Page images

other, temperature 96.5°, pulse 44. In both onite, veratrum, belladonna, bryonia, gelsemithere were evidences of great prostration- um, etc., are all excellent remedies, but they will labored breathing, blue lips, distress of coun- not cut short every case of pneumonia by any tenance, body bathed in profuse cold sweat. means. I speak from experience, and I may The temperature, which had been from three add that I am a graduate of an eclectic as to four degrees above normal during the grip, well as an allopathic school. I do not deny dropt to subnormal when the pneumonia that it is even possible to abort (socalled) appeared, and remained so thruout the attack pneumonia if treatment is begun at once. To -about ten days. Both cases were treated illustrate : I was called not long since to see a with stimulants, strychnin, concentrated nour- patient whose trouble began with a hard chill ishment, etc. Both recovered. Neither was blis- with febril reaction, and whose lungs at the tered.

time of my arrival were very much congested. I In puerperal septicema I have gotten fine re- gave sp. tr. veratrum and bryonia with excellent sults from applications of tr. iodin to the uterus results, and within two days the patient was as and vagina. The uterus should be well swabbed well as usual. Had this case been neglected it out with the iodin, a pledget of absorbent cot- might have terminated in pneumonia. I don't ton on the long handle uterin dressing forceps

What I do know is that at the time of making a good applicator. The iodin may be treatment it was not a case of pneumonia, but applied again in twenty-four hours, but in less one of acute congestion, with threatened pneuquantity. Then wait two or three days before monia which never developt. applying again. I have seen a temperature of In closing, I desire to say that in the be105.5° fall to a 101° in twelve hours, with de- ginning of a case of pneumonia I invariably cided improvement in all the conditions. So give the remedies the Doctor has mentioned far it has given me better results than any as specifically indicated, and follow them up as remedy I ever used, recovery following every my judgment tells me. If the Doctor can have case where used. I have recently treated a case, his patients run thru the three stages of pneuin consultation, complicated with severe neph- monia in two or three days to recovery, he is ritis (Bright's), which was present before con- more successful with the remedies mentioned finement, with eatirely satisfactory results. than I have ever been, or ever hope to be. Of course there should be care and judgment

Buckley, Ills. 0. L. THOMPSON, M.D. in the use of the iodin. In some patients its use may be followed by uterin colic, tho I have Antiseptic Treatment of Pneumonia. seen nothing of the kind in any of the cases Editor MEDICAL WORLD:-Some time ago treated by me. The iodin should be applied you askt what we were going to do for our pneuonly to diseased surface. Usually it need be

monia patients this winter. Nine physicians applied but once to the inside of the uterus, from New York, Tennessee, Texas, Oregon, other applications being made only to cervix Illinois, and Colorado, answered in the Noand posterior vagina. The use of the iodin vember and December issues of THE WORLD. does not exclude such other treatment as may Only two of them made any reference to this be required in each individual case.

as a germ disease, and but one entertained anyCarrsville, Va. GAVIN Rawls, M.D. thing like an antiseptic and eliminativ theory

for its treatment. This apparent indifference Eclectic Remedies in Pneumonia. or lack of knowledge of the true cause and Editor MEDICAL WORLD:—The remarks by proper treatment of this disease causes me to J. C. Mitchell, M.D., page 12, January WORLD, ask, "Mr. Bacteriologist, where are we at?" on pneumonia, it seems to me can scarcely be Since this disease is caused by a pneumonic supported by facts or the experience of others germ, the most rational treatment for its cure of that school.

“Any eclectic, is to remove the germs; hence, the antiseptic that doesn't abort or cure every case of pneu- and eliminativ treatment. The most of the monia in from thirty-six to seventy-two hours nine physicians gave their treatment in detail, should study his drugs more carefully." If which was very similar, and is rather obsolete the Doctor's experience with the remedies with me at least. One says, “I shall use mentioned by him have given him such favor- belladonna, bryonia, aconite, arnica, acetanable results in the treatment of pneumonia asilid, and gelsemium, as indicated, and exthe above remarks would indicate, it may be pect to get along without any trouble, as in that his experience with this disease has been the past, and I have handled the disease at an very limited. While I believe, with the Editor altitude of 10,500 feet.” and the vast majority, that pneumonia is a self- He does not say how long he has practised, limited disease, I also believe at the same time or how many cases he has so treated. I cannot that proper treatment may mitigate and some- understand how these remedies have been so times shorten the duration of the disease. Ac- successful in his hands and in such a high alti

