material, so that at any time he may be
looked upon as nearly aseptic. Hand
brushes he describes as universal labyrinths
for grease and dirt. He rejects all sorts of
chemical methods of purification, partly
because they do not destroy the bacteria
and partly because they cannot be thoro-
ughly carried out. He advises a mechani-
cal cleansing calculated to wash away the
bacteria. He uses a "marble soap," which
is make of a special alkali (steral) and con-
THE CHARLOTTE MEDICAL JOURNAL.
tains marble-dust to take the place of
brushes. After the hands are washed they
are smeared with wax paste to close the
ducts of the sweat and fat glands, which
no method is capable of disinfecting. In
the treatment of wounds he has small re-
gard for antiseptics, which can only control
to a limited extent the development of
bacteria. He advocates an early and wide
incision in suppurative processes and tam-
ponade of the wound with gauze. He
rejects all drains, and uses silk instead of
catgut, because he does not believe that the
latter can be perfectly sterilized. He boils
his silk and immerses it in gelatine to pre-
serve it from infection ; the gelatine is
melted off with hot water at the time of
use. He lays stress upon the necessity of
introducing '-homogenous substances" be-
tween the edges of infected wounds. If
this can be accomplished, such wounds
will heal in the same manner as healthy
cut surfaces. Glutol, a dry and sterile
formalin-gelatine, fulfills this requirement,
— Medical Prooress.
Inhalation of Formalin in Phthisis.
The British Medical Journal of January
28th, 1899, brought out a most interesting
paper by Dr. William Murrell, dealing with
the essential oils, and other volatile sub-
stances, in the treament of phthisis, in
which he discards the use of essential oils,
but favors the use of Formaldehyde, or For-
malin, which he subjected to severe tests
for the inhition of the bacillus tubercul-
losis, showing that the addition of glyce-
rine retarded the results, which with For-
marlin pure and simple answered all his ex-
pectations.
The Cases which Dr. Murrell reports all
show that with the Formalin treatment,
without any addition, he was uniformly
successful, the patient being told to inhale
the substance mostly by dropping it on lint,
and thus allowing it to be absorbed by in-
halation.
We call attention to this contribution of
Dr. Murrell, while we wish particularly to
make some remarks on the paper of Dr.
Lardner Green, which we find in the same
journal under date of January 20th last.
The author fully endorses, by personal
observation, the conclusions Dr. Murrell
has come to, and it is satisfactory to notice
that he also has applied this gas by inhala-
tion, to the full advantage of his patients.
Dr. Lardner Green, however, introduces
into his prescription two incompatabilities,
which we consider it desirable to point out,
and Dr. Murrell's data will assist or con-
firm, from a bacteriological point of view,
the advice not to introduce glycerine. There
is, besides, an abundancy of literature
showing that glycerine forms with formal-
dehyde a chemical compound named gly-
cero-formal, which impairs the non-toxicity
of Formalin, and although this compound
has been recommended for disinfecting pur-
poses, closer study has shown that the more
toxic properties of this body by no means
assist antiseptic action, but rather impede
it. As we said before, this has been con-
firmed by Dr. Murrell, and it is by no
means desirable to encourge the mixing of
these two bodies.
As Dr. Green has experienced, some per-
sons are more susceptible than others to the
fumes of Formalin, and for this reason he
recommends, where indicated, the addition
of aromatic spirits of ammonia. Truly
enough, this addition will effect a material
reductiou of the penetrating effect of For-
malin gas, for the very simple chemical
reason that Formalin gas has great affinity
for ammonia, with which it readily forms a
neutral compound — Formamide — and, as
will be understood, the binding up of For-
malin, thereby reducing very effectually its
activity as a bactericide.
The very simple logic would be, that if a
patient finds the fumes of Formalin irritaing
— that is, more so than he can conveniently
bear — let him reduce the solution by a fur-
ther addition of water : try half the
strength, or even much less — say, ore-
tenth — which will still be effectual as an
inhalation ; but it will be found that even
the sensitive patient will gradually be able
to bear the greater volume of gas, similarly
as a visitor to the room of a patient where
a free use of Formalin is made will, after
a very short time, fail to notice the first in-
convenience of the presence of the gas.
