Where Medical Students Congregate. According to the latest statistics, Chicago ranks first in order as a medical center, with over 2,500 medical students; Philadelphia second, with upwards of 2,300 students; New York shows a decrease in attendance from 1889 of almost 200, giving her the third place, with 1,900 students; St. Louis ranks fourth, with about 1,400 students, having passt Baltimore, Cincinnati and Louisville; Baltimore has 1,300 students, and occupies the sixth place. -Med. Age.

Alkaline Injections for Sterility. Trouette, a veterinary surgeon of Lyons, France, has been experimenting with alkaline vaginal injections on mares that had been ineffectually covered. He treated 436 of them, using 75 grains of sodium bicarbonate to about a quart of water an hour before copulation, so as to counteract the hyperacidity of the vaginal mucus, which was blamed for the preceding sterility. Two hundred and seventy-seven of them were fecundated, 148 remained sterile and fourteen were lost sight of by him. Old brood-mares that had not been pregnant for many years-one having gone eight years, and having been unsuccessfully covered for three consecutive yearsunder the treatment produced fine foals.Exchange.

Diagnosis of Fractures.

Dr. Thomas H. Manley, Professor of Surgery in the New York School of Clinical Medicine, dwelling upon the importance of accurate diagnosis of fractures, offers (Virginia Medical Semi-Monthly) the following conclusions: (1) Fractures, difficult or impossible of demonstration, those fissured vertically, or those nondisplaced through the cancellous tissue of the articular ends of long bones, occur, without doubt, more frequently than is commonly supposed. (2) In injuries of the limbs attended with unusual or doubtful fracture, nothing can justify the application of violence to demonstrate its presence, as in no event are the principles of therapy altered in them. (3) In this class of cases the patient should be given the benefit of the doubt, until, at least, time elucidates it-caution only being observed that the circulation is unhampered and full muscular relaxation is effected. (4) We should never fail, when possible, to utilize the Roentgen rays as a

diagnostic aid, tho their use in this direction is obviously limited. (5) Exploratory incision should be ruled out, unless the fracture is of such description as to demand or justify a simultaneous osteoplastic operation. Am. Jour. of Surg. and Gyn.

Class-Room Notes.

[From Dunglison's College and Clinical Record.] -The most successful treatment that I have found for Tinea Versicolor, a disease which is so often mistaken for syphilis, is

ää f 3ss

Sodii hyposulfitis, Glycerini Aquæ . . q. s. ad f 3viij M. SIG.-Apply locally night and morning. This application, with a frequent change of underclothing, will usually cure promptly. Sometimes it is better to add lime-water instead of plain water.-Hearn.

In the treatment of Hysteria, nothing helps so much as building up the general health. To accomplish this Prof. Dereum

recommends the rest cure. Place the

patient in bed, give the most nourishing ing. Combine massage and electricity. and easily digested food. Use forced feedSwedish movements and out-door sports are often useful. Send your patients away from home among strangers. Have them read or have an attendant read to them.

-The usual Treatment of Eclampsia in the Jefferson Maternity consists in placing the patient in bed, inducing sleep, giving her on a milk diet, using the compound chloral as the choice of hypnotics, placing colocynth pill for a purge, and giving a hot pack at night. In short, all of the often added a tonic of arsenic and gentian. emunctories are stimulated. To this is

-In Chronic Indigestion with Diarrhea in Children where the lesion is in the region of the ileo-cecal valve, Prof. E. E. Graham outlines the following treatment: Starve twenty-four hours, clean out the offending material with a mild calomel purge given in divided doses of or of a grain every half-hour until one grain has been given. Bathe with whisky; practice intestinal irrigation, using for this purpose a No. 10 or No. 12 catheter, and for the irrigation one gallon of an astringent solution, as a teaspoonful to the gallon of a solution of nitrate of silver (60 gr. per f3j). If this fails, dilute hydrochloric acid and strychnia are tried.

-Percuss the Bladder at each visit in low fevers.-J. C. Wilson.

A Pessary which is producing discomfort or irritation should be removed immediately. A woman should be no more conscious of the presence of the pessary in her vagina than of the false teeth in her mouth or her false hair on her head. A pessary should never be introduced until the uterus has been replaced in its normal position. The physician should no more think of introducing a pessary with the, uterus in a retrodisplaced position than he would of placing a truss on an unreduced hernia or of applying a splint before. adjusting the fragments of bone.-Krusen.

-For Simple Catarrhal Stomatitis in Children, Prof. Graham recommends the following prescription for local treatment: Ꭱ

Sodii boratis Glycerini Aquæ . .

q. s. ad. f 3iij M. SIG.-Use as a mouth-wash. This wash is often best used by grasping a pledget of cotton between the blades of forceps and swabbing the mouth with the fluid.

