may be altered in quality by emotional causes, by improper food and improper hygiene. Or it may be caused by over-frequent nursing. More often, however, it is caused by the ingestion of unnatural foods.

There are also pre-disposing inflences which facilitate the action of the exciting causes. These are, especially dentition and the extreme heat of summer.

The Prognosis of the aforesaid disease among the better classes is commonly favorable, but among the weak, puny and half starved childred of our lower east side, large numbers perish, especially during the summer months.

The Old Time Treatment in these cases was a primary purge, calcined magnesia or castor oil. After the purge bismuth subnitrate or prepared chalk was given. Since the introduction of Glyco-Thymoline (Kress) the above menthoned methods have been cast aside. A very good and effective prescription which has given me most splendid results in these kind of cases, in conjunction with a carefully restricted diet is:

Cholera Infantum, a variety of acute catarrhal enteritis of intense severity, corresponding in symptoms and course to cholera morbus in the adult, but much more serious in termination.

Prognosis in these cases is at least not very favorable, although recovery is not impossible.

Treatment of these cases is of quite a different nature from those above mentioned. In the first place the fever must be combated and I kow of no better method than a bath containing some Glyco-Thymoline, at about 80° F., reduced by adding small pieces of ice to 70° or 65°. Next pain, to reduce pain 100th of a grain of morphine sulphate can bo administered to a child of one year. Stmulation with strychnia hypodermically, iced

champagne to prevent vomiting, brandy, whisky and other stimulants.

One of the best methods for irrigating the larger intestine is by introducing a small soft catheter through the rectum and injecting into the bowel about a pint to a pint and a half of warm water containing about 25 per cent. of Glyco Thymoline. This I find removes and prevents the re-accumulation of the fermentative as well as the putrefactive products of the bowel. Should, however, the hyperpyrexia continue the douche may be given at a lower temperature. During convalesce great care must be taken in the feeding of the patient.

Acute Entero-Colitis is an infection of inflammatory nature more severe than dyspeptic enteritis, chiefly of the ileum and colon, affecting especially the lymph follicles. This like the preceding is a disease of the hot months of summer, and the period of teething, especially. It is produced by the same causes as dyspeptic diarrhoea. It is most frequent during the ages of 6 and 18 months. It likewise may be a termination of dyspeptic diarrhoea, or of cholera infantum.

Treatment. The general surroundings and hygiene necessarily play an important part. The medical treatment, however, is somewhat different. Anodynes are more imperatively demanded because there is greater suffering, and depletion may be needed in the beginning, by salines, though good judgment is required because the child's strength must be watched. The colon should be flushed with a solution of Glyco-Thymoline having a strength of 25 per cent. This I find answers admirably in these cases. The solution may be made with iced water. The coming teeth should likewise be watched and the gumbs be scarified whenever required.

I will supplement my remarks by adding a few of the many cases treated with Glyco-Thymoline and leave results to speak for themselves.

CASE I.-M. K., aged 8 months, male, was taken with severe vomiting and colicky pains at night. The vomita contained lumps of coagulated milk. The stools are very offensive and recurred at intervals of twenty minutes. I left a prescription for Glyco-Thymoline, 2 oz., bismuth subnitrate, one oz., rose water enough to make four oz. I called the next morning and

found but little improvement in my patient, and at once flushed out the bowel with a 25 per cent. aqueous solution of GlycoThymoline, and continued the prescription given the night previous. This treatment was continued for three days, the patient steadily improving during that time. I recommended that the child be taken away from the city, which was done. I heard later from the parents that the child had not had a relapse, but made a speedy recovery.

CASE II.-Mary C., age 7 months and a half, was brought to my office, her little knees drawn up, a look of anguish on her face, which was pale and drawn, with eyes protruding. She had a number of watery discharges from the bowels, incessant vomiting, a temperature of 100, a rapid and feeble heart. A further examination of this poor little tot was unnecessary. Anodynes were at once administered to soothe the pain. I washed out the bowels with a 40 per cent. solution of Glyco-Thymoline and administered the same in a 50 per cent. solution with pep. permint water internally in doses of one teaspoonful repeated every two hours. The results in this case far exceeded my expectations. The child made a slow but successful recovery.

CASE III.-L. P., male child, age 16 months; was called to check the diarrhoea, which was of a serous character, having a tinge of blood. The vomiting was not of a severe nature, the only alarming symptoms the child showed were the intestinal ones. Three separate washings of the child's colon were made at intervals of six hours. The child's food was restricted to barley water; this case like the one preceding made a perfect and speedy recovery.

