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of food as well as quality. In this condi- sluggish condition of digestion and assimtion of tongue we have atony also. It is ilation and congestion, especially of the the tongue of advanced fevers, inflamma- base of brain. Restlessness and constant tions of the mucous membranes, and want change of position are present. - Medical of assimilation, hence great caution both Age. of remedies and food. Here we must not use cathartics. Mild aperients may be

Ten Hygienic Aphorisms. carefully used.

The late Dr. Franklin H. Hamilton, of A contracted, pointed tongue, with dry- Bellevue Hospital, is said to have framed ness and dark fur, is the usual tongue of the following decalogue of health precepts: typhoid and other low grades ef fever, 1. The best thing for the inside of a man when all thinking minds would use great is the outside of a horse. 2. Blessed is he care in the treatment and food.

who invented sleep-but thrice blessed the The dryness or moisture of the tongue man who will invent a cure for thinking. denotes the extent of the disease of the 3. Light gives a bronzed or tan color to intestines, and will point us in that direc- the skin; but where it uproots the lily it tion.

plants the rose. 4. The lives of most men A fissured tongue points to the kidneys, are in their own hands, and, as a rule, the either an inflammation or something wrong just verdict after death would be-felo de with secretion.

5. Health_must be earned-it can Yellow coatings are usually associated seldom be bought. 6. A change of air is with morbid liver and want of biliary se- less valuable than a change of scene. The cretions, and would indicate mild hepatics air is changed every time the wind is and tonics.

changed. 7. Mold and decaying vegeRaised papillæ, bright red, denote irrita- tables in the cellar weave shrouds for the tion of ganglionic nerves and irritation of

upper chambers.

8. Dirt, debauchery, stomach, especially the mucus coating. disease and death are successive links in Shows exhaustion ; no digestion, and needs the same chain. 9. Calisthenics may be rest; nux vomica, twenty drops, and the very genteel, and romping very ungenteel: food to be warm and taken in small quan- but one is the shadow, the other, the subtities. Bismuth and pepsin after food. stance, of healthful exercise. 10. Girls

Broad, thick tongue, papillæ not visible, need health as much-nay, more than but looking raw, denotes a septic condition boys. They can only obtain it as boys do. of blood, and favors typhoid fever. Indi- by running, tumbling--by all sorts of incates, if deep red, sulfuric acid; if pale, nocent vagrancy.

At least once a day soda sulfite. Liquid food, sippt warm, girls should have their halters taken off', in small quantities.

the bars let down, and be turned loose like Deep, dark red tongue and dark coating young colts.-- Medical News. indicate septic condition of blood. Shades of dark brown and black denote

Hints. typhoid condition or septic conditions.

It is a bad idea to have office, residence Pale, dirty fur on tongue, denotes acid- and stable in different portions of the city. ity, and a septic condition of system ; in- It is a bad idea to be too prompt with dicates soda sulfite; but if membranes are the hypodermic syringe. It is like a gun, deep red, sulfuric acid will be admissible, dangerous without lock, stock or barrel. because it would show an alkaline condi. It is a bad idea to have a small slate in tion of blood.

It indicates small business. Contracted, pointed, inability to hold It is a bad idea to neglect your office still, and drawn to one side of mouth, de- hours. “Take care of your oflice, and notes trouble with the nerves, and perhaps your office will take care of you." the brain. Requires great care and study It is a bad idea to turn professional of condition.

visits into social business. Dry tongue always denotes feverishness It is a bad idea for the young doctor to or inflammatory condition, affection of the live in single blessedness too long. nerve-centers of ganglia.

It is a bad idea not to send out your Thick tongue, and curved edges up- bills for professional service at the end of ward, denote atony of the nerve-centers each quarter, making no exceptions. of ganglia, requiring stimulants, nux vom- It is a bad idea to encourage your patients ica or strychnin and quinin.

to put off sending for you until unseasonPointed, narrow tongue is the tongue of able hours.

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your office.

