But if the patch is very large, or if the whole scalp is affected, the head is divided into districts, and these are treated successively. The hair is shaved from about the patches. The duration of his treatment was never more than three months, and generally less than two. In no case were the blisters followed by erysipelas or other complications. Treatment of Herpes.-The Medical World gives this formula for the cure of herpes : B Hydrargyri oleatis (20 per cent) Acidi oleic. Etheris acetici Morph. sulphat. Misce. Sig. To be used as a paint. 3 vij 3 ij 3 ij gr. iv Molline.-Under the name of molline Dr. Kirsten highly extols an excipient which appears to be simply a kind of soap. It is obtained by cold saponification with liquid caustic potash, mixed with a small quantity of soda suds; 30 per cent. of glycerine is then carefully poured into this warm. Molline is of a soft consistency, which varies but slightly in any temperature, and may be kept a long time. It is of a yellowishwhite color; its reaction is neutral. Dr. Kirsten considers it to be a good therapeutical excipient in diseases of the skin; mercurial molline, in the same proportions as Neapolitan ointment, is easily prepared and very active. As an excipient for preparations of styrax, liquid pitch, salicylic, carbolic, and tannic acids, white and red precipitates, chrysarobin, ichthyol, sulphur, thymol, molline may be recommended to dermatologists. Salicin for Scarlatina.-W. P. Meharry writes to the British Medical Journal, that in scarlatina, especially in that known as scarlatina anginosa, salicin is of great value, and in those cases of simple scarlatina in which the disease is prolonged by the throat complication, salicin immediately effects a cure. Mr. Meharry generally gives to a child four or five years of age 5 grains of salicin every two hours until the temperature becomes normal. Afterwards the same quantity three times daily for a few days to prevent a relapse. Aborting Furuncles.-Dr. Louis Heitzman, of New York, has had good success in aborting furuncles by the local use of an eight per cent. salicylic acid plaster or salve. For the former, he uses em pl saponat. zii, empl. diachyli. zi, and acid. salicyl. zii. For the basis of the salve, he prefers unguentum aquæ rosa. ON THE SUBCUTANEOUS USE OF ERGOTININE IN DIABETES AND ALBUMINURIA. A. Dehenne (L' Union Med.,) claims to demonstrate : 1st. That ergotine, or ergotinine, subcutaneously will cause the temporary and often the permanent disappearance of the glycosuria, polydipsia, polyuria, emaciation, and weakness of diabetes. 2d. That these symptoms disappear in a regular order; the polyuria and polydipsia disappear after five to eight injections, the glycosuria lessens after the second or third injection, and disappears after the tenth or twelfth. 3d. That the glycosuria reappears if the treatment be stopped too suddenly. 4th. That the disappearance is permanent after six or eight weeks of treatment. 5th. That the injections are perfectly harmless. 6th. That by this treatment diabetics can be prepared for any surgical operation, particularly cataract. 7th. The freedom of this treatment from digestive disturbances. SANITARY. PHYSICIANS AS LEADERS IN SANITARY PROGRESS. BY HENRY HARTSHORNE, M. D., L L. D., OF PHILADELPHIA Preventive medicine is a term which may be used either as synonymous with the whole of Hygiene, or as only including the study of the direct causes of disease and the methods of antagonizing them. Either way, none are so obviously and necessarily interested in all parts of sanitary science and practical hygiene as physicians. Their studies in physiology and pathology, and more especially in etiology, prepare them for the consideration of everything belonging to health, its enemies and its defences. It would be a strange military system, all of whose operations consisted in awaiting the actual attacks of invaders at the hearthstone, with no outer fortifications or guards to anticipate dangerous approaches. Yet, while the physician confines himself to the treatment of developed maladies, and leaves his patients as soon as they are, for the time, well, this is precisely the nature of his practice. Selfishness comes in here, and argues for the doctor: "That is my business, the treatment of disease; that is what I am paid for. It would be a contradiction for me to occupy myself with trying to prevent just what gives all the occasions for my employment. But selfishness here, as everywhere, is short-sighted. Cannot every physician see what the common intelligence of men discerns, namely, that somebody must look after the defence, an ounce of prevention being worth a pound of cure? If not the physician, who else? Shall it be the schoolmaster, or the chairwoman of the "Ladies' Health Protection " Committee? When these find that they can circumvent the medicineman, and render his avocation unnecessary, the doctor and the druggist together, if they do not have to shut up shop, may have at least not a few idle hours. Writing prescriptions in Latin has been defended, on the idea that we must not let our patients into the secrets of our art. It is, at all events, not well that