in 1779, 1837, and latterly in 1886, at Paris. Valleriola described them in 1557, and the epidemiologist Baillou, a Parisian, devoted a remarkable study to them in 1570-71. Is pneumonia a manifestation of influenza, or is it one of its complications? To this the answer, according to the majority of writers on the subject, is, that it is neither one nor the other, that the influenza merely prepares a bed for pneumonia in subjects predisposed.

As regards the generalization of the epidemic there have been some striking examples. For instance, in 1847 the entire universe was struck in a few months. In 1850 all Spain was affected with the influenza on the same day, the rich as well as the poor; no class was spared. Since Hippocrates, it is known that it is the easterly winds which habitually coincide with the epidemic catarrhal constitutions. This fact was corroborated by John Huxam, the English author of one of the best descriptions of influenza given in the last century. In 1837 the savants attributed the epidemic to meteoric, and even sideral influences, of which the easterly wind was the least obscure. It would appear that we scarcely know much more respecting the causes of the present epidemic. It is, however, the manifestation of 1837 which remarkably approaches that of the present one. The description given by Sandras and Landouzy on la grippe at the Hôtel Dieu in January and February, 1837, affords a striking example of this analogy, rarity or absence of maladies several months before the epidemic. The sanitary condition was perfect when at the commencement of 1837 the tickets for admission to the hospital bore the diagnoses of pains, lassitude, catarrhal fever, etc. The same thing happened in 1889. The extreme moderation of the mortality during the whole time of the Exhibition surpassed the most optimistic provisions. In a few days from the 10th of December the hospitals were crowded.

In 1837 the same thing occurred, and such a number of persons stricken at the same time was never before known, even during the memorable cholera of 1832. The follow

ing were the most marked symptoms noticed by Sandras in 1837: extreme lassitude, soreness of the limbs, violent cephalalgia, vomiting, and tendency to syncope. The patients said that they felt as if they had been beaten with a stick. The greater number incapable of standing on their legs, which were almost paralyzed, were obliged to have recourse to stretchers to be conveyed to the hospital. Their physiognomy expressed stupor; they complained of a total loss of appetite and of sleep; they also felt a catching pain in the sides of the chest and cramps in the muscles. The abdominal form of grippe was rarely observed, as also in the present epidemic. Phthisis was ordinarily but not always aggravated by the influenza. Thus it may be seen that the morbid sketch is the same now as it was fiftythree years ago. Even the convalescence and the probable date of cure were also difficult to decide. difficult to decide. The treatment adopted by our ancestors in medicine seemed quite rational, and would have been more usefully carried out now instead of hunting after socalled specifics. In 1864, Carrière, remarking the analogy of influenza with intermittent fever, recommended the use of the sulphate of quinine. The preparations of cinchona bark he thought were not only the best curative remedies, but they were also the most powerful engines of prevention against the epidemic of catarrhal fever. Teissier had also shown, in a remarkable memoir, that the preparations of aconite, while not responding evidently to all the indications of a malady so complicated as is influenza, singularly diminish this sensation of general prostration which sometimes lasts several weeks, and even several months. When the expectoration was difficult, a mixture composed of the acetate of ammonia in an infusion of polygala was administered, or in some cases a vomi purgative was prescribed. During the present epidemic ipecacuanha and opium in combination were also freely employed by the older physicians, and Dr. Alison, of Baccarat, advises the employment of etherized tannin, two drams per day in three wafers, to be taken imme

diately after meals. This medication, he observed, sensibly shortened the duration of the grippe and of its convalescence.

The following note in connection with. this subject may be found of interest. Dr. Renvers, of Berlin, considers that the influenza belongs to the series of epidemic maladies the most anciently known and of the most frequent occurrence. The epidemic habitually lasts from four to six weeks. The disease affects each sex, every age, and every class. It is not influenced by geographical, climatic, or meteorological conditions. It is considered to be an infectious malady, but the infectious agent is unknown. The prognosis has, till now, been particularly favorable, these cases never ending fatally.

