in consequence of the suppuration; very soon a scrofulous ophthalmia of both eyes followed with these symptoms: both eyelids oedematous, conjunctiva palpebræ and bulbi reddened, the eyelids at times glued together, great photophobia and excessive lachrymation. Digestion was good, and the child felt well otherwise, only the boy, who was formerly so sprightly, was now not only dull, but also irritable and quarrelsome. Cured by Graphites 2

Hirschel remarks that Graphites corresponds to both forms of this scrofulous affection. In relation to the ophthalmia we have: heat in the eyes, sensation of biting, as if from something acrid; swelling of the eyelids, redness and painful inflamation, burning, biting and itching in the corners of the eye, accumulation of pus, redness, inflammation and boils of the eyes, morning agglutination; dry secretion of the meibomian glands on the eyelids, great, unbearable sensitiveness to the light.

Hartlaub distinctly remarks: Graphites open the swollen photophobic eyes of scrofulous children, with simultaneous crusty eruption of the face. In relation to the eczema Graphites is especially serviceable when occurring in the face, nose, lips, etc., with painfulness and moisture below the crusts; crusty ulcers, crusta lactea, especially the scrofulous habit with lymphatic cedema, blonde hair, pale face, depression of spirits, etc.

A boy five years old, badly nourished, who had passed through a scrofulous gonitis, which left him with a deformed knee, was attacked with a severe scrofulous ophthalmia of the left eye. For weeks he was unable to open it; hot tears escaped immediately after each trial; the neighboring integument was surrounded by small phlyctænæ, and small pustules; eruption over the whole face; perceptible aggravation from crying or rubbing. Calc., acid nitr., sulph., etc., brought only transient amelioration; relapses always took place, when three symptoms led us to the selection of Graphites: the intense photophobia, with 'simultaneous nightly agglutination of the eyes, the obstinate constipation of the little patient, the rhagades around the corners of the mouth. Received Graphites,2 a few grains every morning, and its beneficial effect was most astonishing, for after one week the boy was well.

EXANTHEM AROUND THE NOSE. A girl of eleven had for eight weeks an herpetic eruption around the nostrils, accompanied by a characteristic scrofulous ophthalmia, with redness, photophobia, and lachrymation, swollen lips, swollen nose, with fluent coryza Graphites,12 three drops in a glass of water, morning and evening, a teaspoonful, removed all those symptoms in a week, but caused an erysipelas of the right cheek, with headache; after desquamation of the affected part she was perfectly well.-H. GOULLON, JR. · Translated in N. H. Jour. Hom.

TRAVELLING WITH THE MEASLES. This advertisement appears in the London Times: "Should this meet the eye of the lady who got into the 12.30 train at New-cross Station on Friday, May 15, with two boys, one of whom was evidently just recovering from an illness,

she may be pleased to learn that three of the four young ladies who were in the carriage are very ill with the measles, and the health of the fourth is very far from what her relations could desire." It would be difficult to imagine anything more delicate. — Sanitarian.

DIPHTHERIA. In the nasal form of diphtheria, a sanious discharge from the nose attracts attention, after some febrile disturbance of a low type. The glands about the angle of the jaw begin to swell, the arches of the palate and tonsils become red and swollen, muco-purulent fluid bubbles in quantity from the narrowing isthmus of the fauces. After a few days the disease may partially subside, or it may rapidly spread to the larynx and pharynx. This form, most common among children, resembling in its early stages a severe form of influenza, is very apt, by the physician who does not take sufficient time to examine his case, to be mistaken for that disease, until the golden opportunity for correct action may be lost. — Jenner, quoted in Med. Union.

GUARANA. In Parry's Food and Dietetics, we find Guarana noticed as follows (pp. 351, 352): "It is used extensively in Brazil, Guatemala, Costa Rica, and other parts of South America as a nervous stimulant and restorative, and also as a refreshing beverage. According to late reports, 16,000 lbs. are annually exported from the city of Santarem.

"The fruit, which is about the size of a small walnut, contains five or six seeds. The seeds are roasted, and, after being pounded, are made into a thick paste with water, and formed into round or oblong cakes, which are dried in an oven or by the heat of the sun, and called guarana bread. The cakes are scraped or grated when required for use, and the powder produced possesses a light-brown color, an odor faintly resembling roasted coffee, and a bitter, astringent taste.

