New Publications.

SAUNDERS' MEDICAL HAND ATLASES. ATLAS of Diseases of the SKIN, INCLUDING AN EPITOME OF PATHOLOGY AND TREATMENT. By Prof. Dr. Franz Mracek, of Vienna. Authorized Translation from the German. Edited by Henry W. Stelwagon, M. D., Clinical Professor Dermatology Jefferson Medical College. W. B. Saunders, Publisher, Philadelphia. 1899. Price $3.50.

This is the most recent addition to this most excellent series of atlases, and is fully up to the general standard of excellence, containing 53 colored plates and 39 full-page half-tone illustrations. Of course the importance of personal inspection of cases in the study of skin diseases is recognized, but for those lacking clinical facilities the next best thing is to have at command numerous well-executed colored plates, such as are presented in the volume before us. Another advantage is

to have the plates small enough for handy reference, and yet sufficiently large for satisfactory representation. The author of this atlas has succeeded admirably in supplying both these requirements, and his selection of atlas pictures is also well adapted to the demand of average experience.

AN EPITOME OF THE HISTORY OF MEDICINE. By Roswell Park, A. M., M. D., Professor of Surgery in the Medical Department of the University of Buffalo, etc. Based upon a Course of Lectures Delivered in the University of Buffalo. Second Edition. Illustrated with Portraits and other Engravings. The F. A. Davis Co., Publishers, Philadelphia. 1899. Price $2.00.

Within a year after the appearance of the first edition of this work it was found necessary to issue a second, which should be sufficient evidence to indicate its popularity with the profession.

Great care has been shown in the preparation of this work, and it presents the history of medicine from the early days among the Hebrews and the Egyptians to the present time. The author makes three peroids: First, the age of foundation; second, the age of transition; hird, the age of renovation. An account

of the various systems, theories and discoveries in medicine, as well as the men themselves who have become famous in the profession, is also given.

The closing chapters are devoted to the history of medicine in America, the history of anesthesia, and an epitome of the history of dentistry; the very last chapter being devoted to iatrotheurgic symbolism, which means about the same as medico-christian symbolism.

LEGAL DECISIONS AFFECTING PHYSICIANS, DENTISTS, DRUGGISTS AND THE PUBLIC HEALTH. BY W. A. Purrington, of the New York Bar. E. B. Treat & Co., Publishers, 241-243 W. 23d St., New York. 1899. Price 50 cents,

This small volume, of over 100 pages, contains a review of recent decisions, as stated in the title, together with a brief for the prosecution of unlicensed practitioners of medicine, dentistry or pharmacy, with a paper upon manslaughter, christian science and other matter. It is hoped that this work may be serviceable in pointing out the true purpose of medical legislation, and persuading those who have given the matter little attention that dentistry is not a trade, etc., but that it is a specialty of medicine.

A STEP FORWARD; A TREATISE ON POSSIBLE SOCIAL REFORM. By F. C. Theo. Kruger.

This is a small brochure of 30 pages, and presents in a nut shell, as it were, the outlines of what the author thinks would be if adopted, a long step forward in social life. If the object could be accomplished it would evidently be a long stride forward in solving a very important question and would prove of inestimable value to millions.

Admires It More and More.

A well known practitioner and ex-professor in a southern medical college writes us under date of May 17th, 1899, as follows: "I admire the SUMMARY more and more, and all who I hear speak of it do the same. I know by the large number of advertisements it contains that it has a large circulation; I know, too, by my correspondents.

Summary Gleanings.

Onions for neuralgia of the stomach. For relaxed uvula use collinsonia locally. Hot food is not well borne in gastric ulcer.

For a hemophillia consider calcium chloride.

It is said that echinacea is "good" in flatulent dyspepsia.

Euonymine is indicated in occipital "bilious headache."

A woman who has had eclampsia should not nurse her child.

Do not leave a woman after labor when the pulse is over 100.

Women with well-marked cardiac lesions should not become pregnant.

For indolent ulcers, bedsores, etc., use, locally, balsam of Peru.

Iris may correct sour vomiting with sour, lemon-colored diarrhea.

Picrate of zinc for loss of sexual power, a power that is not easy to restore.

For constipation in nursing mothers, chew a teaspoonful of flaxseed daily.

Pediculi and their ova may be destroyed by a single application of sassafras oil. Tobacco makes loafers of men, tea makes them gossipy and coffee lethargic.

The only natural fetal presentation is where head leads and child is in universal flexion.

If the pulse in obstructive jaundice be as low as 30 per minute do not consider it alarming.

Alcoholic dementia is not a delirium, unlike that from other diseases, fever for instance.

An old wife's remedy for worms is grated carrot, raw, upon an empty stomach.

B. W. Barnum, of Poughkeepsie, N. Y., writes us that for dysentery and diarrhea he has been using Tannalbin with most excellent results. Old cases as well as new ones, he states, have been cured speedily.

The potash in the strawberry renders its juice a desirable drink for the gouty and for strumous children.

Videl applies green soap to warts constantly for 10 days and then removes them completely by curetting.

A doctor who keeps his library up to the times and buys the best medicines is pretty sure to be successful.

An unusual brightness of the eyes, delicate features with soft, white skin, and fine, silky hair, suggest tuberculosis.

Coughs with dryness of mucous membranes of respiratory tract, attending or coming after measles, suggest drosera.

It is stated that washing out the mouth with a 10 per cent. solution of chloral hydrate often relieves painful dentition in infants.

If in the pregnant state the amount of urea is below 1.5 per cent. treatment should be directed towards the organs of excretion.

To determine the time of gestation count back three months from last day of menstruation; then count forward a year and seven days.

Convallaria calms the nervous symptoms and palpitation in cardiac irregularities. It is a cardinal remedy in exophthalmic goitre.

When you find an infant with puffiness of the eyelids and a waxy skin, look for renal disorders. Confirm the diagnosis by making a urinalysis.

Dr. Pepper valued brewer's yeast above every other remedy in furunculcsis, but we would be somewhat skeptical as to its efficience in true carbuncle.

The white of an egg, well beaten, with a teaspoonful of sac. lac. and a little salt, has in many cases of cholera infantum been the only food that could be tolerated.

Dr. V. S. Laws says that in all cases of earache and deafness of children two or three drops of mullein oil in the clean ear twice a day has given invariable satisfaction. Grown people thus treated are always benefited, even in catarrhal deafness.

VOL. XXI.

TERMS:

Subscription $1.00 per year, in advance, including postage to any part of the United States, Mexico and Canada. Postage to any foreign country in the Universal Postal Union, including Newfoundland, 25 cents a year additional.

Subscribers failing to receive the SUMMARY should notify us within the month and the omission will be supplied. When a change of address is ordered, both the new and the old address must be given. Subscriptions may begin with any number. How to Remit.-Payment can be made by Postal Money-Order, Bank Check or Draft, or Express Money-Order. When none of these can be procured, send the money in a Registered Letter. All postmasters are required to register letters whenever requested to do so. Receipts.-The receipt of all money is immediately acknowledged by a postal card.

Important Notice. The printed address label which

appears on the wrapper of your SUMMARY indicates the date to which your subscription has been paid. Subscribers wishing the SUMMARY stopped at the expiration of their paidin-advance subscription must notify us to that effect, otherwise we assume it their wish to have it continued, expecting to receive a remittance at their earliest convenience.

Address THE MEDICAL SUMMARY, P. O. Box 1217. 2321 Park Ave., Philadelphia, Pa.

This journal has an extensive and constantly increasing circulation, is substantially established, and therefore presents to business houses desiring to reach the rank and file of the medical profession throughout the land, a most valuable advertising medium.

Entered at Phila. Post Office as second-class matter.

U. S. PHARMACOPOEIA, 1900.

The call has been issued for the assembling of the members of the convention to be held for the seventh decennial revision of the United States Pharmacopœia. The convention is to meet at Washington, D. C., on the first Wednesday in the month of May, 1900.

As the period to be covered by this revised issue of the new pharmacopoeia will be the first decade of the new century, and will claim the united allegiance of the medical and pharmaceutical profession to a standard that will embody the result of

No. 5

the work of this most prolific period of any age, the new pharmacopoeia will be looked for with quite a degree of expectancy, and the anticipation that it may worthily and truly reflect the progress of the closing epoch of an eventful century.

The extension of the principle of standardization of galenical preparations is one of the subjects that will again be discussed at this convention. As a standard of activity should characterize all such preparations, however this may be determined, physicians will be unitedly in favor of applying a system of standardization as widely as possible.

That, for an example, the amount of fluid extract or tincture should be taken as a measure of its medicinal activity is preposterous. Different samples of a drug vary greatly in their alkaloidal activity, and from them no definite preparations can be made.

But the subject involves the consideration of the economic problem of the relations existing between the retail pharmacist and the manufacturer. This phase of the matter may have its influence on the minds of the committees in forming a conclusion.

Standardization may include processes not open to the ordinary pharmacist. His business, owing to a number of causes, is not now so prosperous as under former conditions, and in this matter the manu

facturers may add another step in their encroachment upon his grounds.

To the SUMMARY the interests of the physician comes first. This is its unequivocal stand. On this basis, and deprecating the aspect and spirit commercialism, any method, new or old, that adds to the accuracy and consequent effectives of remedies has its unqualified approval and support.

TOXIC EFFECTS AND PECULIARITIES OF

DISEASE.

When what is generally accepted as a medium, or less, dose of any medicine produces an untoward or toxic effect, we have been accustomed to attribute it to an idiosyncrasy of the person to whom the dose was administered, but this presents a rather vague or imaginary idea of the real cause, whatever that may be.

For example. we probably cannot do better than quote from one of our corresspondents, Dr. Brodnax, who writes us as follows:

"A gentleman's wife, a patient of mine, cannot take even two grains of quinine, or any mixture in which quinine appears, without the tongue becoming tremendously swollen so as to protrude from the mouth. Another patient, a man 30 years old, took, last fall, 120 grains in 15 grain doses in eight hours without any other effect than an increase in the fever that followed the chill, which the immense quantity of quinine failed to abort."

Acetanilid has, according to some, caused trouble. One doctor reports a death from 2 1-2 grains in an adult, where in another case 190 grains were taken at one time without death and very little systemic disturbance.

As before stated, we denominate these strange effects idiosyncrasies, but some one has recently presented a strong argument on the subject, contending that it

was not a peculiarity of the individual make up, but a difference in condition. Notwithstanding the plausible explanations already presented on the subject, we cannot exactly see why it is that 30 to 60 grains of iodide of potassium can be taken with immunity for months, and five to 10 grains three times a day brings on another most distressing skin disease. When Dover's powder can be taken by 99 out of a hundred and the hundredth is oppressed with urticaria of a most disagreeable form, it looks as though there were some individuality in the matter.

Also, Dr. A. St. Lawrence Baike, in the N. Y. Lancet for April, gives an instance of an erythematous rash following about 2 1-2 grains of quinine dissolved in diluted sulphuric acid.

These peculiarities appear to run in families, other families being exempt. We have noticed this in some of the eruptive diseases of infancy. One lady remarked to us, "My brother, myself, my child and now my grandchild have had the hives (a specie of measles that appear within the first month of infantile life) and none of my sister's descendants have had it." It is notable that the same disease will appear very severe in some and of a mild form in others.

To our mind it appears probable that this difference of intensity in individuals may be primarily due to a sort of scrofulous diathesis, and in such a condition it is presumed, of course, the tissues would break down more rapidly.

NOTE.

There is no journal just like the SUMMARY. It has an atmosphere of its ownhas cut a niche which no other journal can exactly fill, and consequently no matter what other journals you take the SUMMARY does not duplicate any of them.

Original Communications.

Brief and practical articles, SHORT and PITHY reports of interesting cases in practice, new methods and new remedies as applicable in the treatment of diseases, are solicited from the profession for this department.

Articles intended for the SUMMARY must be contributed to it exclusively. The editor is not responsible for the views of contributors.

Write only on ONE SIDE of the paper.

CHOLERA INFANTUM.

BY WILLIAM HOOKER VAIL, M. D.

HE time is just beginning when we may expect to be afflicted with the ailments and complaints incidental to the approach of the warm season of the year, and of these, by far the most frequent and mortal is that disorder which attacks the infantile portion of the household, oftentimes robbing it of the sweetets and most attractive inmates, whose silvery laughter, lispering voices, pattering footsteps and winesome manners render it a paradise on earth. The mortality among these cherubs from this disorder is enormous, consequently warning word concerning the correct method of treatment to be carried out in this disease is, I think, opportunely and methodical.

a

Cholera infantum, or acute intestinal catarrh, is a severe and dangerous form of infantile diarrhea, observed principally during the first two years of life. It is more commonly seen among the indigent, but it is not confined to them alone by any means, and is most usually noticed in the hot climates, during the hot seasons in the more temperate zones-not only in the United States, but in Europe as well-and occurring just as frequently during the first as the second summer.

Artificially fed babies and those already weaned are mostly attacked. In nutritive value artificial food is seldom identical with mother's milk.

Cholera infantum is a disease of the summer months, and attains the greatest prevalence when the thermometer ranges the highest. In this latitude cases begin to make their appearance in the latter part of May and continue to occur, with varying frequency, until October. July and August are the months in which it

reaches its maximum prevalence and fatality.

Intestinal irritation, heat prostration and toxemia are the three potent factors concerned in the production of this disorder. The irritation of the intestines may be due to an indiscreet diet, an element of bacterial commotion or ptomaine pollution. As regards the latter, it seems to be veracious that, in hot weather, the germs which take on contagious or poisonous matter in the bowels are exceedingly active. Of these three factors, indigestion, which causes the intestinal irritation, is the prime cause of this ailment in infants. This may be due to a non-assimilation of the mothers milk, or to improper food, while the process of dentition in these same young children often aggravates the condition, but is not the cause. Many times this indigestion is brought about by overfeeding, for very few understand the quantity that an infant's stomach can contain, which, according to some authorities, is said to be one ounce at the age of one month, three ounces at the age of three months, four ounces at the age of five months, consequently we can readily understand how easily it is to overfeed.

Whatsoever may be the cause, plausible treatment by antiseptics, flushing and feeding, I believe, constitute our most potent weapons in combating infantile diarrhea. The alimentary canal should be deterged and be maintained in a perfectly clean condition, which is accomplished by a good intestinal antiseptic, and in severe cases this purge should be followed by such antacids and antifermentatives as subnitrate of bismuth and resorcin, to which opium or Dover's powder can be added. A very efficacious mixture I have employed with marked success consists of equal parts of aromatic syrup of rhubarb and castor oil, irrigating previously to its usage with hot water. I often combine a preparation of opium with the castor oil when there is much pain, but not enough to counteract the purgative effect of the other medicament. Camphorated tincture of opium is exellent, or spirits of camphor without the opium. This procedure, together with a vigilant outlook as to the diet, in most