seven cases of gall-stone colic treated with olive-oil. In addition to these the committee collected all the previously reported cases of biliary colic treated according to this method which were accessible, to the number of seventeen. An analysis of these fifty-four cases showed that they were one-third more females than males among the patients; that two died; that in three the results were negative; and that in fifty —that is, in about 92 per cent.-positive relief was afforded. In one of the fatal cases the patient was suffering from adhesive obstruction of the bile-ducts; this case should, strictly speaking be deducted from the failures, as being beyond treatment of any kind, medical or surgical. Moreover, two of the observers stated that they had treated forty other cases of biliary colic in this way without a failure, but unfortunately without keeping any accurate record of them. The committee concludes that the beneficial influence of the oil consists, not so much in dissolving the biliary concretions as in increasing the excretion of bile, and in flushing, lubricating, and washing out the passage of the liver. They also conclude that large doses of the oil are not necessary, since in eight of the cases in which it was given in dessertspoonful doses every three or four hours, it apparently produced the same prompt beneficial effect as that afforded by doses of from five ounces to one and two pints. The committee furthermore concluded that it is immaterial whether olive or cotton-seed oil is used.Br. Med. Journal, Dec. 5, 1891.

A Filter for Bacteria.-The Kieselguhr filter is made from diatomaceous earth, which has had the animal constituents destroyed by heat, and is formed into a hollow cylinder, closed at one end. This cylinder is placed in a metal receptacle and the whole covered with a metal cup, perforated at the centre for the exit of the filtered water. The water is admitted by a cock at the side and near the top of the case containing the cylinder, and forced by the pressure of the main from the outside to the inside of the filter cylinder finds exit by the tube in the centre of the cup. Weyl has examined bacteriologically the water, before and after it passed through this filter, and comes to the following conclusions: First, that this filter, after rigorous tests, is found to give a filtrate more certainly free from sediment than any other house filter on the market. Second, it is easily cleaned; the cylinder may be washed with a stiff brush, and later treated with concentrated hydrochloric acid. The fresher and cleaner the cylinder the greater amount of water is filtered. The cylinder may be easily sterilized by boiling. We think there is no doubt that this filter will intercept the pathogenic bacteria.-Berl. Klin. Wochenschr.

Popular Medicine.-Is the vulgarization of medicine a danger or a benefit to the community? If

we were contented to teach the public the precepts of hygiene and dietetics; if we would instruct them on common subjects of the materia medica; if we could warn consumers of the falsifications of foods and other alimentary products; if we convinced them of the utility of quarantine and isolation hospitals-we should accomplish a useful work. When we pretend, to the contrary, to initiate the profane into the mysteries of anatomy and physiology, by writing monographs or school text books, we engage in work that brings disaster to the profession. Medical publicity is, under certain circumstances, a powerful weapon. If its direct action is injurious; if some of the more or less positive notions that it essays to propagate return against those who use it in the vain effort to reform certain abuses and combat prejudices, which are like weeds springing up to choke and suffocate that beautiful plant, with its many roots-let us rather call it scientific progress--who need wonder? One cannot destroy that which twenty centuries of human prejudice has erected. For hundreds of years the parasite in the medical field, like the modern advertising quack, who steals the last cent of the dying consumptive, with the promise of cure-the brutish piece of humanity who barters his soul's honor for gold-has enjoyed full liberty in the medical field; and, like the fabled serpent who was cut up into sections and each section became a new snake, endowed with increased vigor, so all the attacks on charlatanism fail because it is intrenched behind the rampart of public prejudice. Medical science-strange fact but true-in diffusing instruction in popular medicine and domestic hygiene, has opened the gates for the entrance of the hosts of charlatanism. It was Fourcey who wrote: "Pretended remedies of cure and precaution have occasioned more diseases than they ever prevented. Powdered frog bones, dog oil, hog dung, etc., still have their host of followers and disciples, who deride the solid knowledge of the regular medical faculty." "Medicine," remarks Dr. Brissaud, "has for a long time been the humble servant of empiricism."-Lancet and Clinic.

Gum Chewing.-Is gum chewing harmful? In the first place let us inquire to what use the saliva of the mouth should be put. Nature has given us a pair of parotid glands that are capable of furnishing us about three pints of saliva per day. This saliva is calculated to convert the starchy portions of our food into dextrin, while being masticated before entering the stomach.

