Uremia.

Therapeutics.

When uremia develops, showing the failure in compensation of the kidney, vene

section is indicated to rapidly eliminate the toxins, followed by an injection of the normal salt solution. When convulsions occur such preparations as caffein, scoparius, digitalis and convallaria are useful. If the heart is well compensated and does not enter into the cause of dropsy, the potassium salts, scilla and sweet spirits of nitre are recommended to aid the function of the kidney. Asthma is frequently a symptom denoting the presence of a toxemia and disappears with the improvement, by eliminants, of the heart and kidney. Sometimes it is necessary to resort to chloral or morphine hypodermically in small doses, or perhaps to venesection. Epistaxis sometimes occurs and indicates the necessity of lowering blood pressure. Diaphoretics are indicated very early in the treatment as promoters of elimination and thus relieving the work of the kidney. They should be employed regularly, depending chiefly on hot water or hot-air baths. As to the medicinal agents as diaphoretics, sweet spirits of nitre and liquor ammonia acetatis are preferable, using pilocarpin in emergency cases. Diuretics are of value only when the compensation of the kidney has failed and the urine is scanty and dropsy present. When indicated by poor heart's action and also to assist the kidney, the author recommends a hypodermic injection of morphine, followed the next morning by a hypodermic injection of pilocarpin. The author states that he has never seen any ill-effects follow the use of morphine when given in this way. The operation for stripping off the capsule of the kidney was not discussed by this writer-J.A.M.A.

Surgical Suggestions.

A fracture produced by only slight violence should at once raise the suspicion of a malignant growth. In such a case a uniform dark shadow about the bone as seen in the fluoroscope is to be interpreted as a neoplasm rather than as callus, for recent callus is not opaque to the X-rays.

In the treatment of fractures of the forearm no consideration: is more important than the avoidance of contractures of the fingers, by the intelligent use of splints and by means of early, active and passive movements.

Involuntary urination very often means a distended bladder, and in old men it should at once indicate an examination into the condition of the prostate. Vomiting, too, is often caused by distention of the bladder.

In the presence of anemia or of faintness, without other apparent cause, inquire concerning the passage of black stools. The condition may result from hemorrhages due to an ulcer or neoplasm of the small intestine.

Inflamed areas and abscesses about the knees of creeping infants should be examined for foreign bodies.

An amputation for malignant ulceration should not be performed until the possibility of its being merely a broken-down gumma has been satisfactorily excluded.

Tinnitus aurium, present only in the recumbent posture, is suggestive of aneurism of one of the posterior cerebral vessels.

After circumcision it is important to prevent adhesion of the reflected mucous fold of the prepuce to the corona glandis by the daily passage of a probe about the corona, and by the use of vaseline.

Individuals with bluish sclerotics, and with dark lanugo over the upper part of the back are usually of tuberculosis diathesis; and these signs are not inconsequential in making a diagnosis.

Surgical tuberculosis, no less than pulmonary tuberculosis, calls for the most careful general treatment, post-operative and otherwise.

The temptation should not be yielded to to incise a psoas, hip or other "cold" abscess, except in isolated instances and then only under the most rigid asepsis. The production of a mixed infection means chronic sinus, chronic invalidism and, often, amyloid disease.

Children who complain frequently of pain in the stomach should be examined for evidence of beginning Pott's disease. Such cases treated before the development of curvature usually yield very satisfactory results.

In the early months of pregnancy examinations should be made to determine that there is no retroversion or to treat it if it exists. A retroverted gravid uterus impacted in the curve of the sacrum always aborts.

In typhoid fever spontaneous rupture of the spleen may simulate intestinal perforation.

Before operating for pharyngeal adenoids or hypertrophied tonsils make sure that these are not merely an expression of status lymphaticus. If they are, do not employ an anesthetic. Also determine whether the patient is a hemophiliac. If he is, do not operate at all.

When applying a plaster dressing to the leg always include the foot if the patient is to be confined to bed; otherwise "drop foot" will develop.

In dealing with infections or injuries of the fingers amputation should be a dernier resort. This is especially the case with a thumb, the most important of all the fingers.

The painfulness of withdrawing packings that have dried in a wound may be avoided by soaking them with peroxide of hydrogen.

In an acute condition simulating intestinal obstruction, if a large mass can be felt in the abdomen think of omental torsion.

In excising a varicocele under local anesthesia, tie the upper ligature first; the pain of tying the lower ligature will then be abolished.

When operating for empyema thoracis it is a good rule to aspirate again when the pleura is exposed and before it is incised. This may save some embarrassment.

Hay Fever.

-American Journal of Surgery.

