physician to three New York City hospitals, and a lecturer in a New York City medical college. The advertising quack who uses a daily newspaper, to my mind, is a better citizen, because when a physician is openly bad, he is sometimes then at his best. His avowal is preferable to his hypocrisy. Because a man is a physician confers on him no super-human virtues; he does not acquire them with his diploma, and I have no patience with the smug complacency and self-assertive virtues that engenders an auto-hypnotic condition not unlike a Buddhistic trance. I will not notice any personal communications respecting this letter; on the other hand, I stand ready at my own expense to prove all allegations therein contained. MARTIN W. CURRAN, M.D. Chatsworth, N. J. REPLY TO TREATMENT WANTED. Editor Medical Summary: In your October number, page 250, I notice: "An Interesting Case-Treatment Wanted." The symptoms mentioned were the effect of a cause-stuffed gut, obstruction of the lower bowels, transverse colon or sigmoid flexure or both. A careful examination should make this plain. As a rule, ordinary purgatives cannot dislodge this mass. I have treated many such cases, and resort to a coal-oil injection, giving 4 to 6 ounces mixed with warm normal salt water, and using a long rectal tube, re peating if the first one fails to induce copious evacuations within 12 hours, this will soften and loosen the dry mass; give a mild laxative in 4 hours if necessary, and don't stop until the gut is clean, and as alkaloidal W. C. Abbott says: "Keep it clean." More valuable advice was never given. If the bowels do not move one day, that night take a laxative, having a regular hour to do this, and to evacuate the bowel, go whether you feel the call or not; educate the bowel in this way. Two weeks ago I was called to a case that had been diagnosed appendicitis and found the colon "chuck full" of "Scybala." (Dr. Herrick, of Chicago, was once asked by his student, "what do you mean when you say scybala?" "Old dried dird," was the answer.) I soon had the mass making its exit from the cosy quarters it had so long occupied, probably for months, some of it so dry it floated like a chunk of pine wood. The amount was immense, and no wonder the digestive and every other organ was unable to do its legitimate work. Deep breathing will remedy the short breath, as the diaphragm can do its breathing work. In another case some undigested hardboiled eggs, the only ones eaten for six weeks, came away, having on their route down the intestinal channel lodged against a fecal sand-bar, which a flood of coal oil cut away. He was a young man, and unlike the aged, make a quick recovery. The scybala question asked reminds me of one asked a backward doctor by his student: "Doc., when you come to a word you don't understand what is to be done?" "Read on until you come to one you do understand," was the answer. He did not know anything about a medical dictionary. AMOS SAWYER, M.D. Hillsboro, Ill. EMETINE HYDROCHLORIDE. Editor Medical Summary: To advance ipecac as a therapeutic agent at this late day would seem strange, but the action of one of its products, emetine hydrochloride, is something something wonderful. Take, for instance, a chronic case of dysentery (anobic, for instance). By simply giving the sufferer one-half grain of emetine hydrochloride hypodermically daily for a few days, or one-half grain twice a day for from three to nine days, and in that time he will be cured. Again, in pulmonary hemorrhage, the same procedure will arrest the hemorrhage, and when you have a hard case of skin disease (call it by any name you chose) try emetine hypodermically. When given by way of the mouth this drug will not act, and if anything, may cause vomiting. The price of the drug is anything but cheap. Merck & Co. offer the drug at 85 cents for one grain, or $3.50 for five grains. And Burroughs, Welcome & Co. English firm) offer twelve hypo. tablets of half grain each for 25 cents. So, you may take your choice. R. D. FAIRFAX, M.D. 1924 4th St., New Orleans, La. [For the information of our readers, we will state that Parke, Davis & Co. have just off press a brochure on Emetine, which contains an interesting description of the new method of treatment. A copy of which can, no doubt, be had simply for the asking.-ED.] WHAT SHOULD SHE BE? Editor Medical Summary: The kind of a wife a doctor should have is very important. She should be very discreet, reveal nothing of her husband's business, eschew gossip, be sociable, but not familiar, have no select coterie of friends, but be friendly with everybody. She should never give a "blow-out" to an especially invited company, as by doing so she is almost sure to offend some of her hus band's patrons. Better to never give an entertainment, except to relatives. Public receptions, where every one is welcomed, might be a good stroke of policy, but it might be construed as a means to push the doctor's business, and might be criticized by his professional colleagues and their wives. It is better to refrain from public entertainments, and even private functions at her own home. If the doctor's wife be a club member, it would be all right to have such club meet at her home. Like the minister's wife, a doctor's wife is prominently in the limelight, and she can't be too prudent in her intercourse with the public. Above all things, a wife must not blow her husband's horn. He shouldn't blow it himself! Some doctors do, though! What is needed to-day, is more women who live the true domestic life, without the extravagant, fashion-crazy habit. They should be devoted not only to their husband's success, but should be good Christion and good mother. Such women will not only do for doctors, but for ministers, lawyers, and merchants. The great Dr. Chapman said: "My wife made my home the pleasantest place on earth to me." Another said: "My domestic enjoyments are as near perfect as human conditions would permit." Garfield said of his wife: "I never knew her to make a mistake." Jeffersonville, Ind. By D. L. FIELD, M.D. each week. In general, use sliced apples and celery instead of bread and potatoes. If this diet is followed, there should be a loss of from 22 to 3 pounds each week, and in many cases 4 pounds. This should be kept up until about 15 ponds is lost, and then go back to ordinary diet, reducing quantity of sugar, white bread, cream and much liquid. Diet can be resumed after a rest of three months. Hold your reduced weight for a while. It may be well to do this dieting act several times a year. Chew your food slowly and avoid liquids as much as possible during a meal, and all fluids should be sipped slowly. All intoxicating liquors should be eliminated. REPLY TO TREATMENT WANTED. Editor Medical Summary: I will remind Dr. C. W. Canan, page 250 October SUMMARY, that massage and the following diet list observed might benefit his case: MORNING MEAL-Fruit, an orange or sour apple, or half a grape fruit without sugar, half slice of white bread, a softboiled egg, cup of coffee or tea with small amount of cream; if desired sweetened with saccharine tablet. NOON MEAL-Lean meat of any kind (quarter pound), half slice of bread, a moderate amount of fruit, except bananas; if desired, celery, spinach, asparagus or cabbage. EVENING MEAL-Clear soup if desired, any kind of meat, including also fish (quarter pound), prepared as desired, one or two of the following green vegetables: Spinach, string beans, green peas, celery, asparagus, sliced tomatoes, or Brussels sprouts. For dessert may be taken small quantity of plain rice pudding or small cup custard, or fruit, either cooked or raw, cup of tea without sugar. The total quantity of liquids taken in the form of water, tea, coffee, etc., should not exceed five glasses during the twenty-four hours. Keep an accurate record of weight LEUCORRHEA: ITS MODERN TREATMENT. BY THAKUR RAM DHARI SINHA, L.T.M.S. Medical Practitioner. Leucorrhea is both a symptom and a disease. In order to treat it rationally and scientifically, its varieties and causes should be, as far as possible, ascertained. According to the locality-it is vulvar, vaginal, cervical and uterine. The discharge from the former two is acid and from the latter two alkaline. Its causes are both local and constitutional. I. Local Causes-Inflammation of vagina, vulve, &c.; displacement, congestion, laceration, subinvolution, catarrhal conditions, amenorrhea, dysmenorrhea, new growth, local irritation (as from pessary, &c.), excessive and rough coitus, worms, &c. II. Among constitutional cases may be mentioned constipation (autotoxemia), anemia, general debility, prolonged lactation, unhygienic conditions-bad air, meagre diet, worry, &c., and gonorrhea. Obviously, the treatment is local and constitutional. Remove any local condition causing it and improve the general health. To begin with, give calomel, gr. 1/6; podophyllin, gr. 1/6; bilein, gr. 1/8, and sodium bicarb., gr. 3, for a dose, repeated hourly or every second hour for two or three doses only, and followed by salines, sulphate of soda or magnesia. These should be invariably given as long as the bowels are filthy. Internally, either of the following may be given with advantage: Hydrastis (colorless); sp. medicines, mangifera indica, ferri sulph., ergotinum, triple sulphocarbolates, calcium comp. (calcium lactate gr. viii and calc. chloride gr. iii), hydrastine comp., calcium lactate and calcium sulphide. The diet should be nutritious and easily digested; exercise in the open air, general cleanliness, avoidance of hot condiments, alcohol, late hours and worry. Locally-saturated solution of magnesium sulphate 3i; glycerin 3i; tinct. thuja mx; carbolic acid, mv; to be applied soaked in cotton preceded by warm douche. Vaginal antiseptic, ext. pinus canadensis (white), listerine, 2% watery solution of picric acid, to be injected twice daily and retained for 5 or 8 minutes; specific medicine, magnifera 3ii and water (warm) to be injected two or four times daily. Persistence and perseverance is sine qua non in the treatment of such diseases. Forced drinking of copious water is also very essential for those women who are habitually constipated. "Diagnose very carefully and patiently, fit remedy to condition, always push the selected remedy to effect" is a trite but true saying. Motihari, India. MAN'S FINISH. Editor Medical Summary: "Man that is born of woman is of few days, and full of trouble. He cometh forth like a flower, and is cut down; he flieth like shadow, and continueth not." I have a patient, 89 years old; and another past 80, and one in her 79th year. Their testimony is that their lives have had largely more gloom than sunshine; more sadness than joy. And I have no doubt that in all old age, where there has been a constant struggle for a living, the end of it is welcomed by death. The rule of those who live to old age is that they long for release and the rest of the grave. The fewest number of octogenarians have been so blest with an abundance of this world's goods that they don't welcome the end of mundane existence. One octogenarian, when informed that his end was near, said, "It's all right; my trunk is packed!" It is a beautiful circumstance, that a man so lives that he faces the end "like one who wraps the drapery of his couch about him and lies down to pleasant dreams." That's very different from the death-bed of Benedict Arnold, who, forsaken by those who used him, in his delirium and tortured remorse, exclaimed: "Bring me the uniform I wore when fighting the battles of freedom! May God forgive me for ever having worn any other." Jeffersonville, Ind. D. L. FIELD, M.D. Arbutin in some troublesome bladder cases often acts like a charm. |