mentioning is that physicians often judge heart-action merely by "taking the pulse," and are thereby deceived as to the true condition of the heart. There are times when the pulse may be almost imperceptible, and yet when the ear is placed to the chest it will detect a hard-working heart, which has all or more contractile force than it can maintain. Vasomotor disturbances of the vessels produce this condition, and digitalis will then do harm.

We might name the many faulty anatomic conditions of the heart in which digitalis is useful, but as exact physical diagnosis is not always easy it is better for the practitioner to depend upon the symptoms of weak action than to attempt hair-splitting anatomic diagnosis. Lack of propulsive power due to heart debility is the best indication for digitalis.

As a rule digitalis is contraindicated by simple compensatory hypertrophy, in fatty heart, atheromatous vessels, aortic stenosis, excessive dilatation, or in flabby heart-muscle, with degenerative changes.

Let us briefly enumerate the direct indications again: Weak, rapid, irregular heart-action, with low arterial tension; weak heart sounds; dusky countenance, jugular pulsation, cough, and dyspnea; edema, with weak heart action; anasarca, with scanty, high-colored urine; renal congestion. It is useful as an antidote to aconite poisoning, but is very slow in action, having to be first preceded by rapidly acting stimulants.

THE INDICATED REMEDY-TELA ARANEÆ. This agent, once much in vogue as a remedy for certain malarial manifestations, has a very circumscribed field of action. It is indicated, however, in conditions which few agents meet, and the guiding symptom is prolonged chilliness. Aconite will meet evanescent chills, particularly those followed by a rise of temperature, but it is of no service where chilliness is prolonged. Capsicum will remove chilliness due to atonic gastric troubles or to impaired circulation. But tela is the endorsed remedy for chilliness of protracted character. The trouble may or may not be of malarial origin, or it may be purely neurotic. This form of chilliness is often experienced by persons visiting a new locality, especially those from the Middle and Eastern States visiting the Pacific Coast. The indications are: Debilitated subjects of neurotic tendency with cool, clammy skin, with protracted sensation of chilliness

with or without nervous complication, especially where periodicity is present. (Webster.)

A writer (Dr. Perce) in the Eclectic Medical Journal some years ago gave as the specific indications for tela the following: "Masked periodical diseases in hectic, broken-down patients; in all diseases that come up suddenly with cool, clammy skin and perspiration, and cool extremities; in nocturnal orgasm of either sex; numbness of the extremities when sitting still or lying down. It relieves spasms of the arterioles and stimulates capillary circulation. It relieves hyperesthesia of the cerebro-spinal nerves and the great sympathetic, that depends upon debility. It is the greatest heart stimulant in the materia medica, and lobelia is only second to it." (American Dispensatory.)

EXAMINE THE URINE.-Every sick patient is entitled to a thorough examination. Too often, however, an examination of the urine is neglected. This thought has been recently impressed by the revelations in several cases of disordered health in which the symptoms were quite diverse. In each of these cases a single symptom, together with the facial expressions, led to an investigation of the urine. One complained of an intense neuralgic headache, worse at night and upon lying down. There was also some gastric flatulence. Another complained of intolerable itching about the anus. The third urinated frequently, but not copiously, but the urging was imperative. The fourth experienced an otherwise unaccountable fatigue and gastric distension. A fifth one had a sudden attack of cardiac palpitation, the heart also skipping every third beat. Urinalysis revealed the presence of sugar in each of these cases.

AMONG THE ECLECTIC EDITORS.

Beestings and Such.-In collecting material for a recent materia medica study on Apis, our researches led us into the entire subject of bees, their habits, and the effects of the stings of bees. Among other things came to light, in Motherby's "Medical Dictionary," 1775, the following definition:

"Beestings is a common name applied to the first milk of a fresh cow. It is technically called 'colostrum,' and is defined as 'gently cathartic."""Motherby's Medical Dictionary," 1775.

Lo and behold, instead of "Beestings” being connected with the bee, or with honey, it there applied to something widely different!

Concerning this action of the milk of a fresh cow, we note that among country people the opinion still prevails that it acts as a cathartic, and also that the first mother's milk a new-born babe receives is reputed to be cathartic. This leads us to a subject that may perhaps be exceedingly useful to the makers of serums and such, for certainly there is herein some foundation, which is not always to be said of some of the serums offered at exorbitantly high prices to the medical profession for the cure of diseases of human beings. But, to our text.

Recently we learned that the serum drawn from the leg of a dropsical woman had been discovered to be a wonderful cure for the dropsy, and it is likely now to be furnished in ampules, containing some thirty minims, at a dollar or more an ampule. When this fad has run its course, something else in the serum direction, possibly as elegant, will be discovered to take its place, perhaps at $1 per thirty minims.

One of our friends, whose wife is afflicted with a cancer and who had become despondent over cancer cures in America, read about a marvelous discovery in that direction by a talented physician, a medical authority in Italy, and immediately started with his wife, for the purpose of having the treatment applied. It proved to be a serum treatment, exceedingly "scientific," as science is now applied to medicine, and may be described as follows:

A juice obtained from a six-months fetus, still-born, is carefully bottled and "scientifically" injected into the cancerous tissue, with results so marvelous as to have made a tremendous reputation for this exponent of advanced medical thought in Europe, and perhaps of no less advanced medical thought in America.

Thus our friend and his wife went to Naples, expressly to obtain the benefit of this marvelous cure. But recent letters from him indicate that in her case the serum of the dead fetus seems not to have mastered the cancerous growth, and he is therefore despondent. After having made this long journey and this great outlay of money for this exceedingly "scientific" opportunity, he may perhaps join the "Medical Nihilists," who are schooled in the serum direction.

But let us return to the "Beestings," our opportunity for theorizing therefrom having at least some foundation, which perhaps may not be said of either the dropsy-cure serum from the old woman's dropsical leg or the cancer-cure serum from the juices of the still-born child. Why not take the milk of a mother afflicted with a cancer, pass it through a porcelain filter, and use the fluid as a serum to cure cancer in other people? Why not take the milk of a mother afflicted with rheumatism, pass it through a porcelain filter, and bottle it as a cure for rheumatism? Why not, in like manner, obtain serum from somebody afflicted with the measles or other disease, and then, having injected it into the veins of a mother with a new-born babe, from

her milk strain out a serum to treat the measles? And thus with all other diseases to which humanity is heir? A beautiful conception this, freely offered to the serum therapist, whose excruciatingly "scientific" methods lead us backward in thought to the days of Motherby, of Salmon, and of others whose works in these directions a couple of hundred years ago can give lessons to-day to even the extremists of all these modern serum faddists.

At any rate, if the serums we have indicated fail to accomplish their purpose in the alleviating of disease, they will not fail to bring a great financial return to their makers, possibly a dollar for thirty minims, nor will they fail to permit some talented physician of the Old World, perhaps even of the New, from making a reputation in the newspapers and elsewhere, in the face of many patients such as the wife of my friend who, as has been related, has at least accomplished one object, that of the expenditure of a large amount of money!-Lloyd, Eclectic Medical Journal, June, 1912.

Summer Diarrheas.-In the treatment of summer diarrheas we are laying more stress than ever upon the thorough cleanliness of the gastro-intestinal tract-upon the non-fermentation of food, and upon its immediate and direct appropriation. All of these points must receive a most careful attention, and those who are not familiar with the specific action of drugs, directed to minor but important indications, endeavor to cure their patients with this course alone.

While all these points are having most perfect attention, the specific prescriber will have his eye open to every possible indication for direct medication, and when these are clearly outlined the exact remedy will produce wonders.

Acidity in excess must be done away with. The pointed tongue with reddened tip and edges suggests gastric irritation, and this must have its specific remedy properly adapted. The remedy that will relieve this usually relieves nausea also.

Thorough colonic flushings are of more value in childhood even than in adults, and these must not be neglected. Minute doses of ipecac for simple diarrheas with aconite, if there be the least temperature, will often act much more specifically than more direct astringents, but in simple cases without inflammation, geranium is a marvelous remedy. Neutralizing cordial has always had its place in neutralizing acidity. There is an occasional case, however, in which, from the decomposition of the sugar in it, glyconda is the superior remedy.

If on palpation of the abdominal walls tenderness is found, bryonia must not be neglected, as this prevents a development of acute inflammation. If colic pains radiate from the umbilicus, minute doses

of nux vomica or very small doses of colocynth will correct these pains and promote the action of the other indicated remedies.

There is one indication in acute diarrhea that can be better met with the arsenite of copper than any other remedy, and that is a diarrhea in which there are large, copious, watery discharges which contain but little fecal matter, though they may have a greenish tinge from liver faults. This remedy is most reliable in this form of diarrhea.

Nervous irritation must always be met with a direct remedy. Gelsemium can be usually adjusted, or a trituration of the mono-bromate of camphor will be found excellent. In cases with a tendency to acidity, two or three grains of sodium or strontium bromide will be found very serviceable repeated as needed.

There are certain cases in which the mucous membranes of the mouth and tongue are dark, where the tongue is inclined to be dry, with a brownish coat. In these cases acids are indicated, and the best of these for diarrhea is the aromatic sulphuric acid.

If with the above indications there should be tympanites, especially if there should be a steady aching pain through the abdomen, turpentine should be given in one, two, or three-drop doses every two hours, according to the age of the patient. It is best given in emulsion or on loaf sugar.

As stated at first, while the attention to the food and conditions are absolutely necessary, and while care in adjusting the food during convalescence of the patient is vitally important, the physician must not overlook any of these apparently minor indications for specific drug action. The life of the patient in many cases depends upon this acute observation.-Ellingwood, Ellingwood's Therapeutist, June, 1912.

Care in the Use of Digitalis.-When administering digitalis in large doses, the heart being exceedingly feeble, bear in mind that the patient must not rise quickly to a sitting posture after having been lying down for some time. The patient must be cautioned in this and must rise slowly, giving the heart plenty of time to readjust itself. From the influence of the remedy upon the heart muscle, quick adjustment to changed conditions is not possible. There will be dizziness, rapid and feeble pulse, difficulty of breathing, and perhaps some cyanosis, in the effort the heart makes to readjust itself, and if this is repeated death may occur.

In any heart disorder where digitalis is used, if these symptoms are apt to occur with headache, vertigo, and disordered vision, digitalis must be discontinued. In aortic stenosis and in most cases of mitral stenosis, digitalis is positively contraindicated.-Ellingwood, Ellingwood's Therapeutist, June, 1912.