his case, or his reputation, and not unlikely all three together. A sad result. Similar cases in the practice of the best of physicians have often occurred.

In the former editions of the U. S. Dispensatory, Prof. WOOD doubts any advantage of the aqueous extract over crude opium, either in the uniformity of the dose, or its medicinal effects upon the system. In his last edition, however, he modifies his opinion so far as to admit that opium deprived of its narcotine can be tolerated in some cases where crude opium cannot, on account of idiosyncrasy. The efficacy of the united, or it may possibly be the compound principles of morphia, codeia and narcein, over morphia alone, in many pathological states, is now well established by the experience of many physicians.

Is the habit of taking opium deprived of its narcotine as pernicious to health as that in the crude state? Perhaps, a definite answer will require a longer experience than we now possess. About eight years ago, I had a case that imperatively called for the exhibition of opium. Crude opium or laudanum could not be tolerated, and morphia failed to give relief. By the advice and counsel of my medical friends, I resorted to a preparation deprived of its narcotine -a liquid, aqueous extract-with the most happy immediate effects. The circumstances of the case required the use of the opiate so long, that the habit was established. After this period, the habit already acquired, in addition to delicate health, rendered every attempt at a cessation of the use of the anodyne most painful and distressing, and my patient preferred the risk of the bad effects of the drug, to the suffering inevitable to a cessation of its use. For the last seven years, a dose equivalent to about fifty or sixty drops of officinal laudanum is taken three times a day, just before meals, and thus far no increase of the dose has been required. Neither is there, as yet, any signs of the constitutional poisoning, induced by a long continued and increased use of opium. What the next decade will tell on the constitution, or whether an increase of dose within that time will be required, is more than can be predicted from past experience. The interest of the subject, I am sure, will give me license again, for another short digression upon the therapeutical effects of this most important drug. In the last number of this journal, Dr.

The excuse, if any were needed, for being thus particular in bringing this plant to notice anew, arises from the fact that it must be extremely rare, never having been found, as far as I know, by any other exploring party in California, and the collection of ripe seeds for propagation in our gardens is quite a desideratum. New parties exploring those regions hereafter, may also be incited to search diligently for it, and bring ripe seeds for cultivation.

The two Eschscholtzias, or Californian poppies, are very abundant, very ornamental, and easily propagated. This easy propagation is also the case with most other genera of this order, so that the probability is that if we could procure the ripe seed of the Arctomecon, there would be little difficulty in reproducing it.

The universal narcotic activity and other medicinal characters of the order would lead us to infer that it might possess valuable medicinal properties, and such also as might lead to important results in practical medicine.

There are several other genera of plants belonging to this order peculiar to California and the West, but they are only interesting in a botanical point of view. Their medicinal properties have never been tested. One of them, the Romneya Coulteri, is very interesting on account of its affinities to other orders, forming a connecting link with Nymphaceae, Sarraceniaceae, and Cruciferæ. The seeds of the Romneya, unless very lately, have never been collected. The plant is also very showy, having a pure white flower over four inches in diameter.

TWO FATAL CASES OF OCCLUSION OF THE ILIOCŒECAL VALVE, BY CALCULI OF CHOLESTERINE.

BY G. P. ANDREWS, M. D., OF DETROIT.

THE following cases are interesting as affording examples of a rather rare form of calculus, and the latter one from the length of time the patient survived the total cessation of focal discharge per anum. The calculi, both of which came into my hands for analysis, were of exactly the same character, and very nearly of the same size and weight.

CASE I. Mr. S., æt. 55, a banker, of sedentary habits, and spare form, but enjoying moderately good health. Had suffered, a number of years previous to his last illness, from a severe attack of "bilious colic," the agony attending it being intense, and lasting for several days, when it suddenly ceased.

May 5th, 1864, Mr. S. was seized with sudden nausea and vomiting, without having any previous pain or illness. An irregular practitioner attended him during the first two days of the attack, and among other remedies gave brisk cathartics, and employed enemata freely, but without producing any focal discharge, save of the matters previously contained in the rectum.

In the third day after the initial symptoms appeared, Dr. S., of this city, was called in, and in connection with him I attended the case until its close. Gen. C. S. TRIPLER, U. S. A., was also called in consultation. At this time the patient presented the appearance of extreme exhaustion; pulse rapid and feeble, features wan and pinched, stomach rejecting within a few minutes whatever was swallowed, and frequently violent retching occurred, continuing until a quantity of thin, yellow stercoraceous matter was ejected, when a period of rest would occur, although there was constant pain in the region of the cœcum.

A careful examination excluded all causes for the symptoms save occlusion of the ilio-cocal valve, or concealed hernia, and the local symptoms all pointed to the former as the true source. It was evident that medical means were futile. Inflation of the bowel was immediately resorted to, by means of a large-sized hand bellows, introduced directly into the rectum. Meanwhile, stimulants and sedatives were employed to support the vital forces, and allay irritation. The most effectual means of checking the nausea proved to be iced champagne, in small quantities, frequently repeated. As the inflation of the bowel proceeded, the abdomen enlarged, and tense coils of intestine could be felt rolling over and over and twisting upon themselves, but all efforts to cause the air to pass the region of the iliocœcal valve proved unavailing, although all the force was used which was deemed justifiable. After some hours had passed in these means being persistently employed, upon removing the nozzle of the bellows from the rectum it was found to be full of the same yellow

fluid which was ejected from the stomach, and shortly after, upon attempting to stool, a considerable quantity was passed by the natural channel. The vomiting now ceased, and beef tea and brandy were taken and retained, and hope began to dawn that the obstruction had been partially overcome, but the respite was brief, and the symptoms returned in all their severity, and our patient rapidly passed into the state of collapse, which accompanies sphacelus of some portion of the intestine, and gradually sank, and died a little after midnight of the fourth day. The question of an operation for the surgical relief of the difficulty was considered, but it was not deemed advisable to attempt it.

Autopsy, ten hours after death. Upon opening the abdominal cavity, evidences of extensive previous inflammation appeared in abundant adhesions found between the serous surfaces of the cavity, and in one or two portions the ilium was constricted in its caliber from the effusion of plastic lymph, apparently of long existence, and coetaneous with the adhesions. There were no particular evidences of recent inflammatory action, until we approached the ilio-cocal valve, where for some distance there was vascular injection of both the peritoneum and the intestine, which latter, for about four inches of the portion next the valve, presented the appearance of wet parchment, and was easily torn. Contained within was a hard mass, which upon removal proved to be a biliary concretion, an inch and an eighth in length, three-fourths of an inch in breadth, and five-eighths in thickness. Externally, it was friable, apparently made up of concentric layers of cholesterine, and probably excretine, abundantly stained with bile pigment. A central mass, comprising about one-half the entire bulk, consisted of pure cholesterine, appearing like spermaceti, being totally soluble in boiling ether, and crystallizing in the beautiful rombic plates, so characteristic of this sub

stance.

The effect of the inflation of the bowel had evidently been to move the calculus a short distance, so as to allow a little of the fœcal matter to pass, but immediately slipping down, the occlusion was again complete.

The next case was kindly furnished by Dr. J. S. RAYMOND, of Algonac, Mich., in whose practice it occurred, and from whose notes,

which, with the specimen, were sent to Dr. PITCHER, the following is condensed.

CASE II. "On Sunday, P. M., April 8th, 1866, I was called to see Mrs. A., æt. 56, of bilious temperament, large frame, the mother of five children, previously healthy, and living on a farm.

pills, and ,took a

"A few days previous, in putting up a leach tub, she had lifted a barrel of ashes, and hurt herself internally. On Friday, bowels were uneasy; thought she required physic; took a dose had a slight movement of the bowels. Not being reli dose of salts and senna, and after suffering some time zonger sent for me. I found pulse 80, full and bounding, skin moist, tongue slightly coated, little or no tympanitis, no tenderness of bowels, vomiting, pain of spasmodic character; examination revealed no hernia. Gave cathartic of calomel and rhubarb; ordered large injections of warm water, and hop fomentations externally.

"9th, 8 A. M. Pulse as yesterday; retained the cathartic four hours, then had vomited contents of stomach, with a large quantity of bile; has discharged injections unchanged; gave castor oil and turpentine; fomentations and injections continued.

"9 P. M. Symptoms unchanged, except that the tongue is covered with a thick, black coat; no redness of edges. Bled freely, and continued treatment as before.

“10th, A. M. No alvine evacuations; slight tympanitis; considerable tenderness in the iliac regions, particularly the right; vomiting stercoraceous. Injections of beef tea, fomentations continued; also cathartics, with alterative doses of hydrarg. cl. mitis, and morphine.

"Evening. Pulse 90, softer; other symptoms unchanged. Made thorough examination for hernia per vaginam, and externally, with negative results, as before.

"11th. Less stercoraceous vomiting; pulse small and wiry; tongue dry. Gave mucilaginous drinks, and continued treatment as before.

12th. Drs. CORNELL, of St. Clair, and PARKER, of Marine City, called in consultation. Patient sinking; countenance hippocratic and blue; extremities cold; pulse small and. weak, otherwise unchanged; death considered inevitable, and the alterative treatment seemed the best. Dr. C. having brought the galvanic battery by