[We will take this occasion to say again that we do not send receipt for remittances unless specially requested. We have a careful system of keeping accounts, which is in the hands of faithful and carefully trained clerks, who do nothing else. Every remittance is carefully credited when received. Receipt of WORLD every month, without bills or "dunning letters," is usually satisfactory evidence that one's account is in a satisfactory condition. To send receipt for every remittance received would greatly increase our work. This course is pursued because the remittances received are so many and so small. If our remittances were few and large, our course would be different. However, we are willing to send receipt, if even for $1, when requested; but don't you think that a stamp should accompany the request?-Ed.]

My Treatment of Typhoid.

I

Editor MEDICAL WORLD:-I open the bowels with calomel in broken doses. direct them to take a teaspoonful of sweet oil every morning; and then give during the day the following: tr. iodin 2 drops, spt. camphor 5 drops, turpentine rect. 5 drops, alcohol q. s. to make a teaspoonful. If the temperature runs high I sponge with alcohol freely. As diet, I use eggnog, buttermilk and hot chicken broth; never allow any water; use crackt ice. For prevention of bed sores I use alcohol, frequent change The room to of position, and clean sheets. be well aired. I do not claim this to be specific, but I have never lost a case under this treatment.

Sopchoppy, Fla.

I. H. HUNTER, M.D.

A Desperate Case of Diphtheria, in which 20,000 Units of Antitoxin were Used. Editor MEDICAL WORLD:-On the morning of November 28, '04, I was called to see a girl 11 years of age who had been sick for 5 days in bed with a sore throat and they stated she had become so bad she could not swallow. I found her temperature 104.5 deg., pulse 148, and her throat almost closed, the membrane involved both tonsils and the uvula. I took a swab, sent it to the Health Office, but did not wait for the report (which, by the way, came the next day to me of diphtheria). I at once gave her 5,000 units (10.30 a. m.); returned at 5.30 p. m., found no change in symptoms and gave her 3,000 units; re

turned 9 a. m. November 28, found her weaker but no change in membrane, gave found her 2,000 units; returned at 9 p. m., the membrane not involving new tissue, gave her 4,000 units; returned at II a. m. November 30, found no further tissue involved and gave her 2,000 units; returned at 9 p. m., found no new involvement, but having no antitoxin with me I gave her none; returned at 10 a. m. December 1, and her found new tissue involved and gave 4,000 units; returned at 10 p. m. with 6,000 units with me, but found the whole membrane had been spit out at once and all symptoms better and she had taken nourishment. For 3 days, or from 10.30 a. m. November 28 to 10 a. m. December 1, I had injected 20,000 units of Frederick Stearns' antitoxin. Her recovery was rapid and she was up and around on the 9th. On the 21st I was called and found her all bloated and suffering from acute nephritis, which condition responded to treatment readily and in another week she was discharged But and has been healthy ever since. further, I wish to state that previous to the attack, since the age of 2, she had suffered from hereditary syphilis, which would break out about once a year, and her hair would all come out and she would have pustules all over the body. I was informed she never had any treatment for it as it would get well of itself. But since the attack of diphtheria it has never returned, and she has enjoyed the best of health. H. B. BLYSTONE, M. D.,

Columbus, Ohio.

City Physician.

I

My Average Case of Confinement. Editor MEDICAL WORLD:-I am not an Since my amateur in obstetrical work. graduation at Ann Arbor, in 1883, I have attended over twelve hundred cases. never had anything to do with a case of labor, directly nor indirectly, until I began activ practise. I have never seen another physician manage a case of natural labor, nor have I ever seen such a case detailed in a medical magazine article. Outside of the lecture room, my only teachers have been study and experience. Seven hundred and twenty-three children were boys. The average length of labor pains was four hours and twenty minutes. The cases of twins were one in fifty-one; breach presentations, one in fifty; face presentations, one in one hundred and twenty-two; stillborn, one in ninety-two; forceps delivery, one in

twenty-eight; and primiparas, one in four. I have had one death from puerperal sepsis, for which I plead guilty and humbly beg for pardon. Two cases of puerperal eclampsia, treated by induced labor and medicins; one case of placenta previa, treated by rapid delivery and compression of uterus; two children died from congenital heart deficiency with cyanosis inside of eight days from birth; three had harelip, two in one family; and one had extra fingers. I never have had a case of perineal laceration that extended to the anus, postpartum hemorrhage, ruptured uterus, or deformed pelvis that required surgical interference.

