ciate the humor of our errors; and herein is the Oriental strictly differentiated from the European.

THE OPTIMISM OF THE MAGAZINES.

On the whole, says The Bookman, one arises from a reading of the magazines distinctly encouraged. It is a literature full of promise-brave, exultant. It might well be prescribed by physicians for patients recovering from the grippe, when one always looks on life through blue spectacles. Why, there is magic. in turning over these pages. "The ills that human flesh is heir to"-it is evident that to Hamlet was denied the advantages of a course in magazine reading. In the bright annals of magazine literature. there are no ills (at least, none that can not be cured by ME). Here do we not learn that "Deafness can be relieved and prevented," "Pimples may easily be removed," "Intemperance cured by your wife without your knowing it," "Stammering is cured by correspondence," "The fat may easily become thin," and "The thin as easily become fat," "Cancer is cured without the knife," "Rheumatism without medicine," Stomach troubles "without opiates or cathartics," Blindness "by absorption," "consumptives in the last stages of the disease need no longer worry about the future?"

Sirs, believe me, 'tis a good, kind world. Not only this little matter of no incurable disease, but beauty, health, success, may all be secured by "My system;" and here's my "phiz" with my new way of wearing my beard to prove it, and a letter from my best patient from Oklahoma to conquer your last wavering doubt. Positions of trust secured on payment of a postage stamp, six per cent bearing gilt-edged bonds for the asking, butchers' bills are effete remnants of an unscientifically fed age, gas bills will grow less, and a perfect substitute for coal has been found; while one can not purchase an article from a couch to a cottage without putting money into one's pocket, so one's

wife can easily master the science of growing rich.

Who can deny that the magazines are the most potent champions of romanticism left us today? Believe it all? Why, there is a horse smilingly pacing by the side of an automobile, so it would be foolish to strain at gnats. Delightful, transcendently beautiful world of magazine literature! say I, in which the plumbing never leaks, the hardwood floors never lose their polish, in which the telephone rings not, the automobile. puffs not, neither does it smell. Commend me to it for an hour or two of pure, unadulterated joy!

LEGAL STATUS OF THE DOCTOR'S ACCOUNT BOOK.

William F. Baker, in the Physician's Business Journal, admonishes that the law requires that an account book of original entry must show in plain language and figures, which can be read by judge and jury without personal explanation, the name of the person against whom the charge is made, the name of the person for or to whom the services or supplies are rendered, the date, the description of services, and the charge must be definitely carried out in dollars and cents. The entries must also be made while the transaction is still fresh in the mind-not later than the next day.

Perhaps a reference to actual cases will make the matter more clear. In a case reported under the name of German's Estate, in 14 Weekly Notes, of Cases, Judge Ashman, of the Orphans' Court, makes valuable suggestions as to the proper form of book entries and also points out the deficiencies of existing methods. He says, in part:

"The rule of evidence which introduces a tradesman's books of original entries to prove his sales, is permitted to override the principle that a party may not manufacture evidence for himself, on the ground of convenience.

For the reasons which justify its use in case of a merchant, it has been so far extended as to embrace, perhaps, the books of any person whose business is not in money, but is of such a nature that its transactions can be itemized with the precision with which a sale may be recorded. * * * A physician's book may (and the judge uses the word "may" as meaning "should") cover a daily entry of each visit, with the name of each patient, a list of the medicines furnished, and the price which custom has fixed for this particular service. Such a record will comprise all the incidents of certainty of time, person, labor and value, and each entry will be complete in itself."

Speaking of books in the case under consideration, the judge says: "His diary or visiting list, as a physician, contained on each page a list of names of patients, with tally marks opposite, in columns which were headed separately with the day of the week; the name of the month appearing at the top of the page and the date of the year on the

cover.

One column at the end of the space for each week was headed amount. Preceding these lists, as a sort of preface to the book, was a Table of Signs.' This table embodied a series of hieroglyphics and figures, which were intended to denote visits made and to be made, and visits repeated or to be repeated; consultations proposed or made; services at the office, visits at night, medicines furnished, etc. It is quite clear that entries patterned after this fashion, could serve at best only as memoranda from which to make more formal charges. * * * Allowing the utmost latitude to the plea of convenience and necessity, the law can not tolerate self-proving an entry of services which can be translated only by means of a glossary. Such a writing would be as unintelligible to an ordinary jury as a 'Hebrew Bible' to a deputy sheriff "

LEGAL ASPECT OF AMBULANCE
SERVICE.

