extremely obstinate, a very long time being often necessary to effect a permanent cure. The following case, as will be seen, was treated in a very simple manner, and completely healed in a short time.

A man presented himself in the out-patients room of a hospital with a fistulous opening in his face opposite to the lower canine tooth of the left side, through which the saliva flowed, and whenever the lower lip was moved the saliva passed out in jets. It appears that some years previously he had experienced some clumsy dentistry, and had as a result necrosis of the lower jaw, with an abscess afterwards, which opened through the face. On passing a probe through the sinus, which had the calibre of a crow-quill, it took an oblique course, nearly an inch in length, upwards and backwards. Mr. Bellamy adopted the simple expedient of introducing a small crystal of nitrate of silver into the sinus and leaving it there, as he has been in the habit of doing with troublesome penile fistula. At first the nitrate caused a considerable amount of discomfort and pain, but after two further applications of the salt, at intervals of a week, the canal healed completely, and a small depression was all that could be seen indicating the original position. (Lancet, March 31, 1877.)

Cutaneous Itching.-A correspondent of the British Medical Journal recommends the use of the following lotion for the relief of this exceedingly distressing condition. Acid hydrocyanici dil. 3j., hydrargyri perchloridi gr. xvi., aquæ ad viij. to be applied twice daily by means of a sponge. Or potas. ferrocyanidi one scruple, aquæ eight ounces; to be used as above. Mr. Ready, who has had several cases of cutaneous itching, says that the application to the skin, by sponging, of sulphurous acid, either diluted or at the full strength, has in every case had remarkably good effects. Dilute hydrochloric acid and chlorate of potash given internally are also useful auxiliaries. An old practitioner writes that a few years ago he suffered much from severe itching round the anus by night, and tried everything likely to relieve it, but to no purpose. He left off coffee, of which he drank a pint, made by himself, and therefore good, every morning for breakfast. He soon lost all the irritation, and has scarcely felt it since. (British Medical Journal, March 31, 1877.)

Extracts from British and Foreign Journals.

Salicylic Acid in Cholera.-Most favourable results have been obtained by the use of the salicylic acid treatment of cholera. which was introduced into India by Surgeon-Major Boustead, of the Bombay Army, some months ago. The remedy has been tried in Cashmere recently, and the natives prefer it to every other mode of treatment offered. In answer to correspondents, Dr. Boustead has replied that half a grain for each year of age of the patient is a safe dose to be administered by a non-professional person, but that this dose can be exceeded every hour, if administered under the supervision of a medical man. He adds that it occasionally requires the combination of a dose of opium, when vomiting and purging are very excessive, and that the acid, or salicylate of soda may require to be administered hypodermically. (Englishman and The Times of India, Sept. 30.)

The Treatment of Diphtheria.-Dr. G. R. Cook in treating cases of diphtheria states that he used to follow, without any favourable results, the rules laid down by the German Professor Oertel and others. He then adopted a different mode of treatment, which has been attended with much success. Upon recognising a case to be one of diphtheria, he at once orders a purgative, and prefers a saline. The circulation is much disturbed, the head and neck being very hot and dusky, while the feet are cold and clammy; he therefore next endeavours to restore the equilibrium by bathing the feet in water as hot as it can be borne, until they glow-in some cases repeating this hourly, and continuing to do so at intervals, as it may be necessary, for two or three days, at the same time towels wrung out of ice-water are applied to the forehead and throat, and changed as often as they become warm, which at first appears to be almost every minute. These he continues night and day, until evidences of local excitement are subdued. The patient is to use ice constantly during this treatment. The medicinal treatment he looks upon as of equal importance, and as a valuable adjunct to the cold. To eight ounces of a saturated solution of chlorate

