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J. A. (Joel Asaph) Allen.

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complained of a sense of fulness and distress at the epigastrium
after meals. There are also sour stomach and sometimes heart-
burn or cardialgia. This sensation is not due to excess of acid of
the gastric juice — for that is really diminished — but to lactic and
butyric acids formed from the starchy foods instead of the latter
being converted into glucose. Occasionally nausea and vomiting
occur, notably in the morning, as in the vomiting of drunkards —
or water brash.

Dyspnea is not uncommon, and even paroxysms of peptic
asthma may occur. Besides dyspnea there are not infrequently
palpitation and irregular action of the heart, with intermittent
pulse. In fact, dyspepsia is one of the most frequent causes of
intermittent pulse. These symptoms — dyspnea and irregular
cardiac action — are due partly to pressure from the distended
stomach, and partly to reflex action along the pneumogastric and
phrenic nerves. The patient often complains of vertigo. The
bowels are alternately loose or constipated.



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FUNCTIONAL DT8PBFSIA, SO-CALLED. 603

In the treatment of these cases, removing the cause and regu-
lating the diet are of prime importance. As for removing the
cause, this is often impossible in case the dyspepsia be associated
with organic disease such as carcinoma, phthisis, and diseases of
the liver, especially those that cause obstruction to the portal cir-
culation. Mitral obstruction or regurgitation gradually brings
about this condition. In the former case the blood is prevented
from leaving the lungs, in the latter it is regurgitated back on the
pulmonary circulation. In either case a strain is put upon the
right ventricle and finally the liver itself, together with the whole
gastro-intestinal tract, becomes congested, giving rise to chronic
catarrh of the stomach and bowels. General emphysema brings
about the same result. Here we have obstruction to the pulmonary
circulation, due to loss of capillary area in the lungs from overdis-
tension of the air-cells. In all such cases it is impossible, as a
rule, to remove the cause.

But in irritable dyspepsia, dependent on alcoholism for
instance, the cause can, and should, be removed. In the same way
the opium habit must be dropped. It may be asked how can
opium, which generally causes the atonic form, give rise to irrita-
tive dyspepsia ? Evidently by paralyzing the muscular coat of
the stomach, thus allowing food to remain too long in that organ
and so to cause irritation of the mucous membrane. Gluttonous
habits should be modified and the use of improper and highly
seasoned food, or food that is improperly cooked, be discontinued.
So much for removing the causes of irritative dyspepsia. When
we come to the atonic form, we find that here, too, the cause can
often be ascertained and modified, if not removed entirely. As
such may be mentioned depressing emotions from loss of loved ones,
financial ruin, the so-called disappointment in love, political aspira-
tions and the like. As anything that lowers the vitality is likely
to give rise to atonic dyspepsia, it should always be looked for
and treated, as the dyspepsia is only a symptom of the real dis-
ease. Menorrhagia, excessive sexual indulgence, overwork with
insomnia, as well as lack of sufficient and wholesome occupation,
all tend to lower vitality and should be considered.

Space is wanting to refer to regulating the diet in full. In
general terms, however, it may be said that in any case, meals
should be regular, and the food eaten with deliberation instead of
being swallowed hurriedly, especially while mentally worried
about some scheme or other. In atonic dyspepsia, as a rule, tonic



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604 SELSCTI0X8.

treatment is indicated and the patient has to be bnilt up. But in
irritative dyspepsia the very opposite course is often to be pursaed^
care being taken especially to avoid starchy and fried foods and
fats, as well as alcoholics.

Besides removing the cause and regulating the diet, many
remedies have been suggested and tried by different practitioners
from time to time. Of these remedies I do not hesitate to recom-
mend papoid as one of the best. It dissolves the abnormal
mucous secretions, thus removing a prime cause of fermentation
besides stripping the food of its mucus envelope and thus expos-
ing it to the action of the gastric juice. In addition to its direct
digestive action on the stomach's contents, it also seems to have a
stimulating effect upon the gastric mucous membrane. Its therapy
is not materially interfered with by any of the drugs usually given
internally, and it is equally efficacious in acid, alkaline or neutral
media. That it is not destroyed in the stomach, like animal pep-
sin, is proved by the fact that even in ordinary doses a trace of it
may be found in the stools, thus showing that the whole gastro-
intestinal tract has received the benefit of its action. In cases
where diminished peristalsis is marked, accompanied by accumula-
tions of gas in the stomach and bowels, it is well to add strychnia.
The average dose of papoid is about one and a half to three
grains ter die after meals, and one of the most convenient
methods for its administration is in tablet form.

