Comparison of Professional Fees. an able editorial, says the following: have begun to decline. For their benefit we The Pacific Medical Journal in the course of give below what have been generally accepted as the standard adult dose of many of the alkaloids, corresponding to an average dose of the crude drug. Why a lawyer should be paid 500 per cent. more than a doctor for doing 500 times as little work, we suppose is entirely owing to the fact that the lawyer is that much more capable of taking care of his own interests. Exactly why the secular press of this country should take the same view of the case is a mystery. A case in point. The daily papers at the present time are congratulating ex-President Harrison upon receiving a fee of $25,000 for four hours work in court; had a medical man of equal or more ability than Mr. Harrison charged a many times millionaire $5,000 for a month's constant attention, the whole press would be charging him with robbery -a man to be avoided when you are sick, etc. Another case in point. Judge Levy, of this city, has just allowed a firm of attorneys a fee of $80,000 for looking after the routine business of an estate for a few months, and yet this very same judge refused to allow a fee of $30,000 which a medical man had presented for many month's attendance on a millionaire and his family. The actual work was probably 100 times more than that performed by the attorney who received $80,000; while the responsibility was probably 500 times more, yet his Honor, Judge Levy, saw fit to cut the doctor's fee down to $10,000. And why? [The pages of THE MEDICAL WORLD are open to Judge Levy, of California, or any reputable judge or attorney, to explain if possible, why these discriminations should be made.-ED.] The Dosage of Alkaloids and Other Active So many questions come to us as to what is the required dose of each of the alkaloids, etc., that we wish to make as full a statement as possible of the principles upon which these drugs are properly administered. The idea of a standard adult dose, to secure a full effect, is not a logi. cal one, as what is a light dose for one patient I would be a full dose for another one. The scientific method is to give the minimum dose, usually that contained in one granule or other similar preparation, and repeat it at short intervals until the desired effect is observed, then lengthen the intervals to maintain that effect. Thus no more medicine is given than is needed and the patient does not get an overwhelming effect at any time. However, many do not wish to give the repeated small doses, but wish to give what may be taken as a standard full dose, repeating at longer intervals or when its effects 1 1 Aconitine, grain T Morphine, grain to, 1 Daturine, grain TOO, Duboisine, grain, Emetine, as expectorant, grain as emetic, grain. Gelseminine grain 1 1009 Hyoscine hydrobromate, grain 166 29 These active principles may be given in solution, using due mathamatical precision as to the amount of the drug contained in each drop or teaspoonful of the solution; but we have found it far more convenient, accurate and economical to administer them in carefully prepared granules or other similar preparations, giving the number required by multiplication to make the desired amount of the drug. The Course of Bullets Some people seem to think that a small bullet at very high speed will pierce the tissues of the body without doing much general damage. This, however, is erroneous. The bullet hurries forward with it particles of the substance through which it is passing and thus practically becomes a larger projectile. If a bullet be fired through a book, it cuts out disks of increasing diameter as it traverses the pages. Hence, too, it is plain that the greater the sectional area the greater the damage. As to the heating of the bullet, it has certainly been much exaggerated, and its effects, if indeed it has any, may be safely neglected. The physical constitution of a body has a most important bearing upon a bullet entering it. Why does a bullet of certain size and travelling at a certain rate simply perforate some substances, such as wood or iron, while in others, such as clay, brain, etc., it exercises a bursting and disruptive action? The answer is quite simple: the destructive effects vary directly as the viscosity of the body. This was established by remarkable researches on the effects of bullets on soft tissues made by Huguier after he had observed the results of the wounds inflicted in the fighting in Paris in 1848. suggested, from observations made on certain dead organs, such as lung, that the reason of the great lateral disturbance was that the tissues contained water in large quanity, and that the energy of the moving projectile being imparted to the particles of water caused the dispersion of these in a hydrodynamic fashion. This suggestion was shown to be correct by Kocher in 1874-1876. If a shot be fired through two tin canisters of equal size, the one full of dry lint and the other of wet, it will simply perforate the former, but cause the latter to burst explo. sively. In the same way shots fired into dough have more or less disruptive effect according to the percentage of water in the dough; and in general the more fluid the substance the greater the destruction. Now, in life the brain is a more or less fluid body, though in a state of rigor mortis it is practically a solid owing to coagulation of the blood and protoplasm. Hence, a shot fired into the skull must have a disruptive effect and tend to burst it. From a paper read by Prof. Victor Horsley before