NLM 0510=1440 2 NATIONAL LIBRARY OF MEDICINE ARMY MEDICAL LIBRARY FOUNDED 1836 MM \* aa 2 grains. Carbolic acid, ) Fluid extract hydrastis, 15 minims. These bougies are introduced by means of a special carrier, and are perhaps most useful when the pa- tient is himself compelled to continue his treatment. - 85 - Occasionally the prostatic dilator (Fig. 8) will be of service. It has seemed to me to accomplish its good effect by mechanically emptying the diseased follicles of their contents, and thus allowing the instillation, which should always follow the dilatation, to gain access to every part of the mucous membrane. This is a means of treat- ment which should not be repeated more than once in ten days, and which should be practiced with caution. Stretching should not be less than 36 of the French scale, nor more than 44. Full dilatation of the prostatic urethra by means of the steel sound is impos- sible, since an instrument sufficiently large to overstretch the membranous urethra fits loosely in the physiologi- cally wider prostatic portion of the tube. Gross and others hold that blis- ters to the perineum are extremely val- uable. Personally I have never seen marked beneficial effects follow their use. They often occasion considerable inconvenience or even actual suffering. A milder form of counter-irritation, such as that secured by dint of painting the perineum with tr. iodine 5 ss, tr. bella- donna 1 iss, is distinctly serviceable. — 86 — Electricity is often of service. The proper current for any individual case cannot be formulated. The galvanic current, one pole applied to the lumbar spine, the other to the prostatic urethra by means of a properly arranged urethral electrode, is perhaps most popular. I have, however, in some cases, particu- * larly in those where coincident with prostatorrhcea there was a very marked failure of sexual power, seen much more rapid effects from the faradic current. In nearly all'cases sexual intercourse must be interdicted. When the disease occurs as the result of over-indulgence upon the part of married men, after a brief period of abstinence moderate intercourse may be allowed, since total prohibition may keep the patient in a condition of prolonged and ungratified sexual excitement. This, however, must be deter- mined by the effect produced by intercourse. If this aggravates the discharge, and particularly if it is fol- lowed by lassitude and lumbar pains, it must be for- bidden absolutely. In the majority of cases recovery will follow in from one to three months; sometimes a much longer period is required. In some cases local treatment appears to be dis- tinctly aggravating. Here it is advisable, if the patient's circumstances are such as to allow it, to make a complete change in the mode of life. A prolonged vacation spent in travel or in camping out, or on a shooting expedition, will sometimes cure a case which has obstinately resisted local and general treatment. INVOLUNTARY SEMINAL EMISSIONS. Involuntary seminal emissions, though properly classed with the symptoms of atonic impotence, as- sume such an importance in the eyes of patients and appear in such varying clinical forms that they require detailed consideration. Cases suffering from seminal emissions will com- plain of symptoms corresponding to the following classification: i. Nocturnal pollution, the result of lascivious dreams or a local hyperaesthesia so marked that stimuli too feeble to produce any effect in health are sufficient to excite ejaculation of semen. Usually attended with vigorous erection and voluptuous sensa- tion. 2. Diurnal pollution, the result of impure thoughts or of a peripheral irritation too feeble to excite emis- sion in a healthy man. Usually attended with feeble erection, or at least one which quickly subsides, and with blunted voluptuous sensation. 3. Spermatorrhoea, a condition in which the semen oozes from the meatus without erection and without pleasurable sensation. This loss may be due to im- pure thoughts, or may occur quite independently of appreciable psychical or physical stimulus—the dis- charge flowing, as in prostatorrhoea, after micturition and during defecation. — 88 — Nocturnal pollution.