ginning of all treatment in all cases, and part of it in most of them.

The next point is "dose enuf"; that is, having chosen your remedy, saturate your patient. Get the physiological effect you are after, then increase the time between doses so as to maintain the effect. The best way to saturate the system is by small doses frequently repeated. If this rule is followed you need never get any over action if you watch the effects properly. In regard to particular diseases, no routine treatment can be followed. This is particularly true in the use of the alkaloids. They have often been called "arms of precision," and must therefore be aimed at definit symptoms or conditions. As no two cases, even when the diseases are called by the same name, are exactly alike, so, too, the treatment of each must vary according to the conditions to be met.

One

All doctors have their favorit remedies. This is true of the alkaloidal convert, but I think most physicians who use these remedies use a larger number of drugs than those who use the more bulky forms of medicin. reason is that a much larger supply can be carried in the same space, and the remedies being at hand, they are used. Every hospital interne discovers when he goes into practise that the lack of a well stockt laboratory causes him to forget the use of many remedies he deemed absolutely necessary while in the hospital.

Just a few words then in regard to my favorit remedies. Perhaps I ought to give first place to bioplasm; at any rate I use more of it than of any other drug except saline laxativ. Saline, as I said before, is part of the treatment in every case I handle, at least at the start. It is right to "speak well of the bridge that carries you safely over." Bioplasm stopt the course of a well developt case of lateral sclerosis (my own), and has restored me to very nearly a normal condition-and keeps me there.

Nuclein (Aulde) is very similar to bioplasm, or vice versa as you prefer. In some cases it seems to give me fully as good results. I use it particularly in combination with the arsenates of iron, quinin, and strychnin. This tablet is particularly useful in cases of sexual debility, "night losses," premature senility and cases of this class.

In intestinal indigestion I have used the intestinal antiseptic tablet (W-A) with good success. This is composed of the sulfo-carbolates of lime, zinc and soda. It does exactly what its name indicates. I use it frequently and it seldom disappoints me.

Ammonium, combined frequently with cypripedium, serves me well in cases of seminal emis

sions, premature ejaculation, etc. Arbutin and lithium benzoate I use frequently in bladder troubles, chronic cystitis, and the like. Boldin acts well in torpid liver, also useful in case of gall-stones. Atropin and ergotin, alone or in combination, in cases of menorrhage. rhagia, metrorrhagia and all forms of hemorCannabin and atropin to replace morphin. Cicutin as a spinal sedativ, to relax spasm, priapism, etc. Colchicum in rheumatism is almost a specific. Hyoscyamin as an antispasmodic, or occasionally as a hypnotic, is excellent. Sanguinarin nitrate is an excellent sexual stimulant, especially for frigid women. The combination granule of helonin, caulophyllin, macrofin and hyoscyamin comes last but not least. It gives me better satisfaction than any combination granule I have ever used. It is of service in almost every form of uterin trouble, whether functional or organic. It gives more or less relief even in those cases where some form of operation is the only hope of cure. This granule, or pill, is known as uterin tonic (Buckley), and it deserves its It surprises me nearly every time I use

name.

it.

Quantity of Triturate or Menstruum in 30x. Editor MEDICAL WORLD:-Dr. Spain's contention that "it would require five globes the size of our earth to contain the trituration 30x of a drug" is approximately correct, notwithstanding the fact that Dr. Edgar can make the 30x in thirty little 2-drachm vials." The fact of the business is that Dr. Edgar forgets that he discards nine-tenths of his solution at each dilution, and that is what keeps the quantity down. If he does not believe Dr. Spain's statement, let him undertake to make the 30x dilution of salt and use all of it. If he discards no part of it he will have at the tenth dilution something like 20,000,oco gallons of solution, and the quantity will be multiplied by ten at each subsequent dilution. What, therefore, would be the quantity of salt in a barrel of the 30x? I'll tell you doctor that 40,000,000 such particles of salt could play hide-and-seek on the toe nail of a ptomain for ten thousand years and never find one another. Shubert, Neb. J. F. STONG, M.D.

Homeopathic Treatment of Elongated Prepuce.

