Self Mutilation. Editor MEDICAL WORLD:--About two years ago I was called 7 miles in the country. When I arrived I found a man about 35 years old who had castrated himself, by cutting off scrotum and testicles, and throwing them into the yard. I askt him why he did it. He replied, "I didn't want to be bothered with the things." I afterwards sent him to the insane asylum at Logansport. M. R. GODFREY, M. D. Michigan City, Ind.

Hygiene For The Aged.

Editor MEDICAL WORLD:-Shall we eat to live? or vice versa? Surely not the latter, particularly not after adult life is reacht. If any possible exception obtains to this as applied to human physical strength and development, it is with the young and growing child. However, surfeiting even with proper food is never advisable during any stage of life. Aged people, after the activities of life have in a measure past by, should use especial care in relation to food, air and exercise. The latter should be performed out of choice, and because of the pleasant associations attending employment, practicable in moderation and for the love of it. Proper and needful exercise stimulates appetite and digestion and enables the aged person to eat to live, in lieu of living to eat, or going thru the ceremony of taking food at regular intervals regardless of the demand of the system. But very little food even if of proper quality can be digested and assimilated by the aged except continuous physical activity is kept up. An excellent rule for the aged is, first to never take food except appetite demands it, second, never eat until appetite is fully satisfied. While this rule is good for all, it is especially desirable for the aged, and its observance will be found to be an excellent preventive of a sluggish liver, and consequent hypochondria, enhancing much

the enjoyment of life. The observance of proper hygiene is of special importance to those in the evening of life, to the end that their last days may be spent in peace and comfort. W. C. DARBY, M. D.

White Cloud, Mich.

Case of Strychnia Poisoning. Editor MEDICAL WORLD:-I have been very much interested in the discussion in THE WORLD on "lard as an antidote to strychnin poisoning," so have decided to report a case occurring in my practice. In Dec., '97, J. P., white, a lad of 12 years, took from 10 to 15 grains of strych. sul., with suicidal intent. When he was seized with his first convulsion, a negro man started on foot for me, a distance of about a mile, and when I reacht him, about an hour and a half after the drug was taken, I learned that an old negro woman, who was his only attendant after the man started for me, had given him about a half pint of castor oil and a teacupful of melted lard as soon as she could after his seizure. Nevertheless, when I saw him, he was in opisthotonos position, black in the face, jaws firmly set, sardonic grin, and had all the symptoms of the last stages of acute strychnin poisoning. As I could get nothing in his mouth, I hurriedly made a solution of chloral hydrate and gave him a hypodermic, and repeated until I had injected fully 100 grains before he began to relax sufficient to swallow, when I gave him tannic acid and bromid by the mouth, also a hypodermic of gr. apomorphia. Emesis occurred in a few moments. I catheterized him and remained with him for three hours. No further spasms occurring, I left him and he made a good recovery.

I have thought this a remarkable case on account of the time that had elapsed from the time he had taken the drug until I saw him, and have always believed that the lard and oil given him saved him until I reacht him. However, I think its action was only mechanical, by holding the drug that had not been absorbed in suspension, and preventing the rapid absorption; but that it was being absorbed was proved by the terrific continued spasm he was having. and I have no doubt that he would have been dead in a very few moments but for the timely and free use of the chloral hydrate.

I have learned to depend upon this above anything else in strychnin poisoning, by my experience in one other case,

where no lard was used, but of course combined with other drugs: tannic acid, bromid, emetics, etc.

That lard is of undoubted value I think has been clearly proved in your columns, and I think it would be a good idea to acquaint the laity with its value as much as we can, as that is the nearest and most convenient thing for them to use before sending for a physician.

I have omitted many minor details in the above case, so as not to take up any more space in your valuable magazine than necessary. I am only a new subscriber, and am certainly well pleased with THE WORLD. J. H. MOORE, M. D.

Fair Play, S. C.

Adjusting Fractures and Care of Same.

Editor MEDICAL WORLD:-Nothing in my experience requires more judgment, caution and experience than the accurate adjustment of fractured bones, and retention of the same till the fractured ends are solidly united.

My recent results have been better than during the first years of my practice. Some points may be of interest.

1. Beware of putting up fractures too snugly.

2. Never put bandages next the skin unless you are looking for trouble.

3. The surgeon who never returns to see how his fractured bones are progressing will have crooked legged men cursing him.

