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tured abscess in the lower lobe gave the physical signs similar to those of consolidation of practically the whole left side.

6th. The discharge from the ear was very misleading indeed, but proved to be of short duration. It was likely one of the manifestations of his general sepsis. Why it stopped is impossible to say. The discharge from ear was the only sign of otitis or mastoiditis.

7th. The abscess had not ruptured until the lung was being removed at autopsy.

8th. We must remember that where rupture of an abscess into a bronchus is delayed, the physical signs are those of consolidation in the early stages. After rupture has occurred into a bronchus we get large amount of expectoration of pus of foul odor and the physical signs of a cavity.

Further, we should note that if during the course of pneumonia the time for defervescence arrives, and instead of the usual drop in temperature and subsidance of the other acute symptoms, there occurs increased fever, chills and sweats without notable change in the consolidated area, abscess should be suspected.

If after this, the fever assumes the septic type with marked morning remissions, and if no other cause outside of the lungs can be discovered, even if no expectoration of large amounts of pus be present, we can feel quite sure of an abscess.

Falls Village, R. I.

WHY GALL STONES?

BY WM. M. GREGORY, M.D.

When I took my course in a regular medical college (regular in the allopathic sense, I mean) I was told by the members of the faculty that "The whole broad domain of medicine was open to the regular physician." It ought to be, at any rate; every progressive non-sectarian physician should be perfectly free to use any and every ethical remedy that is practical and efficient, no matter who discovered it, or brought it into use.

This view of regular medicine, however, is not held by any means by many medical men in high journalistic and society positions. A few years ago I offered an article on my method of treating rheumatism to

the editor of a very prominent medical journal, telling him that the article would mention the use of many vegetable remedies taken from homeopathic and eclectic practice. He declined the article in very positive terms, stating that his journal certainly would not mention remedies taken from sectarian schools of practice.

Now, that shows a determination to make and keep allopathic regular medicine a sectarian system of practice.

If all our earnest, industrious, hardworking physicians knew the practical and efficient work that our green plant vegetable remedies will do, their use would soon be multiplied ten-fold.

In the matter of gall bladder cases, particularly those with gall-stone formation. much more can be done in the medical line than is usually done. A long time ago I read in some journal that chionanthus (chionanthus virginica or fringe tree) was the best remedy known to prevent the formation of gall stones. I have used it for a large number of cases, in the specific medicine, and can fully endorse the above statement. The patients who suffer from repeated attacks of gall stone trouble, all have a marked tendency to inspissation. or thickening of the bile, many of them being stout, fleshy, middle-aged or elderly women, who hardly ever drink any water. It is a rare thing to see a free water drinker suffering from any gall bladder trouble.

Chionanthus acts favorably by thinning or liquifying the bile, as a liver and gall bladder that are throwing off the bile as fast as formed are not likely to have any chance to form gall stones.

About three years ago a lady, aged 68, came to me from a near-by small town for treatment for an enormously enlarged liver and hepatic congestion and inflammation, which had existed for five years. She had also a terrible bad case of chronic gastric catarrh, an acute inflamation of the right kidney, and prolapse of the rectum and vagina. She had been dosed so long and thoroughly with morphine and calomel that it was difficult to get her to respond to any medicine. Her stomach was in such a totally broken down condition that I was forced to feed her entirely on malted milk for six weeks or two months. Her sister, a nurse, gave me my first valuable indica

tion for treatment. She said the patient had not had a natural looking passage in three months, some stools white, some gray, some putty color, in fact all colors but normal. I put her on chionanthus and kept her on it Of course I gave as well gelsemium, veratrum, bryonia, apocynum, cinchona, chelidonium and sodium salicilate, to meet the conditions of pain, fever, vomiting and suppression of urine as they arose. After taking chionanthus liberally for a long time, her passages gradually became black, and remained black for at least a month (getting rid of old, long-stored-up bile). After being black for a long time they turned to the natural color and remained so. The constant pain in the right side gradually passed away, her stomach gradually resumed its functions so that she could take solid food, and most wonderful of all, the enlargement of the liver all disappeared! This woman's liver was SO greatly enlarged as to be plainly noticeable to any one. She was examined by several other doctors besides myself, and after a year's taking of chionanthus the enlargement had entirely disappeared. It was a result I had never hoped for, and I shall always be sorry that I did not measure the patient "before taking and after taking." Since then she has remained well, although she takes some of the bitter medicine if her liver makes any suspicious motions.

