method of holding the nose and throwing the head well back when gargling enables the fluid to reach every surface of the pharynx.

The value of the two methods can readily be tested by painting the posterior wall of the pharynx with a strong solution of methylene blue. After gargling with water in the usual way the latter will be perfectly clear and unstained. Then let the patient gargle again by the method suggested, and the injected fluid will be found stained.

THE TREATMENT OF INSOMNIA.-Impairment of the normal ability to sleep (New York "Medical Journal," Oct. 28), often amounting to protracted and exhausting insomnia, not only gives rise to much distress, but also undoubtedly aggravates the trouble

on

which it generally depends-neurasthenia. Wunderlich ("Sammlung klinischer Vorträge," No. 239; "Fortschritte der Medicin," Sept. 20) thinks that two-thirds of all cases of nervous insomnia are due to neurasthenia. In its treatment, he properly insists, hypnotic drugs should be avoided as far as possible. He thinks trional and sulphonal are the best of them. Under no circumstances should the use of morphine be allowed. If drugs are to be used at all it is generally best to prescribe the bromides in diminishing doses, beginning with forty-five grains at bedtime. If, however, there are phenomena of sensory irritation, perhaps antipyrine, lactophenine or phenacetine may also be indicated. That form in which the sleep is broken often depends on excessive gastric secretion and acidity of the gastric juice. For this sodium bicarbonate and bismuth may be given. But the measures most generally appropriate are hygienic and dietetic. In particular the cold pack is highly effective. It must not be so prolonged as to bring on sweating, but should be terminated when the patient begins to feel warm and the pulse increases in frequency.

BLINDNESS IN FINLAND.-The different degrees to which blindness prevails among various populations is always a matter worthy of study. J. Widmark has investigated the subject as regards Denmark, Sweden, Norway and Finland ("Nordiskt medicinskt Arkiv." August; New York "Medical Journal," Oct. 28). He finds that for every 10,000 inhabitants there are 5.3 blind persons in Denmark, 8.3 in Sweden, 12.8 in Norway and 15.5 in Finland. The preponderance in Finland, which is not observed among children under ten years of age, is attributed to the great prevalence of trachoma. Curiously enough, the "endemic" affects only the natives.

EDITOR'S TABLE.

SANITARIAN, DECEMBER, 1899.

All correspondence and exchanges, and all publications for review, should be addressed to the Editor, Dr. A. N. Bell, 337 Clinton Street, Brooklyn, N. Y.

PROGRESS IN MILITARY SANITATION.

Under a recent circular, Department of California, a commissioned medical officer is to be detailed in orders to act as medical inspector of the regimental and recruit camps on the Presidio Reservation, with authority to exercise general supervision over the medical and sanitary conditions in these camps, and to see that the provisions of this order are properly executed. This circular marks a most important step in the progress of military sanitation, as it clothes the sanitary inspector with actual authority in his own department,, places upon him the responsibility for the existence of unsanitary conditions and elevates him from the anomalous condition of mere medical adviser, without powers to accomplish the changes which may appear to him to be advisable. The action above noted will undoubtedly arouse the hostility of line officers, since even the colonel of a regiment may, under its provisions, become subordinate to the sanitary inspector of lesser rank. Hence it is to be hoped that the medical officer selected to fill the latter position will, in addition to his excellent professional qualifications, possess that rare tact and moderation, combined with firmness, which will alone prevent undue opposition to the execution of this order. The system itself is on trial and a sanitary inspector of illbalanced personality may do much to set back the progress of military hygiene for the immediate future.

The lack of executive authority has been a cause for bitter complaint on the part of sanitary officers, and, with indifferent or unfriendly commanding officers, has done much to destroy interest and ambition and to render inspection a purely perfunctory performance. The order above noted places an undivided responsibility upon the sanitary officer and officially recognizes the value of his important duties. We feel that the Army Medical Department and the medical profession at large are entitled to congratulations for this hard-won victory.

MILITARY SANITATION IN PUERTO RICO.

General Order No. 151, dated San Juan, Puerto Rico, September 27, 1899, makes a distinct advance in military sanitation, and, as remarked by the Boston "Medical and Surgical Journal," contains many provisions which might with advantage be adopted in our own supposedly more enlightened communities.

The value of the requirements noted below concerning the maintenance of proper cleanliness in all stores where food is offered for sale will be at once appreciated by all persons familiar with the conditions obtaining in Spanish-American countries. Milk is probably not adulterated to any great extent, and even in towns as large as Ponce the cows are driven to the residence of the customer and then milked. It is said, however, that in the past an occasional clever rascal has been known to secrete in his sleeve a conveniently shaped rubber bulb containing water, and thus dilute the milk during the operation of milking, undetected except by the closest scrutiny. The requirement that all secret or proprietary preparations must bear upon each bottle the exact formula used in their manufacture will be a severe blow to the patent medicine manufacturers of the United States, who have hitherto held a lucrative trade in Puerto Rico, and will undoubtedly excite their active hostility. As in this country, pharmacists in Puerto Rico are universally prescribers, and as they are largely men of no great education, it is with probable detriment to the general health. The provisions of the order are as follows:

(1) Foods and drinks in the meaning of this order are all articles used for food or drink by man, whether simple or compound. The term "drug" includes all medicines used by man, whether for internal or external use.

(2) No adulterated article of food or drink shall be made or sold in Puerto Rico; articles ordinarily recognized as food, which are really mixtures, may be sold if marked with the word "mixture" or "compound." No diseased, decomposed, offensive or unclean article shall be used in the manufacture of any food, drink or medicine.

(3) No person shall sell in Puerto Rico any impure, diseased, decayed or unwholesome provisions, or any adulterated bread, or any food substance mixed with poisonous substance.

(4) No person, whether owner, manager, keeper or agent, bartender or clerk, in any saloon, restaurant, boarding or eating house in Puerto Rico, shall offer for sale any food or drink containing anything poisonous or unwholesome.

(5) No person owning, renting or leasing any stall, room or stand where milk, meat, vegetables or groceries are sold as food shall fail to keep said room, stall or stand in a cleanly condition, nor shall such persons allow such milk, meats, vegetables or groceries to become poisonous or infected or unfit for food by reason of uncleanly condition of such stall, room or stand.

(6) No person shall offer for sale in Puerto Rico any unwholesome, watered or adulterated milk or milk produced from cows which are visibly diseased, or are kept upon and fed on garbage, swill or other deleterious substance.

(7) No person shall sell any article of food or drug which is not of the nature, substance and quality of the substance demanded by any purchaser. And no person shall sell any compound food or drug which is not composed of ingredients in accordance with the demand of the purchaser.

(8) No person in Puerto Rico shall subtract from any article of food any part of it, so as to affect injuriously its quality, substance or nature; and no person shall sell any article so altered without making disclosure of the alteration.

(9) All drugs sold must be of the standard quality and strength prescribed in the Spanish or United States pharmacopeias.

(10) All compound, proprietary, patent or secret remedies sold in Puerto Rico shall bear upon the bottle, box or package an exact formula, stating the constituents of the medicine or remedy.

(11) No pharmacist not a legally qualified physician shall prescribe remedies for the sick. Every bottle, box or package containing any medicine or drug shall be labeled with the name of the same and with the name of the physician who wrote the prescription. Pharmacists shall not sell arsenic or strychnine, or their compounds, or other drugs commonly known as deadly poisons, except upon the prescription of legally qualified physicians. Before such sale is made the name of the drug and the quantity, the name of the physician prescribing, and also the name of the purchaser, shall be entered in a book especially kept for this purpose. The purchaser shall sign his name in a book below the entry made by the druggist. Every bottle, box or package containing a dangerous drug shall be distinctly labeled "Poison," and the person shall be warned of the nature of the article.

THE PATIENT STOMACH.

"The rush of modern civilization ('Medical Press and Circu

lar) leaves little time for the average man to think of anything outside the immediate tether of his own absorbing pursuits. He is content to eat, drink, sleep and take his pleasures as they come, without encroaching upon the period of his scant recreations by such solid labor as that involved in consecutive thinking. In this way eating and drinking are regarded much as breathing or the complex nervous and muscular acts that take place in walking or talking; all are accepted as matters of course. Indeed, it is just this easy way of treating vital functions that only too often leads to their abuse. Let the reader pause for a few moments and think how he treats, and has been in the habit of treating, his own patient stomach. Does he begin the day with a heavy breakfast, including several cups of strong tea? Does he take a meat luncheon, with wine or other alcoholic drink? Does he indulge in afternoon tea and wind up with a dinner of half a dozen courses, tempered with more alcohol? If a man, does he distribute odd alcoholic drinks over the whole day's programme? If of either sex, is tobacco included in the daily trials of the stomach? A steady course of public dinners would, in time, ruin the digestion of a rhinoceros or an ostrich. The three square meals a day of the average country house quickly upset the digestion of the visitor, who is used to think highly and live plainly. Indeed, no great intellectual activity can be permanently associated with gluttony. The amount of abuse the modern civilized stomach can withstand is an eternal monument to the perfecting powers of the evolutional survival of the fittest."

INDIAN PLAGUE HORRORS.

A correspondent of the "Scotsman" ("Medical News," Oct. 21) writes concerning the plague in the city and cantonments of Poona, that to Defoe's most realistic pictures of the plague of London must be added the Asiatic peculiarities. There is the funereal pyre of the Hindu for ghastly cremation, deserted the moment it is lit, and then abandoned to the jackals and the vultures. There is the ghoulish Mohammedan cemetery, where the bodies are tossed or dragged, and not one foot of earth covers them. So few of the living are left to remove the dead that, as in London, the death cart goes its rounds and disposes of the victims wholesale. Two-thirds of the city's native population have died or fled, and among the remaining third there are 1,100 deaths a week. Two new features which have lately appeared are the black death and