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AN IG'RANT KIND 'O JAY.

I am sumthin' of a vet'ran, just a turnin' eighty years;
A man that's hale and hearty, and a stranger tew all fear;
But I've heard some news this mornin' that has made my old
head spin,

And I'm goin' to ease my conshuns if I never speak ag'in.

I've lived my four score years of life, and never till to-day
Was I taken for a jackass or an ig'rant kind 'o jay.

Tew be stuffed with such durned nonsense 'bout them crawlin' bugs and worms,

That's a killin' human bein's with their microscopic germs.

They say there's "mikrobes" all around, huntin' for their prey;
There's nothin' pure to eat or drink or no safe place to stay:
There's "miasmy" in the dew fall and "malary "in the sun;
Tain' safe to be out doors at noon or when the day is done.
There's "bacteery "in the water and "tricheeney" in the meat,
"Ameeby" in the atmospheer, "calory" in the heat;
There's corpussells and pigments" in a human bein's blood,
And every other kind of thing existing sense the flood.
Terbacker's full of "nickerteen," whatever that may be,

And your throat will all get puckered with the "tannin" in the tea;

The butter's "oily-margareen," it never saw a cow,

And things is gettin' wus and wus from what they be just now.

Them bugs is all about us, jest waitin' for a chance
Tew navigate our vitals and knaw us off like plants.
There's men that spends a lifetime huntin' worms just like a
goose,

And tackin' Latin names to 'em and lettin' on 'em loose.

Now, I don't belive such nonsense, and don't intend to try;
If things has come to sech a pass I'm satisfied to die.
I'll go hang me in the sullar, for I won't be sech a fool
As to wait until I'm pizened by an annymallycool.

Lecturer in Paris: 66 Where, where do we find the complexions of the American women?" Voice from the audience: "In ze American drug stores."-Judge.

"My vife leats der fashion this veek alretty," said the German policeman to his friend Reilly, the blacksmith. "Ve had a grade sdade uf affairs at our flat lasd night. She gafe a German.”

"Is that so?" the blacksmith said, greatly interested. "And whoy was not Oi invited me and Mrs. Reilly? Oive read of these Germans in the papers over and over again, the curious favors the guests carry away and all that. Shure, O'im rale sorry yez didn't invite me."

"Yah, dot's so," said the inveterate joker. “Vell, it vos gwide a shmall bardy vot she gafe, mit only von drophy und only von bardickler frent owdside der family invided. Dot vos der doctor. He sayt afdervots it vos von uf der shmallest Germans he ever addended-but dot it seemed healty und he dought it vould lif."—The German Policeman.

OVERTAXING HIS BRAIN.-Old Mrs. Bently-" Did you hear, Josiah, that the young student who has been boardin' at the Hendrickses is very sick?" Old Mr. Bently "Yes, I heerd so; what's the trouble with him?" Old Mrs. Old Mrs. Bently-" Studyin' too hard, I s'pose. The doctor says he's got information of the brain." The Epoch.

THAT ALTERED THE CASE.-Dr. Pillsbury (to patient): "My dear sir, all you need is plenty of outdoor exercise. Now, here is a little work that I would strongly advise you to read. It will teach you how to gain and preserve health. Its title is Physical Culture for the Million,' and-" Patient: "But, doctor-" Dr. Pillsbury: "Well?" Patient: "I wrote that book."-Time.

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"Ah, yes, I see. "What?"

Bicuspid."

Bicuspid."

"I'll buy anything, doctor, if you'll only jerk the tooth out; though it looks a little mean to take advantage of a man in this fix. What are your cuspids worth?" So. Dental Journal.

Mr. Chugwater lay groaning on his bed. Mr. Chugwater's weight is nearly 300 pounds, and the bed was groaning too.

"Where is the pain, Josiah?" inquired his wife, sympathizingly.

"In the small of my back of course!" he snorted. "Where do you suppose a man has the lumbago?"

"You must be mistaken, dear," said Mrs. Chugwater soothingly. "You haven't any small of the back."

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There was an old woman--I tell you true---
Had pains till she didn't know what to do.
She took "sure cure" for them each and all,
But they just grew greater from spring to fall;
Till she prayed for death as the only cure,
And they took her to sail on a lengthy tour.
I'm that old woman-strange is the truth-
But I feel as frisky as in my youth.

