RM -NRLF LIBRARY University of California. GIFT OF -c^- U- f lx.c5-^^SL>vAl)D!^^.aO^. Class PROVISIONAL HAND BOOK or HiEMATHERAPY, OB AUXILIARY BLOOD SUPPLY IN MEDICINE AND SURGERY. The Greatest Therapeutic Discovery of the Age, and of the Ages, is that where we cannot produce Good Blood we can Introduce it. Compiled and Eeprinted from Numerous Medical Journals and Correspondents : Including the "Entire Eecords," up to date, of SOUND VIEW HOSPITAL, Stamford, Conn. Printed i.x>R TUE ^QYININEI COMPANY. No, 75 W*^f?1 Ho'ast(*ii. Stre^it; . New York. Price 10 cents. EXPLANATION. Tn the literature of Haematherapy, herein compiled, the essential factor — bovine blood — is found to be indicated sometimes by that broad expression; usually by the name of the commercial prepara- tion or conserve of the same ("Bovinine") ; and in one or two in- stfinees, is abbreviated infelicitously as "bovine." These variations of phrase have confused some readers, and caused misunderstanding or anxious inquiry as to which is the true article, and where it may l)e obtained. It is needless, for the well-informed, to point out that the only form in which bovine blood has been, or can be, practically avail- able to physicians for the purposes of Ha-matherapy, is that of the article usually specified — "Bovinine" : although philosophical writ- ers, indifferent to that commercial "trade mark," have preferred to emphasize the broad principle, rather than the particular medium. But for the benefit of those who might be perplexed by the variety of phrases, it is proper to explain that they all, necessarily, mean the same article, in practice — "Bovinine" — which, fortunately, la to be had at any drug store, in all the vital efficacy of its main constituent, bovine blood, as taken direct from the arteries of the bullock, unaltered by any process or ingredient. CLASSIFIED CONTENTS. THEORY AND EXPOSITION. I. What is Htema therapy ? — What is Blood? — And Have We a Living Blood Conserve? Bovinine Siniply the Consummate Product of the Process of Nutri- tion in the Living Body. The Sovereign Depurator (Pus-Destroyer) Peroxide-ou-Bovinine. The True Antitoxin without Toxin, for Diphtheria. Blood Treatment in Pulmonary Tuberculosis. Supplied Blood, how related to the condition of Chronic Catarrh. p. 65. Chronic Gastric Ulceration, p. •75. Prof.E-. H. 'Pratt, M. D., on Blood Treatment in Gangrene, Pelvic Operations, and Sterilization of Parts, p. 108. The Philosophy of Topical Blood Supply in Chronic Ulceration, p. 118. The Several Nutrients Experimentally Compared in Topical Tissue- Feeding, p. 119. Tissue-Disintegration and its Physiological Repair: The Assist- ance it Requires, p. 130. The Relation of Pain to Malnutrition of Nerves, and its Magical Annihilation by Supplied Blood, pp. 191, 192. The Power of Supplied Blood in Exhausting Conditions, p. 193. Blood Supply by Subcutaneous and Rectal Injection, p. 196. Direct Blood Supplv in Typhoid Fever: By Prof. Wm. F. Waugh, M. D. The Various Disorders Indicated by the term Bright's Disease: Bv T. J. Biggs, M. D. CLINICAL DEMONSTRATIONS OF THE INVARIABLE EFFICACY OF SUPPLIED BLOOD. AT SOUND VIEW AND OTHER HOSPITALS, AND BY NUMEROUS PRACTITIONERS. I. IN TUBERCULAR DISEASES. Memorable Cures of Luini? in its most Aggravated Conditions. Cases of Mary Noble, John F. Baldwin (of thirty-six years stand- ing) and many others. Tubercular Ulcers and Necrosis of Bone. Pulmonary Tuberculosis, Consum]:)tion or Phthisis: Cases by Dr. K. (E. L. Keyes, of New York) p. ; Dr. T. J. Biggs, of Sound View Hospital, Stamford, Conn. Nos. ii, iii, iv, v, vi, vii, viii, ix, X, xi, xiii, xv, xvii, xviii, xix, xx, xxi, xxii, xxiv, xxv, xxvi. Dr. Dooley, New York, No. xiv. II. ALCOHOLISM AND MORPHINISM. IIL CHRONIC CATARRHAL DISEASES. Chronic Ulcerative Catarrh: Bv Dr. Stafford, p. 65; Dr. T. J. Biggs, pp. &6, 69; Dr. J , pp. 67, 68; Dr. R , p. 69; Dr. C , p. 69; Dr. H , p. 70. 226950 2 Clironic Ulcerative Tonsilitis: J)r. T. J. Biggs, p. 70; Chronic Ulcerative Stomatitis: the saiiie, pp. 71, 72; also by Dr. Dooley, p. 71; Chronic Ulcerative Conjunctivitis, Dr. K , p. 71; and Dr. T. J. Biggs, p. 73; Chronic Ulcerative Otitis, Dr. J , p. 72 ; Chronic Membranous Enteritis : Dr. C , p. 72 ; Dr. T. J. Biggs, p. 73 ; Chronic Catarrhal Enteritis : Dr. T. J, Biggs, p. 74. Chronic Gastric Catarrh: Dr. T. J. Biggs, p. 73; Chronic Ulcera- tive Gastritis: Dr. T. J. Biggs, p. 74; Chronic Gastric Ulcer: Dr. T. J. Biggs, pp. 76, 166; By Dr. L. E. McCormick, Crothers- ville, Ind., p. 166. IV. IN ANEMIA. Cases by Dr. T. J. Biggs: pp. 79, 81, 84, 89, 90, 91; By Dr. Henry T. Halleck, Brooklyn, N. Y., p. 84; By Dr. E. L. Keyes, New York, p. 85: Bv Dr. E (Dr. E p. 85; By Dr. S (Dr. S , New York, pp. 86, 88; By Dr. C (Dr New York) pp. 86, 88; By Dr. D (Dr. J. J. Dooley, New York), pp. 87, 88; By Dr. E (Dr. , New York), p. 88. V. IN FEMALE DISEASES. By Dr. T. J. Biggs, Sound View Hospital : Blood Eepair of Incur- able Ovarian Abscess, Chronic Salpingitis, Cystitis, etc., pp. 93, 94; Of Chronic Ulcerative Proctitis, pp. 92, 94, 106; Of Chronic Eecto-Vaginal Fistulas and Ulcers, pp. 95, 97, 105; Of Chronic Uterine Ulcers and Lacerations, p. 98, and p. 99 by Dr. S ; p. 101 by Dr. Charles L. Bonifield, Cincinnati; Of Chronic Car- uncle of Urethra, p. 102; Of Chronic Ulcerative Endometritis, pp. 103, 192; Tubercular do., p. 103; do. with Typhoid Fever, p. 104. VI. IN PELVIC DISEASES GENERALLY. Ulcers, and Ulcerative Proctitis, with Hernia and double operation, by Dr. T. J. Biggs, pp. 168, 169; By Prof. Jos. M. Matthews, Louisvile, Ky., p. 1'^'.9, With Appendicitis. Dr. T. J. Biggs, p. 170; By Dr. G. W. Combs, Indianapolis, 170; By Dr. W. C. Coy, East Boston; Peri-Urethral, Dr. E. L. Keyes, p. 171, and Dr. t. J. Biggs, p. 171; Fissures in Eectum: By Dr. T. J. Biggs, p. 97. VII. IN GANGRENE— WITH INVARIABLE BLOOD CURE. Cases by Prof. E. H. Pratt, M. D., Chicago, pp. 108, 109, 110, 111; By Jos. L. Black, M. D., Chicago, p. Ill; By Witter K. Tingley, M. D., Norwich, Conn., in New York Medical Eecord, p. 112; By Dr. J. M. Dearborn, Somerville, Mass., p. 113 ; By Dr. J. L. Cushing, Boston, p. 113; By Dr. T. Jensen, Spring Grove, Minn., p. 114; By Dr. G. W. Smith, Macon, Mo., p. 113; By Dr. J. J. Dooley, New York, p. 115. VII. INVARIABLE BLOOD CURE OF ERYSIPELAS. By Dr. T. J. Biggs, Sound View Hospital, pp. 115, 132; By Dr. H. M. Sanger, Providence, E. I., p. 116; By Dr. W. H. Parsons, Omaha, Neb., pp. 116, 117; By Dr. E. C. Frost, Boston, Mass., p .116. VIII. SKIN-GRAFTING SUPERSEDED BY SKIN-PROPAGA- TION FROM SPECKS OR SCRAPINGS OF SKIN OR CALLUS, IN BLOOD. By Dr. T. J. Biggs, pp. 124, 126, 127, 128, 129, 130, 135, 136; By Dr. 0. B. Evans, South Carolina, p. 131; By Dr. H. B. Mackl- veen, Waverly, la., p. 133; By Dr. F. E. Blanchard (New York Medical Jonrnal), p. 134. IX. REBUILDING OF TREPHINED OR NECROSED BONE, WITH BLOOD, WITH OR WITHOUT GRAFT MATERIAL. Bv Dr. T. J. Biggs, Sound View Hospital, pp. 138, 139, 140, 111, ^142, 143, 144, 145, 146, 147, 148, 149; By Dr. E , New York, )). 141; By Prof. Wni. A. White, M. D., Tiifts College Medical School, Boston, Mass. (in Anlantic Medical Monthly), p. 143; By Dr. J. B. Eich, Worcester, Mass., p. 147; By Dr. T , Coving- ton, Ky., p. 147; By Dr. Carl L. Johnson, p. 149. X. SHORT BLOOD REPAIR OF COMPOUND FRACTURES. By Dr. T. J. Biggs, Sound View Hospital (Humerus), pp. 150, 151; Connninutcd Eadius, p. 151; and by Dr. Albert Dunlap, Cres- ton, Iowa, p. 153; Vertebral, operation forbidden, death, p. 153. >[ XI. MALIGNANT TUMORS (EPITHELIOMATA). By Dr. T. J. Biggs, Sound View Hospital, pp. 155, 156, 157. XII. VARIETIES OF CHRONIC ULCERATION. Carbuncle, cases I to IV, T. J. B , pp. 158 to 160 ; Old Trau- matic Ulcers, T. J. B . p. 160; Corneal and other Eye Ulcera- tions: Dr. Louis B. Couch, Nyack, N. Y., p. 161; Dr. Carl G. Winter, Indianapolis, Ind., p. 161; Dr. J. T. Barnett, Hardins- burg, Inch, p. 161; Dr. M. H. Wheeler, Butler, Ky., p. 162. XIII. ULCERATIVE ECZEMA. Of Scalp (T. .T. B.), pp. 163, 164; Of Leg, by a nurse, p. 163; By Dr. H. A. Plummer, East Boston, Mass., p. 164; at Bellevue Hos- pital, p. 164. XIV. CHRONIC SYPHILITIC ULCERS AND INFLAMMATIONS. Gonorrhoea Cases i to xxiii, by Dr. Thos. B. Keyes, Chicago, p. 172; Chancroid, p. 173; By Dr. T. J. Biggs, pp. 172, 173, 174, 175; Dr. W. H. Parsons, Omaha, p. 173; Dr. Jos. L. Black, Chicago, p. 173: Dr. A. M. Blech, Chicago, p. 174. Gleet, Dr. J. J. Doo- ley, p. 174. XV. OLD CHRONIC BURN ULCERS, SKIN REPAIRED BY BLOOD. By Dr. Jos. L. Black, Chicago, p. 175; T. J. B , pp. 175, 176; Bellevue Hospital, p. 176. ABSCESSES. Parenchymatous Hepatitis, Abscess and Sinus, T. J. B , p. 177; (Of liver), p. 178; Lumbar, T. J. B , p. 176; Glandular, Dr. Hatcher, Somerville, Mass., p. 180; T. J. B , 180; Urethral, Dr. C. ^. Smith, Providence, E. I., p. 179; Axillary, T. J. B , p. 180. XVI. CONTINUED EXAMPLES OF BLOOD TREATMENT IN CHRONIC ULCERATION. 15y Dr. Mussey, of Cincinnati, p. 181; Dr. E. B. McCall, Hamers- ville, 0., p. 182; Dr. Blech, Chicago, p. 182; Dr. W. F. Dean. La Grange, 111., p. 183: Dr. J. J. Dooley, New York, p. 184; Dr. Edward A. Welch, Sutton, Mass., p. 184. At Bellevuo Hospital, New York : Blood Cure of fifty-five cases of Burns, Chronic Ulcers, Abscesses, etc., pp. 185, 18G, 187, 188. Summary of Twelve Old Incurable Ulcer Cases, Traumatic and Varicose (T. J. B.), pp. 181), 11)0; By Dr. L for Dr. Connor, Cincinnati, p. 190; By Dr. L. L. Bryant, Cambridgeport, Mass., p. 190. XVII. BLOOD TREATMENT OF CHILDREN'S DISEASES. Malnutrition, T. J. B , p. 193; Dr. Herman D. Marcus, Bhila- delphia, p. 194. Cholera Infantum, Dr. W. C. Wile, Danbury, Conn., p. 194; Dr. S. PI. Moore, Indianapolis, p. 194. Marasmus, Dr. W. W. James, Philadelphia, p. 194; Diththheritis, Dr. A. H. E. Guiley, South Easton, Pa., p. 195; Gastritis, Dr. S. D. Dewey, Kichmond, Va., p. 195; Dr. Edward P. Vollum, Medi- cal Director, United States Army, p. 195. XVIII. CASES REVIVED FROM COLLAPSE IN POST- PARTUM H.-EMORRAHAGE, TRAUMA, ETC., BY INJECTIONS OF BOVINE BLOOD. By Dr. A. M. Blech, Chicago, p. 197; Dr. P , j^ew York., p. 199; By Dr. Stafford, New York, p. 199; T. J. B , pp. 199, 204; Dr. W. S. Howe, Lewiston, Me., p. 200. Extraordinary Vital Inviooration of Woman by Supplied Blood (T. J. B.), p. 300. Vomiting of Pregnancy: Cases 1)v Dr. W. E. Shaw, Cincinnati, 0., and Dr. F. D. Wheeler, Detroit", Mich., p. 302. Blood Sustentation in Last Days of General U. S. Grant; kept alive with Bovinine : General F. D. Grant, and Dr. Douglass, p. 203. Raised from a Dying State by Blood Injection : Dr. W. H. Parsons, Omaha, Neb., p. 203. XIX. CASES OF TRAUMATIC HEMORRHAGE AND COL- LAPSE SAVED BY SUBCUTANEOUS AND RECT AL INJECTIONS OF BOVINE BLOOD. T. J. B , pp. 204, 205, 306, 207; Case under (Esophagotomy, by Dr. E , p. 204; Under Pyaemia and operation, infant (T. J. B — — ), p. 206; Case by Chas L. Bonifield, Cincinnati, 0., p. 206; In Catalepsy,T. J. B , p. 307. XIX. CURE OF BRIGHT'S DISEASE AND KIDNEY COMPLAINTS. By Dr. MacGrath, New York, p. 208; By Dr. T. J. Biggs, pp. 209, "310, 311, 313; Diabetes, T. J. B , p. 317; Dr. Clark, Milford, Mass., p. 317. XX. BLOOD SUSTENTATION AND ANTISEPSIS IN TYPHOID FEVER. Bv Dr. W. F. Waugh, pp. 318, 319; Dr. D. W. Henderson, Marvs- "ville, 0., p. 319; Dr. MacGrath, New York, p. 330; Dr. Robert Frame, Milford, Del., p. 330; Dr. T. J. Biggs, j)j). 331, 333 ; Dr. D. A. K. Steele, Chicago, p. 333; Dr. L. G. Wilberton, Winona, Minn., p. 383; Dr. F. 0. Chambers. Indianapolis, p. 333; Dr. D. Wheeler, Detroit, p. 333; Dr. W. F'. Bnrnos, Indianapolis, p. 223. THE PHYSIOLOGICAL PKINCIPLES OF TREAT- MENT WITH AUXILIARY BLOOD SUPPLY. WHAT IS H^MATHERAPY? It is a treatment which consists in opposing to a condition of dis- ease the very power — good and suiUcient blood — that would natur- ally prevent it; that would still cure it spontaneously; and that ac- tually does cure it spontaneously, wherever the blood-making work of the system is perfectly efficient; and therefore also will cure it, if a deficiency of the vital element be supplied from without, under proper medical treatment. That Blood is such a power as here described, is an undisputed physiological fact. Its transmission from one animated organism to another, for the purpose of supplying a defect in the latter, is the substance of the Blood Treatment; and How to Do this, in different cases, is the form or description of the same, as set forth by clinical description in great variety, throughout the following pages. >It has been abundantly demonstrated in practice that blood can be borrowed for us from the most vigorous animals, and supplied to our deficiency either of quantity or of vital power, by either of three modes of conveyance according to convenience or necessity, \\z.: by subcutaneous injection into the circulation; by direct ab- sorption into the system through the sides of the alimentary canal, upper or lower; or by topical application to any exposed or denuded tissue whatever, to which the native circulation of the patient fails to afford healthy sustenance and protection whether through insuffi- ciency, paucity and sickliness of organic cells, or lack of vital and vi- talizing energy. That this is literally borrowing life, is only another and more startling way of stating the fact, a fact emphasized in a most remarkable way by the observations of Dr. Brakenridge, of Edinburgh, who found that the vital cells of injected blood not only reinforced the circulation by their own quantity and quality, but also revitalized and enlarged the debilitated cells of the patient, and excited an immediate proliferation of new cells. Blood is neither a sectarian nor a proprietary article, any more than air or water, which are equally suitable and necessary in every case and under every system of treatment — at discretion. (Condi- tions of plethora or unreduced inflammation, of course do not indi- cate immediate addition of blood.) WHAT IS BLOOD? In the words of Sir William Hunter, the blood is "a highly or- ganized living tissue;" unlike all other organs, not only living, but lifegiving; a loose tissue, as a concourse of organized corpuscles in a nutritious fluid; but none the less a coherent and constant unit, though in perpetual flux and change like other organs, only chang- ing more rapidly and freely by reason of its all-distributive function; incomparably the most active as well as essential organ in the body, carrying vitality and vitalized substance to every cell of brain, nerve, muscle, bone or organ in the system. Hence it has been properly designated ilie All-organ of life; since it alone, so far as we know, imparts life (derived man knows not how or whence); while all the other organs called vital depend on it for life as well as nourishment, and in return are wholly employed in serving it, either as feeders, carriers, scavengers, or in receiving and transposing its chemical ele- ments for various uses. Thus, the heart is called a vital organ only because it pumps the blood forth on its vital errand; the lungs be- cause they blow oxygen on the blood fire, and blow off its smoke; the stomach and entire digestive apparatus because they purvey and cook for the blood; the liver and kidneys because they secrete, ex- crete, wash and scavenge from the blood; the brain itself, only be- cause it is the storage-battery of vital or rather nervous force, accum- ulated from the blood, arid is charged for the propulsion of the ma- chinery of the living workshop whose essential product is evermore "Blood, which is the life thereof." The production of blood, then, is nothing more or less than the propagation of life in its fundamental organic forms or units; a propagation, too, which is carried on entirely in and by the blood, as the only depositary of life, and therefore the only thing in Nature by which life is or can be propagated, or communicated from one organism to another. At all events, so far as can now be affirmed, or need be considered, the blood is the only vital organ that we know; the only organ that is not merely mechanical or chemical in function, and subservient to the fuelling, distribution or cleansing of that multitudinous all-organ, in which alone the food of life acquires vitality and goes to the maintenance of both form and force in every tissue and organ of the body, from the brain itself to the remotest nerve or pellicle or hair. This is the all-in-all of Life, for which all else may be broadly considered as mechanism. So long as the or- ganic mechanism is kept in good working order, wath a proper sup- ply of raw material, the blood, full-fed, full-celled, and kept clean, is able to convey vitality, vigor and nourishment, to every part; vitality and vigor for defense, and vitalized material for repair, in defiance of hostile influences within or without. But if the conditions be otherwise, impoverishment of the blood results, internal debility ensues, and disease or disease germs meet with weak resistance. This condition may be transient. Or, it may be constant, in a degree not incompatible with a languid persistence of life; in which case, if some unusual attack occurs, it is evident there can be no salvation in the effete organism which has chron- ically demonstrated its incapacity to carry on the sustenance and the care of the blood, and thus to maintain, so to speak, the garrison of its own defence. The defeat of medicine, sudden or gradual, is then certain, unless some other and stronger organism can be made to contribute its vital fluid to meet the default of the failing organism of the patient. That ignominious defeat of medicine has been an invariable result in such cases, from the beginning of the world until recently, because medicine did not know that the blood of bullocks could be substituted in full force and virtue for that which was lack- ing in the blood vessels of the sick, the debilitated, and the dying. Hffimatherapy has now come into the world to change all that, and to give a new lease of life, in supplied blood, to most of those luth- erto condemned to im timely death for want of that vital element. BLOOD AND BLOOD ALONE having been physiologically ascertained to be the essential and fun- damental principle of healing, of defence, and of repair, in the hu- man system; tliis principle is also proved, by years of constant clin- ical experience, to be practically available to the system in all cases, to any extent, and wherever needed, internally or externally. The treatment of disease by Supplied Blood is in principle as old as animal life, and is a new proposition only as to its general praqtic- ability. It is settled, so far as the consensus of enlightened physiol- ogy can settle anything at this stage of human knowledge, that the powers of the blood in its perfect state are adequate to the defence of the organism against all that is properly called disease. The only sure reason why one is taken and another left, of those equally ex- posed to the infection of tuberculosis, of smallpox, or of any other infectious disease, is admitted to be the single fact that in one the perfect blood is doing and has been doing its perfect work for the support and defence of the organism at all points; whereas in the other a deficiency of such health or vitality has somewhere "left him naked to his enemies." The healing of a wound or an ulcer, what- ever help the surgeon can claim to have rendered, is always attrib- buted to the virtue of "good blood," and a failure to heal under the best treatment and external conditions, is charged entirely to pov- erty or impurity of blood. Marvelous healing of injuries which are ordinarily fatal, sometimes astonishes the medical world, showing that it is impossible to draw the line beyond which the vital powers fed by the blood may not withstand any wound that leaves still a workable mechanism with the blood in it! Such is the principle of Haematherapy, as established by the com- mon consent of scientific authorities and by^the undeviating con- currence of facts. As a principle, it can hardly be said now to re- quire discussion on scientific grounds — there is no room left for that. Only, as at first remarked, as to its practicability can any question be raised; and that is mainly or wholly a question of fact; a question on which we present an array of facts beyond measure, in unbroken se- quence and uniformity, authenticated by unquestionable profes- sional testimony and the responsible reports of an incorporated in- stitution of regular medicine and surgery. BUT HAVE WE A LIVING BLOOD CONSERVE? The indisputable propositions above recited suffice to establish the vital virtue of a blood treatment, on the single condition that we have a practicable conserve of Living Blood for the purpose. No physician will dissent from the conclusion when convinced that it is practically possible to obtain and introduce into the system healthy and still living blood, endowed ^dth the same vital force and effect that it exhibits in the natural circulating supply. But, that blood can live outside and after the living body, and for indefinite time, with its corpuscles still charged with the mysterious power that we call Life, and still capable of imparting that power to the inert materials of nutriment and running them as a living pro- duct iuto the constantly vacated moulds of Living tissue — this at first seems a supposition contrary to all probability, analogy and experi- ence. Nothing appears to be deader, if we may so speak, or swifter to corruption, than spilt blood, under the conditions in which we are accustomed to view it. This is the pons asinorum of the new science, at which learned self-sufficiency usually balks, and obsti- nately refuses to inquire further. But, again, if we consider the ease with which life is conserved indefinitely, in every other known depositar}'^ of life, by simply shielding it, as nature and art so often do, from the agencies of cor- ruption — which may be taken for the real synonym of death — and if we remember the numberless instances in which animal life persists of itself as a latent deposit through long periods of suspension of every vital function — we shall find abundant precedents for revers- ing our prima facie presumption that blood corpuscles cannot be preserved alive, and for a probability that the vital power in the life cells (deposited as it is at the bottom of all vital activity, supporting, not dependent on, organization and function), will persist independ- ent of them in a suspended or latent condition, as all the other phy- sical forces do, and as even organized bodies actually do, if simply shielded from intruding forces or the rupture of the protecting cell. With abundant evidence of the persistence of latent life in all other depositaries if protected against the beginning of dissolution, what actual evidence have we that life ^vill Ukewise persist in its cells of the blood if effectually protected, and also that its cells can be and really are thus protected? That evidence is open to every properly equipped physician in any part of the world, in the two-fold observation (1) of the visible con- dition of the preserv^ed corpuscles, and (2) in their invariable exhibi- tion of perfect ^dtal potency when properly applied to a deficiency of the same in the human system or in any locahty thereof. Any physician can satisfy liimself of the perfect condition of the pre- served corpuscles, by simply spreading a drop of "bovinine" on a microscope slide and examining it with a power of 800 diameters or upwards. If familiar with the aspects of living blood corpuscles, the observer will recognize the same aspects in every particular; the same dense crowd of shifting, changing, double-concave, smoothly- rounded, yellowish-red discs, that are described in treatises on the vital fluid in its vital state. This is a statement that challenges veri- fication. To reject it without a test so accessible and conclusive, would be the most natural thing in the world to do — for a mule. But we have found some physicians possessed of microscopes, but not of the technical knowledge for using them successfully. The other test, the final test — the opus operatum — requires more patience and medical science; but whenever fairly tried by a com- petent physician, in cases where the proper technique has been de- veloped, it will settle the great question we have been discussing, be- yond the possibility of mistake.- 9 PREFATOKY NOTE. To the Clinical Reports of Treatment with Auxiliary Blood Supply Edition of 1899. Since last yearns edition of The Provisional Hand Book of Hsema- therapy was issued, great events have transpired in the systematic Hospital development of Medicine and Surgery by the aid of Sup- plied Blood, while previous great events of the same kind have been habitually repeated and confirmed. Not only has the previous edi- tion of ten thousand been exhausted by the orders of physicians (the book is not distributed), but the development of Hsematherapy in directions unexpected and achievements unheard-of, within the past year, has already left last year's record behind almost as far as last year's had left the whole previous art and practice of medicine. These are "words of truth and soberness" — literally and entirely — for which the most searching tests are challenged from the Medi- cal Profession of the world: while full and free facilities for un- biassed scientific and clinical observation, a routrancc, are available at a thoroughly modern medico-surgical institution, independent of our control or influence, established near New York by the chief author of the system (Dr. T. J. Biggs), and known as Sound View Hospital, Stamford, Connecticut. Under such circumstances^ it is a continuing cause of world-wide and unutterable woe, for which the Medical Profession as a body is deliberately making itself responsible, that the principle of Auxiliary Blood Supply is not recognized, as it should be on its face, and adopted, as it should be on the professional tests that have a thous- and-fold established it before the eyes of the medical world. But there is something morally still worse, though there could be noth- ing practically more inhuman, than this negligence. Nothing but respect for professional confidence witholds us from exposing some of the most eminent of American practitioners in medicine and sur- gery who know these things, and who do them privately, but who are too fearful of a passing sneer from the ignorant and base, and too indifferent to the highest of professional ethics, to allow their actual position to be known! To return to our own affair: — Disregarding for the present occa- sion the technical classification and ari'angement of subjects, we be- gin with those in which the innovations of the Auxihary Blood Treatment have been the most startling, or quasi-miraculous, in con- trast to any and all pre\dous achievements of the healing art — fol- lowed by a large accumulation of new and saving experiences in the miscellaneous physical ills that flesh is heir to — not by means of any pretended "cure-all," but by an indubitable help-all, as self-evident . 10 as tlio lielpfulncss of ilie i)aticni's own life blood or breath! The facts that we shall here expressly briDg to the front, for a challenge to all men to test and sift to the bottom for any fallacy in theory or failure in effect — are such as the following: 1. Instantaneous elimination of the diphtheritic membrane and the poison at its roots, and continuous overpowering of the same throughout the system, by the same purely (natural, bland and genial, but potent, agent, that is at the bottom of all real cures — Blood — while, by the same agent directly sustaining nutrition and vitality irrespective of food, and introducing no alien, toxic or doubtful influence into the system. Now, will some one kindly try to expose a flaw in this proposition or in the clinical proofs of it following? 2. Same challenge with respect to the conquest of Supplied Blood over the poison of the Tubercle Bacillus, clinically demonstrated in twenty-six cases of consumption following; invariably, at the worst stages in which a workable respiratory area remained; the nu- trition and vitality of the patient being at the same time sustained throughout the conflict, independently of the necessity of any other feeding. 3. Furthermore, the same conquest carried into every other seat of invasion by the Tubercle Bacillus in the human body, searching out and overpowering the most secret and hitherto ineradicable pro- cesses of ulceration of flesh and rotting of bones; among which the deadly Lupus, in its impregnable strongholds, has bidden defiance hitherto to the most persevering siege by all the best equipped sur- geons of the world: — instanced in immediate cures with Supplied Blood, of some of the most desperate cases on record. We invite any one who will read the cure of John F. Baldwin at Sound View Hospital in four months, after all the medical science of the age had done its best for him for THIRTY-SIX YEARS, leaving his con- dition worse than ever; then to deny, if he can, that here is a power for heaUng that is unparalleled and practically new in the world. 4. Not to dwell on the invariable cure, by Supplied Blood, of all those cases of Chronic Ulceration that never were nor could be cured before, wherever located on the outside of the body, we have now to call attention to a new thing under the sun within six months past, that may almost be said to revolutionize the fate of women — certainly of thousands of women — for by it Ovariotomy should be- come practically a thing of the past, and almost any part or organ of the body, within as well as without, can be relieved of ulcerative inflammation or infection, nourished to perfect repair, and saved. This thing, in its potentiality, is indeed a year or two old in point 11 of discovery (by Dr. E. H. Pratt of Chicago), but in its application to diseased interiors out of human reach by any safe and salutary means before known, it is a thing as yet of the scarce recorded pres- ent hour. It is the Great Depurative Power of Blood and Oxygen as combined in reaction on septic matter of any kind or degree or amount, yet without any influence on living tissue but the most na- tural, soothing, healing and nourishing that can be desired. This Power has now been applied to ovaries in a stage of decay that no surgeon would dare delay to extirpate as the only alternative to speedy death — which, in fact, was already imminent with its most fatal symptoms, compelling the surgeon to throw the whole respon- sibiHty for the first experiment on the patient, who deliberately chose death in preference to mutilation. The easy, rapid, perfect and uneventful restoration of the condemned ovary, in repeated cases, now leaves no room for rational hesitation to lay aside the knife for "bovinine," in future. Even though the prospect of suc- cess be sometimes doubtful, there is no danger in stopping to try the chance, since the treatment removes, at least for the time, the dan- gerous symptoms, and betters the patient for operation if it comes to that. In a variety of the most difficult internal conditions peculiar to women, the most gratifying and extraordinary results will be found in this year's record of Haematherapy; often wholly supplanting or vastly mitigating gynaecalogical surgery with all its dangers and suf- ferings, in every kind of disease or operation to which women or men are subjected. The unique life-saving value of the bovinine-peroxide depuration is also shown in a remarkable instance of hitherto incurable external ulcer, which had eaten unchecked by any remedies at the command of the Boston Faculty of Medicine, until it had reached the pleura, where nothing could have delayed but a few days longer its irruption into the vital cavity, except the bland new detergent, which was ap- plied. This was followed by a constant supply of pure bovinine which built up healthy tissue, filling the cavity, healing the sore, and saving the life that had looked only for a speedy termination. 5. Passing with mere mention the demonstration following of the sovereign efficacy of Supplied Blood in cases of Erysipelas, Eczema, Burns, Fractures, Children's Diseases, and many others accumulated in the present imperfect collection; we call attention, almost as hastily, to the easy disposal, by Haematherapy, of two other condi- tions, which no honest physician has been ab.le to say he could do more than, palliate, heretofore. These two are. Anaemia and Catarrh. In the numerous cures of these two conditions, it will be 12 seen that the means — Supplied Blood — was reasonable, and the re- sult invariably satisfactory in the highest seaise — for no instance of the intelligent application of this treatment is ever withheld from publication, whatever the case or whatever the result. Readers are welcome, if they will, to compare the above general- izations to the array of marvellous cures put forth by every adver- tiser of a quack nostrum or patent medicine; or, if less malicious, to the flattering results often published in good faith, from the prac- tice of some highly approved method — antitoxine in diphtheria, for instance. There are always surprising cures, both with and without the doctor; but the comparison, if carried out completely and justly, will reach this essential peculiarity of ours: that we make nothing of a merely novel percentage of cures, how^ever extraordinary in charac- ter, but present a uniformity of effect to which no parallel can be found, and that based on no partial or select experimentation, but on a fully published record. of every case known of the intelligent ap- plication of the principle, amounting to thousands in every variety of condition, and in the practice of thousands of physicians in every part of the English-speaking world. This other peculiarity will be met with: the opportunity pressed upon every reader, to verify every case personally, on the spot, and observe to his heart's content the operation of the Auxiliary Blood Treatment before his eyes, in any kind or variety of diseases. ISTot to unduly extend this prefatory note, we must perforce re- frain; but the unspeakable relief to sufferers, and great saving of life effected by bovinine in extensive bums, and by skin-propagation with applied blood, minimizing the process of skin-grafting, ought to be specially noticed. Also the injection of a vital sustaining sup- ply of blood in cases of haemorrhage, where the distention of the col- lapsing veins with more water, now much in vogue, can only give a momentary lift, with no restoration, but, on the contrary, a miser- able dilution of the blood. The importance of a rich and vital and immediate blood supply in cases of blood-exhaustion is barely second to that of instant relief from collapse; both of which necessities are met at once by injected blood (in bovinine, or otherwise), and not a single instance of the slightest unfavorable effect has ever been noted, nor can any proba- bility of it be suggested consistently with modem knowledge and methods relating to the blood. / 13 THE SOVEREIGN DEPURATOR (PUS-DESTROYER) PBROXIDE-ON-BOVININE. The knife and curette of iho surgeon may not find their occupa- tion gone, for generations to come; hut their occupation is ah'eady much curtailed, as well as distanced out of sight, potentially, by the development to wliich we give fit promineoice in these first pages, of novel and momentous applications of the hovinine-peroxide reaction with septic matter, in parts and organs that are either out of the reach of the curette, or too delicate in nature or position for its touch, or too far consumed to bear mechanical or antiseptic irri- tants, or of too diffuse (catarrhal) discharge to be covered and con- trolled by such means. For such a depnrator and sterilizer of dis- eased parts wherever they may lie; combining the most searching an- tiseptic power with simultaneous efficacy for allaying instead of ex- citing inflammation, annihilating instead of intensifying pain, and healing and reconstructing instead of destroying tissue — the range of uses must be illimitable beyond our present comprehension. For the present, take the instantaneons eradication of the diphtheritic membrane with its sources, the ready extinction of hitherto ineradi- cable lupus, and the easy depuration and healing of uncontrollable ulceration wathin the very gates of life, and of internal female or- gans diseased past every resort but the knife or death. These we can offer as facts accomplished; refraining from the prediction of equal or greater wonders in sight, but not yet in hand; and begin- ning with the tragical situation and happy issue of THE CASE OF MRS. B , OF BOSTON. The case of this lady — secomdary specific ulcers of head and chest — was the first one admitted to Sound View Hospital, by Dr. T. J. Biggs, August 20, 1897. She was sent there in desperation from Boston, by a prominent physician, one of eight consultants who had done everything possible for her, until, in spite of all known reme- dies, the chest ulcer had eaten its way close to the pleura, the per- foration, of which, with inevitable death, was evidently but a matter of days. The curette had done in vain all that it could do but to break into the very house of life with the deadly infection; not a thing more could be done, and the sufferer was simply turned over to death. But ^^peroxide-on-bovinine" took the case with smiling ease, depurated the uoxious ca\dty in three minutes, and left nothing but a clean place for the healing, nourishing and vitalizing restorative — supplied bovine blood — to occupy aud fill with healthy tissue: which it did. We quote the process as described by the Sound View sur- geon: 14 The preparation of tlic cliest wound for blood treatment was a peculiarly delicate operation; the close proximity of the inner mem- brane rendering the removal of the septic matter very hazardous, so that curetting was out of tlic question; but bovinine followed by per- oxide of hydrogen, was a substitute as gentle as effective in such a case. The wound l)oing ihen washed out with Thiersch solution, the pure blodd treat nient was commenced by dropping bovinine fre- quently into the cavity (instead of packing it, through fear of rup- turing the nicinl)rane), the patient being kept on her back in bed, until a firm layer of healthy tissue was built up from the bottom. After that, it was j)racticable to apply bovinine in gauze packs, changed twice a day. The blood treatment of the head ulcer was more simjile and ordinary. The chest ulcer, by the 26th, was half filled up with sound tissue, and in a most promising condition. At this time, the patient felt it necessary to return, home, and she was discharged under protest; but in a condition now free from danger, and without doubt of continued progress to speedy and entire re- covery by the simple applications she w^as provided with and in- structed to make daily. At the present writing, October 5th, no un- favorable change had transpired. Latest observation (by letter) November 16, 1897: visiting in New Hampshire and reported in good health. * * * [Among the many new remedial procedures, saving members, and replacing or greatly mitigating surgery, which the introduction of Auxiliary Blood Supply now renders practicable, none, thus far, more forcibly demand the attention of the profession than the * TOPICAL HEALING OF OVARIAN ABSCESS (in place of extirpating the ovary, as heretofore necessary in such extreme cases) which is described in the following clinic. Consid- ering the self-respect of woman — which in this case, as in others, deliberately preferred death to sexual dismemberment — and espec- ially considering the dangers, and the undefinable but undeniably injurious consequences, of such dismemberment, it will be admitted that the new remedial process, conditioned on Auxiliary Blood Sup- ply to the antiseptically scoured cavity of an ovarian abscess, ad- vances the healing art by one of its most remarkable and beneficent stages. "Necessity is the mother of invention," and thus it was in the present discovery, for great as was Dr. Biggs's confidence in the constantly realized virtues of Supplied Blood, it will be observed that he dared not trust any means short of ovarectomy, in the case, but was literally compelled by the woman to risk evacuating and healing the diseased ovary, or see her die on his hands without 15 remedy. Henceforth, liowever, the way is opened : the New Power has triumphantly asserted its sufficiency; and a thoroughly equipped modern surgeon need not fear to trust diseased ovaries to Supplied Blood Treatment, with a probability of saving them and earning the blessings of grateful women.] II. TOPICAL BLOOD CURE AND REPAIR OF HOPELESSLY DECAYED OVARIES. (T. J. B.) Dr. T. J. Biggs, Sound View Hospital. Case of Miss L K , Crotona, N". Y.; admitted to Sound View Hospital, Nov. 25, 1897. Salpingitis; Ovarian Abscess; Ul- cerative Endometritis and Proctitis. The condition of the left ovary, per external examination, was so threatening that its re- moval was considered necessary; but the patient persistently refused to submit to it; declaring that she would die rather than be unsexed. The diagnosis was more than confirmed, later, in the progress of the disease. The organ was found to be in fact mainly an excavated shell, filled with pus, already diffusing septicaemia with its most menacing symptoms, and threatening an immediate repture of its at- tenuated wall, to pour the immedicable poison into the peritoneal cavity. All the instruments of surgery could do nothing for it but to cut it out. To open and curette the abscess would have been but destructive and hopeless violence. To have sent in mere peroxide of hydrogen or other simple antiseptic, instead of the curette, would have been useless and also destructive. But the destroyer and the savioitr met together — the peroxide and the blood — in league and mutual influence at once to destroy the sepsis and conserve the or- gan. This sounds romantic, but the metaphor represents a fact of scientific experiment nevertheless. Death or dismemberment was the inexorable sentence of yesterday^s surgery, upon this woman. Not either; but healing and wholeness of womanhood, at once, was the message to her of today's surgery as advanced by the knowledge of hydrogen peroxide on bovinine! We now quote Dr. Biggs: It seemed clear that the organ could not be saved, unless some novel way of reaching it with topical treatment could be devised that might possibly be successful. But being reluctant to experiment in this new field, I again strongly ad- vised removal. The patient again positively refused at all hazards, to have any such operation performed. Meanwhile the condition of the ovary, with severe recurrent elevation of temperature, often caused hours of intense effort and anxiety to avert a sudden catas- trophe. So the case see-sawed between intervals of danger and re- lief, with great and increasing pain, until by January 26,1898, the 16 condition of the ovary became so serious, that a rupture of the abscess into the peritoneal cavity was hourly imminent; while noth- ing in the line of jtrecedent could be done to save the patient, ow- ing to her determined rejection of operation. As a last effort, I now told the patient that I could take no further responsibility in her case unless she would .submit it to my control. Nevertheless, she still stubbornly refused to allow her ovary to be removed. I then consulted with her father on a compromise course which would test the practicability of topical treatment for healing. This was, to do a laparotomy for the purpose of bringing the ovary to the sur- face of the abdominal wound, where it coidd be drained, depurated with the bovinine-peroxide reaction, and topically nourished with the bovinine blood. This was agreed to, and on the 27th, under A C E mixture, laparotomy was performed. The ovary was found thoroughly diseased and tilled with pus, as expected. The broad ligament, however, was in a normal condition except considerable hyperemia. The ovary was now brought forward and stitched to the abdomi- nal wound, incised, drained, scoured of septic matter by peroxide- bovinine, washed out with Thiersch solution, and was then gently packed with iodoform-bovinine gauze. The surrounding tissues were protected with iodoform gauze, and the wound was covered with a wet Thiersch dressing. This procedure was repeated every day to February 9th, when no further evidence of pus could be per- cived, and the ovary had taken on a healthy appearance. Mean- while, I had made a plaster cast of a funnel shape, or hollow cone, the large end of which was applied to cover and protect the wound of the ovary, and a strip of gauze saturated with bovinine was passed into the small end, excluding air, yet so that the liquid should drip into the wound. As often as necessary, more bovinine was poured on the gauze to keep up the dripping blood supply. At suitable in- tervals, the cone was removed and the depuration of the wound was repeated. This alternate cleansing and feeding was constantly con- tinued until March 2d, when the ovary was entirely filled out with new normal tissue, and practically restored to health. March 3d, the edges of the abdominal wound were freshened; the ovary was released from its attachment thereto, and dropped back into its place; the wound was closed with continuous silk sutures, and dressed. March 14th, the wound was entirely healed. The patient was of course still weak; but considering all she had gone through, the sustentation of her system by the internal blood sup- ply continued all through, was a wonder for any who have not be- come accustomed to witnessing it. 17 On the lltli of April, this case was discharged ahsolufely well, a "new woman," and a whole woman; six and a half pounds heavier than she had ever been before in her life. If half — nay, a single instance out of hundreds — of our reports had issued from the cliniquc of the meanest of German professors, the whole American profession would have been convulsed with ex- citement, the daily papers would have been ringing with it from ocean to ocean, and a dozen patented German blood preparations would long since have been clamoring, Behring fashion, for prefer- ence by a hundred thousand eager prescribers. And it would have been, for once — just once — a well grounded and beneficent furor, a veritable New Era in Medicine. SECOND CASE OF SALPINGITIS AND TOPICAL BLOOD TREAT- MENT. (DR. T. J. B.) Miss B , Few York City; age 28; Dec. 30, 1898; salpingitis. right side; in extreme pain and greatly run down. Her secre- tions were regulated, and on December 31st, under anesthesia, the womb was well opened up and a cystoscopic examination showed pus exuding from the right tube. There was also present some endo-metritis. The tube was first catheterized and depurated with bovinine and peroxide. Then the womb was cleansed in a similar manner, and following this was packed with iodoform-bovinine gauze. At the end of twenty-four hours this packing was re- moved, the tube depurated as before, and the womb repacked with iodoform-bovinine gauze. This procedure was continued up to January 20th, at which time it was found that the tube was in a healthy condition, but slight traces of the endo-metritis re- maining. The uterine packing was now discontinued, and intra- uterine injections of bovinine w^ere employed three times a day. January 29th, the patient was discharged cured. Coincident with the above described treatment the patient had been given a table- spoonful of bovinine in milk every three hours. 18 THE CUBE OF PEOFOUND TUBERCULAR INFECTION AMONG THE UNEXAMPLED TRIUMPHS OF HyEMATHERAPY Over ConditioDs Long Proved Incurable l)y Any and All Other Means. MEMORABLE CURES OF LUPUS. Case of Mary Noble, by Dr. T. J. Biggs. Inveterate Tubercular Infection Finally Eradicated by the Virtue of Bovine Blood Nutrition. The lupus case of Miss Mary Noble (age 28), first introduced to the public in "Modern Medical Science" for February, 1896, and only brought to an end March 10,1897, deserves to be considered, in a connected view of its desperate character, long conflict, and suc- cessful issue without surgical interference, .the most memorable case of the kind on record up to that time. It is unnecessary to remark, that lupus is a form of tuberculosis that is the terror and opprobrium of surgery, as pulmonary consumption is of medicine. New cases can scarcely add new horrors to the record of its ravage of the facial organs, in particular. In cases of the profound infection now to be reported, nose, lips and eyes are destroyed without remedy, by the uncontrollable proliferation and burrowing of the bacilli; sometimes assisted, but never arrested, by surgical extirpation. It was no thanks to forbearance or insufficiency of invaders, that any human feature was saved to the face of this young lady, or any limit set in this life to the loathsome ulceration that was overspreading it, under any treatment known to the official teachers of the medical profes- sion. Not only has this been done, but the features have been saved entire, the eyes unhurt, and the countenance undisfigured, save by an inconspicuous scar. The sole positive factor in this result has been Applied and Injected Bovine Blood. The case had originated in a contused lacerated wound over the left supraorbital arch, with questionably aseptic dressing at one of the hospitals. A small abscess developed, which her physician, Dr. Blanchard, incised and cleaned out antiseptically, and healed to a point of the size of a pin head, where it remained at a stand for about a week, and then developed rapidly into an ulcer. Then diagnosing lupus, Dr. Blanchard changed the treatment to counteract it, but without success. The sore would partly heal, and then break down again, with aggravation, working onward gradually toward its pres- ent site. In this way it had see-sawed back and forth with steady advances for two years. Meanwhile, the case had been submitted to Dr. C , at the Demilt Clinic, who exhausted the resources of recognized practice 19 for a considerable time, with no better success. Finally, the patient returned to Dr. Blanchard. After two years of ineffectual resistance to the progress of the infection, it happened that a mutual friend brought "The New Medical Era of Htumatherapy'^ to the notice of the thoroughly discouraged physician, who gladly resigned his case to Dr. Biggs. In summary, to this time, it had been treated with blue ointment, pure kreasote, pure carbolic acid, paste of yellow oxide of arsenic, iodide of sulphur, nitrate of silver, mercuric bi- chloride solutions of different potencies, peroxide of hydrogen, etc.; finally by cleansing and dressing with pure cream, which seemed to do more good than anything else, healing it slightly for the moment; but, in fine, the fruitless exhaustion of all medical resources had con- firmed the case as hopeless. At this time, the ulcer was about two inches in length and one inch wide, with rough corrugated and indurated surfaces, and here and there well-defined tubercles. It lay midway between the supra- orbital arches, beginning just above the root of the nose,- and extend- ing downward on the nose, and laterally over the left upper eyelid. The left eye being highly congested, with purulent conjunctivitis, from the entrance of discharges from the sore, the first thing was to wash out the eye with a saturated solution of boric acid every two hours, for four days, when the inflammation had subsided, and the eye seemed in a healthy condition. Carefully cleansed eyelids and lashes, washed out the eye again, and sealed it to keep out dis- charges for the future. The next day, the ulcer was thoroughly cu- retted and cleansed with peroxide of hydrogen, and two drops of pure kreasote were injected, at intervals of a quarter of an inch all around the border, at the line of healthy tissues, to destroy the bacilli tuberculosis. It was then dressed with wet Thiersch, cover- ing the whole face except mouth, nostrils and right eye. Two days later (7th day) the dressing was removed and the ulcer presented a healthy appearance. It was again thoroughly cleansed with per- oxide of hydrogen, the edges were touched with 25 per cent, pyro- zone, and the wet Thiersch dressing again applied. On the eighth day the ulcer appeared in the condition desired for receiving the vital nutrition so much needed. Blood supply was therefore commenced at this point, by injecting bovinine and salt water, half and half, all around the line of healthy tissue, six or seven drops at every quarter-inch. Then, over the denuded surface was spread the usual dressing of sterilized gauze saturated with bovinine, covered with oiled silk, cotton and band- age. The bovinine dressing was changed every day for the next ten days. Steadily improving under the topical nourishment, the- ulcer 20 by this time had entiroly lifaled, except a minute point halfway down the nose, and one of Ihc size of a pea on tlie eyelid; where it would seem that some bacilli had escaped the treatment. These points were treated again with the same process as before; curetting, cleansing and dressing with boyinine. This was January 27, 1896; the scar was pink, soft and healthy; the constitutional condition all that could be desired; eating and sleeping well; and ever\'thing indi- cated a complete cure. The notable peculiarity always attendant on the appropriate appli- cation of bovinine, and of no other known agent — the absolute anni- hilation of the most distressing and constant previous pain — had been, of course, marked in this case. The first application substan- tially relieved, and the third abolished the pain entirely, from that day to this. But, virulent as the infection had shown itself under the old treatment, which had proved impotent to arrest its progress at all, it was reserved for the beginning of success under the new treatment fully to reveal that profound intrenchment of the disease which in such cases makes the occasionally hopeful appearances a mockery, to the end. The writer watched for eighteen months the wrestle of Haema- therapy with the hideous distemper fastened on that young woman's face. A more stubbornly contested field was never seen. As fast as the ulcer was healed at one position, the deep-seated infection would generate new tubercles and new centres of ulceration else- where. Supposing them extirpated one after another by surgery, how much would have been left of the face, after all their forces had been exhausted — if they ever were? Instead of such undefinable devastation, it was to be seeti what the robust bovine blood, in full perpetual supply, internal as well as ex- ternal, could do to overpower and eradicate physiologically the un- derworking virus. This has been done. By constant attendance on the patient for a year and a half, combatting the obstinacy of the dis- temper with a perpetual supply of vital blood alone (antisepsis clear- ing the way), the end of the struggle was reached; and on the 10th of March, 1897, it had become evident that the peaceful physiologi- cal victory was com])lete: the malign process that had persisted for so many years, had now finally ceased, and the long-afflicted sufferer was discharged, free of all damage or danger, save a soft, healthy cicatrization on the upper part of the nose, and this gradually re- suming natural color, with sensitiveness scarcely less than that of normal skin. 21 The Case of John F. Baldwin, of Thirty-six Years' Standing. Ts placed after that, of Mai-y Noltlc, althoiigli so luucli more con- S2>ieiious, ill order (hat a close comparison of the two, with the sim- plified treatment and speedy result in the later case, may reveal to the reader the measureless therapeutic progress effected by the dis- covery of the depurating and sterilizing power of the bovinine-per- oxide reaction. This was unknown at the time when Mary Noble's case w-as treated; and the difference it makes in the cure of tuber- cular and all other ulcerative and septic processes, is accurately measured by the difference between the eighteen months of her con- flict, and the short and decisive issue of the following case in four months, after thirty-six years of incurable and agonizing tubercular ulceration. LUPUS CASE or JOHN F. BALDWIN, OF NEW YOEK. Thirty-six Years of Disease and Excruciating Pain, Despite the Best Efforts of the Leading Surgeons; Entirely Ended in Four Months by Supplied Blood. Case VI. — Abstract by the Surgeon, Dr. T. J. Biggs, Sound View Hos- pital, Stamford, Conn. Mr. John F. Baldwin, age 79 years, was entered as patient in Sound View Hospital on the 8th of June, 1898; exhibiting a deep lupus vulgaris w^hich involved almost the entire nose, extending down under the left eye and cheek; and also involved the nasal tissues, internal and external, as far back as to the middle anterior nares. He said he believed if blood treatment could not accomplish his cure, nothing could, and in that case he was ready and willing to die: his sufferings had been so constant and severe that opium, morphia, or any other of the anodynes in use had little or no effect, and the only rehef he could obtain, partially or temporarily, was by taking a large drink of whiskey or brandy, which, being a temperate man, he w-as unwilling to do. The present condition began thirty-six years ago, with a little pimple, which would not yield to the usual treatments, and at length broke down into an ulcer. Employing the best known physicians in that line, he resorted to one eminent authority after another, spending money and time freely, but without benefit, only getting worse at every effort. The celebrated surgeon, Dr. "Valentine Mott, went at it vigorously, and compassed literally sea and land for some untried remedy old or new. But all remedies failed to counteract the irresistible progress of the infection, and Dr. Mott himself finally gave it up, having accomplished nothing. Mr. Baldwin next re- 22 sorted to an institution where a specialty was made of such diseases. Here, a plaster was applied, causing excruciating torture, which was endured for a week, when the bulk of the pathological mass came away'. The wound then began to heal partly, and he began to hope that an end was approaching. But the condition soon retrogres.sed, broke down rapidly, and extended farther than ever before. Again he started out in pursuit of various treatments, trying all that held out any hope, in a long struggle without result. One of the numer- ous treatments in a struggle of thirty-six years, consisted in caustics of some kind applied on toothpicks, burning out little pieces of the diseased tissue at a time. This the unhappy patient suffered for five years, with no result but increase in the extent and depth of the ul- ceration. In all this time, no one had thought, or perhaps heard, of the powers of Supplied Blood, to satisfy tortured nerves and to nourish famishing and moribund tissues from which the native blood stream is barred by disease. This, at last, through the sug- gestion of a friend, Mr. Baldwin was led to experience, in Sound View Hospital; admitted June 8, 1898, in a condition completely worn out, so feeble that he could hardly walk upstairs without help, unable to sleep from incessant pain, without appetite, and ready ra- ther to die than endure further. The patient's vitality, though it had been amazing to his friends these many years, was now so much lowered, together with his great age, that I saw it necessary to build him up for a while, before oper- ating. He was, therefore, put on a blood and alterative trentment: a tablespoonful of bovinine in milk every three hours, and a quarter grain protiodide of mercury also at every three hours. This treat- ment was continued for ten days, when the protiodide was discon- tinued, and Barclay's preparation of gold, mercury and arsenic bromide was substituted, ten drops three times a day — this to com- bat a hereditary syphilitic taint. After thus building up the pa- tient as far as possible, on the 20th of June, assisted by Drs. Hoyt and Miller, using chloroform anaesthesia, with a sharp dermal cu- rette, I removed the entire mass of diseased tissue as thoroughly 53 I could. Following this, I touched up the entire surface and edges of the wound with the Paquelin cautery; depurated the parts with the bovinine-peroxide reaction washed out with Thiersch; dried and dusted over the entire surface with lactate of silver; over this placed iodoformized gauze and a bandage. Changed the dressing after twenty-four hours, and for two weeks further, redressed as before three times a day. At the end of this time a large crust covering the entire sore came away, leaving a healthy granulating surface. After that, the wound was cleansed daily with bovinine-peroxide re- 23 action washed out with Thiersch, followed by spraying with pure bovinine; strips of oiled gauze being laid over to prevent evapora- tion of the bovinine. The wound now began to heal rapidly, and by August 22d was healed, except a minute point on the left side of the nose, which I continued to watch and dress daily as before. September 1st, I noted a little development which had escaped the curette and cau- tery, on the upper part of the nose; also one on left cheek at the low- er margin of the cicatrix; and one on the right ala of nose. This necessitated some more thorough scraping under chloroform; the suspicious points were removed, the wound depurated, as usual, with bovinine-peroxide washed out with Thiersch, and a dry dress- ing of boric acid and acetanilide applied. This dressing was not touched for a week; then, having loosened up, it was removed easily, leaving the points that had been curetted in a healthy granulating condition. Depuration and bovinine dressing Avere resumed twice daily as before, and continued to October 33d, and on the 24th, pa- tient was discharged cured; having passed two weeks of probation since the last point of ulceration had healed, without developing any sign of renewed outbreak, or of such flesh as would indicate its pos- sibility. Eemarks. — (1) Immediately after the first dressing with blood following the first and extreme operation, the long and iininter- mitted agony of so many years ended, and in forty-eight hours all pain had ceased and ceased permanently; the removal of the septic excretion having served to let in the supplied vital element to do its healing work on the tortured nerves; (2) the unheard-of rapidity of healing; (3) the smoothness of the cicatrix, soft, pink and healthy, its outline, or demarcation from its normal skin, being almost undis- cernible. INTERESTING FINALE OF JOHN F. BALDWIN'S CASE. After the discharge of the case as above recorded, Mr. Baldwin was visited and watched in New York, with a view to the detec- tion of any traces of tubercle that might remain lurking in his sys- tem. He was feeling perfectly well — the first enjoyment of health in thirty-six years, or even of relief from perpetual suffering — but merely noticed a little itching about the site of the ulcers^ such as often attends such places. This, however, awakened some sus- picion in the mind of Dr. Biggs, and he had his patient out to the hospital again, and made a new examination. Under a powerful lens, a persevering search revealed, on the line of apjjarently healthy tissue around the outside of the scar, a number of white 24 specks of about the area of a pin point. These were closely watched for a number of days, until they were found increasing, gradually, to the size of a pinhead, and finally began to be elevated a little al)ove the cuticle and to assume a slightly bluish tinge. There was no sensation associated with them, except that when touched with a blunt probe they were found a little more sensitive than the ad- joining flesh. Convinced that this was some pathological process, and fearing a possible tubercular character, Dr. Biggs excised one of them, mounted a section, and under the microscope discovered once more the tubercular bacillus. He then removed them all by lifting out with a small dermal curette; applied the electrical cau- tery and bovinine twice; healing them thus, gradually, two or three at a time, and still watching closely for further developments, until there were no more signs for alarm, when the patient finally re- turned home. These minute points of infection miglit, not improbably, have remained latent four or five years longer before breaking out, or, again, they might become encysted and spontaneously healed. No doubt, however, Mr. Baldwin is well rid of them, thanks to a thor- ough watchfulness of the sequelae of cases, which is unfortunately so rare, that the real results and merits of the various treatments of disease remain very uncertain' in spite of all the reports of cases. 25 Abstract from the Masonic Standard, Nov. 5, 1898. JOHN F. BALDWIN'S RECOVERY. Dr. John Alsdorf Gives an Interesting Account of a Famous Case. September 27, 1898. M.I. Frederick Kauter, C4rand Master of the Grand Council of Eoyal and Select Masters of the State of New York. Dear Sir and Brother: I have the honor to report that in compliance with your request, I visited on Saturday, September 24, M.I. John F. Baldwin, Past Grand Master of the Grand Council of Royal and Select Masters of the State of New York, at Sound View Hospital, Stamford, Conn. Brother Baldwin, as you are aware, has for the past thirty-six years, been afflicted with a destructive growth on the face and nose known as lupus vulgaris. Some time in May of this year, I brought to his attention the report of several cures of lupus, performed by Dr. T. J. Biggs, of New York City and Stamford, Conn. Brother Baldwin investigated the reports, and, after careful consideration of the facts, determined to go with his wife to Sound View Hospital and place himself under the care and treatment of Dr. Biggs. At the time of his entrance into Sound View Hospital, he was unable to go up or down stairs, or even from one room to another, without as- sistance. The treatment at first was of a preparatory and tonic character, in order to build up the patient's strength for the opera- tions to follow. It consisted of the internal administration of bov- inine. Under this treament, associated with good food, fresh air, and cheerful surroundings. Brother Baldwin's improvement in gen- eral health was very rapid. Two weeks after his entrance he was able to go off fisliing by himself, and at the expiration of six weeks was considered in a physical condition for the operation. The operation (which, as an operation, was no different from those that had been performed before, always resulting in failure), con- sisted of curetting and cutting away the diseased growth, with the application of the thermo-cautery. Subsequent treatment was the preparation for, and the final application of, bovinine dressings to the wound. Dr. Biggs claims that his success in the treatment of all these pathological conditions is due to the principles of h^ma- therapy, or auxiliary blood sup])ly, viz.: the proper preparation of the diseased surface for, and the application and absorption of, bovinine. Under this treatment the wound rapidly healed, the condition of the patient improved, with entire freedom from pain, and his final discharge from the hospital was to have taken place on the 26th of September. A careful examination of the locality of the lesion re- vealed the fact that there still remained three minute points of de- posit of tubercular bacilli, although there was no abrasion of the skin, and, in order that there should be no possible danger of the re- newal of the process, Dr. Biggs persuaded Brother Baldwin to sub- 5i6 mit to a second operation, which was successfully performed, the 22d of September. Sincerely and fraternally yours, JOHN ALSDORF, M. D. M.I. Comp. Baldwin returned to the city about two weeks ago, greatly improved in appearance and spirits and in good health. He is attending to business as usual, and will fill his old position as Pre- late in Palestine Commandery next Monday night. BRIEF NOTES OF PREVIOUS TUBERCULAR ULCER CASES. CHRONIC TUBERCULAR ULCER— CASE NO. I: BY DR. T. J. B. Louise Gobeley, age 34, 27 Broome Street, Newark, N. J. Tuber- cular ulcer three by two and one-half inches in diameter on right leg over tibia, of six years' standing, had never healed in spite of various treatments. March 15th, 1894, the ulcer was curetted, and then in- jected subcutaneously with iodoform-bovinine at the line of demar- cation, in six places. The wound was then cleansed and dressed with bovinine, renewed daily, and the patient was discharged en- tirely well, April 10th, 1894. CHRONIC LUPUS CASE NO. II: SAME SURGEON. Henry Metz, age 36, January 2, 1896; lupus vulgaris, size of quarter dollar, over mastoid process under left ear; result of a con- tused wound running into an abscess, and now of one year's stand- ing. It bad been opened and cleansed and had healed kindly down to the size of a pinhead, but began again to grow, and microscopic examination of a section proved it a typical case of lupus. From that time an exhaustive series of treatments for that disease had been applied, with nothing more than palliative results. Three times it had been almost healed, only to break down again and grow faster than ever. January 3, by Dr. B the ulcer was thoroughly curetted and sterilized for 24 hours; after which bovinine was applied in gauze. This treatment was repeated until February 13th, when the cure appeared to be substantially perfected. LUPUS CASE NO. Ill: SAME SURGEON. John Fox, age 40; lupus ulcer over the right malar bone. March 16th, curetted and dressed with bovinine. Treatment continued to April 9th, and entirely healed. LUPUS v.: CHRONIC ULCERATION CXXVI. E. H , New York, age 43, April 1, 1898. Lupus on the back of left hand, of the size of a silver dollar; had been treated four years, employing, it is said, twenty-five physicians, but had never healed; treatment consisting of about everything known in piactice, except blood treatment, even to the actual cautery and curettement. After thorough t-urettcnient and storilizatioji, l)C)vinine was injected all around the circumference of the ulcer, and it was then dressed n M-ith a wet Thiersch pack. At the cud of twenty-four hours, the bovinine-peroxide depuration, with Thiersch irrigation was per- formed, lodoforui-bovinine dressing was applied, and renewed daily until April IStli, when another thorough depuration with per- oxide on bovinine was given, with Thiersch irrigation, and dressing now with bovinine pui-e. Thenceforward the progress was satis- factory, and on May 20th, the patient was discharged cured, the wound having entirely and absolutely healed. IRREPRESSIBLE CLINICAL EXPERIENCE. DR. T. E. DAUGHBRTY, BALTIMORE, MD. I know of no better way to show my gratitude for the existence of such an article as "bovinine" than to mention my experience with it, wliich has been most gratifying. Case I. was a man who had been coming to one of our city dis- pensaries for a period of two years, where I had treated him for two large chancroidal ulcers, situated on the scrotum. All ordinary modes of treatment had been resorted to without the slightest signs of improvement. I finally concluded to try blood treatment, and had him come to my office when I began treatment anew by curet- ting the surfaces and applying a wet Thiersch dressing for two days, which left them in condition to absorb the bovinine, which was then applied daily for ten days, when the case was discharged cured. I had similar experience with two cases of chronic ulceration of the leg. I am not an advocate of many proprietary medicines, but bovinine cannot be praised too highly and for the sake of suffering humanity I trust its properties may be known universally. 1406 N. Mount st., Jan. 35, 1899. % * if Dr. W. W. Gleason, Attleboro, Mass., says: Not long since a work- man in one of the large jewelry shops here was brought to me with his leg badly cut to the bone, a gash more than a foot long, being also badly burnt by the friction of a rapidly revolving emery wheel. I cleansed the wound carefully, kept a rich blood dressing (bovinine) continuously applied, and to my surprise, in five days the wound was practically healed." * * * "Another case: An old lady now living, with a series of large in- dolent ulcers, none of which had yielded to the best of customary treatment, by good physicians, but which, again, gave a ready re- sponse to the blood treatment. It is needless for me to say of my former experience with bovinine, that I held it in high esteem as a nutrient, either internally or externally." 28 [The enormous advance in surgery by auxiliary blood supply is so proniinenily represented in 'J'iil)ereular TTU-ers and Bone Ne- croses, that we allow a few instances a proiDineiit jjlace by them- selves, and postpone the once marvellous, but now everywhere com- mon, healing of common ulcers, however refractory, by the same means, to a space further on, which will be indicated in the Table of Contents.] TUBEECULAR DISEASES CONTINUED as yielding to Supplied Blood, in TUBERCULAR ULCERS AND NECROSIS OF BONES. NECROSIS OF BONE (TRAUMATIC) AND TUBERCULAR OSTEOMYELITIS. By Dr. T. J. Biggs, Sound View Hospital. Mr. Ora Eogers, Corona, N. Y.; age 29; September 6, 1897; three years bullet wound with necrosis of head of tibia, from the ball striking the head of the patella, breaking off a spicula of bone from the condyle and driving it into the head of tibia. From the intense pain which the patient had for a long time been suffering, the stiffness of the limb, the general physical ap- pearance, and family history, I suspected a tubercular osteomyelitis, and advised immediate operation. Two weeks were given to cor- rective and supporting regimen, with bovinine in milk or whiskey as the condition required. September 21st, an incision and a careful dissection were made, exposing finally the tibia head. A button of bone was taken out of the head of the tibia, which was found to be diseased through- out. The entire head of the tibia was then curetted out, leaving it a mere shell. The cavity of the bone was at once cleansed out with the bovinine-peroxide reaction, and the product washed out with Thiersch solution, and then packed wdth iodoform-bovinine in sterilized gauze. This packing was changed every twenty-four hours, for one week, with daily cleansing and sterilization as be- fore, when the bone cavity was found beginning to fill up with healthy material. But so much necrosed bone had been removed, that I deemed it necessary for a complete and rapid cure, to em- ploy sponge grafts. From the finest quality of sponge, after being specially prepared, a small layer about the thickness of a finger nail was shaved off with a sharp scalpel, gently laid in the bone cavity, and fed with bovinine by a dropper, the wound being kept open. In five days of this continued treatment, the first sponge graft had become vitalized; healthy granulations having sprouted ■29 like little vines ramifying tlirf»iigh tlio pores of tin- sponge. On the seventh day after the hrst, another sponge graft was applied, and treated in the same way. This also became vitalized, and had pretty nearly filled up the bone cavity with new bone, within seven days, or on the 3d of October. Ten days later, a third sponge graft Avas applied; keeping up the bovinine-peroxide and Thiersch sterilization and bovinine dropping, from day to day. Ten days more suflficed for this last graft, as nourished by supplied blood, to become not only vitalized, but converted to solid bone, like its predecessors, and to fill the cavity entirely. Periosteum was now dissected up and brought in apposition over the site of the late cavity, by means of continuous norse nair sutures. This united completely and firmly, fed with the blood-conserve, in five days. The edges of the external wound were then freshened and brought in apposition by strapping and two heavy catgut sutures; dressing with pure bovinine. The wound was entirely healed, November 2d; but the patient was kept two weeks longer to watch for sequelae. SECOND CASE IN SAME PATIENT. Re-entered November 16, and operated on for removal of a sec- ondary tubercular osteomyelitis, in the shaft of the tibia, about two inches long, and extending down nearly to the medullary canal. It Avas thoroughly curetted out, depurated with the bo- vinine-peroxide reaction and Thiersch irrigation, and packed with gauze saturated with bovinine. This packing was changed once a day until December T'th, when the cavity was entirely filled, and the external wound was healed. A third tubercular deposit had now developed in the right axillary cavity, involving two of the axillary glands, requiring a third operation. FOURTH CASE IN SAME PATIENT. Ee-entered January 6, 1898, with a third development of tuber- cular infection in the tibia, below the others, extending from above the ankle joint, a length of four inches. The necrosed cells were thoroughly removed; going nearly through the diameter of the shaft. The cavity was scoured by the bovinine-peroxide reaction and Thiersch solution, and packed with gauze soaked in iodoform- bovinine. This treatment was repeated until February 2d, at which time, the cavity was found entirely filled up with new bone, and covered with new healthy periosteum. 30 TUBERCULAR OSTEOMALACIA, VERTEBRAL. By Dr. T. J. Biggs, Sound View Hospital. Mrs. T , Portchester, N. Y.; age 39; May 27, 1898; fourth, fifth and sixth dorsal vertebrae badly diseased. The spinous pro- cess of the fifth was almost destroyed, and a sinus leading down to it exuded a large quantity of foul sanguineous pus. This was syringed out with peroxide-bovinine, then filled with bovinine and dressed. On June 6th, I removed the spinous processes of the fifth and sixth vertebrae and the pathological tissues of the cavity and surrounding parts; and to destroy any remaining bacilli, de- purated it with peroxide-on-bovinine; then packed with bovinine in gauze, repeating daily until June 29th, when the cavity was filled with new bone and the wound healed. GANGRENOUS TUBERCULAR NECROSIS OF BONE. Dr. T. J. Biggs, Sound View Hospital. Carl , Stamford; age 28; February 26, 1899; tubercular necrosis of finger; five weeks previous, the end of finger was pinched off between first and second joint, in a steam cutter. A physician stitched it on, put the finger in splints, and dressed it daily with wet bi-chloride dressings, for ten days. The pain was excrucia- ting, the hand and arm so swelled, the severed end of the finger so black, and the smell so foul, that an immediate operation was necessary to save his arm. Following this operation, the patient experienced much relief from pain, but his hand and arm grew steadily worse. When he came to me, the remaining bones of the little finger, and the metacarpal bones, were badly diseased ; those of the little finger being utterly devoid of life. The whole hand and forearm was badly swelled; the axillary glands much enlarged and painful. He was put to bed, and his secretions regulated, and on the next day (27th) under anesthesia, I removed the little finger, excising the head of the first metacarpal bone. I then carried my incision down the palmer surface to the wrist joint, and found the bones so badly diseased that I had but little hope of saving the hand; but I determined to make a stubborn fight for it. Two large glands in the axilla were removed, and the forearm incised over the tendon of the pronator radii longus; the pus having extravasat- ed to that point. The wounds were now all depurated with bo- vinine and hydrozone followed by Thiersch irrigation. lodoform- bovinine was then injected into each wound and they were packed with iodoform-bovinine gauze, and dressed according to the ulcer technique. This procedure was repeated every three hours, up to 31 March 7th, at which time, the formation of pus had entirely ceased. The wounds in the axilla and forearm had healed, and the bones in the hand had taken on a healthy appearance. The hand was now dressed with bovinine pure, three times in twenty-four hours, to March 16th, when the bone had been restored to health and cov- ered with periosteum. March 22d, the wounds were entire- ly healed, and through free use of bovinine internally he had gained over twelve pounds in weight. [For Cases in General of Ulcers, Necroses, Etc., see pages further on, per Index.] TUBERCULAR APPENDICITIS— A NOVEL OPERATION. By Dr. T. J. Biggs, Sound View Hospital. P G , Glenville, Conn.; Russian; age 36; sent by a brother physician, under whose care he had been for more than a year but with no benefit. Received April 16, 1898. Diagnosis: anasmia complicated with tubercular phthisis and appendicitis. (Treatment of the phthisis, under head of Consumption.) A large quantity of tubercle bacilli were found in fauces and throat as well as in the expectoration. Examination over the csecum revealed much tenderness and considerable enlargement. Pain was very severe in the caecum, three hours after eating. This condition had been slowly progressing, and from its general history I diagnosed tubercular appendicitis, and advised operation, to which patient consented. His condition, however, was not such as I cared to operate on immediately, and I therefore put him on a course of pre- paratory medical and blood treatment. May 2d, patient was properly prepared and laparotomy performed. The csecum was found distended, but in a healthy condition. The appendix, how- ever, was completely diseased, and bound down by adhesions to the Cfficum. It was now carefully dissected off, and the surfaces to which it had been adherent were first touched up with the Paquelin cautery, and then cleansed with peroxide-on-bovinine and Thiersch irrigation. The appendix was so firmly adherent to the caecum, that no ligature could be employed to close the appendix opening. For this reason, as well as that the surface to which the appendix had been attached was so extensively involved, I deemed it unwise to close the opening immediatelj^, so therefore stitched it to the abdominal wound, with the intention to treat it exactly as I had treated the ovary in the case of Miss R . A gauzo packing of iodoform-bovinine was laid over the wound, and a dressing such as used on ulcers was applied. The patient reacted nicely from the 32 anaesthetic, and suffered absolutely no pain. The dressings were renewed twice a day, until the 8th, when I found the wound of cascum in a healthy condition, and therefore stitched it up with continuous catgut sutures. By the 18th, the cfficum wound was entirely healed. The sutures holding it to the abdominal wound were now removed, and the caecum was dropped back into the cavity. A drainage tube was inserted, and a wet Thiersch gauze dressing applied. In twenty -four hours, there having been no rise of temperature or indication of any disturbance whatsoever, the edges of the abdominal wound were brought in apposition with three silver-wire and five silk sutures, and a pure bovininc dressing was applied. This was changed daily until the 39th, when the wound had entirely healed. A proper support was now applied, and on the 30th of May, 1898, the patient was discharged cured. Points of great interest in this case are : the rapid healing of the ciecum wound, and the absence of any signs of shock. TUBERCULAR ENTERITIS. Dr. T. J. Biggs, Sound View Hospital. Frank F , Glenbrook, Conn.; Slav; age 26; December 19, 1898; had been suffering with this condition about four years, and had subjected himself to many different treatments without avail. He presented the following symptoms: Severe colicky pain occur- ring in paroxysms, situated above the umbilicus, much localized ten- derness; loose evacuations; occasional attacks of nausea and vomit- ing; the stools contained but little f fecal matter, were greenish yel- low in color, blood streaked, and mixed with undigested food ; appe- tite greatly impaired; digestion and assimilation poor; extreme weakness and emaciation. Microscopic examination of the stools revealed a trace of tubercular bacilli. Patient was kept in bed, given internally a teaspoonful of bovinine in milk and lime water, every hour; together with medical treatment and rectal injections of iodoform-bovinine three times a day. January 1st, the bovinine was increased to a tal)les]wonful every two hours, the rectal injec- tions as before. Januai-y IGth, symptoms had entirely disappeared with the exception of some rectal soreness. The treatment was continued to January 29th, at which time it was found that the condilion was (■()m|)k'tely cured. 