DIURETIN.-Ruggieri (Rif. Med.) tried diuretin in eighteen cases-five of pleurisy with effusion, one of pleurisy and peritonitis, five of cirrhosis of the liver, six of nephritis, and one of heart disease. He thinks the diuretic action of the remedy incontestable, but the increase of renal excretion is most marked in heart cases. It is less so in nephritis, especially in chronic cases. The drug has no effect in cirrhosis of the liver. Ruggieri does not agree with Gram that diuretin is well borne in all cases; in most of the patients on whom he tried it, its administration was followed by headache, giddiness, nausea, vomiting, and diarrhoea.-British Medical Journal.

INFLUENZA COLDS.-Few remedies are more reliable, and act better as a preventive, or lessen the distressing symptoms of an influenza cold, than the following mixture:

Sodii salicylas,

Liq. ammon. acet.,
Aq. camph.,

Misce. Capt.: 3ss. omnis 3tiis horis.

3jss.

3ij.

ad 3vj.

If this preparation be administered every two or three hours when the first symptoms of cold come on, it will almost invariably ward off the attack.-British and Colonial Druggist.

HEMATURIA DUE TO FATIGUE.-Hæmaturia is a symptom which is observed in a number of distinct affections, that caused by malaria being not uncommon in the south. The variety reported by Dr. M. Lannois (Lyon Med.) appears to be very peculiar in its nature. He observed it in a marble-worker, of thirty-two years of age. The trouble had existed since he was nine years old. Whenever he indulged in prolonged walking, or in any efforts which induced fatigue, hæmaturia was observed. Simply desisting from the exercise was followed by a disappearance of the symptoms. Slight albuminuria was detected. The hæmaturia was no doubt caused by a transitory renal congestion, which caused rupture of a few vascular loops, and the consequent presence of blood in the urine. Whilst the presence of albuminuria would indicate the existence of some sort of organic lesion, its exact nature could not be determined.-Weekly Medical Review.

MILK A MICROBE-KILLER.-The results of Dr. Freudenreich's experiments, as now published in the Annales de micrographie, are of the greatest importance. He finds that the cholera bacillus, if put into milk drawn fresh from the cow, dies in an hour, and in five hours if put into fresh goat's milk. The bacillus of typhoid fever takes twenty-four hours to die in cow's milk, and five hours in goat's milk. Other microbes suffer a like fate in varying periods. By this showing, fresh milk is a bactericide or killer of disease-causing micro-organisms. But Dr. Freudenreich's researches go yet further than the foregoing. He finds that milk maintained for an hour at a temperature of 55° (131° Fahrenheit) loses its power to kill microbes a statement which is of interest in face of the common teaching which makes the purification of milk depend upon its being boiled. Again, the microbe-killing properties of milk become weaker the older it gets. Cow's milk after four days, and goat's milk after five days, cease to have any effect upon micro-organisms. The conclusions, at any rate, are altogether in favor of the consumption of fresh milk.-British and Colonial Druggist.

BROMIDE ERUPTION.-R. W. Taylor (Journal of Cutaneous and Genito-Urinary Diseases) points out that bromide eruption occurs in two forms. Usually beginning about the middle portion of the anterior surface of the legs, it may appear in an acute form, with follicular papules, discrete or aggregated. Some become pustular, and may develop either slowly or quickly. The lesions coalesce, and form encrusted uneven surfaces, becoming more or less salient. Ulceration may take place. Under the crusts a papillomatous surface is observed, which may even approach a fungating condition. Scarring and pigmentation are left. The other mode of invasion is by subcutaneous nodules of large or limited extent. First there is slight redness of the skin, the finger detecting some infiltration, and the lesion looking like erythema nodosum. The nodules, which are somewhat salient, and of a dull red color, may gradually become absorbed, or may develop into fungating patches similar to those observed in the previous form.

THE FOOD SUPPLY OF THE FUTURE, by Professor W. D. Atwater, of Wesleyan University, is the first in a series of papers in November Century, which will have especial value to farmers. The writer believes that the doctrine of Malthus -that the time will come when there will not be food enough for the human race, owing to the theory that population increases in a geometrical and foodsupply in an arithmetical ratio-is one which need never give the world any uneasiness, owing to the great advances that are being made in chemistry. Science has shown what are the essential factors in vegetable production, and plants can now be grown in water or in sand by adding the proper chemicals. Professor Atwater gives the result of an interesting experiment recently made in his laboratory. Sea-sand was brought from the shore of Long Island Sound. To divest it of every possible material which the plant might use for food except the sand itself, it was carefully washed with water and then heated. It was put into glass jars, water was added and minute quantities of chemical salts were dissolved in it. Dwarf peas, planted in this sand, grew to a height of eight feet, while peas of the same kind, planted by a skillful gardener in the rich soil of a garden close by, reached a height of only four feet.-Sanitarian.

