What is Wrong with the Masses of the People?

Editor MEDICAL WORLD:-While editors of professional journals, as a rule, find it the better way not to dabble in local or general partisan politics, where the two leading parties are only distinguished by the fact that one is in while the other is out, and THE WORLD has not departed from this general rule, it affords me much gratification to read your article headed "Our profession and the people," page 391, WORLD for November, 1894. I also note with pleasure the literature referred to in your review columns. Physicians are vitally interested in all social and political questions, and I opine there are few of ten or more years practice in the United States who do not find a growing inability on the part of the masses to pay their doctor's bills. There is much food for reflection and action in this condition, and physicians ought to be superior to ordinary partisanship in endeavoring to analyze the causes of the constantly increasing poverty of the masses. To those who can do so, let me suggest most earnestly that they read one book, which, to my mind, is the profoundest treatise on political economy in existence, viz: Progress and Poverty.

The author points out that palliative and partial reforms can never bring prosperity to the masses when fundamental and basic wrongs are permitted to exist.

Oxford, Kan. EDWARD SMITH, M.D., [In addition to what Dr. Smith has wisely

For the past quarter of a century we have seen millionaires increased to thousands, and for every millionaire thousands of tramp3 are created.

For each of these classes the average physician is made to suffer.

The first can pay a professional fee, that to one doctor may be magnificent; but for every fee assured from the millionaire many honest fellowmen are so impoverished, by the making of the millionaire, that nothing but tramps will designate their status. The physician is cheated out of fees from all these, that before paid fairly adequate fees for the necessary professional services.

Is'nt this of interest to our profession? Should it not cause physicians everywhere to give thought to the subject sufficient to bring about an effective remedy for the abuses that are stealing millions and millions out of the pockets of the people, and, through them, of the medical profession?

Should the physicians of the Union unite in a grand effort to overcome the causes of the multiplication of our millionaires and tramps, nothing could prevail against such an organized effort to secure justice to our people, among whom we live and work, upon whose prosperity we depend, and of whom we are a part. Mil lionaires, as well as tramps, would be things of the past, only known to history, and our country be made once more prosperous.

Should it be possible to so unite our profession as to cause this subject to be thoroughly studied in all its phases, with nothing of par tisan feelings in the case, but to endeavor o solve the national problem of abolishing the evils that have so long cursed the whole country, much good could be done.

Bourbon, Ind. A. C. MATCHETTE, M.D.
[See diagrams on next page.-ED.],

"Possessions of the Poor 3 Per Cent.

MIDDLE CLASS

WEALTH

26 Per Cent.

WEALTH OF THE RICH 71 Per Cent.

The above diagrams, suggested by similar diagrams in Vox Populi, of St. Louis, show the distribution of population and wealth in this country. Doctor, to which class in the first diagram do you belong? Or, a more proper question is, to which class do your patrons belong? Now, look at the largest division in the second diagram. Do you think the nine per cent. of population in the first diagram produced the seventy-one per cent. of the wealth represented in the second diagram? If not, why do they possess it? Now, look at the fifty-two per cent. of population in the first diagram and compare it with the little insignificant three per cent. in the second diagram, which represents their possessions.

Do you think that this fifty-two per cent. of population has been to this extent lazy and profligate? If not, why does such a difference exist? Manifestly, by laws which cause or

permit a very unjust distribution of products. We know that the fifty-two per cent. of popula tion classed as "poor in the first diagram are wealth producers, and that the nine per cent. classed as "rich" are wealth "getters." If we had laws so just as to give to the producer the entire measure of his products, there would and could be no wealth "getters" except producers.

These diagrams show at a glance that there is something wrong in our laws concerning the distribution of wealth. It is not strange that human laws should be more or less imperfect, but it is strange that this fact of the imperfection of human laws is not constantly before us, and that we are not continuously watching and striving to correct defects. It is true that our laws have produced much better results than no law at all. Yet, if we do not improve these laws, it will be only a few years until the startling condition shown in the above diagrams will

increase to such an extent that a very small per cent. of the population will owa practically all the wealth of the nation. This very condition led to the downfall of ancient Egypt,

Persia and Rome.

Equal justice to all with special privileges to none" covers about the whole ground; for "special privileges." in some form or other, account for most of the injustice portrayed above.

We imagine some of our readers looking up astonished and asking, "What has all this to do with the medical profession?” Need we point out the fact that if the population and wealth of the rich were measured only by superior merits and industry, and the popu lation and possessions of the poor were measured only by laziness, improvidence and dissipation, the space occupied by the "middle" class in both of the above diagrams would so expand as to occupy almost all the space in each diagram? Then we would hear very little complaint of bad debts, poor collections and pauper practice. Yet the work of the profession would remain practically the same; for all the people, rich, middle class and poor, demand the services of the physician. So, while the physician's work would remain the same, his patrons not only would be able to pay him, but also be able to command good hygienic conditions and carry out all the directions of the physician, resulting in much more gratifying success in every physician's practice, both from a financial and medical point of view. Now, look once more at the above diagrams and imagine what they should be. The above portrayed condition suggests a suspicion that our so called statesmen have been quacks. If a medical man would do as bungling work, and show results as bad, he would certainly be considered a quack. A large per cent of the population of the most productive country in the world is reduced to want! Physicians must study social questions.

