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exact results of the dose given. Better start with a very small dose, and if necessary increase it later, than to start with the regulation dose and injure your patient. I am not supposed to enter into details of the treatment of inebriety or the drug habits in this article, but will do so in a future article if you wish me to.

GEO. H. DENIKE, M.D.

Clinton, N. Y. [Yes, Doctor, please give us details.ED.]

Editor MEDICAL WORLD:-Is there any drug or medication known to the profession that will cure appetite or desire for intoxicating drinks, tobacco, or cigarettes, etc.? I have tried in practise everything I have seen suggested in the medical journals without success, unless the individual taking treatment was using to his utmost his will power to refrain. Then medicin and advice will materially help, and often result in cure. I should like to hear others' experience.

New York City.

A. B. WHITNEY, M.D.

those in which, so far as I know, physicians are in the habit of employing it; namely, as a hemostatic, in its action thru the stomach. In this direction I have used it in a number of different diseases, but more especially in cases of purpura hemorrhagica. In fact it was its use in these cases which called my special attention to its peculiar action thru the blood. The first case in which I noticed this was a truly typical one, and has been my guide in the treatment of all cases of purpura which have come under my treatment or advice since. This case occurred in the early years of my practise; and the fact of my not being overrun with business probably afforded me the opportunity of treating and observing it.

My old preceptor sent me to it, and told me that he and several other physicians had been at work at the case for six or seven weeks, with no especial benefit, which I at once perceived as soon as I came in contact with the case. The patient was a young woman of twenty-two, showing all the unmistakable signs of a severe and long continued attack of purpura.

Rhubarb in Purpura.

Dear WORLD:-In these days of discoveries in medicin, invention and rapid movement, it seems to me that there may be danger of forgetting some of our old and long tried friends in our eagerness to acquaint ourselves with and avail ourselves of the newer ones. There are so many new discoveries constantly coming to the front that it seems hardly possible to keep pace with them.

About two years ago I sent you a little article, which you publisht, on my method of using rhubarb with quinin, especially in the treatment of children. At that time I thought I would soon send you another article on a peculiar use of rhubarb, which if not a new one, is certainly one of which I myself have never heard. I think it is recognized by most practitioners who have been in the habit of using rhubarb much, that it has a quality of affecting the blood in a manner quite different from most vegetable medicins. Whether that peculiar effect is dependent entirely upon its astringent acids, I do not know; but I am not inclined to believe that such is the case. The special uses of rhubarb to which I now refer are of a different nature from

not bleed from, than where she did, because she bled from almost every conceivable point or organ. The hemorrhagic spots were still visible over her whole body, but of course more or less faded and indistinct; more especially the lower limbs. Bad, dark blood dribbled from her gums and also from her nose, giving her, with the ecchymosed spots on her eyes and face, a most distressing appearance of feebleness and misery. The urin was heavily loaded with blood, and I was informed, on that morning of my first visit, that she had had no movement of the bowels, except at a regular time in the morning of each day for some eight or nine days, a gill or so of the same thin dark colored blood, and nothing more.

These were my observations on the first visit. I of course inquired what had been done for her. As I said before, the case was now well on toward seven weeks' continuance. Being young in independent practise, and feeling much delicacy in making innovations and changes in a case of which I knew little (and, seemingly, those who had treated it before knew but little more), I made diligent inquiry in regard to the treatment to which she had been subjected. Opium, iron and ergot-ergot, iron and opium,

