first threat.

This is a very efficacious method of silencing the protestations of this imperious member. No feeling or pressing the diseased organ to ascertain whether the discharge has diminished. Try to induce your patient to brood over his trouble as little as possible; constant dwelling of the mind on it renders a cure almost impossible.

As to therapeutics, you have only the embarrassment of choice. I prescribe usually extract of cubebs and bals. copaiba, with spirit of nitre, after the inflammatory stage has been subdued by salines and tisanes, and sometimes a grain or two of camphor at night when chordee threatens. Be cautious in the use of injections, especially during the inflammatory stage; the one to be used, par excellence, when the time comes, is a solution of corrosive mercury. Gonorrhea is due to the presence, as we have said, of a specific virus, and must be exterminated by a specific germicide: We have this in corrosive sublimate. This therapeutic agent, moreover, was employed against blennorrhagia even before the microbian theory was thought of. In 1805, Russ, of Strassburg, used injections in the proportion of one to ten thousand, as an abortant treatment. It is, however, only during these last few years that this parasiticide has attracted the attention of physicians occupied especially in the treatment of venereal diseases. Tauti in Italy; Diday, Blondeau, C. Paul and Martineau in France, are among those who have strongly endorsed this new method of

treatment.

In women, notably, Martineau has obtained marvelous results by the use of urethral suppositories containing one-thirtieth grain of bi-chloride of mercury. In blennorrhagic vaginitis he uses injections of the same in the proportion of one grain to one thousand of water by means of which he bathes the vaginal cul-de-sac once a day.

I may say, in conclusion, that I have derived the most gratifying and satisfactory results, in a recent case, by the use of corrosive mercury in one part to twenty thousand, which had proved refractory to various. other means. Far from me the pretension of according to one isolated fact a significance it does not deserve, but all things have a beginning. Try it yourselves, and you will not long be deprived of an opportunity. You can find corrosive mercury at any pharmacy, and clap every placeI was going to say in every family, and perhaps nearer home than even that.

THE TREATMENT OF PLEURISY IN CHILDREN.-Dr. Weiderhofer has recently studied this subject, chiefly from a clinical standpoint. The following are the main points of his paper, as given by the Arch. of Ped.: The younger the child the more difficult of diagnosis is pleurisy. The disease may be entirely overlooked without a very minute examination. After the exudate has formed the diagnosis is somewhat less difficult. Then the child breathes more superficially, there is a febrile movement and cough, which may last several days. The frequent and superficial respiration are the more important indications in making the diagnosis. If there is no exudation in the pleural cavity, the child will lie upon the diseased side. As to the physical signs, at first there is general bronchial respiration, gradually there is dullness on percussion and diminution of the respiratory murmur. Should the exudation be abundant the diagnosis may be readily made, but should it be limited to a small area at the base of the pleura the diagnosis will be difficult. The sensation which is yielded by percussion is believed to be of greater assistance in forming a diagnosis than the information which is obtained by auscultation. The prognosis of this disease is usually favorable. Thoracentesis will be necessary in case the exudation is not absorbed, and especially in cases in which it is so abundant as to occasion troublesome dyspnea to the patient. Purulent accumulations rather than serous or sero-fibrinous ones cause trouble of this kind, and can usually be correctly diagnosticated in those cases in which an exudation persists longer than fifteen days, the temperature reaching 104° F., moining and evening, while the child steadily emaciates. The crucial test is, of course, an exploratory puncture. The treatment of purulent pleurisy by aspiration is not followed by the best results, for, in a few days, another deposit of pus has taken the place of the former one. The author believes that it is best treated upon the same principle which governs the treatment of abscesses. An incision, sufficiently large, is made between the fifth and sixth ribs, the pus is evacuated, a drainage tube is introduced, and an antiseptic dressing is applied. The patient is usually cured in from two to three weeks. Should the operation be deferred until an advanced period of the disease the pleural cavity must be washed out systematically with a solution of salicylate of soda or of thymol. Phenic acid solutions are dangerous, and numerous cases of poisoning have followed their use. Unless the operation is performed early there will be deformity of the thorax. If the purulent deposit is left to itself it may point somewhere upon the abdominal or thoracic wall, and will be revealed by swelling, fluctuations, and inflammatory edema. In most cases of this character there is a fatal issue. - Med. Record.

MEDICINE.

VOLITION AND COUGHING.-(Thomas F. Rumbold, M. D., of St. Louis,in the Maryland Med. Jour.)

There is far more probability of an anodyne application relieving a little finger that is benumbed by a blow on the elbow, than that a cough will remove the sensation in the throat that is caused by an irritation due to inflammation or to a lodgement of a secretion behind the soft palate.

I have known patients cough, on an average, ten times every five minutes for two hours in the morning, making two hundred and forty spasmodic efforts to relieve the throat of tickling sensations. Now, this is tiresome to a weak individual and the relief of one-half of their efforts may be sufficient to prevent the throat becoming inflamed and thus prevent the lungs being implicated in the disease. If a healthy individual coughs two hundred and forty times in two hours every morning-not to take into account the very frequent coughing through the day that is done by every such patient-he will, in a few weeks, have his throat so highly inflamed that he may require medical aid for its relief.

