Lumbago.

Lumbago is generally considered to be of rheumatic origin. The probability is that its cause is unknown.

The disease seems to be more nearly allied to neuralgia than to rheumatism, and to be in the nerves distributed to the muscles.

Neuralgia.

Neuralgia is a symptom and not a disease. It indicates an impoverished condition of the trunk of the nerve or the nerve center. An impoverished condition of the nerve is induced by a disturbance in its blood supply. The peripheral nerves being distributed to In a depressed condition of the blood-the surface of the body, their circulation may vessels distributed to the muscles, from be affected by slight changes in temperavarious causes, an ischemia takes place in those vessels and the nerves supplied by them are deprived of their normal stimulant and food, and are in a temporary state of anæmia. Some pathologists attribute the disease to accumulation of uric acid in the pelvis of the kidney, but the uric acid treatment does not bear this theory out.

The most successful treatment in this climate is the sulphate of quinine, because it equalizes the circulation and possibly there is a malarial element which is overcome.

Four grains of quinine every four hours. for three or four days usually relieves the trouble. One-tenth of a grain of calomel, given every four hours until the bowels are thoroughly relaxed, is beneficial when the disease proves obstinate. The calomel in such sized doses acts as a stimulant to the secretory and excretory organs. In chronic lumbago, that is, of two or three years' standing, Warner's salicylic acid compound, which contains salicylic acid, tincture of gelsemium, cemicifuga and iodide of potassium, is an excellent remedy. It does not produce nausea nor depression of the circulation as the salicylic acid does alone or in combination with bicarbonate of soda.

One teaspoonful of Warner's compound should be given three times a day in a little water just after meals.

One four-grain dose of quinine at bed-hour with the foregoing treatment is required in some of these cases.

The above treatment has succeeded admirably in some very obstinate cases of lumbago.

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ture or atmospheric pressure. This is evinced by exposure of an arm from under the covers during the night, or a draught of air on an exposed part of the body for a time is liable to bring on neuralgia the next day or severe cold.

Some forms of neuralgia are toxæmic. Ptomaines and leucomaines pass through the liver and enter the blood stream, and irritate the nerve structures in their centers, and neuralgia is the result-toxine neuralgia.

Another constitutional form is caused from defective food supply to the blood. The food may be taken into the stomach, but not being properly prepared by stomach and intestinal digestion, when it is thrown into the circulation it will not be appropriated by the tissues. The elements destined for the nerve food are diverted to some other channel through this imperfect metamorphosis.

The treatment is through improved nutrition. Here the chemistry of nutrition must be studied. Each case is a law unto itself. The fault is often in the albuminoids not being assimilated. This is shown by local expressions of pain. In fleshy, anæmic, neuralgic patients the probability is they eat too much of the carbohydrates and an insufficient amount of the albuminoids. Such patients should have the latter increased and the former diminished.

TETANUS in a child was treated by Celli with nine hypodermic injections, each containing five centigrams of corrosive sublimate. At the end of a week the child was well.

Homeopathy and the World's Fair.

ULTSMAN diagnoses vesical from renal hemorrhage by washing out the bladder, then injecting twelve and a half ounces of a The homeopaths are going to the World's one and one-half per cent. solution of iodide Fair. In New York they propose to go of potassium. In fifteen minutes he exthrough the records of vital statistics and amines the saliva for iodine. If it is found obtain the ratio of mortality under homeo- there must be epithelial defects in the pathic treatment as compared with that bladder, i. e., the hemorrhage as well as the under regular treatment. Should they find absorption must have taken place in the the result of their investigations favorable, bladder, as intact vesical mucous membrane it is their intention to use it as an advertis- is not capable of absorption.

DRS. PARISH and A. M. PHELPS, of New York, during the past year have made operations for tendon anastomosis in cases of infantile paralysis with success. In Dr. Parish's case the tendon of the paralyzed extensor pollicis was joined to the tendon of the healthy anterior tibial muscle. In Dr. Phelps' case the tendon of the paralyzed gastrocnemeus and soleus was joined to the healthy long flexor of the toes. The junction was made with cat-gut sutures and the wounds closed without drainage. In both cases a marked gain was made in the use of limb.

