some important advantages in that they present us with the particular grouping of active constituents which exists in the drug itself, and upon which our clinical experience of its efficiency has been chiefly or wholly founded.

A new class of preparations has been introduced by the enterprising manufacturers, Parke, Davis & Co., to which they give the name of Normal Liquids,—which are identical with fluid extracts in all respects, except that their strength is carefully adjusted by assay to an absolute standard of strength. The standards of strength adopted are those of a drug of good average quality, so that the dose of the normal liquid is strictly that which the best authorities state as that of the crude drug. This, unquestionably, is an important step in advance in galenical pharmacy, and the character of the firm from which these goods emanate, leads us to expect that we shall find these assayed fluids a valuable aid in scientific prescribing. The name, normal liquids, we learn is not protected by any copyright, and each bottle bears a statement of the alkaloidal strength to which its contents are adjusted. We trust the liberal and scientific spirit in which these products are offered to the profession, will insure them the welcome they seem to deserve. The Southern Practitioner.

THE TREATMENT OF CHOLERA.-PROFESSOR DA COSTA. in a lecture on this subject at the Jefferson Medical College, expressed the following views:

Prophylaxis-Since filth of all kinds leads to a rapid production of the germs, the locality should be rid of the same. The dejecta and cess-pools should be disinfected. Inspect the source of water supply, since the gerus can obtain easy access to wells. Drink only filtered water. Speedy burial of the dead should be urged. No change in diet is necessary. Live as usual.

Better avoid stimulants in the prophylactic treatment. Among the disinfectants to be used are corrosive sublimate, zine chloride, cupric sulphate, iron sulphate and permanganate of potassium.

Internal Treatment.-Must check the early diarrhoea if you desire to be successful, for, in most cases, if you stop this you put an end to the disease. For this purpose the most valuable remedies are sulphuric acid in combination with tr. opii deod., with aq. menth. pip. In India the acetate of lead, grs. iv, with pulv. opii, gr. j, at once with the diarrheal outbreak, and continue every three hours until it checks the discharges. If the above cannot cheek the diarrhoea, use capsicum, gr. j, with opium and camphor.

Second Stage.-Here we have cramps, vomiting and purging Now, stop the use of fluids: allow but a little ice in the mouth. This is a point of great importance. As little food as possible. Stimulus in small amounts, but frequently repeated. Mustard to the epigastrium. Administer, every hour or two:

R Tinct. capsici, gtt. ij.

M.

Tinet. opii deod.. gtt. x, Aquæ camphoræ, tij

If the stomach does not retain the opium, give it hypodermically; but, if possible, give it by

mouth, since it appears to have a local effect. To relieve the cramps, use chloral subcutaneously, in large amounts. When reaction has set in, allow fluids to wash out the kidneys. If he has not reacted, and is not doing well under opiates, try calomel, especially in cases in which the secretions have not been arrested by opium. Give at first, gr. v. to gr. x., then order gr. 4 every hour or so. When the pulse is sluggish, and the temperature below normal, use friction and a hot bath. In this the stage of collapse, stimulants will not be absorbed or they would be of utility, though brandy or whiskey might be tried hypodermnatically.

Caffeine, gr. iss-gr. ij., hypod., stimulates the heart's action. If still the patient fails and the veins are swollen, etc., resort to blood-letting, but possibly the injection of fluids into the veins is better; often the results are marvelous. The thickened blood is made to circu late. Use for this purpose the following: Sodii chlor., 7 j. Sodii carb., iij. Aquæ, Ovj.

B

DOMESTIC REMEDIES OF THE ARABIAN DESERT.-DR. E. GORDON HULL publishes an interesting paper on this subject in the British Medical Journal, April 11, 1885, in which he states that the remedies which the Arabs are in the habit of using are usually derived from the most widely distributed plants. As a diuretic, which they believe to be indicated whenever they suffer from pain in the back and gravel, they use the retem (Spartium monospermum), making a decoction of the top shoots in hot water, and drinking it. They say that it is also purgative. This shrub, which provides them with fuel, and their camels with a scanty nourishment, is almost universal and has a bitter taste. Several species of wild melon of the family of bryoniae, allied to the elaterium, are also in common use as purgatives. Their method of employment is to split the fruit into halves, scoop out the seeds, and then fill the cavities with milk. After standing for some time the liquid absorbs the active principles of the plant and is then used as a purgative. Camel's milk also appears to be possessed of purgative properties. The order composite furnishes several medicinal herbs which the Arabs make use of. The Santolina fragrantissima, a plant of sage-green color, of bitter taste, and strongly fragrant smell, furnishes them. in the form of an effusion, with a carminative which they use for colic and all painful affections; while in the bazaars of Cairo the dried heads of this plant are sold for the same purposes as chamomile. Natives also claim that the smell of this plant is sufficient to drive reptiles from the house, and it is used for this purpose in Cairo and other towns. Another plant of the same order is an arte