I was a captive six months in a heathen land,
Where never a bottle of any brand
Could I procure. Had I staid a year,
I could never have died at all, I fear.

-Pharmaceutical Era.

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Sorry, sir, but you won't answer at all. Good plantation, can equal this treatment. In three weeks morning.' the left leg was entirely healed and the right wound began to granulate.

"Doctor," said little Emily, "do you know that a baby that was fed on elephant's milk gained twenty pound in one week ?"

"Nonsense!" exclaimed the doctor, and then asked: "Whose baby was it?"

"It was the elephant's baby," replied little Emily. -Boston Joke.

A SERIOUS CASE.

According to the Musical Herald, a lady from the rural districts took her daughter to town, and after consulting a number of professors respecting her musical abilities, returned home very much discouraged, and reported to her husband the result of her expedition as follows:

"The first professor said that Almira sings too much. with her borax. If she keeps on, she will get digestion on the lungs. He said she ought to try the abominable breathing and practice solfudgery. Then the next teacher told me that she ought to sing with her diagram, and not smother her voice in the sarcophagus. Then the next he poked a looking-glass down her throat and said the phalanx was too small, and the typhoid bone and the polyglottis were in a bad way; and I never knew that Almira had so many things down her throat, and I'm afraid to let her sing any more, for fear it will kill the poor girl.—San. News.

Col. Kaintuck: "Doctor, your medicines are doing me no good. An old lady in town has written to me to try hot water. She says it is a sure cure."

Physician: "Well, if you will drink plenty of hot water and nothing else you will get well."

"My stars! Why didn't you tell me so before?" "Nothing else, remember."

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A Case of Poisoning Through Dermatol. Dr. Weismueller, reports the following: I. V., thirty-eight years old, had ulcus crucis on both legs for some years. He was under treatment with many physicians, who prescribed mostly internal remedies (sulphur, arsenic, etc.) He finally applied to me. Each leg showed two large ulcers, which were painful and accompanied by secretions. I applied Div dermatol with bandage, and recommended rest. Two days later I changed the dressing, and as no improvement was noticeable and the dressing was very wet, I again dusted dermatol on the wounds. After using 5-8 drachms dermatol in ten to twelve days, no improvement was noticeable. Patient complained of vertigo and itching. At his request to prescribe something else, I gave him a powder to dust over parts, consisting of

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Mrs. Sch. had ulcus crucis on the left leg for two years. Much pain and secreting largely. I prescribed 3iij dermatol to be dusted over the very large ulcer. After three days, I found patient in bed, being unable to walk on account of excessive pain. Patient showed fever (102.5°), complained of headache, malaise, anorexia, and had over the whole body an itching and burning eruption. On the foot I found bullæ filled with serum. I discontinued the dermatol and prescribed my powder (as above). After two days the eruption was diminished, the burning had disappeared. After four more days, patient was able to attend to her business; after eight days, patient was cured.

The same results as above followed the use of dermatol in five more cases of chronic leg ulcer. I came to the following conclusions:

1. Dermatol cannot supplant iodoform; 2. In fresh wounds dermatol does not act as prompt as iodoform;

3. The antiseptic properties of dermatol are not as great as these of iodoform;

4. Iodoform in powder dries wounds as well, if not better, than dermatol.-Berliner Klin. Wochenschrift.

Crystal Springs Gluten, "Poluboskos." A constantly increasing interest in this new food preparation is now bringing it into prominence as an article of commercial importance with dealers, as well as of value to the profession. For a proper conception of its value, it should be borne in mind that it is a food and not a medicine, and that as a food it has its proper place in the maintenance of health.

It is worthy of note that actually the human body lives on and for the nervous system, i. e., without nerves we could have no heart beats, no respiration, no digestion, no thought. When nerves are out of order or deficient in energy, we have disease, dyspepsia, palpitation of the heart, and nervousness.

If the nerves supplying the digestive organs were all actually healthy and full of energy, there could be no indigestion. Therefore it is easy to continue this line of thought and see the fact that as Poluboskos is a nitrogenous food of nature, as such foods supply heat, force, and energy to muscles, nerves, and other organs, and that if the necessary energy be supplied the functions of those parts must be aided, it does seem that any one must reason out and agree that it will be of great value in many disorders, not as a medicine, but as a necessary constituent in the vitality and make-up of the structures themselves; in other words, Poluboskos is a food.