33 TUBERCULAR DISEASES CONTINUED. THE BLOOD TREATMENT IN PULMONARY TUBERCULOSIS. By T. J. Biggs, M. D., New York. The anaemia of tiiLerculosis differs from some other forms in being- as a rule the result of the deleterious effect of toxines upon the blood, or upon the blood-making organs. Simple anaemia at times precedes the development of tuberculosis and becomes a pre- disposing factor to infection with the specific germs, and in the course of the disease such ana3mic states may also result from gastro- intestinal complications. While the toxic form cannot always be distinguished because fre- quently associated with the other toxines, it must be recognized, nevertheless, as the cMef cause of anasmia in all contagious and in- fectious diseases. In its treatment the indication is, of course, the prevention of the production of toxines within the body, which can only be accomplished by the removal of the pathogenic germs, or by th6 production of immimity from their toxines. The pure blood treatment will, I feel confident, accomplish the destruction of the specific germs of tuberculosis within the living organism, or immimity from their toxic products. If infection occur in health}^ persons, their tissues and especially the blood, are capable of offering successful resistance, and the or- ganism is preserved in its integrity. In the established disease, the resisting power of the particular patient has evidently been insuffi- cient, either by reason of the organisms being overpowered by the excessive quantity of infecting material, or by reason of minor re- sistance on the part of the tissues where the specific germs gained entrance. This view is uniformly accepted, and, in the light of pathological investigation as well as of clinical experience, is well proven. We must, therefore, not lose sight of the resisting power of the patient, and its increase must be accomplished, if we expect to deal success- fully with the disease. In the application of specific culture pro- ducts in pulmonary tuberculosis, observations have amply confirmed this view; for the best results from such treatment are obtained in cases where the general strength of the patient is still good, apid es- pecially when the blood approaches a normal standard in the cor- puscles and hfemaglobin. Most patients show a considerable loss in this respect, even in the earliest stages, and these losses have even been observed to progress despite of good appetite, and in patients who for the time gained in weight. 34 It. is, therefore, most rational to seek the regeneration of the blood. In addition to proper dietetic and hygienic management, i naturally looked for a remedy to accomplish this. But all the sup- posed remedies for this purpose have not only failed in the majority of instances, but have frequently interfered with the improvement in other respects, by disturbing the digestion and assimilation of food. After considerable experimentation with all the pharmaceutical remedies, with more or less unsatisfactory results, I discarded them all, and determined to try and bring about a perfect state of nutri- tion by natural means, and resorted to defibrinated blood in the form of bovinine, and so far have accomplished my object most satisfac- torily. From the first to the present time I have not had a single case that did not improve materially. I have thus treated six cases where tubercular ulceration of the epiglottis was so severe that they could not swallow anytliing without the acutest suffering. In these cases bovinine was applied by a steam atomizer, with the result that in each case the condition in the epiglottis was so relieved that food could be swallowed with comfort, and entire healing was rapidly effected. In all cases treated by me it was well ])orne by the stomach and the appetite at once improved, and all other symptoms were alle- viated. Examinations of the blood were made from time to time, and in all cases the improvement of the blood was rapid, with de- generation, fragmentation and disappearance of the tubercle bacilli from the patient's sputum. This proves the germicidal action of the blood, and the efficacy of this means of improving its condition. POINTS ON TREATMENT: BY DR. T. J, B. In nearly all cases of consumption, anaemia, etc., I find the secre- tions sluggish, and the heart action impaired. The proper prepara- tory treatment for these conditions, before introducing the bovine blood, is, therefore, very important. That the system may be able to throw off waste by normal functions is obviously necessary for the due appropriation of nutrition, as well as for other vital pur- poses. Among the first indications, therefore, are: to regulate the bowels; to attend to the condition of the kidneys; and if the urine shows any abnormality, to correct it, which may generally be done by any good lithia water, or lithia tablets dissolved in sterilized soft water: at the same time tone up the heart action and digestion. It it not here intended, however, to suggest any special medication, as every physician will of course proceed according to his own ideas or principles. I have found that it ordinarily takes ten to fourteen days to correct these fundamental disturbances, before commencing ^5 the radical remedial treatment — which of course is no other than blood treatment. Neglect of this essential preliminary may cause and account for much disappointment of the physician's hopes in adopting the great therapeutic agent. Another important condition of success in Haematherapy is, to de- termine by careful study of the patient's temperament, and perhaps by tentative beginnings, the idiosyncrasy relative to the appropria- tion of supplied blood, as to quantity. Persons differ very remark- ably in tliis respect. Some are beautifully affected by very small doses, from three or ten drops to half a teaspoonful, and not so well by more. Others require larger doses, up to a wineglassful, for the proper effect. Bovinine, being in the main pure and living bovine blood, is im- peratively indicated, in fit proportion, wliere there is so much de- struction of tissues as in consumption and other wasting diseases. Its action, simply and briefly told, is threefold: as a rebuilder; a tonic and a retarder of pathological processes. Ichthyol and kreasote serve simply for antisepsis and immediate destruction of bacilli, until the supplied blood can re-establish the constructive, reparative and protective work throughout the system, which belongs to blood alone. MEDICAL ANONYMITY. We have constantly to apologize for initials and blanks in the place of names, in certain important reports of blood cure; with such amends as we can make by offering the full name and address in every case, to any physician who has a legitimate desire to refer to any of our con- tributors. The reticence forced upon us by the professional scruples or interests of metropolitan physicians will be quite intelligible to all who are aware of the fierce proscription that awaits any practitioner in a city like this, whether obscure or prominent — and there are both — who can be charged with either advertising himself as a wonder-worker in medi- cine, or with making any statement that some interested party might be suspected of procuring, or with doing cures by methods never pre- scribed to him by the self-constituted authorities. They cannot be blamed for not courting martyrdom; but the time is near when the preaching and practice of this gospel also, will be as safe as it is honor- able. 36 SECTION ON SUPPLIED BLOOD IN CONSUMPTION. ABSTRACT OJ*^ CLINICAL KKPORTS. CONSUMPTION CASE NO. I: BY DR. K. NOTE: — Some physicians, it is well known, are extremely sensitive to the danger of seeming to advertise themselves or some one else, by iillowing their names to appear in connection with reports of their suc- cessful cases. Such will be designated by an initial; but will allow us to cite them by name and address, privately, to inquiring physicians. Following is an abstract of an early test of haematherapy in a des- perate case of pulmonary tuberculosis by a New York physician of the highest distinction, to whose well-known name the ordinary pro- fession is accustomed to bow down. As an experiment in the last resort and without hope, the powerful remedial effects realized in the course of the ensuing struggle astonished the celebrated profes- sor himself, who had never seen anything like it in all his wide ex- perience. It will not escape notice that tliis struggle was enacted in the worst of climates and during the worst season of the year for consumptives, and an uncommonly severe season besides. On January 7th, 1895, Dr. C , of New Jersey, brought to this eminent consultant Miss Anna B , in an advanced stage of consumption, as will be seen by the following particulars. The upper lobe of the right lung was already completely destroyed, and tubercular deposits were well established in the apex of the left lung. She had also a tubercular diarrhoea, and her stomach had become so weak and irritable as scarcely with difficulty to retain the smallest dose of stimulant, nourishment, or even iced water. In the rapid course of the disease she had been reduced in barely six months from a condition of good health and a weight of 155 pounds to this mori- bund state, with only 103 pounds of weight remaining. Dr. C said that she had been subjected during this time to every treatment suggested by the most eminent modern authorities, but had rapidly grown worse from day to day, as her condition proved that she must literally have done. The medical treatment could be little improved, and was substantially continued; the main effort being directed to re-establishing nutrition, "the physical basis of life." The first effort was made with liquid peptonoids, also giving kreasote, on which there seemed to be a very slight improvement in the first week. The stomach then altogether refused this nourishment. It seemed as if the case must be given up to a hopeless and swift ter- mination, ])ossibly to be somewhat delayed by immediate removal to a favorable climate, which was advised; but for want of means this Avas impossible. "At my wits' end, almost," says Dr. K., "I deter- mined as a last resort to try bovinine; having been assured that it was ox blood perfectly preserved, and in that case believing that if her stomach could retain it, it must necessarily help her. I began 37 with ton (lro])S hourly in iced hrnndy, and giving dilute hydrocyanic acid, two dropS;, every tlirco hours, with five grains sid)-nitrate of bismuth as a stomach sedative. The first three doses were vonnted, and I began to fear that this, like all other remedies, was going to prove useless, but nevertheless I determined to give it a thorough and fair trial. The fourth dose was retained. The course was con- tinued for tliree days, with a half pint of milk punch, which soon began to be retained, three times a day. After the third day the bovine blood was increased to a teaspoonful every two hours, in milk and brandy. On the fifth day the treatment began to show good results; the patient slept better, her night sweats lessened, and her cough decreased in severity. On the eighth day the stomach refused everything, except a little iced champagne. The next day, however, bovine blood was again retained. Tenth day, besides the bovinine, milk and brandy, gave one drop beechwood kreasote every three houi's, which was retained, but with difficulty. The eleventh day was passed comfortably, taking both bovinine and kreasote. On the twelfth day was given also one-quarter grain codena, to relieve the cough, which had again increased in severity. On the thirteenth day the bovine dose was increased to a wineglassful, and kreasote to two drops every three hours. From that day, under the continued blood treatment, the patient has steadily improved, gaining flesh and sleep, without night sweats, and the cough comparatively very slight, until the present date, March 6th, when the right lung seems to have healed, with the exception of a space about the size of an English walnut; her weight has increased to 132^ pounds, and she feels most hopeful. She is still taking bovine blood in milk and brandy every three hours, and one drachm compound syrup of hypophosphates. The improvement is wonderful and worthy of the most careful con- sideration by my medical brethren." CONSUMPTION CASE NO. II— BLOOD DIRECT TO THE LUNGS: BY DR. T. J. B. Mansfield Herron, an Englishman, aged 32, height 5 feet 9^ inches, weight 148 pounds, came under my care, per Demilt Clinic, May 9th, 1895. Physical examination revealed a cavity in the right lung as large as a hen's egg. The sputum contained large quantities of tubercle bacilli. The other typical symptoms of consumption were duplicated in this case: night sweats, insomnia, emaciation, want of appetite, weakness, soreness, cough and bloody expectora- tion. On the third day. May 11th, after preparatory treatment, appli- cations of bovinine and kreasote per mouth and bovinine and salt water to the lungs by atomizer, were commenced, with two hypoder- mic injections of 1-8 gr. pilocarpine each daj', the object of which was to reduce the secretion of mucus in the membranes of throat and lungs. Signs of im])rovement appeared almost immediately in^all symp- toms, and by July 20th he felt so well that he concluded further treatment unnecessary. He then weighed 162 pounds, had no night sweats, slept well, had a good appetite, interest in his work, and felt as like a new man, and nothing the matter with him. The big cavity was almost entirely healed. He decided to return to England, and has not been heard from since. CONSUMPTION CASE NO. Ill— TUBERCULOSIS OF THE LUNGS AND LARYNX— BOVININE BLOOD DIRECT TO THE PARTS: BY THE SAME. Maggie Wurtz, age 29, May 20, 1895. Gave a family history of consumption, of which her mother and sister had died. Complained of weakness, soreness in chest, night sweats and sleeplessness, loss of appetite, a cough with blood-streaked expectoration, and emaciation, a large tubercular deposit in the apex of the right lung, and a cavity in the lower part of the upper lobe of the same; also tubercular laryngitis. She had been under treatment at two of the best known hospitals in the City of New York, without apparent benefit, grow- ing steadily worse in every symptom; insomuch that the usual hope- fulness of consumptives had entirely left her, feeling convinced from her rapid decline that she would never get better. Having attended in the mean time to the regulation of bowels and kidneys, I began on the third day, May 22, to have her take a tea- spoonful of bovinine blood in milk and whiskey every three hours, with one minim of kreasote in a capsule; and the next day com- menced the internal application of bovine blood to the lungs in a saline solution (a teaspoonful of salt to the pint of water) through an atomizer, with an extra long curved glass tube to throw the solu- tion well into the larynx; using one ounce of the solution once every other day, until the 18th of August; continuing also the treatment above described. Within about one week from the beginning of treatment, the pa- tient exhibited signs of decided improvement. She slept nearly all the night, her night sweats were almost wholly discontinued, her cough and expectoration had diminished, her appetite had improved, her strength was renewed, and this rapid improvement continued until, September 11, 1895, she showed a weight of 130l^ pounds, against 98 at the beginning of treatment; the lung cavity entirely healed; no symptoms whatever of phthisis. No defect save a very slight dullness at the apex of the lung, due to encysted tubercle. January 24, 1896, the large lung cavity was still undiscoverable, but a small tuberculous deposit in the right apex, not yet quite ab- sorbed, remained discoverable. Her complexion is growing ruddy; appetite and sleep good; no night sweat and no cough. The sputa, examined on the 25th, showed very few bacilli, much fewer than ever before. Not heard from later. CONSUMPTION CASE NO. IV— TUBERCULOSIS OF THE LUNGS, LARNYX AND PHARYNX— BOVINE BLOOD DIRECT TO THE PARTS: BY THE SAME. Francis La Mar, French, age 35, August 10, 1895; had been treated in a number of institutions in France without any decided benefit; cavity in right lung, size of a silver dollar; tubercular de- posit in the apex; and a tuberculous condition of larynx and pharynx. His weight was 110 pounds, to wliich he had been re- duced in one year from 170 pounds. Suffered great pain through- 39 out the diseased lung, with painful cough, profuse mueo-punilent and blood-streaked expectoration, night sweats, sleeplessness, ex- treme weakness, loss of appetite, and inability to retain food on the stomach. Despaired of recovery. In view of the inability to retain nourishment, the treatment was commenced, or preceded, by appropriate medication, with bovine blood (in bovinine) every two hours. The first two doses were vomited, but the third dose was retained, as were also its successors, without further trouble; and this nourishment was retained, with the happiest effect, right along through the course of treatment. [It is a common experience, that a little perseverance with bovin- ine, by drops, or with crushed ice and a little wine, will in the worst cases directly secure retention and strengthen the stomach for increased quantities. It is even probable that a dose vomited, if not too large, prepares, nevertheless, a better reception for the next.] On the fifth day, a hypodermic injection of two drops kreasote in 10 drops liquid albolene was given between the shoulder blades, and bovinine was sprayed into the larynx and pharynx, with an atomizer. These applications were continued once a day for five days. After this, gave a capsule of two drops kreasote every three hours; continu- ing the bovinine spray and dosage, as before. October 16, 1895. The same treatment has been continued, ex- cept that the bovinine was increased to a wineglassful every three hours. The patient already weighs 119 pounds, and says he feels like a new man; has very little cough or expectoration, with no blood; no night sweats; sleeps well and undisturbed; has a good ap- petite, and enjoys alight diet in addition to continued bovinine. The cavity in the lung is evidently healing rapidly, and is about half re- stored, while the condition of the larynx and pharynx is likewise much improved. (Latest information.) CONSUMPTION CASE NO. V: BY THE SAME. Tom Hines, age 30, September 6, 1895; tubercular phthisis; cav- ity one and a half inches in diameter, in right lung; all the usual symptoms; pain throughout right hmg, almost amounting at times to angina pectoris; appetite lost, and weight reduced to 98 pounds. Two days were given to regulation of bowels, and on the 9th com- menced taking a wineglass of bovine blood and two drops beechwood kreasote, every three hours. November 7th, his weight had in- creased to 114 pounds (16 pounds gain in 30 days); the lung cavity was noticeably decreased; and all symptoms substantially removed. (Latest known.) CONSUMPTION CASE NO. VI— TUBERCULX)SIS OF LUNGS AND LARYNX, WITH TUBERCULAR ULCER OF THE EPIGLOTTIS: BY THE SAME. Mildreth Noble, age 37, October 2, 1895; an advanced stage of both pulmonary and laryngeal tuberculosis; a tubercular ulcer of the epiglottis; a large tuberculous cavity in the right lung; all concomi- tant symptoms; lost appetite, and weight reduced within three months from 131^ to 99^ pounds. The tubercular ulceration of the epiglottis made the pain of swallowing, with or without food, a con- stant torture. 40 The rpgnlar blood treatment was at once commenced, with two drachms bovinine in cream, every two hours. Three days of this alone' sufficed to develop signs of marked improvement, especially in vigor and animal spirits, which had naturally been at the lowest. Bovinine was increased, with kreasote in capsule. Examination after two weeks of this treatment revealed a remarkably rapid im- provement. The night sweats were gone, she slept well, her cough and expectoration had notably diminished, the blood streaks had en- tirely disappeared, and by December 6th, weight had increased to 116 pounds; the lung cavity was decreased by fully two-thirds, and in every symptom the like marked improvement was manifest. Meanwhile, the tubercular ulcer of the epiglottis had been sprayed with bovinine and salt water three times a day. After the tirst three sprayings, the healing and pain-destroying efficacy always at- tendant on bovinine had enabled her comfortably to swallow, while the main effect was two-fold, and was beautifully realized: (1) as topical nutrition, to build up healthy granulation and repair; (2) to supply leucocytes — Nature's great germicide — in sufficient number to overpower the congregated bacilli of tuberculosis and eradicate ptomaines and other toxins from the blood. The result has been a continuous process of healing, practically complete by February 20, 1896. She then decided to go off into the country, and has not since been heard from, as she would have been, assuredly, if she had any further trouble. QUICK CONSUMPTION— CASE NO. VII: BY THE SAME. Mary Burns, age 30; December 21, 1895; as usual, the last resort in an advanced stage of consumption; all the symptoms detailed in previous cases. Six mouths ago, perfectly well, weighed 129, now 110 pounds; with a tuberculous deposit and a large cavity in the right apex, extended to the circumference of half a dollar. Bovin- ine, as usual, with kreasote, and up to January 15, 1896, the usual rapid improvement manifested; night sweats disappeared; also the blood in a reduced expectoration; sleeps* well; better in color; con- traction of the cavity shows arrested consumption of the lung and beginning of repair; continued observations and treatment showed steady improvement, on January 26, 1896, April 2. June 2, November 17, until the latest, June 14, 1897, more than a year and a half after first treatment; in all respects quite well; weight 134 pounds, or five pounds better than ever before; no remainder of the great cavity, which is apparently healed; slight dullness over right apex from encysted tubercle; and but faint trace of bacilli in sputum. CONSUMPTION CASE NO. VIII: BY THE SAME. Mary Blankmeyer, age 26, January 1, 1896; matured phthisis: thirty pounds lost in a year; a tubercular deposit in the right apex and a cavity in upper lobe of same lung. As digestion was good, blood treatment was directly available at once. Improvement was steady and marked; when last seen, February 12th, the gain of flesh was seven pounds, night sweats had ceased, only slight cough re- mained, microscopic examination revealed few bacilli in sputum, she sleeps w^ell, and feels entirely well. 41 CONSUMPTION CASE NO. IX: BY DR. T. J. B. William Cassidy, age 35, January 2, 1896; all the decisive symp- toms of advanced pulmonary tuberculosis; weight reduced in six months from 179 to 120 poimds; general anaemia; appetite gone, and digestion so upset that the most delicate prepared foods could not be retained on the stomach; cavity in upper lobe of the right lung, and a large tuberculous deposit at the apex. After one week of blood treatment, the condition was materially improved; third week, improvement very marked; night sweats en- tirely abolished; cough and expectoration greatly diminished; sleeps better; and can now enjoy and digest ordinary food. Similar re- ports of progress at every examination, covering a year and a half; from January 2, 1896, to February, to May, to July, to November, and to February 5, 1897, with uninterrupted convalescence; weight 153 poimds; ca^aty entirely healed. Last seen, June 16th: good condi- tion unchanged; still no bacilli in sputum; feels perfectly well, in fact, better than ever; no shortness of breath on exertion (as a long- shoreman). This patient had lost fifty-nine pounds in six mouths, when first seen, and was a wreck in lungs, blood, and stomach, un- able to retain the most delicate of the prepared foods, and thus in- capable of being nourished and sustaining life by any means short of supplied blood; which, however, proved all-sufficient for every purpose. CONSUMPTION CASE NO. X: BY THE SAME. John Matthews, age 37, April 9th, 1896; tubercular deposit in the right apex, and a large cavity in upper lobe; lung much contracted, admitting of no complementary air, the expiration still shorter than the inspiration, and puffing; insomnia, with profuse night sweats; cough with muco-purulent blood-streaked expectoration laden with tubercle bacilli; emaciated, anaemic and cachectic, from the previous condition of a large and robust man; no appetite or digestion; con- stipated. On commencing blood treatment he began to improve im- mediately; May 4th, the night sweats had entirely ceased; was sleep- ing well; appetite and digestion restored, with relish for light meals of vegetable and animal food; the lung cavity healing up and di- minishing; the lung retaining complementary air; gain in weight, color and energy, enabling him to work steadily. CONSUMPTION CASE NO. XI— A CHANCE CASE: BY DR. H. Dr. H , now in New York, in 1894 was ship's surgeon on a sailing vessel from San Francisco to Australia, and in that capacity had some care of a consumptive, who was making the same voyage for his health. Many passengers became very sea-sick, including the consimaptive patient, whose attack was of extraordinary severity, insomuch that for two days no noiirishment could be taken, and the imminence of absolute starvation was a complication of pulmonary diseaee with but one issue. Fortimately, the patient bad mth him a supply of bovinine, which his physician, T)r. Lain of San Francisco, had advised him to carry. This Dr. H resolved to apply per rectum. The enema was retained, and the patient's condition show- ed improvement \\nthin an hour. The next day he was feeling much better and had no sea-sickness (usual effect of bovinine at sea); doses 42 of ten drops in port wine began to be retained on the stomach, and to be increased. After the tenth day, he showed not only a com- plete recovery from sea-sickness and stan^ation, but a marked im- provement over his phthisical condition ; and having since continued the blood supply, he now seems to be entirely well. CASE NO. XIII— IN R HOSPITAL: PER DR. T. J. B. Dietrich Ulmer, age 36, October 20, 1896, in K Hospital, New York. All symptoms of advanced stage of pulmonary con- simiption; well-developed cavity in right lung, -with severe pain; nor- mal weight 160 pounds, now 120 pounds. The physician in charge continued his medication, with the addition of bovinine every two hours. The pain disappeared in the first week of the blood treat- ment. Records of November 10th, 24:th, December 12th, February 5, 1897, and June 14th, showed constant and radical improvement, until when last seen, June 14th, after eight months, he was perfectly well, and growing in strength and flesh, having gained 14 pounds, and does not tire in his labor, employed regularly as truckman. CONSUMPTION CASE NO. XIV— IN R HOSPITAL: PER DR. B. Alice Birney, age 27, October 8, 1896, in R Hospital, New York; all s}Tnptoms of pulmonary tuberculosis; cavity in right lung; had suffered for eighteen months, reducing her weight from 126 pounds to 102. Blood and medical treatment up to November 24th showed a gain of four pounds weight; expectoration lessened, with but traces of bacilli; night sweats entirely ceased; appetite and sleep good. Later it transpired that the present tuberculosis had supervened upon a fibroid phthisis, and was thus very seriously complicated with cheesy degeneration of the lungs. Now an unlucky cold gave her a relapse; but, nothwithstanding both the complication and the set- back, February 6, 1897, finds the patient out of hospital and doing well; in improved general condition; weight 114, a gain of twelve pounds; the cavity healing up; expectoration slight, with only a trace of bacilli; no night sweats; sleeps well; improved color, heart action and digestion; barely a trace remains of the cheesy degenera- tion. Last seen June 14th: weight 118^ pounds, a fresh gain of four and a half pounds; feels perfectly well; the cavity still healing, and now two-thirds healed. This issue to the first check experienced (from extraordinary con- ditions) in the blood treatment of consumptives, is among the best of confirmations. CONSUMPTION CASE NO. XV: BY DR. T. J. B. Edgar Jones, age 26, May 21, 1897; all symptoms of tubercular phthisis; cavity in upper lobe left; expectoration contained bacilli tuberculosis in great numbers; family history of consimiption; per- fectly well one year ago, but in the last six months had lost seven- teen pounds. Medical and blood treatment; continued until last seen June 16th, when he had gained throe pounds; the night sweats cough and expectoration much diminished, but bacilli still plentiful; sleep and appetite improved. 43 CONSUMPTION CASE (CASEOUS) NO. XVII: BY DR. T. J. B. Mary Kelley, age 3{>; case of Dr. M , September 8, 1897; case- ous phthisis, a form of pulmonary consumption charactejized by obstruction of tissue, resulting from the cheesy degeneration of in- flammatory products in the lungs, and the subsequent soft- ening and destruction of the caseous or cheesy matter, to- gether with more or k^ss of the lung tissue proper. Since June 1, 1897, her weight had been reduced from 126^ to 94 pounds. All symptoms of a well-defined case. Two weeks after beginning med- ical and bovinine treatment, tlic patient's condition was much im- proved, her slee]) and digestion were normal; October 9th, all symp- toms substantially overcome, and a gain of 12f pounds in weight. Latest seen, November 16th: continued decidedly gaining, no trace of bacilli in sputum, three pounds more in weight, sleep good and re- freshing, appetite good, expectoration and night sweats rare and slight* CONSUMPTION CASE NO. XVIII: BY DR. T. J. B. Mary Flaherty, age 34, October 4, 1897; tubercular phtliisis, of two years progress; previous weight, 120^ pounds; present, 94 pounds; softening in progress; an unusual variety of symptoms and complications [omitted], rendering prognosis decidedly unfavorable. Medical treatment at various points, and bovinine, 30 drops in iced grape juice hourly for the first tliree days; then increasing gradually until by the 28th, the patient's stomach was so much strengthened that she was able to take a wineglassful every four hours. December 16th, the patient was giving every evidence of restored health; not the slightest trace of tubercle bacilli; all symptoms had disappeared; appetite, digestion, and sleep normal; weight, 119f pounds. She was discharged December 27th, with every indication of cure con- firmed. CONSUMPTIO N CASE NO. XIX: BY DR. T. J. B. George S , age 24, January 1, 1898; advanced stage in all symptoms of puhnonary tuberculosis; cavity of the size of a half- dollar in right U])per lobe; deposit in left apex; also tubercular laryn- gitis. Medicinal and bovinine treatment, as usual, and daily appli- cations of iodoform-bovinine to the throat by means of a swab. Wlien last seen, January' 20th, patient had gained four pounds in weight, his cough was very slight, his night sweats had disappeared entirely, digestion and appetite were improved, and the cavity was healing. CONSUMPTION CASE NO. XX: BY DR. T. J. B. Ezra K , Stamford, Conn, age 26, February 1, 1898; tuber- culosis confined to right lung, with apex deposit, and a cavity in the upper lobe; case of six months' standing. Commenced treatment with a hypodermic injection every morning, between the shoulder blades, of oil eucalyptus, kreasote, tincture iodine, and liquid albo- lene; with bovinine internally, as usual. Continued this and the daily hypodermic injection to the 12th, when so decided improve- ment appeared, that the injections were discontinued and the same dose was now given in capsules three times a day, with a wineglass- ful of bovinine every two hours. February 26th, the cough had 44 utterly disappeared, the night sweats liad ceased, digestion was good, five and Ihrce quarter poniids had been gained in weight, ih<' bh)od was nearly normal, and on March 8th, examination proved that the cavity was entirely closed, and except a microscopic trace of bacilli there was not a single evidence of disease. CONSUMPTION CASE NO. XXI: DR. J. T. B. Ella S , Jersey City, N. J.; age 34; April 3, 1898; treated for a year past by prominent city physicians, some for gastritis, some for ansemia, etc.; but all the time getting worse. I first turned my at- tention to her blood, which I found, though normal in color, defi- cient in red corpuscles and hamagiobin. Though this proved an anaemic condition, 1 was not satisfied that anaemia was the cause of the trouble, but believed it to be a symptom of a cause. A thorough examination of the lungs revealed a slight deposit in the right apex, with a cavity abont the size of a hazel nut in the middle lobe. . Spu- tum revealed slight traces of tuljercle bacilli. Patient had lost twenty-five pounds witliin the year; had persistent diarrhoea, loss of appetite, night sweats, insomnia, and occasional attacks of angina pectoris. After medical preparation, bovinine every hour was commenced, with kreasote, etc., injections. Patient began to improve at once, and has not had a single backset, to the present time. At the pres- ent day (May 23d) the patient's condition is really splendid: her weight has increased from 97 to 107 pounds; she sleeps well; enjoys and digests her food and assimilates it; her night sweats have ceased; her diarrhoea has disappeared; her color has returned; and she says she feels well. There is not the slightest trace of tubercle bacilli discoverable in sputum by the most rigorous search, nor any albumen in urine. Physical examination, in fine, shows the lung cavity absolutely healed. CONSUMPTION AND APPENDICITIS CASE NO. XXII: DR. T. J. B. P G , Glenville, Conn.; Eussian; age 36: sent by a brother ])hysician, under whose care he had been for more than a year but with no benefit. Eeceived April 16, 1898. Examination of right lung revealed a large apex deposit, and a small cavity in the upper lobe. There was also a slight deposit in left apex. Scrap- ings were taken from fauces and throat, and a large quantity of tubercle bacilli were found. Bovinine treatment continued for six weeks during which an operation for appendicitis was performed, with novel and successful treatment, elsewhere described, by which time the pulmonary condition was greatly improved, and patient dischaj'ged with attention and observation to be continued. CONSUMPTION AND F^CAL IMPACTION CASE NO. XXIII. Dr. T. J. Biggs, Sound View Hospital. Angelo B , Portchester, N. Y.; age 40; June 4, 1898; general tuberculous condition, centred most severely in the right lung, with a cavity in the u})per lobe, and also an apex deposit. System run down, and anjemic. Was put on suitable remedies, with bovinine every three hours. Patient sufl'ered extremely from constipation, and the night of the 10th, was in great pain, and examination re- 45 vealed J'a'cal ini])aitioji. La})ar()loiny was jjcrfonued, and the im- paction was broken up. The next evening he complained again of great pain, from a hard mass found tilling the rectum up to the sig- moid flexure. The reaction of hydrogen peroxide on bovinine was then employed in the rectum, with a most gratifyiaig effect from its ell'ervescence, m resolution of the mass, which, within four or five minutes after the injection, passed out entire, without any pain, the patient expressed great relief. June 20th, patient began to feel stronger, enjoyed his food aaid slept well, and showed a much bet- ter color. Aug. 3, cavity entirely healed and apex deposit encysted: gain of 13^ pounds; had corpuscles from 1,100,000 to 2,300,000, and hffimax globin nearly normal; no trace of bacilli. CONSUMPTION CASE NO. XXV: DR. T. J. B. Mary C , Stamford; age 30; Nov. 18, 1898; had been under treatment for six months, under the care of no less than six physi- cians, four of whom, severally, pronounced her case to be (1) chronic brooicliitis; (2) atonic dyspepsia, and (3 and 4) heart trouble, and her condition had been steadily growing worse. When she entered Sound View Hospital her temperature was 102|; pulse ranged from 120 to 140; a cough with glairy sputum; respiration from 30 to 50 per minute; pain in chest; hot, dry skin; dry tongue; deranged diges- tion; and great prostration. Patient was thoroughly discouraged, and so prostrated that I feared the condition had continued too long to admit of positive benefit. Bovinine was given every hour; hypodemic injections of creosote, etc., between the shoulder blades, three times a day. Also, her throat w^as swabbed well down into the lar.nyx, as far as a probing could be carried, with bovinine pure. Inhalations of oxygen gas were given every three hours. In ten days she showed a decided im- provement, respiration and pulse slower, fuller and stronger; cough less frequent and severe; expectoration much reduced; slept fairly Avell; and was able to move about without exhaustion as before. Dec. 16 she had gained eight pounds in weight and was still rapid- ly improving. Dec. 20, on physical examination, the tympanitic note could no longer be found by percussion; the vesico-bronchial breathing with moist rales had entirely subsided; her temperature was but slightly over normal; and microscopic examination of blood revealed almost a normal standard of quality. Dec. 2, patient was discharged from hosjiital with instructions to return twice a week, that the throat might be swabbed out with bovinine. I feel that I can safely say that this case is practically cured. CONSUMPTION CASE NO. XXV: DR. T. J. B. Miss E. K . Stamford; Sw^ede; age 19; Dec. 28, 1898; incipient tuberculosis of right lung in apex. The general symptoms Avere not well defined. My attention -was called to the lung by a sharp, shooting pain that she complained of, which was supra-clavicular. So slight were her symptoms, I made a microscopic examination of the early morning throat secretions, in which I was able to find traces of the tubercle bacilli. She w\as put on bovinine every two 46 hours, and her improvement was rapid and uninterrupted. By January 14th, her cough had entirely ceased, and the throat scrap- ings revealed no trace of the tubercle bacilli. January 20th, a thor- ough phonendoscopic examination of the lung revealed the tuber- cular deposit completed encysted and partially absorbed. February 1, 1899, she was discharged completely cured, having gained seven pounds in weight. * « * All of these extreme consumption cases treated with bovinine, have gone about their business, practically cured, to their own sat- isfaction — although taken in hand at a desperate or advanced stage of the disease, in every instance. As none have thought it worth while to report since discharge, it is a safe inference that they continue well; but the task of tracing and reporting still on these dispersed and self-satisfied cases, as above, has been a difficult one, which nothing less than intense professional devotion to the truth and the whole truth in a medical question could have accomplished. CONSUMPTION XXIV: ACUTE AND FATAL. (DR. T. J. B.) In accordance with the principle which makes these records of cure decisive empirically, as well as scientifically — the principle of absolute frankness and fullness in the showing of all results — we introduce in its due order the first instance of an unwelcome ter- mination of pulmonary consumption under blood treatment, al- though there was nothing leit in the lungs of the patient for a basis of repair, when the case was taken, and her restoration would have been practically resurrection. This case, however, is not without rich compensation in the surprising relief from the suf- ferings always connected with so violent progress of the disease, in which the blood treatment showed its unparallelled beneficence under conditions of heretofore remediless and incessant distress. The cure of the constitutional symptoms of consumption, while yet the lungs were actually breaking up, was also most remarkable and unheard of in all the history of the disease. Carrie W , Stamford; age 21; admitted July 28, 1898, with acute tubercular phthisis at an utterly hopeless stale of progress. She gave a history of diagnoses and treatments most amazing. Yearly, for five years past, her parents had buried a victim of con- sumption from among their children. This one was the sixth. A seventh child is now beginning to develop symptoms of the disease, who will come under my care with strong hopes of sav- ing her. Three years ago, her trouble began; and [omitting the sad details of the history] the present record began with the pa- tient in a condition which I felt had progressed too far for any hope of saving her, short of a miracle. She was fearfully emaciat- 47 ed, her lungs were largely infected with tuberculosis infiltration and cheesy degeneration, from two enormous cavities in the right lung and three in the left, and this progress was so rapid as to be perceptible at each daily examination. The lung tissue was so ex- tensively degenerated that there was practically none left fit for a basis for blood treatment itself to build upon. In this condition, penniless, and without so much as a chance for any credit to the treatment, the poor girl was admitted to the hospital, to afford what mitigation might be possible to the suf- ferings of her few remaining days. This mitigation, however, proved to be very considerable; though the predestined failure was accepted with keen regret, being the first in my experience with more than a score of cases in the blood treatment of consumption, almost all in advanced stages of the disease; and this was a case which I believe could have been saved by the treatment six months ago. The treatment was now as follows: kreasote and oil of cinna- mon hypodermically injected between the shoulder blades; deep inhalations of hot inedicated air, and a wineglassful of bovinine in old port wine, grape Juice and milk, alternately, every three hours. Hopeless though the case was, the mitigation effected was remark- able, and very consolatory to the sufferer and her friends, as well as to the physician. Especially this, that the angina pectoris, of which she had suffered three attacks a day for a year past, with prolonged distress for breath, was entirely relieved within four or five days, and she suffered no more of it from August 1st to her death on September 5th. The improvement in other respects was also remarkable, considering the extremity of her condition, and indicated a constitution that need not have been conq^iered if it had been reinforced a little earlier with supplied blood. By August 16th, or within three weeks, she had gained about five pounds in weight; her night sweats had almost ceased, her appe- tite was good, she felt stronger, and slept well. Suddenly, however, on the afternoon of September 4th, the par- tition between the two large cavities in the right lung gave way, causing an almost entire collapse of the chest on the right side, and leaving only the upper lobe of the left lung to breathe with, and this badly infiltrated. All that night, sinking spells followed one another, while she was intermediately revived by hypodermics of strychnine and nitro-glycerine, and sustained by rectal injec- tions of bovinine and some per mouth. Thus she was kept alive until near four o'clock in the morning; when, realizing that the end had come, with full consciousness and clearness of mind, she 48 called her parents, brothers and sisters to her side, bade them goodbye, and told them not to cry, for she was going to sleep in Jesus. I, realizing how painful life was to her, and how un- necessary it was to prolong her sufferings, since there was noth- ing to build on, ceased all treatment at this time, and shortly after four o'clock she was allowed to pass away. Catalogue Case 23: Anemia xxi: Consumption xxi. L M ; age 12; adnnitted January 10, 1898. All symptonns of a well-defined case of anaemia; weight 75 pounds; also slight dullness at the right apex, indicating tubercular complication; the blood was lowered in quality; the sputum showed traces of tubercle bacilli. Treatment : a teaspoonful of bovinine every three hours; also the fol- lowing prescription in capsule — one minim pure beechwood kreasote, three minims oil eucalyptus, five minims oil cin- namon — three times a day. The pharynx, larynx and fauces were swabbed out with iodoform-bovinine daily. Patient showed improvement in a week : sleep normal, di- gestion much improved, assiiiiilition about normal, and strength increased. The case being further complicated by constipation, thirty grains pho.?phaie ( f soda in half a glass of hot water were given every morning before breakfast. March 7th, the bovinine was increased to a tablespoonful in milk every three hours. Improvement continued uninter- ruptedly until March 20th, when the latient was discharged perfectly well; blood almost nornuil in quality by the micro- scope; sputum without a trace cf b .i illi; the deposit in the right apex cleared up; weight '.>7 1-2, a gain of 22 1-2 pounds in less tlnan ten weeks. FROM DR. CARL L. JOHNSON, A.B., M.D., OF UPSALA UNIVERS- ITY, SWEDEN. Some time ago I received a sample of bovinine, and the effects of its use 1 have already seen. I only deplore that it has not been brought to my knowledge before, as I prob- ably could have cured many chronic cases to which I have had to give only palliative treatment. Two cases I am now employing it on are doing nicely : one of necrosis of the malar bone, and the other fistula and marginal ulcer of anus. I am going to try its efficiency in pulmonary tuber- culosis, and if it holds out according to your experience, in that trial, I will be one of your best supporters. •• C. L. Johnson, A.B., M.D. Grantsburg, Wis., October 11,' 1897. 49 BLOOD TEEATMENT IN PHTHISIS. BY I. C. RESHOWER, M. D., NEW YORK. Haematherapy certainly has a wide therapeusis. In almost all diseases where wliite corpuscles are needed to establish an increase of reconstructive elements, I have employed the blood treatment with marked and never-failing success. About a year and a half ago, it came to my knowledge, and since then I have used it extensively in a wide range of cases. One case in particular recalls itself. About a year ago I was called to a child of 2^ years, with broncho-pneumonia; consolidation in both lungs, involving nearly the whole of the right lung; respira- tion extremely shallow and panting; the lips were blue, and the child appeared to be in its last hour. I gave it oxygen and tea- spoonful doses of bovinine in milk every hour and a half. Inside of six hours the change for the better was much marked, breathing much better, blueness all gone, and the child in every way showed a very good chance of recovery, which happily it accomplished. About six months ago, a young woman of 18 came to me, com- plaining of cough, night sweats, and pain in the chest: cold, clammy hands, no appetite, and malodorous breath. Examination showed incipient phthisis, which bacteriological examination verified. I began with 2 m. doses of creosote t. i. d., and hydrocyanic acid and cannabis indica for the hacking cough and tickling which she had in the throat. She continued in this way for two months, with very little improvement, even in spite of her hygienic surroundings, which were of the best. I then decided that bovinine might do good, and I tried it; beginning with teaspoonful doses in.milk every 4 hours: the dose to be increased 10 drops every day, until 3 tea- spoonfuls every 4 hours were being taken. In one month, the im- provement was much marked. The girl now sleeps well, has an ex- cellent appetite, her cough is completely gone. She is still on bovinine without other medication, and I am convinced from this case and others of phthisis, that it is the remedy par excellence. In my hands it has proved so useful in tubercular disease that I have yet to find a case which it will not benefit and in most instances cure. In tubercular lung disease where cavities are already formed it prolongs life, better and more surely than any other therapeutic agent. 50 DIPHTHERIA UNDER SOUND-BLOOD TREATMENT While rallying wide-awake physicians to the prodigious lead offered by the achievements of Hsematherapy more eminently in the cure of consumption and ulceration, we have been watching for a favorable occasion to direct their attention to the equally inviting and much easier field of conquest for competent hsematherapists, in diphtheria. While the statistical delusion and the lethal havoc of anti- toxin have been raging, we have been meditating, as others have, on the singular aptitude of unperverted bovine blood, in its several powers, for antagonizing the special charac- teristics of this terrible disease. But being loth to advance theoretically beyond our clinical supports, we have kept silence, though not in uncertainty. At length, the follow- ing case in point comes to us from unquestionable authority, with such emphatic clinical confirmation at all points of a clear physiological theory, that we feel justified in com- mending the simple treatment described to all physicians, whatever their medical creed, for a hopeful and more than hopeful trial. May we not look, then, for reports of many further cases ? PIONEER CASE OF BLOOD TREATMENT IN DIPHTHERIA. BY DR. SANFIELD, OF CINCINNATI. Mary Bromley, American, age 12, was first seen January 18, 1897, suffering from an aggravated attack of diphtheria. Her fauces, tonsils and palate were covered with diphther- itic membrane which all the usual applications had failed to abate, even temporarily, the exudate continually re-form- ing as fast as it could be removed. As the case had become grave in the extreme, I urged immediate intubation or tra- cheotomy, but the advice was rejected. At this moment, happily for the child and for myself, a professional brother suggested trying Prof. E. H. Pratt's idea of peroxide of hy- drogen on bovinine. Accordingly, the membrane covering the throat, fauces, tonsils and palate, was generously painted all over with bovinine, immediately followed by sprays of the undiluted peroxide. The chemical re-action between these agents and the septic matter, cited by Professor Pratt, vigorously, developed, with a lively effervescence, and at once loosened off and detached the entire membrane, which within five to ten minutes was coughed out complete, in a SI mass that would about fill a teacup. Not the least remark- able feature of the result was that on examination of the dislodged membrane its under surface showed the fibrils or roots by which that formation is known to be interwoven, as it were, with the true tissue, making its removal by the ordinary means so difficult, painful, or incomplete. Here, the false membrane was literally eradicated, by a bland and easy solution of its attachments; and, when the froth of the reaction was washed out, leaving the more or less raw surfaces not only exposed but also permeable to the com- bined antiseptic and reparative powers of the bo vine blood next applied. The breathing of the patient became almost normal, within half an hour. The same treatment was repeated hourly, for the next twelve hours, keeping the exudate perfectly under control ; the membrane but slightly re-forming, and yielding readily, becoming at once dislodged and discharged in small parti- cles. At the end of this time, all evidences of continued formation of membrane had disappeared, and the condition of the true mucous membrane was sensibly ameliorated. The patient being greatly exhausted with the disease and protracted want of nourishment — nothing but whiskey hav- ing been received in many hours — was on the verge of col- lapse, when the administration of bovinine by the mouth was commenced, giving a teaspoonful in milk every two hours. Bovinine was also sprayed upon the raw surfaces, with healing effect, every half hour; but at every third hour, the peroxide was added on the bovinine as a precau- tion against a possible renewal of membrane formation. Resustentation was now so rapid under the vital nourish- ment administered, that in forty-eight hours from the first treatment, the patient was sitting bolstered up and com- fortable, having entered on a stage of rapid convalescence. I am convinced that this novel and simple physiological treatment is well worthy the attention of the profession. It may seem superfluous to add anything to so clear and complete an illustrative demonstration, as that given by Dr. Sanfield's case. Yet it may be useful to note how plainly diphtheria calls for blood, by every one of its symp- toms and conditions, and how precisely blood meets each of its demands. We naturally note first the fatal mem- brane, and the harsh, exasperating applications heretofore required for its dislodgment. Bovine blood, on the con- trary; cooling, soothing, healing, and mysteriously anni- hilating pain, at the first topical application; begins also the oxidation of the exudate or false membrane, by the ac- 52 tion of the oxygen-carrying blood cells, so well recognized as a cardinal element in animal physiology ; then receives fresh and ample reinforcement of oxygen from the addition of peroxide of hydrogen ; raising the oxidizing action to a lively yet bland effervescence of the septic exudate, which immediately comes away, broken up, and probably steril- ized; and, when the frothy effervescence is washed off, leaving the exposed tissue clear to absorb the vital nutrition afforded by the further application of the bovine blood. There is no conceivable reason why this process, repeated at need, should not continue to frustrate the formation of the fatal membrane, from first to last, penetrating antisep- tically to the roots of it in the true membrane ; while the clinical demonstration of its efficacy to this purpose, given by Dr. Sanfield, in an extreme case, is of such a conclusive and universal nature, histologically, that it is just as good as a thousand more of the same. But what of the bacteriological and constitutional sepsis that comes next, in tracing back the chain of causes ? Let us ask, in reply, Who knows of an antiseptic or a germicide comparable to oxygen, whether in remedial or resistant power, and against local or constitutional sepsis or bacterinl invasion ? Only, here is the new and triumphant point of departure : — oxygen is now found practically available for diphtheria, in indefinite power, through the kindly carrier given in all animated Nature for its wholesome, harmL ss conveyance throughout the living tissues! Whether the spraying of peroxide, or the inhalation of oxygen, upon the applied bovinine, will prove to be the preferable method, or in what cases, remains to be determined by further experi- ence. In either way, the principle and the agency are sove- reign and indisputable, if there is any known fact in physi- ology. There is found an avenue and a carrier to the vei y focus of the disease, for that sovereign power that (admit- tedly) forbids disease, and that power in consummate de- velopment or reinforcement. Now reverting to the first onset, in the bacterial or ex bacterial invasion, with its bounding pulse and pyrexia, followed by the ana)mia and prostration produced by a de- cimation of the blood cells; whatever treatment may be pursued with the fever or for the stimulation of the after- depressed circulation, and weakness, must be conceded to 63 be but palliative, and subsidiary to more radical means for reinforcing the blood itself in its nourishing, antiseptic and bactericidal powers. It is only the latter of these powers, that the two most highly approved medicinal ex- pedients of the day aim to reinforce, by different means: the one by stimulating leucocytosis, or an extraordinary proliferation of the white cells that antagonize bacteria; the other, by injecting an antitoxin for the destruction of the bacteria or the neutralizatioh of their poison product. Nourishment, and support of the strength, axe left to the joint care of whiskey and the almost prostrate functions of alimentation. The blood, which was too weak in the firs^ place duly to nourish and protect the system, and is already much further disabled, is hourly becoming still worse dis- abled by its encroaching foe, and septicemia is coming on, while the medical management is calling on the blood to 'proliferate' more; or, or perhaps also, is sending in a foreign ally to exterminate the foe; but, in either case, is leaving the poor blood to exhaust itself unaided, by its own efforts, as well as by the unceasing, if diminished, batteries of the infection : unaided, that is, except by the feeble effort of the stomach to assimilate weak and scanty aliment which it can barely tolerate. This is about all: and how far short of the demands of the situation, and hov/ far our medical aid, after all, is merely throwing the patient back upon the mercies of Na ture for a chance of recovery, is plain to be seen. Now consider bovine Mood, as a palpable combination of all the elements or powers requisite to meet the several con- ditions that confront us. Do we want a life-stream reple.te with the fighting leucocytes; with the red artillery of oxy- gen before which septic matter dissolves in foam and billion- billions of bacteria melt away; and with the richest nutri- tion ready-vitalized for direct incorporation into the tissues of languishing organs and nerves'? There it is. We have always known blood to be all this, and the only new thing to us is that ice can inU^oduce alt thU directly into the im- poverished blood of the sufferer, tlirough faucial and ali- mentary absorbents and if necessary by hy})odermic injec- tion, without the slightest interference with anything in Nature or medicine, and without waiting either for dubious antitoxi nation, or for constitutional blood- recuperation, too 54 slow, if indeed any, to head off the rapid intoxication that is spreading throughout the system. Whatever else we see fit to do, let us at the same time, without taking chances by the omission of other means, try the peroxide-on-bovinine, for the membrane, and the bovinine per se to reinforce the protective and sustentative powers of the blood, as well as to heal the lesions of the throat. SECOND CASE MALIGNANT DIPHTHERIA. Kate H , Glenbrook, Conu.; age 12; American. Was called in consultation, December 12, 1898, Ly Dr. B : a well defined case of diphtheria (malignant). An inspection of fauces revealed them red and swollen and covered with diphtheritic exudation ; ton- sils and uvula were also spotted. Eemoval of a portion of the false membrane revealed the tissues badly ulcerated; breath was foully offensive; lymphatic gland of neck tremendously enlarged and greatly tumefied; membrane had extended into the nasal cavities, also to the larynx; pronounced obstructive dyspnoea; the breathing noisy and stridulous. Urine contained a little over 1 per cent, albumen. I advised immediate tracheotom}', believing it the only chance the child had. This was refused me. I there- fore determined to try the bovinine-peroxide treatment. Bovinine pure was first sprayed into the nasal passages thorough- ly, then peroxide of hydrogen. Eeaction between bovinine and peroxide rapidly took place, and before it had ceased I sprayed also into the throat and larynx the bovinine and peroxide. So ex- tensive was the reaction that the patient almost strangled. About five minutes after the first spraying into the larynx, it was re- peated. This was followed by vomiting and expulsion of the en- tire false membrane that had covered the throat, tonsils, uvula and larynx. The patient was now able to breathe more freely, and was entirely relieved of dyspnoea. The false membrane in nose still remained attached. Therefore, bovinine and peroxide were again sprayed in, and after reaction had ceased, by the aid of a pair of dressing forceps the membrane was removed from both nostrils intact, being in shape conformed to that of the passages. So great was the relief to the patient that she immediately sank into a profound sleep, having been completely exhausted by her previous struggles for life, and having eaien nothing in three days. I determined to give her immediately a high rectal bovinine feeding, which consisted of four ounces bovinine, two ounces milk •and a tablespoonful of lime water. Instructions were given the 85 Jiursc to spray bovinine pure iuto the throat and nasal passages every hour, and every three hours repeat the bovinine and peroxide. Before I left the patient, tlie throat was again sprayed out with the bovinine and peroxide, having hard work to arouse her for it. The nurse M'^as also instructed to give her the rectal feeding every three hours, and by mouth two drops of beeehwood kreasote and one-thir- tieth grain biniodide of mercury. December 14th, I visited again with Dr. B , and found pa- tient greatly improved, only one small patch of membrane, and that on the right tonsil. The throat, although raw, was in a compara- tively healthy condition. Same course of treatment as before ad- vised by me, and ordered carried out by Dr. B . December 17th, saw patient again and found her still improving; patch of membrane on tonsil had entirely disappeared; rectal injec- tions were now ordered twice daily, night and morning, and one tea- spoonful of bovinine in old port wine internally every two hours. The bovinine spray alternating with peroxide of hydrogen was or- dered continued. Up to the time the patient had lived on bovinine with a little milk, to the exclusion of everything else ; but seemed, nevertheless, to be perfectly nourished and gaining in strength. December 20th, again saw patient with Dr. B and found her again much improved. Examination of urine at this time showed it to be normal with the exception of a slight excess of phosphates. Patient said she felt so well she wanted to get up, but I advised her remaining in bed. December 23d, again saw her, found her so rhuch improved that I consented to her sitting up awhile. The throat was now almost en- tirely healed, with the exception of a small spot on either tonsil, and the tip of the uvula. The bovinine pure sprays were ordered con- tinued, and internally, a tablespoonful of bovinine in milk every three hours, and a light nutritious diet. December 26th, Dr. B called on me to say that he had dis- charged the case, cured. THIRD CASE OF EXTREME DIPHTHERIA. Ella S , Stamford, Conn.: American; aged 7; February 27, 1899. Diagnosis diphtheria. Dr. S called me in consultation, with an idea of tracheotomy. An examination of the throat re- vealed the fauces completely covered with the membrane, extending down into the throat. The child could barely breathe, and I at first thought tracheotomy the only remedy. But the mother objecting so seriously to the operation, I determined to try the bovinine and hydrozone. The bovinine was thoroughly sprayed into the throat. 56 and immediately afterwards the liydi-ozone was also sprayed in; the reaction was tremendous, almost strangling the child, and caused vomiting which brought away the entire membrane, leaving an ulcerated, bleeding surface. The mother was instructed to spray in the bovinine and hydrozone every half hour during the night. As she had not been able to take nourishment for forty-eight hours, the child was in a very weak condition; consequently a high rectal in- jection of bovinine and salt water was given, the quantity being two ounces bovinine and one ounce salt water. This was ordered to be repeated in three hours; but in fifteen minutes after the first rectal injection the patient sank into a restful sleep. On returning in the morning we found the patient considerably improved; mother said the child had slept well all night, except when she awoke her to ad- minister the bovinine and hydrozone. An inspection of the throat now showed the surface less red and swollen, and entirely free from false membrane. The bovinine and hydrozone were now ordered every three hours, and bovinine pure sprayed into the throat every hour. Internally, a teaspoonful of bovinine every two hours. March 1st, Dr. S reported the case doing splendidly. March 2d saw the case with Dr. S ; found the patient sitting up iu bed, feeling quite comfortable. Inspection of throat showed that the redness and swelling had entirely disappeared, and the surface was almost healed. I advised discontinuance of the bovinine and hy- drozone, but to continue the bovinine pure spray. Marcli 5th, Dr. S reported the throat entirely healed. THE INVAEIABLE EXPEEIENCE. Having a severe case of indolent ulceration which defied other treatment, I had recourse to your highly recommended blood treat- ment with such gratifying results that I will write about it. The patient came to our cold New Hampshire climate in mid- winter from Southern California with a severe cold and cough, and general anaemic condition added to the frailty usually accompany- ing spinal curvature, with which she was afflicted to an extreme degree. The cough became amenable to treatment, but her right leg had six ulcers, variously situated on thigh, knee and lower part. One of these measured three and one-third by two and one-half inches. Some were very deep, and the ankle and foot were very much swollen. In three and a half weeks after beginning the blood treatment all were healed except the largest of the deep ones which were situated upon the ankle and which had become super- ficial and could be covered by a silver half dime, when she took herself off my hands, about the 20th of March. In the month of May following she reported that the leg "was the best part of her." A. H. Kempton, M. D. Newport, N, H., April 24, 1899. 5? SUPPLIED BLOOD POK CHRONIC ALCOHOLISM, GASTRITIS, AND DELIRIUM TREMENS. CASE: BY THE EDITOR OP "MODERN MEDICAL SCIENCE." I have been for ten years past intimately acquainted with a gen- tleman afflicted with hereditary alcoholism aggravated by habit. Periodically — or sometimes out of period, through some cause of unusual excitement — the onset would occur, when a single glass of liquor would suffice to instantly degrade a bright and cultivated in- tellect to maudlin imbecility, with as little self-direction or self-re- spect as the howling wind. In fact I have seen all this when I knew that nothing alcoholic had passed his lips. But whether with or without an initiatory glass, the inevitable storm went on throughout the completed cycle of debauch. But there came a time when various severe constitutional or func- tional disorders began to prevail, and the paroxysms became furious, with horrid delirious hallucinations. The attacks became more fre- quent and were heralded by loathing of food, sinking and faintness at the stomach, deadly pains in the chest, struggling for breath, etc. ; relieved in the old wa}^, by a determined resort to the whiskey bottle, with aggravated consequences of protracted debauch and delirium, terminated only by exhaustion which came so near to death that it often seemed as if all was about over. The disease of alcoholism had been all along complicated in a measure with the opium habit. Able physicians were now doing all they could for him. Nitrate of amyl revived him from the syncope of suffocation, and the com- pound tincture of cinchona bolstered him up from one attack to the next, as a substitute in part for the more inflammatory whiskey. All the anti-alcohol and anti-opium palliatives known to the pro- . fession had been already exhausted in vain on the milder stages of the case. Despair settled down on the family and friends, not only for him but for themselves. It was at this time that the dawning revelation of Ha3matherapy struck upon the special field of alcoholism. The testimony of Dr. Brackett, of Boston, and others, who had nursed such cases back to health on bovinine (hxe ox blood) came as a ray of hope. Bovinine arid milk at frequent intervals now became the diet of the inflamed and degenerated stomcioli that could relish nothing and bear hardly anything. The attacks were ^oon diminished in frequency and in their desperate character. By and by, it became possible to abort them entirely at the onset, by steady blood treatment, without the aid of stiinulant or tonic. The only relapse that has occurred was the result of an ignorant interruption of the treatment by a person temporarily in the place of the proper nurse. It was a bad relapse, for the time, but was speedily overcome by the restored elixir, and 68 now, I'oj- iiioio, than thi(!C years, I he man has been liiinsclf, in LoiaJ abstinence, all the time. This, notwithstanding the condition of a system debilitated and racked, in old age, with the varied disorders consequent on the terrible abuse of his own and previous lives; dis- orders so severe that it seems as if he must succumb to them apart from alcoholism, but for the constantly revitalizing and reconstruc- tive supply of foreign blood. ALCOHOLISM. At the Massachusetts Asylum for Inebriates, at Foxboro, it is the custom when" a patient is brought in all of a shake from the effects of alcohol, to give him a full cup of bovinine and water, to which has been added from thirty drops to a teaspoonful of tincture of capsicum. This may be given warm or cold, with care not to have it too hot; that is, the water only comfortably hot in the mouth. DELIEIUM TREMENS. Moderately hot water with bovinine, is also administered at the same institution to patients showing symptoms of approaching de- lirium tremens. CHRONIC MORPHINE HABIT: CONSULTATION CASE WITH DR. C , NEW YORK. By Dr. T. J. Biggs, Sound View Hospital. The cure of the various forms of narcotism, by supplied blood, sustaining as well as restoring, under privation of the stimulant, has been well established in the practice of such specialists as Drs. Crothers, of Hartford ; Mattison, of Brooklyn, and others ; and still it is marvelous that the profession at large knows nothing about it, but continues the old unsatisfactory and inconclusive struggle with the fiend by means of drugs, the best testimony being still that few cases are permanently cured. The following case is no exception to either rule : that of the thorough trial of all the accepted reme- dies with thorough failure, or of the complete restoration of the de- generated system by the power of a generous blood supply. George M , of New York; merchant; age 30; first seen in consultation, September 3, 1898. This patient had suffered from circumscribed peritonitis and thickening, with severe pain and ten- derness on account of which his physician had prescribed morphine in small doses; but he had taken to it in his own way until the habit was fastened on him. He had tried hard to break it off, but always with great consequent prostration, irritability of stomach, and vom- iting of everything eaten, until in- thirty-six hours or so he was driven again to the drug for relief. Under this slavery, he would resort to whiskey and beer to overcome the misery of privation. He tried many different physicians, but of course vniih. no avarl. When I met him, he was taking the stimulants, to endure the want of mor- phine, and then, alternately, taking more morphine to keep off in- toxication, taking sixty grains in two days. Dr. C had tried all the nerve tonics and stimulants, to reduce the doses of morphine. 59 without success. I now strongly advised bovinino^ with the mor- phine reduced by half. He was put on a tablespoonful of bovinine every three hours, and fifteen drops in port wine whenever he felt the need of morphine, which was aliout six times a day. For two nights he was allowed one-eighth grain of morphine. The third night, he had no mor- phine, and has liad none since. He luul slept fairly well the first night, and every night better, until by the fifth night his sleep was satisfactory. He now took a wineglassful of bovinine in milk every three hours. On the IGth he said he felt and rested well, suf- fered not at all. Last seen October 6th, still taking bovinine, with no desire for either stimulant or morphine, and would not touch them for the whole world. He had gained in flesh seven pounds. As the cure is physiologically and thoroughly restorative, not arti- ficial, the best hopes may reasonably be entertained for its perma- nence. RELATION OF THE BLOOD SALTS TO THE HEART-BEAT. A strip of vena cava, from the terrapin's heart may be kept in rhythmic action for two days or more, when immersed in a bath containing only sodium chlorid, potassium chlorid, and calcium chlorid. The energy is evidently derived from material within the cardiac tissues, and being thus supplied with adequate stimulus, the beat wilL continue until this is consumed. The normal stimulus is dependent on calcium compounds, but for rhythm, the potas- sium salts are also necessary. The proportion of the three salts necessary is that which occurs in the blood. Such a liquid will not keep the ventricle in action, although it will that of the cardiac tissue at the venous end of the heart. The normal heart's rhythm is, therefore, started at the venous end, because that part of the heart is alone susceptible to the salts of the blood. — W. H. Howell, in Am. Jour. Phys. SALINE SOLUTION. Dr. Poteenko reports two cases of acute parenchymatous nephritis treated by subcutaneous injections of physiological saline solution. In both cases severe uremic symptoms were present, and the quantity of urine passed was small. Three hundred cubic centimetres of salt solution at a temperature of 40° C, were in- jected each time. A beneficial action of the fluid was noticed after the first injection, and manifested itself in a regulation and toning up of the heart action, in a subjective improvement of the general condition of the patient, and almost always by an increased secretion of urine. Of course : but how much better still, if the blood had been re- inforced by blood, and the patient thus securely supported, instead of being diluted with water and the patient perilously weakened? 60 ETIOLOGY AND DIAGNOSIS OF THE ANEMIAS. Dr. T. J. Biggs, Sound View Hospital. AN^KMiA is poverty of the blood. The morbid state is met with as a consequence of profuse or frequently-recurring haemorrhages, of insufficient nourishment, of affections which prevent the nutriment taken from being properly absorbed or assimilated, thus impoverishing the biood by depriving it of its most needed constituents, and of profuse chronic discharges, which drain the blood of many of its important elements, and especially of its oxygen albumen. Other causes of ansemia are by particular poisons, as by malaria, or by the retention of noxious ingredients in the blood, or by diseases of certain glands. Again it is some- times encountered without our being able to trace it to any obvious source. But under all these circumstances we have to deal with a watery blood deficient in red corpuscles; in other words, with an anaemic condition. Whatever may have given rise to anpemia, the manifes- tations of the disorder are much the same. The patient is weak and pale ; his pulse is feeble but generally accelerated ; the appetite is deficient or depraved; the bowels are apt to be costive. Exercise induces great fatig-nf, sliorlnfps of breath, and palpitation; and the disturbance of the heart may be associated with cardiac murmurs or with blowing sounds in the cervical veil s, and is sometimes so persistent as to lead, as will be found elsewhere described, to structu- ral changes in the heart la some cases, furtht r, we meet, among the symptoiKS of the affection, with obstinate head- ache and with dropsy, and in very maay with a persistent pain in the left side, in the region of the spleen. Chlorosis. — H' re the pallid, wax like countenance, the very pale lips, and the paarly eye, afford unmistakable evi- dence of the deterioration of the bleed, consisting chiefly in deficiency of haemaglobulin. The complaint is especially encountered in youug females, and is, as a rale, apsod'ated with amenorrlioea. Many restrict the term to the obvious anaemia combined with suppression of the menses, so often affecting girls about the age of puberty. In pure chlorosis, organic diseases of the g.istro-intestinal apparatus, of the sple(*n and lymphatic glands, or of the lungs and kidneys, ard abbeat, Aie temperature is normal; the nutrition of the body is fairly well kept up; the nervous system is irritable. 61 Sometimes these symptoms of chlorosis happen before pu- berty ; or there are relapses of the malady in middle age. Boys about the age of puberty may also develope the mani- festations of chlorosis. Addison's Disease. — There is another form of anaemia which requires to be specially mentioned — namely, that connected with disease of the supra-renal capsules. Addi- son, whose name the complaint now bears, met with a form of general anaemia which had no perceptible cause what- ever; in which there had been neither loss of blood, nor mental shock or anxiety, nor exhausting diarrhoea; which was concomitant with neither malignant nor scrofulous disease, nor with any affection of the spleen, kidneys, or lymphatic glands, nor, in fact, with any lesion that the most careful examination could detect. While seeking for the explanation of these puzzling cases, he discovered that this peculiar anaemia always occurs in connection with a diseased condition of the supra-renal capsules, and is characterized by distressing languor and great general prostration, remarkable feebleness of the heart's action, loss of appetite, obstinate vomiting, and a singular alteration of the skin. This consists in a dingy or smoky hue of the surface ; or the color may be of a deep amber or chestnut brown, or the altered skin has a bronzed tinge. The change of color begins on exposed parts, such as the face and neck and the back of the hands, and deepens first there; but we also soon find it marked in parts which are naturally the seat of much pigment, such as the axillae, the groins, and the areolae of the nipples. It; is also marked around the umbilicus, on the penis, and on the scrotum, and is dependent upon a layer of pigment in the rete mu- cosum. The skin remains soft and smooth, and becomes in large portions uniformly discolored, gradually deepening and often presenting a hue on the face and hands like that of a mulatto. Any irritation of the skin is followed by dark streaks. Discoloration in patches is both less constant and less significant than extensive alteration in the hue; yet the darkening in undoubted cases may occur in patches, which are usually most obvious on the face or superior ex- tremities. The patient may seem at first sight to be jaun- diced; but the pearly whiteness of the conjunctiva soon dis- pels such an idea. The nails a,re pale and bluish ; the tongue may have patches of dark color ; the body and breath at 62 times exhale an offensive odor; and the blood has been found to contain an excess of white corpuscles and a slight decrease of the red, although it generally does not undergo any important or characteristic change. , Other symptoms are remarkable prostration, generally without any marked waste of the body, feebleness of heart's action and of pulse, and obvious anaemia. In most cases, but far from all, these symptoms precede the discoloration of the skin; and they are not unfrequently associated with pain in the back and with gastro- intestinal irritation, with breathlessness upon exertion, with vertigo, and with dim- ness of sight or impaired hearing. A peculiar odor of the body, like that perceived in the colored race, was observed in two cases, placed on record by Mr. Hutchinson. In the last stages of the malady the temperature falls below the normal. Death may take place gradually from the constantly- growing asthenia; or it may occur suddenly, and where the amount of prostration does not appear so excessive as to foreshadow it. The post-mortem examination shows gener- ally the organs in question totally destroyed. According to the elaborate researchr^s of Wilkes, the destruction is de- pendent upon a peculiar scrofulous degeneration; while Greenhow states it to be due to an inflammatory exudation* of low type. Many of the symptoms of the fully-developed malady may be due to the implication of the nervous branches derived from the sympathetic and pneumogastric, which go to the gland. And as regards all the symptoms, it must, in a diagnostic point of view, be borne in mind that it is their combination rather than the presence of any one which gives them their value, and that this combina- tion consists chiefly in the association of a peculiar dis- coloration of the skin, with a pearly eye, well-marked an- aemia, and prostration, and without the existence of any other disease than of the supra-renal capsules to account for the train of abnormal phenomena. Greenhow has pointed out how certain very long-standing instances of phthisis exhibit an appearance exactly like that of the earlier stages of Addison's disease. Yet the ab- normal pigmentation does not deepen or increase, and the symptoms remain only those of the pulmonary malady. StaiiiH « n the skin from pityriasis versicolor or from syphilis have not the seats of pigmentation characteristic of pig- 63 mental Addison's disease, and they are in patches and sur- rounded by healthy skin, and certainly the syphilitic affec- tion coexists with other significant eruptions or signs. Pernicious Anemia. — A fatal form of anaemia. It is an extreme anaemia advancing steadily, or with slight remis- sions, toward a fatal ending ; yet no cause can be detected for the profound and disastrous alteration the blood is undergoing, nor, indeed, can any adequate cause be dis- cerned for its origin. To pernicious anaemia belong, there- fore, most of the cases of "essential " or "idiopathic anae- mia," which since the time of Addison have been reported. The disorder is most frequent in women, and has been especially observed in child-bearing women; still, it also often happens in men, especially before the age of forty. It sometimes seems to have its origin in long- continued dyspepsia or diarrhoea, or to arise after protracted haemor- rhages or incessant worry — after indeed slowly but steadily- acting debilitating influences; and it has been noted to be of parasitic origin. But in the majority of instances it originates seemingly without cause, and although it has periods of deceptive improvement which may last for months, or, as I have known, even for a year, it usually progresses relentlessly toward a fatal issue. It is true that recently some cases of recovery have been recorded by me under the blood treatment, but of these it is not quite cer- tain that they presented all the well-marked and character- istic symptoms. What are these characteristic symptoms ? An insidious beginning for the obvious anaemia, except at times when this develops itself in the pregnant state; pale tongue; bloodless lips; pearly eye, becoming paler, more bloodless, more pearly, from week to week ; breathlessness ; palpita- tion of the heart, especially on exertion ; weak digestion ; constipation, or constipation alternating with diarrhoea; loud systolic murmurs in the heart, and venous hum in the jugulars; vertigo; finally, extreme exhaustion, sluggish- ness of mind, fainting-fits and dropsy, without persistent albumen in the urine, or disease of the liver or enlargement or valvular disease of the heart, to account for it. In the later stages, too, haemorrhages from the nose and from the gums are not uncommon ; and haemorrhages from the uterus or from the kidneys or into the skin and into the retina. 