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the facial nerve, and we yawn. This phe R Etheris.

.......dr. j

Collodii flex....................dr. )

nomenon is more easily excited in the irritable,

Acid, salicylici..

.gr. xvj

feeble, and nervous than in the more robust; Morphiæ sulph................gr. iv

and it is frequent at the onset of coma, and of

As a paint, in chronic rheumatism.

eruptive and other fevers. But why do we yawn B Aq, ammoniæ...................oz. j

when others yawn? In church, if somebody

Sp. rosmarini..................dr. ij

Lin. saponis.................... oz. iij

coughs, others invariably follow suit. In talk Liniment for muscular rheumatism.

ing to stammerers, we find ourselves stammer-

B Potass. citratis..

ing. The sight of a person in a hysterical or Liq, arsenicalis.......

epileptoid fit will often induce a similar attack

Sp. limonis.......

....dr. iij

Tinct. ferri perchlor........ ...dr. iij

in others, as is frequently seen in hospitals.

Syr. simpl.....................oz, ij

And if, in like manner, some one in our pres-

Aq. chlorof..................ad oz, iv

A teaspoonful, in water, three times a day, in mala-

ence gapes, as though fatigued, we seem at once rial rheumatism.

to associate their actions with a certain idea,

R Potass. iodidi...

.. oz, ss

the idea of gaping; we suddenly realize that

Tinct. cimicisugæ............... dr. iss

we are tired, too, and so we yawn in chorus.

Vin. colchici, .....

...... dr. ij

But what originates this association of move-

Aq. chlorof.....

ad oz. iv

A teaspoonful, in á wineglassful of water, every four

ments with ideas? Is it sympathy, mockery, jeal- | bours, in chronic rheumatism.

ousy, or what? Louis LEWIS, M.D.

B Sodæ salicylatis ............... dr.iv

Vin. colchici...

ci................... dr. ij.

Syr. limonis.................ad oz. iv.

One teaspoonful every hour, in acute rheumatism.

INDEX OF DISEASES.

fin this Index the diseases are taken alphabetically, and

Salol, gr. vi', three times a day, in chronic rher.

matism

Powdered sulphur locally, applied under hot flannel

Began in March number, 1886.- L. L.)

and oiled silk, in chronic rheumatism, lumbago, sciat

ica, etc.

B Quiniæ sulphat...................31

Potass. iodidi..

.............. gr. XXXY

Potass. bicarb.....

..............dr. j

Puly tragacanth co..............dr. iss

Aq. chloroformi.............. ad oz. vj
Shake. One-sixth part three times a day, in acuto
rheumatism involving the heart.

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B Sodæ arseniatis.... ......3j

Sodæ carbonat,...

.....oz. iv

In cxxx water, as a bath, in rheumatoid arthritis.

R Potass. bicarb.,
B Potass, bicarbonat.............. dr. iss

Sodæ sesquicarb.............ā dr. iss
Potass. acetat..................dr, ss

Vin, colchici...................dr. iss
Liq, ammon. acet..............dr. iij

Syr, zingiberis..................02, ss
Aq. dest.................:
; ........... ...oz, iss

Aq. dest....... ......... ad oz, viij For one dose, with dr. ss of citric acid in oz. ij of Two tablespoonfuls with a tablespoonsul of lemon. water, in acute rheumatism.

juice, three times a day, in " gouty" headache.

.............dr.j

B Lithiæ citrat.....

Potass. citrat .................02. ) One teaspoonful in hot lemonade, every two hours, in muscular rheumatism.

B Lithiæ citratis .................. ij
Potass, bicarb.....

dr. iiss
Tinct. aurantii..................02,

Aq. dest....................ad oz. iv One tablespoonsul, in water, three times a day, lo gouly headache.

