The following formula emanates from Dr. of this new substance, which is an iodide of Carles:

in excess, as also by the action of liquor | produce diarrhoea, and that is the experience potassæ and iodine on barium carbide held in of many others who have tried them. The suspension in benzin or chloroform. M. Hal- biscuits, which are thoroughly baked and dried, lopeau is engaged in studying its therapeutical are very palatable and will remain good an ineffects in his skin wards at St. Louis. He has definite time; but the bread, however carefully tried it in cases of soft chancres, and finds its made, will not in summer, at any rate, keep effects to be identical with those of iodoform. more than three days. Dr. White states that -Paris correspondence of Lancet. many patients prefer the taste of soya-bean preparations to gluten.-Boston Medical and Surgical Journal.

EMULSION OF CODLIVER-OIL.

The following note upon codliver-oil is made by Dr. J. Madison Taylor in the Philadelphia Polyclinic: "The best form is a cold-pressed oil from freshly-selected livers. The difference between this and inferior oils, both in taste and efficiency, cannot be overstated. This kind can always be given straight. I devised a very economical and handy form of emulsion, which my assistants use much. In an eight-ounce bottle 6 ounces of oil are put; the mother adds to this one raw egg, one tablespoonful of whisky, and fills the bottle up with glycerin. The whole is then thoroughly shaken and kept in a cool, dark place. It is agreeable and well retained."

A NEW DIURETIN PREPARATION: THEOBROMIN

LITHIUM (LITHIUM SALICYLICUM).

Dr. Chr. Gram, of Copenhagen, says: "The high price of diuretin prevents this real diuretic from coming into general use. Experiments with a new theobromine combination—theobrominlithium (lithium salicylicum) - have shown that this preparation is much more easily absorbed than the ordinary diuretin, and that the therapeutical effects are obtained with smaller doses (3 to 4 grains) just as well, or perhaps still better than with diuretin (6 grains); the same therapeutical results are thus obtained, with a saving of about 20 per cent."-Times aud Register.

ON THE USE OF SOYA BEANS IN DIABETES
MELLITUS.

In confluent acne of the face Phillips has Dr. W. Hale White describes three cases obtained excellent results by painting the afof diabetes mellitus selected at random from fected surface with a solution of lysol, which is several in which he has used the soya-bean allowed to remain for a few minutes. It is then biscuits with good effect. Two preparations taken up by a sheet of bibulous paper and the of the soya bean are sold in England-soya part covered by a layer of crystalline, which is bread and soya biscuits. The oil is removed left in situ for eight days. At the end of this from the flour from which they are made, and period a second application of lysol, followed the writer says this may account for the fact by crystalline, suffices to complete the cure.— that, so far as his experience goes, they do not | La Riforma Medica.

pets and rugs, and lurks in the coaches in which we travel. Our knowledge of the ubiquity and mode of development of the bacillus tuberculosis should afford us the clue as to preventive methods. We are now in a position where something can be accomplished by attacking the source of the malady. The extension of the disease may be limited in two ways, by the destruction of the bacilli and by fortifying the human tissues against their assaults. Tissues rendered healthy by rational

THE LIMITATION Of tubercU modes of life constitute an unfit soil for the

cultivation of the bacillus. Destruction of the bacilli relieves the human organism of threatened danger. We may not hope to annihilate the bacilli. It is chimerical, perhaps, to entertain the idea of exterminating these micro-organisms. In crowded cities too many conditions are favorable to their prolonged vitality and general dissemination. Something, however, can be done toward rendering them less destructive to the human species.

On the one hand, thorough ventilation and, on the other, habits of open-air exercise, diminish the relative proportion of bacilli and their capacity to lodge themselves and develop in the lungs and other parts of the body. Scrupulous cleanliness of house and person is, to a certain extent, protective against the con

The almost invariable fatal progress of the disease seems to discourage the attempt to prevent its spread. More destructive than epidemics which come and go, more fatal to each generation than the ravages of war, the medical profession has heretofore failed to ap-gregation and growth of these germs. City preciate the importance and utility of a combined effort to prevent the spread of tuberculosis.

