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A Case of Cancrum Oris, with Treatment. Recovery After Extensiv Loss of Tissue. Editor MEDICAL WORLD:-I was called to see Hattie N., aged about 2 years, and got the following history: The child had suffered more or less for six months with an aggravated sore mouth, diagnosed stomatitis by the physicians who had seen her. She is the offspring of healthy parents, and has five brothers and sisters, all of whom are in a remarkably healthy condition; was born in the country with salubrious surroundings, where diseases of a malignant character are seldom encountered. Up to the present time the child had not been subjected to any of the epidemic troables peculiar to children; in fact, had undergone no sickness whatever. An examination of the mouth revealed a ragged slufing surface extending over gums of left half of inferior maxilla and mucous membrane of lip, covered with a sanious discharge emitting a fetid and peculiar odor. The external surface of lip presented a livid, glazed aspect which in about twenty-four hours thereafter resolved into a black, gangrenous circumscribed area the size of a silver quarter of a dollar. Realizing that I had a formidable trouble to deal with, I resorted to heroic measures, which consisted of dividing, with scissors, the diseased tissue (following the line of demarcation from the healthy) and applying lunar caustic freely to the entire surface remaining, using frequent ablutions of peroxid of hydrogen, and applying iodoform with balsam Peru. The internal treatment consisted principaly of iron and port wine, with the best available diet, accompanied with improved hygienic surroundings. The disease yielded for a time to this treatment, but after a time renewed evidence of the trouble was exhibited, causing me to despair of the life of the patient The left half of the submaxillary bone and left cheek were involved. I succeeded again, however, in arresting the progress of the disease, by dividing and removing the entire left half of the submaxillary bone, including, of course, teeth and alveolar processes, which was done more readily than I imagined; in consequence of the uniform progress in degeneration of the bone and adjacent tissues, the sequestrum became detacht. At this stage the progress of the disease was arrested and completely eradicated. There was vast hemorrhage during operativ proce

dure, jeopardizing the life of the patient. Several years having past, with no return of the symptoms, I am constrained to believe the patient entirely free from further trouble from the disease. No visible marks are left except a small cicatrix on lip, which would not be noticed by a casual observer. The child has since had whooping cough, measles, etc., followed by no untoward symptoms. I report the foregoing case on account of the rareness of recovery in such cases, and the particular rareness of the disease in this section of the country. Would like to know if cases of the nature of the above are often met with outside of large and crowded cities, or districts where many are thrown together. The above case occurred in a town of less than 7,000 population.

Rock Hill, S. C.

T. L. CORNWELll,

Death from Placenta Previa.

M.D.

The

Editor MEDICAL WORLD:-Mrs. R., aged twenty-nine, eight months pregnant, and the mother of one child nine years old, was taken with labor pains on Friday April 5, 1901, and sent for Dr. S. Doctor responded and on Saturday night told the family to have everything in readiness as the child would surely be born that night. She continued in pain and on the following Monday afternoon the Doctor came to my office and requested me to administer ether to the woman, as it was a case of placenta previa centralis. I accompanied him to the house and witnest a sad picture, a young woman with a death-like pallor, nails and lips cyanosed, pulseless at wrist, heart sound inaudible. Dr. S., removed the tampons which emitted a very disagreeable odor, and gave the woman a warm carbolized douche while I disinfected my hands. I made a vaginal examination and confirmed the Doctor's diagnosis. I found the parts hot, dry, sore and swollen; the os completely dilated and very patulous: the placenta detacht as far as I could map out. Dr. S., informed me that the line of treatment previously pursued was the relieving of pain, detaching the placenta with his fingers, and tamponing vagina. I knew we were confronted with a grave case. I thought of the case I reported in the March WORLD of 1900. Unfortunately I did not think this one would terminate so happily. We were alone with the woman and I askt the

Doctor to request one of the friends to remain in the room until everything was over. After making preparations to combat hemorrhage, shock, etc., I put the woman under ether as far as the primary stage and askt Dr. S. to proceed, as I was afraid to put the woman thoroly under the drug. He then performed internal podalic version and was extracting the child when the woman rolled up her eyes, gave a few gasps for breath, and yielded up all that was mortal. We did all in our power to revive her, but it was of no avail. The operation took only a few minutes and she lost very little blood while operating. It may be she had none to lose. This was one of the saddest cases I ever saw. Just a few moments before the young husband was hopeful; now his wife lay cold in death. What could have been more sad? I shall never forget this case. God knows I never want to meet a similar case. I report it and ask criticism. When reading the medical journals and noting the wonderful things accomplisht by some, I often think how anxious we are to record our successes, and reluctant to write anything about our failures. It is the obstacles we meet that make us better, wiser men. By the way Dr. S. has been practising about eleven years, and claims to have delivered over two thousand women. What country Doctor can hold a candle to that? H. O. LIGHTNER.

