employed as frequently as local remedies in inflammations of the mucous membranes as they deserve to be. They seem to us to be distinctly· sedative, and at the same time slightly astringent, and may be used freely in the most acute stages of mucous inflammation. Thus, in the beginning

8. The Drainage and Sewerage of Cities and of an acute nasal catarrh, bismuth may be blown Towns.

9. The Drainage and Sewerage of Philadel- with great relief. If five grains of the carbonate phia.

24. Test for Impurities in Water: The Use of half-hour before the meal. When it is desired Filters.

29. City versus Country Life, from a Hygienic stomach are rapidly passing into the intestines, Point of View.

Another very curious idiosyncrasy that has come under our notice is in a lady who is thrown into fainting fits by eating the smallest piece of butter. We have known her tried by those who thought her condition was purely imaginative by placing a small piece of butter in a dish of mashed potatoes and giving her a tablespoonful, after telling her that there was no butter in it. In a very few minutes she fell off her chair in a condition of swooning.

Some years ago, one of the residents of the Pennsylvania Hospital was forced to resign, because the moment he went to work in the surgical wards he became afflicted with a crop of boils which would have disrupted the heart of Job with envy. It was only years afterwards that the

unfortunate doctor discovered that the boils were

Under

There is a very well-known practitioner in | Other language I fail to find which can adePhiladelphia who is most violently affected by quately describe the condition assumed by Batthe odor of hyacinths. We have known a single tey's ardent disciples. We hear Dr. Imlach sprig of hyacinth, put in his room without his opening his paper upon pyosalpynx with the reknowledge, to cause in a few moments sick mark "that every Monday, at two o'clock, I see stomach, followed by violent, repeated retching, out-patients at the hospital for women. If unable and great general depression, amounting almost to attend, I were to tell the nurse to send into the to syncope. It would appear as though, if he hospital those women who suffered most and had were shut up in the room with a single hyacinth been the longest ill, out of ten sent in, seven or bulb in full bloom, it would cause his death. A eight would have some chronic inflammatory curious feature of this case is, that the emana- disease of the uterine appendages, and most of tions will produce so much disturbance of his them would prove incurable without surgical system without his perceiving the odor. treatment." And further on: "I have removed the uterine appendages one hundred and twentysix times," all of which he considered in a diseased condition; on the other hand, we hear an authority like Dr. Grimsdale declare that the ovaries which he saw on one occasion removed by Dr. Imlach were perfectly healthy, and this was, I understood, the only time that he (the consultant of the institution) got the chance of being present. We also had the evidence of Dr. Alexander, who declared that out of the large number of postmortems which he made at the Liverpool Workhouse, he very rarely found traces of this disease, although he had paid particular attention to the examination of the uterine appendages. these circumstances, does it not seem time to do something to stay the destroyer's hand, as even the removal of one set of healthy parts would, in the minds of honest men, counterbalance all the supposed good of the remaining one hundred and twenty-five operations, at which neither Dr. Grimsdale or any other man of equal erudition was present; had they been, possibly a few more healthy organs might have been discovered. Poor Baker-Brown in his day was quite as eminent a man as either of the gentlemen referred to; but alas! he fell for performing an operation trivial in its consequences compared to spaying. Dr. Tait and Dr. Imlach have attempted to draw conclusions from the results of their practice by comparison with those of two general hospitals; was this fair or generous on Thornton ward diseased organs alone are intertheir part? I think not, as, I believe, at the fered with; whereas, if I may again quote Dr. Grimsdale, healthy ones have (at least once) been removed in Shaw Street, so that if the same difference of practice exists in Birmingham, it may somewhat account for the disparity of death-rate, operative measures upon diseased subjects being necessarily more fatal than those performed upon perfectly healthy ones. If we dare make use of the analogy of the sow-gelder, he seldom loses a healthy pig, but has large mortality among diseased ones. The matter up to this has been misunderstood by the laity, but let it once become public that women are being unsexed (castrated) in batches, such as described by Dr. Imlach, and the exit of its authors (in this country) from the

produced by the emanations of turpentine, which was, at that time, used in the wards for cleaning off the skin of patients to which the adhesive plaster had remained.

Not long since there came into our office a gentleman to whom morphine was given for the purpose of relieving pain. Contrary to all expectations, a violent diarrhoea was produced by the alkaloid; indeed, so excessive was the flux that it was stopped with difficulty. In this case the idiosyncrasy appears to have been inherited, as the father of the patient was accustomed to use habitually paregoric as a laxative; a teaspoonful of this fluid taken at night would always produce soft evacuations in the morning. As already stated, there is no way of foreseeing these peculiarities. It ought, therefore, to be the habitual practice on the part of the physician, when prescribing for a patient with whom he has not before been acquainted, to ask as to the existence of any such peculiarities, and to pay attention to the answers received.-Therapeutic Gazette.

