come out of this ordeal with great credit, as in only two cases did the errors mount up so largely as to be scheduled, while "co-operative stores" figure on the black list three times, the "doctor's shop" once, and the "drug company" three times. Thus, to put it in another way, 75 per cent of the prescriptions dispensed by the latter class are untrustworthy, 50 per cent of those from doctor's shops belong to the same category, while 20 per cent of the prescriptions dispensed at the stores, and 6 per cent of those at a regular druggist's, will also exceed the margin of error. The moral is obvious.-British Medical Journal.

INOCULATION FOR THE CONTROL OF PHTHISIS. The mortality from phthisis in Paris has amounted in two months to more than one thousand, and it is reported that, with the object of checking this excessive death-rate, French savans are about to try the principle of inoculation, which, under M. Pasteur's recent discoveries, has been received with such extraordinary favor by French professional men. It is proposed to obtain subscriptions for a series of experiments, to be conducted on a large scale over a considerable area and for a period sufficiently long to make the results trustworthy. The influences of climate will be tested by the establishment of different stations for these tentative researches and operations. One of these stations is to be situated on the northern coast, near Boulogne, another in the warmer temperature of the Riviera. Records will be kept of the various experiments, and a journal devoted to chronicling them. The support of several eminent medical men has been already promised, and subscriptions in aid of the project have commenced to flow in. While devoting itself chiefly to experiments on live animals by inoculation, the society will also study to effect the alleviation of phthisis by the destruction of microbes. London Lancet.

is, in fact, the generic name for the volatile oils or hydrocarbons, isomeric or polymeric, with oil of turpentine. Nearly all the terebenes are liquid at the ordinary temperatures, and most of them are lighter than water. Natural terebenes treated with acids, especially strong sulphuric acid, generally undergo an alteration of molecular arrangement without change of chemical constitution, the odor being for the most part greatly altered. A terebene often yields several isomeric modifications by treatment with various acids, or by repeated distillation with the same acid. The substance called pure terebene is made by the action of concentrated sulphuric acid on oil of turpentine. The process is an old one, and, as far back as 1873, M. Riban read a series of papers on the subject before the Pharmaceutical Society of Paris. To prevent any misconception, it may be as well to state that the pure terebene used in the treatment of bronchitis is not a patent medicine; and that it may be made or sold by any body without the slightest fear of infringing any patent rights.

PTOMAINE IN STALE FISH.-Last year several cases of poisoning by stale sturgeon occurred at Kharkov; five terminated fatally. Anrep, studying the cause of these accidents, showed that a ptomaine was the efficient cause, and could be extracted from the fish, as well as from the contents of the stomach and intestines, the liver, blood, brain, and urine of the victims. The alkaloid differs from the ptomaines of Brieger. It is an amorphous, highly alkaline body, forming soluble salts, and extremely toxic. Caustic agents and boiling destroy the toxic power of the alkaloid, which has two chief characters, viz., its fixity, whether in the solid state or in ethereal solution, and the slowness of its reducing action on the blood. The hypodermic injection of a quarter of a milligram in a dog causes vomiting, mydriasis, general prostration, and slowness of the movements of the heart. In the rabbit the action is much more rapid, and the above-mentioned dose causes death in two hours. The march of the symptoms in the poisoned individual is in harmony with the results of physiological research, and indicates, according to Anrep, that

the poison first paralyzes the spinal cord, then the medulla oblongata, and acts, probably, on the plain muscular tissue.-London Lancet.

KENTUCKY DELEGATION TO THE AMERICAN MEDICAL ASSOCIATION.-The following is the list of delegates to the approaching meeting of the American Medical Association, appointed at the last meeting of the Kentucky State Medical Society:

William Bailey, J. A. Larrabee, D. S. Reynolds, J. M. Mathews, William Cheatham, F. C. Wilson, M. F. Coomes, W. O. Roberts, J. B. Marvin, J. P. Thomas, L. B. Todd, J. H. Letcher, Horatius Mann, J. N. McCormack, L. S. McMurtry, Fayette Dunlap, R. C. McCord, O. D. Todd, A. W. Johnstone, H. Brown, and Edward Alcorn.

Those whose purpose it is to attend the meeting of the National Association in St. Louis, are requested to notify the Secretary, Steele Bailey, M. D., Stanford, Ky., at once, giving exact address, so that credentials may be made out and forwarded. All members whose names are embraced in the above list, who will not attend, are requested to so notify the Secretary at the earliest possible date, in order that alternate delegates may be accredited, thereby assuring the Society's membership of full representation in the National Association.

BAD MEDICINE IN CHINA.-Whenever an unskillful physician, in administering medicines or using the acupuncture needle, proceeds contrary to the established forms, and thereby causes the death of the patient, the magistrate shall call in other physicians to examine the medicines or the wound. If it appear that the injury done was unintentional, the practitioner shall then be treated according to the statute for accidental homicides, and shall not be allowed any longer to practice medicine. But if he have designedly departed from the established forms, and have practiced deceit in his attempts to cure the malady, in order to gain property, then, according to its amount, he shall be treated as a thief; and if death ensue from his malpractice, then, for having thus used medicine with intent to kill, he shall be beheaded.-Chinese Penal Code.

To the Medical Officers of the Marine-Hospital Service, Customs Officers, and others concerned :

Official information having been received that the smallpox, which recently prevailed as an epidemic in certain provinces of the Dominion of Canada, is now under control, therefore the Regulations issued October 10, 1885, for the maintenance of quarantine inspections on the northern frontier of the United States, are hereby revoked. JOHN B. HAMILTON,

Supervising Surgeon-General.

WASHINGTON, D. C., March 17, 1886.

THE CREDIT SYSTEM.-A writer in the London Medical Press says:

The credit system prevalent among the habits and customs of the populace is the chief grievance of the doctors. While every other free and independent citizen, as a rule, demands cash down for his wares or services, a doctor is the only man whom an utter stranger has the impudence to expect gratuitous services from, or to ask him to give his advice and medicines on trust. Point d'argent point de suisse, or, No coin no advice, should become the motto of the doctor as it is that of the lawyer.

LACTIC ACID AS A CAUSTIC. - MosetigMoorhof (Centralblatt für Chirurgie) recommends this acid in lupus fungating growths, rodent ulcer, and papillomata. Its value consists in its sparing the sound tissues. The simplest mode of application consists in mixing equal parts of lactic acid and finely powdered silica. This is spread thickly on gum-paper, and retained in position for twelve hours, removed, and renewed twenty-four hours afterward. From five to seven applications serve to cure lupus.

DR. H. J. BIGELOW has declined to accept the appointment which was tendered him at the Massachusetts General Hospital as "surgeon emeritus," and also the five beds which were placed at his disposal.

THE Western Pennsylvania Medical College is the name chosen for the newly organized college in Pittsburgh, Pa. We are informed that it has been liberally endowed, and will begin lectures in October next.

LONG-CONTINUED ALBUMINURIA.-We once asked Dr. Johnson how long he had known a case of albuminuria to extend. He replied, thirty years. We may safely conclude that a disease which could be extended over thirty years might, with more care, extend over forty, and leave life very much uncurtailed. But this implies great care on the part of the patient and physician alike.-London Lancet.

RUSH MEDICAL COLLEGE, CHICAGO.-The forty-third annual commencement exercises of Rush College took place at Central Music Hall on the 16th ult. The graduates in a regular course numbered 156; the Honorary degree was conferred on five gentlemen: Dr. Daniel Hack Tuke, of England; Dr. Grant, of Cairo, Egypt; Dr. Haecker, of Hamburg, Germany, and Drs. Hanna and Sheffield, of Illinois.

J. MILFORD BARNETT, M. D., M. R. C. S., L. M., retired surgeon H. M. Indian Army, College Gardens, Belfast, Ireland, says: "I have tried bromidia, and with very encouraging results. In it the hydrate of chloral is well masked and modified, and the combination seems to diminish the chloral's weakening power on the heart."

FOR INFLAMED PROSTATE.-Acute inflammation and enlargement of the prostate is much relieved by the continued application of hot water to the perineum, and its injection into the rectum, giving directions for its retention. The pain often subsides in a very short time, and micturition becomes easier.-Medical World.

DR. DANIEL G. BRINTON, whose work on American Ethnology was recently very favorably criticised in the Atlantic Monthly, has been made laureate of the Société Amêricaine de France for 1885, and has been awarded the medal of the Society for his works on the aboriginal tongues of America.

