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Personal.

Dr. J. J. Lawrence has taken passage on the Etruria for an extended trip of Europe. He will visit the Paris Exposition, and then do the principal cities and places of note throughout Europe. His principal object is pleasure and recreation, yet he will visit the leading hospitals and chat with some of the leading medical men of the day on the other side of the pond. The BRIEF will be in good hands during his absence, and will appear with its usual promptness and satisfactory style.

Dr. Swift's Letter of Thanks. To the Editor of the Medical Brief:

In the March number of your valuable journal was a communication which was intended for the February number, in which I gave symptoms and stated the condition of my wife. I asked for the opinions of the profession respecting diagnosis and treatment of her disease.

To you, Mr. Editor, and to a multitude of physicians from every quarter of our great country, I desire to express my profound thanks for timely, sympathetic and valuable letters in response to my request.

Their number forbade the attempt of replying personally. I have delayed doing so through the BRIEF, hoping to be able to give a positive diagnosis in the light which time and development of the case might afford. But I am not able to do this even now.

The patient has made slow progresshas seemed to improve somewhat-is stronger and able to be about the house and to ride a few miles in a carriage. The pulse is much less rapid, but is often 100 and not often down to 90. Very little increase in weight-tenderness under pressure upon her abdomen is less, no thirst unusual now, and appetite very good.

There was such variety in expressed opinions of the case as to lead to very careful examinations, and a trial of many prescriptions has been made-all to but little result in betterment of the symptoms. The main difficulty, I am convinced, is in the sympathetic system of nerves with marked failure in the solar and semi-lunar plexuses.

There is anæmia-perhaps as a result of failure in nutrition, notwithstanding appetite has been good most of the time, and apparently no failure in digestive functions. There was no indication of anæmia until after the loss of flesh, for it will be remembered that in 60 days she diminished from 145 to 100 pounds in weight-pulse 140 to 150 during this time, and for two months subsequently.

Veratrum, aconite, strophanthus, digitalis, gelsemium, convallaria, bromides, nor any other remedy, had the least apparent effect to slow the pulse. Succus Alterans, strychnia, iron, quinine and

general tonic treatment has seemed to benefit the patient. Massage, and local counter-irritation to the abdominal region, and iodine to spinal column also seemed to be somewhat beneficial, especially to relieve tenderness of the mesentery. General sponging and friction of the body proved to be of service, especially in allaying restlessness, which was a severe feature of the case. This is still a troublesome complication.

Now, if the readers of the BRIEF find anything of interest in what I have said, I shall be glad. J. M. SWIFT, M. D. Northville, Mich.

Pneumonia.

What is it? Inflammation of the lungs. What is inflammation? It is heat, redness, tenderness, swelling and pulsation in a part.

In pneumonia the temperature ranges all the way from 99, to 105 or 106°. Pulse from 80 to 130 and 140 per minute. Respirations from 30 to 50, owing to the severity of the case.

What is the best treatment? It is an evident fact that all cases do not require the same treatment. We must, therefore, treat them according to the principles of specific medication, if we wish to be successful. Is there any such a thing as specific indications for remedies? Most assuredly there is-none will hardly deny. What drugs then are indicated in pneumonia? If the tongue is heavily coated at the base an emetic is indicated. If it is uniformly coated from tip to base, a cathartic is indicated; if the pulse are full and bounding, veratrum is indicated, but if small and frequent, aconite. If the face is flushed, patient restless and sleepless, gelsemium is unquestionably indicated and will seldom fail to relieve the patient. If there is a sharp pain in the side, bryonia is indicated. If soreness of muscles, with muscular pain, macrotys is indicated. If patient is dull, inclined to sleep, pupils dilated, belladonna is the remedy. If the tongue is pallid, with a dirty coating, sulphite of soda is indicated; if red, an acid. If the pulse is full and soft, skin soft, asclepias is the remedy.

I usually select aconite or veratrum, according to the indications, and then

add the other remedies to them as indicated.

In the last stages of pneumonia, or in any stage, if the patient becomes very weak, and the heart's action weak, we may give stimulants. Carbonate of ammonia is an admirable one; digitalis, convallaria, cactus, etc., are good cardiac stimulants. It is a fact that when a drug is markedly indicated, according to the foregoing, it is a remedy in any disease, it matters not what the name may be. We care nothing for the name so far as the treatment is concerned.

There are a great many other remedies that might be indicated in pneumonia, but space forbids us pointing them out. Try them according to the indications pointed out and be convinced that there is some certainty in the action of drugs. T. J. DANIEL, M. D.

Waveland, Ark.

