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mann from his own experience in the five cases reported concludes: First, that with a transversal division of the skin from eight to twelve cm. long, the longitudinal incision through the parietes can be extended enough to obtain a full view of the organs in question, to reach and manipulate them in such operations as breaking up adhesions, resection of ovaries, removal of tubes and ovaries, removal of small fibroids of the uterus, etc. The work can be done under control of the eye, and we can treat every pedicle without making ligatures en masse; on the contrary, we can ligate the individual vessels and can suture any slit in the peritoneum, thus leaving no stump or raw surface in the peritoneal cavity. Second, there is no doubt that with this procedure it is possible in a great many cases of abdominal section to avoid any visible scar. Third, when uninterrupted recovery occurs, after careful suturing of the incision, the danger of subsequent hernia is almost entirely absent. The method of suturing the incision of the parietes is identical with that employed in almost all abdominal section, requiring careful coaption of the muscles and most careful union of the aponeurosis of the broad muscles with interrupted catgut sutures. Internat. Med. Mag.

and dry will prevent many lacerations, especially as the head can be extracted between pains. M. A. Walker thinks that in many cases it is necessary to retard delivery long enough to allow the pressure of the presenting part to soften and stretch the outlet. Both subjective and objective measures are useful; subjective, such as the mother's refraining from the use of voluntary muscles; objective, as pressure applied by the accoucheur directly to the presenting part, retarding its progress and directing its advance through the axis of the outlet. An anesthetic may be required toward the end of the second stage, chiefly for its property of preventing voluntary and lessening involuntary muscular contraction in case of endangered perineum. J. L. Andrews says the whole subject of prevention of perineal laceration may be summed up in a few words, by (1) patiently and persistently endeavoring to bring the longest diameter of the presenting part in relation with the longest diameter of the outlet, and (2) by securing perfect dilatation of the soft parts. Proper position of the patient is important, and he insists that, whatever the position, the vulva must be thoroughly accessible to sight and touch. An intelligent use of chloroform or ether and the proper use of the forceps are important helps. Many lacer

The Prevention of Laceration of the ations of the perineum are caused by

Perineum in Labor.

G. B. Twitchell (N. Y. Med. Jour., December 28th) regards a certain number of perineal tears as unavoidable, but many may be prevented by proper care. It is of primary importance to keep in the vagina a lubricant to facilitate the normal extension. The natural lubricant should be preserved. Digital examination removes a great deal of the lubricant and gets the perineum ready for a tear. The vast majority of digital examinations. made during labor are without reason. External palpation should be practiced more. Delaying a precipitate labor by chloroform will save the perineum in some cases. In a protracted labor the extraction of the head with the forceps applied before the vagina becomes bruised

These are

the passage of the shoulders. much less excusable than head lacerations. If undue haste is avoided, and the head lifted upward, one shoulder will be behind the symphysis, while the other is safely borne over the perineum.-Internat. Med. Mag.

The Function of the Tonsils.

With a Few Suggestions Regarding the Differential Diagnosis of Tonsillar Affections.

Dr. R. C. Matheny in the Medical Record of September 14, 1901, points out that the anatomic and histologic structure of the tonsil proclaims it to be simply a mass of lymphoid tissue whose function is pre-eminently that of an absorbent. The circle of lymphoid tissue guarding the entrance to the respiratory

and alimentary tracts is not there by accident, and the author pleads, therefore, for a more intelligent and conservative treatment of the tonsils and tonsillar affections. The author refers briefly to the following conditions which justify the excision of the tonsils: 1. Simple hypertrophy of the tonsils, preventing the entrance of sufficient air in breathing. 2. Cases in which the hypertrophied tonsils interfere with the function of the Eustachian tube. 3. Hypertrophied tonsils that are subject to recurring attacks of inflammation. 4. Tonsils which show considerable degeneration. 5. Tonsils whose crypts have become filled with offensive caseous matter. 6. Tonsils that are subject to lacunar ulcerations. 7. Cases in which a quinsy habit has developed. 8. Cases of lupus or tuberculosis of the tonsil.-N. Y. Med. Jour.

[This is good advice and we would · only add the suggestion that whatever usefulness a good normal tonsil may have, it is a thing that no longer exists after this little organ has become permanently diseased and incapable of performing its functions. It is then a local irritant, and a possible source of general infection. It becomes an active, dangerous, organic foreign body.-ED.]

matory symptoms, especially if operated on in the intervals between attacks of inflammation. The drainage is kept up from ten to twenty-two days, changing the tube every second day.-Homeopath. Jour. of Obstet., Gynecol. and Pediat.