NICKEL-PLATED COOKING UTENSILS DANGEROUS.-The Supreme Sanitatsrath of Vienna, having submitted nickel and nickel-plated cooking utensils to a careful chemical examination, has decided that their use, from a sanitary point of view, is not free from serious objection.

DR. JOSEPH HOLT, President of the Louisiana State Board of Health, has been appointed a member of the Council of the Section on Public Health and Hygiene of the next International Congress, Dr. Joseph Jones, of New Orleans, being President of the Council.

Army and Navy Medical Intelligence.

OFFICIAL LIST of Changes in the Stations and Duties of Officers serving in the Medical Depart ment United States Army, from March 14, 1886, to March 27, 1886:

Captain John R. Van Hoff, Assistant Surgeon, ordered from Department California to Department Missouri. (S. O. 60, A. G. O., March 13, 1886.) Assistant Surgeon John J. Cochran, ordered for duty as Post Surgeon, Fort Mason, Cal. 48sistant Surgeon A. S. Polhemus, ordered for duty at Presidio of San Francisco, Cal. (S. O. 18, Department Cal., March 15, 1886.)

OFFICIAL LIST of Changes of Stations and Duties of Medical Officers of the United States Marine Hospital Service, for two weeks ended March 27, 1886:

P. H. Bailhache, Surgeon, detailed as chairman Board of Examiners, March 15, 1886. C. S. D. Fessenden, Surgeon, detailed as member Board of Examiners, March 15, 1886. George Purviance, Surgeon, detailed as recorder Board of Examiners, March 15, 1886. Wyman, Walter, Surgeon, detailed as chairman of board for physical examination officer, Revenue Marine Service. March 27, 1886. Sawtelle, H. W., Surgeon. Granted leave of absence for thirty days. March 27, 1886. win, Fairfax, Passed Assistant Surgeon. Granted leave of absence for seven days. March 22, 1886. Ames, R. B. M., Passed Assistant Surgeon, detailed as recorder of board for physical examination officer, Revenue Marine Service. March 27, 1886. White, J. H., Assistant Surgeon. Granted leave of absence for three days. March 23, 1886.

Ir

VOL. I. [NEW SERIES.]

Certainly it is excellent discipline for an author to feel that he must say all he has to say in the fewest possible words, or his reader is sure to skip them; and in the plainest possible words, or his reader will certainly misunderstand them. Generally, also, a downright fact may be told in a plain way; and we want downright facts at present more than any thing else.-RUSKIN.

Original Articles.

Erysipelas and Other Septic and Infectious Dis-
eases incident to Injuries and Surgical
Operations Prevented by a
Method of

ATMOSPHERIC PURIFICATION. [CONTINUED FROM THE LAST NUMBER AND CONCLUDED.]

BY DAVID PRINCE, M. D.

I. November 17, 1884. Mrs. S., forty-eight years of age, childless. A tumor was first noticed six months ago. Uterus low down in the pelvis, not moving by pressure upon the abdomen.

18th. Cathartic and quinia, five grains (.33 gram).

19th. 8 A.M. Tr. digitalis, six minims (.4 cc.), sulph. cinchonidia and quin. s. aa ten grains (.66 gram).

Operation from 9 to 11; the pedicle being retained in the wound and held by Atlee's clamp. The adhesions were not important. The sutures were of silk, supplemented by long plastic pins with the twisted suture. The wound was dressed by a dry dusting of iodoform, carbolized oil, cotton, a pasteboard over the cotton, and adhesive strips over all, passing around the back.

In the shock immediately following the operation, there was a depression of temperature to 96° F. Eleven hours later the temperature had risen to 99°, and at no time afterward was it above 99.6°. There were nausea and vomiting on the second and third days, but the patient recovered in six weeks without any

No. 8.

mishap. The urine was evacuated partly by a catheter left in, and partly by a catheter introduced at intervals.

For a few days after the operation, sufficient morphia was given to secure comfort, and from five to ten grains of quinine were given daily to the completion of recovery. For a considerable time after the recovery, the patient complained, on moving about, of a drawing sensation, attributed to the tension of the pedicle, but this ultimately passed away entirely.

II. Mary H., aged seventeen, in good health until the discovery of a tumor, a few months ago, which has had a rapid growth, beginning in connection with a fever, which she had in October, 1884. The tumor extends three inches above the umbilicus.

Preparation by laxatives and quinia for two days before the operation, March 9, 1885, between 12 and 2.

A short incision was first made, and a trocar was introduced for evacuating the fluid. This failed in a great degree on account of its extremely multilocular character. The incision was then extended three inches above the umbilicus, and a sac with thin walls ruptured, spilling some fluid into the peritoneal cavity. After lifting out the mass, which was not adherent except to the omentum, the short and flat pedicle was tied in four sections by a salicylated silk ligature. Notwithstanding this, the principal vessel, after division of the pedicle, bled freely, spilling some blood into the peritoneal cavity. This vessel was twisted by pressure forceps, and the end of the pedicle was closed over by the peritoneal membrane with catgut sutures. The outer portion of the oviduct went with the tumor, so that the outer end of its central portion became closed in with the end of the pedicle.

After sponging out the blood (not removing

all the minute clots), the peritoneal lining on opposite sides of the wound was brought together by a continuous suture of catgut, and after this a suture of the muscles was made with catgut.

With a theory of holding the pedicle to the suture line of the abdomen, so that in case of a possible abscess forming in connection with the silk ligatures, the ends of these ligatures, which had been left long, were tied over the catgut sutures already mentioned, and then cut off short.

The cutaneous line of sutures was of three kinds, quilled, twisted, and interrupted.

The wound was covered by pledgets previously soaked in carbolized oil, by sublimated cotton, by a pasteboard, and by a roller bandage.

The spilling of fluid from a ruptured sac and of blood from an artery of the pedicle should be put down as avoidable accidents.

The silk ligature to the pedicle, and its retention by this ligature to the suture line, must be regarded as a bad element in the proceeding, as will appear in the sequel.

The operation was preceded by the hypodermic injection of morphia, one fourth grain, and tincture of digitalis, ten minims. At the close of the operation the pulse was 150, respiration 30, and the temperature 99.2°. Five hours later, pulse 150, respiration 28, temperature 103.2°. Eight hours later, pulse 134, respiration 36, temperature 101.6°.

Four drops of tincture veratrum viride were given.

Sixteen hours, pulse 132, respiration 36, temperature 103°.

Hypodermic injection of one fourth grain of morphine, and a cold-water coil was applied to the abdomen. The pulse, respiration, and temperature were gradually reduced.

Twenty-two hours, pulse 120, respiration 30, temperature 100°.

Morphine, one fourth grain, tincture veratrum viride, four minims.

sided under the application of the coil laid upon the abdomen and carrying cold water. Sulph. quinine in five-grain doses was given every day.

The case progressed uniformly, the temperature sometimes rising and again subsiding under the influence of the cold coil, until the thirteenth day, when offensive pus was found escaping from the hole made by one of the pins of the twisted suture. A syringe was employed to cleanse the supposed small pus cavity, and the suture line was not opened up, as might have been done.

On the eighth day, in connection with a movement of the bowels, secured by a cathartic, she became restless, and the pulse went up to 160, respiration 120, and temperature 104°

After death, which occurred in twelve hours from the incipiency of bad symptoms, there was found an abscess around the pedicle, closed in by adhesions which had given way, permitting fetid pus to enter the general peritoneal cavity.

It is conceived that an abscess had formed in connection with the silk ligature, and traveled along a path made unintentionally by silk coming into contact with a pin of twisted suture. Had the case been understood earlier, and the abscess pumped out and washed with carbolized or borated water, and cathartics not given, it is probable that the case would have proceeded to a successful termination.

The improved practice, avoiding silk and using exclusively animal material for ligatures and sutures, thus greatly diminishing the danger of the formation of abscesses, will be explained further on.

This putrefactive complication came from the air of the room in which the patient lay, and not from the room in which the operation was made.

III. Mrs. P., aged fifty, and mother of sev eral children. The duration of the tumor is three years, and it has been tapped twice-the last time but little fluid was obtained. The

The cold coil was discontinued.

On the fourth day there was a rise of pulse, respiration and temperature; pulse 140, respiration 25, temperature 102.6°, which sub

ness, with abdominal tenderness, leading to the probability of finding adhesions.

May 18, 1885. A cathartic at bed-time. 19th. Five grains of s. quinine morning, and

at noon.