thus constituting the hammer, and the other two phalanges the handle. In this position the tender end of the toe presses on the sole of the shoe, and the angle or hump above impinges on the upper; callus forms, and sometimes even a bursa, and soreness, which renders walking almost unbearable. The flexor tendons, the longus and brevis, are in a state of contraction, atrophy, and fixation.

The etiology of this trouble is not very well understood; but many causes are assigned, such as heredity, rheumatism, too narrow or ill-fitting shoes; and I am almost ready to believe that shoes with toe-caps may cause it. One thing is certain: that the hard, unyielding seam or jointure adds fuel to the fire after the trouble has commenced. In my own case, rheumatism was evidently the cause. I was never in the habit of wearing too narrow shoes, never in my life had a corn or bunion, or overlapping of toes; but I am of a rheumaticoasthmatic temperament. About twenty-five years ago I had rheumatism for the first time in the last joint of the ring finger of my right hand and nowhere else, which ran the usual course; about ten years after this I had two sharp attacks of lumbago a year or two apart, which yielded in a few days to the drawing of a large fly blister. There was another interval of about ten years, when my right knee was attackt; this was stubborn, but after many months yielded to fly blisters, electricity, and to swallowing all the rheumatism samples that I had in my office. But by this time it had attackt the last joint of the middle toe of my right foot, and a year later the last joint of the second toe of my left foot. After the rheumatism subsided I was the possessor of two typical, ideal hammer toes, with all which that means, and which is a plenty. Locomotion finally became so painful that in order to walk even short distances I had to discard all decent shoes and resort to old, cast-off, battered, and hackt ones for nearly a year. In fact, the trouble went from bad to worse until I seemed to be almost forced to go barefoot, wear sandals, or have my toes amputated or the offending joints resected. It was at this crisis that I decided to attempt to straighten the partially anchylosed joints, and to restore the function of the flexor tendons by a persistent course of massage.

Treatment: Palliativ treatment is almost worse than useless, such as corn salves and plasters, and even dividing the lateral liga

ments; the only success I got was from paring and sandpapering off the callus, wetting the surface and rubbing solid nitrate of silver over it several times until a black film was formed. This seemed to take the soreness out, but for a few days only.

My technic was as follows: For the right foot, seize the end of the affected toe laterally between the thumb and index fingers of the right hand and pull it forcibly and steadily forward as if to straighten it or pull it out of root, and at the same time, with the index and middle fingers of the left hand massage the contracted flexor tendons by pushing and pulling them from side to side with osteopathic energy, and from behind forwards from the point where the flexor longus crosses the flexor longus pollicis to its insertion in the base of the last phalanx. Use the same tactics for the left foot, except to change the hands. I did this once daily for several months.

Under this treatment improvement soon commenced; the tendons developt and lengthened; the adhesions of the tendons to the phalanges and metatarsal bone were loosened; the calluses disappeared, and the toes straightened and assumed alignment with their fellows.

About six months ago I was compelled to procure a pair of new shoes, which I put on with much misgiving-I was afraid to risk the ones laid aside a year before, for they all had toe-caps. I have worn the new shoes every day since without a twinge of pain. They have plain toes, somewhat broader than I was used to, and made of pliable. leather.

Of course, "duo hinundines ver non faciunt," nor will the cure of two cases of hammer toe establish a remedy for all cases; yet I cannot see why it should fail in any case, from whatever cause, if properly, patiently, and persistently carried out.

JOHN E. LOCKRIDGE, A.M., M.D.
Indianapolis, Ind.

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Cornu-Cutaneum.

EDITOR MEDICAL WORLD: I have had a case recently which I thought, on account of its rarity, might interest WORLD readers as it did me. About ten years ago a man, an American, then about 40 years of age, consulted me in regard to a brown pigmented spot on his left cheek. It was then about as large as a silver quarter of a dollar. It was slightly rough, and was perceptibly elevated above a level with the skin. He said it had begun about a year prior to this time, had attained its present size in a few months, and had ceased to grow.

He is a married man, in good general health, and of exemplary habits. Gives no history of cancer or syphilis in his ancestry. As it appeared to be benign in character, I advised him to let it alone and let me keep it under observation.

