THE MEDICAL FORTNIGHTLY A Cosmopolitan Biweekly for the General Practitioner The Medical Fortnightly is devoted to the progress of the Practice and Science of Medicine and Surgery. Its aim is to present topics of interest and importance to physicians, and to this end, in addition to a well-selected corps of Department Editors, it has secured correspondents in the leading medical centers of Europe and America. Contributions of a scientific nature, and original in character, solicited. News of Societies, and of interesting medical topics, cordially invited. Advertising forms close on the first and fifteenth of each month. Time should be allowed to submit proof for correction Advertising rates on application. Remittances and business communications should be addressed to the Fortnightly Press Co. Subscription, $2.00 a year, in advance, including postage to any part of the United States, Mexico and Canada. Postage to foreign countries in the Universal Postal Union, including Newfoundland, $1.00 a year additional. Entered at the St. Joseph post-office as second-class matter. The Medical Fortnightly will not be discontinued at expiration of subscription, as many of our readers prefer not to have their files broken on account of failure to remit. Unless we receive a distinct request to discontinue, and payment for all arrearages, this magazine will not be discontinued. Subscriptions may begin at any time; volumes end with June and December. Contributors should understand that corrected typewritten copy is essential to clean proof and prompt publication, and is much more satisfactory than manuscript. Original articles should be as condensed as justice to the subject will allow. Editorial offices in St. Louis, Jacksonville, and St. Joseph, where specimen copies may be obtained, and subscriptions will be received. Contributions and books for review should be addressed to the editors, 319 and 320 Century Building, St. Louis, Mo. MEDICAL MISCELLANY SUBSCRIBE for The Medical Fortnightly. THE best drainage should be afforded for all punctured wounds of the palm; suppurations in this region are very disagreeable and are followed by severe consequences. IN cases of suspected rupture of the bladder, catherization is not always a sure test. The rent may be so large that the catheter draws away urine that has already flowed into the peritoneal cavity. THERE must be in existence few unpublished portraits of Thackeray. One of them is to be presented in the January Century. It is from a photograph of the crayon-drawing from life by E. Goodwyn Lewis. This drawing was done for a member of the Mackworth Praed family, at the sale of whose effects it changed hands in January, 1904. Later the portrait was acquired by the Keninston Public Library. DERMOID OVARIAN CYST SIMULATING FLOATING KIDNEY.-E. A. Isaac's patient was a woman of nineteen years, with an indefinite previous history, who was suddenly seized with abdominal pain and vomiting. On examination a freely-movable tumor was discovered much resembling the kidney, though the author made the diagnosis of ovarian cyst with twisted pedicle. On operation this opinion was shown to be correct, the pedicle being seven inches long and attached to the tissues over the sacrum.-Medical Record. AFTER major amputations an elastic constrictor should always be left at the head of the bed, so that the nurse can immediately apply it in case of secondary hemorrhage. THE COST OF MODERN HOSPITALS.-S. S. Goldwater analyses at length the conditions which cause the cost of the modern hospital building to be so much in excess of what was the case a generation ago. He estimates that a hospital of 1870, 450 beds with a space allowance of 6,000 cubic feet per patient could could be built today at a cost of $1,200 a bed. A modern hospital with the same space allowance would cost double, or $2, 400 a bed, while actually in a hospital recently built 11,000 cubic feet were allowed per patient, and the cost was approximately $4,400 per bed. The author then analyses at length the various features entering into the construction of the modern hospital which contribute to raise its cost to so great a degree, such as fireproof construction, electric light and power, laundry, kitchen, refrigeration, surgical facilities, disinfecting and sterilizing plants, accommodations for the staff, nurses, and employees, laboratories, etc. He summarizes by saying that, aside from economic causes which are beyond our reach, the high prevailing cost of construction is apparently due to new methods of disease-classification and treatment, to more intense nursing, to the discovery of scientific methods of diagnosis, to an application of the principles of wards, work-rooms and living rooms, to the desire to release from the wards during part of the day convalescents to whom the atmosphere of the sick room is detrimental, and finally, to the evolution of the fireproof, and to a certain degree germ-proof, building. If we apply to all of these improvements the rigid tests of result, we shall find that the test is fairly met; but while we may grant that to build a general hospital embodying all of the features enumerated is to tread the path of wisdom, we may nevertheless question the propriety of investing all of our capital in the construction of such a plant. The author then proposes the plan of having the hospital maintain in the country a less expensive branch building for the reception of the convalescent patients, and shows that in this way a much larger number of patients can be provided for at the same expense. For example, the sum of $1,000,000 will provide a city hospital with country annex, it will furnish accommodations for 250 patients. The conditions of operating will also be such as to render this division of the plant the most economical system of managing the hospital, and he urges universal adoption of the plan. Med. Record. Look well to your prescriptions-a careless or dishonest pharmacist may ruin your reputation. IMPORTANT TO PHYSICIANS LITHIA SALT (Wm. R. Warner & Co.) For Alkaline Treatment of Rheumatism, Gouty Diathesis, Cystitis, Gravel, Kidney Troubles, Uricemia, etc. TH HOME OFFICE, ST. LOUIS, MO. PHIS Company sells Five per cent Interest-Bearing Gold Bonds for Savings Investment on partial payments of one dollar per week and over. Also Five per cent Interest-Bearing Gold Coupon Bonds calling for a Cash Investment of $500.00. The Gold Coupon Bonds carry semi-annual five per cent interest coupons. Both the partial payment Savings Bonds and the Gold Coupon Bonds are ideal forms of investment for physicians and other professional men who, from the nature of their pursuits and profession are in the habit of receiving varying sums of money at uncertain intervals, and which incomes in the absence of a stipulated scheme of investment, is likely to be distributed in a way that secures no profit of any kind to the earner. Assets......... April 1, 1904....$505,756.97 Assets.... July 1, 1905..$927,332.58 PROTECTION FUND, March 24, 1905, $500,000. Under the plans of the NORTH AMERICAN INVESTMENT COMPANY OF THE UNITED STATES, fifty-two dollars a year paid in weekly instalments of one dollar each, or an investment in a lump sum of $500, each draws interest at the rate of 5 per cent a year, and-to furnish UNQUESTIONED SECURITY for principal as well as interest-the Company, under State inspection, has deposited with the Treasurer of the State of Missouri FIVE HUNDRED THOUSAND DOLLARS ($500,000.00) as a security fundNO OTHER SIMILAR COMPANY IN THE WORLD CARRIES SO LARGE A PROTECTION FUND of this kind for the protection of its investors No other savings investment company in the world can show so consistent and steady an increase in its business. The Savings Investment Bonds of the company operate in reverse of life insurance. By means of dividends and other distribution of accrued profits the bonds PAY MORE THAN FIVE PER CENT PER ANNUM on the amount invested. It will amply repay any physician or other professional man to make a close inquiry ininto the plans and operations of the Company. To facilitate such correspondence the reader is requested to make use of the subjoined inquiry blank by mailing the same to Cut out and mail this coupon TODAY. North American Investment Co. Odd Fellows Bullding, St. Louis. Mo. Gentlemen- Please mail me literature setting forth the savings investments offered by the company. Name Street M.D. MEDICAL MEMORANDA. FOR SALE OR EXCHANGE.-Betz Body Hot Air Outfit, almost new. Will sell cheap, or exchange for microscope. Address at once, Sadoac,' care "Fortnightly." BOARD OF EXAMINERS.-The Civil Service Commissioners of Illinois have appointed the following Board of Examiners to conduct the examination of applicants for positions as assistant physicians in the State Hospitals for the Insane, viz, Drs. Hugh T. Patrick, Frank Billings, John B. Murphy and Harold N. Moyer, of Chicago, and Dr. Frank P. Norbury, of Jacksonville. This board will prepare the list of questions and grade the papers, the commission itself supervising the examination. PASS CHRISTIAN, THE FAVORITE RESORT OF THE SOUTHLAND.-Physicians who have traveled extensively have pronounced the climate of Mississippi on the Gulf of Mexico, the ideal one for winter, especially for that class of patients who have a tendency to bronchial troubles, and who do not stand the rigorous winters of the north. The Mexican Gulf Hotel, at Pass Christian, is one of the famous hostelries of the South, and under the management of Mr. E. F. Carroll, has grown more popular than ever. Take a trip yourself, doctor, and you will find a climate equalled only in the south of France. Here you will find boating and fishing during our Northern midwinter, and an average temperature of 70 deg. F. The Pass is only fifty miles from New Orleans, and easily reached in two hours via the L. & N. R. R. Do not overlook the fact that not a single case of yellow fever occurred at Pass Christian during the recent epidemic, a fact that speaks volumes for the hygienic surroundings and the peculiarly healthy climate of this resort. Write to Mr. Carroll for full particulars. VIRTUE RUNNING WILD.-The sentiment which underlies the present efforts of certain worthy medical men, to protect the profession from imposition and to make our therapy clean, reliable and trustworthy, is entirely laudable and commendable. The extenat to which some of these gentlemen are permitting their enthusiasm to carry them is lamentable. The judgment passed upon many of the pharmaceutical preparations which have stood the test of time for years in the practices of thousands of successful medical men, has seemed hasty and all-advised. To one who is prejudiced in neither direction, who endeavors to look at the matter with perfect fairness, it is very questionable if it is right that a small faction of the American Medical Association should use the organ owned by all of the members to condemn or detract from the reputation of long established pharmaceutical preparations, many of which are used regularly by a large part of the membership of the association. The manufacture and sale of pharmaceutical preparations is and must be commercial in its character. It can never be strictly professional. The average preparation which has been used by medical men of intelligence for years with good results must have something in its favor, even if its manufacturers are not willing to conduct their business exactly as we may wish to dictate. I have no desire to uphold in any way the secret medical nostrum, but I question as a matter of fairness, the propriety of attacking any well-tried preparations until it is demonstrated beyond reasonable doubt that the members of the Association are opposed rather than being users of the preparation in question. Those who have been placed in positions of power which may be used for the accomplishment of evil as well as good should appreciate that such an office is one of trust and there should be an effort to carry out the will and wish of the majority rather than to be led by personal prejudice or petty motives.-G.T. F. in the The Chicago Clinic and Pure Water Journal. RESPIRATORY AFFECTIONS: SYMPTOMS AND THEIR TREATMENT.—(By Justin Herold, A.M., M.D.) The past few months have afforded me, and no doubt others, opportunities to test the efficiency of the therapeutic qualities of the various remedies vaunted as certain to relieve the harassing symptoms attendant on the diseases produced by the bacillus of that nineteenth-century infant, "La Grippe. I refer to this epidemic particularly, because it had not manifested itself in such virulent form since the memorable grippe epidemic of 1889. The author of this paper, in the past few months has had occasion to employ the several preparations recommended for the relief of the distressing respiratory symptoms attendant upon "la grippe. These manifestations, from my view-point, have been characterized principally by cough and dyspnea, in other words, "dyspneic cough. Expectorant mixtures, anodyne solutions, together with hypodermic medication, produced in me a disgust; and why? Simply and undeniably for the reason that the ordinary cough mixtures contain the opium preparations in such combinations as to leave a depressing effect, which, especially in cases of the grippe of the "depressing or melancholic" type, enhances the already depressed feeling. Combinations of expectorants with stimulating ingredients had no less the same effect. Glyco-heroin, in all the cases in which I have used it, has never caused vomiting, an important point for the physician. Another important point noted was that this preparation of heroin-glyco-heroin (Smith)-never played pranks with the structures composing the vasomotor system. Now, what do we, in treating disease, want in addition to a good stomach and a stable nervous attachment? We want rapid action. That I effected through the use of glyco-heroin. You cannot produce toxic effects with this preparation, as its effects are lasting, and in most cases do not necessitate the use of the drug at very frequent intervals. Glyco-heroin allays cough, without doubt better than any remedy I have used this winter. And that without the sometimes disastrous results of other preparations of the papaver group. Respiraion is stimulated, not in number, but in the depth of the inspiratory act; thus full and complete oxygenation takes place, an important adjunct to the helpful effects of drugs in general, and saving the patient that expensive tank of oxygen. Given full and complete oxygenation, all other symptoms must accordingly diminish; thus temperature and pulse-rate are reduced to a normal condition. Elimina. tion of noxious products not being interfered with the excretion of urine is brought to the normal under the use of glyco-heroin. It is well known that diminished quantity of urine follows as a result of inflammatory diseases of the respiratory tract; thus the standard quantity of urine is enhanced by the judicious use of glyco-heroin: I beg to submit the following cases: Case I.-Acute Laryngitis.-George F. N., aged 14 years. Coasting, perspiration, and no overcoat, a good combination to bring on an acutely inflamed laryngeal mucous membrane. Pain on swallowing, talks in whispers, temperature 101.5 deg. F., pulse 135, respiration 23, cough, barking like dog, uncomplicated case of laryngeal inflammation. Stokes' expectorant did not relieve, seemed to increase cough. Glyco-heroin, full doses of one teaspoonful every three hours, while producing much sleepiness, reduced inflammation, cough, and pain in three days. I then combined it with squills and syrup balsam tolu, to be given every four hours until completely relieved. Case II.-Chronic Bronchitis, Asthma and Emphysema. -Mrs. H. D., aged 44, has had asthmatic attacks, every fall and spring, for the past eleven years; not in winter, but only at the beginning and end of seasons. Iodines, senega, squills, digitalis, and cupping gave relief, but with the penalty of a return of more severe attacks. Dyspnea, cough and expector ation in this case was something frightful to witness. In this case, prompt hypodermic injection of 1-8 grain of morphia relieved somewhat, followed by the use of glyco-heroin, one teaspoonful every hour for three doses, then every four hours, and on the third day every six hours. In this case the glyco-heroin seemed to continue the effect of the morphia. |