gr. every hour for a few doses, then less Strychnin and the Cold Pack. Editor MEDICAL WORLD:-In commenting on Dr. C.'s case of pneumonia in September WORLD, will say that I am well pleased with the concise, direct and uniC. A. MOULTON, M.D. form treatment of the homeopaths, and Would Apply Cold.-Recognizes Crisis. Editor MEDICAL WORLD:-Permit me to submit the following for Dr. S. E. Chap man's case of pneumonia. First I would give him hypodermically sufficient codein, in repeated doses if necessary, to control the chest pain; then strychnin sulf. gr. and glonoin roo gr. to act as stimulants. I find that glonoin acts rapidly in just such cases; both it and the strychnia, as we all know, stimulate respiration. Along with them I would use cold cloths applied to the bare chest, beginning with tepid water, and as soon as the cloth is hot, remove and apply one some cooler until an ice cold cloth is put on, keeping them cold until the temperature is reasonably lower, say 103°, and respiration easy. Repeat when necessary. I think counterirritation with strong mustard at intervals an aid to resolution, notwithstanding some think it never acts beyond the cuticle. The strychnin I would continue to give at regular intervals, say gr. every 2 hours, and gr. if necessary, until I get the physiological effect. The glonoin would come in again in case of threatened collapse. I would nourish patient as well as practicable, and if possible I would stay with patient and ap ply treatment until a change. If stomach would bear it now, I would give 10 gr. doses of chlorid of ammonia every 3 hours in plenty of good whisky to sustain patient. This case is evidently almost to the crisis, and will die or get better very soon. This is my first attempt at writing to a journal in reply to a query, having only been in activ practise eight years. I feel that there are others more competent, therefore I refrain from taking up space that could be occupied by a more experienced man; but the test as given in September issue has so interested me that I find myself trying to detail my method of reating pneumonia, which I believe is reasonably successful. Barry, Tex. STERLING PRICE, M.D. [This is a very good beginning. May others follow your example. Come again. -ED.] am very much surprised at the "round the bush" method of my regular brothers. There was a direct question askt, viz., what would you do at this particular time and stage of the disease? and very nearly all the answers go into detailed treatment of pneumonia instead of answering the question direct. There is no doubt but that this case is at the critical stage, or rather crisis, and the scales of life and death are, if anything, a little overbalanced on the side of death. This poor fellow is lying there with a thready pulse, "batter sputam," labored breathing, etc. Are we going to stand there and order poultices, expectorants and what not, while the poor fellow is fighting for life and has that pleading, confident and expectant look in his eyes? I say no! I will give him strych., the sulf. preferably, or any other preparation of it that I happen to have with me, and give it freely, say gr. every half hour until effect, and it will not take long to get the effect. I will also put him in the cold pack until I reduce his temperature, not forgetting plenty of fresh air. I will not mention my after treatment, as this is not a discussion on the treatment of pneumonia, but rather a request for a prescription for immediate use only. I will not make the assertion that this will positivly tide him over the crisis, as some of our brothers assert their prescriptions will do, because we are dealing with a desperate case with one foot already in the grave; and at best physicians must never get the idea into their heads that they hold the reins of fate in their hands and can manipulate them to suit their pleasure. There is nothing of this meant for publication except the paragraph dealing with the prescription. Ste. Marie, Illinois. W. A. WENZ. [Your letter is all very direct and vigorous, and deserves publication in full.ED.] Don't you think that our people ought to know how to treat pneumonia this winter? Possibly some may say that in the confusion wrought by this unparalleled discussion, they know less than they did before; but you must learn to reive views from every source, yet be able to recognize and cling to safe moorings. Other interesting articles are in hand for next issue. Quiz Column. Questions are solicited for this column. Communications not accompanied by the proper name and address of the writer (not necessarily for publication) will not be noticed. The great number of requests for private answers, for the information and benefit of the writer, makes it necessary for us to charge a fee for the time required. This fee will be from one to five dollars, according to the amount of research and writing required. Who Can Cure This Girl's Catarrh? Editor MEDICAL WORLD:—I am a doc tor's daughter, and would like to know if there is one among all the readers of THE WORLD that can cure me of catarrh. My father says that he cannot. I have it in that form that if I do not keep my head and throat cleansed, my breath is bad. Am much afraid it is going to my lungs, as there have been sore spots in them all summer. Am much worried, and as a last resort consult the readers of Tнe WORLD of which my father is a subscriber. My father has a globe nebulizer in his office. The editor will have my address. Washington. A DOCTOR'S DAUGHTER. [We will leave this case open for discussion. Any who wish to send a private communication to the Daughter may do so thru this office; but we prefer that the discussion be open in the pages of THE WORLD.