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much pus, becomes gelatinized, and so tough that it cannot be poured out. If Mucus, Acetic Acid added coagulates it, forming delicate molecular fibres.

Other Deposits are best examined with the microscope, and compared with good plates, rather than with printed descriptions. The plates in Hoffman and Ultzman on Analysis of the Urine, will answer the wants of most general practitioners, but the text follows the metric system. The urinary deposits may be classified thus:

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Necessary Apparatus. A dozen test-tubes. Alcohol lamp. A small porcelain dish. 2 watch-glasses. A sheet of platinum foil, 34 inch square. 3 pipettes of different sizes, to be used only for urine. A 2-oz. graduate. Urinometer. Blue and red litmus-paper. The reagents mentioned above. A little Grape-sugar, for use in testing the Fehling's solution.

The foregoing directions comprise all that the average practitioner will usually perform in the matter of urinary analysis. For fuller directions, the reader is referred to one of the numerous manuals on the subject, among which may be mentioned Da Costa on Medical Diagnosis, chapter vii.-Tyson on the Practical Examination of Urine,-and Sir Henry Thompson's Clinical Lectures on Diseases of the Urinary Organs, Lecture xxiv.

A" Physician's Pocket Reagent Case," intended for urinalysis at the bedside, is put up by Parke, Davis & Co., and sold at the low price of $1.50. It contains a set of Dr. Oliver's Test Papers, a color scale, specific gravity beads, two test tubes, a pipette, and full directions for the use of the reagents which are absorbed by the test papers.

ETHICS.

The Hippocratic Oath.-I swear by Apollo, the physician, and Æsculapius, and Health, and All-heal, and all the Gods and Goddesses, that, according to my ability and judgment, I will keep this oath and this stipulation :-to reckon him who taught me this Art equally dear to me as my parents, to share my substance with him and relieve his necessities if required; to look upon his offspring in the same footing as my own brothers, and to teach them this Art, should they wish to learn it, without fee or stipulation; and that by precept, lecture, and every other mode of instruction, I will impart a knowl

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edge of the Art to my own sons, and those of my teachers, and to disciples bound by a stipulation and oath, according to the law of medicine, but to none others. I will follow that system of regimen which, according to my ability and judgment, I consider for the benefit of my patients, and abstain from what is deleterious and mischievous. I will give no deadly medicine to any one, if asked, nor suggest any such counsel; and in like manner I will not give to a woman a pessary to produce abortion. With purity and holiness I will pass my life, and practice my art. I will not cut persons laboring under the stone, but will leave this to be done by men who are practitioners of this work. Into whatever houses I enter, I will go into them for the benefit of the sick, and will abstain from every voluntary act of mischief and corruption; and further from the seduction of females or males, of freemen and slaves. Whatever, in connection with my professional practice, or not in connection with it, I see or hear in the life of men, which ought not to be spoken of abroad, I will not divulge, as reckoning that all such should be kept secret. While I continue to keep this oath unviolated, may it be granted me to enjoy life and the practice of the Art, respected by all men, in all times! But, should I trespass and violate this oath, may the reverse be my lot! [Adams's Genuine Works of Hippocrates, Sydenham Society, London, 1849.]

EXTRACTS FROM THE CODE.

Consultations should be promoted in difficult cases. During them no jealousy or rivalship should be indulged. Candor, probity, and all due respect should be exercised towards the physician in charge. The attending physician should first question the patient, the consulting one afterwards putting such other questions as may seem fit to further elucidate the case. The discussion should take place in a private place, and no opinions delivered which are not the result of concurrence. In discussion, the attendant delivers his opinion first, the others in the order in which they have been called.

A Regular Medical Education furnishes the only presumptive evidence of professional abilities and acquirements, and ought to be the only acknowledged right of an individual to the exercise and honors of his profession. No one can be considered a fit associate in consultation, whose practice is based on an exclusive dogma, to the rejection of the accumulated experience of the profession.

Punctuality should especially mark the keeping of these engagements; if one of the parties be delayed, the other should wait a reasonable time, and then, if the attendant, prescribe; if the consulting, he should retire, unless the case is urgent or he be called from a distance, when he should either prescribe for the emergency or leave a written opinion under seal. All theoretical discussions should be avoided. Should diversity of opinion prevail, the majority should rule; should the numbers be equal on each side, the decision should rest with the attending physician. The consulting physician should always justify, as far as may be consistent with truth, the course pursued by the attending one, and no hint impairing confidence in him, or his reputation, should be thrown out. A double fee should be expected in all consultations. Interference. A physician should not visit or prescribe for a patient who has been under the care of another for the same malady, unless in, Ist, a case of emergency; 2d, of consultation; 3d, of relinquishment, by the physician, of the case; 4th, or a regular notification to him that his services are not longer desired. When the case is assumed by another, he should indulge in no insinuations against the former attendant. If called because the family

physician is not at hand, or is sick, he should resign the case to him on his arrival. In case several physicians are simultaneously called, as in accidents, the first arriving should take full charge of the case, unless the family attendant be present, when he should assume the charge; if not present, he should be sent for, and the further treatment resigned to his hands.

