Medical and Surgical and Surgical Journal. of these patients the disturbance of speech lasted from

A case of this sort occurring in Professor Bäumler's clinic at Freiburg gave rise to an investigation of the

three to six weeks, the shortest duration being two days, and the two longest four months and four years respectively. In general the power of speech returned almost as suddenly as it was lost, with the exception of some little hesitation at the beginning in finding the proper expression.

Of the cases of transitory aphasia reported as attendant upon the acute exanthemata, one, in variola, occurred during the prodromal stage; one, in scarlet fever, at the height of the disease; four, of which three accompanied variola and one measles, toward the end of the febrile stage; and two, one in measles and one in erysipelas, during convalescence. All of these cases, except two of small-pox, also ended in recovery. In proportion to the relative frequency of the diseases, aphasia would seem from this to be a less uncommon complication of variola than of typhoid.

Beyond a somewhat severe type of disease and more or less hyperpyrexia these cases exhibit no especial aetiological factor in common to account for the occurrence of the aphasia, and in the two cases followed by autopsies, one of typhoid and one of smallpox, with the exception of a moderate degree of œdema no macroscopic changes were detected in the

brain.

IS IT NEEDED?

THE bill introduced into Congress last month by Mr. Randall, of Pennsylvania, providing for a national pharmacopoeia, to be prepared under the auspices of army, navy, and marine hospital surgeons, seems, at first sight, one which ought to be favored by the medical and pharmaceutical professions throughout the country.

literature of typhoid fever and the collection of twenty- ANOTHER UNITED STATES PHARMACOPIA. seven other cases, the details of which in connection with nine more cases complicating other acute exanthemata-five in variola, two in measles, one in scarlet fever and erysipelas is not devoid of interest.1 The disturbances of speech in these cases belonged to the amnesic or ataxic aphasias, or exhibited a mixture of the two classes, and a very large proportion, twenty-five out of twenty-eight of them, occurred in children, as might be anticipated from the greater impressionability of the nervous system in children. The majority, eighteen, of the patients were between seven and thirteen years of age, five were between three and six years, one was fourteen, and the age of one child was not fixed. Only ten of the cases were females.

When grouped according to the period at which the aphasia declared itself we find twenty cases developing during the course of the fever, and six during the stage of convalescence, the second and third weeks having been the period of election. In only one case is any paralysis reported, and that a right hemiplegia, in a boy, developing fourteen days after the appearance of the aphasia, and disappearing entirely in a short time, although in three other children a transitory paresis or incoördination of movements of the upper or lower extremities was manifested. In two cases deafness, a not very uncommon complication in adults, without aphasia, was observed.

In most of the cases the typhoid fever was of a severe type, as shown by other nervous symptoms; consciousness, however, was not lost in any, or, at the most, only dimmed for a short time. Only one case ended fatally, the others recovering entirely. In most 1 Deutsch. Archiv klin. Med., page 56, 1883, Dr. Richard Kühn.

We suspect, however, that a certain proportion of the enthusiasm which such a proposition may awake would be due to ignorance of the position now held by the United States Pharmacopoeia, which, although in no sense emanating from the government, has been adopted as a legal standard of strength and purity in several States, and by the Treasury Department of the United States, as shown by the following extract from the Customs Regulations, 1874: "Art. 450. All imported drugs, medicines, and medicinal preparations are to be tested in reference to strength and purity by the standard established by the United States, Edinburgh, London, French, and German Pharmacopoeias and Dispensatories. If the articles prove to conform in strength and purity to the pharmacopoeia and dispensatory of the country of their origin they are exempt from the penalties of the law, but if produced, manufactured, or prepared in any other country than the last mentioned, they must conform to the United States Pharmacopoeia and Dispensatory." The Dispensatory is mentioned in the preceding regulation because the United States Pharmacopoeia of 1870 was very meagre in its details, and the Dispensatory alone gave much of that which is now, by the new revision of 1880, contained in the last Pharmacopoeia. Pharmacopoeia has been compiled, arranged, and stud

This

ied by delegates from all parts of the Union, and embodies special suggestions from many medical societies and specially skilled individuals.

seal up the verdict and return it to court on Monday morning. After the judge had left town the foreman of the jury told the officer that a juror was sick, had a chill, and required some brandy. The officer saw the juror, and thought him sick. He sent to a druggist and got a two-ounce vial of brandy, and passed it to the foreman. Afterwards another juror fell upon the floor in a fit, and the officer sent for a physician, and allowed him to administer to the juror in the fit, who recovered. Subsequently the jury agreed upon a verdict for the plaintiff, sealed it up, and were discharged, and returned the verdict to the court on Monday. The presiding judge in superior court was satisfied that the officer acted in entire good faith, and the defendant was in no way prejudiced by his acts. Upon the motion for a new trial the court said:

It must certainly be considered to fairly represent the wishes and opinions of all portions of the United States as fully as the one proposed is likely to do. The result has been one of which we have no reason to be ashamed. The United States Pharmacopoeia is admitted by competent authorities to be one of the best national pharmacopoeias, if not the best, in the world, and, what is very much to the purpose, arrangements were made by the convention which framed it for maintaining it in its present high position and keeping it abreast of the progress of science. We cannot see what is to be gained by another. If the new one is worse than the old it certainly is not wanted. If it is equally as good we shall have the intolerable nui-"We do not think that the rules of law imperatively sance of two authorities, unless the government can compulsorily retire the present work, not on account of age or inefficiency, but on the lowest political ground of making room for somebody who wants the place and has a "claim."

require us to hold that it is a legal cause for us to set aside the verdict when a juror, who is seized with a sudden temporary indisposition, without the intervention or knowledge of either party to the suit, obtains and uses, merely for the relief of his disease or pain, a small quantity of spirits, and where it appears that he is not thereby disqualified for the due performance of his duty as a juror.

The chances of a new pharmacopoeia being distinctly better in the sense of being more scientific, more convenient, or more fully representing the wishes of the country as regards the selection of articles to fill its lists, cannot be considered very good when we remember that the gentlemen chosen from the three government corps (which corps, by the way, were fully represented in the last convention for revision) can hardly be considered experts, if, indeed, they be not almost ama-porary attack of sickness, though it may for the time teurs, and the work must be largely done either by the men who have already given their best to the present Pharmacopoeia, or by others not at all likely to be their superiors in knowledge, zeal, or experience; and, if current reports relative to the influences brought to bear upon the selection of officers for duty are true, the fear that political and social considerations may have more weight than scientific and professional ones is by no means an unfounded one.

"The question of the effect of the introduction of the physician into the jury-room for the purpose of giving medical aid or relief to the juror who appears to have stood in pressing need thereof is not free from difficulty. It is, however, obvious that a merely tem

If the United States want a more authoritative pharmacopoeia they can easily give the existing one all the authority desired. May we be pardoned the surmise that disappointment at the control of the present Pharmacopoeia being no longer almost exclusively vested in the "great medical centre has something to do with this new move!

MEDICAL ATTENDANCE UPON SICK JURORS. A RECENT decision of the Massachusetts Supreme Court concerning the attendance of a physician upon a sick juror has some interest. The defendant in a trial by jury, against whom a verdict was rendered, appealed to have it set aside, and a new trial granted on account of the acts of the officer having the jury in charge. It seems that the court was adjourned Friday afternoon until Monday morning, leaving the jury in charge of an officer, with instructions to discharge them if they did not agree by ten o'clock P. M. that evening, and if they agreed to have them

being incapacitate the juror, is not a necessary ground for the discharge of the jury. It is proper, when the circumstances will admit, to await the result, and see if, within a reasonable time, he so far recovers as to enable the trial to proceed or a verdict to be returned. If such a sickness is brought to the attention of the court while the jury is deliberating on their verdict. and medical attendance appears to be necessary, the better way ordinarily would seem to be for the court to select a suitable physician, and to caution him in advance not to enter into any conversation with any of the jury upon the case, or upon any matter except such as may be directly connected with the needed relief for the disorder. In the present case the judge was not accessible at the time, but nothing appears to have been done differently from what might well have been ordered by him. There is no reason to suppose that either the officer or physician said anything to that the course of substantial justice was to any exany juror which in any way bore upon the case, or tent perverted or disturbed by what occurred. This was a matter which was especially for the presiding justice to investigate. We cannot say, as a matter of law, that a new trial must necessarily be granted."

MEDICAL NOTES.

A correspondent of Science reports a remarkable instance of protraction of life in a spider during complete deprivation of food. He says that on the

15th day of October, 1881, he inclosed a spider in a small paper box. From that day to the 7th day of May, 1882 (two hundred and four days), he carefully watched and daily inspected the prisoner, and can positively affirm that he partook of no food or water. The box in which the spider was confined was as clean and white as white paper could make it, and remained so while he continued to occupy it, except for the appearance of a few dark specks, which were supposed to be the droppings of the prisoner. He was carefully observed every day, and sometimes two or three times in a day, and no emaciation or symptoms of weakness, or even irritability of temper, were detected while he lived. He always appeared as active, and looked as plump and healthy, as he did the day he was dropped into the box, until within three days of his death, when it was first observed that when the box was tipped he would fall from his position.

