The

and mixed with water, and given to the accused to drink. If vomiting follow immediately, the accused is held to be guiltless; but if he fail to vomit, the contrary was held, and he was im mediately stoned or clubbed to death. Berlin Museum possesses the material originally sent to it by Oertel, and recent experiments with it develop the fact that the material now sent from Africa under the name "Hayah" is an extract of the same, and the active principle obtained from both is identical. We await further developments with great interest.

The source of albumen in the urine of some pregnant women, says Professor Parvin, is probably a discharge, as leucorrhoea or cystitis, being washed out of the vagina when urinating; therefore, it is much better to use a catheter, or have the vagina thoroughly washed out before collecting the urine.

Prof. Bartholow considers the most effective treatment for chronic neuritis is galvanism and

morphine hypodermatically. Place the positive pole to the affected part, and negative to the periphery. Repeat this treatment daily for a few minutes at a time. For very obstinate cases, use flying blisters locally, and internally iodides of potassium and colchicum.

A young woman was recently delivered of a strong, healthy child, in the maternity ward of the Jefferson Medical College Hospital, who had performed upon her an amputation of the cervix uteri in the fourth month of pregnancy, for epithelioma, by Dr. William E. Ashton. The operation was performed under strictly antiseptic precautions, and no unfavorable symptoms followed.

The great secret of applying plaster-of-Paris bandages is to have all the sizing out of the material used, so when a piece of muslin to be used is thrown upon water it sinks readily; if it does this it will readily absorb water and plaster and will set quickly; a little salt added to the water is an advantage; a roller made of lint is better than cotton to be applied next to the part. (Dr. Allis.)

Prof. Parvin says the term placental souffle is still used improperly by many physicians instead of uterine souffl, the correct disignation; that the placenta is not concerned in the sound, is proved by the fact that the souffle is heard some days after confinement, and has been heard in uterine fibroids. The sound is synchronous with the pulse of the mother, and of very little value as a sign of pregnancy.

VOMITING OF PREGNANCY.-Prof. Stewart has found oxalate of cerium, gr. ij, before meals, to be the best general prescription for the sickness of pregnancy. Where the sickness is alarming, he often gets good results from bromide of soda, gr. xxx, every two or three hours. The latter preparation he also considers of great use in sea sickness.

Prof. Parvin advises that prolapse of the vagina be treated by astringent injections, having the bladder frequently emptied, especially if a cystocele is associated with the prolapse, which is frequently the case, and apply a suitable elastic ring pessary; if the pessary is uncomfortable or cannot be worn, a large tampon of absorbent wool, dipped in a solution of tannin and glycerin, introduced in the morning and removed at night, may suffice.

For a case of simple goitre of six months' standing, Prof. Da Costa prescribed liq. iodinii comp., gtt. iij, three times a day, gradually increased to ten or fifteen drops three times a day. Locally:

M. And internally, Donovan's solution, gtt, x, three times a day.

CHROMIC ACID FOR EPISTAXIS.-In cases of persistent and dangerous epistaxis try chromic acid. First put enough in to give the water a slight pinkish tinge, and if this is not sufficient increase the strength of the solution, and employ it as a wash till the hemorrhage is stopped. Prof. Waugh lately recalled two cases of diphtheritic epistaxis cured by this means which would otherwise have died, having resisted all treatment until he tried chromic acid

FOCAL OBSTRUCTION.-To break up large fœcal masses and secure an evacuation of the bowels, Prof. Woodbury advises magnesii sulphas, gr. xx, every two hours, with irrigation of the bowels by warm soap suds, through a rectal tube. If there is defective innervation, he also employs Faradism. A digital examination should not be neglected.

VOMITING OF PREGNANCY.-In one of his lectures, Prof. Woodbury said that often the best way to treat the persistent sickness of pregnancy was to make some application to the os uteri, and inform the husband that it was terribly caustic in its action, and the dressings must on no account be disturbed during the continuation of the treatment.

FROM THE DERMATOLOGICAL CLINIC.-For chronic eczema on inner part of thigh, Prof. Shoemaker ordered strychnine. If it produce no impression, then he would give hoang-nan; also use soap for its stimulating and cleansing effect. Locally he ordered:

INTERMITTENT FEVER.-Dr. Vogler (German Hospital) recommends for the constipation in intermittent fever, a powder consisting of calomel, gr. iv, ipecac, gr. j, bicarbonate of soda, gr. xxiv, aromatic powder, gr. xij. Divide into powders, xii; give them as necessary. After the sweating stage is over, he gives a pill of quinine, gr. iss, capsicum, carbonate of iron, and nux vomica, aa gr. ss, oil of cloves, q. s. Give one pill 4 or 5 times a day. For the enlargement of the spleen, he uses the biniodide of mercury ointment, and rubs about 10 or 12 days, especially over the spleen. the abdomen with this every other day, for

Dr. White related a case in which there was an abrasion on the penis a day after connection, which was thought to be benignant, because the initial lesion of syphilis never appears so soon, but in which the characteristic lesion appeared on the abrasion at the end of three | weeks.

AT THE UNIVERSITY HOSPITAL.-Dr. Goodell exhibited a large dermoid cyst, containing bones, teeth, hair, etc., which was removed from a patient while operating for ovarian cyst. The latter, which was strangulated by twisting of its pedicle, and was already becoming discolored, would, in his opinion, have burst and set up fatal peritonitis in a few days had not the operation been promptly performed.

In whitlow, Dr. Agnew claims that the finger should be opened down to the bone without waiting for suppuration to occur, as then it is often too late to save the tendons. He exhibited a case in which this was not done, and the flexor tendons were so injured that amputa tion was necessary to render the hand useful.

Dr. Osler, at the Philadelphia Hospital, December 14th, 1887, laid particular stress on the fact that under ordinary circumstances the pulmonary second sound is of less intensity than the aortic, but when forced inspiration is made and the breath held, in a state of health, or in cases of mitral stenosis or regurgitation, the pulmonary sound preponderates.

Dr. Osler claims that for one case of heart murmur, due to aortic stenosis, we have twenty of murmurs from other causes, the most frequent being atheroma, either of the valves or the ascending aorta. He advises that in all doubtful cases the murmur be forgotten entirely; and that the other heart symptoms, with the general condition of the patient, be taken as the guide to prognosis.

MYALGIA.-Prof. Waugh recommends this prescription in acute myalgia:

Answers to Inquiries in February WORLD. Editor MEDICAL WORLD:

Dr. Harman (p. 62) should try galvanism, not faradism, to the testicles, applying the positive pole to the spine, and the negative to the mouths of the seminal vesicles, by an insulated sound. The negative pole should also be applied to the testicles. The organs should

be allowed rest for a long period. For a pile ointment," (page 65) we have used the following for many years: White lead, lard, of each one ounce; tannic acid, two drachms. The lead must be painter's lead, not the dry carbonate of the druggist, which cannot be made into a smooth enough ointment for tender hemorrhoids. But the operations by injection for internal piles, and dilatation of the sphincter for externals render salves rarely necessary.

Dr. Wesselowski's case is surely one of chronic laryngeal catarrh. A laryngeal examination should disclose the exact nature of the difficulty, and indicate the proper treatment.

I think Dr. Amundson's case (p. 75) is one of hysteria or reflex spasm. I believe that hysteric manifestations are always reflex, and that the exciting cause can be found if looked for. In many cases this will necessitate an inquiry into the sexual relations. The fact that the affection has existed four years without permanent palsy militates against the idea of a centric lesion; the preservation of consciousness is significant.

The exciting causes are so various that only a patient and thorough examination can show which is present in this case. Bromide of ethyl has proved the most successful palliative in many hands, with the triple valerianate pill internally. In one case I found a displaced womb as a cause; in another a tape-worm; in a third, a tender, red spot on the os uteri, which I cured with carbolic acid; and in a fourth, the symptoms resisted all treatment until a brother physician cured the case by marrying her.

Dr. Derby's case (p. 76) is suspiciously like cancer, but may be ulcer. Introduce a speculum, take a look at the abraded surface, and perhaps touch it with nitric acid.

Dr. Cushman's is a peculiar case (p. 76). It is a cardinal rule to look to syphilis as the cause of nocturnal pain. Peripheric neuritis of this sort is a well-authenticated manifestation of lues, and a mercurial course would probably clear up the diagnosis and the disease together. The abortion and subsequent illness would thus be accounted for at the same time. On the same page Dr. Ashworth asks the best method of treating syphilis. He evidently has not the "Manual." When such masters as Fournier and Hutchinson require three and four years of mercury to eradicate this poison from the system, we lesser lights can hardly hope to cure it in as many weeks. I prefer the continuous administration of mercury in doses just below the salivation point, and kept up for a year, at least.

So many have written to me concerning the pilocarpus treatment of erysipelas that I must say a word on it. I heard an old country doctor say there were over 500 varieties of erysipelas. He saw erysipelas in every case he met; in which he was as scientific as Our gynecologists, who see the uterus at fault if the patient has corns.

Jaborandi is not, as far as I know, of any use in erythema, acne, or any other skin disease excepting genuine erysipelas; but for that it is an unfailing specific. Twenty drops of the fluid extract should be given every two to four hours until sweating is induced. After that it is continued in smaller doses until the disease is cured. I generally add digitalis, to keep up the heart.

Pruritus ani is sometimes a symptom of rectal disease, in other cases of general plethora. Local applications are of little use. I once applied a two per cent. solution of sulphate of copper, but even while the smarting continued the patient felt the itching, as he expressed it, deeper in than the burning of the vitriol. I think the itching is due to the blood stretching the vein' walls. Carlsbad salts do well with plethoric persons.

We have not space enough to give instructions as to the method of treating uterine displacements, for that would require a book. In general, remove all pelvic cellulitis by glycerine tampons, replace the womb by pressure with a Smith pessary, and support the organ by a suitable instrument until, by the use of glycerine tampons, the weight has been reduced to normal. Then it may consent to stay in its proper place without the pessary; but the womb is an essentially feminine organ, and takes a deal of coaxing. In aged woman I use the abdominal supporters with cup pessary; in others I prefer the Hodge, Smith or Emmet. WILLIAM F. WAUGH.

