PHYSICIAN'S DAILY MEMORANDUM FOR 1914

White River sets With Record of 56 below-38 at Winnepeg

Toronto, Feb. 11-(Special)-The weather burear reports the cold wave fof yesterday unchanged in position and increased in severity, with no prospects of a milder temperature. The vorecast is the somef or Ontario, Quebec and the Maritine Provinces to-day, to-morrow, "fair and continued extremely cold." Every province from Alberta east reports zero weather or lower. White River, as usual, taking the "cake with 54 at eight o'clock this morning. Winnipeg reports 38 below, Saulte Ste Marie, 22; Toront, 12; Kingston, 30; Otawa, 26; Montreal, 26; Quebec, 32; St. John 16, and Halifax four. Other places in Quebec report 36 below zero.

A Word of Explanation{diarist used extra-large letters}

Our friends will no doubt note the increased size of our "Physician's Daily Memorandum" for 1914, and an explanation is therefore in order. Heretoiore, the book has consisted of about two-thirds blank space and one-third printed space, and thus has been mailable as merchandise, instead of printed matter. Until the Parcel Post law became operative, it was mailable at the same rate of postage to all parts of the country; the new law, however, makes it obligatory to forward all merchandise by Parcel Post, and perscribes thawt all packages over four ounces in weight must be paid for as one pound, and at varying rates, in accordance with the postal zone for which it is intended. When it is considered that about 150,000 copies of this book are mailed, the physician can readily appreciate the almost impossible task of looking up the individual zone rate and affixing the required Parcel Post stamps to each copy. In addition to the infinite amount of time and trouble, which this would involve, it is practically certain that many copies would reach physicians of location, incorrect addresses, etc., etc. For the above reason, and especially because we do not wish to have any physician,pay a single penny in order to receive his copy, we have added a sufficient number of printed pages to render it classifiable as printed matter mailable at ounce rates, with ordinary postage, to all parts of country alike, as has been the case heretofore. In preparing copy for the additional pages, we have endeavored to render same intresting and instructive. It is hoped that the physician will continue to welcome and utilize the book, and that the few waifs of humor that have been interspersed may also be appreciated, when some idle moment makes it possible for the physician to look them over.

M. J. BREITENBACH CO.

Maud, V Melba Aylmer Ont

Physician's Year Book {diarist used extra-large letters} BEING A DAILY MEMORANDUM TOGETHER WITH A MISCELLANEOUS JUMBLE OF FACTS AND SUGGESTIONS OF INTREST AND ASSISTANCE TO THE PHYSICAN, "AS THE DAYS FLY BY" 1914

COMPLIMENTS OF M. J. BREITENBACH CO. 53 WARREN STREET, NEW YORK

CALENDAR 1914

Thursday, January 1 {diarist used extra-large letters} I DAY PAST 364 TO COME

In the Morning or the Evening of life, or at any of the periods typified by Shakespeare's "Seven Ages," tonic medication may be indicated. Pepto-Mangan (Gude) tones, restores and reconstructs surely, promply and pleasantly, in all conditions of systemic devitalization.

Weather Temp Fair 28 degrees

Roads good, no snow on the ground.

We drove Nydia Todd the first time. 6 miles

We brought her. Dec. 29th 1913

{illegible} is not well

{illegible}-At his late residence.  59 Metcalfe street. Stephen W. Tee-ple, esq.,in his 84th year. Funeral private. Friends will kindly omit flowers.

Friday, January 2 {diarist used extra-large letters} 2 DAYS PAST 363 TO COME

Diagnosis of Peritoneal Effusions. With the patient lying on his back in peritoneal effusions of moderate or small quantity, there is always fulness of the flanks, the degree of fulness depending not only on the quantity of fluid, but also on the relaxation and thinness of the abdominal wall. If the abdominal wall is relaxed there is always more less flattening of the abdomen anteriorly; if the walls are tensely distended this appearance is obsucred. If there is much subcutaneous fat the fulness is even more greatly obscured; edema will also obscure it.-A. McPhedran; Canadian Med Assoc. Journ.

Weather Temp Fair 26

Had our dinner at J.G Dana's . N Matthews was buried. Started to snow in the evening. Went to chastitute meeting held at {Hoavers?} Drove Nydia Todd 6 miles

Saturday, January 3{diarist used extra-large letters} 3 DAYS PAST 362 TO COME

Modern Ferruginous Therapy. The form in which to administer iron is distincly important. The old, irritant, astrigent martial medication has had its da, and properly so. The most generally acceptable of all iron product is Pepto-Mangan (Gude), an organic combination of iron and maganese with assimible peptones. It is palatable, readily tolerable, promptly absorbable, non-irritant, and still distinctly potent as a blood enricher and general tonic reconstructive.

Weather Temp northwesteast winds with snow 35 Evelyn was over and spent the afternoon Went for a sleigh ride on the pond Papa & Eugene went to aylmers Billy went 3 miles

WHICH?{diarist used extra-large letters} Which{diarist used extra-large letters} of the numerous prepartions of iron and maganese has attained the greatest reputation and prestige among the medical men of America? Which{diarist used extra-large letters} has become the accepted world-wide standard as a readily tolerable and thoroughly efficient hematinic? Which{diarist used extra-large letters} enjoys "the homage that inferiority pays to merit" -i. e.: universal imitation?

Pepto-Mangan("Gude"){diarist used extra-large letters} is of unquestioned and unqestionable value as a hemogenic and reconstituent in Anmeia, Chlorosis, Bright's Disease, Marasmic states and General Denutrition. In original bottles only. Never sold in bulk. Samples and literature upon application.

M. J. BREITENBACH CO. NEW YORK, U. S. A.

She Wanted Him to Know.

A Boston physician was called out of a sound slumber the other night to answer the telephone. "Hello! what is it?" he asked, little please at the idea of leaving his comfortable bed. "Baby is crying doctor, what shall I do?" came across the wire. "Oh, perhaps it's a young mother, one of his patients. "No," was the reply; "I'm sure it can't be that." "Perhaps he has the colic," returned the doctor, with well simulated solicitude. "No, I don't think so," replied the mother, "he doesn't act that way." "Then perhaps he's hungry," as a last resort. "Oh, I'll see," came across the wirse; and then all was still. The doctor went back to bed and was soon asleep again. About half an hour afterward he was awakened by the violent ringing of the telepohone bell. Jumping out of bed and placing the receiver to his ear, he was cheered by the following message: "You are right, doctor, baby was hungry." - Healthy Home.

She Liked the Hospital Not long ago at a provincial hospital an old woman, who was being discharged completely cured, was having a last interview with the house physician. "Well," he said, "you have to speak well of the hospital now, won't you?" And the old woman replied: "Ay, that I will, doctor. But, sure, I never spoke ill of it. My husband died here."-Current Literature.

The Importance of Nutrivite Repair in the treatment of tuberculosis, is now generally acknowledged. All phthisio-therapists agre that the therapeutic trinity of salvation for the tuberculous invalid is composted of: 1-Fresh, pure air, in abundance, both night and day; 2-A properly balanced ample supply of nutritious food; 3-Plenty of rest, especially during the febrile period. While medication is useless, unless the patient is properly fed, "ventilated" and rested, as aboved referred to; there is no doubt that intelligent medical treatement designed to promote nutition, is indicated in a majority of cases. If the tuberculous patient has been neglected for any length of time, some degree of anemia is almost always present. In such cases, an absolutely bland, non-irritant, readily tolerable and assimilable form of iron, such as exists in Peto-Mangan (Gude), cannot but be of benefit, by stimulating the formation of erythrocytes and hemoglobin, and thus augmenting the oxygen-bearing potency of the blood. Metabolic interchange is thus quickened, better absorption and assimilation of food follows, and as a consequence, nutritive repair is encouraged and hastened

Sunday, January 4{diarist used extra-large letters} 4 DAYS PAST 361 TO COME

Oxygen Inhalation. The writer describes a method of administering oxygen, that in some respects is superior to the methods in general use. It is simplicity itself. The inhalation tube forks into two branches, each of which terminates in an olive-shaped end-piece like that used in the Politzer bag. One of these end-pieces is inserted into each nostril, which it fits snugly. The patient can thus comfortably inhale the oxygen in any posture and without any exrtion on his part. The writer especially recommends the use of oxygen inhalations, by means of this recommends the use of oxygen inhalations, by means of this apparatus, in pneumonia.-Lauder-Brunton; Brit. Med. Journ.

Weather Temp Fine 30

Snow averages two feet on the level and heavier in drifts places. no wa one passed by on the road until evening.

nlc Clarence Skinner and family went by in the Bob-sleigh about five o'clock.

Neba & Eugene had a ride the first of the season. Mr. Cox was with us this evening.

Monday, January 5{diarist used extra-large letters} 5 DAYS PAST 360 TO COME

Post-Grippal Prostration. R Strychniae Sulph. (Gm.o.o2) Pepto-Mangan (Gude) (Cc. 300-orig. bottle) gr. 1/3

                                              3xi

M. Sig.-Tablespoonful after each meal. Children in proportion, according to age Weather Temp Fair 80

Municiple Election also voted for Local Option, lost by 1/6 votes. Pinco elected reeve for Malahide 5. Wagner " mayor of Aylmer. Good sleighing. Drove Nydia 7 miles. Drove Bill 12 miles.

Tuesday, January 6{diarist used extra-large letters} 6 DAYS PAST 359 TO COME Mistrust "Migraines" After 45. A so-called migraine persisting after the age of 45 or 50 is to be looked on with very grave suspicion indeed. In such cases you will examine the urine and the arteries very carefully; or some indications of a latent cerebral tumor may be hit on. Mistrust "migraines," then, however "paroxysmal" the attack may be, hoever typical the affection may appear if they gon on after 45 years of age. I am almost disposed to say curtly, that if in a migrainous person the migraine persists in later life, ther is probaby a screw loose somewhere in his constitution.-T. Clifford Allbutt; Clin. Journ.

Weather Lous Pierce Died. Temp. Fair 29 mr. Baker was here. tea. Snowed a little at four. Good sleighing. mand went to school to-day. Drive Bill 12 miles Nydia Todd 7 miles

miss story taught.

Wednesday, January 7{diarist used extra-large letters 7 DAYS PAST 358 TO COME To Increase Resistance to Colds. When (as is often the case) the patient cannot correct the unhealthfu hygenic conditions with which he is surronded, it is wise to tone up the general vitality and thus render the respiratory tract more resistant o morbific influences. This is best accomplished by prescribing Pepto-Mangan (Gude), as soon as the more acute symptoms have subsided. This efficient tonic reconstructive often enables the patient to ward off further catarrhal attacks

Weather Temp Fair 30

I went to school today good roads and nice sleighing Drove nydia Todd 25 miles Drove Bill 5 miles

miss Story was sick.

Thursday, January 8{diarist used extra-large letters} 8 DAYS PAST 357 TO COME Some "Dont's" in Cardiac Therapeutics. Don't allow a patient with an uncompensated valve lesion to be out of bed. Dont let a child or a young person with chronic valve disease get out of bed until compensation has returned to the heart and circulatory equilibrium has been maintained for at least one month. Don't keep elderly patients with myocardial degeneration in bedd longer than is absolutely neccessary to secure adequate compensation. Don't give children digitalis, unless there is absolute indication for its use.-Med. Review of REviews. (Continued second page following.)

Weather Temp Fair 40 Mrs. Ashbaugh was out here" to-day. Good roads and nice sleighing. Drove Bill 5 miles. Drove Nydia Todd 2.3 miles Cengene got his meres rocking Chair. Saw Makhow Mathews.

Friday, January 9{diarist used extra-large letters} 9 DAYS PAST 356 TO COME How? How{diarist used extra-large letters} does the physician determin the merit of any medicinal agent? How{diarist used extra-large letters} does he seperate the valuable medicinal wheat from the useless therapeutic chaff? The actual experience of medical men everywhere, for nearly twenty years, definitely establishes the unqualified hematinic and reconstructive virtues of Pepto-Mangan (Gude).

Weather Temp cloudly 42

Papa + Mr. Cox went to Mr. Bentley. Eugene went to a boy social. Bill went 10 miles. Nydia went 7 miles.

Saturday, January 10{diarist used extra-large letters} 10 DAYS PAST 355 TO COME

Some "Dont's" in Cardiac Therapeutics-(Continued).

Don't give ditialis to old people as a routine measure. Don't give digitalis to a patient with fatty heart or with any form of pronounced chronic myocardial degeneration. Don't persist in giving digitalis in chronic valvular disease if the symptoms are rendered worse by its use. Don't start in with digitalis in mitral stenosis. Don't give digitalis, strophanthus or any other cardiac stimulant unless rest in bed fails to induce a return of compensation.-Med. Review of Reviews. (Continued second page following.)

Weather Temp Fair but cold 30 Roads in rather good shape Papa and Eugene went to aylmers Drove nydia Todd 5 miles mother melba and I spent the evening at mr {bocer's?} place good sleighing Pa bought his new over bought them of the {Fration?}. Fead a letter from Acentic Teeple Mu Tecple. no better.

"In Union is Strength"{diarist used extra-large letters} The truth of this old adage is well exemplified in therapeutics from the conjoined administration of arsenic, strychnia and

Pepto-Mangan("Gude"){diarist used extra-large letters} The combination acts promptly and vigorously as a general supportive tonic in markedly deviatalized conditions such as Grippe, Prostrationl, Convalenscence from severe Pneumonia, prolonged Typoid, Surgical Shock, etc. Both arsenic and strychnia are thoroughly compatible and readily miscible with PEPTO-MANGAN(GUDE), and either or both may be safely added in any desired proportion, according to age and indication

In 11 oz. bottles only. never sold in bulk.

M. J. BREITENBACH CO. NEWY YORK, U. S. A.

The Estimation and Siginificance of Blood Pressure. Dr. L. W. Littig, in Iowa Medical Journal, in a thor- ough discussion of the subiect, makes the following points:

(1) That the sphygmomanometer is the most useful instrument in general medical work, and that an exam- ination cannot be considered complete unless the blood pressure has been accurately taken.

(2) That the blood pressure at the age of twenty years may be assumed to be 120 millimeters, and that an increase of one-half millimeter for each year above this age is normal with a variation of 15 mm above or below the point so obtained (Faught).

(3) That increased blood pressure indicates chronic interstitial nephritis in 75 to 80 per cent. of all cases, and in the other 20 and 25 per cent. it indicates either a splanchnic sclerosis, or a sclerosis of the aorta above the diaphragm.

(4) With moderate increase in pressure, judicious exercise to stimulate elimination, and castor oil to pre- vent intestinal toxaemia are rational procedures.

(5) Increased arterial pressure may be conservative and unless dangerously high, or compensation be broken, does not require either vasodilators or heart tonics.

(6) If dangerously high vaso-dilators, as nitro- glycerine, nitrite of amyl, or nitrite of soda must be used, especially in cases of coronary sclerosis, as indi- cated by attacks of angina pectoris.

(7) With failing compensation, digitalis becomes the remedy.

The Test of a Tonic.

The field and function of a systemic tonic is gen- erally understood and appreciated by both physician and patient. To stimulate, whip or goad the vital pro- cesses is not to "tone," but, on the contrary, to ulti- mately depress. A real tonic is not a mere "pick-me- up," but some agent that adds genuine strength, force and vigor to the organism. The genuine tonic is a builder or reconstructor of both blood and tissue. Any agent which will increase the power of the blood to carry and distribute the life-giving oxygen is a tonic in the best and truest sense of the word. Iron in some form is an ideal tonic, as it builds up the vital red cells of the blood and the hemoglobin, which is their essential oxygen-carrying element. Of all forms of iron, none is quite as generally acceptable and readily tolerable and assimilable as Pepto-Mangan (Gude). It creates ap- petite, tones up the absorbents, builds the blood, and thus is a real tonic and reconstructive of high order. It is especially desirable because of its freedom from irritant properties, and because it never causes a con- stipated habit.

Sunday, January 11{diarist used extra-large letters} 11 DAYS PAST 354 TO COME

Does Not Irritate the Gastric Mucosa. An English physician writes: "In my hands Pepto- Mangan (Gude) has fulfilled all you claim for it. As it does not constipate or irritate the gastric mucosa (ir- ritable at times in extreme cases of simple primary anemia) it is an ideal remedy in that disease. As it is easily assimilated, it can be given to quite young chil- dren without causing secondary gastro-intestinal de- rangement.

Weather Temp Blustry 20

Eugene event to Aylmer this morning + Boyde. Maude & Jacline went to sunday school. Johns kulbar I went over to the leaves. this afterware. Eugene drove my dice Rodd & miles. Bill even five 5. Goelin stayed to tele as the evening.

Monday, January 12{diarist used extra-large letters} 12 DAYS PAST 353 TO COME

Some "Dont's i" in Cardiac Therapeuticcs-(Continued).

Don't forget that digitalis, strophanthus, strychnine and caffeine are the most effective heart stimulants, and that nearly everything in the line of heart stimulation can be ac- complished by them if they are correctly exhibited. 'Don't use nitroglycerin in cardiovascular disease to reduce blood pressure if the kidneys are much sclerosed, but do not fail to use it freely if coronary sclerosis is present.-Med. Review of Reviews. ( Concluded second page following.)

Weather very blustery Temp 12

Snowed a little off, and on, all d day. Mand & Mella, went to school Augene took them, and event for them. Panas over to Mr Gobes after dinner. Engine was down to Bingham and spent the evening. Nadin went by miles.

Tuesday, January 13{diarist used extra-large letters} 13 DAYS PAST 352 TO COME

"The Best of Prophets of the Future is the Past."

An established reputation, based upon proved accom- plishment, is a distinct asset. The past performance of Pepto-Mangan (Gude) is the best "prophet" of its future action. For more than twenty years it has been building blood in all conditions of devitalization and is still the leading prescription hematinic throughout the civilized world.

Weather Fair Temp

            10 below zero

mahlon Mathews & mrs Harris, came home with ne this morning & I took them back when I went for the girls. Pa went to the factory. Eugene went to Randall belines this afternorr to try and get a Jeef. The Baptist Church people gave a reception funder Mitchell this evenings Nydia 8 miles Bill ten

Wednesday, January 14{diarist used extra-large letters} 14 DAYS PAST 351 TO COME

Some "Don'ts" in Cardiac Therapeutics-(Concluded). Don't forget that individual susceptibility to strychnine varies greatly, and that it is not generally safe to begin with a larger dose than one-sixtieth of a grain every four hours; and that the maximum dose in diseases of the heart is generally not more than one-thirtieth of a grain every four hours.

 Don't prescribe passive movements as part of the treatment without carefully watching very carefully to see that they are not given too vigorously.

Don't expect to get compensation in a bad case too soon; be satisfied if the patient shows slight improvement immediately; permanent improvement must be slow if it comes at all; and attempts to hurry it unduly may prematurely exhaust the heart.-Med. Review of Reviews.

Weather Cloudy Temp 18 below The boys went rabbet hunting caught one d'Augene had a long Chase after another, but dideret catch it, Eugene took the girls to school. I went for them, Pa is downst Scheds this evening. And Eugene has gone away. It is snowing & drifting to night Drove Stydia & miles fill 5 Got Jeggs Eugene Corrowed as Ferrit. Saw Ed Thompson taking his caus over to the little pond Brudster them Nydia 8 miles Bill ten

Thursday, January 15{diarist used extra-large letters} 15 DAYS PAST 350 TO COME

The Handsome Bacteriological Chart, issued by the American agents for Pepto-Mangan (Gude), is a most useful and ornamental addition to the physician's office. It consists of sixty beautifully colored litho graphs of the pathogenic bacteria, and has recently been brought fully up to date by the addition of two excellent plates representing the spirochette of syphilis, and the treponema pallidum of Schaudinn. It is an excellent chart for reference, as well as a reliable guide for the laboratory worker.

