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statement in former attack from eight to ten weeks, and 42 of them were under treatment at the dispensary during this attack from four to ten weeks. He sums up by saying that of the 187 cases of acute gonorrhea, 17 remained under treatment and he believed carried out the treatment faithfully until they were pronounced cured. Of the remainder, 170 cases, 121 were under treatment from four to ten weeks, but he does not seem to be certain of their good deportment. The record of the 17 cases he considers the most important because they were composed of medical and dental students, and married men who were anxious to get well and stayed under treatment until they were pronounced cured, and abstained from all indiscretion, and each case was considered cured when the urine contained no clap shreds with pus and gonococi. The length of time required to cure these 17 cases was as follows: three cases in four weeks, three cases in six weeks, two cases in seven weeks, four cases in eight weeks, and five cases in ten weeks. Three of these had anterior and fourteen general urethritis, and the duration was over six weeks in eleven cases. I have a record of two cases of general urethritis recently treated, one by the hand syringe method at his home, and internal medicine, that lasted twelve weeks, and the other by the irrigation method at my office twice a day combined with internal treatment, that lasted eight weeks, and I believe these cases abstained from all indiscretions.

The diagnosis and cause of gonorrhea does not enter into this paper, as we are all familiar with the fact that it is like the poor, "we have it with us always," it is also a fact, if the statement of the gynecologist be true, that over fifty per cent. of his cases are the result of gonorrhea, that we, as general practitioners, are feeding their tables by not more fully impressing on our patients the gravity of their trouble and the importance of staying under treatment until they are well.

Under treatment which hardly comes under the heading of my paper, I would like to call your attention to the innumerable drugs and plans of treatment so highly extolled in the eulogistic articles of our weekly journals, all claiming to cure gonorrhea in from two to three weeks. Methods claiming to cure in six to eight weeks are not in vogue, and are, therefore, not publisht, but the newspapers are full of the praise of Big G-and similar nos

trums, and what they can do in from two to three weeks. The philosophy of most of these quick cures is based, as a rule, upon the early employment of some strong astringent injection, causing, as pointed out by Taylor, a rapid and early onset of the mucous terminal period of the disease, the chief characteristic of which is a thin watery discharge which might readily pass unnoticed by a careless or unobservant patient.

I have nothing new in treatment to offer to this body. There are four methods employed; 1st, internal medication, alone; 2d, internal treatments combined with a hand injection; 3d, irrigation of the urethra, alone; 4th, irrigation combined with internal treatment. I prefer the fourth mode, irrigation and internal treatment. I irrigate with permanganate of potassium, 1 to 4,000, increasing gradually every two or three days until I reach 1 to 1,000 or 1 to 500 in about two weeks, and I then give a hand syringe with a solution of some mineral astringent, such as sulfat of inc or acetat of lead, two or three grams to the ounce of water. Internally, give first a saline diuretic for eight to en days and then balsam of copaiba and oil of sandalwood, or some remedy of that class until the case is well. I really prefer nitrat of silver, 1 to 6,000, increast to 1 to 1,000, but owing to its staining properties it is diasgreeable to the patient. Also, in my section of the country, the water is full of chlorids, and so few of our druggists use distilled water, that the silver is decomposed in the water and ruined.

In closing I will say, that I have tried to impress three things upon this body by the statistics I have given.

First. That gonorrhea is a more prolonged and serious affection than it is usually considered by the general practitioner and by the laity.

Second. That the period of time for a cure in uncomplicated general gonorrhea is from six to eight weeks.

Third. The importance of making an examination of the urine for clap shreds before deciding that a case of gonorrhea is cured.-H. T. BASS, M. D., Tarboro, N. C., in N. C. Med. Jour.

In seborrhea of the scalp the Medical Age prescribes eight to ten parts of resorcin in ninety each of alcohol and water, to be used as a lotion once daily, after thoro washing of the head with green soap.

Julia's Incubator.

Lyon Médical for March 19th remarks upon the habit among women of using the bosom-the space between the mammary glands-as a repository for various articles, letters, the watch, the purse and the like. Our contemporary goes on to say that Julia, daughter of Augustus Cæsar, being pregnant, was desirous of giving birth to a son. In order to ascertain the sex of her unborn child, she carried an egg in her bosom. The augury was auspicious; a cock was hatcht from the egg, and she bore her husband a son.-New York Medical Journal.

