the fascia, then through the center of the gut, and coming out the same distance on the opposite lip of the integument. In this way he has the abdominal wounds plugged with the knuckles of gut, and the gut surface on a level with the integument. To this he now applies the antiseptic dressings (iodoform and gauze) and leaves it until the fourth or fifth day, when he splits the knuckle of gut and removes the pins. He tells me that he has done five by this method with only one death, and this occurred from pneumonia on the fourteenth day after the operation; the death not due to the operation. He got the idea of doing colotomy in this way from a paper in the British Medical Journal, by MacNamara, upon gastrostomy, in which he brought out the stomach and transfixed it before opening it. Mr. Heath was present with me at Mr. Bryant's operation, and while the patient was being put in position he told me of a case in his practice, where the nurse had placed the patient in the wrong position, and without noticing it, he went on and operated, finding out after he had finished that he had opened the gut in the right instead of the left side. Some smart Alick noticed it, and asked why he had selected the right side, and he answered, "So as to be sure of getting well beyond the disease." It can be easily understood that the great advantage of colotomy, done as I have just described, over the old method, is the diminished danger of peritonitis from escape of contents of the gut into the peritoneal cavity, adhesion of the gut to the abdominal walls having occurred before the opening in the gut has been made. Of course the surface (posterior) of the colon, which is opened in the operation is not covered by the peritoneum, yet in the operations very frequently the peritoneal cavity is opened much oftener, I imagine, than is generally believed.

In his operations Mr. Bryant uses sponges wrung out of hot iodine-water, and dresses the wounds with iodoform gauze. He practices torsions on arteries almost to the exclusion of all other methods. He tells me that he seldom ever uses a ligature. He kept statistics of torsion in all kinds of amputations up to over 110 cases to note the result, and in all of them had only one case of secondary hemorrhage, and

Mr. Bryant has invented a torsion forceps with blades like the ordinary Well's forceps, but a straight wooden handle; the blades work like needle holders. Mr. Bryant is about fifty years old, upward of six feet high, of fine figure, wavy iron gray hair, and side-whiskers. He is exceedingly polite and agreeable, and, as an operator, is skilled and graceful.

I saw Mr. Hulke at the Middlesex Hospital. He is, I should say, nearing sixty years of age, and looks less like a surgeon than almost any one you would meet. Nor does he strike you as being especially neat in his dress or person, yet he is the most exacting operator with his assistants about protecting his patient's clothing and person from blood and dirt, and removing every thing that has been the least soiled in an operation from the room before bringing a new patient in, that I have met on this side. It seems to annoy him greatly to see the least blood upon the floor, or on an assistant's clothes or face, or a soiled towel in the room. He did two operations in the time I spent with him: (1) Laid open a fistulous track in the thigh leading to a caries spot in the bone, and then scraped the bone. (2) A lupoid spot on the face which had nearly healed. He scraped the raw surface thoroughly, then gently scarified the surrounding cicatrix to prevent any interference with the circulation from tension, and finally applied a strong solution of chloride of zinc to the sore. He took me through his wards, where I saw four cases of herniotomy, which had been done for strangulation within the past few days; all doing well. He had not attempted radical cure in any of them, which to me was very surprising, as I think we ought,

in all such cases, to give the patient the chance, which can be done without in the least lessening the chances of recovery. He showed me also a case of aneurism in the left orbit, causing great protrusion of the globe. By placing a towel over the face and your ear to the affected side, the bruit was very loud. Eight months before he had ligated the common carotid, and the trouble entirely disappeared, and, there was no recurrence of it for several months, since which time it has grown rapidly worse. Mr. Hulke is now trying galvano-puncture.

At the same hospital, after leaving Mr. Hulke, I witnessed an amputation of the breast (malignant) by Mr. Gould. The tumor was a very large one which had begun to break down, but there was no axillary involvement. The operator made the "cart-wheel" incision of Gross, removing every thing down to the muscle.

