I

The alkaloids administered according to the rules of dosimetry are easy to administer, and will fulfill every indication, and bring them around all right as quickly as any plan you can pursue. I don't believe in the cold application treatment. If I make any external application it is a warm one. I frequently paint the chest with iodine. To sustain the heart I use strychnine arseniate and digitalin. encourage my patients to take nourishment regularly. On this point I want to say a few words. A few days ago I had a little patient four years old, who was just at the turning point when he refused to take any nourishment whatever. I was completely nonplussed as to what to do with him. He was sinking. I saw that heart stimulants could keep the machinery going but a few hours longer. When I received by mail a package of Eskay's Albuminized Food I immediately had some of it prepared for him, which he took kindly. With that and Protonuclein he commenced rallying at once, and is now getting well. That kid may thank the Smith, Kline & French Co., of Philadelphia, for his life, for I certainly believe the food carried him through.

functional activity of every organ and part.

While this can be done more or less perfectly with a great variety of foods, yet observation and experiment have demonstrated that any article of food, or combinations of foods, to accomplish this end must contain both albuminous and carbonaceous constituents in something like definite proportions.

Though these proportions may be varied somewhat in different latitudes and in different individuals, under different conditions of environment, yet it is accepted as a general rule that an ideal diet should contain about seven parts of carbonaceous constituents to one of albuminous; the former to supply heat to the body, the latter to furnish force, energy, strength and endurance.

Again, since the preservation of life and the maintenance of physiological integrity come only from the ingestion of food, selected with the proper regard for its composition, it follows that any material deviation from this standard of requirement must result in those functional perversions and tissue changes we call disease.

Inversely it follows that while in health food serves the one purpose of maintaining life. We find in many pathological conditions, and especially such as have arisen from an improper diet, that much may be accomplished in restoring the normal conditions by a proper selection of food.

In the management of lithemic cases, which are due to a greater extent to improper food than any other cause, a proper diet is of paramount importance.

The diet of the lithemic resolves itself into, first, the taking of the necessary amount of albuminous and corbonaceous foods to properly nourish the body, and, second, the selection of such albuminous foods as are most easily digested, most perfectly assimilated and converted into urea and leave behind the least amount of uric acid.

Because an albuminous food readily undergoes gastric digestion, it does not necessarily follow that assimilation will be perfect, or that its nitrogenous elements will undergo complete metabolism

into urea; hence the problem of selecting the most eligible albuminous food is not solved by the measure of its digestibility.

Rare roast beef, for instance, which is digested in three hours, is not as readily assimilated and as perfectly metabolized into urea as the albuminous constituents of wheaten bread, that requires one-half hour longer to digest.

Furthermore, if we may accept the late teachings of Haig on diet, the amount of uric acid resulting from the ingestion of a given amount of albuminous food from animal origin is greater than that resulting from a like amount of albumens from a vegetable source.

Since the deductions he has drawn from his studies in physiological chemistry are in keeping with the results of my own observation, I shall, in my endeavor to map out a diet for lithemic patients, merely reiterate what I have said many times during the past 10 years, viz: that meat is not a suitable food for the lithemic.

While lard and the other animal fats are products of animal tissue, it is not necessary to consider them in connection with a lithemic diet, for the reason that they are carbonaceous instead of albuminous, and probably have no direct influence upon the elaboration of uric acid.

Another animal food, however, which must not be overlooked is milk and milk products. A consideration of butter and cream may be omitted, as we have done with lard, and for the same reason. Not so with cheese; it is about one-third albuminous matter, and if used at all should be used very guardedly. It should be taken only in small amounts at any one time, thoroughly masticated and distributed throughout an entire meal of less concentrated foods, like vegetables, cereals and fruits. In extreme cases it may be positively contraindicated.

Another form of animal food to be considered is eggs, with a percentage of albumen almost equal that of lean beef, and showing a digestibility of 1 1-2 hours raw, whipped, and 3 1-2 hours fried or hard-boiled.

Except in cases where the uric acid accumulation is already great, raw eggs

whipped in milk may be permitted, but never fried or hard-boiled.

Coming now to purely vegetable foods, it may be said that almost without exception they are suited to the lithemic and may be selected with much variety, ever keeping in mind their percentage of albuminous constituents and limiting the use of such as are most highly nitrogenous.