of potash, one drachm of hydrochloric acid is added, and a teaspoonful every three hours is given to a child of three or four years of age-the dose for children of six years and upwards being a dessertspoonful. In some cases this mixture is given alternately with salicine every two hours, as Dr. Cook believes that the latter, besides possessing antiseptic powers, promotes digestion. Sometimes the mouth is washed out or gargled with a solution of chlorinated soda, but with this exception no gargle is used. Stimulants and nourishing diet in a liquid form are given from the outset, and of course special symptoms must be treated as they arise. He does not know whether the cold destroys the microscopic organisms directly, or whether they cease multiplying and die because the action of the cold on the affected textures deprives them of support; but the latter he thinks is the probable cause, as after a few hours' perseverance in the treatment the mucous membrane becomes pale and bloodless, the patches cease to spread, the ashen hue turns to white, the breath soon becomes sweet, and a bright line of demarcation separating the affected from the non-affected portions may be distinctly seen to retreat and carry with it the crumbling edges of the patches, until all are obliterated. He has treated nineteen cases upon this plan, some being well advanced and severe, and in no instance has the disease lasted beyond seven days. Not one proved fatal, and only one showed symptoms of diphtheritic paralysis, from which, however, a perfect recovery was made. To strengthen what he has said, Dr. Cook adds that diphtheria proved very disastrous to some families in his locality, suddenly sweeping away all the younger members, notwithstanding all the efforts of the attending physicians. (Canada Med. and Surg. Journal, Nov. 1876.)

Treatment of Neuralgia. Dr. E. P. Hurd, of Newburyport, Massachusetts, gives an interesting account of an intractable case of neuralgia that occurred in his private practice, in which a cure was ultimately effected, though not till after many remedies had been employed. The patient was a young woman, æt. twenty-four, the daughter of a gentleman in good circumstances, who had suffered from measles followed by otorrhoea, and at a subsequent period from typhoid fever, followed by temporary paralysis from dysentery, and from severe intercostal neuralgia. Opiates, Indian hemp, and other narcotics were successively given without much benefit. Paullinia powders (Guarana sorbilis) were given in twenty-grain doses with great advantage, and for four years she experienced almost complete immunity from pain. A visit to Boston caused a breakdown of the nervous system, and pain in the shoulder coming on, Dr. Hurd was called in. Paullinia was ordered without effect. A quarter of a grain of morphia,

injected hypodermically and repeated in an hour, failed. Inhalation of chloroform caused a lull, and after free vomiting she fell asleep. A month later another attack supervened, affecting the shoulder, with tetanoid contraction of the scapular muscles and darting pains, extending to intercostal region. There were no wellmarked points douloureux. Two hypodermics of morphia, one half-grain each, only served to intensify the pain; Squibb's ether was administered for forty minutes without causing relaxation or relieving the pain; but chloroform again brought rest, although no amount of it produced unconsciousness. Relapses continuing to occur, bromide of potassium was ordered in scruple doses, with subcarbonate of iron in half-teaspoonful doses; wine and brandy ad lib. In the next attack th of a grain of atropia was injected hypodermically, and in subsequent attacks croton-oil liniment was rubbed along the lower cervical and upper dorsal regions of the spine; croton-chloral was given in five-grain doses, and ergot and bromide of potassium freely administered, the latter being subcutaneously injected in addition to various preparations of opium. The greatest attention was paid throughout to the nature and quality of the food and to the general functions of the body. Finally, the attacks seemed to be warded off by half-teaspoonful doses of the saturated tincture of gelseminum. (New York Med. Record, No. 315.)

Confectio Damocratis and Warburg's Tincture.-Dr. T. E. B. Brown, principal of the Medical School at Lahore, gives the following account of the preparation of the Confectio Damocratis, Mithridatium, Mithridate, or Damocrates' Confection, which forms one of the ingredents in Warburg's Tincture. London Ph. 1746. R-Cinnamon 3xiv, Myrrh (Balsamodendron) 3xi, Agaric, Spikenard (Nardus Indicus), Ginger, Saffron, Seeds of treacle, Mustard (Thlaspi Arvense) or Mithridate Mustard (Lepidium Campestre), Frankincense (Resin of Abies Excelsa), Chio Turpentine (Resin of Pistacio Terebinthus) of each 3x. Camel's Hay (Juncus Odoratus), Costus (Costus Arabicus or Auklandia Costus or Aplotaxis Auriculata) or Zedoary (Curcuma Zedoaria), Indian leaf-Malabathrum folium (Cinnamonum Tamala) or Mace, French Lavender (Lavandula Stoechas), Long pepper, Seeds of Hartwort (Laserpitium Siler), Juice of the rape of Cistus (Cytinus Hypocistis), Strained Storax, Opoponax, Strained Galbanum (Ferula Galbanifera) Balsam of Gilead (Balsamodendron Gileadense) or expressed oil of Nutmegs, Russian Castoreum, of each Zi. Poley Mountain (Teucrium Creticum), Water Germander (Teucrium Scorodonium), Fruit of the Balsam tree (Balsamodendron pubescens) or Cubebs, White pepper, Seeds of the Carrot of Crete (Daucus Creticus), Strained Bdellium (Balsamodendron Mukul) of each 3vii. Celtic Nard

(Valeriana Celtica), Gentian root, leaves of Dittany of Crete (Amaracus Dictamnus), Red roses, Seeds of Macedonian parsley, Seeds of lesser Cardamonis, Seeds of sweet Fennel, Gum Arabic, Strained Opium, of each 3v. Root of Sweet flag (Acorus Calamus), Root of wild Valerian (Valeriana Officinalis), Aniseed, Strained Sagapenum, of each 3iii. Spignel (Meum Athamanticum), St. John's wort (Hypericum perforatum), Juice of Acacia, the bellies of Skinks (Lacerta Scincus or Psammosaurus Scincus) of each 3iiss; Clarified honey three times the weight of all the rest, or about 128oz. Dissolve the opium first in a little wine, and then mix it with the honey made hot, in the meantime melt together in another vessel galbanum, storax, turpentine, and other ingredients of this kind, continually stirring them, that they may not burn, and when these are melted add the honey by degrees, lastly when the mixture is nearly cold, add the rest of the species reduced to powder. This confection was formerly reputed to contain the antidote for every known poison. This very complex formula consists of no less than 46 drugs with 5 other substitutes for them. Of these, 33 drugs are aromatic stimulants, and so are all the five substitutes, one, gentian, is a bitter tonic, and another, opium, a narcotic, but this is in such small proportion that it would scarcely have any effect. Thus there is only one grain of opium in 140 grains or a quarter of an ounce of the confection. It will be seen that there is a great similarity between some of the ingredients of this confection and those of Warburg's tincture. In both there are the following drugs :-Myrrh, Agaric, Gentian, Cubebs and Fennel, while the Angelica seeds of the tincture replace the Aniseed of the confection, and the Radix Heleni, the Costus root. The tincture, however, has Aloes and Rhubarb as well as quinine and spirit, and is altogether a more powerful preparation, but it would appear that the formula was constructed as an imitation of the Confectio Damocratis, with the addition of the above-mentioned drugs, and the omission of many of little value. He would be inclined therefore to recommend ginger and a small quantity of opium, as the substitutes for the preparation of Warburg's tincture instead of the benzoin, which he had formerly used, when he was unaware of its exact ingredients, and he would, therefore, use the following drugs in preparing the Indian substitute for Warburg's drugs, instead of Confectio Damocratis viii. Take of Ginger Ziii, and of Opium, grains xxxij. It is unnecessary to speak of the uselessness of so complex a preparation, but it is interesting to see how large a number of drugs were formerly used in one recipe. (Indian Medical Gazette, March 1st, 1877.)

Iodized Phenol- -a New Uterine Escharotic and Alterative. Dr. Robert Battey, of Rome, Georgia, gives two recipes