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If the pulse is small and frequent, I give : R

Spec. tr. baptisia

gtts xx to 3ss Lloyd's spec. tr. aconite

Spec. tr. echinacea .

Bij to giv gtts x Water, q. s, ad.


Water, q. s. ad. M. Sig.-Teaspoonful every hour.

M. Sig.-Teaspoonful every two hours. I keep them on this till conditions change. scription in typhoid fever I have ever used,

This is the best all-around antiseptic preBut if the skin is dusky, tongue brown or bluish color, breath offensiv, instead of the

and I have been practising for twenty years, soda I put them on the following:

and have been a close observer. These are a

few thoughts upon the treatment of typhoid R Lloyd's spec. tr. baptisia

fever. If anyone wishes to ask any questions,

gtts xx to 3ss Lloyd's spec. tr. echinacea . Zij to 3iij

I will take pleasure in answering, either priWater, q. s. ad.

· ziv

vately or thru WORLD. M. Sig.-Teaspoonful every two hours alternated with the aconite-one, one hour, the other the next.

Magazine, Ark. T. J. DANIEL, M.D. If the pulse is full and bounding, I give :

[Dr. Daniel is president of the Ark. Eclec

tic Med. Assn., so he can be considered a R

representativ eclectic of that part of the Lloyd's spec. tr. veratrum . gtts xx to 3ss Water, q. s. ad.


country.—ED.] M. Sig.-Teaspoonful every hour, till character of the pulse changes; then I discontinue the veratrum.

No Alcohol in Pneumonia and Typhoid. Sometimes we will meet with a case where the tongue is red at tip and edges, with papillae number, just received, Senator Hanna's case is

Editor MEDICAL World:-In your May prominently elevated, the bowels tympanitic, pulse small, frequent and sharp. It has the

mentioned I take exception to the cause of feel of the “E” string of the violin under

his death. Knowing full well the attitude of your finger. In this case there is no better

the profession in regard to stimulants, will say, remedy in the materia medica than rhus. tox.,

altho trained in that way by Stille, Carson & combined with aconite. I usually write the

Levick, it did not take me very long to get out prescription thus:

of the ruts. I believe liquor killed the Sepa

tor, as it does thousands of others with pneuR Lloyd's spec. tr. aconite

monia and typhoid. I graduated with honor Lloyd's spec. tr. rhus. tox.

aa gtts x

in the class of '68 at the University of PennWater, q. s. ad.

Ziv sylvania, and am proud of it. Dr. Leidy told M. Sig. - Teaspoonful every hour.

me the day of graduation our class was the The bath should never be neglected.

best that ever came before him for examinaIn the latter stages the heart should be sup- tion. I will state positivly I never lost a case ported, if any symptoms of failing, with of typhoid or pneumonia, and I have practised strychnin, cactus, digitalis, etc.

in the alleys of Philadelphia, among the Occasionally we will have trouble in con- Indians of Nebraska, and for the last four years troling the bowels.

Upon the first appear- among the negroes in the hovels in Virginia. ance of tenderness, dioscorea should be given. Have used milk diet and anything I could get I usually combine it with the sedativ. Put to nourish my patients (liquid), but not one from 3ss to 3; in with the sedativ mixture. drop of alcohol in any form. Í challenge my Sometimes we meet a case where the face is professional brethren to a better record, with flusht, eyes bright, pupils contracted, and all their refinements of practise. Keep the restlessness. In this condition gelsemium is “ Temple of the living God” pure and undethe remedy; 3j to zij added to the sedativ filed. Clean up and disinfect; the diet will mixture, and a teaspoonful given every hour. take care of itself. While in Nebraska among Some patients are nervous, restless and sleep- the Indians and forty-five miles from a drunken less. In this condition passiflora, 3ss to 31, doctor, I treated myself of typhoid by ice should be given as needed. Sometimes we cream-cream frozen without favor and a will have trouble controling the bowels, as little sugar; no medicins, no bathing; in bed stated above. They will “run off” as the four weeks to the day. My cases are now old women say: With such a case we some- aborted in from twelve hours to ten days, times get excellent results from the following: according to the case when I take it. R

Lincoln, Va. Geo. ROBERTS, M.D. Subnitrate of bismuth,

3j Sulfocarbolate of zinc

grs. xvj Dover's powder . M. ft. charts No. 8. Sig.-One every three or four

The practician deliberately rupturing the "bag of hours.

in a case of miscarriage should mercifully

abandon his unfortunate victim to Nature, or get a If I were going to select a routine antiseptic better doctor than he, and seek the nearest jail to beg prescription, it would be the following:

for imprisonment, on confession of wilful and inexcus. able manslaughter.