the Royal Institution. Two New Uses for Bichloride of Mercury. We notice the following two interesting items in the Medical Summary: How to Arrest a Boil, Carbuncle or Malignant Pustule. Dr. P. C. Barker writes that he has used the following procedure for several years, with unvarying success. Take a large hypodermic syringe, holding, say, half an ounce, fitted with a small needle. Fill it with a 1 to 500 solution of mercuric chloride, insert the needle into one of the peripheral openings, in case it is a carbuncle, and wash out the little cavity. Then direct the needle towards and into the surrounding induration and force a little of the solution into it. Treat every opening and its correspond. ing peripheral circumference in the same manner, carefully washing out the necrosed connective and other tissues that have become separated. Repeat this daily with the solution, gradually reduced to one-half the original strength, until all induration has disappeared and granulations have begun to appear. If the first injection be thoroughly performed the spread of the carbuncle will be arrested at once, and there will be no more pain. Washing out the little cavities is painless, but the injection into the indurated tissues is not free from pain. The same treat ment is applicable to the little furuncles that invade the meatus auditorius externus, and the inner surface of the alæ nasi. To Abort Syphilis. Bichloride of mercury (10 grains to ounces j), painted on a chancre as soon as it appears, kills all specific germs, and there will be no systemic manifestation. Then you only have a local sore to heal. Lotion of Resorcin for Seborrhea of the Scalp. Dr. Kate W. Baldwin, in the Philadelphia Polyclinic, recognizing the inconvenience and inefficiency of ointments in the treatment of diseased conditions of the scalp, relates her excellent success in treating seborrhea with lotions of resorcin. Many of her cases were of the very worst kind, yet success followed the treatment. The following is an extract from her article : "The fifty cases have been taken from private and dispensary practice, ranging from seven to sixty seven years of age, from all classes and conditions of society. The diseased conditions covering simple seborrhea, with pruritis and falling of the hair, also the most ag gravated cases of seborrheic eczema, with thick, oily crusts literally covering the scalp, and in several cases extending to the forehead and into the eyebrows. "Resorcin stimulates the glands and hair follicles, and markedly increases the growth of hair. It is also an odorless, powerful antiseptic, germicide and exfoliative, readily soluble in water or any strength of alcohol, and so seems particularly adapted to this class of cases, and has been used in each and all of the fifty cases, to the exclusion of all other medicamenta, except as adjuvants or excipients. It may be used in a simple aqueous or alcoholic solution. My standard formula is: "This was varied to suit the particular case, never having increased the amount of resorcin. In a few cases, where the surface was very dry, I have added ten to fifteen drops of olive oil to the four ounce mixture, but it should be thoroughly emulsified, otherwise it is better left out. "According to the case, the lotion should be used once, twice, or three times a week. In very bad cases, every day for a week, and then less frequently. It should be applied directly to the scalp, and not to the hair. This may be accomplished by parting the hair, section after section, and using the solution on a tiny bit of absorbent cotton, the smaller the better. It should be thoroughly rubbed into the scalp un til every bit of the diseased portion is covered, this followed by a brisk, dry shampoo, continued for from two to ten minutes. "In two or three days nearly all of the accumulated necrosed epithelium will be loosened, so that it may be removed with the fine portion of an ordinary dressing comb and brush (it is better not to use the regulation fine tooth comb). In any ordinary case this treatment, thoroughly carried out for from two to four weeks, will put the scalp in a good condition. "In cases where there is much crusting, particularly the thick, oily crusts, the treatment should commence with a thorough shampoo with sapo viridis, adding just enough water to make a lather, followed by sufficient clear water to free the hair from all suds. When dry, apply the resorcin.” New Treatment of Sea-Sickness. soning which have resulted from snake-bites, or from the wounds of poisoned arrows. To enable him to properly prepare himself as a qualified poison physician, the following procedure is adopted: He secretes under the article of fur, which constitutes his only clothing, a poisonous scorpion, to whose stings he freely exposes himself. After the reaction resulting from the first sting is accomplished, another sting is accepted, and when the effect of this is over, a third and a fourth, and so on until the body becomes perfectly insensible to the stings of a single scorpion; then he exposes himself to the stings of two in the same manner. then three, and more scorpions, until at last the body seems utterly unaffected by such poison. Advancing further in his preparation, the poison doctor hardens his body in like manner against the bites of a peculiar webless spider which lives in holes, then in like manner against the bites of the crown serpent. And lastly, to complete the charm or invulnerability against poison, he submits to the bites of the puff-adder. All these preliminaries having been faithfully carried out, the poison doctor is ready to begin the exercise of his art. From time to time, however, he must renew the strength of his healing properties and sustain his reputation as a poison doctor by re-exposing himself to To these bites. Dr. W. N. Skinner, who has had much experience as a surgeon on transatlantic steamers, says (N. Y. Med. Journal, Dec. 9, 16, 23 and 30, 1893,) that after having studied the symptoms of naupathia in their completeness, he is convinced that they are due, above all, to the lowering of the blood pressure, and that this lowering depends upon a paresis of the centers of innervation of the heart and arteries. counteract this he uses a solution of atropine and strychnine hypodermically. The following is the formula which he most frequently employs : R. Atropin. sulph.............0.02 gramme (gr. 3-10) If in One gramme (15 minims) of this solution contains half a milligramme (gr. 1-134) of atropine and one milligramme (gr. 1-67) of strychnine, which he considers the adult dose. the space of two hours after the first injection the patient be not cured, he gives a second, and possibly a third two hours later. It is not prudent to exceed this amount per day. The effects are often surprising. In the majority of cases the vomiting ceases at once, and soon afterwards no more nausea, cephalalgia or distress is felt. Isopathy in Africa. By W. Thorton Parker, M.D. Doctor Thirk, in the year 1846, published in the Medical Weekly, of Vienna, a very interesting account of the so called "poison physicians" among the Caffirs and Hottentots at the Cape of Good Hope, Africa. These medicine men claim to cure cases of poi The treatment of patients placed under his professional care is effected in the following manner: A piece of fur cape of the poison doctor, which has been soaked with the medical man's sweat, is then put into some water which the patient is directed to drink. In cases where the poisoning took place some considerable time before applying to the doctor, some very offensive doses are swallowed by the patient. The poisoning of arrows is effected with the secretion from the water of the spider mentioned above with the venom of the crown snake and the puff-adder mixed with gall. These cases are interesting as illustrations of a savage instinct which recognizes the power of animal extracts as means, not only of inducing serious injury, but as methods to prepare the body to resist these same noxious influences. In England we had Jenner's method in vaccination; in Berlin, the tuberculin of Koch; in Paris, the hydrophobin of Pasteur. The subcutaneous injections of Brown-Séquard are in the same line of thought and experiment. It is the evolution of preventive medicine originat ing in the mind of the untutored savage, and passing onward and upward, until the very highest bacteriological skill confirms its theories for the protection and health of mankind.Druggists' Circular. In Treatment of Pyorrhea Alveolaris. Under the name of Rigg's disease this affection of the teeth and gums is known as one of the most obstinate in yielding to treatment. a recent number of the Philadelphia Polyclinic, Dr. Joseph Head describes his method of controlling this disease. He advises first the removal of all tartar from the roots of the teeth by carefully scraping from the bottom of the pocket to the neck. He then applies aromatic sulphuric acid to dissolve any calcareous pieces that may be left, and to stimulate the parts to healthy action. He then orders the following wash: R. Acid benzoic.... drams j .fi drams iij ...fi ounces iv .....fl drams S M. One teaspoonful in half a glass of water held in the mouth, morning and evening, for two full minutes. For systemic treatment he prescribes lithium carbonate in five grain doses three times a day; or sodium salicylate in proper doses. However, he says that far more valuable than drugs for general treatment is plenty of exercise in the open air, and restriction of diet. Meat should be used sparingly; all alcoholic beverages should be prohibited; and, as a rule, the quantity of food should be diminished. Dr. Head says that he has known patients who have long resisted local treatment, derive speedy relief when they follow the diet he prescribes, which is as follows: All malt or alcoholic beverages are to be prohibited. Meat to be used sparingly. In fact, rather than tell the patient what to avoid it is much better to write for him which foods he can take, such as eggs soft boiled, tripe, oysters raw, roasted, broiled or stewed, always rejecting the eyes. Young lamb three times a week, fresh fish-especially white fish, perch, flounders. White meats of fowl, game birds, etc. An occasional meat broth, or clear soup carefully made, not rich and without vegetables. All fats to be avoided. Vegetables: macaroni, spinach, tomatoes stewed. Peas, fresh and young. Beans: Lima, French and string, young and fresh. Squash and carrots, young. Squash and carrots, young. Oyster plant or salsify, stewed celery. Eggplant baked. Watercress, head cabbage, sauerkraut, Brussels sprouts, cauliflower, lettuce, corn salad. Dry and milk toast, pulled bread, Zweibach (toasted rusk), steamed crackers. Wheat bread rather stale, preferably the crust. Rolls, Graham bread. Oatmeal mush or porridge. Cracked wheat. Weak tea with slice Very little sugar. of lemon instead of milk. Coffee without milk.-Food. Subscribe for 1895, and get the remainder of this year free. The Drinking Treatment of Typhoid. Some years ago M. Debove recommended the use of large amounts of water internally in typhoid fever. "I make my patients drink," he said; and this was his chief special treatment. The object was to dilute the fluids of the system and wash out the toxines in the blood and intestinal canal. M. Lichteim adopted this treatment and reports nine successful cases. Recently M. Maillart, of Geneva, has made an elaborate study of this mode of treatment, reporting fourteen cases in detail, of which one died. (Revue de Médecine, Novem ber, 1893, and March, 1894.) Maillart thinks that the water-drinking method should be "erected into a special method of treatment." In order to secure the proper results the patient must drink five or six litres (quarts) of water a day. There is no contra-indication for the use heart, but has rather the contrary effect. The of water in this way, for it does not weaken the results obtained are a progressive lowering of the fever, a disappearance of dryness of the mouth, a marked sedation of all the the action of the heart and kidneys. There is nervous symptoms, and an improvement in an abundant diuresis and an unusual increase in the perspiration. Urea is carried off in large amounts. The treatment does not shorten the course of the disease, but simply makes it easier and less fatal. Patients, we are told, take kindly to this method. The typhoid patient takes usually six to eight glasses of milk daily, and if to this are added ten to twelve glasses of water, the diluent effect should be very great. -Ed. Med. Rec. A mixture of chloroform (ten parts) ether (fifteen parts) and menthol (one part,) used as a spray, is recommended as an excellent and prompt means for obtaining local anesthesia, lasting for about five minutes.-Boston Med. and Surg. Jour. Chlorinated Lime in Pruritus Ani. Jameison (Edinburgh Medical Journal, June, 1894) states that Berger has had excellent results from the use of liquor calcis chlorate (B. P.) in pruritus ani. A piece of absorbent cotton is saturated in the solution, and inserted into the anus for the distance of an inch. This is left in situ till a slight burning is experienced. The cotton is removed and the anal region washed with the solution. The parts are left undried. Pruritus is said to vanish at once. On its reappearance the procedure must be repeated. Any eczema which may happen to be present will rapidly disappear.-International Med. Mag. Apply by compress covered with impermeable tissue.-Ruel. -Chloride of gold and sodium in pills or granules, given in doses from two milligrammes to three centigrammes improved the general condition of paralytics in the first and second periods.-Boubila. -The majority of so-called recoveries from appendicitis treated medically are not recoveries in the full sense of the word, but simply a respite which enables one to settle worldly affairs and take out a life-insurance policy in anticipation of a fatal termination.-Sanborn. Questions Asked by the Board of Medical Examiners of Virginia. [Our readers will take an interest in perusing this, a fairly representative list of questions. The Southern Journal of Homeopathy, in publishing the list says: "We publ sh these questions for the purpose of exhibiting the fact that the terror of the examining board, even the single board, is largely in the imagination. The properly educated graduate need have no fears, but the ignorant may justly tremble."] 1. Define the term food, give general classification of same and mention the principal inorganic ingredients of food. 2. Give composition of human milk and state what acid is found when it sours. 3. Describe the capillary blood vessels and give the physical condition which influences the movement of the blood through the same. 4. Give origin and distribution of the 10th pair of cranial nerves and their physiological function in connection with the formation of the voice. 5. Give properties, physical and chemical, and also the function of saliva, gastric, pancreatic and intestinal juice, and bile. 6. Describe the tongue and mention the conditions necessary to the performance of the gustatory function. CHEMISTTY. 1. Define atomic weight, molecular weight, combustion and isomorphism. 2. Give history of chlorine, its chief uses and chemical properties. 3. Mention two organic and inorganic bases. Give chemical formulæ of the two latter and state chief chemical and physical properties which as bases distinguish them from acids. 4. Define the following and give example of each, (a) an alcohol, (b) a simple ether, (c) a hydro-carbon, (d) a carbo hydrate. 5. Describe mag. sulph. State how prepared. Give chemical properties and tests for mag. salts. 6. Give source of potassium its physical and chemical properties, and name the principal salts of this metal which are used in medicine. JURISPRUDENCE. 1. Give the legal importance and evidence necessary to establish the identity of the living and dead body. 2. Define a wound legally; classify and give principal characteristics of wounds inflicted on the living and dead body. HYGIENE. 1. State the various methods of cooking food and that most conducive to health and reasons for same. 2. Name the principal occupations or trades prejudical to the health of the operative and what diseases they produce 3. Give the general divisions of the baths, the temperature of each and their hygienic uses. 4. Name the diseases that may be transmitted by the excreta; as alvine discharges, vomica, or sputa, and how prevented. SURGERY. 1. Give symptoms, diagnosis, and methods of treatment of stricture of the urethra. 2. Give causes, symptoms and treatment of intestinal obstruction. 3. Give definition, pathology, diagnosis and treatment of aneurism. |