form of this dreaded disease we see more or less edema about the face, ankles, etc., and later on general anasarca. Then, and sometimes not till then, do we look for albumen, casts and detritus of cell destruction in the urine. Though I am glad to acknowledge that in the past ten years the profession, with better chemical knowledge and microscopical advantages, are coming to be more familiar with the early symptoms of this and other formidable diseases. Then when we have ascertained that our patient has Bright's disease, we may be curious enough (many are not) to differentiate the kind. Interstitial nephritis, sclerosis sometimes called because granular, contracting, etc., like sclerosis of the liver-because of inflammation of the connective tissue and subsequent atrophy due to contraction of the new elements. Dickinson says this form of renal disease is most frequent at fifty, and rarely before twenty years of age, and gives as a probable cause social evils, lead poison, etc. Bartholow says that he has maintained for many years that interstitial nephritis frequently follows the administration of oils and balsams in the treatment of catarrhal affections of the urinary passages. Liebermeister and Bartels have the same idea, that of supposed transference of the catarrhal process from the bladder to the kidney. In reference to the treatment much depends upon our knowledge of the causes which produced the disease. If syphilitic, plumbic, or other causes that may be removed by proper remedies, much can be done by way of medication. And Bartholow speaks highly of the chloride of gold, or of gold and sodium. Arsenides, etc., intended to arrest the hyperplasia of connective tissue, should be prescribed with hope, but, perhaps, with not as much confidence as John G. Thompson used to claim political results in Ohio. However, remedies used with a view of removing causes, together with ferruginous tonics, and aids to digestion so that nitrogenous substances are better prepared for assimilation, together with dry warmth, will probably prolong life, but when any form of Bright's disease becomes chronic, and diuretics become necessary, as they frequently do, the choice must be with reference to whether there is too much arterial pressure or venous hyperemia, or whether certain diuretics will cause arterial pressure and consequent venous hyperemia, for when we have much edema it is presumed there is venous hyperemia, and theoretically we should give some of the potassa salts, pilocarpine and warmth and not digitalis; yet some authors prescribe digitalis with marked increase of diuresis. I believe among the latest, from Russia, is the cockroach. I believe when the disease has advanced to a time when such bugs as cockroaches and cantharides seem necessary, we might as well sing with Shelley: How wonderful is death! Yet both so passing wonderful. A PRACTICAL AND SUCCESSFUL MODE OF DISINFECTING THE ROOM IN CASE OF CANCER-Dr. H. Gerould, of Cleveland, O., writes that from September, 1886, until March, 1887, he had in his house, and under his daily care, a patient with uterine cancer. To counteract the offensive odor of the disease he made repeated experiments with the prominent disinfectants. The following proved to be all he could desire, viz.: 3 drs. of potassium nitrate dissolved in 8 ounces of Platt's chlorides, full strength. In this he saturated thin muslin (cheese cloth), then dried it thoroughly. When it was necessary to clense or purify the room, he burned small strips of the cloth on a shovel in different parts of the room and under the bed clothing. The effect was magical. Almoft instantly all offensive odors disappeared. This was repeated when necessary, the potassium nitrate being used to aid combustion. The result was such that no discomfort was experienced by the attendants, and no offensive odor could be detected in the adjoining rooms. This was daily remarked by friends. The undertaker said it was the first case of death from cancer where he could detect no trace of the disease. This method of disinfection, the writer adds, would be equally efficient in all contagious, pestilential, or infectious disease. TO PAINT A "BLACK EYE."-A writer in the St. Louis Medical and Surgical Journal says: "For "black eye" there is nothing to compare with the tincture or strong infusion of capsicum annuum, mixed with an equal bulk of mucilage of gum arabic, with the addition of a few drops of glycerine. The mixture should be painted over the bruised surface, a second and a third coating being applied as soon as the first is dried. If applied immediately after the injury is inflicted, it will almost invariably prevent discoloring of the tissue. The remedy is also of value in rheumatism, sore, or stiff neck." FRACTURE AND DISLOCATION of the spINE BY ISAAC W. CHISHOLM, M. D., NEW CONCORD, OHIO. Fortunately, fractures and dislocations of the spine are accidents of rare occurrence, for in a large majority of cases they prove fatal. Owing to the limited motion of the vertebræ, through their being so firmly bound by strong ligaments and powerful muscles, it is natural to infer that a dislocation of these bones would be of rare occurrence, and it has even been wholly denied by some surgeons, yet from recorded cases it has been clearly shown that these accidents may and do occur-the causes producing both dislocation and fracture being so closely allied that they may be said to be identical; in fact, they may all be summed up in two words-extreme violence. The following are the generally accepted symptoms of dislocation and fracture of the different parts of the vertebral column: If fracture or dislocation occur above the origin of the phrenic nerve, so that pressure is made upon the spinal cord, there is a disturbance of respiration, and death usually closes the scene. In fracture of the dorsal vertebræ, unless very high up, the upper extremities will be free from paralysis; in either case the bowels will be stricken with torpor, being unable to expel their contents, and the patient's distress will be greatly increased by the accumulation of phosphatic matter in the urine, causing chronic inflammation of the bladder. Fracture and dislocation of the lumbar vertebræ cause, in the lower extremities generally, a cessation of volition and sensibility, varying, no doubt, with the direction in which the vertebræ may be thrown, whether forward or backward; and authors generally state that the feces pass involuntarily, although I think I am justified in saying, from the following case, that the very opposite (extreme torpor) may happen—yet it may be an exceptional case, for in surgery we sometimes have to be governed by exceptions, or anomalous cases. In the aggregate, I think we are safe in stating that if fracture or dislocation of the vertebral column occur above the origin of the phrenic nerve, thus causing pressure upon the spinal cord, immediate death will result; whereas, if the injury be inflicted in the lower portion of the dorsal, or along the line of the lumbar vertebræ, it will cause paralysis of the lower extremities, accompanied by incontinence and constipation, as well as involuntary discharges from the bowels. The prognosis of both fracture and dislocation of any part of the spinal column should be looked upon with grave apprehension. "Few persons," says the distinguished American surgeon, Professor Gross, 86 ever recover." As to the treatment of that class of injuries now under consideration, nothing would be more difficult, perhaps, than to lay down. a methodical procedure; so difficult would it be, that he who should attempt it would in all probability arrive at the conclusion that it was one of the grandest failures he ever made. In no case, perhaps, can nature assert her superiority over those of us who may be called in to play the part of physician, surgeon, or both, than in the treatment of injuries of the spine. In my opinion, Professor Gross never spoke a greater truth than when he said, "Time and a masterly inactivity will accomplish more than all the interference of the best surgeons, except that when the symptoms are well marked, and there is danger of the patient perishing, an attempt, however desperate, would be perfectly justifiable and proper; for," he says, "if we succeed, we obtain a victory; if we fail, we cannot but hasten an occurrence otherwise inevitable." The greatest danger to be encountered, no doubt, in the majority of cases, is the too frequent annoyances of the meddlesome surgeon, even to the oft-repeated taking of the temperature, feeling of the pulse, counting the respiration, waking the patient for the administration of either food or medicine, repeated inquires as to their condition, all of which tend to harass the sufferers and add to their already over-excited nervous system. I was called to attend the following case, and made a report of it to the Cincinnati Lancet and Clinic, one year after the accident, September, 27, 1879. Charles G. G, aged ten, residence New Concord, O., attended a soldiers' reunion in the city of Zanesville, O., September 19, 1878, and while seated under the speakers' stand the structure gave way, the timbers striking him in such a manner as to throw his head violently forward and downward between his legs. When extricated, his eyeballs were protruding from their sockets, and his face congested to a purplish hue, presenting altogether a ghastly appearance. On being taken to the house of a friend, Drs. Oatley and Culbertson were called, and, in consultation with other distinguished surgeons of Zanesville, they found, upon examination, a dislocation and fracture of the third lumbar vertebra, it being thrown backward. Erichsen says he knows of no case where the lumbar vertebræ have been dislocated unless attended with fracture; and in accordance with such high authority I think we are justified in stating that it was so in this case, although a positive diagnosis was impossible. Some, however, take the position, I believe, that the force required to produce dislocation of this character is so great that it would be impossible for a dislocation to occur without also being attended with fracture, and in this case the fracture occurred, we think, in the body of the vertebra, as shown in the cut. On October 2d he was brought to his home (New Concord, O.), two weeks after receiving the injury, and placed in my charge, Dr. Oatley accompanying him, and informing me of the great difficulty of obtaining a passage from the bowels. We concluded to try croton oil suspended in castor oil, and injections of soapsuds and turpentine, but these had little effect. After frequent administration of the oils I abandoned the course, as it sickened him, causing violent vomiting, which was attended, however, with some beneficial results, as the act of vomiting caused small portions of fecal matter to be thrown down into the rectum, whence I could remove them with my finger. I concluded to use injections and my finger, getting away all I could in this manner, and abandoning all physic. About every ten days he would be attacked with nausea and vomiting, the pulse would become greatly accelerated, and the temperature would rise to 105° F. I concluded to try the experiment of feeding him entirely on "slops" or fluids, but this not having the desired effect I gave orders to administer no food whatever at those periods, and applied mustard and hops to the bowels, as they became at those times extremely tender and sensitive to the touch. As there was retention and incontinence of urine I gave him for a while fluid extract of buchu, citrate of potash, and sweet spirits of nitre to assist the functions of the kidneys, hoping also to effect a reduction of the temperature. To my great satisfaction the irritability of the stomach, together with all the other untoward symptoms, were cut short, the tongue commenced to become clean, and he began to have a mdoerate desire for food. I noticed that previous to one of these attacks the tongue would become coated, his desire for food would begin to lessen, and there would be an in increase of albumen and urea in the urine. I would immediately order no food to be given, and apply the mustard and hops to the bowels (abandoning all medicines that I had been administering for the purpose of assisting the function of the |