4. Take plenty of time to set a broken bone; you haven't any more important business than that.

5. Leave your patient comfortable if you possibly can.

6. Return as often as you think it necessary to secure a union that you can be proud of.

7. Profanity and rufness don't make a surgeon.

8. Massage and passive motion should be used as soon as safe, to avoid anchylosis of joints and to get a useful limb as soon as it can prudently be accomplisht.

9. Plaster of paris encasements are one of the most dangerous treatments in use. 10. Never discharge a case of fracture till you know you have firm and complete union. M. C. MARTIN, M. D.

Paxton, Neb.

C. L. Seymour, of Spanish Camp, Tex., writes: "I used to think that government ownership of railroads and the telegraph was populistic' doctrin; but since I have been reading your Monthly Talks I have come to the conclusion that it is right, especially in these days of trusts and other combinations. I will endeavor to have your Talks publisht regularly in our county paper."

The Rational Use of the Injection Treatment of Hernia.

Editor MEDICAL WORLD:-From recent reports and inquiries, the injection treatment is being earnestly discust.

There seems to be doubt in the minds of some as to the permanency of the benefit. It appears that others, also, have obtained a somewhat similar opinion from the article in which I opposed the treatment of hernia under the plan "No Cure, No Pay," stating that the companies who followed that plan failed, owing to their not giving satisfaction. Those companies promist all patients that they would be able to dispense with support after treatment, and it is only natural that those who were not able to do so should become dissatisfied.

According to Malgaigue, the frequency of hernia increases progressively from childhood to old age, when it reaches at the age of 70, one man in every three. This shows conclusively that, as one grows older, the resisting powers of the parts gradually become less, hence more liable to rupture, and consequently there is less prospect of being able to dispense with all support with safety after any treatment. Nature has not only ordained that the resisting powers become lessened after reaching the period of decline, but the construction of individuals varies, the same as in the different kinds of wood. For example, an axe handle can be made of willow, but it would require bracing to prevent it from breaking; while one made of oak would not require support. So too with those whose systems are similar to willow; the hernia may be cured, but the natural disposition remains the same, and to prevent recurrence would require sufficient support to overcome the natural weakness; while those with systems similar to oak will in all probability be able to dispense with support.

The importance of Mr. Birkett's remarks that "the practice of leaving cases of rupture in the hands of mere tradesmen cannot be too highly censured," is only fully appreciated by those who have suffered the torture which is sometimes caused by hernia, or by those who have witnessed a large number of cases.

The general method of simply referring cases of hernia to a truss establishment certainly reflects discredit on the profession; but that such a condition of affairs exists, is due mainly to two causes; viz.: The majority of physicians consider a truss

the only relief obtainable; or, those who are not disposed to treat such patients themselves, seem justified in hesitating to refer patients to specialists. If all specialists would treat patients referred to them by other physicians only for what they were sent, confidence would soon be restored, and would prove mutually beneficial.

The results from the injection treatment in about 95 per cent. of all cases of reducible hernia can be included under one of the following divisions, with an illustration of each:

1. Cases in which the hernial rings and canal can be entirely closed, but require on occasional treatment afterwards to retain them in that condition.

Mr. W., aged 78 and feeble; ruptured twelve years; rupture most likely caused by general weakness. Previous to treat ment, four years ago, he had a scrotal rupture which caused him much annoyance and suffering. Up to that time he had been wearing a severe truss, but had not been able to obtain one which would retain the hernia when coughing or stooping. He received a few treatments, and since that time has remained practically cured, altho it is necessary to give a treatment probably once in three months. He now wears a support with light pressure and is entirely comfortable.

2. Cases that can be permanently cured, but require a light bandage to be worn afterwards.

Dr. W., aged 50; ruptured eighteen years; complete, indirect rupture, medium size; hereditary predisposition. Previous to treatment the hernia would descend as soon as he stood up unless supported, altho he had been wearing a proper truss for years. He received five treatments, but after dispensing with a truss for a few months he felt a sensation of weakness. Two more treatments were given, but after going without support for several weeks, the same feeling returned. Two treat ments were then given and he was advised to wear a linen bandage when riding a bicycle or exerting himself. Three years have past since he received treatment and there are no indications of the trouble returning.

3. Cases that can be permanently cured. and able to dispense with support for an indefinit period.

Mr. E., age 34; ruptured six years. Previous to undergoing treatment he had never worn a truss, and the hernia filled

the entire scrotum. He has not worn support of any kind for the past five years, altho he is a hod carrier.

There can be no doubt of the usefulness of this treatment, providing it be properly given; but, to enable one to secure the most favorable results, it is absolutely necessary to individualize each patient and be guided by the conditions present, and not by the percentage of cures. It has been the means of restoring thousands to a sound condition or in giving relief to those whose existence previous to treatment was one continued life of misery and torture. C. FLETCHER SOUDER, M. D. 1418 Diamond St., Philadelphia, Pa.

[The trouble is that too much is expected of this treatment, and when it fails to do what is manifestly impossible, it is thrown aside as being worthless. Neither of these extremes is justifiable. This is caused partly by the extravagant claims usually made by the advocates of this treatment. Dr. Souder asks that this treatment be regarded just like other operations and remedies in the various departments of the healing art. No surgical operation is universally successful, yet we do not think of throwing surgery entirely aside. Quinin does not cure every case to which it is given, yet no one thinks of discarding this valuable remedy. learn to properly give the injection treatment for hernia, and do not make quackish claims and promises, but as a candid physician quietly and with dignity command the confidence of your patients, and they will be duly grateful for the benefit that you give them by this treatment as well as by other kinds of medical services that you render them.—ED.]

Then

Practical Mitigation of Cruelty to Animals.

Editor MEDICAL WORLD:-The article on page 204 of the May WORLD on “ Vivisection That Arouses No Protest," giving the vast number of bungling and unnecessarily painful castrations of animals, appealed strongly to me. It seems to me that the "societies" are prone to follow one line of thought, and overlook a great many cruelties, whilst they follow some special hobby.

Great stress is laid on the fact that it is a fad for the "tony" class to drive horses which have been dockt; and on the misery endured by the horse during the operation, and ever afterwards by being deprived of this natural weapon against his great tormenter, the fly. This operation is with

out doubt painful, but the stump soon heals, and the immediate suffering of the animal ceases, if the operation is properly performed. Personally I think it a cruelty to cut off the tail of the gentle family horse; and if every member of the medical profession would consider a tailless, mutilated horse a "kicker," and refuse to purchase or drive the same, the example might be emulated by others who are lovers of "man's best friend."

There are other practices which are more reprehensible than docking horses, and which are never toucht upon by our philanthropic friends. The S. P. O. C. T. A. I., some time ago, called the attention of the president of one of our "societies" to the fact that thousands of horses are suffering because of the mutilation of their feet by blacksmiths.

The average blacksmith knows no more of the anatomy of the foot of the horse than he does of the location of the garden of Eden. He cuts and carves until there is nothing remaining bearing semblance to the normal foot. Look on your public streets any day and you will see horses who have been made cripples by the blacksmith. See them limp, or while standing, lift first one foot and then the other, in vain attempt to obtain one moment's respite from suffering. See the contracted foot, and imagine the pain that this poor animal must suffer, until death comes to his relief.

The veterinaries are doing a good work in trying to remedy this evil of mutilating the foot, but the average blacksmith is a pretty poor student; he follows in the footsteps of his master, and can give no reason for the excessive cutting except that he was taught to do it. If these societies are so solicitous about the suffering of dumb animals, why do they not try to prevent some of the remote causes of this suffering, as well as the immediate causes?

There is a law in Massachusetts which provides that whoever performs the operation of docking a horse shall be liable to a fine of fifty dollars. If the society wisht to stop this practice, why did they not have a law past that every person having a dockt horse in his possession should be liable to a fine. If a poor fisherman is found with a few lobsters in his possession, he is fined five dollars for each and every one which does not measure a certain number of inches as prescribed by law. Was this docking law formed to favor a certain class?

If the officers of these societies would

confine themselves to the practical questions connected with the prevention of cruelty to animals, it seems to me that they would accomplish more good. But they do not do this; a tight check rein and a dockt tail seems to be the stock in trade of these sentimentalists.

The officers of some of these societies occupy a great deal of their time in giving medical advice to the surgeon generals of the army and navy of the United States, and in championing the cause of the worthless British sparrow, whilst the real practical work for the alleviation of the suffering of animals is being done thru the efforts of the educated veterinary. The officers of these societies seem blind to any except gross and open cases of cruelty. If they would sympathize along practical lines, and not indulge in so much superstition, such as wearing sulfur in the shoes, or carrying horse-chestnuts in the pocket for frightening away disease, the medical profession would take more practical interest in their societies.

Ipswich, Mass.

WM. H. RUSSELL, M. D.

Medical Philosophy.

Editor MEDICAL WORLD:-I don't agree with Dr. Cooper in the April WORLD.