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grs. xxiv


Twins.--Dr. Rice's B for Burns.-A Factor Ante-Partum Placental Detachment. in the Treatment of Typhoid.

Editor MEDICAL WORLD:-Mrs. A., aged Salicylate of Ammonium.

42, weight 160 pounds, mother of eight chilEditor MEDICAL WORLD:-I have been a

dren, at eight months in gestation contracted subscriber and reader of THE WORLD for a

measles. I was called to see her for severe good many years, and take a great deal of

uterin hemorrhage. When I arrived, hemorpleasure and interest in cases reported and

rhage seemed to have ceast. However, put treatments given. I have been sometimes

her on Hayden's viburnum comp. Altho she amused at repeated rubs given in certain cases,

passed thru a severe siege of measles, with a e. g. single and double placentas occurring

very troublesome cough, I did not see her with twins of the same sex or with the two

again until called to attend her in confinement sexes. In this connection I will say that my

thirty days later. On arrival I found her experience of twenty-five years' practise and

sitting up in a chair; said four hours previous seventeen (17) cases of twins has been a single a profuse hemorrhage from uterus had appeared, placenta, one sac with septum, in each and

but no pain whatever except some pain in every case, and I have had both classes. I

her back. My first suspicion was placenta can “point with pride" to a number of cases

previa. I at once made a digital examination. of “boy and girl," as also of the same sex ;

Found os dilated to the size of a quarter of a but most of my cases where both were of same

dollar ; very low down. Did not find placenta sex were girls. My last case this a.m. I have

previa, but found amniotic membrane perfectly yet to see a case where there were two placen

intact and tightly distended. Introducing my tas. I knew of a doctor (?) who sat for twelve

fingers as high up as possible I could easily hours or more waiting and watching for the detect the life fluid flowing down my fingers second placenta, which never came.

with considerable rapidity. I proceeded to The ☆ sometimes spoken of as Dr. Rice's $

bring on labor as soon as possible. Gave for burns, was given me some twenty-two years quinin and strychnin to maximum, which ago by a German barber. I thought it good seemed to have the desired effect. With one and tried it and have always used it in all cases

short pain the uterus expelled its entire conof superficial burns. It is perfection: Anti

tents, fetus, placenta and a large ragged blood septic, elastic, of the color of the skin; and

clot three times the size of placenta, which one application is sufficient, as when it comes

seemed to be acting as a propeller. Uterus off or is worn off, the new skin has formed. The

contracted nicely and hemorrhage stopt. The B is composed of white glue, glycerin to make

child was dead and perfectly anemic; cord flexible, carbolic acid to make antiseptic, and

and placenta had entirely collapst as tho wa-er; to be applied with a camel's hair brush,

there had been no blood for several hours, after heating to make thin (or liquid) enuf to

altho she had felt the fetal movement thirty spread evenly.

minutes prior to delivery. Mother collapet If anybody is looking for a good treatment

from loss of blood. Had quite a time keeping for typhoid fever, do not forget Dr. Bartho- her alive with nitroglycerin, whiskey, external low's iodin and carbolic acid treatment. I heat and friction to the limbs. Immediately ordinarily give six calomel and soda powders, after reaction I gave three pints normal saline one every hour, every second or third day. solution per rectum and put her on restorativ My success has been one death in forty cases.

treatment, under which she made a slow Some of them, a majority, were severe cases. recovery. It is good treatment and successful.

Diagnosis: Ante partum placental detachAnother good thing, little known, is salicy ment, from the effect of measles on the endometlate of ammonium. In pneumonia it is the

rium, as there was severe bronchial irritation and best treatment I know of and I know whereof

diarrhea from time of attack of measles to conI speak. I use digitalis when required. I finement; in fact, all the mucous membranes place no dependence on strychnin as curativ. I

were severely affected. Were my diagnosis would not condemn its use however, but it has

and treatment right or wrong? Now this is not very much to its credit. Salicylate of

my first pass at a report, but this case interested ammonium is also good in any septic condition. me so, I could not resist the temptation. Geo. MACMURPHY, M.D.

Should be pleased to hear from some brother Ortonville, Minn. Bellevue Hosp., Med, Col., 1878. on similar cases. If this is not worthy of con

[In this connection we are pained to sideration, pardon me and transfer to waste chronicle the recent death of Dr. Bartholow. basket.