"No hand of science can be adorned with jewels."-Davis.

-For the Sleeplessness of Pregnancy a warm bath at night is better than any amount of bromid.-Davis.

-For Urinary Incontinence sweet spirit of niter is useful. It is well to use a little belladonna after several days, when the urine has been well diluted.-Hare.

-The late Prof. Parvin often checkt threatened Abortion by giving a starch-water and laudanum injection, following up the treatment by rest in bed, cold acid drinks and opium suppositories.

-For the Chronic Ulcers of Tertiary Syphilis Prof. Hearn finds acid nitrate of mercury, one part to sixteen parts of water, applied every third day, the best stimulat

ing caustic. ing caustic. It not only destroys the hopelessly diseased tissue, but seems to exert a distinct alterative influence in the less diseased area.

-In a case of severe Epistaxis, Prof. J. Chalmers Da Costa used Carnot's formula of

Normal salt solution . . 16 parts
Gelatin...
1 part

Saturating the cotton with this solution he plugged the nose in the usual way. The advantage of this solution is that it forms an aseptic coagulun.

-Professor Brinton has used for many years the following quieting mixture of simple character in cases after operation where there is slight fever and considerable unrest and nervous complaining: R. Liquor. potassii citratis, f3ss Spirit. ætheris nitrosi. f5j Tinct. aconiti . . . Morphinæ sulphat.

Sig. hour.

gtt. j

gr. M.

In water, every third or fourth

Potassii carbonat.. aa gr.viij. M. Fiat pil. xij.

Sig. One pill three times daily, after meals.

-In Opening a "Ganglion," or enlarged bursa over a muscle tendon, great care should be taken that a general infiltration of the intermuscular spaces does not ensue. Synovitis not infrequently follows this simple minor operation. The loss of a limb, or even of life, has been known as a consequence of carelessness in emptying the ganglion. Instead of cutting into the bursa, some operators strike a blow over the spot with a heavy book, thus rupturing the sac. The sac is filled with a thick, clear, amber-like substance.-Brinton.

-Professor J. C. Wilson prefers to treat Gastric Ulcer by absolute rest in bed, to nourish by rectal enemata, and to keep cold compresses over the stomach. Codein is given by the mouth, or morphia hypoder

matically, to lessen peristalsis and slightly narcotize the patient. Alkaline mineral waters are given, or five to ten grains of bicarbonate of sodium, followed with a little whisky and milk. The cold compress is applied by placing cloths wrung out of cold water over the stomach, covering with oiled silk, and then placing over this an ice-bag. These cloths should be removed and reapplied every three or four hours.

-For Enlarged Glands, where surgical interference is inadvisable, use the following ointment night and morning:

from the nerve-sheath and then injecting a solution of antipyrin at several points along the course of the nerve, 5 grs. being used in all. At the same time the man was given 80 grs. of citrat of potassium a day internally.

-The following method of Sterilizing the Hands and Forearm has been used during the past year in the Jefferson clinical amphitheatre :

First. Scrub well with Johnson's ethereal soap, or green soap and water.

Second. Cleanse the nails.

Third. Take in the hands one dram of chlorinated lime and two drams of bicarbonate of soda; wet and scrub thoroly, working the paste under the nails with small sticks (orange sticks).

Fourth. Wash with sterile water.
Fifth. Wash with alcohol,

Sixth. Wash with bichlorid solution, 1: 1000.

In addition to this precaution, Prof. Keen and his assistants have used, the

latter half of the year, sterile cotton gloves, similar to those used in the Micu. licz clinic. These he finds particularly useful in abdominal operations, not only prophylactic, but as being mechanically of great advantage in handling the viscera,. especially the intestines.

-Hysteria is as much a bona fide affection as any of the other neuroses.- Dercum.

-In all well markt cases of Scabies some eruption will be found on the shaft of the penis.-Stelwagon.

-Prof. Davis has never seen Abortion

brought on by a purgative unless it was given in a poisonous dose.

-Prof. Wilson begins the treatment of his Enteric Fever cases by giving preferably calomel in large doses, or castor oil and a saline. those cases which are seen before the tenth This treatment is used only in day.

-In the Diarrhea of Typhoid Fever Prof. Hare frequently prescribes

In

pain, enucleate the blind eye at once. that way you avoid sympathetic loss of vision in the sound eye. When Sympathetic Inflammation once develops in the uninjured eye, enucleation will rarely ever save the sight.-Hansell.

