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has precisely the same effect as uric acid, and hence has come to be a favorite domestic remedy for headache. When used habitu ally, however, as will readily appear, the effect must be to cause a storing up in the body of uric acid and urates, thus laying the foundation for chronic rheumatism and the various allied conditions which have their foundation in the so-called uric acid diathesis, or lithemia.-Editorial in Good Health.
Climatic Cure of Tuberculosis.
Much has been written about the climatic cure for tuberculosis, but few comprehend its full value.
Patients, in order that they may derive the full benefit from the climate, should be sent, if possible, while the disease is still in the early stage. Many are the cases of socalled bronchitis that have waited and hoped, growing worse daily. Then, as a last resort, the attending physician sends the patient, now a hopeless wreck, to the climate that would have given health and strength earlier in the disease. Too much stress cannot be laid upon the necessity of sending these cases while in the first stages. The writer has seen so many cases sent away from home to die in a few days or a few weeks among strangers. Some, perhaps, more fortunate, realizing their condition, return against the physician's advice and pass away at home.
If all cases were sent away from home at once it would materially lessen the physician's income. But is the true physician to consider this? He is licensed by his State and alma mater to practice medicine for the good of humanity. He is pledged virtually to do what is best for his patients,
regardless of his own consideration from a monetary view. Many more of these cases would recover than at the present time if sent to these resorts early. The physician cannot conscientiously refuse to do this.-Charlotte Medical Journal.
Pathognomonic Sign of Meningitis. M. Netter, of Paris, reports having studied carefully the sign of Kernig in 25 cases of meningitis in children and found it only absent in two patients. As is known, this sign consists in the flexion of the limbs in the sitting posture. In the majority of cases of meningitis, said Mr. Netter, when the patient is in the dorsal decubitus there exist no contractions of the extremities. The articular movements
In the sitting
remain free in every sense. position, on the contrary, the contraction is very evident; the legs are flext on the thighs, and these latter on the pelvis, and in general they cannot be straightened out beyond an angle of 135 degrees, and sometimes even to 90 degrees. At the same time the stiffness of the neck becomes much more markt in this position. Νο satisfactory explanation of this phenomenon has been given, but the sign is of considerable value in obscure cases of meningitis.--Med. Press and Circular.
Instant Relief of After-Pains.
Winterburn says: In many cases a nice warm meal is better than any medicine; still, where the pains are exhaustingly severe, I turn to amyl nitrite. This potent drug is a very efficient controller of afterpains, and, used cautiously, I see no reason to apprehend harm from it. A neat way of using it is to saturate a small piece of tissue paper with five or six drops, stuff this into a two-dram vial, and request the patient to inhale the odor when she feels the pain coming on. It acts with magical celerity.-Louisville Med. Monthly.
drop doses, almost a specific in the chronic Ord has found strophanthus, in five forms of urticaria. It is particularly indicated in the anemia of young women, especially if there is accompanying cardiac weakness with palpitation.-Med. Times.
Dr. J. C. Lightfoot, of Alvaton, Ky., reports a patient who has been "tapped forty-eight times, 480 gallons of fluid, in all, having been removed.
"Her lungs, heart and kidneys are perfectly healthy." (?)
"My patient complains only of the inconvenience accompanying the periodical tapping, which deters her from social pleas
Quite a gay and aqueous girl.-Med. and Surg. Monitor.
Experience has shown that the use of solution of mercuric bichlorid of carbolic acid for irrigation of the peritoneal cavity must now be unhesitatingly condemned, not only on account of the local necrotic effects which are produced, but also because of the more or less grave symptoms of general intoxication which have been time and again observed.-Hunter Robb.
A Point in the Treatment of Hemorrhoids. Sims (Maryland Medical Journal), ligatures the piles in the usual way, then cuts them off close to the ligature. The edges of the mucosa are then sewed together with cat-gut over the stump, so that the raw surface is entirely covered. By this means the risk of suppuration, and the suffering, are reduced to a minimum. An antiseptic dressing is applied. The bowels are moved four days later by salines and an enema. The results of operations thus carried out are most satisfactory.
