eighteenth century that most industrious physiologist the great Haller appears upon the scene, and founds a school o anatomy at Berne developing the real life of the profession of medicine. Up to this period the existence has been largely embryonic and the lecturer leaves the subject a rapidly growing lusty child. Dr. Hamilton was fortunate in presenting the dry, early part of the history of our profession in so entertaining a manner. If he could be prevailed upon at some future time to deliver an address upon the advances made in the last fifty years of medical progress, we feel sure it would be well worth hearing or reading.

HONESTY AT THE DEATH BED.

has not one word or wish more to express, or message to send.

If your estate were about to be lost and your attorney failed to advise you of it, you would judge him false to your interests. Shall your physician be less candid and true when your life is ebbing away and you are helpless? One of the horrible things which many would gladly forget is that once being very near death's door, their physician failed to tell them of the danger, when a half hour's possession of such knowledge might have been worth all their previous life. In every case in which death seemed imminent and the patient beyond the years of childhood, and conscious, the writer has made it his practice to see that the dying one is informed of his condition, or has placed the responsibility for

"Nothing is clearer than that the merciful Creator intends to blind most people as they pass down into the dark valley. Without very good reasons, temporal or spiritual, we should not interfere with His kind arrangements. It is the height of cruelty and the extreme of impertinence to tell your patient he must die, except that you are sure that he wishes to know it, or that there is some particular cause for his knowing it."-O. W. Holmes.

It is not with the desire to criticize that

friends. In not one instance has this been regretted.

When a sick man looks up into his physi cian's face and asks, "Tell me, Doctor, do you think I am going to die?" who gave that physician a right to tell a lie or conceal the truth? Shall his last act to the patient who trusted him, be a false act? In conclusion, we hold that a patient should be advised when danger is present, and when death is inevitable, he should know it!

W. P.

Holmes has done so much to make life beautiful and more "worth living" that all he says regarding life, or the end of life, should receive respectful attention.

Most patients about to die have something to do or say, almost rendered imperative by the closing of this life and the dawning of the next. It is not right that they should be denied the opportunity.

Few are greatly alarmed when told that death approaches. To change the language of the distinguished author, "Nothing is clearer than that the merciful Creator" deprives death of its terrors for "people as they pass down into the dark valley." What one has his "house in order" so completely that he

ATING DISSECTION.

In respect to this important bill, contained in this number, we wish to remind our readers that, in accordance with the resolution adopted at the last meeting, May 3, 1886, of the Missouri State Medical Association, every physician in the state is asked to explain this proposed Statute to the member of Legislature from his District, so that he will be prepared to vote in its favor and thus help secure its passage. Without personal effort this imperatively necessary legislation can not be secured. The Proposed Statute will enable every doctor throughout the State to obtain bodies for dissection, or to study op

erations, without having recourse to grave robbing. It is evident that the individual doctor is relatively as much interested in the new Act as are the medical colleges.

The Missouri Anatomical Association (formed by representatives from each chartered medical college in Missouri) appeals for the support of the new bill as follows:

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"The present Anatomy Act of the Missouri Statutes, 1879, contains the following provisions, which, in practice, experience proves are almost an equivalent to a prohibition of dissection: (1) the Act makes it optional with superintendants of hospitals, etc., whether they shall allow bodies in their charge to be used for dissection. (2) the Act prohibits the use of the body of any person, even if unclaimed for burial by relatives or others, if such person before death has pressed a wish for burial. Political reasons, religious scruples and other motives have been found to influence officers to defeat the spirit of the Act. City undertakers may trump up fictitious claims upon bodies, and to make a farce of the whole Act, it is said that a superlatively considerate attendant actually asked a dying pauper if he wished to be "cut up" by the medical students after death. In fact, as the law now stands, this "legislation" of dissection puts the profession in a worse position than when, in absence of permissory law, resurrectionists were tacitly allowed.

The proposed statute is essentially similar to those of Pennsylvania and Illinois, which are said to work satisfactorily. An abundance of dissecting material will be supplied, so that not only schools but preceptors throughout the State may be amply provided, as their necessities require. There will then be no excuse for the desecration of graveyards, with the consequent distress and alarm of the community."

From the above, it is the present law is The spirit of it is

apparent that not satisfactory. correct, but, un

fortunately, it does not, and cannot, in its present shape be made to accomplish the object for which it was framed. That the supply is by no means adequate in any portion

of the state, we have ample evidence, from the best sources. We are all aware of the energy used by the better class of medical colleges in obtaining plenty of anatomical material, yet, to our personal knowledge, the faculties of the St. Louis schools, after they had done their best, employing all possible fair and honest means, did not have a third of the material needed last winter, to give their students proper opportunities for dissecting. One example will illustrate the condition of affairs. Of 134 bodies buried by the city in a short space of time last fall, the colleges only got 11. That this was not the result of personal ill feeling on the part of the superintendents of the various city institutions towards some one of the colleges or some clique, is evidenced by the fact that all the schools suffered alike. The circular explains to some extent why there is this difficulty.

Drs. C. A. Todd, W. A. McCandless, St. Louis; J. D. Griffith, E. R. Lewis, Kansas City; J. W. Heddens, St. Joseph, have been appointed a committee to look after the interests of the measure especially, by an organization of physicians with representatives in most of the large cities of the state, who are pushing the matter with all possible zeal. They need, deserve and expect the help of every intelligent physician in the state. Keep it in mind, and if you are acquainted with a member of the Legislature, or some one who hopes to be such as the result of coming elections, explain to him why he should vote for the new measure. You may thus not only help a worthy cause, but some day, when you want a body for a trial operation, or when you wish to help some one, in whom you are especially interested, to study practical anatomy, you may be glad, for personal reasons, that you lent a helping hand.

The committee hope to hear suggestions, verbal or written, from any interested enough to make them.

OBSTACLES TO FECUNDATION.-A Paris correspondent of the Philadelphia Medical Times says:

Many women have a deviation without knowing it. It certainly very often constitutes an obstacle to fecundation,-one reason being that the cul-de-sacs formed make a false route for the male organ and complicate the difficulty of fecundation.

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"Acidity of the vaginal mucus seems also to be a cause of the rapid death of spermatoFinally, when I first began to teach, like those who preceded me, I said that, out of a hundred, ninety-nine times sterility was the woman's fault, and only one the man's. But during these last twenty-five years I have arrived at a very different result, which will astonish you as well as it did me. More than ten years ago I found the proportion of husbands who were the obstacles to fecundation rise to seven in eighty cases. I have seen in late years some four hundred cases in which I examined the seminal fluid, and I can now say that of one hundred cases, after two to twelve years of marriage, there were nearly twenty in which the husbands were at fault and the cause of the sterility; and I think when some thousands of cases will be collected that twenty-five per cent will be reached. Don't fancy that it was alone in feeble men that the difficulty resided; not at all. Strange as it may sound, there are a large number of strong men who have no spermatozoa or have them in an imperfect state; and yet they fulfil the conjugal function perfectly well.

One of my latest patients was a colossal man, with a head like a lion, who brought his wife to me complaining that the little woman was no use as to conception. Upon examination, I found her organs and functions in perfect order; and, taking the husband aside, I explained to him what I wanted. Under the microscope I found that there was not a single spermatozoon in it, not one. On questioning him, I found that his desires were ample, and in regard to previous ill health he could only recall a slight orchitis at seventeen years of age. Another patient was a short man who did not present anything particular in his appearance except broad shoulders. His wife was a tall, handsome blonde. They had the same complaint: no

children. Examination of wife showed vag. ina and neck of uterus full of mucus. Examination of husband's spermatic fluid gave a result of millions of spermatozoa, thus reminding me of the extravagant boasting of the Gascon and the Marseillais. The first said that in his rivers there were so many fish that all you had to do was to dip up a bucket of water, and you could get all you wanted. The second replied that in the river in his country it was all fish and no water at all. Between these two extremes there are all sorts of

cases. But it is not sufficient to have a certain number of spermatozoa. Professor Duplay has shown that they exist in quite old men, but they are smaller, and not active; and I contend that fecundation is not possible with such spermatozoa. In making an examination for size, always use the same power of microscope at first. This is important, so that you may be able to judge. The smaller deformed ones oscillate some, but they are not half as long nor as large as they should be. There are exceptions to every rule, but usually they cannot fecundate. It is your duty to see to this matter. In those who have none at all, cure is almost hopeless; but those who still have some may be improved by treatment. It is possible that on the female side likewise some ova cannot be fecundated; but of this we know very little. But let me go on to treatment. For the catarrhal states, use emollient injections for the first few days, to allay any congestion, and then during the intermenstrual period-that is to say, not less than ten days nor more than fifteen after cessation of the menses-practice internal cauterization of the uterus, both the cavity or the neck and the body.

Use for this purpose my portecaustic mounted on very flexible whalebone, that cannot perforate the uterus. Professor Richet uses a solid metal one; but in his hands any instrument will do: don't fancy it · would do so well in yours. Place powdered nitrate of silver in the little cup, close it with some unguent, and penetrate slowly into the uterus, empty the cup, and the operation is over. If you still fear the porte-caustic, use

are

these little whalebone sticks, which mounted solidly with a little cotton, carefully wipe out the mucus to get at the real surface, wet the cotton with a little water, and rub it in powdered nitrate of silver, forming a sort of paste, which you can paint over the surface easily. Keep the woman in bed three days or more, and continue emollient injections, and follow them with astringent ones. As to the narrow conically-necked uterus, the best treatment is dilatation. I do not believe in Sims's American divider, composed of two blades that are introduced, opened, and drawn towards you, as I have seen fatal results in two cases from its use. No, dilate gradually and largely the external orifice only; for, as the other gives passage to the menstrual flux, it will allow the spermatozoa to pass.

"I wish now to teach you some therapeutical measures that I think have never been mentioned by any one. When you are advising a woman who has a deviation, see the husband apart. If she has an anteversion, tell her to prepare for the sexual act by not urinating for five or six hours beforehand, if she wishes to have children. If it is a retroversion, advise as follows. After the monthly period she must eat plenty of eggs and rice, and take a small pill every evening for three or four days (the pill is simply two and a half centigrammes watery extract of opium). During these days she must resist defecation and perform the sexual act. This advise is based on anatomical and physiological facts, and will often succeed in removing these obstacles to fecundation. In one case the full bladder pushes the body of the uterus up, and in the second the full rectum corrects the deviation for the moment." To give further indications, the professor related the case of a patient who had a left lateroversion, making one of the false routes he talks of. Upon questioning the husband adroitly, he found that the conjugal act was performed in the usual classical manner,-dorsal decubitus, in fact, and advised a change by placing the wife on her right side: conception followed, and the woman had eventually five other children.

With these different methods he also advises sterile people to have connection only about the menstrual period, a few days before and after, and never at other times. As to the husbands with no spermatozoa or with insufficient ones, he advises gymnastics, fencing, swimming, velocipedes, walking, etc., exercise of the inferior members, good living, and continence.

SUPRAPUBIC CYSTOTOMY.-From the Proceedings in the Section of Surgery of the British Medical Association, we learn that Sir Henry Thompson throws the full weight of his valuable opinion in favor of suprapubic, as against the other methods of cystotomy. He says the question is a new and burning one. Formerly the surgeons debated the relative advantages of the lateral or median operations, and only very small stones were left to lithotrity. Crushing was an imperfect proceeding and disastrous in its results; now however, by almost universal consent, it is the best operation for nine out of ten stone cases, at least in the adult.

The lateral operation, says the writer, won its success in the hands of Cheselden, and of his followers, through its applicability to the stones occurring in children and middle-aged adults; in other words, for stones of moderate size, to what may be called the "general run" of cases. This now is changed, the "general run" of cases being provided for by lithotrity. This operation has superseded the lateral lithotomy in that class; and for the severe and exceptional conditions, Sir Henry considers the suprapubic operation an available and trustworthy resource.

Its superiority over the lateral mode is thus formulated:

1. Because in the suprapubic operation there are no important structures lying in the line of incision, or sufficiently near to be rendered liable to injury either by the knife or by the forceps.

2. Because the space for removing a large stone above the pubes is practically unlimited.

3. Because there is little or no danger from