AN ENORMOUS SPECIMEN OF ODONTOLITHUS.-J. J. Vin-service. Finally, all possible precautions for the precent, D.D.S., of Amherst, Mass., recently exhibited vention of adhesions of the labia are of the highest ima specimen of tartar, or odontolithus, which measured portance. The dressings should be carefully made and three and a half inches in length and half an inch in frequently renewed. breadth; the base was nearly half an inch thick. The COXALGIA. Dr. Guersant (Med. News and Library), patient, wife of a clergyman, aged 35 years, positively stated that she had always been in the habit of brush-referring to the treatment of coxalgia, thus remarks in ing her teeth inside and outside three times daily. The regard to abscesses :specimen was removed from the coronæ of the teeth of the lower jaw, viz., the incisors, bicuspids, and canines. A species of infusoria, Denticula hominis, was found in it.

THE USE OF IRON IN SCARLATINA.- Russell Aldridge, M.D. (British Med. Journal), is desirous of drawing the attention of the profession to the use of iron in scarlatina. He has given it for the past two years with great success, so much so as to induce him to believe that in it we have a powerful remedial agent for that disease. Not only does it shorten and lessen the severity of the attack, but it also fortifies the patient against the after-consequences-dropsy, etc. The form which he has mostly used has been the liquor of pernitrate of iron in syrup or glycerine, in doses of ten minims every three hours for children of from one to six years, increasing, according to age, to fifteen, twenty-five, or thirty minims. During convalescence he has given citrate of iron and quinine, ammonio-citrate of iron, or syrup of phosphate of iron, according to circum

stances.

NO MENTAL SYMPTOM FOR BRAIN LESION.-T. S. Clouston, M.D., Med. Supt. of the Cumberland and Westmoreland Asylum, Carlisle (The Practitioner), states that at present there is absolutely no mental symptom or train of mental symptoms, which, taken by themselves, are certainly diagnostic of any particular brain lesion. And if this is all that has been gained by centuries of the old method, we cannot lose much, and might gain something, he says, if we began a new method and concentrated the greater part of our attention on the bodily conditions, deeming nothing too trivial to be observed, and nothing too irrelevant to be

noted.

PHYSIOLOGICAL EFFECTS OF ANESTHETICS.-Dr. J. L. Prevost, of Geneva (The Practitioner), in his "Note on the Physiological Effects of Anæsthetics," says in conclusion, that his experiments lead him to believe that chloroform, in order to anesthetize the nervous centres, must reach those centres, and that it only anæsthetizes the part with which it is in actual contact, whether in the case of the brain or in that of the spinal

cord.

GANGRENOUS VULVITIS IN CHILDREN.-Dr. Guersant (Med. News and Library) publishes the following treatment of this affection. It may be local or general, the principal indication being to combat the disease which debilitates the patient. The various kinds of tonics, as cinchona, bitter tonics, broth, wine, coffee, etc., may be placed in the first rank. The local treatment is not less indispensable. Applications of lemon-juice, powders of cinchona and camphor, vinous lotions, etc., may answer the purpose, but these means often fail. The best means of limiting the gangrene is the use of iron heated to a white heat. Cauterization should go beyoud the boundary of the slough, which may still often be crossed by the disease the next day. When this powerful local agent succeeds, there remains a large ulcer, a real burn of variable depth, which requires the same dressing as burns of this region. It is important that slightly camphorated powders of cinchona and charcoal should be applied; and lotions, including aromatic wine or chlorinated water, may be found of

-When the abscess becomes de

cidedly prominent, it is our duty to open it. As a avoid the exhaustion consequent on a long suppurative general rule, we postpone this as late as possible, to discharge. When we decide to open it, we sometimes have recourse to puncture with a long, flat trocar devised by M. Guérin, and to suction by means of a syringe, which may be screwed to the canula; sometimes to simple puncture, or the application of a drainage-tube, according to the method of M. Chassaignac. Sometimes the purulent collections emptied by the trocar do not fill up afresh. Most frequently the abscess is reproduced as before, or else the puncture becomes the seat of a fistulous tract. Advantage may be derived in such cases from iodine injections (one part of tincture of iodine to two parts of water), according to the suggestion of M. Boinet. The drainage-tube has the advantage over ordinary setons of allowing of detergent injections into the purulent collection, by adapting to it the canula with a syringe.

