fectious diseases bacteria circulate in the blood, and that when carried to distant parts having a reduced resistance power they may excite suppuration, with the production of abscesses. As no means have been discovered to rid the blood of these pathogenic organisms, the idea occured that by producing artificially such points of lowered resistance it might be possible to collect them in such places and thus remove them from the circulation. Upon this principle is based the method of Fochier of establishing what he terms fixation abscesses by injecting turpentine into the subcutaneous cellular tissue of the leg. These injections, which are repeated, if necessary, evoke a violent phlegmonous inflammation, which, however, subsides in a few days. The resulting abscesses are opened during the period of convalescence and the pus evacuated. If the abscess threatens to burst spontaneously, another fixation abscess is established at another place. Owing to the marked germicidal action of turpentine the pus is sterile, and the abscesses therefore should be treated according to strict aseptic precautions. Another beneficial effect of such fixation abscesses consists in the promotion of phagocytosis and an increase of the bactericidal power of the blood.

Postoperative Empiricism.

S. T. Pope, Watsonville, Cal. (Journal A. M. A., October 21), criticises certain traditions of the treatment of postoperative cases, such as the food withdrawal before operation, refusal of water after operation, postoperative purgation, etc. The starvation, he says, has often developed a fatal acidosis and we have given beef tea or malted milk when we should have used carbohydrates and alkalies. After all general anesthesias he says it is a good procedure to let the patient drink repeatedly, at intervals, a glass of water containing a dram of sodium. bicarbonate. If this is vomited it is a good gastric lavage; if retained it tends to forestall acid intoxication. He ridicules the fear of constipation after operation and the use of depressant cathartics. The colon tube should be abandoned as of no use; a simple rectal enema will reach all needed parts possible to be irrigated in this way. Morphine, he says, does not favor the production of ileus. Used with judgment it is a beneficent agent after operation, relieving pain and not masking anything to the discerning eye. Giving carminatives for tympanites and hiccup should never be permitted. Their use is irrational and wholly futile. Whatever the demonstrations of Chile or Henderson have proved as regards the nature of shock, they have

made it clear that the hypodermic medication usually indulged in at this time is foolish. Salt solution can be used to excess and conservative measures, such as constriction of the extremities, are better than flooding the system with water. In simple collapse no drugs are indicated and moderate hemorrhage causing fall of blood pressure is probably conservative as tending to produce hemostasis and coagulation. The vasomotor system will readjust its physiologic balance itself if given time. In every case demanding catheterization, hexamethylenamin should be given in sufficient doses to prevent an ascending infection from cystitis and the value of the remedy in infections of the meninges, gall-bladder and serous cavities in general should be sufficient to prompt the employment of this valuable drug. It would be a good routine to give it in every case of confinement. The burden of his article is, he says, that we do a lot of stupid things because others have done them and we should be governed more by the well-proved experiments of modern research and simplicity should be the dominant element in postoperative treatment.

Hexamethylenamin.

D. Vanderhoof, Richmond, Vt. (Journal A. M. A., February 3), says that since its first introduction into medicine hexamethylenamin has become widely extended in its therapeutic applications. As a result of the suggestive reports of its utility when given by the mouth and the evidence of its elimination through various secretions, he began to employ this drug in the fall of 1910 in all cases of common colds that came under his care and in patients suffering from acute or chronic bronchitis. An investigation of the literature supported his views, showing that it could be of value in these conditions. In his treatment of colds with this drug no other remedies have been employed except an initial purgative and subsequent care to see that the bowels remain open. Large doses were found best and as a routine he gives ten grains dissolved in a glass of water four times daily for three to seven days, after which it is discontinued. The patient is instructed to drink water copiously during the time the drug is being taken and he has had but one patient that complained of any irritation of the bladder which ceased promptly after omission of the drug. Two cases of chronic antrum infection which had resisted operative measures and prolonged local treatment induced him to recommend this treatment as a prophylactic against sinus infection

from common colds. In the treatment of both acute and chronic bronchitis hexamethlyenamin produces results, he says, that are incomparable with the usually employed remedies. It is decidedly effective in colds, even when the bronchitis stage has been reached, but its chief value is in preventing this. Some cases do not respond to it and in these it is presumed that structural changes have occurred that would preclude the hope of successful treatment by any remedy.

Nitrous Oxide Anaesthesia in Adenoid and Tonsil

Operations.

Gundelach has found that the anaesthesia produced by nitrous oxide is of sufficient duration, not only to perform a complete amygdalectomy, but to remove the adenoids as well under a single administration. Ordinarily it takes on an average of thirty seconds to anaesthetize a child and forty-five seconds for an adult. It should be remembered that the patient is not carried into the stage of cyanosis. It is possible by means of the Sluder method to enucleate both tonsils and remove the adenoids in less than thirty seconds. Nitrous oxide is contraindicated in the case of obese plethoric individuals or those having atheromatous arteries, and while some have warned against nitrous oxide in infancy, Gundelach has seen no ill effects from it even in very young infants. The only other contraindicatio to his mind is in those cases where the status lymphaticus is suspected, a condition frequent in infancy, often existing without having caused definite symptoms, but nevertheless having caused a hyperthrophy of the pharyngeal ring of lymphatic tissue as a part of its pathological course.-Interstate Medical Journal.

In Hospital.

"Please tell me," said the quizzing Prof.
At nurses' lecture-drill,

"When would you say a man to be

Most dangerously ill?"

"A man," replied a pretty nurse,
The youngest that was present,
"A man's most dangerously ill
When he is convalescent."

-K. M. S.