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which have accumulated either by excessiv phin suppository. With the sixth day all
“ wear and tear," or by defectiv assimilation medication by the mouth should cease.
from whatever cause. In ninety percent of 5. Reduce the temperature by frequently
the cases the natural reparativ and recuperativ sponging with ice water, as long as it seems
powers of the system are sufficient to carry the sufficient; but in severe cases, where the tem-
patient thru the fever, especially if assisted by perature is persistently high, resort to the cold
judicious nursing. Often, however, a case is bath according to the method now familiar to
protracted many weeks by unscientific med- all. The cold bath is seldom required under
dling on the part of the physician.

the restrictions in diet enforced by the Brand
When an animal has fever, nothing will in- method, tho I have given as many as eighty
duce it to take food. Man is the only fool, baths to a patient in severe cases.
who, when the sympathetic is struggling with 6. The following I consider of vital impor-
disease, and the digestiv functions for the time tance in all cases : Give turpentine enemas to
are in abeyance, strives to heap on the over- thoroly empty, and render aseptic, the entire
burdened sympathetic an additional load, on colon, where lies the greatest danger to the
the plea, “nourish your typhoid patients." typhoid patient. This should be given once a
Yet so strong is the tendency to recovery that day, when the temperature is over 102°, and on
nature will struggle against the disease and the alternate days when it is below that point.
interference of the physician for many weeks, 7. No food should be given during the con-
and come out triumphant in the end.

tinuance of pyrexia, unless in severe adynamic This has long been a common observation : cases, or in the third week of ordinary cases, That after a course of typhoid fever the person the dryness of the tongue should indicate the is very much better in health than ever before; need of stimulation, in which give a half ounce persons hitherto thin and puny finding them- of peptonoids or panopepton every three hours. selves almost a new creature, the thin putting Remember that the tongue, not the pulse, gives on flesh, the weak digestiv power renewed, and the indications for stimulants. life-long ailments disappear.

8. Have no consuitations ! They do no good Let us take an average case of typhoid fever, to the patient; they disturb the clear concepone requiring the services of the medical man tion of the case in the mind of the attending in addition to careful nursing. The following physician; they threaten the permanence of are the directions which I would give were I the faith of the patient in the attendant; and addressing a class of medical students :

they lessen the patient's chances of recovery, 1. Have the patient's room cool, airy and by being a constant suggestion that the case pleasant, and partially shaded. Remove from is one of gravity, which should be by all means the room everything suggestiv, such as medi- avoided. cins, glasses, etc. Have all these and 9. Be hopeful yourself. Remember that the everything that suggests sickness placed in weaker the objectiv, and in the quiet of the another room, distant from the patient, where sick chamber, the more activ the subjectiv; all directions to the nurse should be given, your discouragement may be telepathically beyond the patient's hearing or knowledge. conveyed to your patient, even in your abPlace on a table by the bedside a glass pitcher sence. with ice water, from which the patient should 10. Later in the fever, the sympathetic may be allowed to drink ad libitum.

need reinforcing by the cerebro spinal, in which 2. Both doctor and nurse should be cheerful strychnin hypodermically is in order. Here, and hopeful; should by look, act, and tone too, whiskey in doses to fit the case may often constantly suggest to the patient the mildness be required. Whatever the wiseacres may say, of the case and the certainty of recovery, and I know that alcohol is a food. Had I space I any improvement, however slight, should be could produce testimony to this effect from my accentuated in the hearing of the patient. own experience. But, like all foods, it requires

3. Temperatures should be taken in the rec- to be assimilated, and sometimes in severe cases tum, and both it and the other indications the tongue remains dry, and the delirium conrigorously kept from the patient and recorded tinues, in spite of the alcohol administered. in the other room.

Then by giving one-sixth of a grain of calomel 4. During the first four or five days of the every two hours for a short time, you will find fever, calomel should be given as a stimulant the skin soften, and the tongue moisten, beto the sympathetic, giving one-sixth of a grain, cause the alcohol is now being assimilated. with five grains of soda, one in two hours, and Meriden, Conn.

