get out of the house and be off. This is morally wrong and should never be done. The patient has intrusted herself into our care and we have no right to subject her to any inconvenience for the sake of having a little more of said convenience to ourselves, in finishing up the case more quickly. It should only be done when the demand is imperative. But it is sheer nonsense to say, that "its necessity can scarcely ever exist;" that the introduction of the hand into the uterus in search of the placenta "smacks very much of brutality;" and "never go after the placenta; " and that "if we can trust nature," etc. As well might you call surgeon who excises a tumor or amputates a limb, to save life, brutal. Arguing upon the logic of the last quotation, nature is fully competent to complete the work she began with-conception; hence, there is no need of obstetricians! This, however, is not true, for we all know that it sometimes becomes necessary to perform version, to apply the forceps,

Retained and Adherent Placenta. Editor MEDICAL WORLD:

About January 5th, I was called to a case here within the furnace location. Found the patient a mulatto woman, aged 24, the mother of two children, with labor well advanced. I remarked to her that her trouble would soon be over; that a few more pains would bring the child into the light of day, as presentation and every other indication justified such a conclusion. After making this wise prognosis, the pains gradually became more and more feeble and came at longer intervals, and the head was born several hours afterwards with the help of very decidedly voluntary bearing down efforts on the part of the mother. After the birth of the head the uterus declined to take any further action in the matter, and the "subsequent proceedings interested it no more." The child, which was a small one, being delivered, the uterus contracted firmly upon the within > contained placenta and remained in that condition.

Several negro midwives and nurses present had given the patient at different times, some of their powerful uterine stimulants, such as

egg shell and dirt dauber tea, to help along the pains; but all to no purpose. This is a standard remedy with the negroes, and when I am present I never object, for reasons obvious to all. I gave ergot at the close of labor, as is my wont, and saw the child properly attended to, and then came the trouble. I found on examination, the os closed around the placenta and the uterus itself firmly contracted; I made several efforts at extraction, sufficient to prove to me that it could not be done by the ordinary methods, and then sent for consultation with Dr. B. I had, in the meantime, placed the patient upon quinine and ergot.

After several hours' delay Dr. B. arrived. On talking the case over we decided to give chloroform, and see what could be done towards its extraction. Dr. B. gave chloroform, I introduced my hand cautiously in the womb, stripped the after-birth loose from its attachment in part, worked my way up towards the fundus gradually and very slowly, only to find the womb and after-birth firmly adherent and any effort to extract the after-birth would surely bring the uterus with it. We then desisted from further effort and placed the patient on ergot, quinine, and stimulants, cautiously, and made the patient comfortable. I had succeeded in bringing a portion of the after-birth down in the vagina. The next day the husband of the woman sent for Dr. H., an old practitioner in this county, who made further efforts at extraction without success, only so far as to sever that portion of the placenta which I had succeeded in detaching and bringing down in the vagina. Patient was then made comfortable, after being syringed out thoroughly with carbolized hot water.

This was the subsequent treatment: Speculum introduced each day and portion of afterbirth teased away from the os uteri with uterine forceps, then syringed out, three times daily, with carbolic solution, hot; three grains of quin. sulph. every four hours; small doses of whiskey as needed, nourishing diet. The first three days there was slight elevation of temperature; third day some uterine pain and expulsion of small pieces of membrane, very offensive. The rest was taken away in the mannner spoken of, and it was fully eight days before it had all put in an appearance. Patient now appears to be all right; milk secretion established and baby doing well.

Jenifer, Ala.

"All's well that ends well." WM. T. HAMILTON, M.D.

Extraction of Teeth followed by Trismus. Editor MEDICAL WORLD:

On December 29 I extracted four roots of lower molars from a man 25 years old, broken

off twelve years ago. On the removal of one of the roots pus flowed quite freely. On the 30th patient was in and out of the house overseeing their butchering. On January 1st he attended a dance, and soon after he complained of his jaw feeling sore; it was swelled and became locked so that the incisors were about a quarter inch apart. Patient was very nervous; could sleep but a few minutes at a time. At one time muscles of right side contracted and, living close to where an old lady had within a year died from tetanus, he was naturally alarmed. Pot. bromide was thoroughly tried; antifebrin to allay fever, which was 1012, and quiet patient. Secretions were attended to with no improvements until the 6th, when I gave 20 grains of quinine at 5 and 7 with 20 grains pot. bromide, and 15 grains of chloral at 6, 8, 10 and 12, unless he was asleep. Breath was very offensive; no appetite. During the night he sweat very freely for hours, and slept more than he had for days together. Jaws began to move a little, and by the 8th he was discharged feeling quite comfortable.