At Charing Cross Hospital, I attended an amputation through the knee-joint in a case of deformity and wasting of the leg from disease of the joint. Instead of amputating through the leg just below the knee, he disarticulated, making the long anterior flap.

The operator, Mr. Richard Barwell, selected disarticulation over sawing through the tibia, because of the less danger from septic absortion. His assistant, Mr. Roeckel, the Registrar of the hospital, instead of applying Esmarch's bandage, used digital compression of the femoral, which occurred to me as being unnecessarily risky. The chloroformist at Charing Cross is experimenting with cocaine, given in one grain dose by the mouth just before beginning the inhalation of chloroform, to prevent the nausea following the use of the latter. He has not used it in a sufficient number of cases to test it thoroughly, but from the present outlook he does not think it will do any good. Mr. Barwell took me into his ward to see a case of gastrostomy he had done three weeks before. The patient is the subject of malignant disease at the cardiac orifice. She is now up and about the ward, and expresses herself as feeling very comfortable. She takes liquid food into her mouth, and then spits it through a long tube into her stomach.

In order to assist local authorities in the maintenance of quarantine against the introduction of infectious diseases, as provided in Section 4792, Revised Statutes, the act of April 29, 1878, and appropriation acts authorizing the President to maintain quarantine at points of danger, the President has determined to establish, by means of the vessels of the Revenue Marine, a national patrol of the coast of the United States, so far as it may be practicable under existing law and consistent with the performance of the other duties confided to that service.

You are accordingly directed to cruise, actively, with the revenue steamer under your command, upon the outer lines of your cruising-grounds, and to exercise especial vigilance in speaking all vessels arriving from foreign ports, or from southern ports of the United States, directing your inquiries, first, as to the port from which the vessel sailed, and, secondly, as to the health of those on board at the time of departure, during passage, and at the time of hailing; and should the information gained indicate a condition of contagion or infection in the vessel or crew, or that the vessel has left a port at which contagious or infectious diseases were prevailing, her master will be directed to proceed for examination to the outer quarantine station provided for her port of destination.

The following regulations will be observed relative to the inspection of vessels:

If a vessel be found with sickness on board, or in a foul condition, she will be directed to proceed to the quarantine station herein before indicated, and the revenue-marine officer will immediately notify the proper quarantine of ficer. In such case no person will be permitted to board the vessel until the medical officers in charge of the quarantine shall have given the usual permit.

Should the pilot or master of a vessel, when bailed, report cases of recent or present sickness on board, the revenue officer will not board, but will send her immediately to quarantine.

Quarantine officers will be recognized as follows, viz:

Medical officers or acting assistant surgeons of the Marine-Hospital Service in charge of Gulf, South Atlantic, Cape Charles, or Delaware Breakwater quarantines, or any officer of said Service on duty at any port on the interior rivers, the Great Lakes, or Pacific coast, and all quarantine officers acting under proper State or local authority.

Special regulations to aid local quarantine authorities will be promulgated hereafter, should occasion require. C. S. FAIRCHILD, Acting Secretary. WASHINGTON, D. C., April 29, 1886.

LACTATED FOOD.-Dr. J. Milner Fothergill writes to Wells & Richardson Company the following in regard to the nature and uses of this valuable preparation:

Having requested me to give you my opinion, as a food expert, upon your Lactated Food, I do so herewith.

You state that it contains "the purified gluten of wheat and oats with barley diastase and malt extract combined with specially prepared milk sugar;" in other words, that it is self-digestive as regards the conversion of insoluble starch into soluble dextrine and maltose. My experiments with it lead me to hold that this is correct.

The food then contains carbo-hydrates, some albuminoid matter, and the various salts in grain, notably phosphate of lime.

Such a food can be added to milk and treated in

the manner you describe in your leaflet. So prepared with milk it forms an admirable food for infants and dyspeptic persons who require very digestible aliments.

