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milder, for the resistance of the skin diminishes with the lapse of time.

The rays emitted by the Kromayer lamp produce a reaction similar to the above, when the lamp is not brought in contact with the surface, except that a much smaller area only can be reached. When the window, or a quartz attachment of the Kromayer lamp is pressed against the skin, the effects are more intense and much greater penetration is attained.

The light emitted by the Alpine sun lamp is similar to the sun's rays on high mountainshence its name-and for that reason this apparatus has been used in treating various forms of tuberculosis. Dr. F. H. Spencer referred a young woman to me who was suffering from tubercular peritonitis. Two laparotomies had been performed on her, in one of which several feet of intestine had been removed. When I first saw her she had a fistulous opening discharging pus. She was badly stooped over and her face wore a drawn expression. After the first treatment, her features relaxed, her shoulders were drawn back, and she felt no abdominal pain when she walked. After the second treatment, the fistula began to discharge faeces instead of pus. She belonged to the disobedient pauper class and disappeared after the third treatment. Aside from this, I know nothing about the effects of this treatment on tuberculosis. I subjected a number of patients, suffering from insomnia, to a brief general raying with the lamp, and in every instance the treatment was succeeded by a night of profound natural sleep followed by no bad after effects. Whether the rays from this lamp are capable, as is claimed, of stopping uterine hemorrhage or not I do not know, and I cannot see how it can be of value in the treatment of gonorrhea in the female; at least, I have never used it for that purpose.

Coming now to the essential purpose for which this paper was written the treatment of skin diseases I can say with emphasis, that while the mercury-quartz lamp is not a cure-all, it fills an important want in the armamentarium of the dermatologist. In one case of lichen ruber planus, which resisted heavy and prolonged doses of arsenic and mercury, the lesions cleared up after a few treatments and the patient has had no recurrence for one year. I am not pleased with the results I obtained in several cases of psoriasis. In several cases of lichen chronicus simplex and chronic indurated excema, the results were all that could be desired. Today it is the only rational remedy we have for alopecia areata. This remark applies equally well to all disorders of the sebaceous glands. Whether seborrhea, comedones or acne are caused by a form of infection or not is still a mooted question, but that patients suffering from these maladies rapidly recover, when

treated by the mercury-quartz lamp, is a fact that I have repeatedly demonstrated to myself. It may be that the rays kill the micro-organisms. causing the seborrhea and acne, or it may be the purgation of the sebaceous glands which brings about the desired end.

Premature baldness, due to seborrhea, can be checked, and if treatment be persisted in, the patient can be cured. I have not met with success in the treatment of acne rosaceae. Whether this was due to faulty technique or not, I do not know. Lupus vulgaris is fortunately rare in this country, and so far, has been absent from my practice. This fact has prevented me from learning the real value of the ultra-violet ray in the treatment of this malady. One fact concerning lupus is frequently ignored in writings on that subject, viz., lupus is often nothing more than an indication, on the skin, that there is a focus of tubercular infection located beneath the surface. The patient has, so to speak, performed a Von Pirquet test on himself. As fast as we heal the cutaneous lesion by any means, and in fact often before we completely heal it, more bacilli are delivered to the site by the blood stream. Hence, failure to cure lupus is frequently a sign that we are not reaching the reservoir from which the lesion is constantly being re-infected, rather than that our local efforts are inadequate.

There is a human tendency with a new drug, or a new instrument, to exaggerate its usefulness; this unfortunate tendency is even greater in the case of a new apparatus. Despite this fact, I believe that the severe test of time will still further emphasize the fact that the mercury-quartz lamp fills a want in the therapeutic armamentarium of the dermatologist that cannot be otherwise supplied.

Physicians and Surgeons Bldg.

Dr.