I consider my method of attending ordinary labors as good as that of anybody on earth, and I am not holding my breath waiting for some one to show better results. My opinions do not entirely coincide with the best authorities, as will be seen from what follows. I do not conduct my cases as tho they were surgical, from the standpoint of septic precaution. I only use practical measures to guard against sepsis. never treat the eyes of the newborn with nitrate of silver solution. (Try a little in your own eye.) I never use vaginal douches after labor unless urgently called for by grave pathological conditions. The following may be considered a fair average case as I attend them.

I

Without previous notification of any kind, I see my patient for the first time after a long night drive. She has been in labor for from one to three hours, with at least two neighborly women, giving all the superstitious, meddlesome and kindly assistance within their power. She has on a dirty. pair of drawers, an old petticoat, and a calico wrapper. The bed has been "prepared." It has an excelsior mattress much depressed in the center by long-continued nocturnal use, and is covered with the oilcloth from the kitchen table, which converts the depression into a beautiful receptacle for vaginal and rectal discharges. In all probability the ladies present have been making kindly vaginal examinations with fingers that have been-the good Lord only knows where since last they were washt.

I enter the kitchen door, 'place my bag on the table, and ask for a basin of warm soft water and a clean towel. After removing my wraps I scrub my hands for three minutes with McClintock's germicidal soap and a nail brush, and then fill my nails full

of the soap. Upon entering the confinement chamber I discharge a general smile, and then request the ladies to strip the patient completely (between pains) and reclothe her with a clean nightgown, an old washable skirt, and a pair of warm stockings. While they are doing this I fold up an old comfort and fill up the depression in the center of the bed, placing the utility oilcloth over it. Over this I spread a clean sheet and enuf old clean cloths to form an absorption pad of sufficient capacity. The patient is then put to bed in the dorsal position on the right side of the bed, if possible. The nightgown is snugly folded up beneath her shoulders where it will not get soiled, and I proceed to make a careful vaginal and abdominal examination. I examin carefully, both between pains and during a pain, and determin the presentation, the amount of os dilatation, the degree of bulging of the membranes, the capacity of the pelvic straits, and the amount of feces in the rectum. I then almost invariably insert in the rectum a glycerin suppository, whether the rectum needs emptying or not. I find that rectal peristalsis favors uterin activity in these cases. I then get things ready. I call for a glass containing eight teaspoonfuls of water and place therein four hypodermic tablets of scopolamin, 1-100 grain, and four of morphin 1-4 with atropin 1-150, and two granules of carmin. I give the patient one teaspoonful of this solution if I think that the labor is to be somewhat tedious, and two if I consider birth will occur inside of two hours. I then fill my chloroform dropperbottle and place it with the inhaler in a convenient place. I take out my hypodermic syringe and examin it to see that it is working freely, and place it beside a bottle of "ergone" on the table. I put my obstetrical pulling slippers near the stove to get warm, and tell them to put a kettle of soft water over the kitchen fire to boil.

I make frequent vaginal examinations, each time carefully washing my hands with the germicidal soap and filling my finger nails. When the os has sufficiently dilated to make but little resistance to the oncoming head, I break the "bag of waters" with my finger nail, notching it if it is needed in order to do so. From this time on I keep the end of my finger almost continuously upon the child's head to keep in touch with the progress, and to gauge the amount of expulsiv force. When the head

reaches the perineum I compress the fundus uteri with my left hand, and with my right hand covered with a dry towel I compress the perineum from sides toward center to guard against laceration. During these pains I have some one hold the chloroform inhaler on which I have poured the chloroform about three inches from the patient's mouth when she draws her breath in.

When the head emerges I try to favor the perineum by gently pulling forward the shoulder under the pubis so that it will precede the lower shoulder.

