The control animals in which the disease was allowed to progress were also shown, and the difference in the various stages of progression demonstrated.

Professor Doenitz finds that tuberculin injections produce no appreciable effect until the tubercle is fully developed, which is about the middle of the third week, and the treatment begins properly at that time, when a rather severe irritation of the eye is set up, leading rapidly to severe conjunctivitis, iritis, and the development of pannus, the latter covering the entire cornea.

In the control animal these changes are slower, the cornea is cloudy, the pannus slight, and the appearance of the eye would be less alarming were it not that the scar at the point of inoculation has become necrotic and perforation outward has taken place, being the first step to the resulting atrophy of the bulb. In cases where the eye before the experimental treatment has not been intensely irritated, the pannus and conjunctivitis are less, and the effect of the injection and the inflammatory reaction are more confined to the iris, the seat of the tubercle, while the cornea becomes more or less cloudy, so that for a time it is impossible to observe the changes in the anterior chamber.

The cornea then begins to clear, and the absorption of the tubercle can be witnessed under the use of increasing doses of tuberculin, whereas in the control animal destructive changes continue.

Finally, in from three to four months after inoculation the tubercles are entirely absorbed, the posterior synechia separate unaided, leaving pigment, and exudation rests upon the lense capsule; the eye becomes entirely restored as a visual organ, and the author demonstrated a number of such healed eyes.

In the treatment the injections were given daily and increased slowly up to five milligrammes, then the increase was more rapid, and the injections were continued until all tubercular manifestations had disappeared.

The author found that under long-continued small or medium doses, and under long-continued large doses the results were unfavorable; intermittent treatment was also unfavorable.

The product obtained by Klebs from Koch's tuberculin was unsatisfactory.

The author concludes as follows:

1. In the experimental tuberculosis of the rabbit's eye tuberculin is a sure curative agent.

2. Its effect begins not until, microscopically, true tubercle can be demonstrated.

3. Its first effect is a transient, severe irritation.

4. Under the continued treatment the irritation of the eye subsides entirely.

5. If, before beginning of the treatment, deepreaching, destructive processes have not taken place, the cure follows, the eye regaining its vision; otherwise atrophy takes place.

6. For a cure it is necessary that the tuberculin be given in increasing doses in order to maintain a not too slight reaction.-Deutsche med. Wochenschrift, Nov. 19, 1891.

The Treatment of Uterine Hemorrhages. Terillon gives the following rules to determine the cause of a uterine hemorrhage: A woman, less than 27 to 30 years of age, who suffers from hemorrhage, will not have fibroids, but rather an abortion, so often passed unrecognized, a salpingitis, or a hemorrhagic metritis. It is exceptional to meet with an epithelioma. From 35 to 40 years the causes of hemorrhages are many: fibroids, epithelioma or sarcoma, polypus, metritis, abortion or salpingitis. Here, diagnosis is more difficult. It is often impossible to recognize small interstitial myomata and small endo-uterine polypi. In all cases examination of the blood lost will furnish important information. In hemorrhages due to fibromata or salpingitis, the discharge is almost pure blood. In cases of epitheliomata or fibromata undergoing degeneration the blood is mixed with pus and mucus. Besides there is, in the meantime, during the intervals between the hemorrhages, a watery discharge mixed with yellowish clots, which leaves a brownish stain upon the linen. These spots upon the linen yield important results; if the hydrorrhoeic fluid has a fœtid odor peculiar to itself, then the diagnosis of epithelioma is quite certain. In sarcoma this odor appears late.

After the menopause the cause of hemorrhage is nearly always intra-uterine. A more or less periodic discharge takes place, which leads the patient to think that her periods have returned. In nine cases out of ten physical examination will reveal the presence of a sarcoma or epithelioma. One should not forget, however, to keep in mind ovarian cysts developing late and an old fibroid retrogressing.

As to treatment, he recommends: Repose in bed, with the pelvis elevated. This simple measure alone sometimes causes the flow to cease. Hot water has a hæmostatic action and injections may be given either intra-uterine, when the cavity is dilated, or simply into the vagina. The water injections may contain an antiseptic. If this fail, then tampon [the cervix.-ED.]. Hypodermic injections of morphine or rectal injections of opium,

as well as ergotin subcutaneously may be used. One hemorrhage leads to another, thus producing a state of artificial hæmophilia. In patients, who suffer from uterine hemorrhages, one should advise exercise in the open air, douches, frictions of the entire body and salt-water baths. Sun-baths are used in Russia. The patient lies in an armchair, covered with a black cloth, the head protected with a parasol. This causes profuse sweating, the hemorrhages cease and the general nutrition improves.-Rivista Cline Therap.

