vania, in his work on the Principles and Practice of Surgery, page 738, vol. I. On the following day, on our visit, the hip-joint was found to have been dislocated during the night. The boy, contrary to most positive orders, had attempted to raise himself up in the bed, and at the same time turning partially around, threw the head of the bone out; the leg assuming the same position as when we first saw it. Again the patient was placed under the influence of an anesthetic, and the luxation reduced as in the first operation. He was then secured firmly by means of a splint and bandage to the couch in which he lay, in order to guard against a second luxation. In this secured position he lay for seven days, doing well, except some slight peritonitis occasioned by other injuries received in conjunction with the first dislocation. During the night following the seventh day, he loosened the bandage which held his shoulders and body to the bed. Finding himself again free, his first impulse was to get up. (He seemed unable to appreciate his condition.) In this attempt he again threw the head of the bone out of the socket. This, in our opinion, was easily accomplished. In the first place, there was an extensive laceration of the capsular ligament, allowing the head to glide easily from the socket; and secondly, the limb in its secured position to the splint and bed, with the shoulders and body free to move in the direction of the erect posture, and to the right. These movements would, under the circumstances, certainly produce a dislocation (the left limb being the injured one). At our request, Dr. J. C. Reeve, of Dayton, Ohio, was called in council, in order to fortify ourselves against any subsequent trouble, in a legal point of view. The patient was again anæsthetised, and Dr. Reeve thought, upon first examination, there might be a fracture within the capsular ligament; but, upon further investigation, coincided with our previous diagnosis. We then proceeded to reduce the luxation in the manner before mentioned, and with similar success. At the Doctor's suggestion, the splint was reduced in width from five inches to three, and not to be secured to the bed, and the toe was everted to about seventy-five degrees the foot abducted about four inches from the normal axis of the leg-the body was secured to the bed as was previously done. In this position he lay for three weeks, after which time the splint was removed and passive motion induced.

At the time of writing the above, the boy is able to walk without crutches, though there is still some lameness-the foot is still in an abducted position, with the toe everted, giving him altogether an awkward appearance.

In this case the difficulty did not consist in the reduction of the dislocation, but in retaining it in its normal position after reduction; and it is our opinion the injured limb should always be secured with a splint, the normal axis of the leg maintained, and the toe but slightly inclined outwards. It will be seen that the splint, in this case, was left on somewhat longer than would be required in the majority of

cases.

HYPODERMIC MEDICATION.

BY C. B. MILLER, M. D., OF LAWRENCEBURG, IND.

Having employed hypodermic injections in the treatment of disease quite extensively for the last four years, I am induced to give your readers the benefit of my experience-hoping it may disperse some of the clouds of unbelief that hang over many of our professional brethren, and induce them to make a trial of this very valuable therapeutic means.

In many diseases the first indication is the relief of the distressing pain that harasses the patient; and in proportion as we do this, we arrest the wear and tear upon the system. That this indication is best met by this method of medication is shown by its superiority over all others in the facility with which it may be employed, the rapidity and certainty of absorption, and consequently of action, and the knowledge of the exact quantity entering the circulation.

I will give briefly the history of a few cases.

CASE I Was called in the evening of May 21st, 1866, to see M. W., æt. sixteen, who has been a cripple for several years from caries of the femur-the result of an injury. His only suffering now is from neuralgia, the inflammation having subsided and the sinuses all closed up-the pain of which has made life a burden for the past six months, and is willing to submit to amputation of thigh for relief. Injected one-third grain morph. sulph. over seat of pain with effect to relieve it entirely.

May 22-Evening-Slept well last night, and has been comfortable all day. Gave another injection, as he feels slight pain.

June 4—has been able to walk around, and free from pain until last evening, when it returned slightly after exposure. Gave another

injection, and he had no further return within the next year while under my observation, although at work daily.

CASE II-Dr. H. has been suffering with sciatic rheumatism, to which he has been subject for years, for two days. Persuaded him to allow me to inject morhia sulph., one-fourth grain over seat of pain, which relieved it almost immediately. Two days later, felt some symptoms in opposite hip-after getting wet. Injected one-third grain morphia in that with same result as before. Two years have elapsed, and he has felt nothing of his old torment; and it is almost needless to add, is a strong advocate of hypodermic medication in neuralgic affections.

CASE III-Mrs. A. Y., called at my office January 22d, 1867, complaining of facial neuralgia, which has been torturing her for several days not periodical. Has tried various remedies, but none have afforded relief. Injected one-fifth grain morphia in arm, and the pain almost immediately subsided. Repeated injection two days subsequently, which resulted in a complete cure. The first injection in this case occasioned nausea but no vomiting, and a swelling resulted from the last, but disappeared in a day or two without treatment.

CASE IV-Was called early on the morning of November 4th, 1866, to see Mrs. G. N. Found her in the most terrible agony, caused by a cramping of the muscles of one side of the neck, paroxysms coming on every two or three minutes, when her screams could be heard two squares. Pain came on suddenly while assisting her husband to rise in bed he having acute rheumatism. Relieved entirely and permabed-he nently by the injection of one-third grain morphia in arm.

CASE V-S. W. has been suffering for two days from sciatic rheumatim, brought on by exposure to wet and cold. Called at my office December 7th, 1866-scarcely able to walk. Injected one-fourth grain morphia over seat of pain-complained for a few minutes of burning, occasioned, and felt slightly nauseated, but all unpleasant symptoms passed off in a few minutes, and he walked out feeling as well as ever, and has had no return of it, though often exposed to the inclemencies of the weather.

CASE VI-December 26th, 1866, was called to visit Mrs. S. W., and found her suffering severely with sciatica. Has been troubled with menorrhagia. Injected one-fourth grain morphia over seat of pain, which immediatly relieved all pain, when remedies directed against her other symptoms, and tonics to improve tone of system effected a complete cure.

CASE VII-Mrs. C. G. called at my office May 6, 1868. Has been suffering for several days with neuralgia of supraorbital nerve-is rather anemic, and troubled with derangement of stomach. Injected onethird grain morphia in cellular tissue of arm, which relieved neuralgia, though it produced' severe vomiting and great prostration. Gave tonics to improve general health, and she has never suffered since.

CASE VIII-May 21th, 1867, was called to see Mr. J. S., who has been suffering all night with tic douloureux; pain so severe he has been walking the floor for several hours. Gave him an injection of one-third grain morphia, and pain subsided in a few minutes, and has never returned. In this case he had been suffering for several days, but not in the agony in which I found him. He complained a little of the pain of the instrument, but says he never experienced such decided relief from pain so quickly before.

I could go on and amplify cases from my note book, but I have already occupied too much of your space, and certainly enough has been said to convince any one open to conviction of the utility of this agent. I have tried and seen the syringe employed in eclampsia with decided benefit; but have not sufficient experience to state whether it will always act beneficially in that dreaded disease. I have not injected any other medicine than morphia sulph, under the skin, and should be very careful about doing so. I think its chief usefulness is confined to the administration of anodyne remedies. I never employ more than one-third of a grain at an injection, preferring to repeat it to incurring any risks from an overdose. I have never had an abscess result from its use, nor any other serious affection.

DYSENTERIC ARTHRITIS.

The Archives Générales, of August, contains an article with this title, by Dr. Huette. More than a century ago this form of disease was recognized by Zimmerman and others. Most of these observers, however, explained it as occurring from metastasis.

Dr. Huette terminates his elaborate paper with the following conclusions:

"1. There is a variety of arthritis having its sole and necessary cause in an epidemic phlegmasia of the mucous membranes of the rectum and of the colon

"2. This rheumatismal manifestation does not occur in every epidemic of dysentery; it is subordinate to the inflences of a peculiar medical constitution: individual diathesis may favor its development.

"3. Dysenteric arthritis, essentially apyretic, differs in its causes, in its progress, its general aspects, and its consequences from simple articular rhematism. It presents a great analogy with blenorrhagic rheumatism.

"4. Dysenteris arthritis almost always poly-articular, has a duration of several weeks or several months. It generally terminates by resolution-rarely by suppuration and anchylosis.

"5. Metastasis does not explain the appearance of this arthritis, as was form. erly thought; it is more rational to attribute it to a morbid affinity, which, the mucous membranes being diseased, determines reflex pathological effects upon other tissues of the economy."

THE ADDRESS IN MEDICINE, DELIVERED BEFORE THE ANNUAL MEETING OF THE BRITISH MEDICAL ASSOCIATION, AT LEEDS.

BY SIR WM. JENNER, BART., M. D., F. R. S.,

Physician to the Queen; Physician to University College Hospital, etc.

MR. PRESIDENT and GentlemEN: There are special occasions in a man's life when it is well for him to review his mental progress, points in his life at which he does well to note his bounds-to look back over the road he has traveled, count his gains, the difficulties he has overcome, the advances he has made; and so, by a pause in his labors, be stimulated to new efforts, gathering from the retrospect good hopes for the time to come. The same is true of a profession. Its members should from time to time look back to their earlier days; scan the advances their profession has made; compare what it is now with what it has been, and weigh the worth of its reputed progress. There are special reasons why the members of our profession, the practitioners of medicine, should from time to time sum up the gains which medicine has been making as a practical art. For in the daily practice of our profession so much occurs to damp our spirits; so many cases of difficulty arise in which the remedies of our art are doubtful; so many cases in which the practical difficulties in the way of diagnosis are insuperable; and so many cases in which, the diagnosis being clear, we know that we are impotent to cure; so many cases in regard to which our apparently well-founded expectations of affecting a cure prove vain, that even the most hopefully minded must be permitted to doubt if medicine be advancing as a practical art. Many entertain scepticism as to the value of medicine as an art, and especially as to the remedial power of drugs. "I trust you will not cast a doubt on the efficacy of medicine," said a distinguished member of our profession.