64 may also be noticed ; the latter especially is very frequent. Yet, notwithstanding all these grave signs, the body ap- pears well nourisht d; there i?; certainly no decided emacia- tion, except in instances ia which fever is more commonly marked. Now, fever is a significant feature of progressive pernicious anaemia; it has been present in every case that I have met with. It is not an early symptom; belonging to the full development or t ) the latter part of the disease. It is of very irregular type, and not of high intensity, the temperature rarely exceeding 103 degs. F. It is apt to be continued, or to show occasional exacerbations, followed by remissions, the febrile state lasting for days, or even for a week or two, at a time; then there are periods of shorter or longer duration when it wholly disappears, to come on again in an outbreak attended with all the usual signs of a febrile paroxysm for which no cause is apparent. Toward the end of the case it is not unusual for the ansemic fever to have entirely ceasQ,d, and for the temperature to have fallen below the normal standard. The disease may run an acute course. The state of the blood in this perilous malad/ has natu- rally been made a subject of minute investigation; the red globules are pale and strikingly diminished in number ; the white corpuscles are not relatively altered, they may remain normal, and seem to be increased, because the red globules are much fewer. The paleness of the red corpuscles is due to deficiency of hsemaglobin. The shape of these was stated by Eichorst to be characteristically changed, in so far at least that the blood contains a quantity of ill-developed, small, spherical red corpuscles. But these are not patho- gnomonic. Nucleated red corpuscles were detected in the blood of all the patients examined by Howard ; and a much larger proportion than is found normally of small disks of deep color is regarded as important. Of the real cause of the disease we are in ignorance. No constant lesion of the blood-making glands has been found to explain the steady and destructive impoverishment of the blood. The structure of the spleen and of the lymphatic glands is not altered ; the marrow of the bones may or may not be. The most constant lesion is fatty degeneration of the heart, often associated with the same change in the inner coat of the large arteries. A recent writer argues against the separation of pernicious anaemia from chlorosis. 65 BLOOD CUEE OF CHRONIC CATARRH AND CATARRHAL DISEASES. Next in prominence among the unprecedented healing powers developed in the application of an Extraneous Blood Supply, we arrange a few Cases in Chronic Catarrh and Catarrhal Inflamma- tion, such as have never been found or considered curable hereto- fore; once more reminding the profession that no case of unsatis- factory result in the intelligent technical use of this auxiliary has ever been or will be withheld. The uniformity of cures here re- ported is simply the uniformity of the facts in all known cases. CASE I. OF VIRULENT CHRONIC CATARRH BLOOD CURJED. By Dr. S , New York. Margie Bowers, age 24; January 11, 1897; chronic rhinitis, from scrofulous diathesis; mucous membrane much thickened and dark red; a number of polypoid growths; considerable ulceration and loss of structure; thick, tough, greenish and fetid secretion; large accumulations of dried mucus; sense of smell entirely lost, and hearing nearly so; constant frontal headache; congestion of the eyes; in fine, profound general anaemia. All the known treatments were pursued, with little or no relief. But on the 16tli of January, at the suggestion of a professional brother, I determined to test the blood cure, and commenced by giving bovinine every two hours. The nasal passages were thor- oughly cleansed with Thiersch solution; the polypoid growths were snared oft", and the points of ulceration were touched up with 25 per cent, pyrozone. Bovinine in salt water was sprayed into the pas- sages every two hours; preceded every time by washing out with Thiersch solution. The effect of this course of treatment, continued, can only be described as magical. Within the first forty-eight hours, the be- fore constant headache ceased; the discharge was diminished, and its fetid odor had disappeared. January 28th, the sense of smell had returned, and the hearing was improved. February 20th, the points of ulceration were entirely healed and all symptoms were practically normal. How, now, is Supplied Blood related to the physio-pathological condition of Chronic Catarrh, to such purpose as indicated in the remarkable issue of the above treatment? Simply thus: We have in the case an interstitial overgrowth, or hypertrophy, in the mu- cous membrane, which crowds and compresses the capillary blood- vessels so as to shut off the blood and plug them up with thrombi; result, molecular death, proceeding to ulceration; requirement, dis- infectant and penetrating cleansing and stimulation as above de- scribed, preparatory to the introduction of supplied blood to nour- ish the stimulated proliferation of tissue elements and cause ab- 66 sorption of interstitial overgrowth, restore and reopen the capil- laries, and, in short, restore normal physiological action, tone and circulation to the diseased mucous membrane. What a simplicity and "sweet reasonableness" there is in the treatment of Chronic Catarrh, when you understand it! CHRONIC ULCERATIVE CATARRHAL RHINITIS. Case of Dr. T. J. B , New York. L. Hecox; age 36; first seen April 2d, and on May 12th dis- charged cured of a chronic ulcerative rhinitis, of aggravated char- acter and long standing, with symptoms closely resembling the case of Maggie Bowers, and a course of results from blood treat- ment strikingly similar also. The remote cause had been syphilis; had been treated by several prominent specialists with the utmost modern methods, and slight temporary relief, followed every time by return to a worse condition than ever. Wlien the case came into my hands, the sense of smell was entirely destroyed, and that of hearing nearly so. The stench of his breath was something tremendous. The disease had invaded the pharynx, extended to the vocal chords, and affected the voice. There was constant dull frontal headache; profound anaemia, and thirty pounds weight had been lost in the last six months. After three days of treatment above referred to, the headache had ceased, the discharge was diminished, and from the very first application, the intolerable stench of the breath disappeared. By May 12th the patient had gained fourteen pounds, the ulceration had healed throughout, the discharge had ceased, there was no more headache, the senses of smell and hearing were restored. CHRONIC NASO-PHARYNGEAL CATARRH. Dr. T. J. Biggs, Sound View Hospital. Carlo W ; age 30; January 1, 1898; well defined case, with complete loss of hearing in the right ear, due to extension of the catarrhal influence into the Eustachian canal. Twice a day, after having thoroughly cleansed out the passages by dropping in per- oxide-on-bovinine and washing it out with Thiersch solution, he was directed to spray in pure bovinine. On January 12th, he had not had any mucus for three morn- ings, and tlie air passages seemed to be in a normal condition. On the 21st, the Eustachian catarrh was cured, and hearing per- fectly restored. On the 26th, examination showed a complete restoration of the normal condition in all respects. 67 ULCERATIVE OTITIS AND NASO-PHARYNGBAL CATARRH. Case of Dr. J , New York. John Hajmes; age 16; May 10, 1897; suppurative inflammation with severe ulceration in the middle ear; hearing entirely de- stroyed; had been treated for six months, at five institutions, by some of the best specialists, without any apparent result. [Under thorough use of all the most approved applications and nutrients] the condition improved somewhat for a few days and then got worse again. I became much discouraged. But on the 21st, I was persuaded by a professional colleague to try the "blood treat- ment" [technique as already described]. A decided improvement began after the second day, and continued without any relapse, un- til the patient was discharged cured, June 18th : the ulcerations be- ing entirely healed, the inflammation having completely subsided, and the hearing already almost normal. The results attained by me in this case with blood treatment have been so thoroughly satisfac- tory, that I shall continue to employ it in all other cases. OLD CHRONIC NASO-PHARYNGEAL CATARRH. Case of Dr. J , New York. John Bostwick; age 23; June 10, 1897; old chronic case, anterior nares showing three distinct points of ulceration; the posterior nares tremendously hypertrophied, occluding the passages almost entirely; tonsils hypertrophied; fauces covered with points of ul- ceration; large accumulations of fetid mucus and breath so foul that he never went anywhere among others; had been treated by several of the best specialists, with but slight and temporary re- lief. In my judgment an operation was indispensable, and I so advised; but he refused to submit to any operation whatever. My former success with bovine blood encouraged me to try it; spray- ing bovinine into the nasal passages and throat, following it with a spraying of peroxide, and then washing out the product with Thiersch. The patient was directed to apply iodoform-bovinine with a medicine-dropper, and to swab the throat with the same, three times a day, and return every morning for the bovinine-per- oxide treatment. July 17th, all points of ulceration were healed, and the patient was relieved of the distressing accumulation of mucus. The sense of smell was regained, and the hearing almost entirely restored. ULCERATIVE SEVEN-YEAR CATARRH. Case of Dr. J , New York. Ed Eushby; age 22; July 22d; case of seven years standing; ul- ceration on both sides of septum. Bovinine and peroxide of hydro- gen sprayed in, thorough washing out the encrusted accumulations. Bovinine pure was then sprayed into all passages three times a day, with repeated depurations. In about a week (July 30th), all the points of ulceration were healed, and the passages thoroughly opened for use, with very little of unnatural secretion. Last seen August 14th, in a quite normal condition. 68 ULCERATIVE NASO-PHARYNGBAL CATARRH. By the Same Specialist — Dr. J , New York. Annie Bemis; aged 32; came under ray care May 10, 1897, the same day with the former case; catarrh with ulceration of the pas- sages, and an ulcer behind the left tonsil; had received the ap- proved modern treatments without success; large accumulations of mucus and hardened scabs being daily coughed up; with the other usual symptoms of a severe case. After two weeks trial of the usual treatments, as in the former case and with like negative results, the striking success of the blood treatment on that case had just them become apparent, and accordingly, on May 24th, I began the new treatment which was continued, the patient improving daily, without any backset, until discharged, June 26. The senses of smell and hearing were then almost normal; the ulcerations were entirely healed; and the dis- charges had ceased. OLD CHRONIC CATARRH AND ULCERS. Case of Dr. J , New York. George Carter; age 32; August 12, 1897; case of many years standing and many ineffectual treatments of the ordinary kinds; large masses of hypertrophied tissue; and in the throat five dis- tinct ulcers. I removed portions of hypertrophied tissue, the pas- sages and throat were thoroughly cleansed, and a spray of bovinine M^as used every two hours. In one week, all the ulcers in the throat were entirely healed, and the cut surfaces in the passages were half covered with healthy skin. August 7th, the patient was discharged cured. CHRONIC ULCERATIVE CATARRH. Case of Dr. J , New York. Ann Thompson; age 30; June 14, 1897; bad old case, like the rest, ulcerations, etc. ; last resort, as usual, after all" treatments in several institutions. Passages tilled with hard crusts and scabs, which were now dissolved and washed out with the bovinine-per- oxide reaction, and pure bovinine applied thrice a day. July 17th, the discharge of mucus had been reduced nearly to normal quan- tity; the headache had been entirely relieved; and the sense of smell was measurably restored. CHRONIC ULCERATIVE CATARRHAL RHINITIS. Case of Dr. B , New York. Eddie Judson; age 23; September 12, 1897; many treatments had all failed; symptoms of a well-defined case, besides several points of ulceration, with considerable loss of structure; profuse, thick, tough, greenish-colored and fetid-smelling secretion. Tinder usual technique of blood treatment, October 10th, all symptoms had been removed and the patient was discharged cured. Seen again twice, to November 17tli; continuing well. 69 « BLOOD CURE OF CHRONIC CATARRH. Case of Dr. T. J. B., New York. Ethel Strobel; age 29; May 3, 1897; naso-pharyngeal catarrh of long, standing; had been treated by various specialists, at many clinics; the passages covered with hard crusts, with points of ul- ceration; severe headache almost constant. Treatment as already described, and spray of boviniue and salt water every two hours. In ten days the abnormal secretion al- most ceased, and the constant catarrhal headache had entirely dis- appeared. When last seen, June 14th, the ulcerations were en- tirely healed, and the passages looked healthy . CHRONIC ULCERATIVE NASO-PHARYNGEAL CATARRH XIX. By Dr. T. J. Biggs, Sound View Hospital. Sam Ellard, New Haven, Conn.; age 26; June 10, 1898. Had undergone four operations; under care of the best specialists, for eight years; growing steadily worse. Anterior nares, entire left, one ulcer; six ulcers in the right. Passages now depurated with peroxide-on-bovinine, and touched up with Paquelin cautery. Both nasal passages daily depurated, packed with bovinine in gauze and sprayed with bovinine every two Jiours. Bovinine also given internally, as in all cases. July 9th, the healing was com- plete, all over; a result without a parallel to my knowledge. OLD ULCERATIVE CATARRH. Case of Dr. R , New York. Michael Navarro; age 27; August 12, 1897; case of many years standing, treated at various institutions without result; ulceration of the surfaces, exuding such large quantities of mucus as to cause severe attacks of vomiting, followed by hemorrhage. After thor- ough cleansing, I sprayed bovinine and salt water into the i^as- sages every two hours. Within a week, many small points of ulceration had healed, and others were rapidly becoming covered. September 10th, examination showed complete healing of all the ulcers. CHRONIC BRONCHIAL CATARRH. Case of Dr. C . Henry Felix; age 41:; September 14, 1897; chronic bronchial catarrh, which had resisted many treatments; vesiculo-bronchial respiration, profuse sibilant, large and small, bubbling rales; dif- fused spots of the amphoric percussion sound; c6ugh; mucous ex- pectoration ;, weight reduced in six months from 160 to 123: poor a])petite and digestion. After regulating the bowels, bovinine and bronchine every four hours. October 9th, weight 134 pounds, cough and expectoration almost entirely relieved, appetite and di- gestion normal. Last seen, November 2d, still well. 70 OLD CHRONIC ULCERATIVE CATARRH. Case of Dr. H , New York. Peter Smith; age 27; June 18, 1897; case was of many years standing, unsuccessfully treated by specialists at many institutions. All the usual extreme symptoms; which were treated with the usual technique of blood treatment for catarrh, with the result that at the end of the second week, the ulcerated surfaces were all healed except one minute point, and the abnormal secretion of mucus and scab-forming had ceased. July 22d, the healing was perfect and the sense of smell mainly restored. CATARRHAL ORGANIC DISEASES. CHRONIC ULCERATIVE TONSILITIS. Dr. T. J. Biggs, Sound View Hospital. Florence B , Stamford; American; age 14; admitted August 30, 1898. Little Miss B had suffered from this condition for six years, or nearly half her lifetime; constantly treated not only by her family physician, but by no less than six noted specialists, from time to time; yet her condition had constantly grown worse, all the current medical resources having been exhausted by the best practitioners, to no purpose. Her throat by this time had become so thoroughly ulcerated that only special preparations of food could be swallowed, with much pain, which in fact was constant all the time in the absence of irritation; and her breath had become so foul that it was unbearable to be in the same room with her. I began by thoroughly depurating the ulcerations of throat with the bovinine-peroxide reaction; spraying in first the bovinine and then the peroxide of hydrogen, and gargling out the remainder of the foamy product with Thiersch solution; then touching up all points of ulceration with 25 per cent, pyrozone, and finishing with a spray of bovinine pure. The whole of this process was repeated every hour, for twelve days, or until September 10th, with the usual internal administration of bovinine; when all pain had Long ceased, her breath had become sweet, and she could eat almost any ordinary food without inconvenience; many points of ulceration having healed and the remainder healing rapidly; insomuch that in another ten days, September 20, 1898, the patient was entirely cured and discharged. 71 ULCERATIVE STOMATITIS. Dr. T. J. Biggs, Sound View Hospital. Miss M , Stamford; age 28; June 2, 1898; large ulcer at the base of the tongue; one beneath and near the tip, and one around the mouth of Steno's duct, on the right side. After antiseptic preparation of surfaces, patient was ordered to apply bovinine pure, once in a while, by putting a teaspoonful in her mouth and holding it there. The ulcers had been so sore that the patient could not take anything in her mouth without such great pain that she had been almost starved. But after beginning the blood application, the pain ceased, and she could even enjoy a solid diet without much inconvenience. At the same time, the ulcers began to heal rapidly, together with improvement in general condition. July 14, 1898, the cure was complete. CASE OF ULCERATIVE STOMATITIS, BLOOD CURED. By Dr. D , New York. Mary Burke; age 16; July 6, 1897; stomatitis over a year; treated at various institutions without benefit; assimilation sadly impaired in consequence of mastication and nutrition prevented by soreness, and absence of ptyalin ferment. Sterilization of mouth by per- oxide-on-bovinine and Thiersch, t. d., holding bovinine in mouth between times. In ten days, food could be resumed, and cure was complete July 22d, with gain in weight of seven pounds. GRANULATED EYELID OF EIGHTEEN MONTHS STANDING. By Dr. R , New York. Mattie Jones; age 19; June 2, 1897. Her case had for eighteen months stubbornly resisted the various treatments known at several of our standard institutions. Such being the case, I readily pelded to the suggestion of a professional colleague to try a resort to blood treatment. After twenty-four hours of antiseptic preparation pure bovinine was applied, and ordered continued by dropping under the lower eyelid every two hours. July 12th, this patient was discharged; her obstinate chronic distemper thoroughly cured by a simple treatment of less than six weeks. The result I con- sider most remarkable; and I shall give the blood treatment a thorough trial in many other cases, reports of which may be ex- pected. [And are given, passim.] ULCERATIVE CONJUNCTIVITIS. F. S. Ayres, of New York; age 24; November 27, 1897. Four days preparatory treatment, and on December 2d, this was dis- continued, and pure bovinine was applied to the conjunctiva by a dropper, every two hours, after cleansing the eyes each time with tepid Thiersch solution. December 14th, patient was discharged cured of a condition from which he had suffered over four years. n ULCERATIVE CONJUNCTIVITIS. Dr. T. J. Biggs, Sound View Hospital. C ^V , South Norwalk, Conn.; American; age 40; first seen July 23, 1898. Had suffered with ulcerative conjunctivitis of both eyes, for ten years, under many physicians and in live differ- ent institutions, growing all the time steadily worse. The ulcera- tion had destroyed all the hair follicles of the lower eyelids. July 24th, after rendering the parts insensible by a 10 per cent, solu- tion of cocaine, the ulcerated surfaces were brushed over with a 25 per cent, solution of pyrozone; the membrane and ulcerative surface were antiseptically cleansed witli poroxide-on-bovinine and washed off with Thiersch, and bovinine pure was dropped in, every two hours; continuing this, with the bovinine-peroxide depuration night and morning, and dropping the bovinine in every three hours after the 26th, until the patient was entirely cured and discharged on September 1, 1898. ULCERATIVE CATARRHAL OTITIS. Case of Dr. J , New York. John Hayles; age 27; August 14, 1897; after having been treat- ed by many physicians at various institutions; considerable ulcera- tion in the middle ear; all the surfaces exuding pus; drum perforat- ed. Depuration, and iodoform-bovinine was dropped in every two hours. In one week, the pain which had Ijeen prominent in the complaint, was entirely relieved, and the purulent discharge mitigated as to quantity and quality, being now almost clear serum. September 7th, the surfaces were entirely covered with healthy skin, and the condition cured. BLOOD TREATMENT OF MEMBRAXOUS ENTERITIS. The following case is an instance of a dangerous disease which often, and in bad cases like this, usually, runs to a fatal termina- tion in spite of the best efforts of treatment heretofore known. Case of Dr. C , New York. Ann Boyle; age 47; January 8, 1897; suffering from a chronic membranous enteritis, or catarrhal inflammation of the bowels, of four years standing; had been treated at various institutions and by a number of private physicians, without real benefit. The attacks were periodical, recurring weekly, with very severe and exhausting colic, followed hy diarrhoea, with tenesmus, mucus, blood, shreds of membrane and membrane in cylindrical casts. She was very anaemic, weak, and emaciated, having lost thirty pounds in weight, and was subject to severe frontal headache. She was put upon bovinine at once, and by February 7th, the headache had entirely disappeared, digestion was restored, the at- tacks were no longer severe or frequent, one in two or three weeks at most. The blood on examination also showed marked improve- 73 ment, the cells and hgemaglobin, which had been far below stand- ard, now approaching normal, and weight increasing. The im- provement in all symptoms continued steadily, under the same treatment, until on April 1st, her weight had gained ten and one- half pounds, and blood was about the standard of 5,000,000 red corpuscles to the cu. m. m., no more attacks of the complaint, and in short the cure may be considered complete. CASE OF MEMBRANEOUS ENTERITIS. Dr. T. J. Biggs, Sound View Hospital. Mark A , Springdale, Conn.; age 40; November 10, 1898; typical case of membranous enteritis; began about two years ago. Feverishness and soreness and distention of the abdomen, severe recurrent colic around the umbilicus, followed by diarrhoea, with intense pain and tenesmus; passing mucus, blood, shreds of mem- brane and cylindrical casts of the bowels. He had been having those attacks about once a month, a little worse each time. Patient's secretions were regulated; medication appropriate: bO' vinine in milk every hour, and a very light pre-digested diet; also a high rectal injection of bovinine pure, every twenty-four hours. December 26th, bowels had resumed normal condition; stools contained no mucus, blood, shreds of membrane or cylindrical casts; rawness and soreness had entirely disappeared; examination of rectum revealed a normal condition. Patient was discharged cured. This is one of the most difficult of diseases to eradicate. BLOOD CUEE OF GASTPJC CATARRH, AND MEMBRANOUS ENTERITIS. CHRONIC GASTRIC CATARRH OF TEN YEARS STANDING. Dr. T. J. Biggs, Sound View Hospital. George Reynolds, Stamford, Conn.; age 56; October 8th; loss of appetite; gnawing and fullness in the stomach; tenderness and prominence of the epigastrium; morning vomiting of glairy mucus with great retching; constant thirst; great burning at the pit of the stomach; bowels constipated: urine highly colored; mental depression; sleeplessness; attacks of vertigo; follicular pharyngitis of an aggravated type ; much loss of flesh ; muscles relaxed and the skin dry, and in spite of all treatments, had been growing steadily worse for ten years. Treatment : After regulating the bowels and secretions, bovinine in milk every hour, and to allay the thirst, half a teaspoonful of 74 bovinine in ice water, as necessary. By October 9th, the vomiting had ceased, the pain in the abdomen had disappeared, and he had gained three and a half pounds in weight. November 13th, patient was well and hungry, all symptoms had disappeared, and he was now allowed a light general diet; to the present time having taken nothing but bovinine and milk; had gained twelve and three-quar- ter pounds in flesh, and said he was feeling splendidly. CHRONIC ULCERATIVE GASTRITIS. By the same. Sarah M , Hartford, Conn.; age 30; July 4, 1898. Had suf- fered for five years, under various treatments, including digestive ferments, and washing of stomach, without any continuing relief. Microscopic examination of stomach contents gave evidences of ulceration, for which I determined to employ an exclusive bovinine treatment. The first dose was vomited; the second caused some disturbance, but was retained; the third was retained, without any inconvenience, and patient said it seemed to give her great ease. The bovinine was increased and continued to the 25th, when pa- tient said she was entirely free from pain, and, having lived on nothing but bovinine and milk since treatment began, she was given some finely chopped and broiled beef, with a little dry toast, milk and bovinine. She ate every bit, suffered no bad effect and in five hours was hungry again. The bovinine was increased, and this seemed to remove the craving for other food, the appetite be- ing appeased. August 8, 1898, case was discharged cured, with a gain of three and three-quarter pounds in weight, and feeling per- fectly well. CATARRHAL ENTERITIS. Dr. T. J. Biggs, Sound View Hospital. Felix Max, Larchmont, N. Y.; age 37; August 2, 1898; nearly two years under treatment for this condition, but with no relief. I determined to allow him nothing but bovinine and milk inter- nally, with the object of giving the digestive apparatus as perfect rest as possible, and throwing the least possible of faecal matter over the inflamed surface. Eectal injections of bovinine were also given three times a day. August 29th, a discharge from the rec- tum of one and a half years standing liad entirely ceased, together with the chronic pain and soreness. September 5th, patient was discharged cured. 75 CHEONIC GASTKIC ULCEEATION. By T. J. Biggs, M. D., Sound View Hospital, Stamford, Conn. Too often, ulcer of the stomach is not diagnosed until the post mortem. In 5 per cent, of those dying from all causes, ulcers either cicatrized or open, are found in the stomach; the scars of them being the more common. The female sex is more subject to them than the male; which may perhaps be due to the fashionable compression of the waist. It oftenest attacks anaemic or chlorotic individuals, and is not infrequently associated with tuberculosis. Gastric ulceration results from self-digestion of a part of the stomach wall by the gastric juice. This is j)revented in the normal stomach by the circulation of alkaline blood in the gastric mucous membrane. Its most frequent cause is malnutrition of the stom- ach due to altered states of the blood, as in ansemia and chlorosis. The indication of healthy auxiliary blood supply is therefore obvi- ous. The specific symptom is pain which is fixed and does not radiate ; usually under the ensiform cartilage and between the scapulae; is increased by pressure, and immediately on taking food; but often occurs in paroxysms indep'endent of these causes. Vomiting occurs soon after taking food from irritation; the matter vomited often containing blood-streaked mucus. There is haemorrhage in 50 per cent, of cases; varying in amount, and generally black, un- less the ulcer is very large. TREATMENT. The treatment should consist in rest, close attention to diet and secretions, and medicines applied symptomatically from time to time. Absolute rest in bed should be enforced until the symptoms have subsided. The food must be easy of digestion and non-irri- tating, taken in small quantities and often. If the case is severe, rectal feeding should be adopted until the stomach is able to retain food comfortably. For the well-informed practitioner it is need- less to remark that bovinine is the nourishment tacitly indicated in all such cases; using anywhere from ten to thirty drops, according to the case, every one or two hours, in milk that has been boiled, water or cold bouillon. The reason why bovinine is so evidently the specific nourishment for such cases, lies in the fact that it involves but one process of assimilation to the blood, namely, the conversion of the egg albumen contained in it to albuminose; the bulk of the liquid being blood, ready to be absorbed directly into the circula- tion, as perfected nutrition instead of mere nutriment or food. Thus the stomach gets almost absolute rest, even while receiving 76 this nourishment; since, as is well known, the egg albumen itself is passively absorbed into any part of the digestive tract; and so the most perfect nutrition of the system, including the diseased part of the stomach itself, is kept up without interruption, without irri- tation, and without injurious functional labor. CHRONIC GASTRIC ULCERATION. Dr. T. J. Biggs, Sound View Hospital. Miss E E , of Newark, N. J.; age 46; admitted Septem- ber 10, 1897; gastric ulcer; all symptoms of a well-defined chronic ease; dyspepsia, flatulent; fixed pain under the ensiform cartilage, extending back between the scapulse, much increased by pressure, and also greatly aggravated on taking food. There were also paroxysms of pain independently of food or pressure. After eat- ing, she vomited matter containing blood-streaked mucus. She had suffered four hemorrhages of the stomach. The case was of six months standing, and had received many of the usual forms of treatment. The patient's stomach was gently washed out with a 20 per cent, solution of boracic acid. Absolute rest in bed was insisted on. Twenty drops of bovinine were administered every hour in a table- spoonful of lime water. Her functions also were regulated, and bowels washed out once in forty-eight hours with an enema of glycerine and soap suds. At the end of the first forty-eight hours, the patient said she felt greatly relieved of pain, arid had not vomited in six hours. By the 14th, patient showed decided improvement ; vomiting had ceased entirely; there had been no haemorrhage; and it had been remarkable to note the rapidity with which the pain was removed: a phenomenon always attendant on the application of bovinine to painful ulcerations, but which has not yet been decisively account- ed for by the theories that have been suggested. On September 21st, the progressive improvement permitted the patient to take boiled milk, buttermilk, and barley gruel, and could soon be allowed a certain amount of daily exercise in the open air. She now suffered no pain whatever, further than some soreness'to pressure, and the dyspeptic symptoms had almost entirely disap- peared. November 18th, a thorough and careful examination, physical and microscopical, revealed the ulcer entirely healed and health perfectly restored. 77 THE NEW CURE FOR ANEMIA. EEMAEKS ON ANEMIA By T. J. Biggs, M. D., Sound View Hospital, Stamford, Conn. [Ansemia and Chronic Catarrh are two conditions of disease that resemble each other in one respect: acknowledged incurability by methods known to medicine before the introduction of blood feed- ing for the anaemic system and for the catarrhal membranes. An- other resemblance lies in the gentle and insidious operation of both conditions, causing them to be little noted in comparison to the deadly diseases for which they co-operate in laying the foundation — consumption, for one. Consequently, patients attach compara- tively little importance to them, and physicians are baffled by them without wonder or special dissatisfaction. The advent of a treat- ment that makes failure to cure these diseases inexcusable, marks a brilliant era in medicine, and a new exaction of responsibility on all who profess and call themselves physicians.] It is doubtful, in my mind, whether the average doctor realizes the frequency of anaemia. I am sure that if the general practi- tioner gave due attention to the factor anaemia, we should have comparatively few cases of disease extending into the chronic state. Too few physicians are accustomed to take into account all the elements of every case, including this, the most prevalent and es- sential of all. Any disease that depletes the system and draws largely on the vital forces will involve the condition we call anaemia. On all such occasions, it is of the first importance for the doctor to be constantly on the lookout for this condition. The best means of diagnosis is microscopic examination of the blood, to determine its quality from the number of red corpus- cles and the proportion of haemaglobin, and also as to its freedom from bacteria. As to the treatment of anaemia, blood, in my opinion, is undoubt- edly the only agent that can absolutely restore the normal condition of blood. Iron has long been the favorite remedy with the profes- sion for the treatment of anaemia. But the majority of physicians now tell you that iron will act favorably up to a certain point only. Why is this? It is because iron preparations can only stimulate cell proliferation, but cannot help the deficient nutri- tion of the proliferating cells. It is for this reason that, as much 78 clinical experience has proven to me and many others, patients put on iron and other so-called blood tonics, seldom make any permanent improvement. The agent that brings results clini- cally, is one that not only causes rapid cell-proliferation, but sup- plies the new-born cells with direct nutrition, thereby causing them to proliferate in turn; thus finally restoring the blood to the nor- mal standard. Take any two similar cases of angemia, in which the action of blood and of blood tonic may be comparatively studied: give a tonic to one and bovinine to the other, and note the results. It will be found, by careful examination of the blood and general condition, for the first two or three weeks, perhaps, that the ef- fects are nearly identical; the tonic showing an increase of red blood cells, by proliferation due to stimulation. Thereafter, as the cases go on, note by daily examination the fate of the new- born cells. Those that are the oflispring of the tonic stimula- tion perish, for want of the nutrition which the anaemic system cannot provide for them, and there is an end of the improvement — the usual relapse to a worse condition than before. A few of these cells may get some oxygen from the lungs, but the bulk of them are carried around in the circulation in an immature and useless state, and incapable of self-proliferation, because not nourished. i •..• j .M Then observe the bovinine case, and a very different picture will appear. The new cells produced under this treatment, re- ceive at the same time the nourishment necessary to their full development and functional power. Instead of remaining sterile, they proliferate abundantly, and their progeny in turn carry on the proliferation indefinitely, regenerating the blood and the whole system. Without such simultaneous nourishment, it is fruitless to stimulate cell-proliferation by tonics, which cannot feed their progeny, nor find or produce nourishment for them. Neither can the tonics go on stimulating, indefinitely. The power of being stimiJlated is diminished by every application of the unnatural stimulation, until it is at length annihilated. At the same time, and by the same unphysiological or rather anti- physiological intrusion, the functions of digestion and nutrition are upset; and verily, the last state of the patient is worse than the first, or than the first would naturally have become; while the purely physiological operation of supplied blood co-operates with every interest and function of the vital economy, and stead- ily builds up the whole. 79 OBSCURE CASE OF ANJEMIA : WOULD NEVER HAVE BEEN RECOGNIZED. SOUND VIEW HOSPITAL, STAMFORD, CONN. T. J. BIGGS, M.D., SDRQEON-JN-CHIEF. [The extraordinary case recorded below will profoundly interest every thoughtful physician, both from its singu- larity and from the importance of the instruction it affords: a case of obscured ansemia — so obscured by every appear- ance of robust health, that not the slightest guiding indica- tion of the real trouble appeared, until a microscopical di- agnosis, which evidently had never before been thought of, revealed a form of anaemia, or blood-degeneration, most serious from its obscurity, and from its peculiar line of de- velopment. Unable to learn of a counterpart to this case, from cursory examination of the literature or from the ex- perience of eminent consultants in New York, we should feel much obliged for any experience of a like character that others may have had, or may have heard or read of.] Catalogue Case No. 16. Anemia. Miss G. H , Avondale, O. ; age 24; American ; anaemia. First seen November 6, 1897. This case had been under treatment by various physicians, for two years, but the patient got no permanent relief. Some of the physicians had treated her for malaria; some for neurasthenia; some for chronic hepatitis; and still another, for uterine trouble. Casually observing the patient, any one might justly have exclaimed. What a perfectly healthy specimen you are ! Not only was her complexion florid, and her figure rounded and full, but her functions — namely, menstruation, bowels and action of the kidneys — were altogether normal. It was a hard case for diagnosis. The only symptoms apparent were that at times she became exhausted after some trifling exercise, and at other times lapsed into a faint without ap- parent cause; nor were these attacks accompanied with hysteria: she merely complained of being weak and tired. The attacks of fainting were periodical, with at times com- plete unconsciousness ; at other times were such as might be called le petit mal. Outside of these occasional symp- toms, there was every external evidence of health in the fullest sense of the word. The patient said, however, she 80 had noticed that her hair seemed to have grown a bit lighter within the last three or four months. • My first step was the microscopic examination of the blood, which is indispensable for intelligent diagnosis, espe- cially in cases of this obscure description. The blood was about normal in color to the eye ; microscopically, however, the picture was decidedly abnormal. One cubic centimeter of blood showed but 1,500,000 red corpuscles, with a decided overplus of white cells. The red cells were in the various stages of disintegration and paralysis. The haemaglobin was not more than twenty per cent, of the normal quantity. In one specimen of blood from the hand of the patient, the red corpuscles were absolutely devoid of color: this being a most unusual picture, and indicating, in my mind, the ini- tial cause, if not a beginning, of fatty degeneration : a sub- ject too extensive to be discussed within present limits. It was accordingly determined to put the patient on the following simple course of treatment. Night and morning she was massaged with alcohol, and instructed to take plenty of outdoor exercise; at the same time observing great care in dressing to avoid catching cold. From the first, the patient thoroughly enjoyed the taking of bovinine, and consequently a large quantity was immediately pre- scribed : a wineglassf ul every three hours, during the day, in milk. Within the first forty- eight hours, the patient felt very much improved; remarking, **Why, doctor, do you know, I 'feel stronger and brighter already! I know this treatment is doing me much good." The treatment was continued up to the 22d of November; when a microscopic examination of the blood showed that the quantity of hsema- globin was increased to fully half the normal. The number of red corpuscles had also increased considerably. Since November 14th, there had been no fainting spells. In fact, the patient said she hadn't "an ache or a pain." The quantity of bovinine was now increased to a wineglassful five times a day. November 30th, microscopic examination of the blood showed the red corpuscles to be already quite normal in quantity. The haemaglobin lacked but about one- eighth of the normal standard. From the 14th to this date, the patient had continued free from attacks of any kind. She will continue under observation for fully five weeks longer, and reports of the case may be made from time to time} certainly, in case of less favorable appearances. 81 Case of Anemia (Dispensary: T. J. B.). Ella Connolly; Irish; age 34; first seen October 14, 1897: all symptoms of well developed anjemia, of four years standing and resistance to all treatments hitherto em- ployed. Her original weight had been 135 pounds, it was now 102. Her blood was of a brighter color than normal, but microscopic examination revealed a deficiency of red corpuscles and hsemaglobin. It was much thinner than usual, and coagulated slowly and imperfectly, in conse- quence of deficiency in the fibrino-plastic constituent. Symptoms presented were : general pallor, gums and con- junctiva pale, much muscular weakness, deficient appetite and impaired digestion, attacks of vomiting, quickened respiration, irritable temper, vertigo in erect posture, turns of swooning, and hysteria. Heart on examination was found to be very irritable, with soft systolic basic murmur. Menses had ceased for two years. There was more or less oedema of eyelids and ancles, with some symptoms of fatty changes. Cause, chronic nephritis. Treatment :— patient's bowels and secretions in general were thoroughly regulated, and special attention was paid to nutrition, for which, on acco^mt of the irritable condi- tion of stomach requiring great care in this line, she was given thirty drops of bovinine every hour, in a tablespoon- ful of grape juice; also one-sixth grain of calomel every three hours. By the end of two days, the stomach was so much better that a teaspoonful of bovinine in milk was re- ceived every two hours. Continued this, with no medicine except something occasionally to move the bowels, up to November 2d, at which time the patient's condition had materially improved, was feeling much stronger, could eat with pleasure and comfort a light specially prepared diet, and was not easily tired as before; and blood examination showed a much improved standard, with the n'ormal power of coagulation. The bovinine was now increased to a table- spoonful in milk every three hours, and on December 1st to a wineglassful as often. Patient had still continued im- proving; all pallor had disappeared; ability and inclination for muscular exertion returned; appetite and digestion were normal, and also the action of heart ; and the oedema of eyelids and ancles was entirely gone. The same dosage of bovinine was continued to December 18th, when the pa- tient was discharged absolutely cured, with a weight oS 120 pounds. " 82 CASE OF LEUCOCYTHAEMIA, Mary K , Port Chester, N. Y. ; Irish; aged 29; Nov. 16, 1898. — Was called to see her, when careful examination proved it a true case of leucocythaemia ; history as follows : At the onset, her condition, a year previous, was identical with that of simple anae- mia, accompanied by swelling of the abdomen and a feeling of full- ness and pain in the splenic region. The spleen was found to be greatly enlarged. There was great pallor, and enlargement of the axillary and groin glands The ribs and sternum w^ere very tender on pressure ; appetite poor ; digestion feeble ; bowels loose ; patient easily fatigued ; suffered with cardiac palpitation and dyspnoea ; oedema of the eyelids and ankles ; urine scanty, with a specific grav- ity of 1.03. Microscopic examination of blood revealed an enor- mous increase in the number of white corpuscles, a deficiency of red cells, and a reduced quality and quantity of hsemaglobin. Ad- vised patient to abstain from all care and worry ; seek some quiet place in the country, where she could have plenty of fresh air, sunshine and pleasant surroundings. This she consented to do. I had her procure a dozen bottles of bovinine; also bromide of gold and arsenic ; to be taken as follows : begin with a teaspoon- ful of bovinine in milk every hour, and ten drops of bromide of gold and arsenic every three hours. Nov. 21, bovinine was increased to a tablespoonful every two hours. At this time the patient said she felt stronger, and that her bowels were not now so loose. Nov. 26, patient had im- proved still further ; bowels had become normal and the fullness and pain in splenic region were not so pronounced. Spleen, on examination, was found to be a trifle smaller. Nov. 30, bovinine increased to a wineglassful in milk every three hours. At this time, the fullness in splenic region had en- tirely disappeared, but there was still some pain. The oedema of the eyelids had entirely disappeared, and the patient had had no attack of cardiac palpitation for three days. Dec. 6, patient was found to be still improving; spleen had almost resumed its normal size ; pallor less ; oedema of ankles had disappeared ; urine increased in quantity and of lower specific gravity. Dec. 10, patient still doing nicely ; felt much stronger ; had gained three pounds in weight ; microscopic examination of blood now showed less excess of white blood corpuscles and an increase of red ; pain in bones entirely disappeared. Dec. 16, patient still improving; now able to take quite long walks without fatigue ; slept well ; good appetite ; nearly normal digestion. Dec. 20, patient had gained nine and three-quarter pounds in weight ; complexion almost normal, and she felt strong enough to resume her work, which was that of lady's maid. I would suggest that as yet no case of recovery from this con- dition has been recorded, and never, in my experience, have I seen a parallel case of recovery from it. SUPPLIED BLOOD FOR CEREBRAL ANEMIA. By Dr. T. J. Biggs. John "Wright, Esq., an English barrister, aged 53, came to this country in the earlier part of the year, on the advice of Dr. Treves, of London, seeking benefit from an ocean voyage, change of scene and rest. Prominent among his symptoms were: general weak- ness and sudden failures of memory, even from moment to mo- ment; hysterical irritability; inability to direct himself to work or bodily exercise of any kind; constant headache, relieved but slight- ly by lying down; vertigo aggravated by the least exertion; faint- ing fits; general pallor and anaemia; and a stomach so weakened and irritable that every variety of food that money could buy caused only vomiting or nausea. Since arriving in New York he had been treated by a number of our ablest physicians, who had tried all the modern drugs, foods and other means appropriate to the case, Hammond's animal extracts, electricity, etc. These some- times stimulated a slight improvement, from which he immediately relapsed into a condition worse than ever. He was a large man, who had weighed in health 207 pounds, and up to the end of this treatment in America had lost fifty-five pounds, so that his weight was reduced to 152. In this shape, Mr. Wright was introduced to Dr. Biggs by one of the doctors who had treated him for six weeks, and Dr. Biggs fell back at once upon blood treatment pure and simple; beginning with a teaspoonful of bovinine in a glass of milk every two hours, increasing from time to time, up to a wineglassful. In three weeks from the beginning of treatment his pallor had disappeared, also his vertigo ; he could read with comfort, his memory had improved, and he had regained both appetite and ability to retain food in variety. The course of improvement continued steadily, and on December 4th, he had gained in weight fifteen and three-quarter pounds. This interesting case — an utter rout of medical resources turned into victory by simple blood treatment — has since been heard from by letter from England, whither the patient returned. He says he is still feeling splendidly, and gaining flesh. EXHAUSTION BY HEMORRHAGE AND DISEASE. By Dr. R. Hearn, Toronto, Ont. I have used blood treatment with great satisfaction in partial collapse from haemoptysis. It caused systemic reaction with al- most the rapidity of transfusion. In all cases of severe haemor- rhage from any cause, or in low and depleted conditions of the body resulting from typhoid fever or septicaemia, and more especial- ly in diphtheria, gastritis, gastric ulcer or malignant disease of whatsoever nature, its place cannot be supplied by any other agent. 84 RE-ESTABLISHMENT OF CORPUSCLES AND H^MAGLOBIN IN NORMAL QUANTITY AND PROPORTIONS. Cases by Dr. T. J. Biggs. Jennie W ; age 30; at K Hospital, New York; May 9, 1896; all the symptoms of pernicious anajmia in an aggravat- ed form. Anaemic from her fourteenth year, the disease had ad- vanced to the stage of disintegration or disappearance of the red blood corpuscles, and generally of the nucleus or effective part of the while. Such was the condition of her blood when ex- amined, showing also but 8I/2 per cent, of hamaglobin and 2,400,000 corpuscles to the cu. mm. of blood. She was put upon blood treatment solely, for six weeks, when her recovery was by all external evidences complete. Tlie hajmaglobin was raised from Sy2 per cent, to 10% per cent, (a maximum normal) and the cor- puscles from 2,400,000 to 3,900,000 in the cu. mm. of blood— a compleincnt unprecedented in the cure of chronic anaemia, not to say of the pernicious form of the disease. SECOND CASE AT THE SAME HOSPITAL. Annie P ; age 28; was first seen at E Hospital, New York, May 10, 1896; after the extreme operation of hystero- ophorectomy; exhibiting anaemia in the severest form, consequent upon the shock and loss of blood; her blood showed only 8 per cent, of hgemaglobin and 3,400,000 corpuscles per cu. mm. After fifty days of blood treatment exclusively, her blood showed the prodigious increase of 10% per cent, of hajmaglobin and 4,700,000 corpuscles per cu. mm. THIRD CASE— AT THE NEW YORK POLYCLINIC HOSPITAL. Helen W ; age 29; May 10, 1896; anamiia complicated with leucorrhcea; 10 per cent, of haemaglobin and 3,100,000. corpuscles to the cu. mm. Sole treatment, one drachm bovine blood every two hours. After twenty-nine days the ha?maglobin was 10% per cent., and the corpuscles were increased to 4,300,000. BLOOD REGENERATION. By Henry Tuthill Halleck, M. D., Brooklyn, N. Y.— Own Case. "Some three months since, while I was slowly recovering from a severe attack of diphtheria, my attention was called to the blood conserve (bovinine). ] had no faith in such preparations, but was determined to find out in my own case if the high praise given to it was well founded. I took a large tablesi)Oonful four times a day, diluted and flavored to suit, for nearly three weeks, by which time my anaemic condition had almost entirely disappeared, and at the same time a careful microscopic examination of my own blood both at the beginning and at the conclusion of my use of bovinine showed an increase of nearly 35 per cent, of red blood corpuscles in this comparatively short time. "The blood conserve discloses large quantities of blood cor- 85 puscles floating in its albuminous fluid, by the use of a first-class microscope, with one-quarter inch objective and a B eye piece." [This experiment is incumbent on every one who claims to be a physician. But it is also incumbent that he knows how to do it — as too many "physicians" do not.] ANEMIA— CASE XIII. By Dr. K , New York. Maggie Craig; age 30; very reduced case of anaemia; lips and conjunctiva pale, skin lemon - colored; blood corpuscles only 1,100,000 per cu. mm. Had been treated with all the various preparations of iron, arsenic, etc., prescribed for such conditions, together with many foods and so-called rebuilders, protonuclein, in particular, having been extensively employed; but all with ab- solutely no benefit, the patient growing steadily worse. On December 23, 1896, she was admitted to the private hos- pital of the celebrated Dr. K , of New York. The secretions having been regulated, she was then put upon bovinine every two hours, and gradually increased, with a glass of milk at three hours. Evident improvement commenced from the second day; felt already stronger, and slept better. This daily progress was steadily con- tinued, until January 29, 1897, when she was found to have gained eleven pounds in weight, and on February 3d was discharged, in ex- cellent general condition, with a good appetite, and almost normal color. The microscopic examinations of the patient's blood during treatment revealed, on January 7th, an increase of 400,000 cor- puscles; on January 26th, of 800,000; and on February 8th, five days after discharge, but with the continued bovinine supply, of 1,200,000; a total of 2,300,000 (more than doubled); not a robust grade of blood, but quite hearty for one of her temperament, and evidently still on the increase, with a prospect of higher health than she would ever have enjoyed but for having been brought low and to Dr. K 's hospital. ANEMIA WITH IMPOTENCE— CASE XII, IN ANEMIA. By Dr. E , New York. Frank Sawyer; age 49; November 1, 1896; anaemia and func- tional impotence, result of excesses. November 2d, commenced bovinine. December 1st, had gained six and three-quarter pounds; functional power was restored, with improvement evident in all respects. ANEMIA AND INSOMNIA— CASE XI. By Dr. H , New York. Mary Ellis; age 40; November 3, 1896; anaemia and insomnia; had resisted treatment for two years. Treated with bovinine, and by December 9th, had gained five pounds, and was enjoying regular sleep of nights. 86 ANEMIA WITH LIVER TROUBLE, VAGINITIS AND ULCERATION— ANAEMIA CASE XIV. By Dr. S , New York. Mabel Snell; age 22; June 7, 1897; two years under treatment for anaemia, without improvement; pale, waxy complexion, gums and conjunctiva bloodless; rapidly reduced in tlesh, from 91 pounds to 83, within the recent month; blotches indicating liver dis- turbance; enlargement of the liver; accumulation of gas in the intestines; an old vaginitis and leucorrhoea; with several points of ulceration around the external os. The patient was ordered regular bovinine treatment internally, with appropriate medicines. After treating the vagina and uterine ulcerations to a healthily granulating condition, a large tampon saturated with iodoform-bovinine was introduced; removed in six hours, washing out the vagina with Thiersch ; and these procedures were repeated from day to day, until June 30th, when the points of ulceration had become absolutely healed, the vaginitis subdued, and the leucorrhoea very much improved. July 3d, she had gained six pounds in weight, and her blood was almost up to the nor- mal standard in red corpuscles and hasmaglobin. ANEMIA— CASE XV. By Dr. S , New York. Bessie J ; age 32; May 6, 1897; treated with the various so-called blood-makers, at several institutions, for two and a half years past; benefit invariably transient; all symptoms of well-de- fined anaemia, together with gastro-intestinal disturbance; little and non-refreshing sleep; a large decrease of htemaglobin and red blood corpuscles. She had been put upon iron in all its various forms; arsenic, cod-liver oil, various so-called nutrients, and change of air and scenery. I determined, after consultation with a pro- fessional colleague, to employ supplied blood, in bovinine, and this was the entire treatment thenceforward. Her weight when first seen was 110 pounds, and on June 29th was found to be 118. Her color was now very good; her figure considerably rounded out; the gastro-intestinal disturbance entire- ly removed; sleep quite normal; no more headache; blood decid- edly improved. ANEMIA WITH NEURASTHENIA— CASE XVI. By Dr. C , New York. Jennie Laws; age 27; June 2, 1897; had been gradually failing, two years, from a severe mental shock; had lost appetite and in- terest in things; headaches, disturbed menstruation, and insomnia. Original weight 140; present weight 110. Had various physicians with different diagnoses, but uniform results from bad to worse, ending with a general course of patent medicines. She had taken all the preparations of iron and other so-called blood-makers, proto- nuclein, and the various forms of prepared foods — but no bo- vinine. 87- Thorough examination disclosed profound angemia; a decided deficiency of red cells and hgemaglobin, and a marked excess of white cells. The patient was ordered bovinine in old port wine every two hours, with appropriate medicines. At the end of the second week, microscopic examination showed the red cells and ha-maglobin increased and increasing, while the white cells were reduced nearly to normal. Her appetite had returned, she slept well, felt stronger, had no more headaches, had gained four pounds in weight. Bovinine was continued until July 17th, at which time the general health of the patient was found to be nearly normal, as was also the blood standard, and she had gained twelve pounds in weight. ANEMIA— CASE XVII. By Dr. f) , New York. John Eosenstein; age 30; June 16, 1897; pronounced anaemia; loss of appetite, extreme weakness, insomnia, a flatulent form of atonic dyspepsia, and complete constipation; a large deficiency of red corpuscles and hfemaglobin. His weight had been 172 pounds; was now 110. lor three years had been growing worse under reg- ular treatment at various institutions and by several physicians in private practice; latterly with pepto-magnam, iron, and proto- nuclein, with a carefully selected diet. After regulating the secretions, bovinine was given in old port wine, every two hours. At the end of a week, the patient had been relieved of a large accumulation of gas, and the dyspeptic condi- tion was much improved. The bovinine was now increased and con- tinued until July ::^3d; result: weight 126, a gain of sixteen pounds; blood corpuscles nearly up to normal standard of number, dys- pepsia and constipation cured, complexion much bettered, feels strong, and has resumed labor. ANEMIA— CASE XVIII. By Dr. S . Ann Torrance; age 36; July 18, 1897; had been suffering four years; treated by seven doctors and in six institutions, steadily growing worse. Weight reduced from 140 to 112 pounds. All the symptoms of a profound ana?mia were now present, with insomnia, loss of appetite, menses irregular, missing two and three months in succession; much suffering from dysmenorrhoea and leucorrhcea; considerable functional disturbance of heart. First regulating the functions of the system, the patient was then put on bovinine every two hours, with appropriate medicines. In one week she had gained considerably in strength and slept much better. Bovinine was increased. After the first two weeks of treatment, her sleep was nearly normal, digestion much strength- ened, and she was able to undertake some housework, which she had not done before for two years. August 12th, she had gained three and one-half pounds, with a decided improvement at all points, insomuch that she considered herself well. Her blood had 88 reached about the normal standard in red cells and hsemaglobin. [Considering that from two to four years under all that medi- cine could do this patient had only grown worse, and by reasonable inference would only have grown worse still, her restoration in little more than three weeks to substantially perfect health, must be ad- mitted to be far beyond the most flattering precedents in medical experience (prior to ha?matherapy) ; in fact utterly inconceivable from such experience, and a morally certain evidence that the system had been fundamentally revived, and with a prudent pro- longing of the extraneous blood supply will soon become per- manently re-established in its proper powers. It is well also to note that this result is no exception, but one in an unbroken series of exactly the same character; no cases in the blood treatment hav- ing been left out of the reports, or having proved less satisfactory than this.] ANEMIA— CASE XIX. By Dr. C , New York. Mary Riley; age 27; August 10, 1897; ana?mia of three years standing; subjected to many treatments without improvement. All symptoms of a well-defined case, with insomnia, and a highly neurotic condition; the blood deeply impoverished in cells and haemaglobin. After regulating the secretions, a tonic to stimu- late cell proliferation and glandular functions was given together with bovinine every three hours in old port wine. Not much im- provement ensued until the 20th, when a decided and rapid im- provement began. Patient now gained rapidly in weight, slept better, felt stronger, had better appetite, and complexion much improved. Septeinber 7th, patient had gained seven pounds in weight, and the condition of her blood was almost up to the normal standard. ANEMIA— CASE XX. By Dr. D , New York. Lilian D , age 36; August 9, 1897; all symptoms of well- defined anaemia; low standard of haemaglobin and red corpuscles, with excess of leucocytes. The case had been treated at various institutions, with various forms of iron and other so-called blood- makers, but in spite of them all had steadily grown worse. Pa- tient was now ordered bovinine in old port wine every two hours. Septeuiber 10th, examination showed an almost normal condition of l)lood and health; had gained nine pounds; her color was now good, and her strength restored. AN.-EMIA— CASE XXI. By Dr. R , New York. Annie Case; age 33; August 10, 1897; a well-defined case of anaemia; impaired digestion and appetite, insomnia, and a marked 89 deficienc}' of red corpuscles and hfeinaglobin; of several years stand- ing; had resisted many treatments; weight originally 140 pounds; now 110. With constitutional treatment and regimen, bovinine was given every three hours. In two weeks, bovinine was increased, patient having already greatly improved, feeling stronger, sleep- ing well, appetite much better, and blood showing a decided in- crease of red corpuscles and htvmaglobin. On September 8th, the patient had gained ten pounds, and her blood was near the normal standard. ANEMIA— CASE XXVIII. Dr. T. J. Biggs, Sound View Hospital. Jennie M , Stamford, Conn.; age 30; January 29, 1898; anae- mia and general malnutrition; blood profoundly lowered in qual- ity; all the usual symptoms of a well-defined case, such as pale gums, waxy complexion, loss of flesh, and general functional dis- turbance; suffered nightly with agonizing neuralgia. Her digestion was so upset, that I put her on only twenty drops bovinine hourly, and gave a rectal injection of bovinine and milk. The night passed without the neuralgia, so that she awoke greatly refreshed and improved. Bovinine and milk were increased and re- tained, with an enema of bovinine and milk at night, which was retained, and this night also passed without the neuralgia. Feb- ruary 16th, improvement was so far advanced that the rectal injec- tion was discontinued, and bovinine repeatedly increased, up to the 19th, when the blood showed very little shortage of red cells and hsemaglobin, and externally the patient presented every appear- ance of restored health, and was discharged cured. TUBERCULAR PHARYNGITIS AND GENERAL AN.^MIA. Dr. T. J. Biggs, Sound View Hospital. Avis H , Xew York City; age 10; March 5, 1898: pro- nounced angemia complicated with tubercular pharyngitis; treated at Bellevue Hospital the last three months, but had steadily grown worse; not over 1,500,000 red corpuscles to the cu. m. m., and hsmaglobin barely three-fifths of normal ; pharynx and tonsils in a highly vascular condition — surfaces covered with red papilla? con- taining tubercle bacilli; tubercular deposits were also found in the fauces, tonsils and pharynx. Bovinine every two hours; throat cleared of septic matter with peroxide-on-bovinine ; picked up the papillae and snipped off a great number; again pharynx and fauces thoroughly swabbed out with peroxide-on-bovinine. This treatment was repeated twice a day, until no papilla' were discoverable, and the throat presented a healthy appearance. The tonsils l^eing tremendously hypertro- phied, and almost like scar tissue, I determined to excise them; after that applying the bovinine-peroxide three times a day. By April 1st, the stumps of the tonsils were thoroughly covered and healed, and the throat was in a normal condition. April 14th, the little patient was discharged cured. 90 ANAEMIA- CASE XXX. RECTAL POLYPUS, PROLAPSUS ANI; MALASSIMILATION AND INANITION. By Dr. T. J. Biggs, Sound View Hospital. Clara F , New York Cit}^; age 3; January 24, 1898; a ])ro- nounced case of anaemia, with nialassimilation and inanition, and a benign growth (polypus) in the rectum, with prolapsus ani. The general condition of the little patient was so unfavorable that it was found necessary to put her on preparatory treatment for some weeks before operations for the relief of the rectal disorders could be prudently undertaken; the blood showing but one-third of the normal red corpuscles and about a half-proportion of ha^maglobin. There was also constipation, bowels moving but twice a week, ac- companied every time by prolapsus ani, with great pain. She was at once put on bovinine twenty drops in milk every two hours; also rectal injections to clear the mucous surface of the rectum of diseased matter by the bovinine-peroxide reaction and irrigation with Thiersch solution and soap suds, tepii; this followed by injec- tion of pure bovinine. This entire procedure and treatment was repeated daily. On the 17th the rectal growth was injected at two points with bovinine and salt water one to two parts, and this was repeated every other day until the 22d; when part of the growth separated and passed out with the faeces. By this time, the little patient had improved so much that she was permitted to go out daily for exercise with a nurse. March 12th, the operation for complete removal of the rectal growth was performed, under anaesthetic; the rectum was thorough- ly dilated, and the tumor was dissected out. After due antiseptic cleansing of the mucous surface and site of operation, the rectum was gently packed with shredded China silk saturated with iodo- form-bovininc. This packing was removed daily, and bovinine- peroxide reaction repeated, washing out with Thiersch, and re- packing as before. Continuing this procedure daily to the 21st, rectal injections of pure bovinine were then substituted until March 29th, when the healing was complete. Prolapsus ani after defecation still continuing, the rectum was dilated, and with a thermo-Pacquelin cautery with a small tip, five lines were cauterized, commencing at about two and one-half inches inward, and carried down to the edge of the anus in a longitudinal line with the long axis of the gut. These in healing produced cicatrices which by their contraction narrowed the gut while caus- ing adhesion of the mucous to the muscular membrane. Follow- 91 ing this operation, the rectum was cleansed, and packed with China silk shreds saturated with pure bovinine. After twenty-four hours, this packing was removed, and the rectum cleansed again with the bovinine-peroxide reaction and Thiersch irrigation; repacked as before; and the same procedure was repeated every day to April 10th, when all was thoroughly healed; the calibre normal; bowels moving regularly every morning without pain or prolapsus; appe- tite, digestion and sleep all good; the blood by microscopical ex- amination was fully normal in quality; and the child was running about, bright and happy, with every manifestation of perfect and vigorous health; so continuing until April 18th, when discharged. [Blood Treatment of Endometritis, Salpingitis, Vaginitis, Etc., is referred forward to the group of female diseases, in which some of the most brilliant and beneficent triumphs of Hsematherapy will be found; often superseding, and always vastly mitigating, the painful surgical operations to which unnumbered women have been obliged to submit.] ANEMIA— CASE XXVII. Dr. T. J. Biggs. Ida C ; age 29; January 1, 1898. All symptoms of a well- defined case of anaemia; waxy complexion, pale conjunctiva, ema- ciation, loss of vitality, etc. As it was impossible to retain food of any kind on her stomach, I began with but very small doses of bovinine per mouth, relying on rectal injection of the same. The rectal injections were retained, and a rapid improvement resulted. Patient began at once to feel stronger, slept better, digestion and appetite constantly improved, so that by January 6th she could take a teaspoonful of bovinine in a glass of milk every two hours; on the 10th, a tablespoonful in milk every three hours; on the 12th, a wineglassful of bovinine every three hours. On the 21st, the blood showed red corpuscles very little below the standard number. The patient felt that she was well. ANEMIA— CASE XXII. By Dr. T. J. Biggs. Ned Mead; age 55; September 6, 1897; anaemia, of many years progress; decided deficiency of both white and red blood cells, and of haemaglobin. He took the bovinine nicely from the outset, and within a week began to show a decided improvement in sleep and appetite. October 10th, the blood cells and hgemaglobin were al- most normal, and weight increased by twelve and one-half pounds; evidently cured. November 17th, seen, in good health; blood, mi- croscopically, normal. 92 DEPARTMENT OF GYN^CALOGY. Some of the more novel and startling applications of blood heal- ing to the preservation of female organs, such as ovaries, in condi- tions hitherto incurable, and absolutely fatal unless promptly ex- tirpated by the knife, have already been quoted in the foregoing pages and indexed. Among them was the novel operation of ovarian repair, in the case of Miss L — - — K , of Crotona, New- York, devised and performed by Dr. T. J. Biggs, at Sound View Hospital. The further operation for proctitis, in this case at the same time, is here quoted : THE PROCTITIS ULCERATIONS. Complicating the case of Miss L K , there had been a severe ulcerative proctitis of four years standing. This condition had been under treatment at five different New York hospitals and in the hands of five private physicians besides, but no positive re- sults were obtained, beyond a partial relief from pain for short periods only. Examination of rectum now showed that the mucous membrane was tremendously congested, with about twenty points of ulceration, scattered irregularly; the largest on the posterior wall. Anteriorly, one point had almost penetrated into the vagina; the mucous membrane of the vagina being the only part of the dividing wall intact. The sphincters were very tight. Treatment: After thoroughly dilating the sphincters, the rectum was depurated with bovinine-peroxide reaction and Thiersch irrigation. The points of ulceration, with the exception of the one in the anterior wall between the rectum and vagina, were touched up with the small point of a Paquelin cautery. My reason for using the Paque- lin cautery in this case, instead of pyrozone or nitrate of silver, was that as the edges of ulcers were hard, hypertrophied masses, with no absorptive property, their destruction was necessary to prepare proper surfaces for the reception of the healing blood. The an- terior ulcer was gently but thoroughly scraped, and its edges fresh- ened and brought in ap})osition by a continuous catgut suture. The rectum was now washed out again with Thiersch and gently packed with gauze saturated with iodoform bovinine. This was removed later, and the rectum cleansed as before, and a large gelatin capsule filled with bovinine pure, was inserted. These cap- sules were inserted three times daily, and the rectum depurated every morning as at first, for one week. At the end of this time, the ulcers, laterally, and the one sewn up anteriorly, had entirely healed. Posteriorly, they had been reduced to about one-half their original size, and presented healthy granulating surfaces. The bo- vinine gelatin capsules were now inserted night and morning, with morning cleansing as before. At the end of sixteen davs from the beginning of the treatment, the ulcers were found entirely healed, and the rectum in its normal condition. 93 CHRONIC SALPINGITIS: THIRD CASE OF CONDEMNED OVARY SAVED. Dr. T. J. Biggs, Sound View Hospital. Mrs. McC , Stamford, Conn.; age 33; admitted April 11, 1898; salpingitis of left ovary. Had been under the care of a lead- ing physician who advised her to have the ovary removed. This was absolutely refused, and I was called in consultation. I now did not believe that the removal was absolutely necessary. This pleased the patient so much, that she decided to enter the hospital for treatment. Digital examination revealed a soggy mass pos- teriori}^ on the left side, the womb considerably retroverted, and severe endometritis. I put the patient on a teaspoonful of bovinine in old port wine, every two hours, with a hot vaginal douche of plain sterilized water; continued to the 27th, when the pain, which had been previously very severe, was entirely relieved. On the 28th, after etherizing the patient, I thoroughly curetted the womb, and after depuration with the bovinine-peroxide reaction, packed it with bi-sterilized gauze saturated with iodoform-bovinine. Depur- ation and packing was repeated until May 5th, when bovinine tam- pons were applied instead, and the bovinine by mouth was increased to a wineglassful in grape juice every four hours. Patient now felt, as she expressed it, well and happy, aside from the weakness result- ing from former sufferings. The bovinine tampons continued to be applied until the 20th, when the womb was found in a normal con- dition, there was no tenderness over the ovary, and the patient's general condition was better that it had been for years. A Thiersch douche was now employed at bedtime, up to the 28th. May 29, 1896, she was discharged cured, and delighted that her ovary had been saved. ENDOMETRITIS AND THREATENED OVARIAN ABSCESS WITH ULCERATIVE CYSTITIS. By Dr. T. J. Biggs, Soutid View Hospital. Mrs. H ; Sound Beach, Conn.; age 47; August 20, 1898; had been sick five months ; treated by six different physicians, grow- ing steadily worse, and had lost twenty-four pounds of flesh; pain in bladder so severe that she could not sit still for an instant. Bladder w^as now washed out with warm bovinine and salt solu- tion every three hours, and in forty-eight hours she was entirely re- lieved of pain, except a soreness in the womb from the endometritis. Examination now revealed the right ovary very much inflamed, and I began to fear an abscess. The mouth of womb was opened and a tablespoonful of bovinine was injected, followed by a table- spoonful of equal parts peroxide of hydrogen and water. The re- action effervescence of the bovinine and peroxide within the in- flamed womb caused some pain for the moment. As soon as the reaction was completed, the product was washed out with Thiersch, and a drachm of bovinine pure was injected, making an end of pain, as usual. The bladder was next washed out with plain hot Thiersch, and two drachms bovinine and salt solution were in- 94 jected. These procedures, in both womb and bladder, were re- peated three times a day, to the middle of September, and, besides the local treatment, a tablespoonful of bovinine was given every three hours. September 15th, the endometritis had entirely subsided, the in- flamed conditions of ovary and bladder were virtually healed. But some slight points of ulceration remaining in bladder, bovinine and salt water was kept up until October 1st; when its condition was found normal. October 3d, patient was discharged cured, having gained eighteen pounds in flesh. OPERATION FOR OVARIAN CYST AND EXTREME ULCERATIVE PROCTITIS. By Dr. T. J. Biggs, Sound View Hospital. Mrs. H , Sound Beach, Conn.; age 47; August 25, 1898; a large cyst of left ovary, and one of the worst cases of ulcerative proctitis I have ever seen; the whole rectum being one mass of continuous ulceration. The pac tient suffered so intensely in defecation that she used opiates to bind the bowels, and sometimes went as much as eight days without a movement, after which she had to take a high injec- tion of soapsuds and water to bring away the accumulation. The condition was of eight years standing, under treatment by ten dif- ferent physicians, with four operations, but had steadily increased in severity; for the obvious reason, that the effect of medical and surgical treatment is always limited by the blood power of the pa- tient to follow it up, and where this element is inadequate, and the gift of auxiliary blood supply is unknown, the result is the too common one of utter failure. August 26th, under chloroform, the rectum was thoroughly di- lated, depurated by the bovinine-peroxide reaction, washed out with Thiersch, and all the tract of ulceration, which nearly cov- ered the entire surface of the rectum, was touched up with 25 per cent, pyrozone, with the exception of three points which were treated with the electric cautery. The speculum was then re- moved, and pure bovinine was injected, confining it by a pad covered with sheet rubber over the anus, and retained by a T-ban- dage. Patient reacted nicely from the chloroform, and almost the first word she uttered was, "What have you done for me? I am in no pain the first time in years!" For the first twenty-four hours, bovinine was injected hourly; after that, gelatin capsules of bovinine were introduced every two hours. By September 1st, the patient's condition was so vastly improved that she was allowed .to get up and take exer- cise, and the bovinine was applied but three times a day. Septem- ber 12th, the rectal condition was entirely healed, and the gen- eral health so much improved, that the case was ready for the SECOND OPERATION for ovarian cyst, which was performed the same day. An incision four and a half inches long was made through the median line, 95 and search in the cavity revealed a cyst about the size of an Osage orange, with a twisted pedicle. This was removed, and the stump treated with iodoform-bovinine, returned to the cavity, a glass drainage tube inserted, and the peritoneum and- outside wound united by quill sutures; the whole being dressed with iodoform- bovinine gauze. Patient's temperature was carefully watched, and there being no rise, the dressing was not disturbed until Septem- ber 15th. At this time, on removing the dressing, the wound was found in a perfectly healthy condition, with not a particle of dis- charge from the cavity. Wound was now gently cleansed with the bovinine-hydrozone reaction and Thiersch washing, and dressed as before with iodoform-bovinine gauze. At the next dressing, Sep- tember 17th, the drainage tube was removed, the wound was en- tirely closed and dressed with bovinine pure, which was changed twice in twenty-four hours, up to October 14th; when the wound was entirely healed, leaving a strong, healthy, pink cicatrix. Pa- tient having suffered so much in the last few years, was consid- erably run down, so that it was deemed advisable to keep her at the hospital on bovinine a while longer, increased to a tablespoon- ful every three hours, until final discharge, October 28th. RECTO-VAGINAL FISTULA AND RECTAL ULCERS. DOUBLE OPERATION. Dr. T. J. Biggs, Sound View Hospital. Miss W , Glenbrook, Conn.; age 34; April 10, 1898. An ex- tensive operation had left her much exhausted, without other re- sult except an increase of the pathological condition. She said the fistula had been operated on no less than six times; three times per vaginam and twice per rectum; but no line of union had once been obtained. Examination revealed an opening of the size of a quar- ter dollar, with edges ulcerated and very sensitive, causing great pain at every defecation, and passing a large part of the faeces into the vagina, which it was necessary to douche out on each occasion. Complicating this condition were found five points of ulceration, three anterior and two left lateral. I had her put to bed, regulat- ing secretions, and put her on bovinine, a wineglassful every three hours. Patient began to pick up immediately, and on the 25th, her condition being favorable, I performed the following opera- tion. After thorough depuration of the vagina with bovinine- peroxide reaction and Thiersch irrigation, the rectum was fully dilated, the edges of the fistula were freshened by careful dissec- tion of margin, it was depurated with peroxide on bovinine, and a tampon was inserted well up in the rectum, to prevent faeces com- ing down on the site of operation. The speculum was then re- moved, and the vagina was thoroughly dilated in turn, the vaginal edges of fistula were freshened as had been done at its rectal ex- tremity, and the surfaces also treated with the bovinine-peroxide reaction. I now used continuous kangaroo-tendon sutures, going only through the sub-mucous coat, but bringing the vaginal edges of the fistula into close apposition. The vagina was next cleansed 90 with Thiersch, an iodoform-bovinine tampon was inserted, and the speculum removed. The rectum was now dilated again, and con- tinuous silk sutures were employed to close up the rectal end of the fistula. The tampon which had been previously inserted was removed, the rectum washed out with Thiersch, and the points of ulceration were touched up with 25 per cent, pyrozone. A strip of bi-sterilized gauze saturated with iodoform-bovinine was gently packed in, and the speculum removed. The nurse was ordered to give an opium and tannin pill twice a day, to prevent movement of the bowels. Patient reacted nicely from the ether, and suffered little or no pain. At the end of twenty-four hours, both pack- ings w^ere removed, and the rectum and vagina thoroughly cleansed. Examination both rectal and vaginal revealed the stitches in ex- cellent position, and the surfaces also doing nicely. I now intro- duced bovinine capsules rectally, and a cotton tampon saturated with iodoform-bovinine in vagina. These were changed twice a d!ay, up to the first of May, when examination revealed lines of healing almost perfect. Nurse was now ordered to give bovinine injections three times a day, in both rectum and vagina; preced- ing each injection with the bovinine-peroxide depuration and Thiersch irrigation. On the 7th, the vagijial end of fistula had completely united, and the kangaroo sutures were almost all ab- sorbed; the remaining portions being removed with thumb forceps. Eectally, while the line of union was perfect, yet complete organiza- tion of scar had not taken place, and consequently, the stitches were not touched. The ulcers were all healed except one, which had been reduced by half, and the healing of it was favorably pro- gressing. Vaginal injections were now discontinued, and only rectal were employed, three times a day. By the 20th, the edges of the rectal end of sinus were firmly adherent together and com- pletely healed. The silk sutures were then removed. The re- maining rectal ulcer was now reduced to a point in size of a pin head. Therefore daily applications of pure bovinine were made direct to the ulcer by cotton carrier until the 26th, when it was en- tirely healed. Patient was discharged cured. May 27, 1898. Eemarks on this case: The operation here employed is a modi- fied Sims — the one that made that distinguished gyn^ecalogist al- most famous; his idea being that of sewing np both the rectal and vaginal sides of the fistula, in which he used silk mostly. My reason for using silk rectally was that the complete absorption of animal sutures might be interfered with by fseces. On the other hand, at the vaginal side, there being no unhealthy discharge of any kind, I thought it better to use kangaroo, as it w^ould not have to be disturbed. Sims met with failure in 35 per cent, of all his cases, in spite of his improved mode of stitching. Other surgeons, who em- ployed stitching on only one side, have averaged but 8 per cent, of failures. I deem my method superior to all of them, for two reasons: (1) the topical nutrition by applied blood; (2) the kan- garoo suture on vaginal and silk on rectal side, 97 RECTAL FISSUREy AND RECTRO-VAGINAL FISTULA. By Dr. T. J. Biggs, Sound View Hospital. Marie Udsen; Swede; age 26; December 21, 1897; four fissures of rectum, and recto-vaginal fistula. On the 23d, after thoroughly cleansing out vagina and rectum, a plastic operation was performed to close up the fistulous tract. A flap from the posterior wall of the vagina was carefully dissected up and stitched over the opening of the fistula; the walls of the canal having been previously de- stroyed by actual cautery. The stitches used were of the patient's hair, which had been thoroughly sterilized. A double tampon according to the Stafford method was used to keep the womb well forward so as not to rest on the site of operation. The bowels were kept constipated by drugs to prevent movement. Both rectum and vagina were thoroughly cleansed out by the bovinine-peroxide re- action followed by Thiersch irrigation; after which pure bovinine was sprayed in on the side of the womb. This treatment was re- peated several times daily until January 6th, when the wound was entirely healed, the operation having given a perfect result. Treatment of the fissures had been taken up December 26th. The anal fissures were made insensible by applying a 10 per cent, solution of cocaine. After thorough dilatation of the anus and rec- tum by thumb method, they were cleansed by the bovinine-per- oxide process with Thiersch, and bovinine pure was then applied in saturated gauze. This was done twice a day until January 4, 1898, when the fissures were entirely healed. January 12th, the patient was discharged in complete repair. She had taken inter- nally a drachm of bovinine in milk every two hours, during the whole period of her stay. ENDOMETRITIS. By Dr. T. J. Biggs, Sound View Hospital. Mrs. E ; Glenbrook, Conn.; age 30; July 20th. Patient had been suffering for five years with endometritis, the result of which was that although three years married she had never conceived. She was thoroughly run down, and had a profuse discharge of leu- corrhcea. Put to bed, and treated with a tablespoonful of bovinine every three hours. On the 22d, the womb was depurated with per- oxide on bovinine, washed out with Thiersch, and packed with iodo- form-bovinine gauze. This was repeated three times a day until August 12th, and after that twice a day, and the bovinine was in- creased to a wineglassful in milk, every three hours. August 30th, patient was discharged cured, having gained six and a half pounds; discharge entirely ceased, womb well, and general condition greatly improved. 