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Texas; C. W. Johnson, M. D., San Antonio. Texas; D. W. Holmes, M. D., Bellevue, Texas.

The following resolution was passed:

"Resolved-That a directory of the Eclectic physicians of Texas be prepared by the Secretary and a copy sent to each member of the the Association."

Resolution of thanks to the Commercial Club for the use of their Auditorium and to the press of the City for the generous manner in which the proceedings of the convention were handled were adopted.

Installation of officers concluded the business of the Association after which a general discussion was indulged in pertaining to the good of the cause. Visitors and members freely entered into the discussion and general good feeling prevailed.

REPORT OF SECRETARY.

As Secretary of the Texas Eclectic Medical Association, I beg to make the following report:

Through the influence of the Texas Medical Association in the wide publication of its proceedings in State papers and all our journals, more interest has been manifested and a greater number of our Eclectics have come to our State during the last twelve months than in any previous year during my relation to said Association. During the year I have had more correspondence with physicians throughout the United States than I have previously had during the same length of time. I can also say that from my observation as Secretary in constant touch with Texas Eclectics, that our men throughout the State are prospering and are standing by their principles, but I find quite a number of good men who are not identified with our Association. I would urge every Eclectic to not only join our Association, but take an interest in our work and make every effort to attend our meetings. L. S. Downs, M. D., Secretary.

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As you well know from previous notices sent you, our Association is now an assured fact. Our desire is that the Eclectics of North

Texas get better acquainted. Our next quarterly meeting will be in Bonham, Nov. 23, 1905, 10 a. m., in Woodman Hall. A nice program has been, not only prepared, but a written guarantee given that each writer will be there with the goods, as follows:

"Appendicitis-Its Medical Treatment," Dr. W. E. Bridge,

Gober.

"Abortion and Its After Treatment," Dr. M. E. Daniel, Honey

Grove.

"Placenta Previa," Dr. J. A. Lanius, Bonham.

"Bilious Remittent Fever," Dr. D. W. Holmes, Bellevue. "Typhoid Fever," Dr. C. W. Watson, Lannius.

"Texas Eclectic Medical Association," H. H. Blankmeyer, Honey Grove.

Come and be one of us.

BONHAM, TEXAS.

H. H. BLANKMEYER, M. D., President.

C. W. WATSON, M. D., Secretary.

J. A. LANIUS, M. D., Corresponding Secretary.

Bryonia is of special value in the coughs of pneumonia and bronchitis.

In fatty degeneration of the heart, give iron, quinine and strychnine as general tonics.

Hysteric convulsions, when not caused by organic changes, are promptly controlled by gelsemium.

A large gall-bladder, with jaundice, usually indicates obstruction by neoplasms or scar contraction; not by gall-stones.

Chronic jaundice, without remissions or intermissions, is almost invariably due to malignant obstructive disease, and not to calculus.

Tenderness of the gall-bladder signifies an infective inflammation of the gall-bladder, whether due to the presence of a calculus or not, and in mild cases may be the only distinguishing sign. The best method of demonstrating such tenderness is that of Murphy, who says, "The most characteristic and constant sign of gall-bladder hypersensitiveness is the inability of the patient to take a full, deep inspiration when the physician's fingers are hooked up deep beneath the right costal arch below the hepatic margin. The diaphragm forces the liver down until the sensitive gall-bladder reaches the examining fingers, when the inspiration. suddenly ceases as though it had been shut off."

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While the field of this journal is the entire field of Medical and Surgical Science in the advanced light of the present day, its chief mission is the development of knowledge concerning the most direct-the specific-action of drugs in rational lines.

The editors are not responsible for the statements or opinions of contributors.

Short origina! articles are invited from any reader, whether a subscriber or not.

Address all exchanges, books for review, communications, etc., to, and make all money orders, drafts, checks, etc., payable to

THE CHICAGO MEDICAL TIMES, 100 State Street, Chicago.

Entered at Chicago Post Office as Second Class Mail Matter.

Editorial.

CHOREA.

The form of chorea most often met with is the mild form described in England by Sydenham, many years ago, as chorea minon or Chorea Anglicorum. The term St. Vitus dance is erroneously applied to a form of religious mania observed in pilgrims on their way to the grave of St. Vitus. This is a true chorea, Chorca Germanorum, but is uncommon, much more severe than the common form, and may be fatal. It is sometimes hereditarily transmitted from parent to all the children in the family. The minor form is really the true chorea, and has the following char

an actual spasm of a single group

of muscles, or in an occasional case there may be universal spasm. In the onset it is limited usually to a single group of facial muscles, then it may extend to one and then to two or more groups, usually on the same side of the face and finally to the muscles of the shoulder and neck and then to the arm. These spasms may exist uncomplicated; may continue for a certain length of time, to then disappear or become chronic. They may be followed by certain psychoses, although in a few cases the general health is not impaired

In those cases in which it appears in late childhood or early youth, there is often a spinal tenderness which develops over the lower cervical or the upper dorsa! vertebræ, from which the choroic movements seem to start.

It is more common in females than in males, occurring in the proportion of five females to two males. It occurs in children of a neurotic diathesis and those who are easily frightened, especially if debilitated. from previous disease. In 38 cases out of 252 reported by Ashby and Wright, there was a history of severe fright having occurred in from one day to one week preceding the attack.

Among other predisposing conditions are: Overfeeding; feeding with inappropriate and nerve-exciting food and drinks-coffee, tea,

wines, spiced food and all other irritants of the nervous system; psychic influences and psychic trauma; too little sleep. It has often been observed that a large number children were attacked by chorea, which disease originally only existed in one child in institutions where many children are together. This justifies, as a hygienic rule, in the treatment of this affection, the separation of such children from others.

Rheumatism also is considered as a cause of chorea, and its action in the production of this disease is twofold: First, where the rheumatic poison is directly the cause, and, secondly, where, by rheumatic metastasis, pericarditis occurs, or endocarditis leads to the formation of emboli, which finally have become lodged in some of the finer blood vessels of the brain, and there, by pressure, cause these spasms.

This state of embolism is also the reason why, on auscultation, which should never be neglected in a case of chorea, we detect heart murmurs connected with an insufficiency of the mitral or aortic valves.

There are, however, many cases of chorea where no heart affection of a rheumatic origin is found, or at least where it is not discovered until the chorea has been cured, and these, I think, have not been caused by emboli in the brain which had their origin in the rheumatic affection of the heart, but by a di

rect action of the rheumatic poison upon the system at large.

In one case observed by this editor in a boy of seven, rheumatism was first present for nearly a year. The choroic symptoms developed shortly after the appearance of the rheumatism, but did not cease with the end of the rheumatic symptoms, nor was it cured until a phymosis with attachments of the prepuce to the head of the penis was operated upon and cured. Nearly a year after the cure of the chorea there was developed a sudden and violent endocarditis to which the child succumbed.

It has been stated, in regard to the seat of the disease, that its origin is in the corpus striatum and the optic thalamus. Experiments on dogs have shown that, after severing the spinal cord, the chorea only persisted in the lower extremities, from which it was concluded that the seat of the disease in dogs was in the spinal cord. How far the results of these experiments hold good in regard to man must, for the present, remain undecided. Although the seat of the disease is, in most cases, in the brain, there is often involvment of a portion of the cord also in children. There is a wide discrepancy of opinion between different authorities upon this subject.

The prognosis will be favorable in general, but may be grave in very severe attacks, where the patient

has no rest at all, suffers from the loss of sleep, and finally perishes from exhaustion. These, however, are of rare occurrence.

We may say if the disease is diagnosed early, and all the concomitant conditions are subjected to immediate and persistent treatment, that the prognosis is favorable in by far the larger number of

cases.

The treatment should be conducted on the most rational basis possible. Every possible cause should be removed and all results apparent which may have been produced from those causes should be treated promptly and energetically. Any depravity of the blood should be anticipated, and corrected if present. The blood should contain the largest possible amount of red blood corpuscles, and the full number should be preserved by iron tonics and restoratives.

The next important consideration is rest. The patient should have quiet and rest enforced upon him to the extreme degree. There should be no exercise accompanied with excitable conditions, and if the case is at all complex and persistent the patient should be put to bed and kept there..

There is not a large number of medicines that may be given in this connection, but success has followed a few carefully selected. Each concomitant condition should be treated as its direct indications suggest. Then those agents which

act directly on nervous tremorwhich antagonize irregular muscular movements and inco-ordination are selected. These are cimicifuga, scutillaria, valerian, gelsemium, passiflora, the bromides, exalgine, antipyrine, chloral and arsenic. Many others have been used with good results. Iron is nearly always indicated from the tendency toward anæmia, and the stomach conditions present usually demand hydrastine, nux vomica and digestives.

From two to five drops of cimicifuga may be given every two hours in conjunction with gelsemium. valerian or an infusion of scullcap. This is the standard remedy.

Many

Arsenic is the sine qua non of the old school. This may be given in doses of from one to five minims of Fowler's solution three times daily. It is often slowly increased to ten minims and then slowly decreased, to be subsequently increased again as the patient endures. it. I have not needed it. writers were enthusiastic for a while over antipyrine, and it has doubtless cured some stubborn cases by its depressing power. I have used exalgine in many cases with most happy results. It must be given in doses of not more than one-half grain to small children and slowly increased every three hours to the extreme dose of three grains. Many will not stand two grains without cyanosis. If managed carefully, it is a sure remedy in a large

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