became a running ulcer, about one inch in diameter, the furuncles extending as far as the swelling, which was two or three inches on either side. Had it treated by a physician, and ulcer healed over. In 1894 it opened the second time. At that time it was thought best to not heal the ulcer, for fear of injuring patient's general health. The ulcer gradually grew larger, and when I saw patient, a year ago, ulcer was two inches wide and three inches in length, the swollen part extending around limb and about ten inches from ankle upward. I have been able lately to keep it from spreading, but fail to heal it up and grow smaller. It is very painful, especially so at night.

Will the brothers offer suggestions in way of treatment, and what course to follow? Family history points to nothing. Ohio.

O. C.

[The writer does not say what treatment has been tried, nor what authorities he has consulted. Before coming to the WORLD "family," an applicant for help should first exhaust all the means in his reach, and in his report he should state what has already been done. We want our quizzers to be students.-ED.]

What Sized Dose of Strychnin is Allowable? Editor MEDICAL WORLD:-If there is no motion before the House, I would be glad if the Editor and a few of his readers would give an opinion on the huge doses of strychnin recommended by some physicians. I see it recommended in doses ranging all the way from to o gr., and it would seem that this dose could be repeated as often and as long as the same amount of phosphate of soda. It may be that my medical education "smells too strong of pine smoke" to render an opinion on this subject, but it seems to me that this dose is rather large. I would like to know how many o-grain doses a patient would bear. "Till you get the effect" will not do for an answer, for a great many country doctors cannot see their patients oftener than once in 24 or 48 hours. He cannot stay to see the effect, and the nurse might not be able to determin when the effect had been produced. The writer is just recovering from an attack of chicken pox. He has had everything now but a bad conscience and an ugly wife. A. C. GORE, M.D.

Hohenlinden, Miss. [We wish to congratulate the Doctor on

his conscience and his wife. Tho he may have had all other bad things, still he is lucky. We have seen strychnin given in gr. doses every four hours, for a day or two, with the result of perhaps saving a life; but the condition was a very extreme one.-ED.]

Varicocele.

Editor MEDICAL WORLD:-My first question askt you and yours is: Give me the best treatment for varicocele. If I can find so easy, bloodless and painless a cure for varicocele as I have for hydrocele I will be satisfied. THE WORLD certainly is not second to any journal coming to my desk for the general practitioner of medicin. Kindly give me your treatment for said trouble, in your next issue. Falmouth, Ky. M. H. WHEELER, M.D.

[We are astonisht that Dr. Wheeler does not know that the first rule in the WORLD family is to give away anything you may have that is good. If the Doctor has any thing new or better than that now in use for hydrocele, the profession expects him to tell them of it thru THE WORLD.

Varicocele is much more difficult of diagnosis than hydrocele: a dozen other affections simulate it; some of minor importance, others of major import. Picking up the veins under ligatures an inch or so apart, tying each ligature firmly, snipping out the portion thus occluded, and approximating the cut ends by means of the ends of the ligatures, is easy. It is painless under a general anesthetic; it is as near bloodless as any incision in vascular structures can be; it is permanently curativ in the vast majority of cases. Besides perfect asepsis, one must guard against including any nerves in the ligature. The epididymis is to be avoided, also. Only the average knowledge of the parts and moderate skill is required for a perfect result.

The medical treatment includes bathing three times a day with very cold water, and the wearing of a perfectly fitting suspensory. The internal administration of such tonics as strychnin and arsenic is indicated. We have had markedly beneficial results from the use of gradually ascending doses of ergotole.

So thoroly is this affection recognized as surgical, but very few of the modern textbooks on medicin mention it all.

We regret, Doctor, that medicin offers

no specific; but we hope to hear from you early as to your treatment of hydrocele. If any of our readers have anything better than the above to offer the Doctor, we will be glad to give space to the information. -Ed.]

Snake Poison, Etc.

Editor MEDICAL WORLD:-I have just moved to this country, and have taken Government land. I find that when warm weather begins this section of the country will be alive with rattlesnakes, of which there are two species here. I am So afraid of the ordinary non-venomous snake that I generally fall when I see one, and can not arise for a minute or two, so I have been dreading the thought of spring. Remembering that my husband used to take your journal, and that you answered queries, I wish to ask you for remedies for sattlesnake bite. I read that a 1 per cent. solution of potassium permanganate would cure bites of venomous reptiles, but I do not remember if the solution is administered hypodermically or not. Can you tell me of something more simple? Will you tell me what I can take to break up colds and ague, besides quinin? This always produces an itching rash, within an hour or two, with me.

