ble. In children, old and infirm patients, care must be had as to the antiseptic chosen.

In comment Dr. W. W. Van Arsdale says: "If it is desired to employ local antiseptics in erysipelas, a much simpler, more widely applicable and very satisfactory, method is available. Burman (Practitioner, May, 1884), reported some very favorable experience with the local use of iodoform collodium. Dr. Lyttle, of New York (vide report in Boston Medical and Surgical Journal, Jan. 1, 1885, p. 14), also speaks well of the same. We can corroborate this. Especially instructive was a case of erysipelas from a slight wound in the thigh. Wherever the coating was continued well over the neighboring apparently free skin, the process was checked; where this had not been done, the process extended, but was stopped by a fresh properly extensive coating. This application, moreover, alleviates the burning and discomfort immediately.

MORITURI SALUTANT.-With the development and mise en exécution of the system of antiseptic treatment, together with the everincreasing use of bactericides and bacillicides, it may confidently be anticipated that specimens of the various disease-causing fungi and bacilli will shortly be procurable only at fancy prices. With germicides which are capable of annihilating their millions at one fell swoop, irrespective of sex, age, or condition, their source will finish by becoming as precarious as overdredged oyster-beds. Expeditions will then be necessary to the "ultimate realms of the pole " to kidnap a stray,. half-starved micrococcus, and practical bacteriology will be rendered impossible, faute de quoi manger. Enterprising purveyors of natural history preparations will organize exciting hunts in distant climes for a chance spirillum, which will be brought home with conscious and justifiable pride and sold by auction. By the time we have depopulated entire countries of their natural allowance of schizo-mycetes we shall, like the colonials with their murdered sparrows, be glad to offer a premium for their recultivation, and find it be too late, alas! that in the language of the poet, "There's little left to live for now, since my poor vibrio died." Hinc illæ lacrymæ.-London Medical Press.

may

MICRO-ORGANISMS IN TYPHOID.-After examining microscropically the bowel, mesenteric glands, spleen, liver, kidneys, lungs, heart, and brain in fourteen typhoid fever cases, Dr. Mirles, of St. Petersburg, concludes that the short bacilli of Eberth and Koch may, with great confidence, be accepted as always present in this disease, but that, in addition to this

type of bacillus, colonies of three kinds must also be reckoned as characteristic of typhoid: (1) Small colonies in the deep layers of the intestine and in the walls of the capillaries of the heart muscle. (2) Medium-sized colonies of comma form. (3) Large ones of map-like shape, found especially in the mesenteric glands, the spleen, and in the substance of cerebral hemispheres. The author is inclined to agree with Klebs, that some relation exists between the symptoms observed during life and and the organs in which micro-organisms are found. In one case, for instance, where there had been violent and prolonged delirium, numbers of colonies of various sizes were seen in sections of the cerebral convolutions. He thinks also that the early development of cardiac weakness in uncomplicated cases of typhoid depends upon the existence of micro-organisms in the heart muscle, which are gathered in small colonies in the capillaries, and he suggests that it is much to be desired that careful observations should be made in typhoid of the exact condition of the pulse and of the sounds of the heart.-London Lancet.

TREATMENT OF CEREBRAL SYPHILIS. In the New York Medical Journal, May 1st, this question is discussed by Dr. Herbert G. Lytle, who concludes that the treatment of cerebral syphilis is, of course, by mercury and iodide of potassium. The former is curative, the latter palliative. It is strange to see in an English work on syphilis, published in 1884, the statement that iodide of potassium, in some cases, must be given in large doses, 3j to zij in twenty-four hours; but that, as a rule, it is better to begin with about seven grains three times a day. In cerebral syphilis it is best to commence with thirty grains, t. i. d., and rapidly increase the dose until you get its physiological effect or the symptoms disappear. The hygienic management is important. The diet should be plain and nutritious. The patient should avoid bodily and mental exertion or excitement. He should not, as a rule, take alcoholic stimulants. Special symptoms must be met by appropriate treatment.

UNUSUAL CAUSES OF COUGHING.—The “unusual causes of coughing," then, are two: First, hypertrophied glossal papillæ, overlapping an epiglottis which is bent far forward, but otherwise normal; and second, a congenitally asymmetrical epiglottis, which has been made still longer by inflammation, caused by constant friction with the tongue. Abnormal conditions of the tongue and ulcerations of the epiglottis are mentioned in text-books as sources of irritation and causes of cough, but

this relation between the tongue and the epiglottis has not been specially recognized as a strong cough-producing factor. I believe it is frequently so. I consider the recognition of this lesion to be of great importance to the physician; for it explains the etiology of many coughs the causes of which have not hitherto been acurately determined. Since my attention was first called to this lesion, I have seen many cases in which it existed, and in which it could be demonstrated beyond a doubt that it was the sole cause of cough.-Dr. C. C. Rice, Medical Record.

CANCER OF KIDNEY; NEPHRECTOMY.-Dr. W. Orlowski (Warsaw) reports the following successful case. In 1883 one hundred and thirty-two cases had been published with fortytwo per cent mortality:

A woman, aged thirty-seven, had suffered pain for the last six years, occasioned by a movable, hard tumor of the size of a fist, situated in the right side of the abdomen. She had passed bloody urine. The diagnosis of neoplasm in a movable kidney was made. Operation May 15th: incision extending from margin of ninth rib vertically downward to Poupart's ligament, laterally along the external edge of the rectus abdominis muscle, ten cm. in length. Enucleation of the tumor. Ligature of the pedicle en masse. The seat of the tumor remained in communication with the peritoneal cavity. Catgut and silk sutures to close abdominal wound. Patient did well. May 22d, suppuration of the wound till July 5th. July 22d, dismissed from hospital with granulating fistula, and passing 1,500 cubic cm. of urine daily. Was seen again October 16th, when a silk ligature has passed through the fistula by suppuration. -Deutsch. Zeitschr. f. Chir.; Annals of Surgery.

CHRONIC TEA-POISONING.-Dr. W. N. Bullard (Boston Medical and Surgical Journal) gives the details of seventy-four cases of chronic tea intoxication investigated by him, and formulates the following conclusions: (1) The action of tea is cumulative. (2) Its action is more pronounced on the young and on those subject to anemia or physically depressed, although persons otherwise healthy occasionally show toxic symptoms. (3) The average amount of the beverage required to produce toxic effects in persons accustomed to its general use is a little less than five cups per day. (4) Chronic tea-poisoning is a common affection. Its symptoms most commonly are, loss of appetite, dyspepsia, palpitation, headache, vomiting and nausea, and nervousness combined with various forms of functional nerve affections,

such as neuralgia, hysteria, etc. Constipation and pain in the left side or cardiac region are also frequently observed in sufferers from teapoisoning.

HOW TO PREVENT COLDS.-Dr. BrownSéquard, speaking at the Société de Biologie, gives a prophylactic method against accidents that are produced by cold. He said: "The neck is one of the most sensitive regions of the body, and it is not doubted by any one that a large number of cases of bronchitis, etc., are reflex phenomena from the impression of cold on the nerves of the skin in that region. To prevent these troubles, the sensibility to cold must be diminished: that is the best means that can be indicated. To this end I have advised several of my patients to blow air on the neck from a blower, at first using warm air and gradually cooling it off. In ten sittings most of them had become so accustomed to it that they became quite impregnable to the action of cold." [In America, water is generally used instead of air for the same purpose.]— Medical Times.

A QUIBBLE OVERRULED.-A singular case has just been decided by the Paris Civil Tri.bunal. Dr. Peyrol, head surgeon at the Hotel Dieu, claimed 800 francs for extracting a bullet from Mme. de Beauregard, who had accidentally shot herself. The claim was disputed on the ground that the plaintiff stated erroneously that the bullet was lodged in the right thigh. The tribunal overruled the plea, believing that it mattered very little whether the bullet was on the right or the left side, so long as the patient's sufferings had been relieved; and the medical man therefore won his suit.

AN ALKALOID IN KRAUT.-An alkaloid is stated to have been discovered in sauer-kraut, capable of producing serious symptoms of poisoning, such as paralysis of the bulbo-spinal vaso-motor centers and the cardiac fasciculus of the pneumogastric nerve. The said alkaloid is credited with the power of entirely controlling delirium tremens.-National Druggist.

ASCITES IN CIRRHOSIS OF THE LIVER.-Dr. Jacoby, of Bromberg, indorses Professor Ewald's recommendation of early puncture of ascites, and in cases of cirrhosis of the liver as the cause administers pilocarpine. He gives ten drops three times a day of a 0.1-10.0 solution of the muriate of pilocarpine.

