Peculiar Result of a Wound. Editor MEDICAL WORLD: I have a case to report that might prove of some interest to the profession. A man during the civil war was struck with a piece of shell about 4 inch below the infra orbital foramen in the soft parts at the same time the canine tooth of the same side was struck and made it slightly loose. The sore refused to heal and assumed the appearance of a slow epithelial cancer, and remained so until a few weeks since, when the tooth became very loose and he had it extracted. The result was the cancer (?) healed and the man is now well. What will successfully prevent the "ringing in the ears," caused by the administration of quinine, and and not interfere with its therapeutical effects? Clay, Ky. R. L. HARDWICK. For Gastralgia. Editor MEDICAL WORLD: I would advise H. C. Simpson, M.D., of Modoc, Randolph Co., Ill., first to be very regular about his meals, as regards time, and very particular in the selection of articles of food, as he has undoubtedly learned already what agrees with him best; second, would advise one teaspoonful of granulated phosphate of soda in half a tumblerful of hot water before each meal, and two or three tablet triturates of nux and pepsin after meals. Would apply over epigastric region iodide of mercury ointment, and cover with oiled silk; this can be attached to his wrapper with safety-pins and wear it constantly. Also, use electricity daily, or on alternate days. Punctuality in regard to the daily evacuation of the bowels is also very essential in effecting We have had so much trouble lately with careless manuscript that we wish to give notice that we will not hereafter hand to the printers manuscript that is not written reasonably plainly. It is not given to all to be able to write an ornamental hand, but any one who has brains enough to be a competent physician can write a plain hand if he will only try. Remember you are not writing to an intimate friend, who is familiar with your chirography, and on ordinary every-day topics, but to a printer, an entire stranger, and using technical, professional words and phrases, which must be plainly written and not abbreviated in order that any one may know what you mean. are unwilling to submit our readers to the uncertainty of such work. What is worth writing at all is worth writing well. We are perfectly willing to correct errors of language, but not to take the responsibility of determining what you meant to say. We We desire to make the proper correction and to extend apologies to Dr. D. C. Hewson, of Orange, Texas. In his article, on page 67 of February WORLD, the dose is properly a teaspoonful as he stated. Editor MEDICAL WORLD: The index comports with all your other work. It is first class in every particular. CALVIN D. VILAS, M. D. Editor MEDICAL WORLD: Dr. S. S. Gentry ask for a good remedy in Lake City, Minn. Electro-Therapeutical Department. DR. W. H. WALLING, 1411 Arch Street, Philadelphia, Editor. Cases, questions or views upon electricity in medicine are invited. [Letters should be addressed to Dr. Walling, separate from any letter to the business department.] In order to render this department still more useful to the patrons of THE WORLD, the Editor, Dr. Walling, will personally answer any inquiry regarding batteries or instruments, giving advice as to mode of operating, etc. He will also select and forward, at manufacturers' regular retail prices, anything that may be wanted by the great army of WORLD readers. Every battery sent out will be thoroughly tested, and all instruments carefully inspected, so as to guarantee satisfaction. If you have a preference, state it. Always enclose stamp for reply. Primary and Secondary Currents. Editor MEDICAL WORLD: I am a constant reader of the MEDICAL WORLD, which I consider a marvel for the money, and in the March number I notice an inquiry from Dr. Thos. Hermann, p. 121, concerning an article of mine in your October, '88, number, on electricity in gynecology. As the point he raises is an important one, I take pleasure in answering him. There are two currents in every Faradic machine, the primary coming from the carbon of the battery, rushing through the stationary coil of coarse wire and back into the zinc. This is a galvanic current, interrupted, but of so small an electro motive force that it is of no practical value and is therefore never used for purposes of electrolysis, while as an interrupted current its effects are harsh and inferior to those of the induced current. The current set up by induction in a coil of wire placed near or around the primary wire, but in no way connected with it, is called the secondary or induced current and is the one employed under the name of Faradism. The effect obtained from this secondary current varies considerably, as I have pointed out in the article referred to, according to the fineness and length, or the thickness and shortness of the wire. If coarse and short and the interruption slow, we obtain powerful contraction of muscular fibres, whether voluntary or involuntary, situated at or near the poles; while if the wire is thin and long and the interruptions rapid, we obtain a remarkably sedative action on the sensory nerves. Instead, therefore, of having this secondary coil made in a piece with the primary one, I would recommend your correspondent to tell his electrician to make two distinct secondary coils of the above kind, so that he can slip whichever one he likes over the primary coil, and to attach a fast and slow interrupter, for the reasons stated in my paper. (Amer. Journ. Obstet., June '88.) At an outlay of a dollar or two more a few extra coils of different sizes could be procured, with which your cor respondent could carry out some original investigations, the result of which would be welcomed by the profession. Trusting that I have made my answer clear, I remain, etc., A. LAPTHORN SMITH, MD, Pres. Electr. Soc. of Canada. Montreal, March 5, 1889. Excessive Sweating of Hands and Feet.