SUDDEN EDEMA OF THE GLOTTIS AS A FIRST SYMPTOM OF CIRRHOTIC KIDNEY.-B. Fraenkel reported an interesting case of this kind before the Berlin Medical Society. The patient was suddenly seized with dyspnea, and when the author saw him he was sitting on a chair and complaining of the want of breath. A laryngoscopic examination showed swelling of the epiglottis and of the aryteno-epiglottidean folds. As the patient was stepping into the carriage to be taken to the clinic, where tracheotomy was to be performed, he dropped dead. At the autopsy intense edema of the epiglottis and the aryteno-epiglottidean folds was found. There was very marked contraction of the left kidney. The right kidney was enlarged and in a condition of parenchymatous swelling. The immediate cause of death was edema of the. larynx caused by the condition of the kidneys. There was absolutely no effusion in any other part of the body. The patient had never shown during life signs of any disease of the larynx. The whole duration of the disease was not more than an hour. The patient must certainly have suffered with albuminuria for some time, as the urine removed after death was rich in albumen. In the discussion that followed, A. Baginsky remarked that such a condition was observed also in the acute nephritis following scarlatina. De Bary, of Frankfort, had been the first to describe acute edema of the glottis as a first symptom in scarlatinal nephritis. Since then a few cases of the kind have been recorded.-New York Med. Journal.

A CASE OF ABSCESS OF THE SPLEEN; OPERATION; CURE.-In the British Medical Journal, Mr. Chowdhoory, Assistant Surgeon to the Burdwan Municipal Hospital, India, reports a case of abscess of the spleen with the following history: A man, about forty years old, had been suffering for some months with an undefined swelling in the splenic region. He also complained of some pain in the part, and had had occasional fever. He began to expectorate blood and some purulent-looking matter, though previously he had had no lung complaint. From the fact that the spleen was enlarged, and that there was moist crepitation in the left lung, extending from the lower to the upper part, the sputum being chiefly composed of blood and pus, it was concluded that an abscess of the spleen had formed and burst into the left lung. Another symptom leading to the same diagnosis was that he was not much troubled with night and morning cough so common in patients with bronchitis and phthisis. Subsequently the abscess was seen pointing in the splenic region, and on September 17, 1886, it was opened by a free incision. About ten

ounces of pus came out at first, followed by debris of splenic tissue mixed with blood and pus. A drainage-tube was inserted, and the part dressed with boracic lint and iodoform. On September 26th he was discharged cured.

The author states that he has practiced in the malaria districts of Burdwan (Bengal) for more than eight years, and has personally treated over 30,000 cases of malarial fever, but out of the whole number has only met two cases of abscess of the spleen in addition to the one just described.

THOSE LEPROSY CASES.-The following communication has been sent by a number of physicians to Dr. Arthur Van Harlingen, who was recently fined $100 by the Board of Health for not reporting two cases of leprosy under treatment by him:

"As fellow-physicians we are unwilling that you should be personally responsible for the payment of the fine which the Board of Health has, we think, unjustly imposed upon you. We therefore take great pleasure in inclosing you, for the purpose of re-imbursement, and as a mark of our continued respect and appreciation of your personal worth and professional skill, a check for one hundred dollars.

"Although not desiring to commit ourselves collectively regarding the contagiousness of leprosy, we realize the fact that, in the past twenty years, lepers in variable number have been treated in various European and American cities without a known instance of contagion thereby. We feel, therefore, that the action of the said board was, under the circumstances, unjust to you and to your patients."

The communication was signed by Drs. S. Weir Mitchell, D. Hayes Agnew, J. M. Da Costa, J. W. Holland, Roland G. Curtin, Wm. Pepper, Wm. Osler, John B. Roberts, Chas. S. Turnbull, Chas. K. Mills, Roberts Bartholow, S. W. Gross, A. Sydney Roberts, Edward T. Bruen, De F. Willard, Chas. H. Burnett, J. C. Wilson, H. W. Stelwagon, Louis A Duhring, Samuel D. Risley, J. Solis Cohen.

CHROMOGENIC MICRO-ORGANISMS.-It has been found that .03 per cent of a gram of corrosive sublimate prevents the coloration of artificial cultures of the pyocyanogenic microbe and of the fluorescent microbe of the rabbit's intestine, while it requires .04 per cent to arrest the growth of the bacillus. MM. Roger and Charrin, having determined this fact, point out its possible application in the antiseptic system, since it may be practicable to render the microbe harmless without destroying its life, and consequently perhaps without killing the vital tissues in which the germ may be growing.-Lancet.

THE PREVALENCE OF VENEREAL DISEASES IN THE BRITISH ARMY.-From the publication of the Medical Department reports of the British Army in the British Medical Journal, it is learned that venereal diseases continue to be a prolific source of admission into hospital and inefficiency. Primary syphilis caused 11,095 admissions to hospital among the troops in the United Kingdom during the year 1885, and secondary syphilis, 2,336 admissions. These figures give ratios of 127.4 and 26.8 per 1,000 respectively. There were also 10,561 admissions into the hospital for gonorrhea and its sequelae. These being included, the ratio of admission for all forms of venereal disease was 275.4 per 1.000, which is higher than the ratio in the previous year by 4.7, and then the average rate for the preceding six years by 33.9 per 1,000. The figures quoted sufficiently show that the large proportionate numbers of hospital admissions which occurred after the abolition of the Contagious Diseases Acts were abolished are still maintained.

The returns from different military districts exhibit considerable variations in the ratios of prevalence of syphilitic affections, ranging from 189.8 per 1,000 in the Dublin district to 51.2 per 1,000 in the Cork district. An increase in the ratio of prevalence or primary syphilis is especially noted in the home district. The highest rates of prevalence of gonorrheal affections were 160.5 per 1,000 in the Dublin district, 148 in the Channel Islands, and 129.7 per 1,000 in the Northern district.

THE PUPIL SYMPTOMS MET WITH AFTER HEAD INJURIES.-Jonathan Hutchinson, jr., in a review of the pupillary symptoms met with after head injuries, based principally upon cases in the London Hospital, says, "A warm discussion has lately been held as to whether the human iris possesses any dilator fibers, the affirmative being maintained by Iwanoff, Merkel, Jeropheeff, and Henle, while Grünhagen resolutely denies the existence of any such muscles, and is supported to some extent by various observers."

Dr. Gaskell sees "no urgent necessity for a special musculus dilator pupillæ; variations in the extent of the contraction or relaxation of the sphincter are quite sufficient to account for all the differences in the size of the pupil, if only the radical fibers of the pupils possess, as Grünhagen thinks they do, a sufficient amount of elasticity." Dr. Gaskell points out the close resemblance of the nerves which dilate the pupil to those which inhibit the circular muscles of the intestine, and hence speaks of the former as the "cervical splanchnie," although, perhaps, it would be more convenient to use the term pupil inhibitor.

The existence of such inhibitory action on the part of the cervical sympathetic will probably come to be universally admitted, although there may be in addition dilator fibers, the existence of which in birds and certain other animals is not denied. As Gaskell observes, "The attempt to attribute dilatation of the pupil to contraction of the blood-vessels of the iris is, for several reasons, not worthy of discussion."

A METHOD OF ANTISEPSIS FOR THE URETHRA AND BLADDER.-At the meeting of the Academy of Medicine of Paris, October 29, 1887, M. Lavaux read a paper upon a method of antisepsis for the urethra and bladder, and its application to the treatment of strictures of the urethra. The following is a summary of his conclusions, as contained in the Progrès Medical, November 12, 1887 :

1. Continuous lavage of the anterior part of urethra and intravesical injections without a sound constitute a simple and harmless method of accomplishing complete antisepsis of the urethra and bladder.

2. This method is applicable to the treatment of most strictures of the urethra.

3. Thanks to this complete antisepsis and the antiphlogistic action of hot injections into the bladder without a sound, complications due to the rapid dilatation of the urethra are now very uncommon.

4. In the treatment of simple strictures which are easily dilated, rapid dilatation ought to be substituted for slow temporary dilatation, which is of but little value.

5. Intravesical injections made without a sound are sufficient to maintain the caliber of the dilated urethra.

6. Indications for the performance of internal urethrotomy become extremely restricted.

7. This method of treatment, by securing antisepsis of the bladder and urethra, ought to render divulsion and internal urethrotomy much less serious operations.

