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cious. Says he could breathe deeply, but cannot bear the pain; besides, deep breathing excites cough. His pulse is strong, full, and bounding, 100 to 120 per minute. Now, doctors, what shall I call this case? I call it pneumonia.

At this stage of the game I am not afraid of morphin; if there is nausea I give apomorphin; if not, I give morphin with atropin. If I give the apomorphin the stomach is empty in a few minutes. If pain or stitch in side continues, I give a hypodermic of sulf. morphin. This gives perfect ease with deep breathing. At this stage I am not afraid of acetanilid. I generally carry a preparation made as follows:

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M.-Triturate thoroly. Dose, 5 gr. to 15 gr. Follow the hypodermic with a dose of the above mixture. In from 20 to 60 minutes the patient begins to complain, "Oh, I am so A few minutes later a colliquativ hot!"' sweat sets in. Your patient is now comfortable. For an hour or two hours he may perspire so freely as to wet his clothing and sheets. When he ceases sweating I have his sheets and clothing changed. He may have a light chill in from two to four hours after the perspiration sets in; but if he does not turn blue (cyanosis) followed by high temperature, your treatment is safe. He may have a slight rigor, a scarcely appreciable cyanosis and very little rise of fever; do not fear this. In four hours from first dose of mixture, give another small dose of same.

[We present the above portion of a long and frank article from an honest and respected Missouri brother in order to point out the danger of his practise. Perhaps he does not know that the activ ingredient of bromo seltzer is acetanilid. When he knows this he will realize that his acetanilid mixture is too strong, particularly as it is without any tonic or stimulant of any kind neither caffein nor ammonia, which are the drugs usually used to counteract the depressing effects of acetanilid. It is no wonder that his patients become cyanosed, and suffer from drenching sweats. Acetanilid should not be given to such a dangerous degree. It is thought by the most careful and conservativ practicians that such a dangerous depressant should not be used at all in any stage of pneumonia, even in the first stage in plethoric subjects. If it is used at all, it certainly should not be combined with a secret proprietary which is itself heavily charged with acetanilid. An acetanilid mixture should contain something to counteract the depression usually caused by the acetanilid, and the most popular drugs for this purpose are caffein and carbonate

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Editor MEDICAL WORLD:-After reading your editorial in November WORLD, page 440, Í at once purchased 30 grains of quinin hydrochlorate, and made a 2 oz. solution, enuf for four injections, and labeled it, with the idea that I would have it ready and would use it on the first case of pneumonia that I had. I did not have to wait long. A few mornings ago I was called to see a woman about 50 years of age, weight nearly 200 lbs. She had a chill at 1 a.m., had severe pain in her side, respirations were 36, coughing a good deal, and had a very anxious expression. I pronounced it pneumonia, and gave her one large dose of quinin, thinking to follow out Dr. Galbraith's treatment. This was 7.30 a.m. I called again at 5 p.m. and found her vomiting. She had not been able to keep the quinin down. Her fever was 1021⁄2°, pulse 100, the expectoration was markedly rusty, showing that my diagnosis was right. Her inability to keep the medicin down brought to mind the solution of quinin hydrochlorate which I had ready. I went home, got my solution and my antitoxin syringe, and injected a trifle more than a temperature was 9920, pulse 94, expectora quarter-about 9 grains. Next morning her tion still rusty; 5 p.m., temperature 99%, pulse 88. Next morning, temperature 9930, pulse 84; 5 p.m., temperature 9930, pulse 72, sputum clearing. The next morning, the third day of the disease, her temperature was normal, and pulse 72, and her sputum clear.

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Now! Should I wait 8 or 10 years until I can report 50 to 200 cases? I say, no. every one report to THE WORLD right away, and inside of a year we will have a treatment for pneumonia that will reduce the mortality. I would like to have other reports of the injection treatment.

Albany, N. Y. GEO. T. MOSTON, M.D.

Barium chlorid is of value in infectious diseases in which the circulation is weakened by central vasomotor paralysis, rather than by primary weakness of the heart. The drug acts chiefly by increasing the blood pressure thru the influence it exerts upon the vaso-motors. The results in pneumonia are particularly good. This is a drug which has been too greatly neglected in the search for more quickly acting preparations.

Treat Bill Perkins, Not Pneumonia. Editor MEDICAL WORLD:-Rarely do two physicians use the same therapeutic methods in the treatment of pneumonia. Dr. Bogart, page 484, and Dr. Kemper, page 485, December WORLD, treat pneumonia in about the same way. This is the eclectic method of treating the disease.

