TREATMENT OF CONJUNCTIVIAL DIPHTHERIA.

Dr. Vossius (Klin. Mon.-Bl.) treated a child in whom diphtheria had extended from the throat to the eye. The lids were greatly swollen and an ulcer had formed on the cornea. A two per cent. solution of carbolic acid was tried without effect, and the same was true of a solution of boracic acid. Applications of ice were kept on the greater part of the time. Afterwards a four per cent. solution of salicylic acid in glycerine was penciled on the part and dropped into the eye every half hour. The applications of ice were used at night. Under this treatment the improvement was rapid. The ulcer did not extend, and healed without leaving any visible cloudiness. The salicylic acid solution was used nine days.

THE INHALATION OF OXYGEN.

Hayem (Gaz. de Par.) states that the inhalation of from 40 to 90 liters of oxygen daily increases the appetite, slightly elevates the temperature, hastens the circulation and increases the weight of the body. The formation of hematoblasts and red corpuscles is increased, the latter as much as from five to ten per cent. This effect, however, is only temporary, and the proportion soon returns to its former value. In some cases, there is slight intoxication and trembling in the extremities.

The inhalation of oxygen is of value in chlorosis, especially when complicated with stomachic disturbances. The increased power of assimilation is evidenced by the augmentation of the daily amount of urea to as much as forty grams. The inhalation of oxygen will also be of value in continued emesis or painful dyspepsia without chronic gastritis. It recommends itself also in the vomiting of pregnancy and in uremia.

A HITHERTO UNDESCRIBED DISEASE OF INFANTS.

Dr. Riga (Movimento Med. Chir.), has observed a pernicious disease of the mucous membrane of the child's mouth. It consists of the formation of a false membrane between the end of the tongue and the frænum. The membrane is round and small. Children, in whose mouths this appears, lose strength rapidly, refuse to nurse and ninety per cent. of them die. The disease has been observed only in summer and is always associated with intestinal catarrh. It lasts from two to eight weeks. It is found in children only during the first dentition, it is not contaigious, but appears to be infectious. In the Terra di Lavoro the disease has been endemic for sixty or seventy years. During the past decade there has been no diphtheria in that region. No scientific study of the disease or membrane has yet been made.

THE EFFECT OF MASTURBATION ON THE EYES.

Professor Cohn (Arch. f. Ahkde.) reports a series of cases in which he has observed photopsia in young persons (male and female) addicted to masturbation. Apparently there is nothing wrong with the eyes. The retina and nerve are normal in appearance. The pupil responds normally to light; the sight is good, and the distinction of colors perfect. The symptoms are subjective and consist of flashes of light, stars, flecks and points of brilliancy dance in the field of vision. In most of the patients these symptoms disappear in the dark or when the eyes are closed. All the patients were chronic masturbators. Colored glasses benefitted some, but were without value to others. Abstaining from masturbation and the proper indulgence in normal coitus effected a complete cure. He has also noticed obstinate hyperemia of the connective tissue of the eyes in those addicted to this vice.

Finally he has observed clonic spasm of the muscles of the lid due to masturbation.

SELECTED ABSTRACTS.

SURGERY AND THE DOCTRINE OF EVOLUTION.

C. Pittfield Mitchell, M. R. C. S., of Orange, New Jersey, contributes to the New York Medical Journal and Obstetrical Review, for September, 1882, an essay, entitled, "An Evolution Aspect of the Healing of Wounds, with Deductions as to Treatment." As the author tells us in a prefatory statement, this is an application of the Spencerian doctrine of evolution to some of the phenomena of reparative action. The essay sets out with a classificaiion of methods of repair from the standpoint adopted. Next, the grounds for this classification are given, and incidentally we are introduced to an important conception -arguing that, since whatever is profitable to an organism, in the way of structural or functional variation, will be taken advantage of by heredity and natural selection, the functional changes naturally involved in recovery from disease will come within the sphere of their operations. With the zymotic diseases, for instance, natural selection may segregate, and heredity may fix, both the physiological peculiarity which insures immunity, and the physiological activities which establish the status quo when the disease has been contracted. Entering upon the immediate topic of the paper, the phenomena elicited by an incised wound, as the occlusion of arteries, the organization of plastic lymph, the development of granulations, and the physiological adjustment of the tissues to new external condi

tions, are viewed as non-specific functions of the tissues injured superadded to their specific functions. Deducing the evolution of these phenomena from the known action of physical forces, the shares taken by natural selection and sexual selection as factors are then dwelt upon. Special attention is directed to the protective value of the plastic lymph forming on the surfaces of wounds, and the evolutional steps are described by which this function is acquired. Passsing from the structural, the evolution of certain more strictly functional adaptations is next considered. Knowing, in general terms, the atmospheric and other forces to which wounded tissues in the past must have been exposed, the corresponding accommodations of function are inferred. Thus, the general conclusion is drawn that "the molecular constitution of wounded tissues should fit them, on the average, for contact with a mean atmosphere, and certain moderate deviations from this mean." It is pointed out that, although traumatic injuries are not necessary accompaniments of life, they are of such frequency among the lower animals and man as to give validity to this conclusion. An absence of organized adjustments of function to the remaining forces commonly incident upon wounds is inferred from the inconstancy, diversity, and nature of these forces. Such deductions are shown to harmonize with experience, and certain principles of treatment for healthy wounds are presented as corollaries. The gist of them is, that, so far as the exigencies of practice will permit, wounds should be shielded from the incidence of any force to which we may know a priori there cannot exist an organized adaptation. A normal atmosphere should be maintained, and cleanliness should be absolute at every step. Believing that the plasma exuding from the severed tissues is, by "its chemical and mechanical properties, and contact with environing forces during evolutionary time, specially fitted to protect the less stable cells which lie underneath," much importance is attached to the preservation of its integrity. "Wounds should remain open until the surfaces have become glazed, and all interfering applications should be scrupulously withheld." Finally, a verification of these inferences is found in the facts disclosed by Dr. McVail, in his paper in the British Medical Journal for July 23, 1882, on the results of "Ten Years' Surgery in Kilmarnock Infirmary." The method of dressing employed (dry-dressing) essentially fulfilled the above mentioned theoretical requirements, and gave, on comparative analysis, the "best general results covering a lengthened period of time that have ever been recorded in the history of British hospital surgery;" and the last group of cases reported-numbering four hundred and twenty-one, including ninety operations, twenty-three major amputations, forty-five injuries, fifty-two abscesses, and seven compound fractures showed not a single fatality from any cause.

POTASH PERMANGANATE IN CASES OF SNAKE-BITE.

The venom for these experiments was obtained by inciting the animals to bite cotton-wool. It was then diluted with a small quantity of distilled water, and injected by means of a Pravaz syringe into the veins or subcutaneous tissues of dogs. In the former case symptoms of poisoning appeared, and death took place after a longer or shorter time. When the virus was injected subcutaneously, extensive abscesses and mortification resulted. If, however, 2-3 cubic centimetres of a one per cent. solution of potash permanganate were injected immediately after the administration of the venom, all symptoms of poisoning remained absent, and if any such had already appeared (such as dyspnoea, irregular pulse, dilatation of pupils), they soon vanished completely. In thirty experiments the potash salt only failed twice, and the animals in these cases were young, weak and badly nourished. In place of phlegmonous suppuration after the subcutaneous injections there was merely a transitory non-purulent infiltration (Lacerda, La France Medicale).-Edinburgh Medical and Surgical Journal.

THE PROLONGED USE OF CHLOROFORM IN INSTRUMENTAL LABOR.

On August 6, 1878, I was sent for to a case of labor at full time, when I found the os dilating and vertex presenting; I also found antero-posterior deformity. The promontory of the sacrum projected a good deal forward, but the brim was not narrower than I have frequently delivered a living child through at full time, with the long forceps. After some hours, I found the os fully dilated, labor-pains strong, and the head becoming impacted. I thereupon applied the long forceps, and endeavored to extract under chloroform, but ineffectually. I then called in a neighboring practitioner, who also thought he could deliver with the long forceps, but failed. I then preformed craniotomy, using Simpson's perforator freely, and breaking up the cerebral substance, and afterwards using craniotomy forceps, crotchet, etc., but all to no purpose. The base of the skull was so much ossified and so large, that we could not move it, though we applied the long forceps over it, and again endeavored to extract, injecting tepid water, etc.

We then called in a third doctor, who also failed, after repeated trials. We finally arranged to perform Cæsarean section if another endeavor to deliver by the forceps failed. The patient was then fully anæsthetised, and held firmly by my two brethren and a nurse, while I again applied the forceps and made forcible traction, when I was delighted to feel the head yield, and effect the delivery of a very large male child.

As soon as the chloroform sleep passed off, we gave a pill, with two grains of opium, and repeated it daily for a few days, syringing with a weak tepid antiseptic injection. The patient made an excellent recovery, without a single alarming symptom.

What I desire to point out in reference to this case is, that for over six hours (from 4 A. M. to 10:30 A. M.) the patient was almost continuously under the influence of chloroform; that she had no excessive post partum hemorrhage, no vomiting, no nervous shock; and that her recovery was almost as rapid, and fully as perfect, as in the most favorable case of natural labor. These good results I attribute largely to the free and full and prolonged administration of chloroform. I fear that ether would have a greater tendency to favor post partum hemorrhage, and induce vomiting. I have, however, never used ether during my obstetric operations, but chloroform I have repeatedly used in my midwifery practice, and sometimes in prolonged cases, and have never found the slightest ill results to follow its use.-Dr. Olpherts in British Medical Journal.

MEDICAL RUBBING.

Dr. Little made some remarks and gave some demonstrations on this subject before the section of medicine at the late meeting of the British Medical Association. We extract the following from his remarks:

Medical rubbing, when skilfully done, is one of the most effective and powerful remedies that we possess. If it is done by ignorant or untrained hands, it is capable of doing immense injury.

Medical rubbing can restore the wasted muscle, can unloose the stiffened joint, can promote the enfeebled circulation, can bring back sensation to the benumbed limb, can soothe the irritated nerves, and can promote digestion and assimilation by causing healthy waste and excretion. The principles of medical rubbing are simple and easily understood, so that any medical practitioner can train a suitable person in a few lessons.

The rubber should be strong and healthy, bright and cheerful, with plenty of energy and intelligence. A stupid lout cannot make a good rubber.

The hands of the rubber should not be too small nor too large. They should not be bony nor clammy, nor horny nor doughy. They should be firm, warm, supple.

The position of the rubber should always be that of perfect ease. No one can rub if they are craning over a patient, or in a cramped or constrained position, The patient must always be placed in such a posture that the rubber is perfectly at his If this is not done the rubber soon tires, uses unnecessary force, hurts the skin, bruises the muscles, and does more

ease.