R Ammonii sulphide..............gr. xvj

Tinct, aconiti..................m xij

Aq. menth. pip.................oz. Vj One-fourth part every four hours, in acute rheumatism,

R Tinct. guaiaci ammon...........dr. vj

Tinct. aconiti. .................dr. ss
Muc. tragacanth.............

........ oz. iv
Aq. cinnamomi..............ad oz. viij
Two lablespoonfuls every four hours, in chronic rheu-
matism.

R Potass. iodidi...

.dr. j Potass. bicarb. ....

.dr. ij Vin, colchici........

·m xl Ammon, carb...

..gr. xxiv . Syr. zingiberis................. dr. ss Aq. dest... ::.:.:..;:;.:::.

.ad oz. viij Two tablespoonsuls thrice daily, in rheumatic headache.

Antipyrin, gr. xv, three times a day; or gr. vij subcu. taneously, in acute rheumatism.

Ol. gaultheriæ, m xx, ter die, in subacute rheumaasm.

Cold bath, or cold wet pack, in acute rheumatism with hyperpyrexia.

B. Vin, colchici ........)

Sod. et potass. tart... partes equales.

Aq. chloroformi.....)
Dr. j ter die, in chronic rheumatism.

Osmic acid, me iv (100 per cent. sol.) hypodermi. cally, in muscular rheumatism.

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R Chloral hydrat. .................dr.j
Acid, salicylici, ......

cynici................. dr. ss
Ung, stramoni.................. oz. j
Misce. As an ointment, in acute articular rheuma-
tism.

R Succi limonis, .................oz, iss

Syr. limonis...... ............oz. j

Inf. chiralco... ........ ad oz. viij Two tablespoonfuls three times a day, in subacute rheumatism.

B Acidi salicylici,

Potass. bicarb.. .............. da dr. v

Aq. dest......... ............ oz. ij
Dissolve and add

Tinct, nucis vom............... dr. ij
Sp. lavand. co..................dr. ij

Syr, simplicis..............., ad oz. iv
One teaspoonful, in water, every three hours, in
acute rheumatism.

& Potass. iodidi. .......... dr. ij

Vin, colchici,
Syr. simplicis... ........ Kā oz. ss

A. menth. pip.................02. V
One tablespoonful three times a day, in subacute
rheumatism.

Those articles of food which contain the largest percentage of nitrates are the best builders of the muscular system ; phosphates are most needed for the nerves and brain; carbonates help to form the fat. Beans, peas, oats, salmon, eggs, beef, all contain plenty of ni. trates; the same foods, and, in addition, codfish, contain an abundance of phosphates; butter, rice, cabbage, corn, beans, provide the carbonates. Eggs fried in butter, or codfish similarly treated, constitute a perfect Aeshformer.

Hemorrhage from wounds of the scalp is generally arterial, although it does occur, as a rule, in jets. It is to be recognized by its color. Venous hemorrhage from the scalp is of course darker in color, and indicates injury of the cerebral sinuses.

If a little bile be added to human blood, small, right-angled crystals will soon develop; horse's blood will develop cubes ; pig's blood, right-angled prisms; sheep's blood, rhomboidal plates; chicken's blood, cubes, more or less regular; but the blood of a dog will present precisely similar crystals to that of a man.

B Ext. jaborandi o................dr. iss
Soda bicarb,

............ dr. ij
Aq. dest ....... ...........ad oz. iy
One teaspoonsul every three hours, in acute articular
rheumatism.

B Ammon carb..................dr. ss

Vin, colchici..................dr. ss
Tinct. aurantii................02. ss

Aq. dest ...................ad 02, iss
One teaspoonful, in Apollinaris water, every four
hours, in rheumatic headache.

The Current Medical Thought.

Temperature in Jaundice.