98 UTERINE ULCERS AND LACERATION. OLD PERINEAL TEAR. By Dr. T. J. Biggs, Sound View Hospital. Mrs. C L , New York; age 24; September 10, 1897. Following childbirth, a perineal laceration, to rectum ; also lacerat- ed cervix and severe ulcerative endometritis, with copious leucor- rhcea. A case of two and a half years standing, during which many treatments had been employed, such as tamponing, local applica- tions, douches, and injections. The lacerated perineal tissues were now so retracted and atro- phied that it was impossible to bring the edges into apposition; therefore it was out of the question to freshen the edges and unite them by stitching, and a plastic operation was necessary. The lac- eration of cervix was of so long standing that the edges had par- tially granulated over, and in part were in a state of ulceration. The leucorrhoea was one of the most copious and foul-smelling dis- charges I ever saw. The patient was in an almost collapsed state when she entered the hospital, and was therefore put on preparatory treatment for two weeks; regulation of bowels, bovinine, and a light diet. On the 24th, under chloroform, the womb was brought down, well opened, and thoroughly curetted, large quantities of unhealthy granulations being removed. Bovinine and peroxide of hydrogen were then injected into the uterine cavity, and after the chemical reaction ceased, the cavity was thoroughly washed out with Thiersch solution, and the womb was packed with bi-sterilized gauze soaked in iodoform-bovinine. The vagina was then thoroughly cleansed with bovinine and peroxide, followed by Thiersch solution, preparatory to the second operation. After examination, I determined to trim up the cicatri- cial and ulcerating edges of the cervical tear, and these were brought together with four silver-wire sutures. Just back of the womb, within the cul de sac of Douglas, was discovered a polypus about the size of a small fig, which was removed. The vagina was then thoroughly irrigated with Thiersch solution, and packed with bi-sterilized gauze which had been saturated with bovinine and well wrung out; a napkin and a T-bandage being applied to keep this in place. These operations were attended with the usual stimula- tion by whiskey and strychnine, and from the 27th to the 30th, a camphor enema. The vaginal packing was removed in twenty-four hours, and the vagina was washed out as before and repacked with iodoform gauze, and this packing was changed with the same process every day for five days. At the end of this time, the uterine packing was gently removed, the uterus was washed out with Thiersch solution, and the vagina was packed again with bovinine gauze as at first. This packing was repeated until the seventh day, washing out the womb daily with a saturated solution of boracic acid, and then discon- tinued; it having been observed that the point where the polypus had been removed had healed. The nurse was now ordered to give 99 injections in the vagina of one ounce bovinine, with the hips well elevated, three times a day, the object being to stimulate and nour- ish this badly depleted and abused membrane. In ten days after the operation, the silver stitches were removed; the process of heal- ing being found complete, and the line of union perfect. There being considerable retroversion of the womb, bovinine tamponing was employed. On October 11, 1897, the condition of the parts above having now become normal, and the patient's physical condition excellent, I determined to complete my surgical work for the patient without further delay, and after administering chloroform began the opera^ tion on the perinaeum. The edges of the great tear being so re- tracted and atrophied, as before stated, it was necessary to dissect up flaps on either side to a distance of two inches, in order to bring the parts comfortably and safely into apposition. This having been carefully done, the edges were brought together by two rows of sutures: one, of four deep sutures which brought the membranous and muscular tissues in apposition; then six superficial sutures which completely closed the wound. For the deep sutures, silk- worm gut was used, and for the superficial, sterilized catgut. The wound having been thorough cleansed with Thiersch solution and dried, the superficial line of sutures was painted over with iodo- form-bovinine, and covered with flexible collodion. For the next flve days this was not disturbed further than to examine whether all was going on right, and then the superficial sutures were en- tirely removed. The superficial line of incision had healed: but the deep sutures were left in for five days longer, when two were removed; two days later, a third; and two days later still, the fourth. During this period, between the fifth day and the removal of the last deep stitch, the part was thoroughly washed twice a day with Thiersch solution, carefully dried, and iDOvinine was sprayed on. Internal nourishment of bovinine, etc., was of course con- tinued throughout. On November 6th, the process of repair was found to be com- pleted, and the patient was allowed to dress and go about. She re- mained at the institution for two or three weeks continued regimen until confirmed convalescence. ULCERATION OF CERVIX. By Dr. S , New York. Lillie Bentz; age 30; August 9, 1897; ulceration of cervix, taking in almost the entire lip of the cervix on the right side, and extend- ing up on the external surface ; of three years standing and had re- sisted many vigorous treatments. Topical nutrition was applied by tampons of iodoform-bovinine, after suitable preparatory treat- ment, and repeated every six hours for a week; thenceforward, twice a* day. August 22d, case was discharged cured. 100 ULCERATION OF WOMB AND CERVIX. By Dr. T. B. Biggs, Sound View Hospital. Miss C G , New York; age 24; September 10, 1897; se- vere ulcerative endometritis, accompanied by profuse lencorrhoea of the most fetid character. On the cervix, posteriorly, srrew a ])ol}'j)iis as large as an English walnut. The condition was of two years standing, during which time it had been under constant treat- ment by a succession of physicians, had been twice curetted, but had gradually grown worse. There had been no menses for the last six months; but when they were due, she suffered severe neuralgic pain, confined to the ovaries. As she was in a very run-down con- dition, she was put on a regimen of bovinine every two hours, and was put to bed and hot douches of Thiersch, four quarts, were or- dered night and morning. The following day, a bovinine tampon was applied well back in the cul de sac of Douglas, as there was a slight misplacement. On the IGth, the polypus was removed by torsion, the surface exposed was touched up with 25 per cent, pyro- zone, and an iodoform-bovinine tampon was apjlied. (That sur- face was completely healed by the 26th.) On the 25th I thorough- ly curetted the uterus and cervix; removing, together with the granulations, two smaller polypi of the size of hazel nuts. The bo- vinine-peroxide reaction was then applied by injection into the uterus, and the product washed out as usual with Thiersch solu- tion. Narrow strips of gauze were dipped in bovinine, wrung out, and packed into the uterine cavity; a bovinine tampon was inserted and a napkin and T-bandage applied. This treatment and dressing were repeated on the 27th and 28th. About 4 p. m. -on September 30th, menstruation appeared fully and freely, without any pain whatever, and lasted until October 3d. On the 4th, examination found the mucous membrane lining the vagina thoroughly angemic, and therefore bovinine tampons were applied daily until the 12th, and every other day thereafter until November 1st. It should have been mentioned that on September 23d, the initial lesion of syphilis appeared on the right labium major, ran on to its full development, and on October 14th, secondary symptoms began to appear; eruption, falling out of hair, sore throat, and pains in bones. For this condition, besides the bovinine, one-fourth of a grain of mercury biniodide had been given three times a day; this being continued until November 22d, when the eruption was fad- ing and the general condition was good. November 1st, the bovinine had been increased to a tablespoonful every three hours. On the 14th, the bovinine tamponing was changed from every other day to twice a week. The condition of the uterus and cervix was now entirely well; the mucous mem- brane of the vagina was much improved, but was still decidedly anaemic; consequently the womb and vagina were thorouglily sprayed with bovinine every night, until December 10th. After this date a tampon was applied daily, of boroglycorol, glycerine and alum, when the patient was allowed to go out walking, in order to support the womb and to contract the surrounding tissues, which had become more or less relaxed. December 15th the eruption had 101 entirely disappeared, as well as all other syphilitic symptoms. The patient was, however, impressed with the necessity of keeping up anti-syphilitic treatment for at least two years. December 22d, pa- tient was discharged, absolutely cured. UTERINE ULCERATION OF MORE THAN A YEAR. Dr. T. J. Biggs, Sound View Hospital. Miss W , Long Island City, N. Y.; dancer; March 29, 1898; large ulcer covering entire surface of external os ; suffered great and continual pain, particularly when on her feet, insomuch that she had been obliged to give up her occupation. Examination revealed a deep, bun-owing ulcer, exuding a large quantity of muco-purulent pus. She was at once put on a teaspoonful of bovinine in milk every two hours. The ulcer was next thoroughly cleansed of the effete matter by the bovinine-peroxide reaction washed out with Thiersch; touched up with 25 per cent, pyrozone; and pure bo- vinine then applied by means of three small tampons; the process being repeated twice a day. From and after the second of these changes, the patient was entirely relieved (the usual effect) of the severe pain suffered until this time, and expressed herself most de- lightfully surprised; having been under all the various treatments in institution and private practice for over a year, during which she had scarcely been free from the pain and soreness for a minute. The continued effect was almost as magical; by the fourth ap- plication all dfscharge ceased, and the entire surface of the wound had become covered with healthy granulation. On the 28th of March the patient was discharged cured, the ulcer being entirely healed, and leaving no evidence of a cicatrix. CERVICAL ULCER OF FOUR YEARS STANDING, BLOOD-CURED IN TWENTY-FOUR DAYS. By Dr. T. J, Biggs, New York. Lizzie Murphy; age 32; November 10, 1896; ulcer of cervix, of four years' standing; had refused operation; had been treated at various regular institutions without result. November 12th, the ulcer was gently curetted, and dressed with sterilized gauze saturat- ed in bovinine. This was applied once in four hours for a week; thenceforward, twice a day, until December 6th, when the patient was discharged cured. CERVICAL ULCER, TWO AND A HALF YEARS OLD. By Dr. Charles L. Bonifield, Cincinnati. Agnes Eiddle; age 29; September 3, 1896; very deep ulcer of the cervix, which had resisted all the old treatments for two and a half years. Cleaned it out, and applied bovinine by tampon, four tinies a day. Twenty-six days later, September 29, 1896, the ulcer had entirely healed, leaving only a slight trace of its previous existence. ' " 103 CARUNCLE OF URETHRA— ULCERATION— CASE CXXV. " Dr. T. J. Biggs, Sound View Hospital. Marie B ; New Canaan, Conn.; age 45; May 3, 1898. Six months previously, having suffered much distress during urination, followed by excruciating pain after the bladder was emptied, she had been told that she had cancer of the meatus, and under etheri- zation, a growth was partially removed. She now experienced greater pain than ever, which was continuous. Another physician put her through a course of treatment, but she steadily grew worse. On May 3, 1898, she came under my care. Examination revealed a large-sized caruncle, involving the entire circumference of the meatus, and from a half to three-quarters of the anterior portion of the urethra. Laterally, on the right side, was a very hard and pain- ful cicatrix, resulting from the former operation. After a few days of preparatory treatment and regulating the secretions, with a tea- spoonful of bovinine every two hours, on May 6th, she was chloro- formed, and the growth and scar were both carefully dissected out. The urethra was now packed gently with a strip of gauze soaked in bovinine. Incidentally it may be mentioned that the urethra was thoroughly dilated, so that incontinence of urine might result for a few days, to prevent contraction of the urethra down to the de- nuded surface of the wound. At the end of twelve hours, the pack- ing was removed, and urethra and bladder were washed out. A glass tube prepared with many perforations all over its circumfer- ence, was now inserted, and held in place by an improvised harness; the object being to not only thoroughly drain the bladder, thereby giving the muscles rest and keeping the denuded surfaces apart, but also at the same time provide for feeding the denuded surfaces, by dropping in and diffusing bovinine. This tube was allowed to re- main in until the 10th, when it was removed, and the urethra was found to be in a healthy granulating condition. Bovinine pure was now injected with a glass syringe every two hours, and urine drawn three times a day, until the 16th, when the surfaces were almost entirely healed, the normal power of the urethra was restored, and urine was voided without any pain; the only part not healed being the site of the old scar made by the former operation. May 21st, this also being healed, the patient was discharged absolutely cured. UTERINE ULCERATION AND ANEMIA— CASE XXX. By Dr. T. J. Biggs, Sound View Hospital. Mrs. K J ; Swede; New Canaan, Conn.; age 34; Feb- ruary 8th; ulcerative tubercular endometritis, and tubercular vagin- itis; also well-defined anaemia; but half a normal count of red cells and but 40 per cent, of haemaglobin. Given bovinine every three hours. Vagina and uterus cleared out by the bovinine-peroxide re- action, and the latter was packed with iodoform-bovinine in gauze : this twice daily until the 25th, and thenceforward bovinine tam- pons were employed posteriorly and changed twice a day. By March 3d the blood was already almost normal, and the womb and vagina restored to a normal condition. 103 ULCERATIVE ENDOMETRITIS AND ANEMIA. By Dr. T. J. Biggs, Sound View Hospital. Mrs. Kebecca E , New York; age 38; June 36, 1898. Pa- tient had been treated for present condition three years and had spent all her patrimony of $4,000 in this way, and twice suffered curettement, without any benefit whatever, outside of some tran- sient relief. When admitted she was reduced to ninety-two pounds, thin, emaciated, waxy of complexion, and so weak that I decided to do nothing until she could be built up a little by sup- plied blood. Microscopical examination of blood showed haema- globin very much reduced, the red corpuscles not over 1,100,000 per c. c, and the white enormously in excess. Examination of womb revealed extensive ulcerative endometritis, for which curette- ment seemed necessary, but this she positively refused to submit to, having undergone it twice without any benefit. Finding it im- possible to shake her resolution, I consented, under protest, to do the best I could for her without curettement; which, thanks to the mild but powerful depurator, the bovinine-peroxide reaction, I M^as able to dispense with in a case which otherwise could not be (as it had not been) treated with success. Daily, the mouth of the womb was thoroughly opened, and the interior ulceration was depurated with peroxide on bovinine, washed out with Thiersch, and then gently packed with iodoform- bovinine gauze. Patient was given a tablespoonful of bovinine every three hours. This, with the womb treatment, was continued to August 1st, when the bovinine was increased to a wineglassful ; and the womb had improved so much that its treatment was con- tinued only once a day. August 30th, patient was discharged cured, having gained twelve pounds, a splendid color, good appe- tite, sound sleep, and a feeling of strength; with red corpuscles 3,900,000, ha?maglobin almost normal, and white ditto; womb reduced to natural size, hard, in good position, no longer painful, discharge entirely ended, and a delighted state of mind. ULCERATIVE TUBERCULAR ENDOMETRITIS AND ANEMIA. By Dr. T. J. Biggs, Sound View Hospital. Mrs. H , Springdale, Conn.; age 34; January 3, 1898; ulcera- tive tubercular endometritis and well-defined anaemia ; case of three to four years standing and treatment. After preparatory treatment with bovinine, on the 13th, operation for the endometritis — a sharp curettement of womb and cervix — was performed, the cavity was depurated by the bovinine-peroxide reaction, washed out with Thiersch solution; walls touched up with 35 per cent, pyrozone; 104 and packed with strips of bi-sterilized gauze soaked with iodoform- bovinine. This whole procedure was repeated daily, but on the fourth day, a bovinine tampon was substituted, twice a day, con- tinuing the treatment, until February 3d. The patient had suf- fered intense and constant j)ain from the endometritis; but the usual relief resulting from the application of bovinine was imme- diately enjoyed, and she left the hospital on February 16th, free from all discomfort, blood almost normal by microscopical exam- ination, complexion much improved, appetite and digestion good, and weight increased from lOG to 118 pounds, in six or seven weeks. ENDOMETRITIS COMPLICATED WITH TYPHOID FEVER. By Dr. T. J. Biggs, Sound View Hospital. Mrs. J B , Glenbrook, Conn.; age 38; June 2, 1898; condition was that of general debility, constant headache, and at times chills and fever. The endometritis was extreme; the uterus being much enlarged, soft, and filled with unhealthy granulation accompanied by profuse leucorrhoea. June 7th, curettement was performed, and after depuration with the reaction of hydrogen peroxide on bovinine, the womb was washed out with Thiersch, and packed with iodoform-bovinine in gauze; repeated daily vmtil the 12th, when the packing was dis- continued, and the vagina was injected at intervals with bovinine pure, until the 20th, the womb was then found to have returned to its normal size, the leucorrhoea had ceased, and the vagina was in a healthy condition. The nurse was instructed to apply a bovinine tampon daily, and this was continued until the condition of these parts was thoroughly cured, July 1, 1898. On the 14th of June, the characteristic fever of the typhoid con- dition set in, with a steady diarrhoea. Microscopic examination of stools revealed Koch's bacillus, leaving no doubt now of a genuine case of typhoid fever; the crisis was reached, the fever was broken, and the patient entered on the stage of convalescence. The only food allowed was a teaspoonful of bovinine in milk, every two hours. The patient was in an extremely weakened condition from hav- ing gone through so much both surgically and otherwise. She spoke of the bovinine giving her strength, and asked that the quantity be increased, as she felt that it did her great good, and she was given a tablespoonful every two hours; began to pick up rapidly; July 2d, bovinine was increased to a wineglassful every three hours. July 24th, was allowed to get up and sit around in the ward; and at bedtime said she was not tired, and felt splen- did. July 26th, went for a short walk in the grounds, and was up all day. August 1st, was discharged cured. 105 DISEASED PELVIC ORGANS (EVEN EXTREME CASES) CURED WITHOUT CURETTAGE OR EXCISION. Septic matter is removed the most perfectly by the depurative reaction of peroxide on bovinine, while allaying pain and inflam- mation, with local nutrition and healing at the same time. RECTO-VAGINAL FISTULA AND LACERATED CERVIX. Dr. T. J. Biggs, Sound View Hospital. Miss A , South Norwalk, Conn.; age 43; June 10, 1898; pre- viously treated in two institutions, with three operations; two for the recto-vaginal fistula, and one for the lacerated cervix; all fail- ures. The tear of cervix being old and deep, a V-shaped piece was now removed and the edges of the gap were brought in ap- position by three silver wire sutures. The vagina was then thor- oughly depurated by the reaction of hydrogen peroxide on bo- vinine, washed out with Thiersch (as always), and an iodoform- bovinine tampon was inserted. This procedure was repeated in full, twice daily; under which the process of healing was rapid and complete. The last suture was removed on the 21st, as the wound had entirely healed, leaving the scar soft, pink, pliable and normally sensitive. June 24th, after twenty-four hours preparatory treatment, bo- vinine diet, washing out bowels, and sterilizing vagina by bovinine- peroxide depuration and Thiersch irrigation, the second operation was performed for the recto-vaginal fistula. On the vaginal side, the edges were denuded for a quarter of an inch in breadth around the circumference of the fistula, brought in apposition and re- tained by six silk sutures tied upon little india-rubber disks in order to bring the edges more firmly in apposition with less dan- ger of stitches cutting through, the knots resting on the rubber disks. Four stitches were taken in the same manner on the rectal side. The vagina was then packed with gauze saturated with iodoform-bovinine; a tampon similarly saturated was placed in the rectum; and the patient was put to bed with hips elevated. [Omit- ting medical treatment.] The vaginal packing and rectal tam- pon of iodoform-bovinine, with the usual bovinine-peroxide and Thiersch depuration, were renewed three times a day, until by July the line of union was found perfect, though as yet frail, and all sutures on the rectal side of the fistvila were removed, and two of those on the vaginal side. Ju-ly 7th, remaining vaginal sutures were removed, the line of union being complete, perfect and strong. Although debilitated and run down by so much surgical work, un- der bovinine she gained rapidly, and on August 1st was discharged in full health. In this case — an aggravated one, of a class in which fully 75 per cent, of all operations are failures — the rapid and complete re- covery requiring no secondary operation, is a most interesting ex- ample of the vital efficacy of an extraneous blood supply. 106' ULCERATIVE PROCTITIS. By the same. Emma N , New York; age 24; July 14, 1898; had suffered three years, under various treatments constantly, but grew stead- ily worse. Her last physician had attempted blood treatment, but claims to have got no result whatever — quite naturally, even neces- sarily, from the fact that he injected simple bovinine into the rectum without having prepared the internal surface for the ab- sorption of it by thorough cleansing. It is absolutely necessary that any surface to which bovinine is to be applied, should be first made aseptic by the bovinine-peroxide reaction, or otherwise. Patient was now put to bed; secretions were regulated; and on the 15th, after thorough depuration of rectum with peroxide-on- bovinine followed by Thiersch, an ounce of iodoform-bovinine was injected, and a bovinine tampon was inserted. Six hours later, the whole process was repeated. Under the previously unprepared application of bovinine by another, the patient had suffered a good deal of pain, and in a short time the bovinine had passed out as a clot, leaving the rectum very sore. But following my application under bovinine-peroxide depuration, the pain, which had been almost constant, ceased entirely and finally in about twenty minutes; and six hours later, when the tampon was changed, the rectum was found sweet and clean, and all the bovinine had been absorbed, even that in the tampon, leaving it almost white. This was solely due to the fact that the surface had been cleared and prepared to absorb the bovinine freely, without which no good could be expected. The above-described process was repeated every six hours until August 7th, 1898, when the ulcerations had entirely healed, and case was discharged cured. ULCERATION AND FISTULA IN ANO. By the same. John Hatter, Stamford, Conn.; age 39; September 6, 1897; a complete fistula in ano, two and a half inches in length, of large calibre, and of ten years standing; around the anus, a complete ring of haemorrhoids; beyond this, two inches up within the rec- tum, were four ulcers; there was chronic constipation, with hepatic torpor. After a few days preparatory treatment, regulating the secretions, and a diet of bovinine and milk, September 14th, after thoroughly washing out and sterilizing the parts, and anaesthetizing the patient, a double operation was performed, which consisted in a division of the sphincter muscle through the fistula and scraping out the sinus; after which, a modified Whitehead operation, one inch of gut being removed. The wound made by removal of the fistulous sinus was then sterilized by the bovinine-peroxide reac- tion, irrigated with hot Thiersch solution, and packed, as well as 107 the rectum, with sterilized gauze saturated with iodoform-bovinine. This was done daily, up to September 20th; after which, pure boviuine was employed with the same procedure, three times a day. On the 32d, the stitclies were removed, the line of union be- ing perfect around the anus, and the fistulous wound rapidly filling under the topical blood nourishment. On the 28th the ulcers in the rectum were entirely healed; leaving now only a small surface, over the site of fistula, unhealed. October 3d, the fistula was also healed; patient having regular daily defecations normal in quan- tity, and was discharged absolutely well. This case is unusually interesting from the fact that all other treatments — prominent among them Professor Pratt's dilatation — had been employed during the long course of the disease, but no results whatever could be attained. Latest, ISTovember 12, 1897: returned for relief of constipation resulting from slight contraction of sphincter, which was reme- died by dilatation with bi-valve speculum; the healing of parts re- maining perfect, every symptom entirely relieved, and the general condition of health greatly improving. FISSURES OF RECTUM. By the same. John H , Stamford, Conn; age 46; May 18, 1898. Had suf- fered everything from this condition, for ten years, under the care of many excellent physicians, who had, besides numerous medica- tions, performed operations such as dilatation of sphincters, curette- ment of fissures, and applications of Paquelin cautery to them; but all to no avail; the fissures would not heal. The patient was well- nigh discouraged, and said he wished he could die. After a thor- ough application of cocaine, I made an examination, and found six fissures, large and painful; three amounting almost to ulcers. His condition l)eing so much run down, I determined to take a few days to build him up, with bovinine in milk, a light diet, and suitable medication. On the 29th, under chloroform, the rectum was thoroughly washed out and the sphincters completely dilated; a bovinine tampon was inserted, and carried up at least three inches. Another one was placed just beyond the internal sphincter, and a bovinine gauze dressing was applied over the anus and held in place by a T bandage. On the 31st, the rectum was depurated by the bovinine-peroxide reaction and Thiersch irrigation; a bovinine tampon was introduced just beyond the internal sphincter, and a bovinine dressing was applied externally. This procedure was re- peated daily to June 10th, when examination showed the fissures entirely healed, and patient was discharged cured. Points of great iuterest in this case are (1) annihilation of pain and sensitiveness which had been so extreme, but of which there was none at all after operation and blood dressing; (2) uninter- rupted and com]ileto healing in twelve days of all the fissures, which for ten years had refuser! to heal in spite of all surgical and medical tt'eatment formerly known. 108 GANGRENED TISSUE- TRANSMUTED TO HEALTH BY APPLIED BLOOD. CONTINUOUS REPETITION OF THE RESULT BY VARIOUS PRACTITIONERS. The constant evidences heretofore published of immediate ar- rest and purging of gangrene from the most delicate tissues al- ready mortifying, by the simple power of applied bovine blood, have been sufficient to assure all tolerably informed surgeons that here is a power for healing never before known, or imagined pos- sible. EXPERIENCES AND REMARKS ON BLOOD TREAT- MENT IN THE HOSPITAL OF PROFESSOR E. H. PRATT, M. D., CHICAGO. To My Co-Laborers in the Practice of Medicine and Surgery: Something more than five years ago. Dr. C. S. Eldridge, of Chicago, asked me if I was alive to the value of local feeding in varicose ulcers of the legs. I replied that I was not. He then informed me that he had rapidly cured a few bad cases of varicose ulceration of the legs which had proved intractable to all other measures, by the local use of bovinine. SUPPLIED BLOOD VERSUS GANGRENE. During the next week there chanced to come under my ob- servation the only case of gangrene of the scrotum that I had ever seen. The gangrene appeared at the bottom of the scrotum a few days after an operation, and spread rapidly; the lower half of the scrotum rotted away, exposing the testes, upon which gangrenous spots speedily put in an appearance. Red streaks extending from the scrotum upwards and outwards along either groin indicated that the process of death was going on along the tissues in the direction of the cords, the left one being the more marked. The areolar tissue beneath the inflamed tracts rapidly rotted away, so that the finger could readily be passed its full length in the direction of the inguinal canal on either side. The patient's temperature ranged from lOli/^ to 103 de- grees, his pulse seldom going below 120, and death was rapidly approaching. Strenuous efl'orts were made to check the progress of the spreading gangrene, but to no purpose. The necrotic sur- faces were frequently and thoroughly dressed with various anti- septic preparations, such as charcoal, quinine and iodoform, after being carefully cleansed with sometimes bi-chloride solution, some- times carbolized water, and sometimes a weak solution of bro- 109 mine. In spite, however, of continuous and faithful attention to the decaying parts as well as careful treatment of the patient's general condition by the exhibition of appropriate internal reme- dies, the gangrene spread rapidly and the room became so offen- sive with the odor of death as to be nauseating to those in at- tendance upon the case, and the exhibition of Piatt's chlorides and other atmospheric disinfectants seemed to be utterly power- less to control the terrible odor. After at least two-thirds of the scrotum had been rotted away and the patient's life completely despaired of, it occurred to me to try the efficacy of local feeding as a last resort. Under an anaBsthetic, much of the dead tissue was removed with the aid of tissue forceps and scissors, some of it, however, clinging so closely to the decaying surfaces as to render the re- moval of all the patches of gangrene impossible. Iodoform gauze was then soaked in bovinine, each testis was wrapped in a sep- arate strip of it, pieces of it were tucked well up into the groin under the line taken by the rapidly spreading disease, then .a large piece of it was wrapped around the entire scrotum and spread over the outer surfaces of the groins. While memory lasts I can never forget the extreme surprise as well as satisfaction at the result of the first treatment. The odor immediately disappeared from the room, the fever of the patient subsided, his pulse lowered, and he was perceptibly better in every way, his restlessness and thirst rapidly disappearing, and he became for the first time comfortable. Bovinine was poured over the surfaces of the gauze once in two hours, but the dress- ings were not removed for twenty-four hours, and when removed there was no odor whatever to the wound, and although the patches of gangrene were not entirely gone the granulations were of a healthier type. The bovinine dressings were again applied, and were kept in position this time for forty-eight hours (saturat- ing the gauze every two hours by pouring bovinine over its outer surface), when the gangrene had almost entirely disappeared, and the case was evidently rescued. The bovinine dressings were con- tinued until the case was entirely recovered. So much of the scrotum had sloughed away, however, that as the wound healed it left the testes exposed in two-thirds of their extent. SUPPLIED BLOOD IN PLASTIC OPERATION. The man was then anaesthetized, and the lower margins of the remaining portions of the denuded scrotum were drawn down and brought together over the testes so as to satisfactorily cover them. A dressing of bovinine was placed over the wound, which healed without suppuration, and the final result was a complete recovery, the appearance of the parts being that of a first-class amputation of the scrotum. SUPPLIED BLOOD FOR A GANGRENOUS HOSPITAL. The success of local feeding in this case was not forgotten. Soon after, while on service as a consulting surgeon in Cook County Hospital, gangrene appeared in one of the wards, and fully 110 alive to the serious nature of the infection, I tried to prevail upon the authorities of the hospital to furnish bovinine to stay the scourge. This they refused to do on account of the expense of the preparation and because they considered it a food and not a medicine, and a proprietary article at that, and as a result of the various excuses which were trumped up I was not able to obtain it from the hospital supplies, liesolved, therefore, to stay the scourge at all cost, I furnished the bovinine myself, and had the extreme satisfaction of bringing every single case to a rapid and successful recovery, and completely stamping out the plague from the wards in which it appeared. Backed by this experience of bovinine in so formidable a malady as gangrene, it occurred to me that it might be as serviceable to prevent gangrene as well as to cure it. * * * SUPPLIED BLOOD IN GYN^CALOGICAL OPERATIONS. In several of my operations for vaginal hysterectomy, where the vault of the vagina had been in such a poor condition of nutri- tion as to become mottled with purpuric spots while cleansing the vagina for the operation, I had trouble with the subsequent appearance of gangrene in the vault of the vagina. Bovinine here, as in the other cases, had been my sheet anchor and proved ade- quate to the occasion. Eeflecting that what could be cured could certainly be prevented, I then began the practice of local feeding in the vagina in those delicate cases where hysterectomy had been determined upon and the appearance of gangrene was feared as a consequence. Here is a case in point, for instance: A lady, 73 years old, was brought to me for treatment, and on examination I noticed that the vagina was so pale and ansemic and the circulation so poor, that the mere process of examination produced a mottled appearance of the atrophied cervix and the vault of the vagina. I kept the vagina filled with bovinine night and day, until the vagina could be douched and manipulated without inducing purpuric spots. She was anaesthetized and the uterus, ovaries and tubes removed. The wound healed without the slightest trace of suppuration or of any approaching gangrene. She made a rapid convalescence, and in two weeks time she was able to sit up and in a month's time was discharged a perfectly well Avoman. Nearly two years have gone by since then; she has gained thirty pounds of flesh, and is now one of the happiest and healthiest women in Wisconsin. I have found local feeding of the vagina by means of bovinine valuable also not only as a preparatory treatment for operative in- terference, but to renew the tonicity and vitality of the parts in cases where sexual waste from various causes has been excessive and the general strength of the patient correspondingly depleted. It seems to feed, strengthen and revivify the tissues to which it is steadily applied for a few weeks in succession. I have never known it to cause irritation or inflammation or any unhappy re- sults, not even discomfort. On the contrary, it seems to be stimu- lating and strengthening to the general system as well. m BLOOD AND OXYGEN FOR STERILIZATION OF PARTS. While I am speaking of the subject there is another use which 1 have also made of bovinine to which I would like to attract your attention, and that is in the preparation of a field for intended operation upon the skin surfaces. While scrubbing with soap and water, etc., removes the sebaceous matter and other sources of in- fection from the surface of the cuticle, it does not reach the deeper parts of the sebaceous and sweat glands, and at the same time it scratches away so much of the cuticle as to leave the sensitive and readily absorbing surface at the mercy of any infecting mat- ter to which it may be exposed. There is a substitute for the scrubbing which is more effective as a cleansing measure, which saves the traumatism occasioned by the mere scratching of the brush, and which has been so satisfactory in my practice now for several years that I desire to give it my hearty endorsement and suggest it as a measure for general adoption by the profession, and that is the local application of bovinine, followed, while the bovinine still covers the surface, by peroxide of hydrogen. Bo- vinine is so penetrating as to enter both the sebaceous and sweat glands freely, and \^ith the peroxide of hydrogen removes all evi- dence of grease or filth of any kind. After the froth has been washed away by sterilized water, the surface of the skin appears clean and smooth and is then ready for such treatment as the sur- geon may prefer. I have now employed this combination of bovinine and per- oxide of hydrogen in several hundred cases as the first measure in cleaning an operating field, and it has given me such complete and universal satisfaction that I heartily commend it to the con- sideration of my fellow surgeons. Fraternally yours, E. H. PKATT. Chicago, 111., November 6, 1897. GANGRENE OF THE SCROTUM: THE MEMBER ENTIRELY DE- STROYED, AND ENTIRELY RESTORED BY BLOOD TREATMENT. By Jos. L. Black, M. D., Cook County Hospital, Chicago. William F , age 30, came under my care February 38th, in a truly pitiable condition. The scrotum was completely gangren- ous and almost ready to separate. A broad region almost across the abdomen, and from near the navel to points several inches down the thighs, was covered with an angry erysipelatous blush. The affected parts gave out a horribly offensive odor and the skin and breath partook of this to some extent. Feeble and pale; frequent chills; pulse was feeble and thready, running 110 to the minute; respirations 30, shallow; profuse of- fensive diarrhoea; temperature usually near 102 degrees. Imme- diate stimulation was resorted to. When the pulse had been steadied, the affected parts were cleansed and a boracic acid wet dressing applied. This was continued for twenty-four hours, at 112 the end of which time the scrotum sloughed away, septum and all, leaving the testes as bare as if they had been carefully dissected out. The case was seen by a number of physicians and they were unanimous in the opinion that nothing but a plastic operation would answer, some advising the removal of one testis. Instead of resorting to this, I resolved to try Dr. Pratt's treatment with iodoform gauze saturated with bovinine. At the end of forty- eight hours the raw surfaces began to glaze over and, a few days later, granulations sprouted plentifully from the stump of the scrotum. These spread downward and the testes drew up slightly, and at the end of three weeks the latter were completely covered in with a new scrotum. Was discharged April 5th, in perfect health. That this has continued, and that the cure was complete may be inferred from the fact that Mr. F is now a member of a baseball team and engages in various kinds of active work. DIRECT HEALING OF A GRANGRENED STUMP FROM AMPUTATION. By Witter K. Tingley, M. D., Surgeon and Gynaecalogist to the Backus Hospital, Norwich, Conn. (Corrected by the Author, from the New York Medical Record, March 16, 1896.) Mrs. P , aged 74, in poor circumstances, had undergone much privation and suffering. During the cold weather she thought she had frozen the toes of her left foot. From that time she had great pain, and soon the foot, from the scaphoid bone down, became gangrened. I saw her some weeks after the foot became affected. My examination revealed dry gangrene of the lower half of the foot, with the line of demarcation well de- fined. I decided to perform an operation, taking the leg off just below the knee. Everything went well except some pain in the stump, and some little elevation of temperature, with great rest- lessness. When I took down the dressings to remove the stitches, I found what had caused the pain. The anterior flap was black and moist, hav- ing a most peculiar odor, musty. It certainly looked as if the disease had returned in the stump. Without any hope of good results I ordered all the usual dressings stopped, and sterilized gauze soaked in bovinine substituted, to be applied twice a day, the stump to be carefully washed at each dressing with bi-chloride solution, one in two thousand. The result was really surprising. Gradually the black spot looked more and more healthy, the dark appearance grew less and less, healthy granulations started up, and in four or five weeks the stump was white and all healed, the anterior flap, that at the time of operation was thin and flabby, now being plump and firm. 113 BLOOD CURE OF GANGRENE IN AGED CASES CONDEMNED TO AMPUTATION. "The removal of a gangrened leg will not cure a patient, but it is very certain that a cure never can be brought about without amputation." — (Professor Howard Crutcher, M. D.) Case by Dr. J. H. Dearborn (City Physician), Bow St., Somerville, Mass. I was called to au old man, 80 years of age, and found a gan- grenous slough, starting at the ankle and extending up the leg. I called in at once a surgeon in consultation, who, after a care- ful examination, advised amputation above the knee, as the only chance of saving the man's life. But I judged that the shock of an amputation would be too much for him. I poulticed liberally the leg, long enough to loosen up the dead tissue, then curetted all of it out. When I was through I found an area some five inches long and two or three inches wide, of varying depth, extending up from the ankle Joint. About this time I read in a New York medical journal of the successful use of bovinine combined with iodoform locally applied; I had this combination prepared, gauze saturated with it, and the leg dressed every day. Soon healthy granulations appeared, no coarse granulation, or proud flesh at any time. The leg completely healed up, and the man has now had its use for eleven months. Such a result in such a subject I have never before known of, and have no doubt it will be deemed by many of my friends of the profession incredible, but such were the facts. BLOOD CURE OF GANGRENOUS ULCERS ON AGED AND PARA- LYSED LIMB. Case by Dr. J. W. Gushing, Beacon St., Boston. I was called to old Mrs. A , of Eoslindale, a former pa- tient of mine when she resided in the city, and found her with two ulcers on her paralysed foot, one of which showed gan- grene. Her condition was considered very serious. I curetted out all that was possible of the gangrene, caused oakum to be obtained and soft thick pads of it prepared and bound on each ulcer. Into these pads bovinine was poured every four hours. In two months both of these ulcers were healed, the skin growth being smooth. 114 A CRUCIAL TEST IN GANGRENE. A physician of Spring Grove, Minnesota, Dr. T. Jensen, had the good fortune, about five months ago, to read something about the blood treatment, just in time to fall back upon it before am- putating a gangrenous foot of an liabitual drunkard. He reports the following experience : In a state of intoxication, tlie man had driven ten miles in his buggy, with one foot jammed within the hammering compres- sion of the front elliptic spring. Within a week Dr. Jenson found the ankle perfectly black, over an extent of several inches, and tore off with his dressing forceps the dead flesh down to the bone, entirely uncovering the external malleolus, without even yet reach- ing any healthy tissue, and was obliged also to snip off some of the tendo^jig. Continued dressing with carbolated vaseline salve and iodoform gauze for two weeks, while the gangrenous condition continued extending farther up. Convinced now that immediate amputation was imperative, and while preparing to operate. Dr. Jensen providentially received at that moment the information that led him to try "bovinine" as a forlorn hope. He ordered the wound bathed with bovinine and dressed with iodoform gauze as before, four times a day. In ten days, thought he could perceive a slight improvement. In four weeks, the improvement was marked, and the wound was healing from the edges. After two months, the wound had decreased to about half the original size, which was about two by four inches. At the end of four months of bovinine treatment, the wound could be covered by the doctor s thumb. After between five and six months, the wound was en- tirely healed and covered with fresh skin, with only a scar of fibrous tissue about half an inch wide and two inches long. That which makes the case an extreme and crucial one is the fact that the pa- tient had been an habitual drunkard at least as long as the doctor had known him, which was fifteen years, and during treatment still persisted in getting drunk, as soon as he could get up and around. GEO. W. SMITH, M. D., MACON, MO. I was called July 13th to see Mrs. J. W , 65 years of age, suffering from sores on her foot, with the characteristic odor of gangrene; tissues very black; sloughing begun, and ulcers present, with foul odor. These were cleansed with antiseptic hot water, thoroughly dried and dressed with absorbent cotton wet with bo- vinine. Pain was relieved in twenty minutes, and she had the first sleep she had enjoyed for some nights. The li;nb was dressed daily, with bovinine between times if pain began. On the twelfth day, ten of the ulcers were completely healed, the cuticle having come away in sheets. On the seventeenth day all the ulcers were healed, and she has continued to do washing and house work unin- terruptedly since. 115 HOSPITAL GANGRENE AFTER AMPUTATION BLOOD CURED. Case by J. J. Dooley, M. D., New York. Henry Eisendorf, German, age 29, on December 1, 1894, suf- fered amputation of left leg, and was doing nicely until the Sth, when hospital gangrene set in, and I was about to re-amputate im- mediately, higher up, but was persuaded by a professional friend to try a blood treatment of the gangrene. After curetting and cleansing, I covered it with a large quantity of gauze saturated with pure bovinine, changed three times a day, for four days; when examination showed that the gangrene had been cut short, and the wound was assuming a healthy appearance. The bovinine dressing was repeated for three days longer, with the effect of restoring the gangrened tissue to an absolutely healthy condi- tion. Bovinine dressings being repeated daily, by January 10th the healing was perfected. KO TEOUBLE WITH EEYSIPELAS. BLOOD CURE OF ERYSIPELAS WITH DELIRIUM. By Dr. T. J. Biggs, Sound View Hospital. Jane Walsh, Mt. Vernon, N. Y.; age 40; October 19th; a well- defined case of erysipelas and dermatitis, complicated by cerebral thrombosis. On the head and face, the vesicles had coalesced, forming large-sized blots containing a clear yellow serum. The patient's temperature was 105.1; the urine contained li/^ per cent, of albumen. There was also present a low, muttering delirium. Dr. W had tried all the latest treatments but without avail, and had not up to this time been a believer in the blood treatment, but had on the contrary been greatly opposed to it. He was, however, persuaded by members of the patient's family te ^end for me. I immediately cleansed the entire diseased surface with the "bovinine^ peroxide and Thiersch solution, and then had the bovinine pure ap- plied. The effect was magical. All pain and irritation ceased at once, and in half an hour the patient fell asleep. Bovinine was ap- plied every hour for the first twenty-four hours, then every three hours; also a tablespoonful of bovinine internally every three hours. October 25th, the fever had entirely subsided and the urine was normal, appetite good, no pain, and diseased surface healing rapid- ly. Dr. W was delighted, and said he had never seen anything act so thoroughly and rapidly in all his experience. November 10th, the patient called on me, entirely well, having been discharged by Dr. W. on ISTovember 9th; her condition was perfect, not the slightest trace of a scar. 116 BLOOD TREATMENT OF ERYSIPELAS— CASE II— V. By Dr. H. M. Sanger, Providence, R. I. "A case of facial erysipelas, involving also the neck, was that of a man of 63 years whose constitution was greatly debilitated. The disease was spreading rapidly and suppuration commencing. Under the treatment employed, in spite of our best efforts, the condition became grave. Eemembering the good service that bovine blood had done for me in ulcers, 1 saturated a piece of gauze with it and applied it to the affected area, keeping the gauze moist — internal treatment continued. Improvement was almost immediate, and patient made a rapid and uneventful recovery. "Since the above I have treated three other cases of erysipelas; two by simply applying gauze saturated with the 'bovinine,' the other by injecting just at the border of the inflamed patch. Each case made a very rapid recovery, with very slight spreading and no suppuration." [Moral. — Physicians need take no risks with "anti-streptococcus serum," or other morbid animal products.] CASE VI. By W. H. Parsons, M. D., Omaha. Of erysipelatous inflammation of the face, one of the worst cases I ever saw was in Dayton, Ohio. Nothing appeared to check the inflammation, or to stop the spread of the disease. The patient was delirious, prognosis grave. Bovinine upon soft cloths was spread over the entire surface of the face and scalp, and changed every one or two hours. The result was magical. No other kind of applications were made, and patient was convalescent in three days. BLOOD TREATMENT OF ERYSIPELAS. WITH CELLULITIS. By E. C. Frost, M. D., Brocton, Mass. "A case of erysipelas of face and scalp early became a severe cellu- litis and the process of suppuration did not cease till scalp, muscular tissue, cellular tissue, and a large surface of pericranium were de- stroyed, the slough extending from the occipital ridge on the back, to within two inches of the eyebrows on the front, to the zygoma on the left and to a level with the ear on the right. "After the slough was removed, I dressed it at first antiseptically and would then pour bovine blood upon the sore till it was thor- oughly covered, when I would put on iodoform gauze saturated with the same, and hold the whole in place with moist iodoform gauze and a bandage. "It was perfectly wonderful to see the bone cover itself with new pericranium, and the sore fill in with new granulations, till now only a small, irregular strip remains to be covered with cuticle to make repair complete." 117 BLOOD TREATMENT OF TRAUMATIC ERYSIPELAS— CASE VII. By W. H. Parsons, M. D., Omaha. "A man in St. Joseph's Hospital, Oneota, had his arm smashed in a railroad accident; the fractures were compound and badly com- minuted, and in a few days an erysipelatous condition set up, which threatened his life. I was in the hospital, and the attending sur- geon, an old friend of mine, called me to view the case. It was truly desperate. I advised taking ofE all dressings, put the arm on a pillow, cleanse it thoroughly with hot bichloride, and wrap the en- tire arm in pure bovinine. After some hesitation it was done, and in four days the condition had so far changed as to allow the arm to be put back into the dressings. Another life was saved." BLOOD TREATMENT IN BLOOD POISONING— CASE I. By Dr. W. H. Parsons, Omaha, Neb. In St. Louis, a lady had pricked her thumb with some poisonous product, and blood poisoning in its most virulent form supervened, and in spite of the best efforts of several leading surgeons, the case came to a point where amputation at the shoulder seemed the only alternative. The hand and arm were swollen to their fullest ca- pacity, and honey-combed with scores of sloughing ulcers. Upon my advice the hand and arm were dressed six times each day, after having been thoroughly cleansed, with pure bovinine: the ulcers being packed with soft lint saturated with the same, and the entire arm and hand dressed with it. In thirty hours a change was mani- fest, and in sixty hours healthy granulations began to appear, dis- eased tissue to slough out, and in twelve days her hand and arm were as good as new. From the Public Health Journal. BOVINE BLOOD AS A TISSUE-RECONSTRUCTIVE IN ENGLAND. To Whom it May Concern : After a protracted use of the prepara- tion [of ox blood] known as bovinine, I am convinced that our Pharmacopeia has received a valuable and sterling addition. Dr. Howship Dickinson, of London (Eng.), has very aptly defined neuralgia as the "prayer of an impoverished nerve for fi'esh blood." With uninterrupted success, I have found bovinine to be the answer to the prayer. In all ailments which are accompanied or followed by great cardiac depression, notably di})litheria, I have found bovin- ine to be invaluable. In looking liack over a miscellaneous collec- tion of surgical reports of my own cases, the one fact which stands out prominently, is the invariable success which I had with bovinine as a tissue reconstructive. ERNP]ST ROACH, M.D., R.CIS., (Eng.) 121 East 82d St., New York City. 118 THE PHILOSOPHY OF TOPICAL BLOOD SUPPLY IN CHKONIC ULCERATION. By T. J. Biggs, M. D., Sound View Hospital, Stamford, Conn. The treatment of Chronic Ulceration has baffled surgery for centuries. In spite of all their accumulated skill and appliances, the surgeons of the world had, to this day, signally failed in very many cases to accomplish a permanent or a complete repair, and often, even to bring about any improvement. Of whatever variety it may be, and from whatever occasion it may arise, every ulcer depends for its existence upon a failure of the local nutrition due the part from the blood, in consequence of some deficiency of the blood itself, of its circulation, or of its de- fensive energy relative to the attacking cause if such there be. Conversely, it needs no argument to show that a radical cure of ul- ceration must depend on the restoration of the nourishing and vitalizing agency of the blood, in the part affected. But the dif- ficulty, and often impossibility, of so improving the quantity, qual- ity and circulation of the patient's own blood product, as to over- power and sweep away in its current both the agents and the debris of tissue degeneration, while replacing them with the living ele- ments of living tissue, has been the insurmountable barrier to our victory over Chronic Ulceration — insurmountable, that is, by any attempt of human power to insure adequate production and appli- cation of blood by the diseased or debilitated system. When the physician &r surgeon runs up against this barrier, and finds that all the resources of his art cannot bring about a production of blood sufficient to repair the waste of the disease, he knows that he is defeated — ^unless he happens to know that where he cannot produce blood, 'he can introduce it. While the introduction of bovinine blood into the general circu- lation is now known to be helpful and practicable in every case of need for more or better blood anywhere, and should always be em- ployed; the extent of its constitutional efficacy for the cure of ulcers through the general circulation has not yet been fully test- ed, nor need it be, since the immediate and ample supply that can be brought to bear upon them in situ can be depended upon for local effect to the fullest extent. No fact in any science, medical or other, has been demonstrated more absolutely than this. The explanation of the process will be evident to all who are familiar with the cell theory of Virchow, or the study of embry- 119 ology, which shows that all living structures are composed of one or more cells, each cell being i)eculiarly adapted to perform the func- tion assigned to it. Chemical change — including the assumption of oxygen,, and the production, complete or partial, of carbonic gas, and above all, assimilation, secretion, excretion and reproduc- tion — is retained by every tissue to a greater or less extent. Both plants and animals also possess the wonderful power of rearrang- ing the constituents of their nutriment, as combined in the blood, into forms identical with the peculiar components of their vari- ous tissues. Experiments have been made with the individual cells and isolated colonies of simple structures by supplying nutriment arti- ficially, by which they have been kept alive for days independent of the influence of the nervous system, each cell' assimilating, by contact with the proper nutritive medium, the material neces- sary for its growth and integrity. It is therefore proven that each and every tissue is capable by itself of absorbing and assimi- lating nutriment and, of course, all the more, of appropriating the already assimilated and vitalized protoplasm of living blood. Upon these conditions is based the theory of topical feeding in chronic ulceration, and to this inherent power of life in each individual cell, do we owe the success obtained by topical nutri- tion. Granulating surfaces are non-absorbent if their condition be of an acrid nature, or so long as the applications made are irri- tating or incapable of nourishing and vitalizing the individual cells. But if, on the other hand, the substance presented be of a neutral reaction, of a greater density than that of healthy blood, and be composed of substances capable of sustaining the life of those cells, not only will they absorb and assimilate such nourish- ment in large quantities, but they will live and thrive, and as- sist nature in repairing her loss, in such a way as to leave the surface of the part free from scar, or comparatively so. EFFECT OF LEADING NUTRIENTS EXPERIMENTALLY DETERMINED IN COMPARISON WITH MA- TURED BLOOD (IN BOVlNINE). With a view to ascertain -precisely how topical nutrition can be best effected, a series of experiments were conducted, and various forms of nutriment were applied to ulcerated surfaces. Dilute solutions of sugar, starch, predigested starch, malt extracts, peptone broth, beef tea, extracts of beef, dissolved pepsin, papoid, ichthyol, milk, blood clot, ordinary defibrinated blood, and defibrinated ox- blood available in the preparation known as bavinine. Ten con- 120 secutive cases were tried with each substance and the effect ob- served, care being taken to note any existing diathesis in each particular patient, which, if discovered, was promptly treated. In most of the experiments three or more substances were used on the same patient at the same time, according to the number of the ulcers, and while all rendered more or less benefit, milk, blood clot, defibrinated blood, and bovinine, were more prompt in their action than the rest. Further experiments, however, proved that milk turned rapidly sour, and produced irritation; blood clot and ordinary defibrinated blood acted very nicely when the dressings were changed every four hours, but when left longer were found to be decomposed, and thereby retarded the process of healing, which was slow compared with that of the bovinine cases, the ratio being about three to one in favor of the latter. A series of experiments were also conducted with bovinine and iodoform on the same patient; here the ratio was found to be about ten to one in favor of the bovinine. TISSUE DISINTEGRATION: PHYSIOLOGICAL REPAIR, AND THE ASSISTANCE IT REQUIRES. When a part becomes diseased through inflammation of any kind, there is a contraction of the capillaries, with retardation of the flow of blood, dilatation of the vessels, and increased rapidity of circulation; followed by exudation of the liquor sanguinis, with migration of the white corpuscles. This is succeeded by a quies- cent state of the capillaries, with stagnation of their contents, thereby shutting off nutrition; the final result of which is mole- cular death, and ulcerous formation. A careful microscopic ex- amination of the capillaries around a chronic ulcer will reveal thrombi plugging them up for a considerable distance, and shut- ting off nutrition from the part. Now, the serum of normal blood is largely made up of water, including albumin and certain saline constituents. But the serum from diseased tissue is perverted; so that in the liquor sanguinis transuding from the vessels there is a larger proportion of albumin and salts than in serous, effusion proper; and in addition to this there is the presence of fibrin, which causes the effusion to undergo coagulation in the tissues. Such being the case, it follows that the so-called coagulable lymph is liquor sanguinis with the prolifera- tion of white corpuscles which have migrated through the vessels, besides corpuscles in great numbers which have resulted from the proliferation of the fixed cells of the tissue in which the inflam- matory disease is going on.' In other words, it is embryonic tissue. This infant or rudimentary tissue must now be vitally and material- 121 ly nourished, or it will die. As we have seen that the blood in inflammatory tissue is both obstructed, and perverted in all its properties, vital, physical and chemical, it is evident that it cannot supply the part with proper nutrition, and ulcerous degeneration and corruption is the necessary result in due proportion to the change. The chronic failure of our art to cure chronic ulceration is thus clearly explained. It is when this incapacity of the locally obstructed and perverted blood to impart vital nutrition becomes chronic, that a chronic stage of ulceration supervenes; and wher- ever this condition is established, so that nutrition cannot be brought to bear upon the part from within — that is from healthy and sufficient native blood — such cases must always be, as they have always been, permanently incurable by medication external or internal, or by surgical interference, of any kind known to the traditional practice. The sore is a perennial fountain of cells pro- liferating, dying and rotting in an exudate from which vitality and nutrition are excluded by an established condition. One thing is needful, and nothing else will do. The vital blood, that cannot pass alive through the channels blocked by the disease, must be brought to bear from another source, without, and by another way — external application. Three objects or effects are to be accomplished. The first of these, the removal of the septic condition caused by the dead tis- sue, may be fairly accomplished by the usual antiseptic agents — while they remain on the spot — and the second, which is to stimu- late a more abundant cell-proliferation and extravasation of liquor sanguinis, so as to clear the way from the living to the perishing tissues, is also served in a measure by those recent essays in topical stimulation with beef tea, or with inert nutrients, such as eg^ albumen, milk, cream, raw beef, and latest of all, proto-nuclein; which are erroneously supposed to be capable of also creating a nu- trition of the perishing corpuscles — the very point where all such means must fail. Both the stimulants and the stimulating but inert nutrients that constitute the latest modification of the tradi- tional practice with a view to what is supposed to be "topical feed- ing" of ulceration, are alike powerless to vitalize and vitally nour- ish this perpetually perishing embryonic tissue. There is noth- ing in them to do it; be they what they may, the essential condi- tion, life, which is wanting in the sore, is equally wanting in the protonuclein or what -not that is applied to it to produce the effect of life and life only — nutrition. In fact, barring some little degree of vitality that may be lingering in the part itself, 122 it would be quite as useful to plaster your nutrients and stimu- lants on a stone wall. In spite of them, the sore will run on in its devouring cycle without end, as all experience shows, even though insufficient improvement or a temporary palliative healing may sometimes be effected. The bare fact now fully estab- lished, of constant power to heal and heal permanently, in such cases, is an absolute physiological demonstration in itself, that the effective agent (Ijovinine) can be no other than Living Blood, for notliing loss and nothing else conveys such power: Life alone can beget life. It is here, then, that the bovine blood, or bovinine, performs that almost divine function for which it is now famous in its re- sults; accomplishing all the tliree desiderata of healing, simul- taneously, in one- act, viz. : as the prince of antiseptics it annihi- lates sepsis, pus, stench, and pain itself, with a celerity and cer- tainty that seems miraculous in contrast to all that had been here- tofore known of healing powers — yet. not requiring to be with- drawn, like other antiseptics, to give place to the further pro- cesses — it tones up, or rather regenerates, by the life-giving power of Life, the morbid tissues to a more active and healthy pro- liferation; and most unique and exclusive of all functions, it carries no mere inert nutriment, but life and the ultimate physio- logical product of Life-in-nutriment, vital, accomplished and vital- ized nutrition, to the moribund cells; adding to them, besides, its own countless host of robust original cells like a fresh and vic- torious army reinforcing an exhausted garrison and raising the siege. The fixed cells of the structure attacked by the disease, as well as the white cells that migrated under the influence of the inflammation, absorb the vital element applied, with an avidity that is witnessed by the speedy bleaching of the bovinine-saturated gauze applied to the sore, throughout its exact outline; they in- crease rapidly in size, going on to a mature and healthful develop- ment as true tissue cells, compactly woven in true living tissue; proliferating thus in great numbers all over the surface lately dis- eased, until the process of repair is complete and the wound is per- m.anently healed. It is clear that neither chronic ulceration nor any other case for tissue-repair can be successfully handled without a practical ap- prehension at least, of the physiology, the pathology, and the definite therapeutic necessity, here outlined. "Topical feeding" is now often spoken of with high esteem, and many use bovine blood (bovinine) as the prince of topical nutrients, which it necessarily is, being blood; but no physician will comprehend the blood 123 treatment, or the mastery of disease there is in it, until he goes be- yond the comparative estimation of nutrients to the deeper dis- crimination between nutriment and the effected nutrition which no nutrient as such, however highly developed, can command; nutrition, the frustration of which is the very essence and defini- tion of disease, and the insurmountable frustration of which alone constitutes chronic and incurable disease — to be overcome only by the introduction of the living opus operatum of physiological energy, reproducing life itself, as well as reconstructing the organ- ism of life from its living constituents. "H^MATHERAPY" (BLOOD TREATMENT) IN ULCERATION. [From the Medical Summary.] For cases of ulceration, especially the deep excavating variety in the leg, and for ulcers generally, measures commonly employed, as antiseptic and stimulating washes, peroxide of hydrogen, anti- septic fluid, solutions of mercuric chloride, iodoform, etc., with elevation and rest of part, are found to be only partially success- ful, affording at best results not entirely permanent. In only a percentage of cases has skin-grafting succeeded [until] there now comes forward an agent that claims to possess the power to supply this want, revealing a new process, with a new name, in the field of therapeutic achievement. Keports from different quarters of success in its employment, by numerous practitioners of character and experience, make it certain that no mistake has been made in the estimate of its value. It is so simple it is a wonder the discovery of its usefulness was not made before. For this reason many may hesitate to give its claims credence, and refuse to apply the crucial test of experimental therapeutics. To such we would say, if you have a suitable case, get a supply of bovinine, and settle for yourself the question of its availability. — From the Medical Summary : in Southern Clinic. 124 SKIN-PKOPAGATION WITH BLOOD IN THE TKEAT- MENT OF TRAUMATIC INJUKIES AND CHKONIC ULCEKS BY GRAFTING. SKIN-GRAFTING SUPERSEDED BY SKIN-PROPAGATION. The ability of ^aemathe^apy to propagate new skin on the largest raw surface from a few minute and scattered points of graft skin, such as the patient or any one else can furnish from his own cuticle without inconvenience, while at the same time putting a stop to the pain, waste and fever that are so terribly fatal in extensive lacerations or burns, is a discovery full of such blessed respite from agony and death, for the future, that we need not apologize for once more repeating the memorable first case. The pain attendant upon skin-grafting, both to the giver and the receiver, the difficulty of procuring the living human skin in sufficient quantity, and the tedious long period of suffering while the grafts are setting or failing to set — these render a revo- lution in this great life-saving process, that does away all trouble, an event that one would expect to be hailed and celebrated the world over. Why not? Can any one tell? We need only leave the unparallelled and unvarying triumphs of pain- less grafting and propagation of skin from minute bits, over the largest surfaces, to speak for themselves as presented in the accompanying pages, and to point the contrast between the blood-nourishing process and the cruel, half-impracticable and half-unsuccessful practice to which this branch of surgery has been confined hitherto, and with which It is still inexcusably disgraced. EXTENSIVE TRAUMATIC ULCERATION— CASE I. Dr. T. J. Biggs, New York. F. L came to the Demilt Dispensary December 22d, 1892, having sustained, two weeks previously, while at work as brake- man on the Long Island Railroad, a large laceration of the fore- arm, which was denuded of the integument and superficial and deep fasciffi, to the extent of seven inches in its long axis and three and a half inches in width. For two weeks he had been treated at several dispensaries and hospitals, under antiseptic methods, without preventing the formation of a large-sized black slough, about two inches in length and extending down to the periosteum. Furthermore, as a result of the severe blow which the muscles of this region had sustained, total paralysis of the 5; 5' 3- ia o w TO i" a o "o -< y D- D f !" 3 £; ^ "--TO rt 1 o o c cr ^ ?^ 3 3 3 2. ^^ ? inn -• n en 5^ P- CD •-' o o f* => K -S 3 ^ 10 r£.n> fj 5i (O o M -" ^' 2- 2 •« o -^ c a =• c ^ «• — 3 E. _• H-. o •-! D- ?^o S C ., o » 3 so 3 id S o 3 T( rr C ET o- p i^ 3 1^ 3 ^ < CO CD «. „ _. M iU c 3^ ~ -: 3 !B !U ., TO 3 O O .0 SO T3 O U.O a" 2. o so OS •n ctq' en 3 M o ini 5 — M o 135 forearm existed. He had been advised to have the arm amputat- ed. This he refused to submit to; hence his appearance at the Demilt Dispensary for treatment under Dr. Biggs. The preliminary treatment here pursued was the employment of such applications as would tend to hasten the removal of the slough and stimulate the wound to a condition of healthy granu- lation — namely, balsam of Peru, peroxide of hydrogen, etc. The desired condition was obtained in about ten days time, when it was decided to ifndertake to heal the wound by skin-grafting. The method employed, however, was not that of Thiersch, but the direct application of small graft points at intervals to be nour- ished by topical blood supply. After careful cleansing the surface of the wound with Thiersch's solution (corrosive sublimate was not used, as it is believed to coagulate the albumen in the tissues and interfere with the adhe- sion of the graft; and the sovereign depurator, peroxide-on-bo- vinine, was not yet known) and preparing a clean area on the other arm, from which tlie grafts were to be taken; several small pieces of skin were snipped off from this surface, washed with the Thiersch solution, and carefully placed over the surface of the wound at a distance of one inch apart each. Eight of these minute grafts were employed in all. Directly over the grafts were placed strips of rubber tissue, soaked in Thiersch solution, and over this, steril- ized gauze wet with the same solution. The dressing was com- pleted by the application of more rubber tissue over the whole fore- arm, and finally a splint and an evenly-applied bandage. On inspection after forty-eight hours, the grafts were barely ad- herent, and had lost their pinkish hue, showing a want of nutri- tion from the unaided natural circulation. One had been brushed off, leaving only seven, scattered over the surface of the ulceration as sources of skin-propagation. The dressing of bovine blood was now applied, and a peculiar effect was immediately experienced. Up to this moment, the patient had suffered incessant pain in the wound, so severe that, for the two weeks and more previous, sleep could be obtained only by the use of powerful anodynes. The ap- plication of the bovinine was instantly followed by a sense of the most grateful relief, and within a few minutes the pain had wholly disappeared, and (the bovinine dressing being continued) never re- turned ! The grafts were afforded constant artificial nutrition by bo- vinine, on which they thrived, developed and became permanently adherent. The dressings from now on were changed about every forty-eight hours until at the end of about eight weeks, when the wound was found to be absolutely and entirely well, having become covered with healthy epithelium, which had traversed the surface of the wound, having been developed alike from the circumference and from the several grafts. March 6, 1894, the patient was dis- charged in perfect repair; the wound being fully covered with healthy skin, having but a comparatively small pink cicatrix, which was not sensitive, hard, or contracting the surrounding tissues. 