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.2 ounces. .......ää 10 drams. .10 drams.

wahoo, Mandrake et bryonia...

Iodid potassa Oil wintergreen and oil sassafras àã ¦ ounce, dissolved in 8 ounces alcohol, the extracts added, and syrup enuf to make five pints.

I am not offering the above as a model "shotgun" prescription. God knows that it is, but it did the work it was created for, it knockt the use of the much advertised

nostrum higher than a kite. Not one bottle is sold now where a hundred were before, in fact I doubt if it can be purchased at all in the colony at the present time, where three years ago probably 800 bottles were consumed annually. To be sure there isn't a great deal of profit in the mixture that I sell; not more than a few hundred per cent., but by knocking that other fellow out I became and am "it." Go thou and do likewise. Whenever you suffer from such trash think close and deep and furnish the public with something better and cheaper and it will win.

"COUNTRY DOCTOR."

New Sweden, Maine.

Hemorrhage into the Pancreas. Editor MEDICAL WORLD:-In the May issue Dr. Bennette says: 66 'Saw patient that was suddenly seized with great abdominal pain which continued despite all treatment, and died in collapse few hours after," etc.

The severe local pain in the upper reigon of the abdomen (he does not mention nausea or vomiting), the great shock, the rapid and weak pulse with cyanotic condition, and death occurring in so short a time, in one who has been apparently perfectly healthy, points to hemorrhage into the pancreas, a condition that is beyond the reach of drugs, and the end is always fatal unless surgery can interE. ERSKINE, M.D.

vene.

Rogers City, Mich.

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Another peculiarity of this epidemic was the large number of males in which the disease" went down," as the laity term it. I saw at least fifteen cases that were thus afflicted. Presuming that my confreres saw as many cases as I did, we must have had at least 150 or more cases

of orchitis in the city.

Osler says: "One of the most remarkable features of the disease is a tendency to involvement of the testes. This most

frequently occurs after the affection of the salivary glands has subsided. * * * * Orchitis is rarely seen before puberty." The last two sentences agree with our experience the past winter. I have not seen any reasonable cause advocated by the authorities why the testes become affected. The old theory of taking cold is not tenable. I saw only one case in which both testes were involved. I have never seen a case in which the mammæ or ovaries were affected. Statistics quoted by the elder Flint leave us to infer that about 24 per cent. of the cases in men are affected with orchitis. Vogel cites an epidemic of mumps in Munich, in 1857, where there was only one case of orchitis in several hundred cases. The per cent. of orchitis in the epidemic just past was high: I think 15 per cent. would be a safe estimate.

The case referred to in the title of this paper is as follows: T. P. N., aged 16, came down with the mumps March 19both sides. He had several quite severe attacks of nose-bleed. Had several other cases that had nose-bleed. March 23 noticed first symptoms of orchitis-both sides. The morning of the 25th his father called at my office. I prescribed hyd. chlo. mit., tr. aconite and pulsatilla; locally, tr. opii., arnica and borolyptol, ad lib.; scrotum to be covered with hot flannels. Father said he was a little flighty, and had not slept well the previous night. I was called to see him at 7 p. m. of same

day; temp. 103°, pulse 100, tongue heavily coated; mind not clear. March 26, called at noon; pulse 80 and temperature normal. Orchitis much better. Had a good stool. His mind was completely unbalanced; in short, he had acute mania. Could discover no symptoms of brain or spinal trouble. Takes a very

