Imagini ale paginilor
PDF
ePub

states that "As early as 1758 a law was past in France, according to which wet nurses had to inform employers of the occurrence of another conception. Not very rarely will the uterus not be able to resist the persistent mammary irritation kept up by nursing, and the fetus is expelled." Some time ago Robertson remarkt that one-half of the nursing working women of Manchester, England, conceived during lactation. Dr. Barnes ("London Lancet," 1852) has written an able paper on this subject, and has shown that in a given number of instances abortion occurred in 17 per cent of cases in which the female became fecundated during lactation, and in only 10 per cent. when impregnation occurred at other times.

On

In regard to idiocy and imbecility, Dr. C. K. Mills (American Text-book of Diseases of Children, page 673) writes, in speaking of etiology, of Bad health in the " mother and impressions made on her during pregnancy, the father's health or condition at the time of procreation." Sach (Nervous Diseases of Children, page 632) states that "The alcoholic habits of the father at the time of procreation are surely a potent factor of congenital idiocy." page 683 he remarks that "Traumatism during pregnancy is another factor in the development of idiocy in the child. As the influences brought to bear are prenatal in origin, these cases may be included under the heading of hereditary idiocy, and there is all the more reason to do this, as such traumatic injuries are all the more likely to be harmful to the normal development of a child's brain in families with neurotic taint than in families whose histories are entirely negative." Taylor and Wells (Cerebral Palsies, page 516), in speaking of etiology, allude to trauma to the mother during gestation, and intimate that coitus is one of the causes of trauma. Psychic and emotional shocks, nervous and other strains, result in retardation of fetal brain development.

In the same line of inquiry I wish to present a brief abstract of some tabulated observations selected from records because of the known environment of the nurse in her sexual relations. I shall not go into any great detail, as time does not premit. In 51 cases of digestive disturbance in sucklings in which the breast milk showed colestrum characteristics, with greater or less increase in proteids, 24 were relieved with no treatment other than the discontinuance

of coition; 13 received slight medical treat ment, as a mild laxative, or a few doses of calomel and soda, or a little lime-water; 1 proved more intractable and required treatment from one to four weeks; one was pur upon modified milk after three months ineffectual efforts at nursing; one was changed to wet nurse after two months: one died in convulsions apparently as a direct result of excessive coitus after long abstinence. The milk analysis in these cases showed a specific gravity of 1032 fat 2, and proteids 3.8.

These cases are selected because of the apparent marked causative relation of coitus to the disturbed equilibrium of the milk; not that other examples are wanting in which this etiological factor appears equally prominent. But in the cases presented I feel morally certain that sexual indulgence was discontinued, hence the conclusion as to its etiological relationship, and the time limit is too brief to attempt an exposition of the various tests applied to this case, not to mention the many cases rejected as unworthy of classification as to proof of this one cause of disturbed lactation. That menstruation is equally a cause of disturbance I fully believe, and that as such it is much easier of demonstration.

I trust that these few carefully-selected cases may stimulate other investigations in larger clinical fields, with the hope for more exact knowledge upon this important but neglected subject-the modification of breast milk.-Dr. A. C. Cotton, in Chicago Clinic.

The Revision of the United States

Pharmacopeia.

In accordance with the call of President H. C. Wood, the National Convention for the Revision of the Pharmacopeia of the United States of America, will be held in Washington, May 2, 1900.

At no time in the past has so much interest been shown in this work, as in the case now. The interest in this instance centers itself mainly on two points; one looking toward the general betterment of the Pharmacopeia, in keeping with the lines heretofore adopted; the other, backt by commercial interests, having in view the inclusion of proprietary remedies in the official list.

Coming under the first head, may be mentioned the standardization of a number of official preparations made from drugs having definit active principles susceptible

of isolation. The first attempt in this line was made in 1880, when preparations of opium were made to conform indefinitly to certain requirements in strength of alkaloids. In 1890 these requirements were made more definit, and the cinchona barks and nux vomica were included in the same list. This line of progress should, and doubtless will, be continued in the coming revision, including such drugs as belladonna, hyoscyamus, conium, stramonium and many others of like nature. Some drugs, owing to the complex nature of their active ingredients, are practically insusceptible of standardization. Among these may be mentioned digitalis, aconite, veratrum virid and ergot, all important drugs, but all depending for their medical activity upon more than one ingredient, and these present in extremely small

amounts.

