plying by processes of fission and gemmation. This characteristic, originally possessed by inde pendent units, is still, in greater or less degree, a feature of those units which, when combined in various ways, make up the tissues and organs of higher forms of life. At times, and under special circumstances, which, in the present state of our knowledge, in many instances can only be roughly traced, this ancestral tendency of the cells to divide and multiply on their own account shows itself once more with something of its old vigour, and then new formations of various kinds result. When the blood vessels are invaded by pathogenic micro-organisms, may it not be that, as previously pointed out, a kind of warfare, so to speak, goes on between the blood cells and the vegetal germs, and that when the latter gain the victory the man or the animal dies: whereas in cases where the blood-cells possess the power of strong resistance, the sufferer also withstands the deadly effect of the foe? In some instances, then, the fertility of cells in the way of reproduction would be highly servicable to the man or animal, while in others such power of multiplication is manifestly most destructive. Is it not a great question if we should not, in our investigations of disease, search most diligently into all these conditions which would enable us both to control and to facilitate the growth and multiplication of cells?—A. Gresswell in Lancet. some points regarding the enchondromata. En- It will be seen that the view which Dr. D. Astley chondroma myxomatodes presents structural Greeswell pointed out, but which we now wish to features, such as are met with in the notochord of lay stress upon, is that one of the primary prothe vertebrate animals. The cells of some en-perties of cellular organisms was that of multichondromata are stellate, their processes uniting into a network. A like condition of cellular structure is met with in the selachii, which may be regarded as the root forms of the vertebrates. Again, enchondromata are most common in the limbs, and especially in their distal extremities; and, since the original condition of the vertebrate limb is represented in the selachii as a multitude of cartilaginous rods arranged in a definite manner (the rods increasing in number towards the distal extremity of the pro-pterygium, the meso-pterygium, and the meta-pterygium), we are perhaps justified in looking upon these facts as showing to us homologous relationship. Corroboration is seen in the frequency with which cartilaginous bodies develop in connexion with certain joints of the limbs in man and animals. These bodies are either single or multiple, and they are of all sizes up to that of a small apple. Cruveilhier figures a number of rounded cartilaginous bodies in the elbow joint. Mr. Smith removed over 200 loose rounded cartilages from the knee joint of a man at St. Bartholomew's Hospital. He also operated on a woman, aged twenty-eight, who had for six years presented a tumour in the upper third of the right arm, immediately beneath the skin. The tumour was pyriform, tapering towards the axilla. It was three inches and a half long, and two inches in diameter at its thickest part. It was encapsuled, and within the capsule there were found one large mass of cartilage and twelve or more detached lobulated bits of cartilage. There THE CLIMATE OF COLORADO SPRINGS were also similar detached nodules of cartilages in the axilla. The limbs, in fact, of the higher animals may have therefore dormant germs of the ancestral rods of cartilage; indeed, cartilage cells have been found in the synovial tufts of some joints. From such centres some of the abovementioned cartilages had apparently developed. Supernumerary fingers have been referred to the multifid condition of the rays of the selachian fin. New formations of capillary vessels are generally congenital, and they are much commoner in the skin of the head and neck than elsewhere. These facts might suggest the possibility that they bear homologous relations to the vessels which develop about the epiblastic involutions lining the visceral arches of the lower vertebrata. Dr. D. A. Gresswell recently saw a nævus, the distribution of which seemed to afford some corroboration for such a speculation concerning the homology of nævi. It extended in a snake-like form down the right side of the neck; it was distinctly raised, and it passed with a tapering extremity into the external auditory meatus, down which it extended for a considerable distance. FOR THE PHTHISICAL. A gentleman who had tried the favorite resorts of Europe and America, describes the advantages of Colorado Springs as follows in the New York Tribune of May 22, 1887 : No climate is absolutely perfect, so I shall first call attention to the only blemish in the climate of Colorado Springs. We have some wind and, at times severe wind, yet the number of days when an invalid is compelled to remain indoors on account of strong wind is not more than the number he is compelled to spend indoors at Davos, in Switzerland, on account of the falling of snow. Furthermore, if an invalid finds the wind objectionable he can readily escape it by changing to Manitou Springs (ten minutes by rail), which is even more sheltered than Davos. Now as to the advantages of Colorado Springs : 1. Its altitude is six thousand feet above sea level. To the north the land rises gradually, thickly wooded, to the height of 7,500 feet. Six miles to the west runs a spur of the Rocky Mountains culminating in Pike's Peak, 14,200 feet high. Thus the city is sheltered to the north and west, and is open to the south and east. 2. The sunshine is almost uninterrupted. During the winter there is no rain, no cloudy or foggy weather, and hardly any snow. Snow falls very rarely, and when it falls it disappears quickly and almost miraculously, leaving neither mud nor dampness behind. 