caused by an engorgement of the tissues resulting from excessive dilatation of the capillaries.

So much for the etiology and pathology of the distressing condition that annually incapacitates thousands of the most valued citizens of the country every year, and for which no method of treatment heretofore has proved more than palliative.

With the discovery of the remarkable therapeutic properties of the suprarenal gland and the isolation of its active principle, Adrenalin, a new day dawned for the hay-fever patient. As our experience with Adrenalin increases we are more than ever convinced of its efficacy. Its very satisfactory and exceeding prompt action in controlling the paroxysm is simply charming to physician and patient. It affords the sufferer the grateful relief from physical torment and mental anguish that he once learned to expect from cocaine; but the dangers and inconveniences of cocaine are entirely wanting after the use of Adrenalin. The latter powerfully contracts the capillaries, reduces the turbinal turgescence, thus relieving nasal stenosis, and checks the profuse flow of mucus. It also overcomes the sense of mental and physical depression that is so common in many chronic cases.

Adrenalin is used either in the form of the 1-1000 solution or the more recent Adrenalin inhalant. The latter is a permanent oily solution, also of 1-1000 strength. Either solution may be sprayed into the nares and pharynx, during deep inspiration, when it is desired to reach the lower air passages; or the nasal tissues may be treated by means of topical applications on cotton mops. It is unnecessary to use cocaine, as the Adrenalin solutions are not at all or very slightly irritating. Adrenalin is kept in the leading pharmacies of the country, and the physician should have no difficulty in procuring it at any time. Messrs. Parke, Davis & Co., who market the Adrenalin preparations, have published a brochure on the treatment of hay fever that should be in the hands of every medical practitioner. It can be obtained by application to the Detroit office, or any of the branch houses.

AN APOSTROPHE TO MY APPENDIX.

[RECENTLY, upon being shown her appendix about a week after its removal, a young lady of Nashville, the daughter of one of our leading physicians, wrote the following lines, which for quaint humor with a slight tinge of pathos, are the best we have seen upon the subject.- ED.] And so you are bottled up, dear,

Where you no more pain can give;

And so you are bottled up, dear,

That your owner may thrive and live.

harm; in fact, it is too negative. I do not consider it accurate, either locally or generally, and in a great many instances there are failures. During the last two or three years a great effort has been made to prevent smallpox all through the country, and the comparative want of success, I think, is due to the inefficiency of the bovine virus. It is not to be expected, in view of the great demand which has arisen for the use of bovine virus during the last three or four years, that we could always get a good article. You must remember it is in the hands of the manufacturers and commercial men. I think a strict government inspection and control would guarantee the right sort of virus

to use.

There is one thing about it, which is hard to explain. Smallpox during the war was more or less virulent, very much dreaded, and a great many cases died, and this was true just after the war. But at the present time this is an exception. I don't suppose in the majority of communities one per cent. of deaths have occurred in the last few years. It has got to be a very light disease. The cause of that I cannot explain.

Just after the war, we had at Nashville a good deal of smallpox. This was brought there, of course, by the Union Army, and among the people there was, for a year or two, considerable trouble. It was then that I had to vaccinate a great deal altogether from the scab or from the arm direct. In using the scab, we took very few precautions against decomposition. Of course we wrapped the scab up in tissue paper, and kept it dry, as far as we could; but sometimes it was several weeks before it was used, and doubtless it became more or less putrid, and was liable to give a bad sore.

I do not think we can get the profession in this country to return to humanized virus, although I would like to use it. The popular feeling is against it, and it would be very hard to dissipate that prejudice. But by all means the bovine virus ought to be better guaranteed. It is not accomplishing what it ought I know in Nashville in the last three years the Board of Health has spent a great deal of money for vaccination, and

to.

the results are not at all encouraging as to the efficiency of the vaccine.

Dr. Rowan: You will excuse me if I speak a second time. It seems the essential point involved in this question is whether we will continue with bovine matter, or whether we will return to humanized matter for vaccinating. If the humanized matter, after being obtained originally from the bovine matter, is better than bovine matter, why don't our scientific men sterilize that, or put it in condition so that we can use it continually, so that it may be kept in the manner in which bovine matter is kept now, so that in a few months, at least, it will be just as active and just as good as when it was first prepared? The Doctor there alluded to getting the scab of humanized matter, wrapping it up in tissue paper, and retaining it until it became putrified and unfit for use. It seems as though, if we are to go back to humanized vaccine matter, it ought to be sterilized so that we might use it in preference to bovine matter that we are now getting throughout the country.

