prescription difficulties, but the infrequency of such occurrences prove that such prescriptions are rare, or else that the average druggist is wide awake and up to snuff.

In a country drug store, where the prescriptions of a few doctors are dispensed, there is less diversity in the character and composition of prescriptions than in a city pharmacy.

To give this paper practical value, we have spent a few hours tabulating and classifying 1,000 receipts taken at random from the file of a small pharmacy in the suburbs. Sixty-nine doctors of all schools have contributed specimens of their handiwork to the collection. Pharmaceutically considered, they are divided as follows:

Liquids, consisting of solutions, mixtures and emulsions, 592; powders, 156; pill masses and powders in capsules, 135; pills, 25; ointments and cerates, 33; suppositories, 29; plasters, 15; miscellaneous, 15; articles prescribed, 3,437; remedies, 269; quinine is called for, 233; opium, 90; ipecacuanha, 73; morphine, 72; antipyrine, 66; paregoric, 58, and so on down. Simple syrup is used 295 times; elixir simplex, 125; elixir adjuvans, 14.

Of the medicated syrups, tolu leads, 55; ipecac, 44; scillæ, 35; wild cherry, 30; licorice, 30; scillæ comp., 14. Tonics seem to be in demand in this locality, over half of the prescriptions being of that nature. Remedies to ease pain come next. Opiates aggregate 233; chloral, 24; chloroform, 28; ether sulph., 4; chloranodyne, 10; potassium bromide is called for 42 times; other bromides, 23; cathartics are in slight demand; podophyllin is prescribed 20; mercurials are used principally as alteratives; leptandrin is used 14 times; rhubarb, 19; cascara sagrada, 13; blue mass, 4 times. Among the alteratives mild chloride of mercury is used 37 times; corrosive chloride, 13; iodide of potassium, 34; other iodides, 7. Iron in some form is used 60 times.

In the new remedies we find salol, 10; sulphonal, 4; phenacetin, 4; antifebrin, 1; saccharine, 2; ichthyol, 1. Active poisons appear in small ratio: aconite, 45; belladonna, 34; hyoscyamus, 13; arsenic, 13; strychnia, 9; aconitia, 1; atropia, 4; phosphorus, 2; carbolic acid is dispensed 34 times; iodine, 14; iodo

form, 11. As digestives pepsin is used 35; manufacturers specified, 16; pancreatin, 16. Antacids: sodium bicarb. is called for 36 times; proprietary articles, such as lactopeptin, viburum comp., listerine, and others, are called for 35 times. For ointments vaseline seems to be the most popular base, having been used 15 times; lanolin, 2; basilicon ointment, 5; ung. aqua rosæ, 2; lard, 9.

Viewed from a pharmaceutical standpoint, these prescriptions will compare well, I am sure, with any similar number of receipts to be found in any pharmacy on the globe. The absence of the typical shot-gun prescription is particularly noticeable.

There is little tendency to poly-pharmacy in this section, and there is also a marked predilection to prescribe small quantities, 2, 4, and 6 oz. bottles being generally called for, and usually 12 to 20 powders and capsules. I do not think that the same number of prescriptions from so large a number of physicians can be found in any other locality which will make a better showing for professional proficiency. To account for this I would suggest that this is largely due to the fact that our physicians are, as a rule, young men; they have the western push and vim to keep up with the times, and are, in fact, the most enterprising representatives of graduates from our medical centers. I trust that at our next meeting we may have many tabulated reports upon this subject from all sections of the State. I thank you, gentlemen, for your kind attention.-From an address. by Dr. W. I. Cottel, Pacific Drug Review.

SULPHUROUS DISINFECTION.-The following letter, by Dr. Henry B. Baker, Secretary of the Michigan State Board of Health, to E. B. Frazer, M. D., Secretary of the State Board of Health, Wilmington, Del., discusses an important hygienic problem :

Your letter of August 18th, acknowledging the receipt of a copy of my letter to Dr. Duffield (giving results of experience of health officers in Michigan, and an account of the experiments by Pasteur, Roux, Dujardin-Beaumetz, and others relative to sulphurous di-infection), is before me. You ask me for further

opinion, and refer to the report of the Maine State Board of Health for 1889, page 251, and Dr. Mitchell Prudden's estimate of the want of value of sulphurous disinfection. (American Journal of the Medical Sciences, May, 1889, page 470.)