GASEOUS RECTAL INJECTIONS AND THE GLYCOGENIC FUNCTION OF THE LIVER.-MM. Arnozan and Ferré, of Bordeaux, communicated to the Toulouse Congress an interesting observation they had made with reference to gaseous rectal injections, tending to show that sulpureted hydrogen introduced into the animal economy in this manner arrests the glycogenic function of the liver. Three rabbits which had been subjected to these injections died, two of them in a short time, the third after a rapid and progressive emaciation. In all three the liver tissue was found to contain no sugar whatever.-Lancet.

SUBLIMATE PAPER AS A SURGICAL DRESSING. Filter paper prepared in the following way has been found useful as a surgical dressing. It is first steeped in a solution consisting of sublimate, grains three, glycerine, minims seventyfive, and water, three and a half ounces, and then dried. It is not alone useful in small superficial wounds, but even large wounds and major operations may be dressed with this material.

From personal observation Gedeke, Centralblatt für Chirurgie, comes to the following conclusions:

1. That filter paper saturated with a .2 per cent bichloride of mercury solution makes a good material for surgical dressing.

2. That according to the size of the wound, from a single layer up to eight-ply should be used, and the whole held in place by a dry bandage.

3. That such a dressing is particulary adapted to fresh wounds.

4. In complicated injuries of the fingers this dressing has the advantage of acting as a splint as well as a dressing.

5. It should be changed every two or three days.

6. When other antiseptic surgical dressings can not be had, suppurating wounds can be kept aseptic for a short time with this dressing.-Pacific Medical and Surgical Journal.

HYDRASTIS CANADENSIS IN UTERINE HEMORRHAGE. Dr. Hach, of Riga (Proceedings of the Riga Society of Medical Practitioners), has administered hydrastis Canadensis, in the form of an American fluid extract and of a Riga tincture (the latter in doses of one tea-poonful twice a day), in 97 cases of uterine hemorrhage, and obtained either complete or partial success in 47 of them. He gave the drug in 22 cases of uterine fibroid, with brilliant results in 8 cases, and with partial success in the remaining 14; in 4 cases of parametritis, with good results in 3; in 10 of perimetritis, with partial improvement in 4; in 12 of metritis, with success in 7; in 14 of metritis and endometritis, with partial relief in 4; in 19 of metritis and parametritis, with success in 8; in 3 of cancer of the vaginal portion, in all of which bleeding was restrained; in 11 of congestive dysmenorrhea, with some success in only one case; and in 2 cases of climacteric metrorrhagia, in both with partial success. The author found that the American preparation acts much better than the Riga one; at least, of 14 cases treated by the former, the bleeding had ceased in 9; that is to say, in all about which informa

tion could be obtained, the remaining 5 patients having been lost sight of. On the whole, Dr. Hach recommends the drug as a good means of controlling and preventing flooding of any kind. Except some cardiac palpitation in a pregnant woman after taking 30 drops of the drug, he never saw any untoward secondary effects; on the contrary, hydrastis Canadensis improved the appetite and the intestinal function. Dr. von Stryk, of Riga, however, lately saw (ibid.) a woman in the fourth month of pregnancy in whom abortion took place on the third day of the hydrastis treatment, the tincture having been used in daily doses of 100 drops for relief of severe cervical catarrh (Chiari's). Among other Riga practitioners Dr. Huebner obtained satisfactory results from the drug in three cases of fibromyoma, while Drs. Krannhals and Hampeln, having tried (ibid.) hydrastis in hemoptysis of phthisis and nephrorrhagia respectively, did not observe that it did any good.-Brit. Medical Journal.

THE ILLNESS OF THE CROWN PRINCE. It is with the deepest regret we have to announce that symptoms of a somewhat alarming character have again suddenly shown themselves in the case of the Crown Prince of Germany. The worst inferences have been drawn by the lay press from the bare fact that Sir Morell Mackenzie left England hastily on Wednesday morning, although his destination could only have been surmised. From information which we have just received from a trustworthy source at San Remo, there is reason to fear that these apprehensions are but too well founded. Up to the end of last week Sir Morell Mackenzie continued to receive most satisfactory reports as to the progress of the illustrious patient. It appears, however, that a few days ago an excrescence, at first no larger than a hemp-seed, was detected on the left vertricular band (false vocal cord), a part of the larynx which had previously been free from disease; and two days later a second tiny speck was noticed not far from the first. These two nodules soon became fused together, forming one warty-looking mass, which is growing so quickly that an increase in size is distinctly perceptible from day to day, and the vocal cord of that side is now hidden from view. The sudden appearance of this fresh tumor and its extraordinarily rapid development would perhaps seem to be indieative of an acute inflammatory process rather than of the formation of a new growth;

