The North American Review for September contains a discussion of the question "Is Drunkenness Curable?" by Drs. W. A. Hammond, T. N. Crothers, E. N. Carpenter and Cyrus Edson, which illustrates, to some extent, the divergence of views on this point. Dr. Hammond dwells, almost exclusively, on the influence of habit and opportunity in the making of drunkards. Dr. Crothers attributes over 60 per cent. of cases of inebriety to heredity, 20 per cent. to disease or injury preceding the use of spirits, 10 per cent. to brain and nerve exhaustion, 5 per cent. to bad sanitary conditions, and says that "in a small percentage the causes are obscure and unknown," evidently implying that habit, the usages of society and the moral standards of the individual have nothing to do with the matter. Dr. Carpenter takes the ground that "some men are born drunkards, some achieve drunkenness, and some have drunkenness thrust upon them."

The estimate of Dr. Crothers as to heredity can be better appreciated in connection with the context. He says. "The parents and grandparents have been continuous or excessive users of spirits, or have been insane or mentally defective, or have been consumptive, or had rheumatism, gout, or some other profound constitutional disease, before the birth of the child." In view of the frequency of most of these conditions, it may be questioned if a majority of healthy persons could not find instances of one or more of them among the six persons included in two generations of ancestors. At the beginning of this century probably, nearly the whole male population of this country, aside from those whose means enabled them to drink wine habitually, could have been properly described as continuous or excessive users of spirits.

Without questioning the reality of the causes mentioned by Dr. Crothers it seems to us that habit and custom count for a good deal more than he is disposed to admit. The overwhelming preponderance of the male sex in the inebriates of this country does not seem easy to explain on his theory. Women are as much exposed as men to most of the influences he mentions; no such difference in favor of one sex is observed in other neuroses, nor in regard to the use of opium, and other stimulants and nar

cotics, in cases in which social influences do not bear with unequal force upon the sexes. The great rarity of drunkenness among the rural population of Mohammedan countries, and its almost universal prevalence in many savage races, so soon as the opportunity is offered, its varying prevalence in different communities, and in the same community at different times, go to show that the part played by pathological conditions in the beginings of the alcohol habit is a subordinate one. The same thing is indicated by the ordinary course of inebriety. Although there are not a few instances in which a person who has previously been a total abstainer or a temperate drinker suddenly develops a tendency to get drunk, as a rule the drunkard begins as a moderate drinker, and the habit grows on him, like other habits, until it becomes one of excess.

The question of the curability of drunkenness is of much less importance than its preventibility. A state of public opinion that would make the sale and consumption of alcoholic drinks thoroughly disreputable would do more than anything else to put an end to the evils of intemperance. Many excellent people would consider the remedy worse than the disease. Journal of Am. Med. Asso'n.

APHORISMS IN MEDICAL EMERGENCIES.-Accidents in Giving Anaesthetics.-Tincture of digitalis hypodermically; draw out the tongue, and see that respiration is not mechanically impeded; invert the patient quickly and temporarily; use forced respiration promptly; apply external warmth and stimulation to the surface; avoid the exhibition of alcohol.

Angina Pectoris.-Inhalation of chloroform, or of a few drops of nitrite of amyl; 10 grain of nitro-glycerine, internally; placing the feet in hot water; mustard to the præcordial region; dry cup between the shoulders; hypordermic injections of morphine and atropine; administration of stimulent and anodynes.

Apoplexy.-Elevate head and shoulders; if pulse is moderately strong and the brain congested, bleed from the arm freely, sixteen ounces or more; elaterium (grain 1-6) or croton oil, two

drops, in a drachm of sweet oil or glycerine; cold to the head by means of an ice-bag.

Asphyxia.-In drowning, hold the patient's head downward for a few seconds. In hanging or choking, bleed from the jugular. If there is obstruction to passage of air through mouth or nose, open trachea. Artificial respiration at ouce, and to be continued. Friction, warmth, warm bath (100°), ammonia to nostrils, galvanizing of phrenic nerve.

Asthma, Spasmodic.-Hypodermic injection of atropine into the nape of neck; inhalation of smoke of stramonium leaves; fluid extract of nux vomica; internally, alcohol, ether, chloral, opium; inhalation of chloroform cautiously administered.

Colic, Gall.-Morphine hypodermically; inhalations of chloroform; hot applications to the abdomen.

Coma.-Dark room, head high and cool; head shaved; low diet; croton oil; if due to compression, antiseptic trephining; if due to uræmia, pilocarpine and hot baths.

