(c) Give doses of four most efficient hydragog purgatives. (d) Define mydriatics and myotics, and give example of each acting locally. PRACTICE. E. T. BRADZ, M. D., REGULAR E. C. WILLIAMS, M. D., HOMEOPATH. Answer first and second questions and any four of the others. 1. Give common names, incubation periods, periods of eruption, progress and duration of (a) rubeola, (b) rotheln, (c) variola, (d) varicella, (e) scarlatina. 2. Give treatment (including diet) for constipation and diarrheas in children. 3. Define hemoptysis, hematemesis and epistaxis, and how would you distinguish between them? 4. Give causes and diagnosis of catarrhal pneumonia. 5. Define erysipelas. Give cause, and differentiate it from erythema and urticaria. 6. Give treatment for gout, diabetes and chorea, outlining diet for the two for mer. 7. Define the following terms: cachexia, edema, ascites, anascara, and define and give treatment for singultus. CHEMISTRY. SAMUEL LILE, M. D., EXAMINER. 1.-(a) Give physical properties and chemical relations of oxygen. (b) What is ozone? Give chemical formula? (c) What effect has inhalations of ozone on animals? (d) How many compounds of oxygen and hydrogen are there? Name them, and give chemical formulæ. (e) State their uses. 2.-(a) Give chemical formulæ of chloroform, iodoform and bromoform. (b) Mention chief uses of each. (c) What are amines ? 3.-(a) What are hydro-carbons? (b) What are carbo-hydrates? (c) Mention two examples of each. (d) How does CO, effect animal and vegetable life? 4.-(a) Give common name and chemical formulæ of methyl and ethyl alcohol. (b) Give chemical antidotes for arsenic, iodin and nitrate of silver. 5.-(a) Define electrolysis. (b) Give composition of atmospheric air, and state changes in, after respiration. 6. (a) What is hydrochloric acid? Give synonym and chemical formula. (b) What is nitro-hydrochloric acid? Give proportions and synonym. OBSTETRICS. 1. Name (a) the most important diameter of the female pelvis, giving the average measurements of them all. (b) What are the commoner forms of pelvic deformities? 2. What is pelvimetry? its object, and describe a manual method of measuring the diagonal conjugate. 3. Treatment of inevitable abortion. 4. Signs and varieties of (a) uterine inertia. (b) Obstructed labor. 5. Management of labor in face presentations. GYNECOLOGY. 1. Causes of (a) suppression of the menses, (b) menorrhagia, (c) metrorrhagia. 2. Define endometritis, giving its etiology, its varieties, and treatment. 3. Give the pathology of (a) pachy salpingitis. (b) The pathological results of lacerations of the perineum. 4. Name the various operative procedures for the relief of retro-positions of the uterus, giving reasons for a preference, under varying conditions. 5. Give the causes of cystocele and retocele, with a brief description of operation for the cure of each.-From the Bi-monthly Bulletin of the Univ. Col. of Med., Richmond, Va. QUESTIONS WITH ANSWERS IN PHYSIOLOGY AND HYGIENE-University of New York. 1. What is the function of connective tissue? Answer: It serves to bind together, support and move the glandular and living elements of the body. 2. Describe the fetal circulation. Answer: From the placenta the blood passes by the umbilical vein to the fetal liver. It traverses this organ mingled with the blood from the portal vein and enters the vena cava inferior; a small portion flows directly from the umbilical vein to the cava by the ductus venosus. From the inferior cava, joined by blood from the lower extremities and abdominal viscera, the blood passes thru the right auricle into the left auricle by the foramen ovale, thence to the left ventricle and by the aorta to the head. Returning by the su perior cava into the right auricle it falls over the eustachian valve into the right ventricle. From here this blood is directed partly into the lungs, but chiefly by the ductus arteriosus, into the descending aorta to supply the lower half of the body, and in large measure to enter the umbilical arteries, and so to the placenta to be renewed with food and oxygen. 3. Give the composition and the function of pancreatic juice. Answer: Pancreatic juice contains water and 2 to 5 per cent. of solid, viz: albumin, a proteid like myosin, fats, soaps and salts, especially sodium carbonate. By its ferment amylopsin, it converts starch into sugar; by its trypsin it changes proteids into peptone and its steapsin saponifies fat. Rennet is said also to be present. 4. Describe the flow of lymph. Answer: The lymph gathers in the minute intercellular spaces in the tissues, and moves gradually from these into the radicles of the lymphatic vessels. Passing along the lymph vessels the flow is from time to time interrupted by a lymph gland. The lymph enters the gland by the afferent vessel, and after elaboration in the lymphgland tissue, leaves by the efferent vessel. The lymph vessels enforce each other towards the upper part of the body, and discharge by two main trunks into the left and right subclavian veins. 5. Define heart sounds. Answer: The sounds heard over the cardiac region during the different phases of the heart's action. 6. Differentiate voluntary and involuntary muscles. Illustrate. Answer: Voluntary muscles are those under the control of the will. They are chiefly connected with the skeleton. They are composed of striated fibers, bound together in bundles, and each fiber receives its own nerve fiber. Involuntary muscles, not under the control of the will, are non-striated, with the exception of the heart muscle and a few others. The fibers are spindle-shaped, nucleated cells having no surrounding sarcolema. Examples of the former, the deltoid; of the latter, the muscles of the intestinal wall. 7. What is (a) an efferent nerve, (b) an afferent nerve? Illustrate each. Answer: An afferent nerve is one which conveys impulses from the periphery of the body to the nerve center. The superior laryngeal, except a few fibers, to the cricothyroid muscles. An efferent nerve conveys impulses from the center to the periphery. The inferior, laryngeal. 8. Describe the glands and the villi of the intestines. Answer: The solitary glands are small, round, whitish bodies, scattered thruout the mucous membrane of the intestine, most numerous in the ileum and the upper part of the large intestine. Their structure is dense retiform tissue packed with lymph cells and interlaced with capillaries. Their free surface is almost covered with villi. The Peyer's glands are aggregations of these solitary glands in circular or oval patches, from half an inch to four inches long. They are most numerous in the ileum, lie lengthwise in the intestine and on the wall opposite the mesenteric attach ment. Brunner's glands are tubular alvioli, lined with epithelium, found only in the duodenum. The simple follicles of Luberkuhn are simple epithelial lined crypts found thruout the intestine. The villi are minute, highly vascular processes on the membrane of the small intestine, varying from forty to ninety to the square line. The structure of each villus is as follows: The surface columnar epithelium is held on a basement membrane which encloses a network of capillaries, which in turn closely entwine a central lacteal which ends in a blind extremity. In this enclosed network of vessels there are also many lymph cells, larger flattened cells, and unstript muscular cells. 9. Explain the action of the ano-spinal center in defecation. Answer: When the feces in the rectum press upon the sphincter ani, the lumbar sphincter center is inhibited, either by a voluntary act from the brain or by a purely reflex action, and the sphincter is thus relaxt and defecation is accomplisht by muscular effort. 10. Give the mechanism of respiration. Define tidal air, complemental air, reserve air. residual air. Answer: The lungs lie in an air-tight chest with movable walls. When, by muscular contraction the size of the chest is increast, the surface of the lungs must remain in contact with that of the chest. and air thus passively enters the lungs to occupy the increasing space. Tidal air is that which is forced in and out of the lungs in normal, quiet breathing. Complemental air is the amount of air which a forced inspiration can carry into the lungs beyond the ordinary tidal air. Reserve air is the amount of air which a forced expira ion is able to expel after a forced inspiration. Residual air is that which remains in the lungs after reserve air is expelled. 11. What hygienic and sanitary measures should the attending physician take in a case of typhoid fever? The Answer: It is well to keep the patient isolated and, if possible, in a room with little furniture and no carpet, tapestries, etc. The room must be well aired. patient and the bedclothes, etc., should be handled only by the attendant, and the clothes, towels, dishes, etc., must be used only for the one patient during the illness, and carefully sterilized after using; the dishes boiled, the clothes soaked in bichlorid and then boiled. The urine and feces of the patient are to be received into some disinfecting mixture and handled with great care. The nurses and physician must be very careful about the cleanliness of their own hands after touching the patient. 12. What occupations are a menace to public health? Why? Answer: Almost any occupation may be a menace to public health unless conducted with proper regard to locality, number of employes in a given space, ventilation, and other hygienic matters. For example, sweat shops, factories burning soft coal in large towns, improperly ventilated and lighted mills. This menace may be direct, i. e., to the employes' health in such numbers that a large proportion of the public are endangered; or indirectly, by disease germs scattered far and wide in goods manufactured by diseased operatives. 13. Discuss micro-organisms as a cause of disease. Answer: Micro-organisms are believed to cause disease by setting up an inflammation, or by setting free a poison in the body, or both, after having entered the body in one of the various possible ways, e. g., the air inspired, the water or food ingested thru the skin, etc. There are specific and non-specific germs, the specific being those which under proper conditions always produce their particular form of disease and no other; the non-specific produce various forms of inflammation, according to their conditions and the resistances they meet. The discovery of these micro-organisms as the cause of disease makes it possible to study more scientifically the treatment of disease by removing the cause, and to avoid it by prophylactic measures. 14. How does sewage become dangerous to health? Answer: By carrying disease germs, and also by simple putrefaction, and thus contaminating sources of water supply for drinking, wells, reservoirs, etc.; also by contaminating regions where food is prepared, e. g., oyster beds. Improper drainage, too, may contaminate the air by its foul or inert gases taking the place of pure oxygen, and possibly at times by actually carrying disease germs in the air. 15. Give the requisites of a good site for a quarantine hospital. Answer: Isolation, good drainage, and not drainage into another region, pure air, easy access from populous districts for the sake of proper attendants, medicines, food, etc. Nocturnal Enuresis in Children. One's experience in the practice of medicine must be very brief indeed not to have come across numerous cases of this annoying trouble of childhood. These cases, too, are often intractable from a medical standpoint, in spite of the most assiduous and careful painstaking effort to remedy the matter by means of drugs. Dr. Robert T. Morris, of New York, writes emphasizing a point which may be very easily overlookt, and which may prove to be very frequently the cause of the entire trouble. He finds that preputial adhesions, particularly in girls, are much more frequent than is commonly supposed; and are so easily remedied that to free them it ought to be the first instead of the last resort of the medical practitioner. It is successful where, quoting Dr. Morris, "Treatment faithfully with belladonna, moral suasion, the back of a hair brush and even Christian science fail."--Med. Mirror. Insignificant Wounds and Their Dangers. In the present state of knowledge concerning sepsis, its cause and treatment, it is of interest to note the possible dangers from the home treatment of small and apparently insignificant wounds of the hands, feet, etc. A German physician of note has been keeping track of a number of cases where more or less serious results follow injuries apparently slight, which were at first treated by the patient without recourse to the aid of a physician. At the time of his report he had observed 70 cases. In 13 injuries of the thumb, permanent disability resulted in three-fifths of the cases, and the average loss of time during vision. melan the treatment was 33 weeks. Complete and some sulted in complete recovery in a week or No doubt every general practitioner can recall, in his experience, cases in this line where the application of a home-made septic poultice and a generous slopping on of iodin constituted the treatment, and, when Nature refused to recover from both the injury and the treatment, the doctor who was called in to repair the results of ignorance was called incompetent and other uncomplimentary things if he did not succeed in establishing a cure at once. Cannot it be possible to educate the laity to a correct understanding of the advantages of early recourse to medical art, and to a thoro appreciation of the fact that doctors do not seek to increase their business and pile up cost against their patients in advocating this, since they are really working against their financial interest in promoting all measures tending to the quick and permanent cure of disease? Dr. Jacobi says: "I am so convinced of the good effect of a spare diet in old people that I have often insisted that the change be made." Headaches of nasal origin generally occur on first awakening. Headaches from eye strain come on after using the eyes later in the day. Painting the nipples several times a day with the white of an egg is stated to be a most successful treatment for the sore nipples of nursing women. Pagenstecher says that iodid of potassium ointment used about the eye will frequently arrest the formation of cataract Not a single death occurred from chloroform in the American army during the recent Spanish-American war, altho it was used almost exclusively. General nervousness, insomnia, tinnitus aurium, vertigo, spinal irritation and even melancholia with suicidal impulses may be due to the uric acid diathesis. Massage of the region of the stomach and duodenum will, it is said, often cure, in from three to six seances, obstinate cases of the vomiting of pregnancy. Dr. C. S. Middleton says that eryngium aquaticum in five to 20 drop doses of the tincture every four to eight hours, has cured many cases of gonorrhea for him. Salivation, dyspepsia, constipation, headache, disordered vision, irritability, deficient excretion of urine, anemia, in the pregnant woman should make you suspect toxemia. Do not jump at the conclusion that a patient suffering from malaria has nephritis because of albumen in the urine, since some albuminuria exists in about half the cases of malarial fever. Dr. W. F. Ball, of Mantua Station, Ohio. writes: "To cure zymotic poison, snake bite or any poison in system, give an adult dram doses of Lloyd's specifie tincture of scinatia angusta; it acts like a charm."