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Assistant Surgeon A. R. Thomas to rejoin CURRENT EDITORIAL COMMENT station (St. Louis, Mo.,) November 16, 1894.

Assistant Surgeon H. S. Cumming to proceed to Norfolk, Va., for temporary duty, November 22, 1894. Granted leave of absence for eighteen days, November 27, 1894.

BOOK REVIEWS.

ESSENTIALS Of Diseases of THE SKIN. By Henry W. Stelwagon, M. D., Ph. D., Clinical Professor of Dermatology, Jefferson Medical College, etc. Third Edition, with 71 letter-press cuts and 15 half-tone illustrations. Philadelphia: W. B. Saunders. 1894. Pp. 270. Price $1.00 net. Saunders' Question Compends, No. 11.

The popularity of this book and the favor with which it has been received have led to the issue of this third edition. It differs from the older editions, which were noticed in these columns, by a thorough revision with various corrections and additions when these are necessary. Fifteen half-tone illustrations have been introduced, which are a great help in the study of the skin diseases which they illustrate. The letter-press of the book is all that

could be desired. HAND-BOOK OF MATERIA MEDICA, PHARMACY AND THERAPEUTICS, etc. By Samuel O. L. Potter, A. M., M. D., M. R. C. P., London, Late Professor of the Theory and Practice of Medicine in the Cooper Medical College of San Francisco, etc. Fifth Edition, Revised and Enlarged. Philadelphia: P. Blakiston, Son & Co. 1894. Pp. 805. Price $4.50.

The revision of the United States Pharmacopeia has caused the issue of new editions of the most prominent works on materia medica. The articles on alcohol, carbolic acid, creosote and digitalis have been rewritten and many new ones have been added. In the chapter on poisoning, permanganate of potassium as an antidote for morphia and other alkaloids is mentioned, but the nitrate of cobalt, the new antidote for hydrocyanic acid poisoning, is omitted. The book is larger than former editions. It is not only a popular but a very useful work.

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SPECIALISM.

Philadelphia Polyclinic.

THERE can be no question but that specialization, in so far as it is normal, is progress. That the community is better served, more cheaply and satisfactorily served, by legitimate specialists than by jacks-of-all-trades. MEDICAL ETIQUETTE.

Medical Mirror.

THE doctor, like the rest of humanity, will need but few written rules of etiquette if he has a kindly heart and an ever present desire to please. The golden rule is a code of ethics that is good enough, broad and long enough to conduct every man safely through life. THE PHILOSOPHICAL DOCTOR.

Pittsburgh Medical Review.

THE ideal medical man is better described under the title of a "philosophical doctor," rather than as a medical philosopher, for he is primarily a physician, but must make use of philosophical ways and means if he is a rational, and from the standpoint of his fellowphysicians, a successful physician.

RESPONSIBILITY.

Medical and Surgical Reporter. RESPONSIBILITY is measured by the professed ability to accomplish. Where a large price is demanded and paid for services, there is a corresponding increase of responsibility, there being an implied claim of superiority of knowledge and skill over others. And this responsibility is only reduced or relieved by the operation of causes or influences beyond the physician's or surgeon's detection, or over which he has no control.

SUBSTITUTION.

New York State Medical Reporter. PHYSICIANS in writing prescriptions should specify pills of the best make they know of, and they will be more certain of obtaining the therapeutic effects upon which they calculated. This applies not only to pills, but to all articles of merit in and out of the pharmacopeia. There are as bad fluid extracts on the market as there are good ones, and we are sure that it is the duty of the practitioner to indicate on his prescription the maker whom he thinks to be reliable. Every successful preparation has its imitations, and the imitation is impertinent testimony of its value and success.

PUBLISHERS' DEPARTMENT.

All letters containing business communications, or referring to the publication, subscription, or advertising department of this Journal, should be addressed as undersigned.

The safest mode of remittance is by bank check or postal money order, drawn to the order of the Maryland Medical Journal; or by Registered letter. The receipt of all money is immediately acknowledged.

Advertisements from reputable firms are respectfully solicited. Advertisements also received from all the leading advertising agents. Copy, to ensure insertion the same week, should be received at this office not later than Monday.

Physicians when communicating with advertisers concerning their articles will confer a favor by mentioning this Journal.

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PHARMACEUTICAL.

TREATMENT OF ACUTE AND CHRONIC
ULCERS.

BY JAMES OSBOURN DE COURCY, M. D.,
St. Libory, Ill.

PUBLISHED BY LOUISVILLE MEDICAL JOURNAL,
AUGUST, 1894.

I HAVE found no class of diseases yielding to treatment with greater reluctance than "old sores," or chronic ulcers. Recently, however, I have adopted a plan of treatment which is quite different from that laid down in the books, and my results have been much better.

Almost without exception, internal, or constitutional, as well as local treatment, is necessary.

The internal treatment should be directed to the seat of the malady, thus eradicating the general pathological condition, eliminating the poisons and disease germs from the sys

tem.