In case of jaundice, the bodily temperature ""Knee-Jerk.”

is abnormally low, except in those instances

where jaundice is occasioned or accompanied “ Knee-jerk" is the most familiar and most | by a disease which of necessity begets fever. demonstrable of the tendon reflexes. It is When the liver is performing its functions naeasily tested by hanging the leg of the patient

| turally, much heat must necessarily be generaover the fore-arm of the physician, whose hand

ted by the rapid chemical changes involved in is meanwhile placed on the patient's other knee.

its work; but when these changes are lessened The leg should then be struck smartly with the

or held in abeyance, as occurs in jaundice, the edge of the hand (or with a percussion ham- temperature would fall, and no doubt affect the mer), upon the bare skin. Reflex contraction

whole system in like manner. of the quadriceps extensor muscle will be excited, and the foot will be involuntarily jerked upward. The manoeuvre should be tested on

For Bacchanalians. both legs, as a perceptible difference between | Half a teaspoonful of chloride of ammonium the two sides may indicate some pathological | in a goblet of water will almost immediately condition of the spinal cord. The absence of restore his faculties and powers of locomotion knee-jerk, however, is no posisive sign of dis to a man who is helplessly intoxicated. A ease. Reflex movements may be excited in wineglassful of strong vinegar will have the any sensitive part of the body, as the sole, the same effect, and is frequently resorted to by thigh, the buttock, the scapula, or the abdo drunken soldiers to enable them to return men. Foot-clonus, personal reflex, and tendo steadily to their barracks. achilles reflex are examples of deep tendon reflexes. “Knee-jerk” has been a common source Pain at the tip of the shoulder, so frequentof amusement among young people for years. ly sympathic of peptic disease, is also present

in cases of disease of the pancreas. The other Bones of the Insane.

symptoms include a deep aching pain below the In many cases of insanity, the osseous struc centre of the epigastrium, radiating through to tures undergo certain pathological changes, the back, chest-walls, and left lumbar region. which render them peculiarly liable to fracture on the application of very moderate force-a When the muscles of the orbit are paralyzed, degree of force in no way commensurate with

without any apparent local trouble in the eye or the effects produced. This condition espe.

brain, rheumatism will be the most likely cause, cially affects the ribs; and attendants on luna

| or else some lesion of the spinal cord. tics are open to charges of unnecessary violence, when the patients may have received their injuries through the unnatural brittleness

An enema of a strong infusion of green tea of their own bones a condition known as

has acted antidotally in a case of opium poisonosteomalacia.

ing

Frequent doses of antipyrine often change Talipes and Spina Bifida.

the color of the blood to a rich chocolateTalipes calcaneus in infants is commonly | brown. found associated with spina bifida. When the foot is drawn up permanently towards the fore

The Danger in Medical Abbreviations. part of the leg, with great prominence of the We doubt whether many practitioners of heel, a tumor constituting spina bifida may be medicine who are accustomed to write prelooked for in the lumbar spine. Club-foot is scriptions daily realize the danger their patients also frequently thus associated.

run through abbreviated formulas. Some physicians affect an extreme brevity, as if it inti

mated their superior familiarity with the maThe hysterical paralysis of the bladder, which teria medica One of the best we ever knew is not infrequently met with in young females, always wrote out fully the names of the drugs generally yields to the administration of ergot in a clear hand, and took time to do it. How and strychnine ; say half a drachm of liquid many sick persons have been poisoned by excuextract and five or six minims of liquor strych sable mistakes on the part of the druggists in niæ (P. B.) in chloroform water, three times a deciphering prescriptions it would be difficult day. Of course the catheter is sometimes, but to say, and the many jokes said to have been not always, required.

practised on drug clerks whereby meaningless scrawl was translated into a bottle of some com- | Dr. Mathews on the Treatment of Hemorrhoids. pound, have a basis in fact.

