Pneumonia-Treatment.

Taking it for granted that the symptoms, leading to a correct diagnosis in that disease, are now so well established and understood as to leave no necessity for a discussion in this direction, I shall pass at once to a consideration of the suitable treatment - a matter about which I think there is yet some things of importance to be learned.

A full-fledged, well-marked case of pneumonia presents a half-tragical, halfheroical aspect, which strongly inclines the patient and friends to demand a corresponding form of treatment. In the mind of the physician, and especially the young physician, there is much disposition to correspond with such demand in the adoption of heroical modes.

For thirty years I have been thoroughly satisfied that the heroical mode has annually slain its thousands. In confirmation of this view, and at the disagreeable risk of a seeming egotism, allow me to state, that under the conservative mode about to be presented, I have rarely lost a case in thirty years, and not a single case between the ages of ten and fifty years of age-the cases being without complication and the patient in previous reasonable good

health.

Pneumonia among old people and during infancy and early childhood, is always more difficult to manage, with corresponding risk and probable mortality. Of course, a neglect to get timely advice, or violent disregard of advice, may result in death at any age; but with reasonable opportunity for timely judicious advice from a competent physician, under conservative modes, the mortality should be almost nil.

Aconite.-This remedy will be found useful in the early stage of the disease, characterized by strong bounding pulse, hot, dry skin, short, dry cough, rapid, difficult respiration. It fairly takes the place of the cupping, leaching and venesection of the old authors and practitioners of thirty or forty years ago. Its use should be unattended by any tonic or other effect than simple abatement or arrest of symptoms. Place ten drops of the tincture in a full goblet of water, and give teaspoonful doses every hour until better, and then at longer intervals.

Tartar Emetic.-This is probably the most valuable and important remedy in the disease. It comes in well after the opportunity for aconite shall have passed. It is indicated by noisy, rattling respiration; loose mucus or mucus and bloody expectoration; much cough with a difficult expectoration of profuse mucus accumulation in the bronchi.

The large, crude quantity, recommended by the old authors, as Rasori of Milan, and the French physicians about 1800, is not only useless, but in many cases, undoubtedly hurtful. Doubtless, attempts to imitate the practice of Rasori and Laennec have sent untold legions to the grave.

Dose.-Dissolve one-tenth of a grain in a full goblet of water and give teaspoonful doses at intervals of one hour. Should the slightest nausea appear, double the quantity of water. Sometimes there will be simultaneous indications for both aconite and tartar emetic; when the two remedies should be given alternately, at suitable intervals.

Phosphorus.-For

Bryonia Alba.-This remedy has its opportunity in pleuro-pneumonia, where a sharp, lancinating pain in the thoracic wall, much aggravated by respiration or other motion, is such a prominent factor in the general group of symptoms. Five drops of the tincture in half a goblet of water, to be given in teaspoonful doses at intervals of one hour, will be found in most cases to work a speedy and most happy relief from the distressful pain. the "brick-dust sputa" of the middle and later stages, with short, hacking cough; hasty, difficult respiration, dusky complexion and anxious expression of countenance, this will be found very effective. Where there is chest pain with moderate fever, added to above symptoms, it alternates well with bryonia. The best form of administration in the use of phosphorus, is an ethereal tincture. Each dose should be taken from a well-stoppered vial, as it rapidly oxidizes and changes form when exposed to atmospheric action. It is an active toxic agent, and should only be given in doses of from the 1-100 to the 2-100 part of a grain every two hours. It alternates well with tartar emetic where tartar emetic symptoms are added to its

own.

Ipecac will be found an excellent substitute for tartar emetic, in the treatment of children, who do not seem to bear the tartar as well as adults. Children with pneumonia are liable to have nausea, with relaxed bowels, for which ipecac is the proper remedy, while working relief to the pnemonic condition.

Drop doses of wine tincture will be found sufficient, at intervals of one to two hours.

Rhus Tox.-Delay or mismanagement in treatment, sometimes results in a typhoid state, for which the rhus does good service. As it has very strong toxic qualities, it can only be given in very minute doses. Add one drop of the tincture to one ounce of alcohol, shake well and give drop doses at intervals of one to two hours. It alternates well with bryonia.