Editor MEDICAL WORLD:-I wish to say a few words in reply to the paper entitled "Homeopathic Substitute for Circumcision." The paper in question is calculated to prejudice the most liberal among the dominant school. Homeopathic therapeutics were never intended to teach such unreasonable ideas. The writer, if he holds such opinions, would better keep them to himself. I studied in the homeopathic school and have never had reason to regret it; but I have failed to find such a remedy-one with the power to amputate foreskins and fingers cosmetically. I have recently circumcised several children, who were brought to me for worms and other supposed nervous troubles, and have succeeded in relieving them. How any sane man can believe, much less expose, such ideas, I fail to understand. The failure to recognize the necessity for circumcision, and to neglect to perform the operation, would be evidence of gross incompetence. The average homeopathic doctor is familiar with the current literature, and is able to consult with regular physicians, or write prescriptions for all the pharmaceutical preparations. Physicians are getting nearer together. For my part, I am practising medicin honestly and conscientiously. D. O. MCCRORY. Mobile, Ala.

Dr. A. J. Hall, of Jemison, Ala., reports good results in erysipelas from sulfid of calcium internally, and sulfocarbonate of zinc in strong solution applied locally.

Homeopathic Replies.

Editor MEDICAL WORLD:-Page 532. My comment on your editorial, "therapeutic cowardice," would be for such persons to use alkaloids, from a reliable house, as safer than Galenic pharmaceuticals. "Bowel troubles in typhoid." The Editor is correct: That nature means something when causing discharges, and it is hardly correct to fill the patient up with drugs, upon a theory of antisepsis, when the patient's life force is already much deprest. That patient getting up and about is not all the proof. There is where treatment by a law of cure can aid nature restore itself, and these loose discharges, subsultus, etc., are our guides in selecting the remedy to cure, instead of forcing drug action upon any theory.

Page 537.

'Spina bifida." I compliment Dr. Workman on his successful operation. If it shows symptoms of returning, or Pott's disease shows up, I ask him to consider the tissue remedy lacking, and my suggestions, for I have cured such cases with the homeopathic remedy when other practicians prognosed as did his colleague.

Page 538.

Erysipelas." I suggest to Dr. Eads that his cases may have been caused by the home use of tinct. of arnica. It is frequently the cause thru drug store prescribing and the family not knowing how to use this useful remedy correctly. Never use it to an open wound.

Page 539. Dr. Black's treatment of septicemia. Put yourself in his or her place," is the title of a book by Chas. Reade. Page 543.

66

Routine use of douche after parturition." I second and quadruple his comment that "it is unjustifiable."

Page 544. Dr. Giltner takes steam to not learn. The Editor put the heading. The truths I gave were for the profession to learn, and is not literally a

substi

tute for circumcision," but to cure the patient, whose abnormal condition is keeping back proper developabnormal to the proper development, and on the same ment. We give the remedy to absorb only what is principle is that of proper subinvolution restoring the uterus of the new mother to near its virgin size. Dr. G. has viewed my suggestions of proven remedies, verified, and has cured, thru his forcing drug action ideas. I thank him for his compliments on what I know, also for his attack on the jaborandi forcing, før in that rut he is more versed. But during gestation, we have remedies to help nature restore the mammary gland to its natural duty, guided by its previous failure and the concomitants of the woman otherwise, to help us select the remedy, commencing to give it at the third or fourth month of gestation. Many cases in multiparas have been caused by the forcing drug treatments previously, as ergot, camphor, etc.

Page 547. Dr. Boynton makes some good points in his suggestions about changing locations. They are worth thinking about.

Page 549. Dr. Lum's points about R writing are correct. The sooner the profession do their own dispensing, the better for both physician and the people. Having been in the drug business myself, I know something about it. We had one family who averaged at my store $150 per year for patent medicins, and maybe some more from other stores. I, as a physician, would have gladly taken charge of that family at $150 or $100 per year and furnisht the medicin.

Page 559. "Capricious vomiting." I suggest to Dr. Hoyt to dilate the cervix uteri and leave a sponge tent therein for 36 or 40 hours, if possible, before withdrawing it. Add calc. sulfid, smallest dose, but repeat frequently and for some weeks. Don't saturate! Tobo tastes bad enuf if water is used. Get the 1000 from Clapp & Sons. Omit all drugs and local means except cervix dilatation.

Page 560. Capitis, or terebintha poisoning. Give phosphorous 1800 to antidote the poisoning, then follow with psoric 10x in disks two each two hours to cure. Can be procured from B. & T., Chicago.

Page 560. Progressiv paralysis." Electricity I think is harmful; but conium 6x, and nux vomica 6x, three doses of each per day, have helpt others. You

might try the alkaloids conin and strychnin, and proscribe coffee absolutely.

Page 560. Chronic pharyngitis" needs bichromate of potash in a weak solution, frequently repeated. If you use the atomizer as "a placebo," use the bich. potass. in it. This is to cure catarrh and all. Try it. Page 562. "Facial eczema." With what symptoms given, try weak solution of ammon. carb., internally and locally. This is to cure, not to palliate or drive in. Page 562. Rectal prolapse in boy" is absolutely curable by the remedy given internally. I suggest podophyllin 30x if light-colored stools; plumbum 30x if constipated and the sphincter tends to violent constriction at times; merc. vivus 30x if rectum of dark color and bleeds easily and the prolapse is after the fecal discharge; ignat. 30x if worm indications, and prolapse even with soft discharges. Dr. Hines can procure i oz. of disks of one or more of the above remedies from B. & T., Baltimore, and give two disks night and morning. Use no local applications except pure

water.

Page 562. "Chronic diarrhea in female." Needs tinct. cinchona first. Make a solution of robo in water and alcohol, and give 20 drops each three hours. This will build her up at once. You may have to follow with small doses of rheum or nux moschata afterwards. These suggestions, Doctor, are for curativ remedies, not to force a drug action, hoping to abort.

Page 563. Traumatic epilepsy" in 13-year-old girl. Needs arnica 30x first. Send to Munson & Co., St. Louis, and get 13 of disks and give three three times a day. Also procure hypericum 30x and give the same way alternate weeks. It will take fine remedies to cure this case, and crude drugs will not only not cure, but will set the case like soap does an ink stain.

Page 563. 'Ravages of venereal diseases," quoted from Medical Standard. Why, then, not learn how to cure such diseases according to an absolute law of cure? and not suppress them by local and crude practises. JOHN F. EDGAR.

El Paso, Texas.

Cure for Colic in Horses.

Editor MEDICAL WORLD:-In reply to Dr. Gibson's query, page 563, December WORLD, I beg to submit the following:

Twenty years ago I started in business. I knew nothing of business, and considerably less of horses. In the first four years of my experience I lost thirteen horses with colic. They cost me over $2,000. This prompted me to make inquiry in every direction. Finally, I askt a coal agent. It so happened that a relativ of his was a veterinary. He then made it a point to ask the veterinary for a remedy. Later on he brought me the following prescription from M, E. Conrad, V.M.D., West Grove, Pa.:

Give two tablespoonfuls every half hour until pain subsides, or until three doses are given.

I am pleased to state that since then I have not lost another horse. The proper way to give it is to get a syringe to hold one ounce, fill it with the medicin and squirt it in the horse's mouth. Keep away from him so as not to excite him. If given early, one dose will do the business.

I gave the above recipe to a horse doctor of this city some time ago. He uses can. ind. and linseed oil, equal parts. He claims that this is better, because it will not irritate the stomach. Last year he had 229 cases and lost only two. He is, without exception, the most intelligent veterinary I ever knew. He has a tremendous practise. He was educated at the University of Pennsylvania. He uses two ounces of can. ind. and lin. oil, equal parts, mixt, as a dose.

Now, as to a preventativ: About five years ago I was at York, Pa., to buy a horse from a contractor. I got there late in the evening. After we had been at his stable to look at the horse, we came out and he lockt up the stable. He had about 75 horses in there, with no one to look after them during the night. This

surprised me, and then I said to him, "Suppose one of those horses should get the colic during the night; who would find it out?" The stable was 100 yards away from the nearest house. He replied, "We have no colic." Then I askt him how he prevented it. He replied, "I will take you into the stable again and show you." We entered and he showed me a barrel full of Glauber salts. He further stated, "We keep that on hand all the time, and put a handful into the feed of each horse twice a week." When I returned home I bought a barrel, ordered it to be used as above mentioned, and I am pleased to state that we have not had a case since. This beats all the cures. BALTIMORE.

[This is not a veterinary journal, but as nearly every doctor has one or more horses, the above will doubtless be of value to our readers.-ED.]

Is This the Truth?

It is a mighty easy matter now to become an M.D. For $25 you can get a four years' course and a diploma which says, 'Labor conquers all things." and the labor part has conquered when you get the $25. For an additional $10, you can get a four or five years' hospital experience (this is regulated by your age) and a certificate with a big seal and blue ribbons will herald it to the suffering public. The signatures at the bottom of one of these certificates would make a Chinese laundry check look like 38 cents.

