more chloroform is given and the index finger introduced into the vault and any remnants of the growth broken down and scraped If any portion of the growth resists the finger it is removed by means of the forceps. Dr. Lenox Brown, of London, frequently removes these growths with the finger alone, without the aid of instruments and frequently without an anesthetic, but I am convinced that the more humane and thorough method is the one that I have described. This condition is one that is very frequently observed by the general practitioner and is often attributed to enlarged tonsils; these are removed without benefit and the case frequently abandoned. No benefit is derived because the obstruction in the vault still remains after the removal of the faucial tonsils just as before. On the other hand when this growth is thoroughly removed there is no operation that is more satisfactory, and the benefit derived is often remarkable. The Weaning of Infants.-Under the caption of the "Management of Infant Feeding," (Pediatrics, July 15, 1896), Dr. Louis Fischer speaks thus on this highly important subject: "When a child reaches the age of six months, it is well to think of weaning. I have very successfully tried gradual or partial weaning. This consists in giving at the age of six months one handfeeding of six to eight ounces during the twenty-four hours. It is to consist of cow's milk three ounces, and if the bowels are regular, three ounces of barley gruel, made 'water, and about ten-fifteenths grain of ordinary table salt and one-half lump of cane sugar. "Each month following the sixth month we can withdraw one breast-feeding and in its place substitute an artificial feeding, so that by the ninth month the infant is weaned. Unless it be midsummer, or on account of some special condition, complete weaning should take place about the tenth month. In addition to giving a bottle in the method of partial or gradual weaning, a small piece of crust of bread or zwieback can be added to the dietary, besides a little thin beef soup or expressed meat juice." He says further that if the increase in weight does not amount to five or six ounces weekly, it is advisable to make a careful chemical and microscopic examination of the breast milk. The state medical board of Ohio does not recognize foreign diplomas. THE DENVER MEDICAL TIMES THOMAS H. HAWKINS, A. M., M. D., WESLEY T. SUNLEY, COLLABORATORS: Henry O. Marcy, M. D., Boston. Editor and Publisher. S. H. Pinkerton, M. D., Salt Lake City. Bradford Galloway, M. D., Leadville, Colo. G. Law, M. D., Greeley, Colo. SUBSCRIPTION $2.00 per year, in advance; Single Copies 20 CENTS. Address all communications, whether as to business or for the editor to 1740 Welton Street. We will at all times be glad to give space to well written articles or items of interest to the profession. Entered at the Postoffice of Denver, Colorado, as mail matter of the second class. Editorial Department. Changes in the Urine From Food and Medicine. For an accurate understanding of the diagnostic data furnished by the urine, a knowledge of the alterations induced in this excretion by drugs and diet is absolutely necessary. Many a mother has been frightened badly at the supposed occurrence of a urinary hemorrhage, because the attending physician did not inform her that the worm medicine given the child might make its water look like blood. Many a hale man, possibly, has been rejected for life insurance because the examiner mistook a precipitate due to balsam of copaiba for a cloud of albumin. The color of acid urine is apt to be brown, of alkaline urine red, after the ingestion of the foliowing foods and chemicals: bects rhubarb, senna, logwood and madder. Santonin and chrysophanic acid each color the urine, if acid, a bright yellow, turning crimson with alkaline decomposition. Gallic or tannic acid gives a dark hue; salicylic acid. in large doses, green. Coal tar and its compounds, carbolic acid, creasote, resorcin and other phenylic deri vatives may impart to the urine a deep greenish-yellow tinge turning black as the latter becomes alkaline. This striking appearance is due to the decomposition of the phenols into hydroquinon and pyrocatechin, either of which when taken internally produces the same effect on the urine, as does also the inhalation of arseniuretted hydrogen. The natural aromatic odor of normal urine is intensified by a vegetable diet, particularly by asparagus, cabbage, garlic, parsnips, radishes and spices. Many drugs impart their peculiar odor to the urine; among the most common of these are cubebs, copaiba, sandal oil, saffron, tolu, valerian and asafetida. The administration of oil of turpentine yields the aroma of violets. The reaction of human urine is normally acid. On an exclusive vegetable diet it is generally neutral or alkaline, owing principally to the large proportion of contained carbonates of sodium and potassium. The consumption of fruit causes a marked reduction in urinary acidity, the malates, tartrates, citrates and other organic acid salts of the fruits being oxidized into carbonates in the blood. These organic salts of potassium and lithium, as well as the carbonates of the same metals, are much used to render the urine neutral and thereby iess irritating to inflamed urinary passages. The antiseptic organic acids, as benzoic and salicylic, raise the acidity of the urine and retard ammoniacal decomposition within or external to the body. In regard to the quantity of urine, it is universally known that this may be increased by certain drugs, called diuretics, which act in one or two of three ways: 1. By raising the general blood pressure; calomel and digitalis are examples. 