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alysis were strong indications for making a diagnosis of stone in the kidney. The patient, after these long months of severe suffering and danger from uræmic poisoning, was thoroughly discouraged, and consented to an exploratory operation on the kidney. At this time she was voiding from 20 to 24 oz. of urine in 24 hours.
June 11, 1903, assisted by Drs. McVay and Stafford, of Toledo, and Dr. Zumstein, of Detroit, I made the usual lumbar incision, brought the kidney out and needled it thoroughly, but found no stone. In the superior third of the kidney I found a hard mass almost like cartilage, which resisted the needle to a marked degree. I stript the capsule and incised this mass, which, after incision, resembled cicatricial tissue more than anything else. Sutured the incision with cat gut, replaced the kidney, put in my sutures and the patient made a nice recovery. The following is the amount of urine secreted in 24 hours, as recorded each day on her chart for the first ten days after the operation :
From June 11th 8 a. m. to June 12th 8 a. m. oz. XXII.
XXVII. " " 13th or
14th " XXII. 14th
This, you can see, is a remarkable increase in the quantity and there was a continued improvement in the amount of urea excreted until she reached the normal amount. There has been a steady improvement until to-day, six months after the operation, she is passing a normal amount of normal urine, urinates from five to six times in 24 hours, is not troubled at night, can retain the urine from six to eight hours if necessary without any inconvenience, can go out in company and enjoy herself as she has not done for years, and is able to do a fair day's work as a nurse.
When we consider the long period the patient had suffered from this reflex irritation of the bladder, the source of the reflex and the prompt relief that followed the surgical treatment, I feel that I am warranted in calling it unique.
By C. Zbinden, M. D., Toledo, Ohio. No complete proving has been made with this remedy. Some of the symptoms it has produced in healthy persons are the following: Great sleepiness in day time, tired feeling in the early evening hours, heavy sleep, mental depression, vertigo, head feels dull, heavy; pain in forehead, with diarrhæa, paroxysms of severe headache, with darkness before the eyes; rheumatoid pains, fever, chills, heat and sweat; putrid taste, white coating of the tongue, no appetite, or great hunger, eructations with sour taste, desire for acids, nausea and vomiting of food, with putrid odor, pyrosis and gastralgia, vomiting of foamy and slimy fluid, or of bile and blood; great thirst. Pain in region of liver and spleen, colic with retracted abdomen, in case of poisoning, gastro-enteritis with tympanitis; stool soft, of the consistency of mush, or watery, of different colors-yellow, green and white, sometimes mixed with blood, or like gelatine; prolapse of anus.
E. B. Nash (Leaders) says: Podophyllum is a powerful cathartic. The diarrhea of Podophyllum is characterized by (1) the profuseness of the stool; (2) the offensiveness of the stool; (3) the aggravations in the morning, hot weather, and during dentition. Concomitants are prolapsus ani; sleep with eyes half closed, rolling of the head from side to side, moaning, frequent gagging or empty retching.
I have used this remedy mostly for diarrhea and cholera infantum. In former years I sometimes used Podophyllin, but have abandoned it and now use nothing else but preparations of the homeopathic tincture, with much better results.
There was a great number of cases of diarrhæa among children in our city last summer. After observing a few of them I found that they were all of one kind; they all had watery passages, mostly yellow; some had an offensive odor, others had not; they had some colic; some patients vomited, others did not. After experimenting a few days I found that Podophyllum was the remedy for all these cases. From that time on I prescribed it for every case during the season. Before that I had a few times used Sulphocarbolate of Zinc as an intestinal antiseptic, also Pepsin, but found that Podophyllum when indicated, needs none of these adjuvants but does its work alone and is all-sufficient. Stupor is not seen in every case, as it is not an early, but rather a late symptom, but when present calls invariably for Podophyllum. Vomiting, when present with the diarrhæa, needs no Ipecac nor any other stomach remedy, Podophyllum cures it.
The result I had with this drug was a prompt cure in the great majority of cases, and improvement in nearly every case. The few
patients who did not get well with it needed another remedy to complete the cure, and this was Mercurius Sol. I had two deaths from said disease last summer, but both were complicated and neglected cases. There are always weak and sickly children who will die of an attack of diarrhæa, no matter what we may do. The doses I used were from six to twelve drops of the 3x dilution a day.
By H. W. Shaffer, M. D., Tedrow, Ohio. The teething period of children is the most critical period of their early life. The first step in the development of the teeth consists in a downward growth from the rete malpighi or the deeper layer of stratified epithelium of the mucous membrane of the mouth, which first becomes thickened in the neighborhood of the maxillæ or jaws now in course of formation. This process passes downward into a recess of the imperfectly developed tissue of the embryonic jaw, and as they develop they grow upward.
The temporary or milk teeth, are speedily replaced by the growth of the permanent teeth, which push their way up from beneath them, absorbing in their progress the whole of the roots of each milk tooth. The development of the temporary teeth is said to commence about the sixth week of intra-uterine life, after the laying down of the bony structure of the jaw. The permanent successors begin to form about the sixteenth week of intra-uterine life. For this reason the infant's food should be carefully selected. Keeping the mother's health in good condition will greatly aid in the infant's development.
