Chemistry and Calomel. Dr. P. C. Smith, of Orrington, Me., again takes up the calomel question. His article appeared in the July BRIEF under the caption of: "What is Calomel?" Dr. Smith proposes to tell the "old school" what calomel is. He hopes by so doing that he may influence some one to discontinue the use of calomel as a therapeutical agent. He approaches the subject from a chemical standpoint. He says “calomel is mercury and chlorine," which is approximately correct. He then proceeds with his subtle analysis by explaining that mercury is quicksilver. How instructive to the old fogies of the "dark ages " who prescribe calomel! Are you not convinced that calomel is not a hepatic stimulant? Surely calomel must go!

But here is the eye opener: "Chlorine is a combination of muriatic acid and black oxide of manganese." Hundreds, aye thousands will be instructed as well as amused by this important knowledge. Hitherto chlorine has been considered an elementary gas. The doctor's chemistry surely must be a remnant of the "dark ages" of the nineteenth century.

Now, muriatic acid is composed of hydrogen and chlorine, and black oxide of manganese is composed of oxygen and manganese. Hence, according to Dr. Smith, calomel must be a combination of mercury, oxygen, manganese and chlorine. Now, doctor, if your therapy of calomel and your knowledge for its indications are subject to the same discount as your chemistry of calomel, then your patients are to be congratulated that you do not prescribe it.

The fact that calomel contains chlorine is no reason for not prescribing it. Common table salt is, by weight, more than half chlorine. His argument against calomel, because it contains chlorine, is equally applicable against common salt. His argument against calomel, because it is a mineral, applies with equal force against the air he breathes and the water wherewith he quenches his thirst. For are water and air not minerals?

His other argument to discard calomel, because it is a poison, is equally untenable. Atropine, morphine, pilocarpine, strychnine, and arsenic, as well as many other potent and useful remedies, are

equally as poisonous as any of the salts of mercury, yet what physician of sense refuses to prescribe any of them, when indicated, because they are capable of producing harm or even death?

Here is another extravagant statement, to say the least: "And this is the remedy given by the old school in nearly all diseases, as far back as the renowned Paracelsus." The doctor's prejudice

against the salts of mercury has led him to exaggeration, while his knowledge of chemistry has made him exclaim: "I wonder why so many advocate its use if they understand the chemical preparation of the drug."

Now, ye doctors of the "dark ages" are ye not convinced that calomel must go? E. VIVIAN BROWN, M. D.

Doddsville, Ill.

Typhoid Pneumonia.

I have some typhoid pneumonia cases that is now prevalent in this section of the country. I find little trouble in treating the typhoid fever by itself, but the combined lung trouble makes it quite difficult.

The symptoms are a dry hacking cough with but a small amount of white frothy phlegm from the lungs. Singultus is also prevalent in a majority of the cases, and is hard to control.

I have prescribed quinine, spirits turpentine, mucilage, and occasionally opium, with very good results.

The pneumonia is lobular, just like simple pneumonia, but does not readily yield to treatment. I have prescribed milk and brandy, after subsidence of fever, with very flattering results.

I think the cough, which is of a catarrhal nature, must be of sympathetic character, for as soon as the fever is controlled the cough subsides, and the patient is on the road to convalescence.

We attribute the cause of the fever to the mild winter, it not being sufficiently cold to freeze out the germs, and it is now almost epidemic.

Will some of the readers of the BRIEF please give their opinion as to the cough, etc?

I can't do without the BRIEF. To prove which I send $1.00 for its renewal another year. JAS. L. LONG, M. D. Good Hope, Ga.

Milksickness.

What is milksickness? I was called in consultation with Dr. S., on July 16th, 1889, to see Mr. W. S., aged thirty-two years. He was slender built, complexion dark. Was taken sick about ten days previous to my call, with symptoms as follows: Chilly sensations for a day or two, slight elevation of temperature (don't know just what the thermometer did register), with weakness of lower limbs, and trembling of knees; extreme nausea, some vomiting, bowels constipated, but acted very nicely under the influence of an alterative.

Remained in about this condition the first six or seven days of his sickness. After that he became very delirious, talked about every thing; the pupil of his eyes became dilated until he could scarcely see at all, and remained so up to the time I first saw him.

They had called in three other physicians before I was called. The decision being with each one milksick. When I saw him I put him on bromide of pot. for the mania, and iron and strychnia for the debilitated condition. He began to improve immediately, and is up about his business now, says he feels first-rate. Now, brother M. D's, what was the matter with him?

We have a few physicians in this country who have a tendency to call a great many troubles, that have nausea connected with their symptoms, milksick.

I would like to know the symptoms of milk sickness, if there is such a thing. Our authors are very quiet on that subject, especially our late authors.

Will some brother give symptoms and treatment?

The BRIEF is the best practical journal that comes to my office. Long may it live. C. H. EDWARDS, M. D.

Lyons, Ind.

Change of Date.

Since publishing notice of the meeting of the American Rhinological Association in August BRIEF we have received notice of a change of date, i. e. Oct. 9, 10 and 11th. Place of meeting remains the same.

Cholera Infantum-Collinsonia.

I would like to ask my brother M.D.'s some questions, through the columns of the dear old BRIEF. Will some one, or many of them, give best treatment for cholera infantum, in children under two years of age, where the stools are green and watery, and where the child is tormented with griping pains and excessive thirst; bowels moving eighteen to twenty times in twenty-four hours. Would like to hear from some of our best doctors.

What is the physiological action and therapeutic indication of collinsonia, or stone root, and in what pathological conditions is it indicated? In what diseases do you use it? Would like to hear from some one or all who have used it. May the grand old BRIEF continue to J. B. BEARDEN, M. D.

come.

Elijay, Ga.

Ulcers of the Leg.

In the July BRIEF I find many interesting questions discussed. The concensus of opinion with regard to ulcer of the leg appear to be that the condition of impeded return or venous circulation, which is the cause of continuation of the trouble, should be remedied by keeping the foot on a level with the body, by the application of artificial support to the extremity -in the form of an elastic bandage-and by the use of such antiseptic preparations as iodoform, in order to hasten granulation and to keep the ulcer clean and sweet. And also by the exhibition of tonics.

Such a course of treatment will almost invariably cure in a few months, where it is a simple varicose ulceration. I may, however, mention that some two years ago I treated a case of this kind for some time without success, until, on more careful inquiry, I found that in years gone by the patient had suffered from specific" symptoms. I, thereupon, put him on small doses of that much abused drug mercury, in the form of daily inunctions, and gave internally trifolium compound with most satisfactory results. I am not an empiricist myself, yet I am compelled to acknowledge that many cases which have run through the whole category of so-called cures for impure blood," and have been treated by com

petent surgeons have not been cured, when their troubles have been due to obscure syphilitic disease, till put on some preparation of mercury.

While reading Dr. Doane's articles, anent "the man with an idea," I was suddenly called to attend a case of renal calculus. It just occurred to me, that if I were to take our friend's advice to give drugs "in as small doses as possible" in a case of that kind, or even wait to find out, if possible, any idiosyncrasy which the patient might have towards morphia, my services might soon have been dispensed with. Dr. D. also advises us to แ “give a drug if it produces good not evil results, but don't give a drug in order to get a fee or upon the authority of any man."

Surely, no physician would risk his reputation by giving a drug which produces "evil results." "Don't give a drug in order to get a fee." Now, many a physician, in the country especially, where the "medicine" is looked upon as the important thing, and not the advice of the physician, finds it is necessary in some cases, even where advice alone is needed, to give a placebo, in order to keep his patient, and also to get his fee.

With regard to the last statement by Dr. D., I may say that physical diagnosis is so perfect to-day, that we are able, very successfully too, "to prescribe upon the authority of another man.” In fact, this is one reason why we all think so highly of the BRIEF.

J. ALBERT DICKSON, B. A., M. D. Hemmingford, Can.

Veratrum Viride.

