hours.

Bismuthi subnit.

gr. v.
3j.

M. Sig. A teaspoonful for an infant one year

M. Sig. Dust over the affected surface four old every three or four hours.

times daily.

M. Sig. Two teaspoonfuls every hour.

Magnesii sulphatis
Aqua.

M. Sig. Two teaspoonfuls every half hour.

URINARY INCONTINENCE.

B. Tinct. nucis vomica

Tinct. belladonnæ

Ext. hamamelis

Elix. simp..

3j.
mxvj.

fass.

Ziss.

R. Tinct. belladonna

Ext. ergotæ.

Elix. simp..

M. Sig. Teaspoonful before meals.

NEURALGIA.

B. Morphia sulphatis

Tinct. hyoscyami

Vini ipecac.

Vini portense

mxvj.

fzss.

Ziss.

of fibroids, polyps, or other morbid growths in the uterine cavity can only be remedied by the removal of the exciting cause. Metrorrhagia following abortion or parturition is usually due to the retention of a portion of the placenta or the membranes. In such cases the uterus should be dilated and the offending body removed. If the hemorrhage is due to fungous granulations upon the endometrium the curette should be employed.

The majority of cases of metrorrhagia, however, are those in which an excessive or exhausting, escape of blood occurs at the menstrual period, and are, therefore, more correctly spoken of as cases of menorrhagia. Ergot is the remedy most frequently recommended for this condition, and it is undoubtedly beneficial in a large percentage of cases. Ergot alone, however, often fails and occasionally increases the sanguinolent discharge. Better results can frequently be obtained from the administration four times daily of ten minims of nux vomica and one drachm of the fluid extract of hamamelis. Cimicifuga and potassium bromide are promptly curative in some cases. Anamic patients are usually markedly benefited by half drachm doses of the tincture of the chlo

The treatment of metrorrhagia must vary in accordance with the cause and amount of the flow and the condition of the patient. Rest in the recumbent position is imperative in all cases, and all sources of excitement must be rigorously avoided. Laxatives should be ad-ride of iron. Monsel's solution may also be ministered whenever necessary.

given in doses of from three to five drops well diluted. Patients of a nervous diathesis usually improve rapidily when placed upon full doses of quinine, strychnia, and phosphoric acid. Patients of a lymphatic diathesis frequently do better when placed upon half-drachm doses of sulphate of magnesia combined with a few drops of dilute sulphuric acid. In all cases when the pulse is rapid and full, from two to three drops of the tincture of veratrum viride should be given every two or three hours until a marked impression is made upon its force and frequency. The most potent remedy for menorrhagia, however, but which should only be employed after internal medication has failed, consists in the employment of copious astringent intra-uterine injections. Either alum, tannic acid, or Monsel's solution may be employed. The patient should be brought to the edge of the bed, and a double catheter which has been attached to a vaginal syringe Metrorrhagia dependent upon the presence inserted into the os uteri. At least a quart of

If possible an endeavor should be made to ascertain the cause of the hemorrhage before instituting any plan of treatment, but if the flow is so profuse as to induce syncope or threaten life, it should be checked at once by thoroughly tamponing the vagina. In order to be effective every portion of the vagina should be filled so as to bring all the pressure possible against the vaginal walls and the cervix uteri. Partial tamponing is worse than useless. Tamponing may be performed through a cylindrical speculum, but it can be done most quickly and conveniently with the assitance of a Sims's speculum. The tampon should be left in position from twenty-four to forty-eight hours in accordance with the gravity of the case, after which it should be removed and the vagina washed out with cold water in which alum or some other astringent has been dissolved.

the prepared fluid should be injected into the uterine cavity and permitted to flow out into any convenient receptacle. The patient should then be placed in a recumbent position and the vagina carefully tamponed. At the expiration of twenty-four hours the tampon may be reremoved when it will usually be found that the hemorrhage has not recurred. If necessary, however, the injection may be repeated with the certainty of effecting a permanent cure.

PNEU

TREATMENT OF PNEUMONIA. NEUMONIA will be rife during the ensuing six months, but the excessive mortality of which it is said to be the cause is the result of improper treatment rather than of increased severity of the disease. As Dr. Henry Hartshorne recently stated before the Philadelphia Clinical Society, the prominent pathological conditions in pneumonia are:

"Frankly speaking, under the following plan of practice six out of ten cases of acute pneumonia in persons of previously good health, between twenty and fifty years of age, may be reasonably expected to die, viz., treating them from the start with twenty grains of quinine daily, a tablespoonful of whiskey every two or three hours, and a quarter of a grain of sulphate of morphia every six or eight hours. If any patients recover under such treatment, it is an escape probably due to the use of large hot poultices kept applied to the chest; an excellent application.

"Another method of treatment Dr. Hartshorne has had ample experimental reason for believing will be followed by recovery in at least eight out of ten cases of simple acute pneumonia in persons not over sixty years of age, of previously good health, viz., the abstraction, on the first, second, or not later than the third day, of a few ounces of blood from the arm in the stronger patients, by cups or

1. Obstruction to the circulation at the seat leeches in those of less previous vigor of sys

of local inflammation.

tem; about the same time, a decidedly purga

2. Resulting general increase of vascular tive dose of some mild saline medicine; after

tension.

3. Arrest or considerable diminution of the secretions of the skin, kidneys, and bowels. In commenting on the above a contemporary

remarks :—

wards, every two or three hours, a saline diaphoretic, citrate, acetate, or nitrate of potassium, or acetate of ammonium; in the most violent cases, in patients of average constitution, tartar emetic during the first three, four, or five days-not more than one-sixteenth to one-twelfth of a grain every three or four hours, not allowed to cause gastric distress; a warm poultice also being kept applied and renewed over the whole anterior part of the chest until the worst is over.

