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slowly until the sponge is saturated and the hot water begins to flow out over the outward parts, then stop the flow for a few seconds, and continue letting the hot water run very slowly so that twenty or thirty minutes are expended in letting the water out. The points I claim for this plan are:

1. Water can be continuously applied to the uterus hotter than by the common douche, because as soon as any runs over the sensitiv outward parts the flow can be stopt, yet the uterus continues to be bathed in hot water.

2. If any medicament is used in the water it takes less, and so is cheaper.

3. It takes so little preparation that a woman can do it all without the aid of an assistant, there being no heavy cans of hot water to lift. I will not say anything about the therapeutics of the hot water vaginal douche because it is fully discust in the various works on gynecology, but I would suggest that it would be oftener used if it were not for the trouble attending the administration. I do not know if this plan is original with me, but I know it should be generally known, and I take the medium of THE MEDICAL WORLD to give it to the often handicapt country physician who has to get along with so few of the conveniences of his more favored city brother. Philomath, Ore.

C. H. NEWTH, M.D.

A Gunshot Wound.

Editor MEDICAL WORLD:-A boy, 11 years old, living in the mountains of this state, received an accidental wound from an old army gun loaded with shot with paper between the powder and shot and paper on the shot. The charge passed obliquely thru the arm from front to backward and upward, entering about four inches below the head of the humerus, and tore away two inches of the bone (that is, tearing out all the bone), driving some pieces into the flesh about the back part of the shoulder. The tissues were fearfully torn and badly powder burned, making a wound on back of the arm seven inches long, yet the artery and nerve were not wounded. After cutting away the ragged tissue and picking out all pieces of bone that could be found, the wound was washt with a 1 in 2,000 corrosiv sublimate solution, and dusted with boracic acid and powdered oxid of zinc, equal parts, and then wrapt in corrosiv gauze and left until next day. Dressing was the same each day until the powder burn sluft off, then the arm was pusht up until the ends of bone toucht, then bound in a flext position to a heavy paste board cut the shape of the arm and well padded. The wound was left open, however, not even a strip of adhesiv plaster being used to close it. Same treatment was continued, except that peroxid of hydrogen

was poured over the wound and injected into places it would not run into itself, and an ointment of vaseline, boracic acid and oxid of zinc was smeared around the edges to prevent the dressing from sticking.

The result was uninterrupted recovery, the bone having united and the muscles having filled in until the arm is full sized and is as useful as ever, except shorter, of course. The wound was received September 19, 1903; patient was well December 20. My object in leaving the wound open was to allow the muscles to fill in and replace what was torn away. If I had closed it on the back of the arm after the burn sluft off, which I was once tempted to do, it would have healed together and the arm would have been weakened by the loss of that portion of the muscles. As it is, I believe it will be as strong as the other.

Trout, W. Va. J. D. THRASHER, M.D. [You are to be complimented on the excellent results following such a severe injury; it speaks well for your attention. Your report would have been more valuable had you given exact measurements of the arm after complete healing compared with the uninjured arm, and had photographs of the arm at time of injury and afterward. These are easily secured.

It is possible that some of the good result may be ascribed to the cauterizing of the tissues from proximity to the muzzle at time of discharge, and consequent prevention of infection. This should have been included in your report. It is wonderful what recoveries follow proper treatment of gunshot wounds. If you had referred the boy to a hospital, they would have discharged him "cured" (?) in about six weeks, but he would not now have that arm. The profession did not keep up with gunshot wounds in the interval between the Civil and the Spanish-American wars; but the literature since the latter war is voluminous and instructiv, and plainly teaches conservativ surgery. You did well.-ED.]

Stop the Paper.
"I've stopt the paper, yes, I hev;
I didn't like to do it.

But the editor got too smart,
And I allow he'll rue it.

I am a man as pays his debts,
And I won't be insulted,
So when an editor gets smart,
I want to be consulted.

I took his paper eleven years,
An' helpt him all I could, sir,
An' when it comes to dunnin' me,
I didn't think he would, sir.
But that he did, an' you can bet
It made me hot as thunder.
Says I, 'I'll stop that sheet, I will,
If the cussed thing goes under !'
I hunted up the measly whelp
An' for his cunnin' caper

I paid eleven years an' quit !
Yes, sir, I've stopt his paper!"

