able symptoms disappeared, and the gentleman renewed his professional labor. DR. GREY remarked, with reference to the hallucinations which had been attributed to impacted cerumen in the ear, that the question arose whether in any of the cases the hallucination would have been present had there not been a predisposition to insanity, either hereditary or from the previous existence of insanity from other causes. With an excitable condition of the nerve-centres, produced by previous insanity, it was easy to understand how any peripheral cause might develop the predisposition. DR. HAMMOND remarked that he was not able to state whether, in the cases reported, there was any predisposition to insanity. The curious part of some of the cases was, that the patients did not suffer from illusions, but rather from what might be called perversion of hallucination. They did have noises in the ears, and those noises were converted into real voices. He did not know of any example in the entire range of cerebral phenomena, in which a perverted sensation was converted into speech for instance, or anything which conveyed a distinct idea to the senses. The doctor then referred to the danger which attended the introduction of sea-water into the ears, and mentioned cases in which marked cerebral symptoms had been developed in consequence of such irritation. DR. WEBSTER regarded the statement made by Dr. Hammond with reference to the cause of the noise in the ear when the finger was introduced into the external auditory meatus, as entirely new and one which he could not accept. He believed that the noise was produced by pressure of the air against the tympanum, and not simply by introducing the finger into the ear. For, if a cork was introduced into the ear and pressure made, the noise would be produced the same as when the pressure was made by the finger. DR. KIERNAN remarked, with reference to hallucinations based upon perverted sensation, that a patient came under his observation who believed that he had a doctor in his abdomen who was constantly talking to him, but the speaking was not through the ears. With reference to inspissated cerumen, he had found many insane patients whose ears were filled with it, but the removal of the wax had not in any case been followed by removal of the hallucinations. DR. ROOSA remarked that after spending some years in the examination of cases, he had not been able to satisfy himself with reference to the etiology of inspissated cerumen. With reference to its existence he would simply say that he did not believe any person who had had inspissated cerumen more than once in his life had sound ears. If inspissated cerumen occurred more than once in the same person it was evidence that something of the hearing power had been lost, and that it would become still further impaired. With reference to hallucinations, Meyer, of Hamburg, had removed inspissated cerumen from the ears of a large number of insane persons, but in only two cases did the hallucinations disappear after the removal of the wax. DR. LEALE made special reference to the irritation produced by crystals from sea-water left in the ears after bathing, and the importance of carefully washing the ears out with warm water. ABSCESS OF THE BRAIN. DR. J. C. SHAW presented specimens from a case of abscess of the brain. The patient was a man thirty-seven years old, who had had suppurative inflammation of the ear for a number of years. Two weeks previous to his death he had a little extra pain in the ear, but it passed with slight notice. The pain becoming more severe about four days before his death, a consultation was held and an incision was made over the mastoid process for the relief of what was supposed to be inflammation affecting the mastoid cells. The man, however, became rapidly worse, and passed into a state of coma. The mastoid process was also trephined, but no relief was obtained. At autopsy, a small necrosed point was found in the dura mater just above the ear, with a sinus leading up to an abscess. There was extensive meningitis, which was regarded as the probable cause of death. The case was mentioned for the purpose of drawing attention to what was believed to be A NEW FACT IN CONNECTION WITH MENINGITIS AND DR. SHAW stated that he had occasion to make tion this connection, the possible transference of trophic Correspondence. THE DETERMINATION OF SEX IN UTERO. TO THE EDITOR OF THE MEDICAL RECORD. SIR-I notice an editorial in your journal of the 2d inst., under the above caption, and giving the theory of Dr. J. W. Swift, from an article in the Boston Medical and Surgical Journal. If this theory be correct, the product of conception preceding menstruation will be female, and that of conception succeeding menstruation will be male. Dr. Napheys, in his excellent treatise, “The Transmission of Life," intended for popular reading, without giving any theory upon the subject, lays down a rule for the production of the sexes at will, which includes a statement exactly the reverse of the conclusion of Dr. Swift's theory. The discovery of this law of conception he ascribes to Prof. Thury, a French veterinary surgeon of the Academy of Geneva, who made a large number of experiments upon domesticated animals. A certified report to the Agricultural Society of Canton de Vaud, Switzerland, 1867, concludes thus: "In short, I have made in all twentynine experiments after the new method, and in every one I succeeded in the production of what I was looking for male or female. I had not one single failure; DR. SHAW believed with Dr. Grey that mental consequently I do declare the law discovered by Prof. symptoms would be produced by impacted cerumen Thury to be real and accurate." Of course the oponly in those who had a predisposition to mental dis-portunity for studying this law in the human subject is much more limited and uncertain, but Dr. Napheys DR. SESSELL had directed his attention to one case in which hallucinations were removed by the removal of impacted cerumen. With reference to the causation of noise in the ear when the finger was introduced into the auditory canal, he believed the chief cause was the pressure exerted by the finger, and that the arterial circulation had but little to do with it. ease. contends that all intelligent observation tends to confirm its existence. Of his illustrations on this point I give only one: "Physicians constantly observe that if labor comes a few days before full term,' or just at term, the child is more likely to be a female; but if labor is delayed beyond term, which is the same as saying if the conception took place quite a number of days after the cessation of menstration, then it is more likely to be a boy." Since I first read Dr. Napheys on this subject, I have made it a rule at every delivery-one hundred and ten cases-to inquire the length of time from the last menstruation, and, excluding one case where menstruation only ceased at the end of the fifth month of gestation, three premature deliveries and less than a dozen cases where the exact period was not remembered, in every single instance where gestation continued longer than what was considered full term the child was male, and when it did not, the child was female. The value I attach to these observations is only corroborative, because of the impossibility of fixing the exact time of fecundation and the variation in the time of gestation. During this time, however, I have had two cases in which, by reason of my intimate professional relation to the parties who were entirely reliable and of much more than average intelligence, I have been able to very nearly fix the period of conception, and in each case the event proved the correctness of the rule, as given by Dr. Napheys. In the first case the only intercourse during the menstrual month took place on the 9th of September; menstruation was due on the 14th, but did not appear, and on the 13th of the following June the lady was delivered after a thirty hours' labor of a male child. In the other case, intercourse was had twice during the menstrual month-the first, November 30th, thirty-six hours after the cessation of the flow, and the second the following day, December 1st. On the 31st of the following August I delivered this patient of a female child after a labor of ten hours' duration. JOSEPH A. MUDD, M.D. CHAIN OF ROCKS, Mo., Nov. 11, 1878. THE GERM THEORY OF DISEASE. TO THE EDITOR OF THE MEDICAL RECORD. SIR-In order not to occupy your valuable space unnecessarily, permit me just to say, in reply to Dr. Neftel's letter in your last issue, in regard to experiments showing the occurrence of living organisms in blood, that I should be very sorry to claim, or even to receive, without protest, credit as an original investigator which was not justly my due. The fact is, that my observations were laid before the Medical Association of Central New York, Prof. E. M. Moore, President, at Rochester, June 16, 1868, reported in the Rochester Democrat for June 17th, and published in full in the American Journal for July, 1868, which appeared on the 8th or 9th of that month. Scientific men have agreed that the independent observer who first publicly announces a new fact is entitled to the credit of its original discovery; and therefore, as I have by a curious coincidence antedated Dr. Neftel in reading a report of my experiments before a regularly organized medical society by three days, and in publishing it by six days, I trust the claim of priority put forth in my lecture before the Social Science Association will be acknowledged. Besides, my demonstration of the truth in question directly concerned human beings, and was therefore, I submit, far more important to medical science. Very respectfully yours, etc., Jos. G. RICHARDSON. New Instruments. ATOMIZING INSTRUMENTS. NO. II.-DR. J. DE BEER'S ATOMIZING APPARATUS. THE apparatus of Dr. De Beer, of Boston, is intended not only for atomizing purposes proper, but for vapor baths, for fomentations, and for use as a steam croup-kettle. It has connected with it a number of appliances, each of which is intended to fulfil a certain indication. The construction of the stean atomizer can be seen at a glance. The stand is circular, which is possibly a necessity in view of the different uses to which it is put. Otherwise, a broader base would give a firmer support to the apparatus. The support for the medicine-cup and face-shield is attached to the base by a screw, and is of course removable. This is of no special advantage when the apparatus is used merely as an atomizer. There is but one opening in the boiler which is used for filling with water, and for the escape of steam. pears to us that a separate opening for filling and for the safety-valve would be more convenient. FIG. 1. It ap As an atomizing apparatus, it is thoroughly fficient, throwing the spray forcibly and uniformly. The face-shield is attached to the upright rod by means of a spring catch, which is a very convenient arrangement, as is also the movable handle for the stand. A notable improvement would be a nonconducting handle for the boiler itself. The apparatus seems, however, to be specially adapted for cases of croup, having attached to it a so-called croup-kettle, in connection with which can be used different medicated vapors. The steam of the boiler is made to enter a cup P, over which is an inverted bottle M (Fig. 2), from the neck FIG. 2. of which passes a tube F, connected with a hand apparatus V, for condensing steam, and directing the spray against the face. The vapor is medicated by material contained in the glass chamber O. By attaching the rubber tube B, directly to the boiler A, steam can be applied to any part of the body for the purposes of local fomentation, and by inserting the free end of tube in the cup in which medical materials are contained, a medicated vapor-bath can be administered. Vapor can be applied locally to the genito-urinary organs by a very simple procedure. The box in which the apparatus is packed has a false bottom, and when the box is turned upside down an opening is left, over which the patient may sit. The box is elevated by means of iron legs, which are fastened in the corners. The apparatus is also supplied with a kettle, which for the purposes of heating water takes the place of the boiler. As a whole, the apparatus is ingenious, efficient, compact, and calculated to serve a great variety of useful purposes. SOME NEW AURAL INSTRUMENTS. BY SAMUEL SEXTON, M.D., NEW YORK. THE myringotome in use at the present time is sometimes found to be unsatisfactory, it being difficult to make with it a free opening; for, as soon as its point is made to prick the membrana tympani, the patient is unable to resist the desire to remove his head quickly away from the instrument. There is another objection to the needle or lance-shaped myringotome referred to: it may, after perforating the membrane, inflict a painful or injurious wound upon the posterior wall of the tympanum. With a view to overcome these disadvantages I have devised an instrument, two sizes of which are shown in the cut Fig. 1 (A and B), full size. FORD C.H.&.CO FIG. 1. This myringotome, which is made of steel, with spring finish, I have used in a great many cases during the past year, and the favorable results of this experience justify me, I think, in offering it to the profession. The instrument does its work by being thrust gently, with a steady hand, against the membrane. The cutting edge is slightly rounded at the corners. The surgeon having decided upon the size of the perforation required, an instrument is selected with a cutting edge to correspond. I have so far only required two sizes of this instrument, as shown in the The larger one is two, and the smaller one is one and a half millimetres in width. cut. I have had the instrument made with the blue finish, so that its position can be more readily seen as it approaches the membrane through the polished speculum. From experience in using most ear instruments, I am convinced that a handle fixed at an angle of 110° answers the best purpose (an example of which is seen in Fig. 2). In performing the operation of myringotomy with this instrument, the surgeon passes the cutting edge up to the membrane as near as possible without touching it, and then presses it quickly against and through it. The slight pop," which resembles the sound attending the bursting of a light bladder-like substance containing air, assures the operator that the membrane FIG. 2.-Size about one-half. E Figure 2 represents a new aural snare. The handle, A, of this instrument answers for the attachment of all the aural instruments which it is desirable to use in this way; it is made of ivory, and is well balanced when held in the hand. D is the set screw for making fast any instrument used. When arranged for use as a snare, E is the canula, and F the wire snare. At C the wire is caught and held by a simple mechanism. B is a slightly elevated appliance which is milled to prevent the thumb slip B ping off when it is drawn down, be passed over the polypoid growth the same as when using any of the snares which have heretofore been in use. The loop is now tightened over the growth to the extent required, by pulling down B with the thumb. It is believed that this instrument trivance for holding the wire prevents its slipping during an operation, which sometimes is a great annoyance to those using the instruments as at present constructed. Figure 3 represents a new aural pocket-case containing the above-mentioned instruments, together with others needful to have in most instances where a pocket-case is used. It contains the general handle; aural snare; bent forceps of delicate pattern; two bistouries (in one handle) for mastoid or other abscesses; small, sharp-pointed knife; small, round pointed knife (both for use in the meatus externus); curettes; probes; myringotomes; head band and reflecting mirror (the mirror can be held in the general handle if not worn on the forehead); set of Wilde's specula, four sizes; vulcanite cotton-wool carrier, etc. The case is 17 centimetres long, 7 centimetres wide, and 2 centimetres thick. It can be carried in a waistcoat pocket without inconvenience. Morgan City, La.—12 new cases of yellow fever and one death during the last week. Delphi, La.-The first case of yellow fever occurred in August. Total cases to date, 100; deaths, 50. Both physicians died early. Mobile, Ala.-There were 21 new cases of yellow fever during the past week and 8 deaths. Vicksburg, Miss.-There were 4 new cases of yellow fever and 3 deaths during the past week. For the same period there were 8 cases and 2 deaths in the surrounding country. Pass Christian, Miss.-Three new cases of yellow fever during the last week; no deaths. The last case occurred on the 10th, and the last death the 3d inst. Chattanooga, Tenn.-Two new cases of yellow fever and 2 deaths during the past week. Last case and last death occurred on the 10th inst.-both colored. Osyka, Miss.-The first case of yellow fever occurred July 31st. Total number of cases to date, 227; These instruments have been made by Mr. FORD, total deaths, 30. of Caswell, Hazard & Co., New York. ARMY NEWS. Official List of Changes of Stations and Duties of Officers of the Medical Department, United States Army, from November 10 to November 16, 1878. TILTON, H. R., Major and Surgeon. Leave of absence extended two months. S. Ö. 245, A. G. O., Nov. 12, 1878. KING, J. H. T., Captain and Asst.-Surgeon. Assigned to duty at Fort McIntosh, Texas. S. O. 238, Dept. of Texas, Nov. 8, 1878. FINLEY, J. A., 1st Lieut. and Asst -Surgeon. Relieved from duty at Fort Elliott, Texas, and assigned to duty at Fort Wallace, Kansas. S. O. 203, Dept. of the Missouri, Nov. 6, 1878. Office Surgeon-GENERAL U. S. MARINE HOSPITAL SERVICE. WASHINGTON. D. C., Nov. 16, 1878. NATIONAL QUARANTINE REPORT.-Abstract of sanitary reports received during the past week under the National Quarantine Act: New Orleans, La. For the week ending yesterday evening there were 11 deaths from yellow fever. Impossible to procure accurate number of new cases. No new cases or deaths for the past twenty-four hours. Clinton, La. The first case of yellow fever occurred Sept. 7th. Among the white population there have been 40 cases and 15 deaths; among the colored people, 56 cases and no deaths. Moscow, Miss.-Population, 185. First case of yellow fever Aug. 31st; last case Nov. 3d. Total cases, 71; deaths, 35. McComb, Miss.-First case of yellow fever Sept. 28th. Total deaths to date 21. Lake, Miss.-To Nov. 1st there had been 300 cases of yellow fever and 86 deaths. Canton, Miss.-Total cases of yellow fever to Nov. 1st, 919; deaths, 176. Port Gibson, Miss.-To Nov. 5th there were 655 cases of yellow fever and 116 deaths. Havana, Cuba.-16 deaths from yellow fever and none from small-pox for the week ending Nov. 9th. Baltimore, Md.-For the week ending Nov. 9th the average annual rate of mortality in 1,000 of the popu lation, based on the weekly mortality, was 14.3. The deaths include 6 from diphtheria, 5 from enteric, and 3 from scarlet fever. Boston, Mass.-The average annual rate of mortality for the week ending Nov. 9th was 17.5 per 1,000. There were 16 cases of scarlet fever and 3 deaths; 16 cases of diphtheria and 8 deaths. Brooklyn, N. Y.-For the two weeks ending Nov. 9th there were 5 cases of enteric fever and 2 deaths; 41 cases of scarlet fever and 2 deaths; 81 cases of diphtheria and 36 deaths. Burlington, Vt.-For the month ending Oct. 25th the average annual rate of mortality was 7.5. There were no deaths from preventable diseases. Charleston, S. C.-For the week ending Nov. 9th there were 25 deaths from all causes, including 2 from enteric fever and 1 from diphtheria. Chicago, Ill.-Average annual death-rate 14.7 for the week ending Nov 2d. There were 13 deaths from diphtheria, 4 from scarlet fever, and 7 from enteric fever. Cleveland, Ohio.-In the week ending Nov. 9th there were 45 cases of diphtheria and 20 deaths; 2 deaths from enteric fever, and 4 cases of scarlet fever -no deaths. Lansing, Mich.-The deaths for October show an annual death-rate of 7 in 1,000 of population; no deaths from preventable diseases. New Haven, Conn.-For the week ending Oct. 9th there were 22 deaths from all causes, including 2 from diphtheria. New York City.-The average annual mortality rate for the week ending Oct. 26th, was 21.4 per 1,000, The deaths include 11 from scarlet fever, and 18 from diphtheria. Philadelphia, Po.-For week ending Nov. 9th, the rate of mortality was 16.3. The deaths include 10 from diphtheria, 7 from scarlet, and 9 from enteric fevers. Richmond, Va.-The average annual rate of mortality was 15.79 for week ending Nov. 9th. The deaths include 2 from scarlet fever, and 1 from diphtheria. Rochester, N. Y.-For the month of October, the average annual rate of mortality was 12.16 per 1,000. There were 2 deaths from diphtheria, and 1 from scarlet fever. Toledo, Ohio. During the month of October there were 3 deaths from diphtheria, and 3 from scarlet fever. The average annual death-rate was 13.68 for all deaths. Milwaukee, Wis.-For the three weeks ending Nov. 9th, there were 61 cases of diphtheria and 14 deaths, 14 cases of scarlet fever, and no deaths; there were 3 deaths from typhus fever, and 3 from enteric fever. Rio de Janeiro, South America. -For the two weeks ending Oct. 12th, there were 227 deaths from small pox, 3 from typhus fever, 10 from enteric fever, 4 from yellow fever, and 18 reported from "pernicious Deaths from all causes show an average death-rate of 43.5. fever." Great Britain.-In twenty large cities and towns of England, having a population of seven millions, the deaths for the week ending Oct. 26th show an annual rate of mortality of 21.6 per 1,000 of the population. The deaths include 5 from small-pox, 187 from scarlet fever, and 71 from other fevers. In Dublin, for the same week, the mortality rate was 23.5. There were 5 deaths from small-pox, and 8 from scarlet fever. In Belfast, for the week ending Oct. 31st, there were 9 cases of scarlet fever and one death, 3 cases of enteric fever, but no deaths. Stockholm, Sweden. - For the week ending Oct. 12th, the total mortality shows an average annual rate of 17.3. Enteritis and diarrhoea caused one-fifth of deaths. Christiana, Norway. For the week ending Oct. 19th, there were 3 deaths from diphtheria, and 1 from scarlet fever. The average annual rate of mortality was 13.8 in 1,000 of the population. German Empire.-During the week ending Oct. 19th there were 5,475 births, and 3,480 deaths in 149 cities and towns of 15,000 people and upwards, having an aggregate population of 7,439,708. The average annual death-rate per 1,000 of the population was 24.3; the lowest being 11.5, at Potsdain; the highest 37.9, at Augsburg. In Berlin the death-rate was 27. The total deaths include 113 from scarlet fever, 169 from diphtheria and croup, and 70 from enteric fever. There were no deaths from small-pox or typhus fever. The "Rinderpest" is reported to be decreasing in some of the provinces of Turkey. Typhus fever often prevails, but generally over restricted areas. Leprosy prevails to some extent in the province of Canton, which furnishes nearly all the Chinese emigrants to the United States. The disease was introduced into the Sandwich Islands from China. Singapore. The island and part of Singapore are reported free from all epidemic or infectious diseases advices to Sept. 27th.-JNO. M. WOODWORTH, Surgeon-General U. S. Marine Hospital Service. THE THIRTY-SECOND ANNIVERSARY DISCOURSE BEFORE THE NEW YORK ACADEMY OF MEDICINE will be delivered by Prof. W. H. Thomson in the Hall of the Academy, 12 West 31st Street, on Wednesday evenThe medical proig, Nov. 27, 1878, at 8 o'clock. fession are invited to attend. ST. FRANCIS' HOSPITAL, NEW YORK.-Dr. George F. Shrady has been appointed Attending Surgeon to St. Francis' Hospital, New York. fering from a poisoned wound, received during operPROF. MOSES GUNN, of Chicago, who has been sufation, is now rapidly improving. NEW YORK ACADEMY OF MEDICINE.-The Library of this association now numbers seven thousand volumes, while nearly fifty of the leading medical journals of this and other countries are laid upon the tables for the free use of the medical profession and the public. The Library is open from 10 AM to 5 P.M., Sundays excepted. STATE WOMAN'S HOSPITAL.-Dr. Fordyce Barker has resigned his position as one of the surgeons to the New York State Woman's Hospital. Pending the election to fill the vacancy thus created, the staff was enlarged by two additional members. The following A CASE OF OVARIOTOMY-RECOVERY.-Dr. W. E. Rowe, of Waterville, Iowa, sends the following account:-"Some time in March, 1878, Miss B., German, unmarried, aged 23, noticed that her abdomen began to enlarge, and that her previous good health began to fail. Several physicians were consulted in regard to the case, and it was pronounced to be either an ovarian tumor or an extra-uterine pregnancy. Nothing was done, except some medicine given to improve digestion and to regulate the bowels. Her abdomen continued to enlarge, and Dr. T. H. Barnes was consulted. After a thorough and careful examination he unequivocally pronounced it to be an ovarian tumor, and its immediate removal by ovariotomy was recommended, as the tumor was already causing considerable gastric derangement, and also, by pressure on the diaphragm, seriously interfering with respiration. The diagnosis being established beyond a doubt, and the operation decided upon, on Wednesday, September 18, 1878, Dr. Barnes, assisted by Drs. Brown, Earle, Behle, Rogers, and Rowe, removed a China.-Advices from Shanghai to Oct. 1st report only sporadic cases of Asiatic cholera at that port. Cholera first appeared in China in 1820, having been brought by sea from Siam, and has proved very malignant at times, although at no time ravaging an ex-large, solid, multilocular ovarian tumor, weighing tensive region of country. Sporadic cases occur at Shanghai in the summer and autumn of almost every year. All persons visiting China and Japan are advised to be re-vaccinated before going. The universal practice of inoculation with small-pox virus, which obtains in those countries, accounts for the frequent deaths among foreigners from small-pox. Inoculation does not always protect from subsequent attack. Diphtheria is not common in Shanghai. It is restricted almost wholly to higher latitudes of the Empire. Yellow fever is unknown in Eastern China. twelve pounds. Operation--The patient being thoroughly under the influence of chloroform, an incision was made in the linea alba, extending from the umbilicus to the pubis, and the tumor exposed. All hemorrhage was stopped by searing the wound with the galvano-caustic battery. On opening the cavity of the peritoneum a quantity of water scaped, showing the presence of ascites. The tumor being fully exposed, cysts were looked for, and a small one found, which was tapped, and about 3 x. of clear fluid drawn with the expirator. Adhesions were next |