removed. Then, you will find, about three per cent. of them will return, and in a month you can finish it for good. The advantage of using a fine broach, is two-fold. First, it is not so stiff, and enters the follicle much easier, and being fine, you will have no wheals or pustulation. I have had no scars since I used the broach, and inserted the same before pulling out the hair. In our next paper we will speak of the right and wrong way to treat stricture by electrolysis, and why it is best to use a small battery.

[For the Summary.]

CHRONIC CYSTITIS.

BY R. C. MCCANN, M. D, BENTON, MISS.

Editor Medical Summary:-I am highly pleased with the MEDICAL SUMMARY, and look forward each month with pleasure on its arrival at my office. I admire it for the many excellent formulas and the different modes of treating diseases therein contained, and would most respectfully solicit through its columns the best and most approved treatment for a case of chronic cystitis of long standing. Will some of your many contributors respond to my request and much oblige a subscriber.

Repeat in 30 minutes, at same time gave 3 grains hydrate chloral hypodermically. Repeated this in an hour, at which time the arm was perfectly quiet. The patient soon was in a sleep and slept well all night. Next morning the arm was supple and all right. I repeated the hydrate chloral as a precautionary measure, advising rest and quiet. If any brother can name the case would be glad he would do so in the Summary. Did I give the proper treatment?

May the SUMMARY live long and prosper.

[For the Summary.]

A PECULIAR CASE.

BY A. H. WILSON, M. D., SIMPSON, TEXAS.

I was called day before yesterday to see Miss M. E., aged 21 years, apparently in good health. All the organs, so far as I could discover, were in a normal condition, with the exception of the right arm, which was shaking violently from the shoulder joint to ends of fingers. Every muscle seemed to be involved. The bones were very sore to the touch. Sometimes the muscle of forearm would be in hard knots. She had no control of the arm whatever. A stout man made an effort to hold the arm, still he was unable to do so with all his strength. of the arm.

He failed to arrest the motion This gave the patient no pain.

I

Most practitioners of medicine have frequently noticed, upon inspecting a supposed sore throat, that, much to their astonishment, there was but very slight redness of the fauces, and that it could not in any way account for the painful sensations described by the patients. Dr. Huchard says that these cases are not inflammatory angina at all, as the pain is not owing to the inflammation itself, but they are what he calls "neuralgic angina." These cases are similar to those congestions or slight uterine hemorrhages that are associated with lumbo-abdominal neuralgia, or those ocular hyperemias that are provoked or at least kept up by facial neuralgias. The following are the clinical characters that will enable us to diagnose them: 1. An entire discordance between the pain and the superficial inflammation of the tonsils, etc. 2. Entire subordination of the hyperemia to the neuralgic symptoms, which last precedes

all inflammation and often survives it. 3. The character of the pain is not continuous, but manifests itself by paroxysms which take place apart from deglutition, and increase at night. It is also very rarely isolated, but has other neuralgias (facial, occipital, cervical, etc.) at the same time, and it is frequently complicated with otalgia, which is much more violent than in other inflammatory forms, when seen with tonsillitis, for instance. These pains are frequently so violent that one is disposed to think of meningitis.

These clinical facts command the following therapeutic indications: The treatment must be directed more against the neuralgic element than against the congestive one; so that all emollients and antiphlogistic remedies are useless. To fulfill the pathogenic indication, Dr. Huchard advises

AN EFFECTIVE TREATMENT OF HIP-JOINT DISEASE.

Dr. B. M. Griffith, of Springfield, Ill.,reports the following interesting case in a recent number of the Med. and Surg. Reporter, as follows:

"Mr. A. A. B., aged 32 years, Canadian parent age. About four years ago received a severe fall upon the right hip, when alighting from a moving train. To all appearances he soon recovered from the immediate effects of this injury. About two years afterward his hip joint commenced paining him upon excessive exercise or fatiguing use of the limb, and in the course of another year he complained of pain in the knee joint, especially on the inner aspect of the joint. This was the

medicines :

B Quininæ sulphatis...... 20 centigrm;

Ext. aconiti radicis......I centigrm. M. Fiat pil. (one). Sig.-Give three such pills, at an hour's interval, in the morning. When the neuralgic pains are very intense, give a cachet of

hydrobromate of quinine, twenty-five centigrams in which put a granule of aconitine of one quarter milligram size, and give it three times a day.

As to local treatment, order the pharynx to be touched two or four times a day with a little of the following mixture on a brush:

B Glycerini (puri)......10 grm; Morphine hydrochlor..10 centigrm; Aquæ mentha piperitæ.......4 gtt. M. The peppermint acts by its "antalgic" properties, as shown by Delioux de Savignac and others. In all very painful sore throats, accompanied by spasmodic cough, the following formula may be used locally in the same way:

B Glycerini (neutral)......

.........

Aquæ mentha piperitæ,.aa10 grm; Potassii bromidi.................................... 5 grm; Cocaine hydrochlor...50 centigrm. M. Sig-Paint on the part as required.-Ibid.

Anteflexion with mobility, in a virgin, is a physiological condition, and can only be called flexion when the uterus becomes immobile and bound down by adhesions.-Prof. Parvin.

