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Inherited syphilis properly belongs to and is an affection of children in early life. The disease will not be manifest at birth, but symptoms of it will show at from two to four weeks after birth. Such children when born present a wrinkled, old appearance. In from two to four weeks this condition is changed to a reddish, fresh, or lively appearance of the skin, upon which vesicular rash appears. This rash remains for a period of a few days and then is transformed into the pustular variety, and may attack the toes, mouth, eyes and other parts of the body in the form of an inflammation and subsequent ulceration. The deeper tissues and viscera are liable to be invaded by it, and many of the bones become permanently enlarged.

In the earlier stages of syphilis the treatment will consist of such remedies as are known to hasten fatty degeneration of cellaccumulation and eliminate it from the body. Iodide of potassium is the invincible foe of syphilis, and its use should be begun early and carried gradually from thirty grains a day up to three or four hundred per day to asssure complete success.

The idiosyncracy of some patients will not admit of the use of iodine in any form, in consequence of the tendency to iodism in some and salivation in others, while also, in others, perhaps, a papular eruption is scattered over the integument of the legs, arms and abdomen, which will necessitate the suspension of the iodine. In those cases where iodine tends to act in this manner, I add bromide of potassium in about one-half the quantity of the iodide, and have obtained good results from the combination, viz.: R Potassium iodide

Giv
Potassium bromide.

5ii
Aqua menthæ pip

Giss
Syrup stillingia comp. qs. ad

3 viii M. Sig.-One dram every three hours, and gradually increased to half-ounce dose.

The above mixture is intended to relieve coryza, pain in the frontal sinuses, neuralgia and oppression in the head incident to iodism. Every person who contracts syphilis is seized with horror so soon as he is made acquainted with the enormity of the disease, and his brain and nervous system suffer from shock and great mental anxiety, which tends to depress vitality. In all such cases the bromide of potassium or ammonium should be given until the nervous feeling passes off, viz.: R Bromide of ammonium

Ziv
Syrup stillingia comp. qs. ad

Ziv
M. Sig. -Dram doses every two or three hours.

We must bear in mind the fact that syphilis carries with it many complications that are often more difficult to cure than the disease itself. The complications are often so numerous in this affection that any general description of them is next to impossible. In some cases tumors of various sizes, from that of a pinhead to the size of a guinea egg, form beneath the integument and remain until either absorbed or end in suppuration. At no time are they very painful, and they readily yield to appropriate treatment. Syphilitic nodes in the bones, alopecia, ecthyema, necrosis, psoriasis tumors, internal as well as external, softening of membranes, iritis, sclerotitis, otitis and keratitis are some of the more important complications that follow the primary and secondary stages of the disease. Every secretory organ in the human body becomes affected with the poison. The serum, lymph, and blood are degraded and blood poison ensues, causing destruction of the integument, cellular tissue and bones. There is no road in the human body that syphilis cannot find and travel over successfully, leaving plenty of signs or guide-boards to mark its path from the beginning of the first initial lesion to the healing of the last ulcer in the tertiary stage. The treatment will have to be varied to suit each particular case. Each new condition that is present must be met with appropriate remedies, and that, too, at the proper time and stage of the disease. The patient should be instructed in the proper use of hygienic measures, how to bathe himself, what to eat, drink, and how to care for himself during the entire course of treatment.

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SECONDARY SYPHILIS. In the early part of this stage of the disease we often have present a chloro-anæmia, or loss of blood corpuscles, which will require treatment with some of the various preparations of iron, namely:

Ferri Iodid Syrupi
Iris Versicolor Fl. Ext..
Berberis Aquefol. F1. Ext...

.aa 3 i
Syrupi Auranti Cort. q. s. ad.

Z viij Mx. Sig.: One drachm gradually increased to one-half ounce

every four hours. Should this mixture prove disagreeable, then the following one may be substituted, namely: F1. Ext. Echinacea

Zij.
Berberis Aquaefoli, Fl. Ext.

.Z j.
Xanthoxylin, Fl. Ext.

Z ss

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Macrotys F1. Ext.

.3 ij Elixir Simplicis, q. s. ad..

: Z vij Mx. Sig.: Same as above.

In the latter part of the secondary stage of the disease the sulphur ointment, or, what is better, the iodoform ointment wellrubbed along the spine and over the chest, will do much to allay the itching sensations that are often very annoying. The patient after being well-rubbed with the ointment should be given a Turkish, or hot water bath. The way I have the iodoform ointment prepared is as follows, viz:

No. 1.
Iodoform Pulv.

..3 iv.
Balsam Peru

3 j. Oleum Cinnamon

..3 j. Ceratum Simplex

.Ziv.

Mx. Ft. ung

.3 iy xxx.

No. 2.
Muriate Cocaine

.grs. x.
Podophyllin

• grs. XXX. Iodoform

.3 j. Gaultheria Oil

.aa gtts. xxx. Ung. Petrolei Mx. Ft. ung. Sig.: As directed.

Either of these methods will do away with the unpleasant odor of the iodoform.

In the tertiary stage of syphilis the therapeutic value of the sulphide of calcium cannot be overestimated. Its beneficial effect can be noticed upon the subject during the first few days of its use, by an improved appetite, gaining of strength and decrease of the morbid condition of the skin. The best method of prescribing it is in pill form. It is always best to begin with the quarter-grain pills hourly until the disease is brought under its influence, when half-grain pills may be given the same way for a few days; then one-grain pills every two or three hours thereafter. Treat the syphilitic ulcers with bismuth subnitrate, kept constantly applied, to exclude the atmosphere, viz:

Atropia Sulphate
Bismuth Subnitrate

.3 ij.
Mx. Sig.: Use as directed.

Another favorite dressing that has done me good service in the past is, namely:

grs. ij.

.3 ij.

.3iv.

Acid Carbolic cyst

grs. xx.
Liquor Morphia Acetate
Glycerine q. s. ad....

.Z viij.
Mx. Sig.: Apply to sore either on lint or cotton.
Another one, namely:

Oil Cade
Liquor Plumbi Subacetate

.3 iij.
Tinc. Opii deod

.3 ij. Glycerine q. s. ad..

3 vj. Mx. Sig.: As directed.

During the treatment of tertiary syphilis, recourse may be had to vegetable remedies, viz: Fluid extract Fucus vesiculosus, Iris versicolor, Stillingia comp., sarsaparilla comp., etc. They are not only antisyphilitic, tonic and stomachic, but very agreeable menstruums for the exhibition of the salts of copper or potassium. Echinacea is proving a most valuable remedy.

Syphilitic ulcers of the mouth should be treated by the applicacation of argenti nitras, nitric acid, or caustic potash and a gargle of the saturated solution of exsiccated alum may be used three or four times a day until the ulcers heal. Another very good gargle for this kind of sore mouth and tongue may be had in the glycerated tannin. An infusion of white oak bark five parts, compound tincture of myrrh one part, is good. Indolent ulcers that do not readily yield to the above treatment, may be filled with sulphate of zinc and allowed to remain in until thoroughly saturated with blood, when it should be removed and the astringent gargle used until the cure is complete. This latter plan has proved entirely satisfactory in ulcers of the mouth, legs and groin, following bubo and in all cases in which I have used it.

The chief remedies used in syphilitic diseases which I have treated are, viz: iodine, iodide of potassium, iodide of iron, iodide of sulphur, iodide of ammonium, iodide of sodium, sulphate of copper, sulphate of calcium, nitric acid, chloride of gold, echinacea, stillingia, sarsaparilla, Rumex crispus, Fucus Vesiculosus, Iris Versicolor, Xanthoxylum, Phytolacca Decandra, Marotys, Podophyllum, etc. Syrups or elixirs are the best menstruums for the exhibition of all alteratives, and they should be so combined that two to four drachms would be given at a dose, for the greatest good is had through the effects of an alterative administered in this way.

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PACTS AND FALLACIES IN GYNECOLOGY.*

EDNA T. MATTHEWS, M. D., DAYTON, Ohio.

The principal uterine reflex that a woman is subject to is a circumscribed, gnawing, constant attention-demanding pain in the left ovary. This has no let-up day nor night, and finally presents itself to her as the whole trouble, yet how often we hear the story that Dr. So and So said, “Yes, she had ovarian trouble.” Ovarian reflexes, are not numerous; neither are ovarian diseases.

A man who keeps case records will be surprised at the fewness of wrongs either functional or organic with the ovaries. The usual reference is to surface supplied by the external cutaneous nerve, on outer surface of thigh, a small spot near the femoral ring, and one small area on outer surface of heel.

Pelvic floor consists of fascia, muscles and fat extending across the inferior plane of the pelvic girdle. This floor is similar in both sexes in many parts of its construction. In athletic women of active outdoor pursuits we find this floor arched well upward, firm and elastic in texture, labia approximate and an absence of sagging tissues; we should find the same condition in a nulliparous woman.

Injuries to the pelvic floor.-To properly understand these in their present and remote consequential history, complicated with woman's hydra-headed reflex nerve system, requires a varied and extensive knowledge. First, we must understand and consider the evolution of man and the comparative anatomy of some of our fourfooted friends, especially the arrangement and uses of their muscles crossing the opening thereof, the rudimentary coccygeal muscles in man, and the changes wrought in use of muscles and upon contents of cavity by the assumption of the erect position. Probably the formation of the pelvic floor would be adequate, or could be made so, for the support of contents, if woman took her place in the life-work of the human family, eliminating the tomfoolery of modern life and dress, devoting her time to muscle-forming labor instead of effeminating and lackadaisical pursuits. As the world's history is written, and mechanical devices are multiplied, men's wages will become less and women's possible expenditures on self and home will be decreased, they will be compelled to take up lucrative employment in the time that they can spare from their domestic duties. There is no employment so wholesome for

*Reprinted from the Transactions of the Ohio State Eclectic Medical Association.

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