Have you heard of an apparatus, made on the order of a telephone, for deaf people? The receiver pins on the dress and is connected with instrument in the ear. If you know of it and it is really good, will you kindly give me the address of the manufacturers?

While this country is being settled up fast, there is no doctor nearer me than 35 miles. MRS. D. M. DUNCAN.

Winona, Wash.

[We are always glad to hear from the ladies. The rattlesnake always gives warning before it strikes, we are told. One should wear heavy boots that come high up on the leg. The potassium permanganate is injected in a series of punctures about the wound. It is not, nor have we, a specific for snake bite. Many favor free stimulation with alcohol, but others oppose it strenuously. Tie a tight ligature between the wound and the heart, and incise the wound freely so as to encourage free bleeding. The wound may be sucked by the mouth or by means of a "cupping glass," improvised with any small vessel. Snake venom in one's mouth is harmless, provided there be no

abrasion. Fraser advises the application of nitric acid or the actual cautery; or if the bite be upon finger or toe, quick amputation after ligature is permissible. The ligature is retained in place for half an hour, and momentarily loosened and again applied; this process being repeated several times. Intravenous injections of antitoxin and hypodermic injections of strychnin have been recommended. Dr. Calmette has recently produced an "antivenomous serum," which is declared to be highly efficient.

Dover's Powders will often aid in relieving the symptoms of cold. The coryza tablet of Dr. Richards is promptly efficient, tho it contains a half grain of quinin. Unless you are very susceptible to this drug, this amount will hardly produce untoward symptoms. Blennostasin works well in a majority of cases.

We do not know of any such instrument as the one you mention, and can not see how it could be of much use.-ED.]

Phytolacca in Obesity.

Editor MEDICAL WORLD:-Can you give me any information regarding the value of phytolacca fructus in the treatment of obesity, the preparation used and dose? B. A. BARNEY, M.D.

66

Hammondsport, N. Y. [Culbreth, Materia Medica and Pharmacology, publisht by Lea Bros. & Co., 1900, says: Phytolacca fructus contains phytolaccic acid, coloring matter (bleacht by sunlight, yellow by alkalies), sugar, gum. The fluid extract of the fruit is given in 15 to 30 drop doses; the tincture, infusion, and exprest juice are also used. It is alterativ, laxativ, emetic, anodyne, resolvent; paralyzes spine and muscles of respiration in overdose. Two to four drams have produced poisoning similar to that of veratrum. It is used in rheumatism, skin diseases, syphilis, internally; and externally for ulcers, scabies, eczema, tinea capitis, sycosis, tonsillitis, diphtheria, pharyngitis, glandular conjunctivitis, scrofula and hemorrhoids."

Butler, Materia Medica, Therapeutics and Pharmacology, W. B. Saunders, 1900, gives the dose of the fruit as 5 to 30 grains. He makes no comment on the use of the fruit, but speaking of the preparations of the root, he says: "It has been recommended in obesity, possessing undoubted efficacy in this respect. It is claimed that a proprietary preparation

known as 'anti-fat is a resinoid preparation of the berries."

Ellingwood, Materia Medica, Therapeutics and Pharmacognosy, Chicago Medical Press Co. (eclectic), does not mention its use for obesity, but confirms its other uses, and commends it highly.

King's American Dispensatory (eclec tic), Ohio Valley Co, Race St., Cincin nati, 1900, says: "Recently this agent, in the form of an extract of the berries, has been used to reduce obesity. Reports for and against its virtues in this line are now appearing, but its action is still doubtful. Probably it would be more clearly indicated if associated (obesity is meant, Ed.) with a rheumatic diathesis.”

Gould's Dictionary of Medicin, P. Blakiston's Son & Co., says: "Dose of a saturated tincture (of berry), a fluid dram three times a day."

The U. S. Dispensatory states that death has occurred after eating a "double handful of the berries;" also, that "a saturated tincture of the berries may be given in the dose of a fluid dram three times a day. Alcohol, diluted alcohol and water extract the virtues of poke root." Now, Doctor, you have the "authorities." A careful trial can do no harm. Be sure you get a reliable preparation, and advance your dosage cautiously. Have you ever tried thyroid in obesity? It works very well in many cases.-ED]

Editor MEDICAL WORLD:-Mrs. R. contracted rheumatism some four years ago, and was treated for it some two years by two or three physicians, the disease progressing all the time until nearly all of the small joints were enlarged, the cervical ones especially, and were very painful, periodically. At this time I commenced treatment of the case; and now, at the end of another two years, I have succeeded in restoring the joints to a normal condition, and there is no more pain at any point. But there is left that terrible sequel, heart affection. Sleep and appetite are just tolerably good; no great emaciation; can be around at light house work all day. She past thru the menopause, and was in good health when attackt by the rheumatism. The most annoying thing now is a hard, pulsating sound in the left ear. The heavy pulsating in the artery below the heart is some better, but it is still quite strong, and gives a hissing sound from the pulsating

In

point downward. The pulse is regular and generally pretty fair. The heartbeats are short and hard. The greatest complaint now is the thumping in the left ear, which is almost constant. spite of all I can do, the urin will occasionally cause severe burning at the neck of the bladder, and is scanty at such times. I will wait to hear something for my case before giving any further history of it or past treatment. Hartford, O.

A. J. RATHBUN, M.D. [Doctor, your treatment should have been given in this communication. You were very fortunate to be able to restore those small joints to normal condition, and we wish you to tell us just how you did it. Our contributors will doubtless help you, concerning the points upon which you desire aid. We will just say that your patient will be greatly benefited if you will have her to drink two quarts of pure water (not too hard) every twentyfour hours. Then her urin will not become scanty, and she will be benefited in every way. However, unless you insist, she will not actually ingest the quantity of water ordered. A good way is to have her to fill a half gallon bottle every morning and drink the last of it before retiring at night. However, the "heavy pulsating below the heart," with the "hissing sound," suggests aneurism; in which condition liquids should be given guardedly. -ED.]

Dizziness.-Excessiv Venery in a Female.

Editor MEDICAL WORLD:-What can be done for "dizzy people? The symptoms seem to point to some error of digestion or torpor of liver. By long dosing with liver powder and stomachics, and following with iodid of ammonium, two stubborn cases recovered. But a young man, in the prime of life, claims nothing helps him. He seems in perfect health; never had a private disease. Living conditions perfect. No symptom to guide; yet all the doctors to whom he has applied diagnose some unknown error of digestion. Can you suggest anything?

Another. A lady of forty years has "emissions" like a man, at night when asleep. She will dream she is enjoying old triumphs, and off it goes, as much as twice in a night. She has to be careful how she sits on a chair or rides in a buggy, or off she goes. She no longer feels any pleasure in cohabitation. In youth she

was pretty and shapely, and began cobabitating promiscuously and to excess when twelve years of age. She acquired syphilis and was mercurialized in a brutal manner, after which she stopped cohabitating except once or twice a day. A year ago she took la grippe, and also had a severe attack of appendicitis, and after recovering these symptoms developt. She is now plump, and but for these discharges would now be well. Large doses of the bromides in infusion gentian compound help her. Mono-bromate of camphor and lupulin at night does best for the emissions. Can you suggest anything? Northumberland, Pa. J. A. ELLIOT, M.D. [Your "dizzy" patient has vertigo, and you should find the cause and cure him. If he has not been thoroly cleansed with old fashioned epsom salts thru an extended course, see that he is. Do not keep it up too long, and do not give in doses large enuf to derange the stomach. Make a solution strong enuf to purge activly in two ounce doses, and have him take a tablespoonful on rising, before each meal and at bed time; reducing the strength of the solution if it purges too freely after three days' use. Give him a teaspoonful of elixir pepsin compound (Burrough) in water half an hour before meals and also one hour after meals. After he has had a thoro intestinal cleansing, stop the salts and continue the pepsin compound. Examin his ears for impacted cerumen. Have a good oculist examin his eyes for errors of refraction. Be satisfied that he is not neurasthenic. Search carefully for chronic heart disease. You may have a case of Meniere's disease, or of beginning locomotor ataxia or disseminated sclerosis; look up your works on practise on all three. If you can eliminate hysteria, neurasthenia, epilepsy, Meniere's disease and heart trouble, you ought to be able to handle the case to his and your perfect satisfaction. An excellect opportunity, Doctor, for you to win a reputation by study and hard work. Write us later.

Your second case is interesting in a variety of phases. First. You have started on a wrong basis. If you reflect, you will know that the orgasm in a female is not accompanied with the discharge of any vital fluid such as is excreted by the male. The fluid which accompanies the orgasm in the female is merely an excess of the fluid which has been excreted dur

ing the coition preceding the orgasm. It is not in any sense to be compared with the semen of the male.

