way than she had felt for months, and was encouraged to make another application of the elaterium, which we did, and this time, annointed the meatus and surrounding parts with vaseline to prevent adhesion of the exudation. The application resulted the same as before, except the annoyance about the occlusion of the meatus The vaseline prevented it. The The exfoliation was removed the second day by injection of a large quantity of warm water, followed by the hydrastis.

The patient continued to improve, and the treatment was continued every three or four days for a few weeks, until she was entirely well.

Since then we have used the elaterium in every case with the best results.

There is something remarkably singular and unaccountable regarding the action of the elaterium in producing such a great flow of serum, and causing it to coagulate in the vagina. We believe it is the only drug which

has this power.

In using it we have found patients so susceptible to the action of the elaterium that it would make them very weak and sick, and we had to greatly reduce the power of the application by using a smaller quantity of the drug in the vehicle, or a larger quantity of the vehicle. In some cases the application would have but little or no effect unless more of the drug was used.

For the past year we have been using the tincture of the elaterium, one part of the remedy to nine parts of glycerine, and after saturating a large pledget of absorbent wool with the pure glycerine, then dropping about twenty minims of the elaterium and glycerine mixture on wool, and by thoroughly manipulating the wool in the hand, distribute the remedy through the wool, and introducing it into the vagina. We find in this way the coagulated serum attaches to the wool, and is removed with it. A string should be looped around the middle of the wool so patient can remove it before presenting herself for another treatment.-W. D. Gentry, M. D., in Jour. of Obs.

For Endometric Vegetations.

Instead of using the curette to scrape away vegetations from the cavity of the womb-endometrium-as is recommended by authorities in gynecology, I advise injecting the uterine cavity with a mild escharotic, as the following:

Use a fluid drachm in a fluid ounce of warm water, with a long nozzled syringe. Inject to the utmost

recesses of the womb's cavity, fearing no evil. Repeat this operation every three or four days. The oozing, bleeding, and enfeebling discharges will soon cease, and all discomfort pass away.

The curette does not reach all dendritic growths, and those left soon extend to the fresh field. I know by experience what I am I have cured cases in a few talking about. weeks that had been curetted every week for months together. The curette improves a case, but does not cure it.

No danger of having the escharotic enema go through salpingian canals to peritoneum. That bugbear has been exploded by experience; but a cold douche of the endometrium will excite uterine colic in occasional instances.

Besides using the mild injection give Viburnum Cordial internally. Under this treatment the patient will recuperate rapidly.-Eclectic Medical Journal.

To Stop Nose Bleed.

Dr.

DR. W. T. LUSK, of Bellevue, told the class the other day that about twenty years ago he was in the office of a country practitioner when a man came in with the nose bleed. Instead of being greatly disconcerted or excited about the matter and hurrying about to find means with which to plug the posterior nares, he quietly walked o er to a desk, took out a clothes-pin, pushed it down over the cartilaginous part of the man's nose, and went about his other duties. After perhaps ten minutes the clothes-pin was removed and the epistaxis did not return. Lusk stated that this might not seem a very artistic or scientific procedure, but he had been looking for a case the past twenty years in which it would not succeed in checking the nasal hemorrhage. Moreover, it was by no means as uncomfortable as the use of a coagulating salt or a posterior plug. The fingers would answer as well as a clothes-pin, but the nose should be grasped from above downward, not simply clasp the alæ between the thumb and fingerPractice.

Right and Left Sided Disease.

THE editor of the New York Medical Journal discusses the subject of right and left sided disease, and comes to the conclusion that the left side has to bear the brunt of life's troubles. While conditions due to exercise, development, hypertrophies, exostoses, and supernumerary organs are usually found on the right side, the left side has the burden of pathological variation to support. Of left sided disease, ear troubles, gastric ulcer, orchitis, oöphoritis, tubercular affections of the kidney are examples. Cancerous degeneration of the left subclavicular glands following abdominal carcinoma was recorded in twenty-one cases out of twenty

seven. Cerebral hemorrhage is usually into the left hemisphere. Chorea, zoster, and epithelioma are almost always left-sided. Even in the larynx, while itself in the median line, presents an excellent opportunity for the study of this question of locality, as out of thirty-seven cases of malignant disease twenty-six began on the left side. In the case of the Emperor Frederick the first vegetations were seen in the left side. Pleurisy, carotid aneurysm, torticollis, and spinal curvature, are usually on the right side. The Physician and Surgeon.

