the terminal extremities of that nerve.-L'Union Médicale, April, 1872.

On the Use of Baths in Acute Rheumatism, attended with Head Symptoms and High Temperature. By Dr. HENRY THOMPSON, of the Middlesex Hospital. A case has lately occurred in the Middlesex Hospital illustrating the beneficial effects of the bath in acute rheumatism, attended with head-symptoms and high temperature. Dr. Thompson, in his remarks on the case, observes that it is only now and then, in a few rare and scattered instances, that acute rheumatism proves fatal by an unexpected outbreak of overpowering nerve-symptoms, and such a result would have ensued in the instance recorded, according to Dr. Thompson's opinion, if the bath had not been used. The fatal issue in similar cases was formerly referred to the occurrence of metastasis, meningitis, and the like, but now it is said to be due to hyperpyrexia. To this last term, if used in a practical sense, Dr. Thompson makes no objection, as the importance of very high temperature cannot be overrated as a symptom; but in a pathological point of view he thinks that its influence has been exaggerated, for the nerve-symptoms invariably precede the hyperpyrexia. Nevertheless a high body-heat, ranging from 1086 degrees to 112, is incompatible with life, and it is necessary to lower it by such means as are available, and Dr. Thompson thinks that the use of the bath is the best therapeutical agent. The temperature of the bath is 90 to 95 degrees in the first instance, and is gradually reduced by the addition of cold water to 70 degrees. The clinical thermometer must be practically the best guide for the employment of the bath,for at a lower body-temperature than 102.5 degrees it would not be desirable to use it. It is important to observe that, in the case recorded by Dr. Thompson, the most severe and extensive chest complications, such as pneumonia, pleurisy, bronchitis, and pericarditis, underwent no perceptible change for the worse in consequence of the bath. The case itself is recorded at length, with the thermometrical observations taken at frequent intervals from day to day, and the effects produced by the baths, which were eight in number, are accurately noted. The case, however, although terminating in recovery, was a tedious one, and the convalescence was exceedingly slow.-British Medical Journal, August 3rd, 1872.

On the Electrolytical Treatment of Scirrhus. By Dr. J. J. CALDWELL, of New York.-Dr. Caldwell gives the history of two cases in which electro-chemical action was employed for the relief of cancer. In the first there was a hard, large, and painful tumour occupying the base of the mammary gland and involving the nipple; the surrounding tissues were hard and irregular, and the skin was tense and of a purple colour, with two or three ulcerating points, The treatment was commenced on the 25th of September, 1871, by the application of a constant current of electricity of from eight to ten cells, and lasting from ten to fifteen minutes. This treatment

was continued until the 30th of October, when the tumour had nearly disappeared. From the general appearance of the tumour, and the examination by the microscope of a small portion of it, the growth was considered to be of a cancerous nature, but it is right to mention that one of the medical gentlemen who was asked to examine a specimen which was sent him did not admit it to be so. Dr. Caldwell attributes the disappearance of the tumour, in this and other cases, to the decomposing power of the galvanic current, by which suppuration is set up and the growth is destroyed, and he thinks that the solvent action of the electric current is analogous to that exercised by the vital forces on the food in the stomach. In illustration of this action he rendered a piece of beef fluid by placing it in a solution of chloride of sodium at a temperature of 100° to 110°, and acting upon it for thirty-six hours by electrolysis. In the second instance recorded by Dr. Caldwell the result was unsuccessful. This latter case was undoubtedly one of cancer in an advanced stage, and of the form known as fungus hæmatodes. The electrolytic treatment was tried only three times.-New York Medical Journal, May, 1872.

