The diagnosis is positive when the microscope reveals either the meningococcus or the pneumococcus lanceolatus. The micro-organisms are said to be most abundant in the early stage of the disease.

Treatment
of Enlarged
Cervical
Glands.

Chronic enlargement of the angular cervical glands, not due to malignant disease or to dental irritation, has been treated by Dr. J. L. Goodale successfully by way of the tonsils of the same side. For this

purpose a 10 per cent. aqueous solution of iodine is introduced into the crypts by means of a blunt, pliable, silver canula attached to a hypodermic syringe and bent at the distal end. Each crypt is treated with three or four drops of the medicament. The treatment is repeated every third or fourth day, marked and rapid shrinking of the gland usually taking place.

Some Dropsies and Their Management.

Under this title, J. C. Wilson has a very practical and instructive article in the Virginia Medical Semi-Monthly of June 9. After entering into the general causes, such as hydremia, changes in vessel walls, transudation from increased blood pressure and diminished resorption of lymph, he considers the more important special forms.

The edema following hemorrhages in the middle periods of life, he says, usually disappears rapidly. In the extremes of life or after excessive hemorrhages, on the other hand, the aneinia becomes profound, and death can be averted only by hypodermoclysis or intravenous injections of normal salt solutions. For the edema of chlorosis we have a specific in iron administered with a free hand. "Blaud's pill, in 10 or 15-grain doses, or the sulphate of iron in 3 to 5-grain doses, thrice daily, together with a saline or a little aloes once a day, will not only cause the puffiness and edema to disappear, but will cure the underlying condition." The complex circulatory-hemotoxic dropsy of nephritis

varies inversely as the amount of the urine and is often massive in extent. In this form the supplementary action of the bowels must be maintained by Epsom or Rochelle salts or Seidlitz powder. Hot air baths may be urgently needed because of impending uremia. In the early dropsy of nephritis, digitalis is by far the best drug, says the writer. The tincture should be given in ascending doses until from 10 to 20 drops are taken four times a day, closely watching at the same time for toxic, gastric or cardiac effects; if there be great reduction of urine, calomel in 3-grain doses every two hours, until 12 or 15 grains are taken, will frequently produce a great temporary increase. If the pleurae contain fluid, aspiration is indicated both for exploration and as treatment. For the reduction of ascites, the writer prefers the old-fashioned medium-sized trocar and canula, whereas Southey's tubes are safer and more convenient for depleting the lower limbs, when introduced into the outer side of each leg a little above the malleolus. In a case recently under observation, more than four gallons of dropsical fluid were drained away in this manner in the course of forty-eight hours.

For the dropsy occasionally encountered in diabetes, Dickinson recommends rest in bed, bandaging and tincture of iron. Crural thrombosis is best treated, according to Prof. Wilson, by moderate equable compression with a flannel bandage, the elevation of the leg upon pillows, and the hypodermic injection of morphia for the relief of pain. Gentle centripetal massage may be practiced after a time, but not directly over the affected vein, for fear of an embolus. Still later an elastic stocking should be worn, often for a long time.

The edema of pregnancy, if due to simple obstruction, is limited to the lower extremeties and the pudenda. If due to nephritis, it is likely to become general.

Hepatic cirrhosis is by far the most common cause of ascites, for which tapping must usually be repeated

at intervals, midway between the umbilicus and the upper border of the pelvic bone, taking care that the bladder is empty and that no loops of gut are adherent at the point of puncture. Ethyl chloride and incision of the skin with a bistoury are not necessary, but a many-tailed bandage must be used.

The most frequent cause of cardiac dropsy is mitral stenosis, mitral insufficiency coming next. Marked aortic stenosis may also be accompanied by dropsy, but this symptom is quite rare with insufficiency of the aortic valve. The treatment of cardiac dropsy consists in restoring compensation if possible. Rest in bed is of primary importance. Digitalis ranks first among drugs. Caffeine and occasional purgative doses of calomel often serve a good purpose. The bowels, kidneys and skin are to be looked after carefully. A diet as dry as practicable is of great importance in this form of dropsy. The total amount of fluid (milk, weak tea, a little wine and water) should not exceed 250 c.c. The treatment should be thoroughly individualized and the writer remarks truly that no field of therapeutics more closely tests the skill of the practitioner.

Broncho-
Pneumonia

in Children.