told the story of her treatment. Having learned so much, I went home to think over the case. She was suffering, of course, with all the ordinary symptoms of hectic or toxic fever-high temperature, rapid and feeble pulse and headache. I thought the case over and over, in a hopeless sort of way. The case appealed to me strongly, and yet I did not know what to do with it. I saw her again the next morning, and found no change except a general increase of the discouraging, if not almost hopeless array of symptoms. I found that, in the meantime, there had been no movement of the bowels, except the usual discharge of black blood. As I said before, it was now eight or nine days since she had had any other evacuation. I said to myself that the treatment had had its legitimate effect. The alimentary canal had been pretty thoroly paralyzed with the opium, iron and ergot treatment. I must, in some way, produce a mild action of the bowels. What shall I use? I made a rapid canvass of all the old and well tried cathartic remedies, and finally concluded that rhubarb should be my forlorn hope; and this, I thought, I must use in some very mild form, for she was in a state of great debility and very anemic. I concluded that the aromatic syrup of rhubarb should be the preparation. Now with this, what shall I use for an additional tonic? I reviewed all the tonics with which I was acquainted, and settled on compound tincture of cinchona. Having decided thus far, I wrote a prescription as follows:

Tr. cinchona comp.
Syr. rhei. aromat., q. s..

2 oz.

ad 8 oz.

M. Sig. A tablespoonful once in two hours until bowels move.

I think it was something over twentyfour hours before I saw the patient again. My prescription had been faithfully used, and I think almost, if not entirely consumed. But a real evacuation of the bowels had been produced, and the most distressing symptoms had begun to diminish, especially the discouraging hemorrhages. The urin, which I have noticed in all such cases begins to show the earliest effect of the rhubarb treatment, had begun to clear up; the fever was less, and the patient really better. I continued the medicin, giving it less frequently and in smaller doses for several days. Of course I made the best suggestions I could in regard to

her diet. She improved rapidly, and I left her at the end of about two weeks. So far as I ever knew, she had no return of the purpura.

Following this case, during the next few years, I had a number of cases in the same line, which gave me much satisfaction. Some of these, if you think it worth while, I may hereafter try to narrate.

Woodbridge, Conn. J. W. BARker. [As the above case seems to be typical of the class, and if it illustrates uniform success with the treatment given for that class of cases, one is sufficient. If you have made other new uses of old remedies as strikingly successful as the above, we would be pleased to have them.- ED.]

Fractures.

Editor MEDICAL WORLD: Fractures, like deaths and births, are always in season; and so are articles thereon. There is no class of cases which doctors approach with more fear than fractures. The profession is not slandered by the statement that it has not done itself proud in their management. The treatment has been cumbered with too much machinery.

What I shall say on the subject is a rehash of what has been written by others. Iteration and reiteration seem to be necessary to wean the ordinary professional mind from the worship of its idols: hospital and college teachers.

In the February WORLD, 1886, and again more fully in the September WORLD, 1890, page 373, Dr. J. H. Stearns, of Lynn, Mass., describes his method of setting long bones, as follows: To set the thigh bone," Prepare four flat splints of wood about three-eighths of an inch thick for the upper, under and sides of the thigh, in length not to extend above the trochanter, nor below the condyles of the knee. Take a cord and measure around above the knee, fold the cord twice, and you have one-fourth of the circumference; cut off one inch from this. and you have the proper width of the lower ends of the splints; do the same to get the width of the upper ends. Now pad these with cotton and cover with cloth, and you are ready to set the limb. Have a person

to hold the foot, so that the great toe will be on a line with the knee pan, or to correspond with the other leg. Carefully place a splint under, on either side and above; take strong tape, loop it around the middle and tie it as snugly as possible,

then around each end quite tightly. The first one, by this time, will require tightening. Put two others between the center and ends, and keep on tightening them, one after another, until a measurement shows that the leg is as long as the other, and you will find that the bone is 'set' without force and entirely painlessly. Do not, under any circumstances, bandage a broken limb. A fracture thus put up, not tight enuf to impede the circulation, but just tight enuf to prevent the muscles from contracting, and kept thus for forty days and forty nights,' will be found to have reunited with the smallest amount of shortening ever obtained.' The Doctor directs that a starch bandage be applied

later.

About ten years ago a writer, I think in THE MEDICAL WORLD, described his method of applying a plaster of Paris bandage thus: Spread the muslin on a table, sift the plaster over the muslin, wind the muslin around a small, straight stick, the stick the length of the width of the cloth, and roll the muslin around the stick. When the roll is completed, tie strings around it, take it to a butcher and have hin lay it on the meat block and cut the roll thru between ties with his cleaver. To apply, put the bandages into a basin of warm water, and apply as an ordinary baudage."

I at once adopted this method of preparing bandages, and with some modifications have used it ever since, with satisfaction to myself and comfort to my patients.

Dust and roll two, three or four yards of muslin, according to the number of bandages to be used at once. Have them cut in widths adapted to the size of the limb to which they are to be applied. To roll the bandage the stick is a convenience, but not a necessity. Some butchers reluctantly complied with my request to cut it into sections. Without the stick it can easily be cut with any sharp, long-bladed knife.

Below the knee have a stocking put on. This gives a clean, smooth inside surface. Apply circularly, then up and down, finishing with the circular application. Apply so as to leave a thin streak in front, to be more easily cut. A bandage so applied fits like a glove, and leaves nothing to be desired to hold the fragments in place.

Doctor Ezra Miechner, of Chester county,

Penna., wrote a number of articles on fractures. Those which I saw were publisht in the Medical and Surgical Reporter from 1881 to 1886. His writings convinced me that he had a knowledge of fractures, and a skill in their management, beyond the combined knowledge and skill of all the authors, hospital surgeons and college professors in the United States. But because he was not an "authority," the profes sion did not profit by his writings as it should have done. The last article I saw from the Doctor's pen was written in his ninety-second year. The editor of THE WORLD, in my opinion, would furnish the family mighty interesting reading by republishing Dr. Miechner's articles on broken bones.

Brothers, set the bone, apply a constrictor sufficiently tight, and neither screws, weights nor pulleys are needed to keep up extension. Do this and fractures will cease to be an opprobrium of surgery. The methods pursued heretofore are open to severe and adverse criticism. This is a retold story to emphasize information which, upon thoro testing, proves to be of special value. J. S. DODDS, M.D.

6212 Penn avenue, Pittsburg, Pa.

New Treatment for Diphtheria. Editor MEDICAL WORLD:-I like your journal. It seems that you get next to the ordinary doctor with more ease than any other man in the journal business. You seem to know just where he heeds a probe, and it usually comes at the right time. It is evident in my mind that unless your sympathies were with us you would not be able to judge us with such apparent ease. Allow me to give you my treatment of diphtheria, which I do not believe has ever been suggested by any one, and in fact it has been an experiment with me. I place my chief reliance on formalin. I have them procure a steam atomizer, or if there is none to be had, have them cover the patient with a sheet and in a vessel or in the atomizer place a weak solution of formalin. I keep the patient inhaling the steam for at least half an hour at a time, allowing a period of rest and follow up the same treatment until the membrane begins to "sluff off," then at longer intervals. In addition to this the patient is taking teaspoonful doses every hour of the following: Sp. echinacea dr. 3, sp. phytolacca dr. 1, aqua q. s. ad. oz. iv. In some few cases I have given as a gargle pix-cresol,

Flexible Cloth for Splints. Editor MEDICAL WORLD:-Some days ago an agent called on me trying to sell me some flexible cloth, with which to make splints. The price was $5.00 per yard. I was surprised to see the large number of orders he had gotten, and decided to pub. lish a formula that I have had for years. The cloth as prepared by the method I give is to all appearances similar to the cloth sold at $5.00 a yard. It is as follows: dissolve one pound of gum shellac in one pint and a half of 95 per cent. alcohol, with one dram of borax. Let the mixture stand until all of the shellac has been dissolved; then, it is ready to be applied. Old cloth makes the best splints, I generally use an old pair of trousers. Apply the solution to one side of the woollen cloth with a brush and dry thoroly before a hot fire. It takes about one hour to dry properly. Then apply a second coat on the same side, and dry as before. You will then have a single piece, but if you wish a stronger piece, apply the solution on one side of two pieces that have already been prepared, dry them, place them together and press with a hot iron and they will unite and become as one piece. Always be sure to dry out all of the alcohol. To temper the cloth for use, hold before a hot fire until soft, then apply. It will adapt itself to the shape of the limb at once. To make it set quickly, hold in cold atmosphere, or dip in cold water. This formula cannot be generally known, for there would be no sale for the flexible Icloth if it were.

