may be given alone or with other nutriments, one to two teaspoonfuls at a time, every hour if necessary.-St. Louis Medical and Surgical Journal. Ice in the Sick Room. A saucerful of shaved ice may be preserved for twenty-four hours, with the thermometer in the room at 90° F., if the following precautions are observed. Put the saucer containing the ice in a soup plate and cover it with another. Place the soup plates thus arrranged on a good heavy pillow, and cover with another pillow, pressing the pillows so that the plates are completely embedded in them. An old jack plane, set deep, is a most excellent thing with which to shave ice. It should be turned bottom upward and the ice shoved backward and forward over the cutter. -Ibid. Leyden on the Treatment of Obesity. PROFESSOR LEYDEN, President of the Society of Medicine at Berlin, summarizes the experiences and opinions set forth in a discussion on the above subject, as follows (Der Fortschritt, from Deutsche Med. Wochensch.): I fail in concluding, from the present debate, that one method of treatment may claim a signal superiority over the others; and my own experience in practice confirms me in this view. It seems to me that all the various methods possess nearly the same merit; every one of them, when judiciously persevered in, producing the wished-for result. We certainly may regard it as a material practical progress, to be enabled nowa-days to have at our command several efficacious methods of treating obesity, of which we may select that most suitable to the nature of the individual case, being at the same time agreeable to the predilection of the patient. As a general rule, we ought to be guided by the etiology of the case; i. e. we have to withhold that kind of aliment on which the patient has grown abnormally fat. Therefore, the problem how to reduce the superfluous fat in a patient cannot be of great difficulty. The leading principles to achieve this-viz., limited ingestion of food and increased structural metamorphosis, assisted by muscular exercise, are very old, but our means of accomplishing it have enlarged. The treatment, above all, ought not to endanger the general health, and ought to lead to success without the least possible inconvenience to the patient. These two conditions form the main pivot of the present discussion. Without, however, some self-denial, the necessary abstinence cannot be carried All the various methods, notwithstanding their apparent diversity, agree in the reduction of food; and the modern limitation of liquids (Orth's method) is in fact nothing else. Some persons can more easily endure thirst, others hunger. Nor can I perceive a material indication of one method being more effectual than another. With due circumspection and perseverance, every one may finally succeed. But, at the same time, all these methods are fraught with some danger; anæmia, exhaustion, and especially debility of the action of the heart, not uncommonly ensuing after such anti-fat cures, when carried on too energetically and without discrimination. Such injurious consequences may even arise, when the treatment has been undergone with proper precaution and patience. There are many fat persons, whose proper condition of health requires a certain degree of stoutness: they will become ill and weak as soon as they lose fat. The physician, therefore, ought to consider the individual nature. Young persons, on the other hand, especially men who have grown stout from too liberal indulgence in beer or at dinner parties, will soon and without danger be reduced and brought into proper condition by due limitation of their self-indulgent habits. The selection of the method ought to depend not only on etiological considerations, but on the individualizing judgment of the physician, and partly on the preferences of the patient. And in the latter, undoubtedly, fashion plays a very pre-eminent part. No experienced physician will disregard the influence of fashion on medicine and therapeutics; fashion constitutes, I aver, a remedial agent which the physician has, in some degree, to acknowledge. Patients have more confidence in remedies which are of the fashion of the day, and more willingly submit to deprivations enforced by a treatment if this happen to be in fashion, i. e., if a number of well known leaders of society and of their personal acquaintances have accepted it. This influence of fashion we have met with in a remarkable manner in the different methods of treatment of obesity. Twenty years ago Banting's cure was in fashion, which, if used with certain rational restrictions, I still consider the best treatment. At that time persons of the better classes, who fancied or observed the slightest propensity to become stouter, adopted Banting's dietary. At present, for the same reason, they barely dare to partake of soups, and either limit to the utmost their drinks, or entirely abstain from liquids, and consider thirst a far less severe penance than any other kind of treatment. Stout people resort with good effect to mineral waters and baths, losing there from ten to twenty pounds, thus preparing themselves for the dissipa tions of the coming season. They consider it a far smaller ordeal to submit for four to six weeks to the strictest abstinence in order to indulge during the remainder of the year in every luxury of the table, than to regulate their diet and to deny themselves any gastronomic enjoyment all the year through. In concluding with a few words on the history of this subject, I may point out that the problem of the anti-fat cure is by no means one of the exigencies of modern times, but is coëval with medical science, or what in most remote antiquity passed for that. Hippocrates has laid down