one-half pounds. The current had an intensity of four thousand volts. The sloughing and drain of pus was extensive and profuse.

When a living tissue is exposed for a sufficient length of time to X-rays, having considerable power, peculiar changes are effected in the cells, these changes being expressed first by increased cellular activity, and afterwards by cell death. These changes are not produced at once, as when ordinary heat is applied to a part, but appear only after a considerable time has elapsed. Thus, in X-ray burn (focus-tube dermatitis), due to the exposure of the skin to too powerful or too prolonged action of the Roentgen rays, the first signs appear about the third day after. The first evidence is a slight redness of the skin, this deepens and extends, and in a day or two small blebs appear, which break, and from them tissue destruction extends by cell necrosis until large denuded areas may form.

There is no doubt that these rays do produce burns, and there is no doubt as to their frequency. At the present time the number drops to few in estimating from the numbers treated. Only when idiosyncrasy or an extra tender skin is encountered does it unexpectedly occur. Frequent and prolonged exposure to the same area is generally the cause.

The subjective symptoms are here described: First, there is slight tingling, which increases to a burning sensation, with later marked irritation and itching; the skin assumes the sunburn color. It may or may not grow worse. Vesicles may form, leaving a raw, painful surface. The burns are difficult to heal. The deep lesions are osteitis, or a distinct osteoplastic periostitis; there may be violent inflammation of the lungs. Dermatitis, if properly produced, is within certain limits a desirable feature of the X-ray treatment.

Radium, as we know it, is a salt, the chloride, kept in glass tubes not larger than a thick match. This is wrapped with lead for the protection of those who handle it. Lead stops the harmful rays that would otherwise make trouble.

After placing the tube in contact with the skin, and leaving it there for a few minutes, there would be manifest effects

therefrom. The results of these contacts, in the person of one of the investigators, are a forearm scarred and reddened from freshly healed sores. Prof. Becquerel, in journeying to London from France, carried in his waistcoat pocket a small tube of radium to be used there in a lecture. A fortnight later the skin under his pocket began to redden and fall away, and finally a deep and painful sore formed, and remained for weeks before healing. Besides heat and light, this strange element gives out constantly three kinds of invisible rays that move with the velocity of light, or thereabouts, and that have separate and well-marked attributes. Luminosity or phosphorescence, an actinic action analogous to the X-ray and ultra-violet ray, and the power of making other bodies radio-active, like themselves, may be mentioned as some of their peculiar features.

(To be continued.)

[Written for the MEDICAL BRIEF.] A Bad Wound With a Good Recovery.

BY R. R. ANDERSON, M. D., Buford, Ohio.

While hunting rabbits in a thicket of underbrush near his home, November 17, 1900, H. E. L. got upon a log so as to have a better view of his surroundings, and while there discharged one chamber of his double barrelled, muzzle loading shotgun at a passing rabbit. Thinking to reload where he was, and while doing so, the breech of the gun slipped off the log, the hammer of the loaded chamber striking the log, discharged the load, the whole passing through the wrist of the right hand. The load entered the front side of the hand near the lower extremity of the ulna, passing through the wrist, carrying with it completely all of the carpal bones of that hand with their attachments, also destroying the external condyle of the ulna, and the upper end of the fourth metacarpal bone, and destroying, of course, all the small nerves and blood vessels in that part of the fore

arm.

I saw the wound in less than half an hour after the injury, the patient having been brought hurriedly to my office. Mak.

ing a hurried examination, and finding no great amount of hemorrhage, and noticing that the sides of the wrist containing the large blood vessels and nerves was not badly destroyed, and also taking into consideration that he being a man only thirtythree years old and strong, athletic, and of temperate habits, that there certainly was a fair chance to save the hand. This decision was strongly opposed by nearly every spectator present, of whom there were by this time about twenty-five, many speaking loudly against my foolish conclusion.

Paying no attention to their protestations, I sent for my neighbor and friend, Dr. Matthews. who administered chloroform, and in a few minutes the cleansing process was begun.

It took more than an hour to remove all the fragmentary particles, consisting of bone, muscles, tendons, nerves and blood vessels, charred and blackened and torn as they were.

