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and continuously. American doctors have the finest materia medica in the world, good schools, an abundance of clinical material, great natural intelligence and energy, in fact, every facility for progress, if they will restrict themselves to true methods-such as the study of pure drugs and practical hygiene. Bug pathology and serumtherapy are the offspring of a morbid mind, of a mind which has brooded in darkness until it fancies its gloomy imaginings are realities. If the value of a thing is to be judged by its practical results, bug pathology and serumtherapy are of no more use to the world than was the religion of the middle ages which bade the world remain flat and the sun revolve around it at the cost of individual suffering and even life. Let us steer clear of the unnatural in medicine and in everything else.

Gonorrhea.

Foreign progress in the treatment of gonorrhea seems to have been unsatisfactory. For a time the silver salts were the fad of the hour. Nitrate of silver, argentamin, argonin, protargol, alumnol, and ichthyol were at various times heralded as sure cures, and heavily backed up by statistics; but, notwithstanding an unlimited amount of enthusiasm, these much lauded remedies have lost their popularity even with those who first endorsed them.

Dr. Neisser, of Breslau, first introduced protargol to the profession, and made great claims for its efficacy in this disease.

The wider experience of Professor Von Bergmann and Dr. Behrend (the latter has medical charge of the Berlin prostitutes) shows that these claims were

hasty and exaggerated, to say the

least.

Drs. Finger of Vienna, and Lasser of Berlin, have also had poor success with the new silver salt, protargol. It seems that the silver salts, one and all, manifest certain secondary irritative effects, very injurious in the treatment of gonorrhea, as they tend to develop a chronic inflammation more difficult to cure than the acute trouble.

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A Law Unto Yourself. The able and skillful argument of Dr. Page, of Boston, advocating the nonuse of flannels, has elicited much and varied comment. The truth deducible from this mass of conflicting views seems to be that flannels are good for some and bad for others. The enthusiastic parents of a delicate little boy, having a poor capillary circulation, and tendency to congestion of the mucous membranes, imbibed the idea of hardening the child. They began by stripping him of his flannels at night, and substituting muslin night-drawers. Soon the mother began to notice that the child no longer slept soundly, and began to lose flesh. In much alarm, she called in the Editor, who soon drew out the above fact. This child did not generate enough heat naturally to supply the body's needs, and required artificial aid. The general friction of the flannel against the skin kept him comfortable. It is probable this child would have become permanently catarrhal, had he been long deprived of the warmth and comfort essential to health. In other cases, where the cutaneous circulation is very active, the burning and irritation caused by flannels is a serious drain on the nervous system, the sweat glands are kept unduly active and systemic resistance is undoubtedly lowered. Speaking broadly, the bilious and lymphatic temperaments require more heat than the nervosanguine.

What applies to flannels is equally true of bathing, or eating, or sleeping, or any of the other acts of life. Cold baths are better for some, hot baths for others, tepid baths for still others. In the matter of eating, regularity is best for the great majority of people,

but there are individuals with small digestive capacity who thrive best on frequent small snacks taken through the day. When such people are brought down to three daily meals at the usual intervals, they rapidly lose weight and energy. So it is with sleeping. Some need eight or ten hours. Others do just as well on five or six. It is not the length of time we sleep, but the rate. Those who sleep fast, who lie down and become at once dead to the world, get through quicker than the light and dreaming sleeper.

All this but illustrates the absolute necessity of the old family physician. No specialist, however much he may know, can be a satisfactory substitute. Each individual is a law unto himself, and the family physician is the man who thoroughly understands and appreciates peculiarities of temperament and constitution. He alone knows how to adapt his treatment to individual cases so as to get the best. results. The specialist is a sort of advisory court to which the patient and his physician may betake themselves, when the latter has exhausted his skill, or gets out of his depth, but the genius of common sense has more weight in medicine today than all the purely technical skill in the world.

Internal Cleanliness.

Medical writers have always had a great deal to say about cleanliness. We have been told over and over again the importance of keeping the skin clean, but we have heard comparatively little of the far greater importance of internal cleanliness. If we had given more consideration to the condition of the alimentary canal, taken greater pains to keep it always in a healthy condition, we should have less external uncleanliness in the way of blotches, pimples, papules, crusts, scabs, scales, grease, etc., to contend with.

There can be little doubt that consumption, diabetes, Bright's disease, malaria, structural diseases of the liver and the nervous system, the various neuroses, etc., take their origin in some derangement of the digestive tract. It does not matter what a man suffers

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M. Sig. One to two teaspoonfuls three times daily, after meals.

The Seng causes the stomach to pour out gastric juice more freely, the Chionia is a mild hepatic stimulant, promoting the secretion of bile, and the Listerine prevents fermentation of the food.

Those who use this formula will be pleased with its results. Under its use the skin clears up, the secretions become more active, the bowels are gradually regulated, the unpleasant feeling of distention which so often follows a meal disappears, and the perversions and aberrations of the nervous system known as neuroses, gradually cease to trouble patients.

