A Valuable Sign of Hereditary Syphilis.—A Brunet (quoted in Pediatrics) claims that erosion of the first lower molar in a patient, whose other teeth are healthy, is a pathognomonic sign of hereditary syphilis. The first molar of the second dentition is the only tooth the ossification of which begins in utero.

Chromic Acid for Buccal Lesions.—Jarre (St. Louis Medical Review) announces that local applications of chromic oxide promptly cure all inflammatory and ulcerative lesions of the buccal mucous membrane. It should be applied in a concentrated solution and rinsed off at once to restrict its action upon the superficial tissues.

Bronchial Asthma.-During the intervals, Shoemaker prescribes a combination of 12 grains potassium iodide, 3 minims of liquor potassii arsenitis, 30 minims of fluid extract of grindelia, 10 minims of tincture of euphorbia pilulifera, and enough fluid extract of yerba santa to make a teaspoonful, which is taken three times a day.

Freezine.-Formaldehyde as a preservative for milk is best tested for, says Leach, by heating about 10 c.c. of the milk with an equal quantity of concentrated hydrochloric acid and a drop of ferric chloride solution. A violet coloration results if formaldehyde be present. The test is so delicate as to show one part of the gas in 300,000.

Changes in Medical Faculty.-Dr. L. McLane Tiffany having resigned the chair of surgery in the University of Maryland faculty of physic, Dr. Randolph Winslow was elected professor of surgery. Dr. John Holmes Smith was elected professor of anatomy, Dr. D. M. R. Culbreth professor of materia medica, Dr. Frank Martin and Dr. St. Clair Spruill clinical professors of surgery, and Dr. Joseph W. Holland demonstrator of anatomy.

Some Reason for Considering the Vermiform Appendix as a Gland.—Clarence L. Killbourn (Philadelphia Medical Journal) thinks the appendix should be regarded in the same light as the tonsils or salivary glands. The development at first appears about the same time as the diverticulae which form the other glands. The lymphoid submucous layer is far more important than the others. Histologically the appendix resembles an inverted or involuted tonsil. Its situation is well adapted to act upon the contents of the colon, and in structure and location it bears the same relation to the pancreas as the tonsil does to the salivary glands.

An Unusual Cause of Ascites.-Solid and semi-solid tumors of the ovary (Philadelphia Medical Journal) are almost invariably accompanied by ascitic accumulations, whereas cystic growths of the same organ and solid tumors of the uterus are not so accompanied. In cancer of the ovary, however, ascites is by no means a persistent symptom.

Luminous Bacteria. The so-called phosphorescent bacteria of sea water can be cultivated artificially in saline media, emitting light only when oxygen is supplied by agitation or otherwise. Those found in northern latitudes have an optimum growth temperature of 15° C. The light emitted by these organisms includes visually the green and the blue.

Post-Anesthetic Nausea and Vomiting.-Ralph H. Hess (Medical Record) holds that the nausea following anesthesia is due to the excretion of ether by the mucous membrane of the stomach, resulting in acute gastritis. In anticipation of this gastric irritation, it is advised to give one to two glassfuls of water just before beginning the anesthetic.

Local Treatment of Acnc.-Charneil (International Medical Magazine) recommends a sulphur lotion containing 25 grams of precipitated sulphur, 60 grams of alcohol, 200 grams of rose water and 215 grams of distilled water. Shake before using and apply at night with a brush, washing off in the morning with quite warm water, followed by hot compresses.

Urinary Alterations of Hepatic Insufficiency.-These include, according to Ducamp (quoted in Medical News), albuminuria, hyaline and granular casts, diminution of urinary toxicity and retardation of the elimination of methylene blue. Glycosuria, at first only after the evening meal, becomes constant in the advanced stage, and is accompanied by deficient nitrogen elimination and by indicanuria and urobilinuria.

Sanitary Test for Cream of Tartar.-The purity of this substance, says Leach, is usually established if the sample is found to be readily soluble in hot water, since most adulterants other than alum are insoluble. It is best to weigh out .1881 gm. of the cream of tartar and dissolve in hot water, titrating the solution with decinormal alkali. If the sample is pure, it should require just 10 c.c. of the standard solution to neutralize. If alum is the adulterant it is precipitated by the sodium hydroxide, being cleared up by an excess.

The Pain of Cancer.-Discoursing on Roentgen therapy, the editor of the Philadelphia Medical Journal states that while irradiation is less certain than the knife, as a palliative measure in recurring or inoperable cases, it offers a decided means of relief. "An especial gain observed quite constantly is the almost instant relief from the distressing pain of these malignant growths from the first irradiation."

Sand-Brier or Horse-Nettle in the Treatment of Epilepsy.Solandum carolinense has been investigated by M. Clayton Thrush (Philadelphia Medical Journal), who finds the drug probably better than any other known remedy in grand mal of idiopathic type without hereditary taint, and where the disease has begun beyond the age of childhood. The fresh fluid extract, given in ascending doses, from a fluidram upward to the full constitutional effect, and maintained through periods of months, is the ideal form for administration. The drug has the double advantage over bromides of not destroying the red blood cells or impairing the mental faculties.

Examination of Breast Milk.-The microscopic appearance of breast milk is claimed by Friedmann (quoted in Medical News) to be of considerable diagnostic and prognostic importance. The fat drops are normally mostly of medium size; the large ones are comparatively scarce, only 10 to 20 in each field, with a magnification of 400 diameters. When these large corpuscles are over numerous the milk is too fatty and difficult to digest. A preponderance of the small drops usually means a chronic dyspepsia for the nursing infant. The more sparsely distributed the globules and the greater the number of small ones, the poorer the quality of the milk.

Diet in Summer Diarrhea.-All pediatrists agree on the advisability of stopping milk food until the stools are practically normal. Charles G. Kerley (New York Medical Journal) has also discarded the white of egg mixture, because in many children it is not digested and passes on into the intestine as a putrefactive culture as bad as milk. Cereal waters and gruels are advised, particularly barley water and rice water, with occasional additions of one-fourth or one-third as much beef, mutton or chicken broth. Dextrinized gruels are useful in the way of concentrated nourishment. Boiled water should be given frequently. The author has treated 682 cases of summer diarrhea with but 21 deaths.

Alum in Baking Powder.-Albert E. Leach (Reference Handbook of Medical Science) directs to test by burning a small quantity of the sample to an ash, which is then treated with boiling water and filtered. If, on the addition of ammonium chloride to the filtrate, a flocculent precipitate is formed, this will indicate the presence of alum in the sample. The test is applicable in presence of phosphates.

Choice of Hypnotics.—All drugs of this class are objectionable and are purely symptomatic in their usefulness. L. L. Skelton (Clinical Review) formulates the indications for their use as follows: Insomnia from pain-Morphine, coal tar products and large doses of chloral. Insomnia from increased reflex irritability -Chloral, trional, sulphonal. Insomnia from delirium and chronic insanity-Hyoscyamine, combined with morphine. Insomnia from worry and nervousness-Bromides, given in sufficient doses (20 grains three or four times in the daytime), incomparably best and safest hypnotic. Morphine increases reflex irritability. Chloral depresses the medulla and is dangerous in cardiac and vascular diseases. Sulphonal and trional may cause nephritis.

The Second Summer.—The editor of the Medical News offers a helpful article on "Infant Feeding and the Second Summer." He reminds that, to be effective, prophylactic measures must begin with the first warm weather. After milk, the first article added to the diet list should be some form of cereal gruel, barley agreeing best with most, but wheat and corn and oatmeal being also of service; the latter particularly if there is constipation. The time recommended for preparing the package cereal foods is altogether too short, and should be multiplied by three for children's use. Toast and the crust of stale bread are better than the soft center. Regarding potatoes, it is doubtful if the heat of boiling water ever makes them readily digestible. Baking is done at a temperature nearly 200° above the boiling point, and this bursts and changes the starch granules so as to render them comparatively easy of digestion. The green vegetables, such as spinach, are of use, particularly for anemic children, but must be very carefully prepared and thoroughly screened. The source of many digestive disturbances, leading to later serious summer complaints, is in indiscretions of diet, such as concentrated sweets, uncooked fruit and table foods not especially prepared for children.

VOLUME XXII.

AUGUST, 1902.

NUMBER 2.

THE THERAPEUTIC USE OF THE X-RAY.

By G. H. STOVER, M.D.,

Denver, Colorado.

For a long time after Roentgen's discovery it was probably not suspected what possibilities for healing lay in these invisible, yet all-revealing rays.

Perhaps the first intimation I received that these rays had any action beyond "revealing that which was hidden," came to me when patients suffering from painful injuries told me after I had made skiagrams that their pain was less. I did not give much weight to their statements, believing that the analgesia was produced by mental action; that the darkened room, the fragile globe of glass through which millions of volts of electrical force were being driven, the uncanny greenish fluorescence of the tube, and the realization of the presence of this mysterious invisible light, all combined to overcome in the brain of the sufferer the impression produced by his pain.

It was natural that users of the X-ray should sooner or later begin to inquire of it whether or not it possessed a healing power, and it was also to be expected that it should be tried in those conditions which are not amenable to hitherto known remedial agents.

The X-ray has had its successes, too; they are being reported every day; they also seem to be growing in number. These reports must be given some credence, but at the same time we must remember that many other new discoveries have from time to time been widely and enthusiastically heralded as panaceas, have had many and many cures put to their credit, and in a little time have gone to oblivion. So, while we look with hope on this new agent, let us try it, but thoroughly and judiciously, remembering the fate of thousands of other healing. agencies that have come and gone.

Cancer, however, is not the only condition in which the X-ray is claimed to have curative powers. Some of the first reports of radiotherapy were those of the treatment of lupus, and