named because it was supposed to develop singly, tho there are exceptions to this general rule. This is the pork tape worm-people eating raw pork or sausage are the ones most liable to be affected by this variety. I am not able to find on record any case where more than two or three of this variety of tape worm have been removed at one seance, so I am led to believe that Dr. Shirk's worms are not of this species.

The head of a solium is about the size of a mustard seed. It is provided with four suckers, surrounding which is a crown consisting of twenty-six hooks, organs of anchorage. With a microscope of low power these hooks may be seen. Hooks are not found upon the head of taenia cucumeria, nor upon the head of the taenia saginata, or beef tape worm. The beef tape worm is often found in children-not so often in infants. They do not necessarily appear singly. Madame Heller is said to have encountered as many as forty in one patient.

It appears that no age is exempt from tape worm, tho in the majority of cases, the ages are from twenty to forty years. Professor Armor reported in the Detroit Review of Medicin, January, 1872, a case in which an infant five days old passed segments of taenia.

In my own practise fifteen years ago I removed a taenia solium twenty feet long, from a little girl two years old with a decoction of pomegranate bark made after Professor Locke's plan. This medicin has never failed me, tho I have given it to patients when other medicins administered by another M.D. had not succeeded. W. F. CARSON, M.D.

Berlin Center, Ohio.

Spinal Anesthesia.

Editor MEDICAL WORLD:-To the uninitiated, the induction of anesthesia by the subarachnoid injection of cocain or other agent seems a difficult and dangerous procedure. Experience convinces me that the neophyte will retain such ideas if he attempts the process in the manner expounded by Dr. Aguirre to the Association of Military Surgeons.

Don't use cocain. Its succedaneum, benzoyl-pseudo-tropein, or tropacocain, is far preferable. Under its influence the patient seldom experiences the nausea and shock which so frequently accompany the use of cocain; the raging headache, which almost invariably follows the use of the latter drug, does not occur.

Don't make a solution of the agent, same to be injected after permitting a corresponding (?) quantity of spinal fluid to escape. Instead, put one grain of sterilized tropacocain in the barrel of an aseptic Luer syringe and replace the piston. Insert the needle, and when the spinal

fluid appears attach the syringe. This is easily accomplisht without loss of fluid. Work the piston back and forth in its barrel and the tropacocain will quickly dissolve.

Don't insert a needle containing a mandril. Plugging rarely occurs, and if you fear it, the difficulty may be entirely obviated by slitting the skin slightly before introducing the needle.

We have here an extensiv Chinese clientele. Their dread of chloroform and allied anesthetics is so excessiv as to almost eliminate the possibility of their use. At first they were no less dubious concerning medullary narcosis, and in response to an explanation of its advantages would politely murmur: "Ni kong tik ye to ni yap sun ke." (It is hard to believe what you say.) The incredulity of the Caucasian, physician included, is no less; but once the superiority of this method of abolishing pain is understood, one rarely resorts to other anesthetics. J. A. KUYKENDALL, M.D. 526 Turk st., San Francisco.

Operation for Spina Bifida.

Editor MEDICAL WORLD:-I have just read with much interest Dr. Widener's article in November WORLD, page 522, on spina bifida; and as I have been unfortunate enuf to have had several such cases, I wish to give results. Until three years ago I was unable to save a single case. Three years ago one of our local physicians brought me a two weeks' old baby suffering from, I think, the worst case of spina bifida I have ever seen. Tumor size of orange; the covering very thin, almost transparent. I at once suggested an operation by the method I will hereafter describe. I told the parents that unless this was done very soon the child would certainly die. I also explained to them that the operation was by no means a sure cure, but in my opinion it offered the child the best chance for recovery. After consulting several other physicians, they returned to me. All agreed with me that the child would die without the operation, at the same time saying that the operation was just as certain to kill. With a full understanding with the parents, only promising them to do my best, I gave the first treatment the day it was three weeks old.

