with a respiratory rate of 72 a minute recovered. Profuse expectoration seems to be a good sign in the pneumonia, and the fact that the patients sometimes expectorate a great deal of blood does not seem unfavorable. In a few cases, where the toxemia is a very severe and where the pulse rate is, say, 140 per minute; the respirations around 60 per minute, and the temperature about 104 degrees, the prognosis may safely be very unfavorable although the mental faculties may be good.

Many cases undoubtedly are those of pneumonia, when there are present: rapid respiration, pain in the chest, and bloody expectoration; in which percussion and auscultation give no definite signs of consolidation. These cases should, from the start, be treated as pneumonia.

Prognosis in influenza is greatly affected by the location of the patients if the death rates are correct as they must be mentioned in the reports in the various journals by physicians attending the large hospitals.

Patients in rural districts I believe had given a much lower death rate than in cities; small towns I believe give a lower death rate than large ones. This may be accounted for by the fact that the rural communities are better nourished on an average, have lived a more regular life and are not so exposed to cross-infection patients who will stay in bed from the

The influenza-rush has been over for me for now three weeks, and I am glad of it -and I never want to see another case of it. Of course, I had a big experience, met new conditions, some of them easily handled and others entirely beyond the reach of medicine.

One form of pneumonia really phased me, and I was ready to throw up my hands and surrender every time that I encountered a case.

The first case of this kind that I saw was one in consultation, in which the attending physician was not certain that it was pneumonia. My decision was, that it was pneumonia in the worst form, and that it was immaterial what medicines were

being given. This patient lived thirty hours. I lost 3 cases of this kind in my own practice and one other convalescent case of bronchopneumonia. I saw 4 other cases in consultation and heard of several more, but, all these patients died in from twenty-four to seventy-two hours.

I never have liked to acknowledge that I was defeated, that I could do nothing more, that my resources were exhausted, and that I had nothing to offer; however, here, I met my Waterloo and my hands went up in surrender as soon as I saw one of these cases of pneumonia.

I attended and saw hundreds and hun- dreds, possibly a thousand, cases of influenza and a large number of cases of bronchopneumonia, most of which were easily managed, although some of them were tedious and hard to carry to convalescence. I saw no case of croupous pneumonia. Many of the patients were spotted. Some of the victims suffered a second attack, while one had the influenza and three distinct attacks of pneumonia, all inside of five weeks, and then got well in spite of

me.

I used quite a lot of the mixed influenzabacterins (of several makes) and also of the mixed influenza-serobacterin, for purposes of immunization against the disease. By way of treatment, I used influenzabacterins, serobacterins, and mixed-infection phylacogen, besides remedies as indicated, both internal and external. (Eternal and infernal, the old woman called them.)

With a three-and-one-half months' fight with this epidemic, I thought that the loss of only 4 patients was a very low mortality rate, especially when we had no trained nurses, at times only one person to nurse an entire family of from 4 to 9 persons (many of them little children), do the nursing, do all the cooking, chopping the wood, milking the cows, and churning the butter, and so on ad infinitum.

Many times, also, the sanitary conditions were the very worst. Still, this factor seemed to have nothing to do with the recovery of the sick; for, often, where the - sanitary conditions were the worst, there the patients did best and made the quickest and safest recoveries. This would seem to discount the need of cleanliness in sickness, even though we so strongly preach the absolute necessity of scrupulous cleanliness. Understand me, I do not advocate dirt and filth about sick people, for, I like

cleanliness, under all circumstances, as strongly as does anyone; yet, again and again, the filthy victims, in the most unsanitary surroundings, got along very much better than those cleanest and amidst ideal surroundings.

Moreover, I have had the very same experience in the confinement of women. As a rule, wherever the conditions had been most unsanitary, the bedding and clothing the filthiest, often under an old quilt that had not been washed in years and on which the dogs had slept, I have had the least trouble with puerperal infection, and the most rapid and best recoveries. My puerperal septicemias have nearly always been among the ultracleanly. However, understand, there are other factors that enter the sickroom besides cleanliness, and I appreciate those factors. Often, these factors outweigh cleanliness, care, medicine, and all else. I trust that you understand me clearly.

