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his risks from an amputation enormously increased. That risk may not be enough to deter us from operating, certainly not in a case of necesssty. The patient with Bright's disease who has got a leg crushed must have it taken off and take the chances. But the woman who has Bright's disease, and some tumor or little growth not troubling her very much, had perhaps better be left alone. But the other condition of the kidneys, even more fatal and almost prohibitory to operative interference, is the saccharine diabetes which leads to gangrene, and leads to coma, fatal coma, serous effusion in the brain under ether and after the shock of an operation.-Cheever, in Boston Medical and Surgical Journal.

THE HYGIENE OF THE TEETH.—All caries of the teeth begins from the outside, no such thing as internal caries ever having been demonstrated; hence, if the surfaces could be kept absolutely clean, no decay could take place, however poor the texture of the teeth. This is of course impossible, but much in this direction can be attained by attention to hygienic rules. Parents often ask their dentists and medical attendants: “When ought teeth to be cleaned ?"

The answer

assuredly is: “As soon as there are any teeth." A very small toothbrush charged with some precipitated chalk flavored with an aromatic drug to make it pleasant, is perhaps the best means.The Lancet,

ARSENIC IN CHOREA.-Discussing the uses of arsenic, Dr. William Murray, in the Lancet for February 25th, makes a statement that will somewhat surprise American physicians. He says that little stress had been laid on the efficacy of arsenic in large doses in chorea. The use of the drug is a well established plan in this country. It is the common teaching that arsenic is of but little value until its physiological effects have been obtained. It is now the universal custom to carry its administrato that point, and even to restrain its action upon the bowels by small doses of opium. The dose should be regulated according to the symptoms and the tolerance of the patient. The author insists upon giving fifteen-drop doses of Fowler's solution for several days; ten drops, he says, will not answer. No fixed rule can be adopted for the use of this or any other drug. It must be administered according to the age and tolerance of the patient. If taken with food in the middle of the meal, it rarely causes digestive disturbance even in very large doses.—N. Y. Medical Journal.

POTASSIUM BI-TARTRATE IN Ascites.Dr. M. Sasaki, Professor of Clinical Medicine at the University of Tokio (Japan), reports (Berl. Klin. Woch.) very favorable results in the treatment of ascites from the use of potassium bi-tartrate (cream of tartar) in large doses. This treatment was first tried several years ago, in a case of dropsy due to cirrhosis of the liver, and in which all the other remedies—digitalis, calomel, and various other diuretics-ordinarily used under such circumstances had failed. The patient had already been tapped twenty-eight times, when it occurred to the author to try cream of tartar. He began with eight grammes (2 drachms) a day, and gradually increased the dose to thirty-two grammes (say one ounce). Under this treatment the ascites rapidly subsided and soon disappeared completely, not to appear again for two whole years afterward.

Since then Dr. Sasaki and, on his recommendation, several other Japanese physicians (Drs. Tawara, Takabaschi, and Tokura), have often used the potassium bi-tartrate with almost uniform success in cases of ascites due to hepatic cirrhosis, to syphilitic disease of the liver, or to simple chronic peritonitis. As was to be expected, the remedy failed when the dropsy was the consequence of malignant diseases in the abdominal cavity.

Dr. Sasaki administers the cream of tartar in doses of eight to forty grammes (two to ten drachms) a day, the average daily dose being ten to twenty grammes (two and one-half to five drachms). As already stated, he begins with eight grammes (two drachms) and graudually augments the dose till the patient has two or three stools a day. The medicament is administered either as a powder (in cachets or wafers), or in mixture according to the following formula: Potassium bi-tartrate

3 ijss [ 10 gms.]. Distilled water.....

. 3 iijos (100 ]. Lemon syrup...

..... enough to flavor. To be taken in three parts in the course of a day.


It is stated that under this treatment there is a considerable increase in the quantity of urine passed—one or even two litres (one or two quarts) being voided daily in cases where before only 200 grammes (say seven fluid ounces) were excreted; the abdomen steadily goes down, and the ascites diminishes till it has entirely disappeared—which sometimes occurs after only a few weeks. In other cases the disappearance of the fluid takes place more slowly, and in these the administration of the remedy has to be continued for months, which, it is maintained, can be done without any ill effect.

According to Dr. Sasaki, in cases where there is not very much effusion and the patient is not too weak, the potssium bi-tartrate alone is sufficient to bring about the absorption of the fluid; but if the quantity of effusion is considerable and the abdomen is very much distended, the administration of the drug must be preceded by tapping.

