Prescribe Jensen's Crystal Pepsin.

We have used Bovinine with satisfaction as a nutritive tonic.

By all means try Lactated Food for infants with weak digestive powers.

For your cases of chronic constipation, prescribe Tarrant's Seltzer Aperient.

Put into your case a bottle each of Battle & Co.'s Bromidia, Papine and Iodia.

Do not fail to supply yourself with a pocket case of Upjohn's Pills and Granules.

Write to Wells, Richardson and Co., Burlington, Vt., for a specific for cholera infantum,

We have used Lambert's Lithiated Hydraugen with advantage in the uric acid diathesis.

Weinhagen for the finest Thermometers and a good Faradic Battery to recommend to your patients at $3.50. Sample of Nestle's Milk Food will be sent upon application to Thos. Leeming & Co., 18 College place, N. Y.

W. R. Warner & Co., 1228 Market St., Phila., announce that their Ingluvin is an absolute specific for the vomiting of pregnancy.

The Medico-Chirurgical College has marched rapidly to the front. The advanced methods of teaching are in

vogue in this institution.

Write to B. Keith & Co., 75 William St., N. Y., for concentrated medicines, and a valuable treatise on concentrated medication.

Platt's Chlorides can be relied on as an antiseptic and disinfectant. You need not hesitate to recommend them in all cases requiring them.

See the advertisement in this issue of the N. Y. & Chicago Chemical Co., in regard to their Golden Scale Pepsin and Ford's Pepsin.

We have used Stewart's pile ointment very successfully for hemorrhoids. Sample, formula, etc., free, of Fred. W. Stewart, Oswego, N. Y.

For weak digestion, prescribe a dose of Horseford's Acid Phosphate after each meal. Send for sample if you are not already acquainted with it.

If you want the best syringe for your lady patients, prescribe The "Ladies'" Syringe, made by the Goodyear rubber co., 57 Maiden Lane, N. Y.

When you are in doubt as to where to find information regarding new remedies, you may always depend upon Parke, Davis & Co., Detroit, Mich.

Send a postal card to the Phillips Instrument House, 14 Marietta St., Atlanta, Ga., for a complete description of elegant Surgical and Medical apparatus of all kinds.

Use McArthur's Syrup for your cases of consumption, scrofula, etc. A sample free if you agree to pay express charges. McArthur Hypophosphite Co., Boston, Mass.

Chas, Lentz & Sons, 18 N. 11th St., Phila., will furnish you with first-class surgical instruments and appli ances, at 25 per cent, discount now, if you will mention this journal.

Use Marchand's Peroxide of Hydrogen and Glycozone wherever you need harmless yet powerful antiseptic agents. Address, E. Drevet, 10 West 4th. St., N. Y. Mention this journal.

The Hastings Truss Co., 224 S. 9th St., Phila., manufacturers of first class Trusses, Abdominal and Uterine Supporters, Elastic Bandages and Stockings, etc. Send for catalogue and price-list.

The ingenuity of inventors is constantly at work to devise better and less expensive instruments, medicine cases, etc., for your use. Willis H. Davis, Keokuk, Iowa, keeps fully abreast of the times in all these mat

ters.

Freligh's Tonic is a specific in its line. For single free sample or six large samples (for complete demonstration) for twenty-five cents, address, I. O. Woodruff, & Co., 88 Maiden lane, N. Y. Mention THE MEDICAL WORLD.

You do not know what power you may have over chronic discharge unless you have made use of Cuthman's Menthol Suppositories. For samples, address, W. H. Shepard & Co., Three Rivers, Mich., mentioning THE MEDICAL WORLD.

VOMITING IN PREGNANCY-I am using Peacock's Bromides in my practice, daily, and am better pleased with the preparation than ever. I have discovered a new application for it, in a case of vomiting in preg (CONTINUED OVER NEXT LEAF.)

S

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The physician often has as intricate and interesting problems to solve as does the astronomer in the presence of the starry spheres or the chess-player before the exciting board. These problems give the liveliest intellectual pleasure, while also affording the satisfaction of serving mankind in solving them.

