cocci, bacterium coli commune, bacillus pyocyaneus, and bacterium lactis aerogenes, all of which are known to occur in the intestinal contents. It is pointed out that this variety in organisms concords with the multifariousness of the symptoms of gastro-enteritis, whilst it shows that prophylactic measures are more hopeful than therapeutical, the value of which latter must depend on the kind and intensity of the general infection.

CHLOROFORM.-V. G. Stadnitzky, in the British Medical Journal, has carried out a series of elaborate experiments on seven healthy young men in order to study the influence of chloroform, when administered internally, on the gastric functions. In each instance the experiment lasted fourteen days, being divided into two equally long stages, during the second of which the subject was given from 3 to 10 drops of the drug (with water) three times daily. The author's general conclusion is to the effect that CHCI, markedly improves all the functions of the stomach, which fact suggests that the drug might prove very valuable in the treatment of various gastric disturbances and, before all, in dyspepsia.

MECHANO-THERAPY IN CHRONIC DISEASES OF THE HEART.-In the Practitioner, Eccles writes an article on this subject, which is quoted in the Medical and Surgical Reporter. He believes the rationale of the treatment of certain chronic diseases of the heart, by a combination of rest, massage, assisted and resisted exercise, followed by outdoor walking carefully graduated, is based upon:

1. The rest afforded to the overstrained or enfeebled heart by the adoption of the recumbent position for a time.

2. The aid given to the circulation by the mechanical centripetal pressure exercised on the limbs and trunks by massage.

3. The more rapid oxygenation induced by the acceleration of the circulation and the diminution of peripheral resistance by the same means.

4. The improvement in general nutrition, the elimination of waste products, and the increased metabolism induced by the passive and active exercises in and out of doors.

5. The careful preparation and selection of suitable food, coupled with the aid to digestion afforded by abdominal massage and exercise acting directly on the walls of the abdomen and exercising pressure on its contents.

6. The substitution of regular, graduated, assisted and resisted movements for the spasmodic and ill-regulated exercise taken by patients suffering from cardiac functional disturbance, with or without organic lesion.

WOUNDS OF THE CILJARY REGION AND LENS. — Dr. Robert L. Randolph reports in the New York Medical Journal three cases of penetrating wounds of the ciliary region and lens with the following suggestions for treatment :

1. In penetrating wounds of the ciliary region and lens, even where light perception is gone, and where usually enucleation is performed, the removal of the lens will often be followed by the

recovery of comparatively useful vision.

2. The time to perform the extraction is in the first week of the injury, when there is less reason for entertaining the fear of sympathetic ophthalmia, and that sympathetic disease is too remote a contingency in any event, and certainly at this stage, to outweigh every other consideration.

3. The effect of the operation is to remove what is really a foreign body, and at the same time it frees the ciliary region of its infectious contents-very much the effect of opening an abscess.

4. Cleanliness is imperative in this operation. I usually sterilize my instruments in a two per cent. solution of bicarbonate of sodium, and keep the field of operation constantly irrigated with a two per cent. solution of boric acid. Any solutions that irritate—such, for instance, as sublimate solution-are to be avoided, as they weaken the resisting powers of the eye. The after-treatment consists in the instillation of atro

pine, one per cent. every four hours, and the wearing of a compress bandage.

5. Improvement in these cases, as would be expected, is rapid, and unless. it is rapid one should not delay enucleation.

ADULTERATING OLIVE OIL WITH CASTOR OIL. Olive oil, says the Pharmaceutical Era, is found to be frequently adulterated with castor oil. It is even claimed that the olive, especially if it has become strong smelling or rancid, is improved by the addition. As much as 20 per cent. of the adulterant may be added without detection. An Italian expert claims its presence may be discovered by taking 10 cc. of the suspected oil, mixing it with half its volume of hydrochloric acid, and then shaking them together in a test glass graduated to o.I cc. If any castor oil is present the liquid will separate, on standing, into three well-defined layers, the lowest of which will be the hydrochloric acid, the top the olive, and the middle the castor oil. This test may be used with sesame, cotton seed, colza, earthnut and linseed oils.

THE CALIBER OF THE AMERICAN INTESTINE. — In communicating to the Société de Chirurgie, says the Lancet, the results of some experiments he had carried out on dogs with Murphy's anastomosis button, M. Chaput made a statement which seems to us to open up a field for speculation, if not for inquiry. Basing his opinion on numerous measurements of the human intestines, the distinguished French surgeon informed his audience that the 27 mm. button is far too bulky for the small gut in general, and especially for the lower end of the ileum. Of the three sizes he prefers that which is about equal to 21 mm. in diameter; it is the smallest and adapts itself to the situation more readily than the others. Now, the question suggested by M. Chaput's remarks are these: Do American citizens, as a rule, possess more voluminous intestinal tracts than their French congeners, and, if so, how far is cookery responsible for the differ

ence? It is, of course, notorious that French cooking is the best in the world; has this fact any bearing upon the presumably small caliber of the French bowel! Digestion being made easy, so to speak, is it the case that a partial arrest of development has been the consequence? Is there also discrepancy as regards length between the prima via of the two nationalities? Savages are endowed with magnificent mouth furniture, and dental decay is sometimes said to be a product of civilization dependent to a great extent upon knives and forks! Has the human race any reason to dread analogous deterioration as a corollary to elaborate cookery? Finally, and by way of closure to these obiter dicta, are dainty dishes a physiological mistake?

UNION OF FRACTURED CLAVICLE BY SUTURE.-Routier, in the Medical News, has reported the case of a woman, twenty years old, who sought relief for a deformity at the outer portion of the right clavicle of progressively increasing degree. It was learned that a week previously she had fallen from a carriage and fractured the clavicle at the junction of the outer third with the inner twothirds. The outer extremity of the inner fragment appeared as a prominence beneath the skin, and by depressing the soft parts the surface of the fracture was reached. Below and behind this prominence the inner extremity of the outer fragment could be felt. The separation equalled two finger's breadths. Fairly firm union had taken place and the deformity was quite considerable. It was proposed to attempt to correct the deformity under anesthesia, and should this fail to expose the bone and bring the fractured parts in accurate apposition. Permission having been obtained and simple reduction failing, the second procedure was carried out and the two fragments were sutured with strong silk. The overlying periosteum was carefully replaced and sutured with fine silk. The wound was closed and suitably dressed. In the course of three weeks firm union had taken place without the least deformity.

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IT is usually in the early spring that thoughts of study abroad are suggested and

too often, from vague Medical Study Abroad. and unformed ideas on

the subject, is this study unprofitable and the young physician especially is too uncertain of his career to know what he wants in the European schools of medicine. Advice is plentiful and while some are ready to give any kind of advice that will please whether it be right or not, still there are others who will honestly say what in their judgment is the best way of studying abroad.

In the first place it has so often been said that the knowledge of a continental language is not necessary, as much of the work is demonstration, but experience has shown that an acquaintance, even though limited, with the language of the country will render any form of instruction more profitable than the mere guess work of sigus or even the imperfect words of a foreign instructor. The next best thing to both speaking and understanding a language is understanding it alone and the

latter is naturally much easier, but even then the confusing of idioms and difficult negatives has too often left a perplexing impression on the brain.

There are many ways to assist one in learning a foreign language while studying abroad and one is by avoiding one's own fellow countrymen, which is not at all easy, and the other is by leaving all English books at home and using the books of the country. Association with German or French students in class room and elsewhere will in an easy way be the means of imparting the language provided the foreigner in his desire to learn English does not get more than he gives. It is just as well to have some idea what studies are to be followed before starting out, for there is in some places, as for example, Vienna, such a varied menu that unless one is previously prepared, indecision, confusion and discouragement are sure to follow.

The mature physician usually knows what he wants when he goes abroad and if he has some familiarity with the language he goes straight to his point and accomplishes in a few months what he needs, but the younger man who has just graduated will usually do well to wait until he has spent several years in practice in hospital or outside, until he has by elimination narrowed down his work to that point where foreign study begins to be profitable. A specialist has no difficulty in deciding on his work if he is a specialist by elimination of other branches, by succession and not by his own choice. The young man who graduates and begins his special work at once too often makes a poor beginning.

There are now excellent opportunities for special work in this country and all the large cities offer inducements for work in "courses," but it is doubtful if any place in this country can yet compare to the opportunities of foreign hospitals, as in the General Hospital in Vienna, where there are about three thousand beds and ten thousand cases of labor a year. In a paternal government, too, where persons are not equal and do not pretend to be and where military obedience so universally prevails, patients allow themselves to be used for purposes of examination and instruction without a murmur, while in this country where freedom begins with a capital "F" and where equality is a matter of law only and not of fact, even the humblest hospital patient may object to examinations

and what he calls his rights must be respected.

Study abroad may be sneered at by those who cannot go themselves, but the advantages. are numerous if there has been an intelligent preliminary preparation.

Salicylates and Rheumatism.

***

WHEN salicylic acid and its salts were first recommended for the treatment of acute articular rheumatism it was supposed that they were a specific, a form of treatment that would cure every case. It is, therefore, always interesting to record observations on these salts to show the result of experience and careful observation without that harmful enthusiam.

Dr. John W. Shaw of Washington, D. C., asks in the Virginia Medical Monthly how we are to know whether to use the salicylates or not. He thinks that too much confidence should not be placed in the salicylates unless we use them in an intelligent way.

While they possess advantages well known to most physicians, still there are certain objections which are sometimes forgotten.

They may cause nausea and loss of appetite; they are depresing; they have caused albuminuria and hematuria. If the patient can withstand all these objections, benefit will follow the administration of the drug, but if there be any obstacle to the proper absorption of the drug by the intestines then these effects are not beneficial.

Dr. Shaw proposes to give a powder containing equal parts of salicylic acid and bicarbonate of soda, which not only makes a rather pleasant effervescing draught, but keeps the secretions in an alkaline condition and facilitates absorption. As he has found this remedy most satisfactory and also most disappointing he suggests two points which may be kept in mind.

That the physician, after once deciding to administer these remedies, should give them in large doses or not at all—that is, to use no less than 40 to 80 grains during the day.

That after administering the drug in this way, if no amelioration of the symptoms has occurred at the expiration of four days, it is useless to continue this line of treatment, as little good will be exercised over the rheumatic process, and much harm will be done by saturating the patient with such irritants to the kidneys and stomach.

THERE are probably few persons who pay taxes willingly and many who deem themselves conscientious in most The Income Tax. matters seem to think that defrauding the government,

State or city, is not wrong. There can be no excuse for avoiding all just taxes but it will come very hard on some classes of persons to pay in addition to the usual tribute a tax on what moneys they receive.

The laity thinks of the physician who pays a short visit, writes a prescription and receives his fee as one who earns his money very easily and physicians have contributed to this opinion in the way in which they allow free service to be exacted from them by wealthy institutions and organizations which recompense all persons except the physician.

There is no medical man who does not willingly and cheerfully do kind acts of charity and freely gives his services and often his medicines too, in cases where such charity is real charity, but if from every fee or from many of the charges that go down on the physician's book there must be deducted State, city and government taxes and perhaps in addition a tax to a collector for procuring that fee which the unwilling patient too slowly pays him, and if to that the demand for smaller fees be made, the actual reward for services rendered will shrink to a very undesirable size.

In the State of Maryland there are many physicians whose incomes will make them liable for the income tax and this they will pay much more reluctantly than the ordinary taxes, for which they receive a quid pro quo.

If professional men are to be taxed on the same basis as business meh, then some arrangements should be made by which the present system of giving services to wealthy institutions be abolished and the physician should be paid for his work as persons of other callings are paid for their work. Actual charity should not be, and never is refused by the true physician, but the public should never forget that the physician has his living to make.

The number of physicians who have good incomes from the practice of their profession alone is proportionately small. Recently two towns in Maryland have had medical postmasters allotted to them and there are few legislative bodies that do not contain at least one physician.

Smallpox is causing some consternation at Lexington, Kentucky.

Columbus has had a legacy of $125,000 left for a Protestant Hospital.

The Yale Medical School will adopt the course of four years after this year.

Dr. Edward Kulz, Professor of Physiology at the University of Marburg, died recently in his fiftieth year.

Dr. John B. Hart of Waverly has been appointed physician to the Baltimore City Jail to succeed the late Dr. Milton N. Taylor.

Dr. Francis L. DuBois, United States Navy, died suddenly last Sunday of apoplexy at the Kittery Point Navy Yard in his fifty-seventh year.

A new laboratory, to cost $5000, is being fitted up at the Willard Parker Hospital, by the New York City Board of Health, for the production of antitoxine.

The French Government compels a certain proportion of the money made by betting on horse races to be paid into the treasury for the benefit of the public charities. The hospitals last year received about $50,000 from this

source.

The Twentieth Annual Meeting of the American Academy of Medicine will be held in one of the buildings of the Johns Hopkins University, Baltimore, on Saturday, May 4, and Monday, May 6, 1895. Members of the profession and others who may be interested in the topics are invited to attend.

There is a bill before the New Hampshire Legislature to govern medical practice in that State and prevent fraudulent practice and such tricks as Christian science and the faith cure.

Asiatic cholera is beginning to appear in Turkey and vicinity. Eleven cases were reported at Constantinople, and the authorities are taking steps to quarantine all vessels from suspected ports.

During the month of December, 1894, there were reported to the Health Department of Brooklyn, N. Y., six cases of smallpox with three deaths, and during the month of January, 1895, two cases with no deaths.

It has been computed that the death rate of the globe is 68 per minute, 97,790 per day, or 35,717,790 per year. The birth rate is 70 per minute, 100,800 per day, or 36,817,200 per year, reckoning the year to be 365 days in length.

During the Cotton Exposition at Atlanta there will be held a Congress on Yellow Fever, when leading physicians will be invited to assemble and discuss plans for concert of action on quarantine and methods of dealing with the disease.

The Baltimore Medical College will probably erect a new anatomical building to front on Howard Street and a new autopsy room with all the modern improvements will be added. The tuition fees of the college have been raised for all new matriculates.

Dr. Milton N. Taylor, a well known physician and politician of East Baltimore, died at his home last Monday in his seventy-fifth year. Dr. Taylor was City Physician in 1853 and Health Commissioner from 1867 to 1871 and at his death he was visiting physician to the jail.

It is announced that Dr. B. Meade Bolton, Associate in Bacteriology at the Johns Hopkins University, has been appointed Director of the Bureau of Hygiene of the Philadelphia Board of Health. This is a new office in Philadelphia created by the Department of Public Safety in that city.

Dr. Aubert of Mâcon has offered a prize, to be awarded by the Academie de Médecine, to the author of the best work on the following subject: To investigate by clinical and experimental observation if there are among the members of the human race constitutions refractory to tuberculosis.