CONTAMINATION OF FOOD FOR INFANTS. own experience. An attack of acute dysentery having BY H. M. PAINE, M. D,, ALBANY, N. Y. It is claimed by eminent physicians, who have made the diet of infants a special study, that an occasional source of disease is traceable to the contamination of the milk by minute organic growths. These organisms multiply under favoring conditions, very rapidly, more so than the digestive organs are able to destroy. Even after the food is taken into the stomach they speedily develop in it a process of putrefactive decomposition, thereby rendering it in-nutritious and harmful; and causing, by irritating the stomach and bowels, all the well-known symptoms of cholera infantum. It is also stated that these germs form, at times, on meats and vegetables, even when kept in an ice chest; also that an ordinary bouquet of flowers is an occa sional source of contamination. Whether this plausible theory be true or not, the means suggested for avoiding apparent danger in the direction pointed out are reasonable and easy of application. They were: 1. The securing of purity and uniformity of food.This was accomplished by using only condensed milk, diluted with water alone. 2. The preventing of contamination.-This was attained by keeping the milk and all the utensils used as much as possible from all other kinds of animal or vegetable food. The milk, except in very hot weather, was kept in the second story of the building; and when placed in an ice chest was kept in one in which no other kinds of food were preserved. 3. The sterilization of the germs, should any exist. This was done by two methods. First, by raising the temperature of the food, immediately before feeding, to 150 degrees, but not to the boiling point, and then allowing it to cool before giving it to the infant. Second, by dissolving in each bottle of food five grains supervened, in the month of January, upon drinking a glass of buttermilk, numbers of micro-entozoa were found in the evacuations. Two enemata, one at night, the other next morning, of ten minims each of olei terebinthinæ and acidum carbolicum, in two ounces of water, were followed by complete relief. Borden's condensed milk is recommended for use during summer months, being more binding than the Swiss preparations, which are specially serviceable in winter. The doctor states that the quantity of the mercuric chloride is so small no fear need be entertained of producing constitutional effects, the medicine being seldom required longer than two or three days. Having no fear of the least possible danger from medicinal ill effects, I recommended the constant use of the remedy, as previously described, during the summer months. The result of the trial last year was sufficiently satisfactory to warrant its repetition; accordingly I have again commenced prescribing it the present season, and intend continuing its administration during the warm weather. The doctor further suggests the occasional addition of a moderate amount of lime water, to neutralize the excess of sugar used for the preservation of the condensed milk; also, in cases of children over one year old, the addition of wheat phosphates in some form, the Imperial Granum, for instance, which recommendations are pertinent and practically serviceable. 1 have found Ridge's Food and prepared oatmeal combined very useful and satisfactory for the purposes suggested. CLINIQUE. of mercurius cor. of the third decimal potency, with a CLINICAL CASES FROM WARD'S ISLAND view of destroying all the organic elements of the kind in question, if any were present. HOMEOPATHIC HOSPITAL. House Surgeon. This plan was inaugurated early in July, and was REPORTED BY E. GUERNSEY RANKIN, A.M., M.D., faithfully carried out during the warm weather. As each of the four or five bottle-fed infants in the Institu- . tion were exempt from any form of serious disease of the bowels, it is presumable that the plan contributed somewhat to their comfort and safety. * Dr. Ravenburg, of Washington, has invited the attention of the profession to this important subject, in an article published in the Medical Record of July 6, 1878. He recommends that one grain of murcuric chloride be dissolved in twelve ounces of distilled water, and of this one teaspoonful be added to each cupful of food. The proportion is essentially the same as that of the third decimal homœopathic preparation. Dr. R. states that Ringer (pseudo homeopathic authority) assigns to mercuric chloride the first place among the numerous remedies found useful or curative. In severe cases he recommends that the medicine be administered by injection into the rectum, by adding it to a cupful of boiled and cooled water. vere. CASE I.