three weeks, when he came in and entered into a most dramatic detailed description of how he had gone home, couldn't eat supper, thought he would die, sat up till one a. m. taking medicin, got up at daylight, went to the pump to test his "swallow" with fear and trembling, drank a dipper of cold water, sat down to breakfast, satis fied his hunger and had continned to do so until recently, when medicin ran out and he had had an occasional return of trouble; not bad, but he wanted more medi cin. I heard from him yesterday and he's had no return of trouble. Now to size this case up:

And

Let not the ardent homeopath imagin that I am going to star it as a triumph for his dogma, or claim for it scientific accuracy. Oh, no! I will say that had I not been acquainted with the philosophy of Hahnemann I don't know how I could have disposed of the case so easily and simply. But I disclaim any aspect of scientific accuracy in arriving at the happy hit. this is my criticism of homeopathy. It is not yet scientifically practised. Altho I believe homeopathy in the abstract is a science, yet as it stands to-day it is at best only a great aid to the physician in close guessing. I am aware a great howl is liable to arise from the quarters occupied by many of my brethren, but, my friends, I am willing and able to submit proofs to you that my statements are not guess work.

Now as to those of all other faiths: I am quite sure the "regulars" must admit that altho they might agree upon a diagnosis and upon a general alterativ, tonic and sedativ treatment, that when it came to a "showdown" of means they would present the greatest medley of hypophosphites, quinin, iron, strychnin, bromids, etc., and an unbiassed observer would find it hard to select his first weapon of attack therefrom were he compelled so to do. He would probably wind up by doing what we all do when we don't know what else to domix them all together and get rid of the case-either killed, cured or disgusted.

I am something of a hypnotist, but I can't see anything in this case for our friends of mental proclivities to glory

over.

Were I a hydropath I would work his. emunctories with hot packs; I would stimulate the cerebro-spinal and sympathetic systems by "hot and cold spines," and I wouldn't overlook copious enemas.

If my slight knowledge of osteopathy

fails me not, I should as an osteopath seek first for malpositions of cervical structures, muscles, bones, nerves and vessels. If found, they should be replaced as nature intended. Failing to find any material causes, I should carefully consider the case inductivly. Assuming the existance of a small pharyngeal ulcer or irritable spot, I should trace the nerve supplying that spot to its source, then deductivly I should search all lines of possible reflex activity to their organic termini. My taxic treatment, whether specifically directed to any organ or structure, or whether generally directed toward stimulation of all organs, would be determined by my success in locating a specific cause. A specific displacement of bone, muscle, nerve or blood vessel would obviously only require replacement. A failure to locate a specific cause would imply a lowered vitality with accompanying inactivity of all metabolic processes, and demand for the removal of the morbid effect, a general tonic treatment of the entire organism, thru activ stimulation of the great central nervous system, as well as specific attention to the great excretory glands.

It is high time we admit light upon the healing art from all sources. We can surely be no worse off for a breadth of view. Jos. H. MEYERS, M.D.

Leslie, Mich.

"What's the Matter with Kentucky?" Editor MEDICAL WORLD:-Dr Stone, of

Lafayette, Ky., (Oct. WORLD, page 425) says he wishes some light on amenorrhea. samples of a great many more" that never He speaks of four cases, "which are only menstruated. I have practist in Michigan 28 years, and have never seen a case like his, tho I have seen one case that menstruated only twice. Would like to know if there are other states equal to Kentucky in that respect; and if not, what is there in Kentucky so peculiar? Have been trying to think and I make out: 1st, blue grass; 2d, whiskey; 3d, "colonels;" 4th, that so many are handy with their guns, but do not know which to attribute the amenorrhea to. A. F. RANDALL, M.D.

Port Huron, Mich.

Dr. S. C. Lumley, of Leonard, Mich., writes: "I take great delight in reading THE WORLD, devouring it frem cover to cover. It is the best and most practical journal I take."

(Continued beyond Yearly Inder. Raise staples with a pocket knife, ferð Yearly Inder out, and bind in front or back of volume, as desired Dan forget WORLD Binder · 35 cents each, or three for $1.00).

Treatment of Headache. Editor MEDICAL WORLD:-In return for good suggestions received from THE WORLD, I offer the following: Good results will be obtained in the treatment of headache due to intestinal indigestion by the administration, twice or three times a day, of 10 grains each of tannalbin and ichthalbin. Have patient also take before breakfast one level teaspoonful of German cathartic salts, dissolved in glass hot water. In gome cases an enema of warm water in addition is advisable at night. This may seem a great deal to do for nervous headaches;" but if we can relieve cephalalgia of frequent occurrence for many years, even the foregoing will not seem too much for the patient to do.

