the patient from head to foot, after letting on all the light possible in the room. I found, after careful examination of his face, trunk and limbs, eight or ten small pale red macules on his neck and a few more measly rash on the right cheek. I was then convinced that the case was one of the exanthemata. I stretched a portion of the affected skin on his back and ran my finger across the papules in order to see if it could be obliterated, and found that the papule was still felt when the skin was drawn out. Having previously heard of the so-called chicken pox that the negroes had been having a few miles from the patient, I told the family that the case was suspicious, but I could not make a diagnosis; that I didn't believe it was chicken pox, but that it might be German measles, small-pox or something else, and that I would visit him again in twentyfour hours.

On Sunday I again visited him, which was the fourth day of the attack and upon examination, found there was a large increase in number as well as in the size of the papules; on his face and back they were much more abundant, also on the extremities. I again stretched the skin on his face and back and observed that the papules were larger, more firm, globular in shape and felt something like shot beneath the skin. His temperature then was 101°, pulse 100. He had still some cough with a little sore throat, but his head, back and bowels were easier and all the symptoms of the patient seemed to be better, or rather there was a marked decline in the fever, and indications of convalescence. I was fairly well convinced by this time that the trouble was small-pox. I then gave some further directions and bade them adieu, and my visits from that time on were not unlike "angels visits," "few and far between."

Desiring some consultation in the case, on the 18th inst., 10 days later, I had Dr. Pruett, county health officer, to visit the case with me, and at this stage the patient showed an abundance of pustules on his face, chest and neck, and his mother informed us that almost the entire surface was covered with similar eruption to his face indicated.

case of small-pox.

The doctor and myself both pronounced it a well developed Other members of the family have since same case again at about the 21st day; the pits were deep and thick on the face and other portions of the body that I examined.

had it. I saw the

I will now give a synopsis of the chief points in the diagnosis of chicken pox, measles and variola, and will close.

ERGOT; ITS USES AND ABUSES.

By G. R. Burney, M. D., Hard Times, La.

Ergot is probably one of the oldest known drugs. The first pharmacopoeia of the United States gave it a prominent place, and the rules governing its administration and the indications for its use still remain as laid down in that volume. Very little has been accomplished of late to enlarge its field of usefulness, and it is still prescribed semi-empirically by the rank and file of the profession. In a sense Ergot is looked upon with disfavor by the laity, so that the physician not infrequently is obliged to write claviceps purpurea, or secale cornutum, instead of the conventional ergota: nevertheless it is recognized by reputable physicians as one of the most useful drugs in the medical armamentarium. The use of ergot as an abortifacient is fraught with much danger. It causes tonic contraction of the muscular fibres of the os uteri; at the same time it reduces the caliber of the placental arteries and thus diminishes the blood supply of that structure. In other words it destroys the life of the child and prevents its expulsion until kindly nature is forced to intervene. Often the physician is called at this juncture to relieve the patient of the consequences of imprudence, and shoulder the responsibility of her safety at the risk of his reputation. To me such cases have been the most trying and most difficult to handle in all my experience.

Having been engaged in a large obstetrical practice in the city of Chicago, and early learning the advantages of the proper use of ergot, I set about to ascertain which preparations of the drug were most potent, with the determination to use only such as yielded satisfactory therapeutic effects. The result is I have long since gotten into the way of giving half a drachm of Parke, Davis & Co's fluid extract of ergot immediately after delivery, though never before.

This drug should be given in full doses every fifteen minutes in post partum hemorrhage. I do not advise its use in placenta previa, no matter how severe the bleeding may be. In this condition my practice is to evacuate the uterus quickly when, nine times out of ten, nature asserts herself and the

flooding stops. At this point a full dose of ergot does no harm and often obviates the necessity of a speedy call upon the physician. I do not give ergot to anemic indivuals as their arteries and arterioles should have the largest capacity possible, and it is well known that ergot contracts them. I have found ergot of much value in the treatment of various hemorrhages, notably the hematuria of swamp fever. Owing to its tendency to irritate the stomach its adminstration should not be contin. ued for too long a period.

Doubtless many mistakes have been made by the admini. stration of ergot in threatened abortion. A brother practitioner once stated to me that he would never again use the drug. He had given it in a case of impending abortion with subsequent danger to the life of the patient and his professional reputation. Aged patients with slow pulse bear ergot badly, hence the dose under such circumstances should be relatively small. It should not be given when venous stasis or dropsical effusions are present. I regard it with favor in the treatment of paralysis aud many neuroses, and I look upon it as useful in apoplexy. Lately I have been employing ergot in the treatment of hyperemia of the prostate and in cases of so-called "badly cured gonorrhea," prostatorrhea and spermatorrhea; and with such success I advise my confreres to give this matter the benefit of further clinical experiment. I have a case in mind of a man perfectly cured, who came to me four weeks ago, suffering with prostatorrhea. He had been under treatment for several months, and by several physicians, without obtaining relief. In all such cases I am using bougies less, and ergot

more.

One is very apt to meet with preparations of ergot that are wholly inert and therefore useless. For years I have used only the product of one manufacturer, Parke, Davis & Co., and never in a single instance have I occasion to feel that it was anything else than a reliable servant. I have used it hypodermatically in hundreds of cases and have never observed an abscess from the procedure. While a student in the Chicago College of Pharmacy I assayed twenty different preparations of ergot and found that but two of the twenty specimens approached the standard, one of them being Parke, Davis & Co's fluid extract.

It is a fact that the chemical tests are not of much service when applied to ergot, and yet we must have some standard of efficiency. The only reliable test is the observation of its effect upon living animals. Ergot should be used carefully and when a reliable preparation is chosen the physician finds that he has a ready and decisive weapon. I recommend that the fluid extract be given well diluted and, when the hypodermic method of administration is adopted, that special pains be taken to insure the cleanliness of the syringe. Do not purchase ergot preparations in large quantities, and be sure to keep your supply in a cool place.

In conclusion let me say that no practicioner should neg. lect to have this drug with him on all occasions. It should occupy a place with strychnine, nitro-glycerin, and apomorphine as an emergency requisite.

SURGICAL CLINICS AT MOBILE CITY HOSPITAL.

By W. R. Jackson, M. D., Professor of Principles and Practice of Surgery and Genito-Urinary Diseases, Medical College of Alabama.

Gentlemen:-I present today for your consideration and instruction a most interesting case.

Re

Case I. As you readily perceive this woman is ponder. ous in more ways than one.-having a natural weight of 220 pounds and being possessed of an enormous abdominal tumor besides, thus presenting symptoms of a "twenty months preg nancy," as expressed by her physician. She tells us that five or six years ago she began to enlarge in her abdomen. This progressed slowly for four years, but during the past eighteen months rapidity of growth has been marked. membering that the clinical history of tumors, especially at their very inception is exceedingly important, I ascertained that she first noticed the enlargement in the right ilio-inguinal region, hence the inference is that it is a pelvic growth extend. ing into the abdominal cavity. Upon inspection you notice a uniform symmetrical swelling of the whole abdomen, even to the ensiform cartilage. Palpation giving us "resilient fluctuation" at some points and greater resistence at others, showing