SPIRIT OF THE MEDICAL

PRESS.

DIET IN NEPHRITIS.-F. C. Shattuck, Boston (Jour. A.M. A., Jan. 6), lays down the following as the leading principles pertaining to the dietetic treatment of nephritis: 1. Such control as we may have today of nephritis lies in diet and mode of life rather than in drugs. 2. Such drugs as are usful are so in their effect on the general organism and the heart rather than on the kidneys directly. 3. In all cases of nephritis the main aim is to spare the kidneys unnecessary work, remembering that the urinary system is but one, of the many, making up the body. 4. In acute nephritis, as well as in the acute exacerbations of the chronic form, Doctors, Diet and Quiet should work together. Starvation for a few days, regulated by the intensity of the process and the strength of the patient, is the keynote here. 5. In the chronic forms the aim is to lengthen life. Especially in the contracted form of kidney discase, many years of life and comort may depend on the physician's skill in adapting sound principles to the particular case and in securing the co-operation of the patient in persistently carrying out the directions given. Dietary restriction should, in the main, be quantitative rather than qualitative. Alcohol in moderation is not necessarily a poison and may be an aid to digestion. 6. The excess of proteid, not proteid itself, is harmful to the chronically sick kidney. 7. A varied diet is more likely, than a monotonous one, to promote the making of good blood and improving the general nutrition. and that of the myocardium in particular, 8. The amount of albumin is in itself no guide as to the extent of dietary restriction. Shattuck remarks the advisability of a relatively dry diet in dropsical cases, proportioned to the degree of dropsy, he thinks physicians have erred in forcing water, and that the main service von Noorden has rendered is in advocating the limitation of limitation of liquids.

EYES AND EARS THAT MIGHT BE SAVED; AN APPEAL TO THE GENERAL PRACTITIONER. -Samuel S. Wallian says that patients suffering from atrophy of the optic nerve or loss of the special senses, should be under the care of the general practitioner, because these subjects are, with few exceptions, the victims of some form of dyscrasia. This may be from accident from constitutional or specific infection, or from one or more bad hygienic habits. Nearly all of them are badly nourished, usually in the sense of being injudiciously fed. The general practitioner can temporarily ig

nore the local trouble and investigate the general and special condition of the patient's entire organism. The author discourages the use of mydriatics or repeated ophthalmoscopic examinations once the diagnosis is made. The proper dietary is described at length. The food should be rich in phosphates and should contain much refuse. The husk of the grains, especially of wheat, fulfills both requirements. Drinking large amounts of distilled water is also recommended. Turkish baths, especially with the electric cabinet instead of the ordinary hot room, are useful, and alcohol and narcotics must be prohibited. Drugs are of little use; the iodides are usually disappointing, but catophorsis and external applications may be used with inore assurance. To arouse the dormant, debilitated nerve the violet ray, high frequency current, and mechanical vibration are of service, but their use requires careful analysis of each case. - Medical Record, January 6, 1906.

The

EARACHE.-Albert Bardes emphasizes the fact that the importance of this symptom is still not recognized as it should be by either the laity or the profession, and he discusses the nature, etiology, and symptomatology of middle ear infections. Of the treatment he says that as soon as earache begins the patient should be kept quiet, put to bed and placed upon a fluid diet and in other ways treated as we would treat a patient with a high fever. The bowels are to be kept open and a single dose of morphia may be given to insure rest and comfort. Dry heat or else an ice-bag can be applied to the ear. former is more acceptable to most patients. Every three hours the ear should be gently irrigated with a hot solution of bichloride 1 to 5,000 after which a few drops of a 12% solution of carboeglycerin can be instilled. Under no consideration should a person be be allowed to suffer pain longer than twentyfour hours. If the pain continues and the drum-head is inflamed and distended palliative measures are worse than useless and any attempt to abort the inflammation by means other than surgical is dangerous and valuable time is lost in so doing. In bulging drum-head should be treated in the same way as a septic formation in any other place. It should be freely incised rather than simply punctured or allowed to break.-Medical Record, January 20, 1906.

THIGENOL is described as the sodium salt of the sulphonic acid of a synthetic sulpho oil, and has the same therapeutic action as ichthyol, but without its odor and staining qualities.

CLINICAL THERAPEUTICS

A forum of original experience, to which scientific contributions are invited. Responsibility for views promulgated limited to author.

REST AND TREATMENT.

It is important for every physician to appreciate the therapeutic value of rest, and to remember, as Sir Lauder Brunton expresses it, that "in the case of every organ of the body we find that rest is one of the greatest boons when disease is present.'

However, rest is not the only consideration which is demanded, for as Brunton further says, "Rest will not do everything you want, and one must use alone with it various indicated remedies." This implies that we must study the indications for remedies which go along with the conditions in which rest is to be a therapeutic agent. Rest is a remedy near at hand, and yet it is not honored as it should be and too often the drug remedies are ingloriously depended upon, whereas the happy combination of both brings about a consummation devotedly to be wished

Rest is apt to be the dream of the housewife; the speculation of the overworked business man; the hope of the tired school girl and willing boy. All are waiting for that tomorrow (which will never come) when they can rest and recuperate from the abnormal fatigue to which they are subjected.

In the meantime the daily grind goes on, the reserve of energy decreases and ere long a receiver must be appointed to care for the bankruptcy in which they find themselves. The good fat and blood has gone and not until regeneration succeeds the degeneration, will their function of health be recuperated. The blood state must be investigated, as it is the remaining asset upon which must rest the future of the patient. It must be built then, "and not till then" will fortune smile. on the unfortunate victim of abnormal fatigue Denurtition must cease, good blood and honest fat must become real factors in recuperation.

To secure this desired end rest and other proper remedies must be sought. In the overworked, nervously exhausted mother and housewife, with all of her attending woes, worry, insomnia, loss of appetite, constipation and naturally concomitant loss of weight, we find anemia, causing starvation to nerve centers and the whole range of possibilities which can originate from this deplorable state. The same applies to the strennous girl and adolescent young woman where the daily generation of nerve energy is used in her endeavors to keep in line with her fellows in school and social work. Then again, in the business man who in his routine gives

little thought and consideration to that inevitable fate which awaits him, if he does not let up on the strain which is his daily portion for days of the week.

These individuals are familiar patients to all physicians and demand intelligent and thoughtful consideration of their needs from the physician. Rest is of course of paramount importance, but more is needed, and when the routine is established, wherein rest, feeding, massage, etc., are given their just demands, then must be considered appropriate medicinal measures, calculated to insure help to the blood forming functions of the body. It is here that the well deserved and valuable combination and valuable combination pepto-mangan (Gude) is of inestimable help and service. First, because it is tolerated by the stomach and the ingredients being assimilated go to stimulate the hematopoietic organs, and thus improve the quality of the blood. It is especially indicated in all cases where anemia is a feature, and if given with care and consideration for the end to be desired, it is of great value.

The results justify the assertion that this combination of iron with manganese will produce lasting results upon the blood, thus increasing its power and efficiency to restore normal functions to all of the organs of the body, overcome the effects of abnormal fatigue, and increase the whole range of energizing influences so essential to physical and mental welfare. Few physicians appreciate what can be done with the combination of pepto-mangan (Gude) with rest, in the class of cases, thus mentioned. To secure results, a definite routine must be established and faithfully carried out, the physician all of the time remembering that it is keeping everlastingly at it that wins the race in the treatment of such cases.

IN the palpitation accompanying dysmenorrhea, cactus will give you speedy relief.

A chloral solution kept constantly applied to a boil is said to be of great advantage.

FOR URINE IN THE TOXEMIAS OF PREGNANCY. In eclampsia, says Williams (Surgery, Gynecology and Obstetrics), the total amount of nitrogen is greatly diminished, while the ammonia coefficient remains practically normal. In vomiting (acute yellow atrophy), on the contrary, in spite of the scanty amount of urine, the amount of total nitrogen remains approximately normal, while the ammonia coefficient is wonderfully elevated (from the normal 3 or 5 per cent to as high as 46 per cent of the total nitrogen).

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MEDICAL MISCELLANY

THE DIAMETERS OF THE NORMAL AND THE PHTHISICAL CHEST.-From a study of the chest measurements of 502 normal individ. uals and in 54 tuberculous cases, using bony landmarks for locating the length and diameters of the chest, W. A. Bessesen, Chicago (Jour. A.M.A., Dec. 30), deduces in substances the following conclusions: 1. The use of bony landmarks for locating chest diameters is accurate and easily applied. 2. The use of median values for evaluating antropo. metric data saves time and the results are more accurate than the arithmetical average. 3 Important points in the shape of the chest, as well as the movments and capacity may be appreciated by observation of its principal diameters. 4. The development of the human chest passes through various stages from the deep or dorsoventral to the broad or transverse type. 5. In the fetus and young babe, the lower plane gives a greater depth and breadth than the midplane. 6. The fetus under 30 centimeters in length presents a dorsoventral type of chest -it is deep chested. 7. The new-born child, represents the transitional type of chest-it is round chested. 8. During the first five years of life the most notable change is the rapid widening of the chest in its transverse diameter it becomes broad chested. 9. At puberty the chest takes on an increase in length over the diameters-the adolescent becomes long chested. 10. From the eighteenth to the twenty-fifth year the develop.

ment of the chest is fairly uniform in all its dimensions and represents the highest development-the broad long chest. 11. The dorsoventral diameter increases at an even rate from birth to maturity. 12. The phthisical chest of adult fears, in general, shows an arrest in development of the transverse diameter following puberty. 13. The phthisical chest is a narrow one, tending to the rounded form, with a relative elongation.

OBSTRUCTING THE WORK AT PANAMA.The country at large, understanding somewhat of the sources of the current attempts to discredit and thwart the President's policies, will not be surprised at anything that may be said regarding what has thus far been done on the Isthmus of Panama. Three facts may be asserted: (1) We have entered upon a gigantic undertaking; (2) we have made the President responsible for it; (3) there have been no mistakes that need arouse suspicion or cause anxiety. The original form of the Canal Commission was not well adapted to produce results. The President reorganized the commission in such a way as to make it more effective. He took steps to provide for a stable currency on the Isthmus, because this was a necessary business proceeding. There are obstructionists in the Senate who criticise the President for having done these things well, because they hold that he did them without specific authority of law. What the President has been trying to do has been to exercise good faith the authority conferred upon him to proceed with the work at Panama. And he has taken it for granted that the greater authority included the less. In other words, since the law has given him full authority to proceed, it is fair to assume that his authority includes the right to do those things in detail that are indispensable to the main undertaking. There will be canal investigations and interminable criticism at Washington, but the public may rest assured that President Roosevelt, Secretary Taft, Chief Engineer Stevens, and Chairman Shonts of the Canal Commission, with Judge Magoon as minister to Panama and governor of the canal zone, are doing their work with rare intelligence and fidelity. The people of the United States are very lucky, indeed, to have this canal undertaking in such competent hands. Congress has a perfect right to investigate and criticise, and it has unquestionably the power to obstruct the canal work. In the not very distant future there will be a special message to Congress dealing with the question whether or not the canal should be sea level or be built with locks. -From "The Progress of the World," in the American Monthly Review of Reviews for February.