Small crusts are formed which should not be removed, but allowed to fall off naturally.

battery, a rheostat, a milliampermeter, a needle holder drawn.
with fine needle, a sponge, electrode and a pair of epilat
ing forceps. Any good galvanic battery of about 20 cells
will answer. The needle used should be very fine, of
flexible steel. The needle holder need not be arranged
with an interrupter, but if it is made so that the needle
can be set at different angles it will be a great conven-
ience.

A magnifying glass can also be used, but if one has good eye sight it is better to get accustomed to do the work without lenses. Place your patient in such a position as to secure the best light. Then put the sponge electrode in the patient's hand. The needle is then carefully inserted along the hair into the follicle, and the current is closed by the patient grasping the sponge electrode with the hand. A current of from to 2 milliamperes is necessary from about fifteen to thirty seconds. If the hair is seized with the epilating forceps it will come out without any resistance. If the hair can not be removed without resistance or pain, it shows the papilla has not been destroyed, and the needle should remain and the current allowed to pass a little longer. No more than 50 hairs should be removed at one sitting, for the work is very severe on the eyes. The hairs should be removed as far apart as possible to prevent sloughing. After the operation a soothing or slight astringent application can be applied and the parts bathed twice daily with hot water.

Warts, small wens and small fibromata of the skin can be readily removed by electrolysis without leaving scars or disfiguring the patient. It is best to use the negative pole for the needle. The operation is not very painful. A needle holder with a sharp needle must be used and inserted through the base of the tumor. The growth can be transfixed in various directions and a current of from two to six milliamperes may be used for a few minutes each time. The tissues turn pale and frothing occurs around the needle. The growth turns a brownish color, and then dries up and drops off in about ten days, leaving a slightly discolored spot which assumes its natural color in a short time.

If one operation does not have the desired effect it can be repeated in from two to six weeks, after we are satisfied as to result of our work. The skin will be somewhat different from normal, but in time will gain a normal appearance.

Nevus pigmentosus, or pigmentry moles, vary in size from the head of a pin to areas, covering large surfaces of the skin. Sometimes they are covered with hair or bristles. Of all facial blemishes this class of deformities are the most annoying to those afflicted with them, as they attract attention and excite unfavorable comment, and in most cases it is a matter of solicitude on the part of the person affected to get rid of the trouble. The object in operation is of course to remove the abnormality and not produce a greater deformity. This we can do by electrolysis better than by other means. This treatment is under perfect control, and the only objection that can be urged against it is that it takes time, but the object to be accomplished with the results attained, justify any amount of labor. If the mole is covered with hair, they should be removed as directed in treatment of superfluous hair. Then use a current of about five milliamperes, using it carefully, not to use it too strong. For the negative pole use a needle holder fitted with a large sponge. The needle is then passed through the mole on a level with the skin. Small bubbles of hydrogen will escape, and the mass turn white along the course of the needle. The needle can then be inserted at different points until the whole growth has assumed a blanched, frothy appearance and of soft consistence. This will dry up and drop off in a short time, leaving the spot covered with thin skin, slightly discolored, which gradually assumes the appearance of the surrounding tissue. The operation is not vety painful, and there are few people who would not undergo much more pain pain to be cured of these unsightly blemishes.

Diseases of the skin that attack the face, such as eczema, acne and others, are treated by electricity with. gratifying results, but as it would be too lengthy, I have devoted myself to permanent blemishes.

Scars from ulcers, small pox, and thickening of the skin can be greatly improved by galvano puncture.

Nevi of all kinds, such as wine marks, fire-marks, strawberry marks, spider-cancer, ginger snaps, bats, moles, etc, can be removed by the galvanic current. In nevus vasculosus the treatment consists in using an electrode consisting of fifteen to twenty needles very fine and sharp pointed. The strength of current is best judged by the action on the parts, but a battery of fifteen to twenty cells should be used The object of Free Medicine and a Pound of Tea.-There this treatment is to cause an inflammation which will is an enterprising firm in London, says the Medical acclude the lumina of the capillary vessels; and in this Record, which offers to its customers groceries and other way stop the nourishment of the parts. Where the area material comforts for money, while medical opinions is small a single needle can be used with excellent re sults. The needles are passed into the skin firmly and are thrown in for nothing. This, we had supposed, was a distinctly Chicago idea. At any rate, it is rumored quickly, and the negative current passed through about that we shall have in this city before long a grand fiteen to thirty seconds. The skin around the needle bazaar, run by a Chicago firm, where all kinds of goods will swell up in wheals and turn white. This condition, will be sold, and where medical men will be in attendhowever, soon passes away after the needles are with-ance to give free advice to the customers.-Med. Rec.

