The maximum efficient dose of salicylate of lithia is seventy-five grains daily, while sixty grains daily are generally sufficient. Its usual physiological effects are, more or less pronounced headache, vertigo, and considerable deafness, but the buzzing and whistling and other subjective disturbances of hearing, so common after the use of the salicylate of soda, are here comparatively rare.-L'Union Médicale, Dec. 10, 1885

THE INFLAMMATION-PROVOKING PROPERTIES OF JEQUIRITY.-MESSRS. BRUYLANTS and VENNEMANN, like MESSRS. WARDEN and WADDELL, claim to have demonstrated that the inflammation-provoking properties of jequir ity are not due to any microbe, and attribute them to a soluble immediate principle, isolated and called by them "jequiritin," which they believe to have been formed during the germination of the jequirity seed, like diastase in the malting of barley. MESSRS DECHAMP and DUJARDIN, who supposed this to be a mixture, have isolated a new substance from it to which they have given the name of jequiritzymase. As zymases are generally the products of microzymes, they were led to experiments by which they have ascertained that the microzymes isolated from the seeds possess the inflammation-exciting properties of jequiritzymase, and, like it, are capable of liquefying starch; also that they can pass into the bacterial form, the bacteria being still capable of producing the same symptoms, but that when the bacteria are allowed to develop in a filtrated solution of jequirity or a solution of jequiritzymase in contact with air, these preparations lose their activity.-Druggists Circular.

CORROSIVE SUBLIMATE IN CONJUNCTIVITIS. -BELOW has placed on record 65 cases of conjunctivitis (26 simple, 19 pustulous, 2 diphtheritic, 2 gonorrhoeal, and 16 granular), in which solutions of bichloride of mercury (1:200) were used. From the results of these observations, BELOW draws the following conclusions:

1. Under this treatment, the diminution of the secretion, both in chronic and acute conjunctivitis, and the decrease of the hyperæmia, are more rapid than in the similar use of nitrate of silver.

2. Simple phyletænula, thus treated, disappears as rapidly as under the use of calomel.

3. The use of a weak solution of bichloride of mercury in spray yields good results as a prophylactic of gonorrheal conjunctivitis in the newborn.

The sponging is practiced two to eight times daily, and the inner surface of each lid is separately subjected to the action of the solution. -L'Union Medicale, Dec. 12, 1885.

ANTIPYRINE IN EPISTAXIS.-We have before alluded to the hæmostatic properties of antipyrine. DR. LAVRAND, in the Jn'l de Medecin et de Chirurgie Pratiques, confirms other observers. It is certain and prompt in its effects, he says, and is much superior to perchloride of iron, as it is colorless and does not coagulate the tissues like the latter substance. It is used

in aqueous solution, of the strength of 1 to 30. applied on lint and inserted as far as possible into the nares. The nostril is then compressed with the fingers so that the tampon soaked in the hæmostatic is in contact with a large extent of the mucous surface. By means of several applications thus made, M. LAVRAND succeeded in arresting epistaxis which had persisted in spite of plugging of the anterior and posterior nares.

ALVELOZ AS A REMEDY FOR SPECIFIC ULCERS.-Nearly a year ago our Washington correspondent informed our readers of some interesting and promising trials that had been made by several of the medical officers of the Marine Hospital Service of the new Brazilian remedy for cancer, alveloz. A Brazilian physician, DR. CLEMENTS FERREIRA, now writes a letter to M. DUJARDIN BEAUMETZ (Bulletin général de thérapeutique, December 15, 1885), in which he gives brief notes of two cases of epitheliomatous ulceration that were promptly cured by the application of the milky juice of this euphorbiaceous plant, the "lait d'alveloz.`` -N. Y. Med. Jour.

COCAINE IN INFANTILE CORYZA.-As is well known, the coryza of nursing infants may, by preventing suckling, prove a very serious affection. It can be cured, however, according to SEMTCHENKO (Gaz. Med. De Paris, June 6,1885), by the introduction into the nasal cavity, six times daily, of two drops of a two-per-cent. solution of the hydrochlorate of cocaine. According to the author, children which previousty have obstinately refused to nurse will commence to suckle a few minutes after the first application of the cocaine, and the coryza is ordinarily cured after about four days of this treatment.