Prousnitz (Berliner Klinishe Wochenschrift) says that without any doubt Dunbar has proven that hay fever is due to the pollen of graminaceæ floating in the air in the hay season. The antitoxine acts by diminishing the toxines, and the results of its use have been excellent.

Hypnotism

Berezinski (Roussky Vratch) would treat for Morphine Users, drunkenness, the morphine and tobacco habits Drunkards, etc. by the employment of hypnotism, as there are no drugs which will cure these habits. He advocates sanatoria where these cases can be confined and treated hypnotically. He says hypnotism easily and readily cures the tobacco habit, but there is soon a relapse. In alcoholics twenty to eighty per cent. of cures have been effected.

Society Reports--Notes of Interest.

BRITISH COLUMBIA MEDICAL ASSOCIATION-SYNOPSISOF SECRETARY'S MINUTES.

The sixth annual meeting of the British Columbia Medical Association was held in O'Brien Hall, Vancouver, Tuesday, July 18, 1905. Meeting opened at 10 a.m., Dr. W. D. BrydoneJack, President, in the chair. There were present at the meeting forty members of the Association, and about ten visitors, chiefly members of the profession, who had lately been attending the meeting of the American Medical Asociation at Portland. The minutes of the previous meeting were read and adopted.

The following committees were then appointed: Audit Committee, Drs. Pearson, Monro and Lefevre. Papers and Business, Drs. Tunstall, Campbell and Keith. Credentials, Drs. McPhillips, Poole and Pearson. Nominating Committee, Dr. McPhillips, Weld and Pearson.

The following new members were duly elected: Dr. A. Lazelle Anderson, Wm. Stephens, McLellan, A. F. Fuller and C. A. McDermid, all of Vancouver; Dr. C. E. Doherty, of New Westminster.

The President's address was then read, and was much appreciated by all present.

Dr. Tunstall, in the absence of the author, then read a paper on "An Unusual Case of Intestinal Obstruction," by Dr. R. E. McKechnie.

The afternoon session opened at 2.30 p.m., and was fully occupied by the reading and discussion of the following papers: "Infection and Immunity," Dr. C. J. Fagan; "Nevus of the Eyelid," Dr. Glen Campbell; "Bilharzia Hematobia occurring in British Columbia," Dr. R. Eden Walker; "Tuberculosis in New Zealand," by Dr. Wm. Stephens.

At the evening session, 8 p.m., under the head of general business, the following resolution was unanimously carried: "That the British Columbia Medical Association consider that the notification of cases of tuberculosis is advisable, and that the Provincial Government be asked to put the regulations relative to this matter into effect."

The election of officers resulted as follows: President, Dr. Geo. E. Drew, New Westminster; Vice-President, Dr. O. Weld, Vancouver; Treasurer, Dr. J. D. Helmcken, Victoria; Secretary, Dr. R. Eden Walker, New Westminster. Next place of meeting, New Westminster, B.C., date to be left in the hands of the Executive to fix.

Mr. Grant, architect, then was introduced, and with the aid of lantern slides he gave a very interesting description of the construction, etc., of the new city hospital at Vancouver.

Col. Tracey, C.E., next gave an interesting address, also illustrated by lantern slides, on the septic tank system of treating sewage. No further business presenting itself, the meeting adjourned at 10.30 p.m.

On Tuesday afternoon a number of the members with their wives were entertained by an excursion on Burrard Inlet, and on Wednesday afternoon a number of members and ladies visited the Provincial Hospital for the Insane, New Westminster, and were entertained at a garden party by Dr. C. E. Doherty, the medical superintendent, and Miss Doherty. A most enjoyable :afternoon was spent.

Phlebosclerosis.

Dr. Chas. F. Martin, of Montreal, at the annual meeting of the Association of American Physicians, read a paper on Phlebosclerosis, in which he stated that cirrhosis of the veins involved most frequently the veins of the lower extremity, the internal and external sapheni, a condition which occurred before thirty-five years of age mostly. In these cases there was an absence of arteriosclerosis, although this is a common affection, easily detected in over 60 per cent. of all cases. In a majority of the cases (14) examined, there were no evidences of inflammation, and Dr. Martin believed the condition functional from strain, exercise, etc.

Intestinal Indi-
gestion.

Dr. George B. Fowler, New York City, at the 6th Annual Meeting of the American Therapeutic Society, stated that in treating this disease he denies his patients rich soups, steak, pork, chicken and turkey from storage houses, white potatoes (fried), sweet wine, cooked oysters, cheese, kidney, liver, and cooked tomatoes. Rice and hominy, he states, do not tend to create fermentation. He denies there is any difference in the digestive qualities between fresh and stale bread.