especially in influenzal lumbago and the lumbago which closely resembles it, i. c., that occurring at the beginning of acute inflammations of the respiratory tract and angina. Here one or two urotropin tablets coup the affection or at least afford striking relief. Patients with lumbago that prevents their arising in the morning, whose every movement is painful, are able to go about in the room a few hours after taking urotropin.

Almost all febrile processes commence. with stiffness of the extremities and lumbar pain. Here, too, urotropin acts beneficially. We must deposit the origin of lumbago in the kidneys or consider it a neuromyopathy of the dorsal lumbar region. In the first case, urotropin must act by its uric-acid-solvent and disinfectant properties; in the second case, we must assume either a direct action of the urotropin circulating in the blood upon the lumbar region or else an effect from the formaldehyde reabsorbed through the urinary mucosa.

Weitlaner now makes it a routine practice to treat ordinary influenzas with a combination of urotropin (6-grain doses) with opium-ipecacuanha-sodium-salicylate in coffee, and considers. this the best antiinfluenza treatment. He believes that urotropin is not without influence on the grippe itself.

Collargoi Enemata in Septic Affections.

CURT SEIDEL (Deutsche med. Wochenschrift, July 30, 1908,) says: the introduction of collargol into the system by the inunction of unguentum Credé develops a gradual effect and its employment is limited in cases of emaciation and in painful affections. Hence this method is indicated in mild to medium severe or localised and in chronic or subchronic infections. The intravenous injection of collargol, though the sovereign method in grave cases where a rapid and intensive effect is necessary, is often technically difficult. In such cases collargol is often advantageously administered per rectum as originally proposed by Loebl (Schlesinger's division of the Vienna Franz-Joseph Spital) in puerperal sepsis and endorsed by Witthauer in joint rheumatism.

Given by enema, collargol is, of course, less rapidly absorbed into the blood and tissue fluids than when injected intravenously; moreover, the entire quantity is rarely absorbed. Hence a correspondingly larger dose must be used per rectum.

Collargolum enemata have been given by Seidel in over 100 extremely severe cases, such as were formerly treated with collargol intravenously. He gives the case histories of eight typical ones. The treatment almost never fails, not even in very grave

cases, if it is only pushed with the necessary vigor and persistence-a fact which Seidel desires to impress on those physicians who have spoken disparagingly of collargol after they saw no result from their timid and small doses. Collargol is, of course, no panacea; just as a rheumatism or a malaria can not be cured with a single dose of a salicylate or quinine, just so is it irrational to expect a sudden recovery from a sepsis or pyemia after one insufficient or delayed administration of collargol.

Seidel's cases showed that collargol enemata have a material, if not a decisive, influence on the favorable course of severe affections. They produced a rapid improvement in the general condition, return of sleep and appetite, and remission of fever, more or less quickly in accordance with the severity of the case. Selfdeceptions are wholly excluded with one who has thoroughly studied collargol therapy.

Seidel gives the following directions for collargol enemata: (1) A cleansing clyster with warm soap suds. (2) Fifteen minutes after the rejection of the clyster and passage of the fecal residue, a careful irrigation with sodium chloride solution is made, to remove intestinal mucus. (3) Fifteen minutes thereafter an enema of 30 to 75 grains of collargol in two to four ounces of warm boiled water, once or twice daily. This is for severe cases; the dose in milder or chronic ones is 15 to 30 grains. (4) Upon the appearance of the effect, the dose is diminished, but the enemas should be continued for at least two weeks. In case of recrudescence, immediate resumption of the treatment, if the relapse is not due to abscess formation or other local process.

Rectal application of collargol, which leaves nothing to be desired in simplicity and convenience, is indicated not only in septic processes, but also in infectious diseases and mixed infections. He enumerates rheumatism, pneumonia, typhoid fever, septic scarlatina, septic diphtheria, anthrax, leprosy, cerebrospinal meningitis, dysentery, infectious gastrointestinal catarrh (particularly in children), and other general and local bacterial invasions such as angina, phlegmon, erythema nodosum, erysipelas and septic nephritis.

Cuguillere's Serum in the Treatment of Tuberculosis. EUGENE CARAVIA, New York, describes Cuguillere's serum as a vegetable serum which carries colloidal metals already assimilated, that have become organic, living, and possessed of their maximum activity. It is a yellow liquid with an odor of garlic, and is made from organic sulphur taken from the juices of brassica, allium, watercress, horse-radish and other herbs, which are

antiscorbutic and antirachitic. Its formula is: allylum sulphide 1.0; tincture of myrrh 1.1; Hayem's glycerinated serum. 100. The author gives descriptions of experiments on animals and man. by the use of this serum as a curative treatment in various forms of tuberculosis, undertaken by various authors in different countries. Examinations were made of the internal organs of cattle cured by this method with the result of finding no tubercle bacilli, and cure by cicatrisation and phagocytosis. The serum acts in advanced cases where tuberculin is powerless on account of the too great reaction produced. It increases appetite, facilitates digestion and increases weight. Treatment is easier than with tuberculin. The minimum dose is one to two cubic centimeters and the maximum five to fifteen. The writer reports four cases treated by himself and cured. This serum attacks the cause of the disease, the bacilli themselves. It promotes fibrosis, it stops hemorrhage, lessens fever, stops diarrhea and night sweats, helps appetite, strengthens the heart, and lessens cough and expectoration. Medical Record, September 26, 1908.

