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Dizziness.-Itching of Scar.

Editor MEDICAL WORLD:-1. Male, aged 58 years, miner, workt in coal mines nearly fifty years; a stout and well-built man who has always enjoyed good health. Now he complains of " dizziness." Sometimes the vertigo interferes with his work. Bowels acting; appetite good.

2. What is the best application for itching, at night, of large scar following a severe gas burn? Strawn, Tex. PHIL. R. SIMMONS.

[Examin the eyes to see if there is any error of refraction requiring adjustment. If he wears glasses, possibly they need changing. Get the digestiv functions to the best possible tone. Examin the ears to make certain that there is no impacted cerumen.

Often the following tablet

taken every fifteen minutes for four or five doses will banish vertigo when no assignable cause can be discovered :

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Mix and direct one or two tablespoonfuls three times daily about half hour after meals.

Irritability of the stomach, when the maximum dose is employed, may require reduction to smaller doses, yet one should attempt giving sufficient at first to produce results. The patient may be warned that the medicin will produce a considerable thirst, and that water may be taken as freely as desired. Occasionally dermal pruritus is due to a tendency to uric acid diathesis, and in such instances the ordinary diuretics and alkalies, combined with free ingestion of water, will produce satisfactory results. In the way of local applications, nothing can be recommended which will give satisfaction in all cases, and it is a matter of trying one antipruritic after another until one is found which will control the itching. Probably one of the most serviceable in the majority of cases is the following prescription:

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salve is applied. What is it? and the cause and treatment ?

Where can I secure a book entitled Psychopathia Sexualis? I have seen one, and am informed they are not permitted to go thru the mail.

What is the composition of Kidder & Co.'s Asthmatic Pastilles? INDIANA.

[The trouble is probably nervous in origin, and will likely disappear under liberal use of valerian and the bromids. Do you think you got enuf absorption of the cocain thru the skin to have such an effect? Is it not likely that the salve without the cocain would have done fully as well?

You can purchase Psychopathia Sexualis from W.T. Keener & Co., 52 Randolph Street, Chicago, Ill. Mention THE WORLD when

writing to them.

We are not able to give you the composition of the nostrum you mention, but you can make pastilles of your own that will do fully as well, or perhaps better, after the following formula: equal parts of pulverized lobelia, stramonium, potassium nitrate, and black tea. This is used by igniting about half a dram of the mixture and inhaling the fumes as they arise. It could probably be made into pastilles with any mass that would not prevent free burning, but we think the powdered form much more convenient and preferable in every way. -ED.]

A Strange Epidemic.

Editor MEDICAL WORLD:-During the past six weeks our town has been visited by an epidemic, of which, owing to a few peculiarities, I would like to have some assistance in making a positiv diagnosis.

The disease is markedly contagious, as it sweeps thru entire families, respecting neither old nor young, and new-comers are affected after a few hours' exposure.

In a typical case the patient gives a history of a sudden seizure with most agonizing pain in both right and left hypochondriac regions, the pains radiating upward thru the chest to both shoulders, both anteriorly and posteriorly. The respirations are shallow, weak, frequent and painful, running about forty per minute; pulse ranging from 100 to 120, and temperature 100° to 103° F. He complains of headache, vertigo, slight cough and dyspnea. The tongue is heavily coated, face flusht and breath very foul, and the urin is scanty and highly colored. Every case gives a history of constipation during the first twenty-four hours. On physical examination, the liver is found to be enlarged; the stomach markedly distended with gas, in a few cases so much so that the heart is encroacht upon and pronounced palpitation results with lance-like precordial pains. The pulmonary and cardiac signs and symptoms are all negativ with the exception of those already enumerated."

In the treatment of the trouble, the symptoms readily respond to rest, proper diet, and free purgation with calomel and salines. Along with the above I control the pains with turpentine stupes, mustard, etc., and administer anodynes, as chlorodyne and liquid opii compound, until the acuter symptoms abate, while the febril symptoms are very easily held in subjection by small doses of aconite when the fever is 103 or more, and when lower by quinin grs. ij to iv each three hours.

At the end of eight hours the patient is invariably improved, especially after a free passage from the bowels. The extreme tympany has disappeared, the

pulse and temperature are both normal, and the pains

have ceast.

Decided tenderness still exists on palpation of the liver; the patient cannot take a step or a quick turn without severe pain. The skin and conjunctiva are jaundiced, while decided muscular exhaustion is most prominent.