"It contains, in addition to empyreumatic oil (developed by the process of roasting) and tannic acid, a substance called guaranin by Theodore von Martins, but shown by Dr. Stenhouse to be identical with thein. This alkaloid is stated by Dr. Stenhouse to be present to the extent of 5.07 per cent, or, according to the results of the same observer, to the extent of twice the amount contained in good black tea, and five times that contained in coffee; the actual figures given for tea being 2.13 per cent, and for coffee, 0.8 to 1.0 per cent. For Paraguay tea, the amount mentioned is 1.25 per cent.

Guarana is used in South America, to some extent dietetically, but chiefly therapeutically. as a stomachic and febrifuge, and as an astringent in catarrhal diarrhoea and dysentery. It is either eaten with cassava or chocolate, or taken as a drink in sweetened water. In the United States it is employed as a nervous stimulant and restorative, and attention was directed to it some years ago in France, by Dr. Gavrelle, who had held the post of physician to Don Pedro of Brazil. "Alcohol, it is stated, forms the only agent which completely extracts its active principles. Ether and water only do so imperfectly. A watery infusion, therefore, will fail to possess the virtue belonging to guarana.

"Guarana appears for some time to have enjoyed a high repute in

France as a remedy for migraine, or sick-headache; and attention has been recently directed to its employment for this purpose, in Eng and, by my colleague, Dr. Wilks. Articles upon the subject have appeared during the year 1872, in the British Medical Journal, and another article, by Mr. M. C. Cooke, is to be found in the Pharmaceutical Journal (third series, vol. 1, p. 221). From these sources the author's information has been chiefly derived. The experience that has been collected shows that in some cases of sick or nervous headache, it affords the most marked relief, whilst in others it proves utterly useless."

A. J. Eidson, M.D., contributes to the American Medical Weekly, the following:

"In the spring of 1870, while I was practising in Schuyler County, Ill., Colonel Dutton brought with him a quantity of guarana from South America, which he said was used by the natives as a beverage, prepared similarly to coffee. They also used it to prevent sleep and maintain their powers of endurance when on long journeys and deprived of food.

"A further trial proved that its effects were to keep up the strength, prevent exhaustion, headache, hunger, and sleep; producing a slight exhilaration of mind, replacing despondency with hope and cheerfulness; and it accomplished all this without the individual being conscious of any drug result he felt perfectly natural, but remarkably well and fresh. My location, at that time, was in a highly malarial district, and I was suffering from frontal neuralgia and chills, and had worn out quinine, arsenic, and most of the anti-periodics. While using guarana I had neither. The supply of the medicine becoming limited, and not knowing that it would ever be in the general market after once exhausted, I was not disposed to experiment much further, and will only mention two cases of opium poisoning treated successfully with it one was a child a year old, to whom an overdose of tincture of opium had been given; the other, a young lady who had taken four or five grains of sulphate of morphia, with suicidal intent.

During the last few months, I have used the fluid extract of guarana with good effect in spinal irritation, hysteria, delirium tremens, hypochondriasis, and migraine. I have cured one obstinate case of chronic diarrhoea associated with sun-pain, in an old person, when everything else failed. The medicine was used as a drink, prepared from lump guarana, as coffee, and taken with the meals three or four times a day. All other medicines were discontinued. I have also used it in stupor, occurring in a case of typhoid fever, with complete success in forty-eight hours. In sick-headache it is the remedy par excellence, and if it had no further application, it is as indispensable in the list of curative means as any that we possess."

PERSONAL.

As Dr. Ira Barrows, a leading physician of Providence, was riding this morning in a top buggy, the forward axle broke, the horse ran away, and the doctor was thrown out. A hook on the carriage top caught in his eye and tore it completely out.

REVIEWS AND NOTICES OF BOOKS.

Books sent to THE GAZETTE for notice will, after suitable examination and criticism, be presented to the College Library, where they will be accessible to the profession under the rules of the library.

