and to enable it to pursue its stately march in the times that have come and in the times that are coming, to form its own convictions, to act on its own principles without fear or favor, for the general benefit of mankind."-The London Lancet.

PRESCRIPTION WRITING.-The trial of a case of homicide has recently been concluded in the Paris courts, after having lasted for nineteen months. The facts of the case were briefly as follows: A druggist's apprentice, in putting up a physician's prescription, dispensed hydrochlorate of morphine instead of hydrochlorate of ammonia. A child two and a half years old was given the medicine and died. The testimony of experts was brought to bear upon the case, and it was finally proved that the child died from the ingestion of nearly half a grain of morphine. It was also shown that this drug had not been prescribed by the attending physician. A verdict of guilty was therefore rendered against the apprentice, and he was sentenced to fifteen days' imprisonment and a fine of two hundred francs, while the druggist was ordered to pay five thousand francs damages.

Our own country is by no means exempt from similar accidents, and cases in which a druggist's misunderstanding of a physician's prescription has been followed by disastrous results occur only too frequently. A large proportion of the profession seem to make a point of writing their prescriptions as illegibly as possible. The names of drugs are frequently abbreviated almost beyond recognition, and the quantities and directions are most ambiguPharmaceutical journals frequently contain puzzles, in the shape of illegible prescriptions, which often defy interpretation.

ous.

The Journal de Medicine, of Paris, March 16, 1890, in commenting upon the case mentioned above, suggests certain rules which it would be well for physicians in this country, as well as in France, to conscientiously adopt. They read as follows:

of the remedy should be appended to every prescription.

The pharmacist, on his part, should never put up a prescription when there is the least doubt in his mind as to its correctness or meaning; be it either the signification of a single word, or an uncertainty regarding the manner of using the preparations. In all cases of doubt, he should obtain an explicit explanation before proceeding to put up the prescription. In case of an error on the part of the physician, either through inadvertence or ignorance, the pharmacist should refuse to dispense the prescription until the mistake has been corrected. Finally, all druggists would do well never to allow their apprentices or students to put up any prescriptions containing poisonous substances.--Medical and Surgical Reporter.

DOMESTIC FILTERS FOR DRINKING WATER. The American Analyst, March 20, 1890, contains an article by P. T. Austin, taken from the Scientific American, part of which we think well worth reproducing:

During the last few years the subject of water purification has received much attention, and successful methods have been introduced for filtering and purifying water on a large scale. Filtration on a small scale, while successful in many cases, comes, as a rule, under housekeeping, and the success or failure of the method will therefore often depend entirely on the operative ability of some domestic. While I do not wish to undervalue any of the excellent small filters now on the market, I desire to explain a simple method by which any housekeeper of average intelligence can make an inexpensive contrivance which will do its work in a way not easily surpassed by any filter that can be bought. It has been known for many years that the addition of a minute amount of alum to a water containing bicarbonate of lime in solution (and most natural waters contain more or less of this substance) will cause the formation of a gelatinous pre

lects the suspended matters and germs, form

3. Full instructions regarding the exact use

are easly removed by simple filtration. Waters containing clay or mud which is so fine that a

mechanical filter can not remove it, when treated with a small amount of alum can be filtered perfectly clear through a coarse filter. The alum thus added is not left in the water, but is removed by the filtration, for its active constituent, the aluminic sulphate, is decomposed and precipitated by the action of the dissolved bicarbonate of lime. This should be well understood, although if a minute amount of alum were left in the water its effect would not be noticeable, and even if present in larger amounts it would not be at all dangerous. The method of filtration is simple in the extreme. An oil bottle or any long, narrow-necked bottle serves for the filter. Tie around it a string soaked in kerosene, about half an inch from the bottom, set the string on fire, and hold the bottle bottom up. When the string is burnt out, the bottom of the bottle is thrust into cold water. If properly done, this causes the bottom of the bottle to split off evenly. The rim of the glass should now be burred off a little with a round file to remove any sharp edges that may be left. The bottle is then thoroughly cleaned and placed neck downward in a convenient support, as, for instance, through a hole bored in a shelf, or it may be allowed to stand in a wide-mouthed bottle, resting by its shoulders on the rim of the mouth. A small handful of cotton wool is now thoroughly wetted by squeezing it in water, and shreds of it are dropped into the bottle until a layer of about two inches deep has been made. The shreds should be dropped in carefully, so as to distribute them evenly, and not to let them pile up in the middle or at the sides. When enough cotton has been dropped in, a cup or two of water is poured in and the bottle gently tapped. This consolidates the mass and finishes the making of the filter-bed. The amount of alum needed to coagulate the water sufficiently for filtering need not, as a rule, exceed two grains to the gallon, and in many instances may be less; but in certain cases of very dirty waters, such as that of the Mississippi River, the amount of alum may be increased to four er even six grains per gallon. The alum is best kept in a solution of such a strength that a teaspoonful of it will contain a grain. To save trouble, the following prescription will

