The Medical World

C. F. TAYLOR, M. D.

Editor and Publisher

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season was unusually exhaustive, with appropriate treatment, etc. Please refer our editorial department for last June and see if you have any suggestions or improvements to make.

Talking Shop.

We wonder if there is anywhere upon this old planet of ours another class of men so persistently expected and forced to talk shop as the members of the medical

receipt is given.

It is said that "history repeats itself." I doubt the exact accuracy of this statement, for civilization is a more or less constant growth, with a set-back now and then, and here and there. But there are annual repetitions in the practice of medicine, as the same season comes again and again. For example, June is here again, and its demands upon you will be about the same as last year. Instead of repeating what we said last year, we refer you to it in order to refresh your memory. Our consideration of the diarrheas of this

in mere curiosity, whether from the idea that a doctor must be so specialized that he cannot talk upon anything except subjects connected with medicine, whether the laity think that doctors want to have opportunities offered them to exploit their cures, or whether there is the hope of obtaining a fact of therapeutic value in some future crisis of the questioner is an unsolved and unsolvable question. All we can say is that the fact exists that when a doctor goes out to spend an evening, when he meets a friend in the street, when he attends divine service and pauses for the usual moment of converse afterward, when he is waylaid in the house of some patient, or even when he is consulted in his office he is made the target of many pertinent and impertinent questions, as, "Awfully busy just now, doctor? "Much sickness at present? "What's good for a cold, doctor?" or really think the dead can be raised to life, doctor?" all askt with a faith in pleasing that is childlike and bland.

"Do you

It is to be deplored that the occasional young doctor will yield to the temptation to display his knowledge both of disease

and statistics, and will respond with "words of wisdom" to these silly questions. The older man is content to grunt noncommittally and look wise, but the new fledgeling sometimes swells with importance and gives views and ideas that may possibly impress the listener, and then again, may not. But at any rate, But at any rate, such utterances are probably the source of some of the fearful and wonderful newspaper medicine relating to abstruse experimentation with animals and men, wonderful feats of surgery and astonishing cures, with which we have lately been edified.

Medicine is one of the most dignified of the callings to which a man can devote himself, and should be held on this high plane. All effort to popularize it by "talking shop" cannot fail but result disastrously to both the profession as a whole and to the indiscreet talker. It requires special training to fully understand all the bearings of matters upon which idle questions are askt, and without this special technical training misconceptions are apt to arise. In whist Cavendish says, "When in doubt, play trumps;" and in medicine a like aphorism may be made: "When quizzed, say nothing."

"Husa."

About a year ago an article appeared in the Texas Courier-Record of Medicine, by "W. W. Winthrop, A. M., M. D.," extolling in extravagant terms the virtues of "Husa as a remedy for snake bites and the opium habit. This article was quoted and editorially commented on by the New York Medical Journal. Then quite a number of journals noticed the matter, THE WORLD among the number. On account of the large circulation of THE WORLD, and the enterprising character of its readers, the writer of the article received many inquiries concerning the mysterious plant. For this reason he wrote further to THE WORLD, perhaps wishing further free advertising. His letters were very skilfully and artfully worded. We had certain investigations instituted which finally

pointed to the fact that the mysterious "Husa" grew "in the morphin bottle" rather than in the everglades of Florida. The evidence, however, was not in a shape to admit of publication, so we let the matter drop; and we have noticed nothing further on this subject in our exchanges since until recently.

Fortunately the investigation of this subject was forced, as explained below, upon Prof. John Uri Lloyd, of Cincinnati, a prominent eclectic authority and a very skilful chemist. His full report was read before a joint meeting of the Cincinnati Section of the American Chemical Society and the Cincinnati Academy of Pharmacy, and is publisht in the April issue of the Medical Gleaner, of Cincinnati, from which I select the following quotations:

"Naturally, this conspicuity brought orders for Husa to dealers in American drugs and plant products. However, since such a thing as Husa' is unknown in trade, the Lloyd Library was askt to give its habitat and description. And lastly, since 'Dr. Winthrop' used the name eclectic in connection with his wonderful discovery, it was natural that from the study I have made of eclectic medicines, I should be importuned, both by pharmacists and by physicians, for information on this subject. This accounts largely for the interest I exhibit in bringing 'Husa' before this Society. I have before me a mass of correspondence on this subject, which I shall answer as follows, giving some information to those concerned."

*

*

To sum up, * * 'Husa' is said by 'Dr. Winthrop' to be an undetermined plant (unknown to science), found by two plumed bird hunters and gathered by them by the boat load. My investigation of Husa,' as sold by its discoverer to his professional patrons, is to the effect that 'Husa' is a liquid containing large amounts of sulfate of morphin, some salicylic acid, some alcohol, water, glycerin and coloring matter, probably burnt sugar."

"I would define 'Husa' as follows: A solution of sulfate of morphin to be administered under the name 'Husa,' and only by physicians. It is sold to physicians at the rate of $10 for about 234 grains of morphin. In support of this view, I offer the foregoing testimony and submit herewith the morphin obtained from a 25 cc. of each liquid. Until I am furnisht with a new plant containing morphin to the extent found in these experiments, I shall accept that 'Husa' is a con

coction."

Drug Prices.

Please see the article in April WORLD, page 139, entitled "Drug Prices Here and Elsewhere." We publisht the list sent by

the Farbenfabriken of Elberfield Co. without question. In this connection the following letter from Jos. R. Perry, Ph.D., M. D., Manufacturing Pharmacist, of Indianapolis, Ind., will be of interest:

"Editor MEDICAL WORLD:-I was surprised to see in your valuable and very interesting journal, a comparison of prices between Germany and the U. S., showing the U. S. prices to be much higher than those in Germany for the same class of articles. Now, my dear sir, with all due respect to your editorial acumen, I must say that you have been wofully deceived, as the goods in your list can be purchast in the U. S. for less money than in Germany. I obtained quotations from the Indianapolis Drug Co., a wholesale house here. You should be able to get better (lower) prices in Philadelphia. "

articles, but to like conditions of purity, etc., and also to like quantities, as large quantities can be purchast at a cheaper rate than small quantities. In obtaining the prices in this city, we were given the prices for the commercial grade in most instances, rather than the "chemically pure" grade.

We wrote concerning this question to a friend in New York who has spent his life in the drug business, and the following is. quoted from his letter:

"Take, for example, benzoic acid. I can show you price lists where the article ranges from 70 cts. per lb. to over the price you quote-depending upon what the acid is derived from; while at the same time I can show you invoices of Merck's benzoic acid from the gum-the pure article-at less than the foreign price you quote. In the same way I could pick out other articles on the list."

The Importance of Leukorrhea, or “Whites." Probably few women, married or single, but have at some time in their lives.

the discharge known as "the whites." So. accepted has become this proposition among both the laity and medical men, that but little attention is paid to its occurrence save to indicate to the patient the need of the use of some one or other of the nostrums lauded so highly for the cure of the symptom. This attitude has probably arisen from the fact that the occurrence of the symptom is generally passt over by the physician in his search for the cause of diseases, unless there exist other strong indications of ovarian or uterine trouble. It is very rarely that a doctor is consulted for the "whites" alone, and still more rarely that in such event he makes a thoro examination. He usually depends upon some routine formula for a douche, and too often assures the patient that the matter is of little consequence, and that improvement will soon follow. This state of affairs is greatly to be deplored, and this medical attitude is probably responsible for the fact that so many cases of uterine disease reach the point of malig

nancy before they are diagnosed and treated.

Leukorrhea may either occur before or after menstruation, or following cold, fatigue or irritation. In such event it is very slight and transient, the result of local irritation. Occasionally cases beginning thus without apparent importance, develop a chronicity of the symptom, with backache and dragging, tenesmus, bearingdown, etc. Many women become accustomed to these conditions and seldom complain, this often because of a nervous fear of an examination, which also is frequently objected to by their husbands, and also often from a feeling that it is simply a condition common to all of the sex, and does not need remedying.

The danger from the establishing of the chronicity of leukorrhea is not, however, the chief thing to be considered, but the fact that so many malignant diseases are characterized by discharge that to the woman would present no other characteristic than that of "whites," possibly a little more offensive than usual, but still "whites." In this fact, thus briefly alluded to, lies probably the reason that so many cases of cancer and other malignant disease go on to a point where operation is merely palliative and presents little hope for a permanent cure or lengthy relief.

It would seem therefore the duty of a physician to refuse to accept the patient's diagnosis in cases where there exists a vaginal discharge, and to insist upon examination, explaining, if necessary, the possibility that this discharge may indi'cate malignancy, and that he does not care to have the responsibility of the case unless he can make a sure diagnosis. An effort should be made to educate women to comprehend that leukorrhea is not a trivial, but possibly a very serious condition. Examination in such cases should always be made with the view of determining possible malignant disease, and considering the gravity of the possibilities, should be very thoro.

A Definit Standard of Strength for Drugs Wanted.

Sometimes a tall and vigorous stalk proSome soils produces only a small ear.

duce much wheat and little straw, and other soils produce much straw and little wheat. The same truth applies even more generally to plants used in medicine. For example, cannabis indica has always been considered a drug of uncertain action -sometimes having little or no action, and sometimes acting with unexpected promptness and energy. This difference is due simply to a difference in strength of different lots of the drug. Calomel is always the same strength because it is a definit chemical combination, and any disturbance of this definit combination would change its nature entirely. Quinin or morphin are also always definit for the same reason, tho these are definit organic combinations, while calomel is inorganic. But different lots of opium differ widely in their morphin strength. The separation of active principles, as quinin from cinchona and morphin from opium, was a great step in advance. However this is not possible or practicable with many drugs.

The Pharmacopea does not lead. Recognition by it comes only after recognition has become quite general unofficially. In the last revision of the Pharmacopea (1890) three drugs (opium, nux vomica and cinchona, were "standardized." the Pharmacopea is revised every ten years, let us hope that the committee of revision will, in 1900, do all it possibly can in the direction of definiteness of standard in tinctures, extracts, etc.

Danger Lurks in "Headache Powders."

As

The advent of the coal tar derivatives created a new era in medicine. A class of remedies that would relieve pain as if by magic, and without producing the bad effects of opium and other drugs usually relied on for the relief of pain, soon became popular with the profession. Unfortunately this popularity soon spread to the general

public thru the prescribing druggist. Now such items as the following (from a Pittsburg paper) are appearing in the newspapers:

As a result of three deaths from headache powders in this city, recently, the county authorities have taken a decisive step against this free and unguarded use. To-day the Coroner's jury rendered a verdict in the case of Mrs. Celia Butler, who died Sunday, twenty minutes after taking a headache powder, recommending that caution notices be printed on all headache powders containing coal tar derivatives, and that a State law be enacted to enforce the same. The jury urged that in the absence of any law all druggists should warn customers as to the danger of taking such powder.

Quick and magical relief of a severe headache leads to a repetition of the dose upon the least occasion, and also to neglect of the doctor, and neglect of proper rules for living. Thus the apparent blessing is a danger in disguise. Habitual use of these cardiac depressants can only lead to harm, and occasionally, as shown by the above news item, death follows their use. It has been loudly claimed that these "headache powders" are "harmless." Such prompt and powerful remedies cannot be harmless, and the people should be protected from this danger.

More Strange than the Rip Van Winkle Legend.

It

Recovery from long-existing mental aberration by a blow on the head has occurred so many times that it is scarcely a rarity in medical annals; yet such cases are always interesting. The following case is of unusual interest, not only from a medical, but from a sociologic point of view: distances the far-famed but legendary 20 years' sleep of Rip Van Winkle. It is more like a grave which was covered over previous to 1850 suddenly opening, and its occupant being dazed and bewildered by the many strange sights that meet his wondering gaze. We often say, if the dead could arise, what would they think of the many changes of the last half century? In the following newspaper report we have, practically, a case of this kind:

TOLEDO, May 18.-Mathias Steingruber, who is living with his grand nephew, Percy W. Holcomb, on a farm in Jackson township, near Fostoria, fought in the Mexican War as a member of a cavalry regiment. In a charge at the battle of Resaca de la Palma his horse stumbled and fell, throwing him to the ground and paralyzing his spine. Since that time his mind has been clouded. He has always insisted that he was only 21, and was going to vote for Taylor for President.

The other day he was struck on the head with a piece of wood from a buzz saw and lost consciousness. When he revived a peculiar expression was noticed on his face, as if he had just awakened from a long sleep, and he has since recovered his lost senses.