—An occasional emission dur- ing sleep, once every two weeks for instance, is, in a continent man, no sign of undue irritability of the sexual organs; indeed, it is rather to be desired, since it disposes of an accumulated secretion the presence of which is liable to excite disturbing' reflexes. In healthy young men who lead idle lives and who are subjected to venereal excitement, these pollutions may occur much more frequently—two or three times a week—and yet indicate no abnormal local condition. It is not uncommon to find healthy men who, having had no pollution for many weeks, yet after prolonged physical exertion, such as is required in an all-day hunt or a long walk, or even without apparent cause experience several emissions in a single night. Those who work hard, who sleep and eat sparingly, and who are not exposed to sexual excitement, may be conti- nent for months or years without a single emission. Nocturnal pollutions can only be considered as indications of seminal weakness when they are unduly frequent, are followed by lassitude and mental de- pression, and particularly when they are associated with partial or complete impotence. If such emissions persistently occur three or four times a week, when the surroundings of the pa- tient are such that he is not exposed to prolonged sex- ual excitement, and if there is a lessening of physical strength, a sense of fatigue, a disinclination for mental effort, it is quite certain that there is an asthenic con- * - 89 - dition of the ejaculation centre brought about reflexly or dependent upon systemic causes. These unduly frequent nocturnal pollutions are often associated with full sexual vigor. If uncor- rected, however, the erethism of the ejaculatory centre becomes more marked, and there is developed a more or less pronounced form of sexual weakness. Diurnal pollutions, or ejaculations as a result of slight psychical or local stimulation, may occur from embracing a woman or even being in the same room with her, from friction of the garments incident to horseback riding, from the titillation of a shower bath. Indeed, any slight irritation applied to the penis may be sufficient to excite immediate ejacula- tion. I saw one man in whom the act of retracting the prepuce for the purpose of cleanliness invariably excited ejaculation; the passage of a meatus bougie caused the same result. In another case a digital ex- amination of enlarged inguinal glands was sufficient to excite a semi-erection and an ejaculation. The reading of lascivious literature, the hearing of lewd stories, or the simple imaginings of sexual relations, are sufficient to excite an orgasm. The erections when this condition of erethism is developed are usually feeble; exceptionally they are vigorous, but subside promptly when emission has taken place. Spermatorrhoea.—The erection and emission cen- tres, though distinct from each other, are so closely related physiologically that erethism and adynamia — 9° — of one imply a like condition of the other; hence in the most aggravated form of sexual weakness the semen is discharged without pleasurable sensation and without erection, oozing from the urethra, instead of being ejaculated by rhythmic muscular contraction. This oozing may occur as a result of sexual excite- ment or local irritation. The sight of a woman may cause it, or it may be due to the jolting of a wagon or to intentional friction. The following case sent me from the country well illustrates this phase of seminal weakness: A. B., aet. 26, masturbated furiously when sixteen years of age; this he continued for one year, then stopped entirely. Following his excess in this direc- tion, he was troubled with frequent nocturnal pollu- tions—three or four a week. This continued for some years, when he began to notice that attempts at inter- course were not satisfactory, erection was imperfect and ejaculation premature. In the last year, seeing or touching a lewd woman at once excited an emis- sion, unattended with pleasurable sensations and with- out erection. There was no discharge from the penis after urination or defecation, no stricture, nothing ab- normal except a very small penis. He stated that his morning erections were vigorous. This last statement in regard to the morning erection, if true, offers an exception to the general rule, for, as such cases belong to the paralytic type, the erection centre and the muscles innervated by it, and the plexuses anasto- — 9I — mosing with it, are too much exhausted to react fully to the irritation of a full bladder. This patient, under rectal douches, bougies, pos- terior instillations, and tonic treatment, recovered suf- ficiently to break through the strict order in regard to chastity and fornicate repeatedly. This act he was able to accomplish, but from constant trials of his strength did not regain full power. Spermatorrhoea, in the sense of a constant flow of semen from the urethra after urination, during defecation, and at odd times, spermatozoa also being found in the urine, is very rare. Exceptionally a vig- orous man, who has been given to masturbation or excessive fornication, and who stops suddenly, will, in place of frequent nocturnal pollutions, be troubled with mucous discharge which on examination will be found to contain many spermatozoa; this represents an overflow from the seminal vesicles, due no doubt to temporary paresis of the muscular fibres of their ejaculatory ducts. It is, however, not associated with loss of virile power, and though observed in those who exhibit a mild degree of sexual