sary; it seems to act equally well in other cases where pain is felt. In the late epidemic of influenza many cases had inflamed and ulcerated tonsils as one of the most prominent symptoms, and here baptisia acted very efficiently."-Prescription.

FORMULE FOR FERROPYRIN.

Ferropyrin is a compound of antipyrin and ferric chloride, introduced by Dr. W. Cubasch, a physician of Stansstad. It consists of 3 molecules of antipyrin and 1 molecule of ferric chloride, and thus contains 64 per cent. of antipyrin, 12 per cent. of metallic iron, and 24 per cent. of chlorine. It occurs as an orange red, impalpable, permanent pow. der, soluble in 5 parts of water at 15° C. (59° F.), but requiring 9 parts of boiling water for solution. Heating, therefore, precipitates it from its cold solution, in the form of ruby-red leaflets, melting between 220° and 225° C. (428° and 437° F.). It is soluble also in alcohol, wood spirit, or benzol, but almost insoluble in ether.

Dr. Cubasch has employed ferropyrin in anæmia, chlorosis, migraine, divers neuralgias, and in other affections where a combination of iron and antipyrin appear to be indicated. The dose is 0.5 to 1 gramme (7% to 15 grains).

In anæmic and chlorotic patients, especially if they complain of headache, migraine, gastralgia, or other similar nervous affections, the beneficial effects were quickly noticeable, even when the remedy was given in small doses.

M. Sig. Tablespoonful every three hours.

Nervous troubles, headaches, gastralgia, and other painful symptoms, if of chlorotic origin, usually disappear during the first week of the treatment, it is reported; the appetite is improved, the menses become regular, and oedema is quickly removed.

Topically, ferropyrin has proved an hæmostatic and astringent of great value. Dr. Hedderich, of Heidelberg, has used it in many operations of the nose and throat, and found it a reliable styptic, possessing the advantage over other drugs of this class of being free from caustic properties. In nose-bleed it may be used in powder, or in 20 per-cent. aqueous solution, to arrest bleeding; and in

American Medico-Surgical Bulletin.

PERIPHERAL FACIAL PARALYSIS IN SecondARY SYPHILIS.-A case of peripheral facial paralysis in the secondary stage of syphilis is reported by A. Boix. Simultaneously with the facial paralysis there was a herpes zoster occipito-cervicalis. A cure was accomplished in six weeks. As the cause of the affection, Boix considered a compression of the facialis by meningitis sclero-gummosa, from osteitis or periosteitis of the aqueduct of Failopius. Syphilitic neuritis was excluded. The appearance of the paralysis in the secondary stage presaged an early occurence of tertiary symptoms and indicated a high degree of intoxication.-Virginia Medical Monthly.

of that disease with blood-serum, and Dr. De Lancey Rochester, of Buffalo, N. Y., read a report of thirty-three cases treated by Carosso's method. An afternoon was mainly occupied with papers and discussions on malaria,—a subject which appeals forcibly to practitioners in many parts of the United States. A noteworthy contribution was a statistical report on malaria and its complications by Prof. James M. Anders, of Philadelphia.

In the section on Surgery and Anatomy the subject of appendicitis was discussed, and Dr. De Garmo, of New York, read a careful paper on the surgical treatment of hernia. Professor Senn presented a paper upon the treatment of malignant tumors by the toxins of the streptococcus of erysipelas. The distinguished speaker had formed a conclusion adverse to the employment of this method. An interesting communication by Dr. David D. Stewart, of this city, described a case of sacculated aneurism successfully treated by electrolysis through introduced wire.

In the section of Obstetrics and Diseases of Women the treatment of uterine fibroids was considered from different points of view, by Drs. Joseph Eastman, of Indianapolis; A. Lapthorn Smith, of Montreal, Can., and Byron Robinson, of Chicago. Professor Senn described the technique of a new method of abdominal hysterectomy. Dr. G. Betton Massey reported his results in the treatment of hæmorrhagic conditions of the uterus by zinc amalgam cataphoresis. Several papers upon symphysiotomy were presented.

chairman, Dr. John F. Fulton, of St. Paul, Minn. Dr. Turnbull, of Philadelphia, read an important paper on the "Treatment and Prognosis of Chronic Catarrh of the Middle Ear, with Deafness."

In the section on Diseases of Children papers upon typhoid fever in juvenile patients gave rise to an interesting discussion. Papers were also read upon the use of antitoxin in diphtheria. Hypnotism was thoroughly discussed from several points of view by the neurologists, and important communications were offered in regard to the employment of electricity in various diseases of the nervous system.