But by the help of my assistant, and some of the bystanders, I had a rather decent looking wound, large enough to admit three fingers at once.

After thoroughly cleansing the wound with hot carbolized water, I dressed it by placing as large a piece of carbolized gauze in the wound as it would admit, then applied a dressing of the same gauze, with a splint on the front and back sides, and covered the whole with a bandage.

I then placed the patient in my own home that I might the better be able to watch him for a few hours.

He rested very little the first night, except when under the influence of a narcotic.

After redressing the wound, the following morning I sent him to his home, visiting him each day, and dressing the wound as at first. The wound healed very nicely, and gave him very little pain after a day or two, and at the end of the second week had so far healed that I was unable to get the smallest piece of gauze in the opening.

There was never at any time during the healing process a particle of pus present, and at the end of the fourth week the wound was completely healed, and the patient could move his fingers considerably, and in a few months could bend the

wrist some, and use the hand for many things. On the two succeeding springs he was elected township assessor, and did the writing with that hand.

At the present time he has a hand that is quite useful, except for lifting heavy loads, and although about an inch shorter than its mate, yet is called to act many times oftener.

[Written for the MEDICAL BRIEF.] Hypertrophy of the Spleen.

BY ALSEY B. YOUNG, M. D., Brownsville, Tenn,

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This affection, commonly known ague cake, may be considered as the result of, or attendant upon subacute, or chronic inflammation of the spleen, following protracted cases of intermittent or malarial fever.

The size of the spleen varies greatly in these cases. It may be only slightly enlarged in some cases, while in others it is increased to twice its original size, and may become so enlarged as to fill the greater portion of the abdominal cavity.

In these cases we find the patient suffering with a feeling of weight, tension, and distress, with sharp catching pains in the left side on taking active exercise. He is, therefore, frequently unable to take as much exercise as he would like, or as his health would otherwise permit. When the result of malarial influences we also find the patient decidedly cachectic, the skin sallow, wrinkled and dry, urine variable, sometimes scant, at others abundant, bowels irregular, sometimes constipated, at others diarrhea. The patient may have a good appetite, but the food being imperfectly assimilated, his strength is not increased; the nervous system being more or less disturbed, the patient is restless at night, with at times great depression, difficult breathing, and lowness of spirits. With proper management, we can usually assure the patient of recovery in these cases where the enlargement of the spleen is the result of intermittent or malarial fever, but if the splenic enlargement be the original affection with cachectic symptoms depending on it, the prognosis will be unfavorable.

We have many good remedies for the treatment of hypertrophy of the spleen, but I shall only call attention to that of polymnia uvedalia, for if there is any one thing certain in medicine, it is that polymnia exerts a direct influence upon the spleen, and if it were more generally used, doubtless many operations for removal of the spleen might be averted.

We use the specific medicine polymnia internally in doses of five to twenty drops, and have the abdomen over the spleen thoroughly rubbed with the ointment of uvedalia, which should be well basted in with heat.

A recent case of splenic hypertrophy which came to me for treatment, may prove of interest, and serve to illustrate the action of polymnia uvedalia in these

cases.

Mr. McC., aged forty-six; applied to me for treatment, after having suffered for many years from an enormously enlarged spleen, following chills and fever. I found the abdomen protruded to its fullest extent, the spleen filling every available space; and pressed upwards on the thoracic viscera, giving the patient great difficulty in breathing.

I had little hope of the patient's recovery, but decided to try polymnia uvedalia anyway, so I put him on the specific medicine, polymnia internally in tendrop doses four times a day; the dose to be gradually increased to twenty drops; and applied the uvedalia ointment, warm, locally, and well rubbed in over the spleen, night and morning. Under this treatment, the patient began to improve at once, and at the end of two weeks, when he came for more medicine, he said that he felt better, and was more active than he had been for several years.

We continued the treatment, and in three months the spleen was greatly reduced, and the abdomen had almost assumed its normal size, the patient expressing himself as feeling almost entirely well.

I advised him to keep up the treatment, but he moved away shortly after this, and having lost sight of him, I can not say as to the final result of the case. Still due credit should be given to polymnia uvedalia.

[Written for the MEDICAL BRIEF.] Pneumonia.

BY P. M'DONALD, M. D., Grayson, Ga.

Pneumonia, being a prevalent disease at this season of the year, I will give the readers of the BRIEF my experience and success with this much-talked-of malady.

Will say in the outset, that I am not a practitioner of ists, pathys or isms. I believe in the mode that relieves and cures the sick.

Should I find something to-morrow that on sufficient test proves better than my practice to-day, I should not hesitate to adopt it. It strikes me that if the scientific research of the profession was directed more to the treatment, and not so much to the isolation of some little, harmless germ, the mortality in our large cities. would not be on the increase instead of decrease.

Gentlemen, I am a firm believer in the medicinal treatment of pneumonia. In this I mean a cautious, judicial treatment, and I have in my practice a mortality of less than two per cent to back me. Of course, the locality has its weight. I have no doubt that if I lived in some of the larger, crowded cities, where the atmosphere was not laden with oxygen, as it is here, the per cent would be some greater. But I see no need of it being twenty to thirty-five per cent. The main thing I find in pneumonia is to conserve the vital forces, and select the proper remedy. If this is done, your patient will. not need over three or four remedies at the most, and generally two will be sufficient.

Treatment.-The first thing I do when called to see a case of pneumonia is to take in the situation thoroughly, the condition of the bed chamber, the ventilation, and the condition of the patient's stomach and bowels, also the full extent of the disease. If, as is sometimes the case with the poorer classes, the room is open, and fresh air has full sway, I direct to keep room closed as much as possible. If room is tight, I regulate ventilation myself. If the patient's stomach will take food, I give milk, beef tea and gruel or egg albumin regularly. I leave off the calomel

purgation entirely, and if a cathartic is absolutely necessary, give a mild saline. Many times I get along nicely without anything in that line.

Am not much of an advocate of external application, except where we have severe pleuritic pains; then I use libradol or antiphlogistine. In cases where both lungs are involved, it is well to use a large jacket to cover the entire chest, merely to protect it, made of absorbent cotton, held in place with bandages covering the entire chest.

The main part of the treatment is the sedative, and this is the cautious part also.

Pulse small and frequent, constriction of throat with burning of fauces, aconite ten drops to four ounces water; teaspoonful every hour. If pulse is medium, add specific tr. veratrum, fifteen drops, to the aconite.

Pulse full and bounding, pyrexia veratrum fifteen drops to four ounces water; teaspoonful every hour.

Cough, with pain in back and shoulders, extending to occiput, abundant sputa, sticta specific tr. ten drops to four ounces water; teaspoonful every hour. Alternate with your sedative.

Oppressed respiration, diminished expectoration, mucous râles, hypersecretion in bronchioles, feebleness and weakness, ipecac fifteen drops to four ounces water; alternate with your sedative.

Gentlemen, this is one of my pet remedies in pneumonia, and I most always find indication enough to put it in.

Cough, scanty expectoration, moist skin, acute pleuritic pains, asclepias tub., one drachm to four ounces water; teaspoonful every hour.

Full and tense pulse, suppressed hacking cough, with pain in side, respiratory movement restricted, bryonia specific tr. ten drops to four ounces water; teaspoonful every hour.

Bright eyes, contracted pupils, flushed face, determination of blood to the brain, gelsemium specific tr. twenty drops to four ounces water; teaspoonful every hour.

Tongue and mucous membrane purplish in color, breath offensive, sordes on teeth and lips, full abdomen, baptisia ten drops

to four ounces water; teaspoonful every hour.

Dullness, drowsiness, dilated pupils, dull, heavy, aching pain in head, blueness of face and extremities, impaired capillary circulation, belladonna ten drops to four ounces water; teaspoonful every hour.

I combine any two or three of these drugs, and give every hour, alternating with the sedative.

With this collection of drugs at my command, I can most always select a line of treatment that has proven successful in my hands. Watch your patient very closely, see him at least twice every twenty-four hours. Judicious pursuance of these rules, however simple they may seem, will find your patient convalescing from the fifth to the ninth day in the great majority of cases. Then put your patient on a good tonic for two weeks, and it is all over.

[Written for the MEDICAL BRIEF.]

The Ideal Physician.

BY J. A. COX, A. M., M. D.,

Author "Practical Paragraphs for Patients and Physicians," "Practical Problems, Arithmetic and Algebraic," and joint author "The New Arithmetic." Wheeling, W. Va.

In all things terrestrial, we discern what we, at least, style imperfection. It is said that the most perfect apple has in it somewhere a perceptible defect. No individual blade of grass, no forest tree, no bird of the air, no beast of the field, is absolutely perfect, in every sense of the word.

Since, in the physical world, we find imperfection everywhere, so, even in the moral and intellectual worlds do we find deviations from the standard of our ideals. No two wild beasts are exactly alike in ferocity. No two domesticated animals are the same in temperament. No two human beings are identical in disposition.

citizen, does not, of course, in the absolute sense of the term, exist.

Great reform movements often fail, simply because well-meaning, though overzealous, theorists imagine that their ideals of excellency are perfectly attainable. They expect so much that the realization in full of their expectations is practically impossible.

Patients often expect too much of their physician. They can not see why he should fail to cure even incurable conditions. They act towards him as though he should prove himself a veritable miracle worker.

Likewise, physicians may, at times, demand too much of their patients. They may expect absolute perfection in their faith, obedience, and demeanor, whereas, human perfection is, as we have said, unattainable. Whilst absolute perfection in religion, in politics, in society, or in business and professional life, is, in the language of the late Senator Ingalls, an "Iridescent dream," still, we should all strive sincerely to reach, as near as possible, the goal of human perfection-the ideal man, or woman.

Let us then endeavor to picture properly the ideal physician, Let us show some of the signs infallible that mark the physician, who approximates the high standard of perfection.

1. The ideal physician is courteous, kind, considerate, and obliging.

He is a friend, true and tried, both to the rich and to the poor. He prescribes alike to the righteous and to the unrighteous. To all classes and conditions of society he is the same.

He so studies human nature that even the humblest, or vilest among men, may enter his presence without fear or trembling.

In a word, the ideal physician is an ideal gentleman.

2. The ideal physician values the friendship of all reputable physicians. He knows no isms, no schools, no creeds. He does not endeavor to build up a practice by abusing a fellow practitioner. He does not aim to secure patronage by criticizing the line of treatment of a brother physician.

He attends strictly to his own professional work. If he possess real merit, he

relies upon that alone to secure to him, in due time, a full measure of success.

If he possess good common sense, he will not meet abuse with abuse, for he will realize the fact that even just censure will but inure to his rival's welfare. He will know that many a doctor of mediocre ability has been simply slandered into a lucrative practice, while his critics, though, perhaps, men of superior ability, have lapsed into comparative obscurity.

3. The ideal physician is strictly loyal to his patient. He reveals nothing that would, in any way, injure his reputation among men. He would even, if need be, go to prison, rather than, in a court room, disclose a professional secret.

No human frailties are ever commented upon. No shortcomings are ever referred to. No sins of either omission or commission, on the part of the patient, are ever divulged by the truly ideal physician.

4. The ideal physician works unceasingly and unselfishly for the recovery of his patient.

He does not magnify the patient's malady, nor manufacture imaginary ills, in order to secure his patronage. He does not, in any way, retard his restoration in order to extract from him an unnecessary fee. He does not boast of having performed miraculous cures, in order to exploit his own name and fame.

He does not terrify his patient by making grave forecasts as to the final result. On the contrary, he may, indeed, suppress the facts, when a full revelation of the truth would certainly prove disastrous to his patient.

He strives not simply to restore, in the shortest time possible, the body to health and vigor; he aims, moreover, with equal diligence, to guarantee to the sufferer peace and tranquility of mind. His patient's welfare is, indeed, to him of supreme importance.

5. The ideal physician is charitable.

Charity is an attribute of every true physician. In fact, charity is practiced by almost every physician. No other class of professional men so perfectly exhibit in their lives this cardinal virtue.

When friends and kindred fail to comfort and console; when all others have forsaken him, the dying patient can turn