little milk and water. Has no fever. As he had not past any urin for some time, I drew off 20 ounces with catheter. He had not slept any for thirty hours; was very restless, and talked incoherently. Gave him a hypodermic of morphin, gr., and atropia, 1 gr. Discontinued the aconite and pulsatilla; the local applications were continued twenty-four hours longer, when the orchitis had nearly subsided. The morphin had no effect except to increase his hallucinations. His father called in the evening to report. The patient's mind was still full of all sorts of vagaries. I gave him 20 grs. bromid and a couple of calomel tablets. He did not sleep at all, and was very delirious, until I was called at 3 a. m. He was better in every way except mentally; neither could he urinate. Used the catheter again and drew off 14 ounces. He had now been at least fifty hours without sleep; he is beginning to look exhausted; is wildly delirious. I decided to remain with him until he went to sleep. Gave him gr. hyoscyamin hypodermically, and a good dose of hyd. chlo. mit. In thirty minutes he was not so noisy; gave him 10 grs. chloral, and in thirty minutes repeated the chloral and hyoscyamin. He soon dropt into a sound sleep, and slept until 9 a. m., when he awoke for a few minutes, took a little water and then dropt to sleep again, sleeping altogether nine hours. When he awoke from this fine sleep his mind was greatly improved. Had two good stools during the day. He now took water and milk freely. I called again in the evening to draw his urin. I tested this for albumin, but found none. Ordered 10 grs. chloral at bed-time. He slept all night, and when I called in the morning to use the catheter, found him in fine condition. I now decided that his bladder trouble was due to an enlarged prostate, caused by the severe orchitis. For this I prescribed niter, sanmetto and hydrangea; also gave him a tonic of syr. hypophosphites. His father called in the evening; said his son was doing well but could not pass his urin. I gave him a catheter,

which he used all right. The catheter was returned next morning, as the patient voided his urin freely. He had a good night's rest and ate a good breakiast. Patient discharged March 30.

Thus we see that in this unusual case of mumps we had as complications a severe double orchitis, an acute mania and retention of urin, due to an enlarged prostate. We were all pleased to see him make a perfect and rapid recovery. His paternal grandfather always got delirious. when ill. His sister had a severe attack of puerperal insanity several years ago that continued several months. She made a good recovery and had a child since without any trouble. The family thus appears to be slightly neurotic.

In looking over my textbooks, I find that cases of acute mania following mumps is a very rare complication. L. R. MARKLEY, M.D.

Whatcom, Wash.

A Calf with Mumps.

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Editor MEDICAL WORLD:-Mrs. H., very intelligent woman, aged about thirty, wife of a farmer, and mother of two children, is my authority for the following:

Some time in January, 1901, she and both children had parotiditis, and every day she had to milk a cow with a calf only a few weeks old, which she declares had a genuin case of mumps. She says that while milking, the calf would suck from the opposit side of the cow, and by inhaling her feverish breath and taking hold of teats she had milkt with feverish hands, its jaws swelled, and when it would try to suck its jaws would become set and it would utter a pitful bleat and let go of the teat and not try to suck again. She says it was very feverish, and after a few days got well. She firmly believes the calf had as true a case of mumps as she and the children had.

Now, how many of the WORLD "family" think this possible? I'm sure if you could hear Mrs. H. tell of it, you would take off your hat and scratch your head and think some. I have interviewed all the authors at my command, viz: Bartholow, Osler, Strumpell, Hartshorne, Smith's Diseases of Children, American Textbook on the Diseases of Children, and can not find anything on the subject except both works on Diseases of Children say that Pasteur and others have tried to inoculate dogs, rabbits, and guinea pigs

with the microbe of mumps, but all attempts were fruitless. Now, is there not a good lesson right here? Perhaps our investigating brothers would do well to experiment on the cow and horse families more. While I know it is claimed that cats will have diphtheria, a rabid dog inoculate the human, etc., we all know that the human can be inoculated with cow pox from the cow or horse; also anthrax and glanders. If the human is subject to diseases of the cow and horse, why should not the cow and horse be subject to some diseases of the human family?

I firmly believe that the germs of diphtheria, scarlatina, etc., are carried and communicated in the fur of dogs, cats, and other pets; and those of typhoid by our common house fly. I have seen the English sparrow carry to its nest in the spouting of a house, rags and bits of paper from a poorly constructed privy; also pieces of cotton carelessly tost thru an open window after being used to cleanse a syphilitic ulcer. This is one means of polluting drinking water with the germs of typhoid, dysentery, cholera, and the Lord only knows what else. But I am digressing. Can a calf have mumps? This is the puzzle to me now. FRANK KERR.

Bucyrus, Kansas.

