is worth doing, just as abdominal pads, consisting of several thicknesses of flannel, and of generous size, in chronic abdominal troubles,even in summer usually well repay for the trouble, but they are usually neglected because they are so simple. Such simple things are just as "scientific" as procedures that require deeper thought, and that usually do less good.-Ed.] Convulsions in a Child. Editor MEDICAL WORLD:-I would like to ask for help in a case as described below: Girl, twenty-eight months old. Family history good, was healthy till thirteen months old, when she suddenly without warning, while playing, took a convulsion. She had fallen on the floor a few minutes before, but the fall left no sign of bruise or hurt of any kind. The usual worm treatment, along with bromid of potash was given for a few days, and all seemed well for two or three months, when again, without warning, another came, and some harder. After being fretful a few days she was well again. She has had a half-dozen or more since, and it seems would be having them often if it was not for the continous use of bromids. After two or three, at intervals her eyes would look very weak for a day or two and then would be bright as usual again. Of late her general health has failed considerably. It seems that she can hardly keep her eyes open some days. Her head is noticeably large, measuring twenty-two inches at largest circumference, and an inch larger than her sister's, three years older. Her mind is not impaired. In fact she seems unusually bright. She does not complain of anything; just fretful, losing flesh, etc. Much of the time the extremities are cold and the head hot. The treatment for some time has been with the idea of trying to stimulate the absorption of any fluid there might be in the brain, and sedatives to prevent the convulsions, and nothing given for this last purpose seems to do much good except bromids. Also she takes tonics. Any advice will be much appreciated. A. BROTHER. Tennessee. Delivery of Placenta After Abortions. Editor MEDICAL WORLD:-I wish in as brief a manner as possible to relate to the readers of THE WORLD a case which I was called recently to attend, and ask the opinion of as many as possible of the course I pursued. I am perfectly satisfied with the results thus far, but it seems to me that the subject is neglected. At least I find very little writing upon it. I I was called, July 8th, 9 p. m., to see E. Y., colored, aged about thirty-eight. found her in labor at about the fourth month of gestation. On examination I found the os considerably dilated. Patient stated that membranes had ruptured several hours before. There was no hemUntil the orrhage then; had been none. case was terminated there was scarcely any loss of blood. I did very little in the way of treatment, but waited patiently for a short time, when the fetus was delivered. Up to this time there had been very little trouble; but now came the difficulty. There was good contraction, but no expulsive pains. I waited a sufficient length of time and began to make efforts at delivery of placenta, but the os was completely closed; so much so that I was not able to introduce the end of my index finger. I gave fl. ext. of ergot in halfteaspoonful doses every hour or two, but to no avail. I waited about six hours, and attempted to deliver by introducing my hand into the vagina and scooping the placenta out with my fingers, but found that the shock would be too great without anesthesia, so I called counsel. My plan was to empty the uterus as soon as possible for fear of hemorrhage and septicemia as a result of delay. Accordingly, we gave chloroform and delivered. Now, what I wish to know is: Is it advisable to leave such cases to nature and go away? or is it best to do as we did in this case? I reviewed all my old journals and I find very little written upon this most troublesome part of treatment of abortions-that of delivery of retained placenta. It is my lot to meet with such cases quite often, and I have always been successful, not having lost a case. placenta before I leave a case. I would I always deliver the be pleased to see several articles on this subject from those who have had experience. Let us hear from the Editor. Emmet, Texas. J. B. RAMSEY, M.D. [I have not practist obstetrics for some years, but as I call to mind my observations, I am inclined to think that nature will in nearly every instance expel the placenta, if given time. These few words may call upon my head sharp criticism from the up-to-dates." However, consider the great number of abortions that are not seen by a physician; also those in 66 the care of physicians that do not need such measures as in the above case. The facts amply prove that it is only the very exceptional case in which nature will not expel the placenta if given time. However, the physician cannot always spare the time to wait, and if the distance is great, he does not like to leave a patient with retained placenta. Hence the usual practice is to endeavor to remove the placenta before leaving.