Selections. FROM CURRENT MEDICAL Syphilis and Sexual Neurasthenia: Gold Solutions. Within the past six months my attention has been repeatedly called to the gold solutions (known as arsenauro and mercauro) as offering results in my special line of practice not heretofore obtained by treatment commonly in vogue. I am skeptical in regard to special therapeutic agents, as a rule, such claims being made by the manufacturer as would tend to preclude confidence rather than produce it. Knowing the reputation of G. Frank Lydston, M.D., whose writings are so authentic and forcible, and being attracted by his paper read before the Chicago Academy of Medicine, in October, 1894, I determined to test these alteratives thoroughly in my service at the New York Polyclinic, and thus learn from personal observation whether results obtained would warrant me in suggesting their use to the number of practitioners who attend this institution. I must say that the outcome has been beyond all expectations. The classes of cases that came under my ob familiar, so unmistakable to medical men. I think without doubt that arsenauro is the most pronounced aphrodisiac I have ever seen, producing this effect in both sexes. Thus after noting the effect, I was led to extend its use in my private practice. The nervous debility so marked in the sexual neurasthenic is positively controlled by arsenauro. As for mercauro, I am in a position to attest its great value in cases requiring tonic mercurial treatment. I refer to those instances where, in the initial lesion, we give either the protiodide of mercury or inunctions of the ointment. Our patients often rebel at a conIt is here that I tinuation of this treatment. drop doses and increasing a drop a day until put the patient on mercauro, beginning with five evidences of arsenical intolerance are established. Look for puffiness under the lids, which may appear when arriving at eight, ten, fifteen tolerance of the gold may be presented—i.e., or twenty drops, three times daily, or the infrontal headache, a tendency to vertigo, and increased saliva. When any of these symptoms are present, decrease the dose until they disappear, then resume and persist in the treatment-say for at least six weeks without omission. I find these patients who are run down, as it were, under a so-called tonic mercurial treatment, rapidly build up and show such an improvement that I continue them right along with mercauro and apparently abort the later specific lesions-i.e., locomotor ataxia, hemiplegia, etc. In mild forms of syphilis with little or no glandular involvement, and in mixed sores, I immediately resort to mercauro, and I have never seen its equal as a remedial agent in syphilis. It is pre-eminently a new therapeutic agent, the physiological effect being subjudice. In latent lesions it is positively the best remedy. By abundant experience I am settled in my conviction as to its value, and more particularly so when the iodides are not tolerated. We meet many cases that present an idiosyncrasy, either with little or much of the iodide of potash. In these cases, I give mercauro at once, and I am satisfied that my colleagues will agree with me as to its value. servation were as follows: Chronic masturbators, those suffering from the results of incomplete coitus, or certain degenerates, the victims of psychical excitants leading to complete or partial impotence. These are the milder classes of cases so ably described by KraftEbing in his classical work on psychopathia Squamous, ulcerative and tubercular syphilsexualis, and by Schrenk-Notzing in his Sug-ides, hyperplasia and chronic mucous ulceragestive Therapeutics. These patients present themselves with the usual symptoms, i.e., profound anemia, neurasthenia, relaxed scrotum etc., etc. In other words, they belong to the list of sexual neurasthenics. They feel the desire for copulation, but the act is unsatisfactory in that the moment the organ becomes erect, ejaculation takes place, rendering the sexual congress incomplete and disgusting. In several cases I began the administration of arsenauro in five drop doses, increasing daily until the patient reached ten drops, three times daily, continuing this dose for at least eight weeks. It has been interesting to note the excellent general appearance of these individuals after about two weeks of treatment. They were full blooded, hearty and buoyant, differing so markedly from their appearance when they presented themselves-an appearance so In lesions of the skin, such as a tendency to tions are the special Indications for mercauro. eczema where syphilis co-exists, this is a most powerful antidote therapeutically. In chronic catarrhal cystitis, as the result of prostatic hyperplasia, arsenauro is a very valuable remedy. I have seen cases which have existed for years where the bladder would only contract sufficiently to expel a portion of the urine. leaving a residue to undergo ammoniacal decomposition, become absolutely well under the use of this combination. Seemingly it stimulates the viscus to contract, and I have noted the same result in the hypertrophied prostate of the aged, where atony of the bladder existed. It has been remarkable to note the vigor this solution gives to the organ. Of course mercauro must be given preference where a history of specific disease exists, or is suspected. I feel under obligations to those of my colleagues He who attracted my attention to