On Plugging the Cervix Uteri Instead of Vagina in Uterine Hemorrhage. Plugging the cervical canal in cases of severe uterine hemorrhage (other than postpartum) will be found more effectual and much more comfortable to the patient than the older method of plugging the vagina. This may be done by the ordinary applicator.

The size of the os being determined by digital examination, a piece of absorbent cotton is to be neatly wound round the projecting point of the instrument for about two inches of its length, and thickly enough to fully fill the canal. The cotton plug is then to be saturated with whatever antiseptic styptic the operator prefers-saturated solution of alum in glycerine, iodine tincture, or turpentine. [Dry cotton is better.-ED.]

A large-sized cylindrical speculum is then introduced and the os and cervix syringed with hot water, so as to wash away all clots. The cervix is then to be steadied with a tenaculum, held in the left hand, while the plug is passed into the cervix, with the depositor held in the right, as far as possible, and the plug is pushed off the rod and the depositor withdrawn.

The whole operation can thus be done without assistance. If the plug has been made of the proper dimensions, which, of course, must depend on the judgment of the operator, and inserted fully into the cervical canal, there need be no anxiety as to the result, and the antiseptic and astringent action of turpentine, which I generally use myself, leaves nothing to be desired.

The plug may be safely left till expelled by uterine action, when, if the hemorrhage continue, the practitioner will be prepared to adopt other measures-washing out, or curetting the uterus, or both. With a sponge-tent or seatangle in the womb it is always an anxious time for the practitioner, but with the plug properly in position he can take his own time about further interference.-Dr. Alex. Duke in Satellite.

The Action of Wine Upon Pepsin and Digestion.-1. All wines, without exception, interfere with the action of pepsin, those richest in

3.

alcohol, cream of tartar, and coloring matter being most injurious, as it was easy to foresee. 2. Among the elements of natural wines the coloring matters act in concert with the alcohol and the cream of tartar to retard or arrest pepsic indigestion. The acidity of normal wines is unable to excite the action of pepsin; in most cases it does not appear to exist. 4. Among the coloring matters introduced fraudulently into wines methylene blue, azoflavine, solid blue, and especially magenta, interfere with pepsic digestion. The vegetable colors, black mallows, elderberries and maki, like ing, by removing a part of the cream of tartar, œnoline, exert an injurious action. 5. Plaster

eliminates an element of natural wines which retards the action of pepsin in vitro. Digestion is more rapid in presence of plastered wines than of natural wines, but the advantage which plastered wines have in this respect does not conceal their other disadvantages.-L. Hugounin in Bull. Soc. Chim.

Cannabis indica has proved very useful in the treatment of melancholia and mania. It is of great value in the treatment of chorea when arsenic fails. It may be combined with chloral with advantage in such cases. In migraine the drug is of great value; a pill containing a quarter of a grain of the extract, with or without the same amount of phosphide of zinc, will often check an attack immediately, and if the pill is given twice a day continuously the severity and frequency of the attacks are often much diminished. Patients who have been incapacitated for work from the frequency of the attacks have been enabled by the use of Cannabis indica to resume their employment. The drug is also a valuable gastric sedative in cases of ulcer of the stomach and gastrodynia. It may be combined with nitrate of silver, and it increases the efficacy of the latter. It is also a valuable hypnotic.-Br. Med. J.

The attention paid to dietetics by the physician shows pretty conclusively that we are passing into a state of conservative medication. By this we mean to be understood that during the next ten years food and not medicine will prove the most important factor in curing disease.-The Prescription.

A human being supplied only with plain but substantial food-milk, bread, vegetables, a little meat, for instance-taking only the right proportion at regular intervals daily [allowing sufficient time for effective mastication and digestion], furnishes to the cells all the food they need without intensifying or lowering their natural activities.Dr. Paul Paquin in The Little Blue Book.

The Medical Calendar.

PUBLISHER'S MISCELLANY.

The Habit of Washing.-No practice, no custom, however long established, has ever been allowed a permanent right to respect, or even to existence. Sooner or later its turn will come to be weighed in the critic's balance, and its quality will have to be proved. Let us quote, as a recent illustration, the habit of daily bathing, the utility of which has of late, though not for the first time, been seriously questioned. The reasonableness of doubt in such a matter, and under ordinary circumstances, does not, we confess, commend itself to our judgment. Whether the opponents of ablution fear the shock of cold immersion, or whether they dread the cleansing stimulation thus applied to the excreting skin surface, their objection must appear to most persons possessed of ordinary health and vigor to threaten impairment of both by fostering uncleanliness. If, on the other hand, it is the too free application of heat by Turkish and other warm baths which appears objectionable, we will not deny that there is here a possible ground for complaint. Let it not be supposed that we ignore the curative influence or the cleansing property of this method when used with judgment. It has undoubtedly its fitting time and places if rightly applied. It is no less true, however, that experience has often proved the mischievous effects of its misuse-in case, for example, of cardiac weakness or general exhaustion. bathing in like manner is not without its occasional risks. It is not suitable for persons enfeebled from any organic cause, though mere nervous languor is often braced and benefited by it. It has no proper place among the habits of those who are subject to chronic visceral congestions. As regards one advantage derived from bathing-i.e., its cleansing property-there is no reasonable ground for difference of opinion. Man, whether savage or civilized, appears as a rule to have no doubt on the subject. Wherever we find him with water accessible he is a bather. Less practised by one people than another though it may be, there still is commonly recognizable a constant habit of ablution, and this fact in itself attests at least an almost universal belief in the necessity of insuring cleanliness by means of washing. Nor can we find reason to doubt the general soundness of this belief.

