and deodorants cannot be hoped to affect it permanently, while the employment of more radical medicinal means does bring about the desired effect in this condition.

In congestive dysmenorrhea, and in that form which is accompanied by fetid discharge, the indications are to diminish congestion, by promoting the contractions of the uterus and relieving it of the accumulated blood, to stimulate glandular activity in the mucosa, to restore the tone of the uterus and the nutrition of its tissues to normal, and to relieve spasm and pain.

The following cases illustrate the effects which I obtained with the use of Ergoapiol (Smith) in the treatment of dys menorrhea:

Some months ago I was consulted by a young woman who had suffered from scanty, fetid menstruation, accompanied by a great deal of pain, since the birth of her first child seven years previously. Her labor had been followed by a tear of the perineum which had been left unrepaired, and also a laceration of the cervix uteri. This patient consulted a specialist, but his treatment did not give her relief. Examination revealed the presence of the uterine and perineal lacerations already mentioned, and disclosed a chronic endometritis that had given rise to a fetid discharge and to pain during each menstrual period. I repaired the tears, curetted the uterus, and hoped in this manner to obtain permanent relief of the patient's symptoms. After she had recovered from the operations, she declared that she was feeling better than she had been for years. But very soon the fetid discharge and the pain returned at each menstrual period, and evidently something else had to be done if I wanted to save my reputation. I then tried local applications, alteratives, uterine tonics, etc., all without avail, until finally Ergoapiol (Smith) was given. The result was immediate relief and a gradual and permanent improvement in the menstrual flow until it was free from pain and devoid of any disagreeable odor.

This patient was evidently suffering from congestive dys menorrhea which was intensified by the presence of lacerations of the cervix and the perineum which had existed since parturition. The result attained illustrates very well how Ergoapiol (Smith) acted upon the uterus, restoring its tissues. t', normal condition and re-establishing the menstrual function upon its normal basis.

Another type of dysmenorrhea, that which I term "nervous," but which the authorities term "neuralgic," is illustrated by the following case which recently came under my care:

The patient was a young woman who had been married two years, but had not borne any children. She stated that she had pain during the menstrual period from the first onset of menses, and at the time of examination she also complained of a fetid discharge. The menstrual flow was scanty and rarely of blood red color. Just before and after the period she had backache and headache, her complexion was unhealthy, not bright and clear as that of her sister, and she appeared older than she really was. She always dreaded the onset of the menses which recurred with a regularity that is not always present in these cases. She was easily excited, and received impressions vividly and indelibly. Her digestion was poor, and she was often sleepless, irritable, and peevish.

Vaginal examination revealed a slightly thickened os and slight endocervicitis with erosions of the cervix. Cod liver oil, malt extract, hypophosphites, and aromatics, in combination, 25 per cent. of each, were given freely during the intervals between the menstrual periods and for three days befere the expected menstruation Ergoapiol (Smith) was given in capsules, one being given three times daily until the discharge ceased. At the fourth period after the beginning of the treatment she was relieved of all her symptoms, and was free from pain and fetor during menstruation. Locally, tincture of iodine and occasionally tampons of ichthyol and glycerine were ap plied. The cure was permanent and in every way satisfactory.-J. Ridgly Simms, A. M., M. D., in Medical Herald.

REMARKS ON GLYCO-THYMOLINE.-For many years past this preparation has been one of my mainstays in diseases of the mucous membranes, and it has held its place despite the trials of many other agents warranted to supplant it by the advocates who decried glyco-thymoline when I spoke of its virtues. Space is now getting too valuable to waste with long detailed descriptions of separate cases, and anyhow I never did write in that manner-I think general remarks about agents is the better way, and we need this more than stories of symptoms and temperatures, with daily alterations. No class of maladies is more troublesome than disorders of the

mucous membranes, and none more difficult to eradicate thoroughly, and we have been put to our wit's end many times for remedial agents in such cases. The local treatment of catarrhs is frequently disappointing, and none more so than that prevalent one-post-nasal catarrh. Unless we can get an alterative condition established little good is done, and nothing has been of greater service to me than glyco-thymoline, locally and internally, in several hundreds of long-standing and severe cases of this intractable and common affliction. I have come to regard this preparation as a standard and almost routine remedy; I seldom care for a post-nasal trouble without prescribing it at the onset, and if I don't it is not long before it comes into use. It is just alkaline enough, just so as to the dialysis (the action locally with exactly the right amount of fluid excretion through the diseased membrane), just enough astringent without drying the parts, and just the right thing in the direct line of reparative work; it sets up tissue building soon after the membrane gets somewhere near its right shape. Many things are employed in catarrh, but I firmly believe that if I was confined to one agent only, that would be glyco-thymoline. For years I used the so-called antiseptic tablets of boric acid, and glycerine, etc., and with good results, but for a long time past, this is thrown aside and the glyco-thymoline takes its place. I use it in about half strength with a Bermingham douche and from twice to four times daily. With this, in bad cases, I give it internally, adding to it, or giving separately, mercuric bichloride, and if done separately the menstruum is compound syrup of stillingia. In presumed syphilitic persons I always do this.

