above the position it occupied in the bladder. The bladder became so largely distended that we were becoming alarmed, for fear of its being ruptured, and symptoms of septic absorption began to manifest themselves. Upon the whole the case was so alarming in its character that we had concluded to aspirate. Now for my discovery. As a last resort, I suggested to my preceptor that we give him twenty grains of chloral. The doctor was not inclined to have any confidence in the chloral, but on my second visit yielded to my request, and, of course, the young man soon after taking the medicine went soundly asleep, and was aroused by the discovery that the urine was just pouring from him. He passed a very large quantity, saturating his entire bed. The doctor, though, was still disposed to think that the relaxation was due to the chloroform; but he had been thoroughly anesthetized by the chloroform several times, and no such result followed; consequently the effect was clearly attributable to the relaxing effect of the chloral. I had been made aware of the specific effect of chloral on the urinary organs by its use on my own person.

I

To-day a negro man presented himself to me for treatment, suffering from retention of urine, brought on by a contraction of the urethra, produced by a strong injection in the treatment of a recent attack of gonorrhea. tried for two or three hours to introduce even a capillary catheter, but to no purpose. After several hours' hard work with all the different sized gum elastic catheters, I was just about to despair and give it up, when I happened to think of the chloral. I ordered my clerk to give him fifteen grains, and in about twenty minutes the chloral was beginning to stupefy him. I took a No. 12 silver catheter, and, to my complete surprise, it entered the bladder without the least resistance, and, of course, evacuated his bladder completely. I forgot to state that I had made repeated attempts to introduce the same catheter before using the chloral, but did not succeed. Now, Mr. Editor, this effect of chloral is entirely new to me, but whether it is to other members of the profession or not I do not pretend to say. But if it proves as efficacious in all other hands as it has been in mine, it will certainly do away with much of the dangerous and expensive cutting and dilating instruments used for that purpose. Pineville, N. C. JOSEPH A. ARDREY, M. D.

Postural Treatment for Prolapsis Funis-Umbilical Cord Around the Neck.

Editor MEDICAL WORLD:

I have several times seen articles on the pos

tural treatment of prolapsed funis in THE MEDICAL WORLD, SO I will give you a little experience of my own on the subject.

On Nov. 22d, 1885, I was called to Mrs. S., about five miles distance. As I entered the cabin one of the women present said, "Doctor, you are badly needed here. The navel cord is down, and we do not know what to do with it." I immediately proceeded to make an examination and found the cord prolapsed about five or six inches, the vertex, first position, presenting, and not far enough advanced to cause any compression of the cord, which was pulsating strongly. Liquor amnii had discharged just a few minutes before they sent for me, which undoubtedly floated the cord with it. Now, in all my former practice I had never met with a case of prolapsis funis, so I went to work to get the cord back over the head, and keep it there until the contraction would force the head down into the pelvis, leaving no room for the cord to come back down. But all my efforts failed. Neither had I time to study very long what might be best to do, as labor was proceeding rapidly. Suddenly it came to my mind, that if we could hold that woman with her hips up, standing on her head as it were, surely that cord could be reduced without any trouble. But I thought, who ever heard of such a procedure. But this gave me the idea at once. I went to my patient and made her get on her knees in the centre of the bed, facing the head of the bed. I took the bolster and threw it over across the bed and put the two pillows on top. I made her kneel down, and then throwing her body forward and downard resting herself on the mattress below. You will at once see that this position will give a good elevation to the hips. I then introduced the cord and pushed it back, or rather, down, and the cord slipped away from me and that was the last I felt of that cord until the child was born, which took place in less than three-quarters of an hour.

My second case happened January, 1887. Mrs. H., aged 40, mother of ten children. When I arrived the midwife told me the cord was down. I examined and found the cord prolapsed about two inches, and a good vertex presentation. Having so much confidence in the treatment of my first case, I immediately placed the woman in the appropriate position and reduced the cord without any trouble. But had to keep my patient in this position until the contractions had forced the head solidly down into the inferior strait; then I placed my patient on her back, and deiivery was accomplished in a short time. I had delivered this same woman twice before without any accident.

Mrs. H., aged 40, mother of six children, is

a cripple, having had her left hip crushed and thigh bone broken (using her own language), when about nine or ten years old. Her first babe was born dead. The physician that was called delivered by version. The second was delivered by forceps. I delivered her of the last four, and two of them had the cord wrapped around the neck twice, and the other two but once.

With two of them I had considerable trouble before they were resuscitated. The cords are generally long, and the heads of the children large, making labor slow. The cause is, I think, a peculiar swinging gait the woman has in walking, and stooping down to cook at an old fashioned fire-place. All six of her children had the cord around the neck.