CLINICAL LECTURES ON DISEASES OF THE URINARY ORGANS. Delivered at University College Hospital, London, by Sir Henry Thompson. 2d Am. from 3d English Ed. Philadelphia, Henry C. Lea. To have passed through three editions at home and two abroad, within the short space of five years, is not of necessity a proof of transcendent merit even in a medical work, but to have attracted the attention of the best in the profession, to have met with their almost unanimous praise, and thus to have found its way so speedily and extensively to the lower strata of practitioners, is evidence of true value which no one can reasonably doubt.

The work before us belongs to the few which have fallen at once into the places they were intended to fill: firstly, because there was a place to be filled; and, secondly, because it has proved especially qualified to fill it. It has been so favorably noticed by the medical press, and is already so widely known, that it would be a work of supererogation on our part to add our own praises at this time, were it not that thoroughly good and reliable books are really very much more rare than we are generally led to suppose; and that physicians, although they are not permitted to swear by any authority, invariably, or nearly so, seize upon, clutch to themselves, and defend tooth and nail whatever teachings may fall in their way during the more plastic years of their professional lives. It is the duty of the press, therefore, to keep before men's eyes the best works of the day, and to sink out of sight and out of mind as speedily as possible the trash with which we are nearly overwhelmed.

Sir Henry Thompson, one of the foremost of living British surgeons, -and the foremost of any land may always be counted with ease on the fingers of the hand, - is qualified to speak on the subject of the book as are few others to-day. This may be inferred from the interest with which the reports of these lectures, as first published in The Lancet, in 1868, were read both in England and on the Continent, and also from the fact that a number of the ablest surgical works which have appeared since the date mentioned in treating of diseases of the urinary organs bear evidence of having drawn many of their best inspirations from this source. As the author has already placed his mark deeply and lastingly upon modern surgical science and art, we are conscious of bringing nothing new to professed surgeons while speaking of this work in terms of commendation; but among that large class of physicians in this country who are not in the habit of calling in surgical aid whenever the catheter has to be passed, and who are so placed that they could not do so if they would, there must

be many who are casting about for a reliable treatise on the subject in question, and their attention, more especially, we are desirous of calling to the work before us.

In this connection we cannot refrain from expressing surprise that a man of so clear and philosophical a mind as Sir Henry Thompson, who is engaged in we ding out other errors besides those of his own branch of the profession, should be guilty of perpetuating terms as confusing and unwarrantable as "surgical diseases," which he declares to be the subject of his lectures, and which he vainly attempts to define without appearing to see distinctly that it is incapable of a satisfactory definition. It is one of those relics of a time when surgery was in its infancy, when surgeons were lowly, respectable members of the profession, and prohibited from treating any but a very limited class of dis

eases.

To-day, surgery is a science as well as an art, and as such it is so intimately bound up with medical science that we are no longer at liberty to speak of surgical diseases as a class distinguishable from any other, but should have it plainly understood that there is a surgical as well as a medical treatment of diseases in general, and that they go hand in hand instead of excluding each other This is mentioned here merely in passing. On some future occasion we shall have a word more to say on this subject which has wide and important bearing by no means as fully appreciated as it should be.

The more general virtues of the book may be characterized as surgical virtues, and are those of clearness, directness, and the thorough mastery of the various subjects. The absence of verbosity, of bungling, and vagueness in the diction is gratifying in the extreme, and lends a charm to the whole book which all medical students and those who are in the habit of referring to the voluminous works of the majority of writers on surgery, and we may say on midwifery and general practice, will sincerely rejoice in. The happy results of these virtues are the smallness of the volume on so extensive a subject, and the frequency with which perfect gems of expression occur in it, embodying valuable suggestions, plain rules, unmistakable directions, and careful distinctions As the author is not only a thorough surgeon, but a teacher as well, these results are gained by "the colloquial style peculiar and appropriate to the class-room," which has been most wisely and carefully retained in preparing the reported lectures for this volume.

It is impossible here to enter into a detailed consideration of the manner in which the various subjects are treated; but in order to show the scope of the work, we mention cursorily the topics of the fifteen lectures of which it consists.

The first deals generally with the diagnosis of diseases of the urinary organs, and shows how, in the majority of cases, by four leading questions, the most important facts may be gathered concerning which it is essential that the examiner, be he surgeon or physician, should be informed. Having considered the practical bearing of these questions in detail, as well as the minor extensions arising from them, the necessity for ocular inspection and physical exploration by means