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to give syr, of hypophosphites to a year- a recognized medical college, and to pass old baby with no teeth and unable to examination before members of the prowalk, after seeing the almost magical fession, is part of the weeding out process effect of a ten-days' treatment. I can not of evolution, as much so as when healthy, conceive that all of the master minds of strong male animals crowd aside the weak the profession who have gone before, and and sickly for the good of the species. those who are still with us, have, with For the benefit of Dr. Wallace, page ourselves, been deceived as to the results 338, I will give the treatment most beneobtained by this class of remedies. I do ficial in my hands for the conditions mennot pretend to explain how or why these tioned. For congestion of kidney, counter results have been attained. The theory is irritation followed by covering the kidneys that there is a lack of these substances in with a protector of felt or oiled silk. Low the system, therefore they should be sup- specific gravity: above treatment for plied. Dr. Cooper's theory is, well, I cause, plenty of water injected to counterwill not attempt to give his theory, as he act the effect, viz: The accumulation of has explained it in a very lucid manner. toxic material in the organism. For high Now, a noted teacher of medicine has said tension pulse, be careful to give no digi. that when we have facts there is no more lis, but give nitroglycerin, sufficient to need of theories; and it is certainly a fact get its effect on the pulse, up to 1.100 gr. that we have seen remarkable results every fifteen minutes if needed. As to from the use of iron in cases of impover- diet, I have formulated no rule. Every isht blood, or else we have been sadly case must be regulated by common sense. mistaken. I would not wish to be under- Medication ? Iron,
Iron, strychnin, potass. stood that we should blindly give iron bitartrate, are the principal drugs I use. whenever we have anemia, but intelli- according to indications. Mild climates gently inquire into all of the symptoms, are the worst, especially moist mountain make a thoro examination of the case and valleys and the sea-coast. prescribe the best we know for the good of I wish to say a very few words on Dr. the patient, and neither give iron in every Ramsey's case (page 339). I have been case, nor leave it out of our armamen- called a number of times where nature or tarium entirely, as a hobby, simply be- the medical attendant had failed to decause we have given lots of study to the liver the placenta in abortions at about question and cannot understand why it the fourth month, several times when the should do good.
stench from putrid placenta almost drove Dr. Lockhart also, who is a very enter- one from the room, and have never failed taining writer, seems in my estimation to to empty the uterus by combined pressing be in the stirrup riding a hobby; or at on the fundus with left hand and introleast examining some questions thru col- ducing two fingers (not the whole hand) ored spectacles. Does he really mean of the right hand into uterus, then by say that therapeutics is the science of patience, with gentle manipulation the guessing? Does he really charge his placenta can be removed entire, no matter patients for guessing what remedies they how rotten. Make fingers of right and need? Does he believe if every one was left meet at the fundus, and by gentle free to charge for guessing that the fittest pressure the placenta will be loosened and guesser would survive ? No, verily. I be expelled with the fingers. I hare have read some of his articles which would never had to use chloroform in these cases indicate that his therapeutical skill was unless ergot bad been given, causing something more substantial than mere
mere spasmodic (hour glass) contraction; then guessing. I have not the time to notice a few whiffs will relax the circular fibers. his article (page 319) in full, but will say I would lay down this axiom : Never that altho a diploma is no evidence that a leave a woman after labor or abortion man is not a bigoted ignoramus, or in fact until the placenta has been expelled. It that the holder has medical skill, yet it is may come all right; and then it may not. evidence that the man has attended a cer- What do the WORLD readers do for tain term or time at the place where medi- that numerous class of female patients cal knowledge is best learned.
who have leucorrhea, uterine congestion The survival of the fittest is and other minor ills, who will use the an inexorable law of evolution." Let him various vaginal suppositories sold by understand that all legislation requiring agents and will not take office treatment? doctors to pass a certain length of time at Let the country practitioners give their
treatment. I keep a supply of the follow- paralysis of exhaustion
supervenes : ing formula :
2. When aconite is taken internally in exB
cessive amounts, it causes tingling of the 01. theobromæ .
mucous membranes wherever it touches Alumen.
drs. iij them, which sensation finally amounts to Acid tannici.
severe burning" (stimulation) : “this Acid borici
soon passes away” (exhaustion), “and is Acid salicylici .