There are at least two valid objections to the acceptance of Dr. Prudden's conclusions to which you refer: (1) His experiments dealt with a micro-organism which seems to be different from the one most generally accepted as the probable cause of diphtheria. Therefore he may or may not have been dealing with a micro-organism causing diphtheria. (2) The quantity of sulphur burned, the strength of the sulphurous acid fumes which he employed, is not stated. It having been proved by actual experience with disease, and by other laboratory experimentors (Pasteur, Roux, Dujardin Beaumetz, Vallin, Legouest, Polli, Pettenkofer, Dougall, Fatio, Pietra Santa) that sulphurous acid gas is not always a disinfectant when employed in small proportions, and that it is a disinfectant when employed in large proportions, such as result from the burning of three pounds of sulphur to each thousand cubic feet of air-space, no different conclusion should be reached from Dr. Prudden's experiments as published. (American Journal of the Medical Sciences, May, 1889, page 470.)

You mention that Dr. W. H. Welch, of Baltimore, "enters his protest" against disinfection by sulphurous acid gas. I respectfully submit that entering a protest should count for very little in science as against results of actual, practical experience in the restriction of diphtheria; it should not even take rank with definite statements of results of laboratory experiments.

Laboratory experiments are very valuable, but they need to be repeated by the same observer, and by other observers, in order to eliminate errors due to accidental and incidental conditions.

It is not easy to make laboratory experiments which shall conform to or correctly represent average conditions in actual outbreaks of disease. That is probably one reason for the discrepancies in laboratory experiments, and for the disagreement of some laboratory experi

ments with practical experience with disease. One reason for this last disagreement may be that micro-organisms, which, after subjection to a disinfectant, may yet have sufficient vitality to reproduce in a laboratory, where the most favorable conditions are supplied, could not pos sibly do so in the human throat, or el-ewhere in the human body, because of the well-known power of the fluids of the body to destroy micro-organisms, as proved by Dr. Prudden's and other laboratory experiments following, but not confirming, Metschnikoff's doctrine of the phagocytes.

Progress would be easier, more rapid, and the backward and forward movements less frequent if experimenters in laboratories would be more careful in stating the details of their work.

The interpretation of the results of laboratory experiments, and the determination of the bearing which they should have upon practical affairs, is an extremely difficult work, and one in which there is very great liability to error.

Practical health officers need to employ a gaseous disinfectant that shall at once reach all surfaces, ledges, cracks, drawers, and recepta cles of dust wherever it may be in a room, that shall permeate all articles sufficiently permeable to admit disease-causing micro-organisms, that will not necessitate too much labor in the removal of furniture or other articles, and that shall have power to destroy or sufficiently weaken the vitality of the "germs" of such diseases as diphtheria and scarlet fever. and occasionally smallpox, as they are usually distributed in the sick-room, and that shall not destroy, family portraits and similar articles. Only two such disinfectants are prominently before us for choice, chlorine and sulphurous acid gas. Of these two, sulphurous acid gas is made in proper quantity with more cer tainty and less trouble than is chlorine gas; and at present I regard the weight of evidence in its favor as equal to that relative to chlorine gas, concerning which not so much evidence has been published. Practical experience in Michigan proves that by isolation of first cases of diphtheria, and disinfection of premises after death or recovery therefrom, by fumes of burning sulphur, etc., four fifths of the cases and deaths which would otherwise occur from that

disease are prevented. If there is any other method of disinfection, or any other procedure that can be shown to reduce the cases and deaths more than the four fifths, and down to less than an average of two and one third cases and six tenths of one death to each outbreak, I am exceedingly desirous of knowing what it is. But, inasmuch as that is the recent experience in Michigan (outside of the great cities), it does not seem best to give up the methods employed until evidence of a better method is produced.

Meantime I would advise a continuance of sulphurous disinfection for the purposes for which it is applicable, and for which it is greatly needed as stated above, not including the disinfection of excretions from the patient, for which chlorinated lime or liquid is applicable, nor of bits of diphtheritic membrane which should be destroyed by fire, as should also all rags, and every thing else not too valuable used about a patient; and all clothing, bed-clothes, etc. that can profitably be boiled should be so treated.

THE MEDICO-LEGAL ASPECT OF ABDOMINAL SECTION. The technique of abdominal operations has attained so high a degree of excellence that it would seem that little remains to be accomplished to render it absolutely perfect. Unfortunately the same can not be said of our diagnostic resources in conditions of disease within the abdomen, which are still far from being adequate. Every now and then we read of cases occurring in the practice of careful and skilled surgeons, where errors of diagnosis have led to the performance of abdominal operations attended sometimes with fatal results. If these errors have been made by men of acknowledged diagnostic ability, they are much more likely to occur in the practice of surgeons of less skill and experience.

