tents in the camp. Each patient is weighed every week, and a record kept of the same. The temperature, pulse and respi ration are taken every morning and afternoon. Patients are not allowed to stay in the tents during the day, but must be in the open air constantly if the weather permits. The tents are kept wide open all the time, if the weather is not too bad. Many of the patients spend the day under the trees in their cots. If a patient has a temperature constantly or quite frequently of 100 degrees or over, he is kept in bed all the time. Three full meals are given daily. The sick patients, by that we mean those who are kept in bed, and those who have poor appetites and are losing in weight, are given better diet than regular hospital meals. Milk and eggnog is given between meals. Malted nuts, grape juice and lemonade are served in special cases. Many patients are served nourishment during the night. In selected cases, from six to eight raw eggs are given daily in addition to the regular diet. Every effort is made to give as much nourishment as the patient can digest. Malt extract is used extensively before meals. Emulsion of cod liver oil is given in all cases where nutrition is poor and food does not seem to nourish. There is only an occasional case that refuses to take cod liver oil. In only a very few cases is the cough so troublesome as to require medicine. Codeim is given to relieve the dry, irritating, hacking cough. A preparation of guiacol was given early in the season, but was soon abandoned on account of its irritating effect upon the stomach and the deleterious effect upon the appetite.

An abundance of fresh air, sunshine, nutritious food and rest constitute the principles upon which the treatment depends.

In closing I would like to say that each year in my annual report I have urged the necessity of a separate cottage for the tubercular insane. So far we have not been able to secure such accommodations. I believe that in every institution in the state of Ohio, or elsewhere, whether on the cottage plan or any other, that this class of cases should be segregated, and so prevent, as far as possible, the transmission of this dread disease from the infected to the acute curable class of the insane.-Indebted to Dr. Osler and London Lancet.

JOHN M. SHALLER, M. D., DENVER, COLORADO.

Treat all congestive periods with amorphous aconitine, and inflammatory diseases will be very frequently aborted. There can be no pneumonia, pleurisy, pharyngitis, laryngitis, peritonitis or any other inflammation without there first being a period of congestion or hyperemia, lasting from 12 to 48 hours, before inflammation is established. While congestion is forming there are symptoms which clearly show a departure from the normal, and which indicate that a febrile condition is brewing. These symptoms are unmistakable, are recognized by patient or friends, and are usually alluded to as "taking cold." "Taking cold" is primarily a disturbance of the circulation and secretion through the vasomotor nerves, leading to congestion and scanty secretion, which, if not interfered with, lead to inflammation. Febrile movement is early manifest by dryness of the skin, muscular soreness, scanty secretions, disturbance of temperature, chilliness or rigor, rapid pulse and increased respiration. Amorphous aconitine, administered early, will quiet and control the disturbed vasomotor action and circulation, restoring them to the normal before the congestion has had time to pass into the stage of inflammation. This, then, aborts the impending inflammation, whether it is pneumonis or simple pharyngitis, whether germs are the cause or not. There are no remedies which can be internally administered that will directly kill the germs of ordinary inflammatory diseases. No attempt is made to do it. Aconitine does not destroy germs by actual contact, yet it will check pneumonia in its incipiency. In order that germs may thrive sufficiently to produce disease they require congestion. They need more than the normal amount of blood in a tissue to grow rapidly and become active factors in producing inflammations. Take this congestion of blood from them by distributing it and equalizing the circulation, deprive them of the means necessary for their multiplication, and they become as harmless as the many germs that now inhabit your own body. Without congestion, germs can not thrive to the extent of producing pathologic lesions. Any

means that can be employed that can successfully reduce congestion will abort inflammation, no matter what germ is producing it. Many cases of acute peritonitis have been aborted by the use of active salines through depletion of the mucous, muscular and peritoneal coats of the intestines. Nothing directly kills the germs. Nothing was needed to do so, except to deprive them of congestion of blood. Amorphous aconitine will reduce acute congestion more easily and effectually, when properly given, than any other medicine with which the writer is familiar. One granule containing gr. 1-134 should be given to an adult every quarter hour, or every half hour, depending on the degree of fever, until some improvement is manifest. Acute active fever is the indication for the use of amorphous aconitine. The higher the fever and the more sthenic, the more brilliant will be the results. The earlier in the course of congestion aconitiae can be given, the better are the chances for aborting the disease. As conditions improve the remedy is gradually withdrawn by lengthening the time interval between doses.

