nose a tube, and feed through it; after taking food clean out thoroughly and swab the mouth every two or three hours with a cotton pledget saturated with peroxide of hydrogen, and follow this by the use of one of the above-named mouthwashes. A hot bath should be ordered once a day, or a Turkish bath every third day. Give 10 grains of iodide of potassium three times a day, and gr. 1 of atropine at night. Sleep is secured by opiates if the pain is severe. Stimulants are indicated for exhaustion. When convalescence begins there should be ordered open-air exercise, nourishing food, red wines or malt liquors, and tonics. A mild case of salivation can be arrested in two or three days; a severe case is of uncertain duration, and may prove fatal.

In giving mercury, if a prompt effect is desired, give gr. iij of calomel every three hours until a metallic taste is noted in the mouth. If the case is not so urgent, gray powder is a good combination. If it is desired to give the drug for some time, corrosive sublimate is a suitable form, and small doses will actually increase the number of red blood-corpuscles. Corrosive sublimate is to be given alone or combined only with iodide of potassium. In the prolonged use of mercury it will often be necessary to give at the same time a little opium to prevent diarrhœa and griping. A rapid effect can be obtained by rubbing with a gloved hand 3j of the oleate of mercury or 3ss of the ointment into the groin, the axillæ, or the inside of the thighs. Suppositories of mercurial ointment induce rapid ptyalism. Hypodermic injections of corrosive sublimate can be used, and must be thrown deeply into the muscles of the buttock. Old people, those who are exhausted, anæmic, and broken down, and the scrofulous, bear mercury badly. If it be given at all, it must only be given to them in small amounts and for a brief time.

Alkaline iodides, which are useful in removing the products of inflammation, can be given for a long time, and

they admirably supplement mercurials. Iodide of potassium can be prescribed in combination with corrosive sublimate, as follows:

R. Hydrarg. chlor. corros.,
Potass. iodidi,

Syr. sarsaparillæ comp.,
Sig. fzij, in water, after meals.

gr. ij;
3v et j;

q. s. ad fviij.--M.

Iodide, well diluted, is given on a full stomach; it is never given concentrated nor before meals. A convenient mode of administration is to procure a concentrated solution of the iodide of potassium, remembering that every drop equals gr. j of the drug, and give as many drops as desired in half a glass of water after meals. If this disagrees, add to each dose, after it is put in water, 3j of the aromatic spirits of ammonia. Extract of licorice is a good vehicle for iodide. If the mixture in water disagrees, it should be tried in milk. Capsules are satisfactory, but a drink of water should be taken just before and again just after taking a capsule, to protect the stomach from the concentrated drug. Iodide of sodium may agree when iodide of potassium does not. When the iodides disagree they produce iodism. The first indications of iodism are a bad taste in the mouth, running of the eyes and nose, and sneezing, followed by a feeling. of exhaustion, absolute loss of appetite, nausea, tremor, and skin-eruptions (acne, hemorrhages, blebs, hydroa, etc.) If iodism occurs, stop the drug and give the patient Fowler's solution in increasing doses, laxatives, diuretic waters, and also good food and stimulants if depression is great. Sometimes belladonna does good in obstinate cutaneous disorders.

Alcoholic stimulants are used for conditions, and not for diseases, their use being indicated by the state of the patient, rather than by the name of the malady. For a brief acute inflammation in a robust young person alcohol is not needed; but all who are weak or exhausted-the young,

Low muttering delirium is no dose of alcohol in these Two ounces may be needed If the breath of the

the old, those accustomed to alcoholic beverages, those who have high temperatures or failure of circulation, and those who labor under septic inflammations or adynamic processes require alcohol to be given with a free hand. Certain indications for alcohol in an acute malady are a feeble, compressible, rapid, and often irregular pulse and great weakness of the first sound of the heart. a strong indication. There is states it is given for its effect. in a day, or perhaps twenty ounces. patient smells strongly of the alcohol, he is getting too much. If delirium increases after each dose, it is doing harm. Alcohol is contraindicated in acute meningitis. In acute illness use whiskey, brandy, champagne, or alcohol and water. During convalescence there may be used a little spirit-port, claret, or sherry wine or malt liquor. These agents will promote appetite, digestion, and sleep.

