was by this means at once rendered easy to examine, and the paralysis caused by the distension relieved. After this, the cecum should be first examined to ascertain whether it were distended, so as to localize the position of the obstruction. If it were in the large intestine it could be easily and rapidly found; if in the small intestine, it would probably lie not very far below the piece of intestine that had been opened, for the intestine just below the seat of obstruction was generally most distended. If this proved the case, the wound in the bowel could be made an artificial anus; if not, it must be closed and an artificial anus made close above the obstruction.

The port of London Sanitary Committee have, through their medical officer, Dr. W. Collingridge, drawn attention to the dangerous practice of sending home, without disinfection, the effects of seamen who have died from infectious diseases, and instructions have been issued to English consuls in foreign ports asking them to destroy all such clothing.

LONDON, March, 1886.

Translations.

PREMATURE LABOR WITH ATRESIA VAGINE. Before the Paris Society of Gynecology and Obstetrics, February 11, 1886, Dr. Doleris reported a case of premature labor in the person of a woman, twenty-eight years of age, who was at the same time the subject of congenital atresia of the vagina. The woman had menstuated since her sixteenth year. The flow had been very irregular and accompanied with severe abdominal pains. Her hygienic surroundings at this time were bad, and when these were bettered her physical condition improved. At twenty she had a sudden attack of right hemiplegia-doubtless hystericalcoincident with a temporary amenorrhea; this disappeared with the return of the flow.

Af

ter the twentieth year menstruation ceased to be painful; but not so the act of coition, which, since the day of her marriage, had been extremely painful.

When Dr. Doleris first saw her she was pregnant; she could not fix the date of her

last menstruation, but said she had felt the fetal movements four weeks previously. Several days afterward she had severe pains, and at the same time noticed a flow of a fluid, at first whitish, and then greenish, which stiffened the linen. A digital examination, requiring the use of chloroform for its completion, revealed the following conditions: The hymen, widely perforated in the center, remained as a perfect annular membrane without myrtiform caruncule. From the vulva inward the canal was an infundibulum of a few centimeters only in length, and closed by a diaphragm. This diaphragm had a concave surface looking outward, and showed an aperture that, during the first examination, proved too small for the introduction of the uterine sound.

The woman was evidently in labor. At the second examination, two days later, this orifice was dilated to the dimensions of a five-cent piece. The margins were extremely thin, and one could feel, with the finger across this opening, the small fetal parts.

The patient was anesthetized, and Dr. Doleris dilated the aperture with the fingers, but this being insufficient to admit of the extraction of the fetus, he resorted to incision of the constricted part, and completed the delivery. The fetus weighed twenty-seven ounces. The patient made a good recovery. In commenting on the case Dr. Doleris noted:

1. The possibility of conception in spite of the great degree of atresia which existed. 2. The possibility in a like case of spontaneous delivery.

3. He believes that the existence of a hymen in a vagina affected with congenital atresia is incompatible with the theory of Budin, which holds the hymen to be the termination of the vagina in such cases. There exist, however, many facts which do not allow the speaker to accept this theory.

But recently he had been consulted by a confrère in a case of atresia in a young lady eighteen years of age. The hymen was semicircular and unbroken. He ruptured this membrane and attempted to introduce the finger, but found, at a point about a half inch below the hymen, the vagina completely closed by some obstruction. In this obstructing tissue

no aperture could be found that would admit even the finest probe. The theory of Budin does not explain these congenital atresias, which coexist with a normally developed hy

men.

Dr. Martineau, in the discussion that followed, expressed the belief that, on the contrary, after confirmations which he had witnessed many times at the Lourcine, the ideas of Budin as to the real origin of the hymen are fully established. The perfect continuity of the radiating fibers of the vagina with those of the hymen, quite appreciable to the sight, pleads strongly in favor of the direct dependence of the two organs.

Doleris avowed that he did not propose to decide the question, but as Pozzi and Wertheimer had different views on the subject, and such facts as he had given could not be explained on the accepted theory, it was his opinion that new investigations ought to be undertaken on the subject.-Nouv. Arch. d' Obstets. et Gynecol.

MICROBES NOT ESSENTIAL FACTORS IN DISEASE. Before the Paris Academy of Medicine, March 9, 1886, Dr. Colin (d'Alfort) read a paper in which he took bold ground against the theory of microbes, as ap plied to the pathogeny of septic and so called zymotic maladies. It will be fairly allowable to admit the existence and importance of microbian agents only when they shall be proved to produce their alleged effects when introduced into the system through the medium of pure water alone.

It is still permissible to doubt their influence as regards virulence when we see, as in hydrophobia, rot (in sheep), and vaccination, in the viruses of which they do not exist, things take absolutely the same course as in cases where they are known to be present.