enable one to get enough of the solution put up at any apothecary's to last for a considerable time: Alum, 128 grains; distilled water, one pint.

I may add that the expense of this prescription, including the bottle, should not exceed fifteen cents.

The treatment and filtration of the water is best done as follows: A gallon of water is placed in a clean tin pail and two teaspoonfuls of the alum solution are added. It will save time to make, once for all, scratches on the inside of the pail, showing the height of one, two, or more gallons of water. It is then well stirred with a clean tin dipper. It is best to keep this pail and dipper for this use alone. They should be kept scrupulously clean and frequently well scoured with sapolio or a similar kind of soap. After mixing, the water is allowed to stand five or ten minutes, and then poured, by means of the dipper, into the filter. It will run through rapidly if the filterbed has been properly made, and will be as clear as crystal, and not seldom will form an astonishing contrast with the original water. The first half pint of the water passing through should be rejected. The filtered water may be caught in a pitcher or in any other convenient receptacle. A filter-bed will last a day, but it is not advisable to use it longer. Each day the used filter-bed should be thrown away and a fresh one prepared. The method may, of course, be applied to any of the many filters in use, simply adding to the water to be filtered one or two grains of alum to the gallon. It will be a poor filter, indeed, that will not filter clear after this addition. Of late, attention has been drawn to the latent dangers in ice. It has been found that this apparently harmless and attractive substance may fairly reek with disease germs and filth of all kinds. Unless it is known from whence the ice comes, its use may be more dangerous than the use of water. Ice is sometimes derived from water which no one would think of drinking, as, for instance, from ponds in cemeteries and from rivers in the neighborhood of sewer outlets, and as a result may be indescribably foul. Aside from the danger of germs lurking in ice, there is risk in the indiscreet use of water cooled to an ab

normally low temperature, since functional disorders are often caused by the drinking of very cold water. No water is so refreshing as a mountain spring, and one reason of this is that its temperature is just right. It is well to take hints that are given by nature, and the hint that the best temperature of drinking water is about fifty degrees Fahrenheit is a good one, and worth following.-Medical and Surgical Reporter.

ON APPARENT DEATH.-M. Brouardel (Gaz. des Hôpit., No. 55, 1889) thinks that too often physicians consider individuals as being dead when they are not so in reality. Aged people, he states, infants, the newly born, and all enfeebled persons are predisposed to apparent death. It is a well-known fact, it is alleged, that after a difficult labor the newly born is apt to be apparently dead for two, three, and sometimes four hours; and that those who are familiar with the life of newly born animals know that often they begin their respiration after the administration of a warm bath lasting for half or an entire hour; and, according to Paul Bert, the newly born has a special resistance of its tissues that accounts too for the tolerance to certain intoxications, as that of strychnine.

The physician is most apt to be deceived by hysterical persons, who are capable of living like hibernating animals, producing three instead of twenty grams of urea, and forty instead of five hundred and fifty grams of vapor in the twenty-four hours. Under such conditions a false diagnosis is apt to be made, the falsity being recognized, in case of hysterical patients, at the critical moment; as the author expresses himself, at the moment the person is to be laid in the coffin.

In persons convalescing from grave diseases, the author goes on to say, syncope is easily induced at the moment the patient rises; the deficient cerebral circulation and venous stagnation in the lower limbs are favorable conditions to the occurrence of apparent death. He further relates the case of a criminal who was hung in Boston at 10 A. M., taken down at 10:25 A. M., and transferred to the anatomical amphitheater an hour thereafter, when his

pulse recommenced to beat. On opening the thorax, the pulse was seen to beat 40 a minute, and it stopped beating at 2:45 P. M. A similar case of Hoffman's is quoted. In this case the explanation of the accident is that the cerebral blood supply, though deficient, yet was enough to maintain life.

