about 250° C., which can be accomplished within two or three days without complaint on the part of the patient. The air as on its way from the thermometer to the mouth is considerably cooled, and as the valves do not shut perfectly, outer air is also admitted-so that the inhaled air at 250° (thermometer) amounts in reality to only about 150°. 4. Should pulmonary hemorrhage occur, the inhalations must be suspended. 5. With hemoptysis the inhalations are to be continued, with the direction however that the inspiration must be as shallow as possible. 6. With acute pleuritic inflammation, rule 5 is to be observed, excepting when very severe, then rule 4. 7. After having finished a sitting, the patient must keep the room for at least half an hour; then only may he be allowed, and even encouraged-only however in favorable weather -to exercise in open air. As a matter of course, treatment by means of hot air inhalations permits the fulfilling of any other therapeutical indication that may appear necessary, more especially the administrations I know of none. 1888. DR. LOUIS WEIGERT, Internat. Klin. Rundschau. No. 51. Translated from the Philadelphia MEDICAL TIMES. Treatment of Baldness. Dr. Lasser (Therap. Ztsch., December, 1888) recommends for alopecia areata the following treatment: For the first six or eight weeks an experienced hand should thoroughly soap the scalp for ten minutes daily, using for this a strong tar soap. A good lather having been formed, it should be removed with an irrigator, using first luke-warm and then. cold water. The cold douching will, after several repetitions, harden the scalp somewhat and prevent catching cold. After the scalp has been thoroughly dried the following lotion should be applied : R Solution of bichloride of mercury, 8 grs. to 5 oz. Glycerin, Cologne water, āā 3 ij 3 v. Then the scalp should be rubbed dry with alcohol, ninety per cent., to which onehalf per cent. of naphthol has been added. The scalp now being free from any fat whatever, the following is applied: *Their optimum is 37.50 C.; at 38.500 C. their growth is only poorly; at 420 C. their development ceases entirely; if exposed to a temperature of 500 C.. they die within one month, and one single " boiling up," ie., 1000 C. destroys them completely. Before applying the pomade the scalp should be thoroughly washed with soap and water and allowed to dry; then the ointment should be applied, but it should not be left on too long, before being again removed with soap and reapplied. Tar in the form of tar-baths is also an excellent remedy as well as an antiparasite.—Munchener med. Wochenschrift, Dec. 25, 1888. For Rigid Os and Perineum. Dr. Abraham Livezey, of Yardley, Pa., for a great many years has used a rectal injection of a teaspoonful of tincture of lobelia in a sufficient quantity of mucilage of slippery elm, flax seed or other mucilage, immediately after a pain. This evacuates the bowels, making the labor more cleanly, and relaxes the os and perineum, rendering the use of forceps unnecessary in most cases. The well-known combination of tincture of gelsemium and lobelia in suitable doses by mouth will act almost as promptly. Anemone Pulsatilla in Gonorrhoeal Orchitis. resort to such a drug when it has absolute properties of which it is important to avail ourselves, and where the patient has an especially strong stomach," otherwise we do more harm than good by administering it. The stereotyped directions: "Take after meals," is not always right. These remarks are suggested by common ex Dr. Martel has employed anemone pulsatilla for some years in gonorrhoeal orchitis with success. In 1885 and 1886 he reported a series of cases whic he had cured with this agent, in doses of thirty drops of the tincture in twentyfour hours. The drug has the advantage of mitigating the pains and enabling the patient to walk. Dr. Bazy has taken up the experi-perience, and especially are borne out by the ments lately in the Hospital Midi, Paris, and communicates to the Semaine Médicela, No. 2, an account of forty-eight cases so treated. In thirty-five cases, recovery was complete; in ten, there was marked improvement; in two, recovery is uncertain; and in one case the drug had no effect. Razy employs the drug in the following formula: R Tinct. anem. pulsatillæ.......gtt. xxx M. Sig.-Dessertspoonful every two hours. The Interference of Remedies with Digestion. It is evident that the accomplishment of perfect digestion requires not only a healthful state of the organs concerned, but of the nervous mechanism which animates and regulates their functions. When we consider on the one hand the intimate and delicate relationship which exists between the nervous and glandular systems, and how susceptible it is to mechanical, chemical or physiological disturbances; and, on the other, think of the properties of many of the drugs which we are accustomed to administer, we need not wonder at the disagreeable and even disastrous effects so frequently produced upon the digestive processes and organs. Now, it certainly is not in the line of curative treatment to interfere with the nutritive processes by thus striking at their very roots. There may possibly be instances where it is advisable to establish tolerance of the, at first, intolerable medicine. But we think that such a procedure will be found to be generally only admissible and valuable in chronic and pretty forlorn cases. It is well known that some physicians have the knack of prescribing very tasty and attractive medicines, while others are notorious for their bulky and nauseous doses. A nasty remedy brings odium not only to the prescriber, but to the profession at large. By its bulk, its