BERNARD OETTINGER, M.D.

Denver, Colo.

From an " Orificialist."

Editor MEDICAL WORLD :-If Dr. Pierce will carefully examin the lower orifices of the body in his case cited in Nov. WORLD, page 487, he will find a cause for his patient's trouble. It is the sympathetic" that is involved. The "spot" is only a reflex symptom. My experience with this class of cases is that medicin given allopathically, homeopathically or otherwise will do but little good until orificial work has been done. If the Doctor will, under anesthesia, pass sounds to about 17 (American scale), wash out the bladder with boric acid solution, enlarge the meatus, free the frenum and circumcise if necessary, then thoroly divulse the anal sphincter, trim out any irritable points, as fissures, ulcers, pockets, papillae, piles, etc., also dilate the sigmoid, put his patient in bed for ten days, he will have the satisfaction of seeing his patient back at his duties and enjoying good health, putting on flesh, digesting his food all right, and sleeping well. If the Doctor has not had experience in this line of work, he would better call in some brother physician who has, to help him out.

organs controled by the sympathetic will soon work properly, and health will be quickly establisht. First remove the thorn in the flesh, then give your tonics, especially positiv electrification and positiv breeze; then you will get results. There are more ways than by medicin to cure disease. I cannot, from much experience, agree with the Editor that the gastritis is the sole trouble; it is only a symptom, in my opinion. The above treatment has so demonstrated it to me many, many times. I am glad to find a journal that is not an exclusiv dogmatic affair. No "ism" contains all the truth. Success to THE World. St. Paul, Minn. E. HUBBELL, M.D.

[It will be easily recognized that the Doctor is an "orificialist." Orificial surgeons claim great results from operations on the orifices of the body. They are creating a literature on this method of treatment. Their enthusiasm is doubtless developing and establishing much good praetise; but like all enthusiasts, they claim. more for their methods than mature experience will justify.-ED.]

Inflammation in the Antrum.

Editor MEDICAL WORLD:-Dr. W. H. Lancaster's case, page 485-6, November WORLD, reminds me of exactly the same symptoms I experienced last spring, caused by inflammation in the antrum of Highmore, following the grip. I endured it about two months, and then had the antrum opened thru the maxillary bone, which caused the symptoms to cease at once, and they have never returned. However, there is some discharge of pus yet. I am of the opinion that there is pus burrowing in the bones of the head somewhere, and that the patient is absorbing more or less of it continuously. I have never considered myself competent to write for a medical journal, and especially for THE WORLD. I have been a reader of THE WORLD for many years, and now as I am passing down the declivity of time, I enjoy its pages more than ever. The young men of to-day ought to be wiser than the old men, for their advantages are certainly much greater, for which I am thankful. W. C. SMITH, M.D.

Franklin Grove, Ill.

Dr. H. R. Butler, of Atlanta, Ga.. sends $3 for four years and says: "You are a great help to me in my practise. Put me down in the four year column."

Dr. H. Rosahnsky, of Brooklyn, N. Y., sends $1 and writes: "THE WORLD gives me great satisfaction and pleasure. This is my fourth year's subscription."

Report From Dr. Ballard.

Editor MEDICAL WORLD:-I desire to thank my brother physicians, especially those who wrote me privately, for their kindly suggestions in regard to the treatment of my daughter (see September WORLD, page 398). I tried the cimicifuga tr., which seemed to make her worse; and then the homeopathic tr. of pipsisewa, which seemed inert. I now have her on iron, quinin, strych. and arsenic, with pil. cascara co. as a laxativ, and think she is slowly improving. Nearly every remedy recommended I had already used in different combinations. As I stated in my first communication, I still believe her trouble to be a case of chronic malaria, causing severe congestiv headache, and I now think the above treatment is going to cure her. H. F. BALLARD, M.D.

Chenoa, Ill.

In a gracefully worded letter (but too long to publish) Dr. W. T. Risque, of Paynes Depot, Ky., expresses his thanks to the many brethren who kindly offered help to him in the treatment of his case of goiter. He is surprised at the readiness of the WORLD "family" to help in a private way, and as the letters were too numerous to answer singly, he wishes to thank all thru the WORLD. He has his patient on the treatment recommended by two of the correspondents, and he thinks she is improving. He wishes that the "Talks" could be "stampt on the mind and heart of every American citizen." The suggestion to have the "Talks," or parts of them, copied by your local paper, has often been made.

Echoes From the Test Cases.

[The test cases have proven to be prolific producers of manuscript, much to the embarrassment of the Editor. Care must be taken not to allow such matter, however interesting, to crowd out other important matter. For this reason, and in order to avoid too much repetition of the same ideas by different correspondents, we are unable to publish many communications received However, other test cases are ready to be "sprung," and we will continue this feature for the present, but with due regard for other interests.-ED.]

Editor MEDICAL WORLD:-Complaint is made that in my test cases I did not give a sufficient detail of history and symptoms. In reply to this I wish to say that hundreds of physicians in Mississippi prescribe successfully every year for hundreds of just such cases as I have given, with no other symptoms than those I have given, and without seeing the patient.

Kendrick, Miss. C. KENDRICK, M.D.

Replies to Dr. Kendrick's Test Cases. Editor MEDICAL WORLD:-On page 412, October WORLD, Dr. C. Kendrick asks treatment of two test cases. Having had ten years' experience with such cases without a death, I will give you my procedure, slightly modified to suit the case. In the first case I would give four doses of calomel, about two grains each, every two hours, to stimulate the liver. Two hours if bowels have not acted freely. One hour after last dose I would have a saline given after first dose of calomel I would begin and continue every four hours the follow

ing:

M.ft. caps. No. 8. Sig: One every four hours. Treatment seldom fails to stop disease. at once.

In second case, I would give a hypodermic of quinin bimuriate, two grains, at once; to be repeated in two to four hours if I can get back to patient. Would put him on calomel and subnit. bismuth ãã five grains every two hours till four doses are retained, followed in two hours by a saline. Also would give quinin bisulf, six grains every two hours till four doses are given, then four hours apart.

Try to control vomiting with

Editor MEDICAL WORLD:-Permit me to throw in my mite in the discussion and treatment of Dr. Kendrick's test cases. Burn or print these lines as you see fit, and still I shall be open to confess that out of five monthly journals THE WORLD is the most practical, useful and welcome one that comes to my desk. Living as I do in a malarial district, I have seen ⚫ many such cases as Dr. C. Kendrick describes. He gives few symptoms and omits many no doubt; yet quite sufficient to convince me that both are suffering from malaria, caused by a double infection of the tertian parasite. Therefore before treating malaria we should study the pathology of the disease, and thus save our quinin; also patient from disagreeable and often injurious after-effects. The action of quinin is more markt upon the young extracorpuscular bodies, and very slightly upon the parasite during the corpuscular phase of its existence. Therefore the administration of quinin a few hours before an expected paroxysm will not prevent its occurrence, because at the time of its administration the parasites, being within the corpuscles, are in that phase of their existence during which they are least susceptible to the action of the drug. Segmentation is not prevented, therefore, and the paroxysm occurs; but the resulting free young segments are destroyed, and their further evolution cut short, so that the next succeeding paroxysm is averted. It follows then that quinin should be administered from twelve to four hours before the expected paroxysm, so that the maximum influence of the drug shall be obtained at the time of the sporulation of the parasites, for the reason above stated. It exerts but little toxic influence upon the parasites as long as they remain within the blood corpuscles. Being called to the bedside, as we gen. erally are, after the chill is over, I would prescribe for Case I as follows:

Caffeine citratis......

.gr. jj (Heart stimulant to counteract acetanilid; aids in relieving headache and acts as a diuretic. )

Ft. capsulae No. 4. Sig.-One every hour till all are taken, to be followed in from four to ten hours by a saline.

Ten hours before the expected paroxysm begin quin, sulf. gr. iv. every three hours till three doses are given, repeating next day. In forty-eight hours' time the chills will be broken, but I now order or three quinin gr. iij t. i. d. for two weeks; also a tonic:

Sig. Two teaspoonfuls in water after meals. Small doses of quinin and tonic to be given from two to six weeks until satisfied that the patient's blood is repaired enuf to resist the germ.

Case 2 is of a more malignant character, therefore must have immediate and careful treatment. Cold wet cloth to his head. Check vomiting by giving small pellets of ice swallowed whole, which will also relieve thirst. Mustard plaster to the stomach until it gets red, and a cold wet cloth on the neck just above the sternum. Purge by giving some capsules as given to Case 1, but this man may vomit some, so give one every hour till four or five are retained, followed in four or five hours by a saline. Diuretic: Spts. ether nit., m.x to xv until desired effect is reacht.

The great depression should be combated by strychnin and digitalis, and patient sustained if necessary by enemas of whiskey and peptonized foods.

Ten hours before expected paroxysm quinin sulf. gr. iv every three hours till three or four doses are given. If his stomach will not retain the quinin sulf. it may have to be given by hypodermic injections.

This man is not likely to have but one

more chill; yet he is a sick man, and will have to keep his bed for a week or more. After forty-eight hours I would reduce the quinin to gr. iij t. i. d., and give tonic as in Case 1, rot forgetting to give arsenic in increasing doses. Diet must be milk, eggs and liquid food for the first few days, because the stomach will not retain solid food.

I hope I have arrived at the bedside of these victims before the homeopaths have drowned them by giving nat. mur. 200 x, or choked them on their little pills, because I know I can cure both by administering purgativs, quinin and tonics.

E. J. MCLENNAN, M.D.

Malta Bend, Mo.

Editor MEDICAL WORLD:-I am a new arrival in your lively WORLD "family." If you think my method of treating the two test cases given by Dr. Kendrick worth giving to your readers, all right; if not, you will oblige me by giving it a place in your waste basket. In order to exactly meet the wishes of the writer from Kendrick, Miss., I will confine my remarks to the means I would employ in curing at least the first case within twenty-four or forty-eight hours, as demanded by the Doctor. Case No. 1: We are dealing here, as we all know, with two cases of quotidian intermittent fever, where two groups of Laveran's hematozoa coexist and sporulate on alternate days. As stomach is quite tolerant in spite of the threatening appearance of the tongue, I would give him at once 5, or may be 10 grs. of calomel with bicarb. soda, to be followed four hours after by a seidlitz powder, to be repeated if necessary after a few hours. There now existing a great hepatic activity, I would give 10 to 15 grs. quinin every four hours, and if I have time to give three or four doses of quinin before the next paroxysm should appear, ten to one it will fail to materialize. Attention to the digestiv functions, and the continued use of quinin for a time ought to make a sure cure of this case.

Now for case No. 2: As in this case there is yet some pyrexia on second night of attack, there is danger of its merging into the remittent type unless arrested at once. If called during the second paroxysm, finding stomach very irritable, I would give patientgr. each, calomel and bicarb. soda every fifteen minutes for

the double purpose of checking vomiting and increasing the secretions of the gastrointestinal glands. Would stop at 1 gr. Would apply sinapisms to the epigastrium, and give bits of ice to suck. Next in order I would administer sulf. codeine, gr., subcutaneously, as a nervous quietant; then pilocarpin, gr., to promote both diaphoresis and diuresis. As soon as stomach has settled, would give seidlitz powders every two or three hours until free catharsis. I should now consider prophylaxis of a chill, and if I can be with patient, would give him quinin hydrochlorate, gr. XV hypodermically, which I would repeat after six hours, and give same dose per rectum every four hours, until stomach is able to retain the drug, when I would give it per orem with other antimalarial remedies as indicated by the case. E. LABRIE, M.D.

Pleasant Grove, Cal.

[In a long and large editorial experience, we have noticed that a communication coming from a man who is modest enuf to suggest that possibly his contribution should go in the waste basket is almost invariably worthy of publication (tho we are not always able to publish all good communications, owing to lack of space, exhaustion of subject, etc.). Modesty and ability usually go together.—ED.]

Editor MEDICAL WORLD:-The cases of Drs. Chapman and Kendrick are more than mere test cases for the selection of the curativ remedy. To a limited extent they illustrate a distinctiv feature of each school of practise, viz.: Dr. Chapman individualizes that he may treat the patient; Dr. Kendrick generalizes that he may treat the disease; Dr. Chapman has given the symptoms of the patient that each reader can be his own judge of the condition; Dr. Kendrick has given his construction of the symptoms, his diagnosis of the disease, on which we are to select the remedy. Hence these cases are not taken as a homeopath would take them, consisting chiefly of negativ conditions, yet the first one is comparativly clear:

Chill, daily at 10 a. m.

Stages of the paroxysm: chill, heat and sweat, are regular.

Apyrexia clear; appetite good.

These symptoms call for quinin and no other remedy; and to obtain the most prompt and permanent curativ result, it