-PALMAR ABSCESS. Harry H., clerk, aged 22 years, was admitted to the hospital January 23, 1879. About four weeks previous he received a severe blow from a hammer on the first phalanx of the index finger. A day or two subsequently it became edematous and exceedingly painful, and an abscess formed, which included the palm and index finger. He applied hot fomentations, with but little relief; the pain was very seHe then went to Bellevue Hospital. The palm was there incised three or four times at several points, affording a very copious discharge of pus. A solution of carbolic acid was applied, and the abscess syringed out with the same. The hand con He also states that in Virchows Archives, 1875 or tinued to grow worse, and the pus to increase in 1876, a cure of a case of chronic dysentery is reported quantity. The forefinger was apparently about to where organic germs (amobæ) were found in the evacu- slough away. It was accordingly decided best to ations. Ordinary internal remedies having failed, a amputate it, in hopes to save the hand at least. The rapid and complete cure followed the use of medicated patient, being unwilling to submit to the operation, injections selected with a view of destroying the germs. came to this hospital on the above mentioned date, The same journal contains an article on the com parative value of anti-ferments, and to murcuric admission here, the hand presented a most unpromafter having been in Bellevue about ten days. On chloride is there assigned the first place, the propor-ising appearance, being of a blood-red color and tion required to sterilize the fluids being still less, only The doctor cites an instance which occurred in his 1 in 25,000 parts. exceedingly edematous; there was a copious discharge of pus from two openings, one at the metacarpo-phalangeal articulation of the index finger, *Extract from the Medical report of the Physicians to the House ducing a probe, a large, irregular sinus was found to and the other at the first phalangeal. Upon intro of Shelter, Albany, occupy the palm and to connect the openings. The bone of the first phalanx was slightly necrosed. The patient was etherized, the sinus laid open, and the first phalanx scraped, and syringed out with a solution of carbolized calendula. The hand was dressed with lint, saturated with the same, and covered with carbolized cloths. Hepar sulp. 3d was given internally. The same dressing and treatment were continued for the next three weeks, the abscess being syringed out with the carbolized calendula twice a day. There was steady improvement until the whole hand was nicely healed, and the patient discharged (February 15) with only a slight stiffness of the forefinger, not sufficient, however, to interfere with his occupation as clerk. confined to bed, suffering from exhaustion and the effects of prolonged immersion in the cold water. CASE II.-EFFECTS OF FROST BITE, WITH OPERATION suffering most intensely, he was seized with a convul BY DR. THOMPSON. James O'Brien, laborer, thirty years of age. Entered the hospital April 18. Winter before last the toes of both feet were frost-bitten. He was treated at Bellevue Hospital, where the first phalanx of the left great toe was amputated. A short time subsequently ulcers appeared, which caused a good deal of pain, especially in cold weather. On admission to the hospital he walked with a crutch, being unable to bear the full weight of the body on the feet. The toes were very sore, perfectly cold to the touch, and the integument of an unhealthy bluish hue. The left foot was especially painful, the pain being at times so severe as to keep him awake at night. A solution of carbolic acid and calendula was applied and sulph. administered, with not much effect. The feet were then rubbed with vaseline and wrapped in flannels, to restore the natural warmth of the part, and kreos 3x was given internally, followed during the next two weeks by lachesis 6c, ars. 3x, and agaricus 3c. The right foot improved considerably, but the left did not show much change, and the pain was constantly present. Dr. Thompson therefore decided that any further medical treatment would be fruitless, and accordingly, on May 20, performed Hay's operation. After landing at Norfolk, Va., he went to Fortress Monroe, where he remained for four and a half months, doing light work, but never feeling strong. The constitution had not only been reduced by the hardships of a sailor's life, but by excesses of all kinds. After being at Fortress Monroe for three weeks, and five weeks after his shipwreck, he first felt a stinging sensation in the right thigh, running down the course of the sciatic nerve. The pain continued steadily to increase, being much worse in damp or stormy weather. He was attended by an allopathic physician, who gave potassium iodide and applied counter-irritation, without benefit. Experiencing no relief, three months later, when sion, which subsequently proved to be the first of a series of similar paroxysms. In October, 1878, he went to Charity Hospital, having had up to that time eight convulsions, the burning, stinging pain on the thigh remaining as intense as before. At Charity Hospital potassium iodide and the electric battery was the treatment, but entirely without success. He came to this hospital on December 24, 1878, and went out after remaining only a few days. On admittance to the hospital on January 29, 1879, the patient presented a very pitiable condition. There