The saliva will flow just as freely while chewing gum as it will while masticating our food. Now, suppose we chew gum for one, two, or three hours before a meal, what condition are the glands in to furnish fluid to digest starch and lubricate the passage to the stomach? By that time the glands are com

pletely tired out and exhausted, and wholly incapable of doing any more work until rested, and the result is the food must enter the stomach without having the starch changed at all, and it must remain starch until it passes through the stomach into the duodenum, as the gastric fluid of the stomach will not act on starch. Fermentation will set in much more easily, and the stomach becomes sour under more slight provocation than it would if we had not chewed the gum, and the glands had been able to do the work nature designed them to do.

Suppose we should do something to drain away the gastric fluid of the stomach so that when the food enters there is nothing to act upon the nitrogenous portions (which are digested in the stomach), how long would it be before abused nature would cry out in the form of a pain in that organ?

I believe that gum chewing is rewarded in much the same way, only, perhaps, in a less degree, and is the cause of many of the sour stomachs, pinched faces and irritable dispositions we so often meet in the practice of medicine. The writer was once a gum chewer and a dyspeptic, and had all the symptoms that go with such habits. Now I am not a gum chewer, have not the dyspepsia, and enjoy good health, and desire that others should enjoy the same. Yes, gum chewing is harmful.— William F. Hubbard in The Health Exponent.

Sanitary Effects of Civilization.—The impression that civilization is fatal to the Indian constitution—that, like the hare or the quail, under efforts of taming he will pine and die—is a part truth that leads to much error. The "transition period," so indefinite and so much dreaded, has danger only under mismanagement. I will state my opinion of the matter thus: If the Indian were lifted at once from the wildest savagery in which he can now be found, to full civilization-that is, to comfortable and hygienically constructed clothing and housing, to abundant and well-prepared food, to a knowledge and practice of the rules of health governing the more intelligent individuals of the white race-his condition would at once and permanently be greatly improved as to health and longevity. On the other hand, his primitive savage state was better as to health and longevity (and in parenthesis I may add morals as well), than the partly civilized state in which he now exists. Dr. Holder in The Record.

The Proper Diet for Hot Weather.— In an article in the Gentleman's Magazine, which has been reproduced in the Popular Science Monthly for July, Dr. N. E. York Davies treats of the proper diet for hot weather.

"Breakfast, 8:30 to 9 A. M.-Two cups of tea or coffee sweetened with saccharine (?), one or two teaspoonfuls of cream in each; one ounce dry toast thinly buttered; four

ounces of grilled or broiled fish, such as plaicè, sole, whiting, haddock, cod or trout, or four ounces of cold chicken, cold tongue, or of grilled steak or chop.

"Lunch, 1:30 P. M.-Two or three ounces of cold mutton, beef or lamb; three or four ounces of green vegetables, plainly boiled, plenty of green salad, made with vinegar, but without oil; four or five ounces of stewed fruit; water with two or three glasses of pure, dry Moselle, or other Rhine wines. "Afternoon Tea, 4:30, if desired.-Two cups of tea as at breakfast; nothing to eat.

"Dinner, 7 to 8.-Julienne, or clear vegetable soup; three or four ounces of fish; three or four ounces of any red meat, or of chicken, rabbit, game or venison; six ounces of any green vegetable with gravy from the meat only; four ounces of stewed or raw fruit; a little stale or pulled bread, and a small piece of cheese."

For an American the following suggestions are made by the editor of the Boston M. and S. Journal. He rises early, and wants his breakfast by 7 or 7:30 o'clock. For this very reason that he is an early riser, and that he goes to bed early (between 9 and 10 P. M.), he does not wish his principal meal to be in the evening instead of at noon. A hearty meal between 7 and 8 o'clock in the evening would be a physiological mistake for a man who is to go to bed at 9 or 10. On the other hand, the literary man, the student, the journalist, the member of a legislative body whose principal sessions are in the night time, and all who are obliged by their special calling to retire late, need a hearty meal in the evening; and as their sleep must be largely after midnight, they will not be ready for their morning meal till about the time designated by Dr. Davies for the breakfast hour. The "typical American" takes an early breakfast, when he indulges freely in fruit, and never omits a first course of oatmeal and milk, cracked wheat or hominy; this is followed by dry toast, or buttered toast, an egg and a little cold meat or fresh fish, and a cup of coffee sweetened with sugar, not with saccharine, which is reserved for the diabetic. He would be glad of cream if it can be obtained. His dinner is the principal meal, and is always taken near the middle of the day. This is composed of soup, three or four ounces of broiled fish, roast meat, or fowl, four to six ounces of green vegetables (green peas, green beans, stewed turnips, onions, squash), four ounces of potatoes with meat gravy, with pickles and jelly ad lib. The last course, the apple, custard, or berry pie of our forefathers, doubtless does not deserve all the abuse which has been heaped upon it by our English cousins, especially when it is light, without too much "shortening," and with a well-cooked bottom crust.

