The mode of preparing is given as follows: "Put one-quarter ounce Pareira brava to one ounce of boiling water; let it stand for two hours: then add of finely-powdered Hydrastis C one ounce; mix well and reduce to the consistency of syrup by evaporation. Put one ounce of Peruvian bark Calisaya to two ounces of boiling water; let it boil for five minutes; then filter and add one and one-half ounces of bromid potassium. Wash two drams in the salts of carbonate lithia in proper vessels, and add all the ingredients together, and heat on a slow fire in a close covered vessel to 100 degrees specific gravity; remove it to a mortar, pulverize well, and triturate. Divide the whole mixture into fifteen powders."

The reader is warned in the customary fashion against "unprincipled druggists" who undertake to prepare the "prescriptions" as "best they

can," and is invited to send to the advertiser for the "remedies."

The difference between these prescriptions and the "Blodgetti" and "Arabian sea-grass" operations is, that they direct nothing but medicines that really exist, but cannot be "compounded" according the absurd directions, which appear very learned to the average reader.

The only course left open to a conscientious pharmacist, who is asked to prepare such a prescription, is to inform the customer of its exact nature, and to "back up" his statements by the Circular, in which he will find all such schemes explained as they arise. As people seem to take more kindly to what they see in print than to what is told them by a familiar acquaintance, this plan has been found to work well; the pharmacist sustaining his reputation for knowledge and ability.-Duggists' Circular.

Those subscribing now for 1899 will receive THE WORLD free for the balance of 1898.

Dr. Waugh's book on Treatment and THE WORLD until 1900 for $5.

WORLD for 1899 and balance of 1898 for $1.

Current Medical Thought.

Substitutes for the Cinchona Alkaloids in Malarial Diseases.-Continued.

Alum.-At one time this very common drug was held in great repute. Copeland broadly states that the reason for which it has fallen into disrepute is that the large doses demanded caused nausea unless governed by aromatics, although even the nausea and vomiting, by reason of the revulsive effect, often prove efficacious. It is a valuable remedy in malarial hematuria, and in the atonic hematurias that sometimes accompany tropical fevers.

Australian Fever - tree. - Bixby declares that the Australian fever-tree bark (Alstonia constricta) resembles, in its action, a mixture of quinin and nux vomica; that it is an antiperiodic of the highest type, giving better satisfaction than quinin or cinchonidia.

Beberia is another old remedy, and one not without some measure of value. It was introduced by Maclagan, who detailed 40 cases of tropical malarial fevers treated by it, with only 6 failures. Since 1843 the sulfate of the alkaloid has found extensive use in the East and West Indies, tropical America, etc., and Waring expresses the opinion, from the evidence adduced, that it is entitled to rank close to quinin; it is said to be particularly serviceable where there is cerebral disturbances. Maclagan was in the habit of giving 3 or 4 grains every two or four hours, until a total of 1 scruple would be ingested before the expected paroxysm. It was also successfully employed by Godfrey, Dorward, Anderson, Falconer, Dempster, and others. Cawasjee asserts that it is both tonic and antiperiodic, and this view is corroborated by Whitla, who adds, however, that it is vastly inferior to quinin and arsenic. The fact is, probably, that while quinin was expensive, beberine sulfate furnished an excellent substitute, but the low price of the former has practically crowded its rival out of use. Goss, who is an eclectic authority, declares that for several years he employed the salt with good effect, but after a time, and for some unknown reason, it did not act so well, yet, with quinin, the combination proved superior to either alone. He employs twice as much beberin as quinin. During the late civil war, after the stock of quinin was exhausted in the South, attention was turned to the sulfate of beberia, and the

results secured appear to have been fairly satisfactory.

It is important to bear in mind that berberis is not to be confounded with beberia, for they belong not only to different species but to different families and orders. Berberine sulfate is from the two forms of the latter, from which, also, the natives in the East prepare a watery extract called rusot that has long been esteemed a valuable febrifuge. able febrifuge. O'Shaughnessy observed, in nearly 100 cases of malarial fever, several complicated with an affection of the spleen, that the pyrexia was checked, on an average, in three days by rusot. In most instances it occasions a feeling of agreeable warmth at the epigastrium, increases appetite, promotes digestion and acts as a very gentle but certain aperient. It should not be given when there is marked hepatitis or when dysentery threatens,

Calcium phosphate, mixed with one-sixth its weight of washed sulphur, was found most efficacious in all cases and stages of well-marked intermittents by Blacklock, of the Madras Medical Establishment. He was in the habit of preceding the remedy by a purgative, then administering 2 drams daily in treacle. It is more than probable that the good effects here were due to the alterative and aperient action induced, although Cawasjee insists that it is not only beneficial in all low forms of fever, but also a specific for malarial diarrheas.