CASE IV.-R. A., a little tot of the east side, aged 13 months brought up in one of the dark and dingy rooms of a tenement house; this poor little one was suffering for five days before my attention was called to the case. I found it in an emaciated condition, unable to move a limb, the bowel movements were frequent and watery; the little one was on the point of collapse; strychnia was administered hypodermically to stimulate the heart, after which diluted brandy was given every half hour. The colon was irrigated with 24 oz. of a 50 per cent. aqueous solution of Glyco-Thymoline; I had the child under my observation for two and one-half weeks, and with proper food and fresh air the child made a good recovery.

CASE V.-M. M., a boy baby seven months of age, teething and causing all sorts of trouble for its parents who were well to do. Was summoned to the house early oue morning, found the little one vomiting quantities of curdled milk, and movements having a decidedly fetid odor. I tried most everything in this case and received but small relief by the use of Glyco-Thymoline. Upon careful investigation I found that the teeth were causing tha trouble; the gums were then lanced, and the child's diet restricted; that is, the breast feedings were given at three hour intervals, and only lasting five minutes at a time. GlycoThymaline was kept up with perseverance and with good nursing, our little one soon got well.

CASES IN HÆMATHERAPY FROM SOUND VIEW

HOSPITAL.

BY T. J. BIGGS, M.D., NORWICH, CONN.

CASE I-Skin-Grafting with Callus Shavings, in Blood.Mary M.; aged 60 years; Irish. Diagnosis, Ulcer of Leg. Patient admitted to Hospital, March 3, 1902. She had a large varicose ulcer situated over the tibia, about 3 by 2 inches. This condition had existed for nine years, and during that time in spite of all treatment employed had never entirely healed. It had been skin grafted in the old way, three times unsuccessfully. At the time of entering the hospital the patient suffered so severely from pain that at times she would cry out. She was put to bed, secretions regulated, the ulcer cleaned up by means of a dermal curette, and dressed for the first twenty-four hours with a Thiersch pack. On the morning of March 5th, after the surface had been thoronghly cleaned up, a bovinine-pure pack was applied and kept wet with the bovinine for twenty-four hours.

On the morning of the 7th, I determined to employ grafts secured from a callus on the small toe, in order to demonstrate the technique of this mode of skin-grarting to five visiting physicians. The mode of procedure was as follows: The callus was thoroughly scrubbed up, and the external layers scraped off. The thin sections of the layers next to the true skin were ob

tained by means of a very keen razor. Nine of these were deposited on the ulcerous surface. Over these were laid strips of perforated rubber tissue, then strips of plain bi-sterilized gauze saturated in bovinine, and a bandage applied. The nurse was instructed to keep the dressings wet with bovinine pure. This dressing was removed on the 14th, and it was found, much to the delight and astonishment of the visiting physicians, that out of the nine grafts employed eight were firmly adherent and in a healthy growing condition. The ninth had become displaced and was removed. The wound was now dressed with bovinine pure; the dressings being kept wet, and changed once in twentyfour hours. Coincident with the local dressings, from the outset, the patient had been given a wineglassful of bovinine in milk alternating with wine and beer every three hours. On March 24th, she was discharged cured, the entire surface having become covered with new healthy skin.

The experiment has been employed frequently enough by me to demonstrate that where the technique is carefully followed it will in the majority of cases yield the most gratifying results. A point of interest in this case and a usual one, is that from the day of the first dressing of the bovinine up to the time the patient was discharged, she was relieved of all pain.

CASE II.-Skin-Graftings with Skin-Scrapings, in Blood.Anna H.; age 12 years; Irish. Diagnosis, burn of right hand. Patient was admitted to hospital March 8th, 1902. As a result of the burn she had on the back of her hand an ulcerous surface 2 by 1 inches, very painful. and in spite of three months treatment had refused to heal. It was impossible in this case to secure skin-grafts, and as I wished to demonstrate to the visiting phpsicians who were present the efficacy of skin scrapings as a means of bringing about a rapid healing of small surfaces where grafts could not be obtained; with an ordinary vaccinating comb I secured skin scrapings from the little patient's arms, legs, and back. These were deposited within the periphery and dressed as in the other case. The dressing was kept wet with bovinine pure until the morning of the 16th, at which time it was removed and to the delight of the visiting physicians as before, the surface was found to be almost entirely healed, there remaining unhealed only a small space about the size of a ten cent piece, in