Thomas A. Cheatham, in the New York Medical Journal, points out that the ambulance surgeon is frequently called upon to testify in civil suits, criminal and coroners' cases, and after one experience with a clever lawyer whose exacting, rapid-fire cross-examination will make one swear to almost anything, he learns to refrain from expressing cp'nions and to know as little as possible, but to know that little well. Street-car and automobile accidents are daily encountered, and it is far better to make notes of injuries and conditions at the time than to rely on memory for correct testimony when the case comes to trial. When any trouble arises with the patient or bystanders, the ambulance surgeon, invested with the authority of a police sergeant. may make arrests or command the policeman to do so. When a patient d'es with ́n twenty-four hours after arriving at the hospital, the ambulance surgeon is required to make a written statement of symptoms or injuries found when the patient was first examined and the circumstances connected with the case, such as time, place, mode, and extent of injuries, and whether accidental or with homicidal or suicidal intent.

"Dead on arrival" cases are simply pronounced dead, without attempting a diagnosis and reported to the coroner.

THE NEW CASABIANCA. The girl stood on the roller skates,

And yet she could not go; She was afraid to tempt the fates Because she wobbled so. She cried aloud, "Stay, Charlie, stay. Oh! stay, help me along." But Charlie went another way,

Because his feet went wrong. There came a tearing, rending sound, The girl-Oh! where was she? Ask of the giddy youth around, Who viewed her lingerie.

-The Bystander.

KNOWING ALL ABOUT THE CHILD.

A

LBINIA BRODRICK, in the British Journal of Nursing, declares that with children, even more than with adults, the first help towards cure, which is the aim of nursing, is a history of the family, the second the history of the child itself from birth. These are the foundations upon which the careful building up of stone by stone of the healing process must be firmly established. As regards the family history, illnesses of the father, illnesses of the mother, brothers and sisters on either side, and the causes of any deaths; these questions will have special, though often not expressed, reference to tuberculosis, venereal disease and alcoholism. The condition of the mother during pregnancy, the character and duration of the labor, history of previous abortions or stillbirths, the home life-all these need to be known. Then follows the lifehistory of the child itself from birth, its weight and increase in weight, whether breast or bottle-fed, and for how long, the age at which dentition took place, at which the child first sat up, first walked, and was able to speak comparatively intelligibly, the accidents and diseases of its earlier years, its temperament and character. Every scrap of information which the mother can furnish, no matter how lengthily or how ignorantly given, must be patiently listened to and persistently sought. The orange must be dry before it is thrown

away.

SALTING BABIES.

The strange custom of salting newborn babies is still practiced in certain regions of Europe and Asia, says Harper's Weekly. The method varies with the different nationalities of the peoples

employing it. The Armenians of Russia cover the entire skin of the infant with a very fine salt. This is left on the baby for three hours or more, when it is washed off with warm water. A mountain tribe of Asia Minor are even more peculiar in this regard than the Armenians, for they are alleged to keep their new-born babies covered with salt for a period of twenty-four hours. The modern Greeks also sprinkle their babies with salt and even in certain portions of Germany salt is still used on a child at birth. The mothers imagine that this practice brings health and strength to their offspring, and serves as well to keep away evil spirits.

REMOVING GREASE FROM WOUNDED

HANDS.

Ralph H. J. Perry, in the Dietetic and Hygienic Gazette, recommends that in accident cases where the injured parts are soiled with machine grease, paint, oil, varnish and similar substances not removable by water, resort is had to ordinary commercial gasoline. The use of gasoline for this purpose, while not general, is not a novelty. He has so ut'lized it for more than twenty-five years; others have used it, and it is now quite generally used by surgeons who have much factory, machine-shop or railroad surgery. While acting as a solvent for fats, oils, gums, wax and resins, it is, to a certain extent, antiseptic, besides causing no pain; hence it makes an excellent detergent when the parts are besmeared with such substances.

The addition of resublimed iodine to the gasoline (one drachm to the pint) increases its antiseptic powers without affecting its detergency. Iodized gasoline. should be freshly prepared, in small quantities, at the time of use.

To use the gasoline, pour it directly upon the wound from a small-mouthed bottle, letting it wash all over portions of the injury; also make a mop of absorbent cotton or gauze, saturate with the gasoline and gently rub over the parts until cleansed. If the dirt be unusually tenacious, a soft tooth-brush may be used. The body-heat causes the gasoline to evaporate from the surface, leaving the parts clean and dry.

Gasoline is almost as efficient as hydrogen peroxide in breaking up adherent clots, and is not painful.

By way of caution, remember that gasoline vapor is highly inflammable, even explosive; also, that if it gets into the eye, ear or closed cavities it may cause pain, just as do ether, chloroform and other quickly volatilizing liquids. Benzine may, in an emergency, be used as a substitute.

NURSING IN HEART DISEASE.

Dr. Greenwood, in the News Letter, advises that in all severe forms of heart disease, whether the trouble be valvular, muscular or nervous, it is well to remember that the heart works to the best advantage when a patient is in a recumbent position, except, of course, in those cases where orthopnea is present. If, with a poor compensation, or weak muscular action, it is found that the sitting position makes the pulse distinctly weaker and more rapid, the recumbent position should be insisted upon for a time at least. There is no doubt that many patients are saved by the watchful care of a good nurse. Of course there are many patients with heart disease who are up and about and moderately exercising, therefore they are not likely to be under the care of the nurse, so that most of my remarks apply to patients who are severely ill, and in such cases the recumbent position, careful feeding with the avoidance of over-feeding, care of the bowels to relieve any congestion of the blood there and anything that can be

done to make the heart move along smoothly, are of prime importance. The avoidance of excitement, anger or fright are, of course, necessary.

In various forms of valvular trouble, where a compensation has been more or less restored, certain forms of regulated exercise are very important to build up the heart muscle, often in conjunction with various forms of medical baths. Of the drugs used in treatment of heart disease, there are two classes that are to be relied upon, mainly, the tonics and the stimulants. Of the former, digitalis is the leader, and of the latter, strychnia. Digitalis acts largely by slowing the heart's action, increasing the length of diastole, and thus allowing the heart a longer interval of rest between beats. Strychnia acts largely by stimulating the various nerves and cardiac ganglia.

THE ROLE OF THE SHEET.

In connection with the International Congress of School Hygiene which was held in London in 1907, the Lancet refers to an invention by Mr. D. H. Shuttleworth Brown, of Wimbledon, for the purpose of preventing soiled sheets coming into contact with the other articles of bedding, and we again call attention to the matter, because anything which tends to inculcate habits of cleanliness can not too often be reiterated. Many people have the idea that the purpose of sheets is to keep the occupant of the bed warm, but obviously their real use is to insulate by a washable material the sleeper from the mattress and blankets. Therefore the same side of the sheet should always be in apposition to the body, and we note that at a recent meeting of Manchester sheeting manufacturers a resolution was carried unanimously declaring that a bed-sheet should be used. for the purpose of insulating the sleeper. In order to ensure that the person making the bed may be able to distinguish the two sides of a sheet, and also that a

traveler at a hotel, for instance, may be able to see at a glance whether his bed has been properly made in this respect, Mr. Brown runs a tuck across the top and bottom sheets in such positions that when the top sheet is turned back over the counterpane the tucks are quite visible. Bed-ticking is seldom cleaned, and blankets, even by the most careful people, are probably washed not more than once a year, so that unless the "human" side of the sheet is kept from contact with the parts of the bedding less often, or never, washed, there is certainly a risk to health. Especially is this the case in public institutions where sleeping accommodation is provided.

POST-ANESTHETIC CARE.

Joseph B. Hogan, in the New York Medical Journal, reminds us that after the operation is over and the ether withdrawn, the anesthetist's management of the case continues to be of vital importance. Some one should remain with the patient until he is rational. The room should be darkened and quiet. A dry gown and warm bedding should be provided. Liquids may be allowed early. Should there be great thirst, the result of excessive vomiting, salt solution by rectum will relieve. The subsequent dict should be governed by the nature of the operation, permitting a full diet as soon as the best interests of the patient allow. To secure good evacuation of the bowels after the third day, use any means consistent with the treatment of the individual case. A mild diuretic is prescribed by some; certainly the free drinking of water should be encouraged.

Omitting the full consideration of post-anesthetic shock and pneumonia, we will take up briefly some of the unfortunate after-effects of etherization.

Much has been written of the so called ether pneumonia. But the majority of the cases of pneumonia following etherization are not due to the drug per se, but some result from exposure during or

after the operation, or from the aspiration into the lungs of vomited food particles; and these cases should not occur at all, if there are careful preparations before and watchfulness during and after the anesthesia. Most of those cases due to ether itself arise in adynamic subjects which have been "soaked." Yet very rarely does pneumonia appear when no exciting cause other than the ether can be demonstrated.

In conclusion, the author considers what seems superficially to be the bête noire of surgeon, patient and anesthetist, namely, post-anesthetic nausea and vomiting. A surgeon manipulates the cecum, removes the appendix, squeezes the gallbladder, and pulls up the tubes and ovaries to examine them, each procedure being perhaps justifiable, yet, undoubtedly, they are responsible in some degree. for subsequent nausea. And even these patients, under ether, frequently are. observed to have but little nausea, and only the first or the reflex vomiting.

RULES FOR CATARRHAL PATIENTS. Wm. Brady, in the New York Medical Journal, lays down the following rules of living for persons suffering from catarrh :

1. Fletcherize. Do not wash down food with liquids-drink your water, tea, coffee or beer at the end of the meal. Meat once a day or less often. Fruit at breakfast, or at least fruit to start breakfast. No alcoholics, or at most only after dinner. No smoking, or at most once after each meal; cigarettes prohibited.

2. You must wear woolen or wool and silk knitted light-weight underwear at least eight months in the year, with woolen stockings, of course. You can not hope for a permanent cure if you "stick to your cotton." Underwear protects you against sudden changes of temperature from your shop or office to the street; outer clothing, coats or wraps, may be worn as comfort dictates to keep