Whitefield, I. T.

[An interesting case well worth reporting, Never rupture the "bag of waters” in a primipara, and only in a multipara aftor complete distention, and

which you have done modestly and well. No very low position of the presenting part.

criticisms. -Ed.]

High Temperature Following an Intrauterin it from rotting and poisoning the system. Douche.

used as a local dressing echinacea until I got Editor MEDICAL WORLD:-Mrs. S., second all of the underlying gristle cut out; did not confinement, labor lasting two hours, normal let any of this substance rot in the carbuncle. in all respects, placenta delivered by Crede's

Then I used bichlorid dressing for the balance method, complete with membranes intact. All of the time. Fed my patient on panopepton symptoms normal till the third day, when (Fairchild) with raw eggs. Patient made a lochia became offensiv; no rise of temperature good recovery. When full grown the caror pulse; gave vaginal douche of creolin solu- buncle measured 6 by 8 inches. Was in bed tion which was followed in one-half hour by from January 27 until March 24, 1904. slight chill; temperature raised to 102°, last- Tifton, Ga.

J. A. McCREA. ing six hours, followed by profuse sweat. Next morning all symptoms normal except lochia, Dr. I. C. Chapman, of Lafayette, La., which was very offensiv; gave an intrauterin

reports the birth of a child with two perfectly douche of permanganate solution; no debris; formed heads. It died during the process of in one-half hour the patient began to tremble ; birth. He does not say that he preserved the did not feel cold, but trembled all over. This

specimen, so we conclude that he did not. He condition lasted about twenty minutes, when should have preserved it in alcohol, if he could the temperature had reacht 108° in the axilla, have possibly gotten possession of it. pulse over 200, patient acting as tho dazed, but was not delirious until temperature had dropt to Dysmenorrhea.–For Colic in Horses. 106°; then mildly so. This was followed by a

Editor MEDICAL WORLD :-For the “ nine drenching perspiration, and in turn by frequent o'clock exacerbation " (Dysmenorrhea, page attacks of palpitation. The next morning, ex- 167, April WORLD), I would suggest that cept for excessiv prostration and the offensiv

“M.D.” have patient secure a motor for proodor of the lochia, the condition was again pelling her sewing machine or employ the sernormal. No more douches being given, we vices of some available boy. This will give had no more trouble. A profound anemia

her much pelvic rest, and may be a factor in developt, which yielded promptly to treatment, removing the exciting cause. Would also join patient making an uneventful recovery.

the Editor in his matrimonial suggestion. At Some years ago I reported a case of puerperal eight o'clock give hypodermic of morphin 4 insanity, with a temperature of 110°, lasting gr., atropin ito gr. ; at the same time apply a two days, which developt acutely after an intra- rubber hot water bottle containing water as uterin douche, recovery being complete and

near 212° F. as can possibly be borne. Perprompt on ceasing the douches. It took me sistence in the use of hot applications will three douches to catch on in the first instance, afford prompt relief. and two in the last; in both the trouble ceast

Page 165: For the benefit of Dr. H. W. promptly on stopping the douche. The total Scott or others, I give the following prescripabsence of symptoms before and after the treat- tion that I have frequently used with my own ment would seem to eliminate septic infection; horses for colic, both renal and intestinal: or did the expanding of the uterin cavity open Chloroform up channels of absorption that were closed by Spts. nit. aeth. āä. the normal involution, and thereby protected Spts. turpentine

Castor oil.

xij until interfered with by distention with the

Mix well and give in one dose. douche ? or does the nervous, idiosyncrasy offer The horse will be relieved immediately. the explanation? What would have been the

After eight or twelve hours, if bowels have result of continued irrigation? a mistake which

not moved freely, put him into harness and might easily be made under the circumstances.

trot him briskly three or four miles and you MALCOLM G. VIOLET, M.D. will wish your dash board had been built Butternut, Wis.

higher. A good tonic effect follows the free catharsis.

J. Woolsey, M.D. Carbuncle.

Riddleville, Tex.

