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confined to those who can indulge them- ORIGINAL COMMUNICATIONS selves thus. There is much bad cooking
Short stories on the treatment of diseases and experience with among those in moderate circumstances;
new remedies are solicited from the profession for this sour bread, beefsteak fried to death, ab
department; also dificult cases for diagnosis and treatsence of vegetables and fruits from the Articles accepted must be contributed to this journal only.
The editors are not responsible for views expressed by table, not because they are unobtainable,
contributors. but from sheer lack of enterprise. People Copyor pot be perceived on or before the twelfth of the month in quite humble circumstances can bave
cannot be returned. varied and attractive dietary if they will
Certainly it is excellent discipline for an author to feel that he must
gay all he has to say in the feu est possible uords, or his reader only manage well, buying each fruit and is sure to skip them; and in the plaine st possiblé u ord8, of his vegetable when it is the cheapest, at which
reader will certainly misunderstand them. Generaly, also, a
dounright fact may be told in a plain way; and we u ant time it is also the best. Thus the bread, downright facts at present more than anything else.-RUSKIN. meat and coffee dietary, to which a sur
RECORD, prising number of people confine themselves, can be greatly enlarged without
Medical Reminiscences. adding to the expense. The broad gauge
No. 2 physician will curtail or enlarge the dietary of his patient, according to indica
MY FIRST FEE. tions, rather than give tonics, laxatives Editor MEDICAL WORLD :—Strange to and digestives, or in addition thereto. say, I never rendered a bill for my first
Treat the patient, his condition and fee and I never expected to get it. In habits, rather than his symptoms or the fact it was a surprise to me. When I name of a disease. Treat him with proper made my daily calls, at a charitable inhabits, proper diet, and plenty of water, stitution, on Christmas morning, for a then add a little medicin if necessary. doctor knows no holidays, I found the This may not be the most popular course inmates assembled in the sewing.room. at first with some patients, but the broad The Matron returned my cordial Merry gauge man will insist upon it always, and Christmas" with what seemed to me a after a while he will have the complete lack of warmth ; a false note rang in her confidence of the community and the greeting and she mystified me still more patronage that he deserves.
by handing me a pill-box, saying, “ There
has been a good deal of feeling manifested “ External ” Medicin,
concerning you by the inmates of the In some of our colleges we have profes- home, and they have delegated me to tell sorships of internal medicin. But in- you just what they think of you." ternal medicin is not the whole thing.” As I had previously been on the best of When we consider the possibilities of ex- terms with these unfortunate women, I ternal applications of heat and cold, elec- was somewhat taken back by what aptricity, poultices, blisters, baths, etc., we peared to me, at first sight, to be a token find that there is a large field for external of dissatisfaction.
of dissatisfaction. Appearing as cheerful medicin. Will not one of our scholarly as I could under the rather disheartening contributors take this subject up at an early circumstances, I opened the pill-box and date?
found a shining ten dollar gold-piece The approach of cool weather brings to therein, with a folded paper, on which our minds the importance of our “out- was written: " To Leon Noel, with heartsides.” Many people use only two weights felt wishes for health, long life and prosof under garments; a summer weight and perity." a winter weight; and they usually drop Needless to say, there was a revulsion the one and resume the other on a certain of feeling from disappointment to the date-according to the calendar rather realization of appreciation and esteem, in than according to the weather. A variety itself an honor, often sought and seldom of weights should be at hand, and they attained. should be changed according to the weather, It would be very romantic if I could and with but little if any reference to the affirm that I always kept this gold piece almanac. Care in this respect, particularly and cherisht it as a talisman, wearing it in the aged, in children and in all whose as a watch-charm, or having lost it, it resistance is not the strongest, will pre- would incite sympathy if I should aver vent many an illness, with more or less that highwaymen held me up on a dark serious consequences.
