INTERESTING HISTORY. During the past fifteen or twenty years various forms of pain, as neuralgia, headache, dysmenorrhea, sciatica, etc., and high temperature from various causes, have been controlled in an almost magical manner by a new class of remedies: The synthetic chemicals, or coal-tar derivatives, chiefly of German manufacture. Antipyrin, and acetanilid are prominent members of this class of preparations But, as is well known, the magical relief from this class of remedies carries with it a grave danger: That of heart depression, with cyanosis and profuse sweating. Cases of sudden death from this cause have been many, but the greatest harm, which has become very wide-spread, is the insidious injury wrought by occasional doses of these remedies. It was thought that European countries contained all the talent and scientific attainments for the production of remedial chemicals. But at last Yankee inventive genius has come to our aid, and the result is, a group of chemicals far more efficacious than the aniline products (sometimes called dye-house chemicals), and what is, still better, they are absolutely safe, being free from the depressing qualities of the foreign drugs. The first preparation perfected, was one intended to cover the wide field involved by the two leading symptoms met in the practise of medicine, namely, Pain and Fever. The mode of manufacturing it is very complicated, involving many chemical actions and reactions that cannot be entered into here, but those interested in this phase of the subject may obtain full details by writing us. In brief outline: We begin with carbolic acid, then add nitric acid, producing nitro-phenol; then ethylate it through the influence of bromide of ethyl; then it is reduced to the anide group, and afterwards condensed with the two acid radicals, acetic and salicylic acids, the product being a white, crystalline powder. It is the therapeutic value of any medicine that the practical physician is interested in. Here is the strong point of this preparation, the object sought in its preparation being therapeutic efficiency combined with safety. This preparation is practically tasteless, and does not disturb the most delicate stomach. Its action is that of a sedative to the nerve centers, particularly the thermocenter, thus controlling heat at the point of physiological control. It assists elimination by way of the kidneys and the sweat glands, by means of gentle relaxation of those parts. At the same time it is antiseptic, inhibiting bacterial growth wherever it goes in the system. The combined result of all these actions is the elimination of fever and pain. Thus sleep is invited, delightful rest is obtained, and Nature returns to her task of repair and rejuvenation. This remarkable preparation is called Thermol, and its therapeutic application is almost endless. As a temporary remedy, it gives speedy and safe relief, without depression, in headaches, neuralgias, sciatica, painful menstruation, and all painful conditions. As a leading feature in the treatment of serious and protracted cases. it is invaluable in typhoid fever, pneumonia, peritonitis, rheumatism, remittent fever, etc., etc., also in all meningeal inflammations. It has been on the market now for about four years, and has been thoroughly tried, tested and approved by the medical profession in all parts of the country. The above mentioned claims have been more than fulfilled. Wherever known, the demand for Thermol becomes steady and increases rapidly. Sales are rapidly increasing, both through the trade and direct with physicians, as many physicians seem to prefer to order direct from us, again and again, as our books amply show. While salicylic acid is one of the very best antiseptics, it disagrees with the stomach and deranges digestion. This true not only of salicylic acid, but also of the salicylates, is as salicylate of soda. We also know that formaldehyde is the king of antiseptics, and as a uric acid solvent it stands only second to salicylic acid; but the trouble is to place it where we want it. To do this it must be combined in such a way that the combination will split up at the right time and place, and set formaldehyde free slowly and safely where needed. Dr. S. Lewis Summers condenses salicylic acid with formaldehyde, and then acetylizes this union, thus forming the well defined organic chemical compound Acetyl Methylene Disalicylic Acid which has the structural form ula CH2(CC3COOH) But it is not practical to use It is nonirritating to the mucous membranes. As it is not absorbed till it reaches the bowels, it is a valuable antiseptic for the alimentary tract. But in the blood is where it does its chief work, for there it breaks up, and its constituents, as explained above, exert their great powers. It is the eliminator of eliminators. It increases the peristaltic action of the bowels, the diaphoretic action of the skin, the diuretic action of the kidneys, the