The diet should be nutritive and stimulating.

Tue internal treatment is as follows: "As soon as the disease is suspected, twenty drops of the concentrated tincture Hydrastis are mixed with twenty dessert spoonfuls of water; and a dessert-spoonful is administered every hour. As the disease develops itself, the same dose is given every two or three hours. When the fever and erysipelatous swelling of the skin recede, add to the above mixture thirty drops of Veratrum viride, and administer the combination at the intervals mentioned. Let the effect be watched; and, if faintness or prostration, very slow pulse, with nausea and great perspiration, are produced by the Veratrum, the use of that ingredient must be suspended for a timeWhen putrescence is of a marked type, and also when the pustulation is greatly developed in the mouth and on the fauces, the concentrated tincture of Baptisia tinctoria (Keith's) is very serviceable, and may be given in combination with the Hydrastis, in doses of from three to five drops, mixed with each dose of the latter."

"With these simple medicinal means," Dr. Wilkinson declares, "I have obtained results unparalleled in the treatment of small pox."

He explains the results as follows:

1. The disease is abridged in duration. In the first case treated, a severe confluent small pox, the symptoms were over in a week, and the patient out in eleven days.

2. The inflammation and primary fever are certainly and speedily subdued.

3. The pustulation is arrested and the secondary fever is annulled. 4. There is no itching of the pustules, and the patient has no motive to pick the face.

5. There is scarcely any pitting, and a posteriori, there is no seaming, even where the face has been one bag of matter; although, in such cases, the complexion is roughened for a time.

6. The stench of the old disease has no place.

7. The suffering is reduced to a minimum.

Owing to the antiphlogistic exactitude of the Veratrum viride and the stimulating power of the hydrastis, stimulants are borne from the first.

Dr. Wilkinson adds that in but one case was infection communicated in the houses; which, coupled with the complete destruction of the stench, led him to infer that the hydrastis had killed the poison in and about the patient, and neutralized the detached poison particles and made them non-contagious. He also used drop-doses twice a day where the contagion was feared; and apparently with entire success.

The following formula has been used in France and Germany: R Zinc sulph. Digitalis, pulv. aa. gr. j., aquæ 3iv. M. Add half a teaspoonful of white sugar, and give a tablespoonful every hour.

I regard this as an excellent prescription for all kinds of exanthemata; and being "regular" the prejudice of "regulars" need not pre vent them from using it.

At the meeting of the Alabama Medical Association, in 1872, Dr. G. D. Norris, of Huntsville, stated that during the prevalence of small-pox

แ

in that town, certain families "at the instance of some unknown person," had resorted to the free use of a decoction of the root of the black cohosh (cimicifuga racemosa) as a means to prevent the attack of that malady. They escaped the contagion, and it was found impossible to affect them by vaccination, till they had discontinued the use of the remedy. As we need a prophylactic against the vaccine poison, cheap and sure, this is possibly the thing desired.

Two other simple and very effective modes of treatment, alike in principle and mode of operation, are worth attention. One comes from England, and the other from Ohio; they are vouched for by "regular" physicians.

1. By Edward IIine: "I am willing to risk my reputation, if the worst case of small-pox can not be cured in three days, simply by the use of cream of tartar. One ounce dissolved in a pint of water, and drank at intervals when cold, is a certain, never failing remedy. It has cured thousands; never leaves a mark; never causes blindness, and avoids tedious lingering."

*

2. James Moore, M. D., Trenton, Ohio: "Eruption unmistakably that of small pox. Upon the arms, hands, legs and body the pustules were pretty evenly distributed; also a very dense crop all over the face, forehead, and scalp of the head, neck and soles of the feet. By evening of seventh day of attack, at 10.30 o'clock, the pain was almost intolerable. * * I recollected that lemon juice in sufficient quantities was sedative, and would lower the heart's action, and by so doing might relieve me of those unpleasant visions. I therefore squeezed all the juice I possibly could out of one of the lemons into a glass; to which I added about two tablespoonfuls of water, and drank it. I then opened the rind and sucked the remainder of the juice. In about twenty minutes I took another lemon and used it in the same manner. In a short time I felt very cold, as if I was lying in close proximity to a large mass of snow or ice. 'My pulse had dropped down to 60, and I shut my eyes to see whether the unpleasant visions were gone. I not only found that they were gone, but by placing my hand upon my head, I found that the pox on my head had gone also. My head was bathed with a grumouslike fluid, which had exuded from the pox It stained the napkin which I had applied to wipe it off. It seemed as though each had given up its contents and wilted down to a level with the surface. The same had taken place with those upon my face. My beard was glued together with the same kind of fluid. Those, upon my neck had not burst, but had shrunk away, and diminished in size considerably.