Now, although this was not a case of gall stone trouble, the result was certainly a wonderful victory for specific non-sectarian medicine. This woman had been suffering constantly for five years, and under conservative or sectarian allopathic treatment she had nothing but suffering to look forward to. In the usual gall stone case with the attacks of violent pain and vomiting, often followed by jaundice, I find that the chionanthus uniformly stops the trouble. I usually give it combined with specific chelidonium, bryonia and gelsemium. Readers will probably ask, how long does it stop the trouble? An old lady who had had four attacks in one month took the chionanthus for a long time and has had no recurrence in nearly three years. Several younger ladies had had their attacks promptly stopped by the chionanthus, but have come back once or twice during the year for another prescrip

tion of the same, as their liver showed signs they did not like, and they said they did not want to run any risk of getting into trouble and pain again. None have had any actual recurrence.

It is a great aid in keeping these people, so subject to hepatic torpor, in good condition when not under any active treatment, to keep them supplied with the gastrohepatic pills of podophyllin, lepandrin, hydrastis, aloin, capsicum and gamboge. The regular use of these pills is a great help in keeping the stomach and liver functionating normally. It is to be understood that the remedies I have mentioned are the specific green plant preparations. Berea, Ohio.

THE CAUSE OF PREDISPOSITION OF

DISEASE.

BY JOHN A. FISCHER, M.D.

That the cause of disease is still in doubt, is evident by the variety of opinions of scientists of the various schools of medicine. many of the prevailing theories do not deal with the cause at all, but rather with the results. In the clinics and laboratory the individual patient himself appears to occupy but an incidental position.

The most perplexing problem, and without doubt the keynote to treatment of disease is to find and remove the cause. In a recent publication a writer compares science to that of a ship beating to the windward, now to one side, now to the other of the straight line toward the port ahead.

And every now and then it is well that the position as regards the true course should be determined. The chaotic state of our science to-day is largely due to the serious blunder we have made in failing to investigate the question of susceptibility and predisposition. We are familiar with and agree that the cause of disease should be classified into two classes:

First-A predisposition or a cause from within.

Second-The exciting cause, or the cause from without.

Of the predisposition our text-books tell us nothing except perhaps charging it to heredity, or ignoring it entirely.

Osler, in his latest work, under "Predisposing Cause of Diphtheria," says: "Individual susceptibility is a very special factor; not only do very many of those exposed escape, but even those, too, in whose throat virulent baccilli lodge and grow."

This illustrates the importance of determining the predisposition of the exciting cause we are more familiar as scientists have devoted more of their attention to this cause and now hold bacteria, miasms, climate, errors in diet, environment, etc., responsible.

I do not question the influence of these factors, but inasmuch as individuals exposed to either of these influences do not manifest the same symptoms or pathological changes, we are compelled to consider the morbid disposition which lies within the human body, again the predisposition.

About a year ago my attention was called to some remarkable cures by spinal adjustments. They hold the view that all diseases, excepting those caused by traumatism, are due to a subluxation or a misalligament of one or more vertebræ, causing pressure of the spinous nerve at the intervertebral foramen and interfering with the nerve impetus to the organ or tissue it supplies.

The first question that enters our mind is, how can the sympathetic system be influenced by a displaced vertebræ? and in order to answer this question it will be well to refresh our memory as to the anatomy and physiology of the spinal nervous system. The spinal cord is continuous with the medulla oblongata, and extending downward fills the cavity of the spinal canal in the vertebral column.

The spinal nerves spring by four long series of roots, namely, an anterior and a posterior series on each side of the cord, and make their exit through the intervertebral foramen. There are 31 pairs of spinal nerves. The anterior roots convey motor impulses while the posterior roots convey sensations. According to Luschka, each spinal nerve at its exit from the intervertebral foramen gives a small recurrent branch which receives a communicating twig from the sympathetics, and reenters the neural canal to be distributed to the meninges and blood vessels within the canal.

Morris describes the gangliated cord as consisting of a series of ganglia united together by intervening cords. Morphologically speaking, there should be thirty-one pairs of ganglia, that is to say, a pair corresponding to each pair of spinal nerves. We find, however, owing to the cohesion of certain ganglia, particularly in the cervical region, that the number is reduced from thirty-one to thirty-three pairs.

