Notes and Queries.

For this department we cordially invite questions, comments and criticisms on all topics of interest to the physician in his daily work for the relief of the sick, thus making the SUMMARY a valuable medium for intercommunication between the medical profession.

Correspondents will give their names and addresses, but initials only will be printed when desired.

The QUERIES in this issue await the ANSWERS which our intelligent readers may be pleased to contribute for publication in our next.

Please Notice.

So far as possible, it is our wish and desire that the "Notes and Queries" department in the SUMMARY become a free bureau of medical consultation. Every practitioner meets with cases now and then, where suggestions as to diagnosis and treatment would be very acceptable, indeed. We are willing to furnish you with the suggestions-replies to any queries that you will send us, relating to such matters, and only ask that you describe your case briefly and to the point. If we should not feel competent to give you an intelligent reply, we will refer the question to some one who is competent to give a faithful answer. In making replies we have no axe to grind; we simply give you the facts-the unvarnished truths, as we understand them. We would also make a special request that our readers lend a helping hand in these matters. Look over the articles carefully, and if, in your opinion, you could make a suggestion of value or of interest, you would do us a special favor by submitting the matter for publication in the SUMMARY.

Salivation.

Editor Medical Summary:

In six years' practice in the sickly part of Texas, I never saw a case of fever (malarial or typhoid) continue longer than from two to four days after they were salivated. I came to Colorado September 20, 1902, and did well till December 27, 1902, when I took fever. Two physicians called it typhoid, and, of course, I expected twenty or thirty days' siege. In spite of their advice, I took calomel every two or three nights. The twelfth day, following a dose of calomel, I was sal

ivated, which pleased me very much, and so stated to the nurse. The fifteenth day I was clear of fever. I prefer to treat a case of salivation to one of long continued fever, especially in my own case, as I can soon stop the salivation. How does it act, and what is the experience of others?

I will give you my remedy for preventing salivation, where a patient has been salivated a number of times: B. Potassium Chlorate.. Sodium bicarb. Aqua.....

.....

.....

3 ij 3 ij

q. s. ad. 3 vilj

M. Sig. Begin when you start calomel, in tablespoonful doses, two hours apart, or a sufficient quantity to last twelve hours after last dose of calomel is taken.

When the patient claims to be sallivated in an hour after taking first dose of calomel, always begin solution two to four hours before you start calomel. It is almost impossible for the patient to be salivated when he takes it as above, if he avoids exposure to damp air. People who live in malarial districts have to take calomel. I was bothered very much till I began the use of the above, as many patients are so easily salivated. What is the opinion of the SUMMARY readers ?

Howard, Colo.

D. D. HAMILTON, M. D.

Notes and Comments.

Editor Medical Summary :

Tobacco and its use by minors is treated in an editorial in December, 1902, SUMMARY. The father of an eighteen or twenty-year-old boy cannot but be impressed with the article. I have one, and have seen in him the effect of the nicotine. He has stopped its use now for some months, and is improving. I have been preaching against the use of tobacco by men, boys and women for thirty years or more; so much so, that some of the wits sometimes call me "Dr. No-tobac." It is high time the general action of the medical fraternity was commenced, and kept up, when it is stated that within the last ten or twelve years since the cigarette came into use, the number of insane men under twenty-five years of age, in the asylums of the middle and Eastern States, has more than doubled, and the increase is traced to cigarette smoking.

Bro. Smith's article (page 291) puts me in mind of the advice I gave a lady who wrote me about her husband's condition. They resided in New York city. I told her to have her husband take a nap after dinner, cut and carry in his wood and coal, and to walk from his office to his home rather than use the cars. This was over a year ago. A few days ago I received a letter saying that he had recovered his health under my prescription, without any medicine. We are too rapid, We are too rapid, I fear, and the tendency is not toward improvement.

Bro. Canan's article "The House Fly as a Conveyer of Disease," is true to a letter. I have been noticing it even in these back woods, and find that where the houses and yards are kept clean, diseases are scarce, while where the reverse is the case, typhoid fever has had full sway.

Talking about consumption. How many of the SUMMARY readers have read Dr. Ball's treatment? It will be found in his "Multum in Parvo." He cured himself, and has stayed cured for fifty years. The process is simple, and worth hundreds of dollars to any physician having those cases on hand. I had two cases in the early stages treated according to his process, and they improved in every way.

