tion of reports, etc., into as small a compass as possible, all useless elaboration and padding being eliminated. The publishers will be glad to mail copies regularly, free of charge, to any physician who may desire to have it. We have, from time to time, gleaned valuable and practical therapeutic hints from its perusal. Address Victor Koechl & Co., 79 Murray street, New York.

Case of Intestinal Obstruction with Stercoraceous Vomiting during a Period of Thirty-six Hours-Recovery.

Near the hour of bedtime on the night of January 26, 1898, Mr. William D., of Muncie, Ind., came into the office of Drs. Puckett and Boyden and said his wife was suffering from a severe attack of neuralgia of the stomach, and left a slate call for Dr. Puckett. Dr. Puckett being out, Mr. D. secured the services of another physician, who gave the sick woman some considerable relief from pain by a hypodermic injection of morphia. On the following morning, January 27th, Dr. Puckett was again called to see the sick woman.

This lady is sixty years of age and very corpulent, and has an old ventral hernia in the line of the linea alba below the navel. Dr. Puckett found the patient vomiting stercoraceous matter quite frequently. The hernia protruded through its opening, but was returned to the cavity of the abdomen with a moderate degree of manipulation. The doctor recognized the fact of an obstruction somewhere in the small intestine, but whether at the site of hernia or elsewhere he was not certain, but believed the patient would die without an operation, and would as certainly die in one to relieve the obstruction, and hence did not suggest it.

With a vague thought of prescribing something appropriate, he gave her a twenty-grain dose of calomel, which was not vomited immediately, as all other medicines had been, but was retained for about two hours, when she again vomited more of the contents of the bowel, after which a second twenty-grain dose of calomel was again given and retained for about the same length of time. A third dose of same size was given toward midnight, but immediately rejected, with stinking, stercoraceous matter. This character of vom

iting continued during the night and more or less during the next day. She suffered much pain during all these hours, and was given up to die by relatives and friends.

About 11 o'clock a. m., January 28th, Dr. Puckett talked with the writer about the case, and it was decided that a rectal tube should be used to flush and empty the colon with copious injections of very warm water. Dr. Puckett at noon introduced a colon tube to nearly the entire length of the colon, after the patient was placed in the genu-pectoral position, and a gallon of warm water was injected. The tube was withdrawn and the water was ejected with contents of colon from the rectum. This

was repeated, the last of the water coming away clear. The flushing seemed to give a sense of relief to a slight degree. Between that hour (about noon) and 2 o'clock p. m. she was given small drinks of hot water at frequent intervals. At 2 p. m. she was given a tablespoonful of Mapleine from a sample bottle left with Dr. Puckett by Mr. E. H. Schmidt, of the Inland Chemical Company, that morning, and another dose at 4, another at 6, and a fourth at 8 p. m. They were all retained, as was the hot water given at intervals for a considerable length of time-apparently not vomited. The last of the vomiting contained a grain of canned corn and apple core eaten on January 24th. Shortly after 8 p. m. of January 28th one of the family and nurse came rushing into the office and excitedly said that the patient had just had a natural, good operation from the bowels, and was feeling free from pain. This passage contained lumps of apple core and grains of canned corn, surrounded with mucous secretion, and certainly came from the site of obstruction.

At this time, twenty-four hours later, the husband tells me his wife is sitting up and feeling very comfortable. Her bowels were moved a number of times, apparently from the effects of the doses of Mapleine, and now, several days later, she is on the road to rapid and complete recov

ery.

Without questioning the possible or probable good that may have come from the calomel and flushing the colon, Dr. Puckett and the writer believe that the hydragogue effect of the large doses of Mapleine administered so softened the

fæces at the site of the obstruction and excited peristalsis that the fæcal mass was allowed to pass and gave the relief as an important and immediate factor.

We regard the case as a remarkable one, and did not anticipate the recovery, but give Mapleine the largest share of credit in the outcome of the case.

W. J. BOYDEN, M. D.

Maltzyme.

Maltzyme is a diastasic essence of malt, extracted and concentrated by a new proc

As it contains a larger proportion of diastase than any kindred preparation, a tablespoonful will, in ordinary cases, be found sufficient for adults, children in proportion. It should be administered during or immediately after meals.

It is nutritive as well as highly diastasic, because it contains not only the proper amount of digested carbohydrates and nitrogenous material, but also the phosphates of the grain.

It will be found an invaluable remedy for starchy indigestion, and is especially indicated in the treatment of children whose puny development and lack of vigor may be attributed to the imperfect assimilation of starchy and vegetable foods. In such cases Maltzyme will cause prompt increase in weight and dispel the irritability so often due to indigestion.

Grippe.

For grippe, as for all ailments which exist endemically or epidemically, the most diverse methods of treatment and medication have been proposed and a vast number of medicines recommended, but few of which possess any real value. No remedy has had so much success or has proven to be of such true efficacy for the prompt and thorough relief of grippe and the prevention of complications as Tongaline Liquid in doses of a teaspoonful, or a Tongaline and Quinine Tablet, either to be taken at short intervals and washed down with plenty of hot water. A glass or two of hot water between the doses will further stimulate the action of the medicine.

Grippe invariably renders the stomach irritable and the nerves sensitive; so, in order to avoid disturbing effects from internal medication, the inner parts of the

thighs and the abdominal surfaces should be first sponged with alcohol, then with Tongaline Liquid, and hot cloths saturated with the remedy held in apposition by oiled silk bandages, heat being applied by hot-water bag or other convenient method to facilitate absorption.

In like manner Tongaline Liquid may be given externally by the aid of electricity.

It is positively remarkable how quickly and thoroughly the grippe is eradicated and a complete cure is effected by the use of Tongaline as mentioned.

Elixir Six Hypophosphites.

In treating consumption, digestion should be protected at all hazards. Every one must have observed that consumptives rapidly fail when they cannot digest what they eat. How often have we observed this class of patients improve rapidly from the use of the Elixir Six Hypophosphites, for it enables the exhausted to eat, assimilate and eliminate well, or, in other words, to nourish properly.

Something New.

It has just come to our attention that an antitoxin containing 1,000 units to each cubic centirmeter of serum is now prepared in considerable quantities by II. K. Mulford Co. This is the most concentrated serum that has ever been offered the profession, and marks a great triumph in therapeutics. This advance reflects great credit upon Mulford Company, who are leaders in the field of serum therapeutics.

Leinol.

This preparation is a combination of ol lini with acid hydrocyanic in the form of a perfect emulsion. To each fluid ounce is added four drops of sulphate codeine. It is the modified formula of Prof. William II. Thomson, of the University of New York, and is especially indicated in childhood and old age, and from the numerous letters that have been received by the Norwich Pharmacal Company, who manufacture it, they are almost unanimous to the point that it is extremely pleasant to the taste, that it increases the appetite, and dispels night sweats, and in winter coughs, colds and bronchitis its action is all that