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should much rather take our chances under the care of one who only chooses with good judgment, than under the care of an endless experimenter.

But can we not use many formulas without becoming mere copyists? Let us see.

There are a few formulas that are absolute chemical combinations, and are to be administered for the effect of the combination itself or for some product set free by the combination rather than for any of its separate ingredients. These, when used, should be copied exactly, until you can find or originate something better.

There are others which are valuable from the fact that each ingredient, besides having its own influence towards the therapeutic effect desired, also operates to prevent or correct some of the undesired effects of others of the ingredients. A good anodyne combination is an example. In these the proportions of the ingredients should rarely be changed, except for well defined reasons.

There are still others which are simply lucky combinations for the effect of every ingredient

contained. These should be thoroughly studied and changes, omission or substitution of ingredients made to suit each case. The physician should as thoroughly study his volume of prescriptions as any other book in his library. He should also not undertake to make a new complicated prescription himself without much reflection and research; and even then he should be prepared to be sadly disappointed in his results. J. J. T.

The Medical Scrap-Book.

We desire to preserve notes, extracts, and sometimes entire articles found in our course of professional reading. Many plans have been proposed for this, as, for example, an indexed scrap book, an indexed reference book, and other complicated and insufficient methods.

Listen to the method we have devised, which is so easy and inexpensive that the laziest, busiest, most unsystematic or most povertystricken doctor can adopt it with perfect satisfaction.

There is a file used by lawyers, secretaries, business men and others, for preserving letters and documents, which can be bought of almost any stationer at thirty cents each, or can be made by any one whose money is more valuable to him than his time. It consists of a series of apartments which collapse or fold together like the bellows of an accordeon, and is made entirely of paper and pasteboard. These apartments are properly indexed in alphabetical order on the upper margin.

One of these files may be used by the general practitioner who does not care to preserve very much from his reading. A note, extract or clipping has simply to be dropped into the proper apartment, and it is always there for instant reference at any moment. The alphabetical indexing may be allowed to remain or the apartments may be labeled with the names of different departments of the science or different diseases or classes of disease, just as the owner desires. A specialist would label the different apartments according to the diseases of his specialty. One who does a great deal file for each department of medicine and surof reading and selecting will have a separate gery, with the apartments properly labeled for the sub-divisions of the respective departments. As, for example, one entire file each for surgery, obstetrics, and for each of the medical and surgical specialties. A few departments in each file can be left to be labeled as subsequently needed.

In this you can drop an entire journal if you wish to preserve it, or an article which is printed on both sides of the leaf, or even a letter from a medical friend containing valuable information. From time to time you can reject articles which you no longer wish to preserve. The old fashioned scrap-book system has none of these advantages.

When you wish to refer to a certain subject you have right before you everything which you have ever preserved on that subject.

Of course, you will still preserve intact the files of your favorite journal, whatever one that is, and bind it at the end of the year, as the index will be sufficient aid to reference in it.

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The Current Medical Thought.

By a mistake in our mailing room, a number of journals last month, particularly for Indiana and Ohio, were marked with the notice, "Your Subscription expires with this Number," that should not have been so marked. Kindly pardon.

Camphoric Acid.

Camphoric acid has been recently strongly recommended by Professor Reichert as useful in the treatment of acute and chronic affections of the respiratory passages. Externally he has used solutions containing from 2 to 6 per cent. of the acid, and has observed that, when applied to the mucous membrane, it appears to exercise a constringent action within two minutes, and that, besides its antiseptic properties it promotes its granulation without irritation. He recommends, in acute angina, the use of a 1⁄2 to 1.per cent. solution every three hours; in pharyngo-laryngitis and tracheitis, the application, as a spray, of 4 per cent. solution, increasing in strength to 1 per cent. ; in acute catarrh, the introduction of wading saturated with a 2 per cent. solution into the nose; in acute bronchitis, a 1 to 2 per cent, solution applied as a spray to the larynx. Camphoric acid forms white crystalline needles, having an acid taste; it is difficultly soluble in water, and readily soluble in alcohol, ether, or fixed oils (2 per cent.) In order to prevent it from crystallizing out from concentrated aqueous solutions, it is advisable to add about 11 per cent. of alcohol.-Phar. Jour.

