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of the infant. It is never wise, when it is pos- all tissues, and the deaths are rare indeed. sible to employ any of the mother's milk (poor While the fever generally has a slight quality or quantity excepted) to dispense with morning remission and evening rise, it is selit entirely and suddenly; even if but one or two dom observed over 103° F. There is a slightly nursings daily can be furnisht, it may be very coated tongue, possibly slight gastro-intestinal valuable. Before the age of ten months, if derangement, malaise, etc.; but there is noththe milk become deficient in either quantity ing essential but the fever. Quinin eliminates or quality, the physician should make a dili- malarial origin, and the large percentage of gent study of the mother as regards her recoveries removes the question of tuberculosis. physical condition and personal habits, in Not many cases give a history of any affection order that he may be positiv that the deficiency preceding from which infection might have is irremediable before ordering the babe arisen—as in pneumonia or pleurisy which weaned. Chemical analysis is the only scien- sometimes leaves a local focus of infection which tific and accurate method of determining the manifests itself by mild constitutional sympfood value of mother's milk, yet the expense toms of septicemia. The disease has been of the procedure renders it imperativ in many studied by DaCosta, John Guiteras, Cain, instances that we employ less scientific meas- Baumgarten, Goodhart, and Hale White, who ures. First, then, if a babe is growing at a respectivly labelled it “protracted simple normal rate, we assume that it is getting continued fever," "thermic fever," "atypical sufficient nourishment. If it is not growing continued fever of Nashville," “simple connormally, or if diarrhea or vomiting is per- tinued fever," "innominate fever," and “ insistent after other assignable causes have been explicable fever.” The name, simple coneliminated, we assume that the milk is either tinued fever is probably the best, and now has insufficient in quantity or deficient in quality. a recognized place in our text-books on medIf a child is unwilling to cease nursing after a icin. proper length of time at the breast, or if it The diagnosis is an important point, since it relinquish the nipple with a wail of dissatisfac- is necessary to save the patients from being tion, the milk is likely insufficient.

subjected to the hardships of typhoid fever The health of the mother is always to be treatment, when the exigencies of the case do considered as much as that of the babe. Nurs- not require it. Fortunately the Widal test ing longer than ten or twelve months puts a admits of elimination of typhoid fever from drain on the system to which few women consideration; remittent and intermittent should be subjected. The popular belief that fever may be set aside by proper therapeutic a woman will not became pregnant while nurs- tests; miliary tuberculosis can usually be deing has no foundation in fact, and should be tected when carefully searcht for; and the explained to every mother who persists in fever sometimes attending chlorosis, hysteria, nursing her infant for an unduly long time. or nervous disorders ought not to baffle long, Some women in whom the molimen appears any practician of ordinary ability. while nursing, notice that the baby sickens The treatment is entirely symptomatic, and each month when the flow appears. Such merely includes tonic and supportiv measures. women should feed the baby artificially during If practicians would study their cases closer, the continuance of each flow, and usually the there would be fewer cases of “walking milk again becomes fit for use in a few hours typhoid,” “para-typhoid," etc., reported. after cessation of the flow. Should pregnancy occur, the mother should wean the infant at

Reflex Cough. once, regardless of age, since no woman has

Reflex cough is one of the symptoms most the strength to nourish two bodies in this

frequently misinterpreted by the careless and manner, and either the fetus or the infant

superficial diagnostician. Even after cursory would suffer in nutrition.

examination has failed to reveal anything Advice upon this matter is strictly in the

wrong with the bronchial tubes or respiratory province of the family physician; and he should

apparatus, after divers expectorants, sedativ realize this and act accordingly.

and stimulating, have failed to relieve, still the

misguided medication is persisted in until diSimple Continued Fever.

