We refer our readers to the advertisement of Palpebrine which appears for the first time in this number. This product will be found useful in the following forms of external eye diseases: Simple, acute, catarıhal, venereal, strumous and chronic conjunctivitis, acute and chronic blenorrhea of the conjunctiva, inflammation of the lachrymal sac, blepharitis etc. Palpebrine is indicated in all cases where an accurate antiseptic solution of known quality and quantities are required. Palpebrine is superior in its action to the remedies now in use. It contains all the constituents of aqua conradi as recommended by the renowned professor of the Vienna University Ferdinand von Arlt, (see Clinical studies on diseases of the eye by F. Ritter von Arlt. But to these are added a number of other agents which will prove palpebrine to be of much greater value and give it a broader field for action. INDIGESTION-ERUCTATIONS--DYSPONEA.-Dr. Alfred E. Meyer says he has been using "Maltine with Wine of Pepsin" at the New York Polyclinic, and also at the West Side German Dispensary in his Gynecological Clinic with signal advantage with women who are suffering from chronic indigestion, and he also gave it a trial in his private practice. One patient, a lady who had for years had frequent attacks of indigestion, received so much benefit from its use that he decided to report the case. The attacks usually came on about an hour after eating, the symptoms being great distention of the abdomen and a feeling of soreness and dyspnoea. The attach usually lasted from one to two hours. She had been put on various methods of treatment, not only on different preparations of depsin and pancreatin, but also on dietetic treatment, without any marked or permanent benefit. After beginning the use of "Maltine with Wine of Pepsin"-a small wineglass full after each meal-she did not have another attack. The remedy was continued and there appears to have been an entire mitigation of the disagreeable condition under which she had labored for so long, and this too without any special reference as to change of diet. It was noticed that in taking a dose at the beginning of the treatment there were repeated eructations of gas and the uncomfortable symptoms were relieved in a very short time. Dr. Meyer says he thinks that the combination of "Maltine with Wine of Pepsin" is a very happy one. CELERINA. W. P. England, M. D., White Pine, Pa., says: I have used Celerina and am pleased to say that in all cases of nervous prostration, such as follows the use of alcohol, and for all cases of nervous debility, I find it without an equal. After the experience I have had with it I do not hesitate in recommending it to the profession as one of our best nerve tonics. The action of Celerina on the brain and nervous system is that of an exhilarant and slight narcotic, relieving depressions and lessens irritable nerve conditions. In cases of organic and functional lesions of the heart, an increased steadiness of pulse-beat and diminution of pulse irritation is apparent. A. J. Wesco, M. D., Seven Mile, O., says: I have tested Celerina and got good results. Man, aged sixty-five years, mechanic, habits very intemperate, will spree for weeks, came to me with nervous system in bad fix; could not eat or sleep. Gave him eight ounces Celerina, teaspoonful three times a day, which placed him on his feet again, and for that I think it par excellence. Convulsions may frequently be cut short, like magic, by teaspoonful doses of Celerina repeated at short intervals. The nausea as an aftereffect of chloroform or other narcosis, may generally be controlled in the same manner. T. J. Haile, M. D., Atlanta, Ga., says: Celerina has always acted finely in all cases where I have tried it, especially in those troublesome cases of hysteria, nervous depression and feebleness, and prostration resulting from alcoholic excess. Have found its effects very exhilarating and nourishing. In fact, it is my main dependence in all nervous diseases. The psychological depressions and neuralgias, so common in the period following a debauch, are lessened or disappear altogether by the use of Celerina. J. B. Johnson, M. D., 920 N St., Washington, D. C., says: I used Celerina not only as a nervine and tonic, but also found it most excellent, in two drachm doses, in sobering persons who were made drunk by alcoholic drink, and such patients informed me that they were greatly assisted in recovering from a spree by the use of Celerina. After the removal of alcohol, Celerina, given in doses of from onehalf to one ounce every four hours, is speedily followed by the most characteristic symptoms of improvement. Dr. Bramwell, Whitley, Northumberland, England, says: I have found Celerina valuable as a nerve stimulant and restorative in a patient suffering from the effects of a severe drinking bout. RIO CHEMICAL CO., A full size bottle of CELERINA will be sent) FREE to any Physician who wishes to test it, if he will pay the express charges. ST. LOUIS, MO. NORTH CAROLINA MEDICAL JOURNAL. A SEMI-MONTHLY JOURNAL OF MEDICINE AND SURGERY [Entered at the Post-office at Wilmington, N. C., as second-class matter.] VOL. XXXVIII. WILMINGTON, OCTOBER 20, 1896. No. 8. Original Communications. THE RADICAL CURE OF INGUINAL HERNIA. BY JOHN GIBBON, M.D., Instructor in Surgery, Philadelphia Polyclinic and College for Graduates in Medicine; Surgical Registrar Philadelphia Hospital; Assistant Demonstrator of Anatomy, Jefferson Medical College Philadelphia. The subject of the radical cure of inguinal hernia has agitated the surgical mind from the earliest times, and is still one of peculiar interest to the surgeon of to-day. The history of the different means of relieving inguinal hernia, both operative and inoperative, is extremely interesting, and it is the object of this paper to briefly outline the various methods of procedure, from the most ancient times to the operations of Halsted and Bassini. The many operative and mechanical devices for the cure of inguinal hernia are innumerable, a large number of which, having had their day when they were hailed with delight both by profession and laity, were put aside after a short time, only to be followed by some other equally ineffectual measure. However, in the general surgical advancement of the past decade, the operative treatment of hernia has had its place, and to day the surgeon has the choice of several methods of operating, which are accompanied with little risk to his patient, and a greater probability of cure than in any other age. Probably the earliest writers upon the subject of hernia were Leonides and Hippocrates. Leonides, who lived four hundred years before Christ, understood, as well as the surgeons of the seventeenth century, the anatomy of hernia, and the means of reducing strangulated hernia. He, moreover, attempted a cure by means of caustics, a custom practiced extensively in later years. Hippocrates, the father of medicine, who flourished also about four hundred years before Christ, had a good knowledge of inguinal hernia, and approved of the use of the actual cautery in its treatment. Celsus, the great surgeon of the first century, who was so far ahead of his time in all surgical procedures, hands down to us a minute description of his operation for the cure of inguinal hernia and although it was the habit of many operators of his day to remove the testicle in doing a herniotomy, Celsus always spared this organ. It is also said of Celsus that he amputated by the circular flap method, and ligated arteries, both of which were abandoned by those who followed him, and not revived until a few centuries ago. Another fact that was not appreciated until the eighteenth century, but which Celsus was familiar with, was the utility of the application of ice in the reduction of strangulated hernia. In the second century Heliodorus describes an operation for inguinal hernia, which was still practiced in the fourth century by Alexander Trallianus, In the seventh century Galen and Paulus Aegineta both contributed to the literature of the subject. The latter in his operation ligated and removed the hernial sac, and his method possessed other slight improvements over that of Celsus. During the middle ages little or no advance was made in the treatment of hernia, and much that had been learned was forgotten. In the thirteenth century the truss, which had been in use for a long time, applied in various manners, was supposed to result in a cure, and two hundred years later the truss was very generally used, So numerous are the different modes of treatment in vogue during the past few centuries, that for the sake of convenience the classification of Chelius will be used: I. "Increased pressure whilst lying constantly on the back, with or without the simultaneous application of irritating and contracting remedies:" II. "Caustics and the actual cautery." III. "Ligature of the sac with or without cutting it off." IV. "Introduction of foreign bodies into the hernial sac.' V. "Healing-in of a detached portion of the skin or of infolded skin into the abdominal ring." The first method, that of pressure, consisted in applying a linen pad over the abdominal ring, with sufficient pressure to produce an ulcer which in turn was treated with "lead cerate, sponge in turpentine, blister, compres sion screw and alum wash" etc. When ulceration was considered of suffi cient depth a pad was applied filled with contracting remedies such as bark, gall-nuts or iron bullet. Local applications for a long time, were supposed to cure some ruptures, and were made use of both by surgeons and “quacks.'' Parè, for instance, recommended a "decoction of red snails" for the cure of hernia in children. Houston in 1726 published an interesting little volume |