enough to give rise to the speculation not be very profitable if lactation were as to how far the presence of gall stones not forced to some degree. would be capable of causing malignant 4. Experienced agriculturists, like Prodisease. The author has met with a few fessor Armsby and Dr. Sturtevant cases in which the evidence was of an (Science, ix. pp. 602-3), have failed to affirmative nature.. He has seen two see any ill effects attributable entirely to cases in which the passage of gall stones swill, and such veterinarians of ability was attended with sharp hæmorrhage. as Professor Law and Dr. Salmon (Ibid. In one the hæmorrhage preceded the p. 552) corroborate this testimony. passage of a large gall stone without 5. The facts collated by Professor biliary obstruction. The bleeding might Brewer (Ibid. p. 550), showing the ready have been due to the tearing of the absorption of germs and odors by milk, opening between the gall duct and the transmission of the flavor of various bowel. In the second case considerable odoriferous substances eaten by the anihæmorrhage occurred directly after an mal subsequent to the secretion the passage attack of biliary colic with jaundice. of certain drugs administered medicinally After the cessation of the hæmorrhage, into the milk of nursing women, or the a ragged gall stone of such size as might notorious fact that swill-milk stables are have allowed it to traverse the gall-duct "proverbially foul and stinking," have was found in the fæces.-N. Y. Medical Journal.

THE WHOLESOMENESS OF SWILL-MILK. -Dr. Geo. H. Rohé, of this city, writes. as follows in Science of July 22d:

The discussion carried on in the pages of Science for some weeks past upon the healthfulness of milk from cows fed upon distillery-swill has, in my opinion, failed to definitely settle the question. There can be no doubt of the vital importance of the matter, and all physicians and sanitarians will agree that a solution of the problem is highly desirable.

1. I venture to say that no positive evidence has been submitted showing any ill effect of swill upon cows fed with it. The evils attributable to it are largely, if not entirely, to be ascribed to the unsanitary surroundings of the animals.

2. Whatever evidence has any positive value indicates that swill is equally as good and proper food (used with judgement) as hay, dried fodder, ensilage, or bulbous roots. These all differ widely in chemical composition from the green foods (grass, clover, green oats, and corn), which may be looked upon as the normal food of cows.

3. It may be worth while remembering that lactation in a dairy is not a normal process. Dairy cows are "milkmachines." The dairy business would

no bearing upon the case. The evidence required to establish the unwholesomeness of swill as food for milk-giving animals must be of a different character. 6. While it may be conceded that "chemical analyses will not settle the question" of the wholesomeness of swillmilk, the fact remains that we have at present no other way of determining the physical qualities of a specimen of milk. Bacteriological investigations may determine the presence of the germs of tuberculosis, typhoid, and, in view of recent discoveries, of scarlet-fever, but will not enable us to ascertain the relative proportions of the saccharine, fatty, aqueous, or proteid matters present. Chemistry is here still our main-stay, and, other things being equal (more definitely, disease-germs being absent), a specimen of milk nearly approaching the chemical standard established by Koenig may be looked upon as a wholesme food. Other factors besides the food of the animal enter into the production of milk. The age of the animal, period of lactation, time when the milk is drawn, and general sanitary condition, must not be ignored.

7. The asserted greater firmness, and consequent indigestibility, of the coagulum in swill-milk is not based upon a sufficient number of observations to admit of unquestioned acceptance. It should be easy to determine this in any chemical laboratory. No single series

ever.

of observatious would decide this, how- DRY HOT-AIR BATHS FOR SYPHILITIC It would be necessary to test PATIENTS.-Dr. Stepanoff, of Moscow, milk from cows fed upon swill but kept has contrived a plan of treating patients under good sanitary conditions, side by suffering from syphilis which has resistside with milk from animals kept under ed mercurial and iodine treatment. He the ordinary conditions of city stable- has had a box or bath constructed, with life, and fed upon various foods. an iron bottom lined with thick felt, in 8. A scientific solution of the which the patient is placed. The bath question will not be furthered by is heated to about 170° to 190°F. by prejudiced appeals or unreasoning means of two Bunsen's lamps, each condenunciation. Patient investigation, sisting of five burners. After the pakeeping in view all circumstances tient has been "baked," he is put to bed of the question, and avoiding all and covered with blankets, so as to proone-sidedness in considering the matter, long the sweating process commenced will alone bring about the object desir- in the bath for an extra half-hour. ed. Personally I at present occupy the After this he is allowed to dress and go same stand-point as Professor Armsby into the ward to his dinner. By means (Science, x., p. 4), "Much of the common of these baths the mercury is rapidly prejudice against the use of distillery- eliminated from his system, and the slops appears to be occasioned by their patient's condition greatly improves, irrational application, and frequently by and, after a course, mercury is found to the filthy surroundings of the animals, act quickly and energetically-Lon. Lan. rather than by anything injurious in the feeding-stuff iself."

A VIENNA ORDINANCE CONCERNING HOMEOPATHIC PREPARATIONS.

The

SEPARATION OF THE PLANCENTA.-Dr. "Union médicle" states that a recent Berry Hart is of the opinion that the ministerial decree restricts the right to true method of separation of the pla- dispense homœopathic preparations to centa has not hitherto been discovered, those homoeopathic practitioners who and proposes an explanation different really observe the method of dilutions from any yet offered. He says that it laid down by the homoeopathic school. has been proven by Balfour that diminu- The object of the ordinance is to put a ion of the placental site by contraction stop to the abuse by which, under the of the uterus does not cause the separa- guise of the homeopathic preparations, tion of the placenta. It cannot be due all sorts of remedies have been given to exclusively to the formation of blood patients by certain physicians.-N. Y. clot behind the placenta, for often the Medical Journal. placenta comes away without any blood at all. He finds, however, whenever the placental site is caused to expand UTERUS AND OVARIES.-Dr. Sinclair the placenta at once becomes detached. in the Revue Med.-The conclusions are: Thus in placenta prævia, which he de- 1. Lactation tends to prevent conception fines to be the attachment of the pla- by its influence on the ovaries in retardcenta or any part of it to the lower ing a return to a state of perfect ovulauterine segment, as soon as this lower tion. 2. After weaning the evolution of uterine segment begins to expand the attached placenta begins to separate with consequent bleeding.

LONG-CONTINUED LACTATION ON THE

the ovaries becomes more rapid than during lactation. 3. After prolonged lactation a sudden cessation may be folDr. Hart infers from this that the lowed by a rapid evolution of the uterus uterus follows the expulsion of the child and ovaries, giving rise to symptoms of with the extreme contraction, then im- hyperemia of the ovaries and uterus. mediately begins to expand, and along 4. Prolonged lactation may produce a with it the placental site, which in a brief superinvolution of the uterus and ovaries, time results in the detachment of the causing, where circumstances favor, a placenta.-American Practitioner and partial or complete prolapse of the womb. -Arch. of Gynaecology.

News.

MARYLAND MEDICAL JOURNAL ergot administered by mouth and by in

A Weekly Journal of Medicine and Surgery,

THOMAS A. ASHBY, M. D., Editor. GEORGE J. PRESTON, M. D., Associate Editor. Subscription $3.00 per annum, payable in advance.

jection has had its advocates. So far attempts at the removal of these tumors or at limiting their growth have not been as satisfactory as is to be desired, Contributions from practitioners in good standing hence it is not to be wondered at that the invited, and advertisements from reliable houses soli-surgical mind has called to its aid another agent which is likely to supplant, for the time being at least, all other methods of surgical treatment of solid

cited.

All communications relating to the editorial department of the JOURNAL should be addressed to the

editor.

Address all business communications to the JOURNAL PUBLISHING COMPANY, PROP'S. New No. 209 Park Avenue.

BALTIMORE, MD.

tumors.

The treatment of fibroid tumors of

Subscribers indebted to the MARYLAND MEDICAL the uterus by electricity is not a new

JOURNAL are earnestly requested to remit to the Proprietors the amount due. Make all checks and money orders payable to the MARYLAND MEDICAL JOURNAL.

BALTIMORE, AUGUST 13, 1887.

