only. He employed a mixture of one part of papayotin, two parts of glycerine, and two parts of water.

Dr. Smith spoke favorably, also, of the solvent action of trypsin, which, like that of lime water (by itself, of very feeble solvent powers), was increased by being used in connection with alkali. He suggested the following formula for a spray:

Sodii benzoat.

Sodii bicarb..
Trypsin........
Ol. eucalypti.....
Liq. calcis...

•3 j-ij; 3 ij-iij; .3 j; .fzj; .Oj. M.

MENTAL AFFECTIONS ASSOCIATED WITH CHRONIC BRIGHT'S DISEASE. At a recent meeting of the Philadelphia Neurological Society, Dr. William Osler made the following remarks on the above topic, as reported in the Polyclinic:

I would like to make some reference to the occurrence of certain mental affections which come on in connection with chronic Bright's disease. It is well known that certain mental phenomena occur in connection with chronic renal disease besides simple uremic coma. I have reported one case of violent mania in a man aged forty-two years, the subject of Bright's disease. When brought to the hospital he had been maniacal for three or four days. He subsequently became comatose and died. A very interesting case was recently under my care in the University Hospital. A man was brought to the hospital Thursday evening. I saw him on Saturday. He was then quiet, in a semi-dozing condition, but could be aroused, and gave a very interesting account of himself. The whole clinical picture was that of chronic interstitial nephritis. I thought it not improbable that the man might pass into a condition of coma. There was nothing to attract special attention to his mental condition, and I did not regard his condition as critical. That night he got out of bed, in the absence of the attendant, wandered about the ward, and finally jumped out of the window. It was subsequently learned that, before admission to the hospital, he had been violent, requiring two or three men to hold him. We were not told this when he was brought to the hospital. I have no doubt that this was an instance of mental di-turbance due to chronic nephritis. I was told by one of the physicians who attended him that the man was full of delusions. He thought that his wife and others were persecuting him.

I saw another interesting case a year ago last Christmas. This occurred in the prac

tice of Dr. Mullin, of Hamilton, Canada. Here a medico-legal question arose. It was whether or not the man was in a condition to make a will There was no doubt as to the existence of chronic Bright's disease. The mental condition was peculiar. He believed that his wife and others had designs upon his life, and it was with difficulty that he could be persuaded to take food. He thought that people where persecuting him. Although he gave a very intelligent account of himself, it was not considered advisable that he should make his will at that time. He was placed upon a somewhat more active treatment than he had previously received. This man subsequently did well, his mind had cleared, and he recovered sufficiently to get about and to make his will. - Boston Medical and Surgical Journal.

BROUARDEL ON HERMAPHRODISM.- Proffessor Brouardel very carefully epitomized the characteristics of this curious condition in a clinical lecture which he recently delivered, and which is reported in the London Medical Record. He pointed out that hermaphrodism can only be complete so far as the internal organs are concerned. An individual may have one ovary and one testicle, but not a scrotum and a vulva, for it is evidently impossible to have a joining and separation simultaneously. Pseudo-hermaphrodism generally consists of an arrest of development for the male sex (hypospadias) and an excess of development for the female sex (hypertrophy of clitoris and possible obliteration of vulvar orifice). If any difficulty be experienced in distinguishing the sex, the expert should examine the general bearing of the individual - the voice, gestures, face (beard?), the shape of the neck and members, which as a rule are less muscular in the female than in the male, the arrangement of the pubic hair, circular in the female, triangular with the apex pointing to the umbilicus in the male. The essential, of course, is the detection of the testicles and the ovaries, but this, of course, is often difficult or impossible on accont of their nonmigration. They may simulate a painful gland, and may even give rise to the diagnosis of a vaginal hernia. The absence of uterus does not signify much. With hypospad ac males, who disguise their sex because they prefer to utilize their cavity as a vagina, the male sex may be affirmed if the observer can trace (1) a characteristic depression resembling a cutaneo-mucous raphé at the base of the rudimentary penis, pulling it down; (2) the absence of a hymen, carun

COMMUNICABILITY OF SYPHILIS THROUGH THE SALIVA.-Lance-Corporal B., 1st Battalion Middlesex Regiment, was admitted into the station hospital, Dover, in 1886, suffering from two ulcers on the left fore-arm.

A week prior to admission his fore-arm, at the site of the ulcers, was tattooed by a comrade named Private W., who had been discharged from hospital about a fortnight previously, where he had been a patient suffering from a well-marked attack of syphilis. The ulcers, two in number, were somewhat crescentic in shape, have each a diameter about the size of a florin, and were slightly blue in color from the staining of the India ink. They did not show any tendency to heal, and looked like chancres. The glands in the axilla became indurated and enlarged. Eight weeks after his admission a copious rash of a specific character appeared over his body.

