performing even the least office for the patient-a certain something which enables its possessor to do everything for the patient as if from the promptings of good-will and sympathy, and not from measured, mercenary motives. The sick are generally hypersensitive, and are very ready to feel a perfunctory performance of duty.-Hahnemannian Monthly.

A HINT REGARDING TRAINED NURSES.-One of the hardest things for the nurse to learn is not to prescribe for patients. Some pride themselves on carrying out directions to the very letter, but unless the attending physician is also careful to specify what not to do, it is often found that all sorts of liberties have been taken and things performed that were better left undone.

Instruct the nurse never to ask the patient what she or he wants in the way of food. If anything is called for that will not injure, it should be allowed, but even then only a small portion at a time; a little bit in a dainty dish will tempt the appetite, when a larger quantity would induce loathing and nausea.-Detroit Medical Journal.

TREATMENT OF PRURITUS VULVA.-Siebourg (quoted in the American Journal of Obstetrics, October, 1901) has had good results in the treatment of some cases of pruritus vulvæ by subcutaneous local injections of weak solutions of cocaine and carbolic acid. He then attempted to accomplish the same purpose by simple injections of salt solution. He believes that local anesthesia is caused by the pressure of the injected fluid.-The Therapeutic Gazette.

TO GUARD AGAINST THE BITE OF THE MOSQUITO.-McIntosh recommends an application for this purpose in the Medical Record of November 16, 1901, which he has used for some years when out fishing or hunting in swamps where mosquitoes are prevalent, and in the evenings when sitting out-of-doors, and which he has found to be most excellent and efficient; it is the oil of citronellæ (oil of verbena, Indian melissa oil). It has a very pleasant odor, and is not expensive. The oil should be rubbed into the exposed parts and repeated occasionally, or the following is quite as efficient:

Sig. Apply freely to face, neck, hands, and ankles, to prevent mosquitoes from biting.

This is colored with something to make it slightly green.

ACUTE NEPHRITIS IN CHILDREN.-The treatment consists of rest in bed between blankets, milk diet, water drunk freely, and, at the start, a calomel purge followed by a mild saline, such as liquid citrate of magnesia. The body may be sponged with warm water, or a warm bath given once or twice a day, precautions being taken to avoid chill. A non-irritating diuretic is the citrate or bitartrate of potassium, which may be given in

water with lemon juice and sugar. The severe cases with dropsy, fever, and suppression of urine must be treated actively by dry cups on the lumbar region, by purgation with an active saline (magnesium sulphate), and by free sweating by a hot-air bath or hot pack. A daily irrigation of the colon with normal salt is of value. If uremic symptoms set in, bleeding is the most certain means of relief, two to six ounces of blood being drawn from a child of five years. A full and bounding pulse requires nitroglycerin; threatened convulsions demand bromides and chloral by enema. The patient should be confined to bed as long as there is a trace of albumen in the urine, unless chronic nephritis is seen to have developed. The postnephritic anemia calls for iron, preferably Basham's mixture.-Powell, "Diseases of Children."

HEMORRHAGE IN TYPHOID.-Avoid all movement, writes Mitchell Bruce, even for the use of the bed-pan, collecting the stools in a properly arranged towel. Reduce diet to a minimum, giving, for example, half an ounce of peptonized milk every half hour, or a teaspoonful of meat jelly every hour. Thirst may be relieved by wetting tongue and lips, or with a teaspoonful of quite warm water, plain or acidulated; this is better than ice. A hypodermic of morphine arrests peristalsis and aids in producing sleep and mental rest. An attempt should be made to stop the bleeding by astringents, the most powerful of which is a mixture of lead acetate, morphine acetate, and diluted acetic acid in water, or lead and opium pill, or lead acetate suppositories, or an ice-bag may be applied to the right iliac fossa. Brandy is to be given, with the finger on the pulse, in greatly reduced doses at very short intervals, in milk, so that whilst the heart is never excited by the alcohol, its strength is sustained. The value of hamamelis, ergot, and turpentine is still an unsettled question.-Treatment in Practical Medicine.

TANNOFORM FOR SWEATING FEET.-Dr. Grumme, encouraged by numerous favorable reports, has tried tannoform in hyperhidrosis pedis. Being in the military service, he had a rich material to experiment upon. Selecting those men who suffered from particularly severe sweating of the feet, the author treated them with pure tannoform, dusting the powder freely into the stockings, which were put on after washing the feet and worn for twenty-four hours. The effect was unexceptionally excellent, the skin, coming in contact with the powder, assumed a brown discoloration and completely ceased to perspire. After some time the discoloration gradually disappeared, and after from three to four weeks the sweating recommenced, necessitating a new application of tannoform. No untoward results were noticed. If tannoform is employed "diluted" with talc, the action is less marked and less permanent. The use of the drug in the form of ointments and alkaline solutions gave no results beyond more or less extensive blistering of the skin.-Deut. Militärärztl. Zeit.

TUBERCULOUS GLANDS.-To avoid unsightly scars, G. B. Massey (Pro. Phila. Co. Med. Soc.) makes a small opening into the gland with a narrow bistoury under ethyl chloride spray, and inserts a sliver of amalgamated zinc to act as the anode of a galvanic current of one to three milliamperes. This is turned on gradually and maintained for a few minutes till the tract is cauterized and sufficiently impregnated with the oxychlorides of zinc and mercury to keep it patulous for a few days. A gold electrode with amalgamated tip insulated up to one fourth inch from the point is then inserted and two to ten milliamperes turned on for ten minutes, and then the wound dressed. Through the sinus thus formed the dead bacilli and deposition chemicals can drain. The treatment is repeated about every three days till the gland has shriveled.-Medical News.

SPRAY FOR ASTHMA.-Dr. A. Abrams recommends the following solution as a spray in asthma:

NEW REMEDY FOR HEMORRHOIDS.-E. V. Hall (Cincinnati LancetClinic) has used successfully a mixture of echinacea angustifolia and hamamelis virginiana in the treatment of hemorrhoids. In his first case, a lady school-teacher, he directed that two drams of this mixture be injected into the rectum after each operation of the bowels. This treatment was continued until six fluid drams of the mixture had been used, the result being that the patient experienced prompt relief from pain, the hemorrhoids ceased to trouble her, and at the present time she says she is entirely well. Since then he has had equally satisfactory results in the treatment of six other cases. As some patients complained that the medicine was too strong, he modified his formula to read:

A slight burning sensation is experienced after the use of this mixture, but it soon passes away and the peculiar cooling effect of the echinacea is felt by the patient.-Medical Standard.

WHEN amputation of the foot is necessary, the practitioner who has but little surgical experience should select the operation above the ankle. It is more easy to perform, and an artificial foot is far more readily adapted than in tarsal and tibio-tarsal amputations. As a matter of fact the tendency of surgeons generally is to regard the operation above the ankle as the most desirable of all.

THE TREATMENT OF CHRONIC BRONCHITIS IN THE Elderly AND AGED.-Henry Campbell, in the British Medical Journal, briefly sums up the chief points of a paper by him on this topic :

In treating chronic bronchitis in those past middle life the toxicity of the blood should be kept as low as possible.

The air breathed should be pure, and nasal breathing insisted on.

The diet should be a bare sufficiency, and alcohol indulged in sparingly or not at all.

Every ounce of superfluous fat should be got rid of.

The general health should be maintained at the highest possible level. A vigorous circulation should be maintained.

Every precaution should be taken against breathlessness.

Breathing exercises should be resorted to in order (among other things) to preserve the mobility of the thorax.-The Therapeutic Gazette.

CARBOLIC ACID IN HYDROCELE.-At a recent meeting of the New York Academy of Medicine, Dr. William B. Coley said that he found the injection of minute amounts of carbolic acid to be the best method of treating hydrocele. Each injection consisted of two and a half grains of carbolic acid liquefied by the smallest requisite amount of glycerin. The results were just as good as with injections of larger amounts, while the risk and discomfort were, of course, much less. It is convenient to use a small double trocar. The hydrocele fluid having been thoroughly evacuated through the outer trocar, the carbolic acid is injected through the inner trocar attached to a hypodermic syringe. The hydroceles of infancy nearly all disappear spontaneously or are cured by painting with equal parts of tincture of iodine and tincture of belladonna.

