DR. SIHLER gave an instance which he had learned from a patient where during an epidemic of cholera in one German village the neighboring village adopted the policy of strict nonintercourse and escaped. Absolute nonintercourse however could not be enforced, for one man at least was known to have stolen out by night and visited relatives in the infected village. One difficulty in effective quarantine is that it is acknowledged that a man can have cholera in a mild form without being aware of it, and thus spread the disease. DR. POWELL quoted Dr. Pepper as authority for the statement that cholera had been quarantined fourteen times in Staten Island, whereas it had reached New York city but four times. The weight of authority was that cholera could not travel faster than man or baggage and he doubted the existence of a "Cholera zone." DR. VANCE asked how he accounted for the well authenticated cases of ships leaving continents where there was no cholera, not knowing that cholera existed at all, on arriving at a certain latitude and longitude having it all at once break out among passengers and crew; other vessels later meeting the same experience somewhat nearer the continent, and still later an outbreak upon the continent itself, if cholera did not travel independent of man and baggage? DR. THAYER believed that the law governing the spread of cholera was not fully understood, and did not think that there was enough cholera in Europe to reach us this year. He thought the idea of inoculation for cholera was bosh. The disease was one which a man might have several times, as he himself could testify from experience in his own person. There was no analogy in this regard between cholera and small pox; inoculation against palsy of the sympathetic was an absurdity on the face of it. DR. VANCE Coincided with DR. THAYER as to the question of inoculation. The publication of such fallacious reasoning as that by which this theory was bolstered up, and scattering it broadcast, was pernicious, as it led men to neglect those precautions which did give greatest immunity viz. thorough cleanliness and disinfection. 9 HORSFORD'S ACID PHOSPHATE, (LIQUID.) Prepared according to the directions of Prof. E. N. COUNT BUMPORD Horsford, of Cambridge, Mass. Universally prescribed and recommended by physicians of all schools. In DYSPEPSIA, CONSTIPATION, INDIGESTION, HEADACHE, ETC. The lining membrane of the stomach when in a normal condition, contains cells filled with the gastric juice, in which acid phosphate is an important active principle. This is necessary to a perfect digestion. the stomach is not supplied with the necessary gastric juice to incite or promote digestion, dyspepsia will follow with all its train of incident diseases. The only known acid which can be taken into the stomach to promote digestion, without injury, is phosphoric acid combined with lime, potash, iron, etc., i. e. an acid phosphate, which is hereby offered to the public. If INCOMPARABLE.-Dr. Fred. Horner, Jr., Salem, Va., says: “I know of nothing comparable to it to relieve the indigestion and so-called sick headache, and mental depression incident to certain stages of rheumatism. PLEASANT AND VALUABLE.-Dr. Daniel T. Nelson, Chicago, says: "I find it a pleasant and valuable remedy in indigestion, particularly in overworked men.” MARKED BENEFIT.-Dr. A. L. Hall, Fair Haven, N. Y., says: "Have prescribed it with marked benefit in indigestion and urinary troubles." "I OF THE HIGHEST Value.-Dr. N. S. Read, Chicago, says: think it is a remedy of the highest value in many forms of mental and nervous exhaustion, attended by sick headache, dyspepsia, and diminished vitality. IN CONSTIPATION.-Dr. J. N. Robinson, Medina, O., says: "I have used it in a case of indigestion and constipation, with good results. In nervous prostration its results are happy. SPECIFIC VIRTUES.-Dr. A. Jenkins, Great Falls, N. H., says: "I can testify to its seemingly almost specific virtues in cases of dyspepsia, nervousness and morbid vigilance or wakefulness." We have received a very large number of letters from physicians of the highest standing, in all parts of the country, relating their experience with the acid phosphate, and speaking of it in high terms of commendation. Physicians desiring to test Horsford's Acid Phosphate will be furnished a sample without expense, except express charges. Pamphlet free. PROF. HORSFORD'S BAKING PREPARATIONS are made of the acid phosphate in powdered form. They restore the phosphates that are taken from the flour in bolting. Descriptive pamphlet sent free. RUMFORD CHEMICAL WORKS, Providence, R. I. OBSTETRICS. DEATH OF THE FETUS FROM DELAY IN DELIVERY OF THE BODY. DR. SCHULTZ contributes to the February number of the American Practitioner an instance of death of the fetus from the delayed expulsion of the body caused by uterine inertia. The case reported is not an anomalous one; indeed, it is not improbable that this