jected to that treatment you would have a good many visitors up in your establishment from that county, Dr. Murphy. There is a right way and a wrong way of giving quinine. If you give it right you will get therapeutic results, and you will get better results from it in solution with some acid, generally dilute sulphuric acid. You can make it partially palatable, but where I can have control of my patients, I generally give it just so, at the decline of the fever, fifteen grains. It seems to have a bet. ter effect on the plasmodium in small doses, especially in the dry form. It is much more readily absorbed in the stomach when desolved in acid, and consequently requires smaller doses.

I will not enter into a discussion as to the number of fevers which prevail here in this State. I only know that where we live we always have malaria and always will, winter and summer, and we have typhoid fever too. I am not scientific enough to use these instruments, and as to the microscope I am in a state of childish ignorance. I know one when I see it, but as to the use of it I know nothing at all, neither do I understand anything of bacteriology, I am sorry to say. I learn from the younger members because in my day these things were not known. I have stood by bed-sides, and have picked up a little clinical experience, and I still hold that although I would not begin to swear by my diagnosis in malarial or typhoid fever, I arrive at very satisfactory results. I find that quinine properly given will destroy the plasmodium, and when it does not do it, I expect it is typhoid. However, I cannot allow my old friend quinine to be abused in my presence without defending it. There is a right way and a wrong way to give quinine, and if not properly presented to the body, stomach, bowels and liver you will not get good results. I say there is no greater blessing to the people in the world than quinine properly given. I think Dr. Register's paper was a very timely one.

Dr. Duffy. In this connection perhaps it would be well to refer to the preparation of quinine, which so far as I have seen is only put up by Sharp & Dohme, bimuriate of quinine and. urea. I refer to it on account of its remarkable solubility for hypodermic use. That has sometimes served me when nothing else would. I have been called to patients who were comatose

and having convulsions from malarial disease, so that I could not administer anything at all by the stomach. Six grains of that it is put up in three grain tablets-may be dissolved in twenty minims of water. I have used it hypodermically without any abscess. I had the misfortune to get one last year, the first I ever got. Before that I thought it was well nigh proof. It seems to me rather optimistic to expect the eradication of malarial germs by a few doses of quinine. I think this year I had at least three cases of malarial neuralgia with pain over one brow coming on at a certain hour of the day, the most violent neuralgic pain, which I could attribute to nothing but malaria. The periodicity would seem to indicate it, and in these cases I have given quinine regularly, and the pain would come on regularly, no fever, but periodical neuralgia. I have known Warburg's tincture to stop it after quinine had failed to

serve me.

Question asked. "Have you ever given soda"?

Not in neuralgic cases that I remember. In a case where the pain came on periodically at a certain hour, in a place where malaria is common and where malarial fevers are, it is very suggestive of that, especially where Warburg's tincture

cured it.

Dr. Royster.-I want to insist that Dr. Duffy has no absolute assurance that that was malaria, as there are many drugs in Warburg's tincture and among them arsenic. Any body could take exception and say that it was not. I want to ask Dr. O'Hagan the right and wrong way of giving quinine. I would like to know the method of administering it.

Dr. O'Hagan.-I do not profess to say that mine is by far the best and correct way of giving quinine, but it simply suits me. I want to say something about periodic neuralgia. All periodic diseases have a certain cycle to run and are controllable to a greater or less degree by quinine. I have known them time and time again to be modified when the paroxysm comes on, by a dose of quinine, 20 grains. Periodic neuralgia, or sun pain, as it is called, because it usually begins with the rise of the sun, is helped that way, and in periodic neuralgia you will get good results from the use of quinine. Now, Dr. Roysrer, I cannot confine myself to any one method of giving quinine. If I had

a good substantial stomach to deal with, I would give it to him. in solution. Sulphuric acid might add something, and would make it less bitter. If it was a baby, I would put the quinine in some kind of syrup, for with children you have to make the dose as palatable as possible, and it is a hard thing to make palatable. It is almost impossible to administer it hypodermically to children and infants. Even a puncture of the needle, unless it is very aseptic, may cause inflammation but it can be given epidermically. Take the epidermis off by a blister and put the quinine there and it will be absorbed readily. confidence in the administration by inunction. I have no fixed method of giving quinine; I give it according to the case. Some stomachs are exceedingly sensitive, and others take it readily. Dr. Burroughs.-I would like to say something about Dr, Duffy's idea in regard to periodical pains, speaking of it as accompanying malaria. I came from a section of the country where we do not have malarial fever. I have never seen a case of it in the mountains. We have had some cases coming up from South Carolina and from the eastern part of this State, yet among the mountains I have seen this supra orbital pain that he speaks of. It comes on at a certain time each day, and in regard to the treatment, I will say that quinine has no influence on it. A small dose of morphine given hypodermically will relieve it, but it will come back again after a time. I find nothing to serve me so well as a hypodermic injection of nitrate of strychnine. You may rely on it as almost specific in cases of this kind. Nitrate of strychnine given twice a day in doses of of a grain hypodermically and increased gradually to twice that much, will gradually ease the pain and it will disappear in a little while. Keep up the treatment for a week or ten days after, and you will have it no more.

Dr. Flippin.-In connection with the supra orbital pains, I will say that I was raised in a section of country where we do not have any malaria, and I never saw a case except in the eastern part of the state. I have gotten a good deal of good results from the use of salicylate of soda in this periodical supra orbital pain. I give big doses of it, from 20 to 30 grains, and it has always broken it up for me. I have never gotten much results from the use of quinine.

Dr. Robinson.-I did not have the pleasure of hearing the paper, as I came in late. It seems to me that the ground has been pretty well covered, and certainly we have a variety of remedies. sufficient to cure almost any disease of supra orbital neuralgia. I hardly know how to discuss the paper, as I didn't hear it. It impresses me both theoretically and practically that quinine ought to break up these fevers, and as Dr. O'Hagan says, properly administered, it does. I think we very often overlook the fact that we have other factors at play which interfere with the proper administration of and so with the effects of the quinine. Often we have a condition of the alimentary canal which materially interfers with the effects.

THE NEWER PREPARATIONS OF BISMUTH.-(Reynold W. Wilcox, Medical News.)--The author presented a paper on this subject three years ago and has but little to add to and nothing to retract from his statements made at that time. Of the three preparations then studied he has found bismuth naphtolate the most useful. This preparation is decidedly antiseptic. It is partly decomposed in the stomach but the process is completed in the small intestine. A small part of the naphtol is eliminated by the kidney, but the larger portion passes entirely by the bowel. It was found markedly beneficial in several cases of gastric and enteric fermentation, and in one severe case of intestinal putrefaction. Cases of typhoid fever coming under treatment within the first week have lacked the classic symptoms, and presented low temperatures. He draws the following conclusions:

1. That the use of the organic in place of the inorganic bismuth compounds should be insisted upon.

2. That the compounds of bismuth with betanaphtol, phenol, tribromophenol, and tetra-iodo-phenol-phtalein are remedies. which produce practical intestinal antisepsis.

3. That they are indicated in all gastro-intestinal fermentations and catarrhs until the symptoms are relieved, the dose to be determined by the severity of the symptoms.

4. That they are non-toxic and do not give rise to untoward symptoms.

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Editorial.

A VACCINATION RELIC.

Dr. W. S. Everett (Boston Med. and Surg. Jour.) exhibited before the Dorchester Medical Club recently an interesting relic of the early experiences attending the introduction of vaccination in the shape of a certificate bearing the following legend: MILTON, 25th October, 1809.

The twelve children whose names are written on the back of this card were vaccinated by Dr. Amos Holbrook at the town inoculation in July last; they were tested by small-pox inoculation on the 10th instant, and discharged this day from the Hospital, after offering to the world in the presence of most respectable witnesses who honored Milton with their attendance on that occasion an additional proof of the never-failing power of that mild preventive, the Cow Pock, against small-pox infection, a blessing great as it is singular in its kind, whereby the hearts of men ought to be elevated in praise to the Almighty Giver.

The signatures to this certificate are Rufus Pierce, Jason Houghton, Jno. Mark Gourgas, Jedidiah Atherton.