hypochondriasis, it is a condition which under appropriate treatment promptly subsides. I have seen but one case of true spermator- rhoea. This was as follows: A. B., clerk, aged 32, addicted to masturbation for twelve years; has never had connection with a woman, and feels for women no natural desires. During the last two years he has had a constant run- — 92 — ning from the penis, aggravated on urination and defecation. He has frequent nocturnal pollutions; these do not wake him, and he is only aware of them from finding the stains on his garments. During defecation (especially if he is slightly constipated) the discharge is pronounced, has a seminal odor, and slightly pleasurable sensations are experienced during its flow. This discharge runs from the penis in drops without erection. Four years ago the patient noticed that morning erections were absent and priapism did not result from libidinous thoughts. Later, in the last two years, libidinous thoughts caused running of sperm-like fluid from the penis without marked pleas- urable sensations. For the last year he has had no erection. Friction of the glans produced discharge of a whitish fluid. The patient was in appearance a typical mastur- bator. He was small, emaciated, hollow-chested, thin-necked, weak-kneed, shambling in his gait, care- less in his dress and person. In his deep-set eyes rested the shadow of despair. His pale, hollow cheeks, and general expression of moral abasement, were suf- ficiently indicative of the practice which had brought him to this condition. His penis and testicles were unusually small. The penis was cold, shriveled, and almost cartilaginous in its density. Examination of his urine showed large quantities of spermatozoa and oxalates in abundance. The fluid discharged during stool and after urination was swarming with sperma- — 93 — tozoa. He complained of all the various reflexes with which these patients are afflicted: headache, loss of memory, tinnitus aurium, bad taste in the mouth, wind on the stomach, obstinate constipation, palpitation of the heart, shortness of breath, colicky pains, backache, uncontrollable restlessness, pains in the hypogastrium running down the thighs, burning in the anus, etc. Application of the porte caustique to his prostatic urethra stopped his discharge. He was lost sight of, however, before any return of sexual power was noted. The causes of involuntary seminal emissions are the same as those which excite catarrh of the poste- rior urethra and prostatorrhoea. The lesion produced is in the first place hyperaemia or inflammation of the prostatic urethra. This leads to hypersensitiveness of the erectile and ejaculatory centres, followed by ady- namia, or exhaustion. Of the most frequent causes may be mentioned prolonged and ungratified sexual excitement, masturbation and sexual excess, gonor- rhoeal inflammation, exhaustion from overwork, anx- iety or grief; or constitutional conditions, such as acute fevers or consumption in its early stages; or- ganic lesions of the central nervous system, such as are observed in bulbar paralysis; the abuse of drugs, such as alcohol and opium; reflex irritation from the penis, such as that due to phimosis or herpes of the prepuce, or narrow meatus; reflexes from the anus and rectum, such as are dependent on fissures, piles, polypi, or irritation incident to worms or to skin erup- tions or obstinate constipation. — 94 — The diagnosis of spermatorrhoea must be founded on microscopic examination. If the sperm-like dis- charge which flows during defecation, after urination, and at other times, on repeated examination is found to contain a few spermatozoa, never in great numbers, it may be concluded that the case is one of prostator- rhoea. If, however, spermatozoa are very numerous in this discharge, and are nearly always found, the case is one of spermatorrhoea. However, the differ- ential diagnosis is not very important, since the treat- ment of the aggravated forms of both affections is much the same. The prognosis in these cases is fairly good when there is no organic lesion of the central nervous sys- tem, and when the patient still possesses determina- tion enough to help the physician. Some cases improve rapidly under very simple treatment, particularly that directed to subduing the hypersensitiveness of the prostatic urethra. Others, however, yield not at all; in these cases it is possible that the centres are per- manently injured or that changes have taken place in the secreting and excreting apparatus too gross to be repaired. The treatment of nocturnal pollutions must be partly psychical. The great majority of patients consulting physicians in regard to this condition, have in reality emissions not oftener than is consist- ent with perfect health. From reading misleading literature, however, the patient fancies that the loss — 95 — is producing a disastrous