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All pelvic congestions are venous, and the term "chronic inflammation," so far as it applies to the organs in that cavity, is a misnomer, because the arterial vessels are not involved in that process.-Emmet. The most common displacement of the ovary is dislocation downward into the retro-uterine pouch, to which the name of prolapse has been improperly given.-Tait.

Cancer of the womb usually begins on the vaginal portion of the cervix, and consequently has to bear the brunt of the insults of coition and parturition.-Goodell.

Tepid vaginal injections, so generally recommended and inadvertently used by patients in place of hot injections, have no positive therapeutic effect whatever. Barnes.

Marriages Between Cousins.

In an effort to compare one hundred cases of marriage between cousins-german with one hundred hundred average marriages where no relation existed, the author, Dr. John Inglis, says the Medical Record, took by lot from a physician's case-book, who had practised in a town of 1.500 inhabitants for thirty years and knew their family histories well, the names of one hundred families, and had this physician give him the record of these one hundred marriages with regard to sterility, pulmonary, mental and congenital diseases.

These were then compared with the marriages of cousins. The latter showed a lower percentage of sterile marriages and a slightly lower percentage of mental diseases. In pulmonary and congenital diseases there was about the same percentage of difference in favor of the former. In all other particulars the difference amounted to as little as any such comparisons can. In the one hundred cases of those not related, 17 per cent. were sterile; in the cousins-german, 14 per cent. These figures agree very nearly with Huth's investigations.-Med. Standard.

Physical Stock Taking After Forty.

I have for a number of years been impresst with the importance of the individual who has reacht the middle mile post of life calling a halt and taking stock, figuratively speaking, as to his physical equipment, habits of life, work, exercise, diet, etc. The old saw that every man is either a physician or a fool at forty is true, but the trouble with the members of our profession is that at forty most of us are both physicians and fools. Our devotion to others, to our patients and our profession, and our own ambitions, ambitions

in the direction of name and fame rather than wealth, we overlook almost uni

formly our own health. The death rate is not so great among any class of men in cians, and the reason is apparent. The the upper walks of life as among physisaying that a woman is as old as she looks and a man as old as he feels is to a degree true, and yet the statement that everyone is as old as his arteries is universally true. Surely the physician knowing these things should so adjust his personality to his work and his routine of living as to guard himself to the best advantage. We know that all of the organic diseases, Bright's disease, diabetes, atheromatous degenerations in general, are due to the accumulation of earthy materials in the system. to improper diet, improper elimination, which latter is largely brought about by too great nerve tension, overwork, but still in the majority of instances dependent ugen neglect of proper diet. Doctors eat irregularly, hastily, and oftentimes in their desire to tickle their palate they eat to an excess, enormously. The death within the past ten months of six of the leading medical men of America has made a deep impression on me, and I feel that their life and death furnish a text that we should all study. It has been my pleasure to know

them all intimately and well, admiring, appreciating them all and loving them. In the death of these six men, William Pepper, John A. Larrabee, A. M. Owen, John B. Hamilton, George H. Rohë and James H. Etheridge, a great vacancy was left in the ranks of medicine. They were all earnest, honest, constant, unremitting workers; they all gave the least possible thought to the proper selection of diet, the manner and time of eating. I have seen them all neglect their own personal wellbeing along the lines of diet for the benefit of their patients. I have seen them shoveling in food during the time when they were engaged in work and in every way acting like unintelligent beings. Every one of them died forty years, at least, ahead of his time. It is true they did an enormous amount of work, and probably more during the time they did live than many of us who will live twice as long, but they owed it to themselves, to their families, to those who loved them, to give them the benefit of their society for the longest possible time. Every one of these men died suddenly, shocking and grieving the medical world, and every one of them died as the result of atheromatous degeneration, from preventable causesinterrupted metabolism and accumulated earthy materials. Knowing then as we do, about these gouty disturbances, these accumulations of earthy materials that ought to be eliminated and prevented by a proper selection of diet, exercise, habits of life, it behooves us all to study the lesson before us. Nearly every individual drinks too little water. He should form a habit of flushing out his alimentary canal and other excretory organs frequently with large quantities of water during the day and particularly in the early morning. After forty, less meat should be eaten, less food which tends to the accumulation of earthy materials within the body, less nitrogenous food in general. If meat be eaten, chicken, bird, veal, lamb chops and other immature flesh are best; more vegetables and plenty of fruit should be partaken of. Apples are one of the healthiest fruits that can be given, and if the individual will eat every day in the year a sufficient number of apples, there will be less demand for cathartics.

Speaking of these gouty disturbances, my friend, Dr. Hunter McGuire, of Richmond, Va., in the discussion of a paper read by Dr. Upshur, is reported in the Charlotte Medical Journal as having said:

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"I ought to be in a position to say something on this subject, for until not long ago I was disabled, and not until very recently I didn't know anything about the pathology. I don't believe to-day we know any better how to explain the action of uric acid salt than we did a hundred years ago. I am indebted to the book the writer referred to, Haig, for most valuable information on the subject that I never understood until I got hold of that book. I think I understand it now. I never began to get well until I followed the suggestions made by this writer. No one ever tried harder to get rid of anything than I did to get rid of this trouble. one ever took physic more greedily than I did, trying to get well, but the suggestions that this man makes, as soon as I adopted them I began to get better, until today, so far as I know, I am free from gout and can do as much work as I ever did. And his suggestion is very simple. Give up all meat, every variety of meat. I haven't touched meat for many, many months. Give up all coffee, tea, cocoa, because they contain uric acid. Drink milk, eat every variety of vegetable and fruit that you can get hold of. Don't hesitate to eat tomatoes; I eat them whenever I can get hold of them. I don't hesitate to eat an orange. I don't hesitate to drink whisky when I want it, but fortunately I don't want it very often. Now, briefly, that is the way I have recovered my health and gotten rid of this gout. I will suggest another thing; that the nervous system has a little more to do with it than we are disposed to admit. Altho I had gout so badly and it lasted so long, attacking my eyes and making me blind for a little while, preventing my reading for weeks and weeks, altho I have had it in both feet at the same time, and my knees were all swollen and deformed, suffering horribly, I haven't got on my fingers or toes a trace of it. I haven't got a trace of uric acid. And my gout usually came when I was run down, when I had too many sick people, when I had what every one of you have had, patients who gave me too much anxiety. Cases incurable have never troubled my mind much after I concluded that nothing could be done, but in cases which could be helpt, and a number of them, sometimes eight, ten or a dozen people who would die if I made a mistake, constant anxiety in those cases gave me gout. I never drank wine or beer or anything of the sort, never cared for them in my life,

have always been a small eater, always glad to be able to take a small drink of whisky, and I congratulate myself that I am able to do it now and it does not hurt me. I don't know about strawberries. I don't believe I earned the gout by high living. If I had I would have too lost it for I lost everything else that I have earned. It must have been inherited. If it was, it was the only thing that I inherited that I held on to. I only speak about it because I have had so much personal experience. We might well look and see how much the nervous system has to do in this trouble. It has something more to do with it, I think, than we are usually disposed to admit."

Concerning the hardening of the arteries, prophylaxis and treatment, Whittaker recently observed:

"The prophylaxis depends upon the ability to adjust the work to the changes which have already taken place, and to live a life of perfect hygiene. The man of fifty years must learn that he cannot do the work of a man of thirty; that is, as Emerson says, he must take in sail.' Syphilis need not be contracted. Abstention from alcohol is a sine qua non. In avoiding worry the patient may learn to content himself with less wants, remembering the statement of Socrates that he who has the least wants is nearest to the gods. In all things temperance; and this remark applies especially to diet. Arteriosclerotic changes are less frequent in the herbivora. The individual should, therefore, take less animal food, and indeed less food of all kinds. He should especially distrust the heavy evening meal. The best food is milk. An exclusive milk diet, from two to four quarts per day, will put a stop to the changes of arterio-sclerosis in the kidney. Tho strain of hard work must be lessened. On the other hand, the individual should not lead a too sedentary life for fear of increasing abdominal plethora. Coffee produces abdominal plethora. The quantity of it should be lessened, at least. The weight of the whole body must be kept down."

In conclusion, it is well to remember, as one grows older, that he may on general principles safely eat less and defecate more. Put the teeth in the best shape for thoro mastication and eat more fruit and less flesh; exercise liberally, for laziness and indisposition to walk grow upon one as time advances. Exercise certainly favors elasticity of joints, muscles and

arteries. Cultivate a tranquil mind to the fullest extent, not permitting the mental tranquillity to merge into intellectual laziness. Let us more and more determine to be amiable and to love our fellow-man, forgiving or ignoring our enemies. Let us remember more and more as we approach our second childhood, which we all hope to do, that meat is for strong men and milk for babes. Let us trade off some of our horses, walk more and buy cows in their place. Pursuing the proper rules of diet, mental quiet and proper attention to elimination, exercise both physical and mental, let us determine to keep in the harness and do the best work of our lives, tho we may do less of it, and we should all live to be close to one hundred and possibly even cross over the century line.-DR. I. N. LOVE, in Medical Mirror.

