PRACTICAL

MEDICINE,

VOL. XXV.

TERMS.

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TURPENTINE IN BLEEDING FROM THE UTERUS.

In "The American Year Book of Surgery" recently issued we note the following: (The hemostatic properties of the essence of turpentine have long been known, notably through Billroth in 1883, but it is now little used.) A Russian physician, L. F.

No. 10

Linevitch, has been systematically employing it for five years to combat hemorrhages from the uterus. After having opened the neck of the uterus with a dilator, he fixes it with a vulsellum forceps and passes into the cavity of the cervix a tampon soaked in a solution containing one part of carbolic acid and three parts of glycerin, and then proceeds according to need to the further opening of the neck. After this is done he introduces into the cavity of the uterus a mass of iodoform gauze, five or ten per cent. strength, sufficiently large and long to fill the cavity completely, having previously soaked it in the turpentine. The outer extremity of this gauze is in the vagina, which is carefully cleansed of all the excess of turpentine which runs out during the introduction of the gauze. A vaginal tampon of small dimensions is then inserted and the woman is told to remain in bed for five or six hours. At the end of that time when the patient should begin to feel some severe uterine colic, the gauze should be carefully withdrawn. In general the bleeding will be stopped in a definite manner, and after a few days a normal bloody and mucus secretion is seen, abundant in quantity. Occasionally it is necessary to repeat this procedure when the bleeding recurs. The author has never seen the least sign of intoxication or any other unfavorable phenomena follow this method of treatment.

The procedure in question has proved itself particularly efficacious in cases of hemorrhage due to interstitial fibromas of the uterus and to inflammatory disease if the tamponade can be carried out without much dilation of the os. He also notes the report of another Russian surgeon of a case of severe nose bleed which had resisted plugging of the fossas and the internal use of ergot, but which was absolutely controlled by the use of tampons soaked in turpentine. The well recognized antiseptic and healing power of oil of turpentine make this treatment peculiarly acceptable in many cases of hemorrhage and wounds where subsequent infection is to be feared.

IGNORANCES REGARDING THE BROMIDES,

It astonishes the careful observer to note the ignorance of the mass of the profession regarding these commonly used salts, and the carelessness with which they are prescribed. The idea seems to have taken root in the medical mind that "a bromide is a bromide," and when one wants a bromide effect, "any old bromide will do." Small wonder that they are often disappointing, and other injurious. The various bromides differ in composition, indication, dose and physiological action, just as other medicines do. Generally when one prescribes "a bromide," he writes a prescription for the potassium salt, but if asked why he selected that particular drug, he will seldom be able to tell you. If closely pressed for a reason, he will admit, if honest, that he prescribed it solely because he wanted a bromide effect and it was the first name that he happened to think of. Such carelessness is appalling, and the fact of its existing regarding the very commonest and most frequently used of medicines, makes the culpability more aggravated.

The bromide of potassium contains 67.2 per cent. by weight of bromide; the bromide of sodium contains 77.7 per cent; and the bromide of gold but 55 per cent.; yet most of the profession believe the potassium salt to be the most powerful. H. C. Wood, in his Therapeutics, says: Shtcherwak found that the bromide of gold was six times as strong as the bromide of potassium in its action upon the psycho-motor centers." Hydrobromic acid acts on the organism much as the bromide of potassium, yet it is much less apt to produce acne and muscular depression, although it has the disadvantage of being slightly more irritating to the stomach. Bromide of potassium is prone to cause diarrhea when given in large doses; bromide of sodium in similar doses is constipating. The combination of the bromide of ammonium with antipyrin, in the proportion of thirty to seven, has much greater influence in epilepsy than the bromide of potassium. The bromide of potassium will produce acne, muscular depression, and bromism much more readily than other bromides. Bromide of potassium produces toxic effects in greatest degree; bromide of sodium in the least. The bromide of lithium stands first in hypnotic power; bromide of sodium is second; and bromide of potassium is third. As respects the influence of the various bromide salts on the pulse, body heat, and respiration, Bartholow states that they stand in the following order: bromide of sodium,bromide of lithium, bromide of potassium, bromide of ammonium.

We have neither time nor space to devote to teaching therapeutics, but we do plead with the profession to read up in modern works on these important medicines, and to exercise a greater discretion and intelligence in their employment.

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Brief and practical articles, short and pithy reports of interesting cases in practice, new methods and new remedies as applicable in the treatment of diseases, are solicited from the profession for this department.

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C

CIDER VINEGAR AS A REMEDY.

BY W. H. BLAKE, M. D.

RUDE vinegar is obtained by the acetous fermentation of a solution of malt, or of stale beer, wine lees, diluted whiskey or of various fruit juices. The acid principle which these various vinegars contain results from the oxidation of the alcohol existing in the fermenting fluids named, and is known as acetic acid.

The vinegar obtained from apple juice is known as cider vinegar, and is that which for general household use, and for medicinal purposes, is, in this country, commonly preferred.

