was attended by himself and Dr. Chambers for catarrhal pneumonia; she was getting better, when suddenly the muscles of her hands and arms began to waste, she had pain in the course of the nerves, the tendon reflex was entirely gone. Under massage and strychnia she also recovered. These cases are hastily gone over to bring out the differential diagnosis between peripheral neuritis and poliomyelitis. Peripheral neuritis is comparatively a new subject, it was brought to the attention of American physicians by Dr. M. Allen Starr of N. Y. in the Goldsmith lectures.

Dr. J. W. Chambers said peripheral neuritis is a more common disease than is usually thought to be. He knew of two cases of attempted suicide by taking arsenic, they did not succeed in committing suicide but they did succeed in getting a peripheral neuritis. The first case that came to his attention was six years ago. He called it poliomyelitis at the time. Since then, having learned more of the disease, when he saw a case about a year ago, he looked for and found peripheral neuritis. He thought that in a short time we would hear more of peripheral neuritis and less of poliomyelitis. He saw a case last winter, of a lady who had a retroflexed uterus and who was pregnant. She had pains shooting down both legs, and he thought her hysterical at the time; she soon aborted. About six months after there was marked wasting of the lower extremities, and after a while of the upper extremities also. She is much better now and is filling up again. In peripheral neuritis there is not so marked a deformity from contraction of the muscles, as in poliomyelitis, but in the case of a colored man at the City Hospital last winter, there was very marked deformityfrom muscular contraction. This brings us to the consideration of the value of a single symptom-so called pathognomonic symptoms. It is said that the Argyle-Robinson pupil is pathognomonic in tabes dorsalis, but it has been observed in multiple neuritis.

One pathognomonic sign is of no use, unless associated with other signs which must be taken into consideration with it. Dr. Wm. H. Norris said he had seen several cases, one a remarkable case, six years ago, in a highly educated lady of a very nervous disposition. She had been under his care for some time with chronic diarrhoea. She went to New Orleans for the winter, on his advice, and returned in the spring with malaria. About this time she became very nervous over some bonds which she owned. She was suddenly paralyzed and suffered great pain. A diagnosis of multiple neuritis was made. She became much atrophied and there was considerable muscular deformity. She died about three years ago. An idea of the degree of wasting may be formed, from the fact that from 125 lbs. at the beginning of the attack, she was reduced to 65 lbs. at the time of her death.

Dr. G. J. Preston said the cases narrated, go to confirm him in the opinion that peripheral neuritis is a more common disease than is usually thought to be. It seems to be an American disease, as we do not hear much of it in Europe. This may be due to the pressure of our American civilization or it may be because it is more closely observed and in consequence is more frequently reported. Poliomyelitis will often recover, almost perfectly, and rapidly, even in cases where the paralysis is marked. It is probable, in these cases that the large cells in the anterior horns may be affected, (not destroyed) sufficiently to interfere with their functions. Dr. J. E. Prichard then read a paper on: The Use of Splints in Fractures of the Long Bones, and a case of Solution of Continuity of the Left Humerus at the Surgical Neck.

Dr. W. S. Blaisdell said the application of splints to fractures of long bones as recommended by Dr. Prichard could have but one objection to it, and that would be that a crutch paralysis might be induced by the pressure in the axilla.

ABSTRACTS.

ERRATIC PAIN IN LABOR.-At a

meeting of the Virginia Academy of Medicine and Surgery, Dr. Johnston reported the following case:

Dr. Johnston had been called, fifteen or twenty days before expected delivery, to a woman, the mother of four children (good labor each time), who complained of a severe pain, paroxysmal in character, occurring on the right side of the neck, and extending down upon her Suschest to the margin of the axilla. pecting the approach of labor, he asked for an examination but was refused. Early the next morning he was called again and found the child born. The pains had increased in length and intensity, the intervals growing shorter, until suddenly there was a gush of waters, the birth of the child immediately following. The woman had not a single uterine or abdominal pain, and did not, in the least, suspect the real condition of affairs.- Virginia Medical Monthly.

THE ELIMINATION OF IODIDE OF PoTASSIUM BY THE KIDNEYS has been studied by Dr. Ehlers, of Copenhagen, (Annal. de derm. et de syph., 1890, 1, 383). He finds that, on account of the rapid absorption and elimination of the iodide, there is little danger of intoxication by it, even in large doses, so long as the kidneys remain sound. All cases of intoxication by the iodide have been in patients with diseased kidneys, and in them it is found that symptoms of iodism showed themselves when only half of the amount taken was excreted by the kidneys. Under normal conditions, when the patient is taking 20 grammes (about 300 grains) of the iodide during the day, the urine will contain the salt in the proportion of about seventy-five or eighty parts in one hundred of urine. If more than this amount is taken, absorption seems to be

on account

URINE.-The following tests have been published by Zouchlos (Rundschau) and are recommended of their simplicity and accuracy: A solution of 1 part of acetic acid and 6 parts of 1% solution of corrosive sublimate is prepared; to this the suspected urine is slowly added, which at once produces a distinct cloudiness. This test is not affected by peptones, uric acid or the phosphates. A still more delicate test than the above has been proposed by Zouchlos: Three ounces of a 10% solution of rhodium potash, with 6 drams of acetic acid; of this a few drops are added to the suspected urine. If albumen is present, there is at once formed a distinct cloudiness, which is insoluble in excess of the solution.- Virginia Medical Monthly.

