circumstances, principally by the traumatism that, in causing more or less hyperemia of the affected organs, favors the fixing of the embryo, and indicates and determines, as it were, the seat of the cyst which can develop itself in all the tissues, and is more specially found in the abdominal viscera and in the muscles.

The frequency of hydatid cysts in the mus cular tissue entitles them to an important place in the study of muscular tumors.

Their diagnosis is extremely difficult and can only be founded on an ensemble of symptoms, none of which are pathognomonic.

In most cases an exploring puncture helps the diagnosis, and as soon as it is effected these tumors must be removed, either by total extirpation, or by incision of the cyst and scraping the interior. In all cases the antiseptic method must be rigorously applied. The following are a few cases recorded by M. Audiot in M. Polaillon's practice at the Pitié.

tumor.

M. Polaillon diagnosed the presence of a cyst of undetermined character.

A capillary puncture with aspiration is effected. The result is a discharge of a serous, transparent liquid, of a light yellowish urine color. Examined under the microscope, some red globules are perceived in the liquid, also a few white globules, no hooks, but a small shred of membrane resembling that of a hy datid cyst.

A few days after the puncture the patient quitted the hospital. But the liquid soon accumulated again, and on the 13th of August, he returned with a tumor as large as before and of the same character. On the 22nd, a second puncture was made which gave out a rosy liquid in which a few scarce hooklets were discovered. It was, therefore, evidently a cyst formed in the muscles of the abdominal coat. The cystic sac is emptied entirely, and washed with a solution of carbolic acid at 5 per cent.

August 24, evening. Headache, want of

NAL MUSCLES.

Mr. R., æt. 16, printer, born in Paris. No morbid antecedents, but a year ago fell from a third story; the accident left no traces.

One month after the fall patient noticed a tumor in the right iliac fossa. No pain whatever, and it is only lately that he experiences a slight stiffness.

In July, 1883, he entered M. Polaillon's ward at the Pitié. The right iliac fossa is the seat of an ovoid tumor, whose long axis is parallel to the inguinal fold. It is not reducible, fluctuating, and of the size of a co

pain about the right iliac fossa.

The following days fever continues; the cyst suppurates and the suppuration accumulates in the sac which becomes the size of the head of a fetus.

On the 28th incision with bistoury of about three centimeters (1.18 inch). Issue of a quantity of pus; washing out with phenic solution; drain; Lister's dressing.

The washing and dressing renewed every two days. A few shreds of hydatid membrane came away with the washing; moderate suppuration; general health good.

During September and first part of October surprised that the cavity does not close. Patient well and up all day long.

On the 18th of October patient suddenly seized with pain in the iliac fossa round the fistulous opening.

The next day the fistulous orifice was OC

it

cluded by thick, white hydatid membrane. On trying to remove it with the pincers tears, but by compressing the abdomen was enabled to expel it entirely. It is followed

by a mass of thick, greenish, fetid pus; washed out with carbolic acid solution.

The expelled membrane is white and from two to three millimeters thick (from 0.07 inch to 0.118 inch). It forms an ovoid sac about as large as the head of a fetus. It is formed of superposed layers of transparent substances, laminated, thin membranes proceeding from it similar to those found in the liquid after puncture and in the washings. The interior of the sac shows no trace of other hydatid cysts.

After the expulsion of the membrane the seat of suppuration diminished rapidly.

November 20. The cavity is completely filled up. Cicatrization is complete.

There is no retraction of the abdominal coat.

Operation on 15th of June. A horizontal incision of seven centimeters (0.27 inches) causes the tumor to drop down, when it is found to consist of a purulent sac from which about 60 grammes escaped, and a hydatid membrane of three centimeters (0.118 inches) in diameter. Excision of the coatings of the sac and scrapings; suture of the skin, drain.

On the 16, Temperature 37.4° (99.3° Fahr.) Patient complained of headache, of pains in the breast and uneasiness. All these symptoms disappear in the evening.

First dressing on June 18; sutures drawn out; reunion perfect.

Second dressing on June 21; sutures drawn out; reunion perfect.

Third dressing on June 25. Patient entirely cured. Cicatrice slightly adherent at

GREAT PECTORAL.

Blanche M., 39 years, dressmaker, entered June 7. Lived in the country till 1876.

Patient has never had other illness than frequent migraines-headache.

ments of the subjacent muscle.

The action of baths upon elementary respiration and nutrition has been hitherto incompletely studied. The researches of Paul Bert and other authors are open to criti

This swelling, painful on certain days, is more generally indolent. Nevertheless after a prolonged contracture of the great pectoral, becomes very painful. The tumor augments and becomes as large as a chestnut.

There is no pain when the patient's arm is close to the body, but when she extends it backward she suffers sharp pangs.

Patient entered hospital because the tumor had suddenly become as large as a mandarin orange; the skin is red round about it and seems ready to ulcerate.

During repose the pains subside, and the skin over the tumor shows a normal aspect. To the touch a hard tumor is felt, non-fluctuating, spread out and adhering by a large basis to the external face of the great pectoral. The tumor is indolent and movable when the muscle is relaxed, but becomes painful when its position is fixed by contraction of the mus cle. It measures about from six to seven centimeters in all directions (0.23 to 0.27 inch.)

that render it difficult to discourse the fundamental laws of the influence of baths on the living organism.

To solve the problem, it is indispensable to take vigorous animals, and to repeat a great number of analyses of mathematical exactness; the experiments must always be made under the same conditions, not varying more than once for the same animal, for no experiment must ever be complicated. For simultaneous analysis of gases from 10 to 15 cubic centimetres of blood must be taken. Moreover,in order that the study should give proper results, it is indispensable to measure the absorption of oxygen, the exhalation of carbonic acid, and to analyze simultaneously the gases of the blood etc. By scrupulously observing these rules, M. Quniqaud has ob tained the following results:

I. A very cold bath augments absorption of oxygen by the respiratory organs. In one case, the animal consumes 175 cubic centimeters of oxygen in four minutes, three seconds before the bath; after the bath the same

animal consumes 675 cubic centimetres in one minute and forty seconds, or 1882 cubic centimeters in four minutes thirty-eight seconds, or ten times as much. In a second case the animal consumes 1900 cubic centimeters of oxygen before the bath, whilst after the bath it consumes 3992 cubic centimetres in the same time.

II. A very warm bath also augments, but in smaller proportion, the quantity of oxygen absorbed. A dog absorbed before the bath 800 cubic centimeters of oxygen in twenty minutes and forty seconds, and after the bath the quantity absorbed in the same time was 1600 cubic centimeters. In rare exceptions the quantity of oxygen was less than in normal conditions.

III. Another effect of cold baths is to augment pulmonary ventilation, the renewal of air in the pulmonary vesicles. Two examples proved this fact: A dog weighing 5 kilogrammes, causes 25 liters of air to circulate through his lungs in nine minutes before the cold bath, and afterwards 50 liters of air traverse his lungs in three minutes. Another animal before a warm bath passed 25 liters of air through its lungs in three minutes, and after the bath 50 liters in the same time.

IV. The cold bath sensibly augments the exhalation of carbonic acid.

A dog, weighing, 8 kilos, gives out 73 centigrammes of carbonic acid in six minutes before a cold bath; and after the bath the quantity exhaled is 90 centigrammes. Another animal gives out 1.10 gramme before the bath, and 1.48 gramme after the bath and in the same time.

V. A very cold bath, even partial, may cause death in a relatively short time. It is therefore very important to watch extremely cold baths with great care.

VI. The same applies to a very hot bath, even partial which may also cause death.

VII. Under the influence of a bath at 37.5° and 34.5° (99.5° and 94.10° Fahrenheit), the central temperature remaining about the same, the exhalation of carbonic acid varies but slightly; however the quantity of oxygen absorbed is generally rather above the normal.

VIII. A very warm bath favors the pulmonary exhalation of carbonic acid, thus a dog that gives out 2.09 grammes of carbonic acid inten minutes before the bath, exhaled 2.22 grammes after the bath in the same time.

If the exhalation can be observed until the death of the the animal, it will be noticed that the quantity of carbonic acid given out augments gradually, attains a maximum near 42° to 43.5° (107.6°-110.3° Fahrenheit) after which the quantity diminishes a little but does not descend to the normal.

IX. The salutary action of a very warm, bath is easily proved. A dog is plunged into a very cold bath until the temperature of the rectum descends to 24°-23° (75.2°-73.4° Fahrenheit) which is often the inferior limit that the central temperature may attain; if, at the moment of the last gasp, when the animal is already limp and half dead, it is rapidly plunged into a bath at, 50° (122° Fahrenheit), the dog revives rapidly, and at the end of from nineteen to twenty minutes, is saved, runs merrily about the laboratory; this experiment always succeeds.

This shows medical men the use of em ploying heat in all cases of hypothermia as in accoholic patients with low temperature, new born children, anemic patient,etc.

Meeting of May 4, 1887.-Naphthalinic cataract.-M. Dor has continued on rabbits the experiments of M. Bouchard. He administered pure naphthaline and per mouth, in doses of 1 gramme per kilogramme of the animal. From third to fourth day the ophthal moscope showed whitish spots on the retina; towards seventh day opacities of the crystalline lens; on the ninth day the opacity was complete. Autopsy showed white nodosities in the retina and the choroid, also in the lungs, kidneys, heart and even brain. These nuclei were full of leucocytes, and contained crystals. The white spots on the retina were soon surrounded by a red border that rapidly became hemorrhagic. The retina had appearance presented in leucemia and in albuminuria. Therefore naphthaline decomposes the blood. M. Dor differs in opinion with M. Panas on the following points: He has not seen seen the

brilliant synchisis mentioned, and he does not believe that the nutrition of the lens is dependent on the retina. M. Panas administered naphthaline porphyrized in glycerine. It is possible that in this state it may enter into the circulation and by this means into the vitreous and there produce synchisis. M. Panas has always observed synchisis at the outset, followed by round white spots with double slightly protuberant borders, that later on become naveled, then confluent, and ultimately are fused into one. Cataract supervenes only when the white plaques on the retina are formed.

ON POSTERIOR OPHTHALMOTOMY IN GLAUCOMA.-M. Vacher has in two years seen six cases in which iridectomy and sclerotomy had prevented the processus of glaucoma. In three cases he employed posterior ophthalmotomy, and five times with excellent

not

results.

TREATMENT OF GLAUCOMA BY CREATION OF A Fistula of THE CONJUNCTIVA--M. Motais advocates the following process which he successfully employed in 13 cases. The globe being drawn down inwardly by means of a pique de Pamard applied over the cornea, in the space between the tendons of the superior and external right muscles, he plunges a Graefe's knife at 4 or 5 millimeters behind the ocular equator, through the ocular membranes, into the vitreous, and makes an incision of 6 to 8 millimeters from back forwards. A certain quantity of vitreous humor escapes. He removes the pique de Pamard. The parallelism between the conjunctival and the sclerotic wounds ceases as soon as traction is no longer exercised upon the conjunctiva. The wound becomes sub-conjunctival. The tension of the globe remaining considerable, the sclerotic wound remains open, and its edges do not tend to join. The intra-ocular liquids can thus freely communicate with a small pocket that forms under the conjunctiva. Out of 15 cases operated by M. Motais, twice the fistula did not form, and the result did not last; but in the 13 others the fistula subsisted, the ocular tension remained normal, and the pain and other glaucomatous accidents did not return.

M. Galezowski is adverse to this method. The incisions are likely to bring about atrophy of the globe.

M. Saurez de Mendoza mentioned two cases of recurrent glaucoma after operation, in which iridectomy had left enclosings of the iris. Two lateral iridectomies were performed and obtained perfect cure. Professor Gayet has examined before and after operation the microbes in the cul-de-sac of the conjunctiva. He examined 102 cases. He found in the conjunctival secretions of the cul-de-sac 79 fertile and 23 non-fertile tubes. The proportion of parasites is, therefore, 64 per cent. Notwithstanding the most rigorous antiseptic washings. The microbes found were mostly staphylococcus aureus and staphylococcus albus.

ETIOLOGY OF INTERSTITIAL KERATITIS.— M. Trousseau in 40 observations found 37 presenting symptoms, more or less decided, of hereditary syphilis. In three cases only he observed unmistakable syphilis.

M. Haltenhoff mentions three cases of interstitial keratitis in 72 cases of acquired syphilis. In 69 patients, under 19 years of age, he found 23 in which hereditary syphilis was manifest, in 12 cases it was probable, and in 15 others it was doubtful, but possible. In the cases of hereditary syphilis the interstitial keratitis was almost always double, in acquired syphilis, on the contrary, one eye only was affected.

M. Javal has observed paludal keratites that were found to be parenchymatous. They produce deformations of the cornea, visible under the keratoscope.

M. Abadie thinks that malignant parenchymatous keratites are more frequent now than formerly. Subcutaneous injections of bichloride of mercury are indicated in tardy and sclerous forms of syphilis.

M. Galezowski has also observed interstitial keratites, due to acquired syphilis, but these keratites affect only one eye, and do not invade the entire surface of a cornea. Hereditary syphilis may pass over one or two generations.

M. Poncet thinks that ocular affections of

paludal origin are very frequent; it is not necessary to have had attacks of fever, to be affected with impaludism.

M. Gorecki relates a case of perforation of the retina in a girl 12 years old, treated for syphilitic interstitial keratitis.

LONDON LETTER.

LONDON July 9, 1887. EDITOR REVIEW.-The anti-vivisectionists have received a decided blow in the report of the commission on hydrophobia which has just been issued, and which most strongly supports M. Pasteur's methods. The commission was appointed at the instance of Sir Henry Roscoe, the well known chemist, who is a member of the House of Commons, and who has taken an active share in the work, the other members of the commission being Sir James Paget, Sir Joseph Lister, Dr. Quain, Dr. Lauder Brunton, Dr. Burdon Sanderson, Dr. George Fleming, the chief veterinary surgeon of the Army, and Mr. Victor Horsley on whom as secretary the brunt of the work has fallen, including the whole of the experimental investigations.

M. Pasteur has claimed for his treatment that it is both protective and preventive. As regards the former point, the commission reports that it may be deemed certain that M. Pasteur has discovered a method of protec❘ tion from rabies comparable with that which vaccination affords against infection from small-pox. On the second point some members of the commission carefully examined M. Pasteur's work, and then conducted some experiments on the same lines for themselves. The result of Mr. Horsley's experiments was to confirm the statements that the virus was contained in the spinal cord, that it could be transmitted withont essential change by inoculation, that it was rendered more intense by transmission, and that it might manifest itself either in the furious form commonly seen in dogs, or in the paralytic form usually observed in rabbits, or in intermediate forms, but that the disease was always the same, viz., true rabies. The next point upon which

expermintal evidence was sought was the claim that the virus could be so attenuated as to be capable of being inoculated without danger to the animals, and that when used after the prescribed manner, it afforded protection to dogs against the subsequent effects of inoculation with rabid virus. In this respect too M. Pasteur's results were entirely corroborated by Mr. Horsley's investigations.

Some members of the commission also examined for themselves several of the patients who were under M. Pasteur's treatment; Drs. Sanderson and Brunton and Mr. Horsley went over to Paris and personally investigated the histories of 90 consecutive cases. Of these 24 had been bitten by undoubtedly rabid dogs on parts not covered with clothes, and the wounds had not been cauterized. None of the 90 persons died, but it is estimated that but for the inoculations 8 would have succumbed to hydrophobia. It is shown that the proportion of deaths amongst those submitted to M. Pasteur's treatment is far lower than the lowest estimate that has ever been made of deaths from hydrophobia. "From the evidence of all these facts" the reporters write "we think it certain that the inoculations practised by M. Pasteur on persons bitten by rabid animals have prevented the occurrence of hydrophobia in a large proportion of those who, if they had not been so inoculated, would have died of that disease." It would not be easy to express a more strongly favorable opinion than that. Finally the commission believes that until much more stringent regulations are issued by the police, M. Pasteur's treatment will always be of service, but the commission recommends the destruction of all wandering ownerless dogs, discouragement of the keeping of useless dogs by taxation or other means, prohibition of importation of dogs from countries where rabies is prevalent, or the imposition of quarantine, and the compulsory use of muzzles in districts where rabies is prevalent.

There is just one other point arising out of the report which it is worth while to mention. The opponents of M. Pasteur have contended that not only did his treatment do