woman, and with her a weak, rickety, three-year-old child, with big head, groveling on the floor, pressing its forehead against the cool oilcloth; was clad in thick woolen overcoat and heavy "Tam O'Shanter." The child had become restless and almost convulsed at night; eyes rolling, face and fingers twitching, sweating profusely and passing urine in small quantities every ten minutes, crying with pain. I asked why the thick overcoat and heavy cap, and elicited the reply she was afraid to bring the child out without an overcoat, as it was "subject to bronchitis." I inquired if it ever received water to drink, and the mother indignantly answered in the negative, asserting it was allowed only pure milk and, being weakly, strong beef tea. I gave it half a glass of water, which was seized upon with a joyous sound and eagerly drank. When the greater part was gone I took away the glass, but the poor creature screamed for it and drained it to the last drop. The change was immediate and marked. The little one no longer groveled, sweating, restless, panting, miserable, hardly conscious of its surroundings, but sat up cheerfully and began to look around and even to talk. I took off the thick coat and cap and ordered it to be lightly clad, to be kept as cool as possible, and to have its hair cut short; also to be given a little water frequently, and to have its milk and beef-tea diluted. I saw it three days later. Though the hot weather had persisted the child was bright and well; had no more twitchings, no more convulsions, no more restless nights; micturition was no longer painful or too frequent, and there was no excessive sweating.-Arch. of Gyn., Obstetrics and Pediatrics.

THE MORTALITY AMONG RUSSIAN PHYSICIANS.-The study of the relative mortality rates of various professions is an interesting and suggestive one, and has already demonstrated the high death-rate of the medical profession and the shorter duration of life of physicians over many other classes of men.

Some interesting statistics on this subject have recently been published by M. Zelande in Wratsch. There are in Russia between 15,000 and 16,000 physicians, and during the years 1891, 1892, and 1893 a study of the mortality statistics was carried on by M. Zelande. The average mortality each year was 13.9 per cent, the total number dying in the three years being 642. In 417 of these the cause of death was not obtained, but the remaining 225 were classified.

The foremost place is filled by contagious diseases, contracted in all probability at the patient's bedside, typhus fever, diphtheria, cholera, etc., a total of 71 such cases; so that nearly a third of the physicians of Russia, the cause of whose death is recorded, fell, as it were, on the field of battle. The second place is occupied by tuberculosis, which caused the death of 15.1 per cent of the whole number of physicians dying, while in general statistics it furnishes but 11 to 13 per cent of all deaths.

Suicide is relatively very frequent among Russian physicians, reaching 8.8 per cent, and is said to be increasing every year.-Boston Medical and Surgical Journal.

SUPPURATIVE CONGENITAL CYSTS OF THE NECK IN A CHILD FOUR MONTHS OLD; OPERATION; RECOVERY.-M. Crivelli, of Paris, reports such a case. The child, a boy, presents a large, soft, and fluctuating tumor, occupying the lower part of the posterior triangle of the neck. The tumor grew so rapidly that it was aspirated twice, the third time it must have been infected, as it was followed by suppuration. When first seen by the repor ter the face was emaciated, the eyes sunken, the skin pale and wax-like, the body and limbs wasted, the pulse scarcely perceptible and very rapid, the temperature high, the skin covered with cold perspiration, and the breathing short. The child had rigors, and was unable to take nourishment, or to sleep, and in fact presented a complete example of septic infection.

The tumor was quite subcutaneous, and occupied the left posterior triangle of the neck, bounded in front by the sterno-mastoid muscle, which it overlapped and pushed to one side, and below by the clavicle and first rib. size it was almost as large as the child's head itself. The skin at the apex was red and very thin, while the base of the tumor was surrounded by a mass of edematous tissue. Extirpation of the tumor was decided upon as urgent. Ether was used. A vertical incision was made in the skin, starting from the apex of the tumor downward, about three inches in length. About six ounces of thick, greenish pus escaped, which had no odor, but contained shreds of fibrous tissue. The cyst was then dissected out, which took some very careful manipulating, as it was adherent to every thing. The patient rallied well, and had no trouble at the site of the former cyst.