Along with papoid other remedies may be used. One of the
best, in many cases, is the rhubarb and soda mixture with tincture
of nux vomica, or if the case is one due to abuse of alcohol (rum
stomach), tincture of capsicum should be added. Where palpita-
tion and irregular heart's action are present, the tincture of digi-
talis may be added to the same mixture. (Prescription — Tinct.
digitalis, 1 dr., pulv. rhei, pulv. sodii bicarb, of each 2 scr.>
aqusB q. s. ad. f. 2 oz., m. eig. 1 dr. ter die.) Washing out the
stomach by means of the stomach tube was once much in
vogue, but now it is used chiefly in those cases where dilatation
is marked, as in obstraction to the pylorus from cancer or other
cause.

Besides actual treatment, patients who can afford it, often
improve, or are perfectly cured, by taking a course at some water-
ing-place, care being taken to make a proper selection, which can
only be done by advice of some physician who is intelligent on
such subjects. The visiting of watering-places at random and the^



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THE PHYSIOLOGY OF CONCEPTION. 606

use of the waters without proper care and instrQCtion is undoubt-
edly more productive of harm than good.

Before leaving this subject, a word of warning to physicians
and their patients. Alcoholics and opiates may be needed at
times in the treatment of these case», but beware of their repeated
and too free use. It is by these small beginnings, and in such
apparently innocent schools, that the drunkard and opium fiend
are educated. The fatal mistake should not be made of bringing
about some habit worse than the original disease, and more diffi-
cult to cure. — New York Polyclinic.



THE PHYSIOLOGY OF CONCEPTION.

Bt dr. a. D. BARR, Calamine, Ark.

That the union of the spermatozoa with the female element is
necessary for conception is settled beyond controversy ; but con-
cerning the manner of their union nothing has heretofore been
known. Without entering into a discussion of the generally
accepted theories of conception, I will proceed to give what I
believe to be the true explanation of it. The spermatozoa do
not enter the ovum at all. The ovum is the center that collects
the cells that are to compose the embryo.

The true embryonic cells are secreted by the uterine glands,
and, like all other cells, are composed of protoplasm, and are found
by microscopical examination in the secretion of the uterine glands
of all animals, and in the egg of the fowl.

When sexual intercourse takes place, the uterine glands are
stimulated, and pour out their secretion in considerable quantity,
and thus prepare for the reception of the fertilizing agent.

The spermatozoa immediately after entering the uterine cavity
begin to enter the cells that are secreted by the uterine glands.
After the spermatozoa enter the cells, the cells begin to divide, and
within twenty-four hours they arfi greatly divided. The cells
formed by the division of the original one are much smaller —
about the size of white blood-cells. The spermatozoon, being a
living agent, penetrates the cell wall ; the head and body soon
become absorbed by the cell ; the tail is absorbed by the cell wall.
Thus the spermatozoon disappears, and its life or motion is
changed into the molecular motion of the cell. If an ovum is
present in the uterus when the embryonic cells are impregnated,
or reach it before they perish, the cells now being endowed with



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606 SELECTIONS.

life principle, or rather the kinetic energy of the spermatozoon
is converted into the potential energy of the cells, and the
ovum acts as the center around which they are organized into a
living being; and the life of the new being is the potential energy
of the cells again converted into kinetic, or the remanifestation of
the life of the spermatozoon.

The idea that the body is produced entirely from the ovum is
erroneous. The laws governing the organization of the embryo are
analogous to those governing the solar system ; the ovum corres-
ponds to the centripetal force, and the embryonic cells to the
centrifugal. The result of these two opposing forces on living
cells are : the centrifugal force of the cell tends to unlimited
division to such a degree as to produce complete destruction of the
cell, and the centripetal force of the ovum tends to draw the cells
all to itself and thus prevent division \ thus the two forces balance
each other very nearly. It is the variation of these two forces
that results in the differentiation of the cells that compose the
different organs of the body. Of course, each individual cell
possesses centripetal force ; but when the spermatozoon enters the
cell and its life is converted into motion, the centripetal force of
the cell is completely overcome, and if no other force were present
the cell, as before said, would be destroyed by its own force. The
blood cells are formed from these same impregnated and divided
cells. The blood cells are formed in the cells, or rather the cell
is changed into the blood corpuscle. Under the microscope the
cell can be seen in different stages of transformation into red blood
corpuscles, and are readily distinguishable by their change of
color and later by change of shape. I do not think the entire cell
is converted into the red blood corpuscle, but is formed from the
nucleus of the cell ; and during its formation the part that is not
necessary for its production is dissolved, and, perhaps, serves some
unknown use. In support of the view I have advanced, I will
give my own observation, supported by physiological facts already
known.

The uterine glands, as before stated, secrete a perfect cell ; and
if this uterine secretion be examined microscopically a short time
after sexual intercourse, the spermatozoa will be seen in great
abundance mingled promiscuously among the cells. If the same
fluid be examined again after remaining six hours in the uterus,
the number of spermatozoa will be greatly lessened, and the older
cell will be seen to be undergoing typical cell division. If inter-



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THB PHYSIOLOGY OP CONCEPTION. 60 7

course takes place and there is very scant secretion from the
uterus, the seminal fluid remains in the uterus unchanged, and on
microscopical examination it will be seen that the spermatozoa
still retain their vitality ; of course, there will be found a few
embryonic cells which have been entered by spermatozoa and are
undergoing or have undergone division.

Under such circumstances the cells are gradually produced, and
are entered by the spermatozoa as soon as secreted. If the uter-
ine secretion is present in a normal amount when intercourse
occurs, and some of the contents of the uterus, after a period of
twenty-four hours, be placed under the microscope, scarcely a
spermatozoon will be seen. If some of the contents be taken after
remaining in the uterus a short time after intercourse, the sperma-
tozoa can be seen entering the cells, and some will be seen after
they have entered, and will be recognized by the motion in the cen-
ter of the cell.

The same phenomenon occurs in the neuroblastic ovum as in
the ova of the vertebrate, with this difference : in the former the
true ovum is surrounded by the true embryonic cell before impreg-
nation takes place ; while in the latter the embryonic cells are
gathered together by the ovum after they are impregnated. That
the blastodermic membrane is formed from cells that surround the
ovum, and not from cells formed from a division of the ovum
after impregnation, I have demonstrated by isolating the hen from
the male, and I have always found the ovum surrounded by the
embryonic cells when unimpregnated, the same as when pregnant,
thus showing that pregnancy does not cause the almost unlimited
division of a cell all from the entrance of a single spermatozoon.
This is manifestly the reason why there is such a great number of
spermatozoa. The reason that pregnancy scarcely ever occurs
just before or immediately after menstruation, is because in the
latter part of the menstrual month those glands are inactive ou
account of degeneracy, and immediately after menstruation they
are not properly formed, and in either case do not secrete the
embryonic cells.

The ideas set forth in this paper are the result of a careful
study of the subject, extending over a period of eighteen months.
The observations were made on the mare, sow, cat and hen. I
have also found that the uterine glands of the human female
secrete the same cells. I therefore conclude that the embryonic
cells are not formed by the division of a pregnant ovum, but are



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608 SBLECTIOKS.

formed separate from the ovum. Each embryonic cell is impreg-
nated by a separate spermatozoon. The ovum is the center that
gathers the pregnant embryonic cells together. One spermatozoon
is not sufficient to cause pregnancy, but as many as * of

the embryonic cells are required.

The life of the spermatozoa is transformed into the life or
motion of the cells, and is again manifested in the life of the new
being. — St, JLouis Medical and Surgical Journal.



THE TREATMENT OF SCARLET FEVER.

