to resist disintegrating forces, is not the purer product used in medicine.

The best treatment is to remove the

cause.

4. "Pot-bellied children" are both successful and unsuccessful in the conservation of life forces.

When the over-enlarged and heavily taxed liver, pancreas, stomach, and spleen, by hyperfunction succeeds, after a shorter or a longer interval, in overcoming anomalous, anabolic, and catabolic conditions of his tissues, the individual is a success in life.

Proper medical treatment will assist very materially. Furnish the child with food containing the requisite amount of lime; round out his digestive enzymes by carefully and properly selected proteid principles, such as iridin, emetine, podophyllin, juglandin, dioscorcin, boldine, etc., but never cause purgation by any one or any combination of them. Never give magnesium sulphate for laxation; sodium sulphate and phosphate are much better.

If the proteid principles mentioned are rightly used, saline laxation is seldom necessary. But the child who has an intrinsic hereditary defect in the essential life energies, goes the way of all unfits-succumbs to life emergencies.

5. "Nightmare" is a temporary anomalous condition commonly met in adolescents who are overtaxed physically and sexually.

Some of them progress in the retrograde status of health to real epileptic attacks. Every patient is a problem to be solved on his own complications.

Generally, every one of them suffers from indigestion, because their unphysiologic lives precludes normal anabolism, furnishing the right grade of catabolism, from which the digestive-ferment producing can fabricate the proper quality of digestive enzymes-pepsin, divertin, secretin, trypsinogen, erepsin, etc. Hence remove the initial causes and build up nutrition.

6. Getting "turned around" is usually a natural defect that scarcely handicaps in the ordinary pursuits of life; it is similar to the hereditary trait of always being impelled to throw oneself out of an open second or high story window.

I heard a great neurologist say that he always had to combat such an impulse; he

died at the age of 70 from cerebral hemorrhage.

7. Turpentine is an alcoholic solution of pitch. Resins are complex entities, containing two, three or more active proteid principles. These principles, under sufficient dilution and other favorable condi

tions, biochemically attack the animal structure which has its affinitive cognate prinple; the affinities of both are thus neutralized, and the attacked animal tissue is correspondingly biochemically injured.

The resulting lesion is complemented by the reparative process. Remove the initial cause and keep the lesion free from extraneous pathogenic germs.

If in a debilitated subject, treat the man and apply nuclein solution to the sore.

8. In the early years of my practice I extracted the teeth of pregnant women many times, and had no bad results.

9. Pregnancy does not contra-indicate the use of a general anesthetic when urgent. 10. When urgent, children should be medicated, hypodermically, at any age. In impending somatic death hypodermics of atropine and glonoin should never be withheld; likewise, in convulsive fits. JAS. BURKE, M. D.

Manitowoc, Wis.

REPLY TO QUESTIONS ASKED.

Editor Medical Summary:

On page 375, February issue, Dr. Burnett asks the following questions:

"There is a condition the laity call 'Nightmare,' in which the persons think they are awake and try to move, but cannot. There is no pain about it, but a very distressing sensation with strong desire to move, and occasionally they will try to call some one or make a noise. When a person is in this condition if any one takes hold of him and shakes him, the condition passes off at once. What is the cause of this condition, and what are the pathological conditions present? Will this cause death in any case, and what is the treatment for it?"

In reply to this let me state that, in general and in normal condition, dreams and nightmare are so numerous, so varied, so incoherent, that it is almost superfluous to

seek their cause outside of the associations of ideas latent in the mind, or images dormant in the cerebral hemispheres. We dream, just as we think, of all sorts of things and situations, only instead of thought, as in the waking state, we imagine that we act, etc. The difference lies in this, and as the objective mind is in abeyance and reason absent from these subliminal acts, the most extravagant situations are realized, very simply and without any surprise, as if they were natural.

Those characteristic phases may be observed in these subliminal excursions, while in the waking state an idea remains an idea, in the dream it becomes an image, and then a reality, either a person or a thing.

