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statement in former attack from eight to trums, and what they can do in from two ten weeks, and 42 of them were under to three weeks. The philosophy of most treatment at the dispensary during this of these quick cures is based, as a rule, attack from four to ten weeks. He sums upon the early employment of some strong up by saying that of the 187 cases of acute astringent injection, causing, as pointed gonorrhea, 17 remained under treatment out by Taylor, a rapid and early onset of and he believed carried out the treatment the mucous terminal period of the disease, faithfully until they were pronounced the chief characteristic of which is a thin cured. Of the remainder, 170 cases, 121 watery discharge which might readily pass were under treatment from four to ten unnoticed by a careless or unobservant weeks, but he does not seem to be certain patient. of their good deportment. The record of I have nothing new in treatment to offer the 17 cases he considers the most impor- to this body. There are four methods emtant because they were composed of medical ployed ; 1st, internal medication, alone ; and dental students, and married men 2d, internal treatments combiped with a who were anxious to get well and stayed hand injection; 3d, irrigation of the under treatment until they were pro- urethra, alone; 4th, irrigation combined nounced cured, and abstained from all with internal treatment. I prefer the indiscretion, and each case was considered fourth mode, irrigation and internal treatcured when the urine contained no clap- ment. irrigate with permanganate of shreds with pus and gonococi. The length potassium, 1 to 4,000, increasing gradu. of time required to cure these 17 cases was ally every two or three ddys until I reach as follows: three cases in four weeks, 1 to 1,000 or 1 to 500 in about two weeks, three cases in six weeks, two cases in seven and I then give a hand ringe with a soweeks, four cases in eight weeks, and five lution of some mineral stringent, such as cases in ten weeks. Three of these had sulfat of tinc or acetat of lead, two or anterior and fourteen general urethritis, three grains to the ounce of water. Inand the duration was over six weeks in ternally, I give first a saline diuretic for eleven cases. I have a record of two cases eight to en days and then balsam of of general urethritis recently treated, one copaiba and oil of sandalwood, or some by the hand syringe method at his home, remedy of that class until the case is well. and internal medicine, tbat lasted twelve I really prefer nitrat of silver, 1 to 6,000, weeks, and the other by the irrigation increast t 1 to 1,000, but owing to its method at my office twice a day combined staining properties it is diasgreeable to the with internal treatment, that lasted eight patient. Also, in my section of the counweeks, and I believe these cases abstained try, the wiiter is full of chlorids, and so from all indiscretions.
few of our draggists use distilled water, The diagnosis and cause of gonorrhea that the siler is decomposed in the water does not enter into this paper, as we are and ruined. all familiar with the fact that it is like the In closing I will say, that I have tried poor, “we have it with us always,” it is to impress three things upon this body by also a fact, if the statement of the gyne- the statistics T have given. cologist be true, that over fifty per cent. First. That gonorrhea is a more proof his cases are the result of gonorrhea, longed and serious affection than it is usuthat we, as general practitioners, are feed- ally considered by the general practitioner ing their tables by not more fully impress- and by the laity. ing on our patients the gravity of their Second. That the period of time for a trouble and the importance of staying cure in uncomplicated general gonorrhea is under treatment until they are well. from six to eight weeks.
Under treatment which hardly comes Third. The importance of making an under the heading of my paper, I would examination of the urine for clap shreds like to call your attention to the innumer- before deciding that a case of gonorrhea is able drugs and plans of treatment so cured.-H. T. Bass, M. D., Tarboro, N. C., highly extolled in the eulogistic articles of in N. C. Med. Jour. our weekly journals, all claiming to cure gonorrhea in from two to three weeks. In seborrhea of the scalp the Medical Methods claiming to cure in six to eight Age prescribes eight to ten parts of resorcin weeks are not in vogue, and are, therefore, in ninety each of alcohol and water, to be not publisht, but the newspapers are full used as a lotion once daily, after thoro of the praise of Big G-and similar nos- washing of the head with green soap.
These were then compared with the marLyon Médical for March 19th remarks riages of cousins. The latter showed a upon the habit among women of using the lower percentage of sterile marriages and bosom—the space between the mammary a slightly lower percentage of mental disglands--as a repository for various articles, eases. In pulmonary and congenital disletters, the watch, the purse and the like. eases there was about the same percentage Our contemporary goes on to say that of difference in favor of the former. In all Julia, daughter of Augustus Cæsar, being other particulars the difference amounted pregnant, was desirous of giving birth to to as little as any such comparisons can. a son. In order to ascertain the sex of In the one hundred cases of those not reher unborn child, she carried an egg in lated, 17 per cent. were sterile ; in the her bosom. The augury was auspicious ; cousins-german, 14} per cent. These figa cock was hatcht from the egg, and she ures agree very nearly with Huth's invesbore her husband a son.—New York Medi- tigations.-Med. Standard. cal Journal.
Physical Stock Taking After Forty.
I have for a number of years been imGive iron when the menses are scanty presst with the
presst with the importance of the indiand lack color; give arsenic when the vidual who has reacht the middle mile flow is too profuse, prolonged, or frequent. post of life calling a halt and taking stock,
-Fordyce Barker. figuratively speaking, as to his physical Chronic leucorrhea of long standing can
equipment, habits of life, work, exercise, be cured only by persevering in frequent diet, etc. The old saw that every man is local use of astringents thru a speculum, either a physician or a fool at forty is true, together with hot vaginal injections.
but the trouble with the members of our Mundé.
profession is that at forty most of us are All pelvic congestions are venous, and
both physicians and fools. Our devotion the term “ chronic inflammation," so far
to others, to our patients and our profesas it applies to the organs in that cavity, sion, and our own ambitions, ambitions is a misnomer, because the arterial vessels
in the direction of name and fame rather are not involved in that process.-Emmet.
than wealth, we overlook almost uniThe most common displacement of the formly our own health. The death-rate is ovary is dislocation downward into the ret
not so great among any class of men in
the upper walks of life as among physiro-uterine pouch, to which the name of prolapse has been improperly given.- Tait.
cians, and the reason is apparent. The
saying that a woman is as old as she looks Cancer of the womb usually begins on
and a man as old as he feels is to a degree the vaginal portion of the cervix, and con
true, and yet the statement that everyone sequently has to bear the brunt of the
is as old as his arteries is universally true. insults of coition and parturition.—Goodell. Surely the physician knowing these things
Tepid vaginal injections, so generally should so adjust his personality to his recommended and inadvertently used by work and his routine of living as to guard patients in place of hot injections, have no himself to the best advantage. We know positive therapeutic effect whatever.- that all of the organic diseases, Bright's Barnes.
disease, diabetes, atheromatous degenera
tions in general, are due to the accumulaMarriages Between Cousins.
tion of earthy materials in the system, to In an effort to compare one hundred improper diet, improper elimination, which cases of marriage between cousins-german Jatter is largely brought about by too great with hundred average marriages nerve tension, overwork, but still in the where no relation existed, the author, majority of instances dependent ugen negDr. John Inglis, says the Medical Record, lect of proper diet. Doctors eat irregularly, took by lot from a physician's case-book, hastily, and oftentimes in their desire to who had practised in a town of 1,500 in- tickle their palate they eat to an excess, habitants for thirty years and knew their enormously.
enormously. The death within the past family histories well, the names of one ten months of six of the leading medical hundred families, and had this physician men of America has made a deep impresgive him the record of these one hundred sion on me, and I feel that their life and inarriages with regard to sterility, pulmo- death furnish a text that we should all nary, mental and congenital diseases. study. It has been my pleasure to know
them all intimately and well, admiring, "I ought to be in a position to say appreciating them all and loving them. something on this subject, for until not In the death of these six men, William long ago I was disabled, and not until very Pepper, John A. Larrabee, A. M. Owen, recently I didn't know anything about the John B. Hamilton, George H. Rohë and pathology. I don't believe to-day we James H. Etheridge, a great vacancy was know any better how to explain the action left in the ranks of medicine. They were of uric acid salt than we did a hundred all earnest, honest, constant, unremitting years ago. I am indebted to the book the workers ; they all gave the least possible writer referred to, Haig, for most valuable thought to the proper selection of diet, the information on the subject that I never manner and time of eating. I have seen understood until I got hold of that book. them all neglect their own personal well. I think I understand it now. I never being along the lines of diet for the benefit began to get well until I followed the of their patients. I have seen them suggestions made by this writer. No one shoveling in food during the time when ever tried harder to get rid of anything they were engaged in work and in every than I did to get rid of this trouble. No way acting like unintelligent beings. one ever took physic more greedily than I Every one of them died forty years, at did, trying to get well, but the suggestions least, ahead of his time. It is true they that this man makes, as soon as I adopted did an
enormous amount of work, and them I began to get better, until today, probably more during the time they did so far as I know, I am free from gout and live than many of us who will live twice can do as much work as I ever did. And as long, but they owed it to themselves, his suggestion is very simple. Give up all to their families, to those who loved them, meat, every variety of meat. I haven't to give them the benefit of their society touched meat for many, many months. for the longest possible time. Every one Give up all coffee, tea, cocoa, because they of these men died suddenly, shocking and contain uric acid. Drink milk, eat every grieving the medical world, and every one variety of vegetable and fruit that you of them died as the result of atheromatous
can get hold of. Don't hesitate to eat degeneration, from preventable causes-- tomatoes; I eat them whenever I can get interrupted metabolism and accumulated hold of them. I don't hesitate to eat an earthy materials. Knowing then as we orange. I don't hesitate to drink whisky do, about these gouty disturbances, these when I want it, but fortunately I don't accumulations of earthy materials that want it very often. Now, briefly, that is ought to be eliminated and prevented by the way I have recovered my health and a proper selection of diet, exercise, habits gotten rid of this gout. I will suggest of life, it behooves us all to study the les- another thing; that the nervous system son before us. Nearly every individual has a little more to do with it than we are drinks too little water. He should form a disposed to admit. Altho I had gout so habit of flushing out his alimentary canal badly and it lasted so long, attacking my and other excretory organs frequently eyes and making me blind for a little with large quantities of water during the while, preventing my reading for weeks day and particularly in the early morning. and weeks, altho I have had it in both After forty, less meat should be eaten, less feet at the same time, and my knees were food which tends to the accumulation of all swollen and deformed, suffering horriearthy materials within the body, less bly, I haven't got on my fingers or toes a nitrogenous food in general. If meat be trace of it. I baven't got a trace of uric eaten, chicken, bird, veal, lamb chops and acid. And my gout usually came when I other immature flesh are best; more vege- was run down, when I had too many sick tables and plenty of fruit should be par- people, when I had what every one of you taken of. Apples are one of the healthiest have had, patients who gave me too much fruits that can be given, and if the indi- anxiety. Cases incurable have never vidual will eat every day in the year a troubled my mind much after I concluded sufficient number of apples, there will be that nothing could be done, but in cases less demand for cathartics.
which could be helpt, and a number of Speaking of these gouty disturbances, them, sometimes eight, ten or a dozen peomy friend, Dr. Hunter McGuire, of Rich- ple who would die if I made a mistake, conmond, Va., in the discussion of a paper stant anxiety in those cases gave me gout. read by Dr. Upshur, is reported in the I never drank wine or beer or anything of Charlotte Medical Journal as having said: the sort, never cared for them in my life,
have always been a small eater, always arteries. Cultivate a tranquil mind to the glad to be able to take a small drink of fullest extent, not permitting the mental whisky, and I congratulate myself that tranquillity to merge into intellectual la ziI am able to do it now and it does not hurt ness. Let us more and more determine me. I don't know about strawberries. I to be amiable and to love our fellow-man, don't believe I earned the gout by high forgiving or ignoring our enemies. Let us living. If I had I would have too lost it remember more and more as we approach for I lost everything else that I have earned. our second childhood, which we all hope It must have been inherited. If it was, it to do, that meat is for strong men and was the only thing that I inherited that I milk for babes. Let us trade off some of held on to. I only speak about it because our horses, walk more and buy cows in I have had so much personal experience. their place. Pursuing the proper rules of We might well look and see how much the diet, mental quiet and proper attention to nervous system has to do in this trouble. elimination, exercise both physical and It has something more to do with it, I mental, let us determine to keep in the think, than we are usually disposed to ad- harness and do the best work of our lives,
tho we may do less of it, and we should Concerning the hardenivg of the arteries, all live to be close to one hundred and posprophylaxis and treatment, Whittaker sibly even cross over the century line.-Dr. recently observed :
I. N. LOVE, in Medical Mirror. “The prophylaxis depends upon the ability to adjust the work to the changes List of Questions Submitted by the Pennsylwhich have already taken place, and to vania Examining Board in December, 1898. live a life of perfect hygiene. The man of
ANATOMY. fifty years must learn that he cannot do the work of a man of thirty ; that is, as
1. Outline a healthy liver in the erect Emerson says, he must 'take in sail.'
posture of the body. Syphilis need not be contracted. Absten
2. Name three ganglia connected with tion from alcohol is a sine qua non.
the fifth pair of nerves. avoiding worry the patient may learn to
3. Describe the prostate gland, and content himself with less wants, remem
give its position and blood supply. bering the statement of Socrates that he
4. Give the origin and insertion of the who has the least wants is nearest to the pectoralis major muscle. gods. In all things temperance; and this
5. Give the distribution of the radial remark applies especially to diet. Arterio
nerye below the wrist. sclerotic changes are less frequent in the
6. Describe the bip-joint. herbivora. The individual should, there
7. Describe the ureters and give their fore, take less animal food, and indeed less
location and point of entrance into the food of all kinds. He should especially
bladder. distrust the heavy evening meal. The
8. Describe the trachea and bronchi, best food is milk. An exclusive milk diet,
and give their nerve supply, from two to four quarts per day, will put
9. What is the linea alba, and how is it a stop to the changes of arterio-sclerosis
formed ? in the kidney. Tho strain of hard work
10. Describe the sphincter ani. must be lessened. On the other hand, the
THERAPEUTICS. individual should not lead a too sedentary 1. State the changes in the pulse, and life for fear of increasing abdominal ple- how produced, by the administration of thora. Coffee produces abdominal ple- digitalis and veratrum viride. thora. The quantity of it should be 2. In the treatment of syphilitic node or lessened, at least. The weight of the
gumma; state which should be used, a whole body must be kept down."
mercurial or an iodid, and give the reason In conclusion, it is well to remember, as therfor. one grows older, that he may on general 3. Give the reasons which would deprinciples safely eat less and defecate termine the employment of a vegetable or more. Put the teeth in the best shape for a mineral astringent in acute inflammatory thoro mastication and eat more fruit and conditions. less flesh ; exercise liberally, for laziness 4. Differentiate the conditions in which and indisposition to walk grow upon one opium and hyoscin should be used to proas time advances. Exercise certainly duce sleep. favors elasticity of joints, muscles and 5. State when calomel, or podophyllum
should be given, and give the reasons for tive procedure for aneurism of the upper the selection.
third of the femoral artery. PRACTICE
8. Describe the ligation of the radial 1. Give the characteristic appearances, artery at its lower third. and state the time of the eruption in the 9. Describe and give the treatment for exanthematous fevers.
a vesico-vaginal fistula. 2. State the symptoms, dietetic and medi- 10. Describe and give surgical treatment cinal treatment of acute ileo-colitis,
for fissure of the anus. 3. Enumerate the symptoms of simple
OBSTETRICS. spasmodic laryngitis, and give plan of 1. What methods and precautions would treatment.
you employ in the induction of premature 4. Give the symptoms and prognosis of labor ? chronic transverse myelitis, (lumbar). 2. Define, diagnosticate and give treat
5. Give the symptoms and prophylactic ment of ectopic gestation. treatment of cholelithiasis.
3. In what abnormal conditions of the PHYSIOLOGY.
pregnant woman may embryotomy be em1. Give the physiology of the secretions ployed ? of the pancreatic juice, detailing the func- 4. What is the “bag of waters” and tion of each histologic element concerned. how is it formed ?
2. Describe the mechanical and chemical 5. Define abortion and state three of its phenomena of respiration, and give its possible causes. rate at different ages.
6. What are the causes of post-partum 3. Describe the circulation of the blood hemorrhage ? in the infant, just before and just after 7. How would you diagnose and deliver birth.
an occiput in the hollow of the sacrum ? 4. What is the relation of the capillaries 8. How would you diagnose, and what to the circulatory system?
is the mechanism of labor in the left 5. Minutely explain the glycogenic func- mento-iliac anterior position. tion of the liver.
9. Give the etiology, premonitory sympPATHOLOGY.
toms, clinical phenomena and treatment 1. Name each coat involved and detail of eclampsia. the changes occuring therein, in the de- 10. What is the ordinary course of twin velopment of sacculated aortic aneurism. labor, and what are the difficulties likely
2. Describe inflammation in serous to occur? membranes.
MATERIA MEDICA. 3. Describe the post-mortem appearances 1. Name three drugs incompatible with in endocarditis.
belladonna and two incompatible with 4. What is the essential difference be- pilocarpin. tween calcification and ossification ?
2. Give the usual dose of creasote and 5. Designate which component part of tell how it is best administered. the spinal cord is involved in locomotor 3 Name four official pills and give the ataxia and describe the metamorphosis of principal ingredients of each. structure characterizing the pathological 4. Define tinctures, extracts and ointprocess.
ments and tell as a rule how many drops SURGERY.
of a tincture are in a fluid dram. 1. Describe the symptoms and treatment 5. Write a complete prescription, conof acute suppurative osteo-myelitis.
taining at least three drugs, for acute 2. Describe the technique for an opera- bronchitis in an adult. Use no abbreviation on the brain.
tions, 3. Differentiate recto-anal neoplasma
CHEMISTRY. from hemorrhoidal tumors and prociden- 1. Describe the chemical changes in the tia recti.
blood in its passages thru the lungs. 4. Give symptoms prognosis, and surgi- 2. Give a distinguishing test for lactic cal treatment of intussusception.
acid in the gastric juice. 5. Give concisely the symptoms, dangers 3. Describe boric acid and state its uses. and treatment of a fractured rib.
4. Describe a test for organic matter in 6. Name the different varieties of water. wounds and give the general indications 5. How would you detect albumin in for treatment.
the urine and how differentiate it from 7. Describe the preparation and opera- urates and phosphates?