The injection of a glass syringeful of lemon juice into the nose after it has been cleansed of clots, will stop bleeding after everything else has failed.-Med. Summary.
Glasgow's infection hospital is one of its finest features. It is a suburban park, with beautiful grounds and well appointed, attractive buildings, accommodating 1,000 patients. The horror of the pest-house is taken away, and this has stopt the concealment of infectious cases which formerly baffled the efforts of the sanitary department in stamping out epidemics.-Commonwealth.
The chief advantage of vaginal incision and drainage is that it lessens the seriousness of operation by abdominal section, and when the indications are such that the operation can be done thoroly, there is no question that it is much to be preferred .o the abdominal route.-E. N. Liell.
Uremic Ulcers of Intestine. According to Virchow a diphtheritic ulcer is one beginning with superficial scabbing of a mucous surface, and after casting off the scab leaving a permanent loss of tissue. Uremic ulcers, which belong also to this category, are essentially characterized by their situation, and then by their extent superficially and in depth. They are principally met with in the small intestine, whilst those connected with dysentery and mercurial poisoning mainly affect the large intestine. Uremic ulcers often penetrate deeply, and present some resemblances to typhoid ulcers before perforation. In an advanced case, preparations of which were shown, and which proved fatal from granular atrophy of both kidneys, the small intestine from the jejunum downwards was covered with ulcers of this kind, so numerous that scarcely a centimetre of sound surface was left in one place. The pathologic process begins with, first, superficial, followed by deeper necrosis, and not associated with the lymph apparatus. In appearance it resembles a superficial cauterization from some fluid caustic. When in cases of more or less sudden suppression of the renal function or of paralysis of a highly hypertrophic left ventricle which has played an important part in the excretion of urine in the case of contracted kidney, large quantities of urinary salts find their way into the bowel, ulcers are found in the bowel, superficial at first, then passing on to deeper necrosis, they may fairly be designated as uremic ulcers. Med. Press and Circular.
I believe that divulsion of the sphincter is a very wise thing to do in many conditions, and I believe it is a means of curing or abolishing or destroying many forms of hemorrhoids, especially the more superficial ones, particularly about the sphincter and muco-cutaneous border.-B. M. Ricketts.
In genuine felon, true paronychia, which does not early abort of itself, penetration to or destruction of the diseased process beneath the periosteum alone will save the affected joint or cut short the inflammatory changes.-T. H. Manley.
Nitrate of silver stains can be removed by rubbing with a cloth wet in one part each of corrosive sublimate and ammonium chloride to eight parts of water.
Aseptic Surgery in Country Houses. Dr. C. K. Ladd (Pacific Med. Journal) describes the procedure in a case of appendicitis: Water was boiled in a large boiler and cooled. The patient's abdomen was shaved and washed first in yellow soapsuds and afterward in permanganate, followed by oxalic acid. Solutions were made in porcelain wash-basins, which had been scalded before using; the towels used were baked in an oven and afterward wrung out of a strong solution of mercuric chloride in boiled water. The author and one assistant prepared their hands and arms as usual and were covered with aprons of baked sheets, tied around the neck and body by means of bandages. Instruments, ligatures, etc., had been boiled in a solution of soda and water. "It is almost impossible," says the author, "to prevent interested friends from taking the temperature of the boiled water by plunging their hands in it, and their propensity to wipe out aseptic basins with their aprons is absolutely incurable." The burning of from seven to ten lamps gives the heat of a Turkish bath; these must be placed high above the ether vapor.
The Treatment of Bronchitis.
