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Several more letters have been received from Dr. B. M. Jackson, of Omaha, Neb.-you know upon what subject, for I never knew him to write on any but one subject. We cannot give space to these letters. This is not only, my judgment, but it is also the earnestly exprest wish of a number of our readers. There is one point, however, in a letter from him dated May 19, which I must recognize and meet. His letter starts out this way :
SIR: I am informed that you graduated from a medical college which organized less than one year prior there-to. Is this correct? After you graduated, did any one hold you up for an examination or a $60 fee?
There are four pages of this letter, but the above is the point that I want to meet, and meet it squarely, Yes, the statement is true. It was my final course. I had attended medical college before, at Louisville, Ky. Before going there I had read medicin about three years, under preceptors, as was the custom at that time. After the course at Louisville I did about a year and a half of practical work, and then came up for a final course and graduation at Indianapolis. The college chosen was the Central College of Physicians and Surgeons, then newly organized. attracted to that institution by the able Professor of Practice, my friend the now lamented Dr. G. C. Smythe, of Greencastle Ind., and by the distinguisht surgeon, Dr. Joseph Eastman, who only last year passed to the silent majority. But the college, like John Brown's soul, “goes marching on,” and has made a record that every graduate may be proud of. No, I was not
" for a State examination, nor an examination fee, as that was not the law at that time. If it had been I would have obeyed the law as I have always tried to do. My associations and inclinations have always led me to be patriotic in my public relations, and true to the profession and its highest ideals, in my professional relations. Not that I believe in passivly " lying down” and have no independent opinions. I think my record shows that I believe in independent criticism in order to advance healthy progress; but I believe in patriotism first.
As to being.“ held up” for a $50 fee, I here append the examination fees required by the different States : EXAMINATION FEE.
$25 co Arizona..
25 00 Arkansas
North Carolina.............. 10 00 California
North Dakota.... Colorado
The Board may, in Delaware
its discretion, dispense District Columbia.......
with the examination in Florida
case of a physician Georgia
duly authorized to Idaho....
practise in ancther Illinois
State; in which event Indiana
the license fee is $50, Iowa
accompanied by cerKansas..
15 00 tificate or license issued Ky. (registration fee)...
by such other State. Louisiana
Oklahoma......... $ 500 Maine.......
15 00 Massachusetts.
Rhode Island Michigan
South Carolina Minnesota..
South Dakota.... Mississippi
Utah Nebraska (graduates of
Vermont Nebraska College $10,
Virginia all other applicants
West Virginia Nevada .....
Wisconsin-must not exNew Hampshire...........
ceed New Jersey.....
................ 25 00
so evidently they have chosen the wiser course, and have concluded to “quit," at least for the present. But after “resting on their oars awhile, they will think that the effect of our exposé has “blown over," and they will begin putting out their lines again, and try to sell their 65 cent “certificates," decorated plentifully with tinsel and blue ribbon, and gotten up to look like diplomas, for from $15 to $25, to the foolish or vicious hangers-on to the medical profession, with which to deceive the public. This kind of business can't go on in the medical profession as long as the present Editor lives and controls THE MEDICAL WORLD. If any WORLD reader receives literature from the “Christian Hospital," he is requested to send it here immediately. We have stopt this nefarious certificate selling game, and we will keep it stopt. If you know any doctor, or pretending doctor, who has bought one of these certificates, make him so ashamed of it that he will be glad to burn it up.
Do You Want to Buy a Degree ? A correspondent sends to Amer. Med. a letter from a socalled college in Detroit, which is self explanatory.
Doctor, Being Fin. Sec., of above, from March ist I desire to inform you we are just now Issuing Honay Degrees to some of our best U. S. &c. Prof. and men up in standing. Knowing of your medical standing and profession if you are of the Desire and looking for LL. D., in Harness, write me Early when I will send you a
Rekord of data " for filling out for the board to pass on, the only expence $10 for Issue of Same. Waiting a kind reply I am Dear Doctor
Yours Very Respectfully
E. M. LL. D.
Fin Sec Fourth of July Injuries. In treating contusions and lacerations caused by 4th of July explosivs, be sure to open the wound freely, and allow free drainage. The shock of the explosion frequently causes disturbances not visible on the surface, far from the visible seat of injury; particularly is this true of injuries of the hand, the most frequent part injured, the shock following the sheaths of tendons. These deep injuries, and possibly deep implantations of gun powder, are very likely to cause tetanus if not freely and completely opened.
