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induce fibrinous, serous, hemorrhagic, or purulent pleurisy. As to the
treatment of typhoid empyema, M. Achard recommends postponing opera-
tion until the intestinal ulcers are healed and the patient has recovered
strength. This course is possible, as typhoid empyema as a rule does not
run a rapid course and has not a tendency to invade other parts or to give
rise to general infection — septicemia, for example — as has empyema induced
by streptococci. — Lancet,

Metacresolanytol in Erysipelas. — Koelzen, of Loeffler*s Institute
{Deut, med, Woch,, October 27, 1898), relates an investigation into the use
of this agent in the treatment of experimental erysipelas in animals and
ordinary erysipelas in man. One of the objects of the investigation was to
ascertain whether the bactericidal substances anytil and anytol can pene-
trate through the skin as well as ichthyol, from which they are derived.
Metacresolanytol contains forty per cent metacresol and sixty per cent any-
tin. Erysipelas was produced in animals by the injection of the strepto-
coccus or of the bacillus of mouse septicemia. Treatment was commenced
as soon as a florid erysipelas developed in the ear. The author relates in
detail several series of experiments, control experiments being also made.
Painting the surface with the metacresolanytol was found more efficient
than injecting it into the tissues round the erysipelatous patch. When the
painting was carried out every two hours, the results were very satisfac-
tory. Microscopical examination of the tissues in the cases treated by
painting failed to discover the microbes which had originally set up the dis-
ease. The treatment was then applied to five cases of erysipelas in man.
At first the patch was painted for twenty to thirty minutes, and then every
two hours for ten, fifteen, or twenty minutes, according to the size of the

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The American Practitioner and News. 239

patch. The treatment was only continued for two or three days. If the
erysipelas was very extensive, only the edges were painted. The solution
used was a three per cent. Good results were noted in all the five cases,
including a severe one. Details are appended of these cases. The author
maintains that this method of treatment is well worthy of further trial. —
British Medical Journal,

Marriagb and Heart Disbasb. — Vinay (Lyon Medical, January 8,
i899'> discusses at full, both socially and medically, the question. Should a
girl of marriageable age subject to heart disease be allowed to marry ? He
agrees with Jaccoud, Huchard, and others that matrimony is not to be
forbidden when the lesion is compensated and no complication has arisen.
But the patient must be reminded that repeated pregnancies will influence
the cardiac disease prejudicially. On the other hand, marriage must be
forbidden if evident signs of insufficiency have been detected, such as
pulmonary congestion, hemoptysis, and irregular pulse. Most serious,
in this respect, is persistent albuminuria with hypertrophied heart, which
is certain to involve grave trouble during pregnancy, and to compromise
the child's life. Even when a patient is allowed to marry, she must be
carefully watched when she becomes pregnant. During gestation some of
the worst complications, due to thoracic and renal changes, are very apt
to set in unless the patient modifies her habits and her diet. The physi-
cian should insist upon repose, milk diet, aperients, and free and frequent
dry-cupping to the thorax. In this way the tendency of pregnancy to
disturb the circulatory equilibrium is counteracted. The physician, directly
pregnancy is confirmed, should look out for the first evidences of failure
of compensation, such as dyspnea, palpitation, a tendency to bronchitis,
and a pulse which, though it may be regular in rhythm and volume, is
clearly too rapid. These are what Vinay terms gravido-cardiac complica-
tions. — Ibid,

Gastroptosis. — K. Thue {Norsk Mag, f, Laegevidensk,, December,
1898) has examined twenty-two cases of gastroptosis, and finds that the
symptoms are, generally speaking, those of nervous dyspepsia. When one
meets with the clinical picture of nervous dyspepsia complicated with
obstruction, one should always examine into the position of the abdominal
organs. Obstruction is an almost constant symptom of gastro-enteroptosis.
In the diagnosis of gastroptosis the author has employed electric light, the
stomach having been filled with from three quarters to one litre of water.
In five of the male patients examined, including a boy of five years, there
was a rachitically-deformed thorax. The female patients, who had also
borne children, showed a degree of pendulous abdomen. In eleven cases
there was in addition marked nephroptosis. The treatment consisted in
the wearing of abdominal belts, the use of aperients, and careful dieting,
and occasionally washing out of the stomach. — Ibid,

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240 The American Practitioner and News.

