from the limb on either side; bend it slightly at knee and tie the cord connected with the adhesive plaster to the concavity of the foot end of the wire 'so that the free ends of the splint come on a level with the pubes. The limb is now ready for elevating. For this a threeinch flannel bandage and a number of safety pins are necessary. Pin a piece of flannel bandage to outer wire near knee, carry it behind limb to inner wire and secure with a pin. Repeat this below fold of buttock and behind the heel, making splint slightly more anterior above so as to clear pubes when slung.

Now attach a stout piece of cord to the hooks (A and B) by means of a loop at

The apparatus is now complete. Splints around the fracture are not not necessary; but, if preferred, an anterior splint from groin to knee may be applied, with one

each end, and another to C and D, making each loop a convenient length. The two loops are now connected by a third which passes through a pulley on the end of the cord (EF), the upper end of which is attached to a hook in the pole and can be lengthened or shortened by a contrivance similar to that used on a tent rope. By shortening E F the limb is elevated until the deformity caused by the lower end of the upper fragment is overcome. A cradle is made for the limb by strips of flannel like the three already attached, arranged so as to overlap from heel to buttock (only three are shown in the diagram).

on either side at the back, the whole being secured by a starched bandage and left untouched.

In compound fractures the wound can be easily dressed without disturbing the splint. If the wound is at the back, two

or three strips of flannel are removed, the dressings changed and the support renewed, elevating the limb so as to give a better view during the procedure, if necessary, by shortening EF.

In this splint extension is made by the patient's own weight, the original shortening disappears in a few days; by raising himself on his elbows, the patient can assist while a clean sheet or the bedpan is put under him.

Although the description appears complicated, the materials can easily be gotten anywhere, and, once possessed, are ready for a fracture in either limb. The cords for suspension should be kept, for, with everything at hand, a very few minutes suffices for the application of the splint. 3705 Powelton Avenue.

Dr. Senior will give "Treatment of Fractured Thigh in Infants and Children," illustrated, in our January issue.-ED]

No ideas will be advanced as to the etiology etiology or pathology of this disease, nor shall I give any finespun theories as to treatment, for when you get into an epidemic of scarlatina, as I did last winter, you will find that "a condition and not a theory" confronts you.

As we all know, scarlet fever is somewhat variable in its mode of action. Some epidemics are mild, with perhaps not the loss of a single life, while others are very severe, the death-rate reaching a high percentage of those attacked. Then, too, an epidemic that begins in a mild form may very suddenly become severe, and even in the same family, where there are several children, it is possible to see all grades of the disease. Last winter I well remember attending a family of six children, ranging in age from two to seventeen years, all of whom were attacked by scarlatina, and they presented almost every grade of the disease, from that so mild in form that the child was not forced to take his bed, to one so severe that death closed the scene on the seventh day of the disease.

There are many interesting things that might be said relative to the epidemic that was prevalent in this locality last winter, but believing that more is to learned from the study of a disease in the concrete than in the abstract, I shall confine myself to the description and treatment of one case.

On February 20th I was called to see two children belonging to the same family, a boy of three and a girl of eleven years. Several hours previous to my visit the children had been suddenly stricken with vomiting, and when I saw them the vomiting had abated, but they were very restless and their temperature was high. My diagnosis was scarlet fever and I told the family that the rash might be expected the following morning. There was another child in the family, a

baby three months old, and as all the books I had ever read on scarlatina said that children of this age seldom or never contracted the disease, I felt safe in telling the family that the baby would perhaps not be attacked; but in this I was disappointed, for the child promptly contracted the disease and had it in a rather severe form. The little boy of The little boy of three years had thedisease in a very light form, and after the first day was not confined to his bed. He received but little treatment other than close attention to prevent contracting cold during convalescence.

The little girl was in a dangerous condition from the beginning of the disease, and by the fourth day we had little hopes of her recovery. She presented all the symptoms of scarlet fever in its severest form; a temperature that varied little from 105°, except when reduced by sponge bath; an irritable stomach with no appetite; a typical "strawberry tongue;" an intensely sore mouth and throat, with an exudate and membrane resembling that of diphtheria; and a rash of an intense and fiery red that covered the entire body. On the fifth day of the disease the child was in a semi-comatose condition, and it was with difficulty that she could be sufficiently aroused to take medicine and nourishment. Counsel was requested and obtained. The consulting physician gave an unfavorable prognosis; in fact, he thought the child would die. in a very short time. No change of treatment was suggested other than an additional spray for the throat, which was promptly given.

Of the various treatments given by me during the epidemic last winter I know that I got better results from the treatment given this patient than from any other, and had any other treatment been used than the one selected I feel confident that the child would have died. I give the treatment in full, feeling assured that those who give it a thorough trial will be well satisfied with results.

Treatment.

The patient was kept in a well-ventilated room, all drafts being avoided, and

the atmosphere kept saturated with carbolic acid on cloths hung about in the room, and turpentine fumes produced by a can of water and turpentine kept simmering on the stove. No one was allowed in the sick-room except the physician and nurses.

For the itching and burning sensation of skin an application of vaseline was used once or twice daily as necessary. Nourishment, consisting of milk, eggnog, and broths, was given every four hours day and night, but in very small quantities.

The internal treatment consisted of quinine (grains ij) every four hours, and the following:

M. Sig. Spray throat thoroughly every two hours, and allow nothing in mouth for some time after use.

Under this treatment the patient commenced to improve slowly about the ninth day of the disease, and after a long and tedious convalescence entirely recovered.

As so often happens in this disease, the child had otitis media of both ears, and the exfoliation of the skin was so great that the patient literally peeled off all over, even losing the nails from all her fingers and toes.

What I wish to emphasize in this article is this: That I have never yet seen a severe case of scarlet fever without intense throat complications, and I believe that most of our treatment should be directed against the germs that are located in the mucous membrane of the throat and tonsils, for it is here that the

ptomain poisoning is entering the system, and the best method for preventing this is the use of a spray that will have not only an antiseptic but an astringent effect as well. The remedy that will best comply with both these conditions is as old as the hills, and ofttimes forgotten, but my advice to you all is to use the "old-time" solution of chlorine, and be convinced of its efficacy.

Asthma.

By DAVID CURTIS RONEY, M. D. Milan, Ind.

In considering the subject of asthma it would be rather an easy task were we to confine our investigations to the disease as defined by our textbooks. Osler says it should be limited to the affection known as bronchial or spasmodic. Tyson and

Bartholow both make a similar statement. The definitions found in medical dictionaries and encyclopedias are all more or less misleading. They generally make the vague statement that the etiology is obscure. Before we attempt to formulate a definition of this obstinate malady, let us first inquire into the cause.

We find it in the neurasthenic, in the dyspeptic, in the hay-fever patient, in the one with enlarged turbinates or nasal polypi, in patients with cardiac or uterine disease, in hysteria, dentition, worms, bronchitis, laryngitis, and all the different renal and hepatic diseases. In addition, let us not overlook our friends that attribute every form of disease to the uric-acid diathesis; it is the writer's opinion that they are getting near the cause of a great majority of asthmatic conditions. This cause is faulty elimination. If we could put the sewerage system of the animal economy always in condition to properly eliminate the metabolic products, such as toxins and ptomaines, we would hold the key to the situation in most of these

cases.

Just a thought along this line as we are passing. Did you ever think what a complex chemical laboratory the human body is? How it manufactures both

poisons and antidotes? What a field for future investigation, and how little we know about it! Vaughn and Novy, in their new edition of Cellular Toxins, classify a number, but admit that the field is as yet unexplored; but, as our space is limited, we will not follow this line of thought further, however fascinating it may be.

Asthma may be defined as a condition of paroxysmal dyspnea depending on some other pathological condition. It is not a disease per se, and should not be so classed any more than a cough or a dropsy. In Merck's Archives for December, 1901, Professor Bjorkman, after classifying asthma under a dozen different heads, with several subdivisions under each head, says: "Having made a careful study of these facts, it must be evident to any one that to become both a good diagnostician and successful therapeutist of asthma, a physician should be thoroughly acquainted with nearly all the special branches of medicine." Judging from the consideration of asthmatic conditions, as given in our present textbooks, the above is true; but when authors place neurasthenic asthma in the chapter devoted to neurasthenia, bronchial asthma in the chapter treating of diseases of the bronchi, cardiac asthma with diseases of the heart, etc., then will the general practitioner be better prepared to cope with this manysided evil.

