oak bark, or whatever you prefer, will do fairly well, only that it be mild and unirritating. In fact, in the great majority of cases the second part of the treatment may be omitted entirely, one or two thorough flushings with the hot salt water proving sufficient to cure.

This treatment does not preclude the use of any systemic treatment preferred by the physician. However, we believe that in very few cases will he feel the necessity of giving any medicine, except to correct malarial or other coincident affection of the system. The flushing, if thoroughly done, seems to answer the double purpose of removing all irritating matter and arousing the biliary and other secretions.

This treatment is original with us only in the minor details, the general principles having been advocated occasionally for many years. It seems to be one of those good things that are allowed to fall into disuse. We are very desirous of placing before our readers the results of this treatment in those severe dysenteries of the malarial regions. We should be pleased to hear the results from any who give it a thorough, faithful trial.

Current Medical Thought.

Ferric Bromide.

. Dr. Hecquet, formerly physician to the Abbeyville Hospital, very strongly recommends the perbromide of iron or ferric bromide in many affections in which it is desirable to soothe without depressing and to strengthen without exciting. Out of twenty-five cases of spermatorrhoea treated by this drug nineteen were completely cured, two only being unrelieved, and in these cases complications were present in the form of prostatic enlargement and stricture of long standing. The perbromide was frequently found useful in cases of cholro-anæmia, leucorrhoea, hysteria, amenorrhoea, hydræmia of pregnancy, chorea, epilepsy, diabetes, and tuberculosis. In conjunction with Dr. Vacossin a series of trials were made in the Abbeyville Hospital on its action in cases of cardiac hypertrophy, with the result that Magendie's observations, made more than fifty years ago, were confirmed, the patients being strengthened and relieved by the calming of the palpitation and of the dyspnoea. This combination is well borne, even by irri

table stomachs. It may be taken in solution, or in lozenges, the dose being from three to five grains. The action is more rapid than that of most iron compounds, as its good effects begin to manifest themselves in cases of chlorisis during the first week of administration, a complete cure being generally obtained in a month. Dr. Hecquet has found by experience that the ferric salt Fe, Br, acts both more rapidly and gives more permanent results than the ferrous salt FeBr2, and hence he has latterly confined himself to prescribing the former, which he does not hesitate to say is endowed with exceptionally valuable properties, and deserves to be far better known and more employed than it has hitherto been. There is a preparation of the ferrous salt in the Pharmacopoeia of the British Pharmaceutical Conference, which, however is not very largely prescribed. No preparation of the ferric salt seems to be known in this country.-Lancet.

Indigo as an Emmenagogue.

Dr. J. L. Jones, in the Medical Record, describes a case of amenorrhoea which he cured by the exhibition of indigo. He ordered indigo, oz. ij; sub nitrate of bismuth, oz. ss, well mixed. Of this the patient took one-half teaspoonful in one-third of a glass of water, for four weeks, when the menses reappeared without pain.

[This treatment was first published by Dr. Silas F. Yount, of La Fayette, Ind., in the Medical Waif, about three years ago.-Ed.]

Chloral vs. Iodine for Injecting Cavities.

M. Marc See states that he has found a 10 per cent. solution of chloral hydrate to act equally as well as tincture of iodine as a coagulant for injecting hydroceles and other cavities, and to be devoid of the intense irritation and pain frequently caused by this latter. In hydroceles M. See injects about 30 gm. at once into the sac, repeating the operation two or three days later. He also uses the chloral solution as an injection in treating varicose veins, the introduction being made in the neighborhood of the varices.-Times and Register.

THE programme of the fifth annual meeting of the American Orthopedic Association. Washington, D. C., September 22, 23, 24 and 25, 1891, is an exceedingly interesting one. A full report of these proceedings will be of great value to any one wishing to be up to the time in Orthopedic surgery. Address John Ridlon, M. D., Secretary, 337 W. 57th St., New York, N. Y.

Iodide of Potassium for Snake Bite. The Scientific American, for March, contains the treatment of Dr. Garnier, of Ontario, Canada, from which we quote as follows:

"In all cases some time had elapsed after the bite, as the victims had to go from a dis. tance to the doctor's residence. At once a drachm and a half of iodide of potash was given, and in ten minutes half an ounce of sweet spirits of nitre, followed by three ounces of brandy. This was repeated at intervals of twenty minutes for about an hour and a half, when the patients were greatly relieved. This treatment was followed by a preparation, viz. : .4 drachms

Iodide of potash

Fluid extract of sarsaparilla...2 ounces Water enough to make an 8 ounce mixture. To be taken one teaspoonful in water three or four times a day, and all the patients recovered quickly."

How to Sterilize Instruments Without Causing Rust.

VON BERGMANN recommends boiling cutting instruments in a one per cent. solution of carbonate of sodium for five minutes. By means of this solution rust is prevented, although the instruments may be rendered perfectly aseptic. After boiling, they are removed with sterilized gauze at the time of the operation. In this manner all antiseptic solutions are done away with. An indefinite contact of the instruments with this solution will not cause rust.

Reviews.

WE wish to commend the following paragraph in the annual announcement of the Baltimore Medical College:

We conduct regular and systematic daily oral, and periodical written examinations of all work done in the several departments; this more emphatically stamps upon the minds of students what they have seen and heard, and better qualifies them for any additional examination that may be required by any State Board.

These special oral and written examinations held during the course also serve to train and prepare students for their final examination, which is both oral and written.

IT is said that a Russian physician has brought a libel suit against a widower who had pasted on the tombstone of his lately deceased wife the last prescription he had given her, the day before her death.-Pharmaceutical Record.

Certificates of Health to Prostitutes. WHEN discharged cured, shall the lewd woman be given a certificate of health? Instead of answering the question we ask two more. What use will she put the certificate to? Does the physician know that she is free from contagious disease? Neither of the last two questions is difficult to answer. The fact that the physician knows what use she will make of the certificate makes him a party to licentiousness when he gives the "clean bill."

As to the last question, every physician knows that, as representing a fact, the certificate is not worth the paper it is written upon. Of course, no one cares for the possible results that may come to a man for his having placed confidence in the certificate, but to prevent both sexes, don't do it. Because it is a fraud, one's name being paraded among the lowest of don't do it. Because it is wrong, don't do it. -Toledo Med. and Surg. Reporter.

The Emergencies of Parturition. [We quote from Practice the following excellent resume of obstetrical dangers, read by Dr. Landon B. Edwards before the Richmond, Va., Academy of Medicine and Surgery :]

From the moment that woman becomes a wife she is continually subjected to what may be called the emergencies of married life. On the very threshold of the conjugal relation we are confronted by instances of fatal hemorrhages consequent upon rupture of the hymen and vagina. During pregnancy a series of emergencies are liable to occur, ranging from trivial to mortal. The woman pregnant is before us continually as an emergent case. The speaker does not attempt to enumerate all of the accidents incident to pregnancy, but wishes to consider the more critical emergencies requiring prompt, active and skillful interference on the part of the physician. ference on the part of the physician.

Extra-Uterine Pregnancy.-There is not one of these emergencies which is more dreaded than this. If called to a patient supposed to be pregnant, who, for several days preceding the sudden call to her, has been the subject of slight discharges resembling the menses, but lasting longer than usual, and suffering from severe pains and profound shock, we may pretty safely conclude that we have a case of extra-uterine pregnancy with rupture of the tube; and the prompt use of the surgeon's knife is then required.

Rupture of the Uterus.-We are progressing naturally in labor when the woman screams out with sudden pain, succeeded by shock in proportion to the degree of the rupture; profuse perspiration; blanched face; with or without external hemorrhage; upon abdominal

palpation we find Schroeder's contraction ring a few inches below the umbilicus. If the head of the child is accessible to the forceps, at once apply and deliver, or do craniotomy if necessary. Do not attempt version, as we run the risk of enlarging the rent. If this fails, we must, without delay, resort to abdominal incision.