After rendering the surface of the tumor scrupulously clean, I punctured the tumor on one side, passing obliquely thru healthy skin. with a small trocar, withdrawing two to four drams of fluid, at first operation less than at any other time. I then injected one dram of solution of iodo-glycerin (1 part iodin, 6 parts potass. iodid and 50 parts glycerin). After the injection the opening was closed with dry gauze secured by collodion and iodoform. I repeated this operation six times at intervals of one week. After the first operation there

were slight spasms, lasting for about six hours, which were readily controled by small doses of potass. brom. This treatment may be found in Park's Surgery, Vol. II, page 82-3. I saw the little fellow a short time ago, and but for the thickening of the skin over site of tumor, you would not know that he had been afflicted with so grave a trouble. The opening in spine is closed, and he has a good back. This is an operation that requires no particular skill, and offers, I think, equally as good results as the knife. Long live THE WORLD. Woodward, Okla. J. M. WORKMAN, M. D.

Death from X-Ray Burns.

Editor MEDICAL WORLD:-About five weeks ago a prominent business man of our town, who was in fine health with the exception of a chronic eczema which gave him no trouble except occasional itching, was induced to take x-ray treatment for his eczema. He took the treatment given him by a physician who lives in neighboring town. The doctor gave him several exposures, and burned him over a space of about 10 x 12 inches on his back on both sides of spinal column, including the spinal column, and extending up to the neck. The true skin all sluft off leaving a red, raw, discharging surface. He was also burned on the left portion of abdomen, about 4x6 inches; also over the left lumbar region, about 4x8 inches, but not quite so deep. The burns discharged very profusely, and were the most sensitiv sores I ever observed. They were very red, and often the most simple dressing would cause severe pain, and would have to be removed in a few minutes. At times the itching was so severe that nothing but full doses of morphin would control him. After about three weeks' suffering, delirium set in, which continued for about five days till death relieved him of his suffering. Able consultation was had in the case. Both local and constitutional treatment was carried out; tonics internally, antiseptics locally, and the patient was nurst carefully; but the burns were too severe ; they would not heal and were too exhaustiv.

I may be extreme, but after witnessing the suffering and finally the death of one of the best men and a leading citizen of our town and community from excessiv x-ray burns, I feel sure that I would not have an x-ray machine in my office. I write this to THE MEDICAL WORLD, hoping that thru its columns many physicians may be made more cautious and prudent in the use of the x-ray; for I do not believe that the extent or degree of x-ray burns can be properly estimated. They are dangerous and will produce death.

Springtown, Tex. A. S. GARRETT, M.D. [The x-ray is a two edged sword, and the

It

greatest trouble is that you don't know what harm you are doing till after it is done. acts very differently on different people; some stand it very well, while others are very susceptible to it. Unless the greatest care is taken to test each patient's susceptibility, it is easy to do much more harm than good. The November 11th meeting of the Philadelphia County Medical Society was given to a symposium on the use of the Roentgen (x) ray, by a number of gentlemen who have used it much. A number of cases of carcinoma and tuberculosis were given in which it acted like magic; and other cases were given in which it failed utterly or did harm, and some severe burns were reported, but not to such an extent as to cause death. The consensus of opinion was that while it acts beautifully in some cases, we are not yet able to differentiate the cases in which it will act favorably; and until we can do so, we should proceed cautiously, and not neglect other methods of treatment. Eczema was one trouble in which one operator (Dr. J. F. Schamberg) had gotten most satisfactory results from its use.-ED.]

Treatment of Carbuncle.

Editor MEDICAL WORLD:-I have recently treated a carbuncle by applying ichthyol, pure, to entire diseased surface except apex; the broken down surface was cleansed with dioxogen and dusted with iodoform, and tallow cloth applied to same. This treatment was repeated daily, washing off ichthyol every 3 days, and applying as before. Internal treatment, according to indications. Immediate improvement was markt; the hardened surface became soft, the numerous vesicles disappeared, and it began to run in 3 or 4 days, and in 10 days the trouble had practically ceast. I like the above treatment better than any I have used, especially with the patients who object to the knife. J. J. BRIDGES, M.D.

Bethlehem, Ga.

Erysipelas.

Editor MEDICAL WORLD:-I will report two cases of erysipelas treated recently. As they were typical cases with the usual symptoms, I will pass the symptoms and give the treatment.

Case 1. Lady, age 40. No history of previous attacks of erysipelas. Started from a bruise of nose. When I first saw her she had all the usual symptoms with a temperature of 102°. The disease had spread over the face. I covered the infected area with ichthyol and vaseline, equal parts. It seemed to check the spread of the disease promptly. The constitutional treatment was supportiv, with attention to functions. On the seventh day of the disease the temperature was normal, with both

DECEMBER, 1903]

general and local conditions very much improved. Case discharged, and I did not see her again until about two weeks later, at which time she told me she suffered very little inconvenience after my last visit.

Case 2. Young man of good habits, previous health good, no history of previous attacks of erysipelas. While cutting wood he accidentally cut his foot. The cut being slight, it received little attention at the time. Erysipelas started from this cut, and when I first saw the patient it had covered the foot and ankle. Was a typical case of erysipelas.

I covered the infected parts with pure ichthyol, and over this applied antiphlogistine. The case ran an unusually short course. Temperature returned to normal in five days. The constitutional treatment was the same as in case 1. I watcht this case until he returned to his usual vigorous health, which was rapid and without events.

In my early practise this disease gave me lots of trouble. I tried all the socalled specific treatments with but little benefit. At this time my cases ran a course of from two to three weeks, with application of about 10 per cent. solution of ichthyol or a weak solution of some other antiseptic. I have gradually increast the strength of my local application up to pure ichthyol.

My opinion is:

Ist. That the local treatment should be along the line of antiseptic applications (ichthyol the best yet).

2d. That the constitutional treatment should be supportiv, and that the only good constitutional treatment does, is in keeping up resistance.

3d. That the course of the disease can be limited.

Erysipelas is undoubtedly due to bacterial infection, and our aim in treating the disease should be to use locally some antiseptic which will penetrate the skin deeply and stop the growth. Would be pleased to have the experience of readers of THE WORLD in treating erysinelas.

Eadsville, Ky.

J. B. EADS.

Puerperal Septicemia: Its Treatment. Editor MEDICAL WORLD :-When called to a case of puerperal septicemia, the first thing I do is to give a mercurial purge, followed by Epsom salts if needed to produce copious action from the bowels.

I then turn my attention to the uterus. I thoroly curet with screw curet or McDade's curet; afterwards I use the rinsing curet with carbolic acid and steril water 1 to 100 parts. I use the solution as hot as patient can bear it (which is very hot if rinsing curet or irrigator

539

be introduced into uterus before water is turned on). In this manner you can be sure the uterus is empty and clean. It will hardly be necessary to curet the uterus more than twice; usually only once. However, the intrauterin douche of carbolic acid and steril water should be kept up daily until temperature and pulse are normal.

After each douche I pack the uterus with bichlorid or steril gauze, and leave end of gauze extending out as far as the labia majora to insure drainage. I then, before removing the speculum, throw in enuf boric acid to coat over the os uteri and walls of vagina. In some cases that I do not think are improving as rapidly as they should, I swab the uterus with a mixture of tr. iodin and c. p. glycerin, one to four parts. This of course is in addition to and after the douche. I don't often use bichlorid of mercury solution as a douche. As to internal treatment, I give the following prescription:

R

Sul. quinin.

Tr. chlor. iron

Simple syrup, q. s.

M. Sig. Teaspoonful every four hours.

If fever runs high, use ice bag and increase dose of quinin if necessary.

Give Epsom salts as needed to move bowels daily.

Keep patient well stimulated, for which nothing is better than strychnin and whiskey or brandy. Strychnin is usually indicated in about gr. doses every four or six hours, and whiskey or brandy comes in well especially when made into egg-nog, which serves double purpose (stimulant and diet). Some uterin tonic may be given with benefit. Keep patient in bed and very quiet. The diet should be in liquid form and very nourishing.

a

Be sure and change all sheets and bed clothing daily, and when possible change the entire bed.

It is understood of course that all instruments and dressings, as well as your hands, must be steril.

Of course complications sometimes arise, which should be treated symptomatically.

Now I do not claim anything "specific" about this treatment, nor do I say it will cure in two or three days; but it has acted well in my hands. D. W. BLACK, M.D.

Rosebud, Tex.

Osteopathy.

Editor MEDICAL WORLD:-Page 510, November WORLD, article on Osteopathy by Dr. Holmes: As this article is so typical of most of the things written about osteopathy by the medical profession and editors of most medical journals, I cannot allow it to pass by without

correcting some of the ideas which seem to be universal with medical men. The first and strongest point our friends urge, and they delight to hang to it and rub it in, as it were, is the mysticism and secrecy with which osteopathy is surrounded. Well, let us see how much fire there is connected with all of this smoke.

I am the son of a physician, a registered pharmacist in Illinois eight years, in the drug business, eleven years for myself, yet when I wisht to take up medicin no one came around to teach me the art gratis, nor was I foolish enuf to think I could learn it from a few articles in some journal, nor from text-books. But how? In a reputable school with a faculty of experienced teachers, where all the many variations of disease would be shown to me in the clinics, and the medical action of drug medication would be demonstrated. A reputable school of osteopathy requires twenty months' attendance, and teaches all that any medical school does with the exception of surgery and materia medica. The osteopath believes in surgery (when necessary) the same as the medical profession, but he does not study it, because the law restricts the practise of surgery to the medical profession exclusivly. He does not study materia medica because he believes he has a better system of healing. Just let me say in this connection that an osteopath who rants and tears about drugs being all poison and always harmful, and that no good can be derived from their use, belongs to the same class as the M.D. who works overtime to tell what a fraud osteopathy is. In both cases ignorance is at the bottom of their conclusions. A man who is not willing to impute honesty to members of other schools, is not seeking the truth and will never advance.

Now as to the secrecy: To those who wish to know what can be learned from text-books, they have only to patronize their own book dealer, who will get any one of numerous works on osteopathy, at prices lower than the same sized medical books. I might name Riggs' Theory, $2.00; Hazzard's Principles and Practise (verbatim reports of lectures delivered at the American School of Osteopathy) $2 50; Hazzard's Practise, $3.00; Riggs' Man ual, $1.50. These will tell the why, what, and how of osteopathy, just as taught in their schools. Many other works are on the open market the same as any medical book. There are fifteen or twenty good osteopathic journals, which your money will bring to your table just as quick as the osteopaths.

Now doctors, let us hear no more of this fallacy about mystery and secrecy. It does not exist. It is a myth bred and fostered by ignorance.

They say osteopathy is massage. Now again

How

they argue from ground not well taken. many doctors ever had a course in massage? not one in 500. How many of you even have a text-book on massage? not many. Then your ideas of scientific massage are very vague. Like your knowledge of osteopathy, it is wanting, and your opinions upon either subject carry no weight. Invest in some books and learn that these two systems are entirely dissimilar.

The doctors ask, how can osteopaths know any more anatomy and physiology than the doctors? seeing that these studies existed before osteopathy. This is easily answered. If the M. D. would give the same time and follow the same course that osteopaths do with these studies, they would know just the same. It is not what a man can learn, but what he does learn. Doctor, what do you know of the sympathetic nervous system? Can you tell from what spinal segment filaments go out to control the life of each viscus? I never saw a medical school teach that, yet it can be dug out of the medical works. Not what you can know, but what you do know.

The points along the spine designated as centers for controling the organs, and which the profession at large ridiculed very heartily, are now being heralded to the profession as a great advance step by the vibration medicationists, an idea of treatment very popular now. See a late book by Maurice F. Pilgrim, M.D., of New York city, on Vibration, price $1.50, every point in which has been used by osteopaths for ten years or more. Verily you are stealing our thunder as fast as you can assimilate it, and without giving due

credit.

