Графични страници
PDF файл
ePub

binated swelling will sometimes invite the puncture of a hot electric needle, or the sharp points of scissors may be used to partially destroy the blood supply. In all these procedures the mucous membrane should be destroyed as little as possible. The fine electric needle should be nicely inserted at a red heat, and the scissors not to remove tissue, but to scarify. The object is to diminish the blood supply in the over-congested parts, and to reduce the nerve supply in the over-sensitive tissues without injuring the moisture producing membrane. It is our habit to protect all operative wounds in the nose with compound stearate of zinc and boric acid. We must very briefly state, in closing, that bony and cartilaginous spurs on the nasal partition, deviations of the nasal septum, nasal polypi, and enlarged middle turbinated tissues are pathological conditions which often accompany the hypertrophic or moist variety of catarrh, and all these should be removed by saw, knife, scissors or cautery in a manner which will best conserve proper nasal function.

Put the nose in such a condition that the patient will no longer be susceptible to "colds in the head," and the nose and throat specialist can confidently answer yes, when the patient, annoyed by an hypertrophic rhinitis, asks if his catarrh can be cured.

In the next short paper the treatment of atrophic rhinitis will be briefly considered.

123 East Nineteenth Street.

[Written for the MEDICAL BRIEF.] Infantile Hygiene.

BY WALTER M. FLEMING, A. M., M. D., Member of New York County Medical Society, Medico-Legal Society, Physicians' Mutual Aid Association; Qualified Examiner in Insanity and Nervous Diseases in Superior Court, City of New York. New York City.

(Continued Series.)

In regard to the infantile contingent, it is an undebatable fact that as it ages and grows and emerges from its mother's breast, and artificial feeding is inaugurated, the responsibility and duties of its sponsor increase, rather than diminish, as is frequently supposed to be the case. The inexperienced mother is often too

prone to conclude that with the weaning of the infant her constant care and attention to the little one is not now incumbent upon her, and to a great extent can be dispensed with, and the chief part of the irksome requirements heretofore devolving upon her may now be relegated to another-a self-constituted nurse, a servant or some member of the household willing to assume the task. This is often found to be a grave error, and one which might mar the entire nature, and, in short, the temperament and well-being of the dependent little one. For this is the time for the proper care and guidance, to shape its nature and temperament, and plant the seed of a good and amiable disposition, which if carefully observed will ultimately arrive at its fruition, and will reflect both honor and appreciation upon the mother as well as her subordinate, or whosoever may fulfill the requirement under her direct guidance and instruction. The early treatment, guidance and care of the mother is the great factor in the rearing of the child. Upon her devolves the responsibility of the goodness, the amiability and the little care he is to those upon whom the guidance belongs.

It will be found far easier to begin with the right course and tutorage early in the regime to be observed than to defer it until too late, or perhaps to be compelled to undo, questionable training, that has already taken root in the young idea. It takes but a very short time to humor and spoil a child, just as it begins to comprehend that boisterous demands are promptly responded to. It is certainly quite natural for the fond mother to let the little one's weaknesses and demands work upon her sympathies, until over-indulgence sets the pace for future exactions, which are often inconsistent and unnecessary, and with progressing age and indulgence the babe often gets control, exacts all demands and not infrequently has to suffer later on for what should have been impressed upon the little comprehension earlier as wrong.

Thus the child, neglected or improperly guided, learns to have its own way, doing precisely what he was indulged in before,

or taught to do. The proper and the only true course to pursue is to begin early, and by patience and careful training develop in the little dependent good habits, obedience and amiability of temperament. Primarily, the natural guide and tutor is the mother; with her rests the results of the early training.

Regularity of feeding and sleeping and, in short, all of the functions of life. It is only necessary to exercise a little good judgment and avoid over-indulgence. A child is readily taught the proper time for its supply of food and the time to retire as well as the time for amusement and exercise. A little care and attention soon develops obedience and amiability of temperament.

If the little one is given over to the care and guidance of another it is certainly the duty of the mother to be watchful and observant of the course and teachings of the one in charge. Not only of the outings and clothing of the child, but the conversation and teaching, as well as proper guidance as to behavior, habits and associations. The regularity of the morning bath and proper dressing should not be neglected nor lost sight of, and the regular outing and fresh air, when the weather and conditions of health permit. All this, with regularity indoors, as well as out, contribute so largely to the general well-being of the growing child that they are formidable factors in early life, and always worthy of reminder and advisement. The heads of families, more particularly the maternal head, should certainly be advised by their medical counselors if not already conversant with the details and proper course to pursue in the rearing of the little ones. The course inaugurated in early training is the one that has its influence and becomes engraved upon the memory through all time to come.

Next comes the stage of early existence, when children come together in association, playmates and intimates. These intimacies should not develop and run together haphazard, as it were. Care and discretion should be exercised, to be sure that no contaminating influence ereeps in to upset and destroy all the good teachings that has been inculcated

in the young and impressionable mind. "Evil associations corrupt good manners." Often a pure young mind becomes soiled by even brief contact with a perverted one. Not infrequently a profane or vulgar expression will imprint itself indelibly upon a precocious child, with a retentive memory, and repeat itself in a most startling way, and at a most unexpected time. It is, therefore, prudent to avoid if possible all contact and association with the promiscuous urchin of the street. This applies, of course, to children old enough to talk and walk, and to distinctly notice what is transpiring around them. The mother, the nurse or the attendant should take it strictly in charge that no harm comes to the little one, either moral or physical. Good, impressive moral instruction to the walking and talking child, if properly and persistently persevered with, invariably has a most salutary effect. Faith and confidence in the father and mother is among the first attributes to be instilled into the mind of the child. Once trust and belief in the truth, candor and goodness of the parents are fully established in the heart and mind of the child, from that foundation may be reared and dedicated a citadel of faith, love and morality that should be as firm and enduring as a Gibralter.

This much achieved in early life becomes a sheet-anchor of confidence that is ever a protection against the multitude of evils which beset the young from all quarters, and those who escape all the sordid elements with which they are constantly surrounded are indeed the exceptions. All praise to the parents who early guide their offspring to the right course. Their reward is sure to come later in life.

Hotel Wolcott, Fifth Avenue and Thirty-First.

Enclosed find one dollar for your valuable journal, the MEDICAL BRIEF. I am a druggist, but find the BRIEF very interesting reading and proving of value to me in my business.-P. V. COOVER, Jacksonville, Ill.

[Written for the MEDICAL BRIEF.] An Error of Diagnosis-Phimosis.

BY O. H. ROHDE, M. D., Professor of Orthopedic Surgery in the New York Eclectic Medical College. Brooklyn, New York.

It is strange that in spite of the many warnings physicians receive regarding the necessity of examining the male child, many cases of oversight are reported. Phimosis in the male leads to many disorders, ranging from strabismus to actual paralysis, and the severest form of convulsions. These have been illustrated by various orthopedic surgeons, and are taught in every college, and yet every discerning, painstaking physician is compelled very often to remedy the oversight of the obstetrical practitioner, particularly, also, the carelessness of the midwife.

These remarks are called forth by the peculiar case of E. G., a fine manly boy of eleven years, born in Germany, and brought early to this counttry with his parents. Some two years after birth the parents noticed that there was a retention of urine, and at times a slight puffiness of the eyelids and face; again, of the abdomen, and sometimes of the feet. Little attention was paid to these swellings; they were supposed to be caused by a cold. As the boy developed they became more marked. Several practitioners were called in to prescribe for the child, sometimes affording relief, and sometimes not.

When the boy reached his eleventh year, the parents became alarmed at the constant state of edema of the various tissues, and a practitioner was called in, who pronounced the boy dropsical, deeming it a case of anasarca. The boy was obliged to leave school, and as the case became more severe other physicians were called in, as well as some professors, in consultation. It was decided to tap the abdomen, which was done, on the right side, and some two pints of fluid removed, giving temporary relief. The secretions, however, became stronger, and the distension greater. It was noted that the limbs did not swell, only the lower part of the abdomen.

I was called in hurriedly, one evening, near midnight, to examine this case, his

physician being away. The parents asked me to make an examination of the boy, with a view to giving some relief. I carefully examined him, and found that he was almost bloodless, that he had been tapped, and that the abdomen was greatly distended.

On examining the genital organs I found, to my amazement, that the penis was abnormally small, with an adherent prepuce, having an opening through which it was almost impossible to insert a pin. On asking the boy to urinate, he could only pass a few drops, and that with difficulty. It was a typical case of phimosis, pitiable to see, as it meant death if circumcision could not relieve him. Stating these facts to the parents, and they convincing themselves of their truth, and remembering the various symptoms due to this condition in the past, they consented to circumcision, which was done the next day, and the glans penis fully exposed. The operation was almost bloodless, and gave but little pain, but it was too late. A catheter passed into the bladder the following day -there being no pain, and the stitches healing, found no water, the ureters dry, and direct drainage into the abdomen. With the consent of the parents the child was tapped, and a gallon of fluid removed. All was done to sustain the child, but he died the following day.

These are briefly the facts given as found. Comment can be made by the reader. If it were possible that a law could be passed which would compel the medical practitioner who acts as obstetrician, to perform circumcision upon all male children, doing this under the law of the land, the race would be stronger for this right, as the old Hebraic law is as potent towards making stamina and strength and physical well-being to-day as in the days of Abraham. It is the minor details, often neglected, overlooked, deemed of attention by and by, then forgotten, that causes sorrow in many a household, and brings a blight upon a being who would otherwise be in perfect health.

If this meets the eyes of those who are interested in their work, and who handle children to some extent, I would deem my observations to be of value, and feel

[merged small][merged small][ocr errors][merged small][merged small][merged small]

In the profession of pharmacy there are engaged in New York City a number of legally qualified practitioners of medicine, who were at one time, under the laws of the State of New York, entitled to register as pharmacists. The pharmacists of the city of New York have long recognized that their profession ought to be raised to the level of the practice of medicine, believing that the health of the community may be more jeopardized by lack of professional training on the part of pharmacists than on the part of the physician, for however careful the physician may be in prescribing, his best efforts are nullified by a lack of knowledge and experience in the compounding. They, therefore, have advocated the passage of a law which is intended to elevate the profession of pharmacy, in that it shall require that every applicant for a license to practice pharmacy shall present evidence of four years' practical experience, with a diploma from some recognized college of pharmacy, either in the United States or of some foreign country.

In return the colleges of pharmacy will require a certain standard of entrance, and in the State of New York such a law has been recently placed upon the statute books, to take effect January 1, 1905. Under this law the applicant for admission to a college will require a regent's certificate of at least twelve counts, which requirement will be, no doubt, added to in the very near future.

[blocks in formation]

This, in turn, should and will enable the colleges to turn out pharmacists who are in every way qualified to practice their profession in full accordance with the requirements of the physician and the public.

Graduates of the colleges of pharmacy are not usually found among those who either knowingly or dishonestly deal in adulterated drugs.

The first principles taught at the colleges of pharmacy are the maintenance of the proper standard of strength and purity for all drugs and preparations, and any deviation from these lines are never countenanced by any college.

Pharmacists, as a rule, are always willing not only to receive suggestions from physicians bearing on the more accurate carrying out of his plans, but they will at all times be found quite as willing to make suggestions to the physician concerning the mechanical details of compounding a prescription, as well as calling his attention to incompatibles, with which they are of necessity more familiar.