His references to the opinions of certain eminent physicians as an argument to sustain his views are no proof whatever of the uselessness of medicines. It is a notorious fact that many so-called eminent men in the profession are the poorest practitioners we have.

I will admit that there are few physicians who are capable of practising therapy in an intelligent and rational way, but that is no argument against the use of medicines. It is not that there is no indication for medicines, but not to know what to give and when to withhold, that brings medicine into disrepute.

Every physician has had cases that he has been unsuccessful with that have been easily cured by his neighbor, just because he knew what to administer. Medical knowledge is not classified. Every physician has facts from his own experience that are valuable and reliable, but he has not all the facts. The whole trouble in many instances is that we are not able to understand the conditions of each individual patient and the indications for remedies. Some are more able in this line than others.

It is not necessary for anyone to injure

his patient by striking at unknown conditions. We would better be conservative until we can unravel the obscure conditions, and then, if necessary, pour in the shots hot and heavy. It is a good plan to study our cases well. Take a little time

and look them up each day.

We must not rush from one patient to another, trying to do all the practice. Some one else wants to live and work and provide for his family also. When I used to practise in the country, it used to get me all "out of kelter" to get too much on hand. I always enjoyed doing a good day's work without "fuss and feathers," keeping in mind all my cases, then after coming home at night, sit down quietly and read them up, making preparation in mind for the morrow. This was solid comfort; and after a good night's rest (if I got it), to drive out next day with refresht mind and plenty of fresh ideas. had many glorious successes. I am still studying therapeutics and I enjoy it and ever shall as long as I follow the profession.

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Light medication" is all right in some cases, but it won't do in all. We must be prepared, if necessary, to give some very heavy doses. Many lives are saved by men who dare to do heroic things. Be sure you are right, then strike with a vengeance. Many a time have I gotten disgusted with light doses, and growing desperate, thrown in a few heavy shots that accomplisht the object sought.

We can't treat all patients alike. It is provoking that we can't, but so it is and we must submit and study the conditions of each case and meet them accordingly. The treatment laid down by writers for medical journals is practically worthless in a general way. They do some good in giving ideas, but any physician would be very foolish to adopt them as a routine treatment regardless of the clinical history and conditions of each individual case. It is useless to think that any man can lay down a specific treatment for any disease. Every physician should be independent in the way of meeting indications as they arise. Nothing else should be expected of any physician.

No medicine should be given unless there is special need for it.. I contend that no remedy that will cure or relieve is as bad for the patient as the condition that it is given to relieve. For instance, last fall I had a number of very stubborn cases of malaria in which it took as high as 70 grains of quinin between the paroxysms to

break them up. That amount did cure them, and is not that better than to let them run for weeks? The same heroic treatment is necessary in pneumonia complicated with malaria, and it will break the paroxysms and shorten the course of the disease.

Dr. Austin Flint's head was level when he recommended veratrum to control the pulse and salines and diaphoretics in robust individuals who had pneumonia. This treatment will hasten the crisis in spite of all that may be said against it. In asthenic cases of course a supporting treatment is indicated. This shows that routine treatment has no place in medicine. We need not advise light medication nor heavy medication; but use either as it becomes necessary. This is the only safe ground to stand on. Columbus, O.

S. C. DUMM, M.D.

Gleet.

Editor MEDICAL WORLD:-Gleet is the sequel to gonorrhea. The gleet may not appear in full evidence till several months after the previous gonorrhea has been apparently cured. Nevertheless, there has been a very slight mucous discharge noticed in very mild cases; only in the morning, when, by gentle pressure on the glands, a small bead of whitish mucus may be forced out of the meatus. This is the gleety discharge off a gleet sore on the urethral membrane.

When this morning gleet mucus is closely examined, it will be seen to be a soft scab that has come off a urethral sore.

All gleets are associated with a stricture, the sequel to the gonorrheal inflammation. Some are only slight, probably are slight elevation of cicatrical tissue. All strictures are not accompanied by gleet. Only those strictures that are accompanied by a sore have gleet.

After a gonorrhea has run a certain time and is apparently getting well, if the discharge continues losing the pus character, it is caused by a forming stricture or one already developt. Many such cases are made by the severity of the treatment, Strong injections may cause a simple inflamed spot in the urethra to take on ulceration. This then becomes the seat a stricture, forming bands of cicatrical tissue, narrowing the urethra and impeding the flow of urine. Accompanying this is the gleet discharge. In nearly all these cases the doctor is doing harm.

In some cases of gleet, the discharge may