[Doctor, did you read the November WORLD, editorials, and all? We have clearly defined our position on the nomenclature of pneumonia a number of times. It is not right to call anything pneumonia that is not pneumonia. The symptoms of pneumonia are well known and easily demonstrated by those conversant with the methods of physical diagnosis. Your "latter stand" is the only correct one. Pneumonia can neither be aborted nor favorably influenced by any drug at our command. Many a lung is inflamed which never becomes pneumonic. Many conditions will cause a congestion or inflammation of the lung, and such congestion or inflammation may become a pneumonia. But pneumonia is a definit entity, recognized, known, and demonstrable; and is entirely a different thing from inflammation or congestion, altho inflammation and congestion are a part of every pneumonia. Nor can we, doctor, agree with you that your supposed case "would have had it"; he might, and he might not. We most certainly agree with those who treat inflammation, congestion, and engorgement of the bronchial tubes and of the lung promptly and energetically. But the practise of calling every "cold" a "pneumonia" is abominable and leads to confusion, and keeps back any true advance toward a solution of the proper treatment of pneumonia.-ED.]

Pneumonia.-Rhus Poisoning.-The "Moses Sign."

Editor MEDICAL WORLD:-Take all that has been said of pneumonia in THE WORLD: What a collection of ideas! Thirty-nine articles, comments, etc., in 1904, and 27 in 1905-66 in all, including a long article from the Medical Record, with treatments all the way from a fly blister to enormous doses of quinin. Now what does all this avail if we still go on losing our patients? We have as many different modes of treat

ment as we have articles; who is right? Not all, sure. They can all be wrong, but not all right. We can't use a fly blister and jacket at the same time; which is best? In the December WORLD Dr. Bogart gives his treatment: bryonia, veratrum and asclepias, all good in their places, and adds: "The above measures *** are all I have ever found necessary." Now I can show you cases where bryonia would not only do no good but positiv harm; also the other two. Why doesn't he give us the average duration of the disease when treated this way; also the number of cases treated, with death rate? In this way alone can we get at the facts. Something like this: Had 42 patients in 5 years; lost one, seen in dying condition. Duration of disease 4 to II days. (My own record.) Average duration 6 days. Take different types of the disease; e. g., stupor with burning, hot head, red, hot cheeks, red ears, contracted pupils, closed mouth, murmuring and gesticulating in delirium; takes water greedily when offered, but can swallow only a sip at a time on account of shortness of breath; heart's beat strong, pulse quick (130), skin dry and hot; right lung hepatized; great tightness across the chest; cough tight at night, loose of mornings; expectorations when falling will break and fly like thin batter. Or like this: All of the left and part of the right lung hepatized; cough short and hacking; expectoration slight; all organs of the body sluggish; whole body perspires profusely; sweat is very hot; gropes with the hands as if hunting for something; face dull red and looks as if drunk. Notwithstanding this desperate condition, persists in sitting up most of the time. A patient just as described, with incontinence of urin, made her father dress her, and she sat up by the fire two weeks ago; she now begs to be allowed about the house.

Does either of these need the above prescription? I trow not! Do they both need the same treatment? Surely not. And I have had both in my practise and both got well. I gave the first phosphorus and the last opium. But take this: expiration shorter than inspiration; stitching pain in the sides; wants to lie perfectly still, because moving increases the pain; and if a child, cries when being handled; drinks large quantities of water at long intervals; better when lying on affected side; sputum in round

lumps, yellow or "brick dust;" refrains from coughing on account of pain. Bryonia will cure every time.

I have been very lucky in that I have had no heavy drinkers; but the first case above named was only 6 months old; another physician had left it saying it was dying, and it looked like it. Sometimes the onset of the disease is so furious, the whole economy seems to be so overwhelmed with the poison that they are beyond help when we first see them. Also persons debilitated by drink or otherwise, readily succumb to the disease. But given a good constitution, ordinary environments and 48 hours' start of the dread messenger, I believe the proper drug will cure every time.

