canal. In several, have treated abscesses and suppurating glands. Two have had diphtheria. I am sure that a knowledge of a remote syphilitic history, possessed by the father which has made no manifestations for twenty years, except these disturbances in his children, has enabled me to treat them more successfully than I otherwise could have done.

We may theorize as we please as to the cause of scrofula, but the treatment and the cure of the condition is that which is of most vital importance to us as well as to our patients.

It should be our aim to so alter the constitution of our patient as to restore all the tissues to normal modes of action. This can, I believe, be best accomplished by scrupulous regard for food of the most nourishing kind, the purest air and a constant activity of the secretions, and, last but not least, an almost superabundance of good, restful sleep.

As remedial agents iron in one form or another and iodine are, I think, the ideal remedies.

The syrup of the iodine of iron has long been popular.

After over seventeen years of observation of these cares, comparing the results obtained by the use of the above and the various hypophosphites, I have arrived at the conclusion that Gardner's Syrup of Hydriodic acid is theoretically and practically the best remedy within our reach.

I heartily accept and emphasize the tributes of praise that have already been extended to the Gardner Hydriodic Syrup by Drs. J. B. Oliver of Boston, Burral of New York, Shoemaker of Philadelphia, Wile of Connecticut, and other eminent authorities:

"One fluid ounce of this syrup contains 6.66 grains of iodine converted into hydriodic acid. Its action will be found more efficient in equivalent doses than iodide of potassium, while it produces none of the unpleasant effects of the latter, such as loss of appetite, sore

ness in the fauces, nausea, etc. Physicians who use iodide of potassium largely will appreciate this, because it is more active than iodide of potassium, and should be given in smaller relative doses, thus not interfering with digestion.

Its effect upon mucous surfaces is more marked than with other forms of iodine, while it is effective in smaller relative proportions, and when required, it is so free from irritant action that it may be given to the youngest infant."

Children whose sense of taste has been developed take to it readily, and this is a matter of no small import. Enlarged glands which have been a blemish and discomfort for years to their possessor will melt away rapidly under the use of natures divine quintette, viz.: sunshine, fresh air, abundant sleep, good food, muscular activity, aided and abetted by proper stimulation of the secretary, glandular system, which can be best accomplished by the remedy to which I have referred, viz.: Gardner's Syrup Hydriodic Acid.

TH

HIS drug, which was brought to my notice about a year ago as an my antipyretic and analgesic, has, with me, come to stay.

I had employed it primarily simply as an antipyretic, but recently while using it in a case of typhoid fever to reduce temperature its analgesic properties were also made manifest, and whenever used its action in my hands has always been sure, and no unpleasant after effects have been noticed.

Like all antipyretics, when given in a single dose of eight grains, the abstraction of body heat will be followed by a feeling of chilliness, but this soon passes off with no ill results. Given to chil dren, in doses corresponding to their age, the same happy effects are obtained;

and now, whenever I have occasion to use an antipyretic, from whatever cause, except malarial poisoning, my first choice is phenacetine.

The depressing effects produced by antipyrin have led me to be cautious in administering that drug; and, as to antifebrin, the only time I used itin a case of typhoid fever the patient asked me in the morning "why I left her to freeze to death all night?"

The quantity of antifebrin which I gave was five grains. I at once changed to phenacetine in this case, and no complaint was made, although some chilliness was experienced after a full dose of eight grains.

In typhoid fever I sometimes employ the method of giving a single dose of eight grains where the temperature reaches 103° F. or above; and sometimes employ the method of giving divided doses of two grains at intervals of three or even two hours, and continuing this dose throughout the disease, until the temperature remains below 103° F., and I have found in two cases in which I have thus employed it, (the one an adult and the other a child four years old), that I could keep the temperature around the 100° F. point, and in both these cases the severity of the symptoms were greatly ameliorated. I will state that in these cases I also employed throughout the course of this disease, salol, in 2 grain doses, giving it four times during the twenty-four hours, or as near 6-12 6-12 o'clock as possible, and this may, and probably did, have no small influence in keeping the temperature within bounds.

In one case of typhoid fever, which commenced with severe head symptoms, an intolerable headache, which remedies such as the bromides, antipyrin, cold to the head, etc., would not lessen, as soon as the phenacetine was administered regularly, two grains every two hours, the headache disappeared and did not return, except once, and this time I attributed it to error in digestion and

inactivity of the intestinal tract, which was readily overcome by attention to these parts.

In another case of typhoid fever, that of a young girl of 15 years, the continuous method of administration was not so effective in keeping down her temperature, but six grains would reduce it every time, and this case, in which also salol was used throughout, the disease ran a comparatively mild course, and terminated favorably, i. e., ended in recovery.

In another case of typhoid fever in a child four years old, one-third of a grain of phenacetine, given every three hours, controlled the temperature admirably, and the child was free from fever in two weeks. You may say this was not typhoid fever.

It was a fever which continued for two weeks and similar in character to that type of typhoid which has been so prevalent in this vicinity the past fall. It was not a true typhoid but was a continued fever, with high temperature, reaching 104° F. and above, and which responded to the antipyretic employed, which is the main point under discussion.

To a child five years old, who was sick with tonsillitis, with high temperature, I gave phenacetine in doses of two grains, which would recover the pyrexia, and this with no depressing symptom whatever.

A word as to the administration of phenacetine. It is a crystalline substance, insoluble in water, and is best adadministered by having it pulverized and given dry on the tongue, mixed with a little sugar; then giving a little water, it is easily swallowed. A very convenient way of administering it is in the pill form, manufactured by W. H. Schieffelin & Co., of New York. These pills contain two, four and five grains each; and for adults or children, who can swallow a pill, it makes a very convenient method of administration. It was these two grain pills which I

used in the cases mentioned above when giving it in the two grain doses.

I have given you my experience in the use of this drug because I have found it to be so reliable in reducing high temperature in both adult and child. It is easily taken, as it is tasteless, and the dose is small; and given circumspectly I have heard of no ill effects following its administration. One point I would emphasize, if the powder form be used, i. e., to write on the prescription to have the druggist pulverize it, which renders it more easily swallowed. This is also a good point to remember in giving sulphonal, which is also crystalline.

In three such cases I have given sulphonal in doses of fifteen grains, repeated if necessary say once in four to six

hours. In each case the medicine has stopped the spasmodic twitches completely, giving the patient a wonderful relief. If further experience confirms this result sulphonal will be a great boon to surgeons and to their patients.

There are other varieties of reflex spasm which may perhaps be relieved by the same remedy. For instance, in hip disease the inflamed head of the femur provokes frequent nocturnal spasms of the adjacent muscles, causing the patient to awake with a scream.

Extension apparatus generally controls this, but in many instances an adjuvant is needed for a time, and sulphonal may prove to be as effective for this purpose as it is in fractures.

It is probable that numerous other varieties of reflex spasm may be equally benefited by the remedy, so that investigations ought to be made in this direction.

MICROSCOPY.

BY W. J. BURGE, OF PAWTUXET, R. I.

Infusaria everywhere,

Bacilli in thine eye;

Lay aside, Oh man, thy load of care! Lay it aside-and die!

How many Microbes in a tear?
How many in a sigh?

We were never put here to live, I fear,
But only to die, to die!

CREDIT TO THE DRUGGIST.

BY DR. G. II. PEIRCE, OF DANBURY, CONN.

HEN a druggist can wrestle with

WHEN
W prescriptions like the following, and

neither himself nor the patient get downed, we think he deserves a credit mark. The following prescription was handed me the other day by one of our drug clerks, who had kept it, not on "file," but for curiosity's sake:

DANBURY, CONN.

Mr R-Please send me 15c of grose

of sulperment and 10e purselen pouder and please make the mint as strong as you can as I want to put it in the walls. Mrs. M.

Now this, in corrected vernacular, should read:

Mr. R.- Please send me 15 cents worth of corrosive sublimate, and 10 cents worth of Persian insect powder, etc., (the "mint," of course, being eliminated.)

We thought this worthy of going on record.

THE DANBURY MEDICAL PRINTING COMP'Y, No. 7 Delay Street.

DANBURY, CONN., DECEMBER 15, 1889.

EDITORIAL.

THREE NEW REMEDIES AND THEIR VALUE.

T WILL be noted that we have de. voted considerable of the space of this number of the MONTHLY to the history and uses of sulphonal, phenacetine and salol.

For months past communications have been received by the editor from different sources, alluding to one or the other of these drugs, and the idea struck us that it would be well to group them, in order that the reader might judge for himself of their value. The preponderance of the testimony seems to be in their favor and we believe that they have come to stay and will prove valuable aids to the practitioner. It will be noted that some unfavorable comments have been made and results noted, but as a whole the reports are favorable. We have added some abstracts and notes clipped from other medical journals, which we thought

A WORD TO THE PROFESSION.