accident, though by no means frequent, is, on the other hand, not very rare, and that there are but few obstetricians who have not met with a greater or less number of cases of difficult delivery of the shoulders. They, indeed, are very fortunate who have never seen a death from the delay incident to it. The treatment of these cases is then a most important practical question. In its discussion we shall lay aside those examples of great disproportion between the fetal body and the birth canal, as, for example, when tumors of the fetus, or ascites, delay or prevent the expulsion of the body. The history of the cases in which a failure of uterine force results in retention of the shoulders, after the head is born, is in some instances that of a protracted labor, the uterus having become exhausted by long efforts, and almost entirely ceasing to act after expelling the head. In other cases, the head has been delivered by forceps, because of failure of uterine action; and in many such, failure has been brought about by the too free administration of an anesthetic, this agent having been given to the extent of abolition not only of sensibility, but also of volition, and almost of uterine contractions, which at least have become feebler and less frequent. Indeed we believe that many a child's life has been lost by the unrestrained use of chloroform or of ether in labor. The danger to the child arises from compression of the chest, or from pressure on the cord, which may incircle the body once or oftener, and thus render it more liable to have its circulation arrested. To understand how we are to relieve the child most quickly and safely from its imminent peril, we must recognize the mechanism of labor in the delivery of the shoulders, for after this no delay usually occurs in the expulsion of the body. The passive movement of the fetus in the mechanism of labor after delivery of the head, is rotation of the shoulders from the pelvic transverse to the pelvic antero-posterior diameter. The uterine contractions, the most important and active factor in causing such rotation, being weak or absent, we substitute for the vis a tergo, a vis a fronte; that is, with our hands we draw the fetal head farther out, assist ing, it may be, by suprapubic pressure, the descent of the shoulders, and we may also endeavor directly in this traction to turn the occiput toward the mother's left or right thigh according as the occiput was originally toward the left or right side of the mother's pelvis; but traction and pressure being well made, we may generally trust this turning to nature. This movement having been effected, the anterior shoulder will be found just emerging at the pubic arch, for we hold that in all cases of perfect perineum the anterior shoulder, notwithstanding the conflicting statements of some obstetic authorities, is born first. This shoulder, as well stated by Pajot, represents the occiput in delivery of the head, and as in the latter delivery the nape of the neck or the suboccipital region becomes the fixed point resting upon the pubic arch, so the part of the arm just below the shoulder rests upon the arch until the posterior shoulder and arm are delivered, while the body undergoes lateral incurvation, a movement corresponding to extension in the delivery of the head. Once the anterior shoulder has taken the position mentioned, our ef forts must be directed to the delivery of the posterior shoulder, and this end we seek to accomplish by raising the head and making slight traction in order to bring the posterior shoulder far enough down so that a finger can be introduced into the axilla and traction thus made. But if we fail thus to reach the axilla, we may, as advised by Spiegelberg, and as taught by the late Professor Hodge, push the anterior shoulder in behind the pubic joint, thus bringing the neck of the child in the pubic arch, and causing it to press against the subpubic ligament, and by this means the posterior shoulder can usually be brought to the margin of the perineum. This having been accomplished, the head is carried backward, when the anterior shoulder again comes just outside of the pubic arch, and delivery is easily effected. In some cases a blunt hook placed in the axilla may be necessary, only one must be careful as advised by Spiegelberg, not to act upon the humerus on account of the risk of detaching epiphysis. Jacquemier taught that after the head is born two methods are offered the one, traction upon the head, -it sometimes succeeds, but often fails; the other, traction by the fingers in the axilla. He looked upon the latter proceeding as only preliminary to the disengagement of the arms, drawing upon which the trunk is delivered. He thought this method not only furnished the best means of exerting traction, but also very advantageous by lessening the size of the chest. Charpontier endorses the practice, but frankly states the occurrence of an accident in a case in |