SELECTIONS.

Medical Books.-The Denver Medical Book Co. is one of the oldest and most reliable book concerns in the west. Their many years' experience and extensive agencies reduce the cost and time. in securing publications to the minimum.

"It gives me pleasure at all times to render unto Caesar the things which are Caesar's. Although I am opposed to giving certificates relative to proprietary medicines, in this case I overlook my objections as I consider Sanmetto one of the greatest vitalizers of the reproductive organs now in use."-P. C. Jones, M. D., Kansas City, Mo.

Cholera Infantum. --David Coleman, M.D., Tottenville, S. I., reports the following case: "On July 1, last, was called to attend a baby suffering from cholera infantum in advanced stage. I had little hope of saving the child; at once put it on teaspoonful doses of Glyco-Thymoline (Kress). It stopped the vomiting and corrected the bowels--a rapid recovery resulted."

"Coca" has maintained its reputation as a powerful nerve stimulant, being used with good results in nervous debility, opium and alcohol habit, etc. The highly variable character of the commercial drug makes it uncertain however. Robinson's Wine Coca (see page 3) we believe to be a uniformly active article, it being prepared from assayed leaves, the percentage of Cocaine being always determined by careful assay.

W. Irving Hyslop, M.D., 4408 Chestnut St., West Philadelphia, Pa., says: "I have used Celerina quite largely both in private and hospital practice, and with gratifying results. It is void of repugnant taste and is readily retained by the stomach. My experience with Celerina has been confined chiefly to its use in nervous diseases, particularly loss of nerve power, and the opium habit, in which conditions it has served me well, and I shall continue to prescribe it both in private and hospital practice."

Artificial Limbs. It has long been the study of inventors to construct a limb so as to save the wearer suffering from the constant chafing of the stump. The inventor of the Winkley Artificial Limb, who for years was a sufferer from wearing one of the old-fashioned kind, happily solved the problem by inventing the close-fitting socket contained in an outer one in such a manner as to allow of friction between the two sockets, instead of between the socket and stump, thus saving all chafing, irritation and pulling on the end of

the limb.

Treatment of Hypertrophic Rhinitis.-Dr. E. J. Bermingham (New York Medical Times) says that the compound stearates recently introduced to the profession provide a very efficient method of thoroughly applying aristol, europhen, and iodoform to the nasal mucous membrane. The objection to insufflation heretofore existing, that the powder was almost immediately washed away by the movement of the parts, is to a large extent done away with by combining it with the compound stearate of zinc, which adheres evenly and firmly to the mucous membrane for a considerable length of time. After insufflation of the nasal cavities and pharyngeal vault with this preparation, the membrane is frequently seen partially covered with the powder twenty-four hours after its application.

F. A. Rew, M. D., Imboden, Ark., says: "My experience with S. H. Kennedy's Extract of Pinus Canadensis was so decidedly satisfactory and gratifying that I prescribed it with a positive assurance that benefit will follow its use. On the principle that all astringents are tonics,' I use the Pinus Canadensis, in small doses, in pneumonia, bronchitis, typhoid fever; indeed, where the mucous membranes need a tonic, and recognizing the similarity between mucous membranes and the external skin, I use it in erysipelas, nervous forms of eczema, and whenever the skin needs a tonic. It is all I need in many cases of ophthalmia and gonorrhea. Its special therapeutics would fill many pages, and I am satisfied that we will yet find new uses for it."

Sight-Seer's Headache. --There are, no doubt, very many important uses for Antikamnia, of which physicians as a rule may be uninformed. A 5-grain Antikamnia tablet prescribed for patients before starting on an outing, and this includes tourists, picknickers, bicyclers, and in fact, anybody who is out in the sun and air all day, will entirely prevent that demoralizing headache which frequently mars the pleasure of such an occasion. This applies equally to women on shopping tours, and especially to those who invariably come home cross and out of sorts, with a wretched "sight-seer's headache." The nervous headache and irritable condition of the busy business man is prevented by the timely use of a 10-grain dose. Every bicycle rider, after a hard run, should take two 5-grain tablets on going to bed. In the morning he will awake minus the usual muscular pains, aches and soreness. As a cure and preventive of the pains peculiar to women at time of period, Antikamnia is unequalled and unaccompanied by habit or unpleasant after-effect. If the pain is over the lower border of the liver, or lower part of the stomach, or, in short, be it headache, sideache, backache or pain of any other description caused by suppressed or irregular menstruation, it will yield to two 5-grain tablets. This dose may be repeated in an hour or two if needed.

Economic Value of Pigeons.-Carrier pigeons are serving a rather unique purpose in McCook, Neb., for Dr. F. S. Morris. He is using them among his patients to save him long rides, and finds them of much practical advantage. His practice covers a large country territory. When he has one or two patients ill in widely separated localities he finds it difficult to call on them in one day. Under such circumstances he leaves with the family of the sick person several carrier pigeons, to be released daily with a message as to the patient's condition. These pigeons reach home in a few minutes and much time is saved. The doctor at first used but a pair of the birds, but of late has found them of such great use that he has purchased a dozen. He is receiving a large number of communications from physicians in the country districts of other states asking as to the details and success he has met with in the new plan. Dr. Morris claims that he at first used the birds as matter of pleasure, and later found the idea a very practical one. Now on all visits made into the country he carries two of the birds in his saddlebags especially arranged for the purpose.-California Poultry Tribune.