N. NICKERSON. a small dose of castor oil once in twenty-four hours. If the movements are too frequent, so When the tongue depressor causes the patient to that you are not getting the full benefit of the retch, catch the tip of the organ in the fold of a clean

towel and draw it forward ; in this way a good view of calomel, quiet the bowels by an opium or mor- the throat is obtained without inconvenience.

No. 4:

Osteopathy :-Treatment of Disease in Gen- Recently we hear much of auto-intoxication eral.-Mechanical Stimulation and

as a cause of disease, and we treat the condiInhibition of Nerves and Nerve Centers.

tion by increasing elimination; we used to have bad blood and gave blood purifiers.

Instead of increasing elimination by catharIn our three articles previously publisht we tics, diuretics, diaphoretics, etc., would it not have shown that lesions of osseous structure be more scientific to find the cause of this lack and softer tissues along the spine and at other of elimination and by removing it permanently points accessible from the surface of the body “purify the blood” and cure the condition ? are concomitant conditions with internal When all these so-called causes fail to explain disorders. We have shown also that these the condition we call it a neurosis or lay it to external lesions may be either primary or sec- the microbe. To the microbe I'll pay my ondary to the internal, disorder, and that respects later; a word in regard to neuroses whether primary or secondary they are etio- now. What is a neurosis any way? A neurological factors to the condition, and must be sis is a nervous disorder with no discoverable removed or compensated for in order that the lesion. It therefore follows that the doctor parts affected may resume their normal condi- who is the least able to determin positiv causes tion and function.

and conditions will find the most neuroses. To the question, “How would you treat this When we say a disease is a neurosis we thereby or that disease osteopathically ?" the answer admit that we do not know what is the matter must invariably be, “By removing as nearly as —that we are in water too deep for us. For possible those lesions either primary or sec- the lack of a more definit knowledge we may ondary which are associated with the condition call a given set of symptoms a neurosis, but and predisposed thereto." If these lesions are this need not deter us from looking for its removed, the vital recuperativ power left free cause, the removal of which will benefit a to act will when possible restore to their nor- neurosis just as it will any other pathological mal condition the affected tissue. Lister has condition. Yesterday I dropt my watch and shown that when left free to act, every cell it at once showed symptoms of disordered tends to recuperate after injury. The lesions function ; it ran too fast. I lookt at it but associated with a given disease can be deter- could discover no lesions; it was a neurosis. mined only by an examination of the individ- I took it to a jeweler. Did he ask me a few ual case, consequently no stereotyped osteo- questions, listen carefully to its heart sounds, pathic treatment for any disease or class of pronounce it a case of tachycardia, and give diseases can be given. Remove the causativ something to make it run slower ? No, he lesions is the fundamental principle of osteo- examined it carefully for the cause of the rapid pathic therapeutics.

action, adjusted the disordered hair spring, Among the medical profession there is much and by thus removing the cause cured the distalk and earnest endeavor to find and remove That is the osteopathic idea. So all the cause of disease. A review of the para- physicians, like first class machinists, should graphs under etiology and pathology in any endeavor to find not only the exact condition standard work on practise will show in many present, but also the cause of the conditioncases how far we fall short of any tangible some definit, palpable, visible, tangible, physcausitiv factor; how often we mistake the ical derangement that gives rise to the condicondition present for the cause. Habitual tion. I do not mean to say that such cause constipation is said to be caused by deficiency can always be definitly determined, but in by of secretion or paristalsis, indigestion to far the greater majority of cases a thoro physcatarrh of the stomach, or to a lack of pepsin ical examination will disclose some such cause. or hydrochloric acid, etc. This trouble is said Examinations looking to the discovery of these to be due to an inactiv kidney, or that to a causitiv lesions are not made by medical men, lazy liver. We may go still deeper and find nor is it necessary that they should. A knowlthat hygienic and dietetic errors have exerted edge of such lesions would be of little value to an influence and we may claim these things as any physician who confines himself to such the cause. If these things are the cause, then therapeutic measures as drug medication, diewe should look for the cause of the cause. tetics, hygiene, or electricity. These theraWe should find if we can why this lack of se- peutic measures deal more with exciting causes cretion or peristalsis in constipation, why this and conditions ; osteopathic lesions more often catarrh of the stomach, why this deficiency of act as the predisposing cause which permits the pepsin, or hydrochloric acid; we should de- exciting cause to become effectiv and the contermin the cause which permits dietetic and dition to arise, tho this is by no means always hygienic errors to produce such condition in true. one person and not in another.

