tion of definite cutaneous areas; the skin becomes, in the patient sitting or standing. In these two positions marked cases, purple-red and swollen. The limbs are the patient should lean forward and try to relax the usually affected, the face and trunk rarely. The lower muscles. To illustrate the importance of this, two limbs are more frequently affected than the upper. The years ago I sent to a surgeon to be operated upon a distribution is not that of nerve root or nerve trunk, it woman who had a movable kidney and was unable to is often limited by a sharply marked circular line round do her work. The surgeon could not find the kidney the limb. The condition shows a tendency to spread when she was put under the anesthetic. He sent for until the whole distal part of the limb is affected. It me the following day to examine the patient again. I is usually symmetrical, though frequently one limb is could not find the kidney while she was lying upon her affected before the other. The duration of the attacks back, but when she sat up the kidney could at once be varies from half an hour to several weeks; it is usually felt in the right iliac fossa. In examining the left three to four hours. The attacks may appear sponta kidney the left arm should be placed around the body, neously, or may be induced by exertion, warmth, or the physician standing on the right side of the patient, emotion. The effect of position is remarkable; if the the fingers being placed under the last rid; the right foot be affected an attack may often be brought on by hand should be placed under the left costal margin. allowing it to hang down, and during the attack that On drawing the breath or on sitting or standing, if the position always increases the symptoms, whilst eleva kidney be movable, it will be felt between the fingers tion relieves them. and can be made to slip up in a most characteristic way. The left kidney rarely falls to the same degree as the right. I have never observed it to fall below the umbilicus, while the right kidney frequently falls into the iliac fossa and even into the pelvis. It is remarkable that the left kidney feels much smaller than the right Dr. Collier observed ten cases in the National Hos pital for the Paralyzed and Epileptic during six months. The patients were subjects of disseminated sclerosis in five cases, tabes dorsalis in two, neurasthenia in two and myelitis in one. The discovery of these cases in such a short period shows that erythromelalgia is not a rare spmptom of spinal cord disease; it has, no doubt, been frequently overlooked. In several cases the attacks were first spontaneous, then induced by posture; later, a condition of permanent vaso-motor palsy appeared, the attacks still continuing. This sequence suggests, as the cause of the phenomena, an irritative lesion of the vaso-motor centers, progressing to a paralytic one. The pain never preceded, but accompanied or followed the congestion; it seemed to be a local result of the latter. The writer lays stress on the fact that erythromelalgia may be the first symptom of organic disease of the spinal cord.-Medical and Surgical Review of Reviews. OBSTETRICS AND GYNECOLOGY. By C. R. DUDLEY, M.D. Bacteriology of the Female Genital Tract in Health and Disease.-J. Hallé (La Presse Med.) describes his investigations as follows: The staining was made by Grams' method, the alcoholic solution of gentian violet and Loeffler's blue. Several cultures were made from each case and the different media for aerobic and anerobic bacteria were used in How to Diagnosticate a Movable Kidney. each instance. The author used gelatin containing 1.5 -Dr. W. Suckling, in an article entitled "On Movable parts per 100 of solidified beef serum, gelatine covered Kidney, with Special Reference to its Influence on the with a few drops of human blood, and serum gelatine Nervous System" (Edinburgh Med. Jour., September; or ascitic gelatine. The last media seemed to him the Medical Record, October), says: "The diagnosis can be most favorable for their growth, especially after the ad made only by palpation of the abdomen, the patient ly.dition of sugar. For sowing the anaerobic bacteria the ing down. To feel the right kidney the right hand author follows the procedure recently described by should be placed on the abdomen, the thumb being on the last rib at the back and the fingers in front below the costal margin. The kidney may be felt with slight pressure of the fingers if it is pressed down, but if not, when the patient draws a deep breath, the kidney will slip into the fingers and can be slipped back easily. A common mistake is to palpate the abdomen with the flat of the hand; this simply pushes the kidney in front of the hand. The best way is to get the kidney be tween the thumb and fingers, and not to press too (b) THE PSEUDO-DIPHTHERIA BACILLUS, having in heavily, so that the kidney can not come down. When its cultures the appearance of the bacillus of diphtheria; the patient assumes the sitting or standing position, the it shows an aerobic faculty and has never been pathokidney comes down more than it does during inspira- genetic to mice, guinea pigs or rabbits. tion when he is lying down, and it is necessary, before (c) THE CLUBBED BACILLUS OF WECKS, immobile, of concluding that the kidney is not movable, to examine variable size, clubb shaped, or like an exclamation point; Veillon and Zuber in Archives de Medicine Experimen tale (July, 1898). The inoculations in animals have been made from colonies that developed in the solid media. The agar injected with the colonies has seemed to predispose somewhat to the formation of abscesses. The aerobic bacteria isolated are: (a) THE GONOCOCCUS OF NEISSER, which, contrary to the opinion of Werthheim, is never developed in a media completely deprived of air. it is exclusively aerobic and is not pathogenetic to the animals experimented upon. It takes all the coloring agents readily and is stained by Grams' method. (d) THE STREPTOCOCCI-Three varieties were re vealed: the streptococcus pyogenes, the non-pathogenic, and the small streptococcus of Veillon; the last develops better in a media containing ascites, it grows only in aerobic media; animals are not affected by it. (e) THE STAPHYLOCOCCUS EPIDERMITIS ALBUs, not pathogenetic to the mouse, guinea-pig or rabbit. (f) In addition, Hallé has described, without naming it, a very long slender bacillus, sometimes in a mass, sometimes two and two, stains readily by Grams' method. It forms almost invisible colonies and causes no reac. tion at the point of inoculation. The anaerobic species have been differentiated and studied with much care. The author describes four: (a) MICROCOCCUS FETIDUS OF VEILLON which was present under the form of cocci or diplococci. It stains like the streptoccus but it is entirely anaerobic; in the bouillon it forms little grains or clumps but not enough to render the media turbid. The cultures give out a penetrating and a fetid odor. Injected under the skin of a guinea-pig it frequently produces an abscess, the pus from which is not fetid. ity of the cervix uteri the micro organisms are rare and are anaerobic. At two centimeters deeper in the cavity they almost entirely disappear. The anaerobic bacteria. are: the micrococcus fœtidus, the bacillus caducus, the bacillus nebulosus. The aerobic are the ordinary species found in the vagina: the non-pathogenic streptococ cus, the staphyloccus epidermitis albus; the pseudodiphtheria bacillus was not found. In investigating the bacteria of pathological condi tions Hallé reports his personal observations on 18 cases of bartholinitis; of all the species isolated not one was found constantly in the pus and did not appear to be necessary to the production of the abscess. He con. cludes that in bartholinitis with simple pus the gono. coccus is always found; in bartholinitis with fetid con. tents anaerobic germs are always found. In vulvovaginitis of little girls he quotes the results of Fraenkel, Epstein, Vibert and Bordes, Berggrun and adds that from his own investigations immediate stain. ing showed in 25 out of 27 cases the existence of the gonococcus, in the two other cases he found numberless micro organisms. Cultures from 22 cases of vulvovaginitis from another source gave pure cultures of the gonococcus in five instances, and in 12 others the gonococcus associated with different species of bacteria. The other discharges did not contain it. These microbes found by him are in order of frequence: The common diphtheria bacillus, the clubbed bacillus of Wecks, the non pathogenic strepto. coccus were very common species; the staphylococcus epidermitis albus very frequent; the colon bacillus very rare; the streptococcus pyogenes one instance; the small streptococcus one instance. The case in which the colon bacillus was found corresponded to that particular clini cal condition which Epstein has designated epithelial (b) BACILLUS FUNDULIFORMIS has been found by Hallé in the healthy subject, in cases of placental reten tion, and in cases of bartholinitis. It has the form of a very slender stick contained in the leucocytes or scat tered between the cells; in cultures its form is very variable, tortuous, swollen, in long filaments, at other times ramified; it takes the staining effects with difficulty. It is not stained by Grams' method, is entirely anaerobic and causes abscess on subcutaneous injection. (c) BACILLUS NEBULOSUS has been isolated like the two preceding from a healthy patient and has been desquamation of the vagina after childbirth. found in bartholinitis. It resembles the bacillus of septicemia of mice, it stains with Grams' agents, it never thrives in aerobic media. It develops in the form of muddy clumps, little clusters scarcely visible Sometimes forms abscess on inoculation. (d) BACILLUS CADUCUS or clubbed bacillus, the author has been able only rarely to isolate this in pure culture. It is a bacillus of the shape of the preceding, taking Grams' stain. It is exclusively anaerobic and its cultures live only three or four days. In two cases, in young girls, aged 10 and 12 years, Hallé found only the micro organisms which normally inhabit the vagina; although