A CLINICAL LABORATORY. THAT RENDERS A REAL SERVICE The BEEBE LABORATORIES, Inc., have opened a well equipped Clinical Laboratory in the Argyle Bldg., Your inquiries will receive prompt, personal attention. BEEBE LABORATORIES, Inc. ARGYLE BLDG., KANSAS CITY, MO. Side Lights on Cascara-Physicians frequently refer to Parke, Davis & Company as the cascara house for it was this Company which introduced Cascara Sagrada forty-three years ago. Cascara was unknown to the medical profession until Parke, Davis & Company-with the assistance of prominent physicians, chemists, botanists and pharmacologists -studied the drug and definitely established it as a therapeutic agent. Cascara immediatelly sprang into popularity with physicians. It became a subject of discussion in medical meetings-not only in this country, but on the other side of the Atlantic. It was directed to the attention of the British Medical Association at a convention in Cork, Ireland, as early as 1879. It wasn't long before cascara was being prescribed by medical men all over the world. Today the drug is recognized by every pharmacopoeia except the Finnish and Portuguese. It has come to be looked upon as an essential in medical practice. Fluid Extract of Cascara (P. D. & Co.) is an ideal product. It contains all of the tonic-laxative constituents of two-year old bark of Rhamnus Purshiana, the true cascara. The dose is about one-half that of ordinary fluid extracts of cascara. Cascara Evacuant, another notable cascara product, is a palatable preparation of two-year old bark of Rhamnus Purshiana. Cascara Evacuant is about twice as active as the ordinary "aromatic" cascara. Do not forget a common site for a gonorrheal metastasis is in the tendon sheaths of the dorsum of the foot. The joints may not be affected at all. It has not yet been proven that any of the newer agents are superior to potassium permanganate as an irrigation in gonorrhea. Stick to it until some thing better is found. An Old Truism-There is an old saying to the effect that, "Good wine needs no bush" and the same might be applied with equal truth to certain medicinal or therapeutic products which have been in constant use by a large number of the medical profession for a period covering many years. Time tested and trial proven porducts require very little advertising except of a sort to remind the busy doctor of them. This applies particularly to Micajah's Wafers and Micajah's Suppositories, both of which were brought to the attention of physicians a number of years ago and the use of which is steadily and constantly increasing. Both of these products will be found to be of great value in the treatment of conditions for which they are intended. They are ethically advertised and the claims made for them are kept well within conservative bounds. The physician who has used either or both of these products, needs to be told nothing regarding their practical value. The physician who has not used them, would do well to get acquainted with them because by their use, he will be able to secure better results for his patients as well as for himself. Samples and literature of the Wafers and Suppositories will be sent promptly on request to Micajah & Co., Warren, Pa. ANNOUNCING: The opening of a new branch at 718 FELIX ST. (Second Floor) ST. JOSEPH, MO. MERRY OPTICAL COMPANY ANNOUNCEMENTS Drs. W. J. Frick and R. D. Irland announce their association as partners, suite 925 Rialto Building, Kansas City, Mo. Dr. C. Wilbur Mercer has opened offices at 310 Rialto Building, Kansas City. Practice limited to orthopedic surgery. Dr. Oliver C. Gebhart was elected secretary of the Buchanan County Medical Society at its last meeting in St. Joseph. Dr. John P. Lord has been appointed chairman of the arrangement committee, Medical Society of the Missouri Valley, September meeting in Omaha. Dr. Frank Parsons Norbury, of Jacksonville, Ill., has been appointed consultant in neuropsychiatry for the Eighth District, U. S. P. H. Service, by Surgeon General Blue. The Eighth District comprises the states of Illinois, Wisconsin and Michigan. Dr. Carl E. Black, of Jacksonville, Ill., was the principal speaker at the annual dinner of the Western Surgical Association in Kansas City. His subject was "Medical Education and Practice in Greece," illustrated by 125 slides, showing the work done by the medical department of the University of Athens. Colonel H. A. Metz, president of the H. A. Metz Laboratories, Inc., has donated the necessary funds to the Vounteer Hospital, of New York, for the installation and development of a urological and syphilogical department, both in the hospital and its dispensary. It is the hope of Colonel Metz that the department will not only be able to do the usual ambulatorium and beside work of such a subdivision, but that it will also engage in research work which may lead to preventive measures and to treatment, to lessen the evils of syphilis for the betterment of the race. This donation by Colonel Metz is in keeping with his action in developing a large scientific organization in his laboratories in Brooklyn. For Goitre-Doctor, you should try the special goitre tablets put up by the Columbus Pharmacal Co., Columbus, O. One trial will convince you. See announcement in this issue. Tires for the Doctor's Car-If you do not know the efficiency of the "Brunswick Tire Service," and the qualities of "Brunswick" tires, consult Harry Lewis, 22d and Grand Avenue, Kansas City, and you will ride "ever happy thereafter." Golden Opportunities BARGAINS FOR YOU New Sex Book-A practical, common sense, plainspoken little book on the sexual functions, by Mary M Ware Dennett. Price, 25c, postpaid. Address Book Department, Medical Herald, Kansas City, Mo. Bathing Girls-Just out. Pretty, modest and fascinating pictures for the doctor's sanctum. Fifty cents each; five pictures, all different poses, for $2.00. Address Art Department The Medical Herald, Kansas City, Mo. Wanted, Location.