and across the Mediterranean to Castile, where for a long time it made little or no progress.

In Central Europe, now the center of medical science, no art, no science, no culture, found congenial recognition. The refinement of Hellas, of Alexandria, of Rome, was supplanted by the ignorance and barbarism of the Goths, the Vandals, the Franks, and the Lombards. Brute force swayed the destiny of Europe, and for six hundred years every obstacle was thrown in the way of progress.

Priestly arrogance enthralled and directed the thought of the world, and what little there was known of the healing art was completely under ecclesiastical influence, and the cloister became the resort of invalids and the schools of instruction. In the time of Innocent III, about the 12th century, no physician was permitted to visit a patient without first going to confessional, under the severest penalty.

Following the wake of the horrors, the oppression, and the tyranny of the middle ages, reason again triumphed in the establishment of the school of Salerno. This was followed by others, first in Italy, then France and Spain, and later in Germany. From these centers of learning bright rays of culture and science lighted the benighted world, and with increasing intelligence ecclesiasticism lost its sway. With the invention of printing, the discoveries of Gallileo and Kepler in the domain of physics, voyages of discovery and the Reformation, liberty of mind and conscience expanded, science developed, and we find to-day, after innumerable vicissitudes, the healing art an enduring structure, a monument of man's noblest ambition, and highest holiest, impulses, the perfection of which is delegated to us—its votaries.

ABORTIVE TREATMENT OF ACUTE CATARRH OF THE

NOSE AND THROAT.

BY SETH S. BISHOP, M. D., CHICAGO.

Several years ago I experimented in the treatment of acute coryza with a remedy that had proved most effective as an abortive and palliative in hay fever. The results were so eminently superior to any that were obtainable from the classic methods of torturing patients out of "a cold in the head" that I have never been approached with the ancient opprobrium, "A doctor can't cure a common cold.”

In a recent number of the "Journal of the American Medical Association," a writer states that acute nasal catarrh can be aborted in from two to four days. We can do much better than that. We can limit ordinary attacks to a few hours, and severe attacks to a day or two, and so far as actual suffering is concerned, we reduce it to a minimum within an hour. Further than that, instead of putting patients to bed, drenching them with hot drinks and the debilitating sweating ordeal, we can cut short the attack without inconveniencing patients to the extent of interfering with their work.

The treatment is the same that I recommended in a paper in 1887, as follows:

Better than all other drugs, in my experience, has been a combination of morphia and atropia-easily divisible compressed tablets. Not more gratifying results could be reported from palliative treatment than I have obtained from this. For several years past I have rarely employed morphine in my practice without administering atropia with it, believing that the antidote should go with the poison. The relative proportions that have proved so satisfactory are 1-100 grain of atropia to 1⁄2 grain of morphia, in divided doses. A large proportion of atropia given repeatedly is likely to cause a temporary dimness of vision. If carefully adapted to any given case, I do not believe one need fail to prevent an attack or modify one already begun. Where I have been able to administer the remedy myself in the early stages of hay fever, or of acute nasal catarrh, I have never failed to prevent the development of an attack, or at least materially abridge it. If the impending attack is a light one, 1-16 or % grain of the morphia should be given at the first premonition. If the symptoms disappear, that suffices. If they return after a few hours the dose should be repeated, and in this way the paroxysms should be entirely prevented. If the threatening attack promises to be a severe

one, I give 1-6 or 14 grain of morphia, with atropia always, and I have found it necessary in a profound seizure to give 1⁄2 grain before the trouble could be subdued. Minimum doses may be better as a rule, but in this malady the reverse is often true. Where a small dose may not prevent suffering, a little larger one, to produce a decided impression on the nerves, may be completely successful. Those who are conversant with the physiological action of these drugs will readily appreciate how perfectly this remedy meets all the indications for treatment. It relieves excitability or over-susceptibility, and arrests the flux.

If these rules are observed in administering these remedies, and the preparation is reliable and accurate, we can produce similar results in acute nasal catarrh. I do not say the same results, because we have a factor in one that is absent in the other disease. In veritable catarrh there is an incipient inflammation, while in hay fever, even when uninfluenced by treatment, the tissue changes and products of inflammation are absent. The one is an inflammatory catarrh; the other is a nervous catarrh. But in the initial stages of acute catarrh the conditions that obtain are similar to those characterizing hay fever. There is loss of power of the inhibitory vaso-motor nerves, distension of blood vessels, transudation of serum, decrease, and later, increased activity of muciparous follicles, hyperesthesia of the end organs of the sensory nerves, swelling of erectile turbinate tissue, stricture of nasal passages, sneezing, lachrymation and exalted sensitiveness of the surface of the body to cold, etc. During this stage, which appears to be identical with hay fever, and before the tissue changes of inflammation occur, the treatment that succeeds best in hay fever succeeds best here. The treatment should be abortive. It should be preventive, in that it should arrest the progress of the attack before it reaches a stage of actual inflammation. That it can do this is proven by analogy and by fact. In hay fever we have all the apparent features of an incipient inflammation—that is, irritation followed by congestion, but terminating in resolution before any destruction of tissue occurs. This treatment has demonstrated its reliability in preventing the development of threatening attacks of hay fever, and in arresting attacks after they have set in. Reasoning from the analogous conditions presented in the two diseases, I was led to adopt the hay fever treatment in the acute coryza occurring in patients who were not hay fever subjects, and found that during the dry and nervous stages of the disease it possessed advantages vastly superior to any other treatment I had ever used, and I have tried nearly everything prescribed by good authority from Hippocrates down to Davis.

Three important points must be observed in order to be successful with this or any other abortive treatment. First, the remedy must be administered early enough; second, the dose must be sufficient; and lastly, the preparation of the remedy must be accurate and reliable. I give it like a pill, and find it best to use the same tablet continuously in practice. The one containing 1⁄2 grain of morphia and 1-100 grain of atropia sulphate is the most convenient. It can be easily subdivided into halves, quarters, or eighths with a penknife, or into the minutest possible doses for children, by dissolving one, or a fraction of one, in any desired number of teaspoonfuls of water. In this way it is as easy to give with precision 1-50 or 1-100 grain of morphia as it is to give a larger amount. Children being more frequently subject to visitations of coryza than adults, whose powers of resistance are greater, we need a remedy that combines positive success with ease of administration and absolute nicety of dosage. In this one we have these requisites. With the utmost facility we may cut short a distressingly severe attack of acute coryza even in a little child, by giving a minute portion of this tablet dissolved in a little sweetened or flavored water, which will be taken through a tube and rubber nipple used for milk feeding. I have often prevented a siege of inflammation of the nose, and perhaps of the throat, by giving 1-20, or 1-40, or 1-60 of a grain of the morphia in this way. We can do more than prevent suffering from inflammation of the nose and throat by this means, for who can say that an inflammation once established in the upper respiratory tract will not invade the ear or larynx, the bronchial tubes or lungs?

Let us look at one case out of many, illustrative of the rapidity with which the remedy produces the most gratifying results. An opera singer visited my office, and I found her suffering with acute naso-pharyngeal catarrh and irritation of the vocal cords. Immediately I administered % of one of these tablets, representing 1-16 grain of morphia and a proportionate amount of atropia. I gave her several eighths of the tablet also, to take with her to use if occasion should require. She reported on the following day that she was well. The first dose stopped the nasal discharge and sneezing within an hour, and opened the nasal passages so that she could breathe easily through them. At the afternoon rehearsal she felt some irritation of the nose and larynx, but she took another dose which relieved her completely, and in the evening she was able to sing, without any inconvenience, to the end of the opera. S did not experience any of the hoarseness that characterizes the effects of

morphine on some individuals. She had no further trouble for several days, when she had another attack. One dose of the same medicine stopped it at once, and she had no other attack during the stay of her company in Chicago. Of course I did not tell her, nor do I inform any patient as to the composition of the tablet, in order to avoid the possibility of a habit being formed.

I have not mentioned the question of local treatment, for that may not be required if you attack the disease early enough. If the attack is advanced, or severe enough to call for topical applications, a spray of liquid vaseline alone, or in combination with five or ten per cent. of oil of eucalyptus or oil of tar, will very materially aid in protecting, soothing and healing the membrane. I am of the opinion that we should follow closely the methods of skin treatment in medicating the nose and throat. In the various forms of eczema we find ointments - soothing, astringent and gently stimulating, to be the most corrective. So with mucous membranes when inflamed, the most grateful medicaments are of an oleaginous nature. They remain longer in contact with the diseased surface, and afford the medicine a much more favorable opportunity for action and protection. If the throat is invaded, the officinal preparation of glycerine and tannic acid, thoroughly applied every two or four hours, will allay the inflammation more promptly than other remedies. Spray of liquid vaseline, combined as mentioned, for the nose, are excellent, but while the Schneiderian membrane will not tolerate the glycerin and tannin, the throat is much better affected by it than by any other application. I have found that the glycerole of tannin can be projected in the form of a fine spray by the De Vilbiss atomizer if you heat the cup containing it and the tubes too. -Med. Standard.

On the 2d of October the corner stone of the New York Academy of Medicine was laid. Dr. A. Jacobi delivered the address, in which he recounted the struggles of the Academy, and made an eloquent appeal for the support of an institution, which had done so much for the people of New York. He urged the people to be wary in their selection of medical attendants. People should not choose a physician because he is an agreeable companion in the theater or club, but with a view to his capacity for protecting the family against disease. The corner stone was placed in position by Dr. Loomis. The new building will be five stories high, of modified Romanesque style. Its front will be composed of finegrained red sandstone and brick. The library will have a capacity of 250,000 volumes.