Sanguinaria is useful in advanced stages for circumscribed flush on the cheek, much difficulty in breathing, position on the back, burning pain in the chest, much cough, with rust-colored sputa, worse in afternoon.

Gelsemium.-By an oversight, I find I have omitted to place this remedy immediately after aconite. In the earlier stage of this disease, should aconite fail or on any account be contra-indicated, I nearly always find gelsemium the remedy. It is especially suited to children with nausea, soft moist skin, brain disorder, tendency to periodicity in the febrile condition.

Sulphur.-In the last stage of protracted cases, we sometimes reach a point where a variety of small symptomatic debris, seem to stand in the way of convalescence. For this condition, small doses, three or four times a day, will usually regulate matters very satisfactorily.

Local Applications.-Moist heat is the very best, both as a means of palliating pain, and a furtherance of the general treatment. For this purpose, large, hot poultices, or hot fomentations, frequently repeated, will be found very satisfactory.

Diet. This should consist of hot liquids in form of broths, gruels or milk. The habit, now somewhat in vogue, of stuffing a patient without appetite, and stimulation where we already have high

febrile and inflammatory excitement, is most clearly a mistake.

W. A. EDMONDS, A.M., M.D.

St. Louis.

Occipito-Posterior Presentations.

In the MEDICAL BRIEF, of December, page 497, T. Griswold Comstock, M. D., Ph. D., says, in regard to occipito-posterior presentations:

"In this case, with every pain, the occiput is forced into the hollow of the sacrum, where it remains fixed, instead of flexing and distending the perineum, as it does when anteriorly situated; it extends backward, while the cinciput is fixed under the arch of the pubes, and labor is permanently arrested."

He then asks: "Now, what is to be done?" and goes on to say, "Some have tried to push the forehead above the pubis, but have found it impossible," etc.

I would ask the doctor why any one should try to push the forehead up when it is "permanently fixed," and when, at the same time, the pain is pushing the perineum backward?

Suppose we follow nature (unless the head be small so that we can use the vectis to advantage) just apply the forceps, and while the pain is pushing the occiput backward into the hollow of the sacrum, bring the chin out under the arch of the pubes; and then the main trouble is over. This has been my mode of procedure, in an experience of nearly forty-five years, and I have encountered quite a number of cases without the loss of either mother or child. Lincoln, Neb.

B. F. HART, M. D.

Menstruation-Conception.

Dr. Hamilton H.Wilcox, convince that "fine-looking, red-faced, well-formed, plump little sixteen or seventeen year old Miss" that she is all right and that there is no necessity for her menstruation. Tell her medicine may produce disease, but go on romping and playing and in due time she will come out all right.

F. E. Aspinwall, M.D., to prevent conception, castrate the man effectually and thoroughly, or the girl will slip up. P. S. CLARKE, M.D.

Hempstead, Tex.

Genital Functions. God, in the days of Moses, put a guard over the genital functions of the Israelites, so that they should not abuse them. The husband was not permitted to have sexual intercourse with his wife during menstruation, nor short of eight days after; nor short of eight days after any metrorrhagia (Lev. xv., 25). In that way giving rest to the genital functions of both man and woman, twelve or thirteen or more days, which was a wise provision that both man and woman should preserve their genital and general health and vigor, and also beget and conceive stronger offspring, and besides all this, He made other provisions, that if his seed of copulation went out of him, he should bathe himself and be unclean until the even, also the woman and every thing on which was the seed of copulation, and had to undergo a tedious process of purification so that under all those restrictions a man would refrain from masturbation and also would defer sexual intercourse to long intervals rather than endure the inconvenience of being unclean until the even, or for seven days in some cases, and bathing himself and herself, etc., etc., and in this way they would get a further rest to their genital functions which the Gentiles in general knew nothing about. Although the Jews have been a very rebellious people, yet the restraining influence of these laws has helped to maintain them a healthy, vigorous, intellectual people.

God did not explain the scientific bearing of these laws to primitive man; but left this for men in after ages to explain, and now in this 19th century we are just as much under obligation to obey the laws of truth and science, as the Jews were to obey the laws of Moses; therefore let christian nations carry out the spirit of these laws, so far as truth and science teach. Let them never have sexual intercourse out of wedlock, nor during menstruation, nor short of eight days after, and during the remaining intermenstrual period, exercise a restraining influence on themselves from a truthful scientific sense, as the Jews did from a religious sense.