Quite recently an eminent French professor has asked his colleagues to join him in establishing a "league against cancer." With equal, if not superior, propriety we might advocate the formation of a "league against tuberculosis."

As regards the latter malady, we have the advantage of knowing where to direct our attack. The exciting cause of tuberculosis has been tangibly and convincingly demonstrated. The bacillus, upon the activity of which the disease depends, is identified every day in the tissues and products of disease, is disseminated in the atmosphere, mixed with the dust of the streets; deposited upon walls, floors, and ceilings; entangled in the meshes of car

streets and sidewalks should be carefully cleaned, and the drainage of houses should be efficient. The utmost pains should be taken to secure pure food and drink.

The chief agents in the propagation of the disease are tuberculous patients. From the sputum of these unfortunate individuals the bacilli are released and spread throughout the air. It is, consequently, important that the expectoration should be received into vessels which contain a quantity of antiseptic liquid, and that these receptacles should be frequently and thoroughly cleansed. It is better, in fact, that the invalid should make use of boxes which may be entirely destroyed by means of fire. It has been shown that the life of the bacilli, when discharged into a watery solution is only about one-fourth as long as when the sputum is allowed to dry in the air. This leads us to

condemn the too general but offensive practice theria.
of spitting in the street, upon the floor of
houses, cars, etc. Handkerchiefs, shirts, and
other garments which have become soiled by
sputum or pus from a tubercular lesion should
be very carfully washed, or, if possible,
burned. It is prudent to boil milk before
drinking.

As far as practicable patients should be isolated. Upon the broadest grounds of health it is desirable that, whenever possible, a bed and sleeping-room should be occupied by but one person. The sleeper may thus be assured of a sufficient supply of pure air. This requirement becomes all the more necessary in the case of phthisical persons. Consumptive husbands or wives should sleep in separate rooms. Adult or adolescent patients can only be placed in separate rooms. All discharges must be disinfected and destroyed. The attendant should avoid making use of the same dish, cup, saucer, knife, fork, spoon, etc., as the patient, unless they have been carefully washed in boiling water. These table articles can, in fact, usually be appropriated to the sole use of the patient.

Among the poor strict isolation is generally impossible. The husband and wife must usually occupy the same bed and room. There is, in these cases, consequently, all the greater necessity for thorough ventilation, care about the spit-cup and clothing. All can wash table utensils coming from the invalid before they are again used. Destruction of the bacilli contained in the sputum is the chief means of prophylaxis, for it has been shown that the air expired by consumptives is comparatively uncontaminated by microbes. The special dan ger, therefore, is not in the gaseous exhalation from the lungs.

In hospitals the isolation of tuberculous patients is especially demanded. In particular, they should be kept from those suffering from non tubercular disease of the respiratory passages or from typhoid fever. These diseases, by their local and constitutional influences, predispose to the development of the bacillus tuberculosis.

The contagium of tuberculosis is not as virulent as that of small-pox, scarlatina, and diph

Per contra, it is more universally present. It is a more continual danger. Out of the vast number of people brought into close contact with consumptives it is undeniable that numerous cases are contracted and many lives needlessly sacrificed. The writer has a vivid recollection of a case which came under his observation at a time and under circumstances which impressed it indelibly upon his memory. A college-mate-a healthy young man and belonging to a family in whom consumption was unknown-married a lady afflicted with pulmonary tuberculosis. It was not long before the husband's health began to suffer; his strength declined, he began to cough, and, in short, developed unmistakable symptoms and signs of consumption. Another striking feature of the case was that the disease ran a rapid course, and the husband perished before the wife, by whom he had undoubtedly been infected. Striking examples of the transmission of local tuberculosis by means of accidental inoculation have been published, from time to time, in the columns of the MEDICAL BULLEtin. The operation of circumcision according to the Jewish rite, perforation of the ear for ear-rings, wearing the ear rings of a consumptive, injury by a vessel containing sputum from a phthisical subject are some of the modes by which infection has entered the system.