THE LAPAROTOMY EPIDEMIC.-No more momentous question has been ventilated in our profession, nor one requiring greater coolness and decision in its treatment, than the justification or otherwise of those engaged in wholesale spaying, which seems, rightly or wrongly, to have become the fashionable craze of certain gynæcologists.

scene will, I think, be as rapid and decisive as | tion has almost always failed to produce scarla

was that of the clitoridectomist. Before it is too late let them adopt the motto, if they may so apply it, Appetitus rationi pareats.-DR. JAMES M. BENNETT, London Medical Press.

THE CAUSATION AND TREATMENT OF SCARLATINA. A valuable contribution to the literature

of this subject is made by Dr. Whitla in the Dublin Journal of Medical Sciences, in which the writer summarizes pretty carefully the present state of our knowledge. The investigations of Pohl-Pincus, Klein, Eklund, and Octerlony are discussed, but the conclusion reached that, as yet, the living organism of scarlatina has not been demonstrated

or isolated. Much still is known regarding its nature. It is the most tenacious of all contagions. It will survive heat up to near the boiling-point, and a freezing temperature does not destroy it. In England its virus is always more active in autumn. How does it enter the system? The

writer cites cases where a lancet has carried

the disease, but thinks in the great majority of

cases the route of contagion is the pulmonary tract and the throat, first taking effect in the fauces, The ingestion of articles of food which have stood in the sick room appears, in some cases, to have caused the disease, so that it may possibly be absorbed by the stomach. The evidence that the disease may be communicated through the medium of a third party, the writer states is overwhelming. The carrying of the disease by clothing, toys, letters, flowers, and even locks of hair from the sick room are mentioned.

Re

tina. The common rule of isolating scarlet fever patients for six weeks, is considered a safe one; yet, if convalescence be retarded, it may be well to extend the period to nine weeks. Stress is laid upon three points: (1) The poison from the mildest case may produce the most deadly form. (2) In no disease is the part played by individual susceptibility so striking. (3) This susceptibility runs in families, and is often noticed in the most believed to be shorter than is generally supposed. robust members. The period of incubation is The writer is of the opinion that the rule is three or four days; numerous cases are referred to in

which it was only one or two days. To prevent immediate isolation, disinfection of everything the patient from spreading the disease, rigid and which has come in contact with his person, anointing the body with some disinfecting ointment, scrupulous cleansing of the body with tepid baths, or sponging with a solution of Condy's

fluid, are all things to be insisted on in every

case. The writer has no faith in cutting short the disease by destroying the virus at its point of entrance, the throat, during the preliminary stage. It is compared to the excision of a chancre to bolate of soda are believed to do great good by prevent syphilis. Quinine and the sulpho-cardisease. The reckless dosing with chlorate of reducing temperature, but do not shorten the potash is often productive of great harm, as is also the too free use of carbolic acid internally and about the patient; both are believed to increase the liability to renal complications. Great success is claimed for free and fearless purgation by croton oil and the use of the hot pack in treating

uræmic convulsions. A dozen cases are men

tioned as having been so treated successfully.— The Physician and Surgeon.

THE REQUIREMENTS of the SICK-ROOM.-J. Varnum Mott, M.D., Boston, Mass., in speaking of food, says: "We are called on from the very hour of birth to furnish appropriate food for nour

Domestic animals are another medium. garding contagion by means of milk, the writer states that these cases have been found to be from the existence of the disease in the man who delivered the milk, the person who milked the cow, or, more often than either, the presence of scarlatina in the house where the milk was strained, mixed, or allowed to stand. No authenticated cases of disease in the cow were found. The author denies that scarlatina is even a drain disease, in the sense that the poison may be gen-ishment, and when sickness occurs the twofold erated there de novo. There is not, even to his importance of this task is justly appreciated. mind, satisfactory evidence that the general ill Whilst, as a rule, each disease requires a special effects of bad sewerage render a patient more | diet, dependent on several physiological indicaliable to the disease, or render the attack more tions, it will not be possible for us to consider virulent. The disease has continued to deepen more than very generally this subject. Milk in extent and gravity in the face of all modern ranks among the first articles ever known for improvements in sewage management. Em- sustaining life, and is generally liberally supplied phasis is laid on the fact that it is the pulmonary by the natural laws; and when a woman fails to and cutaneous exhalations which are the active be able to supply her offspring with this essential agents in spreading the disease, and not the epi- commodity, there is something radically wrong. thelial scales of desquamation. There is no The beasts of the fields are thus enabled to nurdoubt that the disease is highly contagious as ture their young, and the first instinct developed soon as the rash appears, and analogy would is to seek that nourishment at the maternal fount. render it at least probable that it may be con- Hence milk is known to possess very valuable veyed during the period of incubation. Inocu- properties, and yet a milk diet is not to be dilation of animals with the scales of desquama-rected for an adult without very careful consider

