« PreviousContinue »
those exposed but few times and for short intervals.
These results are sufficient to prove the x-ray far from an inoccuous plaything, and it is now the duty of every operator to learn all the dangers that may beset both himself and the patient. One can easily imagin the sterility induced by the x-ray as figuring in suits for damages in much the same manner and with the same detrimental effect to the agent and to the operator that the burns and dermatitis produced formerly. There is no doubt that this sterility is produced by the x-ray, and in many cases by a very light dosage. Whether or not the effect will pass away in time, or whether it may be permanent, has not been settled. Some cases have recovered, and others of like duration are still impotent.
Every patient exposed to the rays should be protected by lead plates or by lead screens fitted with adjustable openings thru which the rays may pass in treatment. Every operator should employ some artificial aid in adjustment and manipulation of his tube.
Even if the x-ray cause no actual baleful effect, the indications for its use should be clear, distinct, and thoroly understood; and it should not be employed ignorantly nor without due study of the case and of probable results. Under existing conditions, it is frequently employed when we have much better methods of treatment. Some x-ray operators have forgotten the fact that we have the arsenic paste and the knife strongly indicated in some epitheliomas. Grosse, of San Francisco, says: believe it almost criminal that cancers of the lip with beginning glandular involvement should be so treated" (i. e., with the ray). "Epithelioma is to my mind much too frequently treated by this means." Many cases of hypertrichosis, lupus vulgaris, and erythematosus, acne vulgaris, alopecia areata, and psoriasis, do better under treatment other than by the x-ray.
We would not belittle the wonderful results achieved by the intelligent use of this agent in the hands of those who have given the matter comprehensiv study, and who have had enuf experience in its use to insure a mature and competent judgment; but we certainly decry its indiscriminate employment by those who have not devoted more than a modicum of consideration to the subject, and who have no regard to accurate dosage or ultimate effects. Every practician intending to use the x-ray in treatment should post himself thoroly by reading the best and latest literature, and fortify himself and his treatment by moving cautiously in every case, and even then make certain to use every safeguard about the person of his patient and himself.
Hurrah for Courageous Journalism !
The present is a notable time in periodical literature. McClure's Magazine has thoroly exposed the Standard Oil Company and John D. Rockefeller; Everybody's Magazine has exposed the methods of "frenzied finance;" the Ladies' Home Journal has exposed many of the secret nostrum methods, and Collier's Weekly is now engaged in a still greater war against the drug evils. Pages 16, 17 and 18 of Collier's for December 2 are devoted to "The Subtil Poisons," exposing chiefly the acetanilid mixtures, chief among which are "orangeine," antikamnia and bromo-seltzer; and the opium bearing soothing syrups, chief among which is Mrs. Winslow's; and the cocain bearing catarrh cures, chief among which is Birney's. This issue is well worth its price (10 cents) to any physician (address Collier's, 416 W. 13th street, New York City). THE MEDICAL WORLD, several years ago set the example in courageous journalism by exposing fake mining companies, collection agencies, and many other shady things that no one seemed to have courage enuf to tell the truth about. We are gratified to have thus done a great and much needed service to the profession, and we are also gratified that the above mentioned very worthy publications have adopted a similar policy, and are thus doing a great and much needed service to the public at large. Hurrah for courageous journalism !
How can the editor of any medical journal read the exposé of antikamnia above mentioned and print the advertisement of antikamnia in his advertising pages? The profession should ask every medical editor if he has read the article above referred to, and then ask why he carries the antikamnia advertisement. Will you write to the editors of all the medical journals you take about this matter?
Sink-holes for the Savings of Doctors. All kinds of speculation and investment schemes still come to me, either directly from the exploiters, or from the "brethren." The first one I open as a text for these lines reads "8 percent guaranteed." Well, what is the guarantee worth? John Smith, the shoe-string peddler, might say that he would "guarantee 8 percent on $10,000,000; but it would mean a very different thing if "Uncle Sam" would say it. I remember, when a small boy, I saw a young, half-clad but optimistic colored fellow working a game of chance or skill on circus day; it consisted of throwing rings at pins; and a series of prizes was offered. His cry was, "come right up; here's the place to make your fortune in a half an hour!" Where was the "fortune" to come from? Perhaps that negro never even saw a $5 bill. Some of
the seekers after fortune are as short sighted as the players of this ring game. They depend on blatant promises, but they never look to see what is behind the promises.