The last meal, the supper, is rather taken early (as soon as 6 o'clock), and is designed to be a plain, light, substantial meal of bread and butter or tea rolls, a little stewed fruit for relish, and one or two cups of tea. The "average American" seldom eats lunch.Boston Med. and Surg. Jour., July 14, 1892.

Disinfection in France.-In a careful and detailed study of the subject, A. J. Martin (Gazette Hebdomadaire de Médicine et de Chirurgie, May 28, 1892) gives the progress that has been made in France, by public and private measures, towards securing the disinfection of rooms and articles of all kinds used by persons suffering from any of the infectious diseases. The methods principally used are steam sterilization under pressure, in chests made for the purpose, and the lever atomizers.

The burning of sulphur is falling more and more into disuse, as being injurious to articles of clothing and furniture, and preventing the use of rooms for some time; and also as being of doubtful value. A solution of bichloride of mercury, 1-1000, to which is added tartaric acid, is principally used with the atomizers. There are now 272 sterilizers and 307 atomizers in use in France, mostly under the control of the city health or hospital corporations. In cities adopting the system, disinfection is made obligatory by ordinances, in cases of death from any of the infectious diseases, including all forms of tuberculosis, or in cases where the disease has existed and been followed by recovery. The physician in charge of any such case must inform the Bureau of Hygiene. In the case of the poor the service is free, but a charge is made in other cases, and the income thus derived more than covers all expenses, notably at Nice, which is given as a model of the system. The public soon learn to appreciate the advantages of disinfection, and have it done in many cases without there being any disease present, and in Paris and Bordeaux there exist private establishments to do this work for any one desiring it. The importance of disinfecting watering places, especially on the Meditterranean, where so many phthisical patients go, is well understood, and at Mentone the hotel proprietors have formed a syndicate and bought the necessary apparatus; at the same time they entered into stringent engagements to have their houses thoroughly disinfected yearly, and freely aired; to completely disinfect at once any room occupied by a patient with an infectious disease, the floor being covered with sawdust, moistened by a solution of 1-1000 bichloride of mercury and tartaric acid before sweeping and raising the dust; all spittoons are to contain water, to prevent dessication and diffusion of the bacilli, and they are to be thoroughly disinfected daily. These various trials have shown that disinfection is practicable, and its success is assured as soon as the authorities decide to carry out the advice of hygienists.

Hypodermoklysis.-The introduction of saline infusions in the regular treatment of diseases has opened a new and extensive field for medical action. The results that have been published by careful observers of different nations have contributed to estab

lishing this method as a most powerful remedy in cases where formerly the physician was compelled to retreat with resignation from the field of action. The method of performing the infusion is very simple. A glass vessel, containing about thirty to forty ounces, is filled with a sterilized solution of 7 parts chloride of sodium and 1000 parts of water (about three and a half grains to the ounce). The temperature should be about 110° F. A glass siphon leads through a tight stopper from the vessel to an india-rubber tube ending in a large-sized trocar. A glass pipe, filled at the upper end with sterilized cotton, leads to the bottom of the vessel for the purpose of admitting the necessary air. It is unnecessary to add that the utmost care should be taken that all parts of the apparatus be sterilized. The best place for the injection is the abdomen. As soon as the trocar is pushed through the skin into the cellular tissue the saline solution is injected by holding the glass vessel about four or five feet above the abdomen of the patient. The time required for infusing thirty ounces is about five minWhile the infusion is going on, a tumor is gradually formed, the contents of which are absorbed by the cellular tissue in about three hours. While it is true that the formation of this tumor is rather painful, on account of the tension of the skin, it must be remembered that in the majority of cases in which the operation is performed the patient is in a semiconscious condition, and in the remainder it disappears in two or three hours.

utes.

