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the irritability there. And unless he does this The Removal of Growths upon the Skin. his treatment will fail.
Editor MEDICAL WORLD :-Few general Dr. Girk, page 264, may find atropin useful practicians will condescend to attempt the for his salivated friend. Give enuf to dry the removal of the nevus, mole, or the ordinary mouth and keep up this effect for a few days, wart, much less the incipient epithelioma, by using local remedies as suggested. A dram of any other than surgical methods. Only wise tincture of hydrastis in a cup of water is a use- caution, ignorance, or inexcusable timidity ful lotion. Or better, use a granule of ber- can explain the facts. The plea of conservaberine as a lozenge every hour.
tism is not tenable, since both the specialist Whatever Dr. Vital's case, page 264, has, it and the quack remove these growths without is not rheumatism. That is a disease of the more accidents or ill effects than any doctor's fibrous structures about a joint, always febril, every day practise will show. Ignorance ! A and changing from one joint to others, with general practician should not be ignorant of acid sweat and urin. The description reminds any thing in the domain of medicin. Hoping me of a case of abscess in the head of the
that my article will interest practicians deretibia, relieved by trephining. Possibly there lict to their interests and duty, I will give my is a needle that may be found by X-ray exam- methods of removing the various growths. ination. That should be employed at any Warts : The verruca are the most common rate.
of disfiguring skin lesions. More common in Asthma, Dr. Krebs, page 265:-I have yet children, they may be found at any age and in to find a case in which the following combina- any location. They are prone to appear on tion does not discount potassium iodid for the hands. Every physician is familiar with efficiency and quick effect: Mercury biniodid
their appearance, and it is only rarely that a gr. 6, iodoform gr. }, phytolaccin gr. t, of case may present features which render diageach three granules; arsenic iodid gr. oy, one nosis difficult. They may be flat, filiform, or granule; these then to be given together brancht; and about the genitalia may present before each meal and on going to bed. Con- widely varying characteristics. Excepting the tinue and increase the doses till slight irrita- genital wart, I remove them most easily by tion of the eyelids shows saturation, then applying glacial acetic acid several times a day. slightly lessen 'doses and continue. But you The patient is given a small vial of the acid cannot cure any asthma if you neglect to keep and instructed to apply a drop on the end of the bowels clear and aseptic, and keep down a stick three times a day, avoiding enuf being the diet to the needs.
used to permit it touching the healthy skin. Dr. Higdon's case suffers from auto-toxemia If the wart should become inflamed, he is inof intestinal origin-nothing more nor less. structed to suspend applications for forty-eight Page 265
hours, or until the inflammation subsides. The Ăs to W. B.'s case of backache, there is not wart goes, I have a satisfied patient, and he enuf evidence for a diagnosis; but what there tells his friends about it, and he returns when is points to disease of the anterior surface of a again needing a physician. The venereal wart lumbar vertebra-abscess, cancer, aneurysm. only differs from the ordinary form because of If no examination has been made for three moisture, irritation, or compression. It is best months there may be a development that will treated by cleanliness, mild antiseptics, and clear up the mystery. Use the x-ray.
drying powders; but if single, small, or filiSo they have whoopingcough in Virginia, form, may be clipt off with scissors or bispage 266. Now is the chance to test the
toury, and dusted with calomel, iodoform, or claims of those enthusiasts who think calcium boric acid. sulfid will prevent or abort this malady. Don't Moles: The ladies are our best patients when say a word to them but begin giving from moles are considered ; and we always give them to a grain every hour till the breath smells like due attention. The nevus pigmentosus may apa last summer's egg, and see if the child can pear on any part of the body, or it may be develop this affection while so saturated. If congenital. The laity generally ignore them already infected, add to this enuf atropin to unless they appear on face, neck, arms, or slightly dry the throat and keep it so. Of breast. Most patients will suffer their prescourse you will keep the bowels free and asep
ence for years through fear of “ cancer develtic thruout, for we are talking with real doc- oping" if anything is done toward removal. tors.
