systolic bruit may be heard over the base of the heart, and in the veins of the neck the stethoscope will detect the so-called "humming-top" murmur, or bruit de diable; but it must be remembered that this latter sound may be sometimes produced in a healthy person by the mere pressure of the stethoscope.

Anæmic women are generally more or less nervous, and sometimes hysterical, but I should not say there was any marked connection between anæmia and hysteria.

How are these cases to be treated? Clearly by so nourishing the blood as to build up the red corpuscles and raise them to the proper standard in health. Steel is the medicine upon which we chiefly rely to effect a cure, but to be successful in the treatment requires some care and discrimination. If the tongue is coated and the digestion much impaired, the more astringent forms of iron, such as the sulphate or the perchloride, are often not tolerated at first; and the ammonio citrate, the mistura ferri co., or the ferrum redactum, will be the best to begin with. In a large number of cases I have found nothing so successful as a combination of the ammonio-citrate of iron and rhubarb in suitable doses, with equal parts of some bitter infusion and peppermint-water. Sometimes the addition of two or three grains of the carbonate of ammonia seems to be useful. I make rather a point of the rhubarb, although it is so disagreeable to take, as I believe it must assist the action of the steel, especially when the stomach is out of order. If the patient is very nervous, ten grains of bromide of potassium may be added with advantage to each dose of the mixture. If the rhubarb in the mixture does not act enough upon the bowels, it will be necessary to prescribe some aperient pill to be taken at bed-time. Preparations containing aloes are of service, and may be combined with steel. Pepsine is often used with the meals. The diet should be light and simple; beer had better be avoided in most cases, and a glass or two of light claret may take its place with advantage. I believe claret is certainly better than port, although that wine it so often recommended. A moderate amount of exercise out of doors, when the weather permits, should be insisted upon, but anything like fatigue must be avoided. A tepid

bath in the morning, and a rub down afterwards with a rough towel, is a good thing.

By-and-by, in a few weeks, more or less, the steel and rhubarb mixture may be left off, and fifteen drops of the solution of perchloride of iron given after each meal, in a wineglass of

water.

Under the very best and most careful treatment, the improvement in anæmia is not unfrequently slow and tedious, and, to prevent disappointment, it is as well to caution patients and their friends that they are not to expect, as a rule, any very rapid change. Once get the patient on the road to health, however, and time and perseverance will do the rest.-Dr. Pollock in London Lancet.

BANDAGING.*

CROSS OF THE EYE-(MONOCLE.)

DESCRIPTION.-This bandage should be six yards in length and have a width of from one and a half to two inches. APPLICATION.-Taking the right eye for example, standing be

FIG. I

hind your patient, place the initial end of the roller, 1, above the right eye; previously protected by a compress or some cotton-wool. Confine this by one horizontal circular turn, 2, about the head and continue on till you come to the occiput, for the next turn; here you make a pass downwards, coming along under the right ear, then up over the inferior angle of the inferior maxilla of the right side, and across the inner angle of the orbit, finishing the third course of the bandage. Continuing on from this point (the forehead), the bandage is to be carried up over the left parietal protuberance, then down to a level with the circular turns 1 and 2, and finally

*By permission, from "A MANUAL OF BANDAGING," by C. Henri Leonard, M. A., M. D.

finished as a circular of the head, thus making the fourth course. Course 5 is to be executed the same as course 3, remembering to overlap in its course, to the distance of one-half or threequarters of its width, the preceding turn. Course 6 is executed the same as course 4, remembering the overlapping. Finally, when you come near the terminal end of your bandage, confine by one or two circular turns about the forehead and occiput, following courses 1 and 2.

USES. This is a very pretty and firm monocular bandage when evenly applied yet it is one that needs some watching lest some of the courses overslip each other, especially if put on a patient that is not very quiet.

PERFORATED T OF THE HEAD AND EAR.

DESCRIPTION.-The first piece should be three yards long by two inches wide, and to this, perpendicular to its plane, there should be stitched, at eighteen inches from one of its ends, a bandage having the same length and width, save at the extremity attached to the first piece; here it should be semi-oval, with a width two or three times that of the plane of the bandage; this oval part should be perforated by a longitudinal slit of sufficient size as to "take in " the ear.

APPLICATION.-Pass the ear of the diseased side (suppose it to be the right) through the second portion of the bandage, B, bring

ing the bandage closely and snugly up to the head. Carry the shorter end of the horizontal portion of the bandage smoothly around the occiput and forehead, and confine a single horizontal circular turn, 2. Carry, now, the perpendicular portion of the bandage, B, down under the chin, up over the opposite ear to the top of the head

and down to the starting point, thus finishing the first turn of the perpendicular portion of the bandage. Exhaust the remaining portion of the bandage, в, by similar perpendicular turns about the head, and at last confine the end by a pin, to the horizontal turn, 2. This done, exhaust the remaining portion of the roller, A, by horizontal turns about the head, confining as usual.

USES. This bandage is found very useful in maintaining blisters to the mastoid process, or dressings thereto, as is frequently needed in diseases of the ears. It is equally useful in confining dressings upon the ears, temporal, parotid, and tonsillar regions.

FIGURE OF 8 OF THE NECK AND AXILLA.-(SPICA OF THE

SHOULDER.)

DESCRIPTION. -This bandage should be made from a roller,

six yards in length by two inches in width.

APPLICATION. - Place the initial end of the bandage at the

the anterior surface of the shoulder, from under the axilla, to the back of the neck. Course 5 is made the same as course 3; course 6 as course 4; course 7 as course 5; course 8 as course 6, and so on. At last exhaust the bandage by a single horizontal turn about the neck, and confine as usual.

USES.-To confine dressings to the clavicular, sub-clavicular, and axillary regions; and, also, upon the shoulder.

FIG. 4.

DOUBLET OF THE BACK OF THE HAND AND WRIST. DESCRIPTION.-The main bandage, A, should be some twentyeight inches in length by one inch in width. At a distance of three inches from the initial end, stitch, at right angles, another bandage. 3, twenty inches long, by three-quarters of an inch wide; at a point two inches from this, stitch, at right angles to the plane of the main bandage, and parallel to B, another bandage,

Diagram.

c, of the same dimensions.

APPLICATION.-Place the initial end of the bandage, A, upon

FIG. 5.

the back of the wrist, so that the first perpendicular portion of the bandage, B, will correspond to the first interosseous space, and the portion c, with the fourth interosseous space. Confine the initial end by a single circular turn, 2, about the wrist. Carry the portion в down the first interosseous space, around over the palmar surface of the first joint of the index finger, and then back, over the second interosseous space, to the wrist; this done, make another circular turn about the wrist with the main bandage, as turn 3, running over the recurrent portion of в at the wrist. Continue these circular turns of A until the bandage is exhausted, when confine with a pin. Conduct, now, the other perpendicular portion, c, down the fourth interosseous space, across the palmar surface of the metacarpo-phalangeal articulation of the ring finger, back, over the third interosseous space, to the wrist, here tying with the end of the first portion, B. as at D, after the requisite amount of extension of the palmar tissues, or fingers,

has been obtained.

USES.-In cases of burns of the palm of the hand, or extensive suppurations, where vicious cicatricial contractions are to