Now if the patient remains quiet he is comparativly easy; but if he attempts much exercise the symptoms are again soon felt. His relief is but transient tho. After a period of from 12 to 24 hours of comparativ ease the symptoms in many cases return with a fever usually higher than that of the initial attack, ranging from 103° to 105° F. A new feature now presents itself: the tonsils and pharynx are, in a majority of cases, covered with exudates, but a few present only a catarrhal inflammation. The patient is always surprised when I tell him his throat is affected, as in a series of between 400 and 500 cases but one has complained of the throat.

My treatment during this secondary attack is similar to that of the initial symptoms with the addition of an antiseptic throat wash, and at the end of four or five hours all symptoms abate, and the strength is rapidly recovered.

Some few cases are, however, prolonged, and the tenderness, pain and some slight fever return with a markt periodicity every other day, like a tertian paroxysm of malaria. For these cases I frequently prescribe quinin and acid nitro muriatic dilute, with pepsin and strychnin, and in the course of a week they have regained their former health.

During the epidemic six cases have presented a simple orchitis as a sequel, this occurring about one week after the relapse. I think you will concur with me that the disease is somewhat out of the ordinary. Each and every one of my five hundred patients presented symptoms exactly similar except as to severity, and while many have been terribly prostrated with it, I am pleased to say I have not met with a single fatality. Now I ask the WORLD readers for a diagnosis. East Greenville, O. J. F. CAMPBELL, M.D.

[You have given a very full and complete description of the disease, and we only criticize you in that you did not give your own diagno sis. You would not treat 500 such cases without having a very definit opinion as to what you thought the disease to be, even if you treated all cases on a more or less symptomatic basis. Let us know how you labelled it. Do any of the family wish to make a diagnosis for the Doctor?

You should have endeavored to give us something regarding the area of territory involved, the nature of the water supply, the employment of the mass of your people, and other minor details.-ED.]

Capsicum Plasters.-Jeffersonia Diphylla.

Editor MEDICAL WORLD:-In what diseased conditions are capsicum plasters useful? Give directions for their use in each condition.

What are the physiological effect, therapeutic uses, indications and doses of jeffersonia diphylla. Pauline, Ark. J. A. BURNETT, M.D.

[It would not be possible to give a very extensiv reply to the first outside of the general statement that capsicum plaster is a rubefacient, which excites redness and burning, and if the contact be prolonged, a certain degree of vesication. The indications are sufficiently plain to any practician. A few may be cited: Sprains, wry neck, muscular rheumatism, bron

chitis, pleurodynia, tonsillitis, laryngitis, headache (applied to nape of neck), chilblains (when skin is not broken), etc.; in fact, it will relieve pain in almost any location where no contra-indication exists. Capsicum shou'd not be employed to the extreme stage on those who

are very nervous.

Jeffersonia diphylla, otherwise known as twin-leaf and rheumatism-root, is an American berberidaceous herb, useful in rheumatism, and a good substitute for senega. It is alterativ, diuretic, antispasmodic, a stimulating diaphoretic, an expectorant; and in large doses, an emetic. It is used in rheumatism, secondary syphilis, nervous disorders, bronchitis, dropsy, spasmodic affections, colic, and as a gargle in throat diseases. The dose of the fluid extract is 20 to 60 minims. Very few of the writers upon materia medica deign to mention it, despite its virtue.-ED.]

Laxativ for Infants Wanted.

Editor MEDICAL WORLD:-Will you kindly give me a formula for a good laxativ for infants? I get good results with castor oil or small doses of calomel and sodium bicarbonate when a brisk purge is needed, but for a laxativ to combat the constipation of nursing infants have found no efficient remedy. Cascara does not give me good results, as it does in older children or adults. The common household remedy for this condition is "castoria." Can you give me the compo sition of this preparation? W. H. FOLSOM, M.D. Markesan, Wis.

[We think that you will be pleased with the alkalin elixir of the National Formulary, otherwise known as elixir rhubarb compound. It is not intended as a purge, but it will regulate the bowels nicely if given for a considerable period. Cascara could be combined with it to increase the laxativ effect. Have you ever tried cocoa butter suppositories, injections of glycerin, glycerin suppositories, etc., in nursing infants? Many practicians prefer them to any form of medication by the mouth. The glycerin suppository is quick, efficient, and more agreeable to use than the injection; altho with the soft rubber bulb ear syringe, holding about an ounce, quick and satisfactory results are obtained, without danger of deranging the digestion by purgativ drugs. You can easily compound a satisfactory elixir or other combination of laxativ drugs to suit your purpose from the ordinary drugs in common use by adults.

