PROTARGOL IN THE TREATMENT OF GONORRHEA IN WOMEN.-Fürst reports in the International Journal of Surgery upon thirty-six cases, including fourteen of gonorrhea of both the neck and the body of the uterus, eight of gonorrhea of the cervix uteri alone, five of gonorrheal urethro-cystitis, three of gonorrhea of the vulva, three of gonorrheal inflammation of Bartholin's gland, two of gonorrheal endometritis (the reason for separating which from the fourteen mentioned in the first class does not appear), and one of vaginal gonorrhea. He thinks that the strong bactericidal property of protargol, its non-irritant quality, its non-precipitation by the secretions and its consequent marked penetrating power render it easy to limit with it the seat of the disease to the primary site of infection and to destroy the gonococci without irritating the uterus or its adnexa. In uterine gonorrhea he irrigates the uterus with a cent. solution of protargol, and gradually increases the strength to 2 per cent. Then he inserts a 5 to 10 per cent. soluble bougie of protargol into the cervix, and when this has melted the vagina is irrigated with a 10 per cent. solution, and a 10 per cent. protargol-glycerine tampon is inserted. Astringents are used after the second week, and the disease is usually cured in three weeks.

per

SYPHILIS OF THE FEMALE URETHRA.Fisichella (British Medical Journal) reports thirteen cases of ulcerative lesions of the female urethra of a syphilitic nature, and giving negative results to bacteriological examination for tubercle bacilli or for the bacillus of Ducrey-Unna. The ulcers have scooped-out, jagged margins, with grayish base, are torpid, and secrete a sanguino-purulent discharge, not very painful, liable to become phagedenic, difficult to cure and easily relapsing. The most serious symptom is incontinence of urine. In diagnosis one has to distinguish these ulcers from venereal ulcers, from chronic ulcer of prostitutes, from epithelioma, from esthiomenic ulcer, from tuberculous ulceration and from primary syphilis. The first disease is more rapid and more painful, secretes more pus and contains Ducrey's

bacillus; the second is rare in the urinary meatus, is stationary, and is not influenced by specific treatment, and the other conditions are sufficiently characteristic in themselves. In treatment the author recommends injections of calomel or of KI, locally iodoform, tr. iodi, 10 per cent. sol. of ferro-potassium tartrate.

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NERVOUS LESIONS IN GASTRO-ENTERITIS.-E. Müller and Manicatide have published a preliminary note in the Archives of Pediatrics on the changes observed in the nerve cells of the brain

and spinal cord in cases of gastro-enteritis in infants. The changes were of a degenerative character, and affected nuclei as well as the cell substance. They varied in intensity in different cases and in different areas in the same case. Neither the presence or absence of fever, nor the duration of the illness appeared to have any relation to the severity of the cell degeneration. The observation, as the authors point out, illustrates the extent of the toxic effects produced by gastro-enteritis.

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ILIAC PERFORATION IN A CHILD.-M. Kirmisson, at a meeting of the Surgical Society of Paris (Archives of Pediatrics), reports a case of peritonitis in a child of eight years of age. An examination under chloroform demonstrated a localized collection of fluid. He performed a laparotomy and found a perforation in a knuckle of the ileum, which he sutured. The child made a good recovery. In this case there were no symptoms of a perforation, and M. Kirmisson was led to examine the intestines in seeking a cause for the peritonitis.

MARYLAND

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BALTIMORE, OCTOBER 8, 1898.

Water.

THE discussion on the condition of the drinking water of Baltimore still goes on, and yet the condition remains the The City's same. It is no easy matter to weed out the chaff from the wheat and reach the true condition of affairs. The city Health Commissioner, the city bacteriologist, the city chemist, the secretary of the State Board of Health, the ex-engineer to the Water Board, have all expressed their views, and the public has now a confused picture considerably out of focus.

There are two sources of danger-watersource pollution and lack of a proper sewage system. The latter has been evident for years, and now that the sewage commission has made its report and given some practical suggestions, their proposed plans should be attacked and carried to completion as rapidly as time and money will allow. Taking the wellknown sanitary history of Munich as an example, a sewage system would be of incalculable good to Baltimore by reducing the mortality and the sickness.