Method of Performing Circumcision. Editor MEDICAL WORLD:-As I get so much good out of THE WORLD, and recollecting that someone askt the best way to perform circumcision, I will just tell how I do it. I first cleanse the member with warm soda water both outside and inside of the prepuce. Next I apply a cord close up to symphysis pubis around the penis. I next balloon the prepuce with a ten per cent. solution of cocain, letting it remain ten minutes. During this time I inject a five-per cent. solution in four places just behind where I expect to cut on top, bottom and on each side, having two needles ready threaded with silk thread and oiled with vaseline. I then insert the index finger of my left hand down well into the foreskin, opening it up well. Catching the mucus lining and skin well between my finger and thumb, I stretch it out, thrust a needle with thread down from top to bottom between the caput and my finger and the glans penis, and pull it thru long enuf to make two stitches. I then thrust the other needle thru from side to side. Then my assistant catches the threads

and pulls them back, and I cut off the foreskin between my finger and the head of the penis. I catch my threads on the inside and cut and pull them thru; cut and tie the four stitches, which hold the skin and mucous membrane nicely together; then I only have to make two more stitches and the work is done. After stopping hemorrhage with hot water, I dress with a salve made of vaseline, one ounce, sulfate morphin, five grains, oil of peppermint, one dram. I remove stitches on the fifth day. Have it washt with warm water, to which I add two drams of listerine once a day. I never use any other kind of dressing. My patients are generally well by the sixteenth day. They never stop work; just wear loose pants. Success to my old and tried friend, THE WORLD. M. S. MOORE, M.D.

Florence, Ark.

Cure of Contracted Prepuce Without Circumcision. Cure for Warts.

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Editor MEDICAL WORLD: Several months ago I wrote to your journal, giving a new method of treatment for pinhole prepuce instead of circumcision. My method was to drop in a few drops of a 4 per cent. solution of cocain, then bend two probes within inch of their extremities into hooks, then insert them and stretch the prepuce thoroly (which is easily done) and then retract the prepuce over the glans penis, cleanse well, and replace it again. This should be repeated every day or two; it will obviate the necessity of circumcision.

A few months after this another physician wrote precisely the same treatment, but did not give me any credit for the discovery. He may have overlookt my paper, but at any rate, I am entitled to priority of publication, if not of discovery.

Also the use of castor oil for warts was my discovery. I publisht the fact in the Columbus Medical Journal in 1882 or 1883. It should be applied locally for a few weeks. It is a sure cure if faithfully applied. S. C. DUмм, M.D.

Columbus, Ohio.

Congenital Syphilis.

Editor MEDICAL WORLD:-In regard to the case of the girl (page 199, May WORLD) now nine years of age, who had bronchitis at two, and who is unable to learn to read or write, I beg to say that the most important fact is not stated i. e. her mental condition

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Liq. kal. arsenit ..... Hydrarg. chlor. mite.

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M. S.-Three times a day after meals. In this connection I wish to report the following case: Boy, aged twelve, had pneumonia at eight. Previous to that time he had attended school and had been like other boys. Upon recovery from pneumonia his hearing began to fail, until when called to the writer's attention he was absolutely without hearing. Examination of ears showed normal drum membranes, bone conduction normal, and aerial conduction negativ. Teeth suspicious but not positiv.

Eyes O. D. O. S. . Keratitis. Diagnosis, disease of auditory nerve, probably specific. Treatment:

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Whooping Cough.

Editor MEDICAL WORLD:-We have been having an epidemic of whooping cough in our locality. Having treated a great many cases of said disease I thought it might be of some interest to some one of the family of WORLD readers to give my experience with said disease. Having been taught by the text books that whooping cough is a self-limited disease which must run a certain course regardless of medical treatment, and believing that the authors knew enuf not to be mistaken, I was, at first, loth to be concerned with a disease which could not be influenced by medical treatment. The first cases I saw did not come under my care for treatment until they had reacht the spasmodic stage. But the epidemic proving to be a severe one, the people became aroused to the importance of securing medical attention as early as possible, and so I had the opportunity of testing the different plans of treatment during the catarrhal stage. I wish to say here that, in my opinion, it is only during this stage that we can hope to abort the malady. And my treatment during this stage proving so gratifying to me, is my excuse for writing this article. I aborted every case that came under my care during the catarrhal stage. My treatment for this stage was as follows: I gave calcium sulfid to saturation, then continued in less amount so as to keep up the effect. I also gave hyoscyamin, atropin and strychnin in sufficient amount to keep up a constant effect. In no case which came under my care did this treatment fail to cut short the disease before it reached the spasmodic or whooping stage. No case which was allowed to progress until it had reacht the spasmodic stage did I succeed in checking. The treatment after this is merely palliative, and I believe I obtained the best results with small and oft repeated doses of chlorid of ammonium, sweet spirits of nitre and glycerin in solution.