In this condition we personify our ideas, and we attribute to different personages thoughts and words and acts which are entirely our own. These subliminal phenomena are influenced by numerous causes outside of the mind itself. Difficulty of digestion, disturbance of respiration, the position of the body, a rustling of the bedclothes, a covering which is heavy, a chill, a noise, a light, an odor, the touch of a hand, a suggestion, hunger, thirst, general repletion, all have an effect on the subjective consciousness to produce nightmare.

In this connection may be mentioned a hypnotic hallucination, viz.: that of falling over a precipice, sliding down a staircase, of being thrown into the water, etc. It occurs generally, just after sleep has begun,

at the moment the body becomes completely relaxed. It is at this point that the center of gravity is entirely changed. It is, no doubt, this displacement of our center of gravity which gives rise to nightoften of a horrible nature. Our

mare,

attitudes in sleep tend to a passive equilib

rium.

away ternal

All the activities of the senses fade by degrees, and oblivion of the exworld arrives by insensible transitions, as if the soul-so to speak-slowly withdrew itself into its innermost recesses. The eyelids close, and the eye is soonest asleep. The sense of touch loses its faculties of perception, then it too sleeps. The sense of smell disappears in its turn. Hearing is the last to disappear, remaining like a vigilant sentinel to warn us in case of danger; but at length it also fades away. Then sleep is complete, and the world of

with all its infinite diversity. Absurd and ludicrous images of the most incongruous and incoherent character are associated together without the slightest probability or the slightest reason.

We find that some dreams are the result of habitual preoccupations, while others. are from impressions caused by physical sensations. The combination of these resultant causes is sufficient to produce nightmare in its various forms. Cases of final dissolution have been reported, caused by the effects of nightmare. A patient suffering from organic heart disease would, most likely, be launched into eternity during a sudden fall from a great height, or during a severe struggle with an opponent. Many cases of death occurring while asleep can be attributed to no other cause than the condition in question.

As regards treatment, the physician has the remedy in his hands, and that is suggestion, together with proper diet at the last daily meal. Auto-suggestion indulged in by the patient upon retiring will also put an end to the trouble, but it should be persisted in for some weeks.

Question No. 10. "What is the earliest age of children that is safe and all right to use hypodermics for children same as for adults, and what is the earliest age that they can be given at all?

In substituting the word should for "can" my answer would be, Never during childhood, and not unless absolutely necessary after childhood. Presuming that Dr. Burnett refers to subcutaneous injections of morphine, etc., for the relief of pain, permit me to state that the suggestibility of children from three years to twelve or fifteen is so very pronounced, it requires nothing more than skillful suggestions by the physician to inhibit any pain that may be

present.

C. EDWIN GOODELL, M. D.

Newark, N. J.

LABORATORY TESTS IN INFECTIOUS DISEASES, ETC.

Editor Medical Summary:

I was invited to a lecture the other even

of Pathology of Tulane Medical College, New Orleans. He opened his lecture on "Laboratory Tests in Infectious Diseases," by showing the advantage of making a more perfect microscopical test for rectal sarcoma. If you snip off a piece of the mucous membrane covering the sarcoma, the microscopist will not report a sarcoma; hence cut out a piece of the tumor proper and you will receive a positive report from the pathologist. His second subject was an "Improvement Upon the Diagnosis of Scarlet Fever." He agrees that it is caused by protozoa. To find them he proceeds in this manner: He moistens a piece of cotton the size of a ten-cent-piece with stronger ammonia water, and places it upon the thorax (or sometimes in the groin), and permits it to remain until it smarts well. Then remove it and cover the part it occupied with a thick layer of vaseline. In five minutes you will have a blebs or blister formed. To extract the serum introduce a thin aseptic pippet, capillary tube, or use a hypodermic needle for an aspirator. Place a drop of the serum on a slide, dry it, wash with methyl spirit, stain with methylene blue, and with a one-sixth or one-quarter objective you can see the protozoon. You will notice that where the protozoon is in contact with a leucocyte, that the leucocyte is indented and appears as though the leucocyte was trying to engulf it; hence that part of the leucocyte looks like a crescent. These protozoa are shaped quite peculiarly. Some look like thick flagella, some like an eggplant with a tail, and others like the rosette of malaria. In size they are as large and some larger than a leucocyte, hence no trouble to find. In closing, will say that Dr. Duval's lecture was well attended.

R. D. FAIREX, M. D. . IIIO S. Rampart St., New Orleans, La.

GASTRO-INTESTINAL INDIGESTION -QUERY AND REPLY.

Editor Medical Summary:

I have a son who has intestinal indigestion, as I call it. I will give you his symptoms as near as I can, and then I would very much like for you to make out your diagnosis and prescribe for him. His

symptoms are as follows: The attacks come on sometimes once a week, and sometimes once every two weeks, and sometimes only once a month. They usually come at night after going to bed. He gets nervous or uneasy, grunts and groans, gets out of bed and walks the floors for hours; sometimes he is up all night, and during this time he complains of having pain in his stomach and bowels. All this time he will be belching, or trying to belch up gas off his stomach. Of course, I have treated him myself, and have had three or four other physicians treat him, and he went to Hot Springs, Ark., and was treated there by a physician, and also took the hot baths, all with but little or no effect. He is rather thin, weighs about 145 pounds, 24 years old, married three years ago, and one child. He has been afflicted in this way for about four years. His appetite is fairly good, bowels somewhat constipated. He was raised on a farm, but never did much work connected with farm work. He was elected county clerk last fall; prior to that time he had been teaching school. He is temperate, does not chew or use tobacco in any form, or use intoxicating liquors. He is very careful about his diet. Now, doctor, will you please give me your diagnosis and let me have a prescription for him, and thanking you in advance for what you may do for my son, I remain,

Mulberry, Ark.

J. T. C.

[He has gastro-intestinal indigestion, of course, but his chief trouble is the formation of gas which accompanies this indigestion. This is to be combatted by diet, regulation of the bowels, judicious exercise, and the use of anti-fermentative medication. He will not make a rapid recovery under any medication, and he must consent to be patient and persistent. We think a very short trial of the following suggestions will enable you to relieve him so much that he will submit to orders and will take courage.

The constipation must be absolutely eliminated, but you must sedulously avoid those active cathartics which disorder digestion. Let him take some of the following drugs, learning by experience which one suits him best, and then adhere to it. Let him take enough, only, to secure a mushy stool once

a day. We list in order of our preference: Phenolphthalein, I to 10 grains, on retiring; extract cascara sagrada, 5 to 15 grains on retiring; Drysdale's aperient tablet, one to two tablets or pills on retiring, or night and morning. Let him drink a pint of water just after rising in the morning, and just after retiring at night. Before rising let him knead, with the clenched fist, over the line of the colon, beginning on the right side and progressing to the left, and as low down its line as possible, for ten minutes. After rising, or after breakfast, let him go to the closet and take position for defecation even though no desire is felt; do not advise "strainging," but remain on seat for at least ten minutes. After a few days of this regime he will be able to select a regular hour each day for his evacuation, and the bowels will move like clock work. When this occurs gradually reduce his medication till it can be abandoned. It is possible that you might get this same effect through the use of the rectal dilators, twenty minutes, twice daily. him on the following tablets or Betanaphthol, 5 grains, every four Crush, and follow with water:..gr. 40.

Put pills: hours.

R Strychnine

M.

Powd. black pepper,

Powd. ipecac

Powd. gentian

Oleoresin capsicum

.āā. gr. 1/3.

.gr. 2. m %.

Sig. One every four hours. Alternate these so that he takes a tablet

every two hours. This, we believe, will check this excessive fermentation.

He will know that certain foods cause him to develop more gas than ordinarily; let him strictly avoid these. Do not confine him to any rigid diet, as he can learn for himself better than any doctor can tell him what he may or what he may not eat. Let him take enough physical exercise, out-doors, twice daily, so that he will retire at night actually tired.

If he is nervous after he has been on the above line of treatment for one week, put him on the following pill or tablet every three hours till his nerves are absolutely at rest; then suspend till he needs them again:R Camphor .gr. j.

Ext. hyoscyamus,

Ext. valerian

.āā. gr. 2.

We will be glad to learn how this treat

Editor Medical Summary:

The table, in my paper on "The Influence of Climatic Conditions in the Treatment of Tuberculosis," printed in the March number of your journal, is meaningless as it stands. Evidently in my manuscript I neglected to put the proper caption over the different columns.

I give herewith the completed table which, as a favor, I ask you to print in the May number as a correction to my paper, and I ask the readers of the SUMMARY to note and ponder this comparison of climates. There is not much difference in the temperature of the different regions, but in sunshine and rainfall the difference is extreme. You doctors who have tried to treat tuberculosis in the Mississippi Valley or the Atlantic slope, note the difference in the number of clear days. At Cincinnati you have 95 clear days during the year; at Philadelphia you have 106; in Rocky Ford we have 277. To live out of doors is easy and comfortable here. If this alone were the only advantage to be obtained from change of climate, which it is not, yet if it were, it would be worth all the time and trouble and expense of moving.

TABLE OF COMPARISON OF CLIMATES.

ment "pans out."-ED.]

Le Roy, Kansas.

SOME FACTS WORTH REMEMBERING.

Editor Medical Summary:

One remedy that I have found reliable in the treatment of diabetes is the lycopus virginicus (bugleweed), the plant is the part used. From an analysis of the plant we find it contains 40 per cent. of tannin. If I have a patient passing large quantities of water in the twenty-four hours with great thirst, I give the above remedy. Take one ounce of the bugleweed (most drug stores have the pressed herb), make an infusion with it in one pint of hot water, give a tablespoonful four times a day. Dr. John King, in the American Dispensatory, says the above remedy has "cured cases of diabetes where other remedies have failed." In my own practice I have cured many cases of this disease that had been "the rounds" and failed to get any help.

In the treatment of rheumatism we are often puzzled to find a remedy for these old "chronics" that have been "the rounds" and claim that "no remedy can cure them." Take one ounce of cimicifuga racemosa, put in one pint of hot water (not boiling), let it stand for forty-eight hours, then give one tablespoonful an hour after each meal, or, if you choose, you may add one ounce of the cimicifuga racemosa to a pint of gin and let it stand three days, then give a tablespoonful one hour after each meal. This remedy is also called macrotys. Most patients like a liniment to use; they will expect it, and it will give them something to do. Let them use:

M. Sig. Rub the parts thoroughly with the above three or four times a day, and they may rub out the rheumatism in three or four days.

The above are simple remedies, but in my experience the best cures I have ever made have been with simple remedies. Those who are inclined to ignore our simple vegetable remedies should remember the words of Paracelsus: "A physician should overlook nothing; he should look down before him like a maiden, and he will find at his feet a more valuable treasure for all diseases than India, Egypt, Greece or Barbary can furnish." The

above are old remedies, tried and true, that have been tested in hundreds of cases and found reliable.

When you have a patient that complains of a hacking cough and a sense of rawness or sore feeling of the throat and chest, given him three tablets of kali mur., third decimal trituration, (potassium chloride), once in two hours, and notice how soon the cough and soreness will fade aawy. In your cases of chronic catarrh, when the patient complains of pressure at root of nose, "slugs and clinkers" form in the nose, and also a greenish discharge. They have dropping down in the back part of the throat-a stringy mucus. There is just one remedy indicated in such cases, and it is potassium bichromate, the third decimal trituration, two grains once in three hours. As a liquid for the nose, you may use:— R Sol. nitre,

.3j. ...Oj.

M. Put this in two quarts of pure water, let it stand for forty-eight hours, then filter.

Sig. Pour some of the liquid in the palm of the hand, sniff it up each nostril of the nose until it is felt above the back of the throat. Do this four times a day.

I have, in my practice, cured many cases of catarrh where they had been affected with the disease for years and could not smell anything. I have treated the worst cases in northern New England and up around the lakes, in northern Ohio. Every physician in general practice should be able to treat chronic catarrh successfully for it will add just so much to his office busiMany a fine looking young lady is afraid to get married on account of a stinking breath from catarrh, likewise the young man. If you can cure them, they will bless you evermore.

Burlington, N. J.

ELI G. JONES, M. D.

UNUSUAL CASES.

Editor Medical Summary:

A case of typhoid fever in a young girl, aged 15 years, whose illness ran the usual length of time with no complications, and extreme care taken both in the nursing and