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cornea.

oculists have examined the eye, and found no evidence
of disease, neither with the ophthalmoscope nor on the
The man has never used tobacco, spirits,
coffee or tea, and no history of venereal trouble. Is
this a central scotoma? or is it metamorphopsia? Is
it more likely to be a retinal trouble? or a scar on the
cornea? There is no pain, or photophobia. I gave
him a course of potassium iodid, and Burnham's solu-
ble iodin, with no results. Would I better tell him
there is no cause for fear, as the oculists did? or may
we look for trouble?
PACIFIC SLOpe.

strong. Resorcin, 20 grains to the ounce of glycerin, has been beneficial in some instances. Maintain the digestion at the best possible condition, but do not give acids. Avoid all indigestible and starchy foods. If the continued ingestion of laxativs seems to disorder digestion, depend, for a time, on rectal injections; then again order the laxativs, and thus

[We think you may safely assure your patient keep alternating. Persistence will possibly result in a complete cure.-ED.]

that there is no cause for fear. The trouble is a central scotoma, and the lesion is in the retina. It is hardly possible that the sand has caused a macula cornea, which, if present, would most probably have been discovered by one or both oculists. Potassium iodid is the commended treatment, and the drug may be given in large quantities. In addition, you might try pilocarpin muriate sufficient to induce free sweating.-ED.].

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The case has been under my care for about two months. I have kept the bowels open with calomel, giving about two courses each week, and have used such preparations as listerine, glyco-thymoline and chlorate of potassium. Have also toucht the ulcers with carbolic acid solution. G. A. M.; Missouri.

[Your case is one of chronic superficial glossitis, and it will be very obstinate. It is a rare disease, and the progress of the case will be interesting and instructiv if notes are taken regularly and preserved. You will derive most benefit from systemic measures. Maintain the stool in a slightly softer condition than normal by fluid extract of cascara aromatized, in quantity sufficient; give the doses night and morning, stopping short of a purgativ effect. Stop the calomel; it is not indicated. Put her on tonics, like cod-liver oil, iron, quinin, and strychnin. If the cod-liver oil is selected, and it is probably the best (and it may well be combined with the others), watch carefully that it does not derange the digestion. It is best given two hours after meals.

As to local treatment: Remove all decayed teeth. Use a mild antiseptic mouth wash frequently, and apply with a mop which is disinfected or renewed after each application. See that the solution reaches all parts of the buccal cavity. Mildly astringent applications may be made every two or three hours, preferably after the cleansing with the antiseptic. Tannin, alum, zinc, etc., may be employed, care being taken to guard against making solutions too

Lack of Bone Union.

Editor MEDICAL WORLD:-The fragments were removed, and both bones wired, and the wound closed by continuous catgut sutures. The leg, from ankle to above knee, was then placed in a plaster cast. At the end of a week a window was cut in the cast, and the wound found nicely healed, tho considerable hemorrhage had taken place after the cast was applied. Having returned home, the cast was removed five weeks after the operation, but there was no union. The cast was re-applied, and I got about on crutches. In three weeks more the cast was again removed, but yet no union; then after re-application five weeks more were allowed to elapse, when an examination revealed that no union had taken place. Light composition splints, anterior and posterior, were then applied, which held the parts securely and were much more comfortable.

Will some WORLD reader tell me how to induce these bones to grow together? I am 43 years old, and my health was fair before I received this injury. Of late have had a few chills, but believe they are now under control, and I am, feeling better both in body and mind.

The splints, however, are giving me trouble; if applied tight enuf to hold the parts in apposition, sufficient congestion is induced to cause severe pain. The ankle is now ankylosed. Hence I have adopted a posterior Levis splint reaching from just above the ankle to just below the knee, held in place by bandage. This dressing seems to do as well as any I have tried, and normal sensation is returning. Will some of the

WORLD readers give me some advice that will aid in my recovery? I have been confined nearly six months, and I fear that I will always be crippled. I will be certain there is no chance for recovery if six more months elapse without improvement. I have a wife and two children dependent upon me, and while I am not a pauper, I have not stored sufficient in the past to keep the wolf from my door very much longer. Nor did I have a life nor an accident policy before the accident, and now I cannot get either.