On questioning the patient closely, I found that, during the process of being tattooed, the operator, Private W., spat on the patient's arm and then rubbed it, in order to remove the blood which flowed at each puncture of the needle. As the operator, Private W., had recently suffered from au attack of syphilis, the presumption is that the virus. was conveyed to Lance-Corporal B.'s arm. through the saliva of Private W., the tat tooer. There was no evidence to show that Lance-Corporal B. ever had a primary sore prior to this.

The usual treatment for syphilis was adoptted; the eruption soon disappeared, but the ulcers were long in healing.-R. Porter, in British Medical Journal.

LARGE DOSES OF OLIVE OIL IN THE TREATMENT OF HEPATIC COLIC.-Dr. J. Touatre, of New Orleans (Arch. Roumaines de Méd et de Chir.) gives an interesting account of his own cure of biliary colic gall-stones. The method of procedure was as follows: At seven in the evening a blue pill of the weight of 2 grains. was taken, and this was followed twelve hours later by a draught of twelve tablespoonfuls of olive oil; a quarter of an hour later a similar dose of olive oil was taken, and then the patient addressed himself to sleep on his right side. At nine o'clock the blue pill acted, producing a copious bilious evacuation, but no gall-stones were passed.

At three o'clock in the afternoon there was another bilious stool without stones, but from seven in the evening till midnight six stools were passed; the first two contained seventeen calculi of the size of a large pea, of conical shape, grayish-yellow aspect, and soft consistence. Altogether sixty stones. were passed, and six of these had the volume of an olive, and were of a black color. The passage of these calculi by the cystic. and biliary canals was for the most part unattended with pain, a few spasms being felt, probably at the time of the movement of the large calculi. An inexpressible relief was obtained from the pains over the liver and shoulder, which had previously caused much distress; the liver also diminished in size. For three months Dr. Touatre enjoyed perfect health, when the trouble began again; the olive oil was repeated in similar fashion, and with the result that eighteen more calculi were discharged by the bowel. Since then he has enjoyed excellent health. He admits that some courage is required to swallow the large doses of olive-oil.-- The Lancet.

THE RELATION OF TEA-DRINKING TO NERVOUS DISORDERS.- A paper on this subject, from the pen of Dr W. N. Bullard, appears in the Medical Communications of the Massachusetts Medical Society. The author has reached the following conclusions: (1) Chronic tea-poisoning produces a condition of irritability or hyperexcitability of the nervous system, and does this both directly by the action of the tea upon the nervous system, and indirectly by the production of gastric derangement. (2) Tea taken frequently and in moderate doses for a considerable period of time, tends therefore to place the nervous system in a condition in which it is more easily affected injuriously by slight external influences. It therefore favors the production of many forms of functional neuroses, and, if such neuroses already exist, aids in their continuance. (3) There is no evidence that tea taken in the manner described causes any organic nervous lesion, but it is probable that if such nervous lesion should exist, tea thus taken might tend to cause an aggravation and continuance of certain symptoms. (4) There is no evidence that chronic teapoisoning produces unaided any serious functional neuroses in persons not in any way specially predisposed thereto. It does, however, in the manner above described, act as an important factor in the production of neuralgia, hysteria, and allied affections. (5) When taken constantly in very large doses,

dyspeptic symptoms usually intervene before irreparable harm is done to the nervous system. (6) In hemicrania, and possibly some other functional neuroses, there is probably a craving on the part of the nervous system for a slight stimulation, which is better afforded by tea than by any other equally accessible article, and for this reason patients with hemicrania are so frequently tea-drinkers.- Medical Record.

EDEMA OF THe New-born AND PHLEGMASIA ALBA DOLENS. At a meeting of the Academy of Medicine of Paris on November 15, 1887. M. Dumas (Progrès Médical, November 19, 1887) spoke upon the probable identity of edema of the new-born and phlegmasia alba dolens. He thinks the former should not be confounded with sclerema, for it is characterized by the infiltration of serum into the subcutaneous cellular tissue and into all the cellular interstices of the affected parts. On the contrary, this edema should be regarded as a symptom of phlegmasia. Treatment should consist, (1) in the employment of heat in the form of the brooding hen (couveuse) of Tarnier; (2) in the absolute condemnation of manipulation of the affected parts, which was reccommended until then by all authors, as it tends to the formation of emboli.

