knowledged a scientific authority, but he is not a great practitioner and his influence upon contemporaneous medicine is not wholesome.

There is a different ring to the words spoken to another body of medical students, those of Leeds University, by another teacher, Sir James Crichton Browne. He says: "Great have been the contributions of Germany to medicine and surgery, but those of England have been greater still, and while at this moment the young medical men she is sending forth from her universities have perhaps theoretical attainments higher than those who learn at our medical schools, they are no better practically prepared for their professional work. As a clinician our young English practitioner is quite equal to, if not superior to any continental compeer. After all, it is the competent clinician that is the main thing. The researches must always be comparatively few in number. But there is not one of you who may not, by profiting by the instructions here given, become the sure messenger of hope and healing in many a stricken home, and by your skill and science assuage the sufferings of your fellow men.

That kind of talk is helpful. To become a competent clinician, a trusted and loved physician rather than a barren pessimistic theorist, should be the pride and ambition of every young medical man. What Sir James says in praise of the English practitioner, that he is fitted for the practical work of his profession, is equally true of the American. May it always be true. To be a good clinician is, after all, of first importance. To be such you cannot despise the pharmacopea.

Rosacea. In the treatment of this affection, Prof. Shoemaker pays great attention to the digestive apparatus, keeping the bowels freely open; and administers strychnine in full doses. Virginia Medical Semi-Monthly.

WHAT OTHERS SAY

The special indication for cactus is the irregular heart beats, fast for a while and then slower for a while.Kinnett, Chicago Medical Times.

Strychnine unites with the asthmatic leukomain to make of it a complete chemical entity for excretion.-Burke, Dominion Medical Monthly.

Dispense yourself, if you deem it best; but in every case be sure to get what you want if it can be found, and call no man master.-Clinical Reporter.

Let the railers against modern medicine direct their energies to constructing better homes and establishing better sanitation.-Schneider, The Pacific

Pharmacist.

The vague and careless term autoinfection has been given a revealing meaning, leading to a consideration of one of the greatest influences for evil encountered in the study of disease.-H. H. Grant, Louisville Med. Journal.

From 1854 to 1894 only one patient not operated upon died in Guy's hospital from an impacted gallstone, the total deaths from all causes having been over 20,000. Out of thirty-five cases operated upon, ten died.-White, British Med. Journal.

In regional infections, as in pneumonia, phlegmons and carbuncles, the action of aconitine is unimportant in the process of resolution or liquidation of the focal center; but there is always a surrounding hyperemic border that may profit by its continued therapeutic use.-Burke, Southern Clinic.

Camphor is a diffusible stimulant, acting in a few minutes and perfectly safe. My use has been chiefly limited to the monobromate in single--grain doses. It acts promptly and pleasantly. Some of my heart patients carry it constantly in their pockets.-Satterthwaite, Virginia Medical Seim-Monthly.

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MEDICAL RECORDER

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This subject has been neglected by the regular profession, until recently, when Dr. Chas. C. Miller, of Chicago, has taken up the work. Dr. Miller is doing a large amount of original work in this field and reporting his results to the profession. Much of Dr. Miller's work is given in the articles he contributes to The Recorder, each month. This is a class of work for which there is much demand, and physicians competent to do the minor surgical operations required can derive satisfactory results and good remuneration.

The well known London weekly medical journal, The Hospital, has the fol

lowing to say, in a recent issue, regarding Dr. Miller's work:

"American enterprise manifests itself in surgery as in other spheres of usefulness. In a recent article by Dr. Charles C. Miller, of Chicago, the 'cosmetic surgery of the face' is promised a great future. Dr. Miller appears to have given a great deal of attention to the subject, and after working out the relations between the different lines of expression and the muscles which, by their continued contraction, give rise to these lines, he has devised methods of operation by which the various muscles may be divided, and the lines thereby more or less obliterated. Thus the transverse wrinkles of the forehead are, of course, due to contraction of minute fibres of the occipitofrontalis, and these he divides by subcutaneous transverse section by means of a small, sharp hook with a cutting edge. In most cases the corrugator supercilii muscles must also. be divided. For the eradication of crow's feet he performs a canthotomy, and then completes the division of the orbicularis palpebrarum. The treatment of wrinkles about the mouth is on similar lines, but the different points for insertion of the hook and the particular fibres to be divided vary considerably according to the nature of the case, and a large amount of individual skill and experience are necessary for the purpose. Local anaesthesia is recommended for these operations. Dr. Miller is careful not to promise entire obliteration of the lines of age and a complete rejuvenation of the countenance, but even with this precaution the occupation sounds hazardous. It is easy to imagine that in any but very skilful hands such operations might yield as a result the opposite of what was intended."

INFLUENZA

From several parts of the country we hear of an epidemic of influenza again passing over the country, and at the

time of writing it seems to have commenced in Chicago.

Judging from the history of this remarkable disease, we are impressed with the enormous quantity of drugs that have been administered in its treatment, without any definite and conclusive testimony as to the real efficacy of either of the agents most employed. In one of the earlier epidemics camphor became very popular indeed. This was followed by quinine, the ammonia salts, the cold tars, and the bromides. Each of these in turn was given in vast quantities, by the tons in fact, and yet it has not been long since a prominent -physician declared there was no proof that any remedy materially interfered with the natural progress of the disease, or even markedly relieved the symptoms. This, however, was the outgrowth of pessimistic views, and does not accord with the experience and the intelligence of the physician who has eyes to 'see, and a brain to think, and is willing to trust the testimony thereby afforded.

Sir Benjamin Ward Richardson once called attention to the primary need of this affection, of a remedy for the profound relaxation present over the entire body. This, however, is but a symptom, and it seems like better practice to endeavor to eliminate the cause of the depression rathan than to meet it directly. However, both indications may be met at the same time. We could commend the following treatment for influenza, applying thereto the principles of therapeusis which we have found applicable to fevers in general:

First: Completely empty the alimentary canal.

Second: See that the elimination is wide open, so that toxins generated by the disease may be carried out of the body as rapidly as possible.

vital forces generally by the powerful vital incitant, strychnine.

Fifth: Which many persons will put first-relieve the excessive pain when it is present.

Saline laxatives and colonic flushing meet the first indication. The second may be favored by veratrine in small doses, too small to cause vital depression or cardiac weakness, but still large enough to open the emunctories and let out the toxins. In many cases, however, the depression is so great that even very moderate doses of such remedies will prove too prostrating, and here the writer firmly believes a better remedy will be found in gelseminine. For the benefit of those who have not used this remedy, we would say that 1-250 gr. may be given every fifteen minutes, and repeated until the pulse slackens as much as may be deemed advisable, or even until the eyelids droop-this being the symptom of the beginning toxic action of the drug, when its use should be suspended until this symptom passes off.

The writer had occasion to note with surprise, and profound interest the fact that when patients have laid aside their long-accustomed morphine, the feeling of intense debility and prostration which sometimes follows is completely relieved by 1-50 gr. of gelseminine hydrochloride, administered hypodermically. This is the case even when the pulse is feeble and soft, and the other objective signs confirm the patient's sensation of weakness. The pulse improves under this dose of gelseminine, and in a few moments the patient may be going briskly about the room, happily joining in the conversation and avocations of those in the house. those in the house. Surely a drug which causes such relief in such a condition, cannot be dangerously depressant in such doses. This is also a most effectual remedy to relieve the pain of influenza, although in many cases the writer has found relief too marked to be

of various forms of ammonia, such as the carbonate, bromide, salicylate, but not so much from the chloride. Nuclein solution may be given in full doses, that is up to a dram each every twenty-four hours, to great advantage, and at least without harm done.

In the administration of heart-tonics, however, the greatest care must be exercised, as comparatively small doses of strychnine may be followed by over-action and collapse. The writer firmly believes that brucine is better suited to this condition, and in a number of instances he has found that none of the cardiac tensors was admissible in the treatment of this disease; but instead, that those so-called cardiac remedies that lie near the dividing line between tension production and relaxation, do better. He refers particularuy to cactin and sparteine, and either of which may be given frequently and in comparatively small doses.

The patient with influenza does not withstand large doses of any remedy whatsoever. It is not a disease for the sledge-hammer, but for rather cautious dosage, according to indications, with the closest attention to the symptoms, so that the treatment may be modified at a moment's notice. This increased susceptibility of the patient's system to the action of medicine, is one of the characteristic symptoms of the malady.

