perceptible for as long, sometimes, as eighteen minutes. When she would begin trying to breathe, the tongue would drop back in throat and I would have to lift it out with forceps before she could breathe. Just as soon as she breathed she would recover consciousness and converse perfectly rational, complaining, though, of pain in top of head, for five or ten minutes, then would close her eyes, begin grunting respiration and go through with same symptoms as above described. Gave bromide, in full doses, but had to give morphine on account of severe pains. She was relieved this night about 2 o'clock. She had these spells for seven nights in succession, in spite of the many nerve sedatives given during the day to ward them off.

Her menstrual flow came in March, about the 20th, I believe (the first since her confinement). She was delirious for a short while the night before it came on, but took nothing and it wore off. Menstruation was very painful in region of ovaries.

On April 2d, same time at night, she was again taken with pain in head, and in ten minutes after the head began hurting her, every muscle about her began contracting, and in an instant she was as rigid as iron. Respiration seemed to be suspended. The contraction wore off in twelve minutes. She took a deep inspiration and aroused perfectly rational. There was an intermission of a few minutes and the contraction came on again. The head always drew forward. She continued to contract until hypodermatic injection of morphine was given, which relieved her.

Will state here that the morphine never would put her to sleep. She would be wakeful the remainder of the night, and very nervous. She had these contracting spells every night for ten nights in succession.

She menstruated in May. Had the head trouble, was delirious, but no contractions. June she menstruated. Suffered great pain. Had slight contractions. July, had no flow. Had the head trouble, but few contractions. August, had the flow; no contractions. September 15th, had the flow; lasted six days. The night after it stopped she was taken

with the contracting spells as before, and had them as severe as I ever saw.

She is so now that if anything frightens her she will become delirious instantly, and have the contractions.

I will state that three eminent physicians have seen her, in consultation, at different times. Have all suggested treatment, which has been tried, but she has the spells just the same. I think it is reflex nervous action due to uterine or ovarian irritation, though I can detect no displacement.

She has taken various nerve sedatives, with no effect. Secretions are good.

She is of one of the best families of this country. I have a great interest in her, and any help, either through the BRIEF or by private letter, will be gratefully received.

I have another patient affected somewhat like this one, but never has the contractions. She says there is no pleasant sensation at all for her during the sexual act. She is twenty-five years old, married five years. Has one child. Cause and treatment, please.

I have been taking the BRIEF about six months, and will continue to subscribe for it as long as it is published. C. B. HOLMES, M. D. Bentonia, Miss.

A Remarkable Case of Obstetrics. Was called October 17th, to visit Mrs. R., in labor, who is the mother of six children.

Arriving at the bedside I found the pains very irregular, and on making vaginal examination found os already dilated, and giving one fluid drachm of ergot the pains became regular, and child was born in less than an hour. It was a female and weighed nine pounds, strong and healthy.

After child was delivered, she remarked that there must be another; whereupon, on making examination, to my surprise I brought forth another female-dead-inclosed in membrane and looked to be a foetus of seven months, measured sixteen inches in length and weight four pounds, mummified.

After delivering both afterbirths, postpartum hemorrage took place so that she flooded through two bed ticks and on the

floor. After controling hemorrage mother and child are doing well.

Being a young practitioner I have related the case to some of my older brethren but have not received any light upon the subject.

Would like to ask some of my brethren through the BRIEF if they have ever had a case of the kind. Have looked up different works on the subject but failed to find anything that would refer to the

case.

Am taking several medical journals but can say I enjoy the BRIEF the best. B. D. BRACKETT, M. D.

Claypool, Ind.

Pneumonia-Aidoiotomy.

In the March BRIEF, page 124, Dr. G. D. Gray of Buford Station, Tenn., has furnished the best article on the subject of pneumonia that has appeared in its columns for a long time. Whoever carries out his treatment will meet with success.

What Dr. S. B. Houts has to say upon genito-urinary reflexes, page 129, is worthy of special attention. About two years ago I furnished an article upon this subject for a medical journal entitled "Aidoiotomy," in which I mentioned the case of a negro child two years old which had convulsions continuously. This child had been treated by another physician, previously, and although the convulsions were temporarily arrested they returned. The case falling into my hands and the child still having spasms I found a contracted and adherent prepuce.

I performed the operation of aidoiotomy; the convulsions at once ceased. It has been now four years, and the boy has never had a convulsion since. The operation is not so much a circumcision as the cutting away of attachments which by constriction keep up irritation.

I think that physicians often neglect these things, or do not appreciate their importance. J. F. GRIFFIN, M. D.

Cloutierville, La.

We fully appreciate the kindness of our old subscribers in sending us new ones.

Chronic Muscular Rheumatism.

To the Medical Fraternity :— Dear Brothers-You will, many of you, remember of my asking for help for chronic muscular rheumatism, through the BRIEF, some two years ago, and I received many private letters, besides communications through the BRIEF, for which please accept my sincere thanks, but nothing that was advised did any good, because I failed to understand the cause, as did many physicians who saw and examined me, but finally, after suffering untold agony, I made up my mind that it must be of a reflex nature, and began to look for some remote cause.

