ment of the law in regard to those assuming medical degrees which they do not possess, as I can name several who, relying on the unwillingness of medical men to prosecute, boldly affix M.D. or Surgeon to their names. Would you believe that a gentleman could be so far lost to all promptings of honour and integrity, as to solicit a testimonial from an eminent M.D., who took him at his word, and stated that he was a Licentiate of a Royal College, who deny, on inquiry, that any such person ever obtained their diploma? I would feel obliged to any gentleman who would give me information on the following case, as to how the hero could be brought to a sense of duty and a knowledge of his proper position: A Friendly Society in Dublin was lately competed for, and a Mr, D- was elected. Now this gentleman is registered as a Licentiate of the Apothecaries' Hall, Dublin (though proposing himself as a surgeon). Again, he calls himself Doctor on his time-cards, and emblazons his window screens with Doctor D-, Surgeon, in four-inch gold letters; yet modestly styles himself as Apothecary and Accoucheur on his bottle labels. He does not hold any surgical diploma. Is he not liable to prosecution on two charges? For holding the appointment of surgeon to a friendly society, and taking the title of Surgeon unlawfully? Now-a-days, that quackery outside the profession shares deservedly a large portion of our resentment, and defies, under existing legislation, a severe punishment or just suppression, we ought to be doubly cautious of quacks within our own sphere, who, either by advertisement or assumption of degrees, seek to mislead the public. Hoping you will give this early insertion, A DICTIONARY OF MATERIA MEDICA AND THERAPEUTICS. Our author wishes to guard against being thought to cater for the notice of the unlearned public, and therefore he tells us that his work is intended "as a book of reference for the busy practitioner, whose memory may now and then require assistance, or who may wish to be guided in difficult cases by the formulas of others." of practitioners in countries where the officinal preparations Again, it must be confessed, that either prescriptions should be written altogether in English, or, that, at least, the Latin used should be grammatical; but whether it be due to the carelessness of the several prescribers, or to want of time in the editing of the work, there can be no doubt that the blunders are too numerous to be made light of. The genitive case is often omitted when it should occur and inserted when the accusa. tive should appear. Such sentences as " ut fiat pilule viij," "Capiat cyathus vinarius," "cum vitelli ovorum vi," and a host of others equally shocking, are surely more than can be set down as printer's mistakes. Such genitives as "querci" and "spiriti" make their appearance now for the first time in the Latin language. We fear that in attempting to curtail the characters of the drugs, Dr. Wahltuch has often omitted those which are most specific, and we feel sure that the directions given for making most of the preparations are so wanting in accuracy of detail that they would be useless to any one who did not possess a copy of the Pharmacopoeia. There is, however, a very fair list of the various synonyms of the drugs, and this will prove useful to those who may have to consult the works of French, German, Russian, or Italian authors. 66 We cannot see any special advantage in the classification adopted by Dr Wahltuch: it perpetuates such worn-out terms as alterative," and it groups together deodorisers and dis infectants under the antiseptics! We cannot see why nitric acid is not quite as much an antalkaline as sulphuric acid, and we are surprised to find mustard omitted from the emetics while such doubtful emetics as scoparium and buckthorn are in cluded. in the end of the work, and, what we are always glad to see, Gleanings in Medicine, Surgery, ERGOT IN THE TREATMENT OF PURPURA. great success in the treatment of purpura hæmorrhagica with DR. BAUER, of Neutershausen (Deutsche Klinik), reports oftener, daily, until hæmorrhagic manifestations cease. When He gives 8 to 10 grains three times, or anæmia remains he treats it with chalybeates. Now we think that if the "busy practitioner's" memory fail respecting doses and the most ordinary therapeutic and phy-secale cornutum. siological actions of drugs, he would at least prefer a more portable volume than that which Dr. Wahltuch has presented him with, which is larger and heavier than the British Phar macopoeia. We cannot see anything to recommend the tabular form in a work on