Adherent Placenta. Editor MEDICAL WORLD:-The prompt removal of the placenta is generally advised, but in many cases I have resorted to more conservatism. I have very frequently left the placenta in for several hours in preference to forcibly detaching, which if done, very frequently necessitates curetment, and I regard that as being the most frequent cause of infection-it opens the avenues of infection. But when indicated, I strongly advocate a radical operation.

I will venture the assertion that many physicians can call to mind many cases of puerperal sepsis following the forcible removal of an adherent placenta; however, I do not say that it is true in all cases.

Upon finding the placenta firmly at tacht, I usually administer ergot and quinin, in connection with intra-uterin douches, and very frequently resort to packing of the os uteri, and apply ice over the region of the womb. In nearly all cases this procedure has been attended with happy results; while to my knowledge there have been cases treated more radically that have not terminated satisfactorily.

Do not become alarmed too soon at hemorrhage unless very profuse; for it is to be regarded as a favorable symptom of separation, as there is always more or less hemorrhage accompanying the separation of the placenta.

Would be glad to hear from some of the WORLD readers on this subject. Cave-in-Rock, Ill. J. H. GREGORY, M.D.

Fun for the Doctors.

Editor MEDICAL WORLD:-Most physicians of experience have some knowledge of a good ghost story. I want to make a collection of stories concerning the ghostly experience of leading physicians, and I take this method of soliciting the same from such persons as have a

good article which they will contribute. Contributors will please forward manuscript as early as convenient, and see that it is written plainly and as briefly as possible. No article will be publisht which does not, at or before the conclusion, reveal the true mystery of the "ghostly fright." I take this precaution for the purpose of relieving the minds of some readers of superstition, instead of increasing the malady. The object is to furnish a book which will be instructiv to the laity as well as amusing to the profession. A few good articles on Christian science, osteopathy, and other forms of faith cure will be welcome. Each contributor whose article is accepted will receive a free copy of "The Book of Ghosts." Address, J. L. SHORT, M.D. 623 E. Fourteenth Street, Kansas City, Mo.

"Short on Diagnosis.”

Editor MEDICAL WORLD:-I desire to express sympathy with Doctor Beck, of Hanley Falls, Minn. (February WORLD, page 69), in his distress when he hears "about some fellow who has treated two to sixteen hundred pneumonias without a single death, seventy to a hundred membranous croups in one winter and no deaths, lobar pneumonia jugulated while you wait," and so on. I was once so, but further information and more matured judgment have convinced me that all such fellows are long on imagination and short on diagnosis; immense in self esteem but with a paucity of veracity. I am too timid to say that they prevaricate, but I do verily believe that they stretch the everlasting bladder " of truth.

Responding to Dr. Hurd, of Durango, Col., will say that for thirty-eight years I

have used castor oil in treatment of

typhoid fever, and I regard it as a necessary agent in treatment of that disease. Do not believe it necessary to "check the bowels with Dover's powder" or other agent. WM. COMMONS, M.D.

Union City, Ind..

Homeopathy in Grip.

Editor MEDICAL WORLD:-It is very amusing to a homeopath to read your treatment for the grip, February WORLD, pages 41 to 43-and this in the beginning of the twentieth century! A better treatment is to select a remedy according to the law, similia similibus curantur, from the Materia Medica Pura of Hahnemann, and give the remedy indicated, singly and in a potency. At least that is my experience. Camphora, aconitura, bryonia, chiona, and belladonna, have served me well in the present epidemic. Nearly every day's mail brings me the circular or sample of some "specific," but thank fortune, homeopathy is not advertised in

that way.

Would it not be wise to try this method that has stood the test for over one hundred years?

Uniontown, Pa. A. P. BOWIE, M.D.

[Doctor, will you kindly give us an article on the homeopathic treatment o grip, giving details and cases? We are not "hide bound." We are searching for truth.-ED.]

I hand your "Monthly Talks" around among my neighbors, in order to scatter the good seed.-R. T. Connally, Rocky, Ark.

Treatment of Hemorrhoids. Editor MEDICAL WORLD:-In reply to the inquiry of Dr. C. C. Patchen, page 65 of February WORLD, as to the treatment of hemorrhoids as practised by Dr. Johnson, of St. Louis; he used a 2 per cent. solution of eucain and 8 per cent. of cocain applied upon absorbent cotton. After complete local anesthesia, unknown to the patient, he injected from four to eight drops of the Brinkenhoff mixture, but later he abandoned that, due probably to too much irritation caused by the chlorid of zinc, and used the Hoyt mixture. The formula, as given by Dr. Eugene Hoyt, is:

Mix. This makes a 10 per cent. solution. Concerning the application of his solution, Dr. Hoyt says: Introduce the needle so that the point will rest about the center of the growth, press upon the piston gently, so as to void drop by drop, until the hem. orrhoid shows a paleness upon the surface. This is accomplisht without any pain beyond a wave like sensation denoting a feeble knowledge that something is being done.

There is not a hemorrhoid case possible which cannot be obliterated by this treatment, and I am at a loss to explain why so many cling to methods that carry so much havoc and suffering.

I feel justified in saying that the injection treatment of hemorrhoids marks an epoch in the history of medicin, unrivaled in advancement by the treatment of any other disease to which the human family is subject. HENRY M. WOOLMAN, M.D. Newark, N. J.

Treatment of the Alcohol Habit. Editor MEDICAL WORLD:-They say that experience is a good teacher, and eight years ought to do something for even a stupid person. The first impression we had was that the cure for inebriety was a fake and a humbug. We are slow to fall in with a secret, and we condemn it as a matter of principle. We saw the results, which seemed marvelous, and of course they excited our curiosity and interest. Many different formulas were given to the profession from time to time, and thousands of us experimented, with more or less good results, but in the long run giving it up as a failure, or out of our line, and probably condemning it as it was not a

success in our hands. We are looking for specifics, or a medicin which will cure in spite of conditions or surroundings or circumstances; and we forget that the all important thing is the intelligence of the physician, his knowledge of the human system and of human beings, and his power to influence his patient to help the medicin to a final cure. We try a medicin for the cure of the tobacco habit; it does not cure, and we give it up. I do not believe there is any medicin that will cure every case of opium or tobacco or liquor habit. There are medicins that seem to act with certain results in some cases, but the majority of habits must be handled with great skill by no fixt rule, but according to the case in hand.

To get results, I feel that a suitable place should be had for a sanitarium. The surroundings must be of a high character, even if simple. There should be a high moral tone, which would appeal to the better part of any man. I think that the doctor who makes a success of curing habits and nervous troubles is "not made, but born." His success does not depend upon his profound knowledge of theories or bacteria, but upon his ability to read human nature and get the confidence of his patient, and his ability to get the cooperation of the patient. All victims had a beginning by starting moderately; soon a habit was formed, then a diseased condition followed. To cure a person even of an ordinary habit requires tact and skill. Try to cure a person of biting his nails and note the results. You will then appreciate the difficulties that beset a specialist in the cure of drug habits. We are all creatures of habit, and in many people habit is all powerful.

First, to treat any habit one must get the patient to acknowledge that a habit exists, which they cannot control, and be willing to give up the habit. Then the patient must take a time free from any care in which to give up the habit and the best thing that he or she can do is to go to a sanitarium and make a business of it. With the proper help from the physician I feel sure any habit can be cured, even masturbation.

Treatment of liquor habit: We will take a patient who comes in perfectly sober. I use injections four times per day during treatment. The dose must vary according to the individual and the case in hand. I have a solution of nitrate of

strychnin, 1-30 grain to ten drops of distilled water. Better begin by giving about five drops and watch the results. You can easily increase. Look for pains in the legs below the knees, or the hands feeling like closing, also a transparent appearance under the eyes, the appetite not coming as it ought to. If you have none of these symptoms you can gradually increase the dose up to 1-30 of a grain four times per day. Should the patient remain much over four weeks, I would not at any time give large doses of strychnin. I give all my patients the first or second day, according to the condition of the patient, four grains of calomel about half an hour after breakfast, and about half an hour before dinner a good liberal portion of salts. If you do not get a free movement by 3 p.m., repeat the dose of salts. During the treatment watch the patient, and if you find him a little irritable or hankering for a drink, bad taste in mouth, etc., the chances are he is bilious. Give him another dose of calomel and you will be surprised at the results. All inebriates have sluggish livers. I think this is an exciting cause of periodical drinking..

Now as to a tonic: I give the following, in teaspoonful doses, four times per day in a little water:

Chlorid of gold and sodium
Tr. gentian.

Tr. cinchona Tr. columbo Tr. hydrastis Glycerin

Mix.

gr. 1

oz. 2 oz. 1

.

oz. 1

oz. 24

q. s. ad. oz. 8

I am perfectly satisfied with the above tonic. I find it to be a good builder, and it agrees with every patient whether he is being treated for the liquor habit, or is run down from any cause.

If your patient does not get along well there is "some screw loose." Find where the trouble is and rectify it. No disease can be cured unless the cause be removed. You must not let the patient cohabit during treatment, and caution him to be very moderate for some months after treatment is finisht. I have put twenty pounds on a patient, and four weeks after his return home had lost it all. Most inebriates are neurotic, and sexual intercourse is exhausting, which demands something, and of course liquor is the first thing thought of, as it is the thing they have been in the habit of taking. You must not let them drink outside of the institution. Usually they do not think of it; but

You

some cases will tax your ingenuity to the fullest, and also your patience. If you give them a drink you must make them sick, or you are in for it. I usually put them off until "shot time," and then dissolve one-twentieth grain of apomorphin in ten drops of the strychnin solution, and give as a regular "shot." The result is satisfying to the patient, unless he be very nervous and off in his head; then it is of no use, and you would better try some method until you get him normal. Most of the patients come in after a long spree. Look the patient over and decide whether there is a possibility of delirium tremens; if so, be careful not to sober up too quickly. Take away raw liquor and give milk punches and beef tea. Also give the strychnin injection; it stimulates the heart, etc. When you feel there is no danger of delirium tremens, take away the liquor and give the calomel as directed. If patient is very nervous, I give for a night or two the following: Chloral hydrate, 5 grs., bromid of soda, 15 grs., tr. hyoscyamus, 20 drops, at a dose. You can repeat every couple of hours if necessary. Do not continue to give after the extreme nervousness is past. may have a patient who persists in drinking, and there is no danger of any trouble. The way I deal with such a case is this: I insist on giving milk punches and beef tea, giving as an injection strychnin 1.20 gr., atropin 1-20 gr., and morphin 1-4 gr. Having the solutions separate, I draw in so much of this and that, and then I give in one operation. If this is repeated every four hours for a while, the stomach will rebel and the trouble is over. A caution: do not give morphin or any depressant if your patient is very drunk or drowsy, as he will go to sleep and you cannot awaken him. If you have to give apomorphin, do not give if patient is much under the influence of liquor, or you will have trouble. In case a patient should go into a profound sleep, artificial respiration is the best method to keep him alive until after the effect is over In such cases you should stay with your patient, or have a competent nurse. In fact, in bad cases you do not know what will happen for the first four or five days. I had a patient who appeared all right. He had been in the sanitarium five days going about with the fellows picking hops, and on the morning of the sixth day he was taken with delirium tremens and ran away, and

He

for two days we could get no track of him. After forty-eight hours he arrived at his home more dead than alive. returned to the sanitarium and took the treatment, and is O. K. after six years.

After eight years of practical work, I feel that there is nothing more certain of results than the treatment of inebriety; but we must remember that the treatment does not consist in making your patient sick, but in building him up, morally, mentally and physically. There are many agencies at work to undo your good work; namely: good fellow ship, ease of being persuaded or influenced, love for the feeling liquor gave, a loneliness, strong habit, lost "grip" or nerve, lack of confidence, and a belief that they can handle the stuff again safely. I have yet to learn of a case of lapse caused by a bankering for a drink.

It is a difficult thing to give a full detail of any treatment, as the cases met with are so different, and no general rule will work. GEO. H. DE. NIKE, M.D.

Clinton, N. Y.

Ventilation.

Editor MEDICAL WORLD:-In winter and spring I am frequently finding sick rooms that have a temperature of 80° to 90°, with the accumulated expirations of the last few days unadulterated by fresh air. To remain in such a place for half an hour gives me a headache, yet I usually find the inmates of such places quite well accli

mated. I have observed that hot air is an irritant to capillary bronchitis, which is the prevailing winter disease of high altitudes among children. The families that have this disease most are those that have a fear of fresh air; a fear that the baby will take cold. And oh, how they bundle up that baby! It takes more than tame advice to correct these things; it takes earnest and emphatic talk, and then the room is seldom kept below 75°. The two windows that I lower from the top strike terror to the grandmother, and thru her to all the family; and that baby, with a temperature of 102° or higher, "will surely catch cold." I have seen families that were so determined to live in a close atmosphere that I have taken a hammer myself and fixt two windows so they would lower from the top. Often the windows I have lowered have stayed lowered for months, with less sickness than the family has known for years. But this is not a

profitable job for the doctor; and often I wonder if this is why doctors do not oftener get furious over this matter of ventilation. Doubtless any doctor under such circumstances would advise ventilation, but usually his words will pass unnoticed unless he waxes eloquent, angry, or gets in and does it himself. Churches, school houses and halls in the country during cold weather are badly ventilated, and these conditions help largely to give the doctor employment.

Will some one kindly give a course of treatment for post typhoid nephritis with edema and emaciation, in female aged 20? Calcium hypophosphite has proved valuable in all forms of hemorrhage,—frequent, large doses. DR. C. E. BOYNTON. Sandy, Utah.

Editor MEDICAL WORLD:-In the February WORLD, page 66, I see a letter by Dr. A. W. Whitney on the determination of sex, which prompts me to offer, for the consideration of your readers, a formula with which I became acquainted some years ago, and by means of which I have, in almost every instance, correctly anticipated the sex of the expected child.

I do not, for a moment, want to be understood as in any way versely or adversely criticising the advice and rules or conclusions arrived at by Dr. J. G. Davis, and concurred in by Dr. Whitney, but would like to have the army of WORLD readers interested in that much mooted question apply the rules here given and report their

success in correctly naming the sex of the anticipated child.

The rule briefly stated is as follows: If the age of the prospectiv mother, at the time of conception, be an odd number of years, e. g., 17, 19, 21, or 23 years, and if she become pregnant during an odd month of that year, e. g., January, March, or May, etc., she will be delivered of a male child. If she become pregnant during the even months, she will give birth to a female.

If her age be even, e. g., 18, 20, or 22 years, and she become pregnant during an even month, February, April, June, etc., she will have a male, whereas if she become pregnant during the odd months she will have a female. To summarize: Likes, an odd age and an odd month-male. Even age and even month-male. Unlikes, an even age and an odd monthfemale. An odd age and an even month -female.

For this theory or rule I claim no infallibility, but have found it to be almost always reliable and have come to regard it as nearly a true means of arriving at a correct idea as any theory of which I have read. W. C. McCUTCHEON.

Cassopolis, Mich.

[Of all "odd" theories on the sex question, this is the oddest. What can nature know of our conventional system of dividing the year into months? And what effect could the "odd" or "even" of these divisions have on the workings of nature? If this were true, what would nature do in parts of the world where the year is not divided into months like ours, or among savages where "months," neither odd nor even, are known? Yet in all these places they have babies, both male and female.-ED.]

Warning.

Editor MEDICAL. WORLD:-There is a man working among the doctors claiming to be a doctor himself, Dr. Fitzgerald by name. He claims to be from Philadelphia. He has wonderful powers in dislocating his joints and bringing out the muscles, hernia, etc. He is a thief, and has been stealing books from our libraries here and selling them to others. I thought it well to notify the profession thru THE WORLD and stop this nuisance. He stole books from my library and sold some to a druggist right here in town. He was supposed to have gone from here to St. Louis, or west at least. There is a reward here for his capture. Newburgh, Ind.

O. A. LETT, M.D.

Use of Potassium Cyanid in Painful Affections of the Sciatic Nerve.-Report of Two Cases.

Editor MEDICAL WORLD:-In presenting this report no attempt at a scientific consideration of the subject will be made. But being struck by the coincidence of two cases which came under my observation, and as they refused to yield to every other form of treatment, I have deemed them of sufficient importance from a clinical standpoint to report, that they may prove of benefit to some other practitioner.

Case No. 1. Male, age about thirty-five, was admitted to hospital for acoholism. Patient was in fair physical condition with the exception of suffering some from the effect of alcohol. He had at previous times been treated for alcoholism, and was accustomed to indulging quite often, and also attending late suppers, etc. The first few days were markt by a special change, but later the patient complained of a slight pain in right leg along course of sciatic nerve. This gradually increast, confining him to bed and causing him to cry out with pain if leg was moved. There was no external sign of inflammation nor specially tender spots, but pain was continuous along the whole course of nerve.

The usual remedies, as rest in bed, sodii salicylate, colchicin, laxativ salts of lithia, were given; various liniments and bandages were applied, hot applications of various kinds, also a small blister was placed over sacro-sciatic foramen; this workt as usual so far as raising a blister was concerned, but it seemed only to increase the pain in the nerve, which at that time seemed likely to continue. As a last resort injections of morphin were given, beginning with grain twice a day. This seemed to check the pain for a time, but it increast in severity, so the dose of morphin had to be increast so that in about two weeks the patient was taking six grains a day and seemed liable to increase.

In reading a medical journal I accidentally saw an article on use of potassium cyanid in nervous reflex affections of the sciatic nerve; so I determined to try it on this case. I made a solution of potassium cyanid twenty grains to six ounces of water, I saturated a flannel bandage with the solution and wrapt it around the limb, covering that with another flannel bandage and applying hot water bags to outside. In course of a few hours the patient said the pain had dimin