The great advantage of Formalin gas in
the treatment of phthisis is shown by a
great number of authors, and also that it is
equal — nay, preferable — in most cases to
the open-air treatment, unless the open air
can be had on the top of a mountain and
well removed from the contamination of a
populated community. The simple reason
for this is the great affinity of Formalin gas
for all nitrogenous and sulphur compounds,
which -it quickly eliminates from the air of
the room occupied by the patient, and for
which reason it will, under all conditions,
favor the general treatment of disease and
minimize its symptoms. In this respect
the use of Formalin offers the inducement
of further study of what cannot fail to be
a most gratifying subject.
No matter what you say to a chemist, he
always has a retort.
412
THE CHARLOTTE MEDICAL JOURNAL.
A Merited Rebuke.
There is, it is to be feared, a large class
of men in the profession who thoroughly
deserve the following scathing rebuke
which the editor of the Philadelphia Jour-
nal administers to the omnipresent vender
of suggestive and obscene "stories :" We
have no wish to exaggerate the facts either
as to the importance or as to the amount of
smut masquerading as wit in some of the
lecture-rooms, journals, and in the conversa-
tion of some physicians, but we think all
bright clean men will agree that there is
altogether too much of it. We are con-
fident that medical students are fully as
free from the vice as any other class of
young men, and in their behalf as well as
on the score of professional decency such a
purity should be guarded rather than broken
down. But is there a practitioner that does
not look back with shame aed disgust to
the nauseous 'story-telling' of some shame-
less 'professor' of his college days? A
room full of young chaps will perhaps
laugh and applaud — and then go away — at
least the best of them — to loathe the teacher
who thoughtlessly debases his office and
corrupts his audience. We have known
some of the highest officers of a great med-
ical organization who, wherever they went,
left behind the pollution of obscenity and
nastiness. We have known a professor of
the history of medicine who peppered h'"s
lectures with stories erotic and 'tommyrotic'
that showed how pitiable was his reading
of history, and his conception of duty. If
wit happens occasionally and accidently to
be touched with this diabolism, men of the
world will not wince, and may even laugh
the more heartily, but he is an ass and a
knave who from choice and habit delight
in pornographic reek,"
A little cheerful wit is often a pleasant
and useful medicine for doctor as well as
patient, but when it is flavored with filth it
becomes a nauseating dose indeed. Certain-
ly no class of men should avoid such coarse
ness or obscenity more than physicians,
whose constant association in the home life
of the community demands the language
and manners of gentlemen. Nor has inde-
cent language, at any time, a place in the
vocabulary of a cultured physician. Closely
allied to outright decency in a class of
literature with which a few medical jour-
nals are filling their pages and which cer-
tainly cater more to the pruriency than to
the necessities of their readers, while mas-
querading in the garb of science. Those
multiplied discussions of erotomania and
sexual anomalies and disquisitions on the
nature of lust may be of occasional interest
to the alienist, but to the average man are
of no more value than the inscriptions on
the Rosetta stone He reads them for the
same reason, and probably with the same
sensations, that another less "scintific" man
absorbs with eager avidity his "Sapho" or
crowds to see the latest degenerate drama.
In order to be honest with ourselves we
need to get down to first principles. — Med-
ical Standard.
Care in Ascribing Causes.
Patients suffering from any of the surgi-
cal diseases are never content unless they
are able to ascribe their origin to some spe-
cial mechanical injury. Be careful how you
agree with them. A woman with cancer
of the breast, for instance, always remem-
bers some blow or push she received at some
former time. It probably had nothing to
do with it, but unpleasant accusations or
even lawsuits may arise from too ready ac-
quiescence on the part of the surgeon. The
writer remembers a bad case of enlarged
tonsils with adenoids in a child whose
mother accused a teacher of bringing on
these ailments by pulling the child's ear a
month previously. The disease had unques-
tionably existed a long time. It is always
best for the practitioner to be exceedingly
guarded in ascribing causes ; in the first
place because, as a matter of fact, he can
often know but very little in regard to them
and in the second place because he may in-
volve other people and himself into trouble
that had betrer be avoided. Great caution
is especially advisable in venereal cases. —
International Journal of Surgerp.
Water and Obesity.
A physician of Erlangen, Dr. Lorenzen,
experimented with himself for the purpose
of seeing the effects of inhibition of water
upon the body weight. For four years he
indulged in the not ascetic task of drinking
two gallons of beer daily, and discovered
the remarkable fact that he had increased
his weight seventy-two pounds. On stop-
ping the ingestion of water (beer) he re-
duced his weight fourteen pounds in seven
davs. Dr. Lorenzen's experiments are be-
ing performed daily by a large class of our
esteemed Teutonic citizens. — Dietetic and
Hygienic Gazette.
