coming across this case while the "WORLD family was discussing the matter under consideration, I became quite interested in the subject. From the few available crumbs of literature on the subject and an analysis of the thirteen cases reported in the last three numbers of THE WORLD, and my own case reported above, I have deduced the following:

Etiology of umbilical hemorrhage:
a. Faulty ligation of cord.

b. Impertinent tampering with cord.

c. Anomalous distribution of blood vessels.
d. Perverted state of blood.

Umbilical hemorrhage may occur from:
a. The cord.

b. The umbilicus before or at the time of separation of the cord.

c. The umbilicus after the separation of the cord.

a Hemorrhage from the cord is due to the faulty technique of the accoucheur or the midwife, and may be easily corrected by the proper application of a ligature.

b Hemorrhage from the umbilicus before or at the time of the separation of the cord is due to either causes b or c. Ten of the thirteen cases reported in THE WORLD are of this variety, two of which proved fatal. The fatal cases were those reported by Drs. Rice and Jones, and were probably due to cause c. Radical surgical measures might possibly be effectiv in this class of cases. When hemorrhage results from cause b, astringents, caustics, pressure and hemostatics should generally prove effectiv.

c Hemorrhage after the separation of the cord may be due to causes c and d. If due to cause surgical measures may suffice, as in the case reported by Dr. Hostetter. When hemorrhage is due to cause d the outlook is most dismal indeed.

I cannot refrain from taking exception to Dr. E. J. Marsh's paper on the subject (page 114, March WORLD). His application of cobwebs for arresting the hemorrhage is certainly a retrogressiv step. In this age of clean surgery such crude methods should be discouraged among the laity, and much less employed and advised by one bearing the title of M. D. "But suppose the cobwebs had failed?" Cutting out the umbilicus might not be bad surgery, but putting an irritating foreign substance like boric acid or iodoform into a presumably aseptic wound, and then "stitch it up tight," would be quite a primitiv surgical procedure, expecting it to check hemorrhage and the wound to heal by first intention. It might be observed that the doctor has not practised this method, but only suggests its possible utility. Three years ago I was called to see Harvey K., aged 7 years. Made a diagnosis of lobar

pneumonia.

Administered calomel in divided doses, etc. After 24 hours calomel had failed to produce any effect. Boy suffered considerable abdominal pain, restless, pulse rate and temperature higher and pulmonary symptoms very distinct. Gave enema of water, glycerin and salt, which produced a copious movement. Symptoms unchanged for next 12 hours, calomel still not having produced the desired effect. I now gave him a high enema, but the water passed away as clear as when injected. A few hours later I gave a third enema (high), with no better result. I now concluded that my case of pneumonia was complicated with acute intestinal obstruction. Being unable to discover any mass by abdominal palpation, I decided to repeat the injection, introducing the tube as high as possible and injected as much water as the little follow's gut would hold. This time my efforts were rewarded by a copious liquid stool, which contained a number of cream colored, tuf, doughy masses, varying in size. The largest mass crudely resembled an old-fashioned forged nail, being about three inches in length, the stem of the nail-like mass being about equal in bulk to a lead pencil, but somewhat flattened. The head of this mass was about the size of a nutmeg. The other masses were all smaller than the head of the nail-shaped mass. How could these masses have obstructed the boy's intestin? and what was their composition? The large mass had reacht the ileo-cecal valve, where it was intercepted. The increast intestinal pressure produced by the calomel had forced the nail-like process of the doughy mass thru the valve; hence the abdominal pain. The distension of the cecum with water allowed the head of the nail-shaped mass to pass thru the valve intact. Close examination proved the masses to be undigested parts of a tuf, halfbaked doughnut the boy had munched down while still warm the evening prior to his illImmediately after the passage of these masses and the thoro action of the boy's bowels, the alarming symptoms subsided, and the temperature fell several degrees. The pneumonia ran quite a classical course after the little patient had parted with his dough. Denver, Pa. C. O. HENRY.

ness.

Matches in Rectum; also Stick-pin.-Remove the Membranes Thoroly After Labor.— Dilatation of Prepuce.

Editor MEDICAL WORLD:-The slippery elm bark idea ought to save many lives. I have advised the potato diet with good results. I have removed two matches from the rectum in grown people, both claiming that they knew nothing about swallowing them. Upon reaching the rectum they got crosswise and would

not pass. One perforated the anterior wall of the gut, and six months later resulted in a fistula.

I removed a stick-pin from the rectum of a girl baby two years old, in same position (crosswise). The mother was frantic, but I pusht the upper end up and soon delivered it, and the mother, being Irish, showered the blessing of the Virgin upon me; and unlike some others, she doubled my fee besides.

I believe the thing that kills the women after confinement is that a piece of the membrane gets torn off and left in the uterus; then comes the trouble. I see by our brother, C. R. Woods, of India, that the midwife there slides her hand into the womb at once and delivers the placenta, and evidently all the membranes. I take the greatest amount of caution to know that every particle of membrane is delivered, and if I have any doubt I do as the Hindoos do, go after the smallest fragment. Some years ago I had delivered every particle of placenta and membrane as I thought, but later there was some post partem hemorrhage. I passed my hand into the uterus to remove any clots, and what was my chagrin to find also a piece of membrane as large as the palm of my hand. Had I left that I am sure I would have had a bad discharge and probably a chill later; as it was, in five days the woman was up, and hardly any discharge.

Every case that I have attended for a long time made a speedy recovery and had very little discharge.

I used to circumcise the boys for a long or narrow prepuce, but I believe it is wrong. Now I dilate thoroly and my experience is, with much better results. The prepuce was certainly made to cover the delicate glans, and dilating J. C. CAMPBELL.

is O. K.

Attleboro, Mass.

Ꭱ

Chloroform Castor oil.

M. Sig.-Take one-half; and repeat in two hours if

necessary.

To be successful it is necessary to give most careful attention to the details of the treatment. The patient must eat nothing for twenty-four hours prior to beginning treatment. The bowels should be rendered soluble with calomel, and the doctor should personally supervise the treat

ment.

Prepare a suitable vessel and fill with water, which maintain at 100°, and over which have patient sit when dejections from bowels ensue. This is important, as the worm in leaving its warm habitat and coming in contact with a chilly air, often revives enuf to attach itself to the walls of the intestin again, breaking in two, and leaving a segment with the head, thus rendering the treatment a failure.

Begin with one-half of the mixture, and repeat in two hours, if necessary, watching carefully the effects of the chloroform. Save all dejections from the bowels, and ascertain surely that you have the head of the worm. treatment is not unpleasant, and with it I have never had a failure. T. C. GREEN, M.D. Langlois, Ore.

A Polecat Pointer.

This

Editor MEDICAL WORLD:- I wish first to say that THE WORLD is the most satisfactory of all the journals of which I have any knowledge, including its "Monthly Talks," which can not fail of good results, as they consist of sense and are given to men of thought.

In answer to Brother J. P. Phillips, of Yantley, Ala. (page 86, February number), who has excluded all hearsay, and wants only what

APRIL, 1903]

folks know, I would say that I have had a very extensiv knowledge of the polecat in the last one-half century, and have many times been compelled to give them special thought and attention. The only successful way to deal with the stink is to prevent it from getting on your clothes. That I saw practiced by a boy on his way to a dance. He saw a polecat in the road, stopt the team, removed all his clothing, which he gave to a companion, got a club and slew the brute. He had to walk home as the other boy would not let him in the buggy; but the other boy brought the clothing home in good condition. If the doctor should have no one to leave the clothing with he might hang it on the fence and then send some one back after it when he gets home. WM. J. BAKER, M.D. Jaqua, Kansas.

Fissured Hands.—Removing Skunk Odor. Editor MEDICAL WORLD:-Regarding Dr. Boyer's case of crackt or fissured hands, page 84. February number, I will say that several years ago I was troubled similarly. My best success in healing the fissures consisted of tying a single thread of white silk to the very bottom of the cracks coarse enuf to spread them apart a little; then apply a little mucilage, wiping it off around, and let it dry; then apply a thick coat of collodion, cut off the protruding ends of silk, and they will heal in a few days if collodion is kept on. The mucilage is used only to prevent iritation from the contact of collodion to the raw surface. When I was a boy my father (a farmer) suffered in the same way. He used to sew the cracks up, using fine silk. The main thing is to fix the walls of the fissures so that they will not grow deeper; then they will heal. I have had no trouble for several years past, for now when my hands get a little rough, just before going to bed I scour them thoroly with good soap and water with about a teaspoonful of powdered pumice stone added, and when about dry I apply glycerin and rose water, about one to four parts, rubbing in thoroly. I am well aware that some hands will not bear glycerin, but there are plenty of mild ointments that can be used instead, to keep the hands soft.

Dr. Phillips' mishap (page 86) was nearly duplicated by myself during my first year of practise in a country town in New Jersey. Was called in the evening to see a patient and just as I was starting to go up the stoop a small black and white kitten, as I thought, ran along beside the lower step just in time for me to step with my right foot over what proved afterward to be the business end of a skunk (I think they have no polecats in New Jersey).

There was quite a wind blowing, so I noticed nothing, went up, rang the bell, was ushered

175

in and askt to take a seat, when oh, horror of horrors! there came up such a quintessence of odors as no polecat was ever guilty of producing. I buried my right shoe in the ground three or four days; when I dug it up the odor was all gone; hung my trousers in the wind the same time, when the odor was so nearly gone that the application of oil of geranium overpowered the balance. I now use this oil, deprived of its odor, as one of my best remedies for some forms of whooping cough.

Brooklyn, N. Y.. GEO. NICHOLS, M.D.

Homeopathic Treatment for Dr. Boyer's

Case of Crackt Hands.

Editor MEDICAL WORLD:-I cannot refrain from sending thru the pages of THE WORLD a prescription for Dr. Boyer's case of crackt hands (page 84). The remedies that occur to me at first blush are calcarea carb., graphites, petroleum, silicea, sulfur, etc.

I take it for granted that this patient has been thru a course of all the approved topical medicaments, and all have failed for the good and sufficient reason that the condition of the hands is but a local expression of a psoric condition of the system. Hence all external medical treatment is not only useless, but is likely sooner or later to drive this morbific force to some vital organ, to the infinit harm of the patient. The fact that the Doctor's patient "has always been strong and healthy," has probably saved him thus far. How many

thousands are annually going to their long homes by this criminal practise of suppressing these conservativ efforts upon the part of Nature to rid the system of acquired and hereditary taints! Do the majority of the readers of this journal treat offensiv foot sweat by applying astringent powders or lotions? Do you operate upon fistula in ano? If you are doing these things you are seeing patients prematurely dying who might have been restored to perfect health under a more rational therapy. I do not intend these criticisms for Dr. Boyer at all, for I do not know what his treatment has been ; I am only talking on general principles.

But to the case: The Doctor has hardly afforded us sufficient data-or symptoms-to predicate a really scientific prescription upon. I should wish to go into his family and individual history very carefully. Tuberculosis or syphilis may be etiological factors. Or there may be a history of supprest itch in childhood, etc. Of one thing I am positiv: The condition of this man's skin and finger nails point unmistakably to a deep seated psora that nothing but the highly potentiated indicated drug can eliminate! And that the highly potentiated drug which is capable of producing a similar condition will cure him, I would freely stake

my life upon. Graphites 30x, 6 pellets night and morning, will help this case. Possibly a few doses of a much higher potency may be required before the case is perfected; or some other anti-psoric: Calcarea, psorinum, tuber culinum, silicea or sulfur may be needed later

on.

If this were my own patient I should probably give a very much higher potency, for the reason that the action would be much deeper and more permanent.

I sincerely hope that Dr. Boyer will give this prescription a fair trial and report results in THE WORLD. Use nothing externally but warm soft water and castile soap (French), and I would not object to an application of warm mutton tallow night and morning. No other topical applications should be used. Now, gentlemen, I will close by propounding a question: Suppose that the writer is sincere and knows what he is talking about; are you not glad to know that God has given us a natural law whereby we may be guided in the selection of the remedy?

Watsonville, Cal. S. E. CHAPMAN, M.D.

How Not to Do It, and Why!-Rhus Tox. Poisoning.

Editor MEDICAL WORLD: I like THE WORLD, because from its pages we learn from so many pens just how to do it. But it is often more important to know how not to do it. A case in point may be found on page 482 of the November WORLD, where Dr. Williams gives us a remedy for rhus tox. poisoning as follows: Make a decoction of the leaves of the plant, about a half dozen leaves at a dose, or simply chew the leaves and swallow the juice. He says this will cause an eruption of blebs or water blisters, which contain an antitoxin that neutralizes the poison in the blood when it is reabsorbed. The Doctor says he has known a copious eruption to follow the swallowing of a dozen well formed leaves, and that the remedy immunizes against future poisoning from the plant.

The first statement is doubtless true, and I can go him one better, for I have produced the skin symptoms of rhus poisoning by giving internally the 3x dilution in drop doses every hour for twelve hours. This would be 1/1,000 of a drop at a dose, and I have known many cases where the patient was badly poisoned by passing along the road where it grew, without coming in contact with it at all. But the second statement, that such heroic doses immunize against future poisoning from the plant, lacks proof. In fact, experience shows that it is not true. We have a species of rhus which grows all over the hills and along the creeks of California as thick as the hazel brush in some of the middle states. Poisoning from it pro

duces symptoms identical with those of the rhus tox. Some people can handle it with impunity, in others it only produces slight skin symptoms, while in others blebs, swellings and a long train of symptoms on almost every part of the body.

When I came to California, twenty-eight years ago, I was immune. I suppose I was born immune. I could handle the rhus tox. or the California rhus without danger. But in 1881, while clearing some land, I burned some of the poison oak brush and the smoke poisoned me all over. I had a great many of Dr. Williams' antitoxin blebs, but the reabsorption of the serum in the blebs did not cure me, nor render me immune. On the contrary, since that time if I handle it I am poisoned. That chewing the leaves has cured many cases of it cannot be denied, but it is a dangerous experiment. I have known many individuals to be badly poisoned by chewing the leaves. One, John Cuberson, who came here from Dallas county, Iowa, twenty-five years ago, was poisoned. He was advised to chew the leaves of the plant. He did so, and died two days afterward from the poison.

Now, if Dr. Williams' statement had come from Pasteur or from some great German like Koch or Virchow, doubtless many of the American doctors would have accepted it as the discovery of a great scientific fact; but coming from only Whitefish Bay, we must ask for the proof. Now, Doctor, we do not doubt that you can produce blebs on the average victim with a dozen well developed poison oak leaves, but how do you know that there is an antitoxin in the serum of the blisters? How many cases have you treated with such doses? and what has led you to the conclusion that the cure is made by the absorption of the serum in the blebs?

Here, where the poison oak is so plentiful, I have treated hundreds of cases every year, and I can cure my cases with the 3x to the thirtieth dilution of the tincture of the plant in less time than you can produce the blebs with a dozen leaves. I can't tell you just how the small dose cures, only to say similia, similibus, curantur; but I can bring a thousand witnesses to the fact that it cures. I do not know that the blood of the poisoned patient is affected at all; hence I don't treat the blood. If it were in the blood, why don't it poison the patient all over, inside and out? In most cases the parts only which come in contact with the plant are affected, with the exception that in males the scrotum is affected in almost every case. Again, if a patient is badly poisoned with rhus by accident, so that blebs form copiously, as the Doctor says, do these blebs contain antitoxin? If so, why

doesn't it render him immune? but it doesn't, for I have to prescribe for the same patients year after year, and they don't become immune. If I give a person a very small globule of sugar saturated with the thirtieth dilution of rhus tox., it renders him immune while it is in his system. This is so well understood here that many of my susceptible patients come to me for a pill before going out on a picnic, and I have never known one to be poisoned who did this. Possibly it is suggestion, and not the pill which prevents.

Napa, Cal. W. E. ALUMBAUGH, M.D.

Homeopathic Replies.

Editor MEDICAL WORLD:-I wish to suggest the fol lowing helps:

Dr. A. B. C., page 543, December WORLD: Very weak solutions of nitrate of silver; dose each three to eight hours. When rheumatic symptoms, use rhus tox. in granules.

Dr. W. B. Hunt, page 544: Weak lotions of rhus tox. locally, and calcium sulfid internally.

Canada," page 544: Small doses (hypodermically) strychnin plain; not combinations. Dr. J. C. Matthews, page 545 Cases 1 and 2 continue on merc. proto., but No. 3 needs quicksilver plain in 1/1,000 or 1/10,000 of grain doses repeated frequently. Dr. T. H. Lyon, page 547: Infant needs plumbago in small doses internally, and also dusted on. Your suggestions as to clothing are splendid; also the bran in the bath.

Dr. Missouri, page 547: Dysmenorrhea should take creosote in minute doses four times a day during interim; and viburnum opulus tinct. in water at the menstruation.

Dr. W. W. T., page 548: Muscae volitantes needs carbonate of potash.

Dr. Davidson, page 549: Mrs. L. E. M. needs animal charcoal, not vegetable.

Dr. G. H. D., page 549: Prolapsus; continue the witch hazel, but small doses of podophyllin each night to mild action.

Dr. D. H. Swan, page 550: Neurasthenia, and needs hypophosfite of lime (Gardner's), not the compounds.

Dr. G. H. Beatty, page 40, January WORLD: Miss A. needs acid phosfate, dilute, four to six times a day for a month or more. Married lady with cramp in toes and pain in knees needs calcium sulfid in small doses, not up to saturation.

Dr. S. J. Smith, page 41: X needs rhus tox. internally one week and weak solutions of salt (common chlorid of sodium) next week, taken internally four times a day.

Dr. Mac, Michigan, page 42: Dysmenorrhea needs either bromin or bryonia, but he does not give particulars enuf. If he will write me will help.

Dr. G. W. S., page 44: Case 2 needs creosote in small doses. That will cure the neurosis in prostate. Dr. Boyer's case, page 83, February WORLD: Farmer's sore hands: Use no soap and wash in warm water with one-quarter spoonful of carbonate of soda therein each time it is necessary to wash hands. Take five drops dilute muriatic acid in one-half glass or more of water before each meal and at bedtime.

Dr. Reed's, page 86: Small doses of nitroglycerin twice a day regularly for a month and nothing else. Examin the external and middle ear both and correct any abnormality.

Dr. Munroe's, page 88: Give spigelia (pink root), five drops of tincture four to six times a day while making tests as to diagnosis.

Dr. Shulte's, page 89: First case.-Tincture of gelsemium in moderately small doses will help, sure. Second case.-Nymphomania; get from a homeopathic pharmacy 6x or 12x dilution of the mollusc (murex purpurea) and give to her five drops each two hours,

To stop them give a teaspoonful of subnitrate of bismuth and you will see them vanish. A. E. VAN Deventer. Oswego, Ill. [Have you tested this in a sufficient number of cases to warrant such a positiv statement? -ED.]

In order to interest new readers and thus enlarge our circle, we offered (to a selected list of physicians) THE WORLD during 1901 on trial for 25 cents, to be continued at the regular rate after that date if the trial proved satisfactory. We have all along been hearing from these new brethren, the following being a sample: Cold Spring-on-Hudson, N. Y., March 14, 1903.

Dr. C. F. Taylor,

Editor MEDICAL WORLD.

of

Dear Sir-Your favor of March 4 at hand and beg to thank you for extended courtesy. THE WORLD is an addition to the month's medical literature few of us can afford to be without. It is such a relief to have a paper that does not "talk at us " but "with us." always feel that it is an invitation to get together and talk it over. Please find enclosed check for $4.00-$3.co for my subscription and $1.00 for a new subscription for Dr. I am anxious that he should have it. With many thanks, yours, JOHN A. HOLLAND, M.D. If we were to even attempt to print all the nice things said about us in the letters which we are constantly receiving, we would not have room for anything else; so we present the above as only a sample of many hundreds well worth printing.