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. Treatment of Hip Disease. The following is a summary of an interesting review on this topic by B. E. McKensie: 1. Hip disease is a local manifestation of a constitutional disease. 2. Early operative interference is seldom justifiable. 3. As soon as softening can be determined the surgeon should operate and obey indications, observing all care not to injure needlessly the mechanical integrity of the joint, and knowing that he is but aiding Nature by removing tissue that she has already cast off. 4. In the management of the wound the principles of asepticism and antisepticism must be carefully observed. 5. From the earliest moment efficient protection for the joint should be secured and constantly maintained by a well-fitting mechanical appliance. 6. Constitutional treatment is indicated as in other tubercular affections. Great emphasis should be laid on obtaining the freest exposure to sunlight and fresh air. 7. After excision a perfect recovery is never effected, the mechanical integrity of the joint having been interfered with. 8. Following mechanical and constitutional treatment, perfect restoration of function is sometimes secured. 9. Even when softening of tissues occurs and necessitates incision, there is sometimes a perfect restoration, and frequently a highly useful return of joint function.-Canadian Practitioner. Treatment of Diabetes Insipidus. Dr. E. P. Cook, of Frazier, Mo., has recently had the privilege to treat a number of these cases which has proven very successful so far. He is of the opinion that diabetes insipidus is a purely nervous lesion. He recognizes that the diabetic center is an independent reflex cen With reference to the first formula, never mix the rhus up in water; if you do the mixture will not be nice. Rhus aromatica is a stimulant astringent, and, according to the eclectic, is indicated in all cases of over activity of the urinary organs where inflammation is absent and where there is no trace of sugar. Belladonna acts on the circular fibers of the renal vessels, which lack tone in this disease. Gallic acid is a powerful astringent to the urinary organs, and seems to aid the rhus in checking copious discharge of water. Hydrastis is given because of its tonic influence-to build the patient up and to give him an appetite. After one or two weeks' treatment he generally drops the gallic acid, but continues the hydrastis, and adds five to 10 drops of tincture nux vomica to the hydrastis mixture. Continue the rhus and belladonna. Sometimes he uses a belladonna plaster across the back over the kidneys. In from six weeks to three months his patients fail to "show up" for medicine, claiming to be well.-Va. Med. Semi-Monthly. Methyline Blue in Epithelioma. M. Landrewic, of Toulouse, in speaking of the therapeutic action of methyline blue, refers to its analgesic, anti-malarious and antiseptic properties. For many years we have been in the habit of administering this drug with great benefit in that form of malarial poisoning where the symptoms were not strongly marked, but characterized by lack of digestion, constipation and general weariness, with occassional exacerbations. Dr. Landrewic considers the special action of the drug to be upon neoplastic tissue, where it is specially adapted as an application in conjunction with curettage to cutaneous epithelioma. In recent cases the cure was rapid, and in older cases, with extensive destruction of tissue, he thinks it is preferable to the knife. Even if that is called for as a last resort, the previous application of the drug will prove of benefit. -N. Y. Med. Times. Symptoms of Acute Appendicitis. Dr. G. W. Gay says: "The most important and reliable symptoms of acute appendicitis are pain and tenderness in the abdomen. They are always present to a greater or less degree in the early stage of the affection, and the latter persists so long as the active process is going on. Of such vital importance is tenderness in the acute stage as a factor in the diagnosis, that its absence would make one hesitate to call the disease appendicitis, even were the other symptoms present to a marked degree." phate, 1-120 grain every hour or two, and not more than eight or 10 doses being given daily, admirably supports the nervous system, and therefore the heart. When rheumotoid symptoms exist, the sodium benzoate may be substituted, supplemented or followed by cinchonidin salicylate, five grains every fourth hour, or until there is ringing in the ears. Rest in bed, warmth, ventilation, simple, easily digested nourishing food, plenty of pure water, are all important. Febrile temperature does not, as a rule, call for special interference. Whitley's Test for Albumen. The technique of the various tests now generally used are more or less complicated and not entirely satisfactory as to results obtained. Perhaps the oldest and best kown test is by heat and nitric acid. The more modern and simpler one is the ferrocyanide test. The latter does not require heat, but the addition of acetic acid is necessary, as follows: Put into a clean test tube 15 to 30 drops of acetic acid, then add two or three times this amount of a one to 20 per cent. solution of potassium ferrocyanide. The urine is then added to two-thirds the depth of the tube. The resulting precipitate is albumen. The following test commends itself because of its simplicity, trustworthiness and its possessing sufficient delicacy for all practical purposes in routine work. This test gives no reaction with the urates, vegetable alkaloids or mucin, but responds to all conditions of albumen in either acid or alkaline urine. It has no effect upon the normal constituents of urine, except to preserve the specimen indefinitely by it well-known properties. The formula is as follows: Take of urine three parts by volume; formaldehyde (40 per cent. solution), one part by volume. Mix by gently shaking the tube, then set aside for reaction. Soon after the formaldehyde comes in contact with the urine a clouded or murky appearance will indicate the presence of albumen. In a few minutes this changes to a gray or whitish color, when the albumen begins to separate, and in time becomes precipitated. Should no discolor ation occur within a few minutes after adding this reagent to the urine there is no albumen present, but any precipitate by this test is albumen and nothing but albumen. Med. Fortnightly. Hemorrhage in Pregnancy and Labor. Dr. C. E. Paddock in the West. Clin. Recorder, says 1. In a case of abortion in progress (inevitable abortion), plug the vagina. 2. In a case of imcomplete abortion plugging does no good. Curette with the finger under anesthetics. 3. In placenta previa pack the vagina and cervix when you have decided to interfere, or use the Carnes' or Carpentier de Ribes' dilators. 4. In accidental hemorrhage never pack the vagina, but rupture the membranes, apply the binder and use compression. 5. In post partum hemorrhage from the uterus never pack the vagina alone. 6. In post partum hemorrhage from the cervix pack the torn surface if bleeding continues, being careful that it does not interfere with the contraction and reaction of the uterus. Small Things in Surgery. Dr. T. B. Greenley of Meadow Lawn, Ky., in the Jour. of Surg. and Medicine, says: In many instances it is essential for the welfare of the patient to attend to small matters as it is to those of apparent greater moment. I shall mainly in these remarks, confine myself to the dressing and management of wounds. In the first place, if the wound is found to be unclean, it should be washed gently with soap and water, and when clean, if it is oozing with blood, apply spirits of turpentine to the surface. This can be gently done with a feather or a soft piece of cloth. In closing the wound, if a little blood should be present, no harm will result, as it is an antiseptic and does not interfere with healing. Unless there is a vessel of some size involved, the turpentine, as a rule, will act as a hemostatic and command the hemorrhage. It is also an antiseptic. A small, clean-cut wound, as a rule, needs no stitches to close it, as good adhesive plaster, properly applied, will subserve a better purpose. Of course where there is a large wound with much muscular distention, it is essential to use sutures in closing it, these to be followed by adhesive strips. Where there is loss of skin and the wound has to be left open and repaired by granulation, I see that it is thoroughly cleansed by soap and warm water, which is done in a gentle manner, then to arrest oozing apply spirits of turpentine over the surface. I now dress the wound with a coating of an ointment composed of vaseline, oxide zinc, picric acid, and carbolic acid. I aim to dress the wound daily, and if any ointment adheres to the surface, I do not remove it, but aim to keep it evenly covered. In a short time granulations spring up, and very soon the wound heals. With this ointment I have healed up long-standing ulcers. I never use the bichloride of mercury solution as a wash or an application to a raw surface. It is a good thing to cleanse the parts in the vicinity of the wound with, but I think should never be used on a raw surface. If the surface is washed with it in order to destroy microbes, it should be washed off with soap and water. The bichloride, as is known to all, is an irritant poison, and is liable to be absorbed by the system when long continued to an open sore, and will produce diarrhea of a serious character. It is no doubt one of our best antiseptics to cleanse the skin where it is unbroken. But when it comes in contact with albumen in the form of blood or secretions from the surface of the wound its character is changed-in fact, it becomes inert as a disinfectant, being converted into the albuminate of mercury. In contused or lacerated wounds, always save as much of the parts as possible. In such cases we sometimes have trouble in getting them perfectly clean, as dirt, smut, etc., are frequently ground into the flesh. In such cases it requires pains and patience to effect proper cleansing without doing further injury to the parts. A great deal of harm has been done such injuries by washing them with solution of bichloride of mercury. Soap and warm water, with a sponge, are our best means to cleanse such injuries. A weak solution of carbolic acid may be applied after washing. It can not be said to act as a germicide, but is a good antiseptic and will arrest microbric action. I prefer, however, an application of turpentine, as it seems to promote the healing process. In some instances, in cases of compound fractures, no doubt limbs and members of limbs have been removed where, with patience and proper attention, they might have been saved. Surgical Suggestions. Dr. W. J. Bell in St. Joseph Med. Jour. says: Evacuate pus wherever found. To wait for the action of poultices to decompose the skin or "draw" the pus is unworthy a modern surgeon. Immediate amputation of an injured member is now seldom required. Control hemorrhage, dress antiseptically and await reaction. While the foregoing treatment will give by far the best results, although it must be remembered that the danger from cardiac and pulmonary embolism is increased where an effort is made to save bruised tissues. A wise surgeon sacrifices no tissues that if saved would prove useful. Flaps in order to heal quickly must be free from tension. Err in making flaps too long rather than too short. In amputation where bones are sawed it is most difficult to keep thorough asepsis until the healing process is complete. Bandages should be adjusted so as to control hemorrhage from the stump after amputation, but great care must be taken that they be not drawn so tightly as to affect nutrition by obstructing the circulation. Unless there are indications, such as rise in temperature, soiling of the dressing, or hemorrhage, a single dressing should suffice for an amputation. Do not inject cysts or vasular tumors with remedies tending to produce coagulation unless free drainage is provided. Cysts should be evacuated or dissected out, while vascular tumors are best treated by excision or cutting off the blood supply. The following is an extract from an articl in the Md. Med. Jour., by Dr. E. Anderson, of Rockville, Md., on the Therapeutic Uses of Salicylate of Sodium. I have no doubt but that there is a close relationship between rheumatism and tuberculosis, for we often see families divided between the two diseases. I have such a family in mind at the present time. The mother died young, of what I know not. The father, though quite old, was tuberculous. The elder boy developed pulmonary consumption at the age of twenty and died within a year. The surviving son developed rheumatism at about the same age. Though an invalid, he married and had eight children, all of whom were tuberculous. If we wish a tuberculous patient to improve, whether the disease be located in the lungs, abdomen, joints or brain, we must clear away the debris-the products of tuberculosis-before we can hope to establish a cure by building up, and I know of no better agent for the purpose than salicylate of sodium. Iodine has always been found of advantage in this disease, because it acts in a similar way. Nature's method of getting rid of the products of tuberculosis is through suppuration, accompanied by hectic, and usually followed by death. December 12, 1889, an epidemic of influenza made its appearance in my locality for the first time, and I began treating it with salicylate of sodium. I arrested many cases of incipient phthisis before I became aware of its curative properties in that disease. During the summer of 1897 I commenced the treatment of a case of advanced phthisis with five-grain doses of ation occur wit dium, given in tablet form, ding this reage aily, giving the syrup of albumen F this test is mover lowe es at the same time. Alpatient's temperature was an 100 degrees F. and often . high as 105 degrees F., she gained elve pounds and was able to do laundry ork all the following winter. On the rst day of August, 1898, I was called to a K. Ase of phthisis pulmonalis in an advanced tage. The patient was a man twentye three years of age, who had a cavity in the left lung, a temperature of 102 deṛgrees F. and night sweats. He had lost e twenty pounds in weight in three months, and his cough was so troublesome that he got very little sleep at night. I put him on five-drop doses of creosote, three times daily, increasing the dose to twenty-seven drops, which was as much as he could stand. I continued this treat ment for several weeks, and he improved slightly under it, but refused to take it any longer. I then gave him Blancard's iodide of iron pills and salicylate of sodium tablets, giving one pill of the former and a five-grain tablet of the latter three times daily. Under this treatment he gained ten pounds in less than a month. Although I have no hope of his ultimate recovery, it is very gratifying to secure so much improvement in his condition. Take it all in all the salicylate of sodium treatment is the most satisfactory I have ever employed in tuberculosis. Nitroglycerin in Sciatica. In the Lyon Medical for February there is an abstract of an article from the Semaine Medical, in which the author, Dr. P. M. Mikhalkine, of Nijni-Novgorod, remarks that he recently had occasion to become convinced of the powerful antineuralgic properties of nitroglycerin in three cases of persistent sciatica that had been absolutely rebellious to the action of antipyrine, of acetanilid, of chloral hydrate, of the bromides and of other analogous medicaments, as well as to the employment of revulsives. Under the influence of nitroglycerin two of the patients have been radically cured of their sciatica, and in the third case it has produced a considerable ameli |