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peutic trees of homeopathy and eclecticism some 11 years ago, I have not had a pneumonic patient get into so alarming a condition, and therefore was not familiar with this use of phosphorus. I knew it was used in pneumonia, and did consult my authorities and found that they recommended it. But as the case was an important one and one of great personal interest to me, I had not the courage to depend on it without any experience. Hence the consultations. is needless to say that under similar circumstances now I should use phosphorus until its inefficiency was demonstrated before seeking counsel from my confreres of the regular school. Should we regular school men be surprised that pharmacists find profit in plying us with preparations like the one described in enclosed circular, which is a cough mixture containing sixteen distinct drugs besides the syrup used as an excipient?

GEO. M. AYLSWORTH, M.D. Collingwood. Canada.

The Test Case of Pneumonia From an Eclectic Point of View.

Editor MEDICAL WORLD:-In Dr. Chap. man's case I would give guaiacol carbonate, five grains, every four hours; specific bryonia, one drop, every hour; strychnin, hypodermically, 1-30 gr. every three

hours.

I have never found aconite to be of any use in such cases It rather does harm; also veratrum viride sometimes. When the heart is weak, I use either digitalis or glonoin in connection with strychnin, as the case may indicate

I consider external applications of the utmost importance. I order guaiacol, ten drops dropt on the affected area every two or three hours; rub in well. I have seen the temperature drop one and sometimes two degrees in less than half an hour. I sometimes combine the following for external application:

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Herington, Kan.

[Our first thought was to class this among the homeopathic contributions; but we now see that it might be eclectic. As its classification is in doubt, we will put it among the miscellaneous.-ED.]

Eclectic Reply to Test Case.

Editor MEDICAL WORLD:-A more extended description of symptoms in Dr. Chapman's case would assist an electic physician in his choice of remedies. We are to infer that it is due to the sudden arrest of the functions of the skin, that gives rise to the pneumonia we are called upon to prescribe for, without a reference to the present condition of the skin at the seventh day. An extensiv burn with corresponding arrest of the functions of the skin excites intestinal inflammation. Inability to restore the skin functions causes death. In this case, until the functions of the skin are in part restored, may we not infer that the first cause is still extending existing troubles? Asclepias tuberosa is my best remedy to meet this impairment. remedy can give complete and quick relief to the "great dyspnea," due to hepatization. This condition is much aggravated by the pleuritic distress inevitable upon respiratory action. Relief from this pain means deeper breathing, and not so frequent, better aeration, and possibly sleep. Bryonia is my best agent for disease of

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serous membranes with sharp pain on movement. My third remedy to slow and strengthen the heart is aconite.

Specific tinct. aconite......
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M. Sig.-One teaspoonful every two hours.
Diet, hot milk often. Local heat to right side.
Sharpes, Fla. GEO. W. HOLMES, M.D.

From Three Points of View.
EDITOR MEDICAL WORLD:-You may con-

sider me a perpetual subscriber to your
very valuable journal; and when you
want money, notify me.

Alkaloidal Treatment.

Editor MEDICAL WORLD:-I am interested in that hypothetical case of Dr. Chapman's, and while I think that the case if seen early need never have gone to the stage in which it is presented to us, still I understand that this is the stage in which we are all called upon to give treatment, it being the one selected in which to test the virtue of said treatment.

Had I seen such a case early I should have used my alkaloids in an effort to abort the disease. As it now stands, I should judge the time for crisis past, and if there is recovery it will be by lysis.

My treatment would be as follows: temperature is above 1020, every half hour Aconitin gr. 1 and veratrin gr. 1 if until it comes below that point. THE MEDICAL Sponge bath daily, and chest enveloped in a cotton jacket. Maintain free expectoration by the use of emetin gr. and apomorphin gr. as necessary to produce and hold effect. Stimulate the vitality of the patient by the use of glonoin gr. 20 absorbed from the mouth, dissolving a granule on the tongue as required, and give one or two strych, ars. gr. every one or two hours.

WORLD is the most progressiv and up-todate medical periodical that comes to my desk. It is the one the regulars, the homeopaths, and the eclectics need in their business.

I am more than delighted at the prescriptions and treatment of Dr. Chapman's pneumonia test case, by both regular and homeopathic physicians. To my mind, it goes a long way toward proving the homeopathic school of medicin the more scientific, in the treatment of this one case at any rate.

It is rather late to enter the contest now, but I believe I will. After a continued practise of over forty-five years, I believe I am not too old to have my say. If I were still an allopath, I would prescribe as follows for this hypothetical case of pneumonia:

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M. Sig. A teaspoonful every hour. In addition a poultice of antiphlogistine as hot as can be borne. If I were to treat the same case homeopathically, I would use phosphorus 30x, ten drops in four ounces of water, a teaspoonful every hour.

But as I am neither a regular nor a homeopathist, but a biochemist, I would give the patient ferri phos. (phosphate of iron) sixth trituation, five grains every two hours until nearly normal temperature, and then alternate with kali mur. (chlorid of potash) every two hours. From the start I would apply heat to the chest. C. W. STOWE, M.D.

Salina, Kan.

Move bowels daily by saline enema, and of course give light nutritious food frequently. That batter-like expectoration shows that the hepatization is breaking up, and if you can stimulate him (and keep up the process of elimination, without which he could not recover) and keep him from becoming exhausted, you will save him. Under this line of treatment I would promise nothing and expect much. J. F. HARRINGTON, M.D.

New Albion, Iowa.

A Hydropathic Reply to the Test Case. Editor MEDICAL WORLD:-According to your wish to hear a hydropath's opinion in Dr. Chapman's pneumonia test case, I herewith take the pleasure to submit you my plan of treatment in this most critical stage of the described case. Knowing that in the treatment of this dangerous affection the object is to diminish the frequency of the heart's action, to abstract morbid heat and to lessen the intensity and retard the activity of those morbid actions which are raging in the afflicted organs, my directions would be: First, try to get a constant supply of good fresh air in the sick room; then give the patient a cold sponge bath over chest back and abdomen, not exceeding one minute in

duration. About half an hour later, another one. Seeing the patient somewhat improved now, the wet cold bandage folded in four should be applied over his chest; a plaster of cottage cheese instead of the wet bandage is better yet. The cheese is put about half an inch thick on a cloth, and then put over the chest. This wet application must be covered with a dry cloth. This procedure should be renewed as often as they get hot or dry. Hands and feet I would keep in a warm condition. One spoonful olive oil twice a day, and one spoonful tea of foenum graecum every hour, produce a cooling effect inside. Barley water and cold fresh water furnish a most excellent drink.

FRANCIS M. B. FRIEDERICH.

St. Paul, Minn.

Test Case Treated by Light. Editor MEDICAL WORLD:-Referring to Dr. Chapman's case (p. 381), I make the positiv assertion that had a powerful ray of light been projected upon the lungs for fifteen minutes during the first or second day of the attack, the disease would have been aborted. Not in a single instance, but in every case will this result follow the application of light. The bacteria pneuThe bacteria pneumonia are easily, quickly and certainly destroyed in this manner. It is a law. Just as certanly, but not so quickly, can we destroy the bacteria tuberculosis and protozoa of neoplasm by the same force.

If you doubt the destructiv force of light, turn the rays upon the abdomen of a patient who has ascaris lumbricoides and see how quickly these great parasites are destroyed. The discovery is my own. Dr. Chapman's patient needed no medicin. CORYDON E. ROGERS, M.D.

Seattle, Wash. [Doctor, give particulars. Do you use sunlight or artificial light? Do you condense the rays with a lens?-ED.]

Replies to Test Case from "Regulars."

Editor MEDICAL WORLD:-In reply to Dr. Chapman's test case, I would treat patient as follows: First, I presume it is cold weather; therefore we have a stove with fire in the room. Second, place some large vessel filled with water and keep filled and boiling constantly on the stove in room, to which can be added every few hours a teaspoonful of comp. tr. benzoin.

Give patient hypodermically gr. arsenite of strych.; repeat every half hour for four doses, and then continue gr. by mouth every two hours, or p. r. n. Also give grs. x amon, iodid every three hours in solution alone or in combination with carbonat ammon. Give inhalations of oxygen at intervals. For pain in side rub up camphor dr. 1 and chlor. hyd. dr. 1 to which add morph. sulf. gr. 1; apply to side; if does not irritate much, cover with flannel bandage. Push stimulants, keep bowels well moved by Rochelle salts. Have flannel jumper on. Feed frequently with Valentine's meat juice, alternated with one glass skimmed milk in which white of one egg has been beaten, and trophonin one dessertspoonful. Keep room bright and cheerful. Have people few and with bright and cheerful faces, and I think possibly if he has any sort of constitution, he might pull thru; or at least have a fair chance.

After treatment, comp. syr. hypophos., one dessertspoonful every three hours in wine glass of water.

Bel Alton, Md. E. SPENCER, M.D.

A Similar Case.

Editor MEDICAL WORLD: Dr. Chapman's test case of pneumonia in August WORLD is hypothetical. He asks for treatment. In my practise some years ago I had a case which very closely resembles it. My patient was a male about 45 years old, stout but not strong constitutionally; came from a tubercular family. His condition about the sixth or seventh day was as follows: Expectoration rusty, stuck like glue but small in quantity; lung solid, from hepatization no doubt. Respiration 45, pulse 130 per minute, and temperature 107°. Sat bolstered up in bed, and breath so short he could scarcely speak at all; he reacht out with his hands to catch something in an effort to get breath. Treatment: strychnin, ammonia carb. in big doses, whisky and milk; and I envelopt whole of body from waist to shoulders, back and chest in a mustard poultice. This was five p. m.; at ten p. m. I returned, and patient was slightly improved. I went at him with renewed energy and stimulated and nourisht and drugged him, and he recovered.

J. A. HERSHEY, M.D.

Owen Sound, Ont.

Never attempt to reduce a hernia by force.

Refers to the Code.

Editor MEDICAL WORLD:-There is no medical journal publisht now equal to THE MEDICAL WORLD. Every physician, of whatever school or pathy, should read it and make it his constant companion. As to the treatment of Dr. Chapman's case, it is strange to see the unanimity of the homeopaths and the wide difference in the treatment recommended by the regulars. I am a regular and have been an advocate of the code of ethics, and am yet; for I believe that regular medicin gives us the entire field of nature to explore, and give medicin in any dose that experience or science demonstrates to be efficient. case given by Dr. Chapman, if in my hands, I would first empty or clear out the alimentary canal with mercury or sulf. magnesia. Then give the following:

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Keep up this treatment incessantly. Use but little alcoholic stimulants. After the bowels have been thoroly evacuated give plenty of liquid nutriment.

Adrian, Mo. E E. GILMORE, M.D.

Successful in 100 Per Cent.

Editor MEDICAL WORLD:-In response to the request of Dr. S. E. Chapman, Napa, Cal., in the August issue of the WORLD, I suggest the following for the relief of his patient:

1st. Hypodermic of atropin and morphin to relieve nerve shock (indicated by fast weak pulse), to open up cutaneous capillary circulation in order to divert static blood from congested lung, to sustain heart action; to be repeated until the effect of a more permanent heart sustainer can be procured.

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M.-Saturate fine flannel cloth, apply evenly all over affected lung, cover with cotton wool and bandage.

To secure uniform temperature of region of lungs and act as a mild revulsiv over affected lung.

The above treatment may seem rather strange to my brother homeopaths, and to our latter day bug fakirs; but nevertheless it has proven successful in my hands in a hundred per cent. of patients treated between the ages of two years and eightyfive years, during a period of over thirty years of unlimited practise at this place. ONSLOW REAGAN, M.D. Alexander City, Ala.

