Specific for La Grippe.

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John D. McGirk, M. D., of Philadelphia, Pa:, reports in The Med. and Surg. Reporter, great success by the administration of three drops of the fluid extract of aconite root and twelve drops of the fluid extract of gelsemium at one dose, repeating in decreasing doses every four hours until complete relief. seldom requires more than three doses. some cases small doses of gelsemium alone are required to relieve the soreness after the fever has disappeared, and the aconite is no longer needed. A brisk rubbing or massage over the body is useful after the acute symptoms have subsided. The doctor keeps his patient in bed three days, usually gives no purgative, and administers the above medicines himself, as required, not leaving them with the patient. Elixir of Phosphorus, Iodine and Bromine PROF. PEPPER recommends for case: of torpid circulation with sub acute gastric catarrh, and of subacute bronchitis with a relaxed and atonic state of the system, an elixir containing 1-100 grain of phosphorus and 1-6 grain each of iodine and bronine to the fluid dram. He recommends as a menstruum either simple elixir or some balsamic elixir. It should be taken after meals, moderately well diluted, beginning with twenty drops thrice daily and increasing the dose according to indications.

Smoking for Relaxation in Labor. While we do not wish to encourage the formation of bad habits, yet we wish to call the attention of our readers to the recommendation Dr. J. T. Bird, Philadelphia, in the Medical Bulletin, that a few puffs at a good cigar will prove an effectual and not unpleasant relaxant against rigidity of the parts in labor.

Nitro-Glycerine in Symmetrical Gangrene. Dr. B. B. Cates, of Knoxville, Tenn., reports in the University Medical Magazine, success in treating Reynaud's Disease-symmetrical gangrene of the extremities, by hypodermic injections of nitro glycerine, beginning with one one-hundredth grain and gradually increas ing up to one fiftieth grain.

Sodium Bisulphite in Tonsillitis and Coryza. Excellent results are reported from the use of sodium bisulphite in aborting tonsillitis and coryza. Tablespoonful doses of a saturated solution may be given every hour or two for twenty-four hours, or even longer if necessary. The disease is usually controlled in twenty-four hours under this treatment.-Notes on New Remedies.

Prevention of Perineal Laceration.

In a paper read before the Brooklyn Gynecological Society, Dr. J. E. Langstaff recommends a process of thoroughly paralyzing the sphincter of the vagina early in the course of the labor. To do this he gradually inserts four fingers into the vagina as far as the hand will allow, leaving the thumb outside, then, with the palm against the fourchette, presses gradually downward until the hand reaches the coccyx. He says that it causes no pain, and requires but from ten to fifteen minutes. The soft parts are then dilated and there is no danger from a too precipitate labor.

Pilocarpine to Promote the Growth of the Hair.

Surgeon B. D. Basu, Indian Medical Service, reports an instructive case in the Indian Medical Record. The patient, aged thirty-five, had lost his hair at the age of ten, after a spell of continued fever. At the time of consultation there was no hair upon any part of his body, except the eyelashes. The scalp, eyebrow, axillæ and pubes were perfectly smooth. After continued failure with the various stimulating applications, the surgeon began the hypodermic injection into the scalp of five minims of a four per cent. solution of nitrate of pilocarpine, every other day, and a lotion of the same applied to all the affected parts. After about two months the result of such treatment was a growth of hair abont two inches long on all the locations mentioned, which, at first light in color, was growing dark at the time of the report. The surgeon, however, is doubtful of any further progress, and does not think that even that growth will be permanent. No internal medication was taken, and there was no constitutional disturbance from the use of the pilocarpine.

THE Lancet (London) says that without the foundation of a good, sound general education, a medical man will be at a disadvantage perHe may do well, manently throughout life. but he will never do his best, and to no one will the disadvantage be more painful than to himself. This is the chief disadvantage now of our profession. The study of medicine is a commanding study, and those who prosecute it should have the hi hest influence in the community. If they have not, it is largely due to defects in general culture which hinder the full use of their professional advantages and the best expression of their professional knowledge.-Amer. Lancet.