It is a bad idea to make your business ulate it. With a few turns of the nut at secondary to anything else.

the proximal end of the steel rod, the loop It is a bad idea not to stand by your is tightened and the tumor well comrespectable professional brother. Curses, presst. Holding the pile tumor within like boomerangs, come home to base. the loop, in my left hand, and drawing it

It is a bad idea for the professional man down, I commence to sear it with a small to dress and look like a jockey.- Louis- point, either of Paquelin's thermo-cautery, ville Medical Monthly.

or the small point of a galvano-cautery

electrode, which I hold in my right hand. A Simple and Successful Method of Treating While I am searing the pile tumor, I have Hemorrhoids.

an assistant standing by me, who by A large protruding crop of pile tumors means of a dentist's bellows, after each around the whole circumference of the contact and burning of the heated elecanus, with redundency of tissue, an ex- trode, maintains a stream of cold air, tremely varicose condition of the hemor- which is directed upon the burned pile; rhoidal veins, and complicated with the this keeps the tissues cool and protects the above an inveterate and incurable eczema adjoining parts and the pile from too great ani, may be a suitable case for the White- a heat, and from the pain of the same. I head operation, but the majority of cases now slightly tighten the loop but continue met with in surgical practice may be treat- to sear, and as soon as the pile is burned ed by a method much simpler, less danger- near to its base, I release the loop and reous, recovery much quicker, and with the move it.

Then I attack the next pile result that a complete cure is the rule. tumor, proceeding in the same manner in The method that I have employed for every particular as with the first, and so some years past is a modification of the continue until all of them have been declamp and cautery operation. I employ a stroyed. In treating hemorrhoids in this loop of unannealed wire, which is lighter way, the operation is practically painless, than the clamp and easier handled. For the patient can at once get up from the this purpose I use Jarvis's nasal snare, or operating table, and usually express astonthe instrument of Dr. Kellogg, of Battle ishment that his piles have been removed Creek, which is a modification of it.

with so little discomfort. The principle of these instruments is The after-treatment consists of dusting that they strangle the pile tumors and act the stump with an antiseptic powder, and partially as ecraseurs. The evening pre- introducing within the anus a little salicylvious to the operation I direct the patient ated cotton smeared with carbolated vaseto take a dose of oil, in order to empty the line. This method of treating hemorrhoids colon and rectum, and the following morn- has the following advantages: ing he is placed upon the operating table 1. The easy application of the loop over in the left semi-prone position. With an the use of ligatures, injections of carbolic assistant at my side, with my thumbs- acid, and of the heavy steel clamps, will sometimes with Pratt's speculum-I dilate at once be made manifest to any surgeon the anal opening and expose the pile who will try the plan. tumors. If by this dilatation it is not 2. The operation is absolutely aseptic, possible to bring down the pile, I employ so rendered by the destructive action of Allingham's speculum and bring it into the cautery: view through the cleft in the same, and 3. There is no danger of secondary hemirrigate the pile with some antiseptic solu- orrhage, and this is one great advantage tion, preferably Wampole's, which con- of the operation, the eschar made by the tains a small portion of formalin. I now cautery soon drops off, and the healing inject hypodermically a few drops of a process is rapidly completed. five per cent. solution of cocain into the 4. Injecting the pile a few moments bepile, sending in the drops superficially fore operating with 10 drops of a five per along the surface of the tumor. I wait a cent solution of cocain renders the operafew moments, and then introduce small tion almost painless, and in my experience forceps through the wire loop of the in- I have seen no indication of systemic strument; the pile is then seized and intoxication from it, as the anesthetic acdrawn down within the same, and the tion is localized, because the pile is so loop is well pressed down around the base constricted by the wire loop that only a of the tumor so as to be in a position to minimum of the cocain is taken up into hold it well, or, if necessary, to strang- the general circulation.

