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Leucorrhea.

IN cases of leucorrhea or vulvitis, occurring in young girls in which there is no true vaginitis or metritis, the local treatment and the inflammation about the vulva is to be combated. This treatment is both local and general. The parts are to be washed carefully with astringent decoctions cr with a weak solution of Goulard's

extract. After this has been done, the washing may be carried out by weak solutions of bichloride of mercury and by baths and lotions.

In other cases, carbolic acid, in the strength of 5 parts to 1,000 of water, may be employed; and, finally, in obstinate cases, a solution of nitrate of silver, in the strength of 3 grains to the ounce, may be resorted to. In the intervals between the bathings, the parts are to be separated by lint impregnated with a weak solution of carbolic acid, or covered with red precipitate ointment. The internal medication consists in the use of cod-liver oil with quinine, or, in scrofulous children, the use of arsenical preparations. In place of these lotions, leucorrhea may be treated by powders, such as the following:

R. Powdered starch...

......3ij Subnitrate of bismuth... 3iiss Sig.-Mix very thoroughly, and dust the vagina with this powder.

In cases where good results do not follow the use of starch, powdered acetate of lead or tannin may be used, provided care is taken that they are pure. Frequently this treatment is useful after the injections above named have been employed. With this treatment the following prescription is given internally:

R. Powdered sulphate of iron.....
Subcarbonate of iron...

Powdered red cinchona bark.
Pulverized cinnamon.......
Ergotine..........

3ij

.3iij .3j

A small pinch of this powder may be given with the principal meals, and is particularly useful at the approach of the menstrual epochs. Prolonged injections, morning and night, of cold water, to which has been added a little vinegar, may also be advisable.

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The systemic treatment should be the removal of the cause. Any disturbance of digestion must be corrected, if possible, and the diet should be of a simple character.

DR. ORVILLE HORWITZ (Demonstrator of Surgery) recommended the following local treatment for Spermatorrhea. On the first day give a deep urethral injection of per cent. of carbolic acid; on the second day a per cent. solution; on the third day a 1 per cent. solution

In cases of gonorrheal vaginitis the discharge and on the fourth day a 1 per cent. solution of may be stopped by the following:

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sulphate of zinc, and increase the strength of the solution daily until it is a per cent. solution. Usually the treatment may then be discontinued.

In the case of a young man aged 19 years, who had been subject to attacks of Persistent Hiccough for the past three years (the attacks lasting two or three weeks) and who had been treated by the use of bromide of sodium and chloral, neither of the drugs having any effect, Prof. Wilson prescribed the inhalation of nitrite of amyl two or three times a day.

FOR a case of Hysterical Attacks of Pain in the hypogastric region, in a young man aged

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In pill three times a day. Also every night a pill of aloin, grain 1-5, aromatic powder q.s.; and if this is not sufficient to keep his bowels open daily, he should take one in the morning also. He must also moderate the use of tobacco.

PROF. BRINTON said that in the treatment of Tetanus we should try to get rid of the exciting cause by disinfecting the wound and by antiseptic dressings. Keep the patient out of drafts of air, as in his experience they will cause the paroxysms. For the spasms, ether may be given and ice may be applied to the spine, but be careful on account of the depressing effect of the cold. He relies more on chloral and bromide of potassium. Calabar bean has been recommended, but he has never seen any good results from its administration. The patient should be supported by nourishing food, either by the mouth or by enemata, as the longer the patient is kept alive the greater the chance there is of his recovery.

FOR a mild case of Erythematous Eczema, Prof. Henry W. Stelwagon prescribed a lotion of carbolic acid, drams ij, to water fluid-ounces j.

PROF. HARE said that grindelia robusta is one of the best remedies for the treatment of the Poison of Rhus Toxicodendron, or poison ivy.

THE treatment of Asthma, Prof. Da Costa divided into three heads. First, that for the paroxysm: Give a plentiful supply of fresh, pure air and some remedy to relieve the spasm -ether (internally, twenty drops) or chloroform or chloral, also, dry cupping the chest and some slightly nauseating agent which will promote expectoration. Apomorphia is very useful; so are the salts of ammonium. Other remedies that may be used for the spasm are to burn paper that has been saturated with nitrate of potassium (nitre paper), inhalation of steam, and strong, hot coffee.

Secondly, remedies to prevent the paroxysm: Smoke stramonium. This is undoubtedly ef fective, and may be smoked in an ordinary pipe or thrown on a hot coal and inhaled. Belladonna is useful; as is also the combination of belladonna, camphor and stramonium in the form of cigarettes. Nitrite of amyl may prevent it, but cannot be depended on.

Thirdly, the treatment to get rid of the disease: Change of air; each case is a law to itself. Colorado and New Mexico are the best climates. The food should be plain and no heavy suppers. The bowels should be kept open and the patient should be dressed warmly. Remedies that may

be used are arsenic, which is excellent; nitroglycerine (1-200, 1-100 gr. three times a day) and the nitrates; preparations of iodine (iodide of sodium) in cases of lung complications. Blisters are of no use. It is very important that the patient's urinary secretions should be looked after.

PROF. HARE said that sugar of milk is a decided diuretic; that in Dropsy (either renal or cardiac) sugar of milk, ounces j in a pint of water, taken during the day, will cause profuse diuresis.

PROF. HENRY W. STELWAGON gave the following prescription for an ointment for a case

of Scabies:

R. Sulphur præcipitat
Beta naphthol..
Balsam Peruvian.
Adipis, ad..

..3ij .gr. xx

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FOR a case of Hystero-epilepsy in a man aged 45 years, Prof. Wilson prescribed sulfonal, in five-grain doses, three times a day, and directed that the patient's secretions be kept active. He must not become constipated, and should be as much as possible in the open air.

In order to prevent the unpleasant head symptoms that usually follow the administration of large doses of quinine and salicylic acid, Prof. Hare said that large doses of the bromides may be given at the same time and usually will be effective.

FOR the treatment of Erythema Intertrigo, Prof. Henry W. Stelwagon recommended the following lotion as a very good one:

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Is Evolution Trying to do away with the Clitoris ?

DR. ROBERT T. MORRIS, of New York, read

before the American Association of Obstetrics and Gynecology, a paper upon the above subject and presented photomicrographs and sections of anatomical specimens in support of his proposition. The summary of his paper was as follows:

1. The prepuce and the glans clitoris are bound together by adhesion, partly or completely, in about eighty per cent. of all white American women.

2. Such preputial adhesions are rare among negresses, and apparently occur only in a few individuals possessing a large admixture of white blood.

3. Highly developed domesticated animals do not present examples of this degeneration, judging from a fair collection of data bearing upon the subject.

4. When preputial adhesions are extensive the glans clitoris and the imprisoned mucous glands remain undeveloped, but they may develop later when the physician has separated adhesion.

5. The failure of the embryonic genital eminence to properly develop the prepuce and glans clitoris for perfect cleavage probably means that nature is trying to abolish the clitoris as civilization advances.

6. The degenerative process represented by preputial adhesions is characteristic of the civilized type of homo sapiens in which we find decaying teeth, early falling hair and imperfect corneas and eye muscles.

7. Preputial adhesions which involve small. portions of the glans clitoris are of interest simply as anatomical curiosities.

8. Preputial adhesions involving a large

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BELLADONNA will quickly overcome tinnitus aurium of quinine.

Cimicifuga is specific to muscular aching, muscular soreness or pain from whatever cause. If fever is present its effects are greatly intensified by combining it with aconite.

Capsicum in hot infusion is specific to many cases of hiccough.

Hyoscyamus is valuable in the delirium of fevers, accompanied with wild dreams or hallucinations.

From five to ten grains of resorcin, well diluted, will quickly relieve the nausea and depression of debauch.

In spasmodic stricture of the urethra gelsemium alone, or combined with hydrangea, if the sharp pain is present, is almost a specific.

Fifteen grains of salycilate of sodium is specific for supraorbital pain, also for acute coryza, with distressing head symptoms.

In any condition of acute blood stasis of a local character, belladonna acts specifically, quickly equalizing the circulation.

Fluid extract of hydrangea, one drop frequently repeated, is specific to sharp cutting pains in the urethra in the passage of water.

Thirty drops of the fluid extract of poligonum punctanum, in hot water four times a day, is a specific for amenorrhea from cold.

Phytolacca, five drops every two hours, works directly in all cases of glandular inflammation, especially mastitis and orchitis.

Helonia dioica, in five-drop doses, is specific

to the dragging and bearing-down sensation common in many cases of pelvic disorder.