Weather Warm Cloudy Temp I took the girls the school. Then in the afternom John & & went to Allier, and brought the Children home. Eugene went over to help mend M Dances wind snill. I was in to see ours le line. a little while. Lee Muro Thaupson have Mella's old devek. Mrs Thomp Syn & Boy de came and of spent the evening Aydia 7 miles Bill 6

Friday, January 16{diarist used extra-large letters} 16 DAYS PAST 349 TO COME

The Abdominal Woman There is one kind of patient in whom the presence of membranous colitis should always be strongly suspected, and that is what we may speak of as "the abdominal woman." You all know the type; those who have been in practice know her only too well. You remember her constant state of misery and dejection, her obstinate constipation and flatulence, her frequent complaint of vague abdominal discomfort or pain. In such a case you will often find that mucomembranous colitis is the fountain of all the patient's ills- Hutchinson; Clin. Jour.

Weather Temp Thawing & cloudy. Bought half a pig. Aléta & Carl braught the children from school, & alita stayed for tea, then bearl came back & Aug. went to Aylmer with them to an entertainment. John then this after her mas Cengene caught a rabbit, manure, here Bill & miles I was to Kingsmill

Saturday, January 17{diarist used extra-large letters} 17 DAYS PAST 348 TO COME

Especially Valuable With Children. A physician in the upper part of New York State writes: "After twelve years of experience with Pepto- Mangan (Gude) I believe it to be one of the best remedies for anemia and chlorosis and superior to all others, where indicated in diseases of children"

Weather Cloudy Temp. Freezing

John & Eugene was hauling manure all day. I went to Aylmer after dinner & took Mrs. Rodgers for a sleigh ride then we called on Aunty Arnold, found her bright & quite well. The girls did all the house work & played. Commenced on our half of pig that we bought. John & Eugene went to Aylmer. Bill went 7 miles.

WHAT? {diarist used extra-large letters} has been more definitely determined in actual practice than the therapeutic utility of judicious hematinic therapy?

What {diarist used extra-large letters} preparation of iron and manganese is, and always has been, the most openly, flagrantly and universally imitated?

What {diarist used extra-large letters} preparation has been most largely instrumental in demonstating the peculiar value of iron and manganese combined?

Pepto-Mangan("Gude") {diarist used extra-large letters} exercises distinct and definite hemogenic and nutrogenic properties in Anemic, Chlorotic and Marasmic conditions.

In original bottles only, Never sold in bulk. Samples and literature upon application. M. J. BREITENBACH CO. NEW YORK, U. S. A.

Edema of Extremities.

Where edema of legs resisted all measures, especially where incision not permitted, good reuslts obtained from local used of hypertonic saline solutions—25 to 50 gm. (3/4 to 1 1/2 ounces) of sodium chloride to 1 liter (quart) of distileed water. Soak gauze compresses lightly in this, wrap around legs, and cover with thick layer of absorbent cotton, held in place by bandages. Leave dressing on overnight. Equally good results in edemas due to broken compensation, Bright's disease, etc.—Patault.

A Song of Asepsis.

Oh, I love full well the green soap's smell, And the steaming tray's hot breath—As the wild turmoil Of the bubbling boil Sing the song of the microbe's death! Oh, I love the rush of the scrubbing brush Upon the reddened skin, As the ether's fume Fills the room, And the word is passed, "Begin!" Oh, I love the feel of the glist'ning steel Still hot from the cleansing fire, And the blade's as bright As the rays of light From the incadescent wire. Oh, I love full well the green soap's smell, And the steaming tray's hot breath—As the wild turmoil Of the bubbling boil Sings the song of the microbe's death! —J. Lee Hagadorn; So. Cal. Pract.

An Iron Need is a Vital Need.

Ferric re-enforcement is an imperative necessity in almost all cases of anemia, chlor-anemia, chlorosis, tuberculosis, Bright's, malnutrition. Pepto-Mangan (Gude) supplies the essential material: meets the imperative blood need; fulfills the therapeutic indication, without harm to digestion or disturbance of any function. The true test of a tonic is its action as a genuine reconstuctive rather than its temporary effect as a mere "pick-me-up." Pepto-Mangan (Gude) has, for nearly twenty years, been successfully playing the eminently useful role of a true tonic in all sorts of general devitilization. It still maintains its undeniable supremacy as an hematic reconstituent, of special service in the convalescence of la grippe, typhoid, pneumonia and all acute illnesses.

The Hemic Murmur and the Venous Hum indicate a distinct anemia, the character and degree of which may be determined by the blood count and hemoglobin estimation. A therapeutic quartette of marked value in such cases is composed of fresh air, nourishing food, rest, and Pepto-Mangan (Gude). This valuable hematinic is distincly palatable and entirely free from irritant or astringent properties. Its beneficent influence is nowhere better illustrated than in the after-treatment of the acute diseases of childhood. The readiness with which even the youngest child takes and tolerates it, and its prompt and decided tono-stimulant effect upon nutriition generally, renders Pepto-Mangan (Gude) the first choice among reconstuctives in pediatric pratice.

Sunday, January 18 {diarist used extra-large letters} 18 DAYS PAST 347 TO COME

Maxillary Sinus Suppuration. When pus is found in the antrum it can be accounted for in one of four ways: 1. It may be due to an extension of infectious material through the ostium from the middle meatus. 2. It may be due to ifection reaching the cavity from the root of a diseased tooth. 3. It may be a secondary infection of a non-perulent accumulation of fluid. 4. The antrum may be acting as a drip cup for the discharge from the diseased areas high up in the nose.—A. H. Andrews; Detroit Med. Journ.

Weather Fair Temp. Cold

Monday, January 19 {diarist used extra-large letters} 19 DAYS PAST 346 TO COME

THE ILLS OF THE AGED. The Elderly invalid requires gentle, yet efficient treatment.

Pepto-Mangan("Gude") {diarist used extra-large letters} is especially adapted to the ills of the aged, as it it free from harshness or constipating effect.

Weather Cloudy rained a little Temp.

Tuesday, January 20 {diarist used extra-large letters} 20 DAYS PAST 345 TO COME

Alcohol Antidote. Ammonium chloride is recommended as an antidote to alcohol, given in doses of 30 to 60 grains, with copious draughts of water to prevent gastro-intestinal irritation. It prevents the effects of the alcohol, sobers the patients quickly, and is a valuable preventative against delirium tremens. Should the patient not become quiet after taking the remedy, bromide or chloral hydrate may be administered.—Med. Times.

Weather Foggy and cloudy Temp.

Wednesday, January 21 {diarist used extra-large letters} 21 DAYS PAST 344 TO COME

Post-Pneumonic Heat Weakness. R Strychinæ Sulph. (Gm.0.02) gr.1/3 Liq. Potas. Arsen. (Cc. 4.0-8.0) 3i-3ij Pepto-Mangan (Gude). (Ce.330-original bottle) 3xi M. Sig.-Tablespoonful after each meal. Children portion, according to age.

Weather Some Flurries Temp.

Thursday, January 22 {diarist used extra-large letters} 22 DAYS PAST 343 TO COME

Gynecological Hints. In a general way secondary operations on the perineum should not be performed until the end of at least two months. If they are performed earlier the lochia are apt to interfere with union. It is not necessary to stop nursing an infant for more than a few hours following operations on the perineum. After all operations of the perineum the bowels should be kept freely open.—Waldo; Int. Journ. of Surg.

Weather Cloudy Temp.

Friday, January 23 {diarist used extra-large letters} 23 DAYS PAST 342 TO COME

Weak Heart, Gripe Prostration, Etc. We have frequently referred to the complete compatibility of both arsenic and strychnia with pepto-Mangan(Gude), in any desired proportion. The following R is espeically indicated in "grippe" prostration, weak heart, etc. R Strychniæ Sulph. (Gm.0.02) gr. 1/3/ Pepto-Mangan (Gude). (Cc.330-original bottle) 3xi. M. Sig.-Tablespoonful after each meal. Children in proportion.

Weather Temp.

The Time-Tried Tonic

As the years fly by, scores of new and untried remedies are introduced, most of which are ultimately cast into the therapeutic scrap heap of oblivion. As "time tries all things," the preparation that steadily increases in professional favor, for more than 20 years, must possess merit, and stand out as an example of "the survival of the fittest." Pepto-Mangan ("Gade") is such a remedy. The medical profession, throughout the civilized world, continues to pre- scribe it, in steadily increasing quantities, in Anemic, Chlorotic and Marasmic conditions, and whenever a dependable tonic and blood builder is required. In 11 oz. bottles only. Never sold in bulk. M. J. BREITENBACH CO. NEW YORK, U. S. A.

An Up=to=date Doctor.

I was riding with a country doctor one day, when an old farmer hailed him on the road: " Say, doctor, I have got a lame back; what shall I do for it?" "Oh," said the doctor , "you have strained it. Just get a plaster and put it on." The man thought he had been getting something for nothing, but the doctor called him back and said: " A man of your age must look out for kidney trouble; you had better come into the office and let me examine you." As we drove on the doctor chuckled and said,"I will get five dollars for that examinations." "Do you think he has kindney trouble?" I innocently asked. "No," replied the doctor ; "you could not kill that man with a club, but he is the richest man in the country,and he was trying to work for me!"

Diagnosis by Exclution

"There is nothing the matter with you," persisted the Eddyite ,"absolutely nothing. Can I not convinve you?"

"Let me ask you a question?" replied the sick man.

" A thousand if you like"

" Well suppose a man has nothing the matter with him,and dies of it ,what didn't he have the matter with him?- == Philadelphia Press. ==

" Even in the Instant of Repair and Health"

                          (King John)

one needs assistance-convalescence from any severe illnes is accelerated ,and health and "well being" restored through the efficient aid of a potent genreal tonic.

Pepto-Mangan (Gude) materially hastens reparation and reconstuction by contributing , in the readily assimilable form the essentials elements for blood and tissue repair , i. e. iron and manganse.

Pepto-Mangan (Gude) is indicated in anemia, malaria, chlorosis, anmenorrhea, dysmennorrhea, rickets, Bright's disease , as a blood builder before and after operations; as a genreal tonic and reconstuctor in convalescence from diphtheria, tyhoid feve, scarlatina, la grippe, etc.

Pepto-Mangan (Gude) had gained and maintained and unique and unequalled reputation as a pleasent and effcient hematinic in such conditions. Dose:- Adults a tablespoonful 3 times a day; children in proportions.

"Pratice is to Theory What the Feet Are to the Head"- ( De Giradin)

Every theorectical idea and every preconcived notion in regard to medication must,in the long run, give way to and make way to and make way for the facts the perience.One such fact is the undenible superiority of Pepto-Mangan (Gude) as an efficent and invarible tolerable hematinic. That it" does the work" safely quickly and pleasantly is the consensus of opinion of the thousands of medical men who have prescribed it during the last seventeen years in the anemaia, chlorosis and malnutrition genreally.

Sunday, January 25 25 DAYS PAST 340 TO COME The Superiority of the Organic Combination in the domain of iron therapy during recent years, points overwhelmingly to the superiority of the organic com- bination, and clinical experience, as recorded by compe-: tent observers in all parts of the world, has been more favorable to Pepto-Mangan (Gude) than for any other officinal or popular agent known.-American Therapist. Weather Fair Temp. Eugene brought Allarta over in the afterman, Maudie Melba & Collin went de Sunday school. Mark took the bigsleighs & Frok Cedi & no ell to be church. John was down th Sheds. Die Stydia 14 miles

Monday,January 26

Surgical Suggestion.

Lavage of the stomach prepartory to an operation for intestinal obstruction had best to be done before anesthetizing. Performed during narcosis the procedure may cause alarming embarrassment of repiration and, if the throat should become flooded with mucus or stomach content, as occasionally happens,an aspiration pneumonia is very apt to follow.-

Amer.Journ. of Surg.

Eugeme got a new furniture and his new bed head. Head {illegible}over a little while in the evening. Mark and John went down Shed,cut the {illegible} home so mask came home worth John. Eugeme tok the girls to school went for them. Drove Sydia Joulies

Bill Miles

Thursday, January 29

Grippe Prostraction

R Strychnaie Sulph (Gm .00.2)

Pepto Mangan (Gude). (Cc.330-orignal bottle )3xi

M.Sig- Tablespoonful after each meal. Children in proportion.

I think the girls at school Pouring and,aren't for them has like a spring day,turned very cold amoung the hold a horse went day. Eugeme went a spent.the evening.Jhon was home. Drove Bill 10 1/2 milles.

Weather: Very Cold.

I took Mella to school. Mandie was not well enough to go. Mella walked a far home to {unclear}. I met her.

Weather: Raining & freezing.

Ceugene has gone down to Adam for another little calf.Pa has gone down to Sheds this evening.Ceugene went to Aylney and got the bread for us. Farmed & blew a regular hurreycane all day. Polly went for January.

Polly: 11 11 1 6 0

Nydria:11 11 1 9 3

Billy: 11 11 1 4 8

Total: 5 0 1 1/2

To BUILD UP

To BRACE UP

To TONE UP

In any form of DEVITALIZATION prescribe

Pepto-Mangan ("Gude")

Especially useful in

Anemia of all varieties, Chlorosis, Amenorrhea

Bright's Disease, Chorea, Tuberculosis, Rickets,

Rheumatism, Malaria, Convalescence and as a

General Tonic

Dose:-One tablespoonful after each meal.

Children in proportion.

In 11 oz. bottles only. Never in bulk.

M.J. BREITENBACH CO.

New York, U.S.A.

Samples and Literature upon request.

Epistaxis

Pech gives the following simple cure for nose-bleed. Have the patient stand erect with the head up and place the finger on the nostril that does not bleed so as to keep it closed. Patient then slowly inhales through the bleeding nostril and exhales through the mouth. This, continued for a few minutes, will check the bleeding. Avoid blowing the nose or using the handkerchief lest the clots be loosened.

_________

Best He Could Think Of.

In one of the Philadelphia colleges a professor of chemistry asked a student:

"Suppose you were called to a patient who had swal-lowed a heavy dose of oxalic acid, what would you ad-minister?

The student to whom the question was addressed is preparing for the ministry and takes chemistry because it is obligatory.

"I would administer the sacrament," he replied.

_________

A Fair Question.

The physicians were holding a consultation beside the cot of a man supposed to have appendicitis concealed about his person.

"I believe," said one of the surgeons, "that we should wait and let him get stronger before cutting into him."

Before the other prospective operators could reply the patient turned his head and remarked feebly:

"What do you take me for - a cheese?"

"There Are Occasions and Causes Why and Where-fore in all things."

- (Shakespeare)

Although empirical therapy is sometimes the acme of good judgement, the intelligent physician desires his reasonable "why" to be clearly answered before prescribing for his patient. In the case of Pepto-Mangan (Gude) "the why is plain as way to parish church." It furnishes, in agreeable, bland and immediately appropriabe form, the needed material for corpuscular and hematinic reconstruc-tion in anemic, chlorotic and marasmic conditions. "Wherefore" and "therefore" it meets every rational indication, as definitely proved by the hematologic test and the clinical experience of almost two decades of professional use.

______

The Peculiar Pallor

of the cheek, lip and conjunctiva in chlorotic anemia, is characteristic and unmistakable. It is eloquent testimony of an "Iron-hunger." An imperative signal of an "iron-need."

That Pepto-Mangan (Gude) best satisfies this need, is demonstrated by the prompt return of healthy color to skin and mucous membrane. Di-gestion is not disturbed; constipation does not ensure; the teeth are not injured.

Pepto-Mangan (Gude) is indicated in anemia, ma-laria, chlorosis, amenorrhea, dysmenorrhea, rickets, Bright's disease, as a blood builder before and after operations; as a general tonic and reconstructor in convalescence from diptheria, typhoid gever, scar-latina, la grippe, etc.

Pepto-Mangan (Gude) has gained and maintained an unique and unequalled reputation as a pleasant and efficient hematinic in such conditions. Dose:-Adults, a tablespoonful 3 times a day; children in proportion.

Sunday, February 1

32 DAYS PAST 333 TO COME

Puerperal Eclampsia (Concluded)

9. Avoid undue forcing of hot packs for fear of heat-stroke.

10. Secure time for production of elimination by controlling convulsions with morphine.

11. Ordinarily the high blood-pressure needs no specific attention.

12. The successful treatment of eclampsia requires much personal attention by the physician.-Skeel; Cleveland Med. Journ.

Weather Temp.

Rather cold

Did not go to bhurek, nor the children to Sunday school, NOthing doing. Mello burned her leg. Forth hot tea. Good wheeling.

nydia Todd & mikes

Monday, February 2

33 DAYS PAST 332 TO COME

"LaGrippe" Convalescence

In the convalescent stage of La Grippe nothing will more quickly and certainly restore the strength and repair the blood than Pepto-Mangan ("Gude") the ideal hematinic and general tonic.

Weather Temp.

Fair & cold

Killed the beef. Eugene took it and delivered it all. Mark helped to kill it. I took the girls to school. Eugene brought Mella home. Carl & Altaga Maudie took her home with them. Washed to day. Got seven eggo good wheeling

Bill 5' Polly 13 1/2'

Tuesday, February 3

34 DAYS PAST 331 TO COME

Cautionary Points in Anesthesia

The practice of covering a patient's face with a towel after operation, while he, still unconscious, is being taken on a stretcher to his room is to be condemned. So is anesthetiing etherizer away from an unconscious patient to begin anesthetsizing another case, unless some attentive and exper-ienced assistant is specifically notified to watch the patient's gradual recovery from anesthesia. I have seen a patient vomit under such circumstances, when no attendant was close at hand to see that asphyxia did not occur.-Dr. J. B. Roberts; Therap. Gaz.

Weather Temp.

Thawing very muddy. I took the girls to school & went for then Eugene went to Spanta to Turrells sale, bought {illegible text}. John helped Mark all day cleaning up wheat. We started to eat our beef Seven eggo. {illegible text} Good wheeling

Bill 11 Nydia 30

Wednesday, February 4

35 DAYS PAST 330 TO COME

The Secondary Anemia of Tuberculosis

R Liq.potas.Arsenitis (Cc.4.0-80) 3i-3ij

Pepto-Mangan (Gude). (Cc.330-original bottle) 3xi

M. Sig.-Tablespoonful after each meal. Children in pro-portion.

Weather Temp.

Cold frozen all day I took the girls to chool & went for the. Edna Peret came home with Mella. Pa & Eugene went to Sparta to day, for five pigs at McTurrels. Eugene bought the David Adams cow. got twenty eggs, Mella went home with Edna for dinner from school, John has gone down to school this evening. Good wheeling.

Bill ten/0 Polly 30 Nydia 6 pid

Thursday, February 5

36 DAYS PAST 329 TO COME

Acute Appendicitis

At onset withhold all food by mouth to arrest peristalsis and reduce virulence of insteinal bacteria. Avoid giving prugative or fluids. Early or immedate operation is safest course. Appendix should be removed if possible, in diffuse peritonitis invariably so. If purgative has been given, an urgent reason for immediate operation if furnished, especially in children. Where there has been sudden cessation of pain after typical onset, operation should be hastened rather than delayed.-Bruce

Weather Temp.

moved birth day

Thawed a little but the wind was very cold

I took the girls & went for them. Edna Pert came home with last night. I intended going to St Thomas but changed my mind called on Aunty Arnold to few minutes & found her feeling quite well. Mary & Alie was a going for tea at Maudi McLewis. Took a visit with Mrs Celine. Took Maud Thompson to Aylines with me She stayed to her mothers. Emily has time. Paid Mr Adams for the cow. Shed was {unintelligible} this morning Bill II. India 2 1/2 Boys was cutting wood Good wheeling

Friday, February 6

37 DAYS PAST 328 TO COME

They Answered Promptly.

A London, Eng., physician writes: "I have found Pepto-Mangan (Gude) an excellent remedy for anemia, the patients on whom I have tried it answering very promptly to its hematinic properties, even after failure of other treatment, and it appears to be an excellent tonic.