there was an abundant dis charge, he attributes these cases of vulvo-vaginitis to a special state of organism approaching the epoch of puberty and the occurrence of simple leucorrhea in certain young girls. These investigations enabled him to classify under two or three heads the vulvo vaginitis of young girls: 1. Mild leucorrheas of parasitic origin do not extend The investigations of Hallé on the bacteria of the to the vulva and its folds. genital tract of the female in a state of health was de. voted to the flora of the vagina and vulva of girls and of women and to the flora of the uterus of women. In young girls the same micro organisms were found in both vagina and vulva, only more numerous in the latter situation; they were as follows: the bacillus of Wecks, the pseudo-diphtheria bacillus, the non pathogenic streptococcus, the micrococcus fœtidus of Veillon, the streptococcus epidermitis albus, the colon bacillus, an anaerobic bacillus dying quickly in cultures. 2. Green or yellow purulent discharge glueing to. gether the walls of the vagina and often the vulva, persistent and does not yield to cleanliness. 3. The discharges, comparable by the physiological conditions where they are produced and by their bacteterial flora, to the leucorrhea of young girls. He reports a case of general blennorrhagic infection in a female. She was not suffering from blennorrhea at her entrance into the hospital and had had puerperal fever three years before. As a result of mental suffering and In women there was found the micrococcus fœtidus, intemperance to which she was addicted, she was taken the bacillus nebulosus, the bacillus caducus; in the cav-with malaise and general prostration. Examination of each organ of the body failed to reveal the cause of this condition. Bacteriological examination of the uterine cavity led to the discovery of the gonococcus, which was cultivated. Two days later the patient had a peri arthritis of the left elbow and the liquid was removed for examination. The temperature reached 39.5° and even 40 4°C. Endocarditis and pericarditis supervened. Shortly afterward the patient died. MISCELLANY Health Reports.-The following statistics concerning small pox, yellow fever, cholera and plague, have been received in the office of the Supervising Surgeon-General of the U. S. Marine Hospital Service during the week ending January 7, 1899: SMALL-POX-UNITED STATES. Detroit.. Parkland.. Sax and Fox Agency..Dec. 30. PENNSYLVANIA- Bacteriological examination of the genital canal made twenty four hours before death showed no gonococci either in the vagina or in the vulva but only in the cervix uteri where they were accompanied by a slender MICHIGANdiplo bacillus, very abundant, taking Grams' stain. Anaerobic cultures showed the bacillus caducus in the vaginal secretions. The culture from the fluid of the periarthritis of the elbow gave pure growths of gono cocci. The gonococci collected from the elbow joint were exceptionally virulent to animals, a rare condition; mice died in twenty four hours after peritoneal inocula tion. A second injection in mice killed the animals in two hours. Blood drawn from the bacillic vein during life did not contain micro organisms. After death they were not found. The autopsy revealed vegetations on the endocardium and in the aorta; these vegetations triturated and sowed reproduced gonococci; these were slightly virulent for animals. The pericardial false membranes gave the same result. The examination of the serous surface of the uterus did not reveal the pres ence of gonococci, sections show this microbe where the cultures had reproduced it; it was not found either in the kidneys, pleura nor uterus. His observations show that the gonococcus may remain for a long time in the cervix uteri and may suddenly be scattered to other parts of the body and take on an exceptional virulence. In cases of retained placenta and suppuration of geni tal origin Hallé reports several observations. In a case of normal accouchement and without pathological com plication in the puerperium the bacillus funduliformus was found. A second observation, a case of abortion accompanied by extremely fetid secretions but without complications; the aerobic culture gave the non-pathogenic streptococcus; the anaerobic culture showed two species, the micrococcus fœtidus of Veillon, the bacillus caducus. A third case, an abortion following fever where curettage was thought necessary; the aerobic cul. tures produced the colon bacillus and the streptococcus pyogenes; before curettage the anerobic tubes revealed the bacillus caducus; after intervention the anaerobic bacteria disappeared and the lochia lost its fetid odor. A fatal case of puerperal infection gave pure strepto cocci. Another case revealed the existence of anaerobic bacteria in fetid pus from a parametritis opening into the vagina. In this case cultures gave the streptococcus and the bacillus caducus. Hallé proves that the strictly anaerobic can of them. selves provoke suppuration; in a suppurating cyst of the left ovary anaerobic cultures revealed a diplococcus in oval or oblong clumps, a small short bacillus with rounded ends and a sperillum that was not able to be isolated in pure culture. Charlesville Dec. 31, small pox suspected Homer city. 1 1 Dec. 31.... 