(Several different spots may be selected. Ed.)

The effect of the operation in some cases is simply surprising. Where, only a few minutes before, pulse and respiration had ceased, and all hope was abandoned, a perfect change may take place, and a rather abrupt inspiration indicates the return of the patient to life. In other cases the good result is apparent more slowly, and is often denoted by increased diuresis and lower temperature. The indications for saline infusions are manifold.

They have proved successful in cases where severe loss of blood had occurred in cholera, and by Sahli, of Berne, in cases of uræmia and of typhoid fever, with excellent results. Apart from the diuretic effect of the infusions and the washing out of the system, great stress should be laid upon the fact that the specific poisons in the tissues and in the blood are diluted by the infusion. H. points out the importance of the possibility, in typhoid fever, of introducing sufficient quantities of water into the body; notwithstanding the presence of diarrhoea and prostration of the digestive organs, and thus counteracting the drying up of the tissues. Besides these cases, hypodermoklysis has been successfully employed in the following conditions: Septic blood-poisoning, diabetic coma, gastric or intestinal ulcers, and anæmia;

some earthworms were added in each pot with some of the sputa of tuberculous patients and fragments of lung from their dead bodies. A month afterward it was found that the earthworms contained tubercle

bacilli in large numbers, and that guinea-pigs inoculated with them soon died with general tuberculosis. Whatever the bacilli may be, whether tubucular, typhoid, or choleraic, in bodies buried in the earth, it is incontestible that earthworms, everywhere so numerous and active, may preserve the bacilli in their bodies during many months, still living and losing none of their virulent properties and power of rapid germination or reproduction. These are the grounds on which we assert that bodies after death from cholera ought to be cremated, not buried."-Medical Record.

in

A Post-mortem Phenomenon Cholera.-A Vienna physician, Dr. Frey, states that the supposed burial alive of patients apparently dead from cholera may be explained by the fact that the corpses of those who have died from the disease are for some time after death subject to convulsive movements of some muscles, or even of whole groups of muscles. Professor Eichhorst also relates that on one occasion he had left a patient for dead, when, three hours later, he was told that the dead man had revived. He found that the muscles of the upper arm were giving short, quick motions, following each other rapidly, which were interrupted by contractions of the whole group of muscles, whereby the forearm was visibly contracted. The fingers were also distinctly observed to be moving, as though playing a piano. It was only after three hours that the movement of the muscles ceased.-Hospital Gazette.

Papoid.-The physiological actions of Papoid as a digestive agent have been thoroughly established. It acts upon albuminoids, hydrating and converting them into peptones, as fully demonstrated by Herschell. It converts starch with great promptness, the ultimate product being maltose. It emulsifies fats. Herschell declares that it has a direct tonic action on the stomach, stimulating the secretion of gastric juice or pepsinogen. It acts at all temperatures, but attains its maxim activity at about 130 F. In several important points it differs from Pepsin. Papoid acts best in an alkaline solution, but also can act in fluids with an acid or neutral reaction; Pepsin requires an acid solution. Papoid is freely soluble, and is more active when in concentrated form; Pepsin requires free dilution. Herschell also points out the greater digestive power possessed by Papoid than either Pepsin or Pancreatine, and states "that it can be used when Pepsin is contra-indicated or powerless." Papoid has no action upon living tissues, and

is positively innocuous when swallowed in any quantity that is likely to be administered. Papoid is useful when digestion has been overtaxed, or when the secretion of gastric juice is absent or deficient. Experiments of my own and others, have satisfied my mind of the remarkable digestive activity of Papoid. In one of the experiments referred to, the constituents of a hearty dinner of bread, meat, potatoes, peas, mince-pie, and other substantials were placed in a large test-tube and treated with Papoid and bicarbo