- This condition we believe to be of neurotic origin, and must be treated accordingly. The peculiar microbe found in connection with bromidrosis is not, in our opinion, the cause of the disease, but rather one of the results, so that whilst we must disinfect thoroughly and continuously, disinfection alone will not cure this most obstinate and troublesome affection. For Dr. Minnich's case we would suggest the following treatment: A hot foot bath every night, and after drying the feet, wet them well with a solution of boric acid letting it dry on, changing the stockings every day; the stockings, by the way, should be of soft woolen, especially in winter, and every other night use Faradism to the hands and feet by placing the positive pole in the foot and hand bath by a double cord, with the negative about the waist (see Feb. WORLD, pages 80-81), with ten to fifteen minute sittings, using a pleasant current. Give strychnia for its central, and atropia for its peripheral action upon the nervous system. Frequent general bathing should be enforced, the diet and habits carefully regulated, and everything avoided that tends to lower vitality. The same general plan may be followed for sweating of the genitals by immersing them in a bowl of water, to which is attached one positive cord. They may also be dusted with a powder containing powdered boric acid, French chalk, etc. Such a powder might also be used for the feet if thought best.-W.H.W. Faradism in Congestion and Obstruction of the Liver. For Dr. Leh's case, given on another page, we would further recommend the following, viz: Seat the patient upon a well wetted sponge connected with the negative pole of a Faradic battery. For the positive use a small carbon or metal electrode say one half inch in diameter, of course attached to a suitable handle, and the point covered with a little absorbent cotton well wetted, and work the point well up under the floating ribs, about three and a half to four inches from the umbilicus, pressing firmly in and then turn on as strong a current as the patient will comfortably bear; then increase and decrease it by the sliding rod of the machine and, as the patient becomes a little accustomed to it, interrupt the current sharply a few times. A very strong current can be borne in this way, without affecting the muscles; as the electrode is worked in between them we get as near the gall bladder as possible, and the whole organ is acted upon, the effect being apparent in the next stool. A pleasanter and easier method is by the belt-electrode, described on page So of the Feb. WORLD; modifying it to suit the case. W. H. W. Vomiting of Pregnancy, Electricity for. Dr. Adolph Günther, in the Lancet, mentions five cases in which he found electricity of the greatest service. In none of them could any pathological condition of the uterus or its appendages be detected. Four of the cases were primiparæ. The remaining case was that of a woman who had had two confinements previously; in her first pregnancy she had suffered from sickness, but not in the second; in the earlier months of the latter, however, she had suffered from severe pruritus of the thighs. Some improvement only was obtainable by regulating the diet; but this was not of any long duration. Narcotics had only a temporary effect. In the absence of pathological indications, we must seek for the explanation of the vomiting in the reflex action between the uterine and the gastric nervous supplies, just as the tonsils are enlarged in asthma, because of the relation of the cranial and gastric nerves. The female genital organs may be considered as related to other parts of the body from a vasomotor point of view, and the occurrence of vomiting is probably sometimes to be explained from a consideration of that circumstance. a severe case a definite degree of sensitiveness is present, and he believes that there is a functional neuralgia of a reflex nature. In He applied the anode of a constant current in the form of a sponge, in a metal case covered with rubber, to the cervix. The cathode was a plate about four inches by five inches. This was applied over the spine, between the eighth and twelfth dorsal vertebra. It is important to see that the current is not intermittent, and to use only one of low strength. He commenced with two and a half to three milliamperes, and never increased the strength higher than five milliamperes. Each sitting lasted from seven to ten minutes. The vomiting ceased in four days, at the most, in all the As some degree of nausea remained, the treatment was continued for some weeks.