In the treatment of acute diseases of children aconitine manifests its best qualities. Nowhere can any medicine produce such satisfactory results as in the frequent and many acute febrile diseases of childhood. It will make no difference whether the diseases are simple inflammations or zymotix, the early administration of amorphous aconitine will greatly surprise both physician and friends of the patient by its quick, efficacious and pleasant action, which is entirely free from danger to the patient. The dose is important, which is a minimum one, frequently repeated until relief is manifest or until physiologic effects are produced. The above dose has been fixed by years of active experiences, and in the general run of cases it will be found to answer. In very severe sthenic cases with full, bounding pulse it may be necessary to double the amount. In asthenic cases it should not be given. In the general run of cases aconitine will not disappoint. The average cases bear aconitine well. Dose for children: One granule of amorphous aconitine gr. 1-134 is dissolved in 24 teaspoonfuls of water, for each year of the child's age, together with one additional granule. Thus a child of

five years requires six granules dissolved in 24 teaspoonfuls of water; one teaspoonful of which is given every 15 minutes, every half hour, or every hour, according to the severity of the disease or the height of the fever. As fever declines and the patient shows other signs of improvement, the dose interval is extended. The pulse becomes fuller and beats slower before the fever declines; similar to the action of digitalin. Congestions are dissipated, particularly that of pneumonia. The disturbed circulation is restored to the normal, no matter whether germs produce it or not. Inflammations produced by germs are as consistently and as easily aborted during the congestive period as are simple inflammations or non-germ inflammations. Medicines thus administered are not germicides in the same way that bichloride of mercury is, when locally applied to an infected wound; but destroy by lessening the blood or food supply to the germ, and in this way prevent its growth and rapid multiplication. Use amorphous aconitine in the very beginning of pneumonia, and you will soon be convinced that the serious and very fatal disease will stop very suddenly in its course, and the disturbed circulatory conditions will soon be restored to the normal, and pneumonia will thereby be aborted.

A COMPEND OF OBSTETRICS, Especially Adopted to the Use of Medical Students and Physicians. By Henry G. Landis, A. M., M. D., late Professor of Obstetrics and Diseases of Women in Starling Medical College, revised and edited by Wm. H. Wells, M. D. Eighth Edition, Illustrated, Philadelphia, Pa. P. Blakiston's Son & Co., 1012 Walnut St., 1906.

This edition has brought up to date in every way the essentials in Obstetrics. Considerable new matter has been added, including an appendix containing tables of certain obstetric constants, which should be useful to students in condensing their lectures and demonstrations.

The Living Age for June 2 opens with the first part of a new story by Count Tolstoy, entitled, "The Divine and the Human, or Three More Deaths." It is a tale of revolutionary Russia, told with singular directness and power, and illustrating, in a striking way, the horrors of the situation created by conspiracies and reprisals.

PUERPERAL INFECTION.

Edward Speidel, M. D., Professor of Obstetrics and Gynecology, Hospital College of Medicine, Louisville, recommends in puerperal infection the rectal use of collargol, 71 grains in 2 ounces of water, twice daily. An enema of a pint of warm water is first given, and half an hour later the collargol is introduced by being poured into a small funnel at the end of an ordinary rectal tube which has been inserted into the bowels for eight or ten inches, the patient being in left lateral position with hips elevated, so that the solution is retained as long as possible. This, continued for two weeks and combined with nuclein injections, has resulted in the recovery of a number of patients, who, he is sure, would otherwise have succumbed.

Dr. James Vance, of Louisville, said in the discussion: "I have seen Dr. Speidel get some excellent results from collargol and nuclein, particularly in a case of large fibroid tumor with sepsis. Recently we had in the city hospital a case of large pus-tube on the right side. There was nothing in Douglas's cul-de-sac. The urine showed hyaline and granular casts, and we deemed it inadvisable to give an anaesthetic, so we tried collargol. We could not get it promptly at the city hospital. The callargol was given to this patient for a week, and during that time her temperature dropped considerably, her pulse improved, and she felt better. After that we could not get any collargol, and the patient went right back. Upon operation the abscess was found to have invaded the abdominal wall. The patient died."

Dr. J. W. Kremer added: "I had a patient at Gray Street Infirmary with puerperal infection, and we used antistreptococcus serum with bad results. Temperature was 103 and pulse 179 after a 20-cubic centimeter dose, and we thought she would die. A few days later, Dr. Speidel, called in consultation, suggested nuclein solution. We gave two injections of one-half ounce each, with no result. Then we resorted to collargol for two weeks, and on the fourteenth day the temper