Paragraphs.

Facts seem to point to a remarkable and apparently irreconcilable discrepancy between human pathology and experimental physiology.-Ferrier.

Phares' method of treating colic consists in turning the patient upside down-standing him on his head.

A Danish pharmacist has issued a work on Drikkevandsundersøgelser. The English of this sweet mouthful is drinking water.

The highest department of our art, (therapeutics) and one of its chief ends, is in a backward and unsatisfactory condition.-Andrew Clark.

Lemon Juice penciled over hypertropheid tonsils twice a day, is said to effect a cure in young] subjects within two weeks.

Cleanliness is generally regarded as a virtue; but in Germany they call a bath "bad," and even in France they look upon it as a "bain."

The News for 1880, will contain no advertisements inter-leaved in the reading matter. We are assured that its readers will welcome this announcement.

Compound tincture of benzoin applied on a pledget of lint and packed well into the cavity of the decayed tooth, is said to speedily relieve the toothache.

A man whose clothes are saturated with stale tobacco, is not an agreeable visitor in a sick room. Nor is it reviving to a delicate organization to have stimulants applied through the physicians' breath.Crosby.

An aged railroad conductor has noted a fact which negatives the statement that the race is degenerating physically. He frequently comes across boys of twelve as large as youths of sixteen used to be before the days of railroads.

Dr. Fordyce Barker, on the 2d inst., presented the New York Academy of Medicine with a marble bust of T Spencer Wells, the greatest of ovariotomists, he having performed the operation 958 times.

A Miss Whitten, now at Damariscotta, Me., has probably the longest hair of any woman in the world. It is eight feet long, and when dressed in a French twist passes six times around her head. The growth is perfectly natural. Miss Whitten's hair is but little longer than Edwin Smith's beard-74 feet.

The first edition, an unusually large one, too, of the National Dispensatory, lately issued by Mr. Henry C. Lea, has already been exhausted. The work is an admirable one, and doubtless will be still further improved in the second edition, by alterations and additions suggested by reviewers of the first edition.

Another medical college in Indiana, this making five medical schools in that state! The fact leads the American Practitioner to ask, Will not the earnest strife for students, apparently rendered inevitable by this increase of schools, be followed by an indecent, base struggle for patients ?"

Can any one account for the tendency there exists among Gynecologists to the parting of the name in the middle ? For instance, we have T. Gaillard Thomas, T. Spencer Wells, J. Marion Sims, J. Matthews Duncan, T. Addis Emmett, C. Henri Leonard, A. Reeves Jackson, and so forth. Can it be that intimacy with the ladies begets vanity?

The American Bookseller says, sarcastically, "there is but one centre of the literary universe, and that centre is Boston, of course." This remark is iconoclastic, and if it is not promptly and sharply rebuked, we shall not be surprised to hear some equally pertinent reference to some of the centre's" institutions-its antediluvian Medical and Surgical Journal, for instance.

At the very best English dinners, not only is there no butter on the table, but the vegetables are cooked in plain water, and not a drop of drawn butter is served upon them. Except a bit of fat that you oil on the salad, This is very bad,

may get with your meat, and the your food is clear of all grease. and Sir Henry Thompson, in two essays upon dining, published in the Nineteenth Century, mildly calls attention to the evil.-L. P. Yandell

Canada Lancet:-The Belleville Intelligencer, of September 23d, contains an account of "a very critical operation in surgery, recently performed by Drs. (two registered practitioners), in an adjacent village. It consisted in the removal of a Myalord Tarcorna, (tumor), five-and-a-half pounds in weight, from the lumbar vertebræ, at the spinous processes.' The writer of this puff, no doubt, did his work well enough, but the proof reader has made sad havoc of the technical terms. Still the public will never know the difference.

The Daily Telegraph tells us that A young man in Paris in cleaning out his pipe stem with a knit ting needle, ran the point of the instrument into his finger. On the steel lay nicotine, and this, mingling with the blood which flies through the system, at the rate of about 12 inches a second, quickly spread in the arm, until it became necessary to amputate the limb in order to save the smoker." Twelve inches a second is 60 feet a minute, and in all probability it took the surgeon at least five minutes to get ready for the operation. On this basis over 300 feet of arm must have been cut off in order to intercept the poison. The Chemist and Druggist reasons after this fashion, and concludes that the young man must have had a very long reach--one of the longest, if not the longest, on record.

Original Articles.

Catarrh of the Nasal and Connecting Cavities -New Treatment.

BY D. W. C. WADE, M. D., HOLLY, MICH. There is no other mucous membrane that is at once so exposed to irritative influences and so inaccessible for topical treatment as the Schneiderian. In this climate there are none who escape rhinitis altogether, and few who do not suffer in some degree continuously. I believe there are no peculiarities in the pathology of this disease worth discussing, and I take it for granted that it is understood that the necessity for an unfavorable prognosis has been founded upon the fact that constitutional treatment is of little avail in inflammations of any mucous membrane, and that, for anatomical considerations, local treatment in rhinitis has been found to be but imperfectly practicable. I will direct attention to an important difficulty in the way of reaching the whole mucous surface distributed within the head. The antrums of Highmore, the frontal sinuses, the eustachian tubes, and the cavities of the middle ear, are all connected with the nasal cavity, and the inflammation under discussion implicates these localities. These cavities are normally occupied by air, and like all other air receptacles having one small opening, the air must either escape in a contra current or become compressed before fluids can be made to enter. The result of this circumstance is, that the nasal douche and many other modes of treating rhinitis locally, which, on theoretical grounds, promised much, have proved only partially successful, because only a part of the diseased surface has received the benefit of treatment. I propose the plan of reaching the interior of the antrum, frontal sinuses and middle ear by rarifying the air contained within these cavities, and when the air is allowed to re-enter them, to convey with it the medicine it is desired to apply. Sceptical people may doubt the practica bility of doing this, but whoever will try the experiment I shall describe will be satisfied that he has succeeded in rarifying the air in the whole of the nasal and connecting cavities, and that he has intro duced within their interior something beside their normal contents

My method of exhausting the air, as above men tioned, is to attempt to inflate the lungs with the mouth and nostrils closed. Just to what extent the atmospheric pressure can be removed in this way I am unable to say, but that the expanding power of the muscles of respiration is considerable there can be no doubt. It only remains now to contrive a plan of combining medication with rarefaction. I have succeeded best in accomplishing the purpose by using a bent tube, in the shape of a horse-shoe, in which to place the medicine. One arm of the tube being fitted to the nostril, the other arm and

the other nostril being closed by the fingers, and the mouth being closed, the conditions are present for completing the operation. If now an attempt be made to expand the lungs, the residual air of the whole respiratory apparatus must necessarily become rarefied, and by raising the finger from the arm of the tube covered by it, air will at once enter the exhausted cavities. The rapid motion of air through the tube not only minutely subdivides by percussion the fluid therein contained, but conveys the fluid to its destination. Now the air that supplies the exhausted cavities is that which passes through the tube, and the medicated fluid is inti mately mixed with it, therefore the medicine is in. troduced within the remote cavities. This is the theory. Clinically the theory is sustained. Patients are profuse in the expression of the opinion that the medicine is immediately conveyed to the parts I have designated. Insufflation of fluids is not new, but insufflation does not mean exhaustion first, so that by this process the fluids reach only the membrane traversed by air in respiration.

The tube can be made of glass or hard rubber, about 5 inches in length, and to an inch in internal diameter. It should accurately fit the nostril and if too small it can be made to do so by winding a piece of wrapping cord about the end. Among the many applications I have used in this way, no other has equalled in efficiency chloral hydrate in solution of the strength of about five grains to the fluid ounce of water. If this strength does not produce quite a pronounced sensation, it should be used stronger.

U

The accompanying diagram may be an aid in the construction of the tube. Instrument manufacturers might confer a favor upon the profession by placing the instrument in the market in time for the coming campaign, although any physician can readily and cheaply make it from glass tubing with the aid of a spirit lamp. From one-half to one fluid drachm is the proper amount of fluid to apply, first on one side and then the other.

October 16, 1879.

Consumption-Its Cure.

BY CHARLES G. POLK, M. D., PHAR. D.

The cure of consumption is one of the most im portant problems in medicine, and yet one which some physician every now and then claims to have solved. Dr. James H. Salisbury, of Cleveland, Ohio, is the last who heralds such an announcement. I only hope Dr. Salisbury's theory and practice may prove correct; and that this very destructive disease may become amenable to medical science. Churchill twenty years ago brought out his pathology and remedy, and there is no doubt that his discovery has done much towards the successful management of the disease, and I am assured by hundreds of physicians that the isolated hypophosphites have proven of markedly beneficial results.

To-day there is no intelligent physician who puts any trust in nostrums. The active, thinking portion of the profession have learned to regard all such as consummate humbugs even though they be copyrighted by distinguished members of the American Medical Association

One of the most sensible reviews of the subject is a letter from Professor A. P. Dutcher to the editor of the Cincinnati Lancet, noticing my paper, "Tabes Pulmonum." "If," said he, consumption was a unit in its nature, the problem could be easily solved. But as it is a union of many elements, some of which are quite opposite in their character to others, it is one of the most difficult questions in medicine to decide." Though I have devoted twenty-four years of hard labor to the subject, have brought to the task the aid of the microscope, chemical analysis and clinical observation, as well as a careful study of its literature, the task is not completed. I do not like to attack anyone personally, but I must find fault with Dr. McElroy, of Zanesville, Ohio, for not giving the profession an elaborate monograph on the pathology of this malady. I do not think anyone has a more correct and clear conception of the essential nature of tuberculosis than he has. He should give his views more wide dissemination than he has heretofore done.

