Subscribe for the Medical Herald. Tissue Nutrition in Grippal Convalescence. If grip were free from treacherous sequelae, the physician could dismiss his grip patient after the acute period of the disease had passed, feeling sure that an uneventful return to health would soon follow. But these sequelae strike when least expected. The heart muscle fails, with resulting acute dilatation; or a tuberculous taint manifests itself. If it were made a routine practice to insist that grip convalescents take a tissue food of proven merit, such as cord. ext. ol. Morrhuae comp. (Hagee), the complications and sequelae of this infection would not be met so frequently and in less distressing form. Cord. ext. ol. Morrhuae comp. (Hagee) contains the very elements the drained system needs to, restore it to health and vigor, the contained extractives of the cod liver oil, coupled with the hypophosphites of lime and sodium, supplying this need in admirable man ner. lodum-Miller, the soluble iodin, is a preparation of iodine that is soluble in water but contains neither water nor alcohol. It combines with all the water fluids of the body without coagulation of any of them and without precipitation of iodin. It is an iodin (soluble) that is combined with such vehicle that when used in surgery it restores cutaneous surfaces which have been rendered hard and dry from alcoholic washing to a normal physiological, though aseptic, condition. It is an iodine, non-irritating, but of such penetrating, absorbing qualities that it follows down into the hair follicles, the sebaceous and sweat glands and destroys all germs from integual to the deeper tissues. It is the ideal iodine for use in all surgery, dentistry and general practice and is for internal and local application. Telephone No. Main 1510 1173 2255 1635 6326 5267 3499 Atonic Indigestion demands the most vigorous tonic treatment available. For many years seng has held a unique place as a gastro-intestinal tonic, and under its use the most far-reaching benefits are obtainable in all functional diseases of the stomach and intestines. Post-Grippal Complications. If there is one particular feature which characterizes the genuine influenzal attack, it is the decided and sometimes intense prostration that remains after the subsidence of the acute symptoms of the disease. This general vital "set back" is oftentimes entirely out of proportion to the severity of the original grippal attack, and the most robust patients are sometimes the most severely prostrated. In addition to the general devitalization, la grippe is extremely likely to be accompanied with or followed by such troublesome complications as otitis, neuritis, sinus inflammation, gastro-intestinal derangements, resistant and obstinate bronchial catarrhs and, more dangerous than all, a peculiar, more or less characteristic, asthenic, form of lobular pneumonia. The skill of the physician and the vital resistance of the patient are often taxed to the utmost in a combined effort to induce final recovery. Anemia, to some degree, is almost always brought about by the combined devitalizing power of the disease and its complications, and convalescence is likely to be tardy and tedious. An easily borne, readily assimiiable hematinic does much to hasten recovery and pepto-mangan (Gude) is an especially eligible method of introducing the much needed ferric and manganic elements, without producing or increasing digestive difficulty. In no condition does this well tried hematic remedy evidence its undoubted reconstructive power more certainly than in the treatment of post-grippal convalescence. SOME FEATURES FOR EARLY ISSUES OF THE MEDICAL HERALD. The Medical Examination of Prostitutes; its influence on the Spread of Venereal Diseases, Dr. T. M. Paul. Prognostic Interpretation of the Differential Leucocyte Count, Dr. Geo. Howard Hoxie. Primary Carcinoma of the Bronchus and Lungs, Dr. W. L. Bierring. The Retraining of the Human Animal for the Restoration of Health, Dr. H. S. Munro. Role of Cerebro-Spinal Fluid Examinations in Diseases of the Central Nervous System, Drs. A. D. Dunn and G. A. Stevens. The Clinical Significance of Abdominal Pain in Children, Dr. H. M. McClanahan. A Herald binder free to every new subscriber. A diet that is nourishing easily digested and well balanced in its constituents is The Mellin's Food Method of Milk Modification meets these requirements fully and has No physician can afford to take any risk of substitution, if he values his good name. 63 The Medical Herald Incorporating the Kansas City Medical Inder-Lancet Under the Editorial Direction of Chas. Wood Fassett and S. Grover Burnett OUR SLOGAN: "Fewer and Better Medical Journals." EMERSON'S FAMOUS EPIGRAM "If a man can write a better book, preach a better sermon, or make a better mouse-trap than his neighbor, though he builds his house in the woods, the world will make a beaten path to his door." - Ralph Waldo Emerson. "THE OPEN DOOR." We have no latch-string; our door is always open to those who would add aught of scientific interest to our readers, and the pathway to the door of The Medical Herald is not difficult to find. 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Kindly report change of address promptly, giving old address as well as the new location. (Entered at the St. Joseph P. O. as second class matter.) Practice for Sale in South Dakota.-No opposition-good territory-good agricultural country. Business $3,000 to $4,000 a year and increasing; collection good. Must be taken at once. Address J. C. W., care of the Medical Herald. CAUTION! Whenever the true merit of a preparation is authoritatively established. imitation is sure to make its pernicious appearance. To counteract the injurious results of another of these fraudulent proceedings-in this instance affecting firm name and reputation- Sander & Sons have been compelled to appeal to law, and in the action tried before the Supreme Court of Victoria, the testimony of a sworn witness revealed the fact that this witness suffered intense irritation from the application to an ulcer of the defendant's product, which was palmed off as "just as good as Sander's Eucalyptol." Sander & Sons had the satisfaction to obtain a verdict with costs against this imitator, who is perpetually restrained from continuing his malpractice. Dr. Owen, in a report to the Medical Society of Victoria, and Dr. I. Benjamin, in the Lancet, London, both denounced, as others did before, on the strength of negative results. the application of unspecified eucalyptus products. This forms convincing proof that only an authoritatively sanctioned article can be relied on. SANDER & SONS' EUCALYPTOL 1. Has stood the test of Government investigation. 