DIPHTHERIA AND SPEAKING-TUBES.-An outbreak of diphtheria involving twenty-two of the working girls in a certain place of business in Hackney, England, led Dr. J. K. Warry to investigate the causes of contagion. He found that three of the girls whose work was nearest the speakingtubes, and who therefore most frequently sent and received messages, were the first to come down with the disease. The tubes were used at times by every one of the work-girls, but most frequently by these three. The large majority of the girls attacked worked in a large room at the top of the building, but a shop assistant on the ground floor, whose special duty it was to answer the speaking-tube calls from the affected room, was also found to be suffering from sore throat. Were the Klebs-Löffler bacilli transmitted along the whole length of the tube? If so, this bacillus infects at longer range through tubes than in the open.-Boston Medical and Surgical Journal.

THE SMALLPOX AMEBA.-Dr. Maximilian Herzog, of Chicago, claims to have discovered a "smallpox ameba," the presence of which in the blood on the first or second day after vaccination is the only sure test of a success ful vaccination. No matter how swollen the arm or uncomfortable the patient, the vaccination is not effective unless the "ameba" is found, the unpleasant symptoms being due to the vaccine points being loaded with croton oil, or some other irritant.-Ibid.

Special Notices.

CONSIDERABLE interest is being evinced by physicians regarding the tonic stimulant action of Kola, and it is coming to be largely used in cases of nervous exhaustion, as it combines the invigorating properties of caffeine, with the stimulating effects of theobromine and kolanin, which latter peculiar principle is claimed by some investigators to be superior to cocaine as a stimulant, without the enslaving properties of the latter alkaloid. This peculiar principle is found more abundantly in the fresh (undried) Kola nuts, and taking advantage of the knowledge of this fact, Messrs. Frederick Stearns & Company, of Detroit, Mich., have been the first to place on the market a Wine of Kola, for which they have coined the fanciful title "Kolavin" to distinguish their product from similar preparations, which in time will undoubtedly appear. "Kolavin" is a delicious aromatic tonic wine, each dose (a tablespoonful) of which contains 30 grains of the fresh (undried) Kola nuts. It is a prompt and active stimulant, and is useful in all cases where such a stimulant is needed. Samples of "Kolavin" may be obtained by addressing the manufacturers, Frederick Stearns & Company, Detroit, Mich., who are headquarters for Kola nuts in this country, having introduced the drug to the medical profession in 1881, and being the sole importers of the fresh (undried) nuts from Africa. Their Scientific Department has recently issued an elaborate monograph on Kola profusely illustrated, which is worthy of a careful perusal, and will be sent to any physician who will apply for a copy.

New RemediES.—It affords us pleasure to call the attention of our readers to the initial advertisement of Schulze-Berge & Koechl, which appears in our columns in this issue.

This firm represents in this country that well-known and extensive chemical industry, The Farbwerke vorm. Meister Lucius and Bruning, Hoechst on the Main, Germany, and they have already successfully placed before the profession such standard medicinal products as Antipyrine, Dermatol, Lanoline, and Tuberculin (Koch). They will also handle in the United States the new Diphtheria Antitoxin (Behring).

Information or descriptive literature concerning the newer remedies which they import will be cheerfully furnished when requested, and it is their invariable rule to regard all communications from physicians as strictly confidential.

CLINICAL EXPERIENCES WITH SOLUTIONS OF PYROZONE.-Dr. Geo. L. Parmele, of Hartford, Conn., says: 'For about two years I have used pyrozone, and find it indispensable. The one point alone, of its remaining active and efficient after long standing open in the office, renders it vastly superior to ordinary peroxide of hydrogen. In the treatment of alveolar abscess, pus-secreting sockets and diseased antra, I find it of inestimable value: The three per cent for cleansing the mouth, and the five per cent for cases above mentioned. I have not as yet employed the caustic twenty-fiveper-cent solution.

"The fact that I give this testimonial contrary to my usual custom, and unsolicited, will show you how highly I value pyrozone."

