OUR MONTHLY CLINIC.

Please notice that our Clinic department is not used to "boost" proprietary remedies, almanac interests fashion. THE MEDICAL WORLD has no other than to give the medical profession the greatest amount of honest service possible. Those who wish an immediate response by mail may obtain same by inclosing check or money order for $2. The letter will then receive immediate attention and reply. Name and address of subscribers requesting assistance will be withheld if requested; but anonymous communications will reCome ceive no attention. Always sign your name. freely for help, but read up as fully as you can before coming to us.

Food Allergy-Left Handedness.

EDITOR MEDICAL WORLD:-My 18-month-old child is very active and seems to be in perfect health, but (1) he is very sensitive to eggs in whatever form given, even as much as will cover a finger nail; it nauseates him and he What vomits out all the food taken with it. can be done for it? Will it last a lifetime? (2) Since he was able to hold something in his hands, he uses the left one, as when picking up a plaything, holding a spoon, or throwing a ball, etc., and when teaching him and placing the article in his right hand he turns it into the left hand. Why is it and what can be done for it? A PHYSICIAN'S DAUGHTER. [The baby that is sensitive to eggs might possibly be cured by subcutaneous injection of dissolved egg protein. It is being used extensively for allergic reactions of the kind you mention.

If you wish to train a left-handed baby to use his right hand, you would have to tie his left hand a considerable part of the time so that he will be forced to use his right hand, and, when he is older, teach him to use the right Be careful to hand in preference to the left. avoid atrophy of the left arm.-ED.]

Obstetrical Analgesia.

EDITOR MEDICAL WORLD:-I have been following, with much interest, the articles in the journals about obstetrical anesthesia, and have just finished reading the one in the November WORLD. I should like to ask a question or two, and I believe the answers would be of enough interest to warrant their publication.

I

1. Is it not dangerous to the baby to give the mother 4 grain of morphin in labor? have had several very blue babies, difficult to make breathe, from 1/6 grain morphin and cases where the 1/150 grain of hyoscin in baby was born within 2 or 3 hours following the hypodermic; so that I now give only of morphin unless I feel sure the woman will not be delivered for at least 4 hours. You can seldom be sure of this in a multipara, and not Would not there be always in a primipara. the same danger with morphin and magnesia sulphate?

2. In a large percentage of primiparas the labor will last longer than the instillation of the ether mixture. I notice in your article you

Founded in 1798

New York, November 20, 1925.

DR. JOHN C. ROMMEL,
THE MEDICAL WORLD,
1520 Chestnut Street, Philadelphia, Pa.
My Dear Dr. Rommel:

In reply to yours of November 14th, relative to obstetrical analgesia, I would say that if all obstetrical patients were exactly alike in all particulars, it would be possible to regulate dosage that should give us exact results in every case.

In answer to your questions:

seen

1. Your correspondent states that he has several blue babies difficult to make breathe after giving the mother 1/6 grain morphin and 1/150 grain hyoscin, where the baby His was born two or three hours following. method is practically that of the so-called twilight sleep, and blue babies were one of the outstanding sequences of that treatment. The difference between 1/6 and 1/8 of a grain of morphin in such cases is negligible in quantity and result. Following the use of obstetrical analgesia blue babies are very rare, and when they do occur they can be readily accounted for by some other cause. We do not consider that there is the same danger of blue babies difficult to resuscitate following the use of morphin and magnesium sulphate that is experienced after morphin and hyoscin.

2. "In a larger percentage of primiparas, the labor will last longer than the instillation of the ether mixture.' Depending upon the probable progress of the case, in some cases we repeat the whole treatment, or in other cases we leave out the morphin, and in still others we use 10 instead of 20 grains of quinin in subsequent instillations.

3. "Some of my friends find labor stopped by this method." When labor is well established before treatment is begun, it is rare to see it entirely stopped. We do, however, see some cases in which for a time the contractions are less forcible and not so frequent, but not entirely stopped. In some cases this will last an hour or two, and some much less, during the first stage of labor. We do not note this in cases where two instillations are required. Yours very truly,

ASA B. DAVIS, Chief Surgeon.

We would like to hear from our readers who have used or seen this technic used, or who have experience with any other obstetrical analgesia.-ED.]

NOSTRUMS

Diabesan.

