Cord Sixty-one Inches Long. Editor MEDICAL WORLD:-Was called to attend Mrs. H., aged 42, August 12, 1902, at 8 a. m. Multipara. Patient had been suffering for twelve hours before I saw her. After cleansing my hands, etc., I examined patient and found the os dilated to full extent, sac ruptured, head in second position. The pains were very severe. After the fourth pain the head was expelled. I found the cord around the child's neck six times, with a half knot in it four inches from the abdomen. The cord measured sixty one inches. I called the nurse to witness while I untied the knot. The child was somewhat cyanosed, but after artificial res piration it came around all right and is living today. The patient had done no unusual work previous to her confinement, as in Dr. Carl. A. Fjelstad's case in September WORLD, page 403. I have had one other case where the cord was around the neck three times. As this is my first little mite to the great WORLD, for fear it will be cast in the waste basket I will speedily and modestly retire. S. P. DONOHOO, M.D University of Louisville, Ky., 1892. Jefferson City, Tenn. Editor MEDICAL WORLD:-On page 403, September WORLD, Dr. Carl A. Fjelstad reports a case of birth where the cord was around the baby's neck seven times; it was born dead. Some twenty-five years ago I attended a case of confinement in which the cord lackt two inches of being seven times around the child's neck. The child was born alive, and is living today. There was nothing unusual about the case, only the cord was very long, and the child lookt as tho it had been badly nourisht. I have seen the cord three and four times around the neck of the child, but never but once seven times. In case of excess of hemorrhage soon after confinement, give half a teaspoonful of the tincture of opium. It will soon arrest the hemorrhage. I never use any other remedy. In case of convulsions before or after confinement, full doses of morphin will, as a rule, arrest the convulsions without the use of any other remedies. It is better to give a large dose at once, say from a quarter to a half grain. Prairie City, Ill. W. L. KREIDER, M.D. The latest recorded local treatment in erysipelas is to cover the area of inflammation with a piece of lint kept saturated with an aqueous solution of potassium permanganate. Just enuf is added to the water to turn it a good violet color. The lint is saturated in place and is not removed to be wet. This sounds rational, and could not interfere with the standard constitutional treatment. We have not made a personal test. Plural Births.-Child-bearing after Gonorrhea. Editor MEDICAL WORLD:-Some theories advanced in the September WORLD in regard to obstetrics evidently must be wrong or else the old adage that "there are exceptions to all rules" applies in my practise. The theory that in plural births of different sex there will be a placenta for each sex, I know does not hold good. That such may be the case some times may be true, but it is not necessarily true in all cases Is there any fact in embryology that makes a placenta for each child of opposit sex necessary in the nourishment and birth of twins or triplets? I have delivered twins where both were girls, both were boys, and where one was a boy and one a girl, and I never yet met a case where both cords were not attacht to one placenta. In other words, I never attended a twin birth in which there was an afterbirth for each child. This may contradict some theories, but it is a fact nevertheless, and facts are said to be stubborn things. This theory is on a par with the one that says that if a woman has once suffered with gonorrhea she will never afterward bear children. I have exploded that theory to my satisfaction, for I have attended one woman thru a bad case of this disease, who fourteen months after the cure was delivered of a healthy child at full term, and has since borne another one. A. C. FOSTER. Bement, Ill. Twin Girls and Two Placentas. Editor MEDICAL WORLD:-In September WORLD, p. 403. Dr. W. H. Rote, in reply to Dr. Morrow, says: "My experience has been one placenta where babies are of one sex, in twins or triplets, and two placentas if of different sex." I have this day delivered Mrs. V., a primipara, of twins-two baby girls. There were two distinct placentas, one attacht in the right and one in the left cornu of the uterus. Both placentas were removed by the insertion of the hand, thus locating their attachments. This fact leads me to surmise that the ova proceeded one from the right and one from the left ovary. W. C. CROMBIE. Mechanicville, N. Y., September 7, 1903. One