the different brands of aloes this drug has become very popular, and has taken the place of the crude drug to a considerable degree. Aloin enters into almost every emmenagogue pill and mixture. Its value as a therapeutical agent is so well known that it is not necessary for us to speak of it in detail; yet we desire to say that its addition to the drugs in question aids very materially in making Ergoapiol" so valuable a combination. Being a mild stomach tonic, it aids in overcoming the irritable qualities of the savin; also acting as a hepatic stimulant, freeing the portal circulation and relieving the torpid condition of the lower bowel, it goes a great way toward relieving that condition so often present in diseases of womenpelvic engorgement. These qualities make it an ideal adjunct to the emmenagogues mentioned.

Our attention was caled to "Ergoapiol" (Smith) through a reprint from a St. Louis journal. This reprint gave the names of remedies entering into the combination. We at once concluded that this product would be a useful one, and sceuring a supply we began prescribing it whenever indicated.

The results were even greater than we had anticipated. From the beginning we have kept clinical notes of each case, some of which will be recorded in this article. "Ergoapiol is a mild, aromatic stomach tonic, anodyne, antispasmodic and hepatic stimulant. It is also a laxative, an ideal emmenagogue in the full sense of the term, and exerts a decided tonic influence upon atonic conditions of the pelvic viscera. It is indieated to a greater or less extent in all forms of dysmenorrhea, viz., atonic, congestive, obstructive and membranous. In true obstructive dysmenorrhea, due to actual stenosis of the uterine canal, to a sharp flexure of the organ, or to the valve-like action of a clot or a polyp, it is seldom indicated, because this form of organic dysmenorrhea requires either surgical operations or mechanical means to effect a cure. However, good results may be expected from its use after such operations have failed to complete a cure, or to relieve the suffering. It is even useful in the form where clots cause the trouble by their mechanical obstruction, and we have seen its administration cause the passage of a polyp in one patient. Good results may be expected from its use in that form of dysmenorrhea, known as membranous, due to an exfoliation of the endometrium in the form of a membrane. In amenorrhea it is far superior in value to any remedy we have yet tried, if the cases are properly selected. Amenorrhea, due to taking cold at the

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menstrual period, or caused by shock, can be relieved with the remedy in question.

This remedy is occasionally beneficial in certain forms of metrorrhagia, after operations to remove fungoid or polypoid growths, or after curetting the uterus. It is a remedy of great value in menorrhagia, especialy in that form due to fecal impaction, with torpidity of the liver in persons nearing the menopause. Where this trouble occurs in a plethoric and indolent subject the following plan of treatment will generally be all that is necessary: Begin three or four days before menstruation is due and give one brisk mercurial purge, then follow with "Ergoapiol," one capsule three times per day. this plan is carried out for several months at each menstrual period, a cure will be the result.

If

"Ergoapiol" is especially indicated when disturbances of menstruation occur in feeble and anemic women. It should be alternated with some form of iron in such cases.

There is a condition in which the patient's menses are regullar as far as time is concerned. but the flow is very scant, exceedingly thick, tarry in color, with an offensive odor. The patient suffers pain and weight in the pelvis and back; is despondent, loses flesh and strength, and may or may not suffer from various reflex disturbances. In this state of affairs Ergoapiol" will be found a sheet anchor.

Before recording the clinical notes gathered while prescribing the drug under consideration, we wish to call attention to one or two important things before leaving the subject. The first is that form of amenorrhea that is brought about by constitutional disease, such as tuberculosis. In these conditions it is a common occurrence to have women insist on their physicians giving them something to bring on menstruation, thinking that its absence is the cause of their condition, when the fact is, the stopping of menses is only a wise provision of nature to prevent faster decline of vital forces. The course to be pursued is to treat the constitutional disease, and when a cure of the latter has been accomplished, this form of amenorrhea will generally take care of itself. However, when the patient's general health has been restored and the function fails to return, then "Ergoapiol" can be prescribed with good results. Our second subject is that of prescribing emmenagogues indiscriminately without regard to the cause of amenorrhea. Women who know or suspect themselves to be pregnant, frequently consult a physician in the hope that, in the attempt

A most useful adjuvant in the treatment of superficial and deep-seated inflammatory conditions when a local application is indicated.

to bring on menstruation, he will really succeed in causing abortion. Whoever, under such circumstances, prescribes Ergoapiol" with the understood. purpose of inducing the menstrual flow, is liable to have criminal charges brought against him in case abortion actually does take place, even as the result of something the woman has taken or done herself. Before prescribing "Ergoapiol" in amenorrhea, the physician should satisfy himself that pregnancy does not exist, and in case of doubt he should decline the management of the case, unless he can protect himself by securing some trustworthy consultant who will share the responsibility of the case.

Pertinent Thoughts.

The epidemics of la grippe, which have made their annual onslaughts for some years, have taught us that this disease, once considered of no serious consequence, is so dangerous and difficult to treat, that any suggestion regarding medication is always gratefully received.

With each succeeding visitation of this trouble, we have found it more and more necessary to watch out for the disease in disguise, and to treat these abnormal manifestations; consequently we have relied upon mild nerve sedatives, anodynes and heart sustainers, rather than upon any specific line of treatment. Most cases will improve by being made to rest in bed and encouraging action of skin and kidneys, with possibly minute doses of blue pill or calomel. We have found much benefit from the use of Antikamnia and Codeine Tablets in the stage of pyrexia and muscular painfulness. This tablet, containing 434 grs. antikamnia and 14-gr. sulphate of codeine, is a sedative to the respiratory centres. In the treatment of la grippe and its sequelae its value is highly esteemed. In diseases of the respiratory organs following an attack of la grippe, pain and cough are the symptoms which especially call for something to relieve. This combination meets these symptoms, and in addition controls the violent movements accompanying the cough. To administer these tablets in the above conditions place one tablet in the mouth, allowing it to dissolve slowly, swallowing the salvia. Exhibited in the grinding pains which precede and follow labor; in the uterine contractions which often lead to abortion; in the various neuralgias, and in all neuroses due to irregularities of menstruation, this combination affords immediate relief. In these last conditions, always instruct that tablets be crushed before taking.