[A good treatment for excessiv local sweating of the hands or feet is to place a dram or more of commercial formaldehyd in a pint to a quart of water, and allow the parts affected to remain immersed for 15 or 20 minutes just before retiring. For a case like these you mention, we would try, cautiously, a lotion of glycerin, formaldehyd, and water, well rubbed into palms just before retiring. The formaldehyd should not be used too strong, tho it is not poisonous when employed externally in reasonable amounts, and it is not to be used if there are any abrasions or cracks in the skin. Kaposi, one of our best foreign dermatologists, highly commends an ointment of napthol, 5 per cent.; or the same strength of an alcoholic solution of the same drug, used as a lotion. Zinc oleate is well recoinmended by many in excessiv sweating of hands. An aqueous solution of ichthyol, half a dram to the ounce, used as a lotion, has been of service in many cases. The oleate of aluminium is a useful and grateful appliIcation in such troubles. Tincture of the chlorid of iron, mixt with one-third its weight of glycerin, and applied as a paint, allowing to dry slowly, and applying each night at first, and at longer intervals later, has cured many cases. We venture, doctor, that you have not tried all of the above, and that if you do you will have two satisfied if not grateful patients. It is merely a case of keep on trying till the desired result is obtained, for the medication proving efficient in one case will fail utterly in the next. We suggest that you give a different prescription to each patient, and in this way you can proceed with the testing experiments more quickly.-Ed.]

Impaired Arm after Fracture and Repeated Illnesses. Editor Medical World: In April, 1905, I was called to see a boy about seven years old with scarlet fever. His sickness was just moderate. In about two weeks he seemed perfectly well. On August 12 following he fell and broke both bones in right arm about midway between elbow and wrist. By the first of September he had gotten nearly perfect use of it, when the splint was removed for light ones. On September 19 he was taken with a severe attack ol bilious fever. During the first two weeks the temperature ran to 104 degrees several times, and fever did not leave entirely until the last of October. At this time he had lost the use of all of his limbs, and as convalescence began we massaged the whole body with oliv oil and alcohol every day after a soda sponge bath. We soon noticed the limb that had been broken did not gain as the other limbs did. Then we used electric treatments, passiv gymnastics of metacarpo-phalangeal joints, as the hand seemed to be getting quite stiffened. In the early part of winter he was very sick again with la grippe. He is getting to use the arm at present, but it is far from being a good limb. Would be glad to get any information that would help the patient. L. W.

Poynette, Wis.

[The impaired vitality incident to the repeated illnesses is doubtless responsible, in great part, for the condition of the arm. We suggest a long continued course of tonic medication incorporating iron, strychnin, and the glycero-phos fates. A local application which sometimes does good in such cases is prepared by mixing equal parts of oils of spike, stone, and origanum; this liniment being well rubbed in with thoro massage, once to three times daily. If you are placing much confidence in electricity as furnisht by the small hand battery, we feel that we should say that it cannot do much good, but if you have a static machine or other variety of efficient electro-thera peutical application, it may give good service if continued long enuf.-Ed.]

or more.

Epilepsy.

Editor Medical World: Please send me the best information known as to the treatment of epilepsy. I have a patient about 25 years old, who has been under my care for 12 years During that time he has consulted and been under the care of one of the best spécialists in this state for nervous diseases, and has for the last two years been under the care of Dr. W. H. May, of New York. I know that our Minnesota man gave him one of the bromids, and I think that is what Dr. May is giving. Can you give me any information as to what these men use? What do you know of brometone as a remedy for epilepsy? W. G.

Minnesota.

[We have repeatedly toucht upon epilepsy

Editor Medical World and Family: Male, age six months, weight 23 pounds, very fleshy. Had never had a day's sickness previous. Parents both healthy; no tubercular nor syphilitic history in either. Mother states that period of gestation and labor were normal.