Weather Temp.

Very cold this morning wind blowing a perfect hurrycane allday. Started to snow about two this afternoon, then rainy hale. I took the children this morning & to night Mella road home as for as the corner with Alice her a beeil, them came home a foot the next of the way. I went after Maudi & Aunty Maud Thonfon, they went & Mrs Wines to a ladies tea. Maudi & Muriel Fanden helped wait the tables. bought three courses wheeling good Bill/0 Pollu 6 Mydia 11

Saturday, February 7

{typewritten section titled "Surgical Suggestions"}

Weather Cold & blustery all day Temp. {blank}

Snowed a little. Pa, Eugene & Maud went to Aylmer after dinner. Maud joined the library today. Pa had Polly shod. Got the grist from Kingsmill. Mr Conors died at nine this morning. I have been caning mince meat all day, got twelve eggs. Eugene has now gone down to Mr Binghams. Sent the hides away to get tanned. Head a letter from Mrs Darlington, with a little doiley in it. Good wheeling

Polly {11?}

Pepto-Mangan ("Gude")

is the one unquestionably efficient regenerator of blood vitality which can be taken without danger of irritating or disturbing the digestive functions, by patients of all classes and ages, in all condi-tions due to or complicated by a deficiency in the quality of quantity of the blood.

Among its most prominent indicators are:

Simple Anemia, Chlorosis, Leukemia, the sec-ondary Anemias of Malaria, Tuberculosis, Syphilis, Bright's Disease, Rickets, Marasmus, La Grippe, Typhoid Fever, Pneumonia, the Exanthemata, etc. It is also of peculiar service as a general appetizer and reconstituent tonic in Convalescence and in condition of vital depre-ciation from any cause.

In eleven-ounce bottles only. Never in bulk. Literature and samples upon application.

M. J. BREITENBACH CO.

New York, U.S.A.

Digitalis Warnings.

Discontinue the administration of digitalis if any of the following warnings occur: marked nausea, radial pulse below 60, heart block (rapid ventricle unaffected by digitalis for several days suddenly becoming slower), paroxysmal tachycardia, coupled rhythm or phasic ar-rhythmia.

"In a Multitude of Counselors," Etc.

An oculist in Detroit had told her she was suffering from iritis, and should abstain from reading. The fee was ten dollars. The Boston expert sniffed at the men-tion of iritis, and declared there was no sign of it. His fee was ten dollars. A renowned Philadelphia spe-cialist diagnosed the trouble as iritis, and advised (fee ten dollars) an immediate operation; but a celebrated London authority, though discovering in the eye a well-developed case of the disease, thought any cutting should be avoided. Two guineas was his tariff for this advice. Suffering still, despite a treatment faithfully pursued, the desperate patient sought out a resident foreigner, known throughout New York for cunning in cases like hers. His long examination concluded, he said: "It would be good if you took a warm bath once a week." "To be sure," protested the visitor, "but I've had that or a cold bath daily all my life." "Yes," rejoined the specialist, complacently, "it is a very good thing." And then he directed that the next patient be called in. - N.Y. Evening Post.

Convalescence from the Exanthemata.

The first two or three months of the year are usually characterized, in the experience of the family physician, by the occurence in his practice, of a crop of cases of the contagious diseases of children, especially scarlet fever, measles, German measles, etc. This is accounted for by the readiness with which contagion is spread in the school, when ventilation of the school room is the least perfect and closer housing of school children during school hours favors the distribution of com-municable diseases. As the diseases in question are self-limited in nature, expectant and symptomatic treat-ment, together with precautions as to isolation, etc., is about all the physician is called upon to direct. It is well known, however, that in all but the mildest cases, the adolescent subject of scarlatina, or measles, is usually more of less debilitated or devitalized, when convalescence is established. Special care should be taken to avoid admnistration of any tonic or re-constituent which is likely to disturb the child's digest-tion or by inducing constopation, to minimize the ap-petite or desire for food.

Pepto-Mangan (Gude) is the ideal reconstructive tonic for these young patients, because it is pleasant to the taste, easily tolerable by the stomach and readily assimilable by blood and tissue and promptly efficient in restoring appetitie, strength, color and general well-being.

Sunday, February 8 39 DAYS PAST 326 TO COME

To Avoid Infection. In the last analysis, the germicidal activity of the blood is dependent upon its hemoglobin content. Pepto-Man- gan (Gude) places the depleted organism in a better posi- tion to withstand or ward off infection, by aiding the formation of oxygen-carrying hematin and functionally active erythrocytes. Weather Temp. Gelco Pa girls & I was all to Emilies for a ver. Cedis & Stella Bruch was there & Boyde. In the Ihr Loves was evening over & Jurs William Hoves. wife. A very blustery day. not much snas. bu blowing all day Nord wheeli Neplia & Polly 2 1⁄2

Monday, February 9 40 DAYS PAST 325 TO COME

Danger Signals of Cancer. (1) Cancer of the breast: The danger signal here is a small lump. In a woman over 35 or 40, this is cancer in at least 90 per cent. of cases. To wait a month to see if it grows, or shows signs of a cancer, is very likely to mean the woman's death in a short time. (2) Cancer of the uterus: The danger sign here is slight bleeding at irregular times, or any bleeding after the meno- pause.-Childe. (Continued second page following.) Weather Temp. Jery cold in the morning. I took the girls to school. & went for them. took the Anney to fill Pierce for, Jefferies Goose. Pa was down threads. Eugene was over to Me Douces Fold 71.10 north. of eggs good wheeling & Nydia & Bill 10 Polly 7 1⁄2

Tuesday, February 10 41 DAYS PAST 324 TO COME The Anemia of Hook Worm Disease. A practitioner in Virginia reports: "I am very fond of Pepto-Mangan (Gude) in cases of anemia and chlorosis. It acts splendidly in hook worm cases after the worms have been removed with thymol, bringing the color back to the patient's face and ears in a much shorter time than any other preparation." Weather Temp. Very cold.

Me Faepe Sur tied this morning Paosvent upon the trader Hook I took the girls to schools event for them. We did our ironing I stoped in to Mars Thompsons a few minutes. Cengene was over helping Mr Dance saw woods in the afternoon in the four noun the boys Cytting werd in the south mil Good wheeling Nydia & Billy 10.

Wednesday, February 11 42 DAYS PAST 323 TO COME

Danger Signals of Cancer-(Continued). (3) Cancer of the lip, mouth or tongue: The danger sign is a wart or sore that will not heal. If appearing after 40, it is practically sure to be a cancer. (4) Cancer of the skin: The danger sign is a sore on any part of the body, which does not heal, or the rapid increase of growth in a wart or a mole, which may have been present for a long time. If these appear in an individual over 40, they are nearly always cancer.-Childe. (Concluded second page following.)

Weather Grey Cold Ink the girly & girly work to schools goent for these tw Pa to the station. Mnr & W Peeple died this morning. John dief, not come hence to night Cuge ene was Rawing for the Dance this fourncony and this afternoon event of had Adin Phod. Aleta & Carl was here & Eugene ene went with themr downted Thompsons to a Jarry with Shedor's Granks. Whering Nydia 12 - Bill 10. Polly 4.

When a medicinal preparation has been before the medical men of America for 17 years;

When it has increased in both sale and prestige, year by year;

When countless imitations eloquently testify to its sterling merit;

is it not safe to rely upon it in indicated cases?

Such a preparation is

                                                      === Pepto-Mangan ("Gude") ===

Of specific and undoubted utility as a general tonic and reconstructive in Anemia, Chlorosis, Bright's Disease, Marasmic Conditions and Systemic Devitalization Generally.

Specify PEPTO-MANGAN (GUDE).

Supplied in orginal bottles only.

Never sold in bulk.

Samples and literature upon application.

M. J. BREITENBACH CO.

New York, U. S. A.

Operative Management of Compound Fractures.

Dr. B. F. Barnes (Ohio State Medical Journal) concludes:

1. Operative methods should be used only on cases that cannot be successfully treated by other means.

2. Never operate on recent fractures, except those of the skull, or in an already infected field.

3. Keep wound open during interval and use wet dressings.

4. The intermedullary bone splint gives best results whenever practical.

A Greeting to the New Graduate.

When Dr. Clark, who was professor of the principles and practice of medicine in the College of Physicians and Surgeons, was in his prime, so the story goes, a member of the graduating class called on him at his house one morning for the purpose of having his chest examined, for he feared that he had incipient pulmonary disease. Having undergone the examination and received the welcome assurance that his lungs were sound, the young man asked the doctor what his fee was, "Oh, nothing, sir, nothing at all." "Why, how is that?" "Well, you know, dog doesn't eat dog." "What do you mean, sir?" "Simply that one doctor doesn't charge another doctor for professional services." "But, you know, Professor Clark, I'm not a doctor; I'm only a student." "Very well, dog doesn't eat pup." And there was nothing for the young man to pay. - N. Y. Med. Journ.

The Pale Flag of Truce.

The characteristic pallor of the chlorotic subject is the "pale flag of truce," thrown out by the capitulating organism. Unless the essential blood deficiency is corrected, organic disease of more serious import is likely to ensue. Pepto-Mangan (Gude) restores blood vitality in anemia of all varieties. chlorosis, amenorrhea, Bright's disease, chorea, tuberculosis, rickets, rheumatism, malaria, convalescence, etc., etc. Dose: One tablespoonful after each meal. Children in proportion.

The After Treatment of Catarrhal Colds, Etc.

The various colds, "grippes," and catarrhs, that afflict the respiratory mucous membranes during the winter months, are extremely likely to leave their traces upon the general systemic vitality, in the form of a greater or lesser degree of anemia. This is especially true of those whose resistance is "below par," i.e., elderly people, young ill-nourished children, and weaklings from whatever cause. The constitutional after-treatment of respiratory disorders, among this class of patients, is usually more honored in the breach than in the observance. There can be no better routine practice than to order Pepto-Mangan (Gude) as a general tonic and reconstituent, especially when anemia is apparent. This exceedingly pleasant and ferruginous reconstructive is so distinctly palatable as to render it generally acceptable to all patients, and is so entirely free from irritant properties as to insure its ready toleration without causing constipation or disturbance of digestion.

Tardy or Rapid Recovery?

After an acute or exhausting illness the patient always inquire: " How soon will I be up and around?" To "boost up," " brace up" and "tone" up," no medicinal agent is quite equal to

Pepto Mangan (Gude)

It restores appetite and color,vitalizes every function and re-create strength and vigor of blood and body after Typhoid , Pneumonia, La Grippe,Malaria,Scarlet Fever, Measles,Diphtheria and other febrile diseases. It build up the depleted blood after Hemorrhage,Sepis or Supppuration.It imaparts spirits and snap to the Neurasthenic , and reders recovery rapid instead of tardy,after any serious illness.

In 11 oz. bottle only.

Never sold in bulk.

M.J. BREITENBACK.CO

New York, U. S. A.

To insure results to both patients and physican, specify "original bottle."

The After- Treatment of La Grippe.

In view of the succesive epidemics of La Grippe from year to year since this disease was first introduced or imported into this country , it is reasonable to presume that the infectious condition referred to is now endemic , and that the present winter will prove no exception to the rule in the incidence of a incidence of a disorder which is now world-wide in its distribution. If there is anyone particular feature of La Grippe which is common to almost all cases , it is the distinct and pronounced prostration that follows the subsidence of the acute symptoms.

While authorative opionions may differ as regards the treatment of La Grippe during its febrile or active period , there is no doubt of the essential necessity od supportive and tonic treatment during convalescence. It should be remembered , however that the physician who prescribes a course of tonic , hematinic treatment, without reference to the digestion or gastro-intestinal sufficiency of his patient , is very liable to "strike a snag". The digestive syste of the average "grippe" patient, like his general vital tone, is almost always "below par" and the ordinary iron products are likely to produce gastric irritation and digestive discord genrally. Pepto= Mangan (Gude) is particulary serviceable in such an emergency.Its ferruginous content is in readily tolerable and immediately absorbable condition and is assimilated and appropirated without embarresment of digestive vigor or strain upon the asborptive or assimilative functions.When prostration is extreme , it is a good plan to order strychnia, in appropriate dosage, in combination with Pepto-Mangan . There is no surer , safer or more efficent genreal hematinic medication then this.

For "Working" People.

"Ohio produced one of the wittiest physicians this country ever knew," said Congressman Shattuck recently. "He lived at a small place near Cleveland, and was greatly liked. His practice was large, and sometimes people would tell him that they called him in more for the fun that was in it than the medicine. His wit was fully equal to his skill. It was hard to say which did his patients the most good. Just as it happened when one of his patients revolted at a monstrous dose of physic and said, "Why, doctor, you can't mean such a dose as this for a gentleman?" "Oh, no," said the doctor, "it's for working people," - Med. Standard.

Remedy for Mal de Mer.

"I have sailed the seas for half a century, gentlemen," said Captain Cochrane to a group upon the deck on his ship, "when any of you begin to feel qualmish, come to me. I will give you the best remedy I know of."

"What is it?" asked two or three hesitatingly.

"A mint julep."

"Why?" asked the others, restlessly.

"Because it tastes just as good coming up as it does going down."

The party, without excusing themselves, struck for the steward's room. - Gentleman's Magazine.

Symptomatic or Complicating Anemia.

Is that form or condition of blood poverty which results from various constitutional infections and diatheses. Prominent among such causes are, Syphilis, Rheumatism, Paludal Poisoning, Tuberculosis, Carcinoma, etc. In many instances, such an anemia is due to some obscure, latent metabolic perversion, or a slow but persistent intestinal auto-intoxication of gastro-intestinal origin. While it is an axiomatic principle that successful therapy depends upon the removal of the causative factor, it is more than often wise and eminently judicious to adopt direct hematinic treatment while the underlying cause is being sought for and combated. Pepto - Mangan (Gude) being bland, non-irritant and readily tolerable, can almost always be given, with distinct advantageto appetite, digestion, nutrition and general well-being, while causative therapy is under way. Neither constipation nor digestive disturbance results from its steady use, and a general hematic gain is practically a certainty, if its use is persisted in.

Sunday, March 1

IF the physician has at his command a palatable, acceptable and immediately assimilable combination of iron and manganese.

IF this product has answered every reasonable professional requirement for more than 17 years;

IF its use in reconstructuve therapy is veritably world-wide and constantly increasing;

Is it not quite clear that such a preparation possesses the genuine merit claimed for it?

Pepto-Mangan("Gude")

exerts prompt and decided hematinic and reconstructive action in Anemia, Chlorosis, Bright's Disease, Marasmus, Convalescence, etc.

In original bottles only. Never sold in bulk. Samples and literature upon application.

M. J. BREITENBACK CO.

NEW YORK, U.S.A.

Lumbar Puncture.

Since in children the spinous processes of the lumbar vertebra are short and extend nearly directly backward, the puncture is made most readily in the median line, close to the under border of the spinous process of the upper vertebra of the chosen space. In adults, because of the anatomical differences in the spine, and because of the interspinous ligament, there is more room for approach if puncture is made to one side of the median line, and at a level with the lower part of the spinous process of the vertebra next above the space used. The needle, however, should be pointed toward the median line-G. R. Pisek; The Post-Graduate

A Touching Tribute.

A writer tells how a little child once preached a wonderful sermon to him. "Is your father at home?" I asked a small child, on our village doctor's doorstep. "No," he said; "he's away." "Where do you think I could find him?" "Well," he replied, with a considering air, "you've got to look for him some place where people are sick, or hurt, or something like that. I don't know where he is, but he's helping somewhere.-Naational Recorder.

Blood Impoverishment.

In meeting that condition of the system enbraced in the above headlines, is it not true that our first thought, and that to which our instinct naturally leads us, is iron; but viewed from the standpoint of now accepted scientific facts, is this not looking at but one phase of the question? That there is a deficiency of iron in the blood in most forms of anemia is, of course, indisputable; and to endeavor to supply this lack by the administration of iron seems but a common sense procedure.

To invigorate, to rekindle nervous force, to revitalize all functions, and thereby bring about a condition of systemic vigor, of which blood-enrichment is necessarily a feature, the addition of manganese to iron is desirable. In Pepto-Mangan, iron and manganese was first brought to the attention of all the profession by Dr. Gude, Chemist, and this preparation is found to be one of the best therapeutic resources of the present-day physician, and when combined with such other remedies as meet the indication, such as we have spoken of, forms at once a therapeutic arsenal whose fortress is impregnable.

WHERE?

WHERE in the materia medica does the physician look for the most suitable hemogenetic agent?

WHERE does he find iron and manganese-Nature's hematinics-most scientifically combined in condition for immediate assimilation?

WHERE can he find such a preparation in a form as palatable, bland, non-irritant and readily tolerable as

Pepro-Mangan("Gude")

which can be depended upon as a blood-con-structing and nutrition-stimulating reconstituent in Anemia, Chlorosis, Bright's Disease, Marasmus and Innutrition generally?

In original bottles only. Never sold in bulk. Samples and literature upon application.

The Technique of Nutritive Enemata.

It is a good standing rule that all albuminous food should be digested before given as enemata, for, experimentally, albumen is shown to be excreted by the kidneys unabsorbed when injected into the rectum undigested. The practice of giving nutrient enemata with a common Davidson syringe, with a rubber or metal nozzle, cannot be too strongly condemned. Irritation of the bowel, possibly hemorrhage, and imperfect absorption, are the result. A long, pliable rubber tube should be used; a large velvet-eyed catheter does very well, and this should be passed well up the rectum to the sigmoid flexure. About eight inches of tubing should be passed up in the child, and about ten to twelve inches in the adult. There is a good anatomical and physiological reason for this, as fluids absorbed from the sigmoid flexure and upper part of the rectum are carried to the inferior mesenteric vein through the superior hemorrhoidal and sigmoid veins, and so on to the liver through the portal vein. The veins from the lower third of the rectum pass directly to the inferior vena cava, consequently all proteid matter absorbed from the lower one-third of the rectum loses the further digestion in the liver so vital to its assimilation. If injected into the sigmoid flexure it causes less irritation, and there is less liability to rejection.-Canada Med. Record.

The After Care of Operative Cases.

A large majority of surgical diseases, requiring operative interference, are preceded, accompanied or followed by hemolytic changes. In addition to the more or less devitalizing effect of the original condition which brings the patient to the operating table, the necessary anaesthesia, if at all prolonged, reduces the hemoglobin percentage and the shock incident to the operation contributes to the surgical anemia. Hemorrhage, Supporation or Sepsis of course intensifies the post-operative chlor-anemia and renders more than ever necessary the employment of hematogenic measures during surgical convalescence. Judicious feeding alone will not hasten recovery as rapidly as a judicious combination of feeding with a hematinic reconstituent such as Pepto-Mangan (Gude). This palatable, readily tolerable and promptly absorbable organic combination of iron and manganese is distinctly indicated in preference to other blood-building agents, because it is agreeable, non-irritant and free from constipating effect.

The Chlorotic Anemia

of young girls - the classical "green sickness" of the older writers - is peculiarly responsive to the prompt and certain hemoglobin-creating action of

Pepto - Mangan ("Gude")

Series after series of carefully conducted blood tests have abundantly proved its special value in this, as in all other anemic blood states.

In eleven-ounce bottles only. Never sold in bulk. Samples and literature upon application.

M. J. BREITENBACH CO.

New York, U. S. A.

Tumor of the Upper Abdomen.

The decision as to whether a tumor growing on the lower surface of the liver belongs to that organ or to the gall of the bladder, or to one of the neighboring organs in question, is sometimes easily solved, but sometimes utterly impossible. Tumors of the pylorus and duodenum can easily be recognized, because they will rescend with inspiration, and they can be retained by the finger during expiration, while a tumor connected with the liver will rise again with expiration. Tumors of the stomach and intestines also change their position with the inflation of the stomach by air, unless they are strongly attached to neighboring organs. - C. A. Ewald; The Amer. Journ. of Gastro-Enterology

Just as Good as Ever, Too.

An old physician was noted for his brusque manner and old-fashioned methods. A lady called him in to treat her baby, who was slightly ailing. The doctor prescribed castor oil.

"But, doctor," protested the young mother, "castor oil is such an old-fashioned remedy." "Madam," replied the doctor, "babies are old-fashioned things." - London Opinion.

A Systemic Boost.

It is safe to say that the average physician is called upon to prescribe a tonic more frequently than any one other form of medication, unless it be a cathartic. Patients who are patients solely because they are tired, "run down" and generally debilitated, are constant visitors at the physician's office. Such individuals need something that will boost them up to their normal point of resistance and then hold them there: in other words, not a mere temporary stimulatioin, with secondary depression, but a permanent help to the revitalization of the blood and a general reconstruction. Pepto-Mangan (Gude) is not only prompt in action as an encourager of appetite and better spirits, but is also distinctly efficient as a blood builder and systemic reconstituent. It is pleasant, non-irritant, free from constipating effect and does not stain the teeth. It is thus a general constitutional tonic of positive service in all conditions of general devitalization.

HOW?

does the physician determine the merit of any medicinal agent?

HOW does he separate the valuable medicinal wheat from the useless therapeutic chaff?

HOW does he choose his therapeutic working tools?

The ACTUAL EXPERIENCE of medical men for more than seventeen years indubitably establishes the sterling hematinic and reconstructive virtues of

Pepto-Mangan ("Gude")

in Anemia, Chlorosis, Hemic Devitalization from any cause and in General Systemic Denutrition.

In original bottles only. Never sold in bulk. Samples and literature upon application.

M. J. BREITENBACH CO. New York, U. S. A.

Cancer of the Stomach.

The following rules are suggested upon which to base a positive diagnosis of cancer of the stomach:

1. If particles of tumor are found (in the wash water or in the tube) which, under the mircoscope, reveal the characteristic picture of a malignant growth.

2. The presence of a more or less large tumor with an uneven surface, belonging to the stomach and associated with dyspeptic symptoms.

3. The presence of a tumor associated with frequent hematemesis.

4. Constant pains, frequent vomiting, ischochymia, emaciation-all these symptoms being quite permanent and not extending over too long a period of time (six months a year).

5. Tumor and ischochymia.

6. Emaciation, ischochymia, presence of latic acid.

7. Constant anorexia and pains, not yielding to treatment, accompanied by frequent small hemorrhages of coffee-ground color. - Dr. M. Einhorn; N. Y. Med. Journal.

Well Informed.

Little Willie Throop: "Pa, what does the title "Dr." or "Doctor" come from anyway?"

Mr. Throop: "Why, from the Latin word "Dr." or "debtor", used in making out bills, because doctors charge so much, Willie. Latin is a great language. When you wish to know anything in connection witht he languages, always come to your father, Willie." - Brooklyn Eagle.

The Child That Fails to Thrive

is one of the many troublesome and vexatious clinical puzzles that the family practitioner is called upon to solve. To arrive at any definite determination in regard to the treatment of such a child, a careful physical examination is essential, in order that any of the causes which act reflexly through the nervous system may be properly dealt with - Post-nasal adenoids, a redundant prepuce, ascarides, eye strain, as well as other local irritations, may be more or less responsiblefor the child's backwardness, both mental and physical; constitutional diatheses, such as syphilis, tuberculosis and lithemic states, should also be looked for and intelligently treated. After the discovery and removal of the cause, tonic and reconstituent treatment is almost invariably indicated and among the reconstructives especially adapted to the delicate digestive organs of the undernurtured child, Pepto - Mangan (Gude){In BOLD} is easily first. Its iron and manganese content exists in organo-plastic combination with peptones, and the preparation, as a whole, is so pleasant and readily tolerableas well as immediately and wholly assimilable, that children of all ages take it readily and benefit materially from its corpuscle-building and hemoglobin-contributing power.

Parasitic Anemia

is caused by the corpuscle-destroying action of the malarial plasmode or the devitalizing effect produced by infection with tape-worm, hook-worm or other intestinal parasite. After the removal of the cause

Pepto-Mangan ("Gude")

can be depended upon to renew, restore and revitalize the vital fluid, without causing digestive irritation or constipation.

In eleven-ounce bottles only. Never sold in bulk. Samples and literature upon application.

M. J. BREITENBACH CO. New York. U. S. A.

The Effect of Alkalies on the Gastric Secretion.

Hayem states that alkalies given for some time and in sufficient doses, so far from curing hypersecretion of hydrochloric acid, are the most powerful agents in producing it. This is especially true of bicarbonate of sodium. They produce this effect after being absorbed and during excretion. That it is not due to their local action on the gastric mucosa, is proved by the use of mineral waters, which aid the absorption of alkalies, and so produce hyperchlorhydria more readily than alkalies alone. The above is true only if the gastric glands are numerous and active. If the mucosa is atrophied, instead of raising the digestive power of the gastric juice, with a tendency toward hyperchlorhydria, alkalies depress and aggravate the hypopepsia - British Med. Journal

Equal to the Emergency.

Dr. S. M. Brickner tells this story of a reporter for a New York newpaper who was assigned to cover a mysterious death in Harlem. He telephoned the city editor and said that the death was caused by uric acid poison. He immediately received instructions over the telephone to "visit every druggist in Harlem to ascertain who sold or purchased uric acid."

Irregular Menstruation.

Dr. H. Edwin Lewis, formerly resident physician of the Fanny Allen Hospital, now editor of "American Medicine," says that irregular menstruation in young women due to anaemic conditions, Pepto - Mangan (Gude) has in every way proved itself an ideal preparation. He states: "This admirable combination of iron and manganese is readily taken into the human economy and appropriated to its needs, without deranging the weakest alimentary tract or hindering in any way the normal processes of digestion, assimiliation and excretion." He illustrates his article with the reports of four cases, of which we reproduce one as an example. Miss L., age 18. Had never menstruated. Her general appearance was one of profound anaemia. A careful examination eliminated any abnormality of genital apparatus. Organs normal in relation, but undersized. Prescribed Pepto- Mangan in teaspoonful doses after meals gave general directions as to diet, etc. Began to menstruate thirty-two days after beginning treatement; the flow continuing one week. Twenty-nine days later she menstruated again. At the present writing she is still under treatment, and is due to menstruate in seventeen days. Her whole condition is very much improved. - Vermont Medical Monthly.

Rich Red Blood

is the main desideratum in many cases-richness of the circulating fluid in those important basic elements of vitality-hemoglobin and oxygen.

Pepto-Mangan("Gude")

infuses this desirable richness in cases of Anemia, Chlorosis, Amenorrhea, Dysmenorrhea, Rickets, Bright's Disease, etc., by furnishing the necessary hemoglobin-carrying elements-iron and manganese-in form for almost immediate absorption. Repeated "blood counts" as well as clinical experience go to prove this statement.

Sold in eleven ounce bottles only. Never in bulk.

M. J. BREITENBACK CO.

NEW YORK U.S.A.

Causes of Infantile Convulsions.

Central.

1. Diseases of high temperature: Insolation meningitis, the exanthemata, pneumonia, and others.

2. Diseases accompanied by vascular stasis: (Pertussis, cardiac diseases, tumors, hydrocephalus).

3. Diseases characterized by anemia and exhaustion: (Loss of blood, diarrhea).

4. Various toxic causes, such as drugs or uremia: (Belladonna, nephritis).

5. Organic central lesions: (Cebral paralysis, or any other lesions of the brain).

6. Presumably organic disturbance of the brain: (Epilepsy).

Peripheral (Reflex).

Rachitis.

Food.

Intestinal parasites.

Dental irritation.

Foreign bodies in the ear and nose.

Hot baths.

Mental disturbances, such as fright and numerous other causes.-Rotch; Philadelphia Polyclinic.

What's in a Name?

A physician recently opened an office in Chicago, and upon his sign appears the following incongruous announcement:

"MICHAEL MALONEY,

Deutscher Arzt."

The After Care of Children's Ills.

With the advent of school-days, and the daily association of many children in the class room, the contagious diseases of childhood develop and multiply. The exanthemata, as well as diphtheria, whooping cough, etc., comprise a considerable proportion of the diseases that the family physician is called upon to treat during the late Fall and Winter months. The robust child, with but a mild infection, frequently recovers quickly and, perhaps, requires but little attention during the convalescent period, while the child whose general nutrition is "below par" usually emerges from the acute attack with a condition of anemia and general vital depreciation, In the large majority of cases, it is undoubtedly wise to encourage and hasten convalescence by means of a palatable and efficient hematinic and general tonic. For this purpose Pepro-Mangan (Gude) is especially valuable. All children like it and take it readily. As it is non-astringent, it does not, as do other ferruginous remedies, cause or increase constipation. As Pepto-Mangan is prompt and efficient as a blood builder and general reconstructive, it should be preferred among children whenever medication of a general tonic nature is indicated.

Pepto-Mandan("Gude")

is usually preferred by the discriminating physician because:

1-It does its work both promptly and efficiently-

2-It accomplishes its blood regenerative results without producing any of the unfortunate bye-effects (irritation, constipulation, etc.), which so often follow the use of other iron products-

3-It is palatable and acceptable to patients of all ages

These are pertinent and practical reasons for preferring Pepto_Mangan in all conditions in which a general "building up" regimen is indicated.

ADULT DOSE: One tablespoonful in water, milk or other non-acid vehicle, after each meal. Children in proportion.

M. J. BREITENBACH CO.

NEW YORK, U.S.A.

Physiology and Pathology of Bile Secretion.

Albu reports certain observations made in the case of a woman with a biliary fistula. The latter had existed for nine years. Various diets were taken, and it was found that one of milk, eggs, soup, white bread, vegetables and fruit caused a more abundant outflow of bile than a diet in which meat figured largely. The author thinks that it is not possible to determine from experiments on animals just what remedies will in man produce an increased bile flow, and thinks that many investigators have mistaken an outflow of. bile from accumulations in the various biliary reservoirs for an actual increase in its formation in the liver cell.

A Reasonable Inference.

A lady and her little daughter were walking through a fashionable street when they came to a portion strewn with straw, so as to deaden the noise of vehicles passing a certain house. "What's that for ma?" said the child; to which the mother replied:-"The lady who lives in that house has had a little baby girl sent her." The child thought a moment, looked at the quantity of straw, and said:-"Awfully well packed, wasn't she, me?"

The Best Form of Administering Iron.

That the inorganic and other official preparations of iron do not always answer the requirements of actual practice and possess many disadvantages, every experienced practitioner will admit. Summarized briefly, the disadvantages of most of the official preparations are: they often disagreeable to the taste, they affect the teeth, they often derange the stomach, they cause anorexia, constipation and headaches, and, most important, frequently impossible to induce children and women to take any of the official iron preparations. The ingenuity of the chemist was therefore bent for many years upon the production of an iron preparation which should be free from all those drawbacks, and the ideal of an iron preparation has been reached in Dr. Gude's Pepto-Mangan.

(From the Southern Practitioner.)

Dr. Deering J. Roberts, of Nashville, Tenn., editor of the Southern POractitioner, gives the clinical histories of five cases-gastric ulcer, occipito-cervical neuralgia, chlorosis and amenorrhea with dysmenorrhea-ib which the use of Pepto-Mangan (Gude) was followed by brilliant clinical results. In these cases neither the haemoglobin nor the red corpuscles were estimated by laboratory methods, but, as the author says: "Nor was there any need. Each case, its progress and its results have been so plain that he who runs may read."

Monday, April 20

Treatment Of Cellulitis

In cellulitis of hand: Apple bier bandage and hot dressings of saline soloutions. If pain not relived, reapply bandage severeal times; if still ineffective, make incision or incisions into the part, apply the bandage again, continue hot dressings , and have a hand placed in bath of hot saline thrice daily. Give iron and arsenic, prepare and a inject a vaccine, and administer an antitoxic serum, particulary in early stages. Continue Bier's bandage after cellulits has subsided and precscribe active movement and electric stimulation of muscles. - Conner

Weather Rained a mist nearly all day. The girls drove {illegible} Bill.Brands helped me wash.augeme and bark was one the augemes place all day John aren't the mill shed came a took dinner a the great.

The Anemia of Specific Disease

partakes of the general character of all secondary anemias. Anti-sypilitic medication is almost always aided by judicious hematinic treatment.

Peptp-Mangan("Gude")

in this, as in all conditions of blood poverty, is the ideal, non-irritant non-constipating, readily absorbable blood builder and reconstituent.

In eleven-ounce bottles only.

Never sold in bulk.

Samples and literature upon application.

M. J. BREITENBACH CO.

NEW YORK, U.S.A.

Cardiac Diseases in Children.

The following the rules are given by Perrier as to the management of this condition: In the first place, the child should be protected from cold, both because it depresses vitality and also because cold may cause internal congestion. Much fatigue is to be avoided and violent exercise forbidden. In the case of girls, particular attention is to be paid to these points at the approach of puberty. Secondly, the greatest care should be exercised as to diet, which should be simple, and consist largely of milk, eggs, easily-digested soups, and tender, plainly-cooked meats. Milk should be the drink for each meal. Thirdly, a life in the open air is very essential, and the climate should be changed by resorting to warm places in Winter and cool ones in Summer, for all persons with cardiac disease, particularly children, suffer from rapid changes in temperature-Charlotte Med. Journal.

Hard to Understand.

A little girl brushing her hair found that it "crackled" and asked her mother why it did. "Why, dear, you have electricity in your hair," explained the mother. "Isn't that funny?" commented the little one, "I have electricity in my hair and grandmother has gas in her stomach"

The Role of Manganese.

While iron performs brilliant service in anemia and chlorosis, is has been noticed to fail entirely, or almost so, in a certain number of cases. Something else than iron seemed to be lacking and some other remedy seemed to be required. It was Hannon who succeeded in demonstrating, in 1849, the presence of manganese in the blood, and in the same year Petrequin showed that iron and manganese decrease to the same degree in the blood of chlorotic persons, and therefore must be replaced in an equal measure. In 1857 Menke called attention to the pharmacodynamic significance of manganese in the mineral water of Pyrmont, while Prof. Rühle ascribed chlorosis to an impoverishment of the blood in manganese or iron, or both conjointly. The most recent researches have not only confirmed these statements, but have demonstrated that manganese acts more powerfully upon the oxygen of the blood than iron, and hence promotes assimilation more energetically than the latter. That notwithstanding these facts and experiments, the use. of manganese has not become more general, is attributable to the fact that prior to the advent of Pepto-Mangan, it was not found possible to combine both these hematogenic elements palatable, soluble and absorbable form.

Blood Genesis

The formation of a rich, nutrient, circulating fluid which shall contain an abundance of red corpuscles of the necessary structural integrity. How to "build" such blood is an ever-present therapeutic problem.

Pepto-Mangan("Gude")

is a powerful blood-forming agent; it induces the generation of hemoglobin, the oxygen-carrying constituent of the blood; it is a genuine hemoglobinogenetic. It feeds the red corpuscles with organic iron and manganese which are quickly and completely absorbed in cases of Anemia from any cause, Chlorosis, Amenorrhea, Dysmenorhrea, Chorea, Bright's Disease, etc. In eleven ounce bottles only; never sold in bulk.

M. J. BREITENBACH CO.

NEW YORK, U.S.A.

Foreign Bodies in the Ear.

Hummel (Muench. Med. Woch.; Am. Journ. Med. Sci.) makes the following deductions:

1. The relation of the normal ear canal to inanimate foreign bodies is entirely without reaction; that is, the foreign body in the ear does not, per se, endanger the integrity of the ear.

2. Every hasty endeavor at removal is, therefore, not only unnecessary, but can become very injurious.

3. In all cases not previously interfered with (with few exceptions), the foreign substance can be removed from the ear by means of syringing.

4. The general practitioner should never employ anything but the syringe in his endeavors at removal of foreign bodies from the external auditory canal.

5. An instrumental removal of a foreign body from the ear should be affected only by one fully able to examine the ear with an otoscope and acquanited with every operative manipulation in this region.

Medicine and Music.

Dr. W-, who has become a member of the choir of a fashionable uptown ritualistic church, now refers to himself as an Epaesculapian and states that he is a specialist both in anthems and exanthems. - N. Y. Med. Journ.

Modern Martial Therapy.

Amid the veritable swarm of new medicinal agents of all varieties that have been introduced to the therapist during the last twenty years, and in spite of the great advances in general medicine during the same period, there has not as yet been purposed any remedy which can successfully compete with iron in the treatment of anemic and generally devitalized conditions. This metallic element, in one form or another, is still the sheet anchor in such cases, and when intelligently administered in proper form and dosage can be depended upon to bring about marked improvement, provided serious incurable organic disease is not the operative cause of the exisiting blood impoverishment. The form in which to administer iron is, however, very important. The old, irritant, astringent martial medication has had its day, and properly so. Probably the most generally acceptable of all iron products is Pepto - Mangan (Gude), an organic combination of iron and manganese with assimilable peptones. This preparation is palatable, readily tolerable, promptly absorbable, non-irritant and still distinctly potent as a blood builder and general tonic and reconstructive

"Milk Diet" Anemia

Milk, as is well known, is very deficient in iron. After a prolonged milk diet, Anemia is not uncommon, especially after prolonged Typhoid and in Bright's Disease.

Pepto_Mangan("Gude")

when given in milk, both during and after a milk diet, satisfactorily supplies the lacking iron element and thus prevents or relieves the resultant Anemia.

In eleven-ounce bottles only.

Never sold in bulk.

Samples and literature upon application.

M. J. BREITENBACH CO.

NEW YORK, U.S.A.

Peculiarities in Heart Affection in Children.

Barbour, in American Practitioner and News, calls attention to the liability to organic, and the infrequency to functional heart disease in childhood. Endo- and peri- carditis are particularly liable to follow an attack of rheumatism, scarlet fever, diphtheria, etc., and are difficult of diagnosis on account of the lack of definiteness of the heart sounds in children. The treatment is different as the iodides are not well borne. Patient should be kept in bed for weeks at a time on a properly regulated diet. Compensation is easily effected in childhood, but the liability to acute dilatation in acute diseases should be kept in mind. The author briefly alludes to the lackof physical and mental growth frequently caused by heart disease in children.

Hacthing Birds.

A little five-year-old daughter of Dr. Pickens Taylor, of Georgia, was taken down with a spell of intermittent. It became necessary to administer quinine, which he did in the form of small capsules. In order to induce her to take them he told her that they were "little humming-bird's eggs, and were very nice." When the quinine had taken effect. she told her father, with great glee, that the little birds had hatched, and were singing in her head. - Doctor's Recreation Series.

Afterwards.

During the acute stages of any serious illness, such as typhoid, pneumonia, La Grippe, etc., the attention of the physician is, of course, centered upon the ways and means of conducting the patient through the stress and storm of the disease, into the peaceful harbor of convalescence. In many instances, when this point is reached, the physician is inclined to relax his efforts and, perhaps, fails to appreciate the extent of the general devitalization that has followed the severe systemic infection from which the patient has just recovered. Unless the reparative and restorative forces of Nature and forified and stimulated, a slow and tardy convalescence is apt to supervene. The devitalizing influence of the infectious diseases is exerted principally upon the blood itself, readily absorbable and promptly efficient hematinic is therefore always in order. Pepto - Mangan (Gude) is peculiarly adapted to the needs of the convalescent invaild, because, being palatable and non - irritant, it does not impair the appetite or disturb the digestion. It freedom from constipating effect is another distinct point in its favour.

Blood Vitality

the essence of life is the blood. The vital element of the blood is hemoglobin. Without a normal percentage of this elementary principle the tissues are insufficiently oxygenated and poorly nourished. WIth a proper proportion, the vital functions are quickened and the entire system fortified.

Pepto-Mangan("Gude")

is a hemoglobin producer, because of the quickly assimilable organic iron and manganese which it contributes to the devitalized circulatory fluid existing in cases of Anemia, Chlorosis, Amenorrhea, Dysmenorrhea, Bright's Disease, Chorea, etc. Sold in eleven ounce bottles only; never sold in bulk.

M. J. BREITENBACH CO.

NEW YORK, U.S.A.

She Ascertained.

Young Lady (reading report of urinary examination): "Doctor, what are urates?" Doctor: "Five dollars per visit."-Med. Record

A Practical Use for Hypnotism.

"Mammy," said pickaninny Jim, "I's gwine to be one or dese hypnotizers." "Whut's dem?" "You look somebody in de eye, an' he des nach'ly goes ter sleep." "Well, don't you go was'in' yoh time. Dah's sleepfulness nuff in dis here worl' an-," she paused suddenly, and after a moment of thought added: "Jimmy, does you 'margin you could do dat to a chicken?"

A Specialist.

Jones: "Why do you call that Pullman porter 'Doctor'?" Smith: "Why, because he has attended so many berths."-Cornell Widow

The Pallid School Girl.

In view of the modern methods of education, which force the scholar at top speed, it is not to be wondered at that the strenuous courses of study prescribed for the adolescent girl more than frequently result in a general break-down of both health and spirits. Each winter the physician is consulted in such cases and almost always finds the patient anemic, nervous and more or less devitalized. In most instances a rest of a week or two, together with an efficient tonic, enables the patient to take up her school work again with renewed energy. Pepto-Mangan (Gude) is just the hematinic needed, as it acts promptly to increase the red cells and hemoglobin, and to tune up the organism generally. it is particularly suitable for young girls because it never induces or increases constipation.

Post-Septic Anemia

resulting from the blood-devitalizing influence of a constitutional septic infection, requires timely and well-directed hemogenic treatment.

Pepto-Mangan("Gude")

is unquestionably efficient in blood-building therapy, and is always readily taken, well tolerated and promptly absorbed and appropriated. In eleven-ounce bottles. Never sold in bulk. Samples and literature upon application.

M. J. BREITENBACH CO.

NEW YORK, U.S.A.

Poisoning by Illuminating Gas.

I. First stage, preceding loss of consciousness: 1. Fresh air. 2. Aromatic spirit of ammonia. 3. Effervescent sodium phosphate, to produce eructations and relieve nausea. 4. Oxygen inhalation. 5. Analgesics for headache. 6. Avoidance of violent exertion. - II. Second stage, patient unconscious, but breathing: 1. Howard artificial respiration, rhythmic compression of lower thorax, to assist breathing. 2. Oxygen, preferably under pressure. 3. Camphor, caffeine, digitalis, and strychnine hypodermically. 4. External heat, if indicated. 5. Massage of muscles after aerating lungs. 6. Treatment to be conducted in warm room. 7. If not prompt recovery, venesection and normal saline infusion, or use of "pulmotor." - III. Third stage, patient unconscious and not breathing: 1. Same measures as in preceding stage. 2. Blood transfusion. 3. Artifical respiration by Schafer method, patient prone. - McCombs.

Too Common for Her.

"So you have decided to call in another doctor?" "I have," was the reply. "The absurdity of the man prescribing linseed-tea and mustard plasters for people of our position!"

The Remedial Value of Iron.

Amid all the doubt that modern skepticism and therapeutic nihilism have aroused in the professional mind, in regard to the medicinal or drug treatment of disease, we have yet to hear any question as to the distinct value of iron in anemic, chlorotic and generally devitalized conditions. This metal is, indeed, the physician's mainstay in such cases, and cannot successfully be ommitted or replaced. There does exist, however, considerable difference of opinion as to the method of administering iron and as to the most generally eligible preparation of same. The tincture of the olden times, prepared from iron filings, has in these later days been superseded by the less irritant and more tolerable preparations introduced into modern pharmacy. Among such products none has seemed to be so generally acceptable and promptly assimilable as the organo-plastic form represented by Pepto-Mangan (Gude). The ferruginous element in this preparation exists as a true peptonate, in combination with organic manganese, iron's side-partner in reconstructive blood therapy. It is palatable, readily tolerable, quickly absorbable and assimilale and entirely free from irritant or constipating effect. Pepto-Mangan (Gude) rapidly restores vigor to the circulating fluid and because of its blandness and ready tolerability is especially valuable in pediatric practice.

Friday, May 29

Vitalizing as well as Nuritve Treatment

In maasmic and exhauted conditions it is wise to supplement intelligent supportive and nurtive measures with treatment designed to improve the quauntity and quality of the blood. Pepto-Mangan (Gude) is quickly absorbable and furnishes the matrerial necessary to restore the vital fluid. It is therefore indicated in all conditions requiring reconstuctiive measures.

Very warm all day. and raining in the evening

Papa went down to Charlie {illegible} Place to liberal meeting.

Eugeme has made his {illegible} all. We sold 50cents worth of lettuce. Evelyn was over for some lettuce. We carried what we took from her. Frilly on our wheels.

The Anemia of Bright's

although distinctly secondary in character, is usually very much benefited by direct hematinic treatment. In these cases

Pepto-Mangan("Gude")

is especially valuable because of its freedom from disturbing effect upon digestion and from irritant action upon the kidneys. In eleven-ounce bottles. Never sold in bulk. Samples and literature upon application.

M. J. BREITENBACH CO.

NEW YORK, U.S.A.

Pepto-Mangan("Gude")

Is an IDEAL, FERRUGINOUS TONIC, because:

It rapidly increases the number of red corpuscles and the percentage of hemoglobin.

It does not irritate or derange the digestion.

It is distinctly palatable-a point of importance in treating women and children.

It does not constipate.

It does not affect the teeth.

It is the STANDARD HEMATINIC, because:

It contains an appreciable dosage of both iron and manganese, in a neutral organic solution, as true peptonates.

It undergoes no chemical change in the stomach and is ready for quick absorption and rapid infusion into the blood.

It is thus of marked value in Anemia, Chlorosis, Rickets, Chorea, Amenorrhea, Dysmenorrhea, Neurasthenia, Bright's Disease, Convalescence, etc.

M. J. BREITENBACH CO.

NEW YORK, U.S.A.

The Anemia of the Climacteric

due to the more or less excessive direct blood loss, is always materially benefited by the regular use of

Pepto-Mangan("Gude")

This efficient hematinic serves to restore the sufficiency of the vital fluid, and thus render the patient more resistant to the continuous drain upon the vital bank account. In eleven-ounce bottles. Never sold in bulk. Samples and literature upon application.

M. J. BREITENBACH CO.

NEW YORK, U.S.A.

Indications for Operation in Disease of the Biliary Tract.

1. More than one attack of true biliary colic.

2. Symtoms suggestive of upper abdominal adhesions and chronic biiary insufficiency.

3.Hydrops of the gall bladder.

4.Obstruction of the common duct.

5.The occurrence of acute infections complicating previosly existing biliary disease.

6. The evidences of parncretic disease,acute acute subacute or chronic.-J.B. Deave; New York State Journal of Medicine.

Specialization Extraordinary

A prominent physican tells this story at the expense of the modern craze for speialization in the medical profession: A poor woman from the East Slide of New York went to the nearest dispensary to ask aid for her little son,who had one of his his fingers smashed with a baseball bat. At the first room where she applied she was told by a curt attendent that the boy could not be treated there.

"Wrong place." he explained; "this is the eye and ear department."

"Vere is der thumb and finger department?" inquired the woman,simply.

Tuberculous Anemia

although dependant upon and secondary to a constitutional infection, should never be entirely ignored. Fresh air, rest and forced feeding are distinctly supplemented by

Pepto-Mangan("Gude")

the one efficient preparation of iron that acts as a genuine blood constructor, without, in the least, disturbing the digestive functions. In eleven-ounce bottles only. Never sold in bulk. Samples and literature upon application.

M. J. BREITENBACH CO.

NEW YORK, U.S.A.

Post-Hemorrhagic Anemia

whether due to acute, exhausting loss of blood, or the more chronic heorrhages of the climacteric, is a distinct indication for the use of

Pepto-Mangan("Gude")

in full and regular dosage. It creates new red cells, increases the hemoglobin content of the blood and rapidly "makes good" the loss of vital fluid.

In eleven-ounce bottles only.

Never sold in bulk.

Samples and literature upon application.

M. J. BREITENBACH CO.

NEW YORK, U.S.A.

What Is Best in Tonics?

Many people, and perhaps a few physicians, are inclined to consider the terms "tonic" and "stimulant" as more or less synonymous and interchangeable. This, of course, is not the case, although some agents employed medicinally may partake of the properties of both and be properly known as "tono-stimulants." Strychnia, for instance, is a heart stimulant but may also be considered as a general nerve and systemic tonic when given in small and frequently repeated doses. While a stimulant alone is sometimes indicated in conditions of emergency, its long continuance almost certainly produces an after depression. It is sometimes advisable, however, to give stimulant and tonic together in conditions of serious general depression, the first to "boost" the vitality and the second to hold it at the point to which it has been raised and to restore the general tone of the organism. An ideal combination of this nature is Pepto-Mangan (Gude) to which has been added the proper dose of strychnia, according to indications. This combination is especially serviceable in the convalescence of exhausting diseases such as typhoid fever, pneumonia, La Grippe, etc. It is also of much value when the heart needs support and the general system requires upbuilding. Pepto-Mangan restores vitality to the blood by increasing the number of red cells and the percentage of hemoglobin, and the strychnia assists in rendering the combination a peculiarly efficient general bracer and permanent reconstituent.

Count the Red Blood Cells

Both before and after treatment, if you want an accurate scientific proof of the effective blood-building power of

Pepto-Mandan ("Gude")

Watch the mucous membranes of eye and lip, if you want a positive clinical demonstration of its value as an oxygen-carrying, hemoglobin-producing, chalybeate tonic in Anemia, Chlorosis, or Blood Impoverishment from any cause. We will be glad to send you samples for practical ex-perimentation, together with descriptive literature and reports of "blood counts" in a large number of carefully observed cases. Shall we do so? In eleven ounce bottles only; never sold in bulk.

M. J. BREITENBACH CO.

NEW YORK, U.S.A.

Utterly Crushed.

The following report of a conversation heard near a tenement appeared in a recent number of Lippincotts Magasine: "Did that there woman from the mission give ye a call yistidy?" "Deck and she did. Them kind makes me tired. Didn't she set for a good hour talking to me about sanytation an' hygeeny an' how I ought to give civilized milk to my baby, an' all that sort o' rubbish, until I got tired an' I sez to her sez I, 'Did she have any babies of her own?' An' when she looked foolish an' said as how she was 'Miss Brown,' I sez, sez I, 'Well seein' that Iv'e buried ten, I don't see as no one has any call to tell me how to rare up babies, 'speshly some one as never rared up none of her own.' I guess that dashed her so she won't be apt to come round givin' me no more of her gab about civilized milk an' sannytation an' sich nonsense."

Gangrenous Patriotism.

At Marty Maloney's wake a tinge of patriotism is manifest: "Phat did he die of, Mrs. Maloney?" "Gangrene, Mr. Finnegan!" "Well, thank Hivin for the color, Mrs. Maloney!"-Exch.

"Milk Diet" Anemia.

While it is generally conceded that milk is a complete aliment in the sense that it represents the three essential food elements, i. e., proteids, carbohydrates and fats (together with inorganic salts and water), it is equally well known that this otherwise highly nutritive fluid is exceedingly poor in iron. It is not to be wondered at, therefore, that after a prolonged milk diet, some degree of Anemia is very likely to supervene. This is especially true after a long-continued Typhoid, as well as in cases of chronic nephritic disease, in which milk is the principal or exclusive food. The occurrence of such a "milk diet" Anemia seems to be, in many instances, responsible for a tardy and protracted convalescence. Such iron-poverty can be prevented by administering Pepto-Mangan (Gude) both during and after the milk diet period, thus supplying the essential iron in the most easily tolerable, non-irritant and promptly assimilable form. This palatable organic, ferruginous compound is entirely free from disturbing effect upon the digestion, and does not irri-tate, nor constipate, nor does it in any way interfere with such other treatment as the physician may see fit to adopt.

The Anemia of Adolescence

should never be regarded as unimportant or negligible. The correction of improper hygienic conditions and injudicious habits of feeding should be supplemented by the use of

Pepto-Mangan("Gude")

the one especially palatable, non-irritant, readily absorbable, non-constipating blood builder and general reconstructive tonic.

In eleven-ounce bottles only.

Never sold in bulk.

Samples and literature upon application.

M. J. BREITENBACH CO.

NEw YORK, U. S. A.

Surgical Suggestions.

Granulations, or small mucous polypi, often form in the lower portion of the urethra and cause frequent and painful urination. They can easily be removed after the free application of a 2 per cent. cocain solu-tion. As they are usually associated with urethritis, this must be cured by appropriate treatment, as otherwise the growths will return. Not infrequently Skene's glands are infected and to remove the infection it is usually necessary to incise the small ducts (two in num-ber) leading to them.-Amer. Journ. of Surg.

An Eye and Ear Instrument.

"What is a stethoscope and what is it used for?" asked the professor of the class in anatomy. "The stethoscope," answered the pupil at the pedal extremity of the class, *is a sort of microscope used by a doctor for the purpose of looking into the chest of a patient with his ear."

Hard Luck.

"Oh, my!" exclaimed Mrs. Byers over her evening paper, "isn't that too aggravating?" "What's the matter?" demanded her husband. "Why, Banger & Co. are offering unusual bargains in their drug department. Here's a chance to get a complete line of patent medicines at prices cut right in half, and none of us are sick." Phila. Press.

Chronic Ill Health.

Scarcely a day passes, in the life of the busy physi-cian, during which he is not consulted by at least one patient who is the unfortunate subject of chronic ill health, from one cause or another. The different factors responsible for long continued invalidism are varied and diverse, but if we exclude organic disease, such as carcinoma, tuberculosis, syphilis, etc., the large majority are neurasthenics and dyspeptics. Of course every physician realizes that the term "neurasthenic" is unscientific and that it is employed, for want of a better name, for the well-known group of symptoms most often noted in the city dweller. who has "burned the candle at both ends" or whose occupation and environment is such as to produce general as well as nervous devitalization. The chronic dyspeptic is usually a neurasthenic, in whom the digestive symptoms predominate, and who generally requires the same reconstructive treatment and regimen. Nerve tonics, stimulants, "pick-me-ups," etc., are usually not only useless, but harmful, and so-called "nerve foods" are but therapeutic "will o' the wisps." Nutrition and blood glandular reenforcement is the essential indication and there is no general reconstructive and reconstituent that shows more prompt and potent effects than Pepto-Mangan (Gude), a ferruginous and manganic restorative and blood-builder of proved and undoubted efficiency, entirely free from the irritant, corrosive, astringent and constipating effect of the ordinary preparations of metallic iron.

Sunday, July 12

For Quick Reconstruction

of the disintegrated red cells and the creation of newones,Pepto- Mangan (Gude) is especilay to be reccomended for the treatment of plasmodial anemia. Steady treatment with this dependable hematinic , for several weeks is practically certain to restore hemic integrity and place the patient in a positon to ward off fresh infection or quickly throw it off if infection occurs. Arsenic may be added to Pepto-Mangan (Gude) when desired , preferably in the form of Folwers's solution.

Weather Very musem Gut a good Grege. Mr.Coz has here for dinner, The girls are a going area there.This afternoon his father was by eachother all afternoon Courage aren't away This afternoon at stayed evening a hard helps a milk.

Polly L

Thursday, July 16

Blood Reconstruction is Imperative

after direct hermorrhagic loss of any considerable degree. A fourfold combination of prompt and certain service in such cases is rest, nutritious food, fresh air in abundance, and Pepto-Mangan(Gude) restore the red cells and hemoglobin in such conditions.

Very now

Aldoud Graug {illegible} me home the cookies of black cherries we did them up. Then in the evening mr m Hay and maude came and graug he the cookies more frain Blake milles. Eugeument bark went.

Pollly aythen and augment

Blood Integrity

Rich Blood, Red Blood, Blood with plenty of hemoglobin and Red Corpuscles; this is what the pallid, anemic individual needs, from whatever cause such blood poverty may arise. The best way to "build blood" is to administer

Pepto-Mangan("Gude")

This palatable combination of organic iron and manganese contributes to the vital fluid the necessary oxygen-carrying and hemoglobin-producing elements and thus brings about a pronounced betterment in cases of Simple or Chlorotic Anemia, Amenorrhea, Dysmenorrhea, Bright's Disease, Chorea, etc. Sold in eleven ounce bottles only; never sold in bulk

M. J. BREITENBACH CO.

NEW YORK, U. S. A.

Right to the Point.

The writer was recently informed of a certain wealthy lady in this city, whose servant became afflicted with eye trouble. She forthwith sent the servant to one of our leading oculists. The doctor, when asked for his bill, replied: "Five dollars"-she having made in all five visits to his office, at the end of which time she was pronounced cured. A few days later the lady herself had the same condition develop, and at once consulted the sane oculist. She made the same number of visits to the doctor as her servant; whereupon she, too, was cured. On the first of the month following, the doctor sent in his bill for fifty dollars, upon receipt of which the lady hastened to his office and demanded satisfaction, why, under exactly similar circumstances, her servant should be charged five dollars, and she herself fifty; that it was outrageous, etc., etc. The doctor's office was filled with patients, who were greatly amused, apparently, at his expense. However, he had an expedient; and turning, in his mild-mannered tone, he said: "Five dollars, madam." Turning to the cashier, he said: "Cashier, place Mrs. So-and-so in the pauper list. "The lady, finding herself caught in her own trap, had slyly left the doctor's office.-Portion of editorial on "Doctor's Bills," in North American Journal of Diagnosis and Practice.

The Neglected Therapy of Convalescence.

The physician of education and experience,who keeps in touch with the progress of medicine generally, is well informed as to the treatment of most of the "thousand and one" ills that he is called upon to combat. The diagnosis and treatment of acute conditions, as well as the successful management of the more chronic affections, are subjects which he is constantly investigating and studying. It so happens, however, that after the dangerous shoals of medical navigation have been successfully negotiated and when the crisis or danger point has been passed, the physician is all too liable to relax his vigilance and to allow the patient to convalesce without sufficient attention to the therapeutic details of this important period. While the feeding of the convalescent is of great importance, the medico-tonic treatment is equally essential, in order to improve the appetite, tone the digestive, assimilative and eliminative functions generally and to hasten the time when the patient shall be once more "upon his feet." Among all of the general reconstituent and supportive measures in the therapy of convalescence, none is more essential than the reconstruction of a blood stream of vital integrity and sufficiency.Pepto-Mangan (Gude) is distinctly valuable in this special field, as it furnishes to the more or less devitalized blood the necessary materials (iron and manganese) in such form as to assure their prompt absorption and appropriation. One especial advantage of administering these hematinies in this form, is that digestive disturbance is avoided and constipation is not induced.

Blood Poverty

means a diminution of the number of the fundamental red corpuscles; a reduced percentage of oxygen-carrying hemoglobin, and a diminished resisting power against more serious disease.

Pepto-Mangan("Gude")

supplies these deficiencies. it furnishes organic iron and manganese to the blood elements, increases the hemoglobin, and restores to the blood its normal germicidal potency. Pepto-Mangan (Gude) literally "builds blood" in cases of Anemia, Chlorosis, Amenorrhea, Rickets, Bright's Disease, etc. Samples and literature on request. In eleven ounce bottles only; never sold in bulk.

M. J. BREITENBACH CO.

NEW YORK, U.S.A.

Surgical Suggestions.

To account for a chill and pyrexia in a post-operative or post-partum case exclude pneumonia and pyogenic infection before considering malaria. On the other hand, of course, malarial recrudescences are sometimes precipitated by operation and by parturition; and too, it is important to bear in mind that malarial seizures are occasionally marked by vomiting and localized pain and tenderness in appendix region, easily leading to a mistaken diagnosis.-Amer. Journ. of Surg.

The Diaphanous Bostonian.

A specialist in throat troubles was called to treat a Boston lady, who manifested so much interest in his surgical instruments that he explained their use to her. "This laryngoscope." said he, "is fitted with small mirrors and an electric light; the interior of your throat will be seen by me as clearly as the exterior; you would be surprised to know how far down we can see with an instrument of this kind." The Operation over, the lady appeared somwehat agitated. "Poor girl," said her sister, who was present, "it must have been very painful." "Oh, no, not that," whispered the Boston lady; "but just as he fixed his instrument in place I remembered I had a hole in my stocking."

Menstrual Disturbances.

Dr. Edward C. Hill, of Denver, Colorado, discusses the disturbances which are such frequent concomitants of puberty in girls and lays stress upon the importance of hygienic measures, exercise, proper diet, rest from too much intellectual labor, etc. The presence of anaemia and chlorosis call imperatively for the administration of iron. Haemoglobin is valueless, because chemistry proves that when haemoglobin is taken into the stomach it is changed by the acid there to hematin, which, according to Cloetta, passes down the alimentary tract without being absorbed. As to the inorganic compounds of iron most authorities maintain that in order to be absorbed, they must first be changed to albuminates by combining with food matters. All albuminous substances are hydrolyzed to peptones before they are capable of absorption. Hence it follows that a peptonate of iron is the preparation most likely to be readily and completely absorbed and assimilated. The best remedy of this composition is, insthe author's opinion, Pepto-Mangan (Gude), which he has used for the past ten years with great satisfaction, particularly in the hemic and nutritive disorders of female puberty.

The Life of the Flesh IS the Blood

The vivifying, nutrifying, force-engendering power in life resides in the crimson stream which is constantly pumped through the vascular channels to feed the hungry tissues.

Pepto-Mangan("Gude")

is a true "blood builder." It supplies the deficient hemoglobin in cases of Anemia, Chlorosis, Rickets, Amenorrhea, Dysmenorrhea, etc., by infusing organic iron and manganese (oxygen-carrying and hemoglobin-making elements) into the depreciated circulating fluid. In eleven ounce bottles only; never sold in bulk.

M. J. BREITENBACH CO.

NEW YORK, U.S.A.

The Salt Pack in Rheumatic Gout.

Dr. Jonathan Hutchinson says (Polyclinic) that he knows of no remedy so effectual in getting rid of the irritability and synovial infusion, in connection with rheumatic gout, as the salt pack. This consists of flannel, soaked in a saturated brine of common salt, which is wrapped around the affected joint, covered with oiled silk and a bandage, and kept on the whole night. It should be applied every night until the cure is effected. Med. Record.

Modern.-The Przmbgnzanzki-Zut Reaction.

Tae 10 c.c. of the serum of a Greenland whale, which has been harpooned by a Scotchman, and heat to 32.65C. at a pressure of 32 lbs. to sq. in. To this add 10,000,000 lymphocytes at a tuberculous frog. Incubate for 48 hours at 37C. Prepare a second tube containing 5 c.c. of the cerebrospinal fluid of a cab horse from Northern Hackney, which has had repeated injections (m. v) of hydroxyaminoethyldiamidoortho-B-phenyloxybutric acid. Incubate under similar conditions with 5 c.c. of a suspension of B. coli from a pneumonic rat. Mix the contents of the two tubes and add the serum of the patient to be investigated. A positive reaction, i.e., agglutination of the B coli and the formation of B-phenyloxybutytric acid. Incubate under similar cona green fluorescent ring of barium oxybutvlorthephenate, will indicate the presence of pseudofibrillary enlargement of the pituitary body.-The Prescriber.

DYSEMIA.

Dr. Louis J. Gravel, physician-in-chief to the Hotel Dieu Hospital and Chief of the Laboratory, Montreal, Canada, says that the treatment of anamia, or, as he prefers to call it, dysemia, consists in a nutritious dietary, fresh air and sunshine in connection with the administration of iron supplemented occasionally with arsenic. Hydrotherapy is a very valuable auxiliary in some cases. The patient should rest as much as possible and in severe cases should take a vacation in the mountains. Having had his attention directed to Pepto-Mangan through the reports of leading authorities in European and American journals, he subjected it to a thorough test in the Hotel Dieu Hospital, Montreal, and has briefly recorded the histories of a number of typical cases in order to demonstrate its efficiency in dysemia, as shown by the rapid increase of the hamoglobin percentage and number of red blood-cells.

(From the Charlotte Medical Journal.)

Dr. William Krauss, of Memphis, Tenn., reviews briefly a part of the literature on Pepto-Mangan and concludes with the following sentence: "Since there is no official preparation which meets these requirements, the manufacturers of Pepto-Mangan deserve all the credit which the product has earned for them."

A POVERTY of Systemic Iron is a VITAL Poverty:

A RICHNESS of that Metal is a VITAL Wealth:

Pepto-Mangan("Gude")

furnishes, in promptly available form, the absorbable iron that encourages the construction of red cells that include the hemoglobin, that supplies the hematin, that combines with the iron, that carries the oxygen, that stimulates and maintains the reciprocal waste and repair of tissue, that constitutes life and living, It is thus of unquestioned value and anemic and chlorotic conditions and whenever a general reconstituent and vitalizing agent is indicated.

M. J. BREITENBACH CO.

NEW YORK, U.S.A.

Surgical Suggestions.

If the extremities of the stocking, drawer-leg, stockinette or flannel bandage put next to the skin when a plaster cast is to be applied, are turned down over the cast and then a few turns of the plaster bandage are made over them, near but not at the edge of the cast, a neat and comfortable cuff or margin will be thus provided.

An X-Ray Result.

"This X-ray machine is a marvel," Said a medical man to his friend; "it is showing up many a wonder. And serving a mighty good end.

"Last week I examined a puppy- You know how they hang out their tongues- Just a plain every-day kind of doggie; I took a good look at his lungs.

"And when I developed the picture- Now don't tell your sisters and aunts, For it sounds just a little bit shocking- I discovered the seat of his pants!" -Charles Edwin Julian, in Munsey's.

Menstrual Losses.

Dr Julius Heitzmann reports the employment of Pepto-Mangan with much success in chlorosis and in cases of anaemia in girls and women due to loss of blood, menorrhagia, inflammation of the pelvic organs, peri-and parametritis or prolonged leucorrhea. He says: "In almost every instance I observed within a short time increase of appetite, improved nutrition, healthier color of the face and increase of weight. I was surprised to learn how much more readily the Pepto-Mangan was taken than similar preparations, without ill-effects even after protracted use."-Allgem. Wiener Med. Zeitung.

(From Medic. Chirurg. Central Blatt.)

Dr. Otto Roen says that all the chalybeates hitherto in use do not satisfy the chief requirement, namely, a neutral reaction, and lack one important factor so necessary in the treatment of chlorosis and anaemia, namely manganese. In Pepto-Mangan (Gude) it has been found possible to unite all the advantages and eliminate all the disadvantages of ferruginous preparations. As seen from the published literature-which he reviews-clinical experiments extending over ten years have proved it the iron preparation par excellence, the only one in which manganese plays a prominent part as an oxygen carrier to the blood.

Corpuscular Impoverishment

A diminution in the number of red blood cells and a retrograde alteration in their structural integrity. Such are the changes in the blood made manifest by the microscope in cases of Anemia from whatever cause. During the administration of

Pepto-Mangan("Gude")

the microscope evidences a progressive increase in the number, and a constant improvement in the structural character of the corpuscular elements. Especially indicated in Anemia, Chlorosis, Amenorrhea, Bright'sDisease, Chorea, Dysmenorrhea, etc. In eleven ounce bottles only; never sold in bulk.

M. J. BREITENBACH CO.

NEW YORK, U.S.A.

Infantile Stools.

The following summary is appended to a paper contributed to the Physician and Surgeon by Dr. Charles Douglas (Medical Review of Reviews) : Green stools are never healthy. They always show imperfect digestion. The damage to the child is in direct proportion to their presence. These stools render children more susceptible to acute gastro-enteritis in hot weather. The high infantile Summer mortality follows children suffering from this colored stool. Through unhealthy nutrition the blood is poisoned and the various tissues are improperly nourished. The excreting organs, particularly the kidneys and liver, are frequently damaged by the extraordinary duties imposed on them in the elimination of these poisonous results from the blood. The continued irritation and innutrition favors the development of inherited diatheses and acquired cachexias. No child is free from complications dangerous to life, or from developmental errors, who suffers from frequently-recurring green-colored stools, particularly the very liquid and foul-smelling ones.

In Surgical Convalescence.

In order to find out the best hematinic for surgical cases, Dr. S. C. Emley, late Pathologist Augustana Hospital, Chicago, administered various preparations, with the permission of Dr. Ochsner. The preparations used were malt with iron and manganese; malt with iron, quinine and strychnine; Blaud's pills and Pepto- Mangan (Gude). He tabulates the results and says: "After watching the effects of the medication on the patients, and observing the records, it is seen that Blaud's pills acted quickly, but constipated; the malt combinations caused nausea in a few patients, and the malt, manganese and iron combination caused constipation in nearly all. The Pepto-Mangan given in milk was agreeable to take, and in no case did it cause nausea or constipation. While in two cases the Blaud's pills acted more quickly than Pepto-Mangan in two similar cases, on the whole the latter gave better and quicker results than any of the others, and at the same time caused no digestive disturbances in any of the cases."

Like the Building of a House

When a man builds a house he takes care to first prepare a firm foundation. When a physician treats an anemic or chlorotic patient, he must first consider the "building of the blood," the fountain and foundation of healthy life.

Pepto-Mangan("Gude")

supplies the necessary oxygen and hemoglobin-carrying elements and thus successfully builds from the foundation upwards in cases of Anemia, Chlorosis, Amenorrhea, Chorea, Dysmenorrhea, Bright's Disease, etc. In eleven ounce bottles only; never sold in bulk.

M. J. BREITENBACH CO.

NEW YORK, U. S. A.

Infantile Gastro=Enteritis.

Dr. Boyce W. Knight, New York, in American Medicine, contends against the starvation principle in treatment. While he discontinues the use of milk, he puts the patient on a diet of veal or chicken broth, barley water, or one of the dried cereal-containing milk foods. He irrigates the colon but once or twice, during the first twenty-four hours, with sterile water at 100 degrees F. Salol, calomel and castor oil are the principal drugs advocated.

He Knew Her Destination.

A young physician was once called in by a gentleman who had a very sick mother-in-law. After looking into the case carefully, the young M.D. called the gentleman aside and said: "Well, the only thing I can suggest is that you send your mother-in-law to a warmer climate." The man disappeared and came back with an axe a moment later, and exclaimed: "Here, doctor, you kill her. I really haven't the heart."-Argonaut.

Baltimore Charity.

At John Hopkins Hospital a story is told of a woman who, after being treated, lingered in the dispensary. "Is there anything further, madam?" a young doctor asked. "Oh, no, I'm just waiting till they've treated my maid."

Autumnal Ailments.

The Autumn months constitute the season during which the average practising physician is called upon to treat the following conditions: I. Typhoid Fever, which is, more often than not, contracted at some unhygienic Summer resort. The patient may return home during the first week or so, with headache, malaise, etc., or the premonitory or primary symptoms may áppear after reaching home. 2. Malarial Infection, in certain sections, which is more than usually rife in the Spring and Fall seasons. 3. The after results of the gastro-intestinal disorders of infants and young children, due to improper feeding, etc., during the heated term. In almost every instance, when the acute symptoms have subsided, a condition of anemia and general devitalization is the final result that constitutes the essential indication for treatment. In convalescence from all forms of illness resulting in general debility, Pepto-Mangan (Gude) is the one ideal tonic and reconstructive. It not only revitalizes the blood, but also tones up every physiologic function. It stimulates the appetite, improves the absorptive capacity, increases energy and ambition and restores the blood to its normal condition. It is, thus, a general tonic and reconstituent of marked and certain value.

The Peculiar Pallor

of the Cheek, Lip and Conjunctiva in Chlorotic Anemia is characteristic and unmistakable It is eloquent testimony of an "IRON HUNGER": An imperative signal of an "IRON-NEED." That

Pepto-Mangan("Gude")

best satisfies this hunger and supplies this need, is demonstrated by the prompt return of healthy color to skin and mucous membrane. Digestion is not disturbed; constipation does not ensue; the teeth are not injured. Acceptable alike to young and old.

M. J. BREITENBACH CO.

NEW YORK, U. S. A.

Supplied in eleven (11) ounce bottles only. Never sold in bulk. Samples and literature upon request.

Bites of Insects.

Neal writes to the China Medical Journal for March, 1912, that he has found the following procedure very useful: Take one ounce of Epsom salt and dissolve it in one pint of water, wet a bath cloth so that it will not drip and rub the body well all over; do not wipe afterward but dress, and flies, gnats, fleas, bedbugs, mosquitoes, etc., will never touch you. If one is exposed more than usual, being near water, or in a forest, then make a somewhat stronger solution, wet a cloth and rub the face, neck, ears, and hands well-do not wipe, but allow it to dry; it will leave a fine powder over the surface that the most bloodthirsty insect will not attack. Besides, the solution is healing and cleansing; it will heal the bites, subdue the consequent inflammation, and cure many diseases of the skin.

Exact Obedience.

Bedelia: "Phat are yez doin' takin' the lock off the cupboard dure, Pat? Are yez chrazy?" Pat: "No, darlint; the dochtor tould me to-day thot I must quit boltin' me food-and I'm goin' to obey insthructions!"-Cincinnati Times-Star.

Prepare for School Days.

And now the little army of young humanity, after the long vacation, trips back to school to commence the long period of mental and bodily stress and strain inseparable from indoor confinement and long hours of work and study. Is it not the part of wisdom to see that they are well prepared for what, to many of them, is really a serious ordeal?

If the boy or girl (especially the girl at the age of puberty) is anemic, easily tired, pale and listless, it is certainly a good plan to correct this condition at once, rather than to wait until the condition is more serious. If the young pupil is fortified by the toning and building up of blood and tissue, the prevalent school infections, measles, scarlet fever, and diphtheria, are much more likely to pass them by. Pepto-Mangan (Gude) is especially indicated as a blood tonic and general reconstituent for children, as it is palatable, easily taken, free from disturbing effect upon the digestion, and devoid of constipating action. It can be taken for any length of time without danger of injury to the stomach, and its effect is soon noticeable in increased appetite, improved color, better spirits and increased weight.

The Blood Current of the Aged

In old age the heart loses its pumping capacity, the arterial walls soften and the blood stream lacks sufficient force to properly circuit the lungs and receive oxygen. Increase the hemoglobin and the red corpuscles in the blood of the aged subjects and nutrition can be maintained at the proper standard.

Pepto-Mangan("Gude")

makes the blood rich in hemoglobin and red corpuscles, intensifies its affinity for oxygen and invigorates arterial circulation. It exhibits its blood-enriching, strength-imparting and regenerative properties most conspicuously when administered to persons of advanced age.

M. J. BREITENBACH CO.

NEW YORK, U. S. A

Caesarean Section.

Dr. H. H. Witherstine, Rochester, Minn., in The St. Paul Medical Journal, February, 1813, would limit this operation to the following indications: I. When the pelvic diameters are so diminished that it would be impossible to deliver through the birth canal. 2. When the normal delivery of a living child would be improbable. 3. When myoma exists in the lower segment of the uterus, making version necessary. 4. In certain cases of placenta previa when the danger to mother and child would be greater than by the Cesarean route.

Advice as to Tonics. Mother-in-law: "The doctor said I was all run down and needed strychnine as a tonic. Now I don't want to take too much. How big a dose do you recommend?" Son-in-law (hopefully) : "I wouldn't take more than a gallon to begin with.

Hibernian Hemorrhage.

An Irishman was painting a house green when the paint-pot fell to the sidewalk. A woman chanced by. "Mercy! What's the matter? she exclaimed. And the small boy standing near shouted: "That Irishman up there has just had a hemorrhage."

The Return from the Country.

Almost every city family, whose exchequer will permit, is accustomed to spend a goodly portion of the heated term away from home. This is both natural and salutary, provided good judgment is exercised in the selection of the country place or summer resort, as regards its general healthfulness and sanitary environment. Unfortunately sanitation on farms and in rural communities is not always what it should be and the result is that many health and pleasure seekers return in the Autumn depressed and run down or perhaps infected with malarial or typhoid poison. In other cases, especially at crowded fashionable resorts, because of the continual round of exciting amusements, some are tired and fagged out instead of rejuvenated as the result of their Summer's outing. Many are certainly in need of that general constitutional reconstruction and building up of force and resistance which is necessary to withstand the business or social strain of the fall and winter. In such cases there is no one single remedy quite as dependable as Pepto-Mangan (Gude). It increases appetite, restores strength and general vitality, reinforces the hemoglobin content of the blood and acts as a prompt and efficient general tonic and reconstituent for patients of all ages.

"The Best of Prophets of the Future Is the Past."

An established reputation, based upon achievement and accomplishment, is a distinct asset. The past performance of

Pepto-Mangan("'Gude")

is the "prophet" of its future action. For twenty years it has been steadily building its reputation for building blood, in all conditions of Anemic Devitalization. It was the first of the organic combinations of iron and manganese with proteid material, and has since consistently sustained its leadership among similar preparations, and maintained its superiority over all imitations and substitutes. The principle of dignified ethical relationship with the medical profession only has been consistently maintained, and the therapeutic merit of PEPTO-MANGAN (GUDE) has never been honestly questioned. It is still the leading prescription hematinic throughout the civilized world, which fact we consider to be "True evidence of good esteem."

M. J. BREITENBACH CO.

NEW YORK, U. S. A.

Gynecological Hints.

In the treatment of infection following abortion or delivery at term, when putrid material remains in the uterine cavity, this should first be thoroughly removed with the finger, blunt curette or forceps. Then an intrauterine douche of a weak antiseptic solution should be given, to be followed by another of sterile saline solution. Tincture of iodine, one ounce to two quarts of sterile water, is one of the best antiseptics to use in the uterus. Repeated intrauterine douches or medication of any kind is injurious to patients suffering from puerperal sepsis.-Waldo.

A Premonitory Sign of Eclampsia.

Cammaert found, in nine cases, paraesthesia of the legs, pruritus and drawing pains in the legs and in the abdomen, when there was albuminuria and eclampsia, these symptoms not being present in normally pregnant women. From this observation the author suggests that patients having these symptoms should be closely scrutinized for the purpose of determining whether such symptoms are premonitory of eclampsia, especially when albuminuria is absent.-Abstr. Zentralbl. f. Gyn.

The Malarial Anemic.

Whether or not the much maligned mosquito is the intermediate host of the plasmodium malaria, certain it is that the campaign waged for this insect's extermination has not entirely ridden the country of the blood infection for which it is responsible. In addition to the chills, fever and sweating characteristic of the acute forms of the disease, which require immediate antidotal treatment, the physician must recognize the serious injury to the blood itself, due to the invasion and actual destruction of the red cell by the paludal organism. After the subsidence of the acute symptoms, a distinct globular anemia is the result, and unless this is corrected, a reinfection is extremely likely. To. prevent this and to avoid the development of a chronic malarial toxemia, a vigorous blood-building campaign should be instituted just as soon as the febrile movement is controlled. For quick and efficient reconstruction of the partially disintegrated red corpuscles and to encourage the rapid formation of new and functionally active erythrocytes, Pepto-Mangan (Gude) is especially serviceable. Steady treatment with this potent hematinic, for a period of several weeks, is practically certain to restore hemic integrity and place the patient in a position to ward off fresh infection, or quickly throw it off if invasion occurs. When the physician believes that arsenic is needed in the after-treatment, this drug can be readily added to Pepto-Mangan (Gude) preferably in the form of Fowler's Solution.

THE "MOLIMEN MENSTRUALE"

which marks the period of transition from girlhood to womanhood, depends for its success upon the vital integrity of the blood stream, especially its hemoglobin content. A chloranemic circulating fluid renders menstrual initiation difficult and almost impossible.

Pepto-Mangan("Gude")

because of the rapidity and certainty of its vitalizing effect, comes promptly to Nature's aid in the establishment of normal functionation, and at the same time markedly improves the general health and condition of the patient. In 11 ounce bottles only; never sold in bulk.

M. J. BREITENBACH CO.

NEW YORK, U. S. A.

Adrenalin in Asthma.

McCord, Medical Record, discusses the action of adrenalin in the treatment of asthma. He believes it reasonable to conclude that the agent increases the lumina of the contracted bronchioles, which dilatation is probably the cause of the benefit derived. The dilatation results whether the remedy is used subcutaneously, intravenously or endobronchially. The action is transient, but very effective in relieving an acute attack. The subcutaneous method is the most transient. The administration is easy and followed by no bad secondary effects.

Celestial Repartee.

A City Hall employee sends the story of an officeholder who was one of a party that attended the funeral of a Chinaman on a recent Sunday. He took a great deal of interest in the queer services at the grave, and noticed that, among other things, a roasted duck was left there by the departing mourners. Calling one of the "Chinks" aside, he asked: "Why did you leave that duck on the grave? Did you think the dead man will come and eat it?" "Yeppe," replied the Boxer sympathizer- "allee samee as white deadee man come out and smellee flowers."-Philadelphia Times.

Scalp Wounds.

Shave scalp for some distance around wound, either dry, or wet with alcohol; after area dried, paint with tincture of iodine and wash off surplus with alcohol. In suturing use figure 8 sutures, not too tight. Where parts badly torn, provide free drainage; stitches not to be too close together. In all fractures of skull give 40 to 60 grains (2.6 to 4 gm.) of hexamethylenamine daily.-Harper.

Plasmodial Anemia.

In spite of the modern theory of the etiology of malaria and malarial affections (mosquito-borne infection) this plasmodial disease continues to be rife in certain sections of the country and bids fair to be, like "the poor, "always with us." Every physician of experience appreciates the principles which should guide him in the treatment of the various acute manifestations of paludal poisoning, i.e., the destruction of the plasmodial hosts which have invaded the blood and which, if not eliminated, consume and destroy the red cells, the vital element of the circulating fluid. When this purpose has once been accomplished the patient is but partly cured; the damage done to the red corpuscles must be repaired and the vitality of the blood restored, if re-infection is to be avoided. If there is any one condition in which direct hematinic or blood-building therapy is positively indicated, it is in Post-Malarial Anemia. As soon as the febrile period has passed, iron, in some form, should be given in full dosage. Pepto-Mangan (Gude) constitutes the ideal method of administering this essential blood-building agent in this as well as in any anemic condition. Both the iron and manganese in Pepto-Mangan are in organic combination with peptones and are therefore easily and promptly absorbed and assimilated without causing digestive derangement or producing constipation.

In General Debility

following acute diseases, where the functions of the organism are in a state of depression, and in all cases where there is a diminution of the red blood cells and amount of hemoglobin, prescribe

Pepto-Mangan("Gude")

It is pleasant to take, and is free from all corrosive action upon the mucous membrane of the stomach. It does not hinder the normal processes of digestion, assimilation and excretion. When administered for a protracted period it does not create the least aversion.

M. J. BREITENBACH CO.

NEW YORK, U. S. A.

Mouth Inspection in the Treatment of Patients.

Of what avail is it to bombard the stomach with drugs and to diet patients, when the real cause of the symptoms lies in a foul mouth, missing teeth, and filthy bridges and plates? Why prescribe sedative cough mixtures when a long uvula is the cause of an obstinate cough? Why fill a child with tonics when adenoids and enlarged tonsils are the cause of anemia? The tonsils are the cause of so much constitutional mischief that they should always be examined as a routine process. Especially important is this examination in all cases of articular rheumatism, chronic or even acute nephritis and all cases of sepsis. - Morris Manges in New York Med. Journ.

"Served Her Right."

When I hear a machine agent trying to win a customer by claiming all kinds od defects about his competitor's goods, it reminds me of a neighbour lady whose sister had just given birth to twins. She said: "Well, I wanted you to employ a homeoopathic doctor, and his is what you get for calling an allopath. Next time you listen to me." - American Thresherman.

Poetic License.

"Didn't the poet from whom you were reading refer in one of his lines to the germ of immortality?" inquired Mrs. B- of her husband. "Yes, but that strikes me as carrying the microbe theory too far." - St. Louis Med. and Surg. Journ.

In Surgical Convalescence.

After considering the various types of anaemia as they come within the purview of the surgeon, and showing the rational basis and the undoubted clinical results of treatment with iron, Dr. George G. Van Schaick, attending surgeonto the French Hospital and the St. Vincent de Paul Orphan Asylum, New York City, emphasizes the superiority of the organic preparations. In many instances, he says, they have shown a distinct superiority over the inorganic ones, and their greater palatability, together with the fact that they best forms they do not cause constipation and may usually be administered for any length of time, are distinct points in favor of their use. For several years past he made use of Pepto - Mangan (Gude) in all instances of aneamia complicating cases in his surgical practice with exceedingly good results. "The cases cited by Von Ramdohr and Emory Lanphear, as well as those I have observed, show that we have in such preparations as Pepto - Mangan (Gude) a means of obtaining good results with a certainty that is almost mathematical, and without any of the distressing symptoms so frequently following the use of the inorganic preparations."

Post-Typhoidal Anemia

is due to two causes: I. A prolonged iron-poor milk diet; 2. The prostration incident to continued illness. Hematinic treatment is urgently needed during convalescence.

Pepto-Mangan("Gude")

supplies the essential material for blood reconstruction and general revitalization, in palatable, absorbable and assimilable form.

In eleven-ounce bottles only. Never sold in bulk. Samples and literature upon application.

M. J. BREITENBACH CO.

NEWYORK, U. S. A.

His Real Debt.

"Doctor, I shall never forget that to you I owe my life."

"Oh, no," replied the doctor, mildly; "you only owe me for fifteen visits I made you during your illness."

He Understood.

The German papers are telling a story about a Berlin lady who was sent by her physician to one of the well known "cures" in Germany. He gave her a letter which purported to be a prescription for her treatment there, and which she presented to the doctor at the "cure." It read as follows: "Rup, fens, iediega, N. S. ord: ent. li chihrist. nixzi. ehen. Sieihra, berdi, efed, ernein. zel. naus. s. e. h. r. lan gsamdami. t. soihr. gat. toez weimo, nateru, hehatun, dervi. elle, icht. ges, und, et. Versta - N. D. E. N." The doctor perused the lines again and saw that the letters when put in their proper order ran as follows: "Rupfen Sie die Gans ordentlich, ihr ist nix. Ziehen Sie ihr aber die Federn einzeln aus sehr langsam, damit so ihr Gatte zwei Monate Ruhe hat and er vielleicht gesundet. Verstanden?" In English these words mean: Pluck the old goose throughly well. There is nothing the matter with her. But pull out the feathers one by one very slowly, so that her husband may have perhaps be restored to health. Do you understand?" The doctor shook his head dubiously over her, and ordered two months of the usual exercise, baths, waters and rest. - The Amer. Physician.

Secondary Anemias.

Dr. L. S. Chibas, senior assistant house physician, and Dr. G. A. De Santos Saxe, assistant pathologist, Columbus Hospital, New York, made a clinical and hematologic study of Pepto - Mangan in about 40 cases, twelve of which report in detail. There was a uniform increase in haemoglobin and red blood cells. The authors say: "In addition to the forty-odd cases which we studied this winter, Pepto - Mangan has been used in the hospital for over two years in anaemic convalescents. with uniformly satisfactory results. In none of the cases under observation did any untoward symptoms accompanyor follow the use of this preparation. In no case did constipation, nausea, headache, or digestive difficulties follow its administration."

(From the Allg. Mediz. Central Zeitung.)

Dr. S. Ascher, of Hamburg, reports having used Pepto - Mangan (Gude) in 80 cases. In the anaemia accompanying uterine trouble, or following loss of blood from repeated abortions or childbirths, the action of the Pepto - Mangan was uniformly good. In the anaemia developing in the course of chronic malaria Pepto - Mangan rendered him signal service. In pulmonary tuberculosis the effect was of course only relative, yet frequently the author was able to improve the appetite and effect a slight gain in weight.

Friday, October 9

Look to the Bowel.

"At least two-thirds of all sickness is due to the decomposition or fermentation of food waste in the alimentary canal,as a result of which toxic bodies are formed that set up one diseased condition or another, either locally by irritating the mucosa, or remotely, through being absored into the blood-stream and then acting as direct poisons to every body tissue." When we stop to think how many people over-eat and under-excerise in these strenuous days, it is easy to belive this.

Weather a fine day John went are Eugenes all day,I was home alone,doing up {illegible} and walking lureet and grape wine.

Billy and Dell IL

Like the Proverbial Pudding the proof of which is "in the eating," is

Pepto-Mangan("Gude")

the therapeutic value of which is proven "in the trying." That this pleasant tasting, neutral combination of organic iron and manganese is an efficient "blood builder" in cases of Anemia, Chloranemia, Chlorosis, Rachitis, etc., is shown: First-By the rapid improvement in the patient's color and general appearance. Second-By the increased number of red blood cells and the greater percentage of hemoglobin, as shown by instruments of precision. Do you want to make these tests for yourself? If so, we will send you a sufficient quantity for the purpose. In eleven ounce bottles only; never sold in bulk.

M. J. BREITENBACH CO.

NEW YORK, U. S. A.

Poultices as Sedatives.

One reason why the old fashioned poultices fell into undeserved disrepute, says Solomon Solis-Cohen, Journal of Amer. Med. Association, was the fact that poorly made poultices necessitated such frequent change that the evil wrought by the disturbance outweighed the good done by the poultice. Well made poultices, retaining their heat from four to six hours, however, give so much relief from pain-thus acting as sedatives to the nervous system-that they may be classed among agents promoting rest.

Fair Warning.

A popular Cleveland doctor tells this story of a bright boy, his own, who had reached the mature age of nine after an early career marked by many wild and mischievous pranks. His restless nature has made him something of a torment to his teacher at times, and one afternoon not long ago she kept him in after the others were dismissed and had a serious talk with him. Perhaps she was a little afraid that her admonitions were falling on stony ground. Anyway, she finally said: "I certainly will have to ask your father to come and see me." "Don't you do it," said the boy. The teacher thought she had made an impression. "Yes," she repeated, "I must send for your father." "You better not," said the boy. "Why not?" inquired the teacher. "'Cause he charges $2 a visit," said the scamp.-Cleveland Leader.

The Post-Typhoid Tonic

It is usually at this season of the year that Typhoid Fever exhibits its maximum incidence, especially in the larger cities. One probable reason for this is the return of the army of families to city homes from the many more or less unsanitary summer resorts in country districts during the stage of incubation, and the subsquent development of the characteristic symptoms of the disease. As every physician realizes, the systemic poisoning is usually profound and the duration of the infection is such that the organism is almost always distinctly depreciated and devitalized after the four, five or six weeks febrile period. This condition of general systemic depression at the beginning of convalescence certainly indicates the necessity of reconstructive measures. As soon as it is safe to gradually increase the patient's dietary, it is also wise to commence tonic and hematinic treatment. Care must be taken, however, to avoid derangement of the digestion, and for this reason, Pepto-Mangan (Gude) is especially indicated as the most efficent, readily tolerable and generally efficient reconstructive and hematic. This organic combination of the peptones of iron and manganese never creates aversion, destroys the appetite nor causes gastro-intestinal irritation. Through its regular use Typhoid Convalescence is promoted and distinctly hastened.

Marasmus.

Large series of infants with marasmus, congenital or acquired, and premature infants, treated with marked success by external application of codliver oil. Wrap child in oil-soaked flannel from armpits to iliac crests, and cover with oiled silk. Remove flannel, wash skin with soap and water, and reapply flannel, at twelve-hour intervals. Give only water by mouth, in ample quantity. Treatment causes rise in temperature, loss of dryness and wrinkles of skin, and an increase in weight, often considerable. Feed by mouth only when temperature has been normal for a number of days and skin shows increase in fat and water content.-Gray.

Cause and Effect.

Dr. Piller: "Your husband's stomach is in a very bad condition." Mrs. Newlywed: "Oh, my! Do you think my cooking is responsible for it?" Dr. Piller: "Well, it's a severe case of gastritis, and-" Mrs. Newlywed: "Gastritis? Gracious! it's that gas range he made me use this summer!"-Philadelphia Press.

Coughs, Colds and Catarrhs

In all but the most equable of climates, a very large proportion of the population suffers more or less from coughs and colds during the Wither months. Many individuals who, at other times, are apparently in excellent health, contract a cold almost as soon as the cold weather commences, and are scarcely convalescent before another attack occurs, until a sub-acute or more or less chronic naso-pharyngeal catarrh is established which is not thrown off until the Spring opens. The frequency of such respiratory affections during the Winter months is no doubt mainly due to surface chilling from frequent exposure to changes of temperature and the general lack of adequate ventilation of artificially heated houses, stores, offices and schools. Insufficient oxygenation, the longer "housing up" of the individual and the indisposition to open air exercise in cold weather undoubtedly serve to reduce the general vitality and the respiratory mucous membrane becomes less resistant and more readily subject to infective and catarrhal influences. When (as is usually the case) the patient cannot correct the unhygienic conditions referred to, it is the part of wisdom to tone up the general vitality of the patient and thus render his respira- tory tract more resistant to morbific influences. This can best be accomplished by prescribing Pepto-Mangan (Gude) as soon as the more acute symptoms have disappeared. A thorough course of treatment with this efficient blood builder and general tonic reconstructive very frequently places the patient in a position to successfully ward off further catarrhal attacks.

A Hematinic "Hint

"In these days of assimilable preparations of iron, it seems well nigh criminal to subject any man, woman or child to such an abomination as the old muriate tincture, especially when taken in water through a tube." DR. C. E. YOUNG: Dietetic Gazette.

? QUERY ?

How many "therapeutic crimes" have been averted, during the last seventeen years, through the use of

Pepto-Mangan("Gude")

M. J. BREITENBACH CO.

NEW YORK, U. S. A.

Heart Palpitation.

The distressing and excessive palpitation of the heart occurring in nervous, anemic persons can often be averted, according to Dr. G. F. Butler (Am. Journ. of Clin. Med., April, 1913) by bending double, the head down and the hands hanging so as to produce a temporary congestion of the upper half of the body. The heart not infrequently resumes its normal function immediately after such a procedure.

Boiled and Raw Milk.

Brenneman states that raw and boiled milk are clinically very different foods; that the most striking difference between them, as shown by experiments, is in their reaction to rennin; that the casein of raw milk, unless modified so that it will not form hard and large coagula, offers serious difficulties in digestion that are not present in boiled milk; and that these differences between raw and boiled milk should be borne in mind in comparing clinical, therapeutic, and experimental results in infant feeding. (Journ. Amer. Med. Assoc.)

Quinine Cocktails?

First Invalid: "What's the matter with you?" Second Invalid: "Ague. What's your trouble?" First Invalid: "Same thing." Second Invalid: "Good. Let's shake for the drinks." -Chicago News.

Treatment of Cardiac Failure.

M. A. Mortensen (Journ. Mich. State Med. Soc.) has seen great benefit, in a large number of cases of cardiac failure, from using a hot fomentation over the liver and abdomen, with a cold compress over the heart, followed by cold friction to the skin of the entire body. This procedure tends to diminish the con- gestion of the liver, which always accompanies a failing circulation, dilates the capillaries of the skin, and almost invariably gives some relief, at least in the first and second stages of broken compensation.

The Physician's Advice.

Once upon a time a very nervous man called on his physician and asked for medical advice. "Take a tonic and dismiss from your mind all that tends to worry you," said the doctor. Several months afterward the patient received a bill from the physician asking him to remit eighteen dollars, and answered it thus: "Dear Doctor-I have taken a tonic and your advice. Your bill tends to worry me, and so I dismiss it from my mind." Moral-Advice sometimes defeats its giver.

Foreign Bodies in the Tissues.

The best method for the removal of needles, thorns, and such foreign bodies buried in the tissues, according to Blair, of St. Louis, is that of raising a flap which has for its center the supposed site of the needle, etc. The part is rendered ischemic and an anesthetic, either local or general, is employed. The skin and superficial fascia are first raised and failing to find the foreign body, the deeper structures are raised, layer by layer, until the body is encountered.

Practical Hints Regarding Children.

Always teach a nurse that a child cannot swallow as long as the spoon is between the teeth; that it is advisable to depress the tongue a brief moment and withdraw the spoon at once, and that now and then a momentary depression of the nose is a good adjuvant. The taste of quinine is disguised by coffee, chocolate and "elixir simplex." Powders must be thoroughly moistened; unless they be so the powder adhering to the fauces is apt to produce vomiting. Inunctions require a clean surface, and are best made where the epidermis is thin, and the net of lymph-ducts very extensive, as on the inner aspect of the forearm and the thigh. Babies, after having taken opiates for some time, demand larger, and sometimes quite large, doses to yield a sufficient effect. Febrifuges and cardiac tonics, such as quinine, antipyrine, digitalis, strophanthus, sparteine, convallaria, etc., are tolerated and demanded by infants and children in larger doses than the ages of the patients would appear to justify. Mercurials affect the gums very much less in young than in advanced age.-Jacobi.

The Druggists's Trials.

A Forth Worth druggist is in receipt of a curt and haughty note, in an angular feminine hand: "I do not want vasioline but glisserine. Is that plain enough? I persoom you can spell."-Tex. Med. Gazette.

The Pneumonia Convalescent.

In spite of all of the modern advances in scientific therapy, and the improvements in the general handling and management of acute infectious diseases, Acute Lobar Pneumonia still deserves the title ascribed to it by Osler: "The Captain of the Men of Death." There are, however, especially during the Fall and Winter months, many cases of the lobular or irregular Pneumonia that so often complicates or follows La Grippe. When this condition supervenes it is more than likely to follow a subacute or chronic course and. convalescence is frequently long delayed. Under such circumstances, in conjunction with treatment designed to hasten resolution, a general blood tonic and vitalizing agent helps materially to shorten the convalescent period. Pepto-Mangan (Gude) is of much value in this field, because it not only increases the solid elements of the blood, but also acts as a true tono-stimulant to the organism generally. As Pepto-Mangan is free from irritant properties and constipating action, it is especially serviceable in the reconstructive treatment of the devitalization following the pneumonia of the aged.

Pyelitis in Infancy.

The recognition of pyelitis in chidhood is usually easy, and yet it is overlooked again and again simply because the possibility of its occurrence is forgotten and the urine of an infant is seldom examined. Unrecognized acute pyelitis in infancy gives rise to prolonged severe fever, with profound constitutional disturbance, which may be fatal. Recognized and treated appropriately, it often subsides in a few days, and even if symptoms persist for a time they quickly become less severe, and generally soon yield to treatment.-Geo. F. Still; Pediatrics.

The Ultima Thule of Specialism.

At a meeting of physicians, one speaker was cynically deprecating the ultra-specialism of the age in medicine and surgery. Said he: "This rage for parceling out the human frame into special territories is passing all bounds. As it is, we have specialists for the nose, the throat, the ear, the lungs, the heart, the genit-urinary organs, the rectum, the mouth, the brain, etc. It seems to me, gentlemen, that it will not be long ere the specialist, like Alexander, will have to sigh for new regions to overcome. So far as I can see, the umbilicus is about the only portion of the human body not allotted to a specialist." Whereupon a grizzled, veteran practitioner, raising his hand, exlaimed: "Doctor, you're forgetting the naval hospitals!"

Post-Grippal Anemia

may be either mild or profound, in proportion to the severity of the infection and the vital resistance of the patient. After the establishment of convalescence a blood-building campaign is invariably necessary.

Pepto-Mangan("Gude")

here finds a distinct field of usefulness, as a corpuscle-constructor. hemoglobin-creator, and general tonic reconstructive. Palatable, Readily Tolerable, Absorbable, and free from irritant or constipating action. In eleven-ounce bottles. Never sold in bulk. Samples and literature upon application.

M. J. BREITENBACH CO.

NEW YORK, U. S. A

Measles.

Following measures employed in 160 cases: (1) hot bath, followed by (2) application of eucalyptus oil to whole body except hands and part of face about mouth, nose, and eyes; (3) fumigated twice daily with weak alum lotion, and glycerin and borax applied to interior of mouth and gums; (4) tonsils and fauces treated with 1:10 phenol morning and evening, using firm cotton mop on end of forceps; (5) blanket-bath given morning and evening for four successive days, followed by general oil rubbing. Treatment reduced mortality and had favorable influence on course of disease. Careful nursing and maintenance of an even air temperature of 65° F. important accessory measures.-Connolly.

Epitaph.

In memory of our father: Gone to join his appendix, his tonsils, his olfactory nerve, his kidneys, his ear drum, and a leg prematurely removed by a hospital surgeon who craved the experience.-Life.

Obesity.

In the treatment of obesity Laissus has found that when the usual dietetic and hygienic methods fail, some cases are benefited by the administration of a few drops of tincture of iodine in milk. Cases associated with arterio-sclerosis often respond to small doses of sodium iodide.

The Sequelae of La Grippe.

Among all of the various acute and exhaustive illnesses that afflict mankind, there is none that so generally results in distinct prostration as epidemic influenza, or La Grippe. Even the grippal infections which are uncomplicated or unaccompanied by serious organic changes are more than apt to leave the patient in a thoroughly devitalized condition after the acute febrile symptoms have subsided. It is for this reasonthat the treatment of La Grippe convalescence is of special importance. The anemic, debilitated, depressed patient requires a systemic "booster" that will not only stimulate but revivify and reconstruct. It is distinctly, wise, in such cases, to commence vigorous tonic treatment as early as possible, preferably by means of Pepto-Mangan (Gude), the hemic builder and general reconstituent. This standard hematinic increases the vital elements of the circulating blood and, by increasing the appetite and improving the absorptive and assimilative functions, quickly restores both hemic and general vitality.

Convalescence From Pneumonia

The long, weary "pull up-hill" of the weakend convalescent from pneumonia is materially lessened by the administration of

Pepto-Mangan("Gude")

which assists Nature to mount to the crest of the "Hill of Health." Mental depression, languor, and physical weakness disappear after a few weeks' treatment with this reconstructive tonic and nerve invigorator. To assure the proper filling of prescriptions, prescribe an original bottle. Never sold in bulk.

M. J. BREITENBACH CO.

NEW YORK, U. S. A.

Indications for Removal of Surgical Dressings.

1. The removal of stitches. 2. The removal of drainage tubes. 3. Saturation of dressing by abundant discharge. 4. Soiling of dressing by feces, urine, or vomited matter. 5. The disturbance of the dressing by a restless patient. 6. Pain if it is due to pressure, and especially if of a pulsating character. 7. The occurrence of secondary hemorrhage. 8. Fever, if it points to some trouble in the wound.-Roth; Med. Record.

Projectile Vomiting.

"My experience with suggestion reminds me of a friend of mine in Indianapolis who went to Porto Rico. On board the ship a great many were sick, and one of the boys, a young Irishman, was sitting with his arm on the rail, with every indication of seasickness. My friend thought he would console him, and he went up to him and said: 'Comrade, you have a weak stomach.' 'A weak stomach? Oh, I don't know. I'm throwing about as far as any of 'em.'-Dr. George, Indianapolis.

Recipe.

Feeling seedy, he went to his doctor, And here's the advice he got: "Indian clubs are good for the liver, Bohemian clubs are not."

In the Morning or the Evening of Life

or at any of the periods typified by Shakespeare's "seven ages," tonic medication may be indicated.

Pepto-Mangan("Gude")

may be safely and profitably given to the babe in arms, the pallid, anemic school girl, the adolescent youth, the overworked housewife, the neurasthenic business man, the tired school teacher, the society worn matron, or the feeble octogenarian. Patients of all ages take and tolerate it readily, because of its palatability, lack of harshness, and the prompt absorbability. It tones, restores and reconstructs surely, promptly and pleasantly, in all conditions of systemic devitalization. Toinsure results to both patient and physician, specify "original bottle."

In 11 oz. bottles only. Never sold in bulk. Samples and literature upon application.

M. J. BREITENBACH CO.

NEW YORK, U. S. A.

In Chorea and Anmeia

Dr.R.W. Miller, Lecturer on Nervous and Mental Diseases and Proffeser of Theory and Practice of Pharmacy , University College of Medicine , Richmond , Va., states that he is strongly of the opionion that anaemia as an etiologic factor in chorea is worthy if investigation , and in cases where chorea is accompanied by anameia, Pepto= Mangan (Gude) is distinctly indicated and will improve both conditions. Three cases are given an illustration.

Dr.Hermann Metall, assistant physician to the General Polyclinic at Vienna, says:

"The advantage of this preparation (Pepto-Mangan) is that it exerts a simulating effect upon the blood-forming organs,these being excited to greater functional activity,and that the favourable effect manifests itself even within a short time by a increased oxygenation of the blood. At the same time this chalybeate, as already mentioned, cause no digestive disturbances and does not injure the teeth.

He reports a number of cases with blood counts which demonstrates the excellence and efficency of Pepto-Mangan. He adds :" Unpleasent concomitant effects and disagreeble sequeale were never observed during the use of the remedy. Erucatations , pressure in the stomach and nausea were never noticed."

W. Barllett ( Boston Med. and Surg. Journ.) gives the following indication for the open treatment of fractures: (1) When a leg case must be gotten out of bed early;(2) old cases of non-union or extreme mal-union . (3): This treatment is desirable in all fresh, widely- open fractures if shock be past . (4) Chronically infected cases, in which the bones lie bare. He furthur states all compound wounds , whether suppurating or not , are to be packed and allowed to granulate. The patient must be a good surgical risk.

A Prescription That Was Not " Substituted"

An old-school physican practicing in a small town supporting only one druggist of over-scrupulos principals ,wrote for one of his patients the following precription:

R Spir. frumenti, q.s

A.B.C., M.D

Fearing the druggist might hesitate to fill the prescription - it being Sunday- He added the following:

Please give the bearer the above named potation; He's a pretty good champ and employed at the station; The liquid he craves is known as Frumentum and the name at the bottom will tell you who sent 'iM

The letter ' q.s to be very explict, Is a medical dodge known as " quantum suffict" But if if a special tanslation you crave for , It is simply this;Give him all he can pay for.

Friday, December 18

352 DAYS PAST 13 TO COME

To Examine the Colon

for retained feces place the soft part of the four fingers of both hands midway between the umbilicus and ensiform car-tilage, then, by pressing them downwards towards the um-bilicus, the contracted colon can be felt to give the sensation of a tense cord. Another method is to grasp the trunk with the two hands and palpate with the thumbs. The descending colon with the splenic angle can be easily defined. The pelvic colon can only be satisfactorily examined per rectu, and bimanually. It is important to examine the ileum as it enters into the caecum at the same time. - Med. Progress.

Weather Temp.

An nice day Laird Thomphson gave a dinner for her and people, the girls bak their dinner

Billy b-

Saturday, December 19

353 DAYS PAST 12 TO COME

To Hasten Grippe Convalescence.

While opinions may differ to as to the treatment of La Grippe during its active period, there is no doubt of the necessity of supportive and tonic treatment during con-valescence. Pepto-Mangan (Gude) is especially valuable in such cases. When prostration is extreme it is a good plan to order strychnia, in appropriate dosage, in com-bination with Pepto-Mangan (Gude).

Weather Temp.

A moved all the founnor or nearly and last night gad sleighing he leaes birthday & they are all coming aveyla tea. Eugene & Aleta were here & Karltan also

Polley 5 Billis 2 1/2

Too Gory for Him

An actor recently from London relates how, while riding on a "'bus," he overheard an amusing protest from an American passenger who was "of the cloth." The American, he was afterward told, was a bishop visiting one of his English friends among the clergy. The Briton was showing his friend and different phases of London life, and also London town itself, from the top of a 'bus.

Two of lower class of Londoners, who sat in front of the churchman, were engaged in noisy argument, interlanding their conversation profusely with cockney slang and frequent introduction of that much used adjective among that class of people, "bloody." One stated that he was "bloody sure that the bloody bloke would come to some bloody bad end."

The defender of the discussed one declared that he was "bloody glad to inform him that the boy was now a-goin' to some bloody school or other, and was a-gettin' bloody good."

The loud conversation was annoying, not to say painful, to the bishop, who was not used to hearing that powerfully graphic old English word, which is so indiscriminately made use of by certain classes of British to qualify their adjectives and adverbs. Every time the word was uttered he winced as if with a little twitch of pain. At last he leaned depreatingly toward the offenders and said in conciliatory tones:

"My dear friends, cannot you contrive to make your conversation a trifle more anemic?" - N. Y. Chipper.

Mella was fourteen to day

Sunday, December 20

345 DAYS PAST 11 TO COME

Functional Kidney Test.

The removal of a diseased kidney and the retention of one whose power is inadequate to carry on the normal renal function of the two kidneys is, of course, followed by death. Such a result is almost impossible if a preliminary cysto-scopic examination combined with ureteral catheterication is performed.-Nelson; Lancet-Clinic.

Weather Temp.

A fine day We all evejit, to Churel & them to Mrs M Yeayo for drive. Mrs Thompson & Bayder were there. the girls stayed to tea & went to Lelur eh, John and I came home then went back to blurel & got the girls had a lovely time all day. Polley 10

Monday, December 21

355 DAYS PAST 10 TO COME

Without Digestive Disturbance.

A physician of Newcastle, Eng., writes: "The patient to whom I gave sample of Pepto-Mangan (Gude) was able to take it without the digestive disturbances which had previously been caused by inorganic iron prepara-tions. She has since obtained fresh supplies through the local chemist."

Weather Temp.

Cold & Blistery Done about four buches last night. Pa brk Mella to school & went for her. Lord I was hed. Maude was home all day. Eugene & Aleta were here for dinner. I crocheted a Yoke for Maude & Euder waste

Billy 1 1/2 Polly b-

Tuesday, December 22

356 DAYS PAST 9 TO COME

The Heart in Scarlet Fever.

The heart should be carefully watched in all cases of scarlet fever. The possibility of inflammatory lesions, both endocardial and pericardial, should be recognized. I have recently lost a case from heart failure at the end of the sec-ond week. A rapid pules after the subsidence of the fever, or a weak second sound, should place us on guard.-Mc-Clanahan; Jour. Am. Med. Assn.

Weather Temp.

cold snowed Last night, John brk Mella to school. Maudie was home. Then in the afternoon, Maude went over to Cevelius untill we came home, Joe went out to the white school house to an entertainment. Billy 25 Polly 6

Wednesday, December 23

357 DAYS PAST 8 TO COME

Children's Ills,

even when apparently mild in character, frequently resuit in anemia of greater or lesser degree. Because of its palatability, ready tolerability, and promp and complete absorbability, Pepto-Mangan (Gude) is especially indi-cated in the various forms of anemia and general debilty met with in pediatric practice.

Weather Temp.

Very cold

Maudie & Melba went to Aylinia this morning. Got a letter from Aunt Cella last night with two Chaudker chufs for two girls, Eugene was here for dinner and brought me a present of a quarter of beef.

Billey 5- Polly 3 Dell 3

Thursday, December 24

358 DAYS PAST. 7 TO COME

Angina Pectoris

Amyl nitrite still remains the most efficient drug in the attack of angina pectoris. Sodium nitrite acts too slowly, but it may be given in the intervals to ward off attacks. Ery-throl tertranitrate is uncertain in its action. Potassium and sodium iodides are considered useful agents, but I cannot say that I am convinced of their value.-Med. Sentinel.

Weather Temp.

Warmer & snowing

We all went to Aygun to right was at Mrs M Leapo & Mrs Celeines for a few minutes went out with the cuthe lots of snow. Maudie & Melba got to sterling silver of cow each, from Brk Lacey.

Polley 1/2 Dell 2 1/2

Friday, December 25

359 DAYS PAST 6 TO COME

"The Difference Between Day and Night."

A North Dakota physician writes: "If you could have seen the patient, a young lady, before giving Pepto-Man-gan, and see her now, it would be the same as looking at the difference between day and night. She looks well, eats well, sleeps well. It makes me feel good to see the results."

Weather Temp.

Very cold, We all went to Eugenes for Christmas. Mr Dariee went over with us, & Mrs Dunce & Mr Dunce came home with us Carlton stayed for supper & Maudie is agoing to stay all night I got very cold agoing & very cold coming home Wela gave me a lovely charming bag, Mrs Lelasency shines mother died last night Billey 13 Polly 13

Saturday, December 26

360 DAYS PAST 5 TO COME

Treatment of Epistaxis

The writer endorses Naegeli's method of stopping nose-bleed. With the patient sitting in a chair and the physician standing behind him, the latter places his hands under the patient's lower jaw and occipt and pulls the head firmly upward. The effect is still further increased if the upward traction is accompanied by a maximum flexion of the head backwards. The epistaxis usually ceases in a minute or two.-Ritschl; Muench. Med. Woch.

Weather Temp.

Very cold 28 below John & Melba & I went to Mrs Lelins for dinner had goose. Aleta & Maude came home this afternoon while we were gone & got Maudies hat as she can go to lehiach with Aleta tomorrow. Teddy was home with his mother for Christmas intends going back to lelicafa tomorrow. John luck a grisl yeeews was here for apples Billey 8 Polley 8

Medical Aphorisms.

A correspondent signing himself "Artz" sends to the Canda Lancet the following professional aphorisms of Amedee Latour:

1. Life is short, patients fastidious, and the brethren deceptive.

2. Practice is a field of which tact is the manure.

3. Patients are comparable to flannel - neither can be quitted without danger.

4. The physician who absents himself runs the same risk as the lover who leaves his mistress; he is pretty sure to find himself supplanted.

5. Would you rid yourself of a tiresome patient, present your bill.

6. The patient who pays his attendant is but exacting; he who does not is a despot.

7. The physician who depends upon the gratitude of his patient for his fee is like the traveler who waited upon the bank of a river until it would finish flowing that he might cross to the other side.

8. Modesty, simplicity, truthfulness! - cleansing virtues, everywhere but at the bedside; there simplicity is construed as hesitation; modesty as want of confidence, truth as impoliteness.

9. Remeber always to appear to do something - above all when you are doing nothing. - Northwestern Lancet.

Sunday, December 27

361 DAYS PAST 4 TO COME

Evidence of Confidence.

A Michigan physician writes: "I think you will credit me with some confidence in Pepto-Mangan (Gude) when I am using it in my own family and have even refrained from disposing sample supplies to those patients to whom most supplies go, those who are not paying their bills."

Weather Temp.

Cold & Blistery Mrs Charley Priee was buried this afternoon, Evelie came & stayed with Melba, while we went. I called an Aunty Arnold, went over & Mr Loves h night Maudi is out w Eugenes Billey Polley 6

Monday, December 28

362 DAYS PAST 3 TO COME

Treatment of Acne Rosacea.

Where acne indurata is associated, incise papules and pus-tules, scarify distended nasal capillaries, and apply Bier's cup for some time to individual lesions. Have patient apply hot compresses freely to face and at night following oitment: Salicylic acid, 0.6 (gr. x); precipitated sulphur, 4.0 (3j); white petrolatum, 30.0 (3j).-Aronstam

Weather Temp.

Warmer Joe & Jmashel Pa went to the factory then up & Lewises Eugene & Alita came this morning & Pa went to Apliner Eugene got a new pain of B of sleighs him lack for dinner him Eugene went to Apanta with Carlton. Melba went home with Alita Polley 2 1/2 Dell 2 1/2

Tuesday, December 29

363 DAYS PAST 2 TO COME

The One Thing Needful.

Anemic convalescents who fail to respond to well directed dietetic and hygienic measures alone, often show distinct and prompt improvement when Pepto-Mangan (Gude) is added to the treatment. The appetite sharpens, absorp-tion of food is encouraged and nutrition is enhanced.

Weather Temp.

Warm & rainey Mrs Thompsons were op for dinner & tea Uncle Joe wrig Wtman came with them Nellie, Maude came home with ALita yesterday. Joe is agoing to the doings in the Baptist Church. We had our last goose for dinner.

Wendesda, December 30

Alchohol Antidote.

Ammonium chloride is reccomended as an antidote to alchol, given in doses of 30 to 60 grains, with copious draughts of water to prevent gastrointestinal irratation. It prevents the effects of the alchol, sobers the patient quickly, and is a valuable preventive against delirium tremens.Should the pateint not become quiet after taking the remedy, bromide or chloral hydrate may be administered. - Med. Times

Cold

Jhon Maudie and I were down H Ed Thomspsons for dinner and eat {illegible}his Mitchelle and wife for the time this {illegible} was all show and Jhon weren't on mille then we came home.

Billey B Polly B

Thursday, December 31

365 DAYS PAST 0 TO COME

At the End of the Year.

At the end, as well as at the beginning, prescribe Pepto-Mangan ("Gude") as tonic, reconstructive, and blood builder.

Weather Temp.

Rather a fine day. Pa Maudie & I went to Apline & got the cheese cheque Payed Mr Mitchell and we had a visit with them. We went to Mrs McLump. Polly 2 1/2 Billey 5

Costly Courtesy.

He tells it himself, and as he is one of New York's leading physicians and a member of the Amen Corner, it must be true. A patient of his, who is a politican of more than local fame, cane to his office not long ago to consult him. After paying the consultation fee, $5, he asked the physician if he might use his telephone, to which the physician, his fee in his fob, gave a cheerful consent, withdrawing out of delicacy to another room while the conversation over the 'phone was being held. The patient finished after a while.

"I'm very much obliged, doctor," said he.

"Don't mention it, my dear fellow!" said the doctor.

"Don't mention it!"

The patient went his way. A few days afterward the physician received his monthly telephone bill. One of the items on it was "Conversation with Boston, $6.75" The doctor had talked with no one in Boston, but the date was the day on which the patient had borrowed his telephone, after paying his $5 fee. "He talked his fee to Boston, sure enough," says the physician, telling about it, "but seems to me the joke would have been just as good if he had stopped at that."

Dr. H. S. McLay - Dec. 6th

Maud McLay - May 23rth

Mrs. Sweet - July 26

Mr. Sweet - Dec. 11

Eugene Sweet - Jan 2.

Maud Sweet - Feb. 5

Melba Sweet - Dec. 20

Mark Cox - Dec. 19

Carlton Dance - Jan. 5

Alita Dance June 24.

Eclare Maulurs Apr 22

Doubt or Certainity?

HEN a hematinic is indicated the doubtfully assimilable salts of iron may prove of therapeutic value, even though they stain the teeth, irritate the sensitive gastric mucosa, or cause constipation. When the physician prescribes

Pepto Manoan ("Gude")

he is practically certain of the absorption and assimilation of its organically combined iron and manganese, and of its freedom from the disadvantages above mentioned. It performs its work safely, pleasantly and certainly.

M. J. BREITENBACH CO,.

New York, U. S. A.

In 11 oz. bottles only. Never sold in bulk.