The status of the pharmacist at the present time in the different States of the Union is somewhat unsatisfactory as compared to the status of the physician. This state of affairs may be traced somewhat to the fact that the requirements for the usual license to practice pharmacy have not been sharply defined. The "practical experience" covers a multitude of sins, and may refer to work not at all connected with the actual practice of pharmacy. Under the old system, many persons of comparatively little education or training have succeeded in obtaining a license. It must be said, however, that a great many young men desirous of becoming pharmacists enter upon a course of study at some college of pharmacy without attempting to reach the goal of their ambitions by means of the "backdoor" method, viz., the Boards of Pharmacy. In the various colleges and schools of pharmacy throughout the United States a goodly number of such students are in attendance. The aver age requirement of graduation in these schools and colleges is a term of two

years with an optional third year's course, known as the post-graduate course. Most of the colleges also require that the applicant be twenty-one years of age, and that he present evidence of four years' practical experience before graduation and granting a diploma.

The relations between physician and pharmacist are so close and important that a mutual co-operation can be of untold advantage to both, and the tendency of the times is towards such a co-operation.

115 West Sixty-Eighth Street.

Enclosed find one dollar for the MEDICAL BRIEF. I see you get a cussing by the

-; but the like of that only seems uncalled for and all out of order with me. I don't like to hear such and much less read it. This is my sentiment.-J. A. SMITH, M. D., Chattoogaville, Ga.

[Written for the MEDICAL BRIEF.] A Study on Light, A Few Timely Scientific Facts Related for the Comprehensive Understanding of the Practitioner.

BY J. MOUNT BLEYER, M. D., F. R. A., M. S.,
LL. D.,
New York City.

(Continued from page 1073, December BRIEF.) It has also been found that chemical decomposition is produced by the mere juxtaposition of different bodies. If iodide of gold or silver, perfectly pure, is placed upon a plate of glass, and a plate of copper covered with mercury is suspended over them, a gradual decomposition of those salts will take pace, iodide of mercury will be formed, and the gold or silver salts will be reduced to a finely divided metallic state.*

A body whose powers of radiating heat are low, being brought near another whose radiating powers are more extensive, will, in the course of a short time, undergo such an amount of molecular disturbance, as will effect a complete change in the arrangement of its surface, and an impression of the body having the highest radiating powers will be made

Rober Hunt, Philosophical Magazine, Volume XXII, page 270.

upon the other. This impression is dormant, but may be developed under the influence of vapor, or of oxidation.† A body such as charcoal, of low conducting power being placed near another will, in a very short time, produce, in like manner, an impression of itself upon the metal plate. Thus, any two bodies whose conducting or radiating powers are dissimilar, being brought near each other, will produce a molecular disturbance, or impress the one with the image of the other. However small the difference may be, an effect is perceived, and that of the most extraordinary kind, giving rise to the impression of actual images upon each surface exposed.‡

Bodies which are in different electrical states act upon each other in an analogous manner. Thus arsenic, which is highly electro-negative, will, when placed near a piece of electro-positive copper, readily impart to its surface an impression of itself, and so, in like manner, will other bodies in unlike conditions. Every substance physically different, it signifies not whether as it regards color, chemical composition, mechanical structure, calorific condition, or electrical state, has a power of radiation by which a sensible change can be produced in a body differently constituted.

Fable has told us that the magicians of the East possessed mirrors in which they could at will produce images of the absent. Science now shows us that representations quite sufficient to deceive the credulous can be produced on the surface of polished metals without difficulty, etc. A highly polished plate of steel may be impressed with images of any kind which would remain invisible, the polished surface not being in the least degree affected as it regards its reflecting powers, but that by breathing over it, these dormant images would develop themselves, fading away again as the condensed moisture evaporated from the surface.

† Rober Hunt, on Thermography, Etc. Reports of the Royal Cornwall Polytechnic Society for

1842.

I Catalytic force, or attraction of surface, concerned in the diffusive power of gases; an occult energy or power in saturated saline solutions. Proter, Mechanic's Magazine, Vol. XIV, page 106; Ueber Elektrische Abildungen, by G. Karsten. Poggendorff's Annalen, Volume LVII, page 402. Melloni & Brewster may be consulted for much that is most remarkably connected with radiation and colored surfaces.

« ПредишнаНапред »