misia, or wormwood, with a strongly aromatic odor and bitter taste. This is also used to drive away vermin; and from the seeds of some varities of artemisia which grow in these parts santonin seems to be derived. In the wilderness of Judæa there is a variety of marigold which is very common, and which is used by the natives along the Mediterranean seaboard as a sort of tea for flatulence and pain in the abdomen. One of the commonest desert

plants is the zygophyllum, so called from the leaves being composed of short, succulent, jointed segments. These bruised in water form a mucilaginous liquid which the Arabs largely employ as an application for sore eyes. curious tropical plant which is found at the south end of the Dead Sea is the osher (Callotropis gigantæ), a large tree-like asclepiad containing enormous quantities of milky acrid juice. Its properties are stated to be powerfully purgative and emetic. The natives give it to women whose milk is scanty. The castoroil plant also grows here, but its virtues appear to be unknown to the natives. Another common plant is a variety of hyoscyamus, of which the dried leaves are used to smoke and produce a kind of intoxication or delirium, and an infusion of the fresh leaves possesses strong narcotic properties. Only two mineral substances appear to be regarded by the Arabs as medicinal One is sulphur, the other is a kind of common red coral found on the shore of the Red Sea, which appears, however, to be used as a charm.-Therapeutic Gazette, June 15, 1885.

HOW SHALL THE PHYSICIAN CLEAN HIS HANDS-In No. 18, 1885, of the Centralblatt für klin. Medizin is an article by DR. J. FORSTER, of Amsterdam, containing the results of experiments made with a view to determine whether the ordinary methods of cleaning the hands are really effective in destroying or removing all germs. The experiments were made with great care and all the precautions taken which are necessary in investigations about spores. The conclusion reached was that most of the methods, in common use, of washing and disinfecting the hands, do not succeed in freeing them from spores.

The method o experiment was to wash and scrab the hands in soap and water containing disinfectant substances in various proportions, and then wrap them in cotton-wool which had just been exposed to a temperature of 250 to 285° F. [The author points out that a towel hanging in a room might easily communicate germis to hands wiped upon it, even if the previous washing had been successful in freeing the hands from all organisms.] A finger was then inserted into a meat-peptone solution of KOCH's cultivation gelatin in the same manner as in making a vaginal examination. The result was that unle s the finger was complete ly sterilized, colonies of spores developed in the cultivation preparation in from 24 to 60 hours.

The

The disinfectant substances used were carbolic acid, boracic acid, chloride of lime, chloride of iron and corrosive sublimate. only disinfectant which completely sterilized the finger so that no spores appeared in the cultivation medium, was corrosive sublimate in the proportion of 1 to 1000 or 1 to 2000. Repeated tests with this substance were per

formed without the development of a single spore in the cultivation medium, which was usually meat-peptone solution in which spores develop very readily. The solution in every case was tested afterwards to show that it could readily be colonized with spores. The hands were always washed with soap and water and scrubbed with a nail-brush before disinfection in the corrosive sublimate solu

tion.

The other substances experimented with failed to sterilize the finger a single time and its introduction into the cultivation medium always resulted in the appearance of colonies of spores. Even the 24-per-cent. solution of carbolic acid so commonly used for disinfecting the hands failed completely, as did also Billroth's plan of cleaning the hands with hydrochloric acid and a ten-per-cent. solution of phenol in glycerin. It is probable that there is no practical necessity for having the hands absolutely free from spores of every kind, in performing ordinary operations. Still it is a good thing to know how far ordinary methods succeed in di infecting the skin; more important yet is it for the physician to know how he can surely disinfect his hands after exposure to an infectious disease.-Northwestern Lancet.

THE LATEST SPECIFIC FOR GONORRHOEAJACARANDA LANCIFOLIATA.-Jacaranda lancifoliata is a plant indigenous to Columbia, South America, and was brought over to this country by one, who, whilst traveling in the above state, found that the drug was used by the natives as a remedy in venereal diseases. Some of it was placed in the hands of DR. MURRAY SMITH and DR. ALFRED WRIGHT to see what effect it had; and they were very much gratified by its influence in gonorrhoea, acute and chronic, and in vesical affections attended with purulent and muco-purulent urine. The drug acts specially on the genitourinary mucous membrane, and appears to have no deleterious effect in any way, whilst it is taken without nausea, contrasting very favorably with most drugs given internally for these affections. As a remedy for gonorrhea, it will take the place of all other drugs used internally for this disease. It has proved most efficacious in diminishing pain and stopping discharge in acute cases; and in cases of gleet it is most valuable, succeeding in effecting a speedy cure by its use in several cases which had resisted previous treatment, both local and general. A liquid extract is made from the leaf, and may be given in doses of twenty minims or half a drachin three or four times daily.

MR. Z. MENNELL has administered it in fourteen cases during the past four months, and has found it more efficacious than any other preparation, and it has succeeded in stopping the discharge without any complication, in, at the most, three weeks. He has tried it in two cases of syphilis (one in the secondary stage), and has found it, so far, most successful. In four of his cases, where no other treatment had been tried, it succeeded in fourteen days in stopping the discharge, and all inconvenience (chordee, etc.), with no return of any of the symptoms. In all the other cases, where other treatment had been followed, the result was just as favorable, only extending over a period

of three weeks. In none of his cases was an injection used, except where a discharge had persisted over four months, and in another case of long-standing gleet, giving the tincture in 15minim doses, and an injection of the same, ten minims to the ounce. It stopped the discharge in three weeks, and there has been no return for a month. Sandalwood, injections of zine, iodide of potassium, copaiba, and medicated bougies, did not succeed in stopping the gleet, or the inconvenience of constantly passing urine, until, in desperation, he used this preparation.-British Medical Journal.

KEFIR-ZUBER has published a long article upon this subject, in a recent number of the Gazette hebdomadaire de Medicine et de Chirurgie. He defines kefir as kumyss made from cow's milk, but says this is not an exact definition, although it indicates the origin of the preparation. He goes on to say that kefir is "the product of a peculiar fermentation of milk." and is essentially an alcoholic fluid heavily charged with carbonic acid gas. The ferment, when isolated, is described as a yellowish substance, which tends to form small granular masses. When this is added to milk, fermentation rapidly occurs, carbonic acid gas being evolved, while the casein is coagulated. Commercial kefir is prepared by adding to a bottle of milk a teaspoonful of the ferment, and the milk is kept at a temperature of 15° R. for twenty-four hours, being agitated at frequent intervals. At the end of this time it is filtered, transferred to a fresh bottle, which is carefully corked, and again shaken, for twenty-four hours. This process is repeated once more, and at the end of the third day the strong kefir is formed. A strong preparation should foam violently when the cork is removed, should have a creamy consistence, and a pleasant acid smell and taste, and should be free from lumps of casein.

The following analyses are given by TUSCHNISKY, showing the change in cows' milk after it has passed through the fermentation proCOWS' MILK. KEEIR. 38.00 20.00

cess:

Albumins Fats

Lactose

Alcohol

Water and salts..

48.00

38.00

The density of milk is 1.028, that of kefir 1.026. Beginning with two or three glasses daily, the patient should increase the amount until eight glasses are drank each day. The writer states that the indications for the use of kefir are the same as for that of kumyss, viz., impaired nutrition, especially such as results from acute affections or digestive troubles. He cautiously adds that, although the most extravagant praise has been bestowed upon this new remedy, more careful observations are necessary in order to define its precise therapeutic value."-N. Y. Med. Journal.

MURIATE OF COCAINE IN EXTERNAL HEMORRHOIDS.-The uses to which the muriate of cocaine has been put led me to try it as a local

anææsthetic in the excision of external hæmorrhoids.

