call simple things by simple names. He subconsciously knew that many people like thrills, as was pointed out once before; he realized that the person of plebeian mind would more willingly sacrifice good money for being cured of "the deadly urticaria" than a fool thing like hives. Wens, Bunk always called "tumors." When he got ready to remove one of these benign cosmetic nuisances everybody in town knew that the doctor "was going to have an operation." On one occasion a young man who was about to become a benedict arranged with the doctor to remove an unsightly dermoid cyst from his face. The day before the operation, which had been astutely heralded around, the young man ran against a post in the dark and broke the tumor, thus cheating the doctor out of his fee. Dr. Bunk called an unusual wart, mole or dermal excrescence “cancer"; if not already a cancer he would advise an early operation, lest it "turn to a cancer."

Like nearly all irregular medical men, Bunk lay claims to superior knowledge, the possession of things not generally known to the profession. He would often say to an "easy," good-paying patron, "I paid an old German professor $50 for this prescription." The old "German professor" gag has enabled thousands of quackish doctors to collect a better fee for a little while. Bunk would sometimes asseverate that some peculiarly potent remedy, known only to himself, was an inheritance from his grandfather, who consorted with an old Indian chief. That is another one that gets by easily, for lots of folks are ready to put their faith in a remedy purporting to come from a filthy, ignoramus who lays claim to being a "medicine man." Peoria, Ill.

NOTES ON TYPHOID FEVER.

J. A. BURNEtt, M.D.

Water is a very important remedy in the treatment of typhoid fever. It should be used extensively internally and externally, and in some cases by rectum. I do not believe that enemas will cleanse the intestines of fecal matter and gas as well as proper laxatives. Castor oil is a good laxative, but should not be used for those who abhor its taste and smell. Castor oil can be disguised and taken very well, but the patient will belch and smell it, which is very disagreeable. Besides, they will smell it when the bowels act. Phenolphthalein is a good laxative. In the form of phenolax wafers (Upjohn) is very pleasant to take and rarely or never will a patient object to taking it. Patients should be allowed all the lemonade they want and all the buttermilk they desire, unless the amount was very excessive.

If the application of cold water is not agreeable, use hot water. Mouth washes are of extreme value. Common table salt is as good as any. Use from a dram to one ounce to a pint of water and wash the mouth often as necessary. The wash should be held in the mouth until the mouth becomes full of saliva, and this repeated one mouthful after another until the saliva tastes normal. If desired, from half to a teaspoonful of the salt can be put in the mouth without any water, and this held until the mouth is full of saliva.

The mouth washes of antiseptics are good, but the holding of the remedy in the mouth to increase the saliva is very important. There are many other things that could be said, but the essential thing I wish to impress is plenty of water, internally and externally, keeping the bowels cleansed of fecal matter and gas, and the importance of keeping the mouth clean and saliva free. I am not much of a believer in intestinal antiseptics or any heroic drugging. I am not a believer in the so-called abortive treatment, which is claimed by physicians who are in the manufacturing business, and have the abortive drugs to sell. I have no use for the vaccine treatment.

Hartshorne, Okla.

An old man who had been quite excessive in his habits applied to me for weakness and control of his urine. The entire urinary system seemed very weak. He got up frequently nights, and passed water with considerable difficulty from lack of power.

I had what was left of a bottle of thuja on my medicine shelf, but the cork had been out and it had evaporated until that which was left was thick. I gave him eight drops of that every two hours, and he has been a very warm friend of mine ever since.

On the second day there was less weakness and less frequency. On the fifth day he stated he was nearly cured. After two weeks he told me that the entire strength and tone of the organs had all returned, and that he was like a young man again, and all irritation was gone.-Dr. Fitch, in Therapeutist.

NUTRITIVE VALUE OF PASTEURIZED MILK.

In order to settle the controversy as to whether Pasteurization injures the nutritive quality of milk, the United States Public Health Service, in connection with the Bureau of Animal Industry, has decided to conduct a series of experiments and observations extending over a number of months, thus determining the effects of Pasteurization on milk, and also the relative nutritive value of raw and Pasteurized milk for invadils and infants.-Life and Health.

INFECTIONS OF FINGERS AND HANDS.

1. Never hunt for puss with a probe in this portion of the body, as it may spread infection.

2. An incision should be made through the point of infection, giving free drainage.

3. If pus is secreted about or in the joint of a finger, pressure on the end of the finger will give rise to pain, while if the pus is in the sheath of the tendon, the same pressure will cause little or no pain.

4. The tendon should never be laid open from end to end, as this procedure is almost certain to cause sloughing of the tendon.

5. If the tendon sheath is exposed and found distended with purulent or seropurulent fluid, it should be freely drained. 6. If the whole tendon sheath is distended with pus it will be necessary to drain its upper end. Incisions for this purpose in case of the index, middle or ring fingers should be made in the palm of the hand directly over the tendon involved.—Dr. H. B. Garner, in Detroit Medical Journal.

Don't be in too great haste to plug the nose in cases of hemorrhage after operation. The most copious hemorrhage will usually cease within fifteen minutes.

LOCAL USE OF EPSOM SALTS FOR AN INFLAMED JOINT OF A RHEUMATIC NATURE.

Dr. E. H. Leaman, in the Medical World, says that in an inflamed joint of a rheumatic nature the use of a hot saturated solution of magnesium sulphate is an excellent remedy. It should be applied with a goodly supply of gauze and the heat maintained by dry towels and further prolonged by hot-water bottles. In mild cases such treatment continued for twenty-four hours is all that is required.

SOME INDICATIONS FOR ATROPINE.

Dimness of vision; can neither read nor thread a needle; spasmodic winking; eyelids feel heavy and difficult to open; dryness of the throat, almost impossible to swallow; dark red or mottled efflorescent redness of the skin, similar to the rash of scarlet fever; chills alternating with flashes of heat.

AN EFFICIENT NUTRITIVE ENEMA.

Beat one egg thoroughly with a quarter of a teaspoonful of salt, and if desired, a little cream. The bowels should be thoroughly emptied by full enema an hour before the rectal feeding, which latter should be given by means of a soft rubber tube that can be inserted well up the bowel.

TREATMENT OF PUERPERAL ECLAMPSIA.

J.F. Morgan, in Surgery, Gynecology and Obstetrics for February, 1913, states that while venesection is seldom practiced nowadays in the treatment of eclampsia, in suitable cases it is one of the most valuable measures at our command. Where the blood pressure is high, with cyanosis, rapidly recurring convulsions, deepening coma and threatened edema of the lungs, it is particularly serviceable. Its effect strikingly shown in a postpartal case recently seen by the author, who is thoroughly convinced that the blood letting was the principal factor in saving the patient.—N. Y. Med. Journal.

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DEPARTMENT OF AGRICULTURE ADVISES THAT MILK BE PASTEURIZED AT LOW TEMPERATURE.

In order to determine the best way of Pasteurizing milk so as to kill the disease germs and yet not give the milk a cooked flavor or lessen its nutritive value, the Department of Agriculture, through its Dairy Division, has been conducting a series of experiments, treating milk at different temperatures and for different lengths of time. According to the report on these experiments in Bulletin 166 of the Bureau of Animal Industry, when milk is Pasteurized at 145° F. for thirty minutes the chemical changes are so slight that it is unlikely that the protein (muscle building element) or the phosphates of lime and magnesia are rendered less digestible than they are in raw milk.

Moreover, from a bacteriological standpoint, Pasteurizing at low temperatures is found to be more satisfactory than Pasteurizing at high temperatures. According to Bulletins 126 and 161, where low temperatures are used the majority of bacteria that survive are lactic acid organisms, which play an important part in the normal souring of milk. When milk is efficiently pasteurized at high temperatures, the bacteria which survive are largely of the putrefactive kinds, and milk so treated if kept for any length of time has a tendency to rot instead of souring. From the standpoint of economy, the technologist of the Dairy Division finds that Pasteurizing at low temperatures calls for less heat. It is found that it takes about 231⁄2 per cent. less heat to raise milk to the temperature of 145° F. than to a temperature of 165° F. A similar gain is a saving of the ice needed, because it will require 232 per cent. more refrigeration to cool milk to the shipping point when it is Pasteurized at the higher temperature. The Department, therefore, recommends that "When market milk is Pasteurized it should be heated to about 145° F., and held at that temperature for thirty minutes."

Clinically veronal appears incompatible with calomel if administered near together.

WHENCE THE SOURCE OF THE BACILLUS MALARIAE?

Editor Medical Summary:

More than an average lifetime of observation in what is supposed to be a malarious country makes me feel justified in saying that the micro-organism productive of malarial fever is a human product, induced by altered secretions of the human body. When a human body is repeatedly exposed to water or soil gases containing morbific ferments, or to cool intercurrent damp atmosphere which stagnate cuticular elimination, the secretions of the body become altered and transfusions occur which result in a dyscrasia which leads on to the condition or generation of a poison that produces malarial fever. And the frequency and duration of the above exposures give rise to the abnormal conditions upon which the different grades or types of malarial fever depend. The range of malarial fever is from the mildest quotidion to the most malignant hemorrhagic. Also certain articles of diet taken in too great abundance, which decay in place of digest and form gases in the alimentary canal, which when absorbed into the system produces the dyscrasia necessary for the development of malarial fever.

It is at variance with present-day teaching that the human system is competent to generate malaria denovo, but my observation teaches me that such is the case. It is said that the human body and a certain separate type of mosquito are the only two things in which the malaria germ has been found. I use the word "things" through respect to the mosquito, as I am talking about him and not he about me. But if that is true, who will tell which caught it from the other? I have lived in Florida

Editor Medical Summary:

Whenever you inject quinine hypodermically, whether by itself or in combination with urea, and your patient develops tetanus according to the provings of Temple, you have yourself to blame for it. This is well to bear in mind.

A New Stain for Bacilli of Tuberculosis. -When pyoktanin blue is dissolved in rain water and applied to a glass slide with sputum on it, it will stain in a few minutes. Decolorize with nitric acid one part to three of water, wash well; the bacilli are stained a dark blue and hold the stain. This is a better color for photographing the bacilli. Note the fact that no other drug is added.

Some months past Dr. Abbott solicited the aid of several physicians to ascertain the action of "berberine hydrochloride." I procured a bottle of five hundred granules, each containing 1/64 of a grain of the drug, gave it to a lady aged about 40, and stout, with an enlarged abdomen and a medium sized umbilical hernia. She took eight of these granules three times a day; at the end of six weeks there is noticed a great reduction in the size of the abdomen and also the hernia, and also loss of weight. Dr. Abbott expected it to reduce the abdomen through contraction of the cellular tissue. It does it, and also contracts the uterine muscles like ergot.

R. D. FAIREX, M.D. 1825 9th St., New Orleans, La.

REPORT OF AN INTERESTING CASE.

Editor Medical Summary:

The following case may be of interest to the profession on account of its rarity, on which grounds I report it, and not as to any special treatment, etc.

Mrs. J. W., age about 50 years, on the 24th of February last, fell down the back stairway in a city house. She tripped just as she was about to take the first step and fell about nine feet, striking the back of her head and twisting it toward the right, fracturing the fourth cervical vertebra. the X-ray showing a comminuted fracture. The X-ray picture, taken about five hours after the accident, and taken for diagnostic purpose in a hospital, where the patient was taken as soon after the accident as possible. She was completely paralyzed from the fracture down. She was at once put in a plaster cast, extending from head. to top of hips, placed in bed, and kept there for twelve weeks. At the end of the twelve weeks the surgeon who had the case in charge advised removal to her home. She was sent to her home in the city, with no instructions as to how long the cast was to remain or any instructions whatever. The family sent for me to know what to do. I at once wrote the surgeon, and he requested me to take charge of the case, as he could not well sce after her outside of the hospital. I found her with slight motion in her legs, unable to be raised in bed. I removed the cast and found the muscles of chest and back very much atrophied from pressure and want of use. The left arm, from pressure of coat in axilla had' caused considerable edema and pain; the coat having pressed upon the blood vessels and nerves in axilla until the arm was very edematous; no sensation or motion. On her back, near the spine, about one and a-half inches to the right, the coat had pressed until it had caused a slough about two inches long and one inch wide and nearly to the ribs. After the coat was removed the arms began to improve, swelling going down and normal color returning, but no action, but very sensitive. In the right arm she had a little sensation and motion return. As soon as the slough on back healed I had her

propped up in bed, with instructions to massage her thoroughly, give strong baths with magnesia sulph. with ten drops 50% solution carbolic acid to the pint. She could not pass urine, so I had to use the catheter, and gave laxatives and enemas for the production of bowel movement. Her urine was very offensive and filled with a deposit similar to lime deposit in a kettle in which lime water had been boiled. I had the bladder irrigated, using a weak boric acid solution, and after irrigation introduced through the catheter a half pint normal salt solution and left it in the bladder; gave her internally urotropin, five grains four times a day; tincture nux vomica and tincture cantharides three times a day and tonics. She began to show some improvement and by June 20th, could pass urine normally; on July 2nd, I had her put on a stretcher and brought by train to my house in the country, where she now is. She can now walk a little with assistance— had she use of the muscles of her back and arms, I believe that she would be able to walk alone.

I am still using massage in hopes to bring strength to such muscles. Her urine is still ammonical and some deposit still passes when her bladder is irrigated; her bowels now move normally. I expect soon to use static electricity and a special treatment to see if I can not get motion in her left arm and sensation in right; the left arm is hyper-sensitive. Now, as to the first treatment in the hospital: The plaster cast was the correct thing to do, but it should not have extended to her hips. After the first one used, when the second cast was put on, I should only have extended it to just below the axilla, and the third only to shoulder, and then it should have been removed entirely at the end of eight weeks at least; then she would not have had such pronounced atrophy of the muscles from pressure. During the time she was in the hospital her bladder should have been irrigated to prevent sediment remaining in the paralyzed bladder. I do not censure anyone, for we are all loathe to overlook some miner details, and this being such a serious injury, one that few have the opportunity of seeing in a practice of forty or fifty years, and being so much interested in hav