during the day only, the medicine having previously been given both night and day, excepting when she was asleep.

October 11.-Patient still improving; was up for a short time to-day. Buck still a little rigid and arched. No trismus for at least two weeks past. Dose of medicine further increased thus:

Sig. One every two hours during the day.

......xxiv.

October 17.-Patient has been up the greater part of the day; has no complaint; can walk, run, stoop, and rise with perfect ease; spiral curvature gone. Medicine being gradually withdrawn.

October 20.-Dismissed, well.

QUININE AND TYPHOID FEVER.-Dr. O. T. Schultz thus concludes a paper in the American Practitioner for November:

"The question to the solution of which I have now attempted to contribute my mite, I take to be, not whether quinia properly administered in typhoid fever lessens the severity of this disease, its duration, and its mortality, for this point I regard as settled beyond peradventure or doubt, but whether this effect of quinia is due merely to the antipyretic property it possesses in common with cold water, or whether there is some other virtue in quinia that causes its good results in typhoid fever. And if the advantages derived from the employment of quinia in typhoid fever are not due to its antipyretic but to some other property, whether some mode of administering this drug should not be adopted by which, while antipyresis is incidentally accomplished and hyperpyrexia prevented, this other virtue, call it specific, depurative, or what not, may be brought most fully to bear on the typhoid fever process. I think that I have shown that if a dose of quinia, large but proportioned to the age of the patient, is exhibited every other evening, or if the disease is very obstinate every evening, throughout the entire course of the pyrexia, typhoid fever is

reduced to a very manageable and little dangerous affection, and its course greatly curtailed. It matters not whether we call this action of quinia a specific action, or whether we concur with Binz, who asserts that 'Quinia does not put an end to an attack of typhoid fever as it does to one of intermittent fever. In the firstnamed disease it has no specific operation, but only so weakens the putrid ferments that they run their course less destructively.' For, in reality, we know as little of the action of quinia in the one as we do in the other of these fevers, and we simply call the action of quinia in malarial fevers specific because we see that certain easily-recognizable phenomena always follow its use in these fevers. Phenomena of the same nature, only less in degree, also follow its administration in typhoid fever; for, according to Ringer, even in ague quinia frequently removes only the grosser manifestations of the disease, and hence is not by far the ideal specific it is usually thought to be. He says (Therapeutics, 1880, page 579):

once.

"Quinia generally arrests the disease (intermittent fever) at It is well, however, to bear in mind that this remedy may dissociate the other symptoms from the elevation of the temperature; or, in other words, it may remove the shivering, sweating, quick pulse, while the temperature may remain as great, or nearly as great, as on previous days. Mere rest will occasionally effect the same dissociation. Unless the unnatural elevation of temperature has been restrained the paroxysms will speedily return. This fact it is necessary to recollect, otherwise it may be concluded that with the removal of the more obvious symptoms the disease itself is cured, and thus the patient may be permitted to return to his usual avocation.

"A still more curious circumstance remains-that is, quinia may check all the symptoms, even the periodical elevation of the temperature, and yet about the same time of day that the series of symptoms were wont to take place, an increase in the urea and urinary water may occur as during a severe paroxysm; that is, all the symptoms of the paroxysm are absent except those pertaining to the urine.'

"But to the action of quinia in the typhoid fever process of

what kind soever, the experience detailed above appears to me to show conclusively that quinia possesses a property which so subdues, moderates, mildens, and shortens this process that the disease runs its course without producing its usual ravages on those organs on which it is wont to spend its force, and that this peculiar property or power is not identical with that by which it reduces a high temperature to one of low degree."

THE INFLUENCE OF DRUGS ON MILK.-In a medico-legal case MM. Brouardel and Pouchet were asked whether an infant of two months could have been poisoned fatally through its mother's milk, the mother having been for some time under treatment with arsenic, and on several occasions having shown symptoms of arsenical poisoning.

To settle the point M. Brouardel made a number of experiments by giving Fowler's solution to nursing women, the result of which showed that arsenic can readily be found in the milk, even when taken in small doses, but that no toxic symptoms are likely to be produced in the child unless the mother be taking a toxic dose.

