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diazo urin reaction in typhoid, and the quick maladies that lead to sudden calls, most analysis of stomach contents, will likely follow. important and interesting reading.
These questions are signs of the times. They Then there is another group of cases in indicate that the younger men have what the which our beginner may find himself consulted. older men have not, viz. , new methods. But The cases that appear too trifling for the the old men have what we have not: Experi- attention of the family doctor. Friends ask ence. So let's trade.
him why they have headaches, tetter, pruritus, Speaking of students with whom I am bad breath, the blues, insomnia, bad temper, familiar, I know that junior students in Canada anorexia, flatulence, vertigo, pimples, are as familiar with these methods as with per- hives. Never make light of any complaint a cussion, auscultation, etc.
person may make. A lady askt her doctor Knowledge is like mercy :
what she should do when her nose itcht. He “ It is twice blessed; it blesselh him that replied: “ Blow it." Much fun ensued at gives and him that takes."
her expense—and he lost a $600-a-year paFriends of the well worn path, take a junior tient. Inquire into the case ; get at the root student in with you each summer. Hundreds of it; and you may find a condition demandof them will be glad of the chance. Talk ing attention or not, but you will surely find over the new things, tell tales of the past. a patient who is appreciativ of the interest you Neither will be the poorer, both will be the have displayed. It is bread cast upon the richer, and humanity will be the gainer. You waters. will thus have a little post graduate course at Beale wrote a very suggestiv little book home. He learns his subject best who has a once, entitled “Slight Ailments.” If you pupil in it.
E. BDAICO. have Haig on Uric Acid, it will unlock many a Canada.
door. Still better is it if you have learned to P.S. The writer has no axe to grind. recognize autotoxemia from intestinal pu
tridity as a cause of very many slight or Talk with the Beginners.-Economic Condi. indeterminate ailments. If you have learned tions in the South,
to look out for failures in elimination you are Editor Medical WORLD:—The young doc- prepared for most of these "slight” ailments, tor is apt to have quite a lot of spare time on and for most of the big ones as well. This his hands when he first begins “practise ''; in will necessitate chemical examinations of the fact, his first task is the practise of patience urin sometimes; but never neglect to take this rather than practise on patients. And it is trouble if there is the slightest reason for it. good for him to improve this leisure period in But-here is an important point-do not be in making himself ready for the first cases he is too big a hurry to charge for such cases. Your likely to have.
friends have askt you casually about some little What are these? They will come under the discomfort, and you have gone to some pains head of the suddenly arising emergencies, to find out that it is really but a trifle; now do where there is no time to send for the regular not make the mistake of charging heavily. practician and the nearest one is called. That will give you the name of being on the Usually he must surrender the case to the watch for a chance to “do" them; and that family advisor as soon as he puts in his appear- is a disaster. Even tho you have done the ance; but there is a chance for the younger work, recollect that they have not seriously man if he knows just what to do, and shows it. consulted you, and charge nothing. This will This thought comes to me from reading your confirm in them the opinion as to your pereditorial note on poisoning; and the symp- sonal interest in them, and they will come to toms and treatment of all forms of poisoning, you again. Next time you will probably find the study of those most liable to occur, such a real ailment, and then tell them so, and as carbolic acid, concentrated lye and rough that of course you will have to make a charge. on rats, form most valuable subjects for these They will at once see that you charge when leisure weeks or months. Extend this to the there is a real illness to treat and not otherpoisonous plants to be found in the vicinity, wise ; and people are always willing to pay and hence apt to cause trouble ; such as rhus, under these circumstances. In fact, I have stramonium and belladonna. The treatment found them far more willing to pay ten dollars of snake bites comes as a sort of corollary. for a thoro investigation than one dollar for an
There are other emergencies to follow; the offhand prescription. various surgical ones, the hemorrhages, con- With your first case begin to form the habit vulsions, fainting, choking, sunstroke, drown- of thoro investigation.
of thoro investigation. How often we oldsters ing, colics and cramps, hiccup, etc. Indeed, wish we were beginning again, so that we however proficient our young doctor may be, could take the time to do our work up in a workhe will find the study of emergencies and the manlike manner. After while, when the calls become numerous, it will be hard work to give each, and brought five cents each in New each the attention absolutely necessary, much Orleans. Plant that farm with peaches and less what you would like to give them. And other fruit trees, and let them grow up while it then is the time for you to take an assistant, and is used for pasture; and in time a second crop start him in the same way of doing thoro work. would be afforded.
