Acute dilation of the stomach is often mistaken for peritonitis, so that a condition is overlooked that as a rule could be easily corrected, were a diagnosis made, but which is more often fatal.

When the patient keeps regurgitating rather than vomiting, and the upper abdomen is distended, the stomach should be repeatedly washed out with hot alkaline solutions to get rid of the gases and acids that may have accumulated. To keep the condition from recurring a re-establishment of the peristalsis is most important. Nature keeps up peristalsis of the alimentary tract by means of an internal secretion, stored up in the lymphoid tissue, especially the spleen. This internal secretion is produced in the pyloric end of the stomach and can be recovered from its mucous membrane. Intravenous injections of this secretion will produce most remarkable movements of the involuntary muscles.

In all cases where dilation of the stomach or ileus of the intestines are to be feared Hormonal should be used subcutaneously. There is one other internal secretion used by the body to act especially on involuntary muscle seither of the blood vessels, uterus, or intestines. This secretion comes from the hypophysis. Sometimes this will bridge the patient over a crisis when nothing else will.

For many years it was the common practice to use strong cathartics and high enemas to clear out the bowels, then leave the bowels dormant for four or five days following the operation before starting them again. Such a course is not logical, and the gas pains, nausea and vomiting can be largely done away with by following a different course.

One to two properly given enemas will clean out the colon, which is the great object in giving a cathartic.

Just why the physicians ever got into the habit of keeping the bowels locked up following operation is hard to understand. We know the colon is the receptacle for the waste products of metabolism. From this receptacle they may be re-absorbed into the system.

Gases are continuously formed in the colon by the bacteria, and as a result the etherial sulphates, ammonia, cholin, etc., are taken up, causing all forms forms of auto-intoxication. Ought not these poisons be removed every day, even more after an operation than when by one's own activity they are more or less removed?

Experience has taught us that a compound enema once or

twice a day will relieve most of the distension and gas following abdominal operations. Most of the poisons of the body are removed by the kidneys, and a thorough flushing of the kidneys will enable the body to throw off great quantities of toxines and the by-products of cell metabolism.

English surgeons have been following Murphy's idea with most satisfactory results. Suppose it is a case of general peritonitis. following an acute appendix explosion. Every four hours a saline enema is given. Much of this will be absorbed and flush the kidneys, helping them remove the poisons which have been absorbed by the body from the peritonitis.

Sometimes the body is being poisoned by some of its own internal secretions. Then the saline enemas are a vast aid in diluting and removing them. Water is one of the most abundant and important costituents of the body. Its circulation is very interesting. The stomach does not absorb water at all. The lower part of the small intestines and the caecum pass the water from their lumen to the vascular system in which it makes the rounds of the body. Part of it is excreted by the kidney, skin and lungs. Part is excreted again into the stomach, from which it starts on its rounds.

Now we can understand the thirst and intoxication of patients with obstruction of the pylorus. However much water they may drink none of it gets into their system if the pylorus is closed. They are auto-intoxicated because the great means of flushing has been cut off. How the colon may be used to introduce water into the system is well worth knowing. It is a well-known law that in all living tubes there is a double current. In the colon, for example, the contents of the bowels are moving from the ileo-caecal valve to the rectum, but from the rectum to the ileo caecal valve a fine capillary current is constantly flowing. This fine capillary current is the course we want our stream of saline to take. To succeed we must get past a sentinel situated at the junction of the rectum and the sigmoid flexure. Here a nerve center stands guard and may block our purpose by setting up vigorous peristalsis. To avoid that our saline should be given under very low pressure and with the tube juts inside the internal sphincter. Trying to pass the colon tube around to the ileo-caecal valve has caused the death of many a patient.

Doing our work with nature for our guide is so satisfactory that I feel that every physician and surgeon should keep up with the newer things in physiology.

Treatment of Rheumatism With Rheumatism Phylacogen.

Man aged 43, married, American, on September 10 called to see him, had chill and fever-felt stiff. Pain in all the joints, especially left knee, and both feet-swollen, red and very painful. Was unable to use his legs or feet-temperature 104, pulse 110, respiration 22. One year ago patient had similar attack.

September 12 every joint in body was involved. Gave him 20 grs. sodii salicylate every two hours for 15 hours and on the third day repeated salicylate. He was unable to retain the medicine, no relief. September 13 gave him 3 CC Rheumatism Phylacogen. Had severe reaction, feeling of numbness over whole body, rise of temperature to 102, pulse 116, respiration 22. September 14 was free from pain. September 14 gave him 5 CC Phylacogen. No reaction, temperature 101.4, free from pain, could move his feet and knee, although very much swollen.