night, in a desolate street, while I was
hastening on an errand of mercy, and sympathy and—a job. His bill amounted robbed me of this charm, or, that while I to some ten dollars. He askt me if was away from home, thieves broke in he couldn't make me an instrument cabi. and carried away this precious souvenir, net to settle the bill. He said it wouldn't but I can not say any of these things cost much, for, as he was out of work, he truthfully.
would make it for the cost of the material Still, I think that the use I made of my and time. This cabinet, when it materi. first fee was a laudable one.
alized, was about a foot high, about eight With it I paid my first assessment to inches wide and eight inches deep, with the Medical Association, and possibly as seven drawers in it. In fact, it was very a reward, I was made delegate to a na- small, but the bill was another matter. tional convention at which I not only im- Sixty dollars was the amount, leaving a bibed wisdom, but many of the good things balance due to this invalid cabinet-maker of life as well.
of fifty dollars, which he insisted was his It would be gratifying if money had due. On the principle that misery loves always come in as freely, and with as
company, I did not feel as sorry as I should, much expression of gratitude, as did my as this man had settled other accounts, first fee; but like all medical men, I met with other physicians, on the same satisrebuffs, questions of veracity raised as to factory (to himself) basis. the number of visits, and requests for an There was another man. He claimed itemized bill, promises to pay, proposi- to be a doctor. Once he was a blacksmith, tions to trade, and absolute refusal to pay. with “large and sinewy hands." He
One of my first hard-learned lessons mistook his strength of muscle for magwas, that you can't mix medicine with netism, and he set up as a magnetic physifriendship. For example, there was a cian. His patients sat on a stool, and man and he had a farm. Sometimes he when the doctor waved his hands above would send for me professionally, and as them they felt the magnetism. It was I had to drive out of town, he would ask down in the cellar and came up stairs on me to take supper. After urgent solicita- a wire attacht to the leg of the stool. Intion I yielded to his invitations several cidentally the doctor stewed herbs in times.
One evening, when pears were cheap whisky and sold these decoctions ripe, he askt me if I would not like some. for five dollars a bottle. Incidentally he I was diffident about taking them, but he uttered vague dissertations upon Egyptian insisted, saying that he had more than he and Rosicrusian mysteries. All of which could take care of, that they were rotting disgusted wise and honest men, mystified on the ground, and calling to his man, he the simple and the ignorant, and filled his put almost a bushel of these pears into my pocket with money. carriage. The man told the truth about This man, like many others who heal by their rotting; I think some of them rotted faith, fell sick himself, but could not heal on the way home, and the balance rotted himself. As he had curried favor with over night. The few that did appear good me, he called upon me to minister to him. were false-hearted, and as they were In a few days he recovered and called to thrown into the garbage barrel, I thought see me to thank me for my attention. Inof the man who was so free with his bless- cidentally he askt me how much he owed ing, because, as he said, it didn't cost him me, and I foolishly replied "Anything you anything and wasn't worth anything. see fit to pay." Taking his purse from
When I rendered a bill to this hospit- his pocket, with much ostentation he fumable man he rendered a counter-charge of bled over the contents, and after much suppers at a dollar apiece, and pears at hesitation drew out a silver dollar, which four dollars a bushel and came very near he weighed for some moments in his fin. squaring accounts. He always reminded gers, and finally dropt back again. Then me of the patient who received a bill of he drew out a quarter, held it between the twenty-one dollars for seven visits and palms of his hands for a while, then four dollars for medicine. He wrote the placed it on his forehead, and muttering doctor that he would pay for the medicine an unintelligible lingo, he handed it to me and would return the visits.
