sub-acute form, it is a palliative measure that may be resorted to as preparatory to iridectomy; but in neither form can it take the place of this operation. In chronic glaucoma, it may be positively dangerous, because of a tendency it has shown of bringing on acute attacks.

Pilocarpin is the active principle of jaborandi (policarpus penatifolius) which was discovered by Mr. Hardy, and introduced into ophthalmic practice. Its two salts-the muriate and nitrate-are both used, but more especially the former. Its local application causes contraction of the pupil, and increased secretion of the lachrymal gland, and by absorption may produce some of its constitutional effects. These are profuse perspiration, ptyalism and slight nausea, and in larger doses, vomiting, pain in abdomen and genitals, with general prostration.

As, when administered internally or hypodermically in such doses as do not produce the violent physiological effects, it improves the peripheral circulation, decreases the temperature of the body, and causes vascular depletion of the eye, it is a valuable remedy in treating iridocyclitis, in choroiditis exudation, in opacities of the vitreous, in retinal detachment, in glaucoma and in commencing atrophy of the optic nerves. In fact, some claim that it is almost a specific against commencing atrophy.

Locally, it is used in rheumatic and serous iritis, and in specific and rheumatic keratitis. As a myotic, it is inferior to eserine, as the latter produces no unpleasant effects beyond occasionally some irritation of the conjunctiva. For local application, a one per cent. solution (about four grs. to the ounce of water) of the muriate of pilocarpin is most commonly employed. Hypodermically, I have administered it in doses varying in gr. to gr. daily, according to the susceptibility of the individual to its influence, always regulating its administration so as to stop short of nausea and vomiting, as the perspiration, ptyalism and reduction of temperature are sufficient manifestations of its physiological action. In some patients I have seen it followed by profuse perspiration without ptyalism, and vice versa.

Duboisine, the latest remedy in ophthalmic thereapeutics, is the active principle of the duboisia myoporoides, an Australian plant of the family scrofuloricees. The alkaloid was first obtained from the plant by Gerhard, of London.

Its action is very similar to atropine, but more powerful. It therefore belongs to the class of mydriatics, and is antagonistic to eserine and pilocarpin.

It is used in the same class of cases as atropine, but is superior to the latter, inasmuch as it dilates the pupils and paralyzes the accommodation more promptly; its effects are less lasting, and it does not irritate the conjunctiva. From this latter property, it is indicated in cases which show an idiosyncrasy against atropine.

It also has the power of dilating the retinal veins; and further investigation of this property may show it to be a very valuable remedy in some affections of the fundus oculi. In rare instances (as reported by Dr. Seeley, of Cincinnati), when a strong solution has been used too continuously, it has produced vertigo and drowsiness.

The strength of the solution for local use is from two to four grains to the ounce.

All these remedies are very high priced, and have not yet come into common use; and although many experiments have been made as to their applicability, their exact value as thereapeutic agents has not yet been determined.-Southern Medical Record.

THE CURE OF CANCER.

Professor John Clay, of Birmingham, has published some remarkable cases of cancer of the uterus cured by the internal administration of Chian turpentine. We give the following as one of the best marked cases: The patient (æt. 32) came to the Queen's Hospital after having been discharged incurable at the Women's Hospital. She was greatly depressed. She had had repeated floodings, and suffered greatly from pain during the last five months. Consti pation very troublesome, probably due to opiates. She was found to be suffering from epithelial cancer of the os and cervix uteri, but not involving the vagina. There was a cancerous mass of the posterior parts of the os and cervix of the size of a goose egg. This growth pushed the os uteri towards the pubis, almost preventing that part from being felt.

A mixture containing six grain doses of Chian turpentine dissolved in ether and suspended in mucilage, was taken three times

a day, and from this period a very rapid diminution of the growth took place, so that by the sixteenth day it had almost entirely disappeared. The os uteri was now in situ, admitted the finger readily, and the vessels of the tumor assumed a shriveled appearA solution of perchloride of iron was then used daily with excellent effect.

ance.

In the ninth week the patient suffered from spasmodic pains in the back and abdomen, which was attributed to the medicine. Iodide of calcium was then given for a fortnight. After this Chian turpentine was resumed and an arsenical lotion was used locally.

Under this treatment the woman very rapidly improved, the pains ceased and the parts become much reduced in size and more moveable. She was sent to a sanitarium and discharged convalescent.

Professor Clay says the Chian turpentine seems to act on the periphery of the growth with great vigor, causing the speedy disappearance of cancerous infiltration, and thereby arresting the further development of the tumor. It appears to dissolve all the cancer cells. It is a most efficient anodyne, causing an entire cessation of pain in a few days. The professor, whose name is a sufficient guarantee for the diagnosis and the results of treatment, does not affirm that Chian turpentine is a positive cure for advanced cancer of the uterus. Nevertheless all the patients treated are still living, their disease has been arrested and has all but disappeared, and it certainly relieves the pain in a manner which cannot be said of any other remedy.-London Lancet.

PAIN, AND THE THERAPEUTIC VALUE OF MEDICINES FOR ITS

RELIEF.

For the relief of pain, opium stands at the head of therapeutic remedies, and for this purpose commands an immense suffrage.

As the result of careful clinical observation and teaching, we are warranted in concluding that the effects produced by opium. are antagonistic to the action by which pain is produced.

But this proposition should be received with a mental reservation, and accepted under a conditional protest. In prescribing opium for the relief of pain, we should never lose sight of the

special therapeutic action of this drug; also have a clear knowledge of the pathological conditions demanding its use. We should be convinced that it is the right medium to choose; also of its administration in appropriate doses, and at appropriate intervals. These are questions to be considered and decided by the technical skill of the prescribing physician.

According to Dr. Austin and others, there are two ways in which opium may relieve pain first, by its use as a stimulant in small doses; second, by its use as a true narcotic in large doses.

In either manner, it is by the narcotic action of the drug that nervous sensibility is diminished; the perception of external objects and volition become checked, and thus pain is allayed and sleep produced.

In referring to the power possessed by opium, in arresting or mitigating pain, I shall consider morphia as the essential principle of opium, and shall consider the therapeutic power of opium for the relief of pain, without any reference to its various constituents.

We are not interested in any of the symptoms of inflammation but the pain; and, I need not say, that in inflammations of the brain or its membranes, acute or chronic, opium should be used with extreme caution. By way of modifying the injurious effects of opium, and place it within manageable limits, the addition of direct vascular depressents is indicated. For this purpose, we may combine with opium tartrate of antimony.

A combination highly eulogized by Dr. Graves and others, and my own experience with this combination, substantially indorses all that has been said of it in its favor.

The value of opium in controlling or mitigating pain, due to acute inflammation, is often enhanced by combining with it some preparation of mercury-a purgative, as the extract of aloes or the acetic extract colchicum, as in rheumatic meningitis. I have also had pleasant results in these cases from the combination of opium and veratrum viride.

The pain which attends cancer of the brain is often alleviated by the frequent administration of opium. The same may be said for the relief of pain due to abscess of the brain.

In acute diseases of the ear, also in certain inflammatory diseases of the eye or its structures, opium is the remedy for the relief of

pain. The acuteness of toothache is relieved by opium. In many of the inflammations of the chest, pain is a prominent symptom, and calls for relief.

Pleuritis is, perhaps, a fair type of thoracic inflammations; opium should be given for the relief of pain until a mild hareosis is produced, and the remedy should be given early in the disease.

In pneumonia, accompanied by nervous exhaustion and restlessness, opium may be given to relieve pain and promote nutrition. Asthma, though not strictly a pain, is often relieved by opium. Cough, a common feature of various diseases of the chest, is often relieved by the use of opium.

In phthisis pulmonalis, the administration of opium in some form is indicated in order to palliate pain, subdue cough, and allay constitutional irritation.

In cancer of the lungs, opium may be given for the relief of pain. So also in abscess of the lungs, characterized by great pain and restlessness.

In angina pectoris, or cardiac neuralgia, decided relief from pain may be obtained by the use of opium.

In inflammation of the pericardium or endorcardium, pain is a prominent and distressing symptom, for the relief of which opium, in combination with mercury, should be given.

In acute laryngeal diseases, as well as in dysphagia, when painful, by the wise administration of opium, a decided relief may be obtained.

The viscera, contained within the cavity of the abdomen, are all liable to disease, more or less painful. Many of them require prompt and active treatment.

It often happens that a single dose of opium may promptly relieve pain of many days' duration.

Dr. Fox says that the utility of opium in painful affections of the stomach can be scarcely overrated.

In painful affections of the stomach, arising from exhaustion and anxiety, opium is of great value.

Ulceration of the stomach and bowels, especially when perforation has taken place, opium should be given in prompt and decided doses, in order that the system may be under the narcotic influence of the drug. This form of practice is endorsed by Drs. Stokes and Graves.