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PUCLEU

DROPSY

-and specimen of what
physicians are saying.

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-results remarkable, even beyond my expectations.

ANEDEMIN is truly a Medicinal Trocar in Dropsy from any cause."-From member State Board of Examiners.

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-gave tablets as last resort to man 78 years of age dying with a very weak, irregular heart, general oedema, dyspnea, etc., and he made complete recovery."-From member State Board of Health.

-physicians can push ANEDEMIN without fear if the patient can stand the loss of effusion quickly, and it is equally as valuable in the cause, as in dropsical effusion."-From prominent Kentucky physician.

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-Anedemin tablets did everything you claimed for them. Seventeen days after I began using them I was able to leave the hospital where I had been for seven months. I am about ready to resume my practice."From a California physician.

Each physician may test it for himself. Clinical data, literature with exact formula, and samples sent on request.

ANEDEMIN CHEMICAL CO., Chattanooga, Tenn.

"MADE IN AMERICA"

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An Exceptional Local Anesthetic-When, a little more than a year ago, announcement was made that the scientific staff of Parke, Davis & Co. had achieved the distinction of producing a local anesthetic possessing all of the advantages of similar products then in use, minus the disadvantages peculiar to many of them, the intelligence was received by thousands of American surgeons and physicians with manifest satisfaction. The advent of the new product was propitious. The time was ripe for a truly efficient American-made local anesthetic. And Apothesine appears to justify every promise that preceded it. There is abundant evidence that the product can be advantageously used in any case in which a local anesthetic is indicated. Proof of the efficacy of Apothesine comes from all over the United States. Two examples may be cited: A Minnesota surgeon says that he has used Apothesine at least eight hundred times and has yet to find a case that shows any toxic symptoms or incomplete anesthesia; he reports seven thyroidectomies, excision of elbow, amputation of arms, legs, fingers, carcinomas, sarcomas, cysts, and all manner of minor work. A New Orleans surgeon reports 250 operations of various kinds, ranging all the way from amputation of the finger to amputation of the breast, without a single failure and with no untoward result. Comparative tests prove that Aposthesine is as efficient as any synthetic local anesthetic and more potent than most of them. Its toxicity is low, being far less than that of cocaine and no greater than that of the least toxic of other syntheic anesthetics. Apothesine is supplied in hypodermic-tablet form, as follows: H. T. No. 216, each tablet containing 14 grains of Apothesine; H. T. No. 217, each tablet containing 3-5 grain of Apothesine and 1-1600 grain of Adrenalin; H. T. No. 218 (dental), each

tablet containing 1-3 grain of Apothesine and 1-2500 grain of Adrenalin.

A Timely and Important Declaration to the Medical Profession-Founded in New York City in 1867, the House of Schering & Glatz has been from its very inception, and throughout its existence, an American concern, entirely free and independent of foreign control, financial or otherwise. The relation of Schering & Glatz to the German-owned Chemische Fabrik auf Actien (vorm E. Schering) has always been that of an outright buyer of that Company's products with the sole privilege of marketing them in the United States. The German concern has never had a dollar's worth of investment in Schering & Glatz, nor have Schering & Glatz ever owned stock in the German concern, either as a firm, or as individuals. The "Schering" in Schering & Glatz stands for the name of one of the founders, Mr. Hugo Schering, a distant relative of the Berlin family. He and the original partner, Mr. Glatz, both American citizens, have been dead for many years. Schering & Glatz leading chemical and pharmaceutical products, so long identified by the brand name of "S. & G." are now manufactured in the U. S. A., either by ourselves, or under our direct supervision and control. Others, as yet unavailable, will be added as fast as prevailing conditions permit. We guarantee for all of these products a standard of quality fully the equal of the formerly imported. In prescribing "S. & G." products, the physician will henceforth have the double satisfaction of applying therapeutic agents which he has known and relied upon for many years, while feeling assured that he is using the Americanmade products of a wholly American concern. Schering & Glatz, Inc.

New York, August, 1918.

The Medical Herald

Incorporating the

Kansas City Medical Inder-Lancet

Subscription, $1.00 a year, in advance, including postage to any part of the United States, Alaska, the Philippines, Cuba and Mexico. Canada, 25 cents additional. Postage to foreign countries in the Universal Postal Union, including Newfoundland, 50 cents a year additional.

The Medical Herald aims to reflect the progress in the sciences of medicine and surgery, especially throughout the Missouri Valley and Southwest, the territory of its greatest distribution.

Concise and practical articles, news and reports of interesting cases invited, and should be typewritten.

The privilege of rejecting any communication is reserved, and all papers accepted must be for exclusive publication in this magazine, unless otherwise arranged.

To contributors of original articles a liberal number of copies of the Herald will be given (or mailed free of expense if addresses are furnished) and the publishers will furnish reprints at printers' cost, application for same to be made when proof is returned.

The editors are not responsible for the utterances of contributors or correspondents.

Illustrations will be furnished at reasonable rates, if drawings or photos are furnished.

Address all remittances, correspondence, articles for publication, books for review and exchanges to the Managing Editor.

Subscribers changing their addresses will please notify us promptly, as magazines cannot be forwarded without adding postage.

Advertising forms close on the 20th of each month. Time should be allowed for correction of proof.

Electrotypes and changes in advertising copy should be addressed to the Medical Herald, St. Joseph, Mo. Advertising rates on application to the Managing Editor.

Poetic Reprints-Do not mutilate your Medical Herald by tearing out any piece of poetry that may strike your fancy. Write to the Managing Editor, and he will send you a reprint. Reprints are made of all verse appearing in this magazine.

FOOD WILL WIN THE WAR DON'T WASTE IT

Where Edema is Attendant and where the heart, liver and kidneys are involved, Anedemin tablets may be prescribed with absolute fredom and safety and satisfactory results anticipated. These tablets are a combination of the active principles of Apocynum, Strophanthus and Squill with Sambucus as adjuvant and their action immediately eliminates effusion, controlls and increases the power of the heart, liver and kidneys to perform their function and affords the patient prompt relief and comfort. With continued use Anedemin strikes at the root of the trouble removing the cause. Being non-toxic, not cumulative and not a gastro-intestinal or renal irritant, Anedemin may be administered at frequent intervals in large doses and continued an indefinite time in small doses if necessary. The patient does not have to be watched or kept recumbent as in the administration of many drugs of this class. Physicians may obtain samples of Anedemin and literature containing exact formula by writing the Anedemin Chemical Company, Chattanooga, Tenn.

Pond's Extract

A Food Tonic Rich in Hemoglobin-A food tonic containing the nutritive properties of beef blood, rich in hemoglobin and possessing the valuable biologic properties of beef serum unaltered by heat. Such is a description of Bovinine which is offered for infants and adults where nutrition is impaired or where debility is present. Bovinine has been found of value in anemic affections, also in metabolic diseases, in short, wherever the nutrition of the patient has suffered. It also has proved meritorious as a local application in indolent ulcers in which it promotes healing. The Bovinine Company, 75 W. Houston Street, New York City, will be glad to sup ply samples and literature to physicians on request.

CAUTION! Whenever the true merit of

a preparation is authoritatively established, imitation is sure to make its pernicious appearance. To counteract the injurious results of another of these fraudulent proceedings-in this instance affecting firm name and reputation-Sander & Sons have been compelled to appeal to law, and in the action tried before the Supreme Court of Victoria, the testimony of a sworn witness revealed the fact that this witness suffered intense irritation from the application to an ulcer of the defendant's product, which was palmed off as "just as good as Sander's Eucalyptol." Sander & Sons had the satisfaction to obtain a verdict with costs against this imitator, who is perpetually restrained from continuing his malpractice. Dr. Owen, in a report_to_the_Medical Society of Victoria, and Dr. J. Benjamin, in the Lancet, London, both denounced, as others did before, on the strength of negative results, the application of unspecified eucalyptus products.

This forms convincing proof that only an authoritatively sanctioned article can be relied on.

SANDER & SONS' EUCALYPTOL
(Ecalypti Extract)

1. Has stood the test of Government investigation.

2. It was proved at the Supreme Court of Victoria by experts to be an absolutely pure and scientifically standardized prep

aration.

3. It is honored by royal patronage. 4. It always produces definite therapeutic results.

Therefore, to safegaurd the physicians' interest and to protect their patients, we earnestly request you to specify "Sander's Eucalyptol" when prescribing eucalyptus.

The Meyer Bros. Drug Co., St. Louis, Mo., agents, will forward one original package (1 oz.) on receipt on One Dollar.

To allay the itching, smarting and burning of the heat rashes, there is no lotion more effective than Pond's Extract, full strength-or diluted with water equal parts.

Cooling, soothing and anti-pruritic, Pond's Extract is invaluable in the treatment of hives, sunburn, chafing, ivy-poisoning, etc.

POND'S EXTRACT CO., New York and London

Prickly Heat

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MEDICAL SOCIETY OF THE MISSOURI VALLEY, OMAHA, SEPTEMBER 19-20

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A course of Cystogen-Lithia is indicated
in ambulatory patients.

Wherever Uric Acid is a possible Etiological Factor.
CYSTOGEN-LITHIA

is an effervescent tablet containing Cystogen and Lithium Tar-
trate, each grs. 3. Dose, one or two tablets, three or four times
a day, dissolved in a glass of water.

Samples and Literature on Request

CYSTOGEN CHEMICAL CO.
ST. LOUIS, U. S. A.

Doctor Protect Your Bank Account

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The DIMUNETTE CHECK PROTECTOR breaks the paper and forces acid proof ink into the fibre. It is Standard Protection. The "Not Over" limiting line should be placed diagonally through your signature, the item of first importance to your bankerand the crook. If your money is worth having it is worth protecting. Don't wait till one of your checks has been raised. Write for free illustrated booklet on "How Crooks Make Millions."

The American Bankers Association has given repeated warnings against the issuance of unprotected checks. They have said no one is safe in writing checks unless they are effectively protected. The DIMUNETTE gives you the same character of protection which 75% of the banks employ whether it be a limiting line machine or writer. Why pay $20, $30 or $40

for a machine when you can get Standard Protection for $7.50. Made and guaranteed by the oldest manufacturers of check protecting devices in the United States. Just attach your check or money order for $7.50 to this ad and mail to

RALPH E. HERRICK, 307 NEW ENGLAND BUILDING

KANSAS CITY, MO.

and a DIMUNETTE will be sent you prepaid

Refer by permission to the editor of this journal.

When Writing to Our Advertisers, Please Mention The Medical Herald

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Vol. XXXVII.

Incorporating

The Kansas City Medical Index-Lancet

An Independent Monthly Magazine

SEPTEMBER, 1918

Original Contributions

[EXCLUSIVELY for the MEDICAL HERALD.]

FATIGUE NEUROSES*

TOM BENTLEY THROCKMORTON, B. Sc., M. D., Des Moines, Iowa.

In presenting the subject "Fatigue Neuroses," it is quite natural that one's mind be turned to a consideration of such conditions as are capable of producing changes in the nervous system which are not organic in type. It has been the custom for many years to arbitrarily divide all nervous disorders into so-called functional and organic classes. For clinical purposes, it must be confessed that such a division is not entirely without merit, for it has perhaps served as a means for better fixing some of the all too hazy ideas of neurology in the medical students' mind. Today, however, we are brought face to face with the fact that theoretically, at least, it is impossible to have a perverted function of an organ or tissue without there first being an underlying cause, some pathologic change present somewhere within the animal structure. All too well do we realize that the boundary line between the neuroses on one hand and the organic nervous diseases on the other hand is entirely imaginary. To consider a neurosis simply as a nervous disease devoid of anatomical changes is inadequate, for who can conceive of disease or perverted function without there being also the presence of some underlying abnormal physical or chemical basis? Yet I feel that the time is hardly at hand for us to erase the line which at times so narrowly divides the functional disorders from the truly organic ones, but we must needs be content to look upon the neuroses as functional in character until a more definite pathology is established.

In order that the subject may be given proper consideration in the brief space of time allotted, it is necessary that the scope of this paper be well understood, and to this end, attention will

*Contributed to the Symposium on the Diseases of Exhaustion, Medical Society of the Missouri Valley, Keokuk, Iowa, March 22, 1917.

No. 9

be called but to two of the three chief neuroses, namely, neurasthenia and psychasthenia. Hysteria, for reasons obvious to the society, cannot and should not be considered at this time. In this connection also, it might be well to add that the occupation neuroses, the traumatic neuroses, migraine and epilepsy are likewise excluded from consideration, although in some instances fatigue may be a causative factor, to a more or less degree, in producing or promulgating the symptoms arising from such disorders. With these preliminary remarks, let us now turn our attention to a consideration of neurasthenia. While this disorder is in reality a neurosis due to exogenous causes, we find that psychasthenia, in its essence, is the result of causes arising largely within the human economy itself. For years a popular and fashionable disease, of more recent time we find that it is with reluctance that a diagnosis of neurasthenia, or nerve exhaustion, is made. Pardoning a personal reference, I recall the time when in the absence of frank organic changes, a case was considered neurasthenic until proven to be otherwise. Today, I believe the pendulum has swung in the opposite direction, and no case is considered one of just plain "nerves" until every known means for detecting organic changes in the nervous system has been utilized and a negative result obtained.

The commonest cause in the production of the disorder now under consideration is overstrain, mental or physical. True it is also that alcoholism, cocainism, tobaccoism, and allied substances may play at times an important role as etiologic factors, and indeed one must not lose sight of the part played by toxins elaborated during the process of the various infective diseases, but these factors by no means invalidates the assertion that mental or physical exhaustion are the commonest causes. Again, it must not be forgotten that an overlapping of symptoms, supposedly neurasthenoid in origin, with those emanating from a purely organic basis, can and do occur. I recall yet quite vividly the case of a young nurse, who came into the service of Dr. Francis Sinkler, at the Philadelphia Orthopedic Hospital and Infirmary for Nervous Diseases, some years ago. After having passed through the hands of several eminent special

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