ful organ like Him who constructed it, I would be a new Prometheus.

But let us apply the little we do know. The liver stands just within the portal, and all we pour into our stomachs goes to that devoted organ to be sorted over. We know very well the harm we do it by the continued ingestion of alcohol, spices and condiments, excessiv quantities of sugar, nitrogen and perhaps fat; and by simple overeating, and the use of iced beverages. We also know that when constipation allows of decomposition in the alimentary canal, the toxins therein generated go straight to the liver. We can, therefore, lighten the liver's burden of work by keeping the alimentary canal clean and aseptic, and by eating just what we need and no more, in the manner best calculated to insure normal digestion; and thus we give the liver rest from unnecessary work. And surely there is no principle in physics so well establisht as that of rest for a suffering organ.

Beyond this, we can stimulate the skin, with hot baths and salt rubs; we can regulate the habits of exercise; and we can apply the principles of domestic hygiene to the patient's environment. And the doctor who esteems this as of little account has not yet mastered the alphabet of his science. W. F. WAUGH, M.D. Chicago, Ill.

A New Disguise for Castor Oil. Editor MEDICAL WORLD:--Some time ago I was called hurriedly to attend a crew on a small lumber boat that was anchored out on the bay. I was told that it was a case of wholesale poisoning. Seeing that my emergency case was well filled, I hurried to the dock, where a small boat was awaiting me, into which I immediately stept and started at once to the boat about a mile from shore, two men taking me as fast as their strong arms could ply the oars. On arriving I at once climbed the ladder and such a sight as met my gaze will never be forgotten. The captain, mate, purser, boatswain and eight or ten others were lying about on deck, rolling and praying as tho judgment day had already arrived. I asked the first one I could get to speak what they had eaten for their dinner. It happened to be the cook and he could give me the necessary information. He said that besides the usual potatoes, rice, grits, molasses, etc., they had had a large dish of lobster and clam salad, of which they

all ate heartily. Having him to show me the cooking department, I went to work to find the cause of the poisoning. While looking around I was having the man who was acting as my guide to give me a history of the cases, how they began to complain, etc. He said that they had all eaten heartily at noon and had since been lying around on deck, some playing "scrap" while others read or slept. At about four o'clock the mate became very sick and began to vomit and complain of severe pains in his stomach and bowels. By five o'clock the whole crew was rolling around, crying for help from a higher power till about six o'clock (after I had been dispatched for) some of them began to get better, after being thoroly purged. While this history was being given to me I was looking over the cupboard, table, stove and everywhere trying to ascertain the character of the toxicant. I happened to pick up a quart bottle that sat in a box. I opened it and smelled it. I was told by the cook that that bottle contained the olive oil that had been used as a dressing for the salad. The smell revealed the fact that it was not olive oil, but castor oil! Asking him how much he had used, he said that he had used perhaps a pint or more on the salad. So I saw at once that the men had each taken about two ounces of castor oil and that the pains in the stomach were nothing but the griping of the castor oil.

When I went back on deck and told the captain and his men that they had only taken about two ounces of castor oil, a minister could have readily seen that they needed two or three missionaries on that boat, judging from the language that they used. The mate said that he told one of the men to go to a drug store and get some olive oil for the salad, and to fill the castor, and he had gotten castor oil. It had been so disguised by the pepper, mustard, vinegar, etc., in the salad that none of them knew it till after they had been almost frightened to death, but they had only a good castor oil purge. I have seen some inquiry in the journals about disguising the taste of castor oil. I would say, just put it in lobster salad, and give it to men who had had plenty of Spanish whiskey.

Am succeeding with calcium sulfid in boils, furuncles, etc.

F. G. THOMASON, M.D.

Punta Gorda, Fla.

Topics for Discussion. Editor MEDICAL WORLD:-I suggest a few topics for discussion:

1. The merits of veratrum viride. 2. Phosphorus; its most valuable preparation.

3. The most practical splints in present

use.

4. A typical neutralizer for alkalin urin. 5. A drug which universally overcomes excessiv acidity.

6. A simple method of nickle-plating instruments. W. T. MARRS

Jewett, Ill.