HE TIME is fast approaching for

THE

the members of the profession to make out their lists of medical journals to which they intend to subscribe for the year 1890, and as this edition of the MONTHLY will reach a considerable number of the doctors of America who probably have not seen it before, we crave for it a careful perusal. The aim of the MONTHLY has always been high and it is the desire of both the publishers and editor not to let it get below the high standard which has been set.

Its corps of associate editors is composed of the foremost men in the land, who take an active interest in their work. Try a subscription for a year. It will pay and will make you a permanent member of our great big and constantly increasing family. With a little interest on the part of our patrons, the old subscribers, we can make the subscription list of the MONTHLY for 1890 the largest of any journal of a medical character in the whole United States. It is nearly so now. Read the special clubbing rates made in our advertising pages with that sterling paper, The Cosmopolitan, of New York. This is surely an attractive offer. In the meanwhile we wish all

many pleasant returns of this joyous season, a Merry Christmas and a Happy New Year.

PHENACETINE.

Tin 1987 by Dr. Kobler and others, THIS NEW antipyretic was first used

and its use is now sanctioned by a very large number of the leading practitioners of the day. In two short years it has attained a popularity which is phenomenal in a new therapeutic agent, a condition which is chiefly due to the fact that it possesses marked advantages over all other remedies of its class. Dr. Dujardin Beaumetz, of Paris, says:

"The para-acet-phenetidin occurs as a white crystalline powder, liquefying at 135° C'= 275° F, barely soluble in water, very slightly soluble in chloroform, insoluble in glycerine, acidulated water, hydro-chlorate of ammonia, oils and liquid vaseline.

Physiological Action. To a rabbit weighing 2 kilogrammes we have succeeded in administering 37 grains without producing any toxic effect. MM. Misrachi and Rifat also gave to a fowl weighing 1.15 kilogramme eighteen grains of phenacetine without inducing any sign of poisoning. They have even given to animals thirty grains of the drug per kilogramme of their weight without untoward effect. It thus be said that, if phenacetine is toxic in character, it must be so to but a very slight degree.

Therapeutic Action. Like all the analgesic antithermics, the phenacetines have a double action: they lower temperature and soothe pain. The lowering of the temperature is most noticeable in cases of pyrexia; in fevers, 7 grains of phenacetine lower the temperature by 1° to 2° C. (1.8° to 3.6° F.) and the antithermic action following such a dose lasts four hours. In certain cases, however, the apyrexial period is prolonged even from the same dose; it

may even reach eight to ten hours, as indicated by Kobler and Hoppe. Misrachi and Rifat suggest that a dose of 7 grains be administered every four hours, to maintain the condition of

there cuts had never given rise to the pyrexia in those suffering from fever;

even continued for a considerable time,

slightest accident in fever patients. As with all the antithermics of that class, there is invariably observed abundant sweating, and often a sensation of collapse. Phenacetine, then, in febrile conditions, shows itself superior to antipyrin and acetanilid in producing marked antithermic effects without toxic phenomena. But I would, nevertheless, say that in fevers the dose of 1.0 Gm. (15 grains) should never be exceeded.

But it is above all as an analgesic that phenacetine outrivals its predecessors. While it is quite as powerful as antipyrin and acetanilid, it does not cause the pain in the stomach, or the scarlatinaform rash of the former; nor does it give rise to the cyanosis of the latter. However prolonged may be its administration-and we have given it for months in doses of 1.0 to 2.0 Gm. (15 to 30 grains) per day- we have never observed any bad effect. We have used it for the relief of every form of pain (neuralgia, migraine, rheumatic pains, muscular rheumatism, acute articular rheumatism, the lightning pains of tabes, etc.) and always with the best results. Further, in cases of hysteria, and of hysterical or neurotic pains, phenacetine has seemed to produce better effects than the bromides; it calms the excitability of the nervous system, and in some obstinate. cases of nervous insomnia it procured sleep. Phenacetine seems therefore to be not only an analgesic, but a narcotic.

This double action, as an antithermic and an analgesic, results probably from an effect produced on the spinal cord; and phenacetin may he considered a depressor of the excitability of the medulla, but on this point I cannot speak conclusively till the investigations carried