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Editor MEDICAL WORLD: Widow, blond, gray eyes, aged 34 years, one child, 8 years; teacher of needle-work in woman's training school, the picture of good health, headache periodical, coming on once a week and lasting twenty-four hours. The following is her own description of it: "The pain usually begins in the right temple and thru and above the right eye. The worst pain to bear is a kind of thrill or tremble, but that is not all the time. Another feeling is as tho someone had hit me a hard blow on the temple and the little finger had struck the eyeball. Sometimes pain begins on left side, but not often. To lie down makes it worse. Hot or cold applications make it worse. 'Headache powders' have effect. Sometimes a bandage gives a little relief,

no

but not always.
has relieved some.
is not sore to touch. Rubbing feels good,
but pain returns as soon as rubbing is
stopt. Gas comes from stomach a little,
but food and liquids do not seem to aggra-
vate. Have to urinate oftener than usual
when head is aching. Appetite good.
Can usually sleep at night, but am con-
scious of pain the last thing before going
to sleep, and the first thing on waking.
Heat from sun makes it worse. Bad air
makes it much worse. A headache coming
on in the afternoon is very bad in the
early evening and again at noon the next
day."

Soaking feet in hot water
Head feels sore, but

This is her description of a headache which has afflicted her for two years and more; and for which she has had all kinds of treatment, including allopathic, homeopathic, hydropathic (at the "Eureka Spring," Ark.), osteopathic and, I believe, Christian science; but none gave the slightest relief. She said they were getting worse as time goes by and that after getting thru with one she feels that she "just can not stand another."

She

I have been treating her since the 18th of March, but have seen her but once during the time of headache. Then I noticed. the pupils of both eyes were much dilated, a fact which no one else had noticed. is wearing glasses prescribed by one of our popular oculists, with the hope of giving the relief so long sought for at the apothecary shop and the doctor's office. I find nothing wrong with the urin unless it be an over amount of urea. given the homeopathic remedy glonoin without results; am now giving belladonna 6x (began with 3x); under this she has mist one attack and thinks "the spells may be a little lighter."

Have

I have treated, and do now treat, many headaches and have usually been successful in curing them; but this one baffles me, and I now seek counsel from the many readers of THE WORLD to which I am a new subscriber.

In return for some of the many good things that I have received from "THE WORLD Family" I will offer the following formula for a hand lotion. It is the best I have ever used:

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will cleanse his hands thoroly with sapolio, hot water and hand brush, then rinse off with a light bland soap suds and apply the above he need not be ashamed of his hands. DAVID R. OVERMAN,

4948 Maple Ave.,

St. Louis, Mo.

[Doctor, many stubborn headaches are rheumatic. It might be worth while to try anti-rheumatic treatment.-ED.]

Work for Better Health Laws.-The "Pay Doctor."

Editor MEDICAL WORLD:-On page 211, June WORLD, is an editorial giving good advice to doctors on political matters, and telling how to cure the nostrum evil. It is much to be regretted that so few physicians take any interest in legislation relating to medicin and to public health. Some years ago Lieut.-Governor Woodruff, in his speech before the New York Medical Society, said: "The medical profession should endeavor to draw near the executiv and legislators. Much that the profession wants could be easily gained if physicians of the state exercised that tact and energy displayed by politicians." In 1899 the president of the Mississippi State Medical Association said in his address: "Foreign chemicals and medicins should not be patented under any circumstances; and we should never cease to labor in season and out of season until the law is so changed as to require the formula on the label of every patent medicin." If we as individuals and in the medical societies would speak out for a law of this kind, and work as politicians, as suggested by THE WORLD and by Lieut.Governor Woodruff, there is no doubt but that we would succeed. If the law of the National government (it could not be done by the states) required the formulas of all medicins now secret, printed on the label, many thousands of dollars would be saved to the sick and needy. Very few patent medicins would be used. People would learn that nearly all the so called liver pills, pellets, tablets, etc., are made of the cheapest quality of aloes. Thousands of good people who have used patent nostrums would feel like kicking themselves for being so simple. It would be one of the greatest boons to the human race. It is worth working for. THE WORLD tells us how we may succeed.