A good method to help one to control the cough, is to mark each cough on a card, preserve this card, and endeavor to decrease the number of coughs each day. I have known patients to decrease these efforts seventy-five per cent. One patient coughed one thousand and eightyfive times the first day's tallying, on the next day he coughed four hundred and fifty times, on the next, only two hundred and twenty times. This may seem to some to be trifling work, but the result is always beneficial to the cough and to the strength of the patient. Some patients have tried to control the cough without marking each effort down, but they are not certain as to the degree of decrease or increase of the cough; there is no doubt that a person will be more certain of success in controling his cough if he marks every effort on a piece of paper; under these circumstances the mental effort will greatly assist in resisting the sensation of tickling in the throat.

THE THERAPEUTICS OF ASTHMA.-Within the past few years the interest of medical men in the subject of the treatment of asthma has received a fresh impetus from the birth of a new theory of the pathology of the affection. As is well known, Hack and a number of other observers have drawn attention to abnormal changes in the turbinated bones, and in the mucous membrane of the nose and the pharynx, as the chief factors in the causation of a large percentage of the cases of asthma. Hack

laid particular stress on swelling and hypertrophy of the inferior turbinated bones, and recorded several cures brought about by cauterizing or removing the hyperplastic tissue. Since the publication of this article, specialists and general practitioners have, with the aid of highly magnifying reflectors, seen hypertrophied turbinated bones in many an athmatic patient, which there was a great temptation to reduce, either with some ingenious instrument, with the galvanic cautery, or with a powerful escharotic. Although the results have not been so gratifying as Hack's, they have gone far toward affording an apparent verification of this theory; for, if the so-called hypertrophied turbinated bones could be detected at first only with the aid of magnifying reflectors, it was not long before they were sufficiently hypertrophied to be distinct even to the naked eye.

The pendulum, however, is beginning to swing back, as is evident from a recent lively and protracted discussion at several consecutive meetings of the Berlin Medical Society. A number of speakers took part in the discussion, and there seemed to be a consensus of opinion that cases in which asthma was benefited by cauterizing the nasal mucous membrane or the turbinated bones were extremely rare. Such treatment, it was said, should not be employed until a careful examination had been made with a sound, the parts having been made anesthetic with cocaine, and an area discovered a touch upon which would call forth an attack. Scadewald broached a novel method of treatment, based on his no less novel theory of the pathology of the disease. He maintained that bronchial, or true, asthma was due to a neurosis of the trigeminal nerves, and should be treated by faradization of those nerves, the application being made during an attack, as if made in the intervals,

they would not call forth a paroxysm. Lubinski emphasized his previous remarks as to the benefit to be derived from inhalations of pyridine, but the drug must be used with caution, as disagreeable and alarming symptoms may follow its injudicious use. Amyl nitrite, nitro-glycerin, and sodium nitrite act in the same way as pyridine, but all these remedies find their more appropriate application in cardiac asthma.

If any drug deserves the title of a specific in this affection, it is potassium iodide. The remedy was first recommended in asthma by Trousseau, but this use of it fell into oblivion for a number of years, to be only recently restored by the publications of Leyden and Germain See, the latter of whom recommends its administration with lactucarium. Potassium iodide is of great service also in the purulent bronchitis which

occurs as a sequel to asthma.

In many cases of this condition the

various balsams are efficacious; and Lubinski has observed excellent results from the use of Peruvian balsam combined with myrrh, the former in doses from a grain and a half to three grains three or four times a day. If there is really a nasal affection, it should be treated according to its character, and not on any far-fetched theory of its etiological importance. But, in the treatment of asthma, it is of the greatest moment to distinguish true, or primary, asthma-by no means a common affection -from that which is secondary to disease of the heart and lungs. We need scarcely to say that we have had only the former in view in this writing.-N. Y. Med. Jour.

TREATMENT OF ACUTE DYSENTRY.-The inflamed edematous condition of the mucous membrane, and subsequent obstruction to passages from the bowel, is well known. Remembering the relief often obtained from the application of hot water to inflamed surfaces, and the beneficial effects of solutions of bi-chloride of mercury upon ulcerated suffaces, particularly of mucous membrane, the thought occurred to me that if I could carry the hot water into the bowel, allowing it to flow back in sufficient quantity to remove for a distance from above all fecal and offending matter, I should accomplish two important objects—i. e, relief of pain, and prevent absorption of poisonous matter up into the blood, the antiseptic properties of the bichloride aiding in this latter object. Upon this I acted, using a soft rubber tube attached to a Davidson's syringe, passed carefully through this sensitive inflamed tissue, so as to carry the liquid above the rectum into the colon. The patient was placed on his side, with an oil cloth beneath him, and four or five quarts of water as hot as could be borne were injected and allowed to flow back with whatever substance had accumulated or remained in the bowel abɔve. When the water returned clear, then a quart or more of the solution of bichloride, about 1 to 10,000, was injected and allowed to return in the same manner. The effect was immediate relief of pain and tenesmus. A suppository of opium, one grain, was given and retained, and, for the first time after the attack, the patient slept seven hours, awaked refreshed, could take some food, and, if perfectly still, was free from pain. In about twelve hours slight return of pain was felt, and the same treatment repeated. This treatment was continued, with the bichloride solution, four times, and the hot water alone was used for four or five days more, with suppositories of one grain of opium, morning and night, with per