inoperable hernia, where the obtruding lump should be fixed in place as promptly as possible; but he does not think much of the much discussed advantage of greater safety of the harder preparations, nor does he think the objection to the softer forms, that in conditions of fever the correction effects will be lost by the melting of the paraffin, will hold. As to the first, if care is taken with any, however soft, preparation of paraffin, to introduce the needle first before attaching the syringe, it may be easily determined whether it be in a vessel by noticing any escape of blood; and as to the second, the paraffin is not loose in a tissue space, but seems actually incorporated with the tissue fibres, and hence will not lose its form.

After considerable research, Gersuny has learned that he can get excellent results with a mixture of one part vaselin and four parts olive oil, by volume. This is each time prepared fresh and sterilized. It is well adapted at room temperature to diffuse itself and mix well with the tissues of the part and thus actually prevent the formation in lumps so likely to prove objectionable in certain situations. He had the hope that such might be the case; the numerous small particles of paraffin distributed through the tissues becoming encapsulated and serving their prosthetic purpose by simply adding something to the tissues without distending them, the oil having become gradually absorbed. These hopes were fully realized. He has been able successfully to apply this method to the prosthesis of a great variety of deforming pathologic conditions, such as that due to facial hemiatrophy, as a means of elevating healed in, but depressed, Thiersch grafts on nose and elsewhere, to lift scars, and so on, besides those like saddle-back nose and others, where such prosthesis has already been much employed.

Finally, he preferred the olive oil mixture to liquid paraffin of commerce, because it has been demonstrated that olive oil was absorbed subcutaneously, whereas the behavior of liquid paraffin was as yet unsettled.

Sometimes it was advantageous, and safer, to inject, at first very slowly, only a very small quantity of the substance, and in a few days to throw the rest in cautiously into this focus slowly expanding the part by injecting the required amount. Embolism would be less likely in this way.

Department of General Medicine.

In charge of DR. E. M. DUPAQUIER, New Orleans.

ABORTIVE TREATMENT OF FURUNCLES WITH A CONCENTRATED SOLUTION OF IODIN IN ACETONE.-Acetone dissolves about four times more iodin than alcohol. The solution is blackish. It was tested in a systematic manner, on patients in the typhoid fever wards of Prof. Chantemesse. Typhoid cases very often have abundant eruptions of acne and furuncles, which give rise to abscesses and at times quite large sloughings, and it was customary in these wards to use for such eruptions applications of ordinary tincture of iodin. In its stead the following formula was used:

At first this solution is almost similar in appearance to the ordinary iodin tincture. But in course of time, it changes. After fiften days it becomes black and as consistent as syrup; the change is due to the formation of mono and di-iodoacetone. The fresh solution is more irritant than an agedone, while the ordinary iodin tincture on the contrary becomes more and more caustic with time. The following is the method of using the iodoacetone solution. A wad of absorbent cotton secured in any stem or forceps is soaked with the solution and the furuncle or inflamed nodule gone over, leaving a coat of blackish varnish. If the skin be intact the patient hardly feels anything and if broken quite a smarting sensation follows.

As a rule,in 24 hours all signs of inflammation disappeared after a single application provided suppuration had not set in yet. Even when there is pus, but only a superficial drop of it, the furuncle may be aborted entirely. Iodoacetone is indisputably more potent than iodin tincture. But it presents some slight drawbacks, it possesses more causticity than iodin tincture and therefore requires more prudence in its handling. It can bring about phlyctenules and even slight ex-ulcerations. Again if applied over the pulpous granulations of an open boil it causes

acute pain. In one case, iodism was produced, but true it is that iodism was also seen in a case of ecthyma in which iodin tincture was applied.

The drawbacks of iodoacetone mentioned above are nothing when compared with its efficacy. The latter was so manifest that Prof. Chantemesse thought it advisable to publish the present note.-Gazette des Hôpitaux, GALLOIS AND COURCOUX, Jan. 20, 1903.

THE TREATMENT OF AGUE BY INTRAMUSCULAR INJECTION OF QUININ. Says A. G. Welsford, M. D., F. R. C. S., in The Indian Lancet, January 5, 1903: Practitioners who have had experience in the treatment of malaria by both intramuscular and hypodermic injections of quinin solution will scarcely endorse Colonel Smith's condemnation of the intramuscular method and his preference for the hypodermic. The latter injections are often very painful, and may give rise to tender swellings (notwithstanding gentle friction) which are persistent and which may break down and form abscesses. Hypodermic injections into the forearm may cause a paralysis of one or more fingers, which does not pass off some time.

On the other hand intragluteal injections are practically painless and the swelling soon disappears, while their effect on the fever is fully as favorable and rapid as in the case of the hypodermic method. In one patient I injected 5 grains to 10 grains of quinin twice a day for six weeks into the gluteal muscles without a bad effect of any kind, and with most satisfactory results in the fever. In the practice of a tropical hospital under my direction, in which cases of pernicious malaria. were numerous, we abandoned the hypodermic method for the intragluteal with the happiest results.

Of course the strictest antiseptic precautions must be used or abscess will follow. A sterilizable serum syringe should be used, which should be sterilized after each injection. . The skin should be cleansed with turpentine and spirit, and 5 grains to 10 grains of the acid quinin hydrochlorate dissolved in a drachm or less of water, and boiled. The syringe, which before use is washed out with hot water, takes the solution up while hot, and injects it deeply into the gluteal muscles. Finally, the puncture is sealed with collodion, and friction is

employed to diffuse the solution. Although this method is invaluable in severe cases, most people during an ordinary attack of fever would prefer to take their quinin by the mouth.

SUGAR AS A FOOD IN TUBERCULOSIS.-As such, sugar ranks prominently since it is a food-material of very great calorimetric value; it can be substituted for oils and fats which are so often digested with difficulty; more so than fat, it prevents loss of proteids, checking tissue destruction. With little precaution, easily obtained, in order to avoid saturation and intolerance, its use in treatment has given very good results. Curiously enough, it was one of the substances most commonly employed against phthisis in ancient practice.

Indeed, the practical value not only in the cure but also in the prevention of tuberculosis, which sugar seems to possess, is really interesting from the standpoint of modern prophylaxis. In sugar a large amount of calorics are contained in a very small quantity of material, easily taken, still more easily assimilated and utilized. From the researches of Voet and Leyden 100 grams of sugar contain 383 units of heat. True, its calorimetric value is only about half that of fat, but the latter is not so pleasant to ingest; then, it must first undergo transformation into sugar in the liver before being utilized; so, large doses will soon overtax the liver, which is particularly vulnerable, in a number of cases.

Loss of heat is great in tuberculosis, even during afebrile periods. Analysis by Quinquaud and A. Robin have shown. increase in the consumption of oxygen and in the exhalation of carbon dioxide. This loss of calorics is still increased during the febrile paroxysms; patients are then very sensitive to cold. Treatment aims at diminishing this expenditure of calorics by reducing muscular work to a minimum. But, on the other hand, cure by the open air in permanence, even on damp and cold days, calls for foods readily producing heat in order to cope with the temperature of the exterior. Sugar answers this purpose best, since, in the main, it is the real and unequalled fuel for animal mechanism. Besides, more than any other food, it diminishes catabolism of proteids and the wear of tissues, that grave factor in tubercular cachexia. With regard to this saving of proteids, sugar is even superior to fat.

Under the influence of sugar, Rubner, of Berlin, has seen a decrease in nitrogen-loss reach 47 per 100. Finally, sugar contributes largely to increase bodily weight. Accumulating in the form of fat, it constitutes a precious reserve for periods when alimentation for some reason or other is transiently lessened. In zootechnics the part played by molasses in increasing the growth and weight of cattle, is well-known to breeders. While it is not desirable to fatten tubercular subjects to any excess, it should be remembered, however, that phthisis, as the word indicates it, is cachexia that emaciates, withers and dries up the body. Phthisic subjects stripped, as it were, of their flesh are at the mercy of the least complication. A large number of them, as Arthaut justly remarks, die from gradual emaciation and refrigeration. Sugar, says Prof. Gauthier, represents for them a supply of heat, or to speak in a more general way, a supply of latent energy which, when needed, is at the immediate disposition of the cells.-A. F. PLICQUE, Journal de Médecine Interne.

Department of Therapeutics.

In charge of DR. J. A. STORCK, New Orleans.

MEANS OF CONTROLLING BLOOD-PRESSURE.-Crile points out the defects and limitations of strychnin, alcohol, nitroglycerin, digitalis, and saline solution. Uniform pressure on limbs and trunk by means of a pneumatic rubber suit gives a definite control of blood-pressure of from 25 to 40 mm. Patients may be placed in any position during operations because the blood flows back to the heart regardless of posture. Adrenalin chlorid acts. on heart and vessels but not on the vaso-motor center. It must be used carefully in great dilution with saline solution, usually 1 to 50,000. In large doses it may overstimulate the inhibitory mechanism of the heart. This may be prevented by atropin.— Journal of the American Medical Association.