solvent action on the uric acid salts as well as restoring the normal fluidity of the blood, and stimulates the respiratory tract through the incorporated properties of acetic acid. Do not the therapeutic applications suggest themselves readily and abundantly? Wherever there are bacteria to overcome-typhoid fever, scarlet fever-in fact, all fevers, pneumonia, pyemia, septicemia, etc., etc. But its particular application is in the uric acid diathesis, as manifested by the many forms of rheumatism, lithemia, gout, sciatica, etc. But its application does not stop with its many uses as a hematic antiseptic and uric acid solvent. It is excreted in the urine, and hence as an antiseptic to the urinary tract it is of very great value. The urine remains normally acid. Decomposing and ammoniacal urine is speedily corrected, and all inflammations of the tract are beneficially influenced. Try it in gonorrhea. The most frequent use of ur-a-sol is as an anti-rheumatic and as an eliminator of the uric acid salts. When sufficiently large doses are given to meet the requirements, the removal of the pain and the reduction of the temperature to normal are quite promptly obtained. Whilst it increases the quantity of the urinary fluid with an augmentation of the solids of the same, it is steadily removing the excessive presence from the blood of the salts of uric acid through elimination by combination. Thus the system is rid of the toxins of the disease and other effete substances from the blood. Ur-a-sol has now been in successful use for several years, and its use is extending because of its inherent merits. It is truly a remarkable chemical. One notable result of its use (say 10 grains with or after each meal) is increase of the appetite. The explanation is supposed to be this: The elimination of uric acid creates a demand for more nutriment; hence, hunger, and a stimulation of digestion, and assimilation. Usually increased buoyancy and cheerfulness come with the increased appetite. It is now attracting the attention of medical college professors and other leaders of the professionthey are seeking it for investigation, because they have heard of its remarkable usefulness. Send $1.00 Money Order, and we will send you a highgrade, one minute, self registering clinical thermometer, worth more than $1.00 and one ounce of either Ur-a-sol or Thermol, either in powder or 5 grain tablets. Literature free. Address ORGANIC CHEMICAL MFG. COMPANY Successors to LIBERTY CHEMICAL COMPANY 2559 N. Sydenham St., Philadelphia on them, on the same page. These things can be ordered by mail as well as personally. "The Terrors of the Green Room Done Away With," a quiz book designed for students during their examinations, and also during their first years of practise. See adv. on page 2. Do you use the preparations of Messrs. Reed & Carnrick? Have you the entire success in treating dyspepsia that you wish to have? If not, why not try Reed & Carnrick's Peptenzyme? See adv. on page 28, and send for literature. Weaver's Pharmacy make a very clever point in their advertisement this month, when they present a list of the houses that handle Salmacrin, and then ask: "Think you that these firms have stockt this threemonths-old preparation merely because we claim it to be a remedy?" It is a pertinent question, for the list of distributors include some of the greatest names in the drug trade of this country. See adv. on page 15, and give Salmacrin a trial. Write now for samples. "In none of these cases of pneumonia was any remedy except thermol used, and in every case was improvement immediate and recovery rapid. It should be especially noted that there was no tendency to cardiac depression-which is often too true with many of the remedies used in the treatment of this disease-but that, on the contrary, the circulation always became better after the exhibition of the drug. Antipyresis was successfully accomplisht and there was no need for calling into use the digitalis group of drugs. It is a fact that thermol is a safe agent to use in the treatment of pneumonia; it is also a fact that it has decided effects for the better on untoward features of the disease. These are two qualities which stamp the worth of any drug first, that it does good; secondly, that it does no harm. Thermol is, therefore, to be strongly recommended in the treatment of croupous pneumonia."