Placing the child on its side with its mouth in a position favoring expulsion of mucus, I then with both hands compress the uterus firmly around the placenta.

After tying the cord firmly one inch from the body, I cut off and hand the child over with instructions to wipe all blood stains off with a clean cloth wrung out of warm water, and then to freely anoint the baby all over with soft fresh lard. I consider lard the most nearly steril of any substance for this purpose, and it is a ready solvent for the sebaceous material on its skin.

I at once proceed to extract the placenta. by a kneading compression with the left. hand and gentle traction on the cord with my right.

After a careful inspection I permit some old lady to cremate the "afterbirth" so the "woman won't have no after-pains."

With a small pocket electric lamp I inspect the perineum to determin to what extent it is lacerated. If over one-half inch, or if torn behind the skin, I at once give a little chloroform and put in one to three deep silk sutures with a curved needle.

I give one-half teaspoonful doses of the scopolamin solution not oftener than one hour for after-pains, as may be needed.

I order that the baby shall not be washt for three days, that it shall be fed nothing but small quantities of equal parts of milk and water, and that it be put to the breast when it is six hours old. I warn them to give the child no sugar, no whiskey, no "tea," and to keep it hungry, so that when the mother's milk shall begin to flow it will eagerly keep the breasts empty.

I permit but do not advise a "binder" for the mother, and I allow her a generous diet to build up her strength. I do not go to sleep and tell them to call me when I am needed, nor do I stand around indifferently while the woman is suffering. I please my

ST. LOUIS, U. S. A., Dec. 21, 1905. MR. KLINE:-We are pleased to enclose a sample of "Antikamnia Tablets" for pain. A sample of something good for pain, is a "good thing" to keep about the house, or for convenience, in your pocket or purse.

Antikamnia Tablets will relieve all headaches, muscular pains, neuralgias, la grippe, insomnia and women's aches and ills. The enclosed booklet tells when and how many, and druggists everywhere sell them in any quantity or in our regular "Vest-Pocket-Boxes" as below.

Sincerely yours,

THE ANTIKAMNIA CHEMICAL COMPANY, FRANK A. RUF, Pres. and Treas.

Letter to Antikamnia.

Dear DOCTOR TAYLOR:-I inclose herewith a copy of a letter to the Antikamnia Chemical Company. If you think it in the interest of the medical profession you are at liberty to publish it.

It is true that I have invariably destroyed their calendars for a dozen years or more. Their intent, in which they have met with too much success I regret to say, has been to make an advertising medium of the medical profession to get their "AK" tablets onto the laity. I am sorry that the doctors are willing to be such dummies. Very truly, H. W. CHAMPLIN.

BLOOMSBURG, Pa., January 9, 1906. Antikamnia Chemical Company, St. Louis, Mo. SIRS: As I was destroying your 1906 calendar, just at hand, it occurred to me that it is not the

fair thing to permit it to come year after year and immediately consign it to the waste basket. Hence I write to say that Antikamnia Calendars and all other Antikamnia advertising matter and samples coming to me will be immediately destroyed as heretofore for the past dozen years.

My reasons are good and sufficient, as you can readily believe. If thousands of doctors have not written you to the same effect, I am sure it is not because they do not think the same, but simply neglect to take the trouble.

With the best interests at heart of all that pertains to legitimate medicine, I am Yours very truly,

H. W. CHAMPLIN.

Dr. D. A. Walker, of Southwest, Pa., desires a plan for an ideal doctor's residence and offices, latter of two rooms, to be incorporated in the same building. This will be, of course, according to the location -whether city, town or country, size of family, amount of cost to be put into the building, etc. But maybe some one can help the doctor. Also, it might be profitable to discuss the matter of the doctor's officehow many rooms, where located ( (whether in or adjoining his residence or not), furniture, equipment, etc.

Remedy for Fleas.

Editor MEDICAL WORLD-In January WORLD, page 22, "California" wants to know how to get rid of fleas. If a flea is examined under a microscope it will be found to be as full of thorns as a blackberry stalk. Hence the remedy is mechanical. All farmers know that sheep will get rid of fleas, but few people seem to know that the little pests get tangled up in the wool and starve to death. They will live and thrive on hogs and dogs, but the wool on sheep gets away with them. Hence the remedy: a few sheep about the premises a short time, and the fleas are gone. Clyde, Ohio. W. VAN NETTE, M. D.

Pest Remedies.

Editor MEDICAL WORLD:-In answer to "California," in January WORLD, I would say that if he or anyone will write to the Waltham Chemical Company, Waltham, Mass., he will learn of guaranteed remedies not only for fleas, but for various other pests. I am in no way connected with the company, but I know they have remedies for fleas, water bugs, roaches, moths, bedbugs, etc., that will positivly do the business. HALL STAPLES, M. D. [Who knows the composition of these preparations?-ED.]

Waltham, Mass.

In opium poisoning, where it is impossible to get the patient to swallow, strong coffee may be injected into the rectum with good effect.

Those Frisco Lots and a Collection Agency. Editor MEDICAL WORLD:-I took particular notice of Dr. Arthur's article on "A Doctor's Experiences with Various Investments" in January WORLD, pages 15 and 16. The Frisco Lot and Land Company sent an agent thru here. He called on me and I did not bite; he called on another doctor here, one who has a little money to invest, and he invested, as did our banker and some others. They thought the proposition must be O. K., as the agent was a brother-in-law of the banker, and one or two others. When I saw that article, I took it across the street and read it to my friend, the other doctor, and while I was reading it to him, another gentleman who had invested in the lots came in, and when I finisht reading the article they both said that their investments turned out the same as did Dr. Arthur's.

I lookt into the doctor's waste basket and there lay the December WORLD! I said, "Doctor, if you would read that journal you would find lots of those frauds exposed and probably you would not invest your hard-earned money in those shaky investments."

As to collection agencies, I am doing some business with the "United States Federal Co.," of Chicago, Ill. I do not have to pay any membership or retainer's fee or any advance charges. They only want our old accounts that we consider an absolute loss, and we pay them 50% of the first one hundred dollars collected, and after that only 20%; and if nothing is collected we pay them nothing. Mystic, Iowa.

DR. W. J. FENTON.

The Sayers Mercantile Agency Co. of St. Louis. Editor MEDICAL WORLD:-I see in the January WORLD, page 15, a semi-endorsement of the Sayers Mercantile Agency Co., of St. Louis, Mo. I have had business relations with them in the way of collecting medical bills that were very far from satisfactory to me. They charged full commission on bills they only partially collected, and that were never paid in full. For example, on a bill of $32.75 there was collected $5.00, and on this they charge a commission of $4.91 and a docket fee of 50 cents, making their charge Of 41 cents more than the amount collected. the charges for the collection of the other notes none made so bad a showing as the above, but they were far above and beyond what the charges would have been, according to their contract. They got their pay, as charged, by diverting payments to themselves, which should have been sent to me. Parsons, Kansas.

M. W. COWAN, M. D.

Editor MEDICAL WORLD:-On the 22d of March, 1899, I was called upon by a Mr. George H. Bell, who claimed to be an authorized agent of Savers & Co., Collections, Suite 44-46, Laclede Building, St. Louis, Mo., and was so imprest by him that I gave him $800 worth of notes and accounts, paying him 10 cents apiece for the accounts, or $1.20, and bought a book of blanks called a Claim File, for which I paid him $1.00. The $1.20 was for "postage." He very kindly helpt me to make out the accounts on the company's regular form, and courteously left for parts unknown. On the 16th of March,

1900, I wrote to the company and inquired about the collections I had given Mr. Bell. On the 17th of April I received a letter from them, saying that Mr. Bell had never turned in to them any accounts of mine. On the 18th of April, 1900, I received a letter from Sayers & Co., saying that Mr. Bell called that day, and he claimed that he had mailed the list to them at time of receiving them, but the company claimed they never received the same. Mr. B. had fortunately retained a copy of the twelve claims, which he furnisht to them. They askt me to please notify them of the receipt of any money that I might have received on the accounts, and to notify them if I should receive any in the future. On the 8th of June, 1900, I received a letter from Sayers & Co., wanting to know how I liked the Sayers Claim File.

me

This was the last I heard from them by letter or otherwise till December 19, 1904, when another agent of this company called on with credentials and a regular outfit from Sayers & Co., (now 408 Olive Street, St. Louis). He stayed in the town four or five days and got sick, claiming to have the grip, but he was a "boozer" besides. His card bore the following:

This man ran a bill with me for medical treatment amounting to $3.00 and left without bidding me good-bye or thanking me for my kindness, let alone paying me for same. I had given this man two accounts for collection-one a note of $100 and the other an open account of $14, but I never heard from them till the 3d of March, 1905, and again on the 24th of March, requesting me to send them a list of the money payments I had received. On the 25th of March I wrote them, giving in detail the facts concerning their Mr. Mitchell.

So it is seen that even the experienced editor of THE WORLD will make a bad guess once in a while, as shown by his tentative endorsement of this firm of Sayers & Co. But hurrah for THE WORLD anyhow. I believe it strives to be right. J. J. CANNER.

Pana, Ill.

One of the many letters praising THE WORLD and containing pay for the coming year, which we are constantly receiving, winds up this way: "as it would not be pleasant to read something not paid for." Please think of this, all ye who have not yet paid for 1906.

Mercury biniodid, in doses of of a grain, in watery solution every 8 hours, is highly commended by Dr. Hare in the abortiv treatment of tonsillitis.

Sulfate of Copper for Rhus Poisoning.

Dr. Max Werder, of San Francisco, says that a solution of "blue stone" (sulfate of copper), a piece about the size of a pea to a pint of water, will cure rhus poisoning; and that application of this solution to the parts, after suspected exposure, will prevent the poisoning. He says: "I have used it in California for years and it never failed."

Gonorrhea and Bright's Disease.

on

Editor MEDICAL WORLD:-In September WORLD, page 346, I had the honor of calling the attention of the medical profession to the dangers of using methylene blue and salol in cases of socalled "clap,' account of their liability to cause acute Bright's disease, which, if not detected, might run on and become chronic, and thus eventually cause the patient's death. I respectfully suggested, that in my opinion, no doctor should use either of these drugs without making an examination of his patient's urin at least once a week; and if he found more or less albumin, he should immediately discontinue their use. I am surprised that some doctor has not, thru THE WORLD, either had a few words to say in corroboration or criticism of that article.

Gonorrhea is notorious for running a very uncertain course. In one patient it will subside under almost any plan of treatment, while in another it is checkt only by the most skilful treatment on the part of the doctor, and strict obedience on the part of the patient. The remedies which have been proposed for its cure are legion. It may be briefly stated that the treatment depends entirely upon the stage of the disease and the prominence of its various symptoms. I would respectfully suggest as a palliation for the general practician's proverbial ill-success in the treatment of many cases of this disease, that I feel assured that their medical brothers who are so situated that they have had occasion to treat thousands of cases will not severely criticise the following: the doctor who "knows it all" about this very common disease and the proper treatment of all cases of it and its various complications, has yet to be born. Boston, Mass.

GEO. S. WILSON, M.D.

Galangal and False Unicorn Roots.

Dr. E. B. Silvers, of Rahway, N. J., has an article in March WORLD of last year, page 116, in which he recommends galangal root and false unicorn root as stomachics. Inquiries have come both here and to the doctor, as to where those roots may be obtained. We inquired at a leading retail drug store here and were told that these roots are seldom kept in retail stores, and when found in a retail store they are likely to be old; but that they can doubtless be obtained at the wholesale (and retail) house of Rob't Shoemaker & Co., Fourth and Race Streets, this city. Dr. Silvers writes that they can be obtained from Messrs. Peck & Velson, 7 to 9 Gold Street, New York City. They can also doubtless be obtained from our prominent manufacturing pharmacists, as Frederick Stearns & Co., Detroit, Mich.; Wm. R. Warner & Co., of Philadelphia, etc.