"Cold Air in Large Doses." Editor MEDICAL WORLD:-In reply to Dr. Chapman's hypothetical case, would say that lack of air produces great dyspnea, tightness of chest, and upright position. Indications, air in large doses. I had a patient in as near the condition he describes as one case can be like another. Notwithstanding the outside temperature was below zero, he insisted on having no fire in the room, and on having all the doors and windows opened night and day. So cold was his room that it was almost impossible for his attendants to remain in it. This treatment the

patient kept up contrary to my advice for about forty-eight houre. And contrary to my expectations he improved and finally recovered. This case was a very severe one. I fully expected him to die. I am fully convinced that the abundance of cold air saved him. "Similia similibus curantur." I am a "regular" male doctor. H. M. OCHILTREE, M.D

Haddam, Kansas.

A Man Who Recognizes the Crisis as a Factor in Pneumonia

Editor MEDICAL WORLD:-In regard to the treatment of Dr. Chapman's case, first give 5 grains of calomel and bicarbonate of soda, to be followed in fifteen minutes by 10 minims of tinc. digitalis. The latter to be repeated every hour until pulse is reduced to 85 or 90. Apply over the whole chest a light hot pack. If bowels are very costiv, give an enema, as the calomel will not act for about seven hours. Veratrum viride may be substituted for the digitalis. After the calomel begins to act, sustain your patient. Leave the temperature to take care of itself. This treatment will check hepatization and will keep patient stationary for 24 to 48 hours, when a crisis takes place. As the patient has by this time safely crossed the bridge the treatment can be changed.

W. STUART LEECH, M.D.
Foley, Minn.

[Here is a man who takes into account the coming crisis. He has evidently studied the natural history of pneumonia, and treats and manages his patient accordingly. When the crisis is safely past he will not attribute the rapid improvement to the miraculous action of some remedy, but he will know that this improvement is natural after the crisis; and that, the crisis being safely past, the temperature would fall and resolution begin, without any medicin whatever. If the editor bad pneumonia, he would like to be under the care of just such a man as this. The duty of THE MEDICAL WORLD is to mirror the medical profession as it is. It would like to make every one of its readers a student of the natural history of disease and the physiological action of remedies. Every such student will know that the pressing need in this case of pneumonia is to get the patient safely thru the crisis. Nature may be able to do it, but the doctor's duty is to know nature's way and to aid nature.—ED ]

Another Crisis Man-They are so Few.—An Illustrativ Case.

Editor MEDICAL WORLD:-In regard to Dr. Chapman's case, the best authority that I can find on pneumonia, and my experience, prove to me that it is a self limited disease; that it will reach a crisis about the seventh day. This case, then, has reacht the crisis. In ten or twelve hours the temperature will fall to normal, and resolution begin. I know of no drug that would exercise any specific action at this time, but it is well to sustain the heart and husband the vital forces. I would use digitalis and strychnin in proper (regular) doses, awaiting the result of the crisis. Dr. Osler reports a case that came under his care at the Philadelphia Hospital, that was quite similar to the hypothetical case under consideration. This man was brought to the hospital the seventh day after chill, with activ delirium, a temperature of 105°, and pulse above 120. The following morning the crisis occurred. Temperature dropt to 98°, and he entered upon a rapid convalescence. This patient had not been given a drop of medicin from the beginning of the attack until after the crisis had past, and the greater part of the right lung was involved. Now when Dr. Chapman says, "here is a man who must have help immediately or he will die," if he means drug medication I think he is mistaken. Very little medicin is needed in this case at present, and perhaps that given by the homeopathic brethren will be just the thing. A. A. BRADFORD, M D.

Bremen, O.

Recognizes the Crisis as the Great Facter.

Editor MEDICAL WORLD:-There is no known medication that will have the slightest effect on Dr. Chapman's test case of pneumonia. It will run its course uninfluenced in any way by drugs. It is a desperate case as shown by the symptoms. The condition of the sputum is important, and why it "falls to pieces like batter on paper" is explained by its being thin or liquid, all of which indicates approaching dissolution.

The crisis is near, and the thing to do is to support the patient till it passes. Give little medicin, and let each dose have a well defined purpose. Lower the temperature by sponging with cold water and alcohol. Keep the extremities warm. Give hypodermic injection of sulf. strych.

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