The whole question is yet problematical, and though the microbe of Charbon has been well-nigh demonstrated, this is no sufficient reason for concluding that the same condition obtains in all infectious diseases. Even in anthrax itself, Dr. Colin has seen the blood become infectious before the appearance of the characteristic bacilli, from which he concludes.

that the virulence may exist independently of the rods, or that even these bodies may be but a transformation of certain fine primitive granulations. Mechanical, chemical, and physiological functions have been ascribed to microbes, but are these sustained by adequate proof? Instead of demonstration, hypothesis has been adduced, every thing has given way before the microbe, and the power of the living cell of protoplasm to engender pathological conditions is no longer allowed.

In place of straining generalizations and inventing hypothesis, the first principles of which are often neglected, it would be better to face each particular fact and to seek out the conditions under which the organism creates or receives from without the disturbing principles or agents, and the means or methods by which it resists their action.-Progrès Médical.

M.

THE RESPIRATORY CENTERS OF THE MEDULLA.-M. Wertheimer reported at the Academy of Sciences (March 1st) a large number of experiments made by him, bearing upon the determination of the respiratory centers of the medulla. It is generally admitted that these centers are exclusively located in the medulla; nevertheless M. Brown-Séquard demonstrated that, in the case of new-born mammalia, respiration may survive ablation of the medulla. Wertheimer has obtained this persistence of respiration even in the case of adult dogs. According to his views, the arrest of respiratory movements consecutive to operation have for their cause solely the momentary impotence of the medulla due to traumatism. To see it re-established, it is only necessary to wait until the spinal centers have recovered their activity and to practice in the meantime pulmonary insufflation. The return of respiration may be delayed for five or six hours, but ordinarily one or two hours only.

There exist then, in the medulla, nervous centers which preside, some over inspiration and others over expiration. The return of spontaneous respiration even during pulmonary insufflation, shows that the medulla, abardoned to itself, sends rhythmical impulses to the respiratory muscles, without having need to be solicited by any excitant whatever. On

the other hand, the characters which respiratory movements take, when the medulla no longer exerts its influence, prove that the latter acts as a moderator and regulator to the spinal centers, and that in respiration and in circulation its role is identical.-Ibid.

Ar the Anatomical Society of Paris (January 22d), Dr. Crespin presented a specimen consisting of the intra-vaginal part of the cervix uteri, spontaneously separated and expelled during labor in a case of rigidity of the os. The orifice on account of this rigidity would not dilate, and the fetal head, continuing to press strongly on the cervix, under the influence of uterine contractions, caused it to separate at the level of the vaginal attachThe cul-de-sac was not involved, and the patient recovered. - Ibid.

ment.

UNDER the title of Clinical Contributions to Aural Therapeutics, a brochure reprinted from Zeitschrift für Ohrenheilkunde, has been sent us from Berlin. It embraces a translation of a report of three interesting cases made by Dr. Wm. Cheatham of this city.

Abstracts and Selections.

RESORCIN IN GONORRHEA.-Munnich, in Amsterdam, treated 108 cases of the disease with three-per-cent injections of resorcin, and published the very favorable results he obtained from this treatment in the Mon. f. prakt. Dermat.

His method is as follows:

The patients are recommended to drink much water and milk, so that the pus which has accumulated in the urethra may be thrown out with each discharge of urine, micturition always having to precede the injection. The injections are made by the patient himself, during daytime every two hours, and at least twice during the night; for experience soon showed that when the nightly injections were omitted the improvement obtained the previous day was lost again. It is further to be recommended that the patient do not retain the fluid injected into the urethra, but allow it to flow out again. Generally the fourth or fifth day the patients again presented themselves, when they were told to make the injections henceforth only three or four times daily, and but once during the night.

In 67 of the 108 cases the discharge had greatly diminished by the seventh day, and was totally cured on the fourteenth, and only in one single case the last small residue of the discharge had to be removed by a more astringent solution. In those cases which did not end so favorably, at least the acute symptoms rapidly yielded to the resorcin, and once the injections had to be omitted for a few days because an inflammation of the neck of the bladder had developed itself, in consequence of the patient's retaining the fluid too long in the urethra. All recent cases were cured within a fortnight.

injections in fifty-six cases Dr. Letzel tried the treatment with resorcin of gonorrhea. Among these thirty-three were recent cases, none of which had lasted longer than a week, while the other twenty-three represented chronic cases, the most recent of which had a duration of two, the oldest one of five months. In seven of fifty-six cases, three-per-cent resorcin injections were not well borne, they causing severe pain; in two a painful priapismus set in, and in one the direct transfer of the urethral disease to the neck of the bladder was doubtless due to the irritating effect of the three-per-cent solution of resorcin. The other forty-nine cases evinced no trace of irritation. In consequence of this experience, he later invariably commenced the treatment witha two and-a-half-per-cent solution, and only gradually passed over to a three-per-cent one. Thus all irritation was avoided, and in one very chronic case a four-per-cent solution was finally also tolerated.

