the following prescription it is claimed that, observing the above rule, it acts better, is safe, even in cases of pre-existing organic heart lesions, and that it seems deeidedly to lessen the danger of endo and pericarditis arising as complications: Acid salicylici, oz. ; liquor ammonia acetatis, oz. 2; aqua distillat. oz. 3; syrup cortic aurantii, oz. 1. M. Sig. A tablespoonful in water every two hours.

A STUDY OF THE ACTION OF IRON is the subject of a paper by C. H. Williams, M.D., of Boston. By experimentation, the writer found that a freshly-made, clear solution of the tartrate of iron, neutralized with caustic soda, would cause death in a rabbit when from 10 to 20 milligrammes of iron per kilogramme of the animal's weight were injected into its veins. The fatal dose for a rabbit of average size was about one-third of a grain of iron. Death followed in from six to twelve hours. Experiments were also made on dogs and cats. The results of post-mortem examinations of the animals experimented on were given, and the conclusion reached that we have in iron probably not a dangerous element, but at least a drug of more toxic qualities than is generally imagined. Not only when iron is introduced into the veins of animals, but also when given by the stomach in large doses death has followed. It has been observed in healthy men that very large doses of iron caused weakness, a disposition to sleep, colicky pains in the region of the stomach, and vomiting. The blood was also darker than normal. Iron has, without doubt, poisonous qualities; the symptoms which it causes come chiefly from the alimentary canal, and in fatal doses it diminishes the amount of carbonic gas in the blood. Its action in the economies probably resembles that of arsenic and platinum, and we are justified in believing that the action of iron on man in excessive doses would be similar to that observed in animals.

Regarding the tonic effects of iron two theories have been advanced to explain them; the first, that its good effects are produced by its action on the red blood-corpuscle; the second, that it exerts a special influence on the digestive system. Regarding the first, we know that iron is a constituent of the red blood-corpuscles, that in anæmia the number of these corpuscles is less than

normal, and after using iron they are increased, so that it is necessary on the first theory to supply iron in order to have plenty of red blood-corpuscle; but only one-thirtieth part of the red blood-corpuscle is iron, and there are only three grammes, or forty to fifty grains, of iron in the blood, and only a portion of this is likely to be wanting at any time; there is a small quantity of iron in almost all the food we eat, so that any deficit of iron can never be very great. It is well known that it is not by a few doses of iron that its good effects are produced, but only after continued use. For the second theory, the evidence afforded by experiments on animals, as well as the symptoms aroused in man when large doses are given, leaves but little doubt that iron has especial action on the digestive organs, particularly on the stomach and upper part of the small intestine where absorption takes place. Iron should be given on a full stomach. There is little excuse for the extraordinary number of preparations of this drug. A few are all that are needed. The results of experiments and clinical observation show that iron is no exception to the general rule which holds good for all the other heavy metals, such as copper, platinum, arsenic, etc. In excessive doses it may produce deleterious results. The good following its use would seem to be due to its action in promoting digestion and assimilation, rather than to the increase in the number of blood-corpuscles, which is probably a result of the improved nutrition.

HEMOPTYSIS.-Dr. J. M. Williamson, speaking of the treatment of this so often very alarming complaint, makes the following practical points: Constipation must be relieved, and is best treated by salines. A quick pulse must be steadied by Digitalis, of which perhaps the most handy form is the digitaline granule of Quevanne. Cough is to be soothed the simpler the mode of accomplishing this the better, but it must be done; and nothing answers better for this than a chloroform pad laid over the sternum. Generally speaking, we should keep before our minds the advisability of stopping all blood-spitting in phthisis without delay. To this rule there are perhaps two exceptions. The first is that dirty-red, slimy, bad-smelling, never abundant expectoration which hysterical women with phthisis often exhibit at the

bottoms of their spittoons; this may be left to itself. The second is a serious one; it comprises those forms of hemoptysis, usually copious and angry, occurring in advanced and very chronic cases where there is a considerable amount of fibroid induration. In such patients, notable dyspnoea on exertion has for a long time past been a prominent symptom, and respiration has been maintained by a very small extent of lung substance. These cases are open to a special danger, that of fatal embolism in the right chambers of the heart on the pulmonary artery. Not uncommonly the course followed is for the bleeding gradually to abate in quantity, remaining, nevertheless, of the same angry red; then urgent dyspnoea suddenly sets in, and death takes place within 48 hours. Here extremely careful treatment is demanded Can it be right, where only a small surface is available for respiratory function, to control those few vessels with Ergot? Or can it be good practice to pass styptic medicines into a patient's circulation, when his cachectic state, his low vitality, and perhaps some febrile movement, render him especially liable to the formation of thrombi? It is wisest to limit ourselves to external applications, chloroform pads, dry cupping, sinapisms at a distance, or other derivative treatment, with appropriate general management. Further on he gives two cautions, commonplace they may seem, but both of them the outcome of bedside experience. One is, to have some responsible person in constant attendance night and day, till the attack has completely passed away; for death is generally sudden, and it is very appalling to discover too late the consequences of omitting this precaution. The other is, to decline positively to examine a patient's chest while there is any hemoptysis. Irrespectively of the danger of the process, an opinion arrived at by auscultating a chest during or immediately after a bleeding is not a reliable one.

CHLOROFORM MORTALITY.—In a late number of the London Lancet, its editor draws the attention of the profession to the startling increase in the number of deaths from the administration of chloroform, even when every reasonable precaution is taken. He says there is a large population of men and women, but of men especially, who, without presenting, even to skilled observation, their

precise state, are liable to die at any moment. They die from slight mental shock; they die from comparatively slight physical shock; they die under efforts to run or climb; they often die in attempting to catch the train against time; they die in the most ready manner under certain of the anæsthetics. It is certain that they are in great danger under every one of the class of anaesthetics that belong to the chlorine family. The chlorine, which really has nothing to do with the production of anæsthesia, for that depends on the organic radical with which it is in combination, is the cause of the danger. It acts as an irritant. It produces sudden contraction of arterial fibre, arterial shock, by which the course of blood through the pulmonary and systemic circuits is impeded, and the feeble heart, unable to meet the difficulty, is arrested in its action during the second degree of anesthetic sleep. There can be no doubt that when any suspicion exists that life is not at its best and that the heart is feeble, ether should take the place of chloroform. But if the administration of ether is, for any reason, not practicable in the cases to which we refer, then the chloroform administration should be preceded by a full dose of some agent that has the relaxing effect of ether, and that agent is ethylic alcohol. From 1 to 2 oz. of pure alcohol-spec. grav. .830—is a valuable preliminary, and should be given, diluted in 8 oz. water, from 5 to 10 minutes before the inhalation of the narcotic is commenced.

BACILLI.-The word means a minute animal or vegetable parasite which, entering the body and possessing the power of growth and reproduction therein, gives rise to the various forms of disease, according to the nature of the bacillus introduced. The experimental researches, carefully conducted by experienced investigators, and covering a long period of time, would seem to establish as definitely as our present means of research will allow us to determine, that the presence of these parasites is really the essential cause of the disease in question. Up to this present writing it is claimed that the following most serious and most prevalent diseases known to men are produced by the presence of bacilli in the body:

1. Malaria.-The Italian physician Tommasi Crudelli has de

monstrated that malarial diseases are caused by the bacillus malariac.

2. Typhus Fever is, according to the German physician Klebs, produced by the presence of the bacillus typhosus.

3. Diphtheria.-Drs. Wood and Formad of America assert the presence of bacilli in all cases of diphtheria.

4. Anthrax or Splenic Fever.-Pasteur of France has discovered the bacillus anthracis and has successfully cultivated them artificially.

5. Tuberculosis.-To Dr. Koch of Berlin science is indebted for the demonstration of the bacillus tuberculosis. He has succeeded in developing his bacilli outside of the body, artificially, for a period of six months, and then has produced tuberculosis in the bodies of animals inoculated with these artificially developed parasites.

DIGITALIS AND ACONITE.-In speaking of the great results already achieved in therapeutics by the patient investigations of the physiological effects of drugs, Dr. D. G. Brinton, in the Medical and Surgical Reporter, refers to Digitalis and Aconite. especially, and says that it is proven that Digitalis is a tonic for the heart; that under its use the contractions of the organ become more powerful; that in consequence the frequent and weak pulse becomes slower and fuller; and that this remedy should therefore be employed, when the rapidity of the pulse is due to debility of the main organ of circulation and the blood pressure is diminished. The effect of Aconite is exactly the opposite; it reduces the strength of the impulse; in cases of over-action of the heart, of too powerful contraction of the same, it diminishes the frequency of the pulse and reduces the blood pressure. If, for example, a strong and robust adult, with a vigorous heart, is affected with croupous pneumonia, our aim, in the beginning, must be to reduce the strength of the heart, and of the blood pressure, not to increase it, and we give aconite or veratrum viride with happy results; these will diminish the frequency of the pulse. But if an anæmic, or an old person with a weak heart, is suffering from pneumonia, we give digitalis, for it gives tone and strength to the heart, and under its influence the