126 It remains only to add, that the arm, which had been from the time of the injury totally paralysed, was restored to full power. . This brief, painless, and uninterrupted cure, occupying only sixty-four days, and requiring onlv seven minute points of graft skin for some twenty-five square inches of new growth which the nourishing blood-preserve built steadily out from each graft over the bare intermediate spaces — created an epoch in tissue- construc- tion of which the promise is even yet immeasurable: remembering as we should, that in principle and substance it was but a repetition of a clear physiological process which the blood-preserve had al- ready made invariably practicable in hundreds of cases on record, and which his since been incredibly extended in surgical practice with supplied blood. i _ . ; INCURABLE BURN ULCER (OF NINETEEN YEARS STANDING), CURED BY SKIN PROPAGATION WITH BLOOD. By the same Surgeon — Case II. John Francis; age 23; at the New York Polyclinic; had resorted to many competent surgeons, and had in fact been skin-grafted on two occasions, but this procedure had failed both times. As the wound was in an exceptionally unhealthy condition, a longer period was taken for the preparatory treatment, which con- sisted in daily cleansing, followed by the application of blood dressing, by which the wound was gotten into a sufficiently healthy state to warrant the application of skin-grafts in about two weeks; a condition which had never before been attained. On the seven- teenth day, three small grafts, each about one-quarter of an inch in length, were placed on the surface of the wound and held in place by strips of rubber tissue. The dressing employed over this consisted of sterilized gauze saturated with Thiersch solution, for the first twenty-four hours after the operation, and following this up to the time of his recovery, which was absolute and complete, bovinine blood was the only dressing used. Two weeks after the skin-grafting the patient was discharged cured, the whole surface having become covered with healthy epithelium, and has had no further trouble in the lapse of years since. SEVEN-YEAR ULCER CURED IN FOUR WEEKS WITH SKIN-SCRAPINGS IN BLOOD. By the same Surgeon. Patrick S ; at Demilt Clinic; August 16, 1894; varicose ulcer of leg, 21/^x3 inches; had not, in spite of all treatments, healed in seven years. Small quantities of skin scrapings were deposited on the ulcer at six different points, and dressed as described above. The patient was discharged in four weeks with the ulcer com- pletely healed and covered with new skin. • 127 LARGE TRACT OF CHRONIC BURN ULCERATION HEALED BY SKIN-PROPAGATION IN BLOOD, FROM MINUTE POINTS OF DERMAL TISSUE. By the same Surgeon. Mary C ; age 22; February 7, 1895 (surgical ward of Demilt Dispensary), showing a tract of four or five square inches on the right side of her face completely denuded of the skin and super- ficial fascia, in consequence of a burn which had been unsuccess- fully treated by the usual methods in vogue, at two of the city hospitals. The wound extended over the right malar bone, from a point just below the margin of the lower eyelid, downward and sideways over the nose and cheek, a distance of three inches, with an inferior diameter of an inch and a half. Now cleansed and treated with pyrozone, dressed for three days with wet Thiersch, and ten minute points of skin, about one-sixth on an inch in diameter (shrinking to half that size) were then taken and distributed within the periphery of the wound, protected with strips of sterilized rubber tissue and dressing of gauze soaked in salt and water. On the third day, every graft was found adherent, and after fresh depuration, a dressing of gauze soaked with bovinine was ap- plied, and repeated every day for a week, when all the grafts were found to be doubled in diameter. March 9th, making thirty-one days in all, the whole diseased tract was found to be perfectly healed and covered with new delicate skin. Whoever has had a running sore of this size to cover with skin according to the Thiersch method, by making another sore or sores of the same size in the aggregate, to be also treated, will be forcibly impressed by the contrast exhibited in these cases of topical blood nutrition ; not only by the ready and painless transfer of a few scattered points snipped anywhere from the patient's own skin, which heals with but the slightest care; but also by the con- tinuous and rapid proliferation of skin from the graft points, all over the denuded surface, without suppuration and retrogression in any part ; thanks to the vital energy of the applied blood, which ex- pedites the healing process with unprecedented rapidity, and in some mysterious way, from its first application on, removes and pre- vents all pain and inflammation. Not mysterious, but obvious, however, is the virtue of topically supplied blood to fill the place of deficient or unhealthy circulation, making the cure of anaemic, sickly and tainted patients practicable, substantially the same as healthy ones, whereas hitherto it had been but very rarely, if at all, successful, as evinced in the most of these dispensary cases, like the present — an almost uniform record like 128 * that of a woman in the gospel, who }iad for many years suffered many things of many physicians^, and was nothing better but rather grew worse — up to the moment of admission to the new treatment by blood. Attention is directed to valuable late improvements in the technique and detail of skin-propagation from minute points of dermal tissue, in cases here related. A LATE IMPROVEMENT IN THE TECHNIQUE OF SKIN- PROPAGATION WITH BLOOD. By Dr. T. J. Biggs, Sound View Hospital. Sam Coen; age 21; September 20, 1895; surface 2%x3i/2 inches denuded of the fascia — an injury received six months before; had been treated at various institutions without result; had been skin- grafted, or rather, this had been attempted, twice; but in both cases all the grafts died. After two days of preparatory treatment with bovinine, I com- menced skin-grafting after my latest method, first thoroughly cleansing the surface with wet Thiersch solution for forty-eight hours; and the grafts being now deposited on the surface, four layers of plain sterilized absorbent gauze are laid over the grafts, carried around the leg and sewed. I allow this dressing to remain on for ten days, constantly feeding the grafts through the gauze, by keeping it saturated with bovinine and salt water, two to one. This method proves quite as effective as changing the dressing, with rubber tissue to hold the grafts in place; while it has the great ad- vantage of allowing no chance of a single graft being disturbed be- fore it has become firmly fixed. In this case four minute grafts, of the diameter of a small pea, were distributed over the surface of the wound, covered and fed with bovine blood as above described, without change for ten days. On examination at the end of that time, all the grafts were found not only immovably fixed, but grown by one-third of their diameter. Thenceforward, the surface was dressed every other day with plain sterilized gauze soaked in bovinine, covered with oiled silk and bandaged. October 2d, twelve days from the start, the patient was discharged with a complete cure. ANOTHER NEW DETAIL IN SKIN-PROPAGATION FOR DESPERATE ULCERS. By the same Surgeon. Teresa Jones; age 7; January 1, 1896; ulcer from a burn on the right eyelid, a year and a half ago; obstinately refusing to heal, under all the usual applications, including skin-grafting, which had been tried without success. The sore was now thoroughly cleansed and dressed with wet Thiersch for two days. A single minute patch of epithelium of the size of a small pea was taken from the palm of the hand, and 129 applied, under a strip of rubber tissue which was held iu place by a coating of collodion, and a strip of plaster was applied to restrict the movement of the eyelid. A novel and happy detail of technique here employed, was the opening of a small passage through the collodion, above the wound, for cleansing and feeding the graft and raw surface, with another opening below, for draining the discharges. Through these open- ings the ulcer was washed out daily with salt solution, and then fed with bovinine by a medicine dropper, without removing the dress- ings, until January 7th. The graft was then found firmly adher- ent, and from that time until entire healing, was fed hourly with bovinine by the mother, applying it from a saturated wad of cot- ton with a cotton carrier. January 30th, the failure of eighteen months of practice in skin-grafting, etc., had been remedied in twenty-three days with a complete cure. CURE OF CHRONIC ULCERS BY SKIN-PROPAGATION FROM SKIN SCRAPINGS, IN BLOOD. Dr. T. J. Biggs, Sound View Hospital. The surface to be treated is previously prepared for a period suf- ficient to obtain a healthy condition of the wound. A surface of healthy skin or mucous membrane from which the scrapings are to be procured, is prepared precisely the same as though a graft were to be taken therefrom. With a small dermal curette, the sur- face is very gently scraped to remove the exfoliating epithelia, and then once more washed with Thiersch solution, and well dried; after which the cells to be transplanted on the wound surface are obtained by scraping as in vaccination, without producing bleed- ing. Enough of these cells are removed to make a small deposit at four or five different points in a wound about two inches in diameter. Following this, strips of rubber tissue are applied and the dressing is the same as in skin-grafting, remembering that after the first twenty-four hours the use of bovinine alone for nourish- ment and support of the new growth of skin is depended upon to the exclusion of all other dressings. Patrick M ; at Demilt Clinic; chronic traumatic varicose ulcer on right leg, which had been treated at various clinics with- out avail. After the ulcer had been gotten in a condition of healthy granulation the skin scrapings were produced and de- posited on the wound, as above described. The after-dressing of the wound consisted entirely of bovinine. Two weeks after the a])plication of the scraping the ulcer had entirely healed. SKIN-PROPAGATION FROM CORN OR CALLUS SHAVINGS, IN BLOOD, FOR CURE OF CHRONIC ULCER. By the same Surgeon. John Polaskie, suffering from an ulceration over the crest o» the left tibia about two and a half inches in diameter, called upon me, having heard of the blood treatment for ulceration, and feel- ing that he had exhausted all other measures, requested that some 130 form of the method be applied to his case. I decided to use him as a trial case in the use of skin grafts obtained from the hyper- trophied horny tissue of a corn. After treating for a few days with bovine blood, and applying antise])tic dressings to a corn on one of his toes, I then scraped away the outer softened portion of the corn, pared oil' three thin layers of horny tissue, and placed them at different points on the granulation surface, held in place by strips of rubber tissue, and dressed with bovine blood. On the third day the corn grafts showed that they had taken firm hold, and at the end of the third week the ulcer had entirely healed. ANOTHER CURE BY SKIN-PROPAGATION FROM POINTS OF CORN TISSUE, IN BLOOD. By the same Surgeon, John Skolly; age 49; at Demilt Surgical Clinic; August 8, 1894; ulcer was of fifteen months standing; had been treated at four reputable institutions without success. It was now treated with bovine blood for three days as described in former cases; after which, five bits of corn shavings about the breadth of a small pea were distributed over the surface, and secured by strips of thin rubber tissue, with proper dressings in bovinine. At the end of two weeks, the patient was discharged cured, with only a small, soft, pink cicatrix in the place of the ulcer. LARGE AGONIZING TRAUMATIC ABRASION FREED FROM PAIN BY BOVININE DRESSING AND HEALED BY SKIN-PROPAGATION. Dr. T. J. Biggs, New York. Jacob Smith; German; age 56; driver; came October 2, 1895, with the superficial and dee})cr fascia pinched clean off the right forearm, down to the denuded muscle, for a space of two by three and a half inches; the arm having been caught between the wheel of a truck and an iron track rail. The injury was recent, and ex- cruciating pain was manifested by the poor fellow's cries, during the preparatory treatment before applying bovinine. For the first two days the wound was treated with wet Thiersch dressing, and on October 4th, blood treatment was commenced with a daily dress- ing of sterilized gauze soaked in bovinine, and covered with oiled muslin, and a bandage to bring about healthy granulations with a view to skin-grafting. By the second dressing, the last of the pain had vanished, ap usual under the extraordinary physiological operation of bovinine. On the 11th, six bits of skin, of the diameter of a small pea, were disposed on the surface of the wound, and secured and dressed by the improved method before described: that is, simply sewing a strip of sterilized gauze around the limb and feeding the grafts constantly with bovinine through this dressing. In this case the dressing was freshly soaked with bovinine twice a day, so as to keep the grafts constantly bathed in the vitalizing fluid, without disturbing their covering. This was continued until November 5th, when the wound was entirely healed, leaving a small pink cicatrix. 131 SKIN-GRAFTING, WITH AND WITHOUT BLOOD NOURISHMENT. Both Experienced by Dr. O. B. Evans, of South Carolina. For two 3^ears past I have used the "bovinine" preparation of bovine blood, and found it all that it is represented. In all fevers, especially typhoid and malarial, I find it indispensable, staying up the vital forces at a critical period of the disease, and freeing the patient from the .distressing sequences so - often following these fevers. But in ulcers, gunshot wounds, and extensive lacerations of the tissues, is where we discover its magnificent power. I have successfully treated several ulcers of long standing, that had re- sisted all other methods tried by physicians. Also what was pro- nounced cancer of the neck, by several physicians. In gunshot wounds it is superior to anything I have ever used in eighteen years of active practice. I will give you one case of gunshot wound, a type of many of its kind that I have treated. F. M., male, age 35; saw patient July 10th, with the entire "belly" of left forearm shot away by a charge of No. 4 shot. The load entered in above the wrist, ranging through and upward, tear- ing away the "belly" and also sheathing of ulna. After dissecting out two-thirds of ulna, trimming the wound, and putting in a few stitches, I found the cavity left to be four inches long by three wide. The hand and arm being cold, I had it placed in warm bran poultices and kept there eight hours. The arm was then rendered aseptic, and cavity filled with bovinine, and well dusted with iodoform, then wrapped in a bandage soaked in a 1 to 20 olution of carbolic acid. On the third day four grafts were plant- ed. On the seventh day the grafts were vitalized; eighth day, four more grafts were planted; tenth day, wound fresh and nice, no odor, no pus had yet been seen at any time, no pain, no swelling. But I had now used up my supply of bovinine! On the twelfth day patient sent for me to come in a hurry. Found patient in pain, hand swollen, wound offensive, and bandages soaked with a dirty, greenish fluid. Grafts last planted afloat, and granulations melting; in fact, a rapidly developing sepsis. I started a runner at once, sixteen miles, for bovinine ; the arm -was cleansed, the loos- ened grafts taken out, and the wound well cleansed. In six hours I received a new supply of bovinine; four new grafts were planted, the wound soaked with bovinine, and bandages applied. On the thirteenth day no more pus, pain gone, slight elevation of tem- perature, no odor, swelling subsiding. The same dressing renewed daily. August 10th, cavity completely filled; wound looks like a slice of sound beef. In two weeks after, the patient was well, with 132 a slight scar, and he claims as good an arm as ever. It must be, for he is now working out a six months turn on the chain gang. The temperature during July and August was very high, yet you will observe that at no time did any pus appear, so long as bovinine was freely used; but the moment it gave out, inflammation set in, and threatened to destroy not only all that had been done, but even the patient's life. Yet how quickly it all vanished when bovinine was again applied — and never appeared again ! 1 was called to a case last December, and found that a bullet had passed through the abdomen. Shock was so great that I did not expect the patient to live twenty-four hours, but I put him on a teaspoonful of bovinine every three hours in sweet milk; also thirty drops of bovinine injected into the bullet hole every three hours. This man lived fifteen days. The autopsy developed the fact that the intestines were cut in eight places; yet there was very little odor, and no swelling of the abdomen. Kinard's S. C, January 17, 1899 0. B. Evans, M. D. DANGEROUS CASE OF ERYSIPELAS. At Sound View Hospital: Dr. T. J. Biggs. Ella K , Stamford, Conn.; age 36; January 8, 1899; well- developed case of erysipelas. Onset had been sudden, ushered in by a violent chill, followed by a fever which reached 105°, pulse 130, coated tongue, nausea and vomiting, severe pain in limbs, and epistaxis. At the end of a few hours, patient was in a violent de- lirium. Shortly after the chill, an eruption appeared, beginning in red spots, which rapidly coalesced and spread. There was great oedema of the skin; the swelling so great as to close the eyes and distort the features. Vesicles had developed and coalesced, form- ing blebs of considerable size. Patient anaemic with albumen in the urine, and considerable infiltration into the areola tissue. It was a well-defined case of phlegmonous erysipelas, so severe that my prognosis given was unfavorable. Together with internal treatment the entire surface was dressed with bovinine pure, Avhile rectal injections of bovinine, milk and salt water, were given every two hours. The bovinine dressing was changed every two hours. January 12th, the condition had so much improved that it was possible to give the bovinine per mouth ; a teaspoonful every two hours, and the bovinine dressings were changed every three hours. At this time the eruption had begun to subside, the general symptoms had abated, the part aflfected had become more tender, the swelling had almost entirely disappeared, and there was a moderate desquamation. The urine was normal, with the exception of a slight excess of uric acid. January 22, 1899, the patient was discharged cured, without a trace of the condition remaining. I have never in my experience seen so thorough and rapid a result under any other treatment. 133 INCURABLE BURN ULCERS HEALED BY SUPPLIED BLOOD. CHILD SCALDED NEARLY ALL OVER. LAST RESORT, BLOOD-PROPAGATION OF SMALL SCAT- TERED SKIN GRAFTS. By H. B. Macklveen, Waverly, Iowa. I have a case that has recovered from a condition that under ordinary circumstances would have had a fatal termination, and in fact, eminent consultants said the patient must die. May M , age 6 years, in passing the kitchen stove knocked off a large pail of boiling soapsuds, and being dressed in a calico gown, was tremendously scalded. Both arms, and almost the entire body, before and behind, from the mammary region to the soles of her feet (she was barefoot) were scalded. When I was called and first saw her, she was writhing in agony and almost crazed, being unable to understand anything said to her. I used picric acid to relieve the pain, and dressed in the old-fashioned way, and continued to do so for about a month, with old-fashioned results. 1 saw that a fatal termination was inevitable, unless something else was done. I had been opposed by the consultants, in the plan I then tried, when at the beginning of the case I suggested it. But as progress was backward, 1 at last triumphed. I sterilized as near as practicable with hydrozone diluted. Then I transplanted from father, mother, brother and willing neighbors, about 100 small superficial grafts about a quarter inch in diameter. I placed them so as to bridge over the large area at different points. Over each graft I placed a layer of gauze soaked in bovinine, and let it project, so as to nourish the graft by capillary absorption of the bovinine, under the silk which kept the graft moist. In six weeks, the patient was entirely healed up. With bovinine "externally, internally, and eternally," we won the day, and with- out doubt the child's life was saved. January 25, 1899. SKIN-PROPAGATION IN BLOOD, ON OBSTINATE BURN ULCER, HERETOFORE INCURABLE— CASE CVIII. By Dr. D , New York. P. Johnson; age 26; January 2, 1897; ulceration 3x4 inches on left forearm, result of a burn; had been treated in two leading Xew York hospitals, and also by three prominent city physicians in private practice; had only fuj'ther enlarged, and cut down upon the underlying tissue. After curetting and cleansing, for twenty- four hours, it was now depurated with peroxide-on-bovinine, washed off with Thiersch solution; and the surface was now in a healthy condition for skin-propagation from *^^points" of dermal tissue. Two grafts only, of circumference of a split pea, were snipped from the right arm, sterilized, and applied to the central part of the large ulcer, with the regular blood dressing (bovinine). 134 Peroxide-on-bovinine was again applied and washed off with Thiersch; bovinine dressings reapplied; the same [ultra!] pro- ceeding repeated every day until January 12th; the grafts firmly fixed and growing, and new skin putting forth from the edges of the sore on all sides. Thereafter, a dressing of plain bovinine only was applied daily; on tlic 27th, making twenty-five days treatment, the cure was already perfected, and the patient was discharged. BLOOD CURE OF ULCERS FROM AN EXTENSIVE BURN. By F. R. Blanchard, M. D., Lakeview, Mich. (From the New York Medical Journal, August 7, 1897.) April 28, 1897, I was called to see AY. T. B , age 43, who had been injured by the explosion of a mud drum. I saw him an hour after the accident and found him suffering intense pain and wildly delirious; severely burned about the face, neck and upper portion of the chest, arms, and left hand, buttocks, thighs, legs and ankle. I dressed the wounds with limewater and linseed oil four day, and then a dressing of plain vaseline was substituted. May 22d, twenty-five days after the accident, the wounds were all healed except those of the calf and ankle of the left leg; on the calf was an ulcer eight inches long by four inches wide, and on the ankle a strip two inches wide, running nearly around the leg, both having a very unhealthy appearance, with deeply cut edges. I concluded it would be necessary to try skin-grafting, but wished first to get a healthy granulating surface. It was then I conceived the idea of treating it with bovine blood. May 23d — I first cleansed the ulcers thoroughly with the car- bolic solution, then saturated plain aseptic gauze with bovinine and covered the ulcers; over this gutta-percha tissue and wadding The following morning when I removed the dressings there was no pus, and healthy pink granulations were springing up over the ulcers. I changed the dressings every twenty-four hours, and could see a rapid improvement each time, the new skin extending in more and more from the edges. Improvement was so rapid I concltided grafting would not be necessary, and continued the bovinine dressings. June 4th, twelve days after beginning these dressings, the ulcers were entirely healed. One thing noticeable with the blood treatment was the absence of pain. Before I used it the ulcers were very painful, but after appfymg the blood dressing there was immediate relief, and the patient experienced no more pain. The case above quoted from the New York Medical Journal is exceedingly suggestive to the slow-learning and self-esteemed- conservative practitioner. It will be observed that Dr. Blanchard, instead of at once trying the magical treatment with which he evidently was acquainted, must hang back until he had exhausted 135 all the futilities of the traditional practice and prolonged the in- tense sufferings of his patient for nearly four weeks, before he "conceived the idea of treating it with bovine blood," as a last resort! — then, instantly put an end to the month's anguish, and in twelve days healed the enormous intractable ulcers by dressings of bovinine — which he might have done a month earlier. "Con- servatism, with a vengeance — of what? The sores and sufferings apparently. Humanity and medical science must, however, acknowledge an unwonted debt to Dr. Blanchard and the New York Medical Jour- nal, for the tardy action and information so long withheld. Or is it payment of a debt? Now, then, why not push it? Is there anything better that a medical Editor could do? For, the certainty of this practice was established in a thousand cases before Dr. Blanchard's — right under the noses of our New York medical jour- nals. LARGE EIGHTEEN MONTHS CHRONIC ULCER —SKIN-GRAFTED. Dr. T. J. Biggs, Sound View Hospital. Sam W , South Norwalk, Conn. ; age 38 ; case of Dr. B- February 1, 1899. In consultation found an ulcer of eighteen months standing, result of a burn on the left leg, over the calf; size six and a half by seven inches, and deep; had been treated by six physicians, and three times unsuccessfully skin-grafted; almost every kind of application had been employed, but 'had steadily grown worse. Patient was now chloroformed, the ulcer thoroughly curetted, depurated with bovinine and hydrozone and Thiersch irrigation and the wound dressed with iodof orm-bovinine ; this pro- cedure repeated every three hours. February 4th, finding the ulcer in healthy condition, six small grafts about the size of a split pea, were taken from patient's legs and arms, and deposited on the ulcerated surface at intervals of about half an inch; over them one thickness of gauze was sewed around the leg. The leg was put in a Kelly pad, and kept thoroughly wet with bovinine. Feb- ruary 9th, removing the gauze carefully, I found all the grafts firmly adherent and already beginning to extend. The wound was now dressed with bovinine pure, three times a day. March 1st, Dr. B. brought the case to see me. The wound had entirely healed, leaving a soft, pink scar. 136 LARGE FOUR-YEAR-OLD ULCER— SKIN GRAFTED. Dr. T. J. Biggs, Sound View Hospital. Henry G , Greenwich, Conn.; age 26; called by Dr. C- to see the case January 9, 1899. Ulcer of four years standing, the result of a burn, situated on outer aspect of right forearm; size four by five and a quarter inches. This ulcer had been treated at two hospitals and by three physicians, and had been skin-graft- ed three times, but all this had been stubbornly resisted. I sug- gested curettement, but the patient objected to an operation of any kind or to taking an anajsthetic; hence the next best thing had to be done. Sensation was deadened by spraying chloride of ethyl, and the ulcerated surface was thoroughly covered with a 25 per cent, solution of pyrozone; then irrigated with Thiersch and dressed with iodoform-bovinine. The nurse was instructed to change the dressing, first applying the pyrozone, every three hours. February 3d, found the ulcer in a healthy granulating condition; bovinine pure was now ordered as a dressing, to be changed every three hours. February 14th, again found the ulcer healthy, and healing from the edges. I now determined to skin-graft. Six grafts were taken from the patient's thigh, about the size of a small bean and placed at intervals of half an inch on the surface of the ulcer. As in the later cases, a thin layer of gauze was sewed firmly around the arm to hold the grafts in place, and the arm was kept on a rubber sheet, and the nurse was ordered to keep it wet with bovinine. February 20th, I removed the gauze and found the grafts all firmly attached, except one. Bovinine pure, as a dress- ing, was continued, three times in twenty-four hours. March 7th, Dr. C. brouglit the case to see me; the wound had entirely healed, leaving hardly the trace of a scar; simply a whitish discoloration. BLOOD CURE AND SKIN-GRAFTING OF CHRONIC ULCER- ATION— CASE XCIX. IN CHRONIC ULCERATION. By Dr. H , Boston. Ellen Murray; age 27; October 12, 1896; forearm denuded for a space of 5x2% inches, by ulceration consequent upon a burn re- ceived six months previous; under the various usual applications the sore had refused to heal. After preparing by depuration, seven pin-head points of skin were distributed over the wound, and dressed with bovinine in gauze, changed daily. At the third dress- ing the grafts were found all firmly adherent and growing; which continued, under same treatment, until the wound was entirely healed and covered with soft skin, November 27, 1896. Dr. W. W. Gleason, Attleboro, Mass., says: Not long since a workman in one of the large jewelry shops here was brought to me with his leg badly cut to the bone, a gash more than a foot long, be- ing also badly burnt by the friction of a rapidly revolving emery wheel. I cleansed the wound carefully, kept a rich blood dress- ing (bovinine) continuously applied, and to my surprise, in five days the wound was practically healed. 137 CURE OF BONE NECROSIS-RESUMED. The cure of ulcers of the most obdurate character by plain blood dressing after bovinine-peroxide depuration, without curetting or skin-grafting, is really a greater advance on the hitherto prevail- ing practice, then the successful surgery with blood treatment, which we have placed in front on account of the livelier interest attaching to the marvels of skin-grafting in blood. But we here postpone the mass of those simpler and therefore really more re- markable cures (referring to pages given for them in the Index), in order to make room here in the foreground for the equivalent yet more striking process of rebuilding Bones that have rotted away; employing either pure bovinine only, or packing the shell with sponge saturated with bovinine, which speedily becomes bone. Above all, however, the solid repair of a trephine opening in the skull at Sound A'^iew Hospital, by simple applications of bovinine, astonishes surgeons who have seen it, and develops indignant dis- belief in those who have not seen it and do not wish to. And yet, it is far less credible to fill a hole in a healthy skull with a new growth of bone, than to do the same in a case of foul necrosis, that has eaten through bone to marrow and is pouring out corruption through a sinus. At all events, the blood repair of each of these varieties of bone-destruction, and by each of the methods, is here introduced in one chapter, and referred to in the Index. Cases of Tubercular Necrosis have already been given preced- ence, under the head of Tuberculosis, and may be found by consult- ing the Index. TRAUMATIC NECROSIS OF RIBS. Dr. T. J. Biggs, Sound View Hospital. John S , Glenbrook, Conn.; age 34; February 24th; necrosis of left sixth and seventh ribs; result of a former operation for empyema. The lung and pleura had healed, but the sixth and seventh ribs were necrosed for about one and a half inches in length, and half way through the shaft of the bone. I advised an immediate removal of the necrosed bone, but this the patient re- fused to allow. I therefore decided to try and rejuvenate the bone by means of supplied blood. The wound was depurated with the bovinine and hydrozone reaction, followed by Thiersch irrigation, and bovinine dressing, repeated every two hours. March 19th, the bones were covered with periosteum, and the wound entirely healed, leaving hardly the trace of a scar. 138 BONE KECONSTRUCTION: ORDINARY AT SOUND VIEW; UNKNOWN ANYWHERE ELSE IN THE WORLD. FRACTURE OF PARIETAL BONE: DEPRESSED PLATE REMOVED, REPLACED, AND RECLOTHED WITH SCALP. By Dr. T. J. Biggs, Sound View Hospital. Emma Carr, Boston, Mass. ; age 29; came on, July 6, 1898. One year before, while riding a bicycle, was run into by a wagon, the shaft striking the right side of her head and producing a de- pressed fracture of the parietal bone, over the fissure Rolando, which resulted in aphasia and aphonia, with gastro-intestinal dis- turbance. On the 7th, a button of bone was cut out at the site of injury, revealing the inner plate pressing down on the brain. Rais- ing this, the irritated and inflamed dura mater was treated with bovinine pure, applied through a medicine-dropper. Meanwhile, the button of bone was put into a closely sealed bottle of bovinine and salt solution, kept at a temperature of 90 degrees by an alcohol lamp. Application of bovinine to the dura mater was continued every two hours for three days, by which time the area of inflamma- tion had entirely disappeared. The button of bone was then taken from its bovinine bath, washed in hot Thiersch, reinserted where it came from, and wired securely in position with four silver wire sutures. The surrounding periosteum was dissected up and brought over on the reinstated button of bone, secured there by sterilized catgut sutures crossing from side to side, and then dressed with iodoform-bovinine. This dressing was changed every two hours until the 12th, when the catgut sutures had become pretty well absorbed, and the remaining portions were removed. The periosteum was found firmly adherent to the reinstated button of bone, and repair proceeded rapidly and thoroughly. On the 20th, the silver-wire sutures were removed, and the scalp was now dis- sected up and brought over the bone, which had become covered witE" periosteum and firmly adherent all round in its place. The edges of the scalp were brought in apposition by eight silk sutures. On the 27th these sutures were removed, and on August 2, 1898, the patient was discharged cured; the aphasia and aphonia having entirely disappeared, and the gastro-intestinal disturbance as well. Bovinine having been taken internally from the first, beginning with a teaspoonful, and after ten days a tablespoonful, every three hours, the patient had gained five and a half pounds in the four weeks under surgery. [This case, as one among many to the same effect in the applica- tion of HaBmatherapy to bone lesions of every degree, will be inter- esting to the profession as far as it may come to their notice, in evi- dence that instead of throwing away the button of bone and leav- ing the gap in the skull to a skin covering, or an artificial plate, there is no difficulty or doubt of success in re-engrafting and reno- 139 vating the skull or other bones by the aid of topical blood nourish- ment.] ABSOLUTE RE-CEEATION OF EEMOVED SKULL BONE BY TOPICAL BLOOD SUPPLY. In view of the unvarying success of tojjical blood supply in the healing and repair of diseased bone, it is all the more to be expect- ed, although to most persons it will seem still more startling and incredible — that a large trephine opening in the healthy skull or other bone, could be directly filled up with new and solid bone by the same simple agency, without plugging or grafting. The first instance of such repair of a trephine perforation, is given below, from Sound View Hospital, by Dr. T. J. Biggs; and the case being so novel and important, the technique is reproduced in detail. His previous trephinings had been repaired by replacing the button of bone in the perforation it had left, and feeding around it with bo- vinine. This was an entirely new thing in surgery, and a very im- portant contribution to human welfare; the best previous expedient for the protection of the uncovered brain, having been the me- chanical attachment of a thin metallic plate over the dangerous opening — the plate itself being almost as dangerous still, in case of accident. TREPHINE FOR EPILEPSY: PURE BLOOD-REPAIR OF SKULL. By Dr. T. J. Biggs, Sound View Hospital, Stamford, Conn. Matthew D , Stamford, Conn.; age 28; January 15, 1899; diagnosis, epilepsy. About three years previous, while playing baseball, patient had been knocked senseless by a blow over the left superior orbital arch ; remaining so for nearly an hour. A few weeks later, daily fainting spells had come on, and this was fol- lowed in two months by regular attacks of la petit mal. Although attended constantly by physicians, from the beginning, his condi- tion gradually developed into a well-defined case of epilepsy. He was taken to New York and examined by various specialists, and their suggestions were carefully followed, but without avail, his condition steadily growing worse. At the time I first saw him, as above stated, he was having an average of four fits a week ; the sight of the left eye was badly affected; his general physical aiid mental condition was so bad that he could do no work, and could go no- where without the care of an attendant; and so discouraged was he that he said he wished he could die. 140 I concluded, from a careful examination, that this trouble was due to pressure on the brain, resulting from the blow received three years ago, and that an operation was the only thing that could give promise of relief. To this he readily consented; but to make doubly sure of the cause, and also to locate it accurately, on Janu- ary 18th, assisted by Dr. Lloyd, of the New York I*ost Graduate School, I made a thorough fluoroscopic examination of his head. Both Dr. Lloyd and I distinctly joerceived a line of opacity at the site of the former injury, which conclusively proved my diagnosis. The patient's condition of debility and disorder being such as before mentioned, I determined to build him up by a course of pre- paratory blood treatment before operating, and put him on a wine- glassful of bovinine in milk every three hours. January 31st, as- sisted by six of my colleagues, I performed, under anaesthesia, the following operation. Over the site of depression, I made a trap-door flap of the fascia3 and muscles, down to the periosteum. This was carefully dissect- ed back, and following this, I made a trap-door flap of the peri- osteum, and, with the largest-sized trephine, cut out a button of bone, and finding the dura mater adherent at one point to the bone, this was carefully dissected off, and the button of bone removed. Examination of the button showed visible depression, although the brain was found to be in a healthy condition otherwise. To be certain, however, that I had located the exact point of lesion, I pressed my finger on the point where the dura had been at- tached to the bone; and, although the patient was under profound anaesthesia, the pressure produced a well-defined epileptic fit. The wound was now purified with hydrozone on bovinine, and gently mopped out with Thiersch solution. Two flat strips of a quill were then laid across the opening, the ends resting on the bone on either side, to prevent depression and adhesion of the perios- teum, when replaced, to the dura. The flap of periosteum was then brought down, and stitched all around, with the finest catgut, to that from which it had been separated. On the right side, the ends of the quills were allowed to project beyond the stitches. The flap of fasciae and muscles was not brought down at this time; the purpose being to feed the periosteum on both sides with blood through a slit, so as to form new bone. To this end the hea/1 was covered with a canopy of Thiersch-wet gauze, and bovinine was ap- plied to the periosteum every two hours. Continuing this proced- ure up to Februnry 14th, at this time, the periosteum had become so filled with ])one cells that 1 considered it safe to remove the quills, and as it did not collapse at all, I decided to bring down the 141 flap of fasciae and muscles. This, after freshening the edges, was stitched in place with a buried suture of silk, and the wound was dressed with bovinine pure. This healed by first intention; and on February 22d the suture was removed. Bovinine internally was still continued as at first. The patient had now improved greatly in both physical and mental condition; had gained in weight and strength; his memory had greatly improved; the sight of left eye was already normal; and he had not had a fit since the operation. On March 23, 1899, although still retained in the hospital for a study of his case, he was discharged from treatment, really cured. And at this time, an examination over the site of operation showed that new bone had formed over the opening, with perfect solidity, as firm to pressure as any part of the skull. The rapid and entire re-creation of skull throughout the tre- phine opening, by the constructive powers of applied blood; the perfect success of the novel and delicate technique of repair; and the immediate cessation of the fits and mental symptoms, on the removal of a minute projection of bone which had formed over the brain ; are points of surpassing interest to surgeons who can appre- ciate them irrespective of foreign prestige. BONE NECROSIS— CASE XVI. By Dr. R , New York. Martin Carrigan; age 40; June 14, 1897; necrosis of the distal phalanx of the left forefinger; entire posterior surface necrosed and the bone denuded of periosteum; large accumulation of pus. The patient had been to several institutions, at all of which he was refused any treatment short of operation, as absolutely necessary. I quite agreed with the rest, but he stubbornly rejected it. The necrosed tissue was now thoroughly removed; the wound sterilized and depurated with the bovinine-peroxide reaction, then packed with gauze saturated with iodoform-bovinine, and dressed. After twenty-four hours, this was repeated and the wound repacked with pure bovinine in gauze. Still repeating the treatment daily until June 20th, the bone was then found to be restored and completely covered with periosteum. July 6th, the case was discharged in perfect repair ; the finger almost po.rmal in appearance. 142 NECROSIS OF ALL METATARSAL BONES, WITH FOUR SINUSES: CONDEMNED TO AMPUTATION: BLOOD-CURED. Dr. T. J. Biggs, Sound View Hospital. Victor E ; Stamford; Swede; age 39; July 13, 1898; a large opening in the dorsal surface of the foot, had been made by the surgeon in charge, and a cellulitis had begun. I introduced a probe on the dorsal side, and found four sinuses: one directly through the foot, opening out on the plantar side; another leading back as far as the os calcis; another extending back to the right cuneiform bone; and a fourth running directly into the body of the astragalus. The metatarsal bones seemed all to be affected- with necrosis. The wound was exuding large quantities of puru- lent matter, and the patient was suffering intense and constant agony. Six months before he had stepped on a nail, driving it through his foot. In spite of usual treatments, the wound soon showed de- cided infection. A surgeon was called in, and of course proceeded to drain the wound; but made the mistake of opening the dorsal instead of the plantar surface, in consequence of which the wound was but poorly drained. An opening occurred spontaneously on the plantar side; the condition steadily grew worse, and on July 11th the surgeon told the patient that the only thing to be done was to amputate immediately. Instead of this, the patient decided to try another surgeon, and on July 12th was taken from his house to Sound View Hospital'at 8 a. m., and at 8.30 the late surgeon arrived at the house with his instruments to take off the limb, but the bird had just flown. An incision two and a half inches long was made on the plantar side of the foot, and another two inches long on the dorsal side. The wound was then thoroughly scraped, and all points of necrosed bone removed; taking away half of the metatarsal bone. After the cavity was thoroughly cleaned out, I could carry my index and middle fingers together clean through the foot. It was now ready for final depuration and dressing : two ounces of pure bovinine were injected through the cavity, followed by tM'o drachms pure hydro- zone (I having determined on this substitute for peroxide of hydro- gen for purposes of depuration generally hereafter, as being strong- er in oxygen, and so giving more perfect effects.) After the reac- tion had ceased, the product was washed out as usual with plain Thiersch, the cavity was dried, and packed with iodoform-bovinine gauze, an ordinary dressing being applied to the foot. Patient was put to bed, and in an hour and a half later was sitting bolstered up 143 sipping a little bovinine and milk and entirely free from pain. Nurse was ordered to give him a teaspoonful of the bovinine and milk every hour. The wound was thus dressed regularly until August 26th, and thereafter the excavated bones and flesh were treated with pure bovinine dressings, the wound healing rapidly and firmly, and the bone cavities filling up, without interruption. Now, a very remarkable thing was observed : the section of meta- tarsal bone removed had become entirely replaced by new bone; all cavities were filled, and the bone surfaces were entirely covered with healthy periosteum. October 20th, the patient was dis- charged cured, with two perfectly sound and normal feet, and twenty-four and a half pounds of new and additional flesh. All through the treatment, patient experienced no pain, and im- mediately after the first application of bovinine the cellulitis en- tirely subsided. A DESPERATE TRAUMATIC CASE OP BONE NECROSIS BLOOD-REPAIRED. By Prof. Wm. A. White, M. D., Tufts' College Medical School, Boston. [Abstract from Atlantic Medical Monthly.] The patient, a lumberman, had cut his foot with an axe, from the base of the second metatarsal through the middle cuneiform into the scaphoid bones. The cut measured two and a half inches in length, and deep enough to split the middle cuneiform in two. Dilatory treatment and uncleanliness had resulted, by the sixteenth day, in a condition apparently fatal to the preservation of the foot. The injured bones were found to be necrosed and very loose, and the deep, poisoned wound in a state of exuberant suppuration. All the tarsus bones had to be removed, except the os calcis and astra- galus and part of the cuboid; also the base of the first metatarsus was removed. The cavity was curetted and sterilized, packed with iodoform gauze, and left for three days, after which, the cavity was packed with iodoform gauze soaked in bovinine. By the thirty- first day of this treatment, the patient was walking with the as- sistance of a cane, and five days later left for his native Italy, where he is since reported regularly at work on a farm, and "not much lame." 144 FIRST ULCERATION AND NECROSIS OF BONE REPAIRED BY BLOOD TREATMENT. Dr. T. J. Biggs, New York, [Abstract from "The New York Polyclinic."] Ellen Sweeney, age 24; at New York Polyclinic; October 29, 1893; felon of the right index finger; extensive phlegmonous in- flammation, the flexor tendon for about three inches of its length being found to consist of one long slough, and was snapped in half without being submitted to undue tension. The pus had bur- rowed upward to almost the center of the palmar surface of the hand and in depth to the bone itself, which was denuded of perios- teum for almost its entire circumference. It was so devoid of an appearance of healthy bone that the patient was instructed to re- turn the next day for amputation of the finger. But physiological treatment was tried instead. The sloughing soft parts were scraped away, including almost the entire length of tjie flexor tendon of the index finger, and leav- ing an open wound about four inches in length and three-quarters of an inch in breadth, leading down to the bone at the bottom, ex- posed and denuded of periosteum. There was no discernible bleed- ing of the surface of the bone or variation from the general darkish hue which indicated an almost total lack of nutrition. For twenty- four hours the wound was treated antiseptically, and subsequently the only application employed was the sterilized preparation of ox- blood known as bovinine. Daily, the cavity was filled with bo- vinine, and an outer covering lightly applied. The bone and sur- rounding soft tissues progressively regained their normal appear- ance, and the process of repair was uninterrupted from that time on, and the finger is now fairly serviceable. EXTENSIVE NECROSIS OF TIBIA. Dr. T. J. Biggs, Sound View Hospital. Will Mullins; Bridgeport, Conn.; age 38; September 30, 1897; necrosis extending from the middle of upper third to the middle of lower third, in the shaft of the tibia, though not very deep. Pa- tient was put to bed October 1st, and prepared for operation. On the 7th the necrosed cells were entirely removed with bone chisel and mallet; the cavity was touched up with 25 per cent, pyrozone, injected with the bovinine-peroxide and washed out with Thiersch; then packed with strips of bi-sterilized gauze saturated with bovinine. The cleansing and packing were repeated twice a day until the 19th; then once a day to November 3d; the patient taking all the time a tablespoonful of bovinine in grape juice every three hours. On November 4th, the cavity being nearly filled with new bone, bovinine direct was substituted for the bovinine pack-, ing. On the 5th, the wound and cavity being absolutely healthy, the edges were brought in apposition by strips of rubber plaster, and covered with a bovinine dressing. On the 15th the wound was entirely healed, and on the 16th the patient was discharged. 145 DEEP AND EXTENSIVE NECROSIS OF TIBIA, Dr. T. J. Biggs, Sound View Hospital. Louise G ; Bridgeport, Conn.; age 37; October 26, 1897. Tremendous necrosis of tibia, extending from about the middle of the lower third to centre of upper third, resulting from the kick of a horse. Had been treated by a succession of physicians and methods, without result; the last advising operation, for which the patient now came to this hospital. The necrosed portion of bone proved to be fully half an inch in diameter, reaching to the medullary canal, and taking in almost the entire anterior surface of the bone. The periosteum was further badly diseased in spots. After carefully dissecting the periosteum back, the necrosed bone was thoroughly chiselled out, and the cavity sterilized for forty-eight hours, then depurated with peroxide of hydrogen on bovinine, and packed with gauze saturated with pure bovinine. This process and application were renewed regularly until the 15th, when the cavity had became entirely filled up with new bone, which was entirely covered with new periosteum. NECROSIS OF PATELLA— SPONGE-GRAFTED. Dr. T. J. Biggs, Sound View Hospital. Anna L , Glenbrook, Conn.; age 19; June 8, 1898; had been operated on by a physician, but the necrosis only extended. Fol- lowing operation, the bone cavity had been treated with various injections and packings, but with no effect. Patient was now put to bed, secretions regulated, and on July 10th, the necrosed cells were removed; the cavity was depurated by the bovinine-peroxide reaction, etc., and packed with bovinine gauze, twice in twenty-four hours. So much of the bone had been removed that a mere shell only remained, and on July 11th, after again thoroughly sterilizing the wound and cavity, a thin sponge graft was inserted, bovinine dropped on it, and dressing applied, repeated every twelve hours, to the 18th, when another graft was laid over this and treated in the same way. On the 26th, this had become vitalized bone, filling the cavity, or shell, entirely and solidly. August 1st, the stitches were removed, wound having en- tirely healed. TRAUMATIC NECROSIS OF KNEE PAN— NECROSIS CASE XV. Dr. T. J. B. Bridget Hines; age 49; May 12, 1897; necrosis in centre of right patella, result of traumatism a year ago. Had been treated at two institutions, growing steadily worse. May 13th, the necrosed cells were removed, the cavity sterilized, packed with gauze soaked in bovinine, and dressed. The bovinine dressing was changed twice a day and later once a day. June 3d, patient was discharged cured ; the cavity having filled up with new bone, and new tissue being formed over it, with a soft pink scar. 146 OLD BULLET IN HEAD OF TIBIA: CAVITY REPAIRED BY APPLIED BLOOD. By the Same Surgeon, Sound View Hospital. Pat Walsh, Bridgeport, Conn.; September 8, 1897; age 31; bul- let in head of tibia. Examination per X-ray revealed a 38-calibre ball in the head of the tibia. Patient was shot two and a half years ago, and during this time had suffered greatly from pains in and around the knee joint. Until the 22d, preparatory treatment was given, and on the 22d, after etherization, an incision was made, the periosteum was incised and raised for two inches, and a small-sized trephine opened up thoroughly the head of the bone. Thanks to the X-ray, the bullet was found right in line with the opening that had been made in the bone. The ball was removed intact, the cavity was thoroughly cleansed by the bovinine and peroxide of hydrogen process and washed out with Thiersch solution; after which, it was packed with iodoform-bovinine gauze, changed twice in twenty-four hours until the 25th; after which, no sepsis being present, the packing" was discontinued, and bovinine pure was dropped into the bone cavity twice a day ; the cavity being first thoroughly depurated as at first every time. On the 30th, the bone had become filled up and entirely covered with periosteum. A remarkable fact in this case was the peculiarly rapid filling in of new bone by the topical blood nourishment; occupying barely one week. NECROSIS OF COCCYX— BOTH PREPARATION AND REPARATION WITH BLOOD. Case by Dr. H — — , New York. Frank Bulmer; age 52; had been operated on December 6, 1896, for necrosis of coccyx resulting from traumatism several years be- fore. At the present time, the resulting abscess was discharging through a small sinus leading down to the middle segment of the bone and to a superficial necrosis. An incision was made expos- ing the necrosed surface, which was first thoroughly scraped off and the cavity sterilized with Thiersch and peroxide-on-bovinine. The cavity was then packed tvith gauze saturated with bovinine, re- newed every day until December 26th, when the bone was found restored to normal condition, the periosteum completely restored. ' BONE NECROSIS— BLOOD REPAIR— CASE XI. By Dr. L , Assistant to Dr. Connor, Cincinnati. Jim Logan; age 29; October 19, 1896; necrosis of left tibia, three and a half inches long. Necrosed portion of bone removed; cavity cleansed and sterilized, then packed daily with bovinine in gauze. By November 20th, the cavity was filled up with new bone and nearly covered with periosteum. December 2d, periosteum com- plete. December 14th, wound healed, with a pink scar, and no de- pression of surface. 147 BLOOD CURE OF NECROSED BONE CONDEMNED TO AMPUTATION— CASE XIII. By Dr. J. B. Rich, Worcester, Mass., Hospital: reported by Dr. Brown, of Athol, Mass. Wliile practising in North Brookfield, a young man with a pro- nounced case of osteomyelitis of the tibia, very much diseased, by my advice was taken to the Worcester Hospital. It was decided to amputate, but amputation was postponed, and instead, an operation was had in which all the dead bone possible was cut out and dress- ings of bovinine made. The leg healed fully, and the man is now about on his own legs. I understand that Dr. J. B. Eich, of Worcester, was the surgeon who suggested the use of bovinine in this case. NECROSIS OF TIBIA AND BLOOD REPAIR. By Dr. T. J. Biggs, New York. Jerry Dillon; age 50; at Demilt Clinic; May 3, 1895; necrosis of tibia, five inches long and nearly through. In six months had suffered four operations with removal of bone (very little of it be- ing left) and all the regular surgical resources had been employed, without arresting the decay. The remnant was now a mere shell. Necrosed matter removed; cavity sterilized and packed with iodo- form in gauze; later with iodoform-bovinine, and then with pure bovinine, every other day, until filled up with new bone and cov- ered with sound flesh, July 6th. TRAUMATIC NECROSIS OF BONE— SPONGE-GRAFTED WITH BLOOD— CASE LXXIII. Dr. T. J. Biggs, New York. John O'Brien, 195 Mulberry St., New York City; age 56; Octo- ber 3, 1893; deep necrosis on anterior surface of tibia, about three inches long. The wound was rendered aseptic, and the necrosed tissue removed, leaving a mere shell of bone. The cavity was grad- ually packed, at intervals, with thin layers of sliced sponge soaked in bovinine, and kept so, until the sponge vitalized and became solid bone, filling up the cavity, and case discharged cured, December 10, 1893. NECROSIS OF BONE REPAIRED WITH BLOOD— CASE X. By Dr. T , Covington, Ky. James Tandy; age 31; October 3, 1896; necrosis of the os calcis of the left foot. The cavity was cleaned out; depurated by per- oxide of hydrogen on bovinine ; dried, and packed daily with steril- ized gauze soaked in bovinine. The cavity filled up rapidly with new bone, and by November 5th was covered with periosteum. What is most significant of the reparative power of the supplied blood, is the extraordinary fact that an excavation of at least one- third of the bone had been refilled with new bone, within a very little of the normal size. 148 NECROSIS OF MASTOID AND OSTEOMYELITIS. By Dr. T. J. Biggs, Sound View Hospital. Annie B , South Norwalk; age 30; February 3, 1898. Tu- bercular osteomyelitis of left mastoid. Four holes were drilled down into the body of the mastoid process, going deep below the diseased cells, and converging to a junction below them, so that both the clearing and the healing applications going into either of these channels would flow out through all the other three. A bovinine-peroxide injection was forced through the bored chan- nels and washed out with Thiersch solution. Bovinine was then dropped into the holes, and they were packed with gauze saturated with the same. This entire process was repeated twice a day, to the 17th, when the diseased parts were found to have been separat- ed wholly from the healthy body of bone, and were lifted out in a mass, leaving the whole interior a healthy granulating surface. The cavity was washed out with Thiersch and dressed with bo- vinine twice a day, to the 25th, when it had filled with new bone. March 1st, the wound was entirely healed over, and the patient dis- charged. NECROSIS OF MASTOID PROCESS. By Dr. T. J. Biggs, Sound View Hospital. Mrs. C , age 2.9; first seen April 1, 1896, in a ISTew York hospital, after an operation for a mastoid abscess which had con- sisted in chiselling out the bony cells and packing the cavity with iodoform gauze: result, necrosis at the depth of the cavity of the mastoid process. So much bony tissue had been removed, that it was perilous to excavate farther. Dr. B was permitted to ap- ply blood nourishment to the decaying bone. After the cavity was thoroughly cleansed, it was packed with gauze saturated with bo- vinine, and the cleansing and packing were repeated down to May 3d, when last seen, and the necrosed space was nearly filled with healthy bone, the periosteum forming over it, and the lips of the flesh wound in a healthy condition. BONE NECROSIS AND SINUS— CASE XII. By Dr. T. J. B , New York. Jennie Alexander; age 29; January 7, 1897; necrosis of right maxillary bone, result of decayed teeth, and penetrating an area of one by one and a half inches. A sinus had opened externally, down to the depth of the necrosed cavity. An incision was made over the necrosed area, cutting through the sinus, and the ne- crosed portion of bone was removed. The cavity was then steril- ized, and packed with gauze soaked in iodoform-bovinine, for twen- ty-four hours; depurated with peroxide-on-bovinine and packed with gauze soaked in plain bovinine; repeated daily. February 1st, the cavity was filled with new bone and covered with periosteum: February 7th, or at just one month, the patient was discharged in perfect repair, showing only a soft, pink scar, with no depression of surface. 149 ABSCESS AND NECROSIS OF MASTOID PROCESS. By Dr. T. J. Biggs, New York. Mary Casey; age 28; June 29, 1896; abscess of the left mastoid process, wliich had been treated at several institutions. The abscess dipped down well into the cells of the mastoid process, re- vealing an extremely necrosed condition. The necrosed tissue was removed, the cavity well washed out and packed with bicliloride gauze. After twenty-four hours, and after again thoroughly cleansing the cavity, it was packed with gauze soaked in iodoform- bovinine, repeated to July 6th, followed by pure bovinine dressings, till the 12th, when the patient was discharged, the healing being complete. PARONYCHIA OF THUMB, Dr. T. J. Biggs, Sound View Hospital. Mr. A K , Greenwich, Conn.; age 30; May 14, 1898; paronychia of thumb, result of a blow ; thumb fearfully enlarged, large accumulation of pus and suffering so intense that the patient had to be brought by three friends, in a wagon, and was unable at times to refrain from crying out. ' Operation was performed under A. C. E. mixture, and the thumb freely laid open; depurated with the bovinine-peroxide and Thiersch, and packed with iodoform- bovinine gauze. After etherization, to the time of discharge, the patient experienced no pain whatever, except that produced mo- mentarily by the daily (bovinine) dressing. Discharged cured, June 2, 1898; a remarkably short time for a case of this class. TRAUMATIC BONE NECROSIS. Dr. T. J. B., Sound View Hospital. Matilda Freyhoff; age 26; September 27, 1897; necrosis of the first phalanx of left index finger, resulting from a blow causing a periostitis. The necrosed bone cells were removed, the cavity was sterilized, cleansed by the bovinine-peroxide process, and packed with gauze soaked in bovinine; this operation was repeated until October 7th, at which time the bone was completely filled and covered with periosteum. BLOOD REPAIR OF BONE NECROSIS— CASE LXVIII. By Dr. B . Emma Eobbins, 441 West 47th St., New York City; age 30; at New York Polyclinic, December- 2, 1893; necrosis of entire anterior surface of the first phalanx of index finger, the bone being wholly denuded of periosteum. Necrosed bone removed, wound packed with bovinine and repeated until healed, January 6, 1894. FROM DR. CARL L. JOHNSON, A. B., M. D., FROM UPSALA UNIVERSITY, SWEDEN. I only deplore that bovinine had not been brought to my knowl- edge before, as I probably could have cured many chronic cases to which I have had to give only palliative treatment. Two cases T am now employing it on are doing nicely: one of necrosis of the malar bone, and the other fistula and marginal ulcer of anus. 150 SHORT BLOOD REPAIR OP A COMPOUND FRACTURE OP HUMERUS. By T. J. Biggs, Sound View Hospital. Joe Pettig, Stamford; Slav; age 30; September 29, 1898; com- pound fracture of humerus resulting from a violent blow. Sep- tember 30th, assisted by Drs. Phillips and Hoyt, I cut down over the humerus, from the insertion of the deltoid down to the lower end of the shaft. Six spiculae were removed. The wound was then thoroughly washed out, and the bones were drilled and brought together in three places with silkworm gut. After de- purating the cavity with the bovinine-hydrozone reaction and Thiersch wash, and thoroughly drying it, a piece of gauze was packed gently all around it at the different points of fracture, care- fully adjusted, and bovinine pure was poured into the wound ; then an ordinary bandage was placed over it. Over the splint and dress- ing was applied a plaster of paris bandage, which was allowed to dry and a trap-door was cut through it to admit the application of bovinine every hour, to keep the gauze within moist. All this was repeated again and again until October 10th, when the gauze pack- ing was discarded and bovinine pure was directly applied, dropping it into the wound once in two hours, and depurating over again twice in every twenty-four hours. By the 25th, the bones had be- come firmly reunited, and on the 31st, the wound was entirely healed, and the case was discharged cured. Points of great interest in this case are the short time in which the bones thoroughly united and wound healed: usually six weeks being required for ordinary transverse or oblique fractures to unite ; while here there were three points of fracture and compound at that, yet the whole repair was completed in thirty-four days. I am convinced that if all fractures were treated by the open wound method, using bovine blood to hasten repair, no such thing as de- formities or ligamentous unions need ever result. COMPOUND FRACTURE OF HUMERUS; WITH SUPPURATION AND NECROSIS OP BONE— CASE II. By the Same Surgeon, Sound View Hospital. George S , Stamford; Eussian; age, 34 years; compound frac- ture of humerus; middle third; October 24, 1898. It was a com- plete oblique fracture; the wound was foul and filled with pus, and a necrosis had begun at the end'of lower fragment. The patient was put to bed, on a milk diet, the stomach and rectum washed out, and twenty-four hours later, under chloroform, an incision five inches long, commencing at the insertion of the deltoid, was made ; the wound was depurated with a bovinine-peroxide reaction and washed out with Thiersch solution; the necrosed portion was re- moved; the ends of the bones were rounded and dove-tailed, drilled and brought in apposition, and held by silkworm gut. A piece of gauze saturated with iodoform-bovinine was wrapped around the bone at the point of incision, and the wound was packed with iodoform-bovinine gauze, and the arm done up in splints. 151 This procedure was repeated until November 30th, at which time the union was complete, and the wound virtually healed; the pa- tient was able to use his arm and was discharged within the week. COMPOUND FRACTURE OF HUMERUS— CASE III. By the Same Surgeon, Sound View Hospital. George Szlmnak, Stamford; Russian; age 34; November 8, 1898; compound fracture about the middle of the shaft of the humerus; operation November 11th, performed as follows: An incision four inches long was made, beginning at the insertion of the deltoid muscle, which carried it through the wound in an oblique direc- tion, so as to miss the musculo-spiral nerve. The wound was thor- oughly cleansed with bovinine-peroxide, and then washed out with Thiersch solution; the ends of the fragments of bone were rounded off, brought in apposition, and after being drilled were held in posi- tion by silkworm gut. The wound was then packed with iodoform- bovinine gauze, and dressed per technique of ulcer dressing. This was renewed every twelve hours, until November 24th, when bo- vinine pure wa? r^bstituted. December 6th, the bone was entirely covered with p'Griosteum, and was firmly and thoroughly united. December 20th, patient discharged cured, with his arm restored to its full usefulness. The rapid healing of this is unexampled, except in the two cases preceding, and was undoubtedly due to the local nutrition afforded by the auxiliary blood supply. COMPOUND COMMINUTED FRACTURE OF RADIUS. A FOUR "WEEKS CURE. By the Same Surgeon, Sound View Hospital. John Kalish, Stamford; age 30; July 6, 1898. As the result of a blow, the bone was fractured in seven places, and protruding at three. In this case, I carried the incision from the radio-carpal articulation to about two-thirds the full length of radius. I care- fully dissected down to bone, taking care not to injure any ten- dons, and then thoroughly sterilized the woimd by the antiseptic reaction of hydrogen-peroxide on bovinine, with Thiersch irriga- tion. The edges of fracture were next brought into apposition and wired together; after which the arm was put in a plaster cast, with an opening left at the top to dress the wound through. Through this opening bovinine pure was applied every two hours, day and night, up to July 15th, when the wound was found to be in a healthily granulating condition. July 20th, three wire sutures were removed; the bones having fully, but not firmly, reunited. The plaster cast having been removed, the edges of the flesh wound were freshened and brought in apposition and secured, with the exception of a small space at about the centre to allow removal of the last wire suture. The arm was then put up in a pasteboard splint, and carried in a sling. July 30th, the last wire suture was removed, and the opening of woimd over it was closed with strips of plaster. August 3, 1898, the wound had become closed, and the case was cured. 152 I know of no case in the history of surgery of so rapid and thor- ough repair from such a condition as this; the cure, when success- ful, usually taking at least two months in cases of compound frac- ture ; whereas this cure, under the reconstructive agency of supplied blood, was completed in less than a month. BOVININE KEPAIE OF A DESTEOYED AKM. By Dr. Albert Dunlap, Creston, Iowa. October 23, 1896, a man 63 years of age, with the left forearm mangled out of the semblance of a limb, both bones mashed into small pieces, muscles hanging in shreds and torn loose from fascia, from wrist to elbow, and partly gone, the very tendons hanging out ; in a remote rural locality with the most unfavorable surroundings and no modern facilities or resources at hand; three hours already lost without a thing done since the accident; nothing then avail- able but to put the strips of flesh and fragments of bone hastily in place, with splints and a wet dressing of boroliptol; after a long night ride to another patient, was able to get home for "bovinine" and return to apply the all-healing blood to the disintegrated limb just as it stood — instead of cutting it off at once, as the only allow- able course according to all opinions. After sixteen days, not a drop of pus; the wound granulating healthily; looks exactly like a slice of fresh raw beefsteak; no pain; swelling all gone; the ulna already knitted and showing some firmness; the posterior surface of the radius has original shape, and is easily traced and each frac- ture detected; but this bone is not knitting, being crushed into little pieces for some four or five inches; the anterior surface espec- ially seems to be ground up. He lives at some distance from Creston, but writes that the arm has healed and that he is able to use it. The last time I saw him was in the last of December, at my office, less than eight weeks after the accident. The bones were quite firm, and the external injury healed except a spot of the size of a ten-cent piece. I made a new set of splints, as he came without any protection on the arm, and told him that he must wear them until I said take them off. But I understand, indirectly, that he kept them on only a few days, and has since continued using the arm. 153 THE PITIFUL CASE OF FLORENCE COLEMAN. The entire records of Sound View Hospital, published month by mouthy have in two years gathered only two fatal cases; the mori- bund consumptive, taken in the last days of the last stage, and else- where recorded; and the subjoined case of spinal myelitis, which only an absolute refusal of any kind of operation prevented being cured, along with the paralysis of which it was a complication. These cases we insert in fulfilment of our pledge to make ALL results in blood treatment EQUALLY well known. * * * It is a melancholy fact, that ignorance of the saving virtues of blood still prevents a resort to that treatment until all other ex- pedients have been exhausted and the case has been practically given up by the medical profession as hopeless, and sometimes actually moribund. Consquently, all Sound View Hospital cases, with an occasional exception only, enter in a hopeless condition, and not a few with an immediately fatal prognosis. ISTevertheless, with still closer uniformity, those cases have gone out well, after one or two months; proving, not so much the superiority of that hospital in nursing and medicine commonly so called, but the in- comparable saving power of its unique resource — shame on the mod- ern oracles, that it can still be unique! — Supplied Blood. Florence C , Staten Island, N. Y.; age I71/2; July 22, 189S; old fractures of seventh and eighth dorsal vertebra?, total chronic paralysis of lower limbs, including sphincters of rectum and blad- der; and five enormous bed sores. When this child was brought to the hospital, and examined, I was obliged to notify her father that nothing effectual could be ex- pected from treatment, as she was in a practically dying condition, from having been shamefully neglected at the institutions where she had been under treatment. Nevertheless, beyond all expecta- tion, the treatment pursued was successful in curing the local lesions, and commencing a cure of the paralysis, the completion of which was cut short by prohibition of the necessary operation, and for want of this, a spinal myelitis, uninterfered with, ended the child's life, where even a belated operation would probably have saved it. A year and a half ago, she fell from a cherry tree, striking on a fence paling, and fracturing the spinous processes and arches of the seventh and eighth dorsal vertebrte. She was carried unconscious to a Staten Island hospital, where the surgeon removed the spinous 154 processes and part of the arches, but, unfortunately, not enough of them to relieve entirely the pressure on the cord, and the paralysis was not at all relieved. The doctors seemed to lose interest in the case, and the child was practically turned over to the nurses, who sadly neglected her. The father then removed her to one of New York's most famous hospitals. Here, after a few weeks experimentation by the house and visiting surgeons, the case was turned over to the nurses, as a hope- less one; and here, as at the other hospital, was again neglected to the same gross extent as before described; the nurses undoubtedly finding it quite as troublesome as the doctors had found it. As a result of the paralysis of the sphincters, there was, of course, incontinence of both urine and faeces, so that it was impossible to keep the dressings clean for any length of time, and I was told by her that she often lay for twenty-four hours in a mess of urine, fteces and putrid dressings, that made her sick at the stomach by their stench. " As a further result of this neglect, five bed sores started up : one on each heel, one on each of the nates, and one on the small of the back. These sores were dressed with all sorts of ointments, etc. (except, of course, the one sovereign healer, vital blood), but they steadily grew. Finally, father and child being both utterly disheartened, she was brought, in the usual course — dumped, as it were — into Sound View Hospital. When she arrived at the hospital she was so weak that she could not lift her head or hand; pulse 120 and feeble; respiration, 3i; temperature, 103.5. On account of this condition I dared not im- mediately dress the sores, but began to strengthen her with ten drops of bovinine in a teaspoonful of milk every ten minutes dur- ing the first few hours. I have seen many hundreds of ulcers, necroses, etc., but never a case so frightfully neglected as this. The bed-sores on the nates were as large as saucers, the ischia were pro- truding and necrosed, almost the entire sacrum being denuded; the OS calcis was completely uncovered by the sores on both heels; the rectum was packed with hardened faeces which had not been removed for days; the vagina was filled with foul-smelling mucus, and the bladder was so full of mucus as continually to clog up the catheter in removing the contents. This case was washed and dressed throughout, at least twice in every twenty-four hours, and sometimes three or even four times; urine drawn and bladder washed out every six hours; vagina washed out every day; faeces removed by hand, twice every twenty-four hours. This horribly repulsive night-and-day charity work im- posed on surgeon and nurses by humanity alone, for more than two months, had nearly broken them down when amazing paternal folly interposed to render all fruitless and close the scene. But meanwhile, the general condition at once began to improve, and the sores to heal; so much so that after the first ten days I urged the father to consent to my removing the remainder of the depressed bone ; assuring him that otherwise it might set up a fatal 155 condition at any moment. But this was positively forbidden. Still, however, the case continued improving, and the sores healed so well that by the middle of September they had been reduced in size by half, and periosteum was begining to cover the necrosed sur- faces of the bones. Then began a spell of hot weather, so trying that the patient within twenty-four hours developed an acute trophic myelitis with- in the fractured vertebrse. The indispensable operation was again urged, but forbidden ; and, consequently, in spite of everything else that could be done, the child sank under this phase of her disease, and died on the 26th of September. The condition had improved so much, sensation was beginning to return, and the bones and sores were healing so rapidly, that I am confident that if the father had allowed it, the child might have been restored at least to a comfortable condition for many years: even an absolute cure might possibly have been effected, in spite of the hopelessness of the case under any treatment practised else- where as vet. MALIGNANT TUMOES (EPITHELIOMATA) EXTIRPATED AND HEALED. BY MARGINAL INJECTIONS OF BOVINE BLOOD. BLOOD CURE OF EPITHELIOMA IN THUMB AND JOINT. Dr. T. J. Biggs, Sound View Hospital. John Spaulding, New Haven, Conn.; age 30; August 28, 1898; epithelioma of left thumb. He was advised to have it removed by amputation; the growth having involved entirely the first phalange and dipped down into the joint and upper part of the second. To this he absolutely refused to submit, and assumed entire responsi- bility for the consequences, under any treatment I might pursue. Here, then, occurred another occasion, or rather necessity, for ad- vancing the proof of blood treatment into a new and critical situa- tion. Under chloroform, the growth was curetted out as far as possible, and the thumb was laid open posteriorly to the bone, lodoform-bovinine was injected at six points, five minims each, and the wound was dressed with bovinine pure. Patient reacted nicely, and outside of a little tingling, suffered nothing from the operation. Bovinine dressings were constantly repeated, and October 9th, the cure was completed. The remarkable rapidity of obliteration and healing of such a growth, with the entire disappearance of all suspicious tissue is, I think, without precedent. 166 EPITHELIOMA OF URINARY MEATUS. Cured by Topical and Constitutional Blood Supply. Dr. T. J. Biggs, Sound View Hospital. Mrs. M J , Stamford, Conn.; age 50; January 29, 1898; thoroughly anemic, with all the typical symptoms; loss of strength and vitality; an unusually deteriorated quality rather than quan- tity of hsemaglobin, and but half a normal count of red cells in the blood. Four months before, a little red growth about the size of a pinhead, appeared on the left side of the outer lip of the urinary meatus. Her general condition then began to get rapidly worse, with loss of appetite, indigestion, and insomnia. Her physi- cian snared off the growth, touched up the site with nitrate of silver, and gave her calomel to dust over it. It then began healing; but this was temporary, and the sore soon began breaking down and extending around the meatus, growing rapidly, with severe and constant pain, and increasing weakness. My examination revealed the growth now entirely surrounding the meatus, and extending down on the upper portion of the labium minor. I advised immediate operation, but this was refused. Nothing, therefore, remained but to rely on topical and constitutional blood treatment. As she could retain hardly anything on her stomach, I determined to nourish her largely by rectal injections of bovinine. These, with bovinine per mouth, were retained, and she enjoyed immediate improved surface circulation and feeling of strength. Meanwhile, the growth and surrounding tissues were thoroughly cleansed every day with bovinine-peroxide reaction, followed by Thiersch irrigation, and iodoform-bovinine applied. After much persuasion, she was induced to submit to injection of the growth with bovinine, every other day, down deep in the growth and all around its edges, the outer surface being dressed daily with iodoform-bovinine. By the fourth injection, the growth began to shrivel and grow smaller; and on February 17th, it separ- ated from the surrounding tissues and came away; leaving a health- ily granulating surface. This was now dressed daily with pure bo- vinine, after cleansing with bovinine-peroxide washed off with Thiersch solution. February 2Gt]i, the patient was discharged, with the wound entirely healed, leaving a soft cicatrix. Her gen- eral condition had been restored almost to the normal; red blood eorjmscles very little short of full standard; ha^inaglobin normal in both quality and quantity; appetite and digestion good; sleep good; and a gain of six pounds in weight. The remarkable sloughing off of the entire epithelioma, leaving a clean healthy field of repair, in the most exquisitely vulnerable of situations, commands the attention of the profession to the sim- ple means and the easy success. * 157 CURED OF EPITHELIOMA BY TOPICAL AND GENERAL BLOOD SUPPLY. Dr. T. J. Biggs, Sound View Hospital. Sarah M , South Norwalk, Conn.; age 29; January 27, 1898; growth on right ear, involving the entire lobe. Tliree months previous treatment had only reduced the swelling, but the sore began to assume a malignant appearance and continued growing. The patient was at this time highly ansemic by all the symptoms; the red blood cells were only one-third of normal, while the white cells were in excess. January 29th, commenced internal treatment with bovinine every two hours, and topical treatment by injection thrice daily of bovinine and alcohol, deep into the growth on the ear. Follow- ing each injection the wound was dressed with pure bovinine three times a day. February 21st, the growth had disappeared, and the case was considered cured, and the general condition was strikingly improved. I had never known so rapid and complete a result in the treatment of epithelioma. EPITHELIOMA EXTIRPATED BY BLOOD INJECTIONS. Dr. T. J. Biggs, Sound View Hospital. Henry S , Stamford, Conn.; age 41; February 4, 1898; epithelioma of right ear, involving the lobe, of three months stand- ing. Had been treated unsuccessfully with the new specific called erysipeline, under which it had steadily grown worse. Alcohol with pure bovinine was now injected into the growth and into the line of demarcation all around, and it was dressed with iodoform- bovinine, three times a day. March 8th, the epithelioma had sep- arated itself from the healthy tissue almost entirely, and on the 9th I removed it with forceps, leaving a healthy granulating sur- face in its seat; about two-thirds of the lobe coming away. EXTENSIVE CANCER OF BREAST: OPERATION ORDINARILY HOPELESS. Dr. T. J. Biggs, Sound View Hospital. Mrs. H , Maysport Falls, N". Y.; age 40; January 15, 1899; extensive carcinoma of breast, involving all the axillary glands, the pectoralis major and minor muscles, and firmly attached to the ribs. After examination, I felt that there was little or no chance for her, but she insisted on operation, and I reluctantly consented to let her take this slight chance. After four days preparatory treatment, assisted by four of my colleagues, I removed the growth. As above stated, I found it to be firmly attached to the ribs, in- volving both the pectoralis major and minor muscles. These were completely removed, with the gland and axillary glands carefully dissected out. In weight, the amount removed was six and a half pounds. There was little or no hasmorrhage, and the patient re- acted nicely from the anaesthetic and for forty-eight hours follow- ing the operation did fairly well. The wound was dressed with iodoform-bovinine gauze, and at the second dressing was found to 158 be in a healthy granulating condition. Shortly after the second dressing there was a decided change for the worse in her condition. She developed a hystero-cataleptic condition, accompanied by ex- treme prostration. In spite of everything employed, she grew steadily worse, so that on the third day after the operation she was in a semi-comatose condition, and it was necessary to nourish her rectally with bovinine. This certainly did keep up her strength; but she had been sick so long, and the shock of the operation was so severe, that she was past all human power, and on January 26th she passed quietly away, and I can truthfully say that at no time after bovinine dressing was applied did she suffer any pain. Had this case come under my care six months earlier I believe I might have cured her. OTHER VAEIETIES OF CJIRONIC ULCERATIOISr AS TREATED WITH BLOOD. CASES OF CARBUNCLE— No. I. By Dr. T. J. Biggs, Nev/ York. July 6, 1895; John M- — — ; aged 45; at Demilt Surgical Clinic; a large carbuncle, one and a half inches in diameter, on the back of the neck. The little orifices of the first stage had united in one large ulcer, from which there was a profuse discharge of dead cellular membrane. Great prostration, loathing of food, headache, and other signs of low febrile impression. The case had been treated by one of our well known and excellent surgeons, with all the known medicaments suited to the condition (blood, being un- known, of course excluded) : all failing to check the devouring spread of the infection. Preparatory medical treatment Avas now commenced, and the next day, a tablespoonful of bovinine in milk every two hours. July 10th, local treatment was commenced by gently curetting the wound and applying a wet Thiersch dressing, for three days. By that time the wound was in a condition to absorb the blood dress- ing which was relied on to overpower tissue degeneration by vital reparation. Thenceforward, bovinine only was applied, twice a day, with dressings and antiseptics, until August 9, when the sore was completely healed. Still another remarkable result — unheard of even in the rare in- stances where a case like this has been healed, hitherto, but a logical inference from the nature of the topical blood treatment — was the renewal of the wasted tissue, filling up the place of the sore to the level of the surrounding flesh, and covering it, with but a slight pink cicatrix. 159 CASES OF CARBUNCLE— No. II. . By the Same Surgeon. John S ; at Demilt; August 3, 1895; carbuncle on the back of his neck; suffering fearful and incessant' pain, utterly prohibiting sleep and mitigated to bare endurance by one-eighth of a grain of morphine every three hours. The sore was exuding dead cellular membrane, like the former. Its edges were very ragged, and raised with inflammatory oedema, sho^¥ing high inflammation which ac- counted for the extreme pain. After constitutional medical and bovinine treatment, the ulcer was first dressed with wet bi-chloride of mercury, 1 in 500, and the next day, with a charcoal poultice substituted for two days, and (seventh day) the sore was curetted and put under a wet Thiersch dressing for the next two days; after which it was dressed with bovinine alone, until September 7th, when it was completely and smoothly healed, with no depression of the surface, and a hardly noticeable soft, pink cicatrix, the only trace remaining to mark its site. It is hardly necessary to add, that from the moment of apply- ing the bovine dressing, the agonizing pain at once subsided, as usual, and the three-hourly morphine was summarily superseded. CASES OP CARBUNCLE— No. III. A correspondent in England writes that the physicians of his ac- quaintance are becoming, like himself, enthusiastic over the local as well as systemic efficacy of supplied blood. He mentions ad- dresses in particular of four physicians in London and Deptford (which, of course, we do not feel at liberty to print) among those who are now achieving astonishing successes, in the treatment of ulcers, wounds, burns, abscesses, etc., on the same lines with niany others in this country. One of these gentlemen supplies a typical case, the patient a man of 72, in which a monstrous carbuncle had ravaged unchecked until the flesh had sloughed off down to the naked cervical vertebrae and tips of the shoulder blades. The enor- mous sore resisting all the usual expedients to heal it or stay its progress — as must have been the case at such a stage, with a patient of so great age — the physican, though convinced that the man must die, bethought himself of the blood treatment, and as a last re- sort, began the topical application of bovinine. Without giving time and particulars, the correspondent adds simply as the result that the man is alive today to show the place of the deadly car- buncle marked only by a faint pink cicatrix. Enraptured by his first experience, this physician has gone forward into a large prac- tice in ulcer cases, burns, wounds, etc., with the same quasi-miracu- lous success that attends the like treatment among us. IftO CASES OF CARBUNCLE— No. IV. By Dr. T. J. Biggs, Sound View Hospital. K C , Portchester, N. Y.; age 22; first seen May r 1898, with a well-defined carbuncle on the l)ack of the neck, of the size of a twenty-five cent piece, with four perforations. Patient said he had suffered for three montlis so severely that he could not sleep, and unless some relief could be afforded he must resort to morphine, which he had resolutely abstained from, having a dread of the drug. He was requested to be patient for twenty-four hours and see if he did not get relief. After thoroughly depurating the lesion with the bovinine-peroxide and Thiersch, I injected bovinine and salt solution hypodermically around it and dressed it with bovinine pure. In two hours, the pain had c^sed for the first time in the three months and did not recur. Dressed T\dth bo- vinine daily until June 3d, and discharged cured. CASE OF PERFORATING ULCER. Dr. T. J. Biggs, Sound View Hospital. Mr. E ; nativity, Swiss; age 40; August 1, 1897; small per- forating ulcer, probably specific; which had resisted -all customary treatments for six months; about an inch in diameter, just above the nipple on the right side; emitted a very foul odor, but very little excretion. Now, thoroughly cleaned up with pyrozone, and first dressed with wet Thiersch, then with iodoform-bovinine. After second twenty-four hours, the change in the ulcer was as- tonishing; its surface being covered with new and healthy granula- tions. It was now dressed twice a day with pure bovinine, under which it filled up rapidly, and by August 14th was completely healed, leaving a soft pink non-sensitive scar. HYPODERMIC BLOOD TREATMENT OF TRAUMATIC ULCER OF SIX YEARS STANDING— CASE LXXXVII. By Dr. T. J. Biggs, New York. Henry Coligan, 3241/^ East Eighth Street, Kew York City; age 76; ulcer had resisted all the regular treatments for six years. Topical hypodermic injections of blood (bovinine), \nth dressings of same, commenced ISlay 10, 1894, and repeated twice a week for two weeks. The ulcer being then about healed, the blood dressings alone were continued, until the cure was perfected, June 3, 1894. CHRONIC ULCER OF OLD AGE, CURED BY HYPODERMICAL BLOOD-INJECTION. By Dr. Greeley, of Nashua, N. H. "I have used the liovine blood preparation and sterilized water, equal parts, by hypodermic injection, in a case of ulcer on an old woman, and in three weeks it was perfectly healed." 