NEW YORK.

floor, and what was unhealthful up-stairs could not certainly be less so on the lower floor. In addition to the claim that the law was unconstitutional, it was urged that the making of cigars in tenement houses was not detrimental to the health even of those engaged in the business, and a resolution passed by the Board of Health in January, 1883, while the bill was before the Assembly, was presented, which stated that "it is the opinion of this board that the health of the tenement population is not jeopardized by the manufacture of cigars in such houses."

In consequence of the action of the State Med-ers that up to this time the modified route determined ical Society in resolving to adhere to the New Code of Ethics, a number of members who are supporters of the National Code met at the Delavan House, Albany, February 6th, and formed a new State society, which is to be known as the New York State Medical Association. Sixty-five gentlemen from all parts of the State signed the roll, and much enthusiasm was displayed. The following officers were elected: President, Dr. H. D. Didama, of Onondaga County; VicePresidents, First District, Dr. J. Mortimer Craw, Jefferson County; Second District, Dr. Tabor B. Reynolds, Saratoga County; Fourth District, Dr. B. L. Hovey, Monroe County; Fifth District, Dr. N. C. Husted, Westchester County; Recording Secretary, Dr. Caleb Green, Cortland County; Corresponding Secretary, Dr. E. D. Ferguson, Rensselaer County; Treasurer, Dr. John H. Hinton, New York County; Advisory Council, Drs. John P. Gray, Conant Sawyer, J. W. Moore, Thomas Wilson, Ely Van de Warker, Frederick Hyde, M. W. Townsend, E. M. Moore, E. R. Squibb, Austin Flint, Jr., and J. W. S. Greeley. The Association will next meet in New York on the third Tuesday in November, 1884.

The New York State Veterinary Association met at Cooper Institute, New York, on the 6th of February, and completed its organization by electing the following officers: President, Dr. Robert R. W. Finlay; Vice-President, Dr. L. V. Plageman; Secretary, Dr. Halloway; Treasurer, Dr. Middletown, of Fishkill. The object of the Society is the elevation of veterinary science, and its membership is now about sixty.

- The act prohibiting the manufacture of cigars in tenement houses (except on the ground floor), which went into force in October last, has been decided by the Court of Appeals to be unconstitutional. In the case in which its constitutionality was tested, it was claimed by counsel that on the face of the bill it was shown that the business was not considered by the Legislature to be detrimental to public health, because the law allowed it to be carried on upon the ground

upon has met with very slight opposition or objection from property owners or others, and that as soon as the surveys are completed, and the requirements of the law can be fulfilled, the commissioners will take possession of the required lands and begin the work. He thinks this will be done early in the spring, and that the aqueduct will be completed within thirty months from the date of the commencement of construction. He praises the health department for its energy and efficiency, and expresses the opinion that the remarkable healthfulness of the city during the past year is in a great degree due to the constant watchfulness of the department and to the vigorous enforcement by its officers of the sanitary laws. The number of deaths occurring in the city during the year was 33,958, a decrease of 3966 as compared with the previous year. The death-rate, in comparison with that of other large cities, he thinks is not excessive, particularly when the special circumstances existing in New York are taken into consideration, namely, the absolute completeness of the records of deaths; the large tenement-house population, due to the insular position of the city; the great foreign immigration to this part, where many aged, weak, and sickly immigrants remain to die; the influx of sick and poor from the surrounding country and from interior cities, who seek the benefits of the treatment to be obtained in the hospitals; and the great number of visitors and temporary residents always in the city for medical treatment all contributing to swell the mortality and increase the apparent death-rate.

pital was held on the 8th of January, when twentyseven graduates received diplomas, and Prof. T. Gaillard Thomas made an address to the class, from which the following extract is taken: "The lady managers

of this school have looked for and found in it a field

which lay fallow at their very door, and yet a field as noble, as useful, and as consonant with woman's nature as any that civilization offers to mankind. The educated nurse is the lieutenant of the physician in the sick room, one who replaces him in his absence, watches for him the approach of danger, reports for him the progress of the case, and in time of sudden and dangerous emergencies acts for him to the best of her ability. Yet we ask you, nurses, whether this position is not a sufficiently lofty one, a sufficiently responsible one, to satisfy the ambition of any woman?