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[You should have an X-ray picture taken to ascertain just the condition of the bones, in case it cannot be determined definitly any other way.

From your description, we would think that you had union without ossification; i. e., formation of a callus. Or, you might have this condition, complicated by a tapering of the ends of the bones from attrition. It is not possible to suggest accurately the proper treatment without knowing exactly the condition present. We suggest that you put yourself on liberal doses of tonics combined with phosfate of lime. If no improvement is noted in a few weeks, we would have some brother practician rub the ends of the bone firmly together (under anesthesia) so as to set up an irritation between the fragments and break up the callus so that ossification might follow.

The limb would then go in splint or cast just as if freshly fractured. This method is often successful. At the same etherization, we would have the ankylosis at the ankle broken up, and in splinting avoid a recurrence of this deformity. This is all that promises anything outside another operation. We would resort to a second operation before we would give up hope; and if such an operation were necessary, we would prefer one in which pins were used instead of wire. Any modern textbook on surgery will give you all the various operations for encouraging union in bones, and we would never give up until another attempt had been made. It is quite likely that proper treatment will necessitate your again journeying to a hospital. We are interested in your case, doctor, and feel certain that you will entirely recover if you take the means, as hopeless cases of delayed union, in the overwhelming majority of cases, are simply cases of neglect or cases where but one attempt has been made. -ED.]

Probably Epilepsy.

Editor MEDICAL WORLD:-A little girl 3 years old, family history on father's side good so far as I can find out; on mother's side, her grandmother had three sisters to die with consumption, and the grandmother has some kind of skin trouble that has baffled the physicians so far; has had it for years. Now to the child: About one year ago it went to bed one night as well as ever, and some time in the night it wakened up in a spasm, which only lasted a few minutes. But early in the morning I was sent for, and the parents informed me that the child was asleep, and had had three spasms. I stayed all day, and its spasms came on regularly every hour. They finally stopt, due I thought to hot baths. I made a close examination and could find nothing to which I could attribute the spasms. I gave it a calomel purge with santonin, and came home. In about a month they returned, and have done so regularly ever since, except they get closer and now are occurring twice a month. The child is healthy in every other way. I gave it the bromids for a while, then gave it neurosine with pepsin; gave it valerian, and at the suggestion of an old doctor gave Fowler's solution. In about two months the case left my hands and went to another doctor, but today came back to me. I made an examination of the urin and found nothing wrong with it. At the beginning it did not froth at the mouth in the spasm, but now it does.

I don't know what is the trouble, and if the Editor or some of the readers will help me out thru the columns of THE WORLD or by private letter, I will highly appreciate the favor. Any other information in regard to the case will be freely given. Dunnegan, Mo.

C. E. ENGLEMAN.

[We believe the case to be one of epilepsy, and you will probably be unable to locate the cause of the trouble. We suggest devoting your closest attention to the digestion and diet, and to maintaining complete freedom from constipation. Have her parents observe carefully every hygienic precaution in their every day care of her; eating, sleeping, playing, bathing, clothing, etc. Bromid in massiv doses, taking precautions against bromism and derangement of digestion, will probably check the convulsions for a time.-ED.]

A Carbolic Application for Erysipelas.-Coccygodynia.

Editor MEDICAL WORLD:-In the N. Y. Medical Record of December 17, 1904, Major C. H. Hale, English Army, recommends the following for erysipelas:

Pulvis cretæ aromaticus cum opio of the British Pharmacopeia, rubbed with glycerin to the consistence of treacle, with 10 percent of liquefied carbolic acid added. This is painted over the surface with a camel's hair brush, and in about ten minutes the surface is covered with a single layer of lint. The result of the application is that pain very soon disappears, the swelling subsides, and a fair amount of water exudes thru the application (much as perspiration oozes thru theatrical paint), and the part is thoroly protected from air. More important, as showing that the streptococci are being successfully attackt, is the ensuing reduction of the fever, which often falls from 105° to normal in twenty-four hours, and is rarely higher than 99° after forty-eight hours.

