PATENT MEDICINES IN AMERICA.

Recently published statis

tics state that there are 5,000 proprietary articles of home manufacture on the American market; 500 of these are of commercial importance, and fifty are run as an independent business. The patent medicine trade of the United States is $22,000,000 annually; of this $10,000,000 is annually expended in advertisements, and the net profit amounts to $5,000,000.

There are five

The traffic is the work of the past half century, most of the patent medicines having sprung up since 1830. Not one in a thousand patent medicine men has succeeded. firms which have made $1,000,000 each; twenty others will aggregate $5,000,000, and the net savings of all the rest will not reach another $5,000,000. More patent medicines proportionately are sold in the United States than elsewhere. The great middle class buys most of them. The profits from and expenditures on established patent medicines run about as follows:

The smaller country newspapers subsist largely upon advertisements of these "remedies," and at least $100,000,000 have been paid newspapers during the last two decades, while upward of $5,000,000 have been expended in rock and fence advertise

ments.

The field for new patent medicines is narrowed every day. Cathartic pills and sarsaparillas do not succeed readily because so many established specimens occupy the field. Until the stamptax was abolished patent medicines yielded the government $1,800,000 annually. The census of 1880 shows that there were

then 563 establishments in this line in the United States, employing 4,015 operatives; that the capital invested was $10,620,000, and that the value of the annual outfit was $14,682,000. New York stood first in the amount of capital invested ($3,512,430), and in annual output (nearly $4,500,005); Pennsylvania, second in capital invested ($2,000,000), and third in annual output ($1,000,000); Missouri, third in capital ($1,500,000), and fourth in annual output ($750,000); Ohio, fourth in capital ($570,000), and fifth in annual output($450,000); Massachusetts, fifth in capital ($521,000), and second in annual output ($1,500,000).— Exchange.

THE CHOLERA IN EUROPE.-The entire cholera mortality in Europe for four months and a half has been about 2,800, and there seems good reason to believe that it is dying out and will not spread to any considerable extent, though there is still time for further serious outbreaks before cold weather. A c.blegram of August 16 states that the geographical area affected by cholera exhibits the capricious behavior of the disease. Thus, it is worse in Barletta, which is far away to the south, where the coast district between Monte Gargano and Brindisi is easily affected. Thence it makes a clear leap of 300 miles to Ravenna and Bologna, then turns northward, extending, though in a less virulent form, throughout Venetia, including the Island of Chioggia, and reaching as far east as Verona, and as far north as Castel Franco, at the foot of the Alps. It is a noteworthy fact that the places most seriously threatened lie in the center or on the edge of marshy plains formed by the alluvial deposits of rivers or the silting of the sea, which always induce more or less malaria at this season of the year.-Jour. of the Amer. Med. Asso.

WHEN NOT TO GIVE CHLOROFORM IN PARTURITION.-1. Never give it to a woman who has a tendency to flood during every confinement, or to those who have great relaxation of fiber, or weak, anemic women in their eighth or tenth confinement, except for necessity.

2. Do not give it where labor is complicated with severe vomiting, or with acute heart or lung troubles, unless there be an imperative demand for it.

3. It should not be given to complete anæsthesia except for operations, convulsions, or spasms of the cervix, and then one person should devote his entire attention to it.

4. The inhalation should be stopped directly the pulse becomes weak or the respiration irregular.

5. Do not give it if there be grounds to fear fatty or enfeebled cardiac walls.

In cases where it has been given, there should be extra care to prevent post-partum hæmorrhage.-Dr. Saville, of England, in Ala. Med. and Surg. Jour.