He says:

[ocr errors]

tude. I have used for the last four years in theory on uric acid as a cause of the inflamma-
ordinary cases, where there is nothing in the tion. My dear brother, the books give pneu-
condition of the patient that contra-indicates mococci as the cause of pneumonia, and not
their use, mild chlorid of mercury and bicar- uric acid.
bonate of soda, equal parts; carbonate of Now as to his deathrate-3 percent in 106
creosotal ; ergot; urotropin ; antiphlogistine ; cases, from 6 months to 84 years old. This is
and nitroglycerin compound (tablet triturates certainly a remarkable record; but I am con-
No. 618, by Parke, Davis & Co.). In the strained to think that our brother has been
thirty-six years I have practised medicin I have mistaken as to diagnosis in many of his cases.
found nothing that equals these in the treatment Has he not fallen into the habit of many physi-
of pneumonia. W. O. WRIGHT, M.D. cians of calling every case typhoid or pneu-
Greeley, Col.

monia when it is prevalent? I have known

doctors to say, “My dear sir, your little girl has Pneumonia-a Criticism. - How I Handle a bad case of typhoid fever,'' and inside of three Some Difficulties in Labor.

or four days she was out playing as usual. Editor MEDICAL WORLD:- In the Decem- If you will pardon me I will write a little ber WORLD, page 551, under the caption from experience that I have never seen in “There should not be over three percent of books or heard in a lecture: I have often had deaths in Pneumonia," the Doctor proceeds to cases of confinement where the patient progrest give his treatment as follows: A cathartic with slowly until the head of the child passed thru sufficient calomel to move the bowels freely, the upper strait and imbedded itself in the then sodium salicylate, 5 grains, citrate of hollow of the sacrum, and hung there for hours potash, 10 grains, at one dose every two hours, without making perceptible progress. Well, in water, with aromatic spirits of ammonia. after turning the patient on her side, and havTo this he says may be added aconite or ing her get up and walk around, without doing veratrum in small doses, but enuf to reduce any good, I then get a chair and have the husthe pulse in frequency. He also begins with band sit down in it, spread an old dress or strychnin, s'o oro grain every two hours. something over his lap, and have the patient Now, Mr. Editor, I would like to ask him why get up and sit astride his lap, facing him (not he gives the aconite or veratrum to reduce the an elegant position), and have the husband pulse—the force of the circulation-and then lock his arms around her back, and have her gives the strychnin, sb to od grain every two to put her arms around over his shoulders and hours. It does seem to me that he certainly cross- grasp the back of the chair, and when she has fires in his treatment, besides the damage he may a pain have both to tighten their grasp and do by beginning so early with his strychnin. pull together, and my brothers, you will be I have learned that a good general holds some agreeably surprised to see how quickly the of his forces back in reserve, to reinforce as head of that baby will proceed on its journey. the fight progresses. There is no doubt but And when the head begins to press against the that strychnin given at the proper time and in perineum considerably, I take hold of the the proper dose is all right; but it does seem shoulders of the patient and have the husband to me that even at the proper time, when to take hold around the thighs and raise up, needed, that s' or even od grain every two and we lay the patient easily in bed, and then hours is dosing a little heavy. And again, a few more pains will certainly end the birth. sulfo-carbolate of zinc is all right in typhoid Now, please don't lean back and laugh, but fever in proper doses, but I never have seen a case try in the very next case you have and see the of pneumonia that I thought would be benefited results. by its administration. What say others? He And again, you all, no doubt, have had cases does not use opiates for pain and restlessness. of primiparas where the parts were constricted, The hot water or hot poultice of Aaxseed is all perineum rigid, with the labia majora and labia right, but what is the matter with Dover's pow- minora constricted, and with the peculiar ders, say 27/2 to 3 grains, repeated often enufoval or egg shape of those muscles with the to ease pain and quiet the patient, thereby pointed or smaller part up, the muscles very giving him needed rest and sleep? The hypo- tense and forcing the head of the child down dermic of cold water might do if the patient against the perineum. Then there is great had hysteria, but where there is real pain and danger of rupturing the perineum. What do I suffering, to my mind it would not count for do? Why, I have on several occasions used a much. Or if he objected to Dover's, what small, pointed pair of scissors or a sharp-pointed would be the objection to papine, enuf to ease bistoury and divided the labial muscle, say an the pain ?

inch or an inch and one-half below its attachHe says he bases his treatment on salicylate, ments above-and it will surprise you to see potassium citrate and strychnin, basing his how it will relieve the very tense perineum, and

likely with the very next pain the head will be she explained that the day before she burned a born, and with little or no laceration ; and blister on her arm, on the stove pipe. At one you will feel good and congratulate yourself time, as soon as the child was born, I noticed on having done some good for once by de- that it held its hands turned outward; the next cisiv action. You may say the patient and day this was more pronounced, and the toes husband will object. It can be easily ex- pointed downward ; the day following the sterplained to parties of intelligence, and they will num was bulging forward, appearing like what agree to let you do what you think best. is called a “pigeon breast;

ii in three months Corydon, Ind.

Z. T. FUNK. all the joints were stiff; the diameter from

axilla to axilla was two and one-half inches, Influence of the Mother on the Fetus.-An and from sternum to spinal column seven and Obstetrical Record.

one-half inches. The face was beautiful, with Editor MEDICAL WORLD:-For years I have a sad expression. It then died. The mother noticed an annual crop of articles in the differ- had during the last three months of pregnancy ent medical journals regarding the probability worried about a child in just such condition, or even possibility of a pregnant woman mark- which also died at six months. My sister-ining her fetus in utero thru her mental impres- law gave birth to a child that was covered sions. Why this question has not long ago with black, confluent smallpox; a short time been settled affirmativly, I fail to comprehend. before confinement she visited a relativ who It may not be amiss for me to contribute my was just breaking out with that disease. She “mite" toward the settling of the question. was greatly frightened, but she never had any Fifty-two years ago, when I was yet in Vienna, symptom of the disease. After I had confined Austria, a lady friend of the family called one a certain woman six or seven times, with wellday in a very excited condition, stating that formed, healthy children, I was surprised at the she just came from the house of a friend, where next birth to find upon digital examination the she saw the horrible sight of a boy fourteen strangest presentation I ever felt, and to my years of age, who was kept in a separate room, consternation there issued forth a perfect rat's on the floor, as he was helpless, having no head, but the body was perfectly human. The legs. And she remarkt excitedly that if she mother had a terrible fright at a rat when she had such a creature, she would throw him into was not yet aware of her pregnant condition. the Danube. In seven or eight months she The above citations ought to be sufficient to gave birth to just such a creature, but she failed convince any skeptic on the subject. And do to throw him into the Danube. During our we not find in the Bible, thirtieth chapter of Civil war a young man decided to enlist as a Genesis, that nature's law was well understood volunteer ; his married sister became enraged by Jacob, when he took rods of green poplar over it, and she said to him and to all neighbors, and peeled them in part, so as to show streaks that she hoped that his legs would be shot of white and green, and put them in the waterfrom under him. In due time she gave birth ing troughs of the flocks, to make them bring to a girl without legs (!); but the brother re- forth striped and spotted young, which they turned with his legs. Mother and daughter

did? But what is of much greater importance, are still living. I was attending a case where, and which I have seen verified many times, by as the child was emerging from the vulva as observations of many years, is the power of a fast as the pressure was removed, a horrible mother's thoughts over the mental development mass sprang up, which extended from the neck of her offspring. Aside from all ancestral in(covering the whole back) to the nates. I had heritance of characteristics which will crop out, seen several rose cancers, and this mass at once the main line of deportment is markt out by the reminded me of one. The child was still-born. mother during pregnancy. I know a woman, The mother knew that one of her sisters in whose husband gratified her every wish; she Maine was slowly dying of a cancer, but the had privileges in a number of large stores in knowledge of the site of it was kept from her, New York City, but during pregnancy she so she should not mark her child. She con- developt a seeming uncontrolable kleptomania, tinually worried about that sister. One time, which caused her and her husband great trouble as I entered the sickroom, I found my patient and expense. The child of that pregnancy in the third stage of labor, and, of course, I at proved herself an unmitigable petty thief. once devoted myself to my duty. When the Right here I will state that I had a patient child was born, I observed a perfect blister brought to me afflicted with kleptomania ; she extending across the whole wrist, the fluid dis- had an abortion produced in New York City, tending it as much as possible. When I which left her uterus in a deplorable state ; her exprest surprise, the mother held up her arm, petty thefts caused her husband an expenditure which was bandaged around the wrist, and of thousands of dollars. As her uterus imwhich I had not had a chance to notice before ; proved under treatment, she lost her unfortunate tendency to steal. This case helps to vagina. While I at first thought so, I now show how much control the state of the uterus believe it is caused by the relativ position of exercises over a woman's mental and physical the parts. In the right “labium " is a small condition.

glandular body which I pronounced a testicle. I could cite hundreds of cases, as I have In the left one there was nothing. But when been a close observer since 1856. I had over the child was some three weeks old the testicle 400 obstetrical cases before we had a med- on that side had arrived at a similar destinaical college for women in New York City. tion. During the war I labored among the sick sol- All this unfortunate state of affairs was not diers where my husband, Dr. G. B. Hammond, discovered until the second day, when the was surgeon; then I attended college ; gradu- nurse found that, as she exprest it, “the ated in 1867, and then went headlong into baby's got no rectum.” There is absence of obstetrics and diseases peculiar to woman's anus, not even a dimple where it should be. organs. Since graduation I have ministered I advised the parents that an incision could be to over 2,000 obstetrical cases.

I have never

made over the proper location, but they obto this hour lost a woman in the lying-in jected. After two days' crying, and of course state; have never used instruments, and have much suffering, a false opening occurred, too never been obliged to take a stitch for lacera- much anteriorly and to one side of the raphe. tion. The smallest babe weighed one and one- Thru this opening the bowel empties itself, half pounds. She is now a school teacher in the napkin being always soiled. Brooklyn. The largest weighed twenty pounds; With all its misfortunes, small, delicate and it was still-born. My youngest patient was puny, this child proposed to live, which it has twelve years and ten months of age—a case of a perfect right to do, and is now two months incest. My oldest patient was fifty-six years of old and very thrifty. age. Since six months ago I declined obstet- Now, what are we to learn from the fore. rical cases, as, at my age, I fear I cannot do going? full justice to cases. I have had many narrow The first deformity is a variety of hypospaescapes from calamity.

dias, of which there are three: (1) balanic, GERTRUDE HAMMOND HARPER, M.D. those terminating in the glans; (2) penile, Spring Valley, N. Y.

those terminating anywhere along the pendu

lous urethra; (3) perineal, those terminating Deformity of Sexual Organs, and Absence at some point in the perineum. My case of Anus.

seems nearer the last named variety, or rather Editor MEDICAL WORLD :-Father age 38, a peno-scrotal one. Descriptions of operain excellent health, history of having several tions for these conditons are to be found in years since drank to excess, all other history works on surgery. In this case I doubt the negativ. Mother age 36, II.para ; of an ener- successful repair of these parts, because of the getic, domineering disposition. Subject to distant removal of the penis from the present occasional cramping of extremities, but has urethral opening. had no attack since carrying the unfortunate The fistulous anus, is, if possible, a more child which is the subject of this article. unfortunate defect than the sexual. This de

A child weighing five pounds was delivered formity is said to occur once in some 4,588 in hormal labor at term. As is too frequently cases. The congenital absence of anus is a habit with physicians, I handed it over to a divided into three varieties: (1) narrowing, or nurse with only a glance to ascertain its sex. partial occlusion; (2) total occlusion; (3) I announced the arrival of a girl. The old complete absence. My opinion is that this is lady not seeing well, overlookt, as I did, that one of the third classification—that of coma divided scrotum and mal-formed penis plete absence. The presumption is that the covered with vernix caseosa had been mis- bowel contents opened in the direction of taken for labiae and clitoris. Subsequent ex least resistance. For this to accomplish, the amination showed that the child urinated from muscles in that region must of necessity have what would be the normal position of the been very easily divided, and that there are female urethra, and the penis has no urethral no sphincter muscles is evidenced by absence opening whatever. This penis is short and of control of feces. stubby, and the glans is almost entirely ex- Gray gives a very comprehensiv description posed, and is capable of being fully so. of the formation of these structures, which Beneath the urethral opening is a small tri- takes place between the third and fourth angular space into which I inserted a small months of gestation, a variation from which probe. It is apparently a mucous opening, results in a deformity, notwithstanding the but not sufficiently well defined to warrant me belief in a special providence on the part of in believing that Nature tried to make a many of the laity.


I am deserving of criticism for not ascer- hope as to its avail. Penciled skin with 95 pertaining for sure the sex of the child, and the cent carbolic acid and used cocain spray for existence of any deformity; but I promise to deeper tissues; took out one inch of rib and do better in the future. However, in this put in rubber drain. Some pus came out; but instance, I believe it is fortunate that the little relief was afforded. arrival of a "girl” was announced, for social He died three hours after operation. Conand cosmetic reasons. It is obvious that the sultant favored diagnosis of diaphragmatic child can

better get thru the world as a pleurisy. Am very anxious to get opinion of “girl," at least until the age of puberty. A some of the brothers, including Editor. few years hence an operation on the anus may Rosendale, Wis. Chas. A. DeVoE, M.D. be had, and in the event sphincter muscles are [The condition of the right inguinal region found, the child may yet be able to lead a seems to have been lost sight of late in the useful life. Chas. W. MCMILLAN.

A post mortem should have been held. Ada, Indian Territory.

Early in the case more drainage by way of the

bowels, particularly with castor oil, would have Was it Diaphragmatic Pleurisy. been an advantage, and also the use of intesEditor MEDICAL WORLD:-Leo. G., age 13.

tinal antiseptics. We do not see the need or Shortly after midnight on December 7, awoke reason for feeding by the bowel ; and why was with stomach ache, which soon passed away.

it continued so long? The thoracic difficulty Ate breakfast in morning and went to school

seems to have been of late development. Only in forenoon ; ate only a little dinner and a post mortem could have settled the diagnostic remained at home in afternoon, because of point.–Ed.] nausea and abdominal pain. I saw him at 8 p. m. December 8. Temper

Nourish Your Typhoid Patients. ature 101°, pulse 110; right abdominal mus- Editor MEDICAL WORLD :- I have been praccles tense, tenderness over cecum and quite tising ten years; have treated three hundred severe pain. No cough; no symptoms of and fourteen cases of typhoid fever, and have cold; respiration normal. Diagnosed appen. not lost a single case. The thing to do in dicitis. Gave calomel which moved bowels typhoid fever is, keep down fever and nourish next morning, and applied cloths wrung out of your patient well. I direct nurse to sponge hot infusion of smart weed; ordered no feed- patient when temperature goes above 102°. ing and no cathartics. December 9, gave some The sponging will reduce the fever from one to morphin for pain, and nutrient enemata of two degrees. I give but little medicin. Somepeptonized milk.

This treatment was con- thing to keep skin acting well is important to tinued for six days, tho but little of the opiate keep down the temperature. Nourish your was given. There was then no pain, some patients well. I give broths of all kinds with tezderness, and temperature which had been oyster crackers and soda crackers in them in a from 103° to 104.4° dropt to iono. No tumor directed quantity ; also a soft boiled egg three palpable, percussion normal in iliac region. times daily, and oysters, corn starch and rice. Continued rectal feeding, but temperature The majority of physicians put their patients came up and ranged between 100° and 103.2° on a milk diet. I don't ask my patient to take for six days. No chilly sensations, no sweat- milk. I ask them to drink water freely, also ing; felt good, good color, little emaciation. lemonade and chocolate. Nourish your

At 10 p. m. December 20, was called to see patients, and when the fever leaves them there him. For first time he was coughing and ex- is sufficient strength left to enable them to get pectorating ; sputum was fecal in odor; respir- well

. There is a large percentage of deaths in ation very rapid. Examined right chest and typhoid fever caused by physical exhaustion found signs of fluid, low in axillary region; after temperature goes down to normal. They hepatic dulness obliterated. In two hours have been starved to death. My patients do became cyanotic, limbs cold, respiration 70, not have the ravenous appetite that you find pulse 130, temperature 103°. Inserted trocar where they have been starved. I give solid and drew off 12 pint pus, thin, horribly offen- food four days after the fever leaves them. I siv and brownish in color. This relieved him never had a case of hemorrhage of the bowels. considerably.

I never had a patient in bed longer than December 21 a surgeon was called in consul- twenty-four days. Nourish your patients and tation. He said wait a day or two before do it well.

J. L. THOMPSON, M.D. operating in hope that he would be stronger, Limestone, Pa. when a rib resection would be done.

[Doctor, how about all your cases having At 6 p. m. December 21 he again began been genuin typhoid? Thirty-one cases of coughing, extreme dyspnea, cyanosis. I genuin typhoid per year for the first ten years offered to do the rib resection but offered little is a pretty high average. Have not many of

« PreviousContinue »