THE usefulness of good Hypophosphites in pulmonary and strumous affections is generally agreed upon by the profession. We commend to the notice of our readers the advertisement in this number. "Robinson's Hypophosphites," also "Robinson's Hypophosphites with Wild Cherry Bark" (this is a new combination and will be found very valuable) are elegant and uniformly active preparations; the presence in them of Quinine, Strychnine, Iron, etc., adding highly to their tonic value.

I WILL unhesitatingly say that I consider Peacock's Bromides much superior to the ordinary bromides, and the Chionia I believe to be an extremely successful preparation of a very valuable therapeutic agent. I have used both with excellent success. PLYMOUTH, MASS. JOHN J. SHAW, M. D.

Certainly it is excellent discipline for an author to feel that he must say all he has to say in the fewest possible words, or his reader is sure to skip them; and in the plainest possible words, or his reader will certainly misunderstand them. Generally, also, a downright fact may be told in a plain way; and we want downright facts at present more thân any thing else.-RUSKIN.

Original Articles.

ABUSES OF PROPRIETARY REMEDIES.*

BY H. H. ROBERTS, M. D.

In bringing this subject before the Society it is not my intention to condemn any particular manufactory or class of these remedies in either their mode of preparation or the composition of such remedies, but to be pointed on the main facts that are of interest to the physician and drug consumer.

The too common practice among physicians of prescribing proprietary remedies can not be condemned in too strong terms.

That this habit is a fixed one with many physicians is a well-known fact.

This habit or practice may result from various causes, but usually from either indolence on the part of the physician or from the smooth "silver tongue" of some representative of these patented nostrums, whose business it is to lay before the physician the many virtues contained in his particular line, and frequently the physician yields to the words of the tempter, for it is so easy, and requires such a little effort to write a prescription for a proprietary preparation.

The result of this is that it begets the habit of writing prescriptions or dispensing medicine for fixed formula, both to the detriment of the physician and patient. The vast majority of these secret and proprietary remedies are accompanied by a copious amount of literature, and

*Read at the June meeting of the Kentucky State Medical Society, 1894.

also testimonials from physicians and patients lauding the remedy to the heavens as the greatest discovery of the nineteenth century; has cured and will cure every thing from tuberculosis down. We have but to glance over the advertising pages of our leading medical journals to see to what extent this business is carried. When the physician prescribes these secret nostrums the patient pays an exorbitant price for the privilege, for these remedies are much higher in price than similar preparations of official standing, and the physician has no assurance that he knows what the patient is taking or what the result will be.

Besides the patient may not only receive no benefit from the preparation, but in many cases it may be detrimental to the health of the patient, for one of the most severe cases of salivation I ever saw was from the administration of one of the well-known proprietary remedies.

In many cases I believe that, granting that the manufacturers incorporate all the ingredients in the given formula, they so change its composition in producing the beauty of color and making it pleasant for the palate that the drugs are either so modified or chemically changed that their physiological action is almost nil.

This may not only be injurious from the change in the drugs, but greater harm and possibly neglect may result from the remedies being used in cases where the formula seemed indicated. Every time a physician so far forgets himself as to prescribe a proprietary remedy he jeopardizes his own reputation and in some cases possibly the life of his patient.

Another great wrong and injustice which is steadily growing is the prescribing pharmacist. I believe the proprietary remedy manufactories are largely to blame for this.

The first thing they do is to make a thorough canvass of all the physicians in the county, leaving samples, literature, etc. Then the pharmacist is the next victim; he is stocked with a gross or less of the remedy to get rid of as best he can.

All the semi-secret remedies have large, plain directions accompanying the preparations, giving doses, and the diseases for which the remedy is said to be indicated, consequently it is very easy to dispense them. The profession is brought into disrepute by the use of these remedies, and the manufacturers of such remedies feel that they are one of the prime factors for the physician's success. If the remedy is successful, who gets the credit for its virtue? Certainly not the physician who has spent hours of toil to equip himself for the labor in this noble work of