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INTERESTING HISTORY.

During the past fifteen or twenty years various forms of pain, as neuralgia, headache, dysmenorrhea, sciatica, etc., and high temperature from various causes, have been controlled in an almost magical manner by a new class of remedies : The synthetic chemicals, or coal-tar derivatives, chiefly of German manufacture. Antipyrin, and acetanilid are prominent members of this class of preparations But, as is well known, the magical relief from this class of remedies carries with it a grave danger: That of heart depression, with cyanosis and profuse sweating. Cases of sudden death from this cause have been many, but the greatest harm, which has become very wide-spread, is the insidious injury wrought by occasional doses of these remedies.

It was thought that European countries contained all the talent and scientific attainments for the production of remedial chemicals. But at last Yankee inventive genius has come to our aid, and the result is, a group of chemicals far more efficacious than the aniline products (sometimes called dye-house chemicals), and what is, still better, they are absolutely safe, being free from the depressing qualities of the foreign drugs.

The first preparation perfected, was one intended to cover the wide field involved by the two leading symptoms met in the practise of medicine, namely, Pain and Fever. The mode of manufacturing it is very complicated, involving many chemical actions and reactions that cannot be entered into here, but those interested in this phase of the subject may obtain full details by writing us. In brief outline: We begin with carbolic acid, then add nitric acid, producing nitro-phenol; then ethylate it through the influence of bromide of ethyl; then it is reduced to the anide group, and afterwards condensed with the two acid radicals, acetic and salicylic acids, the product being a white, crystalline powder.

It is the therapeutic value of any medicine that the practical physician is interested in. Here is the strong point of this preparation, the object sought in its preparation being therapeutic efficiency combined with safety. This preparation is practically tasteless, and does not disturb the most delicate stomach. Its action is that of a sedative to the nerve centers, particularly the thermocenter, thus controlling heat at the point of physiological control. It assists elimination by way of the kidneys and the sweat glands, by means of gentle relaxation of those parts. At the same time it is antiseptic, inhibiting bacterial growth wherever it goes in the system. The combined result of all these actions is the elimination of fever and pain. Thus sleep is invited, delightful rest is obtained, and Nature returns to her task of repair and rejuvenation.

This remarkable preparation is called Thermol, and its therapeutic application is almost endless. As a temporary remedy, it gives speedy and safe relief, without depression, in headaches, neuralgias, sciatica, painful menstruation, and all painful conditions. As a leading feature in the treatment of serious and protracted cases, it is invaluable in typhoid fever, pneumonia, peritonitis, rheumatism, remittent fever, etc., etc., also in all meningeal inflammations. It has been on the market now for about four years, and has been thoroughly tried, tested and approved by the medical profession in all parts of the country. The above mentioned claims have been more than fulfilled. Wherever known, the demand for Thermol becomes steady and increases rapidly. Sales are rapidly increasing, both through the trade and direct with physicians, as many physicians seem to prefer to order direct from us, again and again, as our books amply show.

While salicylic acid is one of the very best antiseptics, it disagrees wiib the stomach and deranges digestion. This true not only of salicylic acid, but also of the salicylates, is as salicylate of soda.

We also know that formaldehyde is the king of antiseptics, and as a uric acid solvent it stands only second to salicylic acid; but the trouble is to place it where we want it. To do this it must be combined in such a way that the combination will split up at the right time and place, and set formaldehyde free slowly and safely where needed.

Dr. S. Lewis Summers condenses salicylic acid with formaldehyde, and then acetylizes this union, thus forming the well defined organic chemical compound Acetyl Vethylene Disalicylic Acid which has the structural formula CH?(C•C*<CCHE): But it is not practical to use this long chemical name. Hence, for convenience, it has been named Ur-a-sol. This word is gotten in this way: It is a powerful and valuable uric acid solvent. Hence :

Ur(ic) a(cid) sol (vent).

Ur . a . sol.
It is nonirritating to the mucous membranes.
It is acceptable to the stomach.

As it is not absorbed till it reaches the bowels, it is a valuable antiseptic for the alimentary tract.

But in the blood is where it does its chief work, for there it breaks up, and its constituents, as explained above, exert their great powers.

It is the eliminator of eliminators. It increases the peristaltic action of the bowels, the diaphoretic action of the skin, the diuretic action of the kidneys, the solvent action on the uric acid salts as well as restoring the normal fluidity of the blood, and stimulates the respiratory tract through the incorporated properties of acetic acid.