THE CLOTHING OF YOUNG CHILDREN— Mrs. Waller, in the Nineteenth Century, pointed out that it is still too much the custom to leave the upper part of the chest and the lower part of the abdomen exposed, and that hence come pulmonary affections on the one hand, and bowel complaints on the other. "It is a fact, that not only has the child less power of generating heat than the adult, but that it has also a much larger surface in proportion to the mass of its body, and will consequently be far more susceptible to cold. Cold feet cause a large amount of indigestion, and expos

ure of the large blood-vessels of the thigh during childhood frequently sows the seed of kidney diseases, to develop in after life.-Lancet.

PHENOMENAL WEIGHT.-The Medical Press, says that a girl, æt. 19 years, died near Paris. The girl was of an enormous size. A year ago she was weighed, and was found to exceed 470 pounds, and since then she had considerably increased. Around her waist she measured two yards and a half, while the circumference of her arm exceeded one yard. Last year it was proposed to exhibit the girl; but eight men were required to remove her from her room; and as she could not pass through the door, the affair was abandoned. She succumbed to erysipelas, and a special case had to be made to contain the body, and finally it had to be passed through the window.

THE VALUE OF WATER.-It should be generally known that one of the most important agencies in the digestion and assimilation of food is water, and that seventy-five per cent. of the human body is composed of water, and that four and one-half pounds is thrown off daily by the healthy body, and that a diet largely nitrogenous will tax the system severely, unless a considerable quantity of water be taken for the purpose of getting rid of the waste. It is estimated that a full grown male adult requires fifty-two fluid ounces of water daily, and organized structure will not perform its function without its due proportion of this agent.-Med. Rec.

UMPFENBACH adds something to our knowledge of orexin hydrochloride. Experiments made on himself showed that a single dose of four grains always produced a sensation of more than usual hunger, which, as a rule, lasted for some

days. In two cases of anæmia, a convalescent from influenza, and a man with chronic gastric catarrh, the remedy was also successful, with one exception (an anæmic girl). These patients were all sane. Of the inmates of the asylum twenty-five took orexin for want of appetite, dependent on bodily (four cases) or mental diseases (twenty-one cases). Out of the four cases of the first class, three were benefited; of six hypochondriacal and hysterical patients the effect was produced in five; eleven cases had to be fed artificially through a stomach tube, eight grains of orexin given to these twice a day mixed with their soup. In five of these eleven, hunger was so stimulated that they took food themselves for some time; in one the effect was only transient, and in the five others absent. Of the four remaining cases of the second class appetite was improved in only one. Suggestion was avoided as far as possible, and gentian was not combined with the orexin. Unpleasant after-effects were not observed. In conclusion the author says that in orexin we have a really useful stomachic, though like all medicaments, it is not in every case completely successful. A similar conclusion was reached by Dr. Reichmann (Giessen), who gave it in thirty-six cases.-Prov. Med. Jour.

GRAFTING THE THYROID FOR MYX DEMA.--The operation of grafting the thyroid in a case of myxedema has again been performed with success. The patient was shown by M. Merklen, at a recent meeting of the Société Médicale des Hôpitaux in Paris; the thyroid graft was taken from a living sheep at the time of the operation; no antiseptics were used, but the graft and wound were kept carefully aseptic. Healing occurred by first intention, and the patient, a woman aged forty-one, improved considerably. The improvement appeared to be due in great part to the arrest of metrostaxis, from which the patient had previously suffered for months at a time; the hemorrhage ceased three days after the operation, and had not recurred when the report was made three months later. The swelling of the face had decreased, the pseudo-lipomata diminished, and the mode of speaking became more natural. The graft, which consisted of one of the lobes of the gland, was inserted beneath the skin in the right submammary region.-British Med. Jour.

TREATMENT OF TONSILLITIS.-In an article in the Indian Medical Gazette, Hehir recommends pilocarpine in doses of grain every two hours, to reduce the tenacity of the secretion. The drug used in India is, perhaps, of poor quality as such doses here produce much more than the "light salivation" aimed at by Hehir.

