water as hot as the patient can bear wil work like magic. E The tecnic is as follows: Let the patient hold the hed over a sink or some receptacle and from an ordinary syringe bag, let the water run into the mouth and out. The hed should be held so the liquid wil come in contact with the tonsils and fauces. (As some patients ar particular in re- gard to the use of the tube in the syringe bag, the tube can be reverst, or a plain, glass tube terminal can be used.) Actinic rays from the quartz, mercury-vapor lamp (quartz light) bid fair to revolutionize the treatment of nose and throat conditions. The ioe quartz rod applicators shown in Fig. 184 ar especially made for treating hypertrofy of the mucous membrane in the nose. Another quartz applicator shown in Fig. 185 is espe- cially made for treating conditions in the throat such as enlarged tonsils, tonsilitis, acute suppurativ tonsilitis, laryn- geal tonsilitis, and kindred conditions about the fauces. With these quartz applicators the powerful actinic rays ar brot in direct contact with the area to be treated. The reaction is almost immediate and the resolution takes place with greater rapidity than from any other therapeutic agency that I hav ever used or herd o: Quinsy sore throat, as it is commonly cald, probably can be more easily and thoroly cured by means of soluble, stainless iodin and the 3,000-candle-power incandescent lamp than by any other method, except the quartz light. I hav used high frequency surface electrodes for this trouble, as wel as falguration, and both ar good; but more can be done with soluble iodin and powerful light and heat than with all the other methods combined. Zone therapy seems to be especially applicable for all diseases of ear, nose and throat. An old practitioner has recently given me the following formula, which he uses as a swab for sore throat. As he has an extensiv country practis I giv it to you for what it is worth, tho I know “swabs” ar not employd as much as they wer formerly: Zinc iodid .......... 16 gms Todin crystals 15 gms Glycerin 64 mils Aqua dist. . 64 mils M sig. Swab throat every morning. 1173E For painful or obstructed deglutition, stimulation of the 2d and 3d or 6th and 7th cervical vertebrae is in many instances curativ. Zone therapy is of great benefit for this condition. If an operation has to be done upon the nose to enable one to breathe, the sub-mucous operation should be per- formd, as the mucous surface is needed. In regard to the ear, most of the conditions can be cured without operation. See that the ear is wel cleand out and if the Eustachian tube is inflamed, do not immediately insert a catheter, as this is irritating to the membrane. Use the modified Politzer method which is the use of hot, medi- cated vapors under pressure during the act of swallowing. This is easily accomplisht by using the DeVilbiss double nasal tip (Fig. 395) and a comprest air nebulizer. I hav seen cronic conditions, that wer made worse by the use of the eustachian catheter, that wer made very comfortable by following out this method. Vibration over the ear, nose and throat, if properly carried out, is very beneficial in any of these conditions, but probably the most benefit can be derived from the 3,000- candle-power lamp applied over the hed and face. Along with this I always giv oxygen-vapor inhalation and B-D-C therapy. With a double-ear electrode, the sinusoidal, pulsoidal, or interrupted galvanic current can be employd. In many conditions of a sclerotic nature in the ears, I use the slow sinusoidal current, or the pulsoidal current, having the double-ear electrode over the ears for one ter- minal, and the other terminal a sponge or clay electrode over the 2d and 3d or 6th and 7th cervical vertebrae. An efficient remedy for earake in either a child or an adult is a mixture of three drops of carbolic acid (fenol) to one teaspoonful of glycerin. Mix wel and drop into the ear two or three drops. Do not put oil into an aking ear. Glycerin, being hy- groscopic, very quickly takes up water thru the ear drum, thereby lessening the pressure in the middle ear. Oil acts just the opposit. That is why so many “ear drops” with oil as a vehicle ar not efficient. For Mastoiditis the compression radiation from the quartz, mercury-vapor lamp is probably the very bes! pro 1174cedure. Nearly all surgical operations about the mastoid F can be prevented by the quartz light correctly used. For mastoid pains | hav found the quartz light to be very beneficial, especially when used with the 3,000-candle- power incandescent lamp. If none of you hav had the opportunity to use the powerful light over your own face and hed when suffering from acute rinitis, you hav no idea just what relaxation means. Try it. Derness TREATED By Sounp Waves AND Orner Mopa.ities For several years I hav been working out a method for treating certain forms of defness by means of sound waves. So far my work has proved very satisfactory to the patient and the physician. My method is to use a Galton whistle (Fig. 77), or some other device for giving a definit sound vibration. I seat the patient at a certain distance from the whistle, or other device, and instruct him to raise his hand as soon as he does not hear the sound after I hav begun to sound the instrument. : I begin with a sound that he redily hears and then gradually lower the tone until he cannot hear it. In this way the patient exercizes his wil power and at the same time his hearing mecanism. I make a record on a card, so as to know just how much the patient improves from one treatment to another. As he is seated to hav his back to the operator, his eyes can play no part in the work. Your assistant can do this work as wel as you can, and that aids materially in the practicability of the method. I repeat the exercizes several times at each treatment and giv the treatments as often as possible. In many of these cases I hav observd that the patient can hear more acutely if he has had radiations from the 3,000-candle-power lamp over his hed and face for a few minutes previous to the tests. I think the light and heat stimulation aid materi- ally in enhancing the recovery. You wil also notis that the patient wil hear a lower pitch, or a higher pitch farther distant, if he is grounded and faces either north or south, provided he has a normal MM VR. 1175E The pulsoidal current, with some cases, aids very much in restoring hearing, applying the electrodes over the ears. In many forms of defness, especially where the eusta- chian tube is at fault, I hav found that oxygen-vapor inha- lation along with B-D-C therapy greatly aids any other method. The modified Politzer method has been mentiond. For tinnitus aurium there is probably no agency yet dis- coverd that has the magical effect that Zone therapy has. Many cases of otosclerosis, in which the patient has not herd for years and has been annoyd by all sorts of ringing sounds in the ears, hav been not only relievd but cured by this sim- ple method. HYGIENE OF THE Nose AND THROAT The nose creates its own climate and is sympathetically affected, not only by the respiratory system, but also thru other organs. In asthma the irritation of some special focus in the nose wil produce an attack. In hay fever, the starting point seems to be in the mucous membrane of the nose. The ma- jority of conjunctival infections seem to be thru the mucous membrane of the nose. Diseases of the /acrymal sac seem to hav a like origin. The mucous membrane of the nose is of great assis- tance in diagnosis. Many of the deformities of the nose, nasofarynx, farynx, and face ar caused by nasal obstruc- tions. Cronic rinitis is often the etiological factor in produc- ing disease of the air sinuses, farynx, larynx, bronchi, tra- chea, eustachian tubes, etc. Many forms of hedake ar caused by an obstructed nose. The classical experiment of Von Lenharde shows that the lymfatics from the nasal mucosa go directly to the ton- sils. This shows why the tonsils should be saved as wel a8 the mucosa of the nose, whenever possible. A properly constructed atomer and nebulizer ar as important in caring for the nose and throat as a tooth brush is in caring for the teeth. I think the DeVil Manufacturing Co., Toledo. Ohio, make the best atomizers (atomers) and nebulizers t© be had for professional or home use. 1176ATOMERS, NEBULIZERS, Etc. The following illustrations show the atomers that I use—all made by DeVilbiss Manufacturing Co. of Toledo, Ohio. Fig. 389 shows their No. $2, which sprays any liquid, oily or aqueous, in any direction desired. su tC iN ex TURE REMOVED FoR STERLING = : Fig. 389. Showing Atomer, No. 52, Fig. 390. Showing Atomer, No. 51, DeVilbiss Mfg. Co. DeVilbiss Mfg. Co. { Fig. 391. Showing Atomer, No.56, Fig. 392. Showing Nebulizer, No. 80, DeVilbiss Mfg. Co. DeVilbiss Mfg. Co. Fig. 390 shows their No. 51, which seems to hav an advantage over the others as the spraying tube can be redily removed and additional spray tubes can be used. This eliminates the necessity of stopping to sterilize between treatments, and also makes it possible to hav an individual spraying tube for each patient. 