When called I found child restless and crying out occasionally. A few minutes after nursing he would vomit curded milk. Tongue coated, bowels constipated and abdomen distended, slightly; no tenderness; kidneys regular, temperature 102 degrees.

Treatment: Sponged fever down. Gave calomel, grain 1-10 every hour for six hours; followed this with oil. Applied turpentine stupes to bowels; this to be continued until bowels were soft. Had two actions from bowels consisting of milk curds. Appeared to be much better after bowels moved. This being a malarial district, I then gave quinin sulf., one grain every three hours, this to be continued until my return.

Was called again at 4.30 o'clock next morning and found patient very restless, tossing to and fro in crib, throwing his hands and feet, breathing very rapidly with a short expiratory grunt. Persistent nausea. Bowels had not acted during night, but abdomen was very much distended and very tender in umbilical region. Temperature 104 degrees; kidneys regular. Treatment: Sponged; gave sp. tr. aconite, but failed to reduce fever a single degree. Gave repeated enemas with negativ results. Within one hour fever had reached 1071⁄2 degrees. Had two light convulsions just before death, which was at 8.30 same morning. I am very anxious for a diagnosis, if I have given sufficient data. Could this possibly have been volvulus, or intussusception. KENTUCKY.

[Yes, doctor, it "could possibly have been" volvulus; but, unless you were not called for some time after the occurrence of the intussusception, it was not. By this we mean that the distinctiv symptoms of volvulus had either passed away before you saw the case, or that it was not volvulus.

In volvulus the onset is sudden, but the duration of different cases varies greatly. It begins with vomiting and paroxysmal colicky pain. The pains rapidly increase

in severity, and soon lose the paroxysmal character. The vomitus is first the stomach contents, then bilious matter, and finally the character alters to a true fecal material. The abdomen is soft, and is neither tender nor distended until after inflammatory changes have induced congestion and peritonitis. After the intussusception occurs, there may be one or two loose stools, then the constipation becomes complete, neither fiatus nor feces passing; there is, however, passage of blood, or of blood and mucus mixt. The temperature is subnormal rather than elevated, but if peritonitis develop in severe degree, it becomes elevated. Collapse, rather than convulsions, is an end to the scene.

Thus, you see, the case does not correspond to the characteristic symptoms of volvulus, if all the symptoms were recorded. In our opinion, the death might have been caused by any one of a number of causes, and we do not believe it now possible to ever ascertain just what the real trouble was. A post-mortem examination should have been obtained at the time, and all might have been made clear.-Ed.]

Haarlem Oil.

Editor Medical World: Say, I want to help hold up your hands in exposing fakes and frauds. Your courageous stand must meet the approval of all honorable physicians.

Doctor, if I am not asking too much of your time, I want you to investigate "Haarlem Oil," which is highly extolled by the laity in some sections of the country as a cure-all for kidney troubles; said to be infallible, especially in Bright's disease. Said to be imported from Haarlem, Holland, where it is manufactured. What is it? It has one redeeming quality: its cheapness. F. M. DOOLEY, M. D.

Duncan, Miss.

[The "Viavi" treatment consists of the rubbing of ointments on the part, with considerable rubbing. The benefit is chiefly due to the rubbing (a kind of massage), and the psychological element- hope and faith. By liberal advertising they have secured many agents thruout the United States, who make preposterous claims. Patients may protect themselves from such nostrum venders, in so far as money loss is concerned, by posting a forfeit in the amount of the pay demanded for cure, to be paid over to the agent after the cure is accomplisht. This is an effectual method of disposing of quacks; they do not care to do business in that way. They guarantee a cure, of course, but what does their guarantee amount to? Make the guarantee worth something, and they vanish like the thin, hot air which is their only stock in trade. We can not say anything as to the harmful or harmless nature of the methods they employ; some nostrums are harmless.-Ed.]

Metritis.

