body, of the size of a musket ball, covered by the skin, but no trace of cord or testicle. A linear cicatrix on each side of the median line made him suspect castration. On interrogating his patient he learned that the young man, when seventeen or eighteen years old, had obeyed the Scriptural direction, If your right eye offends you, pluck it out, and had, with a planing iron, made an incision in the skin of the scrotum, extracted the testicle, and cut the cord on both sides. Local applications of cold water arrested the hæmorrhage, and he recovered in about three weeks. Certainly it seemed to him disagreeable to live with an empty scrotum, and fearing that he would gain heaven later than he thought he decided upon a new operation. With the chisel he made an incision in the scrotum on the left side, and introduced into the wound a glass ball, which served as a testicle, and relieved his disagreeable void. The wound healed slowly. M. Santesson extracted the ball, and presented it to the Society of Medicine of Stockholm.

- Lecturers on First Aid to the Injured and kindred subjects, which have become so popular of late, do well to translate all technical terms which they may have occasion to use completely into the vernacular, otherwise they may be confronted at their examinations by such startling statements as this, which we learn from an English contemporary to have been actually rendered on such an occasion: "Bleeding from the nose is neither Artillery nor Venus, it is Caterpil lary."

Whatever may be said (and there is much) in favor of the requirement of some compensation from the beneficiaries of a hospital, it is worthy of remark that at Guy's, which for various reasons is a most conspicuous example of the inauguration of the commercial system, the motto of the founder was dare quam accipere. In view of the change of policy it would seem appropriate to make a slight change in this doctrine of the founder so that it should read accipere quam dare.

- A female child, aged six, who was brought to one of the London hospitals for ringworm was noticed to have a patch just above the middle of the forehead, where the skin was white, and the lock of hair growing from it was almost, if not quite, white. The mother had a precisely similar condition, and said that the lock had, at one time, been as long as the rest of her hair, but she had now cut it short. She also said that it was hereditary in her family, having occurred in two of her sisters and one brother, in her father and her grandfather, and that one of her sisters had four children similarly affected, all girls.

-French Fun: Dr. B., after having bought a lot in the Montparnasse Cemetery, went to the marble worker to order the tomb. After the details were arranged the marble worker said: "Monsieur did well to select this cemetery, it is so quiet; and then Monsieur le Docteur must know a good many people here." A writer in the Lancet describes the use of a Hodge pessary in the treatment of a fracture of the lower jaw at the symphysis with external wound of two inches in length. The desideratum was an appa

ratus which should immobilize the jaw and yet allow of the dressing of the wound. The pessary was bent so as to allow the chin to protrude through its ellipse, one bar being moulded so as to support the fracture anteriorly, the other from below. Tapes were sewn to the rounded ends of the pessary for securing it.

Rev. Daniel Waldo, a graduate of Yale in 1788, who died in 1864 at the age of one hundred and two, gave as one of the rules of life which he had acted upon, and which he believed had enabled him to live so long, "Never allow yourself to fall into a fit of anger. One storm of angry passion will cut short your-life more than an ordinary run of fever."

- A very unusual thermometric record for the "temperate" zone is announced from New South Wales. The unfortunate locality is the town of Bourke, some 500 miles from Sidney. It is situated on an immense plain at about the sea-level, separated from the coast by a chain of low mountains. The temperature, as published by the government meteorologist at Sidney, showed an average at the hottest period of the day for the first fifteen days of 1884 of 110.6° F. The lowest figure for any of the days was 103.5° F., and the highest 122° F., which was reached two days in succession.

MEDICO-LEGAL NOTE.

-The following is stated in the Maryland Medical Journal on the authority of Mr. Willoughby N. Smith of the Baltimore bar, and Lecturer on Medical Jurisprudence in the College of Physicians and Surgeons, as being the state of the law in the United States with respect to the sanctity of communications imparted in confidence to a physician by a patient:

In the absence of any statutory provision to the contrary, it is well settled that a physician or surgeon may be compelled to disclose any communication made to him in professional confidence. Stephens' Digest of Evidence, Art. 117.

The States which have enacted statutes changing this rule of the common law are the following: Wisconsin, New York, Michigan, Iowa, Minnesota, Missouri, Ohio, Indiana, and Nebraska.