September 15 gave 5 CC, continued to improve, sat up in chair for two hours, no pain in joints.

September 16 gave 5 CC, left leg swollen, less free from pain, sat up two hours.

September 17 gave him 10 CC, in abdomen, reaction sure, numbness, slight chill, rise in temperature 102.2, pulse 120, respiration 20, absolutely free from pain, swelling nearly all gone.

September 18 very much improved, could sit up, temperature 98.4, pulse 90, respiration 19.

September 20 could stand and walk across the room, says he feels well, eats well, etc.

From first dose September 13 of 3 CC Rheumatism Phylacogen he showed signs of improvement-its effect was immediate and was free from pain. I gave him in all 28 CC Phylacogen. He had a severe reaction from 10 CC-the only other medicine given him was 1-40 gr. strychnine every two hours; did not use any local application; no sedative.

It is my first experience and I would like to hear reports from doctors who have used it. In this particular case it gave excellent results. October 2 he is walking around and is free from pain and says he feels perfectly well.

F. P. DORSEY, Hartington, Neb.

ABSTRACTS.

The Relation of the Tonsils to Rheumatism.

Paul Roethlisberger calls attention in the Munchener Medizinische Wochenschrift for February 20 to the importance of the tonsils as an etiological factor in acute and subacute recurrent polyarthritis and frequently of primary articular rheumatism. He advises careful digital examination of the tonsils and radical operation if the rheumatic condition does not improve rapidly. In many cases the tonsils contain encapsulated abscesses which should be opened.-Med. Stand.

Measles.

Two discoveries about measles, made by Dr. John F. Anderson and Dr. Joseph Goldberger, of the Hygienic Laboratory, Washington, promise to have a decided influence in our management of the disease hereafter. The first is that the epidermal scales which are shed during the stage of convalescence contain no infectious material and do not serve to convey the disease; the contagion is really conveyed by the secretions from the nose and throat. The second is that lower animals may suffer from measles, monkeys already have been infected. The immense practical value of these observations is apparent. How many people realize that measles is the most deadly of all the contagious diseases of childhood, having exacted a toll of 6,598 lives in the last year reported by the census bureau?

The Cause of the Onset of Labor.

Stimulated by an editorial in these columns (J. A. M. A.) commenting on the work of Heide in causing the onset of labor by injection of fetal serum, Rongy has repeated the work of Heide and in a report of nineteen cases adds to the interest and information in regard to this subject. In six patients injected with small quantities of fetal serum, prepared after the method suggested by Heide, ten to eighteen days before term, expulsion of the child followed promptly. In all cases, uterine contractions were observed by Rongy soon after the injection of the serum, although no pains were felt by the patient. It was determined that pains were felt only when there was direct stimulation of the cervix by the pressure of the bag of waters and the oncoming head. In two cases it was found that whereas injection of

a large dose produced reaction promptly, injection of 5 to 7 c.c. followed by a large injection of 20 to 25 c.c. four or five hours later gave a more severe reaction. In two cases of inertia uteri, the serum was very effectual and injection was followed by active labor pains within a short time after injection. Finally in a case of threatened eclampsia, injection of serum induced labor and all urinary symptoms cleared up immediately after the first injection. In seven cases negative results were obtained, in four of these there were precordial pain and oppression, in practically all some nausea and vomiting, and in two slight pains which may or may not have been induced by the serum. These results appear distinctly encouraging. The work of Heide has been corroborated and we have reason to believe that fetal serum does contain substances that may cause the onset of labor. An interesting field has been opened for further investigation. The exact nature of these substances, their mode of action and their role in causing the natural onset of labor are some of the problems to be solved.

The Sweat of fhe Tuberculous.

The question as to the possibility of infection from the sweat of a consumptive has often been discussed, but little scientific evidence has ever been brought forward to prove that any real danger exists from this sorce. It has been recently reported, however, that M. Piery has established the presence of the tubercle bacillus in the sweat of every patient with consumption that he has examined, and that inoculation experiments with guinea-pigs have yielded positive results. If these observations are confirmed, a fresh avenue of infection may be looked for, and it is possible that by this means may be explained the frequent and well-authenticated cases of the communication of the disease by a person attacked by it to another, with no hereditary liability to infection, who is brought into frequent contact with the patient, as in the instances of husband and wife, nurse and invalid, and the like. M. Piery recommends, therefore, the careful disinfection of all garments, bed-clothing, and so on, used by a tuberculous patient, and his or her isolation as far as possible, especially at night time.-The Medical Press.

The Cancer Problem Today.

A. W. Blain quotes Crile as saying that there is no tie of sentiment between a man and his cancer. Enlightenment ought