In twelve hours the application should be washt off and the mixture re applied. The application gives rapid relief, the patient often saying before the painting is over: "How beautifully cool and soothing." Now, I would like to know this formula from the British Pharmacopeia; also how much surface it would be safe to use this preparation on (as I am afraid of carbolic acid-an M.D. in a neighboring town died from the effect of a carbolic-acid bath taken for chiggers). If this is what the author claims for it, I think that the "family" should know about it.

I have a patient, a young married lady, who two months before the birth of her baby was troubled with a severe pain in the tip of the coccyx. I told her I thought that it would be all O.K. after baby was born, but about a month after the birth it returned, and has been very troublesome ever since; troubled more in the evening when she is sitting in a chair, when she can neither sit still nor get up. General health good, only constipation, with which she has always been troubled. No soreness nor tenderness in rectum that I can detect by examination. Pain appears to be in tip of coccyx, and to draw from the sides toward tip. Orlando, Okla. DR. T. L. SHARP.

[Pulvis cretae aromaticus cum opio, British Pharmacopeia, or aromatic powder of chalk and opium, is directed to be prepared as follows: To make the aromatic powder of chalk, take of cinnamon-bark, in powder, 4 ounces; nutmeg, in powder, 3 ounces; cloves, in powder, 11⁄2 ounces; cardamom seeds, in powder, 1 ounce; refined sugar, in powder, 25 ounces; prepared chalk, 1 ounces. Mix. Then to make the aromatic powder of chalk and opium: Take of aromatic powder of chalk, 934 ounces; Mix. opium, in powder, 4 ounce.

We surmise that this is to be applied only to limited areas, since there is undoubted danger of carbolic acid poisoning where sufficient amount is absorbed. However, frequently recommendations appear in medical literature advising the use of even the pure acid as a local application. The Standard Dispensatory states that: "Ointments containing 5 to 10 percent of phenol form an excellent dressing in chronic, sluggish ulcers;" and "2 percent solutions often relieve the itching of jaundice and of many skin eruptions." Some practicians employ the pure acid as an injection into hemorrhoids; others use 50 percent solutions, etc.

It would be interesting to have you report

the details of the death of the doctor as a result of taking a carbolic acid bath.

In the treatment of the lady patient, we suggest that you dilate the anal sphincter thoroly, under an anesthetic if necessary. Also, we would give laxativs regularly in a quantity sufficient to prevent all tendency to constipation. We think this will ameliorate the symptoms. If the trouble had appeared subsequent to labor, one would, of course, think of injury to the coccyx; but this is excluded by the history. Hence we think the origin of the trouble is in the rectum, despite the fact that examination fails to reveal visible lesion.-ED.]

Membranous Entero-Colitis.

Editor MEDICAL WORLD:-I have attended a case of chronic membranous entero-colitis for about a year. It would be very long to mention all remedies I used, but without any exaggeration I may say that I have exhausted the therapy on the subject. The patient is apparently cured, food digests, stools are normal, but always mixt with membrane-at times resembling very long white ribbon. Can you and the medical fraternity help me out by suggesting a good treatment? Ybor City, Fla. G. GRANA, M.D.

[We suggest that since you "have exhausted the therapy on the subject," that you begin over again, and this time on a new route. You will make most progress thru application of dietetics. So long as your patient is voiding the membrane the disease is not cured; and you have merely to be thankful that you have not all the distressing symptoms commonly accompanying this affection. Order large quantities of rich cream and milk to get the benefit of the non-irritating fats contained. To get sufficient undigestible residue in the stool to give peristalsis something upon which to work, order grains, legumes, and vegetables containing a large amount of cellulose. Include plenty of the seedy fruits, such as currants, figs, berries, etc. You will observe that we are outlining a plan of diet that would not be at all permissible in the acute stage of an actual colitis. This is the method of Von Noorden, and many successes are reported. A modified form of the rest cure is also a desirable addition to treatment. He gives a detailed direction for the management of the diet and the hours for administering food, which is too long for these columns. We suggest that you get his book. Three to six weeks are commonly required to effect a markt improvement, and not all cases respond.

If your case is a membranous catarrh of the intestin, which is complicated by a decided enteritis, the forced feeding and coarse food will fail; but we are inclined to think the history of the case indicates it is one of those in which the enteritis feature has been partially eliminated, and that it is the effect which must be combated, rather than a true inflammation.

