mechanical or of nervous origin, and including stricture and prostatic enlargement, is the injection into the bladder of 15 or 20 Cc. of a 2-percent boroglyceride solution with just enough force to overcome resistance of the sphincter and pass into the bladder. Usually one injection is sufficient. But along with this, the patient should take a combination, in tablet form, consisting of berberine hydrochloride, gr. 1-6; juglandin, gr. 1-6; physostigmine salicylate, gr. 1-500; strychnine sulphate, gr. 1-67; capsicin, gr. 1-67. Of these, four tablets a day should be used. This prescription is also of great value in colonic paresis.

Obstinate constipation is one of the most troublesome conditions we have to contend with. Not long ago I read that rectal injections of soft paraffin acted well. I have treated successfully, lately, several cases of obstinate constipation associated with dry, scybalous masses and diminished. reflex irritablilty of the lower bowel, by injecting into the rectum, each night, about 200 Cc. of a soft petrolatum, of near 100° F. melting-point, warmed until fluid. The patient should be in the knee-chest or side posture, a warmed syringe or rectal tube being used to inject the liquefied paraffin. After about eight or ten days the amount injected may be reduced one-half, while in the course of another week or two the injections need be given only every other night, to be discontinued entirely after a while. Should there be no spontaneous movement in the morning, a small dose of effervescent saline laxative before breakfast and a small saline enema should be ordered. Waugh's

three, thrice daily, being the ordinary dosage.

This subject of constipation reminds me of a very troublesome condition that we have to contend with, namely, pruritus ani. Very often this symptom is the result of local irritation in the rectum or large bowel, and in all cases I am in the habit of ordering washing out the large bowel with saline enemas and prescribing, internally, each morning before breakfast a small dose of saline laxative, preferably magnesium sulphate; also, two hours after each meal, a dose of sodoxylin, to overcome any acidemic condition that may be present. Locally, I have the parts bathed twice daily with starch water as hot as can be borne, and the application of the following ointment: Phenol, 20 grains; calomel, 1 dram; tar, 1 dram; menthol, 10 grains; zinc oxide (very fine), 1 dram; petrolatum, 6 drams; lanolin, 2 drams.

I have had excellent success with potassium permanganate in the treatment of amenorrhea in young women. This agent

is useful also in cases of scanty, and perhaps delayed, menstruation. Potassium permanganate may be given in doses of from 1 to 2 grains three times a day after meals, and continued until the catamenia appear and complete their course, when the salt should be discontinued. It should be recommended four days before the access of the next period, and continued till the flow ceases.

I have had as good success with atropine and adrenalin in the treatment of bronchial asthma as I have had with any other drugs.

Gelseminine is a drug that should be used more than it is. I have found it of value in many conditions. Among those that occur to me just now are acute spasmodic stricture of the urethra, and if given after each pain it often will arrest false labor. It is one of the best drugs to give to allay excitement, and to stimulate secretion previous to the administration of quinine. It is very efficacious in early chordee, and, when given in full doses, in many cases of ovarian neuralgia.

Morphine, atropine, and glonoin in small doses are the three best remedies one can give in cases of hemoptysis.

As a prophylactic of recurring tonsillitis, the teeth, gums, and especially the base of the tongue should be brushed two or three times a day with a moistened toothbrush dipped into fine sodium bicarbonate. This oral disinfection should be practised every morning at least, for the flora of the mouth. is particularly apt to flourish during sleep, when none of the mechanical and detergent effects of mastication, salivation, and speech are in operation. Of internal prophylactic remedies, I consider sodoxylin and a saline laxative the best. Forcheimer thinks he

frequently has prevented an attack of quinsy by giving 5 grains of salol every two hours for forty-eight hours.

A flight of storks not so long ago visited Wilmette, the Chicago suburban village where I live. These birds of good luck were first seen over Evanston and their course was watched from the best residences of that suburb with anxiety and alarm. In that particular section but very few people desire a visit from the stork, since it always brings care and noise and disturbance of old, settled ways.

But these birds were evidently heading for the region of Lake Forest. As soon as their coming was observed, consternation ran riot through that patrician quarter. Servants were summoned in hot haste out of every mansion, and there was a great beating of tom-toms and firing in the air. For by the beating of the tom-toms-and

by certain other precautions—one can often scare away the stork.

So it happened this time and Society (with a big red capital S) breathed relief. Soaring high above the din, those storks circled south by sou'west without stopping, and many of them nested in the neighborhood of Milwaukee Avenue, where they are better acquainted and more welcome.

The stork likes to make its nest on the roof of the chimney of a humble home, but it does not often roost on the palatial residences of the North Shore. On Milwaukee Avenue they charge this to "a Yankee trick." Whatever the reason, the fact makes Lake Forest a lonely place. No rout of childish feet upon its lawns; no prattle of baby voices in its halls; its atmosphere serenely still-still and dead as are the hearts of the women having there their abodes.

Noticing the direction the storks had taken, I went down in the neighborhood of Milwaukee Avenue not long after, and there I came upon a throng of children that amazed me. They were running about everywhere. They were arguing loudly, or whispering mysterious secrets, or playing their different games. The sidewalks were full of changing groups; the curbings were lined; and from one gay circle out in the roadway came the sweet shrill chorus of a simple song.

Upon the edge of that swarm I stood still in admiration and counted them. There were just thirty-two children within my easy grasp; nor had they been collected throughout the neighborhood for a showbunch. All along, as I walked up the voicy-noisy street, I met little babies in their mother's arms and children of all ages at their play-I counted nigh onto two dozen more. And were these noisy jolly throng homeless waifs and dirty ragamuffins? No, they were the sons and daughters of respectable people, decently clothed and cared for, and living in comfortable modern houses.

Is human nature the same in some of the North Shore suburbs as it is on Milwaukee Avenue, or has culture sapped its strength? If you of the swell localities, Madame Sansenfant and Madam Amour-Propre,

should see the babes and kids along Milwaukee Avenue, what would the sight do to you? Imagine fifty little ones playing, "Hill-Dill" and "Ring-around-o' Roses" on Lake Shore Drive or Drexel Boulevard, or in the sacred precincts of Lake Forest! It would be the wonder of the city. It would mean the filling of your empty churches. It would foretell the regeneration of the Puritan race.

The United States, and especially the section known as New England, is a farm which needs a change of crops, and it is rapidly getting that change by the survival of the fittest. The Puritans came over here, and by dint of fighting and by virtue of their hardihood they grew to the stature of heroes. They conquered the countrybut afterward the country conquered them. For their reddest blood was always flowing out into the stern life of the advancing frontier and into the making of newly making states; while the Puritan who stayed behind cultivated himself and anon began to prune away his inherited vitality.

The old strength still does break out from time to time. It reddened the fields of Gettysburg and the hill of San Juan, and it bides its hour to do such deeds again. But the cultivated Puritan is apt to deprecate this vigor. As his blood became blue it grew cold. He belongs to a Peace Society. He hates scrapping, and expansion, and new people, and responsibilities. He wants none but a small-sized family; and his children grow up into futile bachelors and faddish old maids.

It is a good strain, this Puritan blood. It makes the best pioneers in the world; yet, on its own soil, as every one knows, this stock is as much doomed as are the Kanaka of Hawaii.

Where can one look for salvation? It is hopeless to suggest a simpler, a plainer life. The country comes to the city, and there it runs the same race of fashion, refinement, emptiness, degeneration; and though a remnant will be saved by the counter current now setting in toward country homes, still, the real chance for the Puritan is in intermarriage with stronger, fresher races. But the Puritan who is rooted in

our soil would sooner see his family-tree decay and perish from the earth.

Yet the new race is on the way. There have been immigrants other than the Puritan-Irish, Scots, Germans, Swedes have grasped the magnificent opportunities presented by the New World, and in the second and third generations they are approaching their prime. Albeit, as unmixed races, they, too, would sooner or later become decadent.

But they will not remain unmixed; and when all these peoples, Swedes, Irish, Yankees, Scots, and the rest are merged and their blood has been mingled through and through, then shall we have the real AMERICAN RACE. This new race will not come right now, or soon, or at any measured period, but it is already coming; and it will culminate in a type better than anything the world has yet seen, the flower of humanity, destined to rule for long years. The Puritan now has his golden chance to impose upon this evolving race the splendid strain of his blood and the stamp of his cherished ideals. Will he grasp the opportunity?

Not, if he clings to his prejudices. Not, if he frightens away the Stork!

rare.

My heart goes out in tenderness to the man who has tried, and failed. He is not Indeed, he is but one of the nine hundred and ninety-nine to be found in every thousand who put a foot forward into unknown darkness, only but to fall.

But though the experience saddens and staggers; though it does not seem to profit him; though it calls out all his faculties to weather the storm created by his efforts to maintain himself and his during the trial, he is stronger for the trouble, and his profit has been quite as great as has that of the One who stepped upon solid ground. His portion has been experience; that, dearly bought though it may have been, will be capital secure when he tries again. And, too, his experience has been a danger signal and the kindness to the many who might try as he has tried.

We all have our goals. They seem to be so brilliantly lighted that a straight-away path is beaconed for us, and we rush head

ong into the way marked out, only to realize that our goal recedes like the end of the rainbow of the stories of our youth. We find pitfalls in the shadows of the great light; encounter stumbling blocks that must be rolled aside and forks in the road the choice between which is a trying task. And earnestly we strive to remove all difficulties, often but to find that we have had naught but our labor for our pains.

We sit down to think it over. We brood and tear our hair, and make miserable with our misery. But let it not be for long.

Life is good-filled to the brim with much that is really worth while. And the hunt is in us, and the hope, and the faith; so let us lift our heads and with our purpose clearly defined let us out and for it.

To brood is to make brood.
To sorrow is to make sorrow.
To whine is to disgust.

So, even though the rainbow ends in a pot of junk, let us smile and make smile as we try again.

There would be no such thing as success if all succeeded; no joy, if all were joyful. Success and joy are comparative conditions, and are only for us in such a measure as we may be able to take them in.

And if we fail, and fail again, we may know the reason, if we will. We are inclined to blame others for ill-success, to elicit sympathy by talking of conditions and evvironments; but deep down in our own hearts we know that our own lack of strength to cope with these conditions and environments, the lack of certain elements in our natures has brought the Black One to us, and that these rocks and pitfalls in the roadway are but chapters in the lesson of life.

One word more.

If things go wrong with you, cut envy from your heart. If you see your neighbors doing the thing that you would like to do, just speed them along. It lowers your self-respect to nurse a wrath against anyone.

We can tell the general type of mind and heart to which a man belongs. We can tell what books he reads-the prevailing thought with him-what Master he follows. We talk with a man on social questions, and we soon know who his Master is. If

he is fond of a strong central government and has aristocratic tendencies, he is a follower of Alexander Hamilton; but if he believes in the "common sense of most," in the people's ability to take care of their own affairs, then he is a follower of the writer of the Declaration of Independence.

There are times and seasons when the best friends would better be far apart in space. Domestic happiness would be increased and last longer if men and women did not live so much together. The friends at Brook Farm could not endure the bodily presence of each other. They scattered, and continued friends. Doubtless the disciples had been together long enough. Peter and Paul did not quite understand one another. There is a personal individuality that must be allowed for.

If you read Emerson a good deal when a boy, it will appear in the formation of your sentences. Once, a boy had his ideal of eloquence: it was to be noisy of speech and to pound the furniture. And when some fortunate evening he heard Wendell Phillips, he heard the orator of America "converse" with a multitude as if he were talking to an individual. After that, the boy did not declaim; he did not sweat and froth and pound any more. When Wendell Phillips came in, minister's sore-throat went out. The boy found out that what the world needs is not noise, but light. This, possibly, may apply to the practice of medicine. Think it over.

Doctors should get closer together than any or all other workers, and if we should more frequently scan the Hippocratic code we would realize more completely our duty. "Put yourself in his place" is a good thought for us to keep in mind, and the old German proverb which freely translated reads, "To know all is to forgive all," should be ever before us.

Let us study and strive to ever have regard for the "other fellow," for God only knows the burden he bears, the blood he sweats; to be glad when gladness comes to him, sorry for him in his troubles, rejoice in his success, sorry for his sorrow.

STRUEMPELL'S "MEDICINE"

A Textbook of Medicine for students and Practitioners. By Adolf von Struempell, M. D., Professor of Special Pathology and Therapeutics at the University of Leipsic. Fourth American Edition, translated by permission from the 17th revised German edition. With editorial notes, additional chapters, and a section on mental diseases, by Herman F. Vickery, A. B., M. D., Instructor in Clinical Medicine, Harvard University, and Philip Coombs Knapp, A. M., M. D., ex-president of the American Neurological Association of the New England Society of Psychiatry. In two volumes. New York and London: D. Appleton & Co., 1911. Price $12.00.

In the first volume a variety of conditions are described, namely, acute general infectious diseases, diseases of the respiratory organs, diseases of the circulatory organs, diseases of the digestive organs, and diseases of the urinary organs.

Struempell's textbook presents the essentials of our present knowledge of medicine. To this end the author has brought the results of his enormous clinical experience into the closest possible relation with the data of pathologic anatomy and general pathology. In discussing therapeutics, he has endeavored to deduce from the nature of the symptoms a basis for rational medical opinion and treatment.

This is a book of clinical medicine, especial stress being laid on the presentation of clinical phenomena as observed by the physician. The work is as the author says, "the outgrowth of an unceasing broad clinical activity and is much more a product of the hospital ward than of the study."

Throughout the entire work the author has endeavored to bring the contents to the level of contemporary medical knowledge. In the discussion of uremia, for instance, the author passes in review the various theories that have been suggested as to the cause of this condition, drawing attention to one of the most recent, namely, the production of nephrolysins-a theory which has been advocated by Ascoli and others. While citing these new theories, the author nevertheless is forced to the unsatisfactory conclusion that, in spite of the large amount of patient research that has been expended on this problem, no solution yet proposed has met with general acceptance.

The second volume is devoted to diseases of the organs of locomotion, constitutional diseases, diseases of the nervous system, including those of the peripheral nerves, of the spinal cord, of the medulla oblongata, of the brain, neuroses without known anatomical basis, and mental dis

eases.

The chapter on chronic polyarthritis will well repay perusal. The author believes that the socalled "rheumatogenous influences" have probably been instrumental in the production of this affection, and, while not giving a really scientific classification, he goes thoroughly into the clinical features under the various forms.

While not as exhaustive as some of the special reference works on medicine, this work nevertheless is peculiarly practical, the salient features being set forth clearly. The illustrations are numerous, while the good quality of paper used in the volumes. renders them unusually clear and distinct. The general arrangement of the subject