To Those Who Wear False Hair.

The English consul at Canton says that eighty thousand pounds of human hair have been exported from that city during the past year, and that it comes mainly from those who have died of contagious disease, mendicants and criminals. The Physician and Surgeon.

Method of Administering Chloroform. In the first place do not use a cone, particularly a paper one, but use an Esmarch inhaler if you have one; if not, simply spread a thin piece of flannel or a handkerchief over the face allowing it to rest lightly on the chin and tip of the nose, dropping the chloroform on the part between the two, or better still, make a support out of broom or baling wire to prevent the handkerchief or flannel from touching the face, thus making an inhaler nearly approaching the Esmarch.

Do not apply more than five or ten drops of chloroform at any one time, repeating every twenty or thirty seconds till the patient is fully anesthetized, then every one or two minutes to keep up the anesthesia,

Don't waste your time and attention with the pulse, but concentrate it all upon the respiration. Note carefully every inspiration and see that they are regular. A few short inspirations or holding the breath for awhile is sure to be followed by a full, deep inspiration, and right here is where the greatest danger lies, for in this deep inspiration an overdose may be taken; to guard against it is simple and easy, one has only to watch for it and when he sees it coming, withdraw the chloroform. Remember that the danger from chloroform is always from an overdose, but that the overdose does not consist in the quantity that may be taken during the administration, at all, but entirely upon the quantity that is taken at any one inspiration-in fact to the suddenness with which it is introduced into the blood and the concentrated form in which it arrives at the brain, producing paralysis of the respiratory center.. Courier-Record of Medicine.

Texas

Points in Specific Medication. TINCTURE of guaiac is a specific for tonsillitis, when we have great swelling with humidity and deep redness of tonsilar mucous membrane. Scores of physicians testify to its specific efficiency in such cases; the dose is only a fraction of a drop, and still one dose of the medicine will give relief. Many of our patients who are subject to attacks of tonsillitis with every slight cold, carry a bottle of the medicine with them constantly, and upon the first appearance of that characteristic stiffness and pricking sensation in the throat, immediately stop its progress by a dose or two.

Penthorum sedoides is the remedy for spring colds with a stuffing up of the nostrils and cold in the head, with profuse nasal secretion; in other words, coryza, with fullness of mucous membranes, abundant secretion, spongy gums, and the conditions so commonly called catarrh among the laity. Internally it should be given in doses of ten drops to four ounces of water, teaspoonful every two hours, and also used as a spray diluted with water.

Calundula as been attracting some attention lately, and perhaps some new indications for its use may appear. Calendula is the remedy for varicose veins, especially of the lower extremities. When we have varicose ulcers on the leg we must first heal the sore; and by bathing the limb with calendula, also giving it internally, the rubber bandage will complete the cure.

Specific medication in chronic diseases is all right. If there is any time when specific medication is strong it is in the treatment of chronic diseases. But it requires most careful study of the morbid conditions, and there is where the trouble may lie, because the physician does not want to study. He is anxious to succeed, but to expend a little nerve force is asking most too much. There may be indications for several remedies in chronic morbid conditions. But we must meet the most urgent first, and the others as they appear, and we will see the morbid conditions vanish as dew before the morning sun.

There is no chronic disease which is commonly more intractable to medical treatment than locomotor ataxia; hence the many remedies, including suspension and galvanism, which have been recommended for it. Still, under the specific indications for drugs no disease has yielded more satisfactory results than this same locomotor ataxia. Every one knows the pathological conditions in this disease-increase of capillary circulation, over-nourishment, with resulting hyperplasia and contraction of connecting tissue, supplanting normal nerve fibres in the columns of Burdach and Gall. The administration of ergot has given a surprising relief in these cases. Sometimes it is necessary

to remove indications for iodide of potash first on account of syphilitic infection, or perhaps there may be an indication for the salycilates. But ergot is the remedy when we have the indication.

Another chronic condition which is speedily and surely dissipated by straight medication is enlargement of the thyroid gland. We speak what we do know when we say give iris-but not the common every day preparations which are usually kept in the drug stores. Tincture or fluid extract made from the dried root has about the same virtue as a tincture of wooden tooth picks. The specific tincture is what we must

use.

When we have enlarged thyroid with anæmic and atonic conditions, especially in young girls just entering maturity, give iris, ten drops to four ounces of water, teaspoonful four times a day.

Another chronic disease which has responded very satisfactorily to specific treatment is vaginal leucorrhoea in young girls otherwise robust. In such cases vaginal examinations are not to be made. Injections are also very mortifying to the delicate shrinking nature of the highly sensitive organization of the patient. You will be perhaps surprised and gratified beyond measure with the promptness with which helonias will relieve the symptom. Helonias acts by increasing the tone of the relaxed and secreting vaginal mucous membrane.

There is one condition which will be removed by small doses of ignatia, which is a great comfort in some ways; and that is feminine sexual frigidity. Do not let your sense of the ridiculous entirely overcome you, but just give the remedy a trial in cases where there are no morbid variations, and nothing in the way but feminine sexual frigidity,-Electric Medical Journal.

Tin Plates in the Treatment of Indolent Ulcers.

IN varicose and other ulcers of the leg, in ulcers about the feet and hands and arms, and in amputation stumps, Dr. E. R. Moras has successfully employed the following proceedure:

With ordinary strong shears cut a piece of tin corresponding to the shape and size of the ulcer, but large enough to overlap one-fourth of an inch of the surrounding skin. Slightly evert the sharp edge of the plate, and cut a piece of oiled silk or rubber tissue protective, of the same size. These are placed in a bichloride solution. The ulcer and surrounding surface are washed with bichloride solution; the protective is then placed over the ulcer, the tin plate over the protective, and firmly fixed with adhesive strips. Be careful that the plate is adjusted with uniform pressure. It is best not to encircle the part with the strips of plaster,

which would interfere with the circulation, and produce a new wound by the adhesive strips cutting into the integument. As a rule, only a light dressing, such as one of gauze, is necessary, for when the secretions are profuse the patient himself may he allowed to renew the outer dressing every second day, and wash away the offensive discharges surrounding the tin plate with plain warm water, or an antiseptic solution.

No preparatory treatment of the ulcer is needed, unless the granulations are unusally elevated above the skin, when they may be levelled by one application of lunar caustic. The primary dressing should be renewed on the fourth or fifth day after its application. When the ulcer is entirely healed it is advisable to reapply the tin plate for a week longer, that the delicate center may have protection while it is becoming firmer. In cases which require it, an elastic stocking or flannel bandage should be worn during the day as long as necessary.— Medic. News.

A Simple Method of Removing a Needle.

DR. CHARLES STEELE, of Clifton, mentions in the British Medical Journal, the case of a young girl who got a needle in her heel, and as it broke it could not be extracted. He directed her to wear a large corn-plaster around the spot, with a little wet cotton-wool in the centre, and to tread freely on the heel. Within a week afterwards the needle protruded, and was easily withdrawn.

An Unusual Treatment for Acute Articular Rheumatism.

DR. W. H. CARRUTHERS, at the June meeting of the Minnesota State Medical Society, 1889, in his report on " Rheumatism," says:

"I believe anything that will combine the two objects I have indicated, viz., reduce temperature and change the blood to an alkaline condition as soon as possible, are the indications for treatment.

My experience has led me to believe that I have a good plan of treatment. I shall not say the best, but one that has been the best in my hands.

"I wish to report a few cases with the results of my treatment during the last three or four years. Having used the treatment laid down in our books with the usual results of having my cases last from ten days to three weeks, I tried the use of ice cold applications to the inflamed joints and the salicylate of soda internally. My results have been the most satisfactory, and I shall only occupy your time for a few 'minutes while I give results in a few of the worst cases I have met since following this plan.