At the last meeting of the American Medical From an exchange the following list is taken,

Association, Dr. Joseph M. Mathews, Professor

A which shows how some common modes of ab

1 of Surgery and Diseases of the Rectum in the breviating may be interpreted to mean severally

Kentucky School of Medicine, Louisville, read from two to five different things, some poison

an interesting paper on the above subject. He ous :

thinks that hemorrhoids is a disease of middle ( May mean Acidum Hy- | life, and that they seldom affect children and Acid. Hydroc. drochloricum, or Acidum old people. He also thinks that there is no Hydro cyanicam.

anatomical basis for the classification of hemor(Acontine.

rhoids into venous, arterial, capillary, etc. As Aconit. Aconiti Radix.

to treatment, he was opposed to carbolic injec(Aconiti Folia.

tions from the start, and he gives the conclusions SAmmonia (alkali.)

of Dr. Andrews against this method, although Ammon. 7 Ammoniac (gum resin.)

he does not seem to have tried them himself. Aqua Chlori

It is true that there has been some bad effects Aq. Chlor.

from this method ; but it is now claimed by Aqua Chloroformi.

some of the later writers that these all arise from (May often be read Aqua Aq. Fontis.

the use of too strong a solution of the acid, and 7 Fortis.

that with the use of a solution of from seven to Calc. Chlor.

(Chloride of Calcium. fifteen per cent. the method is perfectly safe. 7 Chlorinated Lime.

Dr. Mathews also opposes dilation of the (Chlorine.

sphincter, claiming that it is impossible to Chlor. Chloroform.

remove or cure a well-developed hemorrhoid in Chloral.

this way. Above all other methods he favors (Emp. Lytharg (lead plas.

ligation, and his remarks upon this method are ter, old name.)

well worthy of quotation in full. Emp. Lyt.

Emp. Lyttae (blistering "The Ligature.--Certainly, of all known plaster.)

methods, the ligature stands preëminent as an (Extractum Colchici.

operation for internal hemorrhoids. It has Ext. Col.

stood the test of years in the hands of the most Extractum Colocynthidis.

eminent surgeons. To-day it is the most popu( Calomel.

lar method. Easy of execution, free of danger, Hyd. Chlor. Corrosive Sublimate.

and rapid in its results, it can but command (Chloral Hydrate.

the attention of all who are interested in this ( Hydrargyrum (mercury.)

operation. To the principle involved in the Hydras (hydrate.)

use of the ligature all are agreed, but the method Hydrochloras (hydro of application is to a certain degree disputed. Hydr. chlorate.)

The method, as practiced by Mr. Allingham, Hydrocyanas (hydro is to dissect the hemorrhoidal tumor away from | cyanate.)

its attachments, and then to surround the (Hydriodas (hydriodate.) remainder, at its base, with a tight silk ligature. (Ammonia Mixture.

For the first few years in special practice I did Mist, Ammon. Mixture of Ammoniac the operation after this plan. I then modified l (gum resin.)

it for these reasons: 1. It was misleading to (Hydrate of Potash

teach students after this fashion, because there Potass. Hyd. 1 (caustic potassa.)

was much danger in their dividing the artery Hydriodate of Potash which supplied the tumor. 2. There was more (iodide of potassium.)

cutting than was necessary. -Phrenological Journal.

“The modification consisted in running a delicate knife around the base of the pile, simply

going through the integument. This saves any The habitual use of macaroni is said to be a

be a

de

deep cut, and, at the same time, removes all cause of acne.

superfluous skin, or external piles. Indeed,

there are many cases of internal hemorrhoids The uvula is only found in men and monkeys.

which require no cutting at all. This point is

not sufficiently brought out in the books. I Pepsin helps to destroy tape-worm by diges allude to the large internal piles which have no

complication as mentioned here, viz. : super

tion.