In gastritis, chronic enteritis, vaginitis, gonorrhoea, and in recurring attacks of what too many physicians deem appendicitis, I use this agent freely, and always with good results. As a local application to foul ulcers and especially to hemorrhoids I think this preparation is very good. In the nasty leg ulcers which now and then defy all remedies glyco-thymoline does wonders-it can't do harm any time and I am almost persuaded to give it in all instances. In bronchitis and asthma it is fine; in spasmodic croup it fills the bill nicely; it does well in venereal disorders locally, and in balanitis it stops the trouble at once.-W. R. D. Blackwood, M. D., in Medical Summary, December, 1903.

A NEW TREATMENT FOR WRY-NECK.-Leonard K. Hirshberg declares that the pathology of torticollis rests entirely upon negation and probability. The probability is in most cases that the kinesthetic centers for the sternocleidomastoid, splenius, trapezius, scaleni, and deep cervical muscles are the points of origin for the various spasms. Another way to express our ignorance is to say that tortcollis is due to irritation of the nuclei of the neurons. There are many combinations of the various muscles which are possible in this affection. Individuals with neuropathic relatives or ancestry are more subject to torticollis than the average person. Congenital and rheumatic wry-neck are not included in this paper. The treatment of the first patient reported is given as follows: The faradic current was used for five minutes daily over a period of four months. The positive electrode was placed over the wrist and a roller (negative) electrode was applied over the healthy sternocleidomastoid and upper fasciculus of the trapezius on the unaffected side. Liquor potassii arsenitis was given in doses of two drops three times a day for four months. Almost from the beginning there was marked improvement. At the end of the treatment the patient's head was perfectly erect, and a scarcely perceptible stiffness of the muscles remained. The cosmetic result was excellent, and although the arsenic has been stopped for some time, there had been no return of the clonic spasms. In another case treatment consisted of a rigid diet and the application of the faradic current for five minutes daily to the muscles of the well side. Improvement was steady. In the third case the treatment was the same as in the first, and at the end of three weeks the patient discharged himself as cured.-Maryland Medical Journal.

DIASTOLIC AROTIC MURMURS WITHOUT VALVULAR LESIONS.G. A. Gibson believes with Babcock that there is a form of aortic insufficiency, which although not due to valvular defect, yet presents the same clinical features as the organic form, and is so frequently encountered that it may here be briefly dwelt upon. This is a relative incompetence of the semilunar valve, and its causes are found in conditions that predispose to stretching of the ventricular wall and of the basal ring of the aorta. The writer cites two cases in point. The first patient was a man aged 30 years. He was suffering from chronic nephritis. In the aortic area, a hard systolic murmur was heard, which was propagated into the carotids. The

second sound was impure and was followed by a soft blowing diastolic murmur, best heard over the sternum, and hardly propagated at all. Autopsy revealed a dense band surrounding the aorta and pulmonary artery. This caused considerable displacement as well as constriction. The writer believes that the diastolic murmur was produced, not by stretching of the orifice (which was negatived by the result of the post-mortem examination), but by faulty adaptation of the aortic cusps. The systolic murmur was no doubt largely due to some dilatation of the vessel beyond the constriction. The second patient died of aneurysm of the aorta. About a year before his death a diastolic murmur developed over the upper part of the sternam. In neither case was there any permanent stretching of the orifice. The writer believes that the murmur was due to faulty adaptation of the different cusps of the aortic valve. It is impossible to conceive of temporary dilatation, and in default of any pathological proof of enlargement of the orifice, faulty application of the individual cusps to each other cal alone be entertained as the cause of regurgitation.- Edinburgh Medical Journal.

THE WANING GLORY OF THE LEUCOCYTE.-As the chief her in the contest between the bacterium and the man, the leucocyte seems to be suffering the fate of many another shining light of battle, and its once high position is being most vigorously assailed. At first, the only means of defense against bacteria that had once gained a foothold and begun to multiply, so far as known, was the intrepid leucocyte, which was supposed to attack the most virulent bacteria, engulf them while in full activity and either to digest them or die in the attempt. Through the work of Metchnikoff and his school, particularly, this power of the leucocyte was made familiar to all, and the subject was elaborated vigorously. It was not long, however, before voices were raised in opposition, contending that the leucocyte was not so much of a hero after all, but merely a scavanger that picked up the bodies of dead or crippled bacteria and destroyed them, but was unable to give much protection against bacteria that were virulent. The injury to the bacteria, according to these investigators, was essential for successful phagocytosis, and was accomplished by soluble substances present in the serum which possessed marked bactericidal powers. Thus arose two schools-the humoralists and the supporters of the phagocytic theory.