Editor Medical World: Will the Editor and family make a diagnosis in the following case, and suggest treatment? Mrs. A., 59 years of age,

has eight living children, had two miscarriages,

had uterin trouble after the birth of the sixth child, which has not yet left her. Last menstruated in October, 1902. Family history good. Since March, 1905, has complained of a "burning pain" about the uterus, which also radiated to the sides and back. One physician failed to aid her, and she called in a professional friend of mine who diagnosed endometritis and vaginitis. He cured the vaginitis, but made no impression on the endometritis. Another physician, after consultation, failed to suggest measures which would relieve, and I was then called (in November). Uterus found congested, with everted and granulated os. Iodoform, boric acid, zinc, lead, and other agents had been tried without benefit, and all proved irritating. The vaginal mucosa began to sluff, but we succeeded in stopping this. I applied hydrastis, morphin,

and bismuth subnitrate on tampons, which relieved, but did not cure. Meanwhile, we were administering tonic medication by the mouth. We then made intrauterin applications of hydrastis, morphin, bismuth subnitrate, and liquid vaselin. There is no cancer in the family. Middlebrook, Ark. DR. W. T. SWINDLE.

[So long as there is neither offensiv discharge nor bleeding, you need not worry about cancer. The proper treatment of simple erosion of the os is an application of silver nitrate solution, 20 to 60 grains to the ounce, followed by the insertion in vagina of boro-glycerid tampons, and a daily douche of weak boracic acid solution. If there is extensiv laceration of the os, she will require curetting, possibly, with repair of the laceration. If it is a simple severe erosion, the above will cure. Take two tenaculums

and hook on opposite sides of the os, cross them and make traction so as to close the everted os and approximate the tissues in the position they should assume in health: thus you can estimate the degree of laceration, if any. An untorn os is seldom everted, unless the swelling is excessiv. In reporting the case, you should have told us if the vaginitis was specific in character. If so, and the uterus is really invaded, only curettment will avail: even then, the destructiv action may have been allowed to proceed too long already.-Ed.]

True Membranous Croup.-Calx lodata. Editor Medical World: Is true membranous croup contagious? Is there good authority so claiming at the present time?

Is calx iodata (calcidin, iodized calcium) the best known drug now extant in the treatment of the above? J. F. S.

Dennis, Kans.

[True membranous croup is contagious. All authorities so claim. True membranous nothing less. In it the membrane is in the croup is laryngeal diphtheria; nothing more, larynx instead of in the throat or nostril, and the first and best treatment is antitoxin in sufficient dosage as soon as a suspicion is aroused as to the probable cause of the illness. See Dr. Russell's review of the leading authorities on antitoxin in diphtheria, in October, 1905, "World," pages 391 to 395.

Iodized calcium is of value in the treatment of croup (not diphtheria). We are not prepared to say that it is "the best known drug now extant," however. It has been highly commended by various writers in a number of medical journals, and has been

mentioned by a few of the better class of text-books. It depends for its action on the free iodin.-Ed.]

Hands and Arms "Go to Sleep." Editor Medical World: Lady, aged 25 years; hands and arms "go to sleep" at night. Has taken iron, quinin and strychnin for quite a while, but no improvement yet. Will some brother give me a sure remedy? CHAS. SANFORD, M. D.

Board Camp, Ark.

[It will be necessary to attack the trouble thru nerve sedation, or by heart stimulation; and we think probably the latter will.be found to be the route of choice. If you had told us the amount of strychnin yeu had given, it would have been better. We presume you have been giving the elixir of the combined drugs, each dose, probably, containing about 1-60 of a grain of strychnin. If this is correct, raise the dose to I-40 grain of strychnin, alone, every four hours; then, after a few days to 1-30; then to 1-20, and finally, if no strychnin symptoms have developt, to 1-16 grain. If you get no benefit from this, you can abandon strychnin, alone, as a remedy. Reduce the dose to 1-40 grain, in such event, and combine it with strophanthus; and, if the heart be rapid and feeble, incorporate digitalis.-Ed.]

Eczema of Ear.