Dr. Whitman, page 483, treats his patients in an entirely different manner. He uses homeopathic remedies in low dilution. Now, the question arises in the mind of the layman, how can pneumonia be treated scientifically in such diverse ways? If Bill Perkins is sick, and his sickness is named pneumonia, shall we treat pneumonia or Bill Perkins? The scientific therapeutist will answer, treat the condition that you find, regardless of any arbitrary name which may be applied to it. Fit your drugs as therapeutic measures to Bill Perkins and his condition as you visit him from time to time, and change your drugs or other treatment as Bill Perkins' condition changes. It goes without saying, that the close observing physician will see that the conditions of the patient, Bill Perkins, require different treatment during the first, second, and third stages of pneumonia; therefore, Bill Perkins must be treated, and incidentally his pneumonia.

Dr. Bogart gives a mixture of veratrum viride gtt. v-x, bryonia gtt. viij-x, and asclepias tub. 3 ss-3j, in water 3iv. The specific medicins of the above represent I grain of the crude drug to the minim. The specific indication for veratrum v. is a full bounding pulse-i. e., sthenic condition. Indication for bryonia: pain or stitch in the side, worse on movement; that is, inflammation of serous membranes.

V.

Dr. Kemper uses aconite instead of veratrum

This is the remedy for asthenic inflammation, indicated by the frequent small pulse; but it should be remembered that neither veratrum nor aconite should be given when there is a weak pulse.

Dr. Whitman uses aconite in the first stage, followed by bryonia. In the second stage, phosforus.

Phosforus is indicated by a sensation of weight on the chest, frothy or blood streakt sputa. Sulfur is indicated in delayed resolution, or pus formation.

Dr. Whitman says: "Let the heart alone." This pre-supposes that the patient has been under treatment from the beginning. If the heart is failing, and the physician not called until the lung is solidified, what heart remedies should be given? The modern text-book mentions among the prominent remedies which influence the heart, digitalis and nitroglycerin.

The indications for digitalis are: a pulse of

low tension; intermittent pulse with cyanosis; i. e., relaxation of the vessels-dilatation. Digitalis is a very slow acting remedy, and is therefore not a remedy to be depended on in an emergency, being absorbed slowly, and requiring from 12 or 14 to 36 hours in order to get the characteristic effect of the drug. Nitroglycerin is indicated by a high tension pulse; i. e., it relaxes the capillaries and arterioles. Its action is opposed to digitalis.

In pneumonia we have an obstruction in the lungs, requiring the heart to perform an extra amount of work, plus septicemia, from absorption of toxins. The nerve centers are profoundly deprest by the toxic poisoning. The physiological heart remedy would be strychnin or capsicum or both; and for the septic condition, an antiseptic which would be eliminated largely by the lungs. Creasote carbonate is one of the new remedies of this nature. older practicians used the iodids of potassium or ammonium.

The

The older physicians used the jacket poultice. An old physician who had years of experience told me that he had many times witnest the beneficial effect of the jacket poultice, the solidified lung softening, and resolution commencing in from 12 to 24 hours after the application of the poultice. In my own case the hot poultice felt very grateful, and relieved the pain and discomfort, yet I realize that the poultice would kill a patient with feeble circulation thru the lungs.

Dr. Reed uses hot water bottles around the body and ice over the lungs and head. This treatment might do in selected cases. I should select a patient whose power of reaction is first class.

Then again, the treatment of a pneumonia patient in the high altitude of Colorado might differ from that of a patient in a low altitude.

Brethren, "Let us have the conclusion of the whole matter:" Study your patients, study your materia medica, and fit your treatment to the individual patient. Bill Perkins may have pneumonia on Wednesday, and he may have pneumonia on the following Sunday, but his condition may require diametrically opposit treatment; therefore, there is no treatment for pneumonia. Bill Perkins must be treated. Ipswich, Mass.

WM. H. RUSSELL, M.D.

Never attempt to reduce a Colles' fracture without administering an anesthetic. Nearly all cases of deformity following such fractures are due to failure to properly break up the impaction before attempting to secure alignment and apposition of the fragments. Short anesthesia gives ample time to do the adjusting thoroly and completely, and with all opportunity for satisfying oneself as to the accuracy of his work. Once a Colles' fracture is properly reduced, it is very easily retained in position, and any difficulty in retaining the apposition should at once arouse suspicion that the fracture is not properly reduced.

Homeopathy and "Regular" Medicin Compared in the Treatment of Pneumonia. THE WORLD:-In an editorial, page 433, on Pneumonia, you say:

"Altho the disease has been known for so long, and despite the familiarity of every physician with its manifestations, it has, as yet, defied the efforts of clinicians and bacteriologists. We are apparently little nearer its mastery than we were decades ago, and it is certain that our therapeutics, in this connection, must be conceded to be purely empirical, or at best only symptomatic, * * *. Indeed, when the knowledge of the profession is summed up, the result is very unsatisfactory. We have absolutely no drug or method in which we can place any reliance in its power to influence favorably, either the septic condition or the process in the lungs."

The following is clipt from the Dallas (Texas) News:

"Chicago, Ill., Jan. 28th. Drug treatment is useless in cases of pneumonia. The medical profession, so far as medicins are concerned, can be of no assistance in the fight against this disease. The sooner the profession will acknowledge this to the public, and set to work to discover some specific to save pneumonia patients, the better for all concerned. This startling statement by Dr. Arthur D. Regan, who stands high in the profession, has stirred up the members of the Chicago Medical Society at their meeting. Several physicians sprang to their feet to protest against the arraignment. All had to admit, however, that there is no definit remedy known, and they based their protests solely on the contention that they might influence the patient favorably by easing him somewhat, and by the moral effect of their presence."

Here's what homeopathic authorities say. Fisher's Diseases of Children, page 663:

"If there be a disease in which the results of the homeopathic treatment as compared with the old school treatment are satisfactory, that disease is pneumonia. Osler is responsible for the statement that pneumonia is a self-limited disease, and runs its course, uninfluenced in any way by medicin. It can neither be aborted, nor cut short by any known means at our command. This statement is so exactly in variance with the testimony of homeopathic physicians whose word is considered equally as reliable with that of Osler, or any other old school authority, that we are justified in making the statement that homeopathy is far superior as a system of medicin, in this as in many other diseases in which the helplessness of the old school is freely acknowledged. For the clinical

course of pneumonia clearly shows that many, even severe cases, that seem to threaten disastrously, may terminate favorably, and it is a fact, that the ordinary case of pneumonia can be modified and abbreviated in almost every instance if proper medication be applied early. Just why this disease should be abandoned to its unrestricted and natural course is not understood."

Raue, Special Pathology, page 383, says: "The mean or average time which it takes pneumonia to run its course, if it is not interfered with by medicin, is as above stated, twenty-five days. But this average may, by judicious treatment, be considerably shortened, for pneumonia can be arrested in each of

its stages."

Jousset, Practise of Medicin, page 786:

"The various treatments disturb this natural course and increase or diminish the duration of the disease."

Arndt, Practise of Medicin, page 1007:

** the indicated remedy, selected upon homeopathic principles, does, nevertheless, cut short, and modify the course of pneumonia, reduce the gravity of the complications, and materially lessen the death rate."

This comparison of ideas of both schools is

given without comment, to show the WORLD family that there is a better way.

Paris, Texas. G. F. THORNHILL, M.D. [Homeopaths treat the patient, and not the disease-that is, they treat symptomatically. When all doctors treat the patient ill with pneumonia rather than pneumonia, the results will be better.-ED.]

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"Brains "Mud" in Chest Cases. Editor MEDICAL WORLD:-I believe the use of the glycerinized clay poultice by physicians is more from fashion or habit than from a fixt belief in its therapeutic value. I have never used it on my own person except as a dressing for boils; the boils did not improve. The application was unsatisfactory, and a poultice of linseed was substituted with markt benefit. I have sometimes prescribed glycerinized clay for my patients, but have never been able to satisfy myself that it was superior to any old poultice of domestic manufacture. I should, perhaps, make an exception that in inflamed and tender joints an application of the glycerinized clay has given better results than any other external treatment.

In colds, congestion of lungs, pneumonia, etc., an application of hot glycerin or camphorated oil to the chest and covered with a cotton jacket or pad of light material will generally prove useful, and may well be employed. The strongest claims for the glycerinized clay are that it depletes the tissues, is a protectiv, and does not have to be renewed often.