Chronic or predisposing causes such as re

ease.

sult in chronic diseases cannot always be ani will stimulate a fagging heart and respiraremoved immediately, if at all. This is also tion, relieve coma, and frequently stop hiccups. true of many recent or acute lesions. In such Von Wedekinds' test for temulence also illuscases where the causativ lesion cannot be re- trates this: “By simply pressing upon the moved at once is osteopathy powerless to pal- supra orbital notch with a steady increasing liate? By no means; here too this system force you may with a certainty of success bring offers valuable aid. While chronic diseases an unconscious alcoholic to his senses and thus result from chronic causes, it is the acute ex- differentiate between alcoholic and other acerbation of chronic troubles that usually de- comas." We could cite many more direct and mands palliation. These acute exacerbations effectiv results from osteopathic sources, but being new or aggravated conditions, are due to these will suffice to show that mechanical stimnew or aggravated causes and will be accom- ulation and inhibition will influence both motor panied by new or aggravated secondary lesions. and sensory nerves. The removal of these new or aggravated pri- Such stimulation and inhibition when applied mary or secondary lesions will usually give to the nerve fibers directly supplying an organ relief to the acute exacerbation. These acute will therefore influence both its function and lesions can usually be readily removed, being sensation. As have shown, impulses passmainly functional-tissue contractions and ing to the center are reflected not alone to the vaso-motor disturbances-no permanent tissue part in which the afferent impulse originated, changes having as yet had time to develop. If but also along the other fibers emanating from the acute exciting causes—traumatic, hygienic that center. Stimulation or inhibition of nerve and dietetic—which induced these symptoms fibers associated thru a common center with have ceased to be activ, the removal may result an internal viscus will therefore stimulate or in permanent relief. If the exciting cause is inhibit the impulses passing to or from that still activ or if the lesions reform after removal, viscus, thereby influencing its function and they should again be removed, thus preventing sensation. As previously shown, all internal their permanent formation, and so materially tissues have direct reflex connection with the assisting the curativ process. Whatever die- external surtace and tissues of the body. Theretetic or hygienic treatment is indicated is, of fore all nervous impulses may be directly or course, not incompatible with this treatment reflexly influenced by mechanical stimulation and should be instigated.

and inhibition applied from the surface of the If these measures do not suffice for temporary body. Sensory inhibition may easily be demresults, resort may be had to mechanical inhi- onstrated by steady pressure on nerves conbition or stimulation and with good effect. nected with the centers receiving sensation of These measures, however, are secondary in pain ; such inhibition will usually relieve or importance to the removal of lesions.

stop the pain. Such relief often continues Experimental physiologists have not given long after pressure is removed. For example: us a great deal showing the possibility of me- Strong steady pressure over the points of chanical inhibition of nerves and nerve centers emergence of the seventh to the tenth spinal from the surface of the body. Sufficient data nerves will lessen or even stop so severe a pain are at hand, however, to sustain our position as that of gall stone colic. This effect may be that such is not only possible but practical. due to the relaxation of the muscular spasm of Goltz, by repeated tapping at the rate 140 the duct, or to the desensitization of the senstimes per minute upon the abdomen of a frog, ory nerves, or to both. gradually slowed and at last stopt its heart Irritation-alternate pressure and relaxation action. The pulsations resumed when the -of a nerve will increase its activity or stimutapping ceast. Temporary paresis of both late it. Steady pressure produces the opposit motor and sensory nerves in legs and arms effect-inhibition. from prolonged pressure are common occur- The above illustrates the theoretical side of rences. Osteopathic experimentation has amply osteopathic therapeutics; the practical or demonstrated that strong stimulation in the mechanical side we will deal with in a future upper dorsal region will accelerate the heart article. In our next we will consider bacteaction in a healthy individual, as also will in- riology in the light of osteopathy; also the hibition of the pneumogastric. Deep pressure

relation of this system to other therapeutic at the second dorsal will often dilate the pupil. methods.