In bronchitis, as in the case of collections of pus, the object of treatment is to facilitate the draining away of the exudation. This is, however, possible in bronchitis only to a limited extent. Cough, and especially the act of vomiting, assists to this end. The same object has been attempted by means of the elastic corset, respiratory exercises, etc. Often in the early morning the bronchitic brings up a large quantity of sputum by the help of more or less persistent coughing. At this time the patient should lie as flat as possible for a couple of hours, so as to assist the draining of the secretion into the large bronchi, and hence its expectoration. The patient becomes accustomed to the position, even though with some difficulty, and can expectorate by turning the head to one side. After a few days the foot of the bed may also be raised from eight to twelve inches. In suitable cases in from two to four weeks there is a considerable diminution in the sputum. This mode of treatment is adap
ted to cases of chronic bronchitis which have led to a cylindrical or sacculated bronchiectasis in the lower lobes of the lung. It is of no avail in cases of diffuse, and especially recent, bronchitis, with gen
eral secretion, or in cases of abscess cavities communicating laterally or incompletely with the bronchi, or of cavities with irritating contents. It may be difficult to distinguish between these conditions in practice, and this mode of treatment may help in the diagnosis. The number of suitable cases is not large, but at times the results are remarkable.-Gaillard's Med. Journal.
The Craig Colony Prize for Original Research in Epilepsy.
The president of the board of managers of Craig Colony offers a prize of a hundred dollars for the best contribution to the pathology and treatment of epilepsy, originality being the main condition. The prize is open to universal competition, but all manuscripts must be submitted in English. All papers will be passed upon by a committee to consist of three members of the New York Neurological Society, and the award will be made at the annual meeting of the board of managers of Craig Colony, October 10, 1899. Each essay must be accompanied by a sealed envelope containing the name and address of the author and bearing on the outside the motto or device which is inscribed upon the essay. The successful essay becomes the property of the Craig Colony, for publication in its Annual Medical Report. Manuscripts should be sent to Dr. Frederick Peterson, No. 4 West Fiftieth street, New York, on or before September 1, 1899.
Extraordinarily Acute Case of Graves's
E. H. Sutcliff (Lancet, records the case of a woman, thirty-three years old, whose A sister had curvmother died of cancer. ature of spine. The patient had had three severe confinements, which greatly depresst the tone of health. She had all the usual symptoms of the disease. Three thing; took no food, as rectal feeding was weeks before death she vomited everynot allowed; and could sip little water. Shortly after this persistent vomiting supervened, the pulse was 200, a very troublesome and painful cough developed, and the pharyngeal and laryngeal muscles became paralyzed, causing choking from taking water. The patient died three months after first symptoms.
WORLD one year and Dr. Waugh's book, $5. You need them both.
Charges are constantly made against medical men which are most easy to bring and equally hard to refute, so that the matter is usually fought out in court. At first sight it might often seem worth while for a medical man to submit to blackmail; legal proceedings are very long, always expensive, and in cases of this sort not particularly pleasant for the defending side. Small wonder, then, if the busy practitioner is sometimes tempted to buy silence at the price demanded. It is a temptation, however, to which he rarely yields, for he knows very well that the blackmailer is a very vampire, who returns time after time until he has drained his victim dry, so that unless he is met and fought at the outset he becomes more and more difficult to shake off. Everyone should remember this point, and medical men of all others, for their honor is their existence; and if they have not time, or think they have not time, or are too poor to battle single-handed, there is an easy way out of that difficulty-namely, by joining one of the societies organized for medical defence.-Lancet.
Our Monthly Talk
Much has been written and spoken of the achievements of the nineteenth century. Among all its predecessors, it is called the wonderful century. Perhaps the most complete and authoritative statement of the progress of the centurycertainly the most scientific statement-is contained in a book entitled "The Wonderful Century," by the great English scientist, Alfred Russell Wallace.