Death of Dr. Littig-Just as the Herald goes to press, we are shocked to learn of the sudden death of Dr. L. W. Littig, of Iowa City, from septicemia, following the bite of an insect. Littig was graduated from the State University of Iowa, Iowa City, 1883; University of Pennsylvania, Philadelphia, 1884; M. R. Č. S. (Eng.), 1887; a Fellow of the A. M. A.; ex-president of the Iowa State Medical Society and Western Surgical Association; member of the Medical Society of the Missouri Valley, and many other societies; professor of anatomy in the State University of Iowa, Iowa City, from 1889 to 1891; director of the University Hospital from 1900 to 1902; a surgeon of international repute and a gentleman of great distinction and attainments. He will be sadly missed at the meetings of our society. He was 59 years of age.

Leenhardt and Tixier advocate giving quinine intramuscularly in the treatment of malaria.

Spirit of the Coeval Medical Press

DICHLORAMINE-T IN THE TREATMENT OF CHANCROID

Dr. E. G. Eastman, in Clinical Medicine.

It has recently been my pleasure to have used Dichloramine-T in the treatment of chronic chancroid. The employment of the remedy in this field being quite new, it is with considerable interest and no little enthusiasm that I report results.

My patient was a male, aged 27, of pure American extraction, blond, muscular, and of the type of westerner which portrays resistance in every fiber.

June 5, 1917, five days after intercourse with a Mexican prostitute, a sore appeared on the left side of the glans near the frenum. The patient immediately used the old treatment of calomel powder and caustic, but, without any good results. He then consulted a physician who burned the sore three times, causing it to spread. This doctor gave him a powder to apply and said that he thought the sore would dry up very quickly.

Two weeks later the patient was in another city and applied to another physician for relief. This doctor burned the sore and it continued to spread. Again patient was transferred to another city where a third physician was employed. This man was a physician of very good standing in one of our large western cities and pronounced the sore syphilis, administered salvarsan, which was followed up by the use of iodide of potash. The patient also was told to dust the sore with calomel powder. Once again our patient was transferred and a fourth physician was employed, who said the sore was a hard chancer, and burned it. Patient then moved to Chicago and came to my office for treatment. This was November 24, 1917.

From the appearance of the lesion when I first saw it, anybody would have been justified in making a diagnosis of syphilitic chancer. It was ovoid in form, about one centimeter in the large diameter and lay on the left aspect of the glans extending from the frenum upward to a width of about 0.75 centimeter, the outer border being close to the lips of the meatus. The glans was destroyed down to the submucous coat and the base was much indurated. It bore a clearly punched out appearance and was discharging a dark pus unattended with any disagreeable odor. But, the peculiar part of the case seems to be the fact that the third physician to whom this patient applied, made a Wassermann with a negative result. I disregarded this in my diagnosis

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My local treatment consisted of everything that I could think of that might be of service in such a case. It included iodine, phenol, nitrate of silver, permanganate of potash, trichloracetic acid, and silvol. In employing silvol I applied the pure crystals until the heat of the body dissolved them into a molasses like consistency and then applied a bandage. All of this was without any appreciable result. In fact the lesion seemed to be spreading. At this time when both the patient and myself were discouraged, my attention was called to dichloramine-T. This was after weeks of fruitless treatment. The first application of dichloramine-T was used in the 5 per cent solution. It was painless and at the end of one week the sore showed some tendency to improve. The strength of the solution was then increased to seven and one-half per cent.

The method of application was simple. I packed the ulcer with cotton, having first cleansed and dried it, then saturated the cotton with dichloramine-T solution dropped on with a medicine dropper. Cold cream was applied around the neighboring field and the organ bandaged. In using cold cream it will be noticed that I deviated somewhat from the technical instructions, not having any benzoin handy, but, it seemed to prevent any infringement of the antiseptic upon normal tissue and served such a good purpose and was so easily applied that I continued it throughout the case. On one or two occasions when the patient dressed his sore while away from the office, he was too liberal with dichloramine-T, some of it getting on the scrotum, the result being that a mild dermatitis ensued which, however, disappeared upon the application of cold cream.

