gerous effect is ever produced. During the past forty years in which I have used the medicine freely (and I commenced using it when I started in practice), I have never seen the slightest evil effect and regard it as perfectly safe in all cases if used in the small dose. When administered it imparts a bright saffron hue to the urine, so that it is always best to advise the mother or nurse what to expect, as they might become frightened by the sudden change in the color of the urine, if not informed.

Santonine is known as a good worm medicine and so it is; but this action represents only a small fraction of its real value. Its full value is too little known, for which reason I desire to call attention to the agent at this time. As a pleasant and reliable vermifuge it is the remedy par excellence and will expel both stomach and pin worms. Worm symptoms are various and numerous, but those that are usually present in such cases are: a whitish ring about the mouth, slight swelling of the upper lip, much picking of the nose and the uttering of shrill cries during sleep. Although these signs are all well known worm symptoms, yet they do not infallably denote the presence of worms; but they do always indicate irritation of some kind in the intestinal canal, whether produced by worms or some other cause, and call for santonine.

A quarter or half grain tablet, according to the age of the child, should be given every two hours until three or four doses are taken, then followed by some mild purgative. I do not say that a physic is absolutely necessary to success, but a soft state of the bowels will naturally aid the expulsion of worms if there are any. If there be no worms in the stools it is safe to conclude that there are none and that the irritation which caused the symptoms was produced by something else than parasites. Afterwards, the medicine should be continued in less frequent doses for one or more days, when the worm symptoms will have disappeared and the child well. Sometimes, after a vermifuge is given and no worms are seen, the conclusion is reached that the worms have been killed and dissolved into slime. Anybody who chooses to believe such a fiction is, of course, welcome to do so but it is not in the nature of things for living matter to dissolve and disappear in that manner.

A remedy should be selected for its known specific effect, rather than merely for what "it is said to be good for." Some medicines have but one specific action, while others may have two or more. The value of a remdy depends upon its power to relieve suffering and cure the sick; but common sense must

be used and not more expected of a remedy than it is capable of doing.

The real value of santonine, I believe, is found in its power to relieve and control a train of nervous reflexes, which arise from disturbance of the organs that are located in the abdomen and pelvis. The reflexes for which santonine is known to be specific, are those recognized as worm symptoms and already described. It will cure worm fever, which is reflex and due to local irritation; and convulsions, that are produced in like manner are also cured when the worms are expelled and the local cause of irritation removed.

In using santonine as a remedy for worms, I discovered that it also relieved some unpleasant nervous symptoms that were not caused by worms; and for many years it has been my chief reliance in treating nervous children. The only mention that I have ever seen of its benefit in such cases is in the eighth edition of Ellingwood's materia medica. He also seems to have acquired his knowledge, as I did mine, by experience and in a similar manner. The remedy is perfectly adapted to a class of fretful, crying children who have indigestion and a faulty bowel movement, with a tendency to diarrhoea and are poorly nourished. It is especially adapted to those nhildren that are restless and do not sleep well at night, who roll and toss in bed, grind their teeth, have bad dreams and cry out in their sleep. Give such a child one-quarter grain tablet in the evening and a second or third one during the night, if necessary; but usually the first dose quiets the little patient and it seldom has to be repeated.

I can do no better than to here quote Dr. Ellingwood, who says: "I advise with full assurance of satisfactory results that this remedy be used freely in the treatment of reflex irritations. I do not think it will be necessary to give it in large doses. From one-half a grain to a grain and a half in an extreme case will, I think, be sufficient. I would suggest that it be used in the reflex irritations of pregnancy, especially when there is scanty urine, or where there is a deficiency of renal action with much local irritation. Also in the beginning stages of albumenuria of pregnancy I am confident that it will do much towards preventing puerperal convulsions, if given early. I think there are some cases of vomiting during pregnancy that will be quickly allayed by it. I advise that if it be in hysterical conditions and in those difficulties where there is irritation of the ovaries and irritation at the menstrual epoch, especially if it is accompanied with some pain.

"Santonine is a positive remedy with which to increase the secretion of urine in children. It gently stimulates the function

of the organs, promotes normal secretion and relives irritation. It is without doubt our best remedy to restore the secretion in post-scarlatinal and post-diphtheritic nephritis."

Any physician who has never used santonine as a diuretic has missed a good remedy. It will not only relieve suppression, but will also start the flow in retention of urine. It gives tone to the bladder and materially increases its expulsion force. It relieves irritation of the entire urinary tract in both old and young, but is especially to be thought of as a remedy in the urinary difficulties of the aged and particularly in cases where there is inability to void the urne.

BEFORE AND AFTER LABOR.

N. H. Blankmeyer, M. D., Aransas Pass, Texas.

Read before the Texas Eclectic Medical Society.

It is not often the doctor is consulted or notified, until very near the day of labor, unless the prospective mother is not doing as well as her good lady friends think she should.

Then the doctor is consulted by the husband or sent for, to know what is best to do for the wife's swollen feet or the dizzy spells she is having.

If the patient has been pregnant before and gone to full time with swollen feet and no treatment, she will not recognize the seriousness of such a condition, unless advised to notify her doctor, in the future, as soon as she notices any swelling.

If you are consulted or engaged one or more months in advance it is your duty to advise your prospective patron about the danger of heavy lifting, pressure of the abdomen, as in washing, and especially not to raise the arms to extreme heights as in hanging up clothes, house-cleaning, picture hanging, etc.

Common sense would suggest these warnings as it would also other matters to avoid during the months of gestatiɔn, but that kind of sense is too often not in evidence during this time, in some of the very best of well-regulated families.

Do not take for granted all women know such things, and even if your patient does, it will show thoughtfulness on your part and will be advice well received.

A fruit diet will have a tendency to encourage pliable bones. and small ones, especially if a meat diet is avoided, which encourages muscle and a large baby.

Encourage exercise which besides regular walks should include the regular household duties she has been accustomed to; in fact, insist that the patient should NOT lead an idle life if you want the help of the muscles during labor.

Abdominal breathing is good to develop strong muscles, so this, coupled with massaging of the abdomen and perineum five to ten minutes each evening, especially the perineum, will be time and effort that will bear 100 per cent interest.

It will not be necessary to spend $1.00 for the so-called Mother's Friend, as 10 cents worth of sweet oil will answer as well, although olive oil will satisfy the patron better, as it is more costly and not so common as sweet oil.

While the hot, wet towel to the perineum during the completion of the second stage of labor will be fine, it will not prevent as many lacerations as the massaging with olive oil for two or more months before the lying-in period.

This is the most important treatment you can give Primipera, especially if over 30 years of age. DO NOT FORGET THIS.

If your patient is a primipera or has been subject to hard and slow labors, the foregoing advice, coupled with Lloyd Mitchella Compound, teaspoonful every four hours for six to eight weeks before confinement, will assure an easy birth and a grateful patron.

If you have no Mitchella Compound, prescribe Lloyds Sp. Med. Mitchells; Viburnum; Pulsatilla and Macrotys, aa one dram; Glycerine, half ounce; aqua q. s. to make 4 ounces; teaspoonful four times a day.

If the limbs are swollen use Sp. Med. Apocynum 1 dram; Sp. Med. Veratrum gtt xxx Glycerine, half ounce; Aqua q. s. four ounces; teaspoonful two to four hours till relieved; but if you will see that the liver is kept active you will not have swollen limbs to contend with.

As it is often the small things in the practice of medicine that make our best friends, it will be worth your while to explain to your prospective patient the process of labor, how to help pains and prolong them by the steady, even breathing with closed mouth and the slow relaxation as the pains leave. Show her the policy of no fussing and the benefit of the clinched fingers over the fundus of the uterus; but if she must and will not use the clinched hands over the domen, then use a napkin with opposite corners tied, so as to form a loop. This placed over the knees gives a good means of self help, at the same time steadies the knees; avoids the interference of friends with your effors to help and gives general satisfaction; more so than any slipper contrivance or sheet around the bed-posts.

Also instruct the mother about having four or five pads made from newspapers covered with cloth, which when soiled can be destroyed. They are inexpensive, clean and aseptic.

Much more could be said on advice before labor, but the fore

going should be enough to bring out ideas from others better qualified.

As to the after-treatment, there will seldom be any necessity for much if you have been consulted in time and you and your patient have done your duty before birth.

If you have not been too hasty to deliver the Placenta, you will not have any of the secundines to pass two or three days after delivery, accompanied with that tale-telling odor of danger.

Whether a good or bad delivery, it is always policy to be on the safe side by ordering a germicide like the Pix Creosol tablet placed next to the mouth of the womb twice daily for a few days after birth, for which thought I am indebted to Dr. H. W. Gates of Waco.

Do not tell your patient she does not need anything for her after pains, but make them lighter and easier to bear by giving Sp. Md. Jaborandi; Viburnum; Phytolacca and Veratrum aa gtt xx in four ounces of water and order a teaspoonful every three hours. This also has a tendency to ward off breast troubles and brings a good flow of milk.

If you have neglected this step of precaution and the breasts show signs of hardening, or if you are called to a case of caked breasts applications of hot water saturated with Epsom Salts will overcome the inflammation and prevent suppuration.

See that the bowels are moved at least fourty-eight hours after birth and allow but easily digested food so long as patient is confined to bed, being governed much by the habits and surroundings of your patient as to your selection of what foods to advise.

Much has been written of late, as to the necessity of the new mother lying in bed nine to ten days, as has so long been the custom; which no doubt depends much on who your patient is and her power of endurance. The average American woman needs the ten days and more, to allow her generative organs to go back to the normal conditions.

Complications arising must be met as each case indicates, but avoid complications in many instances by the Golden Rule of Obstetrics, "Medlesome midwifery is bad."

"STAMPING OUT TUBERCULOSIS" (Contined).

Dr. Ovid S. Laws, Los Angeles, Cal.

The previous paper gave a few glimpses at the stage work constantly being played by the Medico-Political Trust. As this is the tragedy of modern times, if not of the ages, it is important to know who the contestants are, and methods of warfare.