This combination of reliable remedies will be found of especial value in the spring and summer months. The digestive organs are peculiarly prone to disease at this time, owing to the debilitating influence of the hot weather and the abundance of vegetables and fruit in the dietary. The timely use of this prescription at the first symptoms of distress will often prevent serious illness.

The Navy.

Sir Walter Raleigh truly said: "Whosoever commands the sea, commands the trade; whosoever commands the trade of the world, commands the riches of the world, and consequently the world itself." England is the richest country in the world, and deservedly so for her forethought and statesmanship. Her navy is the largest and most powerful in the world, and fully able to protect her immense carrying trade. International trade is carried on principally through English merchant vessels. If our politicians could cease thinking about themselves for a little while, could check their demagogue clamor, could

stop their intriguing and wire-pulling, and take broad, statesman-like views of our national needs, we might profit by England's valuable example. For the last thirty years we have paid an average of one hundred and fifty million dollars annually to foreign ships for ocean transportation. In 1896 this nation paid fifty million dollars more to foreign steamship companies for carrying our imports and exports than the whole amount received from internal revenue sources, and twenty million more than was derived from the tariff in 1892. That is to say, foreign steamship companies tax us more for ocean freights than we are taxed by revenue laws. Such extravagance, such dependence is not compatible with our national dignity or prosperity. At present our international freight trade is given over to foreigners, and our commerce is largely, therefore, at their mercy.

We should have a merchant service large enough to enable us to divide the carrying trade with England, and a navy powerful enough to give it ample protection. We should then be an independent nation, able and ready to make an arbitration treaty with England in preparation for the great struggle which is surely coming between English-speaking peoples, and the other races of the earth. The increasing supremacy and dominance of the Anglo-Saxon race, the growth and extension of the English language, will inevitably result in an alliance between the weaker nations in an unparalleled struggle against the inexorable "survival of the fittest." The idea of the emotional races is to get rid of hard conditions by destroying them; the Anglo-Saxon idea is to rise to the occasion. When the former attempt to put their idea into practical operation by destroying Anglo-Saxon progress, and reducing civilization to a lower level, they must be placed in subjection. The struggle may be far distant, but it is surely coming, and we must get ready for it by the creation of a large and powerful navy, fully able to protect our interests; and also, by the ratification of an arbitration treaty with England, which will commit both nations to an alliance offensive and defensive, whenever and wherever the welfare of

English-speaking people is menaced. Such action would have far-reaching effects. It would make English-speaking people invincible. They would be able to set the pace, and dictate the policy of the civilized world. This would be the best thing that could happen for the world. The unquestioned moral eminence of the AngloSaxon race would insure peaceful and just settlement of disputed points, and a fair and equitable distribution of commercial advantages.

Let us have a great navy.

Pilocarpine and Atropine.

Pilocarpine is one of those valuable drugs which is too little used because it occasionally produces symptoms of shock. These alarming symptoms can be immediately relieved, however, by timely injections of atropia, one-fiftieth grain. Atropine is the physiological antagonist of pilocarpine, and we should associate the two in mind, so that when we think of one we remember the other.

Pilocarpine is something of an emergency remedy, although indications for its use in ordinary practice are many. It acts more thoroughly and promptly, and a smaller dose is required when given hypodermically, although it may also be given by mouth.

In high fevers, attended by great excitement, in maniacal conditions, however induced, in obstinate rheumatism, lumbago, in Bright's disease, la grippe, acute bronchitis, etc., hypodermic injections of pilocarpine, one-sixth to onethird grain, produces striking results. In five or ten minutes the dry, hot skin is bedewed with perspiration, the parched throat and tongue become moist, the mental excitement and physical restlessness subside, and the patient falls into dreamless refreshing, sleep.

In convulsive muscular action, both tonic and clonic in character, hypodermic injections of pilocarpine give prompt relief. It is of use, therefore, in asthma, whooping cough, tetanus, hiccough. In these cases, it may be given in alternation with atropine, if desired.

In obstinate rheumatism, lumbago, etc., after the salicylates and iodides have been tried and failed, two or three hypodermic injections of pilocarpine will usually effect a prompt cure.

Pilocarpine wakes up the entire secretory system, but its predominant influence is upon the sweat glands. It is an energetic remedy, and, therefore, illadapted to chronic troubles.

Its principal role is to abort or jugulate disease. If the doctor will bear this in mind, and remember the prompt antidotal effect of atropine, he may use it fearlessly and to great advantage in indicated cases.

Run Down.

In this day of great competition, of limited time, and large demands, the condition known as "run down" is becoming a common one. It means that a man has temporarily overdrawn his account with the Bank of Vitality, and that he must live frugally for a time, and conserve his forces. A person in this condition generates daily only enough to keep him alive. He has none to spare for his work. He exists, he vegetates, but everything is colorless and monotonous, life is a dreary blank. Spontaneous cures of this condition are rare. The case must be thoroughly investigated, and intelligently treated. Too many of these individuals are treated on the fad principle. Some of them are given tonics, and nothing else; others are advised to try travel, change of scene and climate; others take the rest cure, electricity, massage, baths of all kinds, douches; some are stimulated to the point of mania, others sedated into imbecility. Many are dieted into inanition, and others made worse by injudicious and forced feeding. Excessive enthusiasm often elopes with the judgment of both doctor and patient. A rational middle course will give the best results in all these cases.

To illustrate: Some time ago the Editor was consulted by a prominent business man of Philadelphia, who had been the usual rounds, without any permanent benefit, and who was fast losing all faith in doctors. He was stripped and carefully gone over, but no organic trouble

was found. Nutrition was below par, the circulation very sluggish, and the nerves and centers torpid. His habits of life were inquired into, and a regular routine laid down for him. He was to go to bed every night at eight o'clock exactly, and stay in bed until eight the next morning whether he slept or not. On rising he was to rub himself well with a flesh brush, breakfast lightly, and then walk a mile without regard to the weather. This walk was repeated in the afternoon. One hour in the morning and one hour in the afternoon was devoted to mental occupation. His supply of cigars was cut down to three daily. The only medicine prescribed was a small teaspoonful of Celerina, in half a glass of hot water, before meals, with an occasional laxative. In three months this man, who had spent three years, and much money, trying to recover his health, was entirely well. Moderation and regularity of life are better than spasmodic devotion to any fad cure.

Uniform Medication.

It is impossible for physicians to get uniform results from medicines unless they use medicines of uniform strength. If the doctor does not yet know this fact and practice his knowledge, it is not the fault of the MEDICAL BRIEF. We have been emphasizing this fundamental truth of successful medical practice for a quarter of a century, and attribute much of our popularity and large circulation to this fact.

Most doctors know that colchicum is a grand remedy in the treatment of sciatica, but few use it. Why? Because the doctor strikes a good preparation one time and is charmed with its action, but the next time he prescribes it, he makes a discouraging failure, and as the failures exceed the successes, he gradually loses confidence in the remedy and discontinues its use. He is robbed of a valuable drug because he does rot know where to obtain a preparation of definite and uniform strength. The English therapeutist uses colchicum a great deal more than we do, because he has access to a good, reliable prepararation. The wine of colchicum of English make can be trusted to do its

work. It can be obtained in this country, and no doubt some of our reputable manufacturing chemists make good preparations, but the ordinary nameless wine found in drug stores is usually worthless.

Another shining example of the unreliability of poor drug preparations is saw palmetto. We have had considerable personal experience with this drug and are familiar with its great curative powers in enlarged prostate, gonorrhea, cystitis, and other diseases of the genitourinary system. There is a large number of preparations of this drug upon the market, but so far as our rather extensive experience goes, there is but one which retains the full therapeutic efficacy of the drug, and that is Sanmetto. The other preparations do not produce definite results, and results are what both doctor and patient are after.

Medicine will never be a science, nor the doctor able to eliminate an element of uncertainty from each new case until he becomes exacting as to the quality of his remedies. When he ceases to use any but medicines of uniform strength, and studies their indications until they are as familiar as the alphabet, medicine will discard that tentative, expectant, and experimental aspect which now consigns it to the midground between science and humbug.

London As a Medical Center.

The degeneracy of German medical thought, together with the practical disadvantages which attend the study of medicine in a foreign tongue, surrounded by foreign customs and modes of thought, have lent great impetus to the revival of London as the great medical center of Europe. The excellent facilities which London possesses in the way of abundant and varied clinical material, her fidelity to sane and legitimate drug therapeutics, and the experienced, skillful and conservative men who honor her medical ranks, have always given London much deserved prominence in the medical world. London has always had the preference with thinking American physicians. For a time, however, the novel claims and sensational methods employed in Ger

many attracted the more credulous and enthusiastic among us. The strong

reaction which has now set in redounds to the credit and real progress of medicine.

Dr. Irving C. Rosse, writing in the Journal American Medical Association, criticises severely the rudeness of the German people, and the cheapness and mediocrity of their civilization. He also dwells upon the impossibility of any broad comprehension of lectures delivered in the German language, and deprecates the study of German, in view of the rapid growth and spread of English.

Dr. Rosse says that in Berlin he was taken for an Englishman, and told that they did better surgical work in his country. He recommends London, Paris and Rome as the best places of resort for special work. But, of course, the two latter cities would be open to the same objections so far as language is concerned.

In this connection, we desire to say that an arrangement has been recently made in London by which American physicians, for a mere nominal fee, will be freely admitted to the medical wards and operating rooms of the principal London Hospitals, with liberty to attend lectures of a practical character, and do experimental work in the laboratories. The facilities embrace a complete course of medical education, with a bacteriological laboratory, a chemical laboratory, and special departments for skin, eye, nose, larynx, gynecology, orthopedics and dentistry. Many of these are in charge of physicians and surgeons who have become well and favorably known to BRIEF readers through their contributions to this journal.

Further information on this subject may be obtained by writing to the London office of the MEDICAL BRIEF, Auckland House, Basinghall Ave. The BRIEF has become very well known and very popular in Europe, by reason of its large and constantly increasing foreign circulation. We, therefore, offer to supply any American physicians who may wish to go to London, with letters of introduction, which will secure for them the fullest possible measure of consideration.

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