STILL ANOTHER CURE FOR CANCER.—In a case of alleged epithelioma involving the facial bones, with extensive infiltration of the tissues, where an operation was not deemed desirable, DR. ANTONI, of Mazzara del Vallo Maggio, applied an ointment consisting of 15 parts of resorcin to 20 parts of vaseline twice a day, with the result, it is said, of completely curing the disease; nothing remaining but a white scar a centimetre in diameter.-Brit. Med. Jour.

MORRHUOL, THE SUPPOSED ACTIVE PRINCIPLE OF COD-LIVER OIL.-By the evaporation of an alcoholic extract of cod-liver oil, CHAPOTEAUT has produced a substance for which are claimed all the active virtues of the original oil, the bulk of which is but_onetwenty-fifth that of the latter.-L'Union Medicale, Dec. 5, 1885.

ALKALOID OF POMEGRANATES.-A crystalline body has been obtained in minute quantities from the rind of pomegranates, which, when placed upon the tongue or other portions of the mucous membrane, appears to cause a paralysis of local sensation after the manner of cocaine.-American Druggist, Dec., 1885.

Vol. IV.

Original Articles.

CLINICAL LECTURE.

BY DR. THEOPHILUS PARVIN, OF PHILADEL

PHIA.

NYMPHOMANIA AND MASTURBATION.

I had intended, gentlemen, to bring before you a woman who is suffering from an unusual and exceedingly distressing complaint, and one that you will seldom hear discussed, while, at the same time, it is of the utmost importance that you should be enlightened on the subject for it is a matter upon which will frequently rest the happiness not only of the individual herself, but of her family, friends, and all who may be in any way connected with her. But the woman has disappointed us; yet, as the subject is so important and so rarely touched upon, I will devote a short time to the discussion of the subjects of nymphomania and masturbation.

The woman whom I had hoped to bring before you is a widow, forty-two years old, whose menstruation ceased three years ago. She was first married at seventeen, her husband subsequently died and she married a second time. After a while this second husband wearied of her, sexual intercourse ceased and they finally separated. For two years she has been practieally a widow,-borrowing a simile from the verdant maiden, she is a grass widow. She comes to us complaning of nymphomania. She has an excessive desire for sexual intercourse; she deviously seeks the company of men, who possess a well-nigh irresistible fascination for her; but she does not consent to intercourse on all occasions. As she expresses it, she is mad after men and when the act has been consummated she is equally mad at them; all sense of propriety is not yet submerged in this mad passion, and by the effort of principle she is frequently enabled to control her terrible and debasing proclivities. After sleepless nights of intense excitement caused by the non-gratification of her terrific passions, she rushes frenzied into the streets to seek relief in diversion, but this demon of lust haunts her footsteps, and finally, in despair, she seeks relief in masturbation. Here, then, in this poor woman we have the dual condition of nymphomania and masturbation, each terrible in itself, but. to

No. 3.

gether, forming a combination well calculated to wreck a woman's life.

The sexual sense, the centre for sexual excitement, lies somewhere in the spinal cord, for if a man fractures his cervical vertebræ, or sometimes, the dorsal or lumbar, he is apt to have erections and seminal emissions, and the same condition has been noted in men who have been hung; but in such cases there is no sensation of pleasure associated with the erection or emission, and no sexual desire, for I could not for one moment entertain the idea that a poor, wretched, condemned criminal, standing on the scaffold with a rope drawn tightly around his neck, on the verge of an awful fate that is about to launch him into an eternity unknown and uncertain, could have the most instantaneous flash of sexual desire.

So, therefore, we cannot consider the genital sense alone (which in the rabbit has been located about the fifth lumbar vertebra) as an explanation of the disease we are discussing. We must look elsewhere, and, I think, must consider the brain. This woman tells us that as a child she learned all about the sexual act, and in this fact we see the sowing of the seed that has produced such a black and dismal harvest. If there is any one thing more important than another in the care of boys and girls it is to keep their minds pure. In this case, as in many others, the sexual organs themselves are not to blame, but the terrible affliction is due to some impure thought in childhool, suggested, maybe, by some casual occurrence that has caused day-dreams and musings, continual or frequent reflection, until the mind in its relation to this sexual passion has become disordered. By the time this woman was married, at seventeen (which was too young), she had, so to speak, her sexual thoughts well developed, and she was in the habit of having sexual intercourse five or six times a week, supposing, as she says, that she was just like other women. But, gentlemen, she was not like other women; in the name of woman, I protest that she is unlike other women. From this case we learn another lesson. I have told you that her second husband wearied of her and left her, and for some time before the separation he ceased to have connection with her. Here is the result of a secret law, as a woman invites a man, so he wearies of her caresses; that which we obtain in this world only by persistent effort, we value more highly; that

which is easy of procurement, we soon tire of. This woman might be leading a happy married life to-day but for this inordinate passion, constantly clamoring for satisfaction, until the husband wearied of her importunities.