It's too late now for some of us to take advantage of this grand clearing sale of medical learning, but to the young man starting in life this is certainly a golden opportunity.

It would be well for any one desiring to take up this course to follow the advice of one who went the long route.

The first and most important thing is the $25, which can be sent by money order or N. Y. draft.

A silk hat will give you the practise of medicin as well as you need know it.

A diamond ring (imitation will do) will make any man an accoucheur.

A Prince Albert coat, to the laity will mean a knowledge of surgery.

Diagnosis is easy, for nine out of ten will know exactly what is the matter with them.

Patent leather shoes will build you up a reputation as a gynecologist.

As to prescribing, just get a lot of tablets; the directions on the bottle will tell you what they are for, dosage, etc.

Get your picture in the paper and advertise to cure all things. A certain percent of your cases will get well in spite of your treatment.

Don't pay any attention to ethics; antagonize every old style physician in the country; make your fees high and collect in advance.

Now, young man, I am satisfied that this will work, for I have seen it tried in several different localities. The people are tired of the old school man and are anxious for a change. If you will follow my instructions, and above all things be brazen, you will be able to stay in most any community for a year.

You understand that the regular physician hasn't any way of letting the public know that you are a fakir and a grafter, and if he did have, his misunderstanding of ethics would prevent him from exposing

you.

True, they have societies everywhere, but their time is taken up in professional research instead of mutual assistance.

Go forth young man, for "the harvest is plenty and the laborers are few."" D. L. BLEVINS, M.D. St. Anthony, Idaho.

In injecting whiskey or ether for surgical shock, or in suspension of respiration during anesthesia, always inject deeply into muscular tissue to guard against slufing of the skin, and avoid the larger nerve trunks, as such injections have been followed by neuritis and paralysis.

Womb Support Became Fixt. Editor MEDICAL WORLD:-Here is an odd case. I was called recently to see a lady aged 78 years, who told me that she had suffered from prolapsus uteri for years, so that she wore a tight T bandage for its support. Three hours before calling me she had taken a hard rubber fenestrated vaginal tip belonging to her fountain syringe outfit and used it to raise the uterus; introducing it nearly its entire length, she supported it upon her T bandage. All went well till she tried to sit down, when she felt uncomfortable; then she tried to remove it, but it firmly resisted all her efforts at removal. I placed her in a good light, and it seemed as if she was firmly held by a six shankt fish hook. The tissues of the cervical canal had crept thru the slots, and aided by swelling, had firmly packt the interior of this umbrella frame like affair, so that it taxt our patience and ingenuity to unlock the combination. CHAS. L. LANG, M.D. Weedsport, N. Y.

For Scabies.

If skin is not broken-Sig.: Three tablespoonsfuls of formaldehyde to a quart of water, and apply with a sponge. If skin is broken, creolin in the same proportions will do the work but takes a little longer.

Randall, Iowa. WM. H. WILLSON, M. D.

Osteopaths.

An old subscriber writes as follows:

Our friend, Dr. D. A. Stevens (page 540, December WORLD), need have no fears; if it is as he tells your readers, osteopathic treatment is a power for good in healing," the system will live; if not, it will go the way of all systems that promise too much. The dangers are many; too many are going into it who are not qualified, who are too old to continue in present profession and take it up because there is "money in it ;" also men who were good professional nurses. I see a danger in the trend of that school to take up the treatment of internal diseases; if they do, that will be the rock upon which their ship will be wreckt. A friend was under treatment for deafness following scarlet fever; her osteopathic doctor, and one of the very best," promist a cure by fooling with the end of her spine for six weeks; she was the same, and he the richer by big fees. Another friend under treatment for rheumatism for five weeks; the doctor fooled with "a nerve at the end of his spine;" no result-the doctor (?) richer by $125.00. Not the same doctorone in eastern New York, the other middle-but both are "shining lights" in that school. Both these men have no medical training, and they are "" making money;" have "done some good work in bone and joint work," so runs the report.

It is reported that a Pennsylvania doctor burnt up, as worthless, $42,000 in accounts. What other business man would allow that amount to stand in accounts until they were "no good?" Moral: Collect closely; if you can't get cash, take a pig, a cow, or a horse, or a load of wood or of corn-something that you can sell or use. If you can't do that, put your accounts in the form of notes-notes draw interest, and they are a better form of obligation than accounts. Accounts may be disputed; and that is the more likely, the older the account is. And while collecting obligations from others, don't forget your obligations to others.

QUIZ

New books as they appear, are sent to our Assistant Editor, Dr. A. L. Russell, of Midway, Washington Co., Pa., for review As the Doctor thus has all the late books for reference, and is made familiar with them by reviewing each one carefully as it reaches him, he is unusually equipt for answering queries. Therefore it has been our custom for a long time to send queries to him for reply. In fact, the Doctor made a special request that this be done, as he enjoys this work. It now occurs to us that time will be saved if you will send directly to Dr. Russell matter intended for the Quiz Department, which has grown so much under his vigorous treatment " Please notice that our query department is not used to "boost" proprietary remedies, almanac fashion. THE MEDICAL WORLD has no interests other than to give to the medical profession the greatest amount of honest service possible. It has absolutely no interests in any proprietary preparation nor any medical supply house. Other medical editors have become, and are becoming, wealthy, by using their pages to increase the sale of preparations that they are interested in; but we prefer to render service to our subscribers that is above suspicion of personal pecuniary interest. How can a man interested in the sale of certain preparations render the best service? He is always trying to push one of his preparations in. That is commercial journalism. We prefer ethical journalism-and so does the profession, for THE MEDICAL WORLD is growing in popularity faster than ever before-and our subscribers are paying ones. They must be, for we have no medicins to "boost," nothing to sell, nothing to depend on but pure journalism; but doctors that want honest, straight journalism are willing to pay for it-they are glad of the opportunity.

Only such queries will be publisht as are likely to interest and instruct many others as well as the one asking help. No charge has ever been made, nor will any charge be made, for this service to our subscribers. However, those who wish an immediate and personal reply by mail may obtain the same by inclosing two dollars to Dr. Russell. This is really a consultation in the interest of the patient, and should be charged to the patient-two dollars being a very moderate consultation fee. The Doctor agrees to give full, careful and immediate attention to such consultations. We reserve the right to publish in this department any such consultations that may be interesting and helpful to our readers. Name and address will be withheld if requested. Come freely for help, but read up as fully as you can before coming to us.

[Any of the special books treating on diseases of the stomach, intestins, or rectum, will give you a certain amount of information along the line mentioned. It is not a matter of sutficient importance to justify the publication of a special book on the subject. Diseases of the Stomach, Hemmeter, publisht by P. Blakiston's Son & Co., has about ten pages; Diseases of the Stomach, VanValsah-Nisbet, publisht by W. B. Saunders & Co., has six pages on the subject, besides mentioning it in connection with various diseases; and there are a number of books publisht on diet in health and disease which discuss the subject. For fuller information, write any of these publishers.-ED.]

Weeping Eczema of Face.

Editor MEDICAL WORLD:-Am troubled with what I diagnose acute inflammatory eczema of the weeping variety. It affects my face, principally the upper eyelids, cheeks, chin and lobes of the ears. Have never been troubled until I started to practise medicin in the country. It comes on when cold weather sets in and when I have to get out and make my drives into the country. This is the second year of my practise, and it is the second time it has come out on me. The eruption persists thruout the winter, is aggravated by exposure, and disappears in the spring. I feel perfectly well in every other particular; am 29 years of age and have never been sick a day in my life. The malady comes on after a drive out in the cold. There is first a

burning and itching of the skin, then swelling of the parts, followed by papular eruption, which later forms vesicles that burst and discharge a serous fluid, which upon drying forms crusts. The amount of fluid discharged is sometimes enormous, and the more I rub the worse it seems to get. Have tried various medicaments but all of no avail. The most emollient preparations, such as zinc oxid ointment, Lassar's paste, etc., are beneficial in as much as they soothe the parts. Water aggravates it. Will you or some of the WORLD family suggest something that will ameliorate the affection, or perhaps cure it? Have any of the brethren suffered with such a malady? If so, will they speak up and say what benefited them? I will be very grateful to them for any help they may bestow. Silver Lake, Minn. T. W. HOVORKA, M.D.