In order to limit the dissemination of tuberculosis it is desirable that the marriage of affected individuals should be discouraged,that cases of disease should be reported to the Board of Health, and be supervised by the public health authorities. A communication urging such measures has recently been made by Dr. Hermann M. Biggs, bacteriologist of the Board of Health of New York. In response to his recommendation the board passed resolutions providing that the public should be instructed by circulars concerning the infectious nature of tuberculosis; that hospitals and dispensaries report such cases to the board; that a special corps of inspectors be organized for investigation and disinfection, and that hospital authorities be urged to separate patients suffering from tuberculosis from those afflicted with other maladies.

A CAUSE OF SUDDEN DEATH
IN INFANTS.

A

cases in which the thymus was enlarged in children who had died of spasm of the glottis. Biedert admits that grave and even fatal consequences may be produced by enlargement of the thymus gland.

The symptoms preceding death were not identical in all of the recently published cases. In those of Gerhardt and Somma we read of an attack of suffocation, with accelerated respiration, cyanosis, dilatation of the pupils, swelling of the veins, and asphyxia. Death occurred during convulsions. Lebedinsky has reported a case, however, in which the diagnosis, made during life, was confirmed by Professor Bystoff, of St. Petersburg, and in which the distinctive symptoms were clearly defined. The case was that of a babe a few days old who presented all the signs of difficult respiration. There was nothing abnormal in the mouth, nose, or pharynx. Respiration was normal almost everywhere except at the upper part of the sternum, where the breathing was harsh and expiration decidely bronchial. Percussion outlined an area of dullness at the upper part of the breast-bone and adjacent cartilages. The voice was unaffected, and the slight dyspnoea increased when the babe slept, on account, presumably, of a lessened action of the respiratory muscles. It was, therefore, surmised that the impediment to respiration was seated below the larynx. As enlargement of the tracheo-bronchial glands is not met with in such young infants, Lebedinsky concluded that there existed slight compression of the trachea by the thymus. He asserts the opinion that thymic asthma is more frequent than is generally supposed. Clinically it is manifested in mild cases by a simple difficulty in breathing, and in serious cases by dyspnoea amounting even to asphyxia. Baginsky, although he does not use the term "thymic asthma," says that we should suspect such a con

MONG the many examples of revolutions in medical opinion may be cited what was described by older authors as "thymic asthma," and upon which considerable stress was laid, but which in later times has been almost totally ignored by writers on the dis eases of children. A very interesting review of the subject is given by Dr. R. Romme in a recent number of La Tribune Médicale. First described in 1723, the affection was treated of by various authors. Kopp, particularly, in 1829, referred all respiratory troubles of young infants to compression of the trachea by an enlarged thymus gland. As late as 1850, Bednar, in his "Treatise on Diseases of Infants," gave a detailed description of the progress and symptoms of the affection, and reported several autopsies of children who died from that cause. "The question seemed to be entirely settled," writes Dr. Romme, when, in 1858, Friedleben denied that an enlarged thymus was capable of exerting injurious pressure upon the trachea, the nerves, or vessels of the neck. The judgment of Friedleben influenced succeeding writers to such an extent that the subject of thymic asthma disappeared from the text-books. The matter again seemed to be definitely set at rest when Grawitz, in 1888, reopened the discussion by a paper published in the Deutsche medicinische Wochenschrift. Grawitz described two cases of sudden death in babes, in one of which suspicion of foul play attached to the nurse in whose charge the babe was left in the absence of the parents. In the second case the infant suddenly expired in its father's arms. In both instances the thymus was hypertrophied. The reporter considered that death was due to compression of the trachea, and quoted an expression of Virchow's "I possess," said that authority, "in my mu-dition "when we see attacks of suffocation seum, the thymus of a child who perished in an attack of thymic asthma. The gland is so enlarged that I do not understand how any one can deny the possibility of death from pressure by an hypertrophied thymus." Analogous cases were described by Baginsky, Paltauf, Somma, Scheele, and Nordmann. Pott also observed six

supervene without known cause, especially in young infants, and that the diagnosis may, to a certain extent, be confirmed when at the same time there is dullness behind the upper portion of the sternum. The little patient of Lebedinsky recovered. At the age of 2 and 4 months the child suffered from subacute attacks of suffoca