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ORIGINAL COMMUNICATIONS

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 u v excellent discipline for an author to feel that he must

say all he has to say in the forest possible words, or Ais reader is sure to skip them; and in the plainest possible words, or Ads reader wol certainly misunderstand them. Generally, also, o downright raet may be told in a plain way: and we want

downright facts at present more than anything else.-RUBKIR. READ REFLECT COMPARE RECORD

are in Oklahoma. Here are two clippings from their catalog :

** Last and greatest of all: To do for the preachers what their theological schools have not done, viz.: Make them physicians of the physical needs of the body as well as of the soul. To prepare them for this two-fold work. What minister has not realized the great need of being able to do this? As the world grows older more and more do we realize we cannot improve on the Christ plan. He sent His disciples out to heal the sick and preach His gospel. The min. ister of Christ today is not prepared for his work until he can cure the sick. Of course, not in the miraculous way in which the Apostles healed; but by using means and knowledge every one has, after being taught how to apply it. Who is so well prepared to administer to the needs of the body as he who thoroly understands and is deeply interested in the needs of the soul? The preacher already possesses a great deal of knowledge ihat will make him a successful practitioner. The preacher has studied the soul, and the doctor the body, whereas the two are inseparably connected and a knowledge of both is necessary to properly administer to the needs of either."

To the school teachers, let us say, here is a chance for you to make from two thousand to five thousand dollars per year. It will far surpass in remuneration the salary of a teacher.”

Comment is unnecessary. This is tempting bait for preachers and school teachers. What a grand thing it is for the health of the people that most states now require a medical examination before granting a license to practise medicin.

Do your medical friends take THE WORLD? If not, don't you think it is because they don't realize what it is doing for the profession? Won't you show them this number, and say that such a publication deserves the support of every medical man?

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Charges for Telephone Advice. Dear DR. TAYLOR:-In THE MEDICAL WORLD for March, the question is raised, what should be charged for telephone consultations. The question is a pertinent one and should receive consideration. While theoretically a telephone consultation should be paid for as an ordinary consultation, there are cases where we ask for reports over the phone and give some advice or directions, and yet we do not wish to make a charge. Let me illustrate :

Some time ago a farmer called me up and told me that his boy, whom I had ushered into the world some four weeks earlier, had a bad cough. It was late, the weather stormy, the distance considerable. So I ordered some simple remedy and was told the next morning the baby was better. I charged fifty cents for my advice, which was cheerfully paid.

Another time a lady called me up, whom I have been treating off and on for years, and gave me all the symptoms of what she called “the grip.” I sent her some medicin and charged a dollar, my usual office fee.

Again, a man is ill with typhoid fever. I can see him only once a day, as he lives, far away and the roads, just now, are not exactly like boulevards. He has a phone in the house and I frequently ask for reports and give directions over the phone. Of these talks or consultations I do not keep track, and shall make no charge.

I think these three instances will illustrate what seems to me a fair use of the phone and a fair mode of receiving returns for telephone advice.

H. Y. ACHARD, M.D. Roselle, III.

At the recent meeting of the American Public Health Association held at Washington, the committee on vital statistics reported that effectiv cooperation had been instituted between that Association, the Conference of State Boards of Health, the American Medical Association, the United States Census Bureau, and the United States Public Health and Marine-Hospital Service for the improvement of the vital statistics of this country. Among the objects sought are the extension of adequate methods of registration, the use of uniform and comparable tables and rates in bulletins and reports, and the improvement of the international classification of causes of death. A pamphlet on “Statistical Treatment of Causes of Death"has been issued by the United States Census Bureau, requests for which should be addrest to Mr. W. A. King, Chief Statistician for Vital Statistics, Census Bureau. It has special reference to the difficulties encountered in compiling deaths returned from several causes, and asks for the cooperation of the profession in framing a thoroly satisfactory method of procedure in such cases.

The impression growing among the profession that early hemoptysis in a given case of tuberculosis is a favorable sign, is explained when we remember that hemoptysis is alarming to the patient and he hastens to the doctor for treatment. Thus he is a more favorable case just because he has earlier care and treatment, and not from any favorable indication as regards the case itself.

A Kiss. “A kiss is a peculiar proposition. Of no use to one, yet absolute bliss to two. The small boy gets it for nothing, the young man has to steal it, and the old man has to buy it, l'he baby's right, the lover's privilege, the hypocrite's mask. To a young girl, faith; to a married woman, hope; and to an old maid charity"Stolen,

The Religious Press and Quackery. Editor MEDICAL WORLD:~I was much pleased to see your expose of the “ Heidelberg Medical Institute of St. Paul” in March WORLD. Let the good work go on. While the aforesaid fakirs are surely bad, they are probably no worse than many others of the same class whose glaring advertisements we see, not only

in the yellow journals and the dailies, but in Should Clergymen and Their Families be those immensely profitable mediums for the

Treated Free of charge ? advertisement of quack doctors, and fake ap- Editor MEDICAL WORLD:- What is the cuspliances and medicins—the church papers. tom among physicians as to preachers: Do Most people are a little shy of these fakes when they practise for them gratis? I have been in they see them advertised in secular papers, but the profession thirty-five years and have always many fall easy victims of the fake when they charged ministers of the gospel one half the read of it in a religious paper. These ads are usual fees. I presented my bill to a preacher a always so worded as to convey the idea, if in- few days ago and he said he never heard of deed not so stated, that the nostrum or appli- such a thing before: “A doctor wanting a ance has the personal recommendation of the preacher to pay his bills.” I told him it was editor, who is usually a D. D., and ought to be my custom and I expected him to pay it and a safe man to follow. I have written several

he did. editors of church papers and they all say that The preachers get a salary just as our civil offitheir papers could not be run on a paying cers, clerks and all others who work for wages ; basis if the patent medicin ads were cut

and doctors work for wages. The preachers out. And they can not or will not see how a expect doctors who are members of their contract to run an ad that brings them such church to help pay their salary, and pay a returns could be quackish or dishonest. The little more than other members, and then do quack is willing to pay greatly increast rates $15, $25 or $50 worth of practise for them for space in said religious papers, and the

without pay:

This is more than I can see business managers of the papers run the ads

the justice in. But if it is customary among for the money there is in it; refusing to ad- the profession I will fall in line. I have mit, however, that by so doing they make always tried to be honorable and never do themselves the channels thru which countless anything that would bring reproach upon thousands of dollars from the poor and unso

the profession, and I still stand on that principhisticated but trusting readers flow to the ple. I know you have a very large basket for pockets of the fakir. Now, what is the remedy

this and all such that is of no benefit to the for this growing evil? I suggest a general brethren; and if you should assign this to it campaign of education by the family physician.

all O. K. But I would esteem it a great favor Let each member of the profession strike a de. for you to drop me a few lines on the subject, cided but tactful blow at this hydra headed

as I want to be right.

JIM. monster whenever opportunity offers, and in

Texas. time the now gullible public will look upon [Doctor, don't ask us to “drop you a few these alluring fakes with the utmost indif

We would like to do it occasionally, ference. Does not much of the blame for the but to attempt to do it for our vast army would condition complained of lie with the family simply kill us. But concerning the above we doctor? Long live The World.

will do better-present it to the profession for Kimbolton, O.

D. L. COWDEN.

discussion. This matter is largely one of local [No, Doctor, the blame should not be placed

custom, and of custom of individual doctors. upon our profession, but we could and should

Many clergymen expect and prefer to pay their do much to mitigate the evil. Doctors could

doctor bills; and many doctors make it a rule point out to people the objectionable adver- to charge clergymen just like anybody else. tisements in their religious papers and advise

However, this is by no means universal-in them to discontinue their patronage of such

fact, perhaps, it is almost exceptional. In papers, and that they should write to head- most congregations there are one or more phyquarters the reason for so doing. That would

sicians, and frequently there are close personal doubtless do much good. If a paper, religious

relations between one or more of these and the or any other kind, cannot exist without the pastor and his family which make ordinary patronage coming from nasty, dishonest and business dealings difficult and undesirable. quackish advertisements, then such paper

Then again, frequently there is rivalry as to should cease to exist. The fact is, that if a

what doctor will have is the honor" of attendpaper has any excuse at all for existence, it

ing the pastor's family, for the influence it will will be strengthened and not weakened by an

give. This we do not endorse. Local custom upright, courageous and honest course. THE and personal preference of each physician will MEDICAL WORLD refuses much advertising, and

doubtless continue to obtain. Perhaps this it fearlessly exposes fraud in its reading col

would be a good question for the fraternity to umns; and it is growing stronger every year.

exchange opinions upon.-ED.] Patrons are not slow to recognize the value of that kind of journalism, and they will support

Operation is now imperativ in all cases of perfora

tion of the bowel in typhoid fever, if it be possible to it.-Ed.]

do the work before the patient becomes moribund.

lines."

Appendiceal Pus Discharged Thru Lung. Ergot in the Treatment of the Opium Editor MEDICAL WORLD:-Reading Dr.

Habit. DeVoe's article, “ Was it Diaphragmatic

Editor MEDICAL WORLD :-In response to Pleurisy ?" on page 60, February WORLD, calls the query of Dr. Callahan in February issue, to mind a case that I postmortemed some pages 51 and 52, just noted. It is certain that fifteen years ago, and which was unique in the when the general practician deals with a extreme, to me, and I have never seen anything morphin case there must be a desire on the like it reported in any of the numerous journals part of the subject to be releast from the that I get. But I feel sure that if Doctor De- thraldom of the drug, or there must be apVoe had “posted ” his case he would have plied a sufficient moral and physical control to found about the same conditions as I did. accomplish the course of treatment determined

The case was as follows: H. E., colored, upon, in spite of the subject's determination to male, 10 years old, was taken with abdominal the contrary. The latter is much more feasible pains, fever, etc. Dr. J. L. Ivion, who had in an institution where just and rational rules been practising in the community about forty are inflexibly applied. No demand should be years, was called to see the boy, and attended made that has not been carefully considered him thru to the end. The Doctor spoke to beforehand; but, when made, it should be me about the case during its progress, and said final. The subject who does not put himself that he was satisfied that it was a case of in accord with the physician, or who does not appendicitis, or what was spoken of at that consent to be controled during the treatment, time as perityphlitic abscess. Operations for might as well be permitted to go to the devil this condition were not so common then as soon as later, for that will be the termination now, especially so in country practise; and of of such a case, no matter what medical help course none was attempted in this case. The may be given him. I ought, perhaps, to excase ran along for some eight or ten days, when cept suggestiv therapeutics, but as to its effithe boy began to cough, and within a couple of cacy I do not know. days began to cough up a dark, offensiv smelling I have “witnest the extreme torture” the sputum. This condition lasted only a few days Doctor refers to, but, tho it was as great a when death put an end to his sufferings. The nervous strain as I ever endured, it did not attending physician askt for and was granted the suggest to me “relenting and allowing the privilege of making a postmortem examination. drug. The result was that within twentyHe requested me to go out with him and make four hours the torture and my strain were over, the examination, which I willingly did. and the rest of the voyage to health was upon a

Upon opening up the body I found the fol- smooth sea. lowing conditions: Right pleura full of dark The Doctor says he employed ergot hypopus, such as patient had been spitting up be- dermically for five days with result : "hard fore death. Upon further examination, found work to suppress abscesses" and "larger appethat the pus, starting from the appendiceal ab- tite for the morphin." If the Doctor had scess, had burrowed its way along up the sufficiently and properly applied the ergot, anterior abdominal wall over the liver, thru the having either wholly discontinued the drug to diaphragm into the right pleura, and had been begin with or used the tapering off plan I discharging thru the lung. Inflammatory ad- suggest, there should have been no appetite for hesions had set up all along the route, which it at the end of five days. As to the abscesses, had kept the pus walled in; the track was not while I have no disposition to hurt anyone, I more than one and a half inches wide. The am not squeamish about injecting in cases that course of the pus was well defined all the way, so often cover themselves from head to foot especially so where it passed over the liver, the with abscesses from their reckless injections of smooth surface of which had been eroded morphin.

morphin. Personally, I have not had half a away, giving the appearance of a very shallow dozen abscesses from ergot in about thirty canal of more than an inch in width over its thousand hypodermics. outer surface next to abdominal wall.

The Doctor did well to begin with a merI have often thought that I would report curial purgativ, followed by a saline, but I this case, but have never done so until now. much prefer the after use of the rhamnus franIn fact this is the first time in my seventeen gula to that of salines, to keep the bowels years of practise that I have ever attempted to daily activ, and only to the degree of mushy write for publication ; and now, dear Editor, stools. if you

think this not of sufficient interest to As to sleep and nutrition, both are imporoccupy space in your valued journal, just chuck tant, and are considered in my paper on ergot it into the waste basket. F. A. YOUNG. in the drug habits, publisht in the January Montgomery, Tex.

issue of The New York State Journal of Med[ Doctor, come again.-ED.]

icin. Galvanization of the cervical sympathetics, dry-cupping and shock, mentioned in is like casting out Satan with Beelzebub. Or, my former letter, are, together with ergot, if to use another simile, it is jumping out of the all are properly applied, sufficient to secure frying pan into the fire. Do not for a moment sleep and calm nervous agitation.

entertain substitution of any drug as a method Let the Doctor remember that morphin has of withdrawing morphin. not been a food or real support to the subject, The way to withdraw is to withdraw. And and that the chief support needed, beside yet we must not withdraw in a way that will warm fluid, easily digested foods, once in three destroy the patient. Sudden withdrawal of hours, is the remedy which counteracts the morphin often does this. Levinstein himself effect of morphin on the circulation : ergot. reports deaths by this method. A death due

As to his case of inflammatory adhesion, I to the withdrawal of morphin is, I am sure wish the Doctor would apply galvanism, using from my own experience and from what I have a large positiv electrode under the back, and seen, absolutely unnecessary. But deaths will a mass of clay paste over the inflamed mass, occur if the drug is suddenly withdrawn. And and extending beyond it, as the positiv elec- in every case of withdrawal suddenly there will trode, and give daily a current of 25 or 30 be intense nervous agony and physical pain. milliamperes for an hour or more at a time. The same may be said of rapid withdrawal. After removing the metal conductor (pliable There are probably not so many deaths when sheet lead or tin-foil) from the clay, the latter from five to eight days are used in withdrawing should be left in position until it is entirely the drug, as when it is suddenly and all at dry.

ALFRED T. LIVINGSTON. once withdrawn, but the suffering is probably Jamestown, N. Y.

just as severe. Only strong men who have not

used the drug long, and who must save time, Treatment of the Morphin Habit by Gradual should attempt either of these methods. Reduction.

Slow withdrawal is the only practical method Editor Medical WORLD:- The subject of in the vast majority of cases. And the "adapthe treatment of morphin addiction makes its tiv” slow withdrawal is the true rational appearance in the pages of The WORLD quite method. By “ adaptiv" slow withdrawal we frequently, and we are pleased to see that the mean taking away a little now and then, Editor "stands pat” for its treatment by grad- according to the condition of the patient. No ual withdrawal of the drug. This is the only hard and fast rules, no machine methods. rational method. The writer of this was once The amount of the drug is reduced today, for so unfortunate as to contract the “ habit" and instance, to as little as the patient can be fairly speaks from dear experience in regard to meth- comfortable with. Never is it reduced to ods of cure. And first let me protest against where there is serious discomfort. The patient the term “ morphin habit.” It is more than is kept on this until he is wholly comfortable a habit. It cannot be dropt at the will of the on this amount, when another slight reduction individual as mere “habits” can. When long is made. Good food, baths, tonics, electricity, used, morphin produces an irresistible impulse all possible adjuncts are used to build up the to its further use, and an “ irresistible impulse” patient. If he should have an attack of interconstitutes a mania. This mania requires treat- current disease, as grip for instance, no attempt ment and attention as certainly as any mania. is made to reduce until the patient has recovAny practician undertaking the care of one ered. Then forward with the reduction again addicted to morphin should always bear in as rapidly as the patient is prepared for it, and mind that his patient is subject to a mania and no more rapidly. By this plan morphin can be not to a mere habit. The cause of this mania withdrawn in from fifty to one hundred days. is a more or less long continued use of morphin. It was in an institution practising this method This use of morphin produces certain physical that the writer finally obtained release from symptoms, and also some other mental symp- the fetters of this fearful drug. And that toms besides the mania. To remove the cause release came with very little suffering. No is the first step in the treatment of any and all intense nervousness, no diarrhea, nothing mental and physical conditions. Removal of severe. I can say truthfully that I did not sufthe morphin is the first and great object then fer as much while under treatment as I did in this condition.

almost any month of the year preceding treatFor the sake of brevity we will not discuss ment. Only one who has used morphin knows the treatment of symptoms, tho it must not what the suffering of the advanced stage of be forgotten that this is very important. morphino-mania is. From the time the

There are occasional advocates of the re- amount began to be reduced I began to feel moval of morphin by the substitution of some better. other drug, as cocain, heroin, soda bromid, etc. One more point. Many unfortunate victims The writer had sad experience in this line. It of the drug hesitate to attempt to get free because they suppose the desire will remain with late for our March issue, else it would have them, even tho not an irresistible desire. This been incorporated with our remarks on pages is a mistake. I have talkt with scores of cured 102 and 103 of that issue.-ED.) patients and found only one who said he still wanted the morphin. Relapses are due to

Antikamnia. pain, insomnia, mental worry-to the same (Please see March WORLD, page 103, bottom of things that caused the original mania. It is

first column. We there suggested that members of

the profession write articles similar to that of Dr. now more than four years since I was cured. Elderdice, on the opposit page, and send same to Since about ten days after the last dose, I can medical magazines other than THE WORLD, and truthfully say I have not had one particle of

see if they could get them in. The following com

munication was sent to another medical publica. desire for morphin. I am careful not to take tion (not the Medical Brief), with the request that opium in any form. I have endured consider- it be immediately returned if it was not acceptable. able pain and expect to endure more, without

Dr. Lowe writes us that this request was made in

order that he might send the article to THE WORLD the least wish for the pain relieving remedy. in time for the April issue, in the event of its rejection Instead there is a shudder at the thought-a

by the journal first addrest. It was returned to Dr. horror of it.

Lowe, and he sends it to us with a letter giving the Ex-FIEND, M.D.

above facts. We cordially welcome the article, as being

in the interest of the medical profession, and here presElectric Belt Exposé.

ent it, omitting, however, the name of the publication it Editor MEDICAL WORLD :-Your exposé of

was first sent to. You see by its form that it is addrest, the St. Paul Electric Belt business in March

all thru, to the other publication.]

Editor MEDICAL WORLD:- In the March issue WORLD was quite interesting. You will see by the enclosed clipping that parties in Chicago written a year ago by Dr. Elderdice, of Mc

of THE MEDICAL WORLD is republisht an article are carrying

on the same nefarious work. Four Knightstown, Pa., in which he gives the formula or five in our city have had the same experience as given in WORLD. Only one of

of the proprietary preparation called ammonol, them has taken the medicin; all others as far

sold by the manufacturers at $1.00 per oz.,

and which the Doctor states can be put up at as I know have had belts and medicin re

a cost of 10 cents per oz. This compounding turned, altho the company finally offered the whole for one dollar. I think it would be well if

of everyday remedies under a fanciful name other medical journals would have the courage

and putting them upon the market at a fancy

price is the speculativ fad of the day among to expose such nefarious work. Oneida, N. Y. H. W. CARPENTER, M.D.

proprietary medicin manufacturers, and is a

curse to the physician not only in a financial Hair Tonic.-Another Doctor who Makes His way, but thru its tendency to cause him to Own “ Analgesic."

neglect his materia medica, and get into the Editor MEDICAL WORLD:-Tell T. M. lazy habit of prescribing these proprietaries Lippit and all others who want a sure, time without a thought as to their modus operandi tried hair tonic and cure for dandruff and indeed, in most instances it would be imfalling out of hair (not baldness) to use : possible for him to post himself upon the phyTinct. cantharides.

siological action of the combination, even tho Glycerin ..

the formula be furnisht him, for the manufactBay rum, q. s. ad..

ziv Mix; use for a hair dressing once a day.

urers are shrewd enuf to include in the Will you please thank Dr. R. B. Elderdice formula some “made to order" meaningless for me for telling us (page 110, March, 1903,

name not to be found in any work on materia WORLD) how he saved $45.00 per year ?

medica nor in the pharmacopeia. They know There are others doing the same (myself in

that the average physician is “dead easy" in cluded). I get better results from the mixture regard to such matters, and that his ethical than from any of the “anti," or coal tar com

demands can be satisfied with any old formula, pounds, at a cost per pound of about what the

however meaningless. proprietary articles cost per ounce, besides the

The physician is apt to consider anything further advantage of knowing just what pro

advertised in his medical journals as above the portion of what it contains, also always having degrading level of the quack nostrums offered a fresh preparation. I would advise every

in the lay press, but alas ! in this he is too often practician to try it; those who prescribe can

deceived, and in many instances he can even have their druggist fix it up for them.

be induced to use and prescribe these very I would like to ask if any of the brethren

preparations simply because he sees them adknow of an easy working formula for prepar

vertised in his medical journals, and because ing either a granular or powdered effervescing they are well spoken of in the (of course not preparation of mag. sulf, or sod. phos.

paid for) advertising editorials. THE MEDICAL La Farge, Wis. E. E. GAINES, M.D.

WORLD is in this respect an exceptionally clean " Rush," 1886.

journal; and taken as a whole, the [This communication was received just too deserves much praise in keeping purged from

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