Hyperidrosis.

Editor MEDICAL WORLD:-I would like to have some suggestions on the treatment of the following case: An unmarried lady, a school teacher, 24 years old, has been troubled since childhood with excessiv sweating of the hands and feet, especially of the hands. They usually have the appearance as if they had been soakt in water. The palms and backs of the fingers are affected most. The water seems to pour thru the skin and drop off in large drops. There is sometimes, but not often, a little edema of the eye lids. Her general health is good. She never had any severe sickness. Temperature normal, pulse 84. Slight trouble with the kidneys at two different times, but the condition referred to existed first. I would be very glad to get some suggestions on this case thru the columns of your valuable journal. C. J. COOPER, M.D.

has

McGregor, Texas. [Have her bathe her feet and hands twice daily in a solution of formaldehyde, one or two drams to the pint. Make the last application just before retiring, and follow it by dusting the skin with a powder composed of salicylic acid one dram, boracic acid two ounces. Both applications must be kept away from the eyes. Examin her urin carefully for albumin. Any part of the body may be treated by these methods. We believe you have nothing more than an aggravated case of hyperidrosis, and that careful and persistent use of these applications will result in a speedy cure in so far as cure is possible. It is likely that after total subsidence of the symptoms for some months after applica tions have been discontinued, they will gradually reappear with increasing severity; in which event you should advise the use of the preparations once or twice a week, and get perfect results.-ED.]

Editor MEDICAL WORLD:-Please let me know thru your columns the correct medical names of white sumach root; red sumach root; and prickly ash root. I find prickly ash under two different names. The first two I can not find at all.

R. C. Prewitt, Jr., M.D.

Golden Lake, Ark. (The U. S. P. recognizes only the fruit or berries of the rhus glabra in preparation of medicin; this plant is styled rhus glabra by the eclectics. The fruit is employed as a mordaunt in dyeing red colors, and

"Penn

we have no doubt that this is the red sumach to which you refer. It has such local names as "upland sumach”, sylvania sumach", and "smooth sumach"; but we have never learned of it's being called "red sumach". The rhus typhina, or Virginian sumach, yields a milky fluid, from which it might possibly be called "white sumach"; it is also known as staghorn, and 66 vinegar plant". It is added to vinegar to increase its strength. It is used in tanning white leather. Combined with alum and green vitriol various yellow, green, and black stains and dyes are produced. King's American Dispensatory (eclectic) classifies the various species of "Rhus" as follows:

Rhus glabra-smooth or upland sumach. Rhus typhina-staghorn or Virginian sumach.

Rhus copallina-dwarf or mountain sumach.

Rhus aromatica-sweet or fragrant sumach.

POISONOUS SPECIES:

Rhus Michauxii.

Rhus venenata-poison sumach-poison elder-poison dogwood. Rhus diversiloba.

Rhus toxicodendron-poison ivy--poison oak.

The terms "white sumach" and "red sumach" are probably local, since we can not find them in any of our reference works.

Prickly ash is also known as "Xanthoxylum ", U. S. P., and as yellow wood, angelica tree, suterberry, toothache tree, northern prickly ash, and southern prickly ash. ash. The berries and bark of both sumach and prickly ash are all that we can find record of having been used, and no authority to which we have access mentions the use of the root.-Ed.)

Does Vaccination Prevent or Modify Whooping Cough?

Editor MEDICAL WORLD:-About seven years ago whooping cough was epidemic in this locality, scarcely a family escaping. I vaccinated a number of children who had the disease, and it was distinctly modified; and others, who tho exposed to the infection, did not contract it. In one family I vaccinated three children and the mother maintains that the vaccination prevented the children from taking the whooping cough. The vaccination was not performed with any idea of preventing

Attacks of asthma are often aborted by provoking nausea rapidly; ipecacuanha, apomorphin, or in the case of non smokers, tobacco may be used.

In severe rheumatism, control the attack early; or prepare for cardiac complications.

Charcoal, two parts; bismuth subnitrate, one part, and magnesium carbonate, one part, will relieve gastric pain due to acidity or the presence of excessiv quantities of gas.

The individual or family history of syphilis is so very important an element in diagnosis and prognosis that it should never be forgotten; the leading question often brings an equivocal or false statement, but careful inquiry will reveal the former existence of syphilitic lesions if they have occurred.

