evaporating this in a tarred porcelain, glass, or platinum dish. In the other solution the casein is estimated by making up the 200 cubic centimeters with distilled water, and precipitating by means of two cubic centimeters of the acetic acid solution. The liquid being then. poured through a tarred filter, the separated casein is retained, and may be dried and weighed. The filtrate contains the sugar of milk, or lactose, which may be easily estimated by Fehling's solution. The whole of these eliminations are said to be easily performed in less than two hours. At the commencement of the process 20 cubic centimeters of the milk should have been acidulated with one cubic centimeter of the acetic solution, and set on a water bath to evaporate, and finished in a hot-air bath. This being done in a platinum crucible, the dry residue, after weighing for total solids, can be ignited, and the weight of ash determined. The complete analysis giving butter, casein, lactose, ash, and water by difference is thus obtained within two hours, the results, with ordinary care and skill in manipulation, being most reliable.

Mr. Harrison Cripps, of St. Bartholomew's Hospital, a well-known authority upon diseases of the rectum, at the last meeting of the Pathological Society of London, showed a specimen of stricture of the rectum. In his experience he found syphilis to be by no means so common a cause of stricture as was sometimes said, and he believed that in many cases it was due to contraction of pelvic cicatrices, leading to distortion of the rectum. He also found that stricture of the rectum was ten times more common in women, who were liable to pelvic cellulitis, than in men, whereas the reverse proportion held with regard to syphilis.

A committee has been formed for the purpose of raising a permanent record of Dr. Redwood's services to chemistry in its relation to medicine and pharmacy. It is proposed to found a Redwood Scholarship. The occasion of the movement is the retirement of Dr. Redwood from the Professorship of Chemistry to the Pharmaceutical Society, which he has held since 1842. The executive committee includes the names of the President of the Royal Col

lege of Physicians (Sir W. Jenner, Bart.), the President of the General Medical Council (Sir H. Acland), Sir G. Burrows, Sir Spencer Wells, and most of the leading men of the profession residing in London.

LONDON, January, 1886.

Translations.

PROVISIONAL CURE OF AN EXTREME SARCOMATOUS GROWTH ON A CHILD'S HEAD BY AN ATTACK OF ERYSIPELAS.-Two years ago a girl, then two years old, was sent to me with sarcomatous growth about the size of a hen's egg, and extending deep into the throat. I advised that the patient be sent to Prof. Lücke at Strasburg, with a view to operation. My advice was not followed. Afterward the astonishing report came to me that the swelling had healed. I supposed that perhaps the greater part of the growth had sloughed away, but that a portion still occupied the left tonsil.

Three months ago I saw the child, when her condition was simply horrible. The tumor had invaded the whole of the back part of the mouth and pharynx. The tongue, pushed forward by the swelling, its left half was an ulcerous mass projecting between the lips. Portions of the tumor occupied the nostrils, the alæ nasi, well on to the cheek-bones (here only under the skin), thence under the inner part of the eyelids, having probably utilized the lachrymal canal, so that the right eye seemed buried in the ragged mass. The child had numerous attacks of dyspnea that threatened its life. It grew more and more difficult to nourish it. When it was brought into the hospital, on the 13th of November, it entered the hospital with every appearance of dying soon. The stench from the tumor made it necessary to isolate the patient. An attack of dyspnea rendered a trachetomy necessary the next day. The patient occupied a room recently vacated by a tedious case of erysipelas; the room, however, having been disinfected, and fresh bedding supplied. On the 17th erysipelas set in, not at the seat of the tracheotomy but in the tumor of the right eye, with a temper

ature of above 104°. I instituted no special treatment of the erysipelas, mainly that the child might die easily, and also, if it lived, that the erysipelas might have undisturbed action upon the tumor. The latter occurred in a most extraordinary manner. Within the next five days, when the fever of the erysipelas disappeared, the tumor had melted away in every direction. The face looked quite as if nothing had happened to it, the eyes were free and clear. A few scars only occupy the eyelids and the nostrils where ulceration of the skin had taken place. The tongue, nearly one half of which had been destroyed, was drawn to one side by a huge cicatrix; the throat had undergone much cicatricial change, the soft palate, which had been perforated, had become adherent to the posterior wall of the pharynx, and the gums to the tongue. Thirteen days after the tracheotomy the canula was removed altogether. Breathing, swallowing, and speaking are all accomplished fairly well. The child's appetite is something extraordinary, and in twenty-six days after the operation she was decidedly sprightly. There remained on

the upper lid and on the end of the nose tumors the size of a pea, which were removed. Microscopic examination of the growth disclosed a round-celled sarcoma; the cells comparatively small, the nuclei already much divided. I naturally fear that the trouble will be again developed from cells still remaining at the seat of the tumor, and think the proper thing to do would be to inoculate with erysipelas, by means of Fehleisen's coccus, in order to get a repetition of processes which have proved so remarkable.

The results attained in this case would seem to warrant such a procedure in other tumors not amenable to operation. Two views of the manner in which the apparently curative action of the erysipelas was exercised may be expressed. Either the micro-organism of the erysipelas, by means of the peculiar bloodchanges it produced, has destroyed the sarcomatous tissue, or it has destroyed a multiplying (as yet unknown) microbe, which is at the bottom of the sarcoma and the changes produced by it. Since the latter process. requires a considerable period of time, it

seems to me that the rapid melting away of the neoplasm in the present case, clearly favors the first view, especially when we reflect how long destructive effects outlast the death of tubercle bacilli. The patient unquestionably continues up to date, January 1, 1886, uncommonly well, and dry cicatrices free from resi due occupy the former site of the tumors.

Any future change in the case will be made public. The facts, as I have related them, certainly seem to warrant the application to practice of the principle indicated.-Deutsche Med. Zeitung.

MILK-WINE OR KOUMISS.-Franz Kogelman, of Gratz, chemist, says we should no longer be dependent on the imported article, as we have the proper ferment in buttermilk.

If one volume of buttermilk be mixed with one or two volumes of sweet milk, in a short time lively fermentation sets in, and in about three days the work is completed. This produces a wine-scented fluid, rich in alcohol, carbonic acid, lactic acid, and caseine, which, according to all investigations yet made, is identical with koumiss. By this means, every one can provide this drink at a trifling cost. The following practical hints for the production of a good article will be found useful:

The sweet milk used should not be entirely freed from cream. The bottles should be of strong glass and only two-thirds filled. The fermenting milk must be industriously shaken at least three times a day, and then the cork put in firmly, so that the fluid will become well charged and cause the carbonic acid to escape forcibly on opening the bottle. The bottles must be daily opened, and at least twice each day brought nearly to a horizontal position in order to allow the carbonic acid to escape and air to enter; otherwise, fer

mentation rapidly ceases. If a drink is desired strong in carbonic acid, the bottles, toward the end of fermentation, should be placed with the necks down. In order to ferment a fresh quantity of milk simply add one third of its volume of either actively fermenting or freshly fermented milk. The temperature should be from 52° to 68° F. About 60° being the most favorable.-Ibid.

PEPTONE IN THE INCUBATING EGG.-In explanation of the frequent occurrence of peptonuria during pregnancy, Dr. W. Fischel, of Prague, suggests that peptone may play an important role in the nourishment of the embryo and its membranes. Any excess of peptone not appropriated in the formation and nourishment of the embryo might succeed in reaching the mother's blood, and be again excreted with the urine. If the tissues of the embryo are built up out of peptone in the same way that the construction and maintenance of the already-prepared tissues is effected with peptone prepared in the alimentary canal, peptone should also be found in sitting-eggs. Acting on this suggestion Dr. F. instituted a series of investigations, resulting in the discovery of peptone in seven embryos, and seventeen times in the remains of the egg, in forty-two tests, made from the sixteenth to the nineteenth day of incubation.-Ibid.

THE FATE OF PEPSIN AND TRYPSIN IN THE ORGANISM.-Sahli has recently announced that in normal urine, besides pepsin, the constant albuminous ferment of the stomach, trypsin, the peptonizing agent of the pancreas, is also present. Dr. Leo, of Berlin states that pepsin is constant in normal urine; in all investigations hitherto undertaken in cases of cancer of the stomach or ileo-typhus, he has observed a marked diminution, or even an entire absence of pepsin in the urine. In accord with Kuene, however, Dr. Leo is not convinced that trypsin is to be found in normal urine. To account for the non-appearance of trypsin in the urine, it is to be supposed either that it is pepsin unappropriated with the feces, or is destroyed in the alimentary canal, or on its way from there to the kidneys.-Deutsche Med. Zeitung.

TEMPERATURE AND THE FILTRATION OF ALBUMEN SOLUTIONS.-Dr. Adolph Loewy, of Berlin, has been making a series of experiments bearing on the influence of temperature on the filtration of solutions of albumen (white of egg and blood serum), with the following results:

temperature, and in proportion to the increase of temperature.

2. The solid constituents of the filtrate are increased in their absolute mass by higher temperature, and also in proportion to the increase of temperature, and the relative mass of solid residuum was increased in nine cases out of eleven.

3. The absolute value of the organic constituents (the residue less the inorganic substances) show increase or decrease corresponding with the increase or decrease of temperature. The percentage of the organic substances was, in most cases, increased.

4. The inorganic substances appear to pass the filter in larger masses under higher temperature, but elevation of temperature has less effect upon them than upon organic substances. Ibid.

PNEUMONIA TREATED WITH LARGE DOSES OF DIGITALIS.-Petrescu, of Bucharest, reports remarkable success in the treatment of acute pneumonia from the administration of large doses of digitalis, given in the form of recent infusion. His conclusions, based upon the observation of three hundred and fifty cases, are as follows:

1. Digitalis causes antiphlogistic and diuretic effects only when given in appropriate doses. 2. This dose is from one to one and a half drams, given during the twenty-four hours, and continued for several days. He has given as much as five drams inside of three days.

3. The treatment of pneumonia by digitalis is the only method at present of reducing the mortality of the disease to a minimum.Ibid.

IODINE IN THE TREATMENT OF CHRONIC RHEUMATISM.-M. A. Fort (Union Médicale) gives the following formula:

Potassium iodide,................................ 5 drams; Potassium bromide,.........75 grains; Syrup of gentian,..... .18 ounces; Tincture of iodine,...20 drops. A tablespoonful to be taken, morning and evening, in chronic articular rheumatism, and the affected joints to be painted with tincture

Abstracts and Selections.

RECENT METHODS OF TREATMENT OF THE ASPHYXIA OF NEW-BORN CHILDREN.-Wm. L. Reid, M. D., writes, in the Glasgow Medical Journal:

It would be interesting to examine all the various plans which have been published, from Smellie's simple one of whipping the child well and rubbing its mouth and nose with onions, to that of Woillez, who puts it up to the neck in the receiver of an air-pump, and alternately rarefies and condenses the contained air. we must content ourselves with adverting to those which have been of late years held in most repute, excluding those which necessitate the employment of complicated apparatus.

But

Besides that of Dr. B. S. Schultze, Professor of Midwifery in Jena, there are eight methods before the obstetric public:

1. Marshall Hall: The patient is turned face downward so as to press on the chest and cause expiration, then turned on the side so as to free the chest from pressure, and produce inspiration by means of the elasticity of its walls.

2. Howard: The arms are extended, the wrists being brought together over the head and the chest thus expanded. The lower ribs are then alternately pressed on and relieved from pressure, so as to cause expiration and inspiration.

3. Sylvester: The arms are raised upward and forward for a few seconds, and then pressed firmly down against the sides of the chest. By means of their muscular attachments the ribs are raised and air sucked in, which is expelled when the arms are brought down again.

4. Pacini: The feet are fixed, and the operator, standing with the head against his own abdomen, seizes the arms at axillæ and pulls the shoulders upward and forward, then allowing them to return to their former position.

5. Bain: The shoulders are raised by lifting the body a foot off the table by seizing its hands. They are then allowed to fall back again, thus causing alternate expansion and contraction of the thoracic cavity.

6. Schücking: Like Sylvester's, except that he carries the arms outward as well as upward. 7. Schüller: The operator puts his fingers under the edges of the ribs, and pulls them up, afterward depressing them.

8. Schroeder: The body is supported by one hand placed under its back, allowing the head, shoulders, arms and pelvis to fall backward with the view of producing inspiration, expiration being caused by sharply bending the body forward so as to compress chest and abdomen.

Lastly, Schultze's method: The child is to be suspended a few inches from the floor, by the two index fingers placed in the axillæ from behind, the thumbs lying loosely over the front of the thorax, and the other fingers spread also loosely over the thorax behind, the head being supported against the edges of the ulnar bones. Without delay in this position, the child is swung sharply upward until the operator's arms are extended horizontally, then the upward movement is continued more gently so as to bring the legs slowly past the perpendicular and allow them to sink quietly against the front of the child's body. The weight of the latter is now supported by the thumbs in front of the thorax, and the chest pressed on all round by the fingers, and its arms laid against its sides. This compression, through the diaphragm below and the fingers all round, causes aspirated fluids to flow freely from the mouth and nose. After being retained in this position a few seconds, the body is swung smartly down again into its former position, taking care that now there is no compression of the chest, either before or behind, but simply a suspension of the child on the index fingers. During this movement the contents of the abdomen, partly by gravity and partly by centrifugal force, fly away from the diaphragm, and, dragging it down, enlarge the chest below. At the same time the arms are separated from the sides, and by their muscular attachments drag the ribs upward, and in this way air is sharply drawn into the lungs. These movements are continued every four or five seconds, unless when a considerable quantity of fluid continues to come from the mouth and nose, when the movement of expiration is on that account prolonged.

A few years ago Dr. F. H. Champneys, Assistant Obstetric Physician to St. George's Hospital, London, undertook a series of experiments on the fresh bodies of newly-born children with the view of finding out simply which method took most air into the chest. The methods tested were the nine I have already mentioned. The conclusions, among others, to which Dr. Champneys came, are these:

"Since the position of equilibrium of a stillborn child's chest is one of absolute expiration, airlessness, or collapse, no method which depends on elastic recoil of the chest walls will introduce air into its lungs. The methods of Marshall Hall and Howard are useless as means of directly ventilating the lungs of still-born children." "Sylvester's method and its modification by Pacini and Bain introduce more air into the lungs than any other method." "Schücking method is no improvement on Sylvester's." "Schüller's method is

useless, and not free from risk." "Schroder's method is useless." "Schultze's plan, although its power of ventilation is less than that of Sylvester and its modifications, yet acts efficiently. The violence of the action of the method of Schultze is not in its favor."

Barnes says, "We need only mention Schultze's method of swinging and tossing the child. It has not been shown to possess any advantage to compensate for the violence which characterizes it." On the same page he adds, "We have tried all these methods excepting Schultze's." It will be long before any method can be shown to possess any advantage if the people condemn it before giving it a trial.

Given the birth of an apparently dead-born child, how ought we to proceed with its treatment? Personally, I believe in hanging it up by the heels with one hand, and clearing out its mouth and throat with the forefinger of the other. If this, followed by sharp whipping of the buttocks with the loosely hanging fingers, does not excite inspiration, I proceed at once with Schultze's method. The following is his own plan: "If the heart is beating strongly, and the child only in the livid state of asphyxia, the cord is not cut, but the mouth cleared out, and cold water squirted on the pit of the stomach and nape of the neck. If the heart's action is weak to begin with, or becomes weak, the cord is divided, allowing three or four teaspoonfuls of blood to escape, and the child dipped suddenly up to the neck in cold water. This failing, or when the child is born in the pale stage of asphyxia, after dividing the cord, clearing the throat, and pulling forward the tongue, swinging is at once had recourse to. The expiration position being gained, fluid pours out of the air-passages by the mouth and nose, and as soon as it ceases the inspiration position is assumed, when oftentimes the air is heard whistling through the glottis. These movements are to be executed eight to ten times, occupying, in all, about a minute. Aside from the ventilation of the lungs, and the removal of fluids from the airpassages, the alternate raising and lowering of the pressure in the thorax acts mechanically in promoting the action of the heart, and the circulation of the blood. In this way oxygen is sooner carried to the medulla, restoring its power of setting up breathing, and this may be proved by noticing that the skin becomes. redder even before spontaneous breathing has occurred. Often a little whimpering sound tells that weak efforts at inspiration are being made, and the swinging must then be timed so that the artificial shall coincide with the natural attempts at breathing. After eight or

If

ten swings the child is put into a warm bath (95°-100° F.) to do away with the evil effect of rapid cooling, and to observe the result of the treatment. If there is no movement, it is swung again for another minute. If there is slight regular movement, the medulla is roused by dipping to the neck in ice-cold water. the asphyxia recur swinging is resumed, although this is always a bad sign, showing that there is an effusion of blood on the brain, or malformation of the respiratory or circulatory organs. The artificial means must not be stopped until the heart's action is completely restored, and the child cries loudly. In the case of a premature child with weak chest walls, or where after swinging a few times no air is heard to enter, it is a wise practice to pass a catheter into the trachea, blow in a little air to distend the air passages, and immediately resume the swinging."

In the employment of this method the following points must be attended to, and I again call your attention to them, because, as Schultze himself says, and as six years' personal and somewhat extensive experience of it has taught me, the success of it depends entirely on the thoroughness of its performance. (1) The first movement must be that of expiration, else the contained fluids will be sucked still deeper into the air-passages. (2) The downward movement must be a fairly sharp swing, else the effect on the diaphragm will be largely lost. (3) If no air is heard entering, either the swing has not been powerful enough, or the thumb and fingers have not left the thorax free, or the glottis is closed. In the latter case the catheter must be used immediately and the swinging resumed.

The three indications to be met are: Ventilation of the lung, acceleration of the circulation, and removal of inspired fluids. Ventilation of the lung alone, as by blowing in air, does little good, because, where the circulation is poor, oxygen is not carried to the nerve centers. Acceleration of the circulation alone, as by warm bath, is not very effectual, because, where there is no entrance of air, it can only do harm by increasing the central congestion. And so with the simple removal of fluids, as by inspiration through the catheter, for the mechanical irritation of its introduction may set up an attempt at inspiration which sucks the remaining fluid deeper into the airr-passages. The advantage of the method we are now considering is that time is not lost in trying to meet these indications one after the other; they are all being attended to at once. For seven years I have practiced it with certainly better results than I formerly obtained by Sylvester's plan.