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there be motion in the joint no effect will be produced on the liquid in the bag.

In the medical clinic was lately presented a case which interested me from its cause. The patient was a woman, aged 35, who complained of excessive flatulency and belching of gas. Had exhausted all the usual remedies; had simplified her diet in trying to cure herself, and cut off various articles of aliment, until she was now living almost entirely on oatmeal. But, in spite of this plain food, was losing flesh and growing steadily worse. Diagnosed as flatulent dyspepsia with sour gastric catarrh. The oatmeal being starchy, and in addition sweetened, thus becoming also saccharine, found a ready ferment in the catarrhal mucus, breaking up into acetic acid and carbonic acid gas. The treatment consisted essentially in regulating the diet; should eat underdone meat and easily digested animal food; must have no starchy or saccharine matters at all, and only such vegetables as contained little or no starch, tomatoes, spinach and celery. To prevent the fermentation in the stomach was given-

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To be taken in mint water three times a day. the patient returned and reported herself cured.

gtt. i gr. xv 3 ss The next week

There was also shown the case of a woman suffering from Bright's disease. She was in the pre-albuminuric stage, characterized by the passage in the twenty-four hours of large quantities of pale urine, but containing no albumen. There was tumultuous action of the heart and breathlessness on exertion. Had formerly slight swelling of legs, but now no dropsy. Arteries rigid and of high tension, showing arterial changes. No cedema of brain, but increase of fluid in peri-vascular lymph-spaces as evinced by constant headache.

The treatment consisted, first, in careful regulation of the diet. Was allowed milk and meat-broths, a few vegetables of succulent variety, some fruits if desired, but very little solid food. Cases of Bright's disease require two indications to be met by

remedies: first, it is necessary to relax the high vascular tension, and thus relieve and benefit the system. For this purpose was given a one per cent. solution of nitro-glycerine, one drop of nitroglycerine to one hundred drops of alcohol. Begin with one minim of this solution three times a day, and daily add a minim till the constitutional effects are produced as shown by frontal headache, flushing of the face and increased action of heart. In the second place, it is required to remedy the overgrowth of the kidney and act locally there. Was given chloride of gold and sodium 1-20 gr. in pill form, three times a day, gradually increased to 1-10 gr.

Perhaps it might be of interest to mention a convenient substitute for Fehling's solution in testing for sugar in the urine. The ordinary solutions deteriorate on keeping and are liable to throw down the sub-oxide of copper themselves if they have not been freshly prepared. Prof. Holland, in his lectures on chemistry, gave the following test fluid which is very efficient, is easily prepared and is not spoiled by keeping :

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To make the test add five drops of this solution to one drachm of liquor potassæ in a test-tube. Boil a few moments to test the purity of the fluid; should it remain clear, then add a few drops of urine. If glucose be present in quantity there is at once thrown down a red precipitate just as in the ordinary Fehling's

test.

To detect minute amounts of sugar, not shown by above procedure, after making the test as above, add half a drachm of urine; boil and set aside. If sugar be present even in very minute quantity, the liquid as it cools will turn to an olive green color and become turbid.

At the last meeting of the County Medical Society, Dr. J. F. Edwards read a paper on "The Suppression of the Illegal Practice of Medicine in Philadelphia." He discussed the present registration law, showed its inefficiency, yet said it would do much

good if properly enforced. In speaking of the qualifications upon which some of these pretended doctors based their claims, he told of one man who, originally a farmer, began to practice because he married the widow of a physician. Another quack had made affidavit that he had been in practice ten years, four of which it was found were spent in the penitentiary. There was quite an animated discussion of Dr. Edwards' paper by the members. The committee who have the matter in charge were assured of the hearty moral and financial support of the Society. The work of prosecuting these illegal practitioners will be pushed vigorously to the undoubted benefit of Philadelphia and its citiTruly yours,

zens.

Philadelphia, February 10, 1886.

HARRY HUzza.

A CASE OF FAITH CURE.

Editors Atlanta Medical and Surgical Journal:

Your fair and candid treatment of the so-called "Faith Cure" question, in December JOURNAL, has induced me to send you copies of "Valley of Baca," and "From Baca to Beulah," by Miss Jennie Smith, the lady who never walked for sixteen years, but, like the cripple spoken of in Acts III., was carried to the tempie. Since her healing she has been an effective, traveling evangelist in the railroad department of the W. C. T. U.

No one who hears her preach will doubt her honesty and sincerity, we think.

There has probably been no more remarkable faith cure in the nineteenth century, and its complete history, as given by herself, with the testimony of her physician, is well worthy a thoughtful perusal by the progressive practitioner.

Very truly,

Baltimore, Md., February 1, 1886.

B.

Book Reviews.

A MANUAL OF OPERATIVE SURGERY. By Lewis A. Stinson, B. A., M. D., Surgeon to the Presbyterian and Bellevue Hospitals, Professor of Clinical Surgery in the Medical Faculty of the University of the City of New York, Corresponding member of the Societe de Chirurgie of Paris. Second Edition, with three hundred and fifty-two illustrations. Philadelphia: Lea Brothers & Co., 1885.

The opening chapter on anæsthesia does not include in the list of agents the bromide of ethyl, which has given satisfactory results with Chisolm and others, and the preliminary hypodermic use of morphine and atropia is overlooked, though generally recognized as modifying favorably the influence of chloroform and ether.

In the antiseptic treatment of surgical wounds, the use of solutions of corrosive sublimate to wash the wound is recommended, notwithstanding the serious effects which are known to have ensued from its absorption. The difficulties presented in ligation of the subclavian artery may be obviated in most cases requiring opiates by ligation of the artery below the clavicle by the French process, and this requires less discrimination in anatomical details.

In describing the circular operation for amputation there is no reference to rounding off the projections at each end of the linear union, which has been found a great improvement, not only for the appearance of the stump, but in obviating sloughing of those corners.

The suggestions of Rizzoli and Esmarch for division of the inferior maxillary, or removal of a wedge-shaped piece of the bone in ancylosis from adhesions left behind by intrabuccal ulcer

ation, are endorsed when the cause itself cannot be removed. But this solution of the difficulty could only be warranted after a faithful effort to dissect out the cicatricial bone from its bony attachments when no osseous union exists between the condyle and temporal bone. No allusion is made to the relief of a bony union between the coronoid process and zygomatic arch, which the writer has separated with saw and chisel, thus securing complete mobility of the articulation.

There is no provision made in complete resection of a considerable segment of the tibia with its periosteum for the removal of a corresponding extent of the fibula, so as to approximate the osseous surface of the tibia. This, of course, involves shortening, but as the author remarks in regard to resection of the femur, "shortening is less of an infirmity than pseud-arthrosis."

In treating of trephining, the omission to notice the conical screw trephine, commended by Galt for security against injury to the brain, may be intentional, but is a defect in a practical point of view.

A successful case of gastrostomy by a North Carolina surgeon has escaped the attention of the author in the very small number noted, and the plan of inflating the stomach to enable the operator to find it when empty is calculated to obviate the difficulties encountered in gastrostomy by the author in locating it.

The cuts of a formidable apparatus with pins in pieces of cork within the lumen of the intestinal canal might have been substituted by a presentation of the Bishop suture for uniting the intestinal walls.

Unnecessary complications are made in the simple operation of circumcision in proposing to slit up the cutaneous prepuce above and below, or again to resort to the process of Delavan. This is an objection in a work on operative surgery intended to be a guide to others.

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