I see in the papers that there is another The price mentioned for land is not unusual. great rush for lands where the Government is There is plenty to be had at any price from opening a small Indian reservation. About two bits an acre up to $250. 50,000 people are struggling and fighting, How about doctors ? I think there are enuí murdering, to get possession of homesteads there for the income-half the present populaenuf to supply one-twentieth of that number. tion of the South is not to be counted on as Do you ever think how much the prosperity of able and willing to pay, so that the allowance our country has depended on that homestead of thirteen white and three colored doctors for law, and how scarce suitable land has become ? Baton Rogue, with 15,000 inhabitants, is not We used to sing in school that “Uncle Sam is to be
kt upon as too little. But as the rich enuf to give us all a farm." But the country attracts immigration there will be boundless West has had its bounds set, it is room for many more doctors. And if there is full, and there remain only the dry lands that any prejudice against northern men there now, require capital in large masses to establish it kept carefully out of our sight. We found irrigation plants. And so we are losing hun- the country and people very much to our dreds of thousands of our farmers to Canada.
liking. But in the South there are millions of acres of Snap Shots at the May WORLD'S Quiz Department. good land still available for the homesteader; Dr. Taylor, page 212, should examin his cotton and timber land open for entry. Why pneumonia patient's sputa for tubercle. Give is it neglected? The state of things described mercury and arsenic iodids, iodoform and by Tourgee, in his “Fool's Errand," no ·
phytolaccin, steadily, and you will find one of longer exists, if it ever did exist. The South the most powerful and effectiv absorbent comwelcomes the northern immigrant; it seeks to binations ever put together. attract him, and gives him a hearty welcome. “ Mich.'s" thyroid case, page 213, will imIt is no longer considered disgraceful for a prove if he stimulates the menstrual flow, not white man to work there at any decent occupa- otherwise. Give sanguinarin, three granules tion. Mechanics get big wages and have four times a day; alternate weekly with same plenty of work. Lands are easily obtained, by dose of senecin
; activ emmenagogs at periods. lease or purchase at easy terms.
“Dysmenorrhea,” page 213. It will do no tunities for investment of small sums harm to paint the lacerations with tinct. benplentiful—the South presents numberless open
zoin. ings for business. Take this example: In our Gallstones (page 213):-After failing with all trip down the Mississippi and residence in ordinary remedies for this, we have used soda Louisiana and Mississippi this past winter, we succinate for twenty years with few failures. never once got as much milk as we needed- Give it with boldin and chelidonin ; and treat not at a price below ten cents a quart. They use paroxysms with hyoscyamin, glonoin, strychnin Holsteins, because they give so much milk. arsenate and dioscorein, aided by hot enemas. We askt one man why he did not get some Keep them up for a year and cure your cases. cows that gave richer milk, like the Alderneys; If there is a specific for albuminuria (page but he askt why he should, when he could sell 214) it is arbutin, that priceless medicament all the poor thin milk he could supply at the rescued by the alkaloidists from its enveloping above price.
masses of tannin in the crude drugs. Give Do cattle thrive there? A bunch of sat cattle one to ten grains a day, with suitable dietsent from Louisiana to Chicago a few months and watch the steady improvement. ago made a sensation by their high quality. Dilation of the veins (page 216) may be Are they expensiv to feed? A field of alfalfa relieved by hamamelin and hydrastin, taken opposit Baton Rouge was cut eight times last for long periods, if care is taken to avoid the year; and plowing goes on the year round in causes of relaxation, such as the excessiv use Louisiana.
of fluids and an idle luxurious life. Beer We made a calculation that a forty acre drinkers are incurable. Ice-water swillers farm a mile from Baton Rouge-offered with ditto. buildings for $4,000—could be bought and Dr. McCall's eye pain (page 217) may indistockt with Alderneys for $5,000, and that it cate accommodativ imperfection and strain, or would pay a gross income of that much every uric acid storms, or malaria-brow ague. This year. We saw peach trees blooming in Feb- is a very nice case for study and investigation, ruary, whose fruit weighed thirteen ounces but the data are not given here. However,
the great alkalometric, antispasmodic triad- mal may be had without injury, providing this hyoscyamin, glonoin and strychnin arsenate- position be not too long maintained. For a will relieve. Possibly the eye may be the certain degree of abnormality of position the place of lowest resistance, in which autotox- body has compensated by elasticity, anastoemia shows its effects.
