M. First add the glycerine to the carbolic acid, after which add the iodine and caramel, and then the potassium salt in crystals. Allow to stand about three weeks, shaking daily to assist in dissolving the potassium. At the end of three weeks the fluid is ready to be used according to the follow. ing directions:

Put a rubber hot water bag over the seat of the operation, to promote absorption of the fluid into the tissues, and have the patient to lie quiet for fifteen or twenty minutes, then apply a well-fitting truss, with instructions to wear it continually day and night until his or her return in a week for another treatment.

Repeat the treatment every six or seven days until cured, which, in most cases, will be from six to eight weeks.

In direct inguinal hernia insert the needle so the fluid will be deposited in the canal. In direct femoral hernia inject the fluid directly into the ring; in umbilical hernia, instead of inserting the needle directly into the ring, begin at one side a short distance from the edge of the ring, and pass the needle vertically downward until the margin of the ring is reached, and deposit the fluid, thus :0:. Make four injections at a sitting, and at the next sitting inject between the old places, thus :0:.

Be sure to have a well-fitting truss in all cases, for the more completely the hernia is retained the sooner will union

occur.

You need have no hesitancy or fear in inserting the needle, and injecting the fluid, as there is practically no danger of peritonitis or inflammation of any kind, as it causes only irritation,

which produces an exudation, which becomes thick and plastic, and, by firm pressure of the tissues to each other, union takes place, which in time becomes fibrous and firm. Always get your injections deep into the hernial canal, and you will be successful.

The spermatic cord and testicles may swell some, but this is not usually bad, and only lasts a short time. If you should puncture the spermatic cord your patient may vomit, or be a little sick, but an injection of morphine in the arm will soon relieve the pain and nausea.

You will find that some cases require larger quantities of the fluid than others. I always begin with six or eight drops, and watch results, and, if no unfavorable symptoms arise, increase to ten or twelve, or rore. You will be governed

in this by he swelling and soreness produced. No time should the swelling and soreness produced be sufficient to confine the patient to the bed.

For children, use smaller doses according to the age, and be governed as above. Instruct your patient to wear the truss in the day time for sixty or ninety days after being discharged. This gives ample time for the old canal to become sound and well.

After the first injection you will notice a hard round lump, which will appear at the seat of the injection, if the size of the former injection was large enough.

It is well to wash the parts with soap and warm water before each injection. Use an ordinary hypodermic syringe with a long re-inforced steel needle. Steel needles are the best, as the fluid soon corrodes the plated needles.

Your hot water bag should hold a quart of water, and you should use the water hot enough to make the skin look red after taking it off, but do not have hot enough to be uncomfortable to your patient. You must insist upon each patient wearing his or her truss just as you leave it when departing.

The grand old BRIEF is always a welcome visitor at my office.

Dysmenorrhea.

Dr. J. W. Pierce, Bean Station, Tenn., has found his cases of dysmenorrhea greatly benefited by Aletris Cordial.

[Written for the MEDICAL BRIEF.]

Quinine in Malaria.

BY THOS. B. GRAYSON, M. D.,
Winkler, Tex.

The article of Dr. Whitman censuring me, and his call on "all fair-minded" men of the profession to "censure" me, on account of my brief communication in the August (1897) BRIEF, has not, in the least, disturbed my equanimity. In discussions of any and all characters, personalities are to be deplored-they prove nothing but the mental weakness, and the unamiable and fiery disposition of those who use and resort to them. After carefully re-reading my article, I find nothing in it to retract, and, therefore, abate not "one jot or tittle of it." I laid down a general proposition, and a rule of action for myself, without personating, or intending to single out any particular or individual member of the profession. If I said the horse was sixteen feet high, I stick to it.

With the Doctor's article before me, as a sample, I, good-humoredly and modestly, suggest I am not the physician whose "support" has not "enriched" medical journals. I assert, that ninety-nine in every one hundred reputable, well-informed, and experiienced physicians, hold quinine to be the remedy, par excellence, in malarial diseases. I did not, in my article, nor

do I now say, that I excluded all other helps and agencies. I endeavor to use it (quinine), as I do all other valuable and potent drugs, judiciously, and, therefore, unhesitatingly call to its aid any other remedy that may be indicated by the general and leading symptoms in the case under treatment.

Anyone who will take the pains to turn to Dr. Hardin's article in June BRIEF, which article I endorsed in its entirety, will find that he does the same thing. Neither of us discard, nor restrict ourselves to the use of one single drug, though we do esteem quinine as the sheet anchor.

Clinical and microscopical study prove that a malarial fever, without complications, will soon subside after the plasmodia of malaria disappear from the blood-that we have in quinine the means to completely eradicate the malarial poison from the blood-and malarial fever in a previously healthy subject, if at once recognized, and properly treated, never ends in death. Any type or form of this fever, if neglected, or mismanaged, is almost sure to become chronic, go on from bad to worse; then it is we must step in, meet the varied indications presented by appropriate and well-chosen remedies.

What does the BRIEF family think of the Doctor's announcement that he has (Continued on page 142).

LOCK BOX 4.