In former times, in order to get the physiological actions and therapeutical effects of a drug, it was necessary to give large doses, the essential principle being mixed with large quantities of neutral or alien matters. The impossibility or inconvenience, therefore, of carrying with one an outfit of medicaments sufficient to meet any emergency that might arise, differentiated the professions of medicine and pharmacy, and created a dependence of the physician upon the druggist that at the present time, and under changed circumstances, is working injury to the medical profession. It is to-day possible to carry in one's vest pocket a supply of concentrated alkaloids and extractives of all the chief articles of the modern materia medica amply large and sufficiently varied to cope with all ordinary cases of disease that one may be called to see. Pharmacological science has of late made wonderful progress, and the richness and diversity of the elegant preparations made by the best laboratories excite genuine surprise and praise. To hand the patient the day's supply of these marvelouse little triturates, discs, pellets, tabloids, or alkaloids, is less trouble than to write a prescription.

2. It saves the patient money and trouble. And why should we not desire to do this? To the vast majority of patients the question is one of great importance. The druggist's bill is doubtless small enough, but it is often unnecessary. Not only the very poor, but even those not poor, feel sufficiently the loss of time and labor incurred in the course of any illness; the worry and care are poignant enough without the unnecessary addition of the apothecary's charge. The interests of patient and doctor are closer than those of doctor and apothecary, and our solicitude for the patient may be reasonably extended to such pertinent things. The sacrifices of loved ones for their sick constitute one of the most pathetic of the many things that touch the heart of every sympathetic practitioner. It is but the simplest duty to spare them a useless addition to the burden.

The druggist must charge about the same for the filling of a prescription for either a small or large quantity of medicine. In acute diseases one kind of medicine is required for but a few doses, when a change is demanded. There is a rain of new prescriptions, much expense and trouble are caused the patient, and the accumulation of bottles of unused

medicines produces malevolent suggestion and discontent. All this is different when the day's, supply is given with the day's visit. The plan also adds but the slightest amount, or none at all, to the physician's expenses. These preparations are almost absurdly cheap. Even if no additional charge be made, the increased practice resulting would fully compensate the little and temporary increase of professional ex

penses.

3. The ordinary character finds it hard to pay for simple advice.

The average person, and even many of the best of our patients, feel some resentment when called upon to pay for advice pure and simple. In matters non-professional everybody is so more than willing to give everybody else the article wholly gratis, that to many it seems like impertinence to ask payment even for the medical variety. The quack, with his unrivalled scent for the foibles of human nature, has profited by this fact, and even if he give only smells and oceanic dilutions of an essential principle, the medicine, or supposed medicine, is given with the advice, and the patient is grateful for getting something for his money. Among the little things that, as causes of professional success, we, in our short sightedness, are prone to overlook, this little factor has doubtless been wondrously effective in biasing the minds of many patients for so-called Homoopathy. Placebos and imagined therapeutics from the essential element of many a hoary and tattered medical joke, and the corresponding psychological fact must be well-rooted in human nature. It therefore obtains that, even if no more worthy and weighty reason existed, one might gladly throw this innocent sop to Cerebus. But, happily, better reasons do exist.

4. In emergency cases, and in severe forms of acute disease, time is saved and the disease more effectually withstood by the immediate ad ministration of the needed remedy.

Every practitioner knows that in many cases greater promptitude in the administration of the medicine will be a decided gain in the control of the disease. Doubtless many a critical stage has been passed in which life might have been saved had the needed drug been at hand and immediately given. The trip to the pharmacist and the de novo preparation of the compound by him (already prepared, and in a hundred forms already present on the druggist's shelves) waste valuable time. In country practice, especially, this is a very impor tant consideration.

5. The accidents of prescription-writing, and of prescription filling, are lessened, while at the same time (with proper care and watch. fulness over laboratory preparations) the effi

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There would necessarily follow-and, indeed, it should have long since have been routine that medical students should have been instructed in the values and varieties of these preparations, and before graduation should become entirely familiar with them. The elder teaching of materia medica, the mediæval pottering over botanical and laboratory trivialities, must give way to civilized ways, and to the knowledge of the use of finished products. The pharmacologist and the chemist are noble allies and helpers, but they are not physicians, nor, if excelling in their work, have they time to be. Neither has the clinician the time to do their work. fessions are henceforth different. As to the drugs he uses, it is now no more requisite that a physician dig the roots and herbs, or exe. cute the thousand chemical and pharmacological manipulative details required in the perfections, than that as to his knives and forceps he should dig the iron, smelt and temper it, and learn the thousand technical details of the instrument maker's art. With its infinite differentiation of function, civilization has rendered all this useless. The physician's task is to intelligently use the instruments (triturate tablet, alkaloid, or surgical knife) furnished him by his friends and allies, the chemist, the pharmacologist, and the instrumentmaker. If these shirk their duty, there are speedy and effective ways of punishment.