Other remedies than the salicylates are to be preferred in the treatment of rheumatism in children. Alkalies, diuretics, laxativs, and special attention to dietetics will often work wonders.

The doctor who cares for his own horses cannot easily have ideal hands for the sick room; but he cannot be excused if he attempt obstetrics or surgery until he is certain that he has rendered them thoroly aseptic.

It is desirable that even the humblest country doctor should have the services of a stable boy.' Besides the positiv danger of infection of patients from the contact of the physician with the horse, there is that indescribable odor which is always present after contact with horse or harness. This odor is offensiv to most

people when well, and doubly so when ill; combine it with the common accompaniment of the smell of horse manure, and you have a combination which is repulSive and nauseating. Avoid it by employing a hostler and wearing gloves whenever you leave your office.

The temporary stomachic derangement occurrring with many women during the menstrual period is explained by Elsner in Archiv. f. Verdauenskrankheiten, as due to hyperchlorrhydia brought about by reflex action or by the direct extension of the pelvic congestion to the region of the stomach. In case of severe menorrhagia, a lessening of the amount of stomachic juices and a reduction in the acidity takes place. This theory may be easily tested by the indicated medication administered as soon as the prodromata of the flow appear. Much inconvenience and suffering might thus be avoided.

A U. S. A. surgeon, just returned from the Philippines, who had himself suffered with pernicious malarial fever, tells us that no reliance can be placed on any drug except quinin. He took 80 grains a day for a considerable period. After either amebic dysentery or severe malarial fever, he finds it necessary to have his patients take a voyage to the United States, as recuperation seems impossible in that climate.

Points in Obstetrics.

Hammamelis is valuable in the var icos veins and hemorrhoids of pregnancy. Use locally and internally to full limit.

In threatened mastitis, use every effort to abort the abscess, both for cosmetic reasons, and because a breast is never again so good a milk producer after it has once healed. Internally: give calcium sulfid, saline laxativs, and belladonna. Locally: apply belladonna, tincture of opium and lead water, and alternate this with tincture of opium one ounce to of sweet oil, applied hot and rubbed in well with gentle massage. Keep the breast under firm pressure at all times except when making applications. If pus form, evacuate promptly at lower part of gland; use an anesthetic so that all pus pockets may be searcht out and thoroly drained.

pint

Never rupture the membranes in a primapara; and never rupture them in a multipara till the second stage is well advanced.

Hirst prefers ether to chloroform in

labor, except in the presence of eclamptic symptoms.

Fifteen grains of chloral by the rectum, repeated once or twice, will mollify the early stages of labor.

It is good practise to give a dram of fluid extract of ergot as soon as the child is delivered. Before the ergot has had time to act the placenta will have been expelled or delivered, and danger of postpartum hemorrhage is averted.

While oxalic acid is one of the best

emenagogs, one must beware of using it in pregnancy, since it is a powerful oxy toxic and may easily induce abortion.

Never use the forceps in a normal labor till the head has been stationary for two hours. Never use them for no better excuse than to hasten the labor.

If the fetal vessels cease to beat for 10 minutes previous to delivery, it may be certain that the child is dead.

If a woman dies suddenly in full term labor, extract the child immediately by version or cesarian section.

Scale pepsin added to quinin will prevent vomiting, when given during labor in the enormous doses necessary to get the effect on the uterus.

Points in Surgery.

Sprains are treated satisfactorily and are rapidly cured by massage with a roller

connected so tricity.

as to furnish static elec

In incised wounds about the angles of eyes and mouth it is often better to use adhesive plaster instead of stitching; the constant motion is apt to irritate the parts

or tear out the stitches.

It is good practise in all surgical cases to eliminate bacterial and metabolic products by increasing the secretion and excretion of the kidneys, intestins, and skin.

When the steam bath is indicated in country practise, it is easily and satisfactorily given by boiling a dozen or more ears of corn, taking them from the water while boiling, wrapping in cloths moistened in hot water, and packing them as close to the patient as possible. Keep him closely covered, and a few moments will bring the most profuse perspiration you

ever saw.