PARIS, January 24, 1890.

Abstracts and Selections.

SOME RECENT ADDITIONS TO THE MATERIA

MEDICA. Among the new drugs which Messrs. Parke, Davis & Co. announce they can supply are the following:

Cocillana. Guarea (species undetermined). Synonym: Sycocarpus Rusbyi, Britton. Part employed: The bark. Natural order: Anacardiaceæ. Habitat: Bolivia. Properties: Expectorant, tonic, laxative. This new remedy possesses a sphere of influence on the respiratory organs somewhat similar to ipecac., but said to be "superior in certain diseases of the air-passages in which the latter is often used." (Dr. D. D. Stewart in Medical News, August 24, 1889.) Besides its excellence as an expectorant, clinical experience has also established the fact that it exerts a tonic influence upon the appetite, and that it reduces the night sweats of chronic bronchitis and phthisis. Cocillana also gives promise of usefulness as a laxative. Dose, 10 to 30 minims (0.6 to 2 c.c.)

Eschscholtzia. (Eschscholtzia Californica, Cham.) Synonym: California poppy. Part employed: The whole plant. Natural order: Papaveracem. Habitat: California. Properties: "An excellent soporific and analgesic, and above all harmless." Recent analysis claims to have discovered the presence of a minute quantity of morphine in the plant. The quantity contained, however, is not sufficient to account for all the therapeutic effects, and further chemical

investigation promises to isolate another active principle which may better explain. its action. The drug is a very useful anodyne in certain cases. The inconveniences. attributed to the use of opium, such as stomach disturbance, constipation, etc., have not, in any case, been observed in its It may with advantage replace opium preparations for children. Fluid extract of preparations for children. the plant. Dose, 15 to 30 minims (1 to 2 c.c.).

use.

Jatropha. (Jatropha macrorhiza, Benth) Synonyms: Jicama, Jicomia, Span. Part employed: The root. Natural order: Euphorbiaceæ.

Habitat: Northern Mexico and Southern States adjoining. Properties: Alterative and cholagogue; in larger dose hydro-cathartic and sometimes emetic. Jatropha macrorhiza, a household remedy of the Mexicans, has been recently recommended for use in this country by Dr. A. H. Noon, on account of its comparative tastelessness; the slight taste the drug possesses being compared to that of the sweet-potato. It has been suggested that as an addition to non-cathartic, but otherwise astringent mixtures, its use could not be otherwise than valuable. Clinical experience will doubtless develop other and more specific indications for its employment. Fluid extract of the root. Dose, to 2 fluid drams (2 to 8 c.c.).

Echinacea. (Echinacea angustifolia, De.) Synonym: Black Sampson. Part employed: The root. Natural order: Compositæ. Habitat: Western United States. Properties: Very strong claims have been recently made for this drug as an alterative of great value in all strumous and syphilitic indications. Old chronic wounds, such as fever sores, old ulcers, etc., have yielded to its use after resisting potassium iodide, sarsaparilla, yellow dock, etc. It is also stated to be an infallible remedy in the treatment of blood-poisoning, of snake-bites, and as a prophylactic and also curative agent in hydrophobia. Fluid extract of the root: Dose, to fluid dram (1 to 2 c.c.).

Hydrastinine. A new derivative of Hydrastine-a possible substitute for ergot. This substance, an oxidation product of bydrastine, white alkaloid of golden seal, has recently been prepared by us in order to afford opportunities for physiological investigation in European laboratories, prominent among which are those of the universities of Dorpat and Berlin. It can be obtained from hydrastine by the action of various oxidizing agents, and though the original methods were attended with considerable

waste, improvements in this respect are constantly being made. So far the most troublesome element is encountered in its purifica tion and crystallization. The reaction tak ing place in its production may be illustrated thus: Hydrastine, C2, H21, No. 6; Hydrastinine, C., H., No. 2; Opianic acid, Co H10, No. 5. The alkaloid or base being sparingly soluble, and moreover rather prone to decomposition when in solution, we have given preference to the hydrochlorate as possessing the desirable elements of stability and solubility in aqueous fluids. Recent advices from the highest European authorities represent it to be of immeasurable service in controlling uterine hemorrhages, far surpassing ergot in efficiency, certainty of action, and safety. Broom-corn Seed. (Andropogon Sorghum: Brot.) Synonyms: Sorghum saccharatum, Pers. Sorg. vulgare, Pers. Part employed: The seed. Natural order: Gramineæ. . Habitat: Sub-tropical; distribution, extensively cultivated. Properties: Diuretic, sedative, demulcent, and soothing to the irritated urinary organs in vesical catarrh, cystitis, and irritable bladder. In the aged, who are compelled to rise frequently at night to void their urine, it has produced great relief. It must not be confounded with broom-top or scoparius. Dose of fluid extract of the seeds: 1 fluid dram (4 c.c.) three to five times daily. Among other products this house has recently introduced may be mentioned the following:

Compound Sulphur Lozenges, Acetanilid Tablets, Soluble Elastic Capsules of Quinine Muriate. They are headquarters also for selected pressed herbs which they guarantee to be superior to any others in the market.

ELECTROLYSIS IN URETHRAL STRICTURE.For the successful carrying out of this treatment much time and patience are necessary. The few failures I have seen have really been due to impatience. When, in a sitting, no progress is apparent after a few minutes, an increased current is turned on, and considerable force used to get the electrode through. Can one be surprised if, under these circumstances, a false passage is made, hemorrhage and urinary fever ensue, and the treatment is cast aside as worthless?

Experience has taught me to limit this method to strictures of the deep urethra, and in these, of whatever variety, it is almost always successful. When I say successful I mean that the same result is attained as when an internal urethrotomy has been performed, namely, the lumen of the stricture has probably been enlarged to 22

Fr., and for the maintenance of which the passage of a bougie at stated intervals is absolutely necessary. I have not the same proportion of cures to record which Mr. Bruce Clarke claims to have obtained for in only one of my cases has an absolute cure resulted, by which I mean that no tendency to recontraction remains, although all instrumentation has been given up for, say, six months. months. Mr. Clarke says that, "Of fifty cases, twenty-three were known to be well after periods varying from one and one half to three years." What does he mean to imply by "well"? If he means that such a one is restored to comfortable micturition, and can maintain this state by passing his bongie at intervals, I can well believe him; but this, of course, is very different from what one usually understands as being well. I have almost entirely limited electrolysis to the treatment of resilient and severe cases of stricture, using it as a substitute for urethrotomy. In this way I have during the past year treated, among others, two medical men, both of whom are loud in its praise and have unbounded confidence in it. In this respect I have been more fortunate than my colleague Mr. Reginald Harrison.

It is, I think, an important point in cases of multiple stricture, and one which I always endeavor to carry out, namely, to deal with those in the penile urethra, either by cutting or dilatation, before applying the electrode to the deep urethra. One is often surprised to find how much benefit has occurred to a deep-seated stricture after free division of a meatal or other anterior one, thus clearly demonstrating its, at all events, partly spasmodic character, a point on which much stress is laid by Otis. To this element of spasm the good effect of electrolysis is no doubt greatly due.

In the Medical Press of April 11, 1888, I published a paper on this subject, and subsequent experience has only confirmed the good opinion I then expressed of it when limited to subpubic strictures.

Before closing these remarks, I would add that this form of treatment is of much benefit in many cases of perineal pain and other urethral neuroses. I am at the present time treating a gentleman, the subject of stricture, for which he has twice undergone internal urethrotomy, in whom the passage of a bougie is always followed by much. genital excitement, and which so annoys him that he has often been tempted to neglect treatment. Since undergoing electrolysis (he has had nine or ten sittings) he is no longer troubled in this way, and his

stricture has been dilated from No. 12 to No. 24, French gauge.-F. Swinford Edwards, British Medical Journal.

BOXING THE EARS AND ITS RESULTS.-We would fain hope that, in deference to repeated warnings from various quarters, the injurious practice of boxing the ears, once common in schools, is fast and surely becoming obsolete. It is too much to say that this desirable end has yet been realized. Certainly the recent observations of Mr. W. H. R. Stewart do not give color to any such view. In a pamphlet on " Boxing the Ears and its Results," lately published and illustrated by appropriate cases, he briefly summarizes his own experience in the matter. He there reminds us that, notwithstanding the toughness of the aural drumhead, its tense expanse will rupture only too readily under the sudden impact of air driven inward along the meatus, as it is in the act of cuffing; and he shows that in one instance at least this injury resulted from a very slight though sudden blow. Given early and skilled attention, the wound may heal very kindly, but if the beginning of mischief be overlooked, as it often has been, further signs of inflammation soon follow, and a deaf and suppurating tympanum is the result. There is practical wisdom in the statement that this consequence most readily follows in the case of the poorly developed and underfed children who abound in every board school. In them an earache would probably receive no very strict attention, and disease might for a time work havoc unimpeded. Where chronic suppuration exists already, and it is only too common, a random knock on the ear may result, as in a case related in the Lancet in a fresh otitis, with fatal brain complications. Schoolmasters and others, who may at times be tempted to apply the correcting hand somewhat too carelessly, might read the few pages of this little work with equal interest and advantage. The close connection between ear and brain should never be forgotten, and the reflection that injury to the former organ most easily terminates in total deafness, and in suppuration which may any day take a fatal course, should assist in the preservation of a sometimes difficult patience. Lincet.

THE ELECTRICAL TREATMENT OF UTERINE FIBROIDS. - Apostoli attacked the method particularized by MM. Championniere and Davion at the meeting of the French Congress of Surgery. Their method is based on

the employment of currents of moderate intensity, the extra-uterine action, and the reversed action.

He claims the inferiority of this method for various reasons. Their statements are based on seven months' experience and eleven cases, while the method of Apostoli has been established seven years, has received the approval of all who have used it, and includes several thousand observations in France and other countries. They remain surgeons and continue to perform castrations and hysterotomies. They select their cases, using the current in aged women or those but little sick, and operating on the young women. They admit of failures which legitimize their surgical intervention. Their method remains vaginal and extra-uterine, preventing all cure of the accompanying endometritis. With them, the relapses are constant if the treatment is not continued. They do not affirm as to the disposition of the inflammatory deposits. "La fonction des eaux chloruées sodiques," which they praise, shows that their method is at fault. They have not proved the evident anatomical reduction of the fibroma.

Apostoli asserts the efficaciousness of his method: Because it has the pretension to suffice in itself, and in most cases to supplant surgery in the treatment of fibroma, it does not require the selection of cases, and all cases are ameliorated, young and old; because failure is the exception in all cases of simple fibroid tumors, not fibrocystic, which are not complicated by ascites, and without puerperal lesions of the annexes; because there is utilized the action of vaginal galvano-punctures, either singly or in conjunction with the intra-uterine action which is necessary for the endometritic lesions; because relapses are the exception, and the greater part of the results remain constant, if the treatment has been sufficiently prolonged; because it embraces with its sphere of action, under formulæ of intensity and diverse localization, the treatment of fibroma, that of endometritis and metritis, and of a great number of cases of Ovaro-salpingitis; because it can do without an additional treatment, even that of les caux chloruées sodiques; because there has been observed an anatomical reduction of the fibroma, not total but partial. His method is inoffensive and always supportable if the rules are conformed with. very rare cases of death observed are due, in great measure, to errors in diagnosis, tumors of the appendage mistaken for fibroma and electrically treated.

The

Apostoli claims the priority and paternity of all medical electrical applications exceeding fifty milliamperes. For two years he has exclusively employed intensities from forty to seventy milliamperes; since that time he has considered it necessary to increase, not in an exclusive and blind manner, as has been stated, but by a rational and progressive method, according to the

cases.