[This is, of course, a new experience. But we want to suggest that there is a better mode of drainage than that afforded by the stiff-rubber tube. Its use requires a sufficient accumulation of material within the uterine cavity to reach the top of the tube, or, at least, the nearest orifice if it is a perforated one. Instead of this, we should prefer the corrugated intra-uterine soft rubber stem, which readily bends with the uterus, and permits the ready outflow of liquids between its grooves and the cervical wall. We have tried both, and know whereof we speak.-ED.]

Chloral Hydrate as an Antipyretic.

An editorial in the Detroit Medical Journal for December, 1901, states that the three qualities demanded in the safe and perfect antipyretic are that it must be aseptic, volatile, and manifest the minimum of solubility toward aqueous fluids. The author affirms that chloral hydrate

Drainage of Uterus in Treatment of alone fulfills all these conditions, although

Salpingitis.

M. Beaussenat, Rev. de Gyn. de Paris: Walton's method of forcible dilation of the uterus, followed by curetting and prolonged drainage with a stiff rubber tube, has been applied by the writer in twenty cases of salpingitis consecutive to endometritis. The catarrhal form was always cured. This result was also freThis result was also frequently obtained in non-cystic, purulent salpingitis. Old and painful parenchymatous salpingitis was much improved in nearly every case. Peri-uterine infiltration may be absorbed after dilation, curetting, and drainage of the uterus. The same treatment is also indicated for pyosalpinx if it is unilateral, recent, small, and has not caused many inflam

chloroform is a good second. Unless pushed too far it is not toxic, and manifests its antipyretic action through its activity as an antiseptic, neutralizing the toxins that induce pyrexia. He adds that it may be safely employed whenever an antipyretic pure and simple is demanded; that it is the best agent in its class in low continued febrile maladies, and after twenty-five years' experience with it recommends it as the only completely satisfactory antipyretic in typhoid conditions.-Cleveland Med. Jour.

[This fully accords with our experience with this drug in scarlatina and other fevers. It is a good antiseptic agent, destroying morbific germs, besides quieting the irritability of the nervous system,

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as you can, but say what you say with an appearance of positiveness.

He whose face is deeply imprinted with the physiognomy of a sneer is an undesirable patient always unless it is cash, and the patient is a traveling man.

It is not profitable as a rule to have the practice of next-door neighbors that run to the office for every trifle; very soon you may dislike to see them come.

One of the most unwise remarks I ever knew an M. D. to make was after he had examined a case, he, looking perplexed, said: "I must go and read up.

It takes more medicine, patience, and judgment to cure a common cough in a pessimist than to reform a bushel of ills in the one whose mind is well pictured with a roseate imagination.

A doctor is liable to make his worst

When men with sclerosed vessels get blunder by saying when the mother is badly sick they don't last long.

Never make a snap diagnosis by holding the pulse, acting brisk and confident, and looking wise.

It is best to be very formal, reserved, and dignified with the next-door neighbors-"Familiarity breeds contempt."

There are many people who are halfsick and half-full most of the time. You can tell them by the feeling of the vessels in the wrist.

I knew an M. D. to lose his prestige by calling appendicitis neuralgia of the stomach; had he kept still he would have lost nothing.

But talking of fools, the worst sample in that line is the doctor who tells his patient everything he is taking and how it is supposed to act.

If called to a patient with fever and the nature of the fever is doubtful, and if no one asks you what is the trouble, treat, but volunteer no information.

It does not pay an M. D. to get a social footing with unrefined people; they will be great friends for a time and then it will be all the other way.

Doctor, clothe your practice in mystery, dark as Egypt's night. Say as little

alarmed: "Oh, there is nothing much the matter." Set it down that a mother's

alarm is not meaningless.

When a patient's pains are the kiama of his own follies, when you tell the truth to him he will know it is the truth, but ten to one he will remark to his cronies that you are not much of a doctor.

"The chief delusion of the pro-surgical gynecologist of to-day is that if he removes the diseased organ or rather organs the patient must perforce be cured. This is a delusion that narrows his usefulness and leads him to perniciously clear out the female pelvis. Be first sure that good treatment, coupled with correct living, has prepared the patient so that an operation will cure."-Peoria Med. Jour.

Medical Inspection of Schools.

In Boston, New York, and Chicago, the system of medical inspection of the public schools has proven a most satisfying procedure. It has largely driven. disease from the schoolhouses and saved the lives, doubtless, of many children. Contrary to expectation, the system has passed the stage of a "fad," as some

were pleased to term it, and it is now recognized by a large proportion of the patrons of the schools as a most beneficent innovation.-Peoria Med. Jour.

