be entertained when the patient again became pregnant. She died without obvious cause three weeks after delivery at full term, and the autopsy showed that the supposed ovarian tumor was really the left kidney in a very advanced state of disease. It weighed twenty-seven pounds three ounces. Pregnancy and renal cancer were mistaken for one another when fetal diagnosis was not so well understood and practiced as it is now, but at the present such an error could hardly be made or adhered to for any length of time by an intelligent and careful observer.

RENAL CANCER.

I. Generally unilateral.

2. Develops from above.
3. Tumor hard.

4. Rarely fluctuating.
5. Irregular, nodulated.

6. Loop of intestines in front of tumor
common. Dullness to the outside.
7. Aspiration brings pure blood and
sometimes cancerous material at
point of needle.

OVARIAN TUMOR,

1. Generally unilateral.
2. Develops from below.
3. Soft.

4. Generally fluctuating.
5. Generally smooth.

6. Intestines pushed aside, resonance on
outside. Dullness central.
Aspiration brings away characteristic
ovarian fluid.

7.

Hepatic and renal tumors have not seldom been confounded. Rayer and Frerichs both mention cases in which renal cancer had been pronounced cancer of the liver. It is true the two may coexist, as was observed in one of my own patients; but as a rule, attention to the following points will distinguish them:

Cancer of the liver lies much higher, and generally presents an irregular nodulated border running more or less diagonally across the abdomen; the intestines never lie in front of it. Jaundice is common, hematuria is rare. In renal cancer the tumor occupies a lower point,

rises vertically and not so high; ascending colon generally lies in front of it. There is an appreciable interspace between the margin of the liver and the upper border of the renal tumor. Jaundice is very rare and hematuria common.

Many other diseases from which renal cancer is to be diagnosticated can be mentioned only in passing. Hydatids of kidney, perinephritis, psoas-abscess, enlargement of mesenteric glands, abdominal aneurism, ascites, distension of cecum and ascending colon, etc.

The judicious employment of purgatives to empty the bowel, the practice of auscultation and percussion, the use of the aspirator and attention to the history of the case, will generally suffice for a correct apprehension of the nature of the disease.

THE HYPOPHOSPHITES.-There can be no doubt that the hypophosphites now in common use prove beneficial in many cases of pulmonary consumption as well as in other wasting diseases. Whether they play the part of supplying necessary materials to the bodily tissues, or whether, through decomposition, they give out force for carrying on the bodily functions, is not definitely settled. It has been shown by experiment, however, that animals fed on the hypophosphites gain largely in weight over those who receive none-the gain being proportionate to the amount fed, and this indicates that they act the part of constructives. In accordance with this view, Dr. T. J. Mays, of the chest department of the Philadelphia Polyclinic, with assistance of Mr. Kyner, the apothecary, has devised a preparation which has yielded good therapeutic results. Its composition is as follows:

DOSE. One teaspoonful before each meal and at bedtime, in cold water.-Polyclinic.

TREATMENT OF EPILEPSY.-(DR. E. D. FISHER, in Journal of Nervous and Mental Diseases.)

In reference to the treatment of epilepsy I depend on the bromides exclusively, usually commencing with thirty grain doses, three times a day.

I prefer, as a rule, the mixed bromides, in the proportion of four parts of the potassium bromide to two parts each of the sodium and ammonium bromide; when cardiac weakness is present, employing digitalis or aromatic spirits of ammonia.

I have not found, as some affirm, that iron acts deleteriously, that is, when anemia is present. Nor does the continued use of the bromides

for years even, in my experience, lead to any mental disturbance; in fact, I find a gradual improvement in this respect whenever I succeed in controlling the disease.

In regard to cure of the disease, in my opinion that is less often accomplished than amelioration of the condition.

HAGER'S CATarrh Remedy.-The formula recommended by DR. HERMAN HAGER is as follows:

Carbolic acid, 10 parts,

Alcohol, 10 parts.

Water of ammonia, 12 parts.

Distilled water, 20 parts.

Take two ounce, wide-mouthed bottles, fill them to one-third with the above liquid; then introduce a bunch of (absorbent) cotton of sufficient size to soak up all the liquid.

To be used in incipient cold in the head, coryza, chronic catarrh, etc. A stronger preparation, also recommended by HAGER, is the following:

Carbolic acid, 10 parts.

Oil of turpentine, 5 parts.

Water of ammonia, 12 parts.
Alcohol, 20 parts.

To be used in the same manner as the preceding.

HAGER recommends these as prophylactics against diphtheria. He advises all those who handle and are about patients suffering from diphtheria or phthisis, to place a vial with this olfactorium to the nose when they approach the patient.-Med. Age.

For cystitis and irritable bladder, Dr. Hearn gave, at the Jefferson College Hospital:

The

In a case of infantile eczema, Prof. Bartholow, besides directions given as to diet, placed the child (aged two years) upon tinct. belladonnæ, gtt. v, ter die, or sufficient to cause dryness of the mouth. object in view is to affect the cutaneous circulation, and thus bring about the desired result.-Col. and Clin. Record.

CORRESPONDENCE.

TAIT'S VERACITY.

EDITOR OF COLUMBUS MEDICAL JOURNAL.-Dear Doctor: Your letter of the 14th inst. received. You say that several medical journals are inclined to strongly intimate that Mr. Lawson Tait either selected his cases in his phenomenal run of 139, or else lies in his report, and you request me to give my views on the subject for publication in your Journal. This request will be most heartily complied with.

I was at Birmingham for the purpose of seeing Mr. Tait at work for many weeks. I saw every operation made by him while I was there, except one emergency case, which was operated upon in the afternoon when I was at work in another part of the city. This case recovered as well as every case of ovariotomy made by him during my stay there. I kept my own notes of the cases and followed them up, and I know there is no possibility of one death without my knowledge of it. As for his selecting only good cases for operation, the assertion is simply bosh. He operates upon every case, good or bad, old or young. I do not see how any man can accuse him of selecting cases if he knows anything at all of him and his teaching. He lays down the surgical law "that in every case of disease in the abdomen or pelvis, in which the health is destroyed or iife threatened, and in which the condition is not evidently due to malignant disease, an exploration of the cavity should be made."

I can say that he follows this law to the letter. He made a number of exploratory incisions while I was there, all of which recovered.

Chillicothe, Ohio, Oct. 16, 1886.

Yours truly,

RUFUS B. HALL.

HOW TO DETECT A MORPHINE-TAKER.-Professor Bull, of Paris, states that there are two ways by which the morphine habitue can be detected, and these are to be found in the skin and in the urine. The skin will be found to be covered with little dark spots situated in the center of little indurations about the size of a large shot. It is needless to add that these indurations are the result of the little wound of the needle, but as these lesions are generally found on the inside of the thighs, the patient refuses to let them be seen, and in that case examination of the urine will prove of great service. A few drops of tincture of iron are put into the suspected liquid, and if morphia be present a blue tinge will be produced.-Med. Record.

SSENGE

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Heating and Ventilating.

The connection of the heating of a house with its ventilation is, of course, inseparable. Many persons will cheerfully expend ten or fifteen thousand dollars in building a house, putting from two to three thousand on outside ornaments, who would not dream of spending five hundred or one thousand dollars for the necessary Hot Water Apparatus to keep this same house thoroughly and comfortably warmed and well ventilated.

In reading the reports from the various Boards of Health, one can not fail to notice the startling increase in the death rate from Scarlet Fever, Diphtheria, and allied diseases. It might safely be said that this condition of affairs is due to the fact that the tightly closed doors and windows, which cold weather makes necessary, prevents the ventilation of houses, which is essential to the maintenance of health.

To those who intend erecting a dwelling, we would advise that the matter of heating and ventilating be given much consideration; and before deciding how it shall be done, consult the A. A. Griffing Iron Co., Manufacturers of the Tompkins Hot Water Indirect Radiator, 518 Communipaw Ave., Jersey City, N. J.