Placenta Prævia.-No life should be so dear to the obstetrician as that of the mother; and when we encounter a central implantation of the placenta, the quickest, surest and best plan is to forcibly tear it from its insertion, even if the child die. There is nothing else to be done, in such a desperate case, with safety to the mother. It is not feasible to attempt to insinuate your hands through the placenta and turn and deliver. It is much easier and quicker to tear it away and pull the head down.

If an adherent placenta does not come away easily, get off as much as possible, and, using antiseptic washes, leave the remainder to be discharged with the lochia.

Post-Partum Hemorrhage.-One hour is not the limit to the liability of this accident. The speaker has seen it three hours after delivery, and remains readily accessible to his patient for several hours, with instructions to the attendants to call him upon the slightest indication of flooding. This is sometimes indicated by swelling of the abdomen without external hemorrhage. In this form of concealed hemorrhage the indications are to cause the womb to contract, by external manipulation, compression, &c. Failing in this, swab out the womb with a towel or sponge saturated in vinegar, whiskey, chloroform, or anything which may be at hand that will constringe the vessels and cause the womb to contract. Don't wait to run to the drug store for some unfailing remedy, but utilize anything which may be at hand in this emergency.

Inversiou of the Uterus is very uncommon, and is supposed to be due to a fatty degeneration of the muscular fibers of the womb. It may sometimes be replaced by continuous double pressure, one hand in the centre and the other around the neck of the womb.

Puerperal Convulsions. It is important to make a proper diagnosis of the particular form of convulsion we are called upon to treat. Use chloroform and bleed in the apoplectiform; in the uremic, pilocarpine hypodermically; in the hysterical form, characterized by heavy, stertorous breathing with periods of relaxation, use morphine. Chloroform, however, may be used in all or any of these. Beware of convulsions which come on with frontal headache and go actively to work to eliminate the poison, restricting the patient to a milk diet. Preven

tive treatment is frequently of the utmost importance. The Doctor wishes to emphasize the necessity for different treatment in the different forms of convulsions. Does not believe in empirical prescribing in these cases.

(Among other things referred to as emergencies were hemorrhage during labor, vaginal and perineal lacerations, dystocia requiring the use of instruments, delivery of monsters, phantom pregnancy, puerperal mania, uterine inertia, &c.)

[SYSTEM, order, classification, is a great aid to ready and accurate knowledge of all kinds. We believe, with the writer of this article, thatcountry roads should be as thoroughly systematized as city streets are.]

A Road-Help For the Country Doctor. "Through rain and mud, in night's distilling dew,

Through raging tempests-trials not a few,
The country doctor wends his weary way—
He does his work, but rarely gets much pay."

It is rarely that we of the medical profession find in the schemes of laymen, aught of benefit to us as individuals. The prevailing sentiment towards doctors of medicine seems to be that every old woman of the past generation knows more than he does-and if an untutored Indian comes along, or a "no sabe" Chinese, claiming to have penetrated Nature's secrets, and to know the arcana of "yarbs," we find our helpless profession abandoned for the aforesaid gullivers of gullible geese. Then we think

dark thoughts, and swear black oaths, and vow that never! no, never! will we answer a call from that party again, who hath so ruthlessly trampled on our professional position, our professional self-esteem, our olden friendship and our services, for which no money can ever pay. Yet at the first call for help from the most aggravating case of the kind, our self-assertion vanishes into thin air, and the divine part of us gains the mastery without a struggle the profession triumphs over the trade! no boycott idea can live for a moment in the presence of suffering humanity, and remembering that the grateful ancients made Esculapius a God, we rise to the God-like rank ourselves, and go forth to answer the summons.

Twenty years ago the writer had just such an experience. A man had driven him, at the point of a pitchfork, in humiliation from his ranch; having sought a quarrel for the purpose of avoiding the payment of a bill. Shortly after, this man's wife lay sick unto death, and a doctor was called from miles away, beyond the writer's field of practice. The woman got worse, and in despair, the man sent his child, a girl of ten years, to the doctor he had in