to be successful when given in the form of the fluid extract in three minim doses every hour. Quinine also may be employed, with a view to its tonic effects. Externally, leeches, rubifacients, turpentine, also spongio-piline, and hot water applications are well spoken of by authors. Besides these, Niemeyer says "that cold compresses to the abdomen exert a most beneficial effect;" and he agrees fully with those who consider the application of leeches to the abdomen, the use of cold compresses, and the internal administration of opium as the most effective treatment. Flint and Professor A. Clark each assert that our main reliance in treatment is opium given fully and freely. Cathartics, mercury, and blisters are alike condemned by most clinical observers and successful practitioners; although there are those who affirm that epispastics do frequently afford relief, and that mercury does arrest or check the inflammation. When an early dyspnoea and cyanosis admonish us of the imminence of fatal symptoms, venesection as a temporary expedient may, as Niemeyer observes, be resorted to, for we know of no other remedies to fulfil this urgent indication. To relieve vomiting, ice is best administered; to check the diarrhoea, opium is to be preferred to all other astringents: as the flux is due to cedema of the intestinal mucous membrane, opium is as beneficial as astringents. When convalescence is established, cod-liver oil and quinine should be liberally prescribed. If the exudation be great, iodide of potassium and acetate of potassa in small doses should, if borne, be ordered in connection with the various preparations of calisaya bark. Above all, fresh air, judicious exercise in the open air, nutritious diet, and quietude of body and mind, should be strictly enjoined. Cathartics should be given with great caution, and not for at least six weeks after recovery; enemata are to be preferred. The tendency to frequent relapses should always be borne in mind, and fatigue, exposure to cold, and inattention to diet strictly forbidden. (Philadelphia Medical Times, vol iii. No. 83, 1873.)

The Employment of Mint for the Suppression of the Milk. Dr. Dasara observes that the knowledge of the antilactiferous properties of mint appears to have been possessed in very ancient times, since Dioscorides mentions the fact in his works, and subsequent writers have only confirmed his statement. Linnæus observed that cows that ate mint in their pastures yielded a very serous milk, and Laewis affirmed that the coagulation of milk in which some leaves of mint were placed was retarded. More recently, M. Desbois de Rochefort, experimenting on mint, found that fomentations of mint applied to the breast, and the infusion taken internally, were capable of suppressing the lacteal secretion, and of preventing the usual accidents attend

ing milk fever in puerperal women. Trousseau expressed some doubt respecting this action of mint in his treatise on Materia Medica. But Dr. Pasquale Pepre, in a note on Trousseau's observation, remarks that the fresh leaves of mint placed in the axilla are commonly used in Naples to suppress the milk. Dr. Dasara determined to experiment for himself, and gives the details of a series of cases in which he tried the effects of the application of mint poultices made from the young sprigs at various periods of lactation, and the following are the conclusions at which he has arrived :—1. It is an established fact that mint has the power of suppressing the lacteal secretion. 2. The suppression of the secretion takes place at whatever period of lactation the mint is employed. 3. The effect takes place in a very short space of time, according to his experiments in from three to five days. 4. The suppressive action of mint can be localized to one breast. 5. No danger, nor even any inconvenience arises, either to the mother or child, either from the use of the mint or from the suppression of the secretion. Signor Dasara nowhere states in his paper the species of mint he employed; the omission is to be regretted. (Rivista Teorico Practica. Fasc. vi., 1873. Giugno.)

Treatment of Whooping-Cough with Quinine.-Dr. B. F. Dawson has recently read a paper before the Medical Library and Journal Association of New York, on "The treatment of Whooping-Cough with Quinine," of which the following is a summary:-Dr. Dawson referred, in opening, to this mode of treating pertussis, as first advocated by Professor Binz, of the University of Bonn, in 1870, through the columns of the May issue of the American Journal of Obstetrics. This author had shown that quinine had accomplished valuable results in his cases of the affection, which he considered to be a neurosis of the pneumogastric nerve, caused by infectious and irritating mucus that has accumulated in the pharynx and larynx; and having found by experiments that quinine destroyed, even when highly diluted, all structures found in normal mucus, he supposed that the mucus of pertussis also would be affected in a similar manner by quinine. In this he was not disappointed, the trial equalling his expectations.

The author mentioned the fungus theory of Dr. Letzerich, of Germany; also Dr. Breidenbach's mode of treatment—namely, the efficacy of the hydrochlorate of quinine, in doses of from 1 to 15 grains. He thought that with such strong testimony in favour of the quinine treatment of pertussis, it was somewhat surprising that nothing, or very little, had been done in this country to test its value.

Having opportunities for testing the value of anything new in

infantile therapeutics, this mode of treatment was applied in nineteen cases occurring in dispensary and private practice, and of these nine were selected as the most striking in their results. Out of the nineteen cases the shortest cure was effected in one day, and the longest-a single case-in twenty; the next longest being twelve days. In but two cases was he disappointed in the efficacy of the quinine. They were two dispensary cases, and the failure was attributed to the negligence of those in charge of them, the quinine not being given to them as frequently as ordered. There was, however, in both these cases some palliation of the paroxysms.

In regard to the administration of so disagreeable a remedy, he found that, though frequently there was some difficulty in getting the children to take it, yet it was exceptional for them to resist after the first two or three doses, and in only a very few did it cause vomiting. The direction to give the children a piece of an orange, or a little sugar five or six minutes after taking the quinine, had doubtless much to do with their seeming willingness to take the "bitter medicine." For his own part he accepts the fungus theory of Dr. Letzerich as the correct explanation of pertussis, and in consequence considers it an affection of the mucous membrane of the pharynx and larynx, and the "whooping" as simply reflex; and the fact that almost all remedies given for other than their local effects have either signally failed or but partially succeeded, he thinks strengthens this hypothesis.

Nevertheless, he does not attribute the rapid cure effected by quinine to the simple destruction of the fungus, but also to its nauseating, bitter taste. In every case of pertussis there is an abnormal secretion of a thick tenacious mucus from the mucous membrane of the pharynx (whether this secretion is due to simple catarrhal or reflex hyperæmia, or to fungoid development it matters not), which may or may not excite a paroxysm of whooping, but which certainly aggravates and prolongs the latter, as may be proved by the fact that the paroxysms invariably cease the moment this mucus is removed either by the coughing, vomiting, or the finger. The effect of a small amount of a solution of quinine, when taken into the mouth and swallowed, is instantly, from its bitter and nauseating taste, to excite a free secretion of thin mucus from the buccal mucous membrane and the salivary glands, and thus softening, render easy of dislodgment the tenacious mucus referred to. The frequent repetition of the quinine, therefore, keeps up this free secretion, and thus prevents the mucus from becoming tenacious and difficult of dislodgment. At each act of coughing the accumulated mucus is readily loosened and expectorated, and unobstructed inspiration obtained. The rapid loosening of the cough, the briefness of

the attacks in comparison with those previous to the administration of quinine, and the easy expectoration, tend to favour, he believes, the correctness of the above theory.

In conclusion, the speaker felt convinced that if the following rules are carefully observed, few, if any, will be disappointed in their results :

1st. Give the quinine-sulphate or hydrochlorate-dissolved by acid in pure water only. For children under three years, from five to eight grains, and for older children and adults, from ten to twelve grains to the ounce.

2nd. Give not less than a teaspoonful every hour, or at the longest every two hours during the day, and whenever cough comes on in the night.

3rd. Give nothing afterwards for some minutes to destroy the taste or wash out the mouth.

4th. Continue giving it, notwithstanding the first doses may be vomited.

5th. Be sure that the quinine is pure and thoroughly dissolved. In the foregoing paper the author wished to be understood as advocating the value of quinine in curing the "whooping chiefly, the cough in some of the cases lasting for some time after the whooping ceased, and which required the usual treatment for bronchial catarrh.

Department of Public Health.

THE DISPOSAL OF SEWAGE.

THE Committee on the Treatment and Utilisation of Sewage, appointed by the British Association for the Advancement of Science, presented a summary report of " final opinions" (as the reports of proceedings in the daily journals phrase it) at the Bradford meeting. This report is of curious interest, for it deals not merely with the treatment and utilisation of sewage as mechanical or chemical economical questions, but it includes also the health-aspect of these questions. Under what circumstances the Committee held itself called upon to express its opinions upon the health-aspects of the questions submitted to it is not stated, and cannot be easily inferred. The con

stitution of the Committee, while admirable in view of an examination of the economical questions attaching to the treatment and utilisation of sewage, is not such as to inspire confidence in opinions which it might express on the health-aspect of these questions. Indeed, having regard to that constitution, it is difficult to conceive that the Association contemplated the Committee extending its labours beyond the subject of modes of treatment in relation to the purification and utilisation of sewage. The different reports of the Committee which have come under our observation do not show, moreover, that the Committee at any time has had before it the evidence which would have enabled it to deal with the health-aspect of sewage disposal, except, it may be said, incidentally, and to a very limited extent, in relation to parasitic disease. It is with some amazement, therefore, not unmingled with regret, that we find the Committee stepping beyond the limits of the duty imposed upon it, and