Calomel.-In both the malarias of the tropics and subtropics calomel always has. and probably always will, figure largely. It was formerly held as a curative agent, but its use in this respect has been well nigh abandoned because of the supposed more specific action of quinin. Waring declares that the mercury salt, given in full dose, 2 to 3 scruples, will frequently abort any onset of malarial character.

Camphor.-A remedy of great power that has almost been lost sight of during recent years is camphor. Waring and a host of German and Anglo-Indian authorities assert that in all fevers, no matter what their original character, when they assume a low type, this drug proves a remedy of great value. Copland, after quoting a host of German writers in favor of the drug, states that, in the stage of excitement attended by vital prostration, the dose, and the medicines which should be associated with it, should have reference to the state of the vital power, to the mildness or

severity of the diseases, and to the nature of the prominent affection or complication. Carbozoate of ammonia, or picrate of ammonium, has also received a share of attention during recent years. Clark claims to have treated no less than 10,000 cases of malarial disease thereby, and to have kept a record of half the number. He chronicles but 9 failures in the 5,000. He adds, "all forms of malarial disease yield promptly," and that it is "a perfect and efficient substitute for quinin"; further, it has the advantage of being inexpensive, requiring but small dosage (to grain four or five times daily), and does not produce any unpleasant effects, such as headache, tinnitus, deafness, digestive disorders, nausea, etc. Popoff employed it in 42 cases, 37 of recent character, and all recovered, the paroxysms ceasing, on an average, in four days. In 3 of 5 inveterate cases the remedy failed. Bose tried picrate of ammonium in four cases with "wonderful results."

Castor is another remedy greatly neglected, but of undoubted power and value in fevers. It has long, in conjunction with myrrh, been considered as a specific in malarial fevers, but its reputation has passed away, owing to the substituting of the American-which is nearly inert-for Russian castor.

Cerevisie Fermentum.-In malarial pyrexias of low type bilious-remittent, pseudo-continued, and even true continued fever-yeast, or "barm," the scum or residuum which forms during the process of fermentation of beer, has been employed on many occasions with signal benefit. In the most obstinate cases of tympanitic distension, enemata of yeast and asafetida are almost invariably efficacious.

Charcoal.-Calagus first called attention to the efficacy of wood-charcoal when given in 1 to 3-scruple doses; he believed it fully equal to cinchona in malarial fevers. Calvert, who was physician to the British forces at Palermo, also employed it with success, and intimates that it is especially useful when marked disturbance of the digestive organs exist, such as flatulence, diarrhea, etc. The remedy, from a rational standpoint, would certainly seem worthy of further trial.

Corn.-Pruitt, of Arkansas, calls attention to the efficacy of a distilled extract of common Indian corn. After the corn has been gathered, well dried, and freed from stems and mildew, 4 pounds of husks with 16 gallons of water are placed in a still

having a capacity of 20 gallons. Ten gallons of the distillate are drawn off, which is clear, transparent, and in odor and taste resembles boiled green corn. For purposes

of preservation 8 drams of alcohol and 4 of glycerin are added to each 15 ounces of distillate. The dose is 1 to 2 teaspoonfuls every two or three hours. The mendicament has no special value in cases of acute malarial infection, but appears to act specifically in chronic forms. The effects of the administration are speedily observed: the temperature soon declines, the irritability of the stomach subsides, the action of liver and kidneys is favorably influenced, and the enlargement of the spleen diminished. In many cases a mild diuretic effect may be observed.

Garrya. The California The California fever-bush (Garrya Fremonti) Smith considers as one of the most effective antiperiodics. Living, as he claims he does, in the South Arkansas River bottom, where, in his opinion, the fevers are of a malignancy equal to any in the world, he has found them terminate quicker under garrya than any other remedy. other remedy. Usually the fever terminates in twelve hours after the drug is begun, and with profuse perspiration and opening of all the emunctories.