17 EE Fig. 391 shows their No. 56. The advantage of this is that it is equipt with post-nasal tips, M and N, and has a lock-nut union for interchangeable tips. Fig. 392 shows their nebulizer No. 80. This nebulizer I hav found to be the best of anything of the kind on the market. The metal table inside of the bottle is made ad- justable so as to regulate the vapor, that is, make it coarse or fine. Fig. 393, This Heater is made of one piece of drawn brass, highly polisht and nickel plated. The top can be removed for adjusting the electric bulb. The bulb is of four-candle-power which wil keep the solutions at from 150 to 160 degrees Fahrenheit. The Heater can rest on a table or shelf, or on a wall bracket, which they can supply. f Fig. 395. Showing Double Nasal Ti Fig. 394. Showing Powder Blower, No. 526. It can be attacht to @"Y No. 73, DeVilbiss Mfg. Co. DeVilbiss Nebulizer When using atomers or nebulizers, I always keep them warm in one of the DeVilbiss Physician's Closed Heate'; shown in Fig. 393. This heater is made of one piece % drawn brass, highly polisht and nickel plated. A £00" 1178candle-power carbon lamp is in this heater, which keeps E the bottles warm. Never use cold solutions in the nose and throat. Fig. 394 shows their No. 73 powder blower for nose and throat. Altho I do not use powder in the nose and throat as much as I formerly did, yet some do and think it is a good method of treatment. For those, I recommend this style blower. Fig. 395 shows the DeVilbiss No. 526 Double-Nasal Tip. This is the nasal tip that I use for the modified Politzer method for treating diseases of the middle ear. I keep many of these double-nasal tips in-a sterilizer always redy to use. The tips ar on flexible tubes so they can be brot nearer to- gether or farther apart, according to the shape of the nose. No. 80 No. 73 No.52 No.56 YJ Fig. 396. Physician's Four Hole Rack No. 529. Fig. 396 shows the DeVilbiss Physicians’ Four-Hole Rack No. 529. This is very convenient for keeping surplus bottles of liquids in. The DeVilbiss Mfg. Co. also make a ful line of hand atomers and nebulizers for home use. Many of these I carry in stock to furnish my patients. Fig. 397 shows No. 16, the one I like best of all. The hand bulb made exclusivly by the DeVilbiss people with the metal connection is shown in Fig. 398. This is without doubt the most complete hand-bulb arrangement made. 1179E Transittumrnation A quick method of ascertaining whether there is an inflamed condition in the frontal sinuses, within the bones about the orbit, or in the antra, is by transillumination. For this a flashlight can be used by putting a piece of rubber tubing over it and passing it wel up into the nasal- orbital angle. If there is no inflammation, the red transil- lumination wil show very clearly. By experimenting on a Fig. 397, DeVilbiss Atomer No. 16, It sprays nose and throat. It sprays any liquid; oily or aqueous. It sprays in any direction. It sprays from any bottle or open container. It has two bottles; one for clensing solution, one for oil. It has no corks nor washers. It has no fine fluid tube to stop up. It has a metal nasal gard which can be used, if desired, when spray- ing the nose. It has an extra outlet tube of hard rubber for use when spraying strong corrosiv solutions. When this tube is used the solution lies in contact with glass and rubber only. It is metal, therefore durable. It can be sterilized by boiling the metal part or passing it thru a flame. It can be used as a nasal douche, or for clensing purposes, by placing the finger over the hole in the cap on the bottle and compressing the bulb. To make extemporancous mixtures, cover the hole in the point with the finger and compress the bulb. This forces the air into the solution and agitates it. It can be used with cither hand bulb or comprest air, The DeVilbiss OBLO bulb is made of highest grade, special stock, molded in one piece, and has a hard metal ball valv. ‘This Atomer complete is absolutely garanteed. Should bulb or metal part prove defectiv, return to The DeVilbiss Mfg. Co. Toledo, Ohio, Windsor, Can., or 71 Newman St, London, W., Eng—with name and address in package—for repair free of charge. Three Ways to Clean this Atomer First—Cover the hole in the point with the finger and compress the bulb. This forces the air current thru the fluid tube. Second—Hold thum over the hole in the cap on the bottle and com- press the bulb, This throws a hevy spray and washes out the instrument. Third—Spred the two tubes apart at the end with a nife blade, remove spray point and after cleaning out the fine hole on each side of the point replace it with the word “up” facing upward. 1180helthy individual, one wil be able to differentiate the normal E and abnormal condition in these sinuses. For examining the antra of Highmore, put the tube into the mouth and hav the patient close the mouth tightly about it. Compare the two sides. This examination has to be done in a dark room. There ar special lamps manufactured for this purpose, but an ordinary flashlight wil do with the right kind of rubber tubing attache, ‘he transilluminators carrying a lamp attacht to the electric lighting system ar unhandy and create too much heat. However they can be used. One of the best and most simple devices for this purpose is the “Reeder Transillum- inator” shown in Fig. 399. Fig, 398. No. 0, Physician’s OBLO Bulb with metal connection for any ‘DeVilbiss Atomer or Nebulizer. = Fig. 399. The Reeder Transilluminator, manufactured by Sharp & Smith, Chicago. The transilluminator has become an important diagnostic agent in otorinology. Thru its use, pathologic changes in many of the accessory nasal cavities hav become visualized. While the ful significance of the picture it portrays may be difficult to interpret, it rarely deceives as to the fundamental facts desired—the presence or absence of disease. The instru- ments now in common usage require the electric current, and some a reo- stat. They ar expensiv and of a size that does not permit them to be used within small cavities. I desire to call attention to an instrument, as illus- trated, which not only overcomes some of these objectionable’ features, but also, on account of its size and shape, has a far broader field of use- fulness. It consists of a small dry cel battery mounted in a case similar to an ordinary flashlight, which has a small but powerful lamp mounted at the free end of a rodlike projection and protected by removable caps, one fenestrated at the side, the other at the end. This instrument is conveniently carried, and is ideal for bedside use and in homes where other means of illumination ar not available. On account of its simplicity and its practicability it is an instrument that wil appeal to the general practitioner as wel as the specialist. 1181E THE PRESERVATION OF HELTH IN THE HOME (Altho I hav written many articles similar to the fol- lowing for various magazines, yet it does not seem out of place to giv it here.) Now that the public schools ar teaching hygiene, even if the parents hav never receivd instruction long these lines, knowledge is carried into the home by the children who hav become enthused over the science of good helth. They ar taut the importance of proper bathing and the value of fresh air. They practis deep breathing and ar told to sleep with plenty of fresh air in their sleeping room. They ar taut to keep the teeth clean and ar shown the cor- rect use of the toothbrush. Within a few years statistics wil not show that 90% of those past forty hav diseasd gums. Altho taut much useful hygiene, the importance of breathing thru the nose has not been sufficiently emfasized. Children should be admonisht to do this night and day. In many cases it has been found advantageous to use isin- glass plaster over the lips at night to compel the child to breathe thru the nose. The nose is less an organ of smell than an organ of respiration, as it is able to change the temperature of the incoming air. It is also an important reflex center and di- rectly aficets the respiratory system. If it is occluded, every other fysiological process in the body is more or less changed. If there is any obstruction in the nose, medical advice should be sought. But it is very seldom, except from accident, that a surgical operation upon the nose is neces- sary if it is cared for in a hygienic manner. Many persons ar under the impression that infectious diseases—like consumption, neumonia, grip, “colds,” etc. —ar spred in some mysterious manner, and that going into the presence of an infected person may cause the disease. They do not realize that most of the infectous diseases that ar “carried” from one person to another, ar contracted because of breathing thru the mouth. If the nose is in proper condition and the person who is exposed to the dis- fate breathes thru the nose, his immunity is greatly en- anst. Expectorating and sneezing in public without proper protection of the nose come under the hed of “unclean habits” just as much as drinking from a common drinking cup. Handling unclean door nobs, hanging to straps on 1182trolly cars, handling unclean money, etc. pollute the hands E and fingers. A person cannot always wear gloves nor carry a disinfectant, but he can cultivate the habit of not rubbing the inside of the nose with the tainted fingers, and can keep unclean objects from the nose as wel as from the mouth. Air is surcharged with dust particles that carry dis- ease-breeding germs. These lodge in the nose and throat with every breth. Therefore placing the fingers in or