Sexual Sense.

I

Use the Saddle More at Night.-Use of Forceps Lessons the Number of Still-births. Editor MEDICAL WORLD:-Please find inclosed $1 for the best medical journal in the world-I make no exceptions. desire to thank Dr. R. V. Pearce, of Howard, Kansas, for his article on "Sexual Sense and Decency," in December WORLD, page 525. I have the first penis to see enlarge from any form of treatment; and as for the sexual act, the size of the penis has not much to do with it; the pleasure derived from the act does not depend on the size. I know a family in this section of father and three sons, and there is not a penis in the lot that will pass for more than three inches during erection; and they and their wives seem to be happy, and each has a large family. I think a man's sexual powers depend largely upon the general health of the person. One can and ought to govern his desires in that direction; sexual intercourse for pleasure is a sin when not designed for offspring.

I think there has been enuf said about lanterns. Most any old lantern will do me in this ruf and hilly country. I have traveled over a very ruf and hilly country for eighteen years, and only during the last two years have I used a lantern, then only when it is as dark as Egypt. I use a Dietz; it occasionally blows out, but not often. Why do you drive at night? What is gained by it? I think more of a good saddle and a good horse than I do of a buggy, from December to May each year. Suppose you are called out at 10 p.m. a distance of five miles, making ten miles to get home. I can saddle my horse and be a mile on the road before you can start, even if you have a driver. Again, if I were to drive in my practise it would require four horses to do my work, two night and two day horses; whereas, with the saddle I can get along with two good horses. I can make this ten-mile trip quicker and as easy with one horse as two, and if detained all night, many people may accommodate one horse and not two. Again, many families live off the road, and it is great trouble to get thru gates, bars, etc., with a buggy. So horseback riding is the way. I have ridden many days when I averaged forty to fifty miles, and visited as high as twenty-five families and prescribed for forty-five patients with one horse. Dr. J. W. Burney, of Des Arc, Arkansas, has a mate to my old horse that I have had in active use since 1890. I have

driven him fifteen miles in two hours, and his ordinary gait is five miles an hour by walking. I have made a calculation that in twelve years I have ridden and driven him equal in distance to three times around the world, or 75,000 miles. Now, my fellow M.D.'s, do more horseback riding. You can keep warmer and make better time. Have a trusty horse and you can go anywhere at night and have very little use for lanterns.

The modern, up-to-date M.D. is not afraid to use the forceps when occasion demands their use. When I hear a physician say he has practised twenty or thirty years and only had occasion to use them two or three times, I cannot understand why or what class of cases he meets. I ask this man, how many still-born children have occurred in your practise in this time? My observation is that the man who scarcely ever uses the forceps has plenty of stillborn children. Study this phase of the question and see if they do not abound. The physician of to-day who will stand by his patient for thirty minutes when the pains are good and the head does not descend any, and finds a caput succedanum forming, and hears the woman say, "Doctor, can't you do anything for me?" and will "rest on his oars," ought to rest in his office the rest of his life. I am not in a hurry to go home or to visit other patients, but I am here to assist this woman in labor. Any ordinary old woman can do as well as many physicians I have known. I have been for fourteen years six miles from the nearest physician, and if I was to call for help when I need it, as many physicians in the city do before they will do anything, graves of parturient women would be thicker than they are. J. L. SAMMONS.

Calis, W. Va.

Editor MEDICAL WORLD:-I have noticed in your journal of late quite a controversy concerning lamps for carriages; and as I have spent quite a sum of money in that direction, I feel that it would be proper to give the sum of my experience to my brothers in the profession. I have had various styles of lamps, including Dietz and the acetylene gas, and the one that leads them all in my opinion is the Ham, No. 18, cold-blast tubular. Any wholesale hardware dealer will furnish them. Our merchants here furnisht one to me for $3.25. It has attachment for fastening on to the bow of top, and another to fasten on dash. It will not shake or blow out, and is a first-class article, full nickel plate and 3%inch lens in front to throw light ahead of horse, which it does nicely for thirty or forty feet. It also makes a nice lantern for any other kind of use. Morenci, Mich.