It is a forerunner of the frequent medical examination of all citizens, that disease may be anticipated and prevented; and that will be near the time when the entire warfare against disease will be a public function and all physicians, sanitarians, and nurses will be salaried public employés.

New Ideas.

A Postal Currency.

Unique Proposition Which Congress has Before It
FOR USE IN MAILS.

Money Can Be Transformed Into Indorsable
Checks.

A unique feature in congressional legislation this winter is presented in the promotion of a postal currency. The system has the approval of many officials, and is endorsed by a long list of manufacturers and business houses throughout the country. Publishers and farmers are especially interested, in that the new currency promises an easy way for a man in the country to promptly send remittance for his favorite publication. Under the present inconvenient money order system the individual desiring to send a small sum of money through the mail is met by the necessity for a time-killing journey to the post office to obtain safe money. This sets up a barrier to the prompt transaction of business and results in much loss from the fact that many people never carry out their original intention to subscribe or purchase. The need is for money in the hands of the people that can be safely and instantly sent by letter.

The provisions of the post check" currency bill, now before Congress, introduced in the Senate by Mr. McMillan, and in the House by Mr. Gardner of Michigan, provides for printing the one, two and five dollar bills in the future with blank spaces on the face. These bills, of course, pass from hand to hand before the blanks are filled. When it is desired to send one in the mails the blanks are filled in with the name of the payee, his city and State, a 2-cent postage stamp is placed in another blank space and canceled with the initials of the sender in ink, the name of the sender is signed on the back, and, presto! his money has suddenly ceased to exist as currency and has been transformed into a check on the United States government, having all the safety of any bank check, and ready for inclosure in his letter. When the payee receives this check he treats it just as he would any other check-indorses it, goes to the nearest bank or post office and deposits it or has it cashed.

The paid check finally reaches the Treasury Department, when it is replaced by a new one with

the spaces unfilled. This keeps the circulation at par. No change whatever is made in the financial policy of the government, the only change being in the character of the printing on the bills of five dollars and under.

The bill also provides for the issue of $75,000,000 of fractional currency, with blank spaces similar to the larger denominations, in place of an equal amount of money of larger denominations, presumably twenty and fifty-dollar bills. The pro

vision under the new system for a continual reissue insures clean money both in the fractional currency and in the larger bills. The government fee on the five, ten, fifteen, twenty-five and fifty-cent pieces is to be one cent each.

BUSINESS ADVANTAGE.

Perhaps in no better way can the reader come to understand the pressing need for postal currency than to recall the times without number when he himself has been desirous of sending a small sum of money through the mails with safety. Always in such cases comes up the barrier, and only the persistent one will carry out his purpose by using stamps, coin placed in holes in pieces of pasteboard, or risking loose money. The average person will not expend the valuable time required for the journey to the post office for a money order. Only the pressure of necessity in the absence of a simple convenient system brings to the money order system its present patronage. Statistics

show that from ten to twenty times the number of letters received by business houses, publishers, and others who do a large business through the mails, contain stamps, loose money or some other representative of money, than contain money orders, a clear enough mark of the disapproval of the public.

While it is not thought that, if adopted, the proposed system would entirely supersede the money order system, because for amounts over $50 the money order would be slightly cheaper, it is thought by the advocates of the pending bills that such a system of post checks would prove a great convenience to those desiring to send small amounts of money through the mails, and would result in gain to merchants, publishers, and business firms who now receive such remittances in the form of stamps (often torn and mutilated), drafts on small banks, or loose coin in letters--always a temptation to postal employes, All these forms of remittance entail some loss, in many cases to the receiver, and to that extent, perhaps, a creditor is unjustly defrauded, innocently it may be, by the debtor. Under the new system these troublesome and unfair methods of making remittances would be done away with, owing to the simplicity and convenience of the post checks, and the cost of sending the remittance would be placed where it properly belongs-with the sending debtor or the person making the purchase.

ALWAYS AT HAND.

The main difficulty with the present money order system is that less than half the post offices in the country are money order offices, and even at these such evidences of money can only be obtained at the expenditure of much time and trouble and during certain specified hours. With a post check note in his possession, one has but to fill in the blank spaces for the purpose, attach a postage stamp, cancel it, enclose in an envelope, place in a mail box, and the transaction is finished.

Unquestionably the intent of the postal authorities is to extend and increase the usefulness and

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popularity of the rural free delivery service. The adoption of the post check notes will afford a most convenient and safe money for the agricultural communities, to whom banks, with their facilities and safeguards, cannot be utilized with convenience. It is claimed by those who have investigated the subject, that the revenues of the Post Office Department would be very materially increased by the adoption of the post check system.

Congress can best judge of the wants of the people by direct word from them. It is difficult to secure legislation of this sort, involving a departure from present methods, unless there be a pronounced demand by the people. Postal Currency can be secured if those whom it would beenefit will write personal letters to their Senators and Representatives in Congress, asking them to favor and work for the McMillan-Gardner Post Check Currency Bill.-Evening Star, Washington, D.C.

Dishonest Substitution.

There is a drug store in New York that has this over its door : "We give you just what you ask for."

One business man devotes all his energy, his money and his time to building up the reputation of a certain article. He enables the retailer to make a large profit, and he spends his money that customers may be plentiful. When a physician prescribes the article in question it is dishonest to "Don't buy that. We say to him, as many do: have something else just as good and much cheaper." It is ungrateful as well as dishonest for the sake of a little extra profit to cut into the legitimate business of the advertising manufacturer.

"Incidentally the patient also is interested in this question of substituting one article for another. That which is represented as 'just as good' is not just as good, but very far from it. If a man has spent a million dollars building up the reputation of a certain article, it is to his advantage to keep up the quality of the material which enters into the manufacture of that article. It would be suicide for him to use inferior material for the sake of a little extra money. The man who makes up an imitation article and announces it as ' just as good' He has invested has no such sum at stake. nothing. He has no valuable name to ruin, and it is to his interest to make the 'just as good' article just as cheap as he can make it.

"The physician should remember these facts and put his confidence in that retailer who gives to the customer just what he asks for."

A child swallowed a round whistle about the size of a quarter-dollar. A neighbor who dropped in advised the mother to give him the unbeaten white of egg, telling her that it would form a coating around the object, which would be carried off through the bowels. This proved true. The same mother afterward had a bristle from her toothbrush lodge in her throat, causing annoyance and irritation. After trying in various ways to dislodge it she thought of the white of egg, and in a little while the offending bristle had disappeared.— Good Housekeeping.

Now in spring is the time your consumptive patients should start to gain by the timely enjoyment of life in the pure open air and the use of McArthur's Syrup of the Hypophoshites of Lime

and Soda. Sample and literature free from McArthur Hypophosphite Co., Ansonia, Conn.

Electricity gives an account of two operations that have been performed by means of two powerful electro-magnets (after radiographic location of the foreign bodies), introduced through tracheotomy openings, whereby nails in the bronchi of children were successfully removed. The method is ingenious, and, we believe, entirely novel.-D. and H. Gaz.

The old reliable Freligh remedies, the Tonic, the Rheumatism Remedy, and the Liver Medicine. Samples for a ten-days' trial will be supplied free by addressing I. O. Woodruff & Co., 97 Reade St., New York. Mention Medical CouNCIL.

In Zululand, when the moon is at the full, objects are visible at a distance of seven miles. By starlight one can read with ease.

Thermol has proved to be a wonderful agent in the treatment of typhoid fever, pneumonia, and influenza. For $1.00 sample supply and a oneminute high-grade thermometer, send $1.00 to the Liberty Chemical Co., Phila., Pa.

When the physician is wrestling with the problem of maintaining a patient's strength in typhoid fever, pneumonia, etc., he should not overlook Nutrient Wine of Beef Peptone, a preparation presenting the entire digestible substance of fresh lean beef in absorbable form. This article, which is made by Armour & Co., Chicago, is the most palatable and nutritious liquid food offered the profession, and serves admirably in all cases where it is necessary to keep up nutrition without taxing the digestive organs. Nutrient Wine may also be used to advantage in that large class of stomach troubles that the average physician meets daily.

For fine buggy-cases, saddle-bags, hand-cases, pocket-cases, address Western Leather Co., 43 Wabash Ave., Chicago. Mention COUNCIL.

Acetylene vs. Electricity.

At the entrance to the harbor of Genoa, Italy, there is an acetylene lighthouse, which has been established two years. In that time many experiments have been tried which go to prove that it is superior to electricity. There is one of this type at Tino, forty miles from Genoa, which cannot be seen from there, whereas the acetylene is plainly visible; the latter is by far the cheapest, costing only $250 per annum, against $5,000 for electricity.-Scientific American.

The really great manufacturers of Static Electric and X-Ray apparatus in the United States are R. V. Wagner & Co., 308 Dearborn St., Chicago. Their Mica Plate Machine is superb. Write for catalogue. Mention MEDICAL COUNCIL.

A doctor may throw away his cigar or put his pipe in his pocket before entering the patient's room, but her ipecac headache is much aggravated by the smell of dead tobacco smoke, and she says to her aunt: "Don't let that man in here again when I have one of these headaches or I shall be sick all over the bed.”—Diet. and Hyg. Gaz.

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