three degrees, and a comparison of the effects observed after various operations appears to prove that the whole of the effect could not be attributed to shock and exposure, but that a large, possibly the greater part, was due to ether, which was the anesthetic used. This view found confirmation in the result of some experiments on dogs; by continuous etherization for an hour, giving five drachms of ether every five minutes, after the animal had been brought thoroughly under the anesthetic influence, the normal rectal temperature of the dog was reduced as much as from 8° to 10° F. Dr. Hare's inquiry suggests that it would sometimes be well for surgeons to combat this antipyretic action of ether by warm applications during the time that the patient is on the operatingtable.-Brit: Med Jour.

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COMPARATIVE THERAPEUTICS UTERINE FIBROIDS. [Villa, Noua. Nor. Arch. d'Obst, et de Gyn., No. 1., 1888.) After an analysis of the various therapeutic measures applicable to uterine fibroids, the following are the deductions in regard to electricity, resulting from experience in Doleris' clinic: No matter what the intensity of the current employed, neither disappearance nor marked diminution in size of the tumor has been noted. Where diminution in size seemed to follow, careful measurements proved that this was illusory, there being simply a downward displacement of the tumor. The pains of which the patients complained were not specially relieved. Whilst in some cases the hemorrhages were favorably influenced, they reappeared on cessation of treatment. The only incontestable gain from the electrical treatment has been the stimulant effect leading to improved nutrition. The current seemed, further, to favor the conversion of inter stitial into submucous growths. Aside from these two advantages, the method is deemed to be a palliative one, on which little dependence can be placed. A proof of the inefficiency of the

fact that many patients, treated amongst others by Apostoli himself, were obliged ultimately to submit to a radical operation.-Journal of Obstetrics.

STOPPAGE OF NATURAL FLOW OF URINE, says Ultzmann, may be caused by: 1. Occlusion of the smaller urinary tubes, as in cholera and any of the renal diseases. 2. By occlusion, twists, and turns in the urethra. Ultzmann records the case of a man, æt. 43 years, with calculus of the kidney, who suddenly developed anuria, which caused death in two weeks. The autopsy showed a cyst of the left kidney as large as a gooss-egg, with obliteration of the ureter, and on the right side an enlarged kidney, with three smalls stones filling the ureter. 3. By a tumor of the bladder.-Er.

A SIMPLE MRTHOD OF REDUCING STRANGULATED INGUINAL HERNIA.-G. S. Perro (Medezinskoje Obosrenje, No. 15, 1887. Translated from Centralbl, f. Chirurg, No. 12, 1888) recommends the following simple procedure for strangulated inguinal hernia. The pelvis is raised by a cushion and the leg flexed and abducted. The scrotum and hernial tumor is grasped by the left hand, and the tumor slightly bent toward the abdominal wall and compressed. At the same time the index finger of the right hand is introduced into the inguinal canal, and by a boring movement pressed in the direction of the horizontal ramus of the pubes. In a short time the strangulated portion of the gut slips into the abdominal cavity, and is followed by the rest of the tumor. The author has succeeded in this manner in reducing six cases of strangulated hernia, when all previous attempts had failed,

THE PROPER TIME FOR THE ADMINISTRATION OF ACIDS, ALKALIES. ETC.Alkalies should be given before food. Iodine and iodides should be given on an empty stomach, when they rapidly diffuse into the blood. If given during digestion, the acids and starch alter and

weaken their action. Acids, as a rule, should be given between the digestive acts, because the mucous membrane of the stomach is in a favorable condition for the diffusion of the acid into the

blood. Acids may be given before food when prescribed to check the excessive formation of the acids of the gastric juice. By giving it before meals, you check the osmosis stomachward of the acid forming materials. ward of the acid forming materials. Irritating and dangerous drugs should be given directly after food, such as the salts of arsenic, copper, zinc, and iron, except where local conditions require their administration in small doses before food. Oxide and nitrate of silver should be giuen after the process of digestion has ended; if given during food, chemical reactions destroy or impair their special attributes and defeat the object for which they were prescribed. Metallic salts, especially corrosive sublimate, also tannin and pure alcohol, impair the digestive power of the active principle of the gastric-juice, so should appear in the stomach during its period of inactivity. Malt extracts, cod-liver oil, phosphates, etc., should be given with or directly after food, so that they enter the blood with the products of digestion.-British Medical Journal.

COMBINED CHLOROFORM AND COCAINE ANESTHESIA.—Professor Obalinski of Cracow, remarking the antagonism between chloroform and cocaine, detertermined to take advantage of it in anæsthesia for operative purposes and has now employed the combined chloroform and cocaine method in twenty-four cases with, as he states, the most satisfactory results. He first administers chloroform by means of an Esmarch's mask until the stage of tolerance is reached, which is generally in from four to twelve minutes, with the use of from one to three drachms of chloroform. He then injects into the region about to be operated on a solution of cocaine of the strength of from 3 to 5 per cent., the

total quantity of cocaine injected being from three to five-sevenths of a grain. Even more than this might, he thinks, be safely used, both because chloroform is the best antidote to cocaine and because part of the cocaine is about to be removed from the body by the operation. After the injection no more chloroform is as a rule given, unless in protracted operations, when very small

quantities are administered at considerable intervals. For this method several advantages are claimed, amongst others the following:-A smaller quantity of chloroform is sufficient; vomiting is very rare; the depression on awaking is much slighter than when chloroform only is used. The only disagreeable symptoms which Professor Obalinski has observed have been excitement and throwing about of the arms tn some nervous people, but as this occurs when chloroform alone is used, it is not at all certain that it ought to be ascribed to the cocaine. He recommends the combined method for extensive operations, finding the local use of cocaine usually quite sufficient to render minor operations painless.-Lancet.

PROFESSIONAL COURTESY.-One hears so much about the jealousy of physicians

of their mutual backbiting, quarreling, and generally splenetic state toward each other-that it is really somewhat refreshing to learn that we are not in reality a disunited body. Our esteemed contemporary, The Journalist, for example, has recently celebrated our united state in the following somewhat ferocious terms:

"There is not in this world to-day a more powerfut, more monstrous, more unjust, and iniquitous organization in existence than that mysterious bond which fetters the medical profession as with links of steel, which is known as 'professional courtesy.' Professional courtesy is an excuse for neglect, for procrastination, for carelessness which is in too many cases tantamount to murder. It is no rash statement to as

sert that there are hundreds of cases known to physicians who are in other respects reputable men, where patients have died through the criminal neglect and stupidity of the attendant physician; yet you could not worm an admission of that sort out of them in a court of law-they are bound by 'profesional courtesy' to allow their ignorant incapable fellowpractitioner to go on murdering without a word of remonstrance."

Thus it seems that physicians do stand by each other, after all. This is not very surprising when one considers the difficulties and limitations of our art. When an architect miscalculates in building a bridge, his incompetency can be demonstrated mathematically; but when a chronic invalid, with some obscure malady, receives a series of prescriptions, under which he or she gets no better, the incompetency of the physician is hard to prove. The malady itself may be impossible of recognition and of cure. Doctors know this. It compels them-if they have any sense of justice to charity toward their fellows. We follow a difficult and laborious calling. There are black sheep everywhere, and sometimes, perhaps, "professional courtesy" has been made to shield them; but we do not think that harm often comes from its exercise, and indeed medicine could not be practiced without it.-Mtdical Record.

THE USE OF THE PHONOGRAHH IN RECORDING CASES.-Most physicians have felt the difficulty of accurately describing or remembering abnormal sounds met with in physical examination. We can classify heart murmurs, for instance, but it is almost impossible to so record the intensity and peculiarity of each as to be intelligible to others.

So it is with lung sounds and the different kinds and degrees of hoarseness. It is hardly exact to say that a patient is slightly hoarse or very hoarse, and affords us little satisfaction in estimating the of progress a case by such symptoms.

It is here that the phonegraph may be of great service, and the time is not far distant when much of the information which we now gain through the stethoscope may be permanently recorded, and the fuc simile of any abnormal sound reproduced at will.

During a somewhat prolonged vacation this summer, the writer has had the opportunity of experimenting with the phonograph. While the instrument is not yet as complete as it probably will be, even now it can be used with great satisfaction.

Not only are different voice sounds preserved distinctly, but I find by attaching the ordinary stethoscope that some of the cardiac sounds could be easily recognized after they had been recorded by the instrument. The most perfect result was from a case of mitral insufficiency. I was not able clearly to record normal sounds on account of their comparative softness, but I believe with a perfect machine even this may be accomplished.

The completed phonograph will probably not be a very expensive machine. It is certainly not complex. The wax cylinders are small, will cost about five cents each, and each will hold the sound imprint of nearly two thousand words.

It will be a great addition to our methods of case recording, when we can have not only the written history and description of the case, but where there are abnormal respiratory and cardiac murmurs, if these, too, can be written down.

While such experiments with the phonograph are so far incomplete, they are very interesting, and bid fair to be of value.-Dr. Wm. Porter, in the Weekly Medical Review.

HEMORRHOIDS.-Dr. T. W. Poole gives vent as follows in the Canadian Practioner: "The piles! Aha! I knew them well, each feature, though I may not see 'em; old foes, which fume and fret, and swell and vex and plague my perineum. You blush at mention of a

'pile,' and would, perhaps, the theme avoid; well, then, suppose, to put on style, we call the thing a hæmorrhoid. Though bearing an ill-omened name, it seemed as if they might not pain us, when first, as visitors, they came and But at took up lodgings iu the anus. each succeeding bout the pulvic pains appeared distincter, and there can be no longer doubt of their relations to the sphincter. You ask me by what obvious signs one may with certainty detect 'em. Well, I can only say that mine are like a hornet in the rectum, which, having wandered from the way, and angry at the situation, stings right and left while yet it may, and tortures me in defecation. 'Avaunt! it is a vulgar rhyme.' Yet stay, there must be means to cure 'em. Oh, yes, if you but give them time, and meantime patiently endure 'em. There are a thousand cures, you know, all certain sure dead-shot candy. "Tis well to buy a score or so and lay them by to have them handy; and when the hornet's rage is spent and things assume their wonted quiet, the cure, though it may not prevent, will buickly quell the painful riot."

as

"Owed Teucrium Scordium.-How slick and cool in Dr. Poole, to run a rhyme on hemorrhoids. The red hot shot that he has got has prompted him and all his kin their best attempts to them avoid. To ease his pain, advance his gain, relief we may accord him. Upon the spot which is so hot, and makes him fret and sometimes sweat, apply the Teucrium Scordium. A powder fine, if good and prime, the days are shortly numbered when he will grin and lively spin, free from the foe, to come and go no more with piles encumbered.

"Alas! the day I found the way, how many have I trusted? My praise is sung on every tongue; from lip to lip, so goes the tip, and every pile is busted. In capsule clean, with lanolin, preserve

the ointment nicely. Insert at night; each weary wight in sweet repose his eyes will close; you have the plan precisely. No more to say upon this lay; the muse is nigh exhausted. Whoever tries, if virtue lies in easing man by this new plan, will kindly keep me posted."

DR. JOHN AULDE, Philadelphia.
Both Dr. Poole and Dr. Aulde
Have of their piles so nicely told
One might be sure that perfect cure
Would follow soon and follow faster
To rid of this extreme disaster.
But we have felt the 'hornet sting'
All round and round the luckless 'ring,'
And candy ate and capsules poked
Till we have thought we've leen joked,
And never were we satisfied
Until a specialist was tried.
He placed our note within his coat,
And, looking wise, he fixed our thighs

Till self and limbs were in the 'Sims,'
Then, by a trick I did not see,
He thrust a needle into me.

I close my rhyme, for since that time.
I've had a cool sensation
Where long before I was quite sore.
And 'hot as all creation.'

Medical Age.-Cincinnati LancetClinic.

TIGHT LACING.-A few nights ago a young lady in attendance at a ball in a suburb of this city, fell while engaged in a dance, and, on being removed to an adjoining room, expired. It was discovered that, being inclined to embonpoint, it was her custom to lace to the extent of reducing her waist to a circumference consistent with the recognized standard, and to this custom, no post-mortem examination having been made, the death was attributed. Whether or not the etiology was correctly ascribed, the circumstance if sufficient to direct attention to one of fashion's most dangerons exactions. Any attempt to banish corsets from the modern lady's wardrobe would be futile in the extreme, She must wear them