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Rhinolith or Nasal Calculus. Miss L. K., aged 24, treated for nasal catarrh from childhood, had for three years before consultation a thick offensive discharge, obstructed respiration, etc. Had headache and weeping of the left eye. Operation was undertaken for removal of hypertrophied tissue of the lower turbinal. This was followed by an attack of sick headache, the retching in its turn bringing on fresh hemorrhage. This was checkt by plugging the naris with absorbent cotton.

When the time came for the removal of the cotton plugs, a portion was found so firmly fixt that force under anesthesia was necessary. The cavity was then thoroly cleaned with hydrozone, one part to twelve of lukewarm water. Perfect freedom was had in breathing thru this nostril until about four o'clock the next morning, when in changing her position the side suddenly became obstructed. After cleansing the nostril, which was seemingly full of an offensive discharge, a body was found, attacht at the posterior end on the outer side of the inferior meatus, lying in a groove or pocket.

The anterior end was sharp like a spiculum of bone, and black; it was freely movable about its long axis, so that you could pass a cotton holder around it and lift it from its bed. After cocainizing, I graspt it with a dressing forceps and, giving it a twist, removed it. I then thoroly cleansed and disinfected the cavity with the hydrozone solution, which removed the odor and rendered the cavity wholesome.

The next day two smaller pieces were removed while cleansing and treating the nose. They were loose and seemed as tho they had just scaled off from the bed where the larger piece had lain.

The spraying of the nasal cavity with hydrozone, followed by the use of glycozone, constituted the treatment for the next four days, by which time the offensive odor had entirely disappeared, and the parts had assumed a healthy condition.

I could only get a negative history as to the exciting cause of the formation, there being no recollection of any foreign object having been put up the nose in her childhood. Microscopic examination reveals that it is composed of amorphous phosphates, undoubtedly the phosphates of calcium and sodium, which came from the tears.

There has been a markt improvement in condition since the removal of the rhino

lith; overflowing of the tears in the left eye has ceased, nasal respiration has become perfect, her voice has lost the nasal twang. and her general health has improved rapidly, as indicated by the fact that she has gained four pounds in weight in four weeks since the operation, and is still improving.-W. H. Poole, M. D., in N.Y. Medical Journal.

Don'ts for the Treatment of Pneumonia. Don't believe that acute pneumonia is a self-limited disease and will get along as well without treatment as with it.

Don't hug the delusion that fever in any degree is a benefit to the patient. Don't fancy that you can always tell croupous from catarrhal pneumonia.

Don't allow pain in the abdomen to draw your attention away from the chest. Frequently the beginning of pneumonia is accompanied by severe pain in the right groin, which may lead one to suspect the onset of typhoid fever.

Don't direct your treatment more towards the heart than towards the lungs. Don't fail to recognize the great influence of the brain and nervous system.

Don't lose sight of the serious indication of rapid and laborious breathing.

Don't be afraid of applying ice to the chest in rubber bags. It will do no harm. Don't fail to apply as many bags as are necessary to cover the area of inflammation.

Don't think that you can get as good results from a tub-bath, or from cold general spongings, as you can from the local application of ice.

Don't become alarmed when the ice produces a sudden drop in the temperature. and think the patient is going into collapse.

Don't fail to retain the ice so long as fever is present, and resolution has not taken place.

Don't omit to apply one or two ice bags to the head.

Don't overlook the beneficial influence of strychnin in combatting pneumonia. Administer of a grain by the mouth every three or four hours, and besides give the same dose hypodermically once or twice a day, until the system becomes irritable.

Don't omit the hypodermic injection of of a grain of morphia once or twice a day to secure rest and sleep.

Don't fail to administer oxygen by inhalation more or less constantly if the patient is cyanotic or short of breath.

Don't fail to bleed if cyanosis and dyspnea are not relieved by oxygen inhalation.

Don't lose sight of the great value of tincture of capsicum in relieving great nervous depression, delirium, dry, blackcoated tongue, picking at the bedclothes, etc. Give it from a half to one teaspoonful doses in water every two or three hours, or oftener, in alcoholic pneumonia.

