almost compelled to resort to a routine treatment. In such cases, of course, he wants the best.

There are constantly being placed on the market new formulas for affections of the air passages. Some of these formulas are of undoubted benefit in some cases, but usually it will be found that the results are far from satisfactory. Many of them cannot be taken when there is any gastric complication, as is sometimes the case, because of consequent nausea and vomiting. Others seem almost invariably to act as cardiac depressants and are highly objectionable for that reason. With the advent of heroin, however, these disagreeable features have, to a great extent, been avoided. Heroin, in the vast majority of cases, can be tolerated by even the most sensitive stomach, and if any disturbance should occur, it can easily be obviated by decreasing the dosage and then gradually resuming the previous amount. Heroin can be prescribed, in cases which are complicated by an enfeebled heart, without danger of depressing effects. As compared with codeine, its sedative action on the respiration is much more powerful. The fatal dose of heroin is said to be one hundred times the efficacious dose, while with codeine the efficacious dose is one tenth of the fatal dose. In other words, heroin is ten times safer than codeine, and can be given in much larger doses, if necessary, without danger. It appears to exert a specific action on the center of respiration without causing disturbances of any other organs or centers, and there is no danger of acquiring any habit by its use.

In phthisical patients the well known lack of appetite and intolerance of various foods renders it imperative to give remedies which will not in any way interfere with the digestive functions, while at the same time controlling or alleviating the cough and other distressing conditions.

Some time ago my attention was called to a preparation composed of a solution of heroin and glycerin, combined with expectorants, called Glyco-Heroin (Smith). Each teaspoonful of this preparation contains one-sixteenth grain of heroin by accurate dosage. It is of agreeable flavor, therefore easy to administer to children, for whom the dose can be easily reduced with any liquid, or by actual measurement. It possesses many

advantages not shown by any other preparation I have used, and has none of their disagreeable features.

In citing some of the cases treated with this remedy I shall not go into a minute description of any case, but briefly state the conditions which existed and the results obtained, which were uniformly good.

CASE I.-S. B., aged 16. Caught a severe cold while traveling. This developed into an unusually severe attack of bronchitis with mucous rales, pain, cough, and some slight fever. Prescribed Glyco-Heroin (Smith) one teaspoonful every two hours, decreased to every three hours. After a few doses were taken there was a decided improvement, the respirations were slower and deeper, the expectoration freer and the temperature normal. In a few days the patient was practically well and able to return to school. No medicine except Glyco-Heroin (Smith) was given and the results from its use were excellent. CASE 2.-W. L., aged 31. Acute bronchitis. Painful cough, with difficult expectoration, particularly when in a reclining posture. Glyco-Heroin (Smith) in teaspoonful doses every three hours gave speedy relief and a cure was effected in a few days.

CASE 3.- S. W., aged 60. Chronic bronchitis. Had coughed for years, with expectoration of a thick, yellow purulent and very offensive matter. Had lost flesh gradually until about twenty pounds below usual weight. No appetite, very constipated, pains all over chest, night sweats, and insomnia. Patient on the verge of nervous prostration, and greatly weakened. She was given bromides, a tonic, and Glyco-Heroin (Smith), the latter in the usual dose at intervals of two hours. The first few doses were not well borne, as they seemed to cause some nausea, but by giving a smaller dose and then gradually increasing it, tolerance was soon obtained, and the results were remarkable. The cough and expectoration greatly decreased, the appetite improved, and the patient became much better in every way. The treatment was continued as before, except that the Glyco-Heroin (Smith) was given every three hours. In three weeks the patient was eating almost everything she pleased, and sleeping well. The night sweats had stopped, together with the cough, and, as the patient.

expressed it, she "felt like another woman." At present she is in perfect health and needs no medicine except an occasional laxative.

CASE 4.-B. E., aged 26. Severe bronchitis accompanying an attack of influenza. Various remedies were tried in this case, with negative results, until Glyco-Heroin (Smith) was given in teaspoonful doses every three hours. In a short time decided relief was obtained, and the cough stopped permanently. CASE 5.— R. L., aged 6. Capillary bronchitis with pains over chest, cough, and difficult expectoration. Glyco-Heroin (Smith) administered 15 drops every three hours. After taking a few doses the condition was much improved, and a speedy return. to perfect health followed.

CASE 6.-W. H., aged 5. Whooping cough. Spasmodic paroxysms of coughing, sometimes being so severe as to cause vomiting. Tenacious mucus was present, requiring great expulsive effort to loosen it. There was little fever, but the patient was much prostrated and weakened by the cough. GlycoHeroin (Smith) was given in ten drop doses every two hours with good results. This was combined with hygienic treatment, the patient being given as much fresh air as possible. In a few days the condition was much ameliorated, the cough under fair control, expectoration was freer and easier to raise, and convalescence uneventful. The case was discharged cured and there were no unpleasant sequelæ, the patient at present being in perfect health.

