much more frequent than in the army. It is the cause of nearly

one-fourth of the deaths.

PIGMENTARY CIRRHOSIS.-M. Letulle, Progres Med., 13th February, in a long communication, describes three cases of pigmentary Cirrhosis not of diabetic origin, in which he made autopsies. All the organs except the eye and the pineal gland were examined. All were gorged with pigments, except the spleen. He described three kinds of pigment; the ocher, the yellowish brown and the black pigment.

SALYCILATE OF METHYL.-M. Gilbert Lassere proposes-Gazette Hebdomadaire-the internal use of Salycilate of Methyl chemically pure, in the treatment of rheumatism; the following is his formula:

Salycilate of Methyl chemically pure I c. c.

Syr. simple.

Aquae distil, aa, 100 gr.

To be taken in spoonful doses in twenty-four hours. The patient absorbs 50 per cent. of the solution. The essence of wintergreen does not produce the same result.

Dr. Le Strat has defended a thesis on the local anaesthetic and anti-rheumatismal effects of the salycilate of methyl when applied cutaneously.

The results of his experiments are that the skin absorbs the salycilate of methyl and the remedy thus enters the circulation, and acts on the rheumatic virus. The cutaneous absorption, independent of its entrance through the lungs, is according to the experiments of M. Le Strat, of undoubted effect. The salycilate of methyl undoubtedly acts with much greater intensity when absorbed by inhalation through the lungs. Diseases that are treated with friction with the essence of wintergreen absorb the remedy by the skin and the lungs at the same time. Rheumatic patients are able to use inhalations through cigars filled with sawdust saturated with the salycilate of methyl with great benefit in very many

cases.

BROMOFORM IN WHOOPING-COUGH.-In the treatment of Whooping-cough, Bromoform has been found to act very satisfactorily, but its administration has been found difficult because it does not readily combine with the usual excipients. M. Marfan-La France Medicale, 26 February, has presented the following formula:

Cub.

Distilled water, g.s., ad 120 cent.

Mix the bromaform and the oil and shake well, then add the other ingredients.

A teaspoonful contains two (2) drops of bromoform. For child one year, one drop of bromoform; increasing one drop for each year of age.

For reasons given they should not be given in diseases of the digestive organs, and it is contra-indicated in all forms of cutaneous diseases. In extensive burns bromides are injurious by still further diminishing reflex excitability and by their injurious effects on perspiration, the radiation of caloric, the elimination of gases and the cutaneous secretions. Bromides are very slowly eliminated; three weeks after the patient has discontinued their use the bromide is found in the saliva and in the urine.

The effects of a bromide may be very active in all cases of renal disease, on account of the interference with elimination. For the same reason it is inadmissible in cases of diabetes. In all diseases the use of bromides may increase the inflammatory condition. Bromide preparations are eliminated through the milk, and consequently they should not be prescribed for nursing women. Evidently the bromides are distinctly contra-indicated in some forms of nervous diseases.

THE USE OF BROMIDES.--Dr. Sterling, in the Wiener Med. Blaet., insists very urgently against the abuse of bromides, and points out their danger. These preparations are generally used as if they were harmless, or nearly so. Generally, the bromides, given in moderate doses and for a short time do not cause any serious disturbance in the system. But, it happens sometimes, that small doses, or even a single large dose may cause very serious results; a jaundiced coloring of the skin, paralysis of the central nervous system, disturbance of digestion, etc. Prolonged employment may lead to loss of memory, impairment of sight and of hearing, of the cutaneous sensibility, uncertainty in the act of locomotion, somnolence, gastro-intestinal disturbance, anemia and extreme emaciation, cutaneous eruptions and a catarrhal condition of mucuous tissues.

Bromides should not be prescribed for those suffering with neurasthenia and those who are already anemic. Those who are

phthisical do not bear it well. Its influence on nutrition is generally injurious and it gives rise to a catarrhal condition of the air passages. The diminution of the reflex excitability prevents the expectoration of the mucous.

LARYNGEAL OR WINTER COUGHS.-Dr. Walter M. Fleming, of New York, in giving his experience in the treatment of laryngeal cough and allied disturbances (Journal of Nervous and Mental Diseases), submits the following:

"In acute attacks of laryngeal or winter cough, tickling and irritability of larynx, faith in antikamnia and codeine tablets will be well founded. If the irritation or spasm prevails at night the patient should take a five grain tablet an hour before retiring and repeat hourly until allayed. This will be found almost invariably a sovereign remedy. After taking the second or third tablet the cough is usually under control, at least for that paroxysm and for the night. Should the irritation prevail morning or mid-day, the same course of administration should be observed until subdued. In neuroses, neurasthenia, hemicrania, hysteria, neuralgia and in short, the multitude of nervous ailments, I doubt if there is another remedial agent in therapeutics as reliable, serviceable and satisfactory; and this, without establishing an exaction, requirement or habit in the system like morphine.

"Finally, in digestion, gastritis, pyrosis, nausea, vomiting, intestinal and mesenteric disorders and various diarrhoeas, the therapeutic value of antikamnia and codeine is not debatable. The antipyretic, analgesic and antiseptic properties are incontrovertible, and therefore eminently qualified to correct the obstinate disorders of the ailmentary canal."

NEURASTHENIC INSOMNIA. In a practical article on the treatment of insomnia, Dr. O. Dornbluth (Aerzt. Centr. Anz.), has recently called attention to the fact that the disorders of sleep, which apparently occur as independent affections, usually allied with or comprising the chief system of neurasthenia or the nervous diathesis, are especially difficult to cope with. While normal sleep can frequently be brought about by general treatment, more often it is necessary to treat the insomnia itself. A distinction should always be made between acute and chronic cases. If the insomnia be due to exhaustion, over-exertion, emotional causes, etc.—no matter what other nervous troubles coexist-the indication for medicinal soporifics presents itself. For this purpose the author has found Trional the best remedy. It is his custom to prescribe

it in tablet form, r.5 Gm. on the first evening, one hour before retiring, in a wineglassful of milk. If satisfactory sleep is obtained the first night it is sufficient to administer 1.0 Gm. the following evening; on the other hand, if sleep is unsatisfactory, the initial dose should be repeated, or even increased to 2.0 Gm. Should the remedy be given continuously for a number of days, it is advisable to let the patient drink one or two bottlefuls of some carbonated alkaline mineral water daily. In cases of insomnia of long duration, however, further measures are indispensable. Care should be taken that the bedroom is well ventilated, thoroughly darkened, and slightly warmed in the winter; the bed should be comfortable and the coverings not too warm; the pillows should be so arranged that the patients head is neither too high or low. Supper should be taken at least three hours before bed-time, tea, coffee, etc., being avoided. Sometimes, however, a glass of lemonade or milk, taken when the patient is in bed, is of service. Gymnastic exercise and walking should be indulged in before the evening meal. A warm sitz-bath of short duration immediately before retiring is also a valuable adjunct in the treatment of many of these cases.-"Cincinnati Lancet-Clinic," December 5, '96.

"COCA WINE AND ITS DANGERS" (British Medical Journal) is suggestive of various meretricious and dangerous imitations of the standard French preparation, Vin Mariani, which is so generally well known to and approved of by physicians, that it would be superfluous for us to recapitulate its virtues. The so-called "coca wines" referred to, are generally solutions of the alkaloid cocaine, in sweetened wine of a low grade (artificial wines). Quantities of such stuff have been seized by various health authorities and destroyed. The danger in the use of such preparations is apparent. They are causing misapprehension of and working an indirect injury to a really valuable drug, for the usefulness and safety of coca, when properly prepared and administered, have long since been recognized.

Physicians will not encounter disappointment whenever using the standard French coca wine, Vin Mariani, as an adjuvant in treatment, as a tonic-stimulant and restorative in cases of depression, anaemia and exhaustion. It has stood the test in practice during nearly thirty-five years. Physicians, therefore, when prescribing coca, should be careful to instruct their patients to procure "Vin Mariani," to avoid the unpleasant after effects common to fraudulent imitations.

EDITOR'S TABLE.

SANITARIAN, APRIL NUMBER, 1897.

ALL correspondence and exchanges and all publications for review should be addressed to the Editor, DR. A. N. BELL, Brooklyn, N. Y.

MORE ABOUT THE BROOKLYN WATER SUPPLY.

The "New York Tribune" of February 14th, reports an interview with Chief Engineer Birdsall of the Croton Aqueduct, who said that the Croton watershed would be sufficient to supply the needs of the present New York city, allowing for the normal rate of growth, for fifteen or twenty years. He did not think it would be wise to draw on the Croton region for the sake of helping out Brooklyn after consolidation, in case of a short supply in that city. Brooklyn, in his opinion, would have to go further out on Long Island, and he believed that plenty of water could be found there— enough to last that city for many years. At the same time Mr. Birdsall expressed much interest in the plan for determining the feasibility of securing water not only for Greater New York, but for other cities, either from the Adirondack region or the Great Lakes. "How much more water can be drawn for New York from the Croton region?"

"From 150,000,000 to 160,000,000 gallons a day. I think we can get enough to last the city fifteen of twenty years, at the present rate of consumption. We are now taking about 220,000,000 or 230,000,000 gallons a day. There is a bill at Albany to prevent us from purchasing any more land in Westchester County, but I do , not think it will pass. We need to take about 15,000 acres more." "Would New York be able to furnish any water to Brooklyn after consolidation, in case the supply in that part of the city got short?"

Brooklyn can get

"I do not think it would be wise to do that. plenty of water by going out further in Queens and Suffolk counties. The trouble over there is that they are not willing to buy enough land, but they sink wells and thus drain water from a large area. It has to be taken from somewhere, and what the people on the island object to is having their water taken in this way without their leave. So they have sought legislation to restrict the Brook