Gowers defines the functions of the spinal cord as follows:

First-The spinal cord conducts motor nerve impulses from the brain and sensory impulses to it.

Second-It constitutes a series of centers for reflex action.

Third-It contains certain centers that ultimately govern nervous action in structures under the immediate control of the sympathetic system, the bladder, rectum, blood vessels, etc.

Fourth-It influences the nutrition in all parts to which its nerves extend.

The sympathetic system was supposed to be a separate system linked, it is true, to the cerebro-spinal system by numerous communications, yet possessing in their ganglia a certain governing power independent of the cerebro-spinal axis.

It is now (according to Morris and others) generally admitted that the sympathetic nerves are merely the viseral branches of the spinal nerves, and that certain ganglia connected with the sympathetic are capable of automatic action.

Understanding, therefore, the importance of the spinal cord as conductors of sensation and motion, and realizing that health is dependent upon the perfect and harmonious co-operation of all the various parts and organs of the body, each performing with unfailing precision its own individual task in the great commonwealth of which it forms a part, any interference of nerve impetus due to pressure or irritation will naturally result in disease.

254 S. 16th St., Philadelphia.

A writer in the Medical Standard says: "Now for croup! Calcidin-a proprietary remedy I know-certainly does give relief in these cases. However, be on the lookout for diphtheria, and in every suspicious patient give a dose of antitoxin."

TYPHOID SOMNAMBULISM.

BY JASPER SELKIRK, M.D. Typhoid somnambulism is the nomenclature for the new complexus recently recognized by Dr. Us. He came home from McWhat's, looking worried; and if a man looks like it, he is it. His better part may be it and not look a bit like it.

Some time ago Mrs. McWhat took cold and skipped her periodical. Dr. Us refused to give her a thing to help her blow out her cylinder and take up twelve baskets of fragments; and ever since she has knocked as the sparks fly upward. The doctor blamed Jake, and that ungrateful old sucker said it was all his wife's fault.

Comes now Jake McWhat with a case of typhoid fever of serious type. Mrs. McWhat tried her dumdest to get Jake to send for that old booze fighter, Hinkmully, on the ground that he could break up anything. But it was not for this feature of the case which caused the world to look blue instead of red to Dr. Us by any means.

While the doctor was wrapped in the garment of intense medical reflection the south wind of inspiration blew softly. through his whiskers; and he suddenly picked up his satchel and started out towards the McWhat domicile, busily engaged in pursuing his good idea. Alighting at the door he entered quietly and found the wife chasing flies off the typhoid focus with a horse-tail brush in her right hand; meanwhile doing a chore now and then with the left hand, and anon accenting an occasional twin. When Mrs. McWhat is busy at both ends she is still able to use her tongue, and was not inclined to-day to make any bones of having tried to pursuade Jake to send for Hinkmully, because he was so good at breaking up things.,

Right here the trouble commenced. Dr. Us informed the folks he intended to use typhoid bacterin instead of the old-fangled dope. There was a reason. Jake might die. If he did the old moss-covered, bill would be interred with the bones. If he pulled through the dead and down bill would show a new ring of concentric growth under its bark. But that was not it.

The inspiration concerning using Jake as a case of justifiable scientific research. A

medical man can put up with a whole lot, in the interest of science; and with Lady McWhat on the butt end of this typhoid fever job there was sure to be something doing every day. However, as Emerson, the New England transcendentalist philosopher has it, there would be compensations. Dr. Us could literally feel himself repelling boarders at the next meeting of the county medical society to be held in the city, and acting the role of therapeutic light shedder. And he a country practitioner, too, mind you. He encored himself several times at the very thought as he plodded his weary way, like the plowman in the poem.

Mrs McWhat tried to make a breach in the walls by declaring how people objected to such spots chosen for the injections. The doctor paid not a lick of attention on earth to the invidious criticism, but viciously grabbed the tail of Jake McWhat's shirt and ripped it midships in his efforts to make way for liberty; as if it had been flimsy tissue paper wrapped round a Christmas gift.

Dr. Hinkmully told Mrs. McWhat that serum for treating diphtheria and typhoid fever was obtained from the horse. He knew Jake got hay fever from the smell of horses in summer time, and he shut his eyes and suggested that the old man might go the way the young man did in Philadelphia the other day when he was forced to take a prophylactic dose of serum for diphtheria.

