outline it. It consists in slitting the punctum vertically downward toward the palpebral fold, in order to increase the size of the opening. Then canting the patient's head to one side, the corner of the eye is filled with an antiseptic astringent lotion. The duct should first be emptied by pressure, and then allowed to fill with this solution. This procedure of emptying and refilling the duct is repeated several times, and thus the antiseptic solution is brought in contact with caniculus, sac, and duct by capillarity and pressure. I have had cases in which, after showing the patient the method once, he has afterward practiced it himself and came back in a week perfectly cured. The method is simple and effective, and can be carried out at home. I have often wondered in those cases where probing has been employed, whether it was the probe or the antiseptic lotion that had done the good. In regard to slitting of the canaliculus, I may say that I do not do this at the beginning of the treatment. If there is narrowing of the puncta the fluid enters more readily if it is cut. DR. GEORGE Friebis:

I should like to ask whether, in the experience of Dr. de Schweinitz, he has met with obstruction due to such causes as inflammation and enlargement of the caruncle? I have in mind one case (a male adult, past middle age), in which I paid little attention to the inflamed caruncle, and the case did not improve under the routine treatment. Upon recognizing the inflammation of the caruncle as a possible cause, and treating it with astringents, I succeeded in curing the epiphora without further instrumental interference. DR. DE SCHWEINITZ:

I have presented this series of cases simply for the purpose of classifying one of the many varieties of lachrymal obstruction. I beg Dr. Thomas will not think that I wish to transfer the treatment of lachrymal obstruction to my friends, the rhinologists, much as I value their aid in the management of some of these cases, and I heartily agree with Dr. Thomas and with Dr. Gould, that the ophthalmological treatment of lachrymal obstruction is of paramount

importance. These cases illustrate merely certain failures in treatment when applied to the ducts alone, because there is obstruction either at the inferior end of the duct or from intra-nasal lesion. I have not intended this evening to include the large number of cases due to obstruction in the caniculus from polypi, from tear-stones, from fungus, or to the obstruction high up, or to those which result from conjunctivitis and from malposition of the punctum lachrymale. Dr. Fox's observation in regard to asymmetry of the face is an important one, and deserving of much study. In regard to the use of large probes, I might not find myself in accord with Dr. Fox. Abnormal position of the canula or its enlargement, as referred to by Dr. Friebis, is an interesting anomaly. You are all familiar with the cases reported by Von Graefe and by Horner. I have some knowledge of a similar case occurring in the practice of Dr. Wallace, of this city. Cases of this character, or others which have been brought up into discussion, have been purposely omitted in the paper of this evening. My idea was simply to show that certain examples exist, and they are not infrequent, which can be treated better with than without the aid of the rhinologist.

TOO EARLY DEVELOPMENT OF THE

SEXUAL ORGANS IN A CHILD.

At a late meeting of the Paris Academy of Medicine, M. Crivelli (Wiener klin. Wochenschrift, July 24, 1890) showed the photograph of an eighteen months'-old girl whose genital organ presented a degree of development such as is usually found at the age of eighteen. The mammæ and the nipples were also well developed; the mons veneris covered with lanugo, the clitoris being also very large. By investiga tion, Crivelli found out that the child was addicted to masturbation. menses had appeared regularly since three months, and lasted from three to four days. Before the appearance of the menses, the child feels sick for about twenty-four hours.-Annals of Gyna cology and Pediatrics.

The

Translations.

PARISIAN MEDICAL CHIT-
CHAT.

COLLATED FROM VARIOUS SOURCES
BY T. C. M.

How to Secure a Medical Practice
While Young.

Once provided with a diploma, the young physician asks himself how he shall open his way to the world of science and the confidence of the public, his future patients. If he is rich, or supported by powerful friends, he will at once proceed to compete for the hospital positions, and, in waiting the result of his concours, he will also long for rich patients with due patience, sustained by the comforts afforded by his personal fortune, or outside aid, or, perhaps, a fat commission from some learned professor to whom he renders service. We know what services are often rendered to men known to science, how books, memoirs and reports are written for those who cannot write, but who bravely sign their names after simply glancing over the proofs prepared for them.

If our young practitioner has no ambition, and is absolutely pressed by material wants, he will bury himself in some remote village, where he will take to "mule riding, and almost die with hunger and fatigue," according to our old friend Amadee Latour. Finally, if our young friend" feels gnawings in his belly," and recoils before the dark perspective of rural interment, if he has some ambition, he will plunge into the Parisian ocean. That is to say, that per fas et nefas he will dive after that which is so often inaccessible, which we call a practice. How secure a practice in Paris?"That is the question." Some young doctors innocently wait for patients to ring their door-bell, putting out the sign, for instance:

DR. XAVIER BILLET.
Consulting Hours 2 to 4 O'clock.

They may remain not only from two to four o'clock, but all day, often with

out seeing a patient. Life becomes a burden, and the inexorable landlord demands his rent promptly each month. Some more pushing young doctors seek the crowded quarters and cultivate the acquaintance of concierges and porters, or loaf around some drug-store, and finally, after ten or fifteen years of constant struggle, manage to secure a living practice. Their "ideal," which is to have a comfortable neighborhood practice, is realized.

All these types of young physicians are curious. What good is there in running for eight or ten years after hospital and other competitive positions, waiting patiently for a practice that never comes? Or which, when it comes, makes stair climbing each day tiresome, an ascension from one floor to another an incalculable number of floors? It is better for the young men to pose before the public earlier, and they can achieve quick success by conquering a practice before dying of old age, by securing early fame either as surgeon or gynæcologist. My neighbor, Dr. Brissay, reveals the method of securing an enormous business. He sent all over Paris the elegant card that follows: DR. BRISSAY, No. 39 Boulevard Haussmann. Mondays, Tuesdays, Thursdays, Saturdays.

Office Hours 3 to 5 O'clock.

SIR: I have the honor of informing you

that my office for medical consultation is open from 3 to 5 o'clock every day, except Wednesdays and Fridays. I perform surgical operations, and attend sick persons at their own Yours very respectfully, homes, if desired. DR. BRISSAY.

To this circular is added a bristol

board card informing people that Dr. Brissay is a specialist, not only in surgery, but especially as to diseases of the urinary passages and diseases of women. But this is not all. Dr. Brissay adds to this a small tinted sheet of note paper containing a printed enumeration of his works. These we learn can be purchased from Doni, Place de la Odeon. Thus one is entitled:

FRAGMENTS OF OPERATIVE SURGERY. By Dr. T. A. Brissay. Complete with Notes Made on a Scientifie Mission by the French Government in

Austria and Germany; with Forty-Three Plates Included with the Text. This work has been highly eulogized by Dr. Peraige in the Surgical Review.

Then follows a long list of other works by the same author.

Thus Dr. Brissay introduces himself to the public. In place of losing ten year's time, and waiting for patients who never come, unless they know that you are living, and not hiding your light under a bushel, this young doctor expends a few hundred francs in printing circulars, of which he issues a number of thousand. He rents a handsome office in a rich neighborhood, and has secured an enormous business.

Here, young man, is a method of securing business, perfectly legitimate, although some sticklers think that the dignity of the medical profession loses some of its prestige. But what difference does that make to Dr. Brissay? Living on the dignity of the medical profession will never give any man bread and butter. Brissay collects his cash and is happy. This new fad of self-advertisement originated in America, and is now quite the fashion in France, although it has not obtained all

the success it merits.

THERAPEUTIC NOTES

FROM FRENCH, GERMAN AND ITALIAN

JOURNALS.

TRANSLATED BY

F. H. PRITCHARD, M.D., NORWALK, O.

CAMPHORIC ACID IN PHTHISIS
AND CYSTITIS.

Dr. Bohland (Gazzetta medica di Roma, No. 24, 1891) has used camphoric acid in the night-sweats of phthisis, and, like Combemale, has gotten good effects. It is preferable to atropine; it is less toxic, and has none of the inconveniences. It is rapidly eliminated by the urine, hence it must be given one to two hours before the sweats begin (see LANCET-CLINIC, Vol. II, 1891). The oxide of zinc, in pill form, a grain or two to each pill, is a favorite English prescription. camphoric acid must be given in doses of one to five grammess (fifteen to seventy-five grains), and in one dose. It also arrests the diarrhoea; the number of stools is not only decreased, but the pain of the tuberculous enteritis is also decreased. Other diarrhoeas are also favorably influenced by it

The

BLACK EYES, ETC.

arnica and the acetate of lead in the

urine it acts well in cystitis, arresting ammoniacal fermentation and favorably

HEMORRHAGE AFTER COCAINE IN TONSILLOTOMY AND EXTRACTION OF TEETH.

