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bacteria. At least twenty varieties of micro-organisms have been obtained from the external genitals by different observers, but owing to polymorphism a number of these may be one and the same. Urinary infection ordinarily takes place by extension upward, following instrumentation, though in the case of the female it may be spontaneous.

spontaneous. Direct extension through the tissues, as in the case of colon bacilli in obstinate constipation, is sometimes observed. Hematogenic infection is frequent in acute infections, but it is doubtful whether micro-organisms can pass through a perfectly healthy kidney. The bacillus typhosus is to be found in the urine in at least one-fourth of all cases of typhoid fever. Urinary tuberculosis usually travels downward from the kidney to the bladder, and is nearly always secondary to tubercular foci elsewhere. The vital importance of asepsis and autisepsis in local treatment and operations about the genito-urinary organs is manifest. For the passage of instruments into the urethra, Dr. Warren recommends to wash the external parts with green soap and warm water, then wash with mercuric chloride, 1:3000, and rinse again with sterile water or saturated boric acid solution.

If possible, the patient should always urinate before operation or instrumentation or even the use of the syringe.

Metallic instruments and soft rubber catheters should be boiled or steamed. Sterile glycerin may be used as a lubricant. Dr. Warren considers silver nitrate (1:3000 to 1:500) the best local germieide, though potassium permanganate (1:2000 to 1:1000), corrosive sublimate (1:10000 or weaker), boric acid, Thiersch solution and salt solution (up to 12 per cent.) are all valuable for irrigations. Internally he recommends urotropin (for typhoid bacilli), sandal oil, boric acid, salol and sodium benzoate.

Advance The best advance agent to many of the proAgent. prietary products upon the market is the

physician himself. The remedies are purported for the exclusive use of the physician, and the

proprietor would not advertise his products through any but legitimate channels for the world, but listen:

He has his tablets and pills stamped or labeled so any fool having seen the “brand” once could tell it again, and if he found the article good would not only purchase it for himself without the recommendation of his physician, but suggest the same to all his friends. Let any physician sit in a drug store almost any day and see how many persons call for some of those X tablets with bile. Let a man get a urethritis, which he has been unable to cure, and upon going to his physician, he will tell him he has been taking “Midy” pills. The manufacturer knows only too well the wide berth the physician gives his products by reason of the brand upon them, and he thinks the physician ought to consider it a great favor to receive gratuitous samples occasionally, if he will but pay the expressage on them. Oh, yes, that is the cheapest method of advertising that such pharmacists can resort to.

Then again, if you keep your eyes open, you will observe that these fellows, not content with this predatory warfare, sometime in the history of their products, now and then in the lower left hand corner of some love journal, in small print, deliberately advertise these same remedies to the public.

Haven't you often had some of your patients ask you: “Doctor, don't you think ‘Midy' pills good for gonorrhoea or — for restlessness ?Whether these remedies, and many others I might mention, are claimed not to be advertised out of legitimate channals, yet no newspaper or street bill-board could be more conspicuous for their display or more harmful to the business of the physician than this very brand which these proprietary products carry. What shall be done about it?

Absolutely refuse to prescribe any article that has a trade mark upon it. A mark that is intended for the patient so he can get it again, and not intended to facilitate the discrimination (?) of the physician.

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Medicines in bottles can have these labels torn off and others substituted, but these labels are intended to stick.

Dr. WoodwoRTH, Pueblo, Colo.

Mercurol in At a meeting of the Genito-Urinary the Treatment Section of the New York Academy of of Gonorrhea. Medicine, held on the 21st of March,

Dr. Ferd C. Valentine reported a case of acute gonorrhea treated by mercurol irrigations. The patient was an American, aged 32, married, the secretary of a corporation, and was unusually anxious to get well with as little loss of time as possible. He had had several previous gonorrheas, resulting in stricture. On January 21, last, while inebriated, he had coitus extra domum. Three days afterwards he found a free, yellowish discharge, with the usual pain on urination. He at once put himself under treatment, and for ten days was irrigated regularly with mercurol, for a part of the time twice a day. Discharge was reduced from a free yellow flow to a slight pinhead drop by the first irrigation of mercurol, 5 per cent., and the urine became clear. Microscopic examination of a specimen of the discharge, which was taken on the first day, showed numerous gonococci characteristically grouped in pus cells. Two days later, after the fifth irrigation, the gonococci were found to have disappeared. A burning sensation was experienced after the irrigations, but the strength of the solutions being reduced, the pain became less and ultimately ceased.

