whole shanty had been turned upside down, and every nook and corner had been disinfected.

The patient is now placed on the table and anæsthetized. The field of operation is once more scrubbed with water and then with alcohol, and surrounded with four clean towels. We wash our hands once more with alcohol and with boiled water, and ask our colleague to do the same. From this time until the operation is completed and the wound dressed, we touch nothing but

our sterilized instruments, sponges, sutures and ligatures, and the wound. Should our colleague forget himself and touch any unsterilized substance, he must scrub again. The four plates with their aseptic contents are carefully placed where no one can reach them except the operator.

Our colleague is on the opposite side of the table and can assist us very materially by keeping the wound open with the long-handled retractor while we do everything ourselves. The operator is responsible for the wound and must see that no one else infects it. At the same time he must not offend his colleague, because it will very materially enlarge his sphere of usefulness if he can gain both the goodwill of his colleague and his admiration for skill and care.

After closing the wound it is well to seal it by placing strips of gauze two inches wide over the incision. and fastening down the edges by applying an abundance of flexible collodion. A large large absorbent

cotton dressing is applied over this, and held in place with adhesive plaster and with a spica bandage, in a manner which will prevent the patient and his or her friends. from touching and thus infecting the wound.

Now the patient is ready to be returned to the filthy bed. Notwithstanding this and all the other undesirable conditions, we can feel certain that the wound will heal primarily, and that the results of the operation will be perfectly satisfactory from the standpoint of aseptic surgery. The microbes in the bed, or on the ceiling, or on the floor, have not been disturbed in the least, but we are certain that no dirty hands or instrument have come in contact with the wound, and consequently it must be aseptic. -New Medical Magazine.

UTERINE HÆMORRHAGE.

In the Clinical Journal for December 18, 1895, Routh enumerates the drugs useful for hæmorrhage, as follows:

Ergot. This is the remedy oftenest given. It acts by contracting the arterioles, apparently by virtue of its action upon the involuntary muscular fiber; and it has a special action upon the uterine muscle, encouraging tonic contraction. It may sometimes act on the intestines, and some people cannot stand it for that reason; this is well seen when the sucking child gets colic while the mother is taking ergot. Occasionally also one sees. the effect of ergot on the heart by a resulting pseudo-angina and in

in people whose hearts are already incompetent. The arterioles all over the body become contracted, and the heart is thus given more work to do. As a rule, however, As a rule, however, ergot can be given for any length of time without trouble. By the lessened vascularity which it produces in the uterus it impairs the nutrition of fibroids, and it favors their extrusion by the uterine contractions it excites. Ergot ought to be given continually in all cases of uterine hæmorrhage where it is likely to be of service, beginning, as a rule, on the third or fourth day of the period, and suspending just before the menses again come on, especially if dysmenorrhoea be usually present. Sometimes one can continue the ergot in such cases by adding belladonna. The usual doses are one-half drachm of fluid extract ergot three times a day, or one or two grains of ergotin, or 120 to grain of the very much stronger ergotinin.

Hydrastis is another very valuable drug, and is somewhat similar in its action to the combined effect of ergot and belladonna; for, besides producing uterine contraction and checking hæmorrhage in the same way as ergot, is is a sedative. Halfdrachm doses of the tincture answer very well.

Cannabis indica is also one of the best drugs we have, but it is not often given. One-fourth, one-third, or even one-half grain of the extract of cannabis indica is the usual dose, and it often seems to stop

or hydrastis. If there be pain as well as hæmorrhage-as, for instance, in dysmenorrhoea caused by fibroids of the uterus-cannabis indica is much more useful than ergot. It can also be given in the form of tannate of cannabin, two to ten grains. The tincture is unreliable.

Lately Dr. Wright, of Netley, has introduced chloride of calcium. It was used many years ago in conjunction with bromide of potassium and chloride of ammonium for fibroids. At that time the action of the chloride of calcium. was not understood; it was supposed that it deposited lime salts in the tissues of the fibroid, inducing calcareous degeneration. It does not do that. Dr. Wright has found. that it is useful in many cases of hæmorrhage, especially those due to hæmorrhagic diathesis. He was able to check hæmorrhage by giving two- to three-drachm doses of the B. P. preparation (liquor calcii chloridi) three times a day, after meals, for two or three days. [The strength of this preparation is one drachm of the calcium chloride to five of water.-ED.] Dr. Wright finds its action is due to the fact that the blood coagulates much more readily under its influence. The writer has tried it in one or two cases in which ergot and cannabis indica have failed, and it certainly does check the passive oozing of blood which sometimes continues for a week or ten days after the more profuse flooding which occurs

Pain Relieved with Utmost Safety. -Albert M. Williams, A. M., M. D., of Bradford, Pa., says: "I have used antikamnia in my practice since its first introduction and used it extensively. At first I was a little cautious and a little apprehensive, and rarely ventured on larger doses than five grains; but for several years I have given it in tenand fifteen-grain doses to adults and, when needed, repeating every hour or two hours. I have rarely been disappointed in controlling pain, if the pain was of a character to be controlled by medicine. In severe neuralgias or any severe form of pain my method is to prescribe ten grains to be given every hour till the pain ceases. I seldom use morphia or opium in any form. I have seen so many unfortunate victims of the opium habit that I shun its use, and antikamnia is my sheetanchor. The effects of opium and its alkaloids, too, are most disagreeable to many people. I always suffered untold misery when I had taken even a small dose of morphia; itching and nausea especially continuing for about two days. There is none of this following the use of antikamnia, and I have never heard of a victim of the antikamnia habit. I have yet to see the first case where any alarming symptoms have followed its administration. I have for a long time been in the habit of prescribing it in a little larger doses than are recommended and any bad results from its use must be due to some idiosyncrasy on the part of the patient."

A $2,500 cash regular practice in railroad county seat of 4,500 inhabitants in Southern Illinois, fifty miles from St. Louis. Price includes two good horses, new buggy, road cart, double and single harness, and Harvard chair, compressed.

Sanmetto in Bright's Disease.— Dr. C. E. Stafford, Trigg, Va., writing, says: "I have used sanmetto with the very best results. I succeeded in making a case of Bright's disease much more comfortable by the use of sanmetto, and am satisfied it should be used oftener in this disease. I regard sanmetto as an efficient and elegant remedy for diseases of the genitourinary organs."

Pilocarpine, as it occurs commercially, often contains jaborin and other allied alkaloids and impurities; jaborin acts like atropin, hindering secretion, and its presence therefore disturbs the therapeutic effect of pilocarpine. The most reliable test for purity is the melting point. The U. S. Pharmacopoeia gives 197° C. (386.6° F.) as melting point; comparative tests recently made in the experimental laboratory of C. F. Boehringer & Soehne showed that Boehringer's pilocarpine muriate melts at 15° C. above any of the other brands in the market. The best of the competing products were recrystallized, and the resulting crystals then closely approximated the "Boehringer" standard, proving that im

purities originally present had been eliminated by the careful recrystallization.

As pilocarpine hydrochlorate is now more popular than ever before in medical practice, and in view of the delicate uses to which it is putinternal or local, with possibility of toxic effects-physicians and pharmacists should exercise special care to prescribe and dispense only an absolutely pure product. And the melting point test seems to be the easiest applied and most reliable; the product should not melt below 197° C.

possessed before commencement of the experiment."

Ferratin in eight grain doses, three times daily, was recommended by Germain Sée, the late distinguished French therapeutist, for "those suffering from anemia from hard work, though apparently in good health; those, of both sexes, affected with chlorosis; those weakened by too rapid growth and puberty; those fatigued by study; and, in short, all in whom a diminution of red blood corpuscles had ensued, due no matter to what causes."

"Eisen-Hunger."-Physiological and clinical tests prove that ferratin supplies the needed iron to nourish the blood and, hence, the system.

On page 341 of Prof. Schmiedeberg's "Arzneimitellehre" (latest edition) this eminent pharmacologists states: "The fact and effect of a craving for iron (eisen-hunger) can be experimentally proved on animals. A strong, frisky dog, after a moderate loss of blood, was fed for five months on pure milk only, and gradually became so weak that he refused further nourishment, became reduced in bodyweight, tottered when on his legs, and finally was at the point of death. At this stage one gramme of ferratin was added to the milk per day; the dog ate this with ravenous appetite, and within fourteen days had regained his weight and general condition to nearly equal the normal strength and activity

Indigestion-Eructations-Dyspnœa.-Dr. Alfred E. Meyer says he has been using "maltine with wine of pepsin" at the New York Polyclinic and also at the West Side German Dispensary in his gynæcological clinic with signal advantage with women who are suffering from chronic indigestion, and he also gave it a trial in his private practice.

One patient, a lady who had for years frequent attacks of indigestion, received so much benefit from its use that he decided to report the case.

The attacks usually came on about an hour after eating, the symptoms being great distention of the abdomen and a feeling of soreness and dyspnoea. The attack usually lasted from one to two hours. She had been put on various methods of treatment, not only on different preparations of pepsin and pancreatin, but also on dietetic treatment,