child having some diarrhoea, I asked to see the passages, remarking casually that now we should have a clew to the whole trouble. The mother had not saved the passages. Unfortunately for me, before I thought, I asked the doctor what was their character, and he was forced to reply that he had not examined them. Determined to shield the doctor, I changed the subject by remarking that after all it might not have been of any importance, only I should like to have seen them for my own satisfaction, a matter so purely selfish that I was forced to smile as I referred to it. I forgot to mention that the prepuce of the child was slightly elongated; that he had a strong liking for sugar and peanuts; and was occasionally peevish when crossed.

While I was washing my hands the father was examining my instruments and asking the doctor all sorts of questions as to their use. I confess I was somewhat surprised at the latter's ignorance, and made an excuse to give the necessary explanations. This was done more to turn the subject of conversation than for any desire to satisfy the inquisitive parent.

After tucking Harry under the chin and bidding good evening to the parents, I retired with the doctor for formal consultation. We agreed that it was a simple case of intestinal irritation, and I suggested a change from rhubarb and soda to chalk mixture well sweetened and highly flavored. "But," said Dr. White, "how about the choked disk? I replied that such, as well as the aortic murmur and increased cephalic temperature, was due to a slight congestion of the pons varolii, which was reflected through the vaso-motor system of those parts. He was satisfied, and thought it best to give such a diagnosis to the mother. I agreed, but he became confused in his explanations and I had to help him out. While Dr. White was in with the child, prescribing the new medicine, I started to go, when the father waylaid me in the hall, asking all sorts of questions about the case. I informed him that the child would probably get better now; that Dr. White, who although young was willing to learn, had agreed to change the medicine, and that if he was careful in studying the new symptons he would not need further assistance. While doing this I impressed upon him the fact that I was a great friend to Dr. White; that he was an exceedingly apt scholar, and, for his opportunities, he was the safest doctor of his age that I knew. Just then the doctor came out of the room, and I kindly put my arm in his, we walked out together, and I confidentially informed him that although his position was a little shaky in that family, I had done my best in accordance with the Code to hold up his hands and say what I could for him as a professional brother. He thanked me, and we parted on the corner.

me.

When I arrived at my office the father of the child was waiting for He requested me to see the patient again that night. The child had vomited since the visit, and the parent did not believe that Dr. White understood the case. In fact he desired me to attend it henceforth. This at first I flatly refused to do, but how I managed it afterward, to the satisfaction of all hands, will be seen in my next. Record.

Medical

GLEANINGS FROM HOSPITAL REPORTS.

BY LUTHER CLARK, M. D., BOSTON.

IN the report of Bethlehem Hospital for 1878, Dr. Savage, speaking of remedial means in insanity, says: "I have already published in the Practitioner' several cases in which relief followed on the development of other diseased processes. The relief in many cases has been only temporary, but in some it has been permanent. The cases already reported I will only refer to in brief.

"Case I. Melancholia passing into partial dementia following childbirth, recovered suddenly and permanently after the formation of a retro-uterine hæmatocele.

"Case 2.

Mania of six months' duration, steadily improved and got well with a severe attack of toothache and gumboil

"Case 3.

Acute mania of four months' duration, with recovery after

inflammation of lower jaw due to a carious tooth.

66

"Case 4 Melancholia, temporary recovery during an attack of erysipelas of the head." Several cases of mental recovery in females with abscesses of the breast are mentioned.

"In cases of mental disease one cannot be too careful in the general diagnosis. In the majority of cases no other specific disease can be detected, but the number of cases that are admitted into asylums suffering from unrecognized phthisis should alone induce every one having charge of mental cases to examine so carefully as not to overlook any possible cause of disease."

One man, aged fifty-three, came into the hospital for insanity of nine months' standing, during which he had made five or six attempts at suicide.

"No improvement took place for ten weeks, when he had an attack of gout. He was at once sane and said he felt all right now,' and that he had not been so well since his last attack of gout. He has been used to have several attacks of gout yearly, but this year had been without one. He rapidly improved, but was kept under observation

for many months, and continued well in mind, having his usual attacks

of gout.

"Another very important question in insanity is its relation to syphilis. In some such cases all the difference between hope and despair lies in the diagnosis. Some cases of syphilitic insanity so closely resemble dementia or general paralysis that the best judges may be mistaken. I have seen some cases in which the patients passed through an ordinary attack of mania; but when they were expected to take a turn and begin to improve, they have remained stationary till it was discovered that they were also suffering from constitutional syphilis, the treatment of which resulted in a permanent cure."

In the volume of reports of Guy's Hospital for 1878, there is also an interesting communication from Dr. Howe upon Antiseptic Surgery and Empyema, in which is incidentally discussed the very important question of removal of mammary cancer by an operation. Though it is considered certain that cancer is a constitutional and not a merely local disease, and though Sir James Paget's opinion that not more than one in five hundred cases is permanently cured by an operation may be correct, yet it is argued that much may be gained by it. Even if the case is to terminate fatally in about the same length of time with or without an operation, yet there is in most cases secured a considerable interval of relief and comparative comfort to patient and friends. Again, the recurring disease is likely to be of a less distressing and offensive character than would have been the primitive disease if it had been unchecked in its course.

Such considerations, with the mitigating improvements in modern surgery, will weigh with homoeopathists, who may hope to do something, during the respite gained, towards checking the fatal constitutional tendencies.

We quote the following paragraph:

"Every one admits that the 'starting cause' of septicaemic conditions may be carried by students from the post-mortem and dissecting rooms to the patients. The fact that it is a point of honor for no one who has been in one of these places to go to an ovariotomy, puts this in a strong light. If this is so, the fact that students crowd round with surgeons and handle the cases as much as possible, may tend to explain why pyæmia occurs more often in our hospitals than in private practice."

In Vol. XIV. of St. Bartholomew's Hospital Reports is an analysis of four hundred twenty-three cases of scarlatina, whichthe writer (Dr. Evans) attended during six consecutive years, in the town and vicinity of Northampton, England. Dropsy followed as a sequela in fifty of the

cases.

Of these, forty-five occurred after simple, only five after anginous cases; according with the common opinion, that the lighter cases are oftenest followed by dropsy. Of these fifty dropsical cases, eleven were fatal, or twenty-two per cent; the dropsical effusion was never into the peritoneum, but into the pleura, pericardium, or arachnoid. Of the whole four hundred twenty-three cases, fifty-three were fatal, twelve per cent; of the cases classed as malignant, there were eleven (ten children and one adult); all died within thirty-six hours from the onset. Besides these, there were several cases without any eruption at all, ushered in with copious vomiting, quickly followed by extreme pallor and collapse, and terminating fatally in twenty-four hours or less. In Dr. Evans's treatment, even by his own showing, there is a sad lack of useful suggestions, especially to any one who can avail himself of the resources of homoeopathy.

The "American Journal of the Medical Sciences" for April contains an elaborate article by Dr. Austin Flint, Jr., giving his "Experiments and Reflections" in regard to the sources of animal heat. He finds that the amount of heat consumed in maintaining the temperature of the body, and the amount converted into the force needed to carry on the vital processes, are much greater than the carbon and nitrogen consumed in the system can supply. When to this is added the heat needed to supply force to all the voluntary muscles, there is a large deficiency to be supplied in some way. Dr. Flint concludes that this large supply is furnished by the oxidation of hydrogen and formation of water. His experiments, made with much care and decision, show that the water which leaves the body in the various excretions is considerably greater in amount than that which enters it in the food and drink, — which goes far towards supporting his theory.

THE initial numbers of two new quarterly homoeopathic journals on special subjects have come to our table, the first in July, "The American Journal of Electrology and Neurology," edited by Dr. John Butler, of New York, and published by Boericke & Tafel; the second in August, "The Homœopathic Journal of Obstetrics and Diseases of Women and Children," edited by Dr. Henry Minton, of Brooklyn, N. Y., and published by the A. L. Chatterton Publishing Company. The price of the first is fifty cents a number (eighty pages) or $2 a year, and of the second $1.50 a number (one hundred and twelve pages) or $4 per year. Both are very neat in appearance, the mechanical execution of the obstetrical quarterly being even elegant. We find some very valuable articles by good writers in both, and give them a cordial welcome with best wishes for their success.

THE NEW ENGLAND MEDICAL GAZETTE.

BOSTON, OCTOBER, 1879.

A NEW College has been organized, and promises to go into actual operation Nov. 5th. Since it is universally admitted that the United States is already overrun with doctors, such as they are, having one to every six hundred of population, a ratio which is very much higher than obtains in any other country on the globe, it is naturally expected that any new institution for making them, when becoming a candidate for public favor, should be able to show a most excellent raison d'être. Therefore, we were curious, when we first heard of this project last May, to know in what its special excellences consisted, and while waiting for its announcement (which has finally arrived), we endeavored by private correspondence to satisfy our curiosity. We knew that there has been of late years great dissatisfaction with the old systems of medical teaching, to remedy which, strong efforts have been made in a few colleges to raise the standard to a much higher point. Was this new college, as it boastfully claimed, to take the lead in this higher education, and put many of the older ones to shame, or was it to be merely one more cheap diploma-factory, a poor one-horse mill for grinding out superfluous, illiterate, unscientific bleeders of the pockets (and possibly veins too) of unsuspecting members of the community? We are very sorry to say, that, so far as our investigation has at present extended, the new enterprise seems to approach nearer to the latter class than to the former. It is located in Buffalo, N. Y. We had never thought particularly of Buffalo's being so far out in the wilderness as to make the great medical centres inaccessible, and we had not heard of any sudden increase of its population of late, but we cannot be expected to know everything, even if we are editors, and doubtless failed to appreciate the situation, for the new announcement opens with these words: "For many years the Queen City has felt the necessity of a liberal medical school, which would instruct unbiassedly in the system having for its guide the treatment of disease in accordance with the law of correspondence or similars." The new dean, Dr. Wetmore, was only converted to homœopathy about two years ago, but immediately recognizing this long-felt want, this necessity which others had failed to recognize, he became the prime mover in the enterprise.

The following extract from the proceedings of the Erie County Ho