feeble, and respiration becomes shallow and frequent. There is no specific antidote, and after the administration of a brisk emetic the sufferer should be kept in a strictly recumbent position, and plied vigorously with stimulants. The effects are usually of considerable duration, and in one case the patient was not out of danger for fourteen hours. We are informed that there is a considerable demand for powders of this description, the purchasers being chiefly young women of the sempstress class. Whether the sale of these drugs should be in some way restricted may be an open question, but it is quite clear that some intimation should be given that they are not free from danger, and that they can not be taken in unlimited quantities with impunity. Many people acquire an unfortunate habit of dosing themselves with remedies of unknown composition, and this death under such sad circumstances may be taken as an indication that the custom is not one which can be indulged in with safety.

THE TREATMENT OF OBESITY.-Opinions concerning the dietetic treatment of obesity have undergone very great changes in the last few years, many from that of almost starvation to fairly liberal feeding. Kisch, of Marienbad (Wien. Med. Press), deprecates too rigidly uniform measures in the treatment of obesity, which should be carefully adapted to each individual case. discusses the principal indications under seven heads:

He

(1) All dietic excess should be avoided; three, or at the outside four, meals a day should be permitted and no food allowed in the intervals. The quantity and variety taken should be based upon the heat-giving properties of the food substances; Kisch gives the value of some of the principal diets in calorics and recommends that no more than the amount necessary to provide the minimum number of calorics should be allowed. (2) As regards quality, the first essential is an adequate supply of proteids; a moderate amount of carbohydrate may be allowed, but the fat must be reduced to a minimum. Piquant seasonings are to be avoided, as they may stimulate to dietetic excess. (3) The consumption of fluid is not to be limited unless symptoms of cardiac failure are present; such liquids as are fancied, with the exception of alcohol, may be taken at any time, but moderation should be observed at meals. Cold water, especially if charged with carbonic acid, is to be preferred; anemic subjects should drink less than plethoric. The amount allowed must be restricted when signs of fatty affec

tion of the heart are present. (4) The author is a strong advocate of exercise and active movements in the treatment of plethoric obesity, the state of the heart always being taken into consideration; they are of particular value in increasing the activity of oxidation processes. In anemic subjects, however, these advantages are counterbalanced by the increased nitrogenous waste which may injuriously affect the heart. In these patients passive movements and massage are accordingly to be recommended. (5) Great importance is to be attributed in the hours of sleep, during which the activity of metabolism is reduced; sleep should be entirely forbidden during the day. (6) Tissue change is also to be increased by baths, particularly in springs rich in carbon dioxide, which are most stimulating to the skin. Turkish baths are also of value if the heart is sound. (7) Finally, it is of importance to secure a pure air, rich in ozone, especially in a high and wooded neighborhood. The lungs are thus stimulated to greater activity, and the effect is aided by the change in the patient's habits and occupations.

ACTINOMYCOSIS OF THE UMBILICUS.-M. Reboul, of Nimes, sent an interesting note ("Gazette Hebdomadaire," 23d of October last) on actinomycosis of the umbilicus by direct inoculation to the Académie de Médecine.

The subject of the operation was a man twenty-one years of age, who was employed in harvesting. In the month of August last he saw, just above the navel, an oval tumor, situated under the skin.

When the patient entered the hospital it was found that the umbilicus was filled with hard papillomatous pimples, that bled a little when pressed; between these pimples were seen two granules resembling grains of wheat.

The case was diagnosed as an actinomycosis of the umbilicus, and the tumor and the umbilical canal to which it adhered were removed.

The results of the operation were very simple: the wound united by first intention and was followed by no unpleasant results what

ever.

The portion removed contained a number of small yellow grains scattered through the mass.

This was examined under the microscope and the grains gave distinct evidence of the presence of actinomycosi.

In the centre of many of the pimples of the tumor small, purulent cavities, each containing a little kernel of wheat surrounded by numerous particles of actinomycosi were found.

Then cultures made on potatoes gave positive proofs of their existence and produced fine colonies.

This case of actinomycosis of the umbilicus is a rare instance of the direct inoculation of man with small particles of wheat containing actinomycosi. A proper attention to propylasis is therefore indicated. Harvesters ought to be warned of the danger of contracting this disease when at work, if their bodies are exposed; they should therefore take sufficient care to protect themselves and cleanse their persons from all articles of dust that may adhere to them when at their work.

INCREASE OF WEIGHT WHILE FASTING.-M. C. Bouchard presented to the Académie des Sciences the results of his experiments on the increase of weight in persons fasting, and receiving only the gas from the atmosphere through the lungs, and subjected to constipation and the retention of urine. When weighed the individual gains 40 grammes in an hour. The cause of this increase in weight is the transformation of the fat into glycogen, under the influence of the oxygen.

M. Berthelot admits increase of weight by oxidation of fat, but does not think the fat is changed into glycogen.

RESECTION OF THE INTESTINES.-M. Boeckel, of Strasbourg, gave the ("Gazette Hebdomadaire," 23d October, 1898) history of three cases of tumors of the intestines which were removed by resection.

The three cases were women, aged, respectively, forty, fortythree and forty-seven years.

The first had a tumor of the cœcum of a tuberculous nature; the others were cancers of the colon descending and of the colon ascending.

In the first case, Boeckel resected a portion of the descending colon near the splenic curve; the ends thus divided were joined by suture; the abdomen was closed and the patient was perfectly restored on the twentieth day.

In the others the surgeon resected the cœcum with the appendix and also a portion of the ascending colon and the ilium, removing

the healthy tissue to a considerable distance beyond the diseased portion; he also formed a communication between the small and the large intestine by means of a lateral union of the first with the second (ileo-colastomy by implantation).

The first case healed after ten days, and the patient was able to resume her usual occupation after six weeks. She has since remained quite well.

The second of these cases died the sixth day after the operation; the operation was performed too late for, at the autopsy, extensive metastases were found under the form of enormous cancerous nodules in the liver, in the chest and in the retro-peritoneal ganglious.

TYPHOID FEVER IN AN INFANT.-M. Cassoute gives to the section on pediatria of the Congrès de Gynécologie, D'Obstétrique et de Pediatrie ("Le Progrès Médical," 22d October last) the case of a child two months old attacked with diarrhoea, hypothermia and collapse. In testing the reaction with the sero-diagnostic, the agglutination, although slow, was found to be complete at the expiration of half an hour. The autopsy confirmed the accuracy of the sero-diagnosis. It would seem, from this case, that many similar cases of typhoid fever run their course unperceived, thus showing the necessity for the systematic employment in similar cases of the reacting agent of vidol.

M. Béry reported, in this connection, many cases in which children showed all the characteristic manifestations of hysteria which seemed to be cases of organic disease. He reports specially a case of false peritonitis which occurred twice, in which he was led into error of diagnosis in the first attack. Hysteria is not a rare disease in infancy and in childhood, and in difficult or doubtful cases it always deserves careful consideration.

UNGUENTUM RESINOL (Resinol Chemical Co., Baltimore) is particularly recommended by Dr. F. J. Champney, of Wyoming, Neb., in cases of chronic eczema, pruritus ani and pruritus vulvæ. An obstinate case of "itching piles," under our own observation, that had resisted everything else, was promptly relieved by it.

PEARLINE?-The Best of Soaps-Above all for cleansing flannels; they require no rubbing in its use, only soaking and rensing.

SANITARIAN, DECEMBER, 1898.

All correspondence and exchanges, and all publications for review, should be addressed to the Editor, Dr. A. N. Bell, Brooklyn, N. Y.

QUARANTINE REQUIREMENTS.

At the time of this writing there are two quarantine conventions in anticipation, one at Memphis and the other at New Orleans, for "the purpose of arriving at the best mode of preventing yellow fever from entering our country from abroad, and, when here, the best method to employ in stamping it out and preventing its spread."

But the Southern mind seems to be already made up. "Old fogies may want shotgun quarantine to last forever," says the "Huntsville Mercury," "but the business interests of the country demand something better; they want a national quarantine."

The Memphis "Scimitar" recently sent out the following note to editors of Southern dailies and prominent weeklies:

"Please send us by return mail one to three hundred words, giving your views of national quarantine, and of the convention to take means toward that end which it is proposed to hold in Memphis."

Twenty-nine replies have been received. Twenty-seven favor national control of quarantine and two oppose the proposition!

So far it appears that the Southern press is almost unanimous in advocacy of an effective general system of quarantine under control of the national government.

"The 'Galveston-Dallas News,'" says the New Orleans "TimesDemocrat," "comes out squarely, emphatically and intelligently in favor of national quarantine, and gives the very best reasons why we should have it. Its declaration is all the more important because Texas was feared as one of the stumbling-blocks in the way of any Federal provision on this subject. Texas has always maintained a position of independence in regard to quarantine, as it has done in not a few other matters, and has actually refused to enter into any plan of co-operation with the other States. 'We