I find fault also with the late application of fixed, plaster, splints in dressing fractures. Put up a fracture as early as you may in a fixed apparatus. Reduction, retention, rest, not constriction, are the three Rs of importance. The very first changes within the first few hours are processes of repair. What wounds shall we drain? Emphatically no wound that is aseptic. The primal exudation of leucocytes is of perfectly normal type, and is the "first aid to the wounded" if the wound is aseptic.

Dr. D. H. CRAIG, of Boston: The matter of rubber gloves was alluded to. The man who has to do the whole work, who has no assistant to help him in a country practice, oftentimes cannot properly sterilize his hands and get everything ready for an operation and maintain his hands in a sterile condition. If we have everything to work with the last thing to do would be to put sterile hands into sterile gloves. But we can carry a pair of sterilized gloves to the operation, and these may be put on hands not perfectly sterile, if one has to do everything himself.

In the shock following severe traumatism the use of the adrenalin chloride in the dosage of ten to twenty minims of the one to one thousand solution properly diluted in perhaps one of the best in conjunction with strychnin and we have not the danger of cumulative action of strychnia after the first shock is over.

In relation to the use of anæsthetics I had a point very forcibly brought to my mind recently which I think is not very generally known. In the use of chloroform or ether the sphincter muscles are the last to yield to the influence of the anaesthetic. If the patient is in the condition of collapse, and you rapidly and forcibly stretch the sphincter ani, you almost invariably produce a gasp which will result in regular breathing following.

ARTICLE XXIX.

INFERENCES TO BE DRAWN FROM THE EXAMINATION OF THE GASTRIC CONTENTS.

BY ELLIOTT P. JOSLIN, M.D.

OF BOSTON.

READ JUNE 9, 1903.

INFERENCES TO BE DRAWN FROM THE EXAMINATION OF THE GASTRIC CONTENTS.

THE gastric contents are examined chiefly to aid in the diagnosis and treatment of catarrh, dilatation, ulcer, cancer and neuroses of the stomach or to obtain proof that it is in a healthy state. The list is a small one. In reality the diagnosis of the various diseases of the stomach is far easier than usually thought. The rule of exclusion can be used to great advantage.

The data upon which diagnoses are based are also few, some six in number. Five of these can usually be detected by gross observation, while the chemical tests for the remaining are extremely simple. The subjects which admit of discussion to-day are: 1. Gastric Motility. 2. Gastric Secretion. 3. Gastric Fermentation. 4. Mucus. 5. Blood. 6. Pus.

Another function of the stomach-absorption-is not included in this list. Absorption may be disregarded, because so little takes place through the walls of the stomach. Practically no water is absorbed. When water enters the stomach, it is either expelled through the pylorus, the cardiac orifice or remains. There are one or two exceptions to this rule of the non-absorption of food in the stomach. Sugar and peptones are absorbed to a slight extent, varying with the concentration of the solution. Alcohol is readily absorbed, as is manifested by clinical experience. When alcohol is absorbed from the stomach, water is secreted into it in more than equivalent volume. Since absorption is of such minor importance, the iodide test for it is superfluous.