In Dermatology, Dr. T. E. Gilchrist, of Baltimore, exhibited protozoa in three cases of skin disease, and likewise presented a report on the pathology of herpes zoster. A number of syphilitic lesions were described by Ravogli, Bulkley, and Tuttle. Many important papers were laid before the Section on State Medicine. A notable feature of the meetings of this section was a symposium on alcohol, by members of the American Medical Temperance Association. Altogether, the proceedings of the forty-sixth meeting were instructive and profitable to the assembled members.

A subject which has caused much discussion and controversy was laid at rest by the determination of the Trustees, that the editor, with the close of the present contracts, should accept no advertisements of medicinal preparations the proprietors of which do not give a formula containing the official or chemical name and quantity of each composing ingredient to be inserted as a part of the advertisement.

In the section of Laryngology and Otology a thoughtful address was delivered by the

MISSISSIPPI VALLEY MEDICAL ASSOCIATION. -The twenty-first annual meeting of this Association is to be held at Detroit, September 3, 4, 5, and 6, 1895. Dr. W. N. Wishard, of Indianapolis, Ind., is the President of the Association, and Dr. H. O. Walker, of Detroit, Mich., is the Chairman of the Committee of Arrangements.

AN EXTRAORDINARY CASE OF SYPHILIS OF THE TONSILS.

IN

N the overwhelming majority of cases the progress of syphilis and the aspect of its lesions are so characteristic that, even in the absence of a history of infection, a careful observer can experience but little difficulty in forming a diagnosis. Nevertheless, in every stage of the disease, we from time to time meet with manifestations which depart decidedly from the typical picture, and which compel us to pass in review various possibilities before we are justified in arriving at a positive conclusion. The initial sore may differ so widely in appearance from the Hun terian chancre as scarcely to be recognized. The superficial erosion of Bassereau is a well known and common form of preliminary lesion and should not be mistaken. The herpetiform multiple chancre of Dubac, however, is quite capable of begetting confusion, and the same is true of the "infecting balano-posthi tis" described by Mauriac.

As regards constitutional syphilis the fever which ushers in the secondary stage is at times so intense as totally to obscure the diagnosis, and may suggest the existence of an eruptive fever. A precocious outbreak of lesions which usually belong to a late secondary period not infrequently disturbs our conception of the march of the disease. Relapsing indurations, ulcerations, or ulcerated gummata upon the penis of old syphilitics are also capable of misleading the surgeon. Gummata in various situations sometimes bear a close resemblance to benign or malignant non specific neoplasms. Finally, some unknown element of personal constitution may so modify a syphilitic lesion as to render a prompt diagnosis extremely difficult. It is of importance, therefore, that unusual manifestations of so wide-spread and destructive a disease as syphi lis should be placed on record for the guidance of the profession.

For such reasons a case described by Dr. J. Sendziak, of Warsaw, is of unusual interest.* The patient, an unmarried woman, 28 years of age, had suffered for three weeks from a

"Cas extraordinaire de Syphilis des Amygdales." Revue de Laryngologie, d'Otologie, et de Rhinologie, May 1, 1895.

sore throat and swelling of lymphatic glands. on the right side of the neck. The trouble began suddenly with a slight fever of short At the first examination white duration. patches were seen upon the right tonsil, and the patient stated that they had been present from the commencement. The general condition was good, but, notwithstanding the use of gargles, cauterizations, and insufflation of antiseptic powders, there had been no improvement in the throat. The case had been thought by good observers to be one of diph. theria. The glandular swelling was about the size of a walnut and very painful to pressure. The skin by which it was covered was neither red nor adherent. The throat presented a remarkable appearance. The right tonsil was increased in size in the vertical diameter and narrowed considerably the passage. The singularity of the appearance was that the tonsil was entirely covered by a bluish-white, thick, and fatty membrane, which could not be detached from the parenchyma of the gland. The other parts of the buccal and pharyngeal cavity presented no apparent change except that the lingual or fourth tonsil was slightly reddened and considerably enlarged, but not covered by a patch.

An

Although Dr. Sendziak dismissed the thought of true diphtheria, it occurred to him that the case might be one of that so-called angina known as chronic fibrinous tonsillitis, a benign affection, marked by thick, diffuse membranes, with or without moderate inflammatory symptoms, the membranes renewing themselves after their fall or removal. This malady has nothing in common with genuine diphtheria, as is proved by bacteriological examination. other supposition was that the case might be one of the forms described by Cadet de Gassicourt as "prolonged diphtheria,”—a chronic disease (with exacerbations) lasting a month or more, and not accompanied by fever. thought of syphilis was dismissed at the time on account of the entire absence of lesions of the skin and lymphatic glands (except the right submaxillary gland), of any history of acquired or hereditary disease, and the dissimilarity of the local manifestations to those typical of lues.

The