hygienic and dietetic rules for the prevention and the treatment of obesity, which are too well known to require further allusion. shall confine myself to quotations from Galen and Celsus. The former gives the following advice: "The best method of getting thinner. consists in gradually withdrawing from the body that whereof there is superfluity, and in strengthening at the same time those parts which had been expanded. Bodily exercise will undoubtedly prove very advantageous, as we see stout horses getting lean by heavy work. Thus, likewise, those will never grow fat who are obliged continually to toil with hard labor. This. however, requires great precaution, it being certain that fat people frequently run danger of death when attempting violent bodily exercise." Therapeutic Uses of Hot Water. DR. D. T. SMITH, says substantially, in the American Practitioner and News: In several cases of deep stupor from intense malarial fever, I am sure I have saved life in this way. In these cases, being called to patients already in such a state of stupor that nothing could be swallowed, and apparently beyond the reach of internal medication in whatever way applied, I have ordered cold water poured on the head in great amount, with the result that they speedily rallied and made a good recovery; quinine, of course, being given to remove the cause of the disease. In persistent vomiting there are few remedies, or none, so efficacious. Cloths freshly wrung from hot water applied to the stomach, iced water externally over the pharynx, and iced water or hot water frequently swallowed in small quantities, relieve the vast majority of cases of vomiting. In the convulsions of children, due to intensity of fever, the method of using it is that already described, viz., pouring it on the head. In the convulsions of hysteria it acts like magic when properly used. In these cases we have to discriminate, since the rude use of water which gives the best result can not always be resorted to. Where we have full control, as among certain indigent and hospital patients, we can relieve these cases almost instantaneously by the dashing of water from a distance upon the face and head, as if we we were bent on drowning them. A few minutes usually suffice for the relief of the worst cases. In many cases of this character, where the nervous element is prominent, the treatment seems to act by breaking up the association of ideas or emotions that have taken on a warped character and engross the attention of the mind. As a hemostatic, hot water occupies the very front rank. In menorrhagia or post-partum hemorrhage nothing else compares with it in a great majority of cases for arresting the excessive discharge. When used for this purpose it ought to have a temperature of from one hundred and ten to one hundred and twenty degrees, and be permitted to drain off freely after reaching the cervix and other neighboring parts. When applied to external bleeding surfaces it may be used of a much higher temperature, even to boiling, provided arrangements are made to remove it at once as one would the actual cautery. Thus, in the slight cuts from shaving, the corner of the towel dipped into hot water and quickly applied to the bleeding spot promptly arrests the hemorrhage. In cases of large bleeding surfaces, as after extensive surgical operations, I have not seen it tried, but, judging from current literature, it is winning a strong position as a hemostatic, even in abdominal surgery. In ulcers of the stomach, giving rise to hemorrhage, hot water is also spoken of in commendatory terms. In gonorrhoea it is an old-time remedy, and its use in dysentery is also advocated. As a diuretic we treat water as a slave. It works so kindly, so surely, and so universally that we lose sight of its virtues, and seem to say, "What merit hath it; it hath simply done that which it ought to have done." Nearly all other diuretics are something of the nature of temporary helps to it, that can often without loss be dispensed with. In the morning, when we need to wash out from the blood and tissues the ptomaines accumulated during the previous night, and which make us feel so weak, languid, and worthless, at a time when it seems we ought to be at our best, what is better than plenty of pure cold water drunk freely from the moment of first waking? In heartburn, and especially in that form in which eructations of sulphuretted hydrogen occur, there is no better course, perhaps, than to fill the stomach with water, pending other measures of treatment. In this way a patient may be able to come out in the morning fresh and comfortable, whereas, if the attack had been permitted to run on through the night, a week would have been required for the stomach to recover its normal tone. In isolation, cold water, applied by means of the most abundant affusion, stands unrivaled. Lead Colic. DR. FRANCIS W. CAMPBELL, in an article published in Cambridge Medical Record, concludes as follows: Treatment. Is palliative and curative. Relieve pain by morphia, by mouth, bowel or hypodermically-warm fomentations to the bowels, followed by hot linseed poultices over the abdomen, on In frost bites, and mild burns also, it which tincture of opium has been is of great efficacy. As a laxative water has no equal for persistence of effect and freedom from untoward after results. In this trouble the patient should begin on first waking in the morning, and drink from time to time as the stomach will bear until breakfast, or as experience teaches it to be necessary. When food is taken into the stomach, and the flow of gastric juice begins, the absorption of water in a measure ceases, and in large quantities it will then prove harmful. For local inflammations, especially