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Inflammatory products, involving the mucous membrane at the neck of the uterus, frequently create an areolar hyperplasia in the parenchyma of the organ; this resulting hyperplasia is followed by muscular atrophy, also involving the sub-mucous fibrous structure of the uterus; this is finally replaced by hypertrophic areolar tissue, causing a transition, as it were, in the structure of the organ.

So much then for the brief and general consideration of the active and predisposing factors in displacement of the womb. Malposition of the entire organ or a change in the continuity of the same, having as an underlying cause the factors mentioned, resulting in flexion or version, is not at all uncommon.

Velpeaux had so often observed anterior flexion of the uterus in healthy women that he considered it a normal condition, and in 1849 read an elaborate paper before the Academy of Medicine at Paris endeavoring to prove his assertion.

Boulard found anteflexion to exist in 80 female foetuses. and in 27 adult female. Verneuil and Follin subsequently confirmed this observation.

In 339 displacements, Nomat found 67 flexions; Meadows, in 84 displacements, reports 54 flexions.

My own table of cases, from the Chicago Polyclinic and St. Joseph's Hospital, records 60 flexions out of a total of 300 displacements.

Scanzoni, in 54 cases tabulated of flexions, 46 anteflexions and 8 retroflexions. Hewitt, in 296 cases of flexion, found 184 anteflexions and 112 retroflexions. Nonat, in 67 cases of flexion, found 33 anteflexions and 14 retroflexions. Out of 1,670 cases of flexion, Ludwig Joseph of Breslau reported 1,100 anterior and 570 posterior.

Statistical evidence as to uterine displacements is not wanting. The sequelæ following flexion and version of this one of the female organs of generation are familiar to us all, venous stasis and uterine engorgement following flexion, with all its accompanying disturbances.

The almost constant back-ache of retroflexion present among the working element in the humbler walks of life, rectal tenesmus, neurotic disturbances, impairment of locomotion, menorrhagia, a predisposition to abortion, pain on sexual intercourse, pelvic and cerebral neuralgia, dysenenorrhoea and sterility.

The long train of conditions pathologic is familiar to us all. It is only actual suffering that brings these patients under our observation.

Can we not, as general practitioners, or as gynecologists, diagnose these abnormal conditions earlier and perchance save those members of the weaker sex from the pitfall of chronic invalidism?

A CURE FOR CONSUMPTION BY THE INHALATION OF MEDICINE THROUGH THE MEDIUM

OF HOT AIR.

By J. BYRON SLOANE, M.D.,

Member of the Wayne County Medical Society, Etc.
Detroit, Michigan.

Some few years ago I commenced a treatment for diseases of the nose, throat and lungs by the inhalation of medicine through a small glass inhaler I had made with an enlargement at one end, in which was placed several pieces of sponge, and on this was dropped the medicine which I wished the patient to inhale. The inhaler was small and could be easily carried in the pocket and was to be used several times a day. It was arranged so a cork closed either end when not in use, which also kept the medicine from evaporating. In inhaling, the air passed through the sponge, took up the midicine as it passed into the lungs. My success with this method of treatment was more than I expected, especially in the acute stages of consumption and in cases of bronchitis. But in the more advanced stages of consumption the results were not so good, and in fact, with those in the third stage very little was accomplished farther than allaying the cough. I finally had several who were using the inhaler arrange a piece of asbestos over the top of a gas jet or lamp chimney by means of wires, and the heat from these caused the air over the asbestos to become heated and they inhaled this hot air instead of the cold, and in each case they received about 50 per cent. more benefit from the same medicine than they did by using cold air or the old way. I then devised an instrument, a cut of which is shown, and since that time I have been treating all cases of nose, throat and lung trouble in this way, and in consumption,

bronchitis and asthma the results that I have obtained have been very gratifying to both patients and myself.

Cases, that under the old way of treating, would have died in a few months' time, steadily improved and in the course of six to twelve, and in some cases, eighteen months they were entirely cured. Those of the milder cases or in the first stage of consumption were cured in from two to four months' time; those in the second stage, where there was not too much derangement in the alimentary tract, improved quite as readily. Those cases in which the stomach was involved, the digestion impaired and more or less constitutional complications, they did not improve so fast, but under a systematic treatment, tonics, etc., to aid digestion, they came out all right, and only one case in any

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stage of the disease that I have treated with medicated hot air, and they followed the directions, that died, and this case when I first saw him was beyond help, but he lived several months, his lungs improved, but his constitution was in such a condition that it was impossible to get him to gain in either flesh or strength, and he finally died from exhaustion. His night sweats

ceased in a few days after using the inhaler, nor did they return; his cough ceased with the exception of coughing up the mucus and corruption that gathered in his lungs and this came up very easily, and was diminished in quantity 75 per cent. from what it was at the beginning of the treatment.

Other cases improved in like manner, especially so far as the lungs were concerned; cough would almost cease in a few days after commencing to use the inhaler, except to raise the discharge from the lungs; night sweats stopped in every case without any medicine being given internally for this trouble; appetite improved and as all medicines except tonics were discontinued, with the exception of a few cases, where a cough mixture was given at the start to help allay the cough, and this was discontinued after a few days, leaving the stomach free to take care of the tonics and foods. Some I gave cod liver oil, especially where it agreed with them, and always with good results.

I have over one hundred inhalers in use among my patients. in different diseases, and in every case they are doing as well as those I have mentioned, and in chronic bronchitis, where it often runs into consumption, I have not failed to cure in every case, and in most cases they use the inhaler without any internal medicine whatever. I will quote one or two cases that I have treated.

Mrs. F. W., aet. 31, came to me suffering from a severe cough; raising considerable of a thick yellow matter. Examination of sputum showed numerous tubercular bacilli; had lost considerable in flesh; appetite gone; had cold night sweats. Commenced her on an inhaler, thirty minutes four to six times a day; gave her general tonics and had her continue using cod liver oil, which she had been taking for several months. She began improving at once and now, something over two years since she commenced the treatment, she is cured and to-day is as well as ever before her sickness and she has been so for over a year, having none of her old troubles and weighs more than she ever did.

Mrs. R. B., aet. 33, was a very fleshy woman until she contracted pleurisy, complicated with pneumonia. She suffered a relapse and her left lung became completely consolidated. A severe cough followed this sickness, and after recovering from the pneumonia she developed consumption. The sputum was laden with bacilli and she lost flesh rapidly; in fact, in a few

weeks she weighed but 127 pounds, where her former weight was 192. I put her on tonics and commenced her using the inhaler six times a day, thirty minutes at a time. Her improvement was marked from the first and in four months time she left for California, her former home. She continued the treatment for six months after arriving there and at the end of that time was completely cured.

In nearly every case I have treated I could quote just such. improvements, not only in consumption but in asthma, bronchitis, catarrh of the nose and throat (when the catarrh is not kept up by some deformity in the nose glands in the nose or nasopharynx), the cure has been equally satisfactory, and we have in this treatment, viz., the introduction of medicine through the medium of hot air, that which promises to be, judging from the experience I have had with it, a positive cure for this all-distressing disease and especially the "White Plague" in the first and second stages, and in a great many cases in the more advanced stage.

Headache of Eye Strain.-Donders' rule of diagnosis, slightly modified by H. H. Seabrook, (Medical Record, July 20) is that when anybody is seen to frown, squeeze the lids together and rub the forehead on using the eyes, eye strain is present. Patients with hyperphoria tip the head sideways upon attempting to see clearly. If the subjects have sick headache from theatre-going, visiting picture galleries, railroad journeys or bicycle riding, esophoria should be suspected, and the diagnosis is made positive when they develop headache regularly after continued fixation of distant objects under different atmospheric conditions.

Subcutaneous Vaselin Injections. This method has been employed successfully by Gersuny (Medical Review of Reviews) in about thirty cases, including urinary incontinence, prolapse of rectum and of genital organs, cleft palate, hernia and various deformities of the soft tissues. The pure white vaselin (melting point 36° to 40°C.) is sterilized by boiling, taken up in the syringe in the melted state, allowed to cool, and then forced out through a fine needle in the form of a thread. The injections are practiced in connection with local anesthesia, and all of them should be made into a single opening.

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