Treatment of The belladonna and calomel treatment has been used successfully in all but one of twenty-five cases of capillary bronchitis by Prof. D. A. Hodghead (Pacific Medical Journal, June) without the use of any other remedies. The calomel is given in 1-10grain dose until the bowels move freely. The belladonna is not begun to be administered until the disease is well established, as the object of this remedy is to diminish the secretions and stimulate respiration, thus enabling the little patient to escape from what it cannot expectorate. To a child a year old a drop of the tincture may be given every hour for twenty-four hours, and then less often, particularly if the belladonna eruption is well marked.

EDITORIAL ITEMS.

Pierce's Pellets.-These are chiefly resin of podophyllum. Viavi." This is said to be a mixture of tannic acid, opium and cacao butter.

Gouty Insomnia.-Sodium sulphate in hot water at bedtime is recommended as curative.

Pain of Zoster.-Sodium salicylate, 4 to 6 grams per day, is recommended by Franz Mracek.

Garfield Tea. This consists apparently of 8 parts cut senna, 6 parts couch grass and 1 part fennel.

"One Night Corn Cure."-A similar preparation is made with I part of salicylic acid and three of lard.

Barr's Dental Anesthetic.-According to Sadler, this is an alcoholic solution of oils of clove and peppermint.

Cystitis. A 1-10 to 1⁄2 per cent. solution of antinosine is said to be an excellent antiseptic for irrigation purposes.

Earache. When due to inflammation, the hearing is usually impaired, which is not the the case in neuralgic forms.

lodoform Injections.-Sweet almond oil is probably the best excipient; the solution, when sterilized, being very stable.

Carter's Little Liver Pills.-A dozen of these contain 11⁄2 grains podophyllin and 31⁄2 grains aloes, with mucilage of acacia.

Artificial Carlsbad Salt. This consists of 1 part potassium sulphate, 9 of common salt, 18 of baking soda, and 22 of dried sodium sulphate.

Hepatic Cirrhosis.-A milk diet is recommended by Cardarelli. If this disagrees an ounce or two of milk sugar should be given each day in weak broth.

Crusted Eczema. In the crusted stage of eczema, diachylon ointment is the most serviceable application. After the surface is clean, Lasar's paste will usually effect a cure.

Phthisical Constipation.-Renzi (quoted in Louisville Medical Monthly) recommends two to four powders daily each containing 3 grains iodoform and 3 to 6 grains of naphthalin.

A Big Medical Contract.-According to the Medical Standard, Dr. Azel Ames, of Massachusetts, has obtained a contract to vaccinate all of Porto Rico's million inhabitants for $100,000.

Headache with Delirium.-Dr. Given Campbell alludes in the Medical Review to the great importance of severe headache persisting in delirium in the diagnosis of cerebrospinal meningitis.

Ice Rubbing in Acute Rheumatism.-Dr. Wm. Ewart (quoted in Medical News) has observed great relief from rubbing the affected joints as often as need be with a piece of ice wrapped in flannel.

Treatment of Erysipelas.-Seneca Powell claims excellent results from the local application of strong carbolic acid, left on for a few moments until the skin whitens, and then neutralized with alcohol. Nervous Headache and Hemicrania.-Lewy (quoted in Medical News) recommends 10 grains each of methylene blue and nutmeg, to be divided in six capsules, two or three of which may be taken in a day.

Fissures of the Tongue.-The Riforma Medica (quoted in New York Medical Journal) gives the formula for a local application, consisting of one part carbolic acid, three parts tincture of iodine and ten of glycerin.

Big G.-This once popular patent antigonorrheic remedy is said to consist of 15 grains each of berberine hydrochlorate and zinc. acetate in 4 drams of glycerin and 71⁄2 ounces of water, with boric acid added as a preservative.

Detection of Corneal Lesions.--In case of doubt one should instill a 2 per cent. alkaline (sodium bicarbonate) solution of fluorescein. Any ulcerated or abraded area is colored green, while a foreign body will be encircled by a green ring.

Diuretics in Pleurisy.-Butler (Medical Standard, April) states that the saline diuretics and vegetable infusions are unreliable in this condition, but that caffeine in 3-grain doses or diuretin in 15grain doses may be usually relied upon.

Saline Injections in Summer Diarrheas. In the summer complaints of children Dr. J. P. Webster (International Journal of Surgery, May) is accustomed to order an enema of one quart of normal saline solution every four hours. The local and general symptoms are both greatly improved. A number 10 or 12 rubber catheter may be used if the colon tube is not at hand.

Hacking Cough.-Redmond Payne reports a case of persistent, hacking cough due to a hidden, unresolved peritonsillar abscess, from which drops of pus were discharged into the pharynx (Pacific Medical Journal, June.) He also alludes to the not infrequent discharge of pus into the pharynx from an old otitis media, which may cause a hacking cough in the same way.