Special Ztottces.

Casb I. M. S., fifty-two years of age, male, was some years afflicted with an ob-
stinate form of erythema, probably of specific origin, which heretofore had resisted
the usual constitutional and local treatments. The itching of the eruption was
intolerable, the anemia very pronounced — the whole constitution run down. Six
weeks medication with lodia, supplemented by extract of malt and cod-liver oil,
brought the case under control. I attribute the good effect of lodia in this, as in
other cases, not so much to its mineral ingredients (potass, iodide and ferri phosphate)
as to their combination with the fresh principles of vegetable alteratives. I, for my
part, believe that only the extracts of the green or fresh plants are reliable for thera-
peutic effects, the common fluid extracts of the dried plants having proven mostly
inert in my hands.

Casb 2. R. W.,aged thirty-eight; female; presented glandular enlargements com-
plicated with functional disorders (dysmenorrhea). The persistent administration of
lodia brought marked improvement, and patient is on a fair way to recovery.

Casb 3. J. P., male, aged sixty ; blood-poisoning with chemicals used for dyeing,
manifesting itself in a rupia-like eruption and general malaise. lodia promptly
eliminated the morbid matter. A. ZiBGi,BR, M. D.

Allegheny, Pa.

Better Stii,i,. — The influenza has been quite prevalent in a number of cities
during the past month. In Richmond there have been many cases, though no deaths
distinctly attributed to it. It is affecting mostly those who have had the disease
almost annually during the past few years. Although the attacks of this year are
relatively mild, they are severe enough to keep business men away from their places
of business. Phenacetin, or better still, antikamnia, with salol or quinia, and a little
powdered digitalis added, has proved a satisfactory plan of treatment, presupposing,
of course, that the bowels are kept open, the secretions of internal organs are attended
to, and that the patient is kept in-doors, especially at night or in bad weather. — The
Virginia Medical Semi- Monthly,

J. L. RiDi^EY, M. D., Huntsville, Ala., says : I have used S. H. Kennedy's Extract
of Pinus Canadensis, both white and dark. I can frequently cure gonorrhea without
any other remedy. I use either as an injection, and prescribe the dark internally,
where there is irritability about the mouth of the bladder. I have learned to regard
it as a specific. In chronic cystitis I have derived great benefit from it, and in leucor-
rhea it relieves when many other remedies fail. It is a valuable remedy, and I have
had marked success with it.

LABOR SAVING : The American Medical Publishers' Association is prepared to
furnish carefully revised lists, set by the Mergenthaler Linotype Machine, as follows :

List No. I contains the name and address of all reputable advertisers in the
United States who use medical and pharmaceutical publications, including many new
customers just entering the field. In book form, 50 cents.

List No. a contains the address of all publications devoted to Medicine, Surgery,
Pharmacy, Microscopy, and allied sciences, throughout the United States and Canada,
revised and corrected to date. Price, $1.25 per dozen gummed sheets.

List No. 2 is furnished in gummed sheets, for use on your mailer, and will be
found a gpreat convenience in sending out reprints and exchanges. If you do not
use a mailing machine, these lists can readily be cut apart and applied as quickly as
postage stamps, insuring accuracy in delivery and saving your office help valuable time.

These lists are furnished free of charge to members of the Association. Address
Chari^ES Wood Passett, Secretary, cor. Sixth and Charles streets, St Joseph, Mo.

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American Practitioner and News.

hec tenui penna.*

Vol. XXVII. Louisville, Ky., April i, 1899. No. 7

Certainly it is excellent diBcipline for an author to feel that he must say all he has to say in the
fewest possible words, or his reader is sure to skip them ; and in the plainest possible words, or his
leader will certainly misunderstand them. Generally, also, a downright fact may be told in a plain
way ; and we want downright facts at present more than any thing else.— Ruskin.

(Dvxginal Clrticlcs*



Ladies and Gentlemen, and Members of the University, at the
request of my old-time friend, Professor Bodine, your able and worthy-
Dean, I appear before you on the present interesting occasion to say a
few words of encouragement to you as Alumni of my old Alma Mater,
the Medical Department of the University of Louisville.

Being perhaps the oldest living alumnus of this reuowned insti-
tution, you will perhaps bear with me if I should fail to meet your
expectations in point of oratory or eloquence. Not possessing the
powers, in these respects, of a, Cicero or Demosthenes, I shall have ta
content myself, as a country doctor, to speak in the ordinary parlance
of the day, if not in a humdrum way.

In the first place, I would like to express my thanks to your eminent
Dean for the honor conferred on me by calling on me to address such
a fine body of young doctors, who are just on the eve of entering one
of the noblest professions extant, being second only to that of The-
ology, and, in fact, in some particulars equal to it ; for in many instances
we have to go among the poor and needy to heal them, as did our
meek and lowly predecessor, the Saviour of mankind.

Every doctor should be proud of his profession and devoted to it,
not only because it affords him a livelihood, but more particularly on
account of the good he can render his fellow-man by the knowledge


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242 The American Practitioner and News.

he possesses in treating and curing, as well as preventing disease.
He should be a philanthropist as well as a scientist.

Our profession for philanthropy and humanity stands, perhaps, at
the head of all professions or associations of men. Medical men many
times sacrifice their lives for the benefit of the sick. We do not flee
when deadly epidemics make their appearance, but meet and combat
them with all the means in our power, many times falling victims in
efforts to relieve others. Of course this action requires heroic effort,
but heroism, properly conducted, is one of our characteristics.

We are the only body of men who use means to diminish or curtail
the source of our income by which we derive a livelihood. Our
profession is doing this every day by endeavoring to prevent the
occurrence of disease. This is done by quarantining, disinfectants,
and general cleanliness.

We should feel proud of our characteristics in these particulars.
To be sure our philanthropy and humane efforts tend to shorten our
longevity, our lives on an average being four years shorter than that of
any other calling or profession. This shortening of life is due to
exposure to the influence of infectious and contagious diseases, and
also to weather conditions. The consideration of all these drawbacks
is calculated somewhat to chill our enthusiasm as professional men,
but our will-power should be sufficient to enable us to pursue an even
tenor of our way.

When we take hold of the plow let us not look back, but go forward

When!you settle in practice, look for a place where you think you
can not only make a living, but where j^ou think you will be satisfied
to remain permanently. You may not jump right into a paying prac-
tice, but close attention to business, together with polite, gentlemanly
deportment, will soon accomplish the desired result.

My advice to alljyoung doctors, as well as others, is as soon as you
are prosperously settled in practice, hunt up a good woman for a wife.
Thisjwill givejyou not only a better standing in the community, but
render you a happier man. It has always been my doctrine that every
good man ought to have a good woman for a wife. He will find her a
great helpmeet through this vale of tears.

If you should locate where there is competition, endeavor to keep
on good terms with your confreres. Nothing seems to me so unpleasant
as to see two or more doctors in a country town not on speaking terms,

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The American Practitioner and News. 243

and talking about each other behind their backs. This condition of
things is not only unpleasant for the doctors, but more so for the com-
munity. In fact, it is sometimes quite a disadvantage to the people.
If one doctor has a very sick patient, and consultation is needed, he is
not sufficiently friendly with the other doctors to consult with them,
and a doctor has to be called from a distance at a big expense to the sick.

It has been a common thing, if a young doctor settles down in a
town or neighborhood where there is an old doctor, for the latter to
pooh-pooh him out, saying he is an ignoramus and knows nothing
about medicine, when probably he knows a great deal more than the
old doctor.

I knew of a case of the kind, the old doctor telling the people that
he had forgotten more than the young doctor knew. The young doctor
on hearing of his talk, simply remarked that he thought the old doctor
was correct when he said he had forgotten so much, as he did not seem
to knoTv much at present, and let it pass.

I can gladly say that I have assisted several young men into prac-
tice within the last score or so of years. I have always regarded it
not only as an act of kindness and friendship, but really a matter of
humanity and patriotism for the old doctor to assist the young physi-
cian in his practice. A matter of humanity in the point of view that
we may teach him to treat his patients more successfully, and in a
patriotic point of view that it will, in the course of nature, be but a
short time before the young will have to take the place of the old.

A doctor should always be a gentleman, both in manner and dress.
In speaking of dress I do not mean to say that he should imitate Beau
Brummel or one of New York's 400, but his dress should be neat and
cleanly, so that he will not attract attention either way.

In his manner he should always be pleasant and courteous. By
observing characteristics of this kind, together with studious habits,
business will finally come to him. "Success to him who pariently

It is a good thing for a young doctor when he settles down to keep
pretty closely at his office, surrounded by his books and medical jour-
nals when not attending his calls. He should not be a common
hanger-on at the post-office, depot, or saloon. Habits of this kind
would soon destroy confidence in his capacity for practice.

It is well for a physician to be a member of his State association,
or at least his county society. This enables him to make acquaint-

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244 ^^ American Practitioner and News.

ances of his medical confreres, which is an advantage, both in a social
and professional point of view. The most eminent men in our pro-
fession are members of medical associations.

The doctor should also supply himself with medical journals, by
which he is enabled to keep up with the advances of his profession.
He should even familiarize himself with the history of medicine.

We have a great many characters in the history of ancient medicine
as well as in modern which are greatly calculated to excite our interest.
Although the earliest history we have any account of is somewhat
mythical, yet it is interesting. If we go no farther back than the
Greeks, and say nothing of the Egyptian, Indian, or Chinese doctors,
we find medicine was practiced long before the Trojan War. Melampus,
two hundred years before that time, was among the first in Greece, and
was somewhat celebrated. He derived great notoriety by treating and
curing the daughters of Proetus, King of Argos. Then came -^scu-
lapius, who was the most celebrated disciple of Chiron the Hermit ;
was the most eminent in a medical point of view ; in fact, was denomi-
nated the god of medicine. He had two sons, both physicians as well
as soldiers. He also had two daughters, Hygeia and Panacea — the
first expressing health and the other a remedy for all diseases. The
latter name will remind you of some of the patent medicines of our day.

We might omit the names of many more of the ancient great
Grecians and come down to the real father of medicine, Hippocrates,
who was born four hundred and sixty years before Christ. He was the
author of a great many books pertaining to his profession, and we
moderns are somewhat astonished at the great knowledge he possessed
respecting medicine. Besides this great man there were others of
eminence, who were either contemporary with him or his early suc-
cessors. He had two sons and a son-in-law who were physicians.
Then came Diocles and Praxagoras, the last of Asclepiadae.

We might also name Plato and Aristotle, philosophers as well as
medical men. They exerted great influence over the minds of the
people. Aristotle left several works on medicine, exhibiting great
genius for the time in which he lived. We might now step down to
the time of Galen, a. d. 200, when we find several sects in medicine,
as we have to-day, to wit, dogmatism, empiricism, methodism, and
eclecticism. Time will not permit me to define these different terms,
but they convey pretty clearly their true meaning. Galen endeavored
to modify the character of these different sects, and, although quite

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The Atnertcfln Practittoner and News. 245

egotistical, exerted a great influence over the medical mind long after
his death.

From the time of the destruction of the Library at Alexander, A.
D. 640, by the Arabs, medicine was on the wane till about the close of
the "Dark Ages." Charlatans and fakirs held sway for centuries.
The revival of true medicine began in the fourteenth and fifteenth
centuries, soon after the discovery of printing, when many universities
were established in different cities of Europe. Many lights in medicine
now began to manifest themselves. We will only cite the names of a
few of the prominent men: Girard of Cremona, William of Salicet,
Arnold De Villeneuve ; Lefranc was from Milan, and was a surgeon.
John Petard was surgeon to Philip Le Bel, of France. Guy de
Chantiac was the most famous of the surgeons during the Arabic
period. The first great physician of England was Linacre, of Canter-
bury. He was physician to Henry the VIII and Queen Mary. We
might also name Ambrose Pare and Guilleman. The latter was the
first to advise the termination of labor in case of hemorrhage or con-

Harvey in the sixteenth century discovered the circulation of the
blood, and Kepler announced that the crystalline lens was not the
seat of vision, but merely refracted the rays of light, and that the
image of objects is painted on the retina.

Great men in different parts of Europe now appeared so rapidly
that time will not permit to further name them. We might, however,
allude to Sydenham and the Hunters, of England.

Medicine and surgery have made such rapid strides within the last
few decades, it keeps one busy to keep pace with them. Hygiene has
also made rapid advances, which, together with the improvements in
treating diseases, have lengthened the average longevity of man nearly
one hundred per cent within the present century.

Besides the possession of general knowledge, the doctor should be
an observer of the Code of Ethics by which the profession claim to be
governed. He should look down upon all fakirs and quacks in medi-
cine, and treat them with disdain. In a word, he should eschew com-
mercialism and active politics, and be strictly an honest, upright man.
Pay no attention to quack advertisements illuminated with portraits of
patients cured, with their certificates in praise of the remedy.

In order to attract the attention of the credulous you see in almost
every paper you pick up pictures of beauty and health, cured by some

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246 The American Practitioner and News.

compound or nerve medicine after all the doctors had failed to do any-
good. These displays are intended to act on the imaginations of the
well, inducing them to try some of the remedies by which they may be
beautified or improved in appearance. Then, perhaps, in the same paper
you will see long articles headed by pictures of skeletons, serpents, id
genus omney which are intended to alarm the people so as to induce them
to think it necessary to take some of the medicine to prevent some great
calamity happening. Now and then we even see some remedy oflFered
for well people to take to keep them from getting sick. All such stuff
you are to ignore and treat with contempt. The noted Rev. Mr. Moody
has- a maxim that will serve to show why it is that the pernicious
advertising of quackery thrives so well in so-called religious journals,
namely: that "sick sheep will heed the call of anybody.''

The doctor should be an even-tempered man, ignoring and allow-
ing to pass unnoticed any gossipy talk he may hear that has been said
about him. In a word, we should learn to govern ourselves, both men-
tally and physically. Especially, don't allow yourselves to worry, but,
as we before remarked, cultivate an even-tempered disposition. Be
rather an optimist than a pessimist.

** Don^t worry your souls with troubles.
And fret and fume all the day,
But grasp them, and like air-bubbles
They vanish in mist away.

"Don*t burden your hearts with sorrow,

And see but the darkness ahead,
But hope for a brighter to-morrow,
^ When the yesterdays all are dead."

And now, gentlemen of the Alumni of the Class of 1898-99, what
shall I say to you in closing? You need not be afraid of living to be
old, as I can assure you that if we live an upright life, and do our duty
as professional men in the various lines devolving upon us, we will be
as happy and enjoy life in old age as well as we do in our younger days.
If we allow ourselves to be guided by our ego, or that second self, the
still, small voice called conscience, we need fear no evil. Then, when
we come to be old and take a retrospective view of our past lives, and that
still, small voice, conscience, says all's well, we should not fear death,
but be proud of our longevity. As an illustration of these views we
have a noble example in our illustrious confrere, the late Dr. Holmes.
At his eighty-fourth birthday celebration he was congratulated on his
young appearance, when he remarked that he had rather be a young
old man than an old young man.

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The American Practitioner and News. 247

Your humble speaker is past the octogenarian mark, and is now
heading for the century mark, and would remark, en passant^ that he
hopes when you arrive at his age you may feel as well and as happy as
he does.

If I have not, in my remarks, met your expectations in ability of
expression, or interest in matter, I hope you will attribute the defects
to the head and not the heart.

I only have to say that I love my profession, my old Alma Mater ^
and my old faculty of the forties. They were a great and good body
of men.

I never feel so happy as I do when among my fellow-doctors ; and
here is to you — with the hope that you may all be able to climb high
up the ladder of fame.

Orbi^ Ky.


Online LibraryUniversidad de Buenos Aires. Facultad de Derecho yThe American practitioner → online text (page 28 of 109)