drain on his system, and is apt to suffer from symptoms which he judges would be commensurate with this loss. The physiology of such pollutions should be clearly explained; the life should be-regulated according to hygienic principles; the patient should be cautioned against thoughts of a libidinous nature, against everything which is liable to cause sexual excitement. He should have his bowels opened at night before retiring, either by cold enema, or by means of salts taken during the day, until the habit of evacuation at this time is acquired. He should sleep on a rather hard bed, lightly covered. He should avoid sleeping on his back—and this may be managed by securing a band about the waist con- taining a block so placed that it presses on the spine when the patient assumes the dorsal decubitus; thus sleep is disturbed. Furthermore the patient should train himself to wake once during the night and empty his bladder, and before retiring should prac- tice light calisthenic exercises and take a cold or cool sponge bath. When, in spite of these precautions, erections and emissions occur, the patient may adjust a ring to the penis, so arranged that when this organ becomes congested the sharp teeth with which the outer band is set around press upon the skin and disturb sleep. (See Fig. 9.) All sources of reflex irritation must be carefully sought for and removed; thus the rectum should be — 96 — examined for fissure and haemorrhoids. The possibility of ascarides must be considered. In cases of phimosis, circumcision should be performed. Narrowings of the meatus must be cut; strictures further back must be divided or dilated; hyperaesthesia or hyperaemia of the prostatic urethra must receive the treatment de- scribed in discussing atonic impotence. Varicocele or hydrocele, if present, should be cured. Fig. 9.—Pollution Ring. Though the local treatment is perhaps of prime importance, general treatment must not be neglected. When the nocturnal pollutions are very frequent, bromide should be administered in full doses, 30 to 90 grains at bedtime. Bartholow particularly recom- mends the mixture of this drug with the fluid extract of gelsemium in 10-drop doses. Atropine, ^ig- grain, three times daily, with twice this quantity given at bedtime: Hyoscine, ^ to y^ grain, at night: Lupulin, 20 grains, three times a day: Monobro- mate of camphor (warmly commended by Hare), 5 grains in pill form, three times a day: Antipyrin, 15 grains, three times a day. Each of these drugs — 97 — may, in individual cases, serve as a powerful aux- iliary in accomplishing a cure. In the cases which have progressed to the point of diurnal pollutions, local treatment is of special im- portance. In addition to the posterior instillations, and the solid stick of silver nitrate applied by the Fig. io.—Porte Caustique. porte caustique (Fig. io), the patient should receive hot rectal douches, the hot and cold needle-spray to the external genitalia, perineum, and lumbar region, and the galvanic and faradic currents over the lumbar spine, in the rectum, and in the prostatic urethra. The first effect of electricity is to aggravate symptoms; shortly improvement sets in, and is gener- ally marked. Of the drugs to be employed in the paralytic form of seminal incontinence, those should be chosen which tend to restore tone to the weakened muscles and to revitalize the exhausted lumbar centres. Among the drugs which have been found most effica- cious are the following—the dose named is that appro- priate to each administration when the medicine is ordered to be taken three times a day: Strychnia, Jg- grain; or, in combination as found in the com- 7 -9«- pound syrup of the hypophosphites, a teaspoonful: Fluid extract of ergot, a teaspoonful: Arsenious acid, b*6 t0 iV grain: Extract of damiana, 3 to 5 grains: Phosphorus, ^ grain. IMPOTENCE OF THE FEMALE. If we adopt the same classification as was ob- served in discussing impotence and sexual weakness in the male, this affection as observed in the female must be limited to cases of malformation either hereditary or acquired, to obstruction from new growths, and to muscular spasm—since, in the case of a woman, performance of the sexual act, at least in so far as her partner is concerned, requires only the presence of a sufficiently long and patulous mucous canal. From the standpoint of the woman, however, fail- ure to experience an orgasm, after what may be re- garded as sufficient mechanical stimulus, represents a common form of impotence. Impotence in the female may be classified under the following heads: i. Intromission of the male organ is impossible. 2. Intromission is possible, but causes extreme pain. 3. Intromission is possible, and does not occasion pain, but the mechanical and psychical stimulus is not sufficient to excite orgasm. 