tion make its appearance, accompanied with febrile symptoms, and a disordered condition of the digestive organs, such as coated tongue, failure of appetite, a vague feeling of sadness and inquietude, perhaps diarrhoea and vomiting; all of which have been most satisfactorily explained to the poor sufferer, on the theory that one must be made worse in order to be made better-that there was a fearful contest going on between the disease and its deadly enemy, the watery antidote; that the latter had got the upper hand, and in a few days, with proper patience, every remnant of disease would be effectually eradicated from the system!

Now, we are inclined to believe that this "bad sturm," as the Germans call it, whether we call it “crisis,' ," "point of saturation," or by any other term, is very satisfactory proof that the water is not suited to that particular case, and the sooner the use of the water is discontinued, the better for the patient.

The scepticism to which we have referred, has been vastly increased during the last quarter of a century, not only in our country but in Europe, by the exaggerated accounts of the efficacy of these agents in so many diseases, and the difficulty of arriving at the exact truth from so many partial and interested witnesses. Besides, the profession found no difficulty in accounting for the improvement by the change of air and scene, freedom from cares of business or the dissipations of pleasure, early hours, simple diet, and attention to the more obvious rules of health. It was the consideration to which we have referred, that led the "Royal Academy of Medicine, of Paris," to prepare a report on the

RECENTLY DISCOVERED MINERAL WATERS. OUR attention has recently been called to the subject of mineral waters, as agents in the cure of disease; and more particularly to the "Gettysburgh" (Pa.), and "Missisquoi springs" (Vt.), the waters of which have been greatly lauded of late in sundry pamphlets and advertisements—in consequence of which, they seem to have come into very extensive use in quite a variety of diseases. Now, it may truly be said that the medical evidence of the value of mineral waters in the cure of diseases is abundant, even to profuseness, in quantity, but its quality is indifferent. Indeed, here, as in medical evidence generally, the quantity is in inverse ratio to the quality; for where little is known very much is usually said and written about it; and those diseases" Mineral Waters of Vichy," to which we are really which are most obscure are most voluminously descanted upon. It cannot be denied that there is a widespread scepticism on the part of medical men, in regard to the alleged virtues of mineral waters, and it has chiefly grown out of the fact that most works that have been published on the subject have been written by interested parties-mostly, indeed, by physicians resident at the Springs themselves-knowing how easily the judgment may be influenced by self-interest. All such works are read with suspicion, and the statements made are received with considerable allowance. And in addition to this, these productions, for the most part, are among the most unsatisfactory, puzzling, and confusing of all medical, or pseudo-medical, works. The diseaseshold in solution such decided doses of medicines as we claimed to be cured are not only extremely numerous, but opposite in their very nature; so that, according to all known principles of pathology, if one class is benefited, the other ought to be made worse. We have often been amused, in reading these productions, to see how ingeniously the writers explain the cause of numerous failures, and the aggravation of the disease, under the name of "water crisis." How often have we seen, while sojourning temporarily at some of our medicinal springs-where patients have been ordered by their medical advisers to take so many tumblers of water and so many baths per day-a cutaneous erup

indebted for most of our knowledge in regard to their nature and value in different diseases. Our Academy of Medicine could not perform a more useful work than by preparing such a report on our principal mineral springs, not only as a guide for physicians, but also the public. Notwithstanding, however, the existence of this incredulity and scepticism, no candid practitioner, who carefully reflects upon the chemical composition and known action of many of our native mineral waters, but must admit that they are powerful agents, capable of producing a decided impression on the secretions, excretions, vital and morbid actions of the body. We know, for example, that some of our mineral springs

are daily in the habit of prescribing, and their action on the secretions is so palpable, that even the most sceptical must learn. Some contain active, aperient, neutral salts in such quantities as to act on the bowels or kidneys; or alkalies sufficient to keep the fluids of the body in a constant state of alkalization; or such a combination of salts in small quantities, and gas, as to act immediately on the skin or kidneys; or they are so highly impregnated with gases, such as carbonic acid or sulphureted hydrogen, whose action is sensibly experienced by any one who will submit his body to the test; or they hold iron in solution, and in that condi

tion, the state of carbonate, which all admit to be its ing the truth of these effects, they have concluded that most active medicinal form, and one retained in artifi- the failure only proves that there are many bodies of cial preparations with great difficulty. Besides, many great efficiency which escape their means of examinaof our springs are hot, and the action of heat is no fan- tion. Chaptal has truly remarked that "the dead body ciful, theoretical notion, but one of the most obvious of the water is alone acted upon."-[Annales de Chistimulants we possess; stimulating the minute cutane-mie, 28, 105.] The Commission, too, appointed under ous vessels, and filling them with red blood, thus tend- the direction of the French Government, by the Acaing to equalize the circulation and relieve internal con- démie Royale de Médecine, to report on the mineral gestions. It is well known, for example, that a single waters of France, in 1836, declare their conviction that bath of the hot waters of Vichy, which contain a con- chemical analysis has not yet added in any considerable siderable quantity of carbonate of soda and carbonic degree to that knowledge of the therapeutical effects of acid, renders the fluids of the body alkaline, even of mineral waters which the experience of their effects gouty persons, whose fluids were previously acid. We had proved before chemistry was brought to their eluciknow that the active medicinal agents referred to are dation; and they insist on the importance of taking mixed in these waters in such proportions that they act into consideration the information which the inhabitas aperients, diuretics, alteratives, and tonics, without ants of the spot can furnish.* any pain, uneasiness, or other discomfort, if taken in proper quantities, with due attention to exercise, diet, and a general observance of the laws of health.

Following this wise, common-sense rule, we find the "Missisquoi Spring," of Vermont, had the reputation in the neighborhood for many years of "curing scrofula, But what shall we say as to another class of mineral itch, salt-rheum, and other cutaneous diseases." It is waters, which are now commanding such general atten- now claimed, in the pamphlet sent us, to cure "cancer, tion, and which contain so minute quantities of saline consumption, syphilis, mercurial sores, tumors, affections ingredients as hardly to account for the powerful effects of the kidneys, cataract, dyspepsia of an aggravated attributed to them? We refer to the water of the character, general debility, and other diseases, cutaneous Gettysburgh and Missisquoi springs. In regard to the and otherwise."-[p. 3.] Judging the "Gettysburgh latter, however, we should state that we have seen no Katalysine Water," so-called, by the same rule, it has accurate analysis of it. It has no sensible properties, cured disorders of the digestive organs (dyspepsia), rheuthough it is said to contain the chlorides and carbonates matism, gout (nodosities of the joints), torpidity of the of soda, magnesia, and lime, carb. manganese, carb. iron, liver, some pulmonary disorders, as chronic catarrh, chlorine, &c. We have prescribed it in cases of cancer, bronchitis, and humid asthma. Analysis of this spring, and known it taken for a variety of affections, but with- by Prof. Mayer, of Washington, reveals the existence out any decided benefit in any. We know it is very of bi-carbonate of lithia, with bi-carbonate soda, potash, fallacious to attempt to estimate the action of medicines magnesia, iron, lime, &c., but in quantities so minute as on the body by reasoning prior to experience, however to give the water no sensible taste. Our experience in logical and clear the chain of reasoning may be. Occa- the use of this valuable water, confirms the conclusions sionally analogy favors us, but the safest plan is to begin stated by Dr. John Bell, of Philadelphia, in the Medical by experience, and then to reflect and reason on the and Surgical Reporter, May 9th, 1868, that it is a very facts which experience has furnished. The safest way, useful remedy in chronic disorders of the digestive we think, in regard to new mineral waters, is to seek organs, and the secondary derangements, as gout, rheuinformation in regard to their virtues from local tradi- matism, hepatic and renal affections, skin diseases, &c., tion on the spot; for in this way, and among the poorer consequent thereon. We have good reason also to beclasses, have the virtues of most springs been discov-lieve, from what we have seen and experienced, that it ered. It will be found that the people in the neighbor-will, by long use, remove nodosities of the joints of a hood of springs have been well aware of the kind of gouty nature. We have also seen cases of albuminuria diseases which are likely to be relieved; and we hold much relieved by it, as well as the irritable bladder of old it to be unreasonable to disbelieve this kind of experi- age, and calculous disorders of the lithic acid diathesis. ence, particularly when confirmed by the more educated Whether the solvent properties of these waters depend and scientific who have subsequently examined it, on the presence of lithia or not, we cannot say; but as merely because chemical analysis does not discover any this agent has the property of rendering the uric acid active ingredient, according to our notions, to account soluble, we think it highly probable. We are pleased for the effect satisfactorily. Can chemistry detect the to learn that the use of this water has been introduced principles which produce contagious or epidemic dis-into the New York Hospital, and that Drs. Parker, eases, or even of the milk-sickness of the breast? Can Stone and Crane, of the Metropolitan Board, are giving it tell us the cause of plague, yellow fever, and chol-it a trial in cases of gout and rheumatism. We shall The best chemists of France admit that chem- again recur to this subject in a future number of the ical analysis has not enabled them to discover in many journal. of their mineral waters, whose effects on the body are well marked, the active principle; but instead of doubt

era?

*Rapport sur les Eaux Minérales de France, etc., 1884, 5, 6, p. 58.

-THE very able letter from Prof. Ordronaux on the question of repetition of prescriptions by apothecaries without authority, to be found in another column, is one which should interest every practitioner of medicine and every pharmaceutist; and while commending it to their attentive perusal, we take occasion to heartily endorse the suggestions therein contained.

THE recent action of the American Ophthalmological Society in reference to the improper use of the title of oculist not only reflects honor upon that body, but also upon the cause of specialism. In a future number we shall discuss the general propriety of such

a movement.

Reviews and Notices of Books.

support to the tumor is advised, more especially if any obvious symptoms of hydrocephalus are present. If the tumor increases rapidly without other symptoms, repeated puncture, without the admission of air, may be cautiously tried; failing in this, injections of iodine may be employed. The number of cases in which a removal of the tumor might be contemplated, are so exceedingly rare, that practically the method is of no account. In the treatment of the allied affection, spina bifida, the author gives but very little encouragement, and seems to appreciate fully all the difficulties which stand in the way of success.

Hare-lip, simple and complicated, next claims attention, following which the whole subject of staphyloraphy is exhibited, and all the accepted methods of operating fully and clearly detailed. Extroversion of the bladder is an affection to which he devotes a very considerable amount of space, and describes an important modification to the operation devised by himself.

The operations for artificial anus and absence of the rectum are also described, together with the procedures advised for other less important malformations, where a more interesting portion of the work, because containing an account of the more common affections, is entered upon.

Part II. opens with some general considerations upon wounds, anesthetics, etc. The author declares himself for the use of chloroform, and for the suture versus acupressure; for both of which preferences very good reasons are given.

THE SURGICAL TREATMENT OF THE DISEASES OF INFANCY AND CHILDHOOD. By T. Holmes, M.A. Cantab., Surgeon to the Hospital for Sick Children, Surgeon and Lecturer on Surgery to St. George's Hospital, Surgeon-in-Chief to the Metropolitan Police, etc., etc. London: Longmans, Green, Reader, and Dyer. 1868. 8vo. pp. 642. THERE is so much valuable material scattered throughout the literature of the profession relating to the surgery of children, not readily accessible, that any attempt to collect and embody it in a systematic and compreFractures and dislocations are the subjects of the next hensive form should be duly appreciated. Such a task chapter, and their peculiarities in childhood sufficiently Mr. Holmes, an author already well known on this side pointed out. The preference is given to the gelatine of the Atlantic, has performed, and he has given us in ad-splint for the very good reason that it can be removed dition the results of his own extensive experience. Although the volume does not much exceed six hundred pages, we have presented to us a rich mine of facts which will particularly interest the practical surgeon. It is written in an attractive style, and filled with lucid descriptions.

The work as a whole is divided into three parts: 1st, Malformations; 2d, Injuries; and 3d, Diseases; the two latter being obviously of most interest to the surgeon. The first chapter of Part I. treats of Joined Twins, and presents us with a very carefully written summary of the nature of such monstrosities and some practical suggestions as to treatment. The subject of congenital innocent tumors next claims attention, their different kinds, pathological anatomy, etc.; and in chapter third we have the interesting subject of nævus written up. The different varieties are concisely described, the various methods of diagnosis pointed out, and the several modes of treatment detailed. Properly viewing nævus as an affection that is not dangerous to life, he advises treatment with the mildest means that hold out any chance for success. The respective advantages of the perchloride of iron, caustics, ligature, vaccination, etc., are fully and fairly detailed, and nothing is said that will tend to stimulate the younger surgeon to yearn for the performance of the graver operations. A very interesting case is referred to of a nævus of the back being partly cured by the friction of the clothes, showing how little sometimes is required to cause some varieties at least of this disfiguring affection to fade and perhaps eventually disappear.

Continuing the subject of Malformations, our author, in chapter IV., commences with those that belong to particular parts of the body, and speaks first of those of the head, giving us a very lucid description of meningocele and encephalocele, and pointing out the inportance of a proper diagnosis before any operative procedure is thought of. As a general rule, nothing beyond

and altered as occasion may require, especially in those cases where much swelling or pain ensues after their application. In this respect this splint has an advantage over the ordinary starch or Plaster Paris bandages, so much used in this country. Aside from the convenience of application, etc., one splint is as good as another, as in the vast majority of cases coaptation is all that is requisite, the softened bones having a preference to bend rather than break.

The question of amputation in cases of compound complicated fracture is candidly discussed, and due deference is paid to the wonderful recuperative power of nature in these young subjects. He does not consider that the most extensive laceration combined with fracture justifies amputation at an early age, unless the main vessels are also injured. "In any doubtful case the limb ought to be preserved until the onset of gangrene renders persistence in the attempt to save it no longer justifiable." In regard to the diagnosis of the "willow or green stick fracture," where of course no displacement, and sometimes deformity occurs, our author, it seems to us, does not dilate sufficiently upon the symptoms of the accident. His remarks upon the separation of epiphyses, particularly those of the elbow, are very systematically put, and some rather unusual forms of the accident referred to.

In the treatment of burns and scalds, nothing peculiar is noted except perhaps the recommendation to use the carbolic acid putty of Lister, which may combine the advantage of an antiseptic to the other applications commonly employed. The after management of these lesions may be summed up under the heads of simple extension, incision, excision, and transplantation.

Two chapters are devoted to the removal of foreign bodies from the trachea and oesophagus. A very valuable table of 28 cases of tumors of the larynx is given as compiled from the Transactions of the London Pathological Society; remarks are made upon the operations of