CHAS. A. BLAIR, M.D.

I enjoy your "Monthly Talks" upon economic matters very much. think they alone are worth the subscription price.-Jos. VON WERTHERN, San Francisco, Cal.

Scarlatinal Uremia.-Psoriasis. DEAR WORLD:-In sending you my renewal subscription, it occurred to me to send you also a few paragraphs in regard to my ' experiences" in practice lately. Let me say at the outset that I like your "Monthly Talks," and I agree with your views as to state ownership of telegraphs, railroads, etc. In this country we are already enjoying the benefits of post office savings banks, and arbitration courts to settle disputes between employer and employee. Your advice a few months ago as to investments was too late to save me from gold mine speculations, which besides considerable financial loss gave me untold worry. I can endorse all you said. Having paid for my experience in speculation, I can assure you no one could now induce me to risk money in any company outside my own village. I like THE WORLD because it is clean, and disinterested, in contradistinction from journals pub lisht to promote the sale of their own wares.

In re the discussion about driving lamps, my experience with various ones during the past twenty years is in favor of the old stable lantern, burning kerosene, and hung from the bottom of the buggy, fastened so it will not swing. It shows a pretty good light for a radius of fifty or sixty feet; it illuminates the ditches on each side of the road, and far enough ahead of the horse to see where you are. Of course the glass sometimes gets partly opaque from mud during a long drive, and if the road is cut into ruts the wheels will sometimes sink so far that the lantern will strike the road; but take it all in all, I prefer it to any other I have tried.

Apropos of the discussion as to the treatment of diseases by the different "schools" of medicin, I wish to add a little, hoping it may help to illuminate the distinctions generally recognized. I was called early one morning a few weeks ago to see a child about eleven years old who was vomiting incessantly. On reaching the patient I found her in convulsions. According to the law of similia, I should have given her strychnin or some other drug which produces convulsions in the healthy; or, according to eclectic teachings, I should have examined the tongue and prescribed according to its appearance. Not having been trained in either of these systems I hunted for the cause of these convulsions, and had no difficulty in diagnosing uremia. The child had scarlatina a few weeks previously, which was followed by swelling of the face and

feet. I considered that the best course was to get the emunctories acting, so I purged and sweated and gave diuretics and salines, after having examined the urin, which was loaded with albumin and casts and had a sp. gr. of 1,015. In a few hours the fits stopt, and in a few days the urin was normal and the child made a good recovery. I may say that I have no confidence in socalled "specifics." I have never found any prescription exactly suited to every case of pneumonia, for instance; indeed, this is one of the common troubles I find drugs of little value in, and I speak from an experience of twenty years in activ practise, tho I have met cases, both of pneumonia and typhoid fever, that seemed to end in resolution in a few days. I never could satisfy myself that anything I had given had "aborted" the disease, so that when I hear of either of these diseases having been "aborted" I am led to believe that the physician making the statement is a young man who will not make such statements ten years hence.

I had a case of psoriasis during the last eighteen months that nearly "broke my heart." It persisted in spreading all over the body in defiance of all I could do. I consulted several eminent brethren in regard to this patient, and in every instance received advice which proved worthless. Some said, it is too acute for arsenic, give antimony; others said, give nothing internally, but use unguenta chrysarobin, pyrogallic acid, chrysofanic acid, oil of tar, carbolic, etc., etc., ad nauseam. The patient herself, after trying all of these in turn, declared in favor of pure vaselin, and I am sure I supplied her with gallons of it. During a very severe spell she got relief sometimes from cold water applications, but it continued, at intervals, to spread until it covered the whole surface of the body, except the palms of the hands and soles of the feet. The scalp was crusted; and the exfoliations of scales in every twenty-four hours from the body would nearly fill a quart measure. This state of affairs continued for weeks and weeks, until in sheer desperation I began giving heroic doses of Fowler's solution, alternating with an alkalin mixture to keep the kidneys acting. In a short time I saw a few small oases" on the arms and legs, which continued to grow until in about five or six weeks the whole epidermis was clean. This convalescent stage was accompanied at times with an intolerable itching. She is now as well as any one, with no sign or symptom of ever having been ill. ONTARIO.

His Last Document.

The widow of Dr. M. J. Belden, of Maquoketa, Iowa, wrote us of the Doctor's death, and also said that he left an unfinished article for THE MEDICAL WORLDhis last effort. She offered to send it to us if we desired it. Of course we askt her to send it. It recently_arrived, with an interesting letter from Mrs. Belden. The article is type-written. Mrs. Belden says that as the Doctor was nervous, and his stroke uncertain, many of the letters are missed or wrong. So we found it, and have corrected it. She said that he intended to rewrite and correct it, but death prevented. We do not wish to start again a discussion on resting on your oars." The chief reason for presenting this is the circumstances under which it was written. How many of us will live to so ripe an age? And how many will write a communication to help and encourage younger members still in the field as the last effort before death comes? Truly, this is indeed being faithful to the end. Here is the article:

MAQUOKETA, Iowa, Oct., 1902. Editor THE MEDICAL WORLD:-I inclose $1.00, for which send me, as usual, THE MEDICAL WORLD. When I am about to renew my subscription for THE WORLD, I wonder if it would interest you or your readers for me to write something. I notice in THE WORLD a great difference in doctors about "those ugly forceps." I am 72 years old, and for fifty years of my life I have been what would be called by the profession a country doctor. I will only add that I have workt hard and have had a great deal of experience. Three years ago I Three years ago I was taken with most dreaded hemiplegia of a mild type, and have not been able to do any business of any kind since, but am merely stopping here waiting for that great change which is sure to come to us all, and I find that I can pass the time in looking over THE WORLD, hence I think proper to renew my subscription.

When I reflect, and when I go to church and hear the different kinds of doctrines (doctoring) preacht, it is no wonder to me that doctors should differ also. When I am told by scientific men that I must be born again, that I must believe so and so, or I cannot enter the kingdom of heaven, etc., it is no wonder to me that when learned men who live by pretending to secure seats for sinners in Paradise differ, why should not the doctors differ, when all they can do is to save, if possible, a person from a temporal death?

How often I am reminded of these things by perusing THE WORLD. Pardon me, my friends, I cannot help but forming some kind of a conclusion about these things. Again, I have to stop and think. The fact is this: A person must think as he is organized, and according to the experience he has had, and the circumstances he is placed in.

I was once young, but am now old, and if I were called upon by a friend to give my advice whether he should send for the man who "lays upon his oars" or one that will deliver with the forceps, I should recommend the latter by all means.

I wish to say to J. R. Smith, M. D., of Warsaw, Mo., that I endorse all that he has said, and I do not believe he has overdrawn the conditions, for I have been to similar cases. If we are not prepared with vectis and forceps when we are called in such cases, I would ask what are we called for? I have been called for six miles to attend a primipara when the midwife had been with the patient for thirty-six hours. and had given her both red and black pepper tea, but the patient only remained the same; no relaxation, pains exhausted, and mother and child nearly dead for the want of only a little help. What am I to do? "Lying back on my oars" will not do; something must be done and that at once. I relieved her with the forceps very soon after my arrival, and I have never regretted it. It is my most candid advice to any young physician to never go into the country to attend any kind of a case of obstetrics without a good case of instruments, that he may be prepared for any and all kinds of emergencies. I now stop in a town of some 5,000 inhabitants; I never expect to attend another case of obstetrics; I sold all of my medicins, books, etc.; but I have kept in my room a case of instruments of the best kind; a case which I have had for over forty years, and when I look at them I reflect on the good they have done, and think that I will never part with them.

I am aware, however, that forceps are used often when they should not be, and in such cases they do more harm than good; but when they are used when they should be, and as they should be, they are the ne plus ultra of all there is pertaining to obstetrics.