On the Therapeutical Uses of the Continuous Electric Current. By Mr. CALLENDER, of St. Bartholomew's Hospital.-Mr. Callender has tried the effect of the continuous electric current in the treatment of various cases, more especially with reference to its electrolytic action on tumours of different kinds. In order to ascertain the effect of the current upon an acute abscess, he employed it in the case of a powerful labouring man, a needle connected with the negative pole of the battery being passed into the abscess while the positive pole was applied to the adjacent skin. The current was applied twice, but its use had no effect on the progress of the abscess, which took its usual course and broke. Mr. Callender then relates three cases of tumour in which the current was applied, and in one the tumour seemed to melt away and disappear under the treatment. In the remaining two cases the results were not so successful, one of them being an instance of recurrent fibroid tumour and the other case being one of cancer of the breast. The successful case was one of recurrent fibroid tumour in the right loin, and four operations had been practised for its removal. Before the wound from the last operation had closed, one or two isolated nodules, growing up from the granulating surface, made their appearance, and it was to these that the electric current was applied. The patient was fifty-one years of age, and his general health was very good. Two needles were used, one from the positive pole being inserted into the growth, the other, connected with the negative pole, being applied to its surface. Some immediate sloughing was caused about the track of the first needle, but eventually the wound healed soundly. Mr. Callender, in drawing some conclusions from his cases, divides the action of the continuous current into that of electrolysis, and that of cauterisation. With reference to the first, he thinks that in no instance has the progress of the tumour been visibly influenced by the use of the

current in the sense of its causing wasting or shrinking of the growth independently of the cauterising action, but he intends to give that plan of treatment a further trial. With regard to the cauterising action, however, he thinks there is no question as to the efficacy and value of the remedy. With twelve cells and two needles small growths may be rapidly destroyed without pain on the part of the patient, and in the successful case recorded they were destroyed so effectually that the skin healed over the parts of the granulating surface from which they were growing. For the cauterising of such recurrent masses, especially for that of the small nodules which spring up about the scar-tissue after removal of a cancer-growth, and which, if allowed to increase, necessitate for their removal a considerable operation, Mr. Callender thinks that the continuous current seems to offer a handy and efficient remedy. British Medical Journal, Feb. 10th, 1872.

On the Therapeutical Use of Guarana (Paullinia sorbilis). By Dr. S. WILKS, of Guy's Hospital, and Dr. P. W. LATHAM, of Cambridge. -Dr. Wilks draws the attention of the profession to guarana as a remedy for sick headache. Some two years ago he received a letter from a medical gentleman in British Columbia, inclosing two powders, which were recommended with much confidence as a remedy for headache. Dr. Wilks tried the powders first on himself, but without much effect, and did not therefore indorse his friend's recommendation. Lately, however, he received a letter from Dr. Wood, of Montreal, also recommending guarana as a remedy for headache, and explaining that he himself had obtained relief from the use of the drug. Dr. Wilks now determined to try the remedy in a systematic manner, and he procured a packet of the powders from Mr. Hooper, the chemist, and prescribed them for various patients with very encouraging results. The guarana has for some time been a favourite medicine in France for sick headache, as well as for various forms of neuralgia, given in doses of ten to fifteen grains or more of the powder once or oftener in the day. The plant from which it is obtained is the Paullinia sorbilis, a native of Brazil, and belonging to the natural order Sapindaceæ. The seeds, roasted, bruised, and pressed into cylindrical masses, constitute the guarana paste, which, when finely pounded, is known as Paullinia powder. It contains, in addition to empyreumatic oil (developed in the process of roasting) and tannic acid, guaranin, a substance identical in composition with caffein. It is therefore efficacious as an astringent, and has much the same effect on the nervous system as tea or coffee. Paullinia powder is used, not only in headache and neuralgia, but also as an astringent in catarrhal diarrhoea, and in blenorrhoea of the urinary organs.-British Medical Journal, April 20th and 27th, 1872.

REPORT ON PHYSIOLOGY.

By HENRY POWER, F.R.C.S., M.B. Lond.,

Examiner in Physiology and Comparative Anatomy in the University of London, Senior Ophthalmic Surgeon to St. Bartholomew's Hospital.

1. Sir W. GULL, Bart., and H. SUTTON. On the Pathology of Chronic Bright's disease with Contracted Kidney. (Proceedings of the Roy. Med. Chir. Soc.,' vol. vii., No. 2.)

2. Dr. DUVAL. Recherches Experimentales sur les rapports d'origine entre les Globules de Pus et les Globules blancs du Sang dans l'Inflammation. (Brown-Séquard's Archives de Physiologie,' Nos. 2-3, 1872.)

3. D. PARASKEVA and J. A. ZALLONIS. De l'Inoculabilité de la Tuberculose. ('Gazette Médicale de Paris,' No. 17, 1872.

4. Dr. THOMAS R. FRASER, M.D. On the Antagonism between the Actions of Physostigma and Atropia. (The Transactions of the Royal Society of Edinburgh,' vol. xxvi.