THE DIGESTIBILITY OF CHEESE.-It is the general opinion of the laity that the eating of cheese after taking food is an assistance to digestion. This view seems not to be in accord with the result of experiments made by von Klenze, as recorded in the Allgemeine medicinische Central-Zeitung, Number XVIII, 1891. He made very thorough tests of the various forms of cheese found in the dietary lists. For the experiments he used an artificial digestive fluid, to which were added fifty cubic centimeters of fresh gastric juice and three cubic centimeters of hydrochloric acid. Into this he placed a gramme of the cheese to be examined. Eighteen varieties were tested, and the following deductions made: Chester and Roquefort cheese took four hours to digest; genuine Emmenthaler, Gorgonzoler, and Neufchatel, eight hours; Romadour, nine hours; and Kottenberger, Brie, Swiss, and the remaining varieties, ten hours. Considering that in a healthy stomach digestion after an ordinary meal is completed in from four to five hours, it would seem from von Klenze's studies, that Chester and Roquefort cheese were the only kinds that were likely to be digested within this length of time, and that the other varieties, some of which are largely in use, not only did not assist digestion, but actually retarded it.-New York Medical Journal.

THE DIETETIC TREATMENT OF DIABETES.-In L'Union Medicale, Dr. Paul Cheron, after giving the principles underlying the dietary methods of Seeger, Senator, Frerichs, Naunyn, Schnee, Bouchardat, and Dujardin-Beaumetz, states that the diet for each particular case must be determined by experiment, regarding as absolutely prohibited those viands concerning which there is consensus of medical opinion. That the diet list should be enlarged at the earliest practicable moment, keeping guard as to the result by repeated urinary analyses. The nutrition must be kept up, but an excessive amount of food is a frequent cause of the disease. As an assistance, exercise (Bouchardat), freedom from care and anxiety, baths, life in the open air, are mentioned.-American Journal of Medical Sciences.

SHALL CLERGYMEN PAY THE PHYSICIAN FOR SERVICES?-This question has come up for discussion, based upon the bill of a Brooklyn physician made against the estate of a Catholic priest for services rendered. The heirs protested on the ground that it was usual for physicians to make no charges under the circumstances. There is no reason why this should be so, however, as was very properly stated by a priest in voluntarily answering the question in a letter to one of the newspapers. We entirely agree with the latter assertion and that, save in a very few exceptional cases, charges should always be made. The physician pays the priest for the marriage ceremony, for christening, and his heirs are expected to be ready with an honorarium when mass is said at the funeral of the doctor, when his many deeds of charity are over. Nor does the physician enjoy a free pew in the church of his choice on the score of helping the deserving poor of the congregation. As a mere matter of advertisement for practice it seldom if ever pays, as the clergyman in many cases chooses a physician for himself, but for policy sake does not care to recommend one doctor more than another for members of his flock. But more than all, the services to the priest or minister are valued in proportion to the amount actually paid for them.-Medical Record.

EXECUTED BY ELECTRICITY.-Charles McIlvaine experienced death by electricity at Sing Sing on the 8th instant. Physicians and scientists from all parts of New York solicited invitations to be present at the killing. The death chair involved in its construction a new feature-that of providing for the application of the current through both hands, as had some time ago been suggested by Thomas A. Edison. The chair itself is the outgrowth of ideas held by Prison Yardmaster Hillert, who, since the quadruple executions last July, has been studying to effect electric contacts without burning the flesh or scalding the skin of the subject. The new chair is fashioned in its general outline after the chairs previously in use. The new pattern involves a change at the arms, however; they are high at the back and fit closely under the armpits of the subject slanting downward to the front. The distinctively new feature was the provision of deep glass cells securely fastened so that the hands may be immersed in water which fill the jars. The water is a solution of chloride of sodium, and warm, so as not to shock the hands of the subject, nervous and on the brink of death. One of the cells received current from beneath, the other from above. The usual coil of conducting wire for the electrode for the head dangled from above. Stout broad straps were placed for fastening the wrists in the cells, and other bands held the elbows tightly.

The Physician and Surgeon

A JOURNAL OF THE MEDICAL SCIENCES.

