confirm this opinion. It is just here gregate income of $699,960. There are that the properties of cocaine and steno- 102 hospitals and medical institutions carpine seem to differ. Cocaine has no supported by voluntary contributions influence upon a cutaneous surface and should stenocarpine possess this latter property to the extent indicated by Dr. Claiborne its value to surgery becomes immense. which have 8,540 beds and an annual expenditure of $2,613,340. The net results of these figures, stated in round numbers, is that there are provided in the metropolis for patients of the nonThe mydriatic effect of stenocarpine, pauper class 10,000 beds, at an annual in association with its anæsthetic pro- cost of $3,350,000. In 1886 the enperties, makes its use in ophthalmology | dowed and voluntary hospitals gave aid of even greater value than cocaine. [to 1,218,841 individuals. As the total Whilst the two drugs have a number of pauper population of London is estiproperties in common the differences in mated at less than one hundred thousand, their physiological action favor a wider over a million applications were made to employment of local anesthesia through the hospitals in London during the year their respective administration. It is by persons who were not paupers. In probable that the discovery of stenocar- other words according to the above stapine will scarcely fall below that of tistics nearly one-fifth of the population cocaine itself in its beneficent results. of London received aid from the LonA wider experience with the former don hospitals during a single year. This agent is now needed to substantiate the statement seems to us to show an enorfull value of Mr. Goodman's discovery. mous imposition upon these institutions Considering the wide distribution of the and to explain to some extent honey-locust tree and the abundance of the general impecuniosity of many of its foliage, coupled with the remarkable the London hospitals now complained of, strength of its alkaloid, the commercial such for example as Guy's and St. status of the discovery is a most import- Thomas's, which have been forced to ant one. Cocaine still remains too much close a large number of beds for want of of a luxury for universal use in surgical money. When it is remembered that practice. A less expressive drug with the financial support of 102 hospitals, properties of equal and substantially the with 8.540 beds, is borne by voluntary same value is a great desideratum. contributions the precarious condition of these institutions is well shown. It is LONDON HOSPITALS. The British stated upon the authority of Sir RutherMedical Journal presents some inter- ford Alcock that the income of fourteen esting facts concerning the hospitals of of the principal hospitals in London London which seem to us to teach an in- from acquired property and annual substructive lesson. The population of Lon- scriptions including the contributions don proper is 4,149,883 at the present from the Hospital Sunday and Hospital time. Add to this the population of the Saturday Funds, is $524,345, while the outer ring of Greater London and the yearly expenditure is $1,100,345. The total population foots up 5,306,508. deficit of $576,000 is either made up This population is larger than the com- by donations, legacies and by the probined population of Maryland, Virginia, ceeds of bazaars and other special efforts, West Virgina and North Carolina.. or is not made up, and the hospitals get The hospitals of London are thus stated into debt, or live on their invested capiThe union infirmaries and the hospitals tal where there is any. We have no and as asylums under the Local Govern- data to compare American institutions ment Board are maintained at an annual with the great metropolitan charities as cost of $2,679,330, which is raised by a above shown. We are quite sure, howgeneral rate; 18,445 beds are this pro- ever, that our hospital population will vided for, but a large portion are only not begin to compare with that of Lonused for infectious cases. There are don in percentage and we are equally three endowed hospitals with an aggre- well satisfied that no such sums of money gate number of 1,804 beds and an ag- have been expended for hospital purposes. | BOOKS AND PAMPHLETS RECEIVED. perineum. The patient presented for Insanity, Its Classification, Diagnosis and Treat-operation, a multipara, was suffering ment. A Manual for Students and Practi- from retroflexion, subinvolution, and tioners of Medicine. By E. C. Spitzka, unilateral cervical laceration of the M.D., President of N. Y. Neurological So- uterus with procidentia. ciety, Consulting Neurologist to North Eastern Dyspensary, etc., etc., New York. Pp. 423. E. B. Treat, Price $2.75. Hand-Book of Gynecological Operations. By Antiseptic Methods Applied to Obstetric Practice. Son & Co. Pp. 175. Price $1.75. acic Diseases. By E. Darwin Hudson, Jr., Dr. Martin described his plan of operation (as given in his book and that of Hegar and Kaltenbach) by diagrams upon a blackboard. He stated that he preferred catgut prepared in oil of juniper for suture material, and that he employed the continuous suture on the vagina and perineum, and the interrupted suture on the cervix uteri. Proceeding to the operation Dr. Martin employed continuous irrigation with weak bichloride solution, stating that he was thus enabled to dispense with significant, and that a cleanly and antiSponges; that the hemorrhage was inseptic operation was thus performed. He first drew down the uterus, and amputated its cervix by wedge-shaped excision of the anterior and posterior lips, with subsequent interrupted suture. He then proceeded to operate upon the anterior vaginal wall, stating that for denudation in such operarions he pre Diseases of Female Mammary Glands. By Theo. Billroth, M.D., of Vienna, and New Growths of the Uterus, By A. Gusserow, M.D., of Berlin. Illustrated. Vol. IX of the Cyclopaedia of Obstetrics and Gyna-ferred a knife which he had devised cology. New York. Wm. Wood & Co. Hand-Book of General and Operative Gynecology. By Dr. S. Hegar and Dr. R. Kaltenbach. Vol. VII of the Cyclopedia of Obstetrics and Gynecology. New York. Wm. Wood & Co. Miscellany. whose edge was so arranged as to cut in introduced the continuous catgut suture many directions. After denudation he from above downward, meeting no difficulty in coaptation until the lower portion of the denuded surface was reached, where it was necessary to introduce étage sutures. The suture was brought back to the point of origin, and the uterus replaced with a sound. The posterior vaginal wall was then denuded, the operation being so perOPERATION FOR PROCIDENTIA UTERI.-formed as to utilize the firm tissues of Dr. A. Martin, of Berlin, was introduced to the Class of Jefferson College Hospital Philadelphia, by Prof. Parvin, on September 22d, and gave a demonstration of his operation for the treatment of procidentia uteri. this portion of the vagina as a support for the uterus. Beginning at the vaginal column, the left side of the denuded surface was first closed, and then the right by the continuous suture. The cicatricial tissue in the perineum was Procidentia uteri, he stated, is not to then exsected; a single strong suture be satisfactorily treated by any operation placed at its upper extremity and the which closes a large portion of the vagina remainder closed by the continuous only; the cicatricial tissue so formed will suture, étage stitches being employed not endure; the operative treatment of whenever needed; the continuous suture this affection to be successful must in- was brought back to the point of comclude the uterus, the vagina, and the mencement, completing the operation. The result was a firm perineum, a vagina restored throughout its entire extent, and a uterus replaced and stimulated to involution by the excision of diseased cervical tissues. If nary drying they absorbed fourteen times The after-treatment advised was three weeks' rest in bed, the avoidance of movement of the bowels for four days, freedom from exercise for three months, and abstinence from sexual relations for eight or ten months. Ordinary precautions to secure cleanliness were to be observed. In the event of pyrexia, antipyA HINT TO THE HOUSEWIFE.-At this retics were to be given. No local treat-season of the year, stewed apples, pears, ment or manipulation was desired. and plums are favourite articles of diet. Medical News. disguises it, and its use in large quantities is calculated to retard digestion. The housewife may, therefore, be grateful for the reminder that a pinch-a very small pinch-of carbonate of soda, sprinkled over the fruit previous to cooking, will save sugar, and will render the dish at once more palatable and more wholesome.-British Medical Journal. For breakfast or luncheon, in the diningroom or in the nursery, there are few PEAT MOSS AS A DEODORIZER.-Dr. D. table dishes more wholesome and more M. Uspenski, in a preliminary note in delicious than well-stewed fruit, served the Vrach, describes a number of bac- up with cream or custard. There are teriological and other observations he many persons, however, who cannot eat has made on a kind of peat moss belong- it, on account either of the acidity of ing to the sphagni, which is indigenous the fruit or the excess of sugar necessary in many parts of Russia and Siberia, and to make it palatable. Sugar does not, which is used with considerable success of course, counteract acidity; it only in the form of course powder for disinfecting cesspools and privies in Warsaw, Riga, and other towns. It is found that about four ounces sprinkled over an ordinary stool are sufficient to deodorize and dry it, so that the receptacle can be emptied and cleaned at proper intervals without any unpleasantness arising. This substance seems to have a wonderful power of absorbing moisture, for it was found by experiment that a pound of it which already contained 25 per cent. of water was capable of absorbing no less than seven pounds and a half more water. When added to fecal matter in the proportion of 10 per cent. by weight, it changes it into an almost dry mass of an earthly appearance, devoid of smell and easy to remove. A hundred pounds of the powdered moss will absorb 1438 litres of ammonia. The dry mass obtained by the action of the moss on feces, on being analyzed by Mr. Miltser, was found to contain from 2.38 to 2.66 per cent. of nitrogen, and from 0.96 to 1.15 per cent. of phosphoric acid, and, of course, formed a very valuable manThe powder as received contained 2.39 per cent. of water and 5.38 per 3. Carcinomatous portions have al cent. of ash, and without any prelimi- ways a light yellow color. ure. DIAGNOSIS OF BEGINNING CARCINOMA oF THE CERVIX.-Since experience has shown that beginning carcinoma of the cervix can be entirely cured by operation, it is important that family physicians send the patients to the specialists early. And in order to make at least a probable diagnosis without microscopic examination of an excised piece, C. H. Stratz says that from his observation and that of others the important signs of carcinoma are as follows: 1. The diseased place is sharply limited by sound tissue, and never goes over into it by degress. 2. A difference in the level of the whole diseased portion can always be made out. 4. The malignant deposits is usually accessible as Vienna, and the cost of shown as finely granular, withish-yellow living is less. The only reasonable obglistening elevations, at least in individ- jection to the frontier county is that the ual places.-Centralbl. für Chirurgie, vernacular is English; nevertheless, it No. 25, 1887.-Jour. Amer. Med. Asso. contains, we believe, a large number of Germans.-Jour. Amer. Med. Assoc., Sept., 3, 1887. ADULTERATION OF RUSSIAN TEA.-So much has been heard about the wonderful excellence of Russian tea and its HOW THEY DEAL WITH BONE-SETTERS great superiority to the article which is IN FRANCE.-The Académie de Médecine retailed in England, that it is rather sur- summoned M. Gilmant, a bone-setter at prising to read in the Peterburgskia Aubervilliers, for illegal practice as a Vedomosti that a large number of medical man. M. Gilmant and his wife analyses made in the Sanitary (Analyti- have imposed upon the credulity and cal) Station of the St. Petersburg ignorance of many of the peasant classes Vratchebnaia Obshtchina led to the con- at Aubervilliers for some time past. The clusion that adulteration of tea has at- Eight Chambre Correctionelle condemntained enormous dimensions in the ed M. Gilmant to three months' imprisonnorthern capital of Russia. Some speci-ment, and Madame Gilmant to fifteen mens, sold at the price of 1 rouble and days' imprisonment.-Brit. Med. Jour. 20 kopecks (about 2s. 6d.), contained only 15 or 20 per cent. of genuine leaves, the remaining 85 or 80 per cent. consist ing of various mixtures, including such an injurious substance as the leaves and flowers of Epilobium angustifolium, or the French willow-herb (Russ. Kaporskytchai or Ivantchai).—Brit. Med. Jl. THE LOCAL TREATMENT OF THE BLADDER.-Ulzmann (Centralblatt für Chirurgie, No. 30, 1887) says: All acute bladder troubles must be excluded from local treatment which is only applicable to the chronic, dietetic and therapeutic measures. In chronic affections we must discover whether the disease is a THE PERCENTAGE OF STERILITY AMONG primary and isolated one, or whether the MEN. Kehrer, of Heidelberg, has exam- urethra or the prostatic portion is inined 96 men, as follows Impotent, 3; hav-volved. ing semen containing dead spermatozoa, The latter is the case, for example, in 29; deficient spermatozoa, 11; excessive young men who in consequence of a spermatic secretion, 53. The percent-gonorrhoea have begun to suffer from an age of sterility is thus 33.32.-Wiener extension of the disease, and treatment Presse, July 10, 1887.-Med. News. of the neck of the bladder must be carried out. THE OBSTETRICAL ADVANTAGE OF OT- A thin catheter is passed into the TER TAIL COUNTY, MINNESOTA.