anaesthesia without the patient's waking or making the slightest struggle.-J. H. Barbat, M. D., in Pacif. Med. Jour.

A New Method of General Narcosis.

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Rosenberg, in the Berlin Medical Society (Deutsche medicinische Wochenschrift, No. 50, 1894), described a new method for inducing general narcosis. Before mencing the anesthetic, the patient's nasal mucous membrane is to be sprayed with a ten per cent. solution of cocaine. During prolonged anesthesia, the spraying is to be repeated every thirty minutes, and again at the end of the operation, no matter how short. His conclusions are: (1) excluding cases of negligence and of poisoning, cardiac syncope in chloroform narcosis is, in so far as it can be attributed to the chloroform, reflex. (2) The syncope and the accompanying respiratory embarrassment are due to irritation of the peripheral trigeminal filaments in the nasal mucous membrane. (3) Every anesthetic inhaled produces the same reflex symptoms as chloroform. (4) By proper cocainization of the nasal mucous membrane, all such reflexes can be positively prevented. (5) Thus a greater part of the dangers of inhalation anesthesia, particularly of chloroform, can be removed. (6) Cocaine possesses a certain action antidotal or antitoxic to chloroform, and thus further reduces the dangers of chloroform. (7) Chloroform in such cases is to be preferred to ether, as being less dangerous. The chloroform must always be administered drop by drop. Universal Medical Magazine.

A New Sign in Auscultation of the Chest. L. F. Alvarez, M.D., in Pacific Medical Journal.

At a meeting of the Second Mexican Medical Congress, held in San Luis Potosi, from the 8th to the 10th of last November, Prof. Carmona y Valle read a paper on a new sign in auscultation of the chest not mentioned by any writer on physical diagnosis. For over twenty years Prof. Carmona y Valle has called the attention of his students to this sign, which consists in a modification of the voice perceived on ausculating the chest at the level of a pleuritic effusion when the patient speaks. The voice is not confused as in the normal state, but clear and more acute than the voice of the person who produced it, and it appears

to come from a distance, though located within the chest; it is not vacillating nor tremulous, and this is what distinguishes this sign from egophony. As in egophony the transmitting medium is liquid and not air, as is the case normally.

Prof. Carmona y Valle formerly compared this modification of the voice to the sound produced by the cornet when played with the key used to subdue its sound, but since he became acquainted with the telephone he believes that it resembles the timbre of the voice transmitted by that apparatus, hence he calls this the telephonic voice. He believes this sign is of great value in the diagnosis of pleuritic effusion, because, besides being constant in all of them, it is not present in cases where there is no liquid in the pleural cavity. It is of great service in distinguishing pleuritic effusions from pulmonary affections, such as edema of the lungs and intra-thoracic new growths, which, like pleuritic effusions, produce dullness and absence from thoracic vibrations on palpation.

He mentioned two cases in which the constant absence of the telephonic voice led to the exclusion of pleuritic effusion and to the diagnosis of pleuro-pulmonar tumor, and in both cases at the autopsy a large sarcoma was found.

Papain for Tapeworm.

Roberts Bartholow, in the Medical News, reports a case in which, after a failure of the usual remedies for tapeworm, a parasite twenty-five feet in length became dislodged and was passed after the use of papain, in ten-grain doses, three times a day after meals. The worm had not undergone solution, but Bartholow thinks the drug had exerted a toxic influence upon it.

To Sterilize Steel Instruments Without Reducing Their Temper.

The usual process of sterilizing surgical instruments by pouring boiling water on them and then cooling gradually, removes their fine, high temper, rendering them nearly useless. Dr. Nathan Hermann, Louisville, in the Louisville Medical Monthly, suggests the following improved method:

"A knife made of the best tempered steel and upon which all the cutler's care has been lavished to the end of supplying it with a perfect edge, will lose the same after

having passed two or three times (varying with its original quality) through this sterilizing ordeal, nor will it ever afterward be capable of holding an edge.

"The process of sterilization which I propose to substitute, and I have already used it myself with excellent results, is to cover the instruments as before with boiling water, but to leave them in their bath but for one minute, when the water is to be poured off or drained off with a siphon, after which they are to be covered with iced lime-water. The temper of the steel is thus preserved or even improved, while the principle of asepsis is also carried out.

"Cold lime-water is the best known means of hardening steel after its temperature has been raised; and the small quantities of lime water adhering to the instrument can not harm the most delicate tissues. In delicate operations, as in laparotomies, the surgeon can prepare his own lime-water by pouring distilled water over lime, when the elevation of temperature incidental to the mixture of lime and water will preclude the possibility of the survival of any germ. The vessel is then closed with a sterilized cotton plug, and set aside to await the pleasure of the surgeon. Some minutes before the operation, a sufficient quantity of this lime-water is decanted into a sterilized vessel containing artificial ice, which, as is well known, is made of distilled water, and you have a thoroughly sterile and innocuous tempering fluid."

Wounds.

Reclus' Method of Treating Crush of the Extremities. Slightly anesthetize the patient by giving several whiffs of chloroform, and carefully wash all the injured parts with water at a temperature of 55 or 60 degrees C. (131 or 140 degrees F.), using a spray of sufficient force to thoroughly penetrate the interstices of the wound, expel blood-clots and detached pieces of flesh, as well as any foreign bodies. Spread upon pieces of aseptic tarlatan a layer of salve made as follows: Salol, resorcin, antipyrin, each 12 grammes (34 drachms); boric acid, 20 grammes (5 drachms); iodoform, I gramme (15 1-2 grains); vaselin, 160 grammes (5) ounces). Press the tarlatin into all the interstices, covering the entire wound. Surround the member with absorbent cotton. Renew the dressing every five or ten days. When the crush has not been too great

this treatment will often enable the limb to be preserved, while, if amputation become necessary, it can be performed later, when partial cicatrization has taken place, thus insuring a stump well covered with soft parts. (Branere, These de Paris, 1894)— New York Medical Reporter.

A New Method of Doing Bloody Operations.

This is advised by Neudoerfer, of Vienna. For twelve years he has used peroxide of hydrogen (H2 O2) as. a disinfectant and styptic. A wound treated with this fluid does not bleed during or after the operation, does not become inflamed, does not suppurate, neither is there any reaction from it. He operates as follows: The field of operation is shaved and cleansed with soap, washed, and moistened with ether. Upon the instruments is poured_boiling water for a quarter of an hour. The surgeon's hands and those of his assistants are thoroughly cleansed with soap and hot water, and washed with ether. No sublimate or other antiseptic comes in contact with patient, surgeon, instruments or bandages. For drying and cleaning wound are used gauze pieces saturated with H2 O2 and well pressed out. These are held firmly upon the wound for one-fourth to one-half second. The few still bleeding vessels are tied; the whole surface is again irrigated with H2 O2 and exposed to the air one or two minutes. Drainage tubes are not absolutely needed. The edges are then closed by sature. The stump is covered with gauze and absorbent cotton and secured by a bandage with moderately firm pressure.

The result is as follows:

I. The wound is covered with a slight foam; there is a little hemorrhage as after an Esmarch bandage. Capillaries, small arteries and veins do not bleed at all, but should be secured by suture.

2. Pain is relatively slight; shock is markedly absent. The patient eats, sleeps and feels well.

3. The process of healing is ideal. When the dressing is changed on the third day for removal of drains, it is found dry, the skin is pale as if nothing had been done. The new dressing may remain from eight to fourteen days, until entire healing has taken place.

The author also refers to the value of H2 O2 in epistaxis, which may be stopped by

simple atomization or touching of the nasal cavity with H2 02. As the latter is a poison to the brain and spinal cord, the quantity used should be carefully graded.-Int. Klinische Rundschau.-Medicine.

Morphinomania.

M. J. Luys reports the case of Dr. X., who had been accustomed to employ about seven grains of morphia daily. Small doses of sodium phosphate were given subcutaneously (with glycerine and water), and as they were gradually increased the morphia was progressively diminished. In two months the morphia was discontinued entirely, and then the doses of sodium phosphate were progressively diminished, and finally stopped altogether in two weeks more. There remained no desire for the morphia at all.-Medical Brief.

Creolin as an Antiseptic in Obstetric Practice. Dr. Wells, in the Philadelphia Polyclinic, desires to call attention to the superior value of creolin as an antiseptic for obstetric use. Used in quantities of one dram to the quart of water it has no irritating effect as has corrosive sublimate. Combined with soap in any form, it makes one of the best irrigations for the vagina either before or after operation or in obstetric practice. It can also be safely used in the strength of one dram to the quart as an irrigating fluid for intrauterine douches, to be applied either by a two-way catheter or a douche curet. Mercuric chlorid used for this purpose destroys instruments, and is in many cases extremely dangerous.

A post-mortem of the late Hans von Bulow showed that in the scar of an injury to the brain, received in childhood, the ends of many nerve-fibres had become imbedded. It is thought that this accounts for the excruciating headaches from which he suffered through his life.-American Lancet.

How to Disguise the Taste of Cod Liver Oil. To disguise the taste of cod liver oil is an advantage which may be obtained by the following plan:

Four hundred grammes of oil are mixed with 20 of freshly roasted and ground coffee and 10 of animal charcoal. The whole is kept in a water bath at 140 degrees F. for 15 minutes in a stoppered flask. It

is shaken occasionally for two or three days and then filtered through paper. The oil is limpid and light colored, and tastes and smells strongly of coffee.-Times and Register.

Ichthyol in Pharyngitis.

E. Sonenberg describes four cases of acute pharyngitis in which he used with success a_2 to 3-per cent. solution of ichthyol. From these and forty other re

corded cases he recommends the use of the drug as a gargle every ten to fifteen minutes.-Medycyna, No. 23, 1894.

Hemoptysis.

Calcium chloride (the pure crystallized salt), 10 to 15 grains (0.65 to 1 gramme) every two hours, in glycerin, simple elixir and water, or in infusion of gentian, 10 grains (0.65 gramme) to the teaspoonful. Reduce frequency of dose as improvement takes place.-S. Solis-Cohen, Philadelphia Polyclinic, January 19, 1895.

Neurasthenia.

Hydrochlorate of cocaine, 0.02 gramme (1-3 grain); vanilla sugar 1 gramme (15 1-2 grains). Give two or three times daily in a glass of milk. Give also the following: coca-wine, 1 litre (1 quart); tincture of nux vomica, 2.50 to 5.00 grammes (3-4 to 1 1-4 fluidrachms); quassia extract, 5 grammes (1 1-4 fluidrachms). A small wine glass at the two principal meals. Given in this manner, the cocaine leads rapidly to regularity in sleep, increase of strength and disappearance of the feeling of prostration.Geley, Journal de Med. et de Chir., November 10, 1894.

What Is and What Was the Vermiform
Appendix?

By F. H. Pritchard, M.D., Weaver's
Corners, Ohio.

The function of this little diverticle is unknown. Some have looked upon it as an appendage of the lymphatic system. The question is, what is it? I am of the opinion that comparative morphology will clear up the darkness here. It is certainly not there for nothing. Nature never makes mistakes. We find it difficult enough to keep her in sight, in our following her. I have been studying the question of late with the meagre literature at my command. I might state my conclusions as follows:

I. The vermiform appendix is a discarded organ, an organ no longer of serviceability.

When our ancestors were in the lower order of animals, and, possibly in the early man of prehistoric time, they were vegetable eaters; they required larger caeca for containing and digesting the more bulky and less concentrated foods. Hence, the cecum was longer and possibly larger to accommodate itself to the greater bulk. For example, the cecum of the giant kangaroo from below the ileocecal valve measures forty-two centimetres. There is no differentiation of appendix here, and cecum is but merely a long tube, of this length, running down from the valve, and ending in a point. (Der Bau des Menschen als Zeugniss fuer Seine Vergangen

Dr. R. Wiedersheim, Professor at the University of Freiburg, Germany, 2d ed., 1893, p. 145.)

There was a time when our ancestors were covered with a natural coating of hair to protect them from the elements. The panniculus musculus were also well developed to protect them from insects; the ear muscles were distinctly functionable, and the ears movable; the sense of smell was better developed; the intestinal tube was longer and the number of molars was greater. The appendix vermiformis then formed a portion of the cecum. But, following this plantivorous period, there came an omnivorous age; the incisors became more developed, the canines came more prominently forward; the cecum, not being necessarily so voluminous, a portion of it became contracted in size, dwindled, and lost its function to serve as an appendage, an appendix (vermiformis).-Wiedersheim, 1. c., Algemeine Betractungen, p. 183.

2. The appendix is still undergoing obliteration from its loss of function.

The appendix is, relatively, much longer in the embryo than in the man of sixty to eighty years. Compare Ribbert's Tables (Wiedersheim, 1. c., p. 146), as well as Wiedersheim's Tables, p. 145. Haeckel claims that the development of the embryo gives us a key to the descent of man, as it passes the greater changes from the ovum to complete development.

3. The appendix being a retrogressive organ, undergoing obliteration, is especially liable to pathological changes (Wiedersheim, note on p. 144). Of that we are all fully aware.-Hahnemannian Monthly.

Bromine In the Treatment of Diphtheria. Dr. Robertson, Jackson, Cal., gives the following treatment in St. Louis Courier of Medicine:

"We have in bromine, for the treatment of the early stages of diphtheria, what I regard as the nearest to a specific of any drug of which I have any knowledge in medicine. A trial will be sufficient to convince any practitioner of its efficiency.

"Bromine is soluble in water by the addition of from ten to twenty-five per cent. of alcohol. The solution, if long kept, loses its color and becomes hydrobromic acid; therefore, it should be prepared in small quantities at a time and frequently renewed

for use.

"Suppose, for example, I am called to see a sick child of five years of age, and upon examination find it to be a genuine case of diphtheria. The treatment will be just the same whether the disease is prevailing epidemically or only sporadically.

"Ordinarily it will be useful to commence the treatment by the administration of a cathartic, in which case I would prefer a few grains of calomel and powdered rhubarb. Two hours after having given the cathartic I commence the topical application of the bromine solution, always using the same strength for all ages and conditions, viz.: in the proportion of eight drops to the ounce, applied in the following manner: Depress the tongue with a tongue depressor or smooth spoon-handle, then with a camel's-hair probang, or swab of some kind, apply the solution to the entire mucous membrane of the fauces and posterior nares, as well as to all other portions where the diphtheritic membrane may be found to exist, and beyond.

"Following is the formula I use for the topical application:

topical application with the internal medicament, one or the other will be brought in contact with the diphtheritic membrane every two hours.

"I gave the bromine internally in doses from one-eighth to one-half drop, according to the age of the patient.

"The efficiency of this bromine treatment will be fully appreciated by any physician trying it; within from forty to forty-eight hours after its application.

"I have seen flakes of diphtheritic membrane detached as large as my thumb nail, which resembled in thickness and color a piece of dressed buckskin."

ruffled edge. ruffled edge. The growth was of the polypoid variety, and was giving him considerable annoyance, not from any pain or discomfort, but was taxing his mental forces to know what the final results would be. He wanted it removed without disabling him, if possible.

Just what to do I was at a loss to know, for I had never had a case or anything like it. So I requested him to come in again and I would decide on some means to remove it. I first thought I would trim it off with the scissors, but was afraid of inflammation following the operation. I next thought of salicylic acid and cannabis indica. Knowing that the two remedies were good solvents of fungi, I prepared salicylic acid, two drachms; fl. ext. cannabis indica, two fluid drachms; water, q. s. for two ounces, which makes an unsightly mixture, but to my great satisfaction it did its work well, dissolving the fungus growth without marring the delicate mucous membrane. The medicine was applied five or six times a day, and required three or four weeks to accomplish its work, removing every vestige of the growth, and there was no return two months later.

A lady presented herself for treatment for a growth in her mouth caused by imperfect fitting plate. The growth was

acida.'

pared the salicylic acid and cannabis indica mixture and ordered it applied five or six times a day. Within one week the growth was dissolved and gone.

Acute conjunctivitis is an affection of the eye we are often called upon to treat. My treatment is simple and has never failed me. It is this: Fl. ext. gelsemium, eight to fifteen drops; pure water, half an ounce; also, borate of sodium, grains five to fifteen; pure water, half an ounce. Three or four drops of each every alternate hour; and if the bowels are not active give first decimal trituration of podophyllin, two to four grains, once or twice a day so as to keep up free action. A slippery elm poultice should be applied to the eye at night.

A similar treatment is efficacious in the treatment of iritis, leaving off the borate of sodium, and giving aconite and belladonna. internally. I have recently treated a very severe case of iritis with the above prescription, and the result was all that could be desired. Don't forget it. Gelsemium is the local remedy for the eye par excellence. It is not often that I claim original