about the happiest results without subjecting the young patient to an operation, which she and her parents dread and which may do harm.

It is well, in these days of the operating craze, not to forget our old friends of the pharmacopeia. An operation which involves so much should be the last resort.

Treatment of Pneumonia in Very Young Children.

By the way of summary, Dr. L. E. Holt, in the Med. News, lays stress upon the following points in the treatment of pneumonia in very small children:

1. No depleting measures are ever admissible.

2. Hygienic treatment, including fresh air, proper feeding and intelligent care, is of the most importance.

3. No unnecessary medication should be permitted.

4. Many annoying symptoms may be relieved by local treatment, such as the cough by inhalations, pain by counter irritation, restlessness by the ice cap or sponging.

5. Stimulants should be deferred until demanded by the condition of the pulse.

6. High temperature is much more safely and effectively controlled by the use of cold than by drugs.

7. Greater caution is necessary in the use of powerful stimulants than is generally observed.

8. Rest is quite as important as in other serious diseases.

Ichthyol for Pruritus.

Dr. Myron E. Fisher, of Delevan, N. Y., in a recent issue of the Med. Record, says: "A short time ago Mr. C. came into my office complaining of a rash which had appeared on several parts of his body, particularly on the hands, arms, chest and back. The pruritus was intense, so much so that he was unable to sleep at night. I made the diagnosis of poisoning by rhus toxicodendron, and prescribed the usual treatment without relief. Finally I made a lotion of one drachm of ichthyol in four fluid ounces of water, and directed that this be thoroughly applied to the affected

parts upon retiring at night. The patient was at once relieved of the pruritus, and after three or four days the rash had entirely disappeared. I report this case because I have never before heard this drug recommended for this affection.

Epidemic Cerebro-Spinal Menigitis.

Dr. Gustav Schirmer, of Chicago, gave brief notes of nine cases in the New York medicinische Monatsschrift, in which he employed inunctions of Crede's silver ointment in epidemic spinal-meningitis with success. His method was to use nearly an ounce of the ointment in the course of three days, and then about a third of that amount on the occurrence of a remission.

Chordee.

Some time ago, says Dr. G. W. Ely, in the N. Y. Med. Jour., I was called to see a patient in the agony of chordee. The day previous he had taken large doses of the bromides as a prophylactic, but seemingly they had no effect. Noting that the glans penis and the prepuce were very dry and sensitive, and seeing a jar of vaselin on the dresser, I thought it rational to expect to relieve him by anointing the glans with it, but I was not prepared for the complete, instantaneous results, for, as soon as the glans were well smeared, the entire organ became flaccid and of nesessity painless. This he tried again during the two succeeding nights with like results.

Soon after this I had another patient with gonorrhea and advised vaselin as above used should should chordee develop, which it did in due course, but as quickly vanished under the soothing influence of three distinct occasions.

Not being able to recall having read this at any time, and deeming it might be of use to others, I put it before them.

Glycosuria in Diphtheria.

The occurrence of glycosuria in diphtheria has been noticed in a few cases, but few observers have been able to make a careful serial test in a large number of cases. Dr. Charles Simon, of Baltimore,

Md., has referred to this condition in a number of cases, and Drs. C. M. Hibbard and Michael J. Morrissey, in the Jour. of Experimental Medicine, have noted a number of cases, from which they draw the following conclusions:

1. There is a transitory glycosuria in diphtheria which is found frequently in the severe cases and is usually present in the fatal ones.

2. This glycosuria is often associated with albuminuria.

3. Injections of diphtheria antitoxin are occasionally followed, for a few days, with a slight glycosuria.—Md. Med. Jour.

Treatment of Otitis.

Dr. H. B. Williams, of Chicago, in the Alkaloidal Clinic, says: "The more I see of chronic suppurative inflammation of the ear the more convinced do I become that the element of chronicity is due to lack of thoroughness in treatment. The method of procedure mapped out below will not succeed in cases where necrosis has occurred, but in all others it will reduce the duration of treatment from months and weeks to days.

"The patient is placed upon the side with the affected ear up. The concha is filled with Hydrozone, which is allowed to remain until it becomes heated by contact with the skin, when, by tilting the auricle, the fluid is poured gently into the external canal. The froth resulting from the effervescence is removed with absorbent cotton from time to time and more Hydrozone added. This is kept up until all bubbling ceases. The patient

will hear the noise even after the effervescence ceases to be visible to the eye.

"Closing the external canal by gentle pressure upon the tragus forces the fluid well into the middle ear, and in some instances will carry it through the Eustachian tube into the throat. When effervescence has ceased the canal should be dried with absorbent cotton twisted on a probe and a small amount of pulverized boracic acid insufflated.

"The time necessary for the thorough cleansing of a suppurating ear will vary from a few minutes to about an hour, but if done with the proper care it does not

have to be repeated in many cases. However, the patient should be seen daily and the Hydrozone used until the desired result is obtained.

"In children and some adults the Hydrozone causes pain, which can be obviated by previously instilling a few drops of a warm solution of oocaine hydrochloride. In this note it has been the intention to treat suppuration of the ear rather as a symptom and from the standpoint of the general practitioner."

Diabetes Mellitus and Pregnancy.

Dr. F. W. Taylor, in the Boston Med. Jour., draws the following conclusions: 1. Diabetes may come on during pregnancy.

2. Diabetes may occur only during pregnancy, being absent at other times.

3. Diabetes may cease with the termination of pregnancy, recurring sometime afterward.

4. Diabetes may come on soon after parturition.

5. Diabetes may not return in a pregnancy occurring after its cure.

6. Pregnancy may occur during diabetes.

7. Pregnancy and parturition may be apparently unaffected in their healthy progress by the diabetes.

8. Pregnancy is very liable to be interrupted in it course, and probably always by the death of the fœtus.—Med. Record.

Typhoid Bacillus in the Urine in Typhoid Fever,

Dr. Richardson, of Boston, has given this subject considerable attention, and in the light of the evidence presented it appears quite plain that the supervision of typhoid patients has heretofore been very inadequate indeed. The urine, as well as the stools of typhoid patients must be disinfected, and, as Dr. Richardson emphasizes, the necessity of such disinfection and supervision does not cease with the subsidence of the fever, but must be kept up sometimes, it would seem, for weeks, sometimes years.

Dr. Richardson dwells particularly upon the value of Urotropin as a urinary antiseptic, with especial reference to its us

in typhoid fever, In one report, 14 out of 66 cases showed the presence of bacilli in the urine. Eleven of these were submitted to treatment with the following results:

Two cases received salol, and in one instance the bacilli disappeared. In one case the salol did not have any effect on the bacilli, and Urotropin was then substituted for the salol, followed by the prompt disappearance of the organisms. Nine cases were treated with Urotropin, and in every one the bacilli promptly disappeared. This favorable result was accomplished in eight out of the nine cases by the use of 60 grains or less of the drug; one case required 200 grains to remove the organisms. A number of the cases (7) were followed for from seven to 66 days after the administration of the Urotropin was stopped and the bacilli did not reappear; so that it seems fair to assume that the removal of the typhoid organisms was permanent.

Freshly passed turbid urine, if acid in reaction, should always be regarded with suspicion when it concerns typhoid patients or convalescents. When such urine, on microscopic examination, shows the presence of bacilli it is quite probable they are the typhoid bacilli, and the results of the cultures can thus be foretold. Jour. Amer. Med. Asso.

A Heart Tonic.

Dr. Neiderkorn says that strophanthus is indicated in almost any irregularity of the heart's action-feeble and frequent cardiac contractions without pyrexia, precordial pain, palpitation, dyspnea, etc. when a heart tonic is required. In structural heart disease we have had excellent results from the use of strophanthus. The dose is from one to 10 drops in water every three or four hours.-Chicago Med.

Veratrum Viride in Puerperal Eclamsia.

Dr. H. R. Coston, in a recent number of the Virg. Med. Semi-Monthly, offers the following conclusions:

1. Veratrum viride is a perfectly safe remedy; even when used in extra large doses no danger need be feared so long as

the patient is kept in the recumbent posture.

2. It is almost a specific when used early in the case for all cases of puerperal eclampsia.

3. Those who inveigh against it have either not used it at all or have used it too sparingly.

4. Use the pulsǝ as a guide, and give the medicine in 10 or 20-drop doses, hypodermically, ever 30 minutes until the pulse is reduced to 60 per minute, and continue the remedy in smaller doses at longer intervals until coma disappears entirely.

Hemorrhoids.

Dr. H. J. Schiff, in a paper read before the Metropolitan Medical Society, and published in the Med. Record, describes his operation as follows:

"Thoroughly stretch the sphincter and pass a plug of iodoform gauze into the bowels as a precautionary measure.

If there is a circle of hemorrhoids divide it into quarters and operate on one hemorrhoid, or one-quarter, as the case may be; seize the mass of hemorrhoid with a clamp, and while making traction make an eliptical incision encircling the mass, and carefully cut from the cutaneous surface inward and upward, leaving the vessels the last part to be severed, and as soon as the vessels come into view grasp them with an artery clamp and separate the entire mass from its connection with the bowel. Now ligate the vessels and suture mucous membrane and cutaneous wounds as you would any other wound in which you sought primary healing. This completes the operation. -Med. Herald.

lodole-Menthol.

Iodole-menthol is said to be a mixture of iodole with one per cent. of menthol. It is calculated to be of special service in the treatment of catarrhal and ulcerous affections of the nose and throat, employed in the form of insufflations. The iodole action is present in marked degree.Merk's Archives.

One dollar for the SUMMARY one year.

Notes and Queries.

For this department we cordially invite questions, comments and criticisms on all topics of interest to the physician in his daily work for the relief of the sick, thus making the SUMMARY a valuable medium for intercommunication between the medical profession.

Correspondents will give their names and addresses, but ínitals only will be printed when desired. The QUERIES in this issue await the ANSWERS which our itelligent readers may be pleased to contribute for publication in our next.

Some Legal Points of Interest to the Physician.

Editor Medical Summary:

In the March number of the SUMMARY Dr. W. V. Wilson (page 55) says: “We, as physicians, should at once enter upon a crusade against unjust legislation and, as the remedy is in our hands, begin at once. Let us petition Congress to pass a law empowering the registered physician of any state to practice in any state."

A national registration law would seem to be the ideal law for the physician, but the power to license is inherent in the state, and Congress cannot interfere with the police power of the individual state.

It has been claimed that the medical laws were unconstitutional; this is a fallacy. Judge Cooley says: "Employments are subject to control under the state power of police and may be regulated in various ways and, in some extent, restricted. * * The state may require special training for some employments, and forbid persons engaging in them who have not proved their fitness on examination and been duly examined. Such are the cases of law and of medicine. If, by such regulation, one who has practiced such profession for a time is prevented from continuing its pursuit, he is not deprived of property contrary to law. * * * The fourteenth amendment is held not to have taken from the states the police power reserved to them at the time of the adoption of the constitution."

In a case which was taken to the United States Supreme Court (129 U. S. 11): "The power of the State to provide for the general welfare of the people authorizes it to prescribe all such regulations as, in the judgment, will serve or tend to serve them against the consequences of ignorance and incapacity as well as of deception and fraud. No one has a

right to practice medicine without having the necessary qualifications of learning and skill, and the State only requires that whoever assumes, by offering to the community his services as a physician, that he possesses such learning and skill, and shall present evidence of it by a certificate or license from a body designated by the State to judge of his qualifications."

Now, for what purpose were the medical laws enacted and licensing boards formed. The result desired was the elimination of quacks and ignorant, irresponsible practitioners of medicine from the state.

We find, as Dr. Wilson says, "that some of the most notorious quacks have been registered." He also says: "I do not see how, once having been legally admitted to practice, any new laws would prohibit the quack, as a license is good as long as the person holding it lives." His premises are correct. He will practice during the remaining part of his life unless convicted of transgressing some law of the state. The medical laws took effect at the time of the enactment of the same. An ex post facto law would be unconstitutional, therefore the quacks who had been in practice for a term of years in the state were registered.

As we view the workings of the medical laws it would seem that, however stringent the medical laws may be, the quacks are not growing fewer.

I was reading, not long ago, of a physician who removed from a certain state to Louisiana. He there obtained provisional license until the official meeting of the board, when he took the examination and failed to answer a certain number of questions in a manner satisfactory to the members of the board. This man is a graduate of a reputable medical college (Kentucky School of Medicine, I think), and had held positions of trust such as pension examiner, examiner for old line insurance companies, etc., and had been a successful practitioner for something like 20 years. It would seem

that the reputable graduates in medicine are the persons who are suffering hardships because of the medical laws, and that the quacks still flourish. I am

a believer in the conservative

license law, but I am not a believer in a board of examiners who formulate questions which they cannot answer themselves; neither am I a believer in a board who do not give a practical physician a practical examination.

If the medical laws are unjustly enforced or the laws are in themselves of such a nature as to be oppressive, the redress lies in the law-making power of the state, where a law may be unmade as well as made. The state has entrusted the licensing power to the members of a board. If the members of this board do not conduct these examinations in accordance with the intent of the framers of the law they should be removed from office and others appointed in their places. The danger in leaving the licensing power in the hands of a few is that these men may receive appointment because of political preference. When the members. of these boards are recognized as peanut politicians then the people will send representatives to the legislature who will obliterate every medical law from the statute book. A conservative license law, administered equitably and justly, is what is demanded by the people and the physician.

I think the medical profession is with Dr. Cobb, and as a unit would desire to reform the daily press of our land, but I am afraid that a movement in this direction would result in a more extended advertisement for the quacks.

The very papers which point the way to the office of the professional abortionist are the first to condemn the respectable, family physician who is called to attend the unfortunate victim of the professional murderer. It is contrary to statute to publish this information, but the business pays and the manager of the advertising department is looking for money, and he pockets his salary with his conscience, as also does the religious editor; it is blood money, yet some of the proprietors of these papers are very religious.

These papers will hound a respectable physician who has tried to save the life of one of these cases, giving him undue publicity, perhaps accusing him of committing the crime (a case of this kind hapPening a short time ago in Massachusetts)

whilst in the advertising columns of the same issue space was sold to the professional abortionist, the clergyman whose sands of life are nearly run, picture published of the man whose prostate gland had been diminished in size, also pictures of clergymen recommending some of the popular alcoholic beverages, testimonials of the deacons who had been rejuvinated by taking the Morman elders' priapism wafers, et als. ad nausem.

I am afraid, Bro. Cobb, that we would have a thankless task on our hands if we attempted to furnish brains for the people by the way of the legislature. It is a case of caveat emptor, and a practical illustration of "Mans inhumanity to man makes countless thousands mourn."

Ipswich, Mass.

W. H. RUSSELL, M. D.

From the Wayside.

Editor Medical Summary:

Often by the wayside of our medical reading we find therapeutic gems that would be lost in the sea of forgetfulness were they not gathered together and placed where they will be handy for ready reference.

Boric acid has some remedial effect in paralysis agitans, given in six-grain doses t.i.d. After a few days gradually increase the dose until double the amount is taken.

Our baby daughter came to us with a burned finger, complaining wonderfully. We coated the injured member with carbolic acid and in an instant there was no pain. There is no absorption of the acid and consequently no toxic effects.

Sodium salicylate sometimes assuages the pain of carcinoma. Try this drug in amenorrhea and dysmenorrhea.

The most annoying symptom in nasal catarrh is the increased secretion, and dry it as much as you will it will not stay dry. Tannin and iodoform (2 to 1) will make a dusting powder that will give you relief.

Glycerin and tannin (4 to 1) makes a splendid topical application in tonsillitis and pharyngitis. Tannin is said to be superior to creosote in destroying the bacillus tuberculosis.