. dr. j
followed by a sense of tingling about the M. Fill in No. 0. or 00. capsules. I lips and finger tips or all over the skin" add such other ingredients as the case
(stimulation); "at the same time the indicates.
patient feels relaxt; the pulse at first beFor prolapsus, I direct the patient to
comes weak and slow, but later rapid and take the genu-pectoral position every running, so that it feels a mere trickle night, introduce two fingers into the va.
under the finger" (approaching exhausgina, spread them open, when the uterus
tion). “Death may be gradual or sudden, will sag towards the umbilicus and assume
the slightest movement of the body which as near normal position as it can, and if
can throw any strain upon the heart stopthere are no adhesions and a good pelvic ping that organ in diastole" (paralysis), floor, this will do wonders if kept up long for “the viscus refuses to respond to enuf. Sometimes it needs six months, but
stimuli." Why? Because the condition
of exhaustion has been induced by overmost women prefer it to ventro-fixation,
stimulation. and it is better than pessaries. Introduce one of the above capsules every night, or
As to veratrum viride, this writer twice a week. For the various other ail
quotes Wood with approval (p. 388,):
6 Veratrum viride slows the pulse by a ments, as erosion of os, etc., add whatever is needed; sometimes extract of opium is
direct depressant action upon the heart needed for pain. I will not add more
muscle, and by stimulating the pneumothis already lengthy letter.
gastric nerves. That this misty teachC. H. NEWTH, M. D.
ing does not exist with these two drugs Philomath, Ore.
only, we will instance a couple of others.
Alcohol, of which Hare says: “It acts
first as a powerful excitant and afterwards The Dual Action of Drugs.
when given in very full dose, as a most Editor MEDICAL WORLD :- Will the same active depressant and paralyzant of the drug stimulate you and depress another nervous system. * * * It stimulates the man at your right hand ?
heart muscle and increases the rapidity as Will the same drug stimulate you now well as the force of its beat. * * * and depress you half an hour later? "Along with the stimulation of the heart,
Don't pronounce these questions absurd a rise of arterial pressure ensues, largely just yet.
due to increast heart action and partly to We will for the present confine' our vaso-motor stimulation. * * * In very attention to one authority of enuf promi- large toxic doses alcohol depresses, pence to satisfy most medical men-not (exhausts) "and finally paralyzes the because he's a worse sinner than others, heart and vaso-motor system as well but because he is the best and most recent the nervous system. * * * " Respiration authority at hand.
is stimulated by small doses of alcohol In Practical Therapeutics, ed. 1897, and decreast by large ones. * * * Its p. 47, we find him saying: “When chief uses are as a rapidly acting stimuaconite is given in moderate medicinal lant in all forms of cardiac failure due to doses, it exercises no markt change on shock or poisons, and as a systemic supany part of the organism, save the circu- port and stimulant in low fevers and in lation, which becomes somewhat slower prolonged wasting diseases, in old age by stimulation of the vagus centers," and then and in convalescence from acute disease. comes in the dual effect on the next page: * * * There is danger of pneumonia from “ If large doses are used, the pulse be- failure of the right side of the heart in comes still more feeble and slow and the sub-acute and chronic alcoholism, and the arterial pressure falls from depression of the physican should always be on the lookvaso-motor center." Upon the same page a out for this complication." little lower down he gives a clear descrip- With these statements before us, is altion of stimulation increast until the cohol a stimulant or is it not? The pres
ent writer believes it is always a stimu- will administer the drug to it in gradually lant, and what is called depression is the increasing doses. At first no appreciable exhaustion of over-stimulation, and that effect is produced, but at a certain point, it would be difficult to differentiate this as the dose is increast, slight heat in the condition from the extreme exhaustion in- stomach is experienced. As the dose conduced by physical exercise, provided the tinues to increase we have successively history and the odor of alcohol were nausea, secretion of mucus, emesis. Asabsent.
suming that we have an organism in which Strychnin-of which the same work (p. the vitality is deprest manifesting itself 288) makes these statements : “The rise locally by nausea and vomiting, and we of arterial pressure which it causes is due begin giving ipecacuanha. In the minute to the stimulation of the vaso-motor center," and dose, which in the normal organism prowith intervention of merely a punctuation duced no appreciable effect, the stimulatmark, goes on to say, “ If very poisonous ing or irritant action raises the vital force doses are injected intravenously, a fall of in the stomach to the norm and the arterial pressure occurs instead of a rise, nausea and vomiting cease. Gradually which is due to vaso-motor depression."
increase the dose and we get successively The writer finds it very difficult to be. warmth in the stomach, nausea, increast lieve that a drug is a stimulant one mo- secretion and emesis. ment and a depressant the next, or a “Few remedies are so efficacious as ipestimulant in one patient and a depressant cacuanha in checking certain forms of in another lying beside him. He much vomiting.” (Ringer's Handbook.) As prefers to believe that once a stimulant, to the kinds of vomiting, he says they are always a stimulant. He therefore thinks in adults, (1) vomiting of pregnancy, (2) that aconite is always a stimulant and nausea and vomiting during lactation, (3) verat. vir., always a depressant of the gan- nausea and vomiting at menstrual periods. glia controlling heart pulsations. T (4) the morning vomiting of drunkards.