Under certain condition and in certain localities pus sinuses and fistulas may be

Both the A, C, E, and the Schleich mixtures are dangerous anesthetics in the hands of those without extended experience. It is better for the ordinary practitioner to stick to his old favorits until some more certain knowledge is obtained regarding the limitations of the newer anesthetics.

In case of a severely bleeding vessel, do not waste too much time in trying to ligate. Compress with fingers, packing, bandage or tourniquet till assistance arrives. It matters not whether the vessel be vein or artery.

In the selection of a styptic, use only one which will hasten or assist the natural processes of healing. Alum is the least objectionable of the chemical astringents; it may be applied in warm solution on any kind of aseptic compress, As it cools about the vascular orifices. under pressure, it deposits aseptic crystals

The actual cautery, with the patient anesthetized, is the most certain and powerful of all styptics. The charred surface is antiseptic, and the separating eschar leaves a healthy granulating surface.

What the Authorities Say About the Treatment of Malaria.

In view of the reiterated laudation of quinin in malarial fevers, and the extravagant claims made for its newer rivalmethylen blue-we append notes from the

latest and best text-books on medicin without editorial comment.

Eichhorst, Practice of Medicin, March, 1901, W. B. Saunders & Co., Philadelphia and London, states: "In the treatment of malarial fever quinin has proved a reliable specific, and it is superfluous to seek

for substitutes. Quinin destroys the malarial plasmodia. In cases of intermittent fever it is sufficient to administer 15 grains of the hydrochlorat three hours before the chill. Occasionally the dose must be doubled, so that two doses of 15 grains are taken at an interval of half an hour. Frequently the febril paroxysm fails to recur after the first administration of quinin, altho it is well to continue the quinin on the following days for about a week. For the relief of the anemia, arsenic and iron may be subsequently prescribed. Methy. len blue has also been reported as being still more destructiv to the malarial plasmodia than quinin, and it has therefore been recommended in, the place of the latter (1 grains every two hours). Quinin and arsenic are also the most efficient remedies for larval intermittent fever. The pernicious, comatose, continued, and remittent malarial fevers require prompt and vigorous dosage with quinin if the threatened dangers are to be averted."

Thompson, Practical Medicin, Lea Bros. & Co., 1900, says: "Quinin furnishes the best illustration of the action of a true specific remedy known to therapeutics, and I am inclined to agree with the statement made by many recent writers that fevers which do not yield to it are not malarial. There have been many substitutes for quinin suggested for malaria, such as Warburg's tincture, salicin, eucalyptol, ammonium chlorid, etc.; but as stated, quinin, if properly given, fails so rarely, except in extreme pernicious cases, that it should be tried in every case before all other remedies."

Medical Treatment of Diseases and Symptoms, Tirard, Thornton, Lea Bros. & Co., 1900, says: "Quinin must certainly be administered during the intervals between separat attacks of intermittent fever. Numerous other remedies have been advocated as substitutes for quinin, and 'their recommendation has, perhaps, been partly due to the former high price of this drug. Methylen blue has been recommended in cases of malaria were quinin had proved useless, or where here was intolerance of quinin. Cadamatis has used it with apparent success in a large number of cases. In some of his cases he has found it advisable to use both methylene blue and quinin, but in the large majority he employed methylene blue alone. According to his account, the drawbacks include staining of the tongue and lips,

and sometimes a slight amount of cystitis. He considers that patients are not only cured of existing malaria, but that they are also rendered immune, so that they may continue to reside in malarial districts with but little danger of subsequent attacks. The daily dose is from 10 to 12 grains for adults, and the drug is to be administered in intermittent fever some ten hours before the beginning of the paroxysm." [Cystitis may be avoided or ameliorated by the simultaneous administration of oil of myristaca in 1 or 2 drop doses. We never institute treatment by more than a 2 grain dose of the methylene blue, and increase as tolerance is noted.ED.]

Merck's Archivs, February, 1900, prints a report by Smithwick, who says: "In fifty cases of malaria, all did well on methylene blue. Methylen blue is a perfect succedaneum for quinin. It is the remedy to use in malaria with hematuria, as it acts in a twofold manner. It is the remedy to give in malaria occurring during pregnancy, as it has no oxytoxic effect and causes a freer action of the kidneys."

Tyson, Practice of Medicin, P. Blakiston's Son & Co., 1900, says: "In intermittent fever the treatment is preeminently by quinin. The pernicious malarial fevers are treated by quinin. Quinin should not be omitted in the chronic form. Had I hemoglobinuria in malaria I should prefer to be treated by quinin."

Virginia State Board of Medical ExaminersFall Meeting, 1900.

SECTION ON MATERIA MEDICA.

Dr. W. B. Robinson, Tappahannock, Examiner.

1. (a) Give the physiological action of the mineral acids. (b) What is the liquor ferri subsulphatis? (c) By what channels is fron eliminated?

2. (a) Give the physiological effects of phosphorus in toxic doses. (b) Give the preparations of potassium. (c) Point out the effect of these salts on the reaction of the urin and the differences in result due to the period of administration.

3. (a) Give the physiological effects of digitalis on the heart. (b) What is atropia? (c) Give physiological action of hyoscyamus.

4. Give dose of the following medicins: 1-Acidum muriaticum dilutum. 2-Tictura ferri chloridi. 3-Syrupus calcii acto phosphatis. 4-Potassii bromidum. 5.-Tinctura belladona. 6-Extractum hyoscyami fluidum. 7-Extractum cannabis indic. -Extractum gels fi fum. 9-Extractum veratri viridis fluidum.

5. (a) Explain how the physiological effects of morphin and atropin when administered together are modified by the reciprocal influence exerted upon each other. (b) Give the antagonists and incompatibles with aconite. (e) Give the synergists to cinchona.

SECTION OF PRACTICE OF MEDICIN,

[Dr. E. T. Brady, Chairman and Regular Examiner.
Dr. E. C. Williams, Homeopathic Examiner.

1. Describe an epileptic seizure. Differentiate it from(a) A uremic convulsion. (b) An apoplectic convulsion. (c) Hysterical convulsion.

2. Give causes, prognosis, and treatment of chorea. 3. (a) Name and describe the appearance of the three most common varieties of intestinal worms. (b) What clinical symptoms indicate their presence? (c) Give treatment for two varieties.

M. Define the following terms: (a) Aphasia. (b) Pyemia. (c) Leucocythemia. (d) Cheyne-Stokes respiration. (e) Hematuria.

5. Give causes, symptoms, and treatment of arthritis deformans, or rheumatoid arthritis.

6. What are urinary tube-casts? Describe the common varieties. What clinical significance attaches to their presence?

Answer all questions in regular order. Number each answer. Make your meaning clear, but do so as concisely as possible. Write out and sign your pledge.

SECTION ON CHEMISTRY.

Dr. O. C. Wright, Jarratt's, Va., Examiner.

1. (a) What is matter, and in what three different conditions does it exist? (b) Give the characteristic properties of each condition. (c) What are crystals, and what are amorphous, dimorphous and polymorphous substances?

2. (a) How does carbon occur in nature? (b) How many different allotropic modifications of carbon exist? Give example of each. (c) Give physical properties of carbon dioxid, and tell how it is formed.

3. (a) Write the chemical formula for nitrate of silver. (b) How is nitrate of silver made? (c) What is the chemical antidote for nitrate of silver? Show by chemical equations what reaction takes place.

4. (a) Give the chemical formula and physical properties of mercurous chlorid. (b) Of mercuric chlorid. (c) Of

mercurous iodid.

5. (a) What is organic chemistry? (b) What elements do organic compounds contain? (c) Give their general properties.

6. (a) What are alcohols, and how are they found in nature? (b) What are aldehyds, and how are they formed? (c) What are ethers?

7. (a) Mention the principal points to be considered in the analysis of uria. (b) Describe the murexid test. (c) Give a reliable test for blood in urin.

8. (a) Describe the diazo-reaction. (b) In what disease is it of diagnostic and prognostic importance? (c) Is the reaction ever present in any other diseases?

Answer only six of the above blocks including the seventh. Pledge.

SECTION ON PHYSIOLOGY.

Dr. Robert C. Randolph, Boyce, Va.,

Examiner.

1. (a) Define metabolism. (b) What products result from the changes that take place in the liver cells during life? (c) Give physical characteristics and functions of bile.