Instantaneous Remedy for Lumbago. Collodion, tincture of iodine, liquid ammonia, equal parts. To be applied widely over the parts with a camel's-hair brush.

The Urine in Organic Kidney Diseases.

In organic diseases of the kidney, albumen is constantly present in the urine, independently of the accidental presence of pus, blood or other fluids containing it. The amount may vary considerably, and in contracted kidney it may be almost absent; but as a rule, there is no true kidney disease without albumen. Casts of the uriniferous tubules are also most frequently found, though they too may be occasionally wanting, and either albumen or casts may be present independently of each other. The specific gravity of the urine is below 1020° in these cases; the left ventricle of the heart is often hypertrophied and there is high arterial

tension. In functional diseases of the kidney, albumen is inconstant, and is often absent in the early morning, appearing later in the day; and the specific gravity of the urine remains normal or may exceed it.

Some Causes of Menorrhagia. When menorrhagia is persistent at each menstruation, and no disease can be traced in connection with the womb, it is well to examine the urine. Sometimes it will be found laden with albumen and casts of tubes, owing to the existence of granular degeneration of the kidneys. Here then is the primary cause of the menorrhagia; the attenuated altered blood escapes with unwonted ease from the vessels of the uterus, each time that they are congested by the menstrual flux. The blocd may also have been impoverished by exhaustion or by prolonged lactation, and the womb itself may be in a condition of perfect health.

Hemorrhoids.

The treatment was accidentally discovered, and consists simply in suspension, as is used in applying a plaster jacket, three times a week, one minute the first few times, and two to three minutes for the times succeeding that. It is said to succeed admirably in locomotor ataxia and in sexual impotence due to cerebral lesions.

The gold medal of the Philadelphia School of Anatomy for the course of 1888 and 1889 has been awarded to Julius T. Vissel, a student at the Medico Chirurgical College. This medal is awarded for the best examination in anatomy, and we herewith congratulate Mr. Vissel and his preceptor, Dr Brumbaugh, of Pipersville, Pa.

The Cure of Bacillary Phthisis.

I

All attempts hitherto made to destroy the tubercle-bacilli in a body infested by them failed for the reason that they possess a greater power of resistance against antiparasitic agencies, than do the cells of the animal organism themselves.

Two years ago I commenced a work concerning the therapy of diseases of bacterial origin. For reasons which I cannot now particularly enumerate I discontinued it in order that I might B. Tr. hamemelis; tr. collinsonia; tr. euo- restrict my attention to a part of the work, viz., nymus, āā. the treatment of tuberculosis. Theoretically, M. S.-Teaspoonful in water four times daily. Take the first daily dose early in made the following deductions : the morning in a tumbler of water in which 10 grains of soda bicarb. is dissolved; then at night just before retiring; remaining two doses between meals. If needed to overcome constipation, use black jack prepared as follows: B.-Aloes socoratin, 3ij; soda bicarb., 3ij; .number six, 3ij; hot water, q. s. to make 3vi. Dose, 20 to 30 minims in water night and morning. By care the dose can be determined that will produce one evacuation daily and not irritate the rectum. We regard aloes a true tonic to the rectum and colon, in appropriate doses. As a local application, use a salve made of vaseline, boric acid and belladonna.-Ga. Ec. Med. Jour.

We are pleased to note that the stand taken by this journal over a year ago-away in advance of the times-in advocating that State boards should be so constituted that examinations in therapeutics should be conducted in accordance with the principles of the applicant's own sect or school of medicine, is now being advocated and agitated by all the leading medical journals and societies of the State.

New Treatment of Locomotor Ataxia and
Certain Diseases of the Spinal Cord.

Dr. Motchonkowsky, of Odessa, Russia, originated the treatment, which has been adopted by Prof. Charcot, of Paris, France, who has used it in fifteen cases with remarkable success.

Just as resistant as the tubercle-bacilli are against such remedies, just so susceptible are they to the influence of temperatures, be they either higher or lower than their optimum temperature.

All varieties of microbes, as was first proven by Pasteur by reducing the virulence of the bacillus of chicken-cholera, and taught later by Toussaint and Pasteur by their protective anthrax inoculation, are thus reduced by the action of increased temperatures.

The temperature limits within which the tubercle bacilli can flourish are particularly narrow.* Were it possible now, by means of a discontinuous sterilizing process, to hinder the tubercle bacilli in their development and thus to diminish their virulence, and were it possible for the human organism to bear the inhalation of highly heated air without detriment, then we would have obtained a means in such inhalations of combating bacillary phthisis.

Thus reasoning, I instituted experiments in various directions, with the following results:

Ist.

The correctness of the announcements made by other investigators concerning the temperature limits, and the effects of various degrees of temperature upon the tubercle-bacilli.

2d. The possibility of lowering their developmental and procreating capacity by means of discontinuous sterilization.

3d. That dry air heated to 150°-180° C. (302°-356° F.) may be inhaled by man without difficulty for several hours, and that such inhalation produce a hurrying of the pulse only during the first few minutes; a diminution in the frequency of respiration, with at the same time a deepening of the inspirations; on elevation of the general temperature of the body by 1° -1° C.; the expired air shows a temperature of at least 45° C.; within an hour after completing an inhalation the temperature of the body returns to normal, and the general wellbeing remains undisturbed.

10

My experiments thus far instituted for determining the temperature of the air contained in the alveoli, and that of their tissues during an inhalation, have thus far not maintained any positive result.

I commenced a series of experiments, with the purpose of determining whether, and in which stage of the treatment, the virulence of the tubercle-bacilli contained in the sputa of consumptives, was, through such inhalations, diminished and thus removed, simultaneously with the reception of a tuberculous patient for treatment by means of highly heated dry air.

I began treating the first patient June 7, 1888. Since then I have treated a very large number of consumptives after the same manner, and moreover almost throughout with such favorable results, that, indeed, every doubt as to the correctness of my premises must be excluded. I intend shortly to have appear in print the clinical history of my first 50 cases, and thus place them at the disposal of my colleagues. Meanwhile I shall limit myself to a representa tion, seriatim, of the general results attained: Removal of dyspnoea. Lessening of cough.

I.

2.

3. During the first few days, especially while inhaling, increased expectoration; later on considerable diminution, up to its complete disappearance.

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ticularly in such cases as previously had been much emaciated, and also in such in whom has occured not only a standstill of the acute process, but already a beginning of the healing process. The absence of increase in weight at first is however easily explainable, when it is considered that patients treated according to my method are not subjected to any extra diet whatever, and that the inhalations require more or less bodily exertion.

15. Microscopic examinations show a gradual decrease of the elastic fibres in the sputa up to a total disappearance of the same, as also a rapid diminution of the pus corpuscles. During the early period of the inhalations, it seems to me that there occurs an increase of the bacilli in the expectoration; but later on there is shown a considerable diminution of the

same.

That a cure can only be a gradual process can be easily understood from all that has now been said. An immediate killing of the bacilli, by means of hot air inhalations only from time to time, cannot be made possible, but simply their discontinuous sterilization. The inhalations continue but for a few hours daily; only during this time are the bacilli exposed to weakening temperature, and after all this is not as high as would appear. For though the inhaled air at the mouth is at a temperature of 160° C. (320° F.), it cools considerably on its way to the lungs by being in contact with tissues and the blood circulating therein, of a temperature of only 37.5° C., as may be inferred from the fact that the exhaled air is warmed to 45° C. (112° F.). Now, inasmuch as this again must have become still further cooled down on its passage from the lungs, we may infer that the air contained in the pulmonary passages during an inhalation must be at a temperature many degrees higher than 45° C.

The experience so far gained enables me to give the following definite directions:

I.

The effort must be made to increase the duration of the inhalations as rapidly as possible, beginning with half an hour twice daily, up to two hours or more twice a day. The more or less rapid lengthening of the sittings, as also the eventual shortening of the same, must be adapted by the observant physician to the individual condition of the patient. Never must the inhalations last longer than is comfortable and agreeable to the patient.

2. The patient must be encouraged to make the deepest possible, and later on, forced inspirations.

3. The temperature of the air during these inhalations, as indicated of course by the thermometer in the breathing tube, beginning with 100°, must as rapidly as possible be raised to

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