The Pay Doctor. Editor MEDICAL WORLD:-The prompt and positiv stand Dr. Livingstone has taken in reference to his bills (publisht in the May WORLD, page 177), is very com. mendable. It will do him no harm in his neighborhood. It makes the laity think It makes the laity think he is a pay doctor, as they frequently express themselves, in contradistinction to the benevolent, philanthropic old samaritan who gets his pay in Heaven. They will praise and tolerate the good samaritan for a few days, as he is very charitable to the poor. Then if the patient recovers they frequently think and say, "there was nothing much the matter; he got well in a day or two." But if the patient continues to be sick, the friends become alarmed and send for a man like Dr. Livingstone, who is a good doctor, but you must pay him promptly. He must necessarily be a skilful doctor as you must pay him. This pay doctor of course takes up the case where the old fool of a samaritan left off, cures the case, and gets his pay, while the philanthropist is frequently censured by the friends for tampering with human life. He may be just as competent as the pay doctor, but he has no business ability, and is a semi-nuisance in the profession. He never sends in a bill; is never thought to be much of a doctor; is always poor and has a hard time to pay his own bills, simply because he does not value his services and the laity does not. man meets with a serious accident, or has a prolonged fever, see how quick the friends send for a doctor of the Livingstone type; and how quickly they pay him. If he gets well the doctor gets the credit; if he dies, they console themselves with the thought, we did all for him that money could do; every attention was given him that money could purchase; the best

If a

talent was procured that money could obtain." But suppose the old fool of a samaritan had the case; he would certainly not get any fee, and be highly censured, and be held in poor estimation by the neighbors.

The following was publisht in a medical journal-don't remember which or when, but recently, and from a man in Kansas. This was on his bill heads:

A prompt settlement of this bill is requested and expected. If bills are paid monthly a discount of 10 per cent. is given. Bills not paid promptly will be past to my attorney for collection.

If you pay your physician promptly he will attend you promptly, night or day, rain or shine, while your slow-paying neighbor suffers and waits, as he made the doctor wait; and while he is waiting the angels gather him in; and then the undertaker sues the estate for expense of interment-all of which you can prevent by paying promptly your best friend, your medical adviser.

I venture to say that the man who has that on his bill heads, is considered the leading physician in the county by the laity, and has more than he can do for cash; and that there are a number of philanthropic doctors in the county who say there is "not much sickness this year." J. G. CRAWFORD.

San Francisco, Cal.

Reply to "Sterility." Editor MEDICAL WORLD:-I have observed in May number (page 197), Sterility's" letter and your advice upon it. Allow me to say that you have omitted one thing most important. Spermatozoa require an alkalin medium for the full play of their vitality. Try a weak solution of bicarbonate of soda as an injection before coitus. I believe this will be probably successful if, as you suggest, the husband be viril. Keota, Iowa.

D. C. MCFARLANE.

cervical canal. Bimanual examination revealed a uterus of an unusual size with fundus resting on the rectum. The patient gave the following subjectiv symptoms: headache, pain in the back, occasional pains down the thigh, and persistent constipation. My diagnosis was acquired sterility due to a stenosis of the cervix uteri as a result of chronic cervical endometritis, with retroversion of the fundus uteri.

The husband was sent for and examined. His history was clear save for having had a gonorrhea some time in the past; his sexual organs were in a normal condition. It was explained to the husband that several months would pass before much could be accomplisht.

The lady was required to be brought to the office three times a week. She was given a prescription containing the fluid. extract of ergot, viburnum, iron, and strychnin; the bowels were kept open with epsom salts; and during the three months she was under treatment, Fredrick Stern's wine of cod liver oil was occasionally given. The local treatment consisted of a gradual dilation of the cervical canal, an injection of a weak solution of boric acid, and tamponing the vagina with surgeon's cotton, which had been saturated with glycerin and carbolic acid. This treatment was persisted in for two months, at the end of which time the uterus was cautiously injected with pure glycerin with three drops of carbolic acid to the ounce of glycerin, never injecting more than a dram of the glycerin at a treatment, and tamponing the vagina after each injection. The tampon not only served as a vehicle for the medicins, but assisted in stimulating uterin contraction and the expulsion of the morbid materials from the body of the uterus; also assisting in changing the deformity of the fundus. My patient improved rapidly; the uterus returned to its normal size, and the malposition was corrected.

I may say here that I find it a very difficult matter in the treatment of uterin disease to keep husbands away from wives before a cure can be affected; hence this tampon arrangement performs many useful functions. I usually let the cotton remain in the vagina until the patient returns to the office.

I directed my patient to submit to the entreaties of her husband. Three months afterward she returned complaining of a

miscarriage. I re-examined her, found no malposition nor disease. She was reassured and instructed to try again; to keep quiet about the time of her "monthlies." In six months she returned to consult me about her delivery. At full term she was delivered of a healthy, lively baby girl. She is now undergoing her third pregnancy. She came to me for treatment April 3, 1898.