CHRONIC CHLORAL POISONING.-A. L. was admitted into the Hotel Dieu, presenting the following symptoms: Temperature 97° Far., pulse 100, full and feeble; expression anxious; eyes sunken; pupils contracted; great restlessness, requiring the constant presence of an attendant to keep him in bed. At times complete anesthesia seems to exist, but he can usually be aroused to a semi-conscious condition when the pupils are seen to dilate. When consciousness is suspended there are no reflex movements, as considerable irritation causes no manifestations of a reflex character. This is unusual, as, under the influence of chloral, voluntary muscles show direct and indirect irritability. Respiration 12 per minute, shallow and irregular. He is said to have taken large doses of chloral for several days, but the exact quantity is not known. With careful and perfect quiet he recovered in a week and resumed his occupation. Chloral fulfils therapeutic indications not met by chloroform, ether, or morphine. It is more soluble in water than chloroform, and therefore absorbed more quickly from the rectum or stomach, or when given hypodermically. In the presence of an alkaline fluid it is decomposed into formic acld and chloroform. It was introduced into medicine by Oscar Liebreich, who tried to obtain the same effects from it that are gotten from chloroform, which he thought would

The breath of paChloral is excreted

result from the decomposition of the chloral in the alkaline . blood. As a sleep-producing agent it was an almost perfect success, but insensibility to pain was not induced. It seems not to undergo decomposition in the blood. No chloroform is found in the blood of animals poisoned with chloral. tients taking chloral is free from chloroform. in the urine, when the urine is acid, but when the urine becoines alkaline it is converted into chloroform. In chloral poisoning there is always a great fall of temperature. The indications are to keep the patient warm. Strychnine does not appear to possess much power as an antidote of chloral poisoning. In this case it did not do any good.-David Jamison, M.D., in N. O. Med. and Surg. Journal.

UNIQUE CASE OF EXTRA-UTERINE PREGNANCY.-At the January 27th meeting of the British Gynæclogical Society, Haywood Smith showed an ovum of five or six months from a case of extra-uterine fœtation. The patient from whom the specimen was removed was 34 years old, married sixteen years, and had eight children, the last three years and a half ago. At the operation it was found the case was one of so-called abdominal pregnancy, the tumor being quite free from attachment to the pelvis, the uterus or its appendages. It was, however, adherent to the omentum, the vessels of which were not very much enlarged.British Gynæclogical Journal.

POINT OF DIAGNOSIS IN ROTHELN.-In the Lancet, April, 1886, p. 785, Dr. Glover says he has noticed the earliest symptom to excite notice in cases of rotheln or German measles, is a swollen gland in the neck at the back of the sterno-mastoid muscle. This symptom he has noticed four or five days before the rash appears. When disease is prevalent, or already exists in a family, and a swollen cervical gland in a young person appears, without obvious reason, it may be suspected that the system is already infected.

Reviews and Book Notices

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A MANUAL ON INHALERS, INHALATIONS, AND INHALANTS, AND GUIDE TO THEIR DISCRIMINATING USE IN THE TREATMENT OF COMMON CATARRHAL DISEASES OF THE RESPIRATORY TRACT. BY BEVERLY ROBINSON, M.D., Clinical Professor of Medicine at the Bellevue Hospital Medical College, New York. Pp. 72.

Behind this alliterative and tautalogical title-page are noticed, with much sound judgment and eminent fairness, the good and bad influences of the list of spray-producers and inhalers properly before the profession.

The writer's confessed fondness for Beseler's globe inhaler, "much more elaborate and expensive, non-portable," is nearly ubiquitous. Our interest in this subject might, in times of greater pecuniary indulgence, inspire us with temerity enough to ascertain its cost. We consider it a palpable error to give this apparatus precedence over Hassall's, one of simplest form, on the ground that with the former no considerable effort of inspiration is required.

THE USE OF ELECTRICITY IN THE REMOVAL OF SUPERFLUOUS HAIR AND IN THE TREATMENT OF VARIOUS FACIAL BLEMISHES. By GEO. HENRY Fox, M.D., Clinical Professor of Diseases of the Skin, College of Physicians and Surgeons, New York, etc. Pp. 67. Fancy has led us to watch with some interest the evolution of this American innovation. This precise description of its appliIcation and the favorable results are no trivial evidences of the independent activity in our national dermatological camp.

The cause of hypertrichosis is safely and vaguely stated as a