In ordinary cases during the teething period about all that is needed is the indicated remedy for the various afflictions caused by teething, and I find Passiflora among the best remedies. But when ordinary means fail to give relief and the gums are much swollen and inflamed, and there are signs of convulsions, it will be proper to lance the gums well down upon the teeth. The routine practice of cutting the gums whenever anything is the matter with the baby that is cutting teeth, is wrong, and there are others who never met with a case where it was necessary to lance the gums, and consequently fail to realize that such cases do occur.
The trouble about gum-cutting comes from a misconception of the subject. The irritation or nervous strain is not caused by the pain or discomfort of the gums, nor is the relief in cutting the gums only, but as the tooth, at the stage of development, is, on the root end, an open tube, filled with the pulpy matter, loaded with the earthy material that is being deposited as the tooth is pushed forward, the mischievous work of this gum is simply in pressing the tooth back on its pulpy base, the sharp edges cutting and lacerating this—to the terrible torture of the little one. Cutting the gums lets the tooth lift, thus relieving the little one. So lance not to relieve the gums, but the toothforming pulp behind the tooth..
Case I. – A very fine well-to-do family. The only little child-ten or twelve months old-kept having convulsions, with gums very much swollen and cutting teeth could not induce the spasms, and the child died from the effects of the convulsions. The history of the baby was related to me by the mother. The second child, a fine-looking boy, with gums very sore and swollen, commenced having convulsions about the same age as the first child. It had one or two a day for three or four days, growing more severe. I was called in to see the little one, and advised their family doctor to lance well down upon the teeth. This was done and the child had no more convulsions, but grew to be a strong, healthy child.
Case II.- Related in Medical Council, December, 1898. Rev. M. S., baby having convulsions, appearing every Sunday and continuing until Wednesday; then stopping until the next Sunday, convulsions commencing as before and lasting until Wednesday. This continued for weeks, until the child became an idiot. The gums had been well scored up from lancing-to no use. At last another doctor suggested quinine for the baby for the peculiar conditions of periodical convulsions, and after receiving it the baby had no more convulsions. But the medicine was delayed too long to save the mind.
Case III.- Baby about sixteen months old. If it made an effort to get hold of something they did not wish her to have, and the article was removed, or if she attempted to secure something just beyond her reach, she would seemingly become vexed and fall down in a spasm. These spasms increased in severity, all remedies failing. The lance was used and the child had no more convulsions.
So it is required of us to study well our cases and act wisely. I am confident that a babe with its undeveloped brain cannot be subject to convulsions to any extent without its brain suffering serious injury, and Opium or its derivations cannot be administered to a babe for any length of time without producing injurious effects on the mental conditions. We should bear in mind that all childrens' troubles are not caused by teething, and that very few need to have their gums lanced.
The best treatment for difficult dentition is preventative. This consists in proper food, good air, proper clothing, cleanliness and exercise. The mother must attend to her diet and health, and avoid all stimulating food or drink which will injure her milk, and thus aggravate the period of teething. These cases are much increased by the parents giving the infant stimulating food whenever it cries from irritation attending this process of teething, and from this cause dentition may result in serious disease. If mothers were able to support infants upon the breast alone with good, wholesome milk, teething would in most children be a comparatively easy process.
HYGIENE IN OYNÆCOLOGY.
By Clara Hyde Gillard, M. D., Port Clinton, Ohio. Dunglison tells us that hygierte is the part of medicine whose object is the preservation of health; it embraces a knowledge of healthy man, both in society and individually, as well as of the objects used and employed by him with their influence on his constitution and organs. Gynæcology, he says, is the doctrine of the nature and diseases of women. You will agree with me that these two definitions to form a text sends one searching through his brain cells for material, for little is to be found in our medical books on preventive cures. The knowledge and recommendation of them certainly are not as remunerative to the physician as remedial cures, yet a satisfaction and gratification to him is to be obtained by recommending the influences which are required to bring health.
Food, clothing, pure air, sunshine and activity are as in child life primary necessities. Food. — The first food for infants' use has not been equaled by any other, and the poor have the advantage of one year's good start over the rich. The greatest enemy of the physical race is the woman who says, “I let my children have anything they want, and they never see a sick day.” This may be true until growth stops and assimilation and metabolism are deranged. The same is true in adult life. Disease is due to deficiency of nutrition or vitality, food should be the basis of every treatment, as improper food leads to a low vitality. A well body must be a complete body, and food alone makes it so. Faith and liver pads can do nothing with an empty stomach, nor can prayer turn a pie-crust diet into flesh and blood. The blood cannot part with its value until it recures it.
Food includes whatever adds substance to the body to supply a new growth in place of that which is lost in daily waste. Food may consist of manythings, but above all in importance is oxygen. Oxygen is the first and most active element that can be taken into the system. No other matter can equal it in importance, whether it found in what we at, drink or breathe. Phosphorous, which is the physical source of