tion of potassium permanganate until the first permanent tinge of pink color appears. One c.c. of potassium permanganate solution equals 3.75 milligrams of uric acid. From this calculate the amount in twenty-four hours.

A shorter process, but one which is less accurate, consists in the precipitation of uric acid with ammonium chlorid (30 grams for each 100 c.c. of urine), allowing it to stand over night, then filtering off the ammonium urate, washing with cold saturated solution of ammonium chlorid, and dissolving in hot water about 100 c.c.), containing about 15 c.c. of concentrated sulphuric acid, and titrating as before.

THE CAUSES OF BLACK URINE.

GARROD (The Practitioner) gives a very comprehensive description of black urine and its causes. Urine which is black or which may become black is excreted in cases of jaundice, especially of long standing; in hematuria, hemaglobinuria, hematoporphyrinuria, melanotic sarcoma, alkaptonuria, ochronosus, in cases where an abundance of indican is present; in phthisis only after standing a long time; in certain rare diseases of undetermined nature, and after ingestion of certain drugs and articles of diet (including carboluria).

When due to jaundice the usual tests for bile pigment will at once reveal its nature.

The blackness in hematuria is merely an exaggeration of the smoky tint and is due to the presence of much of the contained blood-pigment in the form of methemoglobin.

The term "blackwater fever" bears witness to the character of the urine, which may result from the presence of hemoglobin.

In hematoporphyrinuria the color of the urine usually resembles that of port-wine. Urine, whatever its reaction, never shows the spectrum of acid hematoporphyrin unless a mineral acid has been added to it.

True melanuria, associated with melanotic sarcoma, is a rare condition. In melanuria the urine has usually a normal color when passed but the darkening takes place from the surface downward when exposed to the air.

Ferric chlorid or nitric acid causes the cold urine to become plack immediately.

In alkaptonuria the urine has the normal appearance when passed but darkens from the surface downward on standingthe addition of an alkali hastens the process. Such urine reduces Frehling's solution with the acid of heat and ammoniacal silvernitrate solution in the cold.

In indicanuria the color is due to the higher oxidation-products of indol. Thick, cold urine blackens when HNO, is added as with true melanuria, but there is no such immediate blackening.

Black urines with tubercular diseases seem due to the indicanuria which is especially apt to occur in cases of phthisis.

Damson plums, resorcin, hydroquinin, rhubarb and senna may cause black urine. In carboluria the diagnosis can be determined by adding barium chlorid to the urine after boiling the urine with hydrochloric acid. A copious precipitate of barium sulphate is obtained. The color-reaction of phenol with ferric chlorid is not obtained in cases of carboluria.

Mention having been made of ochronosus causing black urine, the following, while not belonging to the department of genitourinary diseases, will be interesting:

Osler, in a recent issue of the Lancet, remarks that blackening of the cartilages of the body was observed by Virchow in 1866, and named "ochronosus." Osler records two cases in brothers. The first was said to be diabetes in a man of 57. The condition was, however, apparently alkaptonuria of long standing, and the copper-reducing substance was not glucose. In this patient there was blackening of the sclerotics and in the cartilages of the ears. On the hands and cheeks the skin was coal black, suggesting powder marks. An interesting fact was that the patient's son had alkaptonuria. The second case, brother of the first, was also suspected of diabetes, but was also found to be suffering from alkaptonuria. He had the same blue-black color of the sclerotics and skin. Osler remarks: "These brothers presented a singularity in gait, walking with a slight bend or incline of the hips. At first I thought the elder brother had had spinal disease, but the spine was straight, and the motion of the hip-joint was perfect. He had had rheumatic pains in several joints, and there were several Heberden's nodes."

ABSTRACTS.

Endermol, a New Vehicle for Ointments.

VIRGIL COBLENTZ, New York, (Medical News, September 3, 1904,) says that endermol, a combination of stearic acid amide and paraffin hydrocarbons, forms an almost white mass of about the consistency of lard, inodorous, of neutral reaction and fusing at 78° to 80°C. The iodine absorption number is 16.98, while that of lard averages about 62; a point in favor of the former as a vehicle for iodine.

When exposed to the air and sunlight under adverse conditions, samples of endermol retained their color, consistency and blandness. When applied to the skin by inunction, endermol forms a smooth, soft, unctuous mass which is readily absorbed. This may be demonstrated comparatively by applying a little of petrolatum, lanolin and endermol in separate portions by inunction to the skin and noting the time required for absorption. Furthermore, applications of endermol ointments of iodine (without potassium iodide), and also of aconite were followed by the excretion of iodine in the urine after about five hours in the former, and the characteristic dryness of the throat in the latter.

Rancidity in fats is due to hydrolysis or splitting up of the esters of the fatty acids, with liberation of the free acids. To the presence of these the irritating properties of rancid fats are due. In endermol, consisting chiefly of stearic amide, we have a stable fatty acid derivative which is not decomposed under any conditions through the action of light, air, moisture or such chemicals as are usually employed in ointments.

To demonstrate the adaptability of endermol as a vehicle for ointments, mechanically as well as chemically, ointments with such substances as the yellow and red mercuric oxide, yellow and red iodide of mercury, zinc oxide, lead subacetate and carbonate, ichthyol, tar, vegetable extracts and mercury were prepared. All of these yielded smooth, uniform ointments which showed no change whatever upon exposure.

