been received. The result of this combination has been to nullify the pains so much as to be in two instances scarcely percepitible, and in others simply uncomfortable. The progress of labor has not been at all interfered with, and neither the mother nor the child has presented evidence of injury from the administration of the antipyrine.

I report this experience thus briefly in order that other observers may test the validity of my results. Should there be concurrence of opinion, the first stage of labor will be rendered practically painless by antipyrine, even as the second and third may at any time be made through resort to chloroform.-Dr. Grandin, in N. Y. Med. Jour.

THE GINGIVAL LINE IN THE DIAGNOSIS OF TUBERCULOUS PHTHISIS.-In the year 1850 A. Fredericq called attention for the first time to a red line which occurs on the gingival border in various diseases. This line is intensely red in cases of acute phthisis and more bluish in chronic cases of this disease. This line was observed by him in the earlier stages of phthisis, and was considered not only of semeiotic but of prognostic value; the more rapid the course of the disease the more intensely red the line, and any diminution in the intensity of this redness was considered as a favorable sign. A bronchitis without this line was considered by him never to be of tuberculous origin. In 1854 Thompson again called attention to this line in phthisical individuals, and found that it was especially characteristic around the incisors of both jaws. He furthermore found that it occured in all stages of this disease, and was occasionally one of the earliest signs, occurring, however, less freqnently in women. When the patient's condition was improved, Thompson observed that the line disappeared; the broader the line the more unfavorable the prognosis, which was also bad when light red spots occurred on the mucous membrane of the cheek. Saunders and Draper followed up the observations of Thompson and concluded that the red line frequently attended tuberculosis, but could not be considered as characteristic of the same. More recently Dr. George Sticker, studied the subject, and finds that the red line of Fredericq and Thompson is almost invariably present in phthisis, and may be considered one of the earliest symptoms of this disease. He furthermore found that the line was present in healthy women in the latter stages of pregnancy, and existed for a time after its termination. In other healthy individuals and in nonphthisical patients this red line is only exceptionally found, and if so, in the senile period of life. In young persons who are not phthisical it is never present. Münch. Med. Woch.

PRACTICAL HINTS REGARDING CHILDREN. ---Dr. A. Jacobi, in the Arch; of Ped. gives some practi

cal points. Probably most of these have been formulated in the minds of the majority of physicians, but some things are such as bear constant repetition.

Always teach a nurse that a child can not swallow as long as the spoon is between the teeth; that it is advisable to depress the tongue a brief moment, and withdraw the spoon at once, and that now and then a momentary compression of the nose is a good adjuvant.

The taste of quinine is disguised by coffee, chocolate and "elixir simplex."

Powders must be thoroughly moistened; unless they be so, the powder adhering the fauces is apt to produce vomiting.

Inunctions require a clean surface, and are best made where the epidermis is thin, and the net of lymph-ducts very extensive, as on the inner aspect of the forearm and the thigh.

Babies, after having taking opiates for some time, demand larger, and sometimes quite large doses to yield a sufficient effect.

Febrifuges and cardiac tonics, such as quinine, antipyrine, digitalis, strophanthus, sparteine, convallaria, etc., are tolerated and demanded by infants and children in larger doses than the ages of the patients would appear to justify.

Mercurials affect the gums very much less in young than in advanced age.

The rectum of the young is straight, the sacrum but little concave, the sphincter ani feeble, and self-control is developed but gradually; for these reasons rectal injection is allowed to flow out or is vehemently expelled. Therefore one which is exThe pected to be retained must not irritate. blandest and mildest is a solution of six or seven parts of chloride of sodium in a thousand parts of water, which serves as a good vehicle for medicine ueless incompatible with the latter. The injection must be made while the child is lying on its side (preferable the left side), not on the belly over the lap of the nurse, for in this position the space inside the narrow infantile pelvis is reduced almost to nothing.

In many cases of intense intestinal catarrh, large and hot (104° to 108° F.) enemata will relieve the irritability of the bowels and contribute to recovery. They must be repeated several times daily. When there are many stools and these complicated with tenesmus, an injection, tepid or hot, must or may be made after every defæcation, and will speadily relieve the tenesums.--Arch. of Gynecol.

RULES FOR A HEALTHY MILK SUPPLY.-- 1. The milk of diseased cows should not be sent to market. Any condition that produces a fever in a milch cow should be regarded as rendering the milk bad. 2. The milk of cows fed upon distillery swill, or those fed entirely or largely upon fermenting brewers

3.

A

grains, should not be sold for infants food. Cows should not be allowed to drink stagnant pond or ditch water. 4. Milk from cows that are overheated or worried, at the time of milking, should not be sent to market. 5. If the udders are dirty, they should be washed clean before milking. 6. The milk should be cooled outside of the stable, and the cans should be covered during the process, to exclude air and dust. Milk should be kept at a temperature below 60° F., but ice should never be put into it. 7. Warm milk should never be received from the dealer, nor should the can be left out on the sidewalk in summer. 8. Milk should always be kept covered, and should never be kept in an ice-box with meats or vegetables possessing an odor. 9. Ice-boxes, stores, and wagons in which milk is kept, should be kept clean and sweet by occasional washing with chloride of lime followed by clean water, or soap and water. 10. When possible, only full cans should be received. small full can is better than a large one partly filled, as the agitation and churning of the milk is less in a full can. Avoid the unnecessary handling of milk. The necessary agitation of shipping and delivering is an injury to it. 11. Milk that has been brought back from the morning rounds should not be mixed with other milk; it should be cooled at once, and sold as soon as possible. | 12. If milk is kept over night, a small portion of it should be boiled to see if it would curdle, before it is sold. 13. Each and every dairy's milk should be tested daily. 14. It is best to make a contract with the one who delivers the milk to you to furnish that of a given test by the lactometer, say 105 to 110, and giving at least ten per cent. of cream. 15. Milk which contains dirt settling to the bottom of the can, blood, offensive odors or taste, should not be sold to customers. 16. Cleanliness in the handling of milk is absolutely essential to its wholesomeness.-Dr. Bartley in Brooklyn Med. Jour.

CONNECTION OF DISEASE WITH INTEMPERANCE.The Committee on Collective Investigation of the British American Association summarize the results of their researches on this subject as follows:

On the whole, then, in addition to the information that we obtain from these returns as to the alcoholic habits of the inhabitants of this country, and as to the relative alcoholic habits of different occupations and classes, we may not unfairly claim to have placed upon a basis of fact the following conclusions:

1. The habitual indulgence in alcoholic liquors beyond the most moderate amounts has a direct tendency to shorten life, the average shortening being roughly proportionated to the degree of indulgence. 2. That a man who has passed the age of twenty-five, the strictly temperate, on the

average, live at least ten years longer than those who become decidedly intemperate. 3. That the production of cirrhosis and gout from alcoholic excess plays the very marked part which it has long been recognized as doing, and that there is no other disease anything like so traceable to the effects of alcoholic liquors. 4. That in cirrhosis and gout apart, the effect of alcoholic liquors is rather to predispose the body toward the attacks of disease generally than to induce any special pathological lesion. 5. That in the etiology of chronic renal disease, alcoholic excess, or the gout which it induces, probably plays a special part. 6. That there is no ground for the belief that alcoholic excess leads in any special manner to the development of malignant disease, and some reason to think that it may delay its production. 7. That in the young, alcoholic liquors seem rather to check than to induce the formation of tubercle: while in the old there is some reason to think that the effects are reversed. 8. That the tendency to apoplexy is not in any special manner induced by alcohol. 9. That the tendency to bronchitis, unless perhaps in the young, is not affected in any special manner of alcoholic excess. 10. That the mortality from pneumonia, and probably that from typhoid fever also, is not especially affected by alcoholic habits. 11. That prostatic enlargement and the tendency to cystitis are not especially induced by alcoholic excess. 12. That total abstinence and habitual temperance augment considerably the chance of a death from old age or natural decay without special pathological lesion.--Brit. Med. Jour.

UNKNOWN SENSATIONS. Sound is the sensation produced on us when the vibrations of the air strike on the drum of our ear. When they are few, the sound is deep; as they increase in number, it becomes shriller and shriller; but when they reach forty thousand in a second they cease to be audible. Light is the effect produced on us when waves of light strike on the eye. When four hundred millions of millions of vibrations of ether strike the retina in a second, they produce red, and as the number increases the color passes into orange, then yellow, green, blue, and violet. between forty thousand vibrations in a second and four hundred millions of millions we have no organ of sense capable of receiving the impressions. Yet between these limits any number of sensation may exist. We have five senses, and sometimes fancy that no others are possible. But it is obvious that we cannot measure the infinite by our own narrow limitations.

But

Moreover, looking at the question from the other side, we find in animals complex organs of sense, richly supplied with nerves, but the function of which we are as yet powerless to explain. There may be fifty other senses as different from

ours as sound is from sight; and even within the boundaries of our own senses there may be endless sounds which we cannot hear, and colors as different as red from green, of which we have no conception. These and a thousand other questions remain for solution. The familiar world which surrounds us may be a totally different place to other animals. To them it may be full of music which we cannot hear, of color which we cannot see, of sensation which we cannot conceive. -Sir John Lubbock, in Pop. Science Monthly.

CHRISTIAN SCIENCE HEALING --Christian science healing, is a glorified form of faith healing, and has an immense following in America. During last season the drawing-room of Lady Mount Temple, at Shelley House, was for several weeks filled by a fashionable crowd of people to listen to a course of lectures by Miss Lord, the editor of The Woman's World. This particular sort of teaching had evidently an attraction for theosophists, spiritualists, mesmerists, et hoc genus omne. Miss Lord has since published as the outcome of the course of lectures a volume of some 500 pages. The essence of the teaching lies in denying the reality of any form of evil-evil is illusion, good only is real and permanent. As pain and disease are forms of evil according to this theory, they do not really exist, except in the imagination, which no doubt might with truth be said of many of the ailments of a fashionable audience. To be rid, therefore, of disease (not surgical disease, be it remembered, for even toothache, if proceeding from caries, resists the treatment), it is not necessary to have faith but reason. Suppose the case is one of facial neuralgia, you may cure your patient either by making a negation or an affirmation Nothing can be simpler. You say either "Your head does not ache, you really have no pain at all, you only think you have, it is all an illusion," or you may proceed by the other method, and say: "You are perfectly well, you were never really better in your life, for good is real and pain is illusion, and that is all, no nasty drugs, no hypodermics, no constant or intermittent currents, no passes, no anything but "words, idle words,"-no, not idle words, you must be in deadly earnest, and under a proper course of this treatment your patient gets well. It beats homœopathy, as you have not even to order globules. Its simplicity is its great drawback with the vulgar, but the highly intellectual theosophical folk who hold that * words are creative acts" find it highly consonant with their ideas, and say it does them and their friends as much or more good than regular practice. Miss Lord cautions her pupils that they must not take fees for their treatment, as people have been prosecuted in America for obtaining money under false pretences when they have taken money for their negative and affirmative. But of

course this is an additional merit of the system to the patients. Surgery is not attempted; it has not been found uniformly successful in cases of dislocation or fracture. It is on record that a Christian science healer did once reduce a dislocated arm by vigorously working it aimlessly about while declaring that "the arm was perfectly well," but that is not to be taken as a precedent. An old monastic chronicle tells how a good brother who had lost an eye prayed for a new one at the shrine of St. Thomas of Canterbury; in the course of time he received a new eye, but the chronicler quaintly adds that "it was a verrey litel one." Christian science healing has not even got to that yet. Br. Med. Jour.

LANOLIN AND BOBIC ACID IN SKIN DISEASES IN CHILDREN. The combination of lanolin and boric acid as an ointment is said to have a most gratifying effect in certain skin diseases in children, especially eczema of the head and face, intertrigo, and seborrhoea. In the case of eczema, for example, with raw patches on the cheeks and yellowish crusts on the head, the surface is first cleansed in the usual way, and then dusted over with finely powdered boric acid. On the following day this washing and dusting over is repeated; already the inflammation will seem lessened. The process is then repeated twice daily, the washing being always done gently, until the skin is in a condition to bear an ointment containing 30 per cent. of lanolin and 8 per cent. of boric acid In the squamous form of eczema with considerable induration, olive oil is well rubbed in and then removed with castile soap, and an ointment containing or 1 per cent. of salicylic acid with 30 per cent. of lanolin is energetically applied according to the degree of induration. This washing and application are repeated twice daily. The strikingly beneficial action of this course of treatment, which is less painful than the use of strong alkalies or oil of cade, is ascribed to the penetrating properties of lanolin, which thus facilitates the entrance of salicylic acid in the deeper layer of the epidermis. Dr. Russell Sturgis, who advocates the above treatment, also finds lanolin a reliable means of alleviating the irritation due to chronic urticaria. -Br. Med. Jour.

PELVIC ABCESS.-Dr. T. Gaillard Thomas, of New York, has found three forms of pelvic abcess: 1. Inflammation of the broad ligament. 2. Of the cellular tissue between the vagina and the posterior part of the uterus. 3. The cellular tissue between the bladder and the uterus. Another form is that which is treated as pyo-salpinx. He thinks that the hazardous operation of laparotomy could often be avoided by opening and draining through the vagina. He thinks that many hard tumors if explored, will show the presence of pus. The man

who waits for constitutional symptoms in pelvic abscess will wait a long time. There are but two passages by which pus ought to be let out-through the vagina and the abdominal wall. If the abscess points and clamors for an outlet through the rectum, I do not think it should be allowed to do so. I have seen two cases in which the patient died from evacuation through the rectum. Gases and fæces passed through the opening. The evacuation should certainly not be made in the bladder. I use Goodell's modification of the German dilators, and always insert the drainage tube. If the abscess is anterior to the uterus, I separate the anterior vaginal wall precisely as I do in uterine extirpation. Pelvic abscess is almost always immovable; neoplasms, movable. This is the great diagnostic difference. Yet some pelvic abscesses are very movable, especially those posteriorly situated. Hence, many are diagnosed fibroid tumors, and cured by electricity. I use bichloride, 1: 1.000. If the symptoms do not disappear, I use a stronger one, but with fear and trembling.

Dr. W. Gill Wylie, of New York, thinks cellulitis has always played too great a role in the etiology of pelvic abscess. Many abscesses, four out of five, occurring within a year or two after delivery, are due to salpingitis or ovaritis, and our best proof is from those who have opened the abdomen. Great mistakes are made by not distinguishing between those due to septic poison and ovaritis or salpingitis. It is of no use to open the vagina and leave a rotten ovary there. My views are, if you have pelvic abscess, patient dangerous, temperature 101° F., and sweating, I would open the vagina or belly at once, and find out just what can be done by the vagina. I have done it often, and if closed soon the danger is small. One patient died in New York, one in Chicago, from using an aspirator in pelvic abscess. Med. Record.

ACETIC ACID AS A DISINFECTANT.---Dr. F. -Dr. F. Engelmann, being much impressed by the numerous fatal cases which are constantly occurring from the employment of intra-uterine injections in obstetrical practice, and feeling that there is doubt whether they ought not to be given up, brings before the profession an antiseptic which he has used for the last two years in a large number of cases, and which has given him excellent results-acetic acid. Some years ago he was led to use and to recommend the employment of acetic acid in diphtheria, and he is convinced that it possesses antiseptic properties in as high a degree as carbolic acid itself, and has at the same time the great advantage of being non-injurious, even when used in a tolerably concentrated form; besides, it has a decidedly styptic effect, and this is an additional advantage in obstetric practice. Again, acetic acid is very diffusible, thus penetrating the tissues to a much greater extent than most other antisep

tics. Corrosive sublimate, as is well known, forms insoluble albuminoid compounds on the surface, and thus does not act upon the deeper parts of the tissues. In one respect acetic acid is similar to corrosive sublimate-viz., in its action on instruments; but the latter is the more prejudicial of the two. The forceps may remain for a quarter of an hour in a 3 per cent. solution of acetic acid without being injured. The irrigator is, however, liable to be affected by the prolonged use of acetic acid solutions. It should be remarked that the hands must be washed twice after using acetic acid, as of course soap will not dissolve where this is present. The skin is rendered peculiarly soft and pleasant to the feel. As to the strength to be used, Dr. Englemann, as a rule, employs a 3 per cent. solution, but he has sometimes employed a solution as strong as 5 per cent.; this, however, is apt to cause a smarting sensation in any spot where the surface is broken. All the cases in which acetic acid was used recovered without abnormal rise of temperature. Lancet.

REVIVAL OF TARTAR EMETIC IN TREATMENT OF PNEUMONIA. The amount of attention that has been given this ancient use of an old drug shows that it has not been so quite forgotten everywhere as it seems to have been here in America.

In Germany the drug has been given after the method of Lebert. Of tartar emetic gr. jss-v are ordered in 3vj of water, of which solution 3ss (= gr. + ) is given every hour till vomiting or diarrhoea occurs, and then every two hours. In most cases these symptoms from the side of the gastro-intestinal tract will cease even under the continued use (Lebert, Brückner); if not, or if opium does not control them, the remedy is to be given up. The tolerance is very variable. Usually, after one or two doses, there is vomiting, which brings great relief, then four to eight watery stools, then sweating and an increased expectoration. The pain and dyspnoea are much relieved. well-ascertained physiological action of tartar emetic is in diminishing the blood-pressure, and its therapeutical action in pneumonia is probably to be found in this effect on the pulmonary circulation (Lebert). The clinical results from its use in the hands of these observers have been encouring. Certainly most physicians would rejoice to have forty successive cases in hospital practice without a death! (Mosler).

The

Dr. Arthur Jamison, basing his conclusions on the careful study of 213 personally observed cases, in 155 of them has acquainted himself with the later history of the case and secured the opportunity of a physical examination at a period not less than two years after the attack. This afterhistory, he considers, should be the guide to treatment, for in 74 of the 155 examined he found traces of an unresolved pneumonia, viz., dulness