It is therefore a matter of importance to determine how far the surgeon can be held responsible for these diagnostic errors, since the greed of attorneys and the avariciousness of the patient's relatives not infrequently place him in the disagreeable position of defendant in a civil or criminal law suit. At the last meeting of the American Medical Association

two interesting and instructive papers were read by Drs. Vanderveer and Wile, on the subject of the "Medico-Legal Aspect of Abdominal Section," which are reported in the Journal of the Association. Dr. Vanderveer states that in the trial of medical men for malpractice, charges to juries have been uniformly that gross neglect or gross ignorance, or both, must be shown on the part of the prosecution, beyond a reasonable doubt, before conviction can be had. It should be borne in mind, however, that it is impossible to make precise distinctions between negligence and ignorance and gross negligence and ignorance; for that which under some circumstances would be ordinary skill, in other circumstances would be ignorance, and still in other circumstances gross ignorance. The responsibility which the surgeon should assume in the class of cases under consideration is well stated in Dr. Wile's paper: "Laparotomy to-day is, in skillful hands, a recognized operation, and there are certain conditions of disease or accident which can be reached only through abdominal section.. The surgeon must be certain as far as possible, from his diagnosis, that a given condition or conditions warranting exploration exist. He ought to be accurately informed as to the correct method of reaching the parts through op

erative interference.

erative interference. He should know just when the operation ought to be performed in order to obtain the best or safe results. Beyond this the responsibility lies with the patient or patient's friends. They should be informed of the danger of the disease as it exists unrelieved; they should be informed as to the gravity of the operation and its risks, and they should be warned that in the event of unfavorable result, either through failure of the vital powers to stand the shock, or from a too great extent of diseased parts to permit successful manipulation; or even in the case of a possible mistaken diagnosis, after sufficient consultation. has been had, the doctor shall not be blamed." It is an unfortunate fact that suits of malpractice against surgeons are tried before juries of laymen, who are unacquainted with the mere rudiments of the surgical art. Moreover the prosecution is frequently permitted to adduce, as expert testimony, the opinions of men

who have never performed a surgical operation of magnitude, and who are perfectly ignorant upon the subject on which they are asked to testify. The experts testifying in these cases should be appointed by the State, and selected from among men of acknowledged surgical skill and ability. By the adoption of some plan like this the accused party would be certain of a fair and impartial investigation of the points at issue. However comforting the reflection may appear, that the unjust decisions of juries are usually reversed by superior courts, it must not be forgotten that the accused surgeon has been subjected to a large expense and loss of time, not to leave out of consideration the anxiety and worry inseparable from every law suit. And we would heartily re-echo the sentiment expressed by Dr. Vanderveer, that the laws should be so modified that surgeons may have better protection in the recovery of time, for expenses they have been put to, when it is proved that the case was urged by some disreputable lawyer, or by those personally malignant, within or without the profession.International Journal of Surgery.

IT WAS DIPHTHERIA THAT KILLED THEM IN MONTMORENCY AND OTSEGO COUNTIES.-The outbreak of dangerous disease which has prevailed in Otsego and Montmorency counties since last spring, and which local physicians said was not diphtheria, and permitted two of the corpses to be sent to Lapeer County, where a case of diphtheria occurred in a person who viewed the remains, has been investigated by the State Board of Health, the investigation having been requested by a union meeting of the boards of health of three townships in those counties. Prof. Vaughan, of the University, a member of the State Board of Health, went and made the investigation. He has also made bacteriological examination of the membrane from the throats of two of the patients, and has found and propagated the micro-organisms which are believed to cause diphtheria. This species of micro-organism is known as Löffler's bacillus. Prof. Vaughan says: "The ba cilli have been compared with the Löffler bacillus, which I had obtained in the laboratory of Dr. Koch at Berlin, and the identity of the two

A HINT FOR THE MICROSCOPICAL EXAMINATION OF URINE.-When attempting to examine urine under the microscope for casts, epithelial cells and other organic bodies, a good deal of annoyance and difficulty is sometimes caused by urates, and also, when the specimen is not quite fresh, by fermentation and putrefactive products. In order to obviate this difficulty, and with the further view of preserving the specimen, Dr. M. Wendringer advises that the urine should be mixed with a nearly saturated solution of borax and boracic acid. This dissolves the urates and keeps the urine from fermenting, and at the same time exercises no destructive effects upon the casts and epithelial elements which it is desired to examine. The solution is prepared by mixing twelve parts of powdered borax in one hundred parts of hot water, and then adding a similar quantity of boracic acid, stirring the mixture well. It is filtered while hot. On long standing, a small deposit crystallizes out, but clings to the side of the vessel, so that it does not interfere with the transparency of the liquid. The urine to be examined is put into a conical glass, and from a fifth to a third of its bulk of the boracic solution added to and agitated with it. The urine will be found to have become clear in a short time-i. e., if there is no cloudiness due to bacteria; and it will remain unchanged for several days. If it is only wanted to clear the urine and to make it keep for a day or two, the addition of a smaller quantity of the boracic solution is sufficient. If a third of its bulk is added, no fermentation or putrefactive processes take place, even if the glass is left uncovered in warm places. Albumin, too, if it exists, is not coagulated. The organic elements as epithelial cells, casts, blood corpuscles, etc.-collect so quickly, without undergoing

any morphological change, at the bottom of the glass, that the first drop taken up by the pipette usually proves a satisfactory specimen.-Lancet.

WILLIAM KEMMLER, convicted of murder, was executed August 6th, in the State Prison at Auburn, New York, under the law, by the use of electricity. After the application of electricity had continued about 17 seconds, he was said to be dead, and the current was stopped. Signs of respiration appeared, however, and the current was again applied, and in about 13 minutes from the first stroke he was again declared dead. Death was then a certainty. The flesh upon the dead man's back was burned, and also a spot on the top of his head, where the electrodes had been placed. The autopsy was made three hours after death. All the physicians agreed that Kemmler must have lost consciousness at the first stroke. Medical and Surgical Reporter.

THE AMERICAN RHINOLOGICAL ASSOCIATION will hold its eighth annual session at Louisville, Ky., October 6th, 7th, and 8th. All leading subjects relating to Nasal and NasoPharyngeal Diseases will be opened for discussion by a leading Fellow of the Association. The medical profession is cordially invited to attend. The secretary, Dr. R. S. Knode, Omaha, Nebraska, will furnish any information to physicians desiring to become members.

BEEF JUICE. The attention of our readers is called to the advertisement of "Beef Juice," a new preparation of that enterprising and reliable firm, Messrs. John Wyeth & Bro. If what they claim for their Beef Juice is confirmed, it will certainly prove a boon to vast numbers of the sick and delicate. This house was the orig inator of "Beef, Iron, and Wine," which has given them a reputation the world over.

THE ASHEVILLE MEDICAL REVIEW is the name of a new monthly edited and published by Frank T. Meriwether, M. D., and H. Longstreet Taylor, A. M., M. D., Asheville, N. C., August 15, 1890. Terms: yearly subscription, $2 in advance. We wish our friends all happiness and success in their new venture.

IT is reported that J. M. Hirsh, a chemist of Chicago, in an interview, August 7th, claims that he has discovered a process by which he can extract aluminum from common clay, at a cost of fifteen cents or less per pound. He proposes to begin work within a few weeks, turning out 300 pounds daily from the start.

AN epidemic was reported at Preston, Iowa, on August 7th, which is said to be of the nature of cholera. Later it proved to be a malignant type of dysentery. Eighteen deaths have occurred in as many days, but the epidemic was said, on August 9th, to have begun to abate.

THE French Senate, on August 4th, voted 1000,000 francs for the establishment of frontier posts to prevent the entry of cholera into France.

DR. KOCH read before the Medical Congress in Berlin a paper in which he is said to have declared that he had discovered a way of killing the tuberculosis bacillus, and of curing tuberculous disease.

DR. BRIEGER, whose name is favorably known for his original work in bacteriology and general pathology, has been appointed Extraordinary Professor in the University of Berlin.

FRENCH lawyers say that the doctors have no legal right to make anatomical experiments on an executed criminal in opposition to his last wishes.

THE International Cremation Congress at Berlin has appointed a committee, consisting of members from the different countries represented at the Congress, for the purpose of furthering the movement for the cremation of the dead.

DR. WILLIAM LOMAX, of Mattoon, Ind., has given his entire estate, amounting to over $100,000, to the Indiana Medical College, of Indianapolis, the only condition being the pay