5. BENJ. W. RICHARDSON, M.D. Report on the Physiological Action of Organic Chemical Compounds. (Report Brit. Assoc.,' 1871.)

ALTHOUGH the first five subjects do not fall within the range of physiology they are of so much present interest that we shall offer no excuse for introducing them as histological memoranda at the beginning of this report.

1. Sir William Gull and Dr. Sutton consider that the visible morbid changes in the kidneys are due to the formation of a fibroid or hyalinefibroid substance in the intertubular parts, including the vessels, and to atrophy of the tubular and intertubular structures of the kidney. This formation commences in different parts of the kidney, commonly near the surface, and it also seems to commence in the outer coats of the arterioles and in the walls of the capillary vessels. Its subsequent contraction draws the Malpighian bodies together, compresses the urinary tubules and vessels, and ultimately obliterates them. The hyaline degeneration, they maintain, may commence in other organs than the kidneys; and, on the other hand, the kidneys may undergo extreme degenerative changes without being attended with the cardiac hypertrophy, and the other vascular changes characteristic of the condition known as chronic Bright's disease. In the discussion which followed the reading of the paper, Dr. Broadbent adhered to the view of Dr. George Johnson, namely, that the thickening of the vessels was due to hypertrophy of the muscular coat, and supported his statement by an account of the effects of the inhalation of nitrate of amyle on the tension of the vessels, as indicated by sphygmographic tracings. Dr. Bastian and Dr. Dickinson, on the other hand, gave clinical evidence in favour of the author's views. Dr. George Johnson thought that the hyaline appearance described by Sir W. Gull and Dr. Sutton was in reality only the swollen and translucent state of the tunica adven

titia, so commonly produced by the imbibition of fluid, especially when that fluid is mixed with glycerine or acetic acid.

2. Dr. Duval's experiments were made upon the cornea, and upon the mesentery of frogs, mice, and rats, with a view of determining the origin of pus globules. The cornea was irritated by being touched with a point of nitrate of silver, or by having a silk thread passed through it. The results of careful microscopic investigation showed that the resulting inflammation of the cornea did not proceed from the periphery towards the centre, but radiated from the seat of lesion. In the parts undergoing change no free white globules were ever seen; the corpuscles always proceeded from a cellular proliferation. The point de départ of the metamorphoses was always the plasmatic cellule (corneal corpuscle), which, far from remaining unaltered, becomes hypertrophied and produces new globules. In the experiments on the mesentery the animals were subjected to the action of curara, and the membrane examined with high powers. It was then seen that no escape of the white corpuscles from the vessels occurred, but that as the circulation became retarded accumulation of these corpuscles occurred at the angles of division and along the sides of the vessels, and that coincidently hypertrophy and multiplication of the corpuscular elements, naturally existing external to the vessels, took place. In a note appended to the paper M. Vulpian, one of the editors of BrownSéquard's Archives,' expresses himself as being opposed to M. Duval's statements, and as agreeing with Cohnheim and Waller in attributing the origin of pus to the escape of white corpuscles of the blood from the smaller vessels.

3. Paraskeva and Zallonis from their experiments on animals and man draw the conclusion that tubercle is capable of being inoculated.

4. We can here only briefly call attention to the long and valuable essay by Dr. Fraser, on the Antagonism between the Actions of Physostigma and Atropia,' which he shows is so remarkable and decided that the fatal effect, even of three and a half times the minimum lethal dose of physostigma, may be prevented by atropia. He gives the details of three series of experiments by which it has been ascertained what is the maximum dose of physostigma that can be counteracted successfully by atropia;-what is the dose of atropia that can counteract any given dose of physostigma;-and what relationship exists between the doses with which this mutual counteraction occurs, and the length of the interval of time by which the administration of atropia precedes or follows that of physostigma.

5. Dr. Richardson gives the result of his inquiries made with a view of determining what is a dangerous, and what a fatal, dose of chloral hydrate. He thinks 140 grains would be dangerous, and that even 80 grains might be fatal. When too large a dose has been taken the patient should be kept in a warm air (90°-100° F.), and should be supplied with half a pint of warm milk, mingled with a little lime water, every two hours. Artificial respiration, in desperate cases, must be maintained. Dr. Richardson also describes the effects of anhydrous chloral, metachloral, bromal hydrate, and nitrate of amyl,