Cold

In bathing temperature is of course a chief consideration. For the robust, cold immersion followed by rapid friction is a valuable tonic of nerve, skin and heart function.

SOME NOTES ON THE ADULTERATION OF FOOD.

In an article on "Cocoa and Chocolate," in the October number of The Gentleman's Magazine, Dr. Crespi says: "The attempt to prepare cocoa in a soluble form has tempted some foreign firms. to add alkaline salts freely. These salts cannot be recommended to healthy subjects as regular articles of food."

The Birmingham (England) Medical Review for October, 1890, contains an article on "Food and Its Adulterations," in which it is stated that "quite apart from any question as to the injury resulting to the human system from taking these salts it would be only right that the medical profession should resolutely discountenance the use of any and all secret preparations confessedly adulterations, and adulterations, too, of a sort not justified by any of the exigencies of the circumstances. Cocoa is only to be recommended

as a beverage when it is as pure as possible." Quite recently a valuable little work on chocolate and cocoa was published in Germany. It describes, with characteristic German thoroughness, the cacao-tree, the properties of its fruit, and the various modern methods of preparing the food product for the market. In treating of "the manufacture of cocoas deprived of a portion of their oil and rendered more soluble," the writer says: "This branch of the manufacture has recently undergone a great development. Hygiene appears to demand a product which, with a diminution in the amount of oil, should be further distinguished from ordinary chocolate by its readily dissolving in water, milk, etc., thereby being much more easily appropriated by the human system. The removal of a portion of the oil ought to make it more readily assimilated by the digestive system. tive system. Starch, cellulose and the albuminoids are of difficult solubility, and must be converted into such a form as to be readily soluble in water. This would render them easy of absorption, and increase their efficiency. In practice this end has been sought in several ways." The alkaline or chemical process "depends on the fact that the roasted cocoa is treated with carbonate of soda, magnesia, potash or bicarbonate of soda.

The cocoa of those manufacturers who employ the alkaline method is sometimes subjected to a perfectly barbarous treatment in order to secure solution by means of the alkali. For instance, the roasted cocoa-beans are boiled with an aqueous alkaline solution; the product is then dried, deprived of its oil and afterwards ground. Or the crushed cocoa is roasted, deprived of its oil, powdered and boiled with water containing an alkali. Both methods of treatment are in the

highest degree destructive to those bodies which are essential constituents of cocoa. It is especially the cacao-red which is attacked, and with it disappears also the aroma."

It should be added that in the manufacture of large quantities by the alkaline or chemical method it is difficult, if not impossible, to so regulate the heat in drying the cocoa after the chemicals are added (the material being then in a very sensitive state) as to prevent the oil from being scorched; and it is well known that burnt oil or fat is wholly indigestible.

The deleterious effects of the chemicals used in such processes have been referred to in general terms; something more definite and precise on that point will be of interest.

In reply to the inquiry, What is the effect on the system, especially on the gastric mucous membrane, of small quantities of dilute alkaline liquids taken frequently and regularly (for example, for breakfast), one of the leading physicians in Boston says: "I would say that while some persons ⚫ and certain conditions of the system might bear without injury dilute alkaline liquids taken at not frequent intervals, yet the great majority of persons and those with a sensitive stomach could not bear the daily use of such liquids without serious injury. It would produce gastritis, or inflammation of the mucous membrane of the stomach, of varying degree, according to the frequency and amount taken and the susceptibility of the person. This would be accompanied with many of the symptoms of dyspepsia, and if carried to any considerable extent, with troublesome eruption of the skin, and not infrequently with serious disturbance of the functions of the kidneys, I certainly think its long continuance would be dangerous."