these products, | Read before the American Gynecological Soand I hope that some one among my hearers ciety at Washington, May 6, 1897. His paper at the Polyclinic will in time work out their was based upon ninety-four ventro-fixations physiological effect. They are certainly valuable curative agents and deserve a careful and fifty-three Alexander's operations. trial. As illustrative, I mention an interesting held that ventro-fixation was the only opercase. Mr. R. J., age thirty-two, widower, sent ation that should be entertained in cases of to me by Dr. L. to be examined for diabetes. retroversion with adhesions; but it should not He had at times, as the doctor informed me, shown traces of sugar in his urine. The pa- be done when the uterus was movable and tient was told by Dr. L. and other physicians when there was no disease of the appendages in New York that his malady was diabetes requiring abdominal section, in which cases the result being that he came to me in a state Alexander's operation had given excellent of extreme mental perturbation, almost verging on nervous prostration. Examination of urine revealed 4 to 1⁄2 of one per cent. of sugar, high specific gravity and hyperacidity. His family history was good, both parents alive and brothers and sisters healthy. He complained of violent headache, loss of sleep, in fact, he was in a profoundly anemic condition, and suffered from neuralgias in his arm, shoulders and lower extremities. Examination revealed hyperesthesia of the skin, tenderness along the lumbar spine, and last but not least, a well-marked specific macular erup- | tion. Recently coitus was denied absolutely. Upon examining the throat mucous patches were discovered on the soft palate and a welldefined chancrous sore on the right tonsil. results. There should be no death-rate to either operation; neither should there ever be hernia, either ventral or inguinal, if the following directions were followed. The two operation were equally easy, although a few years ago the author was opposed to Alexander's operation on account of its difficulty. Now he could invariably find the ligaments, and generally in from half a minute to a minute and a half. He warned his hearers not to do Alexander's operation if there were any adhesions, even if they were loose enough to permit the uterus to be lifted up, because they would be put upon the stretch and would drag so much upon the ligaments as to finally pull them out of their anchorage. In laying down the tech The cervical glands were markedly enlarged. I made the diagnosis of syphilis, as the case was clearly this, and the subsequent treat-nique of Alexander's operation he placed great ment proved it beyond any doubt. The patient was placed on a full diet, allowed some claret as he was sorely in need of a general tonic, and mercauro prescribed in ten | drop doses three times daily, increasing one drop every other day until he was taking twenty drops three times daily, which was his physiological limit. His general condition began to improve in a very short time-sugar disappeared entirely, the eruption and sores improved, headache and nervousness left him, and he gained in flesh and strength. Here then was a typical case of the beginning secondary stage of syphilis benefited by mercauro, the case being one in which the use of other well known mercurials could not have brought about such a result. I mention this case to show the good effect this mercurial tonic will produce, especially in syphilitic anemias.HERMAN F. NORDEMAN, M.D., in N. Y. Polyclinic, April, 1897. Results of Operation on Retroversion of the Uterus. stress upon the importance of putting aside all cutting instruments as soon as the skin, superficial and deep fascia had been cut through. Instead of laying open the inguinal canal, as advocated by some writers, he advised his hearers not to cut a single fibre of the intercolumnar fascia, which was the principal support of the pillars. Moreover, he said, the slightest nick of the fascis of the internal oblique would lead to a false passage and failure to find the ligament. If no cutting instruments were used, but only a Péan's forceps to draw out the ligament, there would be no difficulty in finding it, because there was nothing else in the canal but the ligament. In fact, with the eyes bandaged it could be found and drawn out simply by introducing the closed forceps and then opening them, when the round ligament will fall into them and can be drawn out. He advocated the use of fine silkworm-gut, which could be thoroughly sterilized and left in permanently. Occasionally he had been obliged to remove a buried stitch. In case any fibres of the intercolumnar or internal oblique should be accidently cut, great care should be exercised in sewing them up to avoid hernia. He had only had one relapse after ventro-fixation and one after Alexander, of the cases of ventro-fixation had since become which were both subsequently repaired. Several pregnant, and had had normal confinements. Also several cases of Alexander had had children. Many of the patients had been bedridden invalids for years before, and were now enjoying excellent health. Both operations, each in its proper sphere, had given the greatest The following is an abstract of a paper on the results of 147 operations for retroversion of the uterus, by A. Lapthorn Smith, B. A., M.D., M.R.C.S. England; Fellow of American Gynecological Society; Surgeon-in-Chief