was sick and vomited, after which the various symptoms of poisoning left him.

Dr. I. Althaus speaks highly of the use of injections of glycerine in habitual constipation. It is best injected into the rectum by means of an ordinary glass syringe, a teaspoonful is found quite sufficient for any ordinary case. An evacuation generally takes place, either immediately or within a few minutes after injection. The explanation of the effect is due to the fact that glycerine, when brought into contact with the mucous membrane of the rectum, withdraws water from it, thus causing hyperemia and irritation of the sentient nerves of the rectum, which in its turn leads reflexly to powerful peristaltic contractions, ending in defecation. The larger the accumulation of feces the greater is the effect. There is no discomfort or pain, although sometimes a little throbbing is felt in the rectum for a few minutes afterward.

Professor Atwood has been exploding and ridiculing the prevailing notion that mental exertion consumes much phosphorus in the brain, and that consequently fish is specially good brain food on account of its containing much phosphorus. He denies that fish is peculiarly rich in phosphorus, or that there is any evidence that the brain uses any overproportion of phosphorus, or that there is any more connection between thought and phosphorus than other elements of food. The foundation-stone of the new College of Medicine, Newcastle-on-Tyne, was recently laid by the Duke of Northumberland. The cost of the site and buildings is to be £25,000, and an additional £25,000 is to be expended on a Residential Hall, and to endow the chairs of a public health department, and a department of comparative pathology.

A meeting of the Committee of the Moxon Memorial was held at the Royal College of Physicians recently, Sir William Jenner in the chair. Of the amount subscribed, 100 guineas are to be devoted to a memorial to Dr. Moxon at Guy's, and the balance is to be offered to the Royal College of Physicians for the purpose of founding a Moxon Medal,

to be given every third year for distinguished clinical observation and research,

Dr. A. Gamgee, F. R. S., has been elected an assistant physician and Mr. G. R. Turner an assistant surgeon to St. George's Hospital. LONDON, December, 1887.

Translations.

The

MORPHOLOGICAL VARIATIONS OF MICROBES. At the meeting of the Academy of Sciences, December 12, 1887, MM. Leon Guignard and Charrin presented an interesting report on the morphological variations of microbes. microbe of pyocyanine, whose metamorphoses they had minutely studied, was found in pure bouillon, under the form of a motile bacillus, whose length was equal to twice the diameter. The culture in an oven of 35° acquired a film under which appeared the coloring matter of a greenish blue passing into yellow. The bacilli then began to condense their contents into one or two globules, about which the membrane thickened. These are the encysted cells or ortho-spores. If to the pure bouillon are added various organic or or mineral acids, such as phenol salts, etc., various forms are obtained according to the conditions of the experiment. One of these forms is represented by a true bacterium. It appears at the outset, when to the bouillon is added a small quantity of phenic acid or creosote. If, instead of these latter substances, naphthol 0.25 per 1,000, thymol 50 per 1,000, alcohol 40 per 1,000, are used, bacilli of all lengths, isolated or agglutinated in pseudo-filaments and filaments properly socalled entangled appear, forming a felting on the surface. At all times these different forms are temporary; shortly the normal bacillus re-appears. If bichlorate of potash, 0.10 per 1,000, is added to the bouillon, the culture exhibits all at once entangled filaments, but at the end of five or six days these are replaced by the normal bacillus. With boric acid the transformation is very curious. Indeed in a preparation of 3 per 1,000, development is retarded, but the production of pyocyanine continues. In a preparation of 5 per 1,000 the

culture presents short filaments; with 6 or 7 per 1,000 there is a new modification of straight bacilli bent or curved into a crescent or even a circle. If the curved bacilli do not divide into segments, they are seen to form by turns close spirals. The microbe does not then produce pyocyanine, and it returns slowly to its primitive condition. Bacilli cultivated in bouillon to which has been added 0.75 of creosote or a dram of salicylic acid, at the end of three or four weeks become the site of an internal formation of durable cells, spherical and similar to micrococci. These cells constitute a form for reproduction, for, replaced in pure bouillon, they return to the condition of the normal bacillus, and produce pyocyanine. These important researches show that experimental polymorphism of the microbe of pyocyanine is very extensive, but the most remarkable thing these experiments establish is, that whatever the form one sows in the pure bouillon, bacterium, bacillus short or long, straight or curved, filament, spirillus, or micrococcus, this form reproduces at once the normal bacillus (and it alone) with pyocyanine. This necessary control becomes then the criterion of the purity of cultures. It may thus be perceived what reserve ought to be exercised in the determination of microbian species, and what rôle the medium plays in regard to each determinate micro-organism.-Le Progrès Medical.