Placenta and Two Sexes. Editor MEDICAL WORLD:-On page 401 of September WORLD you ask if Dr. Keeler had only one placenta in twins of different sex. Perhaps the following may be interesting: July 20, I was called to attend Mrs. S. in her first confinement. I arrived at the house about 6 p. m. and found her in hard labor. Pains had started in the morning. Upon examination I found a shoulder presentation and one arm down. I failed to see how "resting on my oars" would avail in this case, so I went to work. After plenty of hard work I succeeded in replacing the arm, and getting hold of a foot, which I promptly brought down. To make a long story short, the foot belonged to a girl, and one hour after, I delivered a boy. There was but one placenta so far as I could determin. If any one thinks it an easy thing to turn a child with its mate still in the uterus, the mother being a primipara, and a little thing at that, he should try it. Just three weeks after the above, I was called to see Mrs. T. Found her in the first stage of labor. Things finally came to a climax and I delivered her of a boy, and in fifteen minutes, during a tremendously hard pain, a girl made her debut. Again I found but one placenta. The cord of the girl was interesting. For six inches from the body it must have been an inch or more in diameter. This, Mr. Editor, is my maiden attempt, and since we country doctors run across some odd things, I concluded to report these two cases since both of them had some odd features. H. Q. ALEXANDER. Elida, O. [We want country doctors, and all other doctors, to talk to one another in these pages just like they would talk when meeting casually upon the road or street, or "around the winter fireside.' This constant rubbing together will keep the dullest mind bright, and keep the interest in professional work up to the enthusiastic pitch. I remember once while a student I visited a strange town and made the acquaintance of one of the leading doctors there-his name happened to be Dr. Good, and he had the reputation of being a good doctor. I plunged into conversation with him about things medical, and he lookt somewhat astonisht at my enthusiasm. Then, becoming confidential, he confest that he was tired of the practise of medicin-" sick of it." Well, one of the missions of THE MEDICAL WORLD is to prevent doctors from getting "sick of" the practise of medicin.- ED.] Editor MEDICAL WORLD:-In September WORLD, page 401, after Dr. C. E. Keeler's article on 66 Forceps in Breech Presentation," The Spermatozoon the "Whole Thing." Editor MEDICAL WORLD:-In August issue, page 352, Dr. J. O. Morrow, of Lisbon, O., reports triplets (boys) with one placenta and three cords. This is not common, but twins are occasionally found in a similar situation. I would like to hear further from the profession in regard to such births. What about the junction of the cords half way to placenta? I have heard of such a thing. I am very much interested in this subject, since it bears some relation to the very much disputed question about the basis of the race. I may here remark that I have studied it to its profound depths and concluded to agree with all the ancients including the old patriarchs of the Bible, and those who framed the theories of the gods having connection with human females and depositing their own tadpoles within their sanctumsanctorums. That is to say, I am convinced that the microbe usually termed spermatozoon is the whole thing, and that there are male ones and female ones. They all know their way to the little cottage (the eye of the ovum) where an appropriate and liberal maintenance awaits them, and where they remain thus nourisht until a change of regimen is establisht. This microbe is the whole man or whole woman. All antiquity declares this, but the most positiv teaching in this direction is that of the Druids. We may remember too the teaching of the Christian Church on the matter of the visitation of the Virgin! Be Prompt in Aiding Labor Cases. Editor MEDICAL WORLD:-I never had a case of postpartum hemorrhage. Why? Because I don't "rest on my oars" and allow my patient to be exhausted before I help her. If you are going to let "nature take her course," you might as well class yourself as an old granny. That is where you belong. When you are called to a labor case, you are called to lessen the danger to your patient. Don't increase it by "resting on your oars." I have repaired more perineums where I did not use forceps than where I did. I consider chloroform and forceps, when used judiciously, the greatest blessings a woman in labor has. Limestone, Pa. J. L. THOMPSON. Fld. ext. taraxacum Fld. ext. xanthoxylum ää Fld. ext. hyoscyamus Fld. ext. nux vomica àã. Glycerin M. Sig.