Acute Dysentery.—In an editorial article on dysentery, Dr. St. J. V. Graham (Georgia Journal of Medicine and Surgery, July, 1899) states that the drug treatment of this disease resolves itself into five or six drugs-calomel, opium, ipecac, tannopine, salines and quinine. If the case is seen early, when diarrhea is present, with a lead colored or brown tongue, much benefit may be derived from giving calomel, 4 grain every fifteen minutes, until six, eight or ten doses are taken. An acid saline is then administered, after which bile usually begins to flow. This is nature's antiseptic, and no chemical compound or so-called intestinal antiseptic can be compared with it. After this has been kept up for a sufficient time for the exigencies of the case, tannopine should be administered, combined with ipecac and opium, in the form of Dover's powder, or of each drug in simple powder combination. Tannopine should be given in 10 or 15-grain doses every two and a half or three hours. An ice bag over the belly is preferred by the writer to any form of poultice. If necessary the bowels are irrigated with a bisulphate of quinine solution-one teaspoonful to a quart of cold water. Very little quinine will be absorbed, for it will not stay in long enough. The diet should be carefully adjusted to suit individual pecularities and the stomach digestion. Stimulants should be used as indicated. The above treatment, which is indicated in acute cases, has proved very successful. In chronic cases, however, an essentially different drug treatment should be resorted to.

DENVER MEDICAL TIMES

VOLUME XIX.

OCTOBER, 1899.

NUMBER 4.

ORIGINAL COMMUNICATIONS.

EXPERIENCE WITH THE BOTTINI OPERATION IN HYPERTROPHY OF THE PROSTATE.*

By LEONARD FREEMAN, B.S., M.D.,

Professor of Surgery, Gross Medical College; Surgeon to Arapahoe County
Hospital and to St. Anthony's Hospital,

Denver, Colorado.

Hypertrophy of the prostate is one of the most annoying and fatal complications of advancing years. It fixes its relentless grasp upon the bladders of all sorts and conditions of men at an age when they are entitled to rest and comfort. Until recently we have been comparatively helpless in the presence of t is affliction, although life could some times be made tolerable by irrigation of the bladder and the constant use of a cath ter. Within the last few years numerous methods of treatment have been suggested, among which are castration, resection of the vasa deferentia, ligation of the internal iliacs, prostatectomy, establishment of a suprapubic fistula, cauterization through the rectum, the administration of animal extracts, etc., None of these expedients is reliable, while some are mutilating and dangerous. When the question is fairly presented, there are few men who will submit cheerfully to castration, or even to vasectomy; and although there have been improvements in prostatectomy, the operation is still difficult and attended with considerable danger in the debilitated.

Enrico Bottini, of Pavia, has come nearer to solving the problem than any one else. For twenty-two years he has been operating successfully with an ingenious instrument of his own invention. For various reasons his work attracted but little at tention until within the last two years, although it is now beginning to receive the recognition to which it is entitled.

The symptoms accompanying hypertrophy of the prostate arise from difficulty in emptying the bladder, due to pouching

* Read before the Rocky Mountain In'er-State Medical Association, at Salt Lake City.

behind the gland and to direct obstruction of the urinary passage. In order to effect a cure, the level of the urethra must be lowered and a free outlet for the urine provided. These requirements can be fulfilled in most cases with Bottini's galvanoprostatic incisor. It contains a concealed platinum blade, heated by electricity, with which grooves are burned through the glandular substance. The procedure has a number of advan tages: (1) There is no mutilation and no external wound, the manipulations being carried out through the urethra. (2) A general anaesthetic, so dangerous in the old and debilitated, is not often necessary, local anaesthesia being usually sufficient (Guitéras employs nitrous oxid gas). (3) There is very little hemorrhage, the vessels being sealed by cauterization. (4) There is comparatively small danger of serious infection, and usually but moderate rise in temperature, the wounds being necessarily aseptic. The charred surfaces tend to prevent absorption until granulations appear. (5) In most instances patients may sit upand even walk about in two or three days, which is of advantage in those who are old and feeble. (6) The effects may be almost immediate, more or less urine being voided within a few hours where it was previously impossible to pass a drop. (7) but few relapses have been observed; in fact improvement has a tendency to be progressive. (8) The operation may be repeated, if for any reason the first attempt has been unsatisfactory. (9) The mortality is lower than with other effective measures. (10) Patients will avail themselves of this method of treatment when they will refuse to submit to castration, prostatectomy, etc.

It is not claimed that Bottini's method is free from danger or inconvenience. Old and feeble men, with inflamed bladders and diseased kidneys, are poor subjects for any operative procedure, and a death will sometimes occur no matter how trivial the nature of the intervention. Even the mere passage of a sound will at times result fatally. The assertion is not toc strong, however, that up to the present time the use of the gal vano-prostatic incisor offers a better chance of relief with less. danger than any other surgical measure.

Bottini's apparatus resembles a lithotrite, the male blade of which is replaced by a platinum knife which can be heated by a current of electricity passing through the handle. Running through the entire length of the instrument, to the end of the female blade and back, is a channel for the passage of ice water, which prevents unnecessary burning of the tissues. The electricity may be obtained from a suitable battery or from the city current, the strength being regulated by a rheostat.

Leaving out many necesasry details, the operation is per formed essentially as follows: