there may be noticed. The woman is mutilated by the removal of some one or more of her organs and becomes no better, but often worse, while the original diagnosis is never questioned, and the nerves and general system are entirely neglected in the treatment. The article is full of strong points and sensible directions, and should be read by all general practioners.

Sanitation is True Economy.

The London Sanitary Record draws a parallel between the stingy city authorities who, in Browning's poem, "The Pied Piper of Hamelin," refused to pay the stipulated price for destroying the rats and lost all their children in consequence, and many of our own modern cities and States who are too mean to pay for scientific sanitary work, but allow epidemics to have almost unrestricted sway. They must pay finally-if not in dollars, then in lives. But the Record might have gone farther and shown that, if the short-sighted officials (or voters) prefer to take the chances and pay in children, they must, finally in addition, pay in dollars even many times more (as the expenses of the epidemic) than the original sanitation would have

cost.

A Common Precaution Not Sufficiently Observed,

We fear that the importance is not sufficiently regarded by many practitioners, of protecting the eyes from contact with active purulent discharges occurring in other parts. When one eye is affected with purulent inflammation the sound eye should be carefully guarded from contagion. Every patient suffering from gonorrhea should be profoundly impressed with the great care which he should observe to prevent conveying the disease either directly or intermediately to either his own or others' eyes, and his awful responsibility if any one should loose one or both eyes through his carelessness in this respect. The most scrupulous cleanliness of hands and immediate destruction by burning, of all soiled articles should be enjoined, as well as private use of towels, handkerchiefs and other personal articles. Infected clothing should not be given to ignorant persons to wash and thus convey the disease, and, on the other

hand, persons doing strange laundry work should not rub their eyes with fingers damp from the suds.

Antiseptic Ointments for Eruptive Fevers.

The treatment of certain eruptive diseases by inunction of the skin with an ointment containing eucalyptol would seem to be beneficial, both on purely theoretical grounds and by analogy, as it is very beneficial in scarlet fever and small-pox. However, it is to be tried in other diseases very cautiously, as a report of five cases in Practitioner, of London, indicates that it does very badly in measles. However, we should like to see it more fairly tried, even in this disease, as in the cases mentioned it seems to have been tried with a proprietary medicine said to contain eucalyptol, rather than with the pure drug itself.

Arsenite of Copper for Typhoid Fever. A. H. Thomas, M. D., of Hurley, Wis., reports a series of ninety cases of typhoid fever (Amer. Therapist) treated with arsenite of copper, with but one death, and that one from hemorrhage. The daily dosage was grain; this amount was dissolved in about two ounces of water, and taken in hourly teaspoonful doses until it was all taken. This was repeated in the same manner each day. Occasional use was made of coal-tar antipyretics and quinine, according to symptoms. The doctor also reports that the after condition of those who recovered under this treatment was better than under the usual treatment; this was especially true of the condition of the intestinal tract.

Proper Out-Houses for School Children. Hon. Nathan C. Schaeffer, Supt. of Public Instruction in Pennsylvania, is making a commendable agitation for well-built and decently kept school out-houses. This subject should be agitated all over the civilized world until the desired object is universally attained. No one knows better than the physician the great amount of disease and suffering entailed upon the human race in consequence of the sins prompted by impure impressions made upon the mind in childhood. Every influence surrounding the child should be of an improving and ennobling character. Hygienic and properly

kept school out-houses will pay the best kind of interest on their cost.

But there should also be properly kept public water-closets for every square or two, without regard to school-houses, in all large cities in the interest of health, decency and sobriety. Malaria Cured by Hydrochlorate of Phenocoll.

The

In the Therap. Monat. Cucco details eightyfour cases treated, of which fifty-two were cured and all the rest but four improved. dosage is from fifteen to twenty-two grains daily. A promising substitute for quinine, producing no unpleasant results.

Pilocarpine for Diphtheria.

For diphtheria give pilocarpine until the characteristic salivation and sweating are thoroughly established. This usually requires hourly doses of from 1-40 grain to 1-10 grain according to the age of the patient After that give at longer intervals to keep up the effect.

Treatment of Typhoid Fever.

In an article in the N. Y. Med. Jour., Dr. T. J. Shuell, of Parnell, Ia., states his belief that the toxic products of the inflammation find their principal lodgement in the colon whence they are absorbed and enter the circulation.

"The indications for treatment will range themselves under three headings in the order of their importance.

1. To remove, at as early a date as possible, all ptomaines and decomposing substances from the colon.

2. To destroy or neutralize the effect of all micro organisms above the cæcum by proper internal germicides, if any be found that will not impair the animal economy.

3. To enforce proper dietary and to treat rationally symptoms and indications as they may arise.

The first indication may be met only by thorough irrigation of the colon. But thorough irrigation of the colon can not be effected unless we pass a tube above the sigmoid flexure. ordinary colon tube may be used, but I prefer a soft-rubber tube of a caliber of from 25 to 32, American scale, and about three feet in length.

The

stream to flow, it may readily be made to pass the sigmoid flexure of the colon and reach to, or near, the cæcum. 1 The water used should be warm and aseptic, which can be effected by boiling. Only in exceptional cases should it be made antiseptic for fear of producing systemic poisoning. At least half a gallon of water should be injected in adults. The injection will distend the gut, remove the accretions from the sacculi, and result in such an evacuation of foul

smelling fæces intermixed with scybala as will surprise both patient and physician. These injections to effect the most good should be employed early in the disease, before the high fever and severe nervous symptoms show themselves. They may be repeated, if necessary, at intervals of three days for the first week or ten days. The only precaution is that they should be used warily when the stage of necrosis of the glandular tissue is reached, as the solitary glands of the large intestine are affected in a large proportion of cases."

The doctor recommends milk as the best article of diet, and gives plenty of pure cold water to drink one to two quarts daily.

Antipyretics in Typhoid Fever.

In Am. Med. Surg. Bulletin, Dr. C. W. Carran, of Va., has an article developing the following conclusions:

1st. The so-called antipyretic remedies are more or less injurious to the patient when given in large doses, or when their use is continued for a considerable period.

2d-They should be prescribed only when cold water cannot be used in some manner, and then only long enough to secure the end indicated.

3d-Cold water is a safe and efficient measure with which to combat high temperature in most cases of typhoid fever; and the manner of its use should be impressed upon the laity more fully by the physician.

nothing is revealed by examination, give her very small doses of arsenic, gr. 1-120, before each meal, and an enema of a grain of silver nitrate in eight ounces of hot water once a day. Still smaller doses of corrosive sublimate, gr. 1-180, once acted well in a similar case for me.

I would suggest the same treatment for H. L. K., (page 20), adding that there is less like lihood of rectal disease. The old-fashioned mixture of rhubarb, hydrastis and potassium carbonate would probably be useful to him, as it usually is when there are fetid, unhealthy stools. With this a diet exclusively of hot milk, until his stools are normal; then returning very gradually to his usual diet. I think he has ulceration of the bowels, although the absence of fever is against this. Has he noticed whether there are mucous, semi-membraneous casts of the bowels in the stools? Mucous colitis presents such symptoms as he describes.

Dr. Lever's case (page 20), reminds me that I have often seen such an appearance in persons dead from consumption. The certain evidence of death is decomposition; but the fact that the heart has ceased to beat, and the pulsations cannot be heard by the trained ear of the physician is fully as positive. Some years ago I traced up every story of burial alive appearing in the papers, and found that all came from the same source the reporter who was in straits for something to fill up space.

Medicus, (page 20), could not improve on his local treatment, but why not give sulphide of calcium internally, one grain daily? Don't be discouraged, for furunculosis is often obstinate. Sedentary habits in a man whose body was designed for manual labor, coffee, beer, sewer gas or other foul air in the house, often keep up this affection. One of my cases resisted all my efforts till the plumber cured her by ripping out the "jerry" drain pipes and putting in good work.

In the negro, I have found it necessary to use hot applications for pneumonia, to treat the case vigorously at first, feed well, and lookout for collapse at the crisis. They rarely have the nerve or the resisting power of the whites.

As to making a plaster cast, Dr. Barringer, (page 20), should shave the skin if it has any hairs, soap or grease it well, and then apply the plaster. Lay two threads or wires along the sides, and as the plaster begins to set, withdraw these and the cast may with care be removed entire. When quite firmly set, the inside is to be greased, the two sides placed together and plaster run in to form the cast.

Spasmodic croup is peculiar to infants under one year old. The treatment is uncertain; but

counter irritants along the pneumogastic in the neck, (mustard is best) should give prompt relief.

For the removal of a brown discoloration on the face, B. L. N., (page 21), may paint. with corrosive sublimate solution, one grain to the ounce or stronger, till the epidermis is removed; then rub with compound iodine ointment, diluted, and then apply lanoline till the skin is restored.

X. X X. asks what will remove superfluous hair from the skin, besides electricity. Nothing. Dr. Mantey, (page 21) will find alopecea areata likely to be of syphilitic origin. Mercury and potassium iodide internally, and cantharides, 30 drops of the tincture to an ounce of benzoated lard locally, would be pretty good

treatment.

