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much more favorable in those cases in which the small intestine is involved.

In the adult, the absorption of toxic products from the intestinal detritus results in a peculiarly vicious train of symptoms, most of which have repeatedly been set down in the many articles that have appeared upon this subject. I find, however, that most of these cases that are markedly benefited by bacillus bulgaricus medication show, first, insomnia.

Whether or not this is owing directly

to the fact that absorption of toxins is greater at night than in the daytime, I do not know; still, it is a definitely established fact that the majority of these patients show more indican in the night urine than in that of the day; while very frequently indican will be present in the first urine voided in the morning, but not found at all in that voided in the course of the day.

Many of these patients suffer from alternating constipation and diarrhea, and it will be noted that during the period of constipation there is more or less periodical rumbling of gas, which usually is sufficiently marked to be noticed by the patient. These patients, as a rule, do not masticate their food, usually are heavy meat eaters (and I believe fresh pastry has an equal value as a causative factor with meat), and many of them are inclined to the use of malt liquors.

In treating these individuals, the initial cathartic always is essential, while the treatment itself may consist either in the exhibition of bacillus bulgaricus bouillon (which may be given after breakfast, alone, because of the usually high starchy content of this meal) or after each meal; or, in the exhibition of tablets, from which equally good results are obtainable. These I give, as a matter of routine, three times a day, generally ordering from four to six at a dose.

The diet should be regulated, and especially should meat and fresh bread be interdicted. If the patient is addicted to the use of beer and other malt-liquors, these should always be prohibited. In my experience so far, light wines are not contraindicated. If the patient be suffering from the socalled bacillary diarrhea, due to the Shiga bacillus or some correlated organism, I prefer the bacillus bulgaricus buttermilk, and let that be the sole diet of the patient for some time. For the average individual, however, this is not sufficiently nourishing, and many soon tire of the buttermilk; so that either the liquid culture or the tablets are usually preferable.

have used the culture in nearly one hundred cases of diphtheria-carriers, most of whom were referred to me because of the persistence of diphtheria bacilli and the maintenance of quarantine.

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In these cases, the liquid culture, full strength. is sprayed into the nose and throat every four hours. No other treatment is used. Originally I sprayed only the throat, but there were frequent relapses, owing to reinfection from the nose. is very essential, therefore, that the nose as well as the throat be thoroughly sprayed. This treatment has cured, in my hands, from fifty to sixty per cent of cases of ozena, some cases, however, requiring as much as six months before they yielded. In some cases, I was unable to obtain lasting results, although this treatment gives relief from the subjective as well as the objective symptoms as long as it is persisted in.

Superficial inflammation of the tonsils and pharynx, especially after the acute stage has passed, virtually always is markedly benefited by this spray treatment. The use of antisepsis upon the mucous membrane of the throat results only in a very superficial inhibitory action, and usually is only sufficient to prevent the multiplication of those bacteria in which intimate contact is obtainable. They are not capable of destroying the bacteria unless used in concentrated form, and then they tend to produce coagulation of the exudate, with the result that their action is limited to the surface only. The bacillus-bulgaricus bouillon, however, does not produce coagulation; it is the introduction of a living germ, inimical to other organisms, upon a surface where conditions are favorable for its development which makes it valuable; and to my mind, this is the rational treatment of such affections.

In the treatment of furunculosis, I formerly used 70 per cent alcohol as a wet dressing, with considerable success. Now, however, I use bacillusbulgaricus bouillon, and wherever drainage is instituted in any of these cases the drain is saturated with this culture. So far as I am able to determine from clinical experience, the results in many cases are such that this method appears to be preferable to the alcohol dressing after the abscess has been opened.

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Aside from the use of the bacillus bulgaricus in intestinal derangement, both in infants and adults, a large measure of success is obtainable from the use of the bouillon-culture in various Fine opportunity for a Doctor at Onida, affections of the exposed mucous membranes. I South Dakota. Address Box 36, Pierre, S. D.

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SUBSCRIPTION: One Year, $1.25. Foreign, $2.00. Single Copies, 15c. Special Numbers, 25c.

ISSUED MONTHLY. IN REQUESTING CHANGE TO NEW ADDRESS PLEASE GIVE FORMER ADDRESS ALSO.
Entered as Second Class Matter, Feb'y 27, 1887, at the Post Office at Chicago, Ill., under act of March 3, 1879.

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NEURILLA FOR NERVE DISORDERS NEURILLA
If Patient suffers from THE BLUES (Nerve Exhaustion),
Nervous Insomnia, Nervous Headache,Irritability.or
General Nervousness, give four times a day one
teaspoonful NEURILLA

In nervous fretfulness of teething Children
give five to twenty drops.

DAD CHEMICAL COMPANY, NEW YORK AND PARIS.

READ THE ADVERTISEMENTS AND TO MENTION THE MEDICAL STANDARD ***

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SUBSCRIPTION: One Year, $1.25. Foreign, $2.00. Single Copies, 15c. Special Numbers, 25c.

ISSUED MONTHLY. IN REQUESTING CHANGE TO NEW ADDRESS PLEASE GIVE FORMER ADDRESS ALSO.
Entered as Second Class Matter, Feb'y 27, 1887, at the Post Office at Chicago, Ill., under act of March 3, 1879.

QUMQIMLIMTIMU❤❤❤QUMLUMLUMLUMVALUMAITUM

NEURILLA FOR NERVE DISORDERS NEURILLA
If Patient suffers from THE BLUES (Nerve Exhaustion),
Nervous Insomnia. Nervous Headache, Irritability.or
General Nervousness, give four times a day one
teaspoonful NEURILLA

In nervous fretfulness of teething Children
give five to twenty drons.

DAD CHEMICAL COMPANY, NEW YORK AND PARIS.

IT

PAYS ΤΟ READ THE ADVERTISEMENTS AND TO MENTION THE MEDICAL STANDARD

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The necessity for Institutional treatment in cases of
Pulmonary Tuberculosis, Inebriety and Mental Dis-
orders has long been recognized.

Many other chronic diseases likewise require the special
attention possible in a well-ordered medical establishment.
Among the maladies to which Institutional Treatment is
especially applicable may be mentioned the following:
Diabetes, Obesity and other disorders requiring special
metabolism studies and individual dietaries.

Neurasthenia, Hysteria, Nephritis and other similar cases
which demand thorough diagnosis, careful treatment and
special dietetic management.

Intestinal Toxemia, the mother of most chronic ailments, in
which a change of intestinal flora, through radical change
of diet and other special means, is essential.

In all cases requiring the use of special diagnostic methods,
close medical supervision, metabolism studies, scientifically
regulated diet and carefully graduated exercise, the Battle
Creek Sanitarium system of treatment is of highest value.
More than one thousand physicians and five thousand members of
physicians' families have availed themselves of the health oppor-
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More than ten thousand invalids have sought and found relief
through institutional treatment at Battle Creek through the advice
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A copy of "The Battle Creek Sanitarium System" will be mailed
free to any physician, on request.

The Battle Creek Sanitarium, Box 233, Battle Creek, Mich.

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