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VOL. XV.

THE MEDICAL SUMMARY,

No. 1

MORE ATTENTION TO THE MANAGEMENT OF FEMALE DISORDERS.

A current professional notion is that if the doctor has the confidence of wife and mother no surer foundation for success is required. Mother and wife, through a chain of pathological sequences growing out of their relations, exercise a definite and controlling influence over the fortunes of the medical man, for from the relations arises a train of evils that demand his counsel and help at every turn.

Deny them attention and impaired usetulness and physical wrecking become a sort of heritage to the woman, and an enduring monument to our stupidity or almost criminal carelessness.

The urgent of wife or mother appeals to our best instincts, and doubles the claim to our active sympathies, and calls for the most devoted ministrations of our art. Our attentions to her wants must be guarded from the extremes of meddlesomeness

and negligence. The vaginal speculum had a "boom;" its friendly aid was invoked on all occasions to throw light on the case, and the cases of ulcerated os uteri needing topical treatment were almost beyond computation. We appreciate the speculum. On the other hand, there has always been a sort of heroic devotion among many practitioners to the vis medicatrix naturas which scarcely needs an instrument of any kind. Defend us from the untranslatable devices of the medical coxcomb. Duty inclines us to heed the tale of woe. Permit skill and delicacy, patiently and perseveringly, to accomplish what may be done to cure the legions of backaches, fallen wombs and ulcerated os uteri.

How can true physicians be content to pass through life and the patient coming up at every step from the wayside vainly asking for relief and receiving none? Yet

it is true, and the world is full of her ailments and practically no well-directed effort made for their alleviation.

To prescribe a box of cathartic or female pills, a bottle of "bitters," a strengthening plaster, does not answer the requirements of professional duty. Treat her as though she were your own wife, mother or dearest friend; correct her displacements, cure her multitudinous ills, or let some one else do it.

Aside from these considerations, success in their path is followed by a harvest of rich reward in pecuniary profits, in the approval of conscience, and not less in grate. ful thanks and praises. Trust nothing to blind credence and idle conjecture, but prove all things.

NEW COINS.

The genuine must have a definite form and bear the stamp of authority, which qualities, however, may be reproduced in the counterfeit, deceiving the closest scrutiny. But there is a quality whose existence is unmistakable proof of genuineness, one which the popular mind has invested with the attribute of infallibility—namely, the ring of the metal.

All new coins appear to be right. See that they have the true ring of a noble metal, or yield the dull saturnine note of the baser sort. Annually the colleges coin hundreds of new M. Ds., new coins, indeed, to swell the circulatory medium or volume; all possess the stamp and inscription of authority, and will be taken as genuine unless proven to be spurious by the crucial test of experience. With the mannerisms, pretensions and credentials of college life, may there be found the gold of true manhood destined to grace the ranks of a great calling.

Therefore let him who approaches the threshold of professional life be endowed, first, with a sense of grave responsibilty,

and, second, with the ring of the true metal, the spirit of an honest, high resolve, born of self-denial, unselfish devotion to the sacred cause of suffering, with freedom from professional intolerance and bigotry, and a zealous aspiration toward the perfect.

Aim to be the pure gold coin of the profession, with the true ring of the metal!

HYPNOTISM.

The popular idea that yielding to the influence of hypnotism may make one a "mental wreck," is not well supported by numerous experiments. It is, however, possible to see how the excitement of being hypnotized, especially in public, might have a secondary effect on the constitution of a young, growing person, and proof has been furnished as sufficient reason why professional hypnotism should not be tolerated in any section of an enlightened country. European governments have taken the initiative in this direction, and it would be well for this country to imitate them.

Hypnotism belongs to the domain of medicine, and its use as a factor for healing-if any good effects at all accrue from its use should be confined to the registered physicians. To have its phenomena exploited on every lecture stage is a mistake that may have many serious results.

Undoubtedly you have cases in practice which would be of interest and importance given in brief to other readers of the SUMMARY. Let us hear from you with a brief. practical article, favorite prescription, or even a therapeutic note from experience will be welcome and acceptable matter for the SUMMARY.

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New Remedies.

In the following we will mention the most import ant new remedies that have been discovered of late, selecting only those whose therapeutical value has been proved, and the administration of which is followed by definite results-therefore, only those that may be relied upon. In a general way their chemical nature, and the sources from which they are derived, as well as the method of manufacture, when known, will also be referred to; their doses will be given, and any obnoxious or dangerous by-effects will be brought prominently to the notice of the reader. Many of the new drugs are so-called proprietary medicines-i. e., their discoverers have secured to themselves the ownership, and in some the exact mode of manufacture is kept secret. For these very reasons we have been the more careful to enumerate only the drugs of recognized value to the profession, such as are being employed by the most eminent members of the fraternity here and abroad, so that the reader may place the fullest confidence in every statement made in

these lines.

Urethan.-Hypnotic pure and simple, especially in children.

By substituting for one of the two hydroxyl groups of carbolic acid the basic Amidrest, and then exchanging the H. atom for organic Radicals (methyl, etc.,) we obtain the ether of carbaminic acid, and all these ethers are known by the generic term of urethans. The formula is exceedingly complicated.

Internally: It has a saltpetre-like taste, and is easily soluble in any medium; the watery solution must be neutral. From 15 to 30 grains pro dosi, it is considered a sure hypnotic, and this dose may be augmented to one drachm without any risk. It is utterly free from all by-effects, and produces the most physiological sleep of any hypnotic, but has no influence on pain.

Strong alkaline medicines with it must be avoided, because of the decomposition of the drug.

It has also proved a splendid antidote in doses of from 60 to 75 grains in cases of poisoning from convulsive poisons, as strychnine, resorcin, picrotoxin, etc.

formerly known by the name of Acetanilid. H2O+C6H5NH (CH3CO).

Antipyretic, anæsthetic and anti-neuralgic. Produces no change in litmus paper.

Internally: Gr. iij to gr. xv (!) dissolved in water or wine, or in pill-form, in typhoid, intermittent fever, pneumonia, pleurisy, puerperal fever, phthisis, to reduce the temperature, and in neuralgia, rheumatism and all kinds of pain, to stop the latter. Well borne by the stomach. It may, however, produce one disagreeable by-effect— cyanosis. Though this generally passes off without danger to the patient, yet care must be taken with the larger doses, or the too frequent repetition of small ones.

Externally: It is also employed as an antiseptic, especially diminishing formation of pus.

Methylalum.-Hypnotic.

Product of a mixtnre of methylalcohol, manganese and concentrated sulphuric acid. CH2OCH3. OCH3 Colorless fluid, of an

aromatic, chloroform-like odor. Does not ignite easily.

Internally, even in small doses, it produces a profound sleep, though that often does not last long. It creates no disturbance. Its effect is remarkable in delirium tremens. Dose from 15 to 80 grains.

Subcutaneously its effect is also rapid, but the injections pain at first.

Externally it acts as a sedative and painremoving remedy. It is here best used in liniments and salves.