There is an air of solidity and safety about the word "bond." Many who will not touch stock will buy bonds. So some slick schemers issue bonds on stock? That catches the bondites, who do not realize that they might as well buy stock as to buy bonds with only stock behind them, or with only the same property behind them that is behind the stock. There
are many schemers after the savings of the people, and many of the people are anxious to let their savings go. The "flotation" of the stock or bonds of a big corporation on Wall street means the exchange of the stock or bonds of said company for the good, solid dollars of the people. If the people knew the safe and permanent value of their dollars, and the uncertain and shadowy value of the securities offered, they would keep their dollars. But the trouble is that Wall street purchasers (speculators) usually expect to sell later for more dollars than they gave. Sometimes they succeed in doing this, and sometimes they don't; but the securities are finally loaded on the public, in exchange for good dollars. If there were no easy public to unload vast securities on, not so many of these securities would be manufactured; or if the schemers were held strictly responsible for the money taken, being forced to either make their promises good or return the money, many a Wall street fortune would shrink to nothing. That's just the kind of a law we need, and it should be vigorously inforced. If the President's plan of National incorporation of all corporations doing an inter-state business (advocated by our Corporation book which came out a year or two ago) were realized, the general government could control absolutely this stock and bond business (few corporations are confined to a single state), and then responsibility could be inforced. The rascals who set traps for the public, advertise glowingly, and by their control of the newspapers work up a sentiment for the corporation (as in the case of the Steel (steal) Trust, Amalgamated Copper, etc.), and load their securities on the public, would be more chary about this sort of business if they were compelled to stand behind every dollar put into the stock by the public. President Roosevelt used to say that publicity would cure the evils in trusts and corporations. Publicity is a good thing as far as it goes, and it does some good; but we have had publicity galore, and many of the evils persist. Responsibility, strictly inforced, with the penitentiary for those who squander the money intrusted to them by the public, would finish the cure. Then the
profession wouldn't be bothered so much with those who wish to sell oil stocks, mining stocks, plantation stocks, etc. By the way, no doctor who has put money into such stocks has come forward to say that he has gotten his money back, out of the enterprise, tho I have publisht an urgent invitation several times. Are we to infer that all such things offered to the medical profession are sink-holes for money? Maybe the money never got further than the schemer's pockets. This is quite likely. Why will doctors throw their money away in this way, when they can keep it safely in bank, or loan it out at good interest on real estate security in their own community? Don't listen to fairy promises of profit. Look to security first.
Here is a quotation from an address delivered before the Technical Society of the School of Mines, at Golden, Colo.:
"In one city, which I will not name, a promoting concern by a combination of circumstances were recently driven into such a corner, by a big daily newspaper, that they had no recourse but to allow an examination of their books by an outside public accountant. The concern had organized and floated seven 'wild cat' companies based on the merest 'prospects' in out of the way, speculativ districts. As a result of the examination of their books by the public accountant he showed that the total receipts from the sale of stock in such seven mining companies was $166,805, out of which only $23,237 had been spent for labor and supplies, $20,578 had been spent for superintendents' traveling expenses (including the promoters) and no less than $114,714 had been pocketed by the promoters for commission and for sale of promotion stock, leaving aggregate cash on hand for the seven companies $2,276 only."
Fortune hunting, even when successful, is a bad business, any way. Today a pauper, tomorrow a millionaire, and next day a pauper again! Not impossible; these things have occurred time and again in the mining districts of the west, in the oil regions, and on Wall street. Where these things are possible, a craze siezes the community; everybody is affected; the foundations upon which reason and morals are based are undermined; the old and true standards are swept away, and moral fiber is worn to tatters. Better stick to the old way. Better work for every dollar, and then guard its safety; thus climbing to comfort and competence (not wealth) for yourself and family, and preserve and hand down to succeeding generations the old tried and true standards of our fathers; standards of industrious honesty
and moral rectitude that have made the world what it is, and that will preserve the best there is in civilization as long as they are adhered to.
With these standards firmly planted in our daily life, we can receive telegrams like this: "Shot No. 9 yesterday; 500 barrels of oil the first 24 hours"; or "Struck a new rich vein today; assays $1000 per ton," etc., together with urgent appeals to take stock before it
rises, without reaching for our pocketbook. Also, we know that no corporation is anxious to get rid of its stock at less than its real value; and that if it would pay better to sell their oil or ore than to sell stock, they would begin selling oil or ore and quit selling stock, which they would keep for its real value. But the craze of the schemers is to exchange bad stock for good dollars. Corporations which are really making big money out of their legitimate business, and have no reason to load their stock on the public, usually keep still about it.