Don't fail to give sodium salicylate, ammonium acetate, potassium acetate, and - potassium citrate, three grains of each, in a dessertspoonful of peppermint water, every three or four hours, if there is the least evidence of a rheumatic complication. Don't overlook the important action of quinin in this disease.

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Don't fail to support the patient with an abundance of nourishing food, such as milk, freshly expressed beef-juice, etc.Thomas J. Mays, M. D., in Polyclinic.

Questions Presented by Examining Board for Illinois Military Surgeons.

SURGERY AND ANATOMY.

1. Detail the treatment of a recent case of compound fracture of the leg.

2. Describe the different kinds of acute synovitis and outline treatment of each.

3. When should you wait for a line of demarcation in gangrene before amputating?

4. From what vessels might hemorrhage come in a wound of upper thigh?

5. Enumerate the coverings of an oblique inguinal hernia.

6. Name the flexors of the forearm and give points of origin and insertion.

PRACTICE OF MEDICINE.

1. Describe pneumonia, definition, etiology, morbid anatomy, symptoms, complications, prognosis, termination, diagnosis, treatment.

2. Describe dysentery, definition, etiology, clinical forms, complications and sequelæ, treatment.

3. Describe yellow fever, definition, etiology, morbid anatomy, symptoms, diagnosis, prognosis, prophylaxis, treatment.

MATERIA MEDICA.

1. What are the more common forms of mercury used in medicine? Write prescriptions for four.

2. Mention the comparative advantage of ether and chloroform as anesthetics.

3. Indications for the use of emetics, cathartics and alcohol.

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2. When with all other conditions the same as in 1, only that the mother is relatively more vigorous than the father, expect a boy.

3. When the parents are relatively of equal vigor, expect an equal division of the children as to sex, for nature seeks the conservation of the sexes. If, however, with the vigor the same, the complexion of the mother is dark and the father is light, you may rather expect a boy. If on the other hand the father is dark and the mother of light complexion, rather leans towards a girl.

4. When one of the parents, tho apparently as vigorous as the other, is comparatively either immature or senile, consider the one nearest the age of stalwart maturity as the more vigorous. For example: A wife sixteen to eighteen, or fortytwo or over, with a husband twenty-five

to forty, prognosticate a daughter. On the other hand, with a husband sixteen to twenty, or forty-eight or over, and a wife twenty to thirty-five, expect a male child. Very many exceptions to these rules will occur; so many, indeed, as sometimes to make them appear of doubtful application. Nevertheless, a patient and extended trial will prove their utility.-Dr. D. E. Keefe, in N. E. Medical Mo.

Medicines that Should Not be Prescribed in Powders.

Medicines that should not be prescribed in powders (Journal of the American Medical Association, April 2, 1898) can be classified into (1) those that absorb moisture readily from the air; (2) those which form a fluid in combination with other substances; and (3) those that are decomposed by the oxygen of the air and change color.

In the first class belong the acid phosphates and their derivatives, the phosphoglycerates. These salts put up in powders liquefy in twenty-four hours; also sodium bromid, which is extremely deliquescent; crystallized calcium chlorid; strontium chlorid; ammoniac citrate of iron and ferricopotassic tartrate; piperazin and lysidin; chloral, dry vegetable extracts, and, in general, all products prepared by evaporation in a vacuum, especially desiccated peptones and extracts of animal organs. The second group in

cludes the substances that alone are not affected by the air, but combined, absorb moisture rapidly; such are antipyrin and sodium salicylate. The third group comprises the alkalin and ferroalkalin iodids and the aristols. A little trick that sometimes prevents trouble is to add a certain amount of licorice powder or cinchona; also to keep the powders in an air-tight glass jar.-Minn. Med. Mag.

A Rational Method of Relieving Asphyxia in the Newly-Born.

Dr. S. Stringer, of Brooksville, Fla., gives the following method for treating an asphyxiated infant: If the child shows signs of asphyxiation do not cut the cord, but expose the maternal surface of the placenta as rapidly as possible to the open air. long as the circulation keeps on thru the cord, he says you need not fear for the child's life, for it is a continuance of fetal life after birth, and will keep the child alive an indefinite time. As soon as respiration occurs, which in some instances has been delayed twenty-five minutes, the

circulation is diverted from the placenta to the lungs, and pulsation in the cord ceases in a few seconds, when the child is to be separated from the placenta as in ordinary cases. The doctor also concludes that, following this chain of reasoning, the best results only can result from the prompt delivery of the placenta in cases of placenta previa.

No Doctor's Bills in Sweden.

The doctors of Sweden never send bills to their patients. If you have occasion to call a physician, you will find him not only skillful in his profession, but a highly educated and honorable gentleman. You will also have a proof of the honesty of the Swedes and their friendly confidence in each other. What you pay your physician is left entirely to your own choice. The rich may pay him liberally, whether they have need of his services or not, if he has once been retained by them. The poor pay him a small sum, and the very poor pay him nothing. Yet he visits the poor as faithfully as he does the rich. A similar custom prevailed up to the middle of the present century in some of the most remote portions of the highlands of Scotland. There the doctor collected his entire year's bills on a certain market day in summer, getting perhaps £5 or £10 from the larger farmers, but only as many shillings from the poorer crofters.-London Answers.

Book Reviews.

The first installment of King's American Dispensatory in the revised and enlarged edition, lately issued from the press of the Ohio Valley Company, of Cincinnati, is just to hand, and is a

most creditable exponent of eclectic pharmaceutic knowledge. It has been entirely rewritten by Professors Harvey W. Felter and John Uri Lloyd, and bears internal evidence of great care and labor. It is a two-volume edition, royal octavo, each volume containing over 950 pages, with complete indexes, and is sold at $1.50 per volume in cloth, or $5 in sheep, postpaid. Our eclectic friends are to be congratulated upon the scientific excellence of the work.

William S. Gottheii, M.D., Professor of Dermatology at the New York School of Clinical the subject of cancer, and the little brochure Medicine, is an acknowledged authority upon from his pen upon the "Treatment of Skin Cancers," publisht by International Journal of Surgery Company, of New York, is a valuable and practical contribution to current medical literature. The subject is treated from the standpoint of the general practitioner, as well as that of the specialists, and, while he mentions every prominent modern method in the non-operative treatment of cutaneous cancers, the author

especially elaborates the caustic method which has been so widely connected with his name. He dwells particularly upon two points as essential— recognition and treatment. The book is printed upon heavy paper, bound in cloth and profusely illustrated, and is sold at $1.

Saunders' Question Compends have long since made for themselves a recognized place in medical bookdom, over 160,000 copies of these publications having been sold since the issuance of the first volume of the series. Morris's "Essentials of Materia Medica Therapeutics and Prescription Writing" has always been one of the most popular of the series, and in its present form, the fifth edition, revised and enlarged, will command an even greater sale. It is bound in the usual blue cloth, has 288 pages, and is sold at $1, subject to the usual trade discounts. Address W. B. Saunders, of this city, for particulars concerning his publications.

Professor W. A. Newman Dorland, of this city, will, beyond a doubt, gain a living reputation as a medical lexicographer thru his work upon "The American Pocket Medical Dictionary," just issued from the press of W. B. Saunders, of this city. It contains the pronunciation and definition of over 26,000 of the terms used in medicine and the kindred sciences, along with over 60 extensive tables. It is beautifully bound in flexible leather, printed in clear type on thin, tough paper, and has 518 pages, while the price, $1.25, places it within the reach of all.

"The Care of the Baby," by J. P. Crozer Griffith, M.D., of this city, is more particularly designed for the use of the mother and nurse of the infant, but contains much of value also for the practitioner. The statements are plainly made and easily understood, and are yet scientifically accurate. That the volume is of value is proven by the fact that it has already reached its second edition, having been revised and enlarged. It is from the press of W. B. Saunders, of this city, is cloth bound, has 404 pages, and is for sale at $1.50, subject to the usual trade discount.