Vanderbilt, 1894. Editor MEDICAL WORLD:-I was called to see a man 74 years of age, on January 27, Case Record and Account Book Combined. 1904, with two small carbuncles on back, at Editor MedicaL WORLD:-I am pleased to upper points of scapulas, eight inches apart. note article in Feb. WORLD on the important I split them and then cross split them. One but much neglected subject of keeping grew no more; the other one kept growing. accounts. I have a method, originating Soon as the skin began to decay, I commenced according to my needs, which I find handy. to cut out the gristle, and would cut a round of We who practise at the cross-roads and in it out every other day. I did this to keep villages, of necessity dispense our own rem

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edies, and I have for the past three years kept

Case Records. a record of same and cases in my journal as Editor MEDICAL WORLD:-In the April numfollows:

ber of your journal, one of your subscribers

wanted a case record blank. I have devised a R (ENTRIES)

(Cr.) (Dr.) system I use in my practise and inclose you No. Totals for February

$263.75 $338.25 samples of my cards. I do not have these

blanks for sale, but have them printed here in

the city and use a Macey card box on my desk Mar. 104. Tuesday.

$22.75 $20.40

for daily reference.

At the end of the year I file all closed cases Jones, James. V. Mary.........


in a Macey filing case, and mark the year on Temp. 102°, P. 110. Malaria. 6036 Cal. T. gr. No. 10–1 every hr.

the end of the box. 6037) Quin, comp. No. 24–1 every 2 hrs.

In my desk box I have two sets of alphabet Weber, J. B. Cr. Check....


guide cards and two guide cards, one markt Coleby, C. B. Med. self.

open cases and one markt closed cases. An Migraine No. 6-1 every 2 hrs. Comp. cath. No. 3-at bedtime.

open case is one which I still have under obser

vation. When the case is dismist I note the Crosby, B. P. Med. self, Bilious.......

.50 8040 Cal. 6 Pellets 2 at 2 doses, 2 hrs.

date and the results or condition of the case Pomeroy, G. Self.

when it passed from my care, and transfer it to Lance boil, Calc. Sulf. gr. 1 No. 40.

the closed case side. In making my record of 6041 Take 1 3x day.

acute cases I have a leather pocket to hold Burpee, L. Conf. Norm. L......

15.00 the record blanks and carry it in my coat Boy 9 lbs. 4 P.M.

pocket. The record is made at the bedside McManus, John. Fred........

1.00 with a fountain pen, as it is then permanent. Extr. teeth,

One who has not tried it does not realize what

an advantage such a record is to a physician. Mar. 204. Wednesday.


It impresses the patient and his friends that

you are a very particular person, and it gives This is more drawn out than I make the them greater confidence. If at any time a entries, as I abbreviate almost all words used.

dispute should arise as to your conduct of the This takes up but little time and space and case, you have your record to refer to, which helps to report a case or series of cases accu- is a great deal better in law than a memory rately, also enables you to give Willie or record. To me it is a pleasure to know I have Grandma the same B of last spring. by the a record of my cases. I think it just as imporbottle being returned with label and B num- tant to keep a record of cases seen in the home ber intact; also it is a good witness in damage as cases seen in the hospital. suits, or a suit of any kind.

Since I have formed the habit of keeping a As to ledger, I use double entry, 434 x 672 record of all of my cases, I know I am a better x 58 inches, flexible leather, with 200 pages physician. I am more observant, more careful and index, and keep it posted to date as near in my diagnosis, and more careful in my preas possible, and carry in pocket; thus am able scribing. I have the case for study at my to tell patron amount of indebtedness any leisure—and, let me say, a library of your own time and place, and thereby collect many cases, your own successes and failures, is of accounts that would be neglected should I more real value than the theories of others. have to use the common phrase, “I don't At my first call to an acute case I take down know, call at office,” which induces neglect. the history of the case prior to my being called.

I also keep a cash and expense account in This I write in on the face of the card before small double entry book, but have never kept making any record of the present condition. a comparativ statement; also issue bills at The chronic case, urinalysis, and obstetric regular intervals, and at termination of cases; record blanks are self explanatory. If more and where there is no response, I see the than one card is used in a case I use an endebtor personally.

velope to hold all the cards of that case. Am an advocate of “deadbeat lists,” com

CLIFFORD E. HENRY, M.D. piled often and freely exchanged, and am Minneapolis, Minn. Jefferson Medical College, 1896. liberal to deserving charities, but draw the [See accompanying card forms. The card line close. B. FRANK WINDLE, M.D. system is now used for many purposes : in Valley Park, Mo.

Barnes, 1897. libraries for cataloging books, as a system of [The above seems rather crude, but it shows book-keeping for keeping accounts, etc. This what can be done with an ordinary blank is our first knowledge of this system being used book which can be gotten at any stationer's. for case records by physicians, but it is a good -ED.)


Card for Acute Cases.


[The dotted rulings are blue; the others are red.)

(Case may be continued on reverse side of card.) Card for Chronic Cases.

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