Editorial Items.-Continued.*

Thyroid Extract as an Emmenagogue.--M. Glynn (quoted in New York Medical Journal) has used this extract with success in the daily dose of 71⁄2 grains for the difficult establishment of menstruation in young girls.

Falling of the Hair.-Hare recommends the following mixture applied with friction in spots to the scalp, night and morning: Fluid ext. pilocarpus, 4 parts; tincture of capsicum, 32; tincture of cantharis, 2; castor oil, 4; alcohol, 128 parts.

Digitalis Poisoning.—The cumulative effects of digitalis are commonly shown by nausea and vomiting, slow and irregular pulse, dim vision, faintness, insomnia or delirium. Tardien states that a blue color of the sclera is also diagnostic of toxic effects.

Another lodoform Deodorizer.-The Pacific Medical Journal avers that a few drops of ichthyol mixed with a few drops of iodoform dissipates entirely the disagreeable odor of the latter. An ointment of these ingredients in vaselin fills many indications.

Thirst in Bright's Disease.-M. Klippel (quoted in Medical Record) states that thirst is present in three or four of every ten cases of interstitial nephritis with arteriosclerosis. There is almost always a sensation of heat and dryness in the mouth and pharynx.

Leather Splints.-To save time in the making, the International Journal of Surgery directs to place the leather in water containing a tumblerful of vinegar to each quart, and it will soften in a few hours. The splint is best moulded over a plaster cast of the limb to be encased.

Examination of Feces for Turbercle Bacilli.-Rosenblatt (quoted in Gaillard's Medical Journal) advises in case of suspected intestinal tuberculosis to give opium until constipation ensues, then scrape the hard scybalae and examine the scrapings for tubercle bacilli in the usual way.

Methyl Blue and Methylene Blue.-Charles Feubner calls attention in the Medical Record to the important differences between these compounds. The former is never used internally, but is dusted on the throat in diphtheria in a 2 per cent. mixture with sugar powder. The latter is a well known remedy in cystitis, pyelitis, malaria, rheumatism and carcinoma. Sodium hydrate changes methylene blue to a violet color; methyl blue, reddish-brown.

Hemoptysis. Senator (Clinical Review) advises the application of an ice bag to the chest and the internal use of hydrastis or hamamelis, or, still better, stypticin. Ergot, he thinks, is of no practical value. Morphine may be needed to allay nervous excitement and quiet cough.

Normal Temperature of Human Body.-According to LieutenantColonel Hamilton (quoted in New York Medical Journal) the normal temperature of the Himalayan inhabitants is between 96 and 97. In the Gurkhas hospital a patient is not well until his temperature has fallen to this point.

Celluloid Thread.-This new surgical product, introduced by Pagenstecher, has great tensile strength (increased by dry heat), is very flexible, is not easily infected and does not readily become untied. Its only disadvantage seems to be the facile absorption of water, to the degree of about 40 per cent.

Epididymitis. One of the best treatments, says Hare, is to paint the scrotum black with many coatings of a strong solution of silver nitrate or iodine, to insist on total rest in bed, and to resort to the local use of cold. The testicles should be supported with a suspensory or adhesive strips, and aconite is indicated for fever.

After-Pains.-Winterburn (Medical Record) says that a hot meal may be better than medicine. For the instant relief of very severe pains he recommends saturating a piece of tissue paper with five or six drops of amyl nitrite and stuffing this into a two-dram vial for the patient to inhale whenever she feels the pains coming on.

Sole Scrapings for Skin Grafts.-J. L. Wiggins (quoted in American Therapist) claims good results from the employment of desicated epithelium obtained from the sole after antiseptic precautions. The scrapings are triturated in a mortar at 110 degrees F. and are sowed over the granulating surface, being protected with rubber tissue.

Sudden Death from Kidney Disease. Of forty-two post-mortemed cases in Hamilton County during the past year, says Louis Schwab (Cincinnati Lancet-Clinic, May 26) kidney lesions were found in a little less than one half the instances. Brouardel in his monograph on this subject states that kidney disease is the most frequent cause of sudden death.

How to Irrigate.-The International Journal of Surgery gives the following sensible advice: "Never use force in irrigating a cavity. The best way to do this, if it is possible, is to simply pour in the water gently from a convenient vessel. If a douche bag or similar apparatus is employed, use only as much pressure as will allow the water to run out quietly."

Chronic Dyspnea. In old persons with bronchorrhea, says Hare, strychnine is the best remedy that we have, while opiates are distinctly contraindicated. In cases of dyspnea, due to emphysema and chronic pulmonary inflammation, or in those persons who take cold on the slightest exposure, particularly after attacks of asthma, arsenic is useful if continuously employed.