Tonics are indicated during convalescence from acute and throughout the course of chronic inflammations. There may be used iron, quinine, and strychnine in the form of elixir; iron alone, as in the tincture of the chloride; quinine in tonic doses (gr. vj to gr. viij daily); or Fowler's solution of arsenic. An excellent pill consists of—

R. Acid. arsenos,
Strychnini,

Quinine,

Ferri redact.,

Ft. in pil. No. xxiv.

Sig. One after each meal.

gr. j;

gr. ss;

gr. xlviij; gr. vj.

Bitter tonics before meals improve the appetite. One of the best of these tonics is tincture of nux vomica.

Antiphlogistic regimen includes all the facts relating to diet, ventilation, cleanliness, etc.

Diet.-When, in the early stages of an acute inflammation,

the patient cannot eat, there must be administered a cathartic before food is given. Nausea is combated with calomel and soda, drop-doses of a 6 per cent. solution of cocaine, iced champagne, or cracked ice. When the process is depressive from the start, and in any case after the earliest stage, feeding is of vital moment. The great tissue-waste calls for much food, but the impaired digestion demands that it shall easily be assimilable; hence it is taken in liquid form, small quantities being frequently given. Milk contains all the elements required by the body, and is the food of foods. If it disagrees, it should be boiled and mixed with limewater, or to each dose an equal amount of Vichy or sodawater may be added. Peptonized milk is a valuable agent. One part of milk, 2 parts of cream, and 2 parts of lime-water make a nutritious and digestible mixture. Milk punch is largely used. Whey may be used when milk cannot be taken. Eggs are highly nutritious, but are apt to disturb the stomach; they may be given as egg-nog, or simply soft-boiled, or the yolk can be beaten up in a cup of tea. When considerable nausea exists the yolk of an egg may be added to 3j of lemon-juice and zij of sugar, the glass being filled with carbonated water. Beef tea is certainly a stimulant, but its food-powers are questionable. It is prepared by cutting up one pound of lean beef, adding to it a quart of water, and then simmering, but not boiling, down to a pint, and finally by filtering and skimming the liquid. The dose is a wineglassful seasoned to taste. Meat-juice, made by squeezing out partly-cooked meat with a lemon-squeezer, is also highly nutritious. Liquid-beef peptonoids are both agreeable and nutritious; they are given in doses of 3ss to 3j. When nothing else will stay on the stomach koumiss will often be retained. This fermented milk is nutritious, stimulant, and very useful. Coffee is a valuable stimulant in febrile conditions. When the sufferer feels able to eat a little, any good

soup, strained and skimmed, should be ordered. As the patient gets better he may be fed on sweetbreads, chops, etc. until he gradually reaches the ordinary diet; if his stomach rejects everything, he must be fed by the rectum.

Ventilation and Cleanliness.-The ventilation of the apartment is of the greatest importance. Every day the windows should be opened widely for a time, the patient of course being protected. A constant access of fresh air must be secured, and the temperature kept at about 68°. The sick man must be cleaned and be sponged off with alcohol and water every day if high fever exists. It is important that the bed-clothing be clean and that the sheet be unwrinkled, as otherwise bed-sores may form.

III. REPAIR.

Repair is an active process by which destroyed tissues are replaced, and it is due to increased nutritive activity, rather than to inflammation. Inflammation may occur, or we may be obliged to induce it when the blood-supply is scanty or the exudation deficient; but certain it is that an aseptic wound heals without many of the evidences of inflammation.

Healing by First Intention.-A wound may heal by "first intention." This mode of healing, which is known as "primary union," occurs without suppuration. If pus forms, primary union will not take place. When the edges of an incised wound are brought nicely in apposition, after stopping the hemorrhage. and asepticizing thoroughly, slight swelling comes on, but no discoloration. Lymph and leucocytes are exuded from the vessels, fibrin forms in this lymph, and the edges of the wound are stuck together by a natural cement. In extensive wounds the exudation is in excess, and much of it must be drained away, for its retention means tension, inflammation, and a warm nest for pus cocci. The exudation is con