"It is the physicians luck to be called after all domestic means have failed. He is supposed to effect a cure forthwith, even though he first has to remove the trouble caused by the lotions, potions, etc., which have been administered by the mother. If the mother had as vigorously watched the cause of the disturbance (faulty feeding) as she applies home remedies, the chances are that the child

would have had no trouble. Infant feeding, then, should receive careful study by the mother, and attention be paid to the details of hygienic care. These measures would do much toward preventing indigestion and gastro-intestinal catarrh.

"Treatment, too, of the diarrhea, which becomes a factor in the prognosis, should always receive attention. The use of mineral acids, bismuth and pepsin is well known, and also the use of Lactopeptine, which has been commended by J. Lewis Smith, who attests its usefulness in these

cases.

"For several years we have used Lactopeptine in the indigestion of infants; in fact, it is much a routine treatment, and the results have always been highly satisfactory. Infants need it when indigestion is more or less chronic, and it will do valiant service in correcting the difficulties of digestion here encountered. In addition to medical care, much attention must be given to the hygienic surroundings of the child, its bath, its outdoor life, its exercise, the water it drinks and the quality and quantity of food taken."

Kidney Disease.

Dr. J. H. Schall, of New York, made urinary analysis of 510 subjects, and recorded 34 specimens which contained albumen with no microscopical evidences of kidney lesion.

The conditions in which the albumen was found are as follows:

Neurasthenia, six: epilepsy, five; dilatation of the stomach, two; morphine habit, four; obesity, eight; mal-assimilation in children, four; after laparotomy, five. Bouchard has seen albumen 26 times in 100 cases of obesity, 58 times in 100 cases of the gout. and 33 times in 100 cases of diabetes.

Therefore, when traces of albumen are found in the urine it should not be taken as a positive proof of the existence of nephritis until it is determined by repeated, diligent, microscopical research that evidences of renal disturbances are absent.

Paraldehyde in Asthma.

The use of this drug in pulmonary complaints seem to grow. MacGregor, in the Lancet, confirms some previous investigations tending to show that it is an efficient remedy to relieve the dyspnoea and spasm of asthma and induce sleep. He reports its use in 11 cases of idopathic asthma with the happy result mentioned. He has used the drug in other forms of spasmodic dyspnoea with results gained by no other. The drug is safe, relieves the spasm and dyspnoea, and without objectionable after effects produces sound and refreshing sleep.

In order to prevent the firm clotting to which cow's milk is prone, some alkaline solution may be added, or some prefer to use a small quantity of a mucilaginous or or other thickening substance, such as barley water, a solution of gelatine, or one of the prepared foods, which act mechanically in obviating the formation of firm clots. Mellins food may be used; in this the starch has been converted into dextrin and maltose.-From Food in Health and Disease, by I. B. Yeo, M. D.

Notes and Queries.

For this department we cordially invite ques tions, comments and criticisms on all topics of interest to the physician in his daily work for the relief of the sick, thus making the SUMMARY a valuable medium for intercommunication between the medical profession.

Correspondents will give their names and addresses, but ínitals only will be printed when desired. The QUERIES in this issue await the ANSWERS which our itelligent readers may be pleased to contribute for publication in our next.

Brewers' Yeast as a Remedy in Farunclosis.

Editor Medical Summary:

It is a well known fact that farunclosis of the skin, and particularly the skin of the face and of the external meatus of the ear, when once they show a faruncle, that these painful and inconvenient, not to say unsightly inflammatory protuberances, are very apt to repeat themselves in different parts of the skin and ear.

For a long number of years I have found that, in hundreds of cases, a teaspoonful of brewer's or baker's yeast dissolved in a tumbler of cold water, with the addition of a pinch of salt, taken on rising in the morning before breakfast will, in a few days, stop the farunclosis. will also stop the pain and inflammation of existing faruncles and prevent their

recurrence.

It

This remedy has been known for a number of years and, although not forgotten by the older practitioners, still a statement is made by one of the foreign medical journals that it had been lapsed into oblivion, and that only lately a celebrated dermatologist of Paris, Dr. Brocq, had rediscovered it. As I have used it for nearly 30 years I feel that I am entitled to protest against such a statement.

Carl Seiler, M. D. 203 Jefferson Ave., Scranton, Pa.

Dysmenorrhea.

Editor Medical Summary:

Thousands of suffering women will rise up and call him blessed who shall first suggest a cure for this distressing malady.

It is known to cause women much suffering and beyond this not much is definitely known; at least, not much of benefit. Yet, on account of its importance, its study should interest medical minds.

Several theories have been advanced as to its causation:

First.-Mechanical obstruction caused by stenosis or flexion of the uterus. These conditions bring on the cramping pains complained of in the attempt of the womb to force the menstrual fluid past its stenosed or flexed point. This is disproved by the fact that a sound may be passed during the supposed accumulation without coming in contact with blood, also by the fact that stenosis and antiflexion have occurred in numberless cases without bringing on dysmenorrhea.

Second.-The Schultze theory, of inflammation situated near or roundabout the uterus is discredited among its own advocates, by their resorting to dilatation as a means of cure.

In

Third. Endometritic hyperesthesia has been advanced as a probable cause. many cases, perhaps all, this condition exists, yet it does not account for the menstrual pain, from the fact that the pain precedes the flow by a very appreciable interval, and in many cases the pain ceases when the flow comes on.

Fourth.-The menstrual blood is dammed back or congested in the tissues of the womb by a spasm of the muscular coat of the uterine arterioles. Nature, with a "mimic labor," forces this fluid through the aforesaid vessels and the pressure then brought to bear upon the nerves causes the dysmenorrheal pain, and when the arterioles are fully dilated and the flow sets up the pain ceases, and any drug that will relax this spasm will relieve this trouble.

We will not have to search very far for a remedy. There are some excellent ones, among which we mention atropine, aconitin and glonoin.

Physiologically atropine acts by first stimulating the vasomotors, but afterwards paralyzes them by over stimulation, thus producing relaxation of the muscular coats of the arteries which they control. Glonoin does primarily and directly what atropine does secondarily and indirectly; that is, it acts upon the vasomotors and relaxes the arterioles, thus relieving blood pressure and its consequent pain in this trouble. Aconitin has much the same effect. Gelsemium and

conium have a fine effect in these cases. The atropine must be given in positive doses. We have employed it in 1-60 grain hypodermically. Glonoin may be used in 1-250 grain doses every 10 or 15 minutes until flushing of the face or fullness of the head. This remedy is a mighty force in this trouble. When given alone I have known two granules, 1-250 grain, to bring on flushing of the face and relief in a very painful case inside of 20 minutes.

Yet, after all, dysmenorrhea, is not a disease, but a symptom, and to cure it we must seek the underlying cause or fail to give permanent relief.

Mosheim, Tenn. M. G. PRICE, M. D.

European doctor, who is superlatively scientific rather than practical, has condemned them.

We believe that in many cases the latter is the entire cause, as we have a class in this country who, we are sorry to have to admit, are always trying to ape some titled foreigner. And right here let us say that in the practice of medicine and surgery we have found no practitioners up to the wide-awake, self-reliant, up-todate American, and we challenge any one to show us a single all-around, good oldcountry practitioner. If there be any such they stay on the other side of the water and keep well under cover.

We have, during the past 10 years or about used the coal-tar products very freely, and, while exercising due care, as we do in the use of any medicine, we have yet to find any of the dangerous results of which we have heard so much. Hence we are forced to ascribe much of this condemnation of these excellent remedies in question to ignorance in their use and prejudice.

We know scores of doctors who have never used aconite for the sole reason that it is an eclectic and homœopathic remedy. Aconite as a remedy is good, as a poison it would be dangerous, and we might say the same thing of about all of our best remedial agents.

Many of the doctors who are the loudest in their condemnation of the coal-tar products will laud to the sky the filthiest and, in my opinion, the most undeserving of all products, viz: antitoxin. FLOYD CLENDENEN, M. D.

