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ORIGINAL COMMUNICATIONS The question has often occurred to me

since: Would it be possible in all cases where Short articles of practical help to the profession are solicited for

the bowel had been emptied from both above this department.

and below, as it was in this instance, to force Articles accepted must be contributed to this journal only. The fluid thru the bowels reversely, as was done in editors are not responsible for views expressed by contributors.

this particular case? It seems not to be Copy must be received on or before the twelfth of the month, for publication in the issue for the next month. We decline

physiologically impossible. Is it often done? responsibility for the safety of unused manuscript. It can Who knows, and who can answer ? usually be returned if request and postage for return are received with manuscript ; but we cannot agree to always do so. Scio, Ohio.

E. E. TOPE, M.D. Certainly 4 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

Quinin Combined with Acetanilid and Capsi. reader will certainly misunderstand them. Generally, also, a

cum for Malarial Fevers. downright fact may be told in a plain way; and we want

downright facts at present more than anything else.-RUSKIN. Editor MEDICAL WORLD :-Most physicians READ REFLECT COMPARE RECORD do not know the value of combining acetanilid

with capsicum with quinin in the treatment of A Large Enema.

intermittent and remittent fevers. It is a comEditor MEDICAL WORLD:-On the afternoon bination of great value in most forms of such of February 15, 1898, Mr. M., a grain mer- fevers. The following is the most often used chant, a large man weighing over 200 pounds, formula, but the proportions can be varied to while loading a car with grain jumpt from the suit the individual need: car to the ground. He felt something give way, which was immediately followed by a Quinin sulfate

. gr. 30

Acetanilid severe pain, located about two inches above

. gr. 20 Pulv. capsicum.

gr. 10 the umbilicus. The pain was so severe that in M. Sig.-Dose, six grains every four hours in rethe course of an hour or two he quit work and mittent fever, and in intermittent fever give four doses walkt about a quarter of a mile to his resi

daily, one every two hours, beginning so that the

fourth dose will come one hour before the chill is due dence, where I saw him in the evening. From the symptoms and history I suspected

Acetanilid causes the action of quinin to be that the bowel had been loopt or knotted, and

much quicker, and prevents much of its unordered enemas of warm water, gave an ano

toward effect, such as headache, besides being dyne for the pain and strict orders that no

a valuable companion for it if fever is present. food of any kind should be taken. The next

Capsicum increases the anti-periodic effect of day the pain still persisted and there was fre quinin, and sustains the vital force and the ac

tion of the heart. In all cases this treatment quent vomiting. Being thirsty he was allowed to drink water, but no food was given; high bott Alkaloidal Co. makes a tablet or granule (I

should be preceded by some cholagog. The Abup and copious enemas of warm water were used frequently, completely emptying the lower

prefer tablets as the granules are so easily lost) bowels. No improvement resulted, and the containing one-sixth grain of each calomel next day the vomiting was stercoraceous,

and irisin ; also a tablet or granule containall the symptoms aggravated. The prognosising one-sixth grain podophyllin. One

of each was looking exceedingly gloomy.

every half hour until six are taken, which I sent for my friend, Doctor A., who con

will make one grain of each, calomel,

irisin and podophyllin, will generally remove curred in the diagnosis of volvulus of the bowel, and we decided to try a forced enema.

biliousness and prepare the patient for the We attacht a bulb syringe to a large rectal quinin mixture. if on the second day the tube, passed the tube full length into the

tongue is still coated, use the tablets or granbowel, and with the patient's hips elevated 12

ules as before, and so on until it is clean. It

is best to follow the tablets with a saline to 18 inches higher than his shoulders, I be

laxativ.

J. A. BURNETT. gan to pump in the warm water and Doctor A.

Cauthron, Ark. to knead the abdomen with his hands. When I had pumpt in about a gallon the patient said, “I believe I'm going to burst." Just

Another Plan Worth $1,000 Per Year. about that time he began to vomit, and we Editor MEDICAL WORLD :-I was much innoticed the distention and tension of the terested in the article on page 284 by Dr. bowels begin to relax. So we kept on pump- Gaston in this (July) issue of The World. ing water into the patient and calling for more Pardon me for sending you blanks of my water, while the patient kept on vomiting it framing. At first I did not collect 60 perup, until we had used more than five gallons, cent of what was due, but since I started on and until the water was no longer discolored. this plan I have collected $1,000 a year more The patient had no more trouble with his than before. There may be better plans, but bowels, and is living and well today.

this has suited me. I keep each month's

and

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This bill does not include any visits made except in the above named month.