cutantous pels There are certain hemorrhoidal swellings who, at a clinical lecture, told his students which are merely dilated veins containing to pay all their attention to diagnosis and a clot of blood that obstructs the circula- prognosis. After an exhaustive dissertation and occasions much distress. This tion on a case, he was leaving the bedside form of a pile tumor may be easily man- without prescribing any treatment, when aged by opening the vein enclosing the the house physician asked what he should clot, and removing the same. This simple give the patient. “Oh," said the physioperation will relieve a poor sufferer, who, cian, “a hopeful prognosis and anything from the mere presence of such a throm- else you please.”—N. Y. Med. Jour. bus, has been in agony at times, perhaps for months past. For external piles,

Chloroform Externally During Labor. called cutaneous piles, we never use either Dr. Archangelsky (Vratch) says that the loop or ligature; they may be excised for several reasons the external application at once, and the anal outlet trimmed- of chloroform to the abdomen in severe that is to say, freed from all excrescences and irregular labor-pains is superior to or tags about it.—Dr. T. Griswold Com chloroform-anesthesia. He employs a mixstock.

ture of one part of chloroform to two or

three parts of olive oil, rubs it in well on Nitroglycerin in Spasmodic Croup.

the abdomen, and then apples a warm Dr. G. G. Marshall has found in nitro

compress. In a very short time the pain glycerin an ideal remedy for spasmodic is relieved, the contractious become regu. croup where steam inhalations and emetics lar and more effective Its advantages fail, or where they depress too much to over chloroform-anesthesia are: The pabear repetition. He recommends it to be tient remains fully fonscious, the pulse given in small doses frequently repeated. and the respiration remain good, there are To children from five to ten months old he no nausea, no vomiting and no uterine gives from one ten-hundredth to one six- atony.-Amer. Med.-Surg. Bul. hundredth of a grain, repeated in from five to ten minutes if no effect is noticeable.

Atresia of the Cervix in Labor. Usually in ten minutes there is markt relief in the dyspnea and general appear all cases due to the inflammation of the

Campbell says that this condition is in ance of the child. By repeating these

cervix which, in the early stages of preg. small doses from every fifteen minutes to once in one to three hours, the laryngeal ing surfaces of the cervical canal. When

nancy, leads to adhesion of the granulatspasms are controlled. Sometimes it is labor begins the upper part of the cervis not necessary to repeat it more than once or twice; at other times the remedy has yields and thins out, while the lower porto be continued at more or less frequent to be discovered by digital examination.

tion remains undilated, and the os is not intervals for two or three days.-Phila- As labor advances the cervix descends, delphia Medical Journal.

and finally appears at the vulva or even

protrudes beyond the orifice in the form of Definitions of the “ Pathies."

à dark red, thick-walled, fluctuating tuThe Clinique for July 15 says that a mor, which becomes tense with every pain. jolly correspondent quotes and forwards The os is concealed by the perineum, and the following definitions :

is to be sought for on the posterior aspect Christian Science-Suggestion plus absurdity.

of the presenting mass. It may be median Divine HeulingOsteopathy

or to one or the other side of the middle Hydropathy

line. When detected, its position is inMetaphysical Healing-" Hypnotism-.

sleep.

dicated by a small circle of a brighter hue Spiritualism is somnambulism, and Theosophy is an intellectual pleasantry.

than the rest of the surface. The treatTo this we might add that there are ill

ment consists in scratching with the fingernatured people who would say that bome

nail and then dilating with the finger. opathy is suggestion in material, plus Rupture of the membranes should in all drugs in infinitesimal, doses. There are

cases be delayed as long as possible.-Briteven members of the "regular" profession,

ish Medical Journal. we believe, who would seem to hold all

Read The World's special articles on seasonable diseases medicine to be principally suggestion. At and you will surely subscribe. One year, $1, four years, least, we have heard of a celebrated hos. Write us your experiences in the treatment of rheumatism

This disease needs thoro discussion. pital physician and teacher in London,

What are your views as to treatment of diphtheria?

