of sterile pus and considerable tissue debris were evacuated. In another case five small injections were given at biweekly intervals without any especial trouble, but about three months after the last both buttocks became red, swollen, and painful, with distinct fluctuation. Operation was refused, and the swelling resolved in about two months; but even now, one year later, the buttocks are still sore and tender on pressure. Several other men have reported similar experiences, the longest interval between injection and abscess being one year. One other patient has had permanent nodules left in his buttocks, and complains bitterly of pains radiating down both sciatic nerves. VE VE VE

Lobelia Enthusiasm. Since elsewhere in this

number of the MEDICAL STANDARD we are giving special attention to lobelia the following testimony of praise for this American drug, contributed by A. F. Stephens to the Eclectic Medical Journal seems quite apropos. Dr. Stephens is not a believer in the antitoxins, which he denounces in a vigorous fashion-and this leads him to speak of lobelia :

I believe lobelia alone is worth more to humanity than all the infernal rot that has been discovered through the poisoning of animals, and the results foisted upon the people who do not know but believe what they are told because it is the voice of "science" which sends forth the edict. Science is a wonderful word to conjure with, and our worthy friends know well how to use it to the best advantage.

It seems to me that time will prove old Samuel Thomson to have possessed more wisdom in his untutored head than all the wise guys that have damned him for a hundred years. Crude he was, and perhaps vain, conceited and egotistical, but he saw with an eye single to the welfare of humanity, and nature held the telescope through which he saw the things that were right.

A case of heat prostration developed terrific convulsions in a man of forty-five. Conditions under ordinary treatment were growing desperate and it looked very much as if the man would die, when a consultant suggested a hypodermic of subculoyd lobelia. A syringeful was given. Relaxation, complete, occurred in twenty minutes. Then a dose three times a day for three days and the man is well. Did lobelia do it? We think

several days. Did lobelia anti in this case? We believe so.

And so we might go on describing other cases and conditions, but please to observe that we do not claim infallibility for lobelia or any other remedy as an antitoxin, but we do assert that we have certain vegetable antitoxins that would put to shame the products of the stable, and we believe it would be well if more of our big brothers would investigate and learn. The spirit of the times is breathing sanitation; let us get away from the barnyard.

In the first case in which this treatment was employed, the patient was a young woman who underwent a laparotomy following attempted abortion. Her condition was most grave and intestinal adhesions were present. A liter of ether [This seems excessive-ED.] was poured into the peritoneal cavity and the abdomen closed, but with a small drain left at the upper part of the wound. The next day the temperature was 38.4° C.; there was a decided fall of temperature on the following days, the cure being rapid.

Souligoux cites several other cases of similar character, and recounts some observations made by Temoin, of Bourges. These were as follows:

The first case reported by Temoin was one of intestinal occlusion associated with peritonitis following rupture of the twisted pedicle of an ovarian cyst. An emergency laparotomy was performed. Blood was found in the peritoneal cavity, due to the rupture of a loop of intestine in torsion. This loop was released, the cavity washed out with ether, then closed, leaving a small drain. Cure followed.

In the second case, there was a generalized peritonitis. Upon surgical intervention, a perforated, gangrenous appendix was found. Lavage with ether, and cure. In the third case, there was a suppurative peritonitis following pyosalpinx. Laparotomy, lavage with ether, and cure. In the fourth case, strangulated hernia, with gangenous intestine and suppuration. Half a liter of ether was introduced within the abdomen through a sound, which latter was left in place. The patient was in a dying condition, but revived and seemed to be recovering. However, she died, in syncope, on the tenth day.

These cases, in connection with those already communicated to the Surgical Society, seem to

demonstrate that the treatment of peritonitis with ether lavage gives very good results.

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About Calcium Therapy.-Paul Saxl, of the Medical Clinic of Vienna, has compiled and published, in the Medizinische Klinik, a summary review of the status of calcium therapy, together with the experiences at the Clinic. As a procedure, the author recommends his own method, consisting in the intramuscular application of the calcium chloride in 5 per cent solution in "absorption to gelatin". The gelatin prevents abscess formation, as proved in 200 cases. It also lessens somewhat the intense pain and the febrile sequel.

Salicylic Ionization in Acute Pericarditis.— Salicylic ionization is claimed, by J. S. Mackintosh (Brit. Med. Jour., Nov. 8, 1913, p. 1205), to be of value in some forms of pleurisy, and now he reports a case in which it was used with success in acute pericarditis.

A thin, delicate girl 18 years of age, developed acute rheumatism after an attack of quinsy, and in its course acute pericarditis set in. The pain was severe, the patient spending the whole of one night in a position of complete orthopnea and being almost without sleep. The next day salicylic ionization was tried, the active electrode, in the form of a pad soaked in a 2 per cent solution of sodium salicylate, being placed over the precordium, while the indifferent electrode was placed on the back. A current of 40 milliamperes was used, and it had not run many minutes before the patient declared herself eased. At the end of the session (about half an hour) the patient laid back on her pillow and fell into a sound sleep. The ionization was repeated on subsequent days, and the symptoms of pericarditis gradually subsided. Acetosalicylic acid was also being taken by the mouth.

It is difficult to believe, the author states, that the great and rapid relief afforded in this case was due merely to tissue-ionization by the galvanic current or to any moral effect. The patient was a favorable subject for the treatment, the thinness of her chest-wall offering a reasonable expectation that the salicylic ions could be made to penetrate to the requisite depth.

Emetine in Dysenteric Abscess of the Liver.— At a meeting of the Medical Society of the Hospitals, held November 28, 1913, Dopter and Pauron presented two patients who had been cured of dysenteric abscess of the liver by means of emetine. In these cases the injection of emetine had preceded the evacuation of the abscess pockets. The

injections had brought about an undoubted reduetion of the severity of the inflammatory process in the liver. Nevertheless, in both cases the hepatic pain persisted.

In one case the pus secured by aspiration resembled that of ordinary suppuration. Two days later, drains having been applied, the discharge had ceased. The drainage, accordingly, was removed at the second dressing, when healing began at once. In the other patient, who had been cured two months before of dysentery, and who nevertheless presented an abscess of the liver, the latter was spontaneously evacuated by vomiting, the pus in this case being also of the ordinary character. The following day the patient was able to resume his occupation.

The authors conclude that the emetine treatment alone causes an arrest of the amebic process and transforms a living abscess into a dead one; however, the treatment is incapable of assuring absorption of the pus. Complete cure cannot be obtained except by spontaneous or induced evacuation of the abscess pocket. When the emetine injections are preceded by such an intervention, the cure follows with surprising rapidity. The authors also state that, while the emetine acts specifically upon the vegetative forms of the ameba, it appears without action in the encysted form, the persistence of which may cause recurrence of the dysentery.

Alcohol in Diphtheria. Dr. A. Jacobi, of New York, while a warm advocate of diphtheria antitoxin, believes that in mixed infections occurring in this disease antitoxin ceases to be a specific. It is in these cases that he believes in resorting to alcohol. In a paper upon alcohol medication (Am. Med., Sept. 1913, p. 516), he gives records of a few desperate cases in which life was saved by the use of whisky. As illustrating his method of treatment, we will let Doctor Jacobi report one case in his own words:

"A boy of three years with the formidable symptoms of mixed infection was 'given up.' I held out the hope of recovery, provided the doctor [in charge] would succeed in getting into him, with other appropriate medication, at least a pint of whisky daily. He did succeed. Five days afterwards the father called in despair, saying his child was alive, but insane. So he was. The boy was better-in fact, on the way to recovery, but drunk. To me, that was a welcome occurrence, for I knew (and I want my readers to know) that no amount of whisky will lead to intoxication when its effect is wanted to combat sepsis. I repeat: No amount of alcohol will intoxicate a thoroughly septic person. As soon as my little patient did

no longer require his big dose of alcohol, it made him insane', intoxicated.

"I had enjoyed that experience before, in many cases, and have since. Maybe my first case of the kind was that of a refined lady who had typhoid fever fifty years ago. I learned the alcohol practice from Dr. Ernst Schilling, who sixty years ago treated many hundreds of cases of typhoid and typhus among the immigrants on Ward's Island. My lady patient, thoroughly septic, took a quart of whisky daily ten days in succession until the beginning of her recovery; no other drop since."

We may be permitted to add that, in these cases of mixed infection, the value of treatment supplemental to antitoxin with such remedies as calcium sulphide and colx iodata, plus proper supportive medication with digitalin and strychnine, makes itself felt immediately and powerfully.

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The Protean Reflex-Pains Resulting Nasal Irritation. That irritation in the nares can give rise to divers and most unusual remote reflex phenomena is well understood, of course; still, a brief reminder of the manifold possibilities may not be unprofitable. This A. Siegmund does in a contribution to the Berliner Klinik (1912, p. 291), who enumerates them as follows, as observed in his own extensive practice:

Painful (as a rule) symptoms referred to the abdominal and pelvic organs; pains simulating appendicitis, more frequently after appendectomy; neuralgias of the ischias and trigeminus; gastric spasms; painful menstruation; besides occasional minor reflexes. When of nasal origin, these symptoms were removable by cocainizing (20-p.c. solution) the mucosa of the nose (sometimes only a small spot is involved) or by correcting any pathologic condition obtaining, as the case might be. Curiously, Doctor Siegmund does not mention asthmatic seizures and convulsions often brought on by nasal irritation.

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Nutritional Value of Soy-Bean. More and more the soy-bean, or soja-the favorite food among the yellow race- is being urged as an article of diet, to take the place of meat. Thus, H. Neumann, of Potsdam, takes up this subject (Berlin Klin. Woch., 1912, p. 1710), particularly advising the extensive culture of this legume in Germany; pointing out how 100 grams of it represent from 400 to 500 calories, and are equal to about 400 grams of meat.

Given in the form of puree, Doctor Neumann has found soy-bean of considerable service and well borne in the various wasting diseases, in diabetes, especially; while he also asserts that it

augments the milk in nursing women. Parenthetically, it may be mentioned, though, that the author refers to a certain proprietary preparation marketed by Zinnert, of Potsdam. The Japanese, it will be recalled, have a special process of fermenting the bean, to render it more digestible, the product being known to us as soy.

Rubidium as a Lithotriptic.--In the southern part of Germany, at Adelholzen, are located three distinct mineral springs patronized for centuries, and of these the Primusquelle is famed as curing kidney and bladder troubles and as a solvent of calculi. As long ago as 1629 a book was written about these springs, being the oldest treatise in Germany on mineral waters. In 1825, Buchner analyzed the water of the Primus, and he encountered a substance which at that period he was unable to identify. Back in 1880, Dr. Max Emmerich (now of Munich) personally convinced himself of the lithotriptic and curative properties of this water, and so caused an official analysis of it made. (1881.)

In a general way, its composition approximated that of the 31 recognized simple cold springs (acratopegens) of Germany, with the important distinction, that the Adelholzen water was found to contain rubidium in the proportion of 0.03461 gram in 1 kilo; the total minerals (Na, Ca, Mg, Fe, Mn, Si, Rb) being 0.509 gram. While other springs contain traces of rubidium (Wiesbaden, Baden-Baden, Miederselters, etc.), only one other in Germany, the Maxquelle, in the Palatinate, holds it in appreciable proportion, i. e., 0.00021 gram per kilo.

At the time, Dr. Emmerich suggested rubidium as the special lithotriptic agent, but even the medical staff of Adelholzen refused to entertain the thought. However, evidences of the special virtues of the Primus in the cure of kidney and bladder disorders of every description and their sequels, including its solvent action upon concretions, has accumulated year by year, so that Dr. Emmerich now has given publicity to his convictions through the Muenchener Medizinische Wochenschrift (April 1, 1913).

Dr. Emmerich tells how, at his first visit at the bath, three days after arriving, he saw-to his intense surprise-in his urine detritus of broken-up vesicular calculi; and he doubts that flooding of the organs with water alone can have this result. While the percentage of rubidium is small, it is not less than the lithium present in famed lithium springs, he argues, furthermore. In addition, experiments in vitro have shown the water to dissolve both pure uric acid and calculi of the vari

ous compositions. Dr. Emmerich urges further investigation.

Typhoid Fever Originating on a Lake-Steamer. -Public Health Reports for December 19, 1913 (p. 2761) gives a record of an epidemic of gastroenteritis and typhoid fever occurring in a party of about 300 citizens of Rhode Island and members of various military organizations of that state who spent most of their time between the evening of September 8 and the morning of September 14 on board the steamer Rochester to attend the Perry centennial celebration at Put-in-Bay on Lake Erie.

Reports were obtained from 235 members of this party, among whom there occurred 122 cases of gastroenteritis and 42 of typhoid-like attacks, 5 ending in death. The attacks of gastroenteritis varied greatly in severity, some being merely a slight diarrhoea, others accompanied by more or less prostration, malaise, gastric disturbances, and fever. The cases of typhoid fever were also quite variable in severity, the dates of their onset falling between September 21 and October 12.

A careful survey of possible sources of infection was made by Dr. Hugh de Valin, passed assist ant surgeon of the United States Public Health Service. He found that there had been numerous cases of more or less persistent diarrhoea among the steamer's crew during the entire season, and 4 cases of typhoid fever were also reported, those attacked being an electrician, a stewardess (who subsequently died), a water-tender, and a meatcook. The water used for drinking purposes on board the ship was pumped up directly from the lake and in part was found to have been taken from sources liable to contamination with sewage. Probable the most important source of contamination, however, was the meat-cook, who apparently was suffering from typhoid fever during the entire trip; this man having been ill with diarrhoea since about September 1, and been admitted to the hospital down with the disease on September 15, the day following the end of the trip. This man worked in the ship's galley, where all the food was handled, cooking meats, making soups, gravies and entrées, and occasionally helping with the salads.

Strychnine Treatment of Trifacial Neuralgia. Five cases of trifacial neuralgia, one of these being multiple neuritis plus trifacial neuralgia, are reported by Thos. J. Orbison in The California State Journal of Medicine (Oct. 1913, p. 418). The treatment consisted in the exhibition of strychnine in massive doses in all five.

In the first case, 1/30 grain of strychnine sulphate was given by mouth hourly for four hours,

forenoon and afternoon. On the second day, the patient was free from the severe pain; on the succeeding day, the pain had ceased entirely. The treatment was continued for several days more, since when there has been no return of the neuralgia.

in the second case, 1/40 grain of strychnine was given, hypodermatically, hourly for four hours, forenoon and afternoon; this being increased to 1/20-grain doses on the third day. By the fourth day, the patient was free from pain, and remained so for six months, when there was a recurrence; but he was relieved within a few days by the same treatment.

The third patient was a teacher 32 years of age, who was compelled to attend to her school duties; for which reason treatment seemed less promising. She took strychnine, 1/40 grain hourly by mouth while awake. The result was more satisfactory than anticipated. The trifacial pain was at first controlled and then it entirely disappeared.

Case 4 was a very severe one, in which morphine, hypodermatically, gave no relief. After a preliminary rest in bed and a course of castor oil, the strychnine treatment was instituted, 1/40 grain being given hourly for four hours, in the morning and the same in the afternoon. The dosage was rapidly increased, until the patient received 1/10 grain hourly day and night, hypodermatically. This was continued for ten days, without untoward symptoms showing, but with unmistakable control of the pain in the face. However, since the pain was not entirely arrested, the alcohol-injection treatment was resorted to. A year later the patient remained entirely free from pain.

Patient No. 5 prior to beginning this treatment had been using morphine daily for some time, although in relatively small doses. He was then given strychnine sulphate, 1/40 grain hourly for four hours in the morning and the same quantity in the same period in the afternoon. The dosage was gradually increased to 1/20 and finally to 1/15 grain. Quinine, 5 grains hourly, was given by mouth at 6, 7 and 8 o'clock in the evening. Under this treatment the pain has been brought under control.

While the number of cases thus far reported is few, the results obtained certainly are most gratifying.

Hobo-"Yes'm I wunst had a good job managin' a hand laundry, but it failed on me. Lady-"Poor man. How did it happen to

fail?"

Hobo-"She left me and went home to her

folks."

lieved by placing a little orthoform dry on the tongue.

Urotropin should be taken internally after abdominal operations to prevent tympanites.

Galyl and ludyl are two new arsenical preparations, said to be less harmful than salvarsan, and equally active as a spirocheticides.

Ross recommends oil of cinnamon in 10 to 12 drop doses in water, repeated every two hours, in the treatment of influenza. After temperature is normal give thrice daily.

For the removal of tatto marks the Physicians' Drug News suggests the following, from Henley's Formulary:

Apply a highly concentrated tannin solution on tattooed places and treat them with the tattooing needle as the tattooer does. Next vigorously rub the places with a lunar caustic stick and allow the silver nitrate to act for some time, until the tattooed portions have turned entirely black. Then take off by dabbing. At first a silver tannate forms on the upper layers of the skin, which dyes the tattooing black; with slight symptoms of inflammation a scurf ensues which comes off after 14 to 16 days, leaving behind a reddish scar. The latter assumes the natural color of the skin after some time. The process is said to have given good results.

Dr. J. F. Roemer, Waukegan, Ill., says that he has used emetine hydrochloride in 1% grain tablets in a case of amebic dysentery which was reported in the August number of the American Journal of Clinical Medicine. The patient is with him in Waukegan now, although he was treated in Texas. The emetine has entirely stopped the discharge of blood and mucus from the bowel, digestion was very much improved and the stools thickened up at once, and he is gaining in every respect. For details Dr. Roemer refers us to the number of Clinical Medicine cited.