Dr. Ramon Guiteras said mercurol was being used at the New York Post-Graduate Hospital. The treatment was less drastic than that described by the reader of the paper, the custom at the institution referred to being to commence with small dosages and gradually increase their strength, especially when new preparations were being experimented with. In the case of mercurol they had commenced with as mild a solution as one-half per cent., and finding favorable, though rather slow results, they had gradually increased it, until now a solution of 2 per cent. was given to all patients who presented themselves at a clinic devoted exclusively to this mode of treatment, of which Dr. Otis K. Newell has special charge.

EDITORIAL ITEMS.

Thyroid Gland for Psychoses.-A number of alienists have observed good results from the administration of this preparation in puerperal mania and melancholia.

Senile Restlessness and Insomnia.-Clement Dukes speaks highly in this connection of nitroglycerine in 1-100 grain dose, or erythrol tetra.nitrate in the dose of 72 to i grain.

Insomnia.—A capsule containing 30 minims of turpentine, given at bedtime, is stated by Bradbury to be sometimes beneficial in the insomnia of overwork and worry, particularly in plethoric subjects.

Bibliographia Medica.-A new monthly international index medicus has been inaugurated in Paris, with Marcel Baudouin as editor-in-chief. The first number appears very complete and systematic.

The Providence Medical Journal.—This is a brand-new quarterly medical magazine, edited and published by the Providence Medical Association. Dr. Geo. D. Hershey is editor. It is a representative New England production.

Faith Cure as a Ground for Divorce.-A divorce was recently granted in the circuit court at Chicago to an ex-congressman (New York Medical Journal), the specified cause being the wife's belief in the efficacy of faith-healing.

Methylene Blue in Malaria.Dr. J. W. P. Smithwick affirms that this drug is a perfect succedaneum for quinin, being particularly indicated in pregnancy and hematuric cases in patients who show an idiosyncrasy toward quinin.

Record of Symptomatology.—This is the name of a new monthly journal devoted to physical diagnosis, published in Omaha and edited by Dr. W. L. Capell. The enterprise is certainly a commendable one and we wish it well.

Serum Therapy.—This is the title of an interesting brochure just published by the scientific department of Frederick Stearns and Co., Detroit. It gives much timely and practical information concerning the principles of serum therapy and the preparation and special uses of the various serums.

Editorial Items continued on Page 607.

BOOKS.

Diseases of the Stomach. Their Special Pathology, Diagnosis, and

Treatment, with Sections on Anatomy, Physiology, Chemical and Microscopical Examination of Stomach Contents, Dietetics, Surgery of the Stomach, Etc.-By John C. Hemmeter, M.D., Professor in the Medical Department of the University of Maryland, Baltimore. With Many Original Illustrations, a Number of which are in Colors. Second Edition, Enlarged

, and Revised. Octavo; 898 pages. Price, $6.00 net, Cloth. . P. Blakiston's Son & Co., 1012 Walnut Street, Philadelphia, Pennsylvania

The high plane to which the specialty of gastrology has been brought is well exemplified by the elegant volume before us. In this second edition the author follows his former division of the text into three parts, namely, the anatomy and physiology of the digestive organs and methods and technics of diagnosis, therapy and materia medica of stomach diseases, and the gastric clinic, which last comprises a systematic account of individual gastric disorders. The author's descriptions of diagnostic methods are very clear and explicit, and all of his writings show a thorough practical familarity with the subject of stomach diseases. The sections on diet are especially valuable. The present edition has been thoroughly revised to date and includes about 100 pages of new matter, imbracing articles on hypertrophic stenosis of the pylorus, obstruction of the orifices, and the use and abuse of rest and exercise in the treatment of digestive diseases. The author's main purpose, to make his book in the highest degree helpful to practitioners, has been achieved with the distinction that good work always receives sooner or later. Prof. Boas has well affirmed that this volume is “The best contemporary treatise not only in America, but in the whole world."

Surgical Pathology and Therapeutics.--By John Collins Warren, M.D.,

LL.D., Professor of Surgery in Harvard University; Surgeon to the Massachusetts General Hospital. Jllustrated. Second Edition, with an Appendix Containing an Enumeration of the Scientific Aids to Surgical Diagnosis, together with a Series of Sections on Regional Bacteriology. Octavo; 873 pages. Price in Cloth, $5.00 net; Half-Morocco, $6.00 net. Philadelphia: W. B. Saunders, 925 Walnut Street.

1900. The method followed by this author of combining pathology with therapeutics commends itself as one of practical service in

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