Abortion-Sciatica. I had occasion to test the treatment for retention of afterbirth, as given by Dr. Andrews (p. 281) and Dr. Smith (p. 284) in June BRIEF, but did not succeed very well, and would like to hear something more from the same gentlemen, or others, on the same subject, as it is very troublesome to manage. I used a tampon and hot carbolized water injections, and the membrane came away the third day. A profuse hemorrhage the last two days. What good could be expected from carbolic acid injections unless they entered the uterus? and are not such injections very dangerous? I used, internally, ergot, cimicifuga and tinct. capsicum, but did not control it well. I believe it bad policy to leave the membranes in utero, and bad to take them away immediately. I would be thankful to have some evidence on which I could act, so as to know which of the two evils is the better. I have, at present, a half dozen cases of hip, thigh and leg diseases over which I have had no little trouble. They have baffled the skill of several physicians and seem very stubborn. A short sketch of some of them may enable you to help me out: Case I.-A negro woman, about thirty years of age, no children; has apparently good health, except hip trouble, which she has had for six years. Pain about hip joint, down back of thigh to the knee. She is always able to be up and do moderate work. I have never been able to improve her condition in the least. Case II.—Mr. C., age twenty-nine, well developed and very muscular. Has been troubled with pain in hip and back of thigh for about six months. Riding in a buggy or sitting quietly in a chair aggravates the pain. He claims to get relief by lying on the floor a short time. Case III.-Mr. S., about nineteen years of age, was taken about six months ago with pain in back and down the thigh, and finally located in the tibia and fibula. The flesh is not sore, nor has it swollen, but slightly perished. He can scarcely walk on that leg. It is hardly necessary for me to mention what remedies I have used, as I could easier mention those that I have not. Is morphine and chloroform injection indicated in sciatica? Any information on the above cases will be thankfully received. The BRIEF is, by far, the best medical journal I have ever seen. Roscoe, Ga. J. R. SEWELL, M. D. Medical Practice Law in Wisconsin, In answer to the request of W. N. Baker, M. D., Bloomington, Tenn., in MEDICAL BRIEF, October, 1889, the law in this State is as follows: "No person practicing physic or surgery, or both, shall have the right to collect in any action, in any court, fees or compensation for the performance of any medical or surgical service, or to testify in a professional capacity as a physician or surgeon in any case, unless he shall have received a diploma from some incorporated medical society or college, or shall be a member of the State or some county medical society legally organized in this State." No person practicing physic or surgery, or both, who is prohibited by the foregoing from testifying in a professional capacity, "shall assume the title of doctor, physician or surgeon, by means of any abbreviation, or the use of any word or words, letters of the alphabet of the English or any other language, or any device of whatsoever kind, printed, written or exhibited in any advertisement, hand-bills, letter or other instrument, nor in any card, sign, door or place of whatsoever." Any violation of this shall be deemed a misdemeanor, punishable by a fine of not less than $25, nor more than $100, or by imprisonment for each offense. "Every person pretending to practice physic or surgery or both, shall, upon demand of any person, exhibit all diplomas or licenses that he may have, and if such person, upon demand, shall refuse to exhibit such diplomas or licenses, any suit instigated against him, under this chapter shall not be considered malicious. SECTION 1, Chapter 256, of the laws of 1881, is hereby amended by adding the following at the end of section 3, of said chapter: the provisions of the foregoing act shall not be so construed as to prevent students from practicing under the direction of a qualified preceptor, nor women practicing midwifery, nor veterinary practitioners in their special departments. SECTION 2.-Section 4, of chapter 256, of the laws of 1881 is hereby repealed. SECTION 3.-This act shall take effect and be in force from and after its passage and publication. Approved March, the 2d, 1882. L. T. BRANCH, M. D. Sechlerville, Wis. Does Hydrastis Induce Cessation of Menstruation? I see Prof. A. Reeves Jackson holds the belief that menstruation, in itself, does women no good. I believe that to be true. We know (or believe) that at maturation of the ovæ, a flow of blood and the peristaltic action of the fallopian tubes, carry the ovæ, or ovum, down to the uterus. But there are a great many good girls and women who don't want such a thing to occur. They firmly and honorably believe that they should not marry, copulate and propagate (and they have a right to), and that the propagation of the species should be relegated to those who find pleasure and profit in it. So if there is a remedy or course of medication to stop and cure menstruation, let us use it. Lowenthal reports several cases where he successfully used hydrastis to prevent menstruation where it was injurious, as in chlorotic and anæmic or dysmenorrhoeic patients. Would it not be better to prevent menstruation than conception? Will the brethren of the BRIEF take it up, investigate and report? Bedford, Ia. M. C. CONNETT, M. D. 1. Slight itching. 7. Patches on flexure surfaces. 1. Cutaneous itching. 4. Pearl-like scales. 6. Extensor surfaces. 7. Patches. 