(OVER]

[On the reverse side is the following :)

Office Calls, 50 cents cash-Home Calls $1.00-Calls at a distance, 20 cents per mile extra. 50 cents extra on calls hetween 10 p.m. and 6 a.m.

Also

Note.-Those who make no effort to pay, need not apply for professional attendance.

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Should Doctors Charge Shop Girls and that clergyman is foolish who insists upon free Widows ?

service as a right inherent in the cloth. The Editor MEDICAL WORLD:—The question of placing of the physician's service free of charge charging the clergy has waned into insignifi- to the clergyman is merely what the conscience cance in our town. We all do this practise and common sense of mankind imposes as a gratis, and don't think anything of it. One custom, and is an additional example of the of our leading physicians has extended this

same principle observed in the railways and courtesy to all shop girls, school teachers, merchants making lower rates for the clergywidows, etc. Doesn't matter what salary

man, and no right-thinking minister of the these young ladies and widows are getting, gospel is either imagining he is classed with their practise is absolutely FREE; hence he has the destitute, outraged, or, taking the same as v drummers all over the city. There is a personal tribute, inflated with pride. “ method in his madness." This“ generous O'Fallon, Mo. B. A. PENDLETON. doctor has a drug store, too.

TEXAS. [This communication does not come from a

subscriber, nor is there anything in the above, Starch Bandages.

nor in the letter which accompanied the above, Editor MEDICAL WORLD:-I see in your to indicate that he is a physician, and his June issue Dr. Bevill has something to say about starch bandages.

name does not appear in the Standard Medical

I graduated in the Directory. We infer, then, that he is a clergycollege here twenty-four years ago; they were

man, perhaps having borrowed THE WORLD much in vogue then, and the late Prof. James from his physician. Can we consider the F. Heustis was a free advocate and firm friend

above a typical expression from the clergy?of them. I have frequently used them, but Ed.] not very recently, as “ there are others" that answer the purpose better. In an emergency,

Cholera Infantum. with nothing more serviceable at ready com

Editor MEDICAL WORLD:- This disease seems mand, I should again make such application, to be an acute catarrhal inflammation of the but are they not now somewhat out of date? mucous membrane of the stomach and intesMobile, Ala. WM. T. HAMILTON, M. D. tins of infants, caused by bad hygiene, denti.

tion, improper feeding, and above all, a conProbably a Voice from the Clergy. tinued high temperature with a faulty nutrition, Editor MEDICAL WORLD:- In a recent num- etc. The symptoms are too well understood ber of your valued journal I notice a discussion to need description, so I shall only remark concerning the physician receiving fees from here that cholera infantum is characterized by the clergyman. Among various expressions I vomiting and profuse watery and fetid stools, find one thinking it proper to make no charge fever, and a rapid wasting of flesh, and many of the country clergyman with meagre salary, times accompanied with convulsions. but to collect from the city pastor who keeps

Treatment : an “auto;" another expressing admiration of

Calomel

Prepared chalk. a preacher who rejected free service because it Pulverized cinnamon

24 grains classed him with paupers. It may be that the

Pulverized opium ..

I grain owner of the "auto" finds it as difficult to live

Mix thoroughly and divide into 16 powders.

Dose.-One every 4 hours, for a child one to three in the style required by the flock he leads as his rural brother to exist upon what he This clears the bowels of all effete matter, receives; and certainly the clergyman wrongly

rouses the liver to action, increases the gastric inferred that he was classed with the destitute.

juices, and prevents desquamation of the muThe question is not, however, an eleemosy

cous membranes, as well as relieves all irritanary one. The physician recognizing in the tion of the fibrillae of the nerves, or sympaclergyman the curè of souls as he himself is the

thetic nervous system. curè of bodies, and appreciating the greater

As soon as the bowels move freely, then advalue of the former, gladly accords to him minister the following: professional services on the same terms as to

Tincture opium, his brother physician.

Tincture rhubarb, Moreover, the reflectiv physician feels that he Compound spirits of lavender, äā . . . . 1 02. is honoring the gospel and worshipping God by

Essence of wintergreen or peppermint, 2 minimis.

