patient had twelve X-ray sessions with no results. In December, 1911, a few lesions on one hand were treated by electrolysis and the rest of the warts on both hands began to disappear. A few months later only whittish spots marked their site.

Prophylaxis of Coryza With Acetylsalicylic Acid.

Sick has found that one or two doses of 1 gm. each of acetylsalicylic acid, taken at the first indication of an oncoming cold in the head, will arrest it. The drug is especially effectual when the first tickling in the throat is felt towards evening, and the drug is taken then and again in the morning. This permits him to go about his surgical tasks after breakfast without any further symptoms of coryza. If acute rhinitis has developed or the coryza relapses, two or three further doses always cured it completely. He does not think the drug acts on the bacteria but it seems to enhance the resisting powers of the tissues. He regards the salicylic preparations as physiologic drugs, as they do not injure the tissues while they re-enforce them, just as we are learning to appreciate and utilize iodin more and more.— Munch. Med. Woch.

Soap in Cholelithiasis.

Mosse emphasizes the two facts that in certain cases of gallstones the knife is the only effective means of cure, and that in certain other cases a cure occurs without any treatment. Besides these, however, there is a group of cases in which the gallstone trouble can be cured by stimulating the secretion of bile, and for this he thinks nothing surpasses a mixture of 10 or 15 gm. of medicinal soap with mucilage of acacia q. s., to make sixty pills; three pills daily. The pills can be supplemented by rectal injections of oil. This treatment is to be commenced on subsidence of the acute attack; during this, belladonna or atropin may be required. This soap treatment was introduced by Senator, and some experiments reported this year from Pawlaw's clinic confirm, Mosse says, this cholagogue action of soap. -Therapie der Gegenwart, Berlin.

Significance of Physiological Age.

Crompton presents the importance of appreciating the differences that may be present between the physiological and the chronological age. He cites the fololwing that was adopted by

the National Educational Association in July, 1911: The laws should recognize the difference between the chronological age of a child and his maturity, and the school age limit of each individual child should be determined by requiring the child to meet physical and mental tests, even though the child be in years above the age standard; in other words, a child's actual age should be determined by physiological data corresponding to the normal standard for the age limits required by law. All children or persons failing to meet such maturity tests at the extreme school age limit should remain under public supervision and control, either until they reach the maturity or permanently. The same principle should be the guide in determining whether a child is fit to be employed in any occupation. Not when a child is fourteen or sixteen years of of age, but when he possesses the maturity of body and mind proper to a normal child of that age, should he be released from the guardianship of the state or of the community. Child labor laws should be so modified as to meet this requirement.-American Journal of Obstetrics.

Heliotherapy in Surgical Tuberculosis.

Gertrude Austin relates her visit to Doctor Rollier's hospital at Leysin, Switzerland, where little tuberculous children are exposed for hours daily without clothing of any kind to the sun's rays in midwinter at an altitude of 5,000 feet. The body of the patient is exposed to the sun's rays in galleries opening into the wards and facing due south. The actual seat of the disease is uncovered for five minutes only, the first day, that the skin may not be burned or blistered; the next day the region is treated for two periods of five minutes each, separated by an interval of half an hour; and on the third day these exposures are extended to fifteen or twenty minutes. Each time a larger area of skin is exposed, so that by the end of a week or ten days the entire body, the head excepted, is lying nude in the sun; later the head, too, is uncovered. The large windows of the steam heated wards are never closed, even at night. A carefully studied diet aids the building up process. Of 369 cases of surgical tuberculosis treated by heliotherapy, 284 (78 per cent) ended in recovery; forty-eight in improvement; twenty-one remained stationary; sixteen (4 per cent) ended fatally. Rollier does not concentrate any one ray (Finsen), but uses diffuse white light just as it comes from the sun.

Measles.

Tait (Br. Med. Journal) basis his paper on the study of 437 cases of this disease in an epidemic. His series gives striking evidence of the fact that death depends upon the pulmonary complications, such as bronchitis, pneumonia, and bronchopneumonia. In the first five years of life the curves of incidence of pulmonary complications and of death are parallel. The total death rate of the epidemic was 5.03 per cent. Severe pulmonary complications were present in 23.57 per cent of all cases. He finds that pneumococcal infection is the prime cause of deaths in measles. It is especially noticeable that in those cases of pulmonary complication in which the cause was prolonged, recovery was almost invariably the rule, even in the most severe cases. Tait found that even children who were suspected of being tuberculous recovered after severe pulmonary complications. In this epidemic epistaxis occurred in ten per cent of all cases, mild and severe. This came on just prior to the appearance of the rash, or within twelve hours after its appearance. He found Koplik's spots of no use in diagnosis, for so many children had some kind of mouth lesion not typical. In his entire series he had no case of the disease without more or less distressing cough. About fifteen per cent of the patients were stated to have had measles before."