The patient was a man about fifty years of age, of nervous temperament, with a timidity of pain amounting to fear, dyspeptic, and general health below par. After having exhausted the materia medica of "remedies," and obtaining no relief, he finally consented to an operation. On examination I found the skin and mucous membrane around the anus mass of corrugations with slight patches of ulceration between the folds; five piles protruded from the anal fissure, four of moderate size, and one with a base about two and onehalf inches in its long diameter.

a

I considered this an excellent case for operation. After the usual preliminary preparation, I began by injecting one-third of a grain of muriate cocaine into each of three of the piles, and in about two minutes, with scissors, I excised them close to the base, the patient experiencing hardly more than slight discomfort. His timidity preventing any further operation that day, a week later I excised the remaining small pile in the same manner, and then began on the large tumor by inserting the needle of a hypodermic syringe, containing about two-thirds of a grain of the salt into the base of the tumor, injecting a few drops under the skin, then traversing the pile in its entire length, depositing the solution in the track of the needle to a point just within the skin on the opposite side. I withdrew the needle, inserted a tenaculum, put the pile upon the stretch, and excised it, without inflicting the slightest sensation of discomfort except that caused by the entrance of the needle into the skin, much to the surprise and delight of the patient.

This operation suggests to me the probability of the usefulness of this drug in the painful clamp and cautery operation for the removal of internal piles.

After the operation there was an unusual amount of mental excitation, slightly flushed face, and contracted pupils. This may have been due to the reaction from his profound depression previous to the operation, as I have not heard of any such effects having been attributed to the drug in the amount used.H. A. SMITH, M. D., in Med. News.

THE BROMIDE OF ETHYL AS AN ANÆSTHETIC IN LABOR.-A paper was read with this title by DR. MONTGOMERY at the April meeting of the Obstetrical Society of Philadelphia.

Reviewing the various anesthetics, he said that chloroform was objectionable in that it caused inertia uteri and tedious labor, and increased the danger of post-partum hæmorrhage. The relative infrequency of fatal cases under its use in surgical practice, and the still greater rarity of serious results from its use in obstetrics, did not warrant its habitual use. The use of ether in natural labor was infrequent, because to relieve pain the patient must be profoundly etherized. Partial etherization only destroys the ability to bear pain without obtunding sensation. Besides, TAIT had demonstrated that ether passed rapidly into the circulation of the foetus, endangered its existence. The mixture of nitrous oxide and air, advocated by KLIKOWITSCH required a special apparatus and was unwieldly. The ideal anæs

thetic was one that was safe for both mother and child, certain in its effects, rapid in relieving pain without producing loss of consciousness, and the effects of which pass off quickly. All these demands were met by the bromide of ethyl. He mentioned 112 cases in which it had been used, 29 of which were in his own practice: none of the mothers died, and but three of the children. In none of the latter could death be attributed to its use. It was administered during the second stage of labor by placing a napkin wet with a few drops of the ethyl over the face at the advent of each pain, and withdrawing it as the pain subsided. Unless a drachm was used the sensation of pain was obtunded without arresting consciousness. The process of labor was carried forward vigorously and quietly, the patient ready to exert or withhold voluntary aid, as her attendant might direct, and the expulsion of the head was attended by no greater pain than accompanied the evacuation of obstinately constipated bowels. His experience did not lead him to believe that its use would induce inertia uteri or increase the tendency to post-partum hæmorrhage.-Physician and Surgeon.

SALICYLIC LEMONADE.-The British and Colonial Druggist says that as a "hospital beverage," which has lately been found of very great value in cases of typhoid and other fevers, scurvy and gout, the following cannot be too widely known, it having been, we understand, first devised by a late medical officer attached to the Soudan expedition:

B Fruct. limon, No. 10.
Acid. citric, 3 ss.

Acid. salicylic., gr. 200.
Sacch. alb.,

Aquæ, ää q. S.

Squeeze the lemons and put the juice aside; boil the fruit in half or three-quarters of a gallon of water for fifteen or twenty minutes; after standing six hours take out the lemons, and again press them before throwing the exhausted pieces away. Add the juice and citric acid to the liquid, boil five minutes, and strain. Whilst hot add the salicylic acid, and stir until dissolved. Sweeten to taste with the white sugar, and make up the bulk to one gallon of water.