Do not the therapeutic applications suggest themselves readily and abundantly? Wherever there are bacteria to overcome-typhoid fever, scarlet fever-in fact, all.fevers, pneumonia, pyemia, septicemia, etc., etc. But its particular application is in the uric acid 'diathesis, as mani. fested by the many forms of rheumatism, lithemia, gout, sciatica, etc.

But its application does not stop with its many uses as a hematic antiseptic and uric acid solvent. It is excreted in the urine, and hence as an antiseptic to the urinary tract it is of very great value. The urine remains normally acid. Decomposing and ammoniacal urine is speedily corrected, and all inflammations of the tract are benefici. ally influenced. Try it in gonorrhea.

The most frequent use of ur-a-sol is as an anti-rheumatic and as an eliminator of the uric acid salts. When sufficiently large doses are given to meet the requirements, the removal of the pain and the reduction of the temperature to normal are quite promptly obtained. Whilst it increases the quantity of the urinary fluid with an augmentation of the solids of the same, it is steadily removing the excessive presence from the blood of the salts of uric acid through elimination by combination. Thus the system is rid of the toxins of the disease and other effete substances from the blood.

Ur-a-sol has now been in successful use for several years, and its use is extending because of its inherent merits. It is truly a remarkable chemical. One notable result of its use (say 10 grains with or after each meal) is increase of the appetite. The explanation is supposed to be this: The elimination of uric acid creates a demand for more nutriment; hence, hunger, and a stimulation of digestion, and assimilation. Usually increased buoyancy and cheerfulness come with the increased appetite. It is now attracting the attention of medical college professors and other leaders of the professionthey are seeking it for investigation, because they have heard of its remarkable usefulness.

Send $1.00 Money Order, and we will send you a highgrade, one minute, self registering clinical thermometer, worth more than $1.00 and one ounce of either Ur-a-sol or Thermol, either in powder or 5 grain tablets. Literature free.

Address

ORGANIC CHEMICAL MFG. COMPANY

Successors to LIBERTY CHEMICAL COMPANY

2559 N. Sydenham St., Philadelphia on them, on the same page. These things can be ordered by mail as well as personally.

“The Terrors of the Green Room Done Away With,” a quiz book designed for students during their examinations, and also during their first years of practise. See adv. on page 2.

icine and Surgery.” We cannot do better than quote from the advertisement. Just think of “A Yearly Di. gest of scientific progress and authoritativ opinion in åll branches of medicin and surgery, drawn from journals, monographs and text-books of the leading American and foreign authors" by such an editor as George M. Gould, A.M., M.D. You cannot read all the journals and you cannot read all the text-books; you need no more than the above quotation to tell you that you need this book. See adv. on title page.:

Do you use the preparations of Messrs. Reed & Carnrick? Have you the entire success in treating dyspepsia that you wish to have? If not, why not try Reed & Carnrick's Peptenzyme? See adv. on page 28, and send for literature.

Weaver's Pharmacy make a very clever point in their advertisement this month, when they present a list of the houses that handle Salmacrin, and then ask: “Think you that these firms have stockt this threemonths-old preparation merely because we claim it to be a remedy?" It is a pertinent question, for the list of distributors include some of the greatest names in the drug trade of this country. See adv. on page 15, and give Salmacrin a trial. Write now for samples.

The Anasarcin Chemical Company sends us the following warning:

“It is reasonable to suppose that if Anasarcin is potent enuf to relieve extreme cases of ascites and general dropsy promptly and without fail, it will have the best chance of restoring the diseased organs to their complete performance of normal functions when administered in moderate doses for a considerable length of time. Such is invariably the case in actual practise; therefore we give warning against too early discontinuance of Anasarcin in any case. Better continue treatment after necessity for it has ceased than to cut it short so early that the work has to be done over again later." See adv. on page 1o.

“In none of these cases of pneumonia was any remedy except thermol used, and in every case was im

especially noted that there was no tendency to car. diac depression-which is often too true with many of the remedies used in the treatment of this disease-but that, on the contrary, the circulation always became better after the exhibition of the drug. Antipyresis was successfully accomplisht and there was no need for calling into use the digitalis group of drugs. It is a fact that thermol is a safe agent to use in the treatment of pneumonia; it is also å fact that it has decided effects for the better on untoward features of the disease. These are two qualities which stamp the worth of any drug : first, that it does good ; secondly, that it does no harm. Thermol is, therefore, to be strongly recommended in the treatment of croupous pneumonia."-Abstract from the Interstate Medical Magazine of a report from records from City Hospital.

Alterative and Tonic-Elixir Six Iodides. An old and well-tried remedy. An ethical preparation, too; in fact, the formula is given in the advertisement: see same on page 11.

As a brain and nerve tonic it has stood the test of 17 years, and is still unequaled for the treatment of paralysis, locomotor-ataxia, epilepsy, neurasthenia, senil and general debility, mental failure, debilitating losses, spinal weakness, nervous dyspepsia, all troubles affecting the brain, nerve centers and spinal cord, and as a safe and powerful aphrodisiac." Concerning Freligh's Tonic. Quoted from the advertisement of I. O. Woodruff & Co. on page 30. See adv. and send for samples.

What do you do for nausea, vomiting, dyspepsia and indigestion? Are you acquainted with Ingluvin? Do you use it ? See page 33, and write to Wm. R. Warner & Co. for further information.

Have you yet tried Glycozone in dyspepsia and allied diseases? See adv. on page 16, and send for particulars.

Mr. Tyree, the Washington chemist, could mix his antiseptic powder with water and sell it to physicians at a price far above what he charges for the powder alone, but he does not. He knows that every physi

(Continued on next page.)

FORCA Bez le property with practise of $3,000. Address

When a scientist demonstrates some new fact, it is of interest to all having an acquaintance with the subject, but when the studies of the scientist are workt out to their proper and intended conclusions, that is, when the machine, chemical, or whatever it may be, is actually made and put on the commercial market, so that the world may actually use it and enjoy the fruit of the scientist's laborious studies, then it is far more interesting. Such a case have we before us in the studies of Prof. Abel, of Johns Hopkins University, when he succeeded in isolating the activ principle of the adrenal glands, and in the placing on the market the fruit of those studies, in the form of "Adnephrin”-a product of the biologic laboratories of the great house of Frederick Stearns & Co., of Detroit, Mich. Write to them for literature.

may have the very practise you want. I have propositions of all kinds. Should you wish to sell your practise, I can place it before the numerous physicians in the United States and Canada who are desirous of securing locations. Write, giving full information, to W.O. Dyer, M.D., Westfield, Wis. ANTED-By a German physician,, good location in Wis

. preferred. Address P.O. Box 42, Pulcifer, Wis.

Office practise free to purchaser of office fur. niture and fixtures.

Soap for right man Oply electrical and X-Ray outfit in this part of State. Address Box 4, Fulton, Ky.

(Continued on next page)

We wish to call the attention of all physicians to a new book : “Saunders’ American Year-Book of Med

See MERCK'S MANUAL, Page 35.

Dionin

Cough, Morphinism,

Corneal Opacities MERCK Q CO., New York

SEDATIVE, ANTISPASMODIC.

ANALGESIC Clinical Reports to Physicians.

Circulation : February, 1904, 35,451.

THE MEDICAL WORLD

The knowledge that a man can use is the only real knowledge; the only knowledge that has life and growth in it and converts itself into practical power. The rest hangs like

dust about the brain, or dries like raindrops off the stones.--FROU DE.

The Medical World

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securing the general adoption of the suggested amendments IRVING SHEPARD, Secretary."

We feel it a duty to recognize the above tendency, and to adopt it in a reasonable degree. We are also disposed to add enui

(enough) to the above list, and to conservativly adopt the followC. F. TAYLOR, M.D., Editor and Publisher ing rule recommended by the American Philological Association :

Drop final"e" in such words as “definite," “ infinite,' A. L. RUSSELL, M.D., Assistant Editor

fayorite, o site: Wpreterie," hypocrit" - requisities

when the preceding vowel is short. Thus,

When the preceding vowel is long, as in . polite,' finite," SUBSCRIPTION RATES: To any part of the United States, ** unite," etc., retain present forms unchanged.

Canada, and Mexico, One DOLLAR per year, or Four YBARS We simply wish to do our duty in aiding to simplify and rationfor THREE DOLLARS; to England and the British Colonies, alize our universal instrument language. FIVB SHILLINGS Sıx Pence per year; to other foreign countries in the Postal Union, the equivalent of 5s. 6d. Postage free. Single copies, TEN CENTS. These rates are due in

Congestion of the Lungs. advance.

Some confusion has arisen in the family thru HOW TO REMIT: For their own protection we advise that

the use of this term, and while it does not our patrons remit ix a safe way, such as by postal money order, express order, check, draft, or registered mail. Currency sent require extended space, we will notice it briefly by ordinary mail usually reaches its destination safely, but and editorially. Congestion of the lungs, per money so sent must be at the risk of the sender.

se, is a rather common condition, with many We cannot always supply back numbers. Should a number fail to reach a subscriber, we will supply another, if notified before

gradations and variations. Violent exercise the end of the month.

will produce a temporary congestion of the Notify us promptly of any change of address, mentioning both old

lungs, as will also high altitudes, inhalation of and new addresses. If you want your subscription stopt at expiration of the time paid

irritants, etc. It is associated with every for, kindly notify us, as in the absence of such notice we will severe inflammatory condition of the lungs or understand that it is the subscriber's pleasure that the subscrip- pleura, and in many instances it is the most

tion be continued, and we will act accurdingly. Pay no money to agents unless publisher's receipt is given.

prominent symptom of the initial stage of

pneumonia. It is a frequent accompaniment ADDRESS ALL COMMUNICATIONS TO

of the initial stage of typhoid fever. Cardiac “THE MEDICAL WORLD"

weakness produces it in chronic form. 1920 Chestnut Street

Philadelphia, Pa. It is positiv that you may have an acute or a

chronic congestion of the lung. without having VOL. XXII. MARCH, 1904.

No. 3

pneumonia. The text-books declare the three Language is a growth rather than a creation. The growth of

stages of pneumonia to be (1) congestion, our vocabulary is seen in the vast increase in the size of our diction- (2) hepatization, (3) grey hepatization. When aries during the past century. This growth is not only in amount, but among other elements of growth the written forms of words are

pneumonia occurs, it is positiv that you must becoming simpler and more uniform. For example, compare Eng. have had congestion before hepatization was lish spelling of a centnry or iwo centuries ago with that of to-day! It is our duty to encourage and advance the movement toward possible ; but by no means are all cases of consimple, uniform and rational spelling. See the recommendations of the Philological Society of London, and of the American Philo

gestion followed by hepatization. This brings logical Association, and list of amended spellings, publisht in the us to the well chewed, but not digested, quesCentury Dictionary (following the letter z) and also in the Stand

tion as to whether or not true pnemonia may ard Dictionary, Webster's Dictionary, and other authoritativ works on language. The tendency is to drop silent letters in some be aborted. The trouble with too many of the of the most flagrant instances, as ugh from though, etc., change ed to t in most places where so pronounced (where it does not affect authors who have discust the matter is that the preceding sound), etc. The National Educational Association, consisting of ten thous

their ideas are constipated, and they adhere too and teachers, recommends the following:

closely to the text-book style of phraseology, “At a meeting of the Board of Directors of the National Educational Association held in Washington, D. C., July 7, 1898, the

diagnosis, etc. We have observed symptoms action of the Department of Superintendence was approved, and many times, and in many varieties of disease; no the list of words with simplified spelling adopted for use in all publications of the National Educational Association as follows: visible complications which could be presumed tho (though);

program (programme); to cause them; no individual peculiarity which altho (although);

catalog (catalogue); thoro (thorough): prolog (prologue);

could be discovered which could act as assignatherofare (tboroughfare); decalog (decalogue);

ble cause ; no drug administered which ever thru (through);

demagog (demagogue); thruout (throughout); pedagog (pedagogue).

could have produced the results; no neglect or " You are invited to extend notice of this action and to join in exposure which might have been responsible ; yet we never thought of trying to make the only in the proper mastication of the proper condition an entity in medical literature, how- kind of food in proper amount. Probably ever often we observed the condition. What all of us eat too much, masticate insuffipractician of extended experience has not had ciently, and allow our tastes to dominate our similar experience? We have just as frequently judgment in the choice of foods. While it is observed cases of acute congestion of the kid- true that none could live by the complicated neys as we have acute congestion of the lungs; formulas which the actual measurement of the yet we have never insisted that this is nephritis. calorics yielded by certain foods, and the

Taken, a patient who has been exposed to actual demand of the organism for a certain inclement weather, who is otherwise perfectly number of calorics would entail, it is quite as healthy, and who has an activ congestion of the indisputable that physiology can teach us lungs with all the accompanying symptoms much regarding the causes of gastro-intestinal developt to intensity, and we are certain that fermentation, would we but learn. Our lay he is threatened with pneumonia. He may not sufferers cannot be expected to know anything have it when we see him; he may have it thru of these mysteries; but is it asking too much the other stages later, or he may not. Whether of the presumably well educated physician the resistance of nature to infection (if infection that he know something of the actual facts ? it be), whether drugs can affect it or not, is Familiar as we are with the libraries of physianother and quite a different question.

cians in activ, extensiv, and remunerativ pracScarlet fever is different from cutaneous tise, we say advisedly that we know no books erythema; small-pox is different from “Cuban which are so antiquated and so little used as itch; diarrhea is different from cholera; and those treating upon dietetics and physiology; congestion of the lungs is different from pneu- indeed, many successful (?) practicians dismonia. Congestion of the lungs may be but a pense with such books entirely, or if they do symptom, or it may be the primary stage of a have one of a date some years back, it is in an disease. Congestion is, in other words, an

excellent state of preservation. incident; pneumonia is an entity. We do not Carbohydrates are responsible for nearly all believe any diagnostician can tell, when he

gastro-intestinal fermentation. When digesfirst examins a case of congestion, whether or tion of carbohydrates is slow, or ceases ennot pneumonia will follow; nor do we believe tirely, bacteria cause an abnormal fermentaany therapeutist can declare beyond cavil that

tion. Bacteria are always present in the small he will prevent pneumonia following a case of intestin, but it is only when carbohydrates congestion, where the conditions favor a further have been ingested in excessiv quantities or extension of the abnormal condition. None of

have been subjected to insufficient mastication, the authorities say more, despite verbosity or that these serve as a favorable nidus for the unproven assertions; hence further discussion growth of the trouble-breeding germs. Carbowould be useless. Treat your congestion of hydrates, no more than other foods, will cause the lungs, when you get it, on rational lines;

excessiv gaseous formation, if properly subif you don't get pneumonia following, en- jected to salivary digestion and efficient musdeavor to be rational still.

cular activity of the gastric walls. Foods fried

in grease and hastily swallowed, are slow o Gastro-intestinal 'Fermentation of Foods.

submit to the feeble kneading of a weakened Probably the commonest affection which the stomach. The same food, properly cookt and American practician is called upon to treat is judiciously masticated, would quickly become gastro-intestinal fermentation ; we do not ex- assimilable. The American palate has a predicept constipation, even. How very seldom is lection for starches and sugars; fresh, hot the treatment satisfactory to either patient or bread and pancakes, reinforced with syrup or physician. The reason need not be sought sugar, are familiar examples. The fermentalong : either the patient will not obey the tion of starch and sugar yields, in the stomach, instructions of the physician, or the physician ethyl alcohol and acetic, butyric, lactic, and is not competent to give the proper instructions. succinic acids, hydrogen gas, and carbonic acid The average physician, consulted regarding gas; not to mention the malodorous combinagastro-intestinal fermentation, gives a cathartic, tions of hydrogen. The ever present cellulose with orders to follow it with some of the mul

is ready to form marsh gas and carbonic acid titudinous preparations or prescriptions pre- gas. sumed and recommended to be able to check No practician will ever get results until the trouble promptly and permanently. Nat- he has studied well the physiology and dietetics urally the results are but temporary, if indeed of the common foods, and establisht his right at all perceptible, since fuel is being constantly to direct what a patient shall eat, and how he added to the fire.

shall eat it. Yet how may he who is himself The solution of the problem is to be sought innocent of knowledge do this? The per

plexing problem may be solved by sufficient quantity to make it laxativ. Distilled water or soft application.

water has a neutral action. Water containing much organic matter frequently provokes diarrhea. An

average sized man should drink from five to eight Diet in Chronic Constipation.

glasses daily. Sweet cider is loosening to the bowels. Cohen's System of Physiologic Therapeutics

Grape juice, if taken freely, acts similarly. Tea is an

astringent, especially when made by boiling or prohas the following good suggestions regarding longed leaching of the leaves. Tea drinking is a not the diet in constipation, and the diet is fully

uncommon cause of constipation. as important as any other part of the treatment; therefore we quote the article ver

Pneumatosis. batim:

One of the most distressing of minor sympIn order to produce peristalsis it is essential that the toms which can afflict humanity, especially if intestins contain a certain bulk of fecal matter. A diet rich in meat and eggs, and the sparing use of

the victim be a lady, is pneumatosis, or the

The vegetables, fruits, and water will produce a small noisy belching of gas from the stomach. residue of undigested matter. Therefore the intestins gas may be odorless or tasteless, or it may carry will fill very slowly to a point sufficient to provoke vigorous peristalsis. When such a diet is habitual to

with it a vile taste and a nauseating odor. It is a patient, it should be changed. Vegetables, fruits, frequently noted in neurasthenia, hysteria, and coarse breads, and water should be taken freely. These foods should contain a large amount of cellu

other neuropathic conditions, and is said to be lose, which remains undigested, fills the intestin, and

especially frequent in cases having a strong excites in it a peristaltic activity:

sexual characteristic. The condition is generThe vegetables that are most laxativ are tomatoes, spinach, Lettuce, asparagus, Spanish onions, salsify,

ally hard to relieve, simply because both patient cabbage, and celery. Spinach and tomatoes are es- and physician persistently refuse to recognize pecially prized for their effect upon the bowels. The the actual conditions. The gas which is so coarse cereals have the same reputation. Oatmeal, cornmeal, and wheaten grits are the best. Bread

noisily expelled is popularly supposed to be the made of coarse flour, such as graham, rye, corn, oats, product of fermentation in the stomach, whereand whole wheat" meal, also helps to prevent and as the truth of the matter is that it is simply air to relieve constipation. Bran bread is especially efficacious. It is made by adding bran to ordinary

that has been swallowed. Air may be aspirflour in as large proportion as is compatible with the ated into the stomach when the cardia is relaxt making of good bread. Such breads as ginger bread and Boston brown bread are also laxativ, but often

and the esophagus closed, either in consequence can not be used because they provoke gastric indi- of a negativ thoracic pressure when the vocal gestion.

cords are closed, or because the lumen of the Honey, molasses, and foods eaten with them are also reputed useful for the relief of constipation.

stomach expands and dilates under nervous inHoney has been used in all ages as a mild laxativ. Auence. Moreover, many nervous people have Many persons are sensible of the stimulation of peris- contracted the vicious habit of swallowing air, talsis that coffee produces. The addition to it of much sugar and cream will sometimes retard gastric diges

either intentionally or unconsciously, until the tion and may thus counteract its stimulating effect stomach is distended and relief by belching is upon the bowel. Fruits have a laxativ influence, partly because of

imperativ. Some of these patients, it is true, the sugar that they contain, partly because of the fruit have genuin dyspeptic symptoms; but many of acids, and sometimes because of their irritating skins them have no actual digestiv disorder. Naturand seeds. Strawberries, blackberries, raspberries, gooseberries, blueberries, currants, and grapes, are

ally, to drench them with acids, pepsins, and effectiv partly because of their seeds and partly be- digestants, is of no avail, and they become more cause of their fruit acids, or the acids which are generated in their digestion. Apples, pears, peaches,

firmly than ever convinced that they have an plums, cherries, oranges, and grapefruits are chiefly

incurable malady. When the stomach becomes purgativ because of their sugar and fruit acids. greatly distended with the air, the luckless Prunes, figs, raisins, and dates have, beside these, either a skin or seeds that act as a local irritant to the

parient often finds more trouble in getting rid intestins. Fruit produces the greatest laxativ effect

of it than she has experienced in acquiring it, when eaten alone. It is therefore best taken at bed. and there is a sense of distention, distress, and time and on rising, a half hour, or, better, an hour before breakfast. A compote with meals will do good,

dyspnea that occasionally becomes so persistent altho it is not so effectiv as fruit taken upon an empty

as to be alarming and to demand relief. If the stomach. Apple butter, date butter, marmalades, and similar preparations are often eaten upon bread or

air escapes into the intestins the torture is miticrackers.

gated for the time; belching will likewise relieve Many who are constipated fail to drink enuf fluids it. The distress may follow every meal, when either to keep the contents of the intestins soft or to form intestinal secretions as abundantly as is needful.

the patient will be firmly convinced that the This is especially true of those who lead a sedentary

trouble is altogether in deficient digestion; or life, and of women. If, upon inquiry, it is found that it may be periodical, occurring only when the enuf water is not taken, more must be prescribed. Slight constipation may often be relieved by taking a

patient is perturbed or fatigued. The condition glass of cold water the first thing in the morning. The is easily recognizable by a careful physical laxativ effect is enhanced if another is taken on retir. examination without questioning the patient, ing. The morning draught stimulates peristalsis and secretion. Under its influence the rectum is slowly provided the examiner be sufficiently tactful and filled, and a half hour or an hour later, breakfast pro- astute. A possible distention of the transverse vokes the desire to defecate. The habitual use of hard water is constipating unless magnesium and

colon must be excluded, and possible gastric sodium sulfate occur with the lime salts in sufficient

dilation and atony must also be considered ; if

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