2. By increasing the blood supply of the kidneys through dilatation of the renal vessels: ethers and alcoholics act in this way. 3. By stimulating the epithelial cells of the renal parenchyma; the potassium salts and the oleo-resins have this effect. Diminution or suspension of the urinary excretion may be induced by large doses of morphine, ergot or digitalis, the depression of function in such cases being due to reduction of circulatory force or to vasomotor irritation and contraction of arterioles, or to both factors combined. Purgatives as a class lessen the amount of water passed by the kidneys; the diminution is most marked with the saline evacuants. In conclusion, let us repeat a few facts concerning common errors in making urinary chemical tests. As already remarked, oleoresins and balsams (copaiba, sandal oil, turpentine and its derivatives) taken as medicines often give a yellowish zone at the circle of contact between the nitric acid and the urine in the cold test for albumin. From a ring of albumin, however, this cloud can be easily distinguished by its solubility in alcohol. Concerning the test. for glucose, many organic medicaments (chloral, chloroform, turpentine, glycerin, salicylic acid, etc.) give rise to urinary ingredi ents which reduce copper solutions to a less or greater degree on prolonged boiling. The phenylhydrazin hydrochlorate test will differentiate all these reagents from dextrose. Sulphur (or albumin which contains it) gives a black precipitate with Boettger's bismuth test for glucose, and hence must be excluded as a factor if this method be used. Bullous Quinine Dermatitis.-The occasional occurrence of drug eruptions in susceptible subjects should always be borne in mind. in determining the origin of any given instance of skin disorder. Illustrative of this principle is a case described by Dr. James C. Johnston in the July number of the Journal of Cutaneous and GenitoUrinary Diseases. The patient, a middle aged German, had taken two doses of fifteen drops each of compound tincture of cinchona in a tonic mixture. Two days later he came to the hospital complaining of intolerable pruritis, with beginning vesiculation of the face. The whole surface of his body was covered with a scarlatiniform rash; the mucous membranes were not affected at any time. In two days after this many of the vesicles had become bullae, particularly on the palms and soles. About half a pint of serum was taken from the larger lesions. Exudation continued for several days, complete repair not taking place until five or six weeks. The treatment in the early stage consisted in the use of astringent lotions of calamine and zinc and black wash; diachylon and zinc ointments were applied after the bullae had disappeared. The same patient suffered in the previous year from a vesicular eruption occasioned by the ingestion of a couple of two-grain quinine pills. The Lingual Tonsils.-Dr. Edwin R. Lewis writes an interesting account of these lymphoid masses and the disorders they produce, (in the first number of the Laryngoscope). The frequent derangements of the lingual tonsil, he thinks, makes a diagnosis of obscure conditions incomplete without an examination of this structure. Inspection is easily performed, the patient drawing on the tips of his protruded tongue while the physician introduces a large hand mirror. One or both lymphoid masses may be enlarged, particularly in middle-aged persons who are subject to rheumatism, constipation or menstrual derangements. The outer layers of the mass are not uncommonly threaded with tortuous veins, which, bursting, might easily lead to the erroneous diagnosis of pulmonary hemorrhage. The tip of the epiglottis is sometimes caught in the nodules, giving rise to an irritating and troublesome cough. Another prominent symptom often present in hypertrophied faucial tonsil is a sense of "fullness and tightness," or a "scratchy" feeling in the throat, suggestive of hysteria. Concerning treatment, any distinct enlargement requires the use of the snare or the cautery; removal with the tonsillotome is seldom advisable. should be remembered that surgical measures are more likely to be followed by serious hemorrhage in elderly people than in children. Constitutional remedies are demanded as a rule. The writer recommends as beneficial in all and curative in many cases the local application of iodine, ten to thirty grains dissolved in an ounce of glycerine with the aid of potassium iodide. The liquid is applied thoroughly to the engorged tissue by means of an Elsberg applicacator and absorbent cotton. Care should be taken not to permit any of the fluid to run down into the larynx. Even for operative cases this local treatment is a good preparatory procedure. The Medical Treatment of Acute Pelvic Peritonitis.-Dr. J. M. Baldy, in the Medical and Surgical Reporter, July 4, 1896, outlines a practical course of treatment of this disorder for the general practitioner. The principal indications are rest, depletion and relief of pain. The patient must be put to bed and kept there. Sexual rest should be strictly enjoined in the stage of convalescence, and particularly at the menstrual periods. The saline cathartics are generally the most effective depletory agents, although scarification or leeching of the cervix uteri is sometimes followed by great relief. A teaspoonful of magnesium sulphate should be given hourly until six or more watery evacuations are produced. Not seldom in mild cases all the symptoms subside after this free purgation. If the epsom salts are not retained in the stomach give calomel in grain doses six times hourly, followed, if possible, by one or two doses of the salts, and an enema of hot soapsuds. In a true inflammatory attack the purgatives will probably augment the pain for a time, but the patient should be admonished to submit to it until the bowels move freely, when it will most frequently disappear of itself. If, however, the suffering is too great to bear, a hypodermic of morphine, one-sixth to one-fourth grain, may be used. The after treatment consists in hot vaginal douches (105° to 110°) twice daily, a gallon at a time, with the patient flat on her back. If the water is merely warm and in small quantity, the douching will increase the congestion and do only harm. Blisters, mustard plasters and poultices, says the writer, have little if any physical effect, but are innocuous. The diet should be regulated |