but, on the other hand, the history of this remarkable case already furnishes a suggestive precedent on both these points. It may be remembered that the growth below the left vocal cord, which was discovered just before his Imperial Highness left Baveno, attained a considerable size in a few days. That tumor does not appear to have developed to any great extent since then; at present, however, we gather that it can not be seen owing to the projection of the fresh growth above it. There are thus at least two independent centers of disease, not including the site of the original growth which was destroyed by Sir Morell Mackenzie. As the Prince has been under the daily observation of a distinguished German specialist, Dr. H. Krause, as well as of Mr. Mark Hovell, there can be no reasonable doubt as to the facts, anomalous and perplexing as they unquestionably are. One

of the most curious features in the case is that the ulcerated surface left by the bursting of an abscess in the immediate neighborhood of the seat of the disease was, toward the end of November, distinctly seen by both these competent observers going throngh the process of healthy cicatrization, till it was completely healed. It can hardly be wondered at that an occurrence so utterly opposed to ordinary experience in the case of cancer should have given the Prince's advisers some encouragement to hope that they had taken too gloomy a view of the situation. It must be evident by this time to all unprejudiced persons that the case is, in its purely medical aspects, one of unusual complexity. We understand that there is not at present any immediate danger, though, of course, under the circumstances, surgical interference might become necessary at any moment. It is gratifying meanwhile to know that the august sufferer experiences no pain or discomfort whatever.Ibid.

ANTIPYRIN As a Uterine SEDATIVE.-M. H. Chouppe has already called attention to the good effects of antipyrin in uterine pains after parturition or in dysmenorrhea. In proof of this he relates the following case: A woman, aged thirty-five, was suffering from a large myoma situated in the posterior wall of the uterus, accompanied by copious hemorrhage, which reappeared after menstruation. Ergot checked the hemorrhage, but caused such severe uterine pains that it had to be discontinued Large doses of morphine were administered. These caused the pains to disappear, but at the same time

the uterine contraction was relaxed and hemorrhage reappeared. Ergot was again administered with similar results. The attacks of uterine pains lasted two or three hours. M. Chouppe then had recourse to antipyrin. An injection, containing two grams of antipyrin, was administered. At the end of twenty minutes the pains disappeared. M. Chouppe then tried the following experiment: an injection of antipyrin was given half an hour before the dose of ergot. The patient experienced no pain, although there was active uterine contraction; hemorrhage was arrested. M Chouppe concludes that antipyrin relieves the pain caused by the uterine contraction which is produced by ergot without diminishing the contraction. He believes that it acts upon the spinal cord, and might be administered with advantage during parturition to women possessing an irritable temperament. Ibid.

The

ANTIPYRIN IN HEMOPTYSIS.--In the Meditzinskoïë Obozrenïë, Dr. M. Byvalkevitch, of the Vilna Military Hospital, states that antipyrin is an excellent remedy for pulmonary hemorrhage of every kind." statement is based on ten cases of hemoptysis in patients suffering from phthisis, bronchiectasis, cardiac disease, and traumatic injury of the chest. The following mixture was invariably employed by Dr. Byvalkevitch R Antipyrini, 3ss; aq. destil., 3iv; essentiæ menthe pip., gtt. xv. M. D. S: A tablespoonful every two or three hours. In none of the cases were more than two doses of the mixture required completely to arrest hemoptysis, even when the daily loss of blood amounted to two fluid pounds. In some of the patients ordinary hemostatics, such as ergot, ergotin, digitalis, atropine, and Haller's elixir had been previously tried without effect.-Ibid.

OLD PRIMIPARE.-The Centralblatt für Gynäkologie has recently reviewed a thesis by Dr. A. Eckhardt on the subject of elderly primiparæ. This thesis is based upon five hundred and forty three first labors in women over thirty years of age, observed in Schroeder's wards. Cases thus relatively old formed but two and a half per cent of all the labors in the same clinic. They depended upon one or two conditions-lateness of the first coitus, or disease in the woman or her consort. The idea so prevalent, that the soft parts are very rigid in old primiparæ was authenticated by Dr. Eckhardt's researches, and this condition accounted for the greater frequency in the same class of

women of lacerations and fistula. Disorders associated with pregnancy were found to be more marked and frequent in old primiparæ than in the total of first pregnancies. Placenta previa and prolapse of the cord were "possibly" more frequent. The statistics proved that contracted pelvis, breech presentations, face presentations, and twin births were also more often seen in old than in younger primiparæ; it is not noted how the greater frequency of contracted pelvis could be explained. Retained placenta appeared more common; atony of the uterus was decidedly often observed in these cases. In primiparæ between thirty and forty years of age the excess of male births was greater than in others, while in primiparæ over forty, on the other hand, there was excess of female births. Relatively, cases of advanced ossification of the fetal cranium were rare. The editor of the article published in the Centralblatt declared that Dr. Eckhardt had exercised very great care in guarding against sources of fallacy in his statistics.-Ibid.

INTERMITTING LIMPING.-M. Terrillon describes a case of an affection not infrequent among horses, but rare in human subjects. In veterinary practice it is not uncommon for horses to be found that are apparently perfectly sound when at rest and at the beginning of motion, but that begin to limp (generally in the hind leg) as soon as active motion is carried on, with evident pain and discomfort, which increases until the animal is covered with perspiration and falls. Recovery takes place after prolonged rest, but symptoms recur, and eventually the animal is killed as useless. At autopsy a thrombus of the iliac is found.

Terrillon's case in a human subject was that of a man twenty seven-years old, a drinker, who complained of pain in the left foot, which intermitted, but reappeared suddenly on motion with so great severity that after a while the patient was unable to go more than a few steps. Gangrene of the foot followed, and amputation with recovery.--Boston Medical and Surgical Journal.

THE ORIGIN OF THE SUPERIOR FACIAL NERVE. It is well known that in cases of hemorrhage and softening of the brain the resulting facial paralysis respects nearly always the orbicularis palpebrarum innervated by the superior part of the facial nerve. In bulbar paralysis a similar exemption of these muscles is also observed. M. Mendel has addressed himself to the study of this subject, and gives the following facts experimentally ascertained.

Extirpation of the muscles innervated by the inferior facial nerve, if accomplished on newborn animals, always causes an atrophy of the nucleus of origin of the facial nerve, Extirpation in a young rabbit and two young guineapigs of the muscles of the eyelids and forehead gave the following result at the end of three months in the rabbit and ten months in the guinea-pigs. The ocular bulb was found to be intact, and so were the trunk and nucleus of the facial nerve. On the other hand, the three brains presented an atrophy of the posterior part of the nucleus of the oculo-motor nerve. The atrophy was not only manifested in the dimensions, but also in the number of nerve cells. These experiments seem to prove that in the rabbit and guinea-pig the superior facial nerve has its origin in the nucleus of the third nerve. It is possibly the same in man. In one case of ophthalmoplegia of central origin the muscles to the eyelids were also paralyzed. At present the course of the fibers is not known in these animals, but Mendel thinks they traverse the posterior longitudinal system. The different origin of the bundles of the facial nerve is not surprising, for a similar occurrence takes place in other peripheral nerves.-London Lancet.

NOT DUE TO VACCINATION.-Alfred S. Grubb, L. R. C. P., writes to the British Medical Journal, and (congratulates himself upon having made a lucky escape. He says: "I was asked by a lady, whom I had attended in her confinement two months before, to vaccinate her baby, as she was going into the country. I thought it preferable to await her return, and postponed the operation. It was well I did so, for within three or four days the child developed a violent attack of desquamative dermatitis, and for a week or two presented a most pitiable appearance, with the skin hanging all over it in rags and tatters. The child recovered in the course of two or three weeks, but it can easily be imagined what would have been the verdict had I been unfortunate enough to have vaccinated the child. As it was, the mother asked me, 'Was I sure I had not vaccinated the child?'" This is another example of the errors so commonly resulting from post hoc conclusions.

MEAT EXTRACTS.-An excellent authority, The Druggists Circular, maintains that the vaunted raw meat extracts are made by taking beef or sheep blood, coagulating the fibrine by churning, and after straining it out adding an equal measure of the white of raw eggs. Decomposition is delayed by the use of boric or salicylic acid or alcohol.