be observed that in one experiment the urine containing urotropin began after some days to precipitate a crystalline sediment of phosphate of lime; if such a precipitate took place in the living body, it would, of course, be a serious inconvenience in the use of the remedy. -University Med. Magazine. Syphilis from an Insurance Point of View. as those in Class 2.-Edinburgh Med. Journal. A Convenient Remedy for Burns. In an Italian journal (Incurabili) Dr. Eriberto Aievoli has recently reported his experience with aristol in the treatment of suppurating wounds, varicose ulcers, suppurative inflammation of glands, frost-bites and furuncles. The drug was always employed in a 10 per cent. ointment, which was spread on sterilized gauze and applied to the affected area. In several cases of in Dr. P. H. Maclaren, of Edinburgh, in considering this subject without reference to general mortality statistics, from which it is difficult to obtain ac-juries of the head this treatment was curate information, states that he is inclined to classify for insurance purposes all syphilitics under the three following groups: 1. If a man has been properly treated, the probabilities are that, provided he is of good constitution and habits, no complications will arise, and the expectation would be that he will go through life with scarcely more appreciable risk than one who has never had the disease. 2. If proposer has not undergone a sufficient course of treatment, and applies for insurance before the expiration of six years, the period at which the disease normally terminates, and yet is not suffering from any tertiary manifestations, and is otherwise satisfactory, the chances are that he may escape the malign form, but 10 per cent. extra should be charged until the expiration of the six years, and the case then reconsidered. especially successful; lacerated and contused wounds at the orbital margin, which are often so slow in healing, healed with remarkable rapidity, the secretion soon diminished, granulations formed, and after a comparatively short time scarcely any scar was perceptible to the naked eye. In cases of varicose ulcers the results were not quite so good, because the patients were unable to obtain the rest so essential in the treatment. A surprisingly prompt effect was derived from aristol ointment, however, in ulcerating frost-bites. Thus, in a boy ten years old, who presented marked swelling of the dorsal surfaces of both hands, with ulcerations in some places, three applications sufficed to produce complete healing. Excellent results were also observed in burns. Two cases are described in detail relating to extensive burns of the second and third degree, which healed rapidly under applications of aristol ointment, while other remedies had proved inefficient. A special advantage of this treat 3. When tertiary symptoms have developed, the proposal should be absolutely declined, because, while treatment was the ease with which this ment may temporarily remove these, it cannot eradicate the tendency to recurrence; and clinical observation has shown that those so affected rarely live beyond a term of ten years, and often much less when palliative treatment is not carried out. While his personal experience is almost favorable regarding the prognosis of the cases included in Class 1, it is questionable when the cases are looked at, with the interests of the offices perfectly safeguarded, if they should not practically be treated in the same way dressing could be removed; owing to the slight secretion and the formation of healthy granulations, the dressings did not become adherent and could be removed without pain. The superiority of aristol over boric acid was constantly demonstrated. In conclusion, the author expresses the opinion that in fresh wounds, burns and frost-bites aristol is deserving of extensive application, as it fulfills all the requirements demanded of a remedy indicated in these conditions. These properties are, essentially, lack of toxicity, rapid relief of pain, and rapid formation of a non-contractile cicatrix. A New Method of Operating for E. Lawrie, M.B. (Edin.), Hyderabad, says the operation for the radical cure of hydrocele should be performed in the following manner: The sac is punctured in the usual way, and when about a third or one-half of the fluid has been withdrawn, two drachms of a saturated solution of bichloride of mercury in glycerine are injected and mixed with that which remains, and allowed to rest in the sac for from half a minute to a minute. The whole of the fluid is then drawn off to the last drop. Very little pain is experienced, and unless the patient is nervous and takes an anesthetic he is able to move about immediately after the operation. For the next few days he must, as a rule, lie about, but need not in any case be confined to bed, and in a week or less he is quite well. Provided the surgeon is careful that his hands and instruments are clean and free from micrococci when the puncture and injection are made, they produce a uniform result-i.e., sufficient aseptic inflammation to obliterate the sac and nothing more.-Lancet. Treatment of Face Presentation by Manipulation. In the Archiv f. Gynäkologie, Band li, Heft 2, Jungmann reports three cases of face presentation in which he succeeded in changing the presentation to an occipital one by a combined manipulation ascribed in various portions to Baudelocque, Schatz, and Thorn. The patient is anesthetized by chloroform and the shoulder of the child raised and its back moved obliquely in the direction best fitted to promote descent of the occiput by the external hand. The internal hand meanwhile raises the chin and brings down the occiput, maintaining it in the desired position until the patient wakes from the anesthetic and pains begin. When the occiput has engaged and flexion is secured the case is allowed to proceed spontaneously. Jungmann concludes that in cases seen before active labor has begun that Schatz's manipulation of raising the fetal body by external manipulation and procuring flexion instead of extension should be employed. When dilatation has begun and the chin is posterior, combined manipulation should be employed when two or three fingers can be inserted through the os and cervix; when the pelvis is normal or very little contracted, and when the fetus is movable. Anesthesia is usually required for this manipulation. Any condition of danger demanding prompt and rapid delivery is a contra-indication for the use of this method.-American Journal Med. Sciences. Conduct of Ordinary Labor Through External Examination Solely. Leopold and Sporlin (Archiv f. Gynäkologie) make a warm plea for limiting examinations made in the course of ordinary labor to the external parts, and the advantages of such a course. Infection is thereby avoided, the natural sense of modesty of the parturient is not offended, and careless rupture of the membranes is avoided. Skill in external examination is acquired with reasonable readiness. In the large majority of cases such examination alone is sufficient for the recognition of the position and presentation of the fetus, and for the study of the course of an ordinary labor. As there can be no objection to its frequent exercise, abnormalities of parturition may the more readily be detected early, and means of correction promptly employed. Experience soon teaches the difference in the position of the fetus assumed in case of pelvic contraction on the part of the mother. The position and presentation having been recognized, the examination for the determination of possible pathologic conditions of the birth canal need be but brief, and can be conducted with great case. For the attainment of this desirable result it is essential that the obstetric pupil familiarize himself thoroughly with the conditions of normal labor as determined by physical external examination, as well as with the physiology of normal labor. Obstetric operations are princi pally to be taught upon the phantom.- matter of determining the degree and Indian Lancet. Indications for Treatment of Angina Pectoris. Dr. J. Burney Yeo, summarizes the the treatment of angina pectoris, as follows: 1. To maintain or improve, when defective, the general nutrition; to avoid all strain, physical and emotional, and to relieve cardiac feebleness and excessive effort. 2. To relieve dyspeptic conditions and flatulent or fecal distentions of the stomach and intestines. depth of the intimacy is often hedged by seemingly insurmountable difficulties, which are increased by the indignation aroused by the merest insinuation that women, in certain ways, can know each other too well.-University Med. Magazine. Hepatic Neuralgia. Pariser, in the Congress for Internal Medicine (Centralblatt f. innere Med., 1896, No. 17, p. 467), reported seven cases of nervous hepatic colic. This is usually mistaken for gall-stone colic, and in one case of the author's an opera3. To forbid the habitual consumption was performed under the erroneous tion of agents which may exercise a tonic action on the heart, such as tea, coffee, alcohol, tobacco, etc., or that which may introduce or develop toxines in the alimentary canal. 4. To avoid and remove all gouty and other blood contaminations. 5. To give such tonic remedies as may improve the cardiac tone and lessen existing tendency to cardio-vascular degeneration. 6. To relieve the paroxysmal attacks by sedatives and stimulants.-Boston Med. and Surg. Journal. The Civil Responsibility of Sexual Hamilton (American Journal of Insanity April, 1896) gives his views on the above important subject in a most instructive article which can be abstracted imperfectly, and the reader is referred to the original article. To quote one paragraph,—When contracts or wills are made by one woman under the influence of another, something more should be conceded as an invalidating factor than the existence of a pertinent and dominating delusion, for there is no stronger dominating influence than a continued appeal to the passions, and especially the sexual feelings; and the apparently harmless intimacy of two women may, if misunderstood, lead to the perpetration of great wrongs and perversion of property. • As the matter of proof is so difficult and the rights of women so zealously guarded by sentimental judges, the idea. The clinical picture is usually precisely like that of colic from calculus. Fürbringer thinks that in hepatic neuralgia the most intense pain is localized in the liver, and is not radiating, and although this is true in many cases, exceptions occur. The attacks last from a few minutes to four or more hours. As in biliary colic, the attack may end in vomiting. The disease is a visceral neurosis, with a neurasthenic or hysterical basis. The most successful treatment consisted in the use of tonics, exclusion of exciting causes, and cannabis indica.-American Journal Med. Sciences. The Nerves of Taste. the L. von Frankl-Hochwart (Wiener klin. Wochenschrift) says the lingual nerve supplies fibres for the sense of taste to the anterior two-thirds of the tongue; these pass entirely or for the greater part into the chorda tympani. Clinical observation of processes situated at the base of the brain proves that these fibres enter the fifth nerve; resection of the Gasserian ganglion very often causes ageusia in the anterior portion of the tongue. It is not known whether these fibres of taste are to be found in the second or third branch of the fifth nerve, and the mode of connection with the facial and chorda tympani is unknown. The glosso-pharyngeus is generally recognized as the nerve of taste to the posterior third of the tongue. In some individuals, however, total destrucion of the trigeminal nerve by basal growths, trauma or resection, does | least 10 or 12 per cent. of the cases, and not interfere with the sense of taste, and probably the glosso-pharyngeus supplies in these cases the entire tongue with taste fibres. Although repeated clinical observation of cases in which the ninth nerve was destroyed has shown alteration of taste only at the posterior part of the tongue, Popl, in his case of compression of the left glosso-pharyngeus by an aneurism, as demonstrated by the autopsy, without involvement of the fifth, was able to observe considerable disturbance of taste in the anterior part of the tongue as well as total ageusia over the left posterior portion.-International Med. Magazine. The Relations of Alcoholic Indulgence to Insanity. Bannister and Blumer (American Journal of Insanity, January, 1896) thus sum up their opinions regarding the effects of alcohol in the production of insanity: Alcoholic excesses produce insanity, being directly the cause of at probably of a somewhat larger percentage. Indirectly they are among the causative factors of a very large propor tion of cases that cannot be directly credited to alcohol. Moderate drinking is a very indefinite term, and this fact alone makes it impossible to utilize satisfactorily any statistics as to its effects in producing mental diseases. There is, however, no reason to believe that moderate indulgence in alcohol is especially conducive to mental health in the average individual, and there is, on the other hand, a certain amount of physiological a priori presumption to the contrary. To the victim of hereditary taint or the neurotic it is undoubt edly often disastrous in its effects in this direction.-University Med. Magazine. PHYTOLACCA, five drops every two hours, works directly in all cases of glandular inflammation, especially mastitis and orchitis. Send your Professional Card for Brochure and Samples to THE ANTIKAMNIA CHEMICAL CO., St. Louis, Mo., U.S.A. THE Cincinnati Lancet-Clinic: New Series Vol. XXXVII. A WEEKLY JOURNAL OF MEDICINE AND SURGERY. CINCINNATI, AUGUST 29, 1896. Whole Volume LXXVI. Original Articles. SERIOUS COMPLICATIONS OF MIDDLE EAR.' BY MAX THORNER, A.M., M.D., PROFESSOR OF CLINICAL LARYNGOLOGY and OTOLOGY, or tions which had been considered hopelessly beyond the reach of any save the most impotent treatment. The last fifteen years have witnessed a most remarkable development in the study of ear diseases. Not alone were aural surgeons interested by this unprecedented progress, but equally so the surgeons, the neurologists, the pediaters, and the general practitioners. This is due to the fact that the seriousness of purulent processes in the middle bearing upon the general health of the individual, and their great danger to life, are now universally understood. This latter point has most prominently been brought to light by numerous investigations made in large hospitals of different countries. It has been conclusively shown that in former years numberless patients died with such diagnoses as meningitis, typhoid fever, brain fever, marasmus (infantile and senile), eclampsia infantum, convulsions, intermittent fever, apoplexy, brain abscess, etc., whereas in reality they were victims of purulent middleear disease which had not been recognized. It is not so very long ago that puru-ear is now generally appreciated; their lent processes in the ear, no matter whether they were acute or chronic, were almost disregarded by otherwise, well-informed physicians. Who does not remember having heard such remarks as "not to meddle with the ear," "that suppuration was nature's own way to get rid of offending material," etc? And this in an age when the dawn of modern surgery, with its brilliant achievements, had spead to almost the remote corners of the earth! Is it strange, then, that there was a time when, in cases where suppurative inflammations of the brain or its meninges were found associated with purulent middle-ear disease, the relation between cause and effect was thoroughly misunderstood? It was thought that the inflammation in the ear was the complication by extension of disease in the cerebral cavity downward, in an attempt to evacuate pus through this organ. However, anatomical and pathological investigations did not fail to clear the views regarding this question. Yet it remained for the application of modern surgical methods to show the true relation of cause and effect, and to point out a way for the treatment of affec Read before the Ohio State Medical Society, May 29, 1896. It would lead me too far to go into a detailed statistical account of the percentage of deaths from ear affections in reference to all other causes, as well as in reference to the number of people who suffer from suppuration of the middle ear. Suffice it to say that autopsies made in large hospitals upon the bodies of all who died have uniformly demonstrated the comparatively large percentage of ear diseases as a cause of death. Among others, this fact has been established with certainty, that at least one-third, and probably one-half, of all brain abscesses are of otitic origin, while almost two-thirds of all cases of |