-Abstract from the Interstate Medical Magazine of a report from records from City Hospital. Have you yet tried Glycozone in dyspepsia and allied diseases? See adv. on page 16, and send for particulars. icine and Surgery." We cannot do better than quote The Anasarcin Chemical Company sends us the following warning: "It is reasonable to suppose that if Anasarcin is potent enuf to relieve extreme cases of ascites and general dropsy promptly and without fail, it will have the best chance of restoring the diseased organs to their complete performance of normal functions when administered in moderate doses for a considerable length of time. Such is invariably the case in actual practise; therefore we give warning against too early discontinuance of Anasarcin in any case. Better continue treatment after necessity for it has ceased than to cut it short so early that the work has to be done over again later." See adv. on page 10. Alterative and Tonic-Elixir Six Iodides. An old and well-tried remedy. An ethical preparation, too; in fact, the formula is given in the advertisement: see same on page 11. "As a brain and nerve tonic it has stood the test of 17 years, and is still unequaled for the treatment of paralysis, locomotor-ataxia, epilepsy, neurasthenia, senil and general debility, mental failure, debilitating losses, spinal weakness, nervous dyspepsia, all troubles affecting the brain, nerve centers and spinal cord, and as a safe and powerful aphrodisiac." Concerning Freligh's Tonic. Quoted from the advertisement of I. O. Woodruff & Co. on page 30. See adv. and send for samples. What do you do for nausea, vomiting, dyspepsia and indigestion? Are you acquainted with Ingluvin? Do you use it? See page 33, and write to Wm. R. Warner & Co. for further information. Mr. Tyree, the Washington chemist, could mix his antiseptic powder with water and sell it to physicians at a price far above what he charges for the powder alone, but he does not. He knows that every physi(Continued on next page.) FOR SALE $2,500 property with practise of $3,000. Address Lock Box 5, Tabor, S. Dak. DOCTOR before buying a medical practise write for my list, as When a scientist demonstrates some new fact, it is of We wish to call the attention of all physicians to a new book: Saunders' American Year-Book of Med See MERCK'S MANUAL, Page 35. I may have the very practise you want. I have propositions of all kinds. Should you wish to sell your practise, I can place it before the numerous physicians in the United States and Canada who are desirous of securing locations. Write, giving full information, to W. O. Dyer, M.D., Westfield, Wis. ANTED-By a German physician, good location in Wispreferred. Address P.O. Box 42, Pulcifer, Wis. $4000 niture and fixtures. Snap for right man. Office practise free to purchaser of office fur Only electrical and X-Ray outfit in this part of State. Address (Continued on next page) Cough, Morphinism, Corneal Opacities MERCK & CO., New York 1 THE MEDICAL WORLD The knowledge that a man can use is the only real knowledge; the only knowledge that has life and growth in it and converts itself into practical power. The rest hangs like dust about the brain, or dries like raindrops off the stones.-FRoude. The Medical World C. F. TAYLOR, M.D., Editor and Publisher A. L. RUSSELL, M.D., Assistant Editor SUBSCRIPTION RATES: To any part of the United States, Canada, and Mexico, ONE DOLLAR per year, or FOUR YEARS for THREE DOLLARS; to England and the British Colonies, FIVE SHILLINGS SIX PENCE per year; to other foreign countries in the Postal Union, the equivalent of 5s. 6d. Postage free. Single copies, TEN CENTS. These rates are due in advance. HOW TO REMIT: For their own protection we advise that our patrons remit in a safe way, such as by postal money order, express order, check, draft, or registered mail. Currency sent by ordinary mail usually reaches its destination safely, but money so sent must be at the risk of the sender. We cannot always supply back numbers. Should a number fail to reach a subscriber, we will supply another, if notified before the end of the month. Notify us promptly of any change of address, mentioning both old and new addresses. If you want your subscription stopt at expiration of the time paid for, kindly notify us, as in the absence of such notice we will securing the general adoption of the suggested amendments IRVING SHEPARD, Secretary." We feel it a duty to recognize the above tendency, and to adopt it in a reasonable degree. We are also disposed to add enuf (enough) to the above list, and to conservativly adopt the following rule recommended by the American Philological Association: Drop final "e" in such words as "definite," "infinite," "favorite," etc., when the preceding vowel is short. Thus, spell" opposit," "preterit," "hypocrit," " requisit," etc. When the preceding vowel is long, as in "polite," "finite,” "unite," etc., retain present forms unchanged, We simply wish to do our duty in aiding to simplify and rationalize our universal instrument language. Congestion of the Lungs. Some confusion has arisen in the family thru the use of this term, and while it does not require extended space, we will notice it briefly and editorially. Congestion of the lungs, per se, is a rather common condition, with many gradations and variations. Violent exercise will produce a temporary congestion of the lungs, as will also high altitudes, inhalation of irritants, etc. It is associated with every severe inflammatory condition of the lungs or understand that it is