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482 those above mentioned and with such will give most satisfactory results, yet it leaves much to be desired. Since the publication of my paper in 1902 I have further discovered that garlic when applied locally is freely absorbed by the skin and penetrates to the deeper tissues, and I have had very gratifying results from the application of poultices of freshly pulped or pounded garlic over diseased areas, and I now employ these three methods combined in pulmonary cases with much success. Garlic when applied in this manner acts as a strong blister, the various varieties of it being of widely different strengths. Some varieties will blister in from four to six hours, whilst others take 24 hours or even longer. It may be advanced that its beneficial effects when applied in this manner are due to its action as a blister, whilst also a certain amount of inhalation takes place. I think, however, it is absorbed by the skin, penetrating to the deeper tissues, as I have had remarkable success with it in cases where the inhalation had failed. Further, it is a most successful treatment when applied locally to any tuberculous lesion, such as a joint, tuberculous glands, &c., even though the skin be unbroken. The garlic when pulped or pounded and applied in this way appears to act more beneficially than the fresh juice. Cases of laryngeal tuberculosis if not very far advanced rapidly yield to the application of garlic either by gargle, or spray, or internal adminis- tration (or comhined), accompanied by a poultice (or blister) of pulped garlic externally. It is an excellent treatment for lupus, and has the advantage that it can be applied to almost any part and over a very extensive lupoid area. Where it can be borne, a blister of pulped garlic is the best and most rapid mode of treatment, leaving it on three or four hours and re-applying in a few weeks, but it can be very efficiently treated with the fresh juice as I described in my paper in the Medical Press and Circular. This method has the advantage of not being at all severe but it is not nearly so rapid in its results. Garlic is a powerful germicide worthy of the careful consideration of bacteriologists and I have the strongest reasons for believing that a poultice of it applied over the seat of inoculation and also given internally will prevent the development of hydrophobia in a person bitten by a rabid animal. Dr. Poore in his work "Nervous Affections of the Hand and other Studies," p. 275, states: 11 The allyl compounds, such as allylic alcohol and oil of mustard, were shown by Koch to be strongly antiseptic and to have a remarkable power of inhibiting the growth of the bacillus anthracis." The farmers in this part of the country largely use garlic for the treatment of symptomatic anthrax, or "blackleg," in cattle and it is most effective. The London Pharmacopoeia formerly recognised garlic and some preparations of it are still officinal in the United States Pharmacopoeia. It is described as being an antiseptic, an expectorant, a rubefacient, a diuretic, an antispasmodic, and a carmin rtive. It contains a volatile oil-sulphide of allyl-to which it possibly owes its virtues. In an old work on therapeutics to hand, by J. Moore Neligan, M.D., 1851, he states that "garlic consists of an acrid volatile oil, fecula, albumen, and a saccharine matter; its medicinal properties depend on the volatile oil, which is heavier than water, of a yellowish colour, and a very penetrating odour; it is composed of six atoms of carbon, five of hydrogen, and one of sulphur" (Wertheim). He further recommends it as an excellent remedy in ascarides. It is, of course, a very harmless substance (especially when diluted) in doses of the juice from half a drachm to one drachm two or three times daily. The addition of a little tr. lavand. co. and syr. simplex makes a fairly palatable mixture, the former masking the odour to a great extent. An infusion with milk is a favourite way of taking it. Half an ounce to one ounce of the bulb may be taken in this way daily. One word of warning I must give regarding its use. I have found some surgeons (to whom I recommended the local application of garlic to tuberculous joints, &c.) fell into the error of injecting the fresh juice with a hypodermic syringe into the joints, &c. This should never be done, as owing to its vesicating action a violent inflammation will at once be set up. The local application should be altogether external, but may be applied over a broken surface of skin and is not then much more severe than if the skin remains unbroken. As some persons are rather susceptible to its blistering effects it is well not to leave the first poultice on more than four hours, after which it will be more easy to judge the length of time to leave the other poultices, which will require to be repeated frequently at intervals of three or four weeks to check the disease in the deeper tissues. The more severely it is blistered the more rapidly will the disease be checked. I think. The blistered surface heals quickly under any ordinary oily application. Such a powerful germicide as garlic, which is freely eliminated by the lungs as well as being freely eliminated and absorbed by the skin is, I think, a most reasonable one to use in the manner above described in such a disease as this under consideration, especially when one con- siders its harmless nature -I am, Sirs, yours faithfully, Kells, co. Meath, Jan. 25th, 1904. WM. C. Mmcnnf, M.D. Dub. DIET IN ITALIAN NAVAL HOSPITALS. THE Annali di M6dicina Navale for December, 1903, contain a lone article on diet in the Italian naval hospitals by a medical officer. f the first class V. Tiberio who is in charge of the pathological labota’ t"ry at Venice. There are, it would seem, four diets, named, re- spectively, entire, three-quarter, half, and quar-er. In all the ingredients are pretty nearly the same, the chief differences being in quantity. The question of the nutritive value of each diet is exhaustively treated, comprehension being assisted by a series of very elaborate analytical tables. The main conclusion arrived at is that on the whole the several diets are fairly sufficient but that in some particulars they are not quite in accordance with the teaching of modern dietetics. It may be noted that all the diets include an allowance of wine which is thus specified : "The wine shall be of the best quality, made in Italy, red. genuinely pure, perfectly sound, free from acidity and mouldiness, without bad smell or bad taste of any kind whatsoever, pleasant to the taste, at least a year old, of not less than 12 degrees of alcoholic strength, and costing 40 centimes the litre." THE VIAVI TREATMENT. To the Editors of THE LANCET. SIRS,-Can you.tell me anything of the above? I had an idea I saw something about it in an old copy of THE LANCET but cannot find it. Was it dealt with in Truth? Some of my friends speak of it enthusiastic- ally, hence my query. I am, Sirs, yours faithfully, Feb. 8th, 1904. SCEPTIC. * The Viavi Treatment is undiluted humbug and quackery. Our correspondent will find our opinion of it in THE LANCET of Jan. 17th, 1903, p. 211. Truth has also dealt with the matter.-ED. L. Bathavon.-(1) The titles are synonymous and therefore (2) any one of them can be used. (3) A qualified medical man is qualified to practise medicine in the wide sense of the word in all its branches. It is not usual for a meiical man to assume the designation of a specialist- ophthalmic surgeon or dentist, for example-without having under- gone special training or enjoyed special opportunities, but we do not think such assumption would be construed by the General Medical Council as a professional offence. Hon. S. Coleridge.-We do not intend to insert any letter from a correspondent who founds upon an obviously accidental and com- pletely unimportant slip accusations of deliberate immorality. Mr. Coleririge can publish his letter elsewhere, can shriek that we have refused him a hearing, and can try to persuade people that we have acted from innate vileness. It is his own complete discourtesy that has decided us to ignore his communication. Mr. H. A. Matheson.-The preparation about which our correspondent inquires was examined some years ago in our laboratory. It is a weak solution in water of sulphurous acid gas (S02). COMMUNICATIONS not noticed in our present issue will receive attention in our next. Medical for the ensuing Week. OPERATIONS. METROPOLITAN HOSPITALS. MONDAY (15th).-London (2 P.M.), St. Bartholomew’s (1.30 P.M.), St. 1’numas a (3.30 P.M.), St. George’s (2 P.M.), St. Mary’s (2.30 P.M.), Middlesex (1.30 P.M.), Westminster (2 P.M.), Chelsea (2 P.M.), Samaritan (Gynæcold gical, by Physicians, 2 P.M.), Soho-sqnare (2 P.M.), Royal Ortlopaodic (2 P.M.), City Orthopaedic (4 P.M.), Gt. Northern Central (2.30 P.M.), West London (2.30 P.M.), London Throat (9 30 A. M.), Royal Free (2 P.ni.), Guy’s (1.30 P.M.). TUESDAY 16th).-London (2 P.M.), St. Bartholomew’s (1.30 P.M.), St. iuomas’8 (6.30 P.M.), Guy’s (1.30 P.M.), Middlesex (1.30 P.M.), West- minster (2 P.M.), West London (2.30 P.M.), University College (2 P.M.), St. George’s (1 P.M.), St. Mary’s (1 P.M.), St. Marleo (2.30 P.M.). Cancer (2 P.M.), Metropolitan (2.30 P.M.), London Throat (9.30 A.M.), Royal Ear (3 P.M.), Samaritan (9.30 A.M. and 2.30 P.M.), Throat, Golden-square (9.30 A.M.), Soho-square (2 P.M.), Chelsea (9 WEDNESDAY (17th).-St. Bartholomew’s (1.30 P.M.), University College (2 ...J!4..), Royal Free (2 P.M.), Middlesex (1.30 P.M.), Charing Cross (3 P.M.), St. Thomas’s (2 P.M.), London (2 P.M.), Kin’s College (2 P.M.), St. George’s (Ophthalmic, 1 P.M.), St. Mary s (2 P.M.), National Orthopaedio (10 A.M.), St. Peter’s (2 P.nx.),- Samaritan (9.30 A.M. and 2.30 P.M.), Gt. Ormond-street (9.30 A.M.), Gt. Northern Central (2.30 P.M.), Westminster (2 P.M.), Metropolitan (2.30 P.M.), London Throat (9.30 A.M.), Cancer (2 P.M.), Throat. Golden-square IQ A.M.). Guy’s (1.30 P.M). THURSDAY (18th).-St. Bartholomew’s (1.30 P.M.), St. Thomas’* f.M.). ùmversity College (2 P.M.), Charing Cross (3 P.M.), St. George’s (1 P.M.), London (2 P.M.), King’s College (2 P.M.), Middlesex (1.30 P.M.), St. Mary’s (2.30 P.M.), Soho-square (2 P.m.), North-West London (2 P.M.), Gt. Northern Central (Gynaeoological, 2.30 P.M.), Metropolitan (2.30 P.M.), London Throat (9.30 A.M.), St. Mark’s (2 P.M.), Samaritan (9.30 A.M. and 2.30 P.M.), Throat, Golden-square IQ Arl A.M.) Guy’s (1.30 P.M.). FRIDAY 19th).-London (2 P.M.), St. Bartholomew’s (1.30 P.M.), St. Thomas b (6.30 P.M.), Guy’s (1.30 P.M.), Middlesex (1.30 P.M.), Charing Cross (3 P.M.), St. George’s (1 P.m.), King’s College (2 P.M.), St. Maryt e (2 P.M.), Ophthalmic (10 A.M.), Cancer (2 P.nt.), Chelsea (2 P.M.), Gt. . Northern Central (2.30 P.M.), West London (2.30 P.M.), London Throat (9.30 A.M.), Samaritan (9.30 A.M. and 2.30 P.M.), Throat, Golden-square (9.30 A.M.), City Orthopaedio (2.30 P.M.), Soho-equare ! SATURDAY 20th).-Royal Free (9 A.M.), London (2 P.M.), Middlesex ....M.J. Bt. Thomas’s (2 P.M.), University College (9.15 A.M.), Charing Cross (2 P.M.), St. George’s (1 P.M.), St. Mary’s (10 1’.)(.), Throat, Golden-square (9.30 A.M.), Guy’s (1.30 P.M.). At the Royal Eye Hospital (2 P.M.), the Royal London Opbthalmlo (10 A.M.), the Royal Westminster Ophthalmic (1.30 P.M.), and the Oentral London Ophthalmic Hospitals operations are performed daily.