8. Round or circular eruptions. Here are two different diseases so much alike that an honest difference of opinion is justifiable and excusable, and practically it may make no difference in treatment. Still, accuracy of diagnosis is required in case of legal difficulties, or in cases of reputation, for a physician's reputation often rests upon a rather infirm foundation. Again we find eczema and lichen planus closely resembling each other, and so on to the end of the chapter. Quackery consists in ignoring scientific rules and terms, but is often more successful than scientific medicine, yet is not as successful in producing permanent results. L. G. DOANE, M. D. New York City. Epidemic Dysentery. I have been much interested in reading the different modes of treatment, advocated in a number of the BRIEF, of the above disease, so thought I would report my mode. I have had a great many cases of it to treat, the past Summer, a regular epidemic prevailing for weeks. I attributed it largely to the cold, rainy weather we had, as many of my patients, and especially young children, had been particularly careful of their diet, thereby hoping to escape the disease. I followed about the same mode of treatment with all, and was successful in every case, but one; and that was an old lady, age eighty-seven years, who was too exhausted by age to recover, though I had the disease well under control before her death-heart failure setting in. I generally found, on being first called to a case, that they had been pretty well dosed with castor oil and laudanum, so that I did not have to begin by clearing out the intestinal canal of any irritating substance. I think some of the cases were aggravated by the cathartic. My plan was first, to order starch water and laudanum injections after each evacuation, and to have the abdomen thoroughly rubbed with a mixture of turpentine and lard, covering with flannel afterward. I have seen marked relief from pain and tympanitis follow the above. Internally, I would prescribe equal parts of Dover's powder and subnitrate of bismuth, about ten grains of each, for an adult and proportion the dose according to age, giving an infant about two grains of each, every three or four hours. That combination has always acted well in my cases, relieving the severe pain and griping complained of, and forming a protective coating to the irritable mucous membrane of the intestines. I also prepared a mixture of tannin about one-half teaspoonful in one-third glass of water, flavored with essence of peppermint, and ordered one or two teaspoonfuls in water, every three or four hours, alternated with the powders. That always checked the bloody evacuations, and soon changed them to a more natural appearance. I laid great stress on the diet, allowing nothing but boiled milk and brandy on the start. When under control, I allowed beef essence, and raw eggs well beaten, browned toast and boiled milk. I strictly forbade vegetables, fruit or starchy food, until the bowels had resumed their normal functions. I had one severe relapse in a patient, a lumberman, who ate chicken broth containing rice. For the severe prostration following the disease, I prescribed quinine, iron and nux vom. For children, elixir lactopeptine and tinct. cinchona. My treatment I consider simple, generally carrying the medicine and preparing it myself, but I found it wonderfully efficacious. There were quite a number of deaths from the disease in this section, but only the one mentioned in my practice, and I have a large share of the practice in this and adjoining towns. May the BRIEF continue to prosper. ELEANOR I. HORN, M. D. Lake George, N. Y. Dysentery. A gentleman asks for the treatment of dysentery, but does not state all the symptoms or give any history of his case. If the gentleman will do so I can answer his questions much better. Dysentery may be idiopathic or may be a complication. LUIGI GALVANI DOANE, M. D. New York City. Milksickness. in In answer to the interrogatory "Is there such a disease as milksickness," asked by Dr. C. H. Edwards of Lyons, Ind., the September BRIEF, I will answer emphatically, yes. A disease specific in its nature as much so as erysipelas, diphtheria or syphilis, and as distinct from malarial or other forms of fever, as malarial is different from typhoid, although in some respects the symptoms simulate those of malarial fever. The disease occurs originally only in the lower animals, as cattle, horses, sheep and goats. The hog seems to be entirely exempt from its ravages. As to its origin in the lower animals, that is a much disputed question by the profession and laity in sections of the country where it is prevalent. The exact origin of the disease has never been demonstrated and it still remains as much a mystery as it did fifty years ago. I have not space in this article to enter into a discussion of it. I have my theory but will simply say, I believe it to be of a vegetable origin, occurring only in virgin soil, and that in timbered lands only. Never saw or heard of a case in prairie lands either new or old. And in timbered lands where it occurs, as soon as the soil is cultivated and the wild vegetation destroyed the disease is forever abated. I was reared in the western part of Montgomery County, Indiana, near Waynetown. In the early settling of that section, and for many years subsequently thereto, the cattle and horses would die annually, every fall, with milksickness, and dogs feasting upon the dead carcases would take the slows, linger for a time, and finally die, from eating the poisoned flesh of the dead animals. But not only the animals, but persons drinking the milk and eating butter and cheese from diseased cows, imbibed the poison and scores of the early settlers of that section fell victims to the deadly poison, and sank to premature graves. In 1860, while I was a medical student, my preceptor, the late Dr. James A. Berry, had four cases, all adults, in the same family and all fell victims to its fearful ravages. In 1865 I commenced the practice of medicine at Green Hill, in the north eastern part of Warren Co., Ind., and at that time the disease was very prevalent in the timbered lands along the Wabash River, and during the eighteen years I practiced in that vicinity, I had a very extensive experience in the treatment of milksickness, seeing and treating more or less cases nearly every fall, as that is the season of the year when it is most prevalent. Symptoms of the disease in man: The onset of the disease is generally abrupt and among the first symptoms is excessive nausea and vomiting with a burning sensation at the epigastrium and an insatiable thirst for cold water, and which