Phosphorus is indicated in hyperemia of the lungs with dyspnea, especially when there are stitches in the chest, acute, quick pain.

Nux vomica in minute doses is specific to that condition in which there is circumscribed sore spots in the muscular tissue throughout the body.

For a dull, hard, steady pain across the abdomen, with or without diarrhea, give from five to eight drops of spirits of turpentine every two hours.

Phosphorus in small doses is indicated in the depression following prostrating fevers, where there has been involvement of the nervous system.

Give small doses of the tincture of sticta pulmonaria where there is sharp pain in the shoulder or back of the neck extending upward into the head.

A solution of two drams of muriate of ammonia in four ounces of water, applied to the parts three or four times a day, will be found an absolute specific for rhus poisoning.

Cactus grandiflora will regulate the action of heart where irregularity is due to feebleness of that organ. It is also specific to palpitation caused by disorders of the stomach.

Give rhus tox. in small doses where there is local inflammation of the skin, burning, bright red and tense. Also where there is a small sharp pulse with sharp pain in the forehead.Chicago Medical Times.

WITHIN the present year, the wife of a prominent city official, who gets ten thousand dollars a year salary, appeared at one of our public institutions, where the poor only are given medical care, with her child, for whom she sought gratuitous advice. The applicant answered the usual questions, which are carefully asked, as to her husband's income and occupation, before she obtained a ticket. Of course the questions were not honestly answered. It was only because the attending surgeon of the outdoor department found the case a serious one, requiring hospital care, that the mother, being frightened, confessed that she was able to pay if attention could be given at her home.-The Post-Graduate.

Meat Preservation.

Das Rothe Kreuz, August, 1892, publishes the following method of preserving meat: Raw, fresh meat is dipped into melted, inodorous and tasteless paraffin. The coating it thus receives hardens at once and can be reinforced

by repeated dippings. When the meat is desired for food, it is placed into hot water. The

coating of paraffin is at once dissolved and, as it floats upon the water, it can be gathered and used again.-Condensed Extracts.

THE books of our subscription department are so arranged that names cannot be entered until subscription price is received. This arrangement is not in reference to a question of credit, but as to expediency in every way; it also avoids the delay, extra time, trouble, expense and inconvenience which are sure to accompany a general credit system in a business having dealings with as many thousands of persons as we do, and extending to every part of this great country, and to a number of other countries. So kindly do not write on a postal card, "Please continue my subscription." It only adds to our work, for we must give you a courteous reply, and the flood of renewals each December keeps our office force very busy, and there is no time for this extra work. To make your part easy, you will find our Order Blank, on another page, a great convenience, also, enclosed combination Order Blank and return envelope. You can use either or both. Now, as to the dollar; your dollar is not much; but it is the many thousands of dollars (and yours is one) that enable us to give you THE WORLD at so insignificant a price. And as to credit for the dollar, please don't ask it. you do so we must give you a courteous answer, and it only adds to our work when we are already very busy. We find that about one in a hundred sends his order without funds. Please don't let us have any this year. We wish we could publish THE WORLD without money and without price; we would cheerfully do it, for it is a great pleasure for us to furnish the means of exchange of thought among the physicians of every part of this great country, and of presenting, in a plain, practical way, the best and newest means of curing disease. This mutual helping society brings the brotherhood closer together, and gives to each the help of all. It is to us a most interesting and useful task; but we cannot do it all ourselves. Only the co-operation of many makes such a great achievement possible

Delicate Test for Albumen.

When

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The test tube is filled one-third with the reagent. The urine is filtered and made strongly acid with acetic acid. It is then allowed to flow down the side of the tube, drop by drop, until it lies in a layer over the reagent. If albumen is present, a sharp, white ring is seen lying between the two layers of fluid. If it is necessary to test heavy diabetic urine, more sugar may be added to the reagent, in order to raise its specific gravity. It is necessary to decompose any carbonate that may be present, in order that it may not form a precipitate with the sublimate. But the precipitate may be rec ognized by the fact that when shaking the liquid the apparently caseous precipitate will disappear and the fluid become clear.-Coll. & Clin. Record.

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COCA ERYTHROXYLON.

"Our Varicocha first his coca sent
Endow'd with leaves of wondrous nourishment,
Whose juice suck'd in and to the stomach ta'en,
Long hunger and long labor can sustain;
From which our faint and weary bodies find
More succor, more they cheer the drooping mind,
Than can your Bacchus and your Ceres join'd.
Three leaves supply for six days' march afford;
The quitoita with this provision stor'd

Can pass the vast and cloudy Andes o'er."

-COWLEY.

FEW drugs have as interesting and remarkable a history as coca erythroxylon. As a source of cocaine alone it deserves a conspicuous niche in the herbarium temple of fame.

The coca leaf is the great source of comfort and enjoyment to the Peruvian Indian; it is to him what betel is to the Hindu, kava to the South Sea Islander, and tobacco to the rest of mankind; but its use produces invigorating effects which are not possessed by the other stimulants. From the most ancient times the Peruvians have used this beloved leaf, and they still look upon it with a feeling of superstitious veneration. In the time of the Incas it was sacrificed to the sun, the Huillac Umu or highpriest chewing the leaf during the ceremony; and before the arrival of the Spaniards it was used in Mexico instead of money.

Coca leaves have secured the general recognition in therapeutics which those familiar with their properties have always indicated. Physicians have become convinced by personal observation that the marvelous effects attributed to the drug are only what might naturally be expected from the action of so powerful an alkaloid as that contained in the coca leaves.

The cordial of coca presents the drug in a palatable form, commending it especially to the large class of patients of delicate nervous organization. In its preparation the astringent and bitter constituents of the drug, which would exert only a disturbing influence, are rejected, while care is taken to retain unchanged the true active principle.

The specific uses of such a preparation will suggest themselves at once to the physician. There are few cases of neurasthenia in which it will not be found useful. Taken after dinner, it serves often to facilitate digestion, and even confirmed dyspeptics find their distressing symptoms relieved by it. It is of especial value in those case where exhausting mental labor has led to morbid depression of spirits. There is no remedy like it for a fit of the "blues." It relieves the nervous irritability that follows indulgence in excesses of any kind, restoring the capacity for work and giving renewed energy. It thus acts as a sort of antidote to the effect of opium, alcohol, tobacco, or coffee, and judiciously used may even enable one to overcome the morbid craving for any of these stimulants when they have been used to excess.

It is said that public speakers and singers have found themselves in better voice after using

coca.

As a remedy for nausea and vomiting from reflex causes, particularly the vomiting of pregnancy, the cordial proves extremely efficacious. For this purpose it should be taken a few minutes before eating, and the dose repeated in an hour or two afterwards. Gastralgia is frequently relieved by this remedy, and nervous headaches often disappear under its use.

It is of service also in cases of asthma, as an aphrodisiac emmenagogue, antiperiodic, in overcoming drunkenness, in nervous exhaustion, and internally and locally for hemorrhoids. As a

restorative of the circulation in cases of enfeebled heart it is invaluable.

The experience of physicians has shown that the cordial may be given in doses of a dessertspoonful to a tablespoonful, repeated as required.

We believe Messrs. Parke, Davis & Co. were the first to introduce to physicians of this country this interesting drug, and have made a thorough study of its eligible and therapeutically efficient administration.

Malthusianism, or Tired Ovaries.

BY J. M. RICHMOND, A.M., M.D., ST. JOSEPH, Mo. [Professor of Obstetrics and Genito-Urinary Diseases, Ensworth Medical College.]

THOMAS R. MALTHUS, a scientific man of the early part of this century, wrote a treatise on the limitation of population, which caused a profound impression, not only upon deep thinkers, but upon the common people. The object of his essay was the improvement of society and increasing the happiness of mankind by restricting births in certain classes, and limiting the number of children to the capacity to support them, a realization of a happy society being hindered by the miseries consequent upon the tendency of population to increase faster than the means of subsistence. Leaving out of the question the moral and social evils resulting from Malthusian practices, the various checks and means of restricting population are fit subjects for our discussion, inasmuch as many of the measures adopted lead to distinct disease. Malthus himself undoubtedly had pure motives in writing, but the agitation of the subject created such an impression upon the popular mind that to-day abortions and measures to prevent conception come within the daily observation of the physician, and the gynecologists find many of their worst cases coming from attempts to prevent child-bearing. In fact, it has become so that the most notable of the crying evils of the day is the effort at restricting population in which one or both parents pay

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