1886. The right limb was apparently three fourths of an inch longer than its fellow, and the foot slightly everted. He complained of excessive fatigue in the joint on walking, especially if the

ground was rough, and if he accidentally stubbed his toe the pain in the joint was quite severe. Upon sneezing or coughing, he would instinctively seize the affected limb in order to lessen the

pain caused thereby. No hereditary taint was discovered by examination of the patient's history. The general health was quite good. On manipulating the limb the hip joint was found rather sensi tive; inversion was limited. When lying on the back patient was unable to place heel of right foot on the toes of the left; the pelvis was also tipped considerably, and the pain was quite marked when the limbs were fully extended in this position. The pain was lessened by flexing the thigh on the abdomen at an angle of about 20°, and slightly everting the foot, and by so doing placing the pelvis flat on the floor. At no time was pain produced by striking the heel of the foot while the limb was extended. The plan of treatment entered upon was one suggested to the patient by Prof. Gunn, of Chicago, i. e., the application of a piaster of Paris cast to the pelvis, and thereby immobilizing the hip-joint. The cast was applied as far up the body as the xiphoid cartilage, and extended down the affected limb to the knee, making it especially strong in the groin. The cast was applied by having the patient stand on a stool, and the limb somewhat advanced and slightly everted, thereby placing the limb in a comfortable position. The patient was afterwards placed on a canvas cot, and a double inclined

plane with a light weight used.

In this position he was entirely comfortable, and commenced improving from the start-cod liver oil and comp. syrup wheat phosphates being the only medication. Patient was kept in the cot for twelve weeks, when the cast was removed. The patient complained terribly of muscular soreness for several days. The limb can now be moved in all directions, flexion and adduction being slightly compromised. No pain in either the knee or hip joints. The movements, while slightly limited, are more powerful than formerly, and are getting stronger. The pelvis is also improved in position. It has been four months since the cast was removed, and neither pain nor any of the old sensations have been felt in the joints.

This case I offer as an illustration of a most effective method of treating hip-joint troubles when seen under such conditions, believing it more efficacious than the use of braces."

[For the Summary.

AN IMPERFORATE HYMEN.

BY R. W. ST. CLAIR, M. D, BROOKLYN, N Y.

That it is necessary to make a correct diagnosis, there is no question. And I think I may go farther, and say there are cases when it is criminal to make a false diagnosis, and the following case is one of them: Miss L- a young lady, against whom nothing wrong had ever even been hinted. Her health had been poor for six or eight years, but until the last few months had not sought advice. She complained of pain in the head, back and abdomen. She had some nausea, the abdomen beca.ne much swollen and very hard. Her feet were also swollen. Some kind friend (?) whispered to other friends that M. L was in trouble. The family doctor was sent for, and without a vaginal examination pronounced her pregnant. The poor mother, half crazed at the condition of her child, and believing her tearful protest, sent for Dr. E. He invited me to see the case, and examination showed a hymen imperforate, and bulging out like a rubber ball. It was decided to operate Immediately. I made an incision from below up, and from left to right A stream of thick, dark bloody fluid, very offen

sive in smell, came away, and though it was not measured, there must have been four or five quarts of it. The abdomen came down to its normal size, all the other symptoms passed away. I saw her two years after; she was well and happy, but had never forgiven the doctor that had made a wrong diagnosis.

CLASS-ROOM NOTES.

The remedy for weak heart is amyl nitrite.

Prof. Bartholow states that he believes nicotine, if rightly used, will prove to be our best remedy for hydrophobia.

Prof. Parvin, for all plastic operations on the female genitals, uses silver wire in preference to either silk-worm or cat-gut.

Dysmenorrhoea and sterility are not half as well explained by anteflexion as by an existing endometritis or metritis.-Parvin.

Prof. Gross recently operated for anal fistule in a child only nine months of age, which had existed for two or three months.

For nephrolithiasis, avoid meats, take systematic exercise, the salts of potassium in lithium, and an abundance of alkaline waters.

Prof. Bartholow insists that in subacute rheumatism no remedy is comparable to tinct. ferri chloridi, especially if in an anæmic subject.

From an antagonistic standpoint, of all remedies proposed for remedial treatment of tetanus none are comparable to nicotine or the preparations of tobacco.

A mixture of collodion, 15 parts, corrosive sub., 1 part, if applied to small, superficial birthmarks, is stated by Prof. Gross to act very nicely and effectively.

Hydriodate of hyoscine is a drug which can be used with perfect safety in cases of kidney disease where morphine is inadmissible. It is a drug

which may give rest when other sedatives fail.

If used in two-minim doses subcutaneously, it may give more satisfaction to the patient than to the attendants, since the unconsciousness may be accompanied by angry and combative delirium ; should this occur, it will probably be sufficient to diminish the amount employed.

It is very rapid in its action, unconsciousness following in from ten to twenty-five minutes, and the after-effects are of a soothing character.

Even when delirium is present in a violent form, it is followed by quiet sleep, and the patient being unconscious, is much more refreshed than by a night of short snatches of sleep produced by chloral or bromide; and the result is a marked improvement in both aspect and temper. And lastly, no irritation is produced around the site of injection.

I believe that hydriodate of hyoscine will probably take a firmly-established position as a sedative in cases where morphine cannot be employed. -Med. and Surg. Reporter.