crimination; that the risks of infection and of secondary operation from portions left behind are rather remote in properly selected cases."

He summarizes as follows: "The majority of the gynecologists interrogated favor a restricted conservatism; that the number of pregnancies occurring after tubal operations is very small; that the results after plastic work on the ovaries are better; that age, the presence of pus, tuberculosis and malignant disease indicate as a rule radical work; that prolapsed ovaries, generally speaking, should be elevated in the pelvis by suspension operations on the uterus, by shortening the ovarian ligament or by placing the ovary in front and on top of the broad ligament; that the functions of the tube and ovary should be preserved whenever consistent with health; that the artificial induction of the menopause brings a very serious disturbance into the life of the patient, and that ovarian transplantation experimentally and clinically has, in a limited field, been productive of satisfactory results.”

I

Fourth of July and Lockjaw.

T is a well-known fact that the Fourth of July brings a crop of lockjaw among children. The reason for this is, that children are allowed to play with fireworks and injure themselves with the various devices for celebrating the Fourth.

The question I wish to raise is, why do injuries on the Fourth of July produce lockjaw more than injuries on any other day of the year? Children are liable to be injured any time, and thousands of cases of injury of all sorts occur during the year. Why should lockjaw be the result of injuries made on the Fourth of July when there is comparative freedom from such result through other injuries?

If the germ theory of lockjaw were a true theory, the only way we could account for the numerous cases of lockjaw that follow injuries on the Fourth of July, would be to assume that the germs of lockjaw are more numerous on our national holiday than any other day.

55

Of course such a claim would be perfectly absurd. If such things as lockjaw germs in the air or earth reach and infect people who are injured, it would not make a particle of difference whether they were injured on the Fourth of July or the tenth of July. Lockjaw would result just the same."

There must, however, be some reason why the injuries on the Fourth of July are especially provocative of lockjaw. It is a very simple one, for which I have contended for many years. It is the nature of the injury, and not the presence of tetanus germs, that causes lockjaw.

The injury produced by toy pistols, exploding crackers and other devices to make noise is a peculiar one. It not only produces a contusion, but a laceration. Such a wound does not freely bleed, if indeed it bleeds at all. The flesh is bruised, the skin partly removed, the raw surface exposed in such a way that the peripheral nerves are especially impinged upon. The wounds are principally of the hands, where these peripheral nerve loops are especially abundant. When the wound heals live nerve loops are caught in the cicatricial tissue in such a way as to produce a constant irritation of the spinal cord.

It is well known that tetanus causes symptoms that almost exactly resemble the symptoms of strychnia poisoning. Strychnia operates upon the spinal cord, producing terrible cramps, and finally permanent spasms of the muscles. This is exactly what tetanus does also. The strychnia operates upon the spinal cord in a toxic way, irritating the cord until the spasms result. So also do the contused wounds caused by Fourth of July accidents. They, through the peripheral nerves of the hands, and sometimes the face, send a constant stream of irritation to the spinal cord until it affects the spinal cord in exactly the same way that strychnia affects it. The irritation, although it may be quite a slight one, is continuous night and day until the resisting force of the spinal cord is finally overpowered.

Tetanus germs have nothing whatever to do with it. It is the nature of the wound. A bursting cracker in the hand.

injures the flesh in just exactly the right way to set up nerve irritation, which is more or less certain to be transferred to the spinal cord.

This is the only possible explanation of why it is we have a crop of lockjaw following the Fourth of July. It is the peculiar nature of the wound produced by Fourth of July accidents. And if there be any such thing as tetanus germs, and if they play any part in the matter, it must be a secondary part, and not a positive action, as some doctors are trying to make us believe.

In proof of what I have been saying about lockjaw, let me cite the report of twenty-six cases occurring in the State of Michigan in 1905: Of the twentysix cases twenty-four terminated fatally, showing that it is a very fatal disease. Two resulted from gunshot wounds. Six were caused by the explosion of blank cartridges. Two reported were umbilical cases, probably due to a constriction of the umbilical cord in young infants. Three, rusty nail wounds. Two, accidents to the feet. One, a wound of the Another, injury finger by a rough pin. Another, injury to the finger in cog wheels. Another, a rusty garden rake tooth. Another, a sliver under the nail of finger.

A consideration of these cases is sufficient to show any candid person that some attention at least must be given to the peculiar nature of the wound. Every one of them were wounds of the kind that I have described above. Wounds that do not bleed freely. Wounds that distort and lacerate and tear the flesh in an unusual manner. They are generally quite superficial wounds, and the injury is chiefly to the nerve loops, and thus the spinal cord is irritated and stimulated in an extraordinary way.

A clean cut rarely if ever produces tetanus. And yet a clean cut would seek to afford a better opportunity for tetanus germs 'than one of these combinations of bruise and laceration which so often produce tetanus.

