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are obtained after a change of climate, when the persons are under medical supervision as to exercise, diet, etc.

AXIOM V. They should be out of doors as much as possible in the sunshine, and busy at something.

Sunshine has much to do with the cure of consumption. Where the shade temperature is nearly 60°, as on the seacoast, it is especially important to keep in the sun. The shade extracts the already deficient caloric and lowers the vitality of the consumptive. To be busy at some employment that will keep the patient in the sun is the great need. "Cowboy" life and fruit raising have been wonderfully beneficial. The great object is to divert the mind from self and not to overdo mild outdoor employment.

AXIOM VI." Consumptives cured by climate may not be able to return to their former place of residence to remain with safety." Experience has proved that in many cases where the disease has been arrested by climate and treatment, it may again become active, if the person returns to where the disease originated. The second enkindling of the disease is often more difficult to subdue because the person is weaker, and, second, because the hope is not so buoyant. A short trip home may not be dangerous, but "get into business and remain" is the advice that should be heeded.

AXIOM VII. Consumption being hereditary, children, whose parents have succumbed to it, should not be allowed to grow up subject to the same climatic conditions that developed the disease which swept off the former generation.

AXIOM VIII. -"The change to the southwest (south and west) has given the best results in the largest number of cases of lung diseases."

"The great question among Eastern physicians and Eastern people is where to send consumptives. Minnesota, which was the resort twenty years ago, has been disappointing, except to a few and at certain seasons. The Pacific Coast and Florida have also been disappointing except for certain cases. There is too much moisture. And the eyes of all have been turned to the southwest."

WHITE OF EGG IN THE TREATMENT OF SORE NIPPLES.-F. Van Allen, M.D., writes to the New York Medical Journal of three cases in which he found white of egg painted on sore nipples several times a day entirely healed them in a few hours.

The albumen may best be applied just after nursing, while the nipple is still moist from the baby's mouth. As somewhat of a thick film is formed, it is well for the nipple to be moistened with a soft cloth dipped in water just before the baby is again put to the breast. The efficiency of the albumen is heightened by allowing it to dry on thoroughly before drawing the clothes again over the breast. - Ex.

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A CASE OF NICOTINE POISONING.

BY GEORGE P. SWORD, M.D., WORCESTER, MASS.

[Read before the Worcester County Homœopathic Medical Society.]

Two years ago, Mr. P―, an intimate friend, came to make me a visit of a few days, and, as he expressed it, his last visit. He felt certain he could live but a short time, and if he must suffer as he had been suffering, he did not care how soon the end came.

His business had been, up to about ten years ago, buying and selling tobacco. Since he retired he has been farming for pleasure.

In conversation he gave me the following history. Age, 58; height, 6 ft.; usual weight, from 175 to 190 lbs., but at that time 140 lbs. Had had but one sickness and that about twenty years ago. He said with the exception of now and then a “bilious turn," had never had any trouble until the previous March, when he was taken while walking on Main street, in Springfield, suddenly very sick. Could not describe his first feelings, but in a few minutes everything began to whirl, and if he had not succeeded in getting hold of a post would have fallen. This lasted from fifteen to twenty minutes before the dizziness passed off. When it did it left him in a very weak condition, but as soon as he was able to walk he went to a friend's office, where he remained several hours. He said his heart felt as though it had stopped beating, and he was cold. On his arrival home they immediately sent for the doctor. He pronounced it biliousness complicated with malaria, and not being one addicted to the use of "sugar pills," he gave him a "blue" pill instead, and quinine. This treatment he thought would bring him out all right in a few days, but we are all subject to disappointments, and so it proved in this case; for instead of his getting better he grew worse, and in a few days another one of these violent ill turns made its appearance. This was followed by more pronounced weakness than the first. Again the doctor was called. He now being fully convinced his diagnosis was correct, ordered the same treatment continued with the addition of an infusion of thoroughwort, and he ordered larger doses repeated oftener. By this time the patient was unable to walk more than a short distance; said his legs would not go, they seemed to give out. Could not go up stairs without sitting down on account of his heart "pounding" so. Said it felt to him as though it was trying to pump itself out. Could not or did not dare to eat much, because the food seemed to lie in the stomach undigested. Up to this time he had been sleeping fairly well, but now he began not to sleep. He said when he would lie down his heart would

beat so hard, he had to sit up. Then he began to be nervous, could not bear to see anybody. Did not care to talk to anyone. All he wanted was to be left alone. Tired of the sight of home surroundings and fully satisfied he had to die, and with the urgent request of his faithful doctor, he decided to see if change of scene would not rouse him from that state of gloomy anticipation, irresolution, and low spirits. While giving the history of what he passed through, and was passing through, I think he smoked as many as four cigars, if not more. When I said to him, "you smoke a good deal," his answer was, "Yes it is the only comfort I have, and when I get so nervous I must fly I find solace in my cigar." He said he had used the weed for thirty years and had been so faithful to it that when he was not smoking, he was chewing.

