HYPERTROPHY OF THE CERVIX.

I bring before you a negress upon whom I propose to operate for hypertrophy of the cervix. She has been married six years, but has had no children, her sterility being due to the hypertrophy. She has had dysmenorrhoea all her life and of late years has been annoyed with leucorrhoea. I find the vaginal walls normal and the fundus in its normal position, hence I know that this projccting cervix cannot be the result of prolapse, it must be due to hypertrophic elongation. The cervix projects like a finger. Now, of course, there is only one way to get rid of it and that is by amputation. I will pass four silver wires through the cervix, which I will then split into two lips. Having amputated these lips, I will draw down the center of each wire which is in the lumen of the cervix and divide it, so that out of my four wires I make eight sutures, four in the anterior and four in the posterior wall. I then bring these wires together and so unite the inner to the outer mucous membrane. I will thus avoid stenosis of the cervix and will get a very good result.

FREE CHLORINE AS A DISINFECTANT.

BY DR. J. M. HARRIS, Yellow Springs, Ohio.

For the last three years I have been using free chlorine as a disinfectant. My experience is not sufficient to establish a principle, or to draw conclusions from, as to chlorine's place in the materia medica, but it is sufficient to make me believe that its freer use in surgery, obstetrics, and contagious ases, disewill enhance greatly the safety and comfort of our patients as well of nurses and attendauts.

On the theory that contagion enters the system by the skin and respiratory organs, from the air, oftener than by any other way, it is evident that no element can destroy this contagion except it is in the form of a gas, and mingled freely with the atmosphere. This element, too, must be respirable in a degree sufficient to combat the contagion, and at the same time not detrimental to the patient. Now Professor Silliman says of chlorine: "It is wholly irrespirable and poisonous." But on the same page he

says that in very small quantities, "it is used with benefit by patients suffering under pulmonary consumption," by means of an inhaler. If it can be beneficial after the poison is in the system, mingled with and protected by the tissues and their secretions, how much more may we reasonably expect when the chlorine meets the enemy before it is intrenched, and in an element where the law of the diffusion of gases brings them so intimately together. ?

In my practice I have frequently had patients and attendants breathing chlorine for days and weeks, in quantities sufficient to be unmistakably detected by the smell, and without any appreciable detriment to either, and this quantity is quite sufficient to destroy the foul odors from very extensive bed-sores, or offensive lochial discharges.

I have used chlorine, gradually eliminated, in a few cases of scarlet fever. Although other children were exposed in the same house, no new cases occurred after the disinfectant was commenced.

The chlorine must be slowly and continuously eliminated. The noxious exhalations, we believe, may be thus rendered harmless, and make after-disinfection of clothing and apartments unnecessary.

For this I have so far used the formula of Dr. Duncan, known as Rex Disinfectant, by which we have perfect and easy control of the quantity of gas given off.

SYPHILIS OF THE EYELID.

By C. W. TANGEMAN, M.D.,

Assistant to Chair of Ophthalmology at the Ohio Medical College.

It is not a rare occurrence to-day to find the eye or some of its appendages involved by syphilis. According to the locating of the lesion the disease may do damage to the vision. Its tendency is not to get well, yet by prompt and proper treatment good results are often obtained. The appearance of chancre itself on the lids is quite a rare occurrence, yet cases have been observed. A development of gummata in the eyelids may be mis

taken for the more common tumors of the eyelid, as the following case will show.

In

W. H., æt. twenty-six, a professional, about six months after the primary sore developed a little nodule in the upper eyelid of the left eye, which was diagnosed a stye. The tumor grew rapidly in size until it was about half the size of a hazelnut. It seemed as though the tissues of the lid all became involved; the active signs of inflammation were absent, only that the skin became discolored, and, as the patient expressed it, it appeared as though it was going to "break and some matter run out." stead of this the margin of the lid began to show signs of ulceration, which in the course of two weeks involved the entire thickness of the lid, beginning at the outer canthus, and extending over one-half of the lid. The process was a destructive inflammation; the lid was thick and heavy; the skin had a bluish red color, and pain was a prominent symptom. The lid at this time was distinctly notched, the eye lashes, with their follicles, having been destroyed. The ulceration extended a little higher on the mucus or inner side of the lid than on the outer surface.

Possibly this tumor, under timely and suitable treatment, would have disappeared, as gummata usually do melt away without causing any particular damage. But instead of that there was a breaking down of tissue and ulceration as above described.

Syphilitic involvement of the conjunctiva is more frequent in women than in men, and with the other corroborative symptoms of syphilis, the diagnosis is usually not difficult to make.

The treatment in this case was the usual constitutional treatment, with thorough cleanliness of the ulcerating surface and the applications locally of the yellow oxide of mercury ointment daily. In the course of a week the patient had sufficiently recovered to be discharged.

No. 393 Elm St.

RESORCIN IN GONORRHOEA-Of course this new remedy has been tried in gonorrhoea, and Letzel reports favorably in the (Centralblatt fur die Mcdi. Wiss.). He commences in acute cases with a two and a half per cent. solution, and increases as tolerance is established, or the acute symptoms subside, to a four per cent solution. With this treatment, he is successful in both acute and chronic cases.

FRONTAL HEADACHE.

BY C. W. TANGEMAN, M.D.,

Assistant to the Chair of Ophthalmology at the Ohio Medical College.

There is scarcely a drug in the whole materia medica that has not at some time since its introduction been recommended by some one for the cure of headaches.

It is not our purpose in this issue to place upon record another agent or mixture that will work miracles in the cure of the various headaches. Our object is to present a series of cases of this painful malady that are not curable by any drug, and at the same time a reason for the above assertion.

Physicians are often failing to cure diseases because they do not understand the proper relation between cause and effect; treating a symptom as the cause. The following brief history of a few cases will fully explain the term of "frontal headache."

CASE I.-Miss S., æt. twenty-two, robust and healthy, had complained for a number of years of a pain over the frontal region. She noticed that whenever the weather was damp and cloudy the pain increased; at times she complained of dizziness, while again weeks might pass when she was entirely free from pain. After having taken numerous remedies she discovered that she saw double when looking at a distance. I examined her eyes, found that there was no disturbance of the muscle ballance, no manifest refractive error. After paralysis of accommodation by dubosia V=20-50, which was corrected by the proper glasses. From this time on patient never again complained of headache-reader may work out the rationale of action.

CASE II.--Mrs. R., æt. thirty-six, complained of headache, and at the same time of pain in her eyes after using her eyes for new work. V=20-30 on both sides. After the use of a mydriatic V-20-200, which was corrected so patient could see perfect by a compound cylindrical glass. Patient has since then not been annoyed at all, looking after her own household duties with perfect comfort to her eyes.

CASE III.-Miss H. called upon her family physician for the relief of very severe pains that she suffered in her head at frequent intervals. Upon careful examination the physician came to the conclusion that the cause of the headache could not be relieved by

a routine course of medication. The patient was referred to the writer for an examination. Her eye looked healthy, but on careful examination she was found to be hypermetropic, which was promptly corrected by the use of a convex glass, with the result of a perfect cure for the headache.

It will be readily understood that only certain cases are relieved by glasses, since they are caused by some refractive error. It should be an important factor in the treatment of obstinate headache that the general physician to whom most of these patients make application for relief always bear in mind to look after the eyes.

No. 393 Elm St.

BOOK REVIEWS.

POST-MORTEM EXAMINATIONS, WITH ESPECIAL REFERENCE TO MEDICO-LEGAL PRACTICE:

By Professor Rudolph Virchow, of The Berlin Charité Hospital. Translated by T. P. Smith, M.D., M. R. C.S., England. With additional notes and new plates for the Fourth Germen Edition. Philadelphia: P. Blakiston, Son & Co., 1012 Walnut Street, 1885, 12m0., pp. 138, three lithographic plates.

The name of the distinguished author is a sufficient guarantee of the completeness and usefulness of this work, for its intended purpose of directing the order and manner of procedure in making and reporting Necropsies.

THE FIELD AND LIMITATION OF THE OPERATIVE SURGERY OF THE HUMAN BRAIN:

By John B. Roberts, A. M., M.D., Prof. of Anatomy and Surgery in the Philadelphia Polyclinic, Surgeon to St. Mary's Hospital. Philadelphia: P. Blakiston, Son & Co., 1012 Walnut Street, 1885, 8mo., pp. 9-78 and index, ten woodcuts.

This is a reproduction in book form of the author's paper on Cerebral Surgery, read before the American Surgical Association, 1885.

Under the three heads of

1. Principles of Cerebral Surgery,

2. Cerebral Localization,