An example will make the idea clear, (5) morning vomiting of general weakness and we select a remedy of ancient lineage met with in convalescents. This is conand in common use among members of the firmed by Hare. (Pract. Therapeutics, Regular and Eclectic Schools, as well as 1897, p. 235.) the followers of Hahnemann-ipecacu- A condition common to all these disanha. The establisht fact that it will not eases is the deprest vitality, and it is act if the pneumo-gastric nerves are sev- this condition of deprest vitality maniered, demonstrates the necessity of vital festing itself by nausea vomiting for which force to secure its action, 'which brings ipecacuanha is a specific remedy thru its it within the scope of this discussion. Its local stimulating effects. The dose being time-honored and pre-scientific use in the just too small to stimulate the stomach large dose as an emetic is well known beyond the norm, checks the vomiting. even to the laity. The use made of it by By increasing the dose, over-stimulation Hahnemann's followers in the minute occurs, ending in the production of dose was made widely known to the regu- emesis. If the vomiting is produced in lar profession by Ringer. The regular the first place by an irritant, over-stimuprofession has thoroly proved its efficiency, lation is already present and ipecacuanba and both effects are cordially accepted by in any dose is useless as a means of relief. the Eclectic School. The U.S. Dis. states In the opinion of the writer, the dffithat ipecacuanha in small doses is a stim- culty has arisen thru attributing two ulant to the stomach, and Hare says: actions that are opposed to each other to “Locally applied to mucous membranes, the same remedy—the so-called dua: ipecac acts as an irritant; emesis is due effects—and that this error is made posto the irritation of the stomach and to an sible by the failure to use a distinct idea effect upon the vomiting center in the of the difference between depression and medulla. (Pract. Therapeutics, ed. 1897, exhaustion, for tho in some respects simip. 234.)
lar, they are far from being identical. Accepting these statements as true, in For instance, a man may be so deprest accordance with the views just advanced by a blow over the solar plexus that he it must be stimulant to the stomach and may be unable to move; the vitality is a.. irritant to mucous membranes in large present but is temporarily held in abet. doses. We will assumiu a normal organism,' ance and nothing but rest is needed tu and beginning with a minute quantity we remove the depression. But if the inabil.
ity to move is induced by want of food all the unpleasant pathological conditions and continuous labor, the vitality is ex- that exist in constipation. hausted or gone, and it will require out- But, says another, the pills always act. side aid in the shape of nourishment in Certainly, because the doseage of catharaddition to rest to restore the vitality and tics is sufficient to overcome all the remove the exhaustion,
antagonism of the belladonna, so far as It would seem to be demonstrated that the bowels are concerned. authorities fail to use the word necessary
I have before me to express clear ideas when describing the B effects of drugs. For, if these clear ideas Aloin are possest by the authorities themselves, Cascarin their language leads to much confusion of Podophyllin res thought among their readers.
Ext. belladonna .
gr. And, notwithstanding their reiterated
Make one pill, statements to the contrary, the questions There is enuf cathartic in this pill for a asked in the first sentences of this note physic, and ten times as much as is should be answered in the negative.
usually needed in a laxative pill, with the GEO. W. AYLSWORTH. belladonna left out. For cases that go Collingwood, Ont., Canada.
for two to four days without action, I usually give aloes } grain, or podo
phyllin is grain, or one drop of the fluid Should Belladonna Enter Into the Composi- extract podoph. with a tonic, three times tion of Laxatives?
a day. In two or three days it will act, Editor MEDICAL WORLD :—Ever since it and in a week or two it may be diminisht. has been the fad, I have wondered why The smallest amount that will do is what belladonna is added to laxatives, and have should be given. been surprised at the alacrity with which If belladonna was left out of the heart the great majority of the profession follow tonic tablets it would be an improvement. without thinking or questioning. They Belladonna is a remedy that should be just follow. The effects of belladonna are continued more than a few days. well known. 1st. It arrests mucous se- Now, Mr. Editor, if I have started the cretion (and others.) 2d. It paralyzes doctors to thinking and to using the circular muscle fiber. 3d. It diminishes knowledge they have instead of following sensibility, all of which are contra-indi- the untherapeutical and unpathological cated in constipation. We often see ipecac use of belladonna in laxative pills, along prescribed to promote mucous secretion, with other discarded fallacies, I am happy. with belladonna, which arrests it. We see Lancaster, Ohio. G. A. HARMAN, M.D. strychnin and aloes prescribed to stimulate muscular contraction in connection The Injection Treatment for Heroia. with belladonna, which counteracts mus- Editor MEDICAL WORLD:--From the incular contraction. We see these and other quiries received, concerning my article in drugs ordered to excite sensation, along the August number of THE MEDICAL WORLD with belladonna, which allays sensation. (page 326), I should have given fuller
But, says one, it prevents griping, and details of how I treat cases of direct hernia the dose is so small it can do no harm. that cannot be retained by a truss. In the first place, the doctor who pre
I first retain the hernia as much as posscribes a laxative that will gripe makes a sible and give a few treatments of the mistake. Belladonna prevents griping by weaker fluid, which soon contracts the diminishing muscular contraction and opening sufficiently to control it, after sensibility; at the same time it no doubt which the progress is much more rapid. diminishes secretion. If it does these It is advisable to put such patients to things it does harm. Then the dose is not bed for a few days till the hernia can be so small as it appears. The effect of bella- retained by the truss. donna continues for from one week to ten If the patient cannot be quiet until the days. If a dose equivalent to sdo gr. of herniæ are under control, in cases of bad atropin be given three times a day in one double ruptures, valuable time can be week we have accumulated the effect of z's saved by treating one at a time, as it is gr., not a dangerous dose, but an unpleas- frequently possible to retain one of the ant one, as it produces dryness of throat ruptures with a truss when both could and dilation of pupils, and aggravates not be.