CHRONIC GLANDERS SIMULATING SYPHILIS. Dr. Sakotski, writing in the Meditsinskoe Obozrenie, describes the case of a young soldier who suffered from ulceration of the palate, which extended into the nasal cavity, and destroyed the inferior turbinated bones. This was followed by a tumor of the eyebrow, by pains in the knee and ankle, suppuration of the left ear, and a metastatic abscess on the back of the right hand. There was at times some evening pyrexia. The case was looked upon as probably syphilitic for about two years. Then nodules and edema began to appear on the face, and this was believed to be glanders. After death, which was due to exhaustion, Dr. Vigandt made a microscopical examination of sections of the nodules, and also examined the ichor of the ulcerated surfaces, finding bacteria resembling those described by Löffler and Schutz, but he was unable to prove them to be the true cause of glanders.-The Lancet.

FOOD AND THE NURSING WOMAN'S MILK. Zalieski's conclusions upon this subject, as stated in Le Bulletin Médical, are as follows:

1. Woman's milk, which is very rich in fat, can have an injurious influence upon the development and nutrition of the child.

2. A food very rich in albuminoids increases considerably the proportion of fat in woman's milk, and causes a corresponding diminution of the sugar. The other constituents of the milk are not sensibly altered. It is possible that alcoholic drinks have the same action as albuminoid foods.

3. The composition of the milk can be told from the manner of life or the food of the mother or nurse, which is a very important matter in the favorable development of the child.

4. The kind of food has an influence upon the composition of woman's milk, exactly as it does in animals.

5. The fat of the milk is formed mediately and immediately, and probably in its greatest quantity, by virtue of the albuminoid substances of the food.

LIGATION OF THE COMMON CAROTID IN A DIPHTHERITIC SCARLATINOUS ABSCESS CAVITY.-Selenkow, in the Centralbl. für Chirurgie, reports the case of a girl, aged nine years. On the third day of an attack of scarlet fever she was taken with diphtheria, and on the sixth day there was considerable swelling of the cervical glands on the right side. After a week a large fluctuating abscess was opened by a small incision, and a thin drainage-tube put into the cavity. On the third day the dressings were stained with blood, which spurted out in a stream when the dressings were removed. The hemorrhage. was arrested by pressure. The common carotid was tied in two places at the level of the cricoid cartilage and cut. There was leftside paralysis for about three weeks, which was still partial after six months, and at this time there were great weakness, chordic disturbances, and inability to concentrate the attention. The patient answered questions slowly, and stuttered somewhat. The intellect, though not brilliant before, was weak. There was no clear pulsation on the right external maxillary and temporal. The left hand was held in extreme flexion and pronation, the fingers balled into a fist, and the thumb drawn into the palm. The patient could change this position only by a strong effort of the will. During sleep the hand and fingers were spontaneously relaxed, to return to the abnormal position again when the patient awoke. A slight blow on the dorsum of the finger caused momentary extension. The muscles on the radial side of the fore-arm were somewhat atrophied. The left foot was turned inward slightly, and in walking the right leg was dragged a little. Journal American Medical Association.

"ARSENIC CANCER."-As the mind is naturally caught by the curious and by the threatening, so we can not avoid alluding to the subject which Mr. Jonathan Hutchinson raised at the last meeting of the Pathological Society. We We fear, however, that at present further light is required before our knowledge can be considered satisfactory. Many among us having a strong belief in the efficacy of arsenic know well its power to produce disease; but, judged from the discussion at the Pathological Society, some do not appreciate the influence of arsenic on the skin. The skin par excellence is the tissue on which arsenic has perhaps its most marked influence; besides improving, it may spoil the complexion, rendering it muddy and unsightly. This latter action is also manifested in all parts of the skin, and may lead to the development of soft corns, not warts, in the palms of the hand and soles of the feet. where a roughened condition also grows up under the influence of this most potent drug. So far Mr. Jonathan Hutchinson goes with safe step on sure ground, but the next move onward toward the belief that arsenic can produce epithelial cancer is less secure. It can not be said outright that arsenic may be the chief cause of epithelial cancer, but we think the position almost impregnable if it be maintained, as, indeed, Sir James Paget and Mr. Hutchinson strongly held, that arsenic may prove one of the causes of epithelial cancer in certain constitutions.

Nevertheless, arsenic will not fall into disrepute, for at the worst it is only when continued for many years in very full doses that the drug is alleged to have so deleterious an action. Such a revelation, if it ever comes, will only make medical practitioners more careful in prescribing arsenic.-The Lancet.

