membrane termed the frænum linguæ, which, existing only in a rudimentary state in some children, is considerably developed in others. He met with a lad fourteen years of age, who was a distinguished pupil at one of the lyceés, and spoke without difficulty. Having occasion to examine his mouth, he found the tongue kept down to the buccal floor of the mouth in consequence of the short and thick frænum which extended to its point. Unable to pass the alveolar arch, the tougue had, by its constant pressure, pushed this forwards so that the incisors were projected externally, becoming also somewhat slanting, and separated from each other by a considerable interval. When he tried to put the tongue out it curved backwards, striking against them. The lad's mother had precisely the same defect, producing with her some difficulty of speech. Out of four of her children, three were born with the same state of the frænum.-Gazette Hebd., November 6.

BROMIDE OF POTASSIUM IN THE NURSERY.-Scarcely any modern remedy has enjoyed such favor among practitioners, and been the subject of such extensive research, as bromide of potassium. Its effects have been vaunted in a considerable number of maladies where it is necessary to exert a sedative action upon the nervous system-for instance, epilepsy, croup, headache, &c. M. Moutard-Martin, a nosocomial physician of Paris, now informs us that it has proved a most useful remedy in his hands for combating certain infantile diseases, and has been of especial service in producing a condition of tranquility in children who are much agitated by disease, and in procuring rest to infants who are deprived of sleep. The suffering which some children undergo from want of sleep, even when not otherwise ill, and the distress to which they put their nurses or parents, are so great that any remedy having, like the one in question, the property of inducing needful repose, must be most welcome both to practitioners and parents. M. Moutard-Martin states that when every other remedy-such as the warm bath, orange-flower water, and the infusion of cherry-has failed in such cases, the bromide of potassium has given the most remarkable results. There are also other cases in which its employment is very valuable in infantile therapeutics. The nervous erythism which attends dentition, and which manifests itself by a condition of excitement, cough and sleeplessness, is often abated by the employment of the medicament; and M. Moutard-Martin is confident that its timely and proper use may even ward off attacks of convulsions. In many cases its action is very prompt and decisive. It should be admistered to very young children in weak doses of from five to twenty centigrammes, and should be withheld in cases of diarrhoea.-Lancet, Dec. 12th, 1868.

WE HAVE SO often occasion to refer to the proceedings of the Académie de Médecine that our readers may like to know a little more of its exact constitution. The Société Royale de Médecine and the famous Académie de Chirugie having disappeared during the storm of the Revolution, and the want of a learned Medical body being felt at the Restoration, the present Academy was instituted by royal charter in

1820, though not formally opened until 1824. Of the one hundred. and fifty one original foundation members, part nominated by the crown and part chosen by the Academy, only four now survive. The Academy now consists of one hundred titular members, distributed into eleven sections-viz., Anatomy and Physiology, ten members; Medical Pathology, thirteen; Surgical Pathology, ten; Therapeutics and Medical Natural History, ten; Operative Medicine, seven; Pathological Anatomy, seven; Obstetrics, seven; Public Hygiene, Legal Medicine, and Medical Police, ten; Veterinary Medicine, six; Medical Physics and Chemistry, ten; Pharmacy, ten. There are also nine "free associates," twelve "national associates," and fourteen "foreign associates;" each of these may be increased to twenty members. Moreover, there are one hundred and twenty "national correspodents" to be reduced to one hundred and sixty-one "foreign correspondents," to be reduced to fifty-Times and Gazette.

ENTIRE removal of the tongue for Epithelioma of that organ was performed by Dr. Fenwick, on Friday, the twentieth November, at the Montreal General Hospital. The patient was a gentleman from Canada West, who came to Montreal to seek advice touching a disease of the tongue, which had been pronounced to be Epithelioma. The operation as performed was speedy and bloodless, being that described by Mr. Nunneley of Leeds. An incision was made in the median line between the chin and hyoid bone, and the genio hyoid muscles separated. A long curved needle, to which was attached the chain of an ecraseur was then introduced into the mouth, through its floor, and close to base of the tongue; this was pushed over the tongue as far back as possible, the tongue being forcibly drawn out of the mouth by a piece of strong thread which transfixed its substance. After applying the chain and strangulating the organ, the operator proceeded to ablate, and the organ was severed in nine minutes and a half. The case has progressed most favorably, the patient returning home, a distance of one hundred and ninety miles, on the twelfth day after the operation.-Canada Medical Journal, December, 1868.

CHINOVIC ACID.-This is a resinous acid contained in all cinchona barks. Its physiological effects have been partially examined by Dr. G. Kerner, in a paper treating mainly of its therapeutic value (Wiener Med. Wochensch., 43; and Practitioner, No. 2, 1868, p. 127). He finds that it adds greatly to the tonic effects of bark, and that it is not liable, like quinia, to cause "cerebral congestion."-Journal of Anatomy and Physiology, November, 1868.

DIGITALIS. Dr. Constantin Paul, the able editor of the last edition of Trousseau's Traite de Therapeutique, has published a research on the influence of digitalis on the pulse (Bulletin General de Therapeutique, Tome LXXIV, 1868, p. 193), in which his principal results were obtained by the use of sphygmograph. He thus states his conclusions: Digitalis, in small doses, generally diminishes the frequency. of the pulse; in large doses, it increases it. When digitalis is exhib

ited in such doses as to produce its hyposthenic effects, it lowers the arterial tension; and the contrary effect may, possibly, be produced by very small doses, as some investigators have asserted. Finally, it is probable that digitalis raises the arterial tension when it diminishes the frequency of the pulse, and that it lowers this tension when it increases the number of the pulsations.-Ibid.

Om Trikinernas naturliga forekommande, af Axel Key, Professor i Pathol. Anat. vid Karolinska Institutet. Prof. Key contributes a paper on the natural occurrence of Trichino, his object being, by pointing out the mode in which the pig becomes affected, to facilitate the prevention of the diffusion of the disease.

It would appear that the trichina spiralis never occurs in birds, fishes, amphibious or invertebrate animals, and that these can not even be experimentally infected. On the other hand, all the mammalia are, with more or less difficulty, capable of being infected. Nevertheless, trichinæ are fortunately not so widely diffused in nature as might be expected from this fact, many animals being protected from trichinosis, not only by the difficulty of infecting them, but also by the nature of their food. It is quite certain that trichinæ are not conveyed to animals in any kind of vegetable food. In addition to men and swine, the animals which have been found spontaneously affected with trichinæ, are rats, cats, foxes, polecats, martens and hedgehogs. There is no doubt, however, these dangerous parasites occur also in other carnivorous animals not yet fully examined. The ruminants seem to be scarcely susceptible of trichinous infection. Prof. Sjöstedt succeeded, nevertheless, in infecting a goat and a sheep. He thinks it important that to these animals the infected food should be given in a fluid form, or cut up in small portions in water, so as to prevent rumination, which probably prevents infection. The author believes that the chief source of the infection of the pig is the rat, in which latter animal the trichina is very common. He says it is ascertained that pigs eat rats, whether they find them dead or catch them living, and he shows that it is precisely the animal infected with and lamed by the disease, that will most easily be caught. Hence he infers that the extirpation of the rat, and its exclusion from the pig-sty, will be the most efficacious prophlylactic means.-Ibid.

A LAD who was dying from exhaustion after an operation performed at the Palermo Hospital, is said to have been saved by transfusion of blood from the veins of two students.

POISONING BY NICOTINE.-M. Tardieu has remarked the curious fact that animals killed by this poison always fall on the right side.—

THE WESTERN JOURNAL OF MEDICINE,

(Formerly, "CINCINNATI JOURNAL OF MEDICINE.")

Thus it will be seen that if man has passions which impel him to the destruction of man, if be be the only animal who, despising his natural means of attack and defence, has devised new means of destruction, he is also the only animal who has the desire, or the power, to relieve the rufferings of his fellow citizens, and in whom the co-existence of reason and benevolence attests a moral as well as an intellectual superiority.-GRAVES' CLINICAL MEDICINE.

VOL. IV.

INDIANAPOLIS, FEBRUARY, 1869.

No. II.

EFFUSIONS INTO THE PLEURAL SAC, AND THEIR TREATMENT BY PARACENTESIS.

BY COLEMAN ROGERS, M. D.,

Adjunct Lecturer on the Science and Practice of Medicine, University of Louisville, Louisville, Kentucky.

Not long since, two cases of chronic pleurisy with effusion, were under my care, in which it was thought advisable to perform the operation of thoracentesis. In both cases there were unmistakable physical signs of a large pleuritic effusion, and though the urgent dyspnæa, so often present, was absent in these cases, the pallor, anæmia, and general debility, showed plainly that the vital function of hæmatosis was seriously interfered with. In both of them, constitutional remedies had been faithfully tried, but of no avail, and the operation was performed as a dernier ressort, with a view either to a permanent cure, or as a mere palliative measure.

The first case operated upon was that of a young unmarried lady, aged about twenty-five years. The chest was tapped on four separate occasions, at her own request. A large purulent collection was evacuated at each sitting, much to the mitigation of her symptoms. At the fourth tapping, the paracentesis of necessity had taken place, and I made a counter opening at the point recommended by Malgaigne.

This patient calls in to see me occasionally, and although it has

been nearly three years since the first tapping was performed on her, she still holds her own, with a fistulous opening in the mammary region of the left side. I am satisfied that life has been prolonged and rendered comparatively comfortable in this case, by the performance of the operation.

The other case operated upon, was that of a man aged twenty-eight years. A thick, glutinous, fibro purulent material was drawn through the canula, by Bowditch's suction apparatus, to the amount of nine pints by measurement. He expressed himself as feeling greatly relieved by the tapping.

I have lost sight of this case entirely, but have no doubt that if the operation could not have effected a radical cure, it certainly prolonged and rendered life more comfortable.

It is remarkable that in a number of subjects, the great pressure upon the lung, of a copious pleuritic effusion, does not produce more manifest dyspnoea. Be this as it may, it is a fair physiological inference, that when the function of one lung is so largely compromised, healthy nutrition and sanguification must fall below par, so intimately dependent are they upon the proper performance of respiration.

The operation of empyema, paracentesis thoracis, thoracentesis, or tapping the chest, lays just claim to being considered one of the oldest in surgery, performed as it has been from the remotest days of antiquity. It owes its origin, it is said, to a mythological legend, which tells us that Jason, seeking death in the midst of battle, received a lance wound in the chest, and was thus artificially relieved of an empyema. Traced as it can be, certainly, from Hippocrates downwards, through all this long series of years, it has afforded a theme for animated discussion as to its merits and demerits, and as to the proper cases, and indications for its performance. It would be a work of supererogation on my part, to even attempt giving a resumé of the opinions of the different authorities, during its earlier history, for it can be truly said that they differ widely on almost every point. The cases imperatively demanding it as a means of saving life, those in whom it would only serve as a palliative, furthering other therapeutic agents brought to bear, the place of election, the mode of operating, and the possible danger and consequences of air being admitted into the pleural cavity, have been subjects of angry discussion in days gone by.

Of late years, however, its utility in many cases, has begun to attract the notice of observers, and accumulated experience attests the fact that it should no longer be regarded the anceps remedium, as