The following questions were also re
A Cure for Malarial Hematuria. ceived: “Do you consider the injection Editor MEDICAL WORLD:-I read many treatment entirely free from danger?” articles containing ideas on practice, but I " In how large a percentage of cases in your like these ideas to be put into practical practice do yoa have abscess occurring use and then afterwards talk of proven after the operation ?"
results. We all have ideas in our minds, The treatment is free from danger when but they are of little or no value until properly administered, or such is my ex- such value is proven. perience, as I have given over 3000 injec- I propose to give you a proven fact contions without unfavorable results, and cerning the treatment of malarial hemahave never had a case of peritonitis or taria. I started out from the Jefferson abscess, but the anatomy of the parts College in 1866, laden with many beliefs should be carefully studied as well as the which soon proved to be fallacious when different varieties of hernia.
it came to saving life. There is no question but that the injec- We fought too much against the laws of tion method will soon be the principal nature, we broke down instead of holding treatment for hernia, especially if Assmy's up the physical forces, and consequently, statements are correct.
soon saw the temple swept to ashes, for In the July issue of the “New Albany we added fuel to the flames. Seeing too Medical Herald," page 145, appears the much of this, I resolved upon a more confollowing, “Muscle Atrophy as a Cause of servative life-saving method if I could Post operative Hernia":
find it. I studied physiology more closely "Assmy conducted a series of experi. and reasoned from common sense princiments upon animals with the idea of ples. determining in what wise the danger of I am a native of Kentucky. I never saw hernia after abdominal operations might a case of malaria hematuria until I went be obviated. He carried many of his in- to South western Arkansas. There I met a cisions to the right or the left of the fellow physician of the Jefferson. He exmedian line thru the main portion of the tended me all courtesy, and I visited with rectus muscle, afterwards closing this in. him his sick. One day he went to see one cision by buried sutures, bringing the of these cases. We found the patient various structures which had been divided dying. Said he, “We never cure these in close contact with each other. A sub- cases; they all die.” I said I would like sequent examination of those animals to take a tilt at one from the beginning. showed that there always resulted an He replied, “You shall have a chance." atrophy of that portion of the muscle lying The next day while in his office, in came between the incision and the mid line of a man from a river bottom with a bottle the body, and that this atrophy cor- of urine, looking like fresh blood. responded exactly in its features with the “There," said the doctor, “is a genuine wasting observed after division of the
case. Go and take it from the start.” I nerve supply. As corroborative of these followed the man to the scene. facts, the author also observed that after Patient as yellow as an orange ; inces. an operation practised on the human thru sant vomiting; chamber half full of this the rectus muscle, the portion of the mus- urine. I had before me my first case. I cle lying to the median side of the incision knew nobody's treatment and consulted atrophied completely. Upon these facts no author. I explained to the patient that the conclusion is drawn that the extra I was sent out by his doctor, who could not median incision may be followed by her- come just then; that I would represent nia, not only because the scar tissue virtu- the doctor, who would visit bim later. ally stretches, but also because from divi. This was satisfactory. I began my treatsion of the terminal branches of the inter- ment. I said to some of the visitors who costal nerves which supply the rectus, this were a dozen or more: “Good men, with muscle atrophies, and hence is unable to your help we will make an effort to save withstand the intra-abdominal pressure." this man. Go at once to the corn-crib and
If there be atrophy of the rectus muscle bring me one dozen ears. Put water in due to division of the nerve supply, is it that pot and put on a big fire, and let this not equally true of the other muscles corn come to a boil as quickly as possible." divided by an operation for hernia ? It was soon done. We put one ear at a
C. FLETCHER SOUDER, M.D. time under the sheet that the man was Philadelphia.
lying on, until we had packed it on each