FROM recent reprints received, in which the subject of surgical treatment of cancer of the rectum is discussed by two men, eminent in rectal surgery, it appears that while

colotomy is the permissible procedure in the vast majority of cases, excision is the ideal access through the sphincter, i. e., not more operation. When the cancer is within easy than three inches above, and has not extensively infiltrated the adjacent tissues.

SURGICAL tuberculosis and lupus are treated by Landerer with cinnamic acid, one part; cocaine hydrochl., one part; alcohol, twenty parts. Of the above, one or two minims are injected about each nodule. The results were in forty-five cases: Thirtyone cured, seven improved, one not improved, and two deaths.

IN cardiac disease, where there is a relaxation of the vaso-motor system and digitalis has its characteristic effect on the heart without corresponding effect on the vasomotor system, small doses of belladonna or atropine can be added with good effect.

ANTIPYRIN, acetanelid and similar compounds should be given very cautiously for the relief of pain in persons about to be exposed to cold; not that they reduce normal bodily temperature, for it has been shown that CHLORIDE of ethel should be very cautiously they do not, but because of their influence are used in producing local anesthesia about the capable of decreasing the production of face, for should it be inhaled it is liable to animal heat by rendering the vaso-motor produce alarming symptoms, such as lividity system less active in adjusting itself to the and difficult breathing. Over-freezing with circumstances with which it is surrounded. it, too, will produce a dermititis.

2. Are Certain Conditions of the TurbiThe first session will begin Wednesday nate Bodies Normal?-C. H. Guibor, M.D., evening at 8 o'clock.

7. The Physical Examination of a Patient nate.

This condition continued for one

prior to Operating on the Eye.-R. S. Magee, year, when he passed about one hundred M.D., Topeka, Kas.

8. A Paper.-B. E. Fryer, M.D., Kansas City, Mo.

feet of tapeworm.

During the year following the expulsion of the tapeworm, his health remained fairly 9. Cataract.-F. B. Tiffany, M.D., Kansas good, but he never recovered entirely. About City, Mo. two years ago his health declined rapidly.

10. A Paper.-W. C. Tyree, M. D., Kansas He was examined by a number of physicians City, Mo.

Volunteer Papers.

Reports of Cases.

Invited Papers.

GYNECOLOGY.

1. Address—Resume of the Gynecological Surgery.-Chairman J. P. Lewis, M.D. 2. Rupture of the Uterus.-L. Reynolds,

M.D., Horton, Kas.

and different opinions were given as to the cause of health failure. He called on me April 14, 1893. The following symptoms presented:

Emaciation, marked hyperæsthesia of the right and left iliac regions and in the whole body. He complained of pain in the

stomach. His stools were free and loose,

and mixed with mucus. In fact, it proved to be intestinal catarrh. The patient was 3. Abdominal Hysterectomy and Hystero- despondent and melancholic: The conjuncmyomectomy-Indications and Technique.tiva was muddy in appearance and the skin

M. B. Ward, M.D., Topeka, Kas.

4. The Erect Posture for Gynecological Examinations.-W. B. Dewees, M.D., Salina,

Kas.

traction of the liver and fæcal masses in the was sallow. Percussion showed slight conintestines. The examination of the abdomen and intestines was made under anæs

5. Septic Conditions following Child-thetic (given by Dr. J. C. McClintock) because birth.-J. E. Oldham, M.D., Wichita, Kas. of the rigidity, tenderness and hyperesthesia 6. Dysmenorrhoea and Relief.-Deborah of the abdominal muscles. K. Longshore, M.D., Topeka, Kas.

7. A Paper.-Geo. Emerson, M.D., Win-walls there was no more tenderness or soreAfter the manipulation of the abdominal

field, Kas.

8. Mastitis and its Treatment.-M. R. Mitchell, M.D., Topeka, Kas.

9. Difficulties Encountered in Abdominal and Pelvic Surgery-How to treat them. A. H. Cordier, M.D., Kansas City, Mo.

10. Puerperal Peritonitis surgically considered.-J. W. Felty, Abilene, Kas.

ness complained of than before.