-Exchange.

How to Save Money. Query:-Wonder how many WORLD readers continue to pay $1 per ounce for antikamnia and other " analgesics" with fanciful names, when they can get acetanilid, the chief constituent of all of them, for about 30 cents a pound?

Wonder if the antikamnia people will make a nice little notice out of the mention of antikamnia on pages 102 and 103, March WORLD, and send it around to be printed in the journals in which they advertise, like they did with the incidental mention of antikamnia in Jan. WORLD, page 16?

See how one doctor saves $45 per year on one preparation, in March WORLD, page 102.

Don't you think this issue of THE WORLD will interest your druggist? Please mark the portions that you think will interest him, and show to him.

Wagon Tongue Pierced Thigh. Good Recovery.

two

Editor MEDICAL WORLD:-On the sixth day of November last, I was 41⁄2 miles distant from my office when a phone message came telling me that a serious accident had happened at the home of one of my nearest neighbors, and requesting me to come just as fast as my horse could bring me. I found that a neighbor girl aged 13 years and small for her age, had been playing by drawing a horse wagon about the yard, she guiding the wagon at the end of the tongue, and two smaller ones pulling by the swingle trees, and some three or four small children were in the wagon. The yard was very steep, and at the bottom of the hill stood several large oak trees. The wagon started down the hill at a great speed. The one at the end of the tongue was not strong enuf to control the course of the wagon, and the tongue caught her thigh between it and a large oak tree. The end of the tongue ran thru her thigh, carrying her dress and two flannel underskirts thru her thigh. There was a projecting iron on the end of the wagon tongue, which pierced the tree fully one inch, leaving fragments of her clothing in the tree. The wagon rebounded and slid some distance further down the hill, carrying the girl, the tongue still projecting thru her thigh.

When I arrived she had been removed and placed on a bed and had been given a dose of morphin, but yet she was suffering much agony. I phoned for Dr. T. D. Hare, of Greenville, to assist. He came quickly and we proceeded to dress the wound. After washing and removing blood clots, using aseptic precautions, we drest the wound, closing the inward side with six stitches and three on the other side. A remarkable feature of this case was that neither

the femur nor the femoral artery was injured. She made a good recovery and is now attending school. Neola, Tex. O. A. ARMSTRONG, M.D.

Remarkable Resuscitations.

Editor MEDICAL WORLD:-Regarding the article on "Simulation of Death," in the Feb. WORLD, page 47, I feel inclined to supplement it, hoping thereby to encourage an extension of time in the endeavors to resuscitate such as raise the slightest doubt as to life being extinct. In my article on "Influence of the Mother on the Fetus" (Feb. WORLD, page 58) I mention that the smallest babe in my obstetrical career weighed one pound and a half. That birth was premature, a little over six months, caused by the mother's falling down a whole flight of stairs. She possest four boys, and this was a girl and stillborn. I immediately prest the father into service, my attention being needed by the mother having severe hemorrhage. I directed his actions, and when I could spare a few minutes I relieved him. I employed every method I could think of (not forgetting even the squirting of raw onion juice into its mouth. Many times the father was tired and discouraged, then I took up the work, reminding him that if he wanted a daughter, he must work for her. In two and a half hours she gaspt like a fish out of water. Then the father suddenly forgot all fatigue. In twenty minutes more she gaspt again, and then in a few more minutes she breathed regularly. We had no incubators then, so I improvised as well as possible by wrapping her in raw cotton, well warmed and plenty of it; laid her before the register during the day and in the mother's arms during the night. We nourisht her by pumping the milk from the mother's breast, and letting her suck it from a bit of linen cloth, and by rubbing her daily with a little sweet and codliver oil, mixt. For three months (until about the time she should have been born) I pursued that course, when she was able to take the mother's breast and we began to dress her; and she developt into an exceptionally bright child, being now a teacher in Brooklyn, N. Y. Three-quarters of an hour would never have accomplisht such result.

I was called to a confinement. When I entered the house an elderly woman said to me: "Now understand; there is to be no baby in this house!" I did not understand what she meant, until after her repetitions it dawned upon me that she wisht to make away with the child, and expected me to assist her in such nefarious business. I hurried into the sick room, saw at a glance that labor had terminated, and there was a bundle of bed

clothing lying on the bed. I quickly suspected foul play, and true enuf, when I opened the bundle I found a finely developt babe with a piece of quilt crammed into its mouth, and life seemed extinct. I at once determined to rescue that child at any cost of labor. In just two hours it began to breathe. I then informed the mother of the patient that but for my persistent effort she would have the pleasure of spending the remainder of her days in the penitentiary. Three-quarters of an hour would not have brought the desired result. I could cite many cases, but these few will demonstrate the impression I wish to make.

are

That many more human beings buried alive than we conjecture, I feel certain of. Why do we read of cases (where a bereaved one frantically begs to have the coffin reopened for a last look) where there are proofs that the body had undergone a desperate struggle for life? It is not so long ago that I read of a mother having become a raving maniac at the cemetery, when the coffin was opened at her request on beholding her darling child in an unmistakable position of having had a desperate struggle. Why have so many partly decayed bodies, on disinterment, been found with handfuls of hair, evidently torn from the head in an agony of despair? Such disasters could be prevented were the bodies kept (but not on ice) until spots of decomposition become visible. In 1857 I had a narrow escape from being buried alive, as I was pronounced dead from exsanguination, the result of a miscarriage caused by injudicious lifting. Dr. Hammond (my husband) was absent from home, and the attending physician was so positiv that I was dead that I was being laid out. I was unable to give a sign of life, but heard what was said. My feelings can better be imagined than described. Suddenly one of my three sisters-inlaw present cried out: "Here comes Gerard!" (my husband). The excitement produced brought the last flicker or spark of life into action, so when he poured rum between my set teeth it produced sufficient excitation to cause me to swallow and-I am here to tell the tale.

Once I was attending a boy of 15, who was suffering from peritonitis; one night when I entered the sick-room, I found eight of the family kneeling around his bed praying, and I was told that he was dead. At once I issued the command: "Stop praying; go to work!" They jumpt up affrighted. I ordered all to rub his whole body with brandy, and I laid my hand on his chest, calling out his name repeatedly, commanding him to come back to us. In a short time his eyes lost the film, he began to breathe, his heart resumed its

function, and so between massage, animal magnetism and brandy, we succeeded in bringing him back to life. He is now living, an honored, valuable citizen of this village.

I describe the particulars of my proceedings in which I have succeeded a number of times, to encourage others in trying to save life where there is the slightest hope; but no time is to be lost, as when the connection between the astral and physical body is once severed, all effort is useless. Senator Hanna is not the first being brought back to life after apparent departure. I am neither a hypnotist nor a Christian scientist. I simply have, during my long span of work, acted on the impulse of the moment. All may smile who feel inclined. I enjoin let all try to do good where they may.

I would yet relate an extraordinary case of "simulation of death." I was born in a small village in Bavaria. When eleven years of age I was taken to live with an aunt in. Vienna, Austria. In a village near my birth

place, one day a traveler went to an inn to engage a night's lodging. The innkeeper told him that all rooms were occupied. As the traveler seemed much disappointed, the innkeeper told him there was the parlor, but that it contained the corpse of his daughter who was to be buried the next day. The stranger said he was not afraid of a dead body, and arrangements were made to accommodate him. Next morning the stranger went his way. During the forenoon the girl showed signs of life. She recovered. In due time she showed unmistakable symptoms of pregnancy, yet she proclaimed her innocence so vehemently, and her parents had no cause to doubt her veracity, that the case found its way into the newspapers, of which there were very few those days; yet the traveler read of the case and at once repaired to the inn where he was recognized. He proclaimed himself the father of the forthcoming child and married the girl.

As I am also one of the "old timers " I liked the article of Dr. Alfred Merser, pages 62 and 63. I could relate many cases of the past that might prove worthy of consideration even in these days of phenomenal advancement.

GERTRUDE HAMMOND HARPER, M.D. Spring Valley, New York.

Editor MEDICAL WORLD:-The Comstock Collection Agency has long since ceast to annoy me. They found I could not be bulldozed or blackmailed, so they left off their mail assaults. I never answered one of their communications. I thought that the best way to treat them. S. M. SNYDER.

Greenwich, N. J.

In dispensing tablets, mark some symbol on the end of the box or envelope, so that you may know just what kind have been dispenst if the patient brings the box back to be refilled.

Coughing as a Cause of Varicocele. Editor MEDICAL WORLD:- Among the causes of varicocele as given in books are constipation, corpulence, constant exercise in the upright position, the wearing of tight belts and trusses, etc., but I have not seen it mentioned as being brought on by coughing.

Four years ago I operated on a young man by sub cutaneous ligation, using catgut. After remaining cured for over two years he informed me that it was as bad as at first.

I could not account for its sudden return, as I had made an examination less than two weeks before, and it was then in excellent condition. He said he had a bad cold. He was taken with a violent spell of coughing while I was making an examination, and the blood rusht thru those veins with terrific force.

From that experience, I am convinced that coughing is a very frequent cause of varicocele; and I cannot imagin any liable factor that would bring greater strain to bear on those vessels:

Formerly I used catgut, but as the operation was not always completely successful I now use silk, and there have been no returns since to my knowledge.

Some authorities advise the use of ether or cocain, while others do not. When cocain is injected the resulting swelling renders it much more difficult to separate the vessels with precision. From my experience, it is unnecessary to use any anesthetic, as there is only slight pain when the needle is quickly passed thru the skin of the scrotum-even less than when tapping for hydrocele.

C. FLETCHER SOUDER, M.D. 1418 Diamond street, Philadelphia.

Suggestions Regarding "Individuality.” Editor MEDICAL WORLD:-Of late years I am cultivating the habit of individuality. I make my own observations and draw my own conclusions, using authorities only "as controls." After I have arrived at settled convictions I would not hesitate to publish them to the world, to be taken for what they are worth. As examples, I offer the following: THE MEDICAL WORLD contains much professional knowledge that is worth preserving, and much that is not. The value of an article is only relativ, depending on the individual wants and tastes. To preserve the useless with me useful is extravagance. It occupies much I phable space and is an incumbrance. I assist. therefore, suggest the following innovadress the publishing journals and magazines: blood clots,sheets and print on one side only. the wound, together with paper fasteners, in stitches and tforations. I would rather pay remarkable featur annum for THE MEDICAL

WORLD in that form than one dollar in its present form. One could then select and preserve such articles as he desires and file them for future reference, consigning the balance to "innocuous desuetude."

The other suggestion I have to offer is this: I am surprised at the amount of knowledge, skill, and ingenuity of country doctors, especially in the northwestern states and the territories. By reason of their splendid isolation, they might settle down to a life of stagnation and "do no more than the law allows." But they are moved by the same spirit of progress, philanthropy, and professional pride as their more favored brethren in the large cities. Their disadvantage may be lack of capital for securing the high priced apparatus now coming into general use, or not having sufficient use for it, to justify the outlay. Scientific men and apparatus in the large cities are a drug on the market. Let the country physicians come together and see if they cannot unite to utilize this talent and the outfits. Let the physicians of a community, or township, organize for the establishment of a modern sanitarium. They may be able to make arrangements with a party having a complete modern outfit, and who knows how to use it, to establish himself among them, on a small, fixt salary and an equitable percentage of all cases he is called on to treat. In this way all the physicians are able to secure the advantages of modern methods at a minimum cost.

Let no one think that I am moved by ulterior motivs; I have nothing to sellneither apparatus nor services; it is merely a suggestion.

Now, Mr. Editor, I know exactly what my articles are worth to you-two cents-you, yourself, have set that price on them. That makes no difference, however, for I am not writing for you, but for the brethren. Have I succeeded in stamping my individuality on you? E. GOODMAN.

San Francisco, Cal. [Yes, the article has individuality. But an article with individuality is not always one with value. Perhaps the above article has value to some readers, but certainly not to all. An editor must recognize variety in needs and tastes, and satisfy the same, if he would be successful. The first suggestion given above is not at all practicable. To carry out the plan would cost much more than double the present price, and what would be gained? It is easy for a reader to skip what he does not want, and mark with a blue or red pencil what is of special value to him. This would clearly identify what he specially values, and there are still other and easily practical ways of doing it. To adopt the author's suggestion would be unjustifiable

"extravagance." The rest of the article "has individuality," so we will let it stand for what it may be worth. The article as a whole illustrates our reply to it: it may be of value to some, and of but little interest or value to others. -ED.]

