There are three distinct departments of medical practice which necessarily claim the attention of the physician. The mechanical or surgical, chemical and functional. In each we have as many distinct classes of remedies. The surgical embraces those forms of disease where the knife of the surgeon is required, or some mechanical apparatus to sustain weak, broken or diseased parts of the body. This department is in a much more honorable position before the world than the others.

The chemical department consists in the use of certain substances which are supposed or known to neutralize certain other substances in the human body acting as the cause of disease. This is an important department and requires great wisdom in its administration. It is that in which, if any, the use of poisons may be admitted. That one poison may, and often does, neutralize another and render the compound more harmless than either of the substances alone, is an established fact. But no department in the practice of medicine is more liable to abuse than this. To make a laboratory of the human stomach and introduce substances inimical to the human body, is an operation requiring both caution and skill. We believe this is sometimes done and valuable lives are thus saved. But we have reason to fear that, by the indiscriminate use of these chemicals, many diseases have been aggravated, and from being simple and harmless, if left to the natural healing power, have become complicated and dangerous. Many physicians use calomel, corrosive sublimate, Fowler's solution and others equally virulent, with seemingly little reflection as to the object they have in view in giving them, or the nature of the articles themselves. Thus lasting sickness is entailed or life

immediately destroyed.

It is upon this department more than any other the united wisdom and experience of our eclectic physicians should be concentrated. Having left the simplicity of the practice of the founders, we are in danger of drifting upon the very rocks that have nearly shipwrecked the old school. Our annual gatherings should find us prepared to take a step forward in rational practice. In doing this we shall merit the name of reformers.

The last thought upon which we can dwell is the use of a most simple but efficient remedy in acute or functional forms of disease. This class embraces the largest part of a physician's practice, colds, coughs, congestions and inflammations, including a great variety of fevers, such as typhoid, scarlet, measles, etc. All come under the term of acute or functional diseases. For these SIMPLE WATER is the most efficient remedy. I make this statement boldly, having had many years of observation and experience in a large practice. It would, no doubt, be interesting and profitable to give many of the cases in detail which have been treated with water alone; suffice it say that the use of water in these forms of disease is both rational and practical. Understanding a few simple principles, any one can successfully apply them. These simple principles relate to the state of the temperature, or heat of the body. If cold, or below the natural standard (98), then use hot water. If not, or above that standard,

use cool or cold water, remembering that by evaporation water at any temperature has a great tendency to cool the body. Care and discretion must always be exercised so as to secure just the desirable temperature. Zymotic diseases, such as measles, scarlet fever, diphtheria, etc., cannot rage if the temperature is maintained at the natural standard.

The application of water for the above purposes suggests itself readily to any one. It requires more time and space than are allowable in an essay of this kind to give specific observations. If any desire to pursue the study more in detail they can find opportunity by consulting the standard publications, giving many most interesting cases of the various forms of acute and malignant fevers, treated simply with water, with a success that surpasses any thing known in any other practice.

Trusting that the foregoing suggestions will awaken inquiry, and lead our noble band of practitioners to a more simple and efficient practice of medicine, is my sincere desire.

DIPHTHERITIS.

BY JAMES TYLER, M. D., of Brockport, N. Y.

I regard diphtheria as one of the modifications of scarlet fever; I have come to this conclusion after a thorough investigation of the two diseases. The reason for these conclusions are the striking resemblance of the diseases in many particulars, and the still more positive evidence that diphtheria frequently assumes the character of simple scarlatina, while in other cases scarlatina not unfrequently is converted into genuine diphtheria. In order to obtain fuller understanding of these supposed distinct affections, let us analyze their respective symptoms. In scarlatina the child is seized with rigors and chills, lassitude, debility, albuminaria, quick, wiry pulse, light furred tongue, a hot and dry skin, and in the anginose form of the disease, with congestion of the fauces, thickening of the lymphatics about the neck, and not unfrequently more or less catarrhal symptoms. In diphtheritis the patient complains of lassitude, headache, loss of appetite, has rigors and chills, albuminous urine, active and quick pulse, a light furred tongue, redness of the fauces, enlargement of the lymphatics about the neck, a hot, dry and pungent surface, and in most cases a copious exudation from the mucous capillaries of the upper air passages. It will be observed that the name diphtheria comprehends the different forms in which it manifests itself, though they may not all be present in each individual case. The first symptom which presents itself in this disease is the local trouble in the throat. The parts are first inflamed, after which an exudation of a grayish white membrane is observed upon the tonsils or uvula, or both. It sometimes shows itself upon the mucous membrane of the nose, the mouth, the conjunctiva, the vagina and anus. In fact all mucous surfaces are liable to be attacked with the disease. When the disease attacks the throat, as it does in almost all cases, it spreads to the larynx and air passages, and produces death by suffocation. If the membrane is allowed to remain on the tonsils and is not removed, absorption takes place, the blood is poisoned, and death will result from the seventh to the ninth day. Diphtheria attacks children from the first to the tenth year of life. It is the most fatal from the third to the sixth year of life. There are three forms of this disease, the catarrhal, croupous, and the malignant. The only partial difference between scarlatina and diphtheritis is the peculiar inflammation of the throat. The only essential difference between the general symptoms of scarlatina and diphtheritis are those which relate to the local affection, or the peculiar inflammation of the throat. Even in this respect, in the anginose form of scarlatina, the symptoms are almost identical. The exception is that in genuine diphtheria the exudation

