difficulties, which he stated were constant, painful, annoying and aggravating to the last degree of endurance. He had traveled extensively in Europe, spent several seasons at Weis-Baden, and had tried the waters at several health resorts in Germany, returning home without much improvement except of a transient character. As the patient was over 70 years old, and greatly broken in health, I was not at all sanguine of affording him much relief, and not anxious to undertake the case, which I fully explained to him. That his age and the many years of his physical martrydom were decidedly against his recovery, all of which he at once conceded, and stated that he only expected and only sought temporary relief. His array of symptoms were truly formidable. He was suffering from dyspepsia, with a full train of attendant manifestations; was in constant dread of heart failure, pain in epigastric regions after taking the slightest nourishment, and complained of acrid eructations and throwing off gas from the stomach; was much troubled with palpitation of the heart, with an intermittent pulse-with a feeling of a general surrender to the persistent invasion of disease. His vesical catarrh was a prominent feature in the multiplicity of his murmurings, and his chamber more than established the fidelity of his painful recitals. I prescribed the following treatment for him, to relieve his costive habit and to arouse his inactive and torpid liver and secretions. I ordered: M. ft. et div. in pil. No. xxiv. S.: Take one pill at bedtime. After five days I commenced the following plan: I washed his bladder out three times a week; first with equal parts of milk and water, pretty warm, then with boric acid, and lastly with hydrastin and papoid. I gave him papoid in combination with soda bicarb. and bismuth, and ordered him to take six ounces of water as hot as he could every morning, with ten grains of sodium chloride, and to take the papoid mixture in the middle of his meals; and once a week he was subjected to vigorous massage by a strong and healthy operator. I regulated his diet to conform to the indications of treatment, In six weeks he had gained five pounds in weight; the mucus that formerly threatened supremacy in his chamber had almost disappeared. His indigestion was immensely improved, his appetite had returned, and to use his own words: "That papoid is surely the long-sought rejuvenating elixir of youth." I gave papoid the credit, because he had traveled the old line of treatment through many years of patient, persevering and unfailing faith, suffering the pains and penalties attending misdirected effort and stubborn adherance to remedies which have survived scientific application. When the secretions of the stomach are in perfect accord with those remedies the results are quite satis-factory, but administration of pancreatin, pepsin and pepsin mixtures indiscriminately, without regard to the condition of the stomach, is a blind and empirical method of meeting the abnormal condition presented.-A. J. Park, M.D., of Chicago in Med. Standard. PUERPERAL HEART-CLOT.*-Heart-clot in the puerperal woman is a very rare complication. The possibility of it has been. denied until a comparatively recent date. This denial has arisen from the fact that after death the heart cavity is found empty and the clots plugging up the pulmonary artery instead. In 1849 Meigs directed attention to heart-clot, and assigned it as the cause of a sudden death in his own practice. Playfair convinced some doubters by a lengthy paper which appeared in the Lancet in 1867. He reported an additional case in 1871. Since that period physicians have been less timid about diognosticating this condition, where symptoms plainly pointed in that direction. Fordyce Barker in his lectures (1869) says: "Observations have demonstrated that clots may form both in the pulmonary artery and in the right cavity of the heart as a primary lesion." *Read before Brooklyn Gynecological Society, by Frank Baldwin, M.D. B-Pulv. Aloes....2 grs. Pulv. Rose Leaves.. gr. Lady Webster Dinner Pills. This is an excellent combination officially designated as Aloes and MasChicas tich, U. S. P. We take very great pleasure in asking physicians to prescribe them more liberally, as they are very excellent as an aperient for persons of full habit or gouty tendency when given in doses of one pill after dinner. ral Pil. Antiseptic Comp. is prescribed with great advantages in cases of Dyspepsia, Indigestion and Malassimilation of food. B-Aloin........1-5 gr. Ext. Belladonna.... gr. INGLUVIN A POTENT AND RELIABLE REMEDY FOR THE CURE OF INDIGESTION, DYSPEPSIA and SICK STOMACH, caused from debility of that organ. It is superior to the Pepsin preparations, since it acts with more certainty, and effects cures where they fail. A Specific for Vomiting in Pregnancy, In doses of 10 to 20 grains. TO THE MEDICAL PROFESSION. Elixir Salicylic Acid Comp. Prepared only by WM. R. WARNER & CO., PHILADELPHIA, PA. This preparation combines in a pleasant and permanent form, in each fluid drachm, the following: So prepared as to afford a permanent, potent and RHEUMATISM, GOUT, LUMBAGO, ETC. This preparation is especially valuable for rheumatic diathesis and in the treatment of acute inflammatory subacute and chronic rheumatism; any of which will yield to tablespoonful doses; every three or four hours, until four doses are taken; then a dessertspoonful at a time and finally decreased to a teaspoonful every three or four hours. In acute inflammatory rheumatism, experience has proven that two tablespoonfuls administered every four hours, until a slight ringing in the ears follows, the dose then decreased to a tablespoonful every three or four hours, will produce the desired effects. The advantages of Elixir Salicylic Acid Comp. are afforded by the combination of Salicylic Acid with Soda in excess, thus forming a salt less corrosive and irritating and more readily borne by the stomach. The other ingredients possesses advantages well known to the Profession to whom this preparation is alone introduced, we therefore suggest the propriety of specifying "Warner & Co.'s" and ordering in fzxii quantities, to obtain original bottles. It is a matter of great satisfaction to us to be able to place before the Profession a remedy so effectual in the cure of one of the most stubborn classes of disease. Elixir Salicylic Acid Comp. is put up in 12-oz. square blue bottles, with prescription label on it, and may be obtained from Druggists everywhere. See that no substitutes are offered. He weakens a part of this statement a little later, when he says that pulmonary thrombi in the great majority of cases are found to have formed around a clot which has escaped from the cavity of the heart. The skeptical have persistently claimed that the clots were formed where found, in other words, that they were pulmonary thrombi and not emboli. Where parenchymatous changes have taken place in a lung tissue, and the vessel walls have become changed, no more favorable location could be imagined for the formation of a thrombus; but recent investigations have demonstrated the fact that clots are not at all apt to form within a healthy vessel. Bencke says that blood may be kept unchanged almost indefinitely within a normal vein or artery, if it is enclosed between two ligatures. To show-on the other hand-what a rougher surface will do, we have only to draw a fine silk thread through the artery of a living animal when a clot will promptly be formed upon it, which will grow and threaten to occlude the lumen of the vessel. It is evident from this that a thrombus is far more prone to locate in a heart cavity where morbid changes have taken place, than within the normal walls of the pulmonary artery. Right here arises another objection to the heart-clot theorynamely, that these clots are travelers from the peripheral veins— especially from the placental site. Playfair, however, states with considerable positiveness, that coagula in the veins, are tenacious, and do not break up until the process of softening has begun which never occurs before the nineteenth day after delivery. This accident doubtless occurs often enough after this time, but it can hardly be held accountable for the deaths which occur from pulmonary emboli shortly after the birth of the child. During the latter months of pregnancy and for several weeks after that event, the condition of the blood is such as to favor the formation of thrombi. The water is increased, as is also the fibrin. There is an actual decrease in red globules and in hæmoglobin. To this blood there is added a large quantity of effete material looking for a place of exit from the body. Of course if the right cavity of the heart has been the seat of morbid changes, the danger is greatly increased. 4 |