Can the readers of THE WORLD give through its columns a formula of a genuine, good healing salve or ointment? The people in my community are greatly attached to good healing salves for all kinds of sores.

THE WORLD is still the best medical journal I can get hold of. H. S. HAID, M.D.

St. Clara, W. V.

Replies.

Editor MEDICAL WORLD:

Why don't prostitutes conceive? One reason is that many prostitutes are in the habit of introducing just before intercourse a small velvet sponge as far as they can introduce it.

Another reason is that after every emission on the part of the male they take a profuse injection of ice cold water, or hot water strongly impregnated with carbolic acid; the efficacy in both injections being due to the washing away of semen; injections taken in sitting posture thus favoring exit of semen by gravitation.

Again, many prostitutes insist upon their paramours practicing onanism, thus furnishing another reason. On the other hand a percentage of prostitutes do conceive, and render aid thereby in filling up the foundling asylums and baby farms" that stand ready with open arms to receive them.

RETAINED PLACENTA.

I cannot see how the question regarding removing placenta within a reasonable time can admit of any argument. We all know that of all sources of post-partum hemorrhage, a retained placenta would naturally be the principal cause, and as to puerperal septicemia, the retained particles of placenta of large or small size is the prime cause of all causes. Then what should be done by the accoucheur? Always follow the uterus down with his own hand, or that of an assistant, as the child is expelled, and never leave the uterus without a hand gently kneading the same until child, placenta, secundines and clots are all expelled, and the uterus is contracted as hard as a cricket ball. I

have anticipated a little by persistence in this kneading after the child is born. The uterus is stimulated to contract on the placenta and by a continuance of this slightly modified, you have Crede's method, and as a rule the placenta is expelled by this method with a little assist ance by the introduction of two fingers to roll up placenta to overcome the vacuum that is often present. Now no hurry is necessary as a rule about removing in the above manner, but if, after 15 or 20 minutes, application of Crede's method, the placenta is still not delivered, I would certainly allow the patient a few drops of chloroform and introduce the hand carefully, properly, and remove placenta. If this procedure under chloroform is "brutal," as some see fit to term it, what would allowing the placenta to remain, perhaps to induce exsanguination, or puerperal fever, and perhaps in either case death, be termed? The above has always been my method as taught by my teacher, the late lamented Prof. E. S Dunster, of Ann Arbor, Mich., and I have never lost a mother yet, or had a severe case of post-partum hemorrhage; neither do I expect to have hemorrhage, or lose a mother from this cause. If I left the

placenta I should be in hot water all the time.

North Berwick, Me. F. B. MORRILL, M.D.

[We regard this letter as a model one in form -the author has given it the title, sub-titles to the different subjects as they occur, and signature and post-office address at the proper place. We wish it were the custom for correspondents to do this.-ED.

Heat the glycerine, and add the oils, stirring constantly until thoroughly mixed; pour in bottle, add the alcohol and shake well. This

is one of the best preparations that I have ever used for croup of any kind, coughs, colds, sore throat, etc. When we hear the characteristic hoarse, piping cough of a child, we put one or two drops of the liniment on a little sugar and give the patient, to be dissolved in the mouth and swallowed slowly. This may be repeated from every half hour to every two or three hours, according to the urgency of the case. No danger in it, as if he gets too much of it he will throw it up. We would also mix a teaspoonful of it with a tablespoonful of lard, and apply it freely to the larynx and upper part of the thorax. My wife could not sleep well without this liniment in the house, for she knows full well by experience that it is opposed to croup. It will be found useful in most all kinds of coughs, added to simple syrup. There is an irritable condition of the stomach shown by reddened tip and edges of tongue, where it would not be best to give it internally, as it would increase the stomach trouble and would not be retained. In that case I would mix it with lard, and apply to the thorax, and expect it to relieve the cough. Brothers, those of you who have not used this liniment would do well to try it. J. G. ELLIS, M. D.

Cerro Gordo, Ill.

would suggest the persistent use of pill aloin, belladonna and strychnia (aloin gr., ext. bell. gr., strychnia gr.), one to three pills daily as may be necessary, gradually diminishing the number as the intestinal muscles gain tone.

I have been through the list of remedies for constipation in my own case, and that of many others, and this beats them all. I use thousands of these pills every year. If these fail, however, I would further suggest :

R Fl. ext. cascara sagrada.
Tint. gentian comp.
Syrup simp.

....

Misce. Signa.-Half teaspoonful before food, morning and night. Dose to be increased or diminished, as required,

Of course, the matter of diet needs attention, as any medication can be materially assisted or retarded by it.

I quite agree with Dr. C. G. Slagle, February WORLD, page 66, in regard to sodium sulphite in diphtheria. For the past ten years or more I have hardly used anything else locally in diphtheria, and also in follicular tonsillitis. For application with brush I use: R Sodii sulphitis.

Glycerinæ...

Aquæ rosa.

Aquæ dest., q. s. ft.

MONOTON

ss

SS

ろり

リ

Misce. Signa.-Apply with brush every hour or two. For gargle or atomizer, to a cup of water add

a teaspoonful of glycerine and two teaspoonfuls of sulphite of sodium. The glycerine aids in I think there is making a clear solution. nothing better than this applied with an atomizer when the membrane has invaded the trachea. I find the above formula, applied with brush, is disinfectant, and rapidly dissolves the false membrane without irritation. Somerville, Mass. E. A. SANBORN, M.D.

Camphor Poisoning.

Editor MEDICAL World: Noticing an article under the above title in a a recent number of the THE WORLD, brings to mind a case that came under my observation

attend a boy, a child of about three years of age. Upon my arrival I found the little fellow in a complete stupor, from which he could not be aroused. His head was rigidly drawn over the left shoulder, and the eyes as rigidly fixed in the same direction, so much so that I could not see the pupils. A mild convulsive tremor shook his little frame at regular intervals. The parents, who had been out at a neighbor's, could not give me a particle of information.

In examining the mouth I thought I detected the odor of camphor. I at once forced the child's mouth open and brought my nose close to it, and found each expiration loaded with the peculiar odor of camphor. I at once concluded that the little patient had swallowed a quantity of that drug.

Mustard and tepid water was immediately given copiously, and I had the satisfaction in a few moments of seeing about a dozen pieces of camphor gum vomited up, about the size of an ordinary pea. In the course of half an hour the little chap was out of danger.

Then, upon making inquiries, a little brother who had been left alone with the patient, and who was a couple of years older, confessed to having "played doctor," and forced the little fellow to swallow "pills," as he expressed it.

The parents had been using a mixture of whiskey and camphor until the liquid had been all drained off, leaving a large quantity of undissolved gum, and this had been carelessly left in reach of the youngsters with the above result. What forcibly struck me was the peculiar position of the eyes and head, with the mild convulsions.

And a most common peculiarity about it is, that I never received a cent for saving the little fellow's life.

Gravenhurst, Ont. A. P. CORNELL, M.D.

Why Don't Prostitutes Conceive?—Quick Cure for Black Eye.

Editor MEDICAL WORLD:

In answer to the question: "Why don't prostitutes conceive? page 53, February WORLD, I would say, they do conceive, and often go to full term. After sexual intercourse they almost invarably wash out the vagina, by the aid of a syringe, which would account in a great measure for those who do not conceive.

In answer to the query of Dr. Douglas, I would say that raw beef applied to the black eye is the quickest method of curing it I have ever tried.

I think "The Chart of Skin Diseases," and "The Urine in Disease" are excellent, and Drs. Lewis and Taylor deserve the thanks of

Why Do Not Prostitutes Conceive? Editor MEDICAL WORLD:

This is variously accounted for by the laity and the profession. First, it is said that few women serve long apprenticeships to the trade without having gonorrhea one or more times. Second, it is averred that frequent and often violent connection with different men produces a low form of inflammation, which proves inimical to conception, either through exciting uterine discharge, which is destructive to the spermatoza, or the mucous membrane of the uterus offers no lodgment to the impregnated

The same explanation applies to the cases in which gonorrhea is held responsible for the condition of barrenness.

Another theory of conception-for it cannot be regarded in a higher light as yet is, that the male element reaches the uterine cavity by a sort of suction process, excited by the sexual orgasm. This theory would fail to account for many pregnancies in the view that Dr. Waugh takes of at least fifty per cent. of women not having or experiencing the orgasm at all. Just what prostitutes lack in this theory I can only guess at; but it is probable that either the uterus fails to respond to the repeated demands or the chronically inflamed mucous membrane, fails to furnish suitable soil for the attachment of the egg.

The theory to which many attach their belief, is that the uterine cavity being in nearly its entire extent lined with ciliated epithelium, this hair-like surface waves or sweeps the male element into the uterus by the undulating motion peculiar to that variety of mucous covering. Anything that would injure temporarily or permanently that lining would interrupt for a time or forever the union of the two elements of the sexes and their attachment, which constitutes conception.

There is a popular notion, which is also satisfactory to many medical men, that the semen reaches the uterine cavity by the male organ so meeting the os uteri as to form a continuous canal, and the force of ejaculation acts as the propulsive power. This theory is bosh. The almost countless means employed to prevent conception show conclusively that there is a very great diversity of opinion as to how it really is accomplished.

The explanation of barrenness in prostitutes would, on the suction theory, be that there being no orgasm there would be no suction. To my way of thinking the best explanation we

have is this: Inability to conceive results from any abuse of the sexual organs, whereby a specific or chronic inflammation is set up, which changes the nature, secretions and functions of the mucous lining of the uterine cavity.

I have in mind now a woman who for a number of years was a muscular prostitute, and who painted the town red at irregular intervals for years. By and by she settled down, reformed and married, and bore her husband several children after the lapse of a few years. Clearly in this case the causes that produced barrenness had ceased to operate and the parts resumed the normal condition, and then conception was possible. Old soldiers in the wars of love after a time lose all power of regaining sexual vigor; hence the great majority of prostitutes fail to conceive even after reformation. It seems passing strange that the theories of conception have so multiplied and the true solution be so slow in making its appearance. J. A. DE ARMOND, M. D.

Le Claire, Iowa. [Other interesting letters on this subject next month.-ED.]

Cascara Sagrada.

Editor MEDICAL WORLD:

66

I notice an article in the Medical Summary of November, 1888, from the pen of James M. Hale, Salem, Ohio, with regard to the effect of cascara sagrada in rheumatism. The glowing account of its virtues as reported by the doctor, and the unusual age of the patients upon whom he tried it with such unvaried success, almost challenges credulity. The cases as reported by the doctor were: First, a Mr. Bonsell, aged 68, with rheumatism so bad he could not rest, or walk without a cane or crutch. After taking ten drops every 6 hours for 48 hours was much relieved. His bowels being too active, reduced to 5 drops. He says he is entirely well. Second case, Mr. Tilson, aged 72, troubled so much with ankles and feet could not stand. Gave him 1⁄2 oz. to take in doses as above. In a week came to my office, said he was better than for two years, and began to dance. The other two were old ladies, 62 and 70 years, who were worse than the other two. Gave them 6 drops, three times a day, with same results." He says he has treated ten cases in all, and with greater success than he ever did ague with quinine.

Having some cases of rheumatism on hand, I thought I would try and discover whether this report was a Munchhausenism, or the remedy a fountain of youth. The first case, I tried it on Mr. K., aged about 45 years. I gave him due warning about the abominable taste of the stuff, and the longing, lingering farewell

it took of the fauces; also that an objection to its flavor was no sign of an idiosyncrasy or fastidiousness of taste. I also suggested to try and mask the taste if possible, but he said he could take anything in the line of medicine; so I left some of the cascara, with directions to take ten drops every 6 hours; also, "if he had tears to shed to prepare to shed them." The person that gave him the medicine said he took it bravely, smacked his lips like an epicure, but very suddenly turned his face to the wall. Next day he was reported a great deal better. Have heard nothing from him since.

My next trial was on a Mr. A., troubled with myalgic rheumatism and constipation. I prescribed:

R F. E. cascara sagrada. Elix. simplis...

3V

S.-Teaspoonful just before meals. If too much catharsis, reduce.

He reported better; catharsis considerable, had to reduce one-half.

My next case was a slight rheumatism with disuria and a heavy sediment in the urine. The sediment under the microscope showed to be lithic acid crystals and amorphous urates. I thought I would try cascara, and watch the effect upon the urine, if any. The rheumatism subsided in one day, and the deposit disappeared in two. Whether this was cause and effect or a mere coincidence I cannot say, the test not being sufficient. Not having patients enough of this kind to make a fair test of cascara, I thought I would report this in THE WORLD, with request that other physicians having similar cases would test, and report through THE WORLD their success.

Being troubled with rheumatism, I thought I would try the success of cascara upon myself. I therefore commenced with ten drops (which I put in capsules, a very good way to get round the farewell taste of it) every 6 hours. Shortly after taking the third dose, I felt its effects very forcibly. While it did not rejuvenate, it made me quite lively; and instead of producing a wish to dance, like the case reported by the doctor, it brought up an irresistible desire to run. This is a condition that is not wanted, for the remedy is not supposed to act in rheumatism through its catharsis. To avoid its purging I think the better plan would be to commence with small doses and increase them till they regulate the condition of the bowels, and hold it at that. As the time of the year has come that will give us more trouble with rheumatism and urinary derangements, the physicians will have better opportunities to test the medical virtue of cascara