The 6-months-old child takes half the dose quoted for the 1-year-old child. The above doses are given every half hour to hour until effect, then less often as required. As you will note, Dr. Radue gives a very small quantity frequently.

Personally, being thoroughly familiar with the drugs and their effects, we are inclined to give more appreciable doses. It might be well for you to feel your way for a time, following either Shaller's rule or basing your practice upon Radue's table.

With the exception of aconitine and veratrine, there is no granule listed that we should hesitate to give (where indicated) to a child of from 6 months to a year old, in from two to four doses, and we believe we get more rapid and better results from such medication.

Be quite sure, though, you select the right remedy. Familiarize yourself with the action of the drug and-when dealing with toxic agents-never dispense at any one time more medicine than can be taken with safety before the time of your next visit. Instruct the attendant how to detect evidences of drug sufficiency, that is, remedial action.

QUERY 5724.-"Hypodermatic Treatment of Asthma." G. H., Texas, asks for "some data as to the latest hypodermic treatment of asthma." We do not quite grasp what specific information is desired. Asthma, of course, is regarded as a symptom. Hence, as it is essential to cure the cause, treatment must be based upon the underlying pathologic conditions. Relief of the asthmatic paroxysm itself is comparatively easily secured, and various drugs have been employed hypodermically for this purpose.

Some time ago a Washington physician recommended an antitoxin. Some patients were relieved promptly, but others died almost as quickly. Dr. Price of Mosheim, Tennessee, has used adrenalin hypodermically, with success; but here,

again, it is necessary to proceed very cautiously. Injections of adrenalin have produced disastrous results. You may remember that some months ago crotalin injections were advocated. This agent, however, has practically been dropped from the armamentarium of the therapeutist.

As there is no accepted "hypodermic treatment for asthma," it would be impossible to supply you with literature upon the subject, although, as pointed out, several articles recommending the hypodermic use of various remedies have appeared in the journals from time to time.

In this connection, we would call your attention to the extreme efficacy of the combination of hyoscine and morphine with cactin. The asthmatic paroxysms are controlled almost instantly by one injection of the standard-strength solution.

QUERY 5725.-"Mucous Colitis. Prostatitis." A. F. W., New York, would like to have any suggestions we can give in regard to the treatment of two of his patients.

Case 1.-Mrs. B., age 55, just past the menopause, for the last year has been suffering from mucous colitis. Our correspondent mentions that Osler says the condition is incurable, and he is almost of the opinion (from his own experience) that Osler is right. His patient will improve for a while, then get as bad as ever again. There is great tenderness over the abdomen, especially when the mucus appears in the stool. No other abnormality can be detected. Intestinal antiseptics, including the sulphocarbolates, salol, copper arsenate, and silver nitrate in small doses, have been used persistently. She improved much on chromium sulphate last fall, but does not seem to receive any benefit from that now. At present she receives hydrastis and nux vomica.

The treatment of mucous colitis usually proving effective in our hands is here outlined, but here, as elsewhere, it is necessary to modify medication from time to time, to meet the symptoms presented by the individual. It is well to bear in mind, in this connection, that this disorder may be

either of a neurotic type or purely inflammatory in character.

Nervous instability almost always exists and not infrequently there is a history of gastric hypersecretion or a hyperchlorhydria. Clinicians are beginning to believe that the arthritic diathesis is present in nearly every case of mucomembranous enteritis. It is quite possible, of course, that intestinal indigestion, with the resultant autointoxication, sets up the neurasthenic condition which accompanies mucous colitis.

You do not mention the presence of constipation. In most cases of mucous colitis, there are obstinate attacks of constipation followed by paroxysms of pain and passage of mucus-covered stools. Even when there is diarrhea, there will be more or less fecal stasis and accumulation of fecal matter in the intestine, which rarely (if ever) is entirely removed. The stools may be ribbon-like or the size of a leadpencil (evidencing spasmodic contraction); again, hardened scybala or masses in some cases resembling sheep dung are passed; in still other cases the stool is formless, consisting of mucus mixed with feces; then, also, the stool may be coated. More rarely casts of the intestine are evacuated. Pain, as a rule, accompanies each movement of the bowels; it is sudden in onset, extremely severe, and usually accompanied by a distinct sense of faintness. Attacks of diarrhea appear at varying intervals covering periods of several hours or even days, and these almost invariably are followed by marked constipation.

As to treatment, throw into the rectum 4 ounces of olive oil to which has been added 5 minims of eucalyptol the patient being in the knee-chest position; then inject 3 or 4 pints of warm decinormal salt solution, this to be retained as long as possible. Repeat these enemata every second or third day.

Internally, give atropine sulphate, gr. 1-1000 to gr. 1-500 three times a day; also hydrastin, gr. 1-16 and eupurpurin, gr. 1-3. In some cases hyoscyamine (gr. 1-250) does better than atropine. After a few days the atropine dosage may be reduced one-half, i. e., to 1-1000 grain.

Before meals, the patient should receive juglandin, gr. 1-6, with nux vomica and capsicin. One hour after food, bilein, gr. 1-12, with pancreatin and sodium sulphocarbolate, gr. 1.

In very obstinate cases, 4 to 8 ounces of olive oil may be injected into the bowel at bedtime and retained through the night.

The diet necessarily depends upon the conditions present. Van Noorden placed the patient upon foods containing a large proportion of indigestible residue, i. e., graham bread and leguminous foods, vegetables containing cellulose, fruits with small seeds and thin skins. In addition, large quantities of fats. This coarse diet works beautifully in the large majority of cases, but if there is any blood or pus in the stools and the constipated periods are absent, it will be well to prescribe for a time mainly farinaceous foods, purees, gruels with cream, plenty of butter, and other substances rich in nitrogen, the idea being, of course, to exercise as slightly as possible the motor function of the intestine, and at the same time to nourish the patient thoroughly.

In a few cases sodium sulphocarbolate irritates the intestine. Here copper arsenate is the remedy of choice, 1-1000 grain of which may be given four times daily, in solution. Nuclein, 5 to 6 minims absorbed from the buccal mucosa, morning and night, will always act beneficially. (Do not use oil of eucalyptus, but eucalyptol.) Some very remarkable results have followed the use of calendula, with or without the addition of resorcin, and a soluble bismuth salt. The writer gives it internally and by enema. Much depends upon the extent of the intestine involved. If you have a copy of "Alkaloidal Practice," read the very interesting chapter upon this disease. Have specimens of feces and urine examined every ten days.

Case 2.-Mr. E., age 67, American, has always been healthy till about three years ago, when he noticed a slight difficulty in urinating. Since that time he has been taking "dope" from advertising quacks. When he came under care this spring, he had to urinate every ten or fifteen minutes, passing only a few drops at a time, with

much pain and tenesmus. The bowels frequently would move at the same time. He had hemorrhoids cured by injection. The urine appears normal. General health good. He works every day.

Treatment has consisted in urethral dilatation with cold sounds. At first a No. 9 was passed, with difficulty, but gradually the size was increased to No. 15, which now passes without much trouble. Tonics, urinary antiseptics, and chromium sulphate have been given. When he empties the bladder with a catheter, the patient can go quite a while without urinating, but so far there seems little real improvement.

We have not a clear-enough idea of the conditions present in this case to aid you very effectively. We believe dilatation of the sphincter ani and the administration of hydrastin, arbutin, and collinsonin, with, perhaps, minute doses of cantharidin, would prove beneficial.

Galvanization of the deep urethra and faradization over the vesical and sacral regions suggest themselves. We should like to have a specimen of this man's urine, besides a clearer idea of prostatic and deep urethral conditions. Is there much relaxation of the abdominal walls? Is the patient obese? Has he ever had venereal disease? Give us all the light you can, doctor, and we shall do our utmost to serve you.

S. R. E.,

QUERY 5726.-"Psoriasis." Pennsylvania, asks us to outline the latest treatment for psoriasis. Patient, female, 35 years. Urine, alkaline, specific gravity, 1002. Has had psoriasis ever since she can remember. Of good weight, 135 pounds. Occupation, clerk. Nervous disposition. Bowels regular. Does not perspire freely. Has scalp disease of years' standing. This woman has to wear undervests with long sleeves and high collars all summer. Iodine seems to do better for the smaller lesions than anything else. The crusts have been removed with the aid of olive oil and alkaline baths.

We regret to say that no "generally efficacious" treatment for psoriasis has yet been devised. The underlying patho

logic conditions (disorder of the bodychemistry) must be recognized and corrected.

It is absolutely essential that free elimination be maintained and nutrition improved. The patient must avoid overwork, worry, excesses of any kind, nursing or other drain upon the system. An acidemia exists in most cases. To control this, give sodoxylin, a level teaspoonful, dry on the tongue, an hour before meals. Bilein, pancreatin, and sodium sulphocarbolate an hour after meals. A saline laxative the next morning upon rising. The triiodides may be given between meals, or arsenic sulphide, gr. 1-67, after eating; alternating arsenic sulphide with the triple arsenates often proves desirable.

As soon as the acidemia is controlled, give, before eating, iridin, alnuin, and rumicin, 1-3 grain each. In all cases the scales should first be removed with warm epsom-salt solution and an alkaline soap. Carbenzol soap proves excellent, or you may use sapo alkalinus of the Pharmacopeia. To the denuded areas apply one of the following preparations: (1) Oil of cade, drs. 2; antiseptic oil, oz. 1. (2) Resorcin, grs. 10; tar ointment, oz. 1. (3) Chrysarobin, gr. 1; salicylic acid, grs. 15; ether, grs. 1; castor oil, m. 5: collodion, enough to make oz. 1. Apply with a camelshair brush. Then paint over the area with plain or benzoinated collodion.

The writer has treated several cases of psoriasis successfully, but the treatment has had to vary from time to time in each case. Indeed, doctor, it is impossible to outline a treatment for the condition. It is the individual himself who must be mended. The suggestions here given, however, will, we think, prove helpful.

If you have a high-frequency apparatus, use the vacuum-tube; or you may treat, twice a week, with one of the high-candlepower therapeutic lamps on the market. baking thoroughly at each sitting.

Lately, applications of antiseptic oil alternated with thuja and echinacea, equal parts, have given some remarkable results, the patient taking epsom-salt spongebaths every other night (epsom salt, 1 ounce; water, 2 quarts; creolin, 20 minims).

T

PREVENTIVE MEDICINE

HERE be three sorts of men as to

the attitude they assume toward a proposed innovation.

1. Those to whom life is but a dull affair, a "demnition grind," welcome anything for a change, just because it is a change. To them agitation is the beginning of wisdom, contentment is sloth, and the gloss is off the new as speedily as the brilliancy of molten lead fades as it begins to cool. They are young, these modern Athenians, hence radical.

2. Others are well satisfied with the things that are and want no change. Their wealth of knowledge, opinions, beliefs, gear, has been earned by hard struggle in the battle of life. Dearly bought, it is dearly held, and they resent its undervaluing and the disturbance of secure possession. They are aging, hence conservative.

3. Nor old nor young, the enthusiasm of youth past, the mind still receptive, the solid substratum of the race receives, with question, yet receives; hears both sides and judges; takes no sides until the evidence is in, and controls the rashness of the one, arouses the other from sloth. Ready to learn, though demanding proof, willing to join the movement for the betterment of the race, but first asking if it be indeed a betterment.

It is obvious that a society, to prosper and progress, must contain all three elements; that each is a necessity to the other. One must be cautioned that the newest is not necessarily the best; the other must realize that it is the horse that pulls the wagon, while the brakes never lift a pound; the third will have no cause to judge unless there are plaintiff and defendant.

Now, doctor, we'll just proceed to classify you, by placing before you this proposition, to change the financial relations of our profession with the public to something more in harmony with modern conditions. Inherited from the days when the sick were brought to the temple, treated by the priest and tendered a testimonial of their gratitude, a voluntary honorarium, this pre- and most un-Christian ideal still

exists in spirit, and sufficiently in fact to place us in this preposterous attitude.

Our charges are made when the patient is disabled, by sickness, from earning the money to pay us. The longer his illness, the larger our bill and the less his likelihood of paying. Illness resulting in death leaves us without recompense, except from previous earnings, and these by no means always available. Every effort we make to prevent illness leads towards our own starvation. The net result is that the profession as a body is desperately hard up, and is driven to turn its attention to outside means of getting support or to graft.

Turn to the picture presented by the plan suggested, that of level payments by the patient, in the nature of an insurance against disease. Let the doctor limit himself to the care of 500 persons, each of whom pays him a stated sum monthly10 to 25 cents to the beginner, rising each two years to 50 cents, 75 cents and $1.00. For this he looks after their health, seeing each patient twice a month, looks into the sanitary conditions of house and vicinity, personal habits, notes disease tendencies or causes that may lead to disease, and advises concerning them; attends those who get sick, and seeks to prevent the spread of infection; does the medical, surgical, obstetric, and specialty work needed, unless in case where still higher special aid is required.

The advantages:

1. The doctor has a sure and adequate income, rising as his value increases, well within the patients' ability to pay.

2. The doctor becomes a practical sanitarium, and his success in preventing disease renders his work easier without cutting off his own livelihood.

3. The doctor is a better all-around physician, taking that comprehensive view of the patient that is lost by the specialist. The doctor learns to study each patient as an individual, to recognize the coming of disease in time to prevent it, or to catch it in the earlier stages when it is easier to manage. We should not have eye-treatment spoiled by fecal toxemia, nor should we have brilliantly successful operations,