after injuries, water stands almost alone. After dislocations or severe sprains or bruises, it is my custom to have a large vessel, usually a bucket, with a hole made in or near the bottom, swung so as to permit a stream of water to pour constantly on the injured part, using water as hot as it can be borne with comfort. In warm weather, however, and in injuries of the extremities, it may often with advantage be used cold. In this way I have seen a case of dislocated patella recover without perceptible swelling. In swelled testicle I employ the same treatment. I was once called to treat a physician who had been thrown forward on to the horn of his saddle, resulting in a severe case of swelled testicle with excruciating pain. Arranging the apparatus as described, in a few minutes, with the hot water, he had relief, and then speedy recovery. sprinkled. A mixture of chloroform and laudanum, applied night and morning to the bowels, is said to be very effectual in giving relief. Have the bowels move freely, and as they are constipated active cathartics are necessary; the most active advised is croton oil, in a dose of two drops; compound powder of jalup is useful; so, also, is sulphate of magnesia, in doses of 3j., every two hours, in one-half pint of water, until free dejections are obtained. Purgatives are useful in removing from the system the lead contained in the contents of the bowels. A drachm of dilute sulphuric acid in a quart of sweetened water, should be taken in the twentyfour hours. It is advised that this kind of lemonade might be used at meals by lead workers, as at this period much lead is thought to be introduced into the system. It would form an insoluble compound with any lead entering the stomach. Its efforts for good are said. to have been tried and not found wanting at the large lead works at Birmingham, England. The great remedy for getting the metal out of the system, which is the object to be aimed at, is the administration of iodide of potassium, a soluble iodide of lead being formed, which passes away in the urine and other excretions. Its use is not empirical, for cases of lead poisoning under treatment, by iodide of potash, have shown lead in the urine when it was not present previous to the administration of the remedy. Clinical observation has also given good proof of its efficacy, as I hope it will in the cases now before you. It is best to begin with a minimum dose of five grains three times a day. It should be gradually pushed till twenty grains three times a day is taken, if the system will stand it as it very often will. The sulphurated or sulphur bath is useful. It is made by putting iv. of the sulphuret of potassium to thirty gallons of water in a wooden tub. The lead appears on the skin as dark discolorations, which can be removed by a brushchange of occupation may be necessary; for the paralysis of the extensors, electricity in its different forms, such as local faradization and galvanization. Strychnia is very useful in this form of paralysis. The powerful effect which strychnia has upon the excitability of the nervous system, and the admirable results which have followed its use in. other forms of paralysis, forces itself on our attention here. It may be employed hypodermically. It is a drug, however, which must be given with great caution, and its effects watched, for its efforts are various on different persons. Certain Points in the Diagnosis of some of the Infectious Diseases. DR. E. G. JANEWAY, in a paper read before the New York County Medical Association, said: particularly scarlet fever and measles, or for purpura hæmorrhagica. A most important question in a doubtful case was, Had there been any exposure of the patient to a disease which might manifest itself in this way? Had the patient visited a strange place, had he been getting new clothing, had a stranger arrived in the neighborhood? Special inquiry should be made as to whether there had been any exposure about fourteen days before the disease developed. The author cited a case of purpuric variola seen in consultation in which the symptoms were obscure and the patient's physicians had scarcely taken the possibility of small pox into consideration. On careful inquiry it was found that the contagion had come from a patient in another town who was nursed and buried publicly through the interest of some charitably disposed ladies. One of the physicians acknowledged that he had never seen, nor even heard of, this form of variola. The case in question established the importance of three facts in making a diagnosis in a case of malignant small pox: 1. The importance of learning the nature of the disease from which this malignant case, not possessing in itself positive features, had developed. 2. Should the patient be dead, this might be learned by investigating others exposed to the original case; these, perhaps having a milder form, might manifest the more characteristic symptoms of the malady. 3. The result of exposure to the malignant case might give a clue to its nature. The cases of malignant small pox which. Dr. Janeway had seen had proved fatal about the fifth day of the disease. One of the best safeguards against an error in the diagnosis of small pox was to bear in mind a classification of the varieties as dependent upon the symptoms. One of the most important forms of the disease, and one in which an error in diagnosis was liable to take place, trated the importance at times of making was the hæmorrhagic, or purpuric. an autopsy in order to decide upon the This was often mistaken for a malignant nature of the disease. The case had type or other infectious diseases, more been reported while he was a member Another case was cited which illus |