The Medical World

C. F. TAYLOR, M.D., Editor and Publisher

A. L. RUSSELL, M.D., Assistant Editor

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No. 10.

Language is a growth rather than a creation. The growth of our vocabulary is seen in the vast increase in the size of our diction. aries during the past century. This growth is not only in amount, but among other elements of growth the written forms of words are becoming simpler and more uniform. For example, compare Eng. lish spelling of a centnry or two centuries ago with that of to-day! It is our duty to encourage and advance the movement toward simple, uniform and rational spelling. See the recommendations of the Philological Society of London, and of the American Philological Association, and list of amended spellings, publisht in the Century Dictionary (following the letter 2) and also in the Standard Dictionary, Webster's Dictionary, and other authoritativ works on language. The tendency is to drop silent letters in some of the most flagrant instances, as ugh from though, etc., change ed to t in most places where so pronounced (where it does not affect the preceding sound), etc.

The National Educational Association, consisting of ten thousand teachers, recommends the following:

"At a meeting of the Board of Directors of the National Educational Association held in Washington, D. C., July 7, 1898, the action of the Department of Superintendence was approved, and the list of words with simplified spelling adopted for use in all publications of the National Educational Association as follows:

securing the general adoption of the suggested amendments →→ IRVING SHEPARD, Secretary."

We feel it a duty to recognize the above tendency, and to adopt it in a reasonable degree. We are also disposed to add enuf (enough) to the above list, and to conservativly adopt the following rule recommended by the American Philological Association: Drop final "e" in such words as "definite," "infinite," "favorite," etc., when the preceding vowel is short. Thus, spell" opposit,' ""preterit," "hypocrit," requisit," etc. When the preceding vowel is long, as in "polite,' finite,' "unite," etc., retain present forms unchanged. We simply wish to do our duty in aiding to simplify and rationalize our universal instrument-language.

"

Is the Body Professional Diseased? Must we conclude that symptoms indicate diseases of the body professional, just as they do of the body physical? If so, and if quackery in the profession is patronized as its continued existence would indicate, then the body professional is diseased. These reflections are caused by the receipt from a North Carolina reader of a lot of circulars received by him from a Richmond, Va. concern very similar to the circulars issued by the villainous "Christian Hospital" crowd of Chicago. (See our exposure of the "Christian Hospital' scheme in July WORLD, pages 294 to 296.) Does such quackery in the profession flourish so well as to justify this scheme in repeatedly lifting its ugly head in a new place soon after it is put down in the old? If so, many who call themselves "physicians" in this country should be ashamed of themselves for patronizing such schemes. In addition to all the flagrantly unprofessional propositions of the "Christian Hospital" crowd, (seemingly copied from the Christian Hospital circulars), the Richmond concern adds "The Safety Pessary,' "Woman's greatest boon." "Positivly precludes all possibility of conception."

We purposely avoid mention of the name of the institution or of the "President and Superintendent," as publicity might possibly be some advantage to these people. The latter, however, is reported in Polk's Medical Directory to be a graduate of the Medical Department of the Univ. of Va., 1883, and of the College of Physicians and Surgeons, Baltimore, 1885. We have written to both these institutions about the matter, and inquired if there is not a way to revoke the diploma of one who brings disgrace upon it and upon the institution

granting the same? A diploma should be revokable when it is dishonored and disgraced; and a list of revoked diplomas (if any) should be publisht in each annual announcement of every medical college. A morality standard should be establisht, and maintained by penalties sufficient to maintain the standard.

County medical societies should take up the subject of boughten certificates which are made to resemble diplomas, designed to be framed and hung in offices in order to impress the gullible public. Any member of a county (or other) medical society who has thus displayed a St. Luke's Hospital (Niles, Mich.) "certificate of membership of staff," or a similar certificate from the "Christian Hospital," Chicago, or from the "Nashville College of Law" (see August WORLD, page 383), or from a certain medical institution in Richmond, Va., and perhaps some others, should be required to discontinue such display, either in public or in private, on pain of expulsion. And the public should be informed that such documents have been boughten, that any body can buy them; that they indicate nothing except it be the gullibility or quackery of the purchaser; and that they are offered for sale only by disreputable parties.

Later: In reply to our letter to the Univ. of Va. concerning the "President and Superintendent' referred to the Dean of the Medical Faculty replies as follows:

"In reply to your letter regarding Dr.

I find that he was a student at the University for a single year, and that during that year he never graduated in a solitary ticket. He left us-for what reason I can't now discover-to go to the College of Physicians and Surgeons, Baltimore, Md. Whether he received a degree there or not, I do not know."

What Will You do in Pneumonia this Winter?

Available statistics seem to indicate that the mortality of pneumonia is increasing. This is a sad commentary on our progress in hygiene and in therapeutics. In the city of Chicago alone, since the census of 1900 more than oneeighth of all deaths have been due to this disease; this is one-third more than those due to consumption, and 46 percent more than all other contagious and infectious diseases combined.

If you have had unusual success in this disease, give the WORLD family the benefit of your experience and your method of treatment, and do it now. We do not care for your not care for your article when it is too late for publication, and too late to do good. Give full data of your cases, and enuf symptomatology as to leave no doubt as to the diagnosis and enuf to give a fair estimate of the severity of the attack. Don't tell us that you "aborted a very severe attack in 24 hours," unless you tell how severe it was, and give temperature, respira

tions, extent of dulness, etc. We do not care for long articles on the text-book style, nor for theories. We want the facts; your failures, and the reasons therefor, as well as your successes, and to what you ascribe them.

Irrigation Treatment of Acute Gonorrhea Found Wanting.

In a paper on the Irrigation Method of Aborting and Treating Specific Urethritis, read before the Philadelphia County Medical Society, Dr. Orville Horwitz calls attention to the large number of patients treated by this method who suffer from a persistent mucoid discharge after they have been pronounced cured by their medical attendant, and suggests that a thoro examination of the urin will reveal that they are not cured completely. He reaches the following conclusions, based on his extended experience: (1) The irrigation method of treatment will not abort acute specific urethritis. (2) It will hasten the terminal stage of the disease, which is prolonged and difficult to cure. (3) Chronic urethritis and involvement of the deep sexual organs are common sequences. (4) In many instances, in order to effect a cure in the terminal stage of the disease, the irrigations must be discontinued and other methods of treatment employed. (5) Irrigation should not be employed in the acute stage of specific urethritis. (6) Irrigation of the deep urethra by means of hydrostatic pressure is injurious in the majority of cases of acute gonorrhea and is conduciv to the development of complications. (7) Little or no progress has been made in the treatment of acute specific urethritis, either in aborting the disease, lessening its duration, or preventing complications. In the discussion which followed, he was supported in his views by a number of experienced clinicians.

We believe that this treatment was a mistake, and should never have been used. If not absolutely harmful, it was impracticable, and gave the quack a stronger and readier hold on his victim. Hyde and Montgomery, in their last edition on venereal diseases, say that this method does not shorten the disease, but, on the contrary, it leaves the mucous membrane in a thickened and congested condition from which it recovers slowly, and that thereby the tendency to complications is augmented.

Lemon Juice in Typhoid Fever.

Some months since considerable excitement was stirred up in medical circles over the use of lemon juice in typhoid fever, because the Chicago Board of Health had made certain experiments with grape juice and lemon juice in this disease. The lay press and its ignorant

reporters pounct upon this and elaborated upon it until no semblance of truth remained. Certain credulous doctors, who prefer gleaning their medical ideas from newspapers in preference to learning from medical journals, immediately proceeded to literally flush all their typhoid cases with lemon, lime, and grape juice. The results will not be chronicled in scientific records; yet the "new idea" continued to spread, and finally many medical journals mentioned the facts or commented upon the abundant material to be noted in the columns of their contemporaries. The enticing promise emanating from the "health board" was quoted by medical journals as follows: "A teaspoonful of lemon juice to half a glass of typhoid infected water is sufficient to destroy the vitality of the contained germs, and thus to prevent their production of the toxin or poison which causes typhoid fever." It was further suggested, and the suggestion was later promulgated as a fact, that "oysters infected with the bacillus of typhoid fever might be made safely edible by the addition of pure lemon juice as a dressing." Illiterate physicians, and yet more ignorant laity, have absorbed such illuminated rot until it has become an actual menace to the high standard of treatment of typhoid which formerly maintained.