on these organs produces irritation, congestion, and even dis- ease; for the membranous linings of the nose and throat ar exceedingly sensitiv and susceptible. The question arises, why do we not all hav the same disease when we breathe the same polluted air? The anser is that our resistance, if it is good, prevents us partly or entirely from contracting disease in this manner. Another feature of immunity is the resisting power of the mucous membranes of the nose and throat. In some people the mucous membranes ar very strong and helthy, while in others they ar not. To remove these disease-bearing germs and to neutral- ize their virulent effects by thoroly cleansing every part of the nose and throat is a duty every person owes to himself as wel as to his family. To clense the nose and throat care- fully every day should be as much of a routine as to brush the teeth. For this purpose an atomer may be employd to spray the proper antiseptic solution on the membranes. This wil reach every part of the nose and throat with an antisep- tic, mild, and non-irritating solution, and means relief of irritation, freeing cavities from infectious particles, and increasing the disease-resisting powers of the membranes. It is not necessary to use any “patent medicin” in the atomer. A teaspoonful of common salt and a teaspoonful of borax dissolvd in a pint of warm water makes a very effectiv wash for the nose and throat. Another simple and inexpensiv wash is made by dissolving a teaspoonful of common salt and a teaspoonful of baking soda to the pint of warm water. These, or any other solution for cleansing the nose and throat should be warm, or a little warmer than lukewarm. With a suitable atomer any of these watery solutions can be redily sprayd into the nose and throat. After the watery solution is used, the nose can be carefully .blown, 1183E care being taken to close one side of the nose at a time. Never blow both sides of the nose at one time. Every child should be taut this as it wil often prevent middle-ear difficulties. After spraying, it is advizable to use an antiseptic, oily, nebulizing liquid. This coats over the mucous mem- brane of the nose and throat, and makes it far less liable to contamination. For this purpose ordinary white hydrocarbon oil, some- times cald paraffin oil or liquid vaseline, is all that is neces- sary. In order to make the oil antiseptic, a little thymol or menthol may be added. Any druggist can mix up a few ounces of this thymol-oil at a very small expense, and it wil last a long time. Tt is now generally conceded that the “germs” of in- fantile paralysis ar carried to the system thru the nose, and that keeping the mucous membrane of the nose oild is a pre- ventiv. When the oil is an antiseptic oil and is used thru a suitable nebulizer several times daily, infection is prac- tically unknown. This profylactic mesure seems to enhance immunity. For making a nebula, a regular nebulizer is required. If a good one is obtaind, it wil last a lifetime. A nebulizer breaks the oil up into a cloud that is inhaled. This passes thru the nasal passages and the bronchial tubes and is very soothing, especially where there is an inflamed mucous mem- brane. In helth the frequent use of the atomer and nebulizer is the “stitch in time” which protects the nose and throat against infection. The tissues take on new life and en- larged glands, defness, and many kindred ailments ar pre- vented. In sickness the regular use of the atomer and nebulizer relieves, soothes, and clenses. It destroys disease-breeding germs and frees the nose and throat of contaminating germs and other particles. The child should be particularly garded against the danger lurking in the air—danger in the form of infectious impurities. His delicate nose and throat membranes ar much more susceptible to the ravages of malignant “germs” than those of the adult. Therefore extreme care and atten- tion should be given to this matter in childhood. Spraying and nebulizing of the nose and throat ar scientific methods of arresting nose and throat troubles, 1184bilding up strong, helthy, disease-resisting tissues, and pre- E venting infection from disease-bearing bacteria. The atomer and nebulizer unquestionably hav their place in the home as much as do soap and tooth powder. It is as important that each member of the family has his or her individual atomer and nebulizer as to hav his or her individual tooth brush. Some may say that as children they had no such appliances as atomers and nebulizers. But neither did they hav tooth brushes. What was “natural” fifty years ago is not “natural” in the same sense now, as our constitutions and environments ar changing all the time. For the crowded tenement, the packt street car, the smoke-laden air, and the hustle and bustle of present-day life, all tend to make our surround- ings different from what they wer half a century ago. 1185,ECZEMA Eczema is one of the most common cutaneous diseases that the physician sees. I shal not enumerate the different varieties as the plan of treatment is about the same for each. If possible, find the predisposing cause and eradicate it. Many of the best authorities seem to think that eczema comes with a “reumatic diathesis,” altho they hardly ever exist together. As in every other condition, do not giv constitutional treatment for the disease, but for the patient. Always change the diet of a person suffering from this complaint. Giv iodin therapy. The location of the lesion must guide us in our treat- ment, but our first thot is soluble stainless iodin and the 3,000-candle-power lamp. Along with the powerful incandescent light always use the quartz light. This plan wil eradicate the lesions in a remarkably short time. If the lesions ar not too extensiv, 10% zinc sulfate used cataforically from the positiv pole wil many times work wonders. Five to 10 milliampéres, depending upon the size of the electrode, for 10 minutes every second or third day is the proper procedure. For local applications, oxid of zinc ointment is to be considerd. If you hav an oxygen-vapor generator, wet a piece of gauze in the used oil and apply to the lesion and cover with oild silk. Leave it in place about twelv hours. If reaction is too great, dilute it with paraffin oil. For eczema of the scalp, there is probably no better application than this terpene peroxid, being careful to not produce too great a reaction. Some hav had very good success with carbenzol (Ab- bott’s), either pure or mixt with glycerin. There is no skin disease that has to be treated accord- ing to individual idiosyncrasies more than eczema, but as a rule the method that produces the best general results is the 3,000-candle-power lamp in connection with the quartz light. There is a French process termd “ecorchement” for removal of cloasma, acne, and many other skin lesions, espe- cially cronic eczema. I can do not better than to quote from Dr. Neiswanger’s book, as follows: 1186“The treatment is divided into two parts. The first, E acting as a dry escarotic, destroys the epidermis together with the pigment underlying it. This is replaced by a soft and pliable new skin that is without blemish. It takes about ten days, does not destroy hair when applied to the margin of the scalp, and leaves no scar. The first part of the process is as follows: Resorcin ... 40 parts Zinc oxid . 10 parts Salicylic acid 2 parts Lard - 20 parts Oliv oil . 8 parts Mix. “This prescription must be mixt accurately and no substitutions made. Rub up the resorcin in a mortar until all the crystals ar thoroly broken down. Mix wel with the salicylic acid and zinc oxid. Do not substitute vaseline or any other vehicle for the lard. “This substance is rubd on the part to be treated twice a day until the skin assumes a crackt and dry appearance just as if chapt; which generally takes four or five days. Then the part is carefully washt with a sponge and soap to remove any residue of the ointment, and after being thoroly dried is redy for the second part of the treatment. “This consists of a paste very similar to our old sur- gical glue and is as follows: White gelatin Zinc oxid .... Glycerin Boiling water ....... “This should be prepared on a water bath by first adding sufficient water to dissolv the gelatin, and then stir- ting in the other ingredients. It is applied as hot as the person can bear it, using for this purpose a painter's fine- hair brush. “Before this preparation has had time to dry, it should be coverd with a sheet of absorbent lint and another coat of gelatin paste applied over the lint. In two or three days this mask becomes loose around the edges and may be re- 1187E moved—the dried skin together with all discolorations com- ing away without aid.” For curing localized areas of eczema, freezing wil often work wonders. Don’t forget to treat the patient as wel as the diseasd areas. Don’t forget to try the quartz light. ENDOCARDITIS (See Hart Disease) ENTEROSPASM (See Intestins) ENURESIS This is often caused by a nervous reflex about the genitals. Examin wel the external genitals and put them in ‘proper condition. Sometimes stretching the Wwagina wil remedy this trouble in young girls. When the involuntary discharge of urin occurs during the day, it generally is a symptom of weakness of the mus- cles about the neck of the bladder or lack of nerv control. Treat the cause. Tue Nocturna TyPE oF ENurREsIS Bed wetting occurs most often in children, altho many adults hav this affliction. Probably one of the best fysical mesures is stimulation of the 5th lumbar vertebra. This can be accomplisht either by the Pulsoidal Current, slow-sine current, manual manipu- lation, powerful light energy, vibration, or concussion. Radiantlight therapy and quartzdight therapy ar valuable adjuncts in treating enuresis. Dietetic mesures must be rigidly carried out. I find the best plan is to see that the patient, whether child or adult, eats only very easily digested food, especially after mid- day, and that they eat and drink nothing at least four hours before retiring. For internal medication probably atropin sulfate, used in the following manner, is the best remedy: Ad 1 grain to 1 ounce distild water. Of this mixture giv one drop 1188for each year of age up to 4 years. Probably this dose is E sufficient for all ages up to 12, after which 5 drops can be given if necessary. Dr. C. F. Dunham recommends giv- ing the dose at 4 and 7 p. m. Suggestion has a great effect upon the curing of enure- sis. Some of the most obstinate cases can be cured by sug- gestion alone. Always examin the urin to see whether there is any organic trouble. Raise the foot of the bed from two to six inches. This wil keep the urin from reaching the neck of the bladder so soon. Be sure the bladder is wel emptied before retiring. EPISTAXIS (See Hemorrage) EROSIONS (See Cervicitis and Erosions) ERYSIPELAS For this condition probably radiations from the power- ful incandescent lamp is our best therapeutic agency. Quartz light is considerd by many to be superior to any other form of light energy. I think the combined light therapy is the best of all. Hot packs to the lower part of the body ar advized by many to reduce congestion in the hed. Some advocate a continuous hot bath or hot pack in erysipelas the same as for measls, scarlet fever, etc. Because of the sedativ action upon the central nervous system and because of its influence upon the circulation, which augments nutrition and the healing processes in the skin, radiant heat is no doubt superior to dark heat. When radiant heat cannot be obtaind, probably the dark heat is the next best agency. Altho the continuous hot bath or pack is more trouble- some to administer, yet it appears to be an exceedingly effectiv remedy. The dietetic mesures in erysipelas should be very rig- idly enforst. A plain, nutritious diet, cutting out all condi- ments, meats, alcohol and tobacco, should never be neglected. 1189E Keep the bowels open if possible thru dietetic mesures rather than thru the effects of cathartics. During convalescence do not forget to use the power- ful radiant light and if possible, the quartz light over the spine. ESOFAGUS, DISEASES OF Esoracitis Feed with non-irritating foods such as milk, cream, egs, gruels, etc. Use powerful radiant light over the eso- fageal region. ULcer OF THE Esoracus Altho this condition is rare, sometimes the offis special- ist is confronted with it. Regulate the diet the same as for esofagitis and over the ulcerated region use compression- radiation with the quartz light. STENOSIS OF THE Esoracus This is probably best treated by means of graduated, conical metal bulbs on a flexible spiral introducer or staf guided by thred. Use great caution in doing the dilating. Probably the Sippy method of passing these bougies is as good as any, if not better. He advizes the swallowing of about 25 yards of No. 8 braided surgical silk. The first yard is placed in a perforated capsule and the rest wound on a spool fastened to the clothes. The first day the cap- sule is swallowd. Then the patient should gradually swal- low one or two yards more each day until the 25 yards hav been swallowd. He says that a silk thred wil go thru any stricture that wil permit the passage of even a small quan- tity of water. Inasmuch as each conical bulb is provided with a central canal that is continuous with the lumen of the spiral introducer, the introducer and bulb can be thred- ded on to this silk and the silk acts as a guide for the dilator. SpasM OF THE Esoracus The offis specialist often meets this condition in hys- terical women. It is best treated by means of suggestion or placebos, as wel as by massage and general constitutional treatment. I find powerful radiant light energy over the throat and stomac region is very efficient in treating this condition. 1190Sometimes if the patient is given a good sized gelatin E capsule fild with oliv oil and told to swallow that whenever she feels the “spasm” coming on and it wil prevent the spasm, it wil act as suggested. EYE AND ITS APPENDAGES Electricity in the form of a constant or sinusoidal cur- rent is of great therapeutic value in the treatment of a great many diseases affecting the eye. The powerful incandescent lamp as wel as the quartz light wil do more for diseases of the eye and its appendages than any other one modality, yet they ar overlookt by most oculists. Colord lights in various forms ar of great benefit in many diseases of the eye and its appendages. The high frequency current thru a vacuum electrode is also of some benefit in treating the eye. For removing displaced cilia, nothing can compare with the electrolytic needle. For relieving or curing hordeolum (sty) nothing is of more value than the powerful incandescent light or the quartz light. Probably the quartz light is the best modality for styes. Some use x-ray for treating the eye and its appendages, but I think there ar other forms of electricity that ar just as efficient which can be used without the danger attending x-ray. Por blefarospasm nothing can compare with the pul- soidal current, if correction of refractiv error does not over- come the trouble. For conjunctivitis, use the powerful incandescent lamp or the quartz light. In some cases oxygen-vapor direct to the membranes is of great value. For gonorreal ofthalmia, the powerful incandescent lamp and the quartz light ar of value. Of course use the silver salts to destroy the gonococci. For tracoma many report satisfactory results from the use of the intermittent Roentgen ray. Others report better success by means of cupric cataforesis or “electric medica- ment diffusion.” For this purpose I use a special copper electrode. I prefer cataforesis to the x-ray. 191E The quartz light is of great value in treating tracoma. Some use high frequency thru a surface vacuum elec- trode for tracoma and report very good results. For stricture of the lacrymal passages negativ galvan- ism thru a silver electrode seems to be the best. For tuberculosis of the eye, treat as for tuberculosis in any other part of the body, but giv powerful incandescent light treatment to the eye itself, while the eye is closed. Quartz light seems to be best of all. Glaucoma has been very successfully treated by means of high frequency currents thru the special vacuum surface electrodes. Another method that some use is negativ gal- vanism with the indifferent or positiv electrode over the 6th and 7th cervical vertebrae. I hav used the pulsoidal current with good results. For cataract in its incipiency, many ar reporting great success from using negativ galvanism by means of the binoc- ular electrode.’ The indifferent or positiv electrode is placed over the 6th and 7th cervical vertebrae during this treat- ment. The pulsoidal current is perhaps the best modality. Some use potassium iodid solution cataforically along with negativ galvanism. For this treatment from 4 to 7 milliampéres of current can be used for about 10 minutes. I hav some reports from physicians who hav apparently cured incipient cataract by means of the powerful incandes- cent lamp alone. Quartz light is being used, but it is too erly to say what the result wil be. Galvanic treatments should be given daily, or every other day, and the light treatments every day. No doubt incipient cataract can be cured by electricity, but mature cataract, as far as I know, can be cured only by surgical extraction. If a person has diabetes, liver, kidney, or other organic disease, improvement is not very satisfactory until the or- ganic trouble is partially cleard’ up. Muscae Volitantes—"Specks Before the Eyes”—if persistent after errors of refraction ar corrected, can often be cured by means of the pulsoidal current, used the same as for opacities of the vitreous. For opacities of the vitreous, no doubt negativ galvan- ism in connection with the pulsoidal current is the treatment par excellence. For this work I use the binocular sponge electrode wet with a sodium clorid solution while the indif- 1192ferent electrode is placed over the 2d and 3d cervical ver- tebrae. Altho Optic atrofy is universally acknowledged to be the most hopeless condition we hav to deal with, yet inter- rupted galvanism to the lids as wel as pulsoidal current wil bring about most astonishing results. I think the pulsoidal current, or the high speed slow- sinusoidal current, applied thru the binocular sponge elec- trode with one electrode over the 2d and 3d cervical ver- tebrae, is the proper treatment to-be given for 10 minutes daily. I giv as strong a current as the patient can tolerate. For inequality of muscular tension, | know of nothing better than the slow-sinusoidal current, or the pulsoidal cur- rent. These interruptions can be given quite rapidly as the muscles we hav to train ar very short and quick in reacting. This method of equalizing the power of the muscles seems to be better than prism exercizing. Where some of the ocular muscles seem to be § par- alyzed, this treatment, in many cases, wil greatly benefit, if not cure the condition. For a moderate amount of strabismus (squint), the slow-sinusoidal current applied thru the special copper elec- trode with one pole over the 2d and 3d cervical vertebrae, in many cases wil correct the condition without operation. Of course we must place the electrode so as to put the con- tracted muscle on a stretch and at the same time contract the muscle that is too long. For alcoholic or tobacco amblyopia, discontinuance of the toxic agent wil, in mast cases, correct the condition. However, the slow-sinusoidal current or the pulsoidal cur- rent for 10 minutes daily to the eyes wil greatly hasten the resolution. A whole treatis can be written on electricity in diseases of the eye, and for anyone who is interested in this subject, I would recommend Dr. W. Franklin Coleman’s work on Electricity in Diseases of the Eye, Ear, Nose and Throat. This work is doubtless the best work on the subject that has ever been publisht. FAINTING If fainting occurs with a white face, it means cerebral anemia and that is best treated by stimulation of the 6th and 7th thoracic vertebrae. 1193F If fainting occurs with a red face, it shows congestion in the hed and for that use prolongd stimulation of the 6th and 7th thoracic vertebrae so as to produce relaxation of the splancnic area. Another remedy for “red face’’ fainting is putting the feet in hot water and putting cold cloths on the hed. For habitual fainting spels, treat the underlying cause. So far I hav found no fysical mesure that can compare with powerful radiant light energy. Never forget to throw cold water in the face. FATIGUE Seek out the predisposing cause. It generally indicates some profound toxemia if it is not caused by overwork. Test the patient Bio-Dynamo-Chromatically to ascertain the etiological factor. Powerful radiant light energy (incandescent light and quartz light combined) as wel as electric light baths, mas- sage, and the magnetic wave current ar all indicated in this condition. Find the cause and treat accordingly. FAVUS (See Skin Diseases) FELONS The best method of treating a felon, if pus is alredy formd, is to open it and then use the quartz light on it, using the compression radiation. If you hav not the quartz light, put the finger into as hot water as can be borne for one hour changing the water every few minutes to keep it hot. The best dressing I know of for a felon is libradol (Lloyd). For aborting a felon, the quartz light with compression radiation is probably the best method. Anyone who has felons has trouble with the whole con- stitution. Put them on a fast, clear the bowels, restrict the diet, and give calcium sulfid (Abbott). (See Furunculus. See Carbunculus.) 1194FOLLICULITIS (See Skin Diseases) FOOT AND MOUTH DISEASE Altho this disease (aftha epizodtica) is a contagious febril disease very common among animals, yet it is often communicable to man. This disease is self-limited and carac- terized by a vascular eruption on the buccal mucous mem- brane, the lips, and the skin of the fingers. Altho many animals hav been kild because of this disease, if they wer isolated and let alone for a few weeks they would get wel. Antiseptic washes ar good for local treatment in ani- mals and in man. The quartz light used heroically thru suitable quartz applicators is the best local treatment. FUNCTIONAL TREMORS (See Tremors) FURUNCULUS (BOILS) For the treatment of boils, I know of no remedial agency that can compare with the dctinic Rays from the quartz, mercury-vapor lamps—quartz light. This method of curing, or aborting boils is nearly specific. Another valuable modality is radiations from the 3,000-candle-power lamp. If the boils hav come to a hed, they must be lanst and this operation should be followd with the hyperemic vacuum cup. After the hyperemic treatment has been given, apply soluble iodin along with the power- ful light and keep the area wel coverd with soluble iodin preparation or pure carbenzol. Insted of carbenzol one can use a 50% creolin and glycerin solution. Enhance elimination by general treatments with the 3,000-candle-power lamp, electric light baths, etc., as wel as by magnesium sulfate taken in hot water on arising in the morning. An ethereal solution of menthol, 10% to 50%, applied with a camel’s hair brush, or cotton applicator, often aborts boils, carbuncles, and inflammatory gatherings; and aids in curing itching eruptions. 1195,Another method of treating boils is to paint a ring of flexible collodion around the boil several times daily. This in many instances, wil cause the boil to soon open. While treating boils, giv calcidin (Abbott's), or some other form of iodin. I giv one to three grains of calcidin t.i.d. between meals, in hot water. Iodin therapy and cal- cium sulfid ar valuable adjuncts. When treating boils, do not forget nascent iodin. Pure ozone forst into the lesion is specific in most in- stances. Oxygen-vapor inhalation along with B-D-C therapy is also of great benefit. GALL BLADDER DISEASE SyMPToMS By means of air-colum percussion it is a very simple matter to map out the gall bladder area. If pain is elicited by pressure over this area, we know that some inflammatory condition is there present. Catarral condition of the gall bladder is very common and givs very many insidious symptoms, many of which ar attributed to tuberculosis. Sometimes there ar mild gastric disturbances, or gas symptoms, especially upward pressure soon after taking food. These gas symptoms may be very regular or come on suddenly. These pressure pains ar mitigated by belching of gas or by vomiting a very little. Sudden, mild dyspeptic attacks ar also typical symp- toms of gall bladder disease, and treatment for gall bladder disease should be instituted as soon as these symptoms ar known. When the gall bladder disease has progrest farther, there wil be a prolongd dul pain in the whole liver region, said pain being augmented by food or motion. Many times deep inspirations wil cause pain thru the liver region, and such pains ar wrongly diagnosed as pleuritic pains. Often gall bladder disease is diagnosed as gastric ulcer. When there is a sudden, severe pain radiating thru to the back or scapular region with spasms of the diafram, nausea and vomiting, stones or concretions in the gall blad- der can be almost surely diagnosed. A sudden severe attack with a sudden cessation of pain is a diagnostic feature of gall stone disease. 1196As gall stone formation in the gall bladder seems to be G invariably preceded by an infection in the gall bladder or ducts, it shows how important it is that treatment be given with powerful light energy as soon as any of these gall bladder symptoms arise. One peculiar feature of gall bladder disease is that nearly 75% of the cases presenting these symptoms ar women. Syfilitic or gonorreal infection wil also cause many gall bladder symptoms, which entirely clear up when ap- propriate treatment is given. Diacnosis Stones or concretions in the gall bladder may be diag- nosed by having the patient lie on the back and slowly ex- hale until their lungs ar as empty as they can make them. At the same time the physician should make stedy pressure just under the edge of the ribs over the gall bladder. Keep making stedy pressure until the fingers ar as deeply seated as possible. Then hav the patient take a slow, stedy breth, expanding the chest as much as possible. If any stones or concretions ar in the gall bladder, the patient wil suffer pain, and that is nearly always a diagnostic symptom of foren bodies in the gall bladder. TREATMENT For large concretions surgical interference is impera- tiv, but for smaller ones the non-surgical method seems to be more efficient than surgery. Dietetic mesures ar first to be thot of and a 24 to 48- hour fast, followd by a diet of Horlick’s malted milk, shredded wheat biscuit and spinach is to be recommended. Keep the bowels open by means of podofyllin and a mild saline laxativ. The fysical mesure abov all others is radiant light with the powerful incandescent lamp in combination with the quartz light over the liver region. I hav obtaind better results from prolongd radiation from the incandescent lamp than from any other mesure. The quartz light is a regulator of metabolism and for its great profylactic power is always to be used if. possible. This radiant light treatment I follow with B-D-C therapy and oxygen-vapor inhalation. 1197G Many a physician has had the credit of curing tuber- culosis as wel as ulcer of the stomac by using powerful ra- diant light energy over the gall-bladder region, following out the methods aboy enumerated. (See Liver.) GANGRENE If the destructiv process has not gone too far, much can be done toward restoring the circulation by means of powerful radiant light energy—incandescent light and quartz light combined. If one can hav only one of these modalities, the quartz light is to be preferd. GASTRALGIA (See Gastric Diseases) GASTRIC CANCER (See Gastric Diseases) GASTRIC DILATATION (See Gastric Diseases) GASTRIC DISEASES Of course in all gastric diseases the first procedure is to regulate the diet. After that I use radiations from the 3,000-candle-power incandescent lamp and also the quartz light, along with stimulation at the indicated area of the spine—usually the 5th and 6th thoracic vertebrae. The radiations from the lamps seem to work like magic upon the gastro-intestinal tract. My tecnic for using this powerful light is to place the lamp from 30 to 36 inches distant from the body and let the light radiate over the stomac from 20 to 60 minutes. I then begin one-minute exposure to the quartz light and increase it reducing the incandescent light til both can be used together for ten minutes. Sometimes it is wel to precede this treatment by 5 to 10 minutes’ treatment over the back, especially over the 1198thoracic region. If you hav a static machine, the static: G wave current with the electrode over the stomac is also very beneficial. There ar some forms of stomac conditions, especially in which there is lack of motiv power, for which the slow- sine wave or the pulsoidal current should be used. For this purpose I put a medium sized clay pad in contact with the 5th and 6th thoracic vertebrae and another over the stomac. Should the stomac be dilated, place the electrode over the Ist, 2d, and 3d lumbar vertebrae and the other over the stomac. These treatments should be given with the patient lying on the back and the light from the powerful incandescent lamp radiating over as much of the abdomen and thorax as is not coverd by the pad electrode. These treatments not only strengthen the stomac muscles, but the abdominal muscles as wel. Zone therapy should never be forgotten in all gastric pain. If there is gastroptosis, elevate the stomac with a suit- able supporter. In nearly all non-malignant gastric diseases, such exer- cizes as wil strengthen the abdominal muscles ar indicated. I must especially mention deep abdominal breathing and such exercizes as ar indicated in visceroptosis. Dietetic mesures must be carried out, but they can be found in almost any standard textbook, so I shal not go into them. Drinking of cool water seems to enhance the flow of gastric juice. Often I find that fruit, eaten before the “meal,” “lies like led” on the stomac. In such cases, have the patient eat the fruit after the “meal” rather than before. The latter is the better plan as a rule. Whenever gastric ulcer is suspected, never fail to use the B-D-C method of diagnosis, and if you get the B-MM VR, localize the lesion and begin vigorous mesures for therapeutically treating a malignant growth. T cannot say that-I would advize an operation, as it seems as tho the non-surgical procedure gave far better results than the surgical. I hav known of patients living for years with what has been diagnosed by the “best men” as cancer of the stomac, but I hav never seen anyone live very long after a cancer of the stomac had been surgically removed. 1199G It is hard to advize on this point as so many circum- stances alter cases. Some patients would not hav a surgical operation while others would if so advized. There is no doubt but that some gastric cancers hav been eradicated by therapeutic mesures. I say this advizedly because I know that those who hav not workt along these lines wil hold a contrary opinion, but however this may be, 1 know I am correct in my statement. Putting a patient with a cancer under ether lowers the resistance and enhances metastasis of the ‘propagating properties” of the growth. An erly diagnosis for cancer of the stomac is the all important point. If the diagnosis can be made so the patient can begin vigorous treatment as soon as the first B-D-C re- action shows cancer, the chances ar very good that the pa- tient wil be cured. I should like to call your attention to red clover or alfalfa tea for cancerous conditions, especially in the ali- mentary canal. The tecnic for making this tea and using it is as fol- lows: Gather the red clover or the alfalfa while it is in blossom. It can then be cut up and put into a large coffee pot and enuf hot water put on it to cover it, when it should be allowd to slowly steep for about six hours. Another way is to let the blossoms dry. In that case a less quantity is used and the steeping should last about twelv hours. Strain the water off and let the patient drink three or four teacupfuls of this tea daily. The dietetic mesures for cancer of the stomac ar gen- erally known, but for the benefit of those who ar not posted on this subject, I wil say that abstinence from proteids is very essential. Give a very bland diet. It is almost impos- sible to lay down any fixt rule for this, as the diet that wil prove beneficial with one person wil aggravate another. Sometimes the diet has to be radically changed every two or three days. The object is to giv a diet that is as non- irritating as possible. Some think that paraffin oil, a table- spoonful taken before each meal helps to reduce irritation. I hav some patients with cancer of the stomac who hav gotten along very wel for a long time on a diet of Horlick’s Malted Milk and clam juice. Rice, baked potato, vegetable soups, etc., ar often very wel borne. If a person has a quarts, mercury-vapor lamp, I should advize the careful use of the radiations from such a lamp 1200over the stomac area along with the radiations from the G powerful incandescent lamp. No matter what modality is used for treating ulcer or cancer of the stomac, never neglect to use oxygen-vapor inhalations and the indicated intermittent color. For washing the stomac in gastric catar, I procede as follows: I giv the patient a pint or so of a hot, boric acid solution, and then slowly shake the body in an oscillator, after which I stimulate the Sth thoracic vertebra and let the patient lie on the right side for a few minutes. In most cases I find this more effectual than using the stomac pump, which is Very obnoxious to many patients and is not free from danger.- The stomac pump certainly is irritating and should not be used when any other method wil suffice. I cannot say that my experience with ‘“‘test meals,” “stomac buckets,” etc., has been very satisfactory. I find that the general therapeutic mesures cited abov wil correct most conditions, no matter what the cause may be. As in every.other disease, find out as far as possible what the predisposing cause is and remedy that. I do not think the test tube or experiments on animals ar very reliable in guiding us in treating gastric conditions in man. Do not forget that the psychic influence in gastric condi- tions plays a most important role. Many times some means used by one physician with the same patient wil be ineffect- ual, while with another it wil be very efficient. GASTRALGIA For this I employ stimulation of 5th and 11th thoracic vertebrae, and giv one whole tablet of chinosol in a glass of hot water, or use the following: R_ Cloroform Comp. Tinc. Cardamon Aromatic Spts. Ammonia Brandy—aa . 30 mils Sig. Shake wel and giv one teaspoonful every 4 or 14 hour til relievd. Use also the radiations from a 3,000-candle-power lamp over the stomac for a half to one hour. iene Spasm is often mistaken for cancer of the sto- mac. The best treatment for this condition is powerful 1201G tadiant light energy and the slow sine current with a weighted pad over the stomac region. Regulate the diet. Bulimia (insatiable hunger). This condition is usually caused by a catarral condition of the stomac. A fast of from one to three days and a greatly restricted diet is of para- mount importance. After this, use fysical mesures the same as for gas- tritis. Anorexia (lack of appetite) is usually caused by a reflex. Discover the cause and treat that. Rumination (Merycism or Regurgitation of food). This condition is usually caused by catar of the stomac or a stomac neurosis. The treatment is to put the patient on a fast of two or three days and then put them on a very restricted diet. Fysical treatment is the same as for gastritis. Vomiting. The forcible expulsion of the contents of the stomac thru the mouth is caused by a reflex or from an accumulation of. gas. Treat the cause. Cyclic vomiting is vomiting which occurs at regular or irregular intervals. This is also cald periodic vomiting or recurrent vomiting. This in a young person is a very serious condition, but it can be cured by treating the general condition of the pa- tient as well as putting them on an extremely restricted diet. Often a neurosis is responsible for cyclic vomiting. Again Bright’s disease or diabetes may be the predisposing cause. At any rate it is a neurosis, and it is necessary that the physician ascertains the underlying cause of the neurosis. Many times the gall bladder is at fault and it is de- ranged because of improper eating. Cyclic vomiting is often the cause of migraine because with the vomiting begins a fearful hedake and then a vicious circle is establisht. The best fysical method for treating this condition is to use combined powerful incandescent light and quartz light with oxygen-vapor and B-D-C therapy. IMPORTANT OBSERVATIONS, Gasrric Diseases I want to especially mention the fact that many patients complaining of “dyspepsia” ar really suffering from patho- 1202logical conditions in the gall bladder. By carefully exami ing a patient and mapping out the gall bladder by air- colum percussion, I