of local infection furnishes the most rational explanation of the sequence of symptoms.

Granting this, we have two purposes in treatment in the early stages of diphtheria:

tion of trypsin may be sprayed into the nose or larynx.

After several applications of trypsin within the hour, a still further attack may be made upon the local disease. Having used more or less freely most of

2. To increase the power of resistance in the general system to infection. In dealing with the false membrane all measures which would tend to irritate or injure the air passages, should be avoided. There should be no tearing away of the exudation, or application of caustics-nor do I think that, except in cases where there is only a small, well defined patch of membrane, the use of the galvano-cautery will prove expedient. To prevent absorption, not only should we avoid making new abrasions in the throat, but I have thought it wise, as far as possible, to cover up those that already exist.

First of all, it is well to remove from the naso-pharynx, or pharynx, if that be the site of invasion, whatever of accumulated mucus and débris there may be. This may be readily done by means of a small syringe, and a weak solution of salt water, or of Lysterine. This may be used either through the nostril or directly in the pharynx. To loosen the attachments and hasten the resolution of the diphtheritic membrane many means have been advocated.

When the patch can be reached, a solution of papayotin may be applied; or better still, one of trypsin. This last used in solution, as suggested by Fairchild and Foster, or still better, a few grains with one or two of bicarbonate of soda, made into a paste with water and spread upon the diphtheritic patch, is the most rapid solvent I have known. If the local disease is beyond the reach of such an application, an alkaline solu

tics commended in the treatment of diphtheria, I have abandoned all else for a solution of equal parts of the tincture of the chloride of iron and glycerine. I have cause to consider this, when well applied over the entire extent of the diseased surface, an almost complete bar to the progress and absorption of the diphtheritic virus.

1. If the potency of the disease lies in the rapid multiplication of bacteria, so strong a chlorine solution is certainly indicated.

2. If absorption takes place through the abraded surfaces and "mouths of lymphatics open," as stated by Oertel, we would from a priori reasoning, expect some good from the local use of iron, while the glycerine may be something more than a mere vehicle, in that it may by affinity relieve to some extent the turgid capillaries of the mucous membrane. The application should be made frequently.

Let me say, in urging the efficacy of this agent, that for two years I have not seen a case of diphtheria die where the whole of the false membrane could be seen and repeatedly covered with this. solution and where appropriate general treatment was given. Thrice within the last week, and many times during the past year, I have seen the characteristic membrane shrivel up and become detached under the influence of the iron and glycerine.

When the local attack is out of reach of the direct application by means of the brush, or better still, the cotton covered probe, the case is very different.

When the invasion is in the nasopharynx, or in the larynx, the result may well be dreaded. Even in such instances I believe the best procedure is to apply the iron locally by spray and where possible by the cotton covered probe.

The covering in of the diphtheritic patch with tolu varnish, as recommended by Mackenzie, may follow the thorough use of the iron solution, and is doubtless protective.

Not only is local treatment important, but it is important to institute it early. The physician should be called at once in every case where there is a doubt. Parents should feel that they are responsible for delay, and that delay is exceedingly dangerous. Many cases that during the first twenty-four hours are easy to treat and curable, are a little later beyond the reach of the most skilful.

A few words as to general treatment. Here, too, I have no sympathy with halfway measures. First of all, in every case, I nearly always counsel the administration of enough of calomel and soda combined to thoroughly evacuate the alimentary tract. It empties the canal of any accumulated material, it stimulates important secretions, and with Ritter, though not to the extent to which he advocates it, I believe it has a favorable influence upon the general condition. At least it clears the decks for action. As soon as the bowels of the child have been well moved, and sometimes not waiting for that, the internal use of the iron and glycerine solution (the same as that used in the throat) may be begun; for we need not fear any chemical reaction. To show that others are falling back upon this well known agent, let me quote from an editorial in a recent issue of the New England Medical Monthly: "It is interesting and somewhat gratifying to note that after each excursion into the

domain of experimental medicine, the profession invariably returns to the older and more effective method of treating diphtheria, which consists of tonic doses of the tincture of iron and a system of extreme nourishment."

To anticipate and antagonize general invasion, the general as well as the local treatment should be instituted early. Where the symptoms demand I prescribe two drops of the iron and glycerine solution for each year of the child's age, in a little water every two hours, and midway between each dose the diphtheritic patch is to be touched or sprayed with the solution. Thus there is an opportunity for the ferric solution to be brought in contact every hour with so much of the diseased membrane as is in the pharynx.

I have not discussed much of the poly-treatment of diphtheria as practised to-day-nor have I time to outline the emergencies which may arise, as I had thought of doing. My object has been to propose a plain and direct method of treatment which any one may use and which is not an experiment.

Many other remedies are often to be added. Pilocarpine, when the skin is dry and there is spasmodic laryngeal contraction; quinine, when the fever is excessive; steam from slacking lime when respiration is labored and the respiratory tract dry; and tracheotomy or intubation when the larynx is greatly obstructed.

Let me, in conclusion, suggest that the physician demand of the people among whom he practices, that they call him at once when suspicious symtoms are observed, and that he answer quickly, act promptly, and see that his instructions are implicitly, obeyed. To treat diphtheria is to fight a battlethere should be no delays, surprises nor compromises.

and hence have properties similar to those of burdock.-Medical and Surgical Reporter.

Mental Disease.

There was no longer any idea of employing the leaves and flowers, whose chief constituent was tannin. The seeds do not contain tannin, but 25 per cent. of a fixed oil, separated by benzine, but slightly soluble in strong alcohol and still less in 60 per cent. alcohol. It deposits, from time to time, crystals whose reaction is neither that of an acid, an alkali, nor a glucoside. On treating the seeds with 60 per cent. alcohol, a liquor results, which yields on evaporation a gummy, resinous extract in proportion of 12 per cent. of the seeds employed.

Dr. Tripier prescribes ten to forty drops of the tincture. He also uses about one-fifth of a grain of the alcoholic extract, combined with three-sevenths of a grain of aloes against constipation.

These pills do not congest the bowel, and hence do not have the tendency which aloes alone has, of producing piles. Aloes alone in the quantity given, would be useless against constipation, and its action in the present instance is due to the Mary-thistle extract which stimulates the liver, and the excessive secretion of bile therefrom resulting produces the desired effeet. Mary-thistle seeds are hence of value in liver and spleen diseases and their consequences,

DR. J. POHL-PINCUS, of Berlin, has recently in a brochure entitled "Polarized Light as a means of recognizing Irritable Conditions of the Nerves of the Scalp," announced that by an examination of the hair roots by polarized light peculiar changes may be observed whenever the patient suffers from physical irritation or mental excitement. This statement is the result of investigations which have now been going on for twenty-five years, and the later observations in the course of the research have uniformly confirmed those made earlier. The hair bulbs are divided into three groups, as follows: Group A: If, in healthy conditions of the body and mind, the hairs that fall out daily are examined microscopically by polarized light, the enlarged bulbous end of the root will show a white contour, and a yellowish or brownish-red centre. Group B: In all irritable conditions of any organ, also in emotional disturbances of moderate grade, without any apparent bodily disease, the bulbous end of the hair root increases in length and breadth (in proportion to the irritation), the central part appears under polarized light of a violet, blue, or bluish-green color, separated from the white contour by bands of yellow and red. Group C: In higher grades of bodily disease or mental disturbance, the bulb becomes still larger, and the bluish centre changes to green, yellow, or orange. A few hairs of the B and C types are found in normal conditions, especially in those more advanced in life. Dr. Pincus gives thirty-one cases showing the effects of painful disease, but more especially of