161 BLOOD TKEATMENT OF COKNEAL ULCERS. BLOOD CURB INDEPENDENTLY DEVISED. By Dr. Louis B. Couch, Nyack, N. Y. (From the New York Medical Times.) The case was certainly extremely dangerous and apparently hope- less. Obtaining plenty of juicy round steak, I applied the juices expressed therefrom almost constantly to the wrinkled, shrunken cornea. The cornea gradually lost its haziness, the ulcerations healed without a scar, and today the eye is as bright and clear as its fellow. CORNEAL ULCERS. By Carl G. "Winter, M. D., Indianapolis. On Thanksgiving eve, 1895, I was called to see a child, aged fif- teen months, with corneal ulcer. I used all of the treatment gen- erally used in those cases, but my result was that I advised enuclea- tion in four days after the beginning of the treatment. This the family would not allow; and so, while thinking over the case, I thought of the blood treatment; used it locally and internally, and the ulceration was cured after treatment of twenty-two days. CHRONIC ULCERATION OF CORNEA. By J. T. Barnett, M. D., Hardinsburg, Ind. Lady aged 61; chronic ulceration of cornea; washed eye twice a day with a 5 per cent, solution of boracic acid; bovinine, one drop applied to ulcer three times a day; gave quinine and iron; kept bowels open. This cured the ulcer in ten days.; — Medical World. CHRONIC ULCERATION (CORNEAL)— CASE CXXXV. Dr. T. J. Biggs, Sound View Hospital. Mike K , Stamford; June 8, 1898; had been under treat- ment in a New York hospital, the disease slowly progressing ; ulcer- ation extended, on the right side of the left eye, from almost the centre of the cornea to and slightly over the sclerotic. Surround- ing tissues were greatly inflamed, and the conjunctiva were ecchy- mosed. First application, a wet Thiersch pack, changed every two hours. After forty-eight hours the treatment of the ulcer was begun. Patient was put in a horizontal position, and one part hydrozone in two of sterilized water was applied to the ulcer; after which, bovinine pure was dropped on. Nurse was ordered to drop bo- vinine in the eye every two hours, and every night and morning cleanse the ulcer with hydrozone and water as before. Patient was soon relieved of all pain, which had been extreme, and the edges of the ulcer were healing, pushing forth healthy points into the centre. All inflammatory action in the surrounding tissues had subsided. Bovinine was continuously applied as before until July 14th, when the cure was complete and case discharged. 162 OTHER EYE CASES. Letters come to us daily from physicians in all parts of the coun- try, who cannot get over being surprised at their successes with blood treatment in all sorts of cases. Here is one from a physician who is no novice at the work, yet who cannot, apparently, reach his "nil admirari" stage, so long as new emergencies call forth new demonstrations of this most versatile power. From Dr. M. H. Wheeler, Butler, Ky. For about six years I have scarcely passed a day without using the Bovine Blood Treatment. I have tested it in hundreds of cases and in as many different diseases, and my results certainly have been marvelous. Eecently, a case of granular lids, burned to a crisp with cupri sulph. and other caustics, came to me. I un- hesitatingly gave bovinine the severe test to which this extreme and unusual condition challenged it: using one-half strength to begin with, and quickly increasing to full strength; after one week the lids had commenced to soften and the granulations to separate. Twenty days made a complete cure. The case was one of two years standing, and the subject was a lady 70 years of age. I can safely say, from much experience, that applied bovine blood will set up healthy granulations when nothing else will, and any one doubt- ing my word will please give it a trial to be convinced. ^Within the last week, I dissected a fatty tumor from the upper eyelid, about the size of a three-cent piece; cauterized the part; cleansed the eye; and after soaking a small piece of borated cotton in bovinine, half strength, placed it over the wound. About thir- ty-two hours after, I redressed the eye and found no roughness, but instead all smooth, clean, and with no inflammation worth notic- ing. I could tire you with cases thus treated successfully after trying many other remedies for them. Cholera infantum should not prove fatal unless the bovine blood treatment is neglected. M. H. Wheeler, M. D. P. 0. box 139, Butler, Ky., September 27, 1897. There is no need to deny that a certain percentage of cures are performed in cases like these and most others, by the best surgeons who still remain ignorant of Hsematherapy. These may be ac- counted for by superior skill and science, supported by excellent native blood and vitality in the patient. The cases they do not care to report are those in which the native blood is inadequate for the healing and repair of the diseased tissue, and the result is '^unsatis- factory." These are the cases that finally drift in their helpless- ness to Sound View Hospital, and are invariably cured "cito et jucunde;" and these are the cases that show the difference between blood treatment and the want of it. 163 CASES OF ULCERATIVE ECZEMA. EXTREME CASE OF CHRONIC ECZEMA OF SCALP. Dr. T. J. Biggs, Sound View Hospital. James Norris, Stamford; age 40; September 10, 1898; eczema of scalp; had suffered more than seven years; treated by one of New York^s celebrated dermatologists; also at Bellevue, and at the New York Hospital ; all the time getting steadily worse. Examina- tion revealed the eczema extending all through the roots of the hair, which came out in quantities; running also back of the ears, and down on the neck. The serous discharge was very profuse, and the surface of the scalp was covered with incrustation. This was the condition to which the case had proceeded under the best treatment known to medical science — at large. It presents, how- ever, no difficulty to medical science as beginning to be understood in obscure corners of the profession. The first thing done was to cover the scalp with hot water com- presses, to loosen up and remove the incrustation, and at the same time lessen the serous discharge. Next followed depuration by the bovinine-peroxide reaction, thoroughly dissolving the septic de- posit at the roots of the hair, which was then washed out with Thiersch solution, until the skin was as clean as a baby's. The scalp was then dried, and open-mouthed to absorb the healing and nourishing blood which was next applied, in a dressing of bovinine pure — which (with the prior preparation) constitutes the secret of success in cases of this nature and" most others. The double pro- cedure was repeated every three hours; thorough work being essen- tial ; but by September 24th, the condition was so much ameliorat- ed that repetition twice a day was deemed sufficient. October 1st, the scalp was entirely healed except a spot of the size of a half dollar over the right mastoid process, and bovinine was applied to this spot every four hours until October 8th; when the disease was absolutely cured, leaving no trace by which any previously diseased spot could be identified, and the hair had ceased falling out and resumed its healthy growth. CHRONIC ECZEMA ULCER BLOOD-CURED BY A NURSE. By Pauline J. Braun, Allegheny City, Pa. "One of my patients in this city, Mrs. E S , suffering for over a year from an eczema ulcer on her leg, was told by her physician that unless entire rest was given the leg, a cure would be impossible. She said that rest could not be thought of, as her reduced circumstances required of her constant labor. I applied bovinine, and after several repetitions the ulcer showed decided improvement, and in a comparatively short time was entirely healed, though all the while Mrs. S was engaged in her daily occupation of washing and ironing." 104 BLOOD CURE OP^ ECZEMA- EXTREME SUPPURATIVE CASE IN OLD AGE. Cases iv to viii: By Dr. H. L. Plummer, 710 Saratoga Street, East Boston. I have found bovinine especially valuable in five cases of eczema, one of which was that of a lady some 76 years old. Both legs were covered with a suppurative eczematous eruption, from knees to ankles. There was not a spot as large as a nickel but showed this eruption. There were also patches about the body. I caused the legs to be thoroughly cleansed, then rubbed in bovinine with the hand, then doing up each leg in four thicknesses of cloth saturated with bovinine, which I was surprised to find bleached out white in six hours. Carefully renewing this dressing, also treated the patches in a similar manner; in three weeks the legs, and the patches about the body were healed up smooth. PUSTULAR ECZEMA OF SCALP OF FOUR YEARS STANDING. By Dr. T. J. Biggs, Sound View Hospital. H Q , New York; female; age 17; May 11, 1898; had resisted all treatment for four years. Cut off the hair and opened the pustules; depurated the ulcerous surface with peroxide on bo- vinine, repeated daily with applications of pure bovinine, until June 3d, entirely cured. ECZEMA OF LEGS. At Bellevue Hospital, New York. Note by the Surgeon of O. D. Department. Jane Foster; age 23; received topical blood treatment for eczema of legs which had resisted all treatment for three years past at the various clinics of the city. Daily bovinine dressings cured the disease absolutely in twenty days. BLOOD CURES OF ECZEMA. Cases IX. and X.; By Dr. Simpson, Boston. Mary K , first seen October 3, 1898; American; age 19; ec- zema of face and neck, had resisted treatment of all kinds for sev- eral years. Treated on the surface twice a day with gauze saturated with bovinine three parts and ichthyol one part; the surface being washed with borax and water and dried, before each application. Allien last seen, November 29th, considered herself entirely well, the surfaces being almost perfectly healed. CASE X. Edward Casey; American; age 20; eczema of both hands; had received but partial benefit from various treatments. Treatment the same as above, beginning October 8th. and discharged cured De- cember 1st. 165 SEVERE CHRONIC OTORRHCEA OF FIVE YEARS STANDING. At Sound View Hospital; Dr. T. J. Biggs. Tim M ; New Canaan, Conn.; age 22; January 3, 1899; chronic otorrhoea of five years standing, result of scarlet fever; had been under treatment by a number of physicians, as well as at two Ear and Eye Infirmaries, but grew steadily worse. Examina- tion revealed the whole tympanic cavity affected, the mucous mem- brane hypertrophied and of a yellowish leathery appearance, exud- ing foul-smelling pus; also a larger perforation of the drum-head, sufficient to afford a fair view of the interior of the cavity. The membrana tympani was partially destroyed, but the membrana flac- cida remained. There was also a slight necrosis of the bone. Bowels were first regulated, and a tablespoonful of bovinine given every two hours. Locally bovinine was injected, and then per- oxide of hydrogen. After the chemical reaction had ceased, the cavity was syringed with warm Thiersch solution, and dried, bovinine pure was injected, and a pledget of cotton soaked in glycerin was introduced. All this was repeated every two hours. January 10th, the necrosis of the bone had been cured, the dis- charge greatly lessened, the hypertrophied mucous membrane re- duced, and was red in appearance, the destruction of membrana tympani checked. Continuing the bovinine applications every three hours, the case rapidly improved, and was discharged cured, February 1, 1899, having gained nine pounds in weight. SCORBUTUS. Dr. T. J. Biggs, Sound View Hospital. Ellen W , New Canaan, Conn.; age 26; January 6, 1897. Symptoms: general weakness, lassitude, and indisposition to men- tal or physical exertion; skin dry, rough, and of a muddy pallor; face bloated, gums red, swollen and spongy, with tendency to bleed ; lips pale, in striking contrast to the unnatural redness of the gums; exceedingly offensive breath; eyes sunken and surrounded with dark blue circles; tissues much wasted; in short, every symptom of un- dermined and deranged bodily nutrition; completing the picture with a persistent dysentery. The blood was of a decidedly abnor- mal standard. The patient had received a variety of treatments for this condition during two years, with little or no benefit, as was quite apparent. January 8th, patient was put on a medical prescription and a teaspoonful of bovinine every two hours. At the end of a week she showed decided improvement, and a gain of one and three- quarter pounds in weight. Bovinine was increased and continued with steady im])rovement, until on February 10th, microscopic ex- amination sho\\ed a percentage of hasmaglobin almost normal, and a gain of over a million red cells per cubic millimetre (2,800,000). February 19th, bovinine again increased until March 8th, when the patient was discharged, in completely restored health, full comple- ment of flesh, face, gums and lips of natural healthy color and tex- ture, without bhjating. 160 BLOOD TREATMENT OF GASTRIC ULCER. We observe in the American Gynsecalogical and Obstetrical Jour- nal, a communication which shows that another physician has come across the Nature-cure for sores. Dr. L. E. McCormick, of Crothersville, Ind., writes of this treatment in a case of gastric ulcer. "The patient, a young lady, came to me some time ago com- plaining that for three or fours weeks she had been unable to re- tain any food whatever upon her stomach : even water was promptly rejected. She was naturally in an extremely emaciated condition, and complained, moreover, that the vomited matter frequently contained blood. She was subject to severe epigastric pain, was ex- tremely nervous and afflicted with headache, insomnia and consti- pation. "I administered various digestive ferments of good repute but they were promptly vomited, as were all other remedies, such as bismuth subnitrate, oxalate of crevium, etc. I realized the grav- ity of the case and knowing of no medicine, or rather trusting none, for her relief, I turned as a last resort to bovinine. Pending its ar- rival from New York I gave her stomach a complete rest from all food and medicine. The vomiting continued at intervals, yet was not so severe as before. When the bovinine arrived I gave her at once teaspoonful doses in milk; it was retained, and from the first dose there was a steady improvement in her general condition. She is now taking it in tablespoonful doses, and the stomach is not only tolerant of solid food but is evidently digesting it. Her sleep is better, the nervous irritability is allayed, her bowels are regular, and for the last week or ten days she has been at her store working as usual. GASTRIC ULCER. Dr. T. J. Biggs, Sound View Hospital. Fred B , South Norwalk, Conn.; age 40; January 2, 1899. This case was of six months standing, but had received no benefit from many treatments employed. He was now unable to retain any food. I gave rectal injections of bovinine and milk every three hours; per mouth, bovinine, twenty drops in lime water every hour. The first dose of bovinine was rejected, the second and third were retained, the fourth rejected; after this the vomiting entirely ceased. When first seen, the patient was so weak that he could not sit up in bed; but by January 7th he had improved so that he was able to sit up in bed for a little while every day. Janu- ary 23d, the gastralgia and haemorrhages had entirely ceased, and the pain in pit of stomach and back was much lessened. He now asked to be allowed to try general food. This was permitted, and he retained it well. February 1st, was allowed to leave his bed and remained up most of the day. Fe])ruary 6th, he went out for a walk, much refreshed and stronger. February 14th, he was dis- charged cured. 167 CASE OF CHRONIC PYROSIS. By Dr. T. J. Biggs, Sound View Hospital. Ella Sterrett, T.ong Island City; age 30; June 10, 1898; chronic pyrosis, under treatment for twenty-four years; almost everything generally known having been done for her, without success, from the beginning of the complaint, in her 6th year. But at the age of 29, it took on a violent form; she became unable to retain any- thing on her stomach; began to lose flesh rapidly; weight reduced within the last year from 160 to 83 pounds; bowels could some- times not move for a week, in spite of cathartics and hot water in- jections. The patient was now put to bed and first the stomach was washed out with a weak Thiersch solution, and ten drops of bovinine in iced grape juice were given every hour, extending through the night. After twenty-four hours, she said her stomach felt greatly relieved. The bovinine was then increased to a teaspoonful in a wineglassful of milk every two hours; the first two doses being thrown off, but the third and subsequent ones were retained, without discomfort. This was continued to the 16th, with steady improvement, when I deemed it wise to suggest an operation for relief of the constipa- tion, as the bowels refused to respond to any but the most drastic cathartics, and these being weakening and irritating, it seemed not wise to continue them. On the 16th, under chloroform, the rectum and anus were thoroughly stretched and the bowel washed high up with soap suds and water. This was followed by a most copious evacuation. She reacted nicely from the anresthetic, and since then the bowels moved regularly once a day. On the 18th, the bo- vinine was increased to a tablespoonful in milk every three hours. After this she was allowed in addition some easily digested food. Xo further attacks of the gastric colic. July 7, 1898, patient was discharged cured, at a weight of 124 pounds: a most remarkable and unparallelled gain of forty-one .pounds in less than a month. BOVINE BLOOD SUPPLIED IN PERSISTENT POST-PARTUM HEMORRHAGE— CASE V. By Dr. Robert Frame, Milford, Del. I delivered Mrs. S , age 36 years, of her third child. On the sixth day after delivery, she was seized with post-partum luemorrhages at frequent intervals, profuse and copious, and this continued for nearly five months. I kept her strength up exclu- sively on bovinine until a recovery was mad.e. I am confident that if I had not used it in this case death would have ensued. 168 CHRONIC EECTAL ULCERATIONS, FISTULAS, &c. ULCERATIVE PROCTITIS; CONGENITAL INGUINAL HERNIA. By Dr. T. J. Biggs, Sound View Hospital. W B , Rotan Point, Conn.; age 6; March 7, 1898. A complicated case of ulcerative tubercular proctitis, congenital direct inguinal hernia, and anaemia. A course of preparative and build- ing-up treatment with the usual bovinine regimen was pursued until the 25th, when the operation v/as performed on the ulcerative granulations of the rectum. The little patient being put under, chloroform, the rectum was thoroughly dilated, the granulations were picked up on a small tenaculum and snipped off, and the sites were touched with 25 per cent, pyrozone. The sites of ulceration were cleaned off by the bovinine-peroxide reaction and Thiersch washing; bovinine tampons were put in; and this procedure was repeated three times a day until the 30th; after which rectal in- jections of bovinine twice a day were substituted for the tampons, until April 5th, when the rectal trouble was entirely healed. SECOND OPEKATION — HERNIA. April 6th, the second operation, for the radical cure of the hernia, was performed. Two eminent surgeons from New York City, Drs. E. L. Keyes and William Hoyt, having been invited to see this interesting case. Dr. Keyes kindly consented to perform the operation with the assistance of Drs. Hoyt and T. J. Biggs. The operating surface having been previously sterilized by the bo- vinine-peroxide reaction and Thiersch washing, a modified Bassini operation was performed on the following lines: An incision was made from one inch above the internal abdominal ring, in line with Poupart's ligament, down to half way on the scrotum. All bleed- ing vessels were secured; the only large one divided being the in- ternal pudential artery. The sac was sought for and found; a ligature was thrown around it, according to the Bassini method; and the portion this side the ligature was removed. The edge of the internal oblique muscle was attached by kangaroo sutures to the border of the rectus muscle; the transversalis fascia and the transversalis muscle were stitched to Poupart's ligament; the cord was laid upon this row of sutures and the external oblique muscle was stitched to Poupart's ligament; this being clearly seen to have- at once obliterated both the sac and the inguinal canal, while at the same time forming a new canal for the cord. The wound was now thoroughly cleansed by the bovinine-peroxide reaction, with Thiersch washing, and the fascia were brought together, with con- tinuous silk sutures. The child reacted admirably from the anaes- thetic, and on the fourth day was entirely free from pain, and in the whole period had developed no rise of temperature. The wound was dressed twice a day with iodoform-bovinine, uniting beautifully, and evidently healing by first intention. It should have been remarked that the sole nourishment allowed throughout the treatment was a teaspoonful of bovinine in milk every two hours. 169 BLOOD TREATMENT IN CHRONIC RECTAL ULCERATION. By Joseph M. Matthews, M. D., Professor of Surgery, and Diseases of the Rectum, Kentucky School of Medicine. "I cannot understand why anyone would advise colotomy in cases of ulceration, per se, of the rectum. With strict antiseptic precau- tions the rectum can be kept perfectly clean, and the bowel can be absolutely rested any length of time by the aid of various fluid foods, or what is better than all in my experience, the preparation called bovinine, which contains 2G.58 of soluble albuminoids, and is the vital principle of beef blood obtained by a new process. I have kept patients for weeks on this preparation alone, during which time local applications were made to the bowel until all ulceration had healed." TWENTY-FOUR-DAY BLOOD CURE OF TEN-YEAR-OLD RECTAL ULCER. By Dr. T. J. Biggs, New York. Clarence Archer; age 37; November 14, 1896; ulcer of rectum, about half an inch inward, result of hoemorrhoids ; treated without benefit for ten years. Daily blood treatment now applied; first washing out the rectum with Thiersch solution, then injecting bo- vinine, retained by a gentle packing of sterilized gauze soaked in the same; this treatment repeated three times a day for one week; thenceforward, the injection of bovinine once in four hours without the packing. Discharged cured, December 8th. BLOOD CURE OF CHRONIC RECTAL ULCERS. By Dr. T. J. Biggs, New York. February 22, 1896; John Hagerman ; age 42; chronic ulcer of the rectum, about one inch inward, and of the size of a nickel; had resisted all the usual treatments for a year. The rectum was now thoroughly cleansed with warm castile soap suds, and then washed out with Thiersch. Bovinine was applied on a cotton tam- pon every three hours (repeating the same process of cleansing and disinfection) up to March 6, when the ulcer was healed to the limits of a pinhead, and on March 10th, the cure was complete. FISTULA IN ANO— BLOOD REPAIR. Dr. T. J. Biggs, New York. Mrs. A , in one of the principal New York hospitals, with a complete fistula in ano, had refused operative treatment, and was consequently turned over by the hospital staff to Dr. B for blood treatment. His first procedure was to remove the walls of the sinus by injecting a 25 per cent, solution of pyrozone with a small specially made glass syringe having a very small nozzle; and pass- ing through the sinus to the rectum, a piece of carbolized silk worm gut, to keep open and promote destruction of the walls by the irri- tation of its presence. This procedure was repeated daily for a week. The last three changes of the gut showed hgemorrhage, in- 170 dicating probable destruction of the walls of the sinus and com- mencement of healthy granulation, and more thorough examina- tion revealed no remaining wall. Now, after washing out the channel thoroughly each day, bo- vinine was injected daily to May 6th, when rectal examination re- vealed no internal opening, and showed that the sinus had healed from within out to the end; externally appearing merely as a little teat of granulations about the external opening, which was re- moved with nitrate of silver and dressed with iodoform-bovinine. BLOOD-HEALING OF PERINEAL TRAUMATIC ABSCESS AND FISTULA. By G. W. Combs, M. D., Indianapolis. "I have used blood treatment in a case of pyonephritic abscess, the patient subsequently undergoing an external urethrotomy com- plicated by a perineal abscess, a fistulous tract connecting abscess with urethra. The patient, debilitated by the pyonephritic sup- puration, was not well prepared for the subsequent operation and disease. The tissues wasted and his vitality diminished. He be- came so weak that his relations became alarmed. It seemed im- possible to secure union. Topical blood treatment was com- menced at this time, and union dated from the commencement of its use. The patient was soon strong enough to sit up, and im- proved rapidly." BLOOD CURE OF FISTULA. By Dr. W. C. Coy, Meriden Street, East Boston. I used bovinine locally in a case of fistula I had operated ; opening up considerable of a pocket that showed a very sluggish intention to granulate, so I heavily saturated iodoform gauze with bovinine, and packed the cavity with it daily. Soon the granulations ap- peared, and the case fully recovered. RECTAL IMPACTION, PERITYPHLITIS AND APPENDICITIS. Dr. T. J. Biggs, Sound View Hospital. A B , New Canaan, Conn.; age 3G; May 5, 1898. Had suffered intensely for six months, without relief, under various physicians, losing sixty-four pounds in weight, and had become too weak to raise his head. Began bovinine internally, with immedi- ate improvement. • By injection of soap suds, he was relieved of a tremendous quantity of fecal matter, first in six days. On the 14th, the appendicitis suddenly developed; operation, 15th; ap- pendix enlarged, filled with pus, and adherent entire to the csecum: causing ulceration so serious that after dissecting it off, it was neces- sary to bring the caecum to the mouth of the wound and stitch it there in order to treat the ulceration with supplied blood. This was done, with the usual depuration by peroxide-on-bovinine twice a day; applying iodoform-bovinine for a week, and then bovinine pure, five times a day. Ulceration was healed and the ciecum re- turned to the cavity, on the 37th. Treatment of the wound with 171 bovinine was continued until healed June 6th; allowed to get up, 16th; discharged 18th with fourteen pounds gained and about nor- mal strength, and was at work on his farm, feeling perfectly well, as last heard from. PERI-URETHRAL FISTULA: THE USUAL DUBIOUS OPERA- TION SUCCESSFULLY SUPERSEDED BY BLOOD TREATMENT— FISTULA CASE IV. By Dr. K , New York. John Phillips; age 32; May 8, 1897; abscess and operation five years before, from which, within a month, there had developed a complete peri-urethro-fistula. Although for two years past the fistula had been vigorously treated, it had never been closed. The edges of the fistula were now gently freshened; the an- terior urethra and fistulous passage were thoroughly washed out with Thiersch solution; the fistula was then packed, from without inward, with gauze saturated with iodoform-bovinine, and the pack kept wet with the same. At the end of twelve hours the packing was removed, and after washing out the sinus, was renewed as be- fore. These procedures were repeated twice a day for one week, when it was found that the whole fistulous passage was budding with healthy granulations. The fistulous passage being now in a healthy granulating condition, instead of packing, a small com- press of gauze saturated with bovinine was laid over the outer mouth of the fistula, and changed every three hours. At the end of a week, the inner opening of the fistula was entirely closed by healthy granulations which were rapidly occluding the sinus throughout. Continuing this treatment until the 29th of June, the sinus was then found to be entirely closed up and healed. PERI-URETHRAL FISTULA. Dr. T. J. Biggs, Sound View Hospital. John H , Glen Brook, Conn.; age 40; May 4, 1898; fistula, the result of an abscess, and of thirty years standing; had been under treatment in four of the best hospitals in the United States, and had been three times operated on, with entire failure of benefit. Examination revealed a large fistulous tract ramifying through into the membranous urethra, through which the urine constantly passed. May 5th, I made a careful dissection of the sinus, taking it out entire. The edges of the wound were sterilized by peroxide on bovinine, closed with silk sutures, and dressed with pure bovinine, changed every two hours. May 14th, the sutures were removed, the wound having entirely healed, and the case was discharged cured on the 16th. COMPOSITION OF THIERSCH DRESSING. Inquiries indicate that some would like to be informed that the Thiersch dressing consists of say two and one-half drachms of salicylic acid with two and a half ounces boracic acid; of which mix- ture a teaspoonful is dissolved in a quart of water, when wanted 172 CHRONIC SYPHILITIC ULCERATIONS AND IN- FLAMMATIONS TREATED WITH BLOOD. GONORRHOEA— CASES I TO XXIII. By Thos. B. Keyes, M. D. Surgeon and Gynecalogist to the Bethesda Free Dispensary, Chicago. The primary treatment which I employ is to fill a two-quart fountain syringe with a warm solution of bichloride of mercury, 1 to 40,000, and irrigate the urethra thoroughly, using a No. 9 soft rubber catheter, going slowly and allowing the water to pass by its side so as not to push the virus farther back. The urethra is irrigated about one or two inches farther back than the inflamma- tion goes. The fountain syringe is again filled, this time with a warm weak solution of sulphate of zinc (one and a quarter grains to two quarts of water), and the urethra again irrigated. After having thoroughly treated the urethra by the irrigations above described, I now fill a Keyes-Ulzman's urethral syringe with bovinine, and in- serting this well back of the inflammation, gradually inject, and withdraw the syringe, at the same time. With most cases one such treatment is sufficient. Summary of Twenty-three Cases Treated as above. In sixteen cases: eleven first attacked one to five days before treatment; and five, second attack two to four days before treat- ment; there were no complications, and the cure was accomplished with one treatment. One case with phimosis, eighteen days standing, cured with four treatments. CHRONIC SYPHILITIC ULCER OF TWO YEARS STANDING. By Dr. T. J. Biggs, New York. Edward Miiller; age 22; 217 West Twenty-seventh Street, New York City. Syphilitic ulcer of right leg, two and one half by three inches, of two years standing, had resisted all other treat- ments. The ulcer was curetted and dressed with a wet bi-chloride of mercury dressing for the first twenty-four hours, after which nothing but blood dressings were employed. The first dressing was applied May 4, 1894, and the patient was discharged cured June 12, 1894. CHRONIC SYPHILITIC ULCER. By Dr. T. J. Biggs, New York. March 3, 1896; Edward Hines;.age 29; syphilitic ulcer over the right tibia, two by one and a half inches in extent. Thoroughly cleansed with bichloride of mercury; touched up with 25 per cent, pyrozone, and dressed with Thiersch solution for twenty-four hours. The usual blood dressing was then applied until April 6th, when the sore was entirely healed, leaving a soft little pink cicatrix, after only eighteen days blood dressing. 173 CHANCROID ULCERATION. By Thomas B. Keyes, M. D., Chicago. From among particularly bad cases of chancroid — the worst I have ever seen — I report the following. Miss M. W. had treated herself for about two months, when the ulceration began to extend rapidly, and when I saw her the whole right labia majora and to the extent of about one inch into the vagina was deeply ulcerated. After putting on a bichloride of mercury pack for about thirty minutes, I gave her some bovinine, which she applied faithfully, and in two weeks the sore was entirely healed. CHRONIC CHANCROID ULCERATION. By Dr. T. J. Biggs, New York. Harry Rimanoczy; age 25; 831 Third Avenue, New York. Ulcer on corona of penis half an inch in diameter of two years stand- ing. Application of blood treatment commenced October 20, 1893 ; patient discharged cured November 28, 1893. This little ulcer had resisted all other treatments. CHANCROID ULCERATION. By W. H. Parsons, M. D., Omaha. Soft chancroid involving the glans and prepuce. The soft ulcer had been doing its work for four weeks; appeared almost malig- nant ; various dressings had failed, such as iodoform, etc. This ulcer was packed in pure bovinine and soft lint, changed every two hours the first three days, then every four hours. In thirty- six hours the diseased tissue sloughed out, healthy granulations set up, and in ten days he was well. This, in brief, is my experience along new lines (that is, new to me). 814 North Twenty-third Street, Omaha, Neb., Nov. 22, 1895. CHRONIC SYPHILITIC ULCERS, OF THREE YEARS STANDING. By Dr. Jos. L. Black, Chicago. Sara Lee; age 45; three syphilitic ulcers on the left leg; had gradually grown larger for the last three years in spite of anti- syphilitic and other treatments employed. August 10, 1893, the ulcers were scraped and dressed with wet bichloride dressings (1-2000) for the first forty-eight hours, after which nothing but bovinine blood dressings were used until the ulcers were entirely healed, September 8, 1893. VENEREAL— CASE XL. Dr. T. J. Biggs, Sound View Hospital. Bert N ; age 24: January 2, 1898 ; chronic urethritis, result- ing from neglected gonorrhoea; gonococci, indicating iodoform- bovinine. After washing out the urethra with a solution of per- manganate of potash, iodoform-bovinine was injected; all, three times a day. January 12th, microscopic examination revealed not the slightest trace of gonococci; consequently pure bovinine was now employed. On the 18th, all discharge had ceased; January 26th, the case was absolutely cured. 174 SYPHILITIC ULCERATION OF SCROTUM. Dr. T. J. Biggs, Sound View Hospital. A C , South Norwalk, Conn.; age 39; May 10, 1898. Ulcer size of half dollar, had cut through the scrotum and over- spread the testes. Bovinine every three hours, and protiodide of mercury. Edges gently but thoroughly curetted; depurated with the bovinine-peroxide reaction; touched up with 25 per cent, pyro- zone; and dressed with iodoform-hovininc in gauze. This treat- ment repeated twice a day to May .20th, and almost healed; then treated once a day. After May 29th, the dressing was pure bo- vinine twice a day; June 3, 1898, completely healed and dis- charged. CHRONIC ULCERATION, URETHRAL. By Dr. T. J. Biggs, Sound View Hospital. N. Kennedy, Stamford, Conn.; age 28; June 4, 1898; ulcerative urethritis, of three years, under reputable physicians, growing steadily worse. Depuration with peroxide on bovinine, and sterili- zation, followed by injection of bovinine pure, repeated every two hours. Healing complete, July 10th. GLEET— CASE XXXII IN THIS LINE. By Dr. D , New York. H ; age 32; had been treated for anterior gleet of three years standing, which resisted all the modern treatments I had brought to bear, and the patient and myself were much discour- aged. On May 14th, a professional brother suggested injecting bovine blood and salt water, and as a last resort I concluded to try it. First, the urethra was washed out with Thiersch solution, and the bovinine and salt water was injected three times a day. The case began to improve almost immediately; May 27'th, was al- most well; June 10th, entirely cured, and patient said he felt all right. The result was so satisfactory that I shall follow the same simple treatment in many future cases, and report them. CASE OF SEXUAL NEURASTHENIA. By Dr. A. M. Blech, Chicago. M. B., Clerk; age 29; had been a heavy drinker on account of trouble and an unhappy love affair, and indulged more in venery than he could stand, with the result that he suffered from impo- tence, which depressed him considerably. He had seen several physicians, and finally was treated by a charlatan with electricity, and with water a la Kneipp, which he declared a humbug. Psychic treatment proved of no avail; strychnia caused palpita- tions of the heart. Bovinine was given in ounce doses before meals, and he improved within ten days. The treatment was con- tinued for a month with very satisfactory results. The patient, who does not live here, informs me by letter that he is now mar- ried and all right. His photograph (in my possession) shows no trace of the old, haggard face he wore when he consulted me first. 175 IMPOTENCE AND NERVOUS PROSTRATION. CASE XXXI IN THIS LINE. Dr. T. J. Biggs. John H ; age 45; May 2, 1897. Case of functional and rela- tive impotence and nervous prostration, which had been treated by many physicians for a long time, with little or no benefit. Treat- ment : one-fortieth grain nitrate of strychnine and two drops dilute phosphoric acid, every three hours, and a teaspoonful of bovinine in milk, every two hours, afterwards gradually increased to a wine- glassful. June 16th, the impotence had given place to full power and function, and the nervous condition was greatly improved. CHRONIC ULCERATION OF BURNS— INVARIABLE AND SPEEDY CURE, WITH MAGICAL ANNI- HILATION OF PAIN, BY BLOOD TREATMENT. CASE OF FIVE YEARS STANDING: By Jos. L. Black, M. D., Chicago. John J ; age 50; first seen Augugt 1, 1895, showing an ex- tensive ulceration of the left forearm, the result of a burn received five years previous, which had never healed, in spite of all treat- ments. It was covered with a thick, viscid, sanguineous discharge, of very foul odor, underlying which was an unhealthy granulating surface. The nicer was thoroughly cleansed with a solution of permanganate of potassium and dressed with wet Thiersch dressing for the first twenty-four hours, after which nothing but blood (bo- vinine) dressings were employed until the patient was discharged with the arm entirely healed, September 20, 1893. In this case, as in the others, the patient was entirely relieved of pain after bovinine dressing. CHRONIC BURN ULCER OF INFANT: FOUR INCHES DIAMETER. Dr. T. J. Biggs, New York. This child— Lizzie Ziskind, 411 Seventh Avenue, New York City, age 2 — must soon have died, under any former treatment, having grown enormously worse for three months. Topical blood treatment commenced December 16, 1893; complete cure, Janu- ary 25th. The incessant and exhausting pain of the little patient was at once and entirely removed by the bovinine dressing. OTHER BURN CASES OF CHRONIC ULCERATION. By Dr. T. J. Biggs, New York. Arthur Thomas, 70 Bowery, age 38. Burn ulcer on hand, three and a half by three and three-quarter inches, with constant and in- curable pain, entirely relieved by first blood dressing, January 12, 1894, and cure completed January 24, 1894. 176 Extremely painful burn ulcer of eight months standing, one inch in diameter, on great toe. Daniel Burk, Washington House, Twenty-third Street, New York City; age 35. Entire relief from and after first blood dressing, April 6, 1894, and complete cure, May 2. Emma Stearns; age 48; June 7, 1898; ulcer of three years from burn, covering whole left side of face ; twice skin-grafted with- out success; utterly refused to heal and still extending; the great trouble being that it was surrounded with so much scar that proper nutrition could not get to the part, and consequently the granulations covering it could not reach maturity. Usual bo- vinine-peroxide depuration, followed l)y bovinine pure, every two hours; later, t. d.; healing completed July 8th. In this case there was an island of ulceration in a sea of scar, with little or no natural nutrition going to it, and yet, under a topical blood supply it healed rapidly and completely. Another point of g^eat interest was this: that the scar of the ulcer healed by blood supply was pink, soft, and sensitive to touch; while a tre- mendous scar surrounding it from the original burn, was white, hard and insensible, although it had had far more natural nutri- tion coming to it than the insulated ulcer. SEVERE BURNS. At Bellevue Hospital, New York. Charles Scheppsky, age 38, electrician, treated for severe burns of arm and hand. Bovinine application removed pain, hastened granulation, and healed the wound in three weeks; less time than I have ever known a cure of an equally severe case. ABSCESSES, GLANDULAR, MASTOID, PERINEAL, ETC., UNDER BLOOD TREATMENT. These cases of abscess will be noted by surgeons as remarkable (like others under the blood treatment) for such uniformly rapid, radical, painless and certain healing, as had never before been knoTWi. LUMBAR ABSCESSES.— LATEST TECHNIQUE. By Dr. T. J. Biggs, Sound View Hospital. Henry B , Huntington, L. I.; age 36; May 1, 1898; two lum- bar abscesses. Treatment was according to the latest technique in this hospital on abscess, as follows: A trocar with canula was in- serted at the lower end of the abscess, and another at the upper end, and removed, leaving the canulas in the abscess. Tlie pus was drained out, and then bovinine pure was injected through the lower canula, and peroxide of hydrogen through the upper one. The 177 chemical reaction where the two met was tremendous, almost forc- ing the canulas out, and continued a full minute. After the reac- tion was completed, Thiersch solution was sent in through the up- per canula and allowed to run steadily through the cavity and lower canula for five minutes. Following this, the lower canula was re- moved, and iodoform-bovinine was injected by the upper one. Then the upper canula was removed, and a compress sufficiently large to cover the abscess sac was tightly adjusted. At the end of twenty-four hours, the compress was removed, the canulas were again inserted, the abscess cavity was depurated by the bovinine- peroxide reaction and Thiersch irrigation as before; and was filled with bovinine pure, this time, through the upper canula. Both were then removed, and the compress was again applied, and was not disturbed — there being no pain or inconvenience or rise of tem- perature — until the 10th, when the abscess was found to be entirely healed. A second abscess, higher up, was now discovered, and was put through the same course of treatment as the former. During the entire period of treatment, the healing process was assisted inter- nally by a teaspoonful of bovinine in milk every three hours. Points of advantage in this procedure, as my experience leads me to believe, are : first of all, it does not subject the patient to a pain- ful surgical operation, and it leaves no scar. In the second place — while, of course, to obtain this result requires much more care than the ordinary operation of opening an abscess — it does away with shock, which is so serious sometimes in the larger operations and particularly with nervous patients. PARENCHYMOUS HEPATITIS, ABSCESS AND SINUSES. By Dr. T. J. Biggs, Sound View Hospital. George Eoth, Portchester, N. Y.; age 29; October 12, 1898; re- mitting fever, temperature 103.4; obstinate vomiting; great de- bility; melancholia; jaundice; constipation, in fact, decided typhoid sysmptoms. Locally over liver, a throbbing tumor presenting limited tender- ness, oedematous, and fluctuating; a careful examination revealed the fact that the abscess was about ready to open into the pleural cavity. I advised an immediate operation, which was consented to. An incision was made over the tumor (transversely) through the fascia down to the muscle, then the largest sized trochar introduced, and the pus pumped out, a little short of a quart being removed, after which the incision was carried down through the muscle, exposing the liver; I now introduced my finger into the wound and found a large sinus leading almost into the pleural cavity, and another 178 directly into the liver substance. It was by far the most exten- sive exudation of its kind I had ever seen. The wound and abscess cavity were now thoroughly cleansed with the bovinine-hydrozone reaction and Thiersch solution, and packed with iodoform-bovinine gauze; this was changed at the end of twelve hours and the wound found to be in a splendid condition, and very little discharge. The cleansing and dressing Avere repeated as before, and at the end of twenty-four hours the wound was found to be in a healthy healing condition with absolutely no discharge. The bovinine pure was now employed, the dressings being changed twice in twenty-four hours. October 21st, the cavity in the liver had entirely filled and healed, and the sinus leading to the pleural cavity had almost filled out. October 28th, the sinus had entirely filled, and the wound was in an absolutely healthy condition, the edges of the external wound were now brought in apposition and dressed with bovinine pure. November 6th, the wound had entirely healed, and No- vember 7th, the patient was discharged cured, having gained eight and a half pounds. ABSCESS OF LIVER. Dr. T. J. Biggs, Sound View Hospital. Ed. B , New Canaan,. Conn. ; age 40 years ; parenchymatous- hepatitis (abscess of the liver); November 1, 1898; intermittent fever, temperature 103% degrees; obstinate vomiting, debility; melancholia, jaundice, constipation, typhoid symptoms; and locally a large prominence over hepatic region with throbbing and limited tenderness; the swelling was generally oedematous and fluctuating. An oblique incision about five inches long was made over the liver, through the fascia, after which a careful dissection was made over a grooved director, down to the liver; the edges of the wound and the cavity were packed with iodoform-bovinine gauze. A large-sized trochar was then attached to a return flow aspirat- ing syringe, then plunged into the abscess and the pus pumped out ; a pint and a half in all. The abscess was incised, depurated with the bovinine and per- oxide of hydrogen reaction, and a careful search with the finger re- vealed that the abscess was just on the verge of bursting into the pleural cavity. The iodoform-bovinine gauze used for packing was then removed, and the abscess cavity and surrounding tissue thoroughly washed out with Thiersch's solution and packed again with iodoform-bo- vinine gauze; the edges of the wound were then brought together with heavy silk sutures, leaving an opening large enough at lower end to drain the wound. A bovinine pure dressing was applied over the wound and the patient put to bed. The procedure of depuration and iodoform-bovinine packing was repeated once every twenty-four hours, until the 20th, at which time it was found the abscess cavity had entirely filled up with healthy tissue, leaving only the external wound to heal. November 30th, patient was discharged cured. His general con- dition was splendid at the end, and he said he felt quite well. 170 MORIBUND CONDITION FROM ABSCESS— BLOOD EFFECTUAI^- INTERMITTED WITH RELAPSE- RESTORED WITH RECOVERY. < Dr. C. S. Smith, of Providence, 11. I., reports the following ex- traordinary case : November 30, 1894, I was called to Mr. who had just re- turned from the Ehode Island State Hospital, where he had been for treatment of a urethral abscess. After careful treatment by the ordinary methods, during which the abscess had been opened and a tube for drainage inserted, he had steadily grown worse, and it was decided that his case was hopeless, and he was according*ly sent home to die amongst his family. I found a temperature of 104, pulse 156, great prostration. On pressing well up in the groin pus would flow from the tube inserted in the urethra, and an active cellulitis had begun over the perineum. From a previous use of bovinine, locally, I thought with its help there might be a fighting chance for the man. I at once opened up the whole area, in which there was a large amount of extremely offensive pus and decomposing fibres of tissue, and after much difficulty this was all cleaned out. I then saturated plain gauze heavily with bovinine, and packed it in liberally, dress- ing every twelve hours. After this I saw no more pus, but all my bovinine dressings came off clean from pus. After the patient had made excellent progress, I tried for two days dressings of iodoform and bichloride; but the second day of these dressings pus showed itself, which a return to the bovinine dressings completely checked. In eight weeks everything was healed, and by the continued use of bovinine the mart rapidly regained his normal strength and is now at work for his old employers. About this time I had a troublesome case of chancre that after a full treatment of some six weeks by antiseptic methods still refused to heal, and showed an angry, pus-depositing surface. I stopped all antiseptics, cleaned the surface thoroughly, and applied bovinine locally, which to the surprise and delight of the patient caused the wound to heal entirelv in a week's time. 180 GLANDULAR ABSCESS. By Dr. Hatcherr, Somerville, Mass. "A case of abscess of the glands of the neck, the sequel of scarlet fever in a patient of marked scrofular diathesis, although cleaned with peroxide of hydrogen, iodoform and other antiseptics, had per- sistently refused to heal. The cavity that was suppurating was large enough to easily admit my thumb. Iodoform gauze, saturat- ed with bovinine was packed into this large cavity; granulation soon followed, and complete union of granulating tissue was ef- fected." "The treatment of abscess lias always been an exceedingly un- satisfactory one to the surgeon as w^ell as to the patient, both from the length of time these can run, the pain attending the usual methods of treatment, with the subsequent redressings, and that in the large majority of cases a prolonged period of disability follows the primary operation." — Edwin M. Hasbrouck, M. D. SURGERY OF CHRONIC GLAND SWELLING AND ABSCESS, WITH BLOOD REPAIR— CASE LXVI. By Dr. B . A boy of 12, N. H. P , (Cincinnati), had been for a year de- veloping a swelling of the glands of the neck, which had been treated unsuccessfully by various physicians, with electricity, mas- sage, inunctions, alteratives, etc., the tumor all the while steadily enlarging. Incision was made, when the sublingual glands were found in a state of cheesy degeneration, and were entirely curetted out, and the cavity was packed with gauze saturated with iodoform- bovinine, while a teaspoonful of bovinine was given in iced milk every two hours. The submaxillary glands, which had been much inflamed, now rapidly subsided to their normal state and size, to- gether with two or three smaller enlarged glands. The dressing was repeated for two weeks, when the cure was complete. LARGE AXILLARY ABSCESS. By Dr. T. J. Biggs, New York. Jerry Dolan; age 33; first seen June 4, 1896, at one of the princi- pal New York hospitals. An incision was made at the lowest point of the abscess; the cavity cleaned out, and after forty-eight hours antiseptic preparation, was packed with iodoform-bovinine gauze ; repeated with pure bovinine later, until the 26th, when the cavity had completely filled and healed. 181 EVERY-DAY ILLUSTRATIONS OF BLOOD TREAT- MENT IN ULCERATION. CASE OF ENORMOUS ULCER— EIGHT YEARS RESIST- ANCE TO OLD TREATMENT— CASE CV. By Dr. Mussey, of Cincinnati, O. Ellen Pryor; age 56; November 3, 1896; chronic varicose ulcer on right leg measuring six by five and a half inches; had resisted for eight years all treatments laid down by the medical authorities, including two unsuccessful attempts- at skin-grafting; and had never healed even temporarily; had cut down almost to the bone, and exuded a muco-purulent discharge in exhausting quantities. Having first prepared the surface by curetting, and sterilization with Thiersch solution for twenty-four hours, I began the applica- tion of bovinine exclusively, in saturated gauze with proper pro- tective coverings, changed twice a day for the first week, and once a day thereafter. Within the first week, improvement was mani- fest, healthy pink granulations springing up all over the surface of the sore. In the second week the picture had a further change; for now, little peninsulas of new skin were putting forth from the periphery of the ulcer on all sides and running toward the centre, to lengths of about half an inch. This mode and process of repair continued to develop, thenceforward, unchecked, until December 18, 1896, six and a half weeks from first introduction; when the cure was perfected, and a large, soft pink scar remained the only witness to the place of that desperate ulceration. BOVININE FOR LEG ULCERS. To the Editor of the Medical Summary: Have you investigated claims of bovinine? It is revolutionizing treatment of these stubborn sores. Literature on the subject of its topical use is rapidly accumulating. An opportunity was lately afforded writer to test its value to specific ulcers of arms and legs. Case was an old syphilitic who came from Cincinnati to be treated by Avriter. On left leg were four ulcers, on right five, and one on each arm, eleven in all. Largest ulcer was on left leg two inches above ankle. Around leg it measured three and one-half inches, was one and a half inches wide, and varied from one-half to five- eighths inch deep. Borders were elevated, hard and livid, surface livid, irritable and bathed in pus. On right leg anterior aspect was the next in size, two and one- half inches long, one inch wide and about a quarier of an inch deep, with which connected an extensive sinus in tissues of outer part. In calf of left, two inches below knee, was a circular ulcer, one inch in diameter and three-quarters of an inch deep, connected by means of a sinus with another. Patient had appearance of a physi- 182 cal wreck, could not walk, and had been under treatment for six weeks, without benefit. Pieces of iodoform gauze of suitable form and size were laid on ulcers, and saturated thoroughly with bovinine, poured from bottle. At first this was done every day, then every other day, finally, every third day. At every dressing parts were irrigated with pure warm water. Having never seen the like it would be hard for one to credit -any statement as to remarkable changes that took place. Only a little while after treatment was begun, large healthy granulations could be seen sprouting up from all points and reaching out from border toward centre. In one week's time the smaller ones were filled to level of surface. Two weeks had not elapsed till, in the largest, several large- eized islets had been built up from bottom, and nearly a half inch of new tissue added to border. In three weeks all the small sores and large one on right shin were entirely bridged over. In one month the largest was almost completely built in, leaving only a small shallow spot in the middle. This may be considered a triumph for the doctrine of rapid cure by topical feeding. R. B. McCALL. M. D. Hamersville, Ohio. PRACTICE OF DR. BLECH, CHICAGO. CASE IV. Chronic ulcer of the Teg, of the indolent variety. Patient a Polish woman, untidy in her habits; suffered with the ulcer for eight years. From the interpreter's description I learn that she had visited every free dispensary and had been treated with anti- septic ointments, with elastic bandages, with the thermocautery, and by curetting. She came to me on account of the pain. There was a varicose condition of many veins, a dirty leg, and an ulcer as big as a half dollar, and about one-half of an inch deep. She was ordered to take several liaths, and then I treated her for sev- eral days with applications of undiluted hydrozone to render the ulcer more healthy. I then curetted the ulcer thoroughly, washed it out again with hydrozone and applied aseptic dressings saturated with bovinine daily for twenty-five days, during which time the ulcer gradually diminished in size and finally healed completely. I used also elastic bandages to stimulate local circulation. Many similar cases could be reported, but the four just cited will have to suffice. They show the value of ox-blood clearly. There is a great field in therapy for such a preparation, and if my readers will give it a fair trial and report their experience in any standard medical journal the purpose of this short article has been achieved. — Cincinnati Lancet Clinic, September 9, 1898. 1443 Michigan Boulevard, Chicago. 183 BLOOD CURE OF INDOLENT ULCERS— CASE XCVIII. By W. F. Dean, B. S., M. D., La Grange, 111. (Abstract from Journal of Orificial Surgery.) Mrs. W ; of Sioux City, Iowa; October 5, 1895; two laro^e indolent ulcers, of over five years standing, on the right leg, and one, of two years' standing, on the left, rendered locomotion al- most impossible. One ulcer was 7x4 inches. About a finger's breadth of skin separated it from the second ulcer on the oppo- site side of the limb, the two extending nearly around the limb. Both feet were stiff and extended, and neither foot could be moved or in the slightest degree straightened from its extended position. The patient ivalked — if walking it could be called — on tip toe, with a cane. The limbs were black to the knees, while the odor from the ulcers was cadaverous, although she dressed them twice daily with a carbonized solution. Since five years ago everything had been done, apparently, to get them healed, but with no result. As a last resort the patient was taken to a hospital for treatment, where she remained seven weeks, and the ulcers were healed only to break out again in one week's time after dismissal. In 1893 [three years later] the left limb also gave way, forming an ulcer. Since that time the condition had been steadily growing worse. The patient was now placed under an anaesthetic, the ulcers thor- oughly curetted, and packed with a 1-2000 corrosive sublimate gauze. The following day the gauze was replaced by strips saturat- ed in bovinine, changed once or twice daily. The flesh filled in very rapidly, and by January 15th the skin, a beautiful child-like pink in color, covered the entire surface, and the limbs were reduced to their normal size. When last heard from, five months afterward, the patient had so far regained her health that she walked to and from her husband's place of business several blocks away, and had reached her former greatest weight of 205 pounds. The general health of the patient should be noted as indi- cated by endometritis, subinvolution, and especially the state of the mucous membrane, which tore like wet tissue-paper; condi- tions never found in a well-nourished body. TRAUMATIC ULCERATIONS IN THROAT: BLOOD-SPRAYED; ALSO BLOOD PER RECTUM— CASE LXXXIX. By Dr. B . John Manley; age 33; October 1, 1895; tonsils and uvula had been removed and the stumps badly ulcerated; many days unable to swallow food, and almost starved. Rectal injections of bo- vinine, and wounds sprayed with iodoform-bovinine, until so far healed that he could take bovinine and milk by the mouth, and the cure was completed November 6th. 184 INVARIABLE RESULTS OF BLOOD TREATMENT IN CHRONIC ULCERATION— CASE CVII. By Dr. D , New York. Pat Devanney; age 60; May 3, 1897; traumatic ulcer on the right leg, four or live inches in dimensions, the result of a kick of a horse two years previous. The contusion and laceration had been so severe that the wound could not be healed, and rapidly broke down into an ulcer, which resisted all treatments employed on it at various hospitals and at the offices of no less than eight competent physicians. The ulcer had cut down through the sev- eral layers of fasciae, and the upper surface of the muscles had been severely encroached upon. The crest of the tibia was exposed to a length of one and three-fourths inches. The centre of the exposed bone was denuded of periosteum for half an inch, with a slight surface necrosis. After aseptic preparation, the necrosed bone cells were removed with the curette, and the whole surface of the ulcer was touched with 25 per cent, pyrozone and dressed with a wet Thiersch pack. After forty-eight hours continued treatment, the ulcer showed a healthy clean condition ready for the absorption of supplied blood. Eight layers of gauze saturated with bovinine were laid over the surface of the ulcer, and covered with rubber tissue, sheet lint, and a roller bandage from the foot to the knee. This dressing was changed twice a day, and later, once a day. In just nine days, the portion of bone that had been denuded of periosteum was soundly covered, and little peninsulas of healthy tissue were shooting out all over the ulcerated surface. This rapid process of repair ended, June 19th, in the complete healing of the ulcer, with its site marked only by a soft pink scar. BLOOD CURE OF CHRONIC AXILLARY ULCERATION— CASE CIX. By Dr. D , New York. Henry Fish; age 19; June 4, 1897; old abscess cavity in the right axilla, which had refused to heal or even to granulate, in spite of every treatment in the established practice. I washed out the cavity thoroughly with Thiersch solution, and packed it with gauze saturated with iodoform-bovinine, every four hours for three days, and twice a day for the ensuing six days. By the tenth day, the cavity was beginning to fill up from the bottom, and was shooting out healthy granulations from all sides. July 8th, it was found to be entirely filled up and healed, with a broad, flat, soft cicatrix. By Lawrence G. Kemble, M. D., Boston. "In my blood treatment of multiple chronic ulcers, wounds, tis- sues, fistulas, etc., by saturated compresses and subcutaneous injec- tion, the rapidity of healing has been remarkably satisfactory, and successful." By Edward A. Welch, M. D., Sutton, Mass. **I have used the '^blood" poultice in two cases of ulceration with success — usual methods having been previously tried in vain/' 185 IN BELLEVUE HOSPITAL, NEW YOEK. CASES TREATED WITH AUXILIARY BLOOD SUPPLY. By J. Heller, M. D., Surgeon O. D. Department. A TRAGICAL CASE OF BURNS IN THE JACKSON FOUNDRY. As Treated With Blood at Bellevue Hospital, New York. In July, 1898, the daily papers of New York contained the pain- ful details of an accident at Jackson Foundry, from which the pa- tient was carried to Bellevue Hospital in terrible agony from in- juries apparently mortal, and indeed undoubtedly so, had it not been for the treatment with supplied blood as lately inaugurated in an important department of that institution. The surgeon in charge of the case sends us the following record : Timothy Monagan, of 206 East 9th St., while carrying a ladle filled with molten iron at the Jackson Foundry on July 17, 1898, was badly burned by having the liquid spilled all over his body in consequence of the breaking of the handle of the ladle. The metal splashed over him, burning him severely, his shoulder and forearm receiving the largest burn, which measured twelve by five and a half inches, destroying skin and fascia, also the muscular tissue in places. A burn on the back, one by two and a half inches; four burns on the neck; three on the side; eight on the chest, and three on the abdomen. He suffered intense pain until an application of bovinine was made, when the pain left him and did not return until the case was cured. [A fact of invariable occurrence in all cases of painful wounds, sores, etc.] I treated him by placing two thick- nesses of cotton flannel thoroughly saturated with bovinine and laid over the burns; this covered with oiled silk to prevent evapora- tion, then a bandage, and dressed every second day. On August 5th he was able to return to work, perfectly cured. Bellevue Hospital, 0. D. Surgical Department, New York. CHRONIC ULCERS. , At Bellevue Hospital, New York. John Greely had suffered for twenty years past with large leg ulcers (specific?), which resisted all treatment heretofore prescribed, and emitted a very fetid odor. At the suggestion of a professional brother, I was induced to try the treatment with Supplied Blood on this and the following cases. The ulcers were depurated with the reaction of peroxide of hydrogen on bovinine previously ap- plied, and then thoroughly washed, and dressed daily with cotton flannel saturated with bovinine pure. All pain ceased, and to my further surprise, the ulcers immediately began to heal, and were entirely closed in three weeks. This was the first case where I had ever seen any treatment give such marked results. 186 CHRONIC AXILLARY ABSCESS. At Bellevue Hospital. Georgie Fuller, age 11, had an axillary abscess which resisted treatment by the ordinary means, until, as a last resort, supplied blood (in bovinine) was introduced topically and internally, con- tinuing the same until cured. After opening and draining the abscess, the standard depuration by peroxide-on-bovinine was fol- lowed by topical tissue-feeding with bovinine pure, which was ap- plied in gauze saturated and packed into the cavity, and renewed from day to day. Very little pus discharge took place after begin- ning this treatment, and the cavity rapidly filled with healthy tissue, until, in three weeks, it was entirely closed and the patient was discharged cured. CHRONIC ABSCESS OF TWENTY YEARS STANDING. At Bellevue Hospital. Delia Molam, age 50, had suffered with an incurable abscess for twenty years, and for the last year and a half had been through constant treatment at three hospitals, without result. After the usual draining, and the novel depuration with peroxide-on-bovinine, the cavity was packed with gauze saturated with bovinine pure, changed daily. After the third treatment all discharge stopped, and in two weeks from the first treatment, the abscess was healed. In view of such unprecedented work, I know not how to say enough for the value of this simple treatment. SENILE ULCER OF LEG. At Bellevue Hospital. Michael Donovan; age 68; very weak and emaciated; a dis- couraging case of intractable senile ulceration. With Q., I., and Str., and also bovinine in milk internally, and bovinine nourishing the lesion externally, to my surprise the ulcer healed very rapidly, and the cure was completed in six weeks; the patient meanwhile having grown stronger than he had been for years. OLD INDOLENT LEG ULCER. At Bellevue Hospital. Charles Berry, age 40, had suffered for years with an indolent ulcer of leg which had never healed under any of the usually known treatments. This case was cleansed and curetted, depurated with peroxide-on-bovinine, and dressed daily thenceforward with bo- vinine pure, for two weeks, at the end of which time the ulcer was healed. CASE OF BUBOES. At Bellevue Hospital. Billy Williams, age 24, suffered with buboes, which for a year past had been discharging constantly, and nothing seemed to help him. Treatment was tried by injecting peroxide of hydrogen and bovinine, with remarkable success. The case was cured in four weeks. 187 HiEMATHEEAPY IN BELLEVUE HOSPITAL NEW YOKK. BRIEF CLINICAL MEMORANDA. Case 1. Emma Comerford, 323 East 35th St.: Chronic ulcer of heel; had resisted treatment for over a year; was completely cured in one month by topical blood-nutrition (bovinine). Case 2. William Cockley, 416 East 10th St.: Severe burn on back of hand; cured in two weeks by bovinine (blood) dressings. Case 3. Michael McMara, 7-41 Second Ave. : Varicose ulcers, one of sixteen years standing, and another of five years, under all pre- vious known treatment ; both entirely cured in eight weeks by topi- cal blood-nutrition. Case 4. John j^earn, 300 East 45th St. : Syphilitic leg ulcer of more than a year's resistance to treatment; cured in six weeks by the same agent as the former. Case 5. Thomas Larkin, 44 East 85th St.: Severe burn caused by electricity, December 20th, at 96th St.. electric power house. Time of cure by topical blood reconstructive (bovinine), three weeks. Case 6. George Ebard, 197 Mulberry St.: Traumatic ulcer on leg from kick of a horse, last July. Same topical blood feeding as above, cured the case in five weeks. Case 7. Andrew Shaughnessey, 262 Grand St.: Ulcer following typhoid fever. Same treatment as the others; cure completed in five weeks. Case 8. Michael Kelly, 240 West 19th St. : Ulcer of four years, cured in four weeks; same treatment as foregoing. Case 9. Thomas Gunn, 447 East 26th St. : Hand burned by ex- plosion of an oil stove. Local blood treatment as above completed cure inside of three weeks. BRIEF JOTTINGS IN MARCH, 1899. Case 14. Pat. Fellows, Mills Hotel No. 1, City; chronic ulcer on right leg of over six years standing; cured in five weeks with topical blood applications. Case 15. Thos. O'Neil, 591 Brown St., City; two chronic leg ulcers of over a year, caused by stone falling on leg; cured in four weeks with topical blood applications. Case 16. Thos. Buckley, City; chronic ulcer on leg of one year; cured with bovine blood in four weeks. Case 17. John Goldin; 127 Varick St., City; chronic ulcer of twelve years' standing; cured in eight weeks by topical blood ap- plications. Case 18. Jas. McElheney, 242 East 87th St., City; chronic leg ulcer of several years standing; cured in four weeks by topical blood applications. Case 19. Thos. Strouse, 146 Mulberry St., City; specific ulcer on leg; cured in eight weeks by blood treatment. Case 20. Chas Scone, 32 Thompson St., City; varicose leg ulcer 188 • of several years; cured in seven weeks by topically applied blood nourishment. Case 21. Wm. Gamble, 420 East 26th St., City; varicose leg ul- cer; cured in eight weeks with topically applied blood nourishment. Case 22. John Noland, 228 East 12th St., City; chronic leg ul- cer; cured in five weeks by topically applied blood nourishment. Case 23. Patrick Milligan, 546 East 15th St., City; chronic leg ulcer; cured in four weeks with topically applied blood nourishment. Case 24. Wm. Coghlan, 416 10th St., City; severely burned hand; cured with bovine blood locally, in two weeks. Case 25. Chas. Bank, 343 East 22d St., City; burns on hands; cured in ten days with applied bovine blood. Case 26. Geo. Hess, 397 Broadway, City; chronic leg ulcer of several years; cured in five weeks with topically applied blood. Case 27. James Flanagan, 315 East 37th St., Gity; fingers frozen; cured with blood treatment in two weeks. - Case 28. Rose Marky, 305 East 24th St., City; chronic leg ulcer of several years; cured with bovine blood in six weeks. Case 29. James Dewneley, 342 East 23d St., City; chronic leg ulcer of several years, cured in six weeks, with topical blood. Case 30. Adolph Kaly, 74 East 1st St., City; chronic varicose ulcer of two years; cured with topical blood supply in seven weeks. Case 31. Pat Welch, 405 East 19th St., City; chronic varicose ul- cer of several years; cured in four weeks with topical blood supply. Case 32. W. Weeks, 288 Bowery, City; chronic ulcer of four years' standing; cured by topical blood supply in four weeks. Case 33. J. Smollem, 8 Jackson St., City; chronic leg ulcer of three years; cured in five weeks by topical blood applications. Case 34. Chas. Pagan, 200 Eleventh Ave., City; chronic leg ulcer of one year; cured in three weeks by topical blood. Case 35. J. Johnson, 309 East 89th St., City; abscess; was washed out with peroxide hydrogen, packed with gauze saturated with bovinine; cured in four days, dressed daily. Case 36. W. Jackson, 110 East 54th St., City; necrosis of jaw- bone; bone scraped and packed with gauze saturated with bovinine; healed in six days. Case 37. John Golden, 27 Vestry St., City; chronic ulcer of sev- eral years; cured with topically applied applications in three weeks. Case 38. M. Kelley, 240 East 19th St., City; chronic leg ulcer cured in four weeks by topical blood. Case 39. L. Hardyan, 324 East 37th St., City; chronic leg ulcer; cured in four weeks by topical blood supply. Case 40. Mary Cibrane, 31 Hamilton St., City; hands burned severely; dressed with bovine blood; cured in two weeks. Case 41. Rose Sapella, 224 First Ave., City; chronic varicose ul- cer; blood treatment; cured in four weeks. Case 42. Ed. Smith, 10 Remington St., City; frost bites; dressed with gauze saturated with bovinine; cured in five days. Case 43. James Gavin, 302 East 35th St., City; hands and arm burned in burning building; dressed with bovinine; cured in two weeks. 189 SUNDRY OLD INCURABLE VARICOSE ULCERS: BLOOD-HEALED. By Dr. T. J. Biggs, New York. Anna Battey, recorded elsewhere, as cured by blood treatment of a varicose ulcer of eleven years standing, in twenty-eight days, October, 1893; came again April 6, 1896, after two and a half years, with a traumatic ulcer of a different part, the former ulcer having been permanently healed. With the usual preparatory and blood treatments down to May 2d, the new sore was entirely healed like the former, only in two days less time. ■Mary Byrne, 205 East Fortieth Street, New York City; age 40; October ]0, 1893. Varicose ulcer, six by two and a half inches on left leg, of fourteen years standing; also on right leg, of three months. Constantly treated at various clinics, but never healed. Used blood treatment; small ulcer healed in twenty-five days, and the large one in eight weeks, and the leg restored to normal size Bridget Welsh, 295 Delancey Street, New York City; age 65; November 8, 1893. Varicose ulcer of twenty years standing; had never been healed; great pain, entirely removed at first application of blood treatment; cure completed December 25, 1893. Mary Breitfuld, 644 Third Avenue, New York City; age 48; Feb- ruary 20, 1894. Varicose ulcer, three and a half by two and a half inches, of six years standing; suffered so much pain that she wished the leg amputated; blood dressing at once removed all the pain ; dis- charged cured April 2, 1894, Kate Keller, 605 East Sixteenth Street, New York City; age 55; October 31, 1893. Varicose ulcer, outer side of right knee, three- quarters of an inch in diameter; cure completed December 1, 1893. Mary Ann Callery, 110 Sanford Street, Brooklyn; age 60; Octo- ber 15, 1893. Varicose ulcer of right leg, one and a half inches in diameter; three years standing; various treatments, never healed. Blood cured complete November 10, 1893. FURTHER SUMMARY OF OLD CHRONIC ULCERS BLOOD-CURED. Cases li to liv: By Dr. T. J. Biggs, New York. Margaret Donovan, 7 Oak Street, New York City; age 50; No- vember 13, 1893; varicose ulcer, two inches in diameter, of two years standing, never healed; cure completed December 19, 1893. Nellie Eavora, 208 East Twenty-'fifth Street, New York City; age 25; January 1, 1894; indolent ulcer one and three-quarter inches in diameter; extremely painful, but entirely relieved by first applica- tion of bovine blood; discharged cured Fd^ruary 3, 1894. Hannah Kerwin, 1499 Lexington Avenue, New York City; age 65; December 7, 1893; indolent ulcer, two by one and a half inches; of two years standing; discharged cured January 28, 1894. James O'Connor, 195 Third Avenue, New York City; age 55; June 4, 1894; indolent ulcer, two by three inches, of five years standing and never healed; discharged cured July 16, 1894. 19C SIX-YEAR VARICOSE ULCER. By Dr D , New York. Henry Mercer; age 70; October 20, 1896; varicose ulcer, middle of left tibia, three by two and a half inches in extent, of six years standing, having never been healed, under all the usual treatments. On the 21st, the ulcer was gently curetted, touched up with 25 per cent, pyrozone, and dressed with Thiersch solution for twenty- four hours. On the 22d, the wound was cleansed with bovinine and peroxide of hydrogen, and dressed with pure bovinine, changed every day until November 6th; then every other day until heal- ing was completed, November 12th; total, twenty-three days, to end the despair of six years regular surgery. ULCER HAD RESISTED TREATMENT THREE AND A HALF YEARS— CASE CVII. By Dr. L , for Dr. Connor, Cincinnati. Floran Atkins; age 45; September 14, 1896; varicose ulcer of right leg, 2l^x2% inches; had resisted all other treatments for three and a half years, when first subjected to supplied blood. Curetted and sterilized, cleansed with peroxide and bovinine dress- ings only applied daily. The sore healed rapidly, and on October 18th (at thirty-four days) the patient was discharged cured. FOUR-YEAR ULCERATION— CASE CXIV. Dr. T. J. BiggSj Sound View Hospital. Annie Carr; age 36; New York. Dr. F sent this case to me, September 13, 1897. Patient had a large ulcer on the right breast, two by one and three-quarter inches, which had resisted all treatments for four years. After curetting, pyrozone, and Thiersch dressings, finding it of a healthy appearance, dressings of bovinine were applied twice in twenty-four hours, and later once a day, until on October 10th, the case was discharged completely cured. CHRONIC TRAUMATIC ULCERATION— CASE LXXXVIII. By Dr. T. J. Biggs, New York. Mrs. Crummey, 303 East Thirty-fifth Street, New York City; age 55; at Demilt Clinic, October 9, 1894. Traumatic ulcer of leg from contusion, two inches in diameter; foul and covered with unhealthy granulations, exuding a thick viscid sanguineous pus; indurated and undermined; also considerable phlebitis. Cleansed, curetted, and dressed with wet bi-chloride; next day, gauze saturat- ed wiih bovinine was laid over the ulcer; over this, sheet lint, oiled muslin and bandage. Dressed thus daily; in three weeks the ulcer was completely healed. By L. L. Bryant, M. D. (City Physician), Massachusetts Avenue, Cambridgeport, Mass. I am now using bovinine locally in all my cases of ulcers, etc., both in my private practice and at the Cambridge Almshouse. At the latter place I. have had several severe, old-standing cases, some of ten to fifteen 3'ears duration. I am buying it a dozen bottles at a time for this use. 191 THE EELATION OF PAIN TO MALNUTKITION OF NEEVES. In March, 1894, the Sanitary Era published the following state- ments on this subject, in connection with the report of a case at the New York Polyclinic, in the early days of Hgematherapy. "The Editor saw the case at the second dressing, and asked the patient if it was painful. She replied that it had been extremely painful until she came to Dr. Biggs, but as soon as he had dressed it the pain ceased and she had suffered no further. This singular experience ])rought to mind the identical report given by the brake- man with the lacerated arm, and also the delighted exclamation heard from another sufferer a moment after the bovine dressing had been applied: "Oh. doctor! what have you been putting on? my pain is all gone!" — an exclamation which the doctor informed ua was a usual occurrence in such cases. As there is nothing of opium, cocaine, ether, arnica, or any other pain-killing drug, or, in short, of any drug whatever, in the bovine blood-preserve, or in any element of the dressing applied, it becomes a subject of most in- teresting inquiry, what could be the nature of this unheard-of and mysterious effect. The Buffalo Medical Journal, for September, 1895, contained a learned and ingenious "Study of the Origin and Nature of Pain," by Herman G. Matzinger, M. D., x\ssistant Physician in the Buffalo State Hospital. Dr. Matzinger's thesis is, substantiallly, that pain is "the result of an abnormal, more or less intense, chemical tissue change, Avhich is always associated with changes in the circulation in the part affected;" and tliat "the entire phenomenon of pain is created and conveyed in the nerve system that accompanies the blood vessels — the sympathetic vaso-motor system — as suggested by Oppenheimer." The nerve ganglia "presiding over the life and nutrition of a given area of tissue maintain a certain tone in the capillaries when chemical changes go on normally, like a mild con- tinuous current; but when the stimulus is increased, it produces a dilatation of the vessels (not a contraction as in muscle reflex) :" hence the phenomena of pain and inflammation. There is now a new and special occasion for interest in this theory of pain. Invariably, infallibly, the introduction of the liv- ing bovine blood into the currents of distempered tissue-change that agonize the sufferer, is found to annihilate the pain in the most mysterious manner, within a few moments, often with but an un- noticed interval. What is so probable, as that reinforcement with the highly vitalized and oxygenated bovine blood should instantly 192 clieck the degenerative tissue-change, clear out its waste (as pus and stench also miraculously vanish in such cases), relieve the dila- tation of the vessels and the tension on their nerves, and thus cut off the source of pain? HOW DOES BOVINE BLOOD ANNIHILATE PAIN? In a Nutshell. — Professor A. L. Loomis, in his "Practice of Medicine," page 107, at the beginning of the chapter on the treat- ment of neuralgia, emphasizes this fundamental aphorism: "Neu- ralgia has been well said to be the cry of a nerve for better blood." The cessation of the excruciating pain of the nerves involved in the degenerative process of ulceration, immediately .following a direct supply of bovine blood to them (when the proper means have been used to clear the way for topical access to those tis-_ sues) has been many times proclaimed by a "cry" of joyful relief; as noted often, but oftener passed without notice, in our reports of cases and operations. The physiological cause of this phenomenon has also been a subject of much speculation. But does not the above-quoted aphorism at once supply explanation and find its own demonstration, in the miracle-like relief of the sufferer, which we have so often witnessed and recorded? Systemic blood sup- ply for neuralgia ought also, though more gradually, to prove the aphorism by a satisfactory answer to ''the cry of nerves for better blood." FIVE YEARS OF ENDOMETRITIS ENDED IN THREE WEEKS. By Dr. T. J. Biggs, Sound View Hospital. Mrs. T , Sound Beach, Conn.; age 36; February 28, 1899; endometritis; had suffered severely for five years, under various physicians, and twice curetted; result, a very aggravated chronic condition; would not allow an operation, and I therefore deter- mined to do the best I could for her under the circumstances. I injected bovinine into the womb, followed by hydrozone. After chemical reaction had ceased, product was washed out with Thiersch solution, and the womb was packed with iodoform-bo- vinine gauze; all repeated twice in twenty-four hours, up to March 10th. The womb had then resumed its normal size, the discharge had ceased, 'and the patient was relieved of all pain. In order to .thoroughly rejuvenate the mucus membrane, I determined to inject into the uterus bovinine pure, twice every twenty-four hours ; continued until March 18th, when the patient was discharged cured. 