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are terse and well knit. He does not dish up all the anecdotes of his predecessors; nor does he disgust us with the pedantry that strings together long words and rings the changes on latin names. He sketches the habits of the acarus scabia in a few brief paragraphs that will not fail to impress the reader, and describes the course and treatment of scabies as distinctly and as instructively. In this last respect we may take the opportunity to remark on the too constantly followed routine in this disease. Is it not time that sulphur ointment was deposed from the place it has so long occupied as the one cure for itch? This is perhaps but an illustration of the neglect of the study on which we have commented, and one of importance too. In hospital and dispensary practice, sulphur will long hold its ground, but there must be with private cases, numerous instances when the practitioner is glad to do without that drug. It can scarcely be too frequently repeated that we may cure scabies easily enough and more pleasantly without sulphur. That agent will accomplish the cito. In most instances it will include the tuto. But in only a few can it comprise the jucunde. Why should we be satisfied with two out of three indications of the old writers, when all may be as easily carried out?

Dr. Anderson's book is a sound, safe guide to practitioner and student. It is written as we have said, in a clear and terse style, in which the meaning is never obscured. We should add that the author's excellencies are enshrined in the best possible setting. Type, paper, printing, engravings are all of the best, and the edges are considerately cut; so that the volume may remain on the shelf without the injury that accrues from ragged edges, and is one of the handsomest that Messrs. Churchill have this year issued. It is but right we should add that the author thanks his friend Dr. John Wilson, for executing a number of accurate drawings from which the illustrations have been taken. These, both wood-cuts and lithographs, are all that can be desired, are no less than 33 in number, and we may add are embellishments worthy of the text.

Correspondence.

SUGGESTED INFANTICIDE AND ABORTION.

been so eminently successful as not to have lost a single patient. M. Perrève, you may remember, did not, with scarcely an exception, complete the dilatation at one séance, in any of the one hundred and fifty to two hundred cases, either fully, or partially, reported in his book. To this practice some would probably attribute his great success.

I have recently followed the method of not fully dilating the stricture by a single use of the forcer* at one séance, in the case of a man beyond middle age. The result has been most satisfactory. At the first operation I dilated the stricture with my double-bladed dovetailed dilator (Fig.) and one forcer, equal to No 11 of Weiss' catheter gauge. After the expiration of a few days a larger forcer was used, equal to No. 14 of the same gauge.

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TO THE EDITOR OF THE MEDICAL PRESS AND CIRCULAR. SIR,-In discussions on Malthusian doctrines and "remedies" for "over-population," it ought to be distinctly understood on all sides, that the medical profession absolutely refuses to have any hand in, or to countenance, any kind of infanticide, avid abortion, or means for rendering intercourse unfruitful (excepting, of course, those cases in which craniotomy or artificial abortion, may be necessaay to save the mother's life, proceedings which should always be sanctioned by a second opinion). I do not find that any such distinct understanding has been put forth; nothing has been said; and people have been left to form their own conclusions. Our opinion ought to be clearly expressed; it is time to speak out on this subject; and he is not true to his profession, but is a very unworthy member of it, who does not firmly refuse to countenance any such acts as those alluded to. Let this, the only sound and honest position, be openly taken up, and then, with this basis, no one need fear being misunderstood in whatever part he thinks proper to take in discussions upon this question. What conclusion may be come to, if any ever is, matters much less than that the character of the medical profession should stand firm and pure.

I am, Sir, your obedient servant,
W. E. C. NOURSE, F.R.C.S.

Brighton, April 2nd, 1889.

MONSIEUR PERREVE ON FORCIBLE DILATATION OF STRICTURE OF THE URETHRA.

TO THE EDITOR OF THE MEDICAL PRESS AND CIRCULAR.

SIR,-Having been anxious to ascertain the experience of my friend, Monsieur Perrève, upon the dilator treatment of stricture of the urethra since the publication of his "Traité des Rétrécissements Organiques de L'Urètre," in 1847, I communicated with him upon the subject, and received the courteous and important reply which I now append.

It will be perceived, from his letter, that he still follows the mode of using the dilator, described in his treatise, and has

The first of these sizes (No. 11) produces enlargement to an extent to which, I am well aware, M. Perrève would not probably dilate at a first séance; nevertheless, according to my experience, I considered it might be permitted with safety. The employment of the second size (No. 144) was produced by a moderately rapid action of the forcer, and with scarcely any pain.

The method usually adopted by M. Perrève, of not producing the full amount of dilatation upon the same day, appears to me to be well worthy of an impartial trial. Unfortunately, however, the sympathetic connection between the constitution and the urethra is so capricious (the most careful use of ordinary bougies and catheters occasionally leading to severe, if not fatal, results), that it is difficult to draw perfectly safe conclusions regarding some of the mechanical modes of treating stricture of that canal. One point is peculiarly worthy of re flection with respect to the treatment by means of dilators, namely, that although this mode of dealing with stricture has now been prominently before the profession for several years, and, like many other surgical procedures, has had, and, indeed, continues to have, its detractors, pathology has not yet unmistakeably solved the following question :-What is the probable state of the urethra in the majority of persons whose strictures have been submitted to this treatment? Such a necroscopic silence appears to me to be a powerful argu. ment in favour of mechanical dilators.

Apprehensive lest I may be misunderstood, let me, in conclusion, remark that whether we complete the enlargement either at one, or in two or more séances, my observation has convinced me that, in dealing with the urethra of these countries, the action of the dilator must be most extensive and complete, particularly in bad cases, or it will be of little service. Your obedient servant,

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Paris, Feb. 9, 1869. "MONSIEUR AND VERY HONORED CONFRERE, -In your kind letter of the 28th of January, you ask me for some observations upon cases of stricture taken, during my practice, since the publication of my "Traité sur les Rétrécissements de L'Urétre," in 1847; and you have obligingly added that you would record these observations in a medical journal.

"Had I foreseen such a friendly request, I would have taken notes of the patients I have treated; but, since my work was published, I have thought that cases were no longer rebladed dove- quired, and I have altogether ceased to take tailed Dilator.t them.

The double

*The wedge which divaricates the two blades of the dilator. +For a description of M. Perrève's instrument, see the numbers of this Journal for December January, and February, 1866 and 1867.

"Therefore, it is only from memory that I must consign to you notes of a few patients whose treatment presented difficulties; and I shall commence with :-

"1. Monsieur Goirin, by birth a Spaniard. This patient had entered the Hospital Beaujon, which he left after five or six days, without the surgeon having been able to pass the stricture with the finest bougies.

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'Immediately on leaving the hospital he sought me ; but, as after several weeks he had been in a state of almost unspeakable suffering, I treated him at his own house.

"The first séance was prolonged and difficult; nevertheless, without departing from the rules of prudence, I was able, on this occasion, to dilate the urethra two lines in diameter, which allowed the patient to micturate freely. The rest of the treatment, which was completed in three more séances, presented absolutely nothing abnormal.

"2. Monsieur Génin wrote to me from his bed, that, being confined by a complete retention, he begged I would repair to his house. (It was the physician of his family who persuaded him to take this step.)

"Three years previously, on the occasion of an attack of complete retention, a false passage had been made at the seat of the stricture; much blood escaped without in any manner changing the position of the patient. This circumstance, joined to the pains M. Génin experienced, rendered my first stance useless; the patient, however, micturated a little. The second séance was, I believe, also without result. It was otherwise with the third, for, on this occasion, I succeeded in clearing the stricture, and in carrying the dilatation to more than two lines in diameter.

"The remainder of the treatment did not present anything unusual. I think I performed four or five séances.

I perfectly agree with Mr. Crofton as regards the superior knowledge of practitioners who have served an apprenticeship to an Apothecary over those who deem three months' hospital dispensing quite sufficient for all future responsibility. I learn that the present state of medical education does not necessarily compel a qualified medical man to be able to know jalap from rhubarb, and if this be true a few years' manipulation with the pestle and mortar, under the guidance of an experienced pharmacist, is absolutely necessary to fit a physician or surgeon for the safe practice of his arduous profession. By the way, the words that I made use of in the Pharmaceutical Journal are not mine, but Dr. Leet's; and of course he is in a position to explain any ambiguity they

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DRS. CARPENTER AND WYVILLE THOMSON'S REPORT ON

DEEP SEA DREDGING.