I have never been able to satisfy myself to what extent it depletes, if, indeed, it does so to any appreciable extent. It is evident that the evaporation is greater than the extraction of moisture from the tissues, or the poultice would not dry at all. Some of its disadvantages are that it is sticky, dirty, ard nasty, and is removed only with great difficulty before it dries; and when dry it crumbles and gets scattered over the bed and floor. It is too compact and too thoroly excludes the air from the skin. Its tendency is to sodden and debilitate rather than give the desired stimulation to the tissues. The poultice is too heavy. A case seen recently will illustrate: A child aged 2 years, ill with pneumonia, 52 respirations per minute, lying on its back, with a half pound of glycerinized clay spread over its chest; poultice to be renewed as soon as it would peel off. This was the fifth day of the disease, and the poultice had been on from the start. Now, suppose we do a little figuring. The little baby's chest muscles were lifting 26 pounds of dead weight every minute; 1,560 pounds per hour, and 37,440 pounds per day-as much as an able bodied man will move with a scoopshovel in a working day. Allowing the posi

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The Swallowing of Foreign Bodies. Editor MEDICAL WORLD:-A couple of weeks ago I was hastily called to see a little boy not quite three years old because he had swallowed a piece of lead. His grandmother is raising the little fellow, as his mother died two years ago. She is a very sensible lady, and has followed nursing a great deal, and so her statements can positivly be relied upcn. As has always been my custom in such cases, I advised a let alone policy. I believe that emetics or purgativs are a positiv harm in such cases. When the object swallowed is sharp, a diet of potatoes and slippery elm will at least do no harm. I advised her to watch the stools carefully, and to report at once any acute abdominal pains.

In just two weeks to a day the little fellow passed the lead, or soldering metal, which it really is. Its weight is two ounces.

My view as to its long journey is that the weight had the effect of drawing the bowels down, and thus it had to virtually travel up hill most of the time. It don't seem possible that so small a child could pass such a large object into the stomach, but the weight must have been an activ factor; then it had to pass the pylorus; this is not very large, particularly in a child; then came the ileo cecal valve. The wonder is that it did not fall into the cecum and give rise to operativ symptoms.

When an open safety pin will safely pass thru a child, most anything else can do so if let alone and Nature given a fair chance. The little fellow suffered very little indeed. About twenty years ago I reported to THE WORLD the case of a child swallowing a lot of small glass tubing, such as was used those days in the nursing bottles. I had only been in prac tise a couple of years and was at a loss what best to do; but I recalled what one of the professors often would tell the boys: "when in doubt, do nothing that can possibly do any harm." I therefore did not prescribe a thing, and in due course of time the child safely passed seventy-four sharp pieces of glass.

Bellingham, Wash. L. R. MARKLEY, M.D. [The doctor inclosed a drawing showing the

size and shape of the piece of metal; it was 1% in. long, 5% in. wide, and in. thick, and nearly regular in shape.—Ed.]

Carbolic Acid and Salt.

Editor MEDICAL WORLD:-In regard to the report of Dr. Wilson, in October WORLD, on the administration of salt as an antidote in carbolic acid poisoning: Shoemaker quotes in his materia medica, Sheurlen and Bechmen, who publisht a few years ago the results of their experiments, proving that the germicidal action of carbolic acid is decidedly increast by the addition of sodium chlorid. A solution of 1 percent of carbolic acid in 24 percent of common salt gives better results than 6 percent carbolic acid in water; so it appears that the doctor was doing just what he ought not to have done. Sulfate of soda or magnesia is a safe and prompt remedy; also vinegar.

Is the doctor certain that his patient swallowed an ounce of pure acid? for such an amount would be immediately fatal in 95 percent of cases. Let us all be careful in our reports of cases, adding to the honor of the profession and THE MEDICAL WORLD. Brooklyn, N. Y.

J. H. TRENT.

Care of Hypodermic Needles. THE MEDICAL WORLD:-Speaking of the sterilization of hypodermatic needles, Dr. Alexander gives us some good hints; but let me tell you how I do it. I could never see the use of the short attempt to cleanse the part for injection, as we know that it takes a thoro washing in order to make the place steril, and who has the time to prepare the part when every second counts against the patient; and time is usually one of the things that we are trying to save when we give a hypodermatic injection. I always have that old stand-by, carbolic acid, at hand, and I simply dip the needle into it (95 percent), and inject into the arm or wherever it happens that I want it. Afterwards I simply dip it in the acid again, and I am ready the next time, even tho I am caught with no other antiseptics, as we all are at times. Even tho a minute globule of the acid remains on the needle at the time of injection, it does no harm. I use the P. D. needle, and with twelve hundred and fifty (1250) injections I have never had an abscess; and the patients do not complain of it hurting as much. As to the care of the needle, suffice it to say that one lasts me from 400 to 500 times, and that regardless as to the period of time that it takes to amount to that many. That is long enuf for any needle to last any way, so why all that idle washing that cannot

be other than incomplete? Maybe this is not new to the family; if not, throw it aside. Bayard, Fla. GEO. D. KENNEDY, M. D.