La Salle, Ill.

Arsenious Acid Causes Necrosis.

Editor Medical Summary:

We were deeply interested in an article by Dr. M. G. Price in the July SUMMARY, entitled "An Answering Shot. Cautiously and intelligently used arsenious paste is a good, old-fashioned remedy for the absolute destruction of tooth nerves, provided the medicament is left in the carious tooth at least 24 hours, but no longer. If the paste is left in a tooth for a longer period dangerous results sometimes ensue.

Some years since we examined the mouth of a Jew in New York City. The upper maxilla was in a terrible condition, caused by arsenious acid paste being left in a large cavity in an upper molar for one week.

The soft membrane of the mouth on the right side was entirely destroyed, and the exposed bones of the upper maxilla were in a serious state of necrosis. The Jew admitted that his dentist had told him to return in 24 hours, but he neglected in doing so and left the powerfully destructive paste in the tooth one week with disastrous results. The fetor from the oral cavity was horrible. The entire process around the molar was destroyed, and pus of an almost unbearable stench exuded from the gums. The two molars on the right side of the mouth were removed, including portions of loose bone, and the parts were thoroughly scraped. The local treatment consisted of powerful astringent washes, with constitutional tonics.

The patient made an uneventful recovery in about seven weeks.

This article was not written in a spirit of criticism directly or indirectly, but to give clinical information to a brother practitioner regarding the local application of one of the most powerful drugs (?) known to medicine, dental and general surgery. Carbolic acid will also produce necrosis, as all surgeons know.

EDWARD H. BOWNE, M. D.

Kingston, N. J.

Medical Legislation.

Editor Medical Summary:

This matter of medical legislation has been discussed and "cussed" at length in some of the medical journals, yet it seems to me that many members of the medical profession who have not had the opportunity to look the matter up do not understand the source of the medical laws or the method of appeal if unjustly enforced. A national medical law would be the ideal law, but the police power of the state, being vested in the state, it goes without saying that Congress cannot interfere with the law making power of the state.

Although this information may seem contrary to the interpretation of the fourteenth amendment, as interpreted by some of the writers for the medical press, yet it is the true one, based upon Cooley and other eminent authorities. W. H. RUSSELL, M. D.

Ipswich, Mass.

Notes and Comments.

Editor Medical Summary:

"Toxic Effects and Peculiarities of Disease," July SUMMARY, is something that every general practitioner meets and sometimes to his sorrow and mortification. It is a very strange thing to understand why some patients cannot take a certain drug or drugs. We, in onr ignorance, call it idiosyncrasy, but does that explain it? We cannot see further, and can only cover the mystery by that term. while the real causes are not understood.

I have a patient to whom glycerin is a poison, and acts as an irritant even when

applied to the hands. I had a patient in which a very small dose of morphine produced the most alarming toxic symptoms and gave me the better part of a night's anxious work to get the patient out of danger. I have known 1-2 grain of morphine injected into the arm to produce death.

Should the doctor receive the blame when he gives the usual dose of a drug sincerely and honestly with the best of intentions and in entire ignorance of the patient's idiosyncrasy until it really reveals itself by the untoward symptoms produced? Of course the public censure the doctor, who meant no harm and tried to do his duty. Such incidents make any honest doctor feel bad enough when death results without the public picking him to pieces.

"Cholera Infantum." This is the coming ailment for the next several months, and it is the duty of every practitioner to know the very best treatment in these cases when they present themselves. Intestinal antiseptics, hygiene, proper food and the support of the vital powers are the chief points to remember. The sulpho-carbolates and the W-A antiseptic should be a part of the armament of every practitioner who treats cholera infantum. The very first thing, however, is to see that the alimentary tract contains no disturbing irritating material, and a cathartic should be given.

