apply the solution on one side of a woolen cloth with an ordinary paint brush, and dry thoroly before a hot fire; then apply a second coat on the same side and dry as at first; when the splint is perfectly dry after the second coat, dash it into cold water, which tempers it and the splint is ready for use. My way of dressing the limb is: Hold the splint before the fire until soft; place a layer of absorbent cotton on it and apply to the limb and bandage. EDW. T. WILLLIAMS, M. D. I solution, powder, capsule or pill. It is very unpleasant to the taste, and if given in fluid form should be in syrup of licorice or rhubarb, as these cover the taste. often give it in capsule with bismuth. Several coated pills on the market are satisfactory, especially Upjohn's, which are coated with keratin. I have given many thousands of these 2 and 5 gr. pills and never had one to disagree. For children I usually give sulfocarbolate of lime or soda, unless the case is a severe one, when I use the zinc in the form of Abbott's granules. "Every day I am getting letters asking me the composition of the neutral mixtAt present I am using this formula: ure. B Sodium sulfocarbolate 1 dr. 1 dr. 1 dr. 6 dr. . . 6 oz. Dose: A tablespoonful every two hours for an adult; children in proportion." Doctors' Rights. Editor MEDICAL WORLD:-With the exception of a few of the larger cities, the prescription-writing physician is a curiosity. The druggist claims that greed has prompted the physician to dispense his own remedies; and the physician claims. that the druggist forced him to do so, which is perhaps nearer the truth. The druggist, tho too honest to substitute or use unreliable preparations, succeeded in lobbying thru and obtaining class legislation granting him special privileges which brought him into direct opposition to the physician. Not content to sell drugs, notions, and to compound prescriptions, without improving his qualifications he had laws framed for his special benefit, so that to-day he has added a full line of cures of his own manufacture, which he advertises liberally; and this law allows. him to recommend and sell what he may think necessary. In other words, he can do the nice office work of the physician and escape all the hard, disagreeable work, which he kindly lets the physician have. All this he enjoys without ever troubling himself to study the diagnosis or treatment of diseases. Not satisfied yet, they discriminated against the physician by denying him the right to register as a pharmacist or engage in the legitimate sale of the very articles which he is fitly qualified to prescribe, and which he uses daily with safety and satisfaction to the public. This is not only a violation of good public policy, inasmuch as it restricts competition without cause, but it is also a violation of the fundamental principles of our Government, which demands that everyone enjoy every privilege which he is qualified to enjoy, and is supposed to make no restrictions except where the public good makes it necessary. Here again, however, our enterprising friends have over-reacht themselves, and also the limit of public safety, by securing privileges which they are not qualified to enjoy and which they most certainly abuse. Where is there a physician who has not been compelled to engage in a conflict with the grim monster, the case made hopeless by the unwise ingestion of some druggist's depressing fever powders or headache cure, to say nothing of the numerous cases where his cleverly-advertised, tho useless and harmful remedies, have been taken till the opportunity to obtain relief is past? Must we suffer the consequences and never once condemn our friend, the druggist? Shall we sit idly by and see this ruin go on? If a pharmacist is to be allowed to prescribe, let us see that he be required to qualify himself to do so. If a man puts a patent medicine upon the market, let us require him to tell the truth about it, which of course would require that he file his exact formula with our National Board of Health or Pure Food Commission, and that he confine his advertisements to statements that are consistent with its ingredients. If every physician will use his influence persistently, regardless of party lines, we can soon secure the abatement of all these nuisances, and the enactment of uniform national laws sufficient to regulate all these matters. First we must refrain from asking for any legislation not actually necessary for the public good. Next we must systematically oppose all legislation which fails to grant each individual all the privileges consistent with his qualifications and the public good; and also insist that no man or class of men be allowed privileges which he or they are not qualified to enjoy without endangering lives, health or other interests of society. Wake up, brothers, and let us follow the example of our worthy Editor, and not An Injection Fluid for the Treatment of Editor MEDICAL WORLD:-Having had letters from all parts of the United States in regard to my injection treatment for hernia, I will publish the same for the benefit of all. Several years ago I selected Lloyd's thuja, and have been using it ever since. I use the thuja in normal solution-no boiling; it is a powerful remedy. The first case was a double indirect hernia. I inserted the needle until it was free in the canal, then injected a few drops at a time. I then invaginated the scrotum with the end of my finger, and rubbed the fluid well around the ring. This was six years ago. He went to heavy bridge work, and several days ago he mentioned to me how free he was from hernia. Repeat every 12 or 14 days, if necessary. If the cord is punctured, an induration will appear, but no harm will be done, and it will pass away in a few days. This treatment is just the thing in children. dren. I have used it successfully in 24 cases. Some cases in men (5 out of 36) come back after a year for me to give them another "shot." A case of double indirect hernia claimed no benefit, but he only wanted to beat me out of my fee. I