with the remark, “ I have put an EgypThere was a patient who was a cabinet- tian charm on this quarter, and as long as maker by trade. He was my patient and you have it in your pocket you will always the Lord knows whose patient he wasn't. have a pocket full of money to keep it He was a peripatetic patient, looking for company." A little later in the day I I got
wanted some cigars, and as this quarter, remnants of a collection of sea-shells; the with the Egyptian charm on it, had not nucleus of a collection of minerals; a charmed my pocket full of money, I spent stuffed bird occasionally and a variety of it for cigars. If anybody has been partic- heterogenous objects gradually accumuularly fortunate it is very likely that he lated and became a source of annoyance, has got hold of this charmed quarter, but but they were offered with such effusiveI do not begrudge him the ownership. ness of good will that I could not resist The man who gave it to me, by the way, taking them. Alas! for human frailty ! is dead; and it was told me, on good au- When reckoning day came, I discovered thority, that his spirit attended his fun- that these trinkets were of priceless value eral; that's the kind of a man he was. -to those who had given them to me.
There was another man and he was a Then I made up my mind that never failure. lle failed systematically and reg- again would I accept a present from a ularly about every six months. He had patient. One little box alone, around a daughter and she had consumption. By which a thrilling story had been wrapt by careful attention I carried her thru many an old sea captain, who claimed that it crises, and she was grateful. While her had been made by the natives of Borneo, father was in business he tried to even ac- cost me twenty-tive dollars, altho it was counts, in trade.
His trade, by the way, first given to me as a “ token of esteem.” was that of dealer in kitchen ware.
Years afterwards, in Birmingham, I saw pots and pans, brooms and brushes and these boxes turned out by the thousands, such like trifles, for myself and all my and I had my suspicions that Birmingfriends, even if they did come high, for ham was the nearest my old sea captain there was a vast difference between the
ever got to Borneo. trade price and the trading price. Finally There is still a pleasant side even in the the family moved West, seeking for new matter of fees, and many patients are places to fail in. I sent him bills for a grateful. I can dimly remember, when I period of several months for a sum of was a youngster, that my father had a several hundred dollars. One day I re- patient who manufactured candy and iceceived a letter informing me that he had cream. How sweet that man's memory is failed again ; that I had never done his to me, for he brought unlimited supplies of daughter any good, but made her worse ; all manners of sweets, and used to send and that he had been advised to sue me for around ice-cream by the gallon, but poor malpractice, adding that he would like to man, he's dead now, and I have never met be a doctor, and ride around in a carriage, one like him since. The nearest I have and live like a prince. I answered him ever come to such a man is when some that if everybody paid their bills as friendly druggist, with an eye to business, promptly as he did, most doctors would has offered me a peppermint drop or a live like paupers and reside in the poor- chocolate cream or a glass of soda. house ; also advising him to let medicine There was another patient, a woman, alone, for he certainly would make a fail- well related and highly educated, but alas! ure of it.
not well balanced mentally. I knew her Few doctors have practist any length of but a short time, for she was committed time who have not been solicited to accept to an asylum. The first time that she trinkets, usually of slight value, as tokens came to see me she askt me if I liked of esteem.
cream-cakes, and I said that I did. That As all others have done, I accepted night a box was delivered at the house such trinkets, and was in a fair way to containing a hundred cream cakes. The have a unique collection of odds and ends family was somewhat in doubt as to the from all parts of the world. The first advisability of indulging in those cream present was a Japanese tea-pot with a cakes, but having tried one on the dog chipt nose, which made it look as if it and a portion on the cat, and finding that was suffering from hare-lip; then I re- they survived, we came to the conclusion ceived a couple of Kaffir spears; then an that they were safe, that they were not ugly looking spear, set with rows of loaded, and accordingly ate them, and the shark's teeth which were said to be poison- supply continued to come regularly for ous, and which therefore kept me in con- several weeks. stant suspense lest someone should be Another patient was an Italian, a young injured thereby.