The statute of Wisconsin provides that " no person duly authorized to practice physic or surgery shall be compelled to disclose any information which he may have acquired in attending any patient in a professional character, and which information was necessary to enable him to prescribe for such patient as a physician, or to do any act for him as a surgeon."—Wisconsin Revised Statutes, Sect. 4075.

The statutes adopted in New York, Michigan, Minnesota, Missouri, Ohio, Indiana, and Nebraska, provide either that a "person duly authorized to practice physic or surgery "shall not be "competent" or that he shall not be allowed" to make the disclosure. But by the statutes of Iowa, Indiana, and Minnesota such testimony may be received with the consent of the patient" in all cases, and in Minnesota the prohibition, in the absence of such consent, is confined to civil cases: the " regular physician or surgeon" may be

compelled in that State in criminal cases to disclose communications reposed in him in confidence by a patient while in actual attendance upon the patient in the capacity of medical adviser.

Correspondence.

SOME SUGGESTIONS UPON CEREBRO-SPINAL MENINGITIS.

MR. EDITOR,

The paper upon Cerebro - Spinal Meningitis by Dr. Mason, in the JOURNAL of February 7th, was of special interest to me from the fact that the first and many of the succeeding cases that occurred during the epidemic mentioned by Dr. Sargent came under my care.

I will go no further than to give the treatment that was found the most successful, namely, to purge drastically with salts. If the purge was omitted over twenty-four hours the patient became unconscious, with a tendency to convulsions. As soon as the bowels were moved freely these symptoms disappeared.

In a case that occurred some months after the epidemic had apparently subsided a different mode of treatment was adopted in consequence of the disease having advanced to the convulsive stage.

A little girl, aged six years, vomited in the morning. I was called soon after. She could hardly be said to be sick, yet something in her appearance reminded me of my former cases. I cannot describe it better than by saying she did not seem to comprehend any question that was asked her. Yet her mother would not admit that this was unnatural, attributing it to my being a stranger.

On my visit the next morning this peculiarity was, I thought, more marked; still the mother would not admit that there was anything unnatural. Soon after my visit she became convulsed, and as I was not sent for, found her so on my visit at night. At this time her pulse was a mere tremor. My first effort was to stop the convulsions, as she would soon die for lack of respiration. As this was before the use of anaesthetics, my reliance was upon opium.

My principal object in giving the treatment in this case is to show that if a medicine is given which is adapted to control the symptoms for which it is given it can be pushed until the object is attained, without its ultimate effects being manifest.

To control the convulsions I dealt out three grains of sulphate of morphine in six powders. I inquired of the mother if she had any laudanum; she brought out a two-ounce vial full. Dr. Jewett, the prominent temperance lecturer, lived opposite, and kindly offered to take charge of the patient during the night; therefore I am confident the medicine was given as directed. My directions were to give one of the powders of morphine every half hour until it controlled the convulsions; if the morphine did not do it then follow it with a teaspoonful of laudanum every half hour. It will be remembered that this was for a child six years old.

On my visit early in the morning I found the child had taken all the morphine and all of the laudanum, yet had a slight tremor of the facial muscles; not a symptom of the ultimate effects of the drug could be discovered, no change in the respiration, no contraction of the pupils. She had no further manifestation of the

disease, except the effect of the deposit of pus upon the membrane of the brain. She was as a new-born infant, and the change in her was as from infancy to childhood, having to learn everything anew. HENRY G. Davis, M. D.

NEWTON, MASS.

Miscellany.

LIQUOR LICENSES IN BOSTON.

THE recent action of the Police Commissioners of

This

Boston in increasing the price of the liquor licenses is supposed to be due in part to the influence of the Law and Order League, and undoubtedly is in accord with general public sentiment as reflected in the daily press. The amount to be collected for the liquor licenses is left within certain limits to the local board, the statute providing, for instance, that the innholder's license (first class) shall be not less than $100 nor more than $1000 per year. Under the former rules the amount was fixed at $300, but is now increased to $600. schedule (A) applies to about thirty hotels in the city proper. Another schedule (B) has been established for hotels outside the old city limits, also numbering thirty, and its fee is $350. These licenses all convey the right to sell all kinds of liquors at all hours. The other classes of licenses, more or less restricted as to the kinds and amounts of liquor to be sold, are held by common victualers, brewers, grocers, etc., and have all, without exception, been increased in price, the increase varying generally from twenty-five to fifty per cent. Only the druggists' licenses, which are fixed by statute at $1, remain unchanged.

