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become "authorities” by distinguisht The thought of calomel gives a homeoservices in the art of healing the sick.- path the horrors; but the judicious use of Ed.]
it cures many diseases.
I have used a good deal of calomel, but
Small doses are
In the first days of tonsillitis calomel Cathartic: Almost equal to a search given to a good purgativ effect, together warrant in legal affairs, it seems to scour with dosimetric trinity and nuclein, will the intestins. I have known it to cause cause the disease to disappear like frost a little blood to appear in children's stools. before the sun, It is best to follow it with salts or some- In the treatment of diphtheria, calomel thing to carry it all out of the intestin. used freely does much good, evacuates
Cholagog: It carries off worn out bowels thoroly, draws blood from throat, bile, and produces good yellow stuols. gets a valuable alterativ action on the
Antiphlogistic: It tends to break up glands, helps to correct a tendency to sepforming inflammation.
ticemia. It wants to be given boldly to As an antiseptic of the alimentary tract, effect (of course this is only a small it is of very certain action.
part of the scientific treatment of diphAs an anthelmintic, it is better used in theria). combination with others of that class. The great antiphlogistic trinity in my
As an antipyretic, it seems to come experience is calomel to free purgation, nearer making a continued fever jump the morphin to relief of pain, and about 30 track than any that I know of. Have gr. of quinin sulfate daily. The inflamseen a few doses in first week of typhoid mation that this does not relieve will genreduce fever, produce sweating, clean the erally take much time and often the surtongue and almost induce convalescence. geon's kvife to relieve.
As an alterativ it has great power; in An experienced physician told me that many incipient diseases it just makes the you couldn't salivate a child with calomel, patient get out of bed and go about his because a child's liver is so large. I have business.
never seen one salivated. As a diuretic as well as alterativ to Calomel has the advantage of a small mucous membranes, it is good in combina- and tasteless dose ; which is worth much tion with squills or digitalis; it acts well in practise. in hematuria ; increases amount of urin Calomel is a powerful and very useful and clears it up.
remedy in the practise of medicin ; but it Calomel used to be my remedy for croup. demands judgment, caution and knowledge The best combination I ever used for croup to use it properly. It will repay any is calomel, gr. 1o; ipecac, gr. 1' ; soda, gr. j, physician to study the use of this agent with potass. bichromate, gr. t, and nuclein very thoroly. M. C. MARTIN, M.D. W-A. one tablet. One of each every half Heartwell, Neb. to two hours, according to urgency. Try [Does the above represent the experiit brothers, and report results.
ence and views of the average doctor Calomel in small doses is antiemetic. I of the “ regular" school? Doubtless our had a case of gallstones with vomiting and eclectic friends will demur, and debility. Gave patient calomel, gr. to homeopathic friends will say that the old each hour, hot water to drink, tablets school is just what it used to be, except nuclein each two hours, and strych. arsen. that smali doses, very small compared to gr. to every four hours. This put him on the old style, are usually given, tho the his feet and at work.
old ten and twenty grain dose is still I have had two cases of meningitis in occasionally given. What we want to get young men, with temperature of 105° F., at is the actual daily practise, at the when I was doing my best to reduce it. present time, of the average pbysician in Gave 20 gr. calomel, and that aborted general practise. See further remarks both cases. No salivation resulted ; only under a pneumonia article in this issue. debility resulted, which was soon remedied. -ED ]
my favorit remedies in pneumonia. Now, Editor MEDICAL WORLD:- Pneumonia to make my patient rest, I use codein. season will soon be here. In the cold For a stimulating expectorant, muriate of season we have more pneumonia from the ammonia is my favorit. Strychnin is a fact that the action of the skin is deficient most admirable remedy in pneumonia, a and the lungs are called upon to do a powerful agent, and depends for its theralarger part of the work of elimination. peutic effects upon the intelligence with This increase of the activity of the lungs which it is given. Patients vary much in is partially responsible for the tendency to the amount of strychnin required to procongestion. Now, it has been my experi- duce the desired effect, hence we must be ence that strong men having large and perfectly familiar with the drug or we will powerful lungs are most apt to be stricken do more harm than good. Pneumonia, with pneumonia ; and those with delicate like typhoid fever, requires close nursing. lungs are more apt to have pulmonary
W. S. ROBINSON, MD. edema.
Frostville, Ark. Now, as to the question of treatment, we [Any profession is made up most largely most all differ. Complications are pre- of its average members. Bright lights and vented, and rapid and complete convales leaders, as well as laggards, are in the cence is assured by the use of the indi. minority. In these pages
the average cated remedies, there is no doubt. I think doctor finds an opportunity to tell his the principal object in the successful treat
co-workers in all parts of this ment of pneumonia is how to promote the great country what he is doing, and how process called resolution.
" When reso
he is doing it. This is of the greatest imlution occurs, the contents of the alveoli portance, for by far the greater part of the become fatty and granular and are ab- work of the profession is done by the aversorbed and the pulmonary epithelium is age men-the "rank and file”-the back. restored.” The treatment is to be varied bone of the profession. The question is, with every case, as no two ever run ex- Is the above a fair example of the treatactly the same course. In all cases I use ment of pneumonia by the average doc. calomel to open the secretions and to tor? We are inclined to think that it is. eliminate waste matter. When the fever We have purposely refrained from any is high and pulse bounding, I give vera- “polishing of the article, in order to subtrum, often in small doses. Veratrum mit the above question. Possibly this may must be used early in the stage of excite- not be a prudent question for us to ask, ment, and pusht to effect, exerting its in. for about three out of every four doctors fluence upon the nervous and circulatory may consider themselves
way above the system. The danger of heart failure from average.” Young men, in their first ten veratrum is less than has been supposed, years of practise, are particularly apt to if given cautiously in small doses. If the think so; but if they don't keep their pulse is weak I use strychnin to sustain thoughts on themselves too much, they get the heart's action. Strychnin is my sov- over it. The average man is peculiarly ereign remedy in pneumonia, but never in fitted to fellowship with and help his fel. the beginning of a violent attack with low average man. We do not wish to high fever. We should watch carefully intimate that every “average doctor" and know when strychnin is indicated. treats pneumonia just as given in the In the treatment of pneumonia I give all above article; but that the article fairly the hot water the patient will drink. Free represents the average treatment. Don't drinking of hot water is useful in the cough, you think so? In what way does your and stimulates the secretions and excites treatment differ? No one will claim that free elimination. Hot water tends to con- the above treatment is perfect. Perfection trol the congestion.
can never be attained ; but it can be apI never use poultices and blisters any proacht by contributions from various more. Instead I use cloths wrung from hot sources, combining the best features from water and alcohol over the chest as dry as many. Let us try to collect these best feaI can get them, removing quite often so as tures and combine them. Let us try the to have plenty of moisture for evaporation same thing in the treatment of other disto carry off the heat. Warmth and moist- eases, also, say for common colds, coughs, ure over the diseased lungs is necessary bronchitis, both tubular and capillary, to life. Belladonna (tincture) is one of etc.-Ed.]
Chloral Hydrate for Strychnin Poisoning. Since then I learn that the patient has
Editor MEDICAL WORLD :—Was called had, no further trouble, has reformed, hurriedly to Mr. L., a young married man
and he and his wife are living happily who, on account of some family unpleas- together and doing well. antness, decided on self-destruction by
M, B. POLLARD, M.D. taking strychnin. He purchased fifteen Winnsboro, Tex. grains from a druggist, stating that he wanted to kill some dogs that were annoying him at night. After procuring the
Skin Grafting. drug he went into a saloon and purchased Editor MEDICAL WORLD:-Congratulaa half pint of whisky; after dissolving tions to Dr. Hurd on his successful case the strychnin in it, he drank a little over of skin grafting, page 429 October WORLD, half the contents of the flask and left for This is such an interesting subject, and home, about three hundred yards distant. success gives so much satisfaction, that I Immediately upon his arrival he was seized am going to describe a method of covering with convulsions, which continued in rapid the entire raw surface with grafts. This saccession. Upon reaching the patient I method I have many a time used, and find found that he had all the symptoms of that it gives quicker healing, a better and strychnin poisoning : Opisthotonos, forcible softer scar, and less contraction than the extension of the lower limbs, tetanic spasms method of planting islands of skin here in rapid succession, dilation of pupils, and there. rapid breathing; cardiac pulsations slow A sharp razor and a willing friend are and the breathing very labored and diffi- essential. When the wound to be covered cult. The time had passed for the intro- is free from slufs, dress with mild antisepduction of the stomach pump as the teeth tics for a few days, and scrub surrounding were tightly clencht; so much so that I skin thoroly with soap and water and I could get nothing into the stomach. I to 1,000 bichlorid. To cut the grafts, would have given him apomorphin hypo- stretch the skin crosswise with the left dermically, but unfortunately I had none. hand, and without further fixing of the The drug had evidently been absorbed skin shave off with a sawing movement a into the circulation, dealing its deadly piece of epidermis as broad and long as effect upon his vitality. As soon as I possible. Pieces 14 inches long by an inch could remove the multitude of people who wide can easily be cut with practise. had assembled around him, in order to These float on the razor, which is moistobtain fresh air and quietude, I thought ened with warm boiled water. Now lay of chloral hydrate being antagonistic to the razor on the raw surface and coax the strychnin, and after taking into considera. graft on to the wound with a needle and tion the amount of strychnin the patient glide it into position. Fit the other pieces had taken, which was fully eight grains, I edge to edge so that the red surface is endissolved two drams of chloral in an ounce tirely covered ; overlapping does not matof warm water, and proceeded to inject ter. If the grafts are refractory and curl this amount in different parts of the arms up the deep surface should be inwards, inand lower limbs till all of it was injected. variably. If the raw surface is too large Immediately after doing that I forced to cover at one sitting, do one section first him to inhale chloroform till the effects of and the other later. the chloral were manifest. This was ac- If in a position where prevention of complisht within fifteen minutes. Chloro- contraction is very important, scrape off form being removed, patient was well under the surface of the wound very lightly with the influence of the chloral; all rigidity a sharp spoon or curet; for this an anesceast and patient slept soundly for nine thetic is necessary, and the grafts can at hours and awoke of his own accord; no the same time be taken from the patient. complaint, only feeling of weakness and After scraping see that all oozing has slight nausea.
. He then took a light break- stopt before applying grafts. Dress with fast. Now as to the amount of chloral that plain sterilized gauze (easily made at was administered, I confess it was rather home), wrung out of warm boracic acid heroic; but considering the amount of solution. This would stick to grafts and strychnin the patient had consumed, I am perhaps pull them off if directly applied, confident the amount of chloral was de- so they must be separated from it by I manded to antagonize the strychnin. inch strips of oiled silk, laid in a parallel
fashion ': inch apart, and crost at right upon the dreaded operation. Finally he angles by another layer similarly arranged, made a clean breast of the matter, and but not quite so close to each other; the told me of his university experience, which intervals allow for oozing. Do your first was the starting point of his illness. On dressing on the third day. The surface examination I found no difficulty in refrom which the grafts have been taken is tracting the foreskin behind the head of dotted with oozing points ; dress this with the penis-in short, there was nothing boracic ointment; it will heal quickly. the matter with him ; his organs were
The above method is known as Thiersch's. essentially normal. With this assurance Philadelphia,
DR. SENIOR. he promptly rallied, and malaria and
typhoid were banisht to the winds.
He said that this same professor-doctor Concerning a Case for Circumcision. had found in the class some fifteen or Editor MEDICAL WORLD :-Some years eighteen other students that in his opinago the term “quacķ was applied to cer- ion needed circumcising. This would tain classes of medical charlatans and pre- afford sufficient material for an interesting tenders. The word was one of reproach, if not a profitable genito-urinary clinic. sanctioned by usage, and had a definit Now, what is the natural conclusion ? meaning. In these days it is less fre- Either that this was a rare and “ measly quently used, and chiefly in a vague and lot of young men, or that the doctor has a indefinit way. But the quack.salvers are “ bee in his bonnet." still with us, more or less prosperous, and The latter is probably the true explanaunder a multitude of titles and guises. tion of the matter. Specialists are liable So long as they sail under their true colors to go daft in their specialty. Some years the community is free to patronize or to ago a really able and skilful surgeon of ignore them, as they choose; but when this city gradually imbibed the notion they “steal the livery of heaven to serve that almost every young man should have the devil in," when the socalled regular his meatus urinarius slit. Eventually he physicians stoop to practise the methods became a monomaniac on this subject, and arts of quacks then, indeed, the com- and did incise right and left as scores of munity is assailed in the very citadel of young men now living can testify to their its friends.
sorrow. When there was no more maThese reflections are called forth by a terial available, he migrated to Manrecent experience somewhat out of the hattan, where he found “fresh fields and common : G. W., a youth of 19 (at whose pastures new.” birth I had the honor of officiating), was In charity, I assume that this doctorrecently matriculated at a southern uni- professor of the Blank University is versity. It chanced that he had as a afflicted with the circumcision bacillus, room mate a young medical student. In developing a monomania for removing the confidence of chumming the medical the foreskin of every young man so unforstudent thought he discovered something tunato as to venture within his reach. unnatural in the genital organs of G. W. But what will be the fate of the young So he advised G. W. to seek medical ad- men placed under his fostering care ? vice; to consult the doctor professor con- Some fathers and mothers would be horri. nected with the university. He did so, fied if they but knew the actual influence and was gravely informed that the opening under which they bave unwittingly placed in his prepuce was gradually closing up, their sons. There are cases in inand that the only remedy was prompt fants and children—but rarely in adults, circumcision. This was news, as well as a in which circumcision is called for; but surprise to the young man, who could not in the great majority of cases of phimosis well gainsay the conclusions of the learned and contracted prepuce, simple dilation professor.
with forceps will remedy whatever trouble He left the university and came home there may be. Of course this simple to this city, as was said, on account of maneuver does not warrant the fee nor his health. He appeared really ill, and secure the eclat that the operation for cirfor some time it was uncertain whether cumcision does; but I consider the result he was suffering from malaria or was more satisfactory, for in my humble opindeveloping typhoid fever. His mind was ion the Creator knew what he was about worried and anxious, constantly dwelling when he ordained the foreskin to be the
8 p.m. Noon Noon
natural and proper covering for the sensi- tainer on tube of the syringe, the air, of tiv corona glandis.
course, having been previously expelled. Brooklyn, N. Y. BENJ. EDSON, M.D. If the anterior urethra only is to be irri
[A good hygienic habit is daily retrac- gated, the fifth finger is firmly prest tion of the foreskin and thro cleansing.– against the urethra, thus preventing the Ed.]
solution from passing beyond the point of
compression. The anterior urethra should Treatment of Acute Gonorrhea.
always be thoroly irrigated first, to preEditor MEDICAL WORLD :- Pursuant to vent pus being washt back into the posyour request for treatment and data on the terior urethra or bladder. I find it almost curability of syphilis and gonorrhea, I impossible to irrigate the posterior urethra send the following, trusting it may be of without allowing the solution to pass into service to the many WORLD readers : the bladder, but always assure the patient
The therapeutics of gonorrhea is in a it will in no wise injure bis bladder. transitional stage. Not a few physicians The solution I find from experience to still cling to the old method of treatment be best suited for irrigation is potassium in vogue at the time when the causativ permanganate, freshly made, and in organism of this widespread malady was strength from 1-6,000 to 1–1,000.
For an unknown. Viewed in the light of modern acate case I proceed as follows: research, all authorities agree that gonor
First day, first visit. Anterior irrigation. rhea is due to a specific organism, the
8 p.m. gonococcus of Neisser; hence the old Second day, 8 a.m.
8 p.m. method of treatment, that is, dosing with
8 à m. Intra vesical
8 p.m. Anterior balsams and the oil of santal, with an Fourth day, 8 a.m. Intravesical astringent injection to be administered by
Fifth day, the patient, is rapidly yielding to the
Seventh day, Noon modern method, the chief aim of which is
Anterior the destruction of the gonococci. It is this
Eighth day, 8 p.m.
SIntravesical recent method of treatment that I wish to
Ninth day, briefly outline.
Ninth day, Personally I have treated and cured
Anterior over two hundred cases in private practise Tenth day,
Intra vesical “
Anterior during the last five years by the irrigation
Tenth day, 8 p.m.
Intravesical “ method, introduced in this country by
Anterior Dr. Ferd. C. Valentine, of New York. Ho The hours will of course vary somewhat, has devised an instrument especially for the only point to observe is that irrigathis work, which bears his name, but an tions given twice daily should be twelve inexpensiv and fully as effectiv an appa- hours apart. ratus can be improvised by using the ordi- If the above treatment is religiously nary fountain syringe with a suitable blunt followed, it will cure 90 per cent of acute pointed glass nozzle. The bag should be cases in ten days and the remaining 10 per elevated to a height of eight to ten feet, cent in three or four weeks. There is no according to the pressure desired. The doubt in the writer's mind that gonorpatient can either recline in a sitting pos- rhea can be cured by the method given. I ture or stand, the latter of which I person- have followed the vast majority of my cases ally prefer, holding a vessel under the from one to five years and find there is no penis to catch the solution. The technic history of a relapse ; in many instances of performing the irrigation is as follows: the patients have married and have beGrasp the penis with the left hand, holding come the fathers of happy families, the the left corpus cavernosum by the third, wives showing no infection whatever. In fourth and fifth fingers in such a manner closing, will say I give no medication that their tips rest lightly on the urethra, internally except alkalin diuretics where the left thenar eminence pressing against there is ardor urinae in acute cases.
I do, the right corpus cavernosum. The index however, absolutely forbid sexual interfinger and thumb are thus left free to course, or what is as bad, sexual excitemanipulate the foreskin and glans, by com- ment, during treatment. As to diet, inpressing which the meatus will open for terdict all alcoholic and spirituous liquors; the introduction of the nozzle. Gently also fats and greasy dishes. Little ealt introduce the nozzle and release the re- allowed, but no pepper or highly seasoned
1:4000 .1: 3000 1: 4000 1: 6000
1:5000 .1:5000 .1: 5000 1:5000 .1:5000 .1:5000 ...1:5000 .1:3000 1:5000 .1: 2000 1: 4000 .): 1000 .1: 4000 ..1:1000 .1: 4000 .1: 1000 1:5000 1:500