be very profuse, not purulent, but of a muco-serous character. In point of fact, the stricture in such cases bids fair to become soon of an entirely obstructive nature, and the character of the case is often altogether misunderstood. All cases of chronic gonorrhea are gleet and should be treated for stricture. Even small strictures often cause profuse gleety discharges I treat gleet with a conical steel sound. First I endeavor to find where the seat of the sore is, then I search for the strict ure. In many cases the stricture is quite small; often it is simply a thickening of the mucous membrane, and these are recent cases. I introduce a conical steel sound, preferring a smooth, olive-shaped tip. I have several sizes. First introduce the smallest size. This will most probably slip by the stricture. Then introduce the next size. Proceed in this way till one is introduced that will not pass the stricture. When you have markt the spot where the obstruction is, you have gained pretty accurate knowledge. The next move is to introduce the next size below. Such a conical sound will allow the olive-shaped bulb to pass;, then, gently force the conical sound thru the stricture to dilate it. The length of time such an operation is to continue depends on the state of irritability of the urethra, judged largely by the amount of pain it causes. Care must be taken not to be too severe on the urethra, I have several times seen severe urethral chills come on that endangered life. Possibly five minutes' manipulation may be long enuf for the first operation. How soon it should be repeated depends on circumstances. It must be remembered that the first stretching of the strictured parts is followed in a few hours by a contraction, and the urethra is often very irritable, Some excellent surgeons are in favor of carrying the stretching to the fullest extent that the urethra and state of the nervous system of the patient will tolerate at the first sitting. If the stricture is a hard one it would better be burst or cut. These are questions for the surgeon to decide, but I am inclined to go slow. If the stricture is recent and small, and the parts soft and easily dilatable, I do not hesitate to use as large a sound as can be, and retain it in position five minutes. I have done some good work by this mode of treatment when the condition of the urethra was favorable, and have made quick cures; but I am not certain that dilating a stricture will cure it, only when it is very recent and soft. The pressure of the cold sound, introduced every day, and the gleet treated by soothing injections, will cure many cases in a short while, but this is not often. +++ The old cases, and in which the stricture is hard, I prefer cutting to the bursting operation. I have seen several severe results follow bursting hard strictures. The cutting operation is not difficult if a good and proper instrument is used. + All gleets are benefited by the introduction of a cold steel sound as frequently as the nature of the case will permit, and the seance should not be too protracted. When urethral chill follows, I prefer to adminI ister gelsemium, quinin and to gr. of atropin, repeated every 2 hours. Comp. tinct. of bark is good, together with minute doses of strychnin, gr., and atropin gr., repeated every hour. As an injection I use chloride of zinc, grs. iv; syrup and water, aā 3ij, inject 3 to 6 times a day. Gelsemium is a valuable remedy to control nervous symptoms in these cases; to it may be added No. 6, of the eclectic dispensary, which is composed of tinc. of myrrh and capsicum. Some old cases of gleet are stubborn, but by proper care, all can be cured, the stricture being treated according to the above methods. I believe all these cases need proper tonics. Syrup of the iodid of iron in 10drop doses three times a day; also hydrastin and berberis aquifolium are good. To prevent the iron constipating, I give a pill: R Leptandrin, 3ss; aloes, 3ss; ox gall, to make a mass. Make 30 pills. One at a time, to be repeated 3 to 6 times a day. The food should be mostly vegetable; also milk and stale, light bread and softcookt eggs. Avoid copulation and all spirituous and malt beverages; moderate exercise in open air; avoid over-eating, but drink an abundance of water between meals; "early to bed and early to rise." DR. Jos. ADOLPHUS. South Atlanta, Ga. Dr. E. T. Spotswood, of Terre Haute, Ind., writes: "I heartily approve your Monthly Talks. The physicians of the nation are losing, or rather they have lost, the influence which they once had in national affairs. It is their duty to assert themselves. The lawyer is a politician in the lowest sense of the word, as he looks at public matters from the standpoint of his own advancement, while the great mass of the clergy are notoriously ignorant and one-sided in their views; and yet these two professions exert a much greater influence in public affairs than does the medical profession. The lawyer talks for his party because he knows that his own advancement depends on the success of his party." Patent Medicines and Their Influence on the Practice of Medicine. Editor MEDICAL WORLD:-There is a condition of things existing in the United States which threatens not only the dignity of our loved profession, but also its permanency. Volumes have been written on this subject, and appeals made to the pride of our standing before the world, urging that something be done to eradicate this evil which is rapidly undermining the very foundations of