made him cough for twenty minutes with no return of the hernia. He had not seen the tumor for two years, tho he was plowing corn and doing other farm work. However, this treatment will not cure all cases. Cases in which the ring cannot be closed by a powerful remedy like thuja, as some cases of large direct hernia, cannot be cured, but may be benefited. Cases for cure by this treatment must be selected with reasonable intelligence, but almost all, or perhaps all, cases can be benefited. Valentine, Neb. J. C. DWYER. Dr. C. Percy Kent, of Kent Island, Maryland, writes: "Could scarcely do without THE WORLD, and your Monthly Talks are excellent." Acute Bright's Disease. Editor MEDICAL WORLD:-I use this title for the case that I relate, as it is somewhat elastic, including a variety of conditions as described by Strumpel and other authors. Loomis in his "Practice" says that we cannot have a case without edema or dropsy, and later says (p. 559): "If the patient has headache, some fever, more or less edema, nausea, and perhaps vomiting, with scanty, high-colored urine of high sp. gr. containing epithelial, small hyaline or blood casts, it is certain that acute Bright's disease exists." My case had all of these symptoms, except the edema (and it might be that this was prevented by the drastic action of elaterium at the start). But if you prefer to call this acute albuminuria, I am quite willing. This subject is interesting to me, because there was another case in the neighborhood under another physician which was rapidly fatal. A young woman (age 21) with nearly complete suppression of urine of low sp. gr., death from uremic poisoning. The point I desire to make is to abstain from diuretics at the beginning; and I would like to read a little discussion about the use of calomel, as Waugh (Treatment of the Sick, page 251) seems to differ with N. S. Davis, Jr., on that point. (Hare's System of Therapeutics, vol. iv., page 885). On April 12th, the day before the onset of the acute attack, Miss E. T., age 16, called at the office. Her father's sister had died of subacute Bright's disease. Her father is weakly, but mother seems quite healthy, having borne eight children. The daughter resembles her mother. She had a cough which had lasted several months, anorexia, lassitude and inability to study efficiently. Her weight had fallen away nine pounds in February, and she had regained three pounds to date. The tongue was pale and indented by the teeth, pulse 100, temperature 993. A specimen of urine was askt for, to be sent later. Early the next morning I was sent for. I found rapid respiration, pain in the region of left kidney, urine scanty and high colored, pulse 130, température 103, nausea and vomiting. Urinary examination showed acid reaction sp. gr. 1036, albumen about, sugar none, and a pinkish deposit. Examination of chest failed to account for the condition of pulse and temperature; only a few indefinite rales over about two square inches in right lower lobe. No chill, no pain in chest. A compound cathartic pill (U. S. P. 1890) was given, and three or four doses of elaterium, grain, produced several watery dejections. Patient was also wrapt in a blanket wrung out of hot water which produced copious sweating. April 14. The temperature was 104, pulse 144, respiration 36; sputum somewhat rusty, probably indicating some broncho-pneumonia, tho auscultatory signs were still slight. Urine past about two ounces at a time, probably eight ounces in a day. I used a liquid antipyretic, which has a good taste (the family is inclined towards homeopathy), which produced a decided effect upon the temperature. Also aconitine 1-134 (my first use of this), one every hour. Rochelle salts, one dram every two hours, until three or four passages. During the next four days there was a gradual improvement in the febrile symptoms. Pilocarpin was used, one dose of wards 1-32, enuf to keep mouth and skin moist. A second sweat bath was given about the fifth day, and the patient seemed very weak after it. gr., after Her father then thought her appearance so much like his sister's, just before she died, that he suggested council. I called in another physician of our village, who advised calomel in Bartholow's mixture, an eight-grain powder every hour; also sodium sulfocarbolate (a thing to which I had called his attention some months before). That evening, about 11 o'clock, I had an extra call, and found patient suffering intense pain from biliary colic. A small quantity of chloroform, by inhalation, relieved the colic, and chlorodyne tablets were left to relieve pain if it recurred. Next morning lumps of thick bile were found in the stool. On April 18th we secured a trained nurse from Galesburg. She knew that antipyretics in general were depressing, and therefore omitted giving that. Her written record showed temperature 102 at 9, 103 at 1 and 104 at 5 p. m., when I called. The formula is this in each dram : [The above is a good example of a clear and logical report of a case, and the diagnostic and therapeutic lesson stands out clearly. I wish to take our readers into my confidence, that still another lesson may be gotten from the above. This case was first reported in a scattering, illogical, indefinite and incomplete manner, evidently due to lack of time for careful arrangement, reflection and looking up of authorities. In this form the report had no scientific value. I returned it to the Doctor, explaining why, and suggesting how to present the case so it would be helpful to other practitioners. Usually such suggestions are not received in the spirit intended, and hence come to naught. The above report illustrates how well it pays to be willing to "try again." False pride is a great hindrance to scientific progress, and unfortunate is the man who is burdened with it. All great men have become great only by the most patient and persevering effort, doing the same thing over and over again a dozen times or more, if necessary, to reach a satisfactory result. Many men who write for medical periodicals