tions, and when attacked by the exanthematous fevers or other diseases of childhood, were lacking in power or resistance or recuperative energy.

As a part of the symposium of infant feeding in the pediatric section at the late meeting of the American Medical Association previously referred to the report of a special committee upon this subject formed an important part in which Dr. Eustace Smith, of London says:

"No artificial food will efficiently nourish an infant unless cow's milk be added; for all preserved foods want the living antiscorbutic principle which is only to be found in fresh foods. In other respects, many of them, such as the desiccated milk foods, contain in themselves; as far as I know, all the elements of nutrition.'

If trouble arises during our care of an infant and indigestion ensue, I most decidedly commend partially predigested milk using the Fairchild peptongenic milk powder, in spite of the fact that Jacobi, Forchheimer and some others pronounce against it. I have had most valuable results from its use. I do not believe in the constant and habitual use

of completely predigested foods. I indorse fully the position of one of our strongest, longest and best workers in the dietetic field, Dr. J. Lewis Smith,

who says:

"I think that it is not best to feed infants habitually with fully digested food, for the stomach of the baby should be allowed to accomplish what it can without being overtaxed. Its normal functional activity produces a healthier state, and conduces to a better condition of the infant in my opinion, that when there is no functional activity except

that of assimilation, as is the case when fully digested food like glucose is given. The same rule applies, I think, to the digestive organs as to the muscles. If we insist on quietude of the muscles, theo atropy and become feeble. If we fully predigest the infant's food, it seems to me probable that glands or follicles which furnish the digestive ferments, lacking the needed stimulation, are likely to suffer deterioration in their functions and furnish ferments

of poorer quality and of less quantity, than when the food is of a nature that requires some digestion."

But if the digestive organs be crippled, I am sure by long experience that I am justified in endorsing the furnishing of food that is ready for immediate assimmilation. I have found in many cases where the artificial digestion was unsatisfactory that if I gave the latter my personal attention, and demonstrated to the mother the process, I had no further trouble.

While I am willing to admit that many mothers can not immediately grasp the difficulties and overcome them, yet I do not agree with Dr. Woodbury, of Philadelphia, who says: "I consider it impracticable. The woman intelligent enough to conduct. the process properly are engaged in teaching in some college, and if married, rarely if ever, have children."

I am disposed to believe that the majority of mothers have sufficient interest. and intelligence to carry out the details nf artificial digestion. The. point I make is that physicians often do not take the trouble to sufficiently elaborate their instructions or go into details in giving directions. An explicit explanation and practical demodstration will often accomplish much whether we order food or physic.

Each case is a law into itself, and we must study it individually and recognize the fact that as in dyspepsia of adults "what is one's food is another's poison." There can be given to no one infant or adult a stereotyped food.

The condition of the food tract must

be studied for each case. We must not forget that the food which agrees with the babe this week or month may for certain reasons disagree the following.

Babies, the same as older people, must have a varied diet. We must not and cannot safely ignore the palate of either.

Farinaceous foods are injurious to young babies for obvious reasons.

It has been found that by adding malt in certain proportions, the same change is exerted in the starch artificially as is produced naturally by the salivary and pancreatic secretions during the process of digestion.

The employment of malt for this purpose was first suggested by Mialhe in a paper read before the French Academy in 1845, and the suggestion was put into practice by Liebig fifteen years later.

Liebig's food for infants contains wheat flour, malt, and a little carbonate of potash, and has gained a well deserved celebrity as a food for babies during the first few months of life.

A form of malted food which is a

modification of Liebig's "Food for Infants" and has a very decided advant age, in that it is much more palatable is "Mellin's Food for Infants," Mellin, the deviser of this food, was an associated chemist with Mialche tue author of the paper read before the French Academy in 1845, and is yet one of the recognized chemists of Europe. The "Mellin's" food is highly commended in certain

conditions by Fothergill, Eustace Smith, Louis Starr and many of the highest authorities on dietetics. I find it valuable to give it simply in plain water now and then, but I frequently order it to be added to milk diluted with water one part to eight, a teaspoonful to a half pint for the purpose of breaking the curd and adding an element of nutrition and aiding digestion.

There can be no doubt that there are some superfluous "Infant Foods" in the market, but in the main I think we may

consider ourselves fortunate that commercial firms have so enlarged the menu from which to choose a food for the child at various times under varrying conditions. Whether selecting a food. or a drug in the disturbances of childhood or later life, a careful discrimination must be exercised.

I feel justified in epitomizing as follows:

1. In the dietetic treatment of the summer diarrhea of infants, the almost

complete withdrawal of food temporarily is sometimes desirable.

2. While a cow's milk diet in its purity or properly modified is in the majority of cases to be preferred as a

substitute for a mother's or wet nurse's milk, there are frequently conditions where all forms of milk are to be withdrawn and raw beef extracts or diluted beef teas, etc. albumen substituted along with broths,

3. As a temporary expedient condensed milk is valuable, but it is objectionable as a permanent food.

4. The addition of malted foods containing proper proportions of carbo hydrates to diluted milk (such as Mellin's food which I have found of great value) is frequently most desirable.

5. Artificial digestion is a great ad

vance, in the direction of the problem of artificial feeding. If the digestive appearratus be in perfect condition, predigestion is uncalled for, but when it is crippled its burdens may be very materially and happily lightened by the careful and judicious use of Fairchild's peptonizing ferments.

6. No stereotyped food which is applicable to all infants, no matter what the age or condition, has yet been devised, and in the nature of things is not likely to be.

TREATMENT OF BRIGHT'S DISEASE. According to Prof. M. Semola (La Medicina Contemp., London Med. Rec., Feb., 1887), the main indications for treatment are: 1, To furnish the patient with the most assimilable food; 2, to excite methodically the functions of the skin; 3, to favor by every possible means the assimilation and combustion of the albumenoids of the food. 1. Exclusively milk diet; ordinary nitrogenous food must be prescribed as most harmful in all periods of the disease. Milk acts marvellously, but not, as is often said, as a diuretic. Milk is only a diuretic because it contains a large quantity of water. When two or three quarts are taken daily the quantity of milk is naturally increased. The milk diet should be continued for a long period. 2. Methodical and repeated dry rubbing of the skin, massage, douche, Turkish baths. Cold water is not to be used, because the power of reaction is lost. Patients are wonderfully sensitive to cold, and the least cold tends to aggravate the disease. 3. The patient must live in a dry, temperate, but uniform temperature; this is most essential. 4. Iodine and chloride of sodium in progressive doses, according to tolerance. 5. After two or three weeks at the most, if the albumen has not entirely disappeared, and especially if the anasarca has disappeared, phos

phate of soda or small repeated doses of hypophosphite of soda or lime, increased gradually to 45 or even 60 grains in the 24 hours, may be given in

The use

stead of the iodide of sodium. of the compounds of phosphorus favors greatly the assimilation of albuminoids. 6. Inhalations of oxygen are very useful, the albumen disappears sometimes in a few days. 7. Astringents are not only useless, but harmful.

DIGITAL EXPLORATION OF THE PERICARDIAL SAC.-Under the very appropriate title of "Invasions of Surgery," in a report to the N. C. Med. Soc., Dr. P. C. Barrenger, of Davidson, Coll., N. C., relates the following remarkable case (Va. Med. Monthly, August, '88):

A student made a successful attempt to drive a sewing needle into the heart. Serious symptoms began twelve hours after, when pain in the region, difficulty of breathing, and a loud pericardial murmur at the apex developed. Thirtysix hours later the symptoms increased so in severity that an operation was decided on. Stezner resected a piece of the fifth rib, opened the left pleural cavity, and then the pericardium, when about a teaspoonful of cloudy pericardial fluid ran out. The needle was now felt lying diagonally in the right ventricle. Its head was then driven out through the anterior cardiac wall, and fixed in this position with the fingernail. The violent, irregular heart-contractions made it so difficult to catch the needle that in the attempt to catch it with the forceps, the needle slipped back into the ventricle, where it assumed a vertical position; an iodoform tampon used to plug up the hole in the pleura was also drawn into the cavity by a deep respiratory effort, and could not be found afterwards. The wound was thoroughly tamponed, and the patient was well in four weeks, although in the mean time there was severe pneuThere is now no heart murmur, nor abmothorax, with copious exudation. normal pulse, nor a trace of pleural exudation; and of course no one can tell where the needle is.

NEW ENGLAND

cine substitution practiced. In order

I. N. LOVE, M. D., St. Louis, Mo.
JOHN J. BERRY, M.D., Portsmouth, N. H.
L. S. MCMURTRY, M. D., Danville, Ky.
MAX J. STERN, M. D., Philadelphia, Pa.
A. M. OWEN, M. D., Evansville, Ind.
ROBERT T. MORRIS, M. D., N. Y. City.
W.F.HUTCHINSON, M.D., Providence, R.I.
GUSTAVUS ELIOT, M. D., New Haven, Ct.
DANBURY MEDICAL PRINTING CO.,
PUBLISHERS.

DANBURY, CONN., DECEMBER 15, 1888.

EDITORIAL.

SENDING PRESCRIPTIONS TO CERTAIN DRUGGISTS.

OME of our esteemed contemporaries have been lately discussing the propriety of a physician directing his patients to certain specified druggists for the purpose of having their prescription prepared. Quite a number of these Journals advance the idea, that to do so, naturally leads to the suspicion that the Doctor gets some gratuity from the druggists in the way of rebates, commissions, etc. We think it the duty of the consentious practitioner to advise his patients to go to those places where he knows the prescription will be

reputation, and the health of his patient, we consider it a part of his bounden duty to direct the patients. to go to such places as he knows are reliable and honest. For ourselves we

have our own druggists the same as we have our own baker, butcher and grocer, because we know they keep good goods and handle them carefully. Therefore we direct our patients invariably to go to such and we are well satisfied with the working of the rule.

An editorial in the St. Louis Weekly Medical Review in discussing this subject in a recent number touches the key note. It says:

"We fail to see why the advice of a a physician to his patient as to the best be attributed to ill-guided judgment.' place to have prescriptions filled, should He is in honor bound to give his patient that which in his judgment is the best opportunity for recovery. So long as 'not all so-called pharmacists are

competent and conscientious" it is the physician's duty to see that his prescriptions are filled by competent parties. He has as much right to patronize a certain druggist as the latter has to purchase his goods of a certain wholesale house."

OUR NATIVE MINERAL WATERS IN KIDNEY TROUBLES. [OT a few of the Mineral Waters of the United States has become noted for their value in various diseases of the kidneys. The most prominent of these which have proved of greatest value are the Buffalo Lithia Water of Virginia, and the Bethesda Water of Wisconsin. Both are warmly endorsed by the leaders of the profession of this country, the first especially in those

conditions, where a slushing out of the kidneys is desirable, and in renal calculi. The latter in Diabetes and Bright's diseases. Of both we have had ample and extended experience, the results valuable to ourselves and patients. In a recent outbreak of nehpretic collic in our own person, the attack under the Buffalo Lithia Water of the Buffalo Lithia Springs of Virginia, was speedily cut short, the stones quickly passed and the debris which followed showed a thorough cleansing of the kidneys and bladder of all foreign substances. All of thereflex symptoms and sequelae were promptly relieved, and we feel under a deep debt of gratitude to this most excellent Water for wonderful relief from suffering and disease.

CAN THESE PILLS BE ACURATE?

IN

N looking over some patent office reports lately, we noted the process of quite a popular pill making concern, which seemed to us to be fraught with so much danger that we propose to lay it before our readers.

The steps in the process are substantially as follows: "I first put in the pan, nuclei of any suitable material or compound to form the center of the pills, set the pan in motion, then moisten the rolling nuclei with any suitable moisture applied in the form of a spray or vapor, then sift on to the moistened nuclei as much of the powdered ingredient or ingredients of which the pills are to be composed by accretion to the nuclei as the damp surface of the rolling nuclei will take on, then moisten the growing pills with the spray or vapor in the manner of first moistening the nuclei, sift on to said growing pills the powered ingredient or ingredients, and so continue the alternate moistening and

powdering until the pills have grown to the desired size. The powdered ́ ingredient may be changed as often during the growth of the pills as may be desirable in accordance with the intended medicinal character of the pills, or they may be entirely formed from a single ingredient or compound. When the pills are of a proper size the same process of moistening and powdering may be continued to coat them, using of course for the powder powdered sugar or any suitable coating material. By this process the manufacture of pills is greatly facilitated, the product cheapened, and the medicinal efficacy increased, the pills being less compact, and hence more soluble and capable of being easily crushed and powdered for contingent uses."

"Having thus described my invention, what I claim is-The process of making pills and confection, which consists in replacing in a revoluble pan nuclei of any suitable material, setting the pan in motion, moistening the rolling nuclei with liquid spray or vapor, sifting on to the moistened nuclei powdered ingredient or ingredients, and so on alternately moistening and powdering until the pills have grown to the desired size, all substantially as set forth."

Now from this abstract it will be seen if we understand the scheme aright, that a quantity of a given drug is sifted upon a lot of the nuclei after they have been wetted, and the nuclei kept in motion during the process. This is repeated till all of the powder, to the given quantity of pills is used up. If this is the method, and we should infer it was from the above, what is to hinder one pill getting a little wetter than another and taking up more of the powder than its neighbor. While this