gestion becomes deranged, and the after conThere is a fever, common in the Southern dition of the patient is worse than the first. States and occasionally observed in the nor- Surely there is no excuse for this variety of thern sections, which is neither typhoid nor malpractise—at least there is no excuse for para-typhoid. It continues for two weeks to failure to suspect the true origin and for three months, and no lesion has yet been dis- neglect in attempting to search it out. In covered. Cases coming to autopsy reveal the summer season, especially, when a patient nothing beyond a state of lowered vitality of presents a history of an intractable cough,

cases.

which may be simply an annoyance, or which lieves that mild cases without diaceturia are may be violent and distressing, and which is aggravated by the oat cure, and his total failure not accompanied by any evidence whatever of belonged to this class. coryza, asthmatic attack, or bronchitis, it is His diet table when instituting treatment high time for the practician to examin other follows: 250 gm. oats; 100 gm. albumin; and parts of the body beside the thorax.

30 gm. butter, daily. A little black coffee or The “stomach cough” is known and recog- a little brandy or wine is allowed. nized in many instances by experienced mothers It has been known previous to the publicaor “old grannies," and the practician who tion of this paper that the rigid “ diabetic" gives a cough mixture is pretty certain to ag- diet, as outlined in the text-books of a very few gravate the case, if indeed he be fortunate enuf years back, was not calculated to maintain the to escape ridicule at the hands of wiser, if un- strength of the patient, and certainly was not learned, therapeutists. This variety of reflex productiv of practical results as regards cure or cough is toucht upon but gingerly, when at all, even improvement in any but exceptional by the text-books; yet every practician of ex

It was also recognized that a plain diet perience has noted it. It cornes from an over- rich in carbohydrates was generally better loaded or improperly functionating stomach, borne by the average patient than the mixt and promptly disappears after a cathartic and diet containing but small proportion of carboingestion of digestants, with a little judgment hydrates. He is very fair in recalling the regarding diet. Impacted cerumen in the ear injurious effects following the craze for the abis a not infrequent origin of reflex cough, and solute milk diet as promulgated by Winternitz; one which will likely baffle the man who makes the “rice cure” of von Duhring; and the “snap diagnoses." The nose is the organ “potato cure" of Mosse ; and he distinctly most frequently at fault, and it is always de- states his wish that such radically minded enserving of an examination when the suspicion thusiasts will not expect too much of the “oat of reflex cough has been aroused. Cough, cure. He reiterates an old axiom in medicin without coryza, may be induced by simple, to the fact that all patients cannot be treated chronic or by hyperplastic rhinitis; spurs, de- alike. Every one reading the paper (The Alections, or abnormalities of the septum ; con- Post-Graduate for April, 1904) will be congestion of the cavernous tissue covering the vinced of his sincerity and of the value of the vomer ; adenoid growths in the pharynx; en- method. largement of any of the turbinated bones; or It is simple, logical, and easily followed, by any vasomotor disturbance in the nostrils. and we advise its trial in suitable cases of diaIf, upon inspection of the nose in cases of sus- betes. Just as to which cases are suitable for pected reflex cough, any alteration, malforma- the oat diet, von Noorden is not yet prepared tion, or unnatural irritability of the intra-nasal to state. He brings out the contra-indication spaces be discovered, they should be promptly mentioned above quite forcibly, and pleads for remedied by suitable application or surgical careful study of the effect on each individual procedure. Even when nothing can be dis

If the profession will use this diet in the covered, the nose is often at fault; in which careful and conservativ spirit which charactercase the application of a cocain solution at izes the originator's efforts, it will not be long suitable intervals will confirm the suspicion and before we will be able to classify the cases as establish a diagnosis in the majority of cases. to whether or not the diet is suited to them. Failure of the cocain should not encourage one Certain it is that a distinct advance has been to abandon the search in the nose when other made (altho it can hardly be dignified as a parts have been examined.

discovery) and much good will result. In any event, never let yourself be led into Readers having diabetic patients upon whom the error of a continued erroneous diagnosis they wish to test the effect of the diet should regarding a reflex cough.