Dose.-Six to 12 drops after each action of bowels. giving time and skill for the benefit of God's

Increase or diminish the dose until it accomplishes its representativ; and the man of God accepts object. this as a tribute to his Master and the cause he In connection with this, scrape and mash represents, a bill indicating to him the physi- fine roasting ears, so there will be no grain or cian's lack of delicacy of perception.

part of a grain, fry perfectly dry and brown, The physician has a right to charge, and and salt to suit the taste. Feed this to the

4 grains 48 grains

years old.

patient every three or four hours. To supply the relief every time. Will give a brief outline of Aesh and strength, give a teaspoonful of cod- treatment: Dose of calomel, 3 to 6 grs.,

folliver oil with maltine three times a day.

lowed in four hours by castor oil. As soon as A cure is certain to follow this treatment. I the oil acts, start f. ext. chaparro amargosa, have used it for 25 years and can truthfully say 40 drops in a little water every four hours. I I have never lost a single case. The common irrigate the lower bowel every four hours with prescriptions I have noticed in THE MEDICAL three pints of normal saline solution. Keep WORLD containing bismuth, I have tried time patient quiet, in bed, and on peptonoids and and time again ; they are worthless. Let the egg albumen as a diet. Hot turpentine fomenWORLD readers try this and report results. I tations to the abdomen is the best thing to reguarantee what I say. L. CASE, M.D.

lieve the pain. Chattanooga, Tenn.

I never use “antikamnia'—the comp. acet

anilid powder does the work just as well. Summer Complaint.

If the members of the “ family” will use the Editor MEDICAL WORLD:-Let me suggest following mixture, I think they will stop buysomething that may be of much assistance to ing vitogen and other expensiv antiseptic powsome doctors and their little sufferers. Take a ders: Bismuth subnit. 50 percent, acetanilid piece of cotton the size of the abdomen-or I 25 percent; boracic acid 25 percent. Keep should say that will cover the abdomen; peel a the part clean with peroxid of hydrogen and thin layer off the top and dust about five cents

creolin water, and use the above powder freely, worth of quinin on the cotton, and lay back and your wounds will heal rapidly. that which you peeled off. Now place this

The WORLD readers should appreciate Dr. over the abdomen, with the quinin side to the Taylor's efforts to take care of them. belly, bind it there, give the child some simple Boykin, S. C.

J. T. HAY, indicated remedy, keep it as quiet as possible, and you will be surprised at results. Notes on Obstetrics and Summer Troubles.

Waitsburg, Wash. A. D. MAHAFFAY. Editor MEDICAL WORLD :--The “rigid os

[Try it without the quinin, and see if the of obstetrics and especially the “ dry labor os results are not the same. A covering over the (where the membranes have ruptured before abdomen, particularly over the solar plexus, is dilatation) is best dilated by introducing the always a good thing for any abdominal disturb- index and middle fingers into the os, pulling it ance. If the covering is slightly irritating, all the down, separating the fingers widely, and then better. A capsicum plaster is a good and con- raising the os near the pubes. Hold the fingers venient form for such application. If you want

there some time, and, if necessary, stimulate absorbtion of quinin by the skin, there are the pains by kneading the fundus with the much better ways to secure it than by applying other hand and watch the results. it dry, in cotton. Do you remember the “liver The most important duty of the physician in pad” and “kidney pad "craze of some years normal labor, except being clean and aseptic, ago? They claimed to cure by absorbtion is the protection of the pelvic floor. When the thru the skin. They did help a great many presenting part presses the pelvic floor, keep it people, but not by absorbtion. A few folds of there until the parts have time to dilate. Time flannel or a capsicum plaster would have done is the best perineal stretcher. Keep the head just as well. These simples often do much pusht back with your hand and turn off the good, and they should not be neglected, as steam. Tell the woman to “quit bearing they usually are.—ED.]

down” and let her cry out. Always, if possi

ble, slip the head over the perineum between Milk and Malaria.-Dysentery:-An Inexpen- pains. siv Dressing Powder.

Examin every pelvic floor by inspection after Editor MEDICAL WORLD:-On page 297, labor, and if torn, repair it then and there. July WORLD, Dr. Hall mentions sweet milk as Don't tie the umbilical cord till pulsation a possible cause of malaria. I have often no

When the child fails to breathe and ticed, during four years of activ practise in cry, the first, handiest and best thing is to this malarial section, that sweet milk in a large dilate the sphincter ani—insert your finger. number of cases causes the liver to become tor- Never make any traction on the cord. Avoid, pid. We all know that when that organ is not if possible, introducing your finger into the os performing its work properly, malaria is the after the second stage of labor. Deliver the usual outcome.

placenta by pressing down the perineum with I saw an article in one of the Spring num- the fingers of one hand, and grasping the bers of THE WORLD, recommending chaparro fundus firmly with the other, squeezing it out amargosa for dysentery. Since then I have (Credé). employed it in a number of cases, with quick Neyer, under any circumstances, give ergot

ceases.

until you are sure the uterus is empty. Its and ridicules those who believe that two plaonly indication is an empty, flabby uterus. centas ever exist in twin pregnancy. Maintain firm contractions of the uterus by My experience in this connection has been kneading the fundus; teach the patient and very limited. I have attended but two cases husband how to do this, which is surely the of twin labor, yet in one of these there were best means they could employ in case of hem- two separate and distinct placentas, the plaorrhage or after-pains.

centa of the second child being expelled ten Summer troubles in children are now on minutes later than that of the first. The memhand. Never, never forget the old tried and branes were also entirely separate and distinct. almost sure remedy-calomelmand don't pre- The fact that Dr. Mac Murphy has never scribe one of the fancy proprietary remedies. seen a case in which there were two placentas Clean out the alimentary canal thoroly with does not preclude the possibility of such an small and repeated doses of calomel. Don't event, and I wish to warn those who may have give calomel tablets or any of the shot-gun attacht undue importance to the Doctor's mixtures when there is nausea and vomiting, remarks, not to leave a case of twin labor bebut give it in a plain, dry powder dusted on fore the expulsion of a second placenta, unless the tongue. After the canal is cleansed with the first has both cords attacht to it. calomel, then treat the case as indicated. Oakdale, Neb.

MAX KOETTER. Large doses of bismuth subnit. fill the indication for more cases than any other single

Twins. remedy. Where there is pain in the belly, Editor MEDICAL WORLD :-In reply to Dr. add camph. tr. opii to your bismuth, and you Mac Murphy's article on single and double have an ideal treatment for enteritis, even if it placentas with twins, will say for the Doctor's is old and sounds simple and plain.

benefit that I have delivered eight sets of If vomiting continues after action of calomel, twins, the last set March 25, 1904; both try ingluvin powders, grs. ii to iv, powd. breech presentations, with two separate and ipecac 18 to X4 grs., or cerium oxalate, but try distinct sacs of liquor amnii; the second sac I your remedies singly.

ruptured after delivery of first child; after the Rest is the first indication in inflammation second one was delivered I removed two sepanywhere, so don't forget that it holds good arate and distinct placentas, nor did I wait : here, and don't crowd the stomach with food. twelve hours for the second placenta, as the Give po food at all for twenty-four to forty- Doctor states he knew one doctor who did. eight hours, and then give albumin water These children weighed seventeen (17) pounds followed by pepsin; later give milk and oyster -boy nine pounds, girl eight pounds. This soup.

WALTER DOTSON, M.D. was the second set in succession, boy and girl Kempville, Tenn.

each time ; one of the first died in four weeks;

the last still survives. J. T. ABSTON, M.D. Unusually Large Twins.

Hickory Flat, Miss. Editor MEDICAL WORLD:-On Sunday, June 19, I was called seven miles in the country to

Twins and Placentas.-Horse Colic. attend a lady in confinement. She had been in labor twelve hours before sending for me.

Editor MEDICAL WORLD:-In reply to Dr. After about an hour I gave her chloroform and

MacMurphy, page 251, June WORLD, would performed version and delivered her of a boy,

say I have seen single placentas with twin and in fifteen minutes after I turned a second births, and also two distinct and separate plababy and delivered; both boys. The first

centas with their respectiv membranes. Noweighed twelve pounds, and the second eleven

vember, '97, I delivered a woman of twin chil. pounds. Twins and mother doing nicely.

dren in which there were two distinct and The reason I report this case is on account of separate amniotic sacs, rupturing at different the weight of the twins-it is the largest I

times, and two distinctly separate placentas. ever heard of; but perhaps some of The

Turning my horse over to the care of a farWORLD readers have delivered larger ones.

mer soon after a long and rapid drive, he was Single placenta. E. M. CLAY, M.D.

given a full drink of cold water and I soon Renville, Minn.

had an interesting case of horse colic which was of an intense character. Having no

chloroform, I gave : Twins and Placentas. Editor MEDICAL WORLD:- In the letter of

R Dr. MacMurphy, in June WORLD, page 251,

Spts, turpentine

Spts. eth. nit, ää the writer states that he has had an experience

zvij of seventeen cases of twin births and “has yet as a drench. to see a case where there were two placentas,” Repeated in half an hour. Still no benefit

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