At a meeting of the Academy of Medicine in New York, Dr. A.
Jacobi read a paper, in which he discussed the question of the
treatment of scarlet fever. He expressed the opinion that in a
mild case of scarlatina little was necessary beyond keeping the
room at a uniform temperature, but well ventilated ; the patient
should have a light diet, with calomel occasionally to prevent auto-
intoxication ; the skin should be oiled and the child kept in bed,
because any case may be followed by renal disease due to exposure.
Sometimes a moderately high temperature is not well tolerated at
the commencement of the case ; therefore some antipyretic, such
as a warm bath, or moderate doses of tincture of aconite should
be given, but not antipyrin, acetanilid or phenacetin. Now and
then the skin should be sponged with alcohol and water to keep
the temperature down. Quinine is not indicated, because it may
disturb the stomach. In severe cases it is too much the custom to
restrict the administration of internal remedies. The principal
complication in these cases is the condition of the throat, the local
treatment of which is likely to injure the epithelial exudate.
Treat the throat via the nose by injections, rather than sprays, of
boracic acid solution, or weak bi-chloride of mercury solution.
Sometimes the condition goes on to the formation of large gland-
ular abscesses or to phlegmonous inflammation : the part should
be incised at once, though there may be but little pus, as much
necrotic tissue as possible being removed by scraping ; the cavity
should be packed with salicylated gauze, because iodoform gauze
may cause troublesome absorption, and carbolic acid causes coagu-
lation. This is also to be apprehended with tincture of iron,
though tincture of iodine does not coagulate blood. The incisions
should not be made under an anesthetic, because the patient is
usually too weak to tolerate anesthesia.



1. The author omits to state the number.



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SOME SUGGESTIONS ON LIFE INSURANCE. 609

Otitis media is another complication of scarlatina that must be
prevented by attention to the nose and throat. For the rheuma-
tism that may occur, salicylate of soda should be used. Often an
endocardial murmur may be heard ; this is actually myocardial,
as degeneration occurs in the heart tissue in consequence of the
fever, no digitalis should be given, but opium and ice over the
heart. For some nervous symptoms that arise, phenacetin may be
given if the warm bath or warm pack prove insufficient. The
post-scarltftinal chorea due to cerebral emboli or to anemia should
be treated symptomatically or according to the causation. Menin-
gitis is due primarily to the throat infection, another reason for
treating that region at once. Post-scarlatinal mental disease must
be treated by rest, freedom from excitement and suitable stimula-
tion. All efforts may fail to prevent the occurrence of nephritis ;
when it occurs the child should be kept in bed and given a warm
bath in the evening, and under no circumstances should he be
allowed to leave the room until all the symptoms are over. In
treating this complication, calomel is of value on account of its
action on the intestinal tract as well as on the kidneys. The
worst cases are those in which there is no dropsy, because there is
likely to be cerebral edema. If uremic convulsions occur, chlor-
oform is indicated ; if morphine is given, it should be in conjunc-
tion with atropine or hyoscyamine. Digitalis should never be
given. Sometimes pilocarpine is useful, but it must be adminis-
tered with caution. For chronic nephritis there is nothing better
than iodide of potassium alternating with bi-chloride of mercury.
— North American Practitioner,



SOME SUGGESTIONS ON LIFE INSURANCE.

By JAMES L. HOPKINS,
Of the St. Louis Bar.

Every professional man has given more or less attention to the
subject of life insurance. A great part of the incomes of the
life companies is derived from them. The writer has been
frequently called on for advice regarding insurance, and as many
of the inquiries have come from the physicians among his
acquaintances, it has occurred to him that a few thoughts on the
subject may be acceptable to the clientele of the Medical Mirror.
The first question is, Who needs insurance ? The answer is,
You do. It matters not that you have no one dependent on you



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610 BBLECTIONS.

for sapporty and that you have ample funds to meet all your debta
as you go along. The day when the assured had to <<die to beat
the game " is past. Every company of any standing issues poli-
cies with an investment feature, and the returns offered for the
use of your money are as good as any ordinary business invest-
ment. The man who is without insurance on his life is as foolish
as the merchant who fails to insure his stock in trade from loss by
fire. This is particularly true of the professional man, whose
brains are his sole merchandise. The amount he carries should be
regulated solely by his means and ability to pay the premiums.
Nothing can be more encouraging to him in an occasional leisure
moment than to examine his policy, note the number of premiums
paid, the cash value the policy now has, the amount of money he
could borrow from the company on the policy as security, and
then to think of how small the effort has been to meet the pay>
ments. He will invariably thank Fortune that he had the pru-
dence to insure when he did. In the late financial panic, when a
member of Congress rose in his seat and asked, << Is there a man
within the sound of my voice who can today, in any bank in
America, borrow 11,000 on his personal note?" and no man
answered, the life insurance companies were lending money to
their policy holders, practically without limit. Banks and great
commercial houses were failing on every hand, but not one of the
great life insurance companies of this country failed.

Having decided that you want insurance, the question is, bow
much, and what kind of policy ? and above all, in what company ?

First, as to the company. You must keep in view the great
cardinal truth of insurance, *<The best is always the cheapest'^
Never buy insurance because it is cheap. You might as well buy
cheap mining stock — a thousand chances to one it will prove
worthless. Never buy insurance because* of statements made by
an insurance agent. Your lawyer, or some other friend, will lend
you the report of the insurance commission of your State. Yon
can there see the tables of assets of the various companies. You
can then select five or ten of the oldest and strongest companies.
You will find that they all charge about the same rate for the same
form of policy, and that each claims to have some advantage in
its favor over the others. Each claims that the insurance laws
under which it is organized are drawn to protect the assured, to
tbe possible detriment of the company. Maine and some other
States have a "non-forfeiture" law, by which, if your policy con-



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SOME SUGGESTIONS ON LIFE INSURANCE. 611

tinaes in force for a stated period and you then lapse in yoar pay-
ments, the former payments will carry the policy for a greater or
smaller period of time, proportioned to the amoant paid in ; and
so with other features of the policy.

Your choice from among these companies must be governed by
your taste or necessities. Head the policy before yon apply for
insurance. Other things being equal, the policy that is shortest
and simplest is the best. Reject the old-fashioned policy of
blanket dimensions and covered with fine print. It may be a good
policy for lawyers to fight over when you are dead, or want to
cash in your insurance ; but brevity is the soul of wit in insur-
ance, so far as the assured is concerned. Be sure you do not con-
fuse the agent's talk with the terms of the policy. If he tells you
that the company will do thus and so, ask him to show you the
agreement in the policy. If it is not there, you may rest assured
that the company will not do as he says. The twenty-payment
life policy is the most popular form now issued, although other
forms have advantages over it. Remember that the agent's com-
missions vary according to the kind of policy, and the kind he
urges you to buy may be the best for him, but the poorest for you.
There are many things in this connection of which much might be
said. But if you insist on seeing a sample policy and reading it
carefully before making your application, you cannot be duped. Be
certain that the policy is written in plain, simple £nglish, and is
brief, and you will never have cause to regret buying it, unless you
buy too large an amount.

And this brings us to the question of how much you ought to
carry. This is a very practical question. You will find men who
sneer at insurance. On investigation you will find that they are
men who have invested a large sum in an insurance policy, out of
all prpportion to their incomes, and have left future payments to
luck. The succeeding payment is not made and the policy lapses.
The holder of the now worthless policy looks at his first premium
receipt, and thinks the company has robbed him, and vows he will
never be caught in a similar trap again. This sounds like non-
sense, but it is literal truth in thousands of cases. Avoid extremes.
Buy a small policy ; then another, of another kind if you like, so
as not to have all your eggs in the same basket. The agent will
not like this course, but you are investing for your own benefit
and not his. A live policy for a $1,000 is worth a thousand lapsed
policies aggregating a million.



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612 SELECTIONS.

And when you come to the experience that the great majority
of physicians and lawyers meet at the end of a life of toil for
others, seeing the end draw nigh, and the wife and little ones not
otherwise provided for, your mind will be eased of a great burden
as you think of the stray fees you have paid for your insurance.
— Medical Mirror.

Liability for Injuries When Death Follows Surgical Opera-
tions. —When death results from a personal injury, as its direct



Online LibraryJ. A. (Joel Asaph) AllenBuffalo medical journal → online text (page 61 of 78)