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Protecting the Perineum.

How to protect the perineum has long been at problem, and the various means proposed have not completely solved it. Pressure directly upon the part while the head is endeavoring to pass the vulvar orifice is extremely imprudent. The powerful pressure upon the perineum by the head above and the hand below so squeezes the tissues that much of their natural elasticity and resistance are lost. So this mode of "supporting the perineum " actually favors rupture, instead of preventing the same.

Dr. Mekerttschrantx, of Germany, advocates the following method: The patient lies on her back with the lower limbs flexed and knees not so far separated as to put the perineum on the stretch. Now the right hand is placed over the

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Sulphate of Aniline for Epilepsy. We have prescribed sulphate of aniline in some cases of epilepsy and infantile convulsions, with sufficient benefit to encourage a further trial of this little-used salt. The dose for infants and children under ten years was one grain dissolved in water, with a few drops of diluted sulphuric acid, administered twice or three times a day. Two grains were given to adults. It had no ill effects in these quantities. Sulphate of aniline is a salt of a light grey colour, which deepens under the influence of light. It gives a "tarry" odor of coal to the excretions, being itself a product of the distillation of coal. It was formerly employed in the treatment of chorea and some obscure nervous affections, but fell into disuetude. It dilates the pupil. It is soluble in ether, alcohol, and in fixed and volatile oils, and sparingly in

one side and the thumb on the other the two sides are approximated, thus relaxing the perineum. He further advises, when the frænum is put upon the stretch, that the left hand be placed above, the wrist resting upon the mons veneris, the fingers grasping the labium on one side and the thumb the other, and by approximating the two sides the frænum is relaxed. After the expulsion of the head the left hand does whatever becomes necessary, while the right hand remains on duty relaxing the perineum during the expulsion of the shoulders.

The doctor reports remarkable results from this method. In fifty primiparæ a trifling rent was observed in only two cases.

The Obstetric Binder.

A German surgeon attributes the shapeliness of English married ladies to the use of the obstetric binder after labors, a practice ignored in Germany, in consequence of which German matrons mostly are disfigured by relaxed and pendulous abdominal walls. On the other hand, there are writers who maintain that the use of the binder favors this very relaxation.

Damage of Syphilis.

The tissues of a person who has had syphilis are to be regarded as damaged, and so permanently placed at a disadvantage for the wear and tear of existence. They are liable under slight irritation to take on an inflammatory condition, which is apt to become chronić. Hence the presence of palmar psoriasis from the friction of an umbrella or walking-stick, and psoriasis of the tongue from the irritation of tobacco smoke, or carious teeth. Further, this peculiarity of the tissues damaged by syphilis must obviously predispose to chronic inflammatory affections of the circulatory and nervous system, and so pave the way under suitable conditions for ataxy or impairment of the cerebral circulation.

Brazilian Remedies.

A very bitter amorphous substance named "vieirine" is much employed in the Brazils, in the treatment of intermittent fevers and gastric disturbances of a catarral nature. Vieirine combines with bases, giving definite substances, and is classed among the organic acids. Vieirate of quinine is employed in malarial diseases; vieirate of sodium in anorexia; vieirate of calcium as a reconstituant for ricketty children and in constitutional debility. The natives of Brazil use vieirine decoction made from the bark

tertiary syphilis.

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psoriasis linguæ.

ichthyosis, which frequently leads to epithelioma. decayed teeth, tertiary syphilis or epithelioma.

L. L.

of a tree belonging to the Brazilian chinchona group, which was long ago described by Saint Hilaire under the name of "chinchonea ferruginea."

Another native Brazilian remedy is obtained from the bark of the white sucupira tree, indigenous to Brazil. It contains much tannic acid, and albuminous and mucilagenous matters, and a volatile bitter principle which disappears when the bark is old or long kept. Sucupira is actively diaphoretic, and is used in rheumatism and gout, and also in secondary syphilis and skin diseases. An alcoholic extract, a tincture, and a syrup are prepared. The extract is given in doses of fifteen grains in the course of the day, in pills. The dose of the tincture is two drachms, and, of the syrup, three tablespoonfuls daily.

Iodoform Internally.

Picric acid is very frequently present in iodoform as an impurity or adulterant, and renders it poisonous. It is detected by shaking the suspected sample with water and treating it with a weak solution of cyanide of potassium. After a while a brown color is developed, due to the formation of isopurpuric acid. Pure iodoform is innocuous, but the impure has its dangers.

Iodoform, taken internally, converts uric acid into urea, thus diminishing the excretion of uric acid. In this way it should be useful in the treatment of gout, and indeed has been found to be so, in doses varying from gr. i to gr. iss, three times daily. By this treatment the uric acid in the blood is lessened.

We have lately applied oil of eucalyptus to chilblains on children's feet with very good results. The pain was in each case quickly relieved, and the chilblains have in a short time disappeared. The oil was simply painted on frequently with a brush.

L. L.

Position in the Treatment of Uterine Displacements.

Position in the treatment of such cases will of

necessity vary according as the uterus is full or empty. In the non-gravid uterus, the genupectoral or genu-brachial position is sometimes alone sufficient to rectify retro-version, if practised night and morning for some time. It is always a useful adjunct to reduction by manipulation, even when the organ is fixed by adhesions. In retroversion of the gravid uterus, the abdominal position is preferable, combined with frequent catheterisation of the bladder.

Life at the Bottom of the Sea. Intense cold, perfect darkness, and a persistent pressure of two or three tons to the square inch, such are the apparent conditions under which life exists on the floor of the deep seas. And not only does it exist, but the creatures which live and move and have their being at these great depths, three miles below the surface, have been found to possess perfectly developed eyes. Light of some description, therefore, is presumably present, probably of a phosphorescent nature.

Batchelorhood and Mortality.

It has been asserted that " batchelorhood is more destructive to human life than the most unwholesome trades, or than residence in an unwholesome house or district where there has never been the most distant attempt at sanitary improvement of any kind." Whether this statement is overdrawn or not, it is certain that the death rate of batchelors is considerably higher than the death rate of married men and widower; and statistics point to the truth of one of the first natural laws revealed to man"it is not good that man should live alone.”

Caisson Disease."

"Caisson disease" is characterized by a train of symptoms produced by working in compressed air, similar to the effects of a descent in a diving bell, as violent throbbing in the ears, with

hemorrhage from the nose or even lungs. The more modified symptoms of a prolonged exposure to this pressure are intense neuralgic pains in the extremities or trunk, epigastric pain, nausea and vomiting; paralysis, more or less complete, local or general; headache, vertigo, and coma. Its onset is usually quite sudden. The attack generally supervenes on leaving the "caisson," seldom during the incarceration. Acute congestion of the brain and cord are the most constant post-mortem lesions. Morphia, alcoholic stimulants and ergot, have given the best curative results.

For Inflamed Prostate.

Acute inflammation and enlargement of the prostate is much relieved by the continued application of hot water to the perineum, and its injection into the rectum, giving directions for its retention. The pain often subsides in a very short time, and micturition becomes easier.

For Ring-worm.

Seven grains of chrysophanic acid in an ounce of chloroform, provides a very successful application in the treatment of ring-worm. It should be cautiously applied to the affected parts only, two or three times daily with a sponge. Alder Smith, in Brit. Med. Journal.

For Dyspepsia.

Five to ten minims of glycerine of carbolicacid in a little water, after meals, is an admirable remedy for dyspepsia, and for the impaired digestion of tea-drinkers and tobacco-chewers. Especially is this useful (in smaller does) in the dyspepsia of children, associated with the presence of worms in the alimentary canal. Glycerine is in itself an anthelmintic of much power.

Salicylate of Lithia.

M. Valpeau (Paris) concludes as the result of his researches that the above salt is preferable to the sodium salt in rheumatism, affecting the fibroid tissue principally, and also in the subacute progressive articular variety. Fifteen to twenty grains three times a day would be an average dose. Some deafness and headache are experienced sometimes, but not the buzzing, singing, and other disagreeable subjective sounds so common during and after employment of salicylate of soda.

THE superficial area of the virgin womb measures sixteen square inches; that of the gravid womb, at term, three hundred and forty.

The Queen of Italy employs a female physician.