THE NASHVILLE ACADEMY OF MEDICINE AND SURGERY, is the name of a new medical society organized in Nashville, Tenn.

The thirty-first annual meeting of the State Society will be held at Winchester, June 23d, 24th, and 25th. The programme, which appears elsewhere in this issue, is adorned by the names of many of the best names in the State, and pledges good work for medicine, while the heartiness with which the local committee of arrangements, seconded by the good citizens of Winchester, have discharged the trust committed to them at the last meeting, leaves no room to doubt that the visitors will find warm welcome and abundant good cheer. The railroads extend to the delegates in transit the courtesy of reduced rates, and the hotels will discount their bills liberally in the interest of science.

Winchester is a beautiful town, and having place in the center of Clarke, one of the eastern counties of the Blue-grass region, the majority of the delegates must pass through this charming stretch of country in making their journey to and from the meeting. The opportunity thus afforded of beholding this most favored section of our commonwealth in all the rich

array of early summer time, is in itself no small inducement for the hard-worked doctor to lay aside for a few days his books and saddle-bags, and will contribute no little to the size and success of the coming session.

But while the above-named features are both pleasing and promising, it may not be out of place to remind the fellows that the Society is possessed of some well-turned by-laws, to the rigid enforcement of which on the part of the president and the cheerful obedience of which on the part of the delegates the perfect work of the sessions is in no small degree beholden.

To the point, we quote as follows from the transactions of 1877:

1. That all executive and miscellaneous, and other than purely scientific business, be limited to the first thirty (30) minutes of each morning session.

2. That the length of time in reading each paper presented to the Society be restricted to thirty (30) minutes.

3. That immediately after the reading of papers they shall be open for discussion, each member speaking to be limited to ten (10) minutes.

4. That volunteer papers or communications be read on the afternoon of the last day of each annual meeting, and at no other time, unless by unanimous consent of the Society.

THE TAX ON OLEOMARGARINE.

The lower house of Congress, after lengthy discussion, has passed the bill taxing oleomargarine five cents per pound, and surrounding its sale with other severe restrictions. In view of all the circumstances this would seem to be a most remarkable measure of protec tion.

What are the facts in the case? Ample experience has shown that oleomargarine is a wholesome and, in the judgment of many, in comparison with inferior butter, an agreeable food preparation. Chemists find difficulty in distinguishing between it and pure butter, while the uninstructed consumer is often not at all able to do so.

In view of the foregoing there appears but a single reason for the suppression of its manufac

ture. It comes into ruinous competition with the product of the dairy. The dairymen insist upon protection against injurious competition, and while their grievance is entitled to a respectful hearing, it is but just to note what other interests are involved in the question. To do this we must note the composition of oleomargarine. The best brands are made of suet, deprived of its stearine by mild heat and high pressure, cow's milk, and cotton-seed oil; the inferior brands, embracing the great mass of the product, from margarine, the semi-solid principle of lard, milk, and cotton-seed oil. Now, not one of these ingredients is injurious, and but one of them can be said to be considerably advanced in price by incorporation with the mixture. The butter and the lard or suet before manufacture have a value per pound not far below the oleomargarine which they, in good part, compose. Cotton-seed oil, then, is the only ingredient invested with large profit as a result of the mixture; and therefore the burden of the prohibition falls, in a great measure, upon the producers of this commodity and the poor, who have in oleomargarine a very good substitute for butter brought within the reach of their means.

Cotton-seed oil is certainly not so injurious as to justify the framing of legal enactments to restrict its use. Thousands of people make use of it in preference to lard, and we are able as a result of agreeable experience to bear testimony to its value as a substitute for the latter in culinary economics. Olive oil has ever held the favored place as an adjuvant in cookery and as a dressing for salads, and cotton-seed oil so closely resembles it that none but the chemist can tell the one from the other. Italy has excluded it from the list of her imports because when mixed with olive oil its presence could not be detected, and so had the same depressing effect upon the price of that commodity that oleomargarine exerts with us upon the price of butter.

It is right that laws should be enacted which will prevent the fraudulent manipulation of oleomargarine in trade. The conservation of good morals requires that fraud should be suppressed in this as in every other similar case; but that the only acceptable substitute for

SAVILE CLUB, LONDON, May, 1886. Editors American Practitioner and News:

There is so much here in the lines I came to work, and my stay is to be so short, that I have little time to see any thing of London but what relates directly to the business that brought me abroad. Hence, what I write must relate almost exclusively to hospitals, the cases, and the surgeons I see in them.

At my second visit to St. Thomas's, Sir William MacCormac did herniotomy on a man, aged thirty years, for the radical cure of an irreducible hernia. The hernia was on the left side, and so large as to cause much inconvenience, and render the subject almost unfit for work. For several days previous to the operation the patient had been kept in bed, and the reducible portion of the tumor kept up. The operation was done under the spray. Before opening the sac, the surgeon made sure that it contained the irreducible portion only. This was found to consist entirely of omentum, much thickened and firmly adherent to the sac. The abdominal opening, which was very large, was now plugged with an antiseptic sponge, both to keep any blood from getting into the cavity or the intestines from getting out. After detaching the omentum from the sac, it was transfixed with a strong catgut ligature just at the external ring, and removed. The sac was then dissected up and cut away just beyond the external ring, and the ring closed by several interrupted catgut sutures. The operator was careful to catch immediately every vessel that bled, and to see that all hemorrhage had ceased before preparing to close the ex

ternal wound. A drainage-tube was now introduced, and the external wound finally closed by interrupted sutures. The parts being sprinkled thoroughly with iodoform, a thick padding of antiseptic gauze was applied, not only over the wound, but covering the entire lower portion of the abdomen, and extending below the groin on both sides. Over this the red macintosh cloth was placed, and all confined by a double spica-the first of gauze, the second of white flannel.* Sir William laid great stress on this particular mode of dressing, and says the result of the operation depends very largely on the manner in which it is applied. Sir William is a careful, painstaking operator, who does all his work thoroughly well.

The second case he brought before the class was one of osteotomy of the femur to straighten a limb, in which the knee had become ankylosed in a semi-flexed position. The operation was done by first making a longitudinal incision on the outer sides of the limb down to

the bone, just above the condyle; passing the chisel with cutting surface parallel to the long axis of the bone, and then turning it. He uses a sand-bag for the leg to rest on. After breaking the bone, he introduced into the wound a few strands of catgut for drainage, and used two interrupted sutures in closing it. The limb was then dressed in plaster-of-paris. He thinks this operation will answer in cases where the flexion is marked, and much prefers it to sawing out a wedge-shaped piece.

The hernia case has done uninterruptedly well.

Ten days after the operation Dr. Ord kindly took me through the medical wards of the hospital, and I saw him examine and prescribe for the patients. You know Dr. Ord personally. He is still much interested in the subject of myxedema-a term he gave to the disease which goes under that name. There was one case of the affection in the ward. He talked much on the subject, but added nothing to what he has published.

You may remember Bristow's Practice contains a good deal from him on the subject. Dr. Ord thinks it likely the Clinical Society will publish his studies of myxedema in book form, the manuscript being now all in the hands of the Society. He is one of the best talkers and most agreeable men I have met.

I spent an afternoon at St. Mark's Hospital with Mr. Allingham, and saw him operate on several cases of piles, remove a polypus, and lay open some fistula. A gentleman present said something to Mr. Allingham about his (Allingham's) operation for hemorrhoids, and he replied, "My dear friend, this is not my operation, but that of Mr. Salmon, my predecessor. He practiced it fifty years ago, and I have not altered or changed it in the least." You are aware that he gives Mr. Salmon credit for it in his work on the rectum. The mortality in the hospital from this operation, as done by Mr. Allingham, is one in a thousand, while in private practice he has not lost one case in three thousand. He thinks the treatment by injections is entirely too uncertain, and the mortality following that of cauterization far greater than that of the ligature, according, of course, to Mr. Salmon's method of using the lig

ature.

After ligating the internal piles, Mr. Allingham always snips off the external ones. Before doing either, however, he dilates the anus thoroughly. In the case of polypus, he dilated the sphincters, then introduced carefully one finger at a time until he got his hand into the bowel. I was rather expecting him to reach up and pull down the tonsil, when he brought down the polypus and threw a ligature around it. In the treatment of fistulæ he says the cause of failure is very frequently due to the fact of the operator having laid open the main tract only and leaving the branches to close them