fluous flesh, or external piles. These require benefit in these operations. In the removal of only to be brought in sight, ligated and returned external piles much benefit is derived from into the bowel. Much stress is laid upon the throwing the solution under the growth. In degree of tightness that should be accorded the the operation for internal piles I have found it ligature; some saying apply it loosely, others of little value.. advising it to be drawn tightly. I am sure that "Antiseptics. Unfortunately, strict antithe tighter a ligature is drawn, the quicker and sepsis cannot be practiced in these operations. more effectual will be the cure. A point is Fortunately, it is not as necessary as when made in suggesting the kind of material to be operating elsewhere. I am in the habit, howused in the ligature. Many preser silk. I am ever, in all these operations, of having strict in the habit of using the stoutest linen thread, surgical cleanliness as regards both the person such as is used by saddlers or shoemakers. The and instruments. If any cutting is done, the twist of silk, or other material, I am sure, has parts are dusted freely with iodoform, and the nothing tɔ do with it, as some seem to think it! gauze of the same applied over the wound. has. The kind of knot to be tied is spoken of, Results.--As the caption of this paper Mr. Allingham remarking that he ties the knot intimates, I have operated about one thousand three times. Twice is quite sufficient, and the times for hemorrhoids by the ligature. I have surgical knot has no advantages over the com: never had to operate the second time upon the mon hard knot. All internal piles existing same patient for the affection. Have never had should be ligated at the same sitting, and all an unnatural contraction around the anus as the returned into the rectum. The greatest care result of the operation, nor had ulceration or should be taken in cutting off the tumors after | stricture to result. I have had in this time one ligating. It is much best to leave the whole case of tetanus, which I believe to have been mass, rather than to have one ligature slip after superinduced by a debauch, the patient having returning the tumors into the bowel. The i been drunk for several days before the operation. presence of the mass in the gut cannot result in The tumors protruded, strangulated and morti. any harm; the ligature is between it and the fied, hence the operation. He recovered from circulation. As a rule, then, it should not be the tetanus under the bromide treatment. Have cut off. A number who have written upon this had one case of secondary hemorrhage occuring subject say that the bowels should be confined on the third day. The rectum was plugged and for from five to seven days, and a light liquid the bleeding stopped. Also one dangerous case diet enjoined. Certainly this is a mistake, for of hemorrhage which occurred one hour after two reasons: 1. In this length of time the feces operation was done, in consequence of the slipwill become hardened and impacted. 2. These ping of the ligature. the pile having been cut patients generally require all the nourishment off. The patient was pulseless and cold when they can get. When following this advice I seen, but the artery was quickly secured and have had as much, or more, trouble result from tied, and he made a good recovery. I have impaction, than from the original operation: | never had a single death result from the operaMy habit is to purge the patient the day of the tion, and but few untoward symptoms." operation, and to give an aperient on the second day after the operation, and each succeeding day thereafter, until the patient is discharged. A poisoned finger is an example of erythema, Consequently a full diet is prescribed if required. / and frequently occurs to cooks, poulterers, and When operating under an anesthetic, I always the performers of post-mortem examinations. divulse ihe sphincters, more especially if any The member becomes swollen and infiamed in cutting is done. This prevents the contracting the neighborhood of the puncture, and red of the muscles, hence obviates much pain when lines spreading up the arm represent inflamed inflamed.

lymphatic vessels, leading to the glands in the

axilla, which will also be probably enlarged. Anesthetics.--It is often asked if the opera- i Whitlow affects the distal phalanx of the finger. tion for internal hemorrhoids can be done and is accompanied by the formation of pus without the use of anesthetics. If the sphincter

cs: If the sphincter and loosening of the nail. If there is no evimust be divulsed because of the complication of idence of

dence of pus near the surface, the inflammation fissure, ulceration, or what not; or if any cut- ! is in the periosteum, and the symptoms will be ting is to be done, then an anesthetic is absolutely necessary. If internal hemorrhoids exist without any such complication, and protrude well in response to the bearing down effort, Stricture of the esophagus causes no real difthen an anesthetic is not necessary. It is often ficulty in swallowing ; but the food persistentsuggested that cocaine could be used with ly regurgitates into the mouth.

ore & cute

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