So I concluded to have my rectum examined, although there was no pain nor discharge in that locality, but upon an examination, by Dr. Ellis, of Corpus Christi, Tex. (as I had gone there from Kansas for my health), a very large dry ulcer on posterior walls of rectum was found. I at once had it treated and cured and my rheumatism disappeared. But, prior to this time, I had discovered a projection of the spinous process of the last dorsal and two first lumbar vertebræ, indicating, to my mind, caries, but other physicians who examined me said there was no caries, but only exostosis, but not being satisfied with their opinions, I came back to Keokuk, Ia., where I graduated in medicine, and had the faculty to examine me, and they said I was right, and all but one advised a plaster jacket; I had one put on, but could not wear it, owing to the pain it produced, so I removed it and had a brace made according to my own idea, and I began at once to improve, and am still improving, and will soon be able to again resume practice. I put on the brace just before Christmas.

Luray, Mo. JAS. W. HANAN, M. D.

Suppressed Menstruation.

Dr. E. S. Robson, Durham, England, says: I had a case of suppressed menstruation of six months' standing, during which time the patient was almost entirely unable to leave her bed. After a week's treatment with Aletris Cordial (Rio) a copious flow appeared. She made a quick recovery after that, and is now able to go about as usual.

I will note a few cases of epilepsy that have come under my observation during the last few years, and should any one of the profession follow the treatment as I have done, they will not be disappointed; I do not claim the drug as a specific, for I know that it is not, I can not, at this writing, give you all the points that I have learned of its therapeutical value during the years that I have been using it, neither can I tell you, from a scientific point of study, wherein lies its chief virtue as an anti-spasmodic, but I know that these cases have been treated extensively with this drug and that cures, which seemed almost miraculous, have resulted:

a

Case I.-A. L. R., aged thirty-two, lawyer, single and had been afflicted for six years. The history of the case as follows: Had finished a four-years course of study at Kenyon College, within a week accepted the position as night editor on the Cleveland Leader, ten days later he fell from his chair in an epileptic fit. Others followed, until he gave up his work, and devoted his whole time to treatment. Everything failed, and he went East and was treated by Dr. Hammond of New York, no benefit from treatment. The doctor advised him to try everything he could hear of and not to give up treatment.

He returned home, was admitted to the bar, commenced the practice of law in Columbus. His father was a physician and at this time was in partnership with the writer. I was young, with only a few years experience, but the old doctor turned the case over to me. I had read a statement in a foreign medical journal regarding borate of soda, it occurred to me to give it a trial. I did so and gave borate soda twenty-four grains at four or five o'clock P. M.; same sized dose at bedtime. After a few days the bowels seemed somewhat loose; gave small dose of morph. sulph., with the bed-time dose of borate soda, which had the desired effect. Improvement by end of first week. Continued without any change. Morphine only when required, perhaps once a week.

Within sixty days he was feeling fine, no fits for five weeks. Treatment continued for "three years." Case well; .doing a rushing business in the courts. I see him often. Five years have passed since the case was discharged.

Case II.-J. D. S., aged twenty-six, married, merchant, hereditary tendency to epilepsy, although they did not appear with him until he was about twenty years old. At the time he came to me the attacks were occurring two or three times a day, and some nights he would have three or four.

Commenced treatment about the same as with case 1, improvement from the third day, no return of fits for nine weeks. Patient said he had been neglecting his medicine, would go at it again.

He did so, but there was not enough stability about him. A few weeks more and he dropped his treatment again; prompt return of his old enemy. He followed this plan during about six months finally quit me and took up with some advertised nostrum, which did no good, he has drifted from one thing to another, until now there is a gradual failing of the mental powers and the end is easily predicted by those who know him.

Case III.-C. W., aged twelve years, good family history, had been having peculiar fits every night as soon as he would get to sleep, for three years, had been under treatment all the time without a shadow of a change for the better, the attacks would occur every night,

sometimes two or three, sometimes only

one.

I asked his father if he would leave the case in my hands for twelve months, he said he would, if there was any change for the better. The treatment was similar to the others, only I never gave him morphine as he never was troubled with his bowels. Improved from the second week, never had another attack after the fifteenth day, discharged him, cured at the end of the year. I do business for the family and see the boy often. Two years have elapsed since his discharge, and all is well.

A few more suggestions may appear in some other articles should the above be "handled with gloves "-not critized too severely. R. C. M. LEWIS, M. D. Centerburg, O.

Breech Presentations-Eczema. A lady of my acquaintance, the mother of eight children, at term, all breech or feet presentations, without version in any case.

For eczema of infants I have used successfully

Help Wanted in Diagnosis and
Treatment.

About six months ago, Mrs. K., age forty-five, mother of several children, was taken with what seemed to be a severe cold. Was troubled at the time with a violent spasmodic cough, especially at night. During this time she noticed a swelling on the front part of her neck, mostly on the left side, which she assures me came in one night's time. About a month after this the enlargement began to pain her, and has continued to do so ever since, the pain being worse on right side, which is swollen less than the left. The swelling is not large and has increased but little in size since its first appearance. Until recently there has been very little soreness, but now there is considerable tenderness on pressure, especially on right side, where the pain is greatest.