-Med. Summary. Castration of the Idiots. Inasmuch as the State has to provide for the vast majority of imbeciles, why should its officers not be given power to prevent the multiplication of this class? This matter is by no means as novel as it may first seem, as is evidenced by the fact that a prominent surgeon in one of our large cities has several times been consulted with regard to this matter and has performed castration at the request of intelligent but unfortunate parents upon their imbecile children. Whilst there is an occasional imbecile child born of intel ligent parents, the vast majority illustrate the law, "like begets like." Not only would castration prevent procreation by these unfortunates; it would also do away with masturbation and venereal disease among them, conditions horrible for the patient and loathsome and disgusting for attendants. Nature weeds out a consider able proportion from these classes by the sunt prelas, To His Delinquent Patient. If I should die to-night And you should come to my cold corpse and say, And you should come in deepest grief and woe, If I should die to-night And you should come beside my corpse to kneel, And you should come to me, and there and then Mr. Smith (bent into the shape of an interrogation point with hepatic colic)— "Oh Doctor, dear Doctor-gee whizz! ouch! great Scott! My guts are tied up in a double bow knot! I'll give you all I've got in this world with delight, If you'll help-O-00-00-help me out of this plight!" And the doctor soon eased him, and solved every doubt, And tenderly watcht him, till " up and about." The doctor (one year later)— "Mr. Smith, I am very hard up, would you care To pay me a little, if you have it to spare ? " Smith (in an injured tone)— "Pay you? Ah yes, I remember it now, But I'm sure I'd got well just the same anyhow; You must wait till I ve paid much importanter debts, Such as club dues, and pew rent, and lost 'lection bets." -Dr. W. C. Cooper in Eclec. Med. Gleaner. Simple Test for Drinking Water. Sanitarians attach special importance to Heisch's test for sewage contamination or the presence of putrescible organic matter in water. The test is so simple that anyone can use it. Fill a clean pint bottle three-fourths full of the water to be tested, and dissolve in the water a teaspoonful of the purest sugar-loaf or granulated sugars will answer-cork the bottle and place it in a warm place for two days. If in twentyfour to forty-eight hours the water becomes cloudy or muddy, it is unfit for domestic 353 apparently purest spring or well water may hold a dangerous amount of organic matter in solution. Infantile Constipation. Dr. W. M. Beach, of Pittsburg, has contributed to a recent number of the Pennsylvania Medical Journal a very interesting article on infantile constipation and summarizes as follows: 1. Infantile constipation is a common affection during dentition. 2. The causes of infantile constipation. are (a) mechanical, (b) neurotic, (c) chemical. 3. Acholia is the most frequent casual factor. 4. In acholic states, certain toxins develop. 5. The bile prevents their formations. 6. Local sequelæ are prolapse and fissure of anus, hernia,, colitis, etc. 7. The constitutional disturbances following are chronic constipation in adult life, auto-intoxication resulting in rheumatism and certain cutaneous diseases, convulsions, neurasthenia and cerebral anemias. 8. The treatment should be directed to the cause, and most cases are curable. 9. Massage and diet are of first importance. 10. Cholagogues and water, aided by systematic enemata, are of inestimable value and are curative.—Med. Mirror. Therapeutic Points. Murrell, of the Westminster Hospital, always seeks to impress upon his students the importance of the following points in caring for the ailing: 1. The value of small doses of tincture of aconite frequently repeated in the treatment of amygdalitis and in the initial stage of febrile diseases. 2. The value of painting the chest and back with liquor iodi fortis-diluted if necessary with an equal volume of the tincture-in all cases attended with cough. 3. The value of a pill of exsiccated ferrous sulfate in conjunction with the administration of purgatives in the treatment of anemia. 4. The value of grain doses of gray powder with an equal quantity of Dover's powder from three to six times a day in the treat nent of syphilis. 5. The value of large doses of the iodids in the treatment of tertiary syphilis. 6. The value of large doses of potassium |