I beg leave to differ with Dr. Vail as to using whisky or brandy. A doctor who knows what he ought to know as to the effects of alcohol will not try to help cholera infantum kill his patients by its administration. A doctor who uses alcohol does wrong and only helps the disease that much more by helping to destroy the white blood corpuscles which fight against the disease. I don't care who the doctor is, he does wrong every time in giving alcohol, and I defy him to prove otherwise by fair experiments on scientific facts.

Outside of the use of alcohol Dr. Vail's article is a good one, and if whisky was out of it it would be par excellence. The doctor has no excuse, for there are plenty of heart stimulants that are true stimulants and do not injure the white blood

corpuscles, such as strychnine, nuclein (Aulde), nitroglycerin and others. Alcohol is no stimulant, but it is an excitant and depressant.

In "Treatment of Erysipelas," Dr. Tucker gives us a very interesting paper and outlines a successful treatment. The main thing in erysipelas is to have an application that is antiseptic, antiphlogistic and soothing. I find that painting the parts with pix-cresol, followed by boraacetanilid mixture in glycerin, does the work. Dr. Tucker shows that he has wit and shrewdness when he diagnosed his case so carefully under obscure conditions, or rather the similarity of its resemblance to erysipelas.

Dr. Morse gives us a very logical, plain, common-sense paper in his "Does Tobacco Cause Amblyopia ?" He disproves the theory and clinches his argument by stubborn facts that show well he knows what he says, and also that he has certainly studied his subject with pains-taking care, and has put this subject in true light so as not to be obscured by any fogy-fangled fogyism, but places it on an X-ray plane. His paper is a very able one, showing careful research and meditation.

"Thermic Convulsions of Children" is a subject that every general practitioner meets more or less, and is one that taxes his ability and knowledge to cope with the cause and relieve the patient. Dr. Mann gives us very good treatment, but he, like so many practitioners, stick to the old rutty, deluded whisky or alcohol whim, believing it does good. Don't toddy your patient; you only toddy the disease, not the patient. Gelsemium, passiflora and avena sativa are par excellence with local treatment.

Dr. Adolphus, in his "Chips From My Workshop," shows what kind of medication he uses and his standing as a practitioner who makes the "chips" fly when he has something to say, as he has had years of thoughtful experience. He gives us some very valuable recipes that are worth noting down for use, for Dr. Adolphus can say, as a general thing, they will cure, as they did so for him. He outlines some very good treatment that is practical. Come again, Doctor; we are always glad to have your old pen wiggle

for the SUMMARY columns, for it always writes down thoughts, mellowed with years of experience. We cannot have you with us so many more Januarys and Mays, and, as you are one of the old "war horses" in practice, we need all you know. Dr. Lockhart gives us an echo from the pacific coast which is not very pacific in his attitude on the question of medical legislation. Dr. L. is not afraid to have an honest opinion and to express that opinion as well as write it down and have it published.

Dr. Brodnax expresses some very sensi ble ideas in his "Eth-Pharmal" dissertation. Dr. B. always finds time to say something interesting, and ends his article with an excellent rule that is worthy of imitation.

"Medical Chips of Practical Value" are worth perusing and contain some good points.

"Diagnosis of Infantile Diseases" should be well studied, as it contains very valuable facts worthy of noting down for bedside diagnosing.

Has any one tried hot water in vomiting? Give the patient all the hot water that can be taken by mouth. Have the water as hot as can be drank.

In "An Answering Shot," Dr. Price reveals the fact that a jackass will bray when you pinch him. Dr. P. hit his critic between the eyes when he quoted old "Bobby" Bartholow. I heard that gifted professor lecture in the rooms of old Jefferson College in 1889 and 1890. Oh, yes; Dr. Price you were all right in your comments on toothache. Let your "D. D. S." Platt bray away.

"A Pointer." The author himself had better practice what he preaches and not criticise others when he himself signs his article "J. M. L, M. D." He had better begin at home first and then look abroad. He did the very same thing that he criticised others for doing, therefore his criticisms are out of place and not appropriate.

I received one letter in regard to my case of death after craniotomy, and the writer expressed the same opinion as I did, that shock caused death.

I have since learned from Dr. Waugh that the night sweats of my patient are