keep a complete record of the weight and general condition of the patient, the excretion of

ammonia and acetone, as well as the exact The Oat Cure: A New Dietary for Use in amount of glycosuria, in order that they may Diabetes Mellitus.

report their results in a manner that will be Von Noorden, the German clinician who logical and convincing to those who have not has done so much to revolutionize the dietary been fortunate enuf to have had the manageof chronic nephritis, is out with an essay advo- ment of a case. The entire “ family” workcating the “ oat cure for diabetes mellitus. ing upon this problem can soon turn in thouHe reports 100 cases treated by a strict diet of sands of reports, and this mass of testimony oats, with a little albumin and some butter. will be convincing as regards the merits or He does not claim to have cured all of them, demerits of the dietary. Von Noorden used but he only reports one total failure. He be- the oats prepared by Knorr or the oat groats

case.

ot Hoenlohe, but we do not doubt that the oat three times a day, and must be continued thru meal of domestic manufacture is as fine and an extended period. Nux vomica and iron fit wholesome as any brand from across the sea. in nicely with the arsenic. Pilocarpin has

numerous advocates, and some advise its use Alopecia Areata.

hypodermically in doses of st to to of a grain The feeling which pervades the professional in proximity to the affected part. Morrow, mind regarding the futility of treatment in holding firmly to the opinion that the disease cases of alopecia areata is, in many cases, as in is parasitical in origin, believes that local a too numerous group of other uncured mala- measures are aided and energized by the indies, well founded. But this intractability is ternal administration of phosphid of zinc and perpetuated by a deficiency in diagnostic strychnin; phosphorus, iron and strychnin; ability, and a consequent carelessness or error

or phosphoric acid and strychnin. in therapeusis which is not excused by the Local measures should produce two results : obstinate character of the disease. There An increast flow of blood to the part thru ought to be more care exercised in making a stimulation, and a positivly destructiv action diagnosis. Perhaps ringworm is most fre- against any parasite which may be present in quently confused with alopecia areata, but the the tissues affected. In this affection the skin two should be easily differentiated. Ringworm will tolerate drastic measures so long as the is always scaly, and even if in some cases this unaffected part is not subjected to the medicais slight, it is always found on close inspection; tion. It is good practise to remove the loose alopecia areata never presents this feature. hairs by grasping between the thumb and The broken off or nibbled appearance of the finger and pulling gently; the loose ones hair in ringworm is not at all like the total come out readily and those with firm attachbaldness of alopecia. In ringworm the bald- ment are not removed. In making application ness is incomplete, and scattered hairs remain; of the medicaments, the area included should in alopecia areata there is no evidence of not exceed a width of over one-half inch outside inflammatory action, and no dilated follicles. the actual area of baldness. With patients not Moreover, ringworm is contagious and more seen oftener than once a week, it is not adthan one case is apt to occur in a family; visable to use the stronger remedies, but to alopecia areata is limited to the individual, and employ some of the following: full strength of is a rarer complaint, only being contagious in ointments of tar or sulfur; 5 to 15 percent cases of parasitic origin.