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Class Room Notes.

under his observation ; it is particularly (From Dunglison's College and Clinical Record.] frequent in cases of epithelioma of the – To make a differential diagnosis be- stomach and uterus, but less common in tween Hysteria and Epilepsy you must re

malignant disease of other organs. member that these diseases may and do occur together. An important point of

Menstruation and Conception During

Lactation. difference is that hysteric convulsions never occur while the patient sleeps. Remfry (Revue Internationale de MédiEpileptic convulsions on the other hand cine et de la Chirurgie, 1896, No. 5) has do occur during sleep.- Dercum.

found by an investigation among 900 nurs- It is quite as important to use anti- ing women that in 57 per cent. only did toxin early in Diphtheritic Poisoning as it is there occur an absolute amenorrhea. Men

and to use hydrated sesqui-oxid of iron early struation was regular in 20 per cent., in arsenical poisoning. Just in proportion irregular in 43 per cent. It was also comas it is used early are its effects of advan

mon for conception to occur during lactatage to the case. Where the posterior tion, 60 per cent. of the menstruating nares or the larynx become involved larger

women conceiving. Among the non-mendoses must be given. Start with 1500 units struating women but 6 per cent. conceived and repeat two or three times in twenty

during lactation.--Univ. Med. Mag. four hours. There is no limit to the dose of Antitoxin.-Hare.

Safety in Anesthesia. -Prof. Montgomery has recently used

The comparative safety and the efficiency Postural Drainage subsequent to pelvic op

of various anesthetics and various methods erations done thru the abdomen with en

of administration is a topic of perennial couraging results. The technic is simple.

interest and importance. The discussion A large quantity of normal saline solution

at the Surgical Section of the College of is allowed to remain in the abdomen, and Physicians, an abstract of which appears the foot of the patient's bed is raised

in this number, was not less important eighteen inches for thirty-six hours after

than any which have preceded it. Dr. the operation. The results are that the Maduro, of New York, who has worked exudate, if infective, is greatly diluted and

with Schleich, spoke enthusiastically in may all be absorbed by the peritoneum ; if favor of the mixtures of benzine, ether inflammatory, is kept liquid ; and organ

and chloroform, adopted by the latter. The ized exudates are avoided. The pressure following are his formulæ : of the viscera is removed, intestinal ad- MIXTURE I. (Boiling-point, 38° C.) hesions are avoided, peristalsis does not

Chloroform, 45 parts. cause pain by irritation, the patient suffers

Petroleum ether, 15 parts. less distress and discomfort, and conva

Sulfuric ether, 180 parts. lescence is naturally more rapid.

MIXTURE II. (Boiling-point, 40° C.)

Chloroform, 45 parts.
A New Symptom of Cancer,

Petroleum ether, 15 parts.
G. Bogdan (Brit. Med. Jour.) relates the

Sulfuric ether, 150 parts. case of a woman, aged forty-eight, who MixtuRE III. (Boiling-point, 42° C.) had suffered from cancer of the stomach.

Chloroform, 30 parts. The disease had gone thru a long period

• Petroleum ether, 15 parts. of latency. The patient presented on each

Sulfuric ether, 80 parts. cheek a patch of wine-red discoloration In the above formulas petroleum ether formed by the dilatation of the superficial signifies purified. benzin, having a boilingvenules; the stain showed out sharply point between 60° and 65° C.; and by against the pale yellow of the surrounding i sulfuric ether" is meant the ether (96 skin. On the strength of this symptom per cent. ethyl oxid) of the U.S. Pharalone Bogdan was able to make a diag- macopeia. The boiling-point of the mixnosis of probable cancer at a time when ture is the point apon which Schleich lays there was yet no other manifest sign of great stress. He asserts that when the that affection. He looks upon such super- boiling-point is higher than the temperaficial varicosities on the cheeks as a valu. ture of the blood the quantity of an anesable help to the only recognition of certain thethic necessary to narcotize is less than cancers; he has seen it in about two-thirds when these are equal; furthermore, that of the cases of cancer which have come the narcosis is much greater with a given

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THE MEDICAL WORLD.