Dr. Wilson, of Kentucky: One point I would like to bring out came under my observation, comparing bovine and humanized virus, and that is that there is no limit to the propagation of humanized virus. I have used virus that had been propagated to the one hundred and twenty-fifth removal from the original virus. Many years ago, when the bovine matter was first introduced, I did not like it, and I made this comparison, and I found this fact, which I observed in a number of instances. While with humanized virus, which you could propagate a number of times, the result of the vaccination being exactly like the preceding one, with no lessening of the typical character of the vaccination, yet with the bovine virus, which I used, because of the difficulty in obtaining good humanized virus, I found this fact that you could propagate it apparently well the first instance; that is, taking the virus from an arm that had been vaccinated with bovine virus; and you could vaccinate from that arm a second remove, and you would possibly get a fairly good result. To propagate from that again, you would fail. Now that was the first thing that shook my faith in the efficacy of bovine virus.

If you'd only behaved yourself, dear,
You would be in your natural place;
But with so many misdemeanors,

We had to bottle you up in disgrace.

If you had only employed yourself, dear,
Since you'd no duties of your own,
By assisting your neighbors with their's, dear,
We would not have sent you from home.

But instead of soothing and aiding,

You made up your mind to provoke,

By constantly nagging, nagging;

Which proved your fatal stroke.

So you see if you'd followed the rule, dear,
"Love your neighbor as yourself; "
You would not have been in a horrid bottle
But where were you born, "my elf."

Your life is ruined I know, dear,

You now an outcast must be;

Condemned to live in a bottle,

Where you naught but a label can see.

Well you do look sorry and sad, dear,

But to reinstate you I'll not consent,

For in reflecting, repenting, and the like, dear,
Your eternity now must be spent.

SAL HEPATICA.- The attention of the medical profession is being directed to the use of Sal Hepatica in typhoid fever and inflammatory conditions of the bowels. It appears to be a very safe saline laxative in such affections, being less obnoxious to the organism than sodium phosphate alone or other salines, and is more readily eliminated.

By commingling lithium and sodium phosphates in proper proportions with certain of the "Bitter Water" salts, the manufacturers of Sal Hepatica claim a compound is secured that is superlatively more active than either the lithium or sodium salt alone, or, indeed, than any of the natural purgative mineral waters. Recognizing this, the most eminent practitioners latterly have taken to prescribing Sal Hepatica in preference to the natural waters, with the result that the remedial action of the latter is enhanced, the untoward manifestations accruing reduced to a minimum and their palatability materially increased.

Sal Hepatica is very effective in limiting and reducing the amount of uric acid formed within the circulation and excreted by the kidneys, and is freely absorbed and taken into the blood, and as rapidly (along with the chemical products formed) eliminated by the excretory ducts or organs, as is readily demonstrated by its presence, after a brief course thereof, in perspiration and urine, the latter more particularly being doubled or trebled as to quantity and rendered decidedly alkaline.

Sal Hepatica is the original effervescent saline laxative, hepatic stimulant, uric acid solvent, and eliminant of irritating toxins in the alimentary tract. It is manufactured under the direct supervision of J. Le Roy Webber, Ph. G., its originator, and only at the laboratories of BristolMyers Co., Manufacturing Chemists, 277 - 279 Greene Avenue, Borough of Brooklyn, New York City.

PUERPERAL SEPSIS.- Edward Speidel, M. D., Professor of Obstetrics and Diseases of Women, Hospital College of Medicine, Louisville, reported before the Louisville Medical and Surgical Society, Nov. 21, 1904, an extreme case of puerperal sepsis in which he had excellent results with collargol. After two weeks' treatment with the remedy, she had a normal temperature and is now convalescent. He does not like the use of streptolytic serum, which he employed in several cases. In one case he used seven bulbs in 48 hours without any result.-American Practitioner and News, January 1, 1905.

COLLARGOLUM IN CEREBRO-SPINAL MENINGITIS.- Gustav Bjorkman, M. D., Professor of Physiology, Milwaukee Medical College, writes in "An Index of Diseases" :

"In my own experience I have met with great success in meningitis from the combined treatment with silver inunctions (Crede) and antiseptic packs on the skull. In some instances the suppuration took an outlet through the nose and ears; all cases that recovered regained their normal health in a remarkably short time. The method is to rub in from 1 to 3 grams (15 to 45 grains) of Unguentum Crede twice a day at first, and, when improvement follows, once a day. It is rubbed either on the trunk or inside the thigh for forty-five minutes. At the same time the hair of the scalp is closely clipped and moist borated gauze, drenched in a one and one half per cent. solution of formaldehyde, acetanilid, and one tenth per cent. of kresemine continually kept over the whole head, from the root of the nose backward down to the neck and on the sides, leaving the ears free. This pack is removed as soon as it becomes dry, and a new one applied. Over the whole is placed a cap of oilcloth. There is no objection to the simultaneous use of the ice-cap on top of the oilcloth or ice-coil on the spine. It should