room, the well-arranged dispensary (in charge of a competent druggist of years' experience) and the faculty room, elegantly furnished. runs from this floor to the top of the building. An elevator The second floor is occupied one-half by the amphitheatre and one-half by the chemical laboratory and its dark-rooms. This laboratory, large and wellequipped, is surpassed by few in this country. It has accommodations for more than a hundred students. It will also be used evenings by the class of the Kansas City College of Pharmacy, the lectures of which are held in the building. The third floor consists of the dissecting room, the museum, the prosectors' room and the biological laboratory. The dissecting room is an exceedingly large one, well-lighted, the heat and water supply as nearly perfect as possible and the tables conveniently arranged. Altogether, the new building of the Medical Department of the University of Kansas City is one of which too much praise cannot be spoken, and the faculty justly feels proud of a college building which stands second to none in the West. E. L. NEW TREATMENT FOR FRACTURED PATELLA. To obtain bony union in fracture of the patella has been the aim of all surgeons, an end never obtained when the fracture was transverse until the day when wiring of the fragments together was tried. In the hands of skillful operators this has been a procedure attended with good results; but such are the dangers incident to opening the knee joint that none but those in high places have had the hardihood to undetake it. That nothing but ligamentous union can be obtained by ordinary methods is admitted by all surgeons; first, because by the peculiar blood supply of the wound and the amount of effusion into the joint; and second, because of the muscular action irresistibly separating the fragments, and especially because of the engagement of the prepatellar aponeurosis between their ragged edges. Now, however, a method of subcutaneous wiring has been proposed which gives all the benefits of, without any of the dangers attendant upon the open operation. This plan, which seems to be rational and practicable as well as safe and certain, was devised by Dr. W. L. Axford who describes the operation in all its details in the Annals of Surgery for July, 1888. Briefly, the directions are: Immediately on the occurrence of a fracture the limb should be placed in a posterior splint, and soft sheep's wool applied to the sides and over the front of the knee and held snugly in place by the roller bandages. If ice-water be kept slowly trickling on the bandage so as to saturate the sponges and keep them well distended, the most potent factors in the prevention of inflammation and limitation of effusion, rest, elastic pressure and cold, will be utilized. At the end of forty eight hours the knee would in all probability be ready for op eration. Strict antisepsis should be observed. If the effusion into the joint be so great as to prevent easy approximation of the fragments it can be removed by Schede's method. Should the fragments still refuse to come together, Bergmann's plan of freeing the bony attachment of the ligamentum patellæ may be resorted to. If, on rubbing the fractured surfaces together, the pressure of the prepatellar aponeurosis seems to present an obstacle to union, it can probably be freed by manipulation of one surface upon the other; if not readily removed there can be no objection to passing a tenotome into the joint for the purpose of clearing the fractured surfaces. For the purpose of wiring the fragments a modified Brainard's drill is used. As small a size as is compatible with the requisite strength is made one inch longer than usual, and at the point is provided with an eye large enough to admit a medium sized silver or iron wire. Two such drills are necessary. An assistant holds the fragments firmly in apposition, the drill is entered from above, traverses the bone in the long axis of the limb, emerges from the skin below the patella, is disengaged from the handle and left in position, serving to support the fragments temporarily. The other drill is now passed parallel to the first, from below upward, the wire hooked into the eye, the drill withdrawn and the ends of the wire twisted over the bone. Drill number one is now armed with wire and withdrawn. A few layers of gauze are placed over the patella and the ends of the wire pushed. through. Over all is placed a cap of hard rubber or felt, perforated for the wires, the ends of which are now passed through, drawn tight and twisted. The Bavarian or open plastic splint may now be applied and, if any reaction be feared, the sponges may be reäpplied, treating the fracture as at first till all danger be passed. Attention should be paid to the quadriceps during recovery. The author claims that by this operation the minimum danger of infection is incurred while at the same time the chances for bony union are second only to those of the open method; that there can be little danger attendant upon it is evident because if the fragments of the patella are kept closely approximated during the drilling neither drill nor suture will enter the joint, and in fact the cavity of the joint need not be disturbed at all except in removing the effusion or possibly when the aponeurosis is freed from between the fragments. E. L. EDITORIAL NOTES. NON-MEDDLESOME MIDWIFERY.- his belief upon a critical study of 8,ooo puerperal women. He lays great stress upon preventing loss of blood as far as possible and on thorough disinfection (i. e., absolute cleanness) of all which has to do with the patient. Regarding vaginal and intra-uterine douches he remarks: "The statement made in so many case histories that the Credé has come to the conclusion that too much is being done in the way of so-called "antiseptic widwifery," and believes now with the majority of American obstetricians that injections should not be employed except when the lochia become foul or there is evidence of septic infection. He bases TREATMENT OF LUXATED CATARACT. -Galezowski read a paper not long since before the Société Francaise d'Ophthalmologie upon the subject of luxated cataract. His conclusions relative to treatment were: (1.) Subluxated and luxated cataracts constitute a variety of complicated cataracts, and should be operated upon with the least possible delay, in order to prevent inflammatory accidents. (2.) The best operative method for the extraction of luxated cataracts is the method with the single flap without iridectomy. (3.) The incision should be made above, preferably, of medium size, and away from the corneal border. The curette with which the luxated crystalline is removed should be comparatively large and concave, in order to better seize a large cataract. (4.) was typical of the rest, and occurred in a man who had shown various nervous symptoms for about two years. He claimed to have no light-perception in the left eye. It, however, appeared normal; and the placing of a prism, with its base up, before the good eye, caused vertical diplopia. He was assured of a speedy cure by electricity. The Faradic current was applied, and its strength suddenly increased so as to cause a decided shock. After this he could see some. After a second application he could read 2050, and, after the third, 20-20. MISSISSIPPI VALLEY MEDICAL ASSOCIATION. The time of meeting of this society has been changed from Sept. 11, 12 and 13 to September 25, 26 and 27, 1888, in order that lowest railroad rates may be secured. Many prominent physicians will be present. The programme is perfected, and the entire time of the meetings from 9:30 A. M. to 5.30 P. M. each day will be taken up with strong papers and full and free discussions, there being nothing in the way of extraordinary or irrelevant business all such matters being settled by committees without discussion. The three evenings will be consumed by public and private entertainments and each and every delegate may be assured that constant efforts will be made in the direction of catering to his comfort and enjoyment. The sentiment animating the committee of arrangements and officers of the Association in planning this meeting has been to provide for good, solid scientific work while the sun shines, and at night let recreative effort and pleasure reign. FOR RECENT PROLAPSUS Uteri.In the treatment of recent cases of prolapsus there is no method that gives more prompt and satisfactory results than this: An injection of very hot water is first to be given; in this water may be dissolved borax and tannic acid in proper proportions. The hot water injections are of course, most beneficial in the stage of inflammation which frequently follows prolapsus, but even in cases where there is no trace of inflammatory trouble they will prove of much advantage, exercising a soothing influence, and if containing the drugs an astringent effect. After the injection a tampon of cotton saturated with glycerine containing a small amount of tannic acid should be introduced, compressing the engorged veins and lifting the uterus to its normal position. The injection should be used night and morning and a fresh tampon introduced by the patient after each injection. If this be kept up for a considerable time, under the supervision of the physician the very best results may be expected. THE REGULAR PHYSICIAN.--The so-called regular physician who writes three prescriptions where one would do, or that writes for a quart bottle of medicine when a dram would be just as efficient, is as low a quack as the writer of the obscene trash that litters our streets under the guise of medical instruction.-Denver Medical Times. Do you not know, Bro. Hawkins, that there are many patients who would not be satisfied with small doses or even small bottles of medicine—who would leave you for some other physician if you failed to give "a tablespoonful every two hours"? You must admit this is so, yet what can you do? Act as you suggest and lose the patronage of the individual? Do you not realize that in at least onethird of all cases seen by you no medicine is needed-simply time? In such cases do you tell the subject "Go thy way; no medicine is needed?" If so you lose a patron. In these things we must be guided much by the person's wishes, ever remembering the advice: When you are doing the least appear to be doing the most. WHAT COCAINE TO USE.-There are many brands of cocaine in the market, and many physicians have found to their annoyance that some are inert and some very irritating when applied to a sensitive membrane. It may therefore be of service to physicians to learn the experience of Dr. Dudley S. Reynolds, editor of Progress, who in the July (1888) number expresses himself in this wise: "The medical profession has about settled its estimate of the therapeutical value of muriate of cocaine, but it is, unhappily, no easy matter to decide upon the most uniformly reliable source of supply. The editor of Progress had about concluded Merck's was the only reliable product, when recently he was induced to make trial of that produced by Parke, Davis & Co. A fresh sample of ten grains was dissolved in five drachms of distilled water, to which was added one drop of liquid carbolic acid. One drop or this instilled into the eye of a man from whose cornea a foreign body was to be removed, produced anesthesia in three minutes, so that incision of the cornea, and turning out of the piece of offending metal was not felt by the patient. Twenty other similar experiments yielded similar results." ELECTROLYSIS IN STERILITY.-Fry, in the American Journal of Obstetrics, claims better results in the treatment of dysmenorrhoea and sterility by the use of electrolysis than by any other method. The advantages are its simplicity, no assistant or anaesthetic being required; its safety; better results and speedier. The apparatus necessary is a good galvanic battery of about twenty-two cells (it is better to have a milliamperemeter to measure the electricity) and the proper insulated electrodes. The method of application is: With the patient in either the dorsal or semi-prone position, the cervix is steadied with a tenaculum. The direction of the cervical canal is explored with the sound. The positive electrode, consisting of a flat sponge about the size of the palm is placed either over the fundus uteri or over the lumbar region. The negative electrode is an insulated copper wire with olive shaped tips of different sizes. One of these somewhat larger than the lumen of the strictured passage is passed gently into the canal, until it meets with the constriction, when it is held in contact with it for a few minutes until absorp. tion removes the obstruction. and the |