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THE ARMY WAR CORRESPONDENT IN the censor may reject. The commanding genMEXICO.
eral may, however, relax the administration of While not of medical interest, we are sure the regulations when military necessity does not the readers of the MEDICAL STANDARD will be require such strictness.
The correspondent on being duly licensed has which will surround the war correspondent in the status of a non-commissioned officer so far as Mexico in case war comes, as it promises to do privileges are concerned. His pass gives him before long. These conditions have already been transportation over all military railways, and he arranged and are given in the last number of the is entitled to draw rations and is allowed tentFourth Estate.
age. A cook for the correspondents' mess is The newspaper man who desires to be a cor- supplied. The aimy wires are open to his use respondent with the army must deposit a certi- when not occupied by official dispatches. Every fied check for $1,000, against which he may draw correspondent must wear olive drab garb for the for subsistence supplies at the commissary or field, with a white arm band two and a half inches for any part of his equipment, such as blankets, wide, bearing the letter C in red on the left arm. tents, saddles, bridles, clothes, and similar avail- His messenger, if he has one, must also wear able articles. He must also provide a bond in olive drab, and a band with the letter M in red. the sum of $2,000 for his good conduct, which Once started as a war correspondent no one in the case of forfeiture may be transferred to may leave the army without the permission of any charity the Secretary of War may designate. the War Department. If dispatches are distort· The correspondent will also take a military ed in the office of publication, or language or exoath of loyalty in the usual form. He must pressions are used conveying a hidden meaning agree to abide by all the regulations laid down which would tend to mislead or deceive the cenfor his guidance. Only one correspondent from sor, such an act will be held to be a violation of a newspaper will be permitted to accompany the the regulations, punishable by forfeiture of privsame field army. Men who have adventure rather ileges and the bond filed with the War Departthan actual service as active journalists in mind ment. Correspondents are to be subject to all will not be received. All who ask to go will be medical regulations of the army. required to show that they are really newspaper No officer or enlisted man in the army will be men and have had experience.
permitted to act as correspondent for any pubForeign correspondents must show that they lication without the consent of the Secretary of have seen service in the field with an army, and War and the majority of war correspondents atmust present credentials from high officers of tached to the army with which such an officer or the army with which they have been in the field, enlisted man may be serving. and letters in each case from their respective dip- No censor may write anything for publication domatic representatives in the United States. No about the war while he is acting as censor. photographers for the press will be allowed with the army. There will be an official army photog
PRESCRIPTION INCOMPATIBILITIES. rapher whose films will be sent to Washington
Dr. Thomas Stephenson, has an interesting promptly and prints wil} be furnished to the
article upon this subject in the Prescriber. Among press at a slight cost. Moving-picture men will also be barred. Reg
other things, he points out the following: ular correspondents will be allowed to carry
It is a well known fact in chemistry that salts small band-film cameras, but their films must in
of a weak acid are decomposed by a stronger acid. all cases be censored, the films being sent to That is to say, the stronger acid has a greater Washington to be developed and passed upon. affinity for the base, with which it readily com
It is proposed to have a commissioned officer bines, setting free the other acid. This happens 2/§Â?2?Â2ÒÂ2âÒâÒ2ÂòÂ2Ò2ÂòÂ?2ūm/22222222\/\/2\\2ū22ūtiņ22/\/2ū2/2/2/2/2/2/2/2ņ2/22\/22 2/22/22/tiūtiņēmēģēm/tim2tiòti2– another to act ascensor with the army in the chloric, is added to a benzoate, salicylate or cinfield AL letters and dispatches must be sub- namate. A solution of sodium salicylate or benmitted to the censor at the field headquarters of zoate will, therefore, be decomposed by the adeach army and receive the stamp of approval. dition of a mineral acid; salicylic or benzoic
The regulations forbid that the correspondent acid, which are only slightly soluble in water, may send the names of regiments or commanders, being set free. Sometimes the liberated acid is the disposition of troops, the state of the army's diffusible in the mixture and easily shaken up, transport, the number of sick, the extent of losses as is the cinnamic acid precipitate in the followin any engagement, or any other matter which ng mixture:
Chloral hydrate is another substance that is Calcii glycerophos .......
gii readily decomposed. With carbonates or hydroxSodii cinnamatis .
ides of the alkalies or alkaline earths (potasAcid. phosph. dil...........
sium, sodium, ammonium or magnesium) chloroGlycerini ..............................31 Infus. aurant. co................... ad zvi
form is set free, and a formate of the base is It should be borne in mind in this connection produced. With certain soluble salts, such as that caffeine citrate is readily dissociated in
bromides and iodides, in the presence of alcohol, aqueous solution, citric acid being set free, and
an oily layer of chloral alcoholate is formed. It that this citric acid may act on a salicylate or a
is therefore unwise to prescribe chloral hydrate benzoate in the same manner as would a mineral and
eral and potassium bromide along with a tincture. acid. For example, the following combination gives a bulky precipitate of salicylic acid, which
CARDIAC PAINS. may be avoided by using half the amount of caf Dr. Samuel West says, in the Clinical Journal, feine citrate:
that cases of cardiac pain fall into two categories.
In the one the pain is felt, more or less, actually Caffein. cit.
in the heart itself. In the other the pain is radiSodii salicyl. ....
ated or reflected, and, though originating in the Syr. tolut.
...........zi Aq. chlorof. ......................ad zviji
heart, is felt as well elsewhere. The heart pain Solutions of iodides are decomposed by certain
is connected with the distension or over-disten
sion of its cavities. This is obvious, and capable mineral acids, iodine being set free. Potassium iodide is thus incompatible with dilute nitric or
of easy demonstration where the pain develops nitrohydrochloric acid, or with tincture of ferric
during or immediately after great exertion, e. g.. chloride, the liberated iodine forming a brown
after running or rowing in a race. This may solution. Spirit of nitrous ether, when kept for
be called heart-strain or heart-sprain. The heart, any length of time, becomes acid and acts in the
once sprained, may, like any other strained same way on potassium iodide.
musclc, remain weak, and liable to pain, with
This may be avoided by previous neutralization of the spirit
even slight effort, for a long time after.
No sharp line can be drawn between these by means of potassium carbonate, or by addition of a suitable quantity of ammonium carbonate
slight attacks of discomfort or pain and those
more severe paroxysms, which, in an extreme deto the prescription. Acetyl-salicylic acid (aspirin) also decomposes
gree, are called angina. Indeed, angina, in its potassium iodide, and when the two are ordered
agonizing and paroxysmal character, closely rein cachets the liberated iodine combines with the
sembles colic, and, as colic is produced by the starch contained in the envelope, forming an un
unsuccessful attempt of an over-distended mussightly bluish-black compound. Some essential
cular organ to empty itself against resistance, so oils, especially if long kept. have the power of angina may be well described as cardiac colic. decomposing potassium iodide.
As the pains of severe colic may not be confined Another instance in which iodine is set free, to the distended organ, but be radiated and rethough not immediately, is when potassium chlo- flected to other parts, so it is not surprising that rate is prescribed with syrup of ferrous iodide. the same should occur in angina. Thus we come In this case the chlorate is gradually reduced to the second category of cardiac pain, the reto chloride, and iodine is liberated from the
flected or radiated group. Of this the most faferrous iodide.
miliar instance is the pain felt in angina in the Glucosides are hydrolyzed in presence of min- root of the neck and left shoulder, or down the eral acids or alkalies. Thus salicin is slowly left arm. changed into saligenin and glucose, and strophan- Why the pain should usually be referred in thin is similarly decomposed.
this direction is not so clear, but it does not alReference has been made in a previous article ways take this course, for it may be felt in both to the decomposition of substances rich in oxy- arms alike, or sometimes in the right alone. gen. Chlorates, nitrates, bichromates, perman- Usually it is when the left ventricle is the seat ganates, etc., decompose with explosive violence of distension that cardiac pain is felt. In mitral when mixed with readily oxidizable substances disease the pain is rarely so severe, and much such as sugar, sulphur, glycerin, reduced iron or more limited in range, not extending far from essential oils. Solution of potassium perman- the cardiac area, and radiating on a more horiganate is reduced by ferrous salts, glycerin, al- zontal plane into the axilla, rather than upcohol, hydrogen peroxide, phenol and most or- wards. I bave tried to connect the varying disganic substances.
tribution of the pain with the distension of the different cavities of the heart, but I have failed off and the patient has brought it to the surto discover any constant or general law.
geon. Should it be replaced? That this may One kind of reflected pain is sometimes met have a chance of success, it is necessary that with in connection with left ventricle distension the wound be recent, very fresh, and the severed or failure, which deserves mention, viz., great end clean-cut, not contused, lacerated or infectcutaneous hyperaesthesia. This may affect the ed. Under these conditions, one may essay the whole praecordial region, and some distance graft. around it, and it may be so acute that the slight- Having washed the tips with lukewarm serum, est touch produces exquisite distress, and per- and also stopped the bleeding, apply the severed cussion is impossible. A somewhat similar con- piece carefully to the stump and fix it with four dition may be met with occasionally where there sutures. Then wait results, examining the finger is acute pericarditis. It is then attributed to frequently. If the detached piece dies, blackens, direct irritation of the branches of the intercos- and especially if it suppurates, the attempt is tal nerves, but I have never seen it so pronounced sure to fail and one better remove the tip. as in the left ventricle cases I have mentioned. To facilitate the cure, many processes have As in these there is no question of pericarditis, been employed. Some have attempted to use it must then be regarded as indirect and reflect- Bier's hyperemia to draw arterial blood to the ed. This condition is easily dealt with, for brush- graft and to disgorge the veins. When the color ing the parts over freely with tincture of aconite of the graft shows that circulation is established, quickly allays it, and, once removed, it does not the apparatus may be removed. Leeches have ordinarily recur.
been applied also to the sound part of the mem* bue
ber; thanks to the local hemophilia and incoagWOUNDS OF THE FINGER-ENDS. ulability developed from the bite of the leech, Guibe (Monde Médical) says that wounds of the local circulation re-establishes itself more the finger-ends are very frequent, but usually readily. Also, to cover over the wound. one may badly treated. In mutilations, when the tip is resort to the Thiersch grafts. completely severed, spontaneous cure is very More promising than either of these methods slow. If the bone is uncovered, the projecting is the application to the wound of nuclein. portion is detached only after a long time, through Frankly, were this to fail, the graft might as a process of ostitis lasting for weeks. Cicatri- well be removed at once, thus saving time and zation once made, the skin of the new formation allowing proper measures to be instituted without is fragile, thin, liable to ulceration, and many delay. Guibe acknowledges that his attempts times quite painfully sensitive.
have not met with the slightest success. The cure is speedy in contused wounds. The When the severed end is held by a pedicle that nail falls off in a short while, a new nail form- is not devitalized, do not hesitate to suture it in ing under it, often irregular and deformed; still, place. all is repaired, whether well or badly done.
When restoration of the severed end is not to In wounds at the joint, if these do not contain be considered, re-arrange the lacerated tissues, enough uninjured vessels, necrosis follows and disinfect with tincture of iodine and remove any cicatrization occurs slowly, as in mutilations. At remnants of the nail. Anesthetize the region other times, if the surfaces are not well held with novocain solution, 42 per cent (or, better, in contact and in the right position, there is a with anesthaine). Detach and remove the nail, luxation of the loose phalanx and between the then, with a bistoury, incise circularly the soft surfaces a bloody mass forms that hinders heal- parts to the bone, some millimeters from the ing. This follows in time, but the finger-end is traumatized parts, avoiding reaction; then sever deformed.
the bone. If the cut has been skilfully made, Diverse complications may occur infectious, the lips of the wound will join readily; if not, etc.), varying with the cause of the injury. There remove a little more bone. Assure hemostasis, may be lymphangitis, phlegmons, suppuration of if necessary, by ligating the collaterals. Now the tendinous sheaths (rare), and sometimes even unite the flaps by sutures passed far enough from tetanus may develop.
the edges. Generally, healing is by first intenTreatment: First wash and carefully arrange tion, the finger shortened, but with a linear rethe fragments, remove foreign bodies, and, if sistant cicatrix. the wound has been soiled by manure or else- In simple wounds of the soft parts, asepticize wise, inject antitetanic serum. If the wound is with tincture of iodine; trim the bleeding surclean-cut and without soiling, this is unneces- faces, cut away the debris of tissues sure to sary.
necrose, pick out any soiled bony bits, then suture Sometimes the end of the finger has been cut the restored ends.
Sometimes there is crushing with a deep wound, ritated, shows increased urinary secretion and a and absence of flaps. Here, anesthetize the blood pressure rather high. A vacation with finger at its base, remove the nail always from ligat exercise and more rest is the preventive prethe point to the base, as its presence would sure- scription which he receives. Mrs. Williams, after ly render the wound more difficult to heal. Then being examined by Dr. Smith, undergoes a slight clean the wound with a small curette, removing operation under local anesthesia, and is relieved with caution any splinters, clots, and other of the first and only malignant cells found in debris. Apply liquid iodine, and suture.
her breast. Richard Roe, who is preparing for These precautions will notably abridge the du- a long journey, is vaccinated against typhoid ration of the disability and render great services fever, a disease no longer existent in Dr. Smith's to the patients.
city, since pollution of the water has been dise *
continued. John Doe, who is a mineralogical exTHE DOCTOR'S DREAM; OR WHAT MIGHT
pert and wishes to do some prospecting in high BE ACCOMPLISHED BY PREVENTIVE altitudes, has his heart examined. MEDICINE.
“There are numerous applicants for pulmonary Here is the story of a dream of a busy doctor, examination. This is done by Dr. Smith and his after a hard day's work, when he had seen some. assistants in a most thorough and up-to-date thing of the terrible results of ignorance, care- manner, and advice is given each according to lessness, over-strain, neglect and vice. The story the findings. It has been many years since Dr. is told by Dr. Victor C. Vaughan, in an address Smith has seen an advanced case of pulmonary given before a group of life insurance company tuberculosis, and the great white plague will presidents. We quote it in part only:
soon be a thing of the past. Everybody goes to "On a certain November day Dr. Smith had a physician twice a year and undergoes a thorbeen unusually busy. Late that night as the ough examination. The result of this examinadoctor sat before his grate he fell asleep, and tion is stated in a permanent record, and no two now he is busy among his patients in a way consecutive examinations are made by the same hitherto quite unknown to him. His waiting- physician in order that a condition overlooked room is filled with people, old and young, of by one may be detected by another. Cases of both sexes, who have come to be examined in doubt or in which there is difference of opinion order to ascertain the exact condition of their are referred to special boards. health. A young man before proposing marriage "The average of human life has been greatly to the woman of his choice wishes a thorough ex- increased and the sum of human suffering has amination. He wishes to know that in offering been greatly decreased. Preventive has largely himself he is not bringing to the woman any replaced curative medicine. Tenements are no harm. He desires to become the father of healthy longer known; prostitution and with it the venechildren and he is not willing to transmit any real diseases have disappeared; institutions for serious defect to them. He tells the doctor to the feeble-minded are no longer needed, because examine him as carefully as he would were he the breed has died out; insanity is rapidly deapplying for a large amount of life insurance. creasing, because its chief progenitors, alcoholThe doctor goes through the most thorough phys- ism and syphilis, have been suppressed. These ical examination and tests the secretions and and many other pleasing visions come to Dr. blood with the utmost care. He understands his Smith in his dream, from which he is startled own responsibility in the matter and appreciates by the ring of the telephone at his elbow. The the high sense of honor displayed by his patient. call says: 'Come quickly to Pat Ryan's saloon A young woman for like reasons has delayed at the corner of Myrtle and Second. There has her final answer to the man who has asked her been a drunken row. Bring your surgical instruhand in order that the doctor might pass upon ments.' Then the smiles which had played over her case.
the face of the doctor in his dream were dis“Here is the doctor's old friend, William placed by lines of care, and he went forth into Stone. Mr. Stone is in the early fifties. He the darkness of ignorance and crime.” has been a highly successful, honorable business It has been proposed that the life insurance man, has accumulated a sufficiency and enjoys companies represented here seek to prolong the the good things which his wife prepares for the lives of their policy holders by offering them table. A careful examination of the urine leads free medical re-examination at stateù intervals. the doctor to caution Mr. Stone to reduce the It has been shown that in all probability this carbohydrates in his food. Mr. Perkins, a law- would financially benefit the companies in the inyer who throws his whole strength in every case creased longevity of their policyholders and the he tries, and of late has found himself easily ir increased number of premiums they would pay.
be examines of by sician in ordinations
This is a business proposition, and I hope that reflex. Superficial reflexes were absent. She had the companies will inaugurate it and thus dem- perfect control over her bladder and bowels. onstrate that the lessening of sickness and the Her pupils were widely dilated but responded deferring of death will pay. Let the insurance to light and accommodation. The response, howmen join the doctors and help in the great work ever, was not well sustained. An electrical exfor the uplift of the race through the eradica- amination disclosed no reaction of degeneration tion of unnecessary disease and premature death. in any of the different groups of muscles. In this way we can hasten the coming of the While in the hospital, Delehanty gave a clinic better man by making the doctor's dream a on her to a body of medical students and in her reality. I am confident that you will do this, presence explained that there was no known ornot because it will pay, but because it is the ganic disease of the nervous system that could highest service you can render humanity.
give rise to the condition she presented, and Now, is this a wild dream?
that it was a pure case of traumatic hysteria. Is it absolutely impossible that part of this The effects of the clinic seemed to have prodream might not come true?
duced a profound impression on her mind, for
on the next day she was able to move her exTRAUMATIC HYSTERIA.
tremities and take her food through the natural Just to illustrate the power of suggestion to channel. cause (or simulate) disease we reproduce from The paralysis, anesthesia and the aphonia bad Colorado Medicine the report of a case of trau- almost entirely disappeared before she was aware matic hysteria, as given by Dr. Edward Dele- of the results of the trial. hanty.
An indulgent jury awarded her some $6,000 as The patient was a young woman who was balm for her fancied injuries. In less than a thrown from her carriage in a collision with a week's time after entering the hospital on a wagon belonging to a wealthy corporation. At stretcher she was able to walk about and left first she felt no inconvenience except the gen- with her physician for her home in the mouneral shock, but accompanied her mother (who tains. was also injured) to a hospital. For three “I have been advised,” said S. Delehanty. months she was able to work, but suffered at “ 'that she has never been the same as before the times with pain in her back. She finally consult- accident. Here suggestion was supplied, uned a physician, who examined her back, also test- consciously, no doubt, by her family physician. ing her legs for anesthesia and loss of power. Each examination which he made suggeste At that time there was no evidence of cord in- symptoms, which later appeared, and when she volvement, but in the course of a week she be- became completely paralyzed he hypnotized himcame completely paralyzed in the legs. It was self into the belief that her condition was due not long until her arms became involved, and to some obscure degeneration in the columns of finally the special senses. She lost the use of the cord, for under oath he testified that she her voice and had difficulty in deglutition so that would never be able to walk and probably would it was necessary to resort to rectal feeding. not live a year.”
For three months she lay in bed, completely Litigants of this class usually look to the famparalyzed. During this time a damage suit was ily physician to support them in their fight being instituted against the company for $25,000. against heartless corporations, and court records She was brought to Denver on a stretcher to at show that they are seldom disappointed. tend the trial. She was taken to a hospital and The best service which could have been renat the request of the defendant I made an ex- dered this girl would have been plain speaking amination. She was pale and anaemic, and bore very early in the case. Had she been taught to the appearance of having passed through a long turn a deaf ear to her distorted sensations, been siege of sickness.
discouraged in her desire to obtain revenge and There was complete paralysis of legs and arms. reward by instituting a damage suit, she would Anesthesia was complete to all forms of sensa- have been saved much pain and anxiety, and tion except about the anal and genital regions, avoided the demoralizing effect, which invariably where sensation was present, but diminished. follows in the train of damage suits. Unexpected jabbing of needles into her body caused no expression of pain on her face. Her To Prevent Mosquito Bites.- Acetic ether, 10 body could have been made a veritable pin cush- grams; tincture of eucalytus, 20 grams; tincture ion without any remonstrance from the patient. of pyrethrum, essence of mint, of each 60 grams;
The knee jerks were increased, but equal. water, enough to make 1 liter. Label: Apply There was no Babinski, Oppenheim or Gordon as a lotion, to prevent the attacks of insects.