-A practicing physician wants to locate in Missouri. Small railroad town preferred. Would purchase a few acres of improved land. Address, F. C. E. care of the Medical Herald, Ridge Building, Kansas City, Mo. Bargains in Electrical Appartus-Victor No. 1, complete D. C. with stand, $100. One Kelly Koett, 8 K. W. Transformer. American Tube Stand and Coolidge Equipment like new, big sacrifice. Terms if desired. Address "Electric," Medical Herald, Kansas City, Mo. Location for Doctor The Commercial Club- of Forestburg, So. Dak., announces a good location for young doctor, who will practice and operate a drug store in connection. A live little town and good territory surrounding. Address, Secretary Commercial Club, Forestburg, So. Dak., for full information. Want to Buy a Chair or Electrical Equipment?Doctor, have you something to sell or exchange? Do you want a location or an assistant? Are you looking for new opportunities? Use and read this column. Ads two cents a word. Remittance should accompany order. Address Bargain Department Column, The Medical Herald. A Gas Oxygen Apparatus-The most accurate and trustworthy gas machine on the market today. If interested, write for full information to the Physicians Supply Co., Kansas City, Mo. See announcement on page 12 this issue. "Poems the Doctor Should Know," 16 pages, 45 poems of war, love and patriotism, including the immortal poem, "In Flanders' Fields," by McCrae, and several answers to its challenge. Price, 10 cents a copy, three for 25 cents. The Medical Herald, Ridge Building, Kansas City, Mo. Why Club a Cough or attempt to overcome bronchial irritation and inflammation by outraging the stomach with nauseous expectorants or "Knock down" narcotics? Oil taken into the stomach, reflexly stimulates bronchial secretion, relieves congestion, soothes cough, does not disturb digestion, nor mask other symptoms. Terraline (Petroleum Perification) is medicinally pure petroleum oil, palatable, without action upon digestion and prompt in its influence upon the respiratory tract. It soothes cough and subdues irritation. TERRALINE is also mildly laxative, when used as an intestinal lubricant. It is an ideal vehicle for many medicinal agents. It is intended for physicians prescribing only, and for the convenience of the physician is put up Plain, with Heroin, or with Creosotes. In spite of the use of arrhenic compounds authorities advise the "follow up" treatment with mercury and often iodide in luetic conditions. PIL MIXED TREATMENT (CHICHESTER) is a perfectly baldependable formula containing mercury and KI, well tolerated, active and efficient. Sold in bottles only-never in bulk. Price $1.00 per bottle. Hillside Chemical Co. NEWBURGH, N. Y., U. S. A. Vol. XXXIX. Continuing the Medical Fortnightly and Laboratory News The Medical Herald and Electro - Therapist Incorporating The Kansas City Medical Index-Lancet An Independent Mouthly Magazine Original Contributions [EXCLUSIVELY FOR THE MEDICAL HERALD.] MARCH 15, 1920 SOME DIAGNOSTIC ADVANTAGES OF SPINAL FLUID ANALYSIS* H. J. LEHNHOFF, M. D., Lincoln, Neb. Making a spinal puncture and analyzing the fluid recovered is not necessarily the business of 1 specialist. In a general practice the necessity of carrying out such a procedure is somewhat uncommon and therefore somewhat difficult merely because of lack of practice and experience. In analyzing the fluid, special apparatus and special technique are necessary in making special tests, to be sure. However, the more important facts can be determined by practically any observing physician, and if special tests are necessary, the fluid can be sent to laboratories which are specially equipped to make these tests. Permit me to say a word in regard to the technique of making the puncture. Location-The space between the fourth and fifth lumbar vertebrae is usually selected for making the puncture. If it is made a vertebra higher or lower, no harm is done. One reason why the lumbar region is selected is simply beCause we wish to avoid the spinal cord. The latter terminates at the first lumbar; consequently there is no danger of injury to the cord if the puncture is made below the second lumbar. A good practical rule is to have in mind an imaginary line drawn straight across the spine from crest to crest of the ilia. The intervertebral space nearest this line is a favorable space to enter. Sterilization-Sterilization of the skin with. odine is sufficient. Local Anaesthesia-There is an advantage ninjecting a little cocaine or novococaine in the area selected for puncture. The injection should he made deep as well as superficial. This will not relieve the pain of the needle passing between the vertebrae. However, the local anaesRead before the Medical Society of the Missouri Valley at Omaha, Neb., Sept., 1918. No. 3 thesia is usually appreciated by both physician and patient, particularly if several attempts are necessary before the membranes are pierced. The position of the patient is a matter of preference. If the patient is an adult and in good strength, I prefer to have him in a sitting position, leaning well forward. The "tailor" position is good. In a child or adult too ill to hold the spine in the position desired, the lateral recumbent position is preferable. If an adult is in the lateral prone position, he is advised to bring the knees well up toward the chin and to grasp the knees in the forearms. As can readily be seen, the object of this position is to obtain the greatest posterior convexity of the lumbar spine; that is, to obtain as much intervertebral space as possible. Needles-The needle employed should be from three and one-half to five inches long and a little larger than a common knitting needle. They should not be absolutely stiff. If they are too large in diameter, more pain is experienced when it passes between the vertebrae. In children, a shorter and thinner needle is preferable. Relation to Spine and Direction-The needle enters the skin on a horizontal line between the spinous processes, which can be felt, and about one-half inch to either side of the perpendicular line of the spinous processes. It is carried in on almost a horizontal plane, the point being a little cephalad, and inward toward the base of the spinous processes. In an adult the point of the needle goes in a distance of two to four inches as a rule. Several attempts at passing the needle are often necessary before any fluid is recovered, and occasionally it is impossible to recover any fluid at all. The needle should not be handled with the naked hand or fingers. Contamination of the should be grasped so as to protect the needle fluid is apt to result. A piece of sterile gauze from the fingers. Collection of Fluid-The fluid should be allowed to drop into a sterile test tube. It is also an advantage to have the tube perfectly dry. A moist tube, particularly if moist with undistilled water, will mar some of the finer tests |