This sad increase in the mortality induced the hospital to return to the serum, which was then procured from Höchst. Immediately there was a change:

In the first week, cured 3; deaths, 2 children.

The total figures were as follows: In the whole space of time 533 cases were treated-303 with the serum, 230 without. The former had 13.2 deaths; the latter, 47.8 deaths. Virchow continued, that, in view of these results, he held it to be the duty of every doctor to use the serum in diphtheria. "All theoretical considerations," he added, "must give way to the brute force of these figures." He continued, that even if disagreeable by-effects were proved to occur here and there, they were not sufficient to dissuade him from continuing the treatment.

This would seem to be a trumpet of no uncertain sound; but the price of the music must go down if anybody but the rich are to dance to the measure.

Notes and Queries.

"BORISM: OR THE TOXIC EFFECTS OF BORAX.-Féré (Sem. Méd.) having given borax a six years' trial, in all doses, in epilepsy, finds it far infe rior to bromide of potassium in efficacy, and far more dangerous in its toxic effects. Gowers noted the diarrhea, nausea, and vomiting caused even by small doses, and accused it of causing psoriasis. In France early attention was drawn to the digestive troubles and eczema induced by it. The intestinal toxic effects are the most frequent and the earliest. Occasionally absolute intolerance exists, nausea and vomiting occurring after the first dose. More often, after a few doses, there are loss of appetite, sensations of weight and heat at the epigastrium, with ensuing nausea, pains in the temples, and vomiting. Administration in glycerine instead of aqueous solution or intestinal antisepsis may remove these effects. Borax determines a peculiar dryness of skin and mucous membranes. The lips and tongue are reddened and denuded of epithelium. The lips and angles of the mouth are fissured, the conjunctivæ injected. The lack of fatty matter in the skin secretion is shown by Arnozan's method. Finely powdered camphor is placed on water, into which is plunged a glass rod previously held in contact with the skin. The camphor particles cease to gyrate if fat be present. No such reaction occurs in "borism." The skin loses its fat in a deter

mined order, naturally sebaceous parts, such as the face, the alæ of the nose, being the last affected by borax. Conversely, the fat reappears first in these parts on the stoppage of the drug. The skin dryness, even without an eruption, often coincides with a dryness of the hair, which falls out. Hence an alopecia of the scalp, which is general. Sometimes even the beard, eyebrows, axillæ, and pubes are stripped. Constitutional skin rashes may be rekindled by borax, but more special to it are (1) an eczema, like seborrheic eczema, but varied. (a) Papules or small circles, with red and squamous border, which, enlarging, fuse together, forming more or less extended, often symmetrical, plaques. This variety begins in least sebaceous parts, the hypogastrium, lateral regions of trunk, etc. Or (b) eruption of seborrheic acne, with slight desquamation of the scalp, with or without alopecia. These forms usually improve under intestinal antisepsis or local treatment without stoppage of the drug. (c) Pink or red, more or less confluent, plaques, giving the skin a uniform tint, with fine desquamations, deserving the epithet "scarlatiniform." (2) Papular eruptions of variable extent, confluent or not, with pruritus, and followed sometimes by fine branny, sometimes by large flaky, desquamation. Sometimes with the papules are petechiæ. Cachexia, emaciation, edema of face and extremities are often present with these generalized eruptions. Or there may be cachexia without cutaneous lesions, the nails being deeply furrowed transversely, as after fevers. Furuncular outbreaks may occur as accidents of cachexia. A line on the gums, similar to the lead line, is probably microbic. In two patients large, painful, symmetrical "myosites" of the sterno-mastoid muscles were present, with slight rise of temperature; this condition lasted fifteen to twenty days. Lastly, separate swellings of eyelids, or face, or extremities, may occur without any other symptom. The urine will then be found loaded with albumen. As these manifestations may escape notice for a time, the danger is obvious. The cessation of the drug, probably owing to its tardy elimination, by no means always arrests the kidney trouble, as in one case of the author's, which went on to uremic coma and death. British Medical Journal.

THE MICRO-CHEMIC REACTIONS OF URINARY SEDIMENTS.-While the diagnostic significance of the staining reactions of various organic substances has received recognition in both biologic and histologic research, the application of this method of differentiation is capable of extension and elaboration. The schizomycetes, for instance, present such a close resemblance one to another that it is often quite impossible to recognize a given variety from its morphologic appearance. Some can be discriminated by their behavior when exposed to certain stains and decolorizing reagents, while the identity of others is only to be established by their appearance in cultures. Histologically we know that the body and the nucleus of a cell each reacts differently to stains; as do also healthy and diseased structures. Extending the application of the principle, we find that tube-casts in the

urine when stained behave diversely in accordance with their chemic constitution; amyloid cast, for instance, assuming a mahogany tint when treated with iodin, and a deep blue when treated with gentian-violet. An interesting contribution to the subject of the color reactions of urinary sediments has recently been made from the Pathologico-Chemic Institute of the Rudolph-Stiftung in Vienna by Grosz (Internationale klinische Rundschau), who has studied the formed elements contained in urine stained with alizarin. To a drop of urine placed on a slide he adds a drop a one-per-cent solution. of sodium alizarin sulphonate, and then covers, the examination being made after the lapse of about a minute. The sediment present is stained differently according to the reaction of its constituent elements. Thus, those of acid reaction appear yellow, those of alkaline reaction violet, and those of neutral or feebly acid reaction red. In the urine from cases of acute gonorrhea were found cylindroidal bodies of mucin, staining red, and resembling tube-casts, the likeness being increased by the presence of leucocytes and epithelial cells. Further investigation rendered it probable that these bodies (which are not visible in the unstained preparations) are derived from the glandular apparatus of the urethra, and more particularly from the glands of Littré. Other long, convoluted, and hyaline cylindrical bodies, upon which are seated isolated leucocytes and epithelial cells, and which appear in unstained preparations as structures of faint contour, are derived from the prostate gland, of disease of which their presence is suggestive. They were also found in the urine passed after coitus. In contradistinction to these urethral and prostatic structures, renal tube-casts stain intensely yellow. The presence of casts is also associated with the absence of a mucoid ground substance that stains red, and accompanies the other two. In some cases of disease of the posterior portion of the urethra leucocytes stained with violet were observed, but the number of cases was not sufficiently large to establish the diagnostic significance of the observation. The opinion is expressed that the reaction of the epithelial cells progresses from acid to alkaline, from the surface to the deeper layers; so that the reaction of the sediment in the urine will indicate the nature and seat of the morbid process in the genito-urinary tract.-Medical News.

Dissolve the citric acid and sodium salicylate in the liquor ammonii citratis. To the glycerin add the tincture of iron chloride, and then mix the two solutions, finally adding the oil of gaultheria. One or two drams of mucilage of acacia would be a valuable addition with which to emulsify the oil of gaultheria.

In this prescription reaction takes place between the ferric chloride and sodium salicylate, resulting in double decomposition, giving iron salicylate in the first solution. Care should be taken to keep the liquor ammonii citratis in slight excess, in order to have a perfectly clear solution of salicylate of iron.

Dose: One or two teaspoonfuls.

This prescription is used principally in the treatment of chronic cases of rheumatism or rheumatoid arthritis in which anemia or other evidence of impaired nutrition is a distinct feature. It is likewise employed in acute tonsillitis of rheumatic origin, and in acute articular rheumatism in anemic subjects, especially if the patient has suffered from one or more previous attacks.

The ordinary dose in chronic cases in adults is a dessertspoonful four times a day; in acute cases the same dose is given every two hours until tinnitus is produced or decided amelioration has occurred, when the dose is diminished or the intervals between doses lengthened.-S. Solis-Cohen, Phila. Polyclinic.