W. A. HINCKLE, M.D. These effects-deviations from the normalm Peoria, Ill. may be induced, tho when tending toward the

(To be continued.) normal, mechanical stimulation and inhibition are much more apparent and effectiv. As gen- Pure and fresh apomorphin should be white. erally known, pressure on the phrenic nerve

greenish discoloration indicates agę or impurity, and will stop hiccups. Dilation of the sphincter dangerous poisoning may result. (H. C. Wood.)

in neither instance should the drug be used, as

A

treatment

QUIZ

antiphlogistine over the knee with plaster casts anteriorly and posteriorly. These were later dis

carded as they seemed to pain her. Abscesses develNew books as they appear, are sent to our Assistant Editor,

opt; the first anteriorly at level with head of tibia; a Dr. A. L. Russell, of Midway, Washington Co., Pa., second to inner side of leg soon followed, situated a for review As the Doctor thus has all the late books for refer. little lower than the first and communicating with the ence, and is made familiar with them by reviewing each one carefully as it reaches him, he is unusually equipt for answering

first. These abscesses were opened and I have been queries. Therefore it has been our custom for a long time to send

washing them out three times weekly with peroxid of queries to him for reply. In fact, the Doctor made a special

hydrogen and bichlorid solution i to 3000 to 4000. Of request that this be done, as he enjoys this work. It now occurs late have been injecting into them, after washing out, to us that time will be saved if you will send directly to Dr. Rus- a 10° iodoform emulsion in oliv oil. sell matter intended for the Quiz Department, which has grown so much under his vigorous

Above the knee at lower end of femur, pus and

Please notice that our query department is not used to "boost” proprietary remedies,

serum collect from time to time. Have aspirated almanac fashion THE MEDICAL WORLD has no interests other

this four or five times, withdrawing considerable matetban to give to the medical profession the greatest amount of honest

rial, mostly pus. After aspirating I injected iodoform service possible. It has absolutely no interests in any proprietary emulsion. Abscesses discharge considerable pus and preparation nor any medical supply house. Other medical editors have become, and are becoming, wealthy, by using their pages to

serum, but less than formerly. Increase the sale of preparations that they are interested in ; but

Knee sensitiv; pains very much, especially in mornwe prefer to render service to our subscribers that is above suspi.

ing after arising, yet this is variable. cion of personal pecuniary interest. How can a man interested in

From November to March--- four months - used the sale of certain preparations render the best service? He is Betz's hot air apparatus three times weekly ; one hour always trying to push one of his preparations in. That is commer- sittings; temperature 350° to 425° F. Was rather discial journalism. We prefer ethical journalism-and so does the profession, for THE MEDICAL World is growing in popularity

appointed in this as knee finally was too sensitiv to faster than ever before-and our subscribers are paying ones.

handle to apply the heat. Since then have been using They must be, for we have no medicins to “ boost," nothing to

the treatment as outlined above, with Angier's petrosell, nothing to depend on but pure journalism ; but doctors that

leum emulsion internally. Medicinally she has been want honest, straight journalism are willing to pay for it--they are receiving calcarea carb. Iox and 3ox; for several glad of the opportunity..

weeks she received calcarea fluor. 30. Only such queries will be publisht as are likely to interest and instruct many others as well as the one asking help. No charge

Swelling and pain in knee is not as great as forhas ever been made, nor will any charge be made, for this service

merly, yet it is still far from being good. Her temto our subscribers. However, those who wish an immediate and

perature, which had been ranging from 100° to 101° F. personal reply by mail may obtain the same by inclosing two

has been normal for several months. dollars to Dr. Russell. This is really a consultation in the interest Is there anything more that I could do locally to of the patient, and should be charged to the patient--two dollars hasten absorption or elimination? She refused operativ being a very moderate consultation fee. The Doctor agrees to give methods. Her appetite is fairly good; bowels regufull, careful and immediate attention to such consultations. We reserve the right to publish in this department any such consulta

lar. Sits all day in a rocker, as attempts to move tions that may be interesting and helpful to our readers. Name

about with use of crutches give her too much pain and address will be withheld if requested. Come freely for help,

from weight of foot.

H. O. WILLIAMS, M. D. but read up as fully as you can before coming to us.

Lansdale, Pa. Resuscitation from Apparent Drowning.

[Your case is interesting in the fact that the

temperature has subsided. This leaves you to Editor MEDICAL WORLD:-May we have some information from the Editor or any of the World family

deal with a simple chronic abscess and its conwho can speak from experience on apparent death comitant symptoms. That is, your case has from drowning ?

reacht a stage of caseation, and you are now (1) How long may a person remain under water and yet be resuscitated ?

dealing with a mixt infection by pyogenic (2) How long should the body be workt with

organisms, most probably the staphylococcus. before giving up? (3) What is the best treatment?

It is possible that your case may terminate in Perkins, Okla. T. L. NOBLITT, A, M., M. D. healing with sclerosis of bone and fibrous

[Your query is of sufficient general interest union about the joint. The ugly feature in at this season to admit of our giving consider- just such cases is that small caseous foci of able space to it elsewhere under the title : unabsorbed or undischarged tubercle are apt Actual and Apparent Death from Drowning : to remain and relight the process long after a Modes of Resuscitation. We cannot state any supposed cure has occurred. Incision may be given time of submersion as necessary to cause necessary, but mere incision, aspiration, and death, since this must be relativ and vary with subsequent washing is unavailing. You should the individual. You note the author states lay the case plainly before her, and tell her that “two minutes may be sufficient," yet pro- that there is only a remote possibility of cure fessional divers give exhibitions of remaining the way she is being treated; that that is the submerged seven minutes. This is due to only way outside operation ; that all the time training and to the lung capacity of the indi- she delays she is in constant danger of the vidual.-ED.]

infection becoming systemic in lungs or

meninges, and quickly ending her life. Then Tubercular Arthritis.

tell her that operation offers strong probability Mrs. H., aet 38. It is now thirty-four months since of cure, but do not go into details with her. the affection began in the left knee. Was treated for twenty months by a physician as rheumatism. I have

When you operate is the time to go into denow been treating her for the past fourteen months. tails, and do it thoroly. Make certain that Several aunts and uncles have died of tuberculosis.

every particle of diseased bone, flesh, cartilage, Some years ago one of her elbows, right I think, and her heel, left, became sore and healed with difficulty etc., is completely removed ; then destroy any only after discharging a portion of the bony structure. tubercles apt to remain by sponging with pure Knee is greatly enlarged and leg is bent to nearly a carbolic acid, wash it away, dust with iodoform, right angle ; rigid. When I first saw this case, April, 1903, I applied

and close the wound; or partly close, pack with iodoform gauze, and repack as it fills up. wonder why you used merc. dulcis and calcarea This will be followed by complete healing if sulf., and in what potency were they employed ? your operation has been thoro enuf; after We do not find the disease mentioned in any which treatment should be instituted looking of the homeopathic books on practise in our towards prevention of recurrence. Do not

possession. Diseases of the tongue, Butlin, rely on scraping if the destruction of osseous publisht by Cassell & Co., sold by Leary tissue at the ends of the bone has been ex- Stuart & Co., New York, N. Y., at $3.25, tensiv. Do an excision, and straighten the gives the fullest information on this disease leg. The immobility of the joint in such and it would pay you well to get it for this one cases is a comparativly small deformity.-ED.] case.-ED.]

Macroglossia.

Application for Corns. Editor MEDICAL WORLD:-I have a very bad case Editor MEDICAL WORLD :-Will you kindly give which I would like to receive some information upon. the working formula for your corn preparation page One of my little patients nine months old has what is 172, April, '04)? I have mixt this up twice, but the known as macroglossia. I lanced its tongue on either salicylic acid being a powder, dries up the collodion side of the raphe and half a teacup full of thick serum and cannabis indica so that it becomes a stiff jelly and exuded. I then gave it merc. dulcis and calcarea cannot be applied with a brush and will not form a sulf. I then lookt up the disease in my text books coating.

F. F. CRANDELL, V. D. and found nothing; only a few lines in the American Turtle Creek, Pa. Text Book of Surgery. It gave the pathology and surgical treatment but not the etiology nor the med

[Salicylic acid varies. Different lots from ical treatment, only a good cathartic. I am a recent the same maker vary when it comes to blendgraduate and this case came in the first day I opened ing it with cannabis indica and collodion. We office. I wish some of the older of the profession, or some one that has had experience in such cases would

have had many lots spoil in the making, or give me a little advice on this case. The child seems soon afterward. When it “jellies" on the in perfect health otherwise, being nearly able to walk,

mixing, or soon afterward, too much salicylic has six teeth and fontanels nearly closed; always had good health.

C. C. WAY, M. D.

acid has been used. We have remedied this, Woodruff, Kan.

C. H. M. C., '04. in some instances, by adding a little ether. It [Both the text-books on Pediatrics and those is essential to use all the salicylic acid the on General Practise are singularly silent on cannabis indica and collodion will take up the subject of Macroglossia; only a few devo- without gelatinizing; and if too much has ting a few lines of valueless material. The been used, it may also be remedied by adding condition is usually a congenital one, and is a little more collodion and cannabis indica, it noted in those tending toward cretinism. In being the ether and alcohol in the respectiv such cases, says Rotch: “ The hands and preparations which acts as a solvent for the feet are apt to be large, thick, and purplish." salicylic acid.

salicylic acid. Consistency is essential, as the It occurs, however, as an acute and transi. secret of success lies in painting” in suctory condition. In such cases the symptom cessiv coats. Then, too, if too gelatinous, the has followed the ingestion of irritants, such as remedy dries so quickly as to fail to penetrate. taking ammonia, potash, or other poisonous Try it again, with these remembrances, and drug or plant into the mouth. In the chronic you will succeed. Another point: At times we form it does not tend to recovery, and the have had this remedy aggravate the corn so treatment followed is mainly symptomatic. that it quickly became sore. We did not Strive to keep the child well nourisht, and use attempt an explanation, for the same formula an alkalin and non-irritating mouth wash fre- had not so acted before. When the corns quently. The disease appears in two varieties. became sore, the formula would not destroy One is the fibrinous, in which the connectiv the corn. When properly made, it is the best tissue is pathologically increast between the we have ever known. We would advise your muscular fibers. The other is a cavernous making up a four-dram vial and testing it, and cystoid degeneration of the interstitial con- just as quickly as you find it working properly, nectiv tissue, by which the resulting spaces make up sufficient to last you a long time, as come into connection with the lymph vessels, it keeps well when tightly corkt. But don't constituting a condition closely resembling forget the usefulness of sand-paper, not too cavernous angioma, from which it receives the fine-quite coarse, in fact-in removing corns, name of lymphangiomata cavernosum.

In

as recommended by an Indiana brother some some cases permanent improvement follows

Better have your patients use surgical removal of a portion of the tongue. sand-paper first, until the sensitiv parts are Your case was probably of the latter variety. reacht ; then follow with the above applicaYour case is well worth keeping a record of tion.-ED.] and making a full report later. If the condition recurs in aggravated form and you can get a In making incisions in the scalp, keep the knife pargood photograph, we will produce it with your allel to the line of growth of the hair ; a less noticeable

cicatrix results than if the incision be made transreport on the final outcome of the case. We

versely.

months ago.

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