pect of cure. Medicinal treatment gave only temporary relief. The doctor ordered injecting into the rectum after each movement, a drachm each of the fluid extracts of echinacea and of witch-hazel. After the patient had used three injections, the hemorrhoids ceased to trouble her, and some time afterward she said she was entirely well. Since then the author has had equally satisfactory results with six other cases. As some of the patients complained that the medicine was too strong, it was modified as follows: Fl. ext. echinacea angustifolia. I OZ. 2 Oz. I OZ. Of this he orders 2 drachms to be injected after each stool. The slight burning sensation soon passes away and gives the pleasant cooling effect of the echinacea.-Merk's Archives, May, 1901. sense of impending suffocation and comparative freedom from nausea, vomiting and retching. 2. Ease and rapidity with which anesthesia may be induced and the ease and smoothness with which it may be maintained. 3. The entire absence or marked abbreviation of the period of excitement. 4. Economy both of ether and time. 5. Profounder first anesthesia, under which minor operations may be done with more certainty. 6. Probably less post-operative nausea and vomiting. A Cheap, and Effective "Take pure gum camphor and pure white crystal carbolic acid, and by trituration make a saturated solution of the I do not Mentholization of the Mucosa of Air- camphor in the carbolic acid. Passages. By W. A. BRIGGS, M. D. Sacramento, Cal. [In American Medicine.] Mentholization of the mucosa of the air-passages before, during and after etherization has given me such satisfaction as to impel me to submit the method to the profession at large. The method is as follows: Sprinkle a drachm of oil of peppermint or of saturated alcoholic solution of menthol in the cone; let the patient inhale of this freely for three minutes, then saturate the cone with ether and bring it down slowly over the face; after a few full inhalations crowd the cone down well and push the etherization as rapidly as is consistent with safety; continue the use of the mentholized cone through the whole period of anesthesia, replenishing the ether as usual. After the operation let After the operation let the patient inhale oil of peppermint or menthol from a handkerchief freely and often until the tendency to nausea subsides. The advantages of this over the usual method are the following: 1. Entire freedom from cough and know what the result is chemically, but we have a clear, heavy, oily liquid, with an aromatic, pleasant, camphoraceous odor. When made correctly it is perfectly bland, not toxic, and, outside of a momentary stinging, is non-irritating. In fact it is quite a local anesthetic, and is the best of all-around anti- and aseptic dressings I have ever used. I have used it successfully in all conditions and classes of wounds about the body, except the eye." So says Dr. E. L. Sharpe, of Pleasanton, Texas, in the New Orleans Medical and Surgical Journal of March, 1902. He cites some striking cases in favor of his claim, and says, also: "This remedy is soluble in olive oil, and for after-dressings I generally use it in solution in proportion of one in three to six of the olive oil. It evaporates on exposure to air, and the oil prevents this to a great extent, thus lessening the necessity of too frequent dressings. For burns I have found the oily solution very soothing and the remedy excellent to stimulate healthy granulation. Scarcely any odor is noticed even during considerable sloughing in tissues. It is a good local application in eczema, tetter, erysipelas, etc." We would be pleased to have reports on the use of this compound, and trust that our readers will give it a trial. The Preventive and Curative Treat ment of Hay Fever. It is difficult to conceive of a more miserable creature in all the world than the hay fever sufferer. The attack not only makes him exceedingly uncomfortable, but renders him unfit for business or the pleasures of society. Aside from the annoying and continual discharge from the nostrils, the eyes are suffused, the secretion of tears is increased, the nasal passages are obstructed, and an intense burning sensation is experienced; the latter is not entirely limited to the mucous membranes, but not infrequently involves the cutaneous surfaces of the forehead, cheeks, and nose. Violent attacks of sneezing occur, which are so prolonged, at times, as to completely exhaust the sufferer and bring on severe beadache. The condition is one of utter wretchedness, and there is extreme malaise, amounting occasionally to complete prostration. The lightest duties become irksome tasks, and many an active, industrious, and useful member of society is completely incapacitated while "the season "" lasts. For years some convenient means of relief has been sought. Change of scene does very well for those, unfettered by business, who can afford to travel. But to many very worthy people a change of scene is out of the question. Naturally the greater number of the afflicted are accustomed to look to the medical profession for the help they need. But what has the medical profession actually accomplished for the permanent relief of the sufferer or the cure of his ailment? There is scarcely a sedative, astringent, tonic, nervine, or alterative drug in the materia medica that has not enjoyed an evanescent reputation as a useful remedy in the treatment of hay fever. Until the discovery of adrenalin, each had been as much of a disappointment as its predecessor, and none had afforded more than the merest temporary relief. There is increasing evidence that adrenalin fully meets the indications as a remedial agent in hay fever. It controls the nasal discharge, allays congestion of the mucous membranes, and in that manner reduces the swelling of the turbinal tissues. As the nasal obstruction disappears, natural breathing is materially aided and the ungovernable desire to sneeze is mitigated. In short, a season of comparative comfort takes the place of the former condition of distress and unrest. Adrenalin blanches the mucous membrane by vigorously contracting the capillaries, and thus reduces local turgescence. It strengthens the heart. and overcomes the sense of malaise so frequently a prominent feature in cases of long standing. CO In the treatment of hay fever the solution of adrenalin chloride should be used. This preparation is supplied in the strength of one part adrenalin chloride to one-thousand parts normal saline solution, and is preserved by the addition of 5 per cent. chloretone. The 1-1,000 solution should be diluted by the addition of four parts normal salt solution, and sprayed into the nares with a " caine" atomizer. In the office, the I-1,000 solution may be applied in full strength. A small pledget of cotton is wrapped about the end of an applicator and moistened with a few drops of the solution (1-1,000). The speculum is then introduced, the patient's head is tilted backward in a position most favorable for thorough illumination by the headmirror, and the visible portions of the lower and middle turbinate bodies, and the septum, are carefully and thoroughly brushed. The same application is made to the other nostril, when usually relief follows in a few moments. Should the benefit prove only partial, the 1-5,000 solution may now be sprayed into both nares, and a few drops instilled into both eyes. The effect of this treatment may be expected to last for several hours. Indeed some physicians report that it is necessary to make but one thorough application daily to afford complete relief. It is also recommended that solution of adrenalin chloride be administered internally in 5- to 10-drop doses, beginning ten days to two weeks prior to the expected attack. In explanation of the beneficial effect of the drug when used in this manner, the suggestion has been made that hay fever is essentially a neurosis, characterized by a local vasomotor paralysis, affecting the bloodsupply of the eyes, nose, face, and pharynx, and occasionally of the laryngeal and bronchial mucous membranes. Adrenalin overcomes this condition, restores the normal balance in the local blood-pressure, and thus aids in bringing about a cure. The profession is to be congratulated that it has at last an agent that, if not a specific, fulfills the therapeutic indications more completely and with greater satisfaction than any other remedial measure recorded in the history of medicine. The Disadvantages of Copper Sulphate in Diseases of the Con junctiva and Cornea. The author asserts, as the result of his experience, that copper sulphate in ocular affections is harmful, and that any of its seeming good effects may be obtained by the use of safer and practically painless means. Trachoma is most successfully treated with frequent irrigations with weak bichloride solution in normal salt. Dr. Cornelius Williams, in Medical Record.-N. Y. Med. Journal. [An important warning, very necessary to bear in mind. This should be copied and permanently placed where it may be frequently seen.-ED.] The Physicians' Pocket Account Book is a very plain, concise and practical system of legal bookkeeping adapted to medical practice. Space for 224 accounts, besides Obstetric, Vaccination and Death Records and an extensive Cash Account. Price of all, in a special leather case, only $1.00. Address THE MEDICAL COUNCIL, 12th and Walnut Sts, Philadelphia, Pa. Surgical Hints. [From the International Journal of Surgery.] In passing a sound, no deviation from the median line can possibly be of service. If the sound cannot be introduced with the aid of patience and gentleness, rough methods will certainly not succeed. [This is not a safe general rule, for a sound will often pass through the urethra by its own weight in devious ways, though holding it to the median line, as above suggested, would necessitate force to pass it through.—ED.] In every case of coma, whether from alcohol or any other cause, always investigate the bladder by percussion, in order to find out whether there is a retention of urine. Should this be the case, measures must at once be taken to empty the bladder. If coma is due to nephritic trouble, it must not be forgotten that the fact that no urine bas been passed for a long time may be due to suppression instead of retention. [We have only to add to this, that if the coma is of nephritic origin, and is accompanied by suppression of urine, it is well to promptly apply dry cups or active sinapisms or even blistering to the lumbar regions, at the same time that there is administered an active hydrogogue cathartic, for instance, elaterium in one-fourth-grain doses every hour. The patient may also be thoroughly sweated. This relieves the blood of poison, and the kidneys of work, while the counter-irritation relieves them of likely engorgement.-ED.] Cases in which there is a dribbling of urine in the bed, attended by the usual disagreeable urinous smell, can be made less obnoxious by pouring some turpentine upon the sheets, where it will not touch the patient's skin. This counteracts the odor to a remarkable degree. [While this combination of turpentine and ammonia, for that is what the urinous smell complained of usually is, may have a neutralizing effect upon a certain proportion of individuals, there are many to whom the one will only prove an aggravation when added to the other. We would prefer bathing with very dilute sulphuric acid for its effect upon the alkaline urine, and a weak solution of formalin for its disinfecting qualities.ED.] It is an invariable rule that, in cases of stricture, whether urethral or due to prostatic trouble, if a catheter has been passed with much difficulty, the bladder should be washed through it and the catheter left in situ for twenty-four hours. This will always permit the introduction of a large instrument later on. [This is correct, but such use of a catheter makes it necessary that it should have been previously boiled for at least twenty minutes in some good antiseptic solution before being introduced.-ED.] When there is no retention of urine, and yet no instrument can be passed, it is sometimes well to pass a catheter as far as it will go, and then leave it in position for many hours. After some time it may be found to go through easily enough. [Such cases are ones of spasmodic stricture, and are readily overcome by persistent, steady but gentle pressure. Sometimes it is advantageous to slightly rotate the catheter, first one way and then another. If the end is tipped with belladonna ointment, its passage will be facilitated. The same is true if there is a preceding injection of a 4-per-cent solution of cocaine.-ED.] While crepitus is one of the most valuable methods of diagnosing fracture, it is well to remember that in many cases, as in fracture of the ribs, transverse fractures of the patella, and anywhere when there is a detachment of processes and apophyses, this sign may fail to be elicited. A upon crepitus as a sign of fracture. better one is preternatural mobility—that is, movement in the continuity of a bone. This is easily elicited when the broken ends are separated. Both this and crepitus fail when the ends are impacted. But under these circumstances there still remains the focus of tenderness, almost always present at the time of injury, which is elicited by gentle pressure, gradually approaching the site of injury.— ED.] A patient with appendicitis in a severe form, who suddenly feels better, while the temperature remains high, does so, as a rule, because the tension has been diminished by the giving way of adhesions. This is a serious complication, as it implies the probabilities of impending general peritonitis, and immediate operation is usually needed in order to save the patient's life. [A good point often overlooked, and which, in consequence, occasionally costs a life, where a better-posted, less-optimistic attendant would have suspected the real trouble, and have promptly taken the proper action.-ED.] In plastic operations in which a flap is to be removed we must always bear in mind the fact that these flaps will contract, and that for this reason they must be cut at least one-sixth larger than the space to be covered. [This applies also to amputation, and, in fact, to all operations in which a certain area is to be covered with skin.-ED.] In septic compound fractures, the fracture itself must be disregarded at first, although some extension is advisable in order to prevent undue contraction of the muscles. The important thing is to treat the sepsis, and this can never be done successfully unless drainage and counterdrainage are thoroughly attended to. [To this we would add only the neces[Too much stress is generally laid sity for antiseptic irrigation.-ED.] Book Reviews. THE CONCISE OBSTETRIC RECORD. Designed for systematic reporting of Obstetric work. The Systematic Record Publishing Company, Detroit, Mich. $2.00, net. This is a large book of octavo size, composed of two-page blank forms, which, when properly filled in with the history of a suitable case, constitute a well-arranged record. At the end of each record there is over a half-page for remarks and the description of general treatment. At the end of the book there are a number of blank pages to supply space, not otherwise provided for, that may be needed. This is followed by several pages of blank summaries, each of which can be filled in at the end of a year's work to show its analysis at a glance. A final summary can be made of all the cases recorded in the book when this is full. This is followed, finally, by a series of blank pages spaced by the letters of the alphabet in proper proportion to constitute an index. We do not hesitate in giving this novel attempt at systematic work in an easilypreserved manner our most unqualified approval, and unhesitatingly recommend all practitioners of obstetrics to possess themselves of a copy to be used in every instance. It will constitute a record of enduring value, especially in the collection of statistics. HYPNOTISM AND SUGGESTION. By R. Osgood Mason, A. M., M. D. Henry Holt & Co., New York. 12mo., 344 pages. This is composed largely of articles that appeared in periodicals, together with such additions and modifications as were necessary to make the subject complete. It is composed of eight chapters in which the subject is ably treated from a rational scientific standpoint by a gentleman who is a master of the subject. He does not presume to write a systematic treatise upon the subject nor its therapeutic uses, but only upon such of its phases as appear to him to be otherwise of much interest and importance. He relates some very remarkable instances of veridical dreams. The chapter on "Rapport" treats most interestingly and sensibly of this subject, and shows that there is an immense field here, as there is in the entire subject of hypnotism, for future study and investigation. All in all the book is most interesting, as well as instructive and profitable, to those who have a desire to make use of the knowledge it imparts. PRACTICAL MATERIA MEDICA FOR NURSES, etc. By Emily A. M. Stoney, graduate nurse, head nurse, and late superintendent of training school for nurses W. B. Saunders, 925 Walnut Street, Philadelphia. Octavo, 306 pages. $1.50, net. The author aims to take up the origin, action, usage, and dosage of drugs, and the symptoms and treatment of poisoning, including the general consideration and classification of drugs in the first part of the book; a regular materia medica is arranged in the second part; while the third part contains information on poison emergencies, poisons and their antidotes, emetics, mineral waters, weights and measures, a tabulated dose list, and a glossary. What nurses want to know of the classification of drugs, preparations, doses, or physiologic actions and therapeutic uses, we utterly fail to see, though thoroughly appreciative of the mischief-making tendency of this utterly useless information. Nor can we see any reason for an inadequate ten-page glossary infinitely inferior to the cheap vestpocket medical dictionary. We see no reason why a nurse should be familiar with the table of dosage because it is not her sphere to determine dosage, for which she is in no way responsible. What she should know is the difference between a teaspoon, a dessertspoon, and a tablespoon. It is not necessary for her to know either the nature or quantity of the ingredients of a dose of medicine thus measured. That nurse is best, all other things being equal, whose knowledge of medicine in any given case is limited to the amount she is to give the patient, and how often and in what manner. It is has often been said that a good assistant never anticipates, except in the general sense in that he is ever ready to instantly supply the needs of his chief. The nurse is but a physician's assistant and a caretaker of the patient, and her duties require her to carry out the instructions of the former with the utmost faithfulness, and she gives to the latter all the sympathy that can flow from a good, noble heart. The moment the nurse arrogates to herself a knowledge and judgment of matters that are peculiar to the physician, and solely within his province, she impairs her usefulness, and is likely to become a detriment and an injury to her patient. The work is unnecessary, a a piece of supererogation, and vaingloriously silly in its conception. We venture to say that its study by a nurse will be to her disadvantage, and recommend its relegation to the limbo of many other things useless. GENITO-URINARY DISEASES AND SYPHILIS. For Students and Practitioners. By Henry H. Morton, M.D., Clinical Professor of Genito-Urinary Diseases in Long Island College Hospital, etc. Illustrated with half-tones and full-page color plates. Pages, xi1-372 Size, 92x7 inches. Price, extra cloth, $3.00 net, delivered. Philadelphia: F. A, Davis Company, publishers, 1914-16 Cherry St. This book is a first-class specimen of the bookmakers' art. It is brief and to the point. In many respects, it might, with propriety, have been called an epitome, su terse is the author's style-by no means a fault, in fact a rare desideratum in the books of to-day. The author evidently knows what he is talking about, and seems to bear in mind the superior value of facts over mere expressions of opinion, giving ample scope to the former, and |