The

nate of sodium and a small amount of water. result was very satisfactory indeed; the meat rapidly softened, and the other ingredients gradually disintegrated, forming a pultaceous mass, which finally separated into a grumuous sediment and an overlying albuminous, dark colored liquid. Papoid acts in alkaline solutions even better than in acid media. It is evident that it is specially useful where there is indigestion due to deficient secretion of gastric juice. In such cases, the administration of an alkaline solution of Papoid favors gastric digestion both directly and indirectly. and indirectly. First, by digesting albuminates and softening masses of food. Secondly, by the action of the Papoid in stimulating the secretion of the Pepsin gland. It retards the fermentation of the undigested masses of food in the stomach, and prepares them for intestinal digestion. In the contrary case, where the stomach contents poured into the duodenum are so acid that they prevent the action of the trypsin, Papoid prevents duodenal indigestion by taken the place of the Pancreatic ferment. As Herschell says, it is obviously of no use to give Pancreatine by the mouth, as it is at once destroyed by the acid of the stomach, and it is practically impossible to administer sufficient alkali to neutralize the excess of acid, and it would moreover be unwise, because it would stimulate still further the secretion of the acid. Papoid is of the greatest use here. In Gastralgia, which often accompanies the condition just named, Papoid with bicarbonate of sodium, gives immediate relief. It is also useful in irritable stomach, nausea and vomiting. In gastric catarrh and the catarrhal conditions of the intestinal tract, popularly known as biliousness, Papoid administered in hot water, fifteen minutes before meals, cleanses off the mucous, and places the mucous coat of the digestive organs in a good condition for secretion. It is useful in the treatment of irritative diarrhoea in young children, to whom it may be given in combination with Salol or Salicylate of Bismuth.

The dose of Papoid ordinarily is one or two grains, but five grains or more may be used, the only objection being that of useless expense and waste, except where very prompt effects are desired.--N. Y. Med. Jr., July 30, 1892.

Contributions and Selections.

AN OBSTETRICAL SYMPOSIUM. TRANSLATED FROM THE Deutsche Medicinal Zeitung

BY H. B. BARUCH, B. S.

PROPHYLAXIS OF PUERPERAL DISEASES.

Professor Frommel says that there are two points which have been energetically discussed among obstetricians, namely, the question of prophylactic disinfection, and the lessening of internal examinations during labor.

The author has made two series of observations in his clinic, with the following results.

From the 1st of April, 1880, to the 15th of November, 1890, there were 559 labors.

Among the cases, whenever it was possible, the women received a full bath, were supplied with clean linen and were confined to bed. Then the external genitals were washed with sublimate solution (1-2000) and the vagina rinsed out with the same solution, and the last year the mucous membrane was at the same time gently manipulated with the fingers.

Of these 559 only five died during the puerperal period. The first died, after a feverless illness, of emboli of the pulmonary artery, the second of croupous pneumonia, the third of carcinoma of the vulva, the fourth from a hemorrhage resulting from the rupture of a large vessel in the ligamentum latum, and in the fifth case alone did an infection set in, originating in bed sores on the completely everted mucous membrane of the vagina. This woman was already in labor, and feverish when admitted.

As this last case may be excluded, prophylactic disinfection may be credited with a mortality of O per cent.

The morbidity in the preceding years varied from 5 to 7 per cent., wherein each rise of temperature above 100 2-5 was so regarded.

From the 15th of November, 1890, until the 11th of December, 1891, 187 cases were confined.

In these, the vagina was no longer disinfected, but here, as formerly, the hands and instruments were most carefully disinfected. The result was at first most favorable. Among about 100 labors there was not a single serious puerperal disease. On the last day of May a woman entered the clinic who had already been treated by a midwife, and who died of a septic peritonitis. Now there followed another favorable period until August, during the course for midwives. A woman fell sick and rapidly failed from sepsis. On the 12th of December a third case resulted unfavorably under the same circumstances. The mortality, during this second period, was 11.1 per cent.

After this very unfavorable result the author considered the cleansing of the vagina, before the confinement, of the utmost necessity.

As to the question raised by Veit, Créde and Leopold about the lessening of the internal examinations, the author says that in obstetrical clinics these must, in the interest of instruction, be practiced. But it should suffice if the student examines once during the beginning of labor, once after the rupture of the membranes and once to determine the direction of the head.

Obstetricians, the author continues, can indeed diminish the number of their internal examinations to a minimum, and indeed, cease them altogether.

The physician, and the young physician in particular, who often has not attended more than the prescribed number of births for his examination cannot relinquish them altogether.

As an equivalent for the danger incurred by these examinations, the practitioner should bring with him from the university a thorough knowledge of prophylactic disinfection in puerperal diseases.

2.-PROPHYLAXIS OF PUERPERAL DISEASES.

PROF. HOFMEIER.

Prof. Hofmeier opposes the oft-expressed advice of famous obstetricians of the present time, to diminish