1. Intromission of the male organ may be impos- sible because of obstructive pathological conditions of the vulva and vagina; these may be congenital or acquired. — ioo -- The congenital anomalies may take the form of absence of the vagina; extreme narrowing of this tube, or its division into two parts, each too small to allow of intromission; or the vagina may have its out- let in an abnormal position—thus it sometimes be- comes continuous with the rectum. On the part of the vulva there may be adhesions of the greater or smaller lips; there may be hypertro- phy of the labiae or clitoris, or, what is perhaps the most frequent congenital cause of obstruction to sex- ual relations, there may be a rigid or imperforate hymen. Barring the absence of the vulva and vagina and the presence of an imperforate hymen, nearly all of these conditions may be brought about by injury or disease. Thus extreme atresia may result from acute inflammation; elephantiasis may cause such swelling of the labiae that sexual approach is impossible; gan- grene or extensive ulceration may practically close the vulva. Deformity, the result of disease, such as coxalgiaor spinal disease, may render approach almost impossible. Treatment of impotence, when it depends upon congenital absence of the vulva or vagina, is of course of little avail. In cases of narrowing, continued dila- tation may bring about a cure. In at least one case where the vagina opened into the rectum, the woman became pregnant. Rigid or imperforate hymen, adherence of the — IOI -- labiae, mechanical obstruction offered by tumors, can of course be relieved only by surgical operation. 2. In women with whom intromission is possible, but who suffer such pain that all voluptuous sensa- tions are abolished, there may be some demonstrable pathological condition such as inflammation or mal- position, or the most careful search may fail to find the slightest sign of abnormality beyond intense hyperaesthesia. All acute inflammation about the vulva, vagina, rectum, uterus or ovaries may render sexual approach painful. Urethral caruncles and urethritis, fissures at the neck of the bladder, haemorrhoids or rectal fissures, ulcerations or displacement of the womb, inflamma- tion of the Fallopian tubes, disease or prolapse of the ovaries, are frequently observed as causes of this condition. At least, when such lesions are cured by appropriate treatment, the pain attendant on sexual relation disappears and normal voluptuous sensations are experienced. As a consequence of the pain excited by efforts at intromission, there sometimes occurs an involuntary tetanic spasm of the perineal muscles, termed vagin- ismus. This renders the sexual act extremely diffi- cult, and sometimes makes it quite impossible, even though the male possess vigorous erection and brutal insistence. It is observed particularly in hysterical females. Not only the sphincter vaginae and trans- versus perinei, but the sphincter and levator ani and -- 102 -- also the involuntary muscles of the vagina are in- volved. As a result the orifice and vaginal canal tightly close, and any attempt to overcome the mus- cular resistance occasions intolerable pain. Occasionally this condition comes on after intro- mission is effected. In such cases it is quite possible for the male organ to be so tightly imprisoned that release is not accomplished until ether is administered to the female. Several such cases are reported in literature, and one recently occurred under the care of a medical friend. Though this condition is usually classed among the pure neuroses, there is usually some source of irritation, which if treated relieves the condition. Rarely, hyperaesthesia of the vaginal mucous mem- brane seems to be the sole cause of spasm. The treatment of these cases depends for its successful issue upon the cure of the abnormal con- ditions which give rise to pain and excite reflexes. A most careful examination of the entire genito-urinary tract must be made. Lesions or displacements of ap- parently slight moment must receive treatment. The usual cause of this condition is inflammation, often fissures at the neck of the bladder. The rectum must be explored with the speculum, and ulceration, fissures or varicose veins must receive surgical attention. If the vaginal introitus is unduly narrow, it may be over- stretched under ether. A partially ruptured hymen must be divided. Finally, if no lesions are discovered — 103 — and if the vaginal mucous membrane is hyperaesthetic, before sexual approach a io-per-cent. solution of cocaine should be applied to this canal and its outlet by means of cotton swabs, and the whole mucous sur- face should be douched daily with hot boric-acid solu- tion two quarts, and should be touched once a week with a 4-per-cent. solution of silver nitrate. 