3. As the city lies open to the east and the higher mountains to the west are at some distance, the daily duration of winter sunshine is very great-fully forty per cent. greater than at Davos. 4. The character of the soil is porous. This is a very important advantage. If rain or snow falls at Denver, for example, the result is mud, and mud means continued dampness. There is no mud at Colorado Springs. 5. The invalid is not restricted to hotel life. Boarding-houses and furnished houses abound. Housekeeping, owing to the presence of a large number of very superior stores, is made easy. Should the invalid prefer hotel life, he will find the hotels first-class, but be it said that no American hotels are so carefully managed as to comfort nor so particular as to ventilation as are the hotels of the Riviera or of Davos. 6. There is nothing of the hospital character about Colorado Springs. Of its 7,000 in habitants, many never were sick, and many who once were are now perfectly cured. The invalids are scattered to such an extent, there are so many amusements and points of interest to disperse them, that one never feels the depressing influence of being in a great consumptive hospital. 7. Amusements are very plentiful. There are few cities in the world that offer such a variety of beautiful rides and drives. Invalids are out riding or driving nearly every day in the year. Many people of wealth and culture reside here, society is pleasant and clubs of all kinds abound-social clubs, reading clubs, musical clubs, fox-hunting clubs, etc. invalid here has neither time nor disposition to mope. 8. One of the objections I found to Davos and the Riviera was that when spring came the patient was chafing to get away. I do not find this at Colorado Springs. Nor is it necessary. The summer climate is just as healthful and just as exceptional as the winter climate. In fact, the reputation of Colorado summers brings thousands of tourists here every summer. The days are warm, not uncomfortably so, and the nights are always cool enough to make a heavy blanket necessary. Some invalids go up into the beautiful near-by mountain parks (8,500 to 10,000 feet high), and live at a farm house or camp out. Some change to Manitou Springs and enjoy witnessing the summer gayety. The majority remains here and are equally benefited. 9. If a patient feels disposed to make a change during the winter, he has a large choice of places which he can visit with safety. He may go to Denver or to any of the towns between Colorado Springs and Pancha An Springs inclusive. This belt of territory is all favored with an exceptional climate. On the other hand, if an invalid finds that the climate does not agree with him, he can travel hence to Southern California quickly and comfortably. Med. News. OPERATIVE TREATMENT OF EMPYEMA In the Archiv. für. Klin. Chirurgie, is a full report of a paper on a new method of dealing with licz, of Cracow, at the last meeting of the German empyema of the antrum, read by Professor MikuSurgical Society. The indications to be fulfilled in the treatment of this condition are, it is stated, clear and simple. In every case it should be the surgeon's endeavor to make an artificial opening in the cavity, and to maintain this opening until suppuration has been completely arrested. The methods which establish an opening into the cavity is thus perforated at a convenient and acantrum by the mouth have two advantages. The cessible spot. The surgeon can readily apply his instruments, and the after-treatment can be conducted under the control of both his eyes and for the flow of pus, and corresponds to the most fingers. Moreover the perforation is well situated dependent part of the antrum. There are, howtion by the mouth. Suppuration in the antrum ever, certain disadvantages attending the operaoften persists for a long time, it may be for months opening until the discharge has closed. This is or even years, and it is necessary to maintain the for the opening to contract and close, unless a stiff not an easy matter, as there is always a tendency drainage-tube be worn. Free communication beinconvenience, and portions of food and other foreign tween the antrum and the mouth is attended with material may pass through the opening into the cavity, decompose there, and set up fresh suppuration. In consequence of these objections to the up the antrum in another direction. An objection oral operation, attempts have been made to open might be made, it is pointed out, to the old operation on physiological grounds. The antrum has not any normal connection with the mouth, but the nasal cavity with which, in a healthy conit is to be regarded as a pneumatic appendage of dition, it has free communication. munication be shut off in consequence of any If this com be the most rational that serves to re-stablish the pathological process, that operation would seem to normal condition. The author is opposed to any method of attempting to reach the antrum through the middle meatus. It would, he states, be found very difficult in such attempt to open up the antrum perforating instrument would be brought into. and afterwards to inject the cavity. Besides, the dangerous proximity to the orbit, which cavity is separated from the nose by only a thin plate of bone. Again, an opening in the middle meatus would be most unfavorably situated for the discharge of a large accumulation of pus. The author advocates an opening made from the inferior meatus. The osseous septum between the portion of the nasal cavity and the antrum is very thick and dense near the hard palate, but soon becomes reduced to the thickness of paper, and may be readily perforated by a stout cutting instrument. For this purpose a short double-edged knife, or rather cutting stylet, set on a curved shank, has been devised. This is introduced along the inferior meatus, until it reaches the inferior turbinated bone, when its point is turned outwards and thrust through the septum into the antrum. The opening having been enlarged by to and fro movements of the instrument, the elongated and curved nozzle of a specially devised elastic bell-syringe is introduced, and the cavity of the antrum is washed out. This operation, which proved successful in two cases reported in this paper, is not likely, it is asserted, to be attended with any difficulty except in cases of abnormal narrowness of the inferior nasal meatus, of extreme hypertrophy of the inferior turbinated bone, or much thickening of the osseous septum between the antrum and the inferior part of the nasal cavity.-Lond. Med. Rec. of a chromic acid solution (twenty or thirty grains to the ounce of water) to a cancer in a state of ulceration is sometimes useful. The following is the formula for preparing the mixture, as published by the dispenser to the Queen's Hospital, Birmingham: An etheral tincture is first made by mixing equal parts of Chian turpentine and ether, and shaking frequently in a well-corked bottle until all soluble matter is lissolved. An emulsion is then prepared in the following manner: Place in a large mortar two hundred and forty grains of powdered acacia, and fifty grains of powdered tragacanth, and one ounce of the tincture of Chian turpentine, mix, and add, all at once, a fluid ounce of water, triturate until an emulsion is formed and then dilute gradually up to eight fluid ounces. Two fluiddrachms will contain seven and a half grains of the pure drug-the initial dose. All trace of ether must be removed by exposure in an open vessel, preferably in the cold.' "Those cases are most suitable for treatment in which the disease affects the skin or mucous surfaces, and the earlier the treatment is begun the better is the chance of success. When the lymphatics are extensively involved, or when the disease has invaded the peritoneum, pleura or vagina, the drug can be recommended merely as a palliative. In cancer of the uterus or rectum, if treatment has not been begun very early, disease of the kidney (not necessarily of a malignant character) is apt to arise. If this condition becomes CHIAN TURPENTINE IN THE TREAT- manifest, the action of the drug will require careful MENT OF CANCER. Dr. John Clay, of Birmingham, England, writes as follows concerning the administration of Chian turpentine in cancer : "Success in the treatment of cancer by this drug depends upon : 1, the mode of its administration; 2, the stage of the disease; 3, the complications by which the growth is attended; 4, the persistence of the treatment. The idiosyncracy of the patient will also influence more or less the rapidity of action of the drug; in one case the good results will be apparent in two or three weeks, while in another it will be as many months before the external appearances will give evidence of any beneficial action. If there is no perceptible increase in the growth in the course of two or three months, it may be relied upon that the drug is exerting a beneficial action, and other things being equal, the ultimate success of the treatment will depend upon the perseverance in its continuance. Everything depends upon the purity of the drug, for there is an immense amount of adulterated and fabricated stuff in the market. There is prima facie evidence of the genuineness of the gum if no violet odor is communicated to the urine, and if no skin rash or cutaneous eruption is manifested after the lapse of a few weeks. The external application watching, and it may be necessary to abandon it altogether. It is advisable, after the medicine has been taken for two months, to omit it for two days in each month, beginning again with it in the same dose that was given at the time of its discontinuance. Opium, in large doses, is antagonistic to Chian turpentine and should only be given when absolutely necessary because of severe pain, and then only in small doses-about seven minims of the tincture incorporated in the mixture. "The combination of resorcin with Chian turpentine (two drachms to eight ounces of the above mixture) is sometimes beneficial. The mixture is given in doses of one teaspoonful in cold milk three times a day after meals, increased in two weeks to two, and in two weeks more to three teaspoonfuls. Its administration is to be persevered in for a long time. Too speedy results are often expected from the remedy, and hence it may be abandoned too early before it has received a fair trial. If the disease seems to be arrested at the expiration of a few weeks, it is quite sufficient to justify a continuance of the drug. "After the arrest of the disease the remedy must be continued until some obvious change takes place, and it must be administered continuously in increasing doses, under any circumstances, even if some apparently discouraging conditions arise.” Dr. Clay adds some remarks concerning the administration of the remedy in individual cases, which, however, we are obliged to omit on account of the pressure on our columns.-Medical Record. MEDICAL NOTES. The subiodide of bismuth is now being much used as a local application at the hospitals, instead of iodoform. There are only two remedies which have the power of causing involution of uterine fibroidselectricity and ergot. The best preparation of aconitine is Duquesnel's. It is three times more powerful than any other preparation in the market. Of internal remedies for hemorrhage of uterine cancer, Prof. Parvin states that probably one of the best is the infusion of cotton root. In constipation caused by a deficiency of excretion, secretion and muscular power, a capital addition to a purgative pill is physostigma. For flushings and other morbid sensations occurring about the climacteric period, Prof. Bartholow prescribed a three grain pill of iodoform, ter die. The best remedy for relief of, but which cannot cure, paralysis agitans, is hyoscyamine, gr. Tho twice a day. Do not produce the active effects of the drug. A case of infantile eczema was recently shown at the Jefferson College Hospital clinic, which had been treated locally with a solution of resorcin, with very beneficial results. For spermatorrhea, characterized by a lack of vigor in the erections, due to a want of tonicity of the vessels, give digitalis; may be advantage. ously combined with the bromides. For dysmenorrhoea, Prof. Bartholow advises the inhalation of amyl nitrite for the attacks, and during the intervals the internal administration of the one per cent. solution of nitro-glycerine. Prof. Da Costa strongly recommends gallic acid in hæmoptysis, but advises it to be given in doses of gr. xv-xx every fifteen minutes "until the blood turns black." It is of no use whatever in small doses. For mitral stenosis, Prof. Bartholow advised that caffeine in gr. iiij doses be given three or four times daily; to improve the general nutrition, gtt. j-v of dilute nitro-glycerine, to determine the dose by the effect. For diarrhea coming as a desire to stool after eating, with thin and watery discharges, Prof. Bartholow ordered the following: Two drops of Prof. Bartholow thinks for beginning pneumonia up to stage of exudation, nothing is better than a combination of tinct. aconiti and tinct. opii. gtt. v of the former, and gtt. viij of the latter, as an initial dose, followed by, respectively, gtt. ij-iij of each every hour, or according to the effect produced. For diarrhea of three months' duration, characterized by a desire to evacuate the bowels immediately after eating, Prof. Bartholow advises the following plan of treatment: Put patient on a miik diet as far as possible, also— Creasoti Ꭱ Bismuthi subcarb. Sig. -Ter die, before meals. mij gr. X-XV f3ss. M. Col. and Clin. Record. THE TREATMENT OF ECZEMA. Ec The diagnosis of eczema is comparatively easy. If we except acne, it is the commonest of all the cutaneous diseases. It includes about one-third of all cases of skin diseases that come under treatment. It seems to be more frequent in this country than abroad, Hebra making it about 16 per cent. of all the cases treated at Vienna. zema is remarkably protean in its manifestations, showing itself under the most varied forms; at one time it appears as an erythema, and at another time takes the vesicular form. Also remember it is the only weeping skin disease-not in the sense that an excoriated surface weeps, but as part of the pathological process of this disease, by an excessive exudation of liquor sanguinis, which cannot be consumed in supplying loss, which remains over and infiltrates the cutaneous structure. The squamous or dry form is mistaken for psoriasis, a squamous syphilide, etc. Seborrhoea also is often mistaken for eczema. It is true the two diseases often present the same or similar appearances as they occur on the scalp. They do often exist toEczema gether, or one is the sequel of the other. of the scalp is, as a rule, seated on a circumscribed spot, while in seborrhoea the scales cover the whole scalp. In cases of doubt, care should be taken to obtain the history, etc., and then a correct diag nosis can easily be made. In considering the treatment, only an outline can be given. To enter upon the subject more fully would be to furnish subjects for an indefinite number of meetings. Eczema is a perfectly curable disease, provided the cause is sought for and remedied. In the acute form care should be taken not to over-treat. The great tendency is to ad A good application for local eczema in children is to apply the ointment in the form of a plaster. Unna, of Hamburg, uses an application called "Salbenmull," consisting of sheets of thin cotton material incorporated with various kinds of ointments; he also uses