Editorial.

of

one. From time to time numerous attempts have been made to disentegrate these solid growths with currents of electricity, but the difficulties in the way of the successful utilization of this force were found innumerable, and brought ELECTRICITY IN THE TREATMENT OF such discouragement that the various at FIBROID TUMORS OF THE UTERUS.-tempts at its employment were wellThere is scarcely a disease with which nigh abandoned. But little progress was woman is afflicted more distressing in made with this agent in the treatment many of its features or more hopeless in of solid tumors until Apostoli, of its near results than uterine fibroid. France, led the way to a new field of Whilst only, comparatively speaking, a work by his experiments and labors. common affection among the white races The revival, or rather successful inaguit occurs with such frequency among ration, of the electric treatment women of African descent that it consti- fibroid tumors begins with Apostoli. tutes one of the most distressing ail- With patient and unflagging zeal this ments which afflict this race. distinguished Frenchman has taught the surgical world that solid tumors are not to be removed by a sudden and complete disintegration of the growth by electricity, but that success must follow frequent applications of the agent and a gradual shrinkage of the tumor mass. Apostoli's work, even to the present Admitting the frequency of these date, has assumed the nature of one uterine growths, their treatment has continued experiment. Whilst he has been highly unsatisfactory. Attempts been rewarded with unmistakable evihave been made to remove them by dences of success, he yet affirms that hysterectomy with such fatal results as to more time and observations are needed discourage this method of operative in- before coming to complete and decisive terference, except in the most extreme conclusions. cases. Normal ovariotomy has been Dr. Apostoli has worked upon these called into existence with the view of tumors from two different directions, limiting the growth of these tumors according to the character of the uterine and of arresting one of their most growth and the nature of its symptoms. alarming symptoms, hæmorrhage. The În those cases of solid tumors the justifiability of this operation, it may be whole extent of the mucous surface of said, is still under discussion and there the uterine cavity must be acted on by are good authorities who question the the negative pole, or should the uterine value of the procedure when applied to cavity be inaccessible a puncture must all cases. The method of treatment by be made into the walls of the growth

It has been said upon good authority that nearly every other negro woman has a uterine fibroid tumor of some character. We believe this to be an exaggerated statement, but it cannot be denied that a very large percentage of negro women are thus affected.

In

and the galvano-caustic action be ap- surface of the cutaneous pole, which is plied directly to the tumor mass. This placed over the lower part of the abdoprocedure acts in a solvent way upon men, is embedded in a layer of wet potthe tissues of the tumor and brings ter's-clay about a half inch thick. By about their rapid elimination, but not this method the skin is not burnt and total destruction. The process is virtu- no great pain results.

ally a uterine cauterization in which With careful attention to details the the highest possible degree of electro-electric current is applied without shock chemical action is used. In those cases and without pain. The sittings are had where uterine hæmorrhage is the alarm- from once to twice a week and the curing symptom to be combatted, Dr. rent is passed through the tumor from Apostoli proceeds in a different manner. eight to ten minutes at each sitting. The positive pole is here brought into The number of applications varies from action, since it possesses coagulating three to four to over thirty. Dr. Aposand hardening properties. The pole is toli has reported a number of cases in applied to the interior of the uterus so which the results were of the most satisthat its coagulating effect may trans- factory nature. form the hæmorrhagic area of the mu- There can be little doubt of the fact cous membrane of the uterus into a sur- that the method of Apostoli has awakenface that will not allow of sanguineous ed an interest in a most valuable theraexudation and excessive secretion. The peutic agent and we think the time is action of the current likewise causes not far distant when electricity will be contraction of the tumor mass, a lessen- called into requisition in the treatment ing of the blood supply, and a conse- of a much larger class of pathological quent partial atrophy of the growth. conditions. We by no means regard it The practical application of the two a panacea for all forms of uterine poles of the battery to the treatment of disease, nor even a specific for uterine these different forms of fibroids has been fibroids. worked out with great care by Dr. It is an agent which may be employed Apostoli, and it is through attentior in the most empirical manner and with given to details that good results must positive detriment, hence there is need be expected from their use in the two for words of caution and conservatism different rôles assumed by them. Dr. A pos- before we jump to rapid conclusions in toli begins by measuring the strength of regard to the great benefits which some the electric current and then proceeds observers claim for it. It will be found, by increasing the galvano-caustic force we think, to have a most useful purpose, until the highest possible degree of elec- but one capable of great abuse and of tro-chemical action is employed. At dangerous charlatanism.