Vinegar is anti-alkaline, excitant, refrigerant, tonic, diuretic and antiseptic; which latter property depends upon the percentage of acetic acid it contains: (6.3 to 7 per cent. of acetic acid having as much power to inhibit the growth of micro-organisms as a 1-1,000 solution of corrosive sublimate) and it also depends, in part, upon its tendency to excite trophic centres and by continuously evoking their energy to maintain the life of tissues and prevent their degeneration.

Vinegar is a safe and efficient antidote for poisoning by the alkalies, and a physiological, if not a chemical, opponent of the sedative vegetable poisons, with the exception of opium; it forms with morphine a soluble acetate without destroving its properties.

Vinegar, as a medicinal agent, is the most generally useful of the vegetable acids; taken internally, in moderate quantities, as an adjunct to food, it is often salutary, especially for the fat and plethoric; but it should be sparingly used by the thin and anemic, and also by mothers having nursing children, as it often injuriously affects the

continued doses, even if diluted, vinegar causes gastric pain and irritability, colic, anorexia, eventual emaciation and cachexia.

The physical effects of vinegar are due to its action as an excitor of ganglionic centers, particularly the vaso-motor, and also to its antalkaline property which corrects any tendency to sepsis of the blood due to excessive alkalinity. It is obvious therefore why its use in the treatment of all febrile diseases is attended with such beneficial results. It diminishes heat, allays pain and abates swelling.

Vinegar, in moderate quantities, properly diluted, when taken internally, allays thirst, reestablishes the functions of the skin and kidneys, abates pain and soreness, swelling and hoarseness of the throat, tends to avert dropsy sequent upon scarlet fever, is valuable for catarrhs, for asthma, for checking hemorrhages, and, applied externally, it is efficacious for bruises, sprains and limited inflammations.

During exanthemata and other febrile affections, sponging the whole surface of the body two or three times daily with one part of vinegar and six to eight parts of water, proves soothing and refreshing; and a similar mixture, sweetened to the taste, constitutes a refreshing, refrigerant drink, especially useful if the tongue has a darkish or brownish coating.

Bathing the chest with vinegar and water, during the intervals, is said to diminish the liability to catarrhs, asthma and angina pectoris.

Particles of lime in the eye are dissolved, and relief from pain is secured by bathing the eye with dilute vinegar.

Bread made into a poultice with strong vinegar and applied for three or four successive nights, abates the soreness of corns and causes them to be easily picked off.

Pure cider vinegar, applied locally, has been recommended as a cure for barber's itch.

The fumes of hot vinegar are not only agreeable in the sick room, but they destroy some odors and cover others; they also often abate headache, drowsiness, faintness and incipient coryza; and inhaling the

fumes will often check vomiting after the inhalation of chloroform. During most laryngeal affections, hoarseness, relaxed sore throat and ulceration of the fauces, decided benefit may often be derived from the inhalation of the vapor of hot vinegar; and it is also useful when the lining membranes of the bronchial tubes are dry and irritable. Vinegar is frequently used as a gargle, and as such, in combination with salt and capsicum, it is an excellent remedy for common sore throat.

A mixture consisting of vinegar one pint, brown sugar one pound, fluoric acid four ounces, has been advised as a valuable escharotic for use in the treatment of cancer.

The application of vinegar is useful for ringworm and for the pruritus of pregnancy.

Vinegar, one pint, capsicum one teaspoonful, boiled and cooled, is used to sponge patients with to check night sweats.

Equal parts of vinegar and water are applied to powder burns, and stramonium ointment is afterward applied.

Vinegar two parts with water one part, in half teaspoonful doses, frequently repeated, has been recommended as antidotal or carbolic acid.

The par-boiled hands of women, after washing clothes, are quickly restored by washing them with vinegar.

The application of cold vinegar and water to the pubes, for uterine hemorrhage, is not only agreeable to the patient, but greatly tends to arrest the flow of blood.

Epistaxis is often amenable to the effect of a pledget of lint saturated with vinegar and placed in the nostril.

The ulcerations of hospital gangrene, of mild character, having been cleansed, may then be washed with strong vinegar and covered with charpie wet in the same liquid, often with good effect.

Warm vinegar is an excellent remedy for milk or mammary abscesses; when the breasts are painfully distended it should be constantly and perseveringly used; it should be applied with a warm hand with much stroking circularly and from the nipple outward; the breast is then covered with warm cloths wet with the vinegar. Vinegar is also useful to abate other swellings, and to prevent discolorations from bruises.

The internal use of vinegar, both by its influence upon the vascular system and by its maintaining the action of the kidneys, tends to prevent the occurrence of dropsy as a sequence of scarletina; and sponging the body with vinegar when desquamation commences, i grateful to the patient, and has a tendency to prevent the spread of the disease. Dilute acetic acid has similar influence.

The internal use of vinegar is efficacious for urinary affections with phosphatic deposits.

Frequently painting the face with vinegar, and keeping a cloth saturated with it over the face so that the patient shall continually inhale its vapor, and painting the face with a four per cent. solution to prevent smarting if the skin should crack, together with the internal use of aconite to keep the pulse at seventy, is an excellent method of treating facial erysipelas; a number of my patients so treated suffered very little distress and were entirely well in from ten to fourteen days.

Granulated sugar moistened with good cider vinegar is useful for hiccough.

A solution of salt in vinegar, in tablespoonful doses, is a common domestic remedy for diarrhea.

It is said that a wineglassful of vinegar will sober a drunken person in a very short time, I have, however, always relied upon eight to ten grains of ammonii carb. in a tumblerful of water, repeated if necessary.

Distilled vinegar comprehends the acetic acid and a portion of the water contained in common vinegar, freed from the gum, sugar, coloring matter, etc., and may be extemporaneously prepared by mixing one part of strong acetic acid with six or seven parts of distilled water, or of clean rain water; yet, although it may be but a notion, I have thought that good cider vinegar was often the best.

Notwithstanding the value of vinegar as a remedy there is one great objection to its use; many people object to anything which they regard as common, no matter how good it may be, and if the physician advises vinegar, sodium bicarb., or any other household preparation, because he knows that it is just what is needed, does not cost money which perhaps the family cannot afford to spare,

and because it can be got quickly, without going out of the house, he will be liable to be considered "an old granny doctor" and may lose the case for no other reason. Your's truly has several times been so punished for just that foolishness.

2116 Mervine St., Philadelphia.

MEDICINAL VALUE OF CHLORINATED LIME.

IT

BY J. DABNEY PALMER, M. D.

'T was Dr. Fourcroy that eminent French physician, who first called the attention. of the profession to the medicinal value. of chlorinated lime. He and certain Dutch physicians of his day had much confidence in its efficacy in the treatment of scrofula. Since then its properties have been investigated by Dr. Beddoes, who remarks that there are few of the common forms of scrofula in which he has not had successful experience with the medicine. The dose in which he employed it was from ten drops of the saturated solution for young children, to two teaspoonfuls for others, three or four times a day. It is best given in milk after meals. Under the continued use of it, hard and enlarged absorbent glands have become. soft and smaller; and the secretions of mucus, urine and perspiration increased. It exercises a specific influence over the lymphatic system. Dr. James Wood also speaks of it as a valuable remedy in scrofula and other states of debility. He used it largely in the treatment of incipient phthisis pulmonalis, in all the external forms of scrofula, in rickets, and in all cases of hectic from great discharges; and mentions that Dr. Ingham, one of the surgeons to the hospital, found it very valuable in discussing tumors and obstructions of different kinds. Strong testimony is given to its efficacy in the treatment of the chronic diarrhea of young children, associated with prominence of the belly and hectic symptoms.

Dr. Reid employed it successfully in the treatment of dysentery. In dangerous disorders of the alimentary canal occurring in children, chlorinated lime is highly recommended; it arrests diarrhea, promotes di

gestion, favors nutrition, and, in many cases, restores the little patient to perfect health. Dr. Wood found it most efficacious in the treatment of tabes mesenterica.

The medicinal value of chlorinated lime is well spoken of by M. Cazenave in chronic skin diseases, especially in lupus, eczema and impetigo. It is recommended in all eruptions attended with itching. Dr. Christison affirms that he never uses any other remedy in the treatment of itch; a solution containing between a fortieth and sixtieth part of chlorinated lime, applied five or six times a day, or continuously with wet cloths, allays, he says, the itching in the course of twenty-four hours, and generally accomplishes a cure in eight days. Dr. Derheims recommends it for the same disease, in the proportion of one ounce of chlorinated lime to one pint of rain water. In treating foul ulcers and suppurating wounds the solution should contain one dram to the pint.

Dr. Pereira states that he has found a weak solution of chlorinated lime a very successful remedy in the purulent ophthalmia of infants. It may be successfully employed in the treatment of all purulent discharges.

Dr. Grafe, of Berlin, cured gonorrhea with it when copaiba and cubebs had failed. He used an injection made by dissolving chlorinated lime, 25 grains, in water, six ounces, and adding wine of opium 1-2 dram. In conclusion I will state that a valuable disinfecting disinfecting and decolorizing dentrifrice for destroying the unpleasant odor of the breath and restoring the white color of the teeth when stained by tobacco, is made by mixing one part of chlorinated lime with twenty parts of prepared chalk and adding from 5 to 10 drops of oil of rose geranium. It effectually cleanses the mouth and whitens the teeth, while it does not injure the enamel.

But why multiply references in support of the medicinal value of chlorinated lime? These are sufficient to entitle it to a prominent place in professional confidence. "It would give me infinite pleasure," says Dr. Sanders, "if the utility of this remedy in such complaints were completely established."

Monticello, Fla.