To start with her case from the beginning: It looks to us as if she had been a victim of nymphomania at the age of twelve. Perhaps her case of syphilis and consequent "brutal mercurialization" which resulted in decreasing her coitions to two daily, was about one of the best things that could have happened to her at that time. Have you suggested to her that two coitions each day is rather more than the average female should undertake? Have her drop it to two each month. Purge her well. Examin her clitoris; you will probably find it hooded or with adhesions and retained smegma. If so, either operate yourseli, or have some competent surgeon do the work at once. Have her use a suppository or wafer containing the following ingredients:

Precede by a vaginal douche of warm water; push the tablet up to the os uteri, and allow it to remain until the following morning. At once on arising, use a vaginal douche of warm water. The tablet is inserted just as she retires. This routine is followed every third day.

She must quit her excessiv venery at once. You must be firm and insist on hygiene as well as medication. Then, unless she has some organic disease, she will improve rapidly. Dose less by the mouth; examin more closely; demand reasonable sexual habits; unhood the clitoris; clear the bowels and get the kidneys acting; and your patient will improve.

Doctor, your letter has been intensely interesting, or we could not have given this amount of space for reply. You ought to relieve these two sufferers, and THE WORLD will be glad to have helpt you.ED.]

"Resolved, that all persons who, when ill, reject, refuse or neglect the aid of medical science are very dangerous risks from an insurance standpoint, and that hereafter they shall not be eligible to membership in this order unless agreeing to obtain, or submit to, such aid when ill, under penalty of forfeiture of insurance."

It will be readily seen that the purpose of this resolution is to protect the order against Christian science risks. It is a wise precaution, and we predict that it will be rapidly adopted by other mutual insurance orders.

Painful Micturition.

In The Journal of The American Medi

cal Association, for December 29, 1900, Dr. Jesse Hawes, of Greely, Col., writes on the use of guaiacol in the treatment of frequent and painful urination. It use is only applicable where the site of the trouble is located in the inner end of the urethra; yet it is here that the great majority of cases have origin. Many cases suffering from irritability of the "deep urethra " are diagnosed as "irritable bladder,' or "cystitis," and are treated by drugs per os. In use a urethra

speculum as large as can be used is past thru the deep urethra, the mucous or blood is mopped up with absorbent cotton and the guaiacol is applied. Not enuf is used to permit its flowing over the mucous membrane; only a surface application is desirable; thus applied, it is anesthetic and stimulant. It gives but slight

pain; no strangury results, and the patient will often retain the urin for hours after the application. Perineal and suprapubic discomfort is lessened, and a few applications, five days apart, are satisfactory to patient and physician. Seventy per cent. of cases are improved and 20 per cent. are cured. If too frequently applied it causes local tumefaction with diminution of the stream, but this passes away in a few days. He reports success in male and female, from childhood to old age

Medicin in the Nineteenth Century. Munsey's Magazine publishes in its January issue "The Story of the Nineteenth Century," divided into different headings. The following is the section given to medicin:

THE BIRTH of modeRN MEDICIN.

The learned professions, too, groped in a twilight. Medical science could hardly be called in its infancy; it was just beginning to exist. The average practitioner rejoiced in the knowledge of three remedies-blood letting, calomel and laudanum ; but the favorit of these was blood letting. The assertion that bleeding travagance; but the practise was disastrous. used to slay as many as disease killed is an exThere survived a pseudo science of blood letting, or phlebotomy, a most ridiculous and pernicious thing, the grewsome inheritance from the middle ages, by which different parts of the body were to be tapped for different diseases-the net result being invariably the same.

Men died of ailments that had not even names. Appendicitis and malaria prevailed then as now, but no one knew what caused them or how to combat them. There was no pitals. If an epidemic started anywhere in the efficient system of quarantine, nor even of hosworld, it traveled until it wore itself out, and in all seaports typhus fever, that now almost forgotten disease, raged without control.

Little or nothing was known of maladies that science since has conquered. Against small pox, and its ravages were frightful; at times its for instance, there was practically no defense,

visitations were almost as severe in London as

those of the ancient plague. Whoever escaped it alive carried to his grave its dreadful scars. These, now happily almost unknown, were very common disfigurements among both men and women. Fine ladies lived in ceaseless terror of small pox, but in spite of all their precautions it ended many a social career.

Surgery was in a state as primitiv as medicin, or worse; indeed, it had made no perceptible advance in centuries. It shocks us now to think that all surgical operations were performed while the patients or victims-were fully conscious, but such is the fact. A field hospital after a battle, in those days, must have