Editor Medical World: Can you help me in a case of eczema of ear involving outer border and lower lobule? Girl eight years of age, in good health, family history good; when about one week old the trouble was first noticed, and has persisted ever since, with the exception of two years, when it healed spontaneously. The case first came under my care about one year ago, when it made its second appearance. At that time the ear was swollen and edematous, with watery exudate, itching, burning, &c. Î used black wash until swelling subsided; then used the following ointment:

ment was manifest. Try this plan, and if the disease retrogresses, it is proof that a milder ointment, instead of a more stimulating one, is required. As an added stimulant we suggest 15 to 25 grains of resorcin to the ounce. We do not see, either, that your ointment is improved by the incorporation of adrenalin chlorid and bismuth.

Most of these cases do better if water is not allowed to come into contact with the lesion. Use warmed glycerin and cotton as cleansing agents, in lieu of water and soap. —Ed.]

Paralysis Following Confinement.

Editor MEDICAL WORLD:-Mrs. P., American, age 32 years, weight 130. Family history negativ. Personal history, general health very good; menstruated first at age of 11 years; periods not regular; usually six weeks apart, and very scanty and painful. Was married at age of 22. About this time was treated for retroflexion and stenosis of cervix; became pregnant about 6 months after marriage, but miscarried, or rather aborted, two months later. Treatment continued for six or eight months. She again became pregnant, and nine months later gave birth to a healthy child. Health has been very good until November 17, 1905, except after each confinement (five children) she suffers considerably with her head, and the lochial discharge usually lasts for 30 or 40 days-rather free and fresh looking. Was confined November 17, 1905, giving birth to a healthy male child. Labor normal, 1. o. a., and comparativly easy. As usual, some headache and discharge rather free. Said she could turn in bed and use her hips and lower limbs much better than after any preceding confinement, saying she was not able to turn in bed or use the hips or legs for three weeks after the other confinements. Gave usual treatment after this confinement: quinin, H. V. C., salines, etc., using as daily vaginal douche carbolic acid one dram to the half gallon of steril water. Took cold and sore throat November 30th, thirteenth day after confinement. Sat up on chair one hour on 1st and 2d of December.; complained some of head and hips. On morning of the 3d was sitting on chair holding baby on her lap, when without warning there seemed to be a general relaxation of the muscles of the whole body, especially those of left arm and leg. She came near dropping the baby; she called to her husband, who took the baby, laid it on bed, wife called for chamber, said her bowels wanted to move. She passed feces and urin, but she fell over on the floor. Then her husband put her on the bed and called for me.

I saw her one hour afterward. She was suffering considerably with her head-frontal and right lateral portion, also right side of neck and shoulder; left arm and leg partially paralyzed; right cheek and side of face considerably blancht, -as is often seen before a severe attack of facial neuralgia. Right pupil dilated. Pulse rather weak, 90 per min.; temperature below normal96 degrees; respiration normal; tongue coated

with thick brown coat and slightly drawn to left. Examination per vagina revealed womb considerably retroflexed, fundus back against sacrum, cervix up against pubic arch, discharge free, rather red and fresh for the length of time after confinement. Nothing more of interest except slight tenderness in region of right ovary. Bladder, kidneys, bowels and stomach normal. All along up to this writing patient remains about the same. Pain in right side of head, neck and face, with itching, especially of inner canthus of right eye, with redness and slight swelling of the lids and conjunctiva; eyeball rather red, but this is probably due to rubbing it so much on account of the intense itching; sight somewhat impaired. Left arm and leg still paralyzed; surface cold, especially elbow and the knee. Kneejerk normal. Sense of weight and tenderness in hips and lower bowels. Uterus smaller and retroflexion somewhat improved; discharge not so free and more of a lochial nature-I mean natural color, consistency, odor, etc. Pulse normal, 72 to 80 per min., rather weak. Temperature normal. Appetite good, bowels and kidneys in good condition. Mammary glands very inactive; right breast secreting scarcely any at all, but this has been so with each confinement; had to raise all the children partially on cow's milk. Says she had always, since she can remember, been affected with peculiar spells occasionally, usually just after retiring at night, as tho one or all of the limbs were numb and swollen, with tingling, etc., her husband usually having to get up and rub the affected limb or limbs (generally the left arm).

My diagnosis is retroflexion with embolism in right lateral sinus.

Treatment: Rest in bed, light, nutritious diet, elevating foot of bed, daily warm salt water baths with brisk rubbing of spine and affected limbs. Vaginal suppositories (G. F. Harvey's formula) placed at mouth of cervix at night, followed by morning douche of warm water and iodin. Local application to neck and head of equal parts of fl. ext. of belladonna, tr. opium and glycerin. Internally, calomel and podoph. to purgation; potas. iod., hyoscyamus, belladonna, zinc, phos., capsicum, strychnin, whiskey, saw palmetto and sandal wood, H. V. C., etc. Podoph. and aloin to keep bowels regular.

Now, if I have made this case clear enuf, please give me diagnosis, prognosis and treatment. Do not be afraid to criticise, as this is my first attempt to write to or ask for help from a medical journal or its readers, altho I have been a subscriber to THE WORLD for nearly five years. I have four volumes of THE WORLD in my bookcase bound with WORLD binders, and I prize them very much. Arlington, Texas.

R. S. PAYNE, M.D.

[We deem your diagnosis correct, and your treatment good. It is probable that you have in this case, and that there has probably been in all her other confinements, considerable subinvolution of the uterus. No lochial discharge should persist so long. Outside of electricity, in galvanic or faradic form, we have no suggestions to make. At

her age, the prognosis as to ultimate recovery from this attack should be good. Have any of the family any suggestions to make to the doctor?-ED.]

Is This Child on the Way to Epilepsy? Editor Medical World: Male child, 4 months, was taken at the age of two weeks with "spells," or "spasms" (as the mother calls them). These spells will last about half to one minute, sometimes preceded by a scream, rigid muscles, cyes rolled back, &c.; then again the scream will be absent; with this exception there is no difference. Has from one to ten per day. These attacks are less frequent and severe when the bowels move daily, but here is the greatest difficulty; it is almost impossible to get them to move even with adult doses of laxativs and purgativs, which I have tried; and it is only with high rectal injections that we get a movement at all, which is then very unsatisfactory. The child takes no notice of any object, even of its mother; has no use of itself; sleeps most of the time, and it is impossible to waken it when asleep. It is large for its age, kidneys o. k., well nourisht, &c.

This is the fourth child. The first lived to be two years old and was taken like this one (about two weeks old), and continued so till its death. It never had any use of itself, did not notice any one, teeth crumbled away as soon as cut, large for its age, same trouble with bowels, &c.

The second child is living (age three years), hearty and natural; never had any indications of "spells."

Third child died at age of one year; was similar to the two described above.

I should like very much to know what the trouble is, and what is the remedy, if any. The parents tell me they had the first child to at least eight or nine different physicians; not one did any good, or even gave any relief. I have tried most every kind of nerve sedativ as well as laxativs, purgativs, that I know of, with no result. There are still more details I should like to mention, but my query is already too long, so I shall stop. I would appreciate any personal answers by mail. R. E. WINE, M. D.

Brentsville, Va.

[On the face of the report of the case, one would, of course, think of epilepsy. If this condition is not now present, and the child lives for any length of time, it may be expected to merge into true chronic epilepsy. It may, indeed, be an example of dissimilar heredity.

The treatment indicated is primarily the removal of the condition which aggravates the attacks; i. e., the constipation. We would suggest the employment of pure butter, softened by heat merely enuf so the child can swallow it. Give the bulk of a walnut with the hull off, four or five times a day, and if results are obtained, the amount may rapidly be reduced. Mechanical laxi