mosis, and lubrication of tissues. This degree WILLIAM F. WAUGH, M.D. of compensated subluxation we speak of as Chicago, Ill.
normal motion. This normal motion if re[Read in “ The Story of New Zealand” how tained for an abnormal degree of time becomes that country disposes of its public lands; par- abnormal. Who has not awakened with “a ticularly read contrasts between their system crick in his neck” from lying too long in an and ours on page 699. Let me add this abnormal position. A few moments of such a remark: If any WORLD subscriber purchases position would have produced no such results. “ The Story of New Zealand," and is dissatis- The condition resulted more from an abnormal fied with his investment after reading the book, degree of time than of motion. By excess of we will return the purchase price upon return time the normal becomes abnormal — the of the book in good condition, and receipt of physiological becomes pathological. a written statement to the above effect. —ED.] Most of the subluxations that we as osteo
paths find are abnormalities of time rather than Osteopathy :-Subluxation of Bony Tissues
of position, and as such are usually more comand Their Relation to Disease.
mon and more pronounced in the direction of the freest motion of the joint involved. These
osseous lesions like those of the softer strucThe consideration of sensitiv areas along the tures are more common and more important spine, as well as muscular and ligamentous along the spine, tho by no means confined to lesions when accompanied by soreness, together with the cause and effect of these con- The spine as a whole is an elastic structure ditions, brings us to the point where we may composed of bony segments between which intelligently consider subluxation of bony tis- are interposed elastic cartilaginous discs. sues and the relation of such to disease These bony segments are held together by ligaprocess.
ments, muscles, and other soft tissues, the The existence and importance of such elasticity of which allows no small amount of lesions, which is a fundamental teaching of normal motion between the articular surfaces. osteopathy, may at first thought appear unrea- The degree and direction of this motion is sonable; but a little meditation and study of limited by bony processes and softer structures the skeleton from the living and the dead sub- which also, in a measure, prevent dislocation. ject will convince anyone that such lesions can This spinal column is not a straight structure. and do exist, and that they demand considera- It has, normally, posterior dorsal and sacral tion and treatment.
curves, and compensatory anterior curves in Let us first understand what the osteopath the cervical and lumbar regions. The motion means by a subluxation. A subluxation is allowed normally between the vertebrae differs usually defined as a partial or incomplete dislo- in degree and direction in different parts of cation. While this is true it does not always the spinal column. Flexion, extension, lateral convey the same idea to all physicians. Every flexion and rotation are permitted in all parts movable articular surface has some position in of the spinal column; the lateral flexion in which the muscles, ligaments, blood vessels, the dorsal and rotation in the lumbar regions nerves, synovial membrane and other tissues are but slight. Accordingly any vertebrae may connected therewith are free from abnormal be deviated and retained (or subluxated) in tension, pressure, and irritation. This posi- any of these positions. The effect upon the tion, which the joint may maintain for a long contour of the spinal column will depend upon period of time without injury to the part, may the degree and direction of the subluxations be considered its normal position. All the and the number of vertebrae involved. various positions from the slightest deviation Hyper extension of the vertebrae in the from this normal to the point of complete dis- upper dorsal region reduces or obliterates the location are but varying degrees of subluxations. normal posterior curve in that region, giving Any deviation from this normal position will rise to the “flat upper dorsal ; associated produce tension, pressure and irritation of the with this there is a corresponding decrease of tissues involved. Such deviations are therefore the compensatory anterior curves in the lumbar limited both as to degree of motion possible, and cervical regions, producing a “straight and degree of time that this motion may be spine.” This condition causes an approximamaintained without serious damage to the part. tion of the spines in the dorsal region and Within certain limits deviation from the nor- separation of them in the cervical and lumbar regions. An increast posterior dorsal curve a degree of deviation directly anterior may produces the opposit condition in these regions. be obtained, especially in the cervical and Two or more vertebrae may be thus involved dorsal regions. Again a vertebra may be rowithout affecting the others. Approximation tated laterally on the one below it on an axis of two spines necessitates increast motion of corresponding to either of its articular procthe articulations above or below, resulting fre- esses. This subluxation necessitates a lateroquently in separation of the spine at these posterior motion between the bodies of the points. These breaks are particularly liable vertebrae which does not normally exist, and is occur between the twelfth dorsal and the first only possible owing to the elasticity of the lumbar and between the fifth lumbar and the intervertebral cartilage. Such rotation can sacrum. The depression or elevation of an occur only toward the side opposit the articuindividual spine, particularly in the dorsal lar process around which such rotation takes region, may give the appearance of an anterior place. These three latter varieties of subluxaor posterior subluxation of that vertebra if we tion being deviations in directions other than judge alone from the spinous processes.
that of normal motion, are subluxations of deLateral flexion of the spine produces scoli- gree as well as of time. osis if it involves a sufficient number of the Another spinal lesion frequently found is vertebrae, and may or may not have a compen- subnormal mobility between two or more satory curve in the opposit direction in other vertebrae. This condition is due to the conparts of the spine. In this condition there is traction, inelasticity, and increase of tissues an approximation of the transverse processes connected with the articulation—a sort of of the vertebra on the concave side, and a fibrous ankylosis resulting, which partially or separation of them on the convex side. This completely prevents mobility of the parts. lateral subluxation may also involve as few as This condition may or may not coexist with two vertebrae, giving somewhat the appearance the subluxations previously described. of vertebrae slightly rotated, judging from the The articulation between the atlas and occi. spine alone, which is due to the approximation put deserves special consideration. This of the transverse processes on one side and a vertebra having no body, articulates only by separation of those on the opposit side. the articular processes. The motion allowed
Rotation of the spinal column as a whole is in this articulation is according to Morris, produced by slightly rotating each vertebra ginglymoid, directly lateral and anieroupon the one next below. This produces a posterior; consequently the occiput may be lateral deviation of the spinous process of each subluxated in any of these directions. The vertebrae and an anterior deviation of the character and position of this articulation transverse process on that side away from which makes it especially liable to such deviations. the vertebrae are rotated, and a posterior This with the close proximity of its transverse prominence of the transverse process on the processes to the important nerves and vessels other side. One or more vertebrae may partake passing thru the jugular foramen, as well as its of this same motion, in which case its spine relation to the vertebral arteries and the first and transverse processes will assume the posi- spinal nerve, makes subluxations at this point tion as given above. These rotary lesions are both far reaching and important in their more common in the cervical and dorsal effects. Subluxations of the fifth lumbar region. Only very slight rotation of the last vertebra on the sacrum are also especially fretwo dorsal and lumbar vertebrae is possible, quent and important. Such lesions make owing to the positions of the articular proc- chronic invalids of many women and cause esses. Subluxations, like normal motion, may sexual organs to be sacrificed on the altar of be in only one direction or may combine two surgery. The coccyx too may be subluxated or more; e. g., a vertebra may be rotated and anteriorly or laterally. flext both anteriorly and laterally at the same The pressure, tension and irritation resulting time. Vertebrae retained in positions of nor- from the prolonged retention of an articulamal motion are the most common subluxations tion in an abnormal position produce sympwith which we have to deal, tho there are toms of local temperature, tenderness, conother subluxations of vertebrae which are of a tractions, and pain; such symptoms in fact as different character. A vertebra may be sub- Hammond and others have described as charluxated posteriorly upon the vertebra below acteristic of spinal irritation,
Vertebral without partaking of the normal motion of the subluxations are sometimes found in which no articulation. This is true of all the vertebrae soreness is present. Such lesions are probably excepting the atlas, which is prevented of long standing, and by its marvelous powers from such posterior deviation by the odon- of adaptability the body has readjusted the toid process of the axis. By abnormal parts so that the new condition is as nearly separation of the vertebrae or their spines normal as possible with the subluxation still
remaining. A similar process is observed even to scoliosis. Contractions of the rotawhen an unreduced dislocation of the head of tore spina will produce rotation of the vertebra the femur forms for itself a new socket and to which it is attacht. Bilateral contractions acquires a degree of normal function with a will produce rigidity or approximation of two decrease of subjectiv symptoms.
or more vertebrae, and by so doing may change These bony subluxations and the coexisting the general contour of the spinal column. lesions of the associated softer tissues may Such contractures in the lumbar region by produce pathological conditions elsewhere by approximating the posterior edges of the verdirect mechanical obstruction and irritation to tebrae will produce lordosis. Similar condithe blood and nerve supply, or the local tions in the upper dorsal region will lessen or pathology may reflexly produce similar condi- obliterate the normal posterior curve in that tions. Such pressure and irritation may area producing a “flat upper dorsal” which stimulate, inhibit, or otherwise modify the decreases the capacity of the chest and often activity of the parts affected; or a primary gives rise to a long train of systemic disturbstimulation may be followed by exhaustion or
The result of contractures along the paresis from over stimulation, the result vary spine resolves itself into a matter of mechanics, ing with the nature and intensity of the pres- the condition produced being but the result of sure or irritation. Pressure upon a nerve may
the totality of the forces acting. be sufficient only to obstruct the free circula- Dorsal and lumbar vertebral deviations can tion of the nutrient fluids within the nerve frequently be seen, if the subject is not too fat, sheath, and yet by such may produce far by having him sit upon a stool with bare back reaching effects.
curved posteriorly and shoulders drawn well Subluxation wherever found produces ten- forward, thus bringing the spines prominently sion, pressure and irritation both intra- and into view. If there is much muscular or extra-articular; but aside from this local adipose tissue, inspection will show little and pathology, vertebral subluxations are particu- resort must be had to palpation. Subluxations larly injurious from the number and impor- in the cervical region cannot be inspected. tance of the nerves and vessels subject to With patient on his back and the neck thoroly involvement. Approximation or rotation of a relaxt, the anterior, lateral, and posterior survertebra, especially in the dorsal region, faces of the transverse processes may readily decreases the size of the intervertebral fora- be felt. mina, causing irritation of and pressure upon The general origin and distribution of the important structures found therein ; viz. : nerves with tissues affected by lesions of certain The anterior spinal nerve roots, the posterior centers will be considered in my next article, spinal nerve roots, and their ganglia, the recur- as also lesions and subluxations other than rent nerves, sympathetic fibers, and blood spinal that are productiv of disease. vessels. The cord itself may be affected and Peoria, Ill. W. A. HINCKLE, M.D. systemic disturbances, apparently much out of
(To be continued.) proportion to the cause, may result, from such lesions irritating and obstructing the afferent
Please understand clearly that we freely and recurrent nerve fibers and the blood vessels passing thru these foramina.
admit that Dr. J. J. Lawrence, of the Medical The causes of these lesions are numerous.
Brief, has as good a right as anybody to make,
advertise, and sell proprietary medicins; and Trauma, which Hammond credited with being the chief etiological factor in producing spinal with the Listerine people, Battle and Co., and
any business connection that he may have irritation, plays a very important role here. It is surprising how many troubles, especially body's business whatever, except his own and
any other business concern whatever, is nochronic ones, can be traced directly to strains,
those immediately concerned. But when he falls, blows, etc. Faulty position is also a factor. Many of these subluxations are un
persists in pushing proprietary medicins to the doubtedly secondary to lesions of the softer
medical profession in an unethical, unjournal
istic, unbecoming, and objectionable manner, tissues. We have shown how unilateral afferent
it becomes the business of the medical profesimpulses, unless of great intensity, beget uni
sion and of the journalistic profession. lateral contractures, relaxations and other secondary lesions along the spine and elsewhere. Such unilateral contractions or relaxa- American Medical Editors' Association. tions from this or any other cause exerts an
The annual meeting of this Association will be held influence upon the osseous tissue which may
in the parlors of the Hotel Dennis, Atlantic City, N.
J., at 2 P. M., June 6th, A most interesting program result in subluxations. Contractures of the has been prepared, and many instructiv papers upon muscles along one side of the spinal column
medical journalism and allied subjects will be pre
sented. All medical editors are most cordially invited will produce lateral flexion of the vertebrae,