2. It was proved at the Supreme Court of Victoria by experts to be an absolutely pure and scientific standardized preparation. 3. It is honored by royal patronage. 4. It always produces definite therapeutic results. Therefore, to safeguard the physicians' interest and to protect their patients, we earnestly request you to specify "Sander's Eucalyptol" when prescribing eucalyptus. The Meyer Bros. Drug Co., St. Louis, Mo., agents, will forward one original package (1 oz.) on receipt of One Dollar. Subscribe for Suck THE LEADING HUMOROUS WEEKLY Package of Sample Copies $5.00 per year Mailed for Ten Cents. Address PUCK, 295 Lafayette Street, New Yor!:. Incorporating The Kansas City Medical Index-Lancet An Independent Monthly Magazine Vol. XXXI No. 2 FEBRUARY, 1912 Organized at Council Bluffs, Iowa, September 27, 1888. Objects: "The objects of this society shall be to foster, advance and disseminate medical knowledge; to uphold and maintain the dignity of the profession; and to encourage social and harmonious relations within its ranks."-Constitution. George Howard Hoxie, A. M., M. D., Kansas City, Mo. T present practically the only value to the general practitioner of the differential count of the white blood cells, lies in the possible diagnosis of leukemia, pernicious anemia, or lead poisoning. A few surgeons also utilize the differential count in order to know when to operate in appendicitis. But I believe that the value of the differential count is not by any means exhausted by its present use; for the fact is gradually coming to light that in the study of the relative numbers of the different cellular elements of the blood, we have an index of the response of the organism to the causa morbi. This response depends upon two factors: (1) the force or virulence of the disease, and (2) the resisting power of the body. Hence in some cases we find a weak response to infection because its virulence is small, and at other times because the body is unable to react. These two alternatives must be kept in mind in all of our studies. That this prognostic study of blood smears is worth while, I thoroughly believe; for the Father of Medicine himself called attention to the fact that the ability to state correctly a prognosis was one of the physician's most valuable accomplishments. should then study the smears of our patients' blood because in them we *Read by title before the Medical Society of the Missouri Valley at Omaha, Neb., September 7, 1911. We shall find additional data on the matter of the establishment of a prognosis. The beginnings of the prognostic studies on blood smears extend back to 1904 when Holmes of Denver presented a summary of his findings before the American Medical Association, as follows: "A. Significance of a low lymphocyte count. (a) A gradual decrease in the small lymphocyte count is unfavorable. (b) When repeated examinations over a long period give a continuous low small lymphocyte count, an unfavorable prognosis is indicated. (c) A prevailing small lymphocyte count with an occasional higher count, indicates a temporary effort towards convalescence with little chance for permanent recovery. (d) A gradual increase in the small lymphocyte count, with an occasional low count, indicates an uncertain convalescence. "B. Significance of a high small lymphocyte count. (a) A gradual increase in the small lymphocyte count is favorable. (b) When repeated examinations extended over a long period give a continuous high small lymphocyte count, a favorable prognosis is indicated. It may be taken therefore as a safe conclusion: 1. That poverty in small lymphocytes exists in connection with a great impairment in body nutrition. and cell metabolism. 2. That this condition exists in typhoid fever, tuberculosis, and a variety of debilitated conditions. 3. That it cannot therefore be interpreted as being characteristic of any particular disease. 4. That whenever it exists it is always to be considered a potent factor when estimated in conjunction with the history of the case and the associated clinical symptoms. But the greatest impetus was given the movement when Arneth published in Muenchener Medizinische Wochenschrift in 1904, 1905, and 1906 his "neutrophilic blood picture," wherein he showed that the gravity of the prognosis parallels the relative predominance of the polynuclear or the mononuclear neutrophiles. The following description of his method may be helpful. He assumes that the neutrophiles enter the blood stream with a single nucleus and that this nucleus divides as the cell grows older. If now the older cells are rap idly destroyed, or many new and im mature cells are thrown into the circu lation, the preponderance of cells will contain undivided nuclei, or at least only two or three fragments. He divides therefore the neutrophiles into five classes, viz: Class I single nucleus (including myelocytes and large mononuclears); class II two nuclei; class III three fragments; class IV four fragments; class V, five or more fragments. The classes are arranged in tabular form with Class I at the left, so that when the numbers in the first two classes are increased we have a "drift to the left." The count is made on the basis of 100 cells, though Minor and Ringer (Amer. Jour. Med. Sciences, May, 1911, page 638) have shown that 200 cells must be counted if we are to avoid a large fraction of error. The "index" represents the sum of the first two classes plus half of the third class. To illustrate, the following is Arneth's normal count: and Minor and Ringer found the following (American Journal of the Medical Sciences, May, 1911): a III IV V 2.5 18.2 55.6 "On the other hand, the lymphocytosis that so frequently accompanies a well-marked convalescence from condition in which poverty of lymphocytes previously existed, would seem to indicate a condition of increased physiologic activity, thus corroborating Virchow's theory of a nutritive and formative hyperacidity of a valescent organism." I II 18.6 5.1 Index 48.5 As an illustration of what happens in disease the following case (tuberculosis sub-acute, Arneth No. 5) may be cited (the total white count here is 8,400): |