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selves of change of climate as a means of limit, will prove successful when all other relief, yet the house should be kept dry measures fail. and warm, and wool should be worn next

Sciatica. the skin. Still these measures are of more

The claim is made that sciatica is purely preventive than curative value. In addition, tone up the system with codliver

a neuritis, but it is nevertheless more

often occurrent as a manifestation of the oil, iron, arsenic, etc., which increase the

rheumatic tendency, and hence the present resisting power of the tissues and lessen

seems an excellent connection in which to the tendency of the structures around the

consider it. It occurs more frequently in joints to involvement. There are varied opinions as to diet,

males of middle life and of the uric acid many recommending an almost strictly follows exposure to cold and wet or an at

diathesis than in any one else, and usually vegetarian diet, while others think it best to maintain constitutional vigor by a lib

tack of inflammatory rheumatism. eral meat diet. This probably depends

It is chiefly characterized by a sharp upon the individual patient. There is a

shooting pain running down the back of consensus of of opinion that all stimulants

the thigh, intensified by movement, and are contra-indicated.

becoming worse at night and on approach Among local measures the use of the Pa

of stormy weather. Recovery may follow quelin cautery has many adherents, and persistent treatment, but relapses often excellent results are quoted from its use.

occur, and sometimes the pain becomes

continuous and chronic. Blisters over the seat of pain are also well spoken of. Among liniments are recom

Enjoin rest upon your patient and apply mended the simple iodin liniment, soap

either hot fomentations or blisters along liniment with potassium iodid applied

the line of the nevre. Give deep injectwith gentle friction, equal parts of chloro

ions of some analgesic such as cocain or form and extract of aconite root or bella- morphin, and give full doses of sodium

Make donna, or veratrin, or ichthyol.

salicylate and potassium iodid.

your patient understand that patience and Myalgia,

perseverance are essential, and that the

chief good to be obtained from a change Under this general term may be classt

of physicians (where there seems to be all manifestations of muscular rheumatism, such as torticollis, lumbago, pleuro- danger of this) is that the other fellow

will probably reap the delayed results of dynia, and cephalodynia. In all of these pain is the chief symptom, resulting from

your attentions. irritation of sensory nerve fibres terminat

Gout. ing between the proper muscular elements Gout is of somewhat rare occurrence in of a voluntary muscle. In all of these this country. It is a disease of the general gentle kneading and rubbing of the af- system, characterized by constitutional fected part with a liniment such as that disturbances and local manifestations, parcomposed of chloroform, extract of aconite ticularly affecting the smaller joints. It root and soap liniment, and a general occurs most frequently in middle or adcourse of hot baths followed by application vanced life among men who have inherited of dry heat will usually yield relief. When the tendency, or who are accustomed to it is at all possible, much relief is often to rich food and the use of stimulants, especbe had by putting the muscles to absolute ially malt liquors and strong wines. rest, best obtained by strapping the af- An attack of the disorder is usually fected parts. Acupuncture has given ushered by restlessness, insomnia, irritabrilliant results. Often the internal use bility, etc., and the arthritic complication of gelsemium, pusht to the physiologic usually appears in the early morning,

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generally as pain and swelling in the ball catarrhal variety, broncho-pneumonia. of the great toe. The joint becomes a The course of the disease is different in all reddish purple and is exquisitely painful of these, and necessarily, different measand tender. There is a moderate general ures must be adopted to meet the different perspiration, constipation and scanty, high indications. Hence it will be well to concolored urine, showing a deficiency of sider the treatment for each variety sepaurates during the continuance of the par- rately, paying no attention to points of oxysm. The prognosis is good in the similarity where they occur. . acute form, but is rather unfavorable in the chronic form.

Croupous Pneumonia, Medical Treatment. Colchicum is first, last and always the The first indication in a case of croupous remedy par excellence in this trouble, and pneumonia is that of absolute rest. A should be given every two hours in doses jacket should be made of oiled silk lined of about fifteen drops of the wine, well di- with a thick layer of cotton batting, and luted. Alkalies are valuable adjuncts, the this should be fitted closely to the thorax salts of potassium and lithium being gen- and lightly sewed together in a way to erally given in conjunction with the col. prevent its slipping from place. A strictly chicum. Constipation should be relieved, liquid diet, or at least a semi: liquid one, and the free drinking of water, particularly milk, broths, eggs, koumyss, beef juice, those containing lithia, should be encour- etc., will produce the best results. aged. Opium constitutes the best local The immediate danger is frequently from application, and the affected part should obstruction to the pulmonary circulation. be wrapt in cotton wool and elevated. A If the patient is in the stage of congestion, light and non-stimulating diet should be with a full and strong pulse, three or five enjoined.

minims of the fluit extract of veratrum

viride, or 1.134 grain of veratrin every Pneumonia, Its Management and Treatment.

hour until the pulse softens is a valuable Too often the patient with pneumonia remedy. This acts by slowing the heart fails to recognize the gravity of his con- action and dilating

the systemic vessels, dition, and in an effort to "fight it off” thus determining the blood from the enkeeps up and about until his vitality is gorged lung. If the patient is very robust, 80 sapt that a fatal termination is in- venesection may often be employed to adevitable. The first step of all is to send vantage.

vantage. If the head is flusht and delirthe patient at once to bed and in a room ium present give 1-200 grain of aconitin, that is thoroly warmed, altho the air or 1-250 grain of gelsemin every hour. It should be kept fresh, and for the best is far better in drug medication to employ results, also moist. Yet the heat is above

Yet the heat is above small doses frequently given than to atall else the indispensable requisite, if choice tempt to “shock the system” by giving must be made among these, tho it is a hard large doses, since the effect of treatmatter to discriminate and say which is ment can be watcht and regulated to a the most important of the three, heat, closer degree. moisture or ventilation.

It is important that the temperature be The treatment will depend in some de- kept down, since the work of the weakened gree upon the type of the disease to be and overburdened heart is increased in an dealt with, for instance whether it is of the arithmetic ratio with every degree of fever. hypostatic variety, a splenization of the Experience seems to have shown that if lung dependent upon the prolonged re- the temperature is kept down the heart cumbent position occurring in sthenic dis- will be equal to the demands made upon eases; the acute specific disease known as it unless it is too much interfered with. A croupous pneumonia or lung fever; or the first step in the process of regulating the

27

THE MEDICAL WORLD.

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system is the placing of the bowels in a solu- For delirium, potassium bromid, hyosble and aseptic condition. To do this ad- cin, musk or camphor all act satisfactorily minister a fairly large dose of calomel, say without interfering with the action of the three or four grains, followed by an ounce other remedies used for conditions enumeof epsom salts in as small a quantity of rated. Where there is high fever also, the water as possible. This will produce a cold pack will serve the double purpose of free evacuation with the removal of as diminishing the delirium and affecting a much of the blood serum as possible, per- rapid reduction of the temperature. forming in some degree the same office Care must be observed in employing the that bleeding wonld. Then inaugurate various antipyretics, since they lower the antisepsis, using those well-tried and reli- cardiac power too effectually, often preable agents, the sulfocarbolates.

venting the proper reaction to meet the When consolidation or hepatization ap- emergencies of later stages, and produce pears there is danger of heart failure from depressing and hurtful results. Venethe strain put upon the right ventricle, section and cold sponging should meet and therefore when this stage begins there with due consideration for the production is indication for the employment of some of any desired effect. form of cardiac stimulant. Perhaps digi. Wherever possible, excessive drug meditalis and strychnin meet this indication cation should be discountenanced. Any best, being administered in accordance prescription made should only be given with the character of the pulse. If digi- until the immediate effect desired is protalis be preferred, about ten drops of the duced, and not continued, as is so often fresh tincture may be given every two or done, until the contents of a three- or fourthree hours, unless the stomach be too ir- ounce bottle is used, irrespective of overritable to retain it, in which case the al- shooting the mark aimed at. kaloid administered hypodermically will It is an excellent measure to keep a teagive better results. If the respiratory kettle boiling in the room in order to retain function is deeply involved at the same the proper moisture in the atmosphere, time the heart weakness is noticed, strych- and a room heated by an open fire is always nin in 1-30 grain doses would better be better for the sick-room of a pneumonia employed, since this drug is of great value patient, if the proper degree of heat, about as a cardiac and respiratory stimulant. 70°, can be maintained.

Certain cases seem to require ammonia, Sometimes cough will prove troublesome. particularly those where the symptoms of and in such case codeia, in doses of onefailure seem very rapidly advancing, and quarter grain, in combination with amhere either the aromatic spirits or the car- monia, will have excellent effect, not only bonate may be employed. The inhalation relieving the symptom immediately under of oxygen often gives quick relief.

consideration, but also stimulating the If the face assumes a bluish or purplish function of the skin. hue, and there is markt engorgement of If there is circulatory failure with pallor, the right ventricle, venesection should be irregular respirations and intermittent resorted to at once.

pulse, the call for alcoholic stimulant is If pain is complained of, place an ice- urgent. It should be met by giving brandy bag over the location, or use the cups. or whisky, in from two to four drams every The hot fomentations may also be used, hour, according to the urgency of the and have long proved efficacious to a cer- symptoms, bearing in mind, however, that tain degree, but the treatment by cold every dram over and above what is strictly applications shows a larger percentage of necessary is productive of great harm, and recoveries, and produces more rapid effects. should be withheld, Opium may also be given.

It is imperative that the eliminating

Kidney

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channels of the system should be kept is estimated so high as 45 per cent. It is open, and that the kidneys especially be generally consequent upon an attack of kept up to the mark. If there is any capillary bronchitis and lasts about three sign of renal hyperemia, it must be promptly weeks or less. A longer duration would met or a fatal result will be imminent. suggest tuberculosis. In the same line, the bowels must be kept The moist, fresh atmosphere at a uniopen and the liver active, and particular form temperature of 70 degrees is imperaattention must be paid to the action of the tive here. The chest should be painted skin. Upon all these points much depends. with iodin and then enveloped in a pneuThe friends of the patient will always monia

jacket made of oiled silk and cotton fight for medication in the form of mix- batting. tures, and are not apt to be satisfied unless The disease generally takes thel(sthenic something of this nature is done. To form, and hence supportive measures are meet this demand, it may be well to give indicated thruout. The diet should be some harmless expectorant which will liquid, or nearly so, and food should be lessen the tendency to cough and allay given in very small quantities, not over an irritation, thus contributing to the comfort ounce and a half at a time. The prostraof the patient. A combination of ammo- tion is usually extreme, and brandy or inium carbonate and Dover's powder in whisky should be given at once. syrup of wild cherry, with the addition of The indications for keeping the bowels a small amount of codeia, is often well- open are urgent, and the kidneys should liked. If there are pleuritic stitches, a be carefully watcht, as a fatal result often fly-blister or a mustard plaster over the is caused by an interference with the seatof pain will give the promptest re

en lief.

Strychnin is'invaluable in this form of Thruout the course of the disease, the trouble, and the cold bath or pack is inpatient should be encouraged to drink valuable where there are any nervous freely of water, lemonade, or any cooling symptoms. It must be used with caution,

however, and the patient carefully watcht. During the crisis, unless absolutely nec- There should be care to prevent any harmessary to check a diarrhea which becomes ful degree of shock. too exhausting, opium should be avoided, Ammonia, senega and squills are all as it will add to the depression of the valuable agents here, but care should be already enfeebled vital forces and dimin- taken to guard against excessive medicaish the ability to rally.

tion. During the convalescing period care Often death seems imminent from the must be taken to guard against relapse, accumulation of mucus in the bronchial and every effort should be directed to sus- tubes, a condition indicated by extreme taining the patient. This does not neces- cyanosis, a weak pulse and bubbling rales. sarly mean the use of alcoholic stimulants, Here there should be the prompt adminissince at this point of the disease the neces- tration of an emetic, wine of ipecac being sity for stimulation will often be better perhaps the best agent, altho the hypomet by the use of a small cup of black cof- dermic administration of 1-12 grain of fee than by giving whisky or brandy. apomorphin will produce prompter results

where its weakening effect upon the heart How to Treat Catarrhal Pneumonia.

is not to be too much to be feared. Still The prognosis of catarrhal pneumonia the condition is one requiring great promptshould always be guarded, since the dis- itude in action, and all effort should be diease is commonly fatal in the old, the very rected to relieving the complication. young or the debilitated The death rate

drink.