I take seven medical journals, but think THE WORLD in a great many respects the best and most practical journal I know of. May it continue to prosper.

THOMPSON M. BAIRD, M.D.

Christiansburg, Virginia.

Dr. W. H. Tucker, Jr., of Double Bridges, Tenn., sends his renewal and says: "The most paving investment of one dollar I can make is for WORLD for 1901."

Hemorrhoids.-The Tobacco Habit. Editor MEDICAL WORLD:-I would be pleased to have the experience of your readers in the medical treatment of hemorrhoids. A Dr. Johnson died in St. Louis, Mo., a year ago who was to my personal knowledge pre eminently successful in treating this class of cases. I quizzed some of his patients in regard to the treatment, but all they were ever able to tell me was that medicin was applied to the hemorrhoids with a pledget of absorbent cotton, and that the treatment was painless. The hemorrhoids would disappear after three or four treatments, and so far as I can find out, the results are permanent. J. Johnson, of Leander, Indian Ter., in In reply to the question of Dr. N. November WORLD, will say that the following is said to be a sure cure for the

tobacco habit:

Doctor and Druggist Again. Editor MEDICAL WORLD:-In the April number of your journal is an article headed: "Another Message from the Front." Now, this battle between the physician and the retail druggist has been on ever since I first attended medical societies. I then gave my opinion as to the remedy. This was about thirty years ago, and I have been compelled to listen to the rattle of the artillery from both lines of defense ever since, and it sounds just as absurd to me now as it did then to hear physicians continually prating about being mistreated when we have the remedy in our own hands. To my mind there is but one remedy, and that is to fill our own prescriptions. Some physicians have said to me, "Oh, we must stand in with the druggist or he will proscribe us." Well, just let them do so; and when it comes to that, physicians can work at the same business. But let us go on a few years longer sending our prescriptions to drug gists to be filled, and thereby teach them to prescribe. Then they will have it all their own way, and the doctors will have frittered away all their power of self defense. Even now I hear it said by the laity : "Why shouldn't the druggist know better how to prescribe than the doctor? for he fills the prescriptions of all the doctors and his own too."

I am doing a general practise and have. not sent a dozen prescriptions to druggists in my life. They may have consigned me to that mythical place where the preachers say most doctors go, but if they have, I have not felt any inconvenience from it yet. H. WHISLER, M.D.

New Antioch, O.

Determination of Sex.

Editor MEDICAL WORLD:-In December WORLD, page 476, I see an article on the determination of sex. I have been comparing Prof. Schenk's theories with the rules laid down by Dr. J. G. Davis, as publisht in the New York Medical Journal of February 24, 1900. The advice and

rule of the latter seems most probable. Results seem to favor Dr. Davis' studies. The mother in mental, physical and sexual ascendency, the product females. The father in mental and physical supremacy, the product males. In other words, let the mother invite offspring the first or second day after menstruation, the father in good condition, product females. Let the mother invite offspring the ninth or tenth day after menstruation, the father in good condition, product males.

It would help establish the correctness of these theories and rules if the profession would take notes and report for publication. A. B. WHITNEY, M.D.

New York City.

Favorit Prescriptions.

Editor MEDICAL WORLD:-I am a new subscriber, and I like your journal very much; it is so practical. I like your plan of asking your readers to send you reports of their successes and failures, and the prescriptions they have learned to "swear by." The following are some of my favorit formulae :

For malarial fever of the intermittent type, I have found the following prescription to be an almost sure remedy to prevent the recurrence of the chill and to destroy the malarial parasite, especially after clearing the bowels with calomel or blue mass: