PHYSIOLOGICAL AND PATHOLOGICAL NOTES.

A New Diphtheria Antitoxin.-The Archives des Sciences Biologiques, issued by the Imperial Institute of Experimental Medicine of St. Petersburg, contains some interesting information respecting the researches carried out by Dr. Smirnow on a new method of obtaining a diphtheria antitoxin of considerable therapeutical activity. The object which Dr. Smirnow had in view was to reduce the time and the expense involved by the present method of preparing the serum, and the method which he alighted upon was the electrolysis of virulent diphtheria broth cultivations. By this means he has succeeded in obtaining an antitoxin of great power, which gives excellent results even when employed in much smaller doses than those at present found necessary with the ordinary horse serum. He states that even in advanced cases of the disease the injection of from one-half to one cubic centimeter enables the animal to resist the inoculated disease without marked reaction, either general or local. seems that the new antitoxin is itself quite innocuous, for guinea-pigs can withstand with impunity doses ten times as strong as those required for curative purposes.-The Medical Press.

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Biological Basis of Menstruation.-J. C. Webster discusses the various theories which have been advanced to explain the meaning of menstruation. He believes that it is not a necessary accompaniment or sequel of evolution, but that there is some relationship between the processes, as is shown by cessation of menstruation in many cases after removal of the ovaries. mentions Lawson Tate's statement that removal of the tubes without the ovaries is followed in 95 per cent. of cases by the same result. A special nervous mechanism controlling menstruation, as suggested by Johnstone, probably exists, but to Webster it seems possible that it is plexiform rather than limited to a single nerve. The view that menstruation is a process by which the uterine mucosa is prepared to receive the fertilized ovum is rejected by the writer for many reasons, as are also other theories of the relation of menstruation to conception. The suggestion, advanced by Geddes and Thompson, that the menstrual process is related to the balancing of anabolism and katabolism in the female organism, is however, considered worthy of study

and forms the basis of the paper. He says that throughout the animal and vegetable kingdoms the distinctive characteristic of the male sex is katabolism and of the female anabolism, and he points out many reasons for this belief. In the female a surplus is produced in the system after puberty, because the anabolic preponderates over the katabolic. When pregnancy occurs this excess is spent in the nutrition of the ovum during its parasitic intrauterine life and during lactation. When these methods of using the anabolic surplus are wanting, menstrual losses occur in order that it may be disposed of. The rhymical character of the menstrual function has probably been gradually determined by the forces of evolution and its marked variations in the human female (unassociated with pathological conditions) point very strongly to an early period of instability in the process, in which the present variations are probably atavistic reminiscences. Although most concisely stated in the author's article, it is impossible to present his reasons for these views in an abstract. -Montreal Medical Journal.

Case of Tansy Poisoning.-W. R. Aylett records the following case:

Strange to say, few cases of tansy poisoning are recorded, and yet the drug is extensively used by the lower classes as an emmenagogue and for the purpose of abortion.

The case that came under my observation was that of a woman from the lower walks of life, aged 25 years.

The preparation used was the oil of tansy, the amount ingested not determined, but probably not more than two drachms. The dose was taken in the morning about ten o'clock, and no effects were observed for two hours. The patient then complained of nausea, muscular weakness, vertigo, and, in her words, "sickness all over."

This condition was followed by several epileptiform convulsions. and more or less stupor

Upon arrival at the Memorial Hospital the patient was comatose, extremities cold, pupils slightly dilated, pulse 88, respiration 44, and temperature 88.5° F. She passed ten ounces of urine, which, on examination, showed nothing abnormal.

Unlike puerperal convulsions, what little consciousness remained was not lost, nor was the general aspect one of eclampsia.

Several large fluid stools, containing much mucus, were now passed, and the intellect became much clearer.

Patient complained of cramps in the lower extremities and of violent pain in abdomen, which was tender to pressure. Pulse eight hours after admission was 100, respiration 36, and temperature 99° F. Eight ounces of urine passed at this time again showed nothing abnormal.

Patient improved steadily from now on, the only features of interest being the pain in the abdomen and the great variations of heart-action and respiration, the former varying from twenty to thirty beats in the half hour, and the latter showing changes equally as rapid.

Sixteen hours after admission only a moderate amount of tenderness over the abdomen, and a slight weakness remained, and in thirty hours the patient was discharged as cured.- Va. Med. Semi-Monthly.

Leprosy Bacillus.-The presence of the lepra bacillus was reported in the medulla of a man 46 years old, who died of syringomyelia (Royal Bacteriological Institute, Lisbon, Dr. Camara Pestana and Dr. A. Beltencourt). At the necropsy

there was found a gliomatous new formation of the medulla, which extended from the bulbous to the middle of the dorsal part, and showed strongest development in the neck region. The medulla was here strongly swollen, and presented a central cavity, while the nerve substance was reduced to a thin bundle, formed mostly by degenerated anterior columns. In the substance which coated the medullary cavity inside, the authors found bacilli, which colored with carbol fuchsin, according to Ziehl, and also with aqueous fuchsin solution at 30 to 60 degrees, according to Gram, and which inoculated into the peritoneum of a guinea pig produced no tuberculosis, and were, according to the opinion of the authors, undoubtedly lepra bacilla. "We do not think," says Scheube in his review in Janus, "this one essay at transmission to decide the question, whether the case was leprosy or tuberculosis, sufficient; whether the bacilli were isolated or aggregated, whether they were found in or between the eells, is not indicated. In the nerves-the nerves examined were medianus and radiatus-no bacilli were found.”—Ex.

DISEASES OF WOMEN AND CHILDREN.

Retroversion of the Uterus.-The results of one hundred and forty-seven operations for retroversion of the uterus were given by A. Lapthorn Smith, before the American Gynecological Society, at Washington, May 6th, 1897. His paper was based upon ninety-four ventrofixations and fifty-three Alexander's operations. He held that ventrofixation was the only operation that should be entertained in cases of retroversion with adhesions; but it should not be done when the uterus was movable and when there was no disease of the appendages requiring abdominal section, in which cases Alexander's operation had given excellent results. There should be no death rate to either operation, neither should there ever be hernia, either ventral or inguinal, if the following directions were followed. The two operations were equally easy, although a few years ago the author was opposed to Alexander's operation on account of its difficulty. Now he could invariably find the ligaments, and generally in from half a minute to a minute and a half. He warned his hearers not to do Alexander's operation if there were any adhesions, even if they were loose enough to permit the uterus to be lifted up; because they would be put upon the stretch and would drag so much upon the ligaments as to finally pull them out of their anchorage. In laying down the technique of Alexander's operation he placed great stress upon the importance of putting aside all cutting instruments as soon as the skin, superficial and deep fascia had been cut through. Instead of laying open the inguinal canal as advocated by some writers, he advised his hearers not to cut a single fibre of the intercolumnar fascia, which was the principal support of the pillars. Moreover, he said, the slightest nick of the facis of the internal oblique would lead to a false passage and failure to find the ligament. If no cutting instruments were used, but only a Pœans forceps to draw out the ligament there would be no difficulty in finding it, because there was nothing else in the canal but the ligament. In fact, with the eyes bandaged it could be found and drawn out, simply by introducing the closed forceps and then opening them, when the round ligament will fall into them and can be drawn out. He advocated the use of fine silk-worm gut which could be thoroughly sterilized and left in permanently. Occasionally he had been obliged to remove a buried stitch. In case any fibres of the intercolumnar or internal oblique should be accidentally

cut, great care should be exercised in sewing them up to avoid hernia. He had only had one relapse after ventrofixation and one after Alexander, which were both subsequently repaired. Several of the cases of ventrofixation had since become pregnant and had had normal confinements. Also several cases of Alexander had had children. Many of the patients had been bedridden invalids for years before and were now enjoying excellent health. Both operations, each in its proper sphere, had given the greatest possible satisfaction.

Vaginal Wash.-Dr. W. B. House, of Detour, Mich., recommends in the Medical World the following combination:

Sig. Use one teaspoonful in a pint of hot water for vaginal injection once daily.

Menorrhagia Due to Uterine Arterio-Sclerosis.- Reinicke has become convinced by the information derived from several necropsies that menorrhagia is frequently produced by sclerous degeneration of the uterine arteries. The impossibility to contract is therefore the cause of the continuous sanguine flow from the arteries, and the usual methods of treatment are necessarily impotent. He states that the failure of ergotin to arrest the flow may be considered presumptive evidence of the sclerosis. The only cure is ablation of the uterus. Except in very severe cases, he advises waiting for the menopause, with repose in the horizontal decubitus if possible, and vaginal tampons in the case of workingwomen.-Semaine Méd.

The Cyclical or Wave Theory of Menstruation, with Observations on the Variations in Pulse and Temperature in Relation to Menstruation.-Dr. Arthur E. Giles read before the Obstetrical Society of London a paper based on observations on the temperature and the pulse before, during and after menstruation.

The temperature observations embrace fifty menstrual periods in forty-five patients; from the fifty cases a composite curve has been drawn up, which may be regarded as the type of the temperature curve in relation to menstruation. It shows that the