Tonirs such as cod.liver oil arsenic and

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La the hypophosphites, should be used in the general discussion, the speeches being

period of convalescence, and a change of limited to five minutes. The writer of ! climate should be enjoined,

these lines was present, and he wishes to

say that this was the most noted medical Pneumonia Following Prolonged Illness.

meeting that he ever attended, and one

which he will never forget. About seventy The pneumonia which follows upon any persons were present, and the above proprolonged illness is in the nature of a hy. gram consumed about three hours, during postatic congestion of the langs dependent which there was not a single effort to be upon a weak heart and a recumbent posi- funny and not a single vulgar allusion ;

. tion.

These matters were considered in an There should be a frequent change of earnest, serious, scientific vein, just as they position in order to prevent the statis of should always be treated. They are a the blood, and such cardiac stimulants as legitimate part of science, and should be

handled just like any other scientific subdigitalis, alcohol, ammonia, strychnin and

ject. turpentine should be used. Turpentine stupes applied externally are excellent to The patent formerly held on antipyrin, set up the necessary counter-action. Sa.

which enabled the manufacturer to sell line laxative may prove useful and the ap- pired; the price now at which this prep

this preparation for $1,50 per oz., has explication of dry cups often gives tempo- aration is bought in New York from the rary relief. Convalescence should be watcht, same manufacturers, same style package, since the attack may predispose to the oc

is 27 cents an ounce. There is no way, currence of the more serious form of under the present laws, by which these catarrhal pneumonia.

synthetic products can be prevented from securing a copyright or patent, and the

only hope is to prevail on the commissionA Notable Meeting.

ers as well as Congress, to make a change SUBJECT FOR DISCUSSION :- “SEXUAL HY

in our patent laws. GIENE."

At this time in the year we always have this Chairman : Dr. John Milton Dodson.

problem before us: Thousands of subscription1. “The Awakening of the Sexual Instinct ;" expired with our December issue, and the renews Dr. Emil Riess.

als are rapidly coming in, but there are thousands 2. “The Effects of Gənital Derangements and

still to hear from. Shall we reserve a sufficient Malformations on Sexual Appetite ;'' Dr. C. S.

number of January Worlds to meet this demand Bacon.

as it comes ? or shall we send January WORLD

to all December expirations ? trusting that the 3. “The Psychical Correlation of Sexual De

renewal will be received soon thereafter. We sire, Love and Religious Emotion ;" Dr. George

have tried both plans, and as for ourselves, we F. Butler.

prefer the plan which is the most considerate to 4. “ The Sexual Act. Frauds in the Conjugal our readers—that is, the latter. This we will Embrace;" Dr. Zeisler.

do. So this issue will go to all those whose sub5. “ The Results of Sexual Excess or Contin- scriptions expired with our December issue, with

“ Sexual Misinformation and Quack the earnest request that those who have not yet Literature ;' Dr. W. T. Belfield.

sent their renewal kindly do so, if it is their wish 6. “The Effect of Coitus during Pregnancy and intention to do so, at their earliest conveni. and Lactation ;' Dr. A.C. Cotton.

ence. If it is your intention to leave us, would 7. “Sex Problem in Education ;" Rev. Paul

you mind sending us a postal card to that effect? Carus, Editor of “ The Open Court.”

This will save us the trouble of sending you

reminders from time to time, thinking that it is 8. “Legal Aspects;" A. S. Trude (lawyer). only neglect or rush of business that keeps you The above was the program of the regu

from us. Also, we always desire the most frank lar meeting of the Physicians' Club of expressions from the members of the profession

-We want to keep in the closest touch with their Chicago, held on the evening of November wishes, views and desires. We here wish to 28. A good dinner was enjoyed before again express our thanks to the many faithful the literary program was begun. When adherents whose renewals we have received in the above program was completed, a

great numbers, and which are still coming in teacher who had been specially invited,

every day. We appreciate promptness, for you

know that uncertainty is not a comfortable state was askt to speak, and then the general of mind. You like patrons that you can “count

ence."

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