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Determination of Sex.

Editor MEDICAL WORLD:-That certain questions will continue to interest man. kind so long as they remain actually unsolved need hardly be asserted. Just how much good may be derived from discussions as to the determination of sex remains an unknown quantity. From men devoted to the science of life these theories may be productiv of good; not that they will ever bear fruit, for nature laughs at some of our efforts, and I have no doubt she indulges in wide smiles when attempts are made to fix things beforehand; but these discussions are instructiv. I claim no originality in what views I shall attempt to bring to your notice on the subject, but do claim to have reasoned and studied to support these views. Believing that the smaller lights often penetrate where the larger ones only cast shadows at times, I beg to differ from Dr. Waugh, feeling that the difference of opinion will furnish something of interest, even if amusement be afforded.

We know that to continue the race of men or animals, males and females must be created; and when we leave the idea of an allwise Creator actually directing min's efforts, holding him in the hollow of his hand, controling his destiny, and seek for more specific causes in nature, I take pleasure in defending a theory, until I am convinced it can almost be called a fact, easily asserted, safe to promulgate, scientific as any, but alas, difficult to put in practise when thought to be needed, for it is simply the workings of nature, and you know that nature is jealous.

The true determination of sex is the sexual power of the male or female at the time of coitus. If on sexual intercourse the male assert his strength and power as a man, fully throwing his whole strength and soul in the act, and the woman is not his equal as to sexual enjoyment and power, the result of the engagement will be a male child. Note that few men acknowledge any weakness sexually except to the doctor, and few women will admit even to the doctor that they have much or any desire for sexual intercourse. How triumphant the air of the man, be he educated or ignorant, when his wife presents him with an heir; there is a feeling that as a father he has acquitted himself well.

Observe the explanations when the first born is a daughter, the reply being that it takes a man to beget a girl, a girl much

preferred, etc. The father of boys seems to think that no explanations are necessary, for he has fully displayed his manhood, and perhaps growing careless, daughters follow.

Of the illegitimate children born, the majority are boys; why? The reason is plain enuf. At the time of the sinning there is less remorse in the conscience of the man; he is the aggressor nine times out of ten, hence he controls the sex.

That a man is apparently weakly is no evidence of his sexual power being frail; rather the reverse. A large, handsome woman can be easily swayed and overcome by a pocket edition of a man; again, a large, handsome, healthy man may be so careful of a small, delicate woman that at the time of creation he may find more life in the precious little parcel than was ever dreamed of.

The African warrior tale only supports my theory; these warriors when making an attack are in the best of condition, elated by victory, maddened by blood; they are at their best or worst sexually; the women are frightened and terrorstricken; no wonder that the result of such intercourse is boys; the man is the power, the woman no heart to produce daughters.

The master and slave problem is much easier. These haughty Arabs cared little for the slave women; they had entire control, and with a little kindness to a woman favored, who being of lower intelligence, no doubt surrendered herself willingly, and she really governed the sex.

As to the Schenk theory, sugar is a heating food; possibly it stimulates the female, causing her to assert her animal passions more than she would without it; the same results again. I have been informed that sugar and fats are favorit diets for the harem; and it may also be noted that the births of sons are events of joy, showing that there must be many daughters born in these places of pleasure.

Old men are successful in the begetting of boys; this is not so much from their power sexually as it is to the natural repugnance a fresh blooming girl feels when joined sexually to an aged man. She can respect him as a father, or dread him as a Satyr; feel toward him as a lover, never.

When animals are mentioned, the facts remain the same. If a well bred stallion continuously serve mare after mare, there will be quite a crop of mares; but let him

perform his part reasonably, and there will be a division. In the case of manufacturing mules the same applies; the Jack is played for all he is worth; result, large consignments of mare mules, which by the way is fortunate for they are greatly in demand.

I regret that I have no remedy to offer to those parents who are not happy over the way nature arranges these matters. If one family has a large crop of boys, another family is blest with the sweetest, and dearest of all things, a nice lot of girls; so no remedy is needed after all. Atlanta, Ga. M. T. SALTER.

A Report of Three Cases of Surgical Abscess Successfully Treated With the Aspirator. Editor MEDICAL WORLD:-Case 1. A two-year-old child, white, healthy parentage, fell or rolled down the flight of front doorsteps, bruising left hip so severely as to cause a large abscess to form in region of hip joint. Inflammation consequent upon the development of abscess produced a low, continued form of fever, diagnosed and treated as typhoid by an eclectic for three or four weeks prior to my first visit to patient. After careful physical examination taken with history of case, I diagnosed abscess of hip. Patient's condition was such that I did not feel warranted in treating it by the open method. Aspirated and drew off one pint of thin, sanguinous pus. In one week pus sac had refilled. Aspirated again, and afterward injected tr. iodin sol. 5 per cent.; left about 2 ounces of iodin sol. in sac. Result, abscess healed rapidly and child was walking around the house with good limb in ten days. Has remained well ever since-ten years ago. Internal treatment, supporting.