The author does not accept this reason; it seems illogical to him that the heart should stop under the influence of simple cerebral anemia, when it continues to beat for about twenty minutes after complete decapitation.

He believes that in infectious diseases and algid fevers there are a good many examples of resurrection; the ptomaines he considers to have characteristic anesthetic properties; injected into a frog, the latter assumes any given cataleptic properties that may be desired.

Allusion is made to the apparent death of animals subjected to congelation. One similar fact is reported to have happened in a grenadier; the man passed three hours in the water in the month of January; resuscitation was brought about by virtue of the persistent care of a young surgeon that was intimately attached to him. Another series of apparent deaths, the author states, is to be looked for in commotion of the nervous system by lightning, which is at the head of the list of causes.

M. Lestier's seven cases are quoted, where the subjects, under the action of lightning, had remained apparently dead for periods varying from several minutes to three hours. Physicians who took the observations stated that no pulse could be felt at all, the excitation having been strong enough to stop the heart's action. A case of Budin's is recited in which a sailor is said to have fallen apparently dead under the influence of an electric discharge; all means used failed to resuscitate the man; he was finally subjected to the influence of hailstones that were falling on the deck, and resuscitation was successfully brought about after continuous treatment for an hour and fifteen minutes. Other facts are related, and it is concluded that such cases are to be classed under the heading of syncope or cerebral commotion. The author alludes to the fact that people have been buried for eight and fifteen days, and yet been resuscitated.

The caution is given not to mistake alcoholic cases; two such are reported in which the subjects were restored to life, one of M. Laborde's, in which the rectal temperature had been 24° C.; the second, M. Bourneville's, in which the rectal temperature had been 25° C.

The author says in a convincing manner that physicians are too hasty to diagnosticate death in unfortunate cases of the use of anesthetics; he thinks that much more time should be spent in trying resuscitation before the case is pronounced hopeless. He finally advises great caution in diagnosticating death, especially in cases of hysteria and syncope. It is easy to hear the heart beat, he alleges, when the heart muscle is contracting vigorously, but in experiments of vivisection it is well known that the heart, without actually stopping, may at the same time not be heard for a certain period.-New York Medical Journal.

THE ANALGESIC ACTION OF EXALGINE.— Exalgine is one of the most important of the newer compounds. If present indications persist, this drug will survive not a few of its rivals for popularity. This opinion, which has led us to keep a close watch upon the reports of those who have made trial of the drug, has been materially strengthened by a clinical lecture by Dr. Thomas R. Fraser, of Edinburgh, published in the British Medical Journal for February 15th. Dr. Fraser is the professor of materia medica in the University of Edinburgh, and is favorably known for his studies of the African ordeal poisons. He presents a table of eighty-eight separate administrations of exalgine to twenty-one patients, which gave relief in sixty-seven instances, and in twenty-one afforded no benefit. cancer of the liver, aneurism of the aorta, and lumbar abscess there were nine trials, two, four, and three each in the order named, with nine failures. In other affections deemed suitable for trial there were seventy-nine administrations with twelve failures to obtain relief; about sixty of these may be classed as neuralgic, while twenty were rheumatic or carcinomatous with one or two exceptions. The condition of some of the patients was not one in which the pain could fairly be expected to be

In

dissipated save by a drug that would produce general narcotism. This is not the property of exalgine. It is not an overpowering analgesic, but it has the enormous advantage of being free from the disturbances and inconveniences that are associated with the action of nearly all other pain-subduing drugs, and from the dangers inseparable from the use of the more powerful of them. The doses given ranged from half a grain to four grains; onegrain doses were frequently followed by relief, lasting from two to twelve hours, making itself felt sometimes in fifteen minutes, and sometimes requiring forty minutes. The largest quantity given in twenty-four hours was fourteen grains, and it seemed not to be followed by any disagreeable, much less dangerous, effect. The majority of the persons experimented upon in this series were inmates of the hospital.-Ibid.

DIPHTHERIA, ITS TREATMENT.-In the North Carolina Medical Journal for March, 1890, Dr. E. B. Goelet, of Saluda, N. C., has an excellent practical paper on diphtheria, in which he says:

The symptoms vary from simple sore throat to complete constitutional prostration. Usually there is, at first, a malaise or tired feeling with loss of appetite; next the throat becomes sore, and there is languidness with fever; then the eyes get dull, showing constitutional depression and feebleness; the tonsils are only slightly enlarged out of proportion to the constitutional symptoms; then appears a general redness of the palate, pharynx, and tonsils, with dusky reddened blotches and white or ash-colored spots, spreading rapidly and developing in glandular enlargements; the inflamed surface exudes false membranes, containing micrococci, which inoculate all other surfaces in contact therewith; and finally the disease expresses itself anywhere on the body there is an abrasion. If let alone the tendency is to death by suffocation, on account of the spread and rapid growth of these false membranes. The involved cervical glands increase enormously. Blood-clots may form and attach themselves to the valves of the heart, then be swept off as emboli.

In tonsillitis there is a sharp attack of fever,

high temperature, and enlarged tonsils, with no history of malaise; the eyes are bright, there is no languor or prostration, the swelling and redness confined to the tonsils.

In follicular tonsillitis there is no fever, no constitutional depression, but very enlarged tonsils on both sides, covered with patches in the depressions of the tonsils; but these patches are superficial and easily removed; in a day or two, under proper treatment, the patches reduce in size and soon disappear.

In scarlet fever the symptoms resemble diphtheria, but the eruption appears in the first twenty-four hours, the throat symptoms come on later, and the redness is scarlet and diffused.

In diphtheria the fever is slight, of low grade, resembling an asthenic type, the eyes are dull, and there is constitutional depression, simple enlargement of the tonsils, inflamed palate and pharynx, with whitish spots or patches appearing upon a reddened base; the spots are adherent and apt to cause a flow of blood when reremoved; there may be an eruption, but that comes on later. The early symptoms are confined to the throat, the patches spread rapidly and inoculate all surfaces in contact with them. The treatment should be based upon constitutional theory. A proper germ-poison put into the blood will arrest its development and destroy the membrane. Sulphur and chlorine are the most potent germicides known. Now we want to get sulphurous acid into the blood; and in order to do so we give the sulphite of sodium. It will not hurt the patient, but will destroy the germ and be excreted by the kidneys as a sulphate. From twenty to thirty grains taken every two hours will keep up a continuous action; large doses act as a purgative, but do no harm. As a local application. use chlorine water. I usually generate it in this way: Take chlorate of potash, zij, and hydrochloric acid [the writer probably meant to say sulphuric acid], mxx; put into a well-stoppered eight-ounce vial, and when decomposition has taken place, add through a glass funnel glycerine, f3ij, to absorb the chlorine; then add water to fill the vial. Use this as a gargle, and it will clean off the membrane as a wet sponge does a slate. It can be even given in doses of f3j every

three hours. As a prophylactic I prefer the sulphite of sodium; for chlorine is a powerful cardiac stimulant and diuretic, and is best suited to severe cases. I have had a number of cases this fall and winter, and have lost only

one.

I have a firm conviction that, if called to see a patient in time, with this treatment there should be no fear as to the result.

ABSENCE OF MALARIA ON THE EASTERN SHORE OF MARYLAND.-In a pamphlet on the Climate of the Eastern Shore of Maryland, Dr. C. W. Chancellor, Secretary of the Maryland State Board of Health, says that for a long time the eastern shore of Maryland has rested under a reputation such as is likely to arise from a careless observation of her physical constitution and relations; but the light of investigation and experience has in a measure dispelled this belief.

The salubrity of any particular locality can not always be exactly interpreted from local conditions, or a mere string of figures be said to represent meteorological phenomena. They are, however, very valuable in conjunction with other knowledge; and any information obtained from intelligent physicians and other persons who have lived long in a place as to its general salubrity is valuable in forming a judg ment of the healthfulness or unhealthfulness of a locality. He has gathered as much of such knowledge as possible in regard to the salubrity of the eastern shore. Reports from a considerable number of local health officers, physicians, and correspondents show that, whatever may have been the condition of this section of the State, as regards malarial and other diseases, in former years, it is now exceptionally healthy; in fact, it is more exempt from disease than any other district in the State of equal area and population. This is especially true in respect to malarial fevers and pulmonary consumption.

The facts which have been obtained indicate that malarial diseases have greatly diminished on the Peninsula in the past ten or fifteen years, and that, exclusive of small areas affected by local conditions, the proportion of uncomplicated malarial fevers to all other cases