Correspondence.

PICHI IN VESICAL TENESMUS.

In the early part of last March I was called to see MRS. H., an aged lady whom I found suffering extremely from irritability of the bladder, with vesical tenesmus. The urinogenital organs generally were in a state of great irritability. She had suffered from this difficulty for several years, and, to still further complicate matters, she was suffering from a bad form of pruritis vulvæ that had also existed several years.

After using various remedial measures for the relief of the vesical tenesmus and extreme irritability of the bladder, with but only partial success, I determined to try pichi, and gave her the following:

B Fl. ext. pichi, j,

Fl. ext. hydrangea, 3j,
Fl. ext. hyosciam, 3 ij,
Syrup, 3ij.

Sig. A teaspoonful three times a day and at bedtime.

This seemed at once to allay the irritability of the bladder, and with it the vesical tenesmus; the extreme irritability of the soft parts also began to abate. The obstinate pruritis that has tormented this patient so long is also greatly improved, and at this writing bids fair for an ultimate cure.

I have strong faith in pichi and in the above case attribute the beneficial results attained mostly, if not entirely, to its use.

I have this case still under treatment and shall continue the above remedies, feeling confident that, although it has existed so long, and resisted the best efforts of several physicians for its cure, by steady perseverance a perfect cure will be effected.

Fairfield, Iowa.

A. G. WARD, M. D.

CASCARA CORDIAL IN PROLAPSUS ANI A case of prolapsus ani in a child six years of age was given under my charge for treatment last fall. On examination the subjective symptoms were, constant constipation of the bowels. The case had been under the charge

of two physicians prior to the engagement of my services, and knowing the qualifications of these gentlemen, I was assured that the usual routine of astringents locally applied, had been tried without benefit. I began the treatment on November 26, by giving twenty drops of cascara cordial three times a day, and apply. ing glycerole of tannin locally after each defecation. The cordial was to be given three times each day or as often as necessary to produce two evacuations of the bowels each day.

The case showed no evident signs of improvement for a month, and the child's parents had almost despaired of success and were on the eve of discontinuing the treatment, but being assured that to complete a cure in the case required perseverance, they continued the remedy for five weeks. The cure is now to be considered complete, as the prolapsus has been absent for two months.

The cure, I am sure, depended on, and was the sequel of the administration of the cordial, as attested by the length of time required. The glycerole of tannin would have shown its beneficial effects sooner than was shown in this case, hence I attribute the cure to the specific effects of the cordial on the bowels, toning them, and thereby overcoming the relaxation which was the cause of the constipation and the prolapsus. THOS. M. BUTLER, M. D.

Funny Louis, La.

ERGOT AND BELLADONNA IN ENURESIS. MRS. H. consulted me in reference to her daughter, aged nine, who had been a sufferer from enuresis for the past four years, notwithstanding she had been for three years of the time under the care of a competent physician. I placed her immediately on fluid extract of ergot (P., D. & Co.) and belladonna, and asked her to report in ten days. This she did to the effect that the child had greatly improved. I wrote a prescription for the same drugs, but at the end of the second ten days the report was not favorable. This experience being repeated my suspicions were aroused as to the reliability of the preparation of the ergot administered, and on inquiry I discovered that the druggist had employed the fluid extract prepared by another firm than Parke, Davis & Co. The fluid extract manufactured by this firm was again resorted to, and improvement again set in and continued steadily until complete recovery resulted. I have deemed it wise to mention this important practical point in connection with this case, inasmuch as had the use of the unreliable preparation been persevered in this testimony to the value of the drug would not have been forthcoming. It becomes the practical therapeutist to have regard to the quality of the preparation of the drugs which he prescribes. Success may often be dependent on little things like this.

ARLINGTON, Indiana.

T. F. GLOSS, M. D.

The Medical Age.

A SEMI-MONTHLY REVIEW OF MEDICINE.

JOHN J. MULHERON, M. D., Editor.

-PUBLISHED BY

GEO. S. DAVIS, Medical Publisher, Box 470.

DETROIT, MICH., MAY 25, 1887.

Notes.