Fehling has lately experimented upon the subject of the elimintation of drugs by the milk, and found that salicylate of soda, iodide of potash and iodoform can all be traced to the urine of the nursling, the latter drug when taken in very small quantities, and even when applied externally. Hence he advises against its use as a dressing for wounds in nursing women. He has also found corrosive sublimate in the urine of children whose nurses had the drug applied externally, but the quantity p ssing to the child was so small that he thinks it unnecessary to use the same precautions with corrosive sublimate as with iodoform.

The narcotic substances are without effect upon the nursling. The largest doses of opium or chloral administered to the nurse do not bring about any especial symptoms in the child.

Atropine was tried on animals, and no dilation of the pupil or other manifestations occur in the suckling, excepting when the maximum therapeutic dose has been exceeded.

Fehling therefore comes to the conclusion that while but few drugs administered to the mother prove deleterious to the infant, a strong exception, however, should be made of those substances that are eliminated with difficulty and accumulate in the organ

ism.

Nevertheless it is certain that many substances, when ingested, produce decided effects upon the milk. "Milk sickness," or the "trembles," occur in persons using the milk of cows which have fed on certain pasturage, and the odor of copaiba or asparagus can be detected in the child's urine when these substances have been taken by the nurse; moreover, artichokes, absinthe, and other substances will make the milk bitter.-North-western Lancet.

POISONING BY CHLOROFORM INTERNALLY ADMINISTERED.Since chloroform administered internally in the treatment of tape-worm has frequently been referred to in these columns, the following case of poisoning through the accidental administration of an overdose, reported in the New York Medical Record for October 3, by Dr. J. M. Latta, of Millerton, Kansas, is deserving of attention:

The case was that of a boy, six years of age, suffering from tape-worm, for which he ordered a mixture of one part chloroform in three parts simple sirup, of which one teaspoonful was to be given every hour until four doses had been taken. By mistake the parents gave the mixture in tablespoonful doses. Twenty minutes after he had taken the fourth dose of the mixture the boy said the medicine was "about to kill him;" he reeled like a drunken person and vomited violently, throwing up mucus tinged with blood. The child was rational when first seen by Dr. Latta, and said that his stomach hurt him, but in a few minutes he became unconscious. The pupils were normal, the breathing easy, and the pulse a little accelerated, but regular, and rather full and bounding. The face was covered with an even red flush, arterial in tint. The temperature was not taken. It was impossible to arouse the boy by calling or shaking him. All the pillows were removed, the body was placed straight and all constricted

portions of clothing loosened, and fresh air was freely admitted into the room. The pulse and respiration were carefully watched, but as they furnished no special indications for treatment nothing more was done. The pulse became gradually less rapid, the flush disappeared from the face, aud in an hour and a half the boy awoke and expressed himself as being all right. A saline was administered a few hours later and the bowels were moved, but there was no appearance of any tape-worm. Therapeutic Gazette.

THE QUESTION OF OPERATION IN CARCINOMA OF THE BREAST. It is the opinion of most writers that carcinoma of the mammary glands is a condition that calls imperatively for operation, not only to relieve pain ard free the patient from a disgusting sore after ulceration has occurred, but also to prolong life. As to the latter point however, there is not perfect unanimity among authorities-rather less, indeed, than is generally supposed by those who have not studied closely the more recent literature of the subject. There are symptoms of a threatened reaction in the mind of the profession, and it is not beyond the range of possibilities that, not many years hence, operation in cancer of the breast will be as exceptional as non-interference is now.

In the article on Carcinoma in the Reference Handbook of the Medical Sciences, edited by Dr. Buck, the author, Dr. Satterthwaite, says that the statistics in a small number of cases would indicate that life is prolonged by operation for an average of more than eleven months, an estimate which he regards as a low one; yet he states that in his cases the growth of the disease was more rapid after removal. Dr. Lemaitre, in a short paper read before the Société de Médecine de la Haute-Vienne (Journal d' Accouchments, October 15, 1885), argued strongly againt the advisability of an operation, and asserted that the subject of mammary cancer lived longer when the policy of non-interference was followed than when the tumor was removed. Boyer says that the extirpation of a tumor of undoubted cancerous nature should never be