"My first case was a man with both knees and one ankle inflamed; I gave sod. salicylate 15 gr. every two or three hours. Towels taken from ice cold water and applied every five to ten minutes, or as fast as they became warm. His temperature 104°, at my visit next morning was 100, pain and swelling nearly gone, having entirely disappeared by next morning.

"Case 2.-Mrs. M-had been sick for two weeks with rheumatism, but considered well by her physician, who had dismissed the case. The next night she sent for me. I called at midnight on my return from other work to find her suffering greatly with an inflamed knee, high fever, and knee apparently so tender she could or would not be moved, or hardly touched. I directed cold towels applied to the knee. She evidently thought I must be either drunk or crazy, as I was a stranger to her. But her husband, thinking the doctor's word must be law, set about carrying out my directions. At my morning visit pain all gone and swelling going, temperature about normal.. I kept track of this case for two or three years, and she had no more attacks. I speak of this as some claim after salicylates relapses are frequent. I have not found it so in my cases.

"Case 3-Mr. G, an elderly man, with right wrist and elbow, and left elbow and shoulder afflicted. I directed, as usual, soda salicylate and cold water; when he found how much relief he obtained he got some snow which he put into towels, and packed that about his sore joints. At my second visit he was only complaining of a little stiffness of the afflicted joints, which had all disappeared by the next day, and he went to his office.

"Case 4.-Miss M

I

In this case I was not so successful, but it will do to point a moral. When I called, I found her with her wrists and knuckle joints, and one ankle afflicted. Her temperature was very high, about 105°. prescribed as usual, and at my second call found no improvement. I was surprised, but on close inquiry found that the cold had been applied not more than two or three times since my last visit. I made a few pointed remarks, and received a note in an hour or two telling me I need not call till sent for. As I have never been sent for, have not called yet; but I learned the lady had a good homeopath to attend her, and remained in her bed almost a month.

"Case 5.-An Irish lad of fifteen years. His left wrist, knuckles and elbow, left knee and ankle, and his right knee. I never saw anybody so bad with rheumatism before or since. His temperature was nearly 1060. I prescribed sod. salicyl. in 10 gr. doses and ice cold applications at once. I met some opposition, as a young lady present said she had once been sick

seven weeks with the same trouble, and they used warm flannels: but a neighbor, whose confidence I had, went in and set to work to carry out my directions. He told me that he heard the boy crying from the pain when two blocks from the house; but in twenty minutes after using the cold to the joints he became quiet and rested well all night. At my call, fifteen hours after my first, I found him sitting in an easy chair with his temperature 100%, pain all gone and little swelling. In two days more he was about his work.

"My last case, which I wish to report, was a German woman. When I first saw her, her right knee was enormously swollen and very painful. She lived in the country, so could not readily get ice, as it was summer time, but she began using water from the well; that was about ten o'clock in the forenoon. Being at her neighbor's at 8 p. m., I ran in to see her. She had as she said gone to her bed for the night.' She had taken quite a large piece of ice which she had procured somewhere, under her knee, and several small pieces wrapped in a towel laid upon it. I thought if she could stand it I could. When I called next day she was about the house at her work.

"These are some of my worst cases treated in the last three or four years, with the ice water packs about the inflamed joints. None of them had relapses, and most of them I have known to be free from any attacks of rheumatism since. Not one has had the least sign of heart complications.

"Dr. Bartholow says: The acute stage of a rheumatic seizure, if the first one, is not often terminated in an earlier period than two weeks and is more frequently prolonged to three or even four weeks.' Mr. Fuller's cases show under the alkaline carbonates, an average of eleven days, with only two per cent. of heart inflammations. While I have not a hundred cases to report, I feel sure if carried out carefully, I can show as good results for hundreds of cases. The average duration of my cases was between two and three days, and with no heart complications, is as good a result as I could wish.

"A word of caution: An old friend of mine used to say to me when I was a boy and working for him, anything that's worth doing at all is worth doing well.' Don't apply cold in any other way but well and thoroughly."Kansas Medical Journal.

The Preparation of Ligatures. DR. J. SCHOU (Ugeskrift for Laeger) recommends the following methods of preparation:

1. Sublimate Catgut: Commercial catgut is wound upon glass spools and placed in 5 per cent. alcoholic solution of corrosive sublimate.