The next morning after the examination the contents of the stomach were withdrawn the patient was given a test breakfast and

two hours after the food was taken, and examined. After the food was removed, measurement was made of the stomach, and it held six quarts of water without pain to the patient. Examination of the contents of the stomach showed the presence of free hydrochloric acid. While the presence of free hydrochloric acid does not preclude Secretary malignant disease, it is a factor against it.

Railroads in Kansas have been asked to make one and one-third fare for round trip on the usual certificate plan. G. C. PURDUE, M.D.,

A Case.

The iodide test proved that absorption of the stomach was practically nil. The salol test showed intestinal absorption fairly good. Diagnosis. -Atonic dilatation of the

BY S. G. STEWART, M.D., TOPEKA, KANSAS. Stomach with probable cirrhosis of liver.

Mr. J. E. R., age fifty-seven, German American. Four years ago he began to fail in health, although his appetite was inordi

Mal-nutrition due to the above condition.

Prognosis. For life good recovery. A fair degree of health may be enjoyed by strict diet, which should be in the main a

dry diet. The stomach should be washed times. On this account and also because out once a day to prevent abnormal fermenta- many physicians when examining the case tion and decomposition of the food. disagreed with me in diagnosis, I wish to make public the final results.

Medicinal Treatment.-Strychnia, the digestive ferments as they may be indicated. Owing to the inactive state of the liver, fel bovis inspis.

Patient died at 1:45 P. M., March 11, 1893. March 12, at 9:30 A. M., I held the autopsy. There were present Drs. Phillips and Lane, of Leavenworth City; Drs. McGill and Walsh, of the Home.

Hygienic Measures.-Bathing, friction of entire body, passive exercise in the open air, in carriage, etc. The dilatation of the stomach is perma- body with rigor mortis complete; a tumor

nent.

For convenience we herewith append the iodide test. Ten grains of iodide of potassium should be given in a capsule. The iodine will appear in the saliva in half an hour, as shown by the starch test paper in the saliva, turning it blue.

External inspection showed an emaciated

three inches in diameter, two inches to the right of the center of the sternum and in the situation of the third and fourth ribs.

On opening the chest and raising the sternum and costal cartilages, a tumor measuring six and one-half inches in its greatest diameter was found to the right of In the case reported the reaction did not the median line, the center of the tumor take place at all. The salol test indicates resting about the situation of the third interthe absorptive power of the intestines. Five space. The lower lobe of the left lung was grains of salol given will be detected in the partially hepatized; the right lung was urine within an hour after taken, as shown pushed upwards and outwards, and consoliby the addition of a drop of the ferric dated throughout the greater portion of its chloride in the urine, giving the violet color extent. On attempting to open the perireaction. cardium it was found to be entirely obliterated, the parietal and visceral portions being firmly adherent.

I was assisted in the examination of this case by Dr. J. C. McClintock, and he agreed with me in the diagnosis made.

Autopsy in a Case of Aneurism.

BY O. C. M'NARY, M.D., SOLDIERS'

LEAVENWORTH, KANSAS.

On examining the tumor, it was found to be an aneurism, originating from the right side of the ascending aorta, beginning about one inch above the semi-lunar valves and continuing up to and including part of the HOME, transverse portion of the arch. That portion of the aorta between the semi-lunar valves and the aneurism, and the portion of the arch between the aneurism and the descending aorta were also enlarged to two inches in diameter. Lying in the anterior part of the sack and partially agglutinated to the wall was a firm antimortem clot, measuring three inches in diameter and onehalf inch in thickness. The capacity of the sac, exclusive of the enlarged portions of the vessel (above spoken of) was twentyfour (24) ounces.

On the eighth day of September, 1888, James M, age forty-five, was admitted to the Hospital of the National Military Home, Leavenworth, Kansas, and at once came under my care. Idiagnosed "aneurism of the ascending portion of the arch of the aorta."

In January following, I reported the case along with five others to the Leavenworth Medical Society, and again on July 8, 1890, I exhibited the case in a clinic before the The tumor had been so firmly adherent Eastern Kansas Medical Society, together to the chest wall in front that its anterior with a case of aneurism of the abdominal wall was in reality the chest wall itself. The case has also been seen by many The third and fourth ribs in this situation physicians visiting the hospital at different were almost entirely absorbed, so that in at

aorta.