Gentian.-Gentian is another drug at one time lauded, doubtless because of its bitterness. Chavasse, of the French navy, asserts that it is a complete prophylactic in the malarial fevers of Guiana. He declares that it neutralizes the miasmatic poison if taken before any pathologica manifestation of the fevers had developed. He gave the tincture in brandy twice daily, and considers that the addition of the spirit is important, inasmuch as it excites the energies of the nervous system "so as to make it accessible to the operation of the drug." Certainly further light on this particular point is desirable.

Gulancha (Cocculus Cordifolius). This is greatly esteemed by Hindoo practitioners, and many English officers claim to have employed it with success. Waring, after trying in twenty cases of malaria such as occur in the Tenasserim provinces, and in much larger doses than ordinarily advised, found that while it prevented the accession of the cold stage in every case, it did not appear to diminish the severity or prevent the return of the hot stage. This action is so peculiar that he suggests further trial.

Iron. The sulfate salt is certainly of value in intermittents, but more often in

combination than when employed singly. Marc employed it with such great success that Corvisart was appointed by the Acaddemy of Medicine to make inquiry thereon; and, though he reported most favorably, from some unexplained cause the drug soon fell into disuse. Waring remarks that it should not be used when there is much gastric irritability or where the patient is short and plethoric, with a determination of blood to the head; further that the bowels should be carefully regulated, and on no account should acids or acidulated fruits be allowed-on these last two points he lays great stress-adding that, properly employed, it is a remedy of great power. He gave from 8 to 10 grains daily, often with a little extract of henbane, in pill form, or in solution with infusion of quassia. Twenty grains daily may be ingested if required. [The writer has employed ferrous sulfate for many years with pronounced success.]

Labarraque's Solution.-The solution of chlorinated soda has long been known for its favorable effects in fevers of a low type, though modern medical fashion is wont to ignore it except as as antiseptic or disinfectant. The history of the preparation, carefully scanned, will be convincing that it is deserving of careful consideration as regards all forms of fever that exhibit any tendency to typhoid.

Opium is a valuable adjunct in the treatment of malarial fevers, though not often employed nowadays as a direct remedy. Its use in this class of diseases dates from before the time of Galen; it subsequently lapsed, only to be reintroduced in modern times by Trotter, and to be taken up and warmly advocated by Lind. The latter declares that, if given in the intermissions, it has not the least effect either in preventing or mitigating the paroxysm; that when given in this cold stage it sometimes removes it; that when administered half an hour after the commencement of the hot stage it generally affords immediate relief. When given in the latter manner it shortens and abates the fit with more certainty than an ounce of cinchona; it generally gives sensible relief to the head, takes off the burning heat of fever, and occasions a profuse sweat; it often produces a soft, refreshing sleep, from which the patient awakes bathed in sweat and, in great measure, free from all complaints. thus given it certainly renders the patient less prone to liver disease, dropsy, etc. Waring remarks that, while he cannot

When

speak of the efficacy of the drug in the hot stage, he has often given 40 minims of laudanum at the commencement or even during the presence of the cold stage. which operated like a charm in cutting it short; and, although it did not appear to shorten the subsequent hot stage, it appeared in many instances to mitigate its severity. So fully aware of the foregoing were the soldiers under Wellington, during the Peninsular War, that, as Joseph Brown states, at the first appearance of the cold stage they applied in most instances for an "ague-draught," which consisted of 40 minims of tincture of opium and 60 minims of ether. (These doses are excessive-for up-to-date human beings.)-DR. C. E. DE M. SAJOUS, in Monthly Cyclopedia of Practical Medicine. (To be continued.)

A New Antidote for Strychnin Poisoning. Strychnin has long been looked upon as one of the most positively fatal of poisons, and most difficult to combat. Still, for all that it is also one of those productive of the most pain, it has been not infrequently been used for purposes of suicide and murder, from the existent lay idea that its use cannot be detected by autopsy, and that its effects so closely resemble those of acute disease that sure diagnosis is impossible.

There has been as yet no convenient and readily applied antidote to this drug. but if the conclusions arrived at by Dr. W. D. Turner, of Fergusson's Wharf, Va., are correct, a safe, sure and simple antitoxicon has at last been found, and it would be well to make experiment with a view to determining its efficiency, and place the credit for the discovery where it belongs.

Dr. Turner relates a series of experiments upon the lower animals, eleven in number, dogs, pigs, calves, a hen and a crow, with an apparent proving of his proposition. He was led to the experiments thru the accidental ingestion of a quantity of strychnia by a valuable dog, which when found was apparently in the agonies of death. The doctor thought the dog was so near dead that it was useless to attempt to save him, but an employe of the place. with a nervous desire to be "doing something," gave the animal about four or five ounces of lard, simply because it was the handiest thing, and possibly with a vague idea of producing emesis. To the surprise of the doctor, the dog was up and running about in less than five hours, and the next day was as well as ever.

Knowing the quantity of the drug the animal must have taken, and having seen its condition, Dr. Turner was naturally struck by its resuscitation from the administration of lard alone, and began his experiments forthwith, pressing into the service of science almost all his live-stock, giving from three to six grains of strychnia sulfate, the dose varying according to the size of the animal, and giving lard in quantities of from 5 to 22 ounces according to the size of the dose and of the animal. In all the experiments made, only two had an unsuccessful issue, and these the doctor attributes to the fact that he had used too small a quantity of the lard, since the next two, conducted under precisely the same conditions, but with double the amount of the lard, resulted in complete

recovery.

Dr. Turner is very modest in his statements, and urges further investigation on the part of the profession, but his discovery is only another proof of what THE WORLD has always contended, that much of the true progress of medicine comes thru the observations and experiences of the country practitioner. The trouble is that, too often, from a sense of diffidence, these men will not seek the credit for their

research and observation, beyond merely mentioning them cursorily in some informal discussion, where they are perhaps seized upon as a hint by the man with an eye to the main chance, who quietly elaborates, and finally announces the discovery as his. Come, friends, do not be afraid to publish what you have found out. It may be incomplete, but it can be elaborated; it may be incorrect, but anyone can make a mistake; it may have been discovered before, but there is never harm in directing attention again to a fact of value; and often what you may consider only iron pyrites, and therefore of comparatively little worth, may turn out to be pure gold.

Treatment of Malaria.

It is usual to begin the treatment of malaria with a cholagog, such as calomel in four quarter-grain doses a half-hour apart, followed by a saline. The idea is to restore the function of the liver, deranged by the malarial poison. The catharsis is also supposed to aid in the absorption of the quinin which is to follow. The efficacy of this preparatory treatment is disputed, however, by such eminent and careful observers as Osler and Austin Flint. With the experience of a long series of re

searches, Flint claims that the use of cathartics not only is of no benefit, but that it actually antagonizes the interruption of the paroxysms. Where constipation exists, however, mild laxatives are indicated. Dr. Clarence J. Manly, of Louisville, Ky., in Therapeutic Gazette. Drugs Which Should Not be Dispensed in Capsule Form.

Sodium salicylate causes gastric disorders, with nausea and vomiting, and should, therefore, be administered diluted with plenty of water. Ulceration of the gastric mucosa has been observed after its use in capsule form. Antipyrin often irritates the digestive tract, and is best given in vichy or soda water. The following drugs are hygroscopic, and, therefore, cause the capsule to become softened: Acid phosphates and glycero-phosphates, sodium bromid, crystallized calcium chlorate, chlorate, strontium chlorid, piperazin, lysidin, chloral, the dry extracts of plants, and, in general, those preparations produced by evaporation in vacuum. Some solid drugs when mixed tend to deliquesce -mixtures of antipyrin and sodium salicylate, for example, when exposed to the air become altered, or, at least, discolored by the continued oxygen. Of this group are the salts of iodin, the alkalies, and the alkalin earths; also aristol. Free iodin combines with the starch of the capsule. producing a bluish-black discoloration.Med. Record.

Treatment of “Black Eyes."

In an uncomplicated case, the course is somewhat as follows: Within an hour or two after the infliction of the violence there will be considerable swelling, redness, tenderness, and more or less pain; then discoloration shows itself. The swelling is apt to subside in two or three days, but the discoloration remains, presenting successive hues-dark red, brown, or black, becoming fainter, then greenish or bluish, and finally yellow. In ten days or two weeks all signs of the bruise will have disappeared.

The treatment of contusions of the lids depends upon whether we see the patient early, when there is considerable swelling, or not until later, when the discoloration is the prominent feature. If he is seen early, treatment consists of cold compresses or cooling or evaporating lotions; with these we can diminish the amount of swelling and discoloration, tho it is