Prof. King's Manual is well adapted for the purposes for which it has been prepared. It fills the requirements of a text-book for students on obstetrics better than the majority of works of the kind with which we are acquainted. As evidence of the high esteem in which it is held, is the fact that it has reached a fourth edition.

Editorial.

THE POISONOUS EFFECTS OF NICOTINE.-The evils of tobacco-smoking have once more been terribly illustrated in the case of a woman residing at Reading, Pa., who died recently. She began smoking at the age of ten, and continued to indulge in the vice until she died. How long she might have lived if she had never contracted the habit of using the weed, it is difficult to say. Under the circumstances, she brought herself to a "premature grave" at the age of 102. Who can say that she would not have attained to the age of 150 years if she had left tobacco alone?

LA GRIPPE-INFLUENZA. -All of our readers have learned through the newspapers that a peculiar epidemic affection, having originated in China and traveling westward, has spread over all Europe and probably has reached this country. At the time of our writing it has not reached Cincinnati, although it may be prevailing here, in epidemic form, by the time the present number of the MEDICAL NEWS reaches subscribers.

The Grippe-La Grippe-Russian Grippe-Epidemic Influenza is a disease that is produced by a peculiar microbe. The microbe, it is stated, is readily seen by a first-class microscopic objective of high power. A good quarter inch objective, of 140° angle of aperture, assisted by the amplification of a deep eye-piece, no doubt will exhibit it. Certainly an eighth or tenth immersion, with a B eye-piece, will demonstrate its presence clearly. We understand that, in order to show it satisfactorily, there is not necessary the complicated coloring processes that are required to exhibit a bacillus tuberculosus. All the preparation needed is to spread thinly a very little nasal mucus upon a glass slide and place it under the objective.

We learn that the microbe is of a peculiar character and

very active in its movements, differing in that respect from the one in tuberculosis, which is motionless. This being the fact, there should be no difficulty in diagnosis; for the presence of the peculiar germ would settle the question at once whether or not a disease was La Grippe. As in all other epidemic maladies, some constitutions are more affected than others; but this differs, it is stated, from all extant epidemic diseases, with the single exception of dengue, in its power of reaching a great part of the population within a few days. It runs its course in any place it visits within a short time, sometimes in a week or two, and then passes on to some other place.

The onset of the disease is said to be as follows: The person affected complains of a muscular aching, with sensations of shivering or rigors, though the temperature is above the normal, as shown by the thermometer. Pyrexia of more or less severity follows. In light cases this will be noticed only at night, though generally, during the day, some acceleration of pulse will be observed with slight increase of temperature. In severe cases the thermometer will register 103° or more, especially at night. These symptoms continue from forty-eight to sixty hours, when often a profuse diaphoresis sets in. It should have been mentioned that during the progress of the disorder, beginning at the start, more or less headache is usually complained of and soreness of the throat. The mucous membrane of the nasal passages, even up into the frontal sinuses, becomes congested or subacutely inflamed, attended with sneezing and a constant discharge of a thin mucus.

In some cases cough of a hacking character is present. There seems to be a tendency for the soreness of the throat to find its way to the bronchial tubes. In such instances the continuance of the disease becomes greatly protracted. Not unfrequently pneumonia supervenes, and the prognosis becomes serious. Exposures to wet and cold and to an unhealthy atmosphere may develop pneumonia or acute bronchitis of a grave character. Though the epidemics in most places are generally light, and very few die from the effects, yet here and there-in cities, especially, where there are very many poor crowded together in unwholesome tenements, and there exist other unfavorable conditions-La Grippe assumes a very serious character, and is attended with a large mortality. We have heard that in some cities typhoid fever, as well as pneumonia, very often results.

All through the affection there is said to be a general feeling of mental and physical depression. Sometimes the throat symptoms and cough will not be marked, and instead there will be severe abdominal pains. Probably in such cases typhoid fever is more apt to occur. Along with the abdominal pains sickness of the stomach is often present, and a rash spreads over the surface of the body.

It is stated that the stage of incubation is about three days. It is not contagious like smallpox or measles, but as are cholera and typhoid fever. When it appears in a place, it spreads through epidemic influence, and residents are liable to contract it whether they are exposed to cases or

not.

La Grippe is to be treated on general principles. The main effort should be to ameliorate the symptoms and protect the disease against complications until the microbe ceases its existence. Evidently its life is limited from one to three days. When the symptoms continue over seventytwo hours, they are not the result of the continuous actions of the germs, but follow upon the lesions that have been set up. There are no specific remedies. In other words, there are no medicines at present known with which the living organisms can be destroyed at the outset. For the headache and fever antipyrine has been found useful, and is largely prescribed. We read a few days ago that it is used in Paris by the ton. Quinine is said not to be of much value. Tr. aconite root, tr. veratrum viride, and tr. belladonna are said to be useful in lessening the pulse and diminishing the heat. We can readily understand that they would be useful. Of course, if pneumonia or typhoid fever complicates a case, the treatment must be according to the symptoms that present themselves.