The tumor appears to be an enlargement of the thyroid gland.

Mrs. K. is quite corpulent. Menses irregular and painful, and has been troubled with diarrhea for last three months. She complains at times of a feeling of giddiness, and is troubled with palpitation of the heart.

Now, brother doctors, please help me out with this case, by private letters or through the "old reliable" BRIEF.

I have tried electricity and have given her the iodides freely, besides making many local applications, but nothing I have done seems to give any permament relief. W. C. WHITWELL, M. D. Salmon City, Idaho.

State Laws Regulating the Practice of Medicine.

Dr. W. W. Baker, of Bloomington, Tenn., gives the law of that State on this subject. It is good-very good. I wish all the States had such a law to protect the people and the profession from imposition. This law meets needed requirements without being discourteous to the profession or insulting to the many respectable medical colleges from which most of the great physicians in the country graduated. All the Southern States have not such a law as Tennessee.

I hope each State will respond to your inquiry, and let the matter be discussed in the MEDICAL BRIEF.

I am an old physician, and write from Mississippi, but am a citizen of Louisi

ana.

Dr. B. asks old and experienced physicians to give plan of management in case of natural presentation. I would say that, generally, there is not much to be done by the physician in such cases; but if the pains were inefficient, I would prefer to give gossypium, and, with the forefinger inserted between the head of the child and the os, gently titillate. This will generally give good expulsive pains.

I would not give ergot until the head was passing the vulva. It can then do no harm, but much good, by causing tonic contraction, separating the placenta, and preventing hemorrhage. S. C. MURPHY, M. D.

Aberdeen, Miss.

Hemorrhoids.

Since my paper on hemorrhoids appeared in the October BRIEF, I have received nearly two hundred complimentary letters, the most of them containing questions. Thank you, brother doctors, for your words of commendation.

I deemed it necessary that a plain, unvarnished statement should be made relative to the treatment of piles, especially so far as the carbolic acid treatment is concerned. So many erroneous statements have been made about this method of treatment that I determined to state the facts, which an extensive and somewhat lengthy experience had proved to me. Of course, in a magazine article,

I could not enter into the minute details of the treatment, as my paper would have been altogether too long, and I am not a believer in long-spun articles in order to say a little. My paper was longer, anyway, than the BRIEF is in the habit of publishing. Still, I know of no method of reaching so vast a number of physicians as through its columns. I thank the BRIEF for varying from its usual custom in publishing my long article.

Being a busy practitioner, I have not the time to answer each letter I have received, separately, and, as so many of them contain the same questions, I will, before very long, give a general answer through the BRIEF.

The subject of rectal diseases is interesting a great number of physicians, I am happy to observe, and if my poor efforts will be the means of helping any one in their treatment, I will consider myself amply repaid for the time and trouble I have taken in preparing my papers for publication.

GEO. J. MONROE, M. D.

Louisville, Ky.

Counterfeiting.

Chas. Chadwick, Ottis R. Wyeth, Louis A. Schoen, Geo. J. Schoen, Chas. ·F. Herrmann, Geo. Eyssell and Horace L. Roy, druggists of Kansas City, were each fined $500 and costs, by Judge Worthen, for counterfeiting the preparation known as Bromidia.

The Treatment of Pneumonia. In looking over some old numbers of the BRIEF, my attention is directed to a remark of Dr. Brodie, of Kentucky, condemning the use of blisters, in pneumonia, in very strong terms. It is a familiar adage, that doctors will differ. This is unavoidable, from the very nature of things; and, in many cases, these differences do not amount to much, but there are cases in which they may endanger the life of the patient.

Pneumonia is a very common and dangerous disease, whether it is regarded from the old standpoint as a "local inflammation with symptomatic fever," or from the more recent standpoint as a "specific fever, the lung being involved as the essential pathological lesion, the result of the operation of a specific germ."

Twenty-five years ago,“lung fever," or "pneumonary fever," was spoken of by the nonprofessional, but it was considered extremely unprofessional for a doctor to use such terms in speaking of pneumonia. But to-day, the man who fails to recognize it as a "specific pulmonary fever" is considered behind the procession.

I do not propose to write on the pathology of the disease, but wish to make a

few remarks on its treatment.

Dr. Brodie says: "Blistering in pneumonia is all wrong." That it is "a very dirty, hurtful practice, that should have exploded when her twin sister (bloodletting) went by the board. You can do more harm with an old fly-blister in pneumonia than all other things can possibly counteract."

I do not know how true the latter remark is, but I do know that in certain stages and conditions in pneumonia, you can do more good with a fly-blister than with all other agencies combined.

The indications differ in different stages of the disease, of whatever form, whether sthenic or asthenic, common or specific. The first stage is one of increased excitability and vascular fullness, with more or less pain and cough. The indications here are to allay the excitability, lessen the vascular fullness, quiet the cough, and relieve pain and the

meeting these indications will materially