Simulative Nephritis.-Under this title Thomas R. Brown (Bulletin of Johns Hopkins Hospital, May) calls attention to the comparative frequency of casts in the urine, with but little albumin or general disturbance, following nephropexy and other operations on the kidney. The condition clears up of itself in a few days or weeks. Would not factitive nephritis be a better name than simulative?

Cardiac Hemoptysis.-Albert Abrams (Medical Standard) states that this symptom rarely calls for treatment. The most important measure is absolute rest in bed. Of medicines, morphine hypodermically is the most reliable. In a recent patient, with intractable hemoptysis, large quantities of flavored gelatin, taken by the mouth, proved efficacious. A similar experience was had in two cases of purpura hemorrhagica.

Cystitis Papillomatosa.-Chronic catarrhal or suppurative trigonal cystitis, with the usual symptoms and seldom hemorrhage, comes under this classification when the cystoscope reveals numerous discrete papillae springing from an inflamed mucous membrane. In discussing this condition Frederic Bierhoff (Medical News, May 26) writes of the curative effects of silver nitrate injections from 14 of 1 per cent. to 1 per cent. in strength.

Sweating Feet. At this time of the year the following advice by the editor of the Medical World is acceptable: Wash feet thoroughly and dry gently once a week. Dust well every night with a powder composed of boric acid, 2 parts, and salicylic acid, 1 part, rubbed into the skin and between the toes. Dust inside of the lightest weight cotton stockings with the same powder and wear during the night. If desired, the feet may be dusted again in the morning.

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DENVER MEDICAL TIMES

VOLUME XX.

AUGUST, 1900.

NUMBER 2.

ORIGINAL COMMUNICATIONS.

ADDRESS ON STATE MEDICINE.*

By WILLIAM P. MUNN, MD.,

Denver, Colorado.

INTRODUCTORY.

Problems that lie in the borderland of medical science and statecraft constitute the material for the study of State Medicine. The relation of the community as a whole to certain facts of scientific medical knowledge, the relation of practitioners of medicine to the rest of the community, the prevention of contagious and infectious diseases, and the relation of scientific knowledge to criminal, sociologic and legal problems, are chiefly recognized as lying in this domain, which is unfortunately too much of a terra incognita to the most of us.

We must recognize the fact that the man who steps beyond the limits of the territory usually assigned to him or his profession by public opinion runs the risk of being charged with impertinence. I trust that the importance of the issues now discussed, and the peculiar advantage of viewing them from a medical standpoint, will obviate any such judgment upon my words to-day. The subjects to be presented are second in importance to none within the range of either medicine or law alone.

TRIUMPHS OF PREVENTIVE MEDICINE.

Modern medicine counts among its greatest triumphs those discoveries in pathology, bacteriology and sanitation upon which the specialty of preventive medicine has been built. Insofar as the welfare of states has been in*Delivered before the Colorado State Medical Society, June 20, 1900.

fluenced through these achievements, they have become part and parcel of the history of State Medicine. CHOLERA EPIDEMIC PREVENTED IN 1892.

Eight years ago Europe and America stood aghast at the invasion of Asiatic cholera, which for the first time in a generation set its foot upon the shores of the two continents. Hamburg alone was ravaged by it; other cities withstood the assault with much the same success as did New York, where only a dozen of those directly exposed to the imported infection lost their lives. The preventive measures then enforced by states, nations and municipalities at the bidding of medical science, were based upon a literal acceptation of the discovery of the comma bacillus by Koch. Every effort was directed toward the destruction of this organism and the purification of water supplies by the methods already demonstrated to be efficacious in the laboratories of medicine. Universal success crowned the efforts of the sanitarians and the threatened world epidemic failed to materialize. The genuine Science of Medicine, the outgrowth of bacteriologic investigation and research, recorded its first great world victory by the use of obstructive tactics.

DIPHTHERIA MORTALITY REDUCED SINCE 1894.

In 1894 from the same centers of scientific research the industrious workers of medicine gave to the world an anti-diphtheritic serum, which was at once hailed by our whole profession as a legitimate and permanent addition to our armamentarium. Diphtheria had been previously a disease whose horrid mortality appalled the stoutest hearts; to-day, with the confident assurance that the use of antitoxin has begotten in our breasts, illness from this cause is easily remedied; contagion is readily controlled. The mortality from this disease has been reduced throughout the civilized world almost three-fourths. Thus has been made a permanent advance that as a life saving measure can never be equaled by any discovery in any of the arts and sciences other than that of medicine. TYPHOID FEVER DECREASING THROUGHOUT THE WORLD.

During the past thirty years typhoid fever has been fought and is now being slowly conquered by a succession