193 THE POWER OF SUPPLIED BLOOD IN FUNCTIONAL OR ATONIC, AND CA6UAL, EXHAUSTION. Some of these classes of disease are among those most intimately and obscurely planted in the system. Though localized in their manifestation, their real aetiology is often unexpressive and un- recognized. In the last analysis, it is probably resolvable in most cases into malnutrition of that part of the system where nervous energy should be developed, and the broadest generalization there- fore is Neurasthenia: either nerve-innutrition or nerve malnuitri- tion, or, again, nerve poisoning. Whatever of medicinal treatment may be indicated by the specialized and localized symptoms, the fundamental indication in all capes remains the same — nourish! But what shall nourish the nourisher? The very trouble in these cases is that the nourishing mechanism itself has given out, for want of power to convert nutriment into nutrition; that is, power to supply itself with power — with nerve power or tone. When the stomach can no longer feed itself from food then the very nourishment of the stomach's power to feed the nervous sys- tem, the blood and the body, must be accomplished otherwise; and unless this be done, the issue can be only decline to slow or sudden death. Stimulants and tonics can only whip up the exhausted stomach. There is no way of replacing its lost nutritive or blood- making power, but by calling in the aid of another and better stom- ach to supply a ready-made nutrition product — the strong vital blood of the bullock. The nervous system, and the local nerve sup- ply, being thus renourished, revitalized and reinvigorated, will be enabled to resume business for itself, to some extent at least, and so far, if not completely, the condition, dyspeptic, neurasthenic, neu- ralgic, etc., will be cured. The same principle, both of aetiology and of cure, is manifestly applicable to every defect of functional tone, intestinal, cardiac, muscular, or purely nervous. At this point, may be most naturally interposed the simple sug- gestions as to the introduction of the extraneous blood supply which are always applicable, and need not be repeated. 1. Study the condition of all the secretions and functions of the patient, and apply such corrective and assistant remedies as your knowledge and judgment may dictate; persevering in this until ir- regularities are as far as possible reduced, 2. Then, or in the meantime, experiment with the patient's re- ceptivity of bovine blood, as to quantity, medium, intervals, etc. 19-1 Begin with so little, and so well disguised in milk, grape juice, lem- onade, coffee, broth, or whatever is most acceptable, that you cannot overtask the stomach or taste with the dose: then slowly increase' until you get a correct gauge of your patient, by which you can pro- ceed further with safety and good effect, as the case advances in the progress of recovery. Some cases must be thus dealt with very delicately and gradually, while many others will accept more robust treatment from the first. Many supplementary hints as to particulars may be picked up in reading from the successful clinical experiences hereinafter re- corded. BLOOD FOR BABIES: IN ANEMIA, INANITION CHOLERA INFANTUM, MARASMUS, Etc. CASE I. Remarks by Dr. T. J. Biggs. In the course of the second year there comes a time when the milk diet begins to be insufficient for the growing child, and Nature calls for a change, while yet the system is in many cases unpre- pared for solid food. This kind of deadlock results in diarrhoea or constipation, anaemia, restlessness, fretfulness, etc. In such cases the fit and radical remedy will be found in the administra- tion of say ten drops of bovinine in a little milk, at intervals of three hours. Little Robert Valverdie, a patient who came under my care in the condition of malnutrition above described (after trying all the usual medical helps with no benefit), was immediately restored by the direct blood treatment. On the second day of taking bovinine, the constipation and other trouble began to be relieved, and on the third day all signs of ill health had disappeared as if by magic. This simple treatment was continued for three weeks, the child thriving beautifully. Where we can administer ready-made life- blood, what more do we want? 195 CASE II. By Dr. Herman D. Marcus (Philadelphia Times and Register). In the treatment of invalids whatever food be given, the quantity should not be large. If insufficient, it is best to increase the nutri- tive value without increasing the bulk. This may readily be done by adding bovinine, from a few drops to a teaspoonful to each cup of food. "A child eight months old had ceased to nurse and all efforts at feeding occasioned such pain that the struggle still further ex- hausted the child. Bovinine was ordered in ten-drop doses every half hour, and as the baby took it readily, the dose was increased to half a teaspoonful. This was the only nutriment taken for days, the child refusing to take the blandest food known." IN CHOLERA INFANTUM— CASE III. By W. C. Wile, A. M., M. D. Dr. Wile relates in the New England Medical Monthly "an instance in the family of a neighboring doctor who kept his baby, which was sutfering from cholera infantum, alive for three days by giving it nothing but one drop of bovinine every fifteen min- utes, which was dropped upon the tongue and allowed to get down into the stomach, as best it could. The child, which was in its sec- ond summer, got well, and the recovery is without question due to the sustaining power of supplied blood." CASE IV. By Dr. S. H. Moore, Indianapolis. While attending a case of cholera infantum in a child of six months, after exhausting all methods of nourishment to no pur- pose (tliey being either rejected or passing undigested, and my patient being at a point of death from starvatio^ I happened to think of a bottle of bovinine left with me a B^rt time before. Without much hope of benefit I commenced the use of it in small doses diluted with the mother's milk. To my surprise it was re- tained and at once a great change was apparent in the little sufferer. I continued it in larger doses and with the most gratifying results. The vomiting ceased, the stools were more natural, showing no un- digested food in the passages — in short, I attribute to the blood treatment the cure of this very critical case. IN MARASMUS— CASE IX. By W. W. James, M. D., Philadelphia. During excessive hot weather I was called to see a child three months old, that was rapidly wasting away from that dreadful disease, Marasmus. ]\ry attention had previously 1)een called to bovinine, and I at once ordered the same to be given in doses of five drops with a tablespoonful of water every hour. Improve- ment was almost instantaneous, and the dose was gradually in- creased to fifteen drops. In about a week's time I had the pleasure of seeing my little patient bright and sprightly, who but a week previou>"]!a l»y Miiotlier physician to die. 196 IN DIPHTHERITIS. By A. H. R. Guiley, M. D., South Eaeton, Pa. I have recently used bovine blood in a case of prostration during severe diphtheritis, where the child, after being deemed dead by the friends and neiglibors for nearly half an hour( so they told me), rallied, and when I called again in the morning, was sitting up. In five days she ran about the house. IN GASTRIC IRRITATION— CASE VII. By Dr. S. D. Dewey, Richmond, Va. I have recently used your blood treatment with the most gratify- ing results. A child who had suffered for many days with the most distressing irritability of stomach, and to whom a number of tried remedies had afforded no relief, after the first dose quietly slept, and waking with no return of nausea, made rapid recovery. CASES VIII, Etc. Dr. Edward P. Vollum, Medical Director, United States Army, reports a large number of army cases of gastric irritation, dyspepsia, nausea and distressing sensations of fullness and weight in the stomach after eating. All of these cases were promptly relieved by bovinine taken soon after eating. He says: "I was greatly sur- prised at the anodyne effect of bovinine on the stomach when I tirst noticed it, but the explanation of the action would seem to be that it contains the vital elements that the stomach in its moments of distress needs." CASE III. By J, A. Clark, M. D., Bedford, Pa. Mr. B is a railroad official high up in the service of the New- York Central Eailroad. He came to Bedford early in the summer of 1891; his case was thought to be a hopeless one and was diag- nosed by one of the most prominent physicians in New York City, to be cancer of the stomach. We kept him alive for days at a time by rectal injections of bovinine, and, when the stomach would bear anything, administered by the mouth, until he was built up suf- ficiently to take solid or semi-solid food, with bovinine as a sup- port between ; and last fall he was so far recovered as to be able to resume his duties as railroad manager, and this summer (1892), he is still improving. By W. S. Morrison, M. D., St. John, N. B. I have proved the efficacy of bovinine in uterine haemorrhages, exhaustive diarrhreas, nervous prostration, excessive irratibility of of the digestive organs, haimorrhages of the lungs, obstetrical cases, convalescence from fevers and the wasting diseases of infancy, such as antemia, marasmus, cholera infantum, inanition and infantile trophy. It is especially beneficial in diseases of women where there are exhaustive demands on the system. 197 BOVINE BLOOD SUPPLY BY SUBCUTANEOUS AND EECTAL INJECTION, FOR POST-PARTUM HEMORRHAGE AND COLLAPSE. OSMOSIS; ALIMENTARY OSMOSIS; AND RECTAL ALIMENTATION. The theory and practice of clinical nutrition falls short of proper development, if the wonderful physiological faculty of Osmosis be not well understood and employed, in a multitude of the most critical situations that confront the physician. This re- source overlooked, as it too often is, or the most effective nutrient to be introduced thereby, neglected, there is in many cases no other help for the perishing patient. A few elementary mem- oranda may properly introduce the record of the latest progress in the employment of this great physiological faculty (so to call it) to save life in extremis. Nutriment is passed into the constructive channels and organs of the body not only through the millions of microscopic mouths called absorbents, but also, in no unimportant proportion, through membranes in which there are neither passages nor pores, being tis- sueless as a waterproof gum. The emulsified food, in this physio- logical process does not filter through the membrane, as if through a strainer, but first gains entrance into the very substance of the membrane by something like a solvent process; which, being of course dependent on some quality in the substance of the mem- brane itself, is called the power or faculty of imbibition. This property operates from both sides of the membrane, bringing both liquids together within it (the blood, and the lymph or chyle of digestion) where the well-known law of inter-diffusion of liquids effects a new composition, each side losing something to the other, and partly passing by each other to opposite sides; but the main body, consisting of the incoming fluid as modified and reinforced by the other, keeps on to its Junction with the vital stream. This is Osmosis: the exit of the inter-diffused fluids which had met so easily within the membrane by the familiar process of soaking into it from opposite sides. But these fluids offer to our contem- plation a mystery in their going forth : a mystery even greater in physiological osmosis than in our extra-physiological experi- ment; where we make the membrane of an egg, or a neutral fluid, a diaphragm between two liquids of different densities, or of dif- ferent composition;, in passing through which diaphragm they will 198 so intermingle and interchange as to form one homogeneous solu- tion throughout both receptacles, as if they had been connected by a pipe; or else, as in certain cases, will make two new solutions dilferently modified by having exchanged constituents with each other. For, considering the vital results in physiological osmosis, and especially considering the distinct selective powers of different membranes for acquiring (or imparting) widely different secre- tions from the same nutriment, there is reason to infer a more than mechanical process of entrance and exit (imbibition and osmo- sis) — something more recondite than the imbibitory and osmotic j)Ower in non-vital apparatus. The employment of the absorptive properties of the mucous membrane of the larger intestine is the capital expedient, in all cases M^here it is desirable to afford the stomach perfect rest, or whenever it is impossible, from any cause, to reach the circula- lion through this organ. We have in the large intestine a large vascular area which is always ready to receive and imbibe the nutrient material intro- duced from without for the purpose of restoring and maintaining impaired or lost vitality. We are thus enabled to reach the circulation by the use of rectal enemata, and it is a well-known fact that a person may be kept alive indefinitely by this means. After careful experimentation with all the principal nutrients, I find that bovine blood fulfills these requirements in the most satisfactory manner, in all cases where rectal feeding is relied upon to support life. The mucous membrane of the large intestine is a medium of directly reaching the circulation, where prompt action is imperative, as after sudden and severe hfemorrhage. Under these circumstances it is essential to have at hand a preparation which can immediately supply the loss the system has sustained, and this is no doubt the explanation of the great success attending the use of bovinine under these cir- cumstances, as will be seen in the subsequent reports of cases. POST-PARTUM HAEMORRHAGE; FAILING UNDER "SALINE SOLUTION:" PROMPT RESTORATION BY BLOOD-INJECTION. By Dr. A. M. Blech, Chicago. L S , primipara. A robiist Germen woman, age 23, with "red cheeks," as her husband described her, suffered from ])(>st-partuiii hamiorrhage, which cxsanguinalod her almost com- pletely. Immediately tainjjoiiing of the uterine cavity with ase])- tic gauze, and intra-cellular injections of a total of three gallons 199 of normal saline infusion saved her life for the moment, but she was left in a precarious condition of subacute anasmia. I injected hypodermatically four times a day for six days half an ounce of bovinine. The woman gained from the start, and even without a blood count one could notice the rapid improvement, as the natural color returned to her cheeks quicker than can be observed by other methods of treatment, such as iron internally, nutritive clysmata, etc., and, what is more, continued on to perfect health. LARGE POST-PARTUM HEMORRHAGE AND EXTREME COLLAPSE, INSTANT REVIVAL AND RAPID RE- COVERY FROM HYPODERMIC INJECTIONS OF BOVINE BLOOD— CASE I. By Dr. P , New York. [The distinction, and a vital one, to be noted between cases like this and those in which the collapsed blood vessels are merely filled up with injections of water, consists in the instant supply of blood — not water — replacing at once that which had been lost, sending nutrition and refreshment throughout the system, and the hourly continued supply of the same speedily restoring the patient to the condition, or even better than that, which she was in before the haemorrhage.] Lucy Bramble, colored, age 31, on December 19, 1896, one hour after her first delivery, suffered a large loss of blood by haemor- rhage, and was found in a state of collapse, cold and clammy, pulse quivering 130 times pev minute, gasping rapidly for breath, and crying out for air. Hips were quickly elevated and two hypodermic injections immediately given, each consisting of four drachms bo- vinine, three of salt water and three of whiskey. Improvement followed within fifteen minutes, in a stronger, fuller and slower pulse, with less rapid and distressed respiration. An hour later, a second series of injections were given, each two drachms bovinine, one of salt water and one of whiskey: recovery still progressing. The flowing ceased shortly, and the patient dropped off to sleep for the next two hours. On Avaking, had no pain, and felt better. Was then given a rectal injection of three ounces bovinine with one and a half of salt water and two tablespoonfuls of whiskey; followed by very decided improvement; the pulse dropped to 98, full and bounding; the respiration became normal. A drachm of bovinine in port wine was given hourly until next morning, when the patient was so far recovered that large quantities of bovinine could be taken. The patient made an uninterrupted recovery and was finally discharged January 2, 1897. 200 BOVINE BLOOD INJECTION FOR POST-PARTUM HEMORRHAGE— CASE II. By Dr. S . New York. Mrs. K , age 31; primapara; family history bad; poorly nour- ished, anasmic, and not well developed, and had scarcely seen a day when she felt well, from childhood. Dysmenorrhoea and catarrhal endometritis added to her disadvantages. The labor was tedious, and about two hours after the delivery the patient had quite a severe ha?morrhage. The pulse became so weak it was diffi- cult to distinguish it, the surface became cold, and the patient was gysping for breath. In addition to the usual treatment a high warm enema of bovinine, Avhiskey, and salt water, was given every four hours, and bovinine by the mouth every half hour. The physician in charge at tirst objected to this plan of treatment, but seeing the marked and rapid improvement, said it gave the best and quickest results he had ever seen. Bovinine was continued" by the mouth three times a day for about four months, at the end of which time she looked better, felt stronger, and weighed more, than ever before in her life. BLOOD SUPPLY IN POST-PARTUM HEMMORHAGE— CASE III. By Dr. S , New York. Mrs. W L , age 28; Il-para; family ]^istory good. The present labor was complicated by an accidental hsemorrhage, neces- sitating rapid delivery. The large quantity of blood lost produced the usual symptoms in exsanguination, syncope, cold surface, feeble pulse, etc. Treatment and result identical in all respects with Case II. SUBCUTANEOUS AND RECTAL INJECTIONS OF BLOOD FOR POST-PARTUM HEMORRHAGE— CASE IV. By Dr. T. J. Biggs, New York. June 23, 1894, I saw with Dr. S , Mrs. T , who had lost a large quantity of blood, the result of a post-partum haemor- rhage, was in a collapsed state, pulse very weak, ranging from 173 to 179, skin cold and clammy, and respiration rapid. Fol- lowing the usual restoratives six ounces of bovinine and salt water were injected into the right nates, and four into the left, with the most happy results. In an hour the patient's pulse had dropped to 99 and was stronger; respiration almost normal. A rectal in- jection of six ounces bovinine in salt water was given, and in about an hour she fell into a quiet sleep. Two weeks from the date of the first subcutaneous injection the patient was again in full health. POST-PARTUM HEMORRHAGE AND COLLAPSE. Dr. T. J. Biggs, Sound View Hospital. Mrs. C , Stamford, Conn.; age 30; August 27, 1898; case of pasturition, stillborn; I was called in consultation, and found the patient almost floating in her own blood. A rapid examination 3 O o < 0X5 N CO M o f^ <_ X c o cr m n "2. c £ (T) O C/) C (/J P 3 5' o O DO CD a. 201 showed that one of the uterine sinuses had not closed, and a small portion of the placenta had been retained. Hastily sterilizing my hand, I passed it well up into the uterus, carrying in it (while re- moving the piece of placenta) a piece of ice which I gently rubbed over the uterine walls, which immediately began to contract. While ordering an assistant to give a drachm of fluid extract of ergot, the vagina was washed out and thoroughly packed with antiseptically prepared pledgets of cotton. 1 now had the satisfaction of observing that the haemorrhage was under control, and turned my attention to the patient, who was about collapsed, entirely unconscious, breathing rapidly, feebly muttering, heart fluttering rapidly and weakly, skin cold and moist, etc. I immediately injected hypodermically, nitro-glycerine one- hundredth grain and strychnine one-thirtieth grain. Following this, an ounce of bovinine was injected subcutaneously in three places on the outer aspect of the right thigh. This brought the pulse about normal. There was now given a rectal injection of four ounces bovinine and half an ounce of whiskey, and the nurse was instructed to inject subcutaneously thirty minims bovinine in double the amount of salt water, every half hour. In just one hour, patient regained consciousness, was able to speak, and said she felt very comfortable. A tablespoonful of bovinine in old port wine every two hours was continued until the 30th, when the pa- tient was feeling fine, and from this on, the dose of bovinine was a wineglassful every three hours. September 6th she was sitting up in a chair, and a day or two later was discharged: a complete recuperation within ten days, from supplied blood. VIOLENT POST-PARTUM HEMORRHAGES AND SUPPLIED BLOOD— CASE VI. By W. S. Howe, M. D., Lewiston, Me. A severe case of placenta previa occurred in a lady who had had several severe haemorrhages before, which had weakened her very much. From the great loss of blood before and after delivery, the case looked doubtful. She could retain nothing but bovinine, with a little brandy and milk for weeks. I am confident that this treatment saved her life, and to it both this mother and child are indebted for their existence, as the child was violently ill a year after from cholera infantum, and was brought through by blood treatment alone. EXTRAORDINARY VITAL INVIGORATION OF A WOMAN BY SUPPLIED BLOOD. Tested in Uranalysis, Etc., by Dr. T. J. Biggs, New York. At the long-distance •'"record-race'' of female bicyclists at Madi- son Square Garden, New York, among the score of young women entered for the test was Miss Frankie Nelson, of Brooklyn, age 24. Like others, she put herself under medical training, but unlike the rest, she was fortunate enough to be directed by the striking ex- perience of two previous record-breakers of the other sex, to the 20S direct blood supply. lu all other respects hex outlook was of the poorest. The doc- tor's examination of her on the day before the race showed her to be both physically and mentally in no condition for the prolonged strain of so formidable a contest, and he strongly advised her to give it up. But as she was determined to persist, he resolved to treat and watch her closely through the contest and see how far "blood would teir' in a naturally hopeless eHort. l^he daily record of treatment and physical examination, par- ticularly in the items of bodily waste, excretion and nutritive sup- ply, was furnished in full, but omitted on account of the excess of other important matter. In short, the register of waste and sup- ply, and the general physical condition, instead of the rapid ex- haustion to be expected from continuous intensity of effort, showed a steady improvement every day, until the end of the sixth, when she had broken the English long-distance record, and won the medal for the United States; not having once fainted or been obliged to dismount. On the day after the completed race, uranlysis showed a per- fectly normal excretion, with no trace of albumen, and general health highly improved. The other competitors were doctored on a favorite stimulant (kola), giving them a fine send-off in the morning, but leaving them weak afterwards, and half of them fainted or were obliged to desist one or more tim'es every day; coming out at the end exhausted in strength, diminished in flesh, and probably the worse in constitu- tion for life. But there was just one exception besides the winner. This was a j'oung lady who perceived how things were going with her and her companions, and before it was too late, applied to Dr. B for treatment. She came out winner of the second place. Volumes of comment and discussion could add nothing to this "record-breaking" record in medicine. VOMITING OF PREGNANCY RELIEVED BY BLOOD INJECTION. By W. E. Shaw, M. D., Cincinnati. In a severe case of vomiting in pregnancy, bovinine was inject- ed rectally every three or four hours for a period of three weeks, the patient taking nothing by mouth, except occasionally a little water, and being relieved of the vomiting. The rectum was washed out twice daily with salt water before the administration of the enema. The patient gained in weight and strength until able to sit up, whereas she was unable to raise her head off the pillow when treatment was begun. By F. D. Wheeler, M. D., Detroit. '^ave used the blood treatment in two cases of persistent vomit- ing in pregnancy with excellent results." 203 A DISTINGUISHED DOCTOR AND PATIENT. General U. S. Grant was sustained for months previous to his decease almost wholly by the use of bovinine, as the following let- ters testify: From General F. D. Grant. "During the last four months of his life, the principal food of my fatlier, General Grant, was bovinine and milk, and it was the use of this incomparable nutrient alone that enabled him to finish the second volume of his personal memoirs. F. D. Grant." From General Grant's Physician, Dr. J. H. Douglass. "I have embodied my experience with bovinine in the case of General Grant, in mv narrative of ^The Last Days of General Grant.' "My attention was first called to the preparation by the Hon. Salem H. Wales, of New York, who sent me a quantity which I critically examined before using, and compared with the various foods which had been most liberally supplied me. I commenced its use some time in April, 1 885, and my record reads as follows : "The liquid nourishment recently used was a preparation known as bovinine. This constituted the General's principal nourishment during the remainder of his life, he taking it well and with satisfac- tion up to the 31st of Julv, when his abilitv to swallow failed. "J.H. Douglas, M. D." [Strange, that the expedient of rectal injection was not em- ployed, to a more delayed, if not a more fortunate, result.] CASE IX. By Dr. W. H. Parsons, Omaha. Miss B , age 16; of Lincoln, Neb.; at hospital in Kansas City, Mo.; laparotomy for ovarian cyst, was performed on June 13th. She was anaemic in the extreme, and generally in bad condition, and tJie low vitality and extreme nervous irritability of the patient gave no promise of a favorable outcome. Shortly after the operation the stomach became so irritable that all nourishment and even cold water were rejected. The tem- perature and other grave symptoms indicated sepsis. On June ISth, the patient's life was despaired of, and the last rites of the church were being administered at the time of my arrival. Rectal feeding had already been tried with beef tea and milk. At my earnest request I was permitted to test the value of blood supply, the doctor saying at the time that the patient Avould not live forty- eight hours. An ounce of bovinine was forced high up into the recium, and the same was repeated in two hours. The distress and painful retching subsided and the stomach remained tranquil. For twelve days bovinine was the only nourishment administered and by this process oE nutrition alone, the vitality of the patient was restored, and on July 3d, this moribund girl was pronounced con- valescent. 204 TRAUMATIC COLLAPSE. Leading New York Hospital: By Dr. T. J. Biggs. Mike Kolly; age 29; October 15th; in extreme collapse from a stab in the neck ^vith great loss of blood. The symptoms being extreme, by permission of tlie attending physician, Dr. H , a rectal injection of eight ounces of bovinine and salt water was given every three hours for two days. In fifteen minutes after the first injection, the reaction from collapse was decided, and by the third clay the patient began taking bovinine by the mouth, a teaspoonful in a tablespoonful each of milk and whiskey, hourly, for four hours, and then a teaspoonful in milk every two hours; re- acted beautifully, and made a recovery so rapid and complete as to be astonishing to those acquainted only with the ordinary treat- ment, in cases of such extreme severity, even where they are pulled through. CASE XI. By the Same. September 19, 1894, I was called to see Mr. V , who had lost a large quantity of blood, the result of several incised Avounds re- ceived in a fight: one cut had opened the radial artery; he was unconscious, and his life was despaired of. I immediately stimu- lated the patient, and ten ounces of bovine blood (bovinine) and salt water were injected subcutaneously, four into the right nates, four into the left nates, and two into the right thigh. In twenty- three minutes the patient regained consciousness with a decided im- provement of the pulse and respiration. A rectal injection of bovinine and salt water was now employed, and an hour after, the patient fell aslee]), from which he awoke much improved. Rectal iiijections were continued every three hours; the patient improved daily, and was soon out of danger, with the wounds healing kindly. SUBCUTANEOUS AND RECTAL SUPPLY OF BLOOD "IN EXTREMIS" (TRAUMATIC HEMORRHAGE)— CASE X. By Dr. T. J. BiggB. Mr. B came to Dr. K 's private hospital May 2, 1894, having an atonied bladder with a rigid neck, for which a perineal section was performed ; followed on the second day by copious dis- charges of blood. After the patient had bled almost constantly for one week, in spite of energetic remedial measures, his recovery was almost despaired of. At this time rectal enemata of bovinine were resorted to, and as the patient was unable to retain anything In' the stomach, he had to depend entirely on this means of nutri- tion. He made a ra])id and uninterrupted recovery, and is at present enjnving sood health, having entirely recovered from the shock of the operation and lunemorrhage. 305 BLOOD-SUSTENTATION UNDER CESOPHAGOTOMY FOR LARYNGEAL, EPITHELIOMA. By Dr. E , New York. This obviously difficult and dangerous operation on the larynx — the mortality having been hitherto about 75 per cent, of cases — is fortunately rare; but, in consequence, the vital indications for treatment have been but inadequately studied and taught. Among the chief elements of danger are, the extreme delicacy of the opera- tion and of the operating field, and the not uncommon necessity for supplementing respiration as well as nutrition through artificial channels: all making a large and continuous drain upon the strength and vitality of the patient under conditions which forbid the possibility of so much as an ordinary supply of nutrition; while a serious interference with respiration impairs the virtue of the blood and every function dependent on it, besides adding much to the distress and exhaustion of the patient. Natural deglutition, with the necessary ptyalin ferment for the due conversion of starch, being impossible during and after the repeated operations, extraor- dinary demands are made upon the intestinal juices, and upon the sinking stomach when it requires absolute rest; thus exacting a supply of blood from the sj'stem which it is in no condition to af- ford. Hence the great uncertainty of carrying the patient through the healing process, however successful the operations, and how- ever assiduous the treatment. CASE. Archie Manley; American; age 57; December 29, 1896; epithe- lioma of larynx. January 1st an operation for the partial removal of the growth left so large an area of raw surface in the throat as to inhibit swallowing altogether, and to compel the resort to oeso- phagotomy for the introduction of nourishment. What should the nourishment be? At the suggestion of a professional brother (Dr. B ) it was determined to introduce a direct supply of bovine blood, in the preparation "bovinine." This exclusively was relied on for sustentation of the patient, with a perfectly satisfactory'^ re- sult, and also after the second operation, for removal of the re- mainder of the growth. RECTAL BLOOD SUPPLY IN COLLAPSE FROM POST- PARTUM HEMORRHAGE. By Dr. T. J. Biggs, New York. March 16, 1896; Ellen Turgis; age 23; collapse from post- partum hffimeorrhage. After cleansing the rectum, injected bo- vinine in saline solution; immediate improvement; repeated injec- tion after three hours, and gave a teaspoonful by mouth. Im- proving rapidly; the enema was finally repeated three hours later. The dose by mouth was repeated every three hours, and increased to a tablespoonful, until March 28th, and she left the hospital well. 206 BLOOD SUSTENTATION AND CURB OF AN INFANT UNDER LUNG-HEPATIZATION, PYEMIA, AND OPERATION. By Dr. T. J. Biggs, New York. Willie Gage, of Brooklyn, E. D., a delicate little fellow of 5 years, was brought to the New York Polyclinic by Dr. , on the 9th of April, 1895. He had been taken on March 2d, with an acute attack of catarrhal pneumonia, and for two weeks past his life had been despaired of, and from the .stage of hepatization of both lungs, the case had developed into one of pyamia. He was brought to the hospital on a litter, too weak to lift a hand, and reduced to a skele- ton, hi* complexion waxy, showing considerable pus absorbed. The stomach had not been able to retain any nourishment for the pre- vious ten days, and the rapid ebb of life had been but slightly re- strained by rectal injections of milk, eggs and whiskey. Bovinine, of course, was immediately substituted, half a teaspoonful, with sherr}'' wine and a little ice water, every two hours. For forty-eight hours this dosage was retained only about one time in three. The bi-hourly bovinine was then reduced to ten drops in iced water, with a rectal injection of half an ounce of bovinine in saline water every three hours. The dose by mouth was now all retained, after the first dose, and the next twenty-four hours showed a slight improvement in the little patient's moribund condition. Con- tinuing this course of treatment for three days longer, the action of the heart had so far improved that it was deemed unnecessary longer to delay operating for the pyaemia. On the seventh day, accordingly, he was put under etherization, and Dr. B removed a section of the fifth and sixth ribs, opened the pleural cavity, and drew from it a full pint of pus. The cavity was washed out with hot Thiersch solution, and then hot salt water, drainage tube inserted, and wound dressed with iodoform gauze, covered with wet bichloride gauze. The child came out of the operation, anaesthesia and shock, in an extremely exhausted condition, and life hung fluttering by a thread. Ten drops of bovinine in a teaspoonful of whiskey were given at intervals of one hour. By the second day, the pulse and heart gained strength, and animation became visible in the face. But at noon of the third day, the surgeon was suddenly summoned by the nurse, who said the child was dying. He was found almost entirely collapsed. Giving the usual restorative injections. Dr. B surrounded the body with bags of hot water, and gave a rectal injection of equal parts of bovinine and salt water. In two hours the pulse became nearly normal, and the respiration grew steadier, fuller, and slower. From this time on, the bovine blood was injected rectally every three hours; the little patient steadily improved; the heart and respiration assuming normal action; strength and energy increas- ing; and the elimination of pus and rejuvenation of the system by nourishment showing in the return of normal color to the face. On the 12th of May, the patient was discharged, completely well, lungs in good order, color restored, appetite good, and every w;iy hearty. 2o: The vital power and efficacy of ready-made blood supply, where the system has become impotent for self-nourishment and utterly helpless, could not be more cogently demonstrated than it is in this extreme and remarkable case. FOR TRAUMATIC COLLAPSE— CASE XIL By the Same. A boy of about 17 years of age was operated on, on the 12th of April, 1895, for the removal of monstrously hypertrophied tonsils and uvula. The operation was fearfully exhausting, and the mon- strous surface of the wound within the throat entirely prevented swallowing, except a little ice water. On the second day appeared symptoms of collapse, which developed to a most alarming pitch, from the impossibility of taking nourishment. It became neces- sary to reinforce at once the exhausted blood supply and sinking system by bovinine injection, as no inert nutritive material could act swiftly enough to save the case. Six ounces of bovinine were injected per rectum, and again the same evening. The symptoms were at once relieved. The bovinine per rectum was continued three times a day for a week, by which time, the throat wound was covered with mucus, and he could swallow it by the mouth. April 2Sth, only seventeen days from the operation, the wound is nearly well; he is eight pounds heavier than before; his color and general appearance better than ever, and he says he "feels first rate." BLOOD SUPPLY IN TRAUMATIC EXHAUSTION. By Charles L. Bonifield, M. D., Cincinnati. In the case of a girl, 14 years of age, from whom a large intra- ligamentous cyst, with extensive adhesions to the liver and stomach, was removed: vomiting commenced on the third day while the pa- tient was taking milk and lime water alternately with whiskey and hot water. The stomach was rested for twelve hours, after which bovinine in water was given. The vomiting ceased and did not recur. The ingestion of bovine blood is not attended by the for- mation of gas, which is a consideration of importance in conditions where tympanitis is a troublesome symptom. BLOOD SUPPLIED IN HYSTERO-EPILEPTIC CATALEPSY. By Dr. T. J. Biggs, New York. Anton , a German, 26 years of age, was suddenly seized with a fit of hystero-epilepsy, and when seen, had already lain in a comatose, semi-cataleptic state for forty-eight hours, without any nourishment whatever. The jaw being firmly set and immovable, a tube was introduced through the nose down into the aesophagus, and through this bovinine was forced, every three hours, while a rectal injection of bovinine was given twice a day. The first in- jection was not retained, but strengthened the organ sufficiently to retain all the subsequent ones. General improvement com- menced immediately. At the end of the fourth day he regained consciousness, the cataleptic symptoms ceased, and he has since beeu doing well. 208 HiEMATHEEAPY IN KIDNEY COMPLAINTS. CHRONIC BRIGHT'S DISEASE. Case by Dr. M , New York. Mr. W , American, merchant, presented on April 20, 1897, a fully developed case of Bright's disease: a well defined inter- stitial nephritis, with hypertroph}' of the left side of the heart, gastro-intestinal disorders, and a loss of fifty pounds in six months, during which his urine almost constantly bore a half of 1 per cent, albumen. Being a man of means, everything heretofore possible had been done for him. He had used many of the best-known lithia waters, with the most advanced treatment employed for his condition by the medical authorities of the world. The result of all this was so far from satisfactory, that when taken in hand by the writer on April 20th, his urine contained 1 per cent, of albu- men, and granular casts in large quantity. 1 was thoroughly dis- couraged with the prognosis, and so intimated to the patient's family. It came to me through a medical brother, that bovine blood had been applied with excellent effect in various types of wasting dis- ease, and after consulting Avith Dr. B , 1 determined on a trial in this desperate case. A teaspoonful of bovinine in sterilized milk, also plain lithia water, was given every two hours. Being beautifully retained by the stomach, it was thus continued for a week, and then the bi-hourly dose was increased to a tablespoonful. After the second week, it was increased to a wineglassful every three hours; medicine having been entirely discarded, except an oc- casional dose of nitrate of strychnine and nitro-glycerine. May 10th, the urine contained barely a trace of albumen, and few casts. May 18th, the albumen had entirely disappeared, and the patient found himself feeling better than at any time since the disease began. May 22d, still no albumen, and feeling well. This rapid and pro- nounced improvement is probably unprecedented in an advanced case, and a case so aggravated as this, in which all the resources of the most advanced treatment hitherto known had proved abortive to so much as check the steady progress of the disease from worse to worse; whereas inmiediately on the second day of blood treat- ment the patient began to feel a perceptible improvement in vigor, which continued to increase from day to day to the present. 209 CHRONIC PARENCHYMATOUS NEPHRITIS: HEPATIC AND GENERAL FATTY DEGENERATION, Dr. T. J. Biggs, Sound View Hospital. David J , Stamford; age 70; January 26, 1898. This pa- tient was almost helpless when carried into the hospital. His legs were abnormally large from excessive oedema resulting from the hepatic degeneration. The stomach was tremendously enlarged, the heart also was enormously hypertrophied and its action much disturbed; there was systolic mitral insufficiency; the whole com- plicated with occasional attacks of angina pectoris. Had been con- stantly under treatment for twelve years, with little or no relief. January 27, he was put on a drachm of bovinine in milk and lime water, every three hours, with regulative medicines, and bandaging of legs. The most marked improvement followed: the oedema rapidly disappeared; the heart action was greatly improved; and by the 10th of February blood and urine showed decided improve- ment ; arrest at the source of fatty degeneration ; albumen disap- pearing; the proportion of red cells to white being thirty to one, and the red cells having risen in number to two-thirds of normal, with a marked improvement in general condition corresponding. The manifest operation of the bovinine had been to set up healthy proliferation and nutrition of red cells, and thus nourishing healthy tissue, to prevent the abnormal deposition of fat in its place. In a case so exhausted of vitality by long disease and old age, this phe- nomenon is certainly remarkable and of great interest to physi- cians. February 23d, the patient left the hospital on foot, with but half of 1 per cent, albumen in his urine, and no fatty cells, by micro- scopical examination, a good allowance of red blood cells and haema- globin, for his age, and feeling well. When last seen in March his improvement was confirmed, continuous and complete. TUBERCULAR NEPHRITIS: OPERATION. By Dr. T. J. Biggs, Sound View Hospital. T H , Springdale. Conn.: age 12; April 15, 1898: tem- perature, 100.5; had lost flesh rapidly; suffered great pain in the right kidney; passed large quantities of light urine, in which some blood was occasionally present, with numerous tube casts and tuber- cle bacilli. I put the patient on bovinine every two hours, with suitable medicines, under which he showed some improvement, after whirh the pain and previous condition returned. Conse- quently, after a day of preparatory treatment, was operated on, 210 May 1st. An exploratory incision was made posteriorly, and the kidney was brouglit to the surface of the wound. It was found tre- mendously congested, and presenting the appearance of a well- defined case of renal tuberculosis. So thoroughly was the kidney involved, that on account of the child's weakened condition I deemed it unwise to allow it to remain, and therefore removed it. Bovinine was applied four times a day to the stump of the kidney, through the drainage tube. On May 27, 1898, the patient was dis- charged cured. The rapidity with which the condition in this case was healed, is undoubtedly due to supplied blood, and a parallel to it I do not know. PARENCHYMATOUS NEPHRITIS IN INFANCY. By the Same Surgeon, Sound View Hospital. Clara T , New York; age 3i/^; June 6, 1898. Within six months after her birth, this child had begun to ^how evidences of kidney trouble, and in spite of medical advice, for the next two years led a miserable existence, sick all the time. The little patient was now put on ten drops of bovinine in boiled milk, every two hours, and nothing else. At the end of a week, the bovinine was increased to half a teaspoonful every three hours. This was continued until July 20th, and was then increased to a teaspoonful. Examination of urine now showed no albumen where at first there had been over 2 per cent, present ; no tubular casts nor granular cells, nor any remaining soreness of kidneys. August 30th, the urine was normal in both quantity and quality, and the general condition was that of health. September 1st, patient was discharged cured. She had entered, an emaciated, listless, lifeless, miserable object; departed, five or six pounds heavier, round, rosy, full of spirits, life and fun. CHRONIC INTERSTITIAL NEPHRITIS. By the Same Surgeon, Sound View Hospital. Walter B , Huntington, Long Island, N. Y. ; age 37; July 7, 1898; had been treated four months for chronic dyspepsia; exam- ination now revealed hypertrophy of left side of heart; urine showed almost 2 per cent of albumen, with tubular and granular casts; Avas voiding large quantities of urine; and was much emaciat- ed and run down generally. Ordered to bed and put on medical and bovinine treatment. In a single week, tlie condition was much im- proved: albumen of urine reduced to half of 1 per cent; second week, only a trace of albumen could be found; August 8th, not the slightest trace of albumen was discoverable; all the general symp- toms had disappeared, except the enlargement of heart ; color much improved, and weight increased by six pounds. He tliought he had entirely recovered. 211 CHRONIC BRIGHT'S DISEASB. Dr. T. J. Biggs, Sound View Hospital. Siegfried H , Portchcstcr, N. Y.; Swede; age 39; diagnosis, chronic parencln'niatous nephritis; first seen December 19, 1898. Patient said she had l)een sick for over u .year, and during that tiine had been nnder treatment by ten didereiit physicians, but had re- ceived no benefit. Some told her she had consnmption, and some chronic dyspepsia. A careful study of the case elicited the follow- ing history: The onset of the disease was gradual, and insidions. The first she noticed was swelling of the feet, which gradually ex- tended all over the body, cansing profound dyspijoea. She became pale, debilitated, and suffered from cardiac palpitation, vomiting, headache, vertigo and defective vision. The nrine was scanty, high colored, albnminons, and nnder the microscope showed hyaline and granular tubes casts, granular epithelium, fatty tube casts, and oil globules. An irritable bladder was a constant symptom. Anaemia was pronounced, from the large waste of albumen. Gastro-intes- tinal disorders and vague neuralgic pains were also constant symp- toms. There was also cardiac hypertrophy, bronchial catarrh, and slight oedema of the larynx", causing a husky voice. Partial amau- rosis, the result of neuro-retinitis. Based on these symptoms I made the diagnosis of chronic Bright's disease, and pursued the fol- lowing course of treatment. Altsolute rest was insisted upon, and for the first two days the patient was ])ut on a tablet of Schering's urotropin in a glass of hot water three times a day, and 1-6 grain of calomel every two liours. At the end of two days, the calomel was discontinued, the urotopin was given twice a day, night and morning, and twenty drops of bovinine in lime water and milk every half hour; no other food being allowed. At the end of three days the quantity of bovinine was increased to a teaspoonful every hour; this w,as continued up to January 1st, when the quantity of bovinine was increased to two teaspoonfuls every hour. On Janu- ary 7th, the bovinine was increased to a tablespoonful every two hours. Up to this time the patient had taken absolutely nothing by way of nourishment but bovinine and milk. Her condition, not- withstanding, was so much improved that a general light diet was allowed. At this time the urine showed a decided decrease in quantity of albumen and tube casts; the dropsy had almost en- tirely disappeared, the dyspncea was lessened, and the sight decid- edly improved. January 15th the bovinine was increased to a wine- glassful every three hours. Yrom this time on the patient's im- provement was rapid. February 1, 1899, she was discharged, prac- ticallv cured. The urine was normal, the cardiac condition, except 212. tbo hypertropliy, was almost norma], and ilie dropsy had entirely disappeared, as well as the dyspeptic symptoms; sight was entirely restored. She had gained twelve and a half pounds in weight. A close watch will be kept of this case, and should there be any re- turn of the conditions, a concise report will be made. CASE OF PURULENT NEPHRITIS. Dr. T. J. Biggs, Sound View Hospital. Henry K , Springdale, Conn.; age 40; February 27, 1899; diagnosis, pyelo-nephritis. Was called to see the case with Dr. B . Patient had just had a severe chill and was suffering from a high fever; severe lumbar pains following the course of the ure- ters; frequent micturition, the urine milky in appearance, neutral in reaction and depositing a copious yellowish-white sediment, a small amount of albumen and considerable pus. Patient -was put on a bovinine diet, a teaspoonful in milk every two hours, with large quantities of lithia water; the improvement was almost imme- diate; at the end of forty-eight hours the fever had disappeared, and the urine had cleared up. March 2d, the bovinine was in- creased to a tablespoonful every two hours. Examination of urine at this time showed (outside of a trace of pus) an almost normal standard. March 12th bovinine was in- creased to a wineglassful in milk every two hours, March 16th, the patient was discharged cured having lived entirely on bovinine and milk during the course of his sickness. RENAL CALCULI, CHRONIC CYSTITIS, HYPERTROPHIED PROSTATE. Dr. T. J. Biggs, Sound View Hospital. Frank Jones; age 51; December 20, 1897; chronic cystitis, renal calculi; intense irritation of the bladder, which troubled him so se- verely that he had been reduced almost to a skeleton; prostate tre- mendously hypertrophied, a membranous stricture; right kidney enlarged. The stricture I divided, cleansed, sterilized and deoxi- dized the bladder, and injected bovinine-salt solution into the blad- der. This treatment was repeated daily until the 29th, when the stricture had healed and the cystitis was greatly relieved. The operation for removal of renal calculi, and treatment of the prostatic condition were deferred for the present. 213 VAKIOUS DISORDERS INDICATED BY THE TEl^M "BRIGHT'S DISEASE." By T. J. Biggs, M. D.. Sound View Hospital. I. CHRONIC paiip:nchymatous nephritis. Synonyms: Chronic Bright's disease; chronic tubal nephrifis — chronic albuminuria; large white kidney. Definition: A chronic inflammation of the cortical and tubular structure of the kidneys; characterized by albuminous urine, tli'op.sy, increasing an;emia, with attacks of acute urtemia. Causes: Occasionally it follows the acute form; syphilis, chronic Jiialaria; chronic alcoliolism; chronic mercurialism ; lead poison- ing; protracted suppuration; some undetermined nervous condi- tion. It is a disease of the young, rarely occurring after forty. Pathological Anatomy: A large white, or yellowish-white, smooth kidney, often twice the normal size ; the capsule is nowhere adherent to the organ. Upon section, considerable tumefaction of the cortical substance and a rarity of vascular stria? are recognized. I'he medullary substance shows no appreciable alteration, its color being normal. The convoluted tubes are irregularly dilated and thickened, and filled with broken-down granulated epithelium and fibrinous casts. In pronounced cases there is fatty degeneration of the tubular epithelium. The intertubular matrix is greatly thick- ened — a change due to hyperplasia of the connective-tissue ele- ments, to the immigration of the white corpuscles and their subse- quent multiplication and fatty transformation, the product of in- creased pressure in the veins. II. INTERSTITIAL NEPHRITIS. Synonyms: Chronic Bright's disease; sclerosis of the kidneys; contracted kidneys; small red kidney; gouty kidney. Definition : An inflammation of the intervening connective tissue of the kidney, chronic in its progress resulting in an induration or hardening, with contraction of the organ; characterized by fre- quent passing of large amounts of pale, albuminous urine, of low specific gravity; disorders of the gastro-intestinal and nervous sys- tems and a strong tenrlency to cardiac hypertrophy and changes in the vessels. Causes: A disease of middle life, from forty to sixty years; gout a very common cause; lead cachexia; syphilis; alcoholism; long- continued worry, anxiety or grief; alterations in the renal ganglio- nic centres (Da Costa and Longstreth). Pathological Anatomy. The kidneys are reduced in size; the capsule is thickened, opaque and adherent. The surface of the kidney is granular, with cysts of various sizes, of transparent color, irregularly over the surface. On section the tissue of the kidney is tough and resistant. The cortical portion is thin, from atrophy, being only a line or two in thickness. Tlie connective-tissue is greatly thickened, compressing the tubules into mere threads; the glomeruli being grouped together in bunches, owing to the wasting of the intermediate tubes. The color varies, from a darkish-brown 214 t(> a yc'llowisli-gray, ticcurding to (lie niii(.)Uiil of Mood in the organ. The left side of the heart is hj'pcrtrophied, and there is also hyper- trophy of the muscular fibre of the arterioles throughout the body; and if the case is protracted the hypertrophied tissues undergo fatty degeneration. In many cases there occurs fatty degeneraiion of the i-etinal tissiu's, or sclerosis oi' llie ncrve-libre layer; ehaiiges which are termed retinitis albuminuria. The ganglionic centres undergo fatty degeneration and atro])hy (Da Costa and Longstreth). Apop- plexy is a frequent termination of interstitial nejdiritis; the ru])ture of a cerebral vessel suggesting it to l)e a disease of degeneration. III. AMYLOID KIDNEY. Synonyms: Chronic Bright's disease; waxy kidney; lardaceous kidney. Definition: A peculiar infiltration into, or a degeneration of, the structure of the kidney, from the deposit of albuminoid material, having a superficial resemblance to starch granules. Similar changes occur in the liver, spleen, intestines and other organs. Causes: The chief cause is prolonged suppuration, especially of the bones; coxalgia; syphilis; cancer. Pathological Anatomy: The kidney is uniformly enlarged. It ]iresents a pale, glistening, translucent appearance, and has a doughy consistency. On section, the surface is homogeneou.s, anae- mic and whitish. The deposit occurs along the renal vessels and in the vascular tufts of the glomeruli, progressing until all parts of the organ are infiltrated. When the organ is thus infiltrated, the proper structure undergoes an atrophic degeneration, the result of pressure. The reaction with iodine and sulphuric acid aft'ords a cer- tain test of the amyloid deposit. One may brush over a section of the affected kidney a solution of iodine with iodide of postassium in Avater, when a mahogany color will be produced, and if dihtted sul- ])huric acid is now added, a violet or bluish tint results. A very pretty reaction is to take a 1 per cent, solution of aniline violet, which strikes a red or pink color with the amyloid material, while the unaltered tissues are stained blue, making a beatttiful contrast. Similar changes occur in other organs of the body. With the amyloid change may l)e associated either parenchyma- tous or interstitial nephritis. GENERAL TREATMENT OF THE VARIOUS FORMS OF "BRIGHT'S DISEASE." It is to be borne in mind that the course of a case of chronic Bright's disease is not continuously downward. Periods of remis- sion often follow the most aggravated symptoms; the patient and his friends being buoyed up by the hope of an early and complete recovery, when, as suddenly, an attack of acute uraemia terminates life. Rest and diet are the most important elements, in the treat- ment. To eliminate the uric acid, diaphoretics and diuretics should be given with care and discretion. Alcoholic stimulation 215 should be avoided. A patient willi this disease should, as far as possible, be relieved Iroiii all cares of business, and spend a goodly portion of time in bed. Great care should be taken to avoid catch- ing cold. The diet should consist of something that will thorough- ly nourish the patient and at the same time give the stomach rest. A large experience in the treatment of these cases has convinced me that bovinine is the remedy "par excellence." It not only sup- plies to the system every element of nutrition, requiring little or no digestion, but checks the waste of albumen and prevents the over- growth of the connective tissue, thereby aiding the kidney in its restoration to normal, as nothing else will do. It should be given in doses from ten drops to a wineglassful in milk, from one hour to three hours apart, according to the age of the patient and the severity of the case. CASE OF TUBERCULAR ANEMIA. Dr. T. J. Biggs, Sound View Hospital. Mary Avery, Portchester, N". Y.; age 40; October 30, 1898; three years had been constantly under the care of various physi- cians, but steadily grew worse; lost thirty-two and a half pounds of weight, and at this time was so weak she could not leave the bed. The blood showed only 1,100,000 red corpuscles to the cu. mm.; a decided deficiency of haemaglobin, and an excess of white blood cells. Lymph from glands contained tubercle bacilli. Eemedies were given to regulate her secretions, and a teaspoon- ful of bovinine every two hours. jSTovember 30th, vertigo, head- aches, night sweats, dyspnoja, and extreme weakness, had entirely disappeared; her appetite was splendid, bowels regular, and she was full of energy and life ; complexion rosy, and weight increased by fourteen and a half pounds. December 3d, a thorough physical examination revealed the fact that the lymphatics had resumed their normal size and were no longer hard. DR. T. E. DAUGHERTY, BALTIMORE, MD. Case I was a man who had been coming to one of our city dis- pensaries for a period of two years, where I had treated him for two large chancroidal ulcers, situated on the scrotum. All ordi- nary modes of treatment had been resorted to without the slightest signs of improvement. I finally concluded to try blood treat- ment, which was then applied daily for ten days, when the case was discharged cured. 1406 N. Mount St., January 25, 1S99. 216 DIABETES MELLITUS. By Dr. T. J. Biggs, of Sound View Hospital, Stamford, Conn. Synonyms: Glycosuria; mellituria. Definition: A chronic affection, characterized by the constant presence of grape sugar in the urine, and excessive urinar\' dis- charge, and a progressive loss of flesh and strength. Causes: Most common in males; occurs at all ages, but most fre- (juently between twenty-five and fifty years; it is often hereditary; excessive use of farinaceous food and malt liquors; sexual excesses. The exact pathology of diabetes mellitus differs in different cases, and in the present state of our knowledge no exclusive view can be adopted. Still, there are reasons for believing that, in a large pro- portion of cases, the nervous system is primarily at fault, though the character of the lesions may vary. Hypera}mia, and hy])ertropliy of the liver and kidneys, are gen- erally present, the result of increased functional activity. The changes in the lungs peculiar to phthisis are often found in very chronic cases. GENERAL TREATMENT OF DIABETES. Impress upon patient the importance of a strictly regulated diet ; prohibit the consumption of such articles as contain sugar, or starch, especially ordinary bread or flour, sugar, honey, potatoes, peas, beans, rice, arrow root, cracked wheat, oat meal, turnips, beets, corn, carrots, fruits and liquors of all kinds, whether distilled or fermented. The diet should be principally animal food, a moderate amount of fluids should be allowed. Saccharin should be used as a substitute for sugar. Eegulated exercise is of importance. The patient should wear flannel and have two or three warm baths every week, or an occasional Turkish bath. My experience shows that the only rational treatment, and one that promises success in a fair number of cases is as follows: From ten dro]is to a wineglassful of bovinine in boiled milk, ad- ministered from once an hour to once every three hours, according to age of })atient and the severity of the disease, also dilute hydro- chloric acid and sulphate of strychnine three times a day — this acts by decreasing the hyperemia and hypertrophy of the liver and kid- neys, thereby lessening their functional activity; the nervous sys- tem also gradually resuming its nonnal state. This course of treat- ment has been, in my hands, the means of curing no less than eight cases. While it is true that the most learned a?tiologists differ as to the causes of this very distressing disease, it is conceded that the ele- ment of nutrition is the all-important factor in its treatment. The })lood preparation possesses in a very marked degree all the elements needed in the reparative process of an organism suffering from this disease, being rich in the vitql and nitrogenous elements that go to repair the waste and debility of the nervous system; it is also prac- tically in the condition of assimilation; and is devoid of all the elements of starch or sugar. 217 PROMPT BLOOD CURB OF DIABETES. Dr. T. J. Biggs, Sound View Hospital. John P , Glenbrook, Conn.; diabetes insipidus; age 36,; JtHiuary 2, 1898; great thirst; increased flow of pale, watery, slightly acid nrine, averaging about four gallons in twenty-four hours, specific gravity from 1.002 to 1.007; urea and other solids greatly increased; sugar and albumen absent; urea and other solids greatly increased; sugar and albumen present; appetite voracious, bowels obstinately constipated, and the skin dry and harsh. The hirge flow of urine was preceded by various nervous phenomena, such as irritability, inability to concentrate the mind, vivid imagina- tion, failure of memory, and headache. Had lost much flesh and was weak and debilitated. Inquiry elicited a history of acquired syphilis. He had been under treatment for over a year, but in spite of all treatments, including an anti-syphilitic, had grown steadily worse. From past experience in the treatment of this con- dition I was convinced that bovinine was exactly indicated, and commenced giving him a teaspoonful in lithia water every hour, alternating with milk and bovinine ; with this I gave him one- (juarter grain proto-iodide of mercury every three hours, and a cathartic each morning before breakfast. N"o other nourishment but the bovinine was allowed. January 6th the bovinine was in- creased to three teaspoonfuls every two hours; January 12th it was increased to a tablespoonful every two hours; January 22d it was increased to a wineglassful every three hours. The patient at this time was greatly improved; quantity of urine decreased to one gal- lon in twenty-four hours; urea and other solids much diminished; bowels normal; and skin moist; nervous phenomena greatly lessened; appetite though large was about normal. Up to this time, the patient had taken no other nourishment than bovinine and milk. February 1st, his condition had further improved, having gained considerably in weight. He was anxious to resume his work, having been absent from it for nearly two years; and on February 10th, he went back to work. February 12th, except a little ner- vousness, his condition was normal — was discharged with instruc- tions to continue the bovinine and report every two weeks. CASES I— IV. By Dr. Clarke, Mllford, Mass. I used the blood treatment in four cases of diabetes, with fine results. Under the best diabetic diet they were making no progress, but with the addition of bovinine, a radical change for the better, and final cure, took place. I heard of the use of it for these cases from a case of diabetes, in Mr. Edward Thayer, of Newtonville; a friend told me that this gentleman had been rapidli' losing strength from the attack, but the blood treatment pulled him up and saved his life. 218 DIRECT BLOOD SUPPLY IN THE TREATMENT OF TYPHOID FEVER. By Prof. Wm. F. Waugh, M. D. The condition of the digestive system during an attack of typhoid fever, as shown in this brief sketch, -warrants our first proposition : That during the course of this fever the power of digesting food is ijnpaired, always seriously, and sometimes ahnost entirely lost, from the suspension of secretion. My second proposition is, that food that will not be digested in the stomach or bowels of a typhoid fever patient, is not only uselesB, but harmful; as in the absence of digestion, decomposition is cer- tain to occur, with the production of substances that are certain to be injurious to the patient. I must refer to this cause the tympan- ites that occasion so much trouble. The conclusion is, that in typhoid fever the stomach and bowels should not be looked upon as,digestive organs, but simply as recep- tacles for food that has been previously digested. That absorption may take place cannot be denied. The whole gastro-intestinal raucous membrane is adapted for absorption. Lieberraeister is right in insisting upon the liberal use of water. The digestion is thereby improved, and the emaciation largely pre- vented. If patients do not ask for it, water should be given sys- tematically in stated quantities. Milk, according to Dujardin-Beaumetz, can only act as salt and water, as neither the fat nor the casein can be absorbed. [But no authorities are needed to assure us that the casein by curdling be- comes liable to decomposition, in the absence of digestion, with the injurious products and effects attributed by Dr. Waugh to undigest- ed food. ]\[ilk is really a kind of food that exacts vigorous efforts of digestion, even in health, and is thus another of the elements to be excluded from the dietary of typhoid fever.] The disease affecting the glandular apparatus of the intestines, absorption through this channel is impossible, and the patient can only be nourished by means of absorption through the veins. In typhoid fever, the glands drained by the thoracic duct are rendered incapable of absorbing food. The only exceptions to this rule lie in the fact that all of Peyer's glands may not be wholly disabled at the same time, as the glandular affection is somewhat progressive fi'om above downward, and some of the glands may not be affected. It becomes, then, a question whether we can supply food at all during a typhoid attack: whether any substance can be directly absorbed into the veins without passing through the intestinal glands, and yet be assimilated. There are two substances in which this jnay be possible. Egg albumen is directly absorbed into the tissues of the growing chick, without digestion or assimilation. Bovinine, consisting of beeves' blood and egg albumen, preserved with glycerine and whiskey, with a little boric acid, answers the need most admirably. It has been my reliance in feeding to typhoid cases for many years, and its suc- cess has demonstrated the correctness of the above proposition. 210 Nothing is so readily absoi'bcd as t'gg albumen and blood, as noth- ing comes so near the eompositiou of the human blood. The gly- cerine assists in keeping the bowels soluble; the whiskey is a useful stimulant, and the boric acid assists the antiseptic remedies with which most practitioners now treat typhoid fever. But there is soniething more than this in bovinine. Some years ago I mentioned this, and called attention to the fact that in blood we have a substance that has been not only digested and assimilated, but vitalized. It is a living fluid, whose existence is identical with that of the individual in whose arteries it flows. I speak simply as a clinical observer ; but I feel sure that when the science of biologic therapeutics has progressed a little farther, we will be furnished the reasons for my present claim ; that there is in blood as nutrition, a value not wholly explicable by its chemical composition. Stern has shown that human blood-serum is destructive to the Klebs-Eberth bacillus, and that the serum of persons convalescing from typhoid fever has an attenuating efl^ect upon the toxicity of typhoid fecillus cultures. The effect of the serum of animals insusceptible to typhoid fever seems to be the next step for investigation. The net results of the application herein recommended are these: I. Avoidance of the gastro-intestinai irritation due to undigested food. 2. The sustaining of the patient's strength, by really feeding him (as distinguished from the mere placing food in his stomach), and the consequent avoidance of collapse, and all the long train of ills that come from malnutrition. 3. The avoidance of the exces- sive emaciation so often seen after protracted attacks of typhoid fever. 4. Shortening of the convalescent period. 5. I put for- ward, tentatively, my impression that the secondary degenerative lesions of muscles, nerves, and other tissues, are not wholly due to continued high temperature, but, in part at least, to innutrition; and that these lesions are not nearly so marked when the patient has been fed upon the system herein advocated. Quite recently a very remarkable series of cases have been re- ported, in which chronic ulcers, even of many years duration, have been cured by the local application of bovinine. Several hundreds of such cases have been so treated with great success. These go so far to confirm my views; for if bovinine can be absorbed from the surface of an ulcer, or from the subcutaneous tissue about it, and so improve the local nutrition as to bring about healing, how much more likely that such a substance can be absorbed from the stomach, and keep up the general nutrition. A "SAMPLE" OF BLOOD POWER. I had two patients with typhoid fever, in their sixth week. I had them on the Woodbridge treatment, but they seemed to get weaker and more exhausted every day. Almost from the first day of the administration of bovinine to the fever patients they commenced improving, and are doing nicely. T>. W. Hendersox, M. T>. ]\rarysville, Ohio, Soptemlior 22, 1807. 220 BLOOD AS SUSTENANCE IN TYPHOID FHVER AND GASTRO-INTESTINAL DISEASES. Thousands of physicians, like those whose contributions appear below, have long been supplying vital blood to their patients in bovinine for typhoid fever, haimorrhagic exhaustion, etc., supposing it to be a peculiarly digestible "food." ^lultitudes of their testi- monials, often very wonderful, have accumulated for ten years; none suspecting the secret of its uni)arallelled virtue. Remarks by Dr. M . In typhoid fever, a disease in which the waste of the nitrogenous elements of the body is excessive and where the function of assimila- tion is m.arkedly impaired, the blood treatment is of especial value, being very readily absorbed for the most part from the intestinal mucous membrane. Not only is the excessive emaciation prevented, but during the whole course of the disease the heart action remains much stronger, and owing to the prevention of the excessive waste and degeneration of the tissues, there is not the usual need for car- diac stimulants. In acute gastritis where all food is rejected, bovinine in small quantities will be retained, and being easily absorbed, allows the inflamed mucous membrane to regain its normal tone. In the treat- ment of chronic gastro-intestinal diseases, where emaciation and weakness are the most marked symptoms, the administration of bovinine gives results that are most satisfactory. In these cases the effect may be noticed from the start, and is continuous and steady. In carcinoma of the stomach, where all foods are vomited, bovin- ine is retained and actually prolongs life, preventing the rapid ema- ciation and starvation and the pain and discomfort caused by indi- gestion of food. SUPPLIED BLOOD IN TYPHOID FEVER WITH COMPLICATIONS— CASE I. By Eobert Frame, M. D., Milford, Del. I have tested this treatment in many cases. In a case occur- ring in a patient, Mr. W. McColley, living near here: disease, typhoid fever; there was a complication of brain and stomach, low jnuttering delirium, subsultus tendinum, tympany, soreness in the right hypogastric region, diarrhoea, and great irritability of stom- ach, in so much that it would reject everything swallowed. The pa- tient was very ana?mic and weak. At this time I commenced using bovinine. It was not only retained, but was readily absorbed. From this time the patient made a rapid recovery. "I have been engaged in the practice of medicine for thirtv-four years, having graduated at Jefferson Medical College of Philadel- phia, class of 1859; and in all this long experience have never met with anything that will compare with this preparation of blood in all cases of irritable stomach and exhaustion. I hope to see it fully endorsed by the profession as The Remedy." 231 AUXILIARY BLOOD IN TYPHOID FEVER. Case in Sound View Hospital, by Dr. Biggs. George T , Bridgeport, Conn.; American; age 38; admit- ted to Sound View Hospital, November 9, 1898, with all the symp- toms of a well-defined case of typhoid fever- the first week ; in- creasing temperature, frequent pulse, coated tongued, nausea, diar- rhoea, and headache. Twenty-four hours after his admission a few spots appeared upon the abdomen and chest. He was put to bed, given a mercurial purge, and every three hours five grains of qui- nine, ten drops of eucalyptus, one drop pure carbolic acid, and two drops tincture of iodine. Also a tablespoonful of bovinine in milk every two hours; this to the exclusion of all other food. To re- duce the fever, he was also given ten grains of antikamnia every three hours as indicated. The second week his fever continued, slightly increased, pulse frequent and compressible, abdomen ten- der, tympanitic and gurgling in the right iliac fossa, nocturnal de- lirium, severe and constant headache- some bronchial rales, sordi of the teeth and lips, persistent diarrhoea; also some disturbance of vision. During all this time he was nourished on bovinine to the exclusion of all other food. Third week, the fever changed from continuous to remittent. Evening excerbations continued as high as the preceding week, and all symptoms remained about the same, until near the end of the week, when a marked amelioration appeared. Fourth week, fever decidedly remittent, almost normal in morn- ing; pulse less frequent, and fuller; tongue clean; abdomen less in size; diarrhoea ceased; and the patient had passed well into the stage of concalescence. Up to this time the patient had lived en- tirely on bovinine and milk; but his condition, nevertheless, as to strength and nutrition, was excellent. He was now given a wine- glassful of bovinine in milk every two hours, and a teaspoonful of elixir of iron, quinine and strychnine, every three hours, and a light diet. His convalescence was now rapid and complete, and on December 12th he was discharged cured. I can safely say that for sustaining nutrition and strength, in this disease, the auxiliary blood supply here employed is the ideal desid- eratum, requiring, as it does, little or no digestion, but, on the con- trary, being almost immediately absorbed into the circulation, it gives the bowel the rest that is indispensable during the progress of this dread disease. 'J22 TVPHOID FEVER. Dr. T. J. Biggs, Sound View Hospital. Geo. T , Bridgeport; American; age 30; admitted to Sound View Hospital, Nov. 9, 1898, with all the symptoms of a well- defined case of typhoid fever, the first week ; increasing tempera- ture, frequent pulse, coated tongue, nausea, diarrhoea, and head- ache. Twenty-four hours after his admission a few spots ap- peared upon the abdomen and chest. He was put to bed, given a mercurial purge, and every three hours five grains of quinine, 10 drops of eucalyptus, one drop pure carbolic acid, and two drops tincture of iodine. Also a tablespoonful of bovinine in milk every two hours ; this to the exclusion of all other food. To reduce the fever, he was also given 10 grains of antikamnia every three hours as indicated. The second week his fever continued, slightly in- creased, pulse frequent and compressible, abdomen tender, tym- panitic and gurgling in the right iliac fossa, nocturnal delirium, severe and constant headache, some bronchial rales, sordi of the teeth and lips, persistent diarrhoea ; also some disturbance of vis- ion. During all this time he was nourished on bovinine to the exclusion of all other food. Third week, the fever changed from continuous to remittent. Evening excerbations continued as high as the preceding week, and all symptoms remained about the same, until near the end of the week, when a marked amelioration appeared. Fourth week, fever decidedly remittent, almost normal in morn- ing ; pulse less frequent, and fuller ; tongue clean ; abdomen less in size ; diarrhoea ceased ; and the patient had passed well into the stage of convalescence. Up to this time the patient had lived en- tirely on bovinine and milk ; but his condition, nevertheless, as to strength and nutrition, was excellent. He was now given a wine- glassful of bovinine in milk every two hours, and a teaspoonful of elixir of iron, quinine and strychnine, every three hours, and a light diet. His convalescence was now rapid and complete, and on Dec. 12 he was discharged cured. I can safely say that for sustaining nutrition and strength, in this disease, the auxiliary blood supply here employed is the ideal desideratum, requiring, as it does, little or no digestion, but, on the contrary, being almost immediately absorbed into the circulation, it gives the bowel the rest that is indispensable during the progress of this dread disease. 223 Chicago, 111., November 3, 1888, I have beeu prescribing boviniue in hospital and private practice for the past two or three years in cases of malnutrition or wasting produced by tyj^hoid fever, tuberculosis and allied conditions, and lind it of marked benefit in sustaining the strength of the patient. I usually combine it with milk. D. A. K. Steele, M. D. 1801 State Street. Winona, j\Iinn., February -1, 1888. I have used bovinine with great satisfaction in cases of malassimi- lation, chorea and typhoid fever. In the latter disease it is a nutri- ent of wonderful value. In one case, a young lady whose tem]iera- ture reached 105 degrees for two days, with other very unfavorable symptoms, it did glorious work, and it was continued during subse- quent convalescence. L. G. Wilbertox, M. D. Indianapolis, Ind., December 30, 1887. I have given bovinine a thorough trial with convalescents from typhoid fevers and gastric troubles with a great deal of satisfaction. I have also used it in enteric diseases of children with wonderful re- sults. I have truly found the preparation quite as valuable as it was represented to me. F. 0. Chambers, M. D. Detroit, Mich., January 10, 1888. I have used bovinine in several cases of ty})hoid fever with the most satisfactory results. Have used it in two cases of persistent vomiting in pregnancy, also with excellent results. 