Could

any greater trust be imposed upon you, any greater confidence placed in you, if you were sculptor, actress, prima donna, lawyer, or physician?" The following is a summary of the annual report, which was read by Dr. Murray: The school was opened, in 1873, by thirteen women, to whom was intrusted the nursing of four wards in Bellevue Hospital. It now numbers sixty-four pupils, and has charge of 258 beds in fourteen medical and surgical wards, the Sturgis and Marquand Pavilions, and the Emergency Hospital attached to Bellevue. The school also nursed 125 private cases last year. Since its opening 105 nurses have been graduated, of whom twenty-five are engaged in hospital work, and 137 in private nursing. There were 813 calls for private nurses last year, of which 184 had to be declined, all the nurses being engaged at the time of application. Over 300 applications for entrance to the school were received, but only forty of the applicants were accepted. The expenses exceeded the receipts by $3,500, but two friends supplied the deficit. About a year ago the school was asked to furnish recruits for an association of trained nurses to be established in Rome, Italy, and on this occasion letters were read from there praising the work of the graduates sent.

Correspondence.

TREATMENT OF DISEASES OF THE EAR. VIENNA, January 12, 1884. MR. EDITOR, Perhaps a few words concerning the treatment of diseases of the ear at the Vienna clinics may be of interest to some of your readers, and I will endeavor to mention some of the more interesting points in regard to it.

At all the clinics for simple otitis media purulenta uncomplicated by profuse granulations or polypi, after syringing and carefully drying the ear, very finely powdered boracic acid is blown in. This powder is allowed to remain until it becomes moist, when it is immediately syringed out, the ear is again carefully dried, and more powder is blown in. This should also be done by the patient at home as often as is necessary. As soon as the powder remains dry in the ear all treatment is stopped, and the powder gradually works its way out without the use of the syringe.

This treatment by means of powdered boracic acid

has entirely superseded the use of astringent solutions,
such as sulphate of zinc, alum, etc., which are now
only used in exceptional cases where boracic acid has
The results obtained
failed to check the otorrhoea.
seem to be very good indeed, and it is claimed that
boracic acid is less irritating than the astringents, and
that when properly prepared, that is to say, very finely
powdered, it never forms hard masses in the ear which
will act as foreign bodies, and so have to be removed.
The best method of obtaining boracic acid of the
proper quality is by precipitating it from a solution.

For cases complicated by granulations which are too small to be removed by the snare, and in the cases of children or adults who are frightened at the idea of being operated upon, spiritus vini rectificatissimi is used. The ear is to be filled with this fluid three times a day, and the alcohol is allowed to remain for from twenty minutes to half an hour, the patient in the mean time lying with his head upon a pillow. If alcohol in its full strength causes pain it should be diluted at first, and its strength increased gradually. Alcohol may be combined with the boracic acid treatment or it may be used after the removal of polypi by the spare. Larger granulations and polypi are removed by means of the snare, the sharp ring, or are touched with caustic.

Ferrum sesquichloridum is recommended as a caustic at all the clinics. It is better than nitrate of silver as it causes less pain and penetrates deeper into the tissues to be removed, and so accomplishes its object more quickly.

Urbantschitsch considers chromic acid, in its most concentrated form, the very best caustic to use for polypi or granulations, but it must always be applied through a speculum, and must not come in contact with healthy tissue, as when it does so it causes great pain. If granulations bleed after being touched with chromic acid a tampon of cotton wool must immediately be inserted in order to keep the acid from coming in contact with the walls of the external canal.

For tough fibrous polypi Urbantschitsch uses the galvano-caustic snare.

For both acute and chronic catarrh of the middle ear, besides the use of the air douche, catheter, etc., if the calibre of the Eustachian tube is diminished, bougies are passed through a catheter to the isthmus tubæ, and the canal is dilated up to the size of one and one third millimetres. In some cases these bougies are allowed to remain twelve hours in a ten per cent. solution of nitrate of silver, and then dried before being used. The ordinary bougies remain in the Eustachian tube about three minutes; those which have been soaked in nitrate of silver from a half a minute to a minute; but in any case if they cause sharp pain they are immediately withdrawn. Besides dilating the Eustachian tube they often act favorably in removing troublesome tiunitus, and it is not uncommon to find that after their use in one ear tinnitus of both ears is improved or ceases altogether. By reflex irritation of the acousticus through their use the hearing is also often improved, but it is doubtful how permanent this improvement is.

Another method employed to mitigate tinnitus, which is often so annoying, is the use of electricity. The constant current is at first tried, and if this fails to accomplish the desired end the induced current is used.

The anode (copper pole) is placed upon the tragus, and the kathode (zinc pole) is brought in contact with

For nasal polypi the ordinary snare, or the galvano-The rags being subjected to the boiling proposed caustic snare, is used. For adenoid vegetations at the posterior nares the galvano-caustic snare, or Stoerk's snare constructed for this purpose, is employed to remove the growths, or else they are repeatedly touched with nitrate of silver, burned with the galvano-cautery, pulled off with forceps, or scratched out with the finger nail. In every case where the nose is found to be diseased, it is treated at the same time with the ear, and this is considered a very important aid to the treatment of the ear itself.