liquid, and contains fifty per cent. of cresols. It can be mixed readily with water,and forms clear solutions with glycerin,alcohol, chloroform, and various other fluids. Fuerbringer recommends half to one per cent. solution for the hands, and onequarter per cent. for instruments. It is one-eighth as poisonous as carbolic acid, and cheaper. Pee recommends a one per cent. solution in midwifery and gynecology, and says a 1 to 200 solution destroys streptococci in fifteen minutes. His experience with it has been very favorable.-Ann. of Oph. and Otol.

So-called Malarial Hemoglobinuria.

Isaac J. Jones, M.D., says in Medical Record: I have read in the Record of June 4th the discussion, in the American Association of Physicians, on the paper of Dr. Hare on "Malarial Hematuria or Hemoglobinuria." Some of the gentlemen evidently mistook hematuria, which is a symptom of many diseases, for the well-marked pathological entity variously denominated "malarial hematuria," "hemoglobinuria," "swamp fever," and "black jaundice."

Malarial hemoglobinuria (I call it so to prevent confusion with hematuria), as it prevails in this section (the Mississippi Yazoo Delta), is always a grave disease, the mortality, as I have observed, falling but little below fifty per cent. It has as distinet a clinical history as croupous pneumonia, and it would be as reasonable to say that the latter disease could be induced by the administration of quinine as the former.

Its pathology has not received the attention that it deserves, but it is certainly not a hematuria. The urine contains no normal blood-cells except in cases of the severest type, when hemorrhage occurs from renal congestion due to increased functional activity required of these organs in eliminating the necrosed blood-disks from the general circulation. Quinia induces more or less congestion of the kidneys, and it would be especially liable to do so when, as in this disease, the organs are much weakened by the strain placed upon them, the blood being at the same time much impaired by the progress of the corpuscular disintegration. These hemorrhages are rarely ever serious. The chief indication for the administration of quinine is the chills which occur in the course of the disease.

These, when closely studied, are found to differ from the chills of malaria in several particulars, viz., the subjective symptoms of cold and discomfort are much more marked in hemoglobinuria, while the same symptoms objectively are slight. They have not the clock-like periodicity, occurring usually at extremely irregular intervals. These chills (rigors) are not followed by marked increase in pyrexia. There is no evidence, pathological or clinical, that this "necremia" is malarial at all, there being just the same evidence that yellow fever is malarial, viz., both diseases occur in sections where malaria is prevalent, and both are usually ushered in with a chill.

To conclude. In my opinion the sole indication for quinine in this disease is in those exceptional cases where the malarial symptoms are marked. At other times it is contraindicated and positively injurious.

Phenacetin in Influenza.

E. Baude, M.D., says: This medicament, which, in Italy, is used as an analgesic-antithermic in the treatment of influenza, has been successfully employed by me in the Military Hospital at Lille.

ears.

Its action is prompt; and it does not, like quinine and salicylate of sodium, give rise to surexcitation or ringing in the Phenacetin increases the urinary secretion, and hence it does not determine, by accumulation, the appearance of toxic pneumonia. It has no unfavorable action upon the kidneys.

The dose of phenacetin varies from one to one and a half gram daily, given in three or four doses at equal intervals. The amelioration in the patient is apparent after the first dose. The temperature falls, and the pains cease promptly. The feeling of fatigue disappears more slowly. There is an augmentation of urine, and this, with transpiration, marks the breaking up of the malady. In twenty-four to forty-eight hours after the beginning of treatment by phenacetin, all symptoms disappear, and the patient enters into convalescence. Bulletin Med., Du Nord.; Bull. Therap., June 8, 1892.