Dr. Sidney Ringer, Professor of Medicine at University College, London, and Physician to the College Hospital, perhaps the greatest English authority on the action of drugs, states in his "Handbook of Therapeutics" that "the sustained administration of alkalies and their carbonates renders the blood, it is said, poorer in solids and in red corpuscles, and impairs the nutrition of the body." Of ammonia, carbonate of ammonia and spirits of ammonia, he says: "These preparations have many properties in common with the alkaline, potash and soda group. They possess a strong alkaline reaction, are freely soluble in water, have a high diffusion-power, and dissolve the animal textures. If administered

too long, they excite catarrh of the stomach and intestines."

All of Walter Baker & Co.'s Cocoa Preparations are guaranteed absolutely free from all chemicals. These preparations have stood the test of

ence.

Treating Diphtheria Successfully.—“ I very seldom trouble myself to write certificates for anybody, but as I have tried 'Platt's Chlorides' in diphtheria, and that it may be the means of inducing somebody else to do so, I will give my experiAdd to a teacupful of hot water one or two teaspoonfuls of the chlorides' and thoroughly swab out the throat, and if the nasal passages are involved, syringe them also about once in four hours. I know I have saved several lives this way. ERNEST M. LYON, M.D.,

"282 Broad Street, Newark, N. J." Another method :

Dr. J. Dean Hammond, 240 Wabash Avenue,

Chicago, writes: "I have used Platt's Chlorides' in the strength of a drachm to six ounces of water as a spray for a severe case of diphtheritic sore throat in a child of three years with complete success."

Antipyrin in the Diarrhea of Children.-St. Philippe (Jour. Méd. de Bordeaux) recommends half grain doses of antipyrin every two hours for diarrhoea in children from one to six months old, grain-doses for children up to one year old, and grain-and-a-half doses for children. up to three years old.-Deutsche Wochensc., No. 44, 1891.

Contributions and Selections.

THE STARCH OF THE BANANA AS A
FOOD FOR INVALIDS.

BY W. GILMAN THOMPSON, M.D., PROF. OF PHYSIOLOGY, UNIVERSITY OF THE CITY OF NEW YORK. There are many disorders of digestion, and many conditions of convalesence in which it is desirable to employ a starchy food that will be easily assimilated, and not undergo abnormal fermentation in the stomach, with production of flatulence, abnormal acidity and other disorders. The starchy foods heretofore obtainable in this country for this purpose have been all derived from tubers or cereals, and attempts are made to render them more assimilable by the addition of digestive ferments or by malting. In the banana, as in other fruits, however, natural fermentative processes occur which convert the greater portion of its starch into dextrin and glucose without artificial aid, and hence the banana tribe with their great develop ment of fruit starch, not only furnish man in the tropics with an indispensable food, but admit of the preparation of flour and meal that possess intrinsic advantages as an article of invalid diet.

The banana is really a variety of the plantain or Plantago musa, but the fruit is not so large or hard as that commonly called plantain, and the flavor is far more delicate. The botanical name of the banana, Musa sapientum, was given because it constituted the principal food of the Brahmins or wise caste of India. There are many score of varieties of the banana, ranging from the most delicate examples of the Musa sapientum family to the heaviest of the plantains, and they vary in digestibility as they do in flavor. Casati1

an intuition that they were more highly nourished by the concentrated food.

In the West Indies, in the Islands of the Pacific, along the Congo, and throughout Central Africa, many natives use bananas as their staple article of food and maintain good physical development. The fact that a diet consisting solely of this fruit will sustain life for long periods, is owing to the relatively high percentage of nitrogen which it contains as compared with sago, arrow-root, and similar carbo-hydrates. This percentage amounts to nearly five parts per hundred of the entire fruit, or one-fifth of the total solids (Corenwinder).

In British Guiana, the banana is employed especially as a nourishing food for young children and invalids. Many persons find that they cannot readily digest bananas as we obtain them in this country, but this no doubt depends upon the fact that the fruit shipped to the United States is picked very green, and is often quite immature and irregularly ripened when eaten. Imperfectly ripened bananas are composed chiefly of starch, but, as the natural ripening proceeds, the saccharine material is converted into a mucilagenous substance which in turn forms sugar (Pavy2).

The flour, which is made by drying carefully selected and well ripened bananas, is, however, remarkably easy to digest and highly nutritious.

Surgeon Parke3, in his instructive and interesting account of his experience with the sick of the Emin Pasha Relief Expedition refers to Mr. Stanley, who was in the midst of a severe attack of acute gastritis, as follows: "He eats porridge made with banana flour and milk. It is very light and digestible and has more flavor than arrow-root; it is also very nutritious. We whites have good reason to know this fact now, as we have mostly lived on banana flour for the past two years."

During this period, it should be remembered, the members of the expedition were taking very long marches and were suffering from frequent attacks of

2. A Treatise on Food and Dietetics. Pavy, p. 321. 3. My Personal Experiences in Equatorial Africa. Parke,

p. 416.