-ED.] Editor MEDICAL WORLD: Will you kindly advise me as to diagnosis and treatment in following case? Female, 55 years, large, weight 180 lbs., married, no children; moderate circumstances, has no household cares; husband is a merchant; they have rooms and board. Her present trouble followed an attack of grip. I saw her first February 11th. As she recovered from the grip, she had neuralgic attacks and her circulation would run down," as she exprest it. When called at these times I would find her pulse slow and weak, from 50 to 60, woman apparently collapst and requiring some effort to reply in whisper to inquiries; face and lips pale; dark circles about eyes. Inhalations of nitrite of amyl and ro gr. doses of nitroglycerin would bring her pulse up to 70 in from one-half to one hour, when she would say she felt better and speak in ordinary tone. She has no organic heart trouble that I can detect. Has been in bed four months. Never sleeps in daytime, but sleeps most of night, especially from midnight till 7 or 8 a.m. Pressure on lower spine shows tenderness; has pain in left side, region of stomach and spleen, pain in hips and limbs over course of sciatic nerve. Gastro-intestinal tract at fault; has indigestion, gas, constipation and hemorrhoids. Diet has been milk, scrapt raw meat, toast or dry bread. Muscles are somewhat flabby, but she is remarkably well nourisht and has lost but little in weight. Perspires a great deal, some days changes night-robe four or five times. For five or six years she has had localized sweating over upper abdomen, space about four inches square. Clothes at this point are kept constantly wet. One physician told her it was a local dropsy; another said under no circumstances should she take anything to check or dry it up. Upon the skin little pin point blebs come and go. She delights in picking or snapping these with her fingers. She has had electricity, sea salt baths, strych. or nux vom. Alkaline powders (bicarb. and phos. of soda) seem to control the gas and sour stomach. Cascara sagrada daily, except when stools are light colored she gets from 1 to 3 grs. calomel. She had similar attacks three and six years ago, when her physicians gave her kolo-cardinette, which she thought helpt her. We tried it again, but she does not improve. My diagnosis has been neurasthenia, and treatment as above. I almost forgot to say the patient has been extremely cheerful. I have never seen her discouraged except when she did not get sympathy where she expected it. She requires lots of sympathy. During a former illness she discharged a physician because he wanted her to get up and go out and take exercise, telling her he wisht his wife were as well. Warren, Ill. U. S. G. KELLER. [This is one of the cases that try the patience of saints, unless the doctor is willing to continue his visits chiefly for the fee, and dispensing chiefly sympathy. However, let us give the patient credit for her cheerfulness. I am inclined to think that an injection of will-power, or resolution, would be the best thing for her. Massage and passive motion would be a good beginning, which could be made to lead judiciously up to gentle exercise without offending her ladyship, and hence without endangering the doctor's standing with her. This should be done by a skilled masseuse, under the general directions of the attending physician. In this way she might be induced to sit up soon, then before many days to take a carriage ride, and so she might be up and about before she would realize it, and forget to say: "O, I can't." However, in a medical way, intestinal antisepsis, by means of the sulfocarbolates, might benefit this patient very much. Also, her intestines may be loaded with accumulated feces. Do you remember the case given by Dr. Waugh a year or two ago? Copious soapsuds enemas were given her several times a day, and continued for about two weeks before all the hard accumulations were removed. A cathartic does not answer in such a case. The liquid stools thus produced pass by the hard accumulations, and the very thing sought is not reacht. Please try these suggestions and report.-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.] "PINK PILLS." Editor MEDICAL WORLD:-I send you formula for Dr. Williams' Pink Pills (made at Gauanoque, Ontario, Canada), said to be exactly as they are: Ꭱ Pil. Blaud mass. Mang. binox Zinci phos. Aloin Ext. damiana Acid aresenius Shuttleworth & Co., Chemists, Toronto, make them, and their agent says they are exactly like Dr. Williams' Pink Pills. A subject worthy of note is that Mary Baker Eddy, the Christian Science Leader, is having a University in Massachusetts, and that the Doctorate and Baccalaureate degrees as C. S. D. and C. S. B. are granted. What next? A Toronto lawyer-a Q. C. -a Mr. W. N. Miller, lately addrest a London, England, audience on Christian Science, and on his card after Q. C. was "C. S. B."-lamentabile est. Carbolic acid Olive oil . ... grs. 3 gr. gr. gr. 10 22/0 gr. 2 J. S. SPRAGUE, M. D. Stirling, Ont., Canada. gr. gr. roo .1 oz. .5 oz. .8 gr. Mix. Inject into the largest piles, eight drops; into the medium-sized piles, from four to six drops; into small piles, from two to three drops; into club-shaped piles, near the anal orifice, two drops. He directs hot sitz baths for cases where violent pains follow an injection. He recommends an interval of from two to four weeks between each injection. The following is the formula for his "celebrated ulcer specific: " Take of Dist. ext. hamamelis Mix. For fistula in ano, inject ten or fifteen drops deep into the fistula and press the track of the fistula with the finger, to force the fluid more deeply in. In cases of rectal ulcer he gives the following treatment: To an ounce and a half of water add half a teaspoonful of the "ulcer specific" and a half teaspoonful of starch, and inject into the rectum every night. Sometimes he orders an injection of starch into the rectum of mornings, after the bowels have moved.-The Medical Waif. .5 dr. .1 dr. .2 gr. .2 dr. The "Brinkerhoff System" as applied to fissures of the anus is this: Once or twice a month, as the itinerant comes around on his cireuit, he inserts his little speculum, cleans out the ulcer, and applies to it a solution of nitrate of silver, forty grains to the ounce. Between the applications the patient uses a morning and evening treatment himself. Each morning he is to evacuate the bowels, then inject the rectum with luke-warm water, and finally insert into it a little ointment, consisting of three grains of carbolic acid and eight grains of sulfur to the ounce of vaselin or lard. For evening treatment he uses Brinkerhoff Ulcer Remedy [the preparation of extract of hamamelis, sol. persulf. iron, etc., given above as "Ulcer Specific."] Add half a teaspoonful of this to the same quantity of starch and about an ounce and a half of water. Inject into the rectum every evening. for. CANCER PASTE. Calomel .1 gr. .2 gr. 1-200 gr. Take of Chlorid of zinc, pulverized bloodroot, flour, equal parts of each, and moisten with aromatic sulf. acid, and it is sure. I use another which will remove lupoids nicely; but, notwithstanding it is simple, it is much more severe than the former. I drain off the white of an egg, then place the yolk in a common mortar, stir into it all the chlorid of sodium I can; grind it to a thoro paste. This is guaranteed to draw the man out of his boots. I use these frequently and always with success. Remember, it is not "what we like, but when, where and how," and I am sure all doctors can use these just as well as the cancer doctor.-F. B. Brewer, M.D., in Chicago Med. Times. Formula for Hood's Sarsaparilla is askt .1 gr. .1 gr. New Idea. TIP-TOP. There is a patent nostrum with no formula attacht, whose nom de plume is Tip-Top, that has gained some notoriety in our country, in skin diseases, and, not that I wish to publish or "steal the thunder" of any man, but as this preparation is nothing more nor less than a modification of Magendie's ointment, I will give it to the readers of the Summary after this form: Take of 60 gr. 1 oz. 1 dr. 3 oz. Tinct. iodin Oil sassafras. Mix. Shake well before using. This preparation is tip-top in some skin diseases, and does not belie its name. With a few drops of carbolic acid added, it will arrest or stop a spider or any other poisonous insect bite from assuming the erysipelatous or gangrenous form that we frequently see in course of the practice of medicine.-Dr. Sturdivant, in Medical Summary. OCULINE, OR "THE BRILLIANT EYE." This is a collyrium advertised by a New York firm. It is guaranteed to cure every description of eye disease, and to impart a beautiful and lasting brilliancy to the organ of vision. Examined by Dr. Fr. Hoffman, it has been found to consist of water containing 1 per cent. of boric acid and 5 per cent. of glycerin. -Pharm. Rundschau. CURE FOR WHISKY HABIT. Dr. A. C. Matchette, of Bourbon, Ind., asks for formula for the "Celso Drink Cure," of Chicago. He also writes as follows: "Some years ago I detailed my treatment for the whisky habit to the many readers of THE WORLD, and have received thousands of commendatory letters from physicians in all parts of the civilized world regarding the merits of the I feel a degree of satisfaction, and thank THE WORLD for its part in making the treatment known. All who have a successful treatment should let it be known as widely as possible for suffering mankind.” cure. Fluid extracts of coca erythox. Cannabis. Celery. Valerian. Cypripedium. Kola. Cinchona. Gentian, of each 1 ounce. Mix. Teaspoonful every two hours. When necessary I add to the above pure scale pepsin, ounce ss, and muriate of hydrastin, dram ss. I alternate this with the following for 4 or 5 M. S. One-half teaspoonful every two hours, taken in a very