To accomplish this object, absolute cleanliness (internal and external), plenty of pure air and sunshine, the religious observance of the laws of hygiene, and a wholesome nutritious diet, are more useful and restorative in their effects than are drugs. All the secretory organs of the body should be required to perform, as nearly as possible, their natural amount of work.

This once accomplished, and all nature's machinery kept lubricated and in good working order, the local treatment and work of reconstruction will be comparatively easy.

The sores, ulcers, acute and chronic, must be kept clean. This is done very satisfactorily by the application of hot water. If the parts can not be soaked in the hot water, an ordinary fountain syringe can be filled with water (as hot as can be borne, without burning), elevated high enough to give sufficient velocity to the stream, which is played over the parts, by the operator holding the nozzle of the syringe a short distance from the seat of the application. The frequency of the washing will depend upon the nature of the case, but should be repeated as often as necessary to keep it clean and free from offensive odors.

To destroy pus and bacteria, and to aid nature in the work of rebuilding the parts invaded, I have found Hydrozone and Glycozone superior to any and all other agents tried.

Hydrozone is first applied (after the hot water) by the use of an ordinary glass dropper, or hard rubber syringe, slowly, all over the ulcer, until the pus is destroyed. Effervescence, or fermentation, continues until the enemy is quite dead, but no longer. One layer of absorbent cotton is saturated with Glycozone and placed smoothly over the parts and held in place by cotton bandage, sufficiently tight to hold the cotton in place.

Other local medication might do as well in some cases, but I have not so found it. The result obtained in the case I report herewith seems to confirm the statement as above made.

Edw. K., aged twenty-three, American, but German descent. A farmer by occupation; unmarried. Rather small in stature, but wellbuilt. Having taken sixteen bottles of "Blood purifier" and a lot of "Anti-constipation pills" within the last eight months for "Falling sickness," came to my office March 19, with both legs most frightfully ulcerated, from knees to ankles, with considerable discharge of pus from various parts of the legs. Such a case should have been sent to a hospital or sanitarium, for the best systematic treatment obtainable, but, unfortunately, he was so situated that he could not be sent to such a place. In a most pleading way he asked me if I could do him any good. I told him I thought so, if he would mind me, and take the treatment that I should advise. He promised, and the treatment was begun.

The legs were cleansed by soaking them for twenty minutes in hot water twice a day, after which Hydrozone was used freely all over the sores, to destroy the pus, the pustules having been opened, and as much pus evacuated as possible.

After this application, morning and evening, the legs were powdered all over the affected portion with a mixture of equal parts of alum, boric acid and aristol, then covered with absorbent cotton, and bound up with an ordinary cotton gauze bandage.

The local treatment was kept up for two weeks. The improvement was slow, but constant. The process of healing advanced from the knees downward, and from the ankle upward, leaving the last part to heal about the middle of the leg, where the ulceration formed a thick crust, extending two-thirds around each leg. The alum, boric acid and aristol powder was discontinued, and Glycozone used as a reconstructive agent, from the end

of the second week. The sores were washed and the Hydrozone used as before mentioned, then the Glycozone was applied to the whole affected parts. A layer of absorbent cotton was saturated with Glycozone, and smoothly placed around the sores, and held in place by a cotton bandage. At the end of the second week after Hydrozone and Glycozone were used as the sole local agents, the young man said he was well, and worked every day from that time.

The internal treatment was changed from time to time as the case required.

Fluid extract nux vomica was given morning and noon, seven drops before each meal. Elixir lactopeptin, with bismuth, was given in drachm doses after each meal, and, occasionally, laxatives at night. Later on, tincture chloride of iron was given, in ten drop doses, after each meal, for one week.

Hydrozone and Glycozone were left to complete the structure, which they did in a way gratifying both to the patient and to myself.

WE call the attention of our readers to the advertisement of the Robinson-Pettet Co., Louisville, Ky. This house was established fifty years ago, and enjoys a wide-spread reputation as manufacturers of high character. We do not hesitate to endorse their preparations as being all they claim for it.

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MEDICAL JOURNAL

A Weekly Journal of Medicine and Surgery.

VOL. XXXII.-No. 9. BALTIMORE, DECEMBER 15, 1894. WHOLE No. 716

ORIGINAL ARTICLES.

THE USE OF FOOD AS MEDICINE.

READ AT THE SEMI-ANNUAL MEETING OF THE MEDICAL AND CHIRURGICAL FACULTY OF MARYLAND, HELD AT Cumberland, Md., Nov. 21 AND 22, 1894.

By Edward M. Schaeffer, M. D.,

BALTIMORE.

Member of the American Association for the Advancement of Physical Education; National Educational Association, etc.

"Half the ills that flesh is heir to

Would not really be so bad,
If we did not daily, thereto,

Add the ills it never had!"