It will increase the flow of the mother's milk. It will supply the waning energies of the young babe when the mother's milk is wanting or of poor quality. It will stimulate and increase the health of the growing child. It will aid the weakest stomach and digestion, and stimulate appetite in dyspepsia, convalescence from wasting diseases, and in the functional disorders of the alimentary canal. It is palatable, easily retained, grows to be liked and wanted, and, above all, is easily digested and assimilated by the most intractable of stomachs.

Many so-called gluten foods contain not only a large percentage of starch, but also large, sharp, flaky particles of bran are left, which are apt to prove irritating to the digestive organs. In Poluboskos the outermost silicious coat of bran, which contains a ferment called cerealine, has been removed. It is this ferment which frequently causes gastric and intestinal irritations, and as the outer covering has no nutritive value, its removal is a distinct advantage. Poluboskos is a fine, granular powder; it gently stimulates without irritating the digestive canal; in short, throughout the human economy it promotes healthy action, and prevents constipation without producing diarrhoea.

These qualities and conditions having become recognized by the profession as the result of continuous exhibition, it goes without saying that Poluboskos is destined to take front rank among our foods, and as the most pertinent fact in support of these statements, we are informed that dealers in our local market have been pushed very closely to supply the demand.From Notes on New Pharmaceutical Products.

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AMPUTATION OF

THE BREAST WITH AN UNUSUAL
ACCIDENT.

BY J. F. PERCY, M. D., GALESBURG, ILL.

In the early part of March, 1891, I was consulted by Mrs. V., æt. 52, housewife. She came complaining of two or three very hard lumps in the right mammary gland, and also of pain in the breast and left shoulder when the right arm was moved. Family history good. The patient is a slightly built, little woman, weighing about one hundred and ten pounds, no fat and of an extremely nervous temperament. I learned from her that she had first noticed these lumps about five years before and fearing that they were cancerous had told no one until the pain and mental worry compelled her to consult a physician.

My diagnosis was scirrhus of the breast and immediate amputation was advised for the treatment. This was finally consented to. The operation was performed March 26th under complete antiseptic conditions. Valuable assistance was rendered by Dr. Tovey and a trained nurse who administered the anæsthetic, chloroform. The operation proved to be a tedious and long one; only a comparatively small quantity of the anesthetic was used, the patient yielding to its influence easily and nicely. This was due in a great measure, I think, to a preliminary hypodermic injection of 14 gr. morphia with 10 gr. atropia. The incisions were fully two inches on each side from the outer margin of the gland. A desire to get every atom of the disease being paramount. The axillary glands were followed up and removed; their removal was extended up to and beneath the clavicle. When ready to close the wound I found it very difficult matter, even if possible to bring the edges of the wound together. In attempting to do this I made use of two silver tension sutures with the lead buttons. What followed the attempt to use the sutures is my apology for reporting this otherwise ordinary case. By a good deal of pulling I succeeded in bringing the edges within half an inch of each other, but in much less time than it takes to write this my patient commenced to bleach out, the respiratory function becoming very faint and shallow with a pulse almost imperceptible at the wrist. I knew that this was not due to the chloroform because we had almost ceased administering it. Without reasoning the matter through, but instinctively, I suppose, I relaxed the tension suture that I had partly fastened. Imagine if you can my delight when I saw the cold pallor of death give way to the warm glow of life. To test and prove the matter I again tightened the suture with exactly the same result. Thus not being able to use the tension suture I substituted for

*Read before the Military Tract Medical Association at Peoria, Ill., Oct. 20th and 21st, 1891.

it a double row of chromicised gut ligatures. With these I was enabled to unite the wound nearly its whole length; a gap of nearly half an inch being left for about two inches.

This granulated up nicely and the whole length of the incision united without the formation of pus. The highest temperature reached the second day was 100° F. But three dressings were made before the removal of the stitches was commenced. Where the edges of the wound were united by granulation the adherence beneath this has since been broken up by massage; and at the present time the patient has a very healthy looking side with, as a result of the operation, some limitation of motion in the right My patient was permitted to sit up in one week from the date of the operation, and at the present writing she is more comfortable and in better health than for a number of years. In all the text books on surgery consulted nothing is said about the liability of an accident of this kind. Jacobson's work on Surgical Operations-the best book of its kind in the English language, does not refer to it. I attribute the condition observed to pressure on the Phrenic nerve interfering with its function.

arm.

CATARRHAL DEAFNESS AND TINNITUS AURIUM WITH A NEW

METHOD OF TREATMENT.

Every physician in general practice is not infrequently consulted by patients of both sexes complaining of gradually increasing deafness, often combined with tinnitus aurium. Much is being written of late regarding these distressing symptoms, but it is mostly in reference to the pathology and etiology, little being said about treatment except in a general way. After examining a patient who comes to us complaining of these symptoms, we usually think of inflating the middle ear by the Politzer method. In many cases this succeeds nicely, especially in the numerous cases due to catarrh. But as we all know by experience some of them will not yield to any known plan of treatment. It is not necessary to dwell upon the annoyance that these patients often experience; so serious does it become at times that alarming morbid conditions of the mind sometimes develop. My purpose in referring to this subject is to bring to your notice a method of treatment that is, as far as I know, new. About four years ago I was consulted by a German man, aged about 50, complaining of noises in his ears, and that his hearing had been growing less acute. On examination I found a mild pharyngitis and the ordinary chronic hypertrophic rhinitis present as almost always in these cases. On examining the ears I found the saucer-shaped depression, with the handle of the malleus prominent; also conditions nearly always found with these symptoms, especially if due to catarrh. I used the Politzer bag at this sitting to see if the eustachian tube could be inflated.

After repeating the process a number of times I found that no impression had been made on the drum, î. e., no congestion was present along the handle of the malleus. I might add here that I believe it to be a clinical fact that if inflation of the middleear by Politzer method does not cause this congestion just referred to, but little if any benefit need be expected from the procedure. When I saw the depression of this man's membrane tympanii and at the same time was a witness of his deafness and heard his complaint of constant noises in the ears, it occurred

The

a better name, we call catarrhal-catarrhal deafness with the frequently coexistant tinnitus. When there is a thickening of the drum or rigidity from adheYsions; or from any cause; or depression especially when the eustachian tube is collapsed this plan is of positive value. In those cases where the drum is held rigid by very firm and old inflammatory adhesions I can well understand how a too forcible rupture of them by suction might cause hæmorrhage and a more serious impairment of hearing than previously existed; but if the simple rule just laid down viz. to carry the force used not beyond the toleration of the patient, no harm will result. I might add here that some patient seem to be able to stand all the suction force that the rubber tube will. In these cases the most harmful result is a slight earache, but this does not occur frequently; when it does, the operation should not be repeated for a week, and then care must be taken not to excite pain again by using too much force.

to me to lift the drums up, by some direct method, land, found in Wood's Medical and Surgical Monoand how better could I do this than to suck them up. graphs for August, 1891. It is this; that when there This I did with the simple instrument I now show are noises in the ears without deafness, look for some you and which I improvised at the time. It is made cause other than disease in the ears. It is thus plainly from a foot of the very best 16-inch rubber tubing obvious that no treatment whether by the Politzer bag with a large tip for inserting in the external auditory or the suction method will be of much value, if the canal and a smaller tip for use as the mouthpiece. I underlying causes of the tinnitus or deafness is not have tried to get this suction force from something understood before treatment is commenced. besides the mouth. I hoped, at one time, that ex-class of cases in which I have found the suction force hausting my Politzer bag of air and attaching it to of most value is that vast number which, for want of the tube would answer, but it is very unsatisfactory, 1 the reason being that we cannot as successfully control the force. There is room, however, for an appa ratus that will obviate the necessity for making use of one's mouth in this way. The effect of this new treatment on the first patient to try it was very gratifying. The improvement as to both the hearing and tinnitus was marked. I had almost forgotten this case when a few weeks ago I received a letter from him asking me to send the apparatus that he might treat himself. He added further that his hearing and the tinnitus was troubling him again, but that he had obtained much benefit from my first treatments and that at the present writing thought that he could hear about as well as when he first came to me. I did not send him the apparatus, deeming it unwise to put anything of this kind in the hands of any patient. Of course we all know that ear troubles not infrequently remain stationary for a long time, only to start up again when the necessary exciting cause develops; and in this way the good results obtained in this case might be accounted for. But I have made use of this plan in so many cases, both with and without the aid of the Politzer bag, and with good results, that I believe it to be a method of value equal to that of Politzer, when used in an appropriate class of cases. One has got to use more care than with the Politzer bag, because if used indiscriminately damage may be done. What these dangers are I will try and point out further on.

A point in regard to the force required to be of benefit in these cases. Carry the suction force up to the point of comfort for the patient. Never use force enough to cause pain. A good practical rule in the great majority of patients is to watch the external canthus of the eye; when that begins to wrinkle usually force enough has been used. Then again it is well to tell the patient before you begin that as soon as the suction causes the least pain he is to indicate it at once. There are a marvelous number of morbid conditions of the body that will produce noises in the ears without their necessarily being due to disease in the ears. Some of these conditions are meningeal or diseases producing sounds central in their origin aural hallucinations regarding sounds would come under this head. Then there are many neurotic or reflex disorders that will cause noises in the ears as a weak cardiac systole, uterine disorders, uræmia, dyspepsia, enlarged tonsils, adenoid growths and noises due to drugs. Blocking of the nostrils from any cause is a prolific source of noises in the ear and unless corrected little need be expected of any plan of treatment.

Then again acute inflammation in the ears and minute foreigh bodies or impacted cerumen with many other abnormal conditions any one of which when present may cause noises and deafness in and of the

ears.

A valuable point in this connection is pointed out in a brilliant paper by Dr. H. M. Jones, of Eng

A CASE OF EPICYSTIC SURGICAL FISTULA WITH REMARKS.-June 10, 1890, I was sent for by a physician friend, Dr. Tovey, of North Henderson, but now of Galesburg, to see J. P. T., æt. 84, U. S. Farmer. I found a rather withered as well as suffering specimen of humanity. I learned from the doctor that he had been called to relieve the old gentleman of retention of urine and that in attempting to do so the catheter would fill with thick blood. My advice was sought as to the advisability of making a supra-pubic puncture to relieve the already greatly distended bladder. After examining the urethra and finding no tear and after gentle attempts to get into the bladder without success I advised against puncture, my reason being that the operation would probably have to be repeated when the organ filled again. After thoroughly canvassing the condition of our patient we advised a suprapubic cystotomy. This was consented to by the patient.

All the ordinary antiseptic precautions being observed an incision was made in the median line the lower angle of the wound commencing with the upper border of the pubic bone. As is not usual in this incision the peritoneal fold was encountered; and this was reflected back. When the bladder was reached silk sutures were put through it to hold it in apposition to the walls of the abdomen. In this way preventing the escape of the urine into the abdominal cavity. I put these sutures through the bladder walls; in performing the operation again I would not do this, it is unnecessary, and then with a fully distended bladder a rupture is liable to occur. After this the incision was made into the bladder and a large quantity of urine and blood clots escaped. On introducing my finger I found the source of the thick blood that

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persisted in blocking up the catheter when the attempts were first made to draw the urine. At the upper and to the left side of the bladder a soft vascular tumor was found, in size about that of a silver dollar. Its tissue was very friable and would bleed on the slightest provocation. We were afraid of it and thus decided to allow it to remain. If it had been removed at that time I feared a frightful and exhausting hæmorrhage, something that the patient would not bear.

In another operation of the same kind I would be prepared to scrape away all such tissue, first ligating the larger vessels that made up its source of vascular supply and then touch the base of the growth with the actual cautery. It is true, I think, that in allowing this growth to remain we did not add to the patient's chances of future trouble from it. Not infrequently when all irritation is removed from about any morbid growth it will remain quiescent for an indefinite time.