becomes converted into fibrous tissue, constituting the formation of the false membrane; whilst in scarlatina anginose it is converted into pus corpuscles, producing a solution of the continuity of the tissue, and the formation of ulcers. Even in diphtheria, the existence of the membrane does not always prevent a solution of the subjacent tissue, as I have seen cases in which the membrane has been perfectly organized, but which became absorbed or disorganized in from twelve to twenty-four hours, leaving deep, ragged, purplish ulcers.

When I come to examine into the cause of diphtheria or scarlatina I find the records are almost uniform in attributing both to a peculiar miasm, the precise nature and character of which medical men do not understand or fully agree upon.

TREATMENT OF DIPHTHERIA.

I use lemon juice freely in such cases. For an external application I use Electric Ointment once an hour, rubbing it on the throat and glands for some minutes, until it is absorbed. I administer IodideBromide-Calcium, compounded from one-half to a teaspoonful in a little sweetened water, once in four hours. In all malignant cases I use Electricity. Cases that cannot swallow will obtain relief in fifteen or twenty minutes, so that they can swallow without much effort. I regulate the Electricity according to the strength of the patient. There is a charm in it. I use for a gargle for the throat one which has always answered for me; others can try it if they choose:

White Pond Lily, pulverized; Myrrh, pulverized; Golden Seal, pulverized; Lupulin pulverized, of each two parts; Borax, pulverized; Alum, pulverized; Bloodroot; Salt, of each one part. Put one full teaspoonful in one-half pint of hot water, add as much good cider vinegar and sweeten with honey. To each dose of this decoction add twenty-five drops of the tincture of Capsicum and twentyfive drops of tincture Hamamelis.

Let the patient gargle with this once in fifteen minutes until relief is obtained; then less frequently. Keep the solution warm, taking out each time simply what you need for one application. I use as a beverage beef-tea and mutton broth. Food that is nourishing is required to keep up the strength of the patient. In treating the throat with Electricity, I use a soft sponge. I attach this to the positive pole, putting it as far back in the throat as convenient, and with the negative treat the throat, chest and upper part of the spine from five to fifteen minutes. No remedy that I have ever tried will relieve as quickly as this. I have used it for some thirty-five years, and know whereof I attirm.

"

TRICHINIASIS.

BY S. ROE, JR., M. D., of Wappinger's Falls, N. Y.

Various are the teachings and writings upon this trying disease, still comparatively little is known or scientifically explained.

In the opinion of the writer, the disease has existed for ages; in fact, ever since pork became a portion of our daily subsistence.

The knowledge of trichina spiralis is of a late date, and brought to light only through the wonderful assistance rendered in pathological researches, by the microscope. The trichina spiralis has been described as consisting of small cysts, of an oblong figure, resembling in size and color the small minute worms found in rain-water casks and in vinegar.

Having an opportunity to visit a patient, in the city of Albany, said to be afflicted with trichiniasis, we endeavored to ascertain the characteristic symptoms. The patient, à male, of middle age, was first attacked, as he supposed, with bilious colic, having intense pain in the epigastric region, with excessive vomiting and a high fever; these were the first symptoms, "though for two weeks previous he had thought that he was affected with rheumatism." Suitable remedies were speedily administered for the supposed difficulty, with apparently little or no success. On the third day diarrhoea set in with such violence that the patient survived but forty-eight hours. After death a portion of the muscle from the gluteus maximus and sartorius, were removed for microscopical examination, which proved to be infested with innumerable parasites the trichina spiralis. The patient being one of the lowest class little could be learned of the history of his later life. It was positively established that he daily eat uncooked smoked sausages. The vomiting and diarrhoea were marked symptoms and seemed characteristic of the disease. The sausages had been eaten freely by the family, though upon all occasions they were cooked.

From this fact we are led to suppose that, if the temperature be raised to 160°, the trichina will invariably be destroyed. Trichinæ, as a rule, invest only the voluntary muscles; the limbs are, as a rule, highly inflamed and generally much swollen. We are unable to state how long the patient had been affected with the disease, for, as before stated, it was one of those cases where but little could be learned, either from the family or the patient.

The symptoms of the disease, when we made the examination, were: Eye lids much swollen, tongue heavily coated "brown,' neck stiff and very sore, a quick pulse, fever and mind deranged, symptoms resembling those of typhoid fever; expectoration, scanty and of a yellowish cast. Examination of the sausages clearly proved