APPENDICITIS Without Operation In ninety-eight per cent of cases by "The Thomas Huntington, Ind. Divide into 144 piils. Dry them by exposure to the ordi nary temperature, until just hard enough to retain their form. Then put them into a well-stoppered bottle. AN EXCELLENT PILL FOR INDIGESTION. No class of cases are of more anxiety to physicians than dyspeptics. No condition is more widely spread than that of dyspepsia. Speak of it in an office crowded with business men and it is astonishing how universal will be the complaint. Hence the physician must be ever be ready to enlarge his armamentarium and be prepared for these cases. Often they come with the history of having taken apparently the whole pharmacopeia, and exhausted every therapeutic measure. In such cases, and, in fact, in all cases I have found a certain combination that acts like magic. This is the pil. antiseptic comp. of W. R. Warner & Co. I have been using their form of the prescription, as it is one impossible of production by the druggist. The ingredients are as follows: Sulphite of Soda, gr. j. Salicylic Acid, gr. J. Ext. Nux Vom. gr. 1-8. Powd. Capsicum, gr. 1-10. Given in doses of one to three pills, this prescription quickly gives relief to the most stubborn case of dyspepsia; it seems to be of no significance as to its form. The combination is most judicious; as can be seen by its ingredients, and with it the physician has another scientific weapon with which to attack the "great American disease."-J. H. ADAMS, 2417 Spruce St., Philadelphia.-The Medical Summary, November, 1902. A VALUABLE PILL FOR PHYSICIANS PRESCRIBING FORMULA ACIDUM SALICYLIC...........1 GR. PIL. ANTISEPTIC COMP.-WARNER A SCIENTIFIC COMBINATION, ASSURING ABSOLUTE INDICATED IN DYSPEPSIA AND INDIGESTION, PARTICULARLY WHEN ATTENDED WITH ACIDITY OF THE STOMACH PLEASE SPECIFY "WARNER & CO." ON YOUR PRESCRIPTIONS Pills sent by mail on receipt of price 55 cents per bottle, 100 pills WM. R. WARNER & CO. 639 N. Broad Street, Philadelphia BRANCHES AT NEW YORK, CHICAGO, NEW ORLEANS A Scientific Blending of True Santal and Saw Palmetto In a Pleasant Aromatic Vehicle. A Vitalizing Tonic to the Reproductive System. SPECIALLY VALUABLE IN PROSTATIC TROUBLES OF OLD MEN-IRRITABLE BLADDERCYSTITIS-URETHRITIS-PRE-SENILITY. M. Sig. A teaspoonful in water at meal times. M. Sig.-Teaspoonful three times a day. PULV. BISMUTHI ET PEPSINI .......I OZ. ..2 drms. .6 ozs. Infants Hospital, Randall's Island, N. Y. B Bismuthi sub carb........... Pepsini.......... Mix. One dose for children. ....aa gr. 2. ( 553 ) PHILLIPS' PHOSPHO-MURIATE OF QUININE,COMP. (The Soluble Phosphates with Muriate of Quinine, Iron and Strychnine.) Permanent.-Will not disappoint. PHILLIPS', Only, is Genuine. THE CHAS. H. PHILLIPSCHEMICAL CO., 128 PEARL ST., New York. BY JNO. A. GAINES, M.D., OF NASHVILLE, TENN. I will omit any anatomical considerations as all are familiar with the pelvic organs and their relation to the external genital track both by continuity of tissue, that is the continuous mucous membrane, and by the intimate connection both by blood vessels and lymphatics. Pelvic inflammation is the result of infection always, whether it is during the puerperium or without relation to pregnancy. There is a class of cases to which I wish to refer however, in which * Read at Nashville Academy of Medicine, Sept. 1st, 1903. there is not strictly speaking, an inflammatory condition; but merely a state of congestion or hyperemia due to circulatory conditions that give a chain of symptoms from which our patients clamor for relief, in which there is no infection. This latter condition being the simpler I shall deal with it first. This condition is due first to malpositions of the uterus and usually its appendages, most commonly a backward displacement with descensus to some degree, thereby making traction on blood vessels and lympathics, with less interference to arterial supply on account of its positive force by markedly telling on venous and lympathic circulation which leaves the tissues surcharged with blood and oedematous. 2nd. To constipated habit, with loaded sigmoid and rectum, thereby making pressure on the veins and lymphatics producing a similar condition of congestion and if not relieved from increased weight, we have brought about the same condition of displacement referred to. 3rd. To this might be added as a predisposing cause, the unruptured Graafian follicle producing the "Follicular cyst" not in. frequently found in nulliparous women toward the middle or latter part of the child bearing period. Thus cysts attain the size of a large hazelnut or larger, and by their weight aid in the displacement of the ovary and tube. These conditions can often be successsully met by replacing the uterus and maintaining it in position with tamponage, using copious douches of hot water of a temperature of 110° or more, for twenty or thirty minutes twice daily, followed by actively depleting agents locally applied, at the same time obtaining copious watery evacuations by repeated saline purgation associated with roborant constitutional treatment and good hygienic sur roundings. An essential to successful treatment is rest in bed, and when exercise is resumed it should be specifically directed and a positive limit placed. I wish here to call attention to a simple and very expedient method of replacing the retro-displaced uterus, in fat subjects or in very nervous patients that cannot sufficiently relax the abdomen to allow the abdominal hand in bimanual manipulation, to be pressed in sufficiently to lift up the uterus. It consists in the use of an irrigator (Fountain syringe answers), hung some six or |