The sore was dressed in this fashion every twelve hours, the patient meantime continuing his hard work of repairing locomotives. At the end of four weeks the sore was about half healed and I increased the strength of dichloramine-T to 10 per cent. Four weeks later the lesion was perfectly healed. At no time was there any discomfort from the use of dichloramine-T and when we consider the intense suffering patient underwent from the use of some of the older excoriating chemicals, we can fully appreciate the comfort of a painless antiseptic.

Dichloramine-T, being in a solution of oil,

seems to fulfill the very want for which we have searched in our quest for a perfect antiseptic. Caustics, of course, are antiseptic, but are objectionable in that they burn in their path an impenetrable wall under which infection may besealed up only to spread by metastasis; and, with dichloramine-T there seems to be no possibility of any such danger.

This case persisted nine months. It was under treatment in my office four months. Two months of old routine treatment only made it worse. The same time spent with dichloramineT effected a cure. How long it might have persisted under the old treatment is interesting to conjecture. I shall continue the use of dichloramine-T in these cases as routine treatment.

Correspondence

THE TRES PALACIOS CLUB-VALE! To the Editor:

In the spring of 1917. I left the Texas coast to come north, engrossed in my plans for the cooperative physicians' club. I looked forward to long years to be spent surrounded by my friends and relatives, all enjoying peace and plenty, in the locality I had selected, with all the United States from which to choose. For some time I had had prostatic trouble, which, however, is not unusual at my age-68. There was one disquieting symptom also, an increasing weakness without apparent cause. This induced me to consult Doctor Lydston, who promptly pronounced my malady abdominal cancer! I was simply paralyzed. Of course, we have some patients affected with cancer; but, Doctor, did you ever dream you would have it yourself? It took me six months to assimilate the idea. Then I came to Chicago, and taking the advice. of Lydston and Ochsner, placed myself in charge of Doctor Blackmarr for treatment with radium and the x-ray. The man is a wonder. I would not have believed it possible for such results to be won as he has secured in my case. Scarcely a visit to his office occurs without my meeting there patients recovering or altogether cured of cancer by his method. It is not merely radium, but the methods of application he has developed. He ought to have an endowment of a million dollars to enable him to fully carry out his work. In my own case, all the tumors have been arrested in development and some have retrograded inside. I am, however, exceedingly weak, and am compelled most reluctantly to lay aside all thought of developing the club, as well as of all other professional work. This will explain why you have not heard more about the club during this summer. I still hope that somebody else will take up the plan and carry it through. William A. Waugh. Chicago, Ills., July 23, 1918.

"CARRY ON"- A NEW MAGAZINE

We are in receipt of a magazine from Washington, under the above title, emanating from the office of the surgeon general of the United States Army, which is filled with interesting. abled soldiers and sailors. On the title page material concerning the reconstruction of disappears an excellent illustration of Surgeon General Gorgas, Col. Frank Billings, Brig. Gen. Robert Noble and Col. C. L. Furbush. Copies of this little magazine may be obtained by any of our readers who will address the editor of

Carry On, care Surgeon General United States Army, Washington, D. C.

The following announcement explains the purpose of the magazine. The medical department of the army will carry on in the medical and training treatment of the disabled soldier until he is cured or as nearly cured as his disability will permit. We shall try to do our part in his restoration to health efficiently with the belief that the wounded and sick soldier shall have the opportunity to return to civil life capable of pursuing a career of usefulness. This will enable him to enjoy the freedom and happiness afforded by world wide democracy for which he has given his all.-Signed W. C. Gorgas, Surgeon General U. S. Army.

Every spendthrift adds to the war's length.

President Wilson says: "The practice of individual thrift is a patriotic duty and a necessity.'

Thrift Honors for Kansas City-Kansas City was the first city in the United States to report one thousand members of a "Baby Bond" club who subscribed $1,000 each.

Billion Arsenical Products-Our readers will be interested in knowing that a full, fresh stock of "Arsenobenzol" and "Nov-arsenobenzol" is now being carried by the Physicians Importing Co., St. Louis. Send for literature and prices.

Loyalty demands that Uncle Sam be the great spender during the war; he knows what is needed to win. And do not forget that every time you buy anything you reduce by that much the supply of labor and materials which he needs. for victory.

