tion of pure terebene was an excellent remedy for this combination of symptoms. It checks the formation of flatus so quickly, and is so efficacious in expelling any that may remain in the stomach or intestines, that I constantly employ it in cases of dyspepsia when flatulence is a prominent symptom. Patients like it, and often continue taking it for months or years. It acts as an antiseptic much in the same way as glycerine, oil of cajeput, and oil of eucalyptus. I am surprised that it has not come more largely into use in the treatment of flatulence. Pure terebene is of such value in winter cough, that I rarely experience the necessity of resorting to other remedies.-Dr William Murrell, in the British Medical Journal for 12th December.

TERPINE.-The Therapeutic Gazette for November gives the following abstract, from the Revue de Médecine, of the researches of Lépine on Terpine:-Terpine, a crystalline hydrate, obtained from the oil of turpentine, is readily soluble in alcohol (in the proportion of 1 to 7). In cold water it is soluble in the proportion of 1 to 200; in water which has first been boiled and then cooled down to a lukewarm state, it dissolves with still greater ease. Lépine maintains that terpine has an action very similar to that of turpentine, but that it acts not only in smaller doses, but also is much better borne by the stomach than the latter. The crystals of terpine have neither taste nor odour, and create therefore no repugnance on the part of the patient, as is so often the case with turpentine. But these are not all the advantages which Lépine claims for terpine. Fluidity and ease of expectoration, our author declares, are the rule after terpine, but not after turpentine; and as this sort of expectoration is produced by terpine even if given in a small dose, this drug must be regarded as the best expectorant in existence. In a dose of 3 to 9 grains, the drug exerts the above-mentioned therapeutic effect with great promptness. Of 200 patients in whom terpine was exhibited, not one complained of any inconvenience experienced by the drug, while the majority felt so convinced of its utility, that they asked for its continuance. In two chronic cases even, which had been very rebellious and resisted every other medication, terpine, given in 2 gramme (30 grains) doses, brought prompt relief. It is a peculiarity of the drug that, given in a large dose, its action is just reverse from its effects produced when given in small doses (about 3 to 15 grains); i.e., it suppresses expectoration when given in large doses, and is therefore useful in cases of bronchorrhoea. Next to its action on the respiratory passages, its diuretic effects claim our attention. In his early researches, Lépine thought favourably of its diuretic power, and anticipated good services from the drug in chronic nephritis. His latest and more expansive observations, however, have convinced Lépine that no such therapeutic employment of terpine was to be thought of; and that the drug, on the

contrary, might, especially in Bright's disease, do considerable mischief, as it decreases the renal secretion, and even causes albuminuria and hæmaturia. The latter consequence may ensue after large doses, and is to be diagnosed not merely by simply inspecting the urine, but by examining the solid sediment for blood-corpuscles, or testing the urine with oil of turpentine and tincture of guaiac, when in cases where blood is present the characteristic blue colour will appear. In healthy individuals, however, no untoward symptoms are ever produced, as demonstrated by a large number of conclusive experiments. Testing the physiological effects of a watery saturated solution on the blood of animals, Lépine obtained the following results:1. Hæmoglobinhæmia, transitory, and without hæmoglobinuria, but with considerable polycholia. 2. Anuria for twenty-four hours following the introduction of the drug into the blood. The scanty quantity of urine secreted during another twenty-four hours looked like a watery infusion. 3. Small quantity of urea in a dark-coloured urine. As to the action of terpine on the nervous system, Lépine found it to act quite the same as turpentine, though in one-third of the dose required of the latter. In neuralgia and hystero-epilepsy, the drug proved actually a success in the limited number of cases in which it was tried by Lépine. In cases of bronchitis it is best given in a watery (and slightly alcoholic) solution, and can be associated with any convenient syrup. In nervous affections it will often be required to combine with it an astringent, in order to avoid diarrhoea.

PERISCOPE OF MEDICINE, CLINICAL AND PATHOLOGICAL. By G. A. GIBSON, M.D., and WILLIAM RUSSELL, M.D.

ACTIVE PULMONARY CONGESTION ACCOMPANYING CARDIAC DISEASE. This condition is illustrated by the case of a man who had aortic aneurism and insufficiency, with a hypertrophied heart. One evening, on coming out of the theatre into the cold but dry air, he was suddenly seized with respiratory embarrassment accompanied by marked oppression. At the same time he developed a severe stitch in the left side. On auscultation there were fine crepitant râles over an area not larger than the palm of the hand. The bases of the lungs were free. Acute pneumonia would have been diagnosed were it not that the absence of concomitant fever excluded the idea. The signs disappeared in the course of a few days. He had similar attacks frequently; indeed, every time he went out in the evening without taking minute precautions he was similarly affected. The only treatment adopted in the attacks was dry cupping over the spot where the râles were present. It is specially to be noted that these active congestions appeared when the cardiac lesion was amply compen

sated for. The expectoration varied in character, but was at times pneumonic or streaked with blood. It is maintained that this condition is to be clearly separated from the embarrassment of the pulmonary circulation so frequent in cardiac affections, and which are the result of stasis. The active congestions are essentially transient and usually localized. These attacks may be often unimportant in themselves if the cardiac lesion be amply compensated for, but they may be sufficient to overturn the balance and be the starting-point of the events which follow failure of compensation.-Le Dr M. Lebreton, Gazette Médicale de Paris, 31st Oct. 1885.

PTOMAINES OF CHOLERA. Researches on the comma bacillus by Nicati and Rietsch were communicated to the Academy of Medicine in October and November. By the injection of pure cultures into the veins of an animal they had produced, by very small doses, the symptoms of cholera, ending in death. They had also separated from these cultures a liquid ptomain capable of producing similar effects. The authors had also separated from the blood and liver of cholera patients dying rapidly and in the algide stage, and when the autopsy had been made two hours. after death, an alkaloid presenting the same chemical characters and the same action on animals as the alkaloid separated from the pure cultures. These facts, it is contended, tend to demonstrate that the comma bacillus is the pathogenic agent in cholera, and that this ptomain is the active element.-Archives Gén. de Méd., December 1885.

TYPHOID FEVER, FOLLOWED BY FATAL PERICHONDRITIS OF THE CRICOID AND ARYTENOID CARTILAGES.-This case is reported from the service of Professor Villemin at Val-de-Grâce Hospital. The patient was 25 years of age, and never had syphilis. The attack of typhoid fever for which he was admitted ran an uneventful course, and convalescence seemed well established. He, however, developed signs of bronchiectasis in the left lung. Seven weeks after the onset of the fever pain in the throat was complained of, which was aggravated by coughing, and a fortnight later dysphagia and partial aphonia supervened. Laryngoscopic examination revealed a sessile polypus on the posterior part of the left inferior vocal cord, which was believed to be of tubercular origin. The propriety of surgical interference was considered, but before any steps had been taken, the patient died suddenly and unexpectedly. At the post-mortem examination the intestinal ulcers were found cicatrized. Several of the bronchi in the left lung presented bronchiectatic dilatations, and some of the bronchial glands were enlarged and tuberculous. The cricoid cartilage, in its entire circumference, was eroded and was bathed in pus, which lay within the perichondrium. The case, apart from the interest attached to the laryngeal affection, showed also the

association of bronchiectasis with tubercular glands, which is rare, and was found by Barthez only once in forty-one cases.-Le Progrès Médical, 17th October 1885.

THE FERMENTATION TEST IN THE DETERMINATION OF SUGAR IN THE URINE.-Einhorn has performed a long series of experiments with the fermentation test in Salkowski's laboratory, and from the results of his investigation he has drawn the following conclusions:1. Urine affords better conditions for the process of fermentation than water, so that a solution of glucose in urine gives a little more carbonic acid than a solution in water of similar strength, and if the urine be concentrated the process is still more aided. 2. Additions of salts or other substances are not necessary in the application of the fermentation test. 3. Without any further check beyond taking equal quantities of yeast, it is possible to determine sugar when present in the proportion of per centum. 4. By boiling urine for ten minutes, it is possible to detect sugar when present in the proportion of per centum.-Archiv für pathologische Anatomie und Physiologie und für klinische Medicin, November 1885.

PERISCOPE OF OTOLOGY.

By Dr KIRK DUNCANSON, Senior Surgeon to the Eye, Ear, and Throat Hospital, 6 Cambridge Street; Lecturer on Diseases of the Ear, Edinburgh School of Medicine.

RECENT OBSERVATIONS RELATING TO MUMPS.-Dreyfuss adds two more cases, occurring in his own experience, to the thirteen cases described by Lemoine and Lannois, and the additional three published by Buck, of New York, of unilateral deafness following mumps. He shares the opinion that many cases of temporary deafness or impairment of hearing following mumps are overlooked by parents, and that probably many cases of unilateral deafness, not attributable to any direct cause, date their origin from a preceding attack of parotitis. According to him, aural troubles set in usually a few days after the onset of the main trouble; in both his cases, not till twelve days after recovery from a mild attack of mumps. Cases are recorded, however, where aural trouble preceded the attack of mumps by two to three days. The aural complications are generally ushered in by rushing, hissing tinnitus, and more or less pain in the ear. Later on, the train of Ménière's symptoms, such as vertigo, nausea, and vomiting, set in. Convulsions or loss of consciousness have, however, never been noticed. In both the author's cases the aural disorder was merely preceded by a feeling of malaise and lassitude. Deafness develops very rapidly, in a few hours, never later than within two or three days; while the membrane, pharynx, and Eustachian tube are to all appearances perfectly normal. The author does not share the opinion of Lemoine and Lannois, that deafness is always irreEDINBURGH MED. JOURN., VOL. XXXI.-NO. VII.

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mediable, as hearing power was almost entirely restored in one of his cases. Dreyfuss entertains views similar to those of Brunner, that the pathological changes consist in an exudation into the labyrinth, with subsequent atrophy, changes resembling those in the testicle in attacks of mumps. He rejects the assumption, as not being tenable, especially in those instances where aural complications arise prior to or after the general attack, that the process is an inflammatory extension from the parotid gland along the facial nerve or through the Glasserian fissure. Furthermore, the rapid development of the deafness would not favour this hypothesis. The author thinks that we have to deal here with a localization (metastasis) of the morbid products, independent of the usual limits of parotitis. Not only the lymphatic, salivary, and seminal glands, but also the organs of special sense are affected in parotitis. The disturbances in the auditory organ are analogous to those which have recently, from the same origin, been noticed in the visual organ, namely, conjunctivitis, amblyopia, and optic neuritis.-Gazette hebdom. de méd. et de Chirurg., No. 30, 1884.

MUMPS AS A CAUSE OF SUDDEN DEAFNESS.-In addition to a general review of the whole subject, with abstracts of the already published cases, Dr Laertus Conner relates one case. The patient was a girl who, a month preceding the examination, had had mumps. As the attack was subsiding, she was suddenly seized with dizziness, staggering, nausea, and vomiting. Seen four days afterward, she was in bed on account of the nausea and giddiness. Temperature and pulse normal; tongue coated. After the action of some calomel powders, the nausea and dizziness disappeared, but a deafness in the right ear remained. When tested by Dr Conner, there was no perception of sound by the watch, tuningfork, or Politzer's acoumeter. Inflation made no change. The drum-membrane indicated a past inflammation of the middle ear. Hearing in L., condition of membrane same as R. Pharyngitis. Examined four and a half months after, the hearing in L. was 72 increased by inflation to R. still in same condition as regards watch, but the tuning-fork is heard on bone, and also at a distance of 4 inches from the ear; the acoumeter at 2 inches. The author thinks it probable that the disease extended from the parotid gland through the middle ear to the labyrinth.-American Journal of Medical Science, October 1884; Dr A. Hartmann of Berlin, and Swan M. Burnett of New York, U.S.A., in Archives of Otology, vol. xiv. Nos. 2 and 3, 1885.

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IN a case of deafness brought to me, now more than ten years since, in a young woman with old scrofulous cicatrices on both sides of neck and chronic suppurative inflammation of both ears, with perforations and discharges from both; disease had done most injury to right ear. The cicatrices were more numerous