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High Temperature Following an Intrauterin it from rotting and poisoning the system. I Douche.
used as a local dressing echinacea until I got Editor MEDICAL World:-Mrs. S., second all of the underlying gristle cut out; did not confinement, labor lasting two hours, normal let any of this substance rot in the carburcle. in all respects, placenta delivered by Credé's Then I used bichlorid dressing for the balance method, complete with membranes intact. All of the time. Fed my patient on panopepton symptoms normal till the third day, when (Fairchild) with raw eggs. Patient made a lochia became offensiv ; no rise of temperature good recovery. When full grown the car, or pulse ; gave vaginal douche of creolin solu
buncle measured 6 by 8 inches. Was in bed tion which was followed in one-half hour by from January 27 until March 24, 1904. slight chill; temperature raised to 102°, last
J. A. MCCREA. ing six hours, followed by profuse sweat. Next morning all symptoms normal except lochia, Dr. I. C. Chapman, of Lafayette, La., which was very offensiv; gave an intrauterin reports the birth of a child with two perfectly douche of permanganate solution; no debris; formed heads.
formed heads. It died during the process of in one-half hour the patient began to tremble; birth. He does not say that he preserved the did not feel cold, but trembled all over. This specimen, so we conclude that he did not. He condition lasted about twenty minutes, when should have preserved it in alcohol, if he could the temperature had reacht 108° in the axilla,
have possibly gotten possession of it. pulse over 200, patient acting as tho dazed, but was not delirious until temperature had dropt to Dysmenorrhea.-For Colic in Horses. 106°; then mildly so. This was followed by a Editor MEDICAL WORLD:-For the “ nine drenching perspiration, and in turn by frequent o'clock exacerbation" (Dysmenorrhea, page attacks of palpitation. The next morning, ex- 167, April WORLD), I would suggest that cept for •excessiv prostration and the offensiv
“M.D.” have patient secure a motor for proodor of the lochia, the condition was again pelling her sewing machine or employ the sernormal. No more douches being given, we
vices of some available boy. This will give had no more trouble. A profound anemia
her much pelvic rest, and may be a factor in developt, which yielded promptly to treatment, removing the exciting cause. Would also join patient making an uneventful recovery.
the Editor in his matrimonial suggestion. At Some years ago I reported a case of puerperal eight o'clock give hypodermic of morphin 4 insanity, with a temperature of 110°, lasting gr., atropin išo gr. ; at the same time apply a two days, which developt acutely after an intra
rubber hot water bottle containing water as uterin douche, recovery being complete and near 212° F. as can possibly be borne. Perprompt on ceasing the douches. It took me sistence in the use of hot applications will three douches to catch on in the first instance,
afford prompt relief. and two in the last; in both the trouble ceast
Page 165: For the benefit of Dr. H. W. promptly on stopping the douche. The total
Scott or others, I give the following prescripabsence of symptoms before and after the treat
tion that I have frequently used with my own ment would seem to eliminate septic infection; horses for colic, both renal and intestinal : or did the expanding of the uterin cavity open
Chloroform up channels of absorption that were closed by Spts. nit, aeth. äå . the normal involution, and thereby protected Spts. turpentine
3 xij until interfered with by distention with the
Mix well and give in one dose. douche? or does the nervous, idiosyncrasy offer The horse will be relieved immediately. the explanation? What would have been the
After eight or twelve hours, if bowels have result of continued irrigation ? a mistake which
not moved freely, put him into harness and might easily be made under the circumstances.
trot him briskly three or four miles and you MALCOLM G. VIOLET, M.D. will wish your dash board had been built Butternut, Wis.
higher. A good tonic effect follows the free catharsis.
J. WOOLSEY, M.D. Carbuncle.
Vanderbilt, 1894. Editor MEDICAL WORLD:-I was called to see a man 74 years of age, on January 27, Case Record and Account Book Combined. 1904, with two small carbuncles on back, at Editor Medical WORLD :-I am pleased to upper points of scapulas, eight inches apart. note article in Feb. WORLD on the important I split them and then cross split them. One but much neglected subject of keeping grew no more; the other one kept growing. accounts. I have a method, originating Soon as the skin began to decay, I commenced according to my needs, which I find handy. to cut out the gristle, and would cut a round of We who practise at the cross-roads and in it out every other day. I did this to keep villages, of necessity dispense our own rem
edies, and I have for the past three years kept
Case Records. a record of same and cases in my journal as Editor MEDICAL WORLD:-In the April numfollows:
ber of your journal, one of your subscribers
wanted a case record blank. I have devised a R (ENTRIES)
(Cr.) (Dr.) system I use in my practise and inclose you No. Totals for February
$263.75 $338.25 samples of my cards. I do not have these
blanks for sale, but have them printed here in
the city and use a Macey card box on my desk Mar. 104. Tuesday.
for daily reference.
At the end of the year I file all closed cases Jones, James. V. Mary.........
in a Macey filing case, and mark the year on Temp. 102°, P. 110. Malaria. 6036 Cal. T. gr. No. 10–1 every hr.
the end of the box. 6037) Quin, comp. No. 24–1 every 2 hrs.