beta-napthol ointment; oil of tar, pure or with Dermatologists differ in their belief as to the alcohol, equal parts; equal parts of oils of cade, etiology of alopecia areata, some holding that oliv, and turpentine, or the following prescripit is always parasitic in origin, and others that tion: sulfur, 2 drams; beta-napthol, i dram; it is a neurotic affection. Perhaps the most lanolin, 2 drams; and vaselin, q. s. to make likely hypothesis is that two distinct etiological an ounce. Once a week, an area not to exfactors operate: in some cases a neurotic ceed two square inches, may be treated with factor, and in others a parasitic one. Such strong applications of carbolic acid, chrysaauthorities as hold to the neurotic theory ex- robin, or tincture of iodin containing four clusivly, direct their chief effort to constitu- grains of bin-iodid of mercury to the ounce. tional remedies; those adhering to the parasitic If the involved area be small, or if there be idea use exclusivly local measures. Since there several small patches, the stronger remedies is as yet no method of settling this dispute, the may be employed regularly. One of the best pathological germ never having been positivly of these, as commended by Robinson, is an isolated, it is the part of wisdom for the general ointment made by incorporating 10 to 60 practician to administer both constitutional grains of chrysarobin to the ounce of lard or remedies and to make local applications of vaselin ; or painting the affected areas with antiseptics and parasiticides. It is also a fact pure carbolic acid, as advised by Bulkley. In that nearly all applications used are both children, or in those with very sensitiv skin, stimulants and parasiticides, and hence meet the carbolic acid may be weakened by one to the requirements of either theory. The con- three parts of alcohol. Such applications are stitutional remedy employed must be directed followed by inflammation and later by exfoliatoward the toning of the nervous system, and tion. Stelwagon advises applying a saturated the best of the class are the following :- solution of chrysarobin in alcohol; and after Arsenic, quinin, nux vomica, phosphorus, pilo- this dries, painting over with two or three carpin, the various iron preparations and cod coatings of collodion. Another strong applicaliver oil. Duhring is one of the most enthu- tion, but one which must be watcht, is made of siastic exponents of the arsenic treatment. It equal parts of oil of turpentine, tincture of capis given in doses of 3 to 5 drops of Fowler's sicum, and tincture of cantharides. This often solution, or the solution of sodium arsenate, requires weakening with oliv oil. Those who

have available the faradic or static current Dr. Ç. F. TAYLOR :- This is a small town with four should try it in all cases, as very flattering re

medical men in it. The other day while in our local

newsdealer's place, I noticed a new copy of the Medports have been repeatedly made upon the use ical Brief on the counter. The newsdealer askt me if of these forms of electricity.

it was a good “seller." He also told me that it had

been sent to him, and he had been askt to keep it for An accurate prognosis requires both ripe ex

sale. I have received a great many sample copies of perience and good judgment. Occurring from the Brief, but always thought it about the poorest thing the age of five to that of fifty, it may be said

in medical journalism I had ever seen. May The

WORLD "live long and prosper." safely that the younger the patient and the Shelburne Falls, Mass.

J. S. OUTHOUSE. smaller the patch, the more favorable the case is for encouraging the hope of a pigmented re

Editor of The MEDICAL WORLD; DEAR EDITOR :growth. In some cases the areas are again I presume there are many physicians that feel as I do covered with hair which lacks the pigment of concerning quackery, patent medicins, and medical

ethics, but prefer to remain silent rather than to exthe surrounding hair and the resultant contrast

press their views on account of either modesty or fear is nearly as distressing as the baldness. No of criticism. But when I learned recently that our case is hopeless; Crocker reports a case where

postmaster and news agent was trying to sell copies of

the Medical Brief, and when I learned thru the columns the entire scalp was denuded, yet the hair of THE MEDICAL WORLD that the Brief was being returned, remaining white for a time, but sold in like manner all over the country, a sensation eventually resuming its normal color. The of disgust came over me, and I wish to express my

sentiments to the profession thru your columns. I first mark of improvement is when the hair at think the Brief is acting contrary to the wishes of the the periphery of the patch is no longer noted best elements of the medical profession.. I fail to see as loose when given a slight pull; next, fine

how any conscientious M.D. can afford to give a medical

journal taking such a course one iota of support. The hairs appear and gradually cover the patch; recent act of placing it on sale to the general public and finally the hair approaches the natural tex- has, in my estimation, stampt it as rotten to the core ;

and there must be something the matter with any ture and regains its normal pigment. A favor

physician who will remain a paying_subscriber after able prognosis is generally safe when the patient being thus insulted.

F. L, REDMAN. is under fifty years of age.

Corinna, Me.