This solution is changed repeatedly until it remains clear (Bergmann). Another method is to place the catgut in a 5 per cent. solution of sublimate for twelve hours, and then to preserve it in a one-half per cent. sublimate solution containing 10 per cent. of glycerine (Schede and Kümmell).

2. Carbolized Catgut: Commercial catgut is wound upon spools, and placed for forty-eight hours, in a 5 per cent. solution of carbolic acid. It is then transferred to a vessel containing a fresh solution of the same strength, when the gut is removed from the spool, and then again firmly wound upon it and preserved in a 5 per cent. solution of carbolic acid in alcohol (Block).

3. Carbolized Silk: The silk is boiled in a 5 per cent. carbolic solution for a period varying from ten minutes to an hour and a half, according to the strength of the silk, the fluid being renewed every half hour. The silk is preserved in a 2 per cent. watery solution of carbolic acid (Czerny).

I

4. Sublimate Silk: The silk is boiled for two hours in a 1 per cent. sublimate solution, and preserved in a 1 to 1000 solution (Schede and Kümmell).-Deutsche Medizin. Zeitung.

Patent Medicines.

In his admirable report to the National Board of Health, Dr. Lewis Diehl alludes to the subject of patent medicines, the trade lists of which he says embrace a larger number of articles than the pharmacopeia, and their consumption is at least equal to, if not greater, than that of legitimate medicines. It is useless to argue with the public that the pernic ious effects of this class of medicines far outweigh their good; that their reputation is based altogether on temporary or imaginary relief; and that, being on this account recommended and resorted to in every emergency, they are likely to do mischief. It is difficult for the public to understand that the manifestations of pain or discomfort are only symptoms of the disease, and that such symptoms, though to the uninitiated apparently identical, may point to entirely distinct maladies, and that therefore the remedy indicated by the one may be entirely unsuited or even hurtful in the other. Moreover, powerful narcotics or stimulants are often largely represented in these nostrums, and it is easy to understand, not only how temporary relief may be obtained, but also how such drugs, injudiciously taken, may be the direct cause of habits, the ultimate consequences of which are moral and mental ruin and death.

By the existing drug law all patent and secret medicines are subject to the same exam

ination as other medicinal preparations, and can not be permitted to pass the custom house for consumption, unless the special examiner be satisfied, after due investigation that they are fit and safe to be used for medicinal purposes. But how is the special examiner to determine the fitness and safety for medicinal use of a preparation unless he has some standard to guide him? It is true, he can by analysis determine the presence of active medicinal agents, quantitatively as well as qualitatively, but the presence of such agents, whether in large or small proportion need not absolutely debar the medicine from entry. If, on the other hand, the quality as well as the quantity of active medicinal agents allowable in such medicines were plainly defined, a standard would be established whereby special examiners might regulate their action.

To reach this class of patent medicines, as well as those that are prepared in this country, both United States and state laws are necessary. The following modification of the plan requiring the publication of the formula upon the label, is proposed by Dr. Diehl as just to manufacturer and consumer:

1. Designate by law what substances shall be regarded as "active" medicinal agents.

2. Designate the extreme quantity of such active medicinal agents as may be contained in a given quantity of a "patent medicine," both with reference to its being the sole active component and to its being combined with other active agents, possessing similar physiological

action.

3. Require all patent medicines, whether of foreign or domestic manufacture, to be registered by their full title at some suitable office, under the control of the general government; require also that the uses to which such medicines are to be applied, and that the doses in which they are recommended shall be placed on record.

4. In the event that such a "patent medicine" contains one or more medicinal agents, classified as "active" within the meaning of the law, require the manufacturer to deposit at the registering office information of the exact quantities of such that are represented by a given quantity of the preparation.

5. Require under all circumstances that the minimum and maximum doses of the "patent medicines" be distinctly printed on the label; and if it contain one or more of the "active" medicinal agents designated as such by law, that their presence be unequivocally stated upon the label; not however, requiring that their quantity or proportion be stated on such.

"A law of this character would enable governments, and the medical profession as well