Rabuteau's Dragees of Iron Laureate of the Institute of France. The studies made by the Physicians of the Hospitals have demonstrated that the Genuine Dragees of Iron of Rabuteau are superior to all other preparations of Iron in cases of Chlorosis, Anemia, Leucorrhoea, Debility, Exhaustion, Convalescence, Weakness of Children and the maladies caused by the Impoverishment and Alteration of the Blood after periods of fatigue, watching and excesses of any kind. TAKE 4 to 6 DRAGEES DAILY. Rabateau's Elixir of Iron is recommended to those persons who may be unable to swallow the Dragees. Dose-a small wineglassful with meals. Rabuteau's Syrup of Iron is specially designed for children. Chalybeate medication by means of Rabuteau's Iron is the most economical and the most rational known to therapeutics. No constipation, no diarrhea, complete assimilation. TAKE ONLY THE GENUINE IRON OF RABUTEAU OF CLIN & CO., Paris. CAPSULES Mathey-Caylus With Thin Envelope of Gluten. Containing Copaiba and Essence of Santal; Copaiba, Cubebs, and the Essence of Santal; Copaiba, Iron, and the Essence of Sanal. "The Mathey-Caylus Capsules, of the "Essence of Santal, associated with the Bal"sams, possess an incontestable efficacious"ness and are employed with the greatest "success for the rapid cure of old or recent "Discharges, Gonorrhea, Blenorrhea, Leucor"rhoea, Cystitis of the Neck, Urethritis, Catarrh, "and other diseases of the bladder, together "with all affections of the Urinary Passsages. "Thanks to their thin envelope of "Gluten, which is essentially assimilable, "the Mathey-Caylus Capsules are digested "by the most delicate persons and never "weary the stomach." (Gazette des Hopitaux de Paris.) PARIS - CLIN & CO. - PARIS AND OF ALL DRUGGISTS. SOLUTION OF THE SALICYLATE OF SODA OF DOCTOR CLIN. Laureate of the Paris Faculty of Medicine (MONTYON PRIZE). Dr. Clin's Solution, always identical in its composition and of an agreeable taste, permits the easy administration of pure Salicylate of Soda, and the variation of the dose in accordance with the indications presented. "The Salicylate of Soda used by Clin is "of perfect purity, and is prepared with "the greatest care; it is a medicament in "which we may have every confidence."(Paris Society of Medicine, Meeting of Feb. 8th, 1879.) Clin's Solution, very exactly mixed, contains: 2 grammes of Salicylate of Soda per tablespoonful, 50 centigrammes of Salicylate of Soda per teaspoonful. PARIS CLIN & CO. — PARIS AND BY ALL DRUGGISTS. NEURALGIAS. PILLS OF DR. MOUSSETTE. The Moussette Pills of aconitine and quinium, calm or cure Gastralgia, Hemierania, Headache, Sciatica and the most obstinate Neuralgias. "The sedative action exerted by the "Moussette Pills upon the apparatus of the "sanguineous circulation by the intermedi"ation of the vaso-motor nerves, indicates "their use in neuralgias of the trigemini "nerves (fifth pair), congestive neuralgias, "and painful and inflammatory Rheumatismal "affections. "Aconitine produces marvelous effects. "in the treatment of facial neuralgias when "they are not symptomatic of intracanial "tumor.' (Society of Biology of Paris, meeting of the 28th Feb. 1880.). DOSE: Take 3 to 6 pills during the twenty-four hours. ACCEPT ONLY THE CENUINE MOUSSETTE PILLS OF CLIN & CO., Paris. E. FOUCERA & CO., Agents for the U. S., NEW YORK. In Corresponding with Advertisers, please mention THE LANOFT-CLINIC. PHILLIPS' COD LIVER OIL EMULSION. Please compare this with any similar preparation in Minute Division-Perfect Emulsionizing of the Oil— THE CHAS, H. PHILLIPS CHEMICAL CO., 77 Pine St., New York. THE CINCINNATI Tancet-Clinic A Weekly Journal of Medicine and Surgery. ESSENCE OF PEPSINE (FAIRCHILD) Ingredient of the GASTRIC JUICE Extracted Directly from the Peptic Glands of the Stomach. See Advertisement ❝ VIN MARIANI" on Insert page xii. Apollinaris "THE QUEEN OF TABLE WATERS." "Much favored by her Majesty." -WORLD, LONDON. - BRITISH MEDICAL JOURNAL. "Cosmopolitan." "Cheap as well as good." "The demand for it is great and increasing." Pamphlets address CHARLES GRAEF & CO.. 32 Beaver St., New York. -THE TIMES, LONDON. See Advertisement BAT TLE & CO. last cover page. What is Kumysgen? It is Kumyss in a dry form, containing all the constituents of the best Kumyss, and requires only the addition of water to produce an article superior in digestibility and palatability to the old form of Kumyss. It is the Ideal Food in all cases where nutrition is an important factor, and digestion is feeble. Kumysgen is the only preparation of Kumyss that will keep. All liquid preparations of Kumyss will keep but a short time, and are constantly changing in the bottle, unless some deleterious preservative is used. Kumyss made from Kumysgen is far more palatable, easier digested and 35 per cent. less expensive than the old style Kumyss. Our Syphon Kumysgen Bottles allow Kumyss to be drawn without loss of contents. A pamphlet containing a careful compilation from the best authorities of the results obtained from the use of Kumyss in the treatment of various diseases, mailed free on request. MANUFACTURED ONLY BY REED & CARNRICK, New York. In Corresponding with Advertisers, please mention THE LANCET-CLINIC THE CINCINNATI LANCET-CLINIC: A WEEKLY JOURNAL OF MEDICINE AND SURGERY. New Series Vol. XXIX. LIC CINCINNATI, Nov. 5, 1892. Whole Volume LXVIII. Addresses. A REVIEW OF SOME RECENT The Address in Medicine before the Missis- BY H. A. HARE, M.D., Professor of Therapeutics in the Jefferson Medical Mr. President and Gentlemen: 66 now too fast to permit us to keep up To deliver an address in medicine The first of these to which I wish to before so distinguished a body of prac- draw your attention is a method of tising physicians as the Mississippi resuscitation in emergencies arising Valley Medical Association is a task during anæsthesia produced by chlorowhich may well cause elation at the form or ether. In all standard texthonor conferred, and fear lest one may books we are told that a battery should be unworthy of so high a place. For be at hand during every operation, and, the moment I regretted that I had in the event of respiratory failure, one accepted the invitation of your honor- pole should be placed over the phrenic able President, for I remembered the nerve in the neck and the other in the words of our medical father Hippo- hand or elsewhere on the patient's body. crates, Rashness is evidence of un- Thus Joseph Mills, in the article on skillfulness." However, a second aphor-"Anæthetics," in Treve's "Manual of ism of Hippocrates urged me to my fate,-"Timidity indicates incapacity." I shall not attempt to-night a complete summary of the advances made in medicine during the past year, since such an attempt must fail for lack of time at my disposal in addressing you, nor shall I weary you with a dissertation on the well-worn subject of medical education or the history of medicine. With your permission I may be allowed to point out several important facts, which must modify our treatment of certain conditions dangerous to life. It is one of the misfortunes of the day that, whereas the progress of medicine was for many years too slow, it is Surgery," directs that in chloroform accidents "the faradic current be applied, one pole to the epigastrium, the other to the right side of the neck, to try to induce the diaphragm to act." I have seen this method resorted to again and again by the ablest surgeons this country has produced, men whose methods in general and whose reputation would justify any one of us here to-night in following their customs; yet a moment's thought as to the action of the faradic current in the rapidly interrupted form in which it is always employed, shows us at once that to use it is to attempt to achieve something of no value. The respiratory movements of that greatest of respiratory muscles | against the region of the phrenic and -the diaphragm-are to and fro,-a pneumogastric nerves. muscular contraction, like all other The next point to which I wish to muscular contractions. Every one call your attention is the limitations of knows that a muscle firmly contracted the treatment of anaesthetic narcosis in in a tetanic rigid spasm by the applica- so far as posture is concerned. tion of a rapidly interrupted current is become a favorite custom with many to as useless as is that same muscle when invert partly or completely any patient relaxed by the over-action of a drug. whose respiration or circulation fails What we desire under such circum- during anæsthesia. It goes without stances is a slow contraction and relaxa- saying that this is only justifiable when tion of the diaphagm, such as we see in heart-failure is shown by marked facial health, and the nearest approach to this pallor. If the respiration is at fault, is, theoretically, to be obtained by the we should carefully avoid any inversion, current which is slowly interrupted. because the presence of still more Practically, however, we find that both venous blood about the already exof these currents are worthless and, hausted respiratory centre cannot aid it, worse than worthless, are dangerous. but only injure it. Further than this, In the first place, it is impossible to by inversion we may distinctly interfere influence the phrenic nerves by any but with the respiratory act by compression strong currents, for the resistance offered of the diaphragm through displacement by the cervical tissues is too great for of the abdominal viscera. The fact is feeble currents to penetrate them. In particularly true in persons with large the second place, it is easier to stimulate pendulous abdomens, or in persons who the pneumogastric nerves by such a have recently suffered or are suffering procedure than than to influence the from tumors of the abdomen. By means phrenic nerves; and, finally, stimulation of these growths the antero-posterior of one phrenic nerve, as directed by and lateral diameters of the chest in the most authors, only results in a contrac- neighborhood of the floating ribs are tion of one-half of the diaphragm. In greatly increased, and the diaphragm is conjunction with Dr. Martin, I have stretched and becomes more sail-like. proved that these opinions are no idle Thus I have seen death follow the theories, as the tracing which I have removal of a large ovarian tumor fortythe honor to show you will indicate. eight hours after the operation, because Here you will notice that, though the the diaphragm, having no points of phrenic nerves were unaffected, the resistance on which to contract, because pneumogastrics were sufficiently stimu- of the collapse of the lower part of the lated to inhibit the action of the heart, chest, simply rose and fell like a sail of and if this inhibition had been added to a vessel coming about,-a useless organ, the depression due to the prolonged use encroaching on the chest cavity during of an anææthetic, or to engorgement of inspiration, and descending in such a the ventricles, it can readily be seen way on expiration that little air passed that death might have resulted at once. out of the trachea. If any of you will I am told by many that they have used place a rabbit under ether or chlorothis method which I have condemned form, when tied flat on its back, so that with great success. My answer to this its ponderous abdomen encroaches on is, that the results obtained, while its comparatively small chest, you will desirable, were reached inadvertently, find that respiratory death quickly not directly, that is to say, the appli- ensues, whereas in the erect position cation of a peripheral irritant to the this does not occur. The pictures skin caused a reflex respiratory gasp which I show you in this connection similar to that seen when a cold wet are taken of a rabbit held in such a way towel is applied to the abdomen. as to emphasize the movement of the Equally good results would be obtained abdominal contents in cases where these if the electrodes were swept over the viscera are large and movable. abdomen and chest, and not pressed Another point of very great import |