3. Even though intromission is possible and pain- less, it is often the case that no orgasm is experienced by the woman. It is undoubtedly true that women, as a rule, are less passionate than men, that many wives and mothers have never experienced an orgasm, that the sexual act is for them merely an expression of conjugal obedience or a means of bearing children, that in itself the whole process is unpleasant or even positively revolting. This depends not so much upon local conditions as upon a frigidity mainly inborn, but partly the result of education. Many women occasionally experience an orgasm, but usually stop short of this, since their husbands are unable to continue in sexual congress for a sufficient length of time. This is sometimes the fault of the man, but more frequently is due to the slow response on the part of the woman. In cases such as these, local treatment is of little avail; the impotence can be classed as psychical, and as such must be treated by means of mental impres- sions. Liquor in moderation, rich food, sea air, and caresses may awaken some response, but at most a — 104 - feeble one. Since sexual desire is dead, pleasure in the sexual act is not to be excited; nor is this to be regretted, since such women make good wives, loving mothers, and are not tempted to stray in the paths which the comparatively small number of their more amorous sisters at times find too alluring. When an orgasm is experienced only at rare in- tervals, because of a too hasty partner, the remedy lies in allowing longer intervals to elapse between the approaches, in making such approaches gradual, and in an effort of the will on the part of the male, by means of which ejaculation may be postponed. The effect of continued efforts in this direction is truly wonderful. I have seen men who stated that they could postpone ejaculation for one or two hours, and there is a religious sect in the State of New York who train their youth so that the intercourse may be con- tinued for many hours without ejaculation. Fluid Saw Palmetto Compound. As is well known, Saw Palmetto is one of the best of our restoratives. It is not only a nutrient tonic valuable in its aid to digestion and assimi- lation, but possesses a special vitalizing action upon the glands of the reproductive apparatus, viz.: the uterus, mammae, ovaries, prostate, testes, etc. Kola is highly prized for its stimulating and sustaining qualities due to Caffeine and Theo- bromine. Its value in depressed condition of the nervous system has long been established. Parsley Seed has attained an enviable reputa- tion as an aperient, tonic, emmenagogue, and general sedative to the genito-urinary tract. It has a special tendency to regulate the functions of the reproductive apparatus regardless of sex. Coca, too, is a stimulant, nutrient, and digest- ant. There is perhaps no remedy in the Materia Medica that when moderately used is so success- ful in restoring the function of assimilation. A sample, together with specimens of three other seasonable preparations, will be promptly * forwarded should you not object to the expressage. PARKE, DAVIS & CO., Detroit, New York, and Kansas City, U. S. A. LONDON, ENG., and WALKERVILLE, ONT. EACH FLUIDOUNCE REPRESENTS EIGHTY GRAINS FRESH SAW PALMETTO BERRIES, TWENTY-FOUR GRAINS KOLA NUT, AND TWELVE GRAINS EACH OF PARSLEY SEED AND COCA, COMBINED WITH AROMATICS. BCII9I9ETIN e*PUBLICATIONS - OF - GEORGE S. DAYIS, Publisher. THE THERAPEUTIC GAZETTE. A Monthly Journal of Physiological and Clinical Therapeutics. EDITED BY H. A. HARE, M. D., G. E. DeSCHWEINITZ, M. D., EDWARD MARTIN, M. D. SUBSCRIPTION PRICE, $2.00 PER YEAR. THE INDEX MEDICUS. A Monthly Classified Record of the Current Medical Literature of the World. COMPILED UNDER THE DIRECTION OF DR. JOHN S. BILLINGS, Surgeon U. S. A., and DR. ROBERT FLETCHER, M. R. C. S., Eng. SUBSCRIPTION PRICE, $ 10.OO PER YEAR. THE AMERICAN LANCET. EDI'IED BY LE-&.ETTJS OOZESOSTOIEt, T&. ID. A MONTHLY JOURNAL DEVOTED TO REGULAR MEDICINE. SUBSCRIPTION PRICE, $2.00 PER YEAR. THE MEDICAL AGE. 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PHYSICIAN'S LEISURE LIBRARY The publication of the Leisure Library has inaugurated a new era in medical literature. The crying need of the busy physician is a library consist- ing of works upon prevalent diseases presenting the information m a concise form, stripped of all details not required by the practitioner. A mine of learn- ing may be worthless if not readily accessible. The Leisure Library provides the physician with short, practical treatises upon individual subjects, prepared by authors who are specialists and authorities. Nowhere can there be secured a better return (in the way of medical literature) for the moderate prices, as follows: 25 cents per volume in embossed paper covers; 5° cents per volume bound in cloth. Complete series of twelve books, in paper, $ 2.50; in cloth, $ S •00- Postage prepaid. Foreign postage, 4 els. per volume. Inhalers. Inhalations and Inhalants. By Beverley Robinson, M.D. The Use of Electricity in the Removal of Superfluous Hair and the Treatment of Various Facial Blemishes. By Geo. Henry Fox, M.D. New Medications. Vol. 1. New Medications. Vol. II. By Dujardin-Beaumetz, M.D. The Modern Treatment of Ear Diseases. By Samuel Sexton, M.D. The Modern Treatment of Eczema. By Henry G. Piffard, M.D. The Diagnosis and Treatment of Hemor- rhoids. By Chas. B. Kelsey, M.D. Diseases of the Heart. Vol.1. Diseases of the Heart. Vo1.il By Dujardin-Beaumetz, M.D. The Modern Treatment of Diarrhea and Dysentery. By A. B. Palmer, M.D. Intestinal Diseases of Children. Vol. I. Intestinal Diseases of Children. Vol. II. By A.Jacobi, M.D. :s 1. Antiseptic Midwifery. By Henry J. Garrigues, M.D. On the Determination of the Necessity for Wearing Glasses. By D. B. St. John Roosa, M.D. The Physiological,Pathological and Ther- apeutic Effects of Compressed Air. By Andrew H. Smith, M.D. GranularLidsandContagiousOphthalmia. By W. F. Mittendorf.M.D. Practical Bacteriology. (Out of print.) By Thomas E. Satterthwaiie, M.D. Pregnancy, Parturition, the Puerperal State, and their Complications. By Paul F. Munde, M.D. S II. The Modern Treatment of Headaches. By Allan McLane Hamilton, M.D. The Modern Treatment of Pleurisy and Pneumonia. By G. M. Garland, M.D. Diseases of the Male Urethra. By Fessenden N. Otis, M.D. The Disorders of Menstruation. By Edward W. Jenks, M.D. The Infectious Diseases. Vol.l. The Infectious Diseases. Vol. 11. By Karl Liebermeister. SERIES III. Abdominal Surgery. By Hal C. Wyman, M.D. Diseases of the Liver. By Dujardin-Beaumetz, M.D. Hysteria and Epilepsy. By J. Leonard Corning, M.D. Diseases of the Kidney. By Dujardin-Beaumetz, M.D. The Theory and Practice of the Ophthal- moscope. By J. Herbert Claiborne, Jr., M.D. Modern Treatment of Bright's Disease. By Alfred L. Loomis, M.D. Clinical Lectures on Certain Diseases of the Nervous System. By Prof. J. M. Charcot, M.D. The Radical Cure of Hernia. By Henry O. Marcy, A.M., M.D., LL.D. Spinal Irritation. By William A. Hammond, M.D. Dyspepsia. By Frank Woodbury, M.D. The Treatment of the Morphia Habit. By Erlenmeyer. The Etiology, Diagnosis and Therapy o Tuberculosis. By Prof. H. von Ziemssen. SERIES IV. Nervous Syphilis. ByH. C. Wood, M.D. Education and Culture as correlated to the Health and Diseases of Women. By A. J. C. Skene, M.D. Diabetes. By A. H. Smith, M.D. A Treatise on Fractures. By Armand Despres, M.D. Some Major and Minor Fallacies concern- ing Syphilis. By E. L. Keyes, M.D. Hypodermic Medication. By Bourneville and Bricon. Practical Points in the Management of Diseases of Children. By I. N. Love, M.D. Neuralgia. By E. P. Hurd, M.D. Rheumatism and Gout. By F. Le Roy Satterlee, M.D. Electricity, Its Application in Medicine. Vol. I. Electricity, Its Application in Medicine. VoL II. By Wellington Adams, M.D. Auscultation and Percussion. By Frederick C. Shattuck, M.D. SERIES V. Taking Cold. By F. H. Bosworth, M.D. Practical Notes on Urinary Analysis. By William B. Canfield, M.D. Practical Intestinal Surgery. Vol. I. Practical Intestinal Surgery. Vol. n. By F. B. Robinson, M.D. Lectures on Tumors. By John B. Hamilton, M.D., LL.D. Pulmonary Consumption, a Nervous Dis ease. By Thomas J. Mays, M.D. Artificial Anaesthetics and Anaesthesia. By DeForest Willard, M. D., and Lewis H. Adler, Jr., M. D. Lessons in the Diagnosis and Treatment of Eye Diseases. By Casey A. Wood, M.D. The Modern Treatment of Hip Disease. By Charles F. Stillman, M.D. Diseases of the Bladder and Prostate. By Hal C. Wyman, M.D. Cancer. By Daniel Lewis, M.D. Insomnia and Hypnotics. By Germain See. [Translated by E. P. Hurd, M.D. SERIES VI. The Uses of Water in Modern Medicine. Vol. I. The Uses of Water in Modern Medicine. Vol. II. By Simon Baruch, M.D. The Electro-Therapeutics of Gynecol- ogy. Vol. I. The Electro-Therapeutics of Gynecol- ogy- Vol. II. By A. H. Goelet, M.D. Cerebral Meningitis. By Martin W. Barr, M.D. Contributions of Physicians to English and American Literature. By Robert C. Kenner, M.D. Gonorrhea and Its Treatment. By G. Frank Lydston, M.D. Acne and Alopecia. By L. Duncan Bulkley, M.D. Fissure of the Anus and Fistula in Ano. By Lewis H. Adler, Jr., M D. The Surgical Anatomy and Surgery of the Ear. By Albert H. Tuttle, M.D., S.B. Recent Developments in Massage. By Douglas Graham, M.D. Sexual Weakness and Impotence. By Edward Martin, M.D. SERIES VII. Appendicitis and Perityphlitis. By Charles Talamon, M.D. Cholera. Vol. I. Cholera. Vol. II. ByG. Archie Stockwell, M.D..F.Z.S. Electro-Therapeutics of Neurasthenia. By W. F. Robinson, M.D. Treatment of Sterility in the Woman. By Dr. De Sinety. Bacterial Poisons. By N. Gamaleia, M.D. The Modern Climatic Treatment of In- valids with Pulmonary Consumption in Southern California. By P. C. Remondino, M.D. Antiseptic Therapeutics. Vol. I. Antiseptic Therapeutics. Vol. II. By E. Trouessart, M.D. Treatment of Typhoid Fever. By D. D. Stewart, M.D. Whooping Cough. Vol. I. Whooping Cough- Vol. II. By H. Richardiere, M.D. [Translated by Joseph Helfman.] RECENT ADDITIONS. Landmarks in Gynaecology. Vol. I. Landmarks in Gynaecology. Vol. II. By Byron Robinson, B.S., M.D. Where to Send Patients Abroad for Mineral and other Water Cures and Climatic Treat- ment. By Dr. Thomas Linn. Treatise on Diphtheria. By H. Bourges, M.D. [Translated by E. P. Hurd, M.D.] Pernicious Fever. By Joao V. T. Homem, M.D. [Translated by Surgeon Geo. P. Bradley, U. S. N.] GEORGE S. DAVIS, Publisher, O- Box 470. IDetroit, I^Eicli. BOOKS BY LEADING AUTHORS. A PRIMER OF PSYCHOLOGY AND MENTAL DISEASE..$ i.oo By Dr. C. B. Burr. Part I is devoted to the study of the faculties of the normal mind, and these are plainly and clearly set forth. Part II is devoted to mental diseases, causes and forms of insanity being discussed in accordance with an orig- inal plan of the author's. Part III deals with the management of cases of insanity. REACTIONS............................................... 2.00 By F. A. Fltickiger, Ph.D., M.D. A Selection of Organic Chemical Preparations Important to Pharmacy in re- gard to their Behavior to Commonly Used Reagents. Translated, revised and enlarged by J. B. Na ;elvoort, analytical chemist to the Pharm.-Chem. Laboratory of Parke, Davis & Co. Authorized English edition. TABLES FOR DOCTOR AND DRUGGIST................ 2.00 Compiled by Eli H. Long, M. D. Comprising Tables of Solubilities, Reactions and Incompatibles. Doses and Uses of Medicines, Specific Gravity, Poisons and Antidotes, Thermomet- nc Equivalents, and The Metric System. SECOND EDITION—En- larged and Revised. THE PHARMACOLOGY OF THE NEWER MATERIA MEDICA— Price, postpaid, in cloth................................... 3.00 Price, postpaid, in sheep.................................... 3.50 THE PRINCIPLES AND PRACTICE OF BANDAGING.... 3.00 By Gwilym G. Davis, M.D., Universities of Pennsylvania and G6ttingen. The most modern and complete work on bandaging ever issued. Contains 172 illustrations, prepared from sketches especially made for this book by the author, printed from 23 plates on separate pages. The book is hand- somely printed on superior quality of paper, with wide margin, and taste- fully bound in red cloth. SEXUAL IMPOTENCE IN MALE AND FEMALE (3d Edition). 3.00 By Wm. A. Hammond, M.D. Probably more unhappiness is caused by sexual impotence than by any other disease that affects mankind. Dr. Hammond discusses Causes. Symp- toms and Treatment. v CLINICAL THERAPEUTICS............................... By Dujardin-Beaumetz, M.D. Dujardin-Beaumetz is easily chief in the field of original therapeutic research and in fertility of therapeutic suggestion. This treatise of 401 pages comprises his lectures on the Treatment of Nervous Diseases General Diseases, and Fevers. 4.00 PHYSICIANS' PERFECT VISITING LIST.................$ 1.50 By G. Archie Stockwell. M. D. Physicians are generally admitted to be exceedingly poor financiers. There is probably no class of professional men who realize so little fin incially from their labors. One cau->eof this is negligence in keeping an account ot their work. This call or visiting list has been constructed with special refer- ence to this desideratum; it is arranged for perpetual use, and in form and finish leaves nothing to be desired as a practical aid to the physician in keeping his accouuts on a business basis. PALATABLE PRESCRIBING (Third Edition)................ 1.00 By B. W. Palmer, A.M., M.D. This book contains over 600 favorite formulas of the most eminent medical authorities, culled from their published writings and private records, and embraces a resume < f the most eligible preparations for the administration of the more recent additions to the materia medica. A NEW TREATMENT OF CHRONIC METRITIS.........50 By Dr. Georges Apostoli. This book of no pages, illustrated with cuts of apparatus, presents the details of Apostoli s treatment by imra-uterine Chemical Galvano-Cauterizations of Chronic Metritis and Endometritis. SANITARY SUGGESTIONS (Paper)..........................25 By B. W. Palmer, M.D. FORMULAE FOR THROAT AND LUNG DISEASES........25 By E. L. Shurly, M.D. These are formulae which Dr. Shurly employs in hocpit^l and private practice, and which he has published at the solicitation ot his students. UNUSUAL BARGAIN! The follotving three boohs will be sold, for a limited time, at half their regular price. Prices quoted are strictly net cash with order. UNTOWARD EFFECTS OF DRUGS...................... $ 1.00 By L. Lewin, M.D. MICROSCOPICAL DIAGNOSIS............................. 1.50 By Chas. H. Stowell, M.S. SELECT EXTRA-TROPICAL PLANTS.................... 1.50 By Baron Ferd. von Mueller. GEO. S. DATZTS, Publisher, P. O. Box 470, DETROIT, ■ ■ MICH. APR S 1946 NLM OSIO^MQ E NATIONAL LIBRARY OF MEDICINE ■^8 •.^ •£ NLM051094402