Case No. 2.-Mrs. G., twice married, had three children with first husband; none with the second. Age 35 years, been married two years second time. Menstruates regularly, but it is painful. Examination revealed no malposition of the uterus or annexa, but a copious milky discharge from the cervix, so abundant that she was compelled to wear a napkin all the time. Her object in consulting me was not to become a mother, she said, but the discharge gave her considerable annoyance and it was this from which she sought relief. "However, Doctor, if you can start me again my husband would be grateful."

My diagnosis in this case was an uncomplicated case of cervical endometritis. I also found a vaginitis, a sort of an extention of the disease from above downward. My treatment in this case was very simple. I put the patient on Fellow's hypophosphites, teaspoonful doses three times a day in water. Gradually dilated the cervical canal, had the patient come to the office three times a week, at which times the uterus, cervix and vagina were thoroly cleansed with a strong solution of borax, alum and tannin; the vagina was then dried out with cotton and a glycerated cotton tampon inserted and held in place by a T bandage. I never altered this treatment. In four months I discharged my patient as cured. When I had forgotten all about the case I was called one night nearly a year afterwards to deliver her. She said "I blame you for this. Doctor." She gave birth to a fine boy. She has been pregnant twice since. These are simple remedies and simple methods that have been useful to me. I am glad to give them to my fellow readers of THE WORLD. CORNELIUS MCKANE, Ph.D., M.D. Savannah, Ga.

Do you not want your medical friends, either in your own vicinity or elsewhere, to read THE WORLD? It is your journal, so all your friends ought to read it. If you want to present it to them, on trial, for the remainder of 1901, send list of names and 23c. each, and we will make this special rate to you, for you to get your friends in.

Suggestion for Sterility. Editor MEDICAL WORLD:-In case of "Illinois" (sterility, page 165, April WORLD, 1901), allow me to suggest the following, with the request that results be reported:

B

Sodii chlorid

Sodii bicarbonat . Aquæ font

.

3ij

Zij

Oij M. Sig.-Use a pint or so as a douche, shortly prior to coitus, passing nozzle high up to cervix, during first week subsequent to period.

Also, to "New Subscriber," page 164, same number: Would suggest hot water and cold, alternately, to improve circulation. In giving him confidence that the normal sexual life of matrimony will develop the sexual organs, caution him to delay the act until all eagerness has worn off, approaching his task as deliberately as he would a good dinner, and prolonging it, so as not to rob his partner of her full share of the pleasure. The length of time the vessels are kept engorged will, in the opinion of the writer, do much to develop, strengthen, and create confidence.

SACRAMENTO.

Conception Favored by Cohabiting Immediately after Conception.

Editor MEDICAL WORLD:-If "Illinois" would advise the married couple to cohabit as soon as the menses have ceast, not waiting even for an hour, it is possible that the lady would conceive. A case in point: a married couple waited two years for offspring. Being very anxious to have a child, they tried all the advertised nostrums for sterility that came under their notice, to no purpose. Both being very particular, they had waited several days after menstruation before cohabiting. A lady friend advised the lady to have coition as soon as menstruation had ceast. The result was that at the end of a year they were blessed with a baby boy. Wyoming, Del. J. H. THOMAS.

Conception Favored by Position. Editor MEDICAL WORLD:-I have a suggestion to make to "Sterility," on page 197 May WORLD. There is no doubt that in the early history of mankind the only known way of performing the sexual act was from behind. That is, man learning by observing the brute creation around him, knew of no other way of having coitus, only while the female was on her knees and hands or knees and chest.

If one carefully studies the anatomy and physiology of the generative organs of the two sexes he cannot help coming to the conclusion that this is the way the Divine Creator intended it should be done. That is, there is a better adaptation of the two sets of organs in this position than in any other, and conception is more likely to

occur.

If the female is on her knees and chest and receive her partner from behind, every contraction of the erector penis muscle causes the carpus spongiosum of the penis to impinge against the clitoris, the most sensitiv part of the female sexual organs, thus augmenting her pleasure in the act. At the same time, when the woman is in this position, the direction of the vaginal canal is downward, at the bottom of which is the os uteri looking upward, ready to receive the semen as it is deposited. The body of the uterus being still lower than the os, the semen readily gravitates to meet the ovum, and there will be no need of plugging the introitus with cotton wool to keep it from running out.

Thus you see, common reasoning would lead us to believe that a woman would be much more likely to conceive in this position than any other, especially when we remember that the uterus is more patulous in this position than any other, and any occlusion from flexions would likely be relieved for the time being if there was no adhesion. Conception would still further be favored if she would retain the position for awhile after the completion of the act.