The same may be said of all other discussions we have had. Look at the articles on rhus tox. poisoning. What can we conclude? That a whole lot of things are good and nothing for certain, Sunny Jim to the contrary. Why did not some one say these persons are prone to an eczema every fall of the year, whether exposed to the vines again or not? A short time since a patient came to me some time after the leaves had fallen with an eruption covering both hands and arms to the elbows and spreading, and askt what it was. Had been treating for years for the same with poor results; local applications would cure it up, but it would reappear, sometimes in the dead of winter. I said to her: "Years ago you were poisoned with poison oak." She said: "Yes, sir; when a young lady, nearly 30 years ago." It can be cured, but local applications will not do it. They relieve the intense burning and itching; an old bacon rind will do the same thing. But the European variety of anacardium, internally will thoroly eradicate the poison. In fact, if a person susceptible will take a few doses of anacardium he can handle the "poison vine" with impunity.

It is only by each one giving his experience that we can ever hope to arrive at anything definit. Our individual experience is too limited to derive conclusions from. For example, the Moses' sign; it was worth more to me in one case than my subscription has cost to date ($3). I have tried it in three cases; workt every time. This is not enuf to fix its value, however; but suppose one thousand physicians would do the same thing. We would then have 3000 cases reported, enuf to determin its value. Lawrenceburg, Ky. R. L. MILTON.

A Little Talk About Extravagant Claims, "Authority," Etc.

Editor MEDICAL WORLD:-Is it not a wonder that anybody in this country should die in this day of specifics and special treatment? Take up the newspapers and they are full of cures. Coughs, colds, consumption, asthma, la grippe, pneumonia, liver trouble, heart disease, kidney trouble-every disease has a perfect and ready specific. But this is not all; take the medical journals and here we find that many doctors have their excellent treatment for every disease, and they seem to be real sorry that every one hasn't learned this precise line of treatment. Then here come the different schools: allopathic, homeopathic, osteopathic, eclectic, electic, selectic, neglectic, and all the tics and ics-every school really rejoicing in its good, new up-to-date treatment; each one chock full of enthusiasm, halloaing at his friends to try this and be convinced.

What a wonder, I say, that we let any die! Oh, how we do pity poor old Osler, Loomis, Tyson, Hare, and all those textbook men who knew nothing whatever of those new and exact specifics! Those poor fellows that people call "authority" are so dry and silly that they actually find some diseases that they can't cure. Osler nor Tyson just couldn't or wouldn't see that cholera infantum-every case of it-could be cured. They treated croup with syrup ipecac, hot baths, etc., not knowing that we have a specific for croup. Why, they didn't even know how to cure pneumonia. Treated it symptomatically, not knowing that we have many specifics for pneumonia. What a wonder every patient under the text-bookmaker didn't die, and how very strange any die under our special specific treatment.

When I was going home from my medical college, I happened to take a seat by a man who said he was an M. D. After we talked awhile he seemed to feel it his duty to give me some instruction, as he had been in the practise for years; so he said: "You go home now and forget, as fast as you can, all your lectures and all you have ever learned in a book, and then you'll begin to know a little about how to cure people. You won't do any good as long as you are stuffed with lectures and book sense." I was surprised at such a talk then, and wondered whether or not he was a real doctor. While that advice was consoling from its simplicity and ease, yet it carried a fear and a feeling of

responsibility with it that I couldn't exactly overcome if I should desire to carry it out. I did the other thing: went home and read my books with all the earnestness of my soul-between calls, at night, after midnight, every single moment I could find. I often thought of the man, and wondered how he felt safe in treating a single severe case of any kind, without going to the best authority for advice. Now I read journals more than I did in those days, and I find, to my surprise, that many of our brothers are giving the same advice in a little different form. Dr. Taylor, have you heard anything like this? "Throw your old text-books aside, and go to the bedside and examin your patient carefully. Learn everything you can about the patient. Give medicin for its effect, and see that it has the effect. Learn lessons from nature, read a few of the best journals and throw your old books away; they are all ten years behind the times anyhow." "Oh, that's text-book treatment; I've long since learned to think for myself." "Ho! I don't care what authority says; I know I've cured pneumonia, and many other things authority says can't be cured."

Now, I am not trying to give exact quotations; only giving the general expressions of some doctors and too large a "some," too. Even those who are otherwise smart are indulging in such so-called "free thinking." What does a man mean when he says he is an independent and a free thinkernot bound to any authority? He may think he is, but what do those who hear him think of him? How do you know, Mr. Free-thinker, that you ever treated a patient with typhoid fever? How do you know there is such a disease as pneumonia? What makes you think there are such conditions of the lung as congestion, red and gray hepatization? How many different lungs have you had an opportunity to examin in those conditions? What makes you think that certain symptoms indicate certain diseases? You knew those things naturally, didn't you?-free-thought them out. Now, didn't about all the real knowledge you have come directly or indirectly from those poor old book-makers? Please sit down and compare your advantages for really knowing things with William Osler's, and let us hear how they compare. I shall be perfectly fair with you: If you have had the opportunities that Osler, Loomis, Hare, and all, or any, of those honorable and glorious old souls, and if you have made as good use of those op

portunities as they have, I shall be glad to call you "authority," and read or hear what you have to say with real joy. I shall feel like a pupil under your instruction, nor will I fear to take your advice.