For some of these a physiological assay has been advised, tho whether this is practical in all cases, it is difficult to determine. Recommendations have been made from various sources, that many of the present official drugs, such as herbs, flowers, etc., would be dropt from the list. We believe such action would be unwise, for, altho some of this class of drugs are not often prescribed by physicians, many of them are in common use as home remedies, and to retain them in the Pharmacopeia will mean that they must conform to a standard in purity, and that penalties for their adulteration may be enforct. Many of these household remedies are of distinct value, and if more frequently recommended by physicians would do much toward discouraging the use of nostrums and proprietary remedies.

A strong attempt will doubtless be made to have included a number of proprietary articles, but we fail to see how this can logically be done. The object of the Pharmacopeia is to furnish a list of drugs whose purity may be guaranteed by appropriate tests and requirements, and whose manufacture necessarily must be free. What, we ask, would be the sense of making antipyrin official, since its manufacture, and everything else pertaining to it, would not be under pharmacopeial control? The code of ethics is distinctly opposed to proprietaryship in medicins, and that also should have appropriate weight. To exclude these synthetic proprietary remedies from the Pharmacopeia, does not mean that they shall not be used, by whomsoever thinks proper, but to include

them would be to clothe them with ethical dignity, to which they are not entitled, and which would lower the tone and value of the Pharmacopeia.-Penna. Med. Jour.

Intestinal Obstructions.

Ileus is not a pathologic entity, but it is a train of symptoms; nausea, vomiting, pain, tympany, inability to produce bowel movement by ordinary means.

Intestinal obstruction occurs under three heads: First, adynamic; that is, lack of power in muscular wall of intestine; second, dynamic, too powerful contraction of muscular wall of intestine; third, mechanical obstruction.

Gall stone in cystic duct is very difficult to differentiate from mechanical obstruction of the bowels.

Uremia gives symptoms that often stimulate mechanical obstruction.

Lead poisoning causes chronic muscular contraction of the intestines at one point.

While carcinoma often produces mechanical obstruction, sarcoma of intestine rarely produces obstruction. In fact, sarcoma enlarges the lumen of the bowel.

Intussusception rarely occurs in adults, but frequently in children. The child at once has intense pain, cold sweat, fainting, collapse and usually a sausage-shapt tumor will be found on physical examination.

The smallest part of the intestinal tract is twelve inches above the ileo-cecal valve.

In mechanical obstruction of the intestines pain is always periodic. The patient is not very sensitive to pressure, but you can excite pain by gently kneading the abdomen.

One of the most important symptoms in locating the seat of the obstruction is the judgment of the patient. Quietly get her confidence and then ask her to carefully locate the pain, and in the large majority of cases by persisting in questioning her, the surgeon will get her to finally locate the point of greatest distress, and that point will be the point of obstruction.

In mechanical obstruction of the intestine the pain is most severe in the early part of the attack. Four or five days after the obstruction began the pain will usually disappear to a great extent.

If there is strangulation of the intestine, vomiting begins almost immediately.

In ileus from sepsis, vomiting occurs only in the early stage, except where general peritonitis is due to streptococcic infec

[blocks in formation]

Dame,

Knowing if he lost the battle, then the doctor was to b ame 'Twas the brave old virtuous doctor, 'Twas the good old faulty doctor,

In the neighborhood of the obstruction there is dulness, which is due to the collection of fluid. At other points in the 'Twas the faithful country doctor-fighting stoutly all ti distended tract there is gaseous distention.

We never have elevation of temperature in primary ileus due to mechanical obstruction. At a later stage of the attack we may have high temperature due to necrosis of the intestine, or peritonitis. The pulse rate is of no particular value as a differential sign of diagnosis.

In the physical examination of the patient there are four most important steps, namely, inspection, palpation, percussion and auscultation. These four are all important, but auscultation is the most important of all. In mechanical obstruction of the intestines by the use of a stethoscope you get a perfect hurricane of noises above the obstruction, which can be followed down to the point of obstruction where the noise ceases.

In my opinion, the two great points of diagnosis are the location of the pain by the patient and auscultation.

One of the most serious features of intestinal obstruction is the paralysis of the tinal obstruction is the paralysis of the bowels, which is caused by prolonged strangulation, and is not relieved by the removal of the cause. The result is that every now and then a surgeon, after removing the obstruction, waits a day or two vainly for a movement, and then is obliged to bring the bowel up to the wound and make an artificial anus, after which the patient will go on to a satisfactory recovery. Dr. J. B. Murphy, of Chicago.

[blocks in formation]

same.

When so many pined in sickness, he had stood so strongly be Haif the people felt a notion that the doctor con ln't die They must slowly learn the lesson how to live from day to day.

And have somehow lost their bearings-now this landmarks away.

But perhaps it still is better that his busy life is done

He has seen old views and patients disappearing, one by one.
He has learned that Death is master both of Science „nd a
Art

He has done his duty fairly, and has acted out his part
And the strong old country doetor,
And the weak old country doctor,

Is entitled to a furlough for his brain and for his heart
-Will Carleton

Injuries to Women in Coition. Under the heading Venus Cruenta Violans interdum Occidens (Monatsschrift für Deutsche Aerzte-Zeitung, September 15th). Geburtshilfe und Gynäkologie, ix. 3: Neugebauer analyzes a hundred and fiftyseven cases of these injuries, including laceration of the perineum, of the sphincter ani, and of the posterior vault of the vagina with rupture of Douglas's pouch and protrusion of coils of small intestine, injuries of the bladder, perforation of the recto-vaginal septum leading to fistula. etc. In twenty-two cases death followed in consequence of hemorrhage, sepsis, or peritonitis. Three women, the successive brides of a hairdresser of the Faubourg St. Martin, are said to have died of injuries sustained in the first intercourse. It seems that it is not alone among the ignorant and brutal that these injuries occur; two of the women whose cases are mentioned were physicians' wives.-N. Y. Med. Jour.

Editor MEDICAL WORLD:-I wish you success in your fight for the poor and opprest of this great Union. If every physi cian whom your voice reaches would help a little, your work would be so much easier, and victory so much nearer. Enclosed find a clipping from a local paper, in which I had a good work; it opened the eyes of the editor and enlightened part of your Monthly Talk" publisht. I think it has done

others. The editor thought it was so nicely written, and others exprest themselves that there is truth in it of which they never thought. Go ahead, Editor Taylor. Your grand work will follow you. DR. M. FRIEDLANDER. McKeesport, Pa.

Sun Baths.

Dr. Wilson says try them for the complexion, for the circulation, for anemia, and for sleeplessness take frequent sun baths. He contends that sun is as necessary to the body as water, and that it is the best sort of a tonic as well as a beautifier. He says: Take all clothing off, and sit or lie in a room flooded with sunshine.

Change the position often enuf to bring all parts of the body in the sun's rays. Tanning and reddening will not hurt the skin, but strengthen and improve it. This remedy he claims will invigorate the entire system, act as a preventive of colds, and improve the disposition by increasing vitality and strength.-Pop. Science News.

A Fine Opening for the Young Physician.

We are too crowded in the United States

but there is a land where room is plentiful and the country overrun with patients. Russia has a population of 127,000,000 and only 18,334 physicians, or one doctor to every 6,926 inhabitants, while the United States, with a population of 75,000,000, has 120,000 physicians, or one doctor to every 625 inhabitants.-Charlotte Med. Jour.

Surgical Treatment of Habitual Criminals.

A. J. Ochsner, M. D., proposes the resection of the vasa deferentia just below the external-abdominal ring, and sums up the advantages of dealing with male habitual criminals in this manner," as follows:

"1. It would do away with hereditary criminals from the father's side. 2. Aside from being sterile, the criminal would remain in his normal condition. 3. This method would protect the community at large, without harming the criminal. (A ten-minute operation under local anes. thesia.) 4. The same treatment could reasonably be suggested for chronic inebri ates, imbeciles, perverts and paupers.". Jour. A. M. A.-Woman's Med. Jour.

Lactic Acid as a Remedy for Baldness. Balzer (Semaine médicale, May 19th; Fortschritte der Medicin, September 20th) practises friction of the bald part daily with a 30 per cent. solution of lactic acid until the skin becomes inflamed. Then the treatment is suspended for a few days, and resumed when the inflammation has subsided. He reports that he has often observed a new growth of hair in the course of three weeks.-N. Y. Med. Jour.

Book Reviews.