2. (a) What are the physical characteristics of normal urin and what amount does the average male secrete in 24 hours? (b) What is the per cent. of solids in normal urin, and what are the chief organic constituents? (c) What are the most important abnormal constituents in urin?

3. (a) What is meant by the terms tidal, complemental, reserve and re.idual air? (b) What are the points of difference between expired and inspired air? (c) What changes does the blood in the pulmonary artery undergo in its passage thru the lungs?

4. (a) Upon what does the force and frequency of the contractions of the heart depend? (b) What events correspond in point of time with the first sound of the heart? (c) Which are the three most important intrinsic cardiac ganglia?

5. (a) Name the centers found in the spinal cord. (b) What would be the effect upon respiration of cutting the vagus upon one side? (c) Locate the respiratory center.

6. (a) What bodies give fibers to form the optic tract? (b) What are the two branches of the 8th cranial nerve, and what are the functions of each? (c) What is the function of the 11th cranial nerve?

SECTION ON HISTOLOGY, PATHOLOGY AND BACTERIOLOGY, R. M. Slaughter, M.D., Theological Seminary, Examiner. 1. (a) Give the histological classification of the following tissues: bone, muscle, free surface of mucous membrane, and the lining of serous cavities. (b) Describe the two modes of termination of nerve fibers.

2. (a) Are bacteria classed as flora, or fauna? (b) Name the three general groups of bacteria as based on morphological characteristics. (c) Define the terms cromogenic, zymogenic, and pathogenic as applied to bacteria. (d) Describe the streptococcus pyogenes (i. e., give its morphology and pathogenicity).

3. Describe the microscopic characteristics of miliary tubercle.

4. (a) What tissues are most commonly affected with fibrinous inflammation? (b) Mention a typical example of fibrinous inflammation. (c) In the stage of "red hepatiza

349'

R. S. Martin, M.D., Stuart, Va., Examiner.

1. (a) How would you distinguish between feigned and real insanity? (b) Define the terms dipsomania, pyromania, and kleptomania.

2. (a) What are ptomaines? In what substance would you expect to find tyrotoxicon? (b) Give a reliable test for blood stains.

3 (a) In case of suspected infanticide how would you determin whether the child was alive or dead when born? (b) What organ is said to resist putrefaction the longest?

4. (a) State difference in character of the testimony of an ordinary witness and that of a medical expert. (b) How could you distinguish between wounds made before and after death?

5. (a) Give symptoms of acute poisoning by tartar emetic -the antidote, and post mortem appearances. (b) Give symptoms and treatment of opium poisoning.

SECTION ON HYGIENE.

R. W. Martin, M.D., Lynchburg, Va., Examiner.

1. (a) In making a qualitative test of water, what impurities should be sought for? (b) Give the sources of wholesome, suspicious, and dangerous water.

2. (a) What is the distinction between sewer-air and sewer-gas? (b) What gives sewer-gas its peculiar fetid smell?

3. Name the principal methods of physical training, and tell how systematic training (physical) affects health and longevity.

4. (a) What is the duty of the State to persons imprisoned on account of crime? (b) What diseases are most frequent among prisoners?

5. (a) What are the advantages of calf vaccine over humanized lymph? (b) State emphatically the best methods of arresting an outbreak of small pox?

SECTION ON OBSTETRICS.

Dr. H. M. Nash, Norfolk, Chairman: Dr. C. W. Rodgers, Staunton, and Dr. M. R. Allen (Homeopath) Examiners.

1. At what period, does retroversion of the pregnant uterus usually occur? The symptoms, prognosis and treatment in both the uncomplicated and complicated varieties.

2. Give the symptoms and prophylaxis of threatened abortion.

3. Define placenta previa, giving its treatment.

4. Etiology and treatment of puerperal eclampsia, referring to 1 latest views as to causation.

5. Give the idions of versions, cephalic and podalic. How performed.

SECTION ON GYNECOLOGY.

Dr. C. W. Rodgers, Staunton, and Dr. M. R. Allen (Homeopath), Norfolk, Examiners.

1. Describe the bimanual examination of the pelvic organs, noting the abnormal conditions it may elucidate.

2. Describe Trendelenberg's position, giving its advantages in abdominal and pelvic operations.

3 Define menorrhagia and metrorrhagia, giving the causes and treatment of these conditions.