taste, consistency, and very appearance nausea, and even vomiting is often induced. This, to begin with, is all wrong; and we should only result of some comparatively recent investigations bearing upon this subject, and with which we all should become familiar. Experiments dealing with the influence of medicines, beverages and condiments upon digesting mixtures have now been published by Fraser (Jour. Anat. and Physiol., Vol. xviii); Petersen (Lancet, 1886); Gluzinsky ("D. Archiv. f. Klin. Med.," xxxix); Roberts ("Dietetics and Dyspepsia." London: Smith, Elder & Co., 1886); Eccles (N. Y. Med. Jour., Dec. 11th, 1886); Fowler Dietetic Gazette, July, 1887). The results of these experiments clearly showed that of the great variety of drugs employed, the effects of which in digestion were observed many markedly interfered with the digestive process, when given in appreciable amount. One lesson of these investigations would be that those remedies known to delay or interfere with digestion should be given in that interval between taking food, when the digestive processes are most nearly at rest. 5 12 C12H12N2O+HNO, C11H11N3O2 + H2O. Antipyrin Nitrous acid " Nitroso-Antipyrin "Water. From experiments it is also inferred that antipyrin with belladonna makes a dangerous compound, the patients suffering severely from respiratory oppression, cerebral pressure, sensation of great discomforature and fright. Much care should be exercised in prescribing. antipyrin in combination with other remedies until it is better known.-The Formulary. Foreign Bodies in the Alimentary Canal. When a foreign body, metalic, hard, sharp, or otherwise liable to be dangerous, has been swallowed, do not give purgatives, but rely upon a coarse vegetable diet--potatoes, bread, cab. bage, turnips, etc., but especially potatoes, with sometimes the aid of a little opium, to produce large fecal masses, which will surround the foreign body, and carry it safely through. You need not expect its expulsion short of from two to ten days. Camphoric Acid in Catarrhs of Mucous Membranes. Dr. Max Neisel states in the Deutsche Med. Wochenschrift, XIV, 40, 1888, that he has employed, in Mosler's clinic, camphoric acid in one-half to one per cent. glycerine or alkaline solution in the form of gargles, applications made with a brush, or inhalations, and has obtained good results in slight catarrhs of the larynx, throat and bronchi. The action of washings of a twenty per cent. alcoholic solution, diluted with lukewarm water to one-half or one per cent., was especially favorable in two cases of chronic cystitis. Given internally, camphoric acid seems to be of advantage in the night-sweats of phthisis. It may be given in capsules containing fifteen or twenty grains.—Schmidt's Jahrbucher, Jan. 15, 1889. CLASS-ROOM NOTES. From The College and Clinical Record. -In a case of post-hemiplegic chorea, Prof. Bartholow directed five drops of the fluid extract gelseminum ter die. -Prof. Da Costa regards the examination for bacilli of tubercle of the highest diagnostic value in the recognition of phthisis. -The long continued use of hot water as a drink is injurious, bringing about atrophy of the gastric glands. (Prof. Bartholow.) In the case of a man with aneurism of the thoracic aorta, Prof. Bartholow directed low diet, rest, ergot daily, and iodide of sodium 3j ter die. In the treatment of the laryngeal complications of phthisis, Prof. Da Costa advises the insufflation of iodoform or application of cocaine. -In a case of inflammation of the patellar bursa, with accumulation of fluid, Prof. Gross tapped the sac by a trocar, removed the fluid and injected twenty drops of pure carbolic acid. -In the treatment of fetid bronchitis, Prof Da Costa recommends full support, codliver oil and carbolic acid, both by inhalation and internally. -Prof Bartholow directed in the case of a man with ascites, the patient being already too weak for any of the more active remedies, that te abdominal muscles be faradized with a ra pidly interrupted current daily. When ordinary remedial measures fail to arrest hemorrhage from the lungs in a reasonable time Prof. Da Costa recommends sulphate of copper in %--% gr. doses, or tinct. matico, 13 ss-j every four hours. -In the treatment of tertiary syphilis Prof. Gross advises the following: In the more -In the treatment of chronic alcoholism, Prof. Bartholow says: For the disorders of digestion, morning vomiting, loss of appetite, accompanied by wakefulness and nervousness, the appropriate remedies are abstinence, careful alimentation, and such tonics as quinine, nux vomica, and the administration of bromide of potassium to procure quiet sleep. chronic cases, where degenerative changes may be expected to have taken place, arsenic in small doses, hypophosphites and cod-liver oil are recommended, and should be given for several months. Chloride of gold and sodium or corrosive sublimate will retard changes taking place in the connective tissue, if given early enough. -When hospital gangrene occurs, isolate the patient at once. Remove the slough by roughly rubbing with sponge (immediately burning the sponge used), cleanse with warm water, dry the wound and cauterize thoroughly with chloride of zinc (with just sufficient water to convert it into an oily liquid) by means of absorbent cotton; allow cauterant to remain on ten minutes; remove and apply antiseptic dressings. An anesthetic should be administered during treatment; good nourishing diet and opium to relieve pain subsequently. (Prof. Gross.) -Aseptic catgut ligatures, chromicized for use on the larger arteries, may be prepared as follows: Take 200 grains catgut; remove fatty matter by immersion in ether