I noticed some time ago in the BRIEF, an article which asked: What is the best heart tonic. In my experience of twelve years I have found nothing to equal veratrum viride, in proper doses it is superior to all other remedies. In all inflammatory disorders in which the action of the heart is too strong and frequent, it is superior to blood letting. In acute pleurisy and pneumonia, when the patient is thoroughly under the influence of the medicine, he is about cured, also all dangerous effects are relieved by vomiting and patient will usually ask for something to eat.

In typhoid fevers, veratrum viride is one of the best remedies used. I feel sure that I cut short many cases by its use. It controls the circulation and prevents the tongue from becoming dry and parched. The doses in these cases must be very small, of Norwood's tinct. one drop, every four hours being sufficient.

In puerperal convulsions it is a most efficient remedy, but must be given in very large doses, the uræmic condition producing tolerance of its effects. A case of this kind can take from thirty to sixty drops of the fluid extract. I have never repeated the dose nor did vomiting

occur.

In membranous croup it is the remedy, but must be given for effect, not ordinary doses, but for a child two and one-half years old twenty drops of the fluid ext. inside of six hours, with the very best results following.

It has been no good in my hands in scarlatina, pyemia, or diphtheria.

In conclusion would say that if I had to rely on four remedies, they would be quinine, calomel, opium and veratrum viride.

I would be pleased to hear from some of the learned brethren on this subject. FRANK P. GRAY, M. D.

East Chicago, Ind. [Has the doctor ever tried cactus grand. as a heart tonic?-ED.]

Infantile Dysentery.

I would ask any of my medical brethren of the BRIEF family, who have a plan of treatment for dysentery among infants and children that is entirely satisfactory to themselves, to give me, by private letter or through the columns of the BRIEF, a detail of their treatment for cases where there is high fever, very frequent discharges of mucus streaked with blood, and mixed more or less with very green bilious matter, where there is a great deal of pain and tenesmus.

My treatment has never been as successful or satisfactory in such cases as I would like, and I hope my medical brethren will help me to a more satisfactory plan of treatment.

JAMES G. PHILLIPS, M. D.
Augusta, Ill.

Lupus.

The physician who applied the powdered pyrogallic acid to the lupus on his lip did well, but he would do much better if he used it at night and washed it off in the morning. Pyrogallic is cousin german to tannic acid, has astringent properties, and is an excellent dressing for ulcers of any nature NOT specific in character.

Salicylic acid, in powdered form, answers better for specific ulcers than any local application I have tried. I dust this on in the evening, permit it to remain all night, and wash it off in the morning, then reapply again at night. I have yet to find but few specific ulcers that resist its action. I have had many L. G. DOANE, M. D.

cases.

New York City.

Calomel Again.

I see that the brethren, after over a year's discussion, are not yet tired of singing the praises of calomel. I like to see such men as Dr. Goss stick to a thing as long as there is a chance to fight back, and die game. I can say, doctor, that I am just as much an admirer of calomel

as ever.

I will relate last winter's experience with the drug, both on myself and four other patients. We all had enlarged livers. Began to be sick the first of the year or thereabout and calomel upon calomel did not seem to do any good. Well, I thought that my patients would go into a hole and haul me into it with them. I fussed over them for a long time till long into April, and in desperation I got out all my MEDICAL BRIEFS and read up your articles, made a memorandum of your remedies, and sent for them. They cost me $5.50.

Before they came, I lay in bed one night thinking what to do for myself and others. Arose, lit the lamp and looked at my tongue, and took a dose of tint. iron mur., took some more iron the next day, and the next and next, and in a little while was well and bowels in good working order. I gave the same to my other patients and they all recovered. I have all of your remedies laying on my shelf now untouched, but I shall try them yet, probably they are good in your climate, but I still think nil up here.

Dr. J. M. Jones' article I like very much and if he wants to know more about calomel in pregnancy will refer him to an article in the BRIEF of November 1882, page 486. There he will find an article written by Dr. D. F. Cecil, which will give him much light on the subject and which I have tried and proved.

Would like to hear from those that have read Dr. Carpender's treatment of pneumonia and if they have practiced it, what success? W. A. HAMMOND, M. D. Paris, N. Y.