Five thousand physicians a month for an indefinite period is the requirement and those doctors who are of the opinion that other physicians in their immediate neighborhood are better qualified or have less responsibility than themselves, should, in view of the crisis now facing us, subjugate their individual opinion and apply to their nearest Examining Board for a commission in the Medical Reserve Corps.

"Keep the Home Fires Burning"

Organized at Council Bluffs, Iowa. September 27, 1888. Objects: "The objects of this society shall be to foster, advance and disseminate medical knowledge; to uphold and maintain the dignity of the profession; and to encourage social and harmonious relations within its ranks."-Constitution.

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CHAS. WOOD FASSETT, Managing Editor

713 Lathrop Building, Kansas City, Mo.

ASSOCIATE EDITORS

P. I. LEONARD, St. Joseph.
J. M. BELL, St. Joseph.
JNO. E. SUMMERS, Omaha.

CONTRIBUTING EDITORS
H. ELLIOTT BATES, New York.
JOE BECTON, Greenville, Texas.
HERMAN J. BOLDT, New York.
A. L. BLESH, Oklahoma City.
G. HENRI BOGART, Paris, Ill.

ST. CLOUD COOPER, Fort Smith, Ark.
W. T. ELAM, St. Joseph.
JACOB GEIGER, St. Joseph.

S. S. GLASSCOCK, Kansas City, Kan.
H. R. HARROWER, Los Angeles, Cal.
JAS. W. HEDDENS, St. Joseph.
VIRGINIA B. LE ROY, Streator, Ill.
DONALD MACRAE, Council Bluffs.
L. HARRISON METTLER, Chicago.
DANIEL MORTON, St. Joseph.
D. A. MYERS, Lawton, Okla.
JOHN PUNTON, Kansas City.

W. T. WOOTTON, Hot Springs, Ark.
HUGH H. YOUNG, Baltimore.

The Editors' Forum

Are You a Real Patriot?

Attend the Omaha Meeting

One of the most important medical gatherings of the year will be the meeting of the Medical Society of the Missouri Valley in Omaha, Thursday and Friday, September 19-20, under the presidency of Dr. A. I. McKinnon of Lincoln. The fact that many of our members are now in the cantonments, and over-seas, makes it imperative that all members of the Home Guard

should gather at this annual session, using their best endeavors to "keep the home fires burning" for our brothers who are engaged in military service. (All those on leave are expected to be with us.) Problems which the Home Guard have to meet are greatly intensified by the demands of war. It has been said and with peculiar emphasis at this time, that "the health of the people is the strength of the nation." Those of us who are not qualified to go to the front have many sacrifices to make at home, and we hope that each and every one will see it their duty to attend this meeting and contribute to its success. Some of the topics to be discussed are:

How May the Home Guard Best Contribute to an Early Victory?

The Declining Birth Rate and Conservation of Child Life.

What Medical Science Owes to the Military Surgeon.

Ways and Means for Reconstruction of Disabled Soldiers and Sailors.

In What Way Can the Women Best Serve the Interests of Their Country?

War Wounds and Gas Infection.

Radium and X-Ray in the Treatment of Cancer. Later Developments in the Cure of Tuberculosis. Syphilis and Salvarsan Clinics.

Have We Any "Slackers" in the Medical Profession?

New Developments in the Treatment of Pneu

monia.

Value of the Dakin and Dichloramin-T Solution in Treatment of the Infected Fracture.

Contributions on the above subjects invited.
Program limited to 20 papers, closing August

25th.

A patriotic dinner will be served on Thursday evening at Hotel Fontenelle at 6 o'clock, to which all are invited. Addresses will be given by representatives of the Medical Department, Army and

Navy, and the Public Health Service of the United States. These will be followed by interesting moving pictures from the war zone. Arrangements are in the hands of a committee appointed by the Omaha-Douglas County Society, under whose auspices this meeting will be held, Dr. John E. Summers, chairman.