When the woman is lying on her back or standing, the uterus is in the position of an inverted bottle, and nothing but the penetrating power of the spermatozoa aided by the ciliary movements of the epithelium would enable them to enter it. I think if those childless couples would act on the above suggestions they might have their wishes gratified.

Newport, N. H. D. M. CURRIER, M.D.

Orgasm in Woman.

Editor MEDICAL WORLD:-This may be divided into two classes: healthy and neurotic. A neurotic woman will have orgasms from the most trivial causes: sudden shock, voluptuous thoughts, a conversation on sexual diseases, being kissed by a man, the penetration of the vagina by the physician's finger in an examination; even the thought of being examined. Usually all these conditions

are the natural product of selfabuse in the female. Such women may have a soft, flabby womb and cervix, or the womb and cervix may be swollen, indurated, and congested. Usually there is tenderness in both ovaries, but most intense in the left; the womb falls low in the vagina; leucorrhea is invariably present; frequently ulceration of the cervix, or it may be hard and ruff from titilation. The clitoris is redundant and intensly sensitiv, and the labii flabby and like bats' wings. Such a woman, in my opinion, cannot be impregnated. When a woman of this class has an orgasm, no perceptible changes take place in the erectile tissues, while in a healthy woman great changes occur in the parts in the process of the act of coition that leads up to and produces orgasm. There is a distinct increase in the size of the clitoris; the labii fill with blood, and are increast in size; the womb drops down in the vagina from three-quarters of an inch to an inch or more; the cervix increases in density, calibre and length; and the fundus and cervix become filled with arterial blood. These preparatory conditions are always present in a vigorous, healthy woman in the act of orgasm. When orgasm commences, or just prior to the act, there is a well markt mucous discharge in the vagina, the quantity being much greater in some women than in others. In the act of orgasm the constrictor muscles of the vagina contract and expand for a minute or more, and while this is taking place there is a distinct oscillating movement of the womb, the os usually gaping, so that the point of a No. 8 rubber male catheter could be inserted from a half to three-quarters of an inch. This is the whole act of orgasm in a healthy woman. Some healthy women never have an orgasm. frequently consulted by women who say their husbands are dissatisfied with them because of sexual inertia in the act of coition. These women live with their husbands without sexual desires; not infrequently they have large families, and during all their sexual life never know the pleasure of an orgasm. Therefore orgasm is not necessary to reproduction in the female. Often this class of women become intensely sexual after the menopause; the sexual appetite being very difficult to satisfy. The suggestion arises that this lack of sexual appetite in such cases is

I am

due to excessiv menstrual flow; and when that flow ceases, and there is, as a result, greater vascular tension, the sexual appetite suddenly develops. Suction by the womb in the act of orgasm would mean alternate muscular expansion and contraction; such contraction and expansion, as we all know, is not pleasurable, and the physical and anatomical condition of a healthy womb precludes any such phenomenon in orgasm. Orgasm is but a natural incentiv to fulfil the fixt law of procreation. Were it not for the prospectiv and real pleasure of sexual intercourse, men and women would not cohabit, would not marry; therefore, sexual appetite and that act are the irresistible forces that fill the gaps in human ranks caused by death. In the male, orgasm is necessary to procreation; in woman it breaks down the natural bars of passiv resistance, and thus makes her a willing partner in the act of reproduction. There are many conditions that in the female prevent procreation: acid secretion of the vagina and womb, ragged ulcers in and around the os, induration of the cervix, a split cervix (in woman a split cervix often prevents orgasm), caustic applied to the cervix until the natural smooth surface at the end is destroyed, congestion of the womb from any cause, too long a cervix, curvature of the cervix, a very short vagina, prolapse of bladder or womb, etc. Vaginismus after orgasm may expel all the semen by spasmodic muscular contraction; such women have usually an orgasm so intense that it is both painful and exhaustiv, and not infrequently the muscular spasms are fol lowed by nervous collapse that may last for several minutes. Only artificial impregnation will succeed in this class of cases, and the manipulations of the physician in the act of injecting semen into the womb must be so delicate as not to excite the slightest erotic desires on the part of his patient, for any condition approaching orgasm would result in expulsion_from the womb of the semen injected. I give you these experiences because I believe a part of them cover ground new to many of my brethren, and I beg of them not to overwhelm me with private letters. Let THE MEDICAL WORLD be our medium of communication. S. E. MCCULLY, M.D. Topeka, Kan.

Do your medical neighbors take THE WORLD? medical friends elsewhere take it?

Do your