COMPRISING THE REGULAR CONTRIBUTIONS OF THE FORTNIGHTLY DEPARTMENT STAFF.

Chronic Empyema.-The treatment of this desperate condition should be radical. We should not hesitate to resect a sufficient number of ribs to give free drainage. Patients even in very weak condition stand the operation surprisingly well. Very little anesthetic is necessary.

Surgical Treatment of Movable Liver.-The American Journal of the Medical Sciences, quoting Ferrier and Auveay on this subject, says:

"In the eleven cases in which it has been employed there have been eight successes, one death and two cases in which the results of the operation are as yet uncertain.

In one of the two cases in which no benefit resulted, a subsequent nephropexy relieved all the symptoms, showing that the trouble had been entirely there and not with the liver.

In regard to the method of operating, the author says that the fixation of the liver is possible without great difficulty; it is a perfectly logical operation, and should be employed when certain definite indications are present, and is entirely justified by the results which have been obtained.

This operation should not be employed in the early stages of the disease where it is possible to secure a recovery by judicious internal treatment directed to the condition of the nutrition of the parts, together with the employment of a carefully applied bandage. It should be employed in the later stages, when the diaggings and compressions, which accompany the condition and produce the pain and disability of the patient, are so marked as to make recovery impossible without surgical interference.

The fixation should be accompanied by operation upon the abdominal wall, correcting the relaxed condition which predisposes to hepatoptosis.

Controlling Hemorrhage from Femoral Artery.-The American Journal of the Medical Sciences quoting Thomas in the Lancet, details the following method of controlling hemorrhage from the femoral artery during disarticulation of the hip or other procedures.

"The common femoral artery and vein were temporarily compressed immediately below Poupart's ligament. At this point the artery is quite superficial and easily felt, and is well above the origin of the deep femoral. The femoral pulse being felt, he made a stab-puncture in the skin, one about an inch outside the pulse and the other about two inches to its inner side- i. e., immediately below the pubic spine. An aneurism needle was pushed from one stab puncture well behind the artery and vein to the other stab-puncture, and two long, thick, silk ligatures were carried back when it was withdrawn. A roll of compressible material was placed over the artery and the two ligatures tied separately over it, after the limb had been elevated for a sufficient length of time to empty it of blood. The knots are not firmly fastened at first; a surgeon's knot is used, held by haemostats, so that they can be readily made tighter if it is found necessary.

The same result can be attained by making one puncture and pushing one blade of a Dayen's broad ligament forceps beneath the vessels, and then clamping them, but this requires an extra instrument and is not available in an emergency."

Antistreptococcic Serum.-Dr. Warren B. Hill, professor of Materia Medica and Therapeutics in the Milwaukee Medical College, in a paper read before the American Medical Association on the above subject, sums up his conclusions as follows:

"Owing to the fact that this serum has not yet reached a state of perfection and cannot as yet be accurately standardized, we are apt to meet with some failures and be subjected to some disappointments in its use. A great many diseases of mixed origin are supposed to be benefited by this serum, but the results of its use must be determined by the extent to which the streptococcus erysipelatus infection acts as an etiologic factor in the disAny disease which is caused by streptococcic infection is certainly benefited, if not cured, by antistreptococcic serum.

eases.

"Serum which is reasonably fresh and hermetically sealed, having been properly prepared and properly inspected, is never an element of danger and may be used with impunity, in reasonable quantities, where the diagnosis is not clear, but where streptococcic infection is suspected."

Flat Foot. Clarke in Lancet of April 23d, '98, gives the following points: Have soles sufficiently wide anteriorly for the toes. Boots have pads of vulcanized rubber so formed that the highest point is in front of the transverse tarsal joints. An outside leg-iron, jointed at the ankle and having an outside T strap is useful in some cases. Manual wrenchings, douchings and suitable exercise may be used in proper cases. Rising on tip-toe a certain number of times, the toes being inclined inward; adduction of the foot several times in succession; walking for a short time daily on the outer border of the foot. Flat foot from rickets requires complete rest.

MEDICAL MELANGE

Patent Medicines Taxed. An important opinion rendered by assistant Attorney-General Boyd, in regard to the taxability of medicinal preparations under section 20 of the War Revenue Act of June 13, 1898, has just been promulgated by the Treasury Department. The opinion in substance holds that the subjects of taxation under the said section and schedule are confined to compounded patent, trade-mark, and proprietary medicines, and to such compound specifics and medicinal remedies as are put up in packages ready for use by the consumer without the intervention of a physician or pharmacist. It is held that the law does not tax medicinal preparations, which are uncompounded, or which, if compounded, are put up under medical or pharmaceutical names for classifications for the use of physicians in practice, or druggists or pharmacists in their trade. This decision is of general importance to the drug and medicine business throughout the country, and had the effect of relieving from stamp tax many standard medicines, such as the serums and others. The amounts of the taxes paid on these excepted articles will be refunded by the government.

Electrolysis. The personal experience and observation of the writer, extending over several years, have led him to the following conclusions: First, currents strong enough to be effective are often excessively painful and therefore intolerable; second, the agent in a limited number of selected cases of intramural tumors is capable of giving more or less relief from the symptoms of hemorrhage and pain; third, appreciable and permanent reduction in the size of the tumor is an unusual result; forth, disappearance of the tumor as a result of electrolysis seldom occurs. In one case the writer observed the disappearance of an intramural leiomyoma after about twenty electrolytic treatments, the current varying fron one hundred to two hundred and forty-two milliamperes. The cure in this case may, however, have been due to the menopause, which was coincident with the treatment. The observations of Vineberg upon the statistics of Keith, Engelmann, Gautier and others eminent electro-therapeutists, show three hundred and seventytwo cases with nine cures and five deaths-an excessive mortality when contrasted with the limited number of cures. Galvano-puncture and electrolysis in fibro-cysts are strongly condemned. The earlier promises of the enthusiastic supporters of electrolysis have not been fulfilled. Its immediate dangers also are considerable. The survival of the electrical method depends chiefly upon the patient's ignorance of its inadequacy and dangers, upon her worship of the mysterious, upon an unreasoning dread of operative measures, and upon a desire to grasp any other promising means of relief.— (E. C. Dudley's work on Gynecology.)

Apartment Disinfection.-Formaldehyde has rapidly gained in favor as a disinfectant in recent years and is now very largely employed by health authorities everywhere. The advantages of the gas are so important that the agent is without a legitimate rival in the field of aerial antiseptics. the several sources of the gas the commercial solution has proven in every particular the best suited. It is easily handled and economic and does not require a great ponderous apparatus. The Sanitary Formaldehyde Regener

ator which is in large demand in the United Stated and Canada, utilizes the commerical solution exclusively. It is portable, non-exclusive, and easily operated. With one machine an operator can disinfect 12 to 20 rooms a day according to their size and distance one from the other. The apparatus was recently very much improved and is now sold under a written guarantee. H. K. Mulford Company, Philadelphia, have recently issued a new brochure on the subject of disinfection, which gives details of work done with this apparatus. The brochure will be supplied upon request.

The Specialty of Pediatrics.-That pediatrics is fully established as a special department of medicine cannot be doubted. There are now very few in America who deny it such a place. Any diversity of opinion on the subject arises from lack of agreement regarding the meaning of the word specialty. No one believes that pediatrics is a specialty like ophthalmology, which should be practiced only by a limited body of men. It is, however, none the less a special department, demanding special study and a certain number of special workers. Such a body of special workers has been developed during the last two or three decades. Many of these men now limit their practice strictly to pediatrics, their work being largely consultations and the supervision of delicate children. Others do general practice, but have become especially expert in the diseases of children from a clinical standpoint, while others, still, by study in laboratories and autopsy rooms, devote themselves to the more purely scientific side of the question. All these are specialists in the true sense of the term. We have before taken occasion to point out the peculiarity of pediatrics, in that it is practiced by two different classes of men-the general practitioner and the strict specialist. There are, in fact, close specialties in which the practitioner confines himself strictly to his department, and there are broad specialties in which the practitioner becomes an expert, but does not limit himself entirely to one class of disease. Of the latter class, pediatrics is an example. It is an offshoot of the department of general medicine and must always continue to be closely allied to it. Man, the highest animal of creation, starts in life the most imperfectly developed and the most helpless of all. The formative and developmental period, therefore, is in many regards the most important one of his life. Hence, the proper management of infant man in health and the treatment of the many diseases peculiar to this period of growth and development form a specialty of very great importance. The truth of this statement is not modified by the fact that the majority of sick children are treated by the general physician.-Archives of Pediatrics, December 1898.

La Grippe. In connection with the consideration of the present epidemic of la grippe the following therapeutic suggestions are seasonable. Maltine with Cod Liver Oil has, in previous epidemics, proved to be a preventive against serious complications growing out of the grip. Malto-Yerbine (Maltine with Yerba Santa) has proved more efficient than any other remedial agent in allaying the otherwise intractable cough which so frequently accompanies an attack of the "grip." Maltine with Phosphate Iron, Quinia and Strychnia has, in previous epidemics, served the medical profession as a tonic of great power in restoring to a normal condition those who have been enfeebled by the disease.

COLLEGE AND SOCIETY NOTES

The Grand River Medical Society held an interesting annual session at Chillicothe, Mo. The officers elected are: Dr. F. W. Burke, Laclede, President; Drs. H. P. Baker, Salisbury, and L. E. Tracy, Chillicothe, Vice-Presidents: Dr. G. M. Lantz, Brookfield, Secretary; Dr. W. A. Henderson, Chillicothe, assistant Secretary; Dr. R. Barney, Sr., Chillicothe, Treasurer; Dr. B. N. Stevens, Chillicothe, Curator.

The Western Surgical and Gynecological Association held an interesting meeting in Omaha, December 28 and 29, under the presidency of Dr. D. S. Fairchild. The local profession tendered the society a banquet at the Paxton, which was a most enjoyable event. The new officers elected are as follows: President, H. C. Crowell, Kansas City; First Vice-President, O. B. Campbell, St. Joseph; Second Vice-President, T. H. Hawkins, Denver; Secretary-Treasurer, George A. Simmons, Lincoln; Executive Board, L. E. Schooler, L. A. Stoddard, O. B. Campbell and Joseph Eastman; Committee on Arrangements, D. W. Smouse, J. W. Cokenower and C. E. Stener. Next meeting in Des Moines, la.

Kentucky University.--The Annual Session of the Medical Department of Kentucky University began on January 2d, 1899, under unusually favorable auspices. On December 31st, the following gentlemen, formerly professors in the Kentucky School of Medicine, were elected full professors in Kentucky University of their respective departments: Prof. J. B. Marvin, B. S., M. D., LL. D., Professor of Principles and Practice of Medicine and Clinical Medicine. Prof. J. M. Holloway, A. M., M. D., Professor of Surgery and Clinical Surgery. Prof. C. W. Kelly, C. M., M. D., Professor of Anatomy. Prof. C. E. Woody, A. M., M. D., Professor of Chemistry and Diseases of Children. Kentucky University on January 1st celebrated the 100th Anniversary of its foundation, it being originally Transylvania University.

The Southern Surgical and Gynecological Association held its annual meeting in Memphis, Tenn., December 6, 7, under the presidency of Dr. Richard Douglass, of Nashville. Officers elected for the ensuing_year were Dr. Joseph Taber Johnson, of Washington, President; Dr. F. M. Parham, of New Orleans, and Dr. W. L. Robinson, of Danville, Va., VicePresidents; Dr. A. M. Cartlege, of Louisville, Treasurer, and Dr. W. E. B. Davis, Secretary. One vacancy only on the council occurs each year, and the term of office is five years. This time Dr. L. McL. Tiffany's term expired, and he was re-elected. His home is in Baltimore. The other members of the council are Dr. L. S. McMurtry, of Louisville; Dr. George J. Englemann, of Boston, and Dr. G. M. Johnson, of New Orleans. Dr. Ernest S. Lewis, of New Orleans, was made chairman of the committee on arrangements for the next annual meeting.

Special Notice. A copy of this issue of the FORTNIGHTLY is mailed to every regular physician in California, Colorado, Oregon and Nevada (in addition to our regular circulation) for a special purpose. We announce this fact so that advertisers may know where to place the credit for inquiries received from these far Western States at this time.