-Otter bladder and then withdrawn about Tail, one of the frontier counties of three centimetres so that the point Minnesota, bids fair to rival the Rotun-rests in the neck. A tepid medicated da Hospital or the Allgemeine Kran- solution is thrown in gently (about 200 haus of Vienna as a resort for aspirants grams). If no fluid flows back it shows for obstetrical advantages and greatness. that the end of the catheter is in the Dr. T. G. Hutton,of Fergus Falls, writes right place, the opening being closed by us that there are now in that county the bladder neck. quadruplets one week old, living triplets eight months old, living twins born of a sixteen-year old mother, and a child twelve months old whose mother is now only fourteen and one-half years old. It may be added for those who may hesitate between Vienna and Otter Tail County, that the latter place is just as After thoroughly injecting the bladder the catheter is withdrawn and the patient empties the bladder himself, and in this way the fluid passes again over the diseased parts. If, on the other hand, the bladder itself is affected the author does not recommend the double catheter because by this method the bladder remains it in position by means of glycerine contracted and only a small portion of tampons. After six weeks a large stem its mucous membrane comes in contact is used. As soon as the uterus becomes with the medicated solution employed. straightened, a permanent stem of vul He prefers injecting the fluid by means canized rubber is introduced, Chamber's of a hand syringe through a soft cathe ter. By the use of the irrigator too great a quantity of solution is permitted to enter which might dilate the bladder, already often in a paretic state, to too great a degree. Only in the rare cases of contracted bladder in young persons is the irrigator to be recommended. bifurcated stem being especially useful. Recently he had employed one which did not separate at the end. This hard stem is worn for three months, and is then removed. The patient is examined in the course of a few weeks, and if the uterus remains in position it is removed. The success of the treatment lies in its gradual character. It is further to be looked to that after The use of the stem had been severely the injection the bladder is wholly condemned, but clinical experience emptied. showed its value. The speaker had seen For washing out the bladder luke- great benefit, dysmenorrhoea and sterilwarm water must be used, medicated ity being both removed. Many hold with tincture of opium, cocaine per that pelvic inflammation is the main cent., resorcin per cent., or carbolic cause of pain in flexions, but the reader acid per cent. in case of sensitive did not believe in the doctrine of such bladder; permanganate of potassium frequent inflammation. The stem when ro per cent. or nitric of amyl three drops carefully used is no more dangerous to half a pint of water in case of amoniacal urine; o per cent. salicylic acid in phosphaturia, etc. than an intrauterine application. He had never seen any inflammation follow the use of the stem in his hands. The A 1 to 10,000 corrosive sublimate so- great trouble is that men try to straightlution may be used when bacteria are en the organ too rapidly and forcibly, present. and without reference to the existence For hæmorrhage to per cent. of subacute inflammation. He never nitrate of silver solution in cold water, uses a stem unless there is dysmenoror fifty to sixty drops of the sesquichlo- rhoa; when the flexion is due to a ride of iron to the quart of water.- fibroid or to pelvic inflammation, it Journal Cutaneous and Genito- Urinary should not be used. Out of sixty-seven Diseases. cases treated with the stem, forty-one were cured. The conditions necessary for success are watchfulness, patience, and slow progress. THE INTRAUTERINE STEM IN THE TREATMENT OF FLEXURES.-Dr. A. Reeves Jackson, of Chicago, read a paper on the above subject before the THE OPERATIVE TREATMENT OF PROSAmerican Gynecological Society. He TATIC HYPERTROPY.-A remarkable case confined his remarks to a limited class is recorded by Landerer, in the Centralof cases. Many forms of flexion require blatt für Chir., p. 292, 1887, in which treament, others are not improved, and being unable to crush a small stone still others are only made worse. He owing to prostatic hypertrophy he perhad not been satisfied with the results of formed the median operation and exincision and dilation. He had used the tracted two small calculi. During the stem for many years without bad results. operation, however, he accidently reDysmenorrhoea is the main indication moved a small portion of the prostate. for treatment, sterility being a secondary The pateint made an excellent and rapid consideration. His method of treatment recovery and could pass his water subis first to dilate by means of graduated sequently in a good full stream, bougies, then after a menstrual period whereas before he had great difficulty in he inserts a soft rubber stem, and keeps voiding it. This condition remained |