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Purgatives act better when given combined rather than given alone.

Salicin may be less effective than salicylic acid, but is indicated in similar cases. However, it acts more kindly in the stomach and less likely to produce ill effects on the heart.

Elix. valerianate of ammonia, dose one teaspoonful, is an efficient yet mild antispasmodic.

Syrup of lactucarium, 1 to 3 drams, is mild, yet a good anodyne for children; no untoward results. Especially indicated in nervous conditions, such as restlessness and sleeplessness. It deserves more extended use.-DR. EARP.

Hydrastis canadensis (fluid extract) is an excellent local application in cervicitis, endometritis and vaginitis, the one great objection to its use being its staining properties.

Typhoid fever in old people has a tendency to induce cataract, most probably by reason of a reduced nutrition during the continuance of the fever.

In treating any form of conjunctivitis do not neglect general medication. Open the emunctories, clean out generally; this often means success.

All forms of Bright's disease are liable to eye complications; look for albuminuria retinitis in these cases.

The one cure for diseased tonsils-hypertrophied, atrophied or buried-is complete removal.

Tubercular renal inflammation is the most perfect type of infectious nephritis.BYRON ROBINSON.

In gonorrhea, the fluid extract of hydrastis canadensis mixed with mucilage as thick as can be used by injection, is of much service. It should be retained in the urethra for some time, and the urethra should have been previously cleansed with water or a solution of sodium chloride.

Bryonia is especially indicated in acute lung or bronchial disorders with no expectoration, dry cough, short and harsh, or hacking, with soreness increased by coughing.

For distress or pain in acute inflammatory disease, aggravated by movement or relieved by pressure, give bryonia.

Aloes is one of the best general cathartics, and hence enters into most of the combinations. In action it is almost a specific in some cases.

For flatulence in pregnancy, Ringer recommends 5 to 15 grains of sodium sulphocarbolate after meals.

The public school represents knowledge, progress, civilization.

DR. BYRON ROBINSON. Dr. Grady recommends, as a liniment for the chest, 15 drops of oil of mustard, a dram each of oil of sassafras and cedar, and 4 ounces of alcohol.

It is advised that carbuncle be deeply incised with a cross incision, and that pure carbolic acid be applied deep into the incision. Ichthyol should then be painted on freely, or the wound should be packed with boracic acid.

Next to ergot as a remedial agent to restrain hemorrhage, Dr. Parvin, of Philadelphia, used to place hydrastis canadensis, 15 to 20 drops ter die.

The late Prof. DaCcsta, of Jefferson. Medical College, used to warmly advocate the use of salicylate of sodium in diabetes, and claims to have had better results with this agent than with any other remedy. Give from a dram to a dram and a half in twenty-four hours.

In the treatment of gout and those with a gouty constitution, Prof. Bartholow used to claim that sulphate of manganese was a remedy of great utility, its virtue being chiefly due to its effect on the hepatic functions.

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PRACTICAL

VOL. XXXI

A MONTHLY JOURNAL OF

MEDICINE,

NEW

PREPARATIONS, ETC.

R. H. ANDREWS, M. D., Editor, 2321 Park Avenue, Philadelphia, Pa

ONE DOLLAR PER ANNUM. IN ADVANCE. SINGLE COPIES, TEN CENTS.

PHILADELPHIA, APRIL, 1909

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HOW TO REMIT: A safe way to remit is by postal money order, express order, check, draft, or registered mail. Currency sent by ordinary mail usually reaches its destination safely, but money 80 sent must be at the risk of the sender. RECEIPTS: The receipt of all money is immediately acknowledged by a postal card. ADDRESS CHANGE: It is particularly requested that subscribers changing their addresses should immediately notify us of the same, giving present and previous location. We cannot hold ourselves responsible for copies of The Summary sent to former addresses unless we are notified as above.

DISCONTINUANCES: The Summary is continued to responsible subscribers until the publisher is notified by letter to discontinue, when payment of all arrearages must be made. If you do not wish The Summary continued for another year after the time paid for has expired, please notify us to that effect.

Address "THE MEDICAL SUMMARY." 3321 Park Ave.

Philadelphia, Pa.

Entered at Phila. Post Office as second-class matter

A BUSINESS TALK.

Doctor, are you making as much money as you think you ought to? Or, to be very blunt about it, do you make as much as you need to keep your family comfortably and to educate your children?

If the answer is not in the affirmative we would be so glad to be able to tell you what to do about it. At best we can only discuss the matter from the viewpoint of a practical individual who has sat on the fence for several years watching the procession go by. Between the lines you may be able to pick up some point that will be

No. 2

of value to you. Or if you are living on the sunny side of Easy Street yourself, this talk may help to open up your heart to the extent that you will strive to aid some brother doctor who is seeing the seamy side of professional life.

The SUMMARY is not a socialist nor does it believe in the socialistic doctrine; but we are simply voicing the common, though somewhat uncanny, fact when we say that this boasted country of ours is not as wealthy and well-to-do as it appears to be. The great masses of our people barely eke out a living, the incomes of perhaps ninetenths of them hardly equaling their needs. Doctors naturally share in this indigence more than any other professional or business class.

To convince you that most all the people of this country are living a hand-to-mouth. existence, you will note these statements which are backed up by a reliable source of information. There are in our country about 15,000,000 of white families. Of this number, it was estimated two years ago, that there were 7,000,000 families of wage earners on a medium wage of $436 a year, and 5,000,000 farmers whose average income is about $350 a year. It is estimated that not over 2,000,000 families of the 15,000,000 make over $2000 a year. The vast majority of families in the United States, therefore, live on $500 a year or less. In consideration of the increased cost

of living the last ten years, it requires very little acumen to see that mere existence for most people is a very serious proposition. Since the doctor's business is mainly with people in the mediocre and lower strata of life, it is no wonder that many thousands of medical men see hard times. In view of the great number of physicians who hang out around the centers of population, it is only natural that a good deal of poverty should exist within our Own ranks. In fact, there is more of it than we see, for the doctor must ever give outward show of prosperity until he has permanently joined the down-and-out ranks.

There are thousands of physicians who are not positively poverty stricken, but who are compelled to live less comfortably than they would in many other lines of business or trade. This class will, perhaps, embrace three-fourths of the medical men of the country. How can doctors get on better in the world and make more money, and therefore live more comfortably?

The first suggestion we offer applies in a general way to everybody, regardless of his avocation or business. It is the old idea of living within one's income and by learning to practice a judicious economy. Doctors should more generally do their own dispensing. It pays to do so. People will more readily pay for something tangible than for a scrap of paper. Let us take cough syrup for an example. A four-ounce bottle dispensed in the office and accompanied by a few tablets will cost the patient from fifty cents to a dollar, depending upon locality. If the doctor will purchase his cough syrup in five-gallon lots he can get it for a little over two dollars a gallon. It is only the cough syrups containing codeine, heroin, and expensive drugs that come high, and, generally speaking, are no better than those costing less money. On the prescription above mentioned the cost to the doctor will not be much more than ten cents, and his margin of profit is several hundred per cent. Of course, this is

putting the doctor on a plane with the medicine seller around the corner, but after all a fellow feels more respectable with money in his pocket. The same rule applies to dispensing in a general way. The more expensive prescriptions and special drugs the patient may get procure and pay for at the drugstore. The majority of medicines are not so high as to preclude the average doctor from carrying a fair stock. Among those inexpensive and money-making drugs which he can use every day are calomel, salts, rhubarb, jalap, digitalis, aconite, Dover powder, acetanilide, strychnine, bromides, boracic acid, tincture of iron, ammonia, and many others. From an economic point of view it pays to dispense, and is not so undignified, either.

ECHINACEA.

Dr. J. C. Robinson, of Cedar, Utah, writes to the editor of the A. M. A. journal as follows:

Kindly inform me as to the real properties of echinacea. Here follows the editor's reply:

"Echinacea has been claimed to have anesthetic, sialagogue, antiseptic, diaphoretic, alterative, and several other properties. Like many other discarded drugs, it has failed to sustain the reputation given it by enthusiasts years ago; it is now seldom prescribed under its own name. In common with numerous other little-used drugs, it is finding a place in proprietary mixtures, whose manufacturers make use of the early enthusiastic and unverified reports to endow their nostrums with remarkable therapeutic properties."

Now, we would like to ask the SUMMARY readers, which reaches the rank and file of the profession, what they think of this. If you have any experience with echinacea, let us have a report; let it be pro or con.

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