The late meeting of the Michigan State Med. ical Society, held at Lansing on the 12th and 13th insts., was a pronounced success, the attendance being one of the largest in the history of the organization, and the reception given by Mr. and Mrs. Barnes being voted very recherché. The members were also very much entertained by visits to the state institutions centred at the capital-the Agricultural College, the Reform School and the Asylum for the Blind. And in addition to all these, the legislature was in session, and the eloquence of the Solons was toned up to a point in keeping with the importance of the occasion. With this aggregation of attractions the meeting was, of course, a success. Being a member of the society we dare not violate its rules further than to state that there were a number of excellent papers read-not enough, however, to mar the general pleasure of the occasion. The Michigan State Medical Society possesses the modesty of merit to a painful degree, and forbids the publication of any of its papers, except in its own Transactions, which usually ap in from three to six months after the meetings adjourn, and are circulated among the members of the society. This prevents that vulgar publicity which would ensue were members permitted to publish their papers in medical journals which are circulated among, and read by the profession. If the medical profession desires to avail itself of the richness which is secreted by the Michigan State Medical Society, it must attend the meetings and receive the droppings as they fall directly from the lips of the assembled wisdom. To disseminate this richness through the ordinary media, would be a species of sacrilege. Such dissemination does well enough in the case of your common State Medical Society, but for Michigan, never-r-r.

The Texas Medical Journal says in connec tion with a decision not to have wine at a banquet to be given by the Texas State Medical Society: "The days of wine-banquets at medical conventions in Texas, we trust, are over,

never to return." Anent this the Medical Record has the following, and we venture to believe that the words will still strike some responsive chords in the breasts of the profession: "There are doubtless some local reasons for omitting the banquet, and we are not disposed to question the wisdom of our vinicidal brethren of Texas. It is a mistake, however, to think that medical meetings can flourish on scientific papers, cases, specimens, etc., alone. The doctor likes, as well as anyone, to get rid of the shop at times and indulge to his heart's content in the pleasures of good-fellowship. State medical societies are most prosperous and enjoyable in proportion as they give occasion for the agreeable social intercourse, combined with the presentation of well-prepared papers and discussions. It is unfortunate if the liberality of spirit and self-restraint of Texans are not so cultivated that banquets can be held at which those wishing to drink wine can do so, while those not desiring it can be served with the potable waters of the locality. Such arrangements prevail at the present time in most civilized sections, and Texas is eminently a civilized and progressive country."

The following explains itself: "DR. DANIEL G. BRINTON, who has been for a number of years editor and publisher of the Medical and Surgical Reporter and the Quarterly Com pendium of Medical Science, begs to inform his many professional friends, and the medical public in general, that he severed his connection with those journals on the 1st of May, 1887. He felt obliged to take this step by the oppo sition of the parties who own those journals to certain changes in the Reporter which DR. BRINTON considered necessary improvements, and justly due in a five dollar journal to subcribers and advertisers. The requisite authority to make these having been refused, he could not conscientiously continue to publish it at that price. It is not his intention to retire from the arena of medical journalism; on the contrary, he hopes in the early autumn to announce his connection with a journal which will fully meet the legitimate demands of the medical public of the day."

Bearing on the communicability of diphtheria and the practicability of its restriction, DR. BAKER presented to the meeting of the State Medical Society, of Lansing, on the 13th inst., a table and a diagram based on a compilation of reports by local health officers in Michigan, for the year 1886. They exhibit the results of isolation and disinfection in out. breaks of diphtheria. In the 102 outbreaks where isolation or disinfection or both were neglected, the average cases per outbreak were a little over 16, and the average deaths were 3.23; while in the 116 outbreaks in which isolation and disinfection were both enforced, the

average cases per outbreak were 2.86 and the average deaths were .66; indicating a saving of over 13 cases, and 2.57 deaths per outbreak, or 1,545 cases and 245 deaths during the year, by isolation and disinfection in the 116 outbreaks, compared with those in which nothing was done.

This is what the microscopist says he does when he drinks water from the lea: he gulps down infusoriæ, and quarts of raw bacteriæ, and hideous rotatoriæ, and wriggling polygastricæ, and slimy diatomaceæ, and hard-shelled ophryocercinæ, and double-barrelled kolpodæ, non-loricated ambædæ, and various animalculæ, of middle, high, and low degree, for nature just beats all creation, in multiplied adulteration.

The council of the English Society for the Study and Cure of Inebriety, have completed arrangements for an International Medical Congress, to be held at Westminister Hall, London, July 5th and 6th, 1887. The object of this congress is to present and discuss the problems of inebriety medically, and from a purely scientific standpoint, by the best authorities, thus laying the foundation for a broader and more exact study of this subject.

The sample-copy fiend is like the poor, in that we have him with us always. His request, however, varies a little at times, as to style. The following is a verbatim copy of the latest of which we are in receipt: "Please send Me some of your Sample Coppies of your Reading Mater, I am a Practissing Phasition an alpathic." The communication is received and filed (in the waste paper basket) under the standing rule governing the disposition of such favors.

Medical Progress.

EUCALYPTUS A SPECIFIC FOR TYPHOID. — In a paper in the Practitioner for May, 1885. I pointed out the great benefits to be derived from the administration of oil of eucalyptus in the treatment of typhoid fever, and the very successful results I had obtained therefrom in a large number of cases; but in notes of this paper that appear in other journals a doubt was expressed as to the diagnosis, . . whether it was true typhoid I had been treating. This was evidently on account of the results I showed, and the Journal de Médecine de Bordeaux -propos of the early reduction of the temperature I had obtained-said "de sorte qu'on est en droit de se demander si c'est bien à la fièvre typhoide qu'on avait affaire.”

No manner of doubt exists in my mind, but it would be a grievous pity if these doubts deterred others from the use of such a valuable remedy as this has proved in my hands, and I purpose, therefore, giving grounds for my belief in the correctness of that diagnosis in the great

majority of the cases; granting for the sake of accuracy that some few of the shorter or less severe ones may possibly have been simple continued fevers, or the "typhoid state" arising in the course of some other affection. Indeed a recapitulation of the symptoms of those cases which I enumerated in my former paper induces one to ask to what other disease they could possibly relate.

Diarrhoea, delirium, eruption, right iliac gurgling, enlargement of spleen, tympanitis, hot, dry, harsh skin, absence of petechia, dry fissured brown tongue, bloody sordes, epistaxis, accelerated pulse, and pyrexia were so commonly present that it would be necessary to doubt the accuracy of received teachings to reject typhoid fever as the complaint suffered from.

Certainly the temperature varied entirely from the prescribed manner and order we are taught as peculiar to typhoid. This, however, is because the eucalyptus obtains control over the temperature at such an early period after its administration as to obviate the maintenance of its height for the usual period (i. e. until the middle of the second week) given by the handbooks. Thus in the chapter on abdominal typhus (typhoid) in WUNDERLICH'S Clinical Thermometry we find the following:

"We may exclude abdominal typhus when between the fourth and sixth day the evening temperature in a child, or adult under middle age, never reaches 39.5 C. (102.1 F.), and indeed if it has failed to do so two or three times; abdominal typhus may be excluded when as early as the second half of the first week considerable or progressive diminutions of the evening temperatures are met with."

By reading on, however, I find the following saving clause, which shall be my apology for believing that such diminutions might happen if a controlling agent such as this medicine were exhibited:

"Or the course appears to be cut short (the italics are mine) and a retrocedent type finds a very early expression, which may lead to complete defervescence even in the beginning of the second week. In not a few cases it happens after therapeutic measures at the beginning of the disease, that this takes the desired turn very early, even after a laxative. If the disease were previously well pronounced, this termination is no reason for altering the diagnosis.

I have not, therefore, as may be seen, attempted to advance anything contrary to the dictum of such an authority as WUNDERLICH in support of my advocacy of the claims of eucalyptus to be regarded as a controlling agent of typhoid fever, and as showing what seems to me the absolute modification of the disease under this "therapeutic measure."

And it is in this complete alteration of the order of the symptoms, of the "fastigium," of the crisis, that we get a feasible explanation of the mode of action of this drug. First, I believe it acts as an antiseptic, shortening the duration of the fever by destroying its cause, rendering inert its bacillus; and, secondly, by lessening the severity of the symptoms by its locally acting and acknowledged healing powers. The inflamed and ulcerated Peyerian glands are soothed, and further spread of the mischief arrested.

