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mental disorder, and a mental element enters | judgment he values.
into every bodily disease, and the increase of
nervous disorders in this country is most clearly
evinced to observant physicians. Mental
anxiety and distress, and sudden fear and shock
are important exciting causes of many of the
modern neuroses. Also the pressure of modern
life, keen competition, and the struggle for
existence. In place of a well-balanced growth
of body and mind we too often meet with head-
aches, imbecilities, nervousness, or insanity,
some of which dates back to the nursery. It
is wise for parents to bear in mind that a moral
and religious training of their children protects
them in great measure against these moral con-
tagia which float about in such varied abundance
in the social atmosphere of cities and towns, and
which are so inimical to mental health.

The subjective properties of an individual's mind depend upon the objective properties of the matter constituting the mind's food. As there is even in the simplest protoplasmic cell the action of individual parts for the benefit of the whole, so in society there is the action of individuals which is either beneficent or the reverse to the whole corporate body of society. Pure and lofty ideals, vanity and goodness, by use are elaborated and by heritage are perpetuated. Likewise, inharmonious development of brain and mind. As the food of the animal is derived from the medium in which it is living, and as the protoplasmic cell maintains its existence by the passage of material in a state of fluidity through infinitesimal pores or spaces into the cell substance, so in the earliest periods of infancy and childhood is the mind prepared either for strength or weakness in the future.

The nervous and mental deterioration, the result of the opium habit, is on the increase, and is most painful to witness. We often see brilliant men and women undergoing a series of painful mental changes directly due to excessive indulgence in opium or morphia. The ready writer, the bright and witty talker, the man of natural ability, with a powerful memory and a gift of ready application has the higher mental faculties in constant operation. He is swayed by changing emotions, and the influence of opium is to intensify, for the time being, the activity of his naturally unstable intellect. When brought into contact with others who manifest the same intellectual tendencies, he has a natural pride in the superiority which secures for him the admiration of persons whose

When exhaustion follows

effort, he succeeds in stimulating his weakened powers by the use of opium or morphia. For a considerable time, perhaps, while the digestive system remains in such a healthy state as to insure the supply of proper solid nutriment, this course is pursued with an appearance of success. Soon, however, the urgent symptoms of indulgence in opium begin to manifest themselves. The mind, when unaided by the stimulus of opium, becomes barren and unproductive. The physician cannot make his diagnosis, the lawyer cannot carry on his case, the clergyman cannot write his sermon, and the lady of society cannot entertain until each and every one has had his or her usual allowance of opium, or hypodermic of morphia. The society woman looks haggard, pale, and wan, ceases to converse, seems in distress, and finally slips away just long enough to go to her room and take a hypodermic of morphia, which completely rejuvenates her. Her eyes brighten, her checks regain a beautiful flush, she sparkles with wit, and is the gayest of the gay. In a short time, however, this deceptive health is replaced by pallor, pain, and distress, and a generally miserable condition, which can be relieved only by morphia again. The man who was accustomed to write with speed, telling criticism, and pointed epigrammatic sentences, has a consciousness that his mind has become incapable of sustained effort, and that his writing is dull and insipid—a feeling which contrasts strongly and painfully with his previous cheering sense of power and fitness. Under the influence of his accustomed dose of opium, he finds that for a time, at least, he can command his intellect. But the control is only a temporary one, and is followed by a greater sense of exhaustion than would otherwise have been experienced. Memory-not so much for passing events as for facts, passages, and references which had been readily acquired-begins to become weakened, and the misery resulting from the loss of a reputation for, and consciousness of, intellectual power, supplies a new incentive to excess. Petit mal, and attacks of simple vertigo come on, showing that the most highly specialized regions are as yet alone affected. At this stage, no one could be regarded as insane, though as great a change of function has relatively taken place as leads in the minds of the lower classes to the display of delusions, of suspicion, and hallucination of the senses. After this, how

ever, if opium indulgence is continued, the | a four per cent. solution, I use hypodermically ordinary symptoms manifest themselves. Irri- to relieve any nervous restlessness a patient tability passes into suspicion, voices are heard, now complains of, and also during the reducillusions experienced, and the mind becoming tionary period, and it works like magic, but I prone to reverie, finds for itself a new and in- would advise physicians never to let patients sane sphere of existence. Intellectual helpless- know what they are giving, as there is, it seems ness and physical changes advance: one lab to me, a liability that the patient may conclude may become weak, one pupil may dilate, and to obtain it and use it himself whenever he if an excessive or even moderate use of opium feels restless and uneasy, and great harm might is still indulged in, the victim has no other thus result. It depends entirely upon the inprospect than to end his days in a state of de- dividual idiosyncrasies of any patient how graded intellectuality and muscular paralysis. rapidly or how slowly we can cure him. The assertions of some men that they can cure a well developed case of opium addiction in two weeks is simply absurd. A somewhat long experience in the treatment of opium addiction enables me to say positively, that unless we keep a patient long enough to perfectly build up his physical, moral, and intellectual health, there will be an inevitable relapse into the old habit the first time that he suffers from physical or mental pain or prostration. It is also useless to try to cure a patient while he is pursuing his accustomed avocations of life. He or she must give themselves up to treatment to the exclusion of all else, or the treatment will result in failure. Even the medical profession do not thoroughly understand this, for it is but a short time since I received a letter from an eminent gentleman, who unfortunately had, as the result of sickness, become addicted to the use of opium, asking me to receive him as a patient, and saying that he wished to devote a few days to his cure. I know of no disease more requiring careful and methodical treatment for a sufficient length of time than the opium habit, and there is a certainty of cure if this is done, and not otherwise.

In the opium habit there exists a departure from a healthy structure of the nervous apparatus, and it is this abnormal condition of the centric nervous system set up by the use of opium, demanding the stimulus of opium, that is essentially the disease. The opium habitué is in a state of unrest and pain, and the urgency for relief is so great that the will has not the power to resist. Opium deranges the action of the heart and capillaries, confuses the brain, and impairs the vital force. In the treatment of the opium habit my plan is as follows: The patient must consent to put himself unreservedly under my control until cured. As he has no will power, he is not allowed to go out for two or three weeks unattended. As I find that most cases are taking daily much more than they really need, I commence treatment by cutting off as much as I think in each individual case the patient will bear, and then reduce from this point a fraction of a grain a day. The nurse is instructed to give one drachm of Warburg's tincture before breakfast each morning. I then administer the combination of bromides mentioned in my paper on "The Therapeutic Use of the Bromides," on page 269 of THE MEDICAL BULLETIN, for November, 1884, commencing with forty grains twice daily, and increasing to one hundred grains twice daily, at 10 A.M. and 4 P.M., freely diluted with water. By this combination of the bromides, as will be seen by a reference to my paper, we do not depress vitality, or produce the injurious results of the bromides as they are commonly ad ministered. When the patients are taking the maximum of the sedative, they are also getting the minimum of morphia. They are then put in hot baths and given sweet spirits of nitre to rapidly eliminate the bromides, and put on a mixture containing tinct. ferri, strychnia, etc., to build up the system, and electricity is also administered. Cocaine, five to ten minims of

HEALTH RESORTS IN NEW

JERSEY.

BY WILLIAM R. D. BLACKWOOD, M.D.,
Neurologist Presbyterian Hospital.
[Continued from December number.]

NE of the most troublesome diseases of
our time is remittent fever. As a rule,

I believe it is always connected with impaired liver action, and the old-fashioned term of bilious remittent is, to my mind, an appropriate name for the disorder.. In many cases some indiscretion in diet is a prime cause for an attack of this fever, and some persons go along year after year without finding out what special mistake they make in eating, or, if they do

know, they do not appear to care enough for their comfort or health to discontinue that which, though pleasing to the appetite, is injurious to their digestion. The treatment of such cases produces no inconsiderable revenue to the family physician in large districts in the South and West.

The dietetic treatment of remittent fever is important. The food must be nutritious, yet digestible, and here the Tartarian Koumiss made by Mr. McKelway, of this city, fills admirably the indication, it being at once easily digested, gently stimulating from its carbonated character, and owning all the food value of good milk. Singularly those who dislike pure milk can take and relish the koumiss. It is invaluable in gastritis and wasting diseases.

66

climate. You can drive in half or an ounce of Wilbur's cocoa butter by rubbing it well into the skin and applying from five to twenty milliamperes of galvanism (anode over abdomen, cathode on lumbar region, or thigh) for ten minutes thereafter. So much for diet.

Error in diet is not always the main cause of these fevers, and, although it is difficult to define precisely when or how excessive heat, moisture, impure air, or defective drainage are the responsible causative agents, it is certain that climate has an important bearing on the matter, not only in producing remittent, but in modifying that type of fever when acquired. The great defect in the climate of Philadelphia, for instance, and its immediate vicinity, is the abrupt and extreme variations of temperature and barometric pressure, hence, any place in which the weather is not extremely cold nor unduly hot, and in which a gradual difference in these respects obtains, is desirable as a residence for those liable to paludal fevers, and such is the territory under discussion. The table appended is official, and certainly shows a favorable condition of affairs.

MONTHS.

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29.801 95
August. 29.832 92 63
September. 29.908 82
October. 29.909
November. 29.933

January.
February.

Mean.

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66

78.82

82

7.12

42

72

68

December.

30.058

61

29.918

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45.58
39.10
32.79

56.34 84 5.83
83 5.12

75.26 80 2.05
66.25 77 5.99

II

85 1.88

86 4.50

29.810

12

29.831 68

19

29.638 85

33

29.731 86

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29.742 92/2

68.77

85

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In phthisis, we need something more concentrated in character so far as animal food is concerned, than that usually given, and in my cases I rely upon the Beef Peptonoids of Reed & Carnrick, of New York. The preparation with gluten and digested milk is not only very palatable and invigorating, but it will agree with a stomach which will not tolerate the meat in any other form. I rely now upon this, or their similar peptonoid, with iron and wine in combination, preferably to cod-liver oil. The solid beef peptonoid of these gentlemen's preparation is an admirable addition to beef tea, rendering it not merely a stimulant, but a true food. It is a waste of time to pour in ordi- July....... nary beef-tea in such cases. As a breakfast drink, for a long time past, I have directed the Cocatina," chocolate preparation known as made by Messrs. H. O. Wilbur & Sons, of Philadelphia. Free from all extraneous matter, exquisite in flavor, and acceptable to weak stomachs, this article fills a real want, for neither tea nor coffee are essentially nourishing, although gratefully stimulant. If the patient after a while wants a change, then I recommend the "Breakfast Cocoa" made by these gentlemen, which is somewhat stronger, but very readily digested. The great point is to secure nutrition with little stomach labor. Medicine is next to useless, in truth it is worse than none at all, if the nutrition is endangered, hence we need less routine dosing with cod-liver oil in its varied forms, and more tact in coaxing the appetite and accelerating the absorption of good blood-making foods. I prefer to rub in cocoa butter (oleum theobroma) over the abdomen, than to risk strong fish oils internally in this

March.

April..
May..
June

Means... 29.847 76.79 34.25

36.53 85 1.73
45.80
87 3.89
56.12 87 2.36

5.36

In a few hours after a rainstorm, no matter how heavy, the soil, from its porosity, is dry, and this is important. The rainfall is also less in the belt named than farther south.

Hammonton has been built by people who came there originally in search of a health resort. Asthma, and diseases of the kidneys and bladder are of rare occurrence, unless in persons seeking relief through climatic advantages. In fact, asthenic diseases generally do well here.

The climatic condition is concisely summed up by the annexed remarks of Professor John

C. Smock, who says, "The annual mean temperature of the southern end of the State is between fifty-three and fifty-four degrees.

"The isothermal lines include the northern parts of Virginia, Kentucky, Missouri, and the southern portions of Pennsylvania, Ohio, Indiana, and Illinois, showing that the average temperature of the year is higher in South Jersey than in the corresponding latitude of the Middle and Western States.

"For the summer months the mean temperature of that part of the State south of Philadelphia is seventy-three to seventy-four degrees, and is isothermal in the Western States with Cincinnati, Springfield, and Rock

Island.

"For the winter months the mean temperature of South Jersey is between thirty-two and thirty-four degrees, the isothermal line of which. degrees tends slightly south of west in crossing Maryland, Virginia, and so on near the line of the Ohio River to St. Louis.

"The modifying influence of the ocean raises the mean temperature of the winter and lowers that of the summer, so that while the isothermal lines for the year run westward from New Jersey nearly parallel to the corresponding lines of latitude, those of the warm months curve northward after crossing the Appalachian ridges, and those of the winter are slightly deflected toward the south."

In confirmation of these remarks upon tem perature, the flora of South Jersey is found to be essentially different from that of adjacent States, and is similar to that of Virginia and the Carolinas.

Space will not admit extended consideration of other advantages of a trip to the "pines" of New Jersey, but we trust that in calling attention to the matter some interest may be aroused in physicians seeking a near at hand health resort for their patients, particularly from Philadelphia, and any who try the " camp cure" in summer, or a winter's stay in one of the villages named, will assuredly not regret the experi

ment.

OLEATE OF COCAINE.-Dr. Samuel Logan (New Orleans Medical and Surgical Journal) states that the suffering due to painful defecation, whether caused by hemorrhoids, fissure of the sphincter ani, or irritability of the rectum, can be immediately relieved by the application of a few drops of a solution of the oleate of cocaine to the affected part.

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CHRONIC CONSTIPATION.

R. Sodii sulphatis

Sodii phosphatis

Sodii chloridi .

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INFANTILE TETANUS.

Dr. Henry Davy (Medical Press) reports a case of this usually fatal disease, in which complete recovery ensued after fourteen days' ad

M. Sig. One teaspoonful in a cup of water ministration of the following combination

before breakfast.

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Liq. ammonii acetatis

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M. Sig.-Apply locally three times daily.

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M. Sig. One teaspoonful half an hour before meals.

CHRONIC ECZEMA.

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Bismuthi subcarb..

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M. Sig. One teaspoonful three times a day.

AMENORRHEA.

Professor Bartholow speaks favorably of the following combination in the amenorrhoea of chlorosis

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CHRONIC BRONCHITIS.

Dr. N. J. Scott (Cleveland Med. Gazette) recommends

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M. Sig. One teaspoonful every three or four hours.

M. Sig. Teaspoonful four times a day, in

water.

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