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The ulcerative form is much larger, and exhibits more marked induration.

The clinical history of chancre in this region is the same as that observed in its ordinary seat. There is a tendency to rapid, spontaneous healing. The treatment should consist in emollient washes and mild astringent antiseptic lotions, the applications being frequently repeated, supplemented by the occasional application of nitrate of silver. Resolution is rapidly accomplished.

Fournier classifies the secondary eruptions as humid or dry; the latter, though not rare, having been rarely described.

The humid syphilides are those most frequently observed: of these the mucous patch is the type. They may be erosive, papulohypertrophic or ulcerative. They may involve any portion of the tongue, though more commonly they are found on its anterior half.. The erosive type develops in the great majority of syphilitics, and is subject to frequent recurrences. Lesions of this type may be dark red, or may be characterized by a gray or diphtheroid appearance. Their smooth surface forms a marked contrast to the villous aspect of the normal mucous membrane. They may be single or multiple; in the latter case they may involve extensive areas. Upon the sides of the tongue they may take the form of fissures or rhagades, forming small lesions perpendicular to the long axis of this organ. Though these lesions are, in so far as their local action is concerned, of trifling importance, as indicating an actively contagious stage of the disease their recognition is a matter of very serious import. Fournier insists upon the fact that these secondary erosions have absolutely no specific characteristics, and that there is not a single sign which will enable the physician to differentiate a mucous patch from an ordinary lesion such as that, for example, which occurs in aphtha As another point of great importance, he states that these lesions. may be exceedingly minute, at times not larger than the head of a pin, that they may lose their customary color and that their recognition may be a matter of very great difficulty even where a careful examination is made. It is essential that these minute lesions should be recognized since, if present, they indicate the possibility of contagion.

The papular type of eruption is rarely found on the tongue. Its manifestations are the same here as in other regions of the body. At times the papules assume the diphtheroid aspect common in the

syphilitic eruptions of the mucous membrane. Left to themselves they may become hyperthrophied, giving to the tongue a peculiar aspect which has been called "the toad-back tongue." The ulcerative type is in no way characteristic, and a diagnosis based upon these lesions alone is impossible.

The dry syphilides form small patches upon the tongue which are readily recognized by their smooth shining appearance, due to the disappearance of the papillæ. These lesions cannot be clearly seen until the tongue has been dried by means of a towel or other soft absorbing material. The surface of the smooth syphilide is then found to be absolutely dry and does not change color when it is touched. with nitrate of silver. There is no trace of erosion.

This form of syphilitic glossitis is peculiar in the fact that it does not correspond with any period in the development of the disease. It is sometimes seen a few months after the secondary eruption; at other times does not appear for years.

Syphilides of the tongue are readily confounded with other lesions of this organ. Fournier, however, calls attention to one eruption which has hitherto not been noticed by syphilographers, and which has been the cause of much misdirected therapeusis. He states that there is among syphilitics a recurrent herpes of the mouth characterized by small, smooth erosions, and identical in appearance with the mucous patches. These lesions commonly appear some years after a methodical course of treatment which has apparently eradicated the disease. Full doses of anti-syphilitics are absolutely without effect. After some days they spontaneously disappear, to occur again at varying intervals, and these recurrences may persist for

years.

This form of eruption is strictly analogous to the recurrent genital herpes described by Doyan. It is frequently encountered among those who have undergone prolonged treatment. Since it is absolutely independent of the original syphilitic poison, and since it is distinctly aggravated by all forms of irritation, its recognition is very important, as otherwise a treatment not merely futile, but positively hurtful, will probably be prescribed.

Again, should a patient with such a lesion consult a physician in regard to marriage, a mistaken diagnosis would lead to unnecessary suffering, since this eruption is absolutely non-contagious and in of fensive.-Univ. Med. Mag.

A NEW METHOD OF IRRIGATING THE NOSE.-(Dr. Pins, of Vienna).-Among all the methods employed for nasal irrigation there is not a single one absolutely free from objection. Most frequently the danger consists in the fluid finding its way into neighboring cavities (sinus, Eustachian tubes, etc.), which entails the temporary suspension of the treatment, and at times causes an extension of the lesions. I have sought, therefore, for some better mode of procedure. I use a bottle of moderate size, into which I dip two glass tubes. The first reaches the bottom of the vessel, the second terminates a little above the surface of the contained liquid. To the first is attached a rubber tube, terminating in a mouth-piece, which the patient holds firmly between his lips. To the second is attached another rubber tube, terminating in an olive-shaped extremity, which is introduced into one of the nasal fossæ. The patient then makes a forced expiration, which on the one hand brings about a complete closure of the posterior nasal fossæ, and on the other forces into the nasal cavity the liquid contained in the vessel. The fluid makes its exit by the other nasal opening. The stronger the expiration force the more complete is the occlusion of the posterior fossæ; the pressure of the fluid can thus do no harm. I have tried this method in thirty cases, and have been very well satisfied with it. The only contra-indications depend on the presence of serious disease of the heart vessels, or of the lungs.-Can. Pract.

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Give the patient a light supper and in the morning a full dose of Rochelle salts and let him fast until afternoon; then give all the worm mixture, having him lie down after taking and resist any tendency to vomit, which is slight. One drachm of tr. card. co., renders it less disagreeable to take.

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IS CONSUMPTION CONTAGIOUS?—At the recent meeting in this city (April 25-26) of the Ohio State Board of Health and Superintendents of Public Schools, no more interesting topic was discussed than the one entitled "Should a Person with Consumption be Allowed to Teach School?" In the debate, one physician-a member of the Board of Health, too-said he would not only exclude the consumptive teacher, but "I would also exclude every child from the school room, who has a cough with free expectoration." To such rabid extremists we offer in this issue two excellent and scholarly articles, and bespeak their careful perusal.

The writer was present at that meeting, and took part in the debate; and his remarks, as taken down by the stenographer, and which we believe express the sentiments of the great mass of thinking and observing physicians, were as follows:

I do not think that the profession has agreed that consumption is contagious in the ordinary sense of the word. That chickens, fed on the sputa of a consumptive person, have died of consumption is, I presume, beyond question; but that a healthy individual, brought into contact with a consumptive in the ordinary manner, will acquire consumption, I do not believe. I can easily believe that a wife, waiting on her husband, shut up in the same room with him at night,. emptying the spittoon, and washing the clothes, may, perhaps, sometimes acquire consumption. Now, I use these words advisedly, because during the sixteen years that I have watched this thing, I have found a great many women thus exposed who have not died of consumption. I remember once a physician called my attention to a case just like the one I have given-a wife whose husband died of consumption after five or six years of sickness. When he died the

doctor remarked that she would die within a year. That was five or six years ago, and she is yet alive and well. That was one case, but I have been acquainted with a number of others, where exposure was almost constant, and still they did not acquire consumption. I think that the profession has gone to a decided extreme in this matter. It is a new matter. We never thought of consumption as contagious until Koch discovered his germ of consumption. The contagion is confined almost exclusively to the sputum itself, so that I hope that our State Board of Health and our school boards will wait a number of years before they decide to turn out their pupils or teachers who have consumption. I would protest against it.

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Small-pox is contagious, because a healthy individual brought into contact with the spores of small-pox will take small-pox, but it is not so with consumption. Let a man have the ordinary amount of exercise, and subject him, in the ordinary intercourse of life, to the expectorations of a consumptive, and he will not acquire consumption.

The ever progressive house of Parke, Davis & Co., are out this month with some reasonable suggestions as to eligible remedies for prevalent diseases of hot weather.

They have a very convenient list of intestinal sedatives, antiseptics, antispasmodics, and anodynes, for diarrheal and dysenterie affections; some new expectorants of note for coughs and colds, and a normal liquid ipecac, always reliable, as an emetic in cases of gastric disturbances, due to accumulated fermented food, so frequently a cause of infantile diarrhea.

By way of gossip, we may state that this house is largely increasing its facilities for the manufacture of pharmaceuticals. Buildings now in process of erection, will double their capacity for production this year, and a new laboratory, very complete in its appointments, is now being built for them in Canada.

THE Ohio State Medical Society held its annual meeting in Columbus, on June 4th, 5th, and 6th. The following officers were elected: President, W. J. Conklin, of Dayton. Vice Presidents, D. N. Kinsman, of Columbus; B. L. Millikin, of Cleveland; D. J. Snyder, of Scio; Orpheus Everts, of College Hill. Secretary, G. A. Collamore, of Toledo; Assistant Secretary, S. A. Spence, of New Philadelphia; Treasurer, T. W. Jones, of Columbus.

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