Heat-stroke. Remove clothing, sprinkle with water, cold cloths to head, hot cloths to feet; antipyrin; bleeding, in robust subjects. After temperature is reduced, give alcohol and diffusible stimulants, hypodermically if necessary.

Pulmonary Hemorrhage.-If severe, raise the thorax, administer opiate; gallic acid, fifteen grains every fifteen minutes; ergotin, five to ten grains hypodermically two to three times daily; ice-bags to the chest; as a last resort a ligature may be thrown around the larger limbs. (Tyson.)

Hemorrhage from Stomach or Bowels.-Tannic acid ten to fifteen grains if due to capillary oozing. If from typhoid fever or ulcer of the stomach, treat as for pulmonary hemorrhage.

Hiccough.-Acid drinks, cold douches, ether or chloroform internally, externally, or by inhalation; musk, opium, antispasmodics.

Hysteria.-Inhalations of ether or chloroform for the spasms. If this is contra-indicated, give mono-bromide of camphor, musk, valerian, assafoetida, the bromides. In convulsive seizures, morphine and atropine hopydermically.

Shock.-Warmth; hot water bottle to feet, flanks and epigastrium; warm affusion to head; horizontal position; frictions, stimulants, brandy, ammonia, galvanism to precordia.

Strangury.-Vesical, hypodermic injection of morphine, to be followed by other remedies; rectal enemata of starch water and laudanum, followed by a hot sitz bath.-E. J. Kempf, M. D., in Amer. Prac. and News.

TATTOO MARKS.-According to Variot, a French authority, the proper way is to wash the part with a concentrated solution of tannic acid, then closely puncture it with a set of needles, such as tattoers use. A crayon of nitrate of silver is next thoroughly rubbed over the area, and after a moment the skin is dried off, when it will be found that the punctures are deeply blackened by the formation of the tannate of silver in the superficial layers of the skin. The cauterization is said to result in an inflammatory reaction for a couple of days, and subsequently in the formation of a crust or thin eschar, which separates spontaneously in from fourteen to eighteen days, leaving beneath it a superficial red cicatrix, which gradually loses its color, and at the end of a few months is scarcely perceptible. Only a small area should be treated at one time, and a dressing of powdered tannin should simply be used.-Scientific American.

IPECACUANHA IN LABOR.-While the accelerating action of ergot in cases of lingering labor is universally known and acknowledged, there is another drug which, so far as I am aware, is not noticed in works on midwifery, and which yet is capable in such cases of rendering signal service. I allude to ipecacuanha. Not only in cases of rigid cervix, where possibly it might be considered to act in a similar manner to antimony, but in cases of simple inertia, in either first or second stage, it is a potent instigator of uterine contraction.

In the course of general practice extending over many years, I invariably carried a bottle of vinum ipecacuanbæ in my midwifery bag, and rarely, if ever, gave a dose of ergot in the first

stage of labor. Time after time, on coming to a confinement case where the pains have been teeble and inefficient, or had totally ceased, two or three 10 or 15-minim doses of the wine at intervals of ten minutes, have been followed in a surprisingly short time by energetic uterine action, with a rapid termination to the labor. It never produces the quasi-tetanic contraction so often met with as the result of ergot, the pains continuing to recur regularly, just as they do in natural labor, but with greater force and at shorter intervals. Conviction of the value of the drug for this purpose induces me to give my experience of it, believing that its merits will be recognized by any who choose to give it a trial.-Drapes in Brit. Med. Jour.

BORAX FOR EPILEPSY.-Dr. Dijoud has tried this remedy in twenty-five cases, and he claims to have entirely cured one, and to have relieved all except six. The duration of the treatment varied from one to seven months, and he was able without inconvenience to carry the dose up to ninety grains a day. This was only possible if a beginning was made with small doses, which were gradually increased; and when the dose exceeded sixty grains daily, he found it advisable to add some glycerine to the water and sirup in which the drug was usually administered. The patients to whom Dr. Dijoud administered borax had been treated unsuccessfully with the bromides.-Med. Record.

CAMPHOR IN PHTHISIS.-Good results are reported from Berlin as attending the use of injections hypodermically of camphorated oil (1 in 10 of olive oil) in the treatment of phthisical patients. Fifteen-minim doses were given, and after a time these were well tolerated, night sweats, irritating cough, and expectoration being diminished in a remarkable manner, even the first dose effecting a very noticeable improvement in the patient's condition. In hæmoptysis the method also proved very useful, patients being enabled to get about again without fear of a recurrence more rapidly than under ordinary methods. The treatment also did good in bronchitis.-Scientific American.