I know that osteopathic treatment is a power for good in healing. It will produce results in many cases impossible to obtain otherwise. To me its greatest work lies in chronic diseases. Why? The structural lesion is corrected and nature is allowed to do her work. If there were no lesion, it would not be a chronic case. Doctor, if you would but learn enuf osteopathy to diagnose, you would see why, in a great many cases, your medication fails. If you think there is no possibility of vertebrae, yes even the atlas, getting out of place, then you need (like the Missourian) showing. I personally know several old practicians who have taken up osteopathy and they say there is little in medicin but much in osteopathy. osteopathy. I know several osteopaths who have taken up medicin, but none of them think any less of osteopathy. If you will investigate honestly and thoroly, then this paper will have accomplisht its object.

D. A. STEVENS, M.D., D.O. 1495 Madison st., Chicago.

Malarial Hematuria.

Editor MEDICAL WORLD:-On page 407 of the September number of your valuable journal, I find a request for a discussion of the above subject. Being forced by age (87 years) and infirmities to abandon the practise of medicin, yet, acting from a feeling of duty, and influenced by philanthropy alone, and being among the first who introduced a treatment which has proved to be eminently successful and gratifying to all parties concerned, I gladly give it again to the fraternity, hoping and believing that if heeded and faithfully carried out, that it will save the lives of many, at least 90 per cent. of the cases treated.

The symptoms characterizing the disease under discussion are so well known that I need not give them here, so will proceed at once to the treatment. The sulfate of quinin is not indicated in any stage of this disease, which is a continued fever and therefore cannot possibly be favorably influenced by this drug; neither should quinin be given at time of convalescence. I have known a few grains given at that time to reproduce at once all of the frightful symptoms of malarial hematuria; it therefore should be left completely out of the list of curativ remedies in this disease.

I commence the treatment with the following: R

Mix and give a tablespoonful every 4 hours. This should be continued until convalescence is fully establisht.

I will here state that we frequently meet with cases whose stomachs cannot tolerate In those ergot in any quantity or any form. cases, at the suggestion of Dr. J. K. Hodge, I use 3ij of the tinct. of iron in the place of the ergot in the above prescription, which has always answered well.

I have given my reasons in full to the medical fraternity in so many journals that I do not feel under any obligation to repeat them here. So in conclusion I will give the treatment during convalescence:

Fertilization between Human and Lower Species.

Dear DR. TAYLOR :-Touching the question as to whether the human ovum has ever been, or can be, impregnated by the semen of a lower animal, or vice versa, by referring to the American Journal of Obstetrics for the month of January, 1897, page 57, you will see it stated that Taruffi quotes the case of the sexual union of an Arcadian shepherd with a she goat, which resulted in the birth of a kid with a human head. I drew your attention once before to a fact which I read some years ago, of a tramp having connection with an ape, or animal of that species, and it was stated that it produced an offspring. I regret that I have quite forgotten the particulars. Vienna, Ontario. R. J. DARRAH.

[Happily such instances are very rare, even and undoubtedly authenticated. My statement if any such occurrence has ever been properly of doubt as to the human female ever having been impregnated by a lower animal, stands; and I am informed that Dr. Jno. C. Dalton, the physiologist, says emphatically, No. Science female.-ED.] and gallantry join in vindicating the human

How Stopping Toothache Gave me a Start. Editor MEDICAL WORLD:-My first location was in a little country village, where my nearest confreres lived twenty-four and forty-two miles, respectivly, north and south. For opposition, however, I had an old physician without a license, whose years of practise exceeded the years on my head, and whom the whole countryside swore by. But he refused to pull teeth; and it was thru this weak link that there occurred breaks into his practise. The first day I opened my office a man came

to

me saying he had walkt the floor for nights, crazy with the toothache. I pulled it and received his heart-felt thanks. The next patient was a young lad whose aching molar had only a small cavity in it. Any tooth is worth five dollars, even to a poor man; and I hated to sacrifice a good one in this case.

"Would you rather I would stop that ache than pull it out?" I askt. "Yes, indeed," he replied.

I recalled what my last preceptor had told me. Once he said, "I never yet have failed to stop a toothache when the tooth has a hole in it. Take ten minims each of chloroform, carbolic acid and glycerin, and add one grain of morphin, and it will stop the severest toothache as if by magic."

I replaced the morphin by cocain, and put a drop of the solution on gauze and into the