We do not know the formula of castoria. The formula given the government at the time it was entered will not produce a combination resembling in any degree the virtues or appearance of the original. With a little study and experimentation you will be able to make up for yourself a preparation which will give as good satisfaction as castoria. All the manufacturing drug houses prepare a compound

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Pain principally on right side, goes from umbilicus to inguinal region, is of a sharp, tearing nature, increast at times by taking food; burning, gnawing sensation in back; vomits hot water of a yellowish color; ankles swell; inguinal glands enlarged and painful; stools from real dark to a greenish color; tenderness on pressure over lower abdomen; eructations frequent and of acid nature; rumbling noise in abdomen most of time. While standing, lower part of abdomen projects and upper part sinks in; part of time has no appetite, and at other times can't eat enuf; has dizzy spells; sick headache most of the time; bad taste in mouth; always thirsty; bowels may be constipated, and then all of a sudden and without any warning there is a change to the opposit. After eating cabbage or food of that kind, she bloats up until it looks like the abdomen would rupture. Has a pulse of 60, temperature normal; has very white, dead-looking skin; has four children; no trouble in labor; at times melancholia; stomach is distended with gas all the time; uterus and left ovary low down; did not locate right one. Urin is dark with brick-dust deposit; does not get any rest when she goes to sleep.

She has spells two or three times a week, when she has all these troubles increast, cold sweat comes out over the body, hands and feet get numb, finger nails turn black, and chest feels as tho a heavy weight was laying on it. There is intense itching and burning near the coccyx. G. F. E., Colo.

[Your patient suffers from gastro-intestinal indigestion. She may have hyperchlorhydria, and possibly dilation of the stomach. She may have a weak heart, and in any event, the heart is opprest when she takes the "spells" when the ends of the fingers darken This is proba

bly caused by pressure on the heart from overdistension of the stomach with gas. In such emergencies give her four drams of chloroform water every fifteen minutes till relieved, or four doses are taken. Let her keep it on hand and take it whenever she feels an attack coming. In the intervals between attacks, examin the heart carefully before and after exertion, and if there is any functional or organic trouble, give it appropriate attention. Strychnin is indicated, unless some condition of the heart be discovered which would forbid its use. She certainly has motor insufficiency of the stomach, and you should direct your medication with that fact in view. We advise putting her on moderate doses of salines for a continuous period, and would also suggest the combination of iron with the strychnin. It is quite likely that her attacks of diarrhea are due to the irritation induced by retention of feces during the attacks of constipation-a true

diarrhea of constipation. We would deplete the uterus by means of boroglycerid suppositories, one every other night, and have her assume the knee-chest posture (opening the vagina while in that position so that it will be completely distended with air) and then sink gently into the accustomed position for sleep, every night. This will allow the uterus to fall into its natural position. She has been absorbing toxins from her vicious habit of indigestion for so long a period that she suffers from autotoxemia, and it will take a considerable time to get her in good condition again; but you ought to be able to do it. See that great care is exercised in her diet, and that she drinks plenty of water between meals. She should wear an abdominal supporter. A skilful physician can treat the most querulous patient for months for such a condition without giving it a name which they can discuss with any too inquisitiv friend. We advise your purchasing some good work on the stomach.-ED ]

Primary Syphilis (?).

Editor MEDICAL WORLD and family:-Case 1: W. P., aged 21, occupation farmer, family history and habits good. On May 10, 1903, had intercourse with woman, and just seven days later developt an ulcer having all the characteristics of a true specific ulcer. Foreskin long, causing erosion of covering of glans penis, explaining rapid development of the chancre, tho he made every effort to keep it healthy by liberal use of soap and water and mild ointments. Inguinal glands on side of chancre enlarged and indurated. The case was so plainly one of syphilis (as he had not had a chance before for several months, as he lives in the country), I put him on quarter grain protiodid of mercury tablets three times a day, 5 percent oleate of mercury, size of a butter bean, rubbed in groins once daily, causing glands to be. come normal. Dusted ulcer with bis. subnit. and it soon healed. I continued this treatment uninterrupted for twelve months without return of symptoms, except about the eighth month small mucous patches appeared, when I toucht them with lunar caustic followed with a wash of kali chlorate, phenol and powdered hydrastis, with iod. pot. 5, increasing to 15 grains three times a day, causing every symptom to disappear at once, continuing to date. Is my patient well? and how are we to know? Can THE MEDICAL WORLD staff or anybody else, by the use of a microscope confirm a diagnosis or find out if cured? Kindly give us your best treatment for primary syphilis. D. H. MCMASTERS, M.D. "Pryorsburg, Ky.