"I lay down and slept comfortably for two hours. I awoke, I presume, from cold, although I had plenty of covering upon me, and the fire was still burning in the grate. I felt so well pleased that I took a little more lemon juice I kept my pulse from 60 to 67 for 36 hours, when all eruptions and elevations had disappeared from my skin. I then bade goodbye to lemon juice and small rox."

As a treatment really Eclectic consists in only holding fast that which is good, I would be disposed to give my suffrage, if the case was my own, to the latter methods cited. Yet, if I was to treat a patient, I

would bathe him as Dr. Wilkinson has described, and give freely the acid draughts here mentioned.

Small pox is a septic rather than an infectious disorder; it will and does originate spontaneously in crowded and unwholesome places; and it is erysipelatous in its character. These facts indicate ozone treatment, thorough cleansing and ventilation, and a careful avoidance of everything empirical. Only by attention to these conditions can it ever be extinguished. A small-pox epidemic often precedes one of dysentery or Asiatic cholera.-Medical Advocate.

Substitutes for Cocaine.

I have recently experimented with other alkaloids as substitutes for cocaine, or, as it may preferably be called, following Sir Robert Christison, cucaine. It was natural at once to turn to caffeine as the mest promising substance. This alkaloid, however, is difficult to manage. It is very insoluble and very refractory to many reagents. I boiled specimen after specimen in hydrochloric acid without obtaining a combination. On evaporating, the well washed crystals appeare I unchanged, and yielded no reaction to the tests for a chloride. The ordinary citrate of caffeine in the market is not a true salt, but an indefinite mixture, and of course, therefore, ill-adapted for the proposed experiments. Acetate of caffeine seems to be more readily formed, but it is unstable, the volatile acid being soon dissipated. I therefore proceeded to make double salts with soda as the additional ba.e, and found myself in possession of some very manageable preparations. Accidentally I first made salicylate of caffeine and soda, and found it possessed in some degree the property sought. Though not very soluble in cold water, it is at once taken up on applying heat, and the solution remains clear on cooling.

A solution of one of the sodio salicylate in two of water may thus be obtained, which will contain 623 per cent. of the alkaloid. Sodio-cinnamate gives the same results. Sodio benzoate gives a similar solution, but is rather weaker of alkaloid, containing only 50 per cent.

I have chiefly used the salicylate and benzoate salts. They are of considerable value and in some cases may replace the much more costly cucaine. Applied locally to mucous membranes, these solutions deaden sensation, diminish pain, blunt the perception of tactile, thermal and dolorous impressions; but they have not at present given me so powerful and rapid anaesthetic influence, as cucaine. I have, however, employed them largely in the pharynx and larynx; I have also resorted to them over twenty times in operating for nasal polypi. In some of these they have been quite successful, but in others less satisfactory, possibly from imperfect application.

The following experiments may interest:-On December 6, 1884 a medical man with a very sensitive urethra, the passage of a sound always giving much pain, agreed to try a solution suggested to him, containing 25 per cent. of sodio salicylate. He reported that it entirely prevented the instrument from hurting him.

A stable solution is well adapted for hypodermic use. To determine

the effect I tried this method on myself. On December 8, at 9.30 A. M., the pulse being 80 and the temperature (sublingual) 98.6°, I injected four minims of a saturated solution, not deeply, but near the skin, to observe the local effect. It caused some pain and a hard lump soon appeared, such as is often seen, three-quarters of an inch by an inch and an eighth. At 10.15 A. M. the pulse was 90 and the temperature 98.8°, with a good deal of darting pain. The swelling pitted on pressure, but was insensitive. At 10.30 A. M. the pulse was 90 and the temperature 99.4°; locally the same; some uneasiness at præcordia had increased gradually. It was troublesome up to 12 30 P. M., when the local pain had nearly ceased, and the swelling had diminished to half its thickness; temperature 99.2°. By 2 P. M. the swelling had diminished to one quarter of its size. At 11 P. M. the induration and pitting were still marked; no other symptoms; temperature 99.2°. The next morning there was only a slight mark; pulse 80; temperature 98°. No doubt this solution was rather too strong for hypodermic use.

