When I first saw the patient he had been taking large doses of antipyrine, which produced cyanosis, and he was delirious from uremic poisoning. We prescribed morphine to relieve pain; potassium acetate and squills for a few days to act on the kidneys, digitalis to keep up the heart pressure, and as much Bethesda water as the patient would drink to dissolve and dilute the poison, flush kidneys and promote diaphoresis; pilocarpine and vapor baths to secure free action of the skin; seidlitz powders to move the bowels, and after a few days a blister to hasten the absorption of the fluid in the pericardium and pleura. Food consisted principally of butter-milk

After recovery from pericarditis and pleuritis, I advised the patient to abstain from alcoholic stimulants and meat, avoid exposure of every kind, drink either Bethesda or pure rain water, and make milk his main article of diet.

I will give several cases in which either water or water and digitalis were used with

success:

1st, 1876. Mrs. S., 25 years old, suppression of urine for more than a week. I passed a catheter, but found no urine in the bladder ;

she had taken different diuretics. I prescribed a glass of water every two hours; the patient

recovered and is still living.

2nd, 1885. Boy 6 years old, nephritis after scarlatina, skin parched, dropsy in legs and scrotum, only partially conscious, would not take fluids. He was promised a tool chest on condition that he would drink half a glass of water every two hours. There was a great improvement in six hours, and the patient is now in good health.

3rd, spring of 1890. Child 3 years old, suppression of urine for several days, patient vomiting every few hours, very stupid, skin parched. I prescribed teaspoonful of water in a drink of water every two hours. On the next day he was much better, and on the following day able to walk about the room.

4th, January 1891. Mrs. R., 73 years old, diabetic coma, had been unconscious for about twelve hours. I was uncertain until I had examined the urine whether I had a case of diabetic or uremic coma, but decided to dilute and endeavor to eliminate whatever poison caused the trouble. The patient had taken no water since the beginning of the attack, because she was unable to swallow. It took me some time to get the tongue and throat moistened, but she then drank a glass of water. I prescribed digitalis and told the nurse to get her to drink as much water as possible. After she had taken six or seven glasses of water she became conscious and remained so for about a week, when she became chilled from exposure,

and had another attack. I prescribed as before and patient has been well ever since.

I do not wish to convey the idea that the diabetes was cured, but simply that she has had no more attacks of coma.

Paris, Ill. W. W. TENBROECK, M. D.

Care of the Kidneys During Pregnancy.Encouraging Lacteal Secretion.-Resuscitating Asphyxiated Infants.

EDITOR MEDICAL WORLD: -Your journal must have an immense circulation, if the letters I have received from various sections of our wide-spread country be an indication. I regret that my article, page 259, WORLD for July was not more comprehensive and complete on the particular point of kidney disease in pregnancy, but it could not well be otherwise. I commenced the article several weeks before its conclusion, was often interrupted. and finally compelled to close and hurry it off in a "raw" state, both for reader and printer.

One correspondent asks me to give "specific treatment" for kidney disease, another for a decrease in the lacteal flow, another how to resuscitate cyanosed babies, etc., etc. It is impossible to fix invariable treatment, because "healthy" or pathological states. no two persons are exactly alike either in their Treatment must vary with circumstances, according to special indications and individual idiosyn

crasies.

In regard to disease of the kidneys, in a general way I may say, that I endeavor to keep the skin in good condition, make free use of saline laxatives as necessary, use persuasive diuretics, not the irritant ones, give chloroform as has been frequently pointed out in THe WORLD, and order abundant exercise short of severe fatigue. This latter I regard as of the highest importance. In aggravated cases, jaborandi per orem or pilocarpine subcutaneously. There is nothing new in the above, and my object in writing the first article was not to talk about treatment, but the importance of making a diagnosis. The average practitioner needs diagnosis very much more than anything else.

Now as to the mammæ, if suppression of the lacteal flow is due to uremic poison, treat the cause first. Then order generous diet, supplemented with some malt liquor, malt extracts or some of the appropriate maltine preparations. Look carefully into the matter promoting the proper involution of the uterus; keep the patient in bed a good long time after labor, and when she is up keep the husband away from the vagina. Sexual intercourse at this time, added to work and worry, will keep up a diseased condition of the genital organs that will be sufficient counter-irritation to dry

up the mammæ in many cases.

To sum it all up there should be abundant rest, cheerfulness and a generous diet with all the emunctories open. See the analogy in the milking cow. As to specific galactogogues so called, they have never given me satisfaction.

Now as to the resuscitation of the cyanosed infant, the following has given me better results than anything else in the way of treatment: Firt wrap the child very warmly, and place in the lap of some person who will obey your orders, lower the head, raise the body, wring out cloths from hot water, place one near the heart and let another embrace most of the cranium, but with especial reference to the occiput and medulla; renew the cloths as necessary, keep the body still and continue the treatment for thirty, forty or sixty minutes, until you are very sure that the case is hopeless, before abandoning the treatment. It is understood, of course, that before giving the above treatment the accoucheur has tried the ordinary modes of resuscitation and failed. The theory is: An abundant flow of blood to the head, kept warm by artificial heat, that the respiratory centre may be stimulated, also the pneumogastric and the local ganglia of the heart. Is the theory rational? It has given me some very gratifying results in cases that seemed to be hopeless. I recognize no necessity for delaying the separation of the infant from the mother if it does not breathe in a short time. If the cyanosis is due to maternal uremia, no good will come to the infant by continuing to pump in the same blood that has produced the condition. I do not forget, of course, that delayed breathing is, at times, due to other causes.

And now a few words about post-partum hemorrhage. This was overlooked in my first communication. Be it understood that I refer to the hemorrhage due to relaxation of the uterus. After the labor is completed and the ⚫ accoucheur has remained with the patient till all his duties are ended, the uterus contracted and he leaves, or is about to leave, when hemorrhage is discovered, due to a relaxed uterus. Permit me to quote here from such an authority as Leishman; he says, "A certain number of cases are no doubt due to slovenly practice, a neglect of details which should be a matter of routine in every case." This is rather vague and not helpful to the student. He says further, "One of the most important, and at the same time most common causes (italics are mine) of post-partum hemorrhage is uterine inertia." He wanders here, and instead of following up this clue to the true pathology and giving us the cause of uterine inertia, he discusses symptoms and treatment for two or three pages, leaving the reader in a very un

certain and uncomforted state on the whole subject. Experience has forced me to the conclusion that uterine inertia is due to obtended sensibility of the spinal cord, a paresis, if this is a better term, brought about by uremic poison. The reflex irritation of labor has spurred up the cord to a more or less good performance of its duty till the fetus is delivered and the calm following the storm allows the cord to relax its vigilance, the grip is removed from the uterus and your flow of blood takes place. Is this theory rational? It can be proved at any time by the accoucheur disposed to test it, and the test is very imple and easily applied. Examine all cases of pregnancy for kidney disease. If disease is present it proves the position I take, or, at least, strongly supports it. If there is no kidney disease and no retained urea, I claim, and my experience proves, that there will be no relaxed uterus. Notice, if you please, the large per centage of cases where the lady is troubled with "pains," either true or "false," for a week or two before final accouchement. She suffers both physically and mentally, and is at times uncertain for hours whether to send for her physician or not, and often the spinal cord, finally goaded to action by demands of the womb, brings on true pains and the labor is ended before the accoucheur arrives, because of the lady's uncertainty up to or near the end. But yet her "time was up" possibly two or three weeks before. The above result is common in many mild cases of uremia. others the case is worse and there may be convulsions, coma and death, but they may be prevented if preventative treatment is given in time.

Oxford, Kansas. EDWARD SMITH, M. D.

An Excellent Acid Tonic.

In

EDITOR MEDICAL WORLD:- I give to the readers of THE WORLD the formula of as fine a tonic as one could desire. Having for many years prescribed this tonic I am satisfied of its usefulness. Its cheapness commends it also, for if preparations of this nature were prescribed and dispensed by every M. D. it is quite easy to realize that, as medical men, we would not so frequently be tempted to purchase the costly stimulants (so highly lauded by the profession) and which, in many istances, fail in our practice.

Many able physicians, by the too frequent and extensive purchasing of the many and widely praised products of this or that Drug Co., are really, in their anxiety to secure success in practice, impoverishing themselves and family.

I have seen plenty of instances where such have not been as successful in their treatment

EDITOR MEDICAL WORLD:-In your August issue Dr. J. A. Randall, Waterton, Me., asks for use and action of the bee sting. (Apium Virus Apis Mellifica). In two cases of preg. nancy, with lower limbs greatly swollen and intolerable itching and stinging sensations, (especially after getting warm in bed) I have used the homoeopathic 3x preparation, and was greatly surprised with the prompt results.

In a few days all swelling, itching and sting. ing sensation had disappeared. It should not be used (except in high potencies) where there is a disposition to miscarry. If the doctor care for any other indications for its use he can look it up in either, Co vperthwaite's Mat. Med. or Hering's Condensed Mat., Med. homopathic publications.

J. BECHTEL MINTZER, M.D. 1626 Vine St., Philadelphia, Pa.

Anti-Constipation Pill.

EDITOR MEDICAL WORLD:-I believe it is the duty of every physician, when he has found a remedy to be efficient in any ailment, to make it known to the profession. It is only in this way that we may expect to progress rapidly along the line of improvement, by working together for the benefit of all.

Seven years ago I suffered with constipation in its very worst form and consequently had an opportunity to test every medicament praised for the relief of the same.

After trying separately most of the laxatives, I then combined those which I found to be the most efficient, and after changing the formula several times, I found to be the best I have ever seen used the following combination for an anti-constipation pill:

Mix.

..gr. 1-30 .gr. 1-100

It is an improvement on the valuable and much used aloin comp. pill. Although the dose is very small, usually one pill is sufficient to move the bowels naturally without griping, or causing debility, producing no disturbance of the organs of digestion but rather tending to give tone to all parts of the alimentary canal.

Since I recovered from my constipation I have used them in hundreds of cases with similar results. I do not claim that they are a specific, but any physician giving them a trial will find them invaluable in his practice.

Since last March I have used in my practice, and furnished to other doctors, sixty thousand of these pills. One physician, to whom I sent one hundred of them last March, ordered six hundred in April, and twelve hundred again in June, and says he does not intend to practice without them. I have them made from pure drugs, and gelatine coated, in large lots for my own use, but for twenty cents per hundred, or one dollar for six hundred, I will send by mail any quantity desired to any physician wishing to give them a trial. I trust this offer will not be construed as a speculating scheme, but simply an act of courtesy to the profession, realizing how difficult it often is to get a coated pill made in small lots at a reasonable price.

Of the many cases I have treated with the above formula I will describe but two, showing the difference in results:

N. P. Ryan, of this town, contractor, about thirty-five years of age, had been constipated for years. After two weeks treatment of one pill every night, bowels commenced to move too freely, when he gradually left off using them and has been free from constipation since, which is two years or more.

The worst case I have had is a lady seventy years old, whose daughter I had just cured. This old lady had suffered with constipation, and sick headache for twenty years, and had tried about everything, only to go from bad to worse. At first she had to use one pill morn. ing, noon and night. Getting so much relief from these she has continued to use them for two years, and at present requires but one a day to keep her all right. Her general health has steadily improved.

In treating such cases of long standing, physicians must have patience and perseverance. Those who lack these, in the use of drugs, would be benefitted by reading Dr. Chas. G. Kerley's (Resident physician, New York Infant Asylum) account of atropine in enuresis,

where he treated twelve chronic bed wetters with atropine without getting any results for the first six weeks, and yet curing seven cases in five months, and the remaining five at the end of one year. How many physicians would have continued treatment after six weeks of constant failure? J. W. GREGG, M. D.