My experience has been, that those people to whom I have given von Ruck's antituberculosis-vaccine are sick less than other people; they rarely have pneumonia, being, possibly, one out of every one hundred cases that I have treated; they very rarely have grip, and then it is only in the nature of a slight cold; all their other troub'es are but slight afflictions and they come nearer staying on the job every day than do other people.

Rising Star, Tex.

B. F. TERRY.

[This writer has made the same observation as has Doctor Terry with respect to patients that were fully immunized against tuberculosis with the complete antituberculosis-vaccine of Doctor von Ruck. Of all those persons whom he immunized in this manner from one to three years ago, only one had an attack of influenza, with severe fever, but, which, subsided rapidly, the patient recovering promptly and perfectly. Others showed slight symptoms of "cold," this never extending beyond the upper respiratory passages and it did not develop in actual illness.

It is a common observation that persons immunized in the manner described no longer are susceptible to "colds" and to other respiratory affections. In other ways, also, they have acquired a greater resistance and a higher degree of good health than they had enjoyed before. This

individual observation is given for what it may be worth. This writer, though, is convinced that the fact stands in direct relation to the complete immunization against tuberculosis-infection-which many times is occult and unrecognized.-ED.]

DENTIST WANTED

Dr. R. T. Bolyn, 123 Main St., Berkeley, Street, Berkeley, Norfolk, Virginia, is desirous to have a competent dentist to locate in his town, of over ten thousand inhabitants, where, at present there is but one dentist. It would seem that this is a favorable opportunity for a good man, and physicians having cognizance of dentists looking for a location might do their friends a good turn by informing them of this chance.

WHAT DO YOU REALLY KNOW ABOUT HEALING THE SICK?

The editor has asked me to write a supplement to my article, "What Do You Really Know About Healing the Sick?" that appeared on page 230 of the March issue of this journal. The article was intended as an acid-test of what the average physician's actual practical knowledge. Among the large number of physicians of the United States and Europe, that have written me concerning that article, only one expressed the thought that he could answer my questions correctly!

In naming the indicated remedy, in answer to each question, I give that one that I have found, in my own practice, to be the best, the remedy that can be depended upon when given according to the indications named in my previous article.

1. When called to see a little child, the mother will tell you that "the child wants to be carried all the time, as soon as I go to lay it down, it cries." Recipe: Tincture of chamomilla, 10 drops in half a glass of water. Give one teaspoonful every hour.

2. A young woman tells you that she flows too much at the monthly period, the blood is dark and tarry, passing in clots. This condition indicates aurum muriaticum natronatum, 3☓. (gold and sodium chloride). Dose, three tablets an hour after each meal.

3. Men at or past the middle age may have chronic enlargement of prostate.

Tincture of hydrangea is the remedy, 6 drops taken three times a day. Calcarea fluorica 6× is the biochemical remedy for this condition. I give three tablets of this remedy every three hours. These two remedies taken at the same time will do more for that condition than will any other medicine.

4. Spinal irritation is one of the most common diseases that we have; yet, very few doctors know how to cure it. There are tender spots along the spine; headache begins in the back of the head, passes over to the frontal region; knees feel cold, the palms of the hands burn, the toes quiver in bed at night, there is numbness in the hands or feet; also intercostal pain.

I

give tincture of belladonna, 1x, 5 drops every three hours; also 2 grains of quinine before breakfast; besides dialyzed iron, 15 drops after dinner and supper. With tincture of iodine, I paint a strip as wide as two fingers along the entire length of the spine, every night and morning, until the skin feels so sore that it becomes unendurable. This treatment I evolved for this condition in 1883, and I have cured a large number of patients with it, and have recommended it to hundreds of other physicians. The patient will begin to improve from the start.

5. For that particular form of indiges tion mentioned in my question, and which is so very common among our American people, the remedy indicated is nux vomica 3x, three tablets every three hours.

6. Intercostal neuralgia calls for just one remedy, namely, specific tincture of asclepias tuberosa, 20 drops every two hours.

7. The patient walks the floor in agony, even after a soft stool. It indicates one remedy, namely, nitric acid 6× dilution, in 5-drop doses three times a day.