Case 2. Mulatto girl, 11 years old, scrofulous diathesis; small for age. For six weeks before I saw patient at her home in the country she had complained of severe pains in right femur, in middle third. On inspection, found right limb enlarged onethird, between the knee and hip; more bulging on outward surface. Could not make out any pus formation at this time. Temperature range 100 to 1024; highest in afternoon. Patient was placed on nutritious diet, tonics and digestives; poulticing applied to inflamed limb over swelling. Six days after my visit, patient was brought in from the country on a mattress, in a wagon, to my office. Pus

was detected in middle third of thigh, on outer aspect very deep. Diagnosed scrofu. lous periostitis. Aspirating needle was introduced, deep down, quite to bone, and drew off two ounces of pus. Injected tr. iodin gtts v, carbolic acid and gum camphor each gr. v, in oil. Manipulated the pus sac well, but tenderly, after injecting the above. Sent patient home. Was brought back to me on crutches in two weeks. Some reformation of pus in same cavity. Aspirated again and injected twice as much of the above-mentioned oily preparation. Result, permanent cure now, after four years.

Case 3. Pelvic abscess in left groin, in region of left ovary, in colored woman, married but no children. Sick for four weeks previous to my first visit. Introduced aspirating needle cautiously thru abdominal wall into peritoneal cavity; pus flowed to the amount of three ounces; very foul smelling and thick; could not empty sac entirely owing to the extreme thickness of pus preventing flow thru needle. One week afterward sac had refilled tight; threatened rupture thru abdominal wall. Aspirated again, this time drawing off some six ounces of very foul smelling pus. Injected the following:

Tr. iodin.
Fomaldehyde.
Glycerin

3ij
gtt. x

3vi

Aquae

q. s. Zij

M. Ft. sol. Sig.-Inject three ounces. Removed most of this by aspiration, after allowing it to remain for five minutes in sac. Did not manipulate at all. No reformation; fever left and patient began eating heartily the next day after operation, and felt well enuf to get up in a week afterward.

Care should always be observed not to allow air to enter pus cavity. These cases had the most unsalubrious surroundings, and surgical intervention by approved methods would have been impracticable. W. P. RUSHIN. Albany, Ga.

Treatment of Tonsilitis.

Editor MEDICAL WORLD:-I was particularly interested in the treatment for tonsilitis given in the May WORLD by Dr. W. E. Johnson and also that given by Dr. Collins (pages 187 and 188). I had a case this spring that I took more than a common interest in. It was one of the slowly developing boggy types of this

trouble, with intense swelling of tonsil and the posterior part of mouth, and also externally extending from the ear downward. After trying nearly every remedy thought of, I began painting the tonsil with tincture belladonna every two hours, and applied the ice-bag to the outside, leaving it on for two hours with intermissions of three hours, and cured the case in twenty-four hours. I don't know that this treatment will answer for all cases. I am certainly encouraged to use it further. Redwood, N. Y. E. E. EDDY, M.D.

Treatment of Inebriety.

Editor MEDICAL WORLD:-I have been interested in noting what physicians have to say in your journal with reference to inebriety and its treatment. Experience has taught me that inebriety is a disease. We may quibble over technical terms and split straws over the precise definition of appetite, desire and habit, but the fact remains that the confirmed liquor drinker is not like other men. He is not in complete health. He is the victim of an abnormal diseased craving, so fixt, so strong, that despite tears, prayers, curses, resolutions and even prison bars, he will indulge and go on to utter ruin, unless it is checkt or removed. This may not constitute a disease, but it is a very real condition, and the cause of much suffering and pain to the victim, to say nothing of the sorrow and anguish of those to whom he is both near and dear.

Personally, I am opposed to the free use of the hypodermic needle in the treatment of inebriety. After careful investigation, I have satisfied myself that this method is responsible for nearly all the "lapses" following treatment in the institutes or drink cure establishments. The nervous system is keyed up to the highest limit by the constant succession of needle shocks; little wonder that the patient misses the stimulus of the" shot," and seeks to satisfy its loss by indulgence in alcoholics. The sudden withdrawal of the needle treatment and the sending of the patient out into the world without support, medical or otherwise, is fraught with danger. The man feels helpless, lost; and, unless aid is forthcoming to tide him over the period. in which nature seeks to restore the system to normal tone, he is bound to fall.

My method of treatment is entirely different: I use a preparation composed ng fluid extract of cinchona rubra,

concentrated extract avena sativa, strychnin nitras and tincture capsicum, eight ounces of the first, adding the others as indicated with reference to age, temperament, dosage, toleration of the different drugs, etc. In the past fifteen months I have treated 221 cases, with but three failures reported; the first misunderstood the directions but was afterward set right; the second pretended to take the medicin but threw it away instead, and the third looks at present writing like a real failure.

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Many physicians have written "sassy letters to me because of my failure to furnish them with what they style an "exact formula." It is hard to make physicians understand the point made clear by Dr. De Nike in your March number, to wit: "It is a difficult thing to give a full detail of any treatment, as the cases met with are so different," etc. This is very true. For instance, one patient tolerates with ease grain strychnin four or five times a day; another flies off at a tangent on 1th grain; one man can stand 30 gtts. avena sativa three times a day, and the next one becomes intensely nervous on one-half that quantity; and one old drunkard takes 20 drops tincture capsicum to the dose without blinking, while the stomach of the recent drinker revolts at 3 drops. To be successful in the treatment of inebriety requires a wide knowledge of human nature, a nice discrimination in the handling of men and a keen sense in the application of remedies to the individual.

The first step must, of necessity, be the checking of the desire for drink, otherwise we have a more or less intoxicated patient on our hands in the early stages of treatment. This is something I never allow. Absolute withdrawal of alcoholics is my rule. By the frequent use of the remedy, say a dram every three hours for four or five days, the appetite or desire for drink is gradually, yet surely overcome, whether the patient be a new or an old drinker. The cinchona is a powerful anti-alcoholic, as well as a superb tonic; strychnin, in modified dosage, serves as a nerve stimulant; avena sativa is a nerve feeder as well as a sedative; capsicum quickens the blood, tones up the stomach, relieves drink-crave; the whole blended form the, to me, ideal mixture for the cure of inebriety. In early treatment intense thirst is created; I advise the free use of cold water, the natural, the perfect elim

inant of the alcoholic taint. The night befor beginning treatment free catharsis is induced by the use of Epsom or Rochelle salts; this course is pursued every third night for the first three weeks. In addition, a sponge bath, tepid water, tri-weekly or oftener, as indicated; regular hours for retiring as well as rising; graded out-door exercise, nourishing foods, and the process of support as well as elimination is kept up along absolutely rational as well as scientific lines. At times unforeseen conditions arise; then comes auxiliary medical treatment of course. In such cases no hard and fast rule can be laid down; each patient is different, in a measure, from the other-the doctor on the spot is the best judge as to what to do.

The preparation of the base of my remedy (cinchona rubra) requires a deal of care. It takes five days' time, and the product is a peculiar syrupy mixture; physicians who have witnessed the operation understand my method clearly, but it is difficult to make it plain in print. One thing is certain it is entirely different from the solutions put forth by the chemist; and it must be made just right to prove effectiv. The commercial preparations will not serve at all. This may sound odd, but it is true. Many physicians trust me to compound the remedy for their use, and in such cases meet with the same success which attends its admin

istration at my hands here in Newbury

port.

With my treatment there is no shock, physical, mental, or otherwise. I use no laxativs other than Epsom or Rochelle salts. No change is made in the food or manner of living. If need be, the patient is at liberty to continue his regular employment. The first step is the checking of the desire for drink; then follows the elimination of the alcoholic taint, the system being supported and strengthened meanwhile along rational and scientific lines. The desire for drink is lost on or

about the fourth day. In a week the patient begins to feel like himself; after that the change is rapid and most gratifying. The moment the craving for drink is at an end, hope revives; confidence is establisht; the haunting terror of the past has vanisht; the future is sunlit. As the man comes back to normal health, the dose is gradually reduced so that, when treatment is brought to a close, he has not only outgrown the use of drink, but the use

of the medicin also.

In a word, he leaves my hands healthy and free. This, it seems to me, embraces the only safe and sensible way to treat the drink habit.

I do not use, nor do I advise the use of liquor while the patient is undergoing treatment. Absolute withdrawal of alcoholics is my rule. In certain drink cure establishments patients are urged to take liquor, whereupon the physician in charge injects a drug antagonistic to it. The patient is made sick and is led to believe that the medicin is "working," whereas he has been made the victim of deception. This is unfair. It builds up false hopes of a cure; leaves the poor fellow with naught save a broken staff to lean upon. Some urge patients to test themselves after going away by tasting liquor. I tell them to let it alone. Having been made immune against snake bite, there is no sense in playing with rattlesnakes. There is less sense in toying with liquor. The saloon is a den, and alcohol a serpent that stings to death. Be thankful that you have been rendered immune against drink and give the saloon a wide berth. CHAS. W. HIDden. Newburyport, Mass.

The Editor wrote the Doctor for details

in making his fl. ext. cinchona rubra. His reply was as follows:

Dear Doctor:-I make the cinchona

by percolation, using the ground bark

must be watcht with care, for just on the turn, if such phrase be allowed, the fluid comes forth in the form which, experience has taught me, will alone serve the purpose; becomes gelatinous, causing a loss of the least carelessness and the mass

odd moments for a period covering six time and I workt at odd moments for a period covering six years before I hit the right combination. This has an odd sound, I know, but it is true for all that. It is simply an instance in which the painstaking originator is able to produce qualities unknown or overlookt in the hurry of commercialism. CHARLES W. HIDDEN.

[Yes, this has an "odd sound," and it also smacks of "commercialism." It seems that the fl. ext. cinchona rub. is a menstruum for the other remedies, which vary so widely in dose. It is difficult to see, then, why the fl. ext. cinchon. rub. should necessarily be made by Dr. Chas. W. Hidden, of Newburyport, Mass.-ED.]

Treatment of Cancer.

Editor MEDICAL WORLD:-Having had pretty sad experience in the treatment of an epithelioma on my ear, owing to conflicting ideas in the profession respecting best treatment, I am now ready to second Doctor A. R. Robison's recent utterances on this most vital question. Doctor Robison (professor of dermatology in the New York Polyclinic) in a recent paper says that in a majority of cases coming under the observation of the surgeon, a well chosen and thoroly applied caustic treatment yields better results than the knife; that in a certain number of cases the knife is the proper agent; that in a few cases the knife followed immediately afterward by a caustic should be used; and finally that some cases were best treated by the curette, followed immediately afterward by a caustic.

Doctor Robison bases his claim for the superiority of the caustic method on the belief that caustics, when well chosen and carefully applied, cause an acute inflammation destroying pathological tissue lying in the lymph spaces outside the general necrosive action of the caustic; and second, that arsenic has a specially selective antagonistic action on cancerous epithelia.

Acting on this conviction, after many years' experience in the New York Cancer Hospital, the Doctor unreservedly says: First, at present we know of no drug, animal extract, serum, or toxin which, given internally, by any avenue of the body, can be relied upon for the cure of cancer of any part of the system.

Second. That the statement the knife is the only reliable agent in the treatment of cancer is not correct.

Third. That caustics judiciously chosen and properly applied may attack deposits of the growth inaccessible to the knife, and in these cases should be employed even if the knife is necessary to prepare the way for their use.

Fourth. That in some cases both the knife and caustics should be used, and in some other cases curetage followed by caustics is the proper procedure.

Fifth. That the majority of cases of cutaneous cancer can be removed with the greatest certainty and the least deformity by caustics, provided they are appliedbefore the lymphatic glands are invaded.

Sixth. That the knife should be used when the lymphatic glands are invaded,

and also in some other cases of external cancer.

It is well to note that he gives preference to arsenious acid with gum arabic, and cocain to prevent pain, and that Doctor Robison's address is 248 West 42d street, New York. JAS. H. CRAIN. Beechwood, Ill.

The Way to “Knock Out" a Nostrum. Editor MEDICAL WORLD:-From 1895 to 1898 I publisht in a local medical journal, Therapeutics of a Country Doctor, to the pecuniary benefit of the publishers and to those who reprinted it, but without adding anything in the line of shekels or other profit to myself as far as I could see; therefore I 66 swore off" on professional writing except for profit for myself. Still it is almost impossible to read a copy of THE WORLD without my fingers beginning to itch for a chance to reply to some of the many bright minds that appear in that forum every month. On page 177-78 of the May number an article by Dr. Dahlstedt reminds me that I have been up against that same nostrum that he complains of, and best of all, I have downed it! This mixture is advertised in various foreign languages, and it seems to have a particularly strong hold on people from the Scandinavian countries. There is nothing wonderful about the remedy; it is a mixture of mandrake and various vegetable alterants, perhaps with very small doses of pot. iod. in it. It is probably a good physic, laxativ I mean, and alterativ. By stimulating the liver of the first case the doctor reports, it undoubtedly helpt to a reasonable cure, for an active liver remedy was just what was needed and should have been thought of by the attending physicians before.

Now, let me tell my own experience with this nostrum. Dr. D. is a Scandinavian and probably practises among that class of people. So am I, and I know how infatuated they are with that much-advertised remedy. Some years ago when I started practising in this colony I was told that if I could succeed in knocking out that remedy I would double the regular practise. I did it, but not in the way that most physicians would have done, by running it down and throwing ridicule on it. Not at all. I simply put up a similar mixture that I knew was good, sold it to all who would rather invest in ready-made

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