If you read women as I do, and as does MR. ACTON (whose great work on the "Reproductive Organs," I think, should be in the hands of every physician), you will agree with me that it is not natural for women to have a desire for sexual intercourse; it is submitted to as a duty. This exceedingly latent sense may be corrupted as I have said, by some occurrence in childhood, till the immoral thought grows by brooding and ultimately becomes so vast as to swallow up the whole being as it has done here, but of course it is rare for such to be the case. I would say to those who have charge of boys or girls, "don't unchain the tiger;" have a care, do not sow the fatal seed. It is unfortunate when a young boy or girl learns about the sexual act and doubly so if learned from some rude and rough companion. Just at the close of the menstrual period, the woman may have some slight desire, but, as a rule, the majority of virtuous women submit merely to gratify the husband's desire. You will have through life nobler, better and happier experiences, if you carry this idea with you: hence I wish to emphasize it. Unfortunately, the pretended sexual rhapsodies of the professional prostitute, of the woman who sells her body for gain, are taken as the type of a virtuous woman. In the male the gratification from the act is confined to one organ and most likely to but a small part of this organ, while in the woman the sense of satisfaction is extended to a much greater surface, not only the clitoris, but the whole vagina participating.

Let me here utter a word of caution: "let him that standeth, take heed lest he fall.' More than one promising young career has been wrecked by the claims of depraved women that they have had intercourse with them while under the influence of chloroform. Let me, therefore, impress upon you never to examine such a woman save in the presence of a third party. When I subjected this woman to an examination (in the presence of DR. MORRIS) I found some peculiar phenomena. When the finger was introduced into the vagina, as soon as the clitoris was barely touched, there were produced irregular movements of the hips and pelvis. As the finger was advanced the muscles about the vagina were thrown into a state of contraction, which closed it tight on the finger, and this caused a sense of gratification to the woman.

In nymphomaniacs, we generally find a coarse skin, large lips, black eyes, black hair, dark complexion and a more or less rigid, contracted and prominent condition of the muscles; there is usually less fat and connective tissue, so that

on the whole the body is more angular and less rounded than in the perfect woman. But there are no absolute physical signs of a nymphomaniac. The evil though, referred to, may grow in the blonde, and the passion become so imperious as to master the whole woman.

There are three stages of nymphomania: the first where the woman has complete control over her erratic desires, and retires to loneliness to dream over her passions; the second, where she seeks the men, and by lascivious looks and gestures, maybe by a partly uncovered person, give evidence of her terrible infirmity; in the third degree, the woman becomes truly a maniac and gratifies her desires, as some older writers tell us, by seeking connection with men and even with dogs. In some cases this condition is caused by local irritation, as by vaginitis, or some uterine or ovarian disease may be the exciting cause. But in very many cases there is no local trouble. Ungratified sexual desire, as you can readily understand, may cause it, as might have been the case here had this woman's desire to copulate several times a week not been satisfied. A case is related of a nymphomaniac under the care of a distinguished Parisian alienist, who was placed in an asylum. On one occasion, when the parents were visiting her, the doctor happened to say in their presence, that marriage would have a good influence on her condition. Shortly after she escaped from the asylum, and one evening the doctor met her on the streets of Paris, a common prostitute, when she told him, with pleasure, that she had cured herself. There are other cases where excessive indulgence or onanism has caused it, so that we cannot recommend the same treatment for all cases, as it would hardly do to advise a woman whose disease was due to excessive indulgence to try matrimony as a remedy; this would be homœopathic, but it would hardly be calculated to cure the disease. The question of removing the ovaries is to be considered, and we must ask the question whether we can thereby cure the disease. This operation is becoming so extremely fashionable that I imagine that after a time but a small proportion of our women will be child-bearing. I would say that in some cases this operation migh relieve the inordinate desire, but it is an operation of mutilation that must be well considered before it is undertaken; it is easy enough to remove the ovaries, but once gone they can never be restored. In this case the operation is not at all indicated, for the woman has passed the menopause; her ovaries are slumbering, in fact they are permanently asleep, in addition to which we have had no history of ovarian derangement, therefore I would not advise the operation. Remember also that I only say the operation might do good, for I consider it very doubtful. Clitoridectomy might do good in some cases; it