Put this in a stone jar and add one pint of boiling water, let it stand until cold, then add a half pint of dilute alcohol, and half pound of loaf sugar, digest for a day or two and then strain through flannel. Bottle for use. Dose for an adult, a tablespoonful every hour, or according to the symptoms; for a child a year old, one to two teaspoonfuls every two hours. Follow this up until the feces change in their appearance to the natural state, then use this:

Mix and give one half to one tablespoonful after every motion of the bowels, for an adult, and for a child a year old, give from one-half to one teaspoonful after each motion of the bowels.

Continue until you get the bowels toned down to one or two motions in twenty-four hours.

This is the treatment I used in the epidemic here in the year 1885, and it was in the worst form. I did not lose a single case. When there was malaria, I used some sulphate quinine, and where there is much fever, I use tinct. of aconite as a sedative.

L. T. BRANCH, M. D.

Sechlerville, Wis.

Epididymitis, or Swelled Testicle. Gonorrheal epididymitis, or orchitis, is probably one of the most frequent complications which we have with gonorrhea, as well as one of the most painful. There are several theories in regard to its cause; the most reasonable to me is that the gonorrheal matter-gonococcifinds its way through the duct, or canal, that passes from the epididymis and testicle to the urethra, through which the seminal fluid passes. This duct, or canal, is lined with mucous membrane of the same character precisely as the urethra, in fact, it is continuous with it. The early stages of gonorrhea only affects the urethra near the meatus, but it extends deeper and deeper into the urethra, and finally may extend through the spermatic canal to the epididymis, and even the testicle itself may become affected, though rarely.

If the epididymis does not always become affected in this way-I believe it generally does-the urethral discharge usually ceases or greatly decreases in quantity, when the testicle or epididy

mis becomes inflamed. I think that gonorrhea is the only disease that will give us an epididymitis. This trouble is more apt to develop about the third or fourth week of a gonorrhea. I have discharged patients as cured of a gonorrhea, to have them return in a short time with a swelled testicle. Some fatigue or over-exertion, or sexual intercourse, or a strong urethral injection, may usher in a swelled testicle during a gonorrhea.

I have just been treating a case where the immediate exciting cause was playing base ball in the third week of a gonorrhea.

The left testicle is more frequently inflamed than the right. Sometimes one will become inflamed, and this subsides and the other will take on the inflammation. This, however, does not occur, as a rule, and if it does it will be several weeks after the inflammation in the first one subsides. A testicle may swell and get well or nearly, the pain and swelling all pass away, and then again become swelled.

I have just been treating a case, where three times in succession the testicle

has inflamed and become enlarged, and than has subsided, each time accompanied with the same pain, the same chills and fever. (When I say swelled testicle I mean epididymitis so-called.) I have noticed in this case that the time from the initiatory symptoms until the next attack has been just fourteen days, which led me to believe, from its periodicity, that malaria had something to do with it. During the last attack I gave him large doses of sulphate of quinine, and in twelve days again I had him take more quinine. There has been no recurrence of the trouble.

When we say epididymitis we do not claim that the epididymis is all that is involved, although I believe it is this primarily, but the tunica vaginales and the spermatic cord frequently becomes affected, even the testicle itself may become inflamed, though this is very seldom the case.

The pain of swelled testicle is very severe, making a patient very nervous and uneasy. Pain may be present in the abdomen, and there may be nausea and vomiting. The parts may be very much swelled. There is usually an effusion of serum into the epididymis, which may be removed by using a hypodermic syringe or aspirator. The back aches terribly sometimes. During the acute stage we have chills and fever. The tongue is coated and dry in the center. The patient may even be flighty and out of his head. In the course of three or four days resolution begins, and if there is no relapse we are entirely through with the trouble in about two weeks. Sometimes, after all the acute symptoms subside, the parts remain enlarged, the induration becomes chronic. I have seen the testicle remain swollen seven months after the original attack. Where the testicle remains enlarged so long the patient is apt to be of feeble constitution.

It seems to prey upon the minds of such patients. They are apt to think that they have been made impotent by the trouble; they borrow a great deal of trouble, but the leading idea is that they have lost their manhood. A mild sort of insanity may ensue, and sometimes a severe type.