Now, just a word about treatment. If our premises are correct regarding the cause and manifestations of asthmatic conditions, the prescriptions would necessarily be many. They are legion. If we had them all compiled and in book form the volume would undoubtedly compare favorably in size with the U. S. Dis pensatory or Webster's Unabridged.

The

When confronted with a patient suffering with asthmatic dyspnea, the great desideratum is to give quick relief. drugs recommended for this are many. I might mention chloroform, chloral, nitrite of amyl, nitroglycerine, nitrate of sanguinaria, hyoscyamine, the different asthma powders, etc. After giving them all an impartial trial, I have never found anything more effective than a hypodermic

injection of morphine with pilocarpine nitrate.

Of course the after-treatment will depend on the particular cause, and generally this is more difficult to find than to formulate a proper prescription.

If this short and imperfect paper shall be the means of inciting the reader to greater research in the field of physiologic chemistry it will have served its purpose.

Ginger.

By W. O. BUNNELL, M. D. Wilkes-Barre, Pa.

Some months ago I started to write a series of articles on some of our common remedies found in all homes, but, after writing a few articles, I was called to take night-charge of a hospital, and as I had my hands full I had to stop writing at that time. But now that I have a little more time to myself I will take the subject up again.

Often, when away from home, we are called to treat a friend for some simple disease, and not having our medicine cases with us, and no drugstore near, we are at a loss what to do. But if we understand some of the common remedies that we can find in almost all homes, we are often able to treat our case and sometimes able to save life. The next common remedy I have found I could use very often is ginger.

The part of the plant used is the root. This is a native of Asia, America, and and Sierra Leone, Africa. The black ginger comes from the East Indies and the white from Jamaica. We find it in the homes in two forms, in the root and powder. Age and exposure impair the active properties. Water, proof-spirit and alcohol take up the virtues of ginger. The oil of ginger may be obtained by distilling ginger with water. It is pale yellow, very fluid, of sp. gr. o.893; boils at 475° Fahr.

Properties and Uses.

Ginger is a stimulant, rubefacient errhine and sialagogue. When chewed it increases the flow of saliva, and when

swallowed it acts as a stimulating tonic, stomachic and carminative, increasing the secretion of gastric juice, exalting the excitability of the alimentary muscular system, and dispelling gases accumulated in the stomach and bowels. It is often used to disguise other drugs, concealing their nausea or preventing their tendency to cause tormina. When taken into the nostrils it causes severe sneezing. It is used in combination with astringents or other agents in diarrhea and dysentery. Forty to 50 grains of ginger in a cup of hot water at bedtime will break up a cold. In diarrhea and dysentery I give 15 to 20 grains in hot water every two or three hours with good results. In dyspepsia 10 to 20 grains in a cup of hot water before meals will often give a permanent cure. Ginger formed into a plaster with hot water and applied to the head will relieve a violent headache. The ginger plaster is good for lame joints, lame back, pain in stomach or bowels. Apply a thick coat and cover over with a paper to retain in place.

I have only given a few of the many uses for this valuable remedy. By a little study one will be surprised to find that we have common remedies that will fill the place of expensive ones, and will give as good results.

32 N. Washington St.

M. Tuffier has made many punctures in the lumbar region to establish the correctness of the diagnosis of fracture of the skull when its existence was doubtful. The cerebro-rachidian liquid is almost always discolored with blood in cases of fracture of the base of the skull, and the great or less discoloration of the liquid is in proportion to the gravity of the lesion. These punctures may also have some value from a therapeutic point of view, as enabling a differential diagnosis in other diseases.

If there is any subject which you think is not sufficiently clear in the minds of the profession in general, give us your opinion in regard to it and we will endeavor to have it plainly and practically treated by a capable practitioner and writer.