But it has a wider range of utility. The body temperature is kept up by the combustion of grape sugar. Grape sugar is supplied from carbo-hydrates, either the insoluble starch or the soluble sugar. Starch forms a great portion of our food, and is converted into grape sugar within the body. Where the system is unequal to the digestion of starch, as in feeble digestion, or conditions of acute disease, then predigested starch must be furnished to the organism. Otherwise the system will perish of exhaustion, just as a fire dies out when its fuel is consumed.

Beef tea contains nothing which can form grape sugar, and in fact is a pleasant stimulating beverage or food adjunct, but without food value practically. (For what food value it has is so infinitesimal that it is not worth counting.) But when it has added to it a food such as your Lactated Food it has a distinct measurable food value. Consequently such food should be given with beef tea, and the compound forms a valuable food.

When Lactated Food is placed in water hot enough to be sipped, a rapid transformation of the starch remaining in it (by the diastase it contains) goes on, and a nutritive fluid is the result, which requires but a minimum of the digestive act.

Such fluid can be flavored and drank as a nutritive beverage, specially acceptable in febrile conditions. Flavored with lemon, ginger, cloves, or other flavoring agents to give variety-a matter far too much neglected in the treatment of the sick-it can be largely used. Or wine, either red, as claret, or sherry or port, can be added to it when a little stimulant is required; and brandy when a stronger stimulant is indicated.

The resort to farinaceous matters, predigested, must become greater and greater as our knowledge of digestion and its derangements waxes larger. It is not merely in the case of feeble infants that such predigested starch and milk sugar are indicated and useful; persons of feeble digestion require these soluble carbo-hydrates which they can assimilate.

But to my mind an equally great matter is the feeding of persons acutely sick, and especially when there is pyrexia, who now are allowed to perish of inanition on the mistaken conviction that beef tea is a sustaining food. It is in the sick-room that soluble carbo-hydrates have a great future before them.

DR. D. G. MURRELL has recently been appointed to the position of surgeon to the Chesapeake, Ohio & Southwestern Railway, with headquarters at Paducah. He will take up his residence in that city, whither he has gone to enter upon his duties. Dr. Murrell, during his stay in Louisville, has made many friends, who contemplate his departure with regret. A gentleman of culture, and a physician and surgeon of fine attainments, he can not fail to take a high professional rank wherever he goes. We congratulate the management of the Chesapeake, Ohio & Southwestern Railway and Dr. Murrell alike upon a relationship that can not fail to make to the good of both and the credit of railroad surgery.

LOSS OF HEARING FROM NOISE.-In answer to a correspondent, the London Medical Press

says:

You ask us if there is any authentic evidence that soldiers or sailors, over whose heads or near whose persons great guns are being frequently fired, lose their hearing sooner than outsiders who are not so situated," and you remind us of Bradlaugh's allusion to the effect that Big Ben had on him when he was confined in the Clock Tower. We can only say generally that there is, we believe, evidence to show that persons who are habitually or for any long periods subjected to these noises are more frequently sufferers from entire or partial deafness than others, and a military friend to whom we referred your question assures us that "several men of the Eightieth regiment, over whose heads the Great Pagoda at Rangoon was assailed by the artillery of the force employed against that structure, did actually lose their hearing." Whether meu employed in iron factories, steamship yards, or other similarly noisy manufactories, are equally affected, we can not say, and the question is, we believe, adhuc sub judice.

A NEW JOURNAL.--We have received the first number of the New York Medical Monthly, a journal of medicine and surgery, edited by Leonard J. Corning, M. D. "The objects of our publication," says the editor, "are entirely practical, and the teachings of the clinic will at all times be accorded precedence over those of the laboratory, except where the latter have an immediate bearing upon diagnosis or therapy."

The journal starts off with a fine list of contributors. We take pleasure in placing it upon our exchange list.

