(8) Be kind and not cold. Don't be a fault-finder, but, at the same time, correct everything that needs it.

(9) If the room is close, tell them what to do to keep it aired. Do not scold be

cause the room is not well aired.

Then

TO THE MEDICAL COUNCIL:

Patient aged 19, gives history of chorea, and inflammatory rheumatism,

which have been cured. Present trouble has lasted for nine months. Two or three

One of my patients said that he had no erection for a week after using the first few doses. Its physiologic action is probably due to its well-known depression of the sensory nervous mechanism. Probably the more expensive coal-tar products are equally efficacious, but my experience with acetanilid is most gratifying.

WALLACE W. DILL, M. D. 310 High St., Pottstown, Pa.

[Our readers will kindly note, by trial in suitable cases, whether or not this is a general effect of the drug. We have never noticed it, but then it is readily overlooked. Early reports of cases will be acceptable.-ED.]

Courvoisier's Law.

When the common duct is obstructed by a stone, dilation of the gallbladder is rare. When the common duct is obstructed by other causes, dilation of the gallbladder is

common.

the pain becomes intense, and lasts for one or two days, then gradually diminishes as the flow becomes less. The pain starts in the left ovary, and radiates down the left limb. I have made a diagnosis of neuralgic dysmenorrhea, and have treated her accordingly, but have utterly failed to arrest the attacks; I have not made a physical examination as she will not submit. Please help me out, if you Thanking you in advance, I am fraternally yours,

Tex.

DR. J. T. M.

[The case is, in all probability, properly diagnosed. It is to be regretted that practically nothing has been said about what treatment has already been used. In this case of ovarian neuralgia, supposedly due to tension of the ovary from the congestion incident to this period, there is nothing so effective as pulsatilla, which may be given in from 5 to 10-drop doses of the fluid extract every four or five hours until effective, after which it is continued as indicated. Το this may be added several doses of Dr. Kenyon's Neuralgic Tablets at threehour intervals until the patient is easy. Also local applications of heat, say a hotwater bag.

We would be pleased to hear from this case again after giving this treatment a trial, and believe that a local examination in this case is unnecessary, because it hardly requires local treatment.

Should it, however, be accompa

nied by uterine flexion or version, local treatment might become a very essential element in the relief of her symptoms. The position of the uterus can be determined through the rectum as well as by the vagina, in fact, more readily so in a virgin because of the lesser sensitiveness of the bowel.-ED.]

Effect on Brain of Post-Mortem Injec

tion of Embalming Fluid.

TO THE MEDICAL COUNCIL:

Can you, or any of your numerous readers, inform me what would be the effect on the brain of the injection, twelve hours previously, of a gallon or less of an embalming fluid composed of formalde hyde, corrosive sublimate, and arsenic? It was injected into the right carotid. A reply through the COUNCIL will be highly appreciated. I may have more to say about the case.

STANLEY M. WARD, M. D.
Hampton, N. H.

[This would depend much upon the ante-mortem condition of the brain and the age of the individual, the fullness of the blood vessels, and whether or not a vein had been opened to permit the escape of the excess of fluid. Supposing the existence of a normal brain at death, and that a vein had not been opened to draw off excess of fluid, there might be hypostatic edema of the pia mater and its choroid, with more than usual fullness of its veins, especially in dependent parts. With a full circulation before injection, there would also be increased fullness of the cerebral arterioles, thus increasing the number and size of the puncta of the centra ovales of the brain. These changes would be most marked the sooner the injection was made after death, say within a few hours. An unusually dry brain. might thus be given a more nearly normal appearance. The presence of formaldehyde would be likely to cause a

toughening, leathery, effect of the cerebral surface and the pia. We would be pleased to comment further upon this case, if an actual one, after full data have been supplied. Is it merely of scientific, or also of medico-legal interest?-ED.]

The Business Side.

TO THE MEDICAL COUNCIL:

Recently there has been much discussion in medical journals under the above attractive heading, especially in THE MEDICAL COUNCIL.

It would seem that doctors need more

protection from themselves than the green countryman who is always at the mercy of every fake-vendor in the country.

I am led to this conclusion by the re

ceipt of a multitude of letters from vari

ous "doctors" who are anxious to make us all rich.

Dr.

lets the readers of his journal in on the ground floor. He is a philanthropist, and shares his prospective wealth freely with his special medicationists only.