8. A case of chronic diarrhea in an old lady, who feels a desire for stool in the morning when she gets up and begins to move around. Prescribe natrium sulphuricum 6x, three tablets to be taken every three hours.

9. When ferrum should be prescribed, the face is ashy-pale in color, it flushes upon the slightest emotion, the tongue is pale; the pulse is a small, thin, empty one. Remember this rule: if iron does not increase the desire for food and the ability to digest it, then you will know that iron is not the remedy that your patient needs.

If you have in hand an obstinate case of anemia and palpitation of heart, where terrum is indicated by the tongue and pulse, prescribe ferrum 3x, three tablets every three hours, in alternation with digitalis 3x, three tablets every three hours. I have seen fine cures effected with these two remedies.

10. Quickness of the pulse, without strength, indicates cactus grandiflora, 30 minims of the tincture to be diluted with 4 ounces of water, and one teaspoonful of this to be taken every three hours.

11. A weak pulse, with a well-marked interval between the pulsations of the artery at the wrist warns us that paralysis has already taken place or is liable to occur in the near future. It indicates just one remedy, namely, kali phosphoricum 3x, three tablets to be taken every three hours.

12. Women at the menopause complain of hot flashes, faintness, perspiration. This calls for one remedy, namely, sepia 6x, three tablets to be taken every three hours.

13. Very often, enlargement of the womb causes some form of displacement. To reduce the enlarged uterus, give tincture of fraxinus americanus in 10-drop doses three times a day.

14. An old lady may consult you about an annoying condition: She passes urine involuntarily when she coughs or sneezes. This indicates causticum 3x, three tablets every three hours.

15. Mental trouble caused by an injury of the head calls for natrium sulphuricum 6x, three tablets every two hours.

16. The patient eats well, but, is losing flesh, and the pulse is rapid and intermittent. this indicates natrium muriaticum 6×, three tablets to be taken before each meal and at bedtime.

17. Bloating of the upper eyelids, swelling of the ankles, the patient has to get up in the night to urinate. This calls for kali carbonicum 6x, three tablets every three hours.

Buffalo, N. Y.

ELI G. JONES.

[We asked Doctor Jones to complete his paper of last month, because it was to be anticipated that the very confident tone of his remarks would induce many physicians to request further information on the subject. We wonder just what the readers of CLINICAL MEDICINE think of the remedies enumerated in the foregoing. Some of

Dr. Alexander L. Pomeroy died the other day at the advanced age of 97 years, after seventy-three years of service. During all this time, he lived in the same house, at the village of Windsor, Ashtabula County, Ohio, and, until shortly before his death, went about attending to his patients. Such a record as this is worthy of notice. I am sending the facts as a tribute of love and respect, and to acknowledge many obligations.

Dr. Pomeroy began his study of medicine in 1840, at the old Cleveland Medical

College. The village of Windsor is about thirty-five miles east of Cleveland. At that time, there were no railroads, no automobiles, no electric lines. The easiest way was, to walk, which the young student did, carrying his carpetbag in hand, back and forth each two weeks of the sessions for "lectures." He was graduated in 1845, and since then his shingle has swung to and fro in the wind of his native village-seventy-three years in the harness!

Turn back the pages of medical history for seventy-three years and list its accomplishments. Eagerly this old-school doctor followed each step of progress, the advent of anesthesia, antisepsis, the antitoxins and the vaccines. He once said to me, perhaps twenty years ago; "It keeps us old fellows hustling to keep up to date these days." How kind he was, how teachable, how eager to learn! I saw him many times while I still was a medical student, and he would quiz me by the hour about things we did at school, about new methods of diagnosis and treatment, and the like.

If any one doctor was the source of inspiration that prompted the writing of "The Letters of Dr. Betterman", it was Dr. A. L. Pomeroy. His character, personality, and life-philosophy made him unique in this age of heartless hustle and relentless efficiency. On his grave, let us lay a wreath, with "R. I. P." shown in large letters.

Youngstown, Ohio.

С. Е. В.