William F. WAUGH, M.D. While they may be safely removed by elecChicago, Ill.
trolysis or excision, we have always preferred
to treat them exactly as we treat warts. We A splendid eye water for routine use in conjunctiv- always get good results, without a scar. itis is made by adding an ounce of camphor water to Freckles : Lentigo is familiar to profession two ounces of a saturated aqueous solution of boric acid. It may be used freely in the most sensitiv eye.
and laity. Blondes are more susceptible than
gr. iij. gr. iss.
brunets. It may attack any portion of the tinued irritation. The socalled soft corn is but body, but generally selects unprotected parts; the ordinary corn macerated by continuous sunlight may influence its appearance, but is perspiration. The source of irritation must generally over-estimated as an exciting cause. first be removed. If great inflammation be They may be removed, but they generally re- present, we keep a piece of lint around or on turn. We dispose of them by having the the corn, soakt with linseed (flaxseed) oil, patient use the following lotion twice a day: day and night till all soreness is gone; then Hydrarg. chlor. cor.
we apply the following, night and morning for Alcoholis Aquæ distillatæ, äā, q. s. ad.
several days, then soak the corn in hot water .. iv
for a few moments and it readily separates from The favorit plan of the laity in rubbing a
the sound skin and may be pickt out. One freshly cut lemon on the spots just before
course does not cure, and the application is retiring is not be ignored.
repeated till there is no longer any hardening Liver Spots : Chloasma may affect any grown
of the epidermis, when properly fitting shoes man or woman. Care is exercised lest one may fail to distinguish between chloasma and tinea
or removal of irritation will permit the skin to versicolor. Prone to appear in pregnancy, any
assume a healthy condition. The application
is made up as follows: one may have them. They are annoying and disfiguring. They are often obstinate, but I
gr. xxx. Tinct., iodin
minims x. have had good success with the following pre
Ext. can. indica
· gr. x. scription applied twice a day :
drams iv. R
Cutaneous horns result from hypertrophy of Zinci oxidi. Hydrarg. ammoniat
the epidermis, and are found on face, scalp, or 01. theobrom.
penis; they are most common in the aged. 01. ricini.
ää fl. 3 iiss.
They are easily cured by excision, and cauteriEss, rosae Misce et signa : Apply night and morning as directed. zation of the base with carbolic acid.
If the emunctories are kept activ, this will Hirsuties : Excessiv growth of hair may disremove most “liver spots,” if the treatment is figure the face or form, and ladies are often persisted in for sufficient time. In obstinate anxious to part company with such growths. cases one may remember that the discoloration The hair may be removed temporarily by applyof the cuticle is the result of an irritant, and ing hydrated calcium sulfid as a thick paste, that this irritant may be external or internal, allowing it to remain until the hair is dissolveá and that one may learn the cause by careful in- or irritation is complained of; 3 to 20 minutes vestigation. Once the cause is known one may be required; the skin is then sponged may act more intelligently. We always inquire clean, and annointed with lanolin. The hair carefully regarding possible external irritants, soon grows again, but if the applications be and we look out for malaria and Addison's dis- repeated often enuf, occasionally one secures ease, and complete our examination by ascer. entire destruction of the follicle. Electrolysis taining the condition of the uterus as regards is only practicable for small areas, and freendometritis, pregnancy, tumors, etc. If you quently the destroyed follicle causes an atrophy find the cause, a little thought will enable you of the cuticle, with a consequent depression in to dispose of the “liver spots” to your own
the-skin which serves as a lodging place for and the patient's satisfaction.
perspiration and dirt, and the after condition Lichen pilaris : Keratosis pilaris are small of the patient with permanent “black-heads" papular elevations surrounding the hair folli- is worse than the first. Simple epilation is the cles, and are a true hypertrophy of the epider- most reliable method. It takes time, but is mis. The elevations are dirty grey in color, not very painful when properly performed. and each is pierced in the center by a hair. It Each individual hair is firmly graspt close to occasionally causes some itching, but only the the skin by small forceps and quickly removed most aggravated cases present evidence of in- by a jerk. flammation. Frequent bathing in hot water Birth marks : Angioma are common. with abundance of good soap, followed by vig- not on an exposed portion of the body, few orous friction of the skin with a ruf bath towel, patients give them much consideration. It and the final application of vaselin or other small, they may be readily removed by ligation simple ointment will bring about a rapid cure. by the subcutaneous method ; by electrolysis ; The disease is the result of filth. It is prone by excision; or by the repeated use of causto attack the extensor surfaces of the arms and tics. It is not practicable to remove a large legs, but may appear on any part of the body. birth mark; often the resultant scar and the
Corns : Clavus spares few adults. Most possible contraction of the subcutaneous tis. common on the feet, they may appear on any sues leaves a worse disfigurement than before. portion of the body as a result of long con- The small birth mark may be removed by re
peated applications of silver nitrate, tincture appear, after waiting 12 hours more the paste iodin, or caustic potassa ; so soon as the eschar is removed and a new application made. After separates another application is made. It is the sluf separates, the lesion is dressed with better to employ operativ procedures in the any simple antiseptic ointment. Healing is larger varieties.