Now, to every one who has his specific for all diseases, who knows all diseases are curable, who has found no trouble since he learned this new remedy, who can cure every case of pneumonia "if he gets there in time," who has actually annihilated cholera infantum, I make this proposition: I will compare results with you. Yes, sir, and I have followed Osler, Tyson and other book-makers, such as Potter. I have been practising only a little over five years, but you can count your practise back to my beginning, taking the same period in which I've practised. Now, as little as those authors know about practise, new remedies, etc., I have been foolish enuf to follow them, and now I am simple enuf to give you my results in every disease treated, if you want them. Also, I believe I can give you as good proof that I have cured several cases of pneumonia as you can that you have; but I don't believe that you, or I, have cured a single case yet. Indeed, I have never even tried to cure a case; but if you can show me that more of your cases have recovered than mine, I shall be glad to take lessons from you. Nor does this mean that I adopt a do-nothing policy. I do believe that I find more to do than those that try

any other disease) is to treat the patient, and not the disease.

Dr. Tope (page 11) is right in asking for "more brains and less mud" in chest cases. Poultices in pneumonia can only do a slight amount of good in the first stage, before hepatization, and as we rarely see a patient as early as that, there will hardly ever be an opportunity to use a poultice intelligently. Since I have discarded the poultice altogether and instead use frequent spongings with alcohol and water, and occasionally the ice bag over the heart, this disease has lost much of its dread for me.

I wonder if the company Dr. Arthur talks about (page 15) is the same I had dealings with in 1904. It was called the International Law and Collection Company, of Dayton, Ohio. My experience with those people has not been quite so pleasant. The same spring I lost $15 thru friend Ostrander.

I don't think that Dr. Ammon's success in the treatment of gonorrhea (page 22) is due to the internal administration of the prescription given. When urotropin was first lauded in the medical press, I employed it largely in nearly all cases of gonorrhea. But I soon found out that an indiscriminate use of this drug often does more harm than good. Now I prescribe it only if the urin is distinctly alkalin. Besides, the dose of methylene blue, and especially that of diuretin, is decidedly too small to be of markt benefit.

That sometimes a large amount of phenol can be taken without causing poisoning I learned several years ago when I treated a patient 70 years old who suffered from anthrax in the back of his neck. (Patient recovered and is still alive and healthy.) After excising the infected part, about the size. of a 50c. piece, I injected 10 per cent. phenol around the wound t.i.d. for 5 days, mostly 8 to 12 syringes full at a time; i. c., 16 to 24 cc. (3iv-vj) That would mean 1.6-2.4 cc. (24-36 m.) pure phenol. Of course, this was not all taken up by the system.

On May 29th, 1905, I saw Mrs. S., a young Polish woman, suffering from anthrax. The site of infection was the upper lip on the right side of the nose. The whole right side of the face was swollen, so that she was unable to open the right eye. I advised them to have the infected part excised, and went home for my instruments. When I returned, in about one hour, the

patient as well as her husband refused to consent to the operation. So I injected 10 per cent. phenol in the manner stated before, and gave internally strychnin, aconitin and calx. sulfurata to saturation; ice bag over the infected part. Patient recovered quickly. Would like to hear from the WORLD family about successful treatment of anthrax. GUSTAF F. HEINEN, M. D.

Blossburg, Pa.

Optimistic Ostrander.

"A MONEY-MAKER FOR HIMSELF."

According to W. M. Ostrander, the Philadelphia promoter, his "Money-maker enters over 90,0:0 homes every month. At this rate, provided he continues to advertise his mouthpiece in the future as extensivly as he has in the past, it won't be long before he will be telling over 200,00 people about his different air castles. Everything to which Ostrander applies his hot air and water multiplies in paper value rapidly; but, so far as being a moneymaker, his client's experience has been that he has benefited only himself.