the subscriber's pleasure that the subscrip- pleura, and in many instances it is the most tion be continued, and we will act accordingly. Pay no money to agents unless publisher's receipt is given. Language is a growth rather than a creation. The growth of our vocabulary is seen in the vast increase in the size of our dictionaries during the past century. This growth is not only in amount, but among other elements of growth the written forms of words are becoming simpler and more uniform. For example, compare Eng. lish spelling of a centnry or two centuries ago with that of to-day! It is our duty to encourage and advance the movement toward simple, uniform and rational spelling. See the recommendations of the Philological Society of London, and of the American Philological Association, and list of amended spellings, publisht in the Century Dictionary (following the letter z) and also in the Standard Dictionary, Webster's Dictionary, and other authoritativ works on language. The tendency is to drop silent letters in some of the most flagrant instances, as ugh from though, etc., change ed to t in most places where so pronounced (where it does not affect the preceding sound), etc. The National Educational Association, consisting of ten thousand teachers, recommends the following: "At a meeting of the Board of Directors of the National Educational Association held in Washington, D. C., July 7, 1898, the action of the Department of Superintendence was approved, and the list of words with simplified spelling adopted for use in all pub Ecations of the National Educational Association as follows: prominent symptom of the initial stage of pneumonia. It is a frequent accompaniment of the initial stage of typhoid fever. Cardiac weakness produces it in chronic form. It is positiv that you may have an acute or a chronic congestion of the lung. without having pneumonia. The text-books declare the three stages of pneumonia to be (1) congestion, (2) hepatization, (3) grey hepatization. When pneumonia occurs, it is positiv that you must have had congestion before hepatization was possible; but by no means are all cases of congestion followed by hepatization. This brings us to the well chewed, but not digested, question as to whether or not true pnemonia may be aborted. The trouble with too many of the authors who have discust the matter is that their ideas are constipated, and they adhere too closely to the text-book style of phraseology, diagnosis, etc. We have observed symptoms many times, and in many varieties of disease; no visible complications which could be presumed to cause them; no individual peculiarity which could be discovered which could act as assignable cause; no drug administered which ever could have produced the results; no neglect or exposure which might have been responsible; yet we never thought of trying to make the condition an entity in medical literature, however often we observed the condition. What practician of extended experience has not had similar experience? We have just as frequently observed cases of acute congestion of the kidneys as we have acute congestion of the lungs; yet we have never insisted that this is nephritis. Taken, a patient who has been exposed to inclement weather, who is otherwise perfectly healthy, and who has an activ congestion of the lungs with all the accompanying symptoms developt to intensity, and we are certain that he is threatened with pneumonia. He may not have it when we see him; he may have it thru the other stages later, or he may not. Whether the resistance of nature to infection (if infection it be), whether drugs can affect it or not, is another and quite a different question. Scarlet fever is different from cutaneous erythema; small-pox is different from "Cuban itch;" diarrhea is different from cholera; and congestion of the lungs is different from pneumonia. Congestion of the lungs may be but a symptom, or it may be the primary stage of a disease. Congestion is, in other words, an incident; pneumonia is an entity. We do not believe any diagnostician can tell, when he first examins a case of congestion, whether or not pneumonia will follow; nor do we believe any therapeutist can declare beyond cavil that he will prevent pneumonia following a case of congestion, where the conditions favor a further extension of the abnormal condition. None of the authorities say more, despite verbosity or unproven assertions; hence further discussion would be useless. Treat your congestion of the lungs, when you get it, on rational lines; if you don't get pneumonia following, endeavor to be rational still. Gastro-Intestinal Fermentation of Foods. Probably the commonest affection which the American practician is called upon to treat is gastro-intestinal fermentation; we do not except constipation, even. How very seldom is the treatment satisfactory to either patient or physician. The reason need not be sought long either the patient will not obey the instructions of the physician, or the physician is not competent to give the proper instructions. The average physician, consulted regarding gastro-intestinal fermentation, gives a cathartic, with orders to follow it with some of the multitudinous preparations or prescriptions presumed and recommended to be able to check the trouble promptly and permanently. Naturally the results are but temporary, if indeed at all perceptible, since fuel is being constantly added to the fire. The solution of the problem is to be sought only in the proper mastication of the proper kind of food in proper amount. Probably all of us eat too much, masticate insufficiently, and allow our tastes to dominate our judgment in the choice of foods. While it is true that none could live by the complicated formulas which the actual measurement of the calorics yielded by certain foods, and the actual demand of the organism for a certain number of calorics would entail, it is quite as indisputable that physiology can teach us much regarding the causes of gastro-intestinal fermentation, would we but learn. Our lay sufferers cannot be expected to know anything of these mysteries; but is it asking too much of the presumably well educated physician that he know something of the actual facts? Familiar as we are with the libraries of physicians in activ, extensiv, and remunerativ practise, we say advisedly that we know no books which are so antiquated and so little used as those treating upon dietetics and physiology; indeed, many successful (?) practicians dispense with such books entirely, or if they do have one of a date some years back, it is in an excellent state of preservation. Carbohydrates are responsible for nearly all gastro-intestinal fermentation. When digestion of carbohydrates is slow, or ceases entirely, bacteria cause an abnormal fermentation. Bacteria are always present in the small intestin, but it is only when carbohydrates have been ingested in excessiv quantities or have been subjected to insufficient mastication, that these serve as a favorable nidus for the growth of the trouble-breeding germs. Carbohydrates, no more than other foods, will cause excessiv gaseous formation, if properly subjected to salivary digestion and efficient muscular activity of the gastric walls. Foods fried in grease and hastily swallowed, are slow o submit to the feeble kneading of a weakened stomach. The same food, properly cookt and judiciously masticated, would quickly become assimilable. The American palate has a predilection for starches and sugars; fresh, hot bread and pancakes, reinforced with syrup or sugar, are familiar examples. The fermentation of starch and sugar yields, in the stomach, ethyl alcohol and acetic, butyric, lactic, and succinic acids, hydrogen gas, and carbonic acid gas; not to mention the malodorous combinations of hydrogen. The ever present cellulose is ready to form marsh gas and carbonic acid gas. No practician will ever get results until he has studied well the physiology and dietetics of the common foods, and establisht his right to direct what a patient shall eat, and how he shall eat it. Yet how may he who is himself innocent of knowledge do this? The per plexing problem may be solved by sufficient application. Diet in Chronic Constipation. Cohen's System of Physiologic Therapeutics has the following good suggestions regarding the diet in constipation, and the diet is fully as important as any other part of the treatment; therefore we quote the article verbatim: In order to produce peristalsis it is essential that the intestins contain a certain bulk of fecal matter. A diet rich in meat and eggs, and the sparing use of vegetables, fruits, and water will produce a small residue of undigested matter. Therefore the intestins will fill very slowly to a point sufficient to provoke vigorous peristalsis. When such a diet is habitual to a patient, it should be changed. Vegetables, fruits, coarse breads, and water should be taken freely. These foods should contain a large amount of cellulose, which remains undigested, fills the intestin, and excites in it a peristaltic activity. The vegetables that are most laxativ are tomatoes, spinach, lettuce, asparagus, Spanish onions, salsify, cabbage, and celery. Spinach and tomatoes are especially prized for their effect upon the bowels. The coarse cereals have the same reputation. Oatmeal, cornmeal, and wheaten grits are the best. Bread made of coarse flour, such as graham, rye, corn, oats, and "whole wheat" meal, also helps to prevent and to relieve constipation. Bran bread is especially efficacious. It is made by adding bran to ordinary flour in as large proportion as is compatible with the making of good bread. Such breads as ginger bread and Boston brown bread are also laxativ, but often can not be used because they provoke gastric indigestion. Honey, molasses, and foods eaten with them are also reputed useful for the relief of constipation. Honey has