QUINOLINE-BISMUTH RHODANAte in GonorrHEA.-The crurin of the market, which was originally recommended for ulcers of the leg (ulcus cruris), is said to be a mixture of three parts of quinoline-bismuth rhodanate and one part starch. Dr. E. Jacobi has experimented with the pure chemical as an injection in gonorrhea, and claims to have obtained most gratifying results. He used it in the following formula:

TURNING AN HONEST PENNY.-"Ah," said one little girl to another, "my mamma gives me a penny every morning for taking a spoonful of codliver oil."

"And what do you buy with the penny?" eagerly asked the second girl, in a tone not devoid of envy.

"Oh," was the reply, "I do not spend it at all; mamma puts it away for me every day to buy more cod-liver oil with !"-New Idea.

Special Notices.

MANY of the genito-urinary diseases, which have heretofore depended for a cure upon the different salts of lead, zinc, copper, or silver, now yield permanently and promptly to Pinus Canadensis. In all inflammatory processes, in fact, whatever may be the stage of malady, this remedy acts successfully. Through its astringent properties it lessens the caliber of the arterioles, minute vessels and ducts, favorably influencing their secretions, and rapidly bringing about resolution. Even in rheumatism and the various other conditions requiring an external stimulating application, it is a very superior therapeutic agent, and internally it is an efficient remedy in pyrosis, acid stomach, colic, diarrhea, and dysentery.

SANMETTO IN CYSTITIS, GONORRHEA, AND IRRITABLE PROSTATE.—I have been an extensive user of Sanmetto for a number of years, and can truthfully say that when the therapy of the pure santal and saw palmetto is indicated, I find Sanmetto a remedy par excellence. I have used it extensively in cystitis, chronic gonorrhea, and irritable prostate, and it has universally relieved, if not cured, my patients. As long as it maintains its present standard of purity I shall use it, for I deem it pure and ethical.

Chicago, Ill.

W. R. HILLEGAS, M. D.

ITS DISTINCTIVE Feature. One needs but to review the physiologic activities of the remedies recommended as tonics and reconstructives to realize the fact that practically all of them have some secondary effects which detract from their clinical value. It may be that they irritate the stomach and thereby excite repulsion on the part of the patient or even induce nausea and vomiting; some of them are astringent, others primarily stimulating but secondarily depressing-and so on through the entire category of remedies, objections more or less serious may be found. It is, therefore, a matter of great importance to employ a remedy which is not only free from deleterious by- and after-effects, but which adapts itself to use as a routine remedy in the many and diverse conditions that call for tonic and reconstructive medication.

The one remedy which many years of experience proves is entirely free from detrimental effects is Gray's Glycerine Tonic. This preparation is of pleasant taste, agrees perfectly with rebellious and sensitive stomachs, patients never tire of its continued administration, and it is extremely effective in restoring tone and vigor to the entire system.

The entire freedom of Gray's Tonic from anything like drug effects is one of the strongest reasons why the best element of the medical profession have adopted the remedy for routine administration in all conditions associated with impairment of general health, lack of nervous energy, general exhaustion—in anemia, malnutrition, neurasthenia, and in chronic wasting diseases. THE PURDUE Frederick Co.

15 Murray St., New York.

IN the supplement to the Journal of Tuberculosis the whole subject of tuberculosis is covered by a series of articles written by Dr. Carl Von Ruck. For controlling the cough of pleurisy, one of the complications of phthisis, the doctor says (January, 1902, page 101): "Cough must be allayed by heroin, codeine or even morphine, the choice being in the order named, but only when required on account of severe pain. I have also employed papine, which has given me very satisfactory results and which possesses the very desirable advantage of not causing constipation."