satisfied with this, and he had to increase the dose to a drachm three times a day. In this quantity, Dr. Murrell writes, "It seems capable of producing the maximum of inconvenience and discomfort, and gives unlimited satisfaction. The purgative effect is very pronounced, and in one case the patient had 56 evacuations in the week. In another case it produced a well-marked rash, covering the arms and legs with an eruption, which forcibly reminded one of copaiba. It was accompanied by intense itching, which disappeared on discontinuing the drug.”

Dr. Murrell has found that guaiacum not unfrequently gives rise to a burning sensation in the throat, and to obviate this he prescribed 10 grs. of the resin in half an ounce of extract of malt, which answered admirably. Dr. Murrell believes that if the drug was triturated with cream of tartar, sugar of milk, or some other equally inert substance, its efficacy would be increased, and it would produce the desired effect in smaller doses.-Therapeutic Gazette.

THE TREATMENT OF BILIARY COLIC.-In the treatment of biliary colic the most important indication is to lead to the increase of the biliary secretion, so as to enable the removal of the obstruction and to force it onward into the intestine. The contraction of the bile-ducts and gall-bladder may perhaps act as auxiliaries in accomplishing this result, but the increase in the biliary secretion is the end to be aimed at.

In a paper published by Professor Sée, in La Médecine Moderne, November 6, 1890, while emphasizing the importance of the early removal of the calculus, the author shows that, in the first place, it is necessary to lessen the suffering of the patient, and that the most reliance should be placed upon a hypodermic injection of morphine, in spite of the fact that morphine itself tends to reduce biliary secretion. Antipyrin exercises little influence on the biliary secretion, but it is of little value in relieving pain. Chloral, if employed at all, should be given in enemata, while chloroform is of undoubted value, not only in relieving the pain, but also by causing relaxation and dilatation of the bile-ducts, and so perhaps facilitating the removal of the calculus. It must be recognized, however, that the indications for the use of narcotics and anaesthetics is a secondary one, and that they should be only employed with the idea of relieving pain, and so perhaps causing a relaxation of the

bile ducts, while the most attention should be directed towards the increase of the biliary secretion.

Experiment has shown that the presence of any mechanical irritation in the bile-ducts serves to increase this secretion. Of the cholagogues, turpentine is one which has certain powers, but it is difficult to employ it in sufficient dose. Nevertheless, it is to this substance that Durand's remedy owes its efficacy. Salicylate of sodium has been recognized as a cholagogue by a number of eminent experimenters, and in watery solution markedly increases the biliary secretion, especially in the amount of water contained in it. This effect persists for some hours after the use of the remedy, and at the same time, in addition to its cholagogic action, also possesses certain values as an analgesic, and should, therefore, not be overlooked in the treatment of the painful stage of the attack. Dr. Sée speaks of the results, especially obtained by Rosenberg, as to the value of olive oil in the treatment of biliary colic, and maintains that, after the administration of olive oil, the biliary secretion is largely increased, and may so assist in mechanically removing the calculus. In addition to this effect, Dr. Sée calls attention to the fact, likewise claimed by Rosenberg, that olive oil, after its administration in large amounts, leads to the development of considerable quantities of fatty acids, which are themselves capable of dissolving cholesterin. In the condition of biliary lithiasis, cholesterin is preciptated, as a consequence of the insufficient quantity of saponified fats, such as the stearate and oleate of sodium. The olive-oil treatment, therefore, gives to the system the fatty matters which were before in insufficient amount, and it is this excess of fatty bodies, which is eliminated in the stools in the form of white masses, which were formerly mistaken for calculi. From a clinical point of view, however, apart from all theory, it seems to be fairly well established that olive oil exercises a considerable action on the biliary crisis itself, and may lead to the diminution or disappearance of the pain or of jaundice. All purgatives should be avoided that have in themselves any marked energy at all, since by increasing peristaltic action they tend to increase the activity of the bile-ducts and so aggravate the patient's condition; so, also, all substances should be avoided which tend to diminish the biliary secretion, and among them the author mentions salts of potassium, calomel, iron, copper, atropine and strychnine.--Therapeutic Gazette.

COL. CHARLES SUTHERLAND, Surgeon U. S. Army, has been appointed Surgeon-General, with the rank of Brigadier-General, vice Jedediah H. Baxter, deceased. General Sutherland entered the military service August 5, 1852, as Assistant Surgeon, having been appointed from Pennsylvania. He has been in continuous service ever since, and brings to his new position as Surgeon-General a rare equipment in experience and personal fitness.-Buffalo Medical and Surgical Journal.

"PRACTICE LIMITED TO ."-We are informed by the American Lancet of December as follows: "An impression prevails that the Code of Ethics of the American Medical Association permits physicians to place upon their signs, cards, etc., the phrase, 'Practice Limited to -,' the specialty being inserted. Dr. N. S. Davis, in the Journal of the American Medical Association, says that such permission is not to be found in the Code, nor is it to be found in any resolution adopted by the American Medical Association. It grew out of the reasoning of a committee of the Association. Few desire to absolutely limit their practice to one specialty.

LONGEVITY.-The medical profession is not usually considered one favorable to extreme longevity, but a retired naval surgeonDeputy-Inspector General Robert McCormick-has just died at the age of 90. He was a pupil of Sir Astley Cooper, and was surgeon to several arctic and antarctic expeditions. His arctic and antarctic experience extended from 1827 to 1853. In the former year he accompanied Sir Edward Parry in the Hecla in his attempt to reach the North Pole. He was chief medical officer and naturalist to the Antarctic Expedition of 1839-'43, and commanded the boat expedition in search of Sir John Franklin in 1852.

SALICIN AND SALICYLATES IN RHEUMATISM.-Haig has found that rheumatics excrete more uric acid while taking sodium salicylate than while taking salicin. This explains the superiority of the salicylate over the salicin in the treatment of rheumatism. The alkalies produce an excretion of uric acid which is less marked. Though useful, they are less efficient than salicylate of soda. All medicines which augment the formation of uric acid are injurious. Haig is of the opinion that these facts prove that rheumatism is

caused by the retention of uric acid in the organism. The uric acid being precipitated in the joints, causes them to inflame. Rheumatism and gout thus involve the same pathological process. Garrod is opposed to this view of the subject, because he has never been able to establish the presence of uric acid in the blood of rheumatics. Haig claims that this absence of the acid in the blood is due to its precipitation m the joints.-Le Bulletin Med.

MARYLAND MEDICAL JOURNAL-ITS NEW EDITOR.-We welcome to the editorial fraternity Prof. J. Edward Michael, M.A., M.D., not as one who comes on trial and who has his reputation to earn, but as a writer and teacher of ripe experience, and as a representative of the Baltimore Faculty who has aligned himself with the most advanced and progressive workers in the direction of higher education. He says in his salutatory: "The Journal proposes, so far as in it lies, to make itself a part of the forward movement, and hopes to preach the gospel of organization, in season and out of season, until the profession of our State will be able to take the place among the professions of other States to which its intrinsic merits entitle it.”

JENNER AND KосH.-Habent sua fata magistri; the reception and diffusion of Jenner's great discovery was different from that of Koch by all the differentiation between the close of the eighteenth and the close of the nineteenth centuries. Jenner, after twenty-one years spent in maturing and perfecting his idea, had to wait long, in those days of slow traveling and undeveloped journalism, before it became public property. Koch, on the other hand, has positively had to suffer from the feverish haste with which his "cure" has been caught up and applied. Vaccination had for years to struggle with opposition and distrust; the injection of the Koch liquid has been so promptly appreciated and put in practice that it is already sharing the reaction inseparable from too sanguine expectation. It is in Germany that the contrast in the fortunes of the two discoveries is most keenly felt, and Stricker's classic monograph on vaccination is appealed to for points of dissimilarity between the slow advance of the one and the "leaps and bounds" of the other. It was not till July, 1801, that the Prussian Medical Department, for the first time on the Continent, issued instructions to all

In

"Collegia Medica et Sanitatis" to give vaccination a trial. June, 1802, the same official authority lent its imprimatur to the practice, and in October of the same year the Anti-Small-Pox Vaccination Institute was established at Berlin. Popular, literature, sermons from the pulpit, dramatic representations, and copy-book aphorisms in schools, had all to be "pressed into the service," as means to awaken the public mind to the importance of vaccination. A specimen of the "Vorschriften zum Schönschrieben by which the juvenile intellect was weaned from the dread of the prophylactic innovation is the following, taken from a publication at Coburg and Leipsic in the year 1805: "Ignorant and ill-disposed people, who will neither understand nor adopt what is good, have spread abroad lies of all kinds against health-giving vaccination." At Magdeburg, about the same time: "The Cow-pox," a family scene in one act, was produced and dedicated by the author, Prof. Rambach, to Dr. Welper, as "the saviour of his children," the piece closing with the introduction on the stage of the children in question, each with well-developed vaccination marks on his arm. By such methods had the good German public, at the beginning of the nineteenth century, to be educated out of their well-grounded dread of inoculation, and into a hearty adoption of vaccination. With Koch's discovery, on the contrary, the profession is laboring to tone down a too roseate expectancy, and thinks it has scored a point when the question has come to be asked: "At what stage of tuberculosis is cure possible?" Meanwhile Koch himself, who 18 in no way to blame for the unreasoning enthusiasm his discovery has evoked, continues to perfect the system which has already cost him sixteen years' work.-Lancet.

THE SILVER LINES OF PREGNANCY.-Langdon thus summarizes a short paper in the Cincinnati Lancet-Clinic: (1) The abdominal lesions known as "ieric albicantes," or "silver lines" of pregnancy (and other abdominal distentions) are a true deformity, due to over-stretching of an abnormally nourished skin. (2) Their prevention may be accomplished by daily inunctions of olive oil, followed by gentle hand friction for about ten minutes; the treatment should begin at, or before the fourth month, bearing in mind. that prevention, not cure, is the object sought. (3) Corsets, constrictions and suspensions of clothing from waist bands are to be