[It is possible that the skin of your face may be so sensitiv by nature that it will not tolerate exposure to cold and wet; some skins are so constituted, and in such a case no medicin will do any permanent good. The indications are plain that the face should be protected in so far as possible. Large goggles similar to those worn by automobilists might do good service in protecting the skin about the eyes. We should think you could fashion a mask from chamois skin, donning it when entering the buggy, and removing it before entering the house, which would allow the face to heal. Once all the eruption and erythema have disappeared, we would endeavor to toughen the skin by applying an aqueous solution of formaldehyde, a dram to the quart of water, at night before retiring. This will toughen the skin, but must not be used when there is any of the eczematous eruption present, and in its use care must be taken that it is not allowed to enter the eyes. We have seen benefit follow the frequent application of pure imported bay rum in similar cases. A long course of lithia might remove the trouble. The irritation induced by the application of water may be avoided by bathing the face with a cloth or sponge dipt in warm glycerin; this will cleanse the face £0 that the use of water may be dispenst with for long intervals, and the glycerin itself will cure many cases of eczema. An occasional skin will not tolerate glycerin, however, and if you find its constant use unsuited to you, it would better be discontinued immediately. For other treatment of eczema, see any good modern text-book. Your diagnosis is correct, but we fear your therapy will be more difficult.-ED.]

Tetanus.

Editor MEDICAL WORLD:-J. W., white, age eight years and five months, on the 26th of October received a slight wound on right thumb by letting a white flint rock fall on it, cutting a gash about a half inch long, bleeding freely. It was drest with a pad of red pepper to stop bleeding, and tied up with a common piece of white cloth. I saw him for the first time on November 10 at 1 p.m.; pulse 100, temperature 99°, respiration 30, tongue clean, bowels had acted from pills given the night before; complained of pain in pit of stomach and jaws, with some stiffness of limbs, but no pain in thumb. The wound had nearly healed; there was still a small scab on it.

I gave him chloral, gr. x and bromid potash, gr. xv every three hours, but he did not rest much. November 11 at 8.30 a.m., pulse and temperature about the same; still complained of pain in stomach and jaws when opening his mouth; stomach felt as hard as a board; slight spasms and tongue very much coated. Gave calomel gr. x, ext. col. comp. gr. iij, soda gr. viij at one dose, followed in five hours with ten drops of turpentine and two tablespoonfuls of castor oil. At 5 p.m. all symptoms worse; bowels had not acted; ordered enema of warm soapsuds, which acted two or three times. Gave him morphin and atropin hypodermatically, which relaxt the system some, and he slept three hours. Increast the chloral to twelve and a half grains every two hours and mustard to spine.

November 12, 6 a.m., pulse 110, temperature 993°, respiration 40; spasms every few minutes, with increast stiffness of limbs; 5 p.m., no better. November 13, 8 a.m., all symptoms worse. Respiration increast to 52 per minute. Gave him bromid every two hours, with six drops tinct. digitalis every three hours; 5 p.m., no improvement and treatment continued. About midnight he called all the family to his bedside, kissed them and told them goodbye. Was taken with a severe spasm which lasted until death relieved him at 4 a.m. on November 14. His mind was clear all the time. He could open his mouth just wide enuf to get a spoon between his teeth. If it was a case of tetanus, was it caused from the wound? or a case of idiopathic tetanus? If not tetanus, what was it? W. S. ROBERTSON, JR., M. D.

Mount Cross, Va.
[Your case was one of true tetanus.

Tetanus

is never idiopathic, but is always a result of the infection following the entrance of the bacillus of tetanus into the system thru a wound. Merely because in some cases no external lesion could be found, some practicians have concluded that no lesion existed; but the view is undoubtedly erroneous. The case presents some features a little unusual, but there is no doubt as to the diagnosis, and it is equally certain that the infection came from the wound.-ED.]

Editor MEDICAL WORLD:-Please give answer to question on page 565 MEDICAL WORLD: "Is a physician obliged to attend a patient who sends for him?"

[The question is the first in list of questions on medical jurisprudence, about middle of second column of above mentioned page. The general answer to this question is, no. However, as the laws of the different states are different, this answer may not apply to all, but we think it does. However, if attendance is begun, reasonable attention may be exacted until formal notice of withdrawal from case has been given, with reasonable opportunity for securing other medical services, and if such notice or opportunity be not given, responsibility for consequences is incurred.—ED.]

An Old Man's Infirmities.

Editor MEDICAL WORLD:-Man aged 72. Seems to have had some stomach trouble for years, at times; other times it does not bother him. Constipated more or less at all times unless aided by laxativs. History shows some liver trouble 30 years ago, lasting several months; was pronounced ulceration of liver at that time. Used to drink considerable. Passes urin 5 or 6 times at night for last six months. Examination fails to show any abnormalities in urin. Total amount