And if commercialism is suspected of bribing the teacher, that, too will come to a righteous ending.

6. It will lessen the evils of hospital abuse, drug store doctoring, the systems of druggist's commissions to physicians, and of counter prescribing.

There can be no doubt that the wretched hospital abuse-that encouraged parasite that is sucking the life blood of his foolish hostis largely a product of this unnecessary_exaggeration of the mechanics of treatment. Doctor and druggist are, in combination, "too much"> for many poor souls that can so easily escape of their sentimental pauperizers. The young the charges of both by the debauching charity practitioner thus denied his legitimate clientel's by those who should be his helpers, may take a hint. He will secure the gratitude of his patients and increase their number by dispers ing his own medicine.

The drug-store doctor can thus legitimatize his ways, and instead of turning his prescription over to his clerk to collect the fee by a double charge for the drug, he may charge for advice with medicine, and not be ashamed to look at himself in the mirror.

"Division of spoils" by druggist with doctor -more common, alas! than we like to know -would thus be checked, and probably the sponger of medical advice would get ashamed to pester the druggist and soft-hearted physi cian.

It may perhaps be said that the plan is now adays beneath the dighity of the aristocratically inclined modern physician. If that be the sole argument against it, the answer would be brief and pointed: Dignity to the dogs!! The physician that in such matters thinks first: of his dignity is a square peg in a round hole.. He is out of touch both with his countrymen and with his fellow practitioners.

It is by no means contended that the plan advocated can have an absolute and unexceptional realization. Judgment must modify all hard and fast rules. In cities where competent pharmacists and full supplies are close at hand. it may be preferable to continue the older method. But the city is a small part of the country, and those desiring to adopt the plan suggested may feel every warrant of good reason to justify their practice of it. both good morals and good medicine.-Medical News.

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THE Southern Practitioner, of Nashville, Tennessee, says of "The Physician as a Business Man:" "While the good year 1891, now closed, has brought to light many useful and valuable books and publications, I sincerely doubt if any, no matter the size or cost, the care and pains, the study and investigation taken in its production will prove of more material value to the medical profession than this. If you want some good practical information, my dear readers, go buy it-ves, at any price."

Sciatica.

Concerning this disease, Dr. Eliot, New Haven, Conn., makes the following suggestions: 1. A large portion of cases of sciatica are neuritis, and not simply neuralgia.

2. Temporary relief of suffering should be secured by hypodermic injections of morphine and atropine, or of theine.

3. Among curative agents, salicylate of sodium and iodide of potassium are especially valuable the former in acute, the latter in chronic cases.

4. Considerable benefit may often be derived from the administration of the more purely neurotic drugs- aconite, belladonna and gelsemium, as:

I

New Method of Treating Abscesses. INSTEAD of the time-honored free incision of the most dependent part, Dr. Piechaud, of Bo.deaux, France, aspirates the abscess, after which he injects a solution of 1 in 1000of corrosive sublimate. For the past ten months he has invariably adopted this method in his hospital practice, and, he declares, with marked success. Even if the skin over the seat of the abscess be thin and undermined, this is no bar to the precedure, for-which he claim as advantages that it is less painful, leads to more rapid healing, and leaves no traces of star.-The London Lancet.-Practice.

Iodide of Arsenic and Mercury for Gleet.

A CORRESPONDENT of the Medical Record regards Donovan's solution of the iodide of arsenic and mercury given in doses of ten miniums thrice daily, as almost a specific for chronic urethral discharge.

Chloral for Pnuemonia.

DR. G. W. BALFOUR gives an article in the Edinburgh Medical Journal, in which he gives high praise of the drug, combined with digitalis. He says:

"The dose of chloral and of digitalis must vary with the age of the patient. For an adult I prefer to give for the first dose twenty grains of chloral in half an ounce of infusion of dig. italis, the subsequent dose being ten grains of chlor 1 in half an ounce of infusion of digitalis every four hours, continued till the temperature falls to no mal, then to be replaced by some appropriate tonic. After the first d se, if it be one of twenty grains, or after the second or third dose, if we begin with ten grains, the pain and cough cease, the patient dozes all day and sleeps sou dly during the night; the glut nous sputa either cease entirely or become changed to a scanty mucous phlegm easily expectorated, the pulse drops, the temperature falls, the disease is arrested, and the patient gradually convalesces."

Benefit of Small Doses.