-Teaspoonful three or four times a day. "What is an editor not askt to do?" (page 379, August WORLD), and why does the editor do it? I have thought of this hundreds of times. It seems that an editor is presumed to “know it all”-but is he obliged to tell it? I say not. For instance, in every issue I see questions askt that ought not to be answered. Formulas are wanted for everything-peruna, a villainous compound of mean whiskey; "orange blossoms," Winslow's soothing syrup, pile remedies-et id omne genus. What do they want with them? To use of course! But is the Editor doing right to give these nostrums, if he knows what they are? Isn't he encouraging their sale and use? If a doctor can't formulate his own prescriptions he ought to go back and study his materia medica and therapeutics until he can-or get a peruna almanac. I have seen several publisht. Brou's injection for instance, in a recent issue, that I am quite sure was not genuin, or if it was, any good average doctor ought to be able to write a better one. Tampa, Fla. J. S. BRUNNER, M.D. [That's just the point. There is nothing remarkable about any of these widely advertised patent medicins, and this should be shown. In regard to a "woman having puppies," we give this remark space in order to show how palpably erroneous it is. Even if a cross between a woman and a dog were possible, the birth would be no more likely to be plural than if the impregnation were by a man, as ovulation by the woman would be the same in either case. By what evidence has the Doctor "known of two cases?" By hear-say, perhaps. If not, we would be pleased to have the Doctor's personal observation. From the vulgar among the laity we sometimes hear that soand-so, or a girl in such a place "had pups," or "had a pup." (I blush as I write such vulgar expressions, but they are current among the vulgar portion of the laity, so we must meet them, and we hope to put an end to them.) It is well known by all physicians that at a certain stage in the development of the human embryo, the fetus looks thru all the stages of lower animal life in its like a lower animal. It is supposed to pass development. The premature expulsion of a fetus in this stage of development, having the appearance of a fetus of a lower animal, might be the basis of rumors of this kind among the laity. If anything comes from the profession on this subject, let it be scientific and amply substantiated by the most careful observations, with preserved specimens. It is not probable that anything will come (we want no hearsay), for it is not likely that a human female was ever impregnated by a lower animal.—ED.] Did Right in Withholding Opinion. Editor MEDICAL WORLD:-Referring to the communication of Dr. J. M., of Illinois, in the September WORLD, pages 416 and 417, I will say that in my opinion the doctor did exactly right in withholding his opinion from the parents, who didn't even pay him the compliment of asking for it. He gave, or tried to give, the old doctor by whose invitation he saw the patient the benefit of his discovery that a dislocation existed instead of a strain. Holding this view, it was morally impossible for him to confirm his friend's diagnosis, and the sequel plainly shows that it would not have been a friendly act had he done so. A dislocated hip tells its own story if given time, and it is a godsend to the doctor whose fame and fortune are involved, as well as to the patient. when some friend, or even foe, discovers and corrects it before it is everlastingly too late. I recognize in the old doctor one of those ultra conservativ men, opinionated in the highest degree. He is well described in the OCTOBER, 1903] Poison-loaded Intestin Should be Purged and Purified A Poison-loaded Intestin Should be Purged and Purified. Editor MEDICAL WORLD:—I do not use profanity, but in Dr. G. M. Robertson's place, as outlined on page 414 of THE MEDICAL WORLD, I fear I should have used strong language. Dr. R. was too mild. To clean out and scour out, as he intimated, was the treatment for that case of poison-loaded intestin. A doctor who ignores intestinal fermentation in any case where it is at all possible has no business practising medicin. Such a man will increase the death rate of his community. To let a patient remain for days with the small intestins full of filth, and quiet him with phenacetin, is about as bad as finishing him with a dose of strychnin at the start. In these cases where a child has overloaded the alimentary canal, it has been my practise to give one or more enemas of soap, glycerin, soda, and warm water; also a large single dose of calomel, followed by an R like this: R Sodium phosfate Sodium sulfocarbolate M. Sig.