The actual facts in the case are that we know that typhoid fever germs are not killed by con tact with lemon juice in the manner popularly used, and it is questionable if their virulence is in the least impaired by addition of lemon juice in any form or strength. Professor

Kitasato, many years since, after extended experiments, merely went so far as to say that a combination of citric acid in a strength of o. 43 percent with acetic acid 0.2 percent, if in contact five hours with typhid germs, would kill them; and that yet further attenuations of the combined acids would check their growth. It is a far way from temporary inhibition of virulence to actual and permanent annihilation. Johnston has found that typhoid bacilli can propagate their kind after twenty minutes' exposure to a 9 percent solution of lemon juice, and are viril after twenty-four hours' exposure to a 2 percent solution. The health board of Buffalo has experimented with lemonade, and has publisht its results. They find that the virulence of the typhoid germ is not affected by fifteen minutes' exposure to the juice of half of a large lemon in a glass of

water.

It appears to be definitly settled that lemon juice, as popularly used in the preparation of lemonade, is powerless to impair the vitality or lessen the virulence of the typhoid germ contained in the water employed to make the lemonade. It is just as certain that if powerless in the

strong solutions mentioned above and in the duration of exposure noted, lemon juice could not be of any avail against the germs in the intestinal contents or in the seclusion of a decaying. Peyer's patch, under the conditions wherein it could reach them.

Altho scientific bacteriology has completely routed the dangerous doctr n, it will only be the reading medical man who will learn of the fact quickly. The laity will continue to rest secure (?) from typhoid fever so long as lemons are obtainable, and the injury done by the careless propagation of this fallacious teaching is incalculable, since the newspaper medical writer finds it less interesting to his readers to correct an error than to foster one. The duty of the medical man is plain: he must make it a point to warn his patients and clientele of the danger of depending upon this method, and insist on the old-fashioned method of being careful in regard to contamination of the water, and of thoroly boiling all water suspected of contamination. Nevertheless, it has long been known that acids were grateful to the patient in typhoid, and it has been the practise of leading medical men to prescribe them alone or in combination. There is no reason why the the juice of the lemon, properly strained, may not continue to be pleasant and refreshing to the typhoid patient, even tho it be possest of neither medicinal nor germicidal properties.

A Remedy for the Dangers of the Barber Shop.

No man of refinement likes to think of having his hair trimmed or his face shaved by the same implements used indiscriminately on other people. Even with one's own cup, soap, brush, razor, and other accessories, it is not a pleasant matter to think too much about. Every practician has noted various cases of disease directly traceable to the barber shop. No matter how cleanly the shop, implements, and attendants may seem, the towels are all washt together, and too often very imperfectly, and are frequently again put into commission before completely dry. The combs are merely wiped clean (?), and their odor is always suggestiv. The barber always has his favorit scissors, clippers, and strop, and all heads and faces look alike to him. Perhaps only an uncomfortable thought to the average man, these facts are a pregnant reality to the physician. Articles have appeared from time to time suggesting a remedy for the evil, but nothing has been done until Missouri gave the movement for cleanliness the seal of legislativ approval and enactment. Every shop in the state is under the supervision of a State Board of Examiners with full power to make rules for the regulation of the shops. All shops must be scrubbed every night with hot water and lye. All scis

sors, razors, clippers, etc., must be immerst in a 10 percent formalin solution after use. The barber must wash his hands after attending to each customer. All towels must be washt and sterilized after use. Sponges must not be used. A special form of disinfection is prescribed when the previous customer has suffered from a lesion or eruption of face or scalp.

The law is good. If it is enforced, it will have the approval of the public. Even with Even with the barbers innocent of knowledge of asepsis and antisepsis, they will soon appreciate the benefits of the system. No customer returns to a shop where he has contracted a skin disease, and he is very apt to tell his friends about it, and they too, stay away. No barber cares to transmit disease, and if they are educated up to the standard of the law they will be its most enthusiastic supporters. We hope it will be rigidly enforced, and that other states will take the matter up.

The Fly Blister and How to Apply it. Every practician thinks he knows all about the fly blister, how painful it is, how oldfashioned, etc., yet it is strange that text-books with few exceptions ignore more than a mere mention of it, and the medical student seldom sees one applied. One of the greatest teachers in America thinks the matter of enuf importance to devote a considerable portion of one whole lecture to it. Many practicians in activ practise for several years never used a fly blister and never saw one applied. It is one of our most potent therapeutical resources in selected cases, and is well worthy of the study of every physician. It is easy of application, and is not at all as painful as popularly supposed; in fact, if the physician did not mention the pain, few patients would.

The fly blister is of value for four purposes: to affect inflammation or congestion; to cause absorption or removal of inflammatory deposits after inflammation has ceast; to relieve pain; for the effect which can be exerted upon the general system by blisters in systemic disease.

When used to affect inflammation, the blister should not be applied over the site of inflammation, but should be placed a little to one side or at some other point known to be intimately connected by nerve fibers with the seat of inflammation: thus, in inflammation about the eye, the blister is applied back of the ear; and in pleurisy or abdominal neuralgia the chosen site of application is over the vertebra where the nerve at fault makes exit. Remember that all nerve pain is referred to the peripheral end, and not to the point of origin. In beginning hip-disease, it would be useless to apply a blister to the knee or ankle

complained of, but great effect is often secured by applying it over the proper place in the affected hip. A fly blister should never be placed directly over the site of an acute inflammation; when it is to be used in such cases, apply it in a circle around the inflamed area, at a little distance. The fly blister does good service in inflammation of the brain, eye, pleura, peritoneum, lung, joint (rheumatic or traumatic), glands, urethra (gleet) etc. The old view, that fever was a contra-indication to blistering, has faded away. One exception should be made in the rule of locating the blister; in peritonitis apply it directly over the seat of pain. In gleet, the cantharidal collodion may be substituted for the blister, and used by painting along the under side of the penis and on the perineum.

To remove the results of inflammation, such as pleurisy with effusion, the fly blister is extremely valuable; in such cases apply it under the arm about two or three inches below the axilla. In old effusions about joints, the blister often succeeds where other means have failed.

The indications for the relief of pain will be plain to all. It is only in chronic pain that the blister is proper, and such rubefacients as mustard plasters generally do full as well and do not leave such an amount of tenderness.

To get systemic effect one must study each individual case before applying the blister. In meningitis, apply in "T" shape to the back of the neck; in intercostal neuralgia and zoster, to one side of the spinal column; in renal irritation, between the kidneys over the spine, etc.

As the blister begins to form, remove the fly blister and apply a warm poultice; this relieves the pain and hastens the process. If the blisters are small, they may be allowed to rupture spontaneously, but if large they should be punctured at the most dependant part and drest with sweet oil or simple ointment carbolized in the proportion of 1-100.

Dentists Working against Their Own Interests.

The National Dental Association, at the recent meeting, held at Asheville, N. C., passed the following resolution :

Resolved: That it is the sense of the National Dental Association that each Medical College in the United States should include in its curriculum a lectureship on Oral Hygiene, Prophylaxis, and Dental Pathology. A special committee of the above Association sends out this further expression:

The dental profession feels that with the introduction of the teaching of oral hygiene in the public schools, which they are striving to accomplish, and the co-operation of medical men who have been specially instructed on this subject, that a great stride will have been made toward the prevention of caries of the teeth, not to mention many other good results to the general

system, which would surely follow a better care of the oral cavity.