[Unquestionably you were wrong in your diagnosis. The true chancre does not appear in seven days after infection. It rarely is seen as early as nine days (questioned by some), and it is oftener nearly or quite three weeks. Your man had chancroid, aggravated by retention of secretions by elongated foreskin. The inguinal glands in the chancre enlarge (in nearly every case) on both sides. If the salient points have all been stated correctly, your patient is well, and would have been well sooner if he had escaped your medication. cation. There is no microscopical method of diagnosing syphilis-the causativ germ has not

been isolated. Purchase a good work on venereal diseases, and perfect yourself on the differential diagnosis between chancre, chancroid and herpes progenitalis. Many good men have gone wrong on these points. Never begin syphilitic medication hereafter until appearance of secondary symptoms. Many men have had their constitutions ruined by too early use of enormous doses of mercury and iodids. We have personal knowledge of cases of herpes having been treated for years for syphilis.-ED.]

Pharyngitis.

A "Florida Subscriber" wishes the best local treatment for pharyngitis and irritation of the post-nasal cavities.

[Such cases are best handled by daily treatment with medicin applied under air pressure. The difficulty is to get the patient to attend regularly. We have found it necessary to provide the patient with a good atomizer, and insist upon its use three or four times daily. We presume from the meager statement given that the trouble is chronic in nature. so, in addition to the cleansing and protectiv applications, it will be necessary to apply stimulating medicin locally. Assuming that your case is a chronic one, we would suggest that you have the patient obtain two atomizers (we have found those put out by McKesson & Robbins to be cheap and satisfactory). One atomizer is used for the cleansing fluid, and the other for the medication. In atomizer No 1, place Dobell's or Seiler's solution. In atomizer No. 2, use liquid petrolatum (Merrill's has workt best in our hands), with any indicated medicament. Spray the nose and throat thoroly with No. 1, and follow with No. 2, immediately. The lozenge put out by all tablet manufacturers containing chlorate of potassium, 21⁄2 grains; borax, 21⁄2 grains; cocain,

grain, will prove palliativ. Aristol, menthol, iodoform, etc., will be valuable in the second solution. Forbid tobacco and liquor. Stop any habit of hawking and scraping the throat in endeavoring to get imaginary mucus out. Have the patient guard against mouth breathing. See that the air of his sleeping room is kept at about 70° F., and is made suitably moist by turpentine vapor generated over a lamp by an ordinary tincup half filled with water, in which has been placed a half ounce of turpentine. See that the nasal chambers are free of disease. If astringent applications seem indicated, nitrate of silver, 5 to 10 percent, sulfate of zinc or tannic acid, 10 to 20 percent, may be used with benefit. It is well to tone up the system with iron, arsenic, quinin, or strychnin. In the acute form of pharyngitis, nothing has served us better than a saturated solution of sumac berries to which chlorate of

potassium has been added. The fluid extract of the berry may be used in lieu of the fresh infusion Saturate the fluid extract with potassium chlorate, and use a dram to a half ounce of water as a gargle every two hours. This is valuable in the chronic form also, but it is difficult to induce the patient to give his trouble proper attention.-ED.]

Editor MEDICAL WORLD:-Will you kindly give me the formula for "Dr. Miles' Anti-Pain Pills?" Pomona, Cal. HANNAH SCOTT TURNER, M.D.

[We do not know. Do any of the family? Probably they are an acetanilid mixture in pill form.-ED.]

Editor MEDICAL WORLD:-Please give status of the institution and treatment mentioned in inclosed advertisement. [Goat Lymph Adv. in Epworth Herald.] This is askt in the hope that the opinion of one high in authority as the editor of THE WORLD may deter an invalid from throwing hard-earned dollars into such concerns. EMMA MILLIKIN, M.D.

Ontario, O.

[There has been a strong effort made by interested physicians to induce the profession to take up this treatment, but it has not met with any very enthusiastic response. The results of treatment have not been as encouraging as the promoters would have the invalid believe. We would advise unfortunate sufferers from incurable disease to save their time and money. W. T. Keener & Co., of Chicago, have a new book just off press in serum therapy, entitled "Serums, Vaccines and Toxins in Diagnosis,' by Bosanquet-$2. This may be of interest in the above connection.-ED.]

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Go 'way Mistuh Skeeter! Don't you sing dat song to me!
I's buyhd about yoh doin's; you'se es tuf as you kin be.
You's been aroun' a-lunchin' on malaria an' things

Till you's jes' about as danj'us as a rattlesnake wif wings.
I didn't use to min' you when you come a-browsin' 'roun',
Ca'se I knowed a slap 'ud send you tumblin' senseless to de ground.
But since I huyhd dem white folks I's as skaht as I can be.
Go 'way, Mistuh Skeeter! Don't you sing dat song to me.
-Washington Star.

