to carry them through the body of the uterus to the fallopian tubes and ovaries, where they come in contact with and penetrate the graafian vesicle to make it fertile.

We thus see a community of origin and a unity of germination in all of the cells which we have described. It is through them that all vital action is maintained, and anything that attacks them undermines the foundation of life.

The Power that vitalizes all living things, has seen fit to choose the smallest and simplest forms by which to build up the most complex animal structures.

As an example of the vital power of germinal matter, let us cite the influence of the virus of any of the modifications of variola. We see there that a minute portion-less, probably, than the hundredth part of a grain-is capable of impressing its peculiar nature upon every particle of the body. And not only every atom of the body at that time, but through them to all which succeed them; and to such an extent is this done, that it gives entire immunity from all subsequent invasions of any of its congeners.

CATARACT.

BY J. THOMPSON, M. D., HARRISON, OHIO.

James Gold, aged eighty-two years, presented himself to me last May, and gave the following history:

Has been totally blind in right eye for fifteen years, and partially blind in left eye for seven years; said his case was deplorable; that he could hardly see to get about; could not count his money; could not distinguish one bank bill from another; nor could he recognize his friends by sight.

On examination without the aid of artificial means, a total, hard, lenticular cataract of right eye, and by the aid of oblique illumination and the ophthalmoscope, a partial cataract of left eye was discovered. He could count one's fingers with left, but could only distinguish light from darkness with right eye. Has very overhanging supra orbital margins and eyebrows; eyeball very much sunken; arcus semilis very distinct; anterior chamber very shallow; integument very flabby, and subject to attacks of eczema.

Pupils quickly responded to atropine; vitreous showed no sign of liquefaction. He had no cough; neither did he have any symptom of diseased kidney.

As he wanted my opinion as to the probable utility or result of an operation, I gave it as follows:

It was by no means such a case as one would select were he simply seeking eclat, as the chances against a favorable result preponderated over those in favor of success from an operation; and were he to wait until the lens of left eye became totally cataractous, he would then the more readily appreciate a good result from operative interference. But, on the other hand, as he was advanced in years, and already feeble; as he had no cough, and as one eye was already useless to him, and the other rapidly passing into the same condition, and as it was impossible for us then to foresee the condition of his health when total blindness established itself, and as the dread of total blindness rendered his life miserable, we therefore left him to determine the matter for himself.

After consulting his relatives, and duly considering the matter, he concluded to take the risk of an operation. Accordingly, a dose of sulph. magnesia was administered on the 16th of June, and on the 17th I extracted the lens, assisted by Dr. W. C. Cooper, of this place. The operation was the one known as the "Modified linear extraction of Von Gräffe."

The stop speculum was used in this case, the temporal end of which had to be pressed back by an assistant, owing to the sunken condition of the eyeball. Great care was necessary in passing knife in front of iris, owing to shallowness of anterior chamber. The sclerotic incision, as well as the iridectomy, were made in upper section of globe. The capsule was freely lacerated, after which the lens was easily extracted by pressure with spoon above and with knife handle below. He counted my fingers immediately after operation. The lens was dark brown and very hard. A compress was then placed over both eyes, half a grain of sulph. morphia administered, and patient requested to remain in a horizontal position for two or three days.

The old man was a very troublesome patient, difficult to control, being hypochondriacal. He got on his feet the day after the operation for the purpose of ascertaining "whether he had lost the use of his feet!"

On the third day subsequent to operation he was troubled with

strangulated inguinal hernia, which I feared would have to be operated upon, but fortunately opium and the taxis relieved the difficulty.

After the above date he progressed rapidly. Wound of sclerotie united by the fourth day, walked about the house on the sixth day, found him weeding his garden on the twelfth day, and by the 15th of July all redness of conjunctiva and sclerotic had disappeared. September 16th, furnished patient number three convex spectacles, which enabled him to read moderately large print, and number six for distant objects, with which he could readily read names on signs across the street.

The above case is reported simply to show that notwithstanding the age and miasmatic debility, chronic cutaneous affection, &c., of patient, a remarkably good result obtained.

A CASE OF PARTIAL PROLAPSE OF THE UMBILICAL CORD RESTORED BY THE AID OF THE KNEE AND ELBOW POSITION.

BY N. D. GADDY, M. D., VERNON, IND.

I was called to attend Mrs P., aged twenty-five years, in her third confinement, on the 29th of last January.

On examination per vaginam, I found the head presenting, os uteri fully dilated, and through it pouched the unruptured membranes.

By the side of the head I detected apparently several coils of the umbilical cord. Finding my efforts to elevate the cord with the patient on her side or back ineffectual, and that its complete descent was prevented only by the membranes remaining intact, I caused her to assume the "knee and elbow" position. Or, what is correct, she was placed with her knees on an elevated part of the bed, and while her hips were thus elevated, the breast lay as low as possible.

I then introduced my hand into the vagina, and with my fingers gently moved the coils of the cord, which, when started, quickly rolled down out of my reach.

The ease with which this was accomplished was as much surprising as it was to me satisfactory.

A large, healthy girl was born soon afterward, without any more trouble with the cord subsequent to its reduction.

OBSTINATE EPISTAXIS.

BY J. W. MOORMAN, M. D., HARDINSBURG, KY.

In the September number of the Journal for the present year appeared a very interesting article on Epistaxis, from the pen of Dr. John D. Jackson, of Danville, Ky.

Epistaxis, though of frequent occurrence, is rarely deemed of sufficient importance to demand professional aid; hence, it is only in the most obstinate cases that the physician is called to interfere. Almost every one has a list of specifics which must be tried in succession before the physician is consulted.

In an extensive practice of several years I can call to mind but few cases of this form of hemorrhage requiring medical aid. Of the cases coming under my care, in at least an equal number the frequency of recurrence gave more trouble than the actual loss of blood at any one time. In this class of cases gallic acid in pretty full doses, continued for some length of time, is the only remedy usually required, but occasionally a short course of iron has been given to improve the condition of the blood, taking care to allow intervals sufficient to remove all risk of incompatibility.

In an article in the American Journal of the Medical Sciences for October, 1865, I called the attention of the profession to the use of the oil of Canada Fleabane, (Oleum Erigerontis Canadensis), in the different forms of passive hemorrhage; and some cases pertinent to the subject were reported. Since that time I have had opportunity to test its virtues in a large number of cases, some of which were epistaxis of a very obstinate character, and in no case have I been disappointed in its effects.

My method of using the oil in epistaxis, as well as in hæmoptysis, is to drop twenty or thirty drops on a handkerchief or into the palm of the hand, and inhale as rapidly as possible; at the same time half a drachm may be taken internally. Should this not prove effectual in a short time, a dossil of lint may be moistened with the oil and introduced into the nostril as high as possible without injury to the mucous membrane. This should be allowed to remain several hours, and is easily removed at the end of several days.

With the precise mode of action of the oil I am not acquainted;

whether it be some specific astringent action belonging to the oil, or whether it acts in the same manner as its kindred, the terebinthinate oils, is not definitely known, but it certainly exercises a very powerful influence over the hemorrhages.

A domestic remedy very efficacious in the treatment of epistaxis, is the continued application of cold to the scrotum of the male, or the mammæ of the female. I have been much pleased with the action of this remedy in some very severe cases resisting the usual methods of

treatment.

In making these suggestions, I would not seem to wish to detract from the value of Dr. Jackson's ably written paper, which is, indeed, the most exhaustive I have seen upon the subject. My desire is, simply, to bring before the profession a remedy which, I trust, will do as good service for others as it has for me.

BIBLIOGRAPHY.

A TREATISE ON THE FUNCTION OF DIGESTION; ITS DISORDERS AND THEIR TREATMENT.

BY F. W. PAVY, M. D., F. R. S.

Fellow of the Royal College of Physicians, &c., &c. Philadelphia: Henry C. Len, 1869. Pp.

246, 8-vo.

The subject of digestion is one of unusual interest, but being so fully discussed in all the works on physiology it seems to us that it might have been omitted in this, the design of which is mainly practical. Every physician may be presumed to have read as much as he has any curiosity to read about prehension, mastication, insalivation, &c., and will consequently be apt to pass by the chapters treating of these processes without notice. Writing as we do for the busy practitioner, we shall pursue the same course.

Dysphagia is one of the troubles pertaining to the function of digestion, and it is one which has its origin so generally in mechanical causes, or in malignant disease, that practitioners are too prone to look upon it as irremediable. Dr. Pavy mentions instances in which the difficulty in swallowing depended upon causes that were easily removed. A case is cited in which Sir B. Brodie relieved a dysphagia