few grammes, and even in chlorosis all of it has not disappeared. Any surplus iron is more likely than not to give rise to gastro-intestinal irritation. He prefers to give the iron in the form of iron filings mixed with chalk, powdered coffee, or rhubarb, in the form of a powder. Vinegar, to which chlorotic patients are often extremely partial, is not to be absolutely forbidden; on the contrary, a draught containing hydrochloric acid, taken after each meal, is a powerful aid to digestion. The constipation should be overcome by means of podophyllin, and the uterine functions should be stimulated at the approach of the menstrual epoch by means of hot baths and an infusion of saffron internally. Massage and general gymnastics are also to be commended as adjuncts. In many cases when iron has failed, arsenical preparations, in conjunction with bitters, are successful, and the binoxide of manganese has given good results when both iron and arsenic had been tried in vain. The binoxide can be given in a powder with charcoal and powdered calumba root, or it may be given in the form of the lactate of manganese, made into pills with extract of cinchona. When iron is well borne he recommends the following formula:- ext. cinchonæ, ext. gentianæ, ext. rhei., ãà, 5 grammes; ferrum tart., 5 grammes; ext. nucis vom., 50 centigrammes; ol. anisi, mv.; glycerine, q.s. To be mixed and divided into 100 pills. Two to be taken before each meal.-Lond. Med. Rec. SALICYLATE OF MERCURY.-Dr. W. C. Caldwell, of Chicago, Ill., in an original communication upon salicylate of mercury in the Therapeutic Gazette, concludes thus on this drug: "I. Because the salicylate is likely not absorbed from an acid membrane, it will usually produce less derangement of the stomach than the bichloride. 2. Because the mercury is combined with an organic radical, it will produce less irritation during both first and elimination-contact actions than the bichloride. "3. Because the salicylate contains less mercury and acts slower than the bichloride, it has less action on albumen and on bacteria of putrefaction and far less on digestion. "4. Because the salicylate passes through the stomach to the duodenum and there is dissolved, it appears that exhibited with hydrochloric acid it would be better adapted for an intestinal antiseptic than the bichloride, which probably is dependent mainly on its elimination-contact action in the intestinal canal. "5. Because the mercury is combined with an organic radical, it should not be prescribed with mineral salts of the heavy metals. "6. Because iodide of potassium given with it converts it into the biniodide, the salicylate should not be exhibited at the same time, unless it be in small doses. "7. Because the salicylate is insoluble in acids, it should not be prescribed with drugs requiring an acid menstruum for solution. "8. Because chemical change occurs when combined with muriate of cocaine, they should not be given together. "9. Because the bichloride is probably more active and effective in syphilis, it probably is the best when it agrees. "10. Because the bichloride has such marked elimination-contact action, it is the better when such action is desired, as in acute tonsillitis, parotitis, etc." EXPERIMENTAL STUDIES ON HYPERPYREXIAS.-M. Ch. Richet, ("Jour. des. Soc. Sci.," No. 20, 1888, has studied the influence of artificial hyperpyrexia, and the result of maintaining the high temperature for a considerable length of time. He says that animals whose temperature attains 45° C. [113° F.], and even 45.6° C. [114° F.], may survive if this thermic stage lasts for a short interval. But an animal succumbs if its temperature is about 43° C. [109.4° F.] for two hours; a crisis occurs before death, the temperature gradually falls, the nervous system seems powerless to generate any more heat, and finally death ensues. Chloralization previous to the artifical hyperpyrexia was found by the author to hasten and assure death. The effect of chloral on the nervous system is considered as that of a depressing agent, which is added to that of the hyperpyrexia. This fact, it is stated, must be of importance in medicine, for the use of chloral seems dangerous in delirium, insomnia, and in other accidents occurring in hyperpyretic patients.-N. Y. Medical Journal. CONTINENCE AND SYPHILIS.-The Lancet, commenting editorially upon our remarks regarding continence as a preventive of syphilis, adds: "Though Dr. Gowers' testimony to the importance of chastity as a means of health is the last great note sounded to Englishmen, it does not stand alone in medical literature. There is another voice which may be recalled here which will sound for generations yet, as characteristic in its ethical strength as in its medical and scientific authority. Sir James Paget, in his clinical lectures, speaking of patients that expect us to prescribe fornication, says: 'I would just as soon prescribe theft or lying, or anything else that God has forbidden. If men will practice fornication or uncleanness, it must be of their own choice and on their sole responsibility.......Chastity does no harm to mind or body; its discipline is excellent; marriagecan be waited for; and among the many nervous and hypochondriacal patients who have talked to me about fornication, I have never heard one say he was better or happier after it; several have said they were worse; and many, having failed, have been made much worse."-N. Y. Medical Record. BLEPHAROPLASTY.-Dr. C. Bolling reports an interesting case of an old man of 62, who had lost both upper eyelids and both eyebrows from epithelioma. The author took flaps of skin from the temples, and fastened them to what was left of the conjunctiva by sutures of catgut, inverting the flap so that the epithelial surface was in contact with the eye. He replaced the eyebrows by flaps taken from the forehead and from the integument between the brows, sewing them together by sutures of silk. The result was very satisfactory, the patient being able to open and close the lids, and presenting very little deformity. RESECTION OF THE INFERIOR MAXILLA.--Dr. R. del Castillo Quartiellerz has devised a plan for excising the inferior maxilla, which he thinks is a great improvement on the ordinary methods, both from a surgical and from an æsthetic point of view. The method consists essentially in passing a specially constructed trochar through the skin. behind the ramus into the mouth, and then making use of the canula as a guide for a chain saw, by means of which the excision is carried out. This procedure has, of course, to be repeated on the opposite side. The only wounds of the skin are two small openings made by the trochar, the cicatrices of which are small and do not disfigure the patient; there is very little hemorrhage, and there being but a comparatively small wound, the amount of suppuration and consequently the risk of awakening the patient, is inconsiderable as compared with that occurring in more severe operations.--Lancet. QUININE IN PREGNANCY.-The idea that full doses of quinine are liable to produce abortion seems to be no longer held. A writer to the Br. Med. Jour. says, "I have frequently, both at home and abroad, administered large doses of quinine (10 to 20 grains) to pregnant women suffering from malarial fevers, and never observed the uterus at all stimulated by it. I do not know of any drug that will cause, when taken internally, the expulsion of the contents of the pregnant uterus. FOR TAPE-WORMS IN CHILDREN.-The Lyon Med. gives the following formulæ as effectual and agreeable: Make into the consistency of jelly, and administer as a confection. CALOMEL AND DIGITALIS IN ASCITES (in dropsy from hepatic cirrhosis).—Schwass (Centralbl. f. klin Med.) advises the use of calomel and digitalis as follows: R.-Calomel, S. Every three hours for a week. 2 grains. The diuretic action of this combination is far greater than that of either drug alone and can also be tolerated longer and better than either drug when taken by itself. PROLONGED GESTATION.-Dr. Mans (N. Y. Med. Jour.) gives a case of prolonged gestation which he thinks can be authenticated. The period of pregnancy, calculating from the time of last menstruation, was 334 days. At the end of this time the patient bore a healthy male infant weighing nine pounds. This almost breaks the record, though Simp sọn mentions a case in which delivery occurred 336 days after mensuration ceased. Playfair places the extreme limit at 295 days. FOR TONSILLITIS.-Dr. John Aulde recommends (Med. Reg.) the following as a useful medicine and gargle in this troublesome complaint: B.-Tr. guaic. ammoniat., Tr. cinchonæ comp., Potas. chloral., Mel. desp., Pulv. acaciæ, Aquam., M. Sig. -Use as a gargle, and take a teaspoonful every two hours. ATROPINE IN HEMORRHAGE FROM THE LUNGS.-Dr. Stirling, says the Therap. Gaz., relates a case in which hemorrhage from the apex of the left lung was entirely uncontrollable by ergotin, and all the other remedies usually prescribed. He administered grain of atropine, hypodermically, with the result that the bleeding was at once stopped. He found that when the drug was stopped the bleeding recommenced, to be controlled by a further use of the atropine. REMOVAL OF TUBES AND OVARIES FOR PELVIC INFLAMMATION.—There are forms of pelvic inflammation which seem to defy almost all therapeutic measures, and Dr. B Bernard Brown, in considering this subject (Maryland Medical Journal), states that he operated in four cases which recovered. From a study of these he concludes: 1. That pelvic disease, accompanied by pain and inflammation, often occurs where neither tumor nor displacement exists to account for it, and where nothing more can be found than tenderness and thickening of the tubes. 2. That disease of the tubes is more common in married women or those who have had children or abortions. 3. That the ovary is more commonly affected in single women, and then it is frequently accompanied by defective development in the uterus. 4. That both of these conditions render the woman almost necessarily sterile. 5. That in removal of the tubes great care should be taken to remove them as close to the uterus as possible, so as to embrace the nerve trunk that enters the cornu of the uterus in the angle between the round ligament and the tube, which |