On examination of his pulse, I found it to be feeble, irregular, and intermittent. I found the heart's action irregular and rapid, and he complained of very distressing palpitations. I also noticed a peculiar twitching of the orbicular muscle of the eye, and in fact there seemed to be a tremor of the muscles of both the upper and lower extremities. There was marked contraction of the pupil. On examination of his throat, I found what appeared to me to be a congested condition of the mouth and fauces. The throat seemed to be swollen, and I could see what I should say were congested veins all over it. There was also increased amount of saliva. He said he wanted to spit all the time. Respirations were short, quick and anxious in character. There was a peculiar dark condition of the skin, and the hands. presented a cold, clammy feeling to the touch. The whole picture was one of nicotine poisoning.

When I told him I thought if he would only give up his smoking he would come out all right, he grew almost insanely excited. "Why, doctor," said he, "My tobacco is the only comfort, in this life, that I have; and I can't believe that is the trouble!" So sure was I that it was at the bottom of his whole trouble, I told him I was going to have a brother physician come in and see him; so I called in Dr. Warren, and he also told him he thought the tobacco was the cause of most of his trouble. He then wanted to know if he must stop smoking. I told him if he would, that I believed within a year he would be well. The same old story; he could not live without it; but finally he said he would use but three cigars a day, one morning, noon and night. So I gave him ignatia to take, and he smoked his three cigars. The following day he went back home, told his doctor what was said to him, and what he had agreed to do. I am afraid the encouragement he received was not just what he wanted, for he told me the doctor said he had thought of nico

tine, but felt sure that malaria was the real cause of the mischief, and thought if he would only go to the salt water for two or three months he would be all right. He went, but only to return no better, but in fact, worse. He then wrote me and said, if I would send him some "little pills," he would stop smoking. I did so, and within six weeks he wrote, he wanted more pills, and that he thought he was somewhat better. From that time on, he has been steadily improving, and to-day he says, "I can once more sleep and feel refreshed when I awake." He weighs over 180 lbs., can now walk as well as ever either up stairs or down, and with the exception of a weakened stomach, he says he is as well as ever he was.

I think that none here will doubt that nicotine was the cause of this man's suffering, and his case is, I believe, only an example of hundreds of cases which come under physicians' care every day, only, as it was in this case, they are treated for dyspepsia or other troubles secondary to the real cause.

[Continued from Dec. No.]

THE SURGICAL CLINICS OF THE MASSACHUSETTS HOMEOPATHIC HOSPITAL.

SERVICE OF NATHANIEL W. EMERSON, M. D.-FOR QUARTER ENDING SEPTEMBER 30TH, 1891.

MAMMARY TUMORS.

There were but three breast cases operated upon, although several others presented themselves in which operations were not advised. The dry method was employed, hemorrhage being controlled by pressure and packing with gauze, and as few arteries as possible were ligated. These cases were as carefully rendered aseptic by preparation the day before the operation as if they were laparotomies. In case two no drainage tube was used, and case one would have done as well without the tube. Case three was an unfavorable one, and the return of the growth is expected; the operation will, however, comfortably prolong life for several months.*

CASE I. Mrs. G―; age, 26. Admitted July 14th. Diagnosis, cysto-ademoma mammæ.

Had been generally well until the birth of her last child, several weeks ago, since which time she had been "tired and

* Nov. 12th. Case III. seen to-day, and the wound is entirely healed, with no appearance of return. There is no pain, although the arm is almost useless from the shoulder to the elbow, because of the mutilation of the shoulder muscles.

weak." Has not nursed her baby because of a growth in her right breast which appeared about sixteen months ago. It was circumscribed, movable, about as large as a small orange, and had caused her no discomfort. Indistinct fluctuation could be determined at one point. The glands were not involved.

July 15th. Patient was etherized. The tumor was found to be a cysto-adenoma, and the entire breast was removed. On the fifth day the wound was dressed. There had been considerable oozing, the bone drainage tube had collapsed, and the wound was healed, except at the point where the tube had been brought out through the lower flap.

July 23rd. The wound was entirely healed and the patient was discharged on the 28th.

CASE II. Mrs. Mrs.; age, 59. Admitted Sept. 15th. Diagnosis, cysto-adenoma mammæ.

Two years ago first noticed left breast was a little sensitive, and upon pressure there was a slightly bloody discharge from the nipple. Eighteen months ago a small nodule appeared on the sternal side of the breast, which gradually increased in size, and was somewhat painful. At present time it is movable, circumscribed, only involves the inner side of the breast, is about as large as a goose-egg, and non-sensitive. Family history good. The glands are not involved.

Sept. 16th. The patient was etherized, and the tumor, with the inner half of the breast and nipple, were removed. The wound was closed with catgut and silk-worm-gut without drainage. The tumor was a cysto-adenoma. The wound was dressed on the sixth day, found healed, and she was discharged on the tenth day.

CASE III. Mrs. W; age, 40. Admitted Sept. 18th. Diagnosis, carcinoma mammæ.

Two months after the birth of a child, in May, '90, she first noticed a small bunch in the left breast: this grew slowly, was painless, and gave her very little discomfort. In December last it was aspirated, and one-half pint of colorless fluid was withdrawn. The aspiration was repeated three times at short intervals, after which the tumor broke down and discharged. In June the breast was amputated, silk was used for ligatures, and the latter were left dependent from the wound. Ten days ago, when the patient first presented herself here, the ligatures still remained, and were removed by the attending surgeon, leaving

a fistulous tract.

When examined, there was an extensive growth, involving the pectoral muscles, and extending as a solid tumor high up in the

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