Brattleboro, Vt.

regulated with the greatest care, without neglecting the treatment of any other ailing actually present. In fine, when he has to deal with such a serious affection, the physician cannot be too scrupulous in his advice, or in insisting that the patient be preserved from the least influence capable of bringing back the fits."

-Knots in Cord.

EDITOR MEDICAL WORLD:-On page 306 of the August No, Dr. J. R. Thompson wishes some one to give the treatment for a case of hysterical epilepsy. Will he try the dosimetric treatment used by Professor Laura Segarido, of Turin, and which I know to have been successful in two cases?

In dosimetric practice I use atropine valerianate of zinc and monobromated camphor. In case of debility or anemia, arseniate of iron and arseniate of strychnine; also, in the following manner: One granule (1⁄2 milligramme) of atropine, morning and night to begin with, and when tolerance is established, increase to 4 or 5 a day, one every three hours, being careful to observe the eyes to lessen or stop the drug when dilatation of the pupil is seen. Valerianate of zinc at 1 centigramme, forty (40) granules a day, eight at a dose Next, monobromated camphor, I centigramme, twenty (20) granules, four at a dose. The two last are to be given alternately, one day the zinc, the next day the camphor. The arseniate of iron, I milligramme, and the arseniate of strychnine, 1⁄2 milligramme are given only in case of debility or anemia.

The doctor calls the fits hysterical epilepsy. Will he please observe the hands of the patient during one of the fits? In true epilepsy I have always noticed that the thumb is forcibly bent in the palm of the hand, and tightly clutched by the other four fingers. In hysteria, on the contrary, the thumb is thrown outwards and fingers bent in the palm. Has any one of the profession ever made a note of this particularity? Permit me here to quote a few words from Professor Laura :

"The physician must remember that in this malady, much more than in any other neurosis, it is necessary to continue the use of appropriate remedies months after the last fit, on account of the well known persistence of the disease and the facility of the relapses. It is hardly worth while to add that the therapeutic rule is to alternate the medicines and to proportion the interval and the dose to the amelioration, using, also, all the time, a mild aperient. The material, mental and moral life of the unhappy patient must also be

New Orleans, La. D. TUREAUD, M.D.

EDITOR MEDICAL WORLD:-Kindly accord me space for a little explanation regarding my reference to The Dosimetric Medical Review in the July WORLD. The Review is published by W. J. Morrison, at 43 Broad street, New York, who also publishes quite a good assortment of the English translations of Dr. Burggraeve's works on dosimetry. As a journal it deals too much with the ultra and not enough with the every day things of life, and comes to us with too few American articles to satisfy American physicians, but is good as far as it goes, and costs $1.00 per year, monthly.

"The Alkaloid" is a new journal, published by Stromberg, Allen & Co., 337 & 339 Dearborn street, Chicago, edited by a good man, Dr. Louis J. Mitchell, 253 W. Madison street, Chicago. I am hoping much from this journal, as it is purely American.

I have just received a helpful little book, "The New Practical Guide to Dosimetric Medicine," by Dr. Burggraeve, secured for me through the courtesy of W. J. Morrison, from Wertheimer, Lee & Co., London. The price of this book bound in paper is 50 c.

The various dosimetric works advertised in these journals will meet all the demands of those anxious to inform themselves regarding the principles of dosimetry.

DR. W. C. ABBOTT.

Ravenswood, Chicago, Ill.

Dosimetric Treatment of Disease.-Malarial Fever.

EDITOR MEDICAL WORLD :-All fevers are in one sense traumatic, that is, the first small beginnings or disturbances in the organism which precede or produce fever are dynamic perversions of physiological action, whether the dynamic injury or traumatism is an external wound or a wound of the blood or tissues by direct action of the materies morbi, the innal ation of mephitic gases and the destruction of red globules by microbes (?) as taught by the germ theory, or a disturbance of the equilib rium of the electrical environment of the patient. The violence done to, and the attack