IN an address before the Medical and Chirurgical Faculty of the State of Maryland, three years ago, attention was called to the "Revival of Physical Education and Practical Hygiene" throughout the country, not only in public-school work, for the symmetrical, rational training of healthy minds and bodies, but as a remedial measure among the criminal classes, the feeble-minded and the insane. Allusion was made to the excellent training schools for teachers, women more especially, now devoted to instruction in scientific bodybuilding, and to the great success of this specialty in educational fields as evidenced by the demand for skilled service and the satisfactory pay which has accompanied it.

A new sanitary era awaits the infant fortunate enough to be born of such parentage and under such popular recognition of his birthrights as will start him. on a life abundantly worth the living, because not hopelessly handicapped by circumstances over which he has no control. They are, however, so indisputably avoidable, that it is a stigma on the courts of law and equity, who remember

his rights of inheritance in property before actually it has entered a girl's mind to dream of her possible maternity, let alone know who is to be the sharer of her joy that a child is born into the world—that no protection whatsoever is granted that he shall be given a body wherewith to enjoy his inheritance, unless we except the humane injunction that "a man may not marry his grandmother."

Let us hope the day will speedily come when there shall be such a popular awakening and sentiment on these subjects, that the people themselves will enforce a law that shall insure to every child the divine right to be well born into this selfish, body- and soul-devouring world. of ours, as we make and corrupt it.

It is my purpose, today, to note the still further progress of the health idea in our noble art, to hail with joy the near approach of an era of preventive medicine, not as a specialty, but as the universal aim of all honest and broadminded practitioners, to congratulate you on the voices in our midst and the heralds in high places, who are proclaiming the gospel of sanitary science to a public who, from a strange mixture of ignorance, prejudice and inclination, have called for and suffered many things of many physicians, contented themselves

with the appearance of health or a low standard of vigor and vitality, and cherished the delusion that doctors could perform "the miracle of reconciling health with intemperance," substitute physic for physique, and sell indulgences for the commission of physiological sins. The man who thinks or boasts that he has the ability to evade nature's laws with impunity is unfit either for earth or heaven; he is the counterpart of the alleged philosopher whom the psalmist has for all time unceremoniously placed in the fool's gallery.

One of England's great therapeutists, the late Dr. Fothergill, an expert in dietetic knowledge, declared that "myriads of our fellow creatures have perished because those around them did not know how to feed them." This remark applies to all sorts, ages and conditions of the human kind. It does not, however, pertain to the lower animals which have a market value and whose lives are not generally insured, so it has been to man's interest to look after their nutrition and promote their viability. The small boy followed healthy instincts who expressed a preference to be the wild. turkey and live on a prairie, rather than the Thanksgiving turkey who got killed

every year.

The time indeed is at hand," says Fothergill, "when systematic lectures on food will be part of medical education, when the value of feeding in disease is admitted to be as important as the administration of medicine."

Every medical student should be required to pass an examination in the physiology of health prior to displaying nis knowledge of disease. How can he understand the latter except in terms of the former? Do we presume to study surgery or pathology in advance of normal anatomy and histology?

Do our medical schools sufficiently emphasize these matters on their true relation? Who started the enquiry "is life worth living?" Somebody's patient; a chronic dyspeptic; a man of drugs; some victim of an ill-mated, because morally illegal, marriage; some egotistic idler; or a person whose very health, perhaps, isolated her or him

from the good society and sympathy of hypochondriacs and robbed them of agreeable (?) conversational resources.

As we watch the rise of a great school of medicine in our State, whose representatives are the bone and sinew of these meetings, did not the trustees first secure a distinguished professor of pathology, and lastly, but most emphatically not least, called on a distant college which has led the van in the study of scientific nutrition through laboratory analysis and research, for a teacher of the principles of dietetics (the art of keeping ali e)?-The noblest specialty of them all, because no other specialty can have permanent success which is not based upon it, embodying as it does the basic facts of right living and healing, a knowledge of the only curative force to which drugs can appeal, the sole hope of the surgeon's brilliant skill, the summum bonum of what we are pleased to call the science of medicine.

Here is another legitimate field for the woman doctor or teacher; and if outside of our profession such invaluable work has been done by a Mrs. Abel and a Mrs. Richards, what may we not expect should the former accept a degree and be assigned to a professorial chair, a position which the latter has for some time honored in the Massachusetts Institute of Technology?

"The scientific aspect of food must be united in the bonds of holy matrimony with practical knowledge of the cook's art, before a man can discourse learnedly of food. It is an irritating, nay, more, a deeply saddening problem, for a wise dyspeptic to ponder, the superabundance in this little world of ours of things cookable, the extreme rarity of cooks. A man is what he eats. Pain is the prayer of a nerve for healthy food. Courage, cheerfulness and the desire to work depend mostly on good nutrition," a point of great practical bearing on all problems of charity organizations and of effective relief to the deserving poor and oppressed.

Why cannot America, like ancient Greece and Rome, inaugurate a sensible enthusiasm or ambition for good health among the masses; why, among the

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