tion to uniform neatness in the application of labels, corks, wrappers, etc., etc., so that the competitive task of the old school pharmacist has been no light one. Notwithstanding these facts, however, it must be acknowledged that he has made a long stride towards agreeable medication in his sugar and gelatine-coated pills which have been upon the market for many years. More recently the compressed pills or tablets and moulded tablets may be named as the latest advance with which the drug market is now flooded almost to the point of nausea, for it seems as though, probably on account of the ease, rapidity, and cheapness with which they can be manufactured, that it has been attempted to make this form of administering medicines as nearly universal as possible. Almost any drug or compound of drugs that can be prepared in the solid form, whether soluble or insoluble, volatile or hygroscopic, may now be found in the form of tablets. Unfortunately, this lamentable criticism may with all fairness be applied to many of the tablets found upon the shelves of the homœopathic pharmacist, for he is not willing to be outdone by his neighbor, and has been almost as indiscriminate in his choice of remedies to be prepared in this form, though he has usually prepared moulded instead of compressed tablets. Medicines put up in tablet form are neat, attractive, convenient, and the dose may be regulated. to a nicety; hence it is no wonder that such strenuous efforts have been made to prepare almost all medicines in this form, but reliability and efficiency should under no circumstances be sacrificed to elegance. Moulded tablets require the drug or medicine to be brought to the condition of stiff paste by the use of a sufficient amount of diluted alcohol, which, of course, must be evaporated from the tablets before they can be stored for use.

I unhesitatingly claim that this method of making tablets is particularly objectionable. The removal by evaporation of the diluted alcohol from the tablet after it leaves the mould is absolutely necessary to its keeping quality, else must and mould would soon and surely damage or ruin it. No one can dispute that coincident with this evaporation any volatile portions of the drug which may be therein contained are sure to be partly or wholly lost, thus rendering the tablet unreliable or entirely inert. For this reason all mother tincture tablets should be discarded as not reliable, because nearly all vegetable remedies from which the tinctures are made, contain more or less of volatile matters.

It seems

particularly inconsistent to see among the lists of mother tincture tablets the names of many remedies such as Asafœtida, Cocculus, Coffea, Ignatia, Nux, Spongia, and many others which

are made into tinctures from the dried drug and then into moulded tablets, which could as easily be made into triturations and compressed tablets, and the undesirable exposure to evaporation thus be entirely avoided. Again, it is exceedingly difficult to thoroughly dry a tablet containing a hygroscopic drug, and even should this be accomplished, the occasional exposure of the tablets to the air when portions are taken for use, or when given to the patient when the bottle is frequently opened as is necessary in taking the medicine, sufficient moisture may be absorbed from the air to cause the tablets to become sticky, adherent to each other, or perhaps even to disintegrate. Among these may be named all of the acetates, most of the chlorides or muriates, and some of the nitrates and carbonates.

Some drugs, like hepar, for instance, are partially decomposed by exposure to moisture, and for this reason should never be made into moulded tablets. Others again, like the iodides, some of the nitrates (as notably the nitrate of silver), phosphorus, etc, are decomposed by exposure to light and air, and for this reason should not be thus exposed as is necessary in drying moulded tablets. Having excluded volatile, hygroscopic, and easily decomposed drugs as ineligible for use in the form of moulded tablets, it is well to consider whether some of them at least may not be suitably prepared as compressed tablets. The same objections can not be urged against this form of tablet because exposure to light, air or moisture is not necessary to their manufacture, though of course very volatile, or hygroscopic drugs should not be put up in this form; neither should insoluble drugs unless combined with a sufficient proportion of some simple, non-medicinal, readily soluble, not easily decomposed excipient which by its own solution shall guarantee easy disintegration of the drug. We, as homoeopathic physicians, usually prescribe drugs or medicines in small doses, hence an excipient is almost if not quite always necessary to bring the quantity of the tablet up to a convenient bulk.

For this purpose no more suitable substance can be found than sugar of milk so largely used in making triturations, and when this is used for an excipient the compressed tablet is quite as readily soluble as is the moulded one. Hence, many medicines may be appropriately put up in the form of compressed tablets that should never be made into moulded tablets, while all that are suitable for the latter can with equal propriety be made into compressed tablets. Manufacturers have claimed greater purity for moulded tablets, but when the possibility of contamination during the drying process is considered when tablets are made on the large scale, and the ease

with which machines may be perfectly cleansed by the thorough application of steam, and subsequent dry heat, the probabilities are strongly in favor of greater freedom from contamination when made by compression.

Compound tablets (those composed of more than one medicinal ingredient), should be summarily dismissed and discarded as a disgrace to Homœopathy, and any homœopathic pharmacist who caters to old school demands for such polypharmacy is false to the principles and demands of true Homœopathy, and deserves to be looked upon with distrust in spite of numerous, oft-repeated, and emphatic self-laudations as superior to all others. In view of these facts is it not our duty as conscientious physicians to prescribe to our pharmacists the forms in which we wish our medicines prepared; and to see to it that we get them prepared in the most reliable manner possible, and to use our influence unequivocally and emphatically in every way in our power against any and all medicinal preparations which can be considered as at all doubtful? For the reasons given let us discountenance moulded tablets altogether, and use our influence to have them supplanted by those made by compression. The list of medicines suitable for preparation in this form is large, including all that may be prepared by trituration except tincture triturations and those made from hygroscopic drugs, all soluble drugs that are not hygroscopic, and all insoluble drugs that will permit of combination with a sufficient amount of soluble excipient; and excluding only volatile or hygroscopic drugs, and some few which are easily decomposed.

M'

ACUTE LARYNGEAL ŒDEMA.*

By C. F. MONTGOMERY, M.D.

Missouri Valley, Iowa.

R. J., æt. 24, caught cold, suffering little inconvenience except slight dyspnoea for two days. When called the following night, found him unconscious, rigid, eyes staring, pupils pin pointed, head retracted, lips cyanotic, inhalations shorter than exhalations. The larynx closed almost immediately upon any attempt at inspiration. Every few minutes a heavy coughing ensued, with very little expectoration of stringy mucous, leaving patient thoroughly exhausted. Realizing that medicines per oram could not be given and that expediency was necessary, I placed five drops apis 2x in twenty min. water and injected into leg, at the

*Written especially for the NORTH AMERICAN.

same time ordering steam inhalation of 1 part fl. ext. grindelia rob. to 2 parts water. Was ready to do tracheotomy if necessary, but relief was afforded in a few minutes and an uneventful recovery took place under the administration of apis 2x for twenty-four hours. Arnica 2x. Mrs. B., æt. 35. Rheumatic neuritis of left ulnar nerve in hands and fingers, also extreme tension with soreness and stiffness of the tendons of the semi-membranosus and biceps of the left thigh. Left foot swollen and puffy. Tubercular tendency, fever, cough, night sweats, etc. Two or three doses of arnica 2x caused the tendons to relax and dissipated the soreness. Recovery from constitutional symptoms took place under the administration of ars. iod. 3x.

Helonias 2x. Miss M., æt. 19. Amenorrhoea from exposure to damp, night air, with scanty secretion of urine. No positive symptoms upon which to base a prescription. Apis 2x would restore kidneys to normal function only as long as taken. Helonias 2x, two grain powder four times a day for three days brought the functions of the kidneys and menses to normal.

CALIFORNIA COFFEE.-An experiment in coffee growing on a large scale is to be made in San Joaquin Valley, California, which, if successful, may mean that coffee planting will become an important industry in that State. It will be at least six years before the result of the experiment can be known. Experts are somewhat doubtful of its success. They say the soil and sunlight are all right in the San Joaquin Valley, but the moisture necessary to the successful raising of coffee is lacking.

A NON-POISONOUS match has been invented by a distinguished chemist, M. Pouteaux. Permanganate of potash and acetate of amyl are among the inoffensive ingredients. At the Pasteur lucifer match manufactory the combination has been tested with satisfactory results. The matches are easily made, without the slightest danger to the factory hands. They ignite readily, there is no danger of explosion when stored, and the disagreeable odor common to lucifer matches is in these replaced by that of aniseed.

GOVERNOR MORTON has apppointed Dr. Theodore K. Tuthill, of No. 319 West Eighteenth street, as Coroner for New York City, in the place of Coroner O'Meagher, deceased.

CONDUCTED BY

WILLIAM TOD HELMUTH, M.D., LL.D.

GEORGE W. ROBERTS, Ph.B. M.D.

SIDNEY F. WILCOX, M.D.

B

SURGICAL CLINIC AT THE FLOWER HOSPITAL.
By WM. TOD HELMUTH, M.D., LL.D.

New York.

EFORE I proceed to the more important business of this clinic, I propose to show you one or two minor cases, which being of the kind which you will certainly meet in the earlier days of your professional career, will no doubt interest you more than the capital operation.

I am disposed to believe that the clinician often takes too much. for granted in lecturing before a class of students, some of whom are but beginning their medical studies while others are about completing their medical education. The Professor from constant repetition has become so familiar with his subject that he is prone to consider his hearers on almost an equal plane of medical knowledge with himself, and is likely to forget that there are in the class to which he speaks so technically, those who are just beginning the alphabet of medical knowledge.

I. Ulcers. The minor surgical cases are those which come under the eye of the young graduate much more frequently than those serious diseases which require the major operations, and even if the latter are encountered they are generally sent by the young beginner to his professor in the adjacent city, or to some one more experienced than himself. For these reasons let me introduce for your consideration first a case of ulcer.

In days not very long ago—well within my own remembrance— when inflammation was considered a very destructive disease, instead of, as it is known to us, a regenerative process, an ulcer was supposed to be made by "ulcerative absorption." This was the doctrine or rather theory advanced by John Hunter, and although there were evidences appearing constantly to prove the fallacy of such a theory, still it held sway among the profession for quite a number of years. It was very soon proved that during inflammation the function of absorption was diminished, and new explanations for the destruction of surface were advanced.

We know now, however, that inflammation is a process of repair, we know that if there be microbic infection which does not allow