It is Importe

For the Physician to watch the character and quality of the remedies used in his prescriptions. Responsibility does not cease when the patient leaves the office, for impure, stale or inferior preparations may be used without his knowledge. Personal examination of remedies prescribed is the best check upon substitution.

Ferro-Salicylata is especially valuable in that shade of disease peculiar in anæmic, delicate, poorly nourished or broken-down patients-usually aged people-children or youth-but met with in all ages. In adults, and often in children when the disease is not plainly chronic, there will be a long series of recurrences with intervals of doubtful health. It may also be employed in acute articular rheumatism, and in some cases of acute tonsilitis, especially where the diagnosis is at first in doubt between rheumatic angina and diphtheria; also in acute rheumatism and rheumatic affections generally.

Ferro-Salicylata may be used in combination with the Iodides and Bromides of Potassium and Sodium. Associated with the former, it will prove an admirable alterative and tonic in secondary syphilis attended by a debilitated condition of the general system. It also combines well with Chlorate Potassium, the Hypophosphites, with Fowler's Solution, the vegetable bitter tonics, either in Fluid Extract or Tincture Form.

Ferro-Salicylata, and all other preparations of this Company,reach the laity through professional channels only. We, therefore, avoid entering into the minute details of their application, leaving the physician to make such practical use of our therapeutic notes as in his judgment may be best suited to individual cases.

Please designate " Ferro-Salicylata-Merrell.”

The best representative of the drug in fluid form, containing the combined alkaloids in the same proportion as they exist in the root, and especially valuable in all diseases of the mucous surfaces. It will mix with water, syrup, glycerine, or alcohol, without precipitation and, being so perfectly bland and non-irritating, may be applied to the most delicate mucous surfaces without unpleasant effects.

An admirable combination of well-known and highly approved medicinal agents; recommended in acute, chronic and capillary bronchitis-in ordinary coughs and colds, and wherever a "routine" expectorant is suggested.

CAUTION -Physicians are reminded that the Elixir Pinus Compositus of this manufacturer is wholly unlike the many syrups, etc., under similar names, and the difference will be readily appreci ated when tried. In testing the physical properties of the Elixir Pinus, note especially its delicate taste and freedom from the odor of rank syrup, the drastic, harsh and repulsive characteristics of the crude blood root, and other coarser ingredients characteristic of competing preparations.

66 Merrell Co.'s" " "Green Drug," Fluid Extracts, True Salicylic Acid, Salts of Hydrastis, Fluid Hydrastis, and Specialties may be obtained of wholesale druggists throughout the United States. Prices current and printed matter cheerfully supplied.

Wm. S. Merrell Chemical Company,

Cincinnati.

ARTHUR J. CONNER & CO., BOSTON.

New York.

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SERVICEABLE

SPECIALTIES.

PICHI, (Fabiana Imbricata), is an emollient, sedative and diuretic in diseases of the Urinary Organs.

It has been found efficient in gonorrhoea, cystitis, dysuria, urinary calculus, and all irritable and inflammatory conditions of the bladder and urinary tract.

The pharmaceutical preparations of Pichi are Fluid Extract and Solid Extract Pichi and Soluble Elastic Capsules Pichi, 5 grs.

CACTUS GRANDIFLORUS is a heart tonic par excellence. In these days when so many persons die of heart failure, the selection of a heart tonic is important.

According to J. Fletcher Horne, M. D., in Londen Lancet, it is especially valuable in nervous and functional disorders of the heart, where digitalis and s.rophanthus are unsatisfactory, such as palpitation, irregularity, fluttering, intermission, slow or rapid action arising from debility, worry, dyspepsia, or the excessive use of tea and tobacco, comprehensively classed as cardiac erethism.

CREOSOTE is of all the methods of treating consumption the most satisfactory.

We supply creosote in Solube Elastic Capsules (Cod Liver Oil, 10 minims, Creosote, 1 minim,) and Enteric Pills of Creosote coated with a material that resists the action of the gastric juice but dissolves in the duodenum.

Send for literature or samples of these products.

PARKE, DAVIS & COMPANY,

DETROIT, NEW YORK, AND KANSAS CITY.

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THE ESSENTIALS OF HISTOLOGY.*

THE third edition of Professor Schäfer's histology has just been issued by Messrs. Lea Brothers. It is an excellent text-book, and one of the best descriptive and practical guides to the microscopical examination of organic tissues. Many new methods will be found mentioned, especially in the department dealing with the examination of nervous tissues. Students will find in this manual all they will desire in a text-book-a complete description in a short compass. By Edward A. Schäfer, F. R. S., Fodrell professor of physiology in university college, London. New (third) edition. In one octavo volume of three hundred and eleven pages, with three hundred and twenty-five illustrations. Cloth, $3.00. Philadelphia: Lea Brothers & Company, 1892.

*

DISEASES OF WOMEN.*

THE large number of gynecological treatises that invite the patronage of the student or practitioner is somewhat bewildering. Dr. Davenport's book, however, is somewhat unlike the rest of its kind. It is a non-surgical treatise, and has two main objects,-to impart to the student the elementary principles of the method of examination and the simple forms of treatment of the most common diseases of the pelvic organs, and to assist the practitioner in understanding and treating the cases he meets with in every-day practice. The work has already passed into a second edition, and the concise and lucid style of the author, and his very thorough manner of treating his subject, will doubtless continue to make his work one of the most popular of its kind.

*A manual of non-surgical gynecology, designed especially for the use of students and general practitioners. By F. H. Davenport, M. D., instructor in gynecology, Harvard medical school. Second edition, revised and enlarged. Duodecimo: three hundred and fourteen pages; one hundred and seven illustrations. Cloth, $1.75. Philadelphia: Lea Brothers & Company, 1892.

REFERENCES.

BOOKS AND PAMPHLETS.

"Two Cases in Abdominal Surgery." By Eugene Boise, M. D., Grand Rapids. Reprinted from New York Journal of Obstetrics and Gynecology.

"Colpo-Perineorrhaphy." By Edward W. Jenks, M. D., Detroit. Reprinted from Journal of American Medical Association.

"Two Cases of Carcinoma of the Uterus." By J. T. Jelks, M. D., Hot Springs, Arkansas. Reprinted from the Journal of the State Medical Society of Arkansas. "Bulletin of the Harvard Medical School Association." Boston: Published by the association.

"Some Effects of Blennorrhoea in Women." By James T. Jelks, M. D., Hot Springs, Arkansas. Reprinted from American Gynecological Journal.

"Report of Eighty Operations Performed before the Medical Class of the College Hospital during the Regular Session of 1891-2." By J. S. Wight, M. D. Reprinted from the Brooklyn Medical Journal.

D*

"The Operative Treatment of Goitre." By J. C. Warren, M. D. Reprinted from Boston Medical and Surgical Journal.

"The Lacerated Cervix." By W. G. Bogart, M. D., Chattanooga.

"Evolution from a Scientific Stand-point." By John Pope Stewart, M. D., of Attalla, Alabama.

"An Epitomized Review of the Principles and Practice of Maritime Sanitation." By Joseph Holt, M. D.

"Rupture of Aortic Valves, with Demonstration of Specimens. Aneurism of Right Auricular Appendix." By Ludwig Hektoen, M. D., Chicago. Reprinted from North American Practitioner.

MEDICAL PROGRESS.

MEDICINE.

POST-FEBRILE INSANITY.

