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Medical Aphorisms. A correspondent signing himself "Artz" sends to the Canada Lancet the following professional aphorisms of Amedee Latour.

1. Life is short, patients fastidious, and the brethren deceptive. 2. Practice is a field of which tact is the manure. 3. Patients are comparable to flannel-neither can be quitted without danger. 4. The physician who absents himself runs the same risk as the lover who leaves his mistress; he is pretty sure to find himself supplanted. 5. Would you rid yourself of a tiresome patient, present your bill. 6. The 6. The patient who pays his attendant is but exacting; he who does not is a despot. 7. The physician who depends upon the gratitude of his patient for his fee is like the traveller who waited upon the bank of a river until it would finish flowing that he might cross to the other side. 8. Modesty, simplicity, truthfulness! cleansing virtues, everywhere but at the bedside; there simplicity is construed as hesitation, modesty as want of confidence, truth as impo. liteness. 9. To keep within the limits of a dignified assurance without falling into the ridiculous vauntings of the boaster constitutes the supreme talent of the physician. 10. Re. member always to appear to be doing something-above all, when you are doing nothing. II. With equal, and even inferior, talent, the cleanly and genteelly-dressed physician has a great advantage over the untidy one.

Benzoate of Soda in Uremia. Starting from Conheim's theory of uremia, and from the fact that benzoate of soda inhibits the formation of urea within the system, Dr. A. S. Partzeosky, of Moscow, administered this substance in ten cases of uremia. The drug was given every hour, in daily doses of one to two drachms-nine cases recovered, one died. Analysis of the cases leads to the conclusion that benzoate of soda cuts short uremic attacks, the convulsive phenomena gradually disappearing and giving way to a deep sleep, which in the majority of cases terminates by passing into full consciousness. Given on the first appearance of symptoms, the salt may prevent any further development of the attack. Albuminuria mostly disappears altogether.-British Medical Journal.

"And so your little sister is dead, Bobby?" said the visitor to Bobby, whose sister died the night before. "Yes, ma'am." "And already in heaven?" "No, ma'am; she doesn't start till to-morrow afternoon at two o'clock."

Acetic Acid as a Disinfectant.

Dr. F. Engelmann, being much impressed by the numerous fatal cases which are constantly occurring from the employment of intra-uterine injections in obstetrical practice, and feeling that there is doubt whether they ought not to be given up, brings before the profession an antiseptic which he has used for the last two years in a large number of cases, and which has given him excellent results-acetic acid. Some years ago he was led to use and to recommend the employment of acetic acid in diphtheria, and he is convinced that it possesses antiseptic properties in as high a degree as carbolic acid itself, and has at the same time the great advantage of being non-injurious, even when used in a tolerably concentrated form; besides, it has a decidedly styptic effect, and this is an additional advantage in obstetric practice. Again, acetic acid is very diffusible, thus penetrating the tissues to a much greater extent than most other antiseptics. Corrosive sublimate, as is well known, forms insoluble albuminoid compounds on the surface, and thus does not act upon the deeper parts of the tissues. In one respect acetic acid is similar to corrosive sublimate-viz. in its action on instruments; but the latter is the more prejudicial of the two. The forceps may remain for a quarter of an hour in a three per cent. solution of acetic acid without being injured. The irrigator is, however, liable to be affected by the prolonged use of acetic acid solutions. It should be remarked that the hands must be washed twice after using acetic acid, as of course soap will not dissolve where this is present. The skin is rendered peculiarly soft and pleasant to the feel. the strength to be used, Dr. Engleman as a rule employs a three per cent. solution, but he has sometimes employed a solution as strong as five per cent.; this, however, is apt to cause a smarting sensation in any spot where the surface is broken. All the cases in which acetic acid was used recovered without abnormal rise of temperature.-Lancet.

A Cold.

The sole exciting cause of ordinary catarrh is cold, acting either directly on the bronchiopulmonary tract, or on some portion of the cutaneous surface generally. Catarrhal congestion, or hay-fever, is due to the action of an organic vegetable matter. When catarrh is epidemic, it comes under the denomination of influenza, which is undoubtedly a zymotic disease, ranking with measles, and whoopingcough. But ordinary catarrh has no such importance. It is a "cold," and nothing more.

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INSENSIBILITY.

Prepared by Louis Lewis, M.D., M.R.C.S.

CAUSES.

Predisposing.-Heredity, corpulence, senile decay, valvular disease, Bright's disease. Exciting-Pressure on brain, abuse of eating, drinking or narcotics; cerebral congestion, cold bathing after intemperate eating, mental overstrain, extreme muscular efforts, suppression of menses.

Sewer-air, choke-damp or other noxious gases; drowning, hanging, lightning, obstructions in air-passages, chloroform poisoning, mechanical pressure on chest or spine, pulmonary collapse, tetanus, embolism, pleuritic effusion, extreme cold. In children, spasm and edemaof glottis, diphtheria.

Collapse. General injuries, gunshot wounds, burns, rupture of internal organs, hemor tensive urinary extravasation. (Sudden shock to general rhage, mental emoion, excessive cold,

nervous system.)

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SYMPTOMS.

Pupils dilated (in danger contracted); eyes staring, flushed, distorted face, teeth closed, slow, full pulse, incoherent speech, stetorus breathing (usually), epistaxis, partial paralysis of face, body, palate or sphincters; high temperature, may smell of liquor.

Pupils dilated, eyes projecting and injected, faintness, vertigo, lividity of face, cyanosis of lips, frothy mucus, clammy skin, gasping or imperceptible respiration, loss of motion and sensation, flickering pulse, clenched hands, cold extending upwards; low temperature.

Pupils dilated, features shrunken, pallor, clammy skin, impaired vision, sighing respiration, feeble pulse, hiccough, nausea, vomiting, rigors, con ex-vulsions, partial or complete loss of consciousness, sphincters relaxed, low temperature.

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TREATMENT.

Horizontal posture, with head raised; cold to head, hot bottles to feet, sinapisms to legs; turpentine enema; leeches to anus, temples or nostrils; dry cupping to nucha; croton oil (m ij in mucilage), calomel, tincture of aconite, or of veratrum (mg v), or ergotine (gr. 4) subcutaneously; bleeding (when the pulse is bounding).

Horizontal position, with head raised (except in embo-
lism); cold effusion, frictions upwards, rythmical pressure
over abdomen, artificial respiration, sinapisms over heart
and ankles; ammonia and whiskey subcutaneously; gal-
vanism, removal of obstructions from air passages, inverted
suspension, especially in chloroform-poisoning, tracheotomy,
etc.; bleeding, transfusion.

In asphyxia of new-born, slapping with wet cloths; hot
and ice-cold water, alternately; artificial respiration, gal-
vanism, catheterization of trachea, laryngo-tracheotomy;
non-interference with cord until pulsation has ceased.

Horizontal posture, with head rather low; hot bottles to feet and legs, warmth to epigastrium; frictions, nitro glycerine (gr. ), ammonia to nostrils; beef tea and brandy; galvanism; ether (3 j) or quinine (gr. vj) or morphia and atropia (q. s.) or tincture of digitalis (m xij) subcutaneously.

Horizontal posture, with head raised; cold effusion, sinapisms, stimulant enema, stomach-pump (if poison suspected), artificial respiration, galvanism, warmth to extremities,catheterization,flying blisters, bleeding; croton oil (mj). In suspected subcranial hemorrhage, with paralysis of one side, exploratory operation on opposite side of cranium. In opium poisoning, strong coffee, flaggilation, artificial respiration.

Horizontal posture, with head raised; ice to shaved head, turpentine enema, croton oil (mij) in mucilage, catheterization, trepining, aspiration or perforation if abscess is diagnosed; removal of tumors or other pressure. In children, avoidance of operation if no brain symptoms

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present.

THE MEDICAL WORLD.

Concussion.

Blows or falls on the head, jars of the
or spinal cord, interfering with falls on the buttocks or back.
(Sudden succussion of brain spine by railway or other injuries, or
their circulation.)

Epilepsy.

Predisposing-Heredity, scrofula, syph-
ilitic tumors of brain, cranial malformation.
Exciting.-Injury to head, intra-cranial
pressure, brain disease, polypus or suppu-
ration in ear, tumors, tape or other worms,
(Nervous disturbance either suppressed eructions, over-eating, sun.
centric or eccentric.)
stroke, extreme excitement, cold, some
fevers, prolor.ged waltzing.

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Inebriation.

In children, dentition, phymoses, worms,
falls, injuries at birth, rickets.

Cerebral irritation from extreme emo

tion, sexual degrangements, change of
life, concussion of spine, puberty, suppres-
digestive disturbance.
sed emotions, malposition of the uterus,

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Pupils contracted at first, afterwards dilated;
helplessness, partial or complete insensibility,
adulter-flushed face (usually), soft, quick pulse; cold
surface, temporary paralysis, often involuntary
micturition, odor of liquor, low temperature.

Predisposing-Heredity.
Exciting. Abuse of liquors, alcohol or
(Poisoning of nervous centres its substiutes (fusil oil, etc.) in
by alcohol.)
ated liquors.

Syncope.

Exhaustion, hunger, hemorrhage, fear,

Pupils dilated, pallor, cold, clammy perspira-
tion; vertigo, shallow respiration, almost imper-
ceptible pulse, partial or total insensibility, sud-
(Deficiency of blood to brain extreme heat or pain, surgical operations, den in outset, short of duration; cold extremi-
ties, flaccid limbs, vomiting.

from heart failure.)

Sunstroke.

heart disease.

Direct solar heat, diffused heat com(Nervous exhaustion from bined with fatigue, hunger or intemper

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Accumulation of urea, ammoniaor other
nitrogenized debris in the blood from re-
nal disease or derangement; scarlatinal
(Blood-poisoning by constit- albuminuria, obstruction of uterus, im-
uents of urine.)
pacted stone, impassable stricture, extra-
vasion of urine, suppression.

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Horizontal posture, with head raised; hot blankets, and
hot bottles to feet legs and sides; frictions, blisters to
nucha, ice to head, bleeding, mercury, beef tea and brandy
enema, enema of salvolatile in solution.
In protracted cases, setons to nucha.

to

In concussion of spine, prone position; counter irritation spine, ice, dry cupping over spine; chloral-bromide of potassium.

Horizontal posture, with head raised; gag between
teeth, sinapisms to nucha and calves of legs, removal of
spicula or pressing bone by trephine, pressure over caro-
tids, nitrate of amyl inhalations, nitro-glycerin, antipyrin,
bromides, puncture of cerebral abscess.

In children's convulsion, hot baths, cold to head, spinal
ice-bag; bromide of ammonium (about gr. iij every ten
minutes).

Horizontal posture; cold effusion, abdominal pressure, compression of ovaries; nitrate of amyl or chloroform inhalations, tincture of musk orvalerian.

Horizontal posture, with head raised; cold effusion, zinc
or mustard emetics, stomach-pump, turpentine or salt and
water enema, strong coffee, vinegar, solution of acetate of
ammonia, pilocarpine (gr.), or strychnia (gr.), or
caffeine (gr. iij), subcutaneously.

Horizontal posture, with head low; cold effusion, stimu
lating enema, frictions, ammonia tonostrils, snuffs, sina-
pisms, turpentine stupes over heart, nitro-glycerin (gr. r),
galvanism, tinc ture of sumbul (mv), or hydrobromate of

quinine (gr. iv in hot water), subcutaneously; artificial
respiration. In extreme cases, transfusion.

Horizontal posture, with head raised; cold effusion (ex-
cept when skin is cold), ice to head, spine or in rectum;
cold drinks, cold baths, turpentine enema, dry cupping or
blisters to nucha, chloroform, bromide of ammonia enema,
(gr. xx), antipyrin (j), or quinine (gr. vj), subcutane-
ously; nitro-glycerin (gr. ) every ten minutes; digitalis.

Horizontal posture, with head raised; cold to head, sina-
pisms to loins, vapor baths, diaphoretics and purgatives, hot
blankets, bleeding, catheterization, chloroform, jaborandi,
nitro-glycerine, strophanthus, elaterium, oxygen inhalations,
poultices of digitalis leaves to abdomen, trasnfusion.

Treatment of Cancer.

The case of the Emperor Frederick has naturally again directed the attention of the profession to the medical treatment of cancer. Neudörfer has just published an interesting little pamphlet on the subject. Carcinosis, the author says, is very probably just as curable as syphilis or phthisis. The excision of a carcinoma, as of a hard chancre, is, as a rule, not far-reaching enough to prevent the infiltration of the surrounding tissues with the specific

microbes and cells. He believes that the medicinal treatment of cancer should be tried more extensively than has been the case hitherto. The rind of condurango and China turpentine have often given promising results. There are also, as in phthisis, climates favorable for cure. On the plateau of Mexico and at the Cape of Good Hope, for instance, cancer is an excep tional disease. The principal office for the surgeon, in Neudörfer's opinion, is not the extirpation of the neoplasm, but the medicinal treatment of the cancer-cachexia, which is the chief factor in bringing about the death. The treatment of cancer is naturally much like that of phthisis. Creasote, which has been found to stimulate the nutrition of the blood-corpuscles, is of equal value in cancer and in phthisis. He has obtained decided results in the treatment of cancer with the following preparation: B Creaso'i puri,

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they are getting to be entirely too numerous." Those who hold this view lose sight of the fact that compulsory attendance upon society meetings is a thing unknown. Every one will admit that it is possible for a physician to devote so much time and attention to society work as to seriously affect his private practice, but a smaller number of patients are lost in this way than by the stay-at-home plan.

By

The Maryland Medical Journal says: the thoughtful, live physician, the question, 'does it pay to belong to a medical society?' will always be answered in the affirmative." This, however, is not apparent to many, as the remuneration, in dollars and cents, comes in an indirect way. The Journal continues thus:

"The amount of practical information which a physician may gain from the discussions of an active society is beyond all calculation."

Nor does the medical society teach him less about himself. It gives him opportunity to compare himself with his fellows, to silently note the points in which he is deficient. It trains him to greater accuracy in the study of his cases, and greater care in their treatment, especially if from time to time he brings the more interesting ones among them to the notice of the society.

Here and there may be found an active, pushing city practitioner who is a member of no society, but this is a rare exception. Our best workers are society men.-Weekly Medica Review.

In a state of typical health, the functions of the body are regularly performed, without the individual's attention being specially called to them. He should scarcely be aware that he has a stomach, heart or lungs. His urine should be clear and inoffensive, and its specific gravity should range in the immediate neighborhood of 1020. His usual temperature should be close to 98 degrees Fahrenheit, and should not vary. He should breathe about twenty times to the minute. He should look his age, but not more. People who look much younger than their age show a tendency to accumulate too much fat, and are apt to have weak hearts. The hair of a healthy person may fall out before its time, but it should not turn prematurely gray. His eyelids should not be puffy, and the corners of his eyes should not be wrinkled. His complexion may be

Some Advantages of Membership in Medical sallow, or dusky, or florid, without detriment;

Societies.

There is, perhaps, no other one thing that conduces so much to the advancement of medical science as does the active working medical society. Now and then we hear it said, "The profession is going wild over medical societies;

but a transparent skin, a marble-white skin, or a tallowy-white skin are indicative of a tendency to phthisis, or anemia, or cancer. A clear eye, not too brilliant, and a clean, firm tongue, seldom accompany disease or even disordered function.

Other Forms of Intoxication. Beer, wine and liquors do not constitute the only inducements open to those who seek tem porary exhilaration or utopian repose from intoxicating agents. Many drugs are capable of producing like effects; and though they may not be quite so palatable, they are frequently made subservient to the wishes of those who cannot or will not get "drunk" through the ordinary channels.