I would like to speak of some other experiences with those "terrible things," but I am admonished by my palsied hand that I must quit.

is delicate and anemic, I give it very guardedly say a 1-10 to a 1-20 gr. every three hours; not for the purgativ effect, however, but rather as an antiseptic to the intestinal tract, preferring to use oil as a cathartic, or rectal enemas in the anemic. Quinin for the first 24 hours-say 40 to 60 grs. divided into 8 doses, one every three hours. If quinin is pusht further, the secretions are bound up (which, by the way, is just what we don't want), with more or less nausea, and a wild-eyed patient greets us, who is really very sick, if not so before. At certain seasons of the year, when there is considerable la grippe or muscular pains with the pneumonia, the following, instead of quinin, is far better:

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Potass. iodid

Ammonia muriate
Soda salicylate.
Tr. opium camph.
Listerine q. s. ad..

M. Sig.-One dram every 3 hours.

For high temperature and nervousness I use Lloyd's specific tinctures of aconite and gelsemium combined, together with sponge baths.

Give instructions for bath to be prepared as follows: Having bared the elbow of the nurse, take a half gallon of warm water, immerse in the water, and add cold or warm as may be necessary, so that the temperature will feel comfortable to the elbow; then bathe the patient with sponge all over, leaving the water on the surface of the body-i. e., not using a towel after bathing. When thru, add a quart of cold water to the basin of warm water, and repeat the bathing, and finally add another quart of cold water, making a cooled bath, and one that the most sensitiv will not object to. Repeat bathing every 4 to 6 hours, or as indicated. As the old idea still prevails with the laity in certain localities that water applied to a pneumonia patient is sure to kill, for the benefit of such, a small amount of alcohol may be added to the bath.

I have had the best results where I have used creosote, given in capsules, 1 gtt. every 4 hours. Increase one gtt. at each dose until 8 gtt. have been reacht, which I continue until convalescence is establisht; or even until patient has been up for some time.

Feeding is a very important factor, which should be done at regular intervals. I order half glass milk at a time, with the white of a fresh egg, and later brandy added.

As the heart shows signs of weakness, start giving strychnin, say 1-40 gr., and

Treatment of Pneumonia—Evidently Eclectic. Editor MEDICAL WORLD:-As this is the season of the year for pneumonia, and as there have been several articles on its treatment contributed to your journal, I thought that I would add my mite, which may or may not be beneficial to THE WORLD family. I shall not have anything to say about the etiology, pathology, or prognosis of the disease, as all are doubtless familiar with that. I believe in treating pneumonia just the same as any other disease, i. e., treating the conditions as they arise; in other words, treating the patient according to the specific indications in each particular

case.

It is hardly possible for us all to see alike, and perhaps it is best that we do not, for if we did we might get into the fix that the old deacon did when, in testifying "in meetin'," said that he was glad that all did not see alike, for if they had everybody would have wanted his wife; another brother got up to speak, and said that he also was glad that everybody did not see alike, for if they did nobody would want the old deacon's wife. And so I suppose that it is best that we don't all see alike—at least in some things.

I believe pneumonia to be a self-limited disease-limited according to the vitality of the patient; and that the great majority would recover without medicin, provided that they had good nursing, proper diet and hygienic surroundings. But they will recover sooner and get up in better condition with proper medical attention, coupled with the good nursing, etc.

with pneumonia, I would examin the case Should I be called to a patient suffering carefully with reference to two things: first, dition exhibited by the symptoms at time of with reference to his actual pathological conexamination, upon which to base my treatment; and second, with reference to the particular disease he has, so as to be able to tell his friends what is the matter with him ; but the name of the disease would have noth

ing whatever to do with the treatment.