Patient : "Doctor, I can't sleep at night.
I tumble and toss until morning."
Doctor: "H'm, that's bad. Let me see
your tongue. (After diagnosis) Physically
you are all right. Perhaps you worry over
that bill you've owed me for the last two
years ! " — The Scalpel.
THE CHARLOTTE MEDICAL JOURNAL.
413
The Uses and Effects of Qude's Pepto-flangan.
By Dr. Julius Heitzmann, Me-nna.
The employment of iron preparations
both in essential ansmia (chlorosis), and
in the symptomatic forms of this affections
produced by severe losses of blood, dates
from the earliest times. Long before the
chemical relation of this effect was known,
these remedies were administered on the
ground of pure empirical experience.
When Hannan pointed out the high
significance of manganes, as well as of
iron, with regard to the absorption of
oxygen by the blood, and when this dis-
covery was confirmed by Ruble, effects
were made to produce, by combination of
both remedies, preparations which would
best fulfill the therapeutic indications in all
directions.
Former attempts of this kind failed to
give the desired results. The aim was to
combine both metals in such a form as
would enable them to be absorbed through-
out the entire extent of the alimentary
canal, and at the same time be devoid of
disagreeable taste which would prevent
their prolonged administration. After a
series of experiments made in this direc-
tion I found in the preparation discovered
by Dr. A. Gude (Pepto-Mangan Gude) a
remedy which fulfilled the above requisites,
and can recommend it most heartily.
Pepto-Mangan — Gude is a clear, dark,
wine-red fluid, having an agreeable, non-
metallic, astringent taste. The latter pro-
perty gives it a great advantage over other
similar preparations, for the remedy is
always taken with pleasure, and may there-
fore be administered for a long time with-
out exciting the disgust of the patient. No
irritation of the stomach is produced, nor
is the digestion disturbed in the least res-
pect ; indeed, as regards the latter, a stimu-
lation of the long-absent appetite could be
demonstrated within a short time.
The Pepto-Mangan — Gude, usually mixed
with some water, is prescribed in doses of
two or three dessertspoonfuls, increased to
as many tablespoonfuls per day. An espe-
cially agreeable manner of administration
is by addition of cold milk, which then
assumes a light chocolate color and an
agreeable taste. Prescribed in this form
we obtain this preparation everything that
could be expected from a remedy for anagmia.
The Pepto-Mangan — Gude may also be
mixed with white and sweet wines, except-
ing the red wines which contain tannic
acid, and an occasional change in the man-
ner of administration is sometimes of ad-
vantage, especially in the cases of children.
The diet, during the use of this prepara-
tion, should consist of milk, meats — especi-
ally ham — fowl, soft-boiled eggs, and other
easily digested foods. On the other hand,
sour and fatty foods, red wines, and raw
fruits are to be avoided.
The remedy is to be administered for a
number of weeks, especially in cases of
chlorosis, but in the case of young girls up
to 12 years of age it is best to commence
with a daily dose of two teaspoonfuls (ten
grammes). In adults the dose of Pepto-
Mangan — Gude may be increased in a few
days to one tablespoonful twice or thrice
daily, or even to ten or twenty grammes.
The preparation should be well protected
from the light, and preserved in a cool place
in a well-stoppered bottle.
I have employed the Pepto-Mangan —
Gude with much success both in chlorosis
and in cases of anaemia in girls and woman
due to the loss of blood, menorrhagia, met-
rorrhagia, inflammation of the pelvic or-
gans, peri- and parametritis, or prolonged
leucorrhoea. In almost every instance I
observed within a short time increase of
appetite, improved nutrition, healthier
color of the face, and increase of weight. I
was surprised to learn how much more
readily the Pepto-Mangan — Gude was taken
than similar preparations, without ill effects
even after protracted use.
To illustrate my remarks I will cite a
few cases :
I will first report a case of chlorosis treat-
ed with this remedy, which was under con-
stant observation. The patient, a school
girl aged i6, began to menstuate one year
ago, but after appearing regularly for three
periods the flow suddenly ceased, probably
in consequence of mental overexertion, and
symptoms of chlorosis soon developed.
