Surgical Suggestions (American Journal of Surgery) Nitrous oxide narcosis can, in most cases, be continued "smoothly, with no cyanosis and with fair degree of relaxation, even for an hour. A laparotomy may be thus performed, if ether and chloroform are contraindicated. To secure such a narcosis it is best to use an apparatus that permits exhalation into the gas bag, and which has a valve for the admission of air. The bag should not be distended fully. After brief air and gas administration, air is turned off and the patient breathes NO, and his own CO2. At short intervals, and whenever there is any cyanosis, a single breath of pure air is allowed. During narcosis, when stertorous breathing calls for extension of the jaw, it is well to hold it forward first on one side, then on the other, alternating at short intervals. Long, continued pressure at the angle or angles of the jaw produces much soreness. Often the jaw can be kept forward by catching the lower incisor teeth in front of the upper ones (if they are strong); a single finger on the chin is enough to maintain this position. When scissors become "catchy" their edges can often be surprisingly smoothed by carrying each blade repeatedly from lock to tip between the firmly pressing thumb and forefinger. Each kind and size of scissors has its own capacity, and should be used only for what it is intended. Ophthalmic instruments are not intended for ordinary dissections, tissue scissors should not be used for cutting bandages, or bandage scissors for plaster of Paris. A scroll-saw, with an assortment of a dozen saws, can be purchased at the hardware store for twenty-five cents; it is ideal for resection of the small bones of the hand and foot, for amputations of the digits, etc. Well tempered carpenter's chisels and gouges, and a carpenter's wooden mallet answer the purpose admirably for bone work. A useful bone drill can also be selected from the stock of the hardware dealer. A gardener's pruning knife and a carpenter's miter saw are the best tools for the removal of plaster dressings. A cheap potato knife, rough sharp end on a stone, is excellent for cutting through starch bandages. Crochet needles are most useful for lifting buried stitches out of a sinus. Knitting needles find another purpose as a means of rupturing the membranes when this is needed in obstetrical work. Sharp and blunt retractors may be fashioned, in an emergency, by bending the tines of a fork and the handle of a spoon, respectively. A teaspoon is also useful as an elevator of the eye, when resection of the superior maxilla is performed. An inverted tea-strainer is useful in the dresssing after colostomy, to pre vent pressure of the gauze upon the gut. A spoonshaped potato cutter may be used, in an emergency, as a wound curette. Similarly, applicators, probes and depressors may be improvised by twisting stout copper wire. The multiple surgical uses of the hairpin are also well-known. stouter material, is necessary, a small self-retaining speculum can be quickly made from steel wire; it often obviates the need of an assistant when searching the hand or foot for a foreign body. If Medical News and Miscellany Let him that would move the world first move himself. SPECIAL CLUB RATE.-The "Cosmopolitan" and "Medical Herald,” for $1.50, twelve issues. See page 77. THE first solid food given typhoid patients by Hare is "the soft parts of stewed oysters;" and this only after the temperature has been normal for nine days. BOUGHT A GOLD BRICK.-About fifty Colorado farmers are protesting the payment of promissory notes given an itinerant "doctor" on the condition that he should cure their rheumatism. The notes are for $42 each. DRS. H. C. CROWELL and C. J. MORROW, of Kansas City, paid a brief visit to St. Joseph on the evening of December 16, when they presented interesting papers before the Buchanan County Medical Society. They were the guests of Dr. O. B. Campbell while in the city. ELECTION OF OFFICERS.-The annual election of officers of the Buchanan County Medical Society occrured on Saturday evening, December 2, with the following result: President, Dr. O. B. Campbell; first vicepresident, Dr. C. G. Geiger; second vice-president, Dr. O. G. Gleaves; secretary, Dr. Chas. Wood Fassett; treasurer; Dr. J. B. Reynolds; censor, Dr. P. I. Leonard; delegate, Dr. T H. Doyle. Arrangements were completed for the annual banquet at Hotel Metropole on the evening of December 30th. BOARD OF EXAMINERS.-The Civil Service Commissioners of Illinois have appointed the following Board of Examiners to conduct the examination of applicants for positions as assistant physicians in the State Hospitals for the Insane, viz, Drs. Hugh T. Patrick, Frank Billings, John B. Murphy and Harold N. Moyer, of Chicago, and Dr. Frank P. Norbury, of Jacksonville. This board will prepare the list of questions and grade the papers, the commission itself supervising the examination. PASS CHRISTIAN, THE FAVORITE RESORT OF THE SOUTHLAND.-Physicians who have traveled extensively have pronounced the climate of Mississippi on the Gulf of Mexico, the ideal one for winter, especially for that class of patients who have a tendency to bronchial troubles, and who do not stand the rigorous winters of the north. The Mexican Gulf Hotel, at Pass Christian, is one of the famous hostelries of the South, and under the management of Mr. E. F. Carroll, has grown more popular than ever. Take a trip yourself, doctor, and you will find a climate equalled only in the south of France. Here you will find boating and fishing during our Northern midwinter, and an average temperature of 70 deg. F. The Pass is only fifty miles from New Orleans, and easily reached in two hours via the L. & N. R. R. Do not overlook the fact that not a single case of yellow fever occurred at Pass Christian during the recent epidemic, a fact that speaks volumes for the hygienic surroundings and the peculiarly healthy climate of this resort. Write to Mr. Carroll for full particulars. VIRTUE RUNNING WILD.-The sentiment which underlies the present efforts of certain worthy medical men, to protect the profession from imposition and to make our therapy clean, reliable and trustworthy, is entirely laudable and commendable. The extenat to which some of these gentlemen are permitting their enthusiasm to carry them is lamentable. The judgment passed upon many of the pharmaceutical preparations which have stocd the test of time for years in the practices of thousands of successful medical men, has seemed hasty and all-advised. To one who is prejudiced in neither direction, who endeavors to look at the matter with perfect fairness, it is very questionable if it is right that a small faction of the American Medical Association should use the organ owned by all of the members to condemn or detract from the reputation of long established pharmaceutical preparations, many of which are used regularly by a large part of the membership of the association. The manufacture and sale of pharmaceutical preparations is and must be commercial in its character. It can never be strictly professional. The average preparation which has. been used by medical men of intelligence for years with good results must have something in its favor, even if its manufacturers are not willing to conduct their business exactly as we may wish to dictate. I have no desire to uphold in any way the secret medical nostrum, but I question as a matter of fairness, the propriety of attacking any well-tried preparations until it is demonstrated beyond reasonable doubt that the members of the Association are opposed rather than being users of the preparation in question. Those who have been placed in positions of power-which may be used for the accomplishment of evil as well as good should appreciate that such an office is one of trust and there should be an effort to carry out the will and wish of the majority rather than to be led by personal prejudice or petty motives.-G.T. F. in the The Chicago Clinic and Pure Water Journal. RESPIRATORY AFFECTIONS: SYMPTOMS AND THEIR TREATMENT.-(By Justin Herold, A.M., M.D.) The past few months have afforded me, and no doubt others, opportunities to test the efficiency of the therapeutic qualities of the various remedies vaunted as certain to relieve the harassing symptoms attendant on the diseases produced by the bacillus of that nineteenth-century infant, "La Grippe. I refer to this epidemic particularly, because it had not manifested itself in such virulent form since the memorable grippe epidemic of 1889. The author of this paper, in the past few months has had occasion to employ the several preparations recommended for the relief of the distressing respiratory symptoms attendant upon "la grippe. These manifestations, from my view-point, have been characterized principally by cough and dyspnea, in other words, "dyspneic cough. Expectorant mixtures, anodyne solutions, together with hypodermic medication, produced in me a disgust; and why? Simply and undeniably for the reason that the ordinary cough mixtures contain the opium preparations in such combinations as to leave a depressing effect, which, especially in cases of the grippe of the "depressing or melancholic" type, enhances the already depressed feeling. Combinations of expectorants with stimulating ingredients had no less the same effect. Glyco-heroin, in all the cases in which I have used it, has never caused vomiting, an important point for the physician. Another important point noted was that this preparation of heroin-glyco-heroin (Smith)-never played pranks with the structures composing the vasomotor system. Now, what do we, in treating disease, want in addition to a good stomach and a stable nervous attachment? We want rapid action. That I effected through the use of glyco-heroin. You cannot produce toxic effects with this preparation, as its effects are lasting, and in most cases do not necessitate the use of the drug at very frequent intervals. Glyco-heroin allays cough, without doubt better than any remedy I have used this winter. And that without the sometimes disastrous results of other preparations of the papaver group. Respiraion is stimulated, not