For example: A patient complains of pains in the joints and fever. The most superficial, remembering the relief obtained from counterirritation, simply applies blisters or poultices, or paints with tincture of iodine. Another, with deeper insight, remembering that there is a poisonous element in the blood causing this inflammation, gives quinine, salicylic compounds, the iodides, guaiac, colchicum, etc., to neutralize it or favor its removal. He is apt to ask his fellow-practitioners such questions as, "what is your formula for rheumatism?" He has implicit faith in formulas. Another, who remembers that this poisonous agent is in the blood, because it is not eliminated by the kid

neys and skin, and who obtains from his patient the history of highly-colored urine with the characteristic deposits, adds to his list of remedies those that will most favor this process, and we find him making use of the lithium salts, the benzoates, pilocarpine, etc., in addition to his remedies for immediate relief. Each one renders a cure more or less complete and permanent according to his progress in the solution of the problem. But here comes one who, bearing in mind his researches into comparative physiology, and remembering the original function of the primitive liver, says: "This patient's liver has reverted back to the uric acid formation;" and so, having found the final solution of the problem, he directs his treatment to the organ originally at fault.

We have dropped the blind use of formulas for the name of the disease long before we reached this point, and are using few or even single remedies according to their specific indications.

At last comes the close student of causes, who determines the habits of life that favor the development of the disease-alcohol and chronic malaria, favoring excessive connective tissue growth, or a superabundance of animal foods containing large quantities of uric acid products, and so on until every probable cause is determined. He advises abstinence from alcoholic drinks, including beer and wine-gives treatment for the chronic malaria, and restricts the use of meats, gravies and meat soups, substituting vegetables and fruits, and puts the patient on the road to permanent recovery. But while he has the mental satisfaction of having solved the problem, yet he is often not as fully appreciated, as is he who merely doses for the symptoms. Yet we think the time is coming when intellectual pleasures in scientific pursuits and the consciousness of doing good will be the physician's highest reward.

J. J. T.

Spermatic Injections.

We have hitherto said nothing regarding the now famous "Elixir Vitæ," because we have felt that there was really little of definite value to be said. Here is, in brief, a summary of the history of the whole matter:

Dr. Brown-Sequard, the eminent physiologist and neurologist, now far advanced in years, but apparently as vigorous and clear-minded as ever, surprised the Society of Biology in Paris by reading before them a paper stating that, while making physiological experiments, he had accidentally discovered that the testicular secretions obtained from the spermatic cord and testicles of the guinea-pig and possibly of other animals, and hypodermatically injected into a man infirm with age, would relieve him of his infirmities and restore to him the vigor of his youth. He stated that he had experimented with it since 1869, and that he attributed his remarkable retention of youthful vigor and health to its influence. The benefits, he said, were manifest in increased mental activity, better digestion and sleep, restoration of sexual power and of tone and elasticity to the muscular system. He had also used it upon others with like benefit, the effects of one injection lasting from two to twelve days. Using the utmost antiseptic precautions, he had never had an unfortunate accident from the practice.

These observations were confirmed by M. Variot at a subsequent meeting of the society, who related the cases of three old men upon whom he had used the injection with marked benefit.

These experiments have been repeated in America, mostly by men hastening to take up the latest craze, but ignorant of the proper manner in which it should be done, and the results have been, principally, abscesses and blood poisoning. We would advise men who have not had extended experience in laboratory manipulations to wait and let this matter be worked out by those who, having better facilities, are better prepared to take its responsibilities. We are promised an exhaustive article on this subject next month. The time for judgment has not come yet.

The Current Medical Thought.

With all the venom of jealousy and malice a drug journal and a rival medical journal are trying, by misconstruction and misrepresentation, to injure Dr. Waugh and The Times and Register. With our readers Dr. Waugh's standing is such that he cannot be affected by any such measures. The Times and Register speaks for itself as an able and interesting scientific journal. To say more is unnecessary.

Chronic Endocarditis.

Dr. Francis Delafield (Medical Record) says: Few cases are more common than this disease, and it may be present within great variations, from a mere inconvenience to great distress on the part of the patient. Nearly all the most important symptoms of chronic endocarditis are due to the disturbances produced in the distribution of the blood throughout the body. It is not easy to say why in some cases of chronic endocarditis there are disturbances of the circulation, and why in others there are

not.

The disturbances of the circulation are due to the endocarditis, dilatation and hypertrophy of the ventricles, inflammation or degeneration of the wall of the heart, inflammation of the coronary arteries, abnormal heartaction and the associated pulmonary emphy. sema, chronic endarteritis and chronic Bright's disease. These conditions, all of them, must be considered in connection with chronic endocarditis. In regard to the last condition mentioned namely, chronic endarteritis and chronic Bright's disease-albumen was present, casts less constant. Anemia and dropsy are present, and the patient gets worse. Changes in structure much the same, however the symptoms may be. Arterial walls thickened. There are three forms of chronic nephritis: 1. Chronic nephritis with much exudation-serum exudes from blood-vessels to the urine; amount of urine varies; specific gravity is lower; albumen and casts are constant; patients do badly. 2. Nephritis with moderate exudation-urine diminished; specific gravity lower; no albumen or casts present unless patient does badly; liable to dyspnea, headache. 3. Chronic nephritis with little or no disturbances-urine shows no change; they gradually grow worse and die.

The Uses of Boric Acid in Gynecology. Dr. W. W. Potter (Journal of the American Medical Association) says:

1. That boric acid is suited to many gynecic uses where antiseptics are required.

2. That it can claim superiority for vaginal tamponment by reason of (a) odorless, (b)

colorless, (c) non-irritant, chemical properties; these admitting of its frequent, liberal, and prolonged employment where this method of treatment is indicated.

3. That it is a remedy of value in sterility due to acrid secretions, that destroy the fecundating power of the spermatoza.

4. That it is one of the best powders to render operation wounds in the genital tract aseptic.

The Baking of Bacilli.

Dr. A. Jacobi (Medical Record) denounces Weigert's advertising scheme and records his own experience in the use of hot air in treating phthisis. Weigert, supposed to be an American physician, now of Germany, claimed to have discovered a method of curing phthisis by the inhalation of hot air, and he had made free use of Dr. Jacobi's name in advertising his apparatus for carrying out this treatment. The treatment was not original with Weigert, nor had Dr. Jacobi, as had been asserted, bought, endorsed, or recommended the apparatus in question. Moreover, as appeared further along, he had little confidence in the method. To Halter belongs the honor of suggesting the treatment of phthisis by the inhalation of hot air with the view of killing the bacilli in the lungs. The idea arose from observing the immunity from phthisis of workmen in a lime-kiln where they were exposed to a high degree of heat, 222° to 158° F.,so high that it would destroy the tubercle bacilli provided it continued at that degree until it had reached the lungs. The air inhaled by workmen in a lime-kiln was dry and rarified. A moist atmosphere of a like temperature would be more destructive to the bacilli, but was less endurable by the phthisical patient. Dr. Jacobi said, that having been requested to admit Weigert's apparatus into his wards at Bellevue Hospital, he did experiment with it some time ago, and for a while the results made a favo:able impression on the physicians in attendance, for the patients, or a part of them, seemed to improve under the treatment. More careful observation, however, showed that the improvement was doubtless due to rest in the hospital, in an atmosphere much purer than that in which the patient had lived in their tenement homes. The instrument itself was not as good as that which one of ordinary ingenuity could improvise; the atmospshere on its way to the lungs from the flame was found to have fallen from above 300° F. to about the temperature of the body when it had reached the mouth. Of course if it were above the temperature of the blood it would become further cooled on its passage toward the lungs. Some of the hot air might get into the alveoli, but very little. In order to obtain

benefit from such treatment it would be necessary not only that the air inhaled be of a high temperature, but that the patient be in a room in which the thermometer registered at least 105.5° F. In other words, it would be necessary to produce a short of artificial fever, and it was evident that such treatment must prove injurious to any other than patients in the very first stage of phthisis. He added that two of his patients suffered from cough and vomiting during the treatment with hot air, and were distinctly better when it was discontinued.

Hot Air Inhalations in Phthisis.

The grass had scarcely grown on the grave of the treatment of pulmonary tuberculosis by gaseous enemata before another curative method was advocated by Weigert, Halter, and Krull; a method which would seem at first sight to have claims to be called curative in that it is designed to remove the cause of the disease by destroying the bacilli in situ. We know that the development of this particular microbe is arrested at a temperature of 107° F.; and if, then, the intrapulmonary temperature can be raised to or above this point and there maintained for a time, the happiest results must follow. I can confirm the statements of the originators of this method as to the ability of patients to breathe with impunity air at a surprisingly high temperature. I have myself inhaled it at 320° F., and seen patients inhale it at 428° F. without notable inconvenience. Nearly six months ago Dr. G. G. Sears, of Boston, began to practice inhalations of hot air on some of my patients in the House of Good Samaritan. His results are now ready for publication, and it will suffice to say here that an apparatus was used devised by Mr. G. L. Kingsley, of the Harvard Medical School, an apparatus which can be made by any coppersmith for $5-that patented by Weigert costs in this country $75-and that we are satisfied that the problem of intra pulmonary direct germicidal action is still unsolved.-DR. F. C. SHATTUCK, in Jour. Amer. Md. Asso'n.

Hernia.