BILE AND FAT DIGESTION.- M. Dastre, in a report to the Society of Biology, at the session of December 17, 1887, referred to the fact that he had previously proven that the presence of bile in the stomach during dif ferent periods of digestion did not take from the gastric juice its digestive power and that consequently it could not be the cause of vomitings or of severe gastric troubles. To-day, thanks to the success of two operations for intestinal cholecysto-intestinal fistula, he thought himself in a position to conclude that the bile contributed as well as the pancreatic juice to the digestion of the fats, an opinion which is counter to that expressed by Claude Bernard. In fact, the two animals being in good condition four months after the establishment of the fistula, they had been given a meal of fat and

milk, and then slaughtered during full digestion. The examination showed with absolute clearness that the lacteals were transparent between the stomach and fistula, and on the contrary entirely white and milky below the fistula, that is to say, where the bile had been able to get. Consequently, if observation on the rabbit shows us that the bile alone is unable to emulsify the fats, the preceding experience shows us that the pancreatic juice alone is also powerless. They must be mingled, and the bile as well as the pancreatic juice takes part in the digestion of fats.-Ibid.

SUBCUTANEOUS INJECTION OF TABLE-SALT IN WEAK HEART.-Dr. Leon Rosenbusch, of Lemburg, reports a most favorable experience in the use of chloride of sodium by subcutaneous injections in cases marked by danger of failing circulation.

He was led to the practice by the experiments of Cautaui, who, in cases of cholera, injected subcutaneously from fifteen to fortyfive ounces of a solution composed of four parts chloride of sodium, three parts of carbonate sodium and one thousand parts of distilled water, with evident advantage.

The author uses this, or an injection of similar composition, in low forms of pneumonia, typhoid fever, chronic nephritis, and all forms of severe hemorrhage.

The following is the resumé by the author of the indications for injection and the amounts to be used:

1. Sudden collapse (five to eight drams of a six-per-cent solution).

2. Paresis of the heart muscles from any acute disease (five to eight drams at once, and then one to two drams daily).

3. Acute gastro-enteritis, great weakness after severe vomiting and diarrhea (eight to twenty ounces of a tepid solution of six per thousand).

4. Hemorrhage from the lungs, stomach, or bowels (five drams, then one and a half drams daily).

5. Heart failure in consequence of chronic disease and cachectic conditions (one and a half drams daily for several days).- International Clinische Rundschau.

Of these he gives fifteen to twenty to an adult on the fast day before the day of treatment, and on the day of treatment the rest within two or three hours.

Purgatives should be given on the fast day, and on the day after the pills should be given from seven to nine o'clock. If necessary an enema shou'd be used to aid in emptying the bowels.

Since Bettleheim began using the keratinized pills, it has only once happened that they have been vomited, and only now and then has a pill passed undigested.

SUBCUTANEOUS INJECTIONS OF ANTIPYRIN IN PAINFUL DISEASES. Dr. Fraenkel, of Breslau, on the ground of numerous observations, has reached a conclusion similar to that of Germain Sée, that in painful diseases subcutaneous injections of antipyrin are followed by the best results. The dose recommended by Sée is a dram of fifty-per-cent solution (water and antipyrin equal parts). According to Fraenkel a half syringeful of a twenty-five-percent solution accomplishes the same result. The effects are perceived in from fifteen to twenty seconds, and last much longer than morphine.

Fraenkel concludes, therefore, that the subcutaneous injection of antipyrin will restrict the use of morphine, lighten the task of the physician, and conduct many patients to a more rapid recovery. International Clinic Rundschau.

Abstracts and Selections.

