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VOL. XV.

THE MEDICAL SUMMARY,

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R. H. ANDREWS, M. D., PROPRIETOR. Subscription Price, in the United States and Canada........ Foreign Countries. These rates include postage, and must be paid invariably in advance. Single copies, Ten Cents. Subscriptions may begin at any time. Subscribers desiring their address changed must give their former, as well as their new, postoffice.

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Address THE MEDICAL SUMMARY, P. O. BOX 1217. Philadelphia, Pa.

PHILADELPHIA, JULY, 1893.

NOSTRUMS.

Contraband articles of merchandise with highly picturesque names, embracing in their unpublished catalogue such wholesome things as opium, morphine, podophyllin, mercury, iodine, cocaine, chloral, strychnine, foxglove, henbane, dogbane, etc., etc., etc., ad infinitum, ad nauseum.

An advantageous quality of the patent article is the facility with which it may be

prescribed. No knowledge is required, the only requisite being that the purchaser read the printed instructions on the wrapper, and go ahead, whatever the troublewhether the body is hot or cold, filled with aches or bowed with care; it supplies every want equally well.

46

The panacea may be a "New Discovery," a "Golden Discovery," a Safe Cure," for the multitudinous ills to which man's unlucky hydrastic machine is heir; an "Indian Dug-Out-of-the-Ground-Root Blood Purifier," or Bone and Nerve Liniment." Whatever name and quality, druggist, storekeeper, grocer, and even postmaster and blacksmith, make common cause, turn doctor and dispenser, invite a gullible public to their places of business, and deal out to them the most active and virulent poisons in disguise that are known to the pages of materia medica; and these daring trafficers-who appear to have neither the fear of hell or the love of heaven before their eyes, legally constituted authority, and an over-indulgent public sentimentrequire no license, no evidence of qualification or ability. The patent medicine fabric is a monumental fraud, because of its

gigantic proportions; and a despicably

mean one, too, because of the advantage taken of the ignorance of a credulous people. Unscientific mixtures of inert, poisonous and worthless drugs, manufactured by ton and hogsheadful, to be swallowed by pint and boxful, at a profit to maker and seller of a thousand per cent!

It would be interesting to know how many are killed annually by patent medicines, and how many have their ailments made worse, requiring protracted courses of treatment and large fees. Have manyfacturers no conscience, the press no dis crimination, the public no limit to folly?

CHOLERA INFANTUM.

The season for this troublesome affection is now upon us, and the all-important question arises how to feed the infant child that it may be kept well, as nine-tenths of the summer complaints of children are caused by what is put into the stomach. Indigestion, or the inability of the delicate stomach to assimilate the improper food put into it, is the cause of the mischief. Atmospheric changes are only a small factor in producing diarrhea, and by care in noting the changes in the weather, and regulating the clothing accordingly, this can be reduced to a minimum. To properly dress an infant child in summer the mother should note every change in the weather, and add or remove clothing accordingly. Use common sense, and keep a child warm in cold weather and cool in hot weather.

So, if the food of a child is of the proper quality, and given in proper quantities, the summer months can be passed in comparative safety. The safest place for a child at any time is at its mother's breast, but even here it is not always safe, because there are many causes that may vitiate the mother's milk, and make it poisonous to the babe's stomach.

Possibly one-third of the children born are bottle-fed infants, who require no ttle care and attention as to diet. This can safely be done provided the proper food can be found. Cow's milk ought to be our main reliance in furnishing nourishment for infants, but, unfortunately, it is very difficult to get it free from impurities; it is

so very susceptible to absorption from the atmosphere, and to be made impure by the surroundings and food of the cow.

On the line of treatment for cholera infantum we invite the best thoughts of our experienced readers, hoping that some practical suggestions upon this subject may be presented for our next issue.

POLYPHARMACY.

It is a certain mental relief to the wideawake and progressive practitioners of to-day to note that the indiscriminate mixing or combining a half dozen or more remedies into one prescription is on the wane. Such prescriptions, however, were not at all uncommon less than a score of years ago, and even at the present time find favor with many.

The idea appears to have prevailed that in putting up such remedies one or more of the medicines were mingled for each symptom noticed in the patient, in order to hit the disease somehow. When we stop to think and consider the meagre knowledge upon which therapeutics was based years ago it is not surprising that such methods should have been in vogue then; but that such practices should prevail to-day is a reflection upon the intelligence and the industry of those who favor them.

The advancements made in physiolog ical chemistry during the past decade have been such that we are now bound to recognize a principle in the administration of drugs; and that is the chemical action or actions which may take place in combining various drugs (even those of purely vegetable extraction), and the chemical action or actions which may take place between these drugs and the natural secretions of organs, and the substances of the cells of the organs themselves, with which they come in contact in the very structure of tissues, by means of the circulation.

New Remedies.

In the following we will mention the most import ant new remedies that have been discovered of late, selecting only those whose therapeutical value has been proved, and the administration of which is followed by definite results-therefore, only those that may be relied upon. In a general way their chemical nature, and the sources from which they are derived, as well as the method of manufacture, when known, will also be referred to; their doses will be given, and any obnoxious or dangerous by-effects will be brought prominently to the notice of the reader. Many of the new drugs are so-called proprietary medicines-i. e., their discoverers have secured to themselves the ownership, and in some the exact mode of manufacture is kept secret. For these very reasons we have been the more careful to enumerate only the drugs of recognized value to the profession, such as are being employed by the most eminent members of the fra ternity here and abroad, so that the reader may place the fullest confidence in every statement made in these lines.

Kairinum.-Antipyretic, febrifuge.

Result of the action of strong sulphuric acid on chinolin. An almost white, crystaline powder, of a salty, pungent taste and camphor-like odor.

Recommended as substitute for quinine. Has the same antipyretic effect, but is no such specific in malaria as quinine. The urine gradually assumes a dark green color if the remedy is administered for any length of time. In larger doses, and when used in debilitated persons, cyanosis and collapsus are apt to occur. Caution is therefore needed. Dose, in adults, grs. viij-xvj several times daily, given in wafers or in capsules, but considerable quantities of water should be drunk immediately after. Dose, in children, from gr. j to grs. viij. Two preparations of it exist, Kairin A and Kairin M, both being crinolin tetrahydrates, the first an æthyl (therefore A), the second a methyl (therefore M).

Only Kairin A is now employed, and this must always be dispensed, when Kairin without the specifying letter A is prescribed, as Kairin M has dangerous byeffects.

taline, flour-like powder, almost tasteless and odorless. C11H12N2O. Easily solu⚫ ble in water.

Internally, as antipyretic, it reduces the temperature for certain in doses of from 60 to 90 grains. Occasionally it gives rise in such doses to vomiting and exanthemata, the latter disappearing within a few days. It has no effect in malaria, but has been used with some success in rheumatism and headache.

Externally it proves an antiseptic, and hypodermically it produces anæsthesia near the locality without giving rise to the disagreeable by-effects of morphia. Dosis for adults 30 to 45 grains, three or four times daily; in children 3 to 12 grains.

Antikamnia-Analgesic and antipyretic. A coal-tar derivative introduced by an American firm. A white crystalline powder. The exact composition is not known, but the remedy itself has become a favorite with many members of the profession after the investigations by Hugo Engel, who found it very reliable in headache and all kinds of pain, and as quickly acting as a hypodermic injection of morphia. Its antipyretic effects he describes as resembling those of antipyrin, phenacetin, etc. It is used only

Internally. To stop pain five grains (best in tablet form) are administered at once; three minutes later the same dose is repeated, and, if necessary, a third dose given three minutes after the second. If ten minutes after the third dose the remedy has had a decided effect, but a little of the pain be remaining, a fourth dose of gr. v may then be administered. In 92 per cent. of all cases it immediately stops the pain.

As an antipyretic from gr. v to gr. x should be given every ten minutes until

be taken only in powder form, none of the known vehicles dissolving the remedy the least.

Thallinum.-Antipyretic, antiseptic and especially anti-fermentive.