The various preparations of iron were tried,
but were either not well borne or excited so
much disgust that they were discontinued
by the capricious patient. A milk cure
was prescribed, but followed for only a
short time. When, however, I resorted to
the Pepto-Mangan — Gude I was surprised
to find that the girl took it willingly and
that it was well borne. She made a rapid
recovery, and after the use of two bottles
had regained her former healthy, color,
while her strength and menstruation re-
turned.
Case II. — A married lady, aged 34, had
acquired — apparently of abortion at a very
early period — an intense peri- and paramet-
ritis with an exudation of the size of a
child's head. The latter disappeared almost
completely under suitable treatment and
rest, so that only a slight induration was
present in the parametrium after three
414
THE CHARLOTTE MEDICAL JOURNAL.
weeks, Owing to the considerable ansemia
and loss of appetite, however, the patient
recovered very slowly, and for this reason
I ordered the Pepto-Mangan — Gude. A
few days after its use the appetite reap-
peared, recovery ensued rapidly, and five
weeks later her health was completely re-
stored.
Case III. — A married lady, aged 30, had
suflFered from leucorrhoea due to catarrhal
inflammation of the vagina for two years,
and although the local trouble had been
much relieved, she continued pale and
weak. As her celorotic daughter at the
time was taking the Pepto-Mangan — Gude
with marked benefit, 1 advised her also to
try this preparation. She followed my
advice, and after fourteen days the weak
sluggish, and pale woman seemed as if
transformed. She has since regained her
former health.
These few cases, which were under con-
tinued observation, will confirm what has
been said above regarding the manner of
application and effect of the Pepto-Mangan
— Gude. I regard it as superfluous to cite
other cases, since a few closely observed
cases teach more than a host of superficial
observations.
On the ground of my experience I con-
sider myself warranted in directing the
attention of physicians to this remedy, and
feel convinced that further trials will give
equally favorable results. Even in cases
where local treatment is necessary the
Pepto-Mangan — Gude will prove a valuable
auxiliary in our treatment. — Allgemeine
Wiener medizinische Zeitimg, xxxvi
Midwifery in New Mexico.
I have a little item of observation in the
obstetrical line that has appealed to me and
no doubt would be interesting to you.
1 had occasion recently to witness the
delivery of a Mexican child by a native
midwife.
Before I begin I will say that these Mex-
icans are a mixture of Indian and Spanish,
and are almost nothing more than savages.
I was called (■♦^here has never been an
American physician in this section) on ac-
count of delayed ( ?) labor ; the woman had
been 'n labor five or six hours. I saw that
everything was all right, and thought it a
good opportunity to see how they do it
where there are no "doctors." Tuis may
not be new to you but it was exceedingly
interesting to me.
The midwife (?) sits "tailor" fashion
between the limbs of the patient (the pa-
tient on her back), and awaits the coming
of the child and receives it in her outstretch-
ed hands. She points to the caput succe-
daneum and shakes her head (seems to un-
derstand). As soon as the child is born it
shifts for itself, and the midwife begins im-
mediately the delivery of the placenta.
She inanipulates the abdomen by pressing
backward and downward, wrist on pubes
and palm over uterus, right hand ; her left
hand partially in vagina, manipulating — I
couldn't tell how. Midwife instructs pa-
tient to poke a piece of rolled paper (ready
prepared) down her throat, which excites
gagging" and wretching, and in that way
aids expulsion. The placenta soon comes
away, and she then lets the mother shift for
herself '\nd wraps the baby and placenta in
a clotli (still attached) and deliberately sits
down on the ground beside the bed ( t) — a
lot of blankets on the ground — and rolls
and lights a cigarette and takes a few puffs,
then proceeds to skein some white cotton
thread from a spool and twists it very care-
fully into a very neat cord about one foot
long and the diameter of a shoe-string.
She then unwraps the baby and placenta
and ties the cord very neatly and securely
about two inches from the child's abdomen,
cuts the placental side and burns the stump
portion beyond the tie (distal end) almost
to a crisp with a lighted candle; oils the
baby with sweet oil and her work seems to
be done.
There were no aseptic precautions what-
ever, and the singeing of the stump the only
antiseptic one.
I understand the mother made an un-
eventful recovery. I have not yet inquired
into the mortality rate, but judge it is very
low, considering. These people are very
filthy. — C. E. Beeson in Cincinnati Lan-
cet- Clinic.
Pepsin is undoubtedly one of the most
valuable digestive agents of our Materia
Medica, provided a good article is used.
