come little else than a drummer for the surgical specialist. Such abject and absolute surrender to the specialist has injured the physician in more ways than one. The diminution of professional income has been marked, likewise the prestige; and that abiding faith and confidence which was wont to be reposed in the family. physician is now, most unhappily, a thing of the past. The signs of the times, however, point to an awakening of the profession to the evils brought about by a monopolizing specialism. The family physician is beginning to see the disadvantages, both to himself and patient, of this wholesale deference to the specialist, and in consequence thereof many physicians are now treating successfully cases which but recently would have been turned over to the gynecological surgeon for mutilating operations. In order to illustrate, in a measure, the value of local and constitutional treatment, I beg to submit the subjoined clinical notes. CASE I-A married woman, age 32. For several months had complained of dull heavy pains in abdomen and back, worse during menstrual periods. Menstruation was scanty and irregular, and there was a moderate leucorrheal discharge. She had lost flesh, was weak, had little appetite, and slept badly. A specialist, whom she had consulted, advised removal of the ovaries and tubes, as the only relief. Examination revealed ovaries tender and somewhat enlarged; also endometritis. She was ordered a hot boric injection twice daily, and put upon the following prescription: R Dioviburnia Fl. ext. cimicifuga Fl. ext. hydrastis Zij aa3ss q. s. ad živ M. Sig. Two teaspoonfuls four times a day. Under the above treatment improvement began at once, and in two months she was discharged cured. CASE 2.-A virgin, age 21, pale, anemic, nervous, and of poor muscular development. For two years menstruation had been profuse, with occasional metrorrhagia. Her principal trouble, however, was dysmenorrhea, the severity of the attacks often compelling her to resort to opiates. The following prescription was ordered, conjoined with regular and systematic exercise in the open This was continued for eight weeks, when an addition was made to the treatment in the shape of elixir iron, quinine and strychnine. An occasional saline laxative was also given to overcome a tendency to constipation. The patient has now, at the end of three months, gained sixteen pounds in weight; the rosy hue of health on her cheeks, and the menstrual function is normal. In conclusion, I wish to remark that the preparation dioviburnia contained in the above prescriptions, is one of the best uterine remedies I have ever encountered. I must confess, however, that I was prejudiced against it at first (as I am against proprietary medicines in general), but hearing it recommended by a physician of eminence and a gentleman for whom I entertain the warmest personal regard, I was lead to give it a trial. In a number of other cases besides those related here, I have had most excellent results from dioviburnia. In cases requiring an antispasmodic, I have found it of especial benefit. In some cases I prescribe it alone, but generally in combination with other remedies. BATHING THE BABY.-The bath is the most essential item in the hygiene of infancy, rightly says a writer in the November number of Archives of Pediatrics. Its proper administration is so important that instruction concerning it should always be furnished by the medical attendant. The first bath ought to be given with special care and as rapidly as possible, preferably without the tub. Lard is the best solvent for removing the vernix caseosa. When the tub is first used the child should only be rinsed in the water after careful soaping and sponging on the nurse's lap, great care being taken to avoid draughts and undue exposure. A fairly strong and healthy child needs to be bathed once daily for at least two years, the late morning being the most suitable time. Cold baths and very hot ones are alike to be avoided. The temperature ought always to be determined with the bath thermometer, the proper temperature at birth being 100° F.; during first month, 97°; from one to six months, 95°; six to twelve months, 90°; one to two years, 86°. The best grade of castile soap is fittest for infants. Soaps containing an excess of alkali are apt to lead to erythema or eczema. A dusting powder is seldom required if the skin is normal and properly dried after the bath. Talc is the best powder for this purpose, though lycopodium, pulverized rice, magnesia and starch are almost as good. Subnitrate of bismuth is an excellent application for chafing. The scalp should be cleansed daily with soap and water until the child is six months old, and then less often. Fear of the bath can be overcome by placing a sheet over the tub and gradually lowering the baby and the sheet into the water. CARDIAC FAILURE IN HIGH ALTITUDES.-The pressure of the atmosphere at sea level is equivalent to the weight of a column of mercury 760 mm. in height. Deducting 6 mm. for the pressure required to overcome the elasticity of the air cells, leaves a residue of about 754 mm. of actual air pressure upon the contiguous heart and great vessels. At an altitude of 10,000 feet (about that of Leadville) above the sea this extra-cardiac pressure is reduced to 495 mm. The blood pressure in the heart and vessels, as shown by the manometer, is practically the same at any altitude, not being diminished by increase of altitude, as is the case with the aerial pressure. It is this difference between the extra cardiac and intracardiac stress, says Dr. Frank Donaldson (Pacific Med. Jour., Oct.) that leads to stretching of the heart walls, with the consequent sudden cardiac dilatation, heart-weakness, murmurs, syncope, dyspnea, and pulmonary hemorrhage, which are often so marked in high altitudes. Of course at extreme heights the want of oxygen is an additional cause of shortness of breath. From clinical observations at various altitudes and from experiments on men and animals in pneumatic chambers, the writer has demonstrated that rarefied air produces no changes in either the frequency or depth of the respiratory act. GASTROPTOSIS.-Downward displacement of the stomach is of more common occurrence than is generally supposed, says Dr. Boardman Reed (Med. and Surg. Reporter, Oct. 3), especially among woman, in whom the deformity is mainly due to vicious modes of dress. Of 28 women examined by the writer in July and August, 21 had dislocated stomachs. In most of the cases the displacement was so far downward that the upper border of the stomach was at or near the lowest rib in the left parasternal line, and lower margin below the navel. The diagnosis was made by percussion with the patient recumbent and standing, both before and after drinking one or more glasses of water. Clapotement was also practiced for the splashing sound, and in the most difficult cases results were confirmed with the electric light inside the viscus, or by inflating the organ with air; in a number of instances corroborative evidence was secured by lavage. As a rule the gastroptosis was complicated by downward dragging of the transverse colon and of one or both kidneys. In connection with dress reform well-fitted abdominal belts are of service in these cases. The resulting constipation is best overcome by diet, massage, and exercise of the trunk muscles. In extreme cases the concomitant floating kidneys need to be anchored in place by an operation. GLYCOZONE Both Medal and Diploma Awarded to Charles Marchand's Glycozone by World's Fair of Chicago, 1893, for its powerful healing properties. This harmless remedy prevents fermentation of food in the stomach and it cures: DYSPEPSIA, GASTRITIS, ULCER OF THE STOMACH, HEART-BURN, AND ALL INFECTIOUS DISEASES OF THE ALIMENTARY TRACT. HYDROZONE IS THE STRONGEST ANTISEPTIC KNOWN. One ounce of this new Remedy is, for its Bactericide Power, equivalent to two ounces of Charles Marchand's Peroxide of Hydrogen (medicinal), which obtained the Highest Award at the World's Fair of Chicago, 1893, for Stability, Strength, Purity and Excellency. CURES DISEASES CAUSED BY GERMS: DIPHTHERIA, SORE THROAT, CATARRH, HAY FEVER, LA GRIPPE,OPEN SORES: ABSCESSES, CARBUNCLES, ULCERS,-INFECTIOUS DISEASES OF THE GENITO-URINARY ORGANS, INFLAMMATORY AND CONTAGIOUS DISEASES OF THE ALIMENTARY TRACT: TYPHOID FEVER, TYPHUS, CHOLERA, YELLOW FEVER, I WOMEN'S WEAKNESSES: WHITES, LEU CORRHOEA,-SKIN DISEASES: ECZEMA, ACNE, ETC. AVOID IMITATIONS. Glycozone is sold only in 4-oz., 8-oz., and 16-oz. bottles, bearing a yellow label, white and black letters, red and blue border, with signature. Charles Marchand's Peroxide of Hydrogen (medicinal) is put up only in 4-oz., 8-oz., and 16-oz. bottles, bearing a blue label, white letters, red and gold border, with signature. Hydrozone is put up only in small, medium and large size bottles, bearing a red label, white letters, gold and blue border, with signature. THESE REMEDIES ARE PREPARED ONLY BY Mention this publication. Charles Marchand Chemist and Graduate of the "Ecole Centrale des Arts et Manufactures de Paris" (France). Charles Marchand 28 Prince St., New York. SOLD BY LEADING DRUGGISTS. Oakland Hydrogen Dioxide is a stable, pure solution of H2 O2, made in accordance with U. S. Pharmacopeia requirements, and thoroughly reliable for all medicinal purposes. It is free from pressure upon opening bottle, retains its strength from four to six months, corked or uncorked. In DIPHTHERIA, ULCERATIVE PROCESSES, NOSE and THROAT affections, BURNS, LEUCORRHOEA, and in all cases where a non-irritating antiseptic is indicated it is of surpassing value. Sample and monograph contain ing full instructions for use, free on receipt of 15c. to repay express charges. The Oakland Chemical Co., 465 & 467 West Broadway, XVIII |