-ED.] Enlarging the Bust. Editor MEDICAL WORLD:-Sometime last winter a lady patient askt me if there was anything she could do to enlarge her bust. I advised her to use ozonized saw palmetto as directed by Dr. E. E. Gilmore in MEDICAL WORLD for June, 1900, page 209. She did so for one month, then the breasts began to itch and soon became swollen, and the whole chest was covered with an eruption which spread to neck and face; one eye was entirely closed. She did not take the saw palmetto, but rubbed it in night and morning. I put her on echinacea tincture, ten drops in water, three times a day, and for the fiery itching ordered her to bathe with tincture echinacea diluted, four drams to eight ounces of water. Under this treatment for one month or more, she recovered from the effects. Thus ended her bust develop ment. About one month ago the whole trouble repeated itself; breasts, neck and face swelling as before. This time both eyes were closed for twenty-four hours, and it is not entirely well yet. She was poisoned by some vegetable poison about twelve years ago, but recovered nicely, and has enjoyed excellent heath ever since. Can the Editor or any one of the WORLD family throw light on the case? J. H. THOMAS, M.D. Wyoming, Del. [It is plain that your patient is susceptible to cutaneous irritation from drugs or external agencies. Some people are so easily poisoned that the mere proximity of So simple a vegetable as a potato vine in bloom will cause edema and eruption. We hardly think it possible that the saw pal metto caused the trouble, but believe some other agent has been responsible. She to vegetable poisoning, and you cannot will probably always be unduly susceptible give any drug or method that will alter this susceptibility. When you next attempt enlarging a bust, try cold bathing of the breasts for ten minutes, twice daily, followed by vigorous friction with a coarse towel, and immediately afterwards with inunction of lanolin or cod liver oil. The bathing and massage must be firm and gentle, lest the gland be bruised. This treatment, if persisted in, will increase the size of the bust. We also gain benefit from breathing exercises. While this does not increase the size of the glands, it does increase the dimensions of the chest in such a manner as to give a fuller bust. Have the patient breathe as deeply as possible three times immediately on arising in the morning and the last thing before retiring at night. The shoulders are thrown well back and the chest well forward, and every possible inch of air is One inhaled and then slowly exhaled. month of such treatment will increase the dimension of the chest at least an inch in the average patient.-ED.] Mosquitos and Malaria. Editor MEDICAL WORLD:-I see in the August number of the Medical Council an article publisht from a pamphlet by the Liverpool School of Tropical Diseases. As the discussion of malarial diseases, their etiology, their prophylaxis and therapeutics are subjects which interest me very much, I wish to ask a few ques tions: In the discussion of the article I allude to, "How we get Malarial Fever," the writer says: "If now we allow mosquitos of the kind called Anopheles to bite persons infected with the malaria parasite, and if we then dissect these mosquitos, we shall easily be able to find the para sites growing also in the mosquitos." Question: Now, why not find the parasites in the other mosquitos? Does this mosquito have first to find some one infected with the germs before it can operate as the distributor? If so, we have still to search for the source which furnisht the original supply. I suppose if those mosquitos are kept away from persons infected with malaria, they are no more to be feared than any other mosquitos? I have long thought that the bites of insects of different kinds were the causes of numbers of complaints and skin eruptions. England, Ark. W. M. ALTER, M.D. [If the Anophele was uninfected, his bite would be no worse than the bite of the other varieties. Why this mosquito carries infection and other varieties do not, has yet to be learned. The insect itself is not the promulgator of the disease further than that he is a carrier and distributor of the germs with which he himself has been infected. The house fly does not ordinarily distribute typhoid fever, but if he has fed on and walkt over the excreta of a typhoid patient, and then has the same opportunity with food to be ingested by a healthy person, the chances of infection are very great. It is all a matter of 2 and 2 making 4, but we cannot always find the second 2. We venture the prophecy that within five years malaria will be under as complete control as small pox now is. The recent discoveries have shed more light on the matter than has ever been vouchsafed us before, and the best men in the world are hard at work attempting to clear up the final details. Just as soon as further definit information is forthcoming, you will find it in THE WORLD. We do not believe that the bites of insects are responsible for skin diseases further than the temporary results of infection from the bite. Admitting that it is possible for insects to carry infection from one human being to another, we must remember that the excursions of such insects are limited in extent, and that infected individuals from whom they must draw their supplies of germs or virus are comparativly rare. In the virulent malarial districts nearly every one has a taint of malaria, and the mosquitos have abundant opportunity; but in no section of the country are any skin diseases found in such universal distribution. We think you are on the wrong track, Doctor, but you may only be a century ahead of your time. Keep thinking and studying, and write us again at later date.-ED.] - Will you Dandruff and Falling Hair. Editor MEDICAL WORLD: kindly give in the next issue of your excellent journal the best treatment for the radical cure of piles? also a good preparation to prevent young peoples' hair from falling out, and to keep the scalp free from dandruff? R. A. DAKIN, M.D. Pugwash, Nova Scotia. [We have in preparation an article on the cure of hemorrhoids, and will publish it as soon as possible. The scalp of both male and female is kept in the best hygienic condition by thoro bathing only when required for purposes of cleanliness, and massage. Too frequent bathing removes the oil from the hair, and too frequent brushing or massage is prone to irritate the scalp. While the amount of fat thrown out by the hair and scalp varies greatly, one is safe in estimating that the hair and scalp of one not exposed to continuous dust, need only be washt once in two weeks. The toilet of the head includes thoro washing of scalp and hair with warm water and bland soap, followed by vigorous friction of the scalp with the finger tips or a small, soft brush, and the gentle drying of the hair by protracted brushing. Massage the scalp, not the hair. After the hair and scalp are thoroly cleansed and dried, one may apply some bland or stimulating preparation which does not contain lead in any form. When the hair comes out, and the scalp seems in fair condition, the best results are obtained by rubbing an aqueous solution of table salt well into the scalp once or twice a day. We use from to a dram to the quart. The hair is separated carefully, and the moistened finger-tips rub the solution well into the scalp, stopping just short of actual irritation; thus the entire scalp is treated, and the less of the solution allowed to dampen the hair, the better. A nice method of cleansing the hair and scalp is to take the whites of several eggs and thoroly shampoo the head, and then rinse with warm, soft water. The following preparations will eradicate dandruff if the scalp receive proper 4 drams 1 grains ....10 grains Mix and direct: Use every alternate day. This will eradicate dandruff in every case not complicated by other actual disease. When other skin disease complicates the case, the diagnosis must be made, and proper treatment instituted. We are always glad to hear from you aliens without our boundaries, and somehow, a good many of you remember us. How do you treat pneumonia up there? Do you have any "hay fever"? Tell us next summer. Give us a good original article that will please your Canadian friends and gladden our hearts.-ED.] Editor MEDICAL WORLD:-A young lady of about 24 years, German parentage, school teacher by occupation and to all appearance enjoying good health, weight about 140 pounds, light complexioned; appetite good; bowels regular; well nourisht and not anemic. Began menstruating at about 14 years of age, but has never been regular. Will go from 6 to 8 and 10 weeks without menstruating, and then not painful or in excess, as we would expect. Nebr. W. A. L, M.D. [Dilate the os thoroly with mechanical dilators during the intermenstrual interval, and keep it open by frequently changed aseptic tents or silver wire dilators. Remove either when the first symptom of the molimen appears. Put her on peptonated solution of iron and manganese, and if this fails, use fluid extract of cotton root bark. Arsenic, iron or strychnin often act well in such cases. Regularity in quantity, time and quality of the menstrual flow is essential to perfect health, and you should help this girl. Write us later.-ED.] Editor MEDICAL WORLD:-Married lady about 28 years old and married six years, no children and no miscarriages. Housewife by occupation. Very small; weight, in health, 116 pounds; now about 95 pounds. Has always menstruated, quite regularly, tho sometimes painful and sometimes in excess. Has used a great deal of patent medicins in the last ten years, and in the last two years a great deal of wine of coca. Came to me in April; appetite poor, digestion very bad, bowels constipated, falling of womb, endometritis and ulcerations of os uteri. Considerable sharp pain in pelvic region. Have tried the usual line of treatment in these cases, but patient gets no better and seems to be getting more nervous and more emaciated in spite of all tonics and supportiv treatW. A. L., M.D. ment. Nebraska. [We would curet the uterus and treat the endometritis by the customary measures. We would keep up tonic treatment in which strychnin and quinin would be the main features. We would not use any form of alcohol unless specially indicated. The dilation of the os necessary for curetment will probably aid in itself in relieving the pain at menstrual periods. Protracted douching with three or four gallons of hot water before retiring will lessen the pelvic congestion. Treat her indigestion as you would any other case of nervous dyspepsia; but we would suggest the addition of generous dosage with bromid of strontium in addition to the usual antifermentivs and digestants. If you can alleviate the endometritis sufficiently to get her pregnant, the chances are greatly in favor of a permanent cure -ED.] Editor MEDICAL WORLD:-Mr. -, age 37, single since 1892; saloon keeper. At present a very moderate drinker; has not drank to excess since 1893. Has not indulged in sexual excess since 1893. Constipated habit. Has feeble erections and premature ejaculations; also loss of semen when bowels move. I have treated him with bromids, ergot, iron, quinin and strychnin, electricity and cold applications. Got some relief while using the bromids and ergot. It requires about double the usual amount of any drug to produce the desired effect. I would like the opinion and treatment of the "brethren," also the Editor's. A. C. T. [Your treatment was orthodox and all right. We would continue the bromids in the form of the strontium salt. We would also advise giving fluid extract of muira puama in 30 drop doses before meals combined with strychnin phosphate in 20 grain doses. He must be strictly continent for a time. The nocturnal pollutions are natural if not in excess of say 1 or 2 each week, "he loses and he must be convinced of this fact in order to relieve his mind. He must think as little as possible of himself and of his affliction, since his trouble is evidently nervous in origin. You say semen when the bowels move.' Are you certain of this? The glairy secretion so often observed passing from the meatus is very rarely semen; it is the secretion from the prostate gland, and is no more debilitating on the patient than so much secretion blown from the nose. You cannot accept his statement on this point, but should secure some of this secretion on a plain glass slide and examin it under the microscope as soon as possible. If you have no microscope, obtain a slide and give it to the patient with instructions to smear some of the secretion on it at the first opportunity, and to bring it immediately to you. You may then send it to some physician friend who has a microscope for examination, or to some of the numerous houses who make a business of doing such work. If microscopical examination does not reveal the presence of spermatozoa, take your books and show him that the discharge is not and cannot possibly be semen. Continue cold applications and institute the hygienic and therapeutic measures we advocate, and if your patient is faithful we believe you will have a perfect cure in a few weeks.--ED] A catheter should never be forced into the bladder. All catheters should be kept perfectly clean. After each using they should be dipt in carbolized oil, washt in warm water, and, if gum elastic, be put away in zinc powder, powdered soapstone, or starch. All soft-rubber articles are rendered hard and brittle by contact with oil or grease. Catheters used in puerperal cases should be rendered thoroly aseptic. Current Medical Thought. The following circular letter has been received from Dr. Fenton B. Turck, of Chicago, the eminent specialist on diseases of the stomach. The Editor decides to exhibit the letter to WORLD readers, together with the questions and his answers. C. F. TAYLOR, M.D., Philadelphia, Pa. Dear Doctor:-I would like to obtain your opinion of the importance of teaching medical students three subjects now neglected in medical education, viz., (1) Hydrotherapy, (2) Medical Gymnastics and Massage, (3) Dietetics. The practical demonstration method of teach ing these branches would not seem to burden the student, especially medical gymnastics, which would rather be a physical benefit and a mental rest. Hydrotherapy and other physical methods of treatment seem now to be almost a necessity in the armamenture of modern therapeutics. This branch and Dietetics are left to the nurse or to the caprice of the patient. A thoro and practical knowledge should belong to every physician. The practical and scientific knowledge of these three branches would put a check upon quackery and ignorance. Kindly answer inclosed questions and oblige, Yours very truly, FENTON B. TURCK, M.D., 362 Dearborn avenue, Chicago, Ill. 1. Are you in favor of including the subject Hydrotherapy in the curriculum of medical schools? Ans. Yes. |