been used in all ages as a mild laxativ. Many persons are sensible of the stimulation of peristalsis that coffee produces. The addition to it of much sugar and cream will sometimes retard gastric digestion and may thus counteract its stimulating effect upon the bowel. Fruits have a laxativ influence, partly because of the sugar that they contain, partly because of the fruit acids, and sometimes because of their irritating skins and seeds. Strawberries, blackberries, raspberries, gooseberries, blueberries, currants, and grapes, are effectiv partly because of their seeds and partly because of their fruit acids, or the acids which are generated in their digestion. Apples, pears, peaches, plums, cherries, oranges, and grapefruits are chiefly purgativ because of their sugar and fruit acids. Prunes, figs, raisins, and dates have, beside these, either a skin or seeds that act as a local irritant to the intestins. Fruit produces the greatest laxativ effect when eaten alone. It is therefore best taken at bed time and on rising, a half hour, or, better, an hour before breakfast. A compote with meals will do good, altho it is not so effectiv as fruit taken upon an empty stomach. Apple butter, date butter, marmalades, and similar preparations are often eaten upon bread or crackers. Many who are constipated fail to drink enuf fluids either to keep the contents of the intestins soft or to form intestinal secretions as abundantly as is needful. This is especially true of those who lead a sedentary life, and of women. If, upon inquiry, it is found that enuf water is not taken, more must be prescribed. Slight constipation may often be relieved by taking a glass of cold water the first thing in the morning. The laxativ effect is enhanced if another is taken on retiring. The morning draught stimulates peristalsis and secretion. Under its influence the rectum is slowly filled, and a half hour or an hour later, breakfast provokes the desire to defecate. The habitual use of hard water is constipating unless magnesium and sodium sulfate occur with the lime salts in sufficient quantity to make it laxativ. Distilled water or soft water has a neutral action. Water containing much organic matter frequently provokes diarrhea. An average sized man should drink from five to eight glasses daily. Sweet cider is loosening to the bowels. Grape juice, if taken freely, acts similarly. Tea is an astringent, especially when made by boiling or prolonged leaching of the leaves. Tea drinking is a not uncommon cause of constipation. Pneumatosis. It is One of the most distressing of minor symptoms which can afflict humanity, especially if the victim be a lady, is pneumatosis, or the noisy belching of gas from the stomach. The gas may be odorless or tasteless, or it may carry with it a vile taste and a nauseating odor. frequently noted in neurasthenia, hysteria, and other neuropathic conditions, and is said to be especially frequent in cases having a strong sexual characteristic. The condition is generally hard to relieve, simply because both patient and physician persistently refuse to recognize the actual conditions. The gas which is so noisily expelled is popularly supposed to be the product of fermentation in the stomach, whereas the truth of the matter is that it is simply air that has been swallowed. Air may be aspirated into the stomach when the cardia is relaxt and the esophagus closed, either in consequence of a negativ thoracic pressure when the vocal cords are closed, or because the lumen of the stomach expands and dilates under nervous influence. Moreover, many nervous people have contracted the vicious habit of swallowing air, either intentionally or unconsciously, until the stomach is distended and relief by belching is imperativ. Some of these patients, it is true, have genuin dyspeptic symptoms; but many of them have no actual digestiv disorder. Naturally, to drench them with acids, pepsins, and digestants, is of no avail, and they become more firmly than ever convinced that they have an incurable malady. When the stomach becomes greatly distended with the air, the luckless patient often finds more trouble in getting rid of it than she has experienced in acquiring it, and there is a sense of distention, distress, and dyspnea that occasionally becomes so persistent as to be alarming and to demand relief. If the air escapes into the intestins the torture is mitigated for the time; belching will likewise relieve it. The distress may follow every meal, when the patient will be firmly convinced that the trouble is altogether in deficient digestion; or it may be periodical, occurring only when the patient is perturbed or fatigued. The condition is easily recognizable by a careful physical examination without questioning the patient, provided the examiner be sufficiently tactful and astute. A possible distention of the transverse colon must be excluded, and possible gastric dilation and atony must also be considered; if |