Hydrocephalus-Tattoo Marks. Yesterday, my neighbor, Dr. J. R. Andre, sent for me to assist him in a confinement adjoining his private residence. Patient, aged twenty-eight, a very refined lady; primipara; full term. The case was one of hydrocephalus, extra large, had no eyes; where the left should have been, was a slight rudiment of a lid; the right was the same, except a very small hole, but no eyeball in either; the entire bridge of the nose was absent, though the internal formation was perfect; the upper part of the mouth was properly formed, while the lower jaw and lower parts of the mouth were wanting; the other parts of the child were perfect.

In an experience of nearly thirty years, and my friend, Dr. Andre, in that of nearly forty, never witnessed such a monstrosity.

Can any one tell me if there is any chemical that will remove india ink stains from the living flesh?

A. TREGO SHERTZER, M. D. Baltimore, Md.

Hyperesthesia.

Please allow me space in your valuable BRIEF to thank those of the fraternity who have written me so kindly and promptly in regard to my case which was reported in May BRIEF. I have received a number of letters from different States, and while all are duly appreciated, I desire to mention especially the names of W. Hambroer, M. D., of Eden Valley, Minn., and A. Trego Shertzer, M. D., of Baltimore, Md., whose diagnoses agree exactly in the case. They both say it is a case of hyperesthesia of the parts, which is correct, I think, as no other cause can be ascertained for the trouble.

For treatment, Dr. Hambroer sent me some ointment, prepared by himself, with directions to apply it once a day on a little piece of lint to the clitoris and meatus urinarius, and at this writing (June 4th) patient states that the trouble is entirely relieved. Whether the relief will be permanent or not, time alone will prove.

Dr. Shertzer, of Baltimore, recommended a four per cent solution of hyd. cocaine, to be applied to the parts once a day, which would have been tried, had not the other remedy proved effectual.

Dr. L. Pike, of Terre Haute, Ind., may think me very dull of comprehension, but he will please excuse me for asking him what he means by his interrogation: "Has the husband a wide, or double, upper lip, the wife narrow?" Perhaps he or some one else can define above interrogation for me.

With best wishes for the whole fraternity, and the continued prosperity of the BRIEF, I am yours, etc.

S. F. BLAKELY, M. D.

Woodward, S. C.

Lupus.

In March BRIEF, page 134, I made inquiry about a lupus on my lip; only one reply, and that came from L. G. Doane, M. D., N. Y., recommended pyrogallic acid. I put the powder on where there was a small scale, next morning there was a scab, it was taken off the third day. I then rubbed the dry powder on for a minute or so, next day there was a scab as large as a nickle and as thick, after three days commenced to apply fl. ext. hamamelis (or witch hazel) about ten

times a day; it healed in seven days after the last was applied and remained so. I report this as it did not detain me from practice one hour.

Thanks to the above brother M. D., also the MEDICAL BRIEF, which is our greatest source of written knowledge. S. SOUTHWORTH, M. D.

Kampsville, Ills.

Abortions.

I have noticed several replies to A Novice's article in May BRIEF, and all seem to differ somewhat. The rational treatment of abortions is to dilate the os and curette or scoop out the uterus. But I prefer the expectant treatment, which has proven satisfactory. That is, to give twenty drops fluid ext. ergot, every three hours, and use warm carbolized injections three times a day. If the hemorrhage is profuse, use the hot carbolized water (100° to 120° F.), suggested by Dr. Andrews in June BRIEF, and give an occasional dose, say fifteen or twenty drops, tinct. opii with the ergot.

In September, 1886, I was called to see a lady who had aborted between the fourth and fifth month of gestation. On arriving, I made an examination and found the foetus lying in the vagina. I removed it with my hand, severed the cord, and attempted to remove the placenta, but found the os so small that I could not introduce my forefinger. adopted the expectant treatment, and in four days after my first visit I removed the placenta and membranes from the vagina. Will state that I made daily examinations.

I

The tinct. opii will relieve the pain and irritative fever that we sometimes meet with in such cases.

Try the above treatment, Dr. Novice, and let us hear the result.

Will state that I have never had a death, septicemia, or any untoward symptoms, to occur from abortions in my practice. GEO. DOUGLASS, M. D. Santuc, S. C.

Sozone.

By request, several have reported to the BRIEF their experience with Sozone as a remedy for asthma and kindred complaints. We repeat the request.

The Signs of Death. The case of Bishop, the mind reader, which excited so much scandal and newspaper gossip, ought to be a warning to surgical "hustlers "in particular, and to the profession in general. The case should prompt every physician to be sure to get written permission, from the next of kin, before making a post-mortem, otherwise a like fate may overtake the zealous and scientific investigator which overtook the three physicians who, in the interest of truth, made a post-mortem upon the body of Mr. Bishop. Added to this, it ought to be the duty of all physicians to be sure the subject is dead, or, still better, to rest awhile, and then proceed carefully.

The signs of death are vague-very vague, indeed-hence the necessity for caution; hence the necessity for investigation.

Let the subject be agitated at once, and answers sent in to the BRIEF to this question :

What are the signs and symptoms (?) of death? L. G. DOANE, M. D.

New York City.

Assistance Wanted.

I wish to ask assistance from some of the BRIEF brotherhood in regard to a case in which I take considerable interest. Being yet quite young in the profession, and not having had the best of advantages, my practice in gynecology (and, consequently, my practical knowledge of the same) has been somewhat limited.

My patient is a married woman, twentysix years of age; one year married; has not been pregnant; menstruates with comparative regularity, and without much pain. She is suffering from marked retroversion, with prolapsus, of womb, the origin of which she thinks dates back about five years. There is also considerable congestion of the cervix, with white-of-egg-like leucorrhea, which has, at times, been quite profuse. The parts, especially the cervix and meatus, are very sore and tender to the touch. Her bladder is very intolerant, which compels her to void her urine on an average once in two hours, night and day. Her back aches almost constantly. She has

considerable nausea at times; headache, sometimes in one part of head, then in another, almost all the time. Bowels are constipated most of the time. She complains most all the time of vague aches and pains in various parts of the body, sometimes in one place, and again in another; also of various other minor symptoms of uterine trouble, which will suggest themselves to every reader. She is also very restless at night.

She has worn a Thomas' retroversion pessary nearly all the time for six months, and has used injections of hot water at night for same length of time. Of late, however, she has been using a small quantity of Kennedy's White Pinus Canadensis in each injection, which has checked leucorrhea considerably.

Now, I would like to know how to correct displacement, congestion and leucorrhea at same time. It seems to me that the pessary aggravates congestion," and without pessary distress is almost unbearable."

46

M. Sig.: Half a teaspoonful in water before meals.

As for the treatment of ulcer, stop the use of any greasy applications, wash the sore well twice a day with a weak solution of carbolic acid and rain water. In washing the ulcer do not rub the raw surface, but saturate a sponge and squeeze the solution into the ulcer, holding the leg in a position that the solution will run out; do not hold the sponge over two inches above the leg, for the granulations are very weak and easily broken up. After washing, dust well with iodoform, stopping its use when the granulations are forming too rapidly. Apply a Martin's elastic bandage 21⁄2 inches wide, 10 or 12 feet long, from the toes to the knee. Have two bandages that you may change night and morning. Keep them clean by washing them in a solution of bicarb. soda and water. Dry them in the shade.

If there is oedema of the leg, due to impaired return circulation of the parts, elevate the foot and give your patient a few days rest.

By following the above closely your patient will be cured, as I have done several of long standing.

W. W. MATTHEWS, M. D.

My Opinion.

Dr. Wilson, Huber, Tex.: your case, I think, is likely cancer or cystic degeneration of the kidney. I would advise aspiration, and if the tumor is found to be other than an aneurism removal; if an aneurism use gradual electrolysis.

Rigors do not occur when tumors are forming, unless they press on some gland or organ, such as the liver or kidneys, so as to interfere with their excretory function. Rigors are caused by nerve irritation, mental or nerve shock, or foreign substance in the blood, septicemia or pyemia.

The pain in limb is caused by pressure on the sacral plexus of nerves by the tumor. The induration of left testicle may be from pressure hindering the return of blood from the testicle, but sometimes results from sympathy with diseased kidney of same side.

Dr. Henton, Stamper, Miss.: paracentesis will only relieve, and ovariotomy is your only cure. Astringents will do no good, neither will other medicines, to prevent the cysts from reforming.

Dr. Williams, Bristol, Dak.: the injection of carbolic acid "into a pile tumor composed of blood," or, in other words, a varicosed hemorrhoidal vein, will always produce an embolism, sufficient to fill the vein, and thereby causes occlusion of the vein, but there is no danger of producing floating or transitory emboli.

Dr. Hartley, Coxburgh, Tenn.: look for left ovary directly back of womb, high up in Douglas' cul-de-sac. See "My Opinion," June BRIEF.

Dr. Fisher, Lancaster, Tenn.: the excessive quantity of liquor amnii was caused by the arachnoid membrane being exposed in the child and the secretion which from exposure become excessive, filled and distended the uterus. I once saw a case in which there were at least four gallons of fluid.

Dr. Voyles, Livonia, Ind.: use twenty grains of iodide of potass. in one-half ounce of water, as spray from steam atomizer, three times daily, and be happy.

Dr. Carter, Thompsonville, Ill.: I would make an exploratory incision, it may be a tumor or a "scrofulous" abscess.

Dr. Doane, New York, protests against my advice to operate on all cases of