Prof. J. C. Wilson says he cannot understand why phosphate of sodium should be given in Catarrhal Jaundice. "Why should you increase the elimination of bile when there is an obstruction to its outflow?" He purges with calomel every two or three days, gives milk and lime-water or Vichy, and also large draughts of hot water several times daily.

-For Venous Thrombosis in the left leg of a convalescent enteric fever patient, Professor Wilson directed that the leg be elevated, that elastic flannel bandages be applied from the foot to the groin, and that morphin be given hypodermically p. r. n. Later he removed the bandage every day or two, bathed the leg carefully, and used the light upward massage, being especially careful with manipulation near the groin, lest some portion of the clot become disengaged; and still later in the case an elastic rubber bandage was, given for daily

Editor MEDICAL WORLD:-Enclosed please find $1 for your valuable journal. I have all the numbers bound except two or three early issues. Would not like to do without it. I hope you will keep hammering away at economic questions. You are right and bound to succeed. The profession owes you a deep debt of gratitude for the many reforms you have introduced into medical journalism. Long may you live and prosper in your good work. Yours truly, Collingwood, Ont., Can. W. F. PETERS.

Our Monthly Talk

Mr. R. E. Diffenderfer, of this city, has spent much of the last few years in China, giving a start to western methods of doing business among the celestials. He has built the first woolen mill ever constructed in the Celestial Empire. When he comes back to this country he occasionally drops in at my office to chat awhile, and I am always glad to see him, for he always has something interesting to say. He recently favored me with one of these calls, and perhaps the WORLD readers would be interested in the conversation.

C. F. T. "How do you do, Mr. Diffenderfer; glad to see you. The far East seems to agree with you" (he is a man of magnificent proportions). "How are you getting along with Li Hung Chang and his people?"

Mr. D. "I have nothing to complain of, excepting that I get more and more out of patience with the indifference of the people of this country to their best interests. China is prosperous, and to the extent that I have gone into business there, I am prosperous, also."

C. F. T. "You always have something interesting to say every time we meet. Have your experiences and observations in the far East caused you to change your opinions concerning any important public questions?"

Mr. D. "Well, you know I was always a very strong protectionist. A Pennsylvania Republican of the old-fashioned sort believes that a high protective tariff is not only the corner-stone, but the entire structure of political economy; and I was a Pennsylvania Republican of that kind. Are you acquainted with the New Home sewing machine? The selling price of them in this country is $50 or $60. I have seen them landed in China for $8.25, to sell for $15.80, our money. Such facts have caused me to think that the tariff is a burden and an injustice rather than a blessing to our people."

C. F. T. "What do you think of the surplus stock' argument so often given as a reason for selling goods to a foreign trade at a much lower figure than the ruling price at home. The idea is that if a factory can produce more goods than sufficient to supply the domestic demand, the surplus' must be worked off' at almost any price, in order to keep all the hands constantly employed, which is not only desirable, but necessary in order to secure the full economies of production."

Mr. D. "There is nothing in it. If prices in this country were put down to the point which seems necessary to secure foreign trade, the domestic demand would increase many fold, the increase far exceeding the total present foreign trade, and our own people would get the benefit of the same. The tariff makes possible abnormally high prices to home consumers. It is also a breeder of trusts. In some ways the tariff has been a good thing in the past, and should, in some instances, be still maintained; but it should not be a political, much less a partisan question. The tariff is a business question, and should be controlled by a commission, and be increast, reduced, suspended, or abolisht, according to (Continued over next leaf.)

his discovery of the tubercle bacillus. So great was the interest in this discovery that it over-shadowed every other feature of the meeting, and it echoed around the world for years afterward. But still people in great numbers die of consumption! Koch's discovery was not therapeuticsonly pathologic; but we all hoped that it would lead to a vastly improved, or possibly a specific, therapeusis. But still the hollow cough and sunken cheek are soon followed by the shroud and coffin. Koch exhausted his skill in the direction of a therapeusis suggested by his first discovery, but his hopes were not realized. Other experimenters along the same line could be numbered by the hundreds, all with the same result. Many vaunted cures have appeared only to soon disappear. Sulfuretted hydrogen gas by rectum was the cure that arose perhaps more rapidly than any of the others, only to soon seek the completest oblivion. Various antiseptic treatments based upon Koch's discovery have been suggested and used with varying success. The latest treatment is that brought forward by Dr. Murphy, of Chicago, consisting of mechanically compressing the diseased lung by hydrogen gas until it heals-a purely surgical procedure.

The problem is still with us and the deaths are still with us. Allow me to here impress a few thoughts concerning this disease. Consumption-a consuming. Why is there a consuming? Because the vital force is insufficient to resist the tendency to decay. The lungs are usually attackt because that tissue is the least resistent. Death is the withdrawal of vital