That I am not alone in my view of the pos

sibility of this method of treatment by striking at the root of the disease, I see from a paper in L'Union Médicale, by M. BOUCHARD, of the 24th August, 1886, on "Intestinal Antisepsis," being the result of investigations he has carried on for years. He therein relates how by the combination of certain antiseptics with charcoal he has obtained remarkable results in the treatment of typhoid fever, naphthol being the agent he has employed with the best results. I have not seen the original paper and am quoting from a review of it, but the treatment and the reasoning seem to me to be pretty nearly identical with my own, and his results are said to be "remarkable."

For the other symptoms apart from the temperature, the diarrhoea-present in the great majority of cases from the earliest stages-was typical; stools thin, generally light yellow or clayey color, pea soupy and stinking, sometimes of a dark brown shade, mucous shreds and blood being not infrequently present.

Low muttering delirium, semi-consciousness, and picking of the bed-clothes existed in some cases, whilst in several there was subsultus tendinum during the height of the fever.

The gurgling in the right iliac fossa I invariably sought for as a very diagnostic sign, and I seldom missed it, or the pain and tenderness on pressure thereabout.

The characteristic rash I found by careful search to be present in more than half the cases, coming out on the abdomen and chest, lasting three or four days, dying away and being replaced by other spots, these in their turn disappearing. Minute sudamina were often present, but in this hot climate when the dryness of the skin is replaced during the amelioration of the symptoms by perspiration, the diaphoresis is so profuse as to account fully for them.

The tongue presented the usual furred ap pearance, being according to the intensity of the disease dirty red, brown, dry and leathery, fissured and hard. In the worst cases the teeth, lips, and gums were covered with bloody sordes.

The enlargement of the spleen was very distinct in a good number of cases; and epistaxis was frequent. Pulse accelerated in keeping with the fever, and the great emaciation which is so generally effected by typhoid was marked; but, on account of the shorter duration of the attacks, in a less degree.

As an external corroboration of this being “bien la fièvre typhoide " I would mention the fact that in the vital statistics for the colony of Queensland, typhoid fever stands third on the list in order of fatality, the mortality being: in 1883, 8.89, in 1884, 18.15 and in 1885, 6.19 per 10,000 of population. Therefore it is impossible to suppose that my cases were not typhoid, a very large proportion of this number having occurred in the Brisbane district.

Again, in the cases which I attended there were very frequently others in the immediate vicinity attended and certified as typhoid by other medical men. In one group of six cases (appended below) attended by me at the same time in one house, another member of the family had just died from typhoid fever-as certified to by the medical man in attendancebefore I was called in. In the case of a young man I attended for this there were typhoid fever cases in the houses on either side, and in

other houses in the street. These cannot have been typhoid and my cases all exceptions.

M. BOUCHARD in the above-mentioned paper on "Intestinal Antisepsis " mentions that after the employment of naphthol and methylnaphthol he obtained fæcal matters nearly free from microbes, and ascertained that these had lost their noxiousness. I have long believed that the fæces were rendered antiseptic by the administration of eucalyptus, for some considerable amount passes through with the motions, as evinced by the smell. If the germicidal property is active in the body on the nidus of the bacilli-the Peyerian patches-a fortiori would it be operative away from the warmth and moisture of the bowel? Practical experience leads me to believe this is so, for I have never seen the attendants on cases treated with eucalyptus catch the disease. My eldest daughter, a girl of thirteen, had the worst at

tack of typhoid last year-in the heat of the summer-I ever saw, and my wife and two lady friends who nursed her through it all, none of them having had typhoid, escaped unharmed. In the group of six before mentioned the mother and two sisters-neither of whom had had typhoid-were the sole attendants on the cases, and did not suffer, though removing the dejecta, etc.

Of this group, all treated at the same time, and under the same circumstances, I here append the pulse and temperature record, as also that of a man and woman attended in another house; all showing the result of treatment by this drug. The evening temperatures I was unable to get, as distances in general practice here debar one from the opportunity of getting twice daily to the cases, and amateur observations are unreliable.