Should I find a full,, bounding pulse, with high temperature and a general sthenic condition of the system. I would prescribe veratrum as the special sedativ, adding it to water in the proportion of om five to ten drops of the specific tinct. as follows: If the patient were an adul, to a half glass of water, and give a teasponfti ever one or two hours,

according to the fever. (I will just say here, to avoid repetition, that all the tinctures prescribed are Lloyd's specific tinctures, because I have found them most reliable.) If the tongue should be pointed, with reddened tip and edges, I would add tinct. of ipecac to the sedativ mixture in the proportion of from two to five drops, and give as before. Should the pulse be small and frequent, with elevation of temperature, I would give tinct. of aconite instead of the veratrum, adding five to ten drops to a half glass of water; teaspoonful every one or two hours. If the pulse were full and opprest, the face pallid, pupils dilated and tendency to drowsiness, I would give tinct. of belladonna, two to ten drops to a half glass of water; teaspoonful every one or two hours until this condition passed away. Should the pulse be full and strong, with bright flush of face, contracted pupils and frontal headache, with general restlessness, I would give tinct. of gelsemium instead of the belladonna, adding it to water, five to twenty drops to the half glass, teaspoonful every one or two hours. If the pulse should be hard and vibratil, with stitching pain in the side, I would prescribe tinct. of bryonia, two to five drops to a half glass of water, teaspoonful every one or two hours. The small, sharp pulse, accompanied with burning pain in side or forehead, demands tinct. rhus tox., two to five drops to a half glass of water, a teaspoonful every one or two hours. Should there be a little tendency to sweating, pleural pain, etc., with cough, tinct. of asclepias is indicated, which should be given in the proportion of from ten drops to half dram to a half glass of water, teaspoonful every one or two hours; it will facilitate the sweating and have a tendency to relieve the pain and cough.

We may need special remedies for the cough, which will be indicated from time to time by the condition of our patient; thus, if there is irritation of the fauces, mucous membranes dry, cough harsh with scanty expectoration of a glairy, tenacious nature, I would give tinct. of sanguinaria, adding it to simple syrup in the proportion of from five to twenty drops to four ounces of syrup, teaspoonful every one or two hours. If the tongue is broad and moist, with full, open pulse, I would use tinct. of lobelia as the cough remedy, adding it to syrup, five to ten crops to four ounces, teaspoonful every hour or two as needed. There are other remedies that may be called for, according to the va ious indications that may obtain during the course of the disease. I believe in giving wha ever is indicated, and as long as indicated, regardless of the stage of the disease.

As to local applica ion, I find that where

there is severe pain, tightness of the lungs, with hard breathing, cloths wrung out of hot water and vinegar, equal parts, and applied to the chest often enuf to keep it hot, is the best application I have used to relieve this condition. I have used antiphlogistine, cotton batten, etc., which are very good where indicated. With children, especially, I most always use stillingia liniment mixt with lard in the proportion of a teaspoonful of the liniment to a tablespoonful of lard, and have it rubbed over the chest and covered with flannel every two hours to three times a day. Turpentine with lard is good, and in some cases the old-fash ioned onion poultice is the best application for a time; but in using poultices, especially with children, we should be careful not to get them too heavy.

The pneumonia patient should have a good, nourishing, liquid diet, such as milk, beef juice, or other good animal broths, until he gets well under way to recovery, when he can have more solid food. Of course the patient's clothing, the bed-clothing and everything around should be kept as clean as possible, and the temperature of the sick room kept at a uniform temperature of about 68° as near as possible, with plenty of ventilation.

This is about the way that I would treat an average case of pneumonia if the indications present called for this medication; but we may find cases that would need entirely different methods of procedure, when we would have to change our plan of treatment accordingly. JOSHUA G. ELLIS, M.D.

Cerro Gordo, Ill.

Veratrum in Pneumonia.

Editor MEDICAL WORLD:-In the December WORLD, page 523, Dr. H. S. Taylor says while many now condemn veratrum in the treatment of pneumonia, he still makes use of it as he did nearly a quarter of a century ago; but now as then with caution, and in such cases as it may be indicated. The above statement is refreshing. A thousand times better give a placebo rather than a remedy that is not indicated. Veratrum, like belladonna, aconite, strychnin, and many other powerful remedies, should not be used in a haphazard way. Veratrum viride is indicated in all acute diseases with a full and bounding pulse, no matter what the name of the disease is. In pneumonia

it is certainly one of our best, if not the very best, remedy we have with the above condition of the pulse. Veratrum is a grand sedativ, controling the heart's action, and in quite small doses a fine expectorant. I use veratrum in pneumonia as a sedativ