Dr., of Iowa, sends samples of "iodized magnesia with proteid," which "prevents inspissation of mucus and bile with cholesterin in the ducts"-a four months' treatment for $2.00. Also a cure for whiskey and morphine habits, which is an "iodized nuclein, with cerebrospinants"-cures made for $4.00 or $6.50 per pair. This is also very cheap, and, as the composition of the powders is so luridly explained, no doubt all members of the profession will jump over each other in their efforts to get a supply before it is cornered by a syndicate.

from

But, hold! Here comes Dr. far-off California, who issues a circular containing a lot of ambiguous language, bad grammar and worse spelling. His specialty is whiskey and morphine habits, which he cures in half the time the other fellow requires. His treatment is slightly more expensive than the other-hence no "samples "--but it will make the doctors' hair stand, such is the power and rapidity of its action.

This formula contains " cascara se

for $10.00.

LITERATURE.

Susceptibility.

Medical journals advertise a host of preparations the formula of which are not given, and we must assume that doctors buy or prescribe them. Yet we condemn the practice of using patent medicines by our patrons!

Oh, brothers, let us be sensible! Let us have at least a modicum of the good judgment, learning and horse sense with which the laity freely credit us.

The

There is no known remedy for the opium or whiskey habit; for cancer or piles; for consumption or spermatorrhea; for gall-stones or dyspepsia, which is not freely revealed in the open medical literature of to day, and no illiterate and impecunious "doctor" possesses the exclusive right to, or knowledge of, anything but gall. Neither is there a royal road to wealth in our business. man who will skin unfortunates by charging "1 to 5 hundred dollars" for a cure of the opium or whiskey habit, and the man who would inveigle physicians into parting with their few spare dollars for shares in some mythica! mining territory are charlatans and mountebanks, who have no business to be recognized as members of a noble and philanthropic profession.

Invest your spare cash for the improvement of your home and the betterment of your family, but do not buy wit; it comes high. If it was not born in you, pray for it.

E. J. MARSH, M. D.
Southwest Oswego, N. Y.

At a recent meeting of the American Dermatological Association, H. W. Stelwagen (Journal of Cutaneous and Genito-Urinary Diseases, October, 1901) reThe indiported a case of this nature. vidual, a young man, had a severe attack of cold some years ago, when a physician prescribed quinine in the ordinary dose. The first dose the patient took was followed by a severe constitutional disturbance, simulating typhoid fever, and by an erythematous eruption, and finally desquamation. Some time after that he took some patent medicine which contained one-eighth of a grain of qui

nine to the dose. He became the victim of another attack just exactly like the first one. The same thing took place every time he took quinine or any of the cinchona derivatives. The patient was made painfully aware of his susceptibility to quinine on different occasions, the most unusual of which was a typical attack following the application of a hair tonic which contained quinine. It was not due to any neurotic disturbance, because the eruption appeared no matter whether the patient was conscious of Some of his taking quinine or not. medical friends administered quinine unknown to him, but it was invariably followed by a typical attack.-The Medical Age.

[Cases like this are worth remembering because they may, at any time, occur in one's practice, and cause confusion. What is true in this case is true of other drugs as well, though not having similar manifestations. Thus it may not be out of place to refer to the urticaria following the ingestion of shell fish, beer, and other articles of diet; to the rash produced upon susceptible people by small doses of the resinoids; the sensitiveness of

ED.]

Epilepsy Cured by Snake Bite.

By DR. J. P. COLLINS, Cedar Mills, Texas.

J. S., age 35, farmer, had been an epileptic for twelve years. On the 19th of May, 1900, he was bitten by a copperhead snake, since which time he has been entirely free from all symptoms of epilepsy, and his general health has greatly improved. That peculiar expression of the confirmed epileptic has disappeared; his eyes are bright, the pupils small and well defined, and his skin is clear and healthy. Was it merely a coincidence? or did the bite of the copperhead stand in a causative relation to the cessation of the paroxysms?-The Texas Medical News.

[We do not believe this case to be a coincidence, nor it it properly viewable as one of cured epilepsy. The publication of this article, appearing less than sixteen months after the infliction of the bite, constitutes too short an interval to claim a cure for epilepsy. It is a wellknown fact that this erratic and evasive disease has, as yet, bid defiance to all proposed methods of cure. It is also well established that it readily yields for a certain time to any active onslaught made against it. The excisions of an old scar, a circumcision, an amputation, an abdominal section, or any other unusual procedure that makes a more or less profound impression upon the nervous system, is apt cause a cessation of epileptic seizures for periods varying from several weeks to two or more years. They return, however, unless the patient dies too soon. Such a thing as an absolutely cured Jacksonian epilepsy is unknown.--ED.]