"In all these conditions there is no indication for alcohol, none for quinine, none for opium. The old-time remedy for the abnormal vascular tension of the first stage was the abstraction of a moderate amount of blood, according to the previous vigor of the patient, by venesection, cupping, or leeching. Having been brought "Should this practice be just now out of up under this régime, Dr. Hartshorne can give fashion, it may be very earnestly said that it is personal testimony to its safety and frequent better to be old-fashioned than to lose a considadvantage. It is astonishing that in these dayserable number of patients dying of a malady of daring surgery, of ovariotomy, and laparot-like pneumonia, which ought not to be mortal." omy, for various occasions, physicians should be so much afraid of taking from a patient a few ounces of blood.

"An adjuvant for such a measure of relief in the early stage of pneumonia, or substitute for it in doubtful cases, is the use of saline purgatives and diaphoretics. These also appear to be in recent practice very often, perhaps generally, neglected, Dr. Hartshorne believes, to a great disadvantage.

We agree fully with Dr. Hartshorne in condemning the fashionable practice of treating pneumonia by quinine, morphia, and whiskey, to the exclusion of venesection, arterial sedatives, and purgatives. It is based upon a fallacy, and is responsible for the sacrifice of thousands of valuable lives. Quinine, however, will be found valuable as an adjuvant in many cases, and indispensable in those occurring in malarious seasons or districts. Aconite

DR. BILLINGS AND THE MEDICAL PROFESSION THE MISSISSIPPI VALLEY.-Why Billings should have singled out this great Valley (or any part of the country) to illustrate his tomfool

MEDICAL NEWS AND MISCELLANY. notions of the alliance of malaria and ignorance,

MALICIOUS MUNDE.-After a brief visit through Belgium, I went to Paris. Everywhere in France I found all enthusiastic for the Congress. I saw such men as Sappey, Charcot, Pasteur, Grancher, Warren (Bey), Péan, Verneuil, Lelaird, and others of like reputation, the very first men in France, and found that while efforts had been made to tincture their minds, it was of no avail. They were for the Congress, first, last, and all the time, feeling honored by accepting positions and expressing their desire to aid in the scientific work of the Congress, by preparing papers and taking part in discussion, as the affairs demand. By-the-by, we made sure from excellent authority, and that in which we have the most complete confidence, that Dr. Paul F. Mundé, of New York City, has been exceedingly busy, especially in Berlin, trying to do all in his power to injure the interests of the Congress. Will it not be worth while for the medical profession of America to put a pin in here. Mr. Mundé may want day and date for this, if so, kindly refer him to me.— London Correspondence Weekly Medical Review.

Dr. NATHAN S. DAVIS has done honor to America. We have always supported the American Medical Association. We do not wonder at the high eulogy passed on Dr. Davis by his confrère, Dr. Campbell. We have had the honor and pleasure of entertaining Dr. Davis for a few days, and have thus the better obtained an insight into his character. Joined to a noble simplicity of character, and to a rare modesty, he possesses a strong individuality, marked by his convictions. Conservative in medicine, yet posted up in modern theories, he can, from a ripe experience of. over fifty years, entertain and instruct. His natural eloquence secured for him the applause of all the meetings he addressed at Brighton, which he won, not by Americanisms, or ad captand. appeals. He is a worthy successor to Dr. Austin Flint. American medicine honored herself in honoring him. We here form ideas about American writers which are erroneous. The men best known in England are not the best men in America. The profession in America are the most capable judges of who the best men are, and if we can take Dr. Davis as a sample of

would be difficult to divine. Was it on account of these notions that he, when a member of the Original Committee," in 1884, in the office of Dr. I. Minis Hays, in Philadelphia, condescended to give the South and West a few positions in the Congress? Was it on this account that they printed and sent out their list, agreeing between themselves, that while it would cause dissatisfaction the physicians of the South and West would not dare to rearrange their work? Could the "downing" he got at New Orleans have had any influence over his own malaria stuffed stomach? It would be well for him to remember that those who live in glass houses should throw no stones. Perhaps the doctor will feel better after the Congress is over? If not he should move away from Washington Flats and quit eating bull-frogs.

Both space and time is lacking for the full consideration of the adroit cunning and subterfugediction practised by his using the term "maWe will, therefore, for the preslaria."

|
ent only assert that the sweeping charge of a
low comparative standard of education upon the
part of the physicians of the Mississippi Valley is
not borne out by the facts, and that Dr. Billings
knew so at the time he made it.—Mississippi Val-
ley Medical Monthly.

DR. BILLINGS'S ADDRESS.-The Doctor could not rise above the petty jealousies that characterize the pigmies of medicine. He could not resist the temptation to strike a blow at those who defeated his scheme of organization of the Congress upon a basis which many of the very best men, even of the North, say was not just-inasmuch as it was not a national representation. Forgetting every consideration of patriotism and of justice, he stooped to the devices of small souls, and cast a slur upon the profession of the Mississippi Valley.

Dr. Billings has disappointed many. It seems he could not rise to the dignity of the realization of the fact that he was expected to represent American medicine, and he stooped to represent a section-a clique! He drew invidious distinctions, and said, in effect, that all the science of the profession resides above, and beyond the malarial belt! He drew a map, and marked out the sections where malaria prevails-all through