Saw in some journal that 60 grains of quinine would cure trismus. I thought this a good chance to try it, but the patient not being robust I only gave 40 grains. I do not know what gave relief, but some one may get where I did, ready to try any thing reasonable. Randolph, O. G. O. FRASER.

Tetanus.

Editor MEDICAL WORLD:

I was called June 13th, 8 p. m., to see Mrs. B., aged 62, very fleshy. On my arrival I found compound comminuted fracture of inferior extremity of radius and ulua.

She had been thrown from a buggy and her wrist was caught between the lower edge of the dash and bottom of the buggy, cutting or crushing both bones at the epiphesis, and all the soft parts of the front and ulnar side of wrist, cutting it more than half off, including both arteries. Both bones protruded about one inch, about on a line with the little finger. Hemorrhage had been profuse. Amputation was proposed, but would not be entertained at all. The parts were washed in a 1-2000 solution of hydrarg. bichlor., bones were replaced,. and the wound sewed up. For three days warmth had to be applied. After that she complained of the hand feeling too hot, and cold applications were grateful.

I dressed the wound every day. There was a moderate discharge of healthy pus, and patient felt quite comfortable. Water was kept dropping from the nozzle of a fountain syringe on the wound at whatever temperature felt best. There was no unpleasant odor. Each

day I wet the parts with same solution I used at first. At 5 a. m., 19th, patient complained of her jaws being stiff. I saw her by 8 a. m., and found I had a case of tetanus on my hands. Called in Dr. P., but amputation was not thought advisable at this late day, nor would patient allow it. Opisthotonus was followed by spasm of the muscles of respiration until patient would become cyanosed; when the spism would relax and she would gasp. A spasm in one part would be succeeded in a few minutes by one in some other part until 8 30 a.m. of the 20th, when the respiratory muscles became fixed, and she died in 39 hours from the time of the first symptoms.

At no time did the temperature exceed 1011⁄2° F., and during the last day it did not exceed 100°.

Amputation on the first evening would likely have saved the woman's life. Randolph, O.

GO. FRASER.

This dose to be given every hour until three doses are given. If the bowels do not move freely give-Glauber's salts in teaspoonful doses, until the stools are copious and free. Give the calomel and ipecac together, and alternate with the saltpeter every half hour. Afterwards, half to one ounce of whiskey every three or four hours. Repeat if the complaint shows tendency to return. I can speak from experience in regard to this treatment, as I have known the fever and swelling to stop in twenty-four hours, and the skin to commence desquamating in twenty four hours more; all appearance of the disease disappearing within three days.

Cases treated by every other means have run their course of nine or ten days, with all the unpleasant accompaniments. I would respectfully urge a trial of this mode of treatment. Brodnax, La. DR. BEN. H. BRODNAX.

Principle of Small Doses. Editor MEDICAL WORLD:

says

I am much interested in an article taken from the Indiana Medical Journal, published by you in October, No. 10, page 366, on the "Therapeutics of small doses." Dr. Swart's ideas and experience in their general trend very nearly accord with my own, but when he "The theories of Hahnamann were all false, and are now abandoned by his pretended followers," I take issue with him. It is true that some of Hahnamann's transcendentalisms are abandoned by a majority of his followers, but many still believe and inculcate them to the fullest extent. See Medical Advance and some other homeopathic journals.

In the four propositions he announces to demolish" Hahnamann's theories" he comes so near to Scylla I wonder he did not know he was in danger of Charybdis, for in his summary of the action of the minimum dose he as clearly demonstrates the doctrine of "simillia" as any He says, professed homeopath could wish. "We have sufficient evidence to believe that at least a few drugs are capable of developing conditions so nearly resembling those produced by certain diseases, as to be in a similar manner and for the same reason prophylactic," and as a matter of fact curative.

Forty years ago, while testing the minimum dose with the view of proving them useless, I became convinced that there was sufficient evidence to believe them curative, and since then have followed the "Therapeutic maxim" of your editorial on 1st page, October, No. 10, and have used "anything on earth or within the earth, or anything in the vast resources of nature that will cure the patient with the least harm." A sensible man, even though he announces himself a "Homeopath" because he has thoroughly tested the dogma and is convinced of its truth, will not forget that he is a physician, (and continuing your maxim), this allows him to choose from the vast domain of therapeutics, unbiased by any exclusive theory, any successful remedy by whomsoever discovered or recommended." Swarts might have quoted Ringer's Therapeutics in support of his fourth proposition, that

Dr.

grain of pilocarpin will check perspiration when 2 or 34 gr. will produce it, or that one drop dose of wine of ipecac will relieve vomiting, oro gr. of bichloride of mercury will

always prescribe according to cause and symptoms, employing the drug which I consider governs those symptons. On page 94, MEDICAL WORLD, Dr. John Aulde, of Philadelphia, gives us his valuable experience, which I fully endorse. Now, in the face of the above facts can I conscientiously act differently to his theory? If small doses will perform what is required of them, why give large ones? I remember a case of one James Fowler, of Gentile Val

In

A great deal is said in the journals of late against the use of ergot in obstetrics, but if given in small doses, five drops or less of the fluid extract in a case of tired uterus every twenty or thirty minutes, alone or combined with cimicifuga, it will act like a charm and no bad results will follow. So with many other remedies which my diary, since 1850, fully attests in almost innumerable instances. what I have said I do not wish to be understood as fully indorsing homeopathy, but mainly to refute Dr. Swart's uncharitable denunciations of Hahnamann's theories and his pretended followers, and to show at the same time how he unwittingly proves the dogma true in his examples of small doses," and like curing like. H. KNAPP, M.D.

Lathrop, Cal.

Liberality.

Editor MEDICAL WORLD:

Your foot note to Dr. Mark's letter, page 471, MEDICAL WORLD, is really sublime. I admire your style. We want truth from every source, and this is just what we do want. I don't care for a name; what I have been in search of all my life has been a simple method of cures ; you may call them allopathy or homeopathy; I don't prescribe for a name, but to cure.

On page 69, MEDICAL WORLD, Dr. Pons seems surprised by what I would term drug symptoms (what else were they), and calls upon your thousands of scientific readers for further information. I will give him the information required. Let him take a glance at Dr. T. F. Allen's Encyclopedia of pure Materia Medica, and he will find almost the exact words he has quoted under the drug, bromide of potassium. Again, what is the principal ingredient in Fowler's solution but arsenic ? Take a look at that, doctor, while so engaged, after which I think you will agree with me when I say that there is nothing peculiar about your discovery. They are no more nor less than drug symptoms, which I always accept as guides in any given case.

I

January, 1883 (he was brought, in fact, in a covered wagon), suffering from caries of bone of left foot, caused by a slight injury sustained some fifteen months before. He had tried the most eminent medical men he could find, but gradually grew worse. His last medical attendant ere I took the case informed him that amputation of the limb was the only means to save his life. Purgatives had been freely administered, causing almost a dysentery. Poor fellow, he looked an object of suffering and misery. I examined him and found caries fully established; told him I would take his case and that I would try and save his limb. I gave him the privilege of staying at my residence till done, and on the 26th day of September I discharged him cured sound and well, after extracting some forty pieces of decayed bone from his foot, and when leaving for his home he danced for joy a hornpipe upon the platform of Spanish Fork depot. No doubt your thousands of readers will anxiously want to know what my prescriptions were, and I will also tell them. I gave him flint and mercury, one in 1000 at first, and towards the end one in 10,000. Almost incredible, but it cured the man, and he is at the present time in possession of his limb, and following his daily avocation as a miner, earning some four dollars per diem. There was one organ of his not remedied by me, and that was his memory, as he had never paid me yet. The latter hint may prove a benefit to some of the brethren of Idaho. DR. JOHN COOK. Lake Shore Villa, Spanish Fork, Utah.

Conservative Surgery, Sulpho-Carbolate of Zinc. Editor MEDICAL WORLD:

I see in the January number of your inestimable journal, an article on "Conservative Surgery," by Dr. Taylor, of Lynchburg, Tenn., which recalls to my mind two cases somewhat similar, that may be interesting to some of your readers.

The first case was that of a colored boy of mine about 8 years old, which occurred in the spring of 1845. He and an older brother were playing with an axe, and chopping alternately, at each other's foot. This boy put his right

foot upon a board and, not jerking it away quick enough, the edge of the axe came down across the metatarsal bones, half way between the instep and the toes, cutting entirely through the foot to the thick skin underneath. I saw him in a few minutes, found the severed portion hanging only by the skin. Having pressure made upon the femoral artery, I brought the parts in apposition, covered the wound with spider's web and held them together, and kept a stream of cold water falling upon the foot for sometime, until the hemorrhage ceased. Then, getting an assistant to hold the foot carefully, I removed the cobweb, and put an adhesive plaster, sufficient to hold the parts together; then with a piece of board the length of the foot placed under it, and a roll of cloth between the ball of the foot and the board, I made all firm with the roller bandage; twelve or fifteen years after, when he died, the cicatrix could barely be seen.

The other case occurring in 1853 was a little girl three or four year old. She and her little

The Felon and its Cure. Editor MEDICAL WORLD:

I find many inquiries in THE MEDICAL WORLD for the treatment and cure of this painful affection. Of all the methods of treatment so far, from the lightning cure by electricity to the most simple, I find none better than to thickly wrap the finger in fine cut chewing tobacco, and keep this saturated for two or three days with tincture of lobelia. Do this previous to the formation of pus, and you may rest assured the felon is cured. I never knew it to P. S. WEIDMAN, M.D.

fail.

Marine, Ill.

Editor MEDICAL WORLD:

My MEDICAL WORLD came to hand earlier than usual, and you don't know how I cherish its well written pages. In my study it takes the place of books, journals, papers, company, in fact everything, until Í have read it thoroughly. DR. WILL. E. HARRIS. Portland, Oregon.

a hatchet and block of wood were used this time, when the boy chopped off the ring finger of the right hand entirely, and the middle and fourth finger were held to the hand by only a piece of skin. I saw her an hour and a half after the accident: found the finger lying on the mantel-piece and perfectly cold; I placed the parts together, taking a stitch or two on the second finger, then with adhesive plasters and small splints, made all secure. She was made to carry her hand in a sling for two or three weeks; she is now a grown young lady, a fine performer on the piano, for which she says she cannot thank me enough. I forgot to say that the wound was between the middle joint of the ring finger and the metacarpal bone.

Now to change the subject, I can say that I have given the sulpho-carbolate of zinc a fair trial in seven cases of typho-malarial fever, and it certainly is a "sheet anchor" in that disease. I lost only one, to which I was called only two days before she died. If the bowels are inclined to be too lax, I combine bismuth with it; if not, lacto-peptine. I give it in 3, 4 and 5 gr. doses, according to the age of the patient, every 5 or 6 hours. I have discarded quinine entirely in this fever. Of course to reduce the fever I use generally antifebrin.

I have used jaborandi in two cases of erysipelas, both facial, one a bad case, with entire success. Twenty minutes after taking the first dose she felt better.

I have used the zinc in gonorrhea and ophthalmia, and it did all that I expected or wished for, namely, cured my patients. Camden, Ala. E. GAILLARD, M.D.

Organs.

Editor MEDICAL WORLD:

I think it a duty that we owe to each other as members of the medical profession to report every interesting case that we are called upon to treat, and especially if the treatment is such as to be of interest to the general medical public, and also to report any discoveries that we should chance to make in our practice. I want to report a discovery, to me, whether it be such to other members of our profession or not.

I was called recently to see a son of my preceptor, who was convalescing from a long attack of typhoid fever. The young man went along about the ordinary course of typhoid fever until he passed the crisis. Then he began to experience very great difficulty in voiding his urine. The bladder was greatly distended by the over-accumulation of urine, and by some means (I suppose by lying on his back so long during the fever), the viscus became wedged deep down in the pelvic cavity, so much so as to displace the rectum very greatly. One could introduce a catheter into the bladder, after chloroforming the patient; but we were never able to get more than about four ounces of urine at a time. That fact puzzled us very much, because we knew that the bladder was full of urine, and we were positive that the catheter entered the cavity of the bladder; yet we could get only about four ounces of urine at a time. But we finally concluded that the bladder, being so deeply impacted into the pelvic cavity, accounted for the catheter only bringing away that amount of water