A GOOD LOCATION FOR A PHYSICIAN.-Any physician who may be looking for a desirable field of labor would do well to consider Meadow Lawn, on the C. O. & S. W. R. R., fourteen miles south of Louisville, in Jefferson County. It is the site till recently occupied by Dr. George L. Pope. The situation is most eligible, the surrounding country picturesque, the land rich, and the people kindly and pros

perous. The property consists of a good dwelling (new), with all needed out-buildings, a large lot suitable for a garden, and an adjacent pasture. Apply to Mr. Simcoe, at Meadow Lawn, or to Dr. T. B. Greenley, West Point, Ky.

A HEALTHY CITY.-Speaking of Goulburn, in New South Wales, a recent English visitor, Dr. J. E. Taylor, says: "It is a picturesque and clean town, with wide streets and fine buildings, surrounded by a breezy, open country on one side, and a bold, craggy ridge, half forest-clad, on the other." He then proceeds to state that "Goulburn is said to be so healthy that the doctors rely on the natural increase of population for a living! People are neither in a hurry to be sick nor to die."Medical and Surgical Reporter.

The

AMERICAN SURGICAL ASSOCIATION. seventh annual meeting of this Association was held in Washington, April 28th, 29th, and 30th. A number of papers were read, some of which were of great value.

The President announced the following committee on the proposition looking to the formation of a Congress of American Physicians and Surgeons Drs. C. H. Mastin, Charles T. Parkes, J. Ford Thompson, J. Ewing Mears, and N. Senn.

The officers elected were as follows:

President, Hunter McGuire, M. D., Richmond, Va.

Vice-Presidents, T. F. Prewitt, M. D., St. Louis, and J. W. Gouley, M. D., New York. Secretary, J. R. Weist, M. D., Richmond,

Ind.

Recorder, J. Ewing Mears, M. D., Philadelphia, Pa.

Treasurer, P. S. Conner, M. D., Cincinnati. Council, Drs. Hunter McGuire, John S. Billings, L. McLane Tiffany, R. A. Kinloch, and Moses Gunn.

Honorary Members-Foreign, Sir William MacCormac; American, Professor Henry J. Bigelow.

Active Members elected, Drs. H. H. Mudd, St. Louis, and Joseph Ransohoff, Cincinnati.

Time and place of next meeting, the second Wednesday of May, 1887, at Washington.

LANOLIN AN OLD REMEDY.--It appears that lanolin is not entitled to take rank among the most recent additions to the materia medica, inasmuch as Culpeper, the venerable "student in Physick," described it in his work published in 1650. This has been lately pointed out by a correspondent of the Chemist and Druggist, who gives the following extract:

"The Way to make Esipus.--Take wool cut off from the neck ribs, and under the pits of the forelegs of a sheep not washed, but well wearied, wash it well in warm water so long till it have left all its fatness in the water, then press it out and lay it by, let that fat and foul water be poured from on high out of one vessel into another a long time till it be froathy, then let the froath settle, and take off the fat that swims at the top, then pour the water to and fro again, till neither more fat nor froath appears, then wash the froath with the fat in cleer water till it be cleansed from the dross and will not bite your tongue if you touch it with it; then keep in a thick earthen clean pot in a cold place."-Canadian Pharmaceutical Journal.

INSECT VISION.-No one yet pretends that we wholly understand the problem of insect vision. The lenses are easy enough to examine and describe, but the delicate, elaborate, and complex apparatus which lies between them and the optic nerves, and so makes the insect a seeing agent, is almost incredible to him who sees them for the first time. That such humble creatures as insects should have been the objects of so wonderful an equipment is a fact which keeps our admiration even more than abreast with our knowledge.-Leisure Hour.

THE NEW YORK UNIVERSITY MEDICAL COLLEGE has just received a gift of $100,000 for the construction and maintenance of a laboratory building, to be known as the Loomis Laboratory. The gentleman who made the gift wishes that for the present his name should not be made public.

A REMARKABLE COMPLICATION.-The Medical Record states that a physician in New York City is said to have the following inscription on his bill-heads: "A patient's gratitude to