The above were all treated with the oil of eucalyptus in doses of from five to ten minims. Of the six all had diarrhoea, none hemorrhage. Five of them had the rash well developed, H had no rash. K, H, and A, were slightly delirious; whisky was administered freely, champagne to K and D. Chicken broth and beef tea to all after the diarrhoea had subsided. Milk during diarrhea. The other two cases were treated in a similar way. K had furious delirium and severe diarrhoea with hemorrhage, but no rash. M had neither of the former but had the rash fully developed.

In the general range of my cases the duration of the illness till the complete establishment of normal temperature has varied from a maximum of twenty days in one case to the minimum of eight days. The average duration has been about fourteen days.

The mortality since I wrote my former paper on this subject in the Practitioner nearly two years ago has been absolutely nil. I have not lost a single case of fever of any kind, and I have had a large number constantly under treatment, all having been typhoid with the exception of a few cases I put down as "low fever" for accuracy.

On this I would recommend a very thorough trial of the use of eucalyptus in all zymotic diseases. In typhoid where the fear of evil is so clearly established as localized in Peyer's patches, the immediate application of the remedy is practicable. I believe eucalyptus to be a specific remedy.

-LEIGHTON, London Practitioner.

ELECTRICITY IN THE TREATMENT OF CERVICAL CATARRH.-The use of electricity in the treatment of diseases of women constitutes one of the most important advances in medicine. It is probable that we are only beginning to recognize the value of this agent, and that the future will show that it has a much greater utility than has yet been given to it.

From LUTAUD'S L'Obstetrique et la Gynecologie en 1886, we learn that JOURET treats catarrh of the neck of the womb by faradization of the uterus, and galvano caustic applications to the cavity of the neck. The purpose of the former is to excite contractions of the uterus, and thus relieve its engorgement and the hindrance to circulation, a condition so liable to occur from the anatomical structure and function of the organ. In all autopsies of chronic

The

For the application JOURET directs that the patient should lie upon her back, with the pelvis somewhat elevated, and that the bifurcated positive pole (covered with moistened chamois skin) should be applied to each side of the recti muscles just above the pubes. negative pole, having the form of a uterine sound, and covered with caoutchouc to a little more than an inch from its extremity, is introduced into the cavity of the neck, or of the body, if the internal os permits. TRIPIER'S instrument is preferred; by it the number of interruptions may be made to vary from fifty to three thousand per minute, and the current can be graduated in tension and intensity. In uterine faradization the intensity of the uterine contractions should be progressively increased according to the sensations of the patient; but when the pain becomes decided, the intensity should be lessened. The duration of

a sitting will vary from five minutes as the minimum to ten as the maximum, according to the sensibility of the person, or the atony of the uterus, the degree of the engorgement, and the length of time it has continued. After an application, if it be properly conducted, the patients, nine times out of ten, express themselves as feeling lighter and able to walk better.

That which TRIPIER has called the chemical galvano-caustic of the cavity of the neck, has been defined by him as a potential cauterization of the cervical tract by the continuous current. JOURET does not regard this as in all cases indispensable, but it is necessary sometimes in consequence of the development of the glands of the cervix, forming the so-called ovula Nabothii; sometimes by the formation of hypertrophies of the mucous tissue which give origin to a thick, creamy, purulent discharge, or which, when ulcerated. cause hemorrhages. In the application of the constant current, a large plate of tin, covered with agaric or chamois which is thoroughly saturated with cold water, is placed upon the abdomen, or upon the thigh, and is the positive pole. The caustic electrode, the negative, is then introduced into the cervix, which is exposed by a speculum; if cauterization of the uterus is desired, the pole is passed into its cavity. Usually intensity of the current is from fifteen to twenty milliampères, and the sitting is from five to ten minutes. The cauterization is, if necessary, repeated according to indications-that is, until the disappearance of the abnormal secretions arising from inflammation of the mucous membrane and from the hypertrophied glands.

JOURET states that he applies this electric treatment almost invariably in chronic endometritis, and that a long experience has led him to prefer it to any other method of treatment, because of the facility of execution and the constancy of the favorable results.