The Obstetric Forceps and Their Relation to Mother and Child.

(From the Bulletin of the Lying-in Hospital of the City of New York. By J. W. Markoe, M. D., Attending Surgeon.)

"Thus have we described the mechanism of the extraction of a possible fellow citizen from its mother's womb, and the great question which now arises is when to apply forceps and what conditions call for the use of this artificial aid. You all know these conditions for each and all of us committed them to memory before we dared present ourselves before the examiners, but do we really know them? Truly not. There is but one thing that will give us skillful judgment in this respect and this is experience.'

"It would be superfluous to go into all of the many complications that may arise in forceps cases, for they are legion, but I would urge you strongly to exercise the utmost conservatism about performing the so-called high operation. It is, I

believe, and feel sure that there are many of you who agree with me, the most dangerous of all surgical procedures, for not only is the life of the mother put in jeopardy but also that of the child; if it were limited to life alone, one could try to soothe his conscience by not repeating it, but too often, although the lives of both mother and child are saved, the mother will be so invalided as never to be the same as formerly and the child becomes epileptic, palsied or otherwise afflicted."

"Unhappily these dire results do not at once appear, and it may not be until years after the operation that the terrible unyielding pressure of those steel blades shows itself, only to be laid at the door of something else. There is not a gynecologist who does not frequently see cases that can surely be traced to ill conducted forceps operations. In regard to the children, it is here more difficult to fix the blame, for we all have seen, and frequently do see spontaneous deliveries in which the mere pressure of the delivery through the maternal canal caused death from cerebral hemorrhage, but is it not safe to say that if the maternal pressure alone may cause such destruction, that the added pressure of the forceps may do the same and in a greater degree?"

"What we all desire is to deliver our patients, be they rich or poor, with the least mortality and morbidity possible, and it would seem better if more could be done in urging patients to help themselves, to use the posture treatment so admirably expounded to us recently by Professor King and to keep our forceps for those cases where we fell quite sure that their use will not inflict any permanent injury upon the mother or child." SOMERS (Omaha).

Digitalis in Heart Disease.

According to the Therapeutic Record in an important article, MacKenzie reports forty-three cases of various heart diseases which he treated with digitalis. MacKenzie says his studies lead him to the following conclusions: Patients react differently to digitalis. So far as the heart is concerned, he says, the difference is partly due to the nature of the lesion with which the heart is affected. Patients having auricular fibrilation are more readily and markedly affected than those with normal rhythm. The drug, in a proportion of patients with normal rhythm, affects the auriculoventricular bundle more particularly, and this produces partial heart block. It is suggested that the suscep

tibility of patients with auricular fibrillation may result from the tendency of digitalis to affect the bundle, the change in the auricular condition rendering the bundle more susceptible to the influence of digitalis. MacKenzie thinks it possible that in slow ing the heart's rate, the digitalis acts by stimulating the vagus nerve. He says digitalis tends to induce auricular fibrillation. In two of the cases of tachycardia outlined in MacKenzie' paper, both of which arose from an abnormal source, the actior of digitalis was to cause the heart to revert to a normal rhythm, He says the diuretic action of digitalis may be produced wit no perceptible change in the heart.

Diagnosticating Typhoid Fever in Children.

Depasse, in Journal de medecine de Paris for June 1, 1912, points out that the peculiar stepladder temperature record, the "ascending oscillation" of Jaccoud, is frequently absent in children, thus misleading the physician who awaits this pathognomonic sign. Furthermore this observer has noted that typhoid in the young is often characterized by an abrupt onset with complaint of sore throat or pain in the knee. Almost certain, according to him, as a sign of a typhoid attack is a sudden rise in temperature accompanied by a slow pulse, or one bearing no apparent relation to the fever, a combination peculiar to this malady, as in all other diseases of children both pulse rate and temperature rise together. An early serodiagnosis should be made in all febrile cases in children, and typhoid fever would be found oftener than the average physician is prepared to believe.

The Complainant: "You see, Judge, I was a little to happy, as you might say, when I went home, and me wife was ironin'. We'd had a word or two in the mornin', an' so I steps up prepared to make peace. I said: 'Let's forget th' quarrel-we were both wrong,' when what does she do but shove the hot iron against me head."

The Judge: "Trying to smooth it over, of course. You can't blame her for that. Go home both of you."