In my desk box I have two sets of alphabet Weber, J. B. Cr. Check....
guide cards and two guide cards, one markt Coleby, C. B. Med. self.
open cases and one markt closed cases. An Migraine No. 6-1 every 2 hrs. Comp. cath. No. 3-at bedtime.
open case is one which I still have under obser
vation. When the case is dismist I note the Crosby, B. P. Med. self, Bilious.......
.50 8040 Cal. 6 Pellets 2 at 2 doses, 2 hrs.
date and the results or condition of the case Pomeroy, G. Self.
when it passed from my care, and transfer it to Lance boil, Calc. Sulf. gr. 1 No. 40.
the closed case side. In making my record of 6041 Take 1 3x day.
acute cases I have a leather pocket to hold Burpee, L. Conf. Norm. L......
15.00 the record blanks and carry it in my coat Boy 9 lbs. 4 P.M.
pocket. The record is made at the bedside McManus, John. Fred........
1.00 with a fountain pen, as it is then permanent. Extr. teeth,
One who has not tried it does not realize what
an advantage such a record is to a physician. Mar. 204. Wednesday.
It impresses the patient and his friends that
you are a very particular person, and it gives This is more drawn out than I make the them greater confidence. If at any time a entries, as I abbreviate almost all words used.
dispute should arise as to your conduct of the This takes up but little time and space and case, you have your record to refer to, which helps to report a case or series of cases accu- is a great deal better in law than a memory rately, also enables you to give Willie or record. To me it is a pleasure to know I have Grandma the same B of last spring. by the a record of my cases. I think it just as imporbottle being returned with label and B num- tant to keep a record of cases seen in the home ber intact; also it is a good witness in damage as cases seen in the hospital. suits, or a suit of any kind.
Since I have formed the habit of keeping a As to ledger, I use double entry, 434 x 672 record of all of my cases, I know I am a better x 58 inches, flexible leather, with 200 pages physician. I am more observant, more careful and index, and keep it posted to date as near in my diagnosis, and more careful in my preas possible, and carry in pocket; thus am able scribing. I have the case for study at my to tell patron amount of indebtedness any leisure—and, let me say, a library of your own time and place, and thereby collect many cases, your own successes and failures, is of accounts that would be neglected should I more real value than the theories of others. have to use the common phrase, “I don't At my first call to an acute case I take down know, call at office,” which induces neglect. the history of the case prior to my being called.
I also keep a cash and expense account in This I write in on the face of the card before small double entry book, but have never kept making any record of the present condition. a comparativ statement; also issue bills at The chronic case, urinalysis, and obstetric regular intervals, and at termination of cases; record blanks are self explanatory. If more and where there is no response, I see the than one card is used in a case I use an endebtor personally.
velope to hold all the cards of that case. Am an advocate of “deadbeat lists,” com
CLIFFORD E. HENRY, M.D. piled often and freely exchanged, and am Minneapolis, Minn. Jefferson Medical College, 1896. liberal to deserving charities, but draw the [See accompanying card forms. The card line close. B. FRANK WINDLE, M.D. system is now used for many purposes : in Valley Park, Mo.
Barnes, 1897. libraries for cataloging books, as a system of [The above seems rather crude, but it shows book-keeping for keeping accounts, etc. This what can be done with an ordinary blank is our first knowledge of this system being used book which can be gotten at any stationer's. for case records by physicians, but it is a good -ED.)
Card for Acute Cases.
[The dotted rulings are blue; the others are red.)
(Case may be continued on reverse side of card.) Card for Chronic Cases.
prietary medicin manufacturers, and against Editor MEDICAL WORLD:Was called to a
their own interests in this way? confinement April 13 ; labor was very slow but
A further objection is, that patients not benormal. Six days later was called to the house ing able to determin their needs, frequently again and was told that the baby was passing injure themselves, and lose valuable time beblood. I askt some questions, then made an fore finally visiting the doctor. Also, the evil examination and found that the baby was
could be prevented by directing that an origipassing blood from the vagina. Normal child nal package be not supplied, or if so, all except for that, with no history to account for wrappings and labels be removed, and the docthe flow of blood. I left some fluid ext. of tor's directions be pasted on. ergot in child's doses, and have not been called since, but was told that flow lasted three to five days.
C. H. HAZEN.
Youth and Age Should Work Together. East Corinth, Vt.
DEAR EDITOR:-Our grand profession has made rapid strides during the last decade.
This is shown by the requests in THE MEDICAL Dr. D. W. Hunt, of Glendale, Cal., writes WORLD during the last few months for the very earnestly concerning proprietaries, his description of the technique of methods diagchief objection being that they are usually pre- nostic and therapeutic familiar to the recent scribed in original packages, and then the graduate but a terra incognita to many men literature that usually goes with the bottle or who graduated years ago. package, goes directly into the patient's hands. On page 165 of the April WORLD is the The next time, the patient goes directly to the request for method of application of normal druggist for the medicin, leaving the doctor saline infusion. out entirely. Furthermore, the patient shows On page 160 of the same number are questhe literature and recommends the preparation tions regarding the use of antistreptococcic to others, who go directly to the druggist for serum, and in a previous number the technique it, omitting the doctor entirely. He perti- for the Widal reaction in typhoid was askt. nently asks, why should doctors work for pro- Requests for other new methods, such as the