But to return to Dr. Salisbury. His idea of excluding fats from the diet of the consumptive is correct, while there is butyric acid in the small in. testines, unless the simultaneous use of pancreatine or extract of malt secures their prompt emulsion and absorption. But fats are of the greatest service in all cases in which they do not produce acid eruc. tations from the stomach, pains in the duodenum, and repugnance to the appetite. Like Dr. Salisbury, I withhold fats in many cases, while in others give them as freely as the digestive organs can appropriate them. The doctor's 'splendid condition of the system" reminds me of a class-mate of mine, who always advised "a judicious course of treatment."

66

The doctor's idea of exercise, while very good in the non-febrile and inflammatory conditions, would

prove highly detrimental in the opposite class. His formulæ are highly eclectic in the combination of tonics, alteratives, astringents, expectorants and aromatics, yet they are certainly botanic, and may bear a somewhat suspicious look, but my own experience with some of these remedies has been favorable; hamamelis is a sedative astringent, and exerts a very beneficial influence over inflammed mucous surfaces; yerba santa and grindelia robusta are very valuable agents. My experience with the yerba santa and grindelia robusta were given in the Physician and Pharmacist, and in New Preparations. I have also tried the pyrus americana, or mountain ash, and have found it to be a valuable astringent tonic. I find it however better to use our old remedies with intelligence than to run after so many

new ones.

The doctor regards consumption as "the consequence of fermenting food and the products of this fermentation." It is strange that in writing his book he has overlooked the fact that there is no duodenal dyspepsia in about thirty cases out of each hundred He might also well ask, how comes the fermentation in the seventy cases? whether it be not a conse. quence, rather than a cause, depreciated organic nerve power, and then seek the cause of the depreciated organic nerve power.

If his book contains even a grain of new philosophy, let us have it; we need all the new light possible. By we I mean all physicians, who, like myself, do not believe in stamping out consumption by any remedy, especially one we find advertised in daily newspapers, railroad guides, and popular magazines as potent to this desirable end. Phthisis, as Dr. Dutcher has well said, is a very complex disease, presents such diversified phenomena, and embraces so many complications that it can only be cured by a "judicious course of treatment" of all the associated lesions. The results collated by me in about two thousand cases justify the conclusion that a considerable per cent. can be permanently cured, and about 80 per cent. can be benefited to a very large extent. But these results will not follow any routine plan of treatment. A month ago a patient was sent to me with a thick fur on the tongue, bowels constipated, stomach irritable, and considerable pain and soreness in the left pleura. The gentleman who sent him supposed he was an excellent subject for the isolated hypophosphites. I took a different view, prescribed muriatic acid, camphor and hyoscyamus, with leptandrin and aloes at bedtime. Today he is much improved, and is taking nitro-muriatic acid and quinidiæ. When I first saw him he was taking cod liver oil, and it was not, of course, doing him the slightest good. Recently I was called in consultation to a case that had a red, raw tongue, and could scarcely retain any food on his stomach; the physician was giving him glycerite of kephaline, and wondered why the remedy was not doing him

any good. I directed sub-nitrate of bismuth, acacia, and lime water. In three weeks this condition was removed, he went back to the kephaline, and is now making a rapid recovery. About three months ago saw a case with another physician; there was considerable pneumonia, and yet the patient was taking cod liver oil and a ride to the park every afternoon. I recommended calomel, quinine and camphor, with absolute rest, until the pneumonia was subdued; I then ordered quinia, sulphuric acid and infusion of wild cherry, and in another week directed glycerite of kephaline, with excellent results. Many similar cases could be recorded. A great amount of injury is caused by routinism. Cod liver oil and the hypo. phosphites of such unequivocal value when indicated, are often used in cases contra indicating their employment, and the consequence is that they are blamed for the results of the physician's ignorance. Churchill, in 1864, published a book of a thousand pages to teach the profession the use of the hypo. phosphites, and yet, in 1872 and 1876, the medical profession of the United States seemed to have been ignorant of the existence of this book. If they had not been, they would not have been victimized so completely. In 1875 he published an abridged English edition, which does not seem to have been perused by some of our Philadelphia Professors even a year ago. I have been engaged during the past year in writing my work on Tuberculosis," and a thousand subscribers already encourage me to hope that my efforts will be more successful than were those of Churchill in getting my views examined by the profession of this country. Churchill believes in a specific remedy-I do not. He thinks the primary lesion is deficiency of hypophosphites in the blood and the proximate error in the heat generating process. I refer it to the deranged nerve influence in those nerve masses which preside over digestion, assimilation, nutrition and respiration. One employs the hypophosphites manufactured in the laboratorythe mono-basic hypophosphites-the other employs hypophosphites isolated from animal brain, the tribasic hypophosphites in their glycero-nitrogenous association. So little was the chemistry of the hypophosphites understood, that as late as November, 1877, one of my assailants had the temerity to ridi. cule the idea that the ordinary hypophosphites are mono-basic, because two equivalents of water are necessary to their existence. Of course he knew better. Gmelin had already stated it on the 114th page of the second volume of his hand-book of chemistry, and it had been reiterated by Churchill on page 59 of his Treatise on Consumption, London 1875, and can now be found on page 141 Bernay's Chemistry; also in Attfield's work on chemistry. Such a mistake was never unintentionally made by a professor of chemistry.

2219 Catherine street, Philadelphia.

Selections.

HYPODERMIC INJECTIONS OF ETHER AND BRANDY. -In cases of vicious insertion of the placenta, when it produces such an abundant hemorrhage that the woman is exsanguinated, and it becomes necessary at once to raise the temperature and stimulate the nervous centers. M. Chantreuil advises the injec tion of sulphuric ether (a drachm for example) into the subcutaneous cellular tissue. A little later we may use one or more similar injections of cognac Under their influence the faintings cease, the heat is re-established and the patient is re-animated. In this way if transfusion becomes indispensable, we have at least gained time.-L' Union Medicale-Hosp. Gazette.

VOL. II.

Editorial.

Sanitation.

Many years ago diseases, or "The Pest," appeared periodically in various parts of the world, spreading terror among the people and decimating the inhabitants. The teachers instructed the people that these dreadful visitations were the just penalties inflicted by an offended Diety, and offerings and prayers were required to placate an angry God. Hence, when the scourge was applied in the form of small-pox, malignant typhus, pest, etc., the people, recognizing that these sufferings arose from violation of laws, betook themselves to their shrines or altars

and there attempted to secure expiation. Sack-cloth and ashes, though possibly good emblems of submission and penitence, were slow to remove diseases which originated in uncleanliness.

The people of the present day recognize the same fundamental fact. Many of the diseases, pests and plagues of the fathers, do arise from violation of laws, and it is not improbable that by some of the rites of the church, especially when cleanliness was enjoined, as in the lavements of the Hebrews, much good was effected.

During the last hundred years very much attention has been devoted to the etiology of diseases, and some of the "visitations" of the ancients, as small-pox, typhus fever, etc., have been shorn of many of their terrors. And yet we are not content. The investigations of recent times indicate that a very large proportion of the sickness and deaths are from causes more or less under the control of the people. This being the case, we hail the advent of sanitary conventions. They have already accomplished much good, and a bright future is before them.

During the month (November 17-24) will be held in Nashville, Tennessee, meetings of more than ordinary interest. It is to be

No. 21

hoped the deliberations of the various learned bodies about to assemble there may result in much good by discussing the causes of diseases-especially yellow fever and of the means best calculated to prevent a recurrence of the sufferings and deaths of the past two years. There are various other ailments, such as summer complaint of children, scarlet fever, consumption, etc., which, from their extensive dissemination, and almost constant presence, have led many to regard them as unavoidable diseases, and therefore merit little attention. It is not improbable, however, that even these may be removed from the front ranks of "Causes of Death," and therefore we bespeak for them, at the earliest convenience, careful consideration.

Miscellany.

W. H. R.

THE LATE DR. LOUIS DAVENPORT.-It is with regret we announce the death of Dr. Louis Davenport, who, while evidently in ordinary health, died suddenly on the 22d of October, 1879. A meeting of the medical profession was held, and a committee consisting of Drs. Brodie, Bissell and Lauderdale reported the following preamble and resolutions, which were unanimously adopted:

Whereas, It has pleased Divine Providence to remove by death from our number, in the prime of life, our beloved professional brother, Dr. Louis Davenport, a gentleman we were all pleased to associate with, and whose relation to the profession had always been kind, social, liberal and ethical; a man whose heart was always open to the poor and suffering and whose skill was liberally dispensed to them without price; therefore,

Resolved, That in the death of our lamented brother the profession have suffered the loss of a worthy member, and one we had all learned to love and esteem.

Resolved, That we unite in offering to his family and friends the assurance of our deep sympathy, not that we may lessen their grief, but as a claim that we can share their sorrow, and more particularly that his decease followed so closely on that of his