The use of petrolatum, as is well known, is restricted to that of a dressing and this to a limited extent owing to its immiscibility with water, certain chemicals and galenicals.

Lanolin, an excellent vehicle, is objectionable because of its stickiness and toughness; and when combined with animal fats (as in lanolin cream), such ointments become rancid and offensive.

There is nothing so objectionable to either the physician or pharmacist as a rancid ointment. While lard or other animal fats may originally have been anhydrous and benzoinated, yet rancidity ensues sooner or later, particularly so when aqueous fluids have been incorporated, as frequently is the case in ointments. Aside from the irritant action, chemical reaction of the liberated fatty acids upon the medicinal agent follows.

Again, lard substitutes consisting of mixtures of suet or taljow or cotton-seed oil, stearin with cotton seed, sesame or cocoanut oils, are not only open to the same objections, but also the possible presence of alum, alkalies or water, which render them still less desirable.

Because of its blandness, pliability and freedom from sticki

ness, endermol is especially adapted as a lubricant for massage treatment, always leaving the skin soft and pliable.

are:

To sum up, the advantages of endermol as an ointment vehicle

Absolute freedom from any tendency towards rancidity, although as much as 15 per cent. of water may be incorporated. Ready penetrability and absorption.

Pliability, smoothness and freedom from stickiness.
Freedom from irritating properties.

Aspiration and Injection of Morphin-Eucain in Tetanus. JOHN B. MURPHY, Chicago, (Journal of the American Medical Asso., Aug. 13, 1904,) says: a patient treated eight days after infection was given three full doses of antitetanic serum, but without effect; the convulsions increased and were almost continuous. Thereupon a lumbar puncture was made and 16 c.c.. of cerebrospinal fluid withdrawn. At the same time 3 c.c. of the following was injected:

This had been sterilised by boiling. The patient slept 4 hours immediately and through the night 11⁄2 hours at a time. There were only 8 spasms in the succeeding 24 hours. A more severe spasm recurring the next morning, another puncture was made, 15 c.c. of fluid withdrawn, and 4 c.c. of the above injected. This was repeated on the two following days and then, with intervals of two days, two more aspirations and injections were made. He was discharged as cured 10 days later.

The quantities of morphine and eucain used were exceedingly small as this was the writer's first case. There was no sweating, headache or collapse, symptoms frequently noticed after lumbar injection of cocain. He believes the eucain should be increased to % to 3 grain at each injection, and this treatment might be made more frequent. Eucain is much safer than cocain, as it admits of boiling and there is less idiosyncrasy to intoxication. Reduction of the spasms prevents death from exhaustion or interference with respiration. The diminution of pus in the aspired fluid would lead one to believe that lessening of pressure aided the fluid in overcoming infection. There is no reason why the cerebrospinal cavities cannot be washed out by salt or other neutralising solutions.

Local Anesthesia with Eucain and Eucain-Adrenalin.

OTTO SIMON, First Assistant in Prof. Czerny's Surgical Clinic at Heidelberg, (Muench. Med. Wochenschr., July 19, 1904,) says: the number of operations at Czerny's clinic and dispensary increased respectively from 1,717 and 1,035 in 1897, to 1,955 and 1,502 in 1902. The increase in the number done by local anesthesia alone was from 91 and 21 in 1897, to 185 and 193 in 1902. During the latter year he witnessed the death of a patient from cocain anesthesia. Only 7 c.c. of a 1-per-cent. cocain solution had been injected into the urethra, but convulsions, arrest of the heart and respiration followed immediately. The patient was a young man with sexual neurasthenia and chronic prostatitis. The fluid had remained in the urethra only two minutes at the utmost.

Since then eucain has been exclusively used for anesthesia, with or without adrenalin, and it has been found perfectly satisfactory. It is comparatively nontoxic, and an isosmotic; warmed solution induces anesthesia as effectively as cocain in the same strength. Adrenalin enhances its action, and concentrations of 1 to 20,000 are free from by-effects in subcutaneous injections. The Oberst technic is preferred; 188 operations done with eucain are given. The supplementary adrenalin was particularly valuable in extirpation of deep tumors, lipomata, adenomata of mamma and struma, excision of small tumors of tongue and lips, angiomata, in operating on the jaws, and in small plastic operations. Eucain is particularly useful as a preliminary to cystoscopy. Journal of the American Med. Asso., August 27, 1904.

Eucain Lactate.

PROF. KATZ, of Berlin, (Therapeutische Monatshefte, August, 1904,) reports excellent results from the use of eucain lactate in rhinology and otology. This new salt is soluble in water to the extent of 25 per cent., while eucain hydrochlorate is only about 31⁄2 per cent. water solution. A tamponade moistened with 15 per cent. eucain lactate solution and left in the nose for four or five minutes produced a thoroughly satisfactory anesthesia prior the introduction of the sound for diagnosing the position, size d nature of polypi and nasal hypertrophies. For the removal of hypertrophies by snare or forceps eucain is preferable to cocain, as it is far less toxic and does not cause shrinkage. There is, besides, no secondary hemorrhage, as eucain lactate does not possess the constricting action of cocain. In some cases the new salt was used in 2 per cent. strength for submucosal injection,

to