The intensity should be moderate in cases of uterine intolerance or peri-uterine affections; the intensity should be increased in all the grave forms complicated by endometritis or by hemorrhage.

Aimé, Martin, and Chroné were the first ones to particularize (1879) the action extrauterine, either on the neck or on the vagina, and were the first to use the reversals or the interruptions of the galvanic current. Moutz Benedick, of Vienna, had also applied the reversed galvanic current before MM. Championniere and Davion.

E., S. M.

VOLVULUS AND ITS TREATMENT.-The following conclusions are arrived at by Dr. N. Senn at the close of an interesting paper upon the surgical treatment of volvulus (Medical News, November 30th), in the course of which he deprecates the resort to any such attempts at taxis as those advised by Mr. Hutchinson, and recently published in his "Archives of Surgery." Dr. Senn gives a successful case of volvulus of the sigmoid treated by laparotomy: "(1) The predisposing causes of volvulus are either congenital or acquired, and consist in elongation of certain segments of the intestine, abnormal length of mesentery, and adhesion. (2) Irregular distribution of intestinal contents and violent persistalsis are the most important exciting causes. (3) Volvulus is most frequently met at the sigmoid flexure and the lower portion of the ileum. (4) Secondary volvulus on the proximal side of other forms of intestinal obstruction is not a rare occurrence; it is also frequently developed during an attack of peritonitis. (5) As a rule, the symptoms are more acute and intense if the volvulus is located above the ileocecal region. (6) Vomiting in cases of volvulus of the sigmoid flexure is not a constant symptom. (7) The most important physical sign of volvulus is a circumscribed area of tympanites which corresponds to the location of the volvulus; but this sign is only of value before general tympanitis has set in, and therefore enables the surgeon in many cases to make an early and positive diagnosis. (8) All cases of volvulus should be treated by laparotomy if reposition can not be accomplished by rectal insufflation of hydro

gen gas. (9) Reposition should not be attempted without evisceration. (10) Evacuation of intestinal contents by a free incision should be practiced in every case where general distension of the intestines is present. (11) Enterectomy becomes necessary if any considerable portion of the intestinal wall has become gangrenous. (12) Irreducible volvulus should be treated by establishing intestinal anastomosis with permanent exclusion of the seat of obstruction from the active fecal circulation. (13) Recurrence of volvulus can and should be guarded against by shortening the mesentery by folding it upon itself parallel to the long axis of the bowel and suturing the apex of the fold to the root of the mesentery."Lancet.

MENSTRUATION AND PSEUDO - MENSTRUATION AFTER DOUBLE OVARIOTOMY AND REMOVAL OF THE UTERINE APPENDAGES.-One of the most interesting phenomena which sometimes follows double ovariotomy, or removal of the uterine appendages, is the persistence of menstruation, or a more or less periodical metro-staxis. periodical metro-staxis. This is usually utterly unexpected to the patient, and may cause her to lose her faith in medicine as a science, or in the operator as a successful practitioner. The phenomenon is also of interest to the physician because of the physiological and pathological questions involved. That the occurrence is not very rare may be seen from the fact that statistics seem to show that from five to ten per cent of women who have submitted to double ovariotomy, or the removal of the uterine appendages, afterward go through the phenomena of menstruation or pseudo- menstruation. Wylie gives ten per cent as the number; Battey four cases out of fifty-four.

As to the causes of this persistent bleeding there is a general agreement among operators; and it is attributed either to leaving behind some portion of ovarian tissue, or to certain diseased conditions in the pelvic peritoneum, blood-vessels, and connective tissues, or to disease of the uterus. Theoretically it is possible always to remove the uterine appendages entire, but in practice it is at times exceedingly difficult. Even though the ovary is freed sufficiently to pass the ligature below it, it is sometimes necessary to "scalp" the ovary to leave a stump sufficiently good to prevent the liga. ture from slipping. Also, in enucleating ovaries densely adherent to the floor of the pelvis, the ovarian tissue is at times torn, and portions are left behind. Besides this, ovarian tissue may remain in the form of