"3. Monsieur X. (a Spaniard, whose name I must forbear By C. R. C. TICHBORNE, F.C.S., Mem. Coun. R.G.S.I., &c. to mention). This patient was treated, for more than a month, by one of the most celebrated surgeons of Spain, and as the treatment by this honorable confrère, in place of diminishing the disease, seemed, on the contrary, to increase it, he recommended him to come to Paris and submit himself to my treatment. The patient came. The treatment presented great difficulties; yet, after the expiration of three weeks, I had carried the dilatation to three lines, or three lines and a half

in diameter.

"I could give the cases of many other patients whose treatment presented difficulties more or less; but to what purpose, since, with a little time and much prudence, I have always triumphed over these difficulties?

"Before bringing my letter to a close, I must observe that we should never employ force against the obstacle, and that we should cease all dilatation as soon as we experience the sensation of a resistance overcome while we are pushing the wedge between the blades of the instrument. It is from having religiously observed these two precepts that I have never had the pain of losing a patient.

"Receive, my dear confrère, the renewed assurance of my friendship and of my obligations.

"VR. PERREVE,

"No. 69 Rue St. Honoré.

"Monsieur le Docteur Richardson."

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I think your correspondent has taken a very one-sided view of the case altogether. The leading article which he so unmercifully condemns must have produced a very peculiar impression on his mind. The remarks therein contained are perfectly consistent, provided that the Pharmaceutical Society of Great Britain can extend its influence to this country after the contemplated "Bill" has become law; and even should not such a beneficial change in the practice of Irish Pharmacy be effected-which is extremely improbable-you are only endorsing the opinion of such learned medical gentlemen as Sir Dominic Corrigan, Dr. Aquila Smith, and Dr. Acland, whose views on the subject are well known.

THE survey-ship "Lightning," having been assigned to the above service, was supplied with the most approved sounding apparatus and thermometers. Dr. Carpenter has forwarded a Preliminary Report to the Royal Society, which contains some important observations. As stated in Professor Thomson's original letter to Dr. Carpenter, the objects of the investiga

tion were as follows:

All recent observations tend to negative Professor Forbes' opinion, that a zero of animal life was to be reached at a depth of a few hundred fathoms. Animal forms had been proved to be abundant at a depth of 300 fathoms. Many of these are new to science. These forms differ greatly from those met with in ordinary dredging; and in some cases they seem closely allied to, and would seem to be directly descended from, the fauna of the tertiaries.

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One of the questions to be solved, is the effects of pressure upon animal life at great depths. "Probably," said Professor Thomson, a perfectly equal pressure to any amount would have little or no effect. Air being highly compressible, and water compressible only to a very slight degree, it is probable that, under a pressure of 200 atmospheres, water may be even more aerated, and in that respect more capable of supporting life, than at the surface."

These points have been in a great measure (determined by the late expedition :

It was found that a pressure of 100 atmospheres is not incompatible with animal life of numerous and varied forms. The distribution of the animal life of the seas beyond the Littoral zone is more closely related to the temperatures of the water than to its depth.

This brings us to a very curious part of the Report-Dr. Carpenter's remarks upon the minimum temperature; which he says is as low as 30° (0°6) over a considerable area. They say there is no physical improbability in the existence of a stratum of sea water at a temperature of 30°, or even 28° underlying a stratum at 39°, for sea-water, in virtue of its saline impregnation, contracts continuously down to its ordinary freezing point, which is below 28° Faht. M. Despretz says that the results of experiment prove that the maximum density of sea-water, cooled down continuously, without agitation, is 25-4 Faht.; when agitated, 27-4. "The cold waters doubtless come down from the North to replace the warm waters sent through the Gulf Stream to moderate the cold of Spitzbergen." Says Lieut. Maury, in recording the temperature of the Gulf Stream, "Its surface temperature was 80°." The deep-sea thermo

meter of the Coast Survey has recorded a temperature as low as 35°. The actinic rays seem to penetrate the sea-water to a great depth, for bright colours were not wanting-orange, red. Astropecten, and small annelides from 650 fathoms were distinguished by the vividness of their red and green colourations.

FURTHER REMARKS ON OCCLUDED HYDROGEN. Graham has assumed that hydrogen may be viewed as a hypothetical metal, which he has called "hydrogenium," and that palladium, with its occluded hydrogen, is merely an alloy of that metal. The density of palladium, when charged with hydrogen, could not be determined by the ordinary manner, because when immersed in water a continuous evolution of minute hydrogen bubbles are determined by contact with the liquid. However, the linear dimensions of the charged palladium wire are altered so considerably, that the difference admits of easy measurement, and furnishes the required density by calculation.

Supposing that the two metals (hydrogenium and palladium) united without any change of volume; the alloy would be a compound of Palladium 100 or 95.32 Hydrogenium 4.908 or 4.68 104.908

100.

The expansion of the palladium, from 100 to 104.9, appears enormous, if viewed as a change of bulk in the metal, due to any physical force, amounting, as it does, to eighteen times the dilatation of palladium when heated from 0° to 100 C. The density of the charged wire is reduced by calculation from 12:3 to 11.79. Again, as 100 is to 4.91, so the volume of the palladium 0.1358 C.C. is to the volume of the hydrogenium, 0.006714 C.C. Finally, dividing the weight of the hydrogenium, 0.01147 grms., by its volume in the alloy, 0.006714 C.C., we find density of hydrogenium 1.708. The density of hydrogenium then appears to approach that of magnesium 1.743 by this first experiment. On the further expulsion of the hydrogen from the wire, the latter contracts, and is after the experiment almost as much shorter as it was previously lengthened. The wire is permanently shortened; but the contraction is in length only. This is, however, partially due to the effects of wire-drawing in leaving the particles of the metal in a state of unequal tension. This tension is excessive in the direction of the length of the wire. The metallic particles seems to become mobile, and to right themselves as the hydrogen escapes. A wire so charged with hydrogen, if rubbed with a powder of magnesia, to make the flame luminous, burns like a wax thread when ignited in the flame of a lamp.

When the occluded hydrogen is expelled by heat the metal loses much of its power to take up hydrogen.

The tenacity of palladium-wire being 100, the tenacity of the palladium and hydrogen is 81.29. The tenacity of palladium is therefore reduced, but not to any great extent.

The addition of hydrogen adds manifestly to the small natural magnetism of the palladium. It appears, therefore, that the hypothetical metal hydrogenium is magnetic. This magnetism is not perceptible in hydrogen gas, which was placed, both by Faraday and Becquerel, at the bottom of the list of dia-magnetic substances. Hydrogen, associated with palladium, unites with chlorine and iodine in the dark, reduces a persalt of iron to the state of protosalt, converts red prussiate of potash into yellow prussiate, and has considerable deoxidizing powers. It appears to be the active form of hydrogen, as ozone is of oxygen.

ON THE METHOD OF ASSAYING SILVER COMPOUNDS IN THE WET WAY.

M. STAS proposes to substitute bromides for chlorides in estimating silver solutions, by Gay Lussac's process. This modification is introduced for the purpose of remedying the solu bility of the chloride of silver in the solution in which it is formed. The solution of the silver salt is not obtained by using a bromide.

TEST FOR NItrates and CHLORATES.

DR. BRAWN puts into a porcelain capsule 1 C.C. pure concentrated sulphuric acid, and then, drop by drop, C.C. solution of sulphate of aniline; the whole is then slowly stirred with a glass rod, the stuff to be tested having been previously

added.

The presence of a very minute quantity of nitrate will produce zones of a beautiful red colour, caused by the formation of fuchsine. A chlorate will produce a splendid blue colour; nitrates produce a red colouration.

SUGAR AND DEXTRINE IN GLYCERINE. THE following test is given :-Five drops of the glycerine to be tested is added to 100 or 120 drops of water, three to four centigrammes of molybdate of ammonium, one drop of pure nitric acid (25 per cent.); the whole boiled for about a minute and a half. If any sugar and dextrine are present, the mixture assumes a deep blue colour.

HYDROFLUORIC ACID.

MR. G. GORE describes the anhydrous acid in a paper read at the Royal Society. It was obtained by heating dry double fluoride of hydrogen and potassium to redness in a platinum apparatus. The lutings were of paraffin, sulphur, and lampblack. Nearly all the operations were effected while the vessels containing it were immersed in a freezing mixture.

The anhydrous acid is a most dangerous substance, and requires great care in its manipulation. It is colourless and transparent at 60° Faht., very thin and mobile, extremely volatile, and densely fuming in the air; it absorbs water very greedily from the air. It is perfectly retained in platinum bottles, the bottle having a clamp-screw mouth and paraffin washer.

The molecular volume was determined. One volume of hydrogen in uniting with fluorine produces not simply one volume of gaseous product, as it does when united with oxygen, but two volumes, as in the case of its union with chlorine. The specific gravity was 9879 at 55° Faht. The anhydrous acid is much more volatile than ether; its boiling point was found to be 67° Faht. Not the slightest sign of freezing occurred on cooling the acid to 30° Faht. On loosening the lid of a bottle of this acid at 60° Faht., it is expelled in a jetlike steam, as from a boiler. The acid had scarcely any effect upon any of the metalloids, or noble metals, and even the base metals, in a state of powder, did not cause any evolution of hydrogen. Sodium and potassium behave in the same

manner.

THE RELATION OF CHEMISTRY TO PHYSIOLOGY. MM. PELISSARD and A. CAHOURS have presented a memoir compounds. Ethylconia, and iodide of ethylconia, are like to the Academy on the physiological action of conia and its conia in this respect that they lead to poisoning of the pneumogastric nerves, differing, at the same time, in possessing a less energetic and more passing action on the voluntary nerves. In equal conditions conia is more poisonous than ethylconia; and is again even less poisonous than the iodide of ethylconia. The introduction of the radical ethyl with conia abolishes the period of convulsions which precedes the paralysis. This is particularly seen in poisoning by iodide of diethylconia. The animal falls incapable of making any voluntary movement.

ADULTERATION OF OPIUM.

MR. J. KING, in the American Journal of Pharmacy, notes the adulteration of this important and expensive drug. Sam ples were examined containing 14 per cent. of starch. The starch granules differed from any of the common starches, being larger than those of wheat and corn, and smaller than those from the potato; it approached more nearly the starch from the bean, both in size and form.

DICHLORO-ACETIC ACID AS A CAUTERIZER.

THIS acid has been prepared by Dr. F. Urner for this pur pose. It does not produce a strong inflammation upon the surrounding parts, and is accompanied by less pain than other cauterizers-stronger as well as weaker ones.

Gleanings in Medicine, Surgery, and the Allied Sciences.

A NEW METHOD OF ARRESTING HÆMORRHAGE.

ON the 21st of November, 1868, Dr. Frank H. Hamilton removed a schirrous breast, when he adopted the following method for controlling hæmorrhage during the operation: Dr. Hamilton says (New York Medical Gazette) in order to restrain the bleeding until the vessel could be secured by ligatures, I adopted the following procedure which I have never used before nor seen suggested by others: After the patient was fully under the influence of ether, I encircled the chest with two long strips of adhesive plaster, each of which was about two inches in width and long enough to surround

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the chest completely and allow the ends to overlap each other.
They were drawn tight, but not so tight as to interfere with
respiration. One of them passed under the breast at a point
about one inch from the line I had indicated to myself as the
probable line of incision; the other passed above the breast,
between it and the axilla, at about the same distance from the
projected upper line of incision; the two strips of plaister
forming an ellipse completely enclosing the breast. Within
this ellipse the incisions were made, and it was apparent that
by the pressure of the plaisters the bleeding from all the tegu
mentary and superficial muscularvessels was completely, or almost
completely controlled; so that the amount of blood lost in the op-
eration was comparatively trifling. On closing the wound I did not
remove these strips. This was an error which on another
occasion I should avoid, since they prevented the complete
and accurate coaptation of the tegumentary flaps and allowed
the margins of the wound to become everted.

SPONTANEOUS POPLITEAL ANEURISM OCCURRING IN A DIABETIC
SUBJECT; FAILURE OF MECHANICAL COMPRESSION; CURED

BY FORCED FLEXION.

difference in the results that had been secured with the usual forms of suture now in general use, including the double rows of interrupted silver suture and the button suture. He said, although the above limit of success had not heretofore been quite reached with his button suture, still he believed it would be with the valuable aid afforded by his late improve. ment, consisting of a self-retaining speculum and a supporting and confining apparatus. This he said did away with the necessity of assistants, and enabled him now to operate successfully upon a small class of cases previously unmanageable, The most obvious results from those improvements, however, he thought would be seen in the diminution of the number of operations actually required, and of the consequent suffering of the patient. In support of his statements, he then narrated five cases presenting seven fistulous openings, one a vesico uterine, all of which had been cured at six operations, since the adoption of the two improvements above made. The size of the fistula and the peculiar adaptation of his suture required in each of these cases, he illustrated with models made of buckskin and the same buttons that had been used, After summing up the results of these operations he called attention to the great value of the linen list which he had used a number of years as a means of diagnosis in cases presenting fistules so small as to escape the closest search with the probe, especially those opening into the cervical canal known as complicated with laceration of the anterior lip of the cervix uteri, and showed the importance of the procedure first adopted by him in their management. His classification of fistules, which is an extension of that of Velpeau, he still thinks is preferable to any other that has been proposed, it being considered more in harmony with the anatomical peculiarities of the parts involved and the modifications required in his suture apparatus to suit individual cases.

vesico-uterine. He also called attention to cases of fistule

ATROPHY OF THE HEART.

M. VERNEUIL Communicated a case of this to the Academy of Medicine of Paris, the interest of which consists in the coincidence of the diabetes, and in the fact of compression, which is usually so efficacious and so innocent, having failed and even produced local lesions of some importance. M. Verneuil terminated his narration with these propositions. 1. The coincidence of spontaneous aneurisms with diabetes, although it has not before been remarked upon, demands serious attention, as it exerts great influence in the choice of the procedure, and raises new questions on the etiology of aneurisms, and the composition and properties of the blood in diabetic subjects. 2. It almost absolutely contra indicates the employment of the ligature, and renders the application of compression very difficult, in consequence of the ease with which eschars are formed under the pads of the apparatus. The following general results are presented by Dr. N. FINN, 3. In spite of the presence of glucose, the blood appears to of the Pathologico-Anatom. Institute of St. Petersburg, as preserve its plastic properties, or, in other words, its aptitude to deposit fibrinous layers in the sac or active coagula. 4. The having been derived from the examination of one hundred hearts. 1. Simple atrophy is never developed as the only anti-diabetic regimen, so different from that ordinarily pre-morbid condition. It is unattended by a morbid condition of scribed during the mechanical treatment of aneurism, does not destroy this aptitude. It would seem, then, prudent to institute such treatment when the general condition calls for it, and to persist in it even after the real or apparent disappearance of the glucose. 5. In popliteal aneurism, the forced flexion of the leg on the thigh is a very important procedure calling for renewed trials. It is harmless, of easy application, and little onerous, inasmuch as it requires neither costly apparatus nor numerous assistants. It demands on the part of the patient a little intelligence and perseverance, and on that of the surgeon a surveillance easy of execution. 6. In some cases it has been attended with very rapid success in the hands of the English surgeons; but in those in which its first trials prove fruitless, it may eventually succeed by employing short séances at long intervals. 7. Its efficacy doubtless depends upon certain conditions, which have as yet been little studied, such as the position and dimensions of the vascular fissure, the relations, dimensions, and consistency of the sac, &c. In the present case it has probably operated as indirect compression. 8. The prolonged, unnatural direction imparted to the knee-joint has given rise to no serious inconvenience, the articular stiffness gradually disappearing and the limb recovering all the amplitude of its movements. 9. The cure, it must be admitted, required a very long time; but then it must be recollected that without flexion it might have been altogether impossible, and most certainly would have been more painful and dangerous. 10. It is true that attitude has been aided by other accessory means, such as direct and indirect compression, but it is to it that recovery is chiefly due. It confirms the conclusion that, in difficult surgical cases, the practitioner, far from obstinately confining himself to a single means, should assemble, combine, and concentrate all the resources which science has placed in his hands.

THE IMPORTANCE OF CERTAINTY IN THE OPERATION OF VE-
SICO-VAGINAL FISTULA, AND THE BEST MEANS OF SECURING
THE GREATEST SUCCESS.

DR. BOZEMAN, in a communication to the Medical Society of the State of New York after stating that the maximum of success was 92 per cent. of all cases consecutively presented treatment, endeavoured to show from statistics the real

the cardiac blood vessels. 2. Neither the absolute or relative weight of the heart, thickness of its walls, nor their reduced circumference can be received as a certain indication of the presence of atrophy of the organ. 3. The brown atrophy of the heart, so-called from a morbid change in the colouring matter of the muscular tissue, is a common accompaniment of all diseases attended with great emaciation. 4. Fatty degeneration of the heart (fatty infiltration) occurs chiefly in persons who have a large development of the subcutaneous adipose tissue; the infiltration is often to such an extent as to prove troublesome. 5. Fatty degeneration of the heart occurs as an acute or a chronic affection. It is observed more frequently on the right than on the left side of the organ. In some cases the entire substance of the walls of the ventricle are affected, in others only a portion. In the chronic form there is always atheromatous degeneration of the cardiac blood vessels. The arcus senilis is never met with in cases of fatty degeneration of the heart.-Centralblatt f. d. Medicinisch. Wissenschaften.

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MODERN HOMEOPATHY.

From the London Monthly Homeopathic Review for June, 1868, we learn that Lord Ebury gave vent to a feeling of regret that the report of the London Homœopathic Hospital did not contain evidence of a greater development of the objects of the institution. The number of patients was not very large, and the clinical lectures had been given up, owing to the attendance being so scanty as greatly to discourage the lecturers." In the London Homœopathic Hospital, in which the cases are not of so serious a character as wash is applied to syphilitic sores, and -grain doses of merone is accustomed to see under treatment in hospital, black cury given internally. Cases of glandular enlargement in the neck were treated with tincture of iodine painted on externally. For cases of continued sleeplessness 1:48 of a grain of acetate of morphia was given every fifteen minutes. The Hospital physicians repudiated, one and all, the fallacies and absurdities of Hahnemann about infinitesimal doses and dilutions. They frequently told inquiring physicians that "the doses were not a part of their system; that like cures like was all their creed; although it is not a matter of general or partial belief that morphia keeps people awake, that iodine produces enlargement

cases "

of the gland, and black wash produces syphilis. These Hospital physicians, and many others, have at last returned to the use of the medicines of the rational school in appreciable quantities; and the editor says the treatment in the above was far too like allopathy to be advisable in a homoeopathic hospital," although "so long as the doses of mercury did not produce mercurialism, our opponents cannot (or rather should not) complain." He also said he would avoid painting a glandular enlargement in the neck with tincture of iodine publicly in a homeopathic hospital, although he might unhesitatingly do it in private practice. And formally admits:"As regards the giving of morphia for sleeplessness, however necessary it may be considered by the medical attendants, it cannot be called homoeopathic treatment." The homœopathic editor trusts his readers will thoroughly understand that he has no wish to object to those methods of treatment per se, although unsuitable for a hospital called homoeopathic. We are hardly surprised to find that Dr. Yeldam, physician to the Homœopathic Hospital, in what is called an excellent speech, delivered at the annual meeting of the Institution, referred to the possible expediency of a middle school which would embrace both homoeopathy and allopathy; and Dr. Reith said he knew many homoeopathists who are prepared for the coalition. The editor of the Homeopathic Review "has not the slightest doubt that some such step, (or surrender) would be fraught with incalculable advantage to practical medicine," and it remains for us to see in what it should consist. If Hahnemann was so utterly mistaken about the efficacy of his infinitesimal doses; if every observation which he made upon the sick was an error; if every supposed cure was simply a recovery, it is not only not possible, but probable, that much of his reasoning and theorising about the similia similibus curantur is also false? If the frank and practical homoeopathists must make such large concessions about the dose, will they not also be soon obliged to make equally large concessions about the theory? If we can judge from the following prescriptions, some of the homoeopathists can make every required conces sion: Quin. sulph., gr. viij; ext. cannabis ind., gr. iv ; ext. aconit. rad. gr. iv. Make 8 pills; 1 every three or 4 hours. Fr. Hydrarg. sub. mur., gr. iij; mass hydrarg., gr. iij; aloes, gr. iij; podophyllin gr. . Make 4 pills; to be taken at once. F. Magnesia sulphat., 3 oz.; tinct. cort. aurant., 16 oz.; acid, sulph. aromat., oz. M.

KRISTELLER'S METHOD.

HERR HILDERBRANDT referred (Berliner Klin Wochenschirift) to this method of expressing the foetus, at a meeting of the Königsberg Med. Society, April 14th, 1868. He first resorted to it with great hesitation, and in a case favourable for the trial it succeeded so well as to astonish him. It was in the case of a second pain, in transverse position, head on left ilium, four extremities presenting. An assistant had failed in an attempt to turn by the feet. H. put back both feet, then the arms, caused the head to present, by means of pressure from without then made one or two strong compressures a la Kristeller, and saw, during the same, the rapid and happy birth of a living child. Since then he has tried the method in a number of cases, and recommends it.

EARLY TREATMENT OF THE INSANE.

In the province of Westphalia the directors of the Marsberg and Lengerich Insane Asylums have ordered that native par tients shall be subsisted free of cost during the first year of their malady. This is done in order that cases may be placed under treatment while yet in the initial stage. They claim to cure 80-90 per cent. of all cases admitted during the first month of the disease, fewer with every additional month, and. assert that incurability is the rule ofter one year's duration. -Berliner Klinische Wochenschrift.

INTESTINAL PUNCTURE IN TYMPANITES.

UNDER the advice of Dr. Foussagrives, intestinal puncture, as a last resource, has been several times practised at Toulouse, on two patients suffering with tympanites. In the first case, the abdomen formed an immense mass; the patient was perfectly cyanosed and suffocating. An exploring trocar was inserted into the most distended part of the lower umbilical region. The gas escaped so violently as to extinguish a candle. The distension returning next day, two fresh (puncture were made in different places, and gave so much relief that the life of the patient was prolonged four days. In another case six punctures were successively made until the gases were naturally evacuated, and the patient cured.-L'Un. Med.

WEIGHT OF THE BRAIN.

AT a meeting of the Vienna Society for Psychiatria and Forensic Psychology. Prosector Dr. Meynert gave some statistics on the weight of the brain. His deductions from the weight of 351 brains, as well as those of Parchappe from 284, prove that the influence of psychoses is much greater than age on the weight of this organ. For example, during the physiologically blooming age of the brain's weight (30-40 years in males), a mean of only 1,317 grammes was given, because brains of the later stages of psychoses were mingled with the others weighed ; on the other hand, in the primary stage of psychoses, without regard to age, a mean of 1,329 grammes was given for conditions of depression and 1,359 for mania. Furthermore, the reduction of weight was always equal to the duration of the disease. It was also found to depend upon the intensity of the latter, as paralytic idiocy was characterized by a great reduction of weight. Meynert also found that insane brains had more cerebellum, proportionally, than sane; and that insane females had more that insane males.

PERTUSSIS.

OPPOLZER says (Wiener Med. Presse) narcotics and astringents appear to reduce the duration of the disease about onehalf. Belladonna is probably the best, but simply because of its narcotic action. Tannin acts well in the third stage, or that of expectoration. In the case of children one or two years old, he began with pulv. rad. belladonna, gr. 1-12th morning and night, gradually increasing up to gr. 1-8th, or gr. 1-6th, taking the pupil as a guide. Emetics are only given when the bronchial tubes are filled with masses of mucus. To those who were arrived at years of discretion, he also gave sodæ bicarb. 3ss., in a tumbler of sweetened water, a mouthful to be swallowed just before an anticipated paroxysm, for diluting the phlegm. The following also acts well the same part :— R Coccionella, gr. v.—viij. Potassæ carbonatis, gr. x. Aquæ f. dest., f. 3j. M. Sig. Give a tablespoonful every two hours.

Change of air is good, even if patient can be 'removed but a few miles. If this is not procurable, keep the patient in a room with an equable temperature. For the resulting anæ mia use good diet. Dr. Link's extract of meat is good. Medicine may also be required.

In conclusion, it may be stated that of late many French physicians recommend the exhalations from lime which has been used in purifying burning gas, or, better still, gazeol Oppolzer has had no experience with these remedies.

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entertained of their recovery.

COD FISH skin, heretofore considered quite worthless, and given away to any one who would take the trouble to haul it, is now, after having been ground fine, to be used as a fertiliser. This new kind of guano is said to be free from the disagreeable odour of the ordinary fish manure.

CONVALESCENT HOME FOR WOMEN AND CHILDREN.-The

Oxford University Amateur Musical Society have announced funds of the St. Mary Magdalene Convalescent Home for a concert for this evening at Willis's Rooms, in aid of the Women and Children leaving Queen Charlotte's Hospital. Elizabeth and Mary Chulkhurst, joined together by the hips HISTORICAL; 1100.-At Biddenden, in Kent, were born and shoulders, and who lived in that state thirty-four years, at the expiration of which time one of them died; the survivor refused, saying, "As we came together so we will also go towas advised to be separated from the corpse, but she absolutely gether," and about six hours after her sister's decease she was taken ill and died also.-A B C Advertiser.

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