As the first case treated by the author in the above-described manner shows, the disappearance of the condition is not only a temporary one, but often a more or less permanent one.—Merck's Bulletin.

A NEW TREATMENT OF ALOPECIA AREATA.-In France the above disease is known by the name of pelade, and its parasitic origin is pretty generally accepted. Dr. Pye-Smith opines that many of these cases of pelade are in reality examples of ringworm in its later stages. However that may be, the practitioner will be glad to be made acquainted with the most recent treatment in vogue in Dr. Hallopeau's wards at St. Louis Hospital. When the affection is limited in extent rapid cure is obtained by repeated applications of cantharides solution with daily use of a ninety per cent. carbolic lotion. Where the disease is more diffused (all the hairy parts of the body or the entire scalp) the following lotion gives good results: Alcohol, 100 gm.; essence of turpentine and camphor, of each 20 gm.; corrosive sublimate, 10 ctgr. Local patches have been successfully treated by M. Hallopeau by the essence of wintergreen, which produces no irritation or pain.-Lancet



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PREPARED FOODS.—Many prepared foods are offered to the medical practitioner, each claiming special advantages.

As the physician is usually unable to personally examine these foods, to determine their composition, he must rely more or less on the statements of the manufacturers, and test such foods by actual practice.

In using prepared foods very great care should be taken at the outset to see that they are in good condition, that no deterioration has taken place through infection with the germs of putrefaction or of disease. We can only be certain in this respect of those foods that are delivered to us in hermetically sealed packages; the contents of which, when milk has been used, having been sterilized before packing. There is little doubt .but that much harm has been done by the use of partially spoiled foods.

It has been quite positively settled that an infant under seven months old cannot digest starchy food. The salivary glands are not yet properly developed, and the secretions of Ptyalin, the ferment of the saliva which acts on starch, does not exist until after the above age. It would naturally seem then that an all milk food would be the only one to use.

As far as I am aware Reed & Carnrick's Lacto-Preparata is the only food of this kind offered to the medical profession or public, and from what I know of its composition, its preparation and the results obtained by its use I am justified in saying that it is a most excellent substitute for mothers' milk, and is safest to use during epidemics of typhoid fever, cholera infantum, and Asiatic cholera. The milk used in Lacto-Preparata is selected with great care, the dairies being under constant supervision. The milk is run through centrifugal machines which not only remove the cream, that constituent which would cause deteroration of the product on keeping, but which also remove all foreign particles, thoroughly cleansing the milk, so to speak.

The cream later on is partly replaced with purified cocoa butter which has been found by experiment to be as digestible as milk-fat and of equal nutritive value; moreover it does not spoil.

The mixture of milk and cocoa butter is now made alkaline with lime water, then sterilized, evaporated to dryness, ground and packed in hermetically sealed sterilized cans.

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The same firm produce another food, adapted to the use of older infants and of invalids, called Carnrick's Soluble Food. It is prepared similar to the Lacto-Preparata, but contains about one-half (1) its bulk of dextrinized flour.

There is only one word of caution that must be given concern. ing the artificial feeding of infants; it is this: Watch carefully the condition of the child ; if the flesh becomes flabby and it does not seem to thrive as it ought, try the effect of small doses of a reliable emulsion of cod-liver oil. It is possible that the system needs a little more fat than it is getting in its food.' No prepared food, as far as I know, contains as much fat as the one recommended in this paper but it is impossible to prepare a palatable food that will keep and which will not be open to more serious objections than the slight deficiciency in fat.–Cyrus EDSON, M.D., Sanitary Supt. Board of Health of New York, in The Doctor of Hygiene..

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DOCTORS, PREACHERS AND RELIGION.-It is not an uncommon thing to hear statements to the effect that the medical profession, as a whole, is un-Christian. Such an assertion is worthy of a serious reply, and that reply is of necessity in the nature of a refutation. The practice of medicine tends to develop in all men of any intellectuality whatever, a realizing sense of the lim. itations of human power and skill, the fallibility of human judgment and the mutability of all things finite. Over and above these facts, the sincere searcher for truth recognizes the supreme power of God. Growing out of this knowledge there is, in most men of experience, developed a reverent spirit which acknowledges with sincerity the ever presént guidance and control of the Divinity.

Such belief, however, does not necessarily impose npon the man any agreement with or submission to non-essential statements of belief that are compiled largely by men whose educa. tion, life and experiences are wholly different from his own. And so, of course, many physicians frankly disown or disavow the lines of belief laid down for them by mere preachers, being fully persuaded that conscientious adherence to the great truths that constitute the essential element of Christianity renders un

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