3 Hustonville.. Dec 31. New Granad. Pittsburg AFRICA Lorenzo Marques, Lelagoa Bay May 1-31 Brazil Rio de Janeiro.... INDIA- Awomori Ken..... Moscow.... Constantino le..... BRAzil— 5 June 1-30 4 14 YELLOW FEVER-FOREIGN. 315 4 2 Dec. 2-9... . . 1 1 Official List of Changes in U. S. Marine Hospital Service.-The following is the official list of changes of station and duties of commissioned and non commissioned officers of the U. S Marine-Hospital Service for the seven days ended, January 5, 1899: PETTUS, W. J., Passed Assistant Surgeon. To proceed to Norfolk and Newport News, Va., for special temporary duty. January 3. PERRY, J. C., Passed Assistant Surgeon. Relieved from duty at Port Townsend, Washington, to take effect upon the arrival of Passed Assistant Surgeon C. H. Gardner, and to retain command of the Port Townsend Quarantine Station. January 3. STEWART, W. J. S., Passed Assistant Surgeon. To proceed to Alexandria, Va., and Hancock, Md., for special temporary duty. December 31, 1898. Relieved from duty at Bureau and directed to Vineyard Haven, Mass., and assume command of Service. January 3. GARDNER, C. H, Passed Assistant Surgeon. Upon being relieved from duty at Baltimore, Md., to proceed to Port Townsend, Wash., and assume com mand of Service. January 3. TABB, S. R., Assistant Surgeon. Upon being relieved from duty at Vineyard Haven, Mass., and upon ex. piration of leave of absence granted by Bureau let ter of November 28, 1898, to proceed to Baltimore, Md., and report to Medical Officer in command for duty and assignment to quarters. January 3. HOLZENDORF, B. E., Hospital Steward. Granted two days' extension of leave of absence. December 30, 1878. APPOINTMENTS. CARLTON, CHAS. G., of South Dakota, to be junior hos. BOOK REVIEWS The Care of the Baby. A Manual for Mothers and Nurses, containing Practical Directions for the Management of Infancy and Childhood in Health and in Disease. By J. P. CROZER GRIFFITH, M.D., Clinical Professor of Diseases of Children in the Hospital of the University of Pennsylvania, etc. Second Edition, Revised. 1898. Price, $1.50, net. [Philadelphia: W. B. Saunders.] In this most useful little work the author has fur nished a reliable guide for mothers anxious to inform themselves on the subject of nursing and caring for their children in sickness and health. The first chapter of the book discusses the hygiene of pregnancy, the method of calculating the date of confinement, and similar data. The characteristics of a healthy baby are considered in the second chapter, and the growth of its mind and body in the succeeding one. The chapters which follow relate to the methods of bathing, dressing, and feeding children of different ages, to the hours of sleeping, to physical and mutual exercise and training, and to the proper qualities of the children's various nurses and rooms. A chapter upon the baby's diseases has been written for those mothers who, through various circumstances, are unable to have a physician con stantly within a moment's call. The book contains quite a number of illustrations which enhance the value by making more plain the meaning of the text. The Sexual Instinct-Its Use and Dangers of Affecting Heredity and Morals. Essen tials to the Welfare of the Individual and the Future of the Race. By JAMES FOSTER SCOTT, B.A. (Yale University), M.D., C.M. (Edinburgh University), Late Obstetrician to Columbia Hospital for Women, and Lying-in Asylum, Washington, D. C., etc. 1899. Price $2.00. [New York: E. B. Treat & Co.] The design of this work is to furnish the non-profes pital steward. December 30, 1898. sional man with a sufficiently thorough knowledge of SOUTHARD, FRANK A., of Indiana, to be junior hospital matters pertaining to the sexual sphere-knowledge steward. December 30, 1898. which he can not afford to be without. Knowing of no PURIFOY, JOHN, JR., of Alabama, to be junior hospital other book of like character the author presents this as steward. December 30, 1898. Death of Dr. J. B. Cox.-Dr. J. B. Cox, one of the oldest citizens of St. Genevieve, Mo., and one of the most prominent physicians of the county, died on December 31, 1898, in the seventy first year of his age. the best effort of which he is capable for the preserva. tion of the individual and the welfare of the race. The following subjects are treated in the work in an interesting and instructive manner: I. The Sexual Instinct and the Importance of a Just Appreciation of Its Influ ence. II. Physiology of the Sexual Life. III. A Proper Calculation of the Consequences of Impurity From a Personal Standpoint. IV. Woman, and the Venereal Warts.-Warts are directly contagious Unmanliness of Degrading Her. V. Some of the In. without any discharge being present in either party, fluences Which Incite to Sexual Immorality. VI. and may occur without intercourse. Several cases are Prostitution, and the Influences That Lead a Woman cited to support this statement.-CATHCART, Med. Rec. Into Such a Life. VII. The Regulation of Prostitu .tion. VIII. Criminal Abortion. IX. Gonorrhoea. practical book as its title indicates, yet its suitability X. Chancroid. XI. Syphilis. XII. Onanism. XIII. for the obstetrician will not lessen its value as a textThe Perversion. The American Pocket Medical Dictionary. Edited by W. A. NEWMAN DORLAND, A.M., M.D., Assistant Obstetrician to the Hospital of the Univer sity of Pennsylvania; Fellow of the American Aca demy of Medicine, etc. 1898. Price, ö1.25, net. [Philadelphia: W. B. Saunders.] In this most useful booklet the chief aim of the author has been to make the selection of words as complete as possible and it has been the author's endeavor to de velop the possibilities of the pocket lexicon to a degree not heretofore attained. Besides the ordinary dictionary words a considerable amount of matter has been in serted in tabular form which will prove of value to stu dents for memorizing, besides serving to group correlated facts in a convenient form for quick consultation. The little work contains the pronunciation and definition of over twenty-six thousand of the terms used in medicine and the kindred sciences, along with sixty extensive tables. book. Indeed, it numbers among its contributors the professors in many of the leading medical colleges, so that it will doubtless have widespread success in the student world. The publishers have spared nothing in typography and illustration compatible with issuing the volume at a price within the reach of all. The Phonendoscope and Its Practical Application. By AURELIO BIANCHI, M.D, Professor of Preparatory Clinical Medicine and of Pathology, Parma, Italy. Translated by H. GEORGE BAKER, A.M, M.D., Physician-in Chief of the Chinese Medical Dispensary, Philadelphia, and author of prize essays entitled "The Revival of Learning," and "The Germans in America," etc. With translations of special articles by Felix Regnault, M.D., France; M. Anastasiades, M.D., Greece. With thirty seven illus. trations. 1893. Price, 50 cents. [Philadelphia: P. Pilling & Son] Chapters I, II and III of this work are lectures deliv. ered by Professor Bianchi at Parma, and one devoted to a description of the Phonendoscope and its practical application in examination of various parts of the body. The "Medical News" Pocket Formulary One chapter (Chapter II) is devoted to phonendoscopy for 1899. Containing Sixteen Hundred Prescriptions representing the latest most approved methods of administering remedial agents. By E QUIN THORNTON, M.D., Demonstrator of Therapeu peutics, Pharmacy and Materia Medica in the Jeffer son Medical College, Philadelphia. In one wallet shaped volume, strongly bound in leather, with pocket and pencil. Price, $1.50, net. [Philadelphia and New York: Lea Brothers & Co.] of the stomach and its contents. A special article by M. Anastasiades on "The Application of the Pho. nendoscope in the Course of Pregnancy," and an article by Felix Regnault on "The Phonendoscope and the Digestion of Fluids," are features of the book. Its illustrations are many and excellent. It gives a clear and easily comprehended description of the phonendoscope and its fields of usefulness. The publishers request that this book shall not be mistaken for the complete book on phonendoscopy in course of preparation. In this useful little book prescriptions are arranged under alphabetical headings of disease so that the prac titioner can instantly run his eye over the recommenda tions of the world's leaders in all the practical branches" of medicine. The author has subjected each prescrip. tion to careful study and verification, and has appended useful annotations and indications as guidance in meeting the various stages and complications. Due atten. tion has been paid to palatability and pharmaceutical elegance, points of increasing importance. The volume opens with a number of pages of useful data. Medical Review" Pocket Reference Book In this most practical and useful visiting list is pro vided blank leaves for twenty-five patient per week, each one being accompanied by a blank page for memo randa. Then follows blank leaves for the addresses of patients and nurses; accounts asked for; memoranda of wants; obstetric engagements; vaccination engagements; Announcement.-The Practice of Obstetrics. By record of births and deaths; cash accounts, etc. The American Authors. Edited by Professor CHARLES first sixteen pages of the book consist of a calendar for JEWETT, M.D. [Philadelphia: Lea Brothers & Co.] 1899; table of signs; the metric or French decimal sys Jewett's Practice of Obstetrics, by American Authors tem of weights and measures; table for converting is forthcoming at an opportune time. Its subject pro- apothecaries' weights and measures into grammes; dose gresses so rapidly, particularly in this country, that a table; a short article on asphyxia and apnea; comparison completely new. book by acknowledged masters of all of thermometers; a table for calculating the period of the subjects it comprises will be welcomed. It will be a gestation, etc. |