trickle down along the side of the tube, held horizontally nearly, so that the two fluids may touch, but not mix. If bile pigment be present, a fine green color will at once be developed below the red Iodine layer. Noel's Test, Pettenkofer's Test, Nitric Acid Test, Oxide of Silver Test.

Sugar, if necessary. Urine containing sugar is usually light-colored, froths readily when poured from one vessel to another, and has a high specific gravity. Fehling's Test, as follows: Add to the boiling urine a few drops of freshly-prepared solution of PotassioCupric Tartrate (Fehling's Solution). If sugar be present, a yellow, orange, or red precipitate of Cuprous Oxide will form, 10 cubic centimeters of the solution being reduced by 0.05 gram. of diabetic sugar. To prepare Fehling's Solution, dissolve 34.639 grams of pure, crystallized Copper Sulphate in about 200 grams of Distilled Water; also 173 grams of chemically pure, crystallized, neutral Tartrate of Sodium in 500 or 600 grams of a solution of Caustic Soda, of specific gravity 1.12, pouring the first solution into the latter, slowly and a little at a time. The clear, mixed fluid is then diluted with distilled water up to a litre. This solution soon spoils, and must be kept in a dark, cool place. Much more convenient are Dr. Piffard's Cupro-Potassic Paste, and Dr. Pavy's Cupric Test Pellets (see Tyson on Urine, page 57); and still more handy are Wyeth's Compressed Tablets for preparing Fehling's Solution of Potassio-Cupric Tartrate, U. S. P. 1880, a box of which costs 50 cents, and may be obtained from any good drug-store. The writer has used these Tablets for some two or three years, with extreme satisfaction.

Pavy's Solution is a modification of Fehling's, is equally good for qualitative and volumetric testing, and is intended for those who prefer the apothecaries' weights and measures to the metric system. It is made in the same manner as Fehling's, 100 minims corresponding to 1⁄2 grain of diabetic sugar, and consists of-Copper Sulphate, gr. 320; Potassium Tartrate (neutral), gr. 640; Caustic Potash, gr. 1280; and Distilled Water, f3 20.

Other Tests for Sugar are Bottcher's Bismuth Test, the Fermentation Test, Moore's, Trommer's, the Picric Acid and the Indigo-Carmine. They are all useful, but will not be detailed here, as one good method is all that the average practitioner wants.

Chlorides. Add a drop of Nitric Acid, and then Silver Nitrate until a precipitate ceases to form. Thus estimate the amount of Chlorides.

Urea. Place a drop of urine on platinum foil, and to it add a drop of Nitric Acid, and leave undisturbed in a cool place for a minute or two. If the urea is in excess, crystals of Uric Nitrate form immediately.

To ascertain the percentage of urea present, use Parke, Davis & Co.'s Ureometer, employing the Solution of Hypobromite of Sodium, instead of the Solution of Chlorinated Soda, the former giving much the best results. This apparatus is simple, reliable, and quite accurate enough for clinical purposes.

Mucus and Pus resemble each other so closely under the microscope, that it is almost impossible for any one, except an expert, to distinguish between them thereby. Mucus is more cloudy and flocculent to the naked eye than Pus, which latter is generally of a stringy consistence and thickish yellow appearance at the bottom of the vessel. The supernatant liquid being poured off, and an equal bulk of Liquor Potassa added, the deposit, if containing much pus, becomes gelatinized, and so tough that it cannot be poured out. If Mucus, Acetic Acid added coagulates it, forming delicate molecular fibres.

Other Deposits are best examined with the microscope, and compared with good plates, rather than with printed descriptions. The plates in Hoffman and Ultzman on Analysis of the Urine, will answer the wants of most general practitioners, but the text follows the metric system. The urinary deposits may be classified thus:

Necessary Apparatus. A dozen test-tubes. Alcohol lamp. A small porcelain dish. 2 watch glasses. A sheet of platinum foil, 4 inch square. 3 pipettes of different sizes, to be used only for urine. A 2-oz. graduate. Urinometer. Blue and red litmuspaper. The reagents mentioned above. A little Grape-sugar, for use in testing the Fehling's solution. Ureometer (Parke, Davis & Co's).

The foregoing directions comprise all that the average practitioner will usually perform in the matter of urinary analysis. For fuller directions, the reader is referred to one of the numerous manuals on the subject, among which may be mentioned Da Costa on Medical Diagnosis, Chapter VII.-Tyson on the Practical Examination of Urine,—and Sir Henry Thompson's Clinical Lectures on Diseases of the Urinary Organs, Lecture

XXIV.

A" Physician's Pocket Reagent Case," intended for urinalysis at the bedside, is put up by Parke, Davis & Co., and sold at the low price of $1.50. It contains a set of Dr. Oliver's Test Papers, a color scale, specific gravity beads, two test-tubes, a pipette, and full directions for the use of the reagents, which are to be absorbed by the test papers.

ETHICS.