If there is constipation with this treatment, rely upon rectal injections of one to eight ounces of oliv, cotton seed, or linseed oil at night, and order retention till morning. If this is not sufficient, employ any of the following by the mouth: sulfur, senna, dandelion, or tamarinds, in the smallest dose effectiv in emptying the bowel without liquefying the stool. Gentle massage of the abdomen, accompanied by electricity, is of benefit in most cases.-ED.]

Infantil Paralysis.

Editor MEDICAL WORLD:-A has a daughter, 8 years old, well formed, eats and sleeps well, has never walkt a step, only as she has been held by the hands; can use her feet and legs as well as any one; will fall if she is turned loose; the doctors that have seen her say she has infantil paralysis. This is A's statement. I have never seen the child. He offers me $1,000 to cure her. What say you about her case? White Oak, N. C. W. H. G. LUCAS.

[The case is probably one of acute anterior poliomyelitis, or "infantil paralysis." There is no "cure" for this condition, but if it is left untreated, or if it is improperly treated, the child will not get any better, and will probably become not only helpless but also actually deformed. Were such a fee offered us, we would carefully and studiously read up in all obtainable authorities, then we would go and see the babe, and ascertain just her condition and the time that had elapst since the paralysis became manifest, the degree of atrophy and deformity present, etc.; then, and then only, would our opinion be of any value as to diagnosis, prognosis, or treatment. If it is acute anterior poliomyelitis, and atrophy and deformity have not appeared to any great degree, and intelligent nursing can be obtained, then much may be done to prevent extension of the disability, and to prevent the appearance of atrophy and deformity, and to conserve what vitality is left. You will then be able to tell the father what you can hope to accomplish, and can agree with him as to the fee proper for your services. You ought not, however, to take this case, or, indeed any other case, on the "no cure, no pay" basis. You will not be able to cure her completely, but you can easily benefit her all of a $1,000 worth, if you are master of the situation when you make the examination, and can secure trained or competent assistance afterwards in the way of nursing.

Hygiene, massage and electricity, you will find as you progress in the study of the disease and of this case, will give you more emphatic results than will drugs.-ED.]

Cactus is of value in tobacco heart. Another power possest by this drug is generally ignored, and that is its influence in cases of subnormal temperature; the eclectics prize it highly in this connection.

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[There would be a great difference of opinion, Doctor, if a vote of the profession were taken to what constitutes "the very best remedy for infantil colic." Some would consider that treatment "best" which would quickest bring quietness and sleep; i. e., opiates; others would insist upon a treatment which would embody an attempt at removal of the cause, in order that subsequent attacks would not occur repeatedly. We confess, personally, to a preference to the latter method, altho some very successful men use the former, and many others a combination of the two. That is, they give the opiates, and then attempt to locate the cause and prevent a return of the trouble.

If immediate relief, only, is demanded, probably the remedy most widely used is a tablet triturate after a formula original with Dr. Waugh, of Chicago, and known as "Waugh's Anodyne for Infants:" it is not a proprietary, and may be purchast from any tablet manufacturer. It is inexpensiv, and effectiv in bringing speedy relief. Any opiate or anodyne may be employed in suitable dose.

Colic, in an infant, is the result of improper food or improper methods of administering food. It may be given too frequently, it may be given in excessiv quantity, even when the food, in itself, is proper and suitable. The hygiene of the infant cannot be discust in the space at our disposal, but any of the modern text-books on pediatrics give it a full discussion. It is certain that few mothers understand even the elementary principles of feeding an infant and every physician ought to hold himself in competent readiness to instil an idea of the care needed in this matter.

The old plan of giving a dose of castor oil to sweep fermenting and decomposing material out of the bowel brings relief, but it leaves the child constipated, and if constipation was a part of the trouble before, it aggravates that condition. Mild carminativs, something after the castoria formula, are often useful. The spice plaster, applied on the abdomen is an adjuvant of any form of treatment. Holding the infant against the breast so that his head will droop slightly over the nurse's shoulder sometimes causes free belching and consequent relief. Any of the aromatic waters may be freely employed. Perhaps one of the best medicaments to employ, while time is being gained, is a few drops of pure whiskey in a teaspoonful of warm water. A short course of fractional doses of calomel and soda, well tri

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[In 1903, Cavazanni, in Therap. d. Gegenw., for September, called attention to the favorable effect of garlic upon tuberculosis, and cited the results of his experiments upon guinea pigs. He fed the guinea pigs on garlic, and afterwards administered to them the dried and powdered sputa of tuberculous patients. Comparing the cases thus treated with "control pigs," he believes they showed very slight lesions, and no distinct evidence of tuberculosis.

Soon after this, articles appeared advocating the employment of the juice of assorted vegetables in human tuberculosis. We read these articles at the time, but they did not make any profound impression upon us. Now, we are unable to find them, and they are not referred to in any of the late text-books. We have had no experience in the treatment of tuberculosis by this "method," and we frankly confess our incompetence to give you the article askt for. We will keep the matter in mind, and if we locate the literature on the subject, will gladly give you the salient points contained therein. If any of the family have preserved such articles, will they favor Dr. Russell with the journal containing same?— Ed.]

Fly-blisters.-Cracking of Joints,

Editor MEDICAL WORLD:-What is the physiological action and therapeutic uses of fly-blisters, applied on different parts of the body? I was told that a flyblister applied on the fourth dorsal vertebra would control vomiting of pregnancy every time; and when applied over the lungs, very useful in pneumonia ; and on the head, useful in most all brain troubles. What is the physiology and pathology of the cracking sound that occasionally takes place in the joints when moving or by a certain twist, pressure, or pulling? JOHN ALBERT BURNETT.

Cecil, Arkansas.

[It is true that a fly-blister applied over the cervical vertebrae will stop some cases of vomiting of pregnancy, but it is not true that it will do it" every time." If the latter statement were true, there would be no necessity for emptying the uterus, as must be done occasionally; nor for death of the prospectiv mother thru exhaustion, as happens in rare instances of pernicious vomiting of pregnancy.

The fly-blister applied in the iliac region has served a useful purpose in some cases.

In pneumonia, the fly-blister does good, in selected cases, by increasing the peripheral circulation on account of its counter-irritant action, and thus decreasing the congestion in the lung beneath its site. This effect has been proven by post-mortem examination.

The theory, in brain inflammation, is the same; i. e., that counter-irritation will attract blood and serum from other parts which are congested and hyperemic.

There is nothing distinctiv in the fly-blister, especially. Any other blister might be substituted. The dry, and perhaps the wet cupping process have the same effect.

We are not able to explain the cracking sound produced by pulling on a joint, as, for instance, noted in the finger; and it is this to which we presume that you refer. Possibly it is due to the sudden separation of the layer of viscid synovial fluid. Often, in the knee and larger joints, the creaking sound is pathological, and is due to changes brought about by the uric acid diathesis.-ED.]

Oxygen.

DEAR EDITOR :-Can you inform me where I can obtain" Avery's Oxygen "and literature? Swannanoa, N. C. CHAS. CLIFF, M.D.

[Oxygen is marketed in strong steel cylinders, from which it is liberated as wanted for use, by loosening a valve attacht to the end of the container. It is manufactured by mixing manganese dioxid with potassium chlorate, heating, collecting the resulting gas, and then pass ing it thru wash bottles containing an alkali. It is administered to the patient by inhalation in such cases of respiratory and circulatory disease as require an increase in the oxygen furnisht the tissues. The value of such inhalations is questionable. You will find the matter discust in the modern text books on medicin and therapeutics, and two pages are devoted to it in the National Standard Dispensatory, publisht by Lea Brothers & Company, of this city.

These gas filled steel cylinders may be obtained thru any supply house catering to physicians, and perhaps thru wholesale druggists. It is likely that the various manufacturers may attach their names to the containers, and it is possible that in this manner you have been prompted to ask for "Avery's Oxygen." The oxygen manufactured by the various houses is all practically the same.

If, on the other hand, this is a nostrum, we know nothing of it.-ED.]

A strong infusion of the roots of alfalfa relieves prostatic irritation and is a mild but efficient diuretic in dropsical cases.

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