of the Samaritan Free Hospital for Women; Gynecologist to the Western Hospital and to the Montreal Dispensary; Professor of Clinical Gynecology in Bishops University, Montreal. I possible satisfaction. Bibliography. TWENTIETH CENTURY PRACTICE: An be complete, but may be truthfully numbered as in the first grade of the first class at this time. International Encyclopedia of Mod. SURGERY: A Practical Treatise, with ern Medical Science. Edited by THOMAS L. STEDMAN, M.D., New York. In twenty volumes. William Wood & Co., 1897. Volume IX-Diseases of the Digestive Organs. The publication of this great work continues right along. The volume in hand contains contributions from Carl Anton Ewald, of Berlin, who writes on diseases of the intestines; Mikulicz and Kümmel on local diseases of the mouth; hernia, by V. P. Gibney and John B. Walker, of New York; diseases of the of the liver, by Semmola and Gioffredi, spleen, by A. Stengel, of Philadelphia; of Naples; diseases of the gall-bladder, by John B. Murphy, of Chicago, and of movable kidney, by K. Franks, Johannesburg, South African Republic. Each of the contributors are men with an international reputation, and the work they have presented the profession in this relation is a clear reflection of medical science at this writing. The Twentieth Century Practice is a whole library of goodly proportions. THE DISEASES OF INFANCY AND CHILDHOOD: For the Use of Students and Practitioners of Medicine. By L. EMMETT HOLT, M.D. Illustrated. New York: D. Appleton & Co., 1897. In the evolution that has taken place in every department of medicine, that pertaining to children and their diseases has not been permitted to lag behind. This handsome volume of more than eleven hundred pages bears ample testimony to the special work that is being done in this direction. The volume under consideration especially treats of diseases of children who are younger than seven or eight years, and may therefore be taken as a work on infantile affections. Surgical questions have been omitted except as regards early symptoms and diagnosis. Special attention is given to the pathology and clinical conditions, with methods of treatment. The work is not claimed to Special Reference to Treatment. Third American edition. Revised and edited In a review of a former edition of this superb work occasion was taken to say that it is the best of the condensed works on surgery in the English language. Being based upon modern ideas, it teaches modern surgery. In the present edition the author and editor have brought the work right down to book on surgery, and is of equal value date, so that it still holds its place as the medical student's very best textto the surgeon and general practitioner. THE DISEASES OF THE STOMACH. By DR. C. A. EWALD. Translated and edited from the third German edition by tion. MORRIS MANGES, M.D. Second revised ediNew York: D. Appleton & Co., 1897. The appearance of the first edition of this work in 1892 by Prof. Ewald acted as a stimulus to further and more general study of pathological conditions of the stomach. In this volume will be found much matter that is new and that is well illustrated, which brings the subject matter down to date. The author directs special attention to the progress made during the past few years in gastric surgery, and discusses the various diseases in which there are indications for operative interference. This work of Prof. Ewald will hold its own as one of the most valuable of the monographs that can find a way to a physician's library. LECTURES ON RENAL AND URINARY DISEASES. By ROBERT SAUNDBY, M.D. Illustrated. Second edition. Philadelphia: W. B. Saunders. Price $2.50. These lectures being such as the author delivered before a class of students, he very naturally began the first by taking up the anatomy of the kidney and then the physiology of that organ, Lippincott's MEDICAL DICTIONARY. following with the pathology and treat- | in an obstetric bag or overcoat pocket. ment of renal and urinary diseases, The mechanical work of their prepaincluding diabetes, illustrating every ration is good. part by the use of specimens and clinical cases. Quotations from numerous authors are frequent, and made freely, giving due credit. The work is a good one, and worthy of a place in any physician's library. The evident increase in renal diseases within the last few years makes their study a necessity to specialist and general practitioner alike. HYSTERIA AND Certain Allied CONDITIONS: Their Nature and Treatment. By R. W. GREENE, A. B., JOHN ASHURST, JR., M.D., G. A. PIERSOL, M.D., and J. P. REMINGTON, Ph.M., Philadelphia, 1897. first and most useful book The very in every physician's office and library is an up-to-date dictionary. There are other excellent books of this class in the market, all good and useful publi cations. The one in hand has the advantage of being concise, and embodied in one volume. The arrangement, typoIllus-graphy and presswork are quite perfect, and of such a character as to make the book attractive. A cursory examination leads to a belief that the definitions will be found to be generally acceptable. By GEORGE J. PRESTON, M.D. trated. Philadelphia: P. Blakiston, Son & Co., 1897. Price $2,00. For sale by Robert Clarke & Co. Hysteria being a nervous symptom, or functional manifestation that is apt to complicate almost any organic disease, it represents a condition about which every practitioner