[The "Letters of Doctor Betterman", which are referred to in this communication, were published serially in Allbright's Office Practitioner, some years ago, and were discussed in CLINICAL MEDICINE for September 1910, on page 935; also in June 1911, page 696. These letters, which are available in book form, should be read by all physicians who are desirous of making the best of their opportunities in so far as they wish to be true physicians. They are an unfailng source of inspiration, of comfort, and encouragement.-ED.]

A GOOD WORD FOR HOMEOPATHY

I have read Doctor Kennan's article in the January number, page 56. The Doctor says that he is a Homeopath. I also am called a Homeopath, although, as a matter of fact, I am nonsectarian, having had the opportunity of being graduated from the regular, the homeopathic and the osteopathic schools. Each one of these systems has its sphere of usefulness.

Your journal is somewhat eclectic, upon an alkaloidal basis. It contains much of Homeopathy and shows the effects of homeopathic prescribing in what might be called the lower potencies or even approaching physiological doses. This field is rather neglected by the homeopathic writers.

I fail to see any reason for the antagonism of the regular school, to Hahnemann and Homeopathy, in refusing to give credit when that system is so much in vogue and its advocates and writers apparently are so much quoted and copied from. Surely, all investigators deserve recognition, even if they may not happen to be just "orthodox." I have about concluded that it is lack of correct information about these branch schools that accounts for the adverse attitude of the regular school.

E. M. MORGAN.

Westmount, Quebec, Canada.

RESUSCITATION-ATTEMPTS AFTER

At ****

DROWNING

,

Florida, on February 7, a number of tourists were bathing in the surf of the Gulf, when one of them, a strong, athletic man of some fifty years, weighing perhaps 180 pounds, suddenly stopped swimming and sank within ten feet of other bathers. Help was summoned and probably fifteen minutes elapsed before he was laid on the beach and efforts at resuscitation were started. An empty barrel being convenient, he was placed across it, to expel the water, if any, from the lungs; none, however, was reported as having escaped. I was a mile away and a motor launch came for me, so that it was at best a full hour before I arrived. When I first saw the man, he still lay over the barrel, with head only six or eight inches above the sand. His face was intensely cyanosed and edematous, and the tongue protruding, and I came very near speaking out, "He is dead already," when his sister-in-law whispered into my ear. "Don't tell his wife so, doctor, but, work."

So, I ordered the body removed from the barrel and placed upon the sand, and I

continued to make respiratory movements, the woman meanwhile closing the nostrils and blowing into the mouth with the inhalatory movement. I gave no medicine, nor said anything about giving any, as the body already was deathly cold, although well wrapped in blankets and rugs, with hot bricks and bottles filled with hot air all around him.

In about another hour, another doctor arrived and began to read from a book and every ten minutes put a granule (presumably Abbott's) on the dry tongue, which was being drawn out for the blowing-in. When I asked, in an aside, "Why don't you tell them that he is dead?" the reply was, "They won't have it".

At about the third hour, someone had brought a hypodermic syringe and 4 tablets of strychnine, 1-60 grain each. I told them to fix up three of the tablets, and I injected this dose into the now rigid body. In about fifteen minutes, I was handed the remaining tablet and I injected that also.

we

By the third hour, the ankles and elbows were stiff, so that I could not bend either. Still, the women said, "Don't stop," and continued our efforts. The woman asserted that she knew of a drowned person having recovered after six hours of effort and the people insisted upon the extra two and one-half hours of work before they would yield.

At the end of eight and one-half hours, the relatives yielded to the inevitable, and at last we could rest from our labors. The other doctor was soon gone, but, when I spoke of leaving, I was requested not to go. So, I stayed till the body was placed on a boat on its way home, and I was invited to come along on the same boat. I was an entire stranger, and it looks to me as if I had done nothing in a medical way to deserve this confidence.

Only a few months ago, we had an almost parallel case here, so far as appearances and result goes.

A man did a hard day's work and within half an hour put on a bathing-suit and sprang into the water. In about half a minute, he called for help, floated some 25 feet, caught a horizontal chain about a foot above on a schooner and fell face forward over the chain. He was taken off in about two minutes more and we had him on the dock, working with him. He, too, was blue, no water came from his mouth; he had no pulse. No hypodermic nor car