The way to do this especially after the first year of married life, is for husband and wife to have separate beds, or still

better, separate apartments during that period, twelve or thirteen days, in which the Jews were forbidden sexual intercourse, and then the balance of the time they ought to exercise as much restraining influence on themselves from a truthful scientific sense, as the Jew was forced by religious penalties to abstain. If all that were carried out, the time they occupied the same bed would be a very few nights in each month. In occupying separate beds, their sleep would be less disturbed and they would be less exposed to temptations to break their rules. To be sexually temperate, husband and wife ought not to have intercourse oftener than once in two or three weeks.

Lord Kame, in his Elements of Criticism, says excesses with one woman producing a disgust for her, produces no disrelish for another. A woman is a counterpart of man, and the same law would apply to her; though if they I could deceive each other so that he would think she was another woman, or he was another man, would be equally satisfactory. Now, therefore, to avoid all such Lord Kame criticisms, let the couple carry out the above rules as firm as the laws of the Medes and Persians, and then they would never get any disgust for each other. Her breasts would always satisfy him, because he did not come in contact with them oftener than rulable. The couple could then endure considerable intercourse at one time without much exhaustion, provided they did not have intercourse oftener than I have designated; but the way they usually proceed, both frequently become exhausted, the man in particular incapable of producing a consummation of orgasm of the woman; but, if they proceed according to the above rules, the orgasm of both is completed, provided the man does not commit onanism (Gen. 38., 9); in that case there is no consummation for the woman, and then they ought to rest from that business, according to the rules I have specified, and, if she remains virtuous, her price is above rubies, and if he does the same, then the same price.

Men should eat to live, and not live to eat. Men ought mainly to cohabit to propagate the species, and not for mere animal indulgence. Many couple have

sexual intercourse every day, and in that case, every other seminal emission of that man on that day after the first, is equal to the loss of half a pint of blood. The woman is not exhausted in the same way, but she is very apt to get worn out and become affected with genito-urinary diseases too numerous here to mention ; but if a couple carry out the rules I have laid down, the man might have two or three seminal emissions on the same day without any injurious exhaustion, or any injury to his wife; however, on all occasions, they had better be temperate; besides, in such a case no damaging exhaustion being produced to the couple there would be no damage to the offspring which might be produced; but with the couple who have intercourse every night, the spermatazoæ become weak and feeble and the ova are prematurely developed and comparatively deficient and the offspring which develops from them is also comparatively weak and incompetent. Good farmers act more consistently with their stock, than men and women act with themselves, for they will shut the male away from the female and admit him to the female to a limited degree at the proper time, in order to save the strength of both male and female, and thereby get good, vigorous, well-developed stock.

Dr. C. H. Merrick, on page 272, Vol. XVI., of the BRIEF, in the beginning of his article, says, in substance, that it is death to a man fifty or sixty years of age to marry a woman much younger than himself, especially if she is lean, hard and amorous. I would say that no harm would accrue to even such if they would observe the rules I have suggested. The balance of the doctor's article is good and worth heeding.

Drs. J. G. Kiernan and S.V. Clevenger in the November Western Medical Reporter, give a large number of horrid cases of sexual perversions. If all those perverts had observed the laws, and rules, and science and truths I have stated, and educated their consciences accordingly, they would never have become perverts.

Probably in the course of two or three months I will continue the above-named subject. SILAS HUBBARD, M. D.

Hudson, Ill.

(Continued from December BRIEF.)

Whenever a Kajan enters a household, he believes it to be his bounden duty, as laid down in the catechism, to shake hands with every one in sight, from the great-great-grandfather down to the tiniest babe, though there may be present a hundred persons.

Not to do so, would be a grievous sin, the burden of which could only be removed by a goodly number of masses. Besides, he would incur the enmity of every one so slighted.

When one Kajan meets another in the road, on foot or on horseback, each must stop and shake hands.

If, on passing one another on opposite sides of a river that is fordable, they must both ride down the banks and meet midway in the stream and shake hands. Not to shake hands with a Kajan, is to lay yourself liable to incur his everlasting ill will. This custom of hand-shaking is universal among these people.

I am reminded of a circumstance that occurred to me something over twenty years ago, when I first located among them in Avoyelles parish. I was then, as it is reasonable to suppose, considerably younger than now. I had observed this disposition among the Kajans of shaking hands, and was told if I wanted to secure their eternal good will and get a large practice, all I had to do was to pay strict attention to the observance of this ceremony. Accordingly, I went into the hand-shaking business on an extensive scale. Shook hands with every man, woman and child I met, under all circumstances. If I went to church, after service I would go up to the chancel and shake hands with the priest, and then stand at the door as the congregation passed out and shake hands with every

one.

I grew immensely popular and got a tremendous practice. Old Dr. Dulaney, who had lived there before me and was considered un bon docteur, but who rarely shook hands, began to lose practice, while I was beginning to have more than I could attend to.

It was the 14th of November, and my birthday. I had invited a number of friends to dine with me. Dinner was over. The afternoon was quite pleasant for November, and my guests and I had taken seats on the "front gallery," as we term the porch down South.

We were puffing away at our cigars, and I, for one, was enjoying myself hugely. A man was observed riding rapidly down the street, who halted in front of my house. It was John Baptiste Delerie.

"I'm behind you, doctor; father is dying, come quick," he said.

I was loth to leave my guests, but duty called me and I was excused. My horse was brought, and, shaking hands with my friends, I left them to their own devices.

Now, there is another habit among the Kajans, quite equal to hand-shaking. When a Kajan of any importance is taken sick, and known to be quite ill, all his friends, his kin, and all who have any interest in him, quit their homes and take up their residence with the sick person; and if the person has little means, one will bring some corn meal, another sugar and coffee, another some meat, and still another something else that will serve for the inner man.

These are prepared by the women in attendance, as it is necessary to have the wherewithal to sustain life while attending the sick. Time and time again have I gone to a sick person and found, by actual count, from seventy-five to one hundred people scattered in and around the house.

When I reached the home of Baptiste's father, there were about eighty-five persons in attendance. I entered and first shook hands with the patient, who, from the casual glance I gave him, did not look to be very sick, and accordingly I began shaking hands as usual. I shook hands with the grandfather and grandmother, then with the paternal and maternal parents, then with some eight or ten brothers and sisters, all the children (ten in number), proceeding on with others as rapidly as the emergencies of the situation would permit. It is true, I found it a little irksome, but necessity knows no law. How long it took me, I can not say. As the poet writes,

"I took no note of time."

(Since then I have taken many a note on time)-but on I went, recklessly shaking hands until I had gone around to perhaps seventy-five, when suddenly some one cried:

"Come, doctor, come quick!"

"Yes, yes," I said; "I shall soon be through. I have only ten or twelve yet to shake hands with."

I finished, however, in a "twinkling," and then went up again to the bedside of the patient, feeling that I would have ample time to make a thorough examination. I placed my hand on his wrist to feel his pulse. He was dead! Cloutierville, La.

(To be continued.)

Piles.

About the first of November last, I was called about eight miles in the country to see Mr. A. W., farmer, age thirty-five years. Found him suffering from piles. I examined him and found three tumors, as large as hen eggs, protruding, blood red, and would bleed with the slightest touch. I inquired how long he had been suffering with the piles, the answer was twelve years, and have been treated by almost every doctor in the county, without any relief, and if you don't cure me I will not pay you one cent.

Poor encouragement for a young M. D., but went to work, in the hope that I would be successful. After three weeks' treatment without the least improvement I felt like giving up. Just then the MEDICAL BRIEF, December number, came and on page 508, I saw that Dr. A. F. Watkins wished that Dr. Griffith would try his treatment, which I adopted in my case at once, and in ten days two of the tumors dropped off. The third not being affected, I repeated the same treatment twice in the remaining tumor which disappeared without dropping off.

Before closing I would like to inquire of Dr. Watkins whether the tumors should drop off or not. I think that it depends upon the amount of blood these tumors contain.

I tender my humble thanks to A. F. Watkins, M. D., for the aid thus received.

Long live the BRIEF.
Beacon, Ia.

J. R. CROSS, M. D.