Appendicitis-Miss, aged seventeen, student. First seen by me on February 5th. Complained of great tenderness in region of vermiform appendix with history of severe attacks of pain and tenderness occurring at shorter intervals for the last six months. Pain of recent attacks severe enough to compel the patient to remain in bed from twenty-four to thirtysix hours. Examination revealed marked tenderness over McBurney's point. Patient was put upon saline cathartics, diet regulated, etc. High-frequency treatment commenced February 12th, repeated every other day. Attacks occurring since are less severe and shorter in duration. Tenderness less marked over McBurney's point. The success obtained in the above cases seems to indicate that there is a new field for the high-frequency current. It is my belief that the good effects of this treatment are due largely to the tonicity brought about by the high-frequency current. This current seems to pick up the link between the X-ray in the cure of cancerous conditions. While the X-ray kills the cancerous tissue it has the same effect upon the normal tissue, and if the treatment is not combined with the high frequency the normal tissue is bound to suffer. If the high-frequency current is alternated with the X-ray the normal tissue is so stimulated as to rapidly take the place of the diseased tissue. 2121 Lake Street. THE COUNTRY DOCTOR. BY JOHN COLLINS, M. D., Quincy, Ark. [Written for the MEDICAL BRIEF.] The busy country practitioner is an exception among the great philanthropists, heroes and benefactors of humanity in that while such men seldom reap a great crop of flowers in the way of highly-scented eulogies and brilliant encomiums until after they have been buried, the overworked M. D. has all the cheap blossoms stuck up to his nose at every turn. After he can not be used through sun and storm and night any longer, few flowers are cast his way. Where in all the fields of human endeavor is more true heroism—more unadulterated charity and philanthropy-exhibited than is over and over manifested in the arduous, strenuous work of the ordinary country doctor, persistently denying himself needed rest, busy still when every muscle is exhausted and every nerve crying for rest, spurring up and using the last remnants of latent force rarely ever called out in any other vocation or predicament, and this repeated and re-repeated ere Nature has regained one-half her normal forces? Added to these recurrent abuses of his life come exposures to cold and storm, unusual to any other vocation; and how much of it goes unnoticed by the public and unrecompensed by the beneficiaries? Charitable work is considered by all as his proper function in a large measure, nor can can he evade much that appeals to him thus. "The busiest man, the hardest worked, The most rushed-up and shoved and jerked, Pulled and cuffed from pillar to post, If such a mortal you would see, Few physicians steer clear of branching off into other business, trying to multiply whatever of competency they may have acquired by launching into merchandising, manufacturing or some other field of speculation. Not 10% of such ventures succeed on the part of the doctor, while a very large per cent prove disastrous. Continued attention to practice, with even a small constant accumulating surplus, invested safely, though at small interest returns, is decidedly the course, for linked with certainty of reasonable competency may be exceptional success in treating diseases and a reputation more enviable than accumulated wealth. LAGGING BEHIND. BY B. B. USSHER, M. D., Dedham, Mass. [Written for the MEDICAL BRIEF.] Everywhere amongst civilized people there are evidences of centralization in opposition to a diffusive policy. In England, Canada and the United States the sectarianists are coming together, and the great waste of power and money is being looked into for economical reasons, but underlying all this is the spur of religion. Where the war of sects has been always manifest, there is a wide and growing spirit of catholicity, a tendency to unify, until one dreams of a day coming when the Buddhist, Mahommedan, Confucianist, Shintoist, and other great religious bodies, will drop out the things that separate and centralize on those that unite, and we shall all see that the healing power spiritually centralizes in a God of love, and the outcome of that conviction will be a firm belief in the fatherhood of God as evidenced by the providential plans and their outcome, evincing a great central creative mind, and on the earth plans a belief in the brotherhood of man, as shown forth in the life and self-sacrificing death of Jesus of Nazareth. Will it have to be said that the medical profession, supposed to be the most progressive, advanced and broad-minded, is lagging away behind the churches, and manifesting a narrower spirit than even the churches did in the last fifty years? As a great profession, we are disgraced by the laws that our brethren, in the different States, have enacted in a spirit of selfishness that is deplorable. Either a man is a physician or he is not. What should determine his status? Why, simply the fact that he holds his diploma as a doctor of medicine from a reputable medical college, whose curriculum is such as to be evidence that he has pursued his study of the necessary courses under competent instructors, and by his college is vouched for as one capable of practicing his profession for the relief of human suffering. Instead of this broad and reasonable catholicity, what do we find? Why, State protective associations of doctors, who, not willing to stand upon their own professional merits, secure legislation that prevents their brother physician from practicing in their State, although human life and comfort may be at stake. As an illustration: I know a physician, a man of standing and fine professional qualifications, a man who has been markedly successful, and a graduate of a leading medical college. He is practicing in the District of Columbia, and is consulted by prominent people all over the country. who desire his services as a specialist. This same gentleman could not go into Alexandria, Va., just across the line, and attend a case without being a law-breaker, and subject to a fine under the laws his brother physicians have engineered through the State Legislature, and this illustration fits every State in the Union where this disgraceful discrimination prevails. It may be said that it is a State measure to shield the profession from quackery, but the protection against that is found in the diploma of the reputable, recognized college. It may be said that men get through the colleges who are not fit to practice, but many an honor man, famed amongst his fellows for his long memory and ability to answer according to the books, has been a dead failure as a physician at the bedside of his patient, and has found himself supplanted by a doctor who did not know so much of what other men thought, but was gifted with more common sense and discrimination. It will be said the State boards are the safeguard of the public, but that is not the case, for in practice many men who have passed the State board examination are obliged to abandon the profession, and take to some other means of living because they are failures as doctors. The public is discriminative. How many amongst the old physicians, the reputable men of years of experience and success, are sufficiently well up to stand an examination in chemistry and bacteriology, those over-rated factors of medical science that are every day, particularly in the latter field, shrinking in importance and reliability? Test tubes may give nice chemical results, but when the life principle is introduced, theory explodes and the fact of failure in expected result remains. The microbe theory, which has run mad, is losing favor, and much that is banked upon now by mere speculative enthusiasts will be forgotten, but in the great verities of the treatment of disease experience and good judgment tells, and when the medical men of the United States get enough catholic common sense and overcome the spirit of greed, then there will be a forward movement that will mean a national recognition of the qualified college-indorsed graduate from Maine to California. A FATAL CASE OF COCAINE POISONING. BY C. D. R. KIRK, M. D., Shuqualak, Miss. [Written for the MEDICAL BRIEF.] Dr. J. D. Kellis, of this place, called the writer in consultation to see Mrs. B., a lady about forty-eight years of age, who had some teeth extracted by a dentist who used about fifteen drops of an 8% solution cocaine. I do not know how many times the dose of fifteen drops had been used, but I suppose it was that quantity for each tooth extracted, and four or five teeth were extracted. Dr. K. arrived soon after the family became alarmed, and at once realized the gravity of the case and gave, hypodermically, a tablet of strychnine and one of atropia, which were exhibiting some of their constitutional effects when I arrived. About one hour after symptoms of cocaine poisoning were noticed. I noted the following condition: There were dilated pupils, the tongue partly protruded, the eyes were closed and all symptoms of the head resembled very much a deep narcosis by chloroform. There was no reflex of the eyes and all the functions of the brain were suspended. The pulse was full and strong, and only a little more rapid than normal. The respirations were about twenty-six, full and easy. The patient's position was changed by rolling and lifting her from side to side of the bed without any sign of disturbance. Dr. K. stated that after he called she vomited freely, the vomitus containing some free blood which had been swallowed after the cocaine had begun affecting the brain. As the pulse remained full and strong and respiration only a little accelerated and the atropia caused a flush of the face, we did not repeat the remedies, and only added a mustard plaster to the occiput. About the time, however, we were expecting to repeat the strychnine, there was a sudden change, which was announced by a weak, rapid pulse, stertorous breathing, and death followed in a few minutes, the paralysis having reached the pneumogastric nerve. The writer had extracted four or five teeth for her several years ago, using a local anesthetic which contained only a very small per cent of cocaine, and the dentist had on a previous occasion extracted several and operated while she was under the influence of the same formula and dose that he had used on that occasion, without any bad results. It seems that, owing to some condition, the nature and existence of which no one could surmise at this time, the patient was rendered extremely sensitive to cocaine and was fatally poisoned by it. The operating dentist should not be held accountable for this unfortunate ending, in view of the fact that the patient had previously, under cocaine anesthesia, shown no special predisposition for its ill-effects. THE DOCTOR. BY J. A. HOUSER, M. D., Indianapolis, Ind. [Written for the MEDICAL BRIEF.] The responsibility of the doctor is so different from that of any other person that it is not easy to make a comparison. All other callings permit special hours for rest and work. The doctor is always on duty. No day so fine nor night so stormy that permits him to rest or shirk. Be he ever so weary, at the call of duty and disease he must take his place to do battle with death and stay the destroyer yet awhile. Others may seek and choose their task; the doctor must take what comes and give his best service, though no recompense beyond the thanks of the helpless is his reward. Though the doctor's learning must be of the highest standard of any professional man, and more difficult to obtain, his labors take him alike to palace and hovel, where his duties are always the same in importance and gravity, and often upon his decision the scale turns to life or death. In his duties he must render the same service to prince and pauper alike, and he feels not less proud to restore the tramp than the millionaire to health. Each to him is a suffering human being, God's creature, and he an humble servant of the Most High. The doctor was there at your birth when you were ruthlessly cast upon the bosom of Nature, like a helpless shrimp tossed among the seaweed by an ocean storm. He heard your first wail of agony and soothed your first pain. All through life he holds your hand, guards your steps and cheers your sad hours. He hears your secrets and shields you from calumny. The highest court on earth can not open his lips to betray your trust. When "the pale horse and his rider, Death," comes and stills forever your throbbing heart, the doctor is there to comfort and solace to the last. His touch is the last you feel, his voice the last you hear, his face the last you see before reason fails, memory fades, eyes dim, and all the world swoons, and you pass to the unconscious sleep. He turns away, like a noble knight defeated again by the "King of Terrors," goes to battle again just as bravely for another smitten by the plague. Though he could beat back no more the relentless reaper he comforts his own heart with the conscious belief that he had done his best. The doctor is a king among men. No prison can lock him out, no castle defy him, no court unseal his lips. He can stop a ship in mid ocean when suffering or danger demands it. He can hold the world's rulers in quarantine until he says they may come ashore. If he raise |