I saw it occasionally for nine years from the time it first came under my observation. There was no apparent change during these nine years. Last spring, about March or April, he called my attention to it again. I found it more elevated in the middle of the brown spot. I still advised to wait and watch.

In June I saw it again. It was assuming a wart-like appearance. The growth was

then about one-half inch across at the base

In September it had begun to pucker at top and was evidently of horny character. I then made a diagnosis of cornu cutaneum, and advised its immediate removal surgically. He would not consent to this. but told me of a certain man who had a cancer cure which would remove cancers

and such skin growths, and that he would have him do it. I felt that it would be a disgrace to let him go to a layman and get done that which I or any other medical man could do. I told him I had half-dozen or more of the noted cancer cures, those which had been most successful, and that I could remove it in this way as well as anybody, but preferred, in this case, the knife, but that if he would not submit to the knife, I would remove it with a paste. To this he consented. So the 1st day of October I asepticised the parts as completely as I could, and prepared a paste as follows:

R

Galangal root, powdered

Sanguinaria, powdered, āā

Chlorid of zinc, q. s. to make a stiff paste
when mixt and thoroly rubbed together
in a mortar.

I spread a layer of this on a strip of chamois skin, wrapt it around the growth at its base, letting the edges extend out to the border of the pigmented area, applied a piece of plain gauze over it, and held it to its place with adhesiv strips.

I applied this every day, making fresh paste each time. In four days the horn, about 3/4 of an inch long, came loose at its base, and dropt out, leaving an elevated hard growth in the skin around as large as the pigmented spot. I continued putting plasters on it sufficiently large to cover it. In four days more a large, tough, hard mass came out, leaving a nice, clean-looking opening in the cheek about 14 inches across, % of an inch deep,

with very precipitate edges. I washt it and surrounding parts with a saturated boric acid solution, and applied a plaster of basilican ointment each day. In two weeks the wound had filled and skinned over, and at this time there is only a scar left, and it does not look half so badly as one would imagin.

So you see, I obtained a nice fee, a nice pathological specimen, and cheated the ignoramus out of his job. There are many very common ailments from which people suffer greatly and for which they would pay nice fees for relief that are tabooed by the profession generally. They pass from our hands into the hands of quacks and charlatans, who cure them, greatly to their credit and to our discredit. The confidence of the patient in us is greatly lessened, if not destroyed, as well as that of the public generally. D. C. SUMMERS. Thornsberry, Ark.

Gelsemium for "Grip."

EDITOR MEDICAL WORLD:-Personally, I wish to thank Dr. Morse for his article in December WORLD, page 519, on "Colds Aborted with Gelsemium." I shall try his stiff dose of 15 to 20 drops in the next coryza case I have. He says this treatment will not abort the acute epidemic catarrh that we call the "grip." Let me suggest his trying the gelsemium in minute doses often repeated for that. For 18 years I have used 14 drops of gelsemium tr. (mother tr. is the best, tho I am not a homeopath) in two-thirds glass of cold water, instructing the patient to take of this when awake one teaspoonful every 15 minutes for 12 or 18 hours, lessening after that to every half-hour, then every hour. If taken in season, the patient can be about his work on second or third day, and no bad effects on heart and various organs follow when this treatment is employed. Gelsemium acts on nerve centers.

ELIZABETH HOYT-STEVENS, M.D. Concord, N. H.

More About Gelsemium. EDITOR OF MEDICAL WORLD:-In the Dec. WORLD, page 519, I notice an article, by Dr. Morse, on the use of gelsemium for aborting common colds and acute coryza. I wish to add my testimony in favor of this treatment. I have used gelsemium for this purpose for 50 years. My practise has been to administer it in 20-drop doses of the tincture in connection with

two or three doses of quinin, 3 grains each. It has given me the same success and gratification as that attained by Dr. Morse. I have generally advised a warm bath, and think that this hastens the cure.

Gelsemium, for this purpose, should not be administered more than three times a day. In severe cases it is advisable for the patient to go to bed for half a day, but this is not absolutely required. One dose of the tincture of gelsemium and one of the quinin in most cases will do the work.

Gelsemium is a heart sedativ, and in all cases it is advisable to combine it with fluid extract of convallaria majalis (lily of the valley), which is a most excellent heart tonic, with no cumulativ action. If to the above treatment one or two doses of pilocarpin is added-enuf to get its specific action on the skin-most all cases will be magically aborted, and no more effectual treatment can be desired.

The value of gelsemium was an accidental discovery. About 60 years ago, in the South, a negro was sent to gather a certain herb which had the reputation of being valuable in cases of bilious fever. By mistake he gathered gelsemium and administered a decoction of it to his master, who had resisted all ordinary treatment. The result was great prostration. There was loss of muscular power; he was unable to move a limb and could not raise his eyelids, and it was thought that he would expire. But after a few hours he revived and had no return of the fever. Some enterprising doctor, knowing of the case, prepared a medicin from gelsemium and disguised it with wintergreen. He called the nostrum "Electrical Febrifuge." After a time it became known to the profession.

Lawrence, Kan.

C. E. WITHAM, M.D.

Family History in Insurance Questions. DEAR DR. TAYLOR:-I want to voice the sentiments of Dr. Henry, of Camden, N. J., in his article in Nov. WORLD, pages 473474, fighting for reform in the making out of insurance companies' blanks. I must say that some of the questions required to be answered are most confusing, while others are decidedly absurd and are a reflection not only on the physician's skill, but on his honesty in dealing with the company.

Dr. Henry might have carried the attack into the realm of life insurance proper, and

illustrated a few of the unnecessary questions required to be answered. Why are these companies so particular about the number of aunts and uncles, half-brothers and half-sisters an applicant may have had, and the ages that each attained, living or dead? I have had blanks returned to me because such small details had been omitted, and requesting me to have the applicant look up the family records and fill in every space. I have before me on my desk the application papers of half a dozen insurance companies, and there is not one of them but insists on these details of family history, which I contend is a most insignificant part of the examination.

There stands the applicant before us. Strip him if necessary; palpate him thoroly and pass judgment; but don't drag from the grave the memory of the paternal grandfather and maternal grandmother, and the recollection of their last days of suffering and distress.

"If your wife is living, what is the state of her health?" Now this is a needless question. If the applicant has tuberculosis, find it out; but don't drag the wife into the examination. "Have any of your relativs other than those already mentioned had consumption, scrofula, insanity, cancer, apoplexy, or other hereditary disease?" Is that a fair question? Now, the only other relativs are the cousins, and I think the company might just as well have included manservant, maid-servant, and neighbors; and since the great Congress of Physicians has recently decided that bovine tuberculosis is communicable to man, I have no doubt the companies will shortly insert the following question also: "Has the applicant's ox or his ass ever been afflicted with tuberculosis ?"

Now, brothers, my remarks are only intended to show the great necessity for reform in the stock questions that insurance. companies ask regarding family history. R. P. MCKENZIE, M.Ď.

Rossland, B. C., Can.

Insurance and Collecting Concerns. EDITOR MEDICAL WORLD:-I want to emphatically indorse what Dr. G. W. Henry says in THE WORLD about sick and accident insurance companies (Nov. WORLD, pages 473-474). In nearly thirty years' practise I have had to do with a great many of these companies, altho I was never insured in but three, or received benefits from but one.

While I have found a good many people

try to beat these companies, I have never found a sick and accident insurance company that was honest, or whose officers were honest; or which in their policies, or blanks to be filled out by client and physician, did not try to have clauses and loopholes to get rid of paying an honest claim, except the plainest cases. Many of these are in fine print on the back of the policy, and as most of the insured are ignorant, they do not read or understand the legal meaning of these clauses.

Even in the plainest cases, unless they expect an advertisement from paying a small claim, they will try and bluff their client out of all or part of his pay. With few exceptions, I have found their agents aids and abettors in their swindling; often even worse than the companies themselves.

Farther, I wish every physician would do as Dr. Henry suggests: whenever he has to fill out one of their tricky blanks, write on the margin: "Ask physicians sensible, honorable questions, and use stationery such that the doctor will not think you a bum concern." They are never slow to write back bluffing replies to the doctor.

About collecting agencies: There was one in this city that for a time, until they had roped in a good many, acted square. It is the Interstate Collecting Agency, claiming headquarters at Olean, N. Y., conducted by W. E. Barrett and wife. They left here very suddenly and went to Oil City; and while we could have sued them, it was not worth while, as the judgments could not have been collected. Wherever they are now, there will be some WORLD readers. I would like such to send me the names of the doctors in their city. A. M. Cook. New Castle, Pa.

The Country Physician.-Children and Sexual Questions.

Dr. Chas. A. Palmer, of Holmdel, N. J., sends a paper which he read before his county society, from which we are pleased to make the following extracts:

The country physician is compelled to handle nearly the entire field of work without assistance, not even a trained nurse. He usually finds his most difficult cases away back in the country many miles from help, and nine times out of ten too poor to obtain a nurse or an extra physician. Consequently the country physician has to "strip off and sail in." He handles the compound fracture as readily as would a whole hospital staff. He comes out as suc

I also think our Hebrew friends stand ahead of us in this line. Have any of you physicians observed it? Have they furnisht as much work for the gynecologist as the Christians? The meeting of a certain Jewish family this summer proved to be of great interest to me. They were exceptionally fine people and rarely would be taken for Jews but for their name. They had a little boy about six years old, their only child then, and he was very anxious to have a little sister, and would often ask his mother if he couldn't have one.

Can you imagin the answer he would get from a Christian mother? He would have his ears cuft until he saw stars. Mrs. G. said: "Yes, my dear, you will have a nice little sister in a few weeks." He then asked where it was coming from. Did she say the doctor was going to bring it in a long black bag and if he didn't be good, the doctor would carry him away in it? Not at all. She said "My dear, little sister is growing now, right next to mother's heart; she is growing there so she will be a woman some day, just like mother is now."

That was all sufficient for the time being. and I haven't the slightest doubt, as time rolls on and this child's mind develops, this mother will have equally as satisfactory explanations for his inquiries as at present. And her children will grow up and realize that children are really born into this world in a perfectly legitimate manner; while ours will continue as before to believe that marriage is only a license to commit adultery, and that children are only the results of a misintention and a very great sinful act on the part of their parents, violating the laws of chastity.

What kind of an education is this to instill into the minds of sweet little children? Our present attitude toward the sex problem is utterly absurd and not a bit progressiv. It is our duty to see that the children have a moral understanding in the sexual line.

It is possible to teach our children the physiology of sex from a very early age. and thereby impart more real morality than

As

is possible with the present method. has been said, knowledge is the only road to morality, and it must reside in the individual.

Tape Worm in a Hen's Egg.

EDITOR MEDICAL WORLD:-On November 24th, my daughter-in-law in breaking an egg preparatory to do some baking, discovered a small worm in the white of the egg; upon touching it, it moved and curled up. That was the last movement she saw. She called me. On using small magnifying glass I pronounced it a tape worm. I put it in a small vial containing alcohol and water, and in a few days took it to Dr. McKenzie, of Lancaster, Ohio, who examined it with his microscope. He found it to be a tapeworm with nineteen segments, in all about one inch long. I read in one of my medical journals not long since of the same incident, but cannot put my hand on it at present. DR. T. R. MASON. Sugar Grove, Fairfield Co., Ohio.

Truth About the Hot Springs. EDITOR MEDICAL WORLD:-In October WORLD, Dr. Edward Tracy, Orthopedic Surgeon to Mt. Sinai Hospital, Boston, has some interesting things to say regarding the Hot Springs, Ark. I believe in all the doctor says of the hot air or hyperemic treatment of rheumatism, but will suggest that he is using a little "hot air" in reaching his conclusions of the effectivness of the Hot Springs baths. There are none so blind as those who having eyes will not see; there are none so deaf as those who having ears will not hear. It is easy to ride our hobbies, but the fact that we ride a mustang does not keep the other fellow from riding a thorobred. Dr. Tracy states that he sent a dentist to Hot Springs for rheumatic treatment and that he died year later, whether of rheumatism direct, of complications or of sequelae he does not say.

Note the doctor's line of reasoning in that he judges the. efficiency of the Hot Springs by one patient. Shall we judge Dr. Tracy's professional ability by the same. case? We would do so were we to follow as his argument directs. On page 442, he says: "These cases" (one sent to Hot Springs and one to Mount Clemmens) "were both severe but in the end results were such as to cause me to welcome any efficient substitute for Hot Springs treatment."

I think it an injustice to Hot Springs to