the first sitting he employs a current ranging from 20 to 100 milliampères

A MOVE IN THE RIGHT DIRECTION.

and later on, as the treatment pro- The announcement recently made by gresses, the current is augmented to 150, the College of Physicians and Surgeons or even to 250 milliampères. It is due of New York to the effect that, beginto the safe utilization of these high cur- ning with the session of 1888-9, and rents that practical results have follow- thereafter, it will require preliminary ed the Apostoli method. To provide examination of matriculants who do against shock, Dr. Apostoli employs the not hold diplomas or certificates from following safeguards: recognized colleges or schools of science, should be hailed with satisfaction by the profession.

The plantinum sound or needle used in the uterine cavity or in the tumor mass is so guarded that the bare metal If anything is needed at the present is only brought into contact with the time it is a reform in our present system surface to be acted upon, and nothing of medical education. Under the exercise else. This is an important step in the of old custom students of any and every management of the current. Next the grade of preliminary training have been

The Science and Art of Obstetrics. By THEOPHILUS PARVIN, M.D., LL.D., Professor of Obstetrics and Diseases of Women and Children in Jefferson Medical College, Philadelphia, etc. Illustrated. Philadelphia: Lea Brothers & Co., 1886. 8 vo. pp. 672. The author of this work enjoys an international reputation as a teacher, writer and practitioner.

freely admitted to courses of medical Reviews, Books and Pamphlets. instruction by nearly every medical school in this country. With absolutely no safeguards thrown around the study of medicine, it is not a matter of surprise that the ranks of the profession of medicine are filled with ignorant, illiterate and incompetent men. The extent of this ignorance and illiteracy can only be appreciated by those who have the means of coming into contact with large numbers of medical practitioners. To the medical editor these revelations of The announcement made several years incompetency are frequent and appalling. ago that he would give to the profession We are frequently in receipt of communi- a text-book on obstetrics was well recations from medical practitioners which ceived. The work promised has made display such illiteracy and ignorance its appearance in style, quality and that we cannot but regret that their character in full keeping with what was prior medical training was so utterly expected at the hands of such an exdeficient as to defeat their usefulness in perienced authority on obstetrics. Dr. professional work to a very great ex- Parvin has written a thoroughly credittent. Whilst we admit that an occa- able book. He has arranged the test in sional man may make an excellent prac-a practical, concise and systematic mantitioner with a very small knowledge of ner and has presented his subject-matter the language he speaks, this argument in good English. His descriptions are will only hold good in such exceptional clear and accurate and his style is easy, cases as make it a dangerous precedent. graceful and lucid. The author deviates Other things being equal the better pre- very little from the usual form of the liminary education the medical student standard of text-book treatises on obstet. has the better is he equipped for the rics. He begins Part I with the study and practice of his profession. He anatomy of the female pelvic organs should at least have a good knowledge and then passes to the consideration of of his own language and some acquain- the physiology of these organs during tance with Latin and Greek, but es- non-gestation. Part II.opens with the subpecially the former. He should know ject of conception and next treats under something of elementary mathematics, various heads the entire subject of preg including arithmetic, algebra and plain nancy, including the pathology of this geometry, and should have some ac- condition. Part III is devoted to a quantance with general history and consideration of the subject of "Labor," modern literature. Those young men both normal and difficult. Part IV who have not enjoyed the advantages of treats of "The Puerperal State" and preliminary instruction to the extent Part V is taken up with a consideration. here indicated should be discouraged by of "Obstetric Operations." This prac their preceptors from studying medicine tical arrangement of subjects under dif and should be refused admission to our ferent departments makes the compremedical schools until they have passed a hension of the scope of the work very satisfactory examination on these intelligible. The various subjects thus banches. treated likewise command our commen The action of the College of physi- dation. Dr. Parvin has made his statecians and Surgeons of New York in re- ments exceedingly clear, and in many quiring a preliminary examination is a places his treatment of the subject-matmove in the right direction and we trust ter is both skilful and interesting. He that their example will be the means of presents a great mass of obstetric inducing other schools to adopt this knowledge in about as narrow a compass as it is possible to condense it without

course.