Obstetric Questions from One who has been a Subscriber for Eighteen Years. Editor MEDICAL WORLD:-I inclose P. O. order for three dollars for four years' subscription to your valuable journal, which I have read with pleasure and profit each year since receiving my first copy of THE WORLD in March, 1886, and I became a regular subscriber in October, 1886, as you may see by referring to your books. Your " Monthly Talks" alone are worth to me more than the cost of subscription, and I hope they are similarly valued by all who read them.

I would like very much if you would call for replies, by country physicians only, to the following questions: 1. Antiseptic precautions in examination (vaginal). 2. Is antiseptic cleansing of the genitals by the physician the rule?

3. Is the Kelly rubber pad used, or not?

4. When forceps are used, or when turning child, do you trust the ordinary nurse or attendant to administer the chloroform?

These points would help a great many young physicians and some older ones. New Milford, Conn.

H. B. GRISWOLD, M.D.

Almanacoid Medical Journals. Editor MEDICAL WORLD:-Nearly every third Canadian M.D., judging from your report of subscribers, is a subscriber to THE WORLD; and it is about time that, with your exposition of the Brief, Canadian and U. S. M.D.'s had their eyes opened. Journals that exist for the purpose of recommending patent or proprietary medicins should be termed Almanacoid; and should have such name in good, large type, and with red ink, placed across the title page.

Önly 15 medical colleges in Chicago, Ills.! If there were only five, or even less, would it not be better for the fair and honored name of medicin? However, it is hoped that Osler's prophecy that in less than ten years there will be one medical college where there now are ten, will come true. It is time joint stock medical colleges were closed; state universities alone should confer medical degrees.

JAMES S. SPRAGUE, M.D., C.M. Sterling, Ontario, Canada.

CURRENT MEDICAL THOUGHT

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Antiseptics.

Two" Good and Cheap Water impregnated with oil of cinnamon, a few drops of the oil to a quart of water, was highly lauded as a cheap and efficient liquid antiseptic by one of our readers a few years ago. Dr. G. H. Chandler brings it forward again in the Alkaloidal Clinic. As a post-partum douche, add 2 to 5 drops to two quarts of water. Increase the strength for other purposes a wet surgical dressing, for example. Another inexpensiv and efficient antiseptic dressing, particularly for leg ulcers, is pure oil of turpentine. While looking for the best, don't overlook the simplest, most convenient and cheapest.

Stomach Prescriptions.

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War, Politics, and Medicin.

How many and how intimate are the relations of medical science to the world! When one thinks of the war in the East there are probably called up only images of wounded soldiers, hospitals, attendant nurses, etc. But other aspects are in reality more vital and far reaching. At least so think the Russian physicians. At the recent ninth Congress of Physicians and Surgeons, four of the principal sections adopted the following resolutions:

A systematic and rational struggle with infant mortality, alcoholism, tuberculosis, syphilis, and other widespread diseases, which form in Russia a public evil of enormous extent, is possible only under conditions enabling a broad dissemination of enlightenment concerning the true causes of their development and the methods of combating them, the necessary conditions being complete freedom of the individual, of speech, of the press, and of assembly.

Three other sections adopted this one:

Believing that the extraordinarily high infant mortality of Russia is due mainly to the poverty and ignorance of her population, the congress expresses the profound conviction that a successful struggle with this evil is possible only by way of broad social

reforms.

Another section of the congress resolved that "corporal punishment should not exist in Russia, and the assistance of a physician, in the capacity of witness or expert, in the administration of such punishment, is inadmissible." These resolutions were naturally distasteful to the reigning bureaucracy, and at the instance of the St. Petersburg municipal authorities the presiding officer of the congress refused to read them publicly at the last general session. The American profession will undoubtedly extend to their Russian colleagues every evidence of sympathy and encouragement in their humane struggle.-Amer Med.

"War," "Graft," and Medicin.

The following incident of Russian administration, if true, as seems probable, shows the valuation put upon the soldier's life by the Russian official class:

A number of royal personages, relativs of the Czarina, had combined to equip a hospital train at St. Petersburg with every requisit for the comfort of the sick and wounded, the box compartments being carefully secured with Imperial seals. After the train left St Petersburg the Czarina telegrapht, commanding a careful inspection of the contents of the train. Under this authority the seals, which were apparently undisturbed, were broken, and the contents were found to be useless blocks of wood. Nothing of any value was found.

In contrast with this is the purity of Japanese administrators, the reception of American nurses, and

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