Salicylic lemonade may be taken freely, either of the strength here given, or diluted with half its bulk of water. It should be freshly made every two or three days, unless it be permissible to "qualify" it by the addition of a little pure French Brandy. If required to be in "bright" condition, add, when cold, a little beaten-up white of egg, boil for three minutes, and filter. If found rather too harsh for some tastes, dissolve in the boiling liquid, before straining, half an ounce of NELSON'S Patent Opaque Gelatin, previously swelled for five hours in cold water.-Medical and Surgical Reporter, May 30, 1885.

PELLETIERINE IN THE TREATMENT OF TAPE-WORM.-DR. H. WILFERL, in the Cincinnati Lancet and Clinic, reports several cases of tape-worm treated with pelletierine.

Five of the specimens were of the variety of

tænia medio canellata: one of tænia solium, found in the little boy.

Dizziness or vertigo was noticed in all the cases, coming on within five to thirty minutes after the remedy was taken, lasting from one to four hours. The dizziness, however, diminishes as soon as the cathartic begins to act.

The pulse, in some of the cases, was slightly increased, but I have never found any elevation in temperature.

In no case was the medicine administered unless the presence of the worm was assured. Regarding the administration of the pelletierine, he states:

The evening preceding let the patient take a light purgative, and take only a light supper. The following morning give on an empty stomach 30 centigrammes sulphate of pelletierine and iso-pelletierine in a solution containing 50 centigrammes of tannin. Ten minutes later give a glass of water, and at the end of three-quarters of an hour a purgative. Advise the patient to pass the rectal contents in a vessel of warm water. Shortly after taking the medicine the patient is seized with vertigo, and the tænia is passed about three-quarters of an hour after administration of the remedy. In case of failure, that is, the worm passes away without the head, wait two or three months before again resorting to the remedy. The same rule should be followed whatever tæniafuge has been taken. Since we have carefully followed this course of treatment we have had numerous successes. In nine out of ten cases we succeed in finding the head. I can therefore affirm that pelletierine is an excellent remedy for tania, if it be not the best. This statement is made in reference to adults. Until more is known about it, I would not venture to recommend it to children.

A NEW METHOD OF TREATING GONORRHŒA. -SENFTLEBEN (Monatsh. f. prakt. Dermatol.) used small medicated bougies, which he introduced into the urethra by means of an instrument that he calls a "pistol" (probably similar to a SIMS' uterine applicator), pushing them down to the membranous portion, where they are left to dissolve. The first application is said to be very painful, but the sensitiveness soon disappears. The following is the formula for one variety of these bougies:

Subnitrate of bismuth, white of egg,
each, 15 grains.

Gum arabic. 45 grains.
Glycerin, 5 drops.

Mucilage 1 drop.

Make ten bougies, from seven to ten ctm. long.

Iodoform, sulpho-carbolate of zinc, corrosive sublimate and nitrate of silver are also used, in amounts varying from one-sixteenth of a grain (of the sublimate) to two grains. The following advantages are alleged: 1. The application is strictly localized at the seat of the inflammation, the exact situation of which may be determined precisely by means of the endoscope. 2. The medicinal substance remains in contact with the inflamed surface for a long time, which is not the case when injections are given. 3. The inflammation is cut short, so that the danger of stricture is averted. The

writer is not satisfied with pursuing the treatment until all discharge has ceased, but continues it until not a single sensitive spot remains in the urethra.-M. Y. Med. Journal.

A NEW TEST FOR BILE ACIDS IN THE URINE.-DR. OLIVER, of Harrogate, has, during the past week, been demonstrating in several of the London hospitals what he believes to be a new test for the detection in the urine of the derivatives of the bile salts. It is in the form of a test solution, and also in that of test paper. The reaction of the test is founded on the physiolical fact that where the bile mingles with the acid solution of peptones in the duodenum, the proteids are instantly and completely precipitated. The test solution is an acidulous antiseptie solution of peptone, and does not present to the urine a constituent extraneous to the orgaism. When brought into contact with a urine containing a bile-salt derivative, a precipitate resembling that of albumen when thrown down by nitric acid at once appears. By using a standard of opacity to represent the very delicate reaction induced in normal urine, DR. OLIVER showed how the quantity of the bile derivatives, as they appear in the marked deviations encountered in disease, can be readily gauged. He has, we learn, found bile acids plentifully present not only in the urine of jaundice and of other hepatic affections, but in that of several cases of anæmia (simple or idiopathic, leucocoythæmic or malarial, and of other morbid conditions ; and his observations generally appear to be of Some clinical interest. We understand that DR. OLIVER is preparing for early publication the data he has collected.-London Lancet.

THE PRINCIPAL ANTIPYRETIC DRUGS AND THE MODE OF RECOGNIZING THEM IN THE URINE. Quinine gives a white precipitate with tannic acid; with solution of iodide of potassium and mercury (Tanret) it gives an abundant yellowish-white precipitate; with solution of iodine a brownish-yellow or chestnutbrown. The presence of salicyclic acid, carbolic acid, resorcine, and kairine is shown by the addition of solution of the perchloride of iron (no reaction with quinine), which gives rise to a reddish-brown, wine-colored, violet, smoky, or bluish color. If, on the addition of sulphuric acid, the color becomes clear red, kairine is present: if the color obtained with the perchloride disappear on the addition of sulphuric acid, salicylic acid or resorcine is present. Carbolic acid with nitric acid gives a blood-red brown color and precipitate, with lively effervescence. Resorcine and salicylic acid are unaffected. Caustic potash, added lastly in excess, gives a golden yellow flocculent precipitate with resorcine; with salicylic acid the original violet color partly returns. If the urine be diabetic, to avoid error, it is well to boil it to drive off volatile products, such as acetone, which would falsify the reaction with the perchloride of iron. The London Medical Record, April 15, 1885.

HYDROCHINON.-DR. FRANCIS KINECUTT (Medical Record), during the past three months, has been carrying on a careful study of the

effects of hydrochinon. The chemical name of this drug is dihydroxyl benzole, and it was found by BRIEGER (Berliner Med. Wochenschr. No. 29, 1884) to be a marked antipyretic. DR. K. has been giving it in doses of fifteen to twenty grains. The conclusions drawn from his experience are the following :

1. That in hydrochinon we possess a new and most efficient antipyretic.

2. That its use is apparently unattended with any injurious effects.

3. That the antipyretic effects of a single dose is comparatively temporary, resembling in this respect that of kairine, thalline, and antipyrine; that the maintenance of moderate temperatures in hyperpyretic conditions can be safely obtained, however, by repeated doses.

4. That while apparently without effect in arresting a specific disease process, its employment is conservative and productive of a marked amelioration of many of the symptoms incident to high temperature.

5. That with our, as yet limited experience with the drug, it should be given prudently, and its effects carefully observed.-Louisville Med. News.

BATHS OF PERMANGANATE OF POTASSIUM. DR. HULLMANN, of Halle, first used this remedy in 1879, for a two-year-old child that was suffering with a scrofulous eruption-eczema and impetigo. After other means had been tried without benefit, he ordered a full bath of permanganate of potassium solution, so strong that the color of the water was between a dark rose and a violet. The child was kept in the bath until the water began to take on a brownish tint. After two weeks of this treatment the eruption entirely disappeared, leaving a slight yellow color to the skin, which disappeared in a few days. Since then DR. HULLMANN has used it with success in the so-called scrofulous exanthemata, in prurigo and eczema, in intertrigo, and during the desquamative period of measles, scarlet fever, and varicellawith the latter, as a preventive against infection. He found it of most benefit when used after free washing and the use of the brush to remove all scales, scabs, and other accumulations. The proportion of the solution required is about grs. xv to Qx. It is put into hot water, which is then allowed to cool in the bath tub.. Archic. für Kinderheilkunde, B. VI., Hft. 3.Jour. Amer. Med. Asso.

BERBERIS AQUIFOLIUM IN ECZEMATOUS AFFECTIONS.--By kind permission of J. H. KELLY, M. D., L. R. C. S. I.. of London, England, we are enabled to publish the conclusions he has arrived at, after a study of the therapeutic effects of berberis aquifolium. In a recent communication to MESSRS. PARKE, DAVIS & Co., requesting this drug, he states:

"I am satisfied not only that it is a valuable alterative tonic, but that it possesses a marked influence in eczematous affections, whether dependent on syphilitic taint or not.

It is particularly applicable in that form of eczema in which there are numerous dry crusts attended with itching. In several cases 1 combined with the berberis aquifolium, the fluid extract of cascara amarga, as follows: