64 THE PHYSICIAN'S ANATOMICAL AID," by to be very much in demand, especially in the Western Publishing Co., of Chicago. Notice the advertisement on page xvi for description. This is without doubt the finest thing in its line ever brought to our notice. The plates are exceedingly fine and the arrangement perfect, while its form is such as to give at once the greatest advantage for display and the greatest security from injury. For the teacher, the student or the practitioner we could recommend nothing better for the purpose unless it should be the cadaver. The price is comparatively low, and the terms very reasonable. Therapeutic Notes of Some of the Newer Medicaments. CONDURANGO WINE. Although condurango has not entirely justified the claims made for it in the treatment Europe. One fluid ounce of the wine represents sixty grains of condurango bark. Dose, one-half to one fluid ounce. Parke, Davis & Co. supply the wine, and also a fluid and solid extract of this drug; and will also mail, on request, a working bulletin on condurango to physicians who wish more detailed information concerning it. Hopkins' Cafe. of cancer, the experiments made with it have OPEN DAY AND NIGHT. demonstrated its utility as a stomachic, and in the form of condurango wine it has grown 729 Kansas avenue. PRESCOTT & ALLEN, Medical AND Surgical Register Correspondence Solicited. 118 East Seventh St., Topeka. OF THE UNITED STATES. The second edition will contain the names of about 100,000 PHYSICIANS IN THE UNITED STATES, arranged alphabetically, also arranged by States and Cities, showing school practiced, date and college of graduation and post-office address. Lists of Medical Colleges, Medical Societies, Hospitals, Sanitariums, Asylums, Mineral Springs, Boards of Health, Medical Journals, Medical Departments, U. S. Army, Navy and Marine Hospital Service, and Pension. Departments. It is the only National Directory of Physicians published, and if you wish a work of the kind for reference, or desire to circularize the profession you cannot procure as complete and reliable a list from any other source. R. L. POLK & CO., Publishers, VOL. II. PUBLISHED MONTHLY TOPEKA, KANSAS, FEBRUARY, 1890. No. 2. more elastic than the absorbent and will not pack into hard balls when soaked in glycerine. It can be sterilized by being heated in an oven to 240 degrees Fahrenheit. For tampons applied in uterine and special ovarian displacements, a cheap kind of cosmoline, very thick and heavy will be preferable to the more fluid petroleum preparations; the former will neither be absorbed by the cotton nor will the tampons get hard, and consequently will retain their place better and longer, and will be soothing to an inflamed vagina. If an antiseptic and depleting effect is wanted, the cotton can be soaked in boro-glycerine, the vagina first having been washed out with an antiseptic solution. Antiseptic sheep's wool can now be obtained in drug stores; it is very light and elastic and will not retain the secretions as does the cotton. Its disadvantages are, its irritating effect, and after a time, its disagreeable odor. Such materials as oakum and sponges are now things of the past. A properly constructed cotton tampon is made with coarse white knitting silk, which is much more comfortable to the patient than the cotton cord. If for support, this should be rolled in a layer or strip of absorbent cotton-not around the cotton-and then tied at one end of the roll or cylinder in a surgeon's knot. Remember always, after drawing taut the first double knot, to carry the right hand around to the left, and to give it a quick pull in that direction, which secures the knot from slipping until the second knot can be made. You will now have a tampon like that shown in fig. 2, the long axis of which, whatever its position in the vagina may be, will, when drawn. upon by the silk cord, correspond with the long axis of the vagina, and consequently may be removed with comparative ease. The silk should not be over twelve inches long and should not project from the vulva more than three inches, since certain movements of the hemorrhages are totally inefficient, other patient in the sitting posture, will frequently means being more scientific. If used for this drag on a long string and tend to displace the tampon. A much better tampon for support is made of antiseptic sheep's wool rolled in a cylindrical form, and a sheet of absorbent cotton, covering what we call the upper end and drawn down on its sides, leaving the wool exposed and projecting only at the lower end. It is tied near its upper end with two or three loops thrown over the body of the tampon, the last hear its lower end, as shown in figure 3. This has the advantage of the preceding, and its shape may be varied as desired, making it round or flat or broad at the top, to suit the wants of any case. The wool in the centre will not absorb and retain the secretions, but acts as a drainage tube, and having the wool FIGURE 2. exposed below, it will not slip as does cotton, and more likely retain its place longer. Tampons as usually applied to control FIGURE 3. purpose however, they should be packed in the vagina through the Sims' speculum, according to the method of Emmett, using a large quantity, in fact filling the entire pelvis, first having emptied the bladder, and if time will permit the rectum also. Pajot's directions. are to use at least a hat full of pledgets. Tobacco Its Effect Upon the Eyesight. BY FLAVEL B. TIFFANY, M. D., PROFESSOR OF OPHTHALMOLOGY, OTOLOGY AND MICROSCOPY IN THE UNIVERSITY MEDICAL COLLEGE OF KANSAS CITY, MO. Tobacco (nicotiana) is a narcotic introduced to the world by Americans through Columbus, in the latter part of the thirteenth century. It derives its name from a pipe used by the natives of San Domingo. This pipe consisted of a hollow y shaped tube, which they called "tabaca." Tobacco chewing was not known to the Europeans when a Franciscan, accompanying Columbus, saw the natives of the coast of South America indulging in. the filthy habit. The vulgar habit is still largely confined to sailors and Americans, while smoking is universal the world over. Tobacco was first taken to Europe by Francisco Fernandez, in the year 1538. The amount of tobacco consumed every year is prodigious. In England it amounts to about fifty million pounds, or twenty-three ounces per head; in the United States there is a larger proportional amount. In 1880 the Jean Nicot, from whom the active principle, United States raised more than 472,000,000 nicotine, derived its name, sent seeds of the pounds, and during the ten year's previous plant to Catherine di Medici. Ralph Lane, America exported two billion pounds, and first governor of Virginia, sent some tobacco over one billion was manufactured for home to Sir Walter Raleigh, who, with Mr. Lane, consumption. The quantity consumed by was the first to smoke the calumet in Europe. growers during the time mentioned is estiTobacco was early thought to possess extraordinary healing powers, and was for some time called "herba panacea." The illustrious Raleigh, knowing its narcotic effect, is said to have smoked several pipes of it just before going to the scaffold. Soon the habit became popular among the Elizabethan courtiers. The components of tobacco are-water, mineral acids and salts. The bases on combustion pass into ash, viz., carbonate of lime, salts of ammonia, and nitrates. In every one hundred parts of ashes there is nicotine (C10 H14 N2) (a volatile alkaloid) one and one-half to nine per cent. This is an active poison— essential oil, a small amount, gives flavor; nicotianin, a solid gum, gives odor; maltic and citric acids 10 to 14 per cent., acetic acid 1 to 3 per cent., oxalic acid 1 to 2 per cent., peptic acid 5 per cent., resins 4 to 6 per cent., sugar 12 per cent., cellulose 7 to 8 per cent., albuminoids 25 per cent. The nicotine determines the strength of the plant, but not the flavor nor the aroma; it increases in quantity with the age of the plant. Young leaves do not contain more than 34 per cent., while older one's may contain from 8 to 9 per cent. The composition of the tobacco smoke differs from that of the plant, containing relatively a much greater per cent. of nicotine. Kissling, experimenting on cigars, found that a large proportion of the nicotine passes unaltered into the smoke. Dealing with tobacco containing 3.75 per cent. of nicotine, he recovered from the smoke 52.02 per cent. of the total nicotine consumed, and the per centage in the unconsumed remains was raised to 4.57. The composition of tobacco smoke is highly complex, but beyond nicotine the only substances found in appreciable quantities are the lower members of the picoline series. mated at more than 280,000,000 pounds, and daily the consumption is increasing. If we stop here for a moment and consider the effect of the poisonous narcotic, its influence on the system, its effects direct and indirect upon the consumer, as well as upon his progeny, we may realize in some degree the part the weed plays in the ætiology of many affections difficult to otherwise account for, such as epilepsy, angina pectoris, glaucoma, hemipegia, asthma, &c. Burton, in "The Anatomy of Melancholy," gives strong expression to two views: "Tobacco, divine, rare, superexcellent tobacco, which goes far beyond all the panaceas, potable gold, and philosopher's stones, is a sovereign remedy in all diseases. "A good vomit I confess, a virtuous herb if it be well qualified, opportunely taken and medicinally used; but as it is commonly abused by most men who take it as tinkers do ale, 'tis a plague, a mischief, a violent purge of goods, lands, health-hellish, devilish, and damned tobacco, the ruin and overthrow of body and soul." 66 'As a therapeutic agent it acts as a narcotic, diuretic, diaphoretic, and cathartic. The smoke relieves exhaustion. The toxic effect of the oil produces restlessness, diminishes bodily and mental vigor; causes anæmia, loss of vision and of memory, palpitation of the heart, paralysis, nausea, vomiting, cold, clamminess and death." King James of England described the use of tobacco as a "custom, loathsome to the eye, hateful to the nose, harmful to the brain, dangerous to the lungs, and in the black, stinking fumes of its smoke resembling the horrible stygian vapors of the bottomless pit." The priests and sultans of Turkey declared the most cruel kind of punishment for its use, namely, the pipe of the smoker to be thrust through his nose. smoking a crime, and sultan Amuret decreed breath, rotten teeth, and sore mouth of the consumer (too loathsome to contemplate). another more noxious evil comes in to contaminate and undermine both mental and physical strength. In Russia the noses of the smokers were cut off. Still the use of tobacco gained ground, and has continued to increase among all nations and conditions of men. The evil effects of tobacco upon the young should be pointed out by the medical profession; and, to my thinking, it would be well were there a law to be enforced by the superintendent and teachers of all public schools, The Turks and Persians are the greatest smokers in the world. In India, all classes and both sexes smoke. In China the practice prohibiting its use upon the part of each and is also universal, even little girls of eight years carry their pouch of tobacco and a pipe as constant companions. every pupil. Such a law already exists in some private schools, and no pupil, from the begining to the close of his career in the school, can use the noxious weed in any form what ever. The smoking of cigars and cigarettes is more injurious than the smoking of the pipe, as more nicotine is absorbed than when the pipe is used. The pipe takes into itself more or less of the volatile oil. General Grant, as well as the Crown Prince of Germany, Frederic, died of cancer caused by smoking cigars. Edwin Booth, as the secular papers say, came near dying from a nervous prostration caused by excessive smoking, his habit being to smoke from fifteen to eighteen cigars daily. According to Mr. Richardson, the pure carbon given off in tobacco smoke settles upon the mucous membrane of the pharynx, larynx, and bronchial tubes, creating an irritation of these parts which is liable to produce serious trouble. It is the presence of pure carbon in the smoke which gives it its peculiar color. The ammonia of the smoke bites the tongue, causing dryness and thirst, and may even result in cancer. It also exerts an influence on the blood and upon the nervous system, producing sleeplessness, headache and lassitude. The most injurious ingredient of tobacco is nicotine. This produces tremor, palpitation, paralysis, functional disturbances of the stomThe use of snuff, which is principally made ach, causing dyspepsia and debility; func- from tobacco, is less injurious than smoking, tional disturbances of the heart, causing irregu- though more disgusting, its nicotine remains larity of its action; of the eye, causing dilata- unchanged. The filthy habit of chewing is tion of the pupil and dimness of vision. In the most deleterious to the general system. the ear it causes subjective symptoms, as of Nearly all excessive tobacco chewers are emaringing of bells, blowing off of steam from an engine, singing of the teakettle, singing of crickets, sighing of the wind through tree tops, chirping of locusts, &c. ciated, blear-eyed, haggard, and eventually dull of intellect; for tobacco stifles the best mental impressions, "blunts the keen edge of thought," puts men in a soured condition in which they talk about luck and chance, blaming others for their failures in life instead of Smoking or chewing in the young impairs growth, produces premature development and physical degradation. Even the smallest recognizing the immutable law of cause and amount of smoking is injurious to the immature. Smoking of cigarettes, so universal among the youth, with its evil effects upon the organism is simply appalling. In cigarette smoking one gets not only the pernicious effects of tobacco, but as cigaretts are extensively manufactured from quids of tobacco-chewers and stumps of cigars picked up from the street, which are often contaminated by the foul effect. Other things being equal, the best man wins in the life race, but the man with a dulled tobacco intellect, a tobacco heart and tobacco stomach, is certainly not on equal footing with him who is untroubled by the toxic influences of tobacco. Take for instance the surgeon addicted to over-indulgence in smoking, surely he cannot carry the steady hand so necessary for the successful operation. My friend, Dr. Galezoskwi, of Paris, tells |