Page 301, "Index Rerum." Go a step further. A few years ago, Dr. D. G. Simmons sent me a visiting list, and I commenced to enter upon it modes of treatment of almost everything, putting name of trouble at top of page, and in index on back. I filled it up, after adding leaves to the inside, and carried it with me as a reminder when I was puzzled about a case or wanted to change treatment. There are about 350 pages and subjects, and three to ten treatments to each. The size being suitable, it can easily be carried in the pocket. I am now filling one more, the visiting list having been sent me two years ago, by the Van Vleet Mansfield Drug Co., Memphis, Tenn.

Bro. Armand is right in every particular, as any one can see who will study his own clientele carefully. It is not an infrequent subject for study, even in these healthy backwoods, and must be more frequent in cities and towns. Don't take everybody's word, as their experiences may be dif

ferent. Study your own cases, separately and together.

Bro. Vail (page 312) wants to know how large a surface denuded of skin by a scald pure carbolic acid can be used on with safety. The largest surface on which I have used it was on a four-year-old child, who turned a pot of hot coffee on its chest, taking off the skin about eight by ten inches. A doctor wrote me some time since that he used it full strength on the body of a railroad engineer whose skin was peeled off from the chin to the pubes, the entire front of his body being denuded. It effected instant relief from pain, and no unpleasant sequela followed. A surface of eighteen by twenty-eight inches, I suppose. It is well known that these very large burns are nearly always followed by death, and I would use it on any size burn, in hopes of aiding recovery, at least, by relieving pain.

Bro. Vail's remarks (page 313) set me laughing. Yes, I have used the bent handle of a pancake turner for a Sim's speculum in one case, and a bent kitchen iron spoon in another case. A pair of old bullet moulds answered as a needle holder with which to sew up a torn perineum. I happened to have a bent needle in the pocket of my alkaloidal case. I was ten miles from home, and was called in while on my return. A "backwoods one-horse cannot carry everything with him on one horse. I have several times used a piece of cypress picket for splints, and common white or black thread as ligatures. We cannot always have everything we want. Recently I have been trying an old remedy for dandruff. I used a fluid soap

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or soap suds on the hair, like a shampoo, and then poured on a teaspoonful of coal oil, and rubbed the whole well into the scalp, and then washed out with warm water. It seems to work very nicely, and to date I have not seen any unpleasant effects on the hair or scalp. It makes the head feel very pleasant. Repeat every second or third day. Three or four applications are generally sufficient to cure. Try it. The soap is made by disolving bar soap in a little hot water. Then add coal oil until the soap is used up.

Brodnax, La.

BEN H. BRODNAX, M. D.

Notes from Practice.

Editor Medical Summary:

I have been using creosotal in my pneumonia cases for some time, and find it to have splendid effect. I have not depended on it altogether, however, but think it indispensable in pneumonia. I have noticed no bad effects either on the stomach or kidneys. I also find tinct. veratum viride (Norwood) almost indispensable in some cases.

I have recently had a personal experience with sciatica, of the vilest kind, and, by the way, if any of you do not know how it feels, from experience, you had better take it for granted, and never experience it, for it is awful. On account of my weak stomach, I could not retain the salicylates, so I thought it a good opportunity to experiment with aspirin, as I had never used it. I found it to control pain nicely, and with no bad effects on the stomach. I had used it for quite a while, almost relieving my rheumatism, before I noticed any › nausea, and that being after a full dose.

It is worth trying in rheumatism. I have >since used it in several cases with good results.

To relieve hysterical convulsions in young women, caused by menstrual disorders, or from any cause, I find hyoscine hydrobromate, i-100 grain, by hypodermic Injection, the best remedy I ever used. It will usually quiet the patient in less than five minutes.

I have used Acetozone exclusively as a Edisinfectant in seven cases of typhoid fever lately, with excellent results. In some cases the temperature was 104°, and would subside in a few days, and never run higher than 102° to 105°, and in most cases lower. In cases with considerable tympanitis, the distention would soon subside, not to return. Neither case lasted over twenty-one days, and some were * clear of fever in seventeen days, while some of the physicians in town had patients - with fever, which lasted from sixty to ninety days. I find that frequent doses of 'castor oil has a splendid effect. I think castor oil is neglected entirely too much Tin typhoid fever.

For gonorrhea, I find nothing better for internal use than the capsules of meth

ylene blue, with copaiba and cubebs. For injection, a two per cent. aqueous solution of Protargol is as good as the best.

For dressing most wounds, and especially fresh incised wounds, I have good results by using Campho-Phenique. As a dry dressing I think it has no equal.

For asthma, I find that Anti-Asthmatic Elixir, (Hare), put up by Parke, Davis & Co., will relieve most recent cases of asthma. S. S. TURNER, M. D.

Ellisville, Miss.

Obstetric Practice.-Reply.

Editor Medical Summary:

Dr. C. W. Canan's article in the February issue of the SUMMARY was read by me (and, perhaps, by several thousand others) with considerable interest, and proved amusing to me, a good deal. The Doctor evidently has an axe to grind for not getting all the obstetric work that should come, by rights, to him.

It is not my purpose here to set up a defence in favor of the often inevitable “granny,” but, rather, to look upon conditions as they really are, and help the Doctor to make a guess as to where the blame mostly ought to rest, whenever, or wherever, the "granny" is preferred to minister in place of a physician. The truth about the matter presents itself to me as follows:

First, the majority of confinements will pass off O. K. without meddling, while, often, the biggest effort put forth by the medical attendant present consists in collecting his fee, while some kind neighborwoman has to do all the work to be done, anyway.

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Second, unless the Virginia "granny' has a monopoly on filth, I could point out many a country doctor, (and a few city doctors, too), whose hands, clothing and obstetric traps are not in the least preferable to the average "granny": in the matter of cleanliness.

Third, cases of puerperal sepsis occur in the hands of some of the best and most up-to-date men in our profession. Witness, for instance, the death of Senator Clark's daughter from such a a cause, recently. recently. That case, or the issue thereof

surely could not be laid to a filthy "granny." Thousands of women are confined annually, in huts and hovels defying description in the matter of hyglene, and get well (on the average) about as quickly as their more fortunate sisters, who are taken care of in the most approved manner.

To sum up, please don't understand me to say that the skillful obstetrician does not deserve preferment over an ignorant widwife in such cases, in spite of facts quoted before, but let me advise Dr. Canan in a few words as to the best course to pursue to seal the fate of the "granny" at least in his own immediate neighborhood.

Doctor, study obstetrics in all its phase, thereby making yourself capable of rendering the best assistance to your patient that any human being can give. Be sympathetic to a degree, be clean, be genteel in short, serve your patient in a manner that will ever afterwards make her say: "Dr. Canan is the man to send for in such cases." Women are grateful, and do not forget good service rendered as easily as some manfolks do. A pleased and grateful woman will work for you "tooth and nail,” and will advertise you better than any newspaper ever can, and will do it free of charge. She will do the latter to your disadvantage in case you incur her displeasure, also "free of charge."

We, here in Nebraska, tried to legislate incompetent midwives out of business, several years ago, but "got left beautifully." It is simply useless to spend one dollar, in order to have laws created for the protection of our profession and our patrons. Our legislators are too apt to see "a nigger in the woodpile." If our work, or its results, cannot command recognition, nothing else will

Osmond, Nebraska.

JNO. MAYER, M. D.

The Treatment of Chronic Leg Ulcer.

Editor Medical Summary:

Prof. John B. Roberts, in his most excellent work on surgery, says: "Chronic ulcers of the front of the leg are common, and are due to poor circulation, chronic inflammatory processes, and general

This is a general statement which is true of chronic leg ulcers, but I believe it is also well to bear in mind other facts regarding the nature of ulcers. Ulcers in general may be said to be healthy, unhealthy, aseptic and septic. A healthy ulcer is well illustrated by the reparative process resultant upon simple excision of normal tissue. An unhealthy ulcer is one which does not heal, as the above variety, and this is due to local or constitutional factors in the case under consideration.

Leg ulcers have no essential difference from those situated in other regions, other than in the fact that their progress toward recovery is much slower, owing to the indifference of circulation. To this fact is due the long continuance of leg ulcers. It is indeed very common to see patients who have had ulcers on the front of the leg for twenty years, or longer. In examining old soldiers for pensions it will be found that many of the veterans have ulcers that have persisted since the war time. This fact, however, is artributable to the fact that the veterans falled to take treatment. In many old soldiers, too, we find varicose ulcers, as a varicose condition of the veins of the leg is very common in persons who have been exposed for protracted periods to cold or damp weather.

The treatment of leg ulcers demands that whatever constitutional vice that may be present in the case be remedied, and that correct local treatment be instituted, Our success will depend upon our ability to successfully carry out these indications.

In any case of ulcer, then, our first duty is to examine the patient with a view of determining what constitutional disease factors are at work. These are to be treated on a rationol basis. If the patient is syphilitic, iodide of potassium or mercury has to be exhibited, and this is to be continued until the disease is brought under control. If there is a general debilitated condition of the system, we shall have to administer cod-liver oil, iron, syr. glycero-phosphates, and other agents which give rational promise of relief. In

a like manner other constitutional vices are to be met, and it would be manifestly Impossible for me to outline these here.

The local treatment of ulcers is highly important, and in many instances is all that is required to effect a cure. The ulcer should be thoroughly cleansed with a medicinal peroxide of hydrogen, and after this is done it should be covered over entirely with Iodomuth. If there is much depth to the ulcer, this should be filled with this agent. Over this is laid a piece of clean linen, and a bandage is brought from the toe to the knee. This treatment is to be applied every twelve or twenty-four hours, according to the severity of the condition. If the ulcer is in a very active state, then it is well and advisable to have the patient stay indoors, and the treatment should be applied every six hours. In some cases we find this course very necessary. In ulcers of a phagedenic character, this course is, in fact, absolutely necessary.

I have mentioned Iodomuth as my favorite application, since that surpasses any remedy I have ever employed as a healing agent. Not only in leg ulcers, but all forms of indolent sores, or venereal sores, it has served me in the most acceptable and superior manner. It does not

complete recovery under this treatment in eighteen days, and has had no recurrence of his trouble in a year.

Mr. A. S., age 65. This patient had an ulcer of long standing, and he was also greatly debilitated. He was put on constructive remedies, and his ulcer treated with the local applications already referred to, and a bandage was, of course, applied. In this connection I may say that in all instances I endeavor to apply a bandage to the tightness of a glove. This patient recovered in a reasonable time.

Mr. S. I. L., age 42, had a chronic ulcer on his leg. He was somewhat anemic and received proper treatment for this. The ulcer was cleansed with peroxide of hydrogen, and Iodomuth was used freely. Over this a bandage was applied. This patient made a prompt recovery.

Central City, Ky.

I. BENNETT, M. D.

qualities in themselves highly commendable. I also use Iodomuth as an internal antiseptic, with superior results.

Mr. H. M., age 31. This man, a railway fireman, sustained an injury in an accident and among other injuries was considerable denuding of the skin in the front of his leg. He got along well in every way, excepting that his leg would not heal. He gave this no special notice and went back to work. He would keep a rag tied around the ulcer, and this was all he did for it. After six months he found the ulcer well marked, growing and giving him a great deal of trouble. He then applied to me for treatment. I found no constitutional dyscrasia, and cleansed the ulcer with pure peroxide of hydrogen, and applied the Iodomuth freely. The dressing was changed for the first week every eight hours. After this, improvement was so marked that it was used only every twenty-four hours. This patient made a

and the exhaustion produced by labor, deter husbands and wives from having children. Every child born is an expense, a great care, and a responsibility, and a man and woman bringing children into the world are selfish, careless and imprudent, unless ways and means are sufficient for the proper education of such child or children. It is all well enough to have a large family if one can educate them. It is better to have fewer and more robust children (one or two) who are strong, intelligent and healthy. After the firstborn, every child is an element of exhaustion for the mother. It takes away her vitality and saps her nervous force; it is a drain upon her physical capital.

Why, then, have large families and make a breeding machine out of a complaisant wife? If a man loves his wife, he will not expect her to sacrifice her nervous and physical forces in order to please a theorist who has always been