our stability as a profession. I refer to the indiscriminate vending of patent medicines. This is an ancient theme, and many pens have scribbled their anathemas against this evil in our medical journals; but still it is on the increase year by year, and soon bids fair to usurp the prerogatives we have so fondly cherisht as belonging only to the legitimate practice of medicine. The difficulties surrounding any efforts looking to the relief of this condition are almost insurmountable. Why? Our first thought would be that any means employed must first have the sanction and endorsement of our state legislatures. Thru them we would naturally think laws prohibiting the manufacture and sale of patent medicines would first have to be enacted. I doubt very much if it is possible to interest the legislature in many states in the Union to move the enactment of any such laws. Take up almost any paper, daily or weekly, and see the endorsement of patent medicines given by governors, senators, congressmen, assemblymen and mayors, with their portraits accompanying. Think you that these men would aid us when they are throwing all their influence in favor of "the stuff." In every soul-especially little ones-there is a craving for notoriety. No doubt these misguided philanthropists gloat over the display of their classic features as seen in the daily prints, and hug to their diminutive souls the flattering thought that it "makes them distinguisht." Would you naturally think that these men, who would allow such a display of their endorsements heralded thruout the land, could be induced to favor a reform in such a cause as ours? Our acquaintance with legislators would lead us to infer that these privileges are not given only for the relief of suffering humanity without some more substantial inducement. Don't rise, gentlemen, I am not going to impeach your integrity; you have done that yourse Gentlemen of the medical profession, there is too much power of money behind these corporations engaged in the manufacture of patent medicines to be met by so feeble an effort as we can exert in securing legislation for our benefit. Our endeavors will be met on every hand by the combined resistance of these wealthy corporations, aided by every wholesale and retail druggist in the land. Compared with their desire for increase of wealth, of how little value are the rights or wishes of so insignificant a portion of the community as we represent. Accompanying their struggle for the increase of their business is advanced the argument that untold benefits to humanity ensue by the use of their advertised panaceas. It may appear so at first, but what ultimate effect these remedies have on the individual does not immediately manifest itself. Is the human system a mechanism which can endure the indiscriminate administration of drugs with impunity? We who have made the subject of the delicate machinery of life our intense study for years feel how inadequate is all our knowledge to meet the different indications as presented in disease. As no two leaves in the forest are exactly alike, so no two cases of the same disease are exactly similar, and yet these widely extolled remedies have such a far-reaching power, and are so nicely compounded, they claim to have the power of curing every disease known to humanity. I believe that fully one-half of all the chronic ailments that afflict our communities is the result of the indiscriminate use of these same remedies. It must be so or else the citadel of life we inhabit is proof against the attacks of such outrageous combinations as some of these patented articles are. Most chronic diseases are now treated by the druggist dispensing these so-called specifics. If one bottle does not cure they willingly take a dozen. Would any of them come to us and follow out a systematic course of treatment for such a length of time? No! If our first prescription does not cure, the everlasting prescriber existing in every community gets hold of them, and presto, they are saved from the schemes of such unprincipled villains as the doctors. Our whole society is permeated with this desire to prescribe. The display of the ability to suggest measures for the cure of every ailment is very gratifying to most individuals. Every house-wife would consider her education sadly at fault if she could not cheat the doctor out of half his cases. I venture to make the statement that nearly all of the patent medicines sold are utterly valueless medicinally, and the only thing that causes them to be at all curative is the influence they have on the mind of the individual-suggestive expectation-with possibly the assistance of the alcohol and morphin which nearly all contain. This is not merely an assertion; let us prove it. Take some of the most familiar remedies of that class and analyze them. First let us take one which is perhaps sold more extensively than any other, Lydia E. Pinkham's compound. Tho Lydia has been dead these many years-rest her soul -her works do follow her. Almost every newspaper you take up you see a picture of a suffering female with an expression on her face as tho she had swallowed a cherry pit and didn't know what to do with it, while the accompanying affidavits tell of the wonders of Lydia's compound. This preparation is said to contain cramp bark, partridge berry vine, poplar bark, unicorn root, cassia, beth root and alcohol. The first two ingredients in this compound might be said to have some value as uterine tonics, but what possible