usually kind and uneventful. Tumor is less Wrinkles may be obliterated by regular and likely to occur than after the use of the knife. persistent massage of the affected skin with Let the general practician pay more attencod-liver oil or lanolin. Use the index finger, tion to such “ foolishness and it will be betand with a stroking motion exert considerable ter for his patients, and better for his bank pressure along the long axis of the wrinkle. account. Neither the specialist nor the quack Use the selected unguent freely. Applications has any right to usurp this field, and no pracare best made before retiring, and as the lubri- tician should either refer such cases to the cants are harmless may be continued at the specialist, or permit them to drift into the discretion of the patient. Usually five min- hands of the quack.
A. L. RUSSELL, utes' daily inunction will result in rapid cure. Midway, Pa.
Epithelioma : The skin cancer is the hardest problem to tackle without thinking of the The Treatment of Disease in General, with knife; yet actual results show much more
Especial Reference to Typhoid. favorably toward the use of caustic. In the Editor MEDICAL WORLD:-In the Indeearliest stages, the patient will often submit to pendent of May 5, appears a letter written an application when mention of operation by Herbert Spencer to Dr. Lewis G. Janes of would scare him to some other physician or Brooklyn, now for the first time made public, confirm him in his determination to die with- closing with the following observation: “In out interference. One must remember the my earlier days, I constantly made the foolish ignorance of the laity; we must remember the supposition that conclusiv proofs would change quack advertisements they have read, until beliefs; but experience has long since dissithey are morally certain they know much more pated my faith in men's rationality.” of their individual case than any doctor ever In somewhat similar frame of mind I apcan; hence we must humor them, in order to proach the subject of the treatment of disease, control them. If we are not equal to the especially of typhoid fever. My views will be task, we would better retire gracefully. We advanced with no expectation that they will be must not forget all they know about “roots; accepted by any large number of physicians, we will remember that they know that a cancer but with a faint hope that they may awaken cut out, always returns; we need to be judi- inquiry in the minds of a few, and in some cious, and get rid of the growth by whichever measure aid in the consummation, for which plan we can induce them to accept. The we all devoutly wish, the shortening of disease, majority of patients will select the caustic. and the lessening of its mortality. Many of Zinc chlorid and arsenic are the most popular these views are not original with me, but are agents. The zinc is used by taking one part held by a constantly increasing number of zinc chlorid and three parts flour and making men. There are some, however, which I have a paste with a saturated solution of cocain evolved from my own experience and obserhydrochlorate. The arsenious acid was first vation, during a long life in both civil and used by Marsden, who recommended two parts military practise. of arsenious acid and three parts of powdered In the editorial remarks in Scribner's Magaacacia with enuf water to make a stiff paste. zine for May, under the heading “ Tonnage in This is applied over a slightly larger area than the Professions," I find the following: “ It that covered by the cancer, to the thickness of is the opinion of one of the oldest medical in14 inch. Marsden warned against covering structors in our country that the schools of tomore than one square inch at a time; but if day aim to turn out more graduates, and betthe area be larger, one may use the zinc paste ter students of medicin than ever before, and at the outside and the arsenious acid paste in that they succeed ; but they do not turn out the center. Either paste is covered with lint, as good doctors, on the average, as they did and left in position 24 to 48 hours ; it is then forty years ago. “The proportion of good removed and poultices applied. The sluf is doctors in the multitude issuing from the slow to separate, but usually comes away
5 modern school is probably as great as the old to 10 days. Robinson advises that the paste schools turned out; the positiv number of the be removed at the end of 24 hours, as he fears less competent is necessarily larger." absorption of excessiv quantity of the drug if The superiority of the doctors of the present the application be continued longer. If the day, over those of forty years ago, it seems paste acts properly in 12 hours there will be to me, consists mainly in diagnosis, hygiene, markt inflammation and edema; if this does not and preventiv medicin, rather than in the treatment of actual disease. Then doctors a cathartic, when it is the poorest of all catharwere compelled to rely on themselves to a tics, producing greenish discharges accomgreater extent, to use their own reasoning pow- panied by griping pains and hemorrhoidal disers, their own common sense, and did not so tress; others claim it as an antiseptic to the blindly follow precedent and authority. The intestinal tract, when, as Dr. Gilman Thompgreat hindrance to progress in the better under- son writes in a paper read before the New York standing of disease and its treatment is the in- State Medical Association, “It is a decided tellectual inertia, which prevails among the misconception to regard calomel as an intestimajority of medical practicians. They accept nal antiseptic. There is grave doubt whether the views of self-constituted authorities without any of it is converted into corrosiv sublimate bringing these views to the bar of reason ; it in the intestin.” Many give it to "act on the is so much easier to take your opinions from liver," by which I presume they mean to cause some one else.
the liver to disgorge bile into the duodenum, Again, I am confident that the antidotal when it has been many times proved by actual theory in combating disease is utterly wrong; experiment in case of biliary fistula that it that we place too much reliance on drugs, and does not do any such thing. In a subsequent too little on the natural recuperativ powers. paper I will give my views upon the action of We are apt to regard disease as a positiv force, calomel, if the patience and forbearance of or entity, which we are to drive out or antag- the Editor holds out; now I will simply state onize, instead of a condition which will often that my experience convinces me that in the right itself with very little aid from ourselves. mercurials we have a direct stimulant to the Nowhere is the chaotic state of the medical sympathetic nervous system. mind more evident than in the treatment of Again, 90 percent of the statistics that are typhoid fever.
given to substantiate the claims of any kind of The following confession, taken from an treatment are of no value, until it is a common article in the Boston Medical and Surgical saying that “you can prove anything by staJournal, written by Dr. Henshaw, will show tistics." A very good specimen can be found that I have not resorted to hyperbole in my in the May number of this journal by Dr. J. remarks: "Within the last few years more L. Thompson, of Limestone, Pa., under the than fifteen hundred remedies have been sug- title “ Nourish Your Typhoid Patients." The gested for the treatment of typhoid fever; all Editor has kindly placed it in immediate juxtasorts and kinds of food have been advocated, position to my article in the same number. In as of special value in the diet; hydrotherapy this communication he claims to have been in and antipyretics have been advised for the practise ten years, during which time he has reduction of the fever; attention has been treited 314 typhoid cases in accordance with called to the value of intestinal antisepsis; his method, without losing a case. The while the special symptoms, arising during the United States census of 1900 gives two places course of the disease, have been relieved, in Pennsylvania of this name, one of which experimentally at least, by almost every re- has too few inhabitants to pay for counting, source of the pharmacopeia.'
and hence is markt with an x; the other Medicins are given with no intelligent idea is credited with 206. The inhabitants of of their therapeutic action. A man reading Limestone, Pa., must be by this time very the reports of cases in the medical press, nearly immune to typhoid fever. would find abundant justification for the opin
Dr. W. Gilman Thompson, in the paper ion exprest two years ago by Dr. Bull, of New to which I have referred above, claims that York, that "medical practise is empirical and the mortality under the modern treatment of probably always will be.” A few years ago, typhoid fever is but 7 percent. There were in one of the medical journals there was a 1,665 deaths reported to the State Health symposium upon the value of quinin in mala- Commissioner of New York last year, which, rial hematuria, in which about fifty doctors par- on Dr. Thompson's estimate, would give 23,ticipated, one half declaring that it was cura- 785 cases occurring in the state during the tiv, and a like number condemning its use in year. Now, I claim that in the smaller towns no measured terms. Not one man gave any and country districts the mortality should be reason why quinin was useful in one class of much nearer zero
ro-indeed, I would in these cases, and the contrary in another. Not one localities advocate calling a coroner's inquest man gave any evidence that he ought to know after a death from typhoid—we know that in or cared to know. A physician should be as the local epidemics, like that at Ithaca, the familiar with the action of his medicins as a mortality was more than double the estimate mechanic with his tools; yet how hazy are the given by Dr. Thompson; the same observation ideas of most doctors as to the action of the applies to the epidemic which occurred at New commonest remedies. Many give calomel as
Haven last year.