To attempt to stop the water-source pollu

in fact, many of the reports, have undoubtedly been instigated by manufacturers of filtration plants, anxious for a fat job and ready to distribute gratuities.

As has been stated before in these columns, a filtration plant would be theoretically the most perfect plan of purifying the drinking water of Baltimore, but several of such plants would be needed, and the cost would not only add greatly to the burdens of the taxpayers, but would not obviate the necessity of a sewage system.

Whatever is to be done should be the work of unbiased experts, assisted by business men whose character is above reproach.

THE Opening of the medical schools in Baltimore this season shows that there is still a goodly number of young men The Medical and women ready to enter a Schools. crowded profession and battle against the longer and more difficult courses and the final State examination. The excellent report of the last State Board shows rather well how the schools stood and of what stuff the candidates are made. There was no accusation of cheating made, and the schools can find no fault with the good work of the examiners. The State Board stands between the poorly-prepared men and the public, and theirs is always most creditable work, of which the good schools are never afraid.

*3 of these cases were contracted out of town.

Yellow fever has appeared in many places in the South.

All of the medical schools of Baltimore have begun work.

Dr. Leonard Wood is doing excellent sanitary work as military governor of Santiago.

Professor Nasse, the first assistant of Bergmann at Berlin, lost his life last month while mountain climbing.

Dr. James L. Ord, a Washington physician, died near Hagerstown last Tuesday, aged seventy-five years.

Tyson will probably succeed the late Dr. Pepper at the University of Pennsylvania, and there will be a general "moving up."

Dr. A. L. Hodgdon has removed from 1235 West Lafayette avenue to the Albion Hotel, Cathedral and Read streets, Baltimore.

Young army surgeons who had never seen a case of yellow fever have now seen many cases, and, in some instances, in their own bodies.

The Craig colony for epileptics are erecting eleven cottages, all to be occupied by women and children, which will accommodate 256 patients.

Dr. John B. Schwatka, who is a democratic candidate for Congress, is a prominent and popular physician of Baltimore. He was graduated from the University of Maryland in 1882.

Many asylum physicians recommend bicycle riding. Weir Mitchell puts his neurasthenics on a wheel as soon as they are physically strong enough.

In Sweden and Norway a legal marriage is not allowed to be solemnized till both parties produce certificates attesting that they bear genuine vaccination marks.

Dr. J. Crocq, professor of special pathology and therapeutics in the University of Brussels, died recently, aged seventy-four. Dr. Crocq was also a member of the Belgian Senate.

Cholera is reported epidemic in Madras and is steadily increasing in its prevalence. During the week ending August 19 ninety-one deaths and about two hundred cases are reported.

Dr. Frederick T. Rogers, who has so ably stood at the editorial head of the Atlantic Medical Weekly, has been forced by other work to retire from the editorial management of this weekly.

M. Sevine has succeeded in making matches without phosphorus and that will strike on any substance. Phosphorus matchmaking was the cause of jaw necrosis and safety matches were too inconvenient.

The Southern Surgical and Gynecological Association will hold its next meeting in Memphis on November 8, 9 and 10. The secretary, Dr. William E. B. Davis of Birmingham, Ala., says that the meeting promises to be one of the most successful in the history of the association, papers having been promised by many of the leading surgeons and gynecologists of the country, especially of the South. Members of the medical profession are cordially invited to attend.

At the recent meeting of the American Association of Obstetricians and Gynecologists, at Pittsburg, the following officers were elected for the ensuing year: President, Edward J. Ill, Newark, N. J.; first vice-president, Edwin Ricketts, Cincinnati, Ohio; second vice-president, A. B. Miller, Syracuse, N. Y.; secretary, William Warren Potter, Buffalo, N. Y., reelected; treasurer, X. O. Werder, Pittsburg, re-elected; executive council, A Vander Veer, L. S. McMurtry, W. E. B. Davis, John M. Duff, L. H. Dunning and Walter B. Chase. Indianapolis was selected as the place for holding the next meeting, the time of which was left to the executive council.

Washington Notes.

Dr. John T. Booth, now on duty as an army surgeon at Fort Myer Hospital, has been installed as surgeon-general of the Union Veteran Legion.

At the first regular meeting of the District Medical Society, Wednesday, October 5, Dr. James Kerr read a paper upon the "Treatment of Colles Fracture by Gordon's Splint." Drs. Haslup, Miller, Ramsburgh, Sampson and Watkins were elected to membership.

The District chemist, in reporting upon the test of eighty-one samples of whiskey and gin, finds an excess of water, sugar and fusel oil. In gin an excess of turpentine was found in several instances. The condition of the samples was bad, so far as cleanliness is concerned, nearly all of them containing sediment of dirt, flies, straw, sticks and other such sub

stances.

The annual report of the Emergency Hospital and Central Dispensary has been submitted to the District Superintendent of Charities. The board asks for an appropriation of $17,000 for the ensuing year. During the year 7722 patients were treated in the dispensary, making 28,759 visits. In the emergency department there were 4205 patients and 6474 visits. There were 2120 operations performed and 36,197 prescriptions compounded.

Dr. John T. Winter, president of the Commission of Pharmacy, has submitted his report to the District commissioner. During

the year there were thirty applicants for registration; of that number eight passed a satisfactory examination. The balance were refused registration after failing at a second examination. Thirty-seven graduates of chartered colleges were registered upon the presentation of their diplomas.

Diphtheria is rapidly spreading in the northwestern and southwestern sections of the city since the opening of the public schools, and will likely affect the city generally before it can be checked. From six to ten new cases are reported daily at the Health Department, and at present there are over 125 cases under treatment. Dr. Woodward, health officer, suggests that the public schools be visited every day by a corps of physicians, whose duty it should be to examine every child and send home all who are affected with contagious disease.

Book Reviews.

AN AMERICAN TEXTBOOK OF THE DISEASES OF CHILDREN, including Special Chapters on Essential Surgical Subjects; Orthopedics; Diseases of the Eye, Ear, Nose and Throat; Diseases of the Skin; and on the Diet, Hygiene and General Management of Children. By American Teachers. Edited by Louis Starr, M.D., late Clinical Professor of Diseases of Children in the Hospital of the University of Pennsylvania, etc.; Assisted by Thompson S. Westcott, M.D., Instructor in Diseases of Children, University of Pennsylvania, etc. Second edition, Revised, 1200 pp. Price, cloth, $7; sheep or half-morocco, $8. For sale by subscription. Philadelphia, 1898: W. B. Saunders, 925 Walnut street.

The first edition of this able work, published two years ago, took at once a place with the best standard textbooks on pediatrics. That a revised edition has so soon appeared attests the earnest purpose of the authors and publisher to make and keep it the highest practitioner's authority on this important subject. The whole of the book has been revised, articles on rapidly progressing departments have been rewritten, some fifty pages of new material on vital subjects have been added. Now, without unwieldiness, this single volume represents as nearly a perfect combination of a handy, uniform textbook, with a collaborated encyclopedia, as we are likely to find in medical literature, and it is up to date, which is very important in a department of general practice on which new light is being so abundantly thrown at this time.

The type used is clear and uniform (there are none of those lengthy "asides," suggesting a magnifying glass), and the numerous excellent illustrations brighten and explain the text. Altogether the book is a credit to the authors and editor and a new proof of the claim of this enterprising firm to a foremost place among medical publishers.

REPRINTS, ETC., RECEIVED. Alcoholic Epilepsy. By C. H. Hughes, M.D. Reprint from the Alienist and Neurologist.

The Opening of the New Lakeside Hospital. By Hunter Robb, M.D. Reprint from the Cleveland Medical Gazette.

Personal Service as the Especial Exponent of a Great Profession. By H. O. Marcy, M.D. Reprint from the Boston Medical and Surgical Journal.