In the eye, the sodio salicylate, except in weak solutions, causes irritation and even pain. Those who have the opportunity will perhaps try weak solutions with a view to determine its effect.-London Lancet.

Treatment of Yellow Fever.

As soon as the patient is taken, which is generally with a chill, followed by pain in the head and back and limbs, if they have eaten heartily before taken, give warm water until they vomit freely; after the contents of the stomach are thrown off keep them in bed, give 8 or 10 drops of Aconite, same of Belladonna-give a teaspoonful every hour, alternately; also a hot mustard foot-bath. If the patient is doing well, continue the same treatment for twenty four hours.

The third day give arsenic and Bryonia the same way; if they complain of sick stomach. give an enema of cold water, apply mustard to the stomach. Should the third day bring burning in the stomach, give arsenicum and lachesis. Should there be brown or black vomit, mix in one-half glass of water as much of the nitrate of silver as will lie on a silver dime piece; give this in alternation with arsenicum every half hour.

Should the brain congest, mix eight or ten drops Veratrum viride in one-half glass of water and give a teaspoonful every half hour until relieved.

Should the kidneys falter or stop in their action, give Nux vomica and cantharides in alternation, apply cloths wrung out of hot water over the lower part of the abdomen and kidneys.

The patient can drink moderately of cold water-ice is better. Give small quantities of rice gruel, not more than a dessert spoonful every three hours; cream is sometimes better, particularly when well received. The patient must be kept in bed all the time, the bed clothing adapted to their comfort. The room should be pleasantly ventilated, but no draft on the sick. Let everything and every person be cheerful in the sick chamber.-Dr. Davis in U. S. Med. Investigator.

Hypodermic Injections of Morphine in Uremic Convulsions. S. Powell writes in the British Medical Journal: In the early part of this year I was attending a child aged six years for a slight attack of scarlet fever. At the end of a week the little patient was apparently well, though anemic. The mother was cautioned about the danger of allowing the child to be exposed in any way, but the caution was not heeded, and the child went in and out as usual. At the end of a fortnight the mother came to me, saying the child's face was swollen, and it was very sick and cross. On visiting, I found the usual train of symptoms of albuminuria, with dropsy. The skin was desquamating, and the child was excessively weak and anemic. I prescribed a purgative and an iron mixture, and ordered warm sponging and bathing.

Three days after seeing the child in the above condition, I was suddenly called by its mother, as the child had been in a fit for an hour or more, and the convulsions were continuous. The child had one fit previously to this seizure, at seven in the morning, which lasted about ten minutes. On my arrival, I found the patient in strong convulsions, perfectly insensible to all external impressions; and it appeared certain that life could not continue long under the present conditions. Another medical man saw the case previously to my visit, and I presume, deemed it hopeless There was no possibility of giving medicine by the mouth; and, not liking to trust to the slow absorption of rectal injection, I injected a solution of oue-twelfth of a grain of morphine with one hundred and twentieth of a grain of atropine under the skin of the arm. In five minutes the convulsions had entirely ceased, the patient was sleeping quietly, the breathing was natural, and the skin was moist and warm, There were no more fits, and the patient was soon well and able to get about again. I may add that I gave the child a vapor bath while I was preparing the solution for injection.

Diphtheria.

With regard to the treatment of diphtheria, I know of nothing too strong to say in the reprobation I think we ought to show towards the treatment by scraping off the membrane; and that by mopping or swabbing the throat with nitrate of silver and other astringents nearly as bad. It forces the fungus to extend to unastringed portions of the mucous membrane, and drives it downward toward the glottis, and I believe it to have been answerable for multitudes of deaths in former less enlightened days. I believe it is a plan never now adopted, unless it be by the gentlemen who call all white patches in the throat diphtheria: It is excellent treatment for simple ulcerative tonsillitis.

Arguing from analogy, and seeing the success in vineyards of the use of sulphur for the cure of oidium, I think this is the most rational line of treatment to adopt to destroy the fungus of diphtheria. Finely powdered sulphur blown on the membrane through a quill or glass tube causes no pain and very little distress to even very young children, and in such cases it is almost the only local treatment that can be adopted. With children a little older, sprays are very useful. Carbolic acid spray