Thru his "Money-maker," Ostrander proposes to tell how, when and where money can be made-yet there are thousands who have paid him big fees to sell real estate who will agree with us that for himself he has done it, but they have long ag, given up the idea that he will ever make money for them

He exposes financial fakirs, excluding himself. He reveals the secret of frenzied finance, excepting his frenzied over-capitalized stock sel ing enterprises.

He will do almost anything as long as he can induce people to purchase his securities Eventually, th se who give heed to Ostrander's advice regarding investments will be forced to realize that theirs was a money losing experience.

Ostrander's most valuable asset, applying a charitable name to it, is an egotistical optimism-it has no intrinsic value, for no man of good judgment at all would incorporate his individuality for $2,000,00 and ask the public to buy a share of himself for the face value of his certificates.

In common with all shrewd financiers, we must confess that the Philadelphia investment parvenu does not lack nerve.-Financial World.

Closed Stomach and Absence of Bladder in Infant.

Editor MEDICAL WORLD:-One day recently I was called to a hospital with which I am officially connected, to see a child that was but twelve hours old and seemed to be in a stupor-so I was told over the 'phone. I found a well-formed baby; externally it seemed to be all right, but it could not be aroused from the stupor in which it had been for two hours. I told the resident physician that I did not think the baby would live many hours. He requested permission to perform a post-mortem when it did die, which I granted, but told him I did not anticipate he would find anything of interest. How easy for one to be mistaken! The baby died when sixteen hours old; the stomach, which we have preserved, was found to be a closed sack, there not being any connection with the intestins; also found the bladder to be entirely absent. Never having heard of a case like this before, I take the liberty of reporting it.

In looking over the maps on page 35 of

on a

more

I think the criticism of Dr. Wm. H. George, page 24, is rather severe brother whom he does not know to be untruthful or mistaken. No person than myself despises the professional man who will make misrepresentations in the treatment and cure of disease, but I am willing to take a man's word for a statement until he is proven a knave.

In the past ten years I have treated one hundred and five cases of typhoid fever, and have not had a death due to the disease. In one of these cases I had a death due to double pneumonia in a young woman who had nursed her three sisters and one brother during their sickness from the disease, with three of them sick at the same time and the nurse seeing to the housework at the time. In this record of cases I have had but two hemorrhage subjects. The first one some years ago, who, while convalescing, was, against my most strict orders, overfed. Result was a profuse hemorrhage and a relapse, with the result that the man from the day of having to quit work as a railroad conductor until he resumed his position was absent six months. My other hemorrhage case was the last one I treated; a maiden lady whom I was called to about the beginning of the second week of the disease. The temperature was 1032° and patient very nervous. Had a hard time convincing her that she should be in bed. Three days later, without any unusuai

symptoms, a profuse hemorrhage occurred.

These cases do not include a single patient that did not go thru the typical typhoid state, the temperatures during the second week ranging from 1031⁄2 to 106 degrees. I do not use the milk diet, nor have I for several years; the reason is that my experience has taught me that there are better ways of feeding. I do use immense amounts of water both internally and externally. Diluted fruit juices, etc., internally. I never have used the cold baths. I never have used the antiseptic treatment (perhaps I am a fool). I have never used quinin in these cases. I do use internally as near as I can prescribe the same, the indicated homeopathic remedy.

I have had hundreds of cases that for perhaps the first three to ten days I have had what looked like a typical typhoid condition, but the same would disappear and patient recover rapidly; but I have never been guilty of calling these cases typhoid fever, nor will I make a positiv diagnosis under a week's time, and I have never regretted doing so. By telling the anxious relativs that the case is one that is of typhoidal character but may not be true typhoid, I believe I have made many friends, and in fact more than the man that makes the hurried diagnosis and heralds himself as a person who cures his fever cases in a few days.

I expect many physicians would question my veracity, but I believe that an investigation of my cases at Mineral Ridge, where I practised for several years, will convince the unbeliever that I am telling the truth about my percentage of cures.

I believe I have handled as hard cases as ever existed. It is something terrible to be a physician, worn out physically by day and night work for weeks at a time during an epidemic of the disease, and have a number of cases that it seems utterly impossible that they can recover-tongues black, swollen and protruding from the mouth, involuntary stools, having to put gloves or mittens on hands of patients to keep them from picking the lips, patients unconscious for days at a time; yet you ask for counsel and are told that they have implicit confidence in your treatment, and they are satisfied you are doing all that is possible. I have been there.

My dear doctor, do you ever send out Some months receipts for remittances?