The work of this century has been chiefly the subjugation and utilization of the physical forces, and the production of material wealth. In this respect, however, it has surpassed the wildest dreams of Aladdin, and eclipsed the wonders of his magic lamp. But material wealth is not always the greatest good-certainly it is not the only good. Under some circumstances it may be a curse. The wild dissipation and debauchery during the latter days of Rome were made possible by the concentration of great wealth in few hands; while the Icelander is frugal, industrious and virtuous in his poverty. Great material wealth may be a blessing or a curse, according to its distribution'; yet this is seldom referred to by our writers or speakers. The tremenduous increase in our national wealth is glowingly portrayed by the grandiloquent style of oratory, but never a word about distribution. The fact that one per cent. of our population own 99 per cent. of the wealth of the United States does not seem to disturb or concern these shallow orators. Every $100 earned in this country is distributed among 300 people as follows: one man gets $70, the remaining $30 being divided among the remaining 299 persons-a fraction over ten cents
each if equally divided. This startling fact seems to be entirely lost sight of by the editorial writers on our great dailies.
The extension of popular education has been
one of the most distinguished achievements of the nineteenth century, particularly in this country. Regarding this I wish to say a few words. The three r's, reading, "riting" and "rithmetic," were formerly considered the essentials of an education, and they were considered quite sufficient for the average man. But we now very plainly see that what were considered essentials are not an education, but the means by which an education may be acquired. One who can read but does not read is scarcely better off than one who
cannot read. Our educators have been very enterprising and progressive (as they have thought), and have led their pupils-children of the masses,
in our public schools-into fields of study heretofore entered only by specialists. Geology, botany, zoology, psychology, mythology, etc., are a few of the many burdens prematurely loaded on our innocent and misguided youth, while the actual world of industry going on around us constantly is untouched. The study of nature is always interesting and ennobling, and I would not decry it in the least; but the question of relative importance is what I wish to call attention to. To make my meaning clear, suppose we take two classes here in Philadelphia, beginning on this beautiful day in January. We will designate them as A and B.
Class A begins the study of geology (one of the most interesting and delightful of the sciences), and receives didactic instruction until the early spring days will permit expeditions over the hills and thru ravines, hammer in hand. Every stratum that crops out on a hillside is examined and placed in its proper place in the wonderful scheme of earth building which has been going on for so many ages.
Class B begins on the same day, to study what man has put beneath the surface of the earth in and about Philadelphia, instead of what nature put there ages ago. First, the drainage system is taught didactically, and the importance of proper and successful drainage on the health and wellbeing of the community. Then they are taken to wherever any part of the sewer system can be seen, and also where new sewers are in process of construction, and all is explained to them. Then the water system is taken up for study. The reservoirs, the engines and pumps, the distributing system to the traps and waste pipes, all are studied from books and diagrams, then by visits to and actual examination of the various parts as far as possible. Then the gas works and distributing system are taken up, tracing the process from the retort to the holder, then to the burning jet in the average home. Next the electric systems for both lighting and power are taken up in the same way, and thoroly studied and understood. What could be more interesting than a course like this?
Now, to which class would you rather have your son belong, A or B? Which class would produce the best men and best citizens? Civic life is necessarily more complicated in large cities than in small towns and in rural districts. But if the conveniences of large cities were more properly studied and understood, ways could easily be found to apply many of them econom
ically to even the smallest places. Classes in small places where there are none of the abovementioned local public services to study could take up the telegraph system of the country, the postal system, the transportation system, etc., and study these things with great edification and profit.
Every boy will be a citizen (and in some states the girls, also), but every boy will not be a scientist nor a professor of dead languages or the higher mathematics. Then is it not rational to educate every boy for citizenship rather than to give him a smattering of many things that he will never use?
In the days when even the most advanced nations were ruled by "the divine right of kings," the object of the one or at most a few master minds who really governed was to keep the nobility amused and the masses enslaved. In this country "education" has run riot among impracticable things, and left citizenship, our most precious jewel, our "possession beyond compare," our greatest duty and responsibility, to take care of itself. When the light is thrown on it, this dissipation and diversion of the time, energies and opportunities of our youth is seen to be no less than a national crime.
The above is an arraignment not only of our educators, but of ourselves as well. Our educators do what we want them to do, and we are responsible for the above-mentioned state of things. When will we know better, and insist upon our youth being educated for citizenship?
A rejoinder might be made by instancing our numerous and rapidly multiplying manual training schools. Yes, this is good, practical work, but there is no citizenship in it. That prepares them only for private pursuits. In this country of government "of, by and for the people," there are large and ever-growing duties which the average citizen never makes any preparation for; ever growing because government is no longer limited to police duties, but it serves the people in an ever-increasing number of ways. For example, the telegraph must soon become a public service in this country as it is in all other civilized countries,except Honduras and Bolivia. So with many other public utilities that we are now allowing to be conducted by private parties for private profit.
It seems that there is a "forbidden nook" in our scheme of education as now pursued-or is it indifferer ce on the part of all-pupils, teachers and people? It is the matter of costs and profits. The cost of carrying a street car passenger in any of our large cities is a little less than two cents; yet the people go along paying five-cent fares as tho it was right. To make matters look right, the street car companies water their stock in proportion, and there is no protest from the indifferent and thoughtless public! The same is true regarding the cost of telegraph service, telephone service, railroad service, etc. If our youth were educated in these things, citizenship would mean much more than it now does, and our country would be vastly improved as a consequence.
Talk to the teachers of your children about this matter. Demand better education in citizenship for our youth from our educators. Write upon the question for your local papers. As a
"starter," ask your local editor to reprint this "Talk" in his paper and make comments on it.
[The following parody on the grandiloquent style of reporting cases may provoke a smile. The author's name will be made known upon request.]
Report of Some Recent Cases.
By Dr. Hornblower, A. M, P. M., Dislocated Member of the Ancient but Honorable Body of Dilatory Survivors. Twice Read Before the Aucient Society of Dilatory Survivors. Again Read and Digested by the Profound Order of Doctoris Billi No Collectus.
It has been ascertained by a diagnosis of pendulum precisum, that if it were so, as it should be, then in that event it is such as it should be. If it were so and no argument can be of a permanent consideration, based upon observation, it is of such a nature as to preclude any effort when and how. It is a well-known fact that in its embodiment of perfection, that if it were to be as it is, then in that event, it could not be other than a Prolongus Laceratus. Having this in view, and counting the Diagnosis of the Iron Cells, it remains undisputed that 60 days pronounced by a judge will produce a greater increase of Hobgoblins, which are and will be if they were. Taking all this into consideration, I at once began my experiments, having at my command the intricate machinery BicycliridumTaka Headus, with results which were found to be far beyond my grasp, but in the mind of the practitioner, will stand such tests.
I herewith submit a few cases:
CASE I. Pat Ching; father, Irish; mother, Chinese. Found him to be somewhat mixed. 'Alf and 'alf. His pulse obscurus. I spoke of his whiskers. He replied not more than 28 per day. Questioned him closely, found he thought I said "whisky." Made close examination and by the action of his palate, I at once diagnosed the case as one of Eat-Em-All-You-Canibus. I placed him on a diet of wash-he-wash. He returned in six months. Could speak Chinese well. Remarkable cure. I asked him for $3.00. He replied, Me no Chink."
CASE II. Miss A Lamb; young lady, aged 59, pulse torpid. Breath irregular and congealed. Complexion furred. At once diagnosed the trouble as being Lambodi. Placed her on a diet exclusively of sheep dip, one quart daily. After three days this was changed, owing to griping sensation in the region of the Stomachichitis. She could talk better, louder and longer than formerly. Lungi Shoutis. Gave her Lamb's works to read, lambs' tongue to eat, and lambs' wool to drink. At the end of 84 days she returned. asked me how much she owed me. I replied $6.50. All she uttered was bah, bah, bah! Entirely cured.
CASE III. Child six days old, female; pulse high. temperature low, actions indifferent. Could not speak; could not walk. Mother said she was born that way. Advised the parent to teach her to walk, and saw no reason why later on she should not talk Muchum Moribus. Advised diet of cabbage, beans and celery, as by this method I desired to introduce iron, new, clean yeast and