ation, and its use must be very strongly indicated. | on the contrary, he should be encouraged to rely Many are unable to properly digest milk unless on a small amount often repeated. Care should diluted with lime water, and hence it is, although be taken that it be prepared in a manner calcuwe recognize it as being very valuable, still it is lated to tempt the appetite. Coaxing should, of capable of giving rise to certain functional dis- course, be indulged in when necessary. The apturbances which it is our duty as medical men to proximate amount of food and the time adminis-. guard against. Beef tea will always very justly tered should be carefully tabulated. Absolute have its advocates, and for adults it is to be pre- cleanliness should be observed in each detail, ferred to milk. Beef extracts, meat juice, etc., and each article should be prepared with great are favored by the profession, and are used as care, ever having it in view that it is for the paexperience dictates. The very best preparation tient. Fruit is indispensable to the sick room, and that I have extensively used is known as Valen- many there are who would thrive in every way tine's Meat Juice.' It possesses the great advan- on what might be termed a fruit diet. There are tage of always being ready for use; it serves best very few conditions that would of necessity prowhen taken cold, and I have yet to meet a case hibit the use of at least some kind of fruit, and where the stomach will refuse to retain it, pro- generally this will prove more grateful and ac viding it be administered diluted (one teaspoon- ceptable than anything else. In the present cenful to a wineglass of cold water), and fed to the tury we are enabled at no very great expense to patient by a teaspoonful at intervals of every two avail ourselves of imported fruits during our or three minutes until the above is given, when a winter months, so a very decided advantage is small piece of ice may be allowed. There are thus held over our ancestors, who, per force of numerous medicinal foods that are much vaunted, circumstances, were unable to obtain any save and all have their adherents. The Imperial native fruits. When broths are to be given let Granum,' in my hands, has seemed to meet with them be sufficiently hot, although not absolutely all that is claimed for it, and experience has boiling, and have them carefully seasoned. brought me to rely on its use where its special When, on the contrary, cold drinks are ordered, properties are indicated. In infantile diseases it care should be taken to insure their being reasonhas proved very efficacious, and I always direct ably cold. Nothing is so apt to discourage a its use when a child is being weaned. Koumyss nervous patient as bringing to his attention unhas within the past few years been added to our palatable food or drink; and in this we cannot list, and in some cases of gastric disturbances it exercise too much care, for we must remember has proved very valuable. Cocoa has been the patient is fully supported in his objections and largely prescribed during the past few months, contempt at such edibles by the instructions given and, whilst it undoubtedly is a valuable tonic, in Revelations iii. 16: Because thou art lukestill it should not be expected to take the place warm, and neither hot nor cold, I will spew thee of food. Alcohol and various drugs are capable out of my mouth.'”—The Microcosm, New York, of exerting a stimulating effect, but should be February, 1886. used with great care, for there are many who today are addicted to its abuse who first indulged at the order of their physician. So in dealing with alcohol and opium there is a moral aspect that should enter into the consideration, and, if possible, I consider it much better policy to disguise its character when obliged by certain symptoms to employ it. Water is not very generally considered as food, but it certainly is under certain circumstances, and often can be retained when meat and everything else is rejected, and it serves the purpose of temporarily quenching the thirst in a case of fever. Eggs raw, or slightly boiled, are valuable adjuncts, and are very largely employed throughout the land, combined with milk. This is very sustaining and highly nutritious, and in most cases should be taken without any alcoholic addition. It is the duty of the nurse, as we have already observed, to attend the wants of the patient, but nourishment comes directly under the directions of the physician, and the nurse is looked to for their being properly carried out. We must never permit a patient to take a large quantity of food at any one time, but,

THE CAUSE OF ELEVATED TEMPERATURE.—

In an article in the New Orleans Medical and
Surgical Journal, Dr. John B. Elliott, Professor
of the Theory and Practice of Medicine, Tulane
University of Louisiana, says:—

From the nature of the forced change involved when chemical energy transforms to tissue-building force, we are entitled to regard it as the most important of all the physiological processes of the body. In it energy becomes constructive, while in all other processes it is destructive. Its control and regulation must, therefore, be considered the highest function of the automatic centres.

It remains further to insist, in this connection, upon the strict quantitative relation existing between chemical energy which undergoes transformation in the body and the modes of force into which it is changed. This may be illustrated numerically by the following: Suppose an amount of chemical energy, represented by the number 12, to undergo transforination into work, heat, and tissue-building force; then the value of the

work, heat, and tissue-building force in their sum, in a state of unstable equilibrium. In almost can never vary from twelve.