— Archives of Gynecology, etc. cases. [We presume the Dr. used a well wetted cotton pad under the (cathodal) negative plate. ED.] Electricity in Dysmenorrhea. Editor MEDICAL WORLD: A lady, thirty years old, married four years, no children, health and appetite good, bowels regular, has been suffering with dysmenorrhea for six years. For a week previous to the appearance of the menses, she is nervous, don't sleep at night and vomits her supper almost every day. Three or four hours after the flowing is established, she is taken with strong expulsive pains as in labor; these last for a couple of hours with intervals of four or five minutes. She has frequent spells of vomiting whica relieves her. There is great sensitiveness of the vagina, the os uteri is rather hard, size normal. She has leucorrhea, and there is some anteversion. Menstruation often appears one week too soon or too late. Five weeks ago she applied to me for treatment. I put her under electricity, as it was the only thing she had not tried, she said. I applied to the os uteri the uterine electrode attached to the positive pole of a galvanic batsometimes to the feet every other day. General tery, and the negative to the lumbar region, Faradization in the interval. I used five to ten cells for twenty minutes. The 17th her menses appeared four days late. She had considerable pain, and I felt somewhat disappointed, as I thought there ought to have been more improvement; she seemed to be satisfied, however. Shall I continue the same treatment? I have noticed that after applying the continuous current the leucorrhea always increases, yet I have seen it recommended in this trouble by some authors. Are you in favor of using salt in the water to wet the electrodes with ? Some advise itothers do not. It seems to increase the current R. CHAREST, M.D. a good deal. St. Cloud, Minn. [ANS.-If you make intra-uterine applications of galvanism, use the negative pole internally; the positive pole is hemoastatic in its action, and would be contra-indicated here. We would suggest the following mode of applying galvanism: Commencing about two weeks before the expected period, apply the current through the abdomen by placing upon it a thick pad of absorbent cotton well wetted -say six by eight inches in size-covered by a metal plate, to which attach the negative pole of the battery. Place a similar pad over the lumbar region -the patient being recumbent-connected with the positive pole, completing the circuit with the battery at zero, and gradually turn on as much current as the patient will bear, say from thirty to fifty milliamperes, continue for from three to five minutes, and as gradually reduce. Make two or three applications per week. The increase of the leucorrhea noted was probably due to the action of the positive electrode for twenty minutes at a time. When the positive pole is used in contact with mucous surfaces the electrode should be made of either patinum or gold, these metals not being decomposed by the acids which collect at this pole. Salt added to the water renders it a better conductor, which accounts for the seeming increase in the strength of the current.-ED.] Editor MEDICAL WORLD: I would like the opinion of the readers of the WORLD in regard to a patient who has been suffering from partial loss of sensation in both. hands since last Oct., unable to button the dress, the shoes, to comb her hair, or to do anything that requires a complicated movement of muscles. Cannot feel a needle or pin when between the fingers. The patient, a woman of 52 years, of delicate constitution, suffered some years ago from atresia of the vagina. For the last few months she has gained in flesh, due to a less active life than formerly. Would like suggestions as to treatment. Bryan, Ohio. S. BELLE CRAVER, M. D. [Will the doctor please give us more of the history of this case. Is there any heridity, or specific taint? Has she pain as in ataxia, or is there any tumor that could cause the symptoms? Also whether the trouble came on slowly or otherwise. We suggest faradism, placing the negative sponge below the occiput, and applying the positive over the anesthetic area by the wire brush, using increasing currents. Franklin's would perhaps be preferable, but is not generally available.-ED.] Treatment for Goitre. Editor MEDICAL WORLD: Please give me the electrical treatment for be slow, and the needle operation may be necessary. Electrolysis properly performed is perfectly safe. Yet we do not advise it except by operators of at least some experience. Measure the neck and note from time to time the change in size, if any, for in the later stages of treatment the reduction is very slow indeed; and please report progress.-ED.] Electricity in the Diseases of Women, by G. Betton Massey, M. D., physician to the Nervous Department of the Howard Hospital; late Electrotherapeutist to the Orthopedic Hospital, etc., etc. Cloth, 210 pp. Price 1.50. F. A. Davis, Publisher, Phila. This little book by Dr. Massey is a yery timely addi tion to electro-medical and surgical literature, dealing, as it does with the practical side of the question, giving the results of treatment and the methods employed without dwelling too much upon mere theory. This might well be called the "Spaying Age." Ovariotomy has been performed in hundreds of cases where no relief from the distressing symptoms was obtained, the lives of the patients being needlessly put in jeopardy. The profession is awakening to the fact that we have in electricity a safe, and in a great many cases a certain remedy for the serious diseases peculiar to women. Where old methods fail, these new ones step in and restore the patients, and we are thoroughly convinced that before resorting to the acknowledged danger of anasthetics and the knife, electricity should be given a fair trial; and the author has given explicit directions how to proceed, describing instruments and appliances, and reporting in full various diseases successfully treated, such as amenorrhoea, dysmenorrhea, menorrhagia uterine fibroids, displacements, endometritis, etc., etc. As to the results thus set forth by the author, we may say that having been associated with him for the last two months at the Pennsylvania Hospital, we can certify from personal observation to the good results in many of these cases. We earnestly commend the book to our readers as a most excellent treatise upon a very interesting subject by a practical and successful worker. There is one thing, however, which we would impress upon every reader of this valuable little work, who is not familiar with electrical applications, and that is not to attempt intra-uterine treatment too hastily. It all seems so simple and easy that almost any one could do it, and so they might, but they might also do infinite harm through ignorance or carelessness, or both. In all cases begin with low powers and work up as experience is gained, or results justify. THE MEDICAL WORLD of Philadelphia deserves well for issuing a most convenient pocket edition of American [Ans. The safest method is by applying hospital formule for ready reference. galvanism directly to the tumor, using well wetted electrodes, the direction of the current being immaterial. Use ten to fifteen cells, five to ten milleamperes, with daily sittings of from five to fifteen minutes. If the tumor is soft in character it will probably yield quite rapidly at first. If hard and dense the reduction, as in all hard growths, will Their visiting sections (removable each month) and ledger for monthly balances is captivating to the man who is a laggard at book-keeping or too engaged to give time to posting his work-indispensable and cheap.Medical Chips. THE MEDICAL WORLD is the only medical journal in the United States having a department of ElectroTherapeutics. Readers say this department alone is worth more than the yearly subscription price. Quiz Column. 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 necessary 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. The article on Sulphide of Arsenic in February WORLD has attracted wide attention. Dr. Lewis kindly gave of his own private supply to the many who inquired about the drug, to make a test. Many letters have been received from these cofirming the beneficial effects as set forth in the article. A report of these will be made next month. The number of requests for the drug has become so great that Dr. Lewis fiuds it necessary to make a charge of one dollar for 200 tablets of one thirtieth grain each. Address, Louis LEWIS, M.D., 36 North 19h St., Phila, Pa. We are pleased to acknowledge the receipt of a fine cabinet photograph of Elmore Palmer, M.D. (class of 1864, University of Michigan), Buffalo, N. Y., and of H. E. Stroud, M. D., of Oceanside, Cal. We have heard it said in very reliable circles that excision of a boy's tonsils in early childhood is always followed by sterility in manhood. Have our readers had their attention directed to this subject? Brief reports, with reference to as many as possible of actual cases supporting either side, will go far towards settling an important question. Dr. S. H. Cowden, of Morrillton, Ark., wishes the experience of any one who has used saw palmetto in gleet. Dr. H. E. Stroud, Oceanside, Cal., will give a prize of five dollars for the simplest, quickest and least harmful treatment of gonorrhea. Bromide of Lithium in Rheumatism. In reply to a correspondent from Union, N. Y., the dose of bromide of lithium varies from gr. ij to gr. x. Gr. v three times a day would be a suitable commencing dose in the treatment of chronic rheumatism. It may be given in combination with other drugs, or alone in water, syrup, or milk. Silver Poisoning from Hair-Dye. A subscriber asks the probable effect on the constitution, if a dye containing nitrate of sil. ver be used for a long period on the hair and whiskers. The constitutional effects of chronic nitrate of silver poisoning are progressive loss of ap petite, albuminous urine, faulty nutrition, palpitation, and a dark purple mark on the gums and nails, caused by deposit of the reduced metal. Later on, deposit is made in the true skin, which becomes general all over the body; and the kidneys, liver, and heart become the seats of fatty degeneration. Many of these effects, especially the minor ones, have been observed in those who habitually use poisonous hair dyes, nitrate of silver being their most frequent ingredient. One of our subscribers has written to us describing the apparently disastrous results of bleeding as practiced by him on an old man in a case of uremia. He draws attention to the fact that bleeding is yet mentioned among other modes of treatment, in Dr. Lewis' chart on the varieties of insensibility. It is questionable if this treatment would be advisable where the patient is old and feeble, but high authorities sanction and advise its employment in certain cases; and the chart is intended to include all means of treatment, leav. ing the practitioner to fit his remedy to the exigencies of the case. Tonsilitic Concretions. Offensive breath. Treatment for Burning Feet. Editor MEDICAL WORLD: When pressed upon Miss M., aged 30, has for years been troubled with the formation of calcareous concretions in the tonsils, which work their way to the surface. When they first break through the surface the odor is very offensive. pus sometimes runs from the opening. At times several can be seen at once partly out, and cause attacks of coughing, and sometimes vomiting. When they are removed the irritation passes away. The left tonsil is completely atrophied, and the right is following. Yet the formation continues in both. Patient has post nasal catarrh, otherwise healthy, but rather spare, perhaps as fleshy as mother or sisters. |