to procure deep and prolonged sleep, however, these effects on the heart and respiration were not produced. In the dog the respiratory movements fell from twenty to sixteen, a fall which is not greater than that which occurs in normal sleep; the differences in the pulse-rate and blood pressure were hardly perceptible. V. Mehring gave the drug to sixty patients in doses varying from 46 to 77 grains, he observed no unpleasant after-effects, no nausea, headache, or digestive disturbance. Scharschmidt found that so large a dose was not necessary, although he corroborates Mehring's statement that even then there was no appreciable disturbance of the respiration or pulse-rate. In 80 per cent of the cases sound sleep of from five to seven hours' duration was procured by doses which did not exceed 45 grains, and were in some instances as low as 20 grains; by repeating the dose, or giving larger one, sleep was, in all the cases where failure was at first noted, subsequently obtained. In 24 of Scharschmidt's cases there was much excitement, and by producing sleep under such conditions as mania, delirium tremens, and epilepsy or hysteria with delirium, amylene hydrate appears to have proved itself superior to urethan. Too large a proportion of pharmacological discoveries have ended in disappointment, and it would be rash, in the face of recent experience, to express a confident opinion that the new hypnotic will prove as useful and as harmless in the hands of other observers as it has done in those of v. Mehring and of Scharschmidt.—British Medical Journal.

SOME VASO-MOTOR PHENOMENA IN TYPHOID FEVER. Dr. Angel Money calls attention (Lancet, December 3d) to certain vaso-motor phenomena which he has noted in cases of typhoid and of rheumatic fever. He divides them into classes as follows: In the first class he places the spontaneous vaso-motor phenomena, by which he means those facts which may be witnessed without further irritation or stimulation than attends the mere exposure of a surface of the body or limb on which the observation may be made. If it be the surface of the abdomen, this may be found to be for the most part of a pinkish hue, such as tends to obscure the presence of rose spots, if such be present; but scattered here and there through the red tint, which they mottle, may be seen areas of whiteness which present a distinct and striking contrast with the general tint, and are, moreover, characterized by varying indistinctness, being whiter or less white at one moment than at the preceding or succeeding moment. If to such a skin, under such circumstances, the additional condition be added of a slight mechanical-electrical or thermal-stimulation, cer

tain further observations may be made, the purport of which he does not pretend to fathom, though it would be easy to offer plenty of hypothetical explanations. It generally happens that the stimulated area or line turns white or ivory-tinted after the lapse of a rather long latent period, variable in different cases and at different times for unascertained reasons, and measurable generally by seconds. The whiteness is not strictly limited to the irritated section, but spreads away from the part stimulated, and in a gradual, decreasing fashion. Moreover, the pallor does not appear abruptly after the period of latency, but the pinkness of the skin gradually gives way to the whiteness, and the changing hue is very perceptible. Thus, both in space and time, the phenomenon has a graduation and a duration which are, comparatively speaking, of slow course, and remind one rather of the contraction of smooth, plain, nerveless muscular fiber, than the rapid, sharp contractions of the well-nerved voluntary muscle.

non.

Again frequently, but not always, it will be found that exposure of the skin of the arm and fore-arm in the same subject presents a contrast with the previously or simultaneously exposed surface of the abdomen, the general tint being white with irregular patches, and sometimes streaks, of pink or darker red. When this condition is evident, and occasionally when there is no such general and spontaneous dissimilarity of appearance, mechanical, and sometimes (always) electrical and thermic irritation of the skin of the arm will be followed after a similar, but perhaps generally a trifle shorter, period of latency by the gradual development of the tache cérebrale or red streak, having the usual characters of that phenomeSometimes the surface of the arm has a general pink tint on first exposing it to the atmosphere, and this may rapidly change to white, but the color of the written characters thereon may be deep red. The contrast in color may be still more remarkable, even in the same case; the writing may be white on the surface of the abdomen, red on the forearm, white on the legs. He lays considerable stress on the circumstance that the temperature of the skin and of the body is usually high in cases which present these vascular phenomena, and, further, I have most generally observed them in full perfection when the skin has not been perceptibly sweating. But, as proving that neither increased heat nor an especial dryness of the cutaneous tissues is necessary to the production of such phenomena, he observes that he has seen them very well marked in cases of epilepsy and chorea of uncomplicated and afebrile sort. It may be

worth placing on record also, in this connection, that in the majority of cases in which these observations were made the brain was eertainly perturbed in its functions, for delirium was frequently present at some period of the twenty-four hours, mostly at night time; still his observations were usually made during the day-time, and when the intellect of the patient, to all ordinary modes of investigation, did not seem to be abnormally affected.