IRRIGATION OF THE PHARYNX.-Dr. Guersant (Med. News and Library) alludes to those cases of very intense inflammation of the pharynx where the patients have much trouble in opening their mouths, and can scarcely separate the teeth. For these cases, and especially for children, in simple or violent inflammation of the tonsils, in abscess of those organs, in pseudomembranous stomatitis, in diphtheritic membranous stomatitis, in diphtheritic pharyngitis, or gangrenous inflammations, or even in chronic granular or other forms of angina, much advantage is derived from irrigations of the throat. As a syringe or an irrigator must always be used, it would only be a question of having a suitable canula to depress the tongue and make the fluid spirt into the different parts of the throat. The ordinary gum canulas do not depress the tongue, and may be bitten and broken by children. In order to overcome this defect, he has had constructed an instrument which is called the canula tonguedepressor, made of bronzed aluminium, that metal having the advantage of not being altered by sulphurous water, which may be used under certain circumstances, ⚫ in chronic amygdalitis for example. It has the shape of the extremity of a spoon-handle, is slightly curved, from five to six inches in length, and one-fifth of an inch thick, and hollow in its whole extent. Its extremity, which is designed to depress the tongue, has on its circumference and on its convexity a certain number of small holes, like those of a watering-pot. At the other end is a true canular extremity, which may be adjusted to the caoutchouc tube of an irrigator, or even of a syringe.

These irrigations may be repeated several times a day. Older persons easily accustom themselves to its use, and even children at last consider it an amusement. In certain forms of chronic amygdalitis, and in granular inflammation, he has obtained good results from irrigation, by the use of sulphurous waters, as practised by Dr. Lambron, at Luchon.

Tinctura colocynthidis, known also as "Dahlberg's Tincture," is made as follows: Colocynth pulp (cut small and free from seeds), 3i; aniseed, 3i; proof spirit, 1 lb. Digest for eight days, express and filter. Dose, 6 to 20 drops.-Pharm. Journ. and Transactions.

THE MEDICAL RECORD.

interested parties are not only withheld from publication, but that medical men are peremptorily refused the privilege of consulting such reports? Some gentlemen have been told that the various opinions of

I Semi-Monthly Journal of Medicine and Surgery. medical men now on file in the office of the Secretary

GEORGE F. SHRADY, A.M., M.D., EDITOR.

Published on the 1st and 15th of each Month by
WILLIAM WOOD & CO., 27 GREAT JONES STREET, NEW YORK.
FOREIGN AGENCIES.

LONDON-TRUBNER & CO.
PARIS-BOSSANGE ET CIE.

LEIPSIC-B. HERMANN.

of State will not be published until they are completed! We may excuse this on the ground that time is required to unravel the mass of red tape in which State documents are officially enveloped; but under the circumstances, believing that Bliss, who is known as a politician, is too much interested in the sale of his remedy to favor the dissemination of damaging opinions, we strain our charity.

If there are any real merits in Cundurango, it is time Rio Janeiro-STEPHENS Y CA. that the profession should hear of them, and we intend to do all in our power to enlighten our readers at once. We are willing to give it every chance to speak for itself in the legitimate way, and invite such as have tried the socalled specific and have sent documents to the Depart ment, to furnish us with duplicates. The discussion

New York, October 2, 1871.

CUNDURANGO UNDER THE PATRONAGE OF belongs legitimately to the medical profession; and

THE STATE DEPARTMENT.

save in a purely official way, the Honorable Secretary has no more to do with the matter than has Mr. Colfax to become an authority on pathology. We present our readers with one of the reports made to the Board of Governors of the New York Hospital, and sent by the Committee to the Department of State. It may be considered a sample of others, to which the profession are positively refused access:—

"The undersigned, a committee of the physicians and surgeons of the N. Y. Hospital, to whom were addressed certain packages of a remedy known as Cundurango, and claimed to be a cure for cancer, which had been sent from the Department of State in Washington to the Governors of the Hospital, and by them referred to the Medical Officers of the Hospital for. trial, report:

That they distributed it among medical gentlemen of known capacity, to be administered by them according to directions accompanying the remedy, to patients under their charge suffering from cancer.

From the written reports of these gentlemen the committee derive the following particulars, which they

THE profession are growing more and more suspicious of the reputed effects of Cundurango, and of the disinterestedness of Dr. Bliss. The reports in the daily papers, the manner in which the remedy was first brought to the notice of the profession, and the attempts to obtain a monopoly of the drug, are facts with which our readers are already familiar. Notwithstanding, however, that a prejudice has thus been created against the vaunted discoverer of this wonderful remedy, and, as a matter of course, against the remedy itself, the profession in their eagerness to find a cure for cancer are not tired in looking for reliable facts. But no trustworthy accounts of the effects of the Cundurango have reached them except negative ones. This does not, however, deter us from seeking more light. The distrust of its virtues is not yet so strong but that we are ready, nay anxious, to be converted to different opinions. Dr. Bliss, it is true, has forfeited the confidence of the profession, has degenerated from a conscientious observer to a mere specu-22d. His patient was a lady, 44 years of age, mother DR. JOHN DOLE, of Amherst, Mass., writes:-"June lator, but there are others, however, who can never descend to such a grade, who have made the best use of cultivated powers of observation, of extensive experience in the treatment of cancer, and are able to judge properly whether the Cundurango is a boon to humanity or is worse than nothing. Very few of such gentlemen have had the privelege of experimenting with the drug. All of these, it would seem, have had such opportunities granted them on an understood condition, that their reports of its efficacy should be sent to the State Department. As a matter of courtesy no medical gentleman could object to such a condition, especially if he have reason to believe that the Department makes the best use of the information thus obtained. But how can we explain the fact that reports adverse to the opinions held by Bliss and other

herewith submit:

of two sons. She had a hard, nodulated, flattened cancer, involving the entire right mamma, which was adherent to the ribs, and covered a space of between three and four inches in diameter. From the surface there oozed a thin serous discharge. In the right axilla and supraclavicular region there were hard nodules evidently involving the axillary plexus of nerves and causing severe neuralgic pains extending down the arm. In the left mamma, which retained its form, though wasted, a hard, small nodule was felt. The disease had existed about two years and a half, and first developed itself locally in the right mamma soon after a severe blow on the part. For several years prior to the appearance of the cancer her health had been deteriorated by repeated hemorrhages from hemorrhoids. These three months before commencing the Cundurango had been successfully operated on by ligation about treatment."

DR. DOLE writes: "I can say but little concerning

the action of cundurango, as most of the effects were negative. It was administered in the form of a decoction (each dose representing what virtue could be thus extracted from exactly eighty grains of the powdered wood and bark), given twice a day, at 8 o'clock A.M. and P.M., two hours after food. You will remember Mrs. W.'s condition when she left New York. The following changes took place: 1st. The third day of administration she reported (unasked) entire freedom from pain in the nodule under the nipple of the left breast, which, up to that time, had been for weeks the seat of severe and constant lancinating pain. This pain never returned. 21. On the fifth day healthy granulations appeared at the edges of the sore, finally springing up in all parts of it, the whole surface presenting from that time a normal appearance: the right arm could be moved with more freedom. 3d. The constitutional symptoms not modified; appetite, pulse, respiration, and temperature remaining the same. Bowels somewhat more constipated, but not markedly so. The neuralgic pains continued with unabated severity during the whole time of administration, and were quieted by McMunn's Elixir Opii, given p. r. n. I noticed also the odor of perspiration, which was very marked and peculiar, like the odor emitted from an uncut cadaver; odor of urine strong, but not unlike that of urine in many acute diseases. After each dose of the medicine (at an interval of from 15 to 30 minutes) a peculiar restlessness showed itself, which continued from two to three hours.

SUMMARY.-Medicine continued seventeen days-a decoction representing 160 grains by weight per day; total relief of pain in left breast; improvement in character of sore, and increase in power of right arm, with partial restoration of power of motion without pain. Noticeable change in odor of perspiration, and a peculiar restlessness following the administration of dose. Should say I witnessed this phenomenon fifteen times. Constitutional effect nil. The appetite gradually failed, but not more rapidly than could be accounted for by the discontinuance of tonics. In conclusion, Doctor, allow me to say, I am very sceptical concerning the power of this remedy, but there was a curious coincidence between its administration and the modification of local symptoms. I tried to guard against any hasty conclusions in the matter. I have hope enough in its power to try it again in a case where the constitutional power was greater than in the case of Mrs. W. The exhibition was stopped eight days before her death; but I was absent, and cannot report on the effects of the change. Dr. B. assures me that the sore continued healthy until death.

the disease was already far advanced, causing a pretty close stricture of the gut. It was noticed that during the brief period the cundurango was used the cancerous growth increased with greater rapidity than at any previous time, and several large nodules of the morbid deposit appeared in the pelvis, causing a protrusion of the abdominal walls. The patient is still living, and intends to make another trial of the remedy whenever it can be obtained.

In conclusion, the Committee do not consider the
exaggerated pretentions claimed for the cundurango
plant as a cure for cancer substantiated by the results
of the trials herein reported. They would not, how-
ever, discourage more extensive and thorough trials of
its virtues, especially if such trials could be prosecuted
without enlisting popular sympathy, which has already
been prematurely evoked, and that without at all pro-
moting the attainment of truth.
GURDON BUCK, M.D.

T. M. MARKOE, M. D., vice
W. H. DRAPER, M.D., absent.

NEW YORK, July 26th, 1871.

Com. of Physicians

and Surgeons, N. Y. Hospital.

The report can speak for itself. We cannot say how many similar documents are kept from the medical public, neither can we do more than conjecture the motives actuating the powers that be; but we have a right, in the interest of truth, to invite all who have tried the remedy to publish their results without delay. We open our columns to such, and may be able to satisfy the suspicions of the profession, long before the Honorable Secretary may have accumulated what in his opinion may be sufficient material to make his official, report valuable. Medical the

Reviews and Notices of Books.

TWENTY-SEVENTH ANNUAL REPORT OF THE MAN

AGERS OF THE NEW YORK STATE LUNATIC ASYLUM.
Albany, 1870.

In the professional part of their Report the view of insanity as a bodily disease, easily curable in its early stages by medical treatment, is strongly insisted upon. If this theory were urged only to encourage the sending of patients to asylums at the earliest possible period, we should hardly care to criticise it. Representations which would fall under the ban of medical ethics, if DR. F. A. BURRALL, of New York, reports, July 10th: used for personal ends, are conventionally proper when I have been using an infusion of cundurango prepared made in behalf of public institutions. But the only seaccording to the officinal formula in a case of rodent rious argument for the policy of placing all the insane ulcer, or, as the disease is termed by C. S. Moore, in asylums built and organized as hospitals has no other F.R.C S., rodent cancer. The ulceration occupied the foundation. When all can be placed under treatment helix and posterior portion of the right external ear, and in such hospitals, it is claimed the sources of chr nic the adjacent part of the scalp. The patient had previ- lunacy will be dried up, and a great burden and reously been using a lotion of a watery solution of car-proach to the community removed. Now, to prove such bolic acid, tannin, and glycerine, and the lotion was a policy mistaken, it should be enough to say that continued. During the six weeks which were neces- the experience of every civilized community condemns sary for a trial of the cundurango the ulceration pro- it. If it were correct, we ought to find a reduction of gressed slowly but steadily. No marked general symp- the numbers of the chronic insane in proportion to the toms accompanied the use of the medicine. increase of asylums; but the fact is, the burden of chronic insanity has grown heavier in a direct ratio to this increase.

DR. H. B. SANDS, of New York, writes July, 15th: My experience in the treatment of cancer by the cundurango plant is confined to a single case in which the remedy was administered according to the prescribed directions for a fortnight. The patient, a lady residing in this city, suffers from cancer of the rectum, and at the time she began to take the medicine referred to

In England, where the policy of hospital asylums has been carried to twice the relative extent reached in this country, there has been a steady increase in the number of incurables. So plain is the inference, that no European writer now believes an exclusive system of

hospital asylums either possible or desirable to be realized.

in them is strongly condemned by the best authorities.

And yet the argument for such a system is based up- Another matter noticed in the Report is that of the on the statistics of these asylums. From 70 to 90 per cost, to the public, of patients in asylums. The hospital cent. of recoveries having been reported in recent cases, system is defended by Dr. Gray, not only from the it has been boldly assumed that these recoveries were curative point of view, but on account of its direct wholly due to asylum treatment, and that all cases of economy. In a pamphlet written in 1868 by Dr. Chapin, insanity might be cured in like proportion. Thus Dr. of the Willard Asylum at Ovid, the average weekly Thurnam, an English alienist, writes: "Of a certain cost of support in several asylums lying in adjacent number of cases brought under asylum treatment with- States was given in a tabular form, and as the cost at in three months of the attack of insanity, 80 per cent., the Utica Asylum chanced to be greatest of all, it was or four-fifths, were restored." Dr. Gray not only grasps put at the bottom of the column. This table Dr. Gray at the inference, but substitutes it for the facts. He copies into his report, and remarks: "It will be obsays: “Dr. Thurnam, a distinguished writer on the sub-served that Utica is the base of the cone! This pamjeet, states that if cases were treated within three phlet purports to be a Report of a Committee of the months of the first attack, four-fifths would recover; American Medical Association. A similar report by but if twelve months elapsed four-fifths were incurable, Dr. Charles A. Lee makes the weekly charge at Utica and so in proportion as the term was longer or shorter." $5.53; at Harrisburg $4.38, and at Northampton $4.78. How entirely fallacious this inference is, may easily be Neither of these statements (sic) are correct as regards shown. The cases referred to were placed in an asylum Utica, whatever may be the facts touching the other for the reason that they were dangerous, or needed institutions mentioned. Public institutions can well special care. What warrant was there for classifying bear the discussions of the questions of expense of the them together as one disease for scientific purposes? care of the dependent." Now, a moment's examinaIn fact, they differed among themselves very widely in tion of the comparative cost at these three institutheir nature. Those whose mental disorder dated back tions may be pardoned. Since our former calcula"three months or less," were cases of the type of deli- tion, more perfect details of the expenditures of the rium. Some exhibited the delirium of alcoholic, puer- Utica Asylum have been published in the Report of the peral, and similar forms of blood-poisoning, in persons Board of State Charities (N. Y.) for 1868. From the of an insane temperament. Others presented simple sum of these expenditures we, of course, omit the paroxysms of maniacal excitement from moral causes. estimated value of “products of the Asylum farm and These attacks are sudden and violent, making it neces- garden." It is customary to exclude the proceeds sary to send the patient at once to an asylum: but they of the "plant," as it is termed, of a public institution are transient, and he is quickly in a condition to be in estimating its current expenses. A small item of discharged. On the other hand, those patients brought "cash refunded patients on leaving " is also to be thrown to the asylum "after a year or more of their disorder," out. Next comes the large item of "buildings and were cases of insanity proper. The technical insanity repairs," including perhaps something which may be of medicine, it should be remarked, is, by its defini- construed as "extraordinary" expenditures. Here, tion, a chronic disorder, and it is chronic not only in however, we are left uncertain. How prone to conits fully developed stage, but in its stage of invasion. fusion upon this point of "ordinary," and "extraordiMost of these cases never exhibited any acute stage. nary" expenditures are all kinds of financial statements, They were never "recent cases," in any practical sense. from ministers' budgets to housekeepers' accounts, it is It was never possible to have brought them to an asy- needless to say. But from their nature, and from the lum "within three months of the date of their attack." custom of asylums, there can be no doubt that all the Their insanity came on almost imperceptibly, and dif- remaining items belong in the calculation. Well; omitferent observers might differ several months, and even ing all those named, the weekly cost per patient at years, as to when it began. Now, a large majority of Utica amounts to $5.45; adding the item of “buildthe patients of asylums are of this class, and nine-ings and repairs," this cost is $6.50. The weekly cost tenths of their number, from the first, gave no reasona- reported by Dr. Gray is $4.72. To reach this figure it ble hope of recovery. is necessary not only to exclude the entire expense of That the recoveries from mental disorder, of what-"buildings and repairs" from the calculation, but ever type, are due to medical treatment, must also be considered an unauthorized conclusion. The theory of insanity as a bodily disease really represents as yet no practical truth. It is strictly entitled to mean only that the most hopeful mode of studying insanity is in its relations and analogies with bodily disease. In a technical sense, of course, it is wholly incorrect. Those cases alone in which no bodily disease can be found to account for the mental disorder are classified in medicine as insanity. And it is clearly false as implying that we have any such knowledge of the pathology and therapeutics of insanity as we have of bodily diseases. The necessary antecedent of this knowledge, cerebral physiology, is as yet nearly a blank for us. As Maudsley says, "We are only on the threshold of the study of the nervous system as an instrument subserving mental function. We know little more positively than that it has such function; we know nothing whatever of the physics and of the chemistry of thought." We need hardly say, then, that no plan of medical treatment is even proposed for any of the forms of mental disorder, while the practice of empirical medication

several other items also, amounting in the whole to $54,341. The weekly cost at the Northampton Hospital for the Insane for 1868-including all the items omitted by Dr. Gray, except less than half that for 'buildings and repairs," rejected as "extraordinary "was $3.99. At the Harrisburg Asylum (Pa.) for the same year, the cost was $4.82, including both ordinary and extraordinary expenses, and all the other items. Finally, it appears that the expenditures of the Utica Asylum for 1868 were more than eighty thousand ($80,000), or 70 per cent. greater than those of the three Massachusetts hospitals for an equal number of patients!

It is by representations like these, skilfully urged in annual asylum reports, that the main efforts to improve the condition of the insane in this country have so long been directed in behalf of a system of close asylums for all. That an unreasonable devotion to this system is, in a great degree, responsible for the abuse and neglect which a majority of the insane in the United States still suffer, we cannot doubt. We freely admit that for a given proportion of this class the hospital asylum is all that can be desired, and that it should