Nothing but the mania for referring everything to disease germs could have so distorted the opinion of the medical profession as to ignore all this sort of evidence. They are determined to have

it that tetanus is caused by a tetanus germ, and no consideration of any other conditions seems to enter into their calculations.

Tea for Worms.

For children from two years upward, the following formula has been used for a number of years, with excellent results: Spigelia. 240 grains Manna. .200 grains Senna. ..100 grains Fennel. 60 grains

Cut the Spigelia into small pieces and mix with the other ingredients, and steep for one hour in a pint of boiling water. Give a child two years or upwards, half a teacupful, warm, morning, noon and night before eating.

Our Correspondence Club.

same.

Some time ago a Correspondence Club was organized among the readers of Medical Talk. We concurred with the idea and instituted the We have received a number of requests from subscribers who would like to reinstate this club. We should be glad to have letters for publication and shall print them as fast as we receive them. A correspondence started in this way in a great deal of good. between congenial people, cannot fail to result "Learn from each other" that is our motto. The people who read our magazine know many things better than we do. We would like to set the people to work learning from each other and a Correspondence Club among our readers is a step in this direction. We are glad to lend it all the assistance we can.

cepted as a standard of guidance is now almost entirely obsolete. This statement is especially true of the suppurative affections of the temporal bone."

In referring to the prevention of aural affections the author states that too little attention has been paid to the prevention of these diseases. "Throughout this entire work, therefore, on all proper occasions, the fact is stated that prevention of aural diseases is usually easy in early childhood, whereas benefit or cure as a result of treatment in later life is often impossible."

As to the diagnosis the following significant remarks are made: "Empiricism in both diagnosis and treatment has heretofore played too large a part in the practice of otology. Since success in the practice of this branch of medicine depends almost wholly upon correct diagnosis, the methods of investigation into the nature of aural diseases are given in detail."

In sketching through the book the observant student is first struck with the wonderful superiority of the cuts. Half-tones, wash drawings, line drawings of the finest quality are made use of to give the reader a correct insight into every anatomical detail. These cuts are taken from life, from anatomic specimens, as well as charts of the highest scientific interest.

Any one who has mastered the anatomy of the temporal bone has crossed the Rubicon in the ordeal of fitting himself for the practice of otology. The cuts in this book lay bare for the first time in medical literature all of the secrets of the temporal bone. Every foramen, canal, sulcus, process, meatus, sinus, aqueduct, is delineated with a painstaking care much exceeding anything that the student could hope to find in any other text-book on the subject.

In diseases of the external ear and middle ear the authors have had, of course, to meet and compete with the very excellent and voluminous literature of recent date by various writers. Backed up by the very latest technology and researches they have been able to add many excellent things upon these muchwritten topics. But in diseases of the inner ear the book will be almost a revelation to many students.

Take, for instance, their treatment of diseases of the labyrinth, which occupies nearly thirty pages of nearly solid reading matter. These pages alone are worth the price of the book to any physician who cares to be able to diagnose the many obscure cases which present themselves to any practitioner, in which dizziness, nausea, noises in the head and other similar symptoms are prominent.

The physician of general practice ought to be able to know enough of this subject at least to recognize when his patient should come under the care of an expert otologist. How many physicians are able to recognize a case of Meniere's disease or hyperaemia of the labyrinth? And yet the welfare of the people depends mainly on the ability of the average practitioner in recognizing these diseases and

referring them to a proper specialist for treatment. Armed with this book the average physician would not be likely to fail to recognize any ordinary case of labyrinthian disease.

It is this kind of medical literature that is really advancing the science of the healing arts without the slightest tinge of suspicion that the authors are covertly seeking cheap notoriety.

Abdominal Breathing.

Query 109: I would thank you to give me some instructions in regard to abdominal breathing without inflating the lungs. I do not believe that I fully understand just how it is done. I feel that your advice has been so helpful to me that I would most gladly adopt any suggestions you see fit to make.-J. R.

Answer: It is very difficult to describe in a letter abdominal breathing. I could show you in five minutes all about it. I began it myself, however, without any instructions. Close your mouth, draw in air through your nostrils, and as you do this raise your abdomen and you will notice that you do not inflate the lungs. Take in air by pushing out the abdominal muscle, then shrink the abdomen, which will force the air out of your nostrils again. At first you may be awkward in doing it, but you will accomplish it after while. I can breathe either way; draw the air in by inflating the lungs and then by pushing out the abdomen. This inflates the lungs downward as well as from side to side and gives an excellent massage treatment to the liver, stomach, duodenum, pancreas and the spleen. It is an excellent calisthenic exercise. There are professionals who are going about the country giving a term of lessons to men and women, for which they charge as high as $50 a scholar, and about the only thing they teach that is of practical value is abdominal breathing. Now try it, and if you still cannot accomplish it, do not hesitate to write me. I want you to learn how.

To Prevent Colds.

Query 107: I am troubled with colds in the head, that are especially bad in cold weather, causing an unusual flow of mucus when I am out of doors and sometimes when indoors, but mostly the former. Would it be advisable for me to get treatment for the same, or do you not think it necessary?-G. G.

Answer: I am going to tell you what to do to prevent catching cold. Sleep with the windows up every night. Every morning you should take a cold rub, exposing the whole body in a cold room. Massage your body with your hands, rub with a coarse towel, keeping busy so as to cause free circulation of the blood, and continue until you get a glow of warmth all over the body. If you have a warm room to dress in you might continue the rest of the exercise before putting on your clothes. After you have washed the hands and

face in the usual way with soft water and soap, give your face a good massage with the hands, then splash your neck and face with cold water. There is no objection to your using warm water on the neck if you will splash it with cold water afterwards. Gargle your throat with cold water, then practice deep breathing through the nostrils for a few minutes, as follows:

Place the forefinger on the left nostri, breathing violently several times through the right nostril, then change and breathe through the left nostril. Then pinch the nose between the thumb and finger and attempt to blow the nose. This forces the air up through the Eustachian tube into the middle ear, and makes a very good ventilation for the head. After you have finished breathing in this manner, breathe several times through both nostrils at the same time. Always keep the mouth closed when practicing this exercise, as well as the cold morning rub. While the chest is inflated, pound the chest with your fist so as to fill your lungs thoroughly with air. All this is to occupy 30 or 50 minutes entirely naked. It will soon become very enjoyable and will be one of the most profitable moves of the whole day.

Query 108: I have been troubled with frost bite. Is there a remedy for this trouble? It annoys me only occasionally.-J. W. F.

Answer: The best remedy I know of for frost bite is hot grease. Take a piece of fat meat and hold it over the fire until the grease begins to drip, then let it drip on the frost bite, just over the place where it is located. It will smart at first, but it ought to disappear very quickly.

Some Pelvic Surgery.

Query 130: I remember reading an article by Dutch Dr. Barnes, concerning the cure of neurasthenia or nervous prostration, and have always been a firm believer that in every case the stomach is the cause. I went to Philadelphia last winter to the famous Dr. J. E. W. He said I had neurasthenic colitis, and prescribed sevetol and olive oil injections, as he thought the chief thing in my case was to increase my weight, as my stomach was very weak. I didn't continue the medicine. Later in March I found I was suffering from a rectal fissure. I went to the hospital for this operation and while under ether the surgeon removed two rather large internal hemorrhoids by tying, dilated the rectum, and cauterized the fissure. The operation was not a success and after several months I was in a worse condition than before. The hemorrhoids came untied and the pieces of mucous membrane became irritated and formed two small polypi growths which became ulcerated, also troubled with fissure again. The only improvement I noticed was better action of the bowels and whole intestinal tract. I had slight hemorrhages from these growths and the fissure. This trouble grew out of the colitis that I

have been troubled with for the past three years. In three months I went again to the hospital and had the growths removed which was a simple operation; also the small ulcer and fissure treated. I lost a great deal of blood after the operation, as I was placed on regular diet, and as I was troubled with constipation, this aggravated the rectum. Had hemorrhages from the places where growths were removed. After two weeks I came home and was a long time getting back my strength. I employed a homeopathic doctor, as this was the only kind of medicine I could take for my nervous condition. I have made such an effort to recover my health. I feel I have been a victim of mistakes, as I wasn't in favor of the removal of the hemorrhoids. I have had more trouble since the operation than I did before.H. C. S., Pa.

Answer: You have certainly been a victim of ill-advised surgery, and you have my sympathy. I think, however, with your good judgment and sense and your age, you will fully recover if you manage the case correctly. I believe I would continue the sevetol as long as it appears to agree with you, and keep the bowels regular. Do not take castor oil. If the sevetol is not sufficient for your bowels, you might take a teaspoonful of olive oil after each meal. You should keep the bowels regular if possible without drugs.

I am very much in favor of using cocoa butter a small pledget of the butter about as large as the last joint of the little finger, inserted into the rectum at night, generally brings about the normal passage of the bowels in the morning. You can get the cocoa butter at any drug store and cut it up yourself. I presume, however, you will have a long siege in regaining your strength and vitality. It is a matter of vitality principally in recovering. You will have to overcome little by little the injuries done your system. It would take a good many months of right living and good treatment to make you entirely well and strong again.

I am enclosing some advice on the treatment of the rectum which you may find of use to you. I meet a great many cases like yours, where serious damage has been done by pelvic and rectal surgery, and while they are not hopeless cases, it takes a good while to get them right again.

A Preacher's Wife.

Query 131: To sum up my feelings in one word, the word crazy covers it. I worked very hard this summer. I went beyond my strength. I am terribly run down in flesh. I have had so much to try my nerves. I have lost all control of my will power. I am weak, and cannot make myself do anything. I cannot concentrate my mind on anything long enough to do it, and get so discouraged that I cry by the hour. I feel if I could go somewhere and have some one take care of me, and if I could be relieved from household

duties, I might get well. But under the present circumstances I don't see how I can ever get well. I don't know how to do anything any more than if I had never done it. I can't stand confusion enough to have a room_swept. Am the wife of an M. E. preacher. In this condition of health I have to move. How can

I ever do it? Everything looks like a mountain to me. Is there anything I can do to get better? I think my blood is thin and my nerves are sick and starved. Would osteopathy help me?-E. A. C., Michigan.

Answer: No one but those who have gone through with it can appreciate what a sufferer

you are.

You need rest. You ought to go away somewhere where you would have nothing to do but recuperate, nothing to think about, no work to confuse you, etc. I presume you will say that this is impractical. I know what it is to be a preacher, and know a thousand and one burdens that fall on the preacher's wife. and I do not see any way that you could escape them, except by going away somewhere. Do it and do it now. But if you cannot get away, you can at least try to make yourself well by the use of the simple remedies. Dr. Nerve Vitalizer is just the kind of medicine you ought not to take. It only nerves you up for a time and squanders your vitality. Whether osteopathy would be of any use to you I am not quite sure. Where there is any bone or spinal derangement they sometimes do a great deal of good, but I doubt somewhat whether in your case you would receive much benefit.

In

Massage of your whole body by some good strong person would be better for you. almost any town you would be able to get a woman to come and give you massage. This should be done at bedtime, and I think you will derive considerable benefit from it. It may sound presumptuous on my part to quote the scripture to a preacher's wife, but will you read over again that saying of the Master: "Come unto Me all who are weary and heavy laden and I will give you rest." Read it over again. Apply it to yourself. Maybe it will take on new meaning now in your time of trouble. It has done so for me.

Stoppage of the Nose.

Query 125: I usually can breathe in all right, but cannot breathe the air out easily. It seems something resists it in the nostrils.D. M.

Answer: There may be an adenoid growth in the posterior nose or it may be due to nasal catarrh. A very good thing for nasal catarrh is to close one nostril and take a deep breath and force the breath through the opposite nostril. Then dose the other nostril and force the breath through the other nostril. You should go out in the fresh air and breathe as above, and do it several times a day. is very beneficial in cases of catarrh, and very useful in opening up the nasal passages; it develops the turbinate bone, which is the one that

This

59

is generaly clogged, and causes the stoppage in the nostrils. Perhaps it would be best to have some surgeon examine your nose and throat. A growth may be found.

Suspected Adenoids in Throat.

Query 112: As a former reader of Medical Talk, I take the liberty of taking a little of your time because of my great faith in your advice.

I have a little boy 5 1-2 years, who seems to be growing deaf. I took him to a specialist on ears. He told me there was no trouble with his ears, but he had "Adenoids" back of his palate, and advised having same cut out. What I want to ask of you is, would you advise this being done? I shrink from a surgeon's knife unless absolutely necessary. I might add that within six months we have moved from a high altitude in the Black Hills to this city. Would that affect his hearing? -S. J. H.

Answer: I see no reason why the change in altitude should affect the little boy's hearing. Changing to a high altitude sometimes does so, but to a lower altitude should have benefited rather than injured his hearing. If I was quite sure that there were adenoid growths in the back part of his throat, interfering with the function of the Eustachian tubes, I should advise them to be removed. The knife is not used in such a surgical operation, but an instrument that scrapes them off or squeezes them off. However, it is a bloody and disagreeable operation, and should not be performed except it is positively necessary. Several cases occur to my mind while writing this where the removal of the supposed adenoids did no good. But, I think in those cases there really were no adenoids there. I labor under a disadvantage in not being able to examine your boy, and hence hesitate a little in giving you any positive advice. Are you sure the tonsils are not enlarged? You could see them for yourself. The enlargement of the tonsils frequently produces deafness when there are no adenoids. I do not think there is any hurry about the boy being operated upon. I quite agree with you, doctor, that adenoids should be removed. My only hesitation is because I am not quite sure of their existence. In your next letter you may make it more clear to me whether or not they are really there. In the meantime the boy should be taught forcible nose breathing, first one nostril, then the other, until he can draw the air easily through the nostrils. Mouth breathing is a very common and a very harmful practice and should be guarded against in every possible way. I have known suspected adenoids to disappear as the result of persistent and thorough nose breathing.

Send 10 cents for sample copy of THE COLUMBUS MEDICAL JOURNAL. If you subscribe this will be credited on your subscription.