453 Antoine Street. D. Wiiehlhh, ^L D. Indianapolis, Ind., December 8, 1887. T have used bovinine in a case of typhoid fever with great effect. The patient's assimilative powers were restored at once, she l)eing almost moribund. W. F. Baijxes. iNf. D. 224 CLINICAL PROOFS OF BLOOD TREATMENT IN ERYSIPELAS. In addition to convincing instances scattered on former pages 115, 116, 117, 132, we are permitted to publish the following unre- served communication from a prominent practitioner of medicine and surgery in Philadelphia: ''Some months ago I had a case at an institution of which I am physician in chief, a lady weighing 300 pounds. Erysipelas had set in on her leg just above the ankle and extended up the leg as far as the knee; it was a very serious case. In the course of a few days ulceration set in and it was a truly horrible sight, the odor was ter- rible, in fact it was so offensive that a physician visiting the institu- tion remarked that he would be afraid that something serious might result to some of the inmates. In a few days gangrene with all its fury set in, and surrounded the whole ulcer. The color was as black as a black hat — it was terrible. I did not know what the re- sult would be, but went to work heroically. I concluded that I would try the blood cure, so I at once used bovinine freely, and in forty-eight hours the gangrene was entirely expelled. I placed her on iron tonics; the ulcer granulated nicely and all was very aatis- factorj'. "I never experienced such a grand and quick dispelling of a griev- ous growth as was obtained by the use of bovine blood. I tried it on another case with the same satisfactory results. Two physicians- were appointed to consult with me in the first case, expecting to see gangrene and a very odorous ulcer, but when they arrived they found nothing but a healthy ulcer. It was truly wonderful — my treatment now for gangrene, ulcers, etc., is bovinine. Samuel C. Henszey, M. D. Thirty-fourth and Hamilton Streets, Philadelphia. ERYSIPELAS. Erysipelas is a diffused inflammation affecting the skin and areo- lar tissue; due to the streptococcus of erysipelas. Symptoms: Continuous erysipelas is known by redness of the skin, which disappears momentarily on pressure; the swelling is puffy, with a distinct edge; the pain is smarting, burning and stinging. The redness is of a vivid scarlet hue, with a tendency to become yellowish if there is much debility. The nearest lymphatic glands are always swollen and tender. In phlegmonous erysipelas, the redness is deeper; sometimes duskv and purple ; the swelling is greater, and is hard and tense; or it may be more doughy and pitting on pressure; the pain is not 225 only burniug, but throbbing. The disease begins with shivering, headache, pain in back, nausea, vomiting, followed by fever, which is of a low type, especially if the patient be old or weak, or if it be of hospital origin. Diarrhoea and perspiration may be present from the outset, particularly if the case be asthenic in character. The cutaneous variety may terminate in resolution, with desqua- mation and slight oedema, or may subside leaving bullge or vesicles remaining under the cuticle, which dry into scabs and peel off, leav- ing a healthy cutis, and sometimes superficial ulcerations. It may terminate by the appearance of small abscesses. Ordinary dura- tion is from seven to fourteen days. The phlegmonous erysipelas often leads to diffuse suppuration of the areolar tissue, when the swelling is flaccid and quaggy; patches of skin become purple and slough; the intermuscular tissue and fasciae may suffer in the same way, and even if the patient escape with life, the limb may remain permanently useless. Phlegmonous erysipelas is more dangerous than the cutaneous variety; the dis- ease is particularly to be dreaded when it attacks the scalp. In old persons, the intemperate, and the very young, the prognosis is very grave. An epidemic of this disease is always more destructive to life than when it occurs sporadically. Traumatic erysipelas is always a cause for grave concern. The tendency to relapse after the disease has disappeared from the part originally affected is very remarkable. T. J. B. CASE OF CHRONIC CYSTITIS. Dr. T. J. Biggs, Sound View Hospital. John R , Stamford, Conn.; age 50; March 6, 1899; diagnosis, Cystitis. Patient had suffered from this condition for several years, one of which was spent in a large New York hospital, 'but little or no benefit derived. The symptoms presented when he first came were: dull pain; frequent but scanty micturitioiT; examina- tion of urine showed it to be alkaline, containing large amounts of muco-pus; on standing, it deposited a thick, glairy, viscid sediment, which under the microscope showed triple phosphates and large pus corpuscles. Immediately after micturition, several ounces of fetid, cloudy, alkaline urine could be removed. Patient presented decided constitutional debility, and occasional bloody urine indi- cated ulceration of the vescical mucous membrane, but as yet no hypertrophy of the bladder could be detected. On account of the vesical ulceration, I determined to treat the patient both locally and internally. He was put to bed, and a bovinine and milk diet pre- scribed, also large quantities of lithia water. Every other day the bladder was washed out with a weak Thiersch solution, followed by a Thiersch-bovinine injection. Internally he was given a wine- glassful of bovinine in milk every two hours. He began to show improvement after the first week; pain was 2-^o less; urine less frequent and more in quantity, and he slept well. March 18th, the Thiersch-bovinine injections were employed once in twenty-four hours. March 28th patient was entirely free from pain, had gained five pounds in weight, slept well, and was per- fectly nourished in spite of the fact that he had taken nothing but bovinine and milk. April 8th, he was discharged cured. CHRONIC CYSTITIS. By the Same Surgeon, Sound View Hospital. Hugh O'N'eil, Greenwich, Conn.; age 34; July 30, 1898; had suffered greatly for three and a half years with cramps and burn- ing, with constant pressure to urinate, resulting from a chronic cystitis. I began on him by washing out the bladder with a weak Thiersch solution twice a day, followed by injection into the blad- der of two drachms bovinine and salt water. The first three or four applications were quite painful, but the rest the patient said were very grateful. September 5th, microscopic examination of urine and cystoscopic examination of bladder showed the condition entirely cured, and the patient was discharged. FORMATION OF BONE. It is now maintained (Medical Eeview) that foreign bone mat- ter, or osseous salts, introduced for the purpose of supplying bone to cavities, act only as stimulants to the proliferation of bone tissue from the mother tissue of marrow or periosteum, and remain them- selves only as unorganized [or absorbed?] surplus material. The formation of bone, in all manner of grafting, therefore, must in all cases be referred ultimately or immediately to the blood, and if this be supplied topically, there is no need of graft-material for filling; as instanced in Dr. T. J. Biggs's complete repair of a large trephine with blood alone, reported in this number of Mod- ern Medical Science. GANGRENE. T. J. Biggs, M. D., Sound View Hospital. Gangrene is the death of any part of the body in consequence of disease or injury. Gangrene is divided into moist and dry. Of the moist gangrene there are two varieties, viz : Localized traumatic gangrene and traumatic spreading gangrene. The causes of moist gangrene are predisposing or exciting. The predisposing causes are : defective nervous power, as in palsied limbs or division of large nerve-trunks; general debility from poor food and improper nourishment; use of alcoholic drinks; debilitating diseases; atheromatous changes in the arteries of old people. The exciting causes result from whatever interferes with or ar- rests the circulation of a part. These may be divided into : (1) Arrest of the supply of arterial blood to a part, which may 22? be produced by accident, or by ligature or other surgical opera- tion, or by thrombosis or embolism of the arteries. (2) Obstruction of the circulation through a part. This may arise from pressure either from within, or from the growth of a tumor; or from without, as from the formation of bed-sores. Ob- struction to the capillary circulation necessarily accompanies all acute inflammations, and forms an important element in the pro- duction of gangrene. (3) Obstruction of the return of venous blood to a part. This is seldom the sole cause of gangrene, even when important veins are occluded by thrombosis or pressure. (4) Extreme weakness of the heart's action. This is a power- ful accessory cause when there is any obstruction, either to the arterial flow or to the venous return. Finally: whatever destroys the cells of a part; as injuries, application of chemical agents, ef- fusion of putrid fluid, absorption of putrid matter, prolonged use of mercury, excess of heat or cold. THE LOCAL SYMPTOMS OF LOCALIZED TRAUMATIC GANGRENE. At the beginning of the attack there is usually pain and tender- ness of the parts, which becomes very acute and lancinating; it is of a severe burning character; there is increased local heat; the dis- coloration, which is at first of a vivid red, is changed to a deep purple or black, with here and there greenish spots. The part becomes greatly swollen, soft, and soggy, from the formation un- derneath of fluids and the gases of decomposition; the epidermis is elevated in blisters. When the part is dead, the pain and tender- ness cease; it becomes cold, the bright redness disappears, and a sickening fetid smell is exhaled. "\Vhen the progress of the dis- ease is arrested, a healthy circulation is established up to the mar- gin of the mortified part, and a line of demarcation separates the living from the dead tissue. LOCAL SYMPTOMS OF SPREADING TRAUMATIC GANGRENE. In this variety, the disease spreads, hour by hour, with alarming rapidity. The color is characteristic and striking, described by Prof. Keen as of a "deep bronze hue, like the rind of bacon." The part is hard and brawny, the limb becomes swollen, and the gases of putrefaction are evolved, giving it a crackling sensation. These gases are hydrogen, nitrogen and hydrogen sulphide. DRY gangrene; senile gangrene; SYMPTOMS. The want of a due supply of arterial blood in these cases is ow- ing not only to the diseased state of the arteries, but also, in a great measure, to the weak propulsive power of the heart, and con- sequent feebleness of the circulation, especially through the lower limbs. When the circulation is sufficiently interrupted to lower the nutrition of the limb, a sensation of weight in the part, with coldness, itching and tingling of the feet, and cramps of the calves, are complained of. These symptoms exist for some time before gangrene comes on. The disease may commence in different ways. In many cases^it begins without any apparent exciting cause. 22S There may be coldness of the extremities, numbness, and tingling. On examination, a small dark or purplish spot may be found on the inside of one of the toes, not larger than a mustard seed. This is succeeded by a vesicle, which exposes a black surface on burst- ing. This gradually spreads until the whole foot is involved, trav- eling up as high as the ankle. It may begin on several toes simul- taneously, or it may show itself on the instep or heel. The part destroyed becomes black, dry, withered, cold, insensible, resembling in appearance the limb of a mummy; hence the change is often called mummification. HOSPITAL GANGRENE is a severe ulceration, in which there is copious exudation, and infiltration of the affected part, together with rapid decomposi- tion. It arises where a number of sick and wounded men are crowded in ill-ventilated apartments, deprived of nourishing food, and where there is no opportunity for separating the infected. It may affect any kind of wound, or even a mere bruise. Hospital gangrene may be divided into idiopathic and traumatic. It is idiopathic when it depends upon constitutional causes, and trau- matic when it has its origin in an external injury. GENERAL COURSE OF TREATMENT IN GANGRENE. Patient must be at once isolated, and, if possible, a special nurse should be assigned to the case, and at the same time the strictest hygienic precautions enjoined. It is proper to commence with a free purge, mercurial preferred; during the course of the disease the bowels should be kept in a soluble condition. To allay pain and irritability and produce sleep, opium in some form should be administered in as large doses as necessary. For the first two or three days a teaspoonful of bovinine in milk should be given every hour — at the end of third day it should be increased to a table- spoonful every two hours. In children, the quantity should range from ten drops to a teaspoonful every hour, or two hours, accord- ing to the age. The bovinine will thoroughly nourish and sus- tain the patient, and at the same time retard the pathological pro- cess by nurturing the blood to its normal quality and keeping it so — the local treatment as follows : The diseased surface should be thoroughly depurated with the bovinine and hydrozone reaction. The hydrozone I now use in preference to peroxide of hydrogen, for the reason that the chemical reaction between the hydrozone and bovinine continues longer, and a greater quantity of oxygen is released: following this, the parts should be irrigated with Thiersch solution, dried, and dressed with bovinine pure as per the technique in ulcer dressings. This process of cleansing and dressing should be repeated from every hour to three hours, ac- cording to the severity of the case. This same course should be adopted in the treatment of erysipelas. 229 * * * SIXTH CASE OF LUPUS. Dr. T. J. Biggs, Sound View Hospital. George P , Stamford, Conn.; age 36; March 11, 1899; Lupus Vulgaris of nose. This condition had beeh of seven years stand- ing, and during that time the patient had been operated on at five different times; the operations consisting of curetting and cauterizing with the Paquelin cautery and various strong acids; but in spite of this, the condition, after a brief improvement, would renew itself in a more aggravated form. When the patient came under my care at Sound View Hospital, the Lupus involved the entire left side of the nose, extending down on the cheek. Ex- amination by the probe revealed it to be very deep. The patient was put to bed, and preparatory treatment instituted. March 13th, under anaesthesia, the Lupus was entirely removed by the curette, following this, the surface and edges were touched with an elec- tric cautery, the wound was cleansed with bovinine pure and hy- drozone, and dressed with Thiersch-bovinine. This dressing was repeated every three hours unto March 16th, The idea of using the Thiersch was to render the bovinine more thoroughly anti- septic for a few days, so as to destroy any remaining bacilli. From this time on it was dressed with bovinine pure three times in 24 hours. The process of healing was rapid and uninterrupted, and on April 10th the patient was discharged cured. Coincident with this local treatment a tablespoonful of bovinine in milk was given every three hours. The remarkable points of interest in this case are its complete, rapid and uninterrupted healing; showing conclu- sively, that for a perfect result the bovinine dressings are absolutely necessary. Five thorough operations performed before I got the case (although at that time the condition had been less exten- sive), were absolute failures. Bovinine seems to act as a specific in these morbid conditions. UNPRECEDENTED CURE OF ANEMIA SPLENICA. (ANEMIA XXXIII.) By Dr. T. J. Biggs, Sound View Hospital. Ella T , Port Chester, N. Y.; age 29; March 1, 1899; diagno- sis, Anaemia Splenica. Patient had been an invalid for four years. Examination revealed the spleen enlarged; the lymphatic glands all over the body swollen, soft to tlie touch, and some even fluctuat- 230 ing; the liver was enormously enlarged; the appetite very poor; digestion feeble; bowels very loose; patient easily fatigued; had severe attacks of cardiac palpitation and dyspnoea; also oedema of eyelids and ankles; urine scanty and of high specific gravity, rang- ing from 1.02 to 1.03. Microscopic examination of blood showed it to be paler than normal, the hsmaglobin reduced in quantity, the specific gravity reduced, 1.055 to 1.040, or even lower; the white corpuscles greatly increased in number and size, the red corpuscles lessened in number and size. I will here note a characteristic point in the diagnosis of this condition. Puncture the finger of the patient with a needle and receive the blood on a piece of white linen or lawn handkerchief, and place by the side of it, a similar stain of blood from a healthy subject. The full color of the latter contrasts strikingly with the stain of the former, which is hardly of a blood color, and translu- cent. I would also here incidentally mention that as yet no case of recovery from this condition had been recorded. The average duration of life under this condition is between two and three years. The following course of treatment was pursued. A teaspoon- ful of bovinine in old port wine, alternating with milk was given every hour, and the patient instructed to be out in the fresh air as much as possible. March 8th, the quantity of bovinine was in- creased to a tablespoonful of bovinine every two hours. March 10th, an examination of the blood showed that the white corpuscles, although just as numerous, had decreased to normal size; specific gravity was slightly higher; the haemaglobin and red corpuscles had increased in quantity — the liver, spleen and lymphatics were reduced in size, and the patient felt stronger. March 14th the bovinine was increased to a wineglassful in milk every two hours. March 23d, bovinine in milk, a wineglassful every hour. By this time the patient was now feeling splendidly, digestion normal; evacuations regular and well moulded; no attacks of car- diac palpitation; dyspnoea and oedema of eyelids and ankles had entirely disappeared; urine almost normal in quantity and specific gravity, 1.018. March 31st, microscopic examination proved the blood to be nearly normal, though there was still a slight excess of white cells. The liver, spleen and glands had resumed their normal size'. April Ist — the patient was discharged. A careful watch will be kept, and should there be any serious relapse a report will be made. This cure, so far as I know, is without a precedent. 231 CARBUNCLE. A prominent personage in New York, no less than the Boss him- self, had lately been tormented with a painful carbuncle on the neck, for which no treatment that "your college wots of" could give any relief, much less healing. Finally, in preparation for depart- ure to Europe, it became necessary to have the carbuncle cut out — all because the best surgeons Mr. Croker knew to call are so ignor- ant of what has been going on under their noses and in certain widely circulated medical literature for five years past, as to be en- tirely unconscious, if not contemptuous, of the nourishing appli- cation of blood (as in bovinine) which has cured the worst of car- buncles "on sight," as it were, both in America and in England, every time; with numerous publicly and professionally attested cases, and not a single failure or even tardiness of cure. See case at Sound View Hospital, in this number of Modern Medical Science. CASE OF ANTHRAX. Dr. T. J. Biggs, Sound View Hospital. Anna M , Larchmont, N. Y.; age 32; March 10, 1899; diag- nosis, anthrax of neck. Patient had a well developed condition of this disease on the back of her neck. The tissue invaded had be- come soft; the skin gangrenous, and had broken down in numer- ous points forming perforations, through which centres of suppura- tion appeared, giving it the appearance of a sieve. The general condition had suffered; had lost in flesh; was pale, thin and ema- ciated. The entire surface and cavities were depurated with bovinine and hydrozone, and then washed with Thiersch solution, and, fol- lowing this, Thiersch - bovinine was injected hypodermically around the carbuncle at the line of demarcation between healthy and diseased tissue. Eleven injections in all were made with ten drops each time. The surface was next dressed with Thiersch- bovinine, changed every two hours, and the injections repeated once in twenty-four hours, up to March 15th. At this time, the slough had separated and come away, leaving a healthy pink granulating surface. Dressings of bovinine pure were now employed up to the 28th of March, and from this time on, once every three hours. April 2d, the patient was discharged cured. There remained only a soft, pink scar that was hardly noticeable. 232 CHRONIC ULCERATION CATARRH. Dr. T. J. Biggs, Sound View Hospital. Will H , Stamford, Conn.; age 24; March 12, 1899; diag- nosis, chronic Rhinitis. Patient had just returned from New York where he had taken a three weeks course of treatment under a specialist, but had gained little benefit. An examination of nares showed the mucous membrane thickened and of a dark red color; the superficial veins were dilated and varicosed, forming small points of ulceration here and there; the secretion was thick, tough and of a greenish color, and very fetid; large collections of dried mucus were formed upon the turbinated bones and septum. He complained of a feeling of fullness in the nares, and increase of se- cretion, which dropped into the pharynx causing paroxysms of hacking and sometimes vomiting, more marked in the morning im- mediately after rising. The sense of smell was entirely abolished ; hearing greatly impaired; voice had a peculiar nasal tone, and his breath was so foul that he had been asked to give up his position, and had to lead almost a hermit's life. So severe had been the strain upon his nervous system, being of a very sensitive nature, that he was in a highly neurotic and debilitated condition. He was put to bed, bovinine, a wineglassful in milk every three hours, was prescribed, and a very light diet. Every two hours, his nares and throat were depurated with bovinine and hydrozone, washed out with Thiersch solution, and bovinine pure was sprayed in. March 20th, his general condition was much improved, as well as the rhinitis. At this time there was only little secretion, not much odor, and he could breathe with considerable comfort. March 29th, the points of ulceration had entirely healed, the discharge had subsided, the breath was sweet, and his general condition greatly improved, having gained seven pounds in weight. April 8th he was discharged absolutely cured. CASE OF SCIATICA, WITH ANEMIA.— XXXIV. John C , South Norwalk, Conn.; Pole; age 39; admitted January 10, 1899; diagnosis. Sciatica, right leg; profound anaemia. Patient had been an invalid for about six years, and during that time, in spite of various treatments, he suffered extremely from the sciatica, and the anemia steadily progressed. On entering the hos- pital, he could not rest the foot of the leg affected firmly on the ground. Microscopic examination of blood gave about 1,100,000 red blood cells to the c. m., and a greatly lessened quantity of haemaglobin. He was now put to bed, and after his secretions had been regulat- 233 ed, bovinine was prescribed, a wineglassful in claret, every three hours. The patient began to improve in every way except the sciatica; I therefore determined to stretch the nerve as soon as practicable. February 2d, patient had gained eight and a half pounds in weight. Examination of blood at this time revealed 2,250,000 red blood cells to the c. mm., and his general -condition, excepting the sciataca, was splendid. February 6th, under anaes- thesia, I cut down, and stretched the nerve. The wound was cleansed with bovinine and hydrogen, with Thiersch irrigation, and dressed with bovinine pure; repeated twice every twenty-four hours up to the 12th, then once in twenty-four hours up to the 15th, at which time the wound was entirely healed, and the patient was en- tirely relieved of pain, but was kept in bed until the 26th. On this date he was allowed to get up and take some gentle exercise, which he did without pain. His improvement from this time was unin- terrupted. March 7th, he had gained a fraction over nineteen pounds in weight, and a microscopic examination of his blood showed a completely normal standard. March 8th, he was dis- charged cured. CHRONIC ULCER FROM VACCINATION. Dr. T. J. Biggs, Sound View Hospital. Sam S , Stamford, Conn.; age 30; March 22, 1899; diagnosis, ulceration of left arm, result of vaccination two months previous. This condition had refused to heal, although he had been under the care of three different physicians in that time. It was about the size of a silver half dollar; had cut down to the muscles; was covered with unhealthy granulations and exuding a foul-smelling, purulent discharge. The sore was now depurated with bovinine and hydrozone, irrigated with Thiersch solution, and dressed with Thiersch-bovinine. This was repeated every two hours, up to the 25th, at which time the sore being in a healthy granulating condi- tion, bovinine pure was employed as a dressing, and changed four times in twenty-four hours, up to April 5th. At this time the sore had been reduced to about the size of a pinhead. Bovinine dress- ings were now renewed twice in twenty-four hours. April 7th, he was discharged cured, with hardly the sign of a scar. CASE OF PYROSIS. Dr. T. J. Biggs, Sound View Hospital. Mary S , Stamford, Conn.; age 36; March 16, 1899; diagnosis Pyrosis. Patient had been a sufferer from this condition for about five years, and during that time, notwithstanding various treat- ments, had received no relief, but steadily grew worse. The symp- toms presented when she came to me were as follows: Loss of appe- tite; difficult digestion; acidity from decomposition of al- 234 bumenoids; heartburn; llatuleiicy; vomiting of partially digested food; soreness in the pit of the stomach during digestion; tongue flabby and pale, showing prints of the teeth; bowels constipated; urine scanty and high colored, with excess of urates; drowsiness after meals, with wakefulness at night; defective memory; head- ache, and absence of mental vigor, with flashes of heat, followed by profuse perspiration; also occasional attacks of palpitation of the heart. As this patient had been treated with all the digestive ferments and tonics, I determined I would employ simply bovinine. A teaspoonful was given, in boiled milk every hour, and increased to a tablespoonful March 21st; again, March 25th, to a wineglassful every two hours. At this time the patient said she was feeling splendidly, but as yet she was allowed nothing but bovinine and milk. April 8th, she was discharged cured, with instructions to report once a week and be very careful what she ate. The bovinine, requiring little or no digestion, is the ideal sustenance for all conditions of weak stom- ach or perverted digestion — there is nothing takes its place nor to compare with it. CASE OF TYPHLITIS. Dr. T. J. Biggs, Sound View Hospital. Henry E , Stamford, Conn.; age 34; March 17, 1899; diag- nosis. Typhlitis. On examination, found patient suffering with pain and tenderness in the iliac fossa, and along the ascending colon, with some prominence of this region; bowels constipated; there was fever, restlessness, also nausea and vomiting; there was much depression of the vital powers. The only distinguishing point between this and appendicitis was the history of the attack. The patient was put to bed, put on a bovinine and milk diet, a table- spoonful of bovinine in milk every two hours, and nothing else al- lowed in the way of food. He was also purged; hot fomentations were applied over the site of the trouble; and one quarter of a grain of codena was given every three hours. March 20th, he was better; little or no fever; pain reduced to a soreness. The bovinine was now increased to a wineglassful in milk every three hours. From March 30th, he was up for two hours each day. April 30th, he was allowed to take a little exercise on the verandah. April 8th he was discharged cured, with instructions to be careful for at least a week. 235 SOME INITIAL CASES IN THE I'KACTICE OF H^MATHEKAPY By a Texas Physician, I have become so much impressed with the marvelous results ob- tainable by the intelligent use of bovinine or supplied blood, in nearly every form of disease, that I feel it a duty to communicate some of the splendid results I have already obtained by its use in my own practice, with a view to interest those of our noble profession who through prejudice or otherwise have not yet given it a trial. Case 1. Erysipelas of the head and face ; the face and head enormously swollen; the patient's temperature ranging from 103 to 104^. I cleansed the entire affected surface with peroxide on bovinine, and then applied externally bovinine pure. The effect was simply marvelous; the pain ceasing shortly after, giv- ing the patient a most refreshing sleep. I prescribed bovinine, applied with atomizer, every three hours, for twelve hours, and thereafter thrice per day; also administered with wine internally, every two hours. Patient made a splendid and quick recovery. Case 2. Child set. 4 years; malnutrition, accompanied with gastric irritation; given up as hopeless by previously attending physician, and brought to me as a last resort; put it on bovinine, using atomizer as in my judgment the best method of conveying it into the system, and directing the parents to give bo.vinine in this way, four times a day, commencing with about teaspoonful doses, combined with fresh cream, and gradually enlarging the dosage; also using in conjunction the hot sponge bath every other night as hot as could be borne, accompanied with gentle massage and a saline enema. Result: a rapid recovery of an apparently hope- less case, and now a finer, healthier child cannot be found. Case 3. A lady had gangrene of the hand, supposed to have originated from the bite of a tarantula or centipede, while sleep- ing; neglect of prompt and proper treatment causing present re- sult. Treatment, peroxide of hydrozone on bovinine and an anti- septic solution (Thiersch's) with bovinine externally four times per day; result: rapid subsidence of pain, entire removal of all foul odor, rapid healing, and quick recovery. Case 4. A boy, suffering with congestion of stomach, bowels and brain; when seen by me, patient was lying in a comatose condition, unable to swallow or to speak. Treatment : injections, per rectum, blisters to the back of the neck, hot fomentations to the abdomen, hot pediluvium, as hot as could be borne, to feet and legs, cold ap- plications to the head, etc., etc. After two or three copious evacua- tions from the bowels, a return of consciousness, but still with in- 236 ability to swallow anytliing. Unfortunately I was out of bovinine. In such circumstances a physician is left if he cannot originate. I sent the patient's father out to hunt me up a Texas mule-eared rabbit, which was soon procured, its head quickly severed from its body, giving me for the time a plentiful supply of fresh blood for present use by adding a little brandy. I had a pretty fair substi- tute for bovinine, and this I had administered by hypodermic in- joction, also using atomizer, for twelve long days. This, with rectal injection, was the only way medicine could be given or life sustained. In this case the recovery was slow but unevent- ful. This obvious blood treatment was something wonder- ful to the astonished but grateful parents and to the visitors and attendants. One old foolish M. D. when told of my treatment in the above case said, "Who the devil ever heard of blood being given internally? He had been practising medicine forty years, and he had never heard of the like. Said he. Dr. Grayson is a crank, and would take up with any new fad, as for himself, he did not propose to have any of it in his. Case 5. Diphtheria; patient, female; set. 16; case considered by the attending physician hopeless, and I was earnestly requested by the parents to take charge of the case. Considering diph- theria as a result of the loss of power in the central nervous sys- tem and particularly of the base of the brain, remedies to meet those indications are imperatively required. Treatment: applica- tion of moist heat to the swollen neck to reduce the inflammation and impart electricity to the central nervous system; the medulla oblongata being considered by physiologists as the automatic cen- tre; hence the necessity of direct stimulation by moist heat. The effect is the same whether applied to the swollen neck or to the inflamed surface of mucous membrane within the throat, which was done frequently in the above case ; also a wash made of dilute alco- hol and oil of sassafras, and used as a gargle also, thus thoroughly cleansing, and that antiseptically, the mouth, tongue and fauces. This treatment with the use of bovinine by spraying with atomizer, constituted the chief procedure in the case, though of course I have not given all the minute details, in the case, deeming it unnecessary, and bovinine being, in my judgment, one of the main factors in the cure of this dread disease. Suffice it to say, the pa- tient made a speedy recovery. I would just remark here, that I have found the happiest effects resulting from the use of the oil of sassafras in connection with bovinine. As you have stated, the vital activity of this living blood con- serve rests on no man's bare assertion ; it speaks for itself to every properly equipped physician who will test its properties microscopi- cally, physically, or therapeutically, proving the great fact that the Blood is the Life. These statements are entirely unsolicited and free. — Wm. K. Grayson, M. D. Butler, Mills Co., Texas, April 8, 1899. 237 CHANGE OF FOOD TO BLOOD THE FUNCTION OF THE EED CELL; NOT DESTROYED BY DRYING. W. Cohnstein and H. Michaelis (Pfluger's Archiv.) show that after the chyle is conveyed into the circulation in the form of a very fine emulsion, a further change takes place in the fat, termed "lipolysis," whereby it is modified into a substance soluble in water. The prop- erty of inducing this lipolysis is stated by the authors to be the prop- erty of the red blood cell and not the serum. The process is in the nature of a fermentation, and is favored by high temper9.tures. The presence of oxygen is necessary for the process, and it cannot be re- placed by any other gas, especially not by hydrogen. The authors further show how faulty analysis of the blood-fats has been because this important factor was not considered; variations as great as 70 per cent, becoming manifest on slight exposure to the air. Dried blood has a similar action upon fats, but a drying point above 40° C. must be avoided. The words above convey a truth of decisive importance as to the vital efficacy of preserved blood; proving that the red blood cell, even when dried, retains its vital lipolytic power, but must not have been heated to fever temperature. Thus, the cold process of blood- preserving, with or without desiccation, preserves the perfect vital element, which is only another name for health wherever introduced in the absence of neutralizing or repellent obstacles — which axe few. Seldom, however, is the disordered system of the patient, or the traumatic or morbid lesions presented to the surgeon, in a ready- made condition to absorb and appropriate the extraneous blood supply, at once, to the best advantage if any. Medical knowledge and skill must be employed to make an intimate diagnosis of the physical conditions, to apply corrective treatment, and to administer the blood in appropriate gradations, along with such medicinal rem- edies as the physician may have at command, according to the wis- dom given unto him. Assistance for these purposes will be afforded in these pages, by a great variety of detailed clinical experiences and results. THE UNDISCOVERED POWERS OF THE BLOOD. Gradually, the medico-scientific world is beginning to apprehend and demonstrate the all-protective virtue that resides in pure un- toxined life-blood. The well-known immimity of the serpent-kill- ing mongoose and hedgehog, to the bites of the most venomous rep- tiles, has been recently investigated and demonstrated in scientific experiments, by Physalix and Bertrand, who have published their report in the Revue Scientifique of Paris. They find in the normal blood of these animals a distinct antitoxin, of such power as to over- come the most deadly doses of serpent venom. 338 The most importajit part of their report, liowever, consists in the evidence they think they perceive, of a common anti-toxic quality in all blood, distributed in various degrees among the different species, but far more universal and powerful than has yet been apprehended. Probably the curative and prophylactic ell'ects of toxin-treated serum should be credited to the normal blood as stimulated by that disci- pline, while the many fatal cases are dne to the animal poison unnec- essarily superadded in the ignorance of our rash experimenters on human life. This is what Physalix and Bertraud say in the direction of a universal immunizing power in perfect normal blood : "Is this immunizing substance peculiar to the hedgehog? We think not. On the contrary, our experiments indicate that it is only the exaggeration of a general fact; that is to say. the presence in variable quantity, in the blood of a great number of animals, of sub- stances capable of neutralizing the effects of venom and of certain toxins." BOVININE is nothing less than the consummate product of the nutritive pro- cess in the living body. It is not to be confounded with mere nu- trients or foods, however elaborated artificially, since it outclasses them by at least three stages of development possible only in the living body — assimilation, composition, and vitalization — already completed. Hence, among the mere "foods," there can be nothing so completely fitted to the wants of humanity as bovinine. It in- cludes, of necessity, all the nutritive principles which enter into the component pari:s of the human body, and being already perfect and perfectly preserved blood, needs no further elaboration in the sys- tem, but goes directly to every part, leaving the stomach entirely at rest, as it so often absolutely needs to be left, and at the same time keeping up a perfect nutrition of the entire body. Bovinine, therefore, is Nature's Vital Essence itself, under another name: supplying, in the very proportions and preparations of Na- ture, the proper elements of the vegetable, animal and mineral king- doms, perfectly combined and compounded, all ready for absorption into the veins and tissues. More than this : in bovinine the vital cor- puscles are preserved intact, and retain all their oxygen-carrying properties. No one who can use a microscope should rest in any doubt on this point. Thus in Bovinine is found all that Nature intended for the perfect nutrition, and vitalization as well, of the entire animal organism. It is, therefore, indicated in all diseased conditions of the body and mind. There is no condition of the stomach or system, so delicate, de- bilitated, or sensitive, but that bovinine may be administered hap- pily and successfully, with due regard to proper dosage, to the neu- tralization of antagonisms, and to the proper avenues to be chosen, according to the condition of the case. 239 MEDICO-SURGICAL PRACTICE OF H^MATHERAPY, OR APPLICABILITIES OF BLOOD TREATMENT. I. IN FEVERS. 1. Continued Fevers: Simple Continued ; Catarrhal; Ty- phoid; Typhus; Cerebro-Spinal; Relapsing: 2. Periodical Fevers : Intermittent ; Typho-malarial ; Pernicious; Congestive; Yellow: 3. Eruptive Fevers: Scarlet Fever; Measles; Rotheln (" German Measles"); Small Pox; Vaccination; Varicella; Erysipelas; Dengue: — In short, for all fevers and wasting diseases, Supplied Bovine Blood (as in bovinine) is fundamental to prevent anaemia and loss of tissue, and to keep up the strength 6// imparted vital nutrition, passively absorbed in a state of functional rest, with scarcely the slightest effort of diges- tion, assimilation, or vitalization ; while it also tones up the native functions for these purposes, and quickens the depleted blood cells themselves to renewed proliferation. Dosage: — From ten drops up to two ounces (bovinine), progressively, as indicated by conditions present; to be taken in milk, wine or grape juice. In case of difficulty in taking or retaining the dose, almost any acceptable medium (not hot) may be used. Bad cases of non-retention may be overcome gradually, by repeating a few drops at a time on crushed ice until it begins to be retained. Rectal injec- tions of bovinine in twice its quantity of slightly- salted water, will serve where administration by the mouth is impracticable or insufficient, or to heal and prevent bowel perforation, . These suggestions as to dosage are applicable to all the cases hereinafter enumerated. r. DISEASES OF THE MOUTH. Stomatitis : Catarrhal, Follicular, Ulcerative : Thrush : Glossitis: — Bovinine and salt solution as awash: a teaspponful every three hours internally, for debility and anaemia. III. DISEASES OF THE STOMACH, Acute Gastric Catarrh; Acute Gastritis; Chronic Gastri" Catarrh; Gastric Ulcer, Cancer, Dilatation, Hc3morrhaq:'^ Gastralgia; Atonic Dyspepsia. — Complete rest of the stomach and yet perfect nutriiio^i 240 at the same time, may be preserved by bovinine treatment; without the irritation of food, but, on the contrary, with relief of pain and soreness, and healing where practicable. Dosage : — From ten drops up to a tablespoonful, as indi- cated, in lime water, every two hours. IV. DISEASES OP THE INTESTINAL CANAL. Intestinal Indigestion; Intestinal Colic; Lead Colic; Con- stipation ; Diarrhoea ; Catarrhal Enteritis ; Croupous Enter- itis; Cholera Morbus; Entero-Colitis; Cholera Infantum; Acute Dysentery, Typhlitis; Perityphlitis; Proctitis; In- testinal Obstruction : — For the bowel, as for the stomach, perfect nutrition, with absolute rest from the action and irritation caused by presence and treatment of food however delicate, is attained through the passive absorption of the living bovine blood in bovinine; thus restoring a normal condition of the or- gans, functions and nerves affected, and resolving patho- logical conditions by supplementing the anaemic deficiency from which they so commonly arise. Dosage. — From ten drops up to one ounce, every two of three hours, in old port wine or milk; or other medium, avenue or method, according to circumstances, as sug- gested under first head. V. diseases of the peritonaeum. Peritonitis : Ascites : — Bovinine as general nutrition and tonic; from ten drops up to a tablespoonful in milk, etc., every three hours. VL diseases op the biliary passages. Catarrhal Jaundice : Biliary Calculi : — To the same gen- eral purposes as above, a teaspoonful every three hours. vn. diseases op the liver. Congestion of the Liver ; Abscess ; Acute Yellow Atrophy ; Sclerosis; Atrophy; Amyloid Liver; Hepatic Cancer: — To the same general purposes as above, from ten drops up to an ounce, every two to four hours, in wine, water, or grape juice, etc. VIII. DISEASES OP THE KIDNEYS. Congestion of Kidneys; Acute Bright's Disease; Albu- minuria; Chronic Parenchymatous Nephritis; Intestinal Nephritis; Amyloid Kidney; Pyelitis; Pyelo-nephritis; Peri- nephritis; Acute Uraemia; Renal Calculi; Cystitis: — This treatment combats the pathological processes by th radi- cal physiological power of pure and perfect nutrition, and 241 its tonic effect, or sustentation of the strength and resistent vigor of the system. The usual dosage : from ten drops up to a tablespoonful, every two to four hours, in milk, wild- cherry brandy, or lime water, etc. IX. ACUTE GENERAL DISEASES. Parotiditis; Acute Articular Rheumatism; Gonorrhoeal Rheumatism; Muscular Rheumatism; Pneumatoid Arthri- tis; Gout; Lithsemia; Diabetes Mellitus ; Diabetes Insipidus; Cholera; Trichinosis: — Supplied Blood, as nutrition and a true tonic, sustains the tissues, organs and functions in health and vigor; thereby preventing the full development of the pathologi- cal conditions begun, and thus warding off the chronic stage. Usual dosage: from ten drops up to two table- spoonfuls, every two to four hours, in milk, lime water or grape juice, etc. X. DIPHTHERIA. In this most important and specific application of Blood Treatment, the general bovinine nutrition — or super-nutri- tion, as it might be called, which is above and beyond the natural operation of food and alimentary functions, and independent of them, however ineffectual they may be through disease— is of course, as in all cases, fundamental ; and in the incipient or even doubtful stage of the disease, is of all things best adapted to resist its progress, not only through sustentation of tissues, organs and functions, especially those of that Great Defender, the Blood, but also by a powerful reinforcement of the same with the abund- ant and robust blood cells of the bullock, as conserved in bovinine. The direct internal operation of this two-fold reinforcement of the blood and of the whole system, is to paralyse the proliferation of the bacillus, to overpower its septic product, to combat the onset of blood-poison and shock, and to prevent blood changes and secondary de- velopments, while sustaining the strength and comfort of the sufferer. Next, in the eradication of the false mem- brane, which is so commonly a direct cause of death, the following simple process is unrivalled perhaps in efficiency, and certainly in mildness and wholesomeness : — With a De Villebras atomizer spray the membrane thoroughly all over with bovinine, and immediately cover this with a spray of peroxide of hydrogen. The combinations instantly formed 243 between these agents and the septio exudate are indicated by a lively effervescence, and the result is a speedy eradi- cation and sloughing-off of the membrane, freeing the true mucous membrane in part from the infection also, which is progressively and at length entirely eradicated by suf- ficient repetitions of the same procedure, at intervals of half an hour to two hours, according to the activity of the exudation. While this is going on, each shower of bovin- ine does an incidental work of nourishment, healing and antisepsis through the open absorbents of the true mem- brane, causing a rapid restoration of that part to health. Unless experience and physiological reason are both at fault, there should be very rare need, if any, for intubation or tracheotomy, where this treatment is intelligently fol- lowed before the last gasps for breath. The internal treat- ment, 'a teaspoonful of bovinine per hour, will be given in whiskey, milk, or other medium, as the conditions may in- dicate to the judgment of the physician. XI. DISEASES OF THE NASAL PASSAGES. Acute and Chronic Nasal Catarrh : — The bovine blood in the average dosage already suggested, will be serviceable for special nutrition and tonic, and also as a spray of the internal parts affected, using one part of bovinine in two parts of saline solution. XII. DISEASES OF THE PHARYNX. Acute Catarrhal Pharyngitis; Tonsilitis : — Treatment similar to the preceding. XIII, DISEASES OF THE LARYNX. Acute Laryngitis; CEdematous Laryngitis; Spasmodic Croup ; Pseudo-croup : — Persistent internal and topical treatment as hereinbefore outlined. XIV. DISEASES OF THE BRONCHIAL TUBES. Bronchitis, Acute, Capillary, Croupous, Chronic; Asthma; Hay Asthma; Whooping Cough; Haemoptysis: — Bovinine as a persistent general nutritive and tonic treatment, in the usual dosage above outlined. XV. CONSUMPTION AND OTHER DISEASES OF THE LUNGS. Congestion; CEdema; Pneumonia, Croupous, Catarrhal; Pulmonary Consumption; Pneumonic Phthisis ; Tubercular Phthisis ; Fibroid Phthisis ; Acute Phthisis ; Emphysema : 243 — Blood Treatment is pre-eminent above all besides, for this class of diseases, and for this class of diseases above most others : 1 . It remedies the anaemia and de-oxygenation occasioned by pulmonary disease and also productive of it, by an in- troduced supply directly supplementing at once the nutri- tion, the white and red cells, and the oxygenation, of the blood, independently of native blood-production in the sys- tem, and in spite of the failure of it from indigestion, mal- assimilation and loss of lung substance, even when these defects have b<5Come irremediable by food and medicine. 2. While thus reinforcing all the tissues and the whole united energies of the system, by a fresh and vigorous blood supply direct from bovine arteries, the defensive and reparative functions of the same perfect blood are conspic- uously active, in overpowering the bacilli tuberculosis, neu- tralizing their septic product, arresting the morbid process of tissue destruction, and rebuilding the excavated sub- slance of the lungs. Usual dosage, progressive according to conditions of stomach, etc., from ten drops in very delicate conditions at first, up to two ounces, once in three hours; in milk, whiskey, wine, grape juice, cold beef tea, etc., according to medical judgment or necessity. Spraying of bovinine and saline solution into the air passages has been found serviceable, and eminently so where the tuberculosis has attacked the fauces, larynx, etc. '' Subsidiary treatment, according to the judgment of the physician, should be directed to the excretory functions and organs ; and this, indeed, is imperative in most condi- tions of disease. It is a trite but vital suggestion, that fresh air and exer- cise, adapted to the strength of the patient, with system- atic lung exercises, chest-expanding arm exercise, and all supplemented by all-over massage with the late Dr. Geo. H. Taylor's admirable machinery, if accessible — will play a most important part in propelling the blood supply in- timately throughout the tissues, while making room for its constructive work by securing a healthful elimination of tissue waste. \ In like manner, the supply of oxygen to the lungs must be sufficient ; and should also b*^ made efficient by oxy- 244 gen-inhalations, where weakness or decay of the lungs prevents a full oxygenation of the blood by respired air. Kreasote has been made an adjuvant to the antiseptic work of blood, in capsule or emulsion of from a half to five minims, once in three hours. XVI. DISEASES OF THE PLEURA. Pleurisy; Empyema; Hydrothorax; Pneumothorax: — Usual dosage and media as hereinbefore suggested. XVII. DISEASES OF THE CIRCULATORY SYSTEM. Acute, and Chronic, Pericarditis; Hydro-pericardium; Acute Endometritis; Cardiac Hypertrophy; Cardiac Dila- tation ; Fatty Degeneration of the Heart ; Valvular Disease of the Heart; Mitral, Tricuspid, and Pulmonic Regurgita- tion; Mitral, Aortic, Tricuspid, and Pulmonic Obstruction; Palpitation of the Heart; Angina Pectoris: ■*— The anaemia usually connected with this class of dis- eases also, and the special pathological changes, are obvi- ously to be overpowered by the free and constant introduc- tion of vigorous bovine blood, more effectually than by any other tonic or nutritive regimen possible. The usual methods and measures of dosage need not be repeated. And, as in all classes of cases here reviewed, it is to be understood that the many important points of regimen, as well as of medication, that require scientific professional attention, in connection with the fundamental element of Supplied Bloody are generally left dependent on the care and judgment of attending physicians, which are always necessary. XVIII. DISEASES OF THE NERVOUS SYSTEM. Cerebral Congestion, Anaemia, Thrombosis and Embol- ism, Haemorrhage, Abscess, Intra-cranial Tumors; Acute Meningitis; Pachymeningitis; Tuberculous Meningitis; Acute, and Congenital, Hydrocephalus. It is obvious that proper nutrition and tone of the associ- ated nervous tissues constitute the condition of health to be aimed at in the treatment of all their diseases; that good and sufficient blood, symmetrically diffused, through the due nervous tone of the vessels, throughout the system, is the one thing needful to secure this condition ; and that in default of this agent and its fit distribution naturally, an extraneous supply of the best quality can be introduced with +^^he most beneficial innervating effect upon all func- tions, restoring balance, and checking the dangerous path- ological changes resulting from nerve impairment. 245 XIX. DISEASES OF THE SPINAL CORD, Spinal Hypersemia, Meningitis, Sclerosis, Antero-lateral ditto. Posterior ditto: Acute Myelitis; Infantile Spinal Par- alysis; Chronic Progressive Bulbar Paralysis: — For such cases, the requirements are analogus to those apparent, as above, in diseases of the nervous system gen- erally. XX. NEURITIS — NEURALGIA: Of the fifth nerve; of the cervico-occipital nerves; of the brachial nerves ; of the dorso-intercostal ; of the lumbo-ab- dominal; of the sciatic nerve; Facial paralysis : — The anaemia always existing in these complaints is a funda- mental factor which should be overcome by persistent sys- tematic introduction of blood from without, which the disease proves the system unable to produce for itself until reinvigorated by a fresh charge of vital nutrition. XXI. CEREBRO-SPINAL NEUROSES. Chorea; Epilepsy: these also fall under the general head of the nervous system, and are amenable to the same fund- amental principle of treatment asserted for the foregoing classes. XXII. DISEASES OF THE BLOOD. Ansemia; Chlorosis; Progressive Pernicious Ansemia, Leucocy thsemia ; Addison's Disease; Scorbutus; Hsema- philia; Purpura; Syphilis: — "Blood for blood," is an axiom that needs no advocate, in the sense of supply and assistance to the poverty or per- verted condition of the native vital fluid. 246 SUPPLIED BLOOD IN SURGERY. SOME SUGGESTIONS IN TECHNIQUE. 1. Antiseptic Preparation of Operating Fields of Morbid Surfaces, etc. — The method of Prof. E. H. Pratt, of Chicago, appears at present to be most comprehensive, not only for the "operating field," as a substitute for the usual pro- cesses of soap, scrubbing, shaving, and irrigation with bi- chloride and other antiseptics, but also as a searching anti- septic for suppurating lesions of any kind, superficial or deep; annihilating pud and stench, and overpowering sep- tic agencies (as well as pain), throughout the course of a sinus or fistula for instance, while at the same ^time ad- ministering a bland stimulus and a healing and recon- structive blood supply even in the brief moment of its operation. The method is simplicity itself: After fairly washing the operating field, apply bovinine generously, rubbing it into the SKia, (or, in the treatment of sinus, abscess, diphtheritic membrane, etc., bathing, spraying, or paclcing, freely with it, by means appropriate to the ca»e), and immediately add to such application peroxide of hydro- gen suificient to produce a lively effervescence, which is accompanied by a noticeable degree of heat. Then wash off, or wash out, the Irothy product with plain w^ter or antiseptic solutions, as the part affected may bear or re- quire. iBichloride of mercury, 1-cJUoO, is chosen as the more powerful antiseptic in ca&e of persistent pus: other- wise, iiiiersch solution is sutticient and le&s irritating. Operation and dies ing may then proceed at once ; includ- ing buitcibie appiicaLiuns of plain bovinine at suitable in- tervals: alternated, ii necessary (^in case, for instance, of per^iotent exudate of pus, or diphtheritic membrane), with repetitions of the peroxiae-on- bovinine process. xn treatment oi tliroat, nose or ear, the mucous mem- brane may be cleared by Professor Pratt s method, or sprayed with equal parts peroxide and water; followed by spray of lodotorm-bovinine, on a surface ulcerated, fecu- lent or pussy; but on simple infiammation use plain bov- inine. in corneal ulcers and other eye affections, erysipelas, eczema, etc., a constantly fresh application of plain bovin- ine, bi-hourly to daily, as the case may require, is all-suffi- cient for antisepsis and healing, and evidently preferable to the admixture of harsher agents. 2. Blood Treatment of Ulcers. — Cleanliness and asepsis constitute the first and last condition of success ; secured by first thoroughly cleansing the ulcer and Hs neighbor- hood with warm water and a pure quality of soap ; shaving 247 the surrounding parts with a razor, and wiping out the ex- cretions of the skin with etht-r; and then applying to the ulcer hydrogen peroxide, twenty-five per cent, pyrozone, or permanganate of potash. ''Professor Pratt's mode of antisepsis with peroxide on bovinine (hereinbefore de- scribed), is simpler, and has the advantage perhaps in di- rectly and at once initiating the reparative action of the bovine blood in some measure.) The surface and edges of the ulcer are to be next stripped of dead tissue \vith a sharp curette : preferably without topical anaesthetic ; though for nervous patients it may be sprayed, through an atomizer, with a mixture of chloroform two and a half drachms, sulphuric ether four drachms, and menthol fifteen grains. Irrigate with mere, bichloride, 1-3000, and dress with sterilized gauze saturated with same, covering well beyond the edges of the sore ; over this a bandage similarly satu- rated; then oiled muslin or silk, or rubber tissue; and en- close the whole limb with cotton batting secured by a bandage. After twenty-four hours replace the bichloride dressing with Thiersch (after washing the parts with same) : not with bichloride which would coagulate the albumen, and separate and break up the blood corpuscles, if brought into contact with the bovinine now to be applied. The next twenty-four or forty-eight hours revealing a thoroughly aseptic condition of the wound, it is covered with sterilized gauze saturated with bovinine and well overlapping; or packed beneath the edges if they are under- mined ; protected by external dressings as before ; chang- ing daily, and watching the condition of the sore, for the removal of any unhealthy granulations, etc. This nourish- ing blood supply will now be eagerly sucked up by the perishing embryonic tissue, bleaching out the gauze daily, and requiring a daily cliange saturated with fresh bov- inine, until the progress of healing may reduce the require- ment to a new dressing every other day. Or, where per- fect asepsis is established and maintained, it may be equally safe and more convenient (especially in skin-grafting) to leave the case undisturbed under a thick pack of gauze which is replenished without removing it, often enough to keep it constantly saturated with bovinine; until healing is decisively advanced. 'Jo hold the bovinine to a rectal ulcer, the rectum is lightly packed with sterilized gauze saturated with the same. . 3. Skin-propagation from minute '' grafts, ^^ in Supplied Blood. — The operating field and its neighborhood is first cleansed by Professor Pratt's method, of peroxide on bov- inine (as hereinbefore described), washed off with Thiersch 248 solution; and (in case of need apparent), the parts, if ulcer- ous, kept under wet antisepti-^ dressings in sterilized gauze — mercury bichioride if pus seems persistent, otherwise Thiersch — for twenty-four hours. A second dressing with Thiersch in a salt solution (teaspoonful of salt to the quart) may be advisable according to circumstances for a second twenty-four hours ; determined by inspection : if the sur- face shows unhealthy granulations, gently curette them away, and give twenty-four hours antiseptic dressing. When the surface appears to be in a healthy aseptic con- dition, a few minute bits of skin (such as may be conveni- ently taken from any part previously cleansed, shaved, and wiped off with ether), are sterilized in a bichloride bath (1-3000), dried with absorbent cotton, and placed symmetri- cally at moderate intervals (half an inch from each other and the true skin, will be close enough) ; then secured in place by strips of rubber tissue half an inch wide, covering the whole surface and bound on with a bandage of steril- ized gauze saturated with bovinine diluted with half as much salt water ; this protected from evaporation with oiled silk, well covered with cotton wool, and secured by bandage. After forty-eight hours remove the outer dressing, and re- new the bovinine-saturated gauze, repeating this daily, or every other day, according to progress. A later and sim- pler method, by constant feeding of the bovinine through a thick pack of saturated gauze, with some advantages on condition of permanent asepsis, has been indicated under the head of ulcers. N. B. — Care should be taken not to apply solutions of cor- rosive sublimate, strong carbolic acid, acetate of lead, tan- nic or mineral acids, strong alcoholic liquors, boiling liquids or any substance which precipitates or coagulates albumen, co-incident with this method of treatment; or, if they have been used, the surface should be washed with plain water before applying bovinine. 4. Treatment of Abscess, Sinus, Fistula, etc. — In case of abscess, incision should be made at the lowest point, for perfect drainage, and large enough for easy curetting and packing of the cavity. After emptying the cavity fill it half full of bovinine, into which inject peroxide of hydro- gen, wash out the frothy effervescence resulting, with Thiersch solution, then thoroughly curette the walls of the cavity, and wash it out again with Thiersch. Pack the cavity with gauze saturated with iodoform-bovinine, cover with. Thiersch-saturated gauze, oiled silk, cotton and band- age, and leave it for forty-eight hours. Then remove the packing and irrigate the cavity with Thiersch, inject either five per cent, pyrozone or peroxide of hydrogen, dry it with 249 absorbent cotton, pack witli iodofonn-bovinine gauze, and dress as before. Is uw, granulations will begin to spring up, healing from the bottom, and less packing will be necessary, changing it daily in plain bovinine, with adaptation to the growth of granulating tissue, and diminishing the fre- quency of dressings as the healing becomes advanced. 5. Necrosis of Bone is treated on the same principles as abscess. Sponge grafting may be resorted to, instead of simple bovinine packing in gauze to be removed. After cutting out dead bone and sterilizing, thin slices of steril- ized sponge saturated with bovinine are laid one at a time in the bottom of the cavity and covered wiih Thiersch gauze paoKing, dressing daily until the layer of sponge becomes vitalized tissue, ihen applying another and so on, until re- pair with new bone is complete. The treatment of the flesh wound, or incision, after repair of abscess or bone, is the same as in ordinary surgery. A Sinus is another situation for treatment analogous with that of abscess. A fine treatment of Fistula in Ano is detailed on page 603, January number M. M. S. 6. Treatment per rectum^ for rectal diseases and also for haemorrhage exhaustion or collapse, for shock, for diseases of or affecting the stomach and other parts of the aliment- ary canal, or in any of the exhausting diseases where nu- trition cannot be sutficiently or quickly enough supplied by the mouth: — bovinine is combined with either milk or a neutral salt solution, preferably from four to eight ounces in a preparation of two parts of bovinine to one of the other, and injected with a large size soft rubber catheter attached to the syringe and introduced about eight or nine inches to reach the sigmoid flexure. If the reotum is fllled with faeces, it should be washed out before introducing the bovinine. 7. Hyp >deriitir,al Injection. Bovine blood (in bovinine) is supplied subcutaneously where an instant response is re- quired, as afier haemorrhage or severe shock; in a propor- tion of one part to two of neutral salt solution (teaspoonful plain salt to pint of water) warmed to 100 degrees F. A good size aspirating needle should be selected, and every- thing should be cleansed and sterilized, before proceeding. After carefully preparing the surface, inject the fluid deeply into the soft tissues of either buttock, after which gentle massage should be employed for about ten minutes. Note. — Thiersch dressing is composed of salicylic acid six drachms and boracic acid six ounces: each quantity divided into twelve powders, and one powder of each dis- solved in a pint of water, makes Thiersch solution No. 1 ; available auy where except the eye, for which double the proportion of water is used, making solution No. 2. 250 SOME VALUABLE COMBINATIONS OF BOVININE. In the surgical treatment and dressing of various lesions, highly satisfactory results have been reached by combining bovinine with the antiseptics or medicaments most appro- priate to the case, properly proportioned and chemically compounded. As a beginning, we present the following formulae, Avhich have been worked out under the direction of medical experience in Haematherapy, by an able chemist, and have been successfully tested in practice for the simul- taneous and composite action of the ingredients. I. BOVININE AND MERCURIC CHLORIDE. Parts :— Bovinine 1,000: Mer. Chloride 1: Sodium Chi. 3. The chlorides are first dissolved in water separately : then the solutions are mixed and added to the bovinine. In this instance, an albuminate of mercury is formed, which is dissolved by the excess of sodium chloride. II. BOVININE WITH THYMOL. Parts : — Bovinine ^40 : Thymol 25 : Alcohol 20 : Glycerine 15. Thymol is dissolved in warm alcohol : then glycerine is added: when cold, the thymol solution is added, little by little, to the bovinine. By taking half as much again of glycerine the work is facilitated; but care must still be taken to mingle very slowly, as otherwise a precipitate of albumen will follow. III. BOVININE ^VITH IODOFORM 2 PER CENT. Parts: — Bovinine luO : Iodoform 2 : Ether 5 : Gum Acacia 5. In preparing the 2 per cent, iodoform and bovinine, little trouble is met with. There is absolutely no change taking place in the bovinine proper. IV. BOVININE WITH IODOFORM 4 PER CENT. Parts : — Bovinine 90 : Iodoform 4 : Gum Acacia 6. The 4 per cent, emulsified mixture requires more care. The iodoform is triturated with ether, the acacia is added, and an emulsion is prepared with the bovinine. Two per cent, more of acacia will form a still better mixture. It is worthy of note that in these compounds the obnoxi- ous odor of iodoform is completely masked. • 251 SCIENTIFIC LIGHT ON NOURlSIIlNa THE 'SICK. The worthless rinsings of beef that obtained universal vogue in sick-room regimen prior to the modern development of the medical sciences, have become a scoff and byword among instructed physi- cians of the present day. And yet, they still retain a traditional hold in the profession itself, that makes the scientiiic exposure of their real constitution exceedingly important. For any in whom this tradition may still linger, it is a professional duty to make a pa- tient study of the threefold series of independent aualyses presented in the London health journal, "Food and Sanitation." and copied beloAv. It will be seen that these analyses are mutually critical and corrective; are by high modern authorities in both hemispheres; aud are- in themselves absolutely conclusive. In a series of analyses and experiments made in 1891 by Mr. R. H. Chittenden, Professor of Physiological Chemistry at Yale Uni- versity, the results of which were communicated to the Philadelphia County Medical Association, on May 13th of the same year, Mr. Chittenden gave the follow^ing as the percentage composition of Lie- big's Extract of Beef, Valentine's Meat Juice, and Bovinine. The figures were; — Exti 2 ozs. COBT 1/2} Water (at 110 C.) 2006 Solid matter 79-94 Inorganic constituents 2404 Phosphoric acid P2 05 9-13 Fat (ether extractives} O'Ol Total nitrogen 9*53 Soluble albumen coagulable by heat 06 Total proteid matter available as nutriment 006 Nutritive value as compared with fresh, lean beef (lean beef = 100) 0-30 2-80 73-40 These analyses were, as regards Liebig's and Valentine's Meat Juice, practically confirmed by results published by Mr. Jesse B. Battershall, Ph.D., F.C.S., chemist. United States Laboratory, New York. Mr. Battershall in FoOD Adulteration, page 256, gives the following analyses; — Liebig's Valentine's Extract. Meat Juice. Water 18-27 5067 Organic Substance 5840 29-41 Ash 23-25 11-53 Sohible Albumen 005 — Alcoholic Extract 4411 — Phosphoric Acid 7-8;) 3-76 Potassa 1018 511 Readers of Food and Sanitation do not need to be told that we accept nothing on hearsay or upon testimonials.' We believe that for the public safety every food, every drug, and, above all, every patent preparation ought to be subject to analysis, as we are now subjecting every patent food offered to the medical profession and the public: The results, be they favorable or the reverse, ought to be honestly stated, the more so as few medical men have the appli- Ceat Juice. Bovinine. 2 ozs. 2 ozs. Cost 3/-. Cost lid. 60-31 8109 39-69 18-91 11-30 1-oa 4-00 0-03 0-78 1-49 2-68 2-43 0-55 13-98 0-55 13-98 352 ances, the time and the training necessary to make individual in- vestigations. ^ We shall, therefore, in investigating Mr. Chittenden's and Mr. Baiuisiiall's anal>be.- . c^! wKh tiiem iu a plaiii, niuLier-of- fact manner, and entirely u}; ') l .eir merits, however unexpected may be the results and astonishing the conclusions. Divesting; thus our minds of cant, we have first to note that Mr. Chittenden gives the soluble albumen as o"o6, whilst Mr. Battershall finds 005 per cent, in Liebig's Extract. In Valentine's Meat Juice Mr. Chitten- den finds 055, i. e., a little over one-half per cent. On the assump- tion, therefore, that Valentine's Meat Juice is worth as a nutrient 3/-, Bovinine/ containing 13 98 pet cent, of available nutrient mat- ter) is worth £2> i6s. 3d. per bottle of two ounces, although Bovin- ine sells at 2/9 per six ounces (= i id. for 2 ounces), as against 3/- charged for two ounces of Valentine's Meat Juice. A similar calcu- lation wdth regard to Liebig s Extract discloses the fact that if Liebig's be worth 1/23 for 2 ounces, Bovinine is worth, on Mr. Chittenden's analysis, the sum of ;i^i4 is. 6>4d. per two ounces. So much for Mr. Chittenden and Mr. Battershall. Our analyses of both Liebig's and Valentine's preparations show that they are more valuable in nutrients than the analyses above given disclose, and that the results of Mr. Chittenden and Mr. Battershall require correction; the gelatine and albumen in Liebig's being 1*35 per cent., and in Valentine's 0*93 per cent. For the purpose of an ac- curate comparison, we give our own full analysis of the three prepa- rations in a comparative form: — Liebig's Valentine's Bovinine Extract of Beef. Meat Juice. uovinme. 2 ozs. l/2i. 2 0Z8. 3/- 2 0Z8. 11 d. Water 16-87 55-ai ^^lilohol'* \ 7842 Fat (Ether Extract) 304 4-80 0.09 Gelatine and Albuminoids 1-35 93 13-32 Peptones 8-20 1-55 000 Creatine and Meat Extractives, (almost non-nutritions) 47-32 18.27 0.55 Salt 508 2-63 1-04 Mineral Matters, Salts of Flesh, Phos- phates, etc 17-46 8-51 0-57 Non-nitrogenous Extractives 0-68 8 08 6-01 10000 100-00 100-00 Calculated comparatively on our own analyses, the albuminoid values work out as follows, taking Valentine's Meat Juice as the basis for the calculations: — Valentine's, containing 0*93 albumin- oids, costs 3s.; Liebig's, with 1*35, costs is. 2^^ d.; and Bovinine, with 13*32, costs I id. If, therefore^ Valentine's be worth 3s., Liebig's is worth 4s. 4d. instead of is. 2j2d., and Bovinine is worth 43s. ■* To avoid the possibility of error, we have had duplicate ana- lyses made of Bovinine. The second analysis gave the following tesults : — BOVININK. Water and Alcohol 80-7C Fat (Ether Extract) 1"21 Gelatine and Albumen 12.92 Peptone -. 0-62 Creatine and Meat Extractives 0-21 Salt 0-78 Other Mineral Matters 0.08 Non-Nitrogenous Extractives 848 100-00 353 It will be noticed that there is a slight difference in the figures, but this is to be expected in any food preparation, which must vary to some extent. The lesson to be learnt from these analyses, and from the others already published in this series of articles, is, that the system of manufacture of patent food preparations needs revolu- tionising, and that no medical man can afford to neglect the study of the real value of the meat extracts, etc., he prescribes. At one time the Liebig and Valentine preparations were undoubtedly the best that were placed at the service of the physician. Instead of advan- cing with the progress of science, the makers have been content to rest where they were when the science of foods was in its infancy. Tradition has invested them with a halo of testimony no doubt hon- est enough in its time, and with respect to some of the most largely prescribed patent foods," that tradition has been handed from teacher to teacher, from father to son, and from school to school, without anyone being iconoclastic enough to examine into its boJia fides. It is dangerous for the medical man, above all men, to take any- thing on trust. Dr. W. M. Graillji Hewitt, in an address to the British Medical Association, emphasised that danger in weighty words, saying: — " For the last six or seven years I have tested by carefully inquiring into the past history of patients mostly suffering from some uterine or ovarian disease, or some af- fliction incidental to child-bed, and these conclusions have stood the test of this long- extended inquiry. I have to state the important conclusion that a continuous insuffi- ciency of food, or what may be called a chronic starvation, ' moi'e or less intense in different cases, was found to have existed universally. Consequently, I have natur- ally been led to consider chronic starvation as a most important factor in disease." Experiments have proved that an animal fed upon Liebig 's ex- tract of beef alone, will succumb more readily than a like animal entirely deprived of food. The claims advanced, therefore, in favor of preparations of Liebig' s Extract of Beef, Meat Juices, and Beef Essences that they represent 30 or 40 times their weight of lean beef is absurd, inasmuch as such preparations are practically devoid of nutritive value, and the waste creatine and extractives (at times half the bulk of the preparation), although of some value as stimu- lants, have the disadvantage that their use in many diseases is posi- tively dangerous. It is time, therefore, that such preparations were relegated to the kitchen for use as flavoring agents — with which no one would quarrel — and that their makers ceased to represent them to the public as foods. What, for example, are we to think of the following announcement accompanying Brand's Essence of Beef — "brand & CO.'S ESSENCE OF BEEF. "This essence conists of the juice of the finest beef, extracted by a gentle heat, without the addition of water or any substance whatever, by a process first discoverea by ourselves in conjunction with a celebrated physician. " In cases of extreme exhaustion or urgent danger, a teaspoonful may be adminis- tered as often as the patient can take it, in less urgent cases it may be taken as re- quired with a small piece of bread and a little wine." —in the light of the following analysis : 254 Brand's Esience of B««t, Cost 1b. 2d. Water 91-23 Fat (Ether Extract) 0-18 Gelatine axid Albuminoids 1'25 Peptones 2'54 Creatines and Meat Extractives almost non-nutritious 3"96 Salt 0.45 Other Mineral Matters 0'39 Non-nitrogenous Extractives None. 100.00 or of the assertions re Liebig's Extract — that it "makes the most nourishing of beef tea? " Again, if we take the nutrient values of the three preparations, as compared with fresh lean beef — Reckoning lean beef as equaling lOO'OO Liebig's equals only O'SO Valentine's equals only 3"80 whilst Bovinine equals . . 72'40 If any reader feels too busy to follow the close analytical details of these three reports, let him fix his attention and rational confi- dence on the summary footing, and the demonstrated difference in value between Liebig's Extract (three one-thousandths) and Bovin- ine, seven hundred and twenty-four one-thousandths, of the nutri- tion in beef ! A medical correspondent, Dr. B , gives us another disclosure of the power of blood upon Ijlood, which has not yet been men- tioned. We have before referred to the microscopical observation of Dr. Brakenriclge, of Edinburgh, in transfusion of blood, tbat the injected corjuiscles not only fulfil their common mission in building up the tissues, but also act upon the enfeebled and decimated native corpuscles with power to rejuvenate and multiply them. The new observation of Dr. B tlirows light upon the nature of tliie mys- terious contagion of vital power. It is understood that the nucleus of the blood cell or corpuscle is electrically positive, while the cor- tex of the same is negative, so that by tlie laws of physics these two should neutralize each other, to the death and disintegration of the corpuscle, but for a certain tension contractility of its structure which seems to restrain such (premature?) escape of energy. The moment this tension begins to be relaxed, however, the energy be- gins to be dissipated; in other words, the vitality of the cell is im- l)aired; its form and substance shrink, and its function fails, whether for resistance to intruding forces, as germ toxins, or for the repair of wastes or lesions. 255 Report on the Use of Bovinine AT THE GENERAIv HOSPITAL OF MEAUX, SEINE-ET-MARNE, FRANCE, By DR. DUFRAIGNE, Surgeon-in-Chief. [translation.] ' ' Having read the eulogistic testimonials of American and English physicians con erning Bovinine, and this preparation appear- ing so familiar to the foreign medical profession, we thought it advisa- ble to give it a fair trial, and that, in spite of our general distrust of all the medical specialties coming to our notice from the other side of the ocean." " Our first trial having been found successful, we felt no hesita- tion in giving a wider field to our experiments and we must say that these experiments fully confirmed the happ\' results of our first trial, and now we may safely declare that the medical value of Bovinine, and above all its nourishing value in certain particular cases, cannot be doubtful, for it is an ascertained fac*^ that the Bovinine preparation surpasses in its qualities all the similar so-called nourishing prepara- tions known to us. Now let us relate a few cases which will de- monstrate the efficiency of Bovinine beyond all doubt. ' ' "A patient aged 40 entered our hospital in May, to be treated for a dififuse phlegmon of the hand and left firearm. Continued anti- septic irrigation seemed at first sufficient to check the inflammation, but soon the articulation of the elbow and th«^ lower part of the arm became invaded, and two large incisions were made on the lower surface of the forearm allowing that part to be drained, and revealed an extensive destruction of muscular tissues." ' ' ' The patient was becoming weaker and weaker, and a large slough over the sacrum with abundan*: discharge gave further evi- dence of the considcable lo's of vitalitx . We had then before us a case of septicaemia, and am]nitation was decided on above the elbow, under very critical circumstance-^ in consequence of the generally debili- tated .state of the patient, who had not been able to take any food for 256 several days. We had then a good opportunity for testing Bovinine, and to see for ourselves if that preparation could justify its reputation. The patient took Bovinine with ease, and a few days after (having taken nothing but Bovinine) gradually recovered his strength; deliri- um and fever disappeared, the mental state was better ; the system being less debilitated absorbed more nourishment, and a general im- provement followed. The terrible effects of septicaemia were con- quered. To-day the patient is able to walk ; he is convalescent." ' ' This splendid result was obtained by the easy assimilation of such a vital extract as is contained in Bovinine." "A young patient aged 15, suffering with osteo-myelitis, half of the lower end of the diaphysis of the tibia being involved, we were obliged to remove a large sequestrum of the anterior surfq^ce of the bone and to curette the posterior face ; in short to make a deep excavation of that region. The patient being much debilitated before and especially after this severe trial, Bovinine was administered, 15 grammes per day, and for eight days the patient took it well." "What is remarkable, regeneration of the bones rapidly became apparent, and when the patient could take the ordinary regimen of food we reduced by half the dose of Bovinine. The result is satis- factory." "Another patient of a delicate constitution, whose left thigh had been amputated, was fed on Bovinine alone for several weeks. By the help of that preparation, the system, which had been so debili- tated before the operation, in consequence of a tumor of the knee, which had resisted treatment for ten months, has regained its vigor. The patient will soon be able to leave the hospital in excellent con- dition." , "Therefore we may condense and say, judging from these cases taken at random, and also from many others which have given the same good results, (and without according to that preparation any therapeutic value), that Bovinine remains a powerful re-building factor for debilitated patients after a long illness; for patients after surgical operations; for patients digesting their food wdth diSiculty; in an accidental or traumatic case, or after a constitutional illness; as the results obtained in our medical service and other wards of our hospitals have thoroughly demonstrated. These results are the consequence of the vital principles contained in Bovinine, principles carefully studied and analyzed by the pharmacists of our establish- ment with reference to their qualitative and quantitative value, promi- nent among which are fibrin, casein, haemoglobin, peptones and the albumen of the egg." (Signed), Dufraigne. THE GREAT FACT IN MODERN MEDICINE: " The Blood is the Life," And Where Nature fails to make Good Blood, WE CAN INTRODUCE IT. LOVININE is Bovine Blood Unaltered from the Arteries of the Bullock : The Universal Auxiliary of Modern Medicine and Surgery, and the TRUE "ANTITOXIN" of Healthy Nature. In the more enlightened progress of Modern Medicine, "Blood- letting " has given place to 'Siood- getting. Aye I Get Good Blood— but How ? Not by the Alimentary Process. It has already failed to do its work (else the patient would not be sick) , and in acute disease must not even be allowed to do the work it can. Stimulate as you will, the whole sum of the patient's alimentary power when fully forced into play, is unable to keep up the nourishing and sup- porting contents of the blood. There is absolutely but one thing to do; and, thank God, that can be done, usually with success, as ten-thousand- fold experience has proved. That one thing is this : where Nature fails to PRODUCE good and sufficient Blood, WE CAN INTRODUCE IT from the arteries of the sturdy bullock, by the medium of BOVININE. The vital activity of this living blood conserve rests on no man's assertion : it speaks for itself, to every properly equipped physician who will test its properties microscopically, physically, or therapeutically. TRY IT IN PRACTICE. TRY it in AncBmia, measuring the increase of red cells and haemaglobin in the blood as you proceed, together with the improving strength and functions of your patient. Try it in Consumjdion, with the same tests from week to week. Try it in Dyspepsia or Malnutrition of young or old, and watch the recuperation of the paralysed alimentary powers. Try it in Intestinal or gastric irritation, inflammation, or ulceration, that inhibits food itself, and witness the nourishing, supporting and healing work done entirely by absorption, without the slightest functional labor or irritation ; even in the most delicate and critical conditions, Buch as Typhoid Fever and other dangerous gastro-intestinal diseases, Cholera Infantum, Marasmus, Diarrhoea, Dysentery, etc. Try it per rectum, when the stomach is entirely unavailable or inadequate. Try it by subcutaneous injection, when collapse calls for instantaneous blood supply — so much better than hlood-dtlution 1 Try 4t on Chronic Ulceration, in connection with your antiseptic and stimulating treat- ment (which affords no nourishment) and prove the certainty and power or topical blood nutri- tion, abolishing pus, stench, and Pain, and healing with magical rapidity zxa^ finality. Try it in Chronic Catarrhal Diseases ; spraying it on the diseased surfaces, with immediate addition of peroxide of hydrogen ; wash ofif instantly the decomposed exudation, scabs and dead tissue with antiseptic solution (Thiersch's) ; and then see how the mucous membrane stripped open and clean, will absorb nutrition, vitality and health from intermediate applica- tions of pure bovinine. Try it on the Diphtheritic Membrane itself, by the same process ; so keeping the parts clean and unobstructed, washing away the poison, and meanwhile sustaining the strength independently of the impaired alimentary process and of exhaustive stimulants. Try it on anything, except plethora or unreduced inflammation ; but first take time to regu late the secretions and functions. Try it on the patient tentatively at first, to see how much and how often, and in what medium it will prove most acceptable — in water, milk, cofl"ee, wine, grape, lemon or lime juice, broth, etc. A few cases may even have to begin by drops in crushed ice. ■ A New Hand-book of Haematherapy for 1898, epitomizing the clinical experience of the previous liree or four years, from the extensive reports of Hospital and private practice. To be obtained of THK BOVININE COMPANY, 75 W. Houston Street, New York *f.-J "J V: " The greatest therapeutic discovery of the age^ and of the ages, is thai where we cannot produce good blood ive can introduce it." What is Haematherapy? A New Thing — and a New Name which, though literally translated (Blood Treatment), may not convey to every one a definite idea. It is a treatment which consists in opposing to a condition of disease the very power - good and sufficient Blood — that would naturally prevent it, that would still cure it spontaneously, and that actually does cure it spon- taneously, wherever the blood-making work of the system is perfectly efficient ; and therefore also tvill cure it, if a deficiency of the vital ele- ment be supplied from without, under proper medical treatment. That Blood is such a power as here described, is an undisputed physio- A Film of bovinine : logical fact. Its transmission from one Showing the Blood-corpuscles Intact, ani^iated Organism to another, for the pur- pose of supplying a defect in the latter, is the substance of the Blood Treatment ; and How to Do this, in different cases, is the form or description of the same. Blood may be taken from a healthy bullock (arterial blood — elaborated with due scien- tific skill) ; or it may be obtained in the well- attested living conserve known as bovinine, from any druggist; and may be introduced into the veins of the patient in either of four ways, that may be most suitable to the case : viz. : by the mouth and stomach; by injec- tion, with one-third salt water, high up in Micro-photographed the rectum ; by hypodermical injection ; or by bjProf. R. R. Andrews, M.D. topical application to any accessible lesion. THE CURE OF PULMONARY CONSUMPTION is one of the latest and most wonderful developments of Blood Power — introduced mainly by the mouth, and sometimes also by spraying bovin- ine into the trachea by an atomizer. Every week of judicious internal blood treatment, with proper medical and hygienic care, has resulted in steady improvement as to all symptoms, with scarcely an instance of check, much less of relapse, until complete apparent cure, and that in the more advanced stages of the disease. As further examples, may be mentioned: Anaemia, Cholera Infantum, Typhoid Fever, Hsemorrhagic Collapse, and many other of the most dangerous and aggravated diseases. IN SURGERY: A CHRONIC ULCER, of no matter how long standing or obstinate and aggravated character, can be cured with certainty — at least, the first instance of failure has yet to be heard of — by constant application o*: bovinine to the wound with proper surgical treatment and sterilization. Such cases are usually cured in from four to six weeks. So of traumatic injuries of all kinds; carbun- cles, fistulas, abscesses, and even gangrene NUMEROUS CLINICAL REPORTS of well known Physicians and Hospitals, where the Power of Supplied Blood is constantly relied on as a cardinal factor in the cure of disease and support of surgery, are at the service of every practitioner who desires to keep up with the progress of his profession, and may readily be obtained (including, of course, the technique and subsidiary^ treat- ments pursued) by applying to * THE BOVININE COMPANY, 75 West Houston Street, New York. PAIENIE3 IDOS