am able to prove that the gall bladder is sensitiv by simply pressing on it with the finger. These patients ar generally suffering from varying degress of colecystitis. It is not a sign that the patient has gall stones because they have an inflammation of the gall bladder. It must be rememberd that gall stone is a terminal result and not the initial cause of colecystitis. The rational treatment for this form of ‘‘dyspepsia” is powerful radiant light and heat directed over the region of the gall bladder. To this ad the quartz light if possible. For internal medication, probably nothing is better than oliv oil, altho there ar very many proprietary remedies on the market for this condition. In many gastric diseases concomitant with pathological conditions in the gall bladder and ducts, I hav found the slow-sinsoidal current to be very beneficial provided there ar no concretions. For such treatment I put the clay-pad electrode over the area of the gall bladder and over that place a sand pad. It is wel to put the indifferent electrode in the rectum. The Pulsoidal Current used for 5 minutes seems to be even better than the slow-sine wave used for 10 minutes. Gastric Diseases CAUSED BY SyFILIS I want to especially mention the fact which many physi- cians do not realize, and that is that many cases of gastric dyspepsia ar caused by syfilis. In using the Bio-Dynamo-Chromatic method of diag- nosis I often find patients giv the syfilitic MM VR who come for advice regarding “dyspepsia” or some other gas- tric condition. When these patients ar treated with the powerful radiant light over the gastric region and ar given the treatment as outlined for syfilis, they make very rapid recovery. Cuinicat Case: ULcer oF Sromac Case 282 Mrs. L. Age 50. Menstruating regularly. Mother of two helthy adults. Had gastric pain for two years, which kept her awake nights. Severe burning in the esofagus and 1203G constant coffing during the day because of it; pain radiated to right scapula-vertebral border; aggravated by hot food or drink; relievd up to two weeks before I saw her, by lying on her back. Had no appetite. The case had been diagnosed as ulcer on the anterior wall of stomac. 1 exam- ind her and found the stomac of normal size, but very ten- der at the cardia and fundus. Also tenderness between the four upper thoracic vertebre and between the first and second lumbar. The urin showed acid equal to 58 N/10 sodium hydrate, but nothing else abnormal. I vibrated sensitiv nervs to inhibition of pain, exhibited powerful light over the stomac for 20 minutes and the same length of time over the back abov the waist line. I gav static-wave treatment over the fundus for 10 minutes. Be- fore leaving the offis, the patient said all pain and soreness wer gone, and she did not cof. Next day she reported a good night’s rest and only slight pain fifteen hours after the first treatment. I gave repetition of the first treatment on three consecutiv days, and after eleven days patient reported having had no pain, no coffing, and good night's sleep since the second treatment. I put her on a diet and reduced the acidity of the urin to 28 N/10 sodium hydrate. No return of the trouble after a year’s observation. GASTRIC ULCER (See Gastric Diseases) GLANDERS Altho this is a disease naturally occurring among horses, yet it is transmissible to man. I hav had one case that appeard to be an infection from the bacillus mallei. Bacteriological examinations ar necessary for a true diagnosis of this condition. Powerful radiant light and quartz light ar the modes to use in treating this condition. Non-irritating nasal washes ar required. Todin therapy is indicated. GLANDULAR FEVER Altho it is doubtful whether there is any such disease per se, yet one wil occasionally find a condition where the 1204cervical glands ar enlarged and the patient is running quite G a fever. Such conditions ar often diagnosed as tubercular. Many times they ar with a mixt infection. The B-D-C method is the one for diagnosis, and that method wil dif- ferentiate the disease from tuberculosis. The treatment is to clear out the system wel and use calcium sulfid internally as wel as iodin therapy. The quartz light over the enlarged glands and the combined powerful radiant light energy over the entire body is indicated in this condition. Watch the urin wel in these conditions and take profylactic procedures so that the kidneys wil not become affected. The quartz light for the local infection is without doubt the treatment par excellence. If any constitutional symptoms resembling furunculosis present themselvs, general treatment the same as for furun- culosis is indicated. GLOBUS HYSTERICUS (See Gastric Diseases) GOITER Under this term may be included most of the non- inflammatory enlargements of the thyroid gland. The right lobe is more frequently affected than the left. It generally develops about puberty or during erly middle life, and is more frequent in women than in men. The etiological factors ar heredity, congestion, and the drinking water. Wearing a tight band about the neck is a predisposing factor. Just what there is in the drinking water that causes this condition, no one seems yet to know; but a change of water, or boild or distild water should be used by anyone residing in a section where there ar many cases of goiter. We ar all familiar with the hart condition, hedake, and other digestiv and nervous symptoms that ar often con- comitant with this disease. Posterior auricular neuralgia, as wel as pain thru the sterno-cleido-mastoid muscle, is often caused by goiter. 1205G We may or may not hat exofthalmos with this condi- tion, but often it is present and also irritation of the sym- pathetic nervs. We may or may not hav any enlargement of the thy- roid gland with hyperthyroidism. In other words, we may hav all the symptoms of goiter without any enlargement of the gland. In treating this condition, try to find the predisposing cause and remedy that. General change of diet and water ar very beneficial, no matter where the patient may be living. Remedy any unhygienic conditions that can be found, Look for abnormal pelvic conditions, as they ar almost always present. Correct them by fysical means. This also applies to constipation and any derangement of the digestiv tract. In fact, make a thoro examination of the patient from hed to foot, including internal pelvic examinations. Sometimes visceroptosis, from its effect upon the thoracic vessels, is a predisposing cause. Post-operativ reflexes ar often the cause. TREATMENT OF GOITER Zone therapy appears to be the most efficacious treat- ment yet discoverd for goiter—either simple or exofthalmic. For this purpose I hav devized special electrodes. (See Zone Therapy.) If one cannot use electricity for this zone therapeutic work, they can use a metal nasal probe that wil reach back to the posterior wall of the nasofarynx. This is fully described in the lecture dealing with zone therapy. Stimulation of the 6th and 7th cervical vertebra wil do much toward the cure of goiter. Some think it is the best treatment, owing to its increasing the sympathetic-vagal tone. The pulsoidal or slow-sinusoidal current may be used for this stimulation, placing the small electrode over the 6th and 7th cervical vertebra and the large one over the sacrum, this treatment to continue for 10 minutes. Concussion can also be used. In connection with this treatment, I use soluble stain- less iodin over the enlargement and giv treatment from the 3,000-candle-power lamp for. about 10 minutes over the chest and neck and 10 minutes over the back. 1206Asa rule, I find iodin in some form to be very beneficial G in simple goiter. Soluble, stainless iodin has an adv: antage over the other as it does not irritate the skin. Using it in connection with the 3,000-candle-power lamp seems to be an ideal auxiliary procedure. In many cases of goiter I hav found internal iodin med- ication to be very beneficial. The only precaution in the administration of iodin in these cases is to watch the hart. If it is increast in rapidity, stop the iodin therapy. Actinic rays from the quartz, mercury-vapor lamp (quartz light) hav a very friendly action in the treatment of goiter. Some say they can rely on this method more than on any other one modality. They ray the growth first and then the whole body. A method for treating simple goiter is by negativ gal- vanism and iodin. A 10% solution of potassium iodid used from the negativ pole while the indifferent pole is placed over the abdomen or back, is by some considerd excellent. For this purpose the regular cataforic electrode should be used, or one made of block tin, as previously described. Ten to twenty milliampéres of current for 10 minutes can be ap- plied about every other day. When using galvanism about the neck watch the hart. For exofthalmic goiter 1 would not advize cataforesis. Galvanism is contra-indicated in tachycardia or any case of goiter where there is nervous irritability. The reason is plain, as a branch of the vagus passes directly over the thyroid cartilage. Galvanism over this area stimulates the vaso-motors and obliterates the action of the sympathetic, thereby increasing the puls rate, which should be avoided. hav purposely mentiond several methods for treat- ing this disease. Of course if the gland has become organ- ized into fibrous tissue, we cannot ‘hope to reduce that, but the general condition of the patient wil be greatly improved. In other words, she wil be symptomatically cured. Some times a gland wil not begin to show any decrease in size until after daily treatments for six weeks, after which period it may begin to decrease very rapidly. In other cases the gland wil show a diminution in size after ten treatments. EXERCIZE FOR GOITER A great aid in treating goiter of any kind is an exercize consisting of the forcible extension of the neck. This ma- neuver is carried out as follows (see lecture on Exercize) : 1207G Let the person stand upright with the neck flext. Hav her very gradually lift the hed until she is looking strait up at the ceiling. As the hed is brot back into position, let it be done very slowly. This maneuver should be carried out 10 to 20 times every night and morning. The object is stim- ulation of the vagus thru the sympathetic. This same exercize is very beneficial in hart affections. FORMULA FOR GOITER This formula was given me by an old and successful country practitioner and he reported very many cures from its use. I giv it for what it is worth: Resorcin ......... 