strong decoction of coca leaves. This is to be kept up until the patient is discharged cured, in about 3 weeks, or, of course, as found necessary in each case. During the first few hours, say from 12 to 72 hours, the patient is furnisht with a very generous quantity of liquors, of the very best brands, until he declines, himself, to use it, which is often within the first day. Sometimes the patient comes boasting that he will "buck the tiger," and never give up the liquor, and such cases sometimes are the first to discard all spirits. Again, others will say little or nothing about drinks, but may be seen sitting beside a pump or hydrant, with a flask in one hand and a cup of water in the other, trying to force his stomach to hold a drink, after a score or an hundred times vomiting it up, when forct down with a gulp of water on top of it, to try to hold it down in the stomach. Such usually yield suddenly to the inevitable, and cry "a pig knows when he has had enuf, so do I," and are on the same speedy road to cure. Many patients feel that as soon as liquor, by taste or smell, vomits them, that they are cured and want to be honorably discharged as cured, but they should be kept on treatment until the experienced physician feels that they are perfectly cured beyond all possible peradventure, as the patient's judgment in these cases should not be relied on. Of course, vast differences in patients will require the physician to exercise the most profound judgment in the treatment and to vary this treatment according to the necessities of each individual case, for in these cases each "is a law unto himself," and the doctor must be prepared for the most thoro and profound under standing of the especial case under treatment, and exhibit his treatment accordingly, or he will have for long, long months, many cases to mourn as failures-not of the line of treatment here indicated, but of his own lack of judgment in pushing or withholding the treatment, to suit the indications present. With careful study of each and every case treated, no matter how stubborn, success awaits the conscientious physician. In these lines nothing has been said of the different cases having a variation of this treatment, but every physician's experience will suggest the variations that the different cases will require as to age, condition, constitution, and he will give each case that medication as he finds indicated and his ability to bear the treatment detailed, either heavier or lighter, as demanded. These cases are to be most generously nourisht and often with the best prepared foods on the market. Cheerful associations as much as possible and all encouragements of a gold cure" club are of the greatest benefit in perfecting a certain and speedy cure. Current Medical Thought. Health Must be Earned. Young men are too prone to succumb to that "tired feeling" often induced by that overindulgence in nitrogenous food, such as meats, and avoid every possible physical exertion, which they so much need. They will ride when they should walk. Some will take more exercise sitting in a chair than others will walking, as in the latter there is no vim and vigor in their movements. Health must be earned; it cannot be bought. I say this in contradiction to the wonderful promises made by the patent-medicine vendors, whose disgusting advertisements in our daily press, setting forth in flaming flambeaus of felicitous fiction the testimony and portraits of distinguisht people, who claim to have been benefited by wrapping themselves around few doses of "Gripan's Gabules," "Giddy Stinkham's Vegetable Compound," "Dr. Billiams' Pale Pills for Pink People," and "Nervy Eura's Greens for Green People," and other forms of "laly-kedope" ad nauseam.-Dr. Joseph Eastman. a The Esquimo gives the doctor his fee as soon as he comes. If the patient recovers he keeps it; otherwise he returns it to the family. In Mexico the doctor gets his fee before the patient is buried; otherwise the deceased is believed to dwell in purgatory until the fee is paid.-Med. Age. Opium For Malaria. But cases of chronic and severe malarial infection are continually occurring in which quinin seems wholly to fail to cure the disease. Such a problem confronted me when my colleague at the Roosevelt Hospital, to whose service I succeeded on the 1st of September, told me that the soldiers in the wards had been there from the 17th of August, and that, tho he had tried every form of administering quinin as to dose or method, as tincture, and free senic, yet the senic, yet the general results had been In some cases large doses of quinia held the temperature for a few days, but only to be followed by relapses. The best results with this drug were in patients who had true intermissions, but these were a small minority, the fever with most of the others running a continuous but very irregular course, the predominant form of the plasmodium be nas Warburg's very unsa administration of ar |