One recommendation for Dr. Us in his willingness to discuss the new methods with his clientele. There is method in his very madness. He finds it acts as a fixing bath to his ideas, if they are passed through the lay mind. It might have hurt his feelings if he could have caught Mrs. McWhat impersonating him behind the big front door after a visit, and insinuating he was a wind bag; it is morally certain he would have raised her ante by charging the regular fee for a consultation, if he had suspected her ulterior motive in saying the gizzard exercises great influence over the brain of the medicated fowl under extenuating circumstances.

Dr. Us gave Mrs. McWhat to understand the oldest clinicians of to-day still remember when it was possible to treat typhoid fever without a thermometer. He even piled Pelion on Ossa by claiming they

thought they were progressive because they had quit using the lancet. Madam at once shied her hat into the ring by declaring a man ought to be bled once a month in order to keep abreast of the women who thrive best under at least twelve hemorrhages per year.

One of Dr. Usses slogans is this: “Ours is the Serum Therapy Age." There is plenty of elbow room for diagnostic skill and instruments of precision. When he lugged his sphygmograph into the sick room Mrs. McWhat came near exploding with curiosity. She had an ingrown toenail on her mind regarding the existence of heart disease in her family tree; and believes in the possibility of inheriting something. Jake told her once Dr. Us said she had a tapeworm, and she had an intuition that the sphygmograph looked like a detector for that parasite.

Walking typhoid and typhoid carriers were novelties to the McWhats. It never rains but it pours. Having a long spell of sickness is the same as living on expense, but it is a post graduate course in information. Frequently Mrs. McWhat had the sensation of being a Thanksgiving turkey stuffed with roast sweet potato dressing until she had her passage over the fence with the neighbor woman. Unfortunately for accuracy descriptions of the sphygmograph in going over the fence got tangled in the neighbor's mind with carriers and walkers and Widals.

In three weeks Mrs. McWhat, who was naturally a bright and shining woman, learned to speak the typhoid fever lingo remarkably well and enjoyed holding learned disquisitions on the immemorial probabilities. Egyptian mummies ought to be arrested by the Department of Health in the United States Government on the ground of being typhoid germ disseminators. It never dawned on the statecraft of Rameses of the Oppression that mummies could be unsanitary. If it did Lister plagiarized his doctrine of antisepsis from the boneyard of antiquity. Grains of wheat and vegetable seeds retaining fructifying power become as cities set on hills that cannot be hid and teach that the bacillus typhus, which is as truly vegetable in origin as a grain of corn is mighty to the pulling down of strongholds to the uttermost roots. But it is bet

ter to bring this paragraph to an untimely end rather than to branch into a description of Mrs. McWhat's idea of the meaning of the term, Esophagus.

Before Hippocrates observed and wrote, it was known how typhoid fever had a bad habit of metastasis coupled with the formation of pus cavities in bone. Dr. Us came out powerful strong on the subject of the Sussex man, whose skull has lately been dug out of the era way down below the hard coal strata. The missing part of the lower maxillary undoubtedly creates a typhoid fever assumpsit. Mrs. McWhat is inclined to believe the relic is the Biblical jawbone used on the Philistines by Samson. Her theory of a pus focus in the symphisis is on a par with interpretation of the Esophagus.

Mrs. McWhat is puzzled to account for the appearance, on schedule time of the typical symptoms of typhpid fever, if the old-style diagnosis was built on the shifting sands of empiricism, rather than on the solid and eternal rock visible under the high-pressure microscope. Patients used to go to bed and develop these symptoms peculiar to a self-limiting disease, and it almost seems to the lady that typhoid fever can think out its course beforehand. Worse still, she pretends to be surprised that people can die of typhoid, if all the doctor's arguments concerning the improvement in typhoid are true. Old ways of doing things are good enough for her; videlicit, having offspring, reckoning time and paying bills.

Her request for the names of some of the diseases which used to be mistaken for typhoid fever was met by Dr. Us in particularizing a few: larizing a few: Appendicitis, la grippe, insidious pneumonia, fevers of malarious type, obscure intestinal complaints, tuberculosis.

Mention of a well worn clinical picture known as the typhoid state made Mrs. McWhat incubate a mental reservation in favor of consulting Dr. Hinkmully on the fragmentary state of medical knowledge regarding actual conditions in the belly and circulation. A woman reasons by analogy. Her own times of sickness are frequently connected with belly symptoms and she is constitutionally inclined to sniff at a malady located half way between the navel and the dilemma.

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