We know of no place in the treatment of this disease for alcohol in any shape whatsoever. We have never found it anything but a disadvantage and a nuisance, while in anything but the smallest doses it is a positive menace to the patient's life.

We would suggest that entirely too much attention has been given to strychnine as a tonic. There are others, and we believe that among these others will be found better tonic remedies to be used in the treatment of influenza. We would especially suggest two remedies for trial. One of these is populin. The tonicity. slowly pronounced, but en

during, of its effects, may possibly be found to be well adapted to the condition presented in this malady.

The other is cornin, a "concentration" from cornus florida. This drug partakes to some extent of the qualities of quinine, without its stimulating effect upon the cerebrum. It is an excellent tonic, like hydrastin, somewhat slow in development, but exceedingly lasting in its action. One or the other of these three remedies may be found especially suited for combating the depression of influenza, and we would suggest a trial of each of them in turn.

The diet should be of food quite nutritious, easily digested, given in small quantities at frequent intervals, and preferably hot. Four ounces every two hours is a fair average adult's dose of food. The fresh fruit juices containing the plant life should be given in at least eight-ounce doses, daily, the best fruit which is obtainable at the time and place being selected, although the writer has a strong preference for the juice of the grape-fruit.

This is another disease in which the open air is infinitely better than any confined room, however carefully its ventilation may be seen to. You cannot have too much ventilation in case of infective disease.

INERT DRUGS

It is a pity that every physician does not render himself proficient in logic before he commenced to study medicine. A vast amount of trouble could be thereby saved. If, however, the medical student has not been taught to think logically, some amends might be made were he to attend a court of medical jurisprudence, which would teach him what is testimony and what is not; in fact, if he were trained in the art of giving and of judging of testimony it would be invaluable. would be invaluable. For lack of this

simple knowledge many a first-rate phy

Suppose we are making physiologic tests of ergot. Administering the drug to a normal individual, no alteration is observable in the tone of the blood-vessels. All that we are warranted in saying in this case, is that we have observed no alteration in tone in those individuals. Were we to go on, however, and say that ergot does not increase the

tone of the blood-vessels, we are making a statement which is not warranted by our experiments.

That ergot, administered to a person whose vascular tension is below par, should restore the tension to normal, is another fact entirely. But it is of the utmost significance if this should be the case. For if it occurs in one instance, with one drug, there is no reason to doubt that it may occur in other instances, and with other drugs.

If Livingston's statement in this respect is established, or allowed, it completely demolishes the whole case that has been built up against cactus, echinacea, hamamelis, and many other drugs. Experiments made with these drugs on individuals in the state of health have resulted in the unwarranted assertion being set forth that these drugs are 'inert.' If, however, ergot exerts an easily recognizable action in increasing the tension of blood-vessels whose tension was previously below the normal

standard, there is no reason whatever for holding that echinacea cannot possibly favorably affect persons who are laboring under septic toxemias, even though no perceptible effect is OCcasioned by the the administration of echinacea on individuals in perfect health.

The same reasoning applies to cactus, which has been termed "inert," because one particular form of effect upon the heart was not manifested in experiments made upon animals, even though that particular effect was one which the advocates of cactus had unanimously denied to it, their judgment being based action of the drug when administered upon clinical observations made on the action of the drug when administered to persons-human beings-in certain conditions of disease. The gap here between the actuality of the observations made, and the widths of the deductions made therefrom, is infinitely greater than in the case of ergot.

The eclectics have used cactus for therapeutic value. years and have a large literature on its wood says in his Therapeutist: Dr. Finley Elling

"Probably twenty thousand physicians have been using this remedy for many years, with results that are impossible with any other single heart remedy, or I believe I am safe in saying, any combination of heart remedies. *** In its general influence, for breadth of action, for specific directness, for reliability, smoothness and general trustworthiness of action, this agent takes precedence over other heart remedies."

These things should render us exceding cautious about making broad statements, because the cause of scientific truth is only hindered thereby. One should be careful not to go a hair's breadth beyond the absolute facts deducible from the data at his disposal. Anything more than this simply shows the ignorance of the party indulging in such rash and heedless statements, and his inability to reason logically.