they should know more about it, or of the science applied in it, than we do ourselves. Such is really the case when the general public gives more attention to practical hygiene than physicians give to it. As things are going, this may soon be the case: Sanitarians now constitute a class, including gentlemen and ladies of leisure and of benevolent minds, architects, plumbers, engineers, non-medical managers of hospitals, unprofessional members of boards of health, and physicians. It is true that a certain number of eminent medical men have been and are prominent in the work of the American Public Health Association, and in the State Boards of Health. But, as compared with the whole number of physicians in the United States, these are few. Again, practitioners of medicine have to be thoroughly versed in hygiene, for its uses in the treatment of their patients. Polypharmacy has not yet died out in practice. Outletting by the lancet has (with doubtful gain) given way to the abundant inletting of potent drugs by the hypodermatic needle. But more and more the evidence accumulates and forces recognition, that, if not "the stars in their courses," at least air, water, food, sunlight and other natural agencies as they are dealt with, war either for or against our patients. Hippocrates, the physician, did well to write a hygienic treatise, on "Airs, Waters and Places. He who does not comprehend the right relations of Hygiene to Therapeutics, is only half armed for the conflict with disease, even with the whole of the Materia Medica at his fingers' ends. One cause for the insufficient interest of physicians, so far, in Sanitary Science, has been the general absence of instruction upon Hygiene in the Medical Schools. Until the University of Pennsylvania established a chair of Hygiene, for a three months' course, in 1866, there was, except a less distinctly professional course in Harvard College, nothing of the kind in this country. In hardly any other medical school to-day, in the United States, is there more than a nominal inclusion of Hygiene, under the wing, so to speak, of Physiology. This ought not so to be, for the reasons that have been above briefly suggested. Hygiene, coming naturally between Physiology and Pathology on the one hand, and Therapeutics on the other, ought to have a place in every medical curriculum. It should be granted a professorship to itself, in the winter course, with examinations compulsory for every graduate. Only when this is done, and the whole acquaintance of the physician with the subject is no longer postponed until after graduation, then to be picked up as it may be, here and there, only then will it be possible for the members of the medical profession fully to maintain the place which is theirs of right, that of thoroughly equipped scientific an 1 practical leaders in sanitary progress. The time may, indeed, and ought, to come, when sanitary counsel may be called for and professionally given, in a manner analogous to that of legal advice, to prevent instead of only to remedy disaster. If a careful man has property to bequeath, he consults a lawyer about his will. When he has a house or farm to sell, or proposes to buy one, a lawyer or conveyancer inspects the title, and sees to the proper and safe couduct of the transaction. So, why should not the family sanitary adviser be consulted about the situation, construction, drainage and ventilation of a proposed new dwelling, to be built or bought. We may suppose many occasions for family sanitary counsel. example: For Freder Doctor, you know our family tendency to consumption. ick is now over sixteen; pale and slen ler, although well. He is not active, and wants to go into a city business college, and then to become a book-keeper. My husband thinks he had better go to Haverford College, where, with his studies, he can play cricket, use the gymnasium, and develop his chest. What do you think about it?" Your husband is right. He ought by all means to avoid a seden tary life. No book-keeping for him. Let him go to Haverford, or on a farm; anything to give him the purest air and a good deal of active outof door life. Thus he may probably overcome the family predisposition.' Again: "My son, just married, has bought a nice house of town, which seemed dry enough when he looked at it, but after the first rain he finds the cellar floor quite damp. His wife is beginning to be rheumatic. Will you look at it ?" The doctor visits the house; he finds a sodded bank sloping towards the cellar wall, so that a heavy rainfall pours right in through the sides aud bases of the windows, and through the imperfectly cemented wall. The grass bank is at once made to slope the other way; a two-foot wide space is opened between it and the wall; and the latter is well covered with Portland cement. The next rain leaves the cellar floor as dry, almost, as the parlor. So we might go on, but without necessity. Our idea is simply to urge that, with the advance of Medical and Sanitary Science, the proportion between interference and nature, between remedial and preventive action, changes. Yet skill and knowledge will always be required, and should be professionally ap preciated and paid for. It will be well for physicirns to use their existing opportunities of leadership, so as to be always prepared to give the best sanitary advice where it is needed; for their own reputation, the advantage of their patients, and, last but not least, the general benefit of mankind. Annals of Hygiene. AN IDEAL SEWAGE SYSTEM. Pullman, Illinois, has the finest sewerage system in the world. The Sanitary Era, describing it, says: Pullman, Ill., twelve miles south of Chicago, is the ideal "city of brick," built by the Pullman Company expressly for the residence of the employes in their great car shops. It has 9,000 inhabitants, and is built with all the advantages which can beobtained where ample capital allies itself to advanced science. The sewage system is that called the "separate, "that is to say, all surface drainage is carried away by one system of pipes, and all house sewage by another. The former flows directly into Lake Calumet, near by; the latter into an underground chamber directly beneath the water tower, cemented and capable of holding 300,000 gallons. From here the sewage is immediately pumped to the sewage farm, three miles away, the amount averaging 100 gallons per day for each inhabitant, whereof only half of one per cent. is solid matter. This farm is underdrained and disposes readily of the sewage; the solid constituents being taken up by growing vegetables, while the clear filtered water flows away to the lake. There are no offensive odors. The size of the farm is about one acre to 100 persons, and there is no reason why it could not be extended to meet the needs of a population of 500,000. Although Pullman is built on an almost flat prairie, but a few feet above Lake Calumet, this perfect double system of drainage and sewage makes this city the healthiest in the world. Its annual death rate has not been over eight in a thousand from the beginning, while that of other cities varies from fourteen to fifty-six in a thousand. SANITARY ITEMS. The Imperial Institute at Tokio, Japan, is said to be the only college in the world which has a professorship of sanitary engineering. The position is filled by an Englishman. The New York Cremation Society reports that there have been nearly two hundred incinerations at its crematory during the past year. The total membership is nearly two hundred, and the society is financially prosperous. The sewage of Los Angeles, Cal., has been used for fertilizing purposes for fourteen years. It is carried in a main sewer for four miles, and is then distributed by irrigating ditches to several farms. This plan of disposing of the sewage was at first bitterly opposed, and the results as regards the health of the neighborhood have been closely watched, but no ill effects have been observed. The Popular Science News, on the subject of impure ice, which has lately been much discussed in medical journals, says: Freezing is a process of crystallization and the tendency is always to eliminate impurities from the crystals; but the foreign matters can and do, remain entangled in the mass among the intercrystalline spaces. There have been undoubted cases of typhoid-fever and other diseases produced from this cause, and it is a safe rule only to use ice formed from water of assured purity. In other words, wholesome ice cannot be made from unwholesome water. The physicians of lower Austria have observed recently a disease, the nature of which remains unknown, that they have only met in the paper-factories, and which they call the rag-picker's disease (Die Handernkrankheit ). The disease commences with weakness, anorexia, insomnia, vomiting, sensations of weight in the epigastrium the second day, sometimes the third; one can see cyanosis of the lips, cheeks, nails, cold sweats, oedema of the lungs, no disturbance of the brain. Generally death is easy, except in cases where there is pulmonary stasis. No abdominal symptoms, no albumen in the urine. On necropsy one finds various lesions of the lungs without special character. This disease, Dr. Hoffman, the Austrian delegate to the Rome International Sanitary Conference, believes to be a "form of anthrax. A short time ago we noticed the advertisement of a recent candidate for mineral-water fame, which was headed in bold letters "It Stinks." The forcible Anglo-Saxon word was the only truthful statement in the advertisement, and that very feebly expresses the horrible and disgusting character of the water referred to, which was possessed of an odor that one could perceptibly feel as well as smell, and which one might readily imagine was a direct importation from that place so graphically described by Dante. It is well enough known that sulphuretted hydrogen is an extremely poisonous gas, and we can hardly conceive how any one can be made to believe that water so impregnated with this disgusting and poisonous gas as to even outrival a very ancient egg in its malodorousness, could be in any way superior to pure water for any purpose whatever. It is not improbable that within a few years it will be discovered that a whole new line of diseases have arisen as the result of this astonishing mania-mineral |