An Enterprising Osteopath.—Question of

Consultation.

Editor MEDICAL WORLD:-We have in our

town a man who is a gentleman, straightforward and honorable in every respect, and a man of good intellect. He has practised osteopathy here several years, and since locating here has studied medicin, taking his required number of terms and graduating in a medical college of good standing, stood the State Board examination and received his state certificate and registered.same.

Now he announces to the medical profession and to the public that he is practising medicin and using osteopathy as an adjunct only, the same as we would use electricity, hot air, etc., as adjuncts.

Now, the question we wish your opinion and the opinion of the readers of THE WORLD on is this: Are we, as physicians, keeping within the bounds of medical ethics when we consult with this man? Is it our duty to consult with him? Of course, consultations to be strictly on a medical basis, and nothing whatever in the osteopathic line.

We inclose his announcement and card, clipt from one of our papers, that you may see it.

Would like to hear from the Editor and readers of THE WORLD on this question. W. P. WATSON, M.D., J. A. FERGUSON, M.D.

Dyersburg, Tenn. [We congratulate the osteopath on his enterprise. We would like to see physicians become as enterprising in regard to osteopathythat is, take it up as a study as this osteopath took up medicin, and master it. We see no reason why you should not consult with this gentleman. You would consult with any other man or woman who has attended medical college in the regular way, and passed the State Board examination. Then why not consult with this man? His card in the paper is modest-as much so as any card could be. I am surprised that he does not mention osteopathy in his card; but he doesn't.—ED.]

Dr. J. M. Luttrell, of Mineral Wells, Tex., gives tr. iodin comp., 5 drops in plenty of water, every three hours, as his chief treatment in typhoid fever. It acts as an intestinal antiseptic.

He wants to know what has been the experience of readers of the "regular" school with Lloyd's specific tinctures. He also wants to know the best motor-bicycle for durability and low cost of running.

Treatment for Epilepsy.

Editor MEDICAL WORLD:-Doctor Noxon asks for treatment for epilepsy. The best treatment I ever used was a teaspoonful of fluid extract of passion flower and a teaspoonful of fluid extract of black cohosh, every three hours, together with some good cathartic.

Search for the cause while giving the above treatment, and remove by surgery if necessary. No drug habit is formed by the use of above remedies. Miss M-, age 33 years, had suffered since 6 years old-frequently 15 to 20 seizures in 24 hours. After five weeks of above treatment, a decided improvement. Treatment continued, and after two months she would sometimes be free from attack as much as three weeks. Dallas, Texas.

S. D. BULLINGTON, M.D.,

Lost Manhood.

Dear DOCTOR TAYLOR:-The young man sat by the window. Who shall say why? He was a very young man. The fuzless innocence of his superior labium was a sleepless incubus to him. This is not exceptional. He did not lack in nativ aplombness, and he was pronouncedly chic. Still he was of a good family and had a golf record. In an idle moment he pickt up a newspaper-a religious hebdomadal. Without any particular reason, his eyes fell upon the picture of a very sincere and plausible looking gentleman. Connected with the picture was printed matter. This printed matter held a revelation for the young man. It was all about lost manhood, and it was the most frightfully convincing stuff he had ever read. After reading, and re-reading it, and nervously studying it, he became convinced that he was a total wreck; or at least that he soon would be, unless he put himself under the care of this eminent physician. The physician was eminent, for, with halting diffidence, he had admitted it in his ad. But the young man shrank from making a confession to "the governor" (his father), and therefore where would the money come from wherewith to remunerate this medical philanthropist? was full of red blood, micturin, concupiscence, etc. His virilic safety valve had been in proper physiological evidence for some time. Under the lurid glare of this learned doctor's flaming periods, nature's innocent assertivness was metamorphosed into the prodromata of knock-kneed imbecility or screeching insanity. The young man was scared gray, almost.

He

To intensify his anguish, the charmed vision of Etta, his sweetheart, floated into his mind— Etta whose melific towardness had saturated his soul with saccharin dreamery. What would she do if she knew he was on the verge of impotency, which would be quickly followed by

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