Thallinum Sulphuricum is the salt of Thallinum employed in medical practice. A yellowish-white, crystaline powder of cumarin-like odor and slightly bitter, spicy taste. Soluble in 7 parts of cold or in onehalf boiling water and in 100 parts of alcohol. It must be protected against the light and administered only in small doses; larger doses should be employed with the utmost caution.

This peculiar product of synthesis (CroH13NO)2H2SO4, has the remarkable property to produce in watery solution with ferric chloride an emerald green color.

Internally, in doses of from gr. % to grs. viij, it is given in aqueous solutions in febrile diseases. The urine assumes a dark brown color, with a slight tinge of green. Externally it is recommended in gonorrhoea in the form of injections and as bougies.

Thallinum Tartaricum has the same effect, is soluble in ten parts of water, and is given in the same doses as the sulphate. Prescriptions:

B. Thallini sulphatis..

gr. vj

Aquæ destill.,

Antithermin.-Antipyretic.

A product of condenzation of phenylhydrazin and lævulinic acid. Colorless, shiny, hard crystals, which produce on the teeth an effect similar to that caused by salol. Complicated formula.

It is insoluble and must, therefore, be administered solely in powder form-perhaps in cachets or capsules. Five grains administered every hour are said to reduce the temperature with the third dose, but it may be well to await more detailed re

M. ft. pilul No. xxx.

.gr. x

. gr. xx

Each pill contain

I saw a few days ago--in The World, I think—a physician's remarks urging doctors to anote their reading, or to keep notes of what they read. Will you allow me to give my experience, a busy life, in a few words? It may be the foundation of a plan for others to build and improve on. Shortly after I commenced practice, and six months before I had a case, I saw an old doctor standing apparently much perplexed, rubbing his chin as if in a deep study. Accosting him as to why his serious looks, he said, "Well, I have a difficult, rare case to treat. Ten years ago I had just such another, and treated it successfully; but I have forgotten what I did for it. I would give now fifty dollars for the prescription I then prepared." Thinks I, Here's a pointer. I'm just commencing, so I will enter every case (when I get any), and keep a record of them; also, as I read I will keep a book in which, under the heading of the disease at top of page, I will set down all of the good formulæ and treatments I come across. This book I will index, and call it my Index Therapeutic.' As an aid to my memory it will refer me to the several modes of all the great minds (and small ones)." So my case book" is ruled (by myself) on the top of the page headings as follows:

NAME

name and date of any service, and back from that to my case-book for the treatment of any case for the last twenty-five years.

In my reading, when book or journal is received, I take off the wrapper, fold it and put it between the leaves, to use in anotation if anything is found of value to me in it. In all the journals there is a good deal that does not benefit the country doctor much-laparotomies, operations for removing floating kidney, etc., etc. I look

over it, note with a check-mark such as I want to study particularly, read the short articles, and check them for a rereading. When I have time I take it up and read the checked articles carefully, note anything on the case on my paper, or outer margin of the journal, if I have had ideas differ from the author. similar ones, my treatment, or how my On the

wrapper (which I use to take notes on) I head it with name, month and year of journal; on margin the page, then name of disease, and the new formula. When the reading is done these slips of paper are put into my “Index Therapeutic," a large book with the name of disease at top of page, and the symptoms of same; and on each page I enter my notes in full. By this means I have all the treatments of all the diseases of which I have read, name of doctor, and volume and number of page of the journal in which the full treatment of each case is set down. In the index, which numbers 400 articles, there are many "aids" to conditions which are not diseases. The book comprises from away back to Wood, Eberele, Gross, Liston and Mutter up (or down) to the last fad of to-day.

It looks like work, you say. Yes, but do

The treatment is put on same line as charges. Thus you see I have a full report of each case in a nutshell. My accounts for charges are entered in a regular day-book, single entry style. If any part of my account is disputed, I can turn to the case-book for proof of service. Thus I can refer to my account books for the

you know what a comfort it is to me when I have a bad case, worried, hot, tired and sleepy, to turn over to the index, then to the page, and find five to thirty, opinions of all the great (and little) thinkers (who thought when they were not hot and tired) set down for me to select from, to get the new idea, or an old one long forgotten or