DR. HENRY M. HURD read a paper on this subject at the recent annual meeting of the medical and chirurgical faculty of Maryland. The Maryland Medical Journal for May 28 contains the full paper, in which the author mentions the recorded cases, from Chomel's, in 1834, to the present time, and reports three cases observed by himself and Dr. Thayer at the Johns Hopkins hospital. Of the three new cases, one was a case of melancholic insanity coming on during convalescence after typhoid fever; the second was one of insanity developing from pneumonia, with systematized delusions originating in the delirium of fever; and the third was one of maniacal excitement following the removal of two diseased ovaries. In this last case there was incoherence lasting several months, after which complete recovery took place. The second case-not a hospital case-was characterized by hallucinations, and delusions affecting the patient's husband; she believed that he and the female nurse had improper relations in her presence, and her embitterness against him became so extreme that she was placed in an asylum. After a year of confusion and delusions recovery set in, and she was restored to perfect mental balance.

Dr. Hurd offers the following suggestion as to an improved classification of post-febrile mental disorder: (1) Cases of insanity following shock. (2) Those developing from diseases due to specific poisons-such as puerperal fever, pneumonia, uræmia, and the exanthemata. (3) Those originating from nervous exhaustion and anæmia. In this group will be found those insanities, secondary to fever, that are an expression of an exhausted physical state; they take the form of delusions of apprehension and fear, hallucinations of sight and hearing, and perversions of taste and tactile sensibility, at times going on to stupidity and mental impairment.

Out of twenty-three cases that have been adequately reported, eleven were of typhoid origin. In four of these delirium was present during the attack; in seven, after it. Eight patients recovered, two died, and one remained insane. The pneumonic cases were two in number, one occurring during the pyrexia and the other after it. Both patients recovered after a tedious convalescence. Nine

of the twenty-three cases were subsequent to surgical operations, and the mental trouble came on at about the ninth day in several of them. In four cases there was excitement, in five there was depression; four patients recovered, four died, and one remained insane.

The author attaches no small importance to the treatment of typhoid fever with cold baths, and considers that it is one of the notable features of that method that so few of the patients develop acute head symptoms. Another suggestion offered by Dr. Hurd is that the patient after febrile disease is very frequently insufficiently fed-with perhaps at the same time insufficient quiet, too many friends or "callers," and a premature sitting-up-and the prolonged abstention from food becomes the determining factor of mental impairment. The term "post-febrile insanity" should, in the author's opinion, be restricted to cases that follow upon exhausting attacks of fever or upon operations and the like, and should not embrace the prolonged delirium that is engendered by toxic conditions.-New York Medical Journal.

DANGERS OF LAVAGE OF THE STOMACH.

IN the Practitioner of April, 1892, Soltan Fenwick, of London, discusses the question of lavage. He points out that attacks of convulsions and tetany have sometimes followed resort to this measure, and also that a number of cases are on record in which syncope and sudden death followed it. He also reports instances in which perforation of the stomach took place, and he has also known gastric hemorrhage to occur.

Besides the other injuries which may follow lavage, he points out that there are other cases on record in which antiseptic materials have been used for washing the stomach, and that as a result death has occurred in this way. This fatality has followed the use of a two per cent. solution of boric acid. The conclusions which he draws are as follows:

At the present day every imaginable symptom that can in any way be connected with the digestive organs is immediately considered as an indication for the use of lavage, and we find that not only are chlorosis, atonic dyspepsia, and the gastric crises of ataxia subjected to this treatment, but even cases of reflex vomiting are supposed by some to necessitate the employment of the douche. But it is obvious that in those cases where the treatment fails to do good, it is extremely likely to do harm, since, as Leube pointed out, it has the effect of removing those products of digestion whose manufacture has caused the stomach a considerable amount of labor. For his part he fails to understand how washing out the organ in a case where the normal amount of secretion proves insufficient can possibly increase its digestive powers, or the lavage of the stomach prevent the occurrence of symptoms which are wholly dependent on organic disease in another organ remotely situated. In one case of tabes dorsalis, accompanied by exceedingly severe gastric crises, he washed out the stomach every day for some weeks, and the state of digestion was carefully watched; but beyond the fact that the symptoms of the disease grew steadily worse, he could detect no material alteration in the condition of the patient. In like manner the few cases of atonic dyspepsia and chlorosis which he has treated by lavage,