-One-half to one teaspoonful in warm water every one or two hours until free purging and vomiting result. In cases of this kind a large dose of aromatic castor oil followed by sulfocarbolates may serve the purpose nicely if the child resists the sodium phosfate treatment. In any case I have never seen cause to regret a three-grain dose of calomel for a four to six-year-old child. However, it should be remembered that calomel will empty the bowels, while it will not clean or purify them thoroly. Sulfo-carbolates do the "scalding out" in the effort toward intestinal anti- and asepsis. As long as there is stupor our patient lacks the energy to cast off excretions properly. Stimulants and not anodynes are indicated, therefore, when ptomain or septic poisoning is going on. The longer I practise the less opiates I use, and I have learned to regard the practician who uses them constantly as superficial in his attainments. C. E. BOYNTON, M.D. Smithfield, Utah. Twenty grains of alum to the ounce of water makes a valuable wash for night sweats or for excessiv perspiration of the hands or feet. 465 Editor MEDICAL WORLD:-In answer to Dr. J. M., Illinois, page 416, September issue: If the case was as plain, and he was as sure of his diagnosis as he makes it appear, I believe he could, and should have convinced the old doctor of his mistake by the various diagnostic methods, if he had persisted in his efforts. As the case now stands, I would go to the family with the doctor's consent; without it, if he will not give it, use plain language, explain your position to them, remind them that we are all liable to make mistakes, tell them of the Doctor's kindness to you-of his long service to suffering humanity, and I believe you can dissuade them from bringing suit. I would also state the facts to Dr. S., and ask him if he thinks his advice to sue the Doctor helps his patient any-in fact, give him to understand that there are others. Westport, Cal. O. W. SHERWOOD. As in a Mirror. Editor.MEDICAL WORLD:-Find $1.00; send THE WORLD on. I guess it is as good as any of them. I notice that all sorts write you about their experiences; some are good and some are not. A good many trust to time, luck, and the Lord, and all go on the theory that 90 percent would get well without any treatment; the latter I think best of. However, I do like THE WORLD, all but the political part, which is all "gush." Yours radically RepubG. W. MAYFIELD, M.D. lican. Bruceville, Ind. [Yes, we publish some articles that do not show ideal attainments in the writers. This is done for a purpose, and that purpose is to show to the profession, as in a mirror, just what the profession is-just the degree of culture and sound judgment to which the rank and file of the profession has reacht. Thus errors are corrected, study is stimulated, observation is made more keen, and judgment is ripened. Average working doctors can help one another better than college professors, library authorities, and laboratory workers can help them. Not that we under-rate the value of the help given by the latter-not at all. But most schemes of professional progress consist only of the latter, and entirely leave out the mutual help. This is what THE WORLD seeks to supply-not as a substitute for the library, ward, and laboratory, but in addition thereto. By supplying a medium for this mutual help we feel that we are doing a work of the greatest value, but which many, particularly among the "self-sufficient" class, do not appreciate, but who need the mutual help as much as any. As to Dr. Mayfield's Republicanism, that is all right. WORLD readers are of all parties. I was born a Republican. The Republican party came into existence as a protest against oppression. The slave-holding aristocracy of the South was the dominant power in this country, and it sought to continue and extend its power. A rapidly growing public conscience said no; and hence the clash-that terrible, awful clash. But like the Puritans of old, who sought the New World for liberty, and as soon as they were free from their oppressors establisht a new despotism, so the victors who freed the slave establisht a new oppression. Lincoln saw it and uttered, in the last year of his life, a wonderful prophecy, that alas, has proven too true. Roosevelt sees it, and his perplexity is how to destroy it instead of being himself destroyed. A public conscience and sense of justice and