I present a concrete instance of "how it is done," from the Philadelphia Ledger for this morning (Dec. 20). The difference between these people and many similar ones is that these people got caught, and were brought to the bar of justice.
SIX MONTHS FOR MINING SWINDLER. THOUSANDS OF POOR PERSONS BOUGHT STOCK NOT WORTH A CENT A BUSHEL.
F. S. Pusey, of Germantown, one of the promoters of a $3,000,000 mining scheme, in which thousands of poor persons invested their savings, was sentenced to six months' imprisonment yesterday by Judge Davis. He had been convicted of swindling A. S. Moore, of New York, out of $4,000. The jury took only ten minutes to decide that he was guilty.
The concern with which Pusey is connected is known as the North Platte Mining and Copper Smelting Company of Wyoming. William R. Brown, secretary and treasurer of the company, is under indictment in Boston. A fugitiv warrant will be issued to-day for A. L. Seymour, of Orange, N. J., a partner of Pusey. Seymour fled to Nova Scotia when the exposé came. The company is in the hands of a receiver.
GOOD NAMES IN THE DIRECTORATE.
Much of the history of the mining scheme was rehearsed in Judge Davis's court. Witnesses swore that Pusey and Seymour organized the company, and, to give it tone and standing, gave a certain number of shares of stock to several well-known Boston business men. These men allowed themselves to appear as officers and directors of the company Joshua Sears was made president: John Curtin, vice-president, and Colonel William R. Brown, secretary and treasurer. The directors were Curtin, Sears, Edwin Cass, Louis F. Wood and Gustavus A. Damon. All are of Boston except Wood, who is a resident of Arlington, Mass. FLOATING THE STOCK.
Three years ago the company began to float its stock. Owing to the prominence of the Bostonfficials, most of the stock was sold in Boston, although many Philadelphians were among the investors. The country was flooded with literature, telling of the company's property in Downey Park, War Bonnet Mountain, Wyoming. The policy of the concern was dictated by Pusey and Sevmour, its originators, who, however, did not let their names figure in the prospectuses. They had an cffice in the Drexel Building.
Among those who sought to obtain the company's stock was A. S. Moore, of New York. He communicated with Colonel Brown, and was directed to see Pusey. He came here, and after a long interview with Pusey, was convinced that the scheme was good. He invested $4,000.
Short articles of practical help to the profession are solicited for this department.
Articles accepted must be contributed to this journal only. The editors are not responsible for views expressed by contributors. Copy must be received on or before the twelfth of the month, for publication in the issue for the next month. We decline responsibility for the safety of unused manuscript. It can usually be returned if request and postage for return are received with manuscript; but we cannot agree to always do so. Certainly it is excellent discipline for an author to feel that he must say all he has to say in the fewest possible words, or his reader is sure to skip them; and in the plainest possible words, or his reader will certainly misunderstand them. Generally, also, a downright fact may be told in a plain way; and we want downright facts at present more than anything else.—RUSKIN, REFLECT
Sudden Death in Labor.
Editor MEDICAL WORLD:-About 3 p. m. December 4th of this year I was hurriedly called by phone to assist Dr. Huber of this place in a case of childbirth. On arrival at the residence of the patient I was informed by the Doctor that he had been summoned about an hour before by the husband to attend his wife, who, he said, had been in labor for sometime and was not getting along right, but gave him no definit information about the case. When Dr. H. got there, he said, he found that the woman had been delivered of the child, but the husband's mother told him that the afterbirth had not been delivered. The old woman had been in charge of the case, and she said she had taken care of many cases before, but this one had gotten beyond her skill. On examination of the patient by Dr. H. he found an arm protruding into the vagina, and informed the family that a twin was yet to be born. On attempting to deliver the babe the Doctor found that it was wedged into the pelvis so tightly that he must administer an anesthetic, and proceeded to do so, but on account of the nervousness and apprehension of the woman he had to call in help. On my arrival and getting the above account from the Doctor, we proceeded to deliver, the Doctor giving the anesthetic, ether, and I to try to turn the child. I found the child wedged into the pelvis as described by the Doctor. After working for more than an hour a foot was secured and the delivery accomplisht. Before succeeding in getting hold of a foot the woman's condition became serious, the Doctor announcing that the pulse was failing, and before I had succeeded in delivering the body Dr. Huber commenced to get ready a hypodermic of strychnin and injected it into the patient's arm. She continued to fail in spite of more stimulants of ammonia, nitroglycerin, digitalis, camphor, &c. She began to raise and lower the lower limbs, and to toss the arms, roll from side to side, and would not
allow Dr. Huber to remove the afterbirth; was not fully conscious; began to mutter; would sit up in bed and squirm around on the but tocks; throw herself down again upon the bed; would thrash the arms around like a windmill; would moan piteously, and continue to thrash around on the bed, now turning her head toward the foot of the bed and then almost immediately reversing toward the head of the bed. It was endeavored to arouse her to consciousness, to recognize her husband, children or friends, but to no purpose. She gradually sank; the thrashing about on the bed became more feeble; the pulse left the wrist and respiration became less and less. The Doctor and I recognized that as soon as she got quiet she would die. She died without ever regaining any degree of consciousness. The afterbirth was not delivered. The second babe was born dead and the right humerus was broken at or near the shoulder. I am certain I did not break it myself. There was some considerable flattening of the arch of the pubes, and the most prominent sacral promontory I ever had anything to do with. Why, it was what might be called a shelving projection of the sacrum. This was a most heart-rending case. We were powerless to save either the mother or second babe. The mother was a stout, robust woman and this was her fourth pregnancy.
I need not point out to physicians the lesson here taught. The husband's mother had "taken care" of several cases of labor and everything had gone well, but here in an unexpected hour fatality loomed up in her path. "I will laugh, sayeth the Lord, in the day of your calamity; "but this was no laughing matter to the helpless physicians and to the sorrowing young husband and to the consciencestricken old woman who had essayed to do that which the law prohibited her from doing. Will these doctors who are howling against the laws enacted to prevent such incompetents from "taking care" of women and to protect the lives of confiding puerperae continue to say that they are solely in the interest of "a few self-seeking political doctors"? Oh, come off! J. J. CONNER, M.D.
Pana, Ill., Dec. 10, 1905.
Puerperal Convulsions. Editor MEDICAL WORLD:-The article of Dr. Paul F. Ela in the December WORLD, page 489, calls to mind some similar cases in my experience, and his reckless use of morphin in those cases induces me to state how I managed them. The first case I ever saw occurred in the summer of 1856. Mrs. P. Sullivan was a stout, young, married woman, whose husband was a track laborer on the railroad. He left his home at six o'clock in the morning, and
did not return till night, consequently she was left alone all day, except when a neighbor happened to call. About the middle of the afternoon one day a lady called and found Mrs. Sullivan lying on the floor, senseless and having almost continuous convulsions. No one of course knew how long she had been in that condition, as no one had seen her since her husband left her in the morning. I saw her first about 4 o'clock p. m.; found her on the bed where the women who had collected placed her. She was scarcely out of one convulsion till another appeared, and was utterly senseless all the time. The first thing I did was to take a full quart of blood from the arm; this checkt the spasm; then I gave ten grains of calomel with half a teaspoonful of sodium bi-carbonate. Made an examination, and found that the labor was making some progress. I did not interfere, leaving the case to nature. Then I made a mixture of Epsom salt and cream of tartar, equal parts, and gave all we could get into her stomach, which was not very much because of her senseless condition. In two hours another terrible convulsion came, and again a large quantity of blood was taken. This ended the spasms, but she lay perfectly motionless and comatose till a pain would come (which was about every half hour), when she became terribly agitated, and it required three or four strong persons to keep her on the bed, but she did not seem to know what she was doing at any time. This continued till four o'clock the next morning, when a dead girl baby was born.
Till this time no medicin was given except as above stated, but now I began to give quinin, as every one in this region at that time was full of malaria, and it was necessary to give quinin in every sort of case. I continued the above named mixture to keep the bowels well relaxt. She still remained perfectly comatose for twenty-four hours after the completion of labor, when semiconsciousness appeared; but for three days from this time she was utterly insane, then gradually regained her senses and made a good recovery, and was in bed but one week.
Have seen a number of cases since that time and have made it a rule to bleed in every case when the convulsion came before the completion of labor, and never give morphin or opium in any form till after the termination of labor, and not then unless the mind is clear between convulsions.
