exercise, and in four weeks she felt assured that with ordinary good luck she was fairly on her feet again.

Mr. L., a man of about forty years, came to me from the headwaters of the Big Sandy, with marked symptoms of tuberculosis, which had been developing for some nine months. Latterly they had been very acute, like those in the preceding case, and it was only by a strong exertion of the will that he reached our city. There were the same indications for remedies (strong), and they were given with the most satisfactory results, and I think with care the patient will make a good recovery.

Three other cases might be described, very similar in character, but there is no need to mention more here. The five are good cases, in that the persons have been stout, even tough, and had strong wills. The disease was acute, and the indications for remedies sharply defined. It may be urged that they were not cases of phthisis, but pneumonias, or forms of bronchitis. It is possible to make such mistakes in diagnosis, but I think I am right in these.

I have one patient doing remarkably well on arsenic and bryonia, with extract of malt and malt infusion. Another, of two years' standing, enjoys fair health on graphites and arsenic repeated occasionally; and some half-dozen or more that I hear from have recovered fair health on the hypophosphite of lime and good hygiene. But I have seen many more which have gone steadily on toward that unknown land, without even mitigation from medicine. These people were born to die of phthisis, or something else of a similar character, in early life. When they are attacked with phthisis nothing will save them.

SYPHILIS IN RELATION TO MARRIAGE.

The Specialist and Intelligencer comments editorially upon the book of Dr. Alfred Fournier, on the above subject, and gives the following summary of his conclusions:

The physician who is questioned by a man who has had syphilis, as to the propriety of his marrying, has a very grave responsibility imposed upon him. If he decide amiss, he may, on the one hand, let a man marry only to infect his wife

and beget a diseased offspring, or, on the other hand, forbid a marriage which would be perfectly or reasonably safe and close the door against all the advantages which would follow it. When he (Fournier) thinks of the happy couples and the healthy children who owe their happiness and existence to his permit, he cannot but think it is a grave error to say a syphilitic should never marry.

If, then, this be sometimes permissible, when is it so? The answer he gives is :

1st. In the absence of actual syphilitic manifestations; 2d. After a considerable time from that at which the disease was acquired; 3d. After a period of immunity since the last outbreak; 4th. When the disease has been of a non-menacing character; 5th. After adequate specific treatment.

The first condition is absolute and inflexible; the second admits the exercise of a certain discretion, though it should not be less than three or four years, and is affected by the fifth; the third condition, the period of immunity, he thinks should be at least from eighteen months to two years. The character of the disease may be shown to be non-menacing by the patient's general condition or by the lightness of his eruptions; while an early affection of the nervous system or the viscera is a very grave sign. By adequate specific treatment, Fournier means active and curative, not timid and indifferent, doses of mercury and iodide of potassium. These are to be used methodically and as indicated in the different stages and degrees of the disease.

DIABETES MELLITUS.

Dr. J. S. Dare (Cincinnati Lancet and Clinic) reports an interesting case, showing the effect of diet on the above-named disease. The following is a brief report of the case. The patient was a physician of active habits and great physical and mental power, and maintained strictly throughout the course of the disease, and, for some time after, a non-saccharine diet:

On the 18th day of January, 1878, he was seized with general rheumatism, with indications of precordial effusion. Prescribed for self forty grains of bicarbonate of potassium every two hours for forty-eight hours. At the end of this time, on

the morning of the 20th, the rheumatic and cardiac symptoms had yielded, leaving him much enfeebled. Now he learns that in the twenty-four hours preceding, he had discharged about three gallons of urine. This excessive discharge continued until the morning of the 23d, he thinking it polyuria induced by the potass. On this morning a careful examination-made by himself showed the urine to contain 18 per cent of sugar, and to have a specific gravity of 1022; supposed quantity in twenty-fours past xx0. On the 24th, there was an increase of quantity, of specific gravity, and of sugar. Now he commenced the use of animal diet, and continued it to the exclusion of amylaceous and medicinal articles, with the following record kept by himself, viz.:

The calcium and strychnia were continued with only one week's intermission, from January 31 to June 1 (about four months), when they were set aside; but the non-amylacious diet was rigidly enforced until the 1st day of March, 1879, a period of nine months after all trace of diabetes had left. On the 1st of March, 1879, he cautiously commenced a return to

his omniferous habits, and is to-day, December 5, 1879, in the enjoyment of his normal condition, possessed of no saccharine tendencies, and weighs 180 pounds.

EPIDEMIC TONSILLITIS.

Prof. J. M. Scudder (Eclectic Med. Jour.) says:

This disease still continues, and new outbreaks are reported from different parts of the country. I am satisfied that it is a modified diphtheria, or at least a blood-relation. It is much less severe, as a rule, yet I have seen cases where there was marked constitutional disturbance, and very sore throat, and as much enlargement of the lymphatic glands as I have ever seen in diphtheria. There is this about it, that if not properly treated it will leave permanently enlarged tonsils, and a pharyngeal and nasal catarrh. I have had some cases in charge since my return, where patients have suffered since spring.

This disease is readily recognized, the patient is debilitated, has some fever, complains of sore throat, has a nasal voice with sound of mucus in the throat and trouble to free it by hawking and spitting. We place the patient in a good light, depress the tongue and see the tonsils very much enlarged, the velum pendulum and mucous membrane of pharynx swollen, all of a deep or dusky red color. The swollen tonsils may be felt at the angle of the jaw, and they are painful on pressure, and the external cervical lymphatics are enlarged.

In the early stage, and in simple cases, the disease yields readily to Tinct. Aconite gtt. v., Tinct. Phytolacca gtt. x., water iv.; a teaspoonful every hour. Even very severe cases will yield to this treatment if there is not a strong indication for some of the antiseptics.

This fall, sulphurous acid is frequently indicated, not only in this, but in all other diseases. The red tongue, not bright and fiery, not dusky, moist, rather full, with dirty coating, in so far as it is coated, dirty secretions about tonsils, dirty mucus bathing the throat. The patient has no appetite, indeed with such a mouth and throat there could be nothing but disgust. I give it in half-teaspoonful doses every three hours, with a

little water, the object being to get its topical as well as its general action. It is an admirable remedy.

If the tongue is broad, pallid and covered with a dirty, pasty coat (moist), I prescribe sulphite of soda in doses of grs. x. every three hours.

In women at the menstrual period, or when there is the odor of cynanche maligna, I use chlorate of potash. It is not indicated so frequently this year as heretofore.

Baptisia has the one indication, the full purplish-red face as of one that has been exposed to severe cold; the same color of mucous membranes.

In treating these cases, I use aconite and phytolacca, whatever other remedy may be indicated, and the practitioner will find that they go very kindly together.

EASY METHOD OF DETECTING BLOOD-STAINS.

Prof. D. S. Kellicott (Buffalo Medical and Surgical Journal), in a very interesting article gives the following chemical and microscopic tests for blood.

The

easy chemical tests may be mentioned as follows:

1. Blood readily dissolves in distilled water, giving a reddish color. Blood dried upon iron and acted upon by the hydrated oxide of iron is insoluble in water. It dissolves, however, on adding citric acid. The undissolved threads of fibrine may be examined under the microscope and chemically tested. (Dissolves in acetic acid, colored by test liquid of Millon and Pettenkofer).

2. To the solution in water add weak ammonia, no change of color, or at least no change to crimson, which excludes certain vegetable stains.

3. Boil a small quantity of the aqueous solution, the color is discharged and grayish floculi appear in it from coagulated albumen; these disappear on adding solution of caustic potassa, the color becoming green by reflected light, red by transmitted light.

4. Obtain the hæmin crystals. This last re-action I consider very delicate, the crystals never failing to appear even when the quantity of dried clot is exceedingly small; a fragment large