MEDICAL REVIEW.

EDITORIALS

L. T. RIESMEYER, M.D., EDITOR.

DEPARTMENT EDITORS:

DR. F. J. LUTZ, General Surgery.
DR. W. B. DORSETT, Gynecology and Obstetrics.
DR. E. C. RUNGE, General Medicine.

PUBLISHED UNDER THE AUSPICES OF THE
MEDICAL REVIEW ASSOCIATION
BY O. H. DREYER.

YEARLY SUBSCRIPTION, $3.50. SINGLE Copies, 10 Cents.

For the sake of truth, however, it must be stated that these mistakes are also apt to be made by people of dissolute habits, and that it is not always learning which creates a predisposition to absent-mindedness. Worry and despondency, cares and anxiety, and other factors might be enumerated as causing that preoccupation of the mind known as absent-mindedness.

The mistake we have reference to consisted in the administration of a dose of corrosive sublimate in place of sulphate of magnesia. Equally serious mistakes have been made time and again, and we vividly recollect an accident which, years ago, occurred in London. A druggist had given a baker arsenious acid instead of cream of tartar, and this poison was made use of in the baking of bread, the consequence being an arsenical poisoning of many individuals.

The morphine receptacle has more than once been grasped by absent-minded and hurried druggists in TO CON TRIBUTORS AND CORRESPONDENTS. place of quinia, and many similar accidents might be quoted. These mistakes are avoidable and need not All letters whether intended for publication or not must contain the writer's Lame and address, not necessarily for occur. They are in many instances not so much to be publication. No attention will be paid to anonymous com- attributed to the negligence of the unfortunate individmunications. uals who happen to make such mistakes, as to the inSecretaries of medical societies will confer a favor by keep-completeness of our laws. ing us informed of the dates of the meetings of their respective societies, and of officers elected.

Members of the profession who send us information of matters of general interest to our readers will be considered as doing them and us a favor, and we shall take pleasure in inserting the substance of such communications.

Communications, Medical Books for review, and all letters containing business communications or referring to the publication, subscription, or advertising department of the REVIEW, must be addressed to O. H. DREYER, Publisher 112 N. 4th Street, St. Louis.

It is high time that a law should be enacted, as it exists in some of the European countries, to keep all the more dangerous poisons, such as arsenic, strychnia, prussic acid, the salts of mercury, morphia, opium, chloral, etc., in a poison-cabinet. Such a cabinet should have two doors, each being marked with a large "skull and cross-bones," and both doors should be required by law to be kept locked. After dispensing a strong poison of any kind the law should direct that the bottle or jar containing it must at once be returned to the poison

Entered at the St. Louis Postoffice as Second-Class Matter. cabinet and both of its doors locked. Neglect of these

Preventable Mistakes of Druggists and

Nurses.

A recent serious mistake entailing the death of two patients, was made by a nurse at the City Hospital, and has created quite a sensation in this section of the country.

As a rule the average citizen is not very charitably inclined towards the person who has made a fatal mistake, no matter how much such persons may deplore the accident themselves and may have to suffer from its consequences.

rules should be adequately punished. Under the existing condition of affairs, dangerous mistakes on the part of hospital-nurses and druggists are bound to occur from time to time and we hope that the State Legislature will be interested in this question and see to it that the proper laws be enacted to squelch the nuisance in drug. stores and hospitals of keeping poisons and harmless articles on the same shelf.

Maragliano's Serum.

Nothing is so liahle to bring into disrepute the experimental efforts of physicians as the hasty publication and indiscriminate, broadcast promulgation of incom plete researches and unproven theories.

If, after the conclusion of a series of accurate experi ments, certain and definite scientific results have been obtained and these results are published in a medical

It is a notorious fact that mistakes where a receptacle containing a deadly poison is mistaken for another containing a comparatively harmless remedy, or where the first is grasped absent-mindedly instead of the second, are occasionally made by most learned men, who, in consequence of intense application to studies are some-journal or read in the form of a paper before a repretimes guilty of an unfortunate momentary absentmindedness, which may be wanting in less educated or absolutely illiterate persons. Such mistakes do not infrequently seriously undermine the happiness of the person who has made the mistake.

sentative body of physicians, with a view of interesting other investigators in the matter, so that the results ob tained may be verified and approved or, as the case may be, rejected, no fair minded person will ever censure such a procedure. But when such experiments are

Superstitions About the Microscope.

lacking in this precise scientific procedure and are made sary, mysterious secrecy the distinguished Genuese in a manner which is open to just criticism, or even in Professor exposes himself also to just criticism. in a negligent manner, and when in addition to this the results of experiments are prematurely published in several medical journals at the same time, not to speak of its advertisement by the daily press, under such cir cumstances the author of the publications can not be surprised if the initiated portion of the medical profession manifests an indifference and skepticism with regard to the value of such publications which, at the present time, finds expression in the severe criticisms regarding the publication and subject-matter of the paper read by Prof. E. Maragliano at the recent meeting of the British Medical Association.

Maragliano has been accused of publishing this paper bearing the highly promising title: "The Healing of Tuberculosis of the Lungs by Means of the Tuberculosis-Healing Serum" in diverse medical journals and, moreover, the inaccuracy of procedure in his experiments has become the subject of severe censure and criticism.

The publication of his paper in the Berl. Klin. Wochenschrift, No. 32, 1895, we have before us, and we must say that in spite of the criticisms which we have read with regard to the shortcomings of the paper, in a scien tific sense, it is the best and most scientific article, on the subject of serum-therapy in tuberculosis, that we have read, and that the method of procedure in his experiments is not absolutely worthless is also evidenced by the fact that his paper is not entirely ignored by men, who have had experience in similar researches.

Maragliano claims that his serum, which he obtains from dogs, horses and asses, which have been injected with the "toxic principles" of tuberculosis, when mixed with "tuberculin" and injected into guinea-pigs, prevents the reaction set up by the latter. The digest of his claimed results in consumptive patients may be expressed by saying that circumscribed tuberculosis of the lunge, uncomplicated by secondary infections, does temporarily get well upon the use of the serum.

At a recent meeting of the St. Louis Microscopical Society one of the younger members, who is teaching histology, but who is still unsophisticated as to what is sometimes expected of microscopists, related the following incident as a sample of naiveté of some medical practitioners when it comes to the judicious and unprejudiced appreciation of the merits and achievements of the microscope.

A physician had sent him a vial of purulent fluid, which had been gathered during the operation of a tumor of the breast, with the request of examining the liquid microscopically in order to determine whether the tumor was a carcinoma.

Similar requests are, in our experience, by no means infrequent. Some surgeons, and not only obscure ones, will remove with a curette a few cells of the mu cous membrane of the uterus and expect of a microscopist to make an examination of the removed tissue and report whether the affection of the organ is of a malignant or a benign nature.

We have compared similar requests to the question of a student (?) of anatomy, who asked the demonstrator, after removing a piece of a nerve-trunk, "Professor, what nerve is this?"

Such occurrences, of which most histologists can cite parallel cases, form one of the arguments for the neces sity of a microscopic training of all physicians, at least in a sufficient degree that the possibilities and impossibilities of an histological diagnosis are properly understood and appreciated.

While the very energetic use of a sharp curette may occasionally remove pieces of tissue large enough to exhibit the characteristic structure of a neoplasm so that a positive diagnosis can be made, the cases in which the tissue removed with a curette consists of a pell mell of tissue elements, without any indication of its architecture, are so predominating that the diagnosis based upon its examination is practically worthless. Such examinations, although they may in rare cases furnish presumptive evidence which, in connection with the clinical

Where Maragliano exposes himself in his experiments to just criticism is that it is acknowledged to be one of the most important axioms, a condition sine qua non, in serum-therapy to endeavor the immunization of suscep tible animals against the toxin of the respective disease before an attempt is made of securing a "healing action" of the serum. For, according to all previous experi- manifestations of disease, may lead the surgeon to arences in serum-therapy, an immeasurably greater quantity of the serum, or a much more effective serum, is necessary, in the majority of diseases, to "heal" animals than to immunize them against the respective toxins.

rive at a conclusion as to the necessary therapeutic procedure, are apt to bring microscopy into miscredit. The removal by the curette of an abundance of epithelial cells or young connective tissue cells may lead a microscopist to suspect a carcinoma or a sarcoma, but a surgeon has no right to perform a radical operation upon such a mere suspicion, when it is an easy matter for him to remove a wedge-shaped piece of tissue large enough to make an exact histological diagnosis.

Judging from the symptoms, produced by Maragliano's serum, and from its method of application, it contains, in all probability, not an antitoxin, but a toxin. Moreover, Maragliano neglects to give a description of his procedure of separating the toxins with which he injects the serum-yielding animals, and only states that The neglect of insisting upon similar requisites for he uses toxins obtained from dead tubercle bacilli cul- the purpose of arriving at a decision based upon an histures. By this, at the present time apparently unneces-tological examination, as well as hasty examinations

and the hasty expression of opinions are often detri crobic origin of tumors, as being devoid of experimenmental to the proper estimation and appreciation of tal and clinical proof, he says: "Should future research microscopy. Surgeons will sometimes ridicule the demonstrate a direct causative relationship between cer diagnosis of sarcoma by a microscopist, because the tain as yet unknown bacteria and the growth of some of neoplasm rapidly improves under mercury and iodides; if they have themselves a passable knowledge of practi cal histology, they will readily see how such a mistake may sometimes happen. These errors are not so apt to occur if the histologist has a properly prepared speci men and sufficient leisure to make a thorough examina tion. But such examinations require a familiarity with the subject, which it takes years to attain. They take up much time, have great practical value and should be well remunerated.

There are few works specially devoted to the pathology and treatment of tumors, and in text-books and systems of surgery this subject does not receive the exhaustive treatment which it deserves. It has, therefore, been a happy idea of Professor Senn to write this book. The usefulness of a treatise of this nature written by an author of Senn's experience, needs no pointing out to the clinician, and in perusing this work we find, what was naturally to be expected, that it contains a relation of many practical diagnostic observations, which are presented in a clear and comprehensible language. That, from an histological point of view, the object is not exhausted is rather an advantage than a disadvantage for a practical treatise of this kind. For clinical purposes, for which the work is evidently intended, we do not know of any treatise that could take its place, and teachers, students and practitioners will find in the work an up-to-date presentation of the subject of the pathology and surgical treatment of tumors, which they can not afford to be without.

the tumors, such tumors would have to be eliminated from this group of pathological products and be classified with the granulomata." As we understand the term granuloma it implies that this neoplasm consists of granulation tissue, which presents itself in the form of a tumor or which is, in other words, a tumor-like product; in contradistinction to ordinary or physiological granulation tissue which rapidly changes into connective tissue during the process of repair. There is no granulation tissue that presents the appearance of, for instance, a carcinoma.

We also do not find ourselves in harmony with the author's definition of a tumor. On page 20 he defines a

tumor as follows: "A tumor is a localized increase of tissue, the product of tissue-proliferation of embryonic cells of congenital or post natal origin, produced inde. pendently of microbic causes." The same, (leaving out the words "of congenital"), may be said with as much propriety of young scar-tissue or of a hyperplastic prolifer. ation, and this definition is therefore not applicable as a designation of what is understood by a tumor.

This, of course, only illustrates that short definitions from the merits of the work, which is a most excellent are often misleading and it does not detract the least and practical treatise.

The text is profusely illustrated, more than one hundred of the illustrations being original, while the remainder have been selected from books and medical journals not readily accessible to the student and the trations and binding are very good. The general makegeneral practitioner. The print is large and the illusup of the book is such that the medical profession may be proud of its acquisition.

Saunders' American Year-Book of Medi-
cine and Surgery. Edited by GEORGE M.
GOULD, A.M., M.D. Assisted by Eminent American
Physicians and Teachers.

We learn from the publisher that this work will be ready by January 1, 1896. It will be a work which places before the physician in convenient form an epitomization of this literature by persons competent to pronounce upon the value of a discovery or of a method of treatment, and this can not but command his highest appreciation. It is this critical and judicial function that will be assumed by the editorial staff of the "American Year Book of Medicine and Surgery."

It is the special purpose of the editor, whose experi ence peculiarly qualifies him for the preparation of this work, not only to review the contributions to American journals, but also the methods and discoveries reported In the author's preface of the book we notice a pas- in the leading medical journals of Europe, thus enlarg. sage on page 6 which appears to be an oversight; for, ing the survey and making the work characteristically after very appropriately discarding the theory of a mi- international. These reviews will not simply be a series

of undigested abstracts indiscriminately run together, disease in the fact that in unfavorable cases a fatal issue nor will they be retrospective of "news" one or two regularly results in from six to eight days after the beyears old, but the treatment presented will be synthetic ginning of the disease. And in this disease we ordinand dogmatic, and will include only what is new. arily distinguish the following causes of death: Moreover, through expert condensation by experienced writers, these discussions will be comprised in a single tion. volume. 2. 3.

The work will be replete with original and selected illustrations skillfully reproduced, for the most part, in tis, gangrene of the lungs, etc. Mr. Saunders' own studios established for the purpose, thus insuring accuracy in delineation, affording efficient aids to a right comprehension of the text, and adding to the attractiveness of the volume..

A work comprising these qualities is particularly valuable to the busy practitioner, who wants, in a nutshell, what is new and of importance.

The author dwells upon these and various other causes, and summarizes as follows: Lobar pneumonia, a typical local infectious disease, which is remarkable "The Review of Reviews."-The special fea- because of the regularity with which, in the majority tures of the November Number are: