found a black liquid (not altered blood), constituting the true black vomit. In this he found many species of micro-organisms, one of which -a rod-shaped bacillus when cultivated in various media would convert its culture-fluid into the same black liquid. When introduced into the intestinal canal of various animals it would soon develop the same characteristics and establish the symptoms of the disease. Hence

place so as to break them, and the fire will certainly be extinguished. This is an exceedingly simple process, and certainly worth a trial. We give it, hoping it may prove successful to any who may take the trouble to try it.-Atlanta Constitution.

For Chronic Catarrhal Rhinitis.

This combination is highly recommended: Salicylate of zinc, tannate of bismuth, of each sixty grains; powdered borax, thirty grains; salol, twenty grains; powdered talc, two drachms. Mix and use as a snuff.

Embelate of Ammonium.

Embelic acid was discovered by Warden only Est fall, and introduced by Merck. It is an rganic acid found in the berries of the embelia res (myrsina). It is a crystalline substance

ich readily melts at 280° Fahr. It is easily soluble in alcohol, but insoluble in water. It forms salts with the alkalies. The ammonium Salt is found to be a most excellent anthelmintic, destroying tena when all other agents have failed. Two grains is the dose for a child, and Eve or six grains for an adult. It has the great advantage of being tasteless; it may be administered in syrup.-Chicago Med. Times.

How to Extinguish Fire.

An intelligent physician said to me a few days ago, I think I can give you a good item," and I replied that I was always on the lookout for useful information. He then said that he had studied the subject very carefully, and was convinced that it would be well for every house to keep its own fire extinguisher, and it could be easily done. It would certainly be invaluable to persons living in the country, and far removed even from neighbors. The doctor then told me that he would give me the exact recipe of the solution now used in the fire extinguishers now being offered for sale:

Take 20 pounds of common salt and 10 pounds of sal ammoniac (muriate of ammonia, to be had of any druggist), and dissolve in seven gallons of water. When dissolved it can be bottled, and kept in each room in the house, to be used in an emergency. In case of a fire occurring, one or two bottles should be immediately thrown with force into the burning

of Infants.

It seems somewhat strange, with our present knowledge of digestive ferments, that the application of pancreatin and pepsin in the diarrheas and intestinal disorders of children, especially those arising from inanition, is not more general.

We believe that an extension of the use of these products in such diseases would not only prove advantageous to the practitioner, but save the lives of many little ones, that otherwise would be doomed.

No practitioner, possessed of a modicum of therapeutic and physiological knowledge, will be found to admit that chalk mixtures, opiates, astringents, etc., meet fairly the indications in these cases. The ant-acids act merely mechanically, soothing the irritated mucous coat of stomach and intestines; the action of opiates which are especially dangerous to administer to nurslings, is uncertain, for it is impossible to gauge their use so as to attain the exact limit essential to intestinal anesthesia and arrest of peristaltic action, without narcosis; and astringents, while repressing secretion, at the same time retain and favor the absorption of ptomaines and other poisonous products which have provoked the flux-they limit the dejections at the expense of non-elimination of the toxic."

In such cases, and in all those of enfeebled digestion and in which the food remains undigested and fermenting in the stomach and intestines, pepsin and pancreatin and peptonized foods, afford us pure and simple physiological remedies, whose administration is attended with no dangers; and their employment does not preclude the use of cathartics, or administration of antiseptics that are anti-toxic to ptomaines.

Recently, we have obtained the best results from such treatment, though it must be admit

ted in cases of unusual gravity, when collapse threaten, that coto and wild yam are sometimes of value to check the flux, the digestive ferment following to secure proper digestion and nutrition. So long ago as 1856, Joulin and Corvisart (Rev. Med. Chir. de Paris) outlined this mode of treatment, and claimed the happiest results therefrom; and more recently it was advocated by Trousseauel, Pidoux, Barthez, and Rilliet, of France, and Ellis and Davidson of the United Kingdom. Later still, Dr. J. Milner Fothergill (Handbook of Practice, pp 40) remarks of pepsin: "Its utility in the treatment of imperfect digestion, and diarrhea in children, is certain.' Prof. J. Lewis Smith (Prof. Dis. Children, Bellevue Hosp. Med. Coll. Archiv. Pediatric, 1866, pp. 518) expresses exactly the same opinion. Prof. Frederick John Farre (Parieras Mat. Med. and Therap., p. 943) commends pepsin "very highly in chotara infantum and summer complaints of children." And Bartholow declares (Mat. Med. and Therap., pp.68): "Very great success has been attained in the treatment of the diarrhea of infants by pepsin. * * *

The motions will be quickly changed in character, and the nutrition of the child improved, by giving it immediately after each supply of food."

He further recommends (Naphey's Medical Therapeutics, pp.395) the employment of peptonized milk, or milk gruel for food in these cases, in which he is supported by Wilson Fox (Diseases of Children, ii, pp. 821) who considers "pepsin invaluable in gastralgia and all irritative states of intestinal and stomach mucous membranes."

With such evidence, and with the physiological knowledge that at present obtains, it is evident the digestive ferments are too little studied or employed. Yet we must admit there have been good grounds for such neglect, in that the pepsins upon the market, for the most part, have been untrustworthy, and with no definite guide for testing, that of the U. S. P. being of a very low standard. These objections no longer obtain, however, for manufacturers have been led to provide accurate tests, and now dissemi nate the same in their literature. Thus we find Parke, Davis & Co. issue a work on Digestive Ferments, that is accurate in all details, and further they have placed upon the market, a new pepsin of higher digestive power than any heretofore introduced, and possessing the exceptional advantages of being absolutely free from ptomaines, readily soluble, and of a digestive power hitherto unattained. Moreover, the standard of pepsin has been raised by the better manufacturers, and it is the practitioner's own fault if he is not able now to secure a preparation suited to his needs.

Wishes.

"If I could cure this case," writes a correspondent, "I might at once ride into an active practice." Yes; but could a large clientage be sustained that had been fortuitously obtained? This, that and the other young man wishes he might be rich-wishes a fortune might be left to him; yet, if it did fall to him, could he keep it? Does not experience show that, in nineteen instances out of twenty, the inherited fortune taketh to itself wings and flies? How could the inexperienced medical man expect to hold a lucrative practice if chance place such a thing in his way? The man who, by his industry and energy, accumulates a moderate fortune has acquired ability to keep it the experience of getting becomes a schooling which extends to the keeping. It is quite the same with a medical practice-the physician who has gained patron after patron, losing one now and then, but gaining three in the meantime, has learnt how to hold a practice; the knowledge obtained is as valuable as the profits secured. It is utterly idle to wish for what one is not competent to possess. Sometimes a young physician of property will buy the business and good-will of an old doctor, expecting thereby to quickly step into a settled practice; but he is not long in feeling that he has made a foolish bargain. In a field of much competition, an established medical practice can be sold, but cannot be delivered. People have their second choice, and will patronize whom they please; they refuse to be sold to highest bidder. The best way to get and hold a business is to begin at the bottom and work gradually upward. To build upon the sand is to get washed away when the floods come. Let the aspiring practitioner be aggressive in his methods for securing practice, yet modest in his movements.

-Prof. Da Costa, in a case of gustatory paralysis, prescribed gr. strychniæ sulph., t. d.; a stimulating mouth-wash of capsicum; and galvanism, five cells, one electrode to the back of the neck, the other over the tongue.

-In the treatment of fracture of the patella, it is important to obtain union between the ends of the divided tendon. This may be done by a suture introduced through the ends subcutaneously, and then drawn together. (Dr. Mears.)

-Never use strands of catgut for drains; horsehair is preferable. This may be prepared by boiling for 8 hours in a solution of 1 oz. of carbonate of soda to the gallon of water, and afterward keeping in 1 to 1,000 bichloride solution. (Prof. Gross.)

-For a girl, aged 13 years, with nocturnal and diurnal incontinence of urine, the patient being weak and anemic, Prof. Da Costa ordered, t. d.

-For a case of commencing exophthalmic goitre, accompanied with chlorosis, Prof. Da Costa directed three drops tinct. strophanthus, t. d., to control rapid action of the heart, and R. Ferri sulph. exsiccat.,

Potassii carbonat., āā ........... gr. iij. M. Ft. pil. j. Sig. Ter die.

-In the case of a man suffering with uremic vertigo aggravated by constipation, Prof. Da Costa directed a diet to consist exclusively of milk, vegetables and fish; 20 drops of dilute nitro-muriatic acid, t. d., and the following for constipation:

R. Extract. colocynth. comp.,
Pulv. rhei, ãã..
Extract. taraxaci,
Extract. belladonnæ,.

M. Ft. pil. j. Sig. One at night.

gr. j gr. ss gr.

Original Communications.

Short articles on the treatment of diseases and experience with new remedies are solicited from the profession for this department; also difficult cases for diagnosis and treatment. Articles accepted must be contributed to this journal only. The editors are not responsible for views expressed by contributors.

Unused Manuscript cannot be returned.

Certainly it is excellent discipline for an author to feel that he must say all he has to say in the fewest possible words, or his reader is sure to skip them: and in the plainest possible words, or his reader will certainly misunderstand them. Generally, also, a downright fact may be told in a plain way; and we want downright facts at present more than anything else.-RUSKIN.

For the sake of greater accuracy, we should greatly prefer that our correspondents would write "dr." and "oz.," instead of the signs generally used in prescriptions. This will greatly facilitate proof-reading, and contribute to the accuracy of the work..

Also, we particularly request you to put a suitable title at the top of your article. If you do not do this, please leave at least two inches of space for us to do so.

Many contributors send their articles just too late for publication, and then write expressing their disappointment, Articles that reach us later than the twelfth of the month are too late for the issue then being made up, and must lie over an entire month.

We have received several communications detailing obstetrical cases characterized by entire absence of lochial discharge. The peculiarity seems to be not so uncommon as was formerly supposed.

We should like for our readers to send us the

formulas of as many patent medicines as they can absolutely verify. We wish to give our readers some valuable information on this subject soon.

Follicular Tonsillitis.

Editor MEDICAL WORLD:-Follicular tonsillitis is recognized under several names descriptive of some feature of the affection; but it occupies an unsettled and anomalous position in the family of diseases. On one side it is allied to diphtheria, for which it is sometimes mistaken, often vitiating statistics of wonderful cures of that formidable disease. As "diphtheritic sore throat" it serves to frighten patients and their friends, and its successful treatment sometimes greatly enhances the reputation of the politic doctor.

When diphtheria prevails this disease is prevalent, and often in the same family some members will have follicular tonsillitis, while others have true diphtheria, both affections being apparently due to the same cause.

Some years ago Dr. Jacobi said that "what is called follicular tonsillitis is mostly diphtheria. This form is frequent in the adult, in whom, however, it loses nothing of its contagiousness." Of its contagiousness there can be no reasonable doubt; but my observation is that it is far more common in children than among adults.

In addition to the throat affection, fever, headache, and anorexia, there are almost invariably marked muscular and articular pains, very like those of rheumatism. It is not unplaining of ill-defined rheumatic pains, mencommon for patients to present themselves comtioning, perhaps, only incidentally a sore throat, which, on inspection, proves to be follicular tonsillitis-the key to the pseudo-rheumatic trouble.

The general debility that follows follicular tonsillitis, this rapid and marked depression of the vital powers, are such as pertain to neither diphtheria nor rheumatism, and are found in few other diseases.

Of the various modes of treatment that have been recommended, the following seems to be the most rational, and in practice has proved effectual:

and grave, and too well known to need here to be repeated.

Everytime (and I allow no discount on this), introduce the hand gently but fearlessly, and remove the secudines whenever necessary.

When does this step become necessary?

When, after due time of waiting, say after one hour at least, during which you have employed Crede's method (the modus operandi of which ought to be familiar to every accoucheur), and the placenta does not make its appearance, do it, and do it well,-not making undue haste, which is liable to tire the arm, especially in cases where the placenta is firmly adherent.

Ergot? No, don't use it, unless there is absolute need for it. I mean by that, if there are marked symptoms of inertia of the uterus. Ergot in the hands of a careful and intelligent accoucheur will work wonders, when clearly indicated, but to use it in every case, as some confess to do, and that before the " finis status secundi," is decidedly wrong and in bad taste, not to call it bad practice.

The reasons I shall presently state.

I do not say that it shall never be used before the expulsion of the fetus, but I do say, never use it until other means have been tried, as for example: five to ten grain doses of quinine twice, with an interval of from fifteen to twenty minutes, or drinks of cold water, or both, which, at my hands, have proven very efficacious. What are the bad effects liable to be produced by the administration of ergot "Anie finem status secundi ?”

In the first place we cannot know whether the placenta is adherent or not until that stage of labor is reached; and I have had two cases in which ergot, used at the proper time, was ineffective in the removal of the placenta, on account of the firmness of the attachments.

In cases where it would be useful, if employed at the proper time, ergot will be apt to produce irregular, if not hour - glass contractions if given too early, in which case you have jumped from the frying-pan into the fire; and even worse than that, for you have produced a complication which you would have escaped if ergot had not been used at all.

Again, profuse hemorrhage is liable to occur from the too early use of ergot. How?

If parts of the placenta are less firmly adherent than others, they will naturally be dislodged, producing a free surface, for the vessels do not close in all cases as readily as we are taught to believe, in which case more blood may escape than the patient can afford to lose. Again, there will certainly be a funeral if ergot is used before the "finis status secundi," if it is a breach presentation, as the os will firmly contract about the after-coming head

upon the escape of the shoulders, so that there will be a fatal delay.

The practice of gently "pulling at the cord" is pernicious and damnable, because enough pulling on the cord before the placenta is dislodged will either rupture the same, when hemorrhage takes place, or an hour glass contraction is produced, and no pulling, whether gentle or not, will dislodge the placenta. Wait with your "gentle" pulling until the placenta is in the vagina. Dr. Woodbridge, I wish to advise always to remove the placenta in the third or fourth months' abortions, as soon as practicable, by the use of a suitable blunt curette, always using one large enough, as it will do more good than smaller instruments, and the curette, rather than sharp-edged spoons. To withdraw the placenta use the ordinary placental forceps.

There can be no serious objections to, nor difficulties in this procedure, for a patient will always submit to such operations as are deemed necessary, and the ease with which this operation can be completed can be appreciated best by those who have tried it.

It may not be absolutely necessary, but it is always absolutely safe, to use for a few days an intra-uterine douche of bichloride of mercury, I in 4,000, or a two per cent. carbolic acid solution. In both instances the water must first be boiled, then cooled to proper tempera

ture.

For the last three years, I have taught these principles in the policlinic and the post-graduate medical schools of Chicago, and never yet in my own practice have I had to record the loss either of a child or its mother when I have conducted the case from the onset of the labor, and I think I have fully, if not more than my share of these cases.

Before closing, allow me to urge the necessity of scrupulous cleanliness, and antiseptic precautions in the management of child-birth.

Look after the nails. After washing dip your hands in a bichloride solution, 1 in 1,000, so easily made by dissolving tablets, which we can carry in a small bottle in our vest pocket, or in our instrument bag. Do not make digital examinations too often, but make the first one thoroughly; in fact, try to find everything you want if possible, and base your diagnosis upon it, and when the head bears down on the perineum, the countenance of your patient will clearly show it; then support the perineum to prevent laceration.

In conclusion, I wish to advise daily irrigations of the vaginal tract for a few days or a week, to remove all clots and other uncleanliness, often found there, and the patient will gratefully thank you for the sense of comfort you have afforded her, and to your