upon the organism, from whatever source, produce the same primary effect, excitation and stimulation of the nervo-vital force, followed in time by fatigue and diminution of that force with consequent disturbance of the circulation. This is eminently the case in malarial fever, which we have all been taught to regard as the result of microbes or germs emanating from marshes and stagnant water, as it prevails principally in paludal districts. In my last I said, "that the pathogenic malarial microbe had never been isolated," and I know no proof of its existence. In an article in The D. M. Review, last year, I endeavored to show that the cause of this fever was a permanent electronegative state of the air where it prevails, together with a complete absence of ozone, nature's great vitalizing agent, from that air, and that this abnormal electrical state occurred only where there was a daily variation of the temperature from 30 to 40 degrees. The only part the marshes and stagnant pools played was in furnishing moisture, the evaporation of which produced the great variation in the temperature. The earth is naturally electro negative, the air electro-positive, as is the human body also, and it has been found that there are two maxima and two minima in the intensity of the free electricity of the air every 24 hours, and these are produced by that great magnet, the sun, the source of all our electricity. Any permanent disturbance of this natural electrical status in our environment seriously affects our delicate and intricate nervous organizations, and failing to obtain our needed supply of elec. tricity and ozone from the usual source, the air, our equilibrium is disturbed, resulting in gangliasthenia, neurasthenia and all the concomitant ills which follow loss of nerve power. Just why this great daily variation in the temperature should produce a continuous electro-negative state of the air, and change the sign of its maximal and minimal electrical intensities, I am unable to say, but from observations and experiments made during a period of 30 years I can state as a fact, which can be easily verified, that so called malarial fevers are never rife or prevail epidemically except when there are such conditions as named above. The daily changes in the electrical intensity offer the best and only sensible reason for the periodicity of the disease of which the germ theory has never been able to give any adequate or rational explanation. The absence of ozone in these paludal districts is easily accounted for as it, being oxygen negatively electrified, could not remain in an atmosphere whose state was permanently electro-negative. Again, it has been established as a physiological fact that the oxygen we inhale with every breath is immediatey ozonified by the vital processes, and its

force of affinity and power of oxidation are intensified and energized into a condition of exalted activity to enable it to keep pace with the rapid molecular death continually going on in the organism, and to oxidize the noxious products resulting therefrom and prepare them for elimination. Nerve force is generated in the very act of molecular death, and life itself depends upon this continuous death and prompt oxidation of its effete products. So long as the normal balance of oxidation and tissue-death is maintained the various reactions of the organism are properly performed and health is the result, but let this balance be disturbed and confusion and disease follow. So in malarial fever, two of nature's greatest vitalizing agents being absent and molecular death continuing with its usual rapidity, with diminished oxidation, the nerve centers are excited and over-stimulated, and the increased nerve force sent to all parts of the organism not being utilized in the chemico vital process of oxidation of tissues and effete matter, the nerve centers, with the vaso-motor nerves, . become fatigued and paralyzed. The first effect of

this nervous stimulation, which is really the first stage of the disease, is to produce a gradual contraction of the arterioles till they refuse a passage to the blood, thus inducing a complete vacuity of the capillaries and ushering in the second or cold stage. In conséquence of the paralysis of the vaso-motor nerves following the stage of stimulation the arterioles relax into a state of almost atonic dilatation and the blood rushes in to fill to their utmost capacity the highly elastic capillaries, which, possessing little or no contractile power, a temporary stasis ensues, followed by the third or hot stage. Oxidation failing to keep pace with the unceasing molecular death the blood stream becomes rapidly poisoned and the capillaries clogged by unoxidized effete matter, not by spores or germs from without.

I would say just here that in this ceaseless, rapid death of the molecular elements of this body is the only resemblance I can see to Dr, Tait's putrefactive germs in living tissues. In fact, this death, upon which life depends, is the first step in a series of reactions of which putrefaction is the final, when the vital force no longer governs, restrains and sustains the physical and chemical forces.

As this article is already too long I will defer the consideration of La Grippe and devote a few lines to the treatment of malarial fever, premising with the statement that the action of quinine, strychnine, arsenic, gelsemine and other nervo vital incitants in curing and preventing it is prima facie evidence of the neurasthenic condition of the patient whatever may be its cause, and dosimetry offers the best