BY F. E. WAXHAM, M. D., CHICAGO, ILLINOIS.

PROFESSOR OF DISEASES OF CHILDREN, AND OF LARYNGOLOGY AND RHINOLOGY, IN THE COLLEGE OF PHYSICIANS AND SURGEONS OF CHICAGO.

INTUBATION of the larynx will ever be recorded among the brilliant achievements of the nineteenth century. The idea originated with Bouchut, of Paris, in 1857, but he like many another being discouraged by opposition and failure, abandoned the golden opportunity to render his name immortal, and left it for another with greater perseverance and genius to develop the operation into a successful procedure.

Bouchut's tubes were cylindrical and short, barely passing through the glottis, and with a head consisting of a slight rim. A thread was left attached to prevent falling into the trachea. Bouchut's enthusiastic claims for the operation and his condemnation of tracheotomy brought down upon him the ill-will of his colleagues, and a committee appointed from the Paris Academy of Medicine, headed by Trousseau, the great tracheotomist, pronounced the operation impracticable and criticised Bouchut and his operation so severely that after a few unsuccessful attempts the operation was entirely abandoned. So completely was the idea of tubage of the larynx crushed out that no further attempts were made in this direction for more than a quarter of a century. The bitterness of the controversy between the tracheotomist on one hand and Bouchut on the other, may be inferred from the following extract of an article from the pen of Bouchut appearing in the pages of the Paris Medical:

"Tubage of the larynx, which the enemies of the author believed dead, stirs itself beneath the shroud of academic eloquence in which it was involved. The clever heads of the times thought that their judgment was without appeal, and,

*Read at a stated meeting of the DETROIT MEDICAL AND LIBRARY ASSOCIATION, and published exclusively in The Physician and Surgeon.

that once buried, that method was to be lost in forgetfulness and oblivion. But it appears that it has come to life again, and its merits have been discovered in America so far as to give it admission to the customary practice of surgeons. This is not done to satisfy our professors, but it has that effect, and no one has protested. Tubage had among us been buried alive, and, after thirty years, I am witness of its resurrection. It comes to us ready to meet the attack of its ancient enemies, of whom the more bitter have happily left this world and are buried in merited forgetfulness. 'Dead dogs do not bite.' At this time tubage is the order of the day and it is practiced, in croup, by the physicians of the large cities of America, to whom it gives results which permit it to compete with tracheotomy. It has even crossed the Atlantic, and, behold, the French journals are happy to speak of it to the profit of their readers."

In 1880 Dr. J. O'Dwyer, of New York, unaware of the attempts of Bouchut and his failure, commenced his experiments in this direction. His first tubes were bivalves with wire heads covered with gutta percha, and the first improvement consisted in constructing the head of metal. The tubes were introduced closed, and opened as the introducer was withdrawn. These tubes were soon found to be defective as membrane would crowd in between the blades causing obstruction. A straight elliptical tube was now tried. These tubes were short, differing from those of Bouchut only in the fact that they were elliptical instead of cylindrical. They were next increased in length that they might not be so readily expelled.

Having become discouraged with tracheotomy, and knowing of Dr. O'Dwyer's work in this connection, and being provided with a set of these primitive instruments through his courtesy, they were introduced into my private practice. Various accidents soon illustrated the necessity for further changes. With my third case the tube dropped through the glottis and into the trachea on account of the small size of the head. I not only lost the tube but the patient as well. In another case, upon post-mortem examination, the tube was found in the right bronchus with the head just above the bifurcation. Again these plain straight tubes were frequently rejected as there was nothing but their weight to hold them in position. This accident was especially of common occurrence among the older and stronger children in private practice. These accidents led first to the enlargement of the head of the tube to prevent falling through into the trachea, and second the addition of a shoulder or swelling in the middle of the tube to prevent too easy expulsion.

The greatest objection to the operation was on account of the inability of the patient to swallow readily, and for the next two or three years every effort was made to overcome this objectionable feature. First a rubber epiglottis was employed to cover the head of the tube during deglutition and this was replaced by a metal epiglottis controlled by a gold wire concealed in the upper end of the tube. This metal epiglottis completely closed the upper opening of the tube during deglutition, and was of great assistance as it enabled patients to swallow liquids which before was difficult or impossible. In the course of time, however, it was discovered that simply placing the patient in an inclined position, with the head lower than the body, was all that was necessary to enable patients to swallow without difficulty. This method of feeding after intubation was first employed by Drs. Carey and Casselbery, of Chicago, and was one of the greatest