This about constitutes my treatment, or that which has proved most satisfactory in my hands. Of course, complications very often arise which require modification of any plan of routine treatment, but I have sufficiently indicated, in the above, my plan of treatment in uncomplicated DR. W. J. SEAL.

cases.

Clinch, Tenn.

Can you get us a new subscriber? Will you do so? Our circulation would be doubled if every reader would do this.

Pneumonia with Erratic Temperature. Editor MEDICAL WORLD:-I wish to report a case that has been very interesting and at the same time puzzling to me. Was called about 4 p.m., on March 22, to see H. B., aged 9 years. Previous health good. One aunt on mother's side and an aunt and uncle on father's side died of phthisis.

Patient had had a slight chill at 1 a.m. the day I was called At time of my visit found a temperature of 1043°, pulse 136, respiration 40; slight cough, no expectoration, no headache or pain. Examination of the chest revealed an engorgement of lower lobe of right lung, breath sounds diminisht, bronchial breathing, but no rales. Diagnosis, acute lobar pneumonia.

Treatment consisted of a laxativ, an expectorant mixture, bathing and aconite for fever; also put on a pneumonia jacket. When I called the next morning, found a temperature of 1013, pulse 120, respiration 40. Appetite good, but limited to a milk diet. Treatment continued. He went on in this way for a few days, his temperature running from 99° to 102° until March 28, the seventh day of the disease. On this day his temperature at 9.30 a.m. was 10030. At 1.30 p.m. it had run up to 104°. pulse 120, respiration 38. Now here comes the puzzling part, and I will give the morning and afternoon temperature of each 24 hours for the next few days. The temperature was taken entirely in the rectum.

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On the 8th, 9th, 10th and 11th it was normal all day.

All this time the pulse and respiration kept pace with the temperature. He had a slight cough, some mucoid expectoration, slept well and had a good appetite, if we had allowed him to eat. He showed considerable emaciation, but no dejected countenance. His tongue was clean, and after the initial chill he had no more. There was slight sweating after the fever went down. The physical signs remained the same as at first until the temperature stayed down, when the dulness gradually

disappeared and the breath sounds became normal. Quinin seemed to have no effect on the temperature, altho I had him up to 10 grains a day for several days. In fact when I stopt the quinin his temperature began to stay down. I could discover no typhoid symptoms at any time.

Now was this a case of delayed resolution, or something else? What was the cause of such an erratic temperature? At one time I was about ready to say phthisis; but the boy is now well and gaining flesh. I would like very much to have opinions on this case.

Prince Bay, N. Y. E. N. SPARKS, M.D.

In regard to Dr. Waugh's remark that the art of prolonging life is still an unoccupied field, Dr. Geo. B. Kline, of Sligo, Pa., writes that this art consists in diet and the use of distilled water-proper diet in kind and quantity to avoid the tendency to concretions, and distilled water to dissolve concretions and prevent their forming. The exact balance of diet to precisely supply the needs, with variations for different seasons, climates, etc., is a thing difficult to attain. The drinking of distilled water to maintain health and dissolve concretions has frequently been advocated, but it has never proven successful. It seems to make the throat dry, and in its hunger for salines, it robs the coats of the stomach of these constituents. Hence distilled water, even tho it be "aerated," has never succeeded as a drinking water.

The above was submitted to Dr. Waugh, who writes as follows:

- In

Dr. C. F. TAYLOR; Dear Doctor: regard to this interesting item I agree with the latter part. I am not in favor of distilled water, nor of sterilized milk or other patent-processed foods prepared under the idea of depriving them of living microorganisms. The fact that the human race has existed for an indeterminate period and has been fruitful, increast and multiplied, covering the earth to a very tolerable degree on the use of foods and drinks which were not deprived of microbic elements, shows at least that the latter are not necessarily fatal. Moreover there are conditions connected with the maintenance of vitality in the human being which are by no means to be disregarded. There are elements beyond which science has not gone and probably will never go. In fact recent observations

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