cases of cholera infantum, subacute gastro-intestinal indigestion and marasmus. His best results were derived from the following line of treatment: Podophyllin, 1-40 grain, or calomel, 1-10 grain, till passages become distinctly bilious; then an intestinal antiseptic, sedative and astringent consisting of 1 dram bismuth subcarbonate, 2 fluid ounce GlycoThymoline (Kress), and chalk mixture to make 3 fluid ounces-"shake bottle and take a teaspoonful every three hours." It is well to give the baby at the commencement of treatment an enema of a pint of warm water containing an ounce of Glyco-Thymoline, and similar daily enemata are frequently advisable.

Technique of Rectal Operations.

L. Rehn (quoted in Progressive Medicine) states his views as follows: 1. In exposing the peritoneal cavity injury to the sacrum should be avoided as far as possible. 2. Cancer of the rectum, even if located high up-which formerly was thought to be removable only by the sacral method-may well be removed by way of the perineum or the vagina. 3. The rectum should be dissected out extrafascially. 4. Cancer of the anus and the slightest cancerous development above the same require high amputation. 5. The sphincter should be retained wherever possible. 6. It is from the abdomino-perineal or vaginal operation that we may expect further progress in the treatment of cancer of the rectum.

Cancer of the Stomach.

Indications for A combination of the following six Operation on symptoms, according to Macdonald (Progressive Medicine) are sufficient to indicate the necessity for an exploratory operation: First, a chronic gastritis which is progressive in character under proper dietetic, medicinal and physical treatment; second, a loss of gastric motility; third, progressive diminution of gastric peristalsis; fourth, a diminution of free

hydrochloric acid, progressive in character; fifth, emaciation of the patient under forced diet; sixth, reduction of the hemoglobin in the blood, progressive to 65% or under, and a moderate leucocytosis. Hematemesis, lactic acid, the Oppler-Boas bacillus and the epigastric tumor usually appear too late for radical surgical intervention.

Indications for
Pelvic Massage.

Olshausen (Progressive Medicine) concludes that massage is indicated for pelvic exudates which fail to be observed and no longer show any sings of inflammation. It is likely to be of value only when the exudate may be pressed between the vagina and the abdominal wall. Tubal enlargements are seldom if ever benefited by this form of treatment. Only those cases of recurrent hydrosalpinx, in which the fluid is periodically discharged into the uterus, should be submitted to massage. When the wall of the tube is thick and there is a surrounding pelvic exudate, massage should be directed only to the removal of the infiltration and not to the relief of the tubal disease. Peritoneal adhesions, hematocele, malpositions of the vagina and uterus are not suitable for massage, although anomalous positions may occasionally be corrected by the removal of pelvic exudates.

Alcoholic
Auto-Intoxication.

The following postulates are laid down by Crothers (Journal American Medical Association) in regard to the actual effects of alcohol: 1. Alcohol in any form, taken into the body as a beverage, is not only a poison, but produces other poisons, and associated with other substances may develop toxins. Alcohol is an anesthetic and not a tonic or so called stimulant. It increases the waste products of the body and diminishes the power of elimination. It also destroys the phagocytes of the blood, and thus removes and lessens the protective power of the blood cells. 2. Wherever

alcohol is used continuously as a beverage, for its medicinal effects, favorable conditions for the cultivation and growth of poisonous compounds are created. These may be neutralized by other conditions and not be apparent in the derangements of the functional activities which follow. 3. The functional and organic symptoms of derangement appearing in those who use spirits in moderation or excess, which quickly disappear by abstinence and eliminative measures, are clear indications of auto-intoxication from this source. 4. The treatment of all such cases, in which alcohol is used in any form, should be by antiseptic and eliminative measures, and the supposition should always include the possibility of poison by chemical products formed in the body.

Hemoptysis. Lemoine (quoted in Medical News) advises a hot foot bath and purgation with 2 ounce each of senna and sodium sulphate in a pint of boiling water. If the bleeding is already subsiding, magnesium sulphate alone may be used. For continuous small bleedings a good prescription is 5 grains quinine and 8 grains ergot, in capsules, every morning. In sudden large hemorrhages omit the pediluvium, envelop the legs in iodized cotton and bathe the hands in hot water; ergotole may be given hypodermically. Perfect rest, control of cough and fasting should be enforced for a time.

Differential Diagnosis of Infectious Processes in the Right Iliac Fossa.

Valdemar Pleth concludes an interesting article in the June Medical Standard with the following summary: That adnexal and appendiceal inflammatory conditions more often coexist than is generally thought; also, that many cases of so-called dysmenorrhea should be studied carefully in order to ascertain appendiceal involvement; also, that in all cases where for any reason the abdomen is opened, the appendix should be

removed whether it be diseased or not.

Furthermore, that whenever operations are to be performed for pelvic pathology, the suprapubic route should be chosen; and finally, that in most cases of abdominal pain (colics), our attention should be directed toward the appendix.

The Cause of
Rheumatic Fever.

Poynton and Paine (quoted in Philadelphia Medical Journal) have isolated a diplococcus from sixteen cases of rheumative fever. They have demonstrated this diplococcus in three rheumatic nodules taken from two cases. In one instance they succeeded in isolating the micro-organism from the nodule in pure culture, intra-venous inoculation of this culture in a rabbit produced polyarthritis, pericarditis and valvulitis; the diplococcus was again isolated from the joint-exudate of this animal. Last October these investigators reported a case of chorea in a rabbit due to the intravenous injection of this diplococcus. The rabbit also developed polyarthritis and valvulitis.

Useful We excerpt the following points by F. W. Items. Campbell from the Medical Record: Calomel in doses of 1-10, combined with a little white sugar, is a very valuable remedy in chronic diarrhea. It is one of the best of gastrointestinal sedatives.

The bisulphide of carbon, poured on cotton in an open-mouthed bottle and held against the forhead, will, it is said, promptly relieve nervous headache.

Wine of colchicum, in doses of 5 to 10 minims, is useful in obstinate sciatica.

Slippery elm infusion is excellent in throat diseases, and is especially valuable in obstinate cases of ptyalism, met with sometimes in the pregnant condition.

Obstinate epistaxis is often benefited by having the patient soak the hands and feet in water as hot as can be borne.

In a recent case of hemorrhage from the bowels in typhoid fever two injections each of 20 minims of ergotol acted well and promptly.

Intraorganic
Injections of
Normal Salt
Solution.

According to Coakley (New York Medical Journal), this solution is entirely innocuous and does not produce hematoma, even when injected into the lungs, spleen, kidney or liver by means of a delicate trocar or needle. It relieves pain and is a powerful stimulant to a failing heart. After bleeding a dog, until the heart had almost ceased to beat, the injection of a few c.c. of saturated salt solution into the pericardium restored the heart's action. The author maintains that such injections retard carbon dioxid narcosis by absorbing the gas.

A Practical Acrostic. S. C. Mish contributes the following unique mnemonic to the

California Medical Journal:

FRACTURES.

False point of motion.

Rotary displacement.

Angular deviation from normal angle.

Crepitus.

Tenderness on point of pressure.

Unnatural mobility.

Retraction of limb by muscular contraction.

Ecchymosis.

Shortening, swelling and pain.

DISLOCATION.

Disturbance in function of joint.

Immobility.

Swelling.

Loss of the natural contour of joint.

Only forced mobility.