Belladonna, in a large dose (and sometimes in small repeated doses), produces a characteristic intoxication--flushed face, congested eyes, daliated pupils, loss of visual accommodation, horseness of voice, drunken, uncertain gait (from paralysis of motor nerves), wild, extravagant fancies, and more or less delirium. Sometimes the ordinary avocations are performed in a dreamy sonambulistic way, after the manner of the hypnotic condition. These effects of belladonna are peculiar to man, and he is sometimes foolish enough to invoke them. Other donkeys, and mules and horses are insusceptible either to its inebriating or any of its physiological actions. Children are remarkably tolerant of this drug, when employed medicinally.

Stramonium and Datura Tatula produce effects very similar to those of belladona. Nicotine causes twitchings, tetantic movments, palpitation, cold perspiration, dyspnea, tremor, and general weakness; and if pushed to larger quantities, contraction of the pupils, amblyopia and paralysis. It rapidly causes salivation in cats. These symptons are hardly those of intoxication; but excessive use of tobacco sometimes produces effects hardly distinguishable from drunkenness.

Conium (or Hemlock) will occasion a condition that might pass muster for intoxication; faltering gait and loss of command over movements, drooping of the eyelids, dyspnea, and convulsions, but little or no mental aberration. The hind legs of rabbits and some similar animals are paralyzed by conium; but frogs are almost insusceptible. Temporary blindness has been produced in man. This plant has been mistaken for parsley.

Cannabis Indica (or Indian Hemp) gives rise to a merry form of intoxication somewhat resembling the effects of nitrous oxide gas. He is monarch of all he surveys, gossips and sings, rubs his hands gleefully, and considers himself a "first-rate fellow." Sometimes there is outrageous delirium, sometimes sexual furor. After a while sleep (or even a cataleptic condition) ensues, with dreams of perfect bliss. On the other hand, nausea and vomiting may

occur, with intense thirst and prostration. Its habitual use impairs the intellect.

Nitrous oxide gas produces an exhilarating intoxication, when administered short of anesthesia. In some it causes uncontrollable laughter, in others a form of hallucination resembling nightmare. It does not usually cause vomiting. When administered with a view to its anesthetic action, immunity from pain is most likely induced throngh oxidation of the nervous centres, by robbing the blood of its free oxygen (for the oxygen of nitrous oxide is in combination with nitrogen, whereas air is a mixture of nitrogen with free oxygen).

Opium acts very much like alcohol in the human system, both being primarily stimulating and subsequently narcotic; and both are at once narcotic in a large dose. Opium causes confused ideas, reverie, pleasurable delirium, and voluptuous listlessness; a sort of a "fool's paradise," from which, however, the patient can generally be aroused to transact business, unless "too far gone." Unfortunately, he experiences no after-inconvenience from an occasional indulgence in smoking opium; but its habitual use has most disastrous effects.

Cocaine causes a pleasing cerebral excitement, with partial anesthesia. Large doses are toxic, producing total anesthesia, tetanic convulsions, mydriasis, high temperature, sensory paralysis, and arrest of respiratory movements.

Chloric ether (spirits of chloroform) gives rise to a gay intoxication, with much joviality and a peculiar brilliancy of the eyes. Many esthetic persons use it secretly, who would shudder at the idea of common intoxicants.

Aromatic spirits of ammonia (sal volatile) has similar attributes, and is also much used, "sub-rosa." Sulphuric ether sometimes causes a singular delusion on the part of the person who inhales it. He thinks he has solved the

great mystery, the secret of life. It is all apparently revealed to him, yet he cannot carry its recollection into his waking moments, and is staggered at the thought of the revelation he has had to leave unrevealed.

"Pulque" (aqua micl) is a Mexican drink, extracted from the American Agave or Magucy, of which there are very many varieties, but only a few yield this product. Others produce "aquardiente," potash, sugar and gum. Pulque is a light colored liquor and contains principally alcohol, gluten, and water. It is much used as a tonic, in gastric disturbances, and in amenor rhea. In larger quantities, it causes a letharg; intoxication, with stertorous breathing, rese bling the drunkenness resulting from too m mbeer. uch

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Absinthe is the oil of wormwood mixed

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