May 21.-Appetite and digestion better. The bromide and hops secure sleep. Is stronger; nerve and mental condition better. Prescribed cod liver oil and extract of malt 3xij, glycerite organismal hypophosphites ziv. M. Sig.-Tablespoonful thrice daily. June 10.-The cod liver oil sickens the stomach. His condition, however, is very much improved. Sleeps well, eats well, good appetite and excellent memory; can read with satisfaction and fix the attention almost as well as ever. Prescribed glycerite organismal hypophosphites 3iij; teaspoonful thrice daily. July 1.-Discharged, well. Case 5.-Mrs. Anna M., age 36; married; mother of three children; is extremely anæmic, weak, nervous, mind debilitated, has suffered terribly from neuralgia; teeth rapidly decaying, appetite bad, bowels constipated, has a cough, cannot sleep, and is extremely melancholy. Is nursing a babe eight months old. July 6.-Prescribed Fl. Ext. Cascara Sagrada to regulate the bowels, the Glycerite of Organismal Hypophosphites as a general tonic, a diet of milk, butter, beef, with gluten flour, and such vegetables as desired. At once wean the baby. July 26.-Reports herself every way better. August 10.-Is gaining flesh and strength. The nervous and mental condition all right. In this case, I am sure the milk was the most efficaciousremedy used, and I believe it, with the baby weaned, would have met every indication; still, I think the hypophosphites aided in hastening the cure. WATER FOR THE SICK AND THE WELL. Radical changes in medical opinion are to be expected during the formative period of medical science. These mutations are sometimes so great as to be positively startling. In one generation, the lancet is unsheathed at every bedside; in the next, it becomes a useless and almost forgotten instrument. Popular remedies, boasted specifics and much-vaunted methods of treatment which should endure forever, if the claims made for them were true, are buried in oblivion within a surprisingly brief period of time. The prevailing ideas with regard to the use of water by the sick forcibly illustrate the fickleness of medical beliefs. Within the memory of most of us, it was the common custom either to withhold water from the sick or largely to restrict its use. Especially in fevers was this the case, and the rule apparently was: The amount of water imbibed must be inversely as the thirst of the patient. It is painful to think of the tortures of the feverish patient denied the means of quenching his agonizing thirst. Vaughan relates a case where the patient was locked in a room and allowed but a small quantity of water. The thirst still existed, and its gratification was a necessity, consequently, the urine as soon as it passed, was swallowed by the patient in vain endeavor to relieve her unbearable suffering. Such treatment seems to us cruel and irrational, but it was in accordance with a prevailing medical belief. But the tide has turned, and now physicians are generally agreed to allow to the sick all the water desired. In proof of this, the opinion of eminent physicians may be cited. Said Dr. J. F. Meigs, in a clinical lecture on "The Internal Use of Water for the Sick: " "What, then, is to be the guide as to the quantity of water to be supplied to the sick? I answer unhesitatingly that, so long as the patient retains his natural senses or appetites, there is no guide so sure and so safe as the thirst. When this is lost, the trained knowledge of the physician, or the common sense and experience of the nurse, must determine the quantities that should be given. What is this thirst upon which I rely so implicitly? It is the appetite implanted in the body by the Creator, for the determination of the amount of water needed. * * For myself, I dare not oppose this divine sense in a thirsty patient, any more than I would oppose the instinct of the infant to take from its mother's breast the material it needs for its growth." Says Prof. Maclean, of England, who has had a large experience in the treatment of the disease of which he writes: "Urgent thirst is one of the most distressing symptoms of cholera; there is an incessant craving for water, doubtless instinctive, to correct the inspissated condition of the blood, due to the rapid escape of the liquor sanguinis. It was formerly the practice to withhold water, a practice as cruel as it is mischievous. Water in abundance, pure and cold, should be given to the patient, and he should be encouraged to drink it, even should a large portion of it be rejected by the stomach; and when purging has ceased, some may, with much advantage, be thrown into the bowel from time to time." Many diseased conditions may be traced to an insufficient water supply. A certain amount of water is essential to organic life. In the fluids of the body, water holds solids in solution and gives that peculiar consistency to the semi-solids which is necessary for normal functional activity. Says Dr. Vaughan in his work on Chemical Physiology and Pathology, "A great many persons drink too little water. The merchant goes behind his counter, and, in order to avoid frequent visits to the water-closet, drinks but little water, consequently, his urine is small in amount, of high specific gravity, strongly acid, and often deposits urates, uric acid and oxalate of lime in the urinary passages. The result is irritation of the bladder, with cystitis, or a stone is formed. If the physician sees him in time to avoid these disastrous consequences and advises him to drink more, the reply often is, 'give me some medicine for it, I do not want to drink much water or I will have to go out every hour.' As soon as his bladder becomes irritated, micturition will necessarily be more frequent and his own actions compel him to traverse a rougher road than the one which he endeavored to shun. It must not be supposed by my specifying the merchant, that this class only commit this error. This same mistake is made by ladies who are out in society much; by the student who does not wish to be interrupted in his studies by the calls of nature; and even by the physician, who is so constantly attending to the wants of others that he forgets his own. From the foregoing, I think that we are justified in deducing the following rule: If your patient complains of some irritation of the urinary tract, and upon examination you find the amount of urine 1000 c. c. or less, the specific gravity 1028 or higher, the re-action strongly acid, no sugar or albumen, have him measure the amount of water that he drinks during twenty-four hours, and see if it is not correspondingly small. If this be the case, it is well to give some mild diuretic dissolved in much water." In accord with Dr. Vaughan's views are those of Dr. S. G. Webber, whose long and able article on "Water as as Prophylactic and a Remedy," has been highly commended by leading medical journals. He regards the drinking of too little water a positive source of disease, and in this connection says: "Water taken with the food favors digestion; when taken into the stomach a part is absorbed by the gastric vessels, carrying with it the soluble constituents of the food. So much as is not immediately absorbed assists in softening and breaking up the larger particles of food, and thus aids in the gastric digestion by facilitating the action of the gastric fluids. A portion of the water is carried off into the intestines with the semi-digested food, and acts favorably in the same way; also the blood being well supplied with water, the fæces are not so hard and dry as would otherwise be the case, and it is easier to keep the bowels regular. "It is certainly no matter of surprise that there should be malaise and distress when the system is loaded with worn-out material, unfit for the functions of life, which the blood cannot remove for lack of menstruum. It is not surprising that the nervous system, which most requires regular nutrition, should suffer most; that muscles badly nourished should ache on motion; that kidneys called upon to secrete an abnormally concentrated urine should become diseased; that the highly acid urine should irritate the bladder. "This view may explain why herb teas, thoroughwort, chamomile, sage, etc., were so popular in our grandmothers' daysindeed, are now popular. The bitter herb is a slight gastric tonic, but the water is a better solvent. Formerly, the good housewife supplied the deficiency in drink by regular doses of herb tea; now the physician supplies it by draughts of spring water. Sometimes, in treating such patients as have been referred to, I administer a diuretic with the water, that elimination may be effected more speedily. "How much water should an adult drink in twenty-four hours? It must be taken into account that water is excreted by the lungs and skin as well as by the kidneys; also, much of the food ingested contains water as one of its constituent parts. Hence the amount of liquid required as drink must vary slightly with the activity of the skin and the character of the food. If much of the diet is made up of soft solids, fruit and watery vegetables, less drink will be needed than if the diet was composed of dry meats and vegetables. The amount of soup ingested would also affect the amount of mere drink required. The average amount of urine passed in twenty-four hours by a healthy adult is stated by Dr. Flint to be about fifty-two ounces, the extremes being thirty-five and eighty-one The amount of drink necessary is stated by Dalton to be about fifty-two ounces-that is, 3.38 pints. An ordinary coffee-cup holds six or seven ounces. The equivalent of eight or nine coffee-cups of drink would not, then, be an excessive amount. Repeatedly, patients have told me that they drink only one or one and a half cups morning and evening, and about the same at dinner, only occasionally taking soup; averaging less than six cups, sometimes small teacups, of drink. Sometimes patients say they drink generally only a little more than a pint a day. ounces. "The medical opinion of the present day is in favor of an unlimited supply of pure water to both the well and the sick -an opinion easily defended on both theoretical and experimental grounds." COCCIONELLA CACTI. TRANSLATED BY PROF. J. TASCHER, M. D., CHICAGO, ILL (From Heilmettel, Radenmacher's.) Coccionella is a curative agent in diseases of the kidneys, in which the basic lesion consists of a hyperæmia, or an inflammatory condition of the kidneys. These conditions |