in number, but in the depth of the inspiratory act; thus full and complete oxygenation takes place, an important adjunct to the helpful effects of drugs in general, and saving the patient that expensive tank of oxygen. Given full and complete oxygenation, all other symptoms must accordingly diminish; thus temperature and pulse-rate are reduced to a normal condition. Elimina. tion of noxious products not being interfered with the excretion of urine is brought to the normal under the use of glyco-heroin. It is well known that diminished quantity of urine follows as a result of inflammatory diseases of the respiratory tract; thus the standard quantity of urine is enhanced by the judicious use of glyco-heroin: I beg to submit the following cases: Case I.-Acute Laryngitis. George F. N.. aged 14 years. Coasting, perspiration, and no overcoat, a good combination to bring on an acutely inflamed laryngeal mucous membrane. Pain on swallowing, talks in whispers, temperature 101.5 deg. F., pulse 135, respiration 23, cough, barking like dog, uncomplicated case of laryngeal inflammation. Stokes' expectorant did not relieve, seemed to increase cough. Glyco-heroin, full doses of one teaspoonful every three hours, while producing much sleepiness, reduced inflammation, cough, and pain in three days. I then combined it with squills and syrup balsam tolu, to be given every four hours until completely relieved. Case II.-Chronic Bronchitis, Asthma and Emphysema. Mrs. H. D., aged 44, has had asthmatic attacks, every fall and spring, for the past eleven years; not in winter, but only at the beginning and end of seasons. Iodines, senega, squills, digitalis, and cupping gave relief, but with the penalty of a return of more severe attacks. Dyspnea, cough and expector. ation in this case was something frightful to witness. In this case, prompt hypodermic injection of 1-8 grain of morphia relieved somewhat, followed by the use of glyco-heroin, one teaspoonful every hour for three doses, then every four hours, and on the third day every six hours. In this case the glyco-heroin seemed to continue the effect of the morphia. A new point in favor of glyco-heroin is that it enhances the effect of morphia when given hypodermatically. Although in seven other cases of asthma with attacks similar to the above, glyco heroin was administered, in two-hourly doses. with the remarkable effect that the cough and dyspnea ceased within four hours. In whooping cough, 22 cases from my case-book show that I prescribed glyco-heroin with permanent and speedy results, given in doses of five and ten drops, as indicated, to these little sufferers. Glyco-heroin (Smith) is far superior to codeine, as sedative, in affections where a direct action upon the respiratory center is looked for. For, certainly, its action must be direct where it is noted that respiration is deepened and prolonged. No vomiting, no nausea, no headache, no depressing of powers of mind or body, no untoward symptoms, glyco-heroin is par excellence the remedy for conditions affecting the respiratory organs, whether in children or adults, in the weakly and in the strong. THE ALKALOIDAL CLINIC HAS CHANGED ITS NAME TO THE AMERICAN JOURNAL OF CLINICAL MEDICINE.-With the January issue we change the name of The Alkaloidal Clinic to one which more fully embodies the scope of our propapanda, namely. The American Journal of Clinical Medicine. We have added to our present strong editorial force (all of which is retained, and with no change in management, or any financial change whatever), Dr. Wm. J. Robinson of New York City, who will conduct a department of "Dermatology and Genito-urinary Diseases;" Dr. Emory Lanphear of St. Louis, who will conduct a department of "Surgery, Obstetrics and Gynecology," and other departments will be added as arrangements can be made therefor. With this additional force, the make-up of the journal will be improved In many ways. The best minds in this country and Europe will contribute articles which will be of unestimable value to the general practitioner who is willing to learn and anxious to keep up with the times. Our platform is as broad as the world. We believe the physician should pluck the health-giving fruit, it matters not from what garden. We believe in and stand for the honest doctor and the honest pharmacist; their interests are mutual, and we decry all attempts to estrange them. We are fully alive to the great awakening of the public conscience now going on, proposing to stand on the very firing line of the movement for professional betterment and the public good, never taking a back step till a complete victory is won, and then we'll stick, too. We shall appreciate your co-operation. DRS. ABBOTT & WAUGH, Chicago, U.S.A. HOW THE NIGHT FELL. By Homer Clark Bennett, M. D., Lima, Ohio. 'Twas an eve in bleak December, and the snow was falling slowly, Only broken by the music of the twittering of the birds, By the call of far-off shepherds, or the low of distant herds. Now the stillness is unbroken, now the silence is profound, Lo! the Day is changed to Night. |