but know that in many instances, if not all, they are due to causes that can be demonstrated in the laboratory of the bacteriologist and pathologist. The science of medicine no longer gropes its way amidst darkness, superstition and mystery, but stands in a blaze of light on the threshold of an era that is destined to place our profession in the very front rank of the sciIt has made more rapid strides of advancement than all other professions combined. The work of our medical officers in the tropics in demonstrating the manner in which malaria a d yellow fever are transmitted will have an influence so far reaching that the most extravagant stretches of the imagination cannot conceive of its limitations.

ences.

And thus it goes on, and will go on until the whole field of medicine will have been cleared up, and where we have but speculated we will know of a certainty, and what now seems dark and impenetrable will be revealed by the light that will come from a thousand laboratories.

The great advancements that are being made by the medical profession throughout the civilized world are such that it should cause every member of tha profession to feel proud of his calling.

Then let us while gathering such knowledge disseminate it among the people, and let them know what is being done by the medical profession, and educate them to the point where they will understand that our fight on patent medicines and quackery is not a mercenary fight, but a fight for their protection; that this war is declared because we are sorry for and pity the poor ignorant dupes of these unscrupulous knaves who cheat them of their substance as the vampire does its sleeping victim.

Since it lies in our power, meinbers of the Middle Tennessee Medical Association, to abate this nuisance, and since it cannot be done by ridicule and fierce denunciation, but can be done by a system of education, thus teaching the people and showing them the error of their way, and that it is for their good we are striving, let us concentrate our efforts and see what we can do to rid society of these abominable parasites.

Clinical Reports.

COUGHS AND THEIR TREATMENT.

BY DRS. ALEX. DESOTO AND C. W. CRIMPTON,
Of Wayside Mission Hospital, Seattle, Wash.

An intractable cough!

What condition so persistently tries the patience of every physician?

Careful examination has been made, the diet regulated, and one of the innumerable prescriptions for that ailment selected, but still the cough continues.

Then more investigation and more careful prescribing; but still after weeks that familiar cough re-echoes through your waiting room, and you wish Mrs. Smith would change her doctor.

No such good fortune attends you, and that cough haunts you as dismal thoughts of phthisis do your patients, until you are almost determined to advise a change of climate.

It is not the object of this paper to go into details regarding the only too well known disadvantages of most of our familiar cough mixtures. Down to that household stand-by, "Cod liver oil in any form," they have proven in the vast majority of instances discouraging failures.

The above mentioned remedy, which the patient cousiders proof positive of the doctor's having made a diagnosis of consumption, may invariably be depended upon to disarrange the digestion at least.

Cod liver oil, once begun, must frequently be continued throughout the entire winter season.

Nor can it be shown that the ingestion of fats and oils into the system, to become oxydized when coming in contact with the oxygen in the lungs, ever does more than raise the local temperature by combustion. Although this may prevent cold in comparatively healthy lung tissue, its therapeutic (?) effect on the

inflamed pulmonary structure may be described as positively

harmful.

Cough is a symptom, varying in intensity and character according to its cause.

Nor is that cause always situated within the respiratory organs themselves.

Cough is essentially a reflex act depending upon an irritation of the respiratory center. These sources of irritation may be subdivided as follows:

Dropping of mucous from the posterior nares in chronic ea

tarrh.

Polypi, enlarged uvula or tonsils, defective closure of the glottis, irritations within the larynx from whatsoever cause, malignant or otherwise.

Bronchitis, pneumonia and pleurisy.

Gastric, when due to derangements of the stomach.

Cardiac disease, irritations of auditory canal, and organic diseases within the abdominal cavity.

From the foregoing causes, it may be readily estimated that to arrive at the exact nature of any given case may not always be an easy matter. Nevertheless, we must relieve the patient without risk of disturbing either digestive or circulatory systems. Any remedy which will attain this object in a goodly number of cases is indeed a Godsend to patient and physician, and in every sense an ideal remedy.

Not until our attention was called to Glyco-Heroin (Smith) did we become acquainted with a remédy which we have used with a most unvarying success in coughs of every description, and in patients of all ages and conditions without the slightest unfavorable effect.

The points which recommend Glyco-Heroin (Smith) are:

1st. Palatability. 2nd. Economy (three to four ounces being ample for a cure of the average case). 3d. Its immediate action, soothing the most trying cases. 4th. Its absolute freedom from unpleasant or unfavorable effects. 5th. It is not only a palliative but a curative agent. 6th. The hysocyamus it contains reaches those trying cases of dry cough due to other causes than simple catarrhal irritation of the respiratory tract.

We are convinced that Glyco-Heroin (Smith) has no competi

tors in results, its action being almost specific. It will give satisfaction in every case where results may be reasonably expected, and in many cases its beneficial effects go beyond the most sanguine expectations.

The character of the cases coming to the Wayside Mis-ion Hospital for treatment may be imagined when it is remembered that it is essentially a charity institution; that the vast majority of patients come to us after having tried everything else. These are worthy prospectors and miners, broken in health and pocket by exposure and misfortune.

As proof of the above we submit the following cases:

I.-D. McD., laborer, 22 years. Had typhoid fever, conva lescence much impeded by severe coughing spells, frothy white expectoration, irritable stomach. This condition defies all treatment. There was marked dullness at apices of both lungs to the third intercostal space.

Morning temperature normal, respiration 28, pulse 104.
Evening temperature 101, respiration 36, pulse 120.

This condition had persisted for nine days, with progressive loss of strength.

Dec. 16th. Glyco-Heroin (Smith), teaspoonful every hour. Morning, temperature normal, pulse 104, respiration 28. Evening, temperature 101, pulse 96.

December 17th. Slight relief to cough, had some sleep. Morning, temperature 100, pulse 96, respiration 24.

December 18th. Relief marked. Morning temperature normal, pulse 80, respiration 20.

December 19th. Expectoration free, appetite and spirits better, rapid improvement.

December 20th. Improvement continued, sat up about two

hours.

January 8th. Dullness and cough gone, spirits and appetite good, gaining flesh rapidly.

January 11th. Discharged cured.

II.-Wm. M. Cook, 52 years. February 19th. Has had a severe cough for last three months, due to cold caught iu a typhoon on the China Sea after three days' exposure to cold and

wet; has hardly any sleep; incessant dry night cough. GlycoHeroin (Smith), teaspoonful every two hours.

February 21st. Immediate relief, has had quite a little sleep.
Improvement continued.
Slept all night.

February 22nd.
February 24th.

February 26th.

Has not coughed in forty-eight hours. February 28th. No return of cough and discharged cured. Is now in charge of the culinary department of hospital.

III.-D. A. Coolie, laborer, 48 years. January 23d. A marked dullness at base of left lung, severe pain and dyspoa; temperature 102, pulse 104, respiration 40. There was daily chilliness at 11 A.M,, followed by temperature of 103% to 104; expectoration muco-purulent; emaciated, irritable, aud appetite completely lost.

January 26th. Glyco-Heroin (Smith), teaspoonful every two hours.

January 27th. Some relief to cough, other conditions same. January 28th. Free expectoration, all conditions still unchanged.

January 29th. No morning rise of temperature; evening temperature 102, pulse 96, respiration 32.

January 30th. Seems somewhat better; had a profuse night

sweat.

January 31st. Temperature 101, pulse 88, respiration 24; took considerable nourishment.

February 1st. Temperature normal, pulse 88, respiration 24; less dullness, no expectoration, cough disappearing.

Spirits vastly improved; said it was his third attack, and that in each former instance he was in bed eleven and six weeks respectively; continued to improve, and was discharged February 26th, well.

IV.-J. J., laborer, 19. January 17th, Pneumonia, third day, dullness of entire right lung. Temperature 103, pulse 120, respiration 60; expectoration prune juice; very restless and thirsty; slight delirium. Glyco-Heroin (Smith), teaspoonful every two hours.

18th. Temperature 102, pulse 102, respiration 48; much easier.