Dr. Letzel observes that the quality of the resorcin is of the utmost importance. The pure article is snow-white and easily soluble in pure water, while resorcin which has the slightest yellowish or brownish color only acts as an irritant to the urethral mucous membrane. The remedy further must be kept in perfectly hermetically sealed vessels; a larger quantity of the solution than four ounces ought never be prescribed. This should be put in a dark bottle.

The chronic cases of gonorrhea did exceedingly well under a three to four per-cent-solution. Ten cases, which had lasted from two and a half to five months, were all totally cured within from fourteen to thirty-two days by the resorcin injections alone, without the introduction of bougies.

All the cases reported by Dr. Letzel as cured were not pronounced as such until their morning urine evinced no longer gonorrheal bacteria. He does not doubt that with resorcin a great step has been made forward in our treatment of this, proverbially, so often intractable complaint.-Medical and Surgical Report.

CHLOROPEPTONATE OF IRON.-The Bulletin Général de Thérapeutique describes Dr. Jaillet's experiments which have led him to prescribe and recommend the use of chloropeptonate of iron. He injected ten grams of this salt into the veins of a bitch weighing twenty one pounds. There was neither coagulation nor embolus. Two hours after the injection was made sixty cubic centimeters of blood were removed from the femoral artery, half of which was allowed to coagulate in order to analyze the serum; the other half was defibrinated. The dog remained alive more than two months after the experiment. The serum contained chloropeptonate of iron. The blood corpuscles, examined under the microscope, were found to be perfectly normal. Dr. Jaillet has experimentally ascertained, by hypodermic, rectal, and intravenous injection, and by ingestion, that chloropeptonate of iron enters the circulatory system and is absorbed into the blood. Chloropeptonate of iron is a chemical combination of peptone and iron- perchloride, which does not undergo any change from the gastric juice, nor from the alkalies of the blood. It is absorbed and assimilated just as it is administered, and produces, in consequence, a higher temperature, increased disassimilation, and more copious excretions. The appetite increases and the patient grows thinner, but the physiological qualities of the blood improve.-British Med. Journal.

EXPLOSIVE DRUGS.-It is well-known that the manipulation of certain pharmaceutical remedies or their preparation may, through ignorance or carelessness, give rise to explosions which, if they do nothing more, are calculated to make the manipulator seriously consider the desirability of changing his occupation. The list of them is rather formidable, and we may be doing good service in bringing a few of them to the notice of the profession, the members of which have quite enough worries of their own to be enabled to dispense with any unnecessary and avoidable sources of excitement. Without alluding to the elementary precautions to be employed in the manufacture and dispensing of nitro-glycerine, the now fashonable remedy, thanks to the advocacy of Dr. Murrell, we may call attention to the liability of mixtures of chlorate of potash and sulphur to explode on percussion or attrition. This is a constantly recurring accident, and yet it is one known to every school-boy. Further, a mixture of chlorate of potash and caoutchouc has been known to explode when used as a tooth powder. Not long since the fall of a bottle of lycopodium in a chemist's shop at Strasburg was followed by an explosion as a result of the

highly inflammable powder taking fire at the gas jet. Elsewhere a druggist who was engaged in drying some hypophosphite of calcium over a sand-bath was killed by the explosion. Oxalate and citrate of calcium are also liable to explode at a high temperature. Permanganate of potassium in combination with any organic substance is apt to explode spontaneously, and a mixture of chlorate of potassium, chloride of iron, and glycerine has exploded in the pocket of the patient who carried it. A chemist at Paris prepared ozone with powders composed of equal parts of peroxide of manganese, permanganate of potassium, and powdered oxalic acid. Every precaution was taken, but the powders had not long been mixed before the bottle which contained them was blown to atoms. Quite recently a medical man wrote a doleful letter to a contemporary narrating his experience when endeavoring to manufacture terebene by acting on oil of turpentine with pure sulphuric acid. An explosion followed, and although, owing to his having taken care to envelop the bottle in a towel, nothing worse happened than serious damage to a new pair of trousers, he thought it his duty to warn others against this particular experiment. Iodine, treated with ammonia, forms, when dry, a compound possessing violent detonating qualities which has several times proved fatal. London Medical Press.

