doubt. Then he quotes Dr. Foerster's statement as to the connection of the corpora lutea with the production of hæmatoma. In his own view, hæmatoma is probably due to some nutritional change in the ovary or its blood vessels, but what such change may be due to he leaves the pathologists to determine.

Dr. Rohe goes on to describe a case which he thinks shows that there is no essential difference between so-called ovarian apoplexy, where the entire ovary is converted into a blood cyst, varying in size from a billiard ball to a foetal head, and those cases which present small collections of blood in the ovarian follicles and minute extravasations in the ovarian stroma.

An ovarian hæmatoma may rupture and give rise to pelvic hæmotocele; or bleeding may continue and patient die of hemorrhage. Peritonitis or sepsis is the most serious danger following rupture.

The diagnosis cannot be definitely made out before abdominal section; and the only rational proceeding is removal of the affected organ.

In the same number of the Journal, Dr. Angus MacKinnon describes an interesting case of vaginal hysterectomy for carcinoma uteri. He is led to do so by the belief that every case in which life has been saved or prolonged by the extirpation of a cancerous uterus should be reported in order to encourage its victims to submit to early operation.

Before entering into the details of his case, he points out that early operation is more urgent when the disease begins in the cervix than when it starts in the body of the uterus. In the former case the disease quickly spreads so as to involve the pelvic lymphatic glands, vagina, rectum and bladder; while in the latter, it may remain confined to the organ for a much longer period-phenomena which may possibly be accounted for by the more immediate vascular connection of the cervix with its surroundings and by the fact that the more fatal types of cancer rarely begin in the body of the uterus.

Among the points which made Dr. MacKinnon's case especially interesting was a vesico-vaginal fistula, which developed high up in the vagina during the second week after hysterectomy had been performed, and which obstinately refused to heal for thirteen months after the operation. All its features and characteristics pointed to cancerous affection, and in this view several physicians concurred. The interesting thing about it was that,

whereas, it had previously resisted all therapeutic treatment, it yielded kindly to an ordinary operation for closure after the patient had undergone a severe attack of erysipelas, which started in the external genitals and spread therefrom over the whole body, lasting through five weeks. Now, the claim has frequently been made that erysipelas favorably modifies, or even cures cancer, and the history of this fistula, added to the fact that there has been no recurrence of the disease after two years, lends some color to the claim. In this connection it should be stated that the operator who performed the hysterectomy, Dr. H. C. Coe, of New York, predicted an early recurrence.

NOTES ON DERMATOLOGY.

BY ISADORE DYER, M. D., NEW ORLEANS, LA., Professor of Dermatology in the New Orleans Polyclinic; Lecturer and Clinical Instructor in Skin Diseases, Medical Department Tulane University, etc.

MASSAGE IN THE TREATMENT OF PRURIGO.-R. Hatsche, of Vienna, reports eleven cases of prurigo benefited by this procedure. The itching was relieved, and the cases cured, in two or three weeks. The rubbing was done daily, for fifteen or twenty minutes at first, and gradually reduced as the symptoms diminished. The method employed was the simple rubbing, starting from the distal end of the extremities and working toward the center.-Journal of Cutaneous and Gen.- Urin. Dis., for June, 1894.

TRICHOMYCOSIS CIRCINATA is the classical term now applied to the ringworm group. Dr. Sabouraud distinguishes three different forms of this affection. One is the trichomycosis, with minute sporules, caused by the microsporon audouini. The diseased hairs are fine, greyish, all bent in the same direction, and broken off six or seven millimeters from the scalp. A large number of ashen scales are scattered over the diseased area, constituting what is known as pityriasis alba parasitica. The microscope shows the hair sheath made up of small, closely packed spores, placed side by side. A second variety is due to the trichophyton tonsurans, of human origin. Here the hair is large, dark colored, short, and bare. It is not sheathed, and there is no epidermic lesion about it. Under the microscope, the spores,

which are comparatively large, are contained within the hair, and are arranged in regular chains along its longitudinal axis.

The trichophyton of animal origin, which comprises about one-twentieth of all cases of ringworm, may be due to various species of parasites, all having the common characteristic scaly lesions of epidermis. The spores vary in size, and are arranged in longitudinal rows. This last variety is of shorter duration than the other two, seldom exceeding three or four months. The small spore variety may last two years or more.

The treatment depends upon the variety. In all cases, the treatment is instituted with the tincture of iodine. This stains the parasitic rings, and outlines the diseased areas. Epilation, washing the scalp, and thorough attention to cleanliness, still is recommended. In the barber's itch variety, the treatment at the start may have to be mild, owing to the inflammation. Here starch poultices are suggested at the beginning, until the acute condition is relieved. Then iodine ointments are applied, beginning with three per cent, and increasing until the pure tincture can be applied. This is supplemented with mercurial plaster. In those cases of trichomycosis circinata with small spores, Dr. Sabouraud uses, instead of this mercurial plaster, the following: R Potassii carbonatis... .3 ijss Aquæ destillat.

M. Sig.

Ol. amygdalæ dulcis

Ung. Petrolati ....

Apply for twenty-four hours.

aa gr. lxxv

.3 x

After this has been applied for the time specified, the scalp is soaped and washed, and then painted with tincture of iodine. In this manner, the treatment is continued.

Correspondence.

TYPHOID FEVER.

BELTON, TEXAS, August 30, 1894.

Editor Texas Medical Journal:

During the past eight weeks we have had what might be termed a mild epidemic of continued fever in this section. I have treated during that time about sixteen cases, several of which were well defined typhoid fever. The majority, however, were of milder form and presented less of the symptoms of typhoid. I am

rather inclined to the opinion that they are all typhoid of a mild or modified type, but of this I cannot be positive.

The duration of the disease ranged from twenty-one to thirtyfive days, except one case, which terminated fatally on the eighth day. This was a boy eight years old, of feeble constitution, with severe diarrhoea and high fever from the fourth day. The nervous system was severely taxed, and the heart's action overwhelmed from the poison of the disease. It is of the treatment You and the readers

I wish to speak more than anything else. of the JOURNAL are probably aware of the fact that I am an enthusiastic supporter of the intestinal antiseptic treatment of typhoid fever, and that I have been for the past ten years. I am more convinced of the superiority of this treatment the longer I observe it; and I am fully sustained in this by our best authorities on this subject. In the 1893 Annual of the Universal Medical Sciences we are advised to make it a routine treatment; of course this does not preclude other lines of treatment.

I have in all of my cases kept the bowels in an aseptic condition as nearly as is possible by the use of bismuth, salol, salicylate soda, creosote, tonic doses of calomel at intervals of two or three days, and naphthalin. By this line of treatment, I prevent to a very great extent all of those bad symptoms and complications which endanger the life and comfort of the patient. I have never had a serious hemorrhage in my practice since I have been using this plan of treatment, and only two slight hemorrhages at all in ten years, while there has been a great number of fatal and severe cases where this has been neglected.

I never have seen any of the severe complications, such as abscesses, thrombi, neuritis, otitis, periostitis, and others too numerous to mention, where the bowels have been kept in an aseptic condition.

It is a well known fact that these complications are produced by the poison of the disease being absorbed into the system, and to prevent this poisoning, we must prevent the formation of them in the intestinal tract. This can practically be done by the antiseptics above mentioned being thoroughly administered from the beginning of the treatment.

Besides the appetite and digestion are kept in the very best possible condition under this plan. Tympanitis, that very distressing symptom, is controlled in this way by preventing that fermentation from which it is produced.

It is surprising the number of physicians who are yet treating

typhoid fever in the same way it was treated thirty or forty years ago, when the literature of the day is strongly in favor of the modern scientific method of treatment, and while the results of the ancient method are so unsatisfactory, with all the long train of bad symptoms and complications.

W. N. ROGErs, M. D.

Society Notes.

NORTHWEST TEXAS MEDICAL ASSOCIATION.

BOWIE, TEXAS, September 20, 1894.

Dear Doctor:-The next semi-annual meeting of the Northwest Texas Medical Association convenes in the city of Bowie, on the 9th day of October, and we take this method of extending to you an earnest invitation to meet with us, and give us the benefit of your counsels as well as the encouragement of your presence.

Our object is to exchange and interchange thoughts on all medical subjects, as well as to engender a more extensive acquaintance and fraternal feeling among the physicians of Northwest Texas.

There

Our Association is young, but thoroughly in earnest. will be several very able papers read at the coming meeting that we know of, and hope for some volunteer papers, and would be glad to have you prepare and read us a paper, or report an interesting case.

[Program omitted.-ED.]

Hoping to see you at Bowie on the 9th of October, I am, yours fraternally, W. L. YORK, M. D., President,

WM. C. DUNAWAY, Secretary.

SPECIAL RATES.

A special rate of one and one-third fare for round trip tickets has been secured, and reduced rates have been tendered the Association by the hotels of the city.

It is expected that this will be the grandest convocation of physicians ever held in Northwest Texas, and we most earnestly solicit your presence.

Bowie's most generous huspitality, in all its fullness, will be extended the Association. H. RILEY,

Chairman Committee of Arrangment.