For constitutional nervous troubles, such as chlorosis, hysteria, etc., compression of the nerves has been long since employed to advantage. Dr. Wide, of Stockholm, has of late also employed compression or pressure upon the nerves for purely local affections. In certain gastric affections, pressure upon the celiac plexus was often very advantage. ously used. He also applied it successfully to the inferior hypogastric plexus, the cervical ganglia, the sympathetic, and the majority of the peripheral nerves. In a number of cases of tabes dorsalis he found the brain symptoms (cephalalgia, etc.) to disappear very rapidly by continued pressure upon the infe. rior hypogastric plexus. Dr. Wide also reports three cases, where neither electricity nor massage affected a result, but where pressure was followed by immediate results.

Owing to its importance in the diagnosis of carcinoma of the stomach, a satisfactory test for the presence of hydrochloric acid has been eagerly sought for, the last one being offered by M. Enald. It is composed of one part of vaniline, two parts of flucoglycine, and thirty of alcohol. On warming slowly the liquid to which the reagent is added, there appears a beautiful crimson-red color if the liquid contains hydrochloric acid in not less proportion than .05 gramme per liter. Lactic acid does not give this reaction.

CORRESPONDENCE.

NEW YORK LETTER.

NEW YORK, Dec. 15, '87. EDITOR REVIEW: A new medical charity (?) has been announced under the title of the Mutual Medical Aid Association; its organization purports to be for the giving of free medical aid to the poor. It has decided to open thirty-six dispensaries in various parts of

It is little wonder, in view of such schemes, that it is extremely "hard picking" for many of the younger members of the profession here in New York. There are already more free medical institutions than the city needs, so many in fact that they almost quarrel for each other's patients.

Much interest has been excited in Brooklyn by a charge brought by Dr.S. Fleet Spier, a prominent physician of that city against the so-called "mind-healers," who seem to flour. ish with especial vigor in the city across the river. Dr. Spier asserts that the death of a certain patient from pneumonia was directly due to the negligence of these new "healers." Their plan of treatment was to sit down in front of the patient and tell her "she would be well if she would only think so." The patient was in the habit of attending faith cure lectures and taking treatment from the "healers," to whom she had paid considerable money. They seem to have placed her under their influence, and to have counselled her not to summon a physician. Dr. Spier has not taken any legal steps in the matter, but has done a great service to the community by calling attention to this matter. The "mental" school of medicine seems to be very flourishing in certain eastern localities. Brooklyn has a "Nazara school of Mento Spiritual Science, or the Divine Philosophy of Cure," presided over by a "spiritual scientist or mental physician, graduate of the Spiritual Science University, Chicago.

It is easy to smile at such delusions, but the matter assumes a serious aspect when persons are led to neglect those measures which should be taken in disease, and rely upon the high flown theories of quacks who deal only in empty words.

The time is near at hand when the annual

The influence of uterine causes was next discussed, and it was shown that when the female cases were arranged according to the age of the patient when the disease commenced, there was a steady increase in the numbers up to the period of the menopause and a steady decrease after that period. Amongst the male cases there was no such regularity. Of the 500 patients 411 were women. and only 89 were men. The influence of anxiety, care, mental shock, injuries, damp, cold and previous rheumatic attacks were discussed, and each shown to have some share in the causation of the disease. He laid great stress upon the extreme symmetry of the joint lesions in rheumatoid arthritis.

He next adduced some arguments for believing that there was a tendency for the joint lesions to advance up the limbs from the periphery toward the trunk, an order of invasion which was sometimes well marked though by no means constant. The knees were shown to be second only to the hands in liability to rheumatoid arthritis. Lastly he showed that there was close resemblance between the distribution of the joint lesions in rheumatoid arthritis and in the recorded cases of arthritis following spinal concussion, whereas in more local spinal injuries one or more large joints were usually affected, as in tabes dorsalis. The associated nervous phenomena, such as muscular wasting, increase of tendon reflexes etc., were regarded as secondary to the joint lesions and therefore as lendiug no efficient support to the theory of nervous origin of rheumatoid arthritis.

At the same meeting Mr. Howard reported a case of a tubercular movable kidney. The patient, a girl aged 16 years, had suffered for more than a year from irritability of the bladder,pain and purulent urine. She was pale but well nourished, and showed no signs of disease except of the urinary organs. A firm, lobulated tumor,having the shape and charac ters of the right enlarged kidney could be felt in the right lumbar region of the abdomen and could be made to move either up un der the ribs or down into the inguinal or umbilical regions. Pressure upon the tumor

produced a feeling of nausea, and manipulation was followed by rigors and elevation of temperature. The bladder was sounded and found natural. The diagnosis made was scrofulous suppuration of a movable kidney. In spite of treatment by rest and drugs, the symptoms increased in severity, and the patient's health steadily deteriorated: it was decided, therefore to remove the kidney. This was done through an incision at the outer border of the rectus abdominis. The commencement of the ureter being found thickened, dilated and lined with granulation tissue, it was attached to the upper end of the wound; the rest of the pedicle was returned into the abdomen. The kidney was found to be enlarged and in great part converted into large. cysts filled with pus and caseous material. The remaining cortex was studded with mili ary tubercle and caseous deposits. Vomiting of blood set in during the second day, and the patient died forty-four hour after the operation.

At the post-mortem examination the other kidney was found to be greatly congested but otherwise healthy: there was no disease of any of the other viscera. He had preferred removing the kidney to making an opening in the loin and draining, because of the mobility of the kidney, the probability that its secreting struction was extensively destroyed and the difficulty, if the kidney were left, of preventing some of the irritating and infective pus still passing into the bladder. The abdominal incision had been adopted because of the size of the kidney and its displacement toward the front of the abdomen.

A long and interesting discussion followed the reading of this paper the chief questions which were raised being the means of making sure that the remaining kidney was sound, as it would be useless to extirpate the diseased one unless this were certain, then the abdominal operation was considered as against draining from the loin, each method finding advocates, and the last and perhaps the most important point was the treatment of the pedi cle. What found most favor was that the artery,vein and ureter should be tied separately,

in the hope of lessening the amount of shock. In a paper read before the Medical Society a few days ago Dr. Cibbons and Mr. R. W. Parker reported a case of tumor of the bladder successfully removed by the galvano-cautery, which was of especial interest from the fact that the interior of the bladder was carefully examined by the eye whilst illuminated with the electric light. The tumor was removed through the dilated urethra, but a suprapubic opening was made into the bladder to enable the operator to arrange the loop round the base of the tumor with greater nicety. After the removal the electric light was called into play and they were thus enabled to make sure that they had done their work efficiently. As is often the case when anything novel is done, most of the speakers found fault with the use of the electric light. One said that the surgeon's sense of touch would enable him to do quite as well witbout seeing as with, another that after removal of a tumor the bladder filled with blood and that therefore nothing would be visible, but no amount of rhetoric of this kind can obliterate the fact that the light was used and was found serviceable.

The Royal College of Physicians and Surgeons have conjointly petitioned the Privy Council for power to give degrees in medicine and surgery and their petition is of coursebeing duly opposed by sundry interested bodies and the professional agitators, and it is more than probable that the opposition will be successful, much to the detriment of our London students who are at an immense disadvantage as compared with the students in any of the principle cities of the United Kingdom. The universities of Oxford and Cambridge will, I imagine, look on placidly, as they will not be seriously affected, they are centers of education not merely examining bodies, such as the new institution would be if created.

THE DISINFECTING MANIA.

EDITOR REVIEW: That the study of bacteriology has helped to stop or prevent the

spread of disease in many instances, very few will question, although there are sceptics who maintain that, in spite of the progress achieved in the knowledge of disease germs, we are as far from successfully combating or treating infectious diseases as we were ten or twenty years ago.

However this may be, modern surgery has practically demonstrated what can be accomplished when the researches of the bacteriological laboratory are applied to the methods of the operating table and the surgical wards.

Yet, there are always two sides to a medal, and the beneficent results of the new science are in a measure counter-balanced by morbid excrescences. The new doctrine seems to have had a deleterious effect on the minds of laymen and physicians.