Peas, beans and lentils, because they contain the largest percentage of albu mens of all the vegetable foods, should be taken, if at all, but sparingly, and in the same manner and with the same circumspection with which cheese may be taken. All other vegetable foods, including fruits, may be included in the dietary of the lithemic as a rule.

The vegetable foods, which in some cases may have an unpleasant effect, are the pulses and cereals, which tend, like meats, by their acids and acid salts, to keep up the acidity of the urine.

In most cases milk, with whole wheat bread, thoroughly baked, rice, oatmeal. barley and rye meal, and fruits will constitute an ideal diet.

The vegetables and fruits may be selected according to the tastes and digestive powers of the patient, and the percentage of albuminous and carbonaceous constituents, as shown by the following table:

No diet, however carefully selected, would fully meet the requirements of the lithemic which did not contain as carefully a selected list of drinks as of foods.

Alcohol meets no need of the lithemic. All spirituous liquors, beer, ale and sour wines should be strictly denied him.

Tea, coffee, cocoa and other similar alkaloid-bearing substances are not suitable for a lithemic and should not be permitted.

Water, milk, and the various drinks made from it; fruit juices, clear or with water; Caramel Cereal and other brands of roasted cereals will furnish an ample variety of wholesome and harmless drinks.

A bright, sparkling cider, not too old and made from sound fruit, is often an advantageous drink for the lithemic. The proverbial after dinner cigar should go the way of the alcoholics.

654 Boalt St., Toledo, Ohio.

Medical Progress.

Under this head we endeavor to present a condensed summary of practical medicine, drawn from the best and most reliable sources, thus saving our readers much labor in winnowing out from the chaff medical grains of real value.

Medical Chips of Practical Value.

PHTHISIS.-Dr. J. H. A. Matte, North Adams, Mass., writes: A favorite way of using Bovinine for my consumptive patients has been to combine rich milk, old whisky and Bovinine in the following proportions: Milk five parts, whisky one to two parts, Bovinine one part; mix well the milk and whisky, adding Bovinine last. Begin with frequent small doses, pushing up the quantity as seems desirable for each case, but advising that neither this nor any food be taken within two hours of the regular time of meals.

MOTHER MARKS-The following is claimed to be very efficacious for the removal of mother marks: Mix one part of tartrate of antimony with four parts of emplastrum saponatum and work into paste. Apply the mixture to the part to be removed to the depth of a line (1-12 inch) and cover with a gummed paper or court plaster. On the fourth or fifth day suppuration sets it, and in a few days scarcely a sign of the mark can be seen.

INCONTINENCE OF URINE IN ELDERLY OR NERVOUS WOMEN.-Some one has made the statement that when there is a frequent desire to pass water, or it runs away in the act of coughing, sneezing or laughing, it is generally due to the want of power in the vesical sphincter. In such cases tincture of cantharides will be found of the greatest service if given in small doses of one minim in water three or four times daily.

PNEUMONIA. In the treatment of pneumonia don't lose sight of the value of spirits turpentine and tincture red pepper, equal parts. Five to 20 drops on sugar every two or three hours, or an infusion of each, and a tablespoonful to the dose. Chloroform water is a nice sedative in tablespoonful doses for an adult in the same trouble.-Dr. Brodnax.

HYDRASTIS.-In a communication to a late issue of the Chicago Med. Times, Dr. B. A. Griffin, of Swan Creek, Ill., says: "As a general remedy in the treatment of all kinds of irritated mucous membranes, nothing gives me more satisfaction than hydrastis. As a local treatmeat in most cases of catarrh, I want nothing better than equal parts of non-alcoholic fluid hydrastis, glycerin and Listerine, accompanied by such general treatment as may be indicated."

The Blaud Pill.

Dr. Wm. H. Porter, in a paper on the use of the iron of Blaud's pill, recently contributed to the New York County Medical Society, concludes that all available inorganic iron is converted into the chloride by the hydrochloric acid of the gastric juice, and that as chloride the iron is acted upon by the sulphur compounds in the intestines, to be excreted as iron sulphide. The only advantage the Blaud pill has over the chloride lies in the fact that the stomach tolerates it better and that by slow conversion it can produce its results without irritation. He advises the compensating of the system for its loss of hydrochloric acid in this change by the giving of that acid to the patient when taking Blaud's pills.

The Diagnosis of Typhoid.

Dr. Osler, in a recent issue of the N. Y. Med. Jour., discusses the diagnosis of typhoid.