has relieved cases of confirmed masturbation, and I would say that when all other means have failed we would be justified in resorting to it. Alas! alas! the world grows old, but there is no novelty of iniquity in the sexual gratification; the same means that were in vogue in bygone centuries and now prevalent in China, are also to be observed among the children of civilization of to-day. Onanism is an ancient sin; to students of the Bible the "sin of Onan" is familiar. The practice of masturbation is not confined to mankind, it belongs to dogs, monkeys, stags, elephants and bears. When the stag is unable to gratify his passion in the natural way he rubs his belly against a tree and thus produces an emission. So that this debasing sin is not confined to this age nor to the human race. The practice is much more frequent among males, some writers going so far as to assert that the majority of boys masturbate once or oftener during boyhood; my own observation has satisfied me that it is very rare among females. Among women we may have lingual or sapphic onanism, the one where the tongue, the other where only the mouth is applied to the sexual parts to perform the act. It will sometimes happen that women procure young animals to satisfy their desire; a young puppy will be used to provoke an emission from the vulvovaginal glands. The finger, a candle or wax instrument is also used. There is such a thing as clitoridian onanism, where one woman with an exceedingly enlarged clitoris, will use this organ on a fellow-being. The great question arises, how are we to make men and women purer? It is sadly true that the study of the classics is calculated to breed and foster immortality. VIRGIL, in immortally beautiful language, really makes arguments in favor of onanism and pederasty. If for no other reason, for this alone, I would favor the banishment of the classics from college courses, for they have a tendency to sow that terrible seed about which I have spoken. Remember that one cannot touch pitch without being defiled. We must begin at the foundation and keep the minds of our boys and girls pure; no matter how they learn these "forbidden fruits," whether from classic poetry or from some rude companion, their immature minds conjure up wrong ideas, and a terrible harvest may be confidently looked for when the secrects of sexual life are made known at an early age.

This poor woman might have been happy if she had not prematurely learned these secrets. When a woman reaches the stage of mania she is a fit subject for an asylum; this case has not yet progressed that far, for, with her, principle is, as yet, the rock in the sea of life; the waves of her passionate desire dash with fury against this rock, but so far it has stood firm. We must endeavor to keep those who have not yet

reached this final stage, by appeals to and influence over their minds. There is a power within us that is not that of the arm or the heart, that is far greater than any other power, and which we call the mind. This we must strive to fill with noble thoughts. Novels, sensational theatrical exhibitions, and lascivious images should be avoided. As a rule, the society of men should be shunned; men, who are honest, are fairly decent creatures, but they are sources of evil to women thus affected. Such a woman should be sent to the country; she should work, plow the fields, if necessary, so as to have the mind so occupied by exercise in the open air as to leave no room for these morbid thoughts. If we can find any local disease, it should be treated. When, in this case, we noted the irritability on the introduction of the finger, already alluded to, we applied muriate of cocaine to the clitoris, and I can assure you the effect was wonderful, the vagina at once behaved as well as the most virtuous vagina in the United States. We also ordered suppositories of cocaine once or twice daily. From these remedies we can hope for some relief, but we can never expect to cure save by influencing the mind, as has been already indicated.

Physicians do not sufficiently realize how much power in this respect they have. Remember that Our Saviour was touched by the woman who was sick and the "virtue went out of him; " he knew that he was touched, so will you, too, feel that a virtue has gone out of you, when, by your ministrations, you have lifted a poor, fallen woman from the depths of despondency and restored her once more to that position she was originally destined to adorn in society. In this way can you do the most good; moral suasion will be far more efficacious than drugs. You may tie the arms of a nymphomaniac and she will masturbate by wriggling motions of her legs and thighs; you may tie her arins and legs and she will accomplish her purpose by rubbing her body against the bead or the bureau, or some other article of furniture; nothing less than death will control this all-devouring passion unless you can impress the mind. Talk about removing the ovaries and clitoris! why, it reminds me of the story of the man who was going to cut off the dog's tail to prevent him from going mad, when some one said that it would be necessary to cut it off close behind his ears.

If you cannot rouse the slumbering reason, if you cannot awaken the deadened conscience, all your efforts will be futile, as there are but few cases that will be benefitted by operative procedures.