THE BUCCILINGUAL FRAGMENT.-For many years it has appeared to the general public that this institution, founded by a man like Ezra Cornell, and largely saved by a man like Henry W. Sage, has been conducted by and in the interests of a gigantic sporting fraternity, comprising about one fourth of all the students. Among them are good men and earnest scholars. Among them also are evidently some who accept the doctrine recently enunciated by the President of Princeton: "I appreciate scholarship as much as any one, but realize the fact that all of those who go to college do not desire to become fine scholars." From their ostensible vocation, study, they find time for numerous avocations, more or less laudable in themselves, but seldom conducive to scholarship. They are pre-eminently the patrons of inter-collegiate athletics, not so much by playing themselves as by attending games, and, until perhaps very recently, betting upon the results. They commonly have plenty of money, not often self-acquired. They contribute liberally to athletic funds; they also, however, demand that others should do the same. They clamor for aid from the antipathetic in paying the salary of a professional trainer, and in the same term spend what would pay that salary many times over for the luxury of witnessing games in distant cities. They convert the college papers into sporting gazettes. They claim to represent the institution before the public. They assume to constitute the "student body," whereas they are merely a buccilingual fragment thereof.-Prof. B. G. Wilder, of Cornell University.

BUTTER AS THE VEHICLE OF TUBERCULOUS INFECTION.-John Bright's ideal of a "free breakfast table" has pretty well been realized; what we now want is a breakfast table free from what Johnson would have called "potentialities" of disease. At present it is not advisable for persons of a timid

disposition, in sitting down to the morning meal, to consider too anxiously of the event. One may face the dangers of the tea urn, the coffee pot, and the sugar bowl with some amount of philosophy, and after all it is only the digestion that is as a rule imperiled by the arts of the adulterator. It is not pleasant, however, to think that poisons may lurk in the innocent-looking sardine, that bread may be a breeding ground for disease germs, and that there may be death even in the milk jug. Mr. Hutchinson, if we remember aright, some time ago spoke strongly in praise of butter as a safeguard against tuberculosis, but now comes M. Roth, of Zurich, who tells us that of twenty samples of butter made of cow's milk, bought in different Swiss markets, there were two which contained tubercle bacilli, and which, when inoculated in guinea-pigs, caused the development of tuberculosis in these animals. Dr. Brusa Fevro, of Turin, has made similar experiments with Italian butters with like results, that is to say, ten per cent of the samples conveyed tuberculous infection. We are not aware that experiments of the same kind have been made with English butter, or with the Brittany, Danish, and American butters so much in use, but as there seems to be no practical method of sterilizing butter known, there is no reason to believe that they are more free from tubercle bacilli than the Swiss and Italian products.-British Medical Journal.

FACIAL PARALYSIS.-The conclusions drawn from the observation of eighty cases of facial paralysis by Dr. Rudolph Hatschek are detailed in the Jahrbuch für Psychiatrie und Neurologie. A short summary of the paper appears in the Neurologisches Centralblatt. Among the eighty cases were ten in which more than one attack had occurred. Sometimes one side, sometimes both sides were affected, and more than once there were third attacks. There seemed to be no tendency for one sex to suffer more than the other, and there was no preference for one side of the face over the other. As a rule the later attack was more severe, but not invariably so. Two of the cases occurred in patients the subjects of diabetes; one occurred in a patient at the commencement of the secondary manifestations of syphilis. One case of double facial paralysis occurred in a boy eight years of age after mumps; in another patient, a lad seventeen years of age, an attack of right-sided facial paralysis succeeded to sore throat with pyrexia. It is also mentioned as an interesting fact that during an epidemic illness (apparently influenza) at Brest facial paralysis was one of the recognized symptoms.-London Lancet.

SCOPOLAMINE HYDROBROMATE IN OPHTHALMIC PRACTICE.-Scopolamine is an alkaloid which was discovered by A. Schmidt, of Marburg, in the root of scopolia atropoides, and has been employed by Dr. Raehlmann, of Dorpat, for more than two years in his ophthalmic clinic with excellent results. At first he used the hydrochlorate, but subsequently found that the hydrobromate was more easy to obtain in a pure state, and so recently