Miscellaneous.-A case should never be abandoned because it is supposed to be a hopeless one.

Contumelious and sarcastic remarks relative to the Faculty, as a body, should always be avoided, "It's a foul bird that fouls its own nest."

It is held unprofessional to resort to “public” advertising, to hold a patent upon an instrument, or to dispense or prescribe a secret nostrum.

Gratuitous services should be given to an afflicted brother practitioner. If compelled to temporarily suspend his practice, on account of sickness, the physician who has been invited to take charge of his cases should turn the accruing fees over to the sick one, save in surgical or obstetrical cases.

NOTES ON SOME NEW REMEDIES.

AND SOME OLD ONES WHICH HAVE RECENTLY COME INTO

PROMINENCE.

Antifebrin, Phenyl-acetamid (CH ̧NHCH ̧O1),—is the latest gift of the German laboratories to the antipyretic list of drugs (pp. 151, 421). It is a white, odorless and crystalline powder, almost insoluble in water, cold or hot, but freely soluble in alcohol and diluted alcohol. It has neither acid nor basic properties, and resists the action of most reagents. It is employed in doses of gr. iv to gr. xv, dissolved in wine, or enclosed in wafers, up to a maximum of gr. xxx in 24 hours. Its antipyretic power is stated in general terms as about four times the strength of Antipyrine. Its effect upon the body temperature begins to become manifest at the end of an hour after its ingestion, reaching its maximum in about four hours, and passing off, according to the size of the dose, in from three to ten hours. The pulse-rate falls proportionately with the decline of temperature. It produces no nausea, even in large doses, nor have any other untoward symptoms yet been caused by it. In many varieties of disease with high temperature it has already proved efficient, including acute rheumatic fever, erysipelas, typhoid fever, septicemia, and phthisis pulmonalis,-and has the additional advantage of being a cheap drug selling at wholesale for about 25 cents per oz. If these claims of Drs. Cahn and Hepp, of Strassburg, become strengthened by further experience, we may have found at last the long-sought substitute for Quinine in pyrexia; though the reported discovery of a synthetical method of making Quinine itself by Dr. C. Hewitt, of London, if true, would seem to leave nothing to be desired in this respect. After all the experiments with other antipyretics, the experience of the profession, as voiced by Dr. Carter at this year's meeting of the British Medical Association, is that Quinine must be placed at the head of the list. (See ante, page 421.)

In a recent publication on the comparative value of the various antipyretics,

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Dr. Pavay, Chief of the Presburg Hospital, gives the palm to Antipyrine (see page 72), as a practical antipyretic, being equally efficient with Quinine and Salicin, while comparatively devoid of the secondary symptoms which detract so much from the value of these two agents. He uses only 3j-ij per diem, and denounces larger doses. Comparing its action with that of other antipyretics, he says that Chinoline causes vomiting, Resorcin and Hydroquinon great nervous excitation, and Kairin a very unpleasant sensation in the face and nose, besides vomiting, cyanosis and collapse.

Avena Sativa, the common Oat, a plant of the nat. ord. Graminaceæ,was official in the U. S. P. 1870, as Avena Farina, or Oat-meal. A concentrated tincture or fluid extract has recently been extensively advertised by drug manufacturers as a nerve stimulant and tonic, especially efficacious in the treatment of chorea, epilepsy, insomnia, nervous exhaustion, alcoholism and the Opium-habit. The seeds contain starch, gluten, gum, etc., and form a nutritious food, the meal being made into a porridge, or gruel. In the latter form it is a good demulcent for coughs. The pericarp contains an amorphous alkaloid, which has doubtless some stimulant and narcotic power; but the claims advanced for it, as a specific remedy for the cure of the opiumhabit, have been strenuously denied by many competent observers. Dose of the concentrated tincture or fluid extract, may be stated at mx-zij.

Cocaine (see page 182). Besides the great value of this alkaloid and its salts for producing local anesthesia, it is coming into daily use as a general stimulant, a diuretic, an analgesic and an anti-pruritic. Doses of gr. ss of the Hydrochlorate twice daily have marked diuretic action, and as such it should be decidely useful in cases of anæmia, uræmia, and weak heart with dropsy. Prof. Laskevitch ascribes to it the power of relieving the paroxysms of angina pectoris, at first only tempering their acuteness, but after a few days' use the attacks decrease in strength and duration, finally disappearing altogether. In sea-sickness it is reported to be very useful, if used in solution; cases in which the tablet form was employed deriving no benefit from it. It is further reported efficacious in the insomnia and diarrhoeas of children. The writer has found it to be an extremely prompt and efficient application, in ointment, oleate or solution (5-10 per cent.), for the burning and itching of Rhuspoisoning, and for pruritus ani et scroti, and similar affections. Mr. Jessup declares that Cocaine, as used in ophthalmic practice, is often injurious, that it may produce glaucoma, and will increase exophthalmos.

The internal dose of Cocaine Hydrochlorate is gr. -ij for an adult; gr. gr.ss, according to age, for a child.

Hoang-Nan (from Strychnos Gaultheriana),—is, in common with the other members of the Strychnos family, a tetanizing agent. It is recommended in leprosy, syphilis, scrofula, varicose ulcers, eczema and other skin diseases; and has lately received attention as a preventive of hydrophobia, if given during the period of incubation in daily doses of gr. xv, which suffice to produce the physiological effects of the drug, namely-heightened reflexes, convulsions and trismus (Barthélemy). The ordinary dose is gr. 4-gr. ss, in pill.

Ichthyol, is a preparation obtained from a bitumen found in the Tyrol, and regarded as the animal residue of antediluvian sea-animals and fishes. Ichthyol has a peculiar odor, a faintly alkaline reaction, and contains Sulphur

in the proportion of ten per cent. It has been introduced by Dr. Unna, of Hamburg, the celebrated dermatologist, as a promptly efficient remedy in certain chronic skin diseases, particulaly eczema and psoriasis. It mixes with vaseline, lard and oils, is soluble in a mixture of ether and alcohol, and is not irritant locally, even if covered with oiled silk.

In one case of eczema infantile, an ointment was applied containing I part of Ichthyol to 5 of Vaseline, resulting in the child's sinking into a stupor which lasted for 12 hours. Though recovery was complete, the result of the application shows that care must be used in the employment of the remedy, as it is not devoid of danger (Sinclair).

Lanolin, is a cholesterin fat obtained from the suds from the washing of sheep's wool, by a process patented in the United States by Prof. Liebreich, the discover of Chloral; and though a very old medicament, being mentioned by Ovid, Herodotus, Pliny and Aristophanes, it is now being introduced to the medical world as the best basis for ointments. It contains 25 to 30 per cent. of water, and readily unites with 110 per cent. of its own weight of water; differing from all other fatty substances, chiefly in resisting saponification and the action of water, having no ten leney to become rancid. It readily passes through the integument, carrying with it any medicament with which it is charged. It is a perfectly neutral base, and hence is not liable to decompose any ordinary substance. The difficulty about its use has been its very disagreeable sheepy smell, but recent samples, exhibited to the British Medical Association, seem to have been devoid of this objectionable quality. It is particularly useful in chronic skin diseases where there is infiltration, and a penetrative action is desired for medicaments. In a few cases of acute and subacute eczema it has proved irritating, but as a rule it is perfectly bland. Where a simple protective action is desired it is inferior to Lard, Vaseline or Cold Cream.

Manganese (see page 256),—is becoming more of an acknowledged remedy in derangements of the menstrual function, as irregular or scanty meïstruation, amenorrhoea, menorrhagia, and even metrorrhagia. By some authorities, the emmenagogue power of Potassium Permanganate is ascribed to its large proportion of Oxygen, which it is supposed to give up to the uterus; as, until recently, Potassium Chlorate was supposed to do by the system at large. According to the views of others who have studied its action, Manganese should be classed with the excito-motors, increasing arterial tension, and specifically acting upon the uterus. The best preparation is the Binoxide, in freshly-made pills of two grains each, of which 1 to 3 or 5 pills may be taken twice or thrice daily. The Permanganate of Potassium has generally been the preparation given when the effects of Manganese were desired (see page 257); but as it causes great gastric irritability, with abdominal pains and burning sensations, besides other decidedly unpleasant symptoms, it is a difficult matter to get patients to take it for any length of time.

Salol, or Phenol Salicyl,-is a new antiseptic and antipyretic, lately discovered by Prof. Von Nencki, of Berne. It is a white, greasy body, of slightly aromatic odor, but no taste, almost insoluble in water, but soluble in alcohol. It is decomposed in the organism by the pancreatic juice, appearing in the urine as urate of salicyl, the decomposition taking place in the duodenum, without any modification of its constituent parts. It, therefore, causes no

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