was an expression of intense suffering. The body was bent forward, and to the left, the head inclining toward the right. The right knee was kept constantly flexed, and the thigh adducted. The right thigh measured in circumference at the upper third 18 in., the left 19 in. above the knee, the right 124 in. the left 13 in., right calf 114 in., left 12 in. Both limbs measured the same in length. There was partial anaesthesia of the whole right thigh down to within an inch of the upper border of the patella. During the first two months, Rhus 1. Colocynth 1. Colchicum 1. were the remedies employed. The convulsions continued to increase in frequency and severity, and the pain was always present. From April 1st. Strychnia 1c. 1 gr. three times a day for two weeks, and then Nux Vom. 1c. were administered, and since the use of these drugs the patient has had but five convulsions, whereas previously he had been subject to as many every week, there sometimes being two or three in one day. The inability to walk without a crutch and cane, the deformity, and above all, the pain, remains unchanged. have been in all about thirty convulsions. These are of a very severe and peculiar nature, and in many respects resembling tetanus. Every muscle suddenly becomes tense, the countenance assumes an expression of anguish, the features fixed and convulsed, relaxing from time to time, and the angles of the mouth drawn down, giving the risus sardonicus. The pupils are contracted, and the eyes fixed. The res piration and pulse are both feeble, but not materially interfered with. There is a condition of opisthotoWhen eighteen years old he went to sea, and fol- nus. During the moments of partial relaxation the lowed a sailor's life from that time until November, hands would convulsively tear at the right thigh, 1877, when he was shipwrecked off the coast of and over the course of the sciatic nerve, as the neuSpain. He and a comrade remained in the water, ralgia at these times is more intense than usual, and clinging to broken spars and life preservers, for apparently is the cause of the reflex convulsions. about twenty-four hours, when they were fortunate There are constant jerkings and quiverings of the enough to attract the attention of a passing Italian whole frame. The suffering is very great, as there is bark, bound for Norfolk, Va. They were taken on complete consciousness. Various palliatives were board and kindly provided for. After the rescue employed. Ether, chloroform, Amyl Nit, and hy the patient became unconscious, and remained so podermic injections of Magendies Sol. of Morphia; for two hours. For the next two days he was the last seemed to have the best effect. The operation was followed by sloughing, and a small amount of gangrene; pulse was 140, temperature 103 4-5; there was a good deal of thirst and gastric disturbance. This condition rapidly disappeared under ars. 1c., 5 gr, every two hours, and the stump granulated and healed. CASE III.-NERVE STRETCHING FOR REFLEX TETANI- There On the 6th of May the patient was shown to Dr. CHRYSOPHANIC ACID IN SKIN DISEASES. Helmuth, who decided to stretch the sciatic nerve. The operation was performed in the amphitheatre of the hospital on May 11th, at 11:30 A. M., the methods of operation being the same as those employed by Dr. Helmuth in cases previously reported. The incision was sewn up with wire, and drainage tube introduced, and dressed with cold water, carbolized 1 to 100. On the evening of the same day the patient's temperature was 1004, pulse 80. There was considerable pain at and below the point of incision, but none at the old seat of pain, i. e., the point over the exit of sciatic from the pelvis. May 12th, A. M. Patient slept well last night. The wound is looking nicely. Not until now has the pain been intense. He complains of a knife-like pain over the point of incision, and at the knee. Ten minums of Magendie's solution of morphia sulphate were given hypodermically, with great relief. In the afternoon of the same day temperature was 101, pulse 90, strong and full. Tincture of aconite was given hourly. Toward evening there another paroxysm of intense pain, for which morphia was again administered hypodermically, and the tincture of aconite continued, the temperature at this time being 103, and pulse 100. was tropics of the old and new world. It contains eightyGoa powder is the product of a tree growing in the four per cent. of chrysophanic acid. The action of the acid on the skin is that of an irritant and a dye. The inflammation of the skin which it causes is often quite intense, accompanied by aedema, acne and occasionally by chills. All these symptoms disappear in ten days. Prof. Newman reports twenty-six cases of psoriasis of from six weeks' to forty years' duration cured in from of chloasma uterinum cured. He also found it curative three to forty-six days. He also reports twelve cases in pityriasis versicolor, herpes tonsurans, lupus, syphilis cutanea, maculosa and papulosa, vegetans, psoriasis, syphilitica, palmaris and plantaris. Its use is contraindicated in eczema, except eczema marginatum and sycosis. He uses it in ointment in the proportion of one part of the acid to four of simple ointment, flavored with any essential oil. In psoriasis the treatment begins with a warm bath, when the scales should be removed by means of a brush and sapo viridis. When extensively diffused on the face and scalp care must be used on account of the skin disorders an ointment in proportion of one to eight violent inflammation sometimes excited. In parasitic is best. losis and tuberculosis, apply twice a day; spread on In chloasma uterinum, lupus vulgaris, macuMay 13. The wound apparently is not going to be added to the ointment for lupus erythematodes. It linen held in place by adhesive straps. Thymol should heal by first intention, as might be expected from the requires long treatment. to be While it does not prevent patient's poor condition. the reappearance of psoriasis, it removes it so speedily that it may be regarded as a most important remedy A. M. Temperature 1021, is quiet and comfortable. In the afternoon there was a slight trembling and twitching of the body, resembling his former convulsions. This condition soon passed off, only lasting for a few moments. May 15. Temperature 101, pulse 96, was a little delirious for a while this morning. Removed drainage tube and sutures. The incision gaped, being covered with healthy pus. Carbolic dressing and straps were then applied. For the next seven days there was some fever, the temperature ranging from 99 to 101°. During this time Hypericum and Kalmia lat. were administered, also Morphia sulphate on four different occasions, twice hypodermically, and twice by the mouth. Hypodermics of water at first afforded temporary relief, but their subsequent use seemed to greatly aggravate the pain. There has been continued improvement up to the present time (June 4.) The body being almost straight, and as yet no return of the sciatica which caused so much suffering. The neuralgia which had been present after the operation was only that which would naturally follow such a procedure. July 20.-Since writing the above, the patient has been free from all pain, except on sudden movement, and has had no convulsions. Two sinuses formed at the point of operation, which, after resisting several measures them to heal, are finally yielding to a solution of to cause nitric acid. The presence of these sinuses have delayed the cure of the case, which seems not far distant. JABORANDI IN PUERPUAL CONVULSIONS.-Dr. H. B. White relates the following case: Primipara at term, health good until within a few days, strange feeling in her head, swelling of feet and legs coming on for several days, and now she could scarcely walk about the room; labor had not begun; had passed but little water for several days, its condition not noted. Infusion of jaborandi was given in repeated doses, but convulsions set in, with stertorous breathing. But a drenching perspiration soon began, and the patient made a good recovery in the usual time, though the urine showed moderate amount of albumen. for skin diseases. After DIAGNOSIS OF LESIONS OF THE CORTEX CEREBRI.— Dr. Maragliano argues that we have means of distinguishing a lesion of the cortex cerebri from one of some other part of the brain. He thinks that convulsions arising from injuries of the cortex are generally the cortex cerebri, the centrum orale is thought to be restricted to one limited group of muscles. the only one that gives origin to localized fits; but the overlying gray matter is unaffected. After diligently we are in want of instances of such fits resulting where searching medical literature he cannot find a single example of partial epilepsy which is not owing to a lesion in the cortex. The loss of consciousness comes on late or not at all, and the paralysis appears gradual and is circumscribed, or there is hemiplegia of one side coming on gradually. The paralysis is soon followed by contractions, or is associated with aphasia, having the character of amnesia or verbal ataxia, or of verbal paralysis. There is a slight loss of temperature in the paralyzed limb, and if there be a localized pain in the by percussion, then the diagnosis of a cortical lesion one part of the head, either spontaneous or brought out cannot be doubtful. Providence, R. I., says: A CURE FOR INEBRIETY.-Dr. J. H. Johnson, of for drunkenness it would appear that it is now discov"If there exists a specific cure small twigs of the Cinchona rubra, and the effects folered. The remedy is prepared from the bark of the powerful tonic and nerve-stimulating properties are lowing its administration are almost miraculous. Its such that it at once begins to take the place of the alcoholic stimulus, and in two days the patient feels a strong aversion to alcohol in any form. In every instance in which I have given this medicament a trial I have met with perfect success, and not only has the patient rejoiced in a complete recovery, but his friends and famdeliverance from the terrible malady. The time for ily have been rendered unutterably thankful for his effecting a cure is from ten to twenty days. I use a saturated solution of the Cinchona rubra, giving a teathe constitutional effects are apparent; then I gradu spoonful every three hours for two or three days, until ally diminish the dose. The Homeopathic Times. A MONTHLY JOURNAL which are constantly coming up in the practice of every intelligent man, should be given to the whole profession as a part of the debt due from each indiIvidual member. The immense amount of clinical material con Of Medicine, Surgery and Collateral Sciences, stantly presenting itself in our charitable institutions THE DUTY OF THE MEDICAL PROFESSION TO ITSELF. It is the boast of the medical profession that its resources are open to all, that it contains no secret remedies, and that the skill and research of each individual member, so far as the line of investigation and mode of treatment goes, is fully at the service of the whole profession. It is this catholicity of feeling which gives our art some claim to take rank among the sciences, and yet what an immense proportion of the working men in our ranks are receivers and not givers. They absorb eagerly, and put to the practical test other men's ideas, but give out nothing of their own researches, of their own practical experience for the benefit of their medical brethren. Their duty commences and ends, in their own estimation, with their own patients and their own pockets. If all were to follow this plan, where would be progress. Instead of being an immense army of thinkers, each one zealous to contribute something to the great store of knowledge, all linked together in a fraternal chain, each one helping the other on in the path of progress, and all with united effort cleansing the sources of sin, and crime, and disease, and bringing to light the harmonious secrets of nature, each man would stand alone, with no one to council, no one to help him in his weary, toilsome path. We wish we could adequately impress upon the mind the fact that in the way of knowledge each individual has a duty to perform to his medical brethren which he cannot in honor or honesty evade. Every educated man in active practice is capable of imparting something to the general store of knowledge. A report of some individual case carefully studied and scientifically treated; a post mortem in which the pathological picture clears up otherwise unintelligible symptoms, and oftentimes suggests more scientific treatment; the specific action of remedies, and a hundred thoughts and suggestions should be utilized for the public good. And just here comes in an important thought which our young friends should not neglect. Cases which are to be written out for the public, if they are carefully prepared, and presented with clearness of style and proper intelligence, not only convey instruction to others, but bring the writer before his professional brethren in a favorable light as a clear thinker, who not only understands his subject, but knows how to ment. The young man taking his place among the draw upon the resources of science with good judgacknowledged ranks of earnest thinkers, hard workers, and good practitioners, at once inspires confidence among his confreres in his ability, and is helped along in the commencement of a profession in which it is often difficult to secure a position. We do not advise any one to write unless he has something instructive to say, and that should be presented in as clear and condensed a manner as possible. But the man who goes through the world with no thought which would be of benefit to his neighbors, with no work so well done that it would not aid others in their toil, has no business in the ranks of a learned profession. He is out of place there, and should take the broom or the pick, and perform simply automatic work. Is it honest to be constantly receiving from the general fund of knowledge, daily using the fruits of others' research, and making no return to the general stock? A great profession should be so linked together that every individual member should do something to aid his brethren in the great work in which all are interested. That something should be done to make the stream of knowledge clearer, stronger, and purer, is evident to every thoughtful observer; but by no means to fill it up with rubbish, gathered loosely, and without judgment, from every quarter; not to confuse the mind with wild and puerile speculations, but to present only ripened thoughts, the result of close analysis and careful research. In this age of steam and lightning when the current of life rushes on so rapidly, when so much is accomplished in so little time, we want the wheat without the chaff. Men who can give that will always find an appreci ative audience. AMERICAN INSTITUTE. We have been frequently asked, "What is the use of membership in the American Institute of Homœopathy? It is an expensive affair, and, as at present managed, unworthy support." Our answer has been, "It is the National repre sentative organization of our school; should be supported upon a high plane, and demands your aid to