? Quiz-Compends? No. 8. A Compend of Diseases of the Eye and Refraction; Including Treatment and Surgery. By George M. Gould, A. M., M. D., and Walter L. Pyle, A. M. M. D. Second edition. Revised and enlarged. One hundred and nine illustrations, several of which are in colors. Philadelphia: P. Blakiston's Son & Co., 1012 Walnut Street. 1899. Price, 80 cents.

The reader is first amazed at the title and then astounded at the price. But, really, this quizcompend is fully up to, or above, the average. It has 279 pages of text, and a table of abbreviations, and a glossary of ophthalmologic terms, and an excellent index; altogether taking up 295 pages. The reader must wonder how such a mass of really valuable material can be aggregated for 80 cents. We, however, all know the is an excellent primer, and can be purchast and standing of the names" Gould" and "Pyle." It read by many practitioners with both pleasure and practical benefit. While only pretending to be an aid to “cramming,” it contains quite a number of valuable prescriptions. In ophthalmia instead of the commonly used two per cent. neonatorum a one per cent. solution is advised, solution for prophylaxis. He who purchases and reads this little volume for "a quiz-compend” will not be disappointed; nothwithstanding the arguments advanced against such works.-A. L. R.

Hay Fever and Its Successful Treatment. By W. C. Hollopeter, A. M., M. D. Second edition, revised and enlarged. Philadelphia: P. Blakiston's Son & Co., 1012 Walnut Street. 1899. Price, $1 00.

This little volume contains 125 pages of text, with an index, and 20 pages of bibliographical references. Its popularity is attested by the call for the second edition inside a year. Only original. "I have compiled, arranged, and annotated the most worthy literature, and I acknowledge my indebtedness to the many authors quoted." "There is little to be said definitly about the etiology." The author reports his experience from over 200 cases relieved, and gives the "sesames" in the words daily sterilization. This, he claims, will permit even the most inveterate chronic sufferer to remain at his post of business during all seasons. He believes that local disease is incidental and not provocative; tho, of course, these troubles interfere with speedy results unless corrected. Diluted carbolic acid is the cleansing and antiseptic agent, giving place to hydrogen peroxid if any idiosyncrasy be apparent. The theory is new, and has proven effective in the author's hands. It is well worthy a trial, and a perusal of the book will render one able to carry out the author's ideas.-A. L. R.

the "successful treatment" is claimed to be

Manual of Orthopedic Surgery. A Treatise on Deformities and Diseases of Joints and Bones. By Stewart LeRoy McCurdy, A. M., M. D., Pittsburg, Penna. Publisht by the

Author. Price, 81.25 net.

This little manual contains 336 pages and 145 cuts. The work is gotten up somewhat better in style than the "quiz-compends," and yet one cannot expect elaborate illustrations and fine mechanical work in a book sent out at this price. The author illustrates a number of appliances devised by himself, among which may be mentioned a pocket knife, a saw for plaster dress

ings, a club foot wrench, etc. He defends the existence of orthopedic surgery as a specialty, and has little sympathy for those practitioners who tell their patients with beginning deformity "they will grow out of it." He makes a plea for immediate and scientific interference, either mechanical or operative. Ingrown toe-nail receives due attention, and an operation is advised. The hot air treatment is mentioned, and the apparatus of Betz is illustrated. He has written well, what he has written; and it forms a good working manual.-A. L. R.

Ocular Therapeutics for Physicians and Students. By F. W. Max Ohlemann, M. D. Translated and edited by Charles A. Oliver, A. M., M. D., Univ. Pa. Philadelphia: P. Blakiston's Son & Co., 1012 Walnut Street. 1899. Price, $1.75.

a

The book contains 259 pages, with an index and a list of authors. It has been dedicated by the author to C. Schweigger, M. D., and by the translator to William F. Norris, A. M., M. D. It is divided into a "general part" and "special part," occupying 80 and 175 pages respectively. The first part takes up general considerations in ophthalmic work and the second part each particular class of diseases, as of the lids, the cornea, the choroid, the iris, etc. The best work of the Continental writers has been condenst. Particular care is taken that no confusion shall arise from use of drugs unofficial in the U. S. P. The metric system is used thruout. The translation of the text from the original has been made by Dr. David Riesman. Remedies are divided into mechanic, thermic, chemic, electric, and general. 1 to 1,000 corrosive sublimate is considered the proper strength for use. on hands, brushes, etc. Regarding electricity

"the curative value of the constant current can not be said to be striking" and "the induced current has fewer indications." 226 prescriptions are given in full. Abundant cross-references are given, and they will be fully appreciated by the busy ophthalmologist. A work of this kind, intended to find its way to the general practitioner as well as the specialist, involves an immense amount of labor, and the work has been well done. Every practitioner should have it. Type, paper, printing and binding are excellent. -A. L. R.

