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THE HEMOSTATIC ACTION OF EMETINE:-Another illustration of the striking action of emetine, in arresting hemorrage, has been reported by Palasne and Champeaux to Bertrand (Bull. d l'Acad. d Med., April 14, 1914.) In this case, there was vomiting of blood, owing to a duodenal ulcer. The bleeding was promptly arrested by a single hypodermic injection of 2-3 grain of emetine hydrochloride. In a case of hemothorax, the result of a penetrating wound of the chest, the injection of 2-3 grain of the emetine, repeated once daily for six days, seemed to control the symptom.

Bertrand again points out the futility of trying to explain the hemostatic effect of emetine through circulatory depression, revulsion or induction of nausea. As yet no completely satisfactory means of explaining just why the emetine stops bleeding has been supplied by anyone; still, that it does do so, and that quickly, there is now an abundance of evidence to demonstrate.-Clinical Medicine.

"DONT'S" IN THE TREATMENT OF INSOMNIA:-H. Crichton Miller emphasizes three points in the treatment of insomnia (1) Never let the insomniac drug himself. (2) Never let him know what he is getting or how much. This is necessary, so that the physician or nurse can adjust the dose without the knowledge of the patient. (3) Never under any circumstances allow the patient to go to sleep with the hypnotic by his bedside, with the idea that he I will not take it unless he needs to. It means that the patient's mind is started on a train of speculation as to whether he will or will not need the drug, even after the light is out and conditions are favorable for sleep. The patient will probably say: "I will not take it now; I will wait another half hour." The upshot of this is that the wretched patient gets five hours' sleep instead of eight, because during three hours the draught was in the bottle instead of in his stomach.-Medical Press and Circular.

CHIONANTHUS :-The liquid representatives of chionanthus virginica, or fringe-tree, are prepared from the bark of the root. I cannot understand why this remedy has not come into more general use by the entire profession. I am sure that my experience with chionanthus in jaundice of every form has been confirmed by many other prescribers. Certain it is that there has been no case of jaundice, whatever its cause, in which I have not seen some little effect from it, while I have cured so many cases of simple obstruction of the ducts and of functional disorders of the liver, and had so very few failures, that I am convinced that, if there ever is to be a specific for jaundice, we shall find it in chionanthus.-Clinical Medicine.

INCOMPATIBILITY OF ADRENALIN AND CHLOROFORM:Surgeons should always inform the anesthetist when they are going to use adrenalin. The anesthetist may be using chloroform, and chloroform with adrenalin is a very dangerous combination. The weakened heart-action from the chloroform, and the contraction of the arterioles from the adrenalin, cause an obstacle that the heart in its embarrassed condition cannot overcome, and a fatality sometimes occurs. Hornabrook especially warns against pluging the nostrils with adrenalin and cocaine, and then following with chloroform as a general anesthetic. Adrenalin can, however, be used with ether.-Critic and Guide.

SODIUM FLUORIDE FOR INSECTS:-Means, Passed Assistant Surgeon U. S. S. Cincinnati, states that at one time the storerooms and pantries became infested with roaches, and the ordinary insect powders seemed to have no effect on them. Sodium fluoride was then used with marked result. Not only were the roaches killed, but also the ordinary black-beetle that is found with the roaches.-U. S. Naval Medical Bulletin, July, 1914.

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BUBONIC PLAGUE IN NEW ORLEANS 1914-15.
GEO. H. TICHENOR, JR., A.B., M.D. (Tulane)

Associate-Editor, Official Journal American Association of Progressive Medicine; Former Medical Inspector and Yellow Fever Expert in "Charge" Louisiana State Board of Health; Nominee of Nicaraguan Minister to United States for Yellow Fever Institute; and Representative of the American Association of Progressive Medicine in Investigating Plague in New Orleans, etc.; Former Member American Historical Association.

The shadow of coming events was seen by four states, according to the Louisiana State Board of Health's report: "The presence of Bubonic Plague in Havana in the summer of 1912 made imperative practical measures for protection. Assured that one state alone can not cope with the problem, Boards of Health of all the Southern States were invited to hold a Plague Conference in New Orleans. Four States sent representatives. Information gained from a visit to Havana relative to conditions and measures was outlined; a plan of concerted action was agreed upon and the resolutions adopted covering the situation were widely published. It cannot be too strongly urged that all city and State officials give heed to the measures, which in the

judgment of the Congress were considered necessary to immunity from this disease."

However, prior to that:

"In 1911, a cursory sanitary survey was made of New Orleans. Very insanitary conditions in good supply places and in public service were noted. The markets in construction, equipment and upkeep were deplorably bad.

"A review of these conditions was sent the Mayor August, 1911, and remedial measures recommended. The market situation as being a positive meance to the health of the people was stressed and immediate improvement asked for."

In justice to all parties concerned, it should be known that New Orleans is the only city in the State which employs a whole-time health officer; the total amount available for the work of the city is an appropriation of $56,683.13, additional revenue $45,664.24, total $102,347.37. (Report 1913.)

There is no sanitary protection, nor sanitary progress in Louisiana; therefore, the State was not prepared to fight the plague. In 46 per cent of incorporated communities no systematic work is done, no accurate records are kept, and no reports made to the State Department, with few exceptions.

"There are in the State 195 incorporated communities. Of these 156 sent replies to questionaire. The records show 104 having duly qualified health boards. In 73 of these no salary is attached. Where there is compensation, the amounts are from $50 to $720 annually, average $191 a year. In 37 there are appropriations; these range from $50 to $2,500. Omitting Alexandria and Lafayette (Shreveport, Baton Rouge and Monroe reports were not received), which appropriated each $2,500, the average annual appropriation is $310.00. In 10 communities there are additional revenues, fines, etc. Only 38 have sanitary inspection."

The lack of funds hampered both State and City Boards of Health in instituting a rat crusade, when danger presented itself at its door. According to a formal resolution

recommended last year by the Louisiana State Medical Society and from its Journal (Pan-American Surgical and Medical), I quote the following, which is self-explanatory:

"Lack of funds hampers both the State and City Boards of Health in instituting a rat crusade. In the last analysis, any anti-rat campaign, especially in a city where the rodents have invaded every precinct, will prove ineffective so long as garbage remains uncovered, stables, granaries, warehouses, markets, etc., remain unratproofed. It would need the great fire of London to clean up some of the rookeries; sixteen miles of wooden wharfage serves as a harbor for these pests, hence advantage should be taken of the high stage of the river to institute a vigorous campaign when the waters force them inland. This was recommended last year by formal resolution of this society. Rats must be starved into submission before they can be induced to enter traps and eat poisoned bait, so it is a question of educating the public. When the individual unit is clean, the community aggregating of units will be clean, hence the necessity of educating the delinquent citizen, who leaves food supplies open to rat visitation. I fear it will require, in the future as in the past, an epidemic visitation to arouse the people to their duty in the premises.

"The main object of the Sunday Symposium on the Relation of Religion to Hygiene and Preventive Medicine, held at the Crescent Theater on the 17th of April, was primarily directed to this problem of municipal cleanliness and rat extermination, both as an economic and health necessity, and a religious duty. The annual loss from rats in what they eat and destroy far exceeds the cost of their extermination; the cost of an invasion of bubonic plague is incalculable. San Francisco expended millions of state and federal money, and still the bacillus pestis lingers in the ground squirrels of the rural districts. It was thought that the co-operation of the clergy of all denominations would have had an influence in quarters where neither the medico, the lawgiver, nor the financiers would have influence."

In order to meet the demands of the times, the Louisiana State Legislature enacted a law authorizing the Governor to raise $150,000.00, as the State contribution to this

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