A Readily Soluble Hypnotic of the Veronal Group. ERNST STEINITZ (Therapie der Gegenwart, July, 1908,) says: the ideal hypnotic must be readily soluble and, therefore, rapidly absorbed, so that the soporific effect may be prompt and certain and that there may be no undesired prolongation of it. Diethylbarbituric acid, one of the best hypnotics known, has the disadvantage of very slight solubility (1:145).

Steinitz experimented clinically with the monosodium salt of diethyl-barbituric acid, placed at his disposal by Schering. It is a crystalline powder 20 per cent. soluble in water; by heating a 30 per cent. solution, permanent in the cold, can be prepared. He used it by mouth, per rectum and subcutaneously.

By mouth the salt is always given dissolved in water, when it has no unpleasant taste. Its action was quicker and more certain than that of diethyl-barbituric acid; occasionally the salt had good effect where the base had been ineffective. A cumulative toxic action was absent, though in some cases 71⁄2 grains were given daily for considerable periods.

In most cases the superiority of the new salt is doubtless due to its being administered thoroughly dissolved. It is best taken on an empty and consequently acid-free stomach-on retiringwhen it passes unchanged into the intestines and is there quickly. absorbed. In the ratio in which absorption and therefore excretion are hastened, the salt naturally diminishes the danger of cumulative toxic actions.

Per rectum the action of the drug was quicker and almost always more intensive. In some cases the effect was excellent when the same dose by mouth had no effect at all. Anesthetic properties were also observed at times. In several cases of cardiac and bronchial asthma, with night attacks, the greatest possible relief was effected by the rectal injections. Seven and onehalf grains were dissolved in about a dram of water and injected with a small rectal syringe.

Subcutaneous injections are intensive rather than rapid in effect. Seventy-five minims of a 10 per cent. solution are used; this hardly irritates and is apparently more quickly absorbed than more concentrated solutions. Abscesses never occurred, though some patients were morphinists who in other places were sown with injection abscesses. In threatened delirium tremens the salt has about replaced chloral by subcutaneous injection. The injection of the salt seemed especially suitable, too, for patients under antimorphine treatment; here its quietening effects were marked.

Steinitz concludes: "On account of its extreme water solubility, the salt can be conveniently administered in a well dissolved and most finely subdivided state. The absorption proceeds more quickly when it is administered on an acid-free stomach and when given per rectum, because the drug remains in its readily soluble

form.

Rectal administration can be recommended when the stomach is to be spared and especially for obstinate insomnias.

Subcutaneous injection we recommend at present only in special cases, where the patients refuse oral medication, for morphine habit, and as a last resort in severest insomnia."

SAMUEL WYLLIS BANDLER, New York, in his Medical Gynecology (W. B. Saunders Co., 1908,) has the following passage: Acute female gonorrheal urethritis: Of the internal antigonorrheic remedies, arhovin is said to be free from the untoward effects of the balsams. Arhovin internally is indicated in inflammation of the urethra associated with pain on urination and cystitis. In the chronic form it sometimes gives great relief. Arhovin causes acidity in alkaline urine, even in one undergoing ammoniacal fermentation. It is sedative and anesthetic to mucosæ and does not annoy the stomach. Six to twelve capsules, each containing 4 grains, are to be taken daily.

ONE of the most important criteria of a well-fitting pessary is that the finger can pass fairly easily between its sides and the vaginal wall.-International Journal Surgery.

TOPICS OF PUBLIC INTEREST.

At Last, The Oxygen Bracer.

Rejuvenator for Work or Play-Successful Experiments on Athletes-Physicians and Surgeons Have Already Proved Its Value.

[New York Tribune, September 13, 1908 ]

XYGEN for jags, for athletics and for new surgical purposes

is coming to the front in a remarkable way. This gaseous element of the air, which the common people have been inhaling right along without knowing it, as M. Jourdain unconsciously talked prose, seems destined to revolutionise modern life in many directions. Uses profound and trivial are within realisation. Scientists are engaged in experiments on the effects of the gas on animals and men. Athletes are clamoring for a stimulant which has no evil after-effects and which will enable them to clip several seconds from the records. It is suggested that campaign orators who tank up on oxygen may yet be able to save the country. The fountain of youth and the elixir of life are nothing compared to the aerial element, according to some enthusiasts. It may cause chagrin in the bosom of the average person to learn that, while he has been breathing the New York mixture that passes for air, the virtues and delights of oxygen have been monopolised by a select circle of financiers, actors, opera singers and fashionable folk. The epicure takes his oxygen highball before and after dinner. John D. Rockefeller is said to indulge moderately in this "gas of the gods," having assured himself that it is not a bad habit, like the use of drugs. The recent cavortings in the Stock Exchange might be attributed to too many oxygen cocktails consumed by brokers. Mme. Nordica warbles more divinely, it is said, when her lung cells are saturated with the Olympian element. Bernhardt would have disappointed more than one American audience if her fragile breathing apparatus had not been reinforced by the contents of several steel tanks. Sir Henry Irving was wont to tour the country in a stateroom filled with a few hundred dollars worth of the gas. The wonderful endurance of fashionable women through a winter's siege of dinners and balls is ascribed to a more or less secret indulgence in the gas that cheers but does not inebriate.

There are a myriad thrilling speculations as to the future. How soon will the subway be oxygenised? When will business men be able to carry flasks of gas in their back pockets and frequently take an enlivening draft for that tired feeling? The cost is not important, for you can get a good drink-that is, a good number of inhalations-at an oxygen parlor for $1.50, but