Doctors work against their financial interests by trying to keep people well. It seems that dentists are actuated by the same high and disinterested motive. An amusing illustration of the opposit is the following: Some years ago fire engines were introduced into Japan. They were violently opposed by the house carpenters, because the engines, by controling fires, hurt the business of the house carpenters.

The Wide Range of Usefulness of Gelatin as a Hemostatic.

The profession as a whole have long felt the need of some drug that would act satisfactorily as a hemostatic. The country practician, often beyond reach of aid or counsel, has yearned for this more strongly than his city brother, who has all the aid and appliances at hand with which to combat terrifying hemorrhage. To be sure, we have a number of drugs supposed to have the power of controling hemorrhage, as ergot, gallic acid, etc., but all are often notoriously wanting in efficiency in many emergencies. The great need has been a drug that was portable, readily prepared, could be used by the mouth and without appliance, and would act systemically or locally.

These severe requirements seem to have been met by gelatin. Besides the advantages enumerated, it is inexpensiv, non-poisonous, and but a small quantity is required to obtain the effect. It has the further advantages that it may be quickly prepared, and may be used locally, subcutaneously, and by the mouth.

"Gelatin has been employed externally to control hemorrhage, and has been given hypodermatically to aid in the coagulation of blood in bleeding parts which cannot be reacht directly. Lancereaux and Paulesco use the following formula:

The mixture is sterilized by heat, and two ounces are injected into the tissues of the thigh or buttock; this is increast to five ounces in later injections if they are needed. Usually one or two doses are sufficient. A like solution may be used locally to check oozing." (Hare, Practical Therapeutics.)

Its local use is detailed as follows:

"Boil four pieces of gelatin each about 10 sq. cm., in 100 cc. of water, and apply locally." (Gould, Year Book of Surgery.)

Its use by the mouth is stated by H. C. Wood, Jr., as follows:

"Pepsin digestion of gelatin does not destroy the coagulating effect on the blood. The resulting product is dialyzable, and therefore capable of absorption. The administration of gelatin by the mouth in the treatment of hemorrhage is, therefore, a rational procedure. The products of the digestion of gelatin, called "gelatoses," seem to have the power if given in sufficient quantity, to antagonize the anticoagulating power of peptone.'

Favorable reports are numerous, and no

practician should be without a package of gelatin in his emergency case hereafter.

The Treatment of Burns and Scalds. Such injuries being comparativly rarely seen, unless the clientele of the practician be constantly exposed by reason of their avocation, the majority of physicians are poorly equipt to meet sudden and trying emergencies. Not only are they poorly equipt with dressings, but they have allowed themselves to fall behind the march of progress in knowledge of the modern and better methods. Carron oil has become familiar to the laity; and many physicians do no better than any bystander could do inasmuch as they simply apply carron oil, and seldom have that ready for use. There are a number of preparations that can be prepared, which will keep permanently and which are better than carron oil.

Every physician should keep at least a quart of his favorit preparation for dressing burns so that it can be as readily reacht as his hypodermic syringe or his medicin case. Valuable time is lost in preparing any of the dressings in common use, or in sending for them and then waiting their preparation by the pharmacist. To meet this lack of forethought many use ointments, alone or combined with antiseptics. Few who have studied the proper method of handling burns, or who have had extended experience in treating them, will defend the use of ointments except on the ground of convenience; the physician has no right to convenience at the cost of his patient. If plenty of linseed oil and an equal quantity of lime water are kept on hand, the carron oil can be prepared by any bystander while the physician is getting his lint or bandages ready; or if properly prepared, it will keep almost indefinitly, and thus a quart of it can be kept in stock ready mixt. It may be made antiseptic by the addition of carbolic acid, 1 part to 20 of oil. ron oil undoubtedly yields good results in so far as scarring is concerned, but it is valueless as a pain reliever except in so far as it is an air proof dressing. It does not in the least inhibit the formation of pus, and indeed it rather encourages the horrible stench accompanying such cases when the lesion is extensiv. The addition of carbolic acid gives a certain anesthetic power and modifies somewhat the pus formation.

Car