Replies.

Editor MEDICAL WORLD:-Dr. Smith (page 30) asks about a case of epilepsy. When the stupor shows that the convulsions are coming he should have a brisk cathartic, followed by bromide of potassium, one scruple four to six times daily, continued as long as there are any signs of the fits. The trouble with most physicians in treating epilepsy is that they do not give enough of the bromide. I have given an ounce in 24 hours with good effect. The opening cathartic is also very important. Overeating is a common exciting cause of epilepsy.

Dr. Finley asks as to symptoms of splenic diseases. Pain and tenderness, with swelling or chronic enlargement, are the principal symp

toms of the few splenic diseases known. Infarctions occur, the vessels being plugged by emboli, when we have pain and tenderness de veloping suddenly. Treatment: rest in bed, saline laxatives, aconitine or veratrine. The only treatment of splenic abscess is excision. For the chronic enlargement of malaria, known as ague-cake, the best treatment is the inunction of the red iodide of mercury ointment, and exposure before a hot fire. Hypodermic injections of ergotine or strychnine, quinine internally, and the use of cold douches are also efficacious.

For sweating feet: wash daily with cold. water, scrape the soles with a case knife or paper cutter every day; wear ventilated or cloth top shoes, and change the stockings frequently.

Dr. Gregory might find relief from the benzoate of lithia if he gives up tobacco. The nitrate of strychnine hypodermically is a useful remedy, and perhaps best suited to such cases as described. Santonine has also proved effectual in some cases, but it is not as yet settled as to which are influenced most favorably by it. The diet should be regulated with a good allowance of vegetables and not much

meat.

Dr. J. E. S. does not furnish the elements for a diagnosis. The history of his case (page 31) points to syphilis, but not necessarily.

Dr. Coon wants a hair dye without lead or silver. Apply to Schering's agents. Some years ago they announced such a dye.

Dr. Patton should try his child with lime; and if it takes it as greedily as it does clay, give the lacto phosphate until the appetite is satisfied.

To Dr. Bronson's case I would give iodoforminternally for a long time, carefully avoiding study, exercise, and all that could possibly aggravate the symptoms. Apply sold stick of nitrate of silver to the spine.

The splints Dr. M. asks about are of felt, dipped into a solution of glue. This is softened by hot water and hardened by cold.

Cannot Dr. Mollyneaux retain his umbilical herina pad in position by adhesive plaster? If not, make a buckskin jacket with the pad attached. W. F. WAUGH, M.D.,

Quiz Department.

Questions are solicited for this Column. Communications not accompanied by the proper name and address of the writer (not necessarily for publication), will not be noticed.

The great number of requests for private answers, for the information and benefit of the writer, makes it necess ary for us to charge a fee for the time required. This fee will be from one to five dollars, according to the amount of research and writing required.

Hematuria.

Editor MEDICAL WORLD:-I see very little on the subject of hematuria, but I have lately had two cases occurring on the same day, October 19th. Believing them to be due to malarial influence, I gave both quinine with opiates at first, and kept the bowels active. The first case, woman of 60, did well. The hemorrhage ceased immediately and has not returned. But the other, also a female, of 38, has baffled my efforts, so far, to entirely arrest the hematuria. Her health improved in other respects; also the urine, which was very turbid and deposited a copious sediment, has become clear excepting for the blood, which undoubtedly comes from the kidneys, as it presents the tube casts. After the first treatment failed I have pushed successively hyoscyamine and dig. italine, iron by hydrogen, arsenious acid and strychnine; quinine, 4 grs., and ergotine, 1 gr,, and at present she is taking a mixture of ergot, digitalis and ferri perchlor. She says she feels so well that she thinks there is nothing the matter and has a notion to quit doctoring, but she says she doesn't like the looks of things. I have been thinking strongly of putting her upon the gallic acid treatment recommended about ten years ago by Dr. Lionel S. Beale, but if any of the WORLD contributors have any suggestions, I will thank them for the same.

JAMES W. OSBORNE, M. D.,

Bealton, Ont., Canada.

condition the next day. Next I heard of the case a week later. I learned the medicine I prescribed was administered once, when the baby passed two ascares lumbricoides and became restless.

Another physician was called in who diagnosed "intussvsception of the bowels," left some medication and prognosticated death within 24 hours. As the baby still lived three days after the specified time, I was called upon again. I found pupils extremely dilated, stupor, arms fairly bent into axillæ, lower extremities constantly in motion, no vomiting for some days, no movement of the bowels for five days, transitory urticaria upon the face, pulse small, jerky. I washed the bowel and removed hardened green feces and one large lumbricoid worm. The restlessness of the feet ceased. ordered some stimulants and left. I called again in the evening of the same day and found facial aspect unchanged, increased stupor and renewed restless of the feet. I washed the bowel again withohut bringing away anything. The baby died that night in great agony.

I

In mentioning the case to an experienced physician, he suggested a possible diagnosis of "acute hydrocephalus."