CASES OF URETHRAL STRICTURE TREATED BY ELECTROLYSIS.-The following cases of stricture were treated by electrolysis, the method employed being essentially that advised by Dr. Newman, of New York, and Mr. Clark, of St. Bartholomew's Hospital, London. The caliber of the stricture having been measured, a bulb-electrode one or two sizes larger is passed down to it, and connected with the negative pole of a galvanic battery. The positive pole is attached to a broad metallic electrode, covered with wet absorbent cotton (or a sponge electrode), which is held against the abdomen or elsewhere. The strength of the current used should be from three to five milliampères. In the cases reported it was four milliampères; a little less in the last case. The electrode will generally pass through the stricture within half an hour, only the gentlest pressure, if any, being exerted. The operation is painless. Very little after-treatment is indicated. In these cases ten grains of quinine were given after each operation, and the patients were advised to keep quiet for a day or two. After an interval of a week or more, not less, the urethra is examined to ascertain the result of the operation.

CASE 1. G. T., twenty-eight years old, was first treated for stricture two years ago. His urethra is very sensitive, and he has several times had chills after the passage of sounds.

Strictures of a caliber of 19 (French scale) were found at inch and at 2 inches from the meatus, and one of 16 at 3 inches. The first stricture was treated by electrolysis May 7th. Electrode No. 20 was placed against the stricture, and with a current of 4 milliampères it passed through in 20 minutes. Within 12 hours the patient had a severe chill, with fever and vomiting, and was quite ill for several days. He returned to the dispensary in about a month, but the result of the operation could not be accurately ascertained, as he had meanwhile been treated by gradual dilatation at the City Hospital. This treatment was continued.

ČASE 2. J. H., fifty-three years old, had strictures admitting 17 at 14 and 12 inches. May 24th electrode 18 passed both strictures in 10 minutes. Although there was no chill, the

operation was followed by malaise lasting a week, with considerable local irritation and a copious discharge. The strictures were found to have contracted to 14, and the treatment was abandoned.

CASE 3. E. J., thirty-nine years old, had his first gonorrhea eighteen years ago, and symptoms of stricture fifteen years ago. He came to the dispensary with a chronic discharge, and when examined was found to have strictures as follows: at inch 22, at 14 inches 18, at 2 inches 14. July 28th the middle stricture (18) was electrolyzed and electrode No. 20 passed through in 15 minutes. The operation caused no constitutional symptoms whatever, but some local irritation with increased discharge and painful micturition, on account of which examination was delayed and the patient was lost sight of until September 22d, when the stricture operated upon and the one posterior to it were found to be the same size as before, while the anterior stricture had contracted. He had no treatment meanwhile. Two days later electrode 17 was passed through the narrowest stricture (14) in 20 minutes. This was followed by no constitutional symptoms and by less local disturbance than before. One week later (October 1st) bougie à boule 18 was passed easily through all the strictures. The urethra was very sensitive. October 8th a bulbous bougie, No. 19, was passed, meeting with some resistance at each stricture. Electrode No. 20 passed all three strictures in half an hour. October 20th the strictures were defined by bougie à boule 21, 22 passing with slight difficulty. Another operation was begun, but when, in about 15 minutes, electrode No. 25 had become engaged in the first stricture, the patient suddenly became faint, and nothing further was attempted. He has not since been seen.

CASE 4. J. C., twenty-eight years old, began to have symptoms of stricture four years ago, and complete retention two years ago. On examination he was found to have a series of strictures, gradually diminishing in size from 25 at 1 inches to 11 at 3 inches and at 5 inches. August 23d electrode No. 15 was passed to the first of the two narrowest stric tures (11), but failed to pass in 20 minutes. This operation was followed by no constitutional symptoms, but by increased discharge, difficult and painful micturition, and a great deal of swelling and induration about the seat of the stricture. The size of the stricture was apparently unchanged. It was deemed advisable to discontinue this treatmeut, and gradual dilatation was substituted. A smaller electrode would probably have been better in this case, but was not at hand.-Boston Medical Journal.

Since the day when McDowell conceived and successfully performed the first ovariotomy, the progress of surgery may be said to have been one triumphal march. The surgeon's hand has been made acquainted with almost every cavity of the body, tracing disease to its secret hiding-places in the most delicate vital organs, where the surgeon's knife and other appliances have been potent to remove it, arrest it, or mitigate its ravages. The abdomen, the pelvis, the thorax, and the cranium have repeatedly been the fields of well-won victories, and now, through successful work in the spinal canal, is added yet another trophy to the conquest.

In the British Medical Journal of the 28th ult. is an account of the removal of a tumor from the spinal cord by Mr. Victor Horsely. The patient, an adult male, had complained for some three years of severe pain in the upper part of the chest, the point of greatest intensity being just below. and to the inner side of the angle of the left scapula. Below the level of this point there was absolute loss of sensation and motion in the body and limbs.

The upper limit of the anesthesia was in the region supplied by the left fifth intercostal nerve. On the right side, though less accurately defined, the anesthesia did not reach a higher level. The symptoms pointed definitely to a tumor of the cord at this point, and seemed to give due sanction to an attempt at its removal. Mr. Horsely laid bare and cut away the laminæ of the fifth and fourth dorsal vertebræ, but did not bring the tumor into view till he had removed the laminae of the third dorsal as well. The growth proved to be a small oval myxoma, compressing and making a deep impression on the left side of the cord below the third vertebra. It was removed without difficulty, under antiseptic precautions, and the wound healed, with a trifling rise of temperature, by first intention, except a point at the upper part, which was kept open for drainage, and through which cerebro-spinal fluid exuded in small quantities for a short time. The pain continued for three or four weeks, after which it slowly and intermittently subsided. At this time (seven months after the operation) there is no pain, while motion and sensation in the lower limbs are almost completely restored. The operation, with its happy issue, bears brilliant testimony to the skill and courage of the able surgeon who performed it, and marks a memorable day in the history of his aggressive art.

A NEW JOURNAL IN SURGERY.

Among the good number of infant medical journals whose birth is ushered in by the new year, by far the most comely, vigorous, and interesting is the "International Journal of Surgery and Antiseptics." It is a quarto of sixty-four pages, published in New York, devoted exclusively to surgery and Listerism, full of valuable original and selected matter, freely illustrated, and edited by Dr. Milton Josiah Roberts. It will be issued quarterly at the amazingly low figure of one dollar per year, and bids fair to be a living exponent of what is freshest and best in the surgery of the day. From our heart we wish it a long and useful life.

ANOTHER NEW JOURNAL.

Among our most welcome exchanges during the early years of the last decade was a journal entitled "Proceedings of the Medical Society of the County of Kings," which brought to our table many able original papers, contributed by the Fellows of this Society, and which we found to be valuable matter for excerpts, and entertaining and instructive for private reading. It is therefore with pleasure that we see the work of this live society again embodied in the form of a medical periodical. The title is "The Brooklyn Medical Journal." It is an octavo of eighty-eight pages, ably edited by a a committee of the Society, and set forth in the best style of the printing art.

DR. SMITH RETIRES.

With this issue Dr. D. T. Smith severs his connection with the editorial department of the AMERICAN PRACTIONER AND NEWS, where for two years he has done able work, not only as translator, reviewer, and writer of leading articles, but in all lines of effort which make to the journal's good.

He leaves us at his own instance, and because of business considerations which forbid his devoting to journalism the time demanded by his former position.

It need not be said to those who know Dr. Smith that he has endeared himself not only to his editorial associates, but to the publishers and printers as well, who, with us, regret the necessity of his retirement.

In reluctantly consenting to his departure we are pleased to inform our readers that our Original department and the department of Reviews will still lay tribute to his facile pen.

LEAD POISONING IN SHEFFIELD.-An epidemic of lead poisoning prevails in this historic English town. Sheffield is supplied with water from two sources, and it has been proved with regard to one of them that there are certain vegetable acids in the water which take up lead and render the water to some extent poisonous.

Notes and Queries.

Editors American Practitioner and News:

THE GEORGIA MEDICAL SOCIETY.-At the annual meeting of the Georgia Medical Society, held January 3, 1888, the following resolution was unanimously carried :

Resolved, That the Corresponding Secretary enter into correspondence with the medical journals of the country in order to enlist their influence in support of the movement to remove the import duties from all medical and surgical instruments and appliances, including those used in the diagnosis as well as treatment of disease, so that they may be furnished to those needing them at the lowest possible price.