In June World, page 231, second column, 29th line from the top (about the middle of the column), by some slip the word aristol got in in place of aspirin in some of the earliest copies printed. If you have one of these, take a pencil and cross out aristol and write aspirin in the margin.
TO CO TO oo 20 OO 10 oo 15 00 10 со 10 00
IO 00 ...................... 10 00
...... 25 00
........ 10 oo
5 00 20 CO 10 00
15 00 ...... IS OO
10 o ....... 10 00
25 00 10 00 25 oo
Traffic in Tinsel. Please refer to the remarkable letter from N. News Wood, on page 243, June World, and our reply on the following page. No suit has been entered, and no more “ Christian Hospital' literature has been received from our readers;
The itching of eczema may be relieved by painting the affected part with three percent aqueous solution of potassium permanganate and allowing it to dry on the lesion.
ORIGINAL COMMUNICATIONS hypertrophy, a normal sized gland or even
atrophy. Prolonged obstruction, complete or Short articles of practical help to the profession are solicited for
partial, results ultimately in relaxation and enthis department.
feebleness of the bladder itself, progressivly Articles accepted must be contributed to this journal only. The less expulsiv power, and less ability to resist or editors are not responsible for views expressed by contributors.
recover from cystitis, which after several interCopy must be received on or before the twelfth of the month, for publication in the issue for the next month. We decline
mittent attacks becomes chronic. responsibility for the safety of unused manuscript. It can The inflammation extends into ureters and usually be returned if request and postage for return are
received with manuscript ; but we cannot agree to always do so. kidneys, and the patient dies of uremia, septiCarteinly it is excellent discipline for an author to feel that he must cemia and the exhaustion from pain, and from
say all he has to say in the fewest possible words, or his reader w sure to skip them; and in the plainest possible words, or his
being deprived of rest by day and night. reader will certainly misunderstand them. Generally, also, a The indications are to remove the obstrucdownrighe fact may be told in a plain way; and we want
dosenright facts at present more than anything else.-RUBKIN. tion, retain all tissues necessary to preserve READ
normal functions, and drain the bladder if
there is cystitis, and there nearly always is. The Principles of Prostatic Obstruction and Early operations removed all the prostate. In its Relief.
this they exceeded the requirements and caused Editor MEDICAL WORLD:—The prostate the few post-operativ complications, incontigland lies against the outer surface of the apex nence and permanent fistula, for, as I menof the bladder, and the urethra passes thru it tioned earlier in this paper, the prostate lies as do also the seminal ducts. There are against the neck of the bladder and more than strong layers of pelvic fascia on both sides of it, half its bulk is of muscular fibers surrounding above and below, which hold it firmly from the beginning of the urethra and continuous underneath. They are part of the pelvic floor, with those of the vesical sphincter. Their which in man is very firm and unyielding. removal deprives the man of that much ability
It consists of glands, fibrous tissue, and to retain his urin directly, and indirectly still muscle in varying proportions, and has scanty more by weakening the insertion of the sphincblood supply itself, altho to reach it one has ter fibers. Also, when the whole of the prosto cut thru plexuses of veins which are just tate is removed, it is in some cases impossible outside its capsule among the layers of support- to avoid removing a strip along the floor of ing fascia.
It greatly imfluences an operation the prostatic urethra, which still further weakens that three-fourths of the normal prostate is the power of retention, as that divides all muscle, which is continuous with the vesical sphincter fibers in that region. Furthermore, sphincter, and assists in controling urination. it removes the ejaculatory and seminal ducts,
The enlargement which occurs in men of which are within the prostate near the median advancing years can cause protrusion upward line and behind or below the urethra, and I and backward only, because the pubic bone is have learned that men of 65 and 75 are very in front, and below the support of pelvic unwilling to be deprived of them. fascia and levator ani muscle cannot be over- The methods of operating depending upon come. Therefore, a large prostate encroaches cauterizing grooves ihru the obstruction are almost entirely into the bladder and somewhat faulty. They fail in cases that do not bulge upon the rectum. The overgrowth may be into the bladder, but obstruct by pressing general and symmetrical, and then causes very along the urethra because they do not always little obstruction or retention, but usually it is relieve and do not prevent recurrence. They in irregular lobules protruding anywhere they are dangerous from hemorrhage, shock, and can, like uterin fibroids composed of many post-operativ septicemia, and they fail to prolittle tumors. If one of these presses against vide continuous bladder drainage, an essential the urethra it causes partial or complete in the majority of cases. Supra pubic operations obstruction ; if they make it crooked they do may be done upon enlargements that are entirely the same. Sometimes a little mass with a long within the bladder, but as no one can determin slender pedicle hangs just where it blocks the before long whether they are, they are very poor passage, and all the rest of the prostate is surgery. The perineal incision and exploranormal. Quite often there is a thickening tion of the bladder by one finger passed thru of tissues around the beginning of the prostatic an opening in the membranous urethra is the urethra that has contracted so much as to only way by which one can know the condi. cause retention, and is so rigid that it cannot tion of the whole prostate. It also enables the voluntarily be relaxt. In any of these condi. operator to discover any complications within tions the catheter is required frequently, per- the bladder and remove one that is curable, haps cannot be dispenst with at all, and only such as stone or tumor. Thru the same inpart of them are hypertrophic conditions. cision in the urethra a retractor is passed by Examination by usual methods may show which the tissues are controled during operation. Only enuf of the prostate is removed and burning are more or less intense. The to cure the obstruction and prevent liability papules soon become pustules, their bases are to recurrence. Complete removal is un- somewhat indurated, and where the papules necessary. It is especially important to leave are close together the part is red and swollen. the prostatic urethra uninjured and preserve in The eruption lasts from five to ten days, the its normal condition that part behind and be- scabs drop off leaving
scabs drop off leaving a redness, which grad. low the urethra, which contains so many ually disappears, with little or no pitting. sphincter fibers and the several ducts. This The temperature is practically normal after the conservatism constitutes the latest improve- pustules are all formed, the appetite gradually ment in methods; it perfects the operation; returns, and the patient makes rapid and uneand its elaboration is largely due to Dr. Hugh ventful recovery with practically no treatYoung, who also invented instruments to make ment. It is very evident that it could not be it easier. The bladder must not be opened, as smallpox, as one man had it who had smallpox that accident adds the danger of permanent about 12 years previous, and others had it who fistula.
had been recently successfully vacinated. It is The deformities upon which the symptoms just as improbable that it could be chickenof this condition depend are now well under- pox, and I was therefore glad to see it named, stood; so also are the indications upon which as the medical works are silent on the subject attempts at its relief are based. The princi- so far as I could learn. ples of the operation are thoroly and finally It is supposed that the soldiers returning establisht, and it is not to be expected that from Cuba and Manila brought the disease to they will ever be materially changed. In the this country, and it has been called Cuban futúre if any improvement is introduced it will and Manila itch, also called Dobie or Dohbie be in methods of arriving at the same results itch by others. I understand that quite a now secured by those we have.
number of ex soldiers were employed in the Old men in great numbers are suffering mines at Tonopah, Nev., where it started, and from this condition and looking to us for cure. on account of no quarantine laws being enUntil recently they have lookt in vain, except forced it was allowed to spread to other towns those in its earlier stages. At last we can in this vicinity.
E. T. KREBS. assure them of relief and comfort as surely and Bridgeport, Cal. safely as anything in reparativ surgery, and secure to them freedom from physical suffering Intra-uterin Douches.-Charging Clergymen. so that their declining years may be prolonged Editor MEDICAL WORLD:- In the current in peace and conteniment as the close of life number of your journal, several cases are reshould be.
William B. JONES. ported in which high temperatures followed the Rochester, N. Y.
use of intra-uterin douches.
draws the correct inference that, in some manPemphigus Acutus Contagiosa. ner, the douche is responsible for the rise in Editor MEDICAL WORLD :—The article on temperature. He also advances several queries pemphigus acutus contagiosa by Dr. Ross in as to the rational explanation. the May World interested me considerably, Nearly two decades ago, when I began for the reason that the very same conditions practise, intra-uterin douching, in puerperal existed in this remote section of the country as cases, had reached the high water mark of its he experienced in his section. Likewise some popularity. I frequently saw this treatment called it smallpox of a mild form, others followed by chills and high temperatures. I chickenpox, etc.
have never found but one explanation that apThe onset is more or less gradual, with peals to me as being rational. About ten malaise and general weakness for from three to years ago a writer, whose name I cannot resix days. Then headache, at first slight, be- call, publisht a short article in the Philadelphia coming more severe until the eruption appears ; Medical News on this subject. His view was also pain in the back with chills and chilliness, that the disturbance is due to the fact that the anorexia, disordered digestion with nausea and douche is usually hot. The high temperature fever between 102° and 103.5° F. These symp- of the douche causes a prompt condensation of toms last about two to five days when the erup- the uterin tissues and contracts the blood vestion appears, first on the sides of the nose and sels and lymphatics. What is the result? A the contiguous part of the cheeks, then rapidly sudden and considerable decrease in the drainappearing on the forehead, neck and all over age. The general circulation is suddenly the body, even on the palms of the hands and overloaded with septic matter, and the chill the soles of the feet and on the mucous mem- and high temperature are the necessary result. brane of the lips in severe cases.
This reasoning appeared logical to me. I tion is about the size of a split pea. Itching have never used a hot intra-uterin douche since
I read that article. I have been careful that ing the storm. Having exhausted the remedial the temperature of the water should not be measures then known to the regular profession, higher than the normal temperature of the in despair I askt my druggist if he knew of body. I have never had a chill or elevation anything likely to be of use. He replied that of temperature to follow this procedure since I he had just recieved Roche's embrocation, have taken the above precaution. A number which he had specially obtained for a child of of my professional friends have observed the a wealthy Scotchman temporarily living in the same change in results. Unfortunately, nearly town, who said “the well-to-do at home never every writer who advocates such a douche, use anything else for whooping cough.” specifies that it shall be hot.
Roche's embrocation is a red oil of which I am fully convinced that I have seen several there is about 1/2 ozs. in each bottle. The cases in which lives have been saved by fre. instructions accompanying it are, to rub one quent and prolonged douches. They are par- teaspoonful into the epigastric region while the ticularly valuable in cases of late infection, due part is exposed to radiant heat, once every to retro-displacements and consequent reten- twenty-four hours. Of course these are not tion of lochia. But unless we unlearn the dic- the words printed upon the bottle, but as I tum of the hot douche, we expose our patients have not seen them for years, I give the idea. to a very real danger.
Here, this bottle costs $1.75, and it is claimed I was interested in the query of the Texas that before the twelve days are past the disease physician as to the propriety of charging will be practically cured. I took a bottle
I clergymen for medical services. I hope he home and it filled the bill. I prescribed it for will not change his attitude in this matter. In others until the idea that drugs act upon discase of a poorly paid clergyman, any physician ease thru the ganglionic nerve centers (see will make a reduction in his bill, just as the Canadian Journal of Medicin and Surgery for grocer or dry-goods merchant would do. But
February and June, and the Eclectic Gleaner it is impossible to render services for nothing, for June this year, for my later words on the to one who is able to pay, without a loss of re
subject) got possession of my mind. Since spect on both sides. There is a still greater then I have prescribed the 1/2 ozs, of oliv objection to such a custom. It sometimes oil (plain or colored) used in the way directed places the clergymen in an embarrassing and for Roche's embrocation, because I believe the un fortunate position. Suppose a member of heat and massage over the solar plexus to be his family is taken sick in the night. He will all that is curativ about Roche's embrocation. hesitate to call a physician if he knows the ser- We have had a number of epidemics of pertusvice is to be rendered without charge; while sis during the twenty years, but I have no if he knew that a charge would be made, he recollection of any difficulty in this treatment would gladly and promptly send the call. if the instructions were faithfully and intelliI recall a sad case, illustrating this point. gently carried out; but the rubbing in of a
. A druggist was taken with cholera morbus in
teaspoonful of oil on a space six inches in the evening and sent for a physician, an inti- diameter takes from twenty to sixty minutes, mate friend. The condition improved, tem- and not unfrequently this time is grudged; so porarily, but about 3 a. m. he became much that of late years I have added the homeopathic
I worse. Knowing that the physician would specific drosera, one drop in water 3viij; a
, make no charge, he would not allow a call to teaspoonful to be given after each paroxysm of be sent till morning. The delay was fatal. coughing. The latter will be attended to when The tremendous loss of Auid had left him the oil is partly or wholly neglected, and one pulseless and all efforts were unavailing. A or two prescriptions are all that will be needed hypodermic of morphin a few hours earlier in any uncomplicated case of whooping cough. would have saved his life.
Of course hygienic measures should not be Cincinnati, O. WM. D. PORTER. neglected.
The gist of the above was publisht in the Whooping Cough.
Medical Brief a couple of months ago, and Editor MEDICAL WORLD :- Page 266–7 of when I received a check for five dollars for the your June issue has a query and reply from you 100 words my hat became so tight that I as to best treatment for whooping cough. Tho thought I should have to purchase a new and
. the main points of what follows have recently larger one; but the last few issues of The been publisht, in my opinion it is worthy of WORLD have saved me that expense from that wider distribution and elaboration to attract
I am not a subscriber to the Medical attention. About twenty years ago my only Brief, and think your position in regard to it. son, a weakly child, was attackt with whoop- et al. is correct, and your reward sure, proing cough, and in two weeks had failed so vided you can stand it to wait long enuf; for much that there was no prospect of his weather- medical men, tho easy game when approacht
while worrying over a puzzling case or cases, two hundred days of sunshine, in which there are not ungrateful to their friends when they was not a cloud to mar the sky, and over one recognize them. My only regret is that you hundred days more that were days of sunshine. did not begin before the silica splint man and The real facts, Doctor, are that we have over the Comstock agency "pulled my leg.” More 300 days of sunshine every year, and that the power to your elbow. Faithfully and frater- city is located seven miles from the base of nally yours.
Geo. M. AYLSWORTH. Pike's Peak, and that the sun rises here as early Collingwood, Ont., Can.
as any place of the same longitude, and sets but ["Wait long enuf?" I can hold out as long thirty minutes earlier. The hours of sunshine as the medical profession lasts and remains true in Colorado Springs are greater than in any to its ideals.-ED.]
other city of the United States. I trust that
this will set you right about sunshine in ColoDysentery.
rado Springs. This city is known the world Editor MEDICAL WORLD:~Of the four varie- around as
“The City of Sunshine.” ties, the (1) acute, (2) amebic, (3) malignant,
B. B. Gaover, M.D. and (4) chronic, I have seen two epidemics of Colorado Springs, Colo. the second-one in 1884, the other in 1901. [We had received the impression somewhere My experience as physician is limited to the that Colorado Springs was in the mountain latter. It is usually confined to the tropics, shadows during the early forenoon and late but occasionally becomes sub-tropical. The afternoon of each day. We are pleased to have duration is usually from six to eight weeks, and the facts.-ED.] it often proves fatal. Treatment is per rectum, at seat of disease, and consists in high enemas
A Business Method Worth $1,000 per Year. (with rectal tube) of ichthyol in warm water, once daily. Large doses of subnit. of bis- Editor MEDICAL WORLD:-For five long muth are given internally, with a small amount years I struggled to keep up with my proof salol (if adult); opiates in limited quantity fessional brethren, always doing a good busto produce rest. Diet confined to milk, whey, iness, but booking an average of one thousand and rice-water. Cold pack and sponge to
dollars a year in bad accounts. Possibly once reduce temperature. This method has been a year, perhaps oftener, I sent out statements. very satisfactory to me.
At the end of five years I was one of the colBut most of our dysentery belongs to the lection agency “suckers." first—the acute catarrhal type, which runs but
I began to think something was wrong. I a few days to a week, and rarely proves fatal found the cause in myself. Bills for my own under appropriate treatment. First, admin- purchases were either due on delivery of ister a saline purge or mercury, in small re- goods, in thirty days or in sixty days. My peated doses, and followed by castor oil or debtor's bills seemed not to be limited ; in Rochelle salts. Give bismuth every two hours, fact never came due. Two years ago I reand the following every twenty to thirty minutes: solved to be my own collector. I actually Spts. camphor
destroyed by fire every memorandum and old Tr. capsicum
account, which in bulk if paid would have Tr, opium Tr. opium camph.
amounted to over five thousand dollars. I Sig.--15 to 20 drops every 20 to 30 minutes.
believed it was not too late to start over Diet, starchy and limited.
again. I personally framed this form of blank Occasional flushing of colon with warm water statement. (See next page.] and pyrolignin ; ipecac suspended in solution I was somewhat timid in sending out the of salol is highly recommended by authorities, first batch, but after that it was a regular but I have not tested it.
routine. Some of my patients and debtors J. G. WILKINSON, M.A., M.D. were insulted (temporarily only), but an exCatherine, Ala.
planation that it was my method of doing
business, and that each and every one of my • The City of Sunshine."
patients got the same thing, never failed to Editor MEDICAL WORLD :-In your com- clear the atmosphere. I have never lost a ment on Dr. Barbour's letter, page 239, June patient by this method. WORLD, you infer that Colorado Springs is Between the 25th and 28th of each month a located in a notch at the base of Pike's Peak, list showing every account is made out. I and receives sunshine only a few hours a day. check each name with a number, either 1, 2, It seems strange that you should make a state- 3 or 4. ment like this, of a city that is so well known Number i gets a statement of his account as as Colorado Springs. Last year our Weather per blank, simply showing amount. Bureau reported that Colorado Springs enjoyed Number 2 gets the same with the following