medicine, we have a remedy of much value. It may be given continuously to the youngest and most delicate children with perfect safety; and in so prescribing it, we are giving a salt of the greatest importance to the general economy when absorbed. It promotes a healthy secretion of bile, and of itself can aid in the assimilation of fatty matter. In regarding the cases where it is indicated, one can not but be struck by the similarity which exists between its action and that often sought by the administration of gray powder 'in alterative doses.' As a rule for its prescription, I am in the habit of telling my students that whenever their minds suggest the ordering of hydrargyrum c. creta as an alterative, they should try first the phosphate of soda. The advantage of the latter over the former, where it has to be continued for some time, is patent to every one. Where the purgative effect, however, is desired, the former is to be preferred. I hope, therefore, that soon the use of the phosphate will displace in many cases the frequent and often long-continued use of the dangerous remedy.

"The cases in which I now recommend it are chiefly the following:

"In infants who are being artificially reared, and who are liable to frequent derangement of the bowels; also when the phosphatic elements in the food seem deficient, or when articles of food rich in phosphates, such as oat-meal, disagree; where, from the character of the motions, there is a deficient or defective secretion of bile. It is thus of service in cases of chalky stools or white fluid motions. I have also found it of service in many cases of green stools. In diarrhoea, generally, it is more difficult to distinguish the class of cases. In simple diarrhoea, such as we frequently meet with in the summer months, I have not found it of much service alone, although it may be of use when given in combination with other remedies. It is chiefly in that class of cases which are more properly termed duodenal dyspepsia that it is of benefit. Diarrhea after weaning is generally of this nature, and the cases are often chronic, or of some weeks' standing, the mother generally having exhausted her own and the nearest druggist's resources before applying for advice. It is also of service in some cases where the diarrhea is due to some general cachexia."

He also uses it with adults in some cases of constipation, and

in cases of duodenal dyspepsia. He likens its action in phthisis to that of the hypophosphites of soda.

The dose for children is four to ten grains in the food, for adults twenty to forty grains in water, and taken after meals. Too small doses fail of their action.

Diphtheria.

DR. REUBEN SEARCY, of Alabama, thus speaks of his experience in the treatment of this disease: I now treat it with a saturated solution of chlorate of potash, acidulated with muriatic acid; i. e., one hundred grains of the potash, in four ounces of water, adding one drachm of muriatic acid. To a child of ten years old, give a teaspoonful every two hours, in sweetened water, and less to younger children. I directed two pieces of fat bacon to be sewed to a piece of cloth, and bound to the neck over the tonsils, and to be worn until after convalescence. When the skin is hot and dry, rub the patient all over with a piece of bacon rind, then wash off with warm water and soap. This always les sens fever, producing sleep and perspiration. This should be repeated as often as the hot skin requires. Gentle aperients, gruels, teas, etc., should be directed, but an active purgative or emetic should never be used.-Atlanta Medical and Surgical Jour.

Prevention of Chloroform Sickness.

IT seems that the plan of administering a few drops of chloroform in water to prevent sickness, proposed by Mr. Chesshire has been tried by Mr. J. Vose Solomon, of the Birmingham Eye Hospital, and others, and has been abandomed. He says (Brit

ish Medical Journal:) "The results of this practice, as observed by me at the Birmmingham Eye Hospital, may be briefly summed up as follows: Where the patient had not been specially prepared for the inhalation, the whole contents of the stomach were rejected; where the precaution of allowing only a small breakfast of tea and toast at an early hour in the morning had been taken, some were sick, and some were exempt from that troublesome complication. There was no certainty. The prevention of sickness and retching during and after inhalation of chloroform, I find best attained, in private practice, by obliging the patient to breakfast, four or five hours before operation, upon

the lean of a small, well-cooked mutton chop, four ounces of tea or coffee, and a bit of toast. In persons of highly-nervous temperament, or whose hearts are feeble, the administration of three ounces of hot brandy and water twenty minutes prior to commencement of inhalation, facilitates the action of the anesthetic, prevents gastric disturbance, and insures satisfactory cardiac action. If the patient be kept entirely without food, or permitted to take only a cup of tea and a little toast for the early morning meal, retching of distressing urgency has been frequently observed. When the patient is much excited by the thought of the contemplated surgical procedure, the process of digestion becomes arrested, and food in a crude state is discharged by emesis.

Bromide of Potassium in Cases of Mania.

DR. THOMPSON, of Dalkeith, states that a patient of his who had suffered from puerperal mania, after her first confinement, recovered under opium; after her second confinement she became chronically insane, and recovered only when removed to an asylum for three months. When pregnant for the third time (second month) she became again insane, and recovered in a few days while taking scruple doses of bromide of potassium frequently, sleep being procured only after still fuller doses at bed-time. He adds that he has had lately a case of acute mania in a male where opium did good, but where the bromide seemed to be much more useful. Although the patient improved under the latter medicine, he ultimately succumbed to the disease. He had only in one other case seen such obstinate refusal of food-every effort to get food over being followed by great exhaustion. He recommends the bromide in mania, especially where opium was no longer advisable, or indeed admissable, i. e., where there was a weak circulation and clammy perspiration. He admitted that in this last condition, in certain other diseases, opium was a valuable stimulant, but here it was the reverse.

Dr. Keiller had used this drug largely as a calmative, and had found it of very great service in delirium tremens and other cases in which wakefulness was a predominant symptom.

Dr. Charles Bell thought that there was some misunderstand ing as to what might be called a large dose of bromide of potassium-the doses varying from five grains to an ounce. Dr. Begbie spoke of half-drachm doses, he believed.

Sir James Simpson said some patients of his would as soon think of giving up their breakfast as their bromide while laboring under fibroid tumors. He agreed that its action should be watched, for although fifteen years had elapsed since it was known, still there was room for inquiry.

Dr. Burn commended its use in fifteen-grain doses three times a day. Proceedings of Edinburgh Obstetrical Society.-American Journal of Insanity.

[Dr. W. E. Brickell and myself gave a patient suffering from delirium tremens, seven ounces of bromide of potassium in thirty hours, without any sensible effect that I could notice.]-J. D. B. -New Orleans Journal of Medicine.

Permanganate of Potash in Acute Rheumatism: By C. M. Fenn, M. D., of San Francisco.

AN extract from a clinical lecture, delivered by Dr. James F. Duncan, at the Adelaide Hospital, some time ago directed my attention to the use, among other remedies, of permanganate of potash in the treatment of rheumatism. I promised myself to make trial of the remedy at the first opportunity. Regarding the socalled chemical theory of the etiology and pathology of rheumatism as, at least, the most plausible, and believing the efficacy of other salts of potash in that disease to be largely due to the measure of oxygen which they contain, it seemed to me that in this salt we possessed a remedy admirably adapted to meet all the indications; and that from the fact of its containing so large a proportion of oxygen (KO, Mn O,) and holding the same in such loose affinity, we should be enabled most speedily to promote the transformation of lactic into carbonic acid. In apparent corroboration of this view, I append the record of three cases.

Case 1. Mr. S., salesman, aged, thirty, after some unnsual exposure was prostrated by a severe attack of rheumatism. Upon an examination of his case the new remedy occurred to my mind. But the urgency of his symptoms was such that it seemed preferable to make use of the medicines we had some confidence in rather than fly to others we know not of. He was, therefore, ordered a preparation of potass, iodide., vin. colch. sem., etc., and submitted to a hypodermic injection of morph. acetas. one-fourth of a grain. To modify the exhausting and troublesome perspiration, he used, on the third day, a vinegar bath, with no appreci

able relief. On the fourth day, discovering no change in his condition, other than might be ascribed to the daily hypodermic injections, I requested him to suspend the mixture and have half a grain of the permanganate, three times a day. At my next visit, on the following evening, I was surprised at the marked abatement of all the symptoms. The tongue was quite clean, the perspiration no longer excessive nor disagreeable, and the pains were so far relieved as almost to preclude the continuance of an anodyne. His c.nvalescence was now constant and rapid, and on the tenth day from the commencement of the attack he was again at his post.

Case 2. Mrs. G., aged thirty-five, of full habit and previously healthy, was attacked during the passage from New York. There had been a considerable amelioration of the more violent symptoms at the time of her arrival here; but some of the larger joints were still tumid and painful. The permanganate of potash was resorted to, and in a few days she was able to attend to her household duties.

The third case I regarded as, in some sense, a crucial test of the remedy. The patient, a man in middle life, had long been a victim distorted with tophaceous deposits, and the malady was so far incurable. This was varied, however, at intervals of two or three months with acute attacks, which apparently resisted all the usual remedies, and expended their force in from two or three weeks. I had previously attended him in several of these attacks, and found the common remedies, colchicum, acetate of potash in larger doses, etc., of but little avail. I now put him on the permanganate, and had the pleasure of seeing him on the street in seven days.

I find the raspberry syrup to be the best menstruum, as it disguises the somewhat nauseous taste of the medicine completely. -Detroit Review.-St. Douis Medical Reporter.

Delirium Tremens Treated with Cannabis Indica.

DR. BEDOE, physician to the Bristol Royal Infirmary, advises, in the traetment of mania-a-potu, the employment of the cannabis indica. He usually begins with a grain of good extract or twenty minims of the tincture; waits from four to six hours, and then, if the patient be awake, gives a double dose. If this also prove fruitless, six hours later he gives three or even four