If

I feel like asking "Medico" (page 21), what he wants to cure his patient for. He should notice whether the womb is tipped back. not, let her take a full dose of quinine the night before the accustomed attack; or a full dose of atropine (gr. 1-100); or else teach her to catheterize herself.

I hope the two valuable letters of Drs. Stocker and Brodnax, in the January WORLD, will not be all we are to have on the subject of quinine causing hemorrhage. The MEDICAL WORLD family, with its thirty odd thousand members, in every State and Territory, could settle this important question if each one who has noted such cases would report them. But the great fault I have to find with you is that you leave a few of us to do the talking and keep to yourselves experience that would be of the greatest value to your fellow doctors.

You will see by the new address that I have gone West to grow up with Chicago.

WILLIAM F. WAUGH, M.D. 834 Opera House Block, Chicago, Ill.

every case of malaria that has presented itself for treatment, and always with brilliant suc

cess.

I will mention one case only. Over three years ago, when I practiced in the country, a stout, able bodied man called to be treated for ague. He had had the disease three months the year before, and, although vigorously treated by two physicians, he did not get well until cold weather set in. He expressed a desire to be cured at once if possible, as he was a laboring man with a family to provide for. Having made an examination I accepted his own diagnosis, and expressed the opinion that I could cure him promptly if he did not object to being made right sick for a short time. I prescribed podophyllin in full doses, and explained to him the action the medicine was expected to have. He told me afterwards that the powders made him awfully sick, so he took four only, but when he recovered from the effects of the medicine he was well. He has not had a return of the disease since. Three years ago I treated a medical missionary sick of typhoid fever. He had been in the mission field, Syria, Asia, for twenty-five years. Malarial fever prevails in that country. He told me that elaterium in large doses was his sheet anchor in obstinate cases. The dose mentioned was very large.

Several of the WORLD'S writers have had good results from the use of nitrate of potassium in such cases, and one used apocynum cannab, flu. ex. successfully.

Some three years ago two doctors, partners, in a Southern State (I cannot now find the article to name them), advanced the opinion that chills are caused by an excess of water in the blood. They claim that the sweat following the chill eliminates the excess of water, and in this way the patient is relieved until the water reaccumulates. Reasoning thus they prescribed acetate of potassium with results that confirmed them. in their belief as to the cause. The articles of "Rhubarb" and Dr. W. B. Crawford, December WORLD, page 422, are the occasion of these thoughts being offered for publication.

It will be observed that all the remedies herein mentioned deplete the blood of water by acting on the bowels and kidneys, in this way effecting a cure; thus confirming the correctness of the theory of the doctors referred to above, unless, perchance, the poison be such that it is simply washed out by the watery discharges

In conclusion I express the opinion that the cause of chronic chills can be removed by any remedy that acts strongly on the excretory and secretory organs, particularly the skin, bowels or kidneys.

Those of your readers who practice in malar

ial districts can test this mode of treatment and report results.

If any of the WORLD's family can reduce enlarged tonsils to their proper size by injections, please report how.

Of six medical journals which I take, I like the WORLD the best.

J. S. DODDS, M. D. 6224 Station st., Pittsburg, Pa.

Milk Sickness.

Editor MEDICAL WORLD:-The affection is not due to milk alone, but beef and butter from affected animals entail it as well as water from certain springs and seeps from the earth.

My first experience with the ailment was obtained through treatment of a family who lived on a farm about three miles south of the village of Harrodsburgh, Indiana, in 1857. The said farm had been abandoned in disgust by its owner, and its cabin became the stopping place of any who chose to risk it.

The evil was finally located in a spring near the cabin and fenced by the neighbors, when all again went well.

A little further down the ravine was another spring wholly free from the pest; but children ignorant and indolent, were trusted to bring water, which they procured from the nearest source until the mischief was done.

There can be no question as to the correctness of diagnosis, for leading physicians of Bedford had treated other cases on this same farm, and among others, this same family, who this time recognized their ailment before sending for medical aid. ing for medical aid. This family could not have contracted the affection from milk, butter or beef for by confession they had neither, and the children finally confessed to having carried water from the "Milk-sick Spring."

Where the water from the two springs unite and mingle, stock may drink with impunity, and in winter and spring time when the earth is full of water, that from the "Milk-sick Spring" may be used without detriment. This all points to a poison in water which, when largely diluted, is not received in sufficient quantity to do perceptible harm; but in summer and in autumn, more or less early according to accession of drought, the poison is more concentrated and the so-called milk sickness results

In 1858, while living at Effingham, Ill., myself and wife had milk sickness, and the personal experience thus gained, together with its frequent occurrence there, led me to seek information from every available source and I here offer a statement of facts pertaining to the mat

ter.

After heavy autumn rains come, people in