THE REFLEX INHIBITORY ACTION OF CoCAINE AS A DIAGNOSTIC FACTOR.-Mr. Hurry Fenwick read at the Medical Society of London, January 9 1888, a paper upon a long series of cases in which pain in various parts of the body had been temporarily relieved in 30 to 180 seconds by urethral injection of twenty-per-cent solution of cocaine. Cases of its action in neuralgic pain of the cranial, cervical, intercostal, renal, and lumbo-sacral nerves were mentioned; the reasons for this power were roughly demonstrated to the Society by means of a decapitated frog. Thus, without a vesico-rectal injection of cocaine, the leg of the decapitated frog was rapidly jerked out of a weak acid solution in some fraction of a second; but after cocaine had been injected into the bladder or rectum, the leg was not withdrawn until after 20 to 30 or more seconds. This remarkable inhibitory power was only observed when weak

acid solutions (that is, weak irritations) were used. Cocaine possessed no power of delaying the reflex excitability consequent upon stronger acid solutions. The following propositions were formulated: (1) Slight nerve irritations (as neuralgias) of any part can be relieved by injection into the urethra of a few drops of a ten or twenty-per-cent solution of cocaine. (2) Severe nerve irritation, as in the pain of carcinoma, inflammation, etc., can not be thus relieved. Mr. Fenwick has used this knowledge largely in the differential diagnosis of urinary disease. Thus, if a renal pain was immediately relieved by cocaine, he judged the neuralgia to be due to a slight irritation, such as that experienced in lithiasis, congestion, or grit. If unrelieved (and cases were given) he diagnosed more serious cases (for example, stone, dilated pelvis, etc.) He then drew attention to the value of cocaine in operations upon the bladder and urethra in preventing damage to an unhealthy kidney. M. Tuffier's experiments upon renal congestion produced by distending the bladder or injuring the walls were mentioned, and it was submitted that this flooding of the kidney (which if the organ was damaged, led to rigors, supperssions, suppurations) might be partially or wholly prevented by the inhibitory action of cocaine upon the renal circulation.

EDEMA NEONATORUM.-Edema neonatorum, though closely associated with sclerema of the newly born, also presents considerable analogy with phlegmasia alba dolens according to M. Léon Dumas, who preceives the analogy not only in symptoms, but also in etiology and pathological anatomy. Nevertheless, thrombosis of veins had not hitherto been described in cases of edema neonatorum. M. Dumas, of Montpellier, has discovered a thrombus in both femoral veins in a fatal case of this affection. While awaiting fresh observations to confirm this view, M. Dumas speculates on the possibility of spontaneous venous thrombosis occurring in the cachectic condition common in many new-born infants, in whom respiration and circulation are not easily established in full perfection.-London Lancet.

syrups, sugars, and candies wherein glucose has

pidity.

Moreover, the bitterest alkaloids (quinia, for instance) make sweet salts when brought into chemical union with it.

As a substitute for sugar in the dietetic management of diabetes mellitus, saccharin has from the first claimed the attention of the therapeutist, and under the searching study of such observers as Stahlman, Salkowski, Stutzer, Adducs, and Leyden, its behavior in the animal economy is pretty well understood.

In an article on "The Use of Saccharin in Diabetes," contributed to a recent number of

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SACCHARIN IN THE TREATMENT OF DIABETES.

Of the good number of compounds which synthetical chemistry has within a decade contributed to medicine and the arts, perhaps the most interesting is orthoanhydro-sulphaminbenzoic acid or saccharin. Though in molecular constitution an acid, its radicle readily forming salts with the alkaloids and the metallic radicles, it is destitute of the common physical properties of acids, non-corrosive, physiologically innocuous, and is three hundred times sweeter than pure cane sugar.

From the day of its isolation and the recognition of its extraordinary sweetness great things have been expected of saccharin, and it would seem not without warrant. The cost of production has been found to be very moderate, and it is now manufactured upon a large scale and put into the market as a rival of sugar. This statement, if not strictly true, at least finds justification in the fact that the German and Russian governments have recently made large contracts with the manufacturers for a supply of saccharin for military use, and it goes without the saying that it will soon impart its sweetening properties to the

tion, Dr. Charles W. Purdy makes large claims for the new sweet. The author finds that from a grain to a grain and a half of saccharin will render a cup of tea or coffee as sweet as will two lumps of white sugar. He says that, from a liberal use of saccharin in practice since its introduction, he has not yet met with a single instance in which its palatability was suggested as being in the least inferior to that of the purest sugar. He calls attention to the fact that the drug is of sparing solubility, and advises its combination (chemical) with sodium, which renders it freely soluble in water without loss of sweetening properties.

He states that, in addition to its value as a flavoring agent in food and drink, saccharin has properties that render it specifically medicinal in the treatment of diabetes mellitus. It has an antiseptic value equal to that of salicylic acid and thymol, and since it exerts no action primarily on the digestive ferments, or secondarily upon the organs of secretion or assimilation (passing through the system unchanged, and imparting its properties to the urine), it may be regarded as competent to forestall the fermentative changes which the food is wont to undergo in the stomach of the diabetic until the weakened organ shall have time to put forth its tardy secretion and establish normal digestion.

Furthermore, there is good theoretical warrant for the opinion that saccharin will prevent acetonemia, and such other fermentative