An overdistended bladder was the irritant in this case, an epicystic surgical fistula would remove that irritation hence the tumor would remain quiet. This may be poor surgery and worse reasoning, yet I believe it to be good sense. As already intimated I ad vised that the fistula made above the pubic bone be allowed to remain and this was done. That it was good practice is, I think, proven by the fact that sixteen months have elapsed since the operation and the patient is alive and enjoying a good degree of health and comfort for one so far advanced in years. It just occurs to me that I have not mentioned the fact of a symmetrically enlarged prostate gland present in this case and to say that its presence was another reason for making this fistulæ permanent. I am convinced, from my experience with this case that it is not necessary to insert any form of tube to permit the urine to escape. All that is necessary is to insert a hard rubber or silver plug to be removed when it becomes necessary far the patient to void urine. Probably the best plug of this kind is that first suggested by Dr. J. D. S. Davis, of Birmingham, Ala. I did not I did not make use of any instrument of this kind in this case and the fistula has remained patent. I believe the operation for epicystic surgical fistula has a great future before it and why it has not superseded the perineal operation in the great majority of cases is a mystery to me. It requires no unusual skill to perform it and from late reports in all sorts of conditions of the bladder which necessitate the operation the results are brilliant. My friend W. T. Belfield, of Chicago has shown its value in hypertrophy of the prostate gland by careful and painstaking labor in collecting statistics of the operation and Hunter McGuire, of Richmond, has called attention to it in the same class of cases by his truly ingenious but unnecessary coffee spout fistula. There is a practical point that I desire to call your attention to in all operations on the genito urinary tract. It is this, never give morphine either before or after these operations. The danger to be feared after an operation of this character is suppression of the urine and it is a fact observed by all many times that there is less urine voided after a dose of morphine than before it was given but lack of this and most important in this class of cases is the fact that less urine is secreted. I am not quite so sure that this danger is to be feared from all the derivatives of opium but that there is danger when morphine is given alone I am convinced. My reasons for this belief is based upon three cases coming under my own observation. Two of them surgical and seen

in consultation, the other a medical case occurring in my own practice.

One of the surgical cases was suprapubic cystotomy for the removal of a foreign body and at the best was a desperate case but I firmly believe that whatever chance the patient had was taken away by the morphine administered before and after the operation. The patient died within twenty-four hours no urine having been secreted by the kidneys.

The other case was the crushing operation for stone. As far as the science of medicine permits us to judge at the present day this was a favorable case for the operation. The stone was very large but soft. No fault could be found with the operation or the technic of the operators except possibly that the patient was kept under the influence of the anaesthetic too long, about two hours. Morphine was given before and after the operation to soothe the patient and it did he also died of suppression within twenty-four hours. The anesthetic used in this and in my own case, the subject of this paper, and, in fact in all of my operations on the genito urinary tract whether epicystic or perineal, necessitating an anesthetic was and is the A. C. E. mixture. I do this because those in a position best to judge say that this class of cases do better than with either chloroform or ether alone. Certain it is that this mixture is much less irritating to the bronchial mucus than when ether is given alone. All three of these cases occurred in old men the two receiving the morphia died, the one that did not get it, although a very unfavorable case for operation lived.

The medical case referred to is briefly as follows: In the evening of July 8, 1890, I was asked to see G. H. S., U. S., at. 44. Railroad engineer. I learned from the wife that the day before patient came in from a very long and exhausting trip on his engine. After retiring found that he could not sleep and as had been his habit got up and took some one-eighth grain morphine pills-how many she did not know, she was alarmed because he had been sleeping so long and because he was so stupid. On arousing the patient found that if I talked sharply and in rather a loud voice that he would remain awake. He did not complain very much except that my loud talking hurt his head. Thought that he would be all right next day and that his wife had become alarmed unnecessarily; the pupils were contracted but responded to light in some measure. My treatment was five drop doses of tr. belladonnæ until the pupils dilated, with ten grains of calomel.

I left word that I would call the next day and if they should need me before that time to send word. I saw the patient next morning and there was no apparent change from the day before. The calomel had not moved the bowels. Had passed urine two or three times since my last visit. I got him up at this visit and he voided urine in my presence. From this I obtained a sample for examination. On boiling this urine it became cloudy, and on the addition of nitric acid albumen was precipitated, in quantity about onefourth by volume. I put him on a treatment for acute albuminuria-I say acute because I had examined this case for life insurance the previous May and there was no albumen present at that time. This man physically was not well developed, yet he had never had any serious sickness. In reporting him to the insurance company, I put him in as a "fair" risk. His application was for three thousand dollars, and

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