Mystery in medicins is in many instances best. On page 242 Dr. Boyntor

tells us his plan and experience on this subject. It is often best for the patient not to know the name of the medicin he is taking. It is much better to be on the extreme in regard to secrecy than to be too free in communicating such matters to the patient. In this as in all other matters we should seek for the happy medium.

If lobster salad disguises the taste of castor oil when administered to the constipated as it did in Dr. Thomason's boat crew (page 220), it will prove a great blessing. But it may be the "Spanish whisky" had much to do in disguising the taste in the cases he mentions. Dr. Thomason should test the matter and report again.

"Country Doctor's" plan of "knocking-out a nostrum" (page 229) might succeed in many like cases, but too often people would rather be humbugged, and pay for it, than to take medicin from the home doctor. Something from a distance and well advertised is what many people want; and nostrums and patent medicin traps catch many good people who are sensible enuf on almost all other subjects. The world is full of such people, and no doubt will be until the end of time. As a rule patent medicins are more injurious to the patient than any one else. My experience is, that the more of such trash the patient takes the more attention he must have from the family physician.

Dr. Crawford's remarks (page 221) on the pay doctor are good and businesslike. It is certainly true that the philanthropic doctor is seldom appreciated like the one who charges a good fee and collects it. The business side of the physician's life too often goes wrong because of lack of business principles. It is all right to be a physician, but it is also necessary to be a man. Treating the sick, or curing them as we sometimes say, should not keep us from making money and collecting bills. Many good men spend their lives in ministering to the needs of their fellow beings, then die poor and go to the grave forgotten by those whom they labored for while living.

Dr. Waugh's article on "Renal Deficiency" (page 218), like all other letters from his pen, is full of interest. It needs no comment, but to be read again and again.

On page 243 Dr. Henry suggests hypodermic injections of sulfuric acid for snake bites, mad dog and tarantula bites,

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Editor MEDICAL WORLD:-A few years ago I happened to attend a woman in confinement, about the seventh month, abortion having been produced by the contraction of rubeola. As soon as the child made its appearance into the world, and before the cord was severed, it was noticed that the child was covered with the characteristic eruption of measles. Both mother and child made an uneventful recovery. Several years have elapst, and they are both living and healthy. Textbooks have very little to say in reference to this subject. Some authors say that measles sometimes occur in utero, and they say women will invariably abort if they contract measles while pregnant. I haven't had occasion to observe this very closely, but I notice abortions are often produced by an attack of measles. I would be glad to know if it often occurs that children are born with the measles.

T. L. CORNWELL, M.D.

mained all night. No progress. Called next p. m., gave morphin one-third grain. No more pains until November, when after severe labor I delivered a boy weighing twenty pounds; width of shoulders seven inches. Child lived ten minutes, but was minus the top of his head. The appearance of the child was that the top of head was sawed at a line half inch above orbit and the entire top removed. The exposed brain lookt like one small oyster each side of median line. Woman since delivered of a child normal in every way. S. D. BOWKER,

Charlemont, Mass.

Medicin and Morals.

Editor MEDICAL WORLD:-Having met a positiv expression that the moral tone of the medical profession is waning, it may be instructiv to revise the situation by the indication of certain straws. Comparing the present with fifty years ago, it is evident that our ranks comprise a lower percentage of communicants and church goers, suggestiv of less integrity. This is at least an untoward circumstance. Simultaneously there comes an aggressiv wave of social disorder which the most sanguin optimist may not ignore. Concurrently, we note the editorial statement in a prominent city paper, of a modern declension in the birthrate of our nativ American population, for which the editor

Rock Hill, S. C. Mumps Communicated at a Dance.-A Mon- assigns several causes, omitting that

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strosity.

In

Editor MEDICAL WORLD:-' "An unusual Case of Mumps" in the June WORLD brings to mind an experience of mine on a much smaller scale. In a neighboring town at a social dance was a young lady that was not feeling well, but danced every figure; later her illness blossomed out into a typical case of mumps. about two weeks I had six cases of mumps, all young men, and in every case the mumps went down "; and in every case both testicles were affected, tho in every case the right member was the more inflamed and swollen. These six cases were all that caught the mumps from the young lady mentioned. Ages of the young men were from 19 to 28 years; young lady 21. In no case did the patient "catch cold." In August, 1899, I was called to attend a French girl (married woman, third child) aged 20. Os dilated to size of a silver quarter; "waters broke " before I arrived. Pain severe and regular. I re

which seems to me most potent. A biting black frost appears to have stricken the domestic primaries, causing a scant supply by cradle immigration. To what extent this adversity is traceable to a lack of professional loyalty to the vital interests of mankind, I do not know; yet we occasionally observe a physician in attendance on a severe case of maternal illness where the husband is promoted to the sick room as substitute for the trained nurse. This is a most awkward collocation, to say the least.