Childhood.

Abt (St. Louis Med. Rev., July 13, 1901), after discussing the symptoms and prognosis of these affections, says that their prophylactic treatment depends upon the fact that the majority of them are rheumatic. The salicylates should The drug be used thoroughly and early. limits the rheumatic process, and may possibly arrest its progress before it has seriously injured the endo- or pericardial structures. Alkalies alone or combined are also useful. Rest in bed should be

insisted upon and begun early in the disease. The external application of an ice-bag is also useful. Counter-irritation in the form of mustard paste or tincture of iodin gives relief at times. To quiet the heart, small doses of aconite are sometimes employed, but this is contraindicated if there are any signs of collapse or cyanosis. When a large pericardial effusion is present, aspiration should be resorted to. Rest in bed for weeks, and perhaps months, is of paramount importance. When cardiac stimulants are indicated, digitalis, strophanthus, convallaria and caffein are used. Iron and arsenic are indicated when anemia is present. Massage, hydrotherapy and light gymnastics act favorably.-International Med. Mag.

[This is good advice, capitally expressed, and we would only emphasize the necessity for insistence upon rest in bed, not only early, but late, in the treatment of the disease, and throughout its active manifestations. The use of the ice-bag supplements this very decidedly, and so does, more especially, the free admission to the patient of fresh air, a point not mentioned by Abt. It is ef fective by supplying more abundantly that element which it is the object of the heart's action to absorb from the pulmonary atmosphere and carry to the tissues -oxygen.—ED.]

The Abstraction of Calcium Salts from the Mother by the Fetus a

Cause of Osteomalacia.

Jennie G. Drennan, in the New York Medical Journal, September 28, 1901, advances the theory suggested by the title of her paper stating that osteomalacia is a disease, the result of a poverty

of calcium salts in the blood of the mother, by which her osseous tissues are starved by the fetus assimilating all the available salts. If her diet had been rich in salts, there would have been a sufficiency for both. The women in whom

this disease occurs oftenest are those whose diet is poor in lime. The disease is commonest among the poor peasant classes in Europe, foreigners in America, and the slum classes of British cities. Naturally, in each succeeding pregnancy the supply of calcium in the tissues will be less, as in all probability the osseous tissues will not recover their first state. -Medical Record.

[This is common sense, yet there are people who try to make others believe that it is possible to bone-starve the fetus by dieting its mother. As we have always maintained, such a regimen would more likely affect the mother than it would her child.-ED.]

Intrauterine Crying.

Planchu and Reure, Lyon Medi., January 6, 1901, discuss a case in which Reure heard loud crying of the child in utero for more than an hour nine days before delivery. The patient complained of a watery discharge, and as on examination no sign of the onset of labor was found, was ordered rest in bed and vaginal douches of hot water. Instead of the douche a pear-shaped syringe was used, which was afterwards shown to eject much air with the water. Reure was called because of the crying, which was so loud on his arrival that he expected to find the child born. The cries gradually diminished in intensity, but are said to have lasted almost continu

ously for two hours and a half. On each of the following nine days fetal movements were felt, and the fetal heartsounds counted to be on an average 135 per minute. The child was born breech per minute. first, alive, but very asphyxiated, and tention on the part of the mother, who was lost owing to the urgent need of atlungs was permitted. Planchu argues was bleeding. No examination of the that this case pleads strongly in favor of the theory that the first respiratory movements are caused by the contact of the nasal and buccal orifices with air circulation.--Homeopathic Journal of Obrather than by obstruction of the fetal stet., Gynecol. and Pediat.

[This is an extremely unusual case, but not at all improbable. We think it worth remarking, however, that many men with the same experience who would report such a case would do it in so defective a manner that the facts would not be credited. In this instance the doctor gives sufficient detail to protect him against a suggestion of error, and explains the phenomenon by the presence of air within the uterine cavity through the agency of a defective syringe. Unusual or improbable occurrences should always be reported with the greatest care, special attention being had to detail, and an explanation of the phenomenon.—ED.]

Salicylates in Rheumatism.

The treatment of rheumatic fever with salicylates has at times proved unsatisfactory to the physician, owing to the remedy not being pushed sufficiently. Salicylic acid should be given in doses of from seven to ten grains every two hours, followed by a glass of milk to avoid irritation of the stomach. It should be continued to the full physiologic effect, manifested by roaring in the ears, when it should be decreased, but not entirely withdrawn. Sodium salicylate should be given in from 10- to 15-grain doses every hour until a similar effect is