one somewhat similar, various medicaments being spread on gutta-percha tissue instead of cotton sheeting; the advantage of this over the former is, that the gutta-percha plaster will adhere to the part without the use of a bandage. The most obstinate cases to treat are those of old, dry, rheumatoid eczemas, found, as a rule, on the limbs of old people. My plan in these cases is to give plenty of salines, unless the heart is weak; if such is the case, caution should be observed, for by giving too much alkali we may produce a state of superalkalinism which may assist to a fatal A very good plan to observe in giving salines to old people is to combine them with digitalis. I also give tonics, such as iron, quinine, etc., and if there are symptoms of rheumatism, it is well to give, in addition, iodide of potassium and colchicum. Externally, I first remove the crusts or scales, which may be done with green soap, the liquor picis alkalinus of Bulkley, or hot poultices; my preference is for the poultice. The heat and moisture seem agreeable to the hot, tense skin, and the patient will express himself well pleased with the treatment. After all the crusts are removed, and we have a clean shining surface, apply an ointment, stimulating or not, as the case would suggest. An ointment which I have found well adapted, when stimulation was required, is composed of the following: minister arsenic, and apply a stimulating ointment, mercury, some preparation of tar, and vaseline. and then trust to nature for the cure. If nature For the removal of crusts in cases of eczema of the had been let alone, or, better, aided by using some scalp, some oil should be used, either olive, or raw bland protective ointment, and a brisk cathartic linseed-oil being the best. In scrofulous subjects internally, she would have brought about the cure you may use cod-liver oil with the hope of good much sooner than she would when stimulated results from the absorption. If there are pediculi almost to the point of irritation. We often find along with the eczema, crude petroleum is useful eczema accompanying digestive troubles. In these for destroying the parasites. cases the diet should be plain and nutritious, and some tonic be used. I prefer tincturæ nucis vomica, combined with some of the simple tonics, such as gentian or cinchona. Although in direct opposition to the teachings of the books, I have seen arsenic do a great deal of good in the eczema of dyspepsia. I think the best plan is to give small doses and very gradually increase-say, two minims of the liquor potassii arsenitis, increased to five, and then return to the original dose. Arsenic is a drug which has caused a great amount of discussion. While it is the dermatologist's sheet-anchor, it may be misused. It was pretty clearly brought out by the recent discussion, by both dermatologists and general practitioners, that arsenic was, in the majority of cases, a very successful and safe drug to employ, provided the physician took care to watch the effect, etc. The habit of pre-result. scribing arsenic in all cutaneous diseases can not be too strongly denounced, and I think the majority of text-books and lecturers are to blame for not teaching the student and doctor how to make distinctions between those cutaneous diseases which are benefited by arsenic and those which are not. In children which appear healthy, but are fat and flabby in texture, fed, as a rule, on food containing quantities of starch, and who are allowed to "drink all the tea and coffee they want,' and other unwholesome food, I have seen eczema which had resisted all other treatment heal up almost by magic under a corrected diet, a brisk mercurial cathartic, and a bland protective ointment applied to the affected parts. The cure is explained by looking at the etiology of eczema in this class of patients-namely, a congested skin produced by a circulation, or a torpid state of the bowels, which we relieve by curing the constipation and restoring tone to the circulation. After this introductory treatment, I give directions regarding food, and often give tonics-such as cod liver oil and some form of iron, preferably the syrup ferri iodidi. In young children, and persons having tender skin, care should be taken not to use an ointment too stimulating. I have a case in mind now where an ointment of the red oxide of mercury was used for a simple eczema, which caused a severe pustular eruption. When the ointment was changed for a simple protecting application, the eczema soon improved, and the child became well. I have seen several cases of eczema resulting from that much-advertised “skin success,' which I believe is composed of the red oxide of R Hydrarg, chlorid. mit. M. Ft. unguent. ounce. gr. XXV. m xx. 3j. Oleate of mercury may be substituted for the calomel, about a drachm of the five-per-cent. to the One of the most distressing symptoms is the intense itching, which may be relieved by the addition of iodoform to this ointment, or, if the disagreeable odor of iodoform is objected to, iodol, a new preparation from iodine, may be substituted with equally good results. I have seen the compound tincture of benzoin, prepared and applied as recommended by Professor Sherwell, of the Long Island College Hospital, allay the itching when all other applications had failed. Dr. Sherwell's directions are to evaporate the tincture to |