The Hippocratic Oath.-I swear by Apollo, the physician, and Æsculapius, and Health, and All-heal, and all the Gods and Goddesses, that according to my ability and judgment, I will keep this oath and this stipulation :-to reckon him who taught me this Art equally dear to me as my parents, to share my substance with him and relieve his necessities if required; to look upon his offspring in the same footing as my own brothers, and to teach them this Art, should they wish to learn it, without fee or stipulation; and that by precept, lecture, and every other mode of instruction, I will impart a knowledge of the Art to my own sons, and those of my teachers, and to disciples bound by a stipulation and oath, according to the law of medicine, but to none others. I will follow that system of regimen which according to my ability and judgment I consider for the benefit of my patients, and abstain from what is deleterious and mischievous. I will give no deadly medicine to any one, if asked, nor suggest any such counsel; and in like manner I will not give to a woman a pessary to produce abortion. With purity and holiness I will pass my life, and practice my art. I will not cut persons laboring under the stone, but will leave this to be done by men who are practitioners of this work. Into whatever houses I enter, I will go into them for the benefit of the sick, and will abstain from every voluntary act of mischief and corruption; and further from the seduction of females or males, of freemen and slaves. Whatever, in connection with my professional practice, or not in connection with it, I see or hear in the life of men, which ought not to be spoken of abroad, I will not divulge, as reckoning that all such should be kept secret. While I continue to keep this oath unviolated, may it be granted me to enjoy life and the practice of the Art, respected by all men, in all times; But, should I trespass and violate this oath, may the reverse be my lot! [Adam's Genuine Works of Hippocrates, Sydenham Society, London, 1849.]

EXTRACTS FROM THE CODE.

Consultations should be promoted in difficult cases. During them no jealousy or rivalship should be indulged. Candor, probity, and all due respect should be exercised toward the physician in charge. The attending physician should first question the patient, the consulting one afterwards putting such other questions as may seem fit to further elucidate the case. The discussion should take place in a private place, and no opinions delivered which are not the result of concurrence. In discussion, the attendant delivers his opinion first, the others in the order in which they have been called.

A Regular Medical Education furnishes the only presumptive evidence of professional abilities and acquirements, and ought to be the only acknowledged right of an individual to the exercise and honors of his profession. No one can be considered a fit associate in consultation, whose practice is based on an exclusive dogma, to the rejection of the accu mulated experience of the profession.

Punctuality should especially mark the keeping of these engagements; if one of the parties be delayed, the other should wait a reasonable time, and then, if the attendant, prescribe; if the consulting, he should retire, unless the case is urgent or he be called from a distance, when he should prescribe for the emergency or leave a written opinion under seal. All theoretical discussions should be avoided. Should diversity of opinion

SPECIFIC GRAVITIES AND SPECIFIC VOLUMES.

725

prevail, the majority should rule; should the numbers be equal on each side, the decision should rest with the attending physician. The consulting physician should always justify, as far as may be consistent with truth, the course pursued by the attending one, and no hint impairing confidence in him, or his reputation, should be thrown out. A double fee should be expected in all consultations.

Interference.-A physician should not visit or prescribe for a patient who has been under the care of another for the same malady, unless in, Ist, a case of emergency; 2d, of consultation; 3d, of relinquishment, by the physician, of the case; 4th, or a regular notification to him that his services are not longer desired. When the case is assumed by another, he should indulge in no insinuations against the former attendant. If called because the family physician is not at hand, or is sick, he should resign the case to him on his arrival. In case several physicians are simultaneously called, as in accidents, the first arriving should take full charge of the case, unless the family attendant be present, when he should assume the charge; if not present, he should be sent for, and the further treatment resigned to his hands.

Miscellaneous.-A case should never be abandoned because it is supposed to be a hope

less one.

Contumelious and sarcastic remarks relative to the Faculty, as a body, should always be avoided. "It's a foul bird that fouls its own nest."

It is held unprofessional to resort to "public" advertising, to hold a patent upon an instrument, or to dispense or prescribe a secret nostrum.

Gratuitous services should be given to an afflicted brother practitioner. If compelled to temporarily suspend his practice, on account of sickness, the physician who has been invited to take charge of his cases should turn the accruing fees over to the sick one, save in surgical or obstetrical cases.

TABLE SHOWING THE NUMBER OF DROPS IN A FLUIDRACHM OF VARIOUS LIQUIDS, ALSO THE WEIGHT OF ONE FLUIDRACHM IN GRAINS.

Pound. Ounces. Drachms. Scruples. Grains. Gallon. Pints. Flounces. Fl'dr'ms. Minims.

TABLE FOR CONVERTING APOTHECARIES' WEIGHTS AND MEASURES INTO GRAMS.

Lighter than water are tinctures, spirits, compound spirit of ether, sweet spirit of nitre, fixed and volatile oils. Ether Fortior, f3j = grams 2.80.

Same as water are waters, liquids, decoctions, infusions, most fluid extracts, and tinctures made with dilute alcohol. Heavier than water are syrups, glycerin, a few fluid extracts, and chloroform. Of the latter, f3j grams 5.50.

=