write too much; it would be better for writers as well as readers if they would write less and better. On the other hand, many of our best practitioners do not write for publication at all. They would serve both themselves and their profession if they would report an occasional case, or present their experience along a certain line or with a particular drug. But it should be done with the same thought and care, and the same concern for a satisfactory result with which the conscientious surgeon approaches an important operation. However, there is room for discussion concerning the above case. The attending physician's diagnosis is, as he has named the article, "Acute Bright's Disease." Perhaps some will think that the pneumonic element was really more important in the case than the Doctor seems willing to admit. Do you remember the case of "concealed" pneumonia reported by one of our Connecticut subscribers a few years ago?. The physical signs were nil, while the clinical history was typical, suggesting that the consolidation must have been in the center of the lung tissue, with sound tissue both front and back. The question is, was there more of this feature in the case than the writer of the article seems willing to admit? No pain was present in the case of pneumonia above referred to, because the pleura was not involved. But the attack was ushered in by the usual chill, which was absent in the above case. The above case is rather an interesting one to study, and the more we study it the more inclined we are to agree with the writer of the article.-ED.] A Commendation of the Lobelia Inflata, and Condemnation of Mercurials as Medicines. Editor MEDICAL WORLD:-I like your liberal principles, both medical and political. They are truly in accord with the trend of American thought in the most intelligent circles, both medical and political. They are also genuinely democratic. Democracy is American; aristocracy is foreign. I have but little respect for the latter unless it be that of brains and learn ing, and this kind is generally the most democratic of all. It knows enuf to realize its own fallibility, and hence is graceful and tolerant, truly democratic. Such is the character of THE MEDICAL WORLD, and all such attract the sympathetic affection of the truly democratic. In consequence of this sympathy I am induced to write this article, which I am sure will be tolerated by you and your readers, whether approved or not. Indeed, I do not write it for approval, but for the earnest consideration of the medical brotherhood. I will try to put afloat upon the great ocean of human thought some suggestions for future consideration as well as some, I trust, for the immediate practical benefit of the profession. 1. I desire to call attention anew to one of the most useful of our remedies which I believe is not so highly appreciated as it should be. It is the Lobelia Inflata. For fifty years I have used this remedy almost every day, and I know its value and desire to induce my medical brethren to use it more freely and not to be afraid of it. There has been so much prejudice against the use of it, because it was the "No. 1” medicine of Samuel Thomson, and there was so much erroneous teaching about it that many medical men fear to use it. But this opposition to its use in unreasonable and unwarranted. All the harm that can come from it is that which will follow the abuse of any potent remedy. It is not poisonous; that is, it will not corrupt the blood or leave any injurious effect behind it, as do the inorganic poisons. It is in the same class as the belladonna, aconite, veratrum, nux and others potent but not poisonous remedies; that is, they do not corrupt the blood or leave organic disease behind them. Like electricity, they will kill if pusht to the killing point, but never will they, like mercury, arsenic and antimony, corrupt the blood, soften the tissue of organs, or produce all, or any, kinds of strange and unaccountable forms of disease. Its therapeutical, or rather physiological, effect is primarily that of relaxation of all muscular tissue, and the antidote to this is stimulation and constriction which Thomson produced by the use of capsicum and vegetable astringents like bayberry bark. This effect is in the highest degree serviceable in all high grade fevers and inflammations. It loosens, opens up and enlarges the blood-vessels and thereby equalizes the circulation, promotes the free flow of blood to the surface as well as thruout the capillary system, thereby aiding in absorption and the elimination of all the waste products and tomaines of metabolism. As a general rule its administration should be with stimulation. It relaxes and the stimulation forces on circulation to the rapid elimination of all waste products and the universal cleaning out of the system. The physician who understands its physiological and therapeutical effects and the counteraction of these, is always its master, as he is of other potent agents, and can use it to the untold advantage of his patients, and also to the increase of his reputation as a "good doctor." Its various preparations will be found in the American Dispensatory, but I now wish to commend specially two of these, the compound tincture and the extract. For those of your readers who may not have this Dispensatory in their library, I append the formulas: Make an infusion with the water and acid and strain when cool; to the residuum add the alcohol and macerate in a warm atmosphere for six days with frequent agitation, then turn all into a percolater and obtain three pints of tincture. Mix with the infusion and evaporate in vacuo to a pultaceous extract. In pneumonia or pleurisy in their earliest stages, that of congestion, cover the patient warm in bed, with hot applications to the feet and a cold compress to the chest or side and give a tablespoonful of this tincture in a cup of hot water, or simple herb tea as hot as possible, every quarter, half · or whole hour as may be necessary until free perspiration and free emesis follow, |