should be as familiar as possible. In this little Manual of Domestic Medicine and volume may be found a good deal of information that will call to mind much Edited by J. WEST ROOSEVELT, M.D. that is obscure in the way of differenti-Illustrated. Price $6.00. D. Appleton & Co., New York. ation of maladies. In this direction a clear presentation of the subject as given by the author will be found of great assistance. Through just such information the practitioner is enabled to indicate the various therapeutical measures that will prove of value in many instances. The author is fairly suggestive all the way through. This is an anomalous production in the way of a book. The title proclaims it as a manual of "Domestic Medicine," etc., indicating that it was prepared for the laity and not for members of the medical profession. For such reason it is necessarily written and illustrated in a manner adapted to the people. In this the author has both failed and succeeded. He has failed in that the subject-matter and illustrations are away up above those who have not shown by his taking up the minute a pretty fair medical education. This is anatomy and physiology of the various organs of the body. In a work on domestic medicine for the laity this is quite beyond the sphere of the book. While it does not pretend to be designed for the use of physicians, there is very much in it that is of special value to them. Bacteriology is drawn upon without stint; in fact, a whole chapter is devoted to this science. A very few laymen who have received a thorough scientific education "Heisler's Embryology." By John C. Heisler, M.D., Prosector to the Professor of versity of Pennsylvania. Anatomy, Medical Department of the Uni will be able to appreciate and under- The work is sold by subscription, and, of course, to the laity. While it is a fair reflection of recent knowledge of the science of medicine, it is altogether too advanced a book for family use. "Mallory and Wright's Pathological TechBy Frank B. Mallory, A.M., M.D., Assistant Professor of Pathology, Harvard Medical School; Assistant Pathologist to the A.M., M.D., Instructor in Pathology, Harvard Boston City Hospital; and James H. Wright, Medical School; Pathologist to the Massachusetts General Hospital. NEW VOLUME IN SAUNDER's aid series. "Sutton and Giles' Diseases of Women." By J. Bland Sutton, F.R.C.S., Assistant Sur- Giles, M.D., B.Sc. Lond., F.R.C.S. Edin., MR. MOULTON begs to announce as in preparation for early publication, "The Doc In Preparation for Early Publication. tor's Window:" Poems by the Doctor, for the "An American Text-Book of Genito Doctor and About the Doctor, edited by Ina Russelle Warren. The compilation of this collection has required two years and it con Urinary and Skin Diseases." Edited by L. nearly every poem of importance on the subject in the English language. It also includes a number of powerful poems never before published. Nearly every phase of the physician's life is introduced, both grave and gay. The book will go through the press "An American Text-Book of Diseases of under the direct supervision of the editor, and the Eye, Ear, Nose and Throat." Edited by will be printed with large, open-faced type on G. E. de Schweinitz, M.D., Professor of Oph-heavy linen paper, will be royal octavo in size, thalmology in the Jefferson Medical College, and B. Alexander Randall, M.D., Professor of Diseases of the Ear in the University of Pennsylvania and in the Philadelphia Polyclinic. "Macdonald's Surgical Diagnosis and Treatment." By J. W. Macdonald, M.D., Graduate of Medicine of the University of Edinburgh; Licentiate of the Royal College of Surgeons, Edinburgh; Professor of the Practice of Surgery and of Clinical Surgery, Minneapolis College of Physicians and Surgeons. "Anders' Theory and Practice of Medicine." By James M. Anders, M.D., Ph.D., LL.D., Professor of the Theory and Practice of Medicine and of Clinical Medicine, MedicoChirurgical College, Philadelphia. "Senn's Genito-Urinary Tuberculosis." By Nicholas Senn, M.D., Ph.D., LL.D., Professor of the Practice of Surgery and of Clinical Surgery, Rush Medical College, Chicago. "Penrose's Gynecology." By Charles B. Penrose, M.D., Professor of Gynecology, University of Pennsylvania. "Hirst's Obstetrics." By Barton Cooke Hirst, M.D., Professor of Obstetrics, University of Pennsylvania. "Moore's Orthopedic Surgery." By James E. Moore, M.D., Professor of Orthopedics and Adjunct Professor of Clinical Surgery, University of Minnesota, College of Medicine and Surgery. 7x934 inches, and illustrated, making a volume of over 240 pages. The bindings will be in library style, uncut, gilt top. Price, in cloth, $2.50; full morocco, $5.00. For further information address the publisher, CHARLES WELLS MOULTON, Buffalo, N. Y. Counter-Irritation in the Treatment of Herpes. Theodore Wilkins (Med. Record, September 26, 1896) states that he had good results from treating herpes by this method. In nearly all cases of herpes zoster a tender spot may be found higher up over the nerve trunk, and at this point the counter-irritant is applied in the form usually of flying-blisters or turpentine. The pain is generally speedily relieved, and the eruption dries up much sooner than would be the case in the natural evolution of the lesions.— University Med. Magazine. THE same high authority who hears the words of grace before a meal also hears the words of comment afterward. -Med. Era. |