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The John C. Baker Co. brings every doctor in America in close relationship with the Cod.

BAKER'S COD-LIVER OIL is pure cod liver oil, the name Baker and the word pure are synonymous in relation to cod liver oil. The Baker people allow no opportunity for adulteration.

They go to the best source of supply in northern Norway to secure the purest product. They are so much in earnest about it that they have fre quently visited that cold country. They have made sure that the cod is net taken at the right season; that every fish is in prime condition, and every liver sound; that the process of extracting the oil is the most improved, and that the oil is shipped under right conditions. These methods are not the development of a day-Baker's CodLiver Oil has a fifty years's history.

These are reasons why, without exception, Baker's Cod-Liver Oil is most efficacious.

JOHN C. BAKER CO., 131 N. 14th St., Philadelphia.

Therapeutic Notes.

Dr. Geo. H. Powers, professor of ophthalmology and otology, University of Californin. San Francisco, in an article in the Med. News, writes as follows in reference to the treatment of pain in otitis: "At my first visit I found a copious discharge of bloody serum from the ear with hardly a trace of pus. He suffered from severe cephalalgia, but there was no special tenderness in or about the ear, and no swelling. Thorough cleansing of the meatus with dry cotton relieved the pain remarkably, and with a dose of Antikamnia, 10 grains, he slept some hours."

Dr. S. A. Buchanan, 432 Snyder, Ave., Philadelphia, Pa., has used Irisol and has had excellent success with it in all of his surgical He writes: "I cannot say too much in

cases.

its favor."

A combination of colchicine and the salicylate have been found very effective in warding off an attack of gout or in dissipating the pain of various derangements, due to an excessive accumulation of toxic principles in the organism.

Many years of successful clinical experience has proved Imperial Granum is a nutriment acceptable to the palate and also to the most delicate stomach at all peroids of life, being in many cases retained and assimilated when everything else is rejected. In very extreme cases the Imperial Granum is often prepared with pure water only.

As an astringent of great power in the treatment of leuco.rhea, Micajah's Medicated Uter

For the EASY extraction of teeth. NO TUG AND PULL. Snap the Fulcrum on your dental forceps, apply the forceps to the tooth in the usual way and simply PRESS ON THE FULCRUM. Extracts ANY TOOTH with surprising EASE and absolute SAFETY. Enclose stamp for descriptive circulars and SPECIAL introductory proposition. Address the inventor.

DR. DUNN, Elma, lowa.

Prof. Otto Juettrer, of Cincinnati, reports that in the treatment of this disease Micajah's Wafers are a sovereign remedy.

The Franklin Mills Fine Flour of the entire wheat, originated and made only by the Franklin Mills Co., Lockport, N. Y., and which is without doubt the purest flour in the world, makes the best bread now known to housekeeping or culinary science, because it contains (reduced to an even finenes) all the bone, muscle, brain and nerve feeding elements of the wheat kernel, so unfortunately lacking in white flour, and is entirely free from the woody outer husk that makes Graham flour so coarse and so painfully indigestible.

Prior to the introduction of anti diphtheritic serum, the mortality from diphtheria at the Harper Hospital, Detroit, averaged for a number of years 40 per cent. According to the 34th annual report or the hospital authorities, as published in the February number of the Harper Hospital Bulletin, page 73, 141 cases were treated at the hospital with the following 1esults: Ordinary diphtheria, 115 cases with one death; laryngeal diphtheria, 26 cases with six deaths; excluded cases moribund or admission, two; mortality under antitoxin treatment, 3.6 per cent. The antitoxin employed. exclusively in Harper Hospital during 1897 was the Anti Diphtheritic Serum of Parke, Davis & Co.'s biological department, and the remarkable reduction displayed in the death rate reflects the highest credit on the efficacy of this match!ess product.

ONE DOLLAR PER ANNUM, IN ADVANCE.

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No. 3.

THE MEDICAL SUMMARY,

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Philadelphia, Pa.

ECZEMA OR TETTER.

These are small words, but signify much to the practitioner who has to do with a malady of wayward tendencies and proverbial obstinacy.

Its moods are legion, for it may be acute, subactute, chronic, erythematous, papular, vesicular or pustular, or all of these together and at once. Such a state of things is calculated to bewilder and vex the mind of the physician, whose greatest ambition is to relieve the patient's burning, itching, swelling and festering patches of integument.

Writers aver that the malady is characterized by the appearance of erythema, papules, vesicles, pustules and chronicity. The usual location is the face, but we know that it makes its unwelcome appearance on other parts of the body, as the arms and legs, and in the exures.

To classify and fully describe the different varieties, with the peculiarities by which the doctor must distinguish them from other eruptions having some misleading likeness, would fill many pages, therefore the reader must search some good work on diseases of the skin, as no attempt is made here to indite such a treatise.

Although it is a large subject, the importance of which is unbounded, yet its intricacies must be patiently followed by the searchlight of science until every obstacle in the way of correct differential diagnosis and effective application of therapeutics has been met and overcome. The reader will kindly remember that we are not attempting a treatise on the subject, but only seeking to impress more

thoroughly on the mind the importance of a much neglected subject, which, from time immemorial, has been greatly misunderstood and badly treated, the physician going at it with a shot-gun prescription, vainly hoping that some one or more of the shot may hit the mark.

Why is this so? Can it be that he is too idolent to devote the necessary labor to its study to adequately master the subject, or is the subject too intricate for the apprehension of the average mind? No one believes the latter.

There is no doubt but that eczema, in all its manifold variations, is within the grasp of any ordinary understanding, if the mind will approach its study persistently and with determination to hold on until success crowns the effort. Indeed no one can treat eczema without knowing, so as to recognize its clinical features at a glance. To the trained mind the way is clear, and the right remedy is never used in the wrong place, but to the eye that sees all things darkly, eczema rubrum may be herpes zoster, or dermatitis herpetiformis may be eczema vesiculosum.

Again the different varieties must be differentiated; the different stages of the same variety must be differentiated, because treatment that fits papular eczema is not necessarily best suited to squamous eczema, and because further treatment, appropriate for an acute stage, may not be the best for the stage of chronicity, and vice versa.

The only condition that seems to justify shot-gun prescribing is where, in the same patch of diseased integument, disease is manifested in two or more of its stages and by its different varieties.

It has occurred to us that the malady has not only been an illy understood source of embarrassment to the general practitioner, but because it has been mis

understood, and treatement, as a consequence, ineffectual and aggravating, it has proven itself a disastrous leak both to purse and reputation. These remarks are particularly directed to the general practitioner, because a goodly share of his business consists in the treatment of affections of the skin.

SPECIFY.

Although your druggist may be perfectly honest in his convictions that his stock is reliable, many never test the quality of drugs purchased, and too often are influenced to sell an inferior quality through the greater margin of profit in it. The only safe rule for the doctor is to specifiy, when prescribing, the product of

the manufacturer that he knows to be absolutely reliable, and to see that his request is carried out.

NOTE.

The summer diseases of children in their various phases form seasonable topics for discussion just now, and we hope that some of our readers at least will look up their last year's case records in this particular line of practice and let us have their best thoughts and deductions incorporated in a brief, practical article, and mail it to us for publication in June or July issue of the SUMMARY. We aim to have all matter in SUMMARY appear in proper season.

Please bear in mind that we are always glad to receive, for publication in the SUMMARY columns, short articles of a practical nature, description of interesting cases, practical notes or paragraphs and well-tried formulas, as well as inquiries on diagnosis, treatment, etc. sides, we hope that our more experienced readers will not be backward in lending assistance to those of their less-favored brethren who may seek it through these columns. The SUMMARY is a recognized medium for the exchange of ideas.

Be

M.

Chloral hydrat Syr. simp....

....... aa 3 iiss

...

. Zij Sig-Teaspoonful every two hours.

I saw her again Feb. 10th and found her condition worse than on preceding visit. The entire muscular system was now involved. Patient was unable to hold anything in her hands, speech unintelligible and heart action irregular. The treatment was changed and the patient placed on liquor potass. arsenitis.

On the morning of the 12th patient was no better. Stomach rejected medicine, food and drink, and patient had not slept any for two nights. I again placed her on increased doses of potass. bromide and chloral hydrate; was called again in the evening to see her and found her still vomiting. I gave a hypodermic injection. of morphine sulphate, gr. 1-4, and atropine sulphate, gr. 1-150, which controlled vomiting, and placed her on morphine sulphate, gr. 1-4, and atropine sulphate, gr. 1-150, and directed it to be given every two hours.

Feb. 13th, a. m.-Patient had slept two hours preceding night and taken and retained some nourishment; continued morphine and atropine.

Feb. 14th, a. m.-Patient much worse. Had not slept any; required to be restrained; delirious.

Feb. 15th, 10 a. m.-Called Dr. J. C. Weidman, of Mercer, Pa., and decided to induce labor, which we did by introducing a soft rubber catheter in uterus, after first having given patient antiseptic douche and sterilizing catheter, which we re

tained by packing vagina with sterilized gauze and a T bandage.

Feb. 16th, II a. m.-Was called and found patient in first stage of labor; convulsive movements not so marked; labor progressed very slowly, being marked with many irregularities. At no time did patient have true labor pains. Pains would come on which would excite convulsive movements of the entire body, when force of pain would be lost. Os at one time soft and fully dilated, and in short time it would become rigid and contracted; uterus would decend low in pelvis and again ascend, or when pain would occur it would ascend and decend. Liquor amnii having broken sometime previously and patient becoming exhausted, I decided to apply the forceps, which I succeeded in doing without an assistant. I had but little difficulty in delivering patient of a living child. The third stage of labor was normal. I remained with patient for some time, and on my departure left some morphine, with instructions to keep her fully under its influence in order to give her much needed rest.

Feb. 17th.-Temperature, normal; discharge, normal; convulsive movements, none. Gave her full doses of chloral

hydrate, continued through the day. Patient growing worse, requiring to be restrained, at 6 p. m.; gave her morphine, no improvement. At 8 p. m., patient wildly delirious; gave her inhalation of chloroform, after which she slept for two hours, and all motion ceased; when she awakened she was worse than ever, but perfectly rational, and thus it continued throughout the night and the succeeding day. Patient growed weaker and finally died on the morning of the 20th from exhaustion.

At no time was there any evidence of septic trouble, and I believe if I had a similar case to treat again I would interfere with pregnancy earlier. Cause should be removed while patient has strength sufficient to endure effects. I discover that many authors give chorea as produced by pregnancy, but very few give treatment. In my experience I would regard chorea as a very grave complication of pregnancy, and medicinal treatment of very little value.

If any of the readers of the SUMMARY have seen similar cases I hope they will give their experienee, as the medical authority on the subject is very rare, and it may be the means of asssisting some brother in a similar case.

Slippery Rock, Pa.

TREATMENT OF TYPHOID FEVER.

BY H. F. FISHER, M. D.

AVE just been reading Dr. R. J. Young's article, March SUMMARY, on Treatment of Typhoid Fever." His experience with the disease is greater than mine, and I would not criticise him, but nevertheless, it appears to me that he used too much medicine. Antiseptics he certainly gave, in the series of cases he referred to, but to my mind he used too many. My own experience is that calomel is as reliable an antiseptic as I know of. I give it in powder with ipecac and bismuth subnitrate as follows:

B. Hyd. chlor. mit....
Pulv. ipecac

Bismuth subnit....

.gr. j .gr. iv 3 ss to 3 j

M. ft. chart No. xij. Sig.-One every two hours.

Sometimes I give it every hour and every three hours, according to conditions, but begin often in giving it hourly, and in about 24 hours every two hours. There are two other drugs that I sometimes vary the prescription with-podophyllin, in 1-12 or 1-10 gr. doses, and calcium sulphide, in 1-8 to 1-6 gr. doses. When the bowels are too constipated the podophyllin acts very nicely, and about the calcium sulphide I cannot tell exactly why I give it, and in fact have only used it in a few cases. I believe that here is a drug that does not receive attention enough. It appears to me to have a mitigating influence upon the toxins in the blood. However, that is as much as I can say of it, and would like to hear from somebody who has had more opportunity to study its action. When I give it I put the powder in a capsule or conceal it in powder form.

Recently, when treating a patient with another physician, we found that she had passed some of the contents of capsules

which were administered five or six days previous. They contained thymol for one thing, but the other ingredients I cannot now recall. They were like little sticks of rubber, and when bent they would straighten out again. No telling what the druggist used to mass them with. Of course, I always have mine filled in powdered form. Can say nothing of thymol, menthol, eucalyptol, hydronaphthol, etc., for I have never used them.

Guaiacol makes an exceedingly nasty mixture to take. I have applied five or ten drops to abdomen for high temperature with apparent benefit and no bad effects, and if I used it at all this would be my method. Cold sponging persisted in will nearly always reduce temperature. When it is not sufficient the guaiacol comes in very nicely. I sponge patients almost continuously for hours sometimes. It is hardly too much to say that the introduction of the cold water treatment for fever is as great a boon to humanity as anesthesia.

I believe zinc sulpho-carbolate to be good where there is too much diarrhea. I combine it with calomel and ipecac in the old, reliable prescription, as I have come to call it. Where calomel is continued in this manner, faithfully, I think there will be little tympanites and little of that distressing dry, brown tongue, though perhaps the ipecac has something to do with the prevention of the latter. I have seen a tongue thickly piled up with that brown, dry coating, and the patient so deeply unconscious that he could not be aroused, and the administration of 1-10 gr. doses of calomel every hour revived his consciousness and moistened his tongue in 12 hours. When the calomel was discontinued the condition returned, to be again disipated by the calomel. This course was repeated once more, and this time I continued the calomel for a week or more and there was no return of the coma and dry, brown tongue, and the patient eventually recovered. This was the case

that led me into the calomel treatment. I do not say that it will shorten the duration of the disease, for I have had cases that were only moderately severe, and where the patient never had any alarming symptoms and never even became un