The extent of the change may perhaps be best realized when it is said that it is estimated that the income from licenses in the city during next year at the new rates will amount to $550,000, as against about $310,000 for the current year. This is supposing that the number of licenses remains as at present at about 2800.

POISONOUS WALL-PAPERS.

As the result of government inquiry, concerning foreign legislation or municipal enactment having for its object limitations, restrictions, or safeguards in the manufacture, use, or sale of arsenical and other poisonous colors in the tinting of wall-papers, textile fabrics, and other industrial decorative purposes, the British Medical Journal reports that the German Imperial law, which supersedes all local legislation, is by far the most complete, and has served as a basis for those of Denmark and other countries; the Austrian laws are very satisfactory, and probably would be more applicable to the circumstances of Great Britain. accordance with a suggestion of the Board of Trade, further special inquiries have been made by her Majesty's representatives abroad on the subject of the customs regulations affecting the importation of textile fabrics and wall-papers, and the result of such inquiries has been to show that no special customs regulations or restrictions exist having for their object the detection of poisonous substances employed in coloring these articles imported into the undermentioned countries: Baden, Bavaria, Belgium, Denmark, France,

In

Deaths reported 2509 (no reports from Cincinnati and Buffalo): under five years of age, 904: principal infectious diseases (small-pox, measles, diphtheria and croup, whoopingcough, erysipelas, fevers, and diarrhoeal diseases) 297, consumption 386, lung diseases 308, diphtheria and croup 57, diarrhoeal diseases 43, scarlet fever 60, typhoid fever 32, measles 21, puerperal fever 19, malarial fevers 18, whooping-cough 14, erysipelas 14, small-pox four. From typhoid fever, New York eight, Chicago seven, Philadelphia six, Boston, New Orleans, and Lowell two each, Baltimore, St. Louis, District of Columbia, Pittsburg, and Providence one each. From measles, Baltimore seven, New Orleans five, New York and District of Columbia three each, Philadelphia, Lawrence, and Taunton one each. From puerperal fever, New York and Chicago three each, Brooklyn, Boston, St. Louis, and Milwaukee two each, District of Columbia, Lowell, Cambridge, New Bedford, and Chelsea one each. From malarial fevers, New York seven, New Orleans four, Brooklyn three, Chicago and St. Louis two each. From whooping-cough, New York four, Philadelphia, Boston, and Baltimore two each, Brooklyn, Chicago, St. Louis, and New Haven one each. From erysipelas, New York seven, Philadelphia and Brooklyn two each, Chicago, Boston, and Baltimore one each. From small-pox, New Orleans three, Philadelphia one.

In 71 cities and towns of Massachusetts, with an estimated

population of 1,299,412 (estimated population of the State 1,955,104), the total death-rate for the week was 18.00 against 16.72 and 16.28 for the previous two weeks.

In the 28 greater towns of England and Wales, with an estimated population of 8,762,354, for the week ending February 16th, the death-rate was 20.1. Deaths reported 3367: acute diseases of the respiratory organs (London) 334, whooping-cough 120, scarlet fever 79, measles 77, diarrhoeal diseases 44, fever 40, diphtheria 39, small-pox (Sunderland 10, Birmingham three, London two, Liverpool one) 16. The death-rates ranged from 11.8 in Portsmouth to 25.8 in Sunderland; Leicester 16.5; Leeds 17.7; Birmingham 17.8; Blackburn 17.9; Bradford 19.4; London 19.8; Birkenhead 21.2; Sheffield 21.7; Manchester 22.8; Liverpool 24.9. In Edinburgh 18.2; Glasgow 25.4; Dublin 31.4.

For the week ending February 16th, in the Swiss towns, there were 40 deaths from consumption, lung diseases 35, diphtheria and croup 13, whooping-cough 10, diarrhoeal diseases 10, scarlet fever four, typhoid fever two. The death-rates were, at Geneva 18.3; Zurich 23.6; Basle 20.2; Berne 23.3.

The meteorological record for the week ending March 1st, in Boston, was as follows, according to observations furnished by Sergeant O. B. Cole, of the United States Signal Corps:

BY E. H. BRAdford, m. d.

It is certainly desirable to place in the hands of the general surgeon a method by which obstinate, relapsed, or half treated cases of congenital talipes equino-varus may be cured without the expenditure of a great amount of time or the trouble of a great amount of special detail. This is particularly needed in the service of a large general hospital, and in the work of a country practitioner. The operation of excision of the tarsus has probably come into vogue on account of this need; but although this mode of procedure is apparently attended by slight risk and followed by excellent results, if equally good results can be obtained by less severe surgical interference the method is certainly to be discarded. Personal experience in tarsotomy has led me to this conclusion, for although excellent results were obtained it appeared that the resistance to correction was not due so much to the deformity of the tarsal bones as to the tissues (presumably ligamentous) binding the displaced bones together, and that theoretically it was better surgery to attack the latter than the former structures. Simple tenotomy is not sufficient to divide the ligaments which lie close to the tarsal bones. A direct incision, proposed and successfully carried out by Dr. Phelps, of Chateaugay, is objectionable on the ground that correction would leave a gaping wound, and also because on general principles a deep incision is to be avoided if equally good results can be obtained without. Gradual stretching, the method most in vogue, demands in the most obstinate cases a great deal of time and a daily attention not always at command.

The method of forcibly rectifying a club-foot is not a new one, but it has not found favor because of the mechanical difficulties encountered, and also because a practicable means of fixation after such correction had not been in use, consequently not enough has been gained to sanction the procedure. Furthermore, tradition has deterred many surgeons from immediate correction in the fear of subsequent non-union of tendons. The first mechanical means of value for the purpose of immediately correcting obstinate club-foot was reported by Dr. Morton, of Philadelphia. In two cases in which I had the opportunity of testing this method its efficiency was proved, and fair results obtained; perfect success was not gained from the fact that perfect fixation through lack of experience in the method and in the mode of after-treatment was not effected, The appliance seemed to be defective in that it lacked precision, relying as it did for the correcting force upon straps, which are liable to stretch and slip. The accompanying drawing (Fig. 1) illustrates an appliance which appeared to remedy this difficulty.

The object of the appliance is to exert pressure under control of the operator in three directions, and also to enable him to twist and raise the front of the

foot.

FIG. 1.

Cross-section.

They should be placed so as to press (1) upon the side of the first metatarsal; (2) on the side of the os calcis just beneath the inner malleolus; (3) on the outer side of the foot over the projecting head of the astragalus. The female screw through which the male screw plays is adjustable upon an arm curved so that pressure can be applied when it may be found neces

sary.

The sockets and arms are arranged so that they can be shifted and placed at any point along the side of the large plate, or can be shifted from side to side, so that the appliance can be used for either foot.

(3.) A straight rod, extended in the plane of the plate, gives increased power in raising the front of the foot. This is not always needed, and can be removed.

In operating upon obstinate cases of club-foot (the only cases for which this method is designed) the method of procedure is as follows: Tenotomy is performed in the usual way, the plantar fascia divided first, the tibiales tendons (if contraction is present) and the tendo Achillis last (after the deformity at the arch of the foot has been in a degree corrected); the foot is then forcibly manipulated with the hands, pressure being exercised upon the projecting head of the astragalus by the thumbs, and force applied in a counter direction by the hands grasping the ankle and fore part of the foot. It will be found in certain cases that complete correction of the deformity cannot be accomplished by the hands alone, and the hindrance will be seen to be not a shortened tendon or any tissue accessible to the tenotome.

The instrument just described is then to be applied, and the screws turned and adjusted so that the plates will press upon the os calcis, the head of the astragalus, and the side of the first metatarsal as far as its articulation with the tarsus. The foot will now be firmly held, and by additional turns of the screw force can be Rotation upwards applied in the desired directions. and outwards can be effected by twisting the plate and the equinus deformity of the foot can be corrected by pressing the end of the plate upward. In case it is desired to increase the power in this direction this can be done by increasing the length of the handle. If the screw plates are properly adjusted it will be found that there is no danger of a fracture, as the pressure can be so directed that the ligaments will yield before any of the bones of the tarsus can be broken. An anesthetic is of course required, and correction will be done gradually rather than by any sudden tear. The extent to which force can with safety be applied is with difficulty defined; it may be said, however, that experience shows that a much greater pressure can be used than would at first be thought feasible, in a majority of cases enough force can be used to convert the foot from the position of varus to that of valgus, aud to correct the