In the claims that are made for the results I will endeavor to use plain language, that obtained from various remedial agents, no cog- can be understood by anyone who has kept in nizance is given to the fact that all forms of touch with the progress of modern thought. disease have decidedly decreast in severity If there is any lesson which a close study of during the last forty years. This is due, in disease and its remedies extending over a truth, to improved hygiene, and to the labors period of fifty years has taught me, it is the of our health boards, but it is especially owing extreme simplicity of the laws of health and to an entire change in what, for want of a better disease. In my early days I was fortunate in name, I have termed the "epidemic constitution coming under the teaching of Prof. E. R. of disease.” Any man whose memory goes Peaslee, one of the brightest men that ever back to the epidemic of diphtheria soon after adorned American medicin. One of the the close of the Civil war, knows that the axioms which he gave me has been my guide diphtheroid disease we have now is no more thru life, viz.: “ Disease is modification of like the diphtheria of that day than typhus is vital force.” In this he anticipated, by half a like typhoid. The socalled diphtheria of the century, the development of the psychological present day, in its inception, before there is therapeutics of the present day. We now septic infection from the putrescent membrane, know that what was called vital force, or “vis is simply the result of irregular and exag- medicatrix naturae,” is the subliminal self, so gerated action of the sympathetic, and can be well presented by Hudson, Myers, and others, aborted by simple means.
and that it works thru the sympathetic nervous The antitoxin craze of the present is but a system. Anyone who desires an elucidation repetition of the wholesale venesection of the of this statement should read the paper by the latter part of the eighteenth, and the criminal late Dr. Pilgrim, in the number for October, abuse of mercurials in the first half of the 1903, of the Journal of Advanced Therapeutics, nineteenth century. They all exhibit the
or a more extended consideration in Vol. i profession in one of its periodical attacks of of F. W. Myer's recently publisht work on hysteria, from which nothing ever arouses it “Human Personality and its Survival of Bodily but the spread of some gigantic protest like Death." Thompsonianism, homeopathy, Christian sci- Evolution teaches us that if we go back in ence, and kindred epidemics of delusion. the development of animal life, in time the These are simply revolts of the plain people brain disappears; still further back every trace against the absurdities and abuses of the physi- of the spinal cord is lost; but we never lose cians, and antitoxin would go the way of the the sympathetic. Therefore, for a perfect other lumber to the garret of obscurity if it understanding, I would promulgate these artiwere not upheld by the large financial interests cles of belief, which I feel very confident the engaged in its manufacture. Indeed, the science of the twentieth century is going to whole bacterial theory is going to be on trial make clearer as time goes on: during the next decade. Already there are 1. Thru the sympathetic nervous system are signs that the craze has reacht its height, and carried on all the functions of organic life. a saner view of things is beginning to take its 2. Vital force, the “ vis medicatrix naturae,” place.
which Myers shows plainly is the subliminal The wonderful developments in psychological self, acts thru the sympathetic. therapeutics are destined to have a profound 3. The cerebro-spinal nervous system is a influence upon the thinking minds of the pro- later development, and as far as organic life is fession, which will materially modify the med- concerned, simply reinforces the sympathetic. ical practise of the future.
4. Disease is modification of vital force, and The case of the state of Missouri against the consists at first in irregularities in the action of city of Chicago, now pending before United the sympathetic. Consequently it naturally States Commissioner Bright, is of interest in follows that the duty of the physician is to find this connection, owing to the testimony of what aid he can render to the natural recuProf. Jordan, of the University of Chicago, perativ powers, and beyond that to hold his supported by that of Profs. Russell, of the hand. University of Wisconsin, and Zeit, of the 5. Physiological rest to an overworkt or disNorthwestern University. If their testimony abled organ is the logical demand of nature, is sustained, it will show that the idea, so con- and the only sensible way to repair of disfidently promulgated, that epidemics of typhoid ordered function. are due to the conveyance of germs in sewage Now, in typhoid fever, what have we in its and running water, must be materially mod- inception, before organic changes have taken ified.
place? I have claimed that typhoid fever is a In giving my ideas in reference to the treat- conservativ process. It is an effort of nature ment of disease in general, especially of typhoid, to remove, burn up, and get rid of impurities,