Boston paper: MRS. A.: "I hear that the MONTMACKINGTONS are going to spend the winter in Paris." MRS. B.: "Indeed? You surprise me! When were they bitten?"

EPILEPSY A REFLEX SYMPTOM.

BY G. A. HARMAN, M. D., LANCASTER, OHIO. I wish to call attention to some points in epilepsy which have been hinted at now and then, but have not received the attention they deserve. I refer more particularly to its reflex character.

That the affection is usually incurable is too well known by the profession and public. But why? Probably because we do not know its cause its pathology. The brain has been examined time and again, slice by slice, under the microscope in vain. This brings us to the question: Does its cause, or lesion, necessarily lie in the brain? I do not believe that it does, but rather that the paroxysm is reflex, even when there is a depression of the skull to account for it. The part depressed is always over the cerebrum, the irritation of which is communicated to the cerebellum, and we have epilepsy as a reflex.

That intestinal worms do sometimes produce epilepsy in children, is an admitted fact. I had a case of a young lady, æt. 15 years, who had several paroxysms. Inquiry showed that her menses were irregular as to time and quantity. The normal condition being established by appropriate treatment, the epilepsy ceased. young lady in this neighborhood, who had been an epileptic for years, while burning brush fell in a fit with one hand in the fire; it was burned badly. She never had another paroxysin.

A

Somewhere in the past I learned of a man, a confirmed epileptic, who accidentally cut off one of his toes, and never had an attack afterwards.

Do not these cases prove that epilepsy may have its point of origin in any part of the body? Evidently, in one case it resided in the intestines; in the hand in another; and in the last in a toe. In the former two the causes were removed by remedies; in the latter two destroyed by accidents.

We know that tetanus is a reflex disease, or at least the point of origin may be in a distant, and unimportant part. It seems to me that tetanus and epilepsy are closely allied, but differ widely, as we know, in gravity. If the greater disease can be produced by a distant cause, why not the less? I believe it is. The point of origin may be a cicatrix, a contraction, an adhesion, or a foreign body in any part; lumbricoides, ascarides, a deranged uterus, a depressed skull, or what not, the irritation from which is conveyed to the cerebellum, and from thence reflected to all parts of the body in the form of an epileptic paroxysm. When the profession ceases to look to the brain for the sole cause of epilepsy, and appreciates what I believe to be a fact-that any portion of the body may be the point of irritation from which the

epilepsy proceeds-they will have arrived at a truer pathology, and will treat this dreadfu disease more successfully.

RHUS AROMATICA AS A HÆMOSTATIC. WM. B. HARRISON, M.D., COLUMBIA, TENN. Mrs. A. R., bricklayer's wife, aged 47, ap proaching the change of life, applied for treatment. There was severe hemorrhage. I treated the case for some time, using all the ordinary means, local, such as the tampon, sugar of lead, etc., and also internal, having given amongst other remedies large doses of ergot of different reliable brands. The treatment had little or no effect, the case only getting better as the menses naturally disappeared for the time being, and in the course of one or two months the same thing would be gone through with again. In the meantime a bottle of fl ext. rhus aromatica (P., D. & Co.) was left as a sample and I determined to give it a trial. I gave it in about 10-drop doses repeated about every three or four hours, and before the patient had taken four doses she was much better and very shortly the hemorrhage stopped entirely This happened over a year ago, and the lady is now alive and well. She was troubled subsequently to some extent each month for several times, but not so severe as before, and the same remedy helped the case after taking two or three doses each time. She now keeps a bottle of it in the house and would not be without it on any account.

Mrs. B. M., carpenter's wife, delicate, approaching the change of life. Sent for me, complaining the same as the above case. I went through the same plan of treatment, such as giving ergot, etc., with better result than in the previous case, but still the hemorrhage was such every month as to badly exhaust the patient. I then resorted to rhus aromatica in the same doses as in the previous case and with the most happy results. The hemorrhage came under control much more readily and effectually than it had done under the usual line of treatment.

I have reported my experience to other medical men in the neighborhood and the result of their experiments have resulted very similar to mine. I also know of cases in which other physicians have used the drug in from five to ten-drop doses in cases of hemorrhage from the kidneys and with very good results.

RECENT ADVANCES IN SURGERY.

BY C. E. NELSON, NEW YORK.

In the New York journals of Jan. 23, are accounts of two remarkable classes of operations, the first embracing laparotomy, for removal of stones in different organs. The