Of late cases have come under my observation which remind me of the peculiarities of a certain class of insane who constantly wash themselves in order to do away with imag. inary impurities and contaminating materials.

As every new discovery is eagerly grasped by the insane and made a part of the stock of their delusions, so with the microbian doctrine. Instead of the familiar aspect in asylums of persons constantly pulling worms out of their noses or other parts of their body, the man with bacilli or micrococci in his skin or brain makes his appearance.

The hypochondriac especially has been badly affected by some facts regarding the transmission of disease by water, ice, food, etc. The fear of infecting himself with some terrible malady interferes with the enjoyment of his favorite dishes, and adds a drop of gall to his most cherished cups.

I know of some persons who, in order to be sure of avoiding the deadly microbes, drink only distilled water.

Highly amusing are many of the measures either in actual operation or proposed to prevent or to stamp out epidemics, on the antimicrobian plan. Imagine the feelings of Koch when,on his return from cholera stricken Italy, crossing the frontier of Switzerland, he was collared by the official sanitary enthusiasts and thoroughly fumigated.

Preventive measures are certainly of the highest importance, and have doubtless been of decided effect in threatening epidemics, but many of them have proved and still are proving nugatory, owing to their being superfluous and infeasible.

One of the latest propositions showing the absurdity of a certain kind of medical logic, is that of a physician in the far off Caucasus. He believes that the mouth pieces of the telephones are instrumental in spreading disease, and that they ought to be disinfected before and after using. Some (!) disinfectant fluid should be kept at every telephone station,and the speaker should, first of all, dip the mouth piece into the fluid, and then wipe it with a clean towel.

Who guarantees the cleanness of the towel? Such crude notions are the outgrowth of a mind filled with bacteriological facts, ill understood and misinterpreted.

Fortunately there are other things to be done in this world than to discover means of evading infection. The workers in pathological laboratories would have achieved very little if they had frittered away their time in personal disinfection.

ANTIPYRIN.

L. BREMER.

SEDALIA, Mo., Dec. 25, 1887. EDITOR REVIEW: I notice in the REVIEW of 17th inst., a letter from Dr. Mansfield, of Metamora, Ill., in relation to antipyrin. In a few words, I can state that the doctor's experience comports with my own, almost exactly. And I should defer making any report, after endorsing the precautionary measures of altogether abandoning antipyrin in the treatment of typhoid fever, if I did not think this an opportune time to call a halt to some of our younger and more enthusiastic brethren in regard to new remedies. There seems to be a disposition to manufacture "theories," and make everything bend to your theory.

The same may be said in regard to the bacteria nonsense that is but a revamp of

views long since buried, which could not and never will bear the scrutiny of common sense.

We often hide behind the impregnable fortress of "scientific investigation," in order to cover up very unscientific deduction. It is a good deal like the old exploded dogma of accusing the liver with all the faults and ills that flesh is heir to. I probably should not have extended this communication to this length had I not been duped to some extent by this eternal clamor about new and specific drugs. Not being a "scientific investigator" myself, in the sense of that term to-day, and depending upon my more favored brethren for new facts in progressive medicine, I, of course, expect, with the great army of my confreres, to have to await the decision of our more favored investigators.

But I have about come to this conclusion: When any thing appears to receive such a meed of praise and notoriety that will cause it to supersede all old established usages and upturn what was established as fact by all known means of investigation, I am disposed to fight shy of the new comer. I have no doubt that a great many lives have been absolutely sacrified by this blind following after theoretic medication that the application of a little common caution would have prevented. It is somewhat like the case of a big negro who applied for baptism by immersion in an early day. By some means the subject slipped out of the minister's hands just at the moment of immersion, and after a great amount of floundering about he succeeded in gaining the outskirts of the assembled multitude, and was heard to mutter with an ominous shake of the head, and while the water was still pouring off him, "Some gent'man's nigger get killed at dat foolishness yet." No antipyrin for typhoid.

JNO. W. TRADER.

-Depaul states that the maximum of the fetal heart sounds may be heard in the vicinity of the quadratus lumborum muscle, on a line from the right sacro-iliac synchondrosis to the umbilicus.