Dr. W. W. Kinkead, of Nashville, Tenn., in an article on the above subject in the Col umbus Medical Journal, gives the following example as a reliable treatment for an acute cold, and for the incipient stage of inflammations of the air passages, as tonsillitis, bronchitis, etc.:

R Atropine sulphatis. .grains 1-60 to 1-100
Morphine sulphatis.
...grain ss
Aquæ destillatæ..
.fluid ounces ij

M. S.-One teaspoonful every half hour.

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Loss of the Amniotic Fluid During the Latter Months of Pregnancy.

PHYSICIANS in Constant practice occasionally observe a patient who complains that she cannot retain her urine, or that a fluid of some kind is constantly flowing from her, at other times there is a gush of water, which she feels confident is not from urination. She feels weak and dizzy for a moment, and then recovers entirely and there are no farther symptoms. The physician should know that this flow of water is an actual loss of amniotic fluid, and unless he is aware of the pathological factors that may be involve in the case, and appreciates the situation, he may be led into the error of predicting an immediate labor, and may even go as far as to have the nurse called, and all preparations made for an immediate delivery, which will not occur, the patient sometimes going weeks and even two months to fnll term, and passing through a normal labor, with the usual quantity of liquor amnii. The explaLation of this condition, which has occurred, in this editor's experience three or four times is, that there is a division, as it were, in the water sac, an adventitious pouch perhaps, which contains an amount of the fluid independent of the true sac. This being abnormal, and not possessing as thick walls as the sac proper, and being liable to considerable pres sure, is easily ruptured, and the contents of the sac escapes. If the rupture is a small one, and the lining membrane of the sac continues in a normal condition, the fluid continues to be secreted, and dribbles away constantly. If the rent is a large one, the integrity of the membrane will probably be destroyed and there is no farther secretion. These cases involve no danger, are not especially significant, and demands no treatment except the usual care.Chicago Medical Times.

Comparative Study of Anesthetics.

In the Journal of the American Medical Association, Dr. Lawrence Turnbull reports the occurrence of forty-three deaths from chloroform and ether since the report of the Hyderabad Commission, Jan. 1890. Of this number thirty-nine were from chloroform and four from ether. He presents the following conclusions: (1) During the protracted use of chloroform as an anesthetic, the blood is changed in character, lowered in pressure, with weakening of the action of the heart and changes in its structure. (2) Dilatation of the heart occurs under the use of chloroform at all stages while the heart-muscle is weakened. (3) Cardiac failure occurred before respiration in thirteen out of forty-three cases of death from chloroform. (4) The depressing

influence of chloroform on the heart mechanism is not exerted through the vagus nerves, and section of both vagi does not obviate the weakening and dilating influence of the drug. (5) Too many trifling operations are done under chloroform; its use should be reserved for those cases in which ether, nitrous oxide or cocaine will not produce the anesthesia desired. (6) Ether deaths, as a rule, occur in patients of a certain class, usually from obstructed respiration, and occasionally the heart will stop first, as in two of the four cases. (7) Watch both pulse and respiration, both in chloroform and ether: when the breathing becomes very rapid, danger is near. These changes are apt to follow the first acts of respiration. Chloroform vapor should not be employed over four per cent."

In contrast to these results we wish to mention the safety of bromide of ethyl.

Treatment of Hip Joint Disease by Continued Catharsis.

Dr. H. H. Spires, Edinburgh, O., in Cleveland Medical Gazette, reports that the following treatment was ordered by a cattle dealer, friend of the patient's family:-"Two grains of calomel three times a day, and on the morning of each third day a tablespoonful of epsom salts in a small glass of water; this routine to be continued until a cure is complete." This treatment, began in January, resulted in a cure of the case by the following May. After eight years the limb was a little shorter, but otherwise well. The Doctor reasons it out as follows: "What then is the rationale in this case? The medicine simply acted as a drainage o the hip through the primæ viæ. External drainage is used by modern surgery in many cases of hip disease. Why not make internal drainage equally effective?"

Malpractice and Morphine.

A South Dakota Court has now before it a suit for money damages against a physician. who, is is alleged, has by continuous hypodermic injections of morphine, rendered a patient a mental and physical wreck. The action is brought by the wife, who states that she has been deprived of her support through the improper treatment of the physician.

This is a novel case, and yet foreshadows what may be a long line of malpractice suits, for there is little doubt that the morphine habit is growing, and that physicians are sometimes responsible for the sad results.-Buffalo Med. and Surg. Jour.

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