He calls attention to the variations in the intensity of the infection from the very mild cases, lasting from five to 10 days, to those of acute typhoid septicemia.

Early and pronounced localization of the infection may call attention away from the real disease. Peculiarities in the symptoms, such as entire absence of the most prominent.

The diagnosis between typhoid and malaria should not be difficult, but physicians living in malarial districts are very prone to call even a continued fever malaria. He says that two clinical rules should guide practitioners above Mason and Dixon's line.

1. An intermittent fever that resists quinine is not of malarial origin.

2. A continued fever in these localities is not due to malarial infection.

In conclusion he says that we must learn to suspect typhoid fever, and not malarial, in every case of fever of six or seven days' duration, particularly if it resists the action of quinine. For too long we have employed the Anglo-Saxon method of procedure, and in a given case have assumed innocence of anything so serious as typhoid until in the onset of some serious symptom the guilt was only too evident! It is high time, now, that we adopt the Gallic usage, and regard every case of continued fever as guilty -that is, as a typhoid-until the contrary be clearly demonstrated.

Asthmatic Dyspnea.

Dr. V. W. Gayle, of Kansas City, Mo., concludes an article, in Merck's Archives, on quebracho by saying that in cases of asthmatic dyspnea, where the paroxysms come on with great severity, with a purple face, livid lips, breathing labored, shoulders elevated with each inspiration, quebracho in doses of two to four Cc. every half hour, for three or four doses, will afford marked relief. Give the fluid extract and use syrup as a menstruum. The activity of the kidneys and glandular system, particularly of the salivary and intestinal glands, will be increased.

Quebracho is also said to be a good remedy in atheroma of arteries, and in degeneration of eardiac muscles.

The Cold Stage of Intermittent Fever.

In an article on the "Therapy of Nitrites," in the Va. Med. Semi-Monthly, the author, Dr. J. N. Upshur, of Richmond, Va., says:

"Both nitroglycerin and amyl nitrite will cut short the cold stage of intermittent fever. The latter often lowers temperature, sometimes several degrees; nitroglycerin is not so pronounced in this direction. These agents have been recommended in whooping-cough and spasmodic croup, but the author has no clinical experience to sustain the sugges

tion, and in neuralgia of the fifth pair of nerves, and migraine accompanied by facial pallor. But that form of neuralgia marked by flushing of the face is aggravated. Tetanus and hydrophobia are said to be benefited.

Testing Albumen in Urine.

The best method for testing albumen in urine, and one which gets rid of the difficulties attending Heller's nitric acid test in the form of rings at the junction of acid and urine, is the following:

Place one drachm of strong colorless nitric acid in a test tube, then carefully allow about 1-2 drachm of distilled water to float on top of the acid, by means of a pipette. The urine is now allowed to trickle through the layer of water, which washes it, and when it comes in contact with the acid a white film of coagulated albumen will be seen, free from any coloring matters. This method is quite simple and free from error. In all cases when the urine is cloudy, it must be filtered before applying tests.

Gonorrhea and Vulvo-Vaginitis in Children.

Dr. Nosotti (British Med. Jour., Sept., 1899) speaks well of Protargol in the treatment of gonorrhea at all stages. The solutions used varied from 1-2 per cent. in the early days to two per cent. in the latter stages. No ill effects were noticed; no epididymitis or other secondary inflammation. It was much more satisfactory as an injection than permanganate of potash. It was found very useful in the vulvo-vaginitis of children. Partargol causes a free elimination of epithelial and pus cells and of gonococci from the urethral mucous membrane.

The Urine in Disease.

The following rules, formulated by Dr. Formad, concluded an article which appeared recently in the Pacific Med. Jour.:

1. Sediment in the urine has no significance unless deposited within 24 hours. 2. Albumen in the urine does not indicate kidney disease unless accompanied by tube casts. The most fatal form of

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A TEXT-BOOK OF EMBRYOLOGY FOR STUDENTS OF MEDICINE. By John Clement Heiser, M. D., Professor of Anatomy in the Medico-Chirurgical College, Philadelphia. With 190 Illustrations; 20 of them in Colors. W. B. Saunders, Publisher, Philadelphia. 1899. Price $2.50. This is a most excellent work on the subject of embryology, and evidently will supply a long-felt want, which is something that cannot be said of many books published in our days. While there are, of course, many works treating on the same subject, yet none of them are so well adapted as a text-book as the one now before us. The subject matter is so arranged that it will be an easy task for the student to grasp it.

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