make it what it ought to be." It is up-hill work to argue a cause in the face of so many irregularities, eccentricities, and general illmanagement. Since 1875 we have paid, annual dues of $7, for which we have to show one volume of Transactions, bound in paper, costing about three dollars. In our opinion, the unbusiness like procedure of electing a secretary for five years, with a salary of $1,000 per year, has done much to demoralize the members, and lessen their respect for the organization. If we mistake not, some of the present officers were of the committee which recommended the Institute to an action which was sprung upon it without deliberation. Does any one suppose that such a measure would have carried if due notice thereof had been published in advance? This committee ought to have known that so important and vital a proposition should have lain over one year, that all the members might be informed of it, so that a fair expression of sentiment could be obtained. The organization has been guilty of irregularities, which we shall not detail, and which a far seeing justice has long since frowned upon. "Is the American Institute of Homœopathy truly representative of the profession in this country?" Our school claims over five thousand practicing adherents, and this organization, in the last report we have, claims only about eight hundred in its membership, many of whom are hopelessly delinquent, to say nothing of the other hundred or so honorable gentlemen, who have been laid on the shelf with the title of "senior member;" and we can scarcely call the organization which includes less than one-fifth of any particular class as representative of a sect. The organization, to be a success, must include a larger proportion of the members of the profession in its membership, and, unless some plan is devised by which a greater interest can be awakened, the society will die of inanition, as might be expected under such management, as we have experienced in the past. The idea of a scientific society placing its members, as they arrive at the age of fifty years, upon the list of "senior members," without dues, is an unheard of, an unwarranted, and an unnecessary proceeding, and one which we have no doubt a majority of the "seniors" themselves would disapprove. Most of these gentlemen are in a pecuniary position to meet their dues without murmur, and to such as are not, under certain circumstances the Institute would no doubt remit. If any favor is to be shown, it should rather be to some worthy young man who is unable to avail himself of the advantages of society membership when he most requires it, and not force it upon those who are not only able but willing to bear their share of any legitimate burden which has for its object the promotion of scientific investigation. The delay in issuing the Transactions is another serious error of past management. The minutes of the meeting should be in the hands of each member within two weeks of the meeting, and the complete volume of proceedings, including papers, within four months. This would involve very little additional expense to the society, and would prove a great satisfaction to the members, especially those who have been unable to attend the meeting, many of whom are perfectly ignorant of the business affairs of the Institute. At present we have no printed information whatever of the business affairs for the years 1876, 1878, and 1879, excepting occasional items in the journals, and under these circumstances can we expect the members to retain an interest in its affairs (for they have absolutely nothing to base it upon), or to create any? In other words, the members who do not follow the meetings through the entire session, are liable to be ignorant upon very important matters which concern each individual member. We trust that the new executive will take measures to remedy these evils, and we have no doubt the society will sustain the president in reasonable efforts-if he should find it necessary to exert them— to overcome a procrastination which has done the Institute a great deal of injury. Shall we have a copy of the minutes? LESSON TO SURGEONS. A RECENT Occurrence in a Western town ought to prove a good lesson to some of our young and daring (!) surgeons who are ready to operate upon any occasion, regardless of risks. The case reported was one in which the head of the patient was so flexed that the chin touched the chest, and the diagnosis of "anchylosis of the cervical vertebra" was mistaken for a case of "rheumatism." of Reposing confidence in a recent graduate, the patient was etherized, and the "operation straightening attempted. The evidence before the coroner states that "sudden cracking noises were heard twice" while the traction was being exerted by the combined power of two men, and the "operation" was about to sucbroken neck," and was no more. ceed, when, lo! the patient gasped his last, with a The verdict was: ·Deceased came to his death by a fracture of the vertebræ of the neck while undergoing a surgical operation," etc. Comment is unnecessary. |