A Systematic Treatise on Materia Medica and Therapeutics with Reference to the Most Direct Action of Drugs. By Finley Ellingwood, M.D. With a Condensed Consideration of Pharmacy and Pharmacognosy. By John Uri Lloyd, Ph. D. Publisht by the Chicago Med. Press Co., 103 State Street, Chicago, Ills. Price, in cloth, $5 net.

This work is Eclectic; it "sticks out" all over it. Evidently the author has not hoped for many "rational" readers, since he uses the terms "we," "us," and "ours," all too frequently for over sensitive readers. Nevertheless the most strict adherent along the old line can learn much from the careful perusal of this volume. The U. S. P. is fully recognized, altho no subservient deference is paid. The volume does not lose establisht facts, and yet it reaches further; it includes the "more recent observations of the actions of drugs, many of which have never before appeared in book form, and the author's personal observations." In the preparation of the volume he has drawn upon "the entire literature of the Eclectic School." In his preface he deplores the fact that too

many students, finding in the great writers skepticism and doubt, have developt a disgust for therapeutics. This reminds us of the remark of the elder Wood: "Show me a man who does not believe in the administration of medicin, and I will show you the man who does not know to prescribe or administer medicin." The author does not fail to catch hints from eminently irregular sources," and "add them to the fund of general knowledge." The plan of "a single remedy to a single condition" is prominent. He believes typhoid fever can be aborted "within a few days" by the use of bowel flushings and intestinal antiseptics. And further: "Curettage or antiseptic flushing of the uterus will cause the high temperature of puerperal fever to suddenly drop." Under Pharmacy and Pharmacognosy Prof. John Uri Lloyd says that experience has led him to hesi tate to express himself on problems that at one time would have presented no cause for hesitation. He does not love elixirs, confections or sugar-coated pills. "The gelatine-coated pill is the only pill that I commend to my friends." Tablets are briefly mentioned, and their use designated as "the tablet craze;" altho* many tablets are fine remedies." The Professor occupies 22 pages on the various medicinal classes of preparations, as syrups, tinctures, elixirs, extracts, tablets, pills, etc. The main body of the work classifies drugs into eleven groups. Those acting upon the nervous system, upon the heart and circulatory system, upon the respiratory system, upon the stomach and gastric and intestinal digestion, directly upon the intestinal canal, upon nutrition and the blood, upon excretion, upon generative organs, upon cutaneous surface, upon micro organisms and parasites, and tricity and Electropathy" has 18 pages. The miscellaneous. A chapter on "Medical Elecbook is completed by a good index of remedies and an index of diseases. In all it has 706 pages. thists and regulars would derive a benefit from Every Eclectic will get it, and most homeopa

its perusal. It comes from men in search of truth and who have tried to be fair to all creeds and prejudices; and yet, who, being convinced of the truth, do not hesitate to "hew to the line. let the chips fall where they will." The paper and binding are rather inferior; but typography is excellent.-A. L. R.

Asthma; Recent Developments in its Treatment. By Ernest Kingscote, M. B., C. M. L. R. C.S. Edin.; Fellow of the Medical Society of London, etc. With colored frontispiece and illustrations. London: Henry J. Glaisher, 57 Wigmore Street, Cavendish Square, W. 1899. Price by mail, 5s id.

It is a cloth bound 8vo. of 187 pages. The paper is heavy and sized, and the type small, yet easily readable on account of wide spacing. "This book makes no pretensions to be considered an exhaustive treatise on asthma. It merely consists of the record of a number of observations taken during some years' special practice in that subject." The author has something new to offer, and because of our slight knowledge of the etiology and pathology of this distressing symptom of a number of diseases, he is entitled to a hearing. Without saying that every case of asthma is due to dilated heart, he says that he finds practically all his asthmatic cases have dilated hearts, and by treating the dilatation he

« ÎnapoiContinuă »