Robinson's Lime Juice and Pepsin, and
Arom. Fluid Pepsin, (see ad. in this num-
ber) we can recommend as possessing merit
of high order.
The fact that the manufacturers of these
palatable preparations use the purest and
best Pepsin, and that every lot made by
them is carefully tested, before offering for
sale, is a guarantee to the Physician that he
will certainly obtain the good results he ex-
pects from Pepsin.
"It takes the starch out of me to be
chewed up this way," growled the potato.
"Don't fret," said the sirloin as they to-
bogganed down the esophagus, "you'll feel
sweeter in a short time. — American Medi-
cal yournal.
THE CHAELOTTE MEDICAL JOURNAL.
415
Rockbridge, Va., Alum Water.
That are of Intrinsic Value to the Medical Profession.
Extract from a paper read before the Atlanta Society of Medicine, April 26, 1887, by John
S. Todd, M. D., Professor Materia Medica and Therapeutics, Atlanta Medical College, Ga.: Ex-
President of Georgia Medical Association ; not read in our interest, but in the interest of Science
and his profession :
"Some four and a half years since I had, among other cases, one of dysentery, which resist-
ing all medication, became chronic, and a large ulcer of the rectum DEVELorED. I called
in consultation a noted surgeon. The patient's condition was one of extreme emaciation ; blood
and mucus in large quantities were voided about an average of once an hour. The dose of opium
had been increased to 3 dr. laudanum in twenty-four hours and i gr. morphine twice a day, and
still matters grew woi-se. We decided to inject solution 30 grs. to oz. nit. silver in rectum. The
result was a COLLAPSE that nearly proved FATAL. Upon it being suggested later that the oper-
ation be repeated, the patient, a young man, said if we and his family insisted, to avoid it he
WOULD COMMIT SUICIDK. Dr. W. S. Armstrong was then called in with me. He suggested an ex-
clusively milk diet, gradual reduction of opium, and Rockbridge (Va.) iron and alum water.
Immediate improvement set in, and in TEN days so great was THE constipation that oil and
enyemas had to be resorted to to procure an evacuation from the bowels. Since that time I have
TREATED SEVERAL CASES ECiUALLY AS BAD, WITH SAME HAPPY RESULT, using Same diet and
medicines, for of all agents for this disease. I consider the Rockbridge alum and iron water
THE FIRST. It is equally efficacious in chronic diarrhcea, as my records attest."'
Dr. Todd, March 21, 1900, writes : I have for 16 years used these grand waters con-
stantly in my practice with increased and increasing satisfaction, I inclose you article written 3
years ago on opium. "In chronic diarrhoea and dysentery, the milk diet, Rockbridge Alum
Water, and small doses of opium given cautiously — very cautiously lest your patient acquire the
opium habit— has proved so invariably successful with me, that I have come to treat these
CASES with a CONFIDENCE BORN OF SUCCESS. "
Dr. Hunter McGuire, Virginia's great surgeon, says: As an astringent and tonic it is
one of the mosc valuable I have ever used.
Dr. S. Gaillard Thomas, Professor College of Physicians and Surgeons, N. C: Most effi-
cient astringent and tonic waters I have ever employed.
Write JAMES A. FRAZIER. Mgr. Receiver, Rockbridge Alum. Springs, for Pamphlet.
Dr. Banner. -Eye, Ear, Nose and Throat,
We have had a worthy addition to the
medical fraternity of Charlotte in the com-
ing of Dr. Banner of Mt. Airy.
He comes thoroughly furnished with every
scientific equipment for the most modern
treatment of all diseases of the eye, ear,
nose and throat and behind his instruments
will be found a man of rare ability and
skill.
In no other department of medicine is
there such sure returns for the right man as
in this specialty and we hope that Dr. Ban-
ner will. do great things for himself and the
profession in his chosen field.
Militant Advocates of Vaccination.
A Christian Scientist lectured recently in
Victoria, B. C, on the -'Failure and Ini-
quity of Vaccination," and his remarks
were so outrageously slanderous and false
that they aroused the ire of the anti-faith-
healers in the audience, and a general melee
ensued. When order was finally restored
most of the men present bore marks of the
fight, and several of the "scientists" ac-
quired a sudden "belief" in epistaxis. —
Medical Record,
Dr. Edward Francis Brady, in an article
entitled Epilepsy (Hospital and Clinical
Reports), says: I do not approve of the
Gowers plan of treatment. The dosage is
too massive and I think unsafe. The dan-