Dr. Buisseret (Revue de Laryngologie, No. 22, 1891; Med. Neuigkeiten,

COSIS OF THE SKIN AND

SOFT PARTS.

vaso

Dr. Köttnitz (Deutsch. med. Woch enschrift; Med. Neuigkeiten, No. 48, 1892) recommends in actinomycosis of the skin and soft parts the employment of the nitrate of silver in substance,

with the greatest confidence. He has used this remedy in four cases of actinomycosis of the skin and soft parts of the

THE CINCINNATI

long-lasting fistulæ, and cured his patients. In one case recovery has been lasting for three years; in the other three a year to a year and a half. They all presented carious teeth on that side of the mouth.

A SPECIFIC FOR SCARLET
FEVER.

Dr. Vidal (Medicinische Neuig keiten, No. 48, 1892) has used liquor ammonii acetici in large doses with good results in the treatment of scarlet fever. He advises as a dose one gramme for each year of the patient's age, yet, in adults, thirty-five grammes (one and a fourth ounces) must not be exceeded. It may be administered in elder-flower infusion. This remedy rapidly reduces the temperature, especially when employed early. It is an extremely useful remedy in any eruptive fever.

No subject can be of greater practical importance to mankind than this. All must eat, and each one desires to have food that is pure and free from contamination; he especially desires to know what it is he eats. It would simply be a work of supererogation for us to call attention to the necessity of being furnished with pure food, and such is not the intention of this article: we desire to call our reader's attention to the bill which has been introduced into Congress, and which has passed the Senate, entitled "An Act for Preventing the Adulteration and Misbranding of Food and Drugs, and for Other Purposes."

So far as we can judge from the information at hand the bill is the offspring of Alexander J. Wedderburn, Chairman of the Legislative Committee of the Virginia State Grange, and he certainly seems to be very much in earnest about the measure.

The bill is too long for us to print

The first section provides for the organization, in the Department of Agriculture, of a section to be known as the food section of the chemical division. The work shall be under the direction of the chief chemist, whose duty it. shall be to procure, from time to time, under the rules, and analyze or cause to be analysed or examined, samples of food and drugs offered for sale in any State or Territory other than where manufactured, or in a foreign country. These samples must be in original or unbroken packages.

In case of drugs:

First. If when sold under or by a name recognized in the United States Pharmacopoeia it differs from the standard of strength, quality, or purity according to the tests laid down therein.

Second. If when sold under or by a name not recognized in the United Pharmacopoeia, but which is found in some other pharmacopoeia or other standard work on materia medica, it differs materially from the standard of strength, quality, or purity according to the tests laid down in said work.

Third. If its strength or purity fall below the professed standard under which it is sold.

Fourth. If it be an imitation of and

any article known to be adulterated or misbranded, and provides a penalty of fine and imprisonment for such offenses. The third section provides for the taking of samples and analyzing of the same under the direction of the chief

chemist.

Section four relates to the duties of district attorneys in regard to this bill. We print sections five and six in

full:

SEC. 5. That the term " drug," as used in this act, shall include all medicines for internal or external use. The term "food," as used herein shall include all articles used for food or drink by man, whether simple, mixed or compound. The term "misbranded," as used herein, shall include all drugs, or articles of food, or which enter into the composition of food, the package or label of which shall bear any statement purporting to name any ingredients or substances as not being contained in such article, which statement shall be false in any particular; or any statement purporting to name the substances of which such article is made, which statement shall not fully give the names of all the substances contained in such article in any measurable quantities.

SEC. 6. That for the purposes of this

article.

In the case of food or drink:

First. If any substance or substances has or have been mixed and packed with it so as to reduce or lower or injuriously affect its quality or strength. so that such product when offered for sale shall be calculated and shall tend to deceive the purchaser.

Second. If any inferior substance or substances has or have been substituted wholly or in part for the article, so that the product, when sold, shall tend to deceive the purchaser.

Third. If any valuable constituent of the article has been wholly or in part abstracted, so that the product, when sold, shall tend to deceive the purchaser. Fourth. If it be an imitation of and sold under the specific name of another article.

Fifth. If it be mixed, colored. powdered or stained in a manner where by damage is concealed, so that such product, when sold, shall tend to deceive the purchaser.

Sixth. If it contain any added poisonous ingredient or any ingredient which may render such article injurious to the health of the person consuming it.

Seventh. If it consists of the whole or any part of a diseased, filthy, decomposed, or putrid animal or vegetable substance, or any portion of any animal unfit for food, whether manufactured or