the vagina. The three points from which secretion should be obtained for examination are: the cervix, the urethra and Bartholin's gland. Gonococci are more likely to be present if the secretion be obtained just after the cessation of a menstrual period or as the lochia is beginning to diminish after the emptying of a pregnant uterus. If difficulty is encountered in demonstrating the organism in a suspicious case, slight traumatism to the points from which the secretion is to be obtained and the taking of the smears twenty-four hours later will sometimes result in more organisms being present in the discharge and thus facilitate their demonstration. A simi

lar result may be obtained by a chemical irritation, such as the application of a strong solution of silver nitrate and the examination of the increased secretion thus produced.

Treatment of Ringworm-J. W. Miller (Ther. Gazette) reports good success in the use of iodine in goose grease, ten per cent strength. In the eastern public schools oleate of copper is largely prescribed. The use of ointments to bring about a cure is time-consuming and laborious. The child will frequently lose the whole school term. The massive-dose (measured) x-ray therapy is by far the most rational treatment for this condition today. The subject is so important that it is worth while to devote some time to its adequate description. Epilation must be secured with a single dose of rays; the dose, therefore, must be sufficient, but not so heavy as to cause an inflammatory reaction of the scalp, for in such a case the hair will not grow again. The dose must, therefore, be measured by means of a Sabouraud pastille, which is placed at a distance from the source of the rays half as great as the distance of the scalp from the rays. Irradiation causes the pastille to darken in tint; when it reaches a standard tint, which is given in each case of pastilles sold, the area of the scalp which has been exposed will have received a pastille dose of x-rays. The match between the pastille and the standard tint must be made by daylight. This dose has been found by experiment to be adequate to produce epilation without causing permanent baldness. The hair begins to fall about three weeks after the dose has been given, and epilation is complete in about a month. The case is now free from infection and may go to school. The hair begins to grow again within two months.

VE VE VE

Collargolum as a Specific for Scarlet Fever Dr. I. L. Van Zandt, whose advocacy of creosotal in the treatment of pneumonia will be recalled,

is an enthusiast regarding the use of unguentum Crede in the treatment of scarlet fever. We cannot give his faith expression better than in his own words, quoted from the Charlotte Medical Journal:

"I am emboldened on the basis of fifteen years' experience to say that properly used collargolum is as surely a specific for scarlet fever as is antitoxin in diphtheria.

"I know that some of my friends have used it without getting results such as mine, but when I hear of this, I feel sure that the technique of giving was defective, for though I have generally been reputed to be a modest man, I am not modest enough to assume that I have not had in fifteen years what would have been a bad case but for the treatment, while my neighbors have been losing cases, and furnishing, in others, work for the aurist.

"We all recognize that quinine is good for 'malarial' chills, and yet if twenty grains is necessary for a given case and only five is given, or, if twenty is given and vomited, or if twenty is given by injection into the bowel and immediately passed, we do not say that quinine is not good for chills, but we put the blame on the failure in administration.

"So a failure to get the collargolum into the blood is, I think, responsible for these failures of others."

Dr. Van Zandt, in treating an adult, generally directs one-fourth of the half ounce package to be rubbed in once or twice daily, according as there is little or much fever.

When the skin is cool and moist, the ointment does not go in readily, and he prefers the collargolum by enema-generally for an adult, ten to fifteen grains in a teacup of warm water once or twice a day. With children he uses rather more in proportion. He is not afraid to use any amount, as he is sure it is absolutely non-poison

HUBBARD'S PRACTICAL SURGERY. Practical Surgery, Diagnostic, Therapeutic and Operative. By B. Roswell Hubbard, M. D., Professor of Surgery in the California Medical College of Los Angeles. Second edition. With numerous illustrations. Young & McAllister, Los Angeles, 1913. Price $6.00.

This is a very interesting book. While the author devotes considerable attention to surgical pathology, he has not gone into this phase as elaborately as most books upon surgery. Probably the criticism that most reviewers will make of the book is that he has not gone into the pathology enough. However, there are plenty of other surgical works which delve deeply into pathological research, and Doctor Hubbard has used the space which might be used for that purpose to elaborate upon surgical therapeutics, which after all is probably more interesting to the average practitioner than the more "scientific" discussions. Also, he takes up a large number of topics which are not usually touched upon in surgical works at all. For instance, there are chapters upon surgical dressings and how to prepare them, on mediums for drainage, the preparation of ligatures, sutures and suture materials, upon tissue preservatives, upon the use of the leech and the application of heat and cold, upon rubefacients, disinfection, urinalysis, burns and scalds, sterility, transfusion, trussfitting, and numerous other items of the greatest practical value which the average doctor does not know where to find, and as a matter of fact cannot find in most textbooks.

Also, Doctor Hubbard has faith in the use of drugs even such common, every-day drugs as echinacea, calcium sulphide, arsenic, escharotics for skin cancers and lupus, and many other things too numerous to mention.

All things considered, Hubbard's book is a mighty good book to own, and a mighty convenient book to use. We predict that the doctor who has this lying upon his office table will find it of almost every-day value. It is well illustrated,

though not elaborately, and it is well printed and bound.

慌慌慌

LIFE AND LAW.

Life and Law. The Development and Exercise of the Sex Function, Together with a Study of the Effect of Certain Natural and Human Laws, and a Consideration of the Hygiene of Sex. By Maude Glasgow, M. D. G. P. Putnam's Sons, New York, 1914. Price $1.25.

Of the making of books upon sex there seems to be no end. To speak frankly, we are getting tired of this literature, though we must admit that there is real necessity for works which discuss the sex function in a sane, honest, matter-of-fact and chaste way. Doctor Glasgow's book seems to be

a work of this kind, and as such we believe it a safe book to put in the hands of the laity. It takes up the origin and development of sex, which is discussed from a biologic standpoint; and there are chapters upon parental care and protection; upon the reproductive sacrifice and development of the generative apparatus; upon secondary sexual characteristics; upon fertilization; periodicity in the male; female adolescence; menstruation; motherhood; nutrition and reproduction; the venereal diseases; prostitution; the white slave traffic; and instruction in the hygiene of sex.

The book is certainly an exceedingly readable one, and one which is likely to hold the interest of anyone who takes it up.

A NOTABLE WORK ON BIOLOGICAL
THERAPEUTICS.

A book of uncommon interest and value to physicians has just been issued from the press of Parke, Davis & Co. It is a new "Manual of Biological Therapeutics," receipt of a copy of which is hereby acknowledged by the editor of this journal. The book is handsomely printed in large, clear type, on heavy enameled paper, and bound in cloth. It contains 174 pages of text, upwards of thirty full-page plates in color, and

a number of half-tone illustrations in black and white, together with a comprehensive index. As its title suggests, it is a concise and practical treatise on biological therapeutics, and so replete with useful information that no practitioner should miss the opportunity to secure a copy, especially in view of the fact that the publishers announce that the entire edition is to be distributed gratuitously to members of the medical profession, on individual application.

Something of the scope and value of the work may be inferred from this incomplete list of the subjects treated: Biology; Bacteria; Immunity; The Preparation and Uses of Sera; Antidiphtheric Serum; Concentrated Diphtheria Antitoxin; Allergic Reactions; Antitetanie Serum and Globulins; Antigonococcic Serum; Antimeningitic Serum; Antistreptococcic Serum; Bacterial Vaccines or Bacterins; The Opsonic Index and Description of Method of Taking It; When Serums Should Be Used and When Bacterial Vaccines Are to Be Preferred; The Various Bacterins and Their Indications; Smallpox Vaccine; Pasteur Antirabic Vaccine; The Diagnosis of Typhoid Fever; The Agglutination Test Without a Microscope; The Agglutometer; Ehrlich's Diazo-Reaction in Typhoid Fever; Gonococcus Antigen; The Wassermann Reaction; Coley's Mixture; Coagulose or Hemostatic Ferment; Bacillus Lactis Bulgaricus; Phylacogens, Their Preparation and Mode of Use; Mixed Infection Phylacogen; Pneumonia Phylacogen; Gonorrhea Phylacogen; Erysipelas Phylacogen; Rheumatism Phylacogen; Typhoid Phylacogen; Tuberculins in Diagnosis and Treatment; Organotherapy; Thyreoidectin and Thyroprotein; Thyroid and Thymus Glands; Adrenalin and Pituitrin; Corpora Lutea; The Biological Farm and the Research Laboratory.

To our physician friends we suggest the propriety of writing at once for a copy of this "Manual of Biological Therapeutics," addressing the request to Parke, Davis & Co. at their home office in Detroit, Michigan. It will not be amiss to mention this journal in writing.

THE TREATMENT OF BURNS. Some suggestions upon the treatment of burns were made by Dr. John A. Wyeth, at a clinic held in the Post-Graduate Hospital, New York, during the meeting of the International Medical Congress in this country. We quote from the Medical Record:

Burns of the head and face are the most dangerous; those of the extremities the least grave. Recovery rarely follows destruction of one-third of the cutaneous surface. Death may result from shock, from ulcer of the duodenum, or from

exhaustion following prolonged suppuration and septic absorption.

When a severe burn or scald is encountered the immediate indication is relief of pain by the hypodermatic administration of morphia, or by some form of opium given by rectum or stomach. The most convenient local remedy is a saturated solution of baking soda in water, with submersion of the burned surface, if possible, or a mixture of bicarbonate of soda and cornstarch, one teaspoonful of each to a quart of water. The dressing should be kept wet with the solution, which is applied freely to the burned area. After five or six hours the free application of the following mixture, made into an emulsion, will be found beneficial:

These are melted together and, when cooling, 40 minims of ichthyol added.

Either of these ointments should be applied thickly on the soft, linty side of canton flannel, on surgeon's lint or on several layers of sterile gauze. The application should be repeated daily at first, after opening all blebs. In opening the blebs care should be taken not to remove the epidermis of the bleb, as this may become revitalized, thus greatly accelerating the healing process. In changing the dressing it is important not to disturb new granulations, but simply to wipe over them. When healing is well under way the dressing need be changed only every second or third day.

In the treatment of the depression or shock which often follows severe burns, stimulation with whiskey or brandy, by enema or by mouth, is indicated, as well as the hypodermic injection of morphine. Physiological salt solution, introduced by the colon, or injected into the areolar tissue, is of great value when the burn is extensive and the shock profound. It should always be remembered that opium and alcohol should be

given sufficiently cautiously to avoid too profound narcosis with the former, and with the latter increase in the fever reaction which follows when the patient rallies from the shock.

In an emergency, when the remedies mentioned may not be obtained, a coating of ordinary white lead, as mixed for use in painting dwellings, is an efficient protection when poured over the burn. Flour sprinkled over until all the excoriated surface is well hidden is a method of treatment which is applicable in almost any emergency. Rubber tissue, or oil-silk, sterilized and laid over the raw surface, with cotton batting applied over it, but never directly on the burned surface, is equally efficient. Lint, or a soft cloth, dipped in a 2 per cent carbolized oil, may be employed directly on the burn.

No pressure should be exercised in holding the dressings in place. When the back and posterior aspects of the extremities are chiefly involved, the prone position is of necessity maintained.

HE KNEW THE ANSWER.

His name was Tommy, and he came home from school looking so down in the mouth that mother asked him severely what was the matter.

Out of his little trousers pocket he fished a note from the teacher, which said, "Tommy has been a very naughty boy. Please have a serious talk with him."

"What did you do?" asked mother.

"Nothing." sobbed Tommy. "She asked a question, and I was the only one who could answer it."

"H'm," murmured mother. "What was the question?''

"Who put the dead mouse in her deskdrawer?" answered Tommy.

ADMINISTRATION OF ATOPHAN. Atophan-or, phenyl-quinolin-carbonic acidemployed as an eliminant of uric acid, occasionally gives rise to gastric disturbances. To obviate this trouble, it is now recommended to administer this remedy rectally, in the form of suppositories. Among those having tried this method is G. Klemperer, of the Moabit Hospital at Berlin, who has demonstrated (Ther. d. Gegeneo., Dec., 1913) that the atophan is absorbed from the rectum and, as a consequence, the amount of uric acid eliminated greatly increased. He recommends this method in cases of rheumatism and gout where the patient's stomach is irritable; albeit that occasionally it will induce rectal disturbance, even diarrhea.

The uterine oozings are usually accompanied with uterine hypertrophy. I am not an advocate of indiscriminate currettage, but I am confident that may cures result from Woodward's method of intrauterine irrigation with no undesirable results whatever. Internally I prescribe often a capsule made of 14 grain of hydrastine, 4 grain nux vomica, 1/2 grain ergotin and perhaps 2 grains of bisulphate of quinine. This dose is repeated every two to four hours for weeks in some cases until the condition is overcome. I have cured many cases of metrorrhagia at the menopause with this combination, correctly adjusted to the patient's needs. It not only cures the uterine condition, but the gastrointestinal apparatus and the nervous system are sufficiently restored to normal tone and function.

This

Amebicidal Treatment of Pyorrhea. In a recent number of the Dental Cosmos, M. T. Barrett, a Philadelphia dentist, made the startling statement that pyorrhea is caused by the presence of amebæ in the gum margins. He has been studying the subject in association with Prof. Allen J. Smith, of the department of pathology of the University of Pennsylvania. They found these organisms in the mouths of about fifty persons suffering from the disease, while they were not present in unaffected individuals. Having in mind the amebicidal action of emetine in tropical dysentery they made trial of the same drug in their cases of gingivitis, a 12 per cent solution being used to fill the diseased pockets. treatment was repeated every day or every other day. The results were surprisingly satisfactory. Not only was there improvement in the local condition, but there was an associated change for the better in the systemic condition-indeed, there was every evidence of complete cure in several well-advanced cases. If Barrett's results are duplicated by other investigators we have here the promise of a great therapeutic discovery. Pyorrhea is now known to be much more than a mere local disease of the mouth which is responsible for the untimely loss of teeth-more even than the cause of disturbing systemic symptoms. It is undoubtedly responsible for a large proportion of the arthritides, including arthritis deformans, in some cases at least. It undoubtedly may be a factor in other more or less remote affections of the human body. And it is very common. To find a real cure for it is to confer a real boon upon the We shall watch with eagerness for further developments.

race.