Was called to a lady who had been in the care of an old midwife for forty-eight hours and should have been delivered hours before, and would have been had she had proper attention. Found nothing serious the matter, but the woman much exhausted. Soon delivered
a babe with the forceps; then found another, which followed in a very short time. The patient seemed all right, and I was about to leave, when a violent convulsion seized her. I at once gave her a hypodermic of one-third of a grain of morphin, which was all that was necessary; no trouble followed, and she with the babies got on all right.
Have used veratrum viride in some cases with good effect, and since the introduction of the bromids and chloral hydrate, have used them quite extensivly with satisfactory results. Chloroform is all right to modify the spasms, but it don't cure the patient. My formula for the bromids and chloral is: Potass. brom. 3 3, chloral hyd. 3 2, camphor water q. s. f3 4. Mix. Sig. Give a tablespoonful in water as required.
I have never seen but one woman die with puerperal convulsions, and I shall always believe she would have recovered if she had been properly bled.
Was called in consultation; found the case like several others I had seen-no worse; had been having spasms frequently for ten hours. I advised bleeding at once, but the attending physician and friends objected and the woman died.
To repeat, I say bleed in all cases when the fit comes before the termination of labor, and after, if the wasting has not been very free and if the patient remains comatose. I have sometimes bled the third time and have never had occasion to regret it. I believe the Epsom salt and cream of tartar mixture an excellent adjuvant, given to free the bowels thoroly, and it undoubtedly has a good effect on the kidL. L. SILVERTHORN.
Treatment of Eclampsia. Editor MEDICAL WORLD:-Every pregnant woman whose urin gives the slightest indication of albumin should be immediately put upon an exclusiv milk diet. This regimen is the preventiv treatment par excellence of eclampsia.
When a patient attackt by eclampsia is vigorous and cyanotic, bleeding from four to five hundred centigrams is indicated, and should be followed by the administration of chloral. She should be put upon a milk diet as soon as possible.
When the patient is delicate, the cyanosis less markt, the convulsions less frequent, chloral alone may be sufficient.
Labor should be allowed to begin spontaneously, and to pursue its natural course whenever possible. If the contractions are insufficient, delivery may be accomplisht by version or by the forceps, if the child is living; if dead, by cephalotripsy, basiotripsy or cranioclasis.
Interference should be postponed until the parts are completely dilated, so that the operation may be performed without injury to the mother.
Labor should be induced in those cases only in which medical treatment has completely failed. Incisions of the cervix for the purpose of inducing labor, should never be attempted.
Eclampsia depends upon the association of two elements: Toxemia and heightened reflexes. Many cases in which reflex influences are the preponderating cause are relieved by delivery; others suffer from genuin toxemia, and die in spite of all treatment.
There is another class between these two in which treatment may be very efficacious. Unfortunately the symptoms are not easily differentiated. Chloroform is an important remedy when the convulsions are caused by reflex action; but its prolonged use may be dangerous when they are due to toxemia. Light, noise and cutaneous irritation should be avoided, and blisters, leeches, and bleeding are not recommended by some.
Milk is a great preventiv, and a curativ when the danger of convulsions is not imminent. As soon as the presence of albumin is recognized, milk diet should be instituted and maintained until after delivery, even when the symptom does not persist. Albuminuria is but a danger signal, and the danger may remain after the signal disappears. St. Meinrad, Ind.
N. A. JAMES, M.D.
Faulty Treatment of Pneumonia. Editor MEDICAL WORLD:-I have just finisht reading THE WORLD for November. This issue of THE WORLD has caused me to think. What a help it is to one of us little fellows to get a journal once a month that sets us thinking and helps us to think. I am now 52 years of age, have practised 30 years, hoping all that time that I should some day be a doctor; but I am yet a student. Several pages of the November WORLD are devoted to pneumonia, a very interesting subject to me. It seems that no age, or sex, or environment, is exempt from this dreadful scourge. I am unable to give
statistics as to deaths or recoveries from this disease for two reasons: First, I have kept no record of my cases; second, I may have been mistaken as to some of the cases being pneumonia. I am sometimes called to see a patient, find face flusht, respiration hurried, fever high, intense pain in one, sometimes both sides of the chest, tongue coated, urin scanty and highly colored, and troublesome cough. Began with a severe chill or rigor. At this time there is some resonance in all parts of the lungs, tho I hear crepitant rales. Expectoration principally mucus, tough, ropy, and tena