man who had run away from home in A whale's tooth and a walrus tusk; the Italy because his father wanted him to be a priest. He kept a fruit stand, and being
Notes and Comments. thrifty past for well-to-do in the Italian Editor MEDICAL WORLD :-Let me reiter. quarter. He was recommended to come ate the advice given by the Editor to write to me by an artist, and with the Italian out your experience with the summer comwarmth of affection became much attacht plaints now, while their memory is fresh to me. Certain afternoons of every week in your minds, to be filed away until the I held a reception for Italian patients in- next hot season opens. Otherwise much troduced to me by this man, and altho valuable material may be lost. Things these people were lowly, their gratitude look so different when one has bad time was sincere and their payment, small tho to forget. The old reliance on calomel it was, was prompt. These people always and chalk mixture will reassert itself when indulged in a sort of a surprise party when the memory of their failure has dimmed. they came to see me, bringing the choicest May be we did not use them skilfully enaf of fruit and Italian dainties, which, tho in those fatal cases; and next time we they were strange in form and make, were
will be doubly careful, and they must sucnone the less acceptable, but I never could ceed. Do not Professors Bigman and Oldmake up my mind to accept their cordial fogie say calomel is the best of intestinal invitation to dine with them.
antiseptics? Does not opium check perWhen we went to Europe, in the sum- istalsis, chalk neutralize acidity, bismuth mer, this little family sent to the steamer allay irritation, ipecacuanha stimulate a large basket of the choicest fruit that healthy secretion, rhubarb sweep out the they could find, and proved that the hum- trash and leave a healthy bowel, the tanblest minds are sometimes the richest in nins, mineral acids and silver astringe gratitude and good will.
and pepsin digest albuminous food? And Once it was my good luck, and only surely, with these good things, we must once, to be remembered by a patient in succeed. But as each successive season his will. A valuable watch had been pre- shows the fallacy, the use of the intestinal sented to him, and he was anxious that I antiseptics, and the application of the should have it, but desired that it should principles of practical sanitation, are remain in his wife's possession until her forced upon the profession. And it may death. Some six months after, she died, be accidental, or it may be significant, but and a gentleman waited upon me with a I do not recollect seeing in the columns of copy of her will, bequeathing to me the our World a letter telling of the doctor watch, a French clock and a picture. He who has fairly tried these remedies and also stated that he was the executor of gone back to the old way. the estate, and that, as he wanted to give Dr. Aylsworth (page 375) has put his his son a watch, he hoped I would take finger on the weakest spot in our armortwenty-five dollars and let him keep the the action of drugs. We know very little watch. As I knew that the watch cost of the intimate nature of this action; in some two hundred dollars, I told the man fact, since Headland wrote his book over that I preferred the watch, not for its in- thirty years ago, no better theory has trinsic value, but as a remembrance of a arisen than the one Dr. Aylsworth attackt. man whom I esteemed.
The difficulty has been that the drugs with These are but a few of many incidents which tests were made were of such variwhich I might relate concerning fees, but able composition that equally trusty ex. they will suflice to show both sides of a perimenters reported directly contrary question, on the one hand full of annoy- effects from them. But with the isolation ance,vexation and insult, and on the other of the active principles this has been fraught with manifestations of gratitude. changed ; and if anyone will study the Massachusetts.
latest editions of Brunton and Wood, he (This series will be continued for a number of months. will see what has made a new therapy The title of No. 1 was “My First Prescription," in September possible. WORLD.]
