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tory foci, vasomotor paralysis, etc. After consideration, it seems to the writer that the principal cause of albuminuria with casts and later suppression in these surgical states, excluding pressure on or direct trauma to the urinary organs, is in lowered general blood pressure from shock and deficiency of fluids. The urinary condition would therefore be comparable to that observed in the renal ischemia of cholera and severe diarrheas, albumin escaping through the cells impaired by relative dehydration, and also being formed from these injured cells by maceration, as in the urine of chronic cystitis and in that retained within the bladder of dead persons. If these views are correct, albuminuria and urinary suppression after operative procedures are an accompaniment rather than a cause of failing vital forces, the phenomena being of the same nature as those noted toward the fatal end of nonsurgical cases. Rational deductions for practice are to have plenty of fluid in the body and to prevent undue lowering of blood pressure, by short operations and by the free use of strophanthus, strychnine, digitalis, apocynum cannabinum, and particularly by the systematic injection of physiologic salt solution. Here as elsewhere and now as ever the heart is the mainspring of life, and its action must be considered first of all and in due season.

CHRONIC NASOPHARYNGEAL CATARRH.

This condition may depend on atrophic rhinitis, enlarged pharyngeal tonsils, the exanthemata, alcoholism or chronic Bright's disease. The patient complains of "dropping in the throat, hawking, hemming," swallowing and nasal secreatus, sometimes with nausea and vomiting in the morning after breakfast, and frequent headache. The symptoms are much worse in cold, damp weather. Inspection shows a constant, more or less profuse, thick, yellow, mucopurulent discharge from the vault of the pharynx. Posterior rhinoscopy reveals a large amount of thick, inspissated mucus in the vault and behind the palate; also a projecting gland-mass back of the vault. The mucous membrane is thickened and dull red in the simple relaxed form; dry and glazed in dry catarrh (hearing improved during running stage of a cold); with scattered millet-seed-like elevations and injected vessels in granular catarrh.

For the simple form of the disease Kyle advises local applications of a solution of one drop of carbolic acid, five grains of borax and twelve drops of glycerine in one ounce of water; or of 1/2000 trichloracetic acid, or two to five per cent. zinc chloride solution or zinc sulphocarbolate solution (eight grains to the ounce), or a one to three per cent. formalin solution. In making these applications the probe should be curved so as to mop the back part of the soft palate. In the atrophic form the author directs to use freely a tepid alkaline antiseptic solution with the post-nasal syringe, followed by hydrogen peroxide and, if need be, the curved applicator with cotton to remove crusts. For excessive dryness he sprays every two or four hours with six drops each of oil of cassia and of sandalwood to the ounce of liquid albolene or benzoinol. The compound tincture of iodine is recommended for internal use. In the case of children Jacobi injects carefully into the pharynx twice a week a solution of one-half or one grain of silver nitrate in one ounce of water, using a dram of sodium chloride to the pint of water several times a day by insufflation.

BATHING.

Man should be a clean animal, both within and without. The external use of water is often or more benefit by way of its neurotonic effects than for mere cleanliness. For most adults a daily morning cold shower bath is a most excellent preparation for the day's work. Children, invalids and the aged may be given tepid baths, making better the night's rest. The cool tub bath is an important prophylactic against infantile summer complaint. Russian and Turkish baths are luxuries rather than necessities. Surf bathing is an invigorating pleasure. Strongly alkaline soap should not be used on the body. Infants and little children should be well massaged while in the bath. The duration of a bath ought seldom to exceed ten minutes, lest reaction be slow and difficult. When the full bath is impracticable at the time, it is well at least to bathe the feet and other parts most used or exposed to dust and friction. A cold bath morning and evening is of service as a prophylactic against heat prostration.

CLOTHING.

Two important sanitary factors are equal pressure and equal warmth. The extremities should be especially protected. Infan

tile colic is frequently due to refrigeration, from allowing the child to walk or sit on a wet floor, or lie in a wet diaper or with the abdomen exposed to a draught of cold air.

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On account of its being relatively a non-conductor and a good absorber of moisture, wool is generally the best cloth for clothing at all seasons. Of secondary value are silk and linen-mesh goods. into extra-sensitiveness by wearing mufflers and "chest protectors.' Rubber articles hinder natural evaporation, and should be used only in hot weather. The chest and neck should not be coddled Much of the baldness of men is doubtless due to their tight unventilated hats. Leather footwear should be comfortably loose, with broad toes, low heels and soles of fair thickness. Even China is awakening to the calls of hygiene, and the Dowager Empress has issued an edict prohibiting foot-binding in the kingdom. White clothing is much worn in tropical countries, to reflect the sunlight and so reduce the effects of the great heat. duce displacements of the womb and paresis of the diaphragm. Corsets and other waist-constricting devices are a predisposing cause of gall-stones and enteroptosis. The follies of fashion proIt should be added, however, that the corset is passing, for the time at least, and the "Greek girdle" now largely worn is so narrow that it cannot be injuriously tightened without making the parts above and below bulge so much as to render the wearer ridiculous. Indiscretions at the menstrual period are a prolific source of future suffering from endometritis and sterility.

EXERCISE.

Parts and organs that are not used must atrophy. Daily systematic exercise, preferably in the open air, is conducive to health and longevity. Walking is perhaps the best exercise for most people, and a total of ten miles per day is a proper average. The use of the bicycle has done much good and a little harm. Hamilton said, "The best thing for the inside of a man is the outside of a horse." Athletic sports are frequently overdone, and the victors become eventually physical wrecks. The rational object of exercise is not to develop muscular lumps and humps, but to keep the human organism at its highest working efficiency. Girls should be encouraged to exercise as fully and freely as boys.

EDITORIAL ITEMS.

Pulmonary Gangrene. Sajous uses inhalations of carbolic acid, m. iii-vi to a half pint of boiling water.

Fibroid Phthisis. Hare recommends the continuous employment of arsenic.

For Pneumonic Cough. Preble employs carbonate of guaiacol in 5- grain doses, either with or without apomorphine, 1/20 grain.

Constipation of Infants. Ringer recommends sodium bicarbonate, one-half to one drachm to the pint of milk.

Gall-Stone Vomiting. Bartholow used to give a few drops frequently of ether or chloroform.

Acute Perihepatitis. Tyson recommends cuppings, sinapisms, fomentations; surgical intervention if suppuration.

Volvulus. Anders advises gastric lavage every four hours; no food for some hours; hydrostatic or pneumatic pressure or celiotomy.

Pulmonary Apoplexy. Tyson advises absolute rest, counterirritation over the area involved, and anodynes to relieve pain.

Anemia. Brunton praises the ammoniocitrate of iron (dose 2 to 5 grains) as a medicine for young women.

Rectal Polpi and Large Hemorrhoids. Sulphur as a remedy is particularly valuable. It may be given as the compound licorice powder.

Senile Bronchorrhea. According to Hare, strychnine is the best remedy. Opiates and other sedatives are contra-indicated.

Bronchial Asthma of Children. Garrod employs chloral hydrate, 2 to 5 grains each hour during the asthmatic fit.

American Medical Association. Physicians going to Portland in July to attend the A. M. A will have to go by way of the Union Pacific Railway if they want solid comfort.

For Habitual Constipation. Roth prescribes: R Ext. cas

carae fl., syrupi zingiberis, aq. dest. aa. partes equales; one to two teaspoonfuls at night as required.

Acute Constipation With Autointoxication. Thornton advises to take six ounces of liquor magnesii citratis and repeat in six hours if necessary.

For Passive Pulmonary Congestion. Shoemaker prescribes: R Ergotinae gr. 1/3; ext. digitalis gr. 1/4; pulv. ipecac co. gr. ii; one pill every three or four hours.

Vomiting of Appendicitis. John Ashhurst, Jr., employs calomel (1/20 to 1/12 grain) with bicarbonate of sodium (1 or 2 grains) in repeated doses.

Vomiting of Typhoid Fever. Charles W. Earle furnishes the following: R. Bismuthi subnit. gr. iv; acidi carbol. m. 1; glycerini m. viii; aquam q.s. A teaspoonful every two to four hours.

Pneumokonioses. Anders advises change of occupation or several hours' exercise daily in the open air. Treat supervening chronic bronchitis and emphysema or tuberculosis.

Neurotic Cough in Children Near Puberty. Correct habits (masturbation, etc.) and hygiene. Take regular outdoor exercise and cold shower baths, and bromides for short periods.

Hope's Dysentery Mixture. R Acidi nitrosi 3i; mist. camphoræ 3vii; tinct. opii gtt. xl. A fourth part to be taken every three or four hours.

For Lead Colic. Morphine should be administered hypodermically; magnesium sulphate and dilute sulphuric acid may be given by the mouth.

Vomiting of Acute Pancreatitis. Louis Starr has the patient swallow lumps of ice; also iced carbolic acid water and effervescing draughts.

Sick Stomach Due to Constipation. Hare employs a pair of seidlitz powders, one-fourth of each paper in half a wineglassful of water every fifteen minutes till all is taken.

For Chronic Constipation. Da Costa prescribed: R Aloini gr. 1/12; strych. sulph. gr. 1/60; ext. colocynth. comp. gr. 1/12; hyoscyami gr. i. One pill after each meal.

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