after a long attendance on a patient, when he presents his bill, is told that all the money there was in the house has been given the druggist and that he must wait; and too often the hope of receiving his fee is deferred until the heart is made sick.

The great sin, however, of which druggists are too often guilty, is the abuse of the trust and confidence reposed in them by the physician, and this consists not only in their repeating prescriptions without the instruction of the physician, but also in actually treating other patients with the combinations recommended by the physician in a given case. This evil obtains largely in the case of specific venereal diseases.

It is now in

this city a comparatively rare occurrence for a physician to meet with a case of gonorrhoea, for instance; not because there is less of this trouble than formerly, but largely because of the fact that almost every druggist prides himself on his ability to treat it successfully, and does so with formulæ prescribed originally by some physician who has been his patron.

The legitimate work of the druggist is to dispense according to the prescription of the physician, and as long as he confines himself to this he should receive countenance and support; when, however, as is done in the vast majority of instances, he assumes the office of physician, that countenance and support should be withdrawn. Physicians in good standing, moreover, are supposed to be governed by the Code of Ethics of the American Medical Association and a conformity to the requirements of this instrument would necessitate a withdrawal of their patronage from every druggist in this city with, perhaps, one or two honorable exceptions The code especially declares it to be the duty of physicians " to exercise their option in regard to the shops to which their prescriptions shall be sent, to discourage druggists and apothecaries from vending quack or secret medicines, or from being in any way engaged in their manufacture. To say nothing of the thousands which are lost to physicians every year through the twofold office of physician and dispenser assumed by our druggists, the public is made to suffer incal

culable injury through the sale of patented medicines. The only remedy, and one which many of our physicians are adopting, to remedy the evil is for physicians to restore the prescription case to their offices and to keep thereon only the standard preparations of the pharmacopoeia. By this means the druggists would be made to recognize that physicians have rights which they are bound to respect if they would share their patronge.

METEOROLOGICAL REPORT for June, C. HENRI LEONARD, M. D., Observer for STATE BOARD OF HEALTH.

BAROMETER.-Highest, 30.049; lowest, 29.506; range, 0.543; average,

29.863.

TEMPERATURE.-Highest, 88; lowest, 50; range, 38; average, 69.3. It will be noticed that the highest given is not as high by several degrees as that read from several reliable thermometers at our jewelry houses; this difference is owing to the fact that the latter were exposed to the reflected heat rays from the pavements, although not exposed to the sun. The temperature I give is the exact temperatnre of the air. In '72, the average temperature was 68.3; in '73, 69.3; in '74, 68.9; in '75, 67.2; hence, the month has been somewhat warmer than the average.

WINDS.-Greatest velocity, 30 miles per hour; on one observation, at 7 a. m., of the 22nd, there was an absolute calmn, the first instance so far this year. At a good many observations the velocity has not been above 4 miles per hour. Prevailing direction was S. W., and the total number of miles "travelled," 4,643; considerable less than in the months of either May or April.

CLOUDS.-There were but three clear days; 12 cloudy ones and 17 rainy ones; a gain of three pleasant days over last month.

RAINFALL.-Greatest daily amount, .25 of an inch; this was on the 17th. Total amount of precipitation, only .51 inches. I have repeatedly heard this month spoken of as a "wet month," when, on the contrary, it has been the dryest month we have had in years; we have had hardly half as much rainfall as in any of the 4 preceding Junes; farther than that our observations do not extend. Our records show that this June has less than one-half the precipitation last; tess than one-third that of June of '74; of about onefourth that of June of '73; and two-thirds that of June '72. We had a rainfall last month that in a single hour measured as much as this whole month taken together.

MOISTURE.—This has been very abundant, showing a corresponding increase with the temperature. The maximum amount was 7.95 grains to each cubic foot of air; this was on the afternoon of the 26th. The prevail. ing amount has been in the neighborhood of 6 grains to each cubic foot. We had no rainfall on the day of the greatest saturation. At nine other observations the amount was 7 grains, or above, to each cubic foot of air.

OZONE.-Present on 25 days; a falling off of 4 days from last month, in conformity to the ozone chart of Prof Kedzie, of last year's observations. On 4 of these days there was only a "trace" found. The maximum coloration was 2; this was on the 25th., a day of no rainfall, and was reached at both the morning and afternoon observation.

THE

PENINSULAR JOURNAL

OF MEDICINE.

AUGUST, 1876.

Original Communications.

PUERPERAL CONVULSIONS-A Paper read before the St. Clair, Sanilac and Lapeer Medical Society. By C. M. STOCKWELL, M. D., Port Huron, Mich.

Of this most formidable disease Cazeaux says: "Among the various convulsive diseases that may appear during pregnancy, parturition, or lying in, there is one which has such well marked characteristics, and whose physiognomy is so peculiar, that I can scarcely comprehend the want of accuracy that still exists in most classic works on the subject." Meigs says: "It is of a nature so dreadful that we might reasonably suppose it to have been the object of much attention and of most careful study, for it ought to awaken in the mind everywhere, a strong desire to know and fully understand its principles and cure; nevertheless the thousands of examples of the disorder that have been ob. served and studied, have left us even in this enlightened age, with great differences of opinion concerning its nature, causes

and treatment." With such declarations, by men of acknowledged eminence in the profession, before us, we proceed to the study and exposition of Puerperal convulsions with no little hesitation and misgiving. Offering this as our apology, "In a multitude of counsel there is safety."

To a brief analysis of views propounded by prominent writers on this subject, first of causation and pathology, and last of treatment, we will append our small note of individual observation, thought and experience, with the hope of inviting a more critical and personal investigation and observation, and such expression of results as shall conduce to mutual professional progress.

Of cause, Barnes in his Lumlian Lectures states the following propositions :

Ist. Pregnancy and labor require for their due fulfilment an extraordinary supply of nerve force.

2d. This extraordinary supply of nerve force implies a corresponding organic developement of the spinal cord.

3d. The provision of an extraordinary supply of nerve force implies a greatly augmented irritability of the nervous centres, rendering them more susceptible to emotional and peripheral impressions.

4th. The disturbance in nutrition occasioned by pregnancy, almost always entails some alteration of the blood, which increases the irritability of the nervous centres and favors the evacuation of any latent convulsive or other nervous diathesis as chorea, epilepsy, or vomiting.

5th. Where the blood change wrought by pregnancy is marked by albuminuria a poisonous action of peculiar intensity is exerted upon the nervous centres tending to produce eclampsia.

6th. Obstinate vomiting in pregnancy probably sometimes proves fatal, by the development of an organic or systemic morbid process.

7th. Menstruation resembles pregnancy in giving rise to an exalted nervous erethism; and ovulation is a primary exciting cause of epileptic, vomitive and hysterical convulsions.

8th. At the climacteric age again there is a renewed susceptibility to convulsive diseases.

9th. Pregnancy by evoking or producing convulsive diseases, under certain known and passing conditions puts to the test the various theories of the pathogeny of these diseases.

10th. The rational treatment of these diseases in women must take into account the two great factors in the production of these diseasese, viz: an exalted nervous irritability under the stimulus of the reproductive functions and a lowered or empoisoned condition of the blood.

Physiological dissections and vivisections made by Schoff, Flourens, Hartwig, and Marshall Hall have fully established the fact that when the lobes of the cerebrum and cerebellum are both removed, convulsions may be occasioned to any extent by irritation of the cranial terminates of the spinal marrow. Marshall Hall found that while irritation of the brain proper of a dog produced no convulsive action, pinching the dura mater lining the cranium, to which branches of the 5th pair are distributed, did excite convulsion. (Tyler Smith Braithwaite's Retrospect, Part II., p. 223). A fact thus established by such authority, we naturally look to spinal irritation (not to the irritation of brain substance except in small degree to a portion of its membrane) either direct or reflex as the true source whence convulsions arise. In support of, and in confirmatory evidence of the propositions quoted and the conclusions arrived at, by the experiment alluded to, and as well of exalted nervous irritability, we further quote from foot notes in Ramsbotham's Obstetrics, p. 27, in which that author expresses his belief that this affection, eclampsia, originates most frequently in some deranged state of the uterus itself, probably in its nervous system and consists in some irritation propagated from that organ to the brain. He says that he has met with some cases that strongly impressed him with the idea just expressed, the most striking of which are the following: He was called by one of the midwives of the Royal Maternity Charity, to the assistance of a