Another vicious lapse and a sort of "rat hole" which may well deserve scrutiny, is the gradual elimination from medical college announcements of the exaction from a candidate of a written testimonial of good moral character with specifications. On the contrary, I noticed a few days since an annual college synopsis under this head only this almost parenthetic remark: "the candidate to be of desired character." On this basis of no

basis, I ask, what degree of moral turpitude would suffice to debar a person from an honorable place in this very respectable calling?

For several years past we have heard much about elevating the standard of the profession. If anything has been accomplisht in that enterprise the reform must have been handicapt by unfortunate limitations confined mainly to the mental phase. Having noticed no abatement of accessions, we must conclude that doctors are almost the only commodity which may be improved in quality without affecting the volume of supply. Medical students are remarkably promiscuous as to char acter, yet those who have been rejected by the Faculty are as scarce on the came pus as dead cavalry-men on Confederatsoil in 1862. Are medical colleges fostering an alliance between medical mediocrity and moral idiocy? Pray! have we not had quite enuf of that sort already for the spice of variety? In view of the intimate relation between the doctor and the family, it is apparent that personal purity in a physician is of greater importance than in a pastor; and that while "evil communications corrupt good manners," there is no agency more subversiv of popular virtue nor a more deadly foe to society than a mercenary or carnally-minded physician. Throw open the household to a centipede rather than to such a biped; debar also him who, at the momentary solicitation of the unit, deliberately betrays the vital interests of the race.

J. A. MOWRIS, M.D.

Lafayette, N. Y. [Dr. Mowris opens up an interesting field for an exchange of views. The high ideals of the doctor are to be admired, but many will consider his charges entirely without foundation. We are apt to minimize the evils, and maximize the good, of the past; conversely, we are prone to exaggerate the evils of the present without appreciating the vast improvements of the present over the past. If we view society broadly we will find that improvement in morals is about as great as the advances in other respects. Here and there may be a local decline, but in general there has been an elevation. But few will claim that the percentage of church communicants is an infallible indication. We will venture the assertion that as society has advanced in moral integrity, the medical profession has advanced in high ideals.-ED.]

Suppository for Prostatitis.

Editor MEDICAL WORLD:- Prostatitis can often be treated by medication very successfully. But if you try it, you must be doctor and manufacturer. You must get a suppository mould, and weigh and measure and mix. My experience with druggists is that if they have not the exact article in stock you ask for in a prescription, "any old thing" will do. Hence I advise, be your own compounder. You can get a mould that will produce a dozen at each moulding; you will find this mould also useful in preparing rectal sup positories for piles and for use in cases of vaginitis, vaginismus, and vaginal catarrh. After the douche your vaginal suppository will often produce marvelous results, and give the proprietary preparations a black eye, if not a clean cut knock-out. I usually put up 7 ounces at a time. I use 4 ounces of paraffin wax and 3 of cocoa butter. I melt them together and then add the remedies, mixing with a spoon till a consistent mass is obtained. Always remember you can injure your compound by using more heat than will keep it so as to run freely. Constantly stir the mass while you are filling your moulds, and fill quickly, so the drugs will be evenly suspended. Now for the medication: For prostatitis, take as follows to the 7 ounces of butter and wax:

1 dram pulverized cocain,

2 drams pulv. ext. hyoscyamus, P.D. & Co., 2 drams pulv. ext. cannabis Ind. P. D. & Co., 14 drams pulv. ext. belladonna, P. D. & Co. Triturate this mass in a mortar thoroly, then add it to the other mass already melted. In these cases exact medication gives exact results, and we can have no exact medication when we deal in unknown strengths of drugs; hence my reasons for using only Parke, Davis & Co.'s extracts in powder. Under this treatment you may expect immediate relief. The fellow who had constantly to watch for a secluded corner will in a short time be able to use his fingers for other purposes than on his pants' buttons; the fellow who ever and anon springs from his bed with a moan and sigh, will find mind and body in the paradise of youth, such as it was before sexual madness with the iron sway of a despot swept him into a vortex of misery. You will need cold to cool your suppositories; fill your dish with pounded ice, then add salt, then carefully push your mould in before the mass sets.

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