Nasal Hemorrhage at Close of Typhoid Fever.

Editor MEDICAL WORLD: -Sometime ago the suggestion was made in your valuable magazine, that it would prove interesting and profitable to hear from the readers of THE WORLD regarding experiences with emergency cases. Apparently this suggestion was overlookt, as I failed to discover a single response in succeeding numbers of THE WORLD. seems that we could not but be greatly benefited by a series of communications on such an important branch of medical science.

It

There

is much that the wisest or most self-complacent might learn from even the very trivial of accidents. In hope that we may hear more along this line, I will relate a case that fell to my lot, and tho it may be insignificant to some I trust it may prove of some benefit.

The patient, a man past 50 years of age, had been ill nearly four weeks with typhoid fever of average severity. On the twenty-second day after the temperature had fallen to normal, I was suddenly called to see the patent because of hemorrhage, as the messenger, a boy, explained. Hurriedly I went to the man's assistance; and, imagin my surprise to find him bleeding rather profusely from the nose and not from the bowel, as I had anticipated. In the first stages of the disease I might have been better equipt to treat this emergency. As it was, very good results were obtained for the time being with a pledget of cotton in the anterior nares, pressure on the side of the nose, and cold applications to the head. The opportunity was embraced to better equip myself, and upon a renewal of the trouble, an injection of tannic acid, the best astringent within my reach, together with the cotton plug anteriorly, the patient propt to a sitting posture, the head tilted forward a little, checkt the flow almost entirely for an hour. If there was any bleeding at this time it was almost imperceptible. It was necessary, however, to resort to the same measures in about an hour's time, and upon a recurrence of rather profuse hemorrage the third time, having lost faith in the milder or less heroic remedies, the cotton plug was applied both posteriorly and anteriorly, with success. Up to this time the patient's condition had been good. However, upon applying this latter treatment—and it required only a few seconds to insert the catheter which had been previously prepared-the loss of blood was greater than at any time since my

arrival. In truth this loss in addition to that before, in connection with the naturally anemic and weakened condition of the sufferer, caused markt collapse symptoms. The cold moist skin, an almost imperceptible pulse beat, shallow respirations and temperature subnormal (96° for two days) made the chances for recovery slight indeed. But with stimulants, and subsequently in addition a light and concentrated diet with iron, the patient rallied, and after a four months' fight--a fight which at times seemed hopeless-recovered.

Altho such accidents are rare in typhoid, one case is reported in this locality, where even the cotton plugs were ineffectual and death was the result. Called again to treat a like case, I would not dally with astringents, etc., but would use the more heroic measures at the beginning, saving as much blood as possible to an already weakened body. Two brethren advised for nasal hemorrhage, in THE WORLD, the use of an inflated condom and also a piece of bacon fat shaped to fit the nares.

This case suggested to me, how little used is the normal saline solution in country practise as compared to city, and prompts the questions:

(1) What is a simple method, and, briefly, the technique, of the application of normal saline solution?

(2) Also in case of shock from railroad, mine, or other injury, should the first aid be only stimulation? Is not a hypodermic of morphin indicated except in the severe grades?

(3) What effect, if any, would child birth have on a woman subject to epileptic seizures? W. Va. E.

[We will leave these questions open for discussion. Let those with experience reply to one or more.-Ed.]

A Dead Horse after Using Colic Remedy.

Editor MEDICAL WORLD:--In January issue, 1904, I note on page 26: "Cure for Colic in Horses." This morning I had occasion to use it; one of my horses had colic. I gave him one ounce of cannabis indica in linseed oil; repeated same dose in one hour, and had a dead horse in one hour after last dose. I feel confident the horse died from the effect of the drug and not the colic. I am not a veterinary, but I fear our Baltimore friend has advised larger doses than necessary or expedient.

H. W. SCOTT, M.D.

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