CAUSE OF CACHEXIA ACCOMPANYING NEOPLASMS.- Quite often a small, non-ulcerating, malignant tumor produces such a marked cachexia that we are at a loss to account for it. It was assumed that the tumor cells secreted a poisonous substance which was absorbed by the system, but no one attempted to isolate this toxin. Early this year, however, Kullmann has found that the cells of cancer contain a substance which rapidly dissolves blood corpuscles. This toxin he isolated and injected into the bodies of animals, producing a prompt and active dissolution of the blood corpuscles. A similar substance has also been isolated from the cells of sarcoma.- Canadian Practitioner.

Abstracts.

ASPIRATION AND INJECTION OF MORPHIN-EUCAIN IN TETANUS.*

BY PROF. JOHN B. MURPHY, CHICAGO.

A patient treated eight days after infection was given three full doses of antitetanic serum, but without effect; the convulsions increased and were almost continuous. Thereupon a lumbar puncture was made, and 16 cc. of cerebrospinal fluid withdrawn. At the same time 3cc. of the following was injected:Beta-Eucain, I 1-2 gr.; morphin sulphate, 1-3 gr.; sodium chloride, 3 gr.; dist. water, 3 1-2 ozs.

This had been sterilized by boiling. The patient slept four hours immediately and through the night one and one-half hours at a time. There were only eight spasms in the succeeding twenty-four hours. A more severe spasm occurring the next morning, another puncture was made, 15 cc. of fluid withdrawn, and 4 cc. of the above injected. This was repeated on the two following days, and then, with intervals of two days, two more aspirations and injections were made. He was discharged as cured ten days later.

The quantities of morphin and eucain used were exceedingly small, as this was the writer's first case. There was no sweating, headache, or collapse, symptoms frequently noticed after lumbar injections of cocaine. He believes the eucain should be increased to 1-6 to 1-3 grain at each injection, and this treatment might be made more frequent. Eucain is much safer than cocaine, as it admits of boiling, and there is less idiosyncrasy to intoxication. Reduction of the spasms prevents death from exhaustion or interference with respiration. The diminution of pus in the aspired fluid would lead one to believe that lessening of pressure aided the fluid in overcoming infection. There is no reason why the cerebrospinal cavities cannot be washed out by salt or other neutralizing solutions.

* Abstracted from Journal of American Medical Association, August 13, 1904.

Editorial.

ANNUAL COMMENCEMENT AND CLOSING EXERCISES OF THE MEDICAL DEPARTMENT OF THE UNI

VERSITY OF THE SOUTH.

The John S. Cain Medical and Surgical Society held its annual meeting in the auditorium of the medical college on Monday evening, Oct. 24, at 8 P. M., presided over by the President, W. J. Schmidt of Louisiana.

The exercises consisted in talks by the Dean on the value of medical society work and medical organization; by the Rev. Dr. Guerry on the mission and duties of the physician.

Two most excellent papers, one by A. S. Spangler of Tennessee, the other by T. R. Bausch of Pennsylvania were read.

Diplomas were then presented to thirty-two members of the society, attesting honorable membership therein.

The Society then adjourned to the E. Q. B. club rooms, and with the recently organized Alumni Association of the Medical Department, participated in an elegant parting banquet, which was presided over by J. M. Cunningham of Louisiana in his usual felicitous style. Toasts, responses, and speeches by students and members of the other departments of the university were indulged in until a late hour.

The annual commencement exercises of the medical and pharmaceutical departments, and training school for nurses were held in St. Augustine's Chapel at Sewanee on the morning of Tuesday, Oct. 25, a large attendance being present. There were thirty-six graduates it medicine, twenty in pharmacy, and four in the training school.

After a short service, certificates were presented by the Registrar, the Rev. Arthur H. Noll. In the absence of the Vice Chancellor, Dr. J. S. Cain, Dean of the medical school, presided and conferred the various degrees. The valedictory was delivered by Dr. A. S. Spangler of the senior medical class. Diplomas from the Nurses' Training School were presented to Miss Anesta Abernathy, Miss Vera P. Potter, Miss Eloise F. Richmond, and Miss Roberta J. Dunn, after which the degrees of Doctor of Medicine and Graduate in Pharmacy were conferred by Dean Cain. W. B. Hall,, M. A., M. D., delivered the faculty charge to the graduating classes. W. J. Schmidt, M. D., Ph. G., of Louisiana, was awarded the medal for the highest honor in the medical class, and James W. Falvey, Ph. G., of Texas, that in the pharmacy class. Honorable mention was made of A. S. Spangler, M. D., of Tennessee, and E. C. Seawright, M. D., of Georgia, in medicine; and of C. R. Reaves, Ph. G., of Tennessee, and W. J. Griffis, Ph. G., of Georgia, in pharmacy.

The degree of Doctor of Medicine was conferred on the following: F. A. Bausch, Pennsylvania; W. D. Bieberbach, Massachusetts; W. N. Breck