THE TIME IT TAKES TO THINK.-Men in all ages have been familiar with the fact that thought is habitually more active and more speedy in the case of some persons than of others. Whether in the exercise of the imaginative or the reasoning faculty, or in the action of that guiding purpose of life which we call the will, the general truth of this observation has been always evident. As we come to a higher stage in human development, with its corresponding increase of intelligence, it is not remarkable that the mind should seek to subject itself to a closer scrutiny, and to catalogue more exactly the results of its introspection. This has happened with regard to the question before us. In particular has the period which intervenes between the impact of impressions from without and the visible response of the will in muscular action or other mode of expression become of late years a subject of careful investigation. Since the first quarter of the present century, when the comparative speed of visual observation was chronicled in the case of the astronomers Bessel and Struve, the varying rate at which the mind responds to the numerous impulses which reach it from the outer world has been measured with some exactitude. Most of our readers are familiar with the term "reaction" period., They will recognize it as expressive of the whole interval between the action of a stimulus, of whatever kind, and the They will also perceive in the period of "revisible response of the individual affected by it. duced reaction" that interval shortened by the space of time allotted by experimental precision to the transit of purely sensory and motor impulses the period, namely, which changes the one into the other, and represents in the mind the average time required to think and to will. Discoveries not now very recent have taught us that the ordinary duration of this period is, in the case of simple impressions, about one tenth of a second, and that where the impression is rendered complex by affording the mind a choice of sources to which it may be referred, the time required is increased by about another tenth of a second. An equally interesting side of the subject, however, is that which exhibits the force of impressions as

Alarming reports continue to come in of the spread of black diphtheria in Clay and adjoining counties. Local physicians are unable to control the disease. There have been over fifty deaths within three weeks.

cepted and, in familiar phrase, digested by the mental centers before they are visibly transformed into action. The rapidly energizing power of sudden fear, joy, hope, and desire is thus explained. So likewise the contrary effect of some of these emotions may be explained as being due to a stunning effect produced by the

causes which give rise to them upon the mental centers. It is also manifest that the energy of the mental reaction must largely depend upon the reserve of force in those centers at the time of activity. They must not be overtaxed by prior stimulation and excessive use; if their response is to be a vigorous one, they must be weil nourished and have seasonable rest. is, therefore, even in these psychological minutiæ a moral for the times-namely, that if we would preserve our mental efficiency amid the changing pressure of circumstances, we must by occasional recreation withdraw the mind from too continuous application.-The Lancet.

There

NURSES.-Nurses have good reason to believe that their calling and their class are looking up. There is perhaps a little fear of their being too much "nursed," and we are not surprised to see indications that they are conscious of this risk, and showing a desire to be a little more independent. There certainly is now a large number of women with sound knowledge of nursing work and of what is wanted to place the workers in a sound and satisfactory position before the public; and it would seem well that, if nurses are to be educated and organized, they should debate the question of their own education and organization with as little interference as possible. We presume it is with some such views that a number of ladies met on Wednesday, December 7th, on the invitation of Mrs. Bedford Fenwick, late matron at St. Bartholomew's Hospital, to discuss the advisability of forming an association for the mutual help of all women engaged in nursing the sick and for the advancement generally of their professional usefulness, both to medical men and the public. The representative nature of this movement may be gathered from the list we publish in another column of ladies who have consented to act on an executive committee of a British Nurses' Association, which it was resolved to form. It is premature to express a definite opinion on the views of the matrons and others assembled at the residence of Mrs. Bedford Fenwick, but they may confidently rely on the support of the profession in any well-conceived plan for raising the education status of nurses. body can be satisfied with the existing state of things. Many of the present nurses, though immensely more efficient than their predecessors, are still inadequately trained, and show strange limitations of knowledge and education even in their peculiar work. The public are ready to pay and are actually paying considerable sums for professional nurses, and it is only fair that nurses should be able to provide guarantees of efficiency. A short time ago we commented on the importance attached to nurs

No

ing in American cities. In almost all of these a register of nurses is kept, and in most cases a two years' hospital training is required as a condition of admission to the register. There is an extensive feeling that some such system of registration must be established here. At the meeting of ladies on the 7th inst. a feeling was expressed that the training must be real, and must be more prolonged than in many of our nurse-training institutions. The object of these ladies, indeed, is to command the respect of the medical profession, and through it of the public. There is reason to believe that they have already secured the support of many leaders in the profession. It is probable, however, that both the question of nurses and of midwives will soon have to be considered by the legis lature, and that some authoritative medical body must have legal power to deal with them in the public interest. We hail the meeting referred to above as a sign that we shall soon have an organized system for the education and certification of nurses.-Ibid.

THE QUESTION OF EXTRACTION After VerSION. It is the rule of practice with many that in transverse presentations turning by the feet should be followed by immediate extraction. This doctrine has recently been notably supported by Winter on the strength. of the histories of three hundred and ten transverse presentations at the maternity of the University of Berlin. Winter's propositions are: (1) Turning should not be performed until the os uteri is sufficiently dilated to admit of extraction. (2) The best results for the child will be secured when version is immediately followed by extraction.