almost as soon as swallowed is re jected. The vomiting is incessant and often very troublesome to control. In connection with the vomiting there is nervousness and feelings of lassitude and uneasiness and great muscular weakness. The tongue is deeply furred, with a yellowish or brownish coat, and the skin is red and flushed, indicative of great febrile movement, yet this is deceptive, as the fever is generally of an asthenic type, pulse rarely running over 90 or 100, and the surface is cool to the sense of touch. In most cases there is an offensive odor, somewhat similar to mercurial ptyalism, though this symptom is not always present, only those who have imbibed a large amount of the poison have the offensive smell. One of the pathognomonic symptoms of the disease is the greatly contracted and shriveled condition of the abdomen, causing a perceptible pulsation of the abdominal aorta along its entire course. The bowels are constipated and often difficult to get a free operation. The disease is very malignant, and unless properly treated usually ends in death. TREATMENT,-The nature of the disease being that of a vegetable poison, the treatment consists mainly in giving an andidote for the poison, and experience has taught that the antidote, whatever the nature of it may be, is alcoholic stimulants. This is almost a specific, as near as quinine is for malaria-and the most suitable form in which to administer it, is whisky or brandy. I usually commence the treatment by giving a tablespoonful of whisky every hour, and continue it until the patient is convalescent, which is usually in two or three days. This almost invariably stops the nausea and vomiting, quenches the thirst, quiets the nervousness and restores sleep and after a good nap, the patient awakens much improved. I often have seen patients who were in a very critical condition after a few days of the above treatment, apparently convalescent. For physic I give castor oil in combination with whisky until I get a free passage from the bowels. To control obstinate vomiting apply a blister to the epigastrium, and to the vesicated surfaces apply a small amount of sulph. morphia. After the patient has made some improvement the stimulants are given less frequently, and sulph. quinia alternated between the doses. If the above course of treatment is pursued, no other remedies are needed. Some have advised the alterative effects of the mercurials, and gave calomel, but in my experience they proved of no avail whatever, the patient growing worse as long as they were used. In case the patient is not seen until a state of collapse, then vigorous stimulation both internal and external should be used. Whisky or brandy, internally, at frequent draughts, and sinapisms to the extremities and over the abdomen, and frictions of whisky and cayenne pepper to the spine and limbs, or heat by the usual mode of corn ears dipped from boiling water, or heated bricks, or jugs of hot water. The great point is to bring about speedy reaction. As soon as this is accomplished the usual mode of treatment should be pursued. Ambia, Ind. A. V. MOORE, M. D. PUS IN URINE.-To detect pus in urine, drop enough tincture of guaiac into a specimen to produce a milky appearance; then heat a few moments. The pus will produce a blue tint. Carbolic Acid Treatment of Hemorrhoids. It is an indisputable fact that until within the past few years, an operation for the radical cure of hemorrhoids was considered so formidable an undertaking that their treatment, outside of palliative measures, was almost entirely eschewed by the general practitioner. Having retired from the general practice of medicine for the purpose of taking up the study and pursuing the treatment of rectal diseases, I feel constrained to offer a few remarks concerning the carbolic acid treatment of hemorrhoids, more especially, after seeing, in some of the current medical literature, Dr. Mathews, Louisville, Ky., quoted on the advancement in the treatment of rectal diseases, which advancement reminds me of that period in the history of medicine (1609) when the French Academy, a beacon light and fountain (fons et origo) of medical science and literature, expelled one of its members for making use of quinine in curing his cases of ague. About this time and in direct accordance with the same status of medical learning and scientific (?) advancement, a surgeon who dared to bring together the edges of a cut surface to unite by first intention, or who had ventured to dress wounds by water dressings, in lieu of plugging by pieces of lint or wax, by which the healing of wounds was protracted to weeks and sometimes months, met with universal reprobation and was accused of quackery. Why were these palpable means of advancement tabooed by the learned profession? Was it because they were not discovered or taught by the crowned heads, and consequently not considered sufficiently scientific? Dr. Mathews says: "The treatment of hemorrhoids by carbolic injections is fast losing favor, and their removal by incision is by far the most scientific and freest from danger." Are twenty-dollar gold pieces fast coming into disfavor and quarter-dollars taking their place as being more desirable and valuable? This appears to me to be about the ratio of difference in the treatment of hemorrhoids by carbolic acid of proper strength and properly applied, and that of the knife, ligature, etc. Why are carbolic acid injections coming into disfavor? It is because you can not chloroform, tie, cut, bleed and otherwise torture your patients? What are the dangers of carbolic acid when properly used? If you inject a coagulating fluid into a coursing vein you might expect some trouble to arise, or if you inject a cauterant deeply into the tissues of a gut you might expect some sloughing. Carbolic acid is a local anaesthetic, antiphlogistic, cauterant and antiseptic, and will strangulate the circulation in a hemorrhoidal tumor as effectually as a ligature, and do it cleaner, leaving no scar or stump behind. If sepsis ever occurs such results must be occasioned by the solution being too weak, decomposition taking place from the half dead and half living tissue; extensive sloughs |