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every one or two hours, according to the severity of the diarrhoea. While many report failures with epilobium, it has been our happy experience to be able to control the diarrhoeal discharges with it without difficulty.

HYDROCHLORIC ACID.-The indication for an acid is usually present in this fever, and to meet that condition hydrochloric acid is most efficient. It helps to keep the secretory glands in good condition and favors the stomachic digestion of food. Moreover, it is a pleasant sour to be added to drinks, and is decidedly antipeptic and anti-typhoidal in action. It is called for by the long, red, and pointed tongue, dry as a bone, and sordes upon lips, teeth, and tongue. Few cases of typhoid fever will be encountered which do not require the grateful assistance of hydrochloric acid medication. Use just enough of it to make the drinking water pleasantly sour.

POTASSIUM CHLORATE.-This is the agent to control decay and stench. The unhealthy secretions which gum up the mouth, thick, stinking saliva, and broken-down oral epithelia, and offensive urinary and bowel discharges can be largely deodorized by the judicious use of potassium chlorate. The destruction of these vitiated products does away with the probability of their absorption, and sepsis is thus largely restrained. When given in small doses, two or three grains, in plenty of water, three or four times a day, we have never observed any kidney damage from it. In fact, only salutary effects have come from its use; and we have used it almost daily in the varied needs of practice for many years. Indeed, we would feel at a loss without the help we derive from potassium chlorate where the secretions have a cadaverous odor.

THE INDICATED REMEDY-SANGUINARIA.-By our American progenitors in medicine sanguinaria or blood-root was held in high repute. Their use of it, however, was of the heroic type, it being chiefly employed as an emetic, escharotic, and stimulant wash for various ulcerations. Thacher brought its pulmonic qualities to the attention of doctors, while Colden used it in jaundice. To-day, though it might advantageously take the place of some of the hepatic stimulants, it has for this purpose fallen into unmerited neglect. Even its pulmonic virtues are being forgotten, though there are many, whom fashions in medicine do not easily

carry into the changing currents of time, who still employ sanguinaria with decided benefit in afflictions in which cough is a prominent symptom. The mistake in its earlier employment, as we view it, consisted in the use of too large doses, resulting in a too vigorous action. When used in very small doses it has at least two well-defined fields of action, and in these it will well repay study and further development-we refer to hepatic and cholic disorders and to diseases of the respiratory tract. Catarrhal jaundice of a non-obstructive type, gastric and duodenal catarrh, all dependent upon a torpid action of the liver, with deficient, suppressed, or vitiated biliary supply, and when the circulation is feeble and sick-headache accompanies, sanguinaria may correct. Upon the respiratory tract it acts somewhat like lobelia, re-establishing secretions when scanty and restraining them when profuse. This it does by correcting the underlying conditions and promoting normal activity. Thus it finds a use in acute and chronic bronchitis, in acute laryngitis, relaxed sore throat, mucous croup, whooping cough, and humoral asthma. It is not without value to allay cough in some cases of phthisis, and in pneumonia we have used it with decidedly beneficial results as regards the quieting of irritation and liquefying of tenacious secretions. The indications for sanguinaria are: Feeble circulation with cold extremities; red and irritable mucous membranes; sensation of burning and itching of the mucous surfaces, particularly of the fauces, pharynx, nasal and aural passages; "less frequently of the larynx, trachea, and bronchia; occasionally of stomach and rectum, and rarely of vagina and urethra;" irritative cough and irritating discharges; distress at post-sternal notch, with dry, rasping, or explosive cough; the throat feels as if the walls rubbed each other. Sanguinarine nitrate meets the same indications.

THE MEDICINAL RELIEF OF CONSTIPATION.-Physicians and other people have learned to their sorrow that ordinary constipation, that not dependent upon intestinal disarrangement or other organic conditions, is not easily overcome by heroic measures. Cathartics have had their day, and while giving temporary relief often leave the patient in the conditions of the Scriptural woman who suffered much at the hands of physicians and whose last state was worse than her first. Of course, the ideal way of overcoming

most cases of constitution is by the proper regulation of the diet, and such mechanical means as massage, vibration, etc., and occasionally, in low impaction, the gentle use of the high colonic flush. Most people, however, will not carry out instructions intelligently; and if not given medicinal relief by the doctor, will seek relief at the hands of some other physician.

If constipation is very marked, the occasional use of hepatointestinal stimulants may be useful. One of the most efficient of these is the aloin, belladonna, ipecac, and strychnine combination, of which I prefer over all others I have ever used, both for kindly action and efficiency, the Lapactic pill. Another excellent agent which is not only laxative, but tonic to the intestinal tract, is the fluid extract of cascara sagrada. Many excellent combinations are upon the market, but the following, which can be prepared by the physician himself, is an excellent agent: R. Fluid extract of cascara, 3ii; essence of anise, 3i; fluid extract of licorice, zi; simple syrup q. s., 3vi. Mix. Sig. One teaspoonful at bedtime, or twice a day if required. If one does not object to the bitterness, the fluid extract may be taken in water without further additions. While such preparations as we have mentioned give one a good start in treatment and satisfy the patient, further measures should be taken toward a cure of the habit. The patient should be instructed to make the effort to evacuate the bowels at exactly the same period of the day, repeated day after day. If failure results, a second attempt should follow in about onehalf hour. No violent straining should be indulged in, for that nearly always defeats the object sought. The mental attitude also has a remarkable effect in aiding evacuation. Persistence is usually rewarded by success.

Meanwhile agents should be given to correct abnormal intestinal and stomachic conditions. Proper secretion must be encouraged, and for this purpose there are some specific medicines which will work wonders, will not do harm like cathartics, and will aid if anything will to restore normal functioning of the intestinal glands and musculature. A mere mention of these is sufficient, and if given a fair and persistent trial, will, we are satisfied, give satisfactory results. Try one drop of specific lobelia four or five times a day; or one drop of specific nux vomica in a glass of water before breakfast; or five drops of specific hydrastis in water three or four times a day. Podophyllum, leptandra, tarax

acum, and like agents in small doses may aid, but if given in too large amounts will give the pernicious effects of catharsis. The main thing is persistence in medicines which in small doses gently stimulate secretion. Violent methods are harsh, unsafe, and disappointing.

SODIUM SALICYLATE.-The vicissitudes of the season are the occasion of pain-pain of a rheumatic or of neuralgic type. For pain of the first type, and indeed for the underlying rheumatic cause, no agent is more generally efficient than sodium salicylate. In recent years some have sought to substitute aspirin for the sodium salt, but in our experience, while often capable of promptly relieving the pain, we have encountered from its use disagreeable nausea and vomiting and profuse sweating. But for acute headache, brought on by colds and acute catarrh, for neuralgic headache in rheumatically inclined individuals, and for acute rheumatism, to control pain, shorten the course of the disease, lessen its severity, to prevent cardiac and other complications, and to allay the fever, sodium salicylate has been all that could be desired. We are careful, however, about the preparation employed. We use only the product prepared from wintergreen oil or the product from birch oil. That derived from coal-tar should not be used, for from it have come most of the cardiac accidents, the gastric distress, and other unpleasant effects attributed to salicylic acid and the salicylates. We find that while sodium salicylate has one drawback-the production of marked lassitude that this is so greatly overbalanced by its good effects as to prove of little consequence. Again, the disagreeable sweetish taste can be made somewhat palatable by judicious combination with agents which either do not impair its efficiency, or may even enhance its virtues. Nothing adds to its palatability so much as fluid extract of licorice: to this may be added essence of wintergreen, itself antirheumatic, or essence of peppermint or anise or cloves. These alone, without the licorice, do not so satisfactorily mask the unpleasant sweetness of the salt. To aid its efficiency, macrotys, bryonia, colchicum, or iodide of potassium may be combined with it when well indicated. That it is an ideal anti-rheumatic is certain; but its effectiveness and kindly action depends upon the quality and source of the salt employed. The considerably higher price of the better article should be no bar to its employment, for the returns in efficiency of action and the reputation the prescriber acquires

for the quick relief of rheumatic pain far more than compensate for the difference in price. Use only the best drugs: they pay large dividends in the long run.

BED SORES.-Among the most annoying features of prolonged illness or cases of injury are bed sores. Where caused by pressure or prolonged contact with the bed, as in cases of fracture, such sores are amenable to treatment; but when the integrity of the nerve supply is impaired, then it is often extremely difficult to bring about a repair of tissue. Rubber rings partially inflated aid by taking off the pressure, but often alone fail to relieve the distressing complaint. The following preparation has promptly healed bed sores of the pressure type in several instances: . Pulverized camphor, 3ss; boric acid, 3i; bismuth subnitrate, 3i; petrolatum, adeps lanæ hydrosus, aa zi. Mix. Apply spread upon smooth, sterile cloth. This is particularly soothing, grateful, and healing in bed sores of the aged.

AMONG THE ECLECTIC EDITORS.

The "Still Small Voice" in Medicine.-The wind and the sun were disputing which was the stronger. Suddenly they saw a traveler coming down the road, and the Sun said: "I see a way to decide our dispute. Whichever of us can cause that traveler to take off his cloak shall be regarded as the stronger. You begin." So the Sun retired behind a cloud, and the Wind began to blow as hard as it could upon the traveler. But the harder he blew the closer did the traveler wrap his cloak round him, till at last the wind had to give up in despair. Then the Sun came out and shone in all his glory upon the traveler, who soon found it too hot to walk with his cloak on. "Kindness effects more than severity."-Esop's Fables.

"And after the earthquake a fire; but the Lord was not in the fire; and after the fire, a still small voice."-1 Kings 19: 12.

In the quotations given above, we recognize wanderers from times gone by that by many writers have been dressed up in different languages, but the fact remains that ever the still small voice is mightier than the wind that rends the mountains.

Paralleling these passages we find the record of the men in medicine and in pharmacy, teaching that heroic medication and cruelty to the sick are less effective than the kindly touch of a harmless remedy.

Not long ago, does it seem, since in heirloomed prejudice we questioned the value of the small dose of aconite and of other drugs for which John M. Scudder pleaded in behalf of the "still small voice."

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