materia medica where the object is minute detail for reference, as with a good index there can be no delay in ac. quiring this information from any good book on the subject. On the contrary, the tabular form excludes all that minute detail respecting the conditions which modify the dose and action of drugs, without which it is impossible for any scientific physician to write a rational prescription. There is an old saying that "what is one man's food is another's poison," and while Dr. Wahltuch recognizes the truth of this as regards the empiric use of formulæ, he does not hesitate to encourage the malpractice by grouping together the formula ATROPIA AS AN ANTIDOTE TO OPIUM POISONING. DR. M. S. BUTTLES relates (Med. Record) the following case occurring in his practice, which shows the value of belladonna in cases of poisioning by opium :-" Mrs. W. aged 38, had been troubled with retroversion, perimetritis, and severe endometritis, and has had several severe attacks of pericarditis, which have left extensive adhesions. Had severe neuralgic pains all along the left side, for which I had been in the habit of giving her subcutaneous injection of gr. ss morphic sulphatis. On January 20th last, I gave her one of these hypodermic injections, which gave but slight relief; the next morning I repeated it injecting exactly m xv. Magendie's solution (equal to gr. ss morphia), and remained in the room fifteen or twenty room. Medical News. A MONSTER.-A human monster, a female child with two ation has shown that the spinal column divided into two at the first of the true vertebræ, and that from this point two perfectly developed necks and head proceed. The breast is half We have not yet heard in how far the internal construction of as broad again as is usual, the limbs simple and well formed. the breast is simple or complex. It appears that the child died in the course of birth, from the pressure of the two heads against each other.-Galignani. minutes, when she seemed a little easier, and I retired to my office down stairs; but was very soon summoned by the nurse, who stated that Mrs. W. was dying. I found her lips purple, the respiration seven per minute, no pulse at the wrist, but one sound at the heart; pupils contracted to a fine point, frothing at the mouth, and the extremities cold. I commenced arti-heads, was born a few days ago at Zerbst. A careful examinficial respiration (for while I was cogitating on my handiwork, she entirely stopped breathing), which by myself and assistants was kept up for about half an hour, when I attempted to give her some strong coffee, but she could not be made to swallow. I had sent for several neighbouring physicians, who were all out; but just at this moment my friend, Prof. Chas. A. Budd, providentially called on me, and was immediately shown to the He declared that she was dead, and laughed in his sleeve' at the idea of keeping up artificial respiration. By this time I began to think of sending for an undertaker (for she had come to me from a neighbouring city for treatment), but as a' drowning man clings to a straw,' so I was eager to give her every possible chance, and asked Dr. Budd to suggest something, at the same time mentioning belladonna, when he said that atropia might be given hypodermically, if I wanted to do something, but as she was dead it would not bring her round. We resolved, however, to try it. By this time artificial respiration had been kept up for an hour and a half. One-sixtieth of a grain of the sulphate of atropia was injected, and in fifteen minutes she showed signs of life, the pupils began very slightly to dilate, and in ten minutes more she began to breathe, and the respirations rose to twelve per minute; in half an hour we repeated the dose, making in all one-thirtieth of a grain of atropia; and in about fifty minutes from the time of giving her the first injection, she returned to consciousness, and is living, now, with a blank in her life of two and a half hours. To Prof. Budd is due the credit of suggesting the remedy." LACTATE OF ZINC IN EPILEPSY. DR. HART has tried this remedy in combination with belladonna on 240 patients in the Western Lunatic Asylum in Kentucky, all of whom had been affected with epilepsy from three to six years. An improvement took place in all, and in no case did he use it without effectually controlling the paroxysm in from twenty-four to forty-eight hours. His formula was: R. -Zinci lactatis gr. xxx; ext belladonna gr. viii; M. ft. pil. x. S.-One before each meal.-Humboldt Med. Archives. OPIUM AND STRAMONIUM. DR. J. F. TREUMAN was called to see a mother and two daughters. They had had paroxysms of ague, and had taken. they supposed, fennel-seed, but it proved to have been stiamonium-seed instead. When first seen the mother and one daughter were raving like maniacs, while the other was rapidly sinking into coma. Tr. opii was at once given, and morphia injected subcutaneously. The youngest girl recovered rapidly, but the others only after having taken several large doses of morphia. The recovery in each case was complete.-Chicago Med. Journ. NEW USE OF IODIDE OF POTASSSIUM. DR. A. DE BEAUFORT (Bulletin de Therapeutique), reflecting that iodide of potassium is freely eliminated in the tears and uterine mucus, tried it in free doses in cases of chronic inflammation of the lachrymal tube and also in chronic metritis. His success was most decided. He says: "In cases of internal metritis, with abundant leucorrhoea, and all that train of circumstances which render so many women miserable, I have often seen, when all other means have failed, prompt and decided amelioration, and, in some cases, a positive cure, result from the free use of iodide of potassium. "-Philadelphia Medical and Surgical Reporter. ROYAL HOSPITAL FOR DISEASES OF THE CHEST.-The annual meeting was held last week at the hospital, City-road. The Secretary read the report, which stated that during the year 142 in-patients and 3,772 out-patients had been relieved. Mr. J. G. Glyn, M.P., had resigned the office of treasurer, on his important appointment in the House of Commons, which had been subsequently filled by the late treasurer's brother, Mr. Pascoe C. Glyn. The receipts from all sources had been 2,0907., while the expenditure had amounted to 2,4137., showing a balance due to the treasurer of 3231. The report having been received and adopted it was announced that H. R.H. Duke of Cambridge had consented to take the chair at the forthcoming annual dinner. THE GREAT NORTHERN HOSPITAL.-The triennial festival in aid of the funds of the Great Northern Hospital, Caledonian road, was celebrated last week, when about 150 gentlemen sat down to dinner under the presidency of Lord Houghton. From the annual report of the institution it appears that this hospital on account of its proximity to two of the large metropolitan railway stations and the cattle market, is peculiarly subject to the influx of dangerous casualties and the pressure on the accommodation is very great. The hospital has recently entered upon enlarged premises, and it possesses a large out-patients' department, which is daily frequented by a large number of sick poor. An average of 400 new patients are admitted each week. For the new premises the committee have paid 6,000l., leaving a debt of 3,000l. still to be removed. During the twelve months ending on the 30th June last 56,045 out-patients were relived, and 297 in-patients, a total number of 590,093 patients having been relieved since the hospital opened in 1856. In the course of the evening, Lord Houghton in an appropriate speech urged the claims of the institution upon the support of the benevolent so successfully that the sum of funds of the hospital in the course of the evening. 6677. 1s. was announced as having been contributed to the MEDICAL SOCIETY OF LONDON.-The ninety-sixth anniversary dinner of this Society was celebrated at the Albion Tavern, on Monday, the 8th inst., under the presidency of Dr. Richardson. Amongst the distinguished guests, were Sir Wm. Fergusson, Bart., the President of the Clinical Society Mr. Paget), the President of the Obstetrical Society (Dr. Graily Hewett),Mr. Hepworth Dixon, &c. &c. Nearly 70 Fellows of the Society were present, and the evening passed off with eclat, previous to the dinner, Sir Duncan Gibb delivered the Annual Oration after which, the President, with a few appropriate remarks, presented the Silver Medals for the year-one to the retiring Secretary Mr. Francis Mason, the other to Dr. Henry Day of Stafford, and the Diploma of the honorary Fellowship to Dr. C. J. Hare, one of the past Presidents. The following is a list of the newly elected Officers and Council for the ensuing session. List of Officers and Council for 1869-70.-President :Peter Marshall, Esq.; Vice Presidents :-John Gay, Esq; George Buchanan, M.D.; Andrew Clark, M.D.; William Adams, Esq.; Treasurer: C. H. Rogers-Harrison, Esq; LibraHORING in the Wurtemb. Med. Corr. Bl., 1868, relates the ian :-S. Day-Goss, M.D.; Secretaries in Ordinary :-A. case of a child three and a half years old, that swallowed a Ernest Sansom, M.D., J. Wickham Barnes, Esq.; Secretary solution of one gr. atropia in three drachms of water. Vom for foreign correspondence :-J. Althaus, M.D.; Councillors : iting occurred, and very promptly symptoms of poisoning. A-W. Cholmeley, M.D., C. Cogswell, M.D., Victor de subcutaneous injection of one-eighth of a grain of morphia was promptly practised. Very soon a decided improvement in the condition of the child took place. The pulse fell at once from 160 to 120; the respirations from between 30-32 to 28. By the end of 45 minutes consciousness and speech had returned. In a few hours the child was fully restored, with the exception of some dilatation of the pupils, which continued a few days longer.-Centralblattf. d. Medicinisch. Wissenschaften. CASE OF POISONING FROM ATROPIA. Méric, Esq., R. W. Dunn, Esq., W. Tilbury Fox, M.D., NOTICES TO CORRESPONDENTS. Mr. W. S. WHATFORD, Brighton.-In an early number. Dr. GEORGE Down will please received our best thanks. TO THE EDITOR OF THE MEDICAL PRESS AND CIRCULAR. SIR,-Would you be so kind as to inform me, through the columns of your Journal, what the best mode of procedure would be in order to secure an appointment as surgeon to one of the steam ships plying between this country and America. I have applied more than once to some of those so-called "agents," but without success. Also the remuneration given to a surgeon for his services, or whether there be a fixed stipend for the voyage? By doing so you will greatly oblige, Yours faithfully, A SUBSCRIBER. NOTICE TO ADVERTISERS. The Medical Press and Circular OFFERS UNUSUAL ADVANTAGES FOR the Insertion of announcements from its extensive and largely increasing circulation in each of the three divisions of the United Kingdom and the Colonies. Being also supplied to the Hospital Libraries, &c., it will be found a most valuable medium for Advertisements of Books, Vacancies and Appointments, Sales, and Transfers of Practices, Surgical Instruments Chemicals, and Trades generally. The scale of charges is as follows:- One £0 3s. 6d. 0 Os. 6d. 1 5s. Od. 2 5s. Od. 4 Os. Od. The average of words per line is twelve. Advertisements for Insertion in this Journal must be at the *"Apropos of ship appointments, they are mostly secured by private interest; those under the Commissioners of Emigration are subjest to great competition; the Peninsular and Oriental Company's appointments are still more eagerly sought, and are, therefore, more difficult to secure; next, perhaps, in order, might be placed some of the private firms, and the American packets. The Royal Mail service is more accessible, because all the new appointments are made to the ANATOMICAL, SURGICAL, AND ORTHOPEDIC West India stations, from which the medical officers are promoted to other and more eligible stations. Some very respectable agents give their special attention to such appointments." SIR, MECHANICIAN, 29 Leicester square, W.C. Having succeeded to the Business carried on for so We are not aware of the remuneration given to surgeons on board Cassedy; Messrs. Nelson and Son, Leeds; Mr. Holmes Coote, London; APPOINTMENT ADAMS, J., Esq., F. R.C.S.-Consulting-surgeon to the London Hospital, BUSH, WILLIAM. M.R.C.S.-Sole Medical Officer to the Bath Ear and CHEADLE, W. B., M.A., M.D.-Assistant-physician to the Hospital for BOOKS, PAMPHLETS, &c., RECEIVED. The History of the Poor-law. Annual Report of the Devonshire Hospital. California Medical Gazette. Trubner's Oriental Literary Record. The Monthly Homoeopathic Review. The Practitioner, for March. The Monthly Microscopical Journal. On Catalepsy. By Adolphe Wahltuch, M.D., &c. Churchill and Sons. London: John Managing Assistant for thirty years, I beg to solicit a continu ance of those favours which have hitherto been so liberally bestowed. I take this opportunity of informing you that my great experience in the Military and other Hospitals, together with private cases of a very numerous kind, render me fully competent to undertake and carry out any instructions entrusted to me. Should my services at any time be required, I shall be at your commands. I beg to remain, Sir, Your obedient servant, WILLIAM MILLER. TWINBERROW'S PATENT DOUBLE-ACTION SYPHON SYRINGE, with ADDITIONAL PIPES FOR ALL PURPOSES, possesses these advantages:-1. It is WITHOUT A PISTON; therefore, There is No EXERTION required in its use. AS THE STREAM FLOWS UNINTERRUPTEDLY, DOUBLE the QUANTITY is discharged in HALF the USUAL TIME, with double effect. From J. ERICHSEN, Esq., Professor of Sur gery at University College: "TWINBERROW'S DOUBLE-ACTION SYPHON SYRINGE is the most generally useful Instrument of the kind with which I am acquainted, being COMPACT, PORTABLE, and NOT LIABLE TO GET OUT OF ORDER. It may be rendered available as an EYE DOUCHE, an EAR SYRINGE, and for WASHING OUT THE BLADDER. For these purposes it is peculiarly well adapted, being CONTINUOUS IN ITS ACTION."-From SIR W. FERGUSSON, BART., Professor of Surgery at King's College: "I have seen and made use of your DOUBLE-ACTION SYRINGE, and think very highly of it." TWINBERROW & SON, Dispensing Chemists, Sole Patentees. 2, Edwards-st., Portman-square, and 45, Westbourne-grove, London. HUXLEY'S SPIRAL ABDO MINAL BELTS, for Pregnancy, Obesity, Ovarian Disease, and Air-pads for Hernia. Made on principles approved by the first Physician - Accoucheurs and Surgeons. Directions for measurements: circumference, at a, b, c; depth, from a to c. Discount to the profession, 20 per cent. HUXLEY'S OBSTETRIC BINDER, 3s. 6d. HUXLEY'S PATENT MOC MAIN TRUSS, in which the troublesome lever spring is entirely dis pensed with, is acknowledged by hundreds of wearers to be the most comfortable and efficacious Truss yet devised. Prices, to the Profession only: Single, 98. and 128. Double, 14s. 3d. and 17s.,-nett. ED. HUXLEY, 12, Old Cavendish street, Oxford-street, London. Agents for Calcutta: Messrs. Bathgate and Co. Bombay: Rogers and Co. Montreal: R. Birks. "SALUS POPULI SUPREMA LEX." WEDNESDAY, MARCH 31, 1869. 266 CONTENTS. ORIGINAL COMMUNICATIONS. On Stricture of the' Rectum. By Holmes Coote, F.R.C.S., Surgeon to St. Bartholomew's Hospital.. On the Mode of Action of the Cholera Poison: By Arthur E. Sansom, M.D. Lond., M.R.C.P., Physician to the Royal Hospital for Diseases of the Chest...... On Infanticide and Abortion as Suggested Institutions. By Ewing Whittle, M.D., M.R.L.A., Lecturer on Medical Jurisprudence and Toxicology to the Liverpool Royal Infirmary School of Medicine A Case of Pyæmia with PneumothoraxDeath by Coma. By Richard Barwell, F.R C.S., &e..... PAGE 263 264 265 A Practical Treatise on Metritis and Para- .... 281 282 282 OBITUARY. 276 277 HOSPITAL REPORTS. METROPOLITAN FREE HOSPITAL AND FARRINGDON DISPENSARY. Cases of Syphilis treated without Mercury. By Charles R. Drysdale, M. D., M.R.C.P., F.R.C.S., and Robert W. Dunn, Esq., M. R.C.S. Via Medica.. The Neil Arnott Exhibition in Physical Original Communications. ON STRICTURE OF THE RECTUM. By HOLMES COOTE, F.R.C.S., CONTRACTIONS of the rectum may proceed from inflammatory effusion and from thickening of the walls of the gut, or from cancerous deposit. According to my experience the latter is the more common, especially when the patient has passed the middle period of life. The following remarks refer only to the non-malignant variety of stricture of the rectum. Now the esophagus and the rectum, the two extremities of the alimentary canal, are, though both exposed to causes inducing contraction, placed in a somewhat different physiological condition. The food, properly masticated and softened, passes rapidly down the former passage. But in the rectum, the faces, often hard and accumulated in abnormal amount, may be allowed to remain, giving rise to local disturbance, and occasionally to a state of general illness. I have not seen many cases of stricture of the esophagus that were not associated with cancer. In one case the cause was the contraction of a large cicatrix covering an ulcer made by the action of strong nitric acid on the mucous membrane, the patient having made an attempt to commit suicide. In another case the canal of the oesophagus, just below the level of the cricoid cartilage, was reduced to a quarter of an inch in diameter, and was flattened from before backwards. The tissues around were thickened, indurated, and consolidated. Above the stricture there was the ulcerated aperture of an abscess. Below the stricture the mucous membrane was healthy. Patients have also presented themselves with symptoms of spasmodic stricture, which were relieved by general treatment and the careful use of the bougie. The museum of the hospital gives the following illustra 277 Medical News, Notices to Correspondents. 284 tion of non-malignant strictures of the rectum. Series xvi No. 31. Portion of a rectum, the cavity of which, at its upper part, is contracted to a quarter of an inch in diameter without any visible change of structure. The contraction includes about an inch of the length of the intestine, and was probably occasioned by the action of the muscular fibres. No. 32 shows a case of general thickening and induration of the coats of the rectum, and a close annular stricture from two to three inches from the anus. Above the stricture the intestine is dilated, and the muscular coat is thick and strong; below it, there is diffuse superficial ulceration of the mucous membrane. Another specimen shows annular contraction, with thickening induration and superficial ulceration of its coats in the line of junction of the colon with the rectum. It was so close and firm that a finger could not be passed through it: except at this contraction of large portions of the canal. In one specispot the rectum was healthy. Several specimens show men, just above the anus, numerous ulcerated apertures, with smooth edges, led through the walls of the rectum into short fistulous canals in the surrounding indurated tissue. One of the canals extended through the coats of the bladder into the cavity. The whole tube of the rectum is narrowed. A middle-aged woman suffered many years from stricture of the rectum. After death it was found that the mucous membrane had been completely removed by ulceration to the extent of several inches above the anus. Abscesses had formed around and burst into the tube, and all the tissues were indurated and contracted. I have met with several cases of a thickened and tuberculated condition of the mucous membrane of the rectum in young girls, most of whom, however, had been leading a life of prostitution; indeed, I have at the present time a girl so affected under my care. The early stage of this disease may be illustrated by the following specimen. No. 64. The rectum of a girl, aged twenty-five. The mucous membrane is entirely removed by ulceration for several inches above the anus, and above the ulcerated part it is slightly thickened. In the more advanced stage we find the coats of the intestine generally thickened and of very dense texture, the mucous membrane in some situations tuberculated, and in others ulcerated, and the cellular ture. and adipose tissue around indurated. After a time the Thus we are justified in asserting that stricture of the rectum may be induced by prolonged irritation, leading to inflammatory induration, and to ulceration; the mucous membrane may become tuberculated; the surrounding tissues similarly changed, and, finally, adjacent organs also become involved and adherent. Of all causes, habitual constipation is the most frequent, and it is remarkable to what an extent in some persons fæcal accumulations are allowed to proceed. Some short time ago,being in a large country mansion to see professionally a lady somewhat advanced in years, I was surprised to find the only water-closet on the ground floor, at the end of some long and intricate passages. When commenting on the slight inconvenience of such an arrangement to the inmates, I was informed that the lady of the house rarely had an action of the bowels more than once a week. Both Mr. Travers and Mr. Ashton mention cases, in one of which an excessive growth of fat, and in the second a ❝large mass, very dense, and having the appearance of fat, but in reality composed of fibrous tissue alone," were the causes of stricture. (To be continued.) argued that the rice-water stools owe the peculiar flocculent appearance which they possess to the presence of epithelium; that, therefore, there must be, during the choleraic attack, not only a falling-off of the epithelial particles lining the intestinal canal, but also a rapid formation, growth, decay, and decadence of successive generations of epithelium. Further investigation has shown that this view is not tenable: the greater part of the denuded epithelium passes away in the stage of simple diarrhoea; which gives the flocculent character to the rice-water stools is not epithelium, but fibrillated mucus carried down by the albumino-saline liquid excretion. that The signs, however, do not admit the hypothesis of an irritant cause acting in a definite manner upon definite portions of the canal, as an inorganic irritant would act. It would seem that there are foci and loci in which the disease-producing molecules manifest their morbid activity; and this is just what, according to our own theory of causation by organised particles, we should expect. The cholera-genic molecules, swallowed under circumstances which permit of their active vitality, become irritants of the whole mucous tract. They find amid the epithelial cells of the alimentary canal a soil in which they can mul tiply with great rapidity; and, just as fungi of a larger growth will in a single night lift up by their development a heavy stone, so these increasing within and around the individual epithelial cells detach such cells from the subjacent tissues. Hence the irritation which excites the action of the bowels, and induces the diarrhoeal flow; thus, the epithelial cells, with some of the countless germs which have induced this exfoliation, become carried away from the organism, while others remain behind to continue their fatal work; thus, also, are produced (the epithelium being stripped from their surface) the eroded portions of the intestinal tract. Such are the views of those observers who hold to the ON THE MODE OF ACTION OF THE CHOLERA fungous origin of cholera. It has seemed to me that the POISON. By ARTHUR ERNEST SANSOM, M.D. Lond., M.R.C.P., Physician to the Royal Hospital for Diseases of the Chest, City Road. (Continued from page 201.) We have now to consider the probable mode by which the germs of cholera produce the flux from the intestinal canal. We may divide the duration of the flux into two periods-the one in which there is such evacuation as obtains in ordinary diarrhoea, i. e., a looseness without any specific character; the other in which is the condition known as "rice-water evacuation." If we agree that the cholera poison is directly transmitted to the surface of the gastro-intestinal tract, we may, with much prima facie probability, assign these effects to its irritant action upon the structures—an irritation which differs in degree, and so produces the diarrhoeal (pre-choleraic) or the true choleraic flow. Pathological anatomy teaches that in greater or less degree the whole alimentary tract presents signs of morbid action in cases of cholera. The pharynx and œsophagus have, in some cases, presented their mucous lining covered with soft pulpy detritus. The stomach has been found thickened as to its lining membrane, its solitary glands enlarged, and tenacious mucus and exfoliated epithelium free within its cavity. The intestines have shown signs of denudation of their epithelium; from patches of the mucous surface villi have been found completely detached; the glands of the intestines have been found enlarged. In the interior of the intestines have been found the shed epithelium and the detached villi, together with stringy and laminated mucus, hæmatin mingled with many organised bodies, evidently derived from the vegetable world, and vibriones and other infusoria in myriads. All these signs are consistent with the hypothesis of a cause which is a direct and violent irritant of the lining structures of the alimentary tract. So, also, is the evidence afforded by the examination of the evacuations themselves. It has been theory accounts for the symptoms with a great amount of plausibility, although, as I said before, I wholly demur to any conclusion which avers of such or such organised particle, "this is the efficient agent in producing cholera." I hold that whatever is observed may be but the index of what is not observed, and that, though certain bodies may be concomitants of the proliferation of organised bodies which are the disease producers, we are not justified in concluding that they are themselves the vera causæ. I have not observed, however, that in this question any analogical experimentation has been adopted. One of the first questions which I conceive to arise is-Have we any evidence that fermentation (growth of living vegetable particles) can take place within the living body, and can produce, proprio motu, morbid symptoms? Of course, it is known that in circumstances in which aliment is retained in the stomach, fermentation with the development of torule and of sarcinae can and does take place; but I do not know of any synthetic researches on this question. I have myself put the matter to a practical test, and I think the lessons cannot fail to be of much value. Fermentation within the living body.-In September, 1868, I was engaged in microscopic observations upon fermentation, the growth of yeast torule, and the effects of I determined to try the sulphites upon the process. whether the phenomena could take place within the stomach of an animal. I therefore mixed together German yeast and rice powder, and gave them as food to a healthy The mixture was readily eaten by the white mouse. animal, but twenty-four hours afterwards it was found panting and dying. Having given chloroform vapour to kill, I immediately examined the body. I found the stomach filled with a brownish red substance, which, on examination, proved to consist of stomach tubes detached from the walls of the viscus, a mass of cells of shed epithelium, together with vegetable spores and fragments of completely Portions of the stomach wall were torulæ. denuded, the exposed membrane presenting the appearance of thin parchment. The intestines, small and large, were |