Dr. Easton (page 385) asks for treatloid directly antagonized by atropin, and diagnosis correct in so far as the presence eliminated very rapidly thru the kidneys. of albumin and casts in the urine was conThe indications are, therefore, to empty cerned, and the neurasthenia could scarcely the stomach, neutralize the muscarin with have been more complete. His digestive atropin, and support by food, strychnin power was almost nil, emaciation and and tincture of iron until the poison has debility markt, sleep very imperfect. But been eliminated. The death cup or poison the resources of his physicians seemed to amanita contains phallin, which acts like have been exhausted when the diagnosis serpent venom, dissolving the blood-cor- had been made-they diagnosed and did puscles and causing death by asphyxia. nothing. This is a The symptoms are slow in appearing, with a certain class of highly cultured about eight hours after the poison has physicians. been swallowed. Phallin is a toxalbumen, My own diagnosis went a step farther. and is destroyed by heat (coagulated); The patient's bowels were loaded; he had hence thoro cooking renders it innocuous. some flatulence and abdominal uneasiness. It is so deadly that one-third of a raw cup The spleen was not enlarged, which diskilled a boy twelve years old. There is posed of the malarial theory. His heart no known antidote. The treatment con- was very weak, but under moderate doses sists in emptying the stomach, combating of cactus it responded in a way that indithe symptoms of muscarin, if it also is cated the soundness of this organ. Under present, and sustaining the strength with a diuretic the urine rose to sixty-eight strychnin. Transfusion of blood should ounces daily, and the kidney affection be practist. No known remedy stops the evidently had not seriously impaired its action of phallin on the blood-cells.
ment of sunburn. As a boy I employed "WORLD One year and Dr. Waugh's book, $5. You need them
a preparation known as camphor ice, and Dr. W. S. Harrell, of Spearsville, La., writes: “Inclosed
since that time have found nothing better. find one dollar for the best medical journal publisht. THE World is all right."
“ Toadstool poisoning” is an uncertain Dr. J. Walter Rowland, of Herndon, Kan., writes: “If the term, since there are several poisonous profession would lay aside political party prejudice, and reason together, it could be a great power in the reform fungi with different toxic principles. The movement. Ignorance and prejudice keep mang a good fly amanita contains muscarin, an alkathing from being perfected."
I then turned my If J, M.'s case (page 385) was really attention to the bowels; began to empty erysipelatous, he would find a full dose of them by colonic flushings and repeated pilocarpin quite effective. But it looks to doses of barabana water, an agent I want me more like a form of angioneurotic to recommend for obstipation. The first edema. Keep the skin wet with a solu- effect of liquefying retained fecal masses is tion of mercuric chlorid, one to 1,000, and to intensify the symptoms of auto-toxemia, let this be applied whenever there is a sign as absorption is increast, so that the of a new attack.
neurasthenia deepened into melancholy. I have just had two cases of gonorrhea But as the bowels were emptied and rentreated with silver citrate locally and dered aseptic, the mental condition imcalcium sulfid, seven grains a day, in- proved, the appetite returned, the digesternally. One case was well in three tion was carefully nurst, and strength days; the other in eight. The injection began to grow. Small quantities of food was not irritating, and, like the nitrate, were given frequently, the predigested seemed to convert the inflammation into a foods and pure fruit juices first, then simple urethritis.
other articles added gradually. The albuPerhaps we are all given to the riding of min has disappeared, he sleeps soundly hobbies; and the frequency with which I without hypnotics, enjoys his full meals, have written and talkt of intestinal anti- rides ten or more miles on his bicycle sepsis has certainly justified the allegation without fatigue, and is recovering rapidly. that this is a hobby of mine. But it is a Now, if there's anything here indicating pretty good sort of a hobby to ride, as the skill beyond that to be expected of a medifollowing case will show :
cal student, I fail to see it. Why did not A distinguisht jurist from a Southern my colleagues cure this simple case ? Bestate came to me recently. He had spent cause they forget that the alimentary canal five months with the best physicians of St. is with reason termed prima via; because Louis in various sanatoria. I mention they neglected to see that it was emptied this because if ever one has the oppor- and disinfected, and one of my pet theories. tunity to reach correct diagnosis it is is that this is the first duty of the doctor ; when he has the patients under his own because they were satisfied to rest on their eye in a sanatorium. And this gentleman diagnosis of neurasthenia and Bright's surely had diagnosis enuf. Every care without ascertaining the cause of these had been taken, and pains lavisht upon affections. And I verily believe that conhis case. He had profound neurasthenia, stipation and auto-toxemia are to be malaria and Bright's disease; and had credited with most cases of nephritis. For been pronounced incurable. I found the altho the kidneys may eliminate the tox