the flushing had completely revolutionized her health; they made her feel light and strong; they relieved the pressure in the abdomen; their presence caused eructations always. Sleeps better after taking one. In fact, if she find that insomnia be upon her, she takes a flushing and is sure to sleep soundly thereafter.

Eating when fatigued will be followed by great tympanites, which a flushing is sure to relieve. Formerly had great acidity of the stomach; now she never has it. Formerly she used to have a headache, with vomiting and prostration, lasting thirty-six hours every two or three weeks; since August she has not had one. Urinates very freely after using flushing, which lightens her very much.

Case III.-Mrs. R., age 29, has had chronic digestive disturbances; a poor breakfaster for years; has gastric dyspepsia characterized by pain; load, weight, gas, acid and bitter pyrosis; could eat but few things, butter especially distressing her; constipated and costive since girlhood; for years had a sense of pressure in the rectum; at times, of late, has had it all the time. Flushing first given the 17th of May, 1887, twice per week, at bedtime. At first they produced pain and nausea, and once vomiting followed. These adverse symptoms were relieved when the water passed. The discharges from her bowels were simply enormous. They were continued until she passed yellow feces. On the 28th of June she was eating everything. She has become a good breakfaster. On the 1st of August she was doing all her own housework, the first time in three years.

Case IV.-Miss C., age 30, always constipated. very muddy complexion, chloasmic spots all over her face, capricious appetite, seeks relief for a progressively increasing nervousness, which has been upon for the part three years, and is very much worse in the past six months, and threatens to lead her to a suicide's grave. She experiences sudden misgivings; she has nervous prostration, colon filled to an enormous extent. Flushing was used and continued daily for a period of one month, when she reported that she was better in every way, does not give out any more; is stronger in all things; her complexion is clearing out; the chloasmic spots are unchanged; the appetite decidedly vigorous. In this case the fecal reliefs were enormous, and the improvement so rapid that there was no question of their being cause and effect.

Case V.-Mrs. A. age 34, has been having epileptic convulsions since April, 1883, two years subsequent to her only confinement. Immediately after her confinement, in February, 1881, she began to experience nervous symptoms, such as numbness, twitching of the left side of her body; these increased until convulsions began in April, 1883. From that time until the 1st of May, 1887, she was under the care of various European and American physicians. She had had the cervix and perineum closed by operation; she had had almost endless medication, had used hydropathy, but still the convulsions continued. Careful examination revealed a loaded colon, universal congestion of the pelvic organs, and renal insufficiency. It was evident that the convulsions arose from some trouble upon the left side of her pelvis, which, in a normal state, would not produce convulsions, as

subsequent events showed, but in a congested condition was sure to precipitate convulsions. This was shown by the fact that the convulsions were preceded by an intense agitation of the muscles of the left lower extremity, which became

more and more uncontrollable until the convulsion developed a pain in the left leg,and could be produced by a pressure on the left side of the pelvis. Treatment for left-sided sciatica with ether and ice was given immediately after confinement. Pain through the pelvis from overexertion, or from too much standing, would be produced in the left leg, just the same as would be produced by digital pressure. There never was a convulsion that was not preceded by this disturbance of the left side. Matters clearly pointed to the pelvis for treatment for the relief of the convulsions. It was considered that if the pelvic difficulty could be relieved by any means, that possibly the convulsions would be arrested; accordingly, daily flushings of the colon and a diuretic were used; glycerin tampons were also daily used. The amount of relief was very great. For weeks the daily report was that the flushings came away looking like soapsuds, indicating a probable overplus of bile, which seemed to be confirmed by the fact of stomach indigestion and intestinal fermentations which she had had for years.

Her

The result of the treatment so improved the patient that in three months after the beginning of the flushings, etc., the convulsions ceased for a period of nineteen months. During that time she again visited Europe, relaxed her vigilance as to the care of her health, returning to America in January of the present year. face showed that she was absorbing feces again, and in various ways she indicated that her trouble was returning. Before she left for Europe the pelvic organs were in a condition demanding no further treatment. She was urged to return to her flushings, which she omitted to do and went straight on her iniquitous course of neglecting herself, and in February, about a month later, she had one of the most terrific convulsions she had ever experienced.

I believe that the flushings did for this patient what medicine could not do. They thoroughly evacuated her bowel and gave her alimentary canal a chance to absorb food instead of feces. I furthermore consider that the successful treatment of this patient with medicine, without flushings of the colon, will be entirely unsuccesful.

Case VI. Miss O. has been having chills paily, has a constant bad taste in the mouth, has vertigo, scalding urine, has eczema extensively on the right hand and fingers. Examination reveals a loaded colon, although her bowels move nearly every day. Ordered daily flushings of the colon, a daily laxative, and the potash citrate. In a week the chills ceased entirely, the vertigo had disappeared, the urine was improving. Medicine stopped, and the flushings continued for a period of six weeks daily. The surprising thing is that at the end of six weeks the hand was entirely well.

The question comes up, was not the eczematous condition of the hand a thing permitted to supervene from fecal absorption?

Case VII.-Mrs D., aged 29, has psoriasis covering a large portion of her body. She has as much unsound as sound skin, has had it more or less since the 8th year of her age. She is gouty, has gastric indigestion, headaches every two or three weeks, which always wind up with vomiting. After giving her medicines for a period of seven months without much benefit, I discovered an impacted condition of her colon. The effect of the flushings seemed to be to relieve her of all dyspeptic troubles, relieved her headaches entirely, and at the end of three months of using flushings, the psoriasis had almost entirely disappeared. The last time that she was seen a few spots of it remained on the abdomen and forearms.

The question arises, did the prevention of fecal absorption relieve a skin disease?

Case VIII.-Mrs. W., age 30, has had headaches for years anywhere from once a month to once in four or five days which prostrated her, lasting from six to twenty-four hours. She always had been constipated, and strange to say, about the only thing that ailed her was headache. Her colon was found loaded.

Flushings ordered for a period of three months, without medicines. The headaches were completely and permanently relieved; her complexion which had always been muddy cleared up greatly, sending out in bolder relief the chloasmic spots which decorated her forehead and temples.

I have often questioned whether chloasmic spots were not due to fecal absorption. These spots are pigmentary matter deposited under the skin. It is a physiological fact that all pigments originate in the liver. In a condition of health their abnormal deposit we never see. It is only when the patient is not well in some way, that these spots are noticed. They are infinitely more common in women than in men. It is easy to see that their sedentary life is more apt to lead in them to the filling of the colon. Absorption from the colon produces a poisoned blood, which in turn deranges every organ of the body, among others the liver. It is possible that the action of light, as in photographs, contributes in some way to precipitate the deposits

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of these chloasmic spots, because we see them chiefly upon the parts of the body exposed to light.

The use of a long rectal tube is unnecessary. The patient should be placed in a genu-pectoral position, the shoulders thus being lower than the hips. The water will be made to descend while anatomically ascending the intestines. Patients can be made to receive from one to six pints of water in this position without the slightest trouble. One of the effects of the water is to distend the colon, and in that way pressing away the walls of the loculi from the accumulations they fall into the current of water, and are passed out while the water is leaving the intestine. The patient will oftentimes complain of severe tormina; checking the current of water for a few seconds, and will be followed by complete relief. The presence of such a strange foreign body in the intestine as hot water in many cases excites prodigious peristaltic activity, thus producing the tormina. Plain hot water is all that is necessary to use. the water should be hot; cold water,or tepid water, will not do. It will produce great suffering. One patient took the flushings for a fortnight, returning vowed she never would use any more because they produced such terrific cramps. Upon inquiry it was found that she was using tepid water. The subsequent use of hot water by her was never followed by a cramp. Upon many patients this large amount of water acts as a vigorous diuretic. Where patients suffer as well from renal insufficiency, I am in the habit of telling them to use a pint or a pint and a half of hot water after the flushing has passed away, and to lie upon the back with hips elevated far half an hour. Thus retaining the water, it will act as a powerful diuretic. Some patients can administer this flushing with greatest ease, while others will develop a most phenomenal awkwardness. I am in the habit of telling patients to kneel in the bath tub, who are at all awkward about using these flushings.

June 13 I was called to see Mrs. N., aged 21; a primapara; well developed and a picture of health. Pregnancy had advanced to about 81⁄2 months. She had enjoyed perfect health prior to and during gestation.

On June 12, she had headache, slight uterine pains and feverish sensations. These symptoms became aggravated during the following day,

1Chicago Medical Society Trans. Condensed.

and when seen her temperature was 100.5, and uterine contractions were quite strong.

For two or three days previously she had done active service, including work on a sewing machine, which probably was the cause of the premature labor.

The pains were occurring about every fifteen minutes, and lasting about five minutes; were confined to the lower part of the abdomen, chiefly to the left, and were not "bearing down"

SOME singular dicta have crept into the discussion of the Maybrick case by the British medical journals. The details of the case are

as follows: Mr. Maybrick, a hypochondriac patent medicine taker, arsenic eater and secret drinker, was taken ill after a visit to the races where he ate and drank heartily and was wet through, with vomiting and stiffness in the legs. He was treated for gastro-intestinal catarrh by several physicians and given small doses of ipecac and Fowler's solution, bismuth, carbolic acid, cerium oxalate and similar remedies to relieve gastric distress. As constipation was present, cascara sagrada was administered. Sulphonal was given to secure slumber. The patient was doing well up to three days before death when diarrhoea attended by tenesmus set in. Four days before death suspicion of arsenic poisoning was raised by an interested party but on examination of the excreta no traces of arsenic were found. From this time on the patient was kept under surveillance, but on the first day thereafter he grew rapidly worse and died two days later. The British medical journals with their usual bias for the prosecution have summed up in favor of arsenic poisoning albeit leading forensic experts like Tidy whose work on "Legal Medicine" is an Anglo-Saxon standard, Fitzgerald and Kinkhead claim that death was caused by ordinary gasteroenteritis. Small quantities of arsenic were found by Stevenson in the intestines, liver and kidneys by the use of tests long since abandoned by toxicologists as defective. Had no arsenic been medicinally given the patient, and had he not been an arsenic-eater, this finding despite its defective origin might have been of value, but in the light of these facts it becomes valueless, especially when the defective nature of the tests is remembered. The British Medical Journal lays down as a starting point that vomiting attended simultaneously with diarrhoea, in an adult is indicative of poisoning. Every American physician of any experience will take issue with this dictum. Vomiting attended simultaneously with diarrhoea may result from a chill, from nephritis, from malarial hepatic disease, from hepatic cirrhosis, from bad water, from impure food, and in certain persons from cold. This dictum has therefore no value, moreover it has no bearing on the case. The vomiting of Mr. Maybrick did not Occur simultaneously with his diarrhoea. Dr. Tidy claims that since pain was absent gastro-intes

inal disease was not of arsenical origin and this claim is certainly a justifiable one especially in view of the facts of the case. In view of the facts given, the only ones bearing on the medical aspects of the case, the conservative scientist could find but one verdict as regards the arsenical theory-not proven. Mrs. Maybrick's immorality has no bearing on the scientific aspects of the case nor has the amount of arsenic found strewn lavishly over the house after suspicion had been aroused by a person inimical to the accused. On the clinical symptoms, post mortem findings and toxicological results "not proven" would be the only justifiable vercict,

JUDGE EWELL,a prominent Chicago authority on microscopy, in discussing a question likely to be raised in the Cronin case as a means of filling the gap in the evidence which fails to trace the doctor to the blood-stained cottage, says in a recent communication to a local contemporary:

"There are several mammals, and among them the dog, whose red blood corpuscles are so nearly of the size of the red blood corpuscles of man, that it is rash to express an opinion as to their source. Especially is it so when, as is usually the case in medico-legal investigations, the specimen submitted for examination is not fresh blood, but has been exposed to atmospheric and other unknown influeuces. Nevertheless, there have been in the past in this city so-called experts who heve even gone so far as to profess to identify the person from whom a given specimen of blood has been taken. Again, it is well known that the red corpuscles, even when fresh, vary in character within quite wide limits, so that unless the mean of the measurements of a large number of corsuples is taken, the results arrived at may vary sensibly from the true mean size, even if it is conceded that in a given person in good health such man is practically a constant one, a position to support which some evidence exists. An expert, therefore, who would venture to pronounce an opinion as to the source of a given specimen from a measuremsnt of the corpuscles, as is reputed to have been done in at least one case in the past, betrays either gross ignorance or culpable recklessness."

The great mass of authorities fully agree with Judge Ewell. It is therefore astonishing to find that a medical politician who has long been a tool of a local political ring, claims to be able to say from an examination of blood, not only that it is human but that it came from a particular individual. He claims that the blood of the blood-stained trunk, of the blood-stained

cottage and of the lamented Dr. Cronin are identical. Such a claim in the present state of science is so criminal an absurdity that it merits the severest professional condemnation as a disgraceful attempt to secure newspaper notoriety as an "expert."

THE "MEDICAL RECORD" seems to have finally reached the conclusion of the August MEDICAL STANDARD that the "Elixir of Life" was an expression of approaching senility on the part of Brown-Sequard, for it says:

"Its vaunted affects are impossible and ridiculous. It is opposed to all known physiological and biological laws, and had it not been bolstered up by the reputation of a Brown-Sequard, it would scarcely have been heard of outside or the Paris society where it was proposed, and no one would ever have looked upon it in any other light than as the foolish conceit of an old man, in whose mind the dreams of returning youth had assumed the counterfeit of reality."

The August MEDICAL STANDARD clearly indicated the abscesses, blood poisoning, embolis, etc., which have since been o richly reaped from the crop of experiments performed by medical seekers after notoriety.

SUBSTITUTION is a very old vice. It was advocated by Galen and "became so general in the Middle Ages that ("Pictorial History of Ancient Pharmacy"), it was found expedient to designate the proper succedanea." Even as late as the eighteenth century the practice survived, but evidently was becoming very disreputable, for Dr. Smollett ("in Roderick Random") says concerning a French apothecary settled in London:

"He had a great deal of business, but as he was mostly employed amongst his fellow refugees, the profits were small. However, his expense for medicine was not great, for he was the most expert man at a substitute of any apothecary in London, so that Random was sometimes amazed to see him make up a physician's prescription without the least hesitation, though he had not in the shop one drug mentioned in it. Oyster shells he could invent into crab's eyes, common oil into oil of sweet al. monds, syrup of sugar into balsamic syrup, Thames water into aqua cinnamomi, turpentine into capivy, and a hundred more costly preparations were produced at a moment's notice from the cheapest and coarsest drugs in the materia medica, and whenever any common thing was ordered for a patient by himself, he always took care that it should be disguised in color or taste, or both, in such manner that it could not be possibly recognized."

At this late day it is somewhat astonishing to find physicians defending the practice. The "Medical Times and Register," which lately distinguished itself by swallowing up all the small fry

of Philadelphia medical journalism has recently advanced the following argument in a seemingly serious editorial on substitution:

"Now if it be pardonable to mystify a patient a little by a bit of clap trap, and no physician can succeed who fails to array the mental force of his patient on his side, is it not equally justifiable for the druggist to do the same to the physician if the conditions are alike."

The "Western Druggist" does not rebuke this arrant sophistry too strongly when it says:

"This sophistical defense of substitution appears in the 'Medical Times and Register' of Philadelphia, anent a copyrighted preparation claiming to be a tasteless quinine but which did not contain quinine at all. No reputable pharmacist would venture to enunciate such views and it is a sad reflection on the medical profession that they should be uttered by one of its 'organs.'

OUR patent medicine contemporary, the N. A. P., with the benevolent object of giving its senior editors notions anent "secondary infection," as wide circulation as possible, has imbued one of its pet advertisers with some decidedly original ideas on bacteriology as witness the following dissertation on microbes in the nostrum columns of that foe of everything reputable, the Chicago "Times," by the manufacturer of a compound advertised in the N. A. P. and its ally, the "Times," to "cure consumption and germ diseases."

The Tubellaria Microbe, so called because of its peculiar rotary motion, is communicated by water into the human system or the inhalation of rain, mist, or fog. It at once attacks the lungs, forming that awful disease so well known in science by the term of tuberculosis.

The Planaridæ Microbe is one of the most deadly of its kind. It has the power of reproduction in the most striking manner, some species actually propagating by natural fission. That is to say, that the Planaridæ Microbe can by casting off the merest fragment of its body, be capable of realizing an independent existence and thus multiply ad infinitum.

The Tænia echinococcus Microbe in its larval condition is probably more injurious to the human race than all the other species of microbe. It is unquestionably a more frequent and immediate cause of death than any other internal parasite. They are introduced into our bodies by partaking of water or food in which the microbe larva has been introduced. They have a special liking for the liver and bore their way through that organ, defying all known remedies to destroy them.

The Trichina Spiralis Microbe when observed in the human muscle, presents the form of spirally coiled worms in the interior of small, globular, oval or lemon shaped cysts, invisible to the human eye. The medical treatment vary with the stage of the disease. The first treatment, however, must be the attempt to expel the parasites from the intenstines

must