Recent dispatches say that the disease is abating at Co.penhagen. It is stated to be spreading at Cassel, and many physicians have been attacked. At this place it is compli

cated in many cases with pneumonia.

It prevails to a great extent in London, and is increasing in Vienna. The mortality here is large.

The Marquis of Salisbury is said to have the Grippe in a severe form. The Queen is stated to have sent Sir Wm. Jenner to attend him.

We learn that it is thought the epidemic is prevailing in New York. Dr. Bryant, of the Board of Health, has issued the following bulletin: "The increased death rate of the

diseases unfavorably influenced by the prevailing epidemic of influenza, emphasizes the importance of the employment of physical care on the part of all, healthy and diseased alike. Exposure to the influences of extremes of temperature should be avoided, especially by the aged and those who are afflicted with pulmonary disease. Persons suffering from colds or from suspected influenza should seek medical advice at once. The aged and infirm should avoid, as far as possible, personal contact with those already afflicted with influenza.

Large numbers of the police force in New York are said to be suffering from influenza, and are too sick to perform duty.

REDUCING FAT.—Mr. Davies, in his work on "Foods for the Fat," says that two rats, weighing 12 oz., were placed on an exclusive diet of lean meat and water. They remained healthy in appearance, but steadily lost weight, and in a month's time weighed only 834 ounces. They were now placed on a miscellaneous diet, and in a week's time weighed 121⁄2 ounces.

BOOK ON THE PHYSICIAN HIMSELF. This is the title of a work we noticed among the Book Notices of the MEDICAL NEWS a few months ago. Our notiee of it was briefer than we desired on account of want of space. But though we refer to it now, it is not for the purpose of describing it more in detail, but to express the regret that the moral principles set forth in it are not better understood among physicians and observed. A great many physicians, we feel sure, do not keep in mind the declaration that "whatsoever a man soweth, that shall he also reap." If they did, they would often hesitate to commit an act of injustice against others of their profession, for the reason expressed as follows by the author, Dr. Cathell: "Any one upon whom you encroach in an unprofessional manner will feel himself justified in retaliating with your own weapons, and you will reap a crop similar to the seed sown. Whenever you sow a thistle or a thorn, you will reap thistles or thorns; whenever a wind is sown, a whirlwind will be reaped; whilst the sweeter seeds sown by others will be yielding to others sweeter fruits. Away then with all that is unethical." Away, also, we advise, with all secret, undermining conduct. If preferment can not be obtained by merit, go with

out it. We advise every medical man to obtain a copy of Dr. Cathell's "Physician Himself," and both read and study it.

SULPHONAL. This drug is exciting a great deal of interest in the profession at this time. It was discovered by Prof. E. Baumann, of the University at Freiburg. Its physiological actions and clinical uses were first examined by Prof. Kast, who is a member of the medical faculty at Freiburg University.

Dr. Wile, editor of the New England Medical Monthly, pronounces it a reliable hypnotic, which has none of the peculiar effects of the narcotics on the nervous and circulatory systems. Also, he says, it has no injurious secondary effects, and may be taken in proper doses with impunity in order to produce natural, quiet sleep.

Our experience with sulphonal probably has not been so great as Dr. Wile's, yet so far as it extends it is confirmatory of his experience. We have found that it seldom fails to produce sleep. We have prescribed it in wakefulness in hysterical cases and in cases of insanity, and have found, in nearly all of the cases, that it promptly caused sleep. In no instance, as sometimes happens with opium, morphine, hydrate of chloral, etc., did it increase the insomnia, or produce any unpleasant effects upon the nervous system. We were recently called to attend a lady who informed us that she was in the habit of taking ten grains of sulphonal every night, just before retiring to bed, in order to cause sleep. She said she had contracted this habit several months before our seeing her. There were no indications of its having injured her health. We have urged her to discontinue the drug, but as she can not sleep without it, as she states, she continues taking it in violation of our remonstrances.

It is insoluble in water, and is absolutely free from taste or smell. With very sensitive patients this fact is of considerable advantage.

Prof. Kast published the results of his experiments with sulphonal in the Berliner Klinische Wochenschrift, No. 16, 1888. Our friend, Dr. Wile, translates as follows: "He gave the drug to twenty healthy persons, after having convinced himself of its relative harmlessness by experimenting on dogs. These had demonstrated a decided physiological action on the gray cortex of the cerebrum, inducing sound, natural sleep, without any disagreeable after-effects. The