being of a scrofulous diathesis I also prescribed iodide of potash and iron with intent to improve and tone up her general health. At her monthly periods I gave her fl. ext. ergot, and recommended a warm bath. I also cupped her at that time and kept up the continuous use of bromide of potash. But she did not seem to improve.

I then prescribed Aletris Cordial one teaspoonful three times a day all time, and Celerina to be given a teaspoonful three times a day for a week before her period, as the fits only returned at that time. I then discarded all other remedies but these, as the former seemed to do no good. To my surprise at the next recurring period, she menstruated, but not free enough, so I prescribed a continuous use of aletris cordial, under which she improved, menstruating regularly, and would have got entirely well but she quit taking medicine without my consent.

During this time I touched the os uteri occasionally with tinct. iodine; but when I prescribed the cordial it seemed to have a curative effect on the os which was inflamed. I think in the future, both of the above preparations will fill a valuable place in medicine. This is the first case of epilepsy I have noticed being entirely cured with celerina. But this patient has missed the attacks, now near six months.

Selections.

ERYTHROXYLON COCA; ITS VALUE AS A MEDICAMENT.During the last few years the therapeutic use of coca has been so greatly extended that it may be interesting and useful as a résumé to enumerate its many applications.

Although coca has, from its earliest introduction as a pharmaceutical product into France, enjoyed the highest professional recognition, this South American plant can hardly be said to have entered into current therapeutics. It is only since the discovery of the scientific application of the alkaloid of Erythroxylon coca, and since the important essays on the drug and the experiments

made with it, that physicians generally have studied and recognized its therapeutic value.

It is well remembered how, in former years, the virtues of the salts of quinine were held to entirely supersede those of cinchona; in like manner this inevitable error has arisen with coca, its alkaloid, cocaine, only having been considered by many.

In consequence of the tests made with cocaine, which, from a physiological point, have established the dose and the limit of its toxic effect, and, from a medical view, have brought to light cases of abuse which have resulted in more or less serious accidents, many have been led to regard the plant coca itself as a dangerous drug.

The proof of the therapeutic value of the coca leaf is clearly shown by the many excellent results obtained in practice with such reliable preparations of the drug as have been furnished the profession by that worthy pharmacist, Mariana.

As to the comparison which many of our confrères make between the preparations of cocaine and coca, we do not fear to state that, however sound may be the theory of preferring to administer certain alkaloids to administering a preparation of a plant of which the virtues vary according to where and how it was gathered, the place of its cultivation, its quality, and the constitution and nature of the preparation-we repeat, we do not fear to state that in the majority of cases, as the alkaloid does not contain all the active principles of the plant, it cannot be preferred, except in special cases where the particular action of the alkaloid alone is desired.

The fact is well established that the salts of quinine cannot replace the the extract, the wine, or the powder of cinchona, the tonic principles and the essential oils of which have, without doubt, shown a special therapeutic value; and I need merely cite the indisputable success obtained by Professor Trousseau with the powder of cinchona in checking malarial fevers which had resisted even the largest doses of sulphate of quinine. More especially cocaine cannot replace all the active principles and the essential oils of the leaf of Erythroxylon coca, as has been proved from the time of the earliest discovery and use of this plant.

In 1887, at the Institute of France (Académie des Sciences),

and in 1888 at the Académie de Medecine, I demonstrated that coca, by virtue of its active principals, had three very distinct, separate actions (published in the "proceeding") :

1. As an anesthetic, acting upon the protoplasm of the terminations of the sensory nerves, preventing the transmission of sensations to the centers, the unconscious sensibility of Bichat.

2. As a nerve tonic, producing functional excitement of the cerebral and spinal nerve centers and increasing the intellectual and musculur activity.

3. As a tonic to the unstriped muscular fibres of the stomach, the intestines, and the bladder, producing functional excitement of the constrictor action of the great sympathetic nerve, with consequent functional exaltation of all the smooth muscular fibres or muscles of organic life.

The dissatisfaction produced and the complaints which are made that the plant is wanting in uniformity of quality and is unreliable in producing the desired effects, are due to the varying quality of the preparation.

An essential requisite to produce reliable uniform preparations of coca is a thorough knowledge of the origin of the leaf, its nature, and its quality.

Careful study and researches made by Mr. Mariani for many years as to the origin, the nature, the species, the culture of the different leaves of coca, and the care which he gives to his preparations, have been the means of placing at our disposal products uniform in quality and unvarying in their effects in those varied cases where their internal administration is called for.

I will cite but a few names among those of my many confrères whose accorded experience with the Mariani coca preparations coincides with my own, which I am about to set forth, based upon continued observation in hospital and private practice.

It has long been known that the natives used the coca leaves to lessen fatigue, to keep up the spirits, and to appease the cravings of hunger.

The first and main application of the "vin Mariani" is, therefore, as a general tonic for persons either physically or mentally overworked (Brown-Sequard, German Seé, Dujardin-Beaumetz,

Ball, Bouchut, A. McLane Hamilton, A. E. Macdonald, A. L. Ranney, L. C. Gray, L. Weber, Carlos F. Macdonald, H. M. Lyman, I. N. Danforth, P. S. Conner, J. K. Bauduy, C. H. Hughes); in convalescence after lingering, wasting diseases, where nourishment is needed and where it would be dangerous to overcharge the stomach; with all whose recovery is tardy from wasting or constitutional weakness; in chlorosis, anæmia, and rachitis (Ch. Robin, Durand Fardel, Gubler, De Pietra-Santa, Fordyce Barker, Isaac E. Taylor, A. L. Loomis, W. T. Lusk, F. P. Fos ter, C. C. Lee, J. J. Henna, L. L. McArthur).

It is further used in diseases more specially referable to atony of the smooth muscular fibres, among which we class atony of the stomach. In dyspepsia, in those very common cases where this organ has become weak and torpid, is distended, and fails to secrete gastric juice, coca is well indicated (De Saint-Germain, Cottin, Dieulafoy, Salemi, Companyo, Rabuteau, A. J. C. Skene, P. A. Morrow, T. C. Giroux, Hunter McGuire, E. R. Palmer, O. O. Burgess, J. R. Leaming, Daniel Lewis, T. E. Satterthwaite, W. H. Pancoast, D. F. Woods, J. N. Hyde, L. G. N. Denslow, J. Leonard Corning).

It is also serviceable in weakness of the vocal cords, in the case of ministers, singers, actors, teachers and orators (Ch. Fauqel, Morell Mackenzie, Lennox Browne, Botkine, Cozzolino, Zawerthal, Poyet, Coupard, Fraenkel, Marius Odin, Labus, Massei, Louis Elsberg, R. P. Lincoln, Beverly Robinson, W. C. Jarvis, H. H. Curtis, C. C. Rice, C. E. Sajous, E. Fletcher Ingals, H. Schweig, T. R. French).

It is, moreover, of value in weakness of the vascular organs, with the anæmic, the plethoric, where, principally on the face, the small blood-vessels show enlargement or venous arborescence which points to a similar state in the vessels of the nervous centers. The same vascular weakness is also observed with the varicose, in whom coca is indicated; likewise with the paraplegic, with whom it regulates the circulation of the nervous centers (Bernard, Bètancès, Landowski, Casena ve-Delaroche, Gazeau, Rabuteau, V. P. Gibney, Robert Newman, E. B. Bronson, J. E. Janvrin, B. McE. Emmet, W. O. Moore, W. J. Morton, D. W Yandell, J. H. Etheridge).

It may be also as a regulator of the nervous centers that the intusion of coca known as the Mariani produces such marvelous results in mountain sickness, in sea sickness, and in the vomiting of pregnancy. It is well remembered how this preparation sustained the illustrious General Grant during several months (Cuffer, Letellier, Dèrrècagaix, Trossat, Bouloumie, Dechambre, Fordyce Barker, G. F. Shrady, J. H. Douglas, H. T. Hanks, G. R. Fowler, J. M. Keating).

it

From a psychological point of view and from mental pathology may be stated that coca is the only drug which successfully combats melancholia, low spirits, and all forms of depression of the nervous system, upon which it acts "like fulminate," to use the felicitous expression of Professor Gubler.-Marc Laffont, M. D., Prof. of Physiology at the Faculty of Lille, France, in N. Y. Med. Journal.

INDIVIDUAL PROPHYLAXIS.-It is not strange, perhaps, that the Chinese who live so nearly opposite us on the globe should have many customs which are directly opposed to ours; but one peculiarity of this people strikes us as smacking of the zenith rather than of the nadir, and that is this: It is said that physicians are compelled to recompense patients who fall ill, instead of receiving fees for restoring them to health.

Why should not the physician's duty be that of the director of the right and the warner against the wrong way of life, physically speaking; that of the "cane carsem," rather than merely to try to restore their pristine health to those whom the results of heredity or indiscretion have overtaken? This, of course, presupposes that to perform this office the physician is amply rewarded, and that, too, with a readiness, promptness and willingness equal at least to that with which insurance dues are settled.

It is indeed strange that in a country where a strong, general sentiment demands laws to be made requiring ships, bridges, boilers and engines to be inspected at stated intervals, lest from the effects of use and years some accident occur, dangerous or fatal to human life, yet individually the masses are so careless about the mechanism of their bodies, a mechanism more complex