value the rest have to cure anything no man knoweth. For years physicians have prescribed the first two mentioned articles, but never did they suppose their use could jerk the womb back into position if misplaced, or cause a suffering female of some eighty summers to dance a jig after a few doses of the medicine had been taken. Lydia's compound is said to do it. Another: Pisos' Consumption Cure is composed of tolu, lobelia, cannabis indica, chloroform, morphin, tartar emetic and spearmint. What a long hunt such a mixture as that would have after the tubercle bacilli; and even if caught, could it possibly kill the little fellow? Just a soothing cough medicine, that is all, but when widely advertised tis said to cure consumption. Shilo's Consumption Cure contains morphin, muriatic acid, henbane, ginger, wild cherry, chloroform, peppermint, alcohol, tar and sugar. This mixture is warranted to cure consumption; why don't it? Comment is unnecessary. Pierce's Favorite Prescription contains savin, cinchona, agaric, cinnamon, acacia, sugar, digitalis, opium and oil of anise. This represents perhaps the least valuable compound among those given above, and yet in all the newspapers you will see depicted to catch the eye, skulls and skeletons, which from the advertisements following you would imagine this prescription could almost rehabilitate with living flesh and blood. One more: 66 Kennedy's Medical Discovery," composed of sneeze-wort, bitter root, wintergreen, licorice, sugar and alcohol. This is said to be one of the most powerful powerful alteratives known to science. If a person knew he was paying a dollar a pint for such stuff it would certainly prove "alterative" to his opinion of its value. The remedies I have mentioned are a fair sample of the patent medicines of the present time, and do they not bear out the statement I made, that their value depends almost entirely on suggestive expectation and not on their worth medicinally? If we as physicians should prescribe these same remedies to our patients, could they accomplish in our hands such wonderful results as are claimed by patent medicine vendors? No. It needs the green panel bottle with its pink label and alluring suggestions to effect a cure so startling and universal. Of what possible utility is it for us to write of these abuses and have our articles publisht only in medical journals? They do not reach the eyes of those they are intended to benefit. The physician knows and feels this encroachment upon his prerogatives, and needs no instruction. Why not extend the field of their publication and let them appear in reputable newspapers? Why not cause these worthless prescriptions to be printed side by side with these flaming advertisements? Let people be disillusioned and educated to the fact that their credulity is being imposed upon, and that these wonderful remedies are mostly composed of opium, alcohol and some bitter principle without special value. If they knew this, would they be likely to be imposed upon a second time? You say newspapers would not publish such prescriptions; then buy up a newspaper or any number of them if necessary. The medical profession is rich enuf to have their side of the question publisht, as well as the patent medicine man. The czar of all the Russias has suggested the calling of a peace conference of all the nations of the earth. Why should not the medical profession suggest the calling of a health conference of representatives from every county and State in the Union? Let this assembly devise means to protect themselves against this evil, which usurps slowly but steadily year by year more and more the rights which they alone should possess? Notwithstanding abler minds than mine have written pages on this subject, I have yet to know of any feasible plan suggested for a reform in this direction. At first thought the means I have spoken of may seem somewhat visionary. Can any of you think of a better plan? If so, let us hear from you, that we may usher in the beginning of some plan to maintain our standing before the world. The test of our supremacy in the field of medicine will have to come some time, and the question must be solved whether the opinion of a man who has spent years of study to attain a thoro education in an honorable profession is of more value than that of the charlatan or a person wholly uneducated. Why not begin it now? FORDYCE H. BENEDICT, M. D. Danger of the Injection Treatment for Goitre. The danger of irritant injections has once more been emphasized by the sudden death of a lady in this city soon after receiving such treatment for the cure of a goitre. A "specific" for the treatment of goitre, which has been much advertised in the last two years, consists in the injection into the tumor mass of a mixture of carbolic acid and tincture iodin. One might suppose that Providence guides the hand of him who makes irritant injection into such a dangerous area. But there be others who have more respect for the supernatural than to believe that Providence sanctions such questionable methods. Dangerous methods are seldom called for in the treatment of goitre. Theodore Koches, who, upon this subject, can speak more authoritatively than any other man, says that 90 per cent. of the cases which come to his hospital in Berne are so benefited by medical treatment that no surgical operation is required.-Indianapoplis Med. and Surg. Monitor. Quiz Column. Questions are solicited for this column. Communications not accompanied by the proper name and address of the writer (not necessarily for publication) will not be noticed. The great number of requests for private answers, for the information and benefit of the writer, makes it necessary for us to charge a fee for the time required. This fee will be from one to five dollars, according to the amount of research and writing required. Dr. T. W. Mask, of Arcadia, La., asks for best treatment for bemicrania. He has been subject to sudden and severe attacks for 20 years. Who will give a good article on this subject? Dr. J. W. Miller, of Eureka, Tex., asks for best treatment for vomiting of pregnancy. Does the Doctor remember the article which we publisht a year or two ago on the success of protonuclein in this annoying trouble? This will be a good subject for discussion. I would be glad to have the addresses of some of the readers of THE WORLD who have practised venesection to any extent. Clayton, Ill. H. J. PARKER, M. D. Editor MEDICAL WORLD:-Would the patella of a man 43 years of age, fractured by violence or a sudden strain upon the ligaments, the two parts being separated half an inch, so unite by being closely and firmly held together, as to obliterate all evidence of fracture at the end of fifteen months, and at the same time the knee be partly anchylosed? the medical profession. Some of our phyHypnotism is getting quite a hold upon sicians are relieving the pains of parturition and surgical operations by it. What do you think of the advertisement here inclosed? Chicago, Ill. N. W. ABELL, M.D. [Union after fracture of the patella is almost always if not always ligamentous. There are reputable and professional books and periodicals on the subject of hypnotism; for example, "Suggestive Therapeutics," of your city. Don't pay a high price for a so-called "correspondence course," and a so-called " diploma." ED.] Editor MEDICAL WORLD:-Kindly let me know your opinion of the following case: In a recent case a woman died after lingering thirteen days. One physician claimed that death was due to a rupture at the fundus of the uterus. The lochia Constipation in Infants.-Injury to Arm. Editor MEDICAL WORLD:-Can you give me any formula that will work in constipation of nursing babes? Have had mothers change food and use laxatives, or when artificial food was used, have changed that. Have used castoria until 3 and 4 drams were given at once. Injections, usually of glycerin, or water and oil, are successful. A man was shot thru the fore-arm, bullet entering between radius and ulna on dorsal surface, and made its exit just in front of elbow joint, chipping lower edge of radius. Patient used the arm soon after shooting, to show that he could. Wound healed well, but arm has shrunken considerably. Can use it very little now. Can not rotate it. Can rotate it with the other hand toward radial side, but it immediately flies back when right hand is taken away. Fingers are numb. At times pain in elbow and shoulder joint are severe. We thought the arm was doing well at first, but since the atrophy began, and tendency of the hand to hang with palm down, we have used electricity, but with no improvement. Have tried to get the patient to go to an X-ray instrument, but he has not done so. The pain at shoulder likely comes from bullet wound in left breast, 1 inch above and a little to left of nipple. Any information you will send me will certainly be appreciated. Claude, Tex. W. A. WARNER, M. D. [Constipation in infants will be a profitable subject for our readers to discuss. Injury to arm is a serious one, and the prospect for it is not encouraging. Massage at regular intervals, and also immersion in hot water, may be beneficial.-ED.] Editor MEDICAL WORLD:-I hope that I do not infringe on valuable space or violate the rules of propriety in asking the WORLD family for information in constructing a short-distance telephone. Often in small towns, country or village, the doctor's office is a short distance from his residence, and a home-constructed telephone on a cheap scale, connecting home and office, would be of great advantage. Our city cousins are blessed with all telephone advantages. Who will come to the assistance of the country doctor? If the editor will kindly give space to an article on a cheap, home-made telephone for the use of the rural doctor, I believe that it would be of benefit to many. J. O. ROBINSON, M. D. Battleground, Ind. [Who will inform us how to construct such a telephone? - ED.] Formulas. [In our issue for November, 1897, we began republishing the formulas for the leading advertised nostrums. We do this believing that physicians have a right to know what the people are taking, and that they ought to know in order to administer proper antidotes if called in case of an overdose, which often happens, particularly with the various soothing syrups given to children. Back numbers can still be furnished to those who wish the series complete.] AYER'S (MRS. harriet huBBARD) RECAMIER BALM. Recamier Balm comes in a cheap glass flask, tied with a bit of ribbon and filled with water; contains a white powder-the oxid of zinc-and corrosive sublimate. This preparation is sold for $1.50. It costs, at most, to make it, ten cents.Boston Journal of Health. Since the analysis of the Boston Journal of Health came to the writer's notice, R. G. Eccles has examined Recamier Balm, which he states in the Druggists' Circular, to contain substantially 24 grains corrosive sublimate and 60 grains zinc oxid.-Secret Nostrums and Systems. |