Perro advocates the following method for reducing strangulated hernias. The pelvis is raised upon a pillow, thighs flexed and abducted; "the scrotum and hernia are seized by the left hand and elevated toward the abdominal walls, and pressure made upon them. The index finger of the right hand is passed into the inguinal canal, and by a boring and rotating pressure is directed toward the horizontal portion of the pubis." In a short time the hernia disappears. He has succeeded in six instances where taxis as ordinarily employed had failed. -American Practitioner and News.

Creolin in Obstetrics and in Gynecology. Creolin has been used by me for some months, to the exclusion of other antiseptics, in obstetrics, and also in the treatment of certain diseases of women. A brief statement of the application of this agent and the methods employed may be of some interest.

First, of the use of creolin in gynecology. Creolin has in my patients proved useful in cervical catarrh. Begin by thoroughly cleansing the cervical canal of the tenacious and opaque secretion which occupies it, and then by means of cotton wrapped upon the end of Emmet's applicator, swab the diseased surface two or three times, fresh cotton replacing that which has been used at each reapplication. It is important that no drops of creolin fall upon the vagina, for it may cause some suffering, therefore place in the vagina just below the mouth of the womb a small piece of clean cotton to absorb any of the medicine which may escape during the application. In most cases it will be advisable to apply the remedy once in three days. Creolin is a useful viginal injection in these cases, and also in others where such injection is required, especially if there be a vaginal catarrh. The strength of this injection will be one teaspoonful to a pint of water.

An antiseptic ointment, certain in power and not unpleasant in odor, is often desired, not only by the obstetrician, but also by the gynecologist. I believe that benzoated lard, | to which four per cent. of creolin is added, will meet these indications satisfactorily. Here let me mention one of the uses of this ointment which I believe will not disappoint. In many cases, whether of descent or of posterior displacement of the womb, cotton-packing is often employed successfully. It is usual in this packing to use several pieces of cotton; but let me suggest a better way, as it seems to me. These single pieces are liable to become displaced, and one or more of the lower ones to fall out, or be pushed out if the patient be long standing, or make any straining effort, as when at stool; of course when the foundation gives way the superstructure must sink or fall.

Let the practitioner who has found patients complain of this accident, or who otherwise has been disappointed with the ordinary tampon, try the following plan: Take a strip of prepared cotton (absorbent cotton has been employed), possibly two inches broad and ten or twelve long-it may be of greater or less width or length, according to the capacity of the vagina-then with a spatula smear each side of the cotton with the ointment suggested,

eum

or some similar preparation; next, supposing the uterus to have been replaced, and the perinnow retracted with a Sims' speculum, the physician takes his pocket dressing forceps, seizes the cotton strip at one end, and carries it up to the vaginal vault anterior to the cervix, lodging it there; he then with the forceps carries a fold of the cotton to the posterior vault covering over the mouth of the womb, and thus with alternate folds backward and forward, the ends of the folds resting directly upon the posterior and anterior vaginal walls, the canal is packed, either partially or completely, as the special case will require. This packing is firmer than if separate pieces of cotton are used; its removal, of course, is easy and quick, for we have only to take hold of the lowest fold with finger or forceps, and the work is almost instantly done.

I have had a packing of this kind, the ointment previously mentioned being used to coat the cotton, remain six days, and upon its removal the only odor that could be detected was that of creolin. Of course this may not be realized in all cases, for in some women the vaginal discharges are much more liable to become offensive than in others.

In several cases of operations upon the vagina and upon the external sexual organs I have employed a solution of creolin for instruments to be placed in, for disinfecting the hands, and as an application to the part operated upon.

In obstetric practice those who believe in antiseptics frequently use a solution of carbolic acid for disinfecting instruments, and of corrosive sublimate for vaginal or uterine injec tions, for bathing the external sexual organs, and for rendering their hands antiseptic. Some deplorable results have followed uterine injections of solutions of corrosive sublimate; indeed, I have seen two cases of corrosive sublimate poisoning, not fatal, however, result from vaginal injections, the strength of the solution being 1 to 2000. It is true that the obstetrician is now wiser and more cautious, and no one would think of administering to a puerpera a uterine injection of the strength just mentioned. Nevertheless, it is better for us to have a single antiseptic, and that should be one which will reveal itself both by sight and smell. A solution of corrosive sublimate makes revelation to neither sense, and that of carbolic acid to but one. Creolin has a very decided odor, which if not positively pleasant, is certainly less disagreeable than that of corbolic acid. Mixed with water in the proportion generally employed, one teaspoonful to the pint, it makes a milk-colored fluid.