littin's quantity of the anesthetic, when the boil- prolonged with so much less ether than is ing-point of the latter is greater than the usually the case, diminishes the probability temperature of the body. Hence, the nearer of the unpleasant after-results from irritathe boiling-point of the anesthetic ap- tion of the kidneys, of which surgeons in proaches the body temperature the less general take so little account.--Phila. likely are unpleasant results. The boiling- Polyclinic. point of chloroform is 65° C., of ether 34°C. By mixing ether and chloroform in definite

Causes of Death. proportions, with the addition of benzin, It is estimated tbat only 900 persons Schleich has succeeded in producing anes- out of 1,000,000 die from old age, while thetic mixtures of any desired boiling 1,200 succumb to gout, 18.400 to measles, point; the use of which, he claims, gives 2,700 to apoplexy, 7,000 to erysipelas, 7,the rapidity of chloroform with the safety 500 to consumption, 48,000 to scarlet fever, of ether, with quick recovery, and a mini- 25,000 to whooping.cough, 30,000 to tymum of unpleasant results. Dr. Maduro phoid and typhus, and 7,000 to rheumahad collected in the neighborhood of 1,000 tism. The averages vary according to locases, in which these mixtures had been cality, but these are considered accurate given by Schleich and others, and the gen- as regards the population of the globe as eral result of which seemed to be quite a whole.-Med. Age. favorable. . . At the Polyclinic Hospital we have been

Toothache of Hunger. employing for nearly three years the com- In some persons hunger will excite bined administration of ether and oxygen. markedly disagreeable sensations in the The method is very simple. From a cyl. teeth. A case is publisht of a gentleinder of compressed oxygen, with or with- man who, while convalescing from typhoid out the interposition of a rubber bag as a fever, was seriously annoyed by painful regulator, the oxygen passes thru a wash sensations in two of his molars whenever bottle in which, instead of water, ether is he became hungry. The pain was suffiplaced, and taking up the anesthetic on its cient to rouse him from sleep, and could way, enters the patient's nose and mouth not be allayed except by the introduction thru a mask of spun metal edged with a of food into the stomach, when instant rerubber pneumatic cushion and fitted with lief followed.—Maryland Medical Journal. two valves, which automatically open and close for inspiration and expiration respect- Better Have Your Family Physiciao. ively.

Just keep the heart a beatin' warm, If it is desired to increase the amount of

Be kind to every feller ; : ether in proportion to the oxygen, the long

Look fer the rainbows in the storm, tube of the wash bottle is pushed further

But-carry yer umbreller! into the fluid ; if it is desired to give very

Be brave ter battle with the strife, little ether in proportion to the oxygen, the

Be true when people doubt you,

Don't think that money's all in life, . tube is brought nearly to the surface of the

But-carry some about you! fluid ; and if oxygen only is to be given,

An' when it's time to shuffle off the tube is listed entirely clear of the fluid

An' you bave done yer mission, or better, a switch connection is made

Just put yer trust in Providence, by which the oxygen passes into the mask

An' call a good physician ! without going thru the ether bottle. With

- Atlanta Constitution. this method, the patient remains ruddy

Dr. Waugh's book on Treatment and THE WORLD until during the entire process of anesthesia. One feels quite assured of the safety of his Don't neglect to send all potes on treatment. They will be

of value to somebody. patient, even in cases in which otherwise B. F. Shipley of Alpha, Md., says: “I like The World more he might be in doubt. It is possible that and more wiih each issue, not only for its many valuable

hints on the practice of medicine, but as a wonderful Schleich's mixture used with oxygen might teacher on governmental principles. 'Keep on with the good be better than ether. That remains for experience to determine. We certainly feel

Our Monthly Talk justified in urging upon the profession that, notwithstanding the rarity of direct acci- I have frequently called attention to the meandents from ether, it is their duty to guard inglessness of our elections. This is well illusagainst misfortunes, even so little to be ex

trated by the following clipt from the Literary pected, by the conjoined use of oxygen. In

Digest concerning the recent election :

The newspapers find all sorts of lessons in the outcome: addition, the fact that anesthesia can be

indorsement of the Administration's Pbilippine policy:

1900 for $5.

work."

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