THE MEDICINAL EMPLOYMENT OF COFFEE.

JONATHAN HUTCHINSON in his Archives of Surgery says: "I have often been in the habit of prescribing coffee as a medicine in certain states of great debility. It appears to me to be a remedy quite unique in its usefulness in sustaining the nervous energy in certain cases. Apart from its general usefulness, I have found it of especial service after operations where anaesthetics had been used, and in states of exhaustion where alcohol had been pushed and a condition of semi-coma followed. In these latter cases I have sometimes prescribed it as an enema when the patient could not swallow, and with the best effects. Its value as an antidote to opium is of course well-known. Tea and coffee seem to me to be much alike in many respects, but I would give great preference to the latter as to its sustaining power. It would, I think, be a great advantage to our working classes, and a great help towards the further development of social sobriety, if coffee were to come into greatly increased use, and if the ability to make it well could be acquired. As an example of the difference of effect of tea and coffee upon the nerves, I may note, what I believe many sportsmen will confirm, that it is far better to drink coffee than tea when shooting. Tea, if strong or in any quantity, especially if the indiivdual be not in very robust health, will induce a sort of nervousness which is very prejudicial to steady shooting. Under its influence you are apt to shoot too quickly, whereas coffee steadies the hand and gives quiet nerves. My object in the present note is, however, to illustrate the remarkable power of coffee as a restorative medicine.

In the case of an old man in whom colotomy was done in a very desperate stage, he being almost moribund, good rallying took place under injections of coffee and milk. During the first two or three days great use was made of coffee, and I believe that the recovery that resulted was largely to be credited to it. I have employed it in many similar, though less severe cases. It is my almost invariable prescription for elderly people after an operation for which an anaesthetic has been given. One of the most remarkable facts, however, which I have ever witnessed, illustrating its powers, was the following: I was called late one evening to an elderly lady whom I had repeatedly seen previous on account of multiple sarco

matous growths in her bones. She had been in an almost dying state for more than a month, and at length it seemed that her end was come. I found her in a state of deep collapse, with pale face and dusky lips, and unable to speak or recognize any one. Her breathing was short and rapid. Her daughters were attempting to force brandy into her mouth by the spoon, but she could not swallow it, and I learned that they had given a good deal of champagne and brandy during the afternoon. Her pulse, although very rapid, still beat well, and was not in keeping with her other symptoms of collapse. This made me think that probably more alcohol had been given than was useful, and I resisted the importunity of the relatives that subcutaneous injections of ether should be made. Feeling sure that she was sinking, and expecting that all would be over in an hour or two, I wished to take my leave The patient's daughters, however, in great distress, begged me to stay to the end. I waited about an hour, still refusing to administer more alcohol. At the end of that time the nose had become cold, and the face was bedewed with a clammy sweat. It was under these circumstances that, in consequence of the urgent solicitations to do something, I thought of trying a coffee enema. After the nurse had prepared it, she appealed to me as to whether she should give it, evidently thinking, as I did, that it was absurd to attempt anything in a patient so nearly dead. It was, however, administered, and with the surprising effect that within a quarter of an hour the patient opened her eyes and recognized those about her. In another half hour she spoke to us, and color began to return to her face. The coffee was repeated several times during the night, with the addition of some very small quantities of brandy. The result was that the patient recovered and lived for three weeks afterward.

"In this instance I have no doubt that alcoholic stimulants, whilst they sustained the circulation, had acted injuriously on the nervous system, and that the patient, already extremely weak, had been pushed into a condition approaching that of intoxication. It is, I believe, very easy on the deathbed to over-use alcohol, although, in the case which I have narrated, the disease being incurable and the suffering great, the prolongation of life for a few weeks was not a matter of real importance. There are, however, many others in which death may be close at hand, where an expedient such as I have described may be the means of permanent restoration to health."

ANYBODY MAY LEARN TO SWIM.

TWO HALF HOURS OF DETERMINED EFFORT WILL ACCOMPLISH THAT

RESULT.

The fact that so many lose their lives because they have never learned to swim will, I trust, be regarded sufficient apology for pointing out the further fact that anybody may learn to swim in two half hours spent in determined efforts to that end. To begin with, let it be understood that the act of "treading water" consists in simply remaining in one place in the water in an upright position. by motion of the arms and legs moved as a dog, horse, or ox moves his legs in swimming, omitting his effort to move forward. This having been understood, let the tyro wade out from the shore in gradually deepening water until he finds himself in water, say, up to his chin; then turn round, face the shore, and proceed to tread water, continuing his efforts until he finds himself standing upright, his feet not touching bottom. Half an hour's persistent effort will enable him to master this his first lesson. When he has done so much, he has virtually captured the whole business. When he again goes into the water, let him go out to the same depth, turn round, face the shore as before, and strike out in front with his hands and arms, at the same time kicking backward. He will find, almost before he is aware of it, that he is off bottom and slowly swimming toward the shore. In fact, he has learned to swim. His flights will be short at first. He can easily learn the common strokes and methods of swimming after he has first learned to swim dog fashion. All he needs, however, is practice to enable him to swim at will, according to his physical strength. In these suggestions the masculine is assumed to include the feminine.-Natator, in the New York Times, July 26, 1897.

DR. PARR.-Dr. Parr had a great deal of sensibility. When to him, in Lincoln's Inn Fields, the account of O'Coigly's death was read, the tears rolled down his cheeks. One day Macintosh, having vexed him, by calling O'Coigly "a rascal," Parr immediately rejoined, "Yes, Jamie, he was a bad man, but he might have been worse; he was an Irishman, but he might have been a Scotchman; he was a priest, but he might have been a lawyer; he was a republican, but he might have been an apostate."

MEDICAL EXCERPT.

BY T. P. CORBALLY, A. M., M. D.

DISTURBANCE OF SPEECH IN EPILEPSY.-M. Nevsky (Archives of psychiatria, neurology and legal psychopathology), "Le Progres Medical," 21 August, says:

"These disturbances are still but very little studied; while they are not always present, nor absolutely the same in all cases, they have many features in common that it will be of interest to develop. The most frequent and the most important of these peculiarities are the following: 1. Slowness in pronouncing the words; this slowness is rarely continuous; most frequently and especially when the disease is advanced, words or phrases pronounced slowly, alternate irregularly with words and phrases pronounced rapidly. 2. The repetition of words or syllables and of sounds or of phrases, with a tendency to repeat several times, particularly the commencement of the phrase. 3. The prolongation of the vowels and the syllables. 4. Difficulty of motor co-ordination; difficulty of finding, at first, the attitude of the tongue and the lips necessary for the emission of the desired sound. 5. Pauses unusually long and inappropriate, especially between the syllables of the same word, or between different words. 6. Expiratory or inspiratory stammering. 7. An unnatural pitch of the voice, the emission of some very loud sounds. 8. A weakening of the voice which may end in almost complete extinction. These changes may make their appearance at the beginning or toward the end of the disease, their course is always chronic and in proportion to the progress of the intellectual debility; the different attacks are followed by an increase of the disturbance, which diminishes gradually during the periods that intervene between the attacks."

In a very severe and protracted case that came under the observation of the writer a few years ago, nearly all the irregularities noticed above were found from time to time. The one noticeably absent was the difference in the pitch of the voice. The young man, when first observed, was about twenty-one years of age, addicted to vicious habits, and about three years later became a complete imbecile. He spoke rarely, and words were elicited from

him with difficulty.

TO RECOGNIZE HORSE-FLESH.-"La Journal d'Hygiene," of the 5th of August, gives the following as a means of recognizing horse-meat, even when mixed with the meat of other animals:

The best process is based on the well known reaction of iodine on glycogene, which, even if in variable quantity, is found always in the flesh of the horse. The following is the German method of proceeding:

I. A small quantity of the meat to be analyzed-50 gr.—is chopped as fine as possible. It is then boiled for an hour in four times its weight of water.

2. Then there is added caustic potasa (equal to 3 per cent. of the meat) dissolved in a like quantity of water, and this is again heated until the muscular fibres are dissolved.

3. The decoction of meat thus obtained is collected, evaporated until the weight is double that of the meat used, and is then filtered. 4. This solution of meat, having become completely cold, is treated with dilute nitric acid, in order to remove the color and to separate the greater part of the albuminoid substances; it is again

filtered.

5. While the meat gelatin obtained by the process No. 1 is treated with dilute nitric acid, the product of No. 4 is treated with a perfectly saturated solution of iodine, warmed.

The solution of iodine thus obtained is poured gently on a filter in a test tube over the flesh of the horse, and there is formed immediately, at the line of contact of the two liquids, a ring, brownishred, approaching violet, the color of which, both in force and in intensity, depends on the quantity of horse-meat contained in the test tube, in proportion to the quantity of glycogen. By this method 5 per cent. of horse-flesh added to other kinds of meat can be detected.

This process is recommended to military confreres, in the absence of chemists and pharmacists.-Dr. M. de T.

NERVOUS LESIONS IN LA PESTE.-M. Nepveu, of Marseilles (“La France Médicale, 20th of August), says: In very fine cuttings of the cerebral circumvolutions, bacilla are found scattered here and there, or gathered together in little groups, particularly numerous in the veins, or they are found on the walls or in the clots in the sub-arachnoid space. Great numbers of leucocytes are found, becoming more rare as the investigation is pursued deeper. The capillaries are congested; they contain, besides the great quantities of leucocytes, the bacilli of the plague, which may be seen