THE CURE OF FISTULE BY INJECTIONS OF OIL OF TURPENTINE.-Cases of anal fistula in connection with carious bone, fistula in connection with the teeth, fistula of the duct of Steno, and atonic fistulæ of various varieties have all been treated with good results by Dr. S. Cecchini by the injection of oil of turpentine (Wiener Med. Blätter, January 14, 1886). The reason for the employment of this drug is attributed by the author to the fact that oil of turpentine, on the one side, is a powerful stimulant to the formation of granulations, and, on the other hand, is an antiseptic; while when employed with ordinary care it can produce no unfavorable results. His results are based on a large number of cases, which are reported with very great care and accuracy, and in every appearance seem to warrant reliance on the author's statement. A permanent cure was stated to have been procured in a large number of cases. First, as regards anal fistula, he details seven cases of fistula in four individuals in whom the injection was repeated several times at intervals of three days. The author recommends the employment of syringes with blunt nozzles, then the closing of the opening of the fistula with the finger after the injection has been made, so as to insure

thorough contact. The pain produced is slight, and is quite bearable, although, if necessary, the oil of turpentine may be diluted with olive oil. In five cases the fistula were completely cured. In one the patient stopped the treatment before a perfect cure resulted, as he was satisfied with the improvement that followed. In another case of a complete sinuous fistula in a decrepid man considerable improvement was produced, and, after finally being operated upon, the fistula was cured. In cases of fistula in connection with carious bone, four cases are reported in which cure was completely produced in from two to three months. It is hardly necessary to analyze his other cases, except to add that in all a favorable result appears to have been obtained. - Therapeutic Gazette.

INFANT FEEDING.-At the February meeting of the Medical Society of the State of New York, Dr. E. F. Brush, of Mount Vernon, read a paper with this title, and pointed out some simple methods of feeding an infant when it had been deprived of the breast. (New York Medical Journal.) He stated that one of the greatest elements of failure in the artificial feeding of infants was the desire to give one sort of food alone under all circumstances, and hence the blind prescription of patent foods. He advised, on the contrary, the preparation of foods from simple articles to meet the requirements of each case as it arose. When with food thus prepared there was a failure, the physician at least knew what the failure arose from. Commencing, then, with the child at birth, the author gave his formula for the best substitute for colostrum, and his further treatment of the cathartic effect was either excessive or defective. He then discussed the question of the best staple food. He had no hesitation in saying that it was cow's milk, which, however, was subject to many conditions that rendered it unfit, unless due care was exercised. In 1879 he had pointed out the difference between the milk of the ruminant and non-ruminant animals as regarded particularly the quantity and quality of the caseine contained in them, and the difficulty experienced by infants in digesting a milk intended for calves. When an infant vomited a hard curd, the indications were that the milk must either be prevented from coagulating in the stomach or coagulated and broken up before entering the stomach. He showed that it was inadvisable to use an alkali, and therefore preferred the latter course, that of coagulating and breaking up the milk before giving it. In other cases he recommended the addition of lime-water as the safest agent,

as it did not, like other alkalies, keep the stomach in an alkaline condition, nor cause an acid condition of the intestines. In case of diarrhea in children fed on milk, the indications were to stop the milk immediately. The milk was usually the cause of the trouble, and it was rendered unfit by the physical condition of the cow, such as rutting, gestation, the ingestion of poisonous herbs, cruel treatment, and the like, to all of which states many cases of diarrhea in infants could be traced. In these cases of diarrhea he recommended oatmeal-water, which his analysis had convinced him was somewhat similar to milk in composition. He insisted on the necessity of the medical attendant himself preparing or teaching the preparation of these simple foods. In all cases the child should be put back on its ordinary milk diet as soon as possible. As to the kind of cow best adapted to supply milk, he preferred the common-grade cow to the Jersey or fancy breeds. The latter were of a tuberculous tendency, the fat in the milk was not sufficiently emulsified, and they were of an excessively nervous temperament, while the common cow ordinarily was gentler and a good feeder. She should always be stall-fed. When milk was bought, that of one cow should always be avoided. In cases of constipation, raw malt-water, carefully prepared as a diluent of the milk, was efficacious.

Dr. Jacobi said that the tendency of cow's milk to coagulate in a very hard curd could be overcome by a method which he had some years ago learned from Dr. Loomis. It consisted in adding half a teaspoonful of dilute muriatic acid to a pint of water, mixing this with a quart of milk, and then boiling. The taste was pleasant, and coagulation would take place in fine particles, as in woman's milk. Therapeutic Gazette.

ON TUNNELING THE LARGE PROSTATE.The operation of tunneling the enlarged prostate from the perineum, which I introduced nearly five years ago, has been so favorably received in this country and in America, as a means of relieving the more urgent symptoms sometimes attending this complaint, as well as of permanently reducing the size of the gland, that I am induced again to draw attention to this treatment and to notice some modifications which tend to simplify the performance of the operation. As it may be regarded as the only treatment which hitherto has been immediately followed by atrophy, or shrinking of the large gland, and the complete recovery of the patient, it is important that its value should be tested by others, who have not yet had the opportunity of doing so. Of the various authors