We have before us the third edition of "Diet for the Sick," by Miss E. Hibbard and Mrs. Emma Drant, 103 pages, board sides, postpaid, 25 cents, the Illustrated Medical Journal Company, of Detroit, Mich., publishers. The recipes have all been tried, and are those largely used by the Detroit hospitals. Added to these are various diet tables, as for: Anemia, Bright's disease, calculus, cancer, consumption, diabetes, dyspepsia, fevers, gout, obesity, rheumatism, uterine fibroids, etc., as given by the highest authorities. The booklet is intended to be given to the family by the physician, and for such purposes, one-half dozen will be sent, prepaid, on receipt of $1.00.

The second edition of "Dynamical Therapeutics" keeps pace with the progress of the times in eclecticism, altho it is somewhat conservative, in that newer ideas are not adopted until proven of value. The volume is a full octavo, bound in cloth to resemble sheep, with 934 pages, and very thoroly indexed in a manner that completely organizes the book. It is the

most extensive work on specific medication ever pubiisht. It contains a large amount of positive therapeutic knowledge, condensed, methodically arranged, and easy of access, with an introductory part on principles and technicalities, making the entire subject clear. The author, Herbert T. Webster, M.D., professor of the principles and practice of medicine and pathology in the California Medical College, has been a faithful and tireless investigator for thirty years, and has, in consequence, succeeded in producing just the kind of volume needed by the busy eclectic practitioner. The work is sold only by subscription, and will be forwarded to any part of the country on receipt of the list price by the publishers, the Webster Medical Publishing Company, of San Francisco, Cal.

We are in receipt of a copy of H. K. Mulford Company's new price list of pharmaceutic and biologic products. It is thoroly revised and enlarged to 228 pages by the addition of new and enlarged sections. Among other new and interesting additions is a list of standard ointments, soluble elastic capsules and granular effervescent salts. The nomenclature of the firm's diphtheria antitoxin has been materially changed, a fact which will be appreciated by the numerous friends of this product.

The 14th Annual edition of the Columbia Desk-pad Calendar, issued by the Pope Manufacturing Co., of Hartford, Ct., is being distributed. Contributions in the shape of testimonials to the merits of Columbia product, or clever bits of verse about bicycling in general, appear at the tops of the various pages. The pages for Sundays, the first day for each month, and holidays, present appropriate selections from well-known authors. Any person may obtain a copy by applying to the nearest Columbia dealer or by sending five 2-cent stamps to the Calendar Department of the Pope Company.

Dr. W. C. Abbott, editor of the Alkaloidal Clinic, has long used THE MEDICAL WORLD Visiting List in his practice. A year or two ago he wrote us that he wanted to publish a visiting list to supply to readers of the Clinic, and that he considered the plan on which THE MEDICAL WORLD list was constructed the best conceivable, and that if he published a list he wanted it on the plan that would best serve the needs of the profession. After considerable correspondence on the subject the doctor came to Philadelphia last summer, and finally an arrangement was made by which we transferred to him all rights and title to THE MEDICAL WORLD Visiting List, and sold to him all stock on hand. has now made an improvement by which the monthly section (removable) and the ledger are carried in the same case, and he has changed the name to "The Physician's Protective Visiting List." A copy of the new form is now before It is superior and elegant in every way. It is without doubt the best arranged and most convenient system of keeping physicians' accounts in existence. It is called "protective " because it is the only list published in which the original charges are entered in a form that will stand in a court of law. Also, should a physician who uses the ordinary list die, his family

us.

He

would be likely to lose all his accounts, perhaps covering a number of months, made in the ordinary list. The "protective" list avoids this danger. Each year this list will save many, many times its cost, besides its great convenience and the little trouble in keeping accounts by its use. Price, list complete, comprising case, ledger and twelve sections, $2. Sections separate, $1 per dozen. Orders may be sent either to THE MEDICAL WORLD or to the Clinic Pub. Co., Sta. X, Chicago.

Practical Points,

When you cannot procure from your jobber, Marchand's medicinal preparations in their original, unbroken package, viz.: Peroxid of hydrogen (medicinal), glycozone, hydrozone and eye balsam, please address your order to either Messrs. Schieffelin & Co., 170 William Street, N. Y., or Charles Marchand, when orders will be filled promptly.

Doctors say that the more one takes of salts and pills, the more constipated the system becomes. One enjoys both the method and results when Syrup of Figs is taken; it is pleasant to the taste and acts gently yet promptly on the kidneys, liver and bowels, cleanses the system effectually and overcomes habitual constipation permanently.

In a case of fatty degeneration of the heart in one of my patients the general symptoms were: Fatigue on the least exertion, especially markt when going up-stairs; headache, difficult breathing, frequent nausea and occasional vomiting. Phytoline was prescribed before and after meals as directed. At the end of the second week his heart beat stronger and quicker, the breathing became easier, and the edema of the extremities began to subside. He began to lose flesh, altho the appetite became almost ravenous. treatment was continued two months with constant improvement, and, having lost 36 pounds, was discontinued. This has been over a year ago, and he is still perfectly well. Nathaniel F. Lindsay, M.D.

The

A physician of considerable prominence says: "The fluctuating temperature that constantly attends tuberculous conditions is attributable to the disorganizing influence of the tubercle bacillus upon the nerve tissues, especially the medulla. This condition is usually described as reflex. Rational relief is found in that agent which encourages the hasty return of normal vitality to the nervous system and one which serves to establish a uniform heat genesis. I have found that Angier's Petroleum Emulsion admirably meets these requirements."

The I. W. Kelley Company has a taking and satisfactory answer to the problem of hot air therapeutics. Physicians are enthusiastic over their simple and practical solution of this proposition. It costs less than two cents per gallon to operate. Write for particulars and mention THE WORLD.

Dr. N. Allen Heaton, Washington, D. C., writes: "Sharp & Dohme's aseptic syringe has been adopted by the surgeons of the New York hospital. It is far superior to any upon the mar

ket and will do more to assist and advance hypodermatic medication than any single improvement of which I am at present aware." Write the firm for particulars.

A prominent physician writes: "I have just had an opportunity of seeing the wonderful value of Imperial Granum in milk infection. I ordered the baby to be fed on Imperial Granum, prepared with pure water only, increasing by one teaspoonful the quantity of Imperial Granum directed to be used when prepared with milk. An immediate improvement and most satisfactory recovery of the case was the result."

The main factor that makes human milk, where it is normal, of superior value, is the ready digestibility of its albuminoids, and cow's milk made up with Eskay's Albumenized Food shows clinically like ready assimilability of its albuminoids. Send for sample, and mention THE WORLD.

"Viskolein," the new antiseptic treatment for fevers and other zymotic diseases, has been purchased by The Viskolein company, 5 Beaver Street, New York City. Viskolein is one of the few successes of the year. It will abort fevers if its use is begun in the early stages of the disease, and will modify it in every case. The treatment consists of three forms: No. 1, (tablets) antipyretic, to be prescribed only when the temperature runs too high; No. 2, (capsules) the antiseptic proper; and No. 3, (solution) a solution of the powder (No. 2) for subcutaneous administration. Of the hypodermatic feature, the Denver Medical Times says, editorially, "The subcutaneous method is rather a novel feature in antiseptic medication and there is much to be said in its favor." The price of the treatment, complete, is $3. Full information will be sent on application.

Dr. T. Pickles, of Anna, Ill., writes the following therapeutic results from actual experience: "For sore nose, nasal catarrh, etc., I have used Unguentine for the past three years, and have yet to see the case that was not cured within a reasonable length of time. In cases where dry scabs or scales form in the nose, I order say a half-ounce of unguentine, make a small mop, with a little roll of absorbent cotton on the end of a small stick, roll the mop in the unguent and apply well up both nostrils, at the same time have patient to snuff the nose until the unguentine can be plainly tasted. Use only once a day, just before retiring for the night. This generally cures within three weeks." Write for sample, doctor, and mention THE WORLD.

The new 1898 antitoxin brochure of H. K. Mulford Company is a thoro revision and improvement of that issued last year, and is very handsomely executed. It is a valuable reference book on the serum treatment of diphtheria, and should be in the hands of every physician who sees cases of this disease. A novel and interesting feature of the book is a section of official reports on the employment of diphtheria and a complete symposium of what all recent testbooks say of the antitoxin treatment. It will be mailed gratis to you upon receipt of request. Mention THe World.

Don E. Ashley, M.D., Guy's Mills, Pa., says:

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