The dilated pupils and transitory urticaria may and may not have been due to the other physician's medication.

What is the diagnosis and treatment?

Dr. W. Finley's case of bromidrosis, mentioned in January number 1895, may be benefitted by the internal administration of tincture of belladonna thrice daily, and a local application of boracic acid on absorbent cotton. els must be regulated. A. M. OSNESS, M.D. 504 S. Brown St., Dayton, Ohio.

Correction.

Bow

mit an interesting case for diagnosis.

I was called in to see a baby of 15 months in its third week of illness. History, that of occasional cough with vomiting, anorexia, continuous somnolence, constipation. Baby passed a worm two weeks previous. Mother stated to have lost two children with the same symptoms.

On examination of thorax and abdomen, I could find nothing abnormal, no elevation of temperature, head somewhat enlarged, countenance calm; the little hands were placed above the eyes as if shading them, though they were closed.

As I could come to no conclusive diagnosis, I prescribed santonin with calomel and intructed the parents to apprise me of the baby's

should read "serious."

Dundee, N. Y. J. M. OVENSHIRE, D. D. 8.

Dr. J. A. Meunich, of Madison, Wis., wishes a formula for making the hair curly and glossy.

Dr. S. J. Smith, of Filley, Neb., wishes to know which is best for general practice, a faradic or a galvanic battery. He also wishes the best formula, derived from long actual experience, for dropsy accompanying heart valvular insufficiency.

Dr. J. S, Hadley, of Arlington, Neb., wishes formula for Fenner's Kidney and Back-ache Cure.

Editor MEDICAL WORLD:-In the December number of 1894, on page 450, I presented a case for diagnosis and treatment. I note that the January number has not answered. Probably not clear enough symptoms given. However, patient has been depending on and waiting for some answer.

He now has some dizziness and dark spots before the eyes occasionally, and the confusion of ideas is very much worse. Arm and hand better. Symptoms seem to point to multiple sclerosis, but still many symptoms absent for that disease. B. A. BOBB, M. D.,

Mitchell, So. Dak.

Editor MEDICAL WORLD:-At about seven years of age a patient of mine showed a fissured tongue, and at times the fissures were deep and painful. She menstruated at 15. Has been irregular ever since. Had chlorotic anemia at 16. Had a few acne pustules on forehead for two or three years. Tongue swelled at times but never much, Sometimes the tongue is glazed as if with porcelain; again it is cracked and fissured. She is now 19; is very anemic; has dyspeptic symptoms and her stomach fills with gas after eating. She does not vomit much; has never vomited blood. Menstruation scanty. Strength not as good as last year. Afternoon temperature, 101°. Pulse, 96. Appetite now variable. Appetite was depraved a year ago and the patient took to chewing paper,

etc.

Now, syphilis is excluded. What can you tell me about that tongue? A. M. ERICAN.

Editor MEDICAL WORLD:-Please state if you are acquainted with the proprietary medicine known as 66 'Zuni," put up by the Zuni Medicine Co., Santa Anna, Cal., whose agent for Missouri is W. E. Roeschell, Booneville. Have you any means of obtaining its analysis, and what would it cost me? It is put up in packages as a tea, and is, I believe, of the cactus (giant) family. I would be glad to ascertain its composition. H. H. ST. JOHN, M. D.,

La Belle, Mo.

[Not knowing the formula, we call upon our readers.-ED.]

Editor MEDICAL WORLD:-I have two young: men under my charge that get on terrible drunks, for two weeks at a time; continue to drink to keep off delirium tremens, but wind up with two or three days of the "horrors" every time. What is the best remedy to sober up a man to avoid the nausea that follows? Wade, N. C. L. A. MUNS, M. D.,

Editor MEDICAL WORLD:-I am puzzled with a very difficult case and appeal to THE WORLD readers for aid.

Female, age 11, white, family history good. Five years ago had an attack of scarlet fever, since which time she has been enjoying excellent health. Suddenly, some four weeks ago, had a discharge through ears and nose, yellowish. At times she complains of very severe headache, shortly after she has a similar discharge from the top of her head; and where a moment before you could not detect a wet hair, there is a sudden discharge of enough matter to form a good sized pool on the floor.

Between attacks, which average two a day, she enjoys her usual good health. Now what is it and what treatment would you suggest? Answers received direct or through THE WORLD will be appreciated.

JNO. R. BAER, M. D., Sassamanville, Montg'y Co., Pa.

Editor MEDICAL WORLD:-I renew my subscription for ninth year, continuous, without a single issue being missing, and all carefully preserved in MEDICAL WORLD binders.

As I have heretofore written and received good advice through these columns, I again ask, viz.: Two months ago a lady patient of mine picked up a heavy tongue attached to a thresher, and in attempting to throw it from her to one side, threw it with a force, and, it being heavy and the truck wheels wide and low, they naturally swung back into the position they occupied before being moved, causing the tongue to fly back and fall with considerable force, lighting on the lady's bare foot, between the second and third meletarsal bones, causing a contusion and, I think, fracture of the same. There was no attention paid until the foot became very painful and swollen. I have since treated her