1725 Arch St., Phila.

On Accidental Concealed Hemorrhage.
(Continued from February Number.)

Editor MEDICAL WORLD:

I shall to-day cite another case of accidental concealed hemorrhage, which occurred in my practice about a year ago.

I was sent for at 11 P.M. to see Mrs. A., a Swedish lady, aged twenty six years, who had usually enjoyed good health. Upon reaching her bedside, I found her in labor with her second child, and crying from constant aching and cutting pains in the back and loins. She said they were worse than she ever had had before, and earnestly desired to be relieved of them. My attention was called to the great pallor of countenance and rapid feeble pulse (120 per minute). On examining her per vaginam, I found the os soft, undilated, and not affected by the pains. I learned that during the afternoon, while she was walking across the room, she felt something give way and drop suddenly to the bottom of the abdomen, and she nearly fainted away. She gradually recovered a little after resting in the recumbent posture, but continued to feel exhausted. About 6 P.M., she began to experience pains, which increased in severity until 9 o'clock, when they began to act as powerfully as when I saw her. I ordered her to be kept in bed and have frequent draughts of tea and coffee, and I administered a draught containing a quater of a grain of tartar emetic.

I visited her again at I A.M as I had been sent for to relieve her agonizing pain. I found her now more exhausted and gave her some morphia without any benefit. At 2.30, she had a copious discharge. At this time the os was the size of a half-dollar, membranes tense, vertex presenting. I ruptured the membranes and the head followed immediately, and the pains altered magically, becoming more tolerable, intermittent and expulsive. Soon the head emerged, followed by a terrific gush of coagulated blood. The body was expelled more feebly, with considerable hemorrhage. was still born. I immediately sustained pressure upon the abdomen by the hand.

Child

I have taken the trouble to go over many cases mentioned in different treatises and hospital reports, and thus comparing about twentythree cases in number, and, having added my two cases, it seemed remarkable to me that in all these cases the symptoms were nearly alike, so that on analyzing them I find that the chief diagnostic symptoms are:

I. Sudden fainting and collapse, with blanching countenance.

II. Continuance till delivery, more or less, of the same; but such as to cause great alarm to the medical attendant.

A Peculiar Knife Wound.

Editor MEDICAL WORLD:

I was called at 12 o'clock at night to see one J. J., a German, aged 24. I found the patient in a very bad condition, and that he would soon die. The story they gave me was that he had been cut on the leg, with a knife, at 9 o'clock. A doctor had been called, had dressed the wound and left, saying it did not amount to anything. Two hours later another one had been called in, with the same result. I found him in great pain, with a desire to pass water, but unable to do so. I found a small wound on the thigh two inches below the trochanter on a line with the crest of ilium. With the probe I found its direction upward and inward. It passed under the sartorious muscle over the femoral artery, under Poupart's ligament directly toward the bladder. did not probe any farther, but tried to draw his water. I could get nothing but blood. He died in two hours. Dr. W. went with me, and the family gave us permission to open the body. We found that the knife had passed as above and entered the bladder. There were three distinct wounds of the bladder, as if the knife had been churned in the wound, making but one outside, but had changed its course inside and entered the bladder in three places. I gave my testimony at the trial that the leg must have been strongly flexed, and that it was, in my opinion, impossible for him to fall on his own knife and produce a like wound. Also, the knife had been partly withdrawn twice and again sent to the hilt, making three distinct wounds. Three others gave the same testimony. Yet the assasin was let go free. I have seen many strange wounds during my practice and also during the war, but this was a very peculiar one. Two doctors had passed it as hardly worth dressing.

Brooklyn, N. Y. R. W. ST. CLAIR, M. D.

Editor MEDICAL WORLD:

I think the binders much improved by your slight departure in the matter of tying; they are simply perfect now. Respectfully, JA. MCKINSTRY.

Longmeadow, Mass.

Successful Prescriptions.

Editor MEDICAL WORLD:

While studying in Dublin, I made it a point always to note down what we called "the pet prescriptions" of the physicians and surgeons of the various hospitals. These being free to all students to come and go as they pleased, it was a matter of no small pleasure for us to circulate among them, and imbibe the varied teachings at the clinics, as they were usually delivered to us in a fashion not calculated to rust in the cerebrum. I wish to bring some of these treatments to your notice, and, in doing so, will endeavor to be as concise as possible. I shall commence with some of the prescriptions of my revered old preceptor, Arthur Wynne Foote, LL.D., M.D., Professor of Practice and Senior Physician to the Meath Hospital.

This was his usual treatment in
DIPHTHERIA:

B Tincturæ ferri chloridi,
Spiritus etheris sulphurici..
Potassii chloratis..
Syrupi limonis.
Aquæ..

M. f. mist.

Sig. f3 ss every third hour.

.ǎā .f3 iv
θίν
.fz iss

.q. s. ad...f viij

If dissolution is immi

nent give same dose every fifteen minutes. Gargle in same disease:

B Glycerini carbolici,

Liquoris soda chlor........āā....fz ss
Aquæ ros..
.q. s. ad... viij

M. f. garg.