1.5 gms. Tine. capsicum 8.0 mils Tinc. cantharides 15.0 mils Biclorid of mercury. 0.1 gms. Boracic acid .. 0.5 gms. Salicylic acid .. . 2.0 gms. Aqua q-s. ad..... 120.0 mils M. sig. Apply morning and evening with little friction. If much tenderness, omit an application. Gotrer—Cuinicat Cases Case 283 Miss G., 26 years old. Was sent to me three years ago for diagnosis and treatment. She complaind of, extreme nervousness and dysmenorrea. Upon examination I found she had a simple goiter and her uterus was retroverted. I began at once treating her with the slow-sinusoidal current, one pole being attacht to my special uterin elevator and elec- trode and the other to a clay pad over the abdomen. While giving her this treatment the radiations from the 3,000-candle-power light wer directed over her abdomen. I followd this stimulation of the 6th and 7th cervical ver- tebra and oxygen-vapor inhalation with B-D-C therapy for 40 minutes. These treatments wer given daily for one month. Her following menstrual period she told me was easier than any she had had in eight years. As I was going to be away for about two months, I told her she had better go out in the country and follow up outdoor life and practis the gymnastics for her pelvic con- dition as wel as hyper-extension of the neck for the goiter. 1208Her third period after this was “without any pain G whatsoever.” I saw her six months after the treatment and her goiter was entirely gone, all nervous symptoms had dis- appeard, and her dysmenorrea was entirely cured. She has had no return of these troubles in a long titne, has gaind in flesh, and says she feels like a “new woman” and as if life wer worth living. She has recently married. Case 284 Miss H., 24 years of age. Scool teacher. Was sent to me for diagnosis as to the cause of her extreme nervousness. I found she had tachycardia, and altho she showd practically no signs of goiter, I diagnosed the case as hyperthyroidism. I prescribed exercizes such as I advize for pelvic dis- eases. I also prescribed the neck bending exercize. Six months after she began these home treatments her mother reported that she was entirely cured and was able to attend to her scool duties in a way she had not been able to since she began teaching. Case 285 Miss D., 30 years of age. Scool teacher. Complaind of extreme nervousness. Upon examination of the neck I found quite a large goiter and prescribed zone therapy for it. Within two months all signs of the goiter disappeard without any treatment other than that of using a metal probe at the posterior farynx at the indicated zone. As she lived some distance from the offis, she had these treatments only once a week. The other treatments she gave herself about four times daily. I could mention very many cases of goiter which hav been reported to me by my pupils that hav been cured, or greatly relievd, by following out methods similar to those abov cited. The following case was reported by Orin W’. Joslin, M.D., Medical Director Dodgeville General Hospital and Pine Grove Sanitorium, Dodgeville, Wis., under date of Jan. 5, 1918: Case 286 C. D., man aged 28. Goiter. Could hardly breathe when he came to the hospital. Puls 130. Goiter mesured 28 1209inches. The only treatment given was zone therapy in the upper farynx with the Pulsoidal Current, 5 minutes on each side, and stimulation of the 7th cervical vertebra. In two days the goiter was reduced 2% inches and the puls was reduced to 80. 8. Edgar Bond, M.D., Richmond, Ind., reports as fol- lows: Case 286 Miss H. Aged 23. Had all the symptoms of advanst exofthalmic goiter with a large deformity of neck. M treatment was deep massage with iodex ointment along with concussion stimulation of the 6th and 7th cervical vertebra, deep cervical manipulations over the gland along with bi- polar sinusoidalization at the junction of the 6th and 7th thoracic vertebre for the control of the unbalanst sympa- thetic vagal system. Used iodin cataforically occasionally over the gland itself, and lookt after the dietetic and hy- gienic conditions. In eighteen months there was almost a complete disappearance of the symptoms along with a re- gaining of lost flesh. My experience shows me that as a rule we do not treat these cases long enuf. We become discouraged before we have gone far enuf. This case I am giving in particular to emfasize what I consider is almost criminal neglect on the part of medical men who hav thot it necessary to hav these cases operated on and hav never used these methods. GONORREA (See Part One, Lecture XX) GRIP—INFLUENZA (See Part One, Lecture XXII) HABIT SPASM (See Corea) HART DISEASE Hart diseases ar functional or organic. Under the hed of functional hart diseases can be men- tiond intermittent or irregular hart. 1210The treatment for functional hart disease is the treat- ment of the cause. If from overwork, hav the patient rest. If from some habit or occupation, hav it changed. Some cases of neurotic hart ar very much improved by the use of the pulsoidal current over the eyes and 2d and 3d cervical vretebra. The magnetic wave current as wel as the powerful ra- diant light therapy (incandescent and quartz) is unques- tionably of much value in treating this condition. The organic hart diseases ar endocarditis, pericarditis, myocarditis, fatty degeneration of the hart, hypertrofy of the hart, “leaky” hart, etc. Hydrocarditis often follows or is concomitant with scarlet fever, nefritis and ascites. The etiological factor of most organic hart troubles ar alcohol, tobacco, syfilis, gonorrea, and drug poisoning. Any factor that causes “reumatism" or reumatic symp- toms or even malaria ar often etiological factors in causing organic hart diseases. Corea is often concomitant with endocarditis. Exanthematous fevers ar also etiological factors of hart disease. Auto-intoxication, if carried far enuf, is also an etiolog- ical factor, but when auto-intoxication is severe enuf to cause endocarditis or other hart diseases, syfilis or gonorrea is usually the cause. The diagnosis of these conditions is quite easy if one uses a good stethoscope, and the best one that I know anything about is the Scott's Non-Roaring Stetho- scope shown in Part One of this book. In examining the hart, always examin when the patient is standing or sitting and also when they ar in a recumbent position. Find out if possible the etiological feature and treat that. All alcohol and nicotin in any form must be prohibited in treating hart disease, whether functional or organic. Often the use of tea, coffee, and chocolate has to be prohib- ited. Iodin therapy is often indicated in treating these con- ditions. For general treatment, the powerful radiant light ther- apy—incandescent and quartz—oxygen-vapor inhalation, B-D-C therapy and the magnetic wave current ar indicated. 12H In many hart conditions rest in bed is imperativ, but with many conditions if the patient is careful not to over- exert themselvs, they wil liv to a “good old age” and die of some other condition. HART BURN (See Gastric Diseases) HAY FEVER (See Eye, Ear, Nose and Throat) HEDAKE First try to ascertain the cause and remove that. Dietetic and hygienic mesures ar almost always sutt- cient to clear up the ordinary hedake. Zone Therapy is probably the remedy par excellence for the ordinary hedakes. Many times eye strain is the cause of hedake, and very often the way the patient lies in bed is the cause. Take away the pillow and hav the hed of the bed elevated from three to six inches. This many times wil cure hedakes that cannot be cured in any other way. The twisting of the neck on the pillow is often the cause of many exasperating hedakes. Put- ting the feet into hot water is also a very good procedure. Relaxing the splancnic area by prolongd stimulation thru the 7th and 8th thoracic vertebra is often very benefi- cial in curing hedakes. Avoid hedake powders or pils. HEMATOMATA (See Bruises and Hematomata) HEMOPTYSIS Find the cause and treat that. (See Tuberculosis). HEMORRAGE Altho this really comes under the domain of surgery, there ar some forms of hemorrage that can be controld by the Quartz Light. Ina “‘bleeder” the least abrasion wil start 1212