Diabesan is the name of a preparation claimed to be "indicated in all cases of diabetes and glycosuria," and marketed by the Solosan Company of Morristown, New Jersey. According to an advertising circular issued by the Solosan Company, diabesan contains as its chief therapeutic agent:

the trypsin of dead yeast cells, 'not dried yeast cells,' cells which are no longer able to cause fermentation, and therefore do not affect the carbohydrate food; but on the other hand in contrast to all other yeast preparations digests albumen and reduces it to an animo-body [sic] where it can be absorbed and used in rebuilding wasted tissues."

The claim is made that diabesan "restores to the human system the faculty to digest both albumen and carbohydrates and makes use of same in the economy of the human body." The evidence offered to support this claim is contained in a paper written by A. H. Werner, president of the Solosan Company, entitled "The Rational Treatment of Diabetes." This paper contains a number of fallacies that vitiate the rather intangible and very poorly written argument. The first of these is that in diabetes it is difficult for albuminous foods to be properly digested. There seems to be no ground for this assumption, which forms the underlying premise of the author's argument. An equally questionable assumption is the further claim that if protein be properly digested, all the woes of the diabetic will disappear and that the trypsin contained in diabesan will accomplish this result. Dead yeast presumably contains a small amount of tryptic ferment. But it is doubtful that it survives passage through the stomach; and, in any event, it is unlikely that yeast contributes materially to the aid of protein digestion under the conditions of alimentation that ordinarily prevail in patients with diabetes. It would therefore appear that the claims for diabesan are irrational and unscientific.

Since the assumptions on which the claims for diabesan are based have no more to support them than the published work of A. H. Werner, president of the Solosan Company, the Bureau of Investigation was asked for a report on his medical qualifications. The Bureau reported as follows:

"According to our records, August Henry Werner claims to have been graduated in medicine in Germany. He is said to have come to the United States as agent for the manufacturers of 'Iodeol' and to have formed the Werner Chemical Company to exploit that product. As president of that company he submitted a paper Iodeol on in 1914 which bore the name 'A. H. Werner, M. D., graduate of the University of Strassburg, Alsace.' A search through the lists of medical graduates of the University of Strassburg covering the years 1882 to 1912 failed to reveal the name of Å. H. Werner.

In 1914 a copy of the International Brief. a publication issued by a New York quack, contained, in addition to a full page advertisement of

Iodeol, an advertisement of one A. H. Werner, described as 'Professor Psychotherapy and Biology of the Old Physio-Medical College.' This 'college' has since been exposed as a crude diploma mill. The International Brief purported to be the official organ of the 'International Alliance of Physicians and Surgeons,' of which an A. H. Werner was given as one of the vice-presidents'!

"In 1915 one A. H. Werner was advertising a 'consumption cure' in New York newspapers, and later was convicted of practicing without a license and fined. In 1916 the name of A. H. Werner appears as 'second vice-president' of the 'American Association of Progressive Medicine,' an organization that was exposed in THE JOURNAL, September 19, 1925. In the same year A. H. Werner seems to have been 'medical advisor' for the Bachelet Medical Apparatus Co. In this capacity he applied for advertising space in THE JOURNAL, but the advertisement was rejected. In 1917 and again in 1918 Werner is said to have taken the New York State medical examinations and to have failed each time.

"In 1920 one A. H. Werner was president of the Rhinol Co., Inc., exploiting a 'Specific in Hay Fever.' In 1921 the name of A. H. Werner appears as a member of the board of trustees of the 'Allied Medical Associations of America,' which was exposed in THE JOURNAL, July 5, 1919. In 1924 the name of A. H. Werner was listed as one of those who would present a paper at the 'American Association for Medical Physical Research,' which was dealt with in THE JOURNAL, September 19, 1925."

The biographical files of the American Medical Association-the most complete extant and based on official data-fail to show that there is any other A. H. Werner, calling himself a physician than August Henry Werner.

From the Bureau's report it appears that A. H. Werner, president of the Solosan Company, is not a properly qualified medical authority. The case reports appended to the "Reprint" on diabesan are quite unconvincing. They are so meager and incomplete that nothing is proved either way. The claims for diabesan are not in harmony with accepted facts, nor supported by acceptable evidence; nor does there appear to be any evidence that trypsin-or a preparation such as diabesan, said to contain it-has any value in the treatment of diabetes.-Jour. A. M. A.

Hooper's Anodyne.

The O. P. Hooper Chemical Company, Chester, Pa., shipped in June, 1922, a quantity of "Hooper's Anodyne" from Pennsylvania to New York. The federal authorities seized the product on the charge that it was misbranded. When analyzed in the Bureau of Chemistry it was reported to consist essentially of morphin hydrochlorid, glycerol, sugar, salicylic acid and water, flavored with spearmint. The following claims were printed on the bottle:

"Administered To Children Suffering From Colic Summer Complaint Produces or Teething It A Most Wonderfully Beneficial Effect . . for Violent Colic . . . in Teething."

"For Babies Relieves Colic, Aids Digestion... mades Teething Easy

"Invigorates The Stomach and Bowels, Prevents Vomiting, Also Inflammation Of The Stomach and Gives Tone and Energy To The Whole System.'

"Will almost instantly Relieve . . . Colic."

In other words, this preparation belonged to that vicious group of nostrums sometimes spoken of as "baby killers." The stuff was declared misbranded because the claims made for it were false and fraudulent. In September. 1924, judgment of condemnation and forfeiture

was entered and the court ordered that the product be destroyed.-Notice of Judgment No. 12755; issued March 13, 1925.

Grandma's Sarsaparilla.

The

About one hundred bottles of "Grandma's Compound Sarsaparilla" shipped from San Antonio, Texas, by the Park Laboratory Co. of that city to California in September and November, 1922, were seized by the federal officials on the charge that the product was misbranded. The preparation was analyzed in the Bureau of Chemistry which reported that it consisted essentially of potassium iodid (0.3 per cent.), alcohol (2.6 per cent.) with plant extractives including a laxative drug, sugar and water, flavored with sassafras oil. preparation was declared misbranded, first because the label declared the presence of 10 per cent. of alcohol when actually there was only about 21⁄2 per cent.; further, because it was fraudulently claimed to be a specific for all diseases of the blood, syphilis, rheumatism, erysipelas, pimples, boils, ringworm, female weakness, general debility and all constitutional diseases. In February, 1924, judgment of condemnation and forfeiture was entered and the court ordered that the product be destroyed. -Notice of Judgment No. 12658; issued February, 1925.

Ark-A-Lu.

The Vawter Drug Stores, Monroe, La., in June, 1923, shipped a quantity of "Ark-A-Lu,” which the federal authorities declared was misbranded. The Bureau of Chemistry reported that analysis showed the stuff to consist essentially of Epsom salt, iron chlorid, nitric and hydrochloric acids, and water, with wintergreen flavoring. The label stated in effect that the preparation was an effective remedy and cure for stomach, liver and kidney diseases, rheumatism, piles, "Blood Diseases, Chills, Fever, Ague and Nervousness." These claims, naturally, were declared false and fraudulent and in October, 1924, judgment of condemnation and forfeiture was entered and the court ordered that the product be destroyed.Notice of Judgment No. 12766; issued March 13, 1925.

CURRENT MEDICAL THOUGHT.

Doctors.

Machines last for years and years when they are given careful and proper care. The body is a divine machine, like which there has never been anything made to compare. It is so wonderful, it puts up with so much, that its owner often forgets to give it the care that it demands-and the result is a body that rebels some day in order to attract attention to its needs.

And that brings me to the subject of this talk.

The doctors of the future will be those who keep the body well, instead of treating it when

it gets ill. Medicine is a great science, but the doctor himself can be so much greater than his pills and plasters. As he is in most instances.

One of the closest disciples of Jesus was a physician, and he was known as "the beloved."

Doctors are not honored enough. Thousands of them are martyrs to their calling. Their unselfishness is something extraordinary at times.

Maybe at some not very distant time we shall arrive at the period where we will need little medicine, for we shall have learned more about the care of our bodies in health. But so long as we have with us the noble men who daily give their all for the help of others, let us render to them our greatest gratitude and appreciation.-GEORGE MATTHEW ADAMS, in Philadelphia Evening Bulletin.

Food Allergens and Arthritis.

Food allergy, in J. A. Turnbull's opinion, is an important factor to be investigated as well as other sources of arthritis. A diet should be worked out for each individual, the diet of each depending on his own individual sensitization. In the cases reported by Turnbull, the progress of the arthritis was arrested and the patients were relieved from their joint pains when the foods to which they were sensitive were omitted from their diets. Elimination of the food allergens produced changes of the articular and periarticular adhesions, allowing increased movements of the parts. (Boston Med. and Surg. Jour.) Other manifestations of food allergy should be carefully noted and investigated, and treated on desensitization lines. These ailments are becoming more and more frequent.

Triple Distilled Water in the Treatment of Children.

Theodore Le Boutillier (Archives of Pediatrics) recalls that the intravenous use of distilled water has been employed for some time in massive doses, though small quantities, as now given, have produced speedy and spectacular results in many cases. With this treatment there is an average increase of the red cells, which lasts over a week. the white cells are not increased, but the hemoglobin is increased; the coagulation time of the blood is decreased, and the carbon dioxid content of the blood is changed remarkably.

The triple distillation of tap water removes all possible contamination or any poisons. The water should be freshly prepared and used within three or four days at the most to prevent absorption from the glass container.

Two methods of administration have been used. The first, and by far the best, is the intravenous method. The solution when injected should be as close to the body temperature as possible. Where a vein cannot be found it may be given intramuscularly, but this is distinctly painful for about fifteen minutes. The dose varies with the age and condition of the

patient, from 0.5 to 1.5 c. c. intravenously, or 2.0 to 3.0 c. c. intramuscularly. In a chronic or subacute condition, one treatment a week will be sufficient, while in acute cases the treatment should be given at about two or three day intervals until a maximum result is obtained, at which time they should not be given more frequently than at weekly or two weekly intervals. Too large a dose will increase all the symptoms for which the patient is being treated.

Remarkably good results were obtained in cases of acidosis, some of them associated with cyclic vomiting, in pertussis, bronchial asthma, various forms of neuritis, scarlatinal rheumatism, urticaria and eczemas, and angioneurotic edema.

Pernicious Anemia.

Dr. Frederick M. Allen, director of the Physiatric Institute of Morristown, N. J., in an address before the Allegheny County Medical Society, reported encouraging results of a new treatment for pernicious anemia.

The first step in treatment consists in locating and removing surgically the focus of infection, believed in many cases to be in the teeth. The gallbladder is thought also to be a seat of infection in some cases. A second phase of the treatment is a diet planned to favor survival of the red blood corpuscles.

Complete cures are not claimed, but gains in health and strength seem to justify greater hopes than hitherto had been entertained.

races.

They are relatively very scarce in the African and American black tribes. In Europe its distribution is even. That it occurs in greater number in urban population is due, besides their sedentary habit, also to the fact that the conservatively thinking village people are accustomed to the thought that as their ancestors so also they have to struggle with urinary troubles in old age. In Tyrol (late Austria, now Italy) where goiter is endemic, hypertrophy of the prostate is very frequent also. This can be explained only with the correlation of some internal secretion disorder. That hypertrophy of the prostate is not dependent on previous inflammation is proved by the fact that in Egypt, where prostatitis bilharzica is a very frequent disease, hypertrophy of the prostate is relatively infrequent.

Vaccine for Rocky Mountain Spotted Fever.

The United States Public Health Service, one of the duties of which is to investigate diseases of man with the ultimate purpose of devising means for prevention and cure, has recently announced the results of experimentation which lead to the belief that a most unusual vaccine has been produced which may protect human beings against Rocky Mountain spotted fever.

"Rocky Mountain spotted fever, sometimes called tick fever, which occurs principally in certain northwestern states, has been the subject of investigation and experimentation for a number of years," says Surgeon General Cumming. Little was known of the disease before 1902. It has an exceedingly high fatality rate; in some localities about 7 patients out of every 10 die.

It is a fatal disease when contracted in the laboratory. Assistant Surgeon McClintic, an officer of the Public Health Service, contracted Rocky Mountain spotted fever while engaged in experimental studies in Montana and died in line of duty, as did also Laboratory Assistants William E. Gettinger, and George Cowan -all martyrs to science.

The disease is transmitted by ticks. A peculiar feature of the virus which produces this fever, a feature discovered by Public Health Service investigators, is that it passes through developmental phases in the tick-the intermediate host-whereas it has no such phase in man or animals.

At one period in the life of the tick, the virus of the disease as obtained from the ticks will not, when inoculated, produce the disease in animals. This period corresponds in time with the hibernating period in the life of the tick, or at least to the period of its At life in which the tick takes no food.

another stage of development, corresponding to the feeding time of the tick, the virus is highly infective and virulent.

In 1923 and 1924 the investigators prepared a protective vaccine made by extracting and attenuating the virus from macerated infected ticks during the stage at which the virulence of the virus was highest-a period following the ingestion of animal blood by the tick; and this vaccine was found to protect laboratory animals from the disease. During the present year these experiments were continued and the vaccine was tested on monkeys and man. It was proved that it protects guinea pigs. rabbits, and monkeys, and it is now believed to have modified the severity of the disease in the case of a man who contracted it after having been vaccinated. The man was engaged in dipping cattle in Montana-an occupation involving exposure to the infection. Together with several other men, he was vaccinated late last spring, and some time afterward he contracted the fever. This case was exceedingly mild, though it is usually severe and highly fatal in that locality. None of the other vaccinated men contracted the disease. Should this vaccine fulfil the expectations confidently hoped for, another advance will have been made along that high road of preventive medicine known as "immunology," toward the goal set by Pasteur when he stated that it was within the power of man to cause all germ diseases to disappear from the world.

5. Anaphylaxis can be prevented by giving the second injection before the tenth day.

6. Anaphylaxis can be passively transferred from mother to her offspring; that is, if mother should be given one injection, and her offspring should be injected with her blood, and then with an injection of the sensitizing substance, the offspring will develop anaphylaxis.

Experiments seem to establish definitely that the anaphylactic reaction takes place not in the blood stream, but in the fixed tissue cells.

Practically, the knowledge of anaphylaxis is very important.

1. Some diseases can be diagnosed by taking advantage of the fact that if a person is unusually sensitive to a certain infection because he is infected with it, an injection of a specific bacterial protein will cause a sharp reaction and will help diagnose his infection; on this principle are based such tests as tuberculin; luetin (for syphilis), and mallein (for glanders), Schick's test for diphtheria; a small amount of specific bacterial protein is injected into the skin, and if a person suffers from an infection caused by this particular bacterium, a marked reaction shows itself both at the site of injection and in the general condition of the patient.

2. It explains the mysteries of the so-called "serum disease"-disease which follows the administration of various serums. In many cases the serum should be given in very small doses before the full amount given in order to avoid the possibility of anaphylaxis.

Besredka, of Paris Pasteur Institute, developed a more perfect technic of "desensitization." that is, avoiding the anaphylaxis, by testing the sensitiveness of a patient by first introducing minute quantities of the serum subcutaneously.-EISENBERG, Principles of Bac

teriology.

Anaphylaxis.

Anaphylaxis is the opposite of prophylaxis -the latter is the prevention of infection, while by anaphylaxis we mean sensitiveness due, not only to bacteria, but to any other proteins. It explains why some people are left more susceptible to infectious disease after one attack than ever before; why some people cannot eat certain kinds of food, as, e.g.. shellfish; why in some people injection of a serum (not only immune serum, such as diphtheria, but even a normal horse serum which is given to control hemorrhage) produce dangerous symptoms of shock, and at times, even death. The main facts about anaphylaxis can be summed up as follows:

1. Any protein-whether bacterial, plant or animal-can produce anaphylaxis.

2. The second dose of such protein may be infinitesimally small.

3. If the animals do not develop anaphylaxis after the second injection, they remain forever immune.

4. The greatest liability for the development of anaphylaxis is between the tenth and fifteenth day after the first injection.

THE HEALING GODS OF ANCIENT CIVILIZATIONS. By Walter Addison Jayne, M. D., Emeritus Profes sor of Gynecology and Abdominal Surgery, University of Colorado. 600 pages. 7 illustrations. Published by Yale University Press, New Haven, Conn. Price, $5.00.

The author has delved deeply into lore of ancient peoples and presents the leading facts gleaned by his great labor. It is a wonderful presentation of the superstition, imagery and medical worship of periods of time long since passed, but which archeologists are constantly uncovering and explaining to the modern world. (Continued over next leaf)