The statement of a few facts will assist the reader in realizing the extent of the grievance and the justice of the plea for which we ask co-operation.

1. Physicians are at the mercy of instrument-makers in regard to price, make, and quality of finish, because of the lack of sufficient competition.

2. The price of instruments made in this country is out of proportion to that paid for similar instruments on the continent of Europe.

3. Surgical instruments and appliances are so costly that but few doctors entering the profession can provide themselves with an outfit adequate to carry on a general practice. At present prices it is impossible for a country physician's income to sustain his investing in costly instruments, and as a result many simple cases, such as retention of urine, foreign bodies in nose or throat, deep-seated abscesses, etc., all of which could be reliev ed at once with the proper instruments, must either die from the immediate cause or from the effects of time lost in seeking skillful manipulation, or else they are frequently crippled and disfigured, because the most intelligent help, though patiently given, is itself crippled for want of proper instruments.

4. The cheaper grades of instruments are either antiquated or so poorly made that they may prove a cause of failure in opera

5. European instruments are from 25 to 75 per cent cheaper than ours, and their introduction into the market will enable the mass of doctors to buy those of prime necessity, will bring down the price of home-made appliances and oblige the makers to use good material and put a better finish to their work.

6. The removal of import duties on surgical and other instruments used by the profession, and on medicines in general, will produce the same results as we all know it did on the article of quinine. J. C. LE HARDY, SAVANNAH, GA. Cor. Sec. Georgia Med. Society.

A

APOSTOLI'S TREATMENT OF UTERINE FIBROIDS.—Much interest is taken in Apostoli's treatment of fibrous tumors of the uterus by electrolysis. The paper of Dr. Rosebrugh, which we publish, describes well the history and methods of the treatment. number of eminent men in Great Britain and on this continent have been carrying it out for some time, and report excellent results. Dr. Keith, of Edinburgh, is especially enthusiastic over it; and, although he has the most successful hysterectomist in the world, unhesitatingly condemns the operation of hysterectomy, and advises a preliminary trial of Apostoli's treatment in all

cases.

Dr. Lapthorn Smith, of Montreal, in a paper published in the Canadian Practitioner, last month, says: "The absolute safety of Apostoli's method, and the certainty of relief from all the symptoms, render its superiority over operative procedure unquestionable." Dr. Apostoli has had remarkable success, as is admitted by all who have visited his clinique in Paris, and others claim very good results.

It happens unfortunately, however, that this treatment, in the hands of some, has not been devoid of danger. Whether this arises from a want of skill or not, time will show. It is certainly necessary to be very cautious and careful in pursuing this treatment, as we can not help thinking it is ac

At a meeting of the British Gynecological Society, held in December, Dr. Farncourt Barnes reported a case which he had under this treatment, where only two applications of the galvanic current had been tried, yet the temperature had gone up to 103° F., and the patient was apparently dying.- Canadian Practitioner.

A VENERABLE CHARITY.-The Hospital of St. Katharine was founded and richly endowed by Queen Matilda in the year 1148, and was originally served by the Augustine monks of the neighboring Monastery of the Holy Trinity. The hospital was dedicated by this Queen to St. Katharine, in pure and perpetual alms, for the repose of the souls of her son Baldwin and her daughter Matilda. Queen Eleanor, widow of Henry III, after a long struggle with the monks, succeeded in regaining control of the hospital for the crown, and in 1273 founded the hospital afresh for a master, three brother chaplains, and three sisters, ten poor women called bedswomen, and six poor scholars: the right to nominate the master, chaplains, and sisters was reserved to herself and the queens of England, Among subsequent benefactors of the hospital, which appears to have hitherto been a purely religious and charitable institution, we find Edward III and Phillippa, his wife, who granted certain lands in Kent and Hertfordshire, and a new charter which specially prescribed visitations of the sick as one of the duties of the community. Richard II, Henry V, Henry VI, Edward IV, Henry VIII, and Queen Katharine were benefactors of the hospital, which escaped extinction when the other religious houses were suppressed, owing, it is said, to the personal intercession of Anne Boleyn. However this may be, her daughter, Queen Elizabeth, took some interest in the hospital and preserved it from destruction.

her successors.

DEATH FROM CHLORAL.--Mr. Peter Henry McClaren, L. R. C. P., of Bedlington, England, died recently from the effects of a dose of chloral, taken to procure sleep.