water and ice are allowed. Alcoholic stimulants are rarely called for, milk and the concentrated foods being amply sufficient to nourish and maintain the patient's strength. ***. In conclusion, I would say that the antiseptic plan of treatment is deserving of attention, for, while by the old, or expectant plan, the mortality is from 15 to 20 p. c., by the antiseptic the mortality is practically reduced to insignificance.-N. C. Med. Jour. Thyroid Feeding in Exophthalmic Goitre. Now that the use of thyroid gland in the treatment of disease is receiving so much attention, the following case may be of interest: ally prescribed. He steadily improved, and for the last three months has been able to do heavy work without the slightest discomfortan experience nnknown to him, he says for many years. The exophthalmos is now scarcely perceptible, and would not be suspected without close examination. There is now a depression in place of the previous fullness in the thyroid region. The pulse is 76. The area of car liac dulness is unaltered. Arterial throbbing has disappeared. The patient is greatly surprised at the change which has come over him, and continues to take a quarter of a lobe twice a week. One cannot be sure there is a connection between the treatment and the improvement, though the patient has no doubt on the matter. Brit. Med. Jour. Hemorrhoids. W. U., aged 46, a laborer, came under ob- Injection Method of Treating Certain Classes of servation last May on account of an attack of diarrhea, which had kept him awake the whole of the night before. He said that for twenty years he had had a swelling in the neck and a prominence of the eyeballs. Several doctors had noticed these peculiarities. During that time he had suffered much from palpitation and breathlessness, which rendered him unable to do a good day's work. His face wore a very anxious expression, the eyeballs were very prominent, a wide ring of sclerotic being visible; the upper eyelids did not accompany the eyeballs in downward movement, and carrying the hand rapidly in front of his eyes did not cause blinking. There was visible arterial throbbing in the neck, and a fullness in the thyroid region protruding well in front of the anterior border of the sterno-mastoid muscles. Pulse 126. The apex beat was in the sixth intercostal space just outside the nipple line. The upper margin of the cardiac dulness was in the third intercostal space, the right margin at the left border of the sternum. No murmur was detected. There was no albumen in the urine. The diarrhea was checked by opium. Then quinine, iron, digitalis, and arsenic were given for a fortnight without benefit. He was then put upon raw sheep's thyroid (a quarter lobe per diem,) minced and flavored with a little salt and vinegar. His wife gave him, through a misunderstanding, lb. daily for two days. This caused dyspeptic symptoms- nausea, eructations, vertigo, and insomnia. His face and legs swelled, in consequence, he thought, of the "neckbergs," by which name thyroids are known to butchers in this locality The thyroid was discontinued for a week, and the unpleas ant effects of the previous mistake having passed off, was resumed in the quantity origin is sometimes very efficient in simple hemorThis method, though generally condemned, rhoids without ulceration, and where the sphineter is relaxed. The bowels should be washed out with enemata, and antiseptic precautions carefully observed. The tumor is brought into view, without a speculum, if possible, the parts thoroughly cleansed, and a needle introduced from the base of the tumor to the center. The blood is then pressed out of the tumor with the finger, and great care taken to see that the needle is neither in the cellular tissue beneath the hemorrhoid, or immediately adjacent to the mucous membrane. The fluid is to be injected in very small quantities in different parts of the hemorrhoid through the one puncture; two are generally sufficient-never more than four minims. I prefer the following modified Shuford's solution: The fluid should always be perfectly clear, and should never be used when of a reddish or yellow color, for it is then likely to cause considerable irritation. The injection causes no pain, and does not interfere with the patient's occupation. It is sometimes necessary to repeat the operation on a large hemorrhoid, but this should not be done for three weeks. There is nothing in the fluid to produce suppuration, and when this occurs it is due to faulty technique. I have never had death, hemorrhage fistula, stricture, or protracted ulceration produced by this method in nearly one thousand injections, and I believe this is due to antisepsis, and the injection of very small quantities of weak solutions. Some cases recur in from two to four years, but the treatment can then be repeated satisfactorily; in the majority of cases there is no return.-Am. M. S. Bulletin. Ammonium Embelate as a Tenifuge. Dr. A. Durand (Inaugural Thesis; Bordeaux, 1893.) The author has conducted a series of clinical experiments with AMMONIUM EMBELATE, which prove the reputed anthelmintic value of this remedy. Of eight cases the tenia were killed and completely expelled in seven, while in the eighth, in which pelletierine had proved of no avail, the parasite was only partially removed. The patients were subjected to the milk-diet for three days-ammonium embelate being given on the morning of the second day, on an empty, stomach, in doses af 40 centigrammes (6 grn.), taken in wafers and followed by a purgative— preferably castor oil in 30 gramme (1 fl. oz.) doses after 24 hours. The author considers ammonium embelate a reliable and harmless tenifuge.-Amer. Med. Surg. Bulletin. A Good Recovery From a Bad Injury. BY T. J. NEWLAND, M.D., SURGEON, N.P.R.R., Ellensburg, Wash. On January 16, 1893, Mr. B., aged about 30 years, while acting in the capacity of brakeman for the N. P. R. R., fell from the top of a box car of a moving train to the track, and a loaded car passed over his left foot diagonally from the heel forward across the arch, inflicting a severe compound-comminuted fracture of the tarsal bones, and a greatly lacerated condition of the soft tissues, almost severing the foot, with the complete distruction of all the principal nutrient blood vessels-a sickly sight of mangled tissue. was It was found necessary to remove many fragments of bone, and when the wound properly cleansed and ready for the dressing, I found I had removed of the bony tissue the head of the astragalus, all of the cuboid, scaphoid, external and middle and a part of the internal cuneiform. Thus you will observe that the arch of the foot was entirely destroyed, there being no bony connection left between the remaining portion of the astragalus and the metatarsal bones. The soft tissues of the external and internal surfaces were mutilated, leaving intact only the tissues of the plantar surface and a narrow strip on the top, with only a few superficial cutaneous vessels left to nourish. fess that the prognosis was not a bright one, but armed with a knowledge of modern aseptic measures and the means of carrying them out, I felt encouraged to make an effort to save all I con that was left of the patient's foot. A large piece of moist sterilized gauze was drawn through the foot, and all the openings well packed with the same sort of material. Circulation by the superficial vessels remaining was encouraged by artificial heat, which was found to be essential for about three weeks. It was dressed as often as deemed necessary. The large cavities filled but slowly on account of the deficient circulation, by granulated tissue, without suppuration, the wound remaining aseptic throughout. The foot shortened some by contraction of the remaining tendons, and in a couple of months there was considerable strength in the foot, and the patient was going about comfortably on crutches. On April 26th following he was transferred to the company's hospital at Missoula, where the remaining granulating surface was successfully covered by skin-grafts by Dr. J. J. Buckley, chief surgeon, and the patient soon discharged. Today, and for several weeks past, only a little more than twelve months since the accident, the man walks as rapidly as the average individual. True, he limps some, but the foot has become quite strong. The new tissue formation has become dense and hard, forming a good false joint. This case has been of great interest to me, and I believe it should be to every surgeon, on account of the anatomical arrangement of the bony structure of the foot being so extensively disorganized, and yet its functions so nearly restored. It should teach us that conservative surgery should never be lost sight of, and that it is very often rewarded by flattering results. -Med. Sentinel. The Sulphites and Hyposulphites. In an interesting and exhaustive article in the Jour A. M. A., Dr. Joseph Jones, of New Orleans, gives some important facts regarding this useful class of agents (the sulphite and the hypo-ulphite of sodium calcium potasium or magnesium). In the treatment of wounds they present the following advantages: 1, anesthesia of the wound; 2, prevention of nervous accidents; 3, excitation of granulation and acceleration of cicatrization; 4, diminution of the quantity of pus, which it renders viscid, sweet, inodorous and neutral. Under the head of Physiologic Action the author concludes as follows: Giving credit to the consciencious experiments of Polli and of Burgreave upon animals, it becomes difficult to refuse to admit : 1, that these salts exercise upon the economy a very marked action, an action almost specific in certain cases; 2, that their administration is able not only to retard death, but also to alleviate the symptoms of purulent infection, produced by the introduction into the circulatory system, in large doses, of pus, or of blood rendered putrid by divers poisons, and to effect a cure in a marked number of such cases. Purulent infection, purulent diathesis and metastasis, phlebitis, pyemia, putrid infection, puerperal fever, form a group of septic diseases presenting a special character of putridity and a mixed alterati n of liquids and solids. It is well known how grave the prognosis is in all these affections, and how powerless and uncertain are all therapeutic means. The indications can be much better met, and success becomes much more certain with the sulphites. Under Therapeutic action, they are recommended for use in blood poisoning from various sources, malarial fevers, typhoid fever, the eruptive fevers, diphtheria, and as a lotion in catarrhal states of the bladder and the genital and other mucous passages. Formulas. Therapeutic Hints. (From The Medical Record) BROMIDROSIS. Internally give m viij. tinct. belladon. in 3ss. fluid extract ergot, three times a day; externally, use on the body the following powder several times daily: R. Salicylic acid.. Boric acid... Zinc oxide. Powdered starch.. Ottar of roses... PLEURITIC EXUDATION. To prevent extension of exudation: Absolute rest in the recumbent position, until temperature has been normal for eight days, the heart and respiration being the guides as to increase of fluid. No movement to be permitted for the purpose of examining the chest or for any other object. Striking results reported. 25 gram (dr. 64) M. S. Teaspoonful every two hours, or, if the bleeding is severe, every hour. Better results follow the use of the ergotine in this mixture than when it is given alone hypodermatically. CHRONIC GONORRHEA AND GLEET. R. Eucalyptol (Sander & Son's)..................dr. iij Spir. vin. rect....... Zinci. sulph... Morphinæ sulph... Aquæ font. q. s. ad .... Oz. i ..grs. xv .grs. iv .oz. iv M. Sig. Inject one to two oz. twice daily. Shake well before using. Corrections. It is very difficult, as prescriptions are ordinarily written, to have them all set up in type without some slight error. Hence, readers of medical journals should always be guided some-what by their own judgement when the apparent dosage is very far from that ordinarily employed. On page 146, April WORLD, prescription for gonorrhea, the bromide of potassium should read dram iss and the last ingredient should read ounces viii instead of drams viii. In the prescription for scarlatina, same column, the salicylate of soda should be grains xxx to drams ii, and the last three ingredients should be, "of each q. s. ad ounces iv." The annual meeting of the American Medical Association will be held in San Francisco, Cal., on June 5th, 6th, 7th, and 8th. For any desired information address the Permanent Secretary, Dr. W. B. Atkinson, cor. Broad and Pine Sts., Philadelphia. Reviews. In writing for any publication reviewed please mention THE MEDICAL WORLD. MANUAL OF THERAPEUTICS. By A. A. Stevens, A. M., M.D., of Phila. Cloth, 485 pages, $2.25. W. B. Saunders, 925 Walnut St., Phila. A very useful manual, bringing the subject up to date. The newer drugs, introduced within the past few years, are duly recognized. A TEXT-BOOK OF THE DISEASES OF WOMEN. By Henry J. Garrigues, A. M., M. D., of New York. Price, net, cloth, $4.00, sheep, $5.00. W. B. Saunders, 925 Walnut St., Phila. It is with pleasure that we place before those of our readers who need a work on this subject, this excellent volume by Prof. Garrigues. The reputation of this distinguished author for thorough conscientious work is sufficient guarantee of its great value. The book is most magnificently illustrated with three hundred and ten engravings-many of them colored plates. NURSING IN EYE DISEASES. By C. S. Jeaffreson, M. D., F. R. C. S. E., of Newcastle-on-Tyne. cloth, 90 pages, price two shillings six-pence. John Wright & Co., Stone Bridge, Bristol, England. This will prove a most useful hand-book to physicians doing much work in diseases of the eye, both for the hints to themselves and as a book of instruction for their nurses. The author gives many illustrations showing methods of bandaging, dressing etc. He gives detailed nursing directions for cases after each one of the principal operations upon the eye. LECTURES ON AUTO-INTOXICATION IN DISEASE, OR SELF-POISONING OF THE INDIVIDUAL. By Ch. Bouchard, of Paris. translated by Thomas Oliver, M.A., M.D., F. R. C. P., of Newcastle-upon Tyne, England. Cloth, 302 pages, octavo, $1.75, The F. A. Davis Co., 1914 Cherry St., Philadelphia. net. This is a scholarly and most important work. Too seldom does the physician sufficiently recognize the significance of self-intoxication. In the future it must be more generally recognized in estimating causes, diagnosis and prognosis and in determining treatment. The author treats of Production and Elimination of poison; Toxicity of the urine; Toxicity of the contents of the intestines; Chronic gastrointestinal intoxication; Dilatation of the stomach; Typhoid fever; Jaundice and bile-intoxication; Pyocyanic disease; Diabetes; Cholera; General therapeutics of self-poisoning. CLINICAL LECTURES ON PEDIATRICS. By A. Jacobi, M.D. Cloth, 195 pages, Published by Bailey & Fairchild, New York, N. Y. This is a work of great interest to the physician especially desiring more light on the treatment of diseases of children. Prof. Jacobi is high authority on the subject. OF ANOMALIES OF REFRACTION AND OF THE MUSCLES THE EYE. By Flavel B. Tiffany, M.D., Kansas City, Mo. This book is profusely illustrated, and contains, in addition to what is found in the ordinary books on this subject, a chapter on "How to examine the Eyes," with all the latest approved methods. The subject of "Heterophoria,' with all its phases, is thoroughly discussed. There is also a chapter on "Spectacles," with valuable hints to the optician, and one on "Strabismus." The colored Plate opposite page 195, illustrating tests for astigmatism, is of especial interest. Biographies and elegant portraits are given of three eminent eye surgeons-Von Helmholtz, Donders, and Landolt. The work is eminently suited to the wants of the general practitioner. THE Doctor takes a professional magazine for business purposes. But he and his family also desire a literary magazine for entertainment and general culture. We advise our readers to send 15 cents to The Cosmopolitan Magazine, New York, N. Y., for a sample copy of this magazine, a charming entertainer for only $1.50 per year. The April number contains an extreme rarity-a Corsican story by Napoleon Bonaparte, the only story ever written by the great General. This manuscript has slumbered in obscurity for over a hundred years, now to be published for the first time by this enterprising magazine. THE NEW YORK STATE MEDICAL REPORTER. Monthly, $1.00 per year; edited by H. Bronson Gee, M.D., published by George R. Fuller, Rochester, N. Y. We wish the new journal a brilliant career in the field of medical literature. WHAT an appropriate name has that matchless magazine-THE Arena, of Boston, Mass. As in the physical Arena of old were fought many fierce conHlicts, so here is waged the nobler warfare of the cause of truth and justice against greed, wrong and oppression -the cause of the useful people against gamblers, adventurers and speculators. Doctor, it will refresh you after a days weary round to read one of the spirited articles in THE ARENA. Your wife, sons and daughters will also be lifted up and inspired by it. Subscribe for it at once and form an ARENA Club in your community. See article, "The Cause of Financial Panics," in March number. LONGEVITY, WITH A LIST OF OVER 250 CENTENARIANS. By Archie Atkinson, M. D., Baltimore, Md., late Prof. Pract, of Med. Balt. Med. Col· lege, ex-member Medico-Chirurgical Society, of Md., ex-member Md. Academy of Sciences, member Balt. Microscopical Society and late resident physician to the Greenbrier White Sulphur Springs Greenbrier Co., W. Va. This paper is a curiosity in that it presents a list never before presented to the public that we have seen. It shows that no one condition of life, or no one locality specially, favors the prolongation of human life; that neither the rest of affluence, or the labor of the poor man conduce much to the attainment of very old age. The long list would serve to show the helplessness of old age and the great neces |