right are arising that must successfully oppose the domination of corporations, trusts and other concentrated capitalistic interests. Chattel slavery was tangible, in a certain limited section, and its defenders were brave and "above board fighters. Ihe new enemy is in our midst, is cunning, and frequently hidden like a snake in the grass. The policy of this enemy has been to secretly contribute money to, and control, both of the great political parties. Then it is sure of victory. Its chief exploits have been, unfortunately, thru the Republican party, using the good name and glorious past of that party to further its own selfish endsusing patriotism, "old glory," and sectional differences to serve its selnsh ends. Many in both parties have served party, losing sight of principle. This party adhesion has been of great service to the new enemy that knows no party nor patriotism except personal power and aggrandizement. Many of us have become slaves to party, and all of us have become slaves to this new oppression. Let us burst the bonds of party, and open our eyes to new conditions, as civilization is constantly developing them, and insist on economic justice to the people.-ED.] Poetical Correspondence. We sometimes have to write to some of our friends concerning delinquent subscriptions. Last May we had occasion to write to Dr. Powers concerning subscription for 1902, and 1903, introducing our letter with the expression "We are not mad.' The doctor promptly responded (May 21) with $2, and a very unique letter. We have saved the letter, hoping to make room for it in WORLD, and here it is: C. F. TAYLOR, M.D., Dear Doctor : I am not mad, I am not sick, I am not even grieved; THE WORLD is sure a "cracker jack" and always up to snuff; May success attend the publisher. And if Im still alive, Pardon my past negligence. Respectfully, H. W. POWERS. All of the Menstruum not Used. Editor MEDICAL WORLD:-On page 317 of your July issue, Dr. P. A. Spain indulges in some Munchausen mathematics. He sets up a man of straw, and then amuses himself and attempts to instruct his colleags and ridicule a scientific fact of which he is profoundly ignorant, by knocking him down. Why not first solve the problem by making the first five or six potencies of salt? He could do it in half a day and save his reputation as a man of truth and a mathematician, and the sixth centesimal potency of salt will cure more cases of intermittent fever for him than all the quinin in Texas, so it would be labor well expended. In the January issue of the Medical Advance we explained this matter for Dr. Quine, and the same explanation may help Dr. Spain see it in a new light, or at least see the difference between fact and fiction. THE ATTENUATION AND POTENTIZATION of drugs. Dr. Quine now tackles the great stumbling block of allopathy, that which has blocked the pathway of investigation for many an honest man, the question of the dose; quoting freely from the Organon what seems to serve his purpose of ridicule and omitting the context as usual. We give his amusing mathe matics, copied, no doubt, from Sir J. Y. Simpson, for amusement and instruction. Liquids are potentized by adding one drop a grain of the medicin. One grain of the thir- Suppose a grain of chalk be carried to the "A decillion grains." How many grains in a pound? "7,000." How many carloads in a decillion grains? 2500 million, million, million, million, million, million, million, million carloads of 25 tons each." Allowing 200 cars to the mile and the distance from the earth to the sun one hundred million miles, how long would the train be? And a grain of this mixture taken from any one of the cars is the homeopathic dose. A drop of "mother tincture" shaken, not too hard, with eleven quintillion hogsheads of alcohol of 140 gallons each, makes the 30th potency. If a gallon of this were given daily to each of the 500,000,000 people on the earth, it would take them fifteen trillion years to consume that one drop of "mother tincture." If you did not know that these statements are easily refuted, in case they are not true, and that my reputation as a teacher is back of the statement that they are true, you could not believe that I am speaking in soberness and sincerity. This learned mathematical demonstration of a scientific problem all hinges on the small word "if." If the entire menstruum were used? But it is not, and the Professor knew it was not when he made the mythical statement to his confiding students, and if "my reputation as a teacher" is not better in other subjects, his veracity and honesty may be, and perhaps have been |