In a recent number of the Zeitschrift für Geburtshilfe und Gynäkologie Dr. R. Dohrn, of Königsburg, assents to the first of these propositions, but not to the second. "It is generally admitted," he remarks, "that the child's life will be endangered if, the waters having escaped, 'the faulty presentation is allowed to go unremedied after the os is sufficiently dilated to admit the hand. Whether tetanic contraction occurs after such neglect or not, and whether or not there is compression of the umbilical vessels, the diminution in the capacity of the uterus and the consequent curtailment of the respiratory surface of the placenta are enough to endanger the child's life. The exceptional cases in which neglected cases result in the spontaneous birth of living children are not to be considered as an argument for delay in turning, for it is proba ble that in such cases, although the liquor

amnii below the child has drained away, enough remains above it to keep the placental circulation intact.

"The waters, therefore, are to be looked upon as indispensable to the integrity of the fetal circulation. On the other hand, version should not be performed too soon after the waters have escaped, for if the degree of dilatation is insufficient at that time there will be danger from the compression of the cord by the cervix. The operation will not usually be difficult unless the uterus has already been subjected to repeated unskillful and unsuccessful manipulations. Rupture of the uterus, although possible in such cases, is not common, and as a rule it occurs only after the os has been completely dilated."

Winter's second proposition, as to the time which should elapse between version and extraction, is of great practical importance. That writer reports 236 cases of turning followed by immediate extraction, the os being fully dilated, in which only 5 children were born dead against 27 cases of turning before the os was fully dilated, the course of the labor being then left to nature, in which 13 children were born dead. These facts, he thinks, speak forcibly in favor of waiting for full dilatation, and then immediately following version with extraction. To Dohrn, however, these figures are not conclusive upon the general question, for the children in the second series of cases were placed under more perilous conditions than the others in consequence of premature interference, and better results might have been secured in all probability if complete dilatation had been waited for.

Dohrn believes with Boër that in parturition the forces of nature should be allowed full sway until there is evidence that they can no longer be trusted; that every interference for which there is no definite indication is reprehensible, and that extraction without a special cause is no exception to this rule. The results of extraction will vary with the manual dexterity of the operator and the degree of his knowledge of the mechanism of labor. This is amply shown by contrasting the two per cent of mortality after version in Winter's statistics (the operators being skillful obstetricians) with the fifty-seven per cent mortality which is given as the frightful rate in general practice in the Duchy of Nassau, according to a recent report. The inference is obvious, that the natural forces were not given fair play in that locality. An important injunction is, that in extraction the force should be exerted in the direction

In

which the uterine contractions indicate that the fetus is to take in any given case. twenty-nine cases in Dohrn's public service in which turning was performed after the os was fully dilated, the delivery being then left to nature, there was not an accident, and he therefore infers: (1) That in transverse presentations podalic version should be performed only when the os uteri is fully dilated, although to this there may be occasional exceptions. (2) That extraction should follow immediately upon version only when there is a well-defined indication for such a procedure; if there is no such indication, the safety of both mother and child will be most favored by awaiting delivery by the unaided natural power.-N. Y. Med. Journal.

SEXUAL INSANITY IN INEBRIETY.-In the first class, most commonly noted after inebriety has begun, sexual irregularities appear. Thus, a man previously moral

will consort with the lowest women or have a mistress, and pursue a line of most unusual conduct, irrespective of all social and family relations. The boldness and impetuosity of this conduct suggest disease and failure of the brain to realize the nature and consequence of acts. As an example: a man of excellent character, married, with fine family, became an inebriate, dating from an obscure brain injury. Suddenly he became a constant visitor to a house of ill-fame, appeared in public with the inmates, and gave no reason for this. A professional man of high standing became an inebriate and began to keep mistresses and associate with fast women. In these cases such conduct indicates a sexual delirium and degeneration, associated with and following inebriety, that is very grave. It is more often noticed among the steady and constant drinking inebriates.

In the second class, where sexual exaltations precede the drink paroxysm, there is always a marked neurotic element present. Such cases are often periodical inebriates. Thus, in a case under observation, a man of correct habits will, for two weeks before drinking, manifest almost ungovernable sexual impulses. He will consort with many women each day, have sexual dreams at uight, and conduct himself in a very unusual way. Finally he becomes intoxicated and the sexual impulse dies out. Long inter vals, sometimes months, follow before it returns, during which he is entirely abstinent. In other cases this impulse will begin with intrigues with women and secret journeys to large cities, visiting bad houses,