for twenty-four hours; wrap when dry on spools and immerse forty-eight hours in following solution : R. Acid, chromic.,. Acid, carbolic., : Remove the catgut under antiseptic precautions; dry, wrap up in any aseptic impermeable material, and before using place for a short time in ordinary 1 to 1000 corrosive solution to which one-fifth its weight of alcohol has been added; these ligatures cut through in about seven days. (Prof. Gross.) Original Communications. Short articles on the treatment of diseases and experience with new remedies are solicited from the profession for this department; also difficult cases for diagnosis and treatment. Articles accepted must be contributed to this journal only. The editors are not responsible for views expressed by contributors. Unused Manuscript cannot be returned. Certainly it is excellent disciptine for an author to feel that he must say all he has to say in the fewest possible words, or his reader is sure to skip them: and in the plainest possible words, or his reader will certainly misunderstand them. Generally, also, a downright fact may be told in a plain way; and we want downright facts at present more than anything else.-RUSKIN. In these columns, ▲ is frequently used instead of 3. Uterine Displacements and Flexions - Their Mechanical and Clinical Treatment. [Continued from March number,] Editor MEDICAL WORLD: IV. MECHANICAL TREATMENT. This was at first attempted, if I remember right, by the late Sir James Y. Simpson, Dr. Gaillard Thomas and others, and their object must have been to obtain that point d'appui externally on the pubes or sacrum. These contrivances, of which many varieties exist, I recommend heartily to be relegated to the nearest gynecological museum as inefficient, unclean, and not unattended with danger. Dr. Meadows invented an admirable instrument on the above plan, which is of great service in those cases where a combination of intra-uterine, stem and vaginal support is called for. Some years ago it was considered the worst kind of quackery to recommend an abdominal brace. Opinions on this subject have undergone great changes. Abdominal braces. can do a great deal of good if employed properly and under certain circumstances. Whenever a patient tells me that she feels as if she needed some support, a brace does good, and she should be supplied with it. A brace does not remedy a malposition of the uterus in the least, but it relieves the uterus of the weight of the superincumbent viscera by narrowing the aperture of the pelvis, and in so preventing the viscera from resting upon the uterus. If a woman has lost her sigmoid curve in her spine and so no longer preserves the obliquity of the pelvis the axis of the trunk of her body being nearly brought into a position of coincidence with the axis of the superior strait-an abdominal brace will act like a charm. In the normal pelvis the axis of the superior strait forms an almost oblique angle with the spine. When this angle has been lost, from excessive hard work or any other cause, the visceral weight, instead of falling upon the pubes, falls directly upon the uterus. In such an instance abdomi nal braces are of great service (1) by restoring to some extent the obliquity of the pelvis, and (2) by affording an artificial support for the intestines. In some cases of anteversion I introduce a Hodge pessary, and so succeed in raising the fundus of the womb above the pubic bone, and when once raised to this position, what better method of keeping it off the bladder than by the application of an abdominal supporter. This is Prof. William Goodell's theory and practice as taught in the Medical Department of the University of Pennsylvania, and is based upon good and sound theory. V. CLINICAL TREATMENT. Regarding vaginal injections in gynecological practice, they are either simple or medicated, cold or hot, and are used for different purposes, as cases may demand their employ ment. Emmett is the great advocate of hot injections in gynecological practice. The rationale of hot vaginal injections is that hot water as a therapeutic agent produces contraction of the blood-vessels and absorption of hyperplastic tissue and plastic exudation. The nutrition of the parts in question is not interfered with by hot as it is by cold injections; for the relaxed capillaries regain their tone and transmit the blood more rapidly, while the contraction of cold is so severe as to arrest circulation entirely if continued. Permanent restoration of tone and calibre of blood-vessels depends on the high degree of temperature, large quantity, long duration and steady perseverance-a proper position, with elevated hips, not to be overlooked. I will admit that there are counter-indications and dangers in using these injections where there is a possibility of injecting the fluid directly into the uterus in cases of lacerated or gaping cervix and a patulous os internum, particularly in retroverted and prolapsed uterus. Astringent injections are mainly used where it is desirable, after having reduced displacement, to corrugate the vagina and cause contraction of vaginal walls, thus aiding materially in affording support to the uterus, the vulva at the same time regaining to some extent its natural resiliency. The several factors that tended to produce or keep up the prolapsed condition are gradually eliminated, or at least lessened. One of the best astringent preparations which has proved so eminently successful in my hands is the extract of pinus canadensis, which I heartily recommend. Any existing ulcerations of cervix and os uteri are speedily healed by the above-named preparation. The general health must be attended to. Iron, quinine and |