List of Questions Submitted by the Pennsylvania Examining Board in December, 1898.

ANATOMY.

1. Outline a healthy liver in the erect posture of the body.

2. Name three ganglia connected with the fifth pair of nerves.

3. Describe the prostate gland, and give its position and blood supply.

4. Give the origin and insertion of the pectoralis major muscle.

5. Give the distribution of the radial nerve below the wrist.

6. Describe the hip-joint.

7. Describe the ureters and give their location and point of entrance into the bladder.

8. Describe the trachea and bronchi, and give their nerve supply,

9. What is the linea alba, and how is it formed?

10. Describe the sphincter ani.

THERAPEUTICS.

1. State the changes in the pulse, and how produced, by the administration of digitalis and veratrum viride.

2. In the treatment of syphilitic node or gumma; state which should be used, a mercurial or an iodid, and give the reason therfor.

3. Give the reasons which would determine the employment of a vegetable or a mineral astringent in acute inflammatory conditions.

4. Differentiate the conditions in which opium and hyoscin should be used to produce sleep.

5. State when calomel, or podophyllum

should be given, and give the reasons for the selection.

PRACTICE.

1. Give the characteristic appearances, and state the time of the eruption in the exanthematous fevers.

2. State the symptoms, dietetic and medicinal treatment of acute ileo-colitis.

3. Enumerate the symptoms of simple spasmodic laryngitis, and give plan of

treatment.

4. Give the symptoms and prognosis of chronic transverse myelitis, (lumbar). 5. Give the symptoms and prophylactic treatment of cholelithiasis.

PHYSIOLOGY.

1. Give the physiology of the secretions of the pancreatic juice, detailing the function of each histologic element concerned.

2. Describe the mechanical and chemical phenomena of respiration, and give its rate at different ages.

3. Describe the circulation of the blood in the infant, just before and just after birth.

4. What is the relation of the capillaries to the circulatory system?

5. Minutely explain the glycogenic function of the liver.

PATHOLOGY.

1. Name each coat involved and detail the changes occuring therein, in the development of sacculated aortic aneurism. 2. Describe inflammation in serous membranes.

3. Describe the post-mortem appearances in endocarditis.

4. What is the essential difference between calcification and ossification?

5. Designate which component part of the spinal cord is involved in locomotor ataxia and describe the metamorphosis of structure characterizing the pathological process.

SURGERY.

1. Describe the symptoms and treatment of acute suppurative osteo-myelitis.

2. Describe the technique for an operation on the brain.

3. Differentiate recto-anal neoplasma from hemorrhoidal tumors and procidentia recti.

4. Give symptoms prognosis, and surgical treatment of intussusception.

5. Give concisely the symptoms, dangers and treatment of a fractured rib.

6. Name the different varieties of wounds and give the general indications for treatment.

7. Describe the preparation and opera

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1. What methods and precautions would you employ in the induction of premature labor?

2. Define, diagnosticate and give treatment of ectopic gestation.

3. In what abnormal conditions of the pregnant woman may embryotomy be employed?

4. What is the "bag of waters" and how is it formed?

5. Define abortion and state three of its possible causes.

6. What are the causes of post-partum hemorrhage?

7. How would you diagnose and deliver an occiput in the hollow of the sacrum?

8. How would you diagnose, and what is the mechanism of labor in the left mento-iliac anterior position.

9. Give the etiology, premonitory symp toms, clinical phenomena and treatment of eclampsia.

10. What is the ordinary course of twin labor, and what are the difficulties likely to occur?

MATERIA MEDICA.

1. Name three drugs incompatible with belladonna and two incompatible with pilocarpin.

2. Give the usual dose of creasote and tell how it is best administered.

3 Name four official pills and give the principal ingredients of each.

4. Define tinctures, extracts and ointments and tell as a rule how many drops of a tincture are in a fluid dram.

5. Write a complete prescription, containing at least three drugs, for acute bronchitis in an adult. Use no abbreviations.

CHEMISTRY.

1. Describe the chemical changes in the blood in its passages thru the lungs.

2. Give a distinguishing test for lactic acid in the gastric juice.

3. Describe boric acid and state its uses. 4. Describe a test for organic matter in water.

5. How would you detect albumin in the urine and how differentiate it from urates and phosphates?

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