Be sure to make your room reservation at Hotel Fontenelle, which will be headquarters. All meetings will be held in the ball room on the mezzanine floor. A large number of interesting commercial exhibits will be placed on this floor and will be well worth inspection.

Program will be issued early in September. Be sure to attend this meeting and bring a friend. We need new members to recruit the ranks of our society which are somewhat depleted by the demands of our country.

CHARLES WOOD FASSETT, Secretary.

The Poor Critter

It has been said that the Gods on high Olympus weep salt, briny and bitter tears whenever they behold the spectacle of a jester. who attempts to take himself seriously.

Hence, when "Life" (which used to have the reputation of being a "funny paper") devotes a part of its space to a fulmination-of the pop-gun variety-signed by one “C. H. T.” whoever he or she, may be, against the "Allopathic" medical profession the "pop" should be--and no doubt will be taken as a joke.

Perhaps "C. H. T." belongs to a "certain school of treatment-the Homeopathic." Perchance another-"the Osteopathic"-is honored by his or her allegiance. We rather suspect "C. H. T." to be a Christian Scientist, in which case we extend our smpathy to Mother Eddy,

et al.

We wonder if "C. H. T." were to contract diphtheria if the "squirt-gun" of antitoxin would be despised?

We wonder also, if "C. H. T." would decline the laboratory product, Salvarsan, provided it were indicated-which we hope is not the fact?

We don't wonder, however, what ails "C. H. T." anyway.

The symptoms are all too plain, the diagnosis does not even have to be confirmed in the laboratory. "C. H. T." is afflicted with Pernos

pera.

And Pernospera, while not fatal, is incurable either by Homeo, or Osteo., or C. S.

"C. H. T's" tirade against the "Allopathic" medical profession will not accomplish any harm so far as that branch of the "medical priesthood" is concerned.

Every religion has had its mockers. The biggest apple in the tree gets the most sticks thrown at it.

.

"C. H. T's" pernospera is harder to cure than pneumonia-no matter what school is consulted. Even the poor animals that are "tortured" according to "C. H. T." have one on this contributer to "Life"- animals don't have pernospera.

There has never been discovered a serum that will cure it. We doubt very much if there ever will be. "Friendless soldiers" in the hospitals don't suffer from pernospera, which attacks the wielder of the pen, not of the sword.

Is it possible that "C. H. T's" effusion is a part of the Hun propaganda?

Statistics show there is more pneumonia at home than in the hospitals.

"C. H. T." has it in for the "Allopath" for some reason or other-or what is probable judging from the arguments (?) advanced for no reason at all.

Doctors are ever charitable-they have to be in order to live up to the ideals of the medical profession. Allopathic, Homeopathic, Osteopathic or any other 'pathic.

"C. H. T." opines that the head-in-the-sandfession. But evidently the ostrich has one on hiding-ostrich has nothing on the medical pro

"C. H. T."

Because the ostrich has at least a head to hide. But if you will look up the meaning of the word "Pernospera" in the dictionary you will find it refers to "a blight that attacks the bean." Having "Pernospera" "C. H. T." deserves the pity, and the sympathy of the medical profession-including all "pathics."

joke, is properly placed on a page of "Life.” "C. H. T." is evidently a joke, and being a

The Falling Birth Rate

of Germany

In spite of many protests to the contrary, by German authorities, our government's information bureau has had many evidences of Germany's desperate efforts to increase the birth rate, whether legitimate or illegitimate. Here is a copy of a letter found on a German prisoner captured by the Americans (translation):

Since, as a result of the war, the greatest part of the manhood of the country capable of bearing arms has been called to the colors, it is the duty of the masculine population, in the interests of the fatherland, to take to themselves in loving manner the young women who have been left behind with the object of doubling or trebling the birth rate.

We believe that in you we have found the right man, and that you, in this difficult time, will fulfill this honorable and responsible duty in a conscientious manner.

The duty with which you have been intrusted is of a public nature, and by refusal you will incur severe penalties under the statutes of war.

You will be informed upon visiting this office as to the district alloted to you and the addresses of the women to be visited by you.

You may use this communication as a voucher.

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