The Doctor writes privately that he wrote The Interests of the Profession.

the above just as he felt, “ mad and dis

gusted.” But he then laid it aside for a week, American medical journalism is of vital interest to every American doctor.

hesitating to send it. Then he referred it to Any

one of the brightest physicians in this secAmerican doctor who does not feel that this is true fails to understand and appreciate his

tion," who said: “Send it along. It is all interests and his rights. In determining, a

right. Those are my sentiments. There are

thousands of physicians that approve of the question like this, every one should consider

course of THE MEDICAL WORLD, but do not the welfare of the profession as a whole. To judge only from one's own surroundings, and

like to express their views." the conditions existing in his own necessarily

He also incloses a printed circular letter,

mailed (according to postmark) in St. Louis, limited horizon, is narrow and selfish. Every true doctor will stand for the interests, dignity

July 21, 1904, to the news agent, Mr. W. I.

Burrill, Corinna, Me., which reads as follows: and welfare of the profession as a whole. Medical journalism is the organ of the pro

Dear Sir :-We send you by mail today two sample

copies of the Medical Brief to be placed on your stand fession as a whole; therefore its ideals should for sale. The Medical Brief is the largest circulated be the highest, and it should be devoted medical journal in the world, its great popularity being solely to the interests of the profession.

due to the great number and variety of articles from

physicians everywhere. These thoughts are suggested by numerous The Medical Brief is read not only by the medical letters that come to this office, a few samples

profession, but by all professional classes interested in

medicin and surgery. of which we will here present.

We believe that we can interest you by offering you Editor MEDICAL World:-I admire your stand

an inducement to keep the Medical Brief on sale. against the Brief and other professional parasites. It

Retail price, single copies. comes to me regularly, yet unsolicited and against my

Trade price

5 cents. wishes. Wishing you continued success in your laud

Mailable at pound rates. able labors. I am, yours very fraternally,

Front covers of unsold copies returnable, to St. Millville, Mo.

J. MORSE GRIFFIN.

Louis office.

The above undoubtedly came directly from Editor MEDICAL WORLD:-Inclosed find $2.00 for the publication office of the Brief, for the cirone year back and one to come. I don't think any

cular has “ The Medical Brief, J. J. Lawrence, other than the easiest kind of an individual would fail to see thru the graft the Medical (?) Brief has been A.M, M.D., editor and proprietor," etc., handing out for the last ten years. I fail to see how printed at the top, and it was sent in a printed any honest, half-awake man can countenance the besmircht thing. I was looking for some one to get after

Medical Brief envelope, and the name and adit and supposed it would be THE WORLD. You are dress of the newsdealer is printed on a slip, all right, doing a good work, and an honest medical

which was pasted on the envelope, showing that fraternity will be with you.

T. D. WHITE. Orrstown, Penna.

a printed list was used in sending out the

. IO cents.

above circular letter, and also indicating that Whitlock.” The first paragraph of this letter is as the same communication was sent to the entire

follows: list of news dealers, all over the country.

In the course of my whole career as a speculator and observer

of wheat conditions, I have never seen such a chance as now exists Corinna, Me., is a small town, with only two to make big money. I don't mean to double or triple your money, doctors. Please notice that in this communica

but to make at least £5,000 on every $500 and possibly double or

triple tha:. tion it is distinctly stated that the Brief is not

Following this there are what purport to be reports confined to the medical profession, and circula- on the wheat conditions all over the world. These are tion to the laity is earnestly solicited! And how used to show that wheat is a good thing to speculate about the Lawrence list of proprietaries: seng,

upon.-Kansas City Times, Aug. 20. chionia, neurilla, celerina, sanmetto, respiton,

A doctor who sent $25 soon received $35 in etc., etc.? Are they to be used “not only by

return after a short time. Thus encouraged, the medical profession ?" Are they to be he sent more money, which did not return. pusht to the laity, like antikamnia? Wherever

And thus it goes. Better earn your money; the Brief goes, the almanac advertisements of and then you would better keep it, and get the the Lawrence list go, for that is the purpose good of it yourself, instead of turning it over of publishing the Brief. What do doctors to some schemer to enjoy. think about it? Many, like the above, have exprest themselves freely.

Eight Great Secrets of Success.

A man with a mania for answering advertisements Dr. C. F. TAYLOR; Dear Doctor :-The World has had some interesting experiences. He learned that has so many short, practical articles from the rank and

by sending $1. to a Yankee he could get a cure for file of the profession (just the kind the busy doctor

drunkenness. And he did. It was to "take the pledge needs); and you and Dr. A. L. Russell give us such

and keep it." valuable assistance when we write you about our puz

Then he sent fifty cents to find out how to raise turzling cases; and above all, your pages are so free from nips successfully. He found out: "Just take hold of boosting proprietary remedies, that your journal easily

the tops and lift." stands on a high plane as a pure, clean, and valuable Being young, he wisht to marry, and sent thirty-four magazine. The stand that you have taken against

one.cent stamps to a Chicago firm for information as to almanacism,”' in so-called medical journals (like the

how to make an impression. When the answer came Brief), is certainly commendable. Keep on Dr. Tay.

it read, “Sit down on a pan of dough.” lor, the medical profession will certainly appreciate

Next advertisement he answered read “How to the good you are doing for the profession.

double your money in six months.” He was told to I wish some of the WORLD family would tell me

convert his money into bills, fold them, and thus double where Dr. Lawrence got the rabbit's foot that he works

his money. on doctors to make them pay him to advertise his

Next he sent for twelve useful household articles and remedies. Well, it does look like “ some of the people

got a package of needles. can be fooled all the time."

He was slow to learn, so he sent $1. to find out“how As I always expect to read The World, I inclose to get rich." “Work hard and never spend a cent.” check for $3.00 for four years.

That stopt him.
Newstead, Ky.
B. A. CANDLE, M. D..

But his brother wrote to find out how to write without pen and ink. He was told to use a lead

pencil. The Records Show that Doctors are

He paid $1. to learn how to live without work, and Speculators.

was told on a postal card : “Fish for easy marks, as

we do." The Kansas City papers publish several

German Orthography. columns concerning the Rialto Grain and Securities Co. fraud. Examination of the

The German language, as written at present, is in

about the state of confusion in the matter of spelling records show that there was only one resident that has long characterized our own tongue. We are of Kansas City who was an “investor," and glad to learn, therefore, that an attempt to secure uni. he was a doctor! The papers give his name

formity, so far as medical language is concerned, will

be made at the next general meeting of the editors of and address, but we will not do so. Further

German medical journals--New York Medical Jouron in the report (Kansas City Star, Aug. 20)

nal, September 10, 1904. occurs the significant sentence: “Many doctors

So you see,

“there are others.” But those seem to have been bitten.” Then follow the “others” (and this applies to the French, too) names of some of them. A Kentucky brother recognize the fault, and are trying to correct wrote us not long ago, “What doctor would be it. How about ourselves? fool enuf to send money to schemers for speculation ?". Let the above be a reply. Where hot packs fail to bring relief in acute in. Yes, there are lots of them ; but we are trying

flammation of the kidneys, pilocarpin will often aid

admirably. to open the eyes of doctors, so they will not do

A crystal of chloral in a cavity of an aching tooth and such foolish things. When you get such things held in by a pledget of cotton moistened with clove oil as the following, don't bite:

relieves like magic. In advertising for business the company made liberal

In angina pectoris, after giving nitrite of amyl by use of circular letters. One of these letters told its

inhalation, it is good practise to apply a mustard readers that the royal road to wealth was speculation.

plaster to the precordial region. Another circular contained what purported to be a Arsenic is beneficial in that form of diarrhea charac. copy of a personal letter written to a man in New terized by an uncontrollable desire to evacuate the Orleans and supposed to have been written by “Mr. bowels immediately after taking any food.

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