institution is physical culture and hydrotherapy. In the application of the former, patients are divided into classes and made to drill and exercise regularly so many times a week in a systematic manner adapted to their condition. A special teacher of physical culture gives his entire time to this work. Measurements are taken of the capacity of the lungs, the muscular strength, also of the heart's action, weight and shape of the body, and records are kept showing the changes and improvements which follow. The tables indicating the net gains in physical vigor and improved health following this exercise are very significant. At the close of the physical culture exercises, each patient is given a warm or cold shower bath, depending upon his condition, which is regulated by the teacher of physical culture. The baths are very elaborate and modern in all the details, and are well adapted to give new vigor and produce a powerful remedial action on the body. Both Russian and Turkish baths are freely used and few, if any, institutions in the country have more complete hydropathic means and measures for successful application of a remedy that is too much neglected in neurotic and other diseases. These two remedial measures, physical culture and baths, are the most advanced and promising means of treatment known up to the present time for neurotics of this class. Notwithstanding the supposed incurability of such persons, the statistics of those who have been under treatment here show a number of recoveries, and in the future, when more curable cases are admitted, this percentage will increase rapidly. The Foxboro Hospital has been for a long time the center of much criticism, but fortunately this is decreasing. The management has been continuously embarrassed by an ignorant public sentiment, who expected them to treat the most incurable of all cases on the most economical scale and to the satisfaction of all persons. The delusion that the inebriate was simply vicious and suffering from moral disease within his control has made the public very uncharitable in their criticisms. Now that the fact is being recognized that inebriety is a disease and curable as other diseases are, the management of the hospital can concentrate their efforts in the solution of the problems of treatment rather than in continuous efforts to educate

the public. After looking over the buildings and the patients and the measures adopted to help them, our association expressed a unanimous sentiment that this institution in facilities, surroundings and conception of the work was a credit to both its managers and the State of Massachusetts. Plans for the organization of similar institutions in at least two States are being perfected and will no doubt be established in the near future. The asylums at Binghamton and Fort Hamilton attempted to solve the problem in the care and treatment of the wealthy inebriate. They failed from political interference. The hospital at Foxboro, beginning with the pauper and indigent spirit drinkers, is going to succeed and prove what a few private asylums have been so long urging, namely, that the inebriate could be scienentifically, practically and economically treated and restored. This must be done in a hospital where the management can be independent and free from the criticisms of patients and their friends, and above all, political influence for position and gain.-Quarterly Journal of Inebriety.

The Diagnosis of Enteric Fever.

The difficulties that surround the diagnosis of typical enteric fever are manifold. Sooner or later the most careful practitioner is certain to find himself cast upon that particular rock which lies ahead of the medical pilot. Various tubercular conditions often closely simulate typhoid fever, and should be carefully excluded from all doubtful cases. Tubercular meningitis and acute miliary tuberculosis are often extremely difficult to differentiate, more especially the latter when complicated with tuberculosis of the intestines, with attendant diarrhea and swollen abdomen. Even the more chronic condition of tuberculous peritonitis may resemble typhoid fever so nearly as to lead to confusion between the two affections. Perhaps the most common source of evil is to mistake enteric fever for primary pneumonia. The latter malady, when of the extreme type, may be difficult to distinguish. As a complication of enteric fever, it occurs in the later stages. The symptoms accompanying appendicitis and perityphlitis often suggest typhoid fever, but the two affections can usually be distinguished by a due consideration of the local signs and symp

toms. In its early stages the bowel fever is often mistaken for influenza. Ulcerative endocarditis and pyemia are occasional pitfalls, especially when the former causes intestinal hemorrhage from embolism. The intermittent malarial fevers are sometimes very difficult to distinguish from typhoid. Unfortunately Widal's serum test is not invariably positive in its results. It nevertheless offers valuable evidence after the seventh to the twentieth day of the fever, and should be repeated several times where results are negative. A full recognition of the risk of overlooking typhoid fever is perhaps the greatest safeguard against error that can be placed in the hands of the medical practitioner. -Med. Press and Circular.

Smallpox and Chickenpox.

A writer in the Lancet, referring to the prevalence of smallpox in London, and the difficulty sometimes in mild cases of differentiating between this disease and chickenpox calls attention to a well-known method by which the object can be attained. The vesicles in chickenpox are unilocular, while in smallpox they are multilocular, the practical result of this pathological fact being that, if a chickenpox vesicle be pricked with a needle, its contents can be completely evacuated, and the cell will collapse; whereas in smallpox, if you make twenty pricks with a needle, the vesicle will not collapse, because, being multilocular, it is impossible to empty it.-Med. Times.

A REPORT OF TWO CASES OF SEPTICEMIA, SUCCESSFULLY TREATED WITH H2 O2 MEDICINAL.-Case 1.-February 6, 1894, was called to see Homer B., aged fourteen, who had been ill with a swelling in right groin for three weeks. Had been treated with hot applications, etc., but during that time abscess continued to grow, and at the time that I first saw him fluctuation could easily be made out. Temperature 102.5° F. Pulse 120. Great emaciation. Constant vomiting. Daily chills followed by copious sweating, denoting pus absorption. Diagnosed appendicular abscess and advised operation. This was done same day under local anesthesia.

Much pus escaped, and several small portions of fecal matter, denoting an opening into the gut.

Temperature remained high, and sweats continued for three days following operation, indi

cating the presence of pus. I then began the use of Marchand's H2 O2 medicinal (15 vol.) so as to destroy the pus and morbid elements which were still there. I injected four ounces of H202 with a glass syringe slowly, while patient was in the Trendelenberg position, and allowed it to remain about fifteen minutes. The boy was then lowered and laid upon his right side, when large quatities of pus, broken down tissue and gas flowed from wound. By gentle compression and massage of abdomen much more was obtained. Large quantities of sterilized gauze were packed over the opening in right side.

The flushing out with H2O2, etc., was repeated every twelve hours.

The improvement was prompt. Temperature reached normal and remained so after forty-eight hours.

Wound was now washed out with H2 O2 daily for four weeks, after which time the abdominal wound and fecal fistula were entirely healed. Patient has since developed into a full grown laboring man, and has had no hernia nor any outward symptoms of severe illness.

Case II.-March 2, 1897, was called to see George T., a farmer, aged thirty-eight years, who had been in the care of a Christian scientist for four weeks for a large swelling in right side. The treatment consisted in endeavoring to persuade the man that he was not ill, and insisting that he take active exercise. Found patient in recumbent position with knees flexed upon abdomen, and suffering intense pain over right side of abdomen, which was filled with a soft, fluctuating mass. Temperature 103.8° F. Pulse 130. Opened abdomen under local anesthesia and evacuated three quarts of foul smelling pus.

Used four ounces H2 O2 full strength, slightly warmed, after pus had ceased to flow, and repeated procedure every twelve hours.

This caused cessation of all untoward symptoms for eight days, when chills and fever returned.

Another swelling was then noticed in right lumbar region, which, upon opening, gave one quart of pus.

Flushed this second abscess in same way. The temperature soon reached normal, and patient made an uneventful recovery with exception of swelling of inguinal glands in left groin, which yielded in three days to hot fomentations.

For conclusion, I might say that in the above cases I used no medicines internally, and nothing externally but clean linen, plain gauze and H2 O2 (Marchand's).

The operations performed were simply opening abscesses, no drainage-tubes, no flushing with salt solution or water, and no packing of abscesses.

Though I used the H2 O2 in large quantities, and made no special effort to see that all the solution returned, and though it was used over a period of several weeks, no untoward symptoms developed from its use.

The above gratifying results induced me to use Hydrozone (which yields thirty times its own volume of nascent oxygen instead of 15 volumes) in other cases where a large amount of pus was present, with such good results that I am now giving the preference to this very strong solution.-E. J. MELVILLE, M.D., Bakersfield, Vt.

Translations.

PARISIAN MEDICAL CHIT-CHAT.

BY T. C. M.

New Serum Specifics for Typhoid and Scarlet Fevers-Colloidal Silver in Infectious Diseases-A Glance at the Microbian Theory - Boucher Winds His Medical Horn Again.

According to their habitual methods, the managers of Pasteur institutes give the public press their new gr-r-r-eat discoveries. The general news agencies of Europe proclaim to an ever credulous public the wonders of the grand panaceas. Thus read the following dispatch:

"CAIRO, December 23, 1902.-A little more than a year ago-to state the date exactly, for this is the scientific way, November 8, 1901-Dr. Chantemesse, member of the Academy of Medicine, Professor to the Chair of Experimental Pathology to the Faculty of Medicine of Paris, made known to his medical societies and hospitals the composition of his anti-typhic serum, the employment of which, in the treatment of typhoid fever, gave the most marvelous results in his hospital practice.

"The method consists in injecting under the skin of the sick a dose of fifteen cubic centimetres of a serum obtained from the typhic toxine, not the bacilli of the dis

ease.

"Since that time Dr. Chantemesse has been able to establish a comparison between patients treated by this method and patients treated by ordinary medication. Professor Chantemesse, has to-day made known the results of these comparisons, amid the applause of the medical world present, in his communication to the International Medical Congress held at Cairo."

The many readers of the LANCET-CLINIC will remember that only a few weeks since we gave the disastrous results of this treatment in South African English practice. But to resume. Dr. Lutaud, in a late editorial in the Journal de Medecine de Paris, writes as follows:

"We shall not discuss, at the present moment, this new serum that consists in the abstraction of the typhoid toxines, no

longer using the bacilli of the malady. The readers of the Figaro and Petit Journal and other political journals of large daily circulation are overcome with emotion.

"But we have followed the use of this serum in our hospitals for a year, and know the results. Since this new serum is asserted to have a certain action like the spinal marrow preparation used in the treatment of hydrophobia, it is necessary in order to jugulate typhoid fever to employ it at the very commencement of the malady. Now this, unfortunately, amounts to nothing. Fatal cases have been entirely too common after the famous treatment, and all will recall the case of a brilliant young interne who expired under this sure serum at the commencement of last year.

"We shall see the splendid statistics that Dr. Chantemesse shall presently give us; they will, doubtless, be only comparable to those once furnished by the Pasteur Hospital in hydrophobia, where 2,000 cases were treated and 2,000 cured. This making of statistics is not difficult."

We have before called the attention of the profession to Baltimore and Chicago, and their grand philanthropic Pasteur institutes. In these cities hydrophobia was almost an unknown quantity; in fact, very, very few doctors ever saw a case, but thanks to the beneficence of serotherapeutists, hydrophobia cases are now treated by the hundreds, if we are to believe the reliable (accent on the lie) statistics, published by the medical savants of those two American cities. But let us return to the French editorial again for the benefit of the LANCET-CLINIC readers. Lutaud continues :

"But those who know typhoid fever clinically, a disease in which the lethality and prognosis are so largely variable, will be hard to convince. All know that this malady may assume the most benign form, so that in many cases there is really no use for medicines but simply therapeutic dietetics; so this new serum works marvels (?) in such cases.

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We call the attention of our confrères to this public newspaper agency notice, for they may be sent for by those very intelligent (?) patients who depend on sensational political newspapers for medical knowledge. Thus our fellow-doctors will be on their guard when their patients happen to belong to the common class of