He finds few cases benefited by aconite; rapid relief ensuing in only two cases out of seventeen, and both these were children. Locally he recommends steaming, and the application of cocaine in 6 per cent. solution, and of powdered guaiac resin. Internally he gives tartar emetic in doses of grain every two hours; adding ammonia or strephanthus to combat depression if excessive. He also believes that port wine is of local value, as well as the best stimulant. Further, he advises concentrated liquid

food, the stereotyped initial mercurial purge, small incisions into the affected gland, and tepid, antiseptic gargles. By these means he reduces the duration of the attack to three days.-Times and Register.

CURE OF GANGRENE.-I had a case of gangrene of the third finger which extended rapidly into the hand, in spite of all I could do by following the directions of all authorities I have seen on the subject. The purplish color advanced steadily under the serous bleb, until it reached the middle of the metacarpal bone. In the palm this color was not perceptible, owing to the thickness. of the skin, but it presented a peculiar tallowy color to a corresponding extent.

Believing that any further advance would entail a loss of part, if not the whole, of the hand, I felt justified in indulging in an experiment that seemed to me likely to succeed. I immersed the hand in alcohol, contained in a large pitcher suspended over the patient as he lay in bed, elevating the hand to prevent swelling of the arm. The alcohol was kept warm by means of a coil of rubber tubing in the bottom of the pitcher, through which hot water was kept flowing. The advance of the dreaded purple color was checked. The already gangrenous tissue assumed a hard, cooked appearance. I continued this plan of treatment for about sixty hours, when I replaced the alcohol by a boracic acid solution, kept hot by the same apparatus. This acted as a most efficient poultice, and in a-short time the dead tissue was cast off, fortunately leaving enough live tissue next the bone to throw out granulations. In time the hand and finger made a perfect recovery.-Allingham, Canada Lancet.

The officiat, or second grade of prac titioners in France has long been threatened, and appears now to be on the

point of extinction. The Chamber of Deputies some time since appointed a committee to examine and report upon the subject, and the result of its deliberations is entirely in favor of suppressing the officiat. The report presented to the Chamber states that there is every reason to expect that the number of doctors of medicine that will graduate in future will be quite sufficient for the needs of the population, especially if more protection is afforded by the law against the encroachments of quack and of foreign practitioners. It is also pointed out that not only the great majority of medical men, but of the exist ing officiers, are in favor of the suppression of the lower grade. The number of candidates for it has of late decreased considerably, and since 1883 the course of study and the examinations have been raised to a level not very much inferior to those required for the doctorate. The report recommends that the existing officiers he admitted to the doctorate on passing two clinical examinations. It is greatly to be desired that the whole medical profession should possess the same diploma-viz., that of Doctor of Medicine-as is now (according to the committee) the case in Germany, Austria, Italy, Belgium, Holland and Spain. Here the committee's information must be considerably at fault, for in Germany, Holland and Spain practice is by no means confined to M. D.'s. Lancet.

CLINICAL OBSERVATIONS ON SOME NEW PHARMACEUTICAL PREPARATIONS. In a paper read before the Thirtyfourth Quarterly Meeting of the North Central Ohio Medical Society, held at Mansfield, Ohio, September 26, 1890. Dr. R. Harvey Reed, of Mansfield, says:

"Every age in medicine and surgery has had its fanatics, who seemed to live for little else excepting to ride some particular hobby to death; whilst, on the other hand, every age has had its old

fogies who would rather perish than turn an inch to the right or left of the old time-worn rut of their forefathers.

"The hundreds of worthless 'new remedies' that are placed before the profession for their patronage from year to year, is enough to disgust them with all new remedies. It seems to me that many of our manufacturing chemists spend the bulk of their time seeking for something that is new, regardless of its real merits or value.

"If only they can strike the profession with a 'new remedy' of some description or other, they are perfectly happy.

"But with all these criticisms we must admit there is now and then a new remedy comes to light which has real and lasting merit, which in a large degree atones for the defects of many of its worthless compeers."

Then after referring most favorably to the non-irritating preparation of cascara sagrada, prepared by Mr. J. Le Roy Webber, Ph. G., the author makes the following statement as to his experience with pancrobilin:

"In this direction, however, we have another 'new remedy'which has gradually engrafted itself into my good graces, which is becoming more and more permanent the longer I use it. This is what is